DOUGLAS COUNTY BOARD OF HEALTH

MEETING OF MARCH 15, 2017

 

APPROVED JUNE 21, 2017

The regular meeting of the Douglas County Board of Health was held on March 15, 2017, in the meeting room of the County Administration Building, 1616 8th Street Minden, NV  89423, beginning at 2:00 PM.

Call to Order

 

Members Present:

Dr. John Holman, Chairman

Nancy McDermid, Commissioner

Barry Penzel, Commissioner

Steve Thaler, Commissioner

Larry Walsh, Commissioner

Dave Nelson, Commissioner

Ron Pierini, Douglas County Sheriff

 

Staff Present:

Karen Beckerbauer, Social Services Manager

Laure Penny, Clerk to the Board

Zachary Wadle, Deputy District Attorney

PLEDGE OF ALLEGIANCE

Member Thaler led the Pledge of Allegiance.

PUBLIC COMMENT (No Action)

No public comment.

APPROVAL OF AGENDA

MOTION to approve the agenda; carried

RESULT:              APPROVED [UNANIMOUS]

MOVER:              Larry Walsh, Member

SECONDER:              Steve Thaler, Member

AYES:              McDermid, Penzel, Pierini, Thaler, Walsh, Nelson, Holman

APPROVAL OF MINUTES

MOTION to approve the Minutes of January 11, 2017; carried

RESULT:              APPROVED [UNANIMOUS]

MOVER:              Barry Penzel, Member

SECONDER:              Nancy McDermid, Member

AYES:              McDermid, Penzel, Pierini, Thaler, Walsh, Nelson, Holman

 

 

 

ADMINISTRATIVE CALENDAR

 

1.                   For possible action. Discussion on approval of Resolution #BOH2017R-001 that provides for the creation of a Committee on Health that will act as an educational and advisory body to the Douglas County Board of Health.

 

Karen Beckerbauer, Social Services Manager, read the Resolution into the record.

 

You may view the full resolution by clicking on the agenda packet link next to the Meeting title in Agenda Center.

 

Member McDermid commented that the Resolution addresses the first meeting of the calendar year but doesn't mention how often the advisory board will meet. She asked for clarification about the meeting schedule. Ms. Beckerbauer responded that they discussed holding monthly meetings initially and then on an as needed basis. Ideally, the advisory board would meet at least quarterly to allow the committee members time to prepare presentations for Board of Health meetings. Member McDermid remarked that if it’s not specified in the Resolution then it’s left up to the committee to determine their meeting schedule and asked if that was the intention of the resolution. Ms. Beckerbauer responded yes.

 

Member Thaler asked if the resolution should be amended to require the advisory committee meet at least once a year. Zachary Wadle, Deputy District Attorney, responded that the intent behind the open ended scheduling was to provide the advisory committee some flexibility. He noted that all the advisory committee meetings would be subject to the Open Meeting Law, would be noticed and the public would be made aware. Ms. Beckerbauer would have the discretion to convene the advisory committee as necessary to provide appropriate advice to the Board of Health. Member Thaler asked for clarification about the Board of Health meetings and how they would line up with the advisory committee meetings. Mr. Wadle responded initially   more meetings would be required. The concept is that the advisory committee will meet in advance of the Board of Health to provide whatever input and advice the committee feels is appropriate to help this Board make the ultimate decisions.

 

Member McDermid believes the Board of Health should schedule their meetings for the year so the advisory committee will know when to meet.  Chairman Holman agreed and confirmed that he would take care of it.

 

Member Penzel commented that he looked over the composition of the advisory committee and since one of the major elements we encounter is mosquitos and mosquito bites he suggested that somebody from the Mosquito District serve on the advisory committee. Ms. Beckerbauer responded that it was discussed, but she has not had the opportunity to reach out to them. She plans on doing so. She advised that they were not considered as part of the original makeup of the committee but that it might be relevant, especially this year.  Chairman Holman

 

stated that it would be a reasonable option to  invite a member of the Mosquito District to attend a meeting on a particular issue but maybe they wouldn’t have to

 

attend every meeting. Member McDermid concurred with Chairman Holman. Member McDermid asked for clarification on the phrase “a representative appointed by the agency” does that mean it’s a person within that agency? Ms. Beckerbauer affirmed that they wanted to get away from identifying specific individuals and rather which agencies they wanted to be represented. The idea is each of those identified agencies would appoint someone from within their   ranks to represent them on the advisory committee. Member McDermid declared that she is familiar with most of the agencies represented on the advisory committee but that she is curious as to who makes up the Environmental Health Department, Health Care Coalition and the Behavioral Task Force.  Member McDermid thought that one of the groups missing from the advisory committee is the Community Emergency Response Team (CERT). She advised that CERT volunteers are well trained and are called in all types of emergencies.  Ms. Beckerbauer informed members that the Behavioral Health Taskforce was part of the Stepping Up initiative that was brought to the Commission last February.  It is comprised of social services providers, private non-profits within the community and behavioral health providers within the community. They are a subset that came out of the Health Care Coalition which consists of all of the health care providers from birth to death. Member McDermid reiterated that other than the Sheriff’s Office, the two fire districts, and animal services the rest of the advisory committee is unknown. Ms. Beckerbauer confirmed that some of it is unknown and needs to be formulated into something more cohesive. 

 

Member Walsh emphasized that he is happy about the forming of the advisory committee and he looks forward to their input. He commended Ms. Beckerbauer on how well she crafted the language and said he supports the resolution.

 

PUBLIC COMMENT

 

Dave Fogerson, East Fork Fire District and Health Care Coalition Chairman, noted that the Health Care Coalition was born from an informal group that met to   identify community issues. He believes those meetings are how we got to where we are today with public health in Douglas County. He explained that the Health Care Coalition has built a nice organizational structure with the Board of Health at the top and what they need to do now is fill in the pieces below. Mr. Fogerson explained that what the Health Care Coalition is trying to do is provide levels of meetings so the right decision makers are at the right meetings. He emphasized that if approved, the advisory committee would be a nice step to formalize the Behavioral Taskforce and the Health Care Coalition. He closed by saying the advisory committee would give both groups a place to live and would allow them to bring information to the decision makers of the community.

 

Public comment closed.

 

MOTION to adopt Resolution BOH2017R-001; carried

RESULT:              ADOPTED [UNANIMOUS]

MOVER:              Nancy McDermid, Member

SECONDER:              Barry Penzel, Member

AYES:              McDermid, Penzel, Pierini, Thaler, Walsh, Nelson, Holman

 

2. For possible action:  Discussion to accept Title X Subgrant from Carson City Health & Human Services in the amount of $16,420. For Family Planning Services from January 1, 2017, through March 31, 2017.

Karen Beckerbauer, Social Services Manager, explained this is part of a three-year grant cycle that is renewable every year. Because Douglas County separated its clinic from Carson City Health and Human Services this subgrant represents the tail end of the financial year with the new year starting April 1, 2017.

 

Member Thaler mentioned that he looked through the scope of work very carefully and would like confirmation that this money would not be a backdoor way of funding Planned Parenthood or abortions. Chairman Holman reported that there is language in the grant that prohibits them from encouraging or providing for abortion services. He also confirmed that they are not looking to backdoor into any kind of abortion services or even recommend abortions to patients.

 

No public comment.

 

MOTION to accept Title X Subgrant from Carson City Health & Human Services in the amount of $16,420. For Family Planning Services from January 1, 2017, through March 31, 2017; carried

 

RESULT:              APPROVED [UNANIMOUS]

MOVER:              Nancy McDermid, Member

SECONDER:              Steve Thaler, Member

AYES:              McDermid, Penzel, Pierini, Thaler, Walsh, Nelson, Holman

 

3. For possible action:  Discussion to accept Title X Subgrant from Carson City Health & Human Services in the amount of $22,311. For Family Planning Services from April 1, 2017, through March 31, 2018.

Chairman Holman briefly explained that this grant starts with the new year.

 

No public comment.

 

MOTION to accept Title X Subgrant from Carson City Health & Human Services in the amount of $22,311. For Family Planning Services from April 1, 2017, through March 31, 2018; carried

 

 

RESULT:              APPROVED [UNANIMOUS]

MOVER:              Nancy McDermid, Member

SECONDER:              Dave Nelson, Member

AYES:              McDermid, Penzel, Pierini, Thaler, Walsh, Nelson, Holman

 

4. Discussion to approve and authorize County Health Officer to sign Conflict of Interest Statement for Title X grant funding.

 

Karen Beckerbauer, Social Services Manager, explained that the conflict of interest statement is a requirement of accepting the Title X grant funding. The agenda item today is asking the Board’s permission for Dr. Holman to sign the conflict of interest statement. She will do some additional research to be certain if each of the members of the Board   need to sign as well. Ms. Beckerbauer indicated that it is a basic conflict of interest statement and it is a requirement that all staff and the governing body for the clinic sign.

 

Member McDermid advised that definition C, under conflict of interest says “including a member of a governing or advisory body” so it is her assumption that the new advisory committee members would need to sign too. She read a section of the conflict of interest statement that says “a decision that may result in personal monetary or another gain for that person or a relative as a result of a business dealing” and stated that the Commissioners deal with a lot of things but this is the first conflict of interest she has ever seen. She asked if it was because it’s a federal grant.  Ms. Beckerbauer responded that was her understanding and that she will do some additional research. Member McDermid indicated that everyone should sign.

 

Member Penzel asked Ms. Beckerbauer to confirm that this item is specifically regarding Dr. Holman signing and that additional research will be completed to confirm whether or not the members of the Board of Health are required to sign as well. Ms. Beckerbauer replied that he was correct.

 

Chairman Holman described an example of a conflict related to heath care funding.   His example was a person with stock in Pfizer only stocking and prescribing Pfizer medications.   He added that because it’s federal money we have to acknowledge that we’re not going to participate in anything like that. 

 

No public comment.

 

MOTION to approve and authorize County Health Officer to sign the Conflict of Interest Statement for Title X grant funding and direct Ms. Beckerbauer to see if anybody else with regard to the Board of Health or advisory committee needs to sign the Conflict of Interest as well; carried

 

 

RESULT:              APPROVED [UNANIMOUS]

MOVER:              Nancy McDermid, Member

SECONDER:              Ron Pierini, Member

AYES:              McDermid, Penzel, Pierini, Thaler, Walsh, Nelson, Holman

 

5. Memorandum of Understanding for reciprocal backup vaccine storage between Douglas County Community Health and Premise Health @ GE Wellness Center.

Karen Beckerbauer, Social Services Manager, explained the next two items speak to a function of the Community Center.  The clinic is located in an area that has

 

experienced multiple power outages and the supply of vaccines have had to be relocated, so as not to compromise them.  The plan is to get a generator in the Community Center that will serve as backup for the kitchen as well as the laboratory where the vaccines are stored. Until a generator is purchased arrangements must be in place in case   more power outages occur.    Chairman Holman asked Ms. Beckerbauer how much money is currently tied up in the vaccine inventory.  Ms. Beckerbauer responded approximately $60,000 to $80,000.

 

Member Thaler advised that he was not aware that there was no generator at the Community Center. He mentioned that there is money in the Indigent Defense Fund Reserve and he feels the County Manager’s office could find a way to use that money to purchase a generator. Ms. Beckerbauer responded that there are funds being raised right now for the purpose of purchasing a generator and it has been ordered but, it will be a lengthy process because of the size of the unit that is required and the housing structure that will accompany it. Member Thaler asked for clarification regarding whether or not we are waiting for funds to be raised through some non-profit group. Ms. Beckerbauer advised that we are not.

 

Member McDermid concurred that getting a generator sooner rather than later is important. She believes having the MOU is the right way to go until a generator is purchased. Ms. Beckerbauer shared that when the generator is in place, smaller entities like GE, will be able to store their items with us if they have the need. She advised that it was the idea behind a reciprocal agreement between both entities.

 

Member Penzel mentioned that currently you can purchase refrigerators that are LP gas and they automatically switch from electricity to LP gas.

 

Ms. Beckerbauer explained what Douglas County Community Health has done in the interim is contracted with Buffo Electric and there are alarm monitors installed in each of the units in case there are fluctuations in temperature that fall outside the acceptable range.

 

 

No public comment.

 

MOTION to approve the Memorandum of Understanding for reciprocal backup vaccine storage between Douglas County Community Health and Premise Health @ GE Wellness Center; carried

 

RESULT:              APPROVED [UNANIMOUS]

MOVER:              Steve Thaler, Member

SECONDER:              Nancy McDermid, Member

AYES:              McDermid, Penzel, Pierini, Thaler, Walsh, Nelson, Holman

 

6. Memorandum of Understanding for reciprocal backup vaccine storage between Douglas County Community Health and Carson City Health and Human Services.

 

Chairman Holman asked Ms. Beckerbauer if this MOU will just be in place in case the MOU with GE couldn’t be used. 

Karen Beckerbauer, Social Services Manager, explained that Douglas County Community Health initially sought an agreement with Carson City Health and Human Services but they were subsequently approached by Premise Health @ GE Wellness Center to be their backup.   In light of the fact that travel through the Carson Valley can be difficult at times,  Douglas County Community Health agreed to formulate a similar agreement with GE. 

 

No public comment.

 

MOTION to approve the Memorandum of Understanding for reciprocal backup vaccine storage between Douglas County Community Health and Carson City Health and Human Services; carried

RESULT:              APPROVED [UNANIMOUS]

MOVER:              Larry Walsh, Member

SECONDER:              Dave Nelson, Member

AYES:              McDermid, Penzel, Pierini, Thaler, Walsh, Nelson, Holman

 

7. For possible action.  Discussion to approve Douglas County's enrollment in the National Association of Counties' Live Healthy program for health care and dental discounts for Douglas County residents.

Karen Beckerbauer, Social Services Manager, explained that there was a presentation at the Nevada Association of Counties (NACo) Conference about this program. Douglas County has participated in the prescription discount portion of this program since 2005. It fell by the wayside because people didn’t seem to be using it. Additional programs have been added that allow for discounted medical enrollment and dental programs. This program also allows for financial assistance

 

for items like hearing aids. It works based on an individual’s income.   If a person is within the income range they will pay a monthly fee to be a member of the program and they will also receive discounts at participating providers. The

 

County must be enrolled in the prescription program in order to participate in the health and dental program. Once we are fully enrolled in the program,     Douglas County will be reimbursed a few cents on the dollar every time a prescription card is used.

 

No public comment.

 

MOTION to approve Douglas County's enrollment in the National Association of Counties' Live Healthy program for health care and dental discounts for Douglas County residents; carried

RESULT:              APPROVED [UNANIMOUS]

MOVER:              Dave Nelson, Member

SECONDER:              Barry Penzel, Member

AYES:              McDermid, Penzel, Pierini, Thaler, Walsh, Nelson, Holman

CLOSING PUBLIC COMMENT (No Action)

No public comment.

ADJOURNMENT

MOTION to adjourn; carried

RESULT:              APPROVED [UNANIMOUS]

MOVER:              John Holman, Chairman

SECONDER:              Steve Thaler, Member

AYES:              McDermid, Penzel, Pierini, Thaler, Walsh, Nelson, Holman

 

There being no further business to come before the Board, the meeting adjourned at 2:36 p.m.

                                                                                                  Respectfully submitted:

                                                                                                                                                                                                                                                                                        ______________________________________

                                                                                                  Dr. John Holman, Chairman

                                                                                            Douglas County Board of Health

 

ATTEST:

 

_______________________________

Kathy Lewis, Clerk-Treasurer