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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