Galion Board of Health Meeting

1.     Accreditation of the Galion City Health Department

Dr. Novack stated that Public Health Accreditation Board (PHAB) standards are the framework that will guide the accreditation process. It will be the task of the leadership of Galion City Health Department (GCHD) therefore, to merge all activities through those standards. Standard 1.1 Participate in or Conduct a Collaborative Process Resulting in a Comprehensive Community Health Assessment is fulfilled by the Board’s action last month accepting as its own the 2012 Avita Health System Community Health Assessment (CHA). Standard 1.4 Provide and Use the Results of Health Data Analysis to Develop Recommendations Regarding Public Health will be fulfilled by GCHD’s participation in and the Board’s approval of a collaboratively produced Community Health Improvement Plan (CHIP). That process is underway since the first meeting at Galion Community Hospital on March 15, 2013. It is entitled the Crawford County Wellness Coalition.  At the most recent meeting on August 5, the coalition identified six disease processes on which to focus: 1) disability and chronic pain; 2) heart disease and stroke; 3) mental health and mental disorders; 4) nutrition and overweight; 5) substance abuse; 6) tobacco abuse. These priorities are correlated with Healthy People 2020. Dr. Novack advised the Board to examine, amend and eventually measure the Department’s work based, in part on chosen processes identified in the Coalition’s work.  PHAB accreditation requires evidence of community-wide collaboration, priority setting and assessment of work. As GCHD progresses through accreditation, it will be necessary for the Department to originate previously unused measures for its reporting to the Board. Dr. Novack advises this will be a learning process and the Board as well as the Department must become accustomed to a changing landscape of priorities and activities. The maintenance of essential services such as vital statistics, immunizations and food safety will provide the core ongoing activities, while re-orienting these activities and adding new ones will require flexibility and openness to change.

2.     Get Galion City’s fair share of PHEP funding restored- pending further discussions with Crawford County General Health District (CCGHD)

3.     Rationalize Nursing Functions- Dr. Novack commented that the Nursing department is undergoing change with changing personnel and re-orientation to the accreditation process.

a.     School Nursing

b.    Immunizations

c.     Access to care

                                          i.    MAC reimbursement- $4,648.83

d.    Outbreak Reporting

e.     Workforce Development and maintenance of skills

                                          i.    Sandy completed Epi Info course

4.     Implement grade level food health inspections on Galion City Health Department website- Dr. Novack relayed Ms. Zmuda’s information that her communications with Ohio Department of Health (ODH) that the State of Ohio prevents a Board of Health from setting additional public reporting requirements for Food Service Organizations (FSO) and Retail Food Establishments (RFE). Mr. Schilling asks how other states and even other Ohio Municipalities such as City of Columbus can provide on-site publically displayed ranking. Dr. Novack stated that in the case of Columbus, the displayed color coding, the colors represent the RFE’s status in the enforcement process. Green shows the facility has met the standards of Columbus Public Health; yellow: the facility is in an enforcement process due to uncorrected violations; red: the facility has been ordered closed, or is on probation and has uncorrected critical violations; white: increased frequency of inspections.

a.     If is not permitted per ODH, what method provides public notification and improved restaurant performance?

5.Implement electronic board document system- BlueSky

6.Establish secure internet section to website for posting of internal documents, forms, manuals, policies, procedures- Dr. Novack reported that there is no news on the new server quote. He anticipates completing a contract for server work by the next Board meeting. He commented that aside from finding the best value in server replacement, he was awaiting the discussions between the Boards of GCHD and CCGHD. Since those meeting have not revealed a commitment for immediate increased collaboration, he will expedite the server replacement.

7.     Implement use of credit card for payment of services- Mr. Schilling reports on new options (see below)

8.     Review, revise and convert into an editable electronic document the department personnel manual- see #6

9.     Develop set key metrics that the department will measure and track its performance – Dr. Novack stated that key measures of Department performance are in process and depend on process in #1. These measures will conform to the following PHAB standards: Standard 1.2 Collect and Maintain Reliable, Comparable, and Valid Data That Provide Information on Conditions of Public Health Importance and On the Health Status of the Population; Standard 1.3 Analyze Public Health Data to Identify Trends in Health Problems, Environmental Public Health Hazards, and Social and Economic Factors That Affect the Public’s Health; Standard 3.1 Provide Health Education and Health Promotion Policies, Programs, Processes, and Interventions to Support Prevention and Wellness; Standard 9.1 Use a Performance Management System to Monitor Achievement of Organizational Objectives; Standard 9.2 Develop and Implement Quality Improvement Processes Integrated Into Organizational Practice, Programs; Standard 10.1 Identify and Use the Best Available Evidence for Making Informed Public Health Practice Decisions; Standard 10.2 Promote Understanding and Use of Research Results, Evaluations, and Evidence-based Practices with Appropriate Audiences

10.  Develop and execute strategic goals with community organizations to deal with areas of  concern shown in Community Health Assessment Survey- Dr. Novack states that this goal will be fulfilled with accomplishment of #1.

11.  Communicate other major operational issues to assist the Board in understanding the organization’s business dynamics

a.     Change in Licensing council

b.    Listeriosis implication in local facility

c.     Accrued vacation and sick leave balances

d.    Discussions on Environmental health

e.     Proposed personnel options

f.     Off-site childhood immunization outreach

g.    Vital measures:

                                          i.    Births 2013 through July

1.     Total – 217

2.     Low-weight- 10

3.     <37 weeks – 12

4.     Teen Births- 22

                                         ii.    Deaths 2013 through July

1.     Total- 133

2.     Average age of Death- 79

1.     Top 3 Causes of death- circulatory, respiratory and neoplasms

                                         ii.    Reportable Diseases 2013 through July-

1.     Chlamydia- 18

2.     Hepatitis C, Chronic- 16

Mr. Long made a motion to approve the monthly reports, seconded by Mr. Schilling.  The motion carried. 

Ms. Crossland explained that Galion St. Joseph has requested one hour of nursing presence in addition to the as needed hours. The contract was previously approved and is now signed by the school. Mr. O’Leary requested a cost analysis for nursing services be done. 

The contract was previously approved and is now signed by the school.

This item was tabled and pending Ms. Zmuda’s return from vacation. 

Mr. Schilling stated that he will distribute by email the United Bank details on credit card use. Mr. O’Leary asked that the department likewise coordinate with the auditor’s office. 

Mr. Schilling relayed the discussion that he and Mr. Long had with representatives of the Crawford County General Health District Board. He states he hopes there can be more discussions. 

Dr. Novack presented to the Board the new annual maintenance agreement with CHC Software of Vermillion, OH for the Health Department Information System (HDIS). The new agreement will not include a food protection module. Ms. Zmuda anticipates that she will use the module developed for the Ohio Department of Health (ODH) for that service. Mr. Schilling made a motion for approval. The motion was seconded by Mr. Long. The motion carried.

Ms. Crossland presented a proposal for this year’s Influenza vaccination season. She recommended $23 for the trivalent intradermal and $27 for the quadrivalent vaccines. Mr. Long made a motion for approval. The motion was seconded by Ms. Kerr. The motion passed. 

Dr. Novack stated that he has discussed with Mr. Martin Tremmel, interim Commissioner of Richland County Health Department the possibility of sharing services in the Department of Environmental Health. This effort is in response to an Ohio Department of Agriculture audit revealing a need for Ms. Zmuda to have recurrent food code training and evaluation. There is also a need to provide the city coverage for Ms. Zmuda’s leave time. Mr. Long discussed the possibility of approaching Bowling Green State University for placement of environmental interns. The Board, by unanimous consent, agreed with having discussions and will await the opportunity to evaluate proposed formal relations. 

Ms. Hobson requested a reduction on her obligation to the Department. She has asked to have full-time hours reduced to 24 hours per week. She will continue to provide Crestline schools with coverage for the contracted 20 hours per week and will fill the rest of her hours as requested by Ms. Crossland. The Board, by unanimous consent, concurs with the decision.

Ms. Swinehart was amenable to the request for an increase in her hours with the Department. Dr. Novack requested that Ms. Swinehart increase her hours from 8 per week to 16. She has agreed. Ms. Crossland will make work assignments. The Board, by unanimous consent, concurs with the decision.