Board of Health Meeting MINUTES
Wednesday, May 4, 2016
CCHD 115 4th 5t. So, Great Falls, MT 59rrc1 (l€ Conf Rm)
Members Present:
Bill Bronson, Chair
Tammy Lacey, Vice Chair
Jane Weber
Ryan Burke
Matt Martin,
DDS
Peter Gray
Tanya Houston
Staff/Visitors Present:
Sandy Johnson, Environmental Health Manager
Katie Brewer, HO Assistant
Erin Merchant, Preparedness and Communications Officer
Casey Mohler, Accountant
Sara h
Robbin, Registered Sanitarian
Mr. Bronson colled the meetinq to order ot 7l:33 o.m. A quorum wos present.
Ms. Locey orrived ot 77:34 a,m.
Mr. Grdy orrived ot 77:35 d,m.
AGENDA ITEMS:
1. Aporove Minutes from April 6h, 2016, Board of Health (BOH) meetins*: Mr. Bronson
Ms. Weber moved to approve the April 6th, 2016, minutes as presented. Mr. Burke seconded
the motion. With all members voting in favor, the motion passed.
2. cascade ciw-countv Board of Health Requlation Re: Montana clean tndoor Air Act and smokinq
Shelters (Resulationl - Open Space lnterpretation: Mr. Bronson
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As requested during the April BoH meeting, Ms. Houston followed up with Lewis & clark county
BoHto discusstheir interpretation of"open ai/'with regardstotheir local regulation, Montdno
Cleon lndoor Air Act lmplementotion Protocol
for Lewis & Clork County ll &C County CIM
lmplementation Protocol).
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The email response to Ms. Houston identified that L &C County CIAA lmplementation
Protocol, Page 3, #4 defines an "Enclosed public place.,,The response went on to state
that the structu res can only have two walls regardless of the use of screens or grates.
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Mr. Bronson added that Yellowstone County
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lt was discussed if any BOH members felt the Regulation needed to be updated or revisited for
clarification purposes, to inform Mr. Bronson and it would be placed on Agenda for the next
is interested in developing a similar regulation
or
protocol.
BOH meeting.
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3. MCIAA Compliance Checklist - Shelter Review: Bill Bronson
Ms. Houston had drafted the compliance letters to the establishments discussed during the
March and April BOH meetings and forwarded them to Ms. Shannon for her review and revision. The
letters are pending approval byMr. Bronson before beingfinalized and sentout. Mr. Bronson willtouch
base with Ms. Houston to discuss some suggestions regarding the letters.
. To Ms. Houston's knowledge, no other complaints regarding smoking shelters have been
received.
4. Totem Beveraqes, lnc. Litiqation Update: Ms. Haisht.
Discussion determined thot Aqendd ltem 4: Totem Beveroges, lnc. Litiqotion lJpdote, would be moved to
the end of the meeting due to Ms. Hoight possibly ottending the meeting lote.
5. Environmental Health Report: Ms. Robbin
Ms. Robbin presented the BOH with an online sample of the "press agent" for the Envision
Connect Software that the Environmental Health Department (EH) is transitioning to.
Once fully implemented, the "press agent" will allow the public to view inspections of all
regulated facilities, dating back to January 2015.
Ms. Robbin reminded the BOH that grades would not be issued to establishments due to their
potentially subjective nature.
After reviewing their options, EH agreed the "press agent" would provide:
Facility name and address;
Type of inspection;
The inspection date;
The follow up inspection date (if a follow up inspection is required);
The actual inspection categories and data;
Violations categorized as:
(Red) Critical ltems: violationsthat, if left uncorrected, are more likelyto
contribute to food contamination or illness; and
(Blue) Non-critical: violations that, if left uncorrected, could lead to more
serious problems, but do not impose immediate threats to food safety.
EH will refresh the "press agent" on a weekly basis.
EH has held several meetings in an attempt for operato r/esta blish me nt owners to have a chance
to view the "press agent" and provide feedback.
While EH did receive RSVP's, only one operator attended the initial meeting.
lmplementation of the "press agent" is estimated to begin mid-summer.
EH has been informing establishment owners of this transition over the past 18 months and will
continue to do so.
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5. Communicable Disease: Ms. Merchant
a. Communicable Disease Report
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Ms. Merchant reported that influenza numbers are beginning to decrease.
Two adults passed away the previous week due to complications of influenza.
Two long-term facility care units reported several cases of influenza.
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One unit reported (6) cases; and
The other unit reported (7) cases.
Both units have taken the proper precautions and worked with Ms. Furan to implement
the correct prevention measures.
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lt was discussed that when CCHD is notified of an influenza case, Ms. Furan documents the
information and reports hospitalizations and deaths to the state.
Ms. Merchant reported that each year, the Public Health Emergency preparedness program
updates and reviews their plans and protocols and presented the following two items that required
signatures of approval by the BOH:
b. PHEP Communicable Disease Surveillance and Response protocol Checklist
The protocol and checklist describe how CCHD conducts routine communicable
disease surveillance within the community and how the agency responds to cases
and/or outbreaks.
Ms. Merchant reviewed and verified that the above-referenced plan and checklist
did not have any changes from the previous year with the exception of contact
information. Ms. Merchant updated the appropriate contact information.
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Ms. Lacey moved the BOH approve and sign the PHEP Communicable Disease Surveillance and
Response Protocol Checklist. Mr. Burke seconded the motion. With all members voting in favor, the
motion passes.
c.
PHEP Specimen Transport Plan Checklist
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The protocol and checklist describe how CCHD will work with community partners
and stakeholders to ensure correct collection, packaging and transport of suspected
hazardous clinical and environmental specimens to the Montana public Health
Laboratory when a public health emergency is likely.
Ms. Merchant reviewed and verified that the a bove-refere nced plan and checklist
did not have any changes from the previous year with the exception of contact
information. Ms. Merchant updated the appropriate contact information.
Ms. Merchant verified the required containers are available and specifically labeled
at ccHD.
Ms. Weber moved the BOH approve and sign the PHEP Specimen Transport plan Checklist. Dr.
Martin seconded the motion. With all members voting in favor, the motion passes.
7.
Finance Report: Ms. Mohler
Ms. Mohler presented the Finance Report to the BOH explaining that at this time, the primary
focus is on budgets. Currently Ms. Mohler is working on ensuring the current fiscalyear budget is fully
expensed and planning for the next fiscal year as the new contracts come through.
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Ms. Mohler and Ms. Houston have met with the County Commissioners to review the 4th
Quarter of the General Fund budgets.
Meetings are scheduled with Ms. Mohler and CCHD division managers during May to
ensure budget planning runs smoothly.
Ms. Mohler met with Ms. Smith to enter most of the General Fund expenses into the
budgeting system for the upcoming fiscal year.
lt is likely that CCHD will not see reimbursement from Buckle Up Montana (BUMT) by
the end of the fiscal year.
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BUMT communicated that they would not reimburse CCHD until the County
Audit for fiscal year 2015 is completed and submitted.
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Ms. Weber stated the 2015 audit would not be completed until late August or
early SePtember.
Ms. Houston will follow up with the County Commissioners for guidance to
meet contractual obligations and budget accordingly.
Revenues received in April:
Montana Tobacco Use Prevention Program - 56000.00;
Air Quality - S 2926.00; and
lmmunization Project (307): 58460.00.
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8,
CCHD Annual Reoort
Ms. Houston stated that the Annual Report was revised to reflect the Agency as a whole rather
than four departments. When presenting to community partners, Ms. Houston presents the full report.
For the BOH, Ms. Houston invited a representative from each division to highlight their areas and
answer any potential questions.
a. Prevention Services (PS): Ms. Merchant
Ms. Merchant highlighted the following:
. ln 2015, the changes in the school immunization regulations took place;
. Gonorrhea increased at a statewide level;
. Hepatitis Ccases increased. This was likely a result of an increased number of
providers testing. Ms. Merchant expressed the hope that awareness will spread as
a result from the increase of testing.
. CCHD's Health Promotion Specialist, Penny Paul was nominated for the Betty
Bollinger Award by the Montana Cancer Coalition.
r A "Flufit" event was held in 2015. The event provided flu shots and offered Fit
Cards, take-home screening tests for Colorectal Cancer. The tests are stooltests.
o 66 Fit Cards were distributed.
o 57 Fit Cards were returned.
o 12 ofthe returned cards showed abnormal readings.
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A successfulfull-scale exercise
for responding to Ebola Virus took place; and
The CCHD website has had an increase in visits.
Family Health Services (FHSI: Ms. Jones
Ms. Jones highlighted the following:
Due to employees retiring and moving, WIC had four openings they were able to fill
with qualified individuals that have done an outstanding job stepping in.
Although WIC was understaffed for several months, 19,888 clients were
seen last year. Only 128 less than the year before.
MCH Block Grant allows a wide range of work to be completed that is related to
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prevention.
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FHS has
been an affiliate of Parents as Teachers since 2007.
to participate in a
quality endorsement projectthatwill beginJuly 1't,2016. lf all criteria met,
the chances are promising to become a Blue Ribbon Affiliate.
For the last 8 years, the 16 essential requirements of the model have been
Last year, the FHS was selected as one of the agencies
met each Year.
Parents as Teachers with Connections continues to host monthly events for parents
and children, resulting in an increase of participation.
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Since it has restarted, the Follow the Child Program for foster children has seen a
steady increase of enrollment.
39 children are currently enrolled.
Public Health Nurses complete medical summaries which are compiled into
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monthly reports.
Negotiations are taking place for funding per child from Child and Family
Services.
At the end of 20L5, a subgroup of the Center for Mental Health started a Suicide
Prevention Team involving a collaboration of multiple agencies in the community.
ln 2015, bylaws were written for Toby's House Crisis Nursery, the application for
501 (c)(3) status was completed, and a tax id number was assigned.
Seve ral su bcomm ittees are currently being formed.
The Noble Referral System is paid through June 3oth, 201.6 through the Maternal,
lnfant and Early Childhood Home Visiting (M IECHV) funding.
The Coalition is working on figuring out how to sustain the system and invite
additional agencies to join the system.
Circle of Security Classes are continuing.
Reimbursement for the classes is provided by a grant that flows through the
University of Great Falls.
Maternal, lnfant and Early Childhood Home Visiting (MIECHV) program is being
restructured and renamed to Healthy Montana Families.
Programs currently included within MEICHV:
Expansion MIECHV (Parents as Teachers);
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SafeCare; and
Healthy Montana Families Project (HMFp).
MIECHV grants are ending September 30.
A Request for Proposal will be released near the end of May.
The entire program will be combined into one contract versus the three
separate contracts it has utilized in the past.
lt is anticipated that future funding will be less, but the actual amount has
yet to be determined.
HMFP completed 862 home visits and had 100% enrollment.
MIECHV Expansion completed 474 home visits and had 76% enrollment
SafeCare completed 311 home visits.
Environmental Health: Ms. Johnson
Ms. Johnson highlighted the following:
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Over 800 licensed establishments were inspected in 2015.
The new Montana Food Code and Cottage Food Law also went into effect in 2015.
lT is anticipated that more people will be registering as cottage food
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operations.
Rabies Prevention is working on reducing the number of Post Exposure Prophylaxis
(PEP) recommendations.
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EH is
The goal is to reduce PEP recommendations to 15%.
recommendations for 2015 was around 237o.
continues to work on improving the Rabies Prevention Program.
PEP
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fully staffed.
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An additional sanitarian position was approved by the County
Commissioners since the previous Annual Report.
The new position was filled in November 2015 with the individual passing
the Registered Sanitarian exam in January 2016.
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Administration: Ms. Houston
Ms. Houston specified some areas she highlights when presenting the Annual Report to
community partners:
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Though CCHD and CHCC share the same location, they are different agencies and
are under different leadership.
Ms. Houston uses last year's bat incident that occurred in one of Great Falls' public
schools to draw attention to the collaboration between CCHD and GFPS.
She noted in 2008, a similar situation in Ravalli County took place involving a
bat in a public school. The Ravalli County bat was confirmed as positive for
rabies. During that occurrence, PEP was pursued by 74 individuals.
The current cost of PEP exceeds $12000.00
Only (3) individuals were recommended PEP during last year's occurrence in
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Houston attributes the low numbers to the co aboration
between CCHD and GFPS.
Ms. Houston added that Ms. Johnson and Ms. Smith were recognized by statewide
organizations for their contributions.
o Both were nominated and selected as successful recipients of annual
rewards.
Ms. Lacey requested that Ms. Houston discusses immunizations and the collaboration between
the School Board on Monday, May 9th.
CCHD and GFPS during her presentation of the Annual Report to
9. Health Officer's Report: Ms. Houston
Ms. Houston relayed the following general programmatic updates:
Ms. Houston received the cleared report from the Agency for Toxic Substances and Disease
Registry (ATSDR) regarding the ACM Smelter Residential Soil Health Consultation.
ATSDR requested Ms. Houston forward the report to the BOH.
ATSDR and the Environmental Protection Agency (EPA) are presenting a Community
Meeting on May 11th. CCHD will attend in a supporting capacity and provide fact
sheets outlining safe gardening tips, etc.
Ms. Houston facilitated another Core at Work (CaW) session with new staff and several
other county employees.
CaW is a workshop offered to allCCHD staffthat helps create a culture of
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accountability.
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(3) sections discussed during the workshop:
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Responsibility;
Collaboration; and
lnfluence.
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4. MCIAA Compliance Checklist - Shelter Review Revisited: Ms. Haieht
Ms. Haight was unable to attend the BOH meeting. Mr. Bronson will communicate with Ms.
Haight and email the information discussed to the BOH.
10. Public comment on anv public matter that is within the Board of Health's iurisdiction MCA 50-2116.
None wos given
Member Comments:
o Ms. Weber thanked CCHD for sending out their May 2015 Newsletter, adding that the photos of
CCHD and CCHC staff was very helpful and appreciated.
o Ms. Lacey stated that Kindergarten Registration was taking place (May 4th, 2015) and during that
time, vaccinations were also being offered at several of the schools. She added that these type
of collaborations between GFPS and CCHD assist with the overall health of the community.
o Mr. Bronson discussed that the City Commissioners would be touring CCHD on May 9th.
o Ms. Gardner will attend the June 1'r,20L6, BOH meeting to assist with preparing the BOH for
CCHD's upcoming Public Health Accreditation Board site visit.
Locey
I Bronson, Chair
odjourn the meeting. Mr. Grey seconded the motion. The meeting wos odjourned
Date
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