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 25, 2008, at 1:00 P.M.
MEMBERS PRESENT:
H. Banks Carroll, M. D.
Todd Jarrell, M. D.
Howard Willis, M. D.
Jim Wetherington, Mayor
MEMBERS ABSENT:
Isaiah Hugley, City Manager
Mrs. Brenda Dozier
James A. Lawrence, D. D. S.
OTHER PRESENT:
Dr. Zsolt Koppanyi
Ed Saidla
Pam Middleton
Karon Bush
Sheila Mayfield
Vanessa Downer, D. D. S.
Charlene Ellis
Dr. Carroll called the meeting to order and asked if there were any questions
or comments on the previous minutes. Dr. Carroll asked for a motion to approve
the minutes. A motion was made by Dr. Jarrell, seconded by Mayor Wetherington
and approved by those members present.
Dr. Carroll announced there will be no Columbus Board Meeting in July.
The next Board Meeting will be August 27, 2008.
Dr. Carroll asked for any Excused Absences for today. Ms. Dozier and Dr.
Lawrence are both out of town and not in attendance. A motion was made by Dr.
Jarrell to approve the absences, seconded by Mayor Wetherington and approved by
those members present.
Dr. Carroll stated there was no Old Business on the Action List for today.
There is some New Business that needs to be discussed. There is an equipment
request that has been submitted to the Board by Dr. Downer for a
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dental equipment purchase. Dr. Carroll asked if the Board Members had received
the faxed information regarding the details of the equipment.
Dr. Carroll asked Dr. Downer to discuss with the Board Members details
regarding this proposed purchase. Mr. Saidla stated that he would discuss the
financial information after Dr. Downer completes her discussion.
Dr. Downer states that she is trying to update the x-ray imaging equipment for
the dental clinic. The need is there for the use of electronic equipment when
Medicaid and other entities need prior approvals for services. At the present
time we are using the traditional system of developing a film x-ray through a
processor, using chemicals, etc. what we want to do is digital x-rays where you
see the image in a few seconds on a computer monitor. It?s going from a small
old fashion x-ray picture to an image that can be enlarged or enhanced on the
computer. The old equipment is approximately thirteen years old and was
purchased along with the dental chairs when we moved into this building. Dr.
Carroll asked Mr. Saidla for the financial figures regarding this equipment
purchase. Mr. Saidla stated that to replace the current processor the cost is
approximately $5,000 to $6,000. The cost of x-ray film and developing chemicals
are approximately $3,500 per year and the sink components in the dental clinic
must be replaced at least once a year because of the chemical damage. With all
of the associated cost, Dr. Downer would like to move toward the digital
processing unit. The total cost of it is approximately $20,000. If this Board
approves of this purchase, it will be necessary to receive sealed bids from
three different vendors according to policy. Dr. Downer indicated that $10,000
is from special funds that another district did not use that was returned back
to the State Office that has been offered to us to be spent by June 30th. The
other $10,000 would come from fees that Dr. Downer has generated this pass year
from doing dental services here at the Health Department. Dr. Wills asked what
is the Medicaid reimbursement for x-rays? Dr. Downer stated that the panorex is
$56.00 and bitewing (2) is $28.00. Mayor Wetherington made a motion to approve
this purchase. Dr. Willis seconded the motion and it was approved by those
members present. Dr. Willis asked about the software cost for the program. Mr.
Saidla stated that with this particular program, it is a one time fee.
Dr.Willis asked if it would be forever and Mr. Saidla stated that yes, when you
buy the equipment, you buy the software. There is no ongoing cost. Dr. Willis
asked if there was a maintenance contract with the program?
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Mr. Saidla stated there is a two year warranty on the system and a five person
user license along with technical support. Dr. Carroll asked if there was any
other discussion regarding the equipment. Dr. Carroll stated there was a motion
on the floor for the equipment purchase. He again asked for a second, and all
in favor with an ?I? vote. There being none opposed, the equipment purchase was
approved.
Dr. Carroll asked Ms. Middleton and Mr. Saidla to discuss the FY09 Grant-in-Aid
Budget. Ms. Middleton stated that this budget was presented in February, 2008.
(Ms. Middleton referred to the hand out copies of the report)
This information was presented to the City and it has been approved for the
same amount presented last year. There was an adjustment from what was asked
for verses what was received from the City. Everything else has remained the
same. There were no changes. Dr. Carroll asked for any comments regarding the
budget report. Ms. Middleton stated that as Dr. Koppanyi had mentioned, the
Grant-in-Aid Master Agreements have not arrived yet. Dr. Carroll asked how the
FY2009 budget compared to the FY 2008 budget as far as the amounts. Ms.
Middleton stated that the PH Budget now is $6,665,726 which also includes
vacant positions (approximately 10) (nurses/nutritionists) which have not been
filled. Dr. Carroll asked if there has been any success in procuring nurses
recently? Ms. Mayfield stated
there were several nursing positions filled taking nurses from other health
departments and also a management position open with no prospects. Mr.
Saidla stated that even with the States effort last year to bring nursing
salaries up to 75% of market value, there is still a lot of difference between
75 and 100% of market and so the hospitals are getting the nurses. Ms.
Middleton stated that the adjustment in the current budget did not happen until
January and the FY09 Budget reflects the full year. Dr. Koppanyi stated that
notification was received from the State Emergency Preparedness section that
the State money from CDC and HRSA will also be reduced. Dr. Carroll asked for a
motion to approve the budget. A motion was made by Dr. Jarrell, seconded by
Mayor Wetherington and approved by those members present.
Dr. Carroll asked Dr. Koppanyi for the Director?s Comments. Dr. Koppanyi stated
at this moment, we are waiting for the outcome of the reorganization
of DHR and the future of public health. There has been no official
announcement. Dr. Koppanyi stated that the counties received information,
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bypassing the District, from the Department of Community Health asking if each
of the local boards would like to participate in establishing primary care
clinics in the health departments. Dr. Carroll asked who contacted the
counties. Dr. Koppanyi stated it was Community Health/Medicaid. This
information was sent to the 159 counties and not to the district health
directors. As everyone is aware, we had two of the last two community health
clinics; one in Webster County and the other in Talbot County. Both clinics
were forced to close on June 30, 2005. Both clinics were heavily used by these
underserved communities seeing approximately 2100 clients in each clinic.
Former President Carter even contacted the Governor in an effort to keep the
Webster County Clinic open. However, the State eliminated the funding forcing
both clinics to close. Dr. Willis stated that it was a good initiative to look
at the needs of primary care in all 159 counties, but using Talbot County as an
example, his primary care clinic has been there 15 years. Care was provided on
a sliding scale because that is how the agreement with Medicaid and Medicare
read. The federal program moved in and another physician came in and now the
clinic has been squeezed out. When this sort of thing is done, you must look at
the resources that they have and one of the things that Dr. Willis purposed up
to Dr. Toomey (former State Health Director) is that instead of bringing the
federal programs in, why not subsidize the people who are already there;
community based, from the area, etc. Dr. Koppanyi stated that several proposals
have been made to DCH since many health departments are already doing some
primary care functions which include STD follow-ups, chasing down infectious
diseases, providing some pregnancy related services, etc. that some of the
private providers do not do and we are also able to do the community outreach
and contact tracing that t private practice cannot afford to do. What is
proposed is that public health services and we should be reimbursed like the
federally qualified health centers which have a more favorable rate. Dr. Willis
suggested that a partnership with existing service providers and public health
to include additional funding support for providing these existing services is
what is needed in the counties. Dr. Koppanyi stated that we have five counties
with no physicians and six or seven counties with no local hospitals leaving a
single public health nurse as a primary provider of services in the county.
Dr. Carroll stated that certainly in today?s environment providing primary care
in those arenas is going to be very difficult and tricky in how you are going
to do it financially.
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Dr. Carroll asked for any other comments. Dr. Willis referenced his
conversation after the last board meeting with Mr. Saidla concerning the
Amateur Radio Club and use of the MMRS trailer. Mr. Saidla stated that on the
suggestion from Dr.Willis, the process had been changed and we would be
entering with the Amateur Radio Club to provide the services to operate it.
The Radio Club will have possession of the trailer but it will still belong to
the Columbus Health Department and they will provide the services to operate
it. Mr. Saidla stated that he also has a packet of information about the
Columbus MMRS for each board member.
Dr. Carroll asked Ms. Middleton to present the financial report to the Board.
Ms. Middleton stated beginning in August, when the program presentations are
made to the Board, she wants to include financial information and show which
grants deal with the presenting program. We will base the presentations on the
Grant Report going directly down the list and inviting those persons in to
present a program overview and this will allow you to see the money amount that
applies to that particular program. Dr. Willis said that would be good and
would make him feel better about his seat on the Board. Ms. Middleton stated
there are programs like District Women?s Health, District Child Health that are
not listed on this budget but fall under the lead county. Ms. Middleton stated
that a budget meeting could be set up as a training session and this was done
several years ago. Dr. Carroll stated that certainly as times change, we need
to adapt to a changing financial arena, we need to be more knowledgeable.
Dr. Carroll asked if there was any other business to discuss. There being none,
the meeting was adjourned.
Respectfully submitted:
___________________________________
Charlene Ellis, Secretary
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