WEBVTT 00:00:00.386 --> 00:00:08.959 - Okay, I would like to call the October 7th, 2025 special session of the New York County Board of Health 00:00:08.959 --> 00:00:17.202 - to order. We're meeting tonight just to talk about the revisions to some position descriptions that 00:00:17.202 --> 00:00:25.774 - we need to vote on before the county council's meeting next Tuesday. But we have an emergency item that 00:00:25.774 --> 00:00:26.846 - just came up 00:00:27.010 --> 00:00:34.613 - that Professor Hagman informed us about, and it has to do with, you have a handout there, urban forestry 00:00:34.613 --> 00:00:42.070 - is applying for a grant from the Indiana Department of Natural Resources having to do with emerald ash 00:00:42.070 --> 00:00:49.383 - borers, and we don't have to write anything, all we have to do is verbally support the position, but 00:00:49.383 --> 00:00:53.438 - I'm going to turn it over to George, who is our expert. 00:00:54.306 --> 00:01:05.153 - Well, very briefly, it's simply a resolution which says that we support the application of the Bloomington 00:01:05.153 --> 00:01:15.392 - Urban Forester to do proposed work, including evaluating existing ash trees, recalling the ones that 00:01:15.392 --> 00:01:23.198 - are ill and need to be removed and are a danger, and then thirdly, replacing 00:01:23.394 --> 00:01:32.724 - with native trees of other kinds so that the urban canopy remains more or less as it is now, maybe even 00:01:32.724 --> 00:01:42.054 - improved a little bit. Trees don't seem to be a health item in the larger scheme of things, but I think 00:01:42.054 --> 00:01:50.846 - that if you consider their role in a few things that I pointed to there, urban heat environments, 00:01:51.458 --> 00:01:59.972 - controlling stormwater, a variety of other things. It would be worthwhile at least adding our two cents 00:01:59.972 --> 00:02:08.322 - in a positive way to this grant application. It costs us nothing and it may bring some funds our way, 00:02:08.322 --> 00:02:16.591 - which will have good public health effects. Thank you. Discussion or questions for George on this? I 00:02:16.591 --> 00:02:20.766 - just had never heard of the quote, urban forestry. 00:02:20.962 --> 00:02:30.044 - Well, he used to be called the city forester. Is a person? Oh yeah. It's not a group? No, there is a 00:02:30.044 --> 00:02:39.126 - tree commission which advises the urban forester and the guy's name is Pesky Smith. Okay. And he's a 00:02:39.126 --> 00:02:48.478 - guy who comes out when you have a tree fall in the road or you have a park tree that has a misadventure 00:02:48.478 --> 00:02:50.366 - or plants new trees. 00:02:50.818 --> 00:02:59.067 - where they need to be planted, and it's possible to do that. Very cool. He's going to do the city, though. 00:02:59.067 --> 00:03:06.930 - He doesn't handle the county? No, this is not county. This is the city. But of course, the effect is, 00:03:06.930 --> 00:03:14.948 - since the city's in the county, a county-wide effect as well. I would know that we approve the proposed 00:03:14.948 --> 00:03:20.190 - resolution as written in this handout. I second. All in favor? Aye. 00:03:20.386 --> 00:03:27.413 - Any opposed? Thank you very much. Thank you for bringing this to our attention. Thank you for being 00:03:27.413 --> 00:03:34.511 - here. Thank you. I appreciate you doing that. So we're going to move on to, I think that you all are 00:03:34.511 --> 00:03:41.890 - aware from our last a couple of meetings, because as of January 1st, we will no longer have the contract 00:03:41.890 --> 00:03:47.582 - with IU Health Community Health to provide public health nursing services, which 00:03:48.354 --> 00:03:56.769 - consists of communicable disease case investigations required by state law of every local health department, 00:03:56.769 --> 00:04:04.490 - as well as providing vaccinations for low income people who need vaccinations, many times children. 00:04:04.490 --> 00:04:12.442 - Doing tuberculosis case investigations, that's part of the communicable disease function and lead case 00:04:12.442 --> 00:04:18.078 - investigations. Again, part of the legally mandated communicable disease 00:04:19.170 --> 00:04:26.401 - functions. So we are proposing to the County Council and the reason we're having this meeting tonight 00:04:26.401 --> 00:04:33.845 - is because we need to vote to approve these job descriptions so that they can go to the Council at their 00:04:33.845 --> 00:04:41.006 - next Tuesday meeting. Usually this would have been done by their PAC, their personnel committee, but 00:04:41.006 --> 00:04:46.110 - they have disbanded PAC temporarily and the full Council is going to be 00:04:46.626 --> 00:04:54.668 - reviewing these on Tuesday, and we hope that they pass so that we can get them to WIS, which is a whole 00:04:54.668 --> 00:05:02.401 - other time delay, but we have no choice about it. And so we're really gonna be behind the egg balls 00:05:02.401 --> 00:05:10.212 - if we don't get moving on this. I made, because we've talked about this, but it changed somewhat. It 00:05:10.212 --> 00:05:14.078 - didn't change substantively. The details changed. 00:05:14.562 --> 00:05:23.459 - Sarah, Lori, Lisa, and I have been working on these frantically. So what you see is our collective wisdom. 00:05:23.459 --> 00:05:31.858 - Hopefully, it's wisdom. And I want to just go through this with you so that you understand before we 00:05:31.858 --> 00:05:40.339 - discuss it. So we have an existing position, the Director of Health Services, which is close to being 00:05:40.339 --> 00:05:43.998 - filled. Sorry, George, do you want to move? 00:05:44.162 --> 00:05:52.608 - Yes, we do. OK. You can take my chair if you want. That's at a PATD level. This position will supervise 00:05:52.608 --> 00:06:00.892 - these positions that we're proposing because they're all providing health services, so it made sense. 00:06:00.892 --> 00:06:09.744 - So you will see in your packet a revision for this position that has already been passed through everything. 00:06:09.744 --> 00:06:12.830 - OK, this is existing, already passed. 00:06:13.506 --> 00:06:21.838 - but we had to revise its duties slightly to include supervision of these three. So that's the reason 00:06:21.838 --> 00:06:30.087 - for the revisions there. This is our new position, so brand new. This will be funded with the money 00:06:30.087 --> 00:06:39.078 - that we will not be paying IU Health under the contract in January. We are making all these, we're proposing 00:06:39.078 --> 00:06:43.038 - all these be past C positions. We are requiring 00:06:43.426 --> 00:06:50.419 - a nursing degree and a license because we want them to be able to give injections. So treatment for 00:06:50.419 --> 00:06:57.761 - antibiotics for sexually transmitted diseases, anything else that might come up as well as vaccinations. 00:06:57.761 --> 00:07:04.894 - So this is the new position. We're calling each of them public health nurses, which is what they are. 00:07:06.242 --> 00:07:13.453 - Lori got some public health nurse job descriptions from other local health departments, and she just 00:07:13.453 --> 00:07:20.736 - copied a whole lot of the language because it made great sense, right? We didn't have to reinvent the 00:07:20.736 --> 00:07:27.876 - wheel. So this primary position is called public health nurse communicable disease. That's what the 00:07:27.876 --> 00:07:36.158 - CD is. This person will have lead responsibility for communicable disease investigations. So interviewing patients, 00:07:36.482 --> 00:07:44.896 - doing contact tracing, making sure those patients have been adequately treated, getting those contacts 00:07:44.896 --> 00:07:52.411 - tested and treated as needed, putting all the data into NBS, which is the state's database, 00:07:52.411 --> 00:08:01.069 - which is required. So this is the lead. And then these other two positions are already existing positions 00:08:01.069 --> 00:08:04.990 - in the health department. So these are not new. 00:08:06.722 --> 00:08:15.039 - This position formally was titled Behavioral Health and Wellness. We're changing the title just to Public 00:08:15.039 --> 00:08:23.121 - Health Nurse. This position is currently vacant. As is this position currently vacant, it was formally 00:08:23.121 --> 00:08:31.125 - called COVID-19 School Liaison. So you're going to see those in your packets as well. We have changed 00:08:31.125 --> 00:08:36.382 - the duties so that they can provide school health liaison services 00:08:36.610 --> 00:08:44.844 - which is one of the things that will be lost due to the contract expiring with IU Health. And they will 00:08:44.844 --> 00:08:53.079 - support this position. So if there's a disease outbreak, which we hope there never is, these folks will 00:08:53.079 --> 00:09:01.630 - be surge capacity. They will be able to help. They can help do vaccine outreaches, medication distribution. 00:09:02.306 --> 00:09:11.733 - whatever you can think of that we might need to take care of in an emergency, they're going to be back 00:09:11.733 --> 00:09:20.976 - up. And so you will see those duties in the existing. And a whole lot of this has changed. The title 00:09:20.976 --> 00:09:30.494 - of this has changed. What questions do you have? How do you historically observe therapy in the device? 00:09:31.010 --> 00:09:39.566 - DOT would be led by this physician. And my sense is, I mean, this is something we don't know yet, but 00:09:39.566 --> 00:09:48.123 - unless we had a TB outbreak, I think the volume of patients that we'd need to monitor who were on DOT 00:09:48.123 --> 00:09:56.595 - could be handled by this physician. But if not, if we had an outbreak, somebody throw some salt over 00:09:56.595 --> 00:10:00.286 - your shoulder or something, these two folks 00:10:00.514 --> 00:10:07.529 - would be trained to step in. Yeah. Yeah. So this, uh, this path C level is that we were worried before 00:10:07.529 --> 00:10:13.862 - that we weren't going to offer enough money to attract a nurse. We believe we looked at the, 00:10:13.862 --> 00:10:20.809 - at the numbers. We believe this salary will be healthy enough to get a nurse. Lori and Sarah are away 00:10:20.809 --> 00:10:27.687 - at a, at a local health department bootcamp training right now. So I don't have Lori to specifically 00:10:27.687 --> 00:10:29.662 - ask, but I have been assured 00:10:30.370 --> 00:10:38.401 - that that question has been looked at in the answer to our satisfaction. Other questions? I presume 00:10:38.401 --> 00:10:46.593 - from a budget perspective, two existing positions without that contract that supports the other ones. 00:10:46.593 --> 00:10:54.785 - We're really good from a budget perspective. So just you might not be aware, but IU Health, when they 00:10:54.785 --> 00:10:58.078 - were doing all of these services for us, 00:10:58.338 --> 00:11:06.084 - They employed, they had three FTE public health nurses doing this. We will have one FTE public health 00:11:06.084 --> 00:11:13.829 - nurse about 0.25, 0.25, and 0.25. So basically we're going to be doing, we're proposing to do it with 00:11:13.829 --> 00:11:21.423 - 1.75 FTEs, what we previously had been purchasing at three FTEs. So there will be money, there will 00:11:21.423 --> 00:11:28.030 - be money to do this. There may be money left over, but there will be money to do this. 00:11:28.578 --> 00:11:38.613 - Okay. So, like I say, we spent such a long time doing this. I hope you guys are okay with it. Yeah, 00:11:38.613 --> 00:11:48.950 - it was great. Thank you. You're welcome. You're very welcome. Thanks to, you know, Lisa and Laurie and 00:11:48.950 --> 00:11:57.982 - Sarah, because it was rough. But we got it done. We feel real good about what's in there. 00:11:58.530 --> 00:12:06.041 - We think it's comprehensive. We think it's going to meet the needs. And especially when you remember 00:12:06.041 --> 00:12:13.700 - that our health is still going to be in the vaccine business. So we're hoping that's not a huge volume 00:12:13.700 --> 00:12:21.285 - for us, but we're prepared for this. Yeah, the only concerns I had was the previous scope of practice 00:12:21.285 --> 00:12:25.598 - we talked about, which has been resolved with the nurses. 00:12:26.082 --> 00:12:34.234 - And the other was whether we had enough money to attract quality nurses. And it sounds like we actually 00:12:34.234 --> 00:12:42.307 - cut some FTE, which is amazing. So I think we're good. I do not have any public comment on the agenda. 00:12:42.307 --> 00:12:50.223 - But since we're doing good with time, if there is anybody on the meeting virtually who would like to 00:12:50.223 --> 00:12:54.142 - make a comment on this topic, only on this topic, 00:12:54.722 --> 00:13:03.295 - of the position revisions. You could raise your hand and we'll see if we'll see if our technology works. 00:13:03.295 --> 00:13:11.787 - Unlike the county council whose technology seems to never work. Okay, I do not see any hands for public 00:13:11.787 --> 00:13:20.442 - comment. Question, do we need to vote on each of these separately or from the negatively similar package? 00:13:20.442 --> 00:13:22.238 - Do you have any idea? 00:13:22.850 --> 00:13:32.076 - If Laurie were here, I would turn to Laurie and say, what do we need to do? We have voted as packages 00:13:32.076 --> 00:13:41.121 - before. I think we should do it individually. So I am good with that. Can I ask one question first? 00:13:41.121 --> 00:13:42.206 - Absolutely. 00:13:42.434 --> 00:13:48.767 - There's three public health nurses. I'm just trying to figure out one of them in here says the ability 00:13:48.767 --> 00:13:55.284 - to analyze, evaluate, observe, diagnose, and investigate. I'm interested in the diagnose question. Please 00:13:55.284 --> 00:14:01.555 - tell me. It is on page five of the public health nurse that used to be behavioral health and wellness 00:14:01.555 --> 00:14:05.182 - coordinator. Okay. Hang on. Hang on. I'll get right there. 00:14:05.634 --> 00:14:13.511 - And I reviewed these beforehand and that was the only question that I had on any of them. And is that 00:14:13.511 --> 00:14:21.389 - the only position that you're saying. Yes. On page five. Page five it is kind of right down where did 00:14:21.389 --> 00:14:29.343 - I find it. But it's not in red. Yes it's not in red. So it's here. Okay let me let me back up. If it's 00:14:29.343 --> 00:14:30.270 - not in red. 00:14:30.658 --> 00:14:37.641 - That is not a revision we are suggesting. That's part of the existing job description that has already 00:14:37.641 --> 00:14:44.488 - been approved. Because this is an existing job description, the old behavior health and wellness, as 00:14:44.488 --> 00:14:51.335 - well as the COVID-19. So the only revisions we made are things that you're going to see appearing in 00:14:51.335 --> 00:14:58.046 - red. This one is completely black because this is our new one. There was nothing to revise, right? 00:14:58.434 --> 00:15:06.937 - So this guy, this guy is the outlier. The language about diagnosis is not going to be in the current 00:15:06.937 --> 00:15:15.861 - paper. Well, it's already in there. It's already in there. Somebody has already approved it. It's already 00:15:15.861 --> 00:15:24.280 - been through. It's not correct. Yeah, it could get us in hot water. It could be. That was my point. 00:15:24.280 --> 00:15:26.974 - Because nurses cannot diagnose. 00:15:27.202 --> 00:15:35.780 - Well, I rhetorically ask, I wonder how it got through. Well, I wondered if behavioral health and wellness 00:15:35.780 --> 00:15:44.358 - coordinator, if this was like a psychologist or an MS or something like that. And if it's a psychologist, 00:15:44.358 --> 00:15:52.855 - a psychologist could provide psychiatric diagnoses in counseling. How hard would it be for you to remove 00:15:52.855 --> 00:15:54.878 - this work, like do a red 00:15:54.978 --> 00:16:11.175 - Okay. Shall we vote on that? Yes. So I would move that we remove the diagnose word from this job description. 00:16:11.175 --> 00:16:24.574 - Go ahead a second. All in favor? Aye. Any opposed? Okay, motion passes. So it's page five. 00:16:25.218 --> 00:16:34.172 - right there on the old behavioral health and wellness. It's right there. Since we're on this one, and 00:16:34.172 --> 00:16:43.038 - we're going to do this individually, does someone want to make a motion to pass this one as amended? 00:16:43.038 --> 00:16:52.958 - Karen, I've got another thing that bothers me. On this job description? Well, this one? OK, we're going to this. 00:16:53.378 --> 00:17:01.656 - Is that what we're on? No. It doesn't matter. It's on almost all of them. OK. OK. What does it say? 00:17:01.656 --> 00:17:10.017 - Well, this one, particularly, it says under requirements. That's one of the things that bothered me. 00:17:10.017 --> 00:17:18.378 - Position requires a nursing license. OK. Now, when they talked before, when we met last meeting, our 00:17:18.378 --> 00:17:23.262 - health officer made comments about hiring an LPN, correct? 00:17:24.194 --> 00:17:32.912 - possibly in one of these positions, they do not have a license. They have what's called certificate 00:17:32.912 --> 00:17:42.328 - when they graduate. And if it's going to be has an Indiana license, it should be an active Indiana license. 00:17:42.328 --> 00:17:51.046 - I think that should be added. It requires an active Indiana nursing license. Are you writing? Okay. 00:17:51.046 --> 00:17:52.702 - Linnea is writing. 00:17:53.250 --> 00:18:01.637 - I would ask, although you're saying an LPN doesn't get a license. They don't have, they get a license 00:18:01.637 --> 00:18:10.270 - but when they, credentials, they don't have a license. The wording that you suggest, would that prohibit 00:18:10.270 --> 00:18:18.903 - an LPN? No. Okay. That's what I just wanted to make sure. If we say, position requires an active Indiana 00:18:18.903 --> 00:18:22.110 - nursing license. And I'm going to ask, 00:18:22.466 --> 00:18:33.554 - Could you please make that change to the old behavioral health awareness? LDS have a nursing license, 00:18:33.554 --> 00:18:44.533 - but when they graduate, there's some place here it says degree nursing. Yeah. Right. They don't have 00:18:44.533 --> 00:18:48.990 - a degree. They have a certificate. Yeah. 00:18:49.090 --> 00:19:01.051 - and on the new one as well. I just want them all to be consistent. The one that we don't have to change 00:19:01.051 --> 00:19:12.782 - is the health services director, because again, that's already been approved. All we're changing here 00:19:12.782 --> 00:19:18.302 - is that they're going to supervise these folks. 00:19:18.402 --> 00:19:28.062 - and oversight. All of them should say the same thing as Kay said it. Do you need her to say it again? 00:19:28.062 --> 00:19:37.816 - Okay, so I want to be clear. So on the behavioral health and wellness coordinate, public health nurse, 00:19:37.816 --> 00:19:46.718 - it says a nurse degree and Indiana license are required. So that means they have to be in our 00:19:47.298 --> 00:19:55.465 - That's right. Right. So is that what they want? But an LPN would have an associate's degree. No, 00:19:55.465 --> 00:20:04.052 - they do not. They do a certificate. They have a nursing certificate. But Ivy Tech has a program. They 00:20:04.052 --> 00:20:12.556 - have a two-year RN program and a one-year LPN program. An LPN is a one-year program. OK. So we would 00:20:12.556 --> 00:20:15.166 - need to remove. Are you ready? 00:20:16.706 --> 00:20:26.945 - from the behavioral health and wellness, remove the thing that says nursing degree, and just let it 00:20:26.945 --> 00:20:37.388 - say what you're already going to put in about the active and the analysis. And then we'll be sharing. 00:20:37.388 --> 00:20:45.374 - Yes. So for the COVID-19, that's marked out, public health measures. On page. 00:20:45.538 --> 00:20:53.350 - Oh, yeah, it's the same thing. Your job requirements of the old COVID school health liaison make it 00:20:53.350 --> 00:21:01.397 - the same. So take out nursing degree, retired and insert active Indiana nursing offices. And then what 00:21:01.397 --> 00:21:09.210 - about on the new one? On the new one, as it now says position requires a nursing license, we should 00:21:09.210 --> 00:21:14.366 - just make it say what the same thing that you're putting into it. 00:21:23.298 --> 00:21:31.923 - Thanks. So do you, I just want to make sure so for the health services director. Yes. It says, and this 00:21:31.923 --> 00:21:40.382 - is not a change, but it says nursing degree from accredited institution and Indiana license required. 00:21:40.382 --> 00:21:48.841 - And that person is an R. This is an R and this is a different level. Absolutely. And this has already 00:21:48.841 --> 00:21:52.158 - been approved. So we're good with that. 00:21:55.074 --> 00:22:06.627 - Now, if anybody would like to make a motion. I will motion that we approve the public health 00:22:06.627 --> 00:22:19.671 - nurse communicable diseases position with the already discussed amendments tonight as otherwise written. 00:22:19.671 --> 00:22:23.646 - All in favor? Aye. Any opposed? 00:22:24.322 --> 00:22:37.551 - Okay, we have passed the public health nurse communicable diseases. Who would like to go next? Okay, 00:22:37.551 --> 00:22:50.910 - so I move on the public health nurse position that we approve the proposed changes in red. Which one? 00:22:51.458 --> 00:23:02.130 - The one that used to be behavioral health and wellness coordinator. But also that we approve the language 00:23:02.130 --> 00:23:12.902 - change for job requirements and that that will say instead of a nurse degree and Indiana license required, 00:23:12.902 --> 00:23:14.110 - it will say 00:23:14.882 --> 00:23:24.191 - and Indiana license. And active Indiana nursing license. Otherwise, we'll get an auto mechanic. You 00:23:24.191 --> 00:23:34.058 - understand? OK. I second that motion. All in favor? Aye. Aye. Any opposed? OK, so we've passed the former 00:23:34.058 --> 00:23:43.646 - behavioral health and wellness coordinator position. Next up. And that includes the elimination of the 00:23:43.646 --> 00:23:44.670 - diagnosing 00:23:45.122 --> 00:24:00.130 - Yes, yes. Okay, so for, let's see, for the job description, formerly COVID-19, changing that to public 00:24:00.130 --> 00:24:14.846 - health nurse, I make a motion to change the description as with the items in red. And the amendment. 00:24:15.074 --> 00:24:24.476 - Nice discussed. And the amendment on your job requirements. Do I have a second? I second. All in favor? 00:24:24.476 --> 00:24:33.878 - Aye. Any opposed? Okay, the former COVID-19 has been passed. So all we have left is the Health Services 00:24:33.878 --> 00:24:40.478 - Director, which just had those supervisory responsibilities stuck in it. 00:24:43.938 --> 00:24:53.987 - I motion to approve the Health Services Director position with the read additional responsibilities 00:24:53.987 --> 00:25:04.238 - as discussed. All in favor? Aye. Any opposed? Okay, we've done our business. Thank you. Can I ask one 00:25:04.238 --> 00:25:06.750 - question? Well, you can. 00:25:06.882 --> 00:25:16.343 - I'm looking at this required 35 hours of annual online training, including mental health, suicide prevention, 00:25:16.343 --> 00:25:25.287 - nutrition, infectious diseases, and chronic disease. What job description are you on? Oh, I'm on public 00:25:25.287 --> 00:25:33.888 - health nurse. That used to be what? COVID-19. Okay. Okay. I'm just thinking of availability. Are we 00:25:33.888 --> 00:25:36.382 - sure that that is available? 00:25:37.250 --> 00:25:45.998 - Yeah. Oh, yeah. It's on in-train. That's what I'm asking. Is it free? Oh, yeah. OK. Yeah, yeah. Because 00:25:45.998 --> 00:25:54.410 - on in-train. Yeah. From what it looked like to me, I'm starting to put together a training plan for 00:25:54.410 --> 00:26:02.990 - Lori. All of the training modules on communicable disease case investigation are also on in-train. So 00:26:02.990 --> 00:26:05.598 - we're going to be fine. Right. 00:26:07.746 --> 00:26:20.062 - Yay. OK. Thanks, guys. Anybody want to adjourn? All in favor? Aye. Thank you. Thanks so much for coming.