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.