Columbus, Georgia

Georgia's First Consolidated Government

Post Office Box 1340
Columbus, Georgia, 31902-1340
(706) 653-4013
fax (706) 653-4016

Council Members

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, May 28, 2008, at 1:00 P.M.

MEMBERS PRESENT:

H. Banks Carroll, M. D.

Todd Jarrell, M. D.

Howard Willis, M.D.

MEMBERS ABSENT:

Jim Wetherington, Mayor

Isaiah Hugley, City Manager

Mrs. Brenda Dozier

James A. Lawrence, D.D.S.



OTHER PRESENT:

Mr. Bill Rumer, Attorney

Dr. Zsolt Koppanyi

Ed Saidla

Margaret Gosden

Eileen Albritton

Pam Middleton

Karon Bush

Sheila Mayfield

Pam Fair

Mark Ellis



Dr. Carroll welcomed Dr. Todd Jarrell to the board meeting as a new Board

Member.

Dr. Carroll noted that there was not a quorum today. Dr. Carroll said that the

meeting will continue and the motions can be done by telephone and

confirmations be done later.

Dr. Carroll called the meeting to order and asked if there were any questions

or comments on the previous minutes. Dr. Carroll stated there are two Excused

Absences for the meeting today; Dr. Lawrence who is out of the country in Italy

and Mrs. Dozier who had a previous appointment.

Dr. Carroll asked for any Old Business/Action List. There being none, he asked

for any New Business. Dr. Carroll stated there is an Equipment Request and he

asked Mr. Saidla to present the request to the Board. Mr. Saidla stated that he

had several equipment items requiring approval from the Board. Mr. Saidla

stated that the vast majority of the equipment will be funded by grants

controlled by this board. As a pass through from the State and/or Federal

government; the first request is for the purchase of a 14 foot trailer to be

used by the Metropolitan Medical Response System .The MMRS executive committee

has requested the purchase to provide a back up communication center in

disaster response to be used by the Columbus Amateur Radio Club for the set up

mobile ham radio operations as a community partner in order to set up a mobile

ham radio operations center in the event of a disaster. The total cost is

$8,788.50. The Russell County EMA requires a ham radio base station at a cost

of $2, 579.99. Also to be purchased ?Live Process Programs? for the three MMRS

hospitals that currently do not have the software and user licenses, this

allows hospitals throughout Georgia to communicate during a disaster to

coordinate and allocate resources quickly between hospitals. It is very

expensive as you see at $11,667.00 per license. The three hospitals set up will

cost $35, 001.00. This is a onetime fee. Mr. Saidla stated the hospitals

included are Martin Army Hospital, East Alabama and Jack Hughston Memorial. The

other hospitals in Georgia received the same software in an earlier purchase.

All three hospitals are part of our MMRS including Lee and Russell County

included by the Federal government in our region. Dr. Koppanyi stated there the

MMRS is a six county area and Lee and Russell are included.

Dr. Willis asked how does the Columbus Amateur Radio Club fit into this?

Mr. Saidla stated that they provide the emergency backup radio communication in

time of a disaster to all hospitals as well as for the EMAs and other

organizations. Dr. Koppanyi commented and Ms. Gosden stated that during Katrina

the only communications going through were the ham radio operators. Dr. Willis

asked why this group was never heard of until there was a financial request.

This is just a small portion of this particular grant which is a little over

$250,000 in funding coming to the six counties to increase our preparedness and

readiness. Dr. Willis asked if this covers the rest of the district or just

these six counties? Mr. Saidla stated it covers Lee, Russell, Harris, Muscogee,

Chattahoochee and Marion Counties. Dr. Koppanyi stated that our area is one of

124 MMRS communication special grants for preparedness in the nation. This

effort has been in planning and execution for about six-eight years. Dr.

Carroll asked if this was the first request out of this $250,000 which is in

actuality the 2007 monies? Ms. Gosden stated that the Federal government

chooses the MMRS sites and we were statically chosen; Atlanta and Columbus are

the only two in Georgia based on the likelihood that a significant event may

happen here, Ft. Benning and several worldwide companies calling Columbus home

make our fair city a target for a threat. The MMRS areas are set based on the

metropolitan statistical area (MSA).

Dr. Willis asked that if we buy the equipment to let the Amateur Radio Club use?

who keeps it up and who is responsible for it?...when you give it to

them?....Mr. Saidla stated they basically are responsible, but the vehicle

actually still belongs to the Columbus Board of Health. There will be a

Columbus Board of Health sticker on it and should our Memorandum of Agreement

with the Radio Association ever change then it comes back to the Board of

Health. Dr. Willis asked how do we monitor this sort of relationship? Mr.

Saidla stated that we have meetings every other month bases with all of the

different parts of the MMRS group and we have yearly Memorandum of Agreements

that are issued between us and each of the partners involved. Inventories of

equipment are maintained and checked yearly. It is a huge variety of

organizations and individuals that make up the MMRS group. Dr. Carroll asked if

the previous six years all of the grant monies been used and consumed 100%? Mr.

Saidla stated yes, but there are a few items that continue to remain but once

the grant period ends then all of the monies are expended. Ms. Gosden stated it

is a bit like building a house, you start it out very small and we have

gradually built our preparedness up. Certainly the hospital committees and

hospital preparedness were our first priorities and this purchase is to assist

Ft. Benning and the hospitals in Alabama to bring them on par with the Columbus

hospitals. Dr. Koppanyi stated that one of the advantages is that we have all

of the decominination equipment for the five hospitals here. We have purchased

them and they are in the same type used by the fire department, etc. so we have

the same equipment and the same training. Dr. Willis stated that he is not

having a problem with that, but he is having a problem with is the end point of

reporting.

Mr. Saidla stated that it remains the property of the Health Department and we

verify where every piece of equipment is on a regular basis. A full discussion

of systematic reporting to the Board insured.

Ms. Gosden stated that a copy of the quarterly MMRS report generated by Tamber

Fuller including annual should be provided to the Board. Dr. Carroll stated

that he knew there had been educational programs?.and he stated that he could

see why Dr. Willis would want more information because the MMRS area includes

entities in Alabama.

Ms. Gosden stated that copies of our letters of Memorandum of Understanding

within the MMRS organization should be provided to the Board. The grant is

about community preparedness. Over the six years of its existence $2M dollars

has been spent to move toward a goal of full community preparedness. The MMRS

is unusual in that it is headed by Public Health. Most grants are headed by

Public Safety. We have actually done a lot more to assist the medical community

in the overall preparedness of our community because of the reach and the

concern of public health.

Dr. Carroll asked Mr. Saidla to discuss the other proposed purchases. Mr.

Saidla stated that the Georgia Emergency Management Association through the

state public health office contacted us and offered funding to purchase two

trucks to move trailers and response equipment that we have from place to

place. They did that based on the fact that we have 16 counties and the rural

nature of our area initially GEMA and the Department of Forestry Services were

to be responsible in Memorandum of Agreement with the state office to provide

for the transport of these trailers in times of emergency, however, GEMA has

realized that they do not have the staff nor the equipment and the Department

of Forestry has said they don?t have the right equipment to move standard type

trailers on the road and so GEMA has provided us with some one time end of the

year funding to purchase these two vehicles. They actually gave us the total

amount of money which was for one truck and Mr. Saidla was able to get two

trucks off of the state contract for the price of one on the regular retail

market. They have approved?if this Board approves?..that we can move forward

with the purchase of a 2008 Ford F-350 Duel Rear Wheel Pick Up Truck as well as

a Ford F250 Pick Up Truck. Ms. Gosden stated that this item addresses one of

the major concerns the Board expressed when the trailers were transferred to

our custody in that we did not have the physical capacity to move and place

them.

The only vehicle we have in inventory capable of moving the response trailers

is the one used to move the mobile Dental Clinic. Our concern was that we have

a requirement to be able to place the trailers on a site anywhere in the 16

counties within two hours. We knew at the time that was not possible with one

truck. GEMA now puts us in a position and we are grateful for this, to be able

to be able to set the trailers in place within the 16 counties. This now puts

us in a position to be able to deploy the equipment that we already have. Dr.

Willis stated that he remembered when that came up in some trailers that were

discussed buying before about how we were going to transport these things. Ms.

Gosden stated that they had this agreement with the Forestry Department, now

they realize that is not a good one. This is GEMA coming back and addressing a

hole in their plan and we are grateful for that.

Dr. Carroll asked about the third purchase. Mr. Saidla stated that this is an

item that was in the original budget for this year for another Vector Control

truck. It happens because of the state contract pricing we can purchase an

F-Ford 250 for less that we can purchase a F-Ford 150 pickup truck and the

holder of the state contract has informed me that there is going to be a major

price adjustment in next year?s budget which will increase next year?s contract

price. We have $12,252.00 for vehicles remaining in the amount of money that

was originally budgeted in this year?s budget. It would have been enough money

to purchase this truck had the Crown Victorian (the vehicle that was stolen

last year out of the parking lot on 11th Avenue) and we had to replace it with

a van so in doing that activity we used part of our operating money that was

for a vehicle. Our Vector Control Program is in desperate need of a fleet

replacement with this new truck. There would only be a difference in the budget

of $5,702.00. Ms. Gosden stated that the Crown Victorian was a 1995 model. Dr.

Carroll asked if it had ever been located and Ms. Gosden stated that it had

been and of course had been stripped. It was found about five blocks from the

Health Department. Dr. Carroll asked if the budget difference was covered. Dr.

Carroll asked for any additional questions in regards to this issue. A question

was raised about fuel access. Mr. Saidla stated that the City of Columbus

provides the health department with fuel for our vehicles. The fuel is

purchased at the city?s price. Dr. Willis mentioned a fuel shortage?and several

things that can be affected are they going to freely give the fuel to you. Ms.

Saidla stated that because of our agreements with the City, we are basically

third on the list of priority right behind the fire trucks, police and

ambulances. They need us to move equipment.

Dr. Carroll asked for any other questions or comments regarding this equipment

and vehicle approval request. Dr. Carroll stated that there could not be a

motion at this time, officially, that the Board members are aware and educated

on what is being voted on. Mr. Saidla stated that he had another page and a

half of information and he apologized because he would have provided more time

for this information but the State came to us approximately two weeks ago and

told us there was some one time emergency preparedness funding that we may be

able to receive and we were to provide them with the list of requested items

that we had. We still do not have their final approval on these items but if we

are approved for these funds they have to be spent by August 7th and in order

to get these items purchased and taken care of, we need Board approval for

these items. If the funding does not come then none of these items are going to

be purchased. Dr. Carroll asked who decided which items were needed? Dr.

Koppanyi, Mr. Saidla and the Emergency Preparedness staff met and talked about

the different issues associated with planning and preparedness that we had and

what was needed in order to help make us more prepared for an emergency

situation. Dr. Carroll asked if this was a joint decision along the Emergency

Preparedness? Dr. Carroll asked if this would be a portion or all or none or

some portion of this? Mr. Saidla stated that it could be portions of it and it

all depends on the final amount of money the State indicates that they are

going to allow for purchase. Dr. Carroll said that a motion is needed for

approval of this if the money is available to spend for this. Dr. Carroll asked

if there were any questions on any of the items listed on the second and third

pages of the list. Dr. Koppanyi stated that the fingerprint scanner is a

requirement by the Federal Government. It can be used both for our new

employees or volunteers. Dr. Carroll asked if the Board Members could be

provided a list that could be reviewed and if there were any questions they can

be addressed.

Ms. Gosden stated that in the past, the Board Members were contacted by

telephone for their voting and she asked if the Board would prefer that this be

recorded through an e-mail or if they prefer the telephone or fax or whatever

meets the Board?s pleasure. She stated that this information would be very easy

to include as an e-mail attachment as Dr. Willis has pointed out to us this

afternoon. Some guidance is needed on the handling of this issue. Dr. Carroll

stated that each member of the Board needs to express which way would be best

for them to receive information. Dr. Carroll stated that a fax would be better

for him since he does not check e-mails during the day; Dr. Willis stated the

fax would be best because that gives you a printed record. Ms. Gosden stated

that Ms. Dozier and Dr. Lawrence may or may not have fax capabilities it may be

more appropriate for them to get e-mails. Dr. Carroll stated that Dr. Willis

was referring to on the e-mail that if there were educational tools to help him

understand what is happening, he would appreciate it also and Dr. Jarrell as

well as Dr. Carroll. Ms. Gosden stated at the next Board Meeting the quarterly

report will be available for the Board to review.

Dr. Willis stated in the area of New Business he would like to ask a question

in regards to the recent tragic event at Doctor?s Hospital. What part would

public health have in that scenario? Is that a public health emergency? Mr.

Saidla stated that it was a public safety/law enforcement emergency. Ms.

Gosden stated that we did take care of the office building that is adjacent to

the hospital by locking the suite and assuring the security of employees. The

Management Team was convened immediately and made decisions regarding the

safety of our employees and clients in the adjacent building. In terms of our

direct influence, that would not be public health, but rather a law enforcement

matter. Dr. Willis stated that in fact the hospital had to shut down and would

that not be a public health matter? Mr. Saidla stated that public health was

aware of what was going on and had Columbus Regional acting as the Regional

Coordinating Hospital requested assistance, we would have activated the

response team and provided whatever assistance needed. Ms. Gosden stated that

if that call had come, we were ready and assembled. Dr. Koppanyi and Mr.

Saidla were on the road traveling back to Columbus, but was in the decision

making and all others were available in one room or available by communication

within moments. A full discussion of physician and nursing support issues

related to hospital disaster response ensured. Dr. Willis asked what is the

threshold requiring a Public Health response?

Ms. Albritton said that she thought that a good example of how the process

works is when we had the tornado in Sumter County. Because we were contacted at

a certain point in terms of helping to relocate families to safer environments

and then of course as the situation unfolded, public health played a key role

in trying to find additional resources at the temporary hospital facility but

that request came from the hospital because you don?t want to overwhelm the

system with lots of people showing up, they can?t handle the response. Ms.

Gosden stated that is correct and we need to go back and look at what are the

numbers in the threshold. Since the Doctors Hospital event, this needs to be

looked at. There were concerns that Public Health did not get appropriate

notification while our Management was monitoring the situation through our own

internal channels, and not relying on the news media, formal contact from

Columbus Regional was not received. The situation in Americus was a much better

example because when that call came between about 10 or 10:30 at night, within

less than 30 minutes, our EOC was up and operating and ready to go. We did not

stand down until about 3am, Eileen, Tamber and I were there and ready to call

in whatever resources were necessary. So, you are right, we do need to go back

and look at it?I think that was such an unexpected thing and all the people

involved probably were so emotionally upset. Dr. Carroll stated that he thinks

the standard needs better definition. Mr. Saidla said that he would get back

with the hospital committee?they meet on a monthly basis?.and certainly I know

that Columbus Regional and Doctors have conducted extensive debriefings about

this issue and certainly as a part of our community partnership we will go back

to them and see what we need to modify and to change. Dr. Carroll stated that

this incident has triggered some questions on emergency preparedness and the

thresholds and definitions ?.that is all we need is an educational process to

us as Board members to make sure that we do our responsibility as a Board to

implement that. Mr. Saidla stated there will be a completed report on this by

the end of the month.

Dr. Carroll asked Dr. Koppanyi for his comments. Dr. Sandra Ford has been

appointed as interim as State Health Officer after Dr. Brown retired on April

30, 2008. The State office is still in the middle of reorganization. We still

don?t know what our State funding will be. The District Health Directors are

meeting with Dr. Ford on May 29th to receive additional information. Dr.

Carroll stated that Dr. Ford is appointed by the DHR Commissioner, B. J. Walker

and confirmed by the DHR Board. Ms. Gosden stated that the GIA budget has not

been broken down?since the Governor signed it?Ms. Gosden had conversations with

the GIA Office on Friday afternoon at 3pm. No allocations are known at this

time. Dr. Koppanyi stated that this is rather difficult situation because of

the purposes of the county funding. Dr. Koppanyi commented about the success of

the pandemic flu tabletop exercises that had been done that included community

partners. These exercises have created a lot of exchange of what would happen

if the community were hit by pandemic flu and talking about realistically that

vaccines will not be available and how can a community respond to it. The

Columbus exercise was very productive and the consultants that had been

presenting the tabletops stated that our Columbus group was one of the most

enlighten and informed?and hardest working?.group they have worked with across

the country.

Dr. Carroll stated that the financial reports would not be presented today

because of the length of other discussion.

Ms. Gosden asked Dr. Carroll for a few moments to speak to the Board. Ms.

Gosden said that beginning tomorrow, May 29th, she will be on extended sick

leave; she will be filing a disability application to the State of Georgia

Employees Retirement System. She is having continuing problems with her

diabetes and now degenerative disc disease in her back.

Dr. Carroll said informally?thank you for all of your commitment ?your

educational process for each doctor and board member?your patience with us?.the

community thanks you very much.

Dr. Carroll asked that Mark Ellis present his presentation at a later date to

the Board.

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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