- Hello and welcome to the November 20th Board of Health regular meeting. I'm officially calling you to
- order. I really appreciate you all being there in the room because I've been sick for over a week. I'm
- going to turn off just so you know I'm going to turn off my camera and my mic unless I'm speaking because
- the coughing has just been ridiculous. So let's jump right in with approval of
- Let me find my agenda. Approval of previous meeting minutes. I make a motion to approve the meeting
- minutes for October 16th, 2025. Is there any discussion? Thank you, George. Is there any discussion? No edits?
- Since I'm virtual, we have to do a roll call vote instead of just a voice vote. Mike, how do you vote
- on this? I vote to approve. Thank you, Lisa. Hi. George. Hi. Is Lee in the room? No.
- And we don't have Steve online. Correct. Doesn't look like it does. I am also I so passes unanimously.
- Is there anyone in the room? I'm not going to bother reading the statement unless we have people who
- want to make public comment. Is there anyone in the room signed up for public comment? No. Okay.
- is there anyone online signed up for public comment who would like to make public comment? There are
- no hands. I don't see any hands either. The public comment period is for items not on the agenda. Hopefully,
- my very fuzzy brain will remember before we vote on something.
- And you guys go ahead and like, interrupt if I forget, because I'm like, I'm dopey. All right. So we
- will also allow pub brief public comment before we take a vote on our items. So just briefly, our public
- comment policy requires people speak no longer than three minutes.
- We do not allow any personal attack slurs or insults, profanity, disruptive behavior. You will be called
- out of order. You may be muted or asked to leave the room, et cetera. And that is it. So I think, hang
- on a second. I think I'm going to turn it over to Lori for her updates. And I think she probably has
- a lot of updates.
- Yes, but I tried to swim it down a little bit. So just to start off, so just found out. This week that
- the 2026 funding amount for help first Indiana state funds did slightly increase just from
- around approximately 814,000 to 826,000. But I think we all agree that will take whatever additional
- funding that.
- We are able to receive the county will receive a single direct deposit of this amount after January
- 1st of the 1st of the year. We're currently working on submitting core service data from July to October.
- This is required. So all of those for services.
- I'm working with the new administrative assistant on learning that system and how to input the information
- that can be challenging and somewhat confusing, very time consuming. But once we have someone trained
- to be able to assist with this, that'll help a great deal. All of the final core service data.
- for the year will be submitted in January and then the state will give us a report of all of the information
- that we'll be able to see broken down by each individual core service. This week, county council did
- approve the job descriptions for the three public health nurse positions and moving forward with hiring
- during the hiring freeze. So all three nurse positions have been posted at this time.
- The county facility and fleet director is working on the mobile unit purchase. So we provided specs
- from the vendor searches that we did internally. He has that information, but he's looking into other
- vendors that could maybe find a comparable model at a reduced cost. So in progress. I've spoken with
- the Indiana Department of Health vaccines for children.
- Quality assurance specialist about the transfer of services from health to the county. So this individual
- did say that this is something that they've never had to do before. So they really don't have any idea
- how easy or how challenging this process will be for us to get all of the information changed over.
- They actually would prefer that the county wait until January to order after they're able to get all
- of the information uploaded and transferred over for vaccines. So any VFC vaccine stock that we have
- during the transition will stay with IU Health and then the county would be submitting an order for
- VFC vaccine supply in January.
- I've also communicated with Vaxcare. So Vaxcare is the third party billing who we get private stock
- and they do all of the vaccine billing for us. I don't believe that we would want to terminate this
- agreement. After speaking with them, if we were to terminate this agreement, we basically would be charged
- fees for all of the vaccines that are in stock, which could be anywhere from 30 to $50,000.
- There is not a minimum administration requirement for using this service. Previously, we were concerned
- because we thought that we had to administer at least 1,000 doses. That could have been the
- case historically, but he said that that's not the case now. I just want to make sure, I guess, with
- the board that we're
- comfortable with keeping the backs care doing our public stock vaccines and our private stock and having
- that available once we take back over nursing services. So I think that sounds fine. Thank you for explaining it. Okay.
- So a little bit of information about the IU Health Agreement and requesting the equipment in exchange
- for a 30-day extension. So I heard back from County Legal, they actually believe after talking with
- the state and reviewing the grant documents and county policies that the items would have to go up for
- public sale. And so we're not sure that
- Well, we don't really think that that's going to be an option just because of the way that the county
- policy and the retention schedule is for county grant purchased items. The refrigerator, for instance,
- would have to go for sale and then you buy it? No. It's county, all of the county property,
- We can keep, but if for some reason, if we wanted to sell it or dispose of it, it has to go through
- that. So I, we, in my opinion, you certainly don't want to dispose of any of that. But if they wanted
- that, we really wouldn't be able to just provide it in exchange for the services, but,
- the equipment that IU Health wants, which is not everything. So the generator, there were some chairs.
- Those items would have to be taken through the county and go through the process of being put up for
- public sale. And then IU Health could purchase those items. So that's my understanding. I've
- been communicating with the Morgan County Health Department. So they are
- happy to work with us through this transition and help to support us with services. They are short staffed,
- so their ability would be somewhat limited, but we're actually working on seeing if we can come up with
- an inter-local agreement where they could be helping to provide some of those services during a transitional
- period. One of the suggestions that I made when speaking with them is I thought it would be
- Helpful number one, if they were to fill us at an hourly rate, that way it gives us some flexibility.
- It can kind of go around what capacity they have and what needs we have. I did also mention that I would
- want them to commit to at least a few days monthly where they would be coming
- here on site and providing vaccinations and health screenings. We would be able to use our services
- and our supplies, and then we would just be paying them an hourly rate for some of those services. So
- if they're working with their county attorney and auditor on working up an agreement, that would be
- presented to the board.
- Let's see, public health preparedness. They've had two successful medical reserve volunteer opportunities.
- They have transitioned to using the state emergency registry of volunteers for Indiana volunteer management
- system. So this is essentially the electronic registration system and database that's used for volunteers
- who want to assist during public health disasters.
- We've received a large stock of backup PPE and equipment from the Indiana Department of Homeland Security.
- Some of these items include cots, gowns, respirators, gloves. This is allowing us to replenish some
- of our older and expired PPE that we had. You might have saw some of that downstairs.
- Preparedness is also working with area schools and daycare providers, assisting them in developing and
- conducting emergency training exercises this coming spring for their faculty and staff.
- Preparedness is hosting a vehicle preparedness workshop coming up in December. This will be held in
- the lower level of the department on Friday, October 5th in the evening from 530 to 630 PM. So this
- would be a free workshop. Participants will receive a starter emergency kit for their vehicle for those
- who register and attend the workshop.
- Did you say October 5th? Oh, I might have December 5th. Sorry. It seems like those are the bags, the
- 18 bags or something that we did yesterday. Okay. All right. There is a link to register on the preparedness
- page of the website and it's being shared on social media.
- For our disease intervention services assume our newest disease intervention specialist is continuing
- with her training. She's on track to start working independently on cases in early twenty, twenty six.
- Due to the visor recall for by selling, we are only able to use our supply for pregnant patients. So
- this is making treating patients with syphilis more challenging. We did have to return over 40 doses
- that were affected by the recall and the shortage is expected to go through 2026.
- Our DIS employees, along with Positive Link staff, have started testing at an agency in Terre Haute
- that works with people experiencing homelessness. So their plan is to go every other month to offer
- testing for sexually transmitted infections, HIV and hepatitis C, to help establish connections and
- offer screenings for harder to reach and higher risk populations.
- Due to the county hiring freeze, we have been unable to fill the fourth disease intervention specialist
- position. So this is resulting in the department will be losing grant funds that support this program.
- So this is grant funding that was coming from the CDC. We have around $100,000 from that grant that
- will go unused due to not being able to
- hire for personnel costs. The Indiana Department of Health will still need to find coverage for the
- additional four counties that we had agreed to take on but are unable to do so due to that hiring freeze.
- And so we're looking to see how this may or may not impact our program in 2026. So the current grant
- ends February 26 of 2026.
- For environmental, they are preparing an educational seminar. They will be providing this for
- the Environmental Health Student Society at Indiana University in 2026. And Wastewater is planning a
- well water education day in January with the Indiana Department of Health. Some more information to
- come on that.
- And our maternal child health coordinator has partnered again with Purdue Extension to host nutrition,
- cooking and education classes for families. So that was offered this month. There were four sessions
- in total of teaching just basic nutrition, doing cooking demonstrations, incorporating some family activities
- and providing recipes for families to try making at home.
- Any questions? Where are those demonstrations given? It's at one of the libraries. The Southwest New
- Annex? That's the one with the really nice kitchen. Yeah, that's a really nice kitchen. Laurie, I have
- a question. Yes.
- And pardon me if my fuzziness, if you already said this. So we are unable to hire for the 4th TIS position
- to cover the additional counties, but I thought I heard you say we're just going to keep the money.
- Don't we have to return the money to IDOH? No, IDOH is taking money back, so they're going to be re
- issuing a grant agreement, essentially cutting the funding.
- Okay, thank you. Any other questions for Lori? Okay, we are on to old business and looks like we have
- a ton of contracts and stuff to vote on. So, Lori, I'm probably going to turn it over to you. The first
- year is the renewal of the syringe service program contract. Yes, so this is a.
- Standard agreements, so the county has been doing this since 2015. Correct since 2015. So. Not a whole
- lot of changes. There is 1 change. This is not a final contract. We are still waiting from legal, but
- just due to the nature of needing to get this approved before the end of the year.
- wanted to go ahead and put it in front of the board for approval and then the final contract income
- for ratification after that goes through our standard county processes. So not a whole lot here has
- changed. There's one addition under 3C just because the syringe service programs, there is
- discussion that those could sunset July 1st of 2026. So if that were to occur, then we would not be
- able to continue providing this service after that date. Could you help us understand why the second
- line on the next page, page three, it's beginning with insurance and running through gas? Yes.
- Is that sound? Yes.
- So a few years back, it was, it's really challenging to kind of go through receipts and expenditures
- and making sure that that's aligning with the contract terms and how the money is being spent. So we
- make the decision to just, you know, that we would ask them to just use this money for personnel costs.
- This is just updating that agreement to say that we're going to provide this funding, but you're only
- allowed to use it for personnel costs. You can't use it for any other items. Thank you. I just have
- a couple of comments about the contract. That was obviously before my time.
- The impetus for this contract initially was in 2016, well, rather in 2015, there had been a report that
- there were exponential increases in hepatitis C. And so that was the idea behind the exchange program.
- I would love to see, I know the gentleman came to speak with us before, but I would like
- if he would come again and maybe give us some data from Monroe County. A quick Google search does not
- show that we actually have data available that says what our HEPC rates were 2016 to 2024 in Monroe
- County. We can get that data. Can we get it? Okay. So I would like to kind of review that and see,
- you know, that our interventions are making a difference.
- My other concern is that now we're in a scenario where we have so many needles in our community that
- are posing a public health threat, if you will, to children and workers for the city and the county.
- And whether or not that's directly related to this or not, I don't know.
- but I feel like that that in some fashion needs to be addressed and that's probably a multi, it's probably
- a task force kind of question where the city or the county officials come and I don't know if they meet
- with the Indiana Center for Recovery. So for instance, my one question would be when do clients actually
- bring, they brought 50 needles
- they hand those in for proper disposal and then they get 15 needles. Is that exactly what's happening?
- No, we, we asked Dick that when he was here last time and he answered, I can't remember his answer right
- now, but that's been, and he's planning on coming in December, but Kathy, I guess you can.
- I think that it's not like when you started this to do it in a need space model, not a one-for-one.
- They say that one-for-one actually puts people more at risk. So they ask people, they're supposed to
- go through it with everybody. How many syringes can you eat? So you can have a good syringe for each
- of the use. And then that's what they're supposed to do. So that's the best practice and that's what
- they are. Lisa, can I ask you to cite your sources
- on what you just said about all these needles in the community. I haven't heard that at all anywhere.
- So I would be interested in where you got that information. Sure. So in today's social media world,
- there's just so many concerns. And certainly, I've been out and about in the community. So there are
- some concerns at the parks.
- And also in waterways and areas, especially near the Shalom Center, where there's just sort of piles
- of needles and actually business owners are going out themselves, putting on, you know, big thick gloves
- and picking that stuff up because they don't want, you know, their client, their people who are coming
- to their businesses, they don't want that.
- either being seen or they don't want them at risk. And so it's a, it's a, it's an issue and it's, I
- feel like it's an issue. It's a public health issue and I feel like we need to address that. I think
- that's important. It's occurring. It's an, it's an issue and it's a public health issue. I haven't,
- like I say, I have not heard it's occurring. I haven't seen any media reports on it.
- I will not put any credence in anything that occurs on social media, frankly. I also want to apologize
- to you because, well, to everybody. Laurie and I in putting together the agenda for this meeting, we
- discussed having a presentation from these folks at this meeting as well as IU Health.
- and we decided to put that off till December because we've had so many things to vote on tonight. So
- otherwise, otherwise it would have happened. Sure. I can say the health department, we take calls from
- the public and they, people can call in at any time or report needles and our employees, all of them
- are trained in
- they'll go out. So if individuals reach out to us, we respond the best that we can and we do go pick
- up ones that we know about. That's really good to know. Thank you. Really good to know. When this program
- was first initiated, that was a public concern at that time. And that was one of the things that we
- came up with is that our own employees would respond.
- and it seemed to be that the problem became lesser. There are instances, I guess, of like really large
- and maybe you can just give an example of this where it's not something that our employees can go out
- and address, but for the most part, the majority of the calls really may go out. You don't have the
- capacity to do the camps. Yeah, that's what we've been.
- We can't believe that any other problem that if they call, we sent staff out as soon as possible or
- that day. I'm thinking of it. Nobody's got to it yet. We do it as quickly as we can. Any other board
- comments or questions on this contract? Sarah has a comment.
- Okay, so two things. One is that within the city's parks, at least the ones that I visit, there are
- boxes for syringe disposal, and those seem to work very well. I walk around the parks and I do not see
- needles. I'll often see the little orange caps, but I don't see the needles running around, which is great.
- Something that came up at council was that on IU's campus, they had difficulty, you know, individuals
- perhaps with diabetes who have syringes had no way of disposing of them easily. So I happened to meet
- with someone from IU's safety department who does risk
- And I suggested to her that risk and safety, this is a real issue. And she promised me that she would
- go up the chain and see what we can do to increase the number of boxes and availability of boxes for
- syringes on IU's campus since neither the city nor the county can do that on their own. So that is also
- being addressed
- and I hope that that will make council members and perhaps commissioners happy that indeed we are doing
- our part to try and ameliorate that difficulty. Thank you. Any other comments or questions about this contract?
- If not, can I get a motion? Okay, I move to approve the contract. Could I make a motion that we approve
- or we have the report next month and then vote to approve it? It sounds like Lori has a deadline to get it.
- That's why we're doing it tonight. Is that correct, Laurie? Yes, unless the board hosted a special session
- in the beginning of December. Yeah, let's not do that. This is just a renewal. They're going to give
- us a report. They've never, never, in my experience, not given us what we asked for. We can just invite
- them to the meeting in December and they will come.
- I mean, you can go ahead and make a motion. Go ahead and make a motion for that if you like. I thought
- we had a motion on the floor. Yes. And I'll second that motion. Maybe I didn't hear it. What's the motion?
- You made the motion. I made the motion. Thank you. Yes, you do. So we have a motion on the floor. We
- have a second to the motion. Yes.
- You guys don't need me. I'm going to go to bed. You guys don't need me. Okay. Kay, what's your vote?
- Yes. Okay, George. George. Aye. Mike. Aye. Lisa. Aye. And I'm an aye.
- So Linnea and Laurie, if you could just make a note to yourself to ask them to come talk to us in December,
- that would be great. And then if we could get, if you could also ask someone to prepare the hepatitis
- C data that Lisa requested, that would also be awesome. Yes. Thank you. Next one, renewal of agreement
- with Health Net.
- So last year when we were transitioning into Health First Indiana, this was a partnership agreement
- that we started with Health Net. So the core service deliverable is addressed at access and linkage
- to clinical care. So this is just a renewal. So the only changes that have been made is the time period.
- In addition, under number 2F, under reporting and metrics, so information has been added just because
- of the compliance with Health First Indiana and insurance funds are used for Indiana residents who are
- lawful and present. Information has been added to this contract to ensure that those funds are being
- spent according to that
- change in the legislation. Let's see I did invite Melissa here today to answer any questions or if she
- wants to provide just a brief summary of some of the success that they've seen for the program. Yeah
- and I'll say Kay Wiles is also she's the director of our Health Net Homelessness program she's on as well but
- Yeah, I'm Melissa Burgess. I'm the coordinator for our health net hip street medicine team here in Wilmington
- and very grateful for your support over the past year. We, with your funding, we were able to begin
- our evening clinics at Wheeler Mission. So our street medicine team consists of two family
- nurse practitioners, one psychiatric family nurse practitioner, four street outreach case managers,
- and myself. So with this then starting in January, we
- started at Wheeler on Tuesday evening and Thursday evenings, really with the goal of hoping to reduce
- emergency runs, but also just be able to connect folks to care, the unhoused community. So, to date,
- since the beginning, we have held 51 clinics and we have
- had 69 patient visits. So some of the services that we provide are the MSC, the mental status exams
- with our psychiatric family nurse practitioner, doing vitals, bridging prescriptions, doing a lot of
- wound care, and just relationships. So helping people will know that we're there. And we're also there,
- we have clinics on Tuesday and Thursday mornings, but the goal of Tuesday and Thursday evenings with
- this funding is
- begin to be a resource available to folks to help reduce those emergency departments. So I've been really
- excited about the results. We have tried to get ambulance runs, but we don't have access to that data
- to see if we have to reduce it. But I think just the impact of having that many clinics and seeing that
- many patients this year has been
- Been pretty impactful. We also through this, then have established now a relationship with emergency
- department. So we actually are going into the emergency department a couple of mornings with the support
- of this as well to.
- identify kind of the most visited patients. So those frequent flyers that continue to go to the emergency
- department, again, it's all kind of connected, you know, whether they're at the shelter or they're literally
- on the streets. So the whole goal of street medicine is to meet people where they are. And so meeting
- them in the hospital, helping to build that relationship and then reduce those visits as well. But that's
- a quick snapshot and happy to answer any questions or K as well.
- Given that you're dealing with an unhoused population, how do you comply with the requirement that these
- be Indiana or U.S. citizens? No, we... I'm sorry, it's a new requirement. It's a contract. That was
- not in your last year's contract. That would be new for this year. That was a good question maybe going forward.
- I know there's a form that will submit with, we will complete with every person that we encounter to
- verify that they are a resident and be able to submit that documentation. We also use as mandatory,
- it's the homeless management information system per HUD for all of our services. So we document that
- and we are as well. Thank you. Okay. I would like to,
- just mentioned, thank you first of all for your report and thank you for your great work. We're very
- excited. We were always very excited about this, but one of the things that we as a board had a question
- about before we started the con was, and I see that Amy Meek is on here and I don't know, she probably
- doesn't have this information right at her fingertips, but I'll ask her anyway. What we wanted to know
- was if we could,
- establish how many of these folks were going to the emergency department between five and nine, which
- we understood was the critical time period. And so that we could track the results of what it was you
- guys were doing in an actual reduction in ED visits. And I still, I don't believe we've ever seen the
- data. Amy, do you have any
- Any sense of of that? And I'm also glad to hear that you're actually going and working with those folks
- in the emergency department. That's a great idea. Amy's unmuted. Yeah, so I'm driving because I wasn't
- planning on talking on this meeting. Sorry.
- I mean, that's information I don't recall you asking us to get, but we track that. So we have it, we
- have a dashboard we track it in. But it's not something I have to present to you here, no. Dawn,
- you're muted. Thank you. Then Lori, if we could take whatever steps
- We need to, since Amy has that information on a dashboard to find out the number of ED visits among
- the homeless if they can identify it that way between five and nine PM before we started this contract
- and now so that we could just understand that would be great. Yes. Thank you. So I'm curious, Melissa,
- Are those 69 individual patients or patient encounters? So they could be duplicate visits. So because
- of the way that we encounter that, because some patients are seen multiple times. But I can drill that
- down. Yeah, I was just curious. Because when I heard 69, I was like, yeah, but are those individual
- visits or individuals themselves? Yeah, yeah. It's not the actual individuals. It's the patient visits.
- So some do have to be.
- Okay, thanks. And that's over what period of time again? From January 7th up until Tuesday night. Oh,
- no, I'm sorry. I don't have that. That is until September 30th. This is just a report of three. For
- nine months. On those Tuesdays and Thursdays. And we are there from 5 to 8. Thank you. Thank you very
- much. Any other?
- You can assume those 69 visits are people we have kept out of the emergency program. Both from
- the psychiatric side as well. That's great. Any other questions or discussion? Okay. Are we ready to
- go? I motion to approve
- the agreement with the Health Net Homeless Initiative Program. I second that motion. Okay, motion and
- second. Lisa, how do you vote? I. Mike. I. A. I. George. I. I am also an I.
- Passes unanimously. Next item of business. Oh, can I point out that on these votes you have not asked
- for? Yes. And yes, let me say right. In our design. We can it's it's. I'm just going necessary. Yes,
- I forgot to do it because it's so new.
- I am forgetting. Why don't we pause right here? I didn't see any hands up though. So let me get back
- to the meeting. Do we have any hands up of anyone that would like to make a comment on either of those votes?
- There's no hands. Okay. Thank you. Thank you, Sarah. All right. Next item fee schedule updates. Lori.
- Thank you. Sorry. The schedule updates. So we have made some changes here proposing to.
- and make some increases in our vital records. And so the price of birth and death certificates hasn't
- changed since 2015. Of course, as we all know, costs for supplies, postage, shipping, employee salaries
- have increased. In addition, we have also added one full-time employee to our vital records just recently.
- And so these increased costs were really just
- We haven't compensated for that over the past 10 years. So we're just looking at trying to update some
- of our fees now. Statewide certificate price ranges go anywhere from $8 to $25 for a birth certificate
- and $10 to $30 for a death certificate. This price increase will put our death certificates at the state average.
- and our birth certificates will be a little bit above the state average. One additional change is bringing
- back the smaller birth certificate. So this was discontinued in April of 2024 when some changes were
- made, but there's really a lot of feedback from the public that they would really desire having this
- option back for the smaller birth certificate.
- Questions or thought on that our director of vital records is here and happy to comment. These are questions
- I just want to say that I think that's extremely expensive for the death certificates because I just
- recently found out that many people have are requested to have five or six of them. To you know when
- someone in the family dies and they're trying to get all the arrangements in order.
- That they sometimes have to request a large number. We are within the state average. Can I ask like
- ballpark? You may not have these right with you of like, how many of these are we giving? Like.
- how many birth certificates, how many death certificates, what are the numbers we'll want to have here?
- They're listed in the county report. All right, in the report. The county commissioners. So, we have
- the expert. Yeah, so I have a three-year average sales for birth certificates is 5,078, and a three-year
- average for death certificates for the year 8,471.
- And what is your sense if you can tell us to case point how many people needing death certificates request
- multiple copies at one time? Yeah, to be honest, most of them buy them through the funeral home. At
- the time everything is going on and I know they're still paying this price, but it's. Included with
- everything they're doing at the funeral home. Individually, we.
- don't get a lot of walk-ins for these. Like I said, they're either getting them to the funeral home
- or they're finding out several years later, oh, I forgot about this bank account or I forgot he was
- on this card title and they're coming in for maybe one or two. Thank you. They come down from the funeral
- home. The funeral home buys them from us. Oh, okay. So they send us orders daily for
- I need 10 for Mr. So-and-so, I need three for Ms. So-and-so." Family tells them how many they need.
- Funeral Home orders them from us and then comes, pays us, picks them up. They do not charge more than
- we charge. Whatever they pay us is what they charge the customer. They order multiple sometimes. Yes.
- Some people, for example, maybe somebody who's very wealthy or prominent may have
- tons of property or things they do. Social security requires them. Veterans do get a free one for veterans
- use only. Thank you. Thank you. Thank you. Any other questions? Can I have a motion? Make a motion to
- approve the
- Department updated, department fees. This is for 2026 event. We'll just put it into one of the events.
- So I make a motion to approve updated. I'll second it. Thank you. I'm going to remember. Do we have
- any hands online events?
- Anyone that would like to make a public comment about the fee increase before we vote? There are no
- hands. Thank you, Linnea. Okay, Mike? Aye. Lisa? Aye. George? Aye. Kay? Aye. I'm also an aye. Passes
- unanimously.
- Uh, ratification of job description modifications. I believe that this pertains to the changes that
- was made to the, to the new, the new, new position and the revisions on the other two. Is that correct?
- Laurie? Um, my understanding is can maybe a few of the changes before she sent them to whisk, uh, just
- to make sure that, uh, so well, number one, the nurses could not have the same title.
- So we had to modify that so that there were three different titles. And then just to make sure that
- there was consistent language in the requirements. Any other changes with those that we should be aware
- of? Not to my knowledge.
- One there are their health and wellness coordinator was changed to just public health nurse. And then
- the one that's focusing on school liaison that was added after public health nurse and then the communicable
- disease. So that gave them three different titles. Thank you. Any questions on this discussion?
- All right. Can I have a motion?
- I move that we approve the modified job descriptions as submitted. I second. Thank you. Is there any
- public comment on the job descriptions? Please raise your hand online. No hands. Thank you. All right,
- Lisa. Bye.
- George. Hi. Okay. Hi. Mike. I'm going to pass this unanimously. Okay. New business. We are discussing
- an MOU with Centerstone. Lori. Yes. So a few months back,
- Myself and Dr. Pritchard went and met with Centerstone about the possibility of working with them to
- meet some of our core service requirements under Health First Indiana. So, chronic disease is one of
- the areas that we've really been trying to address. And we have a large stock of blood pressure monitors
- that we are able to provide.
- to those in need. So that was one of the areas that we discussed with Centerstone. Is this a need that
- their patient population is seeing that could benefit? And this was something that they were interested
- in working with us on. So essentially if they have patients that they identify as having hypertension
- and without a way to monitor and check that at home,
- that this could be provided in agreement. The patient would be agreeing to submitting baseline information
- and then reporting on two other blood pressures within the yearly time period so that we could just
- continue to collect data over time. They'd also be providing zip codes of the recipient, age of the
- recipient. Let's see.
- They would be letting us know the reason for providing the blood pressure monitor and be giving us that
- information as well as collecting and ensuring that the blood pressure monitors are going to Indiana
- residents locally present in the United States. So they will be completing that paperwork and submitting
- that paperwork for our internal records as well.
- So this is just an agreement that essentially we would be providing blood pressure monitors to Centerstone
- for patients that they identify at no cost. Right, and that's why it's an MOU and not a contract, because
- we're not giving them money. Right? Yes. Questions, discussion?
- Um, I, I don't. Okay. Thank you. We have a large, uh, we have a large stock and, uh, with not having
- the behavioral health and wellness program anymore, this still will ensure that we are addressing chronic
- disease and looking on that. So more of a comment than anything, um, just for future reference, uh,
- there will be a internal medicine residency program.
- starting in Bloomington in July of this year. Residency training programs are usually managing patients
- that are generally high need. So just put on the radar if we have other things that we can potentially
- do. That'll be starting in July of this coming year through the IU School of Medicine, IUL. It'll be
- initially located, it's a primary care residency, initially located kind of on the west side
- And there will have 6 residents starting, so it would be a nice thing to potentially volunteer and help
- with as well. Other comments or questions about the. Okay, can I get a motion? I'll make a motion to
- approve the memorandum of understanding. Between the. Department and center staff.
- I will second that motion. Mike, how do you vote? Aye. Lisa? Public comment. Oh, sorry. Public comment.
- Sorry, sorry, sorry. Public comment. Anyone want to make a comment on this? Please raise your hands
- online. There are no hands. Thank you. Okay. Now, Mike, how do you vote? I still vote aye.
- Okay, Lisa. Hi, George. Hi. Okay. Hi. I vote I pass this unanimously. Looks like our last item of business.
- Who will eventually local agreement with Morgan County Health Department.
- Yes, so I wanted to get this on the agenda again, just because of the timing that we're looking at.
- And so I would be seeking approval that I could go ahead and move forward once we're able to work out
- an interlocal agreement with Morgan County to help us during the transition for nursing services and that that
- Could be brought back to the board of health for ratification, depending on the planning of the next
- board meeting and when we would need to get that through county approvals. I think Laurie already gave
- us information on this and answered questions, but are there any other questions before we. Before we do this.
- So Lauren, you're asking not for a vote on something specific. You're asking us to authorize you to
- continue working to create this agreement, right? Well, we would want approval that the county could
- approve the interlocal agreement and then the board could ratify that to approve it after the fact if need be.
- Okay. I'm thinking of how, go ahead, George. I don't know how we say the motion. Go ahead. Lori's effort
- to craft or explore an interlocal agreement with Morgan County to support our efforts as an apartment.
- I second the motion. Is there any public comment on this? Please raise your hand online. I have a question.
- Does that meet what you need, Lauren? I'm not sure. I think the county can approve it because
- my understanding is an
- I'm still trying to learn about the interlocal agreements, but it can be a little, there's some time
- consumed with that on the county side. And just because of the urgency of, we would be trying to get
- this, that I could take it through the commissioners for approval. Just at the board's direction, at
- the board, our direction too. Yes. That if you're okay with that, that I could take it,
- to the board of commissioners for approval and then provide an update and the Board of Health could
- then approve and ratify that after the fact. Just running into December and meetings and timelines.
- So does George need to modify his motion or do we need to start over? You can modify it or you can withdraw
- it and have a fresh motion at the table.
- I'm not sure it needs modification. It was an endorsement by the board of support of the efforts of
- Lori to pursue the interlocal agreement with Morgan County. And I guess the other part of it is we need
- to say that that can go then before the commissioners. Is that the piece you're missing? That would
- be my assumption. Yes. OK.
- I would accept that as a friendly amendment. Thank you. Thank you. Are you good, Linnea? Yeah,
- I got it. Okay. Now, is there any public comment? Okay. Mike, how do you vote? Aye. George? Aye. Kay? Aye.
- Lisa. Aye. And I am an aye. Passes unanimously. Do we have any board member or health officer comments?
- I would just briefly remind the board that that we periodically should review our fee schedule because
- As we noted earlier in the case of the vital records fees, they hadn't changed since 2015. And if we
- make small incremental changes, they're more likely to be accepted by the public and appear to be reasonable
- and be reasonable if they're reviewed regularly and are adjusted as needed.
- So maybe we ought to think about scheduling such a review. Every three to five years, maybe. I'm not
- sure exactly when or where. I thought we had a schedule, didn't we? Yeah, there is one where they rotate,
- right? The codes that go for review, the wheel. Can you explain the wheel? Years ago, there was a set
- up so that certain codes get reviewed on different years. So you would check.
- based on the year you would check the different codes and then every code got reviewed every couple
- of years. But does that include reviewing the code fees at the same time? Yeah, if fees are included,
- I think they were looking at some of them this year. As I recall, it was every other year. Most of that
- the fees are in environmental or federal records. So maybe with the one for, I'm sorry,
- Maybe with the one for vital records, maybe it was reviewed on schedule and the review said we don't
- need to raise it every time it was reviewed. There were changes made and was that 2022? It was right
- when you came. So yeah, we raised one fee for the home birth registration, but
- And I wasn't interested in so we apparently thought the others weren't there at the time, but.
- It's been. Kind of a crazy few years since then, so a lot of lot of prices have increased for the supplies
- and the paper and all of that kind of thing. So I thought we'd look at it again. But we also have that's
- good food inspection fees and a variety of others that are.
- Something we should consider. Yeah, environmental has made a few changes and Mike, the director
- of environmental actually brought a change that he wanted to their food fees and I told him it was a
- little too late because it was just yesterday and this was already. Just yesterday. So it'll have to wait.
- And yes, the only thing I wanted to add was that Laura alluded to the relationship between the ice and
- positive Lincoln terrible. I spoke with TIS yesterday and although we had instructed when I sat on the
- board for our previous health officer to pursue checking.
- or getting DIS into our county jail, I'm going to be pursuing that as a, as something that the board
- wanted to do last year and really it never quite came to fruition. So at the moment I realized the jail
- folks are really kind of tied up with just trying to deal with the new justice
- center and what is going on between the council and commissioners in that purview. However, our relationship
- with PositiveLink makes it more of an opportunity for us to be able to do HIV testing along with our
- other DIS testing in the jail and at least have HIV meds provided for six months
- for the folks who test HIV positive. So I think that should take some of the onus off of our testing
- in the jail and make it a bit easier. The only other thing I would add is that when our public health
- nurses were in there vaccinating, they were well received, had an excellent relationship with the inmates
- as well as
- the jailers and with the nurses who care for the imprisoned. I think all the way around, this might
- work out much better than we had anticipated. I'm confused and I don't know if anyone remembers when
- we talked about this, like Sarah said, maybe a year ago.
- I thought we resolved this question when it was identified that there was an agency that was funded
- who was going into our jail and I think a couple other jails to provide testing. And we just. That fell
- apart because that group that I think was a faith based group going in then stopped
- at our jail. So that relationship ended. That's the information I didn't have. Because I thought that
- was still happening. I thought that was still happening. Information to the state, and they had never
- done that. Yeah, whatever it was, they pulled out. Yeah. OK. OK. That makes sense. Thank you, Sarah.
- Any other comments?
- All right. Can I have a motion to adjourn? Motion to adjourn. I'll second. Okay. Let's have a roll call
- vote on this because everybody's, everybody's aye. But Mike, how do you vote? Aye. George? Aye. Okay.
- Aye. Lisa? Aye. Happy Thanksgiving. I am also aye.
- Everybody have a good Thanksgiving. I will see you in December.