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.