- Okay, I would like to call the October 7th, 2025 special session of the New York County Board of Health
- to order. We're meeting tonight just to talk about the revisions to some position descriptions that
- we need to vote on before the county council's meeting next Tuesday. But we have an emergency item that
- just came up
- that Professor Hagman informed us about, and it has to do with, you have a handout there, urban forestry
- is applying for a grant from the Indiana Department of Natural Resources having to do with emerald ash
- borers, and we don't have to write anything, all we have to do is verbally support the position, but
- I'm going to turn it over to George, who is our expert.
- Well, very briefly, it's simply a resolution which says that we support the application of the Bloomington
- Urban Forester to do proposed work, including evaluating existing ash trees, recalling the ones that
- are ill and need to be removed and are a danger, and then thirdly, replacing
- with native trees of other kinds so that the urban canopy remains more or less as it is now, maybe even
- improved a little bit. Trees don't seem to be a health item in the larger scheme of things, but I think
- that if you consider their role in a few things that I pointed to there, urban heat environments,
- controlling stormwater, a variety of other things. It would be worthwhile at least adding our two cents
- in a positive way to this grant application. It costs us nothing and it may bring some funds our way,
- which will have good public health effects. Thank you. Discussion or questions for George on this? I
- just had never heard of the quote, urban forestry.
- Well, he used to be called the city forester. Is a person? Oh yeah. It's not a group? No, there is a
- tree commission which advises the urban forester and the guy's name is Pesky Smith. Okay. And he's a
- guy who comes out when you have a tree fall in the road or you have a park tree that has a misadventure
- or plants new trees.
- where they need to be planted, and it's possible to do that. Very cool. He's going to do the city, though.
- He doesn't handle the county? No, this is not county. This is the city. But of course, the effect is,
- since the city's in the county, a county-wide effect as well. I would know that we approve the proposed
- resolution as written in this handout. I second. All in favor? Aye.
- Any opposed? Thank you very much. Thank you for bringing this to our attention. Thank you for being
- here. Thank you. I appreciate you doing that. So we're going to move on to, I think that you all are
- aware from our last a couple of meetings, because as of January 1st, we will no longer have the contract
- with IU Health Community Health to provide public health nursing services, which
- consists of communicable disease case investigations required by state law of every local health department,
- as well as providing vaccinations for low income people who need vaccinations, many times children.
- Doing tuberculosis case investigations, that's part of the communicable disease function and lead case
- investigations. Again, part of the legally mandated communicable disease
- functions. So we are proposing to the County Council and the reason we're having this meeting tonight
- is because we need to vote to approve these job descriptions so that they can go to the Council at their
- next Tuesday meeting. Usually this would have been done by their PAC, their personnel committee, but
- they have disbanded PAC temporarily and the full Council is going to be
- reviewing these on Tuesday, and we hope that they pass so that we can get them to WIS, which is a whole
- other time delay, but we have no choice about it. And so we're really gonna be behind the egg balls
- if we don't get moving on this. I made, because we've talked about this, but it changed somewhat. It
- didn't change substantively. The details changed.
- Sarah, Lori, Lisa, and I have been working on these frantically. So what you see is our collective wisdom.
- Hopefully, it's wisdom. And I want to just go through this with you so that you understand before we
- discuss it. So we have an existing position, the Director of Health Services, which is close to being
- filled. Sorry, George, do you want to move?
- Yes, we do. OK. You can take my chair if you want. That's at a PATD level. This position will supervise
- these positions that we're proposing because they're all providing health services, so it made sense.
- So you will see in your packet a revision for this position that has already been passed through everything.
- OK, this is existing, already passed.
- but we had to revise its duties slightly to include supervision of these three. So that's the reason
- for the revisions there. This is our new position, so brand new. This will be funded with the money
- that we will not be paying IU Health under the contract in January. We are making all these, we're proposing
- all these be past C positions. We are requiring
- a nursing degree and a license because we want them to be able to give injections. So treatment for
- antibiotics for sexually transmitted diseases, anything else that might come up as well as vaccinations.
- So this is the new position. We're calling each of them public health nurses, which is what they are.
- Lori got some public health nurse job descriptions from other local health departments, and she just
- copied a whole lot of the language because it made great sense, right? We didn't have to reinvent the
- wheel. So this primary position is called public health nurse communicable disease. That's what the
- CD is. This person will have lead responsibility for communicable disease investigations. So interviewing patients,
- doing contact tracing, making sure those patients have been adequately treated, getting those contacts
- tested and treated as needed, putting all the data into NBS, which is the state's database,
- which is required. So this is the lead. And then these other two positions are already existing positions
- in the health department. So these are not new.
- This position formally was titled Behavioral Health and Wellness. We're changing the title just to Public
- Health Nurse. This position is currently vacant. As is this position currently vacant, it was formally
- called COVID-19 School Liaison. So you're going to see those in your packets as well. We have changed
- the duties so that they can provide school health liaison services
- which is one of the things that will be lost due to the contract expiring with IU Health. And they will
- support this position. So if there's a disease outbreak, which we hope there never is, these folks will
- be surge capacity. They will be able to help. They can help do vaccine outreaches, medication distribution.
- whatever you can think of that we might need to take care of in an emergency, they're going to be back
- up. And so you will see those duties in the existing. And a whole lot of this has changed. The title
- of this has changed. What questions do you have? How do you historically observe therapy in the device?
- DOT would be led by this physician. And my sense is, I mean, this is something we don't know yet, but
- unless we had a TB outbreak, I think the volume of patients that we'd need to monitor who were on DOT
- could be handled by this physician. But if not, if we had an outbreak, somebody throw some salt over
- your shoulder or something, these two folks
- would be trained to step in. Yeah. Yeah. So this, uh, this path C level is that we were worried before
- that we weren't going to offer enough money to attract a nurse. We believe we looked at the,
- at the numbers. We believe this salary will be healthy enough to get a nurse. Lori and Sarah are away
- at a, at a local health department bootcamp training right now. So I don't have Lori to specifically
- ask, but I have been assured
- that that question has been looked at in the answer to our satisfaction. Other questions? I presume
- from a budget perspective, two existing positions without that contract that supports the other ones.
- We're really good from a budget perspective. So just you might not be aware, but IU Health, when they
- were doing all of these services for us,
- They employed, they had three FTE public health nurses doing this. We will have one FTE public health
- nurse about 0.25, 0.25, and 0.25. So basically we're going to be doing, we're proposing to do it with
- 1.75 FTEs, what we previously had been purchasing at three FTEs. So there will be money, there will
- be money to do this. There may be money left over, but there will be money to do this.
- Okay. So, like I say, we spent such a long time doing this. I hope you guys are okay with it. Yeah,
- it was great. Thank you. You're welcome. You're very welcome. Thanks to, you know, Lisa and Laurie and
- Sarah, because it was rough. But we got it done. We feel real good about what's in there.
- We think it's comprehensive. We think it's going to meet the needs. And especially when you remember
- that our health is still going to be in the vaccine business. So we're hoping that's not a huge volume
- for us, but we're prepared for this. Yeah, the only concerns I had was the previous scope of practice
- we talked about, which has been resolved with the nurses.
- And the other was whether we had enough money to attract quality nurses. And it sounds like we actually
- cut some FTE, which is amazing. So I think we're good. I do not have any public comment on the agenda.
- But since we're doing good with time, if there is anybody on the meeting virtually who would like to
- make a comment on this topic, only on this topic,
- of the position revisions. You could raise your hand and we'll see if we'll see if our technology works.
- Unlike the county council whose technology seems to never work. Okay, I do not see any hands for public
- comment. Question, do we need to vote on each of these separately or from the negatively similar package?
- Do you have any idea?
- If Laurie were here, I would turn to Laurie and say, what do we need to do? We have voted as packages
- before. I think we should do it individually. So I am good with that. Can I ask one question first?
- Absolutely.
- There's three public health nurses. I'm just trying to figure out one of them in here says the ability
- to analyze, evaluate, observe, diagnose, and investigate. I'm interested in the diagnose question. Please
- tell me. It is on page five of the public health nurse that used to be behavioral health and wellness
- coordinator. Okay. Hang on. Hang on. I'll get right there.
- And I reviewed these beforehand and that was the only question that I had on any of them. And is that
- the only position that you're saying. Yes. On page five. Page five it is kind of right down where did
- 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
- not in red.
- That is not a revision we are suggesting. That's part of the existing job description that has already
- been approved. Because this is an existing job description, the old behavior health and wellness, as
- well as the COVID-19. So the only revisions we made are things that you're going to see appearing in
- red. This one is completely black because this is our new one. There was nothing to revise, right?
- So this guy, this guy is the outlier. The language about diagnosis is not going to be in the current
- paper. Well, it's already in there. It's already in there. Somebody has already approved it. It's already
- been through. It's not correct. Yeah, it could get us in hot water. It could be. That was my point.
- Because nurses cannot diagnose.
- Well, I rhetorically ask, I wonder how it got through. Well, I wondered if behavioral health and wellness
- coordinator, if this was like a psychologist or an MS or something like that. And if it's a psychologist,
- a psychologist could provide psychiatric diagnoses in counseling. How hard would it be for you to remove
- this work, like do a red
- Okay. Shall we vote on that? Yes. So I would move that we remove the diagnose word from this job description.
- Go ahead a second. All in favor? Aye. Any opposed? Okay, motion passes. So it's page five.
- right there on the old behavioral health and wellness. It's right there. Since we're on this one, and
- we're going to do this individually, does someone want to make a motion to pass this one as amended?
- Karen, I've got another thing that bothers me. On this job description? Well, this one? OK, we're going to this.
- Is that what we're on? No. It doesn't matter. It's on almost all of them. OK. OK. What does it say?
- Well, this one, particularly, it says under requirements. That's one of the things that bothered me.
- Position requires a nursing license. OK. Now, when they talked before, when we met last meeting, our
- health officer made comments about hiring an LPN, correct?
- possibly in one of these positions, they do not have a license. They have what's called certificate
- when they graduate. And if it's going to be has an Indiana license, it should be an active Indiana license.
- I think that should be added. It requires an active Indiana nursing license. Are you writing? Okay.
- Linnea is writing.
- I would ask, although you're saying an LPN doesn't get a license. They don't have, they get a license
- but when they, credentials, they don't have a license. The wording that you suggest, would that prohibit
- an LPN? No. Okay. That's what I just wanted to make sure. If we say, position requires an active Indiana
- nursing license. And I'm going to ask,
- Could you please make that change to the old behavioral health awareness? LDS have a nursing license,
- but when they graduate, there's some place here it says degree nursing. Yeah. Right. They don't have
- a degree. They have a certificate. Yeah.
- and on the new one as well. I just want them all to be consistent. The one that we don't have to change
- is the health services director, because again, that's already been approved. All we're changing here
- is that they're going to supervise these folks.
- and oversight. All of them should say the same thing as Kay said it. Do you need her to say it again?
- Okay, so I want to be clear. So on the behavioral health and wellness coordinate, public health nurse,
- it says a nurse degree and Indiana license are required. So that means they have to be in our
- That's right. Right. So is that what they want? But an LPN would have an associate's degree. No,
- they do not. They do a certificate. They have a nursing certificate. But Ivy Tech has a program. They
- have a two-year RN program and a one-year LPN program. An LPN is a one-year program. OK. So we would
- need to remove. Are you ready?
- from the behavioral health and wellness, remove the thing that says nursing degree, and just let it
- say what you're already going to put in about the active and the analysis. And then we'll be sharing.
- Yes. So for the COVID-19, that's marked out, public health measures. On page.
- Oh, yeah, it's the same thing. Your job requirements of the old COVID school health liaison make it
- the same. So take out nursing degree, retired and insert active Indiana nursing offices. And then what
- about on the new one? On the new one, as it now says position requires a nursing license, we should
- just make it say what the same thing that you're putting into it.
- Thanks. So do you, I just want to make sure so for the health services director. Yes. It says, and this
- is not a change, but it says nursing degree from accredited institution and Indiana license required.
- And that person is an R. This is an R and this is a different level. Absolutely. And this has already
- been approved. So we're good with that.
- Now, if anybody would like to make a motion. I will motion that we approve the public health
- nurse communicable diseases position with the already discussed amendments tonight as otherwise written.
- All in favor? Aye. Any opposed?
- Okay, we have passed the public health nurse communicable diseases. Who would like to go next? Okay,
- so I move on the public health nurse position that we approve the proposed changes in red. Which one?
- The one that used to be behavioral health and wellness coordinator. But also that we approve the language
- change for job requirements and that that will say instead of a nurse degree and Indiana license required,
- it will say
- and Indiana license. And active Indiana nursing license. Otherwise, we'll get an auto mechanic. You
- understand? OK. I second that motion. All in favor? Aye. Aye. Any opposed? OK, so we've passed the former
- behavioral health and wellness coordinator position. Next up. And that includes the elimination of the
- diagnosing
- Yes, yes. Okay, so for, let's see, for the job description, formerly COVID-19, changing that to public
- health nurse, I make a motion to change the description as with the items in red. And the amendment.
- Nice discussed. And the amendment on your job requirements. Do I have a second? I second. All in favor?
- Aye. Any opposed? Okay, the former COVID-19 has been passed. So all we have left is the Health Services
- Director, which just had those supervisory responsibilities stuck in it.
- I motion to approve the Health Services Director position with the read additional responsibilities
- as discussed. All in favor? Aye. Any opposed? Okay, we've done our business. Thank you. Can I ask one
- question? Well, you can.
- I'm looking at this required 35 hours of annual online training, including mental health, suicide prevention,
- nutrition, infectious diseases, and chronic disease. What job description are you on? Oh, I'm on public
- health nurse. That used to be what? COVID-19. Okay. Okay. I'm just thinking of availability. Are we
- sure that that is available?
- Yeah. Oh, yeah. It's on in-train. That's what I'm asking. Is it free? Oh, yeah. OK. Yeah, yeah. Because
- on in-train. Yeah. From what it looked like to me, I'm starting to put together a training plan for
- Lori. All of the training modules on communicable disease case investigation are also on in-train. So
- we're going to be fine. Right.
- Yay. OK. Thanks, guys. Anybody want to adjourn? All in favor? Aye. Thank you. Thanks so much for coming.