MORROW COUNTY BOARD OF HEALTH April 16, 2017APPROVED BY BOH on April 17 3017

BOARD OF HEALTH MEETING

MEETING MINUTES

March 20, 2017LOVE LIFE. LIVE HEALTHY

Board Members Present: Board Members Absent:J. Grant Galbraith, MD – (GG) Jim Albertson – (JA) Martha Mooney, DVM – (MM) Jeff Polzin, RPh – (JP)David Woodward - (DW)

Management Present: Staff Present: Community Present:Pamela Butler, MPH Lynne Keesey Brad Schneider Brian Benick, R.S., MPH Brandy Brewer Kay Benick, R.N. BSN

CONVENTION CALL TO ORDER:The meeting was called to order at 6:00 PM by Martha Mooney, Board President.

1.0 INTRODUCTIONS

Everyone in the room introduced themselves and reminded to sign in on the sheet.

2.0 APPROVAL OF AGENDA The Board President (MM) asked for a motion to approve the agenda as written.

No agenda changes were noted. Motion was made by DW with a second by JP to approve the agenda without changes. No abstentions. All ayes – motion passed.

3.0 APPROVAL OF MARCH 20, 2017 MINUTES

The Board President (MM) asked for a motion to approve the March 20, 2017 minutes as written.

No additions or changes were made. Motion was made by JP with a second by DW. No abstentions. All ayes – motion passed.

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MORROW COUNTY BOARD OF HEALTH April 16, 2017APPROVED BY BOH on April 17 30174.0 APPROVAL OF FINANCIALS

The Board President (MM) asked for a motion to approve the financials provided.

JP made the motion to approve the financials as presented followed by a second from DW. No abstentions. All ayes – motion passed.

5.0 PUBLIC PARTICIPATION

No one from the public submitted and intent to address the Board and no one came to the meeting who addressed the Board.

Brad Scheider, The GrowthCoach, was invited to share the draft of the MCHD’s strategic plan with the Board of Health. The plan is needed as the third leg of the pre-requisites for the applying to the Public Health Accreditation Board. The final version will be provided at the April 2017 Board of Health meeting for adoption. Brad discussed the steps that led to the MCHD Balanced Scorecard Strategic Plan document.

That Board of Health members were impressed with the amount of work completed in a small amount of time.

Following the adoption at the April 17, 2107 BOH meeting, the Board members will be asked to sign the Letter of Support needed by the governance group (The Board of Health).

NOTE:In order to apply, MCHD must include the Community Health Plan (CHA), the Community Health Improvement Plan (CHIP), the MCHD Strategic Plan and the Letter of Support. The cost of application will be $14,000.00 (Refer to the document provided entitled, PHAB’s Five Tier Accreditation Fee Schedule - Effective July 1, 2016-June 30, 2018). Annually, there will be a cost, that may change, sent to PHAB. Currently, the annual fee is $5,600.00.NOTE:(1)Community Health Assessment (Adult and Youth) $40,000

Morrow County Hospital paid 25% $10,000Delaware-Morrow County Mental Health & Recovery Board paid 25% $10,000

(2)Community Health Improvement Plan $8,000Received funding from Ohio Department of Health $15,000Difference paid for employee time/benefits for accreditation

(3)Strategic PlanTotal contract costs have not been tallied to include employees’ time/benefits.

6.0 ADMINISTRATIVE / AGENCY ACTION ITEMS PAMELA BUTLER

6.1 The Board President (MM) asked for a motion to approve the out-of-state travel for Ashira Vantrees, MCHD Emergency Preparedness Planner, to attend the national conference in Georgia. (Motion details listed below).

DW made the motion with a second by JP. No abstentions. All ayes – motion passed unanimously.

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MORROW COUNTY BOARD OF HEALTH April 16, 2017APPROVED BY BOH on April 17 3017

MOTION FOR TRAVEL TO ATLANTA GEORGIA FOR EMERGENCY PREPAREDNESS CONFERENCE: Motion to allow Ashira Vantrees, MCHD Emergency Preparedness Planner, to accept the NACCHO 2017 MRC Training and Travel Invitation to attend the MRC Leadership Summit and 2017 Preparedness Summit April 24 – 28, 2017 in Atlanta, GA. Ms. Vantrees received notice that she was awarded funding to cover the 1) round-trip airfare/train; 2) 5 nights lodging; 3) registration fees; and 4) allowable per diem for meals. It does not include the following: 1) extended stay (hotel or airfare); 2) rental cars; 3) hotel / airport parking; 4) ground transportation (taxis or shuttle); 5) airline baggage fees; 6) mileage; and /or 7) incidentals. NOTE: Approximate cost to MCHD will be round trip mileage to Columbus Airport (15.2 miles) and parking expenses of approximately $28.00 – total cost should be less than $100.00.

6.2 The Board President (MM) asked for a motion to approve a mileage stipend for up to $500.00 for public health students completing an internship for MCHD. (Motion details are below)

JP made the motion seconded by GG to approve the motion. No abstentions. All ayes – motion passed.

MOTION TO PROVIDE MILEAGE STIPEND OF $500.00 FOR PUBLIC HEALTH STUDENTS: Motion to provide mileage stipend to interested university/college students which allows an opportunity to complete internship at MCHD. This will be an incentive for students to choose MCHD as a place to complete their public health requirements for graduation. NOTE: Refer to the Internship Mileage Reimbursement Document

6.3 The Board President (MM) asked for a motion to allow the Health Commissioner to make decision regarding the length of time for renewal of hardware / software options from Business Communication Specialists. (Motion details are below)

DW made the motion and seconded by GG to approve. No abstentions. All ayes – motion passed.

MOTION TO ALLOW HEALTH COMMISSIONER TO MAKE DECISION REGARDING LENGTH OF TIME FOR RENEWAL OF HARDWARE AND SOFTWARE OPTIONS FROM BUSINESS COMMUNICATION SPECIALISTS: Motion to make effective decision on length of contract based on standard terms and conditions. This will include discussion with Wes Stone, IT Specialist, with Delaware Health District. The costs are from minimal support at $250.00 to maximum of $1952.00 for five (5) year support. Email will be sent out with final cost. Review attached quote.

The decision was made in consultation with MCHD’s contracted IT person to contract for one (1) year at this time. The cost for the Partner support Renewal Options was the first one - 1 year Hardware & Software; No Phones for the costs of $459.00.

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MORROW COUNTY BOARD OF HEALTH April 16, 2017APPROVED BY BOH on April 17 3017

The quote was submitted on March 22, 2017 and received by Business Communication Specialists.

6.4 The Board President (MM) asked for a resolution to approve the Memorandum of Understanding Resolution #2017-006 for badge printing. (Resolution details are below)

JP made the resolution with a second by DW to approve. No abstentions. All ayes – resolution passed.

RESOLUTION #2017-006: RESOLUTION TO APPROVE THE MEMORANDUM OF UNDERSTANDING FOR BADGE PRINTING: Morrow County Board of Health hereby resolves to approve the memorandum of understanding for badge printing between Morrow County Health District and the Morrow County Emergency Management Agency (EMA). The badges will be used by MCHD personnel for identification to the general public / community.

6.5 The Board President (MM) asked for an approval for Resolution #2017-007 to remove equipment from the MCHD inventory. (Resolution details are below)

DW made the resolution followed by a second from GG to approve. No abstentions. All ayes – resolution passed.

Resolution #2017-007: RESOLUTION TO REMOVE THE FOLLOWING EQUIPMENT FROM THE MORROW COUNTY HEALTH DISTRICT’S INVENTORY FOR 2017: Morrow County Board of Health hereby resolves to approve and adopt the removal of the equipment as found in Addendum A (Page 3 of resolution) from MCHD inventory. Documentation will be sent to the Ohio Department of Health as required or is necessary.

6.6 The Board President (MM) asked for an approval of Resolution #2017-008 to approve and adopt the MCHD Mass Fatality Plan. (Resolution details are below)

GG made the resolution with a second by JP to approve the mass fatality plan. No abstentions. All ayes – resolution passed.

Resolution #2017-008: RESOLUTION TO REVIEW, APPROVE AND ADOPT THE MORROW COUNTY MASS FATALITY PLAN: Morrow County Board of Health hereby resolves to review, approve and adopt the MCHD Mass Fatality Plan, developed in coordination with local county partners. This plan shall be reviewed annually by Emergency Preparedness Coordinator along with multi-disciplinary advisory group and then taken to the BOH if extensive updates are required. This document (plan) will be kept in the Emergency Preparedness Area.

6.7 The Board President (MM) asked for an approval of Resolution #2017-010 to approve the Memorandum of Agreement (AOA) with the Salvation Army. (Resolution details are below)

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MORROW COUNTY BOARD OF HEALTH April 16, 2017APPROVED BY BOH on April 17 3017

DW made the resolution with a second by JP to approve the MOA document. No abstentions. All ayes – resolution passed.

RESOLUTION #2017-010: RESOLUTION TO APPROVE THE MEMORANDUM OF AGREEMENT WITH THE SALVATION ARMY: The Morrow County Board of Health hereby resolves to review, approve and adopt the Memorandum of Agreement between Morrow County Health District and the Salvation Army for the provision of food and water resources for volunteers at the time of an incident. The document provides the “Scope of Services” by each party involved as provided on the MOA.

6.8 The Board President (MM) asked for an approval of Resolution #2017-011 to approve the use of credit cards for payment of MCHD services. (Resolution details are below)

JP made the resolution with a second by DW to approve the resolution. No abstentions. All ayes – resolution passed.

Resolution #2017-011: This resolution is to establish and approve the use of Stripe (credit card payments – eCommerce) for payment of fees for Morrow County Health District services. This proposal will remain in effect until further notice from the Board of Health.

NOTE:The Stripe program will be reviewed annually due to changes in credit card fees and/or any other changes.

7.0 NURSING ACTION ITEMS KAY BENICK

7.1 The Board President (MM) asked for an approval of Resolution #2017-009 to adopt and approve the Reproductive Health and Wellness Program Assurances. (Resolution details are below)

JP made the resolution with a second by GG to approve the RHWP Assurances document.. No abstentions. All ayes – resolution passed.

Resolution #2017–009: RESOLUTION TO ADOPT AND APPROVE THE REPRODUCTIVE HEALTH AND WELLNESS PROGRAM ASSURANCES: The Morrow County Board of Health hereby resolves to review, approve and adopt the Reproductive Health and Wellness Program Assurances and Title X Requirements as required for funding compliance. (Assurance page has a list from one to seventeen statements of required assurances).

7.2 The Board President (MM) asked for an approval of the motion to approve the hiring of two registered nurses to provide services in the Nursing Division. (Motion details are below)

DW made the motion followed by a second by GG to approve the hiring. No abstentions. All ayes – motion passed.

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MORROW COUNTY BOARD OF HEALTH April 16, 2017APPROVED BY BOH on April 17 3017

Motion to Hire Two (2) Registered Nurses to Provide Nursing Services: The Nursing Division has applied and received several new funding streams with deliverables that will extend the current workforce beyond the point of no return. With the increase in responsibilities as discussed in a previous BOH meeting, there has been a need to solicit resumes/applications, and interviews for two positions. One position, Megan Clay, will be taking on the part-time duties of Vicki Allen,

Cardington School Nurse as well as other duties as required such as Lead Education, Health Promotion in the community, and New Born Home Visiting. Megan should be starting at MCHD beginning April 3, 2017 at a rate of $21.50.

Morgan Kocher will be taking on clinic nursing duties, the immunization action plan (IAP) grant, developing communicable disease skills and Project DAWN education. Morgan will begin her new duties on March 30, 2017 at a rate of $21.50.

7.3 The Board President (MM) asked for an approval of the motion to approve the change in personnel to higher level of responsibility in the Nursing Division. (All of the Motion details are below)

In order to be efficient and save time, GG organized and made the motion for all of the following changes. This was followed by a second by DW to approve all changes in the Nursing Division as indicated in the motion details below. No abstentions. All ayes – motion passed.

Motion to Change Nursing Personnel to Higher Level of Responsibilities: The Nursing Division has applied and received several new funding streams with deliverables that has extended the current workforce beyond the point of no return. The Nurses have stepped up to learn, apply new skills and take on many additional roles / responsibilities in the past year. In order to retain the talent in the workforce that MCHD has in place, it is necessity to provide them with increased pay. But, with increased pay come increased roles / responsibilities. Stephanie Shaver now has the qualifications to meet the Epidemiologist 2 position

due to her coursework. The potential for contract with Crawford County to pay for her services, this increase and change in classification is warranted. Stephanie will be moved to the Epi 2 position and Clinic Manager (PHN 3). Both of these rate changes were incorporated in the decisions made last year and as approved last year should increase Stephanie’s pay to $24.50. She will be taking on the total management of the clinic and training / supervising others.

Jessica Garver has increased billing and taken on the lead role for our Practice Management System. MCHD was told that due to her diligence is “scrubbing” claims prior to submission, MCHD is achieving a 60% reimbursement rate rather than the 20% that the other counties have managed to achieve. She has stepped up to be the RHWP nurse and she has established Risk Standards / Best Practices for the clinic practice as well as carrying out standing orders. She has exceeded expectations and should be rewarded for her hard work and increased work load at a PHN 3 and rate of $23.00.

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MORROW COUNTY BOARD OF HEALTH April 16, 2017APPROVED BY BOH on April 17 3017

Amy Briski is almost at the end of her school nursing certification. Although Ohio does not require a school nurse certification, Amy is using her education and training to bring together all school nurses once a month. This allows collaboration and coordination in school policies and procedures. This has allowed for more continuity between schools. Amy is certified to teach CPR for the agency and is developing a Human Trafficking Taskforce. She should be moved to a new pay rate of $21.50 – same as the incoming new nurses.

NOTE:All employees have stepped and taken on new roles / responsibilities especially with the requirements in accreditation, workforce development, quality improvement and performance management. Within the next month, all employees will be reviewed for potential pay raises. There is a new (2017) wage / salary survey that will be used for comparison of staff roles/responsibilities.

8.0 ENVIRONMENTAL HEALTH ACTION ITEMS BRIAN BENICK

8.1 Since there were no comments / concerns by the public, the Board President (MM) asked for an approval of the second reading of the change to Environmental Health fees (Resolution details are below)

DW made the resolution followed by a second from JP to approve the increase in environmental health fees. No abstentions. All ayes – motion passed.

8.1 RESOLUTION #2017-046 R: This is the SECOND READING of the increase in Environmental Health fees to meet cost changes.This resolution to increase water and sewage environmental health fees is due to external issues and rising costs. There has been a $10.00 added cost for water sample pick up for laboratory testing. Also, the Prosecutors’ Office wants all letters to go out certified thus increasing the current costs for the Operation and Maintenance (O & M) sewage program by $10.00. (Refer to the yellow highlighted areas in the document)

NOTE:Most of the fees HAVE had no changes to reflect increased costs to the agency and many have not been reviewed since 2007. All EH fees will be evaluated using cost methodology for meeting costs in order to complete the program responsibilities without using general revenue funds

Next month (April 2017) will be the THIRD AND FINAL reading of the EH increase of fees.

9.0 INFORMATION ITEMS AND COMMENTS

a. Environmental Health Division: Brian Benick For the next 3 days, Brian Benick and Rodney Brewer (both EH) will attend the

annual state conference that will give 18 continuing education hours for sanitarians / S.I.Ts.

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MORROW COUNTY BOARD OF HEALTH April 16, 2017APPROVED BY BOH on April 17 3017

New 2017 - 2018 HSTS funding- Another $300,000 funding was applied for, approved by the BOH and sent on

to EPA.- There has been discussion taking place regarding where this program should

be housed (MCHD versus the Board of Morrow County Commissioners). b. Nursing Division: Kay Benick

Updated monthly Community Disease Report The Request for Proposals for the HMG program should be available soon.

Collaboration with Delaware on HMG Central Intake and Referral; potential contract by MCHD to take on the Delaware Home Visiting program

Continuation of Reproductive Health –training for implementation of EHR (electronic medical records) took place. Funding for this was made available through additional monies from ODH.

Immunization Action Plan Grant (IAP) – MCHD received the Notice of Award 03/20/2017 – program to begin on April 1, 2017

Morrow County Annual Review Report (CEBCO – February 2017). There will be three (3) places available for county employees to have a health assessment.

Update on RN Positions PHEP Epidemiology responsibilities – MCHD has been asked to contract with

Crawford to provide EPI – 2 services. This potential contract is being evaluated for cost effectiveness and time requirements as needed by Crawford.

c.Health Commissioner Ethics training – minimum of 1 hour required – for all public employees.

Scheduled for June 15, 2017 beginning at 10:00 AM and ending at 11:30 AM. - Scheduled for Community Services Building. - Sent out notices to other Morrow County employees / township trustees,

villages, etc. to attend- This will provide 1.0 + hours of continuing education for BOH members.

Memorandum from Ohio Department of Health: Regarding LHDs participating in accreditation readiness project (See Information Item from Lance Himes, General Counsel – Dated 03.17.2017).

- The document discusses the LHD accreditation work plans with deadline submission of 04.30.2017.

- There was a webinar / conference call to give additional details and provide the work plan that is needed to be completed.

Director Hodges (Director of Ohio Department of Health) – resigned from ODH and leaving by 03.31.2017.

Julie Walburn, (Chief of Staff of Ohio Department of Health) – leaving to go to Youth Services.

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MORROW COUNTY BOARD OF HEALTH April 16, 2017APPROVED BY BOH on April 17 3017

Medical Reserve Corps funding of $13,000 received today for Stop the Bleeds Campaign.

Legendary Service – all day customer service training provided to all staff on February 15, 2017 by Columbus State College in the Community Services Building.

- Martha Mooney Allegra Waldron attended training along with employees.

Hinkle Report to the Auditor of State -required document submission – needed 30 day extension due to new county accounting software.

Quality Indicators submitted by March 1, 2017 – as required by ORC Annual Financial Review (AFR) – completed by March 1, 2017 – as required by

ORC District Advisory Council Meeting – held on Thursday, March 16, 2017 – required

meeting by ORC. See packet of information provided to all who came to meeting.- DAC meeting for 2018 already scheduled and approved for Thursday,

March 15, 2018. Current website has been updated and new launch to take place within the next

six to eight weeks. To check it out go to www.morrowcountyhealth.orgd. Board Members

It was suggested that the HC extend an invitation to the Morrow County Board of Commissioners for the April 17, 2017 Board of Health meeting. Charles Howland, Morrow County Prosecutor, would receive an invitation as well. The meeting will be to discuss the current status of the HSTS funding.

10.0 EXECUTIVE SESSION – REFER TO ORC CHAPTER 121.22The members of a public body may hold an executive session only after a majority of a quorum of the public body determines, by a roll call vote, to hold an executive session and only at a regular or special meeting for the sole purpose of the consideration of any of the following matters:

(1) To consider the appointment, employment, dismissal, discipline, promotion, demotion, or compensation of a public employee or official, or the investigation of charges or complaints against a public employee, official, licensee, or regulated individual, unless the public employee, official, licensee, or regulated individual requests a public hearing. Except as otherwise provided by law, no public body shall hold an executive session for the discipline of an elected official for conduct related to the performance of the elected official's official duties or for the elected official's removal from office. If a public body holds an executive session pursuant to division (G)(1) of this section, the motion and vote to hold that executive session shall state which one or more of the approved purposes listed in division (G)(1) of this section are the purposes for which the executive session is to be held, but need not include the name of any person to be considered at the meeting.

If a public body holds an executive session to consider any of the matters listed in divisions (G)(2) to (8) of this section, the motion and vote to hold that executive session shall state which one or more of the approved matters listed in those divisions are to be considered at the executive session.

Motion to go into Executive Session: Time 7:30 PM - Roll Call VoteThe motion to go into Executive Session (By using the above reason) was made by JP with DW following with a second. A Roll Call vote was called by the HC for each of the attending BOH members.

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MORROW COUNTY BOARD OF HEALTH April 16, 2017APPROVED BY BOH on April 17 3017

Brian Benick, Kay Benick, and Pamela Butler were asked to stay for and attend the executive session.

Mooney Y Albertson ___ Polzin Y Woodward Y Galbraith Y

All ayes – motion passed by roll call vote.

Motion to return from Executive Session: Time 8:08 PM - Roll Call Vote The motion to return from Executive Session was made by DW with a second by GG. The HC proceeded to do a Roll Call Vote for each of the BOH members who attended the meeting.

Mooney Y Albertson ___ Polzin Y Woodward Y Galbraith Y

All ayes – motion passed ending Executive Session by roll call vote.

11.0 The meeting was adjourned at 8:12 PM with a motion by GG and a second by DW. NO abstentions.

All ayes – motion passed. Meeting adjourned.

NEXT MEETINGMonday, April 17, 2017 at 6:00 PM

___________________________________ ________________Martha Mooney - Board of Health President Date

___________________________________ ________________Pamela Butler - Board of Health Secretary Date

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