Columbus, Georgia

The regular meeting of the Columbus Board of Health was held in the

Administration Conference Room of the Health and Human Services Center on

Wednesday, June 23, 2004, at 1:00 P.M.



MEMBERS PRESENT:

James H. Sullivan, M.D.

Howard Willis, M.D.

James A. Lawrence, D.D.S.



MEMBERS ABSENT :

Mayor Bob Poydasheff

Carmen Cavezza, City Manager

Marquette McKnight

H. Banks Carroll, M.D.





OTHERS PRESENT:

Bill Rumer, Attorney Nannette Turner

Zsolt Koppanyi, M.D. LaQuita Rogers

Dee Cantrell Cheryl Johnson

Margaret Gosden Ed Saidla

Eileen Albritton Laney Clark

Pam Middleton





Dr. Sullivan called the meeting to order and asked for a motion to approve the

minutes of the last meeting. A motion was made by Dr. Willis, seconded by Dr.

Lawrence and passed by those members present. Dr. Carroll and Mrs. McKnight

were contacted after the Board meeting and they voted yes to accept the minutes

of the last meeting.



Dr. Sullivan asked if there were any Excused Absences. He stated that he was

not sure at this time. Several other Board Members were expected.



Dr. Sullivan asked if there were any Old Business that needed to be discussed.

Dr. Lawrence stated that he had given Pam a list of nine dentists that could

see patients. Pam stated that a copy of this information would be placed in all

of the Board Member?s Book.



Dr. Sullivan asked for the New Business. He asked Mr. Rumer if he would comment

on the Master Public Health Agreement. Mr. Rumer stated that the Master

Agreement for FY 2005 is like all of the previous years. There are a few

changes such as in Paragraph 101, stating that the State of Georgia encourages

all minority business enterprises to compete for contracts for good, services,

and construction. Also, the State encourages all companies to sub-contract

portions of any State contract to minority business enterprises. Contractors

who utilize qualified minority subcontractors may qualify for a Georgia state

income tax deduction for qualified payments made to minority subcontractors;

Paragraph 103, states that the DEPARTMENT agrees to disburse 100 percent of the

Medicaid reimbursement funds to the Board and upon review of the cost

allocation plan, it will notify the BOARD if administrative cost may be

expended as outlined or if the plan is not approved and must be resubmitted for

further consideration. Provide technical assistance with program development,

implementation, operation, evaluation and fiscal administration. Paragraph 126,

amended to include criminal records investigations which would not apply to

persons employed in day-care centers, group day-care homes, family day-care

homes, child-caring institutions or child care learning centers which are

required to be licensed, registered, or commissioned by the Department or by

the Georgia Department of Early Care and Learning or to personal care homes

required to be licensed, permitted, or registered by the Department. Paragraph

#134 involves compliance with executive orders concerning ethics and was added

for FY2005. Mr. Rumer stated that everything else was about the same as in

previous years. Dr. Sullivan asked if there were any other questions. There

being none, Dr. Sullivan asked for a motion to accept the Master Agreement. A

motion was made by Dr. Lawrence, seconded by Dr. Willis and passed by those

members present. After the Board meeting, Dr. Carroll and Mrs. McKnight were

contacted and voted yes to accept the Master Agreement.



Dr. Sullivan asked if there was any more New Business. Ms. Gosden stated that

Public Health has been working on the acquisition of a badge system for the

Metropolitan Medical Response System Budget that would allow us to load the

credentials of the physicians and health care providers across hospitals. In

case of an emergency, you would know what credentials all professionals would

have and what they could offer. There has been a follow-up on a $12,000 -

$14,000 commitment for this project of which is only one component that

requires the approval of the Board. The one component is a printer. You can

understand why the printer would be the most expensive item, because it must

take the photograph, laminate it and apply the magnetic strip to the back of

the badge. We would be able to put in 200,000 names in the system. The cost of

the printer is $4,175.00. The software will be purchased in the next fiscal

year to make the system operational. We will need to schedule with the

hospitals an opportunity to take the pictures of the medical staff who work

with the credentialing department of each hospital to put their credentials on

the badge. This is one of the projects at the heart of the MMRS plan not yet

completed projects. Dr. Sullivan asked if this would include St. Francis

Hospital, and Ms. Gosden stated that everyone would be included. Mr. Saidla

said that this would include volunteers, health department staff, other staff

nurses, etc. and all the other persons that we might need to identify certain

people in a disaster situation. This would include all of the MMRS area, which

is five counties and will include two counties in Alabama. Ms. Albritton stated

that it might be necessary to take pictures of the volunteers throughout the

District that might volunteer for S & S. The volunteer, in order to be covered

under the State Volunteer Program, would have to be prescreened and

credentialed. Mr. Saidla stated that the advantage over this system is that

each hospital will maintain their part of the database. The main system will be

here, where each of the hospitals, through secure connections, get the info

they need, but each hospital will be responsible for keeping their staff and

their physician information up to date so that our staff does not have to do

that. This is another advantage to this particular system. Dr. Sullivan asked

for a motion to approve this purchase. A motion was made by Dr. Willis,

seconded by Dr. Lawrence and approved by those members present. After the Board

meeting, Dr. Carroll and Mrs. McKnight were contacted and voted yes for the

purchase.



Dr. Sullivan called on Dr. Koppanyi for the Director?s Comments. Dr. Koppanyi

stated that the Adolescent Program had been eliminated. As you know the

Columbus clinic, the Teen Center, has been continued under our own interest and

not the State?s. Dr. Koppanyi stated that work has begun on the campaign for

the mosquito season starting. There has been an intern in the other counties

from the State who has set up mosquito traps to evaluate the effect of

mosquitoes. So far, there has been no report of any infected ones, but it is

still early in the season.



Dr. Sullivan called on Pam Middleton for the financial report for May 2004.



Ms. Gosden presented information and a report back to the Board regarding Dr.

Crenshaw and Primary Care figures. An analysis was done of Dr. Crenshaw?s

practice. It was noted that percentage wise, in terms of money, the largest

care is Medicaid followed by self-pay then Medicare and insurance. The persons

who are self-pay have no other reimbursement means. These persons are put on a

sliding scale. Collections through May 30th are showing $97,194.00. Ms. Gosden

noted the second page of the report showing the type of patient: 25% Medicaid,

52% self-pay and 77% of her patient base is what is considered an indigent pay

source. An answer to the question; is she seeing who we have hired her to see?

The answer to the question is absolutely yes. We also realize that we need to

up the insurance participation to help us balance off. The large number from

indigent pay sources. She is getting more new patients. She asked if anyone had

seen the bus shelters around town, with her picture on the sides. The last page

of the report is the write-offs. It states that the self-pay write offs are

approximately 25% of the total self-pay charges for the same time frame. Dr.

Willis asked where the difference of Dr. Crenshaw?s salary is going to come

from. Ms. Gosden stated that we propose that it be taken out of the Fund

Balance (Restricted). We would ask the Board to allow us, as we balance out, to

restrict that amount out of Fund Balance to cover Dr. Crenshaw?s salary. Dr.

Willis referred to the copy of the information in hand that referred to

actually what was collected. Ms. Gosden explained that the first sheet is what

has been collected, actually payments that have been received. The second sheet

is just by patient mix and the third shows you what has been written off. As of

June 10th the amount of $7,034.00 in Medicaid, $14,908.00 in Medicare,

$4,962.00 in insurance and $12,247.00 in self pay for a total of $39,153.00.

These are the full charges not what we will get reimbursed. This was a good

beginning for Dr. Crenshaw. Dr. Crenshaw started with almost a zero patient

base. She had charts in the room, but she had to build her reputation, and it

is felt that she is doing that. Dr. Lawrence stated that he was surprised that

more than 25% was written off. Ms. Gosden stated that she felt that the people

that were coming to see Dr. Crenshaw were trying to pay. Dr. Sullivan asked if

the staff here was utilizing primary care services and Ms. Gosden referred to

the Employee Express. Dr. Sullivan asked for a motion to approve the amount for

Dr. Crenshaw?s salary. ($60,000 - $65,000) Dr. Lawrence made a motion to

approve the amount; Dr. Willis seconded and passed by those members present.

After the Board meeting, Dr. Carroll and Mrs. McKnight were contacted and voted

yes.



Dr. Sullivan asked Nannette Turner, with the West Central Georgia Cancer

Coalition to present the program to the Board.



Dr. Sullivan asked if there were any other business to bring before the Board.

There being no further business, the Board was adjourned.



Respectfully submitted:





_______________________

Pam Middleton, Secretary