WEBVTT 00:00:00.866 --> 00:00:12.119 - call the meeting to order for today. Is that acceptable, Ann? I want to add the vote on whether or not 00:00:12.119 --> 00:00:23.482 - we can add a couple of agenda items. The first one is actually a little different than the item we have 00:00:23.482 --> 00:00:29.054 - on the agenda. It says clinical office assistance. 00:00:30.082 --> 00:00:41.124 - What I actually want to address is a and and job a job description for the clinical assistant position 00:00:41.124 --> 00:00:51.844 - so that we can send that in a timely fashion to the Council, hopefully for approval. So that we can 00:00:51.844 --> 00:00:59.134 - have staffing. OK, so if I could get someone and more, do you have? 00:00:59.330 --> 00:01:11.878 - copies of that. We had that updated one. Yeah, so this one. Oh, OK, perfect. OK, great. It's in the 00:01:11.878 --> 00:01:24.677 - left side of your folder that. So there are four of them, but I just put them in here. So. Did I have 00:01:24.677 --> 00:01:28.190 - a motion for that? So move. 00:01:30.274 --> 00:01:46.705 - And anyone second? Second. OK, so we'll add that to the agenda. Aye. Aye. I'm voting number two. Aye. 00:01:46.705 --> 00:01:58.142 - OK. And then the second item to add is for an update from Kathy Hewitt 00:01:58.818 --> 00:02:09.425 - regarding the state changes, the state law changes for the needle exchange program. So if I could have 00:02:09.425 --> 00:02:20.135 - a motion, a verbal motion for that. I'm so sorry. Where would you put that? Number five, we'll put that 00:02:20.135 --> 00:02:27.550 - as number five. This job description specifically is number four. Well, 00:02:28.226 --> 00:02:38.651 - or just replace number three on the job? Well, no. It's a separate thing, actually. So anyway, number 00:02:38.651 --> 00:02:49.077 - four will be the job description that we just approved. And number five would be an update from Kathy 00:02:49.077 --> 00:02:57.662 - Hewitt. So I need a motion for that. So moved. I'll second that. All in favor? Aye. 00:02:59.426 --> 00:03:11.869 - Okay. So I do want to welcome Dr. Kevin Moore. He was approved by the commissioners. He is an ER physician. 00:03:11.869 --> 00:03:23.390 - So welcome. Next on the agenda, we have approval of the previous minutes. Those were from December, 00:03:23.390 --> 00:03:26.846 - 2025. December, he goes 18th. 00:03:30.018 --> 00:03:42.523 - December 18th, 2025. Does anyone have any changes to the minutes? I move that we accept the minutes 00:03:42.523 --> 00:03:55.402 - as written. I will second. All in favor? Aye. All right. So regarding general public comments that I'm 00:03:55.402 --> 00:03:57.278 - going to read, 00:03:57.762 --> 00:04:05.627 - The Monroe County Board of Health encourages and welcomes public input. Written comments may be submitted 00:04:05.627 --> 00:04:13.196 - at any time via email at boardofhealth.co.munroe.in.us. During meetings, comments related to specific 00:04:13.196 --> 00:04:20.393 - agenda items will be heard after the board's discussion of that item and prior to taking a vote. 00:04:20.393 --> 00:04:27.294 - At this time, we would like to invite those who would like to comment on any non-agenda item 00:04:27.810 --> 00:04:35.302 - to speak. For those attending in person, please sign in at the front of the room and those joining us 00:04:35.302 --> 00:04:42.795 - online. Please use the raise hand feature to indicate you would like to provide comment. Each speaker 00:04:42.795 --> 00:04:50.140 - will have three minutes and we ask that you please begin by stating your name for the record. Do we 00:04:50.140 --> 00:04:57.118 - have any hands? Okay, seeing no hands and no one in the room for public comment will continue. 00:04:59.426 --> 00:05:10.954 - Oh, excellent. We get department updates from Lori Kelly. We have quite a few, I think. So we'll just 00:05:10.954 --> 00:05:23.838 - start off with vital records. So vital records has actually been tracking data related to the legislative changes 00:05:23.970 --> 00:05:32.006 - that we saw with Health First Indiana and how those funds can only be used for Indiana residents lawfully 00:05:32.006 --> 00:05:39.662 - present in the United States. So an example of that in February, 80% of the customers going to vital 00:05:39.662 --> 00:05:47.319 - records did have a real ID or they could otherwise provide identification to confirm their residency 00:05:47.319 --> 00:05:50.654 - and lawful presence. 20% were out of state. 00:05:50.850 --> 00:05:59.435 - individuals or otherwise had to rely upon our non-HFI funded employee to be able to provide and complete 00:05:59.435 --> 00:06:07.612 - those services. So we'll continue just kind of tracking some of this information department-wide to 00:06:07.612 --> 00:06:15.870 - see how it's impacting us because we don't have a non-HFI employees in every area of the department. 00:06:16.034 --> 00:06:22.886 - which is putting us into a situation where we then have to turn those individuals away. We have two 00:06:22.886 --> 00:06:29.806 - employees in Vital Records who need to complete their online training in order to keep their Indiana 00:06:29.806 --> 00:06:36.657 - notary license. So they'll be doing that. The cost is pretty inexpensive. It's just $50. So they're 00:06:36.657 --> 00:06:37.822 - working on that. 00:06:38.882 --> 00:06:47.402 - with harm reduction. Our harm reduction specialist is working with the city on outreach for naloxone 00:06:47.402 --> 00:06:56.258 - training and distribution, trying to really focus on businesses and training staff for some of our local 00:06:56.258 --> 00:07:05.200 - businesses here. She's also completing certified peer support professional training and will be certified 00:07:05.200 --> 00:07:07.646 - once she completes the exam. 00:07:07.810 --> 00:07:16.124 - So in Indiana, these professionals use that experience with this formal training. It's essentially to 00:07:16.124 --> 00:07:24.439 - help connect, inspire change, and support individuals for people who are going through their recovery 00:07:24.439 --> 00:07:32.753 - process. Planning is underway for the biannual Monroe County Substance Use Disorder Awareness Summit. 00:07:32.753 --> 00:07:34.302 - It's a large work. 00:07:34.914 --> 00:07:42.842 - This event is going to take place September 1st and 2nd at the Convention Center. So they're looking 00:07:42.842 --> 00:07:50.848 - at selecting speakers for two different tracks. So one track would be an all-day national speaker who 00:07:50.848 --> 00:07:57.598 - comes in and actually surveys the community prior to the event, does some evaluation. 00:07:57.698 --> 00:08:06.412 - and then he shares what he has learned about drug trends in the area and nationally. The second track 00:08:06.412 --> 00:08:15.125 - will have multiple speakers who are focused on providing information on recovery and resilience, drug 00:08:15.125 --> 00:08:23.070 - trends and changes, how drugs are made and how that's impacting communities and individuals. 00:08:25.314 --> 00:08:34.073 - I have submitted the letter of intent to apply for grant funding that does support the salary expensive 00:08:34.073 --> 00:08:42.748 - of our harm reduction specialist. The award period, it's going to be 12 months and would run from June 00:08:42.748 --> 00:08:46.622 - 1st of this year to through May 31st of 2027. 00:08:46.978 --> 00:08:55.372 - That grant application, again, will be focused on this individual providing HIV testing, harm reduction, 00:08:55.372 --> 00:09:03.687 - and support services for the Syringe Service Program. Harm reduction and disease intervention are still 00:09:03.687 --> 00:09:11.761 - working on providing the drop-in testing services to the public and for free. So looking at starting 00:09:11.761 --> 00:09:16.798 - that in April. So free testing will be offered one day a week. 00:09:16.930 --> 00:09:26.317 - during some of the evening hours for HIV, HCV and STIs. Public health emergency preparedness. There 00:09:26.317 --> 00:09:36.361 - were 37 individuals in the public trained and stops the bleed during February. They are looking at hosting 00:09:36.361 --> 00:09:43.870 - monthly preparedness trainings for the public. Some of the topics would include 00:09:44.034 --> 00:09:53.303 - preparing for power outages, emergency communications, vehicle preparedness, and building emergency 00:09:53.303 --> 00:10:02.664 - kits. Transitioning more into our health services, disease intervention specialists, that next grant 00:10:02.664 --> 00:10:05.630 - application has been submitted. 00:10:05.762 --> 00:10:13.891 - So we are hoping to receive just under $300,000, which would continue to support our three full-time 00:10:13.891 --> 00:10:22.100 - disease intervention specialist positions and related expenses such as mileage, technology, supplies. 00:10:22.100 --> 00:10:26.526 - When will we know when we get it? If we get it or not. 00:10:27.234 --> 00:10:36.246 - Hopefully within the next month. So there was a little bit of a delay. So because we lost that grant 00:10:36.246 --> 00:10:45.793 - funding, because we could not get approval for the additional position with the grant funding, our renewal 00:10:45.793 --> 00:10:55.518 - was delayed. So they actually had to amend that grant to extend that so then they could reduce the money and 00:10:55.682 --> 00:11:04.858 - Now, so we're kind of behind, so we hope to know within the next month. Laura, can you help us understand, 00:11:04.858 --> 00:11:13.949 - originally the grant was for the two positions and then we added more because of the state's requirements 00:11:13.949 --> 00:11:22.610 - and requests to us. So we've gone back to three and it seems to be working very nicely here. Will we 00:11:22.610 --> 00:11:24.926 - have to go back to council 00:11:25.666 --> 00:11:33.609 - not only once we've got the letter, but once we actually have the funding in order to support those 00:11:33.609 --> 00:11:41.553 - positions. Well, the county commissioners will have to approve the new grant and then it will go to 00:11:41.553 --> 00:11:49.735 - council and council will have to approve the funds and the appropriation for all of those lines or the 00:11:49.735 --> 00:11:55.454 - personnel. So do we expect the same kind of prolonged delay that we had 00:11:55.554 --> 00:12:04.835 - between the letter and the actual funding after July 1st, which means then we have to go to council 00:12:04.835 --> 00:12:14.487 - and hope that they will indeed approve those positions. And in the interim, do those positions continue 00:12:14.487 --> 00:12:18.942 - to work? I mean, how does that work out for us? 00:12:19.394 --> 00:12:27.532 - The idea is that we hope there's not any issues with those positions because there is still some leftover 00:12:27.532 --> 00:12:35.363 - funding from the grant that actually ended at the end of February. So that was when it was originally 00:12:35.363 --> 00:12:43.270 - going to end. So even with the reduction of the $58,000 roughly, we still had some extra funds, again, 00:12:43.270 --> 00:12:48.414 - just because of those long delays where we couldn't hire and fill. 00:12:48.610 --> 00:12:57.600 - So they've amended that to extend that we can continue using those funds until 2027. And in this time 00:12:57.600 --> 00:13:06.678 - period also we'll be getting a new contract for the grant cycle that we should have started March 1st. 00:13:06.678 --> 00:13:15.668 - So basically we're covered and even if council delays approval of utilization of that funding for the 00:13:15.668 --> 00:13:16.638 - positions, 00:13:16.930 --> 00:13:23.884 - we should still be okay and that DIS can continue their work. That's how we are currently operating. 00:13:23.884 --> 00:13:30.839 - Okay, great. Thank you. Can I ask a question about the Stop the Bleed program that we have? We train 00:13:30.839 --> 00:13:37.724 - individuals from the community for that. How does that go about? How does it happen? Do you want to 00:13:37.724 --> 00:13:43.646 - talk about that? Sure. Okay, yeah. So I'm the director of public health preparedness. 00:13:43.778 --> 00:13:51.375 - So Bryce is our emergency preparedness coordinator, and he offers the certified staff of leading training 00:13:51.375 --> 00:13:58.541 - to either individuals who request it, we do phones to classes here, or the library, for example, if 00:13:58.541 --> 00:14:06.138 - anybody would like to sign up, it's free of charge. We also work with organizations to train their staff, 00:14:06.138 --> 00:14:12.158 - channels for their coaches or personal trainers, as well as going into the schools. 00:14:12.482 --> 00:14:18.007 - The Girl Scouts. Yeah, Girl Scouts and Boy Scouts. And we do offer blade control kits to the people 00:14:18.007 --> 00:14:23.533 - who participate in this training. Some of them are something to start with. And where do those kits 00:14:23.533 --> 00:14:29.555 - come from? Those kits come from the Stop the Bleed organization. So it is what they recommend. Penistatives, 00:14:29.555 --> 00:14:35.246 - an alternative, things like that. Do we pay for them? Yes, they are covered by our preparedness grant. 00:14:35.246 --> 00:14:40.606 - OK, but is there a reason I'm asking this? Because I'm on the track, Chambu Jack Project Vivian. 00:14:41.474 --> 00:14:52.360 - there's a lot of money for that sort of thing. Well, we had money. Actually, we had our meeting just 00:14:52.360 --> 00:15:03.247 - two days ago, and we have money, and we specifically discussed the Stop the Bleeding of the Kids. So 00:15:03.247 --> 00:15:09.822 - I'll get you more information. Let's see, we should move on. 00:15:10.786 --> 00:15:19.600 - I'm currently working with the City of Bloomington Mobile Integrated Health to schedule a back to school 00:15:19.600 --> 00:15:28.245 - health fair later this summer. So where we can provide vaccinations, hygiene kits, you know, some back 00:15:28.245 --> 00:15:36.639 - to school supplies, sunscreen, and offer health screenings for adults at no cost during that event. 00:15:36.639 --> 00:15:37.982 - Also looking at 00:15:38.146 --> 00:15:47.841 - working with them on chronic disease initiatives where we can focus on the high blood pressure and diabetes, 00:15:47.841 --> 00:15:57.090 - continue providing access to that equipment that we have in stock now. So those blood pressure monitors 00:15:57.090 --> 00:16:06.340 - and glucose tests for individuals who have that chronic condition and don't have a way to monitor their 00:16:06.340 --> 00:16:08.030 - condition at home. 00:16:08.354 --> 00:16:17.324 - We currently have two nurses that are completing their training, going through all of their onboarding, 00:16:17.324 --> 00:16:26.467 - orientation, state trainings. We are looking at scheduling appointments for vaccines and health screening 00:16:26.467 --> 00:16:35.006 - starting in April. One of the areas that I'm trying to navigate right now, which we'll talk about, 00:16:35.202 --> 00:16:42.817 - later in the meeting is, you know, lack of a dedicated front desk support position that would be able 00:16:42.817 --> 00:16:50.282 - to help us get these services up and started. So to start out, we'll have a main phone line. All of 00:16:50.282 --> 00:16:57.822 - the nurses have their individual phone line, but we'll have to alternate between the incoming calls, 00:16:57.822 --> 00:17:00.734 - going, ringing to all the nurse lines, 00:17:00.834 --> 00:17:07.690 - And someone that's available can answer it, address questions, schedule appointments in times where 00:17:07.690 --> 00:17:14.615 - it has to go directly to voicemail because they're just not going to have the capacity. They may not 00:17:14.615 --> 00:17:21.677 - be in the office. They might be out in the community and then those calls would be returned at a later 00:17:21.677 --> 00:17:29.150 - time. So really hoping to be able to avoid that. We have had complaints over the past years about, you know, 00:17:29.314 --> 00:17:37.219 - call our clinic and get directly to a person to provide assistance and to schedule appointments and 00:17:37.219 --> 00:17:45.599 - that delay of care. We are also going to start scheduling the lactation counseling appointments on Monday 00:17:45.599 --> 00:17:53.662 - afternoons in April. Aubrey, our maternal child health coordinator, will be providing those services. 00:17:56.898 --> 00:18:05.415 - So Amira, one of our new nurses, she's going to be working with Indiana University on the goal program. 00:18:05.415 --> 00:18:13.604 - So that's Get On Board Active Living. It's an eight week session this summer. So she'll be spending 00:18:13.604 --> 00:18:19.582 - some time with Indiana University prior to that program starting just to 00:18:20.194 --> 00:18:27.424 - develop the program materials, training, advertising. And then during that eight week session, it's 00:18:27.424 --> 00:18:34.871 - about 10 hours of work time dedicated each week specifically for that program. She's also working with 00:18:34.871 --> 00:18:42.173 - Purdue Extension for matter of balance classes for the public. So that's around our fall prevention, 00:18:42.173 --> 00:18:46.366 - our trauma and injury prevention core service. We haven't 00:18:47.042 --> 00:18:57.755 - get determined, the dates and times, but hope to know that before the end of the month. Let's see. So 00:18:57.755 --> 00:19:07.943 - working on the transition of our communicable disease case management with the neuro, oh, sorry. 00:19:07.943 --> 00:19:16.766 - It's OK. I'm just curious. I'm wondering if the goal and the Purdue balance classes 00:19:17.666 --> 00:19:26.705 - that Amira may take up. Will those again fall under our HFI requirements? Yes, and it's really crucial 00:19:26.705 --> 00:19:35.481 - that we get those going because that's what we've been, you know, needing to focus on over the past 00:19:35.481 --> 00:19:45.310 - year. I'm just wondering in terms of the participants having to prove their eligibility under HFI funding, will 00:19:45.730 --> 00:19:59.958 - Amira's work fall under those guidelines? And if so, how do we envision making that work or is somehow 00:19:59.958 --> 00:20:06.174 - it's exempt from that? Yes, so that position 00:20:06.626 --> 00:20:15.901 - is being funded through grant funding, which will not limit those services. Thank you. That's what I 00:20:15.901 --> 00:20:25.452 - needed to know. Yes. So as long as we're not incorporating or purchasing those HFI supplies, then we're 00:20:25.452 --> 00:20:35.646 - fine. Yay. OK, yes. So just we'll be transitioning the communicable disease and reportable conditions from our 00:20:35.874 --> 00:20:44.353 - staff who are currently covering that. So Kathy Hewitt and Linnea to the nurses over the next few weeks 00:20:44.353 --> 00:20:52.669 - to begin, you know, taking that on. Can we just thank the two of them? They've been doing so much for 00:20:52.669 --> 00:21:00.985 - us in this time. Thank you. As of this morning when I looked, we have 98 open investigations. Not all 00:21:00.985 --> 00:21:03.838 - of them are being worked on and 24 00:21:04.130 --> 00:21:16.369 - to get started, so definitely do a lot of work in that area. Oh, let's see. So there was an issue recently 00:21:16.369 --> 00:21:28.037 - discovered with lead blood testing, so missing records associated with lead results coming from Riley 00:21:28.037 --> 00:21:30.782 - locations in the state. 00:21:30.946 --> 00:21:40.225 - So the Indiana Department of Health has been working with the Indiana Health Information Exchange for 00:21:40.225 --> 00:21:49.686 - that IHI. And IU Health on the issue recently received a data dump from IU Health of over 8,000 records 00:21:49.686 --> 00:21:55.326 - from April of 2025 to December of 2025. So they're looking on 00:21:55.458 --> 00:22:06.054 - the long-term solutions and the issues with the technology and that information not crossing over. That's 00:22:06.054 --> 00:22:16.450 - just something with our lead program. That information just did not get back to the clinicians? I don't 00:22:16.450 --> 00:22:25.246 - know all of it, but from my understanding, it wasn't transferring to our state systems. 00:22:25.730 --> 00:22:35.036 - It went, the pediatricians were testing children for lead. It was going to the lab, but the lab was 00:22:35.036 --> 00:22:44.807 - not reporting back to the state, the environmental system. Is that right? That's my understanding. Yeah, 00:22:44.807 --> 00:22:54.206 - so it wasn't being then dumped into our system where we go and check. And so I can remember in 2025, 00:22:54.466 --> 00:23:00.390 - towards the end, the Indiana Department of Health reaching out and saying, you know, there seems like 00:23:00.390 --> 00:23:06.198 - the numbers are off and kind of starting to look at it. So I think that they realized something was 00:23:06.198 --> 00:23:12.238 - going on. And so I'm not sure what's been going on the back end. But apparently there was an issue with 00:23:12.238 --> 00:23:14.910 - that transmission of data just not happening. 00:23:15.330 --> 00:23:23.109 - So the results were being reported back to physicians when they weren't being recorded with the state, 00:23:23.109 --> 00:23:30.812 - is that correct? Or not all of them? Not all of them. And so then we weren't seeing those results. So 00:23:30.812 --> 00:23:38.969 - they're going to get a, say, backlog list? Yeah, so that's what they're now dumping in. It's just confusing 00:23:38.969 --> 00:23:45.086 - because we certainly had the one family, the public health nurses were following 00:23:46.018 --> 00:23:54.317 - that had extremely high levels. And so I know we were getting, at least our public health nurses were 00:23:54.317 --> 00:24:03.022 - getting those results. And I assume they were getting through the system and not directly as the clinician 00:24:03.022 --> 00:24:11.646 - of note time. Well, we can still see some of the, some of it now. So I don't think that, I mean, I don't. 00:24:11.646 --> 00:24:14.494 - Just some of it didn't, so either, 00:24:14.786 --> 00:24:23.421 - whoever was doing it or something happened, just everything went a bit skew. Okay, got it. Thank you. 00:24:23.421 --> 00:24:32.056 - Let's see. So if you can remember the Fresh Connect program, and I'm talking about that last year. So 00:24:32.056 --> 00:24:40.606 - I'm scheduled to meet with the Veterans Office Director again next Friday. So we're going to kind of 00:24:40.606 --> 00:24:43.230 - circle back around and revisit 00:24:43.458 --> 00:24:51.577 - whether that's a program that we could work with the Monroe County veterans to get going this year. 00:24:51.577 --> 00:24:59.859 - Fresh Connect is that program that provides access to fruits and vegetables. Participants essentially 00:24:59.859 --> 00:25:08.222 - are identified as having a chronic condition, so high blood pressure, diabetes, heart disease, cancer, 00:25:08.222 --> 00:25:09.278 - for example. 00:25:10.434 --> 00:25:18.746 - they would agree to participate in providing biometric data and questionnaires where we can evaluate 00:25:18.746 --> 00:25:27.388 - and understand barriers to eating healthy, engaging in physical activity, accessing healthy foods, maybe 00:25:27.388 --> 00:25:35.865 - how their health status is impacting their mental or emotional wellbeing so that we could collect this 00:25:35.865 --> 00:25:40.062 - data over time and also evaluate program outcomes. 00:25:41.858 --> 00:25:53.542 - I have all of the questions. I'm just wondering if vets in particular were focused on because they are 00:25:53.542 --> 00:26:05.113 - used to providing data and they don't necessarily have the same amount of skepticism that many of the 00:26:05.113 --> 00:26:11.806 - other folks within the community who may need that kind of 00:26:12.034 --> 00:26:20.309 - help may have of providing their personal data. Is that the idea? The idea was trying to find those 00:26:20.309 --> 00:26:28.585 - with a need that would also fit in with our HSI restrictions. So what are some of those populations 00:26:28.585 --> 00:26:37.274 - that have needs that we feel pretty comfortable are going to be Indiana residents that could with lawful 00:26:37.274 --> 00:26:41.246 - status. But that's the thing about the country. 00:26:41.506 --> 00:26:50.737 - Great. Thank you. Um, let's see. Also working on now promoting our service with the milk bank. So we 00:26:50.737 --> 00:26:59.877 - are a milk express site. We have the freezer now. Aubrey and I have gone through the training so we 00:26:59.877 --> 00:27:06.366 - can begin distributing that donor human milk to families. Essentially, 00:27:06.626 --> 00:27:18.015 - We are basically the access point. Families can go online and order that. It's shipped to us and we're 00:27:18.015 --> 00:27:29.405 - ensuring that the families can pick that up from our location. I had a PowerPoint. Just, is that okay? 00:27:29.405 --> 00:27:34.270 - Yes, perfect. Sorry. I felt like we haven't 00:27:34.754 --> 00:27:45.254 - met, I guess, for three months. Oh, yeah. Yeah, sure. Not a whole lot. So just kind of focused on some 00:27:45.254 --> 00:27:55.856 - of the highlights from the core service data that we submitted to the state in 2025. Let's see. So this 00:27:55.856 --> 00:27:59.934 - just kind of gives you some information 00:28:00.706 --> 00:28:12.768 - for 2025, so we had 19 active TB patients, 350 being treated for LTBI and provided 390 tests. So Linnea 00:28:12.768 --> 00:28:24.598 - created and sent out this community survey in 2025. So this was conducted during October and November 00:28:24.598 --> 00:28:27.614 - to just be able to try to 00:28:27.906 --> 00:28:37.055 - collect some public input on services. So we did, just within those two months, receive input from 315 00:28:37.055 --> 00:28:45.937 - individuals. 310 of those live, work, or attend school in Monroe County. So this just kind of gives 00:28:45.937 --> 00:28:54.997 - us an idea about some of the community input and what services we can provide. How did that survey go 00:28:54.997 --> 00:28:57.662 - out? Who were the people that 00:28:58.210 --> 00:29:06.096 - No, it's in your packet. Could you just add a little bit on that? Sure. Yeah. So it was made available 00:29:06.096 --> 00:29:13.983 - online. We also had hard copies that we distributed to groups and to individuals. We also had sandwich 00:29:13.983 --> 00:29:21.869 - boards with a QR code on it so that people could utilize all the devices to respond to the survey. You 00:29:21.869 --> 00:29:26.846 - certainly got a lot of information. We didn't better conduct it. 00:29:27.746 --> 00:29:37.021 - So this was during that time period too when we were going with the council about the mobile unit and 00:29:37.021 --> 00:29:46.114 - how we can better serve the community and what is the community really looking at from us as far as 00:29:46.114 --> 00:29:55.480 - services and how we can help assist them. So that's just one little snippet of the information and the 00:29:55.480 --> 00:29:57.662 - rest is in your packet. 00:29:58.370 --> 00:30:07.608 - So this was a good highlight for 2025. So our vaccinations so over 1300 for children and 1600 for adults. 00:30:07.608 --> 00:30:16.498 - Oh, so let me talk about the vaccines. I guess again the Indiana Department of Health. They have come 00:30:16.498 --> 00:30:24.254 - out and conducted their site visit for our vaccine program, so everything has been done. 00:30:24.418 --> 00:30:32.775 - Submitted for our vaccine for children. The backs here account has now been transitioned over fully 00:30:32.775 --> 00:30:37.790 - to the Monroe County Health Department. We are waiting for. 00:30:38.914 --> 00:30:46.641 - just a few more pieces of equipment from Vax care. So essentially the electronic hub that we use for 00:30:46.641 --> 00:30:54.522 - inventory counts and the devices that we use to scan the doses before they are administered. We expect 00:30:54.522 --> 00:31:02.172 - to receive those next week and then we can move forward with placing our first orders for vaccines. 00:31:02.172 --> 00:31:08.446 - So communicable diseases. This just kind of gives you a snippet of the work being 00:31:08.738 --> 00:31:21.069 - done there. So 269 completed case investigations. Those don't include the work that our disease intervention 00:31:21.069 --> 00:31:32.609 - and harm reduction is doing with the HIV STIs and HCV. So chronic disease provided 573 blood pressure 00:31:32.609 --> 00:31:38.718 - checks, 262 A1C tests, and then 98 cholesterol tests. 00:31:38.882 --> 00:31:47.108 - So really hoping to, we'll be incorporating these tests for free once we start scheduling patients in 00:31:47.108 --> 00:31:55.173 - office. And then over time, once we can expand and be going out in the community and offering these 00:31:55.173 --> 00:32:03.399 - services as well. Is that data from in-house and the outside events? I'd have to look, I pulled these 00:32:03.399 --> 00:32:08.318 - directly from what the state gave me for their core service. 00:32:08.642 --> 00:32:19.360 - because they kind of track it differently. And referral services, so, you know, 646 referrals for hepatitis 00:32:19.360 --> 00:32:29.285 - care. So that really kind of stood out to me. Just the amount of work that employees are doing just 00:32:29.285 --> 00:32:35.934 - to be available to help connect individuals to referrals and care. 00:32:39.234 --> 00:32:47.268 - So here's our KPO priority that we really need to focus on this year. So if we can remember back at 00:32:47.268 --> 00:32:56.025 - the start of Health First Indiana, we had to submit what they were referred to as key performance indicators 00:32:56.025 --> 00:33:04.863 - at that time. Now they're calling them key performance outcomes. So this was one based around fall prevention 00:33:04.863 --> 00:33:08.478 - and that rate of non-fatal hospitalizations. 00:33:08.866 --> 00:33:13.982 - 2025, isn't that fair? 00:33:14.690 --> 00:33:22.119 - So we're not headed in the right direction with this as of right now. So it'll be really good once we 00:33:22.119 --> 00:33:29.620 - can get a mirror up and going and doing that matter of balance. Also trying to work with the hospitals 00:33:29.620 --> 00:33:37.340 - to see if we could collaborate on a referral system. So are there frequent fallers? Are there individuals 00:33:37.340 --> 00:33:38.942 - that they can provide 00:33:39.298 --> 00:33:49.748 - our information and then we can connect with them to offer them our programming and education. And then 00:33:49.748 --> 00:33:59.996 - that's just additional data that kind of shows where we're at. I'm curious here. So is there anything 00:33:59.996 --> 00:34:07.934 - in our looking even at that data and collecting that data that correlates with 00:34:08.226 --> 00:34:16.146 - substance abuse disorder. Well, so we get this information from the state, and so that's not something 00:34:16.146 --> 00:34:23.912 - that I've seen, and I'd have to see how they're maybe capturing that. Yeah, because I think it would 00:34:23.912 --> 00:34:31.602 - be interesting in capturing that data to look at substance abuse and or substance use and how those 00:34:31.602 --> 00:34:36.446 - falls correlate. OK, let's see what I can find out about that. 00:34:36.994 --> 00:34:45.655 - And that's just another, just kind of gives you a breakdown of where some of those falls are coming 00:34:45.655 --> 00:34:54.142 - from. So our other, so we submitted one to focus on decreasing the smoking rate during pregnancy. 00:34:54.498 --> 00:35:02.132 - So we are slowly increasing our quit for two participants. So if we can remember, we had to temporarily 00:35:02.132 --> 00:35:09.545 - suspend that program when the changes were made to remove tobacco cessation and prevention from core 00:35:09.545 --> 00:35:17.032 - public health service in Health First Indiana. So we had a little bit of gap in being able to provide 00:35:17.032 --> 00:35:18.206 - these services. 00:35:18.754 --> 00:35:27.546 - Looking back at the February monthly reports, we now have seven active participants and just hope to 00:35:27.546 --> 00:35:36.512 - continue to grow from there. So our disease intervention specialists wanted to focus on increasing the 00:35:36.512 --> 00:35:41.822 - proportion of Monroe County syphilis cases being treated. So 00:35:42.530 --> 00:35:51.970 - Nationally, the Indiana Department of Health has reported congenital syphilis cases have increased. 00:35:51.970 --> 00:36:01.411 - They increased 82% between 2020 and 2024. So really just, this was really an important area for GIS 00:36:01.411 --> 00:36:11.134 - employees to focus on. Is the congenital syphilis increase almost double in that short period of time? 00:36:11.522 --> 00:36:19.704 - What's, do you know the end? Is it in five or is it 50 or 50? Just that percentage, the 82% from 2020 00:36:19.704 --> 00:36:27.805 - to 2024. So, I mean, in what they're, what I'm hearing is, you know, that limited access to prenatal 00:36:27.805 --> 00:36:36.147 - care, medication shortages, particularly for pregnant. One of the other things that we're seeing across 00:36:36.147 --> 00:36:40.158 - the state is that there are emergency rooms where 00:36:40.546 --> 00:36:50.964 - patients are visiting and are not being checked for any of the communicable diseases, especially when 00:36:50.964 --> 00:37:01.177 - it's recognized that this is a pregnant woman who may not be getting prenatal care. So while we may 00:37:01.177 --> 00:37:06.590 - be doing well here, and we've seen the numbers here, 00:37:06.882 --> 00:37:15.243 - being lower than obviously across the state and the area up in the Northwest part of the state being 00:37:15.243 --> 00:37:22.941 - some of the highest we're seeing. Across the state, the number has dropped in the last year, 00:37:22.941 --> 00:37:31.385 - which is great. It's a sign that things are coming down as the amount of awareness is increasing, but 00:37:31.385 --> 00:37:35.358 - they are finding that there are emergency rooms 00:37:35.458 --> 00:37:43.923 - that are not checking pregnant women for syphilis and galorea. When would they check? During a routine 00:37:43.923 --> 00:37:52.471 - visit. That's something that wouldn't happen. Well, there's a big move through IDOH for that to happen. 00:37:52.471 --> 00:38:01.100 - If women are not getting prenatal care, and that's the only place they're being seen is in the emergency 00:38:01.100 --> 00:38:05.374 - room, that that happened there, that indeed this is 00:38:05.826 --> 00:38:11.720 - It's a high risk to infants and the long-term effects and costs to the state are enormous. Well, I find 00:38:11.720 --> 00:38:17.387 - it interesting. As medical director of the emergency department for the past four and a half years, 00:38:17.387 --> 00:38:23.055 - I've never heard of that. I've never heard that. I communicate with the OB doctors all the time. So 00:38:23.055 --> 00:38:28.892 - if IDOH is doing it, they need to increase their penetrance so that we can address it. The other thing 00:38:28.892 --> 00:38:34.729 - is that they tried that with hepatitis. They tried to test everyone with hepatitis and they found that 00:38:34.729 --> 00:38:35.806 - a lot of resources 00:38:36.034 --> 00:38:41.699 - no change in outcomes. So nothing, that's saying that we shouldn't be doing it. And I'm saying that 00:38:41.699 --> 00:38:47.421 - there needs to be, we need numbers and we need some penetrance. So I've never heard of that. One and 00:38:47.421 --> 00:38:53.822 - a half years. That they know, you know, it's not penetrating. It's clearly not. Okay. I'll let him know. Thanks. 00:38:56.258 --> 00:39:04.077 - Let's see, so General Environmental wanted to focus on being able to get these properties. So actually 00:39:04.077 --> 00:39:11.744 - as of 2025, there's only one property left that needs to be tested to determine whether it's safe to 00:39:11.744 --> 00:39:19.411 - come off the list or whether decontamination needs to occur. So we really pretty much knocked all of 00:39:19.411 --> 00:39:23.358 - those out in 2025 and hoping to be able to get this 00:39:23.458 --> 00:39:31.856 - last one taken care of as well. So 13 went to one. Nice. Yeah, so we contracted with an individual who 00:39:31.856 --> 00:39:40.172 - went in and did the testing and then he was qualified enough that he could also do decontamination on 00:39:40.172 --> 00:39:48.325 - the properties that needed that to get them into safe levels. So for the people living in them. And 00:39:48.325 --> 00:39:50.526 - then this is just our last 00:39:50.818 --> 00:39:59.044 - KPO, so focused on decreasing the rate of drug-related poisoning fatalities. So still just continuing 00:39:59.044 --> 00:40:07.430 - to focus on distributing Narcan, providing education and training, being able, working with our suicide 00:40:07.430 --> 00:40:15.656 - overdose fatality review teams and community partners. There's a huge amount of that. Is that, so the 00:40:15.656 --> 00:40:20.414 - number says, is that on the right decrease the rate of two 00:40:20.610 --> 00:40:26.986 - That's a goal. It looks like we're so far ahead of the goal. Is that correct? Yes. So we're doing good 00:40:26.986 --> 00:40:33.549 - on all of them except for our fall prevention. Yeah. I definitely noticed in the past few years, decrease 00:40:33.549 --> 00:40:39.801 - in the number of people that are sent to the emergency department who are near fatal events or fatal 00:40:39.801 --> 00:40:46.116 - events. So that's good. I will stop now. Well, thank you. Is it possible? So the checklist one really 00:40:46.116 --> 00:40:47.230 - cares about that. 00:40:47.714 --> 00:40:54.657 - And some of those, you know, when we talk about these numbers and trying to get the percentage increase 00:40:54.657 --> 00:41:01.600 - and decrease, it changes the math if we know the numbers. And these numbers come to you from the state, 00:41:01.600 --> 00:41:08.276 - is that correct? Yes. Do they ever give you the numbers or do they just say the percentage? I think 00:41:08.276 --> 00:41:15.486 - we can ask for it in different ways. But yes, we do get it all from them. So that's something that we could 00:41:15.586 --> 00:41:21.870 - If there's different formats or something specifically you'd be interested in, we can definitely reach 00:41:21.870 --> 00:41:28.093 - out to them about that. I think that generally when you look at these things changing so greatly, the 00:41:28.093 --> 00:41:34.621 - numbers matter. Is it five? Is it three? Is it 50? It matters in terms of how you approach these problems, 00:41:34.621 --> 00:41:41.088 - I think. We certainly found it in dealing with hypertension and diabetes and severe phobic complications, 00:41:41.088 --> 00:41:42.430 - those relative risks. 00:41:42.594 --> 00:41:54.842 - And that matters more than necessarily the percentage change. And in presentations, we do get numbers. 00:41:54.842 --> 00:42:06.972 - So they have that, and they do give it to us. OK. Laurie, I have a question. When we met in December, 00:42:06.972 --> 00:42:11.966 - we talked about employees were requesting 00:42:12.290 --> 00:42:19.698 - assistance monetarily with certifications and the board asked, could we get a list and the number of 00:42:19.698 --> 00:42:27.033 - certification licenses required because you didn't know how to, we were going to be able to respond 00:42:27.033 --> 00:42:34.882 - to that with the limited funds that we had. Where are we on that? So Marissa, the administrative assistant 00:42:34.882 --> 00:42:36.862 - has been creating and, um, 00:42:37.122 --> 00:42:44.388 - gathering all of that information. So I think it's probably at a point to where we can provide that 00:42:44.388 --> 00:42:51.800 - to the board at the next meeting. So one of the challenges that we at that time were dealing with was 00:42:51.800 --> 00:42:58.558 - because of the changes that were made when County Council amended our budget and essentially 00:42:59.842 --> 00:43:09.498 - we had zero dollars that we could use towards that. So we've been working over the past few months to 00:43:09.498 --> 00:43:19.155 - submit our financial reports and new budgets for additional funding to be able to now start providing 00:43:19.155 --> 00:43:27.486 - some of those. But I think the question would be for the board developing a policy. So, 00:43:28.194 --> 00:43:36.359 - Is our people required to have the certifications prior to hiring and maintain those over time as part 00:43:36.359 --> 00:43:44.602 - of their employment? Or is it the expectation that the county will cover those costs that are required? 00:43:44.602 --> 00:43:52.529 - Well, it would really depend on the positions, I would think. For instance, if you're looking for a 00:43:52.529 --> 00:43:58.078 - nurse, certainly they should have certification before they're hired. 00:43:58.242 --> 00:44:06.551 - And so then do they maintain paying for their license, you know, like other organizations, I guess, 00:44:06.551 --> 00:44:15.607 - require, or does in that transition to the county covering those costs? And the cost of continuing education 00:44:15.607 --> 00:44:24.830 - for those individuals. And I think, Lori, what you shared with me was that Lori's coming up with a schedule of 00:44:25.058 --> 00:44:33.531 - who has which certifications, how many people in a particular department need to be certified and can 00:44:33.531 --> 00:44:42.086 - it be done on some kind of rotating basis so that each year so many certifications are handled so that 00:44:42.086 --> 00:44:50.559 - we're not like every year taking on all the certifications within the whole department and be able to 00:44:50.559 --> 00:44:54.878 - better manage the financial effects of that kind of 00:44:55.554 --> 00:45:04.082 - process? Well, I think it's from my opinion only. In my opinion, I think it can be challenging in some 00:45:04.082 --> 00:45:12.362 - ways to think about a strict standardized system because our funding fluctuates so much. So when we 00:45:12.362 --> 00:45:14.846 - were going into Health First, 00:45:15.074 --> 00:45:23.166 - Indiana and we were going to have to start providing all these new core services and these new activities. 00:45:23.166 --> 00:45:30.804 - And we had additional funding to then where people could start getting those trainings and doing all 00:45:30.804 --> 00:45:38.669 - of the, you know, develop development. And well, when funding kind of falls back, then how do you, what 00:45:38.669 --> 00:45:42.526 - are your choices with maintaining those over time? 00:45:43.266 --> 00:45:51.501 - So currently they cover their? No, they can't. They can cover, as in from our budget. I will say that 00:45:51.501 --> 00:45:59.735 - anything related to trauma, and I'll get Kimberly, anything related to trauma, even if it's, it can't 00:45:59.735 --> 00:46:07.808 - be tangential, but if it's related to trauma or it affects the care of Hoosiers in trauma, the TRAC 00:46:07.808 --> 00:46:09.342 - has funds to help. 00:46:09.826 --> 00:46:16.159 - So I think when you have that conversation with Kimberly, you can talk to her about other things that 00:46:16.159 --> 00:46:22.554 - might be useful for getting nurses with certain certifications and education and so on because there's 00:46:22.554 --> 00:46:28.824 - different money available. And then, you know, is there, are there performance measures that are put 00:46:28.824 --> 00:46:32.798 - into place or standards and expectations that if the funding is 00:46:33.442 --> 00:46:39.966 - you know, being provided for employees to obtain these additional trainings and certifications that 00:46:39.966 --> 00:46:46.620 - they are actually then carrying out those, those programs, um, you know, over time, or what do you do 00:46:46.620 --> 00:46:53.470 - when you invest $5,000 in someone and then they need to go take a better paying job? Um, and so, I mean, 00:46:53.470 --> 00:46:58.558 - I think those are just all things that anybody has to. It'll be very helpful. 00:46:58.882 --> 00:47:06.472 - to get an idea of what kind of certifications we're talking about, how many employees we're talking 00:47:06.472 --> 00:47:14.290 - about, et cetera. I personally have never worked at a place where it was expected. You just always did 00:47:14.290 --> 00:47:22.031 - your own. It was never provided. That's how it was always been for me. If it's been provided, I mean, 00:47:22.031 --> 00:47:22.942 - once you've 00:47:23.586 --> 00:47:30.961 - been able to provide it, and then you have to take it away for some reason. That creates a lot of discord 00:47:30.961 --> 00:47:38.196 - with the employees. Yeah, so I think that's one of the big challenges with this makeshift in the health 00:47:38.196 --> 00:47:45.362 - first. You have this huge influx and all these opportunities, and then it's taken away, and how do you 00:47:45.362 --> 00:47:51.902 - readjust? I think having all that information in one document would be a good start. I agree. 00:47:53.570 --> 00:48:03.904 - And is this something that you could imagine the commissioners might want to help address because it 00:48:03.904 --> 00:48:14.340 - sounds like policy and that they may have, you know, across the county have some kind of ideas. Well, 00:48:14.340 --> 00:48:22.014 - I wish that the county did have a policy on it because I think it would be 00:48:22.338 --> 00:48:29.498 - easier if there was a standard policy across the county, but there's not. So maybe that is something 00:48:29.498 --> 00:48:37.084 - the commissioners really need to address. That would be the council, right? No, commissioners need policy. 00:48:37.084 --> 00:48:44.386 - Council runs money. So it would have to go to commissioners to really develop a policy that they might 00:48:44.386 --> 00:48:50.270 - want to talk to council about, but it would be their policy that they would direct 00:48:50.850 --> 00:49:00.600 - counsel would be paying for, I guess. Yeah. To me, it sounds like your point about people leaving after 00:49:00.600 --> 00:49:09.130 - you've paid for their certification. Well, having certification to work here should be one 00:49:09.130 --> 00:49:18.692 - of the requirements. They should expect that. So what I would suggest is that maybe we have some sort 00:49:18.692 --> 00:49:20.286 - of cost sharing. 00:49:20.866 --> 00:49:29.649 - so that everyone has some skin in the game, that the employee gets some assistance paying for certifications, 00:49:29.649 --> 00:49:37.794 - but the county paying for all of it, I think, is like, hey, I've never worked anywhere where somebody 00:49:37.794 --> 00:49:46.018 - paid for my continuing education to get my, renew my license. Did you? I mean, you did, yeah. So maybe 00:49:46.018 --> 00:49:48.254 - having some kind of stipend 00:49:49.634 --> 00:49:58.593 - Oh, I say stipend or some set amount for, and then they pay the rest of it. Yeah. I mean, my, my license 00:49:58.593 --> 00:50:07.552 - was a trivial amount because the state, you know, has states cheap and you know, that they make it cheap 00:50:07.552 --> 00:50:16.852 - for everybody. But, but the getting the, you know, paying for the, for the continuing ed was not necessarily 00:50:16.852 --> 00:50:18.302 - inexpensive. So, 00:50:18.466 --> 00:50:25.852 - Are you helping the providers? And I believe the nurse is also gonna, so I've been like, my license, 00:50:25.852 --> 00:50:33.166 - certain amount of CME per year provided by organization. So I think it depends on the umbrella that 00:50:33.166 --> 00:50:40.918 - you're working under. So it's a perk. So it's a cost sharing thing or? No, no, they, for license renewal, 00:50:40.918 --> 00:50:46.110 - DEA renewal. So they pay for all. Do you think that's required to work 00:50:46.818 --> 00:50:55.806 - they pay for and then they also provide a certain amount of money per year for CME that I can use however 00:50:55.806 --> 00:51:04.285 - I see fit as long as it's requirement. Yeah, it's an iceberg. So that's all in an Excel spreadsheet 00:51:04.285 --> 00:51:13.273 - so we can submit that with the next board package. Okay, thank you very much. Very good job. I'm a little 00:51:13.273 --> 00:51:14.206 - bit tired. 00:51:14.306 --> 00:51:24.853 - That's what I was doing all day. Were you going to address the HIP? Oh, sure. Great Medicine is well 00:51:24.853 --> 00:51:35.400 - in here? Yeah, we can. So I think this is, I think you saw this at the December meeting. Let me find 00:51:35.400 --> 00:51:42.814 - it, I guess. It looks like this. Oh. This is the Great Medicine theme. 00:51:43.234 --> 00:51:52.668 - This was the pilot program that we started with Health Net. So when this came about because we were 00:51:52.668 --> 00:52:02.763 - looking at ways to reduce the emergency visits and emergency response calls that were going to the Wheeler 00:52:02.763 --> 00:52:12.574 - mission and then to the emergency department. So we took a portion of the Health First Indiana funds to 00:52:12.802 --> 00:52:22.194 - help cover personnel expenses for Health Net staff to begin really focusing on trying to intervene to 00:52:22.194 --> 00:52:31.586 - provide services. And so this is just some of the outcomes that we've seen since that program started 00:52:31.586 --> 00:52:40.702 - and how it's reduced the emergency department visits. And can you remind us how much we contribute 00:52:41.282 --> 00:52:51.667 - this program? So 135,000 I believe last year and this year. Okay. So we as a health department, we've 00:52:51.667 --> 00:53:01.950 - contributed that amount to this program. Yes. Do we have any idea how much IU Health has contributed 00:53:01.950 --> 00:53:10.910 - to Health Net for this program? That I do not know. Would you be able to find that out? 00:53:11.074 --> 00:53:21.802 - For us, that would be really interesting information. Since we're improving things for your emergency 00:53:21.802 --> 00:53:32.530 - room. So the numbers, sorry, the numbers, so if you take $135,000 and divide by 92, so that's $14.60. 00:53:32.530 --> 00:53:40.734 - On the other side, there's a three. Yes, but that's $1400, $14.67 per person. 00:53:41.570 --> 00:53:50.270 - So yes, it would be that, you know, we're contributing. So it would be interesting to see, you know, 00:53:50.270 --> 00:53:58.971 - what IU contributed as well. Yeah. So we'll continue to get some of these updates and information of 00:53:58.971 --> 00:54:08.188 - these services. So I think there's a little bit of a slow start, again, just because people at the Wheeler 00:54:08.188 --> 00:54:09.566 - Mission weren't 00:54:09.762 --> 00:54:19.891 - they weren't aware and it was a new system, but as word got out, they began to start seeing more individuals. 00:54:19.891 --> 00:54:29.375 - So really great program and I think it's great that we've been able to continue supporting them. Okay, 00:54:29.375 --> 00:54:37.662 - so the next item is older continuing business. I just want to say that behind the scenes, 00:54:38.146 --> 00:54:50.245 - the amount of machinations that Lori has had to do to get us transitioned to doing the vaccines on site 00:54:50.245 --> 00:55:02.460 - as opposed to those occurring at the clinic at IU, or rather at Miller Drive. It's been a lot, and she's 00:55:02.460 --> 00:55:07.230 - done an awesome job. So we kind of meet. 00:55:07.746 --> 00:55:19.140 - barriers more along the way than, than I would like to see. Um, and I don't know how to improve our 00:55:19.140 --> 00:55:31.103 - relationship with council and with our, um, liaisons. I don't know if, uh, you know, we go even publicly 00:55:31.103 --> 00:55:37.598 - individually to the meetings and you know, say, Hey, we, 00:55:37.698 --> 00:55:47.042 - We kind of need some help and some collaboration. Peter Iverson, we actually have not met with him once 00:55:47.042 --> 00:55:56.745 - since January 1st. And that would be helpful. And we're going to also talk about that. I guess I'm skipping 00:55:56.745 --> 00:56:06.718 - ahead a little bit. But on item three, we were on the agenda for a council. And then to work on this position, 00:56:07.618 --> 00:56:15.563 - that we desperately need to provide services for Monroe County and we were taken off the agenda with 00:56:15.563 --> 00:56:23.743 - no notification and found out at a later time. So I. So anyway, we're we're we're moving ahead planning 00:56:23.743 --> 00:56:31.688 - on giving the vaccines and everything is. Mostly in place and we just need people. I mean, you can't 00:56:31.688 --> 00:56:36.958 - provide health care or health services that part of things without 00:56:37.122 --> 00:56:46.198 - without people who are trained. And so, and that's, you know, physically we've been challenged to try 00:56:46.198 --> 00:56:55.542 - to get that rolling. I don't know if Dr. Moore knows this, but you know, the county has a hiring freeze. 00:56:55.542 --> 00:57:03.550 - I've heard of that. Yeah. Yeah. So, and they're rabidly sticking to that, even though we, 00:57:04.930 --> 00:57:16.204 - IU decided not to continue our contract at the clinic, which put the onus on us to hire employees to 00:57:16.204 --> 00:57:27.366 - run that clinic. Well, they're not letting us do it. So I don't know how they expect us to continue 00:57:27.366 --> 00:57:34.398 - as we were, but with no extra people. I mean, that's basically 00:57:34.882 --> 00:57:43.847 - the road we're running into. And we have money to pay these people. So it's not like we're asking for 00:57:43.847 --> 00:57:53.251 - extra. And I guess I'll just add that Laurie's been incredible in making sure that we have two individuals 00:57:53.251 --> 00:58:02.216 - who have been helping us immensely track core services, which we're very grateful for. But she's also 00:58:02.216 --> 00:58:04.062 - had to deal with the 00:58:05.666 --> 00:58:15.584 - The tech people who were very slow in giving us phones and internet to this new section. The physical 00:58:15.584 --> 00:58:25.988 - plant people who painted things but then didn't get stuff moved and we've been slowing. We got a generator 00:58:25.988 --> 00:58:35.614 - contract but then it turned out that no, they needed to do something else because it doesn't work. 00:58:35.842 --> 00:58:48.463 - So there have been so many elements. Unfortunately, it's not only counsel. It's been one headache after 00:58:48.463 --> 00:59:01.327 - another. And Lori has been just a godsend because we would not be where we are now without her diligence. 00:59:01.327 --> 00:59:03.390 - So kudos to you. 00:59:05.250 --> 00:59:13.366 - We won't fail. Can I ask, where are the two nurses located now? I know we had a space. So right over 00:59:13.366 --> 00:59:21.401 - in the area. And that's also where our maternal infant care person will be dealing with moms. Yeah. 00:59:21.401 --> 00:59:29.677 - So it's a little chilly because there's still some holes like in the roof. The roof is kind of OK, but 00:59:29.677 --> 00:59:33.534 - the ceiling, they're just, but they're, I mean, 00:59:33.890 --> 00:59:44.115 - reverse, right? You know, we're all here because we're dedicated to serving my county. And I think we're 00:59:44.115 --> 00:59:54.340 - that's what I try to focus on every day is how fortunate we are to have people who come into this office 00:59:54.340 --> 01:00:00.670 - every day, despite all the barriers that we face. And so is that 01:00:00.994 --> 01:00:09.997 - Do we go to the commissioners over? We have the holes in our roof where we're trying to be patient. 01:00:09.997 --> 01:00:19.000 - I think it's on the list. The roofing people have been here forever. The physical plant people know 01:00:19.000 --> 01:00:28.003 - what's going on. It's just, they're dealing with the whole county. It's. All right, well, moving on 01:00:28.003 --> 01:00:29.534 - to new business. 01:00:30.818 --> 01:00:40.776 - So we have the 2025 annual report for all of our core services and all of our divisions. I won't go 01:00:40.776 --> 01:00:51.530 - through all of them. We have the vital records, food protection, chronic disease management, immunizations, 01:00:51.530 --> 01:01:00.094 - trauma, et cetera. And so does anyone have any questions about the report or comments 01:01:00.834 --> 01:01:12.242 - So at the end, we have goals for 2026 are to work on securing additional funds since we've met with 01:01:12.242 --> 01:01:23.763 - those challenges and to continue to meet criteria for the health first funds. I think our goals have 01:01:23.763 --> 01:01:30.494 - had to change because physically things are just difficult 01:01:30.626 --> 01:01:42.672 - just to try to get more funding. So I think that we need to ask for public, or well, I need actually 01:01:42.672 --> 01:01:54.837 - a motion to, let me back up. Any questions about the report or discussion? I always enjoy reading it. 01:01:54.837 --> 01:01:58.654 - I think it's the together well. 01:01:58.946 --> 01:02:11.610 - Everybody worked on. Yes, that's a lot of information. It's impressive. We have a lot of people come 01:02:11.610 --> 01:02:24.775 - through our door that we serve, which is awesome. Thank you. So do I have a motion to approve the annual 01:02:24.775 --> 01:02:28.286 - report? So moved. I second. 01:02:29.474 --> 01:02:47.062 - Okay, so prior to the vote, we take public comment regarding the annual report. Any hands? Okay, so 01:02:47.062 --> 01:02:58.494 - we'll vote on the approval of the 2012-2025 annual report. Okay. 01:03:00.994 --> 01:03:13.000 - So then we have the vitamin angels grant renewal. So this is 50 clients to be served those who needed 01:03:13.000 --> 01:03:19.710 - vitamins. I'll let Laurie speak a little bit about that. 01:03:20.866 --> 01:03:27.955 - don't have a whole lot. I mean, we, we essentially started this program shortly after we developed and 01:03:27.955 --> 01:03:34.974 - hired the maternal child health coordinator. So this, um, just allows us the opportunity to get these 01:03:34.974 --> 01:03:41.994 - vitamins in for free that then we can distribute to the community. Um, so through partners or through 01:03:41.994 --> 01:03:48.670 - individuals and just hoping to be able to continue providing access. Um, I have a question back. 01:03:50.850 --> 01:03:59.072 - maybe September or October, we talked about the prenatal vitamins that we were giving out. And Dr. McKinley 01:03:59.072 --> 01:04:07.066 - at that time actually looked at the vitamins and found out that they weren't recommending the allowances 01:04:07.066 --> 01:04:14.755 - on the vitamins that were being given out weren't necessarily recommended by the FDA or whoever does 01:04:14.755 --> 01:04:18.942 - that recommendation. Are these vitamins the same ones? 01:04:19.234 --> 01:04:28.266 - I'd have to look and see whether it's the same formula. We talked about it and we all agreed that in 01:04:28.266 --> 01:04:37.209 - fact they were going to check with the company to see if, I can't remember which vitamin it was. Do 01:04:37.209 --> 01:04:44.542 - you remember, Steve? No. I remember Dr. McMaster saying he reached out to someone 01:04:44.738 --> 01:04:52.415 - to discuss it, to see if they would change their allowances to fit what should be on it. And I don't 01:04:52.415 --> 01:05:00.092 - know what happened with that. Yeah, I'd have to ask. I think I remember, and that's what, gosh, this 01:05:00.092 --> 01:05:07.921 - goes back more than a year, I think, Kay. It seems like an eternity, because I know I was on the board 01:05:07.921 --> 01:05:13.470 - then. Time goes fast. What I'm remembering is that we got an answer back 01:05:13.922 --> 01:05:21.230 - and that he was satisfied with the response that we got in terms of the vitamins that were being distributed. 01:05:21.230 --> 01:05:28.139 - I don't remember that. That's the part I remember, and I may be wrong. Can we check through our minutes 01:05:28.139 --> 01:05:34.783 - or something? All right, and I can call and do it. Oh, OK. We really want to make sure the vitamins 01:05:34.783 --> 01:05:41.493 - we're giving out meet all the recommended requirements. Absolutely. And I can't admit that. It seems 01:05:41.493 --> 01:05:43.486 - funny that they wouldn't have 01:05:43.970 --> 01:05:58.974 - A cog recommended levels. Anything is possible, so I think then we should table this until next meeting. 01:05:58.974 --> 01:06:09.406 - OK. Then Steve real. I call him and ask him. The next item is regarding. 01:06:09.890 --> 01:06:18.652 - clinical office assistance, and we're gonna have two agenda items here. So first, I'm gonna have Lori 01:06:18.652 --> 01:06:27.328 - address item number three. Is this regarding the letter? Well, so I mean, essentially, I think we've 01:06:27.328 --> 01:06:35.918 - gotten a little bit further along than when I originally created the agenda. So ultimately, I think 01:06:35.918 --> 01:06:39.870 - the goal is that the board would be approving 01:06:40.034 --> 01:06:48.167 - this job description so that we could then hopefully move forward. But essentially, well, you know, 01:06:48.167 --> 01:06:56.626 - we've been working since late 2025 to try to get, you know, staffing and positions in place. So I can't 01:06:56.626 --> 01:07:05.329 - remember the exact date, but earlier this year, I had submitted a request to the County Council to discuss 01:07:05.329 --> 01:07:08.094 - being able to develop a position. 01:07:09.058 --> 01:07:16.748 - Well, that was actually after I got the notification that they removed the request. So this goes back 01:07:16.748 --> 01:07:24.362 - to like January. Did we get an explanation as to why they removed your foot resource? The email that 01:07:24.362 --> 01:07:32.203 - I received was from one of the county attorneys that says, Lori, hello. I wanted to make you aware that 01:07:32.203 --> 01:07:38.686 - the health department agenda request was removed. Yeah. So that's not an explanation. 01:07:39.842 --> 01:07:49.725 - So I just kind of sat on it for a while because I knew that we were going to be running into some resistance. 01:07:49.725 --> 01:07:58.709 - And then wanted to circle back around just because, again, we're trying to get services in place to 01:07:58.709 --> 01:08:07.784 - start scheduling and providing services. So let's see. We've had communications with Kim Schell. Dr. 01:08:07.784 --> 01:08:08.862 - Robinson is 01:08:09.058 --> 01:08:18.006 - both in the theater about, you know, how can we get this request back in front of the full council for 01:08:18.006 --> 01:08:26.867 - discussion about how we can develop and receive approval for this position. So that's kind of a guess 01:08:26.867 --> 01:08:35.467 - for that. And my perception was, so I spoke to both Kim, Michelle, and then Peter, and Peter just, 01:08:35.467 --> 01:08:38.334 - Kim said, you know, they wanted, 01:08:39.970 --> 01:08:45.309 - Well, it was very confusing because they sort of wanted job descriptions that were related 01:08:45.309 --> 01:08:51.176 - to job descriptions that were for Futures Clinic just because they would have some kind of template 01:08:51.176 --> 01:08:57.219 - for things that had been approved before. But I said, well, we don't have Futures Clinic and so that's 01:08:57.219 --> 01:09:03.438 - kind of obsolete and we need very specific things for the clinical assistant. So she said, talk to Peter. 01:09:03.438 --> 01:09:05.726 - So I spoke to Peter and he said, well, 01:09:07.362 --> 01:09:16.197 - you know, you work with Kim to work on getting us the language. So I took from that, well, I think they 01:09:16.197 --> 01:09:24.693 - just want something in front of them. And then I guess it's unfortunately gonna have to go before I 01:09:24.693 --> 01:09:33.444 - can miss no matter what, because it's a new position and a new job description. So we're back to, it's 01:09:33.444 --> 01:09:34.718 - just a lot of, 01:09:35.490 --> 01:09:42.627 - And PAC is currently paused, so they're not taking requests. So the council would first have to unanimous, 01:09:42.627 --> 01:09:49.297 - well, I don't know, maybe they've changed some of theirs, so I don't wanna speak, but all I know is 01:09:49.297 --> 01:09:56.100 - the council would first have to approve that something could go to PAC for PAC to consider to send it 01:09:56.100 --> 01:10:03.037 - to WIS and then WIS to the full council. And then I think the hiring, part of me would assume that then 01:10:03.037 --> 01:10:04.638 - the hiring freeze would 01:10:04.866 --> 01:10:13.048 - be in addition to that. Okay. So I assumed when I saw it was removed that it was because they weren't 01:10:13.048 --> 01:10:21.231 - going to approve a new position anyway. And so they just took it off their agenda. So they would have 01:10:21.231 --> 01:10:29.012 - one less item. That was my assumption. So I didn't necessarily take it personally. So, you know, 01:10:29.012 --> 01:10:32.702 - so it was, uh, but I could see how they want, 01:10:33.282 --> 01:10:42.827 - to have a full job description if they're going to consider it. So that's, Lori worked on this and we 01:10:42.827 --> 01:10:52.747 - did a few revisions. She did a few revisions. We worked on it and feel that this is appropriate language. 01:10:52.747 --> 01:11:03.134 - So we would like to present this. And at some point we have to have them understand that we are not, you know, 01:11:04.354 --> 01:11:13.816 - county roads and we're not the county. We're not any. We're different than any of their department and 01:11:13.816 --> 01:11:23.277 - say, you know, these are vital services. You can't really provide services without. The staff members, 01:11:23.277 --> 01:11:30.718 - so I'm not sure how else to get that across to Council. And I did. Reach out to. 01:11:31.458 --> 01:11:40.256 - Again, to try to try to get additional information from other local health departments to help explain 01:11:40.256 --> 01:11:48.883 - that we're not asking for anything that's out of the norm. So I was able to capture information from 01:11:48.883 --> 01:11:57.938 - other health departments so that that's available as well. Let's see. Let me ask for this job job because 01:11:57.938 --> 01:11:59.390 - we finished last 01:11:59.682 --> 01:12:10.426 - We finished last year, and we had a grant for those employees that now we no longer have. Does that 01:12:10.426 --> 01:12:21.492 - grant money extend into this year, and how far into this year does that grant money go? So I guess I'm 01:12:21.492 --> 01:12:28.798 - trying to think about which grant. Well, the grant that would cover 01:12:29.506 --> 01:12:37.109 - this employee. Okay, so I think that there's a couple different ways that it could be funded. We have 01:12:37.109 --> 01:12:45.010 - not fully used the amount that originally was intended for the IU Health contract. So that is one option. 01:12:45.010 --> 01:12:52.837 - I would say that they would not prefer that option because it's local. They would come from local county 01:12:52.837 --> 01:12:56.638 - dollars, but that is an option. We could pull from 01:12:56.770 --> 01:13:06.413 - the school liaison grant that were remaining to use down those balances, or we could submit to use one 01:13:06.413 --> 01:13:15.868 - of our other state funds for this position. But we were paying to support a front office position as 01:13:15.868 --> 01:13:23.358 - part of our contract obligation with IU Health, so essentially we would be just 01:13:23.522 --> 01:13:30.692 - be taking another portion of those funds that were originally set aside for the contract and moving 01:13:30.692 --> 01:13:37.934 - it to cover these expenses. And it would not fall into HFI so then we wouldn't be getting kind of in 01:13:37.934 --> 01:13:45.319 - the weeds with that hole. So now we have somebody at the front desk who has to make sure that checking 01:13:45.319 --> 01:13:53.278 - the residency and such. It would seem like the school liaison would be great because this person might also be 01:13:53.474 --> 01:14:04.412 - working to schedule our outreach to schools for vaccinations, to the community with the trustees in 01:14:04.412 --> 01:14:15.568 - the different townships for outreach and visits across the community into the more rural parts of our 01:14:15.568 --> 01:14:23.006 - county to provide screening and vaccinations. So it would seem that 01:14:24.258 --> 01:14:35.904 - would really work well for us, at least in this moment. And I mean, ultimately, would it take, in answer 01:14:35.904 --> 01:14:47.549 - to Lisa's question, would it take our showing up again at council to show our solidarity with our health 01:14:47.549 --> 01:14:53.982 - administrator that, indeed, we need a front office person 01:14:54.338 --> 01:15:03.679 - to be the voice, at least as far as the clinic goes, for the county to show our commitment to our county 01:15:03.679 --> 01:15:12.931 - residents that indeed we want you to come in, we want you to be vaccinated, we want to provide the care 01:15:12.931 --> 01:15:22.095 - that you want and need in this county rather than getting a machine that says, oh, we'll call you back 01:15:22.095 --> 01:15:23.518 - someday, maybe. 01:15:24.514 --> 01:15:34.078 - And it may take our showing up. And the sarcastic part of me wants to say, well, would each one of you 01:15:34.078 --> 01:15:43.735 - come in on a daily basis and fulfill that role for us if we can't hire someone? But that's my sarcastic 01:15:43.735 --> 01:15:51.070 - side. When is the next opportunity to give a department update to the council? 01:15:51.970 --> 01:16:01.798 - Is that a 24 and that does that have to be on their agenda or if, you know, okay. So maybe we should. 01:16:01.798 --> 01:16:11.530 - So you, so you're looking tonight for a, for a, a motion to that says, go ahead and, and submit this 01:16:11.530 --> 01:16:17.022 - for approval or is this, or are you the revised version? 01:16:18.306 --> 01:16:28.112 - Or do you need to take this to Kim first to have her look at it and, well, you know, smith it and, 01:16:28.112 --> 01:16:38.215 - you know, I think that the process changes. So I'm not sure. Uh-huh. So Kim shell being the secretary 01:16:38.215 --> 01:16:44.158 - for the, for the council who you meet with her and she does 01:16:44.290 --> 01:16:53.397 - She changes things and she's a, she's a wizard at that. I spoke with her and I spoke with her and she 01:16:53.397 --> 01:17:02.326 - sent me these and said, well, you know, cross out edit, you know, what is not applicable because it 01:17:02.326 --> 01:17:11.523 - relates to futures and then add in what you need. So, um, was she happy with the order? Because again, 01:17:11.523 --> 01:17:12.862 - Molly and Kim, 01:17:13.378 --> 01:17:22.774 - It had issues with you. You know, I can't even go there, honestly. Yeah, OK. Got it. They have the unrevised 01:17:22.774 --> 01:17:31.739 - version, and so that was submitted to the council office. The revised version just adds some additional 01:17:31.739 --> 01:17:40.532 - language around job requirements and makes sure there's a little bit more specific. I understand your 01:17:40.532 --> 01:17:41.566 - hesitation. 01:17:42.946 --> 01:17:50.759 - Yeah. So, so, well, I mean, so what, what do we, are we, are we going to submit the revised version 01:17:50.759 --> 01:17:58.573 - or, okay. I mean, I think in my opinion, again, I think that all I would like, I feel as though all 01:17:58.573 --> 01:18:06.543 - we can do is try to proactively take all of the steps we can to say, we approve this job description. 01:18:06.543 --> 01:18:11.934 - We approve it going to the council for review to go to pack and, um, 01:18:13.026 --> 01:18:24.638 - I'm trying to take some action. But I think this is one of the challenges because of how long the process 01:18:24.638 --> 01:18:36.140 - takes. It could be, you know, we're going to have several months. But we want to get it in before budget 01:18:36.140 --> 01:18:39.646 - time. So then I would move that 01:18:40.002 --> 01:18:52.450 - that we submit the revised version to the appropriate county officials, whether that be PAC or the council 01:18:52.450 --> 01:19:04.316 - for their approval to submit to PAC. And then to WIS. Steve, you might want to include an approval by 01:19:04.316 --> 01:19:06.526 - the board of this. 01:19:06.786 --> 01:19:16.491 - Yeah, I think we should maybe. Maybe the first one be. That we approve the revised version as a bowl 01:19:16.491 --> 01:19:26.484 - as the board and maybe the second one that we request. I don't know. Can we ask that request as a board 01:19:26.484 --> 01:19:36.670 - to be added to discuss the position at the next Council meeting? Is that out of line? Is that? Allowed or 01:19:38.082 --> 01:19:44.924 - I can just say no. Oh, they can just say no. So that would be my... Do we have to have a resolution 01:19:44.924 --> 01:19:51.765 - to discuss it or can't we just get on, try to get on their agenda to discuss it? Hopefully it is on 01:19:51.765 --> 01:19:58.744 - the agenda. It was submitted for the 24th. I see. Oh, okay. So maybe we just do one motion. It should 01:19:58.744 --> 01:20:06.270 - certainly include the approval. Yeah, well, the approval of the clinical assistant position. Revised version. 01:20:07.554 --> 01:20:14.242 - So that's the motion that we approve the revised version of it. Say it again. Is that the motion that 01:20:14.242 --> 01:20:20.798 - we approve the revised version? Yes. For submission? That is the motion. Well, that would be either 01:20:20.798 --> 01:20:27.617 - one of our motions or not. I would second that. I would second his. Okay. We're in this together. Yeah, 01:20:27.617 --> 01:20:32.862 - here we go. I'm so sorry. I just wanted to be very clear on what the motion is. 01:20:33.442 --> 01:20:45.664 - to approve the revised version and submit it to the appropriate company official for next steps? No, 01:20:45.664 --> 01:20:58.129 - I disagree with that. I think we should approve it. And? And then do a second one. We haven't approved 01:20:58.129 --> 01:21:00.670 - this clinical health 01:21:01.730 --> 01:21:09.759 - clinical assistant position. You approved it back when we were making the changes with the health services 01:21:09.759 --> 01:21:17.563 - director, but this is now revised. Okay, so we approved those. We just voted on them and approved them. 01:21:17.563 --> 01:21:24.542 - I think that's what we do with this one. Yeah, I think we just so let's change the notion to 01:21:26.306 --> 01:21:36.361 - Well, I can't do whatever you want. OK, well, the motion will be to approve as the board the clinical 01:21:36.361 --> 01:21:46.514 - assistant position. Job description job description that is revised. We have in front of us and we can 01:21:46.514 --> 01:21:54.302 - get a copy of that to linear. So do I? That's the motion. OK. I said that's I. 01:21:55.458 --> 01:22:06.915 - Will you second it? I submit that as my motion then. OK. I retract my first motion and I submit that 01:22:06.915 --> 01:22:18.259 - one. Now second that. All in favor. Aye. OK. Now, do we have to submit this revised version or? The 01:22:18.259 --> 01:22:24.158 - county council. Yes. I say we make a second motion. 01:22:24.898 --> 01:22:37.741 - to put the revised version before council for approval. So moved. Sorry. All in favor. Wait, we need 01:22:37.741 --> 01:22:49.822 - public comment on it. Oh, I'm so sorry. Yes, we need public comment. Seeing no public comment. 01:22:49.822 --> 01:22:54.654 - All in favor. Aye. Okay, great. Okay. 01:22:55.074 --> 01:23:05.919 - And so the item under new business, and I want to apologize, Kathy, because I should have put you higher 01:23:05.919 --> 01:23:16.352 - up on the schedule so you didn't have to wait. I've been entertained by this. Just for a background, 01:23:16.352 --> 01:23:23.582 - there was a law change this session. And the details are that for the 01:23:23.970 --> 01:23:32.979 - Needle exchange. It has to be one to one and the second. Well, I saw really three changes. The second 01:23:32.979 --> 01:23:41.988 - is that you have to have a valid ID ID and the third is you have to be. Essentially, and it says it's 01:23:41.988 --> 01:23:51.262 - the language is vague, but at least in the county and maybe surrounding counties that language is vague. 01:23:52.034 --> 01:23:59.815 - once you have this proof of residence. So please Kathy give us your update. So the key updates are the 01:23:59.815 --> 01:24:07.597 - long was extended until July 1st, 2031. So that's a five year extension before it was always two years 01:24:07.597 --> 01:24:10.014 - at a time. So that's a benefit. 01:24:10.402 --> 01:24:16.948 - It did go to the one-for-one model, which means people will need to bring in syringes in order to get 01:24:16.948 --> 01:24:23.558 - the same number of syringes when they go. Before we did as needed basis or how many they needed to use 01:24:23.558 --> 01:24:30.104 - a clean syringe each time they came back. Definitely before they came back up to a certain level, but 01:24:30.104 --> 01:24:32.286 - now it's got to be a one-for-one. 01:24:32.482 --> 01:24:39.416 - So staff has really been doing a lot of education in the last couple of weeks, giving out a lot of sharps 01:24:39.416 --> 01:24:46.155 - containers and informing people on a work on a top basis. It's going on on social media as well to let 01:24:46.155 --> 01:24:52.893 - everybody know. They're for citizens. So they have some things now too. So you were talking about they 01:24:52.893 --> 01:24:55.902 - have to be and it is vague. They must be from 01:24:56.418 --> 01:25:04.202 - Um, a resident of a county within the Indiana housing and community health development authorities balance 01:25:04.202 --> 01:25:11.695 - a state continuum of care region. So, um, so basically those are like the housing regions of which all 01:25:11.695 --> 01:25:19.115 - the counties are in sections. We are actually in region 10. I brought this to bathroom so you can see 01:25:19.115 --> 01:25:24.862 - where we're at. Um, in our region is Martin, Bowen, Green, Lauren, and Morgan. 01:25:24.962 --> 01:25:31.237 - along with Monroe. So it's a six county region. So participants are supposed to be from one of those 01:25:31.237 --> 01:25:37.823 - counties and they have to show a valid ID when they come in. So the law did say we do not have to collect 01:25:37.823 --> 01:25:44.284 - information. So I do not want to collect information, but what I'm requiring people to do is staff have 01:25:44.284 --> 01:25:45.278 - to check an ID. 01:25:45.378 --> 01:25:51.637 - You have to see where the person is a resident of one of those counties, document the counties, document 01:25:51.637 --> 01:25:57.776 - the checked ID, and then sign their initials. So we have a log that they're supposed to track on every 01:25:57.776 --> 01:26:03.916 - other person or every person. And for the one for one, they do an air table. So it's tracking counters 01:26:03.916 --> 01:26:08.446 - that everybody who comes in and the service that they receive is anonymous. 01:26:08.546 --> 01:26:14.987 - But they have to check certain design instructions out and I'd like to get the back end access to the 01:26:14.987 --> 01:26:21.617 - back end of the air table program. But if I can't, I can also always get a report from them on a minimum 01:26:21.617 --> 01:26:25.342 - of once a week basis so I can see what's going on in that. 01:26:26.274 --> 01:26:31.350 - Another big change is that Indiana Department of Health will now be responsible for determining if the 01:26:31.350 --> 01:26:36.326 - program is in compliance. So we are expecting an update and guidelines from Indiana State Department 01:26:36.326 --> 01:26:41.402 - of Health. We thought they would be out last Friday, but we were told that they've delayed. So I think 01:26:41.402 --> 01:26:46.428 - their leadership is looking at it on what, you know, carefully thinking about what guidance they want 01:26:46.428 --> 01:26:48.350 - to give us. So we're waiting for that. 01:26:48.578 --> 01:26:56.736 - And once we get that guidance, we can update what we have now, share it with the board, and share it 01:26:56.736 --> 01:27:05.135 - with the legal. And as long as that's approved, well, it's to get those procedures too. Kathy, I'm just 01:27:05.135 --> 01:27:13.535 - curious. Will our unhoused folks be able to show some kind of documentation from, for instance, Wheeler 01:27:13.535 --> 01:27:18.462 - or Beacon that they are getting services from those folks to 01:27:19.554 --> 01:27:28.549 - show that they live within this region rather than because obviously even if they actually own an ID, 01:27:28.549 --> 01:27:37.633 - it may not be from this local area. I checked with the DMV and there are procedures where somebody who 01:27:37.633 --> 01:27:43.806 - isn't housed, if they are going to get services at Beacon or Wheeler, 01:27:43.906 --> 01:27:50.415 - Beacon or Wheeler can sign up, write a letter on letter hat saying that this person is getting services 01:27:50.415 --> 01:27:56.798 - from us and they can get their mail there. So that address will become their legal address. So that's 01:27:56.798 --> 01:28:03.119 - one they can do. And also get letters from other official government sites or other to say that they 01:28:03.119 --> 01:28:09.502 - got a letter from them and that can suffice as presidency. Thank you. So Kathy, are you doing onsite? 01:28:09.698 --> 01:28:17.317 - It will also be doing on-site checks. Nico is there three days a week too, so I hear from that. Plus, 01:28:17.317 --> 01:28:25.010 - I'll do on-site checks as well, drop-ins too. Excellent. Okay. Great. Thank you so much. There's a few 01:28:25.010 --> 01:28:27.774 - more changes. Oh, yes, please. Okay. 01:28:28.066 --> 01:28:34.279 - syringes service programs who operate a fixed site that can't be within a 1,000 feet of a school, a 01:28:34.279 --> 01:28:40.679 - licensed daycare, or a building that's primarily used as a church without written permission from that 01:28:40.679 --> 01:28:47.017 - establishment. But that doesn't pertain to distribution of loxome, providing referrals, education, or 01:28:47.017 --> 01:28:53.231 - accepted syringes for safe disposal. So the other thing they want tracked is efficacy of treatment. 01:28:53.231 --> 01:28:54.846 - We give referrals out for 01:28:55.042 --> 01:29:00.657 - many services, especially for drug treatment services, but they want efficacy of that treatment tract. 01:29:00.657 --> 01:29:06.273 - So we're talking about getting word of mouth and asking people, like people always volunteer when they 01:29:06.273 --> 01:29:11.942 - go to treatment. So just checking in with them and seeing how they're doing and giving support and then 01:29:11.942 --> 01:29:15.486 - tracking what they say that they're doing. So the other thing or 01:29:16.322 --> 01:29:22.632 - they said was that we can't distribute chemical reagents or precursors. Nobody does that now that I 01:29:22.632 --> 01:29:28.942 - know about. So we were kind of discussing like how that came to be. We're meeting at SEP or syringe 01:29:28.942 --> 01:29:35.252 - exchange programs, administrators. And that was definitely a conversation that we had in our group. 01:29:35.252 --> 01:29:41.309 - So they're talking about that they can't distribute like suboxone. Is that what they're saying? 01:29:41.309 --> 01:29:45.726 - What are they? No, they were talking about epinephrine. So, you know, 01:29:46.274 --> 01:29:53.230 - Yeah. I wonder if they're talking about the tests, the point of care tests that people can use to determine 01:29:53.230 --> 01:30:00.315 - if what they're about to ingest slash inject has contained fentanyl. If those tests exist, there's opposition 01:30:00.315 --> 01:30:06.756 - to those being distributed with public funds. That's my guess. The things like the zine test or the 01:30:06.756 --> 01:30:13.261 - fentanyl test, is that what you mean? Yeah, that's my guess. They made them legal last year. I begin 01:30:13.261 --> 01:30:15.966 - to think they took it back out this year. 01:30:16.514 --> 01:30:31.077 - not to check for that. Are you all anticipating a drop off in what we've seen in terms of the decreasing 01:30:31.077 --> 01:30:44.670 - HIV and hep C numbers? I mean, we've seen a lot of people come through and things were improving. 01:30:45.186 --> 01:30:51.542 - with the amount of needle exchange we have, are we expecting those numbers to go back up now that these 01:30:51.542 --> 01:30:57.653 - restrictions are in place? I'm really hoping not. I'm hoping with a lot of education and after they 01:30:57.653 --> 01:31:03.826 - see how it's still being supported, even with these new changes, that they don't need to worry. It's 01:31:03.826 --> 01:31:09.998 - still something that we're there to serve them and to help them and to help them get the things that 01:31:09.998 --> 01:31:13.726 - they need. Now, you're also hoping that we won't get as many 01:31:13.954 --> 01:31:22.828 - requests to come pick up needles. Actually, those have greatly gone down. I track them every month for 01:31:22.828 --> 01:31:31.616 - like one of our reports, and we do not get, you know, as much of that the ones we used to get. That's 01:31:31.616 --> 01:31:40.404 - seriously gone down the last few years. Oh, thank you. So we don't get ready-made requests to go pick 01:31:40.404 --> 01:31:41.438 - up needles? 01:31:41.762 --> 01:31:51.338 - That is many, not like we did, especially like in the beginning. The article was talking about the Southside 01:31:51.338 --> 01:32:00.387 - businesses, make it sound like they're inundated with abandoned syringes on their property. And I have 01:32:00.387 --> 01:32:08.030 - no doubt that they find some down there and in their mind that maybe that means a lot. 01:32:08.258 --> 01:32:15.925 - where people say, oh, you have to come. There's like a million syringes, and you get there, and there's 01:32:15.925 --> 01:32:23.666 - one. I think they expand sometimes. We're happy to go if people need it, but they really have gone down. 01:32:23.666 --> 01:32:31.259 - That's something that I think. Interesting to know that. And I think our hepatitis C numbers have gone 01:32:31.259 --> 01:32:36.862 - down, but I think there's a rise in HIV cases that we were concerned about. 01:32:37.730 --> 01:32:48.613 - At some point we need to address that. Okay, are there any other comments from board members or from 01:32:48.613 --> 01:32:59.926 - help officer? Yes, I'll be your help officer tonight. I'm curious, what's happened with our mobile unit? 01:32:59.926 --> 01:33:07.038 - I'm sorry, I don't mean to open a can of worms, I'm just curious. 01:33:07.298 --> 01:33:17.429 - has the individual who was looking at it and telling us what was available, have they come forth? And 01:33:17.429 --> 01:33:27.660 - what's going on with that now that we may have some nurses? Well, so we need to go back to the council 01:33:27.660 --> 01:33:36.798 - to have that re-appropriated because it's changed budget years. So that has been submitted. 01:33:37.282 --> 01:33:47.105 - for their review and approval this month. So hopefully that continues and it has still been. Still on 01:33:47.105 --> 01:33:57.314 - the list of that is being the units are being looked at or purchase for the fleet person is still looking 01:33:57.314 --> 01:34:06.078 - for us. It's still on the list of things that need to be done, but we really if we can get 01:34:06.178 --> 01:34:15.505 - The approval again for the appropriation, we need it to be done so we don't have to do this again. Is 01:34:15.505 --> 01:34:25.199 - that also something that's going to be going up before council in like maybe this next week? So hopefully 01:34:25.199 --> 01:34:34.526 - next week. So indeed it might be helpful to have board members present to support you in the request. 01:34:35.746 --> 01:34:46.256 - Hopefully it's smooth sailing. Just thought I'd ask. Yeah, there's a lot of excitement in the department 01:34:46.256 --> 01:34:56.265 - for being able to have that unit and start providing services. So hope we can get that done soon. I 01:34:56.265 --> 01:35:05.374 - guess I'll only share that since it doesn't appear on here, the idea we created this rural 01:35:05.570 --> 01:35:18.306 - outreach funding. But we are not all happy because we have this large urban floor. So some of our surrounding 01:35:18.306 --> 01:35:31.390 - counties may or may not receive funding, but it may sort of float west eventually, possibly. It's still a child. 01:35:34.658 --> 01:35:48.721 - Peter just expired. We won't let them get you. You have to wait. They're there right now. They're waiting. 01:35:48.721 --> 01:35:57.790 - Any other comments? Okay, well I make the motion to adjourn. Second.