ST. LAWRENCE COUNTY BOARD OF HEALTH

MINUTES

For April 17, 2012

The St. Lawrence County Board of Health (hereafter typed SLCBOH) met onTuesday, April 17, 2012 in the 2nd floor conference room of the Human Services Center, Canton, New York.

MEMBERS PRESENT:Jim Bunstone, Benjamin Gruda, Gregory Healey, Robert Kimmes, Timothy Monroe, and Anthony Tramontano.

PUBLIC HEALTH STAFF PRESENT: Myrna Barney, Public Health Sanitarian; Sandra Worden, Director of Patient Services; Rosemary Brown, Administrative Assistant

MEETING TO ORDER

President Benjamin Gruda called the meeting to order at 6:01.

MINUTES OF THE MARCH 20, 2012 MEETING

Mr. Gruda asked if there were any corrections or additions to the March 20, 2012 minutes. There were none. He asked for a motion to accept the minutes as written. Mr. Kimmes made the motion and Mr. Monroe seconded. The minutes were approved as written.

COMMUNICATION

There were no new communications to discuss.

PUBLIC COMMENT

There were no public comments.

REPORTS

Tobacco – Ben Todd

Mr. Todd explained that the Power Point presentation he was going to present was similar to the one he gave last year except for some updates. Please see the attached Power Point presentation.

The survey referenced in the Power Point ranking St. Lawrence County in the top three counties for tobacco use at 27% asked people 18 years of age and older if they had smoked 100 cigarettes in the past thirty days and if they were still smoking.

Workplace tobacco bans, such as the one at Clarkson University, seem to be the most effective way of enhancing the chance of smokers quitting. Every school in New York State has a tobacco-free campus.

Anyone who is regulated under OASES regulations is required to have a tobacco-free policy. Some hospitals that are enforcing the policy have the policy listed in their policies for personnel and guests. First offense warrants a warning and if another offense occurs, the offender is asked to leave. Other places put up signs and never enforce the policy.

Other counties who have elected to have tobacco-free policies are Cattaraugus, Livingston, Ontario, Schuyler, Seneca and Ulster. Clinton County is in the process of enacting such a policy. All of these have used the Board of Health as an enforcement tool.

Resolution

President Benjamin Gruda made a motion to introduce the resolution for a vote. Dr. Monroe approved the motion and Mr. Bunstone seconded it. A discussion ensued.

Mr. Bunstone told the committee they needed to decide whether they were going to request the Board of Legislators to establish a law or pass a resolution because the procedures were different for each. If the committee wants to enact a local law, there are four steps that need to be taken. If it becomes a local law part of the process is enforcement. This will become another issue. This is one of the steps – trying to decide an avenue of enforcement.

Some local laws are all inclusive and others have exceptions such as when an individual is entering or exiting the property in a motor vehicle. Other exceptions are county roads. Mr. Gruda stated he would like to leave the resolution as broad as possible and leave the exceptions to the Board of Legislators.

Mr. Bunstone stated he was afraid when it got down to the resolution being adopted by the Board of Legislators to adopt the law, they wouldn’t be comfortable doing so. He asked if it would be better to have the resolution worded in such a way that the Board of Legislators actually supported the St. Lawrence County Board of Health adopting a local law.

After further discussion it was decided the wording in the last paragraph be changed from “that the Board of Legislators adopt a law prohibiting tobacco use on all real property owned or leased by the county” to “that the Board of Legislators support the adoption of a law written by the St. Lawrence County Board of Health prohibiting tobacco use on all real property owned or leased by the county”.

Mr. Bunstone told the Board that ifthey would like the resolution to be presented to Services Committee next Monday he would see that it was added to the agenda. The Board decided they would like the resolution presented as soon as possible and felt the chance of approval would be enhanced if Ben Todd presented his Power Point at Services and if members of the SLCBOH attended. Mr. Bunstone told the Board the meeting startsat 5:30 in the Board chambers. Mr. Gruda felt the presentation to the Board should focus primarily on the fiscal and medical implications of smoking.

Dr. Monroe made a motion to accept the amendment to the resolution and Mr. Bunstone seconded. All were in favor of the amendment.

OLD BUSINESS

Vote on Changes to By-laws

The provision in the St. Lawrence County Board of Health by-laws requiring that at least one of the two positions of President or Vice –President must be a physician was discussed at the last meeting. Per the last meeting, it was discussed that this provision be stricken from the by-laws. Mr. Gruda asked if there was any further discussion. There was none. Mr. Grudaasked for a motion to have the phrase “at least one of the two elected officers must be a physician” be stricken. Dr. Monroe made the motion and Dr. Healey seconded. The motion passed.

CHHA/LTHHCP – Sandra Worden, DPS

On March 26, 2012, the Board of Legislators decided not to sell the CHHA. Due to this decision, staff is in the process of making every effort to turn the CHHA around. We’re setting goals, marketing, searching for new sources of revenue, asking for team work, and working to increase staffing. Four nurses will be hired – three of these will be for the CHHA Program and one will be for Prevent. We have received six applications and will start interviewing next week. These are experienced nurses and some have CHHA experience.

Ms. Wordenshowed the CHHA Weekly Report which is presented weekly to the County Administrator and Chair of the Board of Legislators, Sallie Brothers. This report lists the number of referrals, referral source, billable visits, average number of visits per nurse per day, and average length of visit. Also at this weekly meeting, avenues of improvement and progress of efforts are discussed.

Directors and supervisors are visiting hospitals on a weekly basis. We’ve developed promotional packetsand will be visiting physician’s offices and nursing homes to distribute them. Specific objectives that need to be met are communication, staff involvement, locking of notes in a timely manner, and an increase in referrals and revenue. The staff’s morale also needs to be addressed.

At the present time, CHHA and LTHHCP have a total of 185 clients. Last week we received 22 referrals. We had to refuse one referral due to the lack of staff because it involved a 4xday therapy. Health Services of Northern New York is working with us and they are supplying nurses in the Conifer and Piercefield areas. There are no longer delays in accepting referrals unless it is a complicated case.

One of the avenues of accepting more referrals is nurses being able to work an 8-hour day vs. a 7-hour day. This is a union issue. A nurse will only be allowed to work an 8-hour day when an extra patient can be seen. A union representative will be coming to explain this to the staff.

NEW BUSINESS

Personnel

Ms. Worden explained the following changes in personnel:

Director of Patient Services – Sandra Worden

Supervisor of Prevent and EI – Laura Duval

Hiring of Nurses for CHHA and Prevent – in the process

Support Staff Losses:

-Account Clerk/Typist is being transferred to another department

  • The State will take care of billingfor Early Intervention which will ease some of the burden of this loss.

-Keyboard Specialist – is being transferred to another department

  • We have a second Keyboard Specialist who works solely with CHHA and she will take on the responsibilities of the transferred staff member.

We will be trying to handle these losses within our department by rearranging duties, but if it does not work, we will ask to fill these positions.

Other

The SLCBOH was scheduled to vote on the sale of the CHHA, but it was decided that they would wait for six months to do so due to the decision of the Board of Legislators not to sell.

Executive Session

None necessary.

Adjournment

Mr. Gruda made a motion to adjourn the meeting at 7:32 and the motion was seconded by Dr. Healy. The motion was carried and the meeting was adjourned at 7:32.

Respectfully Submitted,

Rosemary A. Brown

Administrative Assistant

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