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, March 23, 2005, at 1:00 P.M.



MEMBERS PRESENT:

Isaiah Hugley, City Manager

Mayor Bob Poydasheff

Marquette McKnight

Howard Willis, M.D.

H. Banks Carroll, M.D.





MEMBERS ABSENT:

James H. Sullivan, M.D.

James A. Lawrence, D.D.S.



OTHER PRESENT:

Bill Rumer, Attorney

Ed Saidla

Margaret Gosden

Pam Middleton

Eileen Albritton

LaQuita Rogers

Cheryl Johnson

Hank Wilson

Joe Vitale



Dr. Carroll, Vice Chairman called the meeting to order and asked for a motion

to approve the minutes of the last meeting. A motion was made by Mayor

Poydasheff, seconded by Dr. Willis and approved by those members present.



Dr. Carroll informed the Board of two Excused Absences for today?s meeting. Dr.

Lawrence is out of town and Dr. Sullivan is ill. Dr. Carroll asked for a motion

to accept these Excused Absences. A motion was made by Dr. Willis, seconded by

Mr. Hugley and approved by those members present.



Dr. Carroll called on Ms. Middleton to invite the service award recipients to

step into the Board Room to receive their awards: Fran Hall for 25 years of

service, Milton Watkins 25 years and Cheryl Gray for 30 years of service.



Dr. Willis stated to Dr. Carroll that he wishes to be placed on the agenda at

some point during this meeting. Dr. Carroll asked Dr. Willis what subject would

be discussed. Dr. Willis said that it was regarding HIV Infection and follow-up

on the Medicaid HMO.





Dr. Carroll asked if there was any Old Business and referred to the Action

List. Dr. Carroll asked Mr. Saidla if there was anything on the Action List

that he needed to address. Mr. Saidla stated there were some issues. He stated

that he wanted to make the Board aware, in Dr. Koppanyi?s absence, a lot of

work has been done responding to the companies bidding as Managed Care

providers under the Medicaid RFP. Companies should have their bids in by April

4th to the Department of Community Health. At this time, we are in the process

of responding to six (6) companies concerning our interest in participating as

a provider rendering our usual department services. Dr. Willis stated that it

appears to be a move at the state level to negotiate services for the network

and we need to make sure that we are part of that. Mr. Saidla stated there has

been a consultation with Dr. Brown this morning on a conference call about some

other issues and the State Public Health Division is looking at trying to do

that, but they have also directed the local boards of health as the legal

entity in each of the counties, to proceed with signing the Memorandums of

Agreements/Letter of Intents with Managed Care companies. Ms. Gosden stated

there are four major players we have been in contact with and at least two of

them have expressed very openly their desire and need for us to be in their

network. We already see so many Medicaid covered lives (24,000) within our 16

counties. Ms. Gosden stated that these companies realize that in some of the

other counties, for which this Board is the lead county, we are the only

services available. She said that they are very solicitous to our returning The

Letters of Intent. We are returning the letters but including a listing of

services we provide so that they know what services we can provide. She states

that the health departments cannot be the medical home for patients. Most of

the companies are proposing a hybrid system including both a rate for Primary

Care Providers and a fee for service capitates for specialty services. They

have indicated that Health Departments would fall into the fee for service

category. Mayor Poydasheff asked if public health has an organization similar

to what the city has in regards to the Georgia Municipal Association? Ms.

Gosden stated that we have the Georgia Public Health Association. Mayor

Poydasheff stated that he did not know what GPHA does, but when they (as the

City of Columbus) goes into contracts, for example, Medicare or whatever the

situation is, franchises, it is always checked with their people because they

may have a better overview. Ms. Gosden stated that public health does not have

that structure.



Dr. Carroll asked Dr. Willis to present his concerns to the Board. He stated to

the Board that he had drafted a preliminary letter which he gave copies to

Board Members. He stated that he would like to submit it today as the first

draft. He wants all of the Board Members to review and offer any input in order

to get a final draft. (See Attached Copy of Draft Letter) He stated that any

reference to HIV testing/mandatory is going to create problems. He feels that

the document needs to be looked at and then presented to our delegation and see

if they will submit it for us.



Dr. Carroll called on Mayor Poydasheff who had the following comments: 1) Mayor

Poydasheff stated that in going back to the days before a person could get a

marriage license, you had to be tested for STD?s, primarily syphilis. He feels

that it is important for the welfare of the community at large with people

getting marriage licenses, that they be tested. In the event they have it, they

can unknowingly pass it on to their children. Ms. McKnight had one

question?..who gets license to be a food service provider? Dr. Willis stated

that you must get permission to start a food service restaurant. He was talking

about the license holder of the restaurant?.who then would hold their employees

accountable or require their employees to do this testing. Ms. Gosden stated

that a long time ago, when she first came to work for the Department of Public

Health, there were food handler permits, where the people had to come on a

yearly basis. Those were done and they included a variety of things within the

permit. At that time, the permit was a City Ordinance. Mr. Saidla commented

that at one time it was a State Law and the State dropped it, in similar

fashion to the dropping of the premarital testing two years ago. Ms. McKnight

stated that realizing that this is a resolution and not obviously drawn up like

a legislative piece, it could not be included in a legislative enactment

because there is no part that would say that person may not be handling the

food. Mr. Rumer stated this is a more of a visionary statement to say that this

is a Public Health issue that we see and we have this vision now. Ms. McKnight

said that if hair care and hair care products were going to be discussed, then

that would also include nail salons. Mr. Rumer was not sure what was meant by

?hair care?. Ms. Gosden explained it was the sterilization of the hair clippers

and scissors. Ms. Albritton stated that may effect support of such legislation

would be studies to one issued, which document cases spread among hair care

workers. Dr. Willis stated that he really did not want to get into that; 1)

because that would be difficult to prove and 2) we are still learning about HIV

disease and transmission. Years ago when it was first being looked at, people

swore up and down that it could not be transmitted through salvia. We know that

is not true anymore, it can be. So we are not sure about the transmission of

HIV disease and we can?t understand why the transmission is so endemic and

epidemic in certain countries of Africa where sexual transmission is not a

major means of spread. There is an unknown transmission factor that we are

concerned about. The thrust of the document is to follow-up on the CDC article

which can be located on the Georgia Health Department website. Dr. Carroll

asked if anyone else had any questions on this issue. Mr. Hugley stated that he

had several questions; 1) is there similar legislation? Dr. Willis stated that

he had not looked that far; 2) at the last meeting the discussion was about

another piece of potential legislation and how that political machine works.

You need to get others in other regions or a state association to endorse it.

When it is given to our local delegation for example, they do not know that a

statewide association/organization is driving this. You are asking them to take

a piece of legislation and drop a bill for something for this local board not

knowing if the other health department boards across the state have endorsed

it. This issue, if done locally, other health departments need to endorse it.

What does the Georgia Public Health Association think about this? Do they

support this? If the Board says yes and they say that they do not want to be

involved with this issue, it is not going anywhere. Dr. Willis stated that when

he was drafted to do this project, he thought that he would try to get a

document from this group and then present it to the local medical society to

see is we could get them to endorse it, then ask the state medical societies,

and finally our chain of command including some of consumer groups. He said

that once the final document is obtained from this group, he wants to notify

the people at CDC, because they had an article about two weeks ago that

detailed the failures of protection and the lack of effective screening. They

are recommending some new screening policies and procedures and I would like to

get their input too. Dr. Willis stated that he is going to ask David Satcher

to help him push this, as head of the Primary Care Center at Morehouse College.

Dr. Willis asked that everyone look at the document, review it and help him

with it. Healthcare workers and especially the attorney need to look at the

document to make sure that the appropriate language is used. After that is

done, the document will be brought back for the final approval and then

processed with the chain of command.



Dr. Willis said that the Clean Air issue needs to be dropped from the Action

List. Mayor Poydasheff stated that the Clean Air Issue is in the Georgia

Legislature. He said that he feels that if the Georgia Legislature fails to

act, he feels the City will act. The Mayor said that he was going to support an

ordinance that would prevent smoking in public places except American Legion,

VFW, some types of bars and pool halls. Ms. McKnight stated that she had spoken

with Pete Robinson and he said there was a point of contingency between the

House and Senate Version. The House Version had an exception for bars and

restaurants where patrons were not eighteen years of age and older. There is a

feeling that the House will meet more of the Senate Version provisions, which

means all public places. Mr. Saidla stated there was also exclusion for

facilities that had less than five employees. Dr. Willis made a motion for the

Clean Indoor Air Ordinance be dropped from the Action List, Mayor Poydasheff

seconded the motion and it was approved by those members present.



Dr. Willis mentioned the food service issue on the Action List. He stated there

may be a way to get this back in front of the State Legislatures. Mr. Saidla

stated that food service is regulated. He said that the food service

regulations are not only a State Regulation but also adopted in total by the

City Council providing for enforcement. Dr. Willis is actually speaking about

the issue of convenient stores serving meals such as hotdogs, fried chicken,

etc. Those facilities are regulated by the State Department of Agriculture not

by Public Health. The Mayor suggested that a letter be composed and sent to his

office so that he can send the letter to the appropriate person. Mr. Saidla

stated that contact could be made if the Board wants to pursue it.



Dr. Carroll asked for any New Business. There was none.



Dr. Carroll mentioned that Dr. Koppanyi is recovering from surgery and is doing

well.



Dr. Carroll called on Pam Middleton for the February 2005 financial report.

Mr. Hugley stated that public health had submitted their request to the City.

There will be a 10% cut across the Board and this will possibly apply to other

agencies that the City funds. He states that the Board needs to be aware of

this if indeed the 10% cut applies to the health department. This will not

impact anything that is required by the State.



Dr. Carroll called on Hank Wilson, SNS Plan and Joe Vitale, Emergency

Coordinator, to present the presentation to the Board.



Dr. Carroll asked if there was any other business to bring before the Board.

There being no further business, the Board was adjourned.



Respectfully submitted:







_____________________________

Pam Middleton, Secretary