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, February 28, 2007, at 1:00 P.M.
MEMBERS PRESENT:
James H. Sullivan, M.D.
Isaiah Hugley, City Manager
Mrs. Brenda Dozier
James A. Lawrence, D.D.S.
Howard Willis, M.D.
OTHERS PRESENT:
Zsolt Koppanyi, M.D.
Bill Rumer, Attorney
Dr. Janice Carson, PH Director
Judy Thomas, Assistant to Mayor
Candice Nowicki-CDC Mgt. Assistant
Ed Saidla
Margaret Gosden
Eileen Albritton
Pam Middleton
Cheryl Johnson
Karon Bush
Sonya Tate
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 Mr. Hugley, seconded by Dr.
Lawrence and approved by those members present.
Dr. Sullivan asked for approval of only one Excused Absence for Dr. Carroll who
had a previous commitment. A motion was made by Dr. Lawrence, seconded by Mr.
Hugley and approved by those members present to accept this Excused Absence.
Dr. Sullivan stated there is nothing on the Action List at the present time.
Dr. Sullivan stated that under Old Business only one item remains from the last
meeting regarding the five year audit contract bids. Dr. Sullivan called on Ms.
Gosden to give a report. Ms. Gosden stated that after the board meeting on
January 24, 2007, letters were hand delivered on the 6th of February requesting
bids with a deadline response date of February 23rd. Bids were requested from
Albright & Fortenberry & Ninas, Fountain-Arrington and Bass; and Robinson,
Grimes and Company. The letters were hand delivered and signed for by each
company. On February 15th, a call was received from Jina Stone of Robinson,
Grimes requesting additional information. She requested a copy of last years
audit report and asked if we were unhappy with our current auditors. Ms. Stone
also wanted a copy of the journal entries for FY06 and requested what we paid
our current auditor per year. Ms. Gosden stated she left a voice mail offering
to answer her questions inviting Ms. Stone to come by and review the audit
report. We would be happy to share the journal entries but would not be able to
give her information regarding the cost of the audit. Ms. Gosden stated that
she had not heard back from Ms. Stone by the 23rd of March and when no
response was received other than the proposed from Albright & Fortenberry, it
was assumed there was no interest in bidding. The bid amount was the same
previously submitted from our current auditor. Dr. Sullivan asked for comments
from the board members. Dr. Willis asked that a letter of documentation be
received from those who did not respond and this would be proof that bids were
asked for but not responded too.
Ms. Gosden suggested that a letter be sent from the health department asking
for a denial response from the companies in question. Mr. Hugley stated that
the City does not take that approach. A bid response is sent out, it is
documented who the bid goes to, if there is no return mail, it is assumed that
it was received and if we don?t hear back from you, and there is a sole bidder,
we then proceed with that sole bidder. Dr. Sullivan asked for a motion to
approve the five (5) year audit contract. A motion was made by Mr. Hugley,
seconded by Dr. Willis and approved by those members present.
Dr. Sullivan called on Ms. Gosden to report the FY08 City Budget information.
Ms. Gosden referred to the reports that Board Members received and she stated
that an increase is requested for FY 2008. She stated it has been several years
since an increase had been received. Ms. Gosden asked if there were any
questions regarding the budget report. Dr. Lawrence stated there appeared to be
a large number of vacant positions and his concern was with the filling of
these positions. Dr. Sullivan asked for a motion to approve the FY08 City
Budget. A motion was made by Dr. Willis, seconded by Dr. Lawrence and approved
by those members present.
Dr. Sullivan asked the board members to refer to a copy of the Columbus Board
of Health Resolution located in their books. Dr. Sullivan stated that this was
an important issue and stated this Resolution was written by Hal Lowery,
Barstow County in North Georgia. He feels that this issue needs to be
considered today. He stated this is the first time, in a long time, that almost
every board of health in the State of Georgia united and passed resolutions on
this subject. This Resolution has been accepted by Augusta, Macon, and counties
around Atlanta.
Dr. Sullivan read the Resolution (See Attached Copy) and the Board Members
followed along with their copies.
Dr. Sullivan asked for any suggested changes to the Resolution. Mr. Hugley
stated that it would be good to have all members of the board to show a yes by
their names not necessarily sign the Resolution. This would show individual
support from each member and the local delegation would see and would know who
is on the Board of Health here in Columbus. Dr. Willis asked how many Districts
are in the State. Dr. Koppanyi stated there are 18 Districts. Dr. Willis asked
if the other 18 Districts would agree to this Resolution. Dr. Sullivan asked
for a motion to accept the Resolution. A motion was made by Dr. Willis,
seconded by Ms. Dozier and approved by those members present.
Dr. Janice Carson and Candice Nowicki, entered the Board Meeting.
Dr. Carson introduced herself to the Board Members. Ms. Dozier introduced
herself to Dr. Carson since she was not on board for the previous meetings with
Dr. Carson.
Dr. Carson introduced her Assistant- Candice Nowicki, Senior Management
Official from the CDC.
Dr. Sullivan asked Dr. Koppanyi for the Director?s Comments. Dr. Koppanyi
referred to a copy of the Legislative Study Committee Report found in the Board
Members books. Dr. Koppanyi stated that several participated in a 4- day
Bio-Terrorism course for Radiation Hazards and Dirty Bombs, etc.
In regards to the Men?s and Women?s Health Fair, there were 1600 to 1700
persons participating. Vouchers were given out for the Prostate Exam, Mammogram
and Flu Shots.
Dr. Sullivan called on Pam Middleton to present the financial report to the
Board.
As a follow up to previous discussions, Ms. Gosden stated that the Fee Income
has been closely watched. This Board had opted to collect the fees in one
fiscal year budget and expend them in the next year as Prior Year Program
Income. Ms. Middleton provided a written report to Ms. Gosden showing where we
are in FY2007 compared to what was rolled this year from FY2006. The Fee
Income would be drastically down if it were not for Interest Income. For
example; Out Patient Flu is down $28,506, we are holding an overage of flu
vaccine. Basically any one of the Medicaid Programs you can name i.e. ESPT is
down $29,851, Rehab Service Option is down $32,123; Pregnancy Related Services
$6,144 and PCM is $21,821. Minor downward trends in the Out Patient Collection
Fees i.e. Immunizations $2,673; Out Patient TB $1,715, Out Patient Diabetes
$1,074 compared to $5,300 last year. Income is slowly being received from the
CMOs. If it were not for the Interest Income, we would have a major problem.
Ms. Gosden asked if there were any questions. The Fees rolling forward for next
year are some $73,277 short of what had been collected in FY06 to roll to FY07.
Environmental Health is up $8,139. The fees collected from the client across
the desk on the Discounted Services most all were up i.e. STD collected
$14,772; Child Health is up $2,721. Ms. Gosden asked if there were any
questions.
Dr. Sullivan asked Cheryl Johnson, Public Information Officer, to present the
presentation to the Board. Ms. Johnson introduced Ms. Sonya Cochran as the back
up PIO and stated that she is also with the Health Education Department.
Dr. Sullivan asked Dr. Carson to speak. Dr. Carson stated that at #2 Peachtree
St. things needed to be done differently. Dr.Koppanyi had taken Dr. Carson out
in the field with his staff and hearing some of the things that they were
saying. The staff shared concerns about the number of requirements that they
had for reporting some other things that seem to them to be programs with
concerns. So back in October, they initiated what is called the State Office
Integration Project. All of the programs and services that are provided are
being looked at, all of the reporting requirements that they are asking the
staff at the local health departments to carry out and they are working to
consolidate them as much as possible. Such that when the new Master Agreement
comes out it will be signed at the beginning of the next fiscal year, they hope
to have reduced requirements in there and they hope to have as much
consolidation as possible so that the staff at the local level won?t have to
carry out redundant work. As they were going through the process of looking at
our programs and services, they thought it would be a good idea to also take a
look at Georgia Code to see what exactly Public Health needs to be doing. They
took a look at the mandated services and it is very clear in the law there is
delineation between the work of the State Office and the work of the local
Boards of Health. The law specifies that the local Boards of Health are
responsible for doing a community assessment to identify what the needs are and
then take a look at the resources that are required to meet those needs and
then come up with a budget that is then submitted to the county officials so
that they can get appropriate funding in order to help meet the needs that the
community has identified through the assessments. We recognize that when you
look at the current materials that Board of Health members have, as far as
orientation is concerned, that spells out the things that need to be done. Some
of the Board of Health members did not fully understand the needs or the
mandates that the State Law says that the Boards of Health are suppose to carry
out. So with that work there is one dated February, 2005 and in some of her
visits she has come upon some Board of Health members who felt that the Board
of Health and the County Commissioner?s responsibility was to only provide
facilities and equipment. Often as opposed to?no your job is to take a look at
what the community needs and then help to facilitate the delivery of services
to meet those needs. So, what we recognized was that Board of Health
orientation was not even in the orientation manual, just a guideline. There is
no standardized process in the State of Georgia for orientation of Board of
Health members. So we have pulled together a Board of Health Orientation Task
Force. I will invite any and all of you who are interested in coming together
with us to join with us as we work to come up with some new materials for Board
of Health members. We are hoping to prepare them in a manner that will be easy
for Board of Health members to utilize; rather it?s a DVD and a booklet
supplement. We will develop something new that will help Board of Health
members recognize what their roles and responsibilities are. I encourage Board
of Health members to go through the process because there are no mandates
stating that the Boards of Health be oriented. Dr. Willis stated that NALBO
does a wonderful job. Dr. Carson stated that she was glad that Dr. Willis
brought that up. She stated that they talked about working together as a task
force when she presented this to Fulton County. One of the Fulton County Board
of Health members actually is a member of NALBO and she shared that across the
nation there is no standardized process. NALBO is actually trying to work on
this issue. A GPHA representative recognized that several years ago there was
an orientation process that health directors went through, but that had stopped
and he is now on board with us working with the creation of these new
materials. We have some board of health members, we could always use more and
so I encourage you to give me a call and we will add you to the list of those
who are reviewing materials from other states and will help us then trap
something for the state of Georgia. This is just a part of what we are also
looking at as a much bigger process. Board of Health responsibilities are
outlined in the National Public Health Performance Standards. The Fulton County
Board of Health has gone through that assessment and the last that I spoke with
them, they were working on receiving their results of their assessment to see
how they were performing. Those guidelines also work to serve as a foundation
for a process that is called Voluntary Accreditation for Local Boards of
Health. The State of Georgia is now in the process of exploring the
accreditation process and what that would mean for local boards of health in
Georgia. It is recognized there are 18 states already that have initiated this
process. Our partner to the north, North Carolina, has already put into their
state code that by the year 2014, all of their local boards of health will
actually be accredited. They have also taken the next step of putting dollars
into the budget to assist those local boards of health in going through the
accreditation process. The task force began this month and a resolution has
been drafted to send forward to the State Legislature, hoping they would create
a study committee to work parell with us and to look at the issue of voluntary
accreditation for the local boards of health in Georgia. There has been some
concern that in the State of Georgia we have 159 counties and that some of
these counties have health departments that only have one staff member. How do
you accredit the health department with only one staff member? We realized that
as we go through this exploration process, these are issues that we need to
work out, but the feeling is that the train is already on the track and it?s
moving along and we recognize accreditation is going to be a national process
in fact they are looking to appoint an interinum director at the national level
sometime in May. This is an opportune time for us at the state to begin an
investigative process and if we could possibly craft something before
everything is finalized at the state level, it has been said that they have
already stated that those states that have the process in place that will meet
the national guidelines, they can be grand fathered in to the national system.
We are hoping that we can get to that point. So from the state office level, we
are looking at the mandated services, getting out the integration project,
doing the board of health orientation and also working on voluntary
accreditation. Dr. Carson stated that she is out and about in the field, she is
listening to what the health department staff members are telling her and
looking to what the board of health members are telling her and taking that
back to Atlanta and trying to make a difference. We realize first and foremost,
public health is not delivered at 2 Peachtree it?s delivered here at the local
level. Dr. Carson stated that she needed to be a good partner to the board
because she needs the board to be the service delivery bond for her. She stated
if she did not cultivate the relationship, then she is not doing her job. She
thanked the board members for letting her speak and she asked if there were any
questions.
There was a brief discussion between Dr. Willis and Dr. Carson regarding the
above issue.
Dr. Sullivan thanked Dr. Carson for her comments.
Ms. Nowicki with CDC also had comments to the Board. Dr. Koppanyi ask that the
CDC let us know before a press release, because this has happened in the past
and is very disturbing when you walk into your office at 8am in the morning and
there are stacks of phone slips about something you don?t have a clue about.
Ms. Nowicki thanked Dr. Koppanyi for letting her know about this and advised
him to let her know if this happens again to call her directly and she will
contact communications about the issue. Ms. Nowicki stated there are two
different things that can be done on a weekly basis; 1. she gets a list of
potential press issues that will come up and 2) and access to the portfolio to
the leadership level.
Dr. Sullivan asked if there was any other business to discuss. There being
none, the meeting was adjourned.
Respectfully submitted:
____________________________
Pam Middleton, Secretary
Attachments
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