- call the meeting to order for today. Is that acceptable, Ann? I want to add the vote on whether or not
- we can add a couple of agenda items. The first one is actually a little different than the item we have
- on the agenda. It says clinical office assistance.
- What I actually want to address is a and and job a job description for the clinical assistant position
- so that we can send that in a timely fashion to the Council, hopefully for approval. So that we can
- have staffing. OK, so if I could get someone and more, do you have?
- copies of that. We had that updated one. Yeah, so this one. Oh, OK, perfect. OK, great. It's in the
- left side of your folder that. So there are four of them, but I just put them in here. So. Did I have
- a motion for that? So move.
- And anyone second? Second. OK, so we'll add that to the agenda. Aye. Aye. I'm voting number two. Aye.
- OK. And then the second item to add is for an update from Kathy Hewitt
- regarding the state changes, the state law changes for the needle exchange program. So if I could have
- a motion, a verbal motion for that. I'm so sorry. Where would you put that? Number five, we'll put that
- as number five. This job description specifically is number four. Well,
- or just replace number three on the job? Well, no. It's a separate thing, actually. So anyway, number
- four will be the job description that we just approved. And number five would be an update from Kathy
- Hewitt. So I need a motion for that. So moved. I'll second that. All in favor? Aye.
- Okay. So I do want to welcome Dr. Kevin Moore. He was approved by the commissioners. He is an ER physician.
- So welcome. Next on the agenda, we have approval of the previous minutes. Those were from December,
- 2025. December, he goes 18th.
- December 18th, 2025. Does anyone have any changes to the minutes? I move that we accept the minutes
- as written. I will second. All in favor? Aye. All right. So regarding general public comments that I'm
- going to read,
- The Monroe County Board of Health encourages and welcomes public input. Written comments may be submitted
- at any time via email at boardofhealth.co.munroe.in.us. During meetings, comments related to specific
- agenda items will be heard after the board's discussion of that item and prior to taking a vote.
- At this time, we would like to invite those who would like to comment on any non-agenda item
- to speak. For those attending in person, please sign in at the front of the room and those joining us
- online. Please use the raise hand feature to indicate you would like to provide comment. Each speaker
- will have three minutes and we ask that you please begin by stating your name for the record. Do we
- have any hands? Okay, seeing no hands and no one in the room for public comment will continue.
- Oh, excellent. We get department updates from Lori Kelly. We have quite a few, I think. So we'll just
- start off with vital records. So vital records has actually been tracking data related to the legislative changes
- that we saw with Health First Indiana and how those funds can only be used for Indiana residents lawfully
- present in the United States. So an example of that in February, 80% of the customers going to vital
- records did have a real ID or they could otherwise provide identification to confirm their residency
- and lawful presence. 20% were out of state.
- individuals or otherwise had to rely upon our non-HFI funded employee to be able to provide and complete
- those services. So we'll continue just kind of tracking some of this information department-wide to
- see how it's impacting us because we don't have a non-HFI employees in every area of the department.
- which is putting us into a situation where we then have to turn those individuals away. We have two
- employees in Vital Records who need to complete their online training in order to keep their Indiana
- notary license. So they'll be doing that. The cost is pretty inexpensive. It's just $50. So they're
- working on that.
- with harm reduction. Our harm reduction specialist is working with the city on outreach for naloxone
- training and distribution, trying to really focus on businesses and training staff for some of our local
- businesses here. She's also completing certified peer support professional training and will be certified
- once she completes the exam.
- So in Indiana, these professionals use that experience with this formal training. It's essentially to
- help connect, inspire change, and support individuals for people who are going through their recovery
- process. Planning is underway for the biannual Monroe County Substance Use Disorder Awareness Summit.
- It's a large work.
- This event is going to take place September 1st and 2nd at the Convention Center. So they're looking
- at selecting speakers for two different tracks. So one track would be an all-day national speaker who
- comes in and actually surveys the community prior to the event, does some evaluation.
- and then he shares what he has learned about drug trends in the area and nationally. The second track
- will have multiple speakers who are focused on providing information on recovery and resilience, drug
- trends and changes, how drugs are made and how that's impacting communities and individuals.
- I have submitted the letter of intent to apply for grant funding that does support the salary expensive
- of our harm reduction specialist. The award period, it's going to be 12 months and would run from June
- 1st of this year to through May 31st of 2027.
- That grant application, again, will be focused on this individual providing HIV testing, harm reduction,
- and support services for the Syringe Service Program. Harm reduction and disease intervention are still
- working on providing the drop-in testing services to the public and for free. So looking at starting
- that in April. So free testing will be offered one day a week.
- during some of the evening hours for HIV, HCV and STIs. Public health emergency preparedness. There
- were 37 individuals in the public trained and stops the bleed during February. They are looking at hosting
- monthly preparedness trainings for the public. Some of the topics would include
- preparing for power outages, emergency communications, vehicle preparedness, and building emergency
- kits. Transitioning more into our health services, disease intervention specialists, that next grant
- application has been submitted.
- So we are hoping to receive just under $300,000, which would continue to support our three full-time
- disease intervention specialist positions and related expenses such as mileage, technology, supplies.
- When will we know when we get it? If we get it or not.
- Hopefully within the next month. So there was a little bit of a delay. So because we lost that grant
- funding, because we could not get approval for the additional position with the grant funding, our renewal
- was delayed. So they actually had to amend that grant to extend that so then they could reduce the money and
- Now, so we're kind of behind, so we hope to know within the next month. Laura, can you help us understand,
- originally the grant was for the two positions and then we added more because of the state's requirements
- and requests to us. So we've gone back to three and it seems to be working very nicely here. Will we
- have to go back to council
- not only once we've got the letter, but once we actually have the funding in order to support those
- positions. Well, the county commissioners will have to approve the new grant and then it will go to
- council and council will have to approve the funds and the appropriation for all of those lines or the
- personnel. So do we expect the same kind of prolonged delay that we had
- between the letter and the actual funding after July 1st, which means then we have to go to council
- and hope that they will indeed approve those positions. And in the interim, do those positions continue
- to work? I mean, how does that work out for us?
- The idea is that we hope there's not any issues with those positions because there is still some leftover
- funding from the grant that actually ended at the end of February. So that was when it was originally
- going to end. So even with the reduction of the $58,000 roughly, we still had some extra funds, again,
- just because of those long delays where we couldn't hire and fill.
- So they've amended that to extend that we can continue using those funds until 2027. And in this time
- period also we'll be getting a new contract for the grant cycle that we should have started March 1st.
- So basically we're covered and even if council delays approval of utilization of that funding for the
- positions,
- we should still be okay and that DIS can continue their work. That's how we are currently operating.
- Okay, great. Thank you. Can I ask a question about the Stop the Bleed program that we have? We train
- individuals from the community for that. How does that go about? How does it happen? Do you want to
- talk about that? Sure. Okay, yeah. So I'm the director of public health preparedness.
- So Bryce is our emergency preparedness coordinator, and he offers the certified staff of leading training
- to either individuals who request it, we do phones to classes here, or the library, for example, if
- anybody would like to sign up, it's free of charge. We also work with organizations to train their staff,
- channels for their coaches or personal trainers, as well as going into the schools.
- The Girl Scouts. Yeah, Girl Scouts and Boy Scouts. And we do offer blade control kits to the people
- who participate in this training. Some of them are something to start with. And where do those kits
- come from? Those kits come from the Stop the Bleed organization. So it is what they recommend. Penistatives,
- an alternative, things like that. Do we pay for them? Yes, they are covered by our preparedness grant.
- OK, but is there a reason I'm asking this? Because I'm on the track, Chambu Jack Project Vivian.
- there's a lot of money for that sort of thing. Well, we had money. Actually, we had our meeting just
- two days ago, and we have money, and we specifically discussed the Stop the Bleeding of the Kids. So
- I'll get you more information. Let's see, we should move on.
- I'm currently working with the City of Bloomington Mobile Integrated Health to schedule a back to school
- health fair later this summer. So where we can provide vaccinations, hygiene kits, you know, some back
- to school supplies, sunscreen, and offer health screenings for adults at no cost during that event.
- Also looking at
- working with them on chronic disease initiatives where we can focus on the high blood pressure and diabetes,
- continue providing access to that equipment that we have in stock now. So those blood pressure monitors
- and glucose tests for individuals who have that chronic condition and don't have a way to monitor their
- condition at home.
- We currently have two nurses that are completing their training, going through all of their onboarding,
- orientation, state trainings. We are looking at scheduling appointments for vaccines and health screening
- starting in April. One of the areas that I'm trying to navigate right now, which we'll talk about,
- later in the meeting is, you know, lack of a dedicated front desk support position that would be able
- to help us get these services up and started. So to start out, we'll have a main phone line. All of
- the nurses have their individual phone line, but we'll have to alternate between the incoming calls,
- going, ringing to all the nurse lines,
- And someone that's available can answer it, address questions, schedule appointments in times where
- it has to go directly to voicemail because they're just not going to have the capacity. They may not
- be in the office. They might be out in the community and then those calls would be returned at a later
- time. So really hoping to be able to avoid that. We have had complaints over the past years about, you know,
- call our clinic and get directly to a person to provide assistance and to schedule appointments and
- that delay of care. We are also going to start scheduling the lactation counseling appointments on Monday
- afternoons in April. Aubrey, our maternal child health coordinator, will be providing those services.
- So Amira, one of our new nurses, she's going to be working with Indiana University on the goal program.
- So that's Get On Board Active Living. It's an eight week session this summer. So she'll be spending
- some time with Indiana University prior to that program starting just to
- develop the program materials, training, advertising. And then during that eight week session, it's
- about 10 hours of work time dedicated each week specifically for that program. She's also working with
- Purdue Extension for matter of balance classes for the public. So that's around our fall prevention,
- our trauma and injury prevention core service. We haven't
- get determined, the dates and times, but hope to know that before the end of the month. Let's see. So
- working on the transition of our communicable disease case management with the neuro, oh, sorry.
- It's OK. I'm just curious. I'm wondering if the goal and the Purdue balance classes
- that Amira may take up. Will those again fall under our HFI requirements? Yes, and it's really crucial
- that we get those going because that's what we've been, you know, needing to focus on over the past
- year. I'm just wondering in terms of the participants having to prove their eligibility under HFI funding, will
- Amira's work fall under those guidelines? And if so, how do we envision making that work or is somehow
- it's exempt from that? Yes, so that position
- is being funded through grant funding, which will not limit those services. Thank you. That's what I
- needed to know. Yes. So as long as we're not incorporating or purchasing those HFI supplies, then we're
- fine. Yay. OK, yes. So just we'll be transitioning the communicable disease and reportable conditions from our
- staff who are currently covering that. So Kathy Hewitt and Linnea to the nurses over the next few weeks
- to begin, you know, taking that on. Can we just thank the two of them? They've been doing so much for
- us in this time. Thank you. As of this morning when I looked, we have 98 open investigations. Not all
- of them are being worked on and 24
- to get started, so definitely do a lot of work in that area. Oh, let's see. So there was an issue recently
- discovered with lead blood testing, so missing records associated with lead results coming from Riley
- locations in the state.
- So the Indiana Department of Health has been working with the Indiana Health Information Exchange for
- that IHI. And IU Health on the issue recently received a data dump from IU Health of over 8,000 records
- from April of 2025 to December of 2025. So they're looking on
- the long-term solutions and the issues with the technology and that information not crossing over. That's
- just something with our lead program. That information just did not get back to the clinicians? I don't
- know all of it, but from my understanding, it wasn't transferring to our state systems.
- It went, the pediatricians were testing children for lead. It was going to the lab, but the lab was
- not reporting back to the state, the environmental system. Is that right? That's my understanding. Yeah,
- so it wasn't being then dumped into our system where we go and check. And so I can remember in 2025,
- towards the end, the Indiana Department of Health reaching out and saying, you know, there seems like
- the numbers are off and kind of starting to look at it. So I think that they realized something was
- going on. And so I'm not sure what's been going on the back end. But apparently there was an issue with
- that transmission of data just not happening.
- So the results were being reported back to physicians when they weren't being recorded with the state,
- is that correct? Or not all of them? Not all of them. And so then we weren't seeing those results. So
- they're going to get a, say, backlog list? Yeah, so that's what they're now dumping in. It's just confusing
- because we certainly had the one family, the public health nurses were following
- that had extremely high levels. And so I know we were getting, at least our public health nurses were
- getting those results. And I assume they were getting through the system and not directly as the clinician
- 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.
- Just some of it didn't, so either,
- whoever was doing it or something happened, just everything went a bit skew. Okay, got it. Thank you.
- Let's see. So if you can remember the Fresh Connect program, and I'm talking about that last year. So
- I'm scheduled to meet with the Veterans Office Director again next Friday. So we're going to kind of
- circle back around and revisit
- whether that's a program that we could work with the Monroe County veterans to get going this year.
- Fresh Connect is that program that provides access to fruits and vegetables. Participants essentially
- are identified as having a chronic condition, so high blood pressure, diabetes, heart disease, cancer,
- for example.
- they would agree to participate in providing biometric data and questionnaires where we can evaluate
- and understand barriers to eating healthy, engaging in physical activity, accessing healthy foods, maybe
- how their health status is impacting their mental or emotional wellbeing so that we could collect this
- data over time and also evaluate program outcomes.
- I have all of the questions. I'm just wondering if vets in particular were focused on because they are
- used to providing data and they don't necessarily have the same amount of skepticism that many of the
- other folks within the community who may need that kind of
- help may have of providing their personal data. Is that the idea? The idea was trying to find those
- with a need that would also fit in with our HSI restrictions. So what are some of those populations
- that have needs that we feel pretty comfortable are going to be Indiana residents that could with lawful
- status. But that's the thing about the country.
- Great. Thank you. Um, let's see. Also working on now promoting our service with the milk bank. So we
- are a milk express site. We have the freezer now. Aubrey and I have gone through the training so we
- can begin distributing that donor human milk to families. Essentially,
- We are basically the access point. Families can go online and order that. It's shipped to us and we're
- ensuring that the families can pick that up from our location. I had a PowerPoint. Just, is that okay?
- Yes, perfect. Sorry. I felt like we haven't
- met, I guess, for three months. Oh, yeah. Yeah, sure. Not a whole lot. So just kind of focused on some
- of the highlights from the core service data that we submitted to the state in 2025. Let's see. So this
- just kind of gives you some information
- for 2025, so we had 19 active TB patients, 350 being treated for LTBI and provided 390 tests. So Linnea
- created and sent out this community survey in 2025. So this was conducted during October and November
- to just be able to try to
- collect some public input on services. So we did, just within those two months, receive input from 315
- individuals. 310 of those live, work, or attend school in Monroe County. So this just kind of gives
- us an idea about some of the community input and what services we can provide. How did that survey go
- out? Who were the people that
- No, it's in your packet. Could you just add a little bit on that? Sure. Yeah. So it was made available
- online. We also had hard copies that we distributed to groups and to individuals. We also had sandwich
- boards with a QR code on it so that people could utilize all the devices to respond to the survey. You
- certainly got a lot of information. We didn't better conduct it.
- So this was during that time period too when we were going with the council about the mobile unit and
- how we can better serve the community and what is the community really looking at from us as far as
- services and how we can help assist them. So that's just one little snippet of the information and the
- rest is in your packet.
- So this was a good highlight for 2025. So our vaccinations so over 1300 for children and 1600 for adults.
- Oh, so let me talk about the vaccines. I guess again the Indiana Department of Health. They have come
- out and conducted their site visit for our vaccine program, so everything has been done.
- Submitted for our vaccine for children. The backs here account has now been transitioned over fully
- to the Monroe County Health Department. We are waiting for.
- just a few more pieces of equipment from Vax care. So essentially the electronic hub that we use for
- inventory counts and the devices that we use to scan the doses before they are administered. We expect
- to receive those next week and then we can move forward with placing our first orders for vaccines.
- So communicable diseases. This just kind of gives you a snippet of the work being
- done there. So 269 completed case investigations. Those don't include the work that our disease intervention
- and harm reduction is doing with the HIV STIs and HCV. So chronic disease provided 573 blood pressure
- checks, 262 A1C tests, and then 98 cholesterol tests.
- So really hoping to, we'll be incorporating these tests for free once we start scheduling patients in
- office. And then over time, once we can expand and be going out in the community and offering these
- services as well. Is that data from in-house and the outside events? I'd have to look, I pulled these
- directly from what the state gave me for their core service.
- because they kind of track it differently. And referral services, so, you know, 646 referrals for hepatitis
- care. So that really kind of stood out to me. Just the amount of work that employees are doing just
- to be available to help connect individuals to referrals and care.
- So here's our KPO priority that we really need to focus on this year. So if we can remember back at
- the start of Health First Indiana, we had to submit what they were referred to as key performance indicators
- at that time. Now they're calling them key performance outcomes. So this was one based around fall prevention
- and that rate of non-fatal hospitalizations.
- 2025, isn't that fair?
- So we're not headed in the right direction with this as of right now. So it'll be really good once we
- can get a mirror up and going and doing that matter of balance. Also trying to work with the hospitals
- to see if we could collaborate on a referral system. So are there frequent fallers? Are there individuals
- that they can provide
- our information and then we can connect with them to offer them our programming and education. And then
- that's just additional data that kind of shows where we're at. I'm curious here. So is there anything
- in our looking even at that data and collecting that data that correlates with
- substance abuse disorder. Well, so we get this information from the state, and so that's not something
- that I've seen, and I'd have to see how they're maybe capturing that. Yeah, because I think it would
- be interesting in capturing that data to look at substance abuse and or substance use and how those
- falls correlate. OK, let's see what I can find out about that.
- And that's just another, just kind of gives you a breakdown of where some of those falls are coming
- from. So our other, so we submitted one to focus on decreasing the smoking rate during pregnancy.
- So we are slowly increasing our quit for two participants. So if we can remember, we had to temporarily
- suspend that program when the changes were made to remove tobacco cessation and prevention from core
- public health service in Health First Indiana. So we had a little bit of gap in being able to provide
- these services.
- Looking back at the February monthly reports, we now have seven active participants and just hope to
- continue to grow from there. So our disease intervention specialists wanted to focus on increasing the
- proportion of Monroe County syphilis cases being treated. So
- Nationally, the Indiana Department of Health has reported congenital syphilis cases have increased.
- They increased 82% between 2020 and 2024. So really just, this was really an important area for GIS
- employees to focus on. Is the congenital syphilis increase almost double in that short period of time?
- What's, do you know the end? Is it in five or is it 50 or 50? Just that percentage, the 82% from 2020
- to 2024. So, I mean, in what they're, what I'm hearing is, you know, that limited access to prenatal
- care, medication shortages, particularly for pregnant. One of the other things that we're seeing across
- the state is that there are emergency rooms where
- patients are visiting and are not being checked for any of the communicable diseases, especially when
- it's recognized that this is a pregnant woman who may not be getting prenatal care. So while we may
- be doing well here, and we've seen the numbers here,
- being lower than obviously across the state and the area up in the Northwest part of the state being
- some of the highest we're seeing. Across the state, the number has dropped in the last year,
- which is great. It's a sign that things are coming down as the amount of awareness is increasing, but
- they are finding that there are emergency rooms
- that are not checking pregnant women for syphilis and galorea. When would they check? During a routine
- visit. That's something that wouldn't happen. Well, there's a big move through IDOH for that to happen.
- If women are not getting prenatal care, and that's the only place they're being seen is in the emergency
- room, that that happened there, that indeed this is
- It's a high risk to infants and the long-term effects and costs to the state are enormous. Well, I find
- it interesting. As medical director of the emergency department for the past four and a half years,
- I've never heard of that. I've never heard that. I communicate with the OB doctors all the time. So
- if IDOH is doing it, they need to increase their penetrance so that we can address it. The other thing
- is that they tried that with hepatitis. They tried to test everyone with hepatitis and they found that
- a lot of resources
- no change in outcomes. So nothing, that's saying that we shouldn't be doing it. And I'm saying that
- there needs to be, we need numbers and we need some penetrance. So I've never heard of that. One and
- a half years. That they know, you know, it's not penetrating. It's clearly not. Okay. I'll let him know. Thanks.
- Let's see, so General Environmental wanted to focus on being able to get these properties. So actually
- as of 2025, there's only one property left that needs to be tested to determine whether it's safe to
- come off the list or whether decontamination needs to occur. So we really pretty much knocked all of
- those out in 2025 and hoping to be able to get this
- last one taken care of as well. So 13 went to one. Nice. Yeah, so we contracted with an individual who
- went in and did the testing and then he was qualified enough that he could also do decontamination on
- the properties that needed that to get them into safe levels. So for the people living in them. And
- then this is just our last
- KPO, so focused on decreasing the rate of drug-related poisoning fatalities. So still just continuing
- to focus on distributing Narcan, providing education and training, being able, working with our suicide
- overdose fatality review teams and community partners. There's a huge amount of that. Is that, so the
- number says, is that on the right decrease the rate of two
- That's a goal. It looks like we're so far ahead of the goal. Is that correct? Yes. So we're doing good
- on all of them except for our fall prevention. Yeah. I definitely noticed in the past few years, decrease
- in the number of people that are sent to the emergency department who are near fatal events or fatal
- events. So that's good. I will stop now. Well, thank you. Is it possible? So the checklist one really
- cares about that.
- And some of those, you know, when we talk about these numbers and trying to get the percentage increase
- and decrease, it changes the math if we know the numbers. And these numbers come to you from the state,
- is that correct? Yes. Do they ever give you the numbers or do they just say the percentage? I think
- we can ask for it in different ways. But yes, we do get it all from them. So that's something that we could
- If there's different formats or something specifically you'd be interested in, we can definitely reach
- out to them about that. I think that generally when you look at these things changing so greatly, the
- numbers matter. Is it five? Is it three? Is it 50? It matters in terms of how you approach these problems,
- I think. We certainly found it in dealing with hypertension and diabetes and severe phobic complications,
- those relative risks.
- And that matters more than necessarily the percentage change. And in presentations, we do get numbers.
- So they have that, and they do give it to us. OK. Laurie, I have a question. When we met in December,
- we talked about employees were requesting
- assistance monetarily with certifications and the board asked, could we get a list and the number of
- certification licenses required because you didn't know how to, we were going to be able to respond
- to that with the limited funds that we had. Where are we on that? So Marissa, the administrative assistant
- has been creating and, um,
- gathering all of that information. So I think it's probably at a point to where we can provide that
- to the board at the next meeting. So one of the challenges that we at that time were dealing with was
- because of the changes that were made when County Council amended our budget and essentially
- we had zero dollars that we could use towards that. So we've been working over the past few months to
- submit our financial reports and new budgets for additional funding to be able to now start providing
- some of those. But I think the question would be for the board developing a policy. So,
- Is our people required to have the certifications prior to hiring and maintain those over time as part
- of their employment? Or is it the expectation that the county will cover those costs that are required?
- Well, it would really depend on the positions, I would think. For instance, if you're looking for a
- nurse, certainly they should have certification before they're hired.
- And so then do they maintain paying for their license, you know, like other organizations, I guess,
- require, or does in that transition to the county covering those costs? And the cost of continuing education
- for those individuals. And I think, Lori, what you shared with me was that Lori's coming up with a schedule of
- who has which certifications, how many people in a particular department need to be certified and can
- it be done on some kind of rotating basis so that each year so many certifications are handled so that
- we're not like every year taking on all the certifications within the whole department and be able to
- better manage the financial effects of that kind of
- process? Well, I think it's from my opinion only. In my opinion, I think it can be challenging in some
- ways to think about a strict standardized system because our funding fluctuates so much. So when we
- were going into Health First,
- Indiana and we were going to have to start providing all these new core services and these new activities.
- And we had additional funding to then where people could start getting those trainings and doing all
- of the, you know, develop development. And well, when funding kind of falls back, then how do you, what
- are your choices with maintaining those over time?
- So currently they cover their? No, they can't. They can cover, as in from our budget. I will say that
- anything related to trauma, and I'll get Kimberly, anything related to trauma, even if it's, it can't
- be tangential, but if it's related to trauma or it affects the care of Hoosiers in trauma, the TRAC
- has funds to help.
- So I think when you have that conversation with Kimberly, you can talk to her about other things that
- might be useful for getting nurses with certain certifications and education and so on because there's
- different money available. And then, you know, is there, are there performance measures that are put
- into place or standards and expectations that if the funding is
- you know, being provided for employees to obtain these additional trainings and certifications that
- they are actually then carrying out those, those programs, um, you know, over time, or what do you do
- when you invest $5,000 in someone and then they need to go take a better paying job? Um, and so, I mean,
- I think those are just all things that anybody has to. It'll be very helpful.
- to get an idea of what kind of certifications we're talking about, how many employees we're talking
- about, et cetera. I personally have never worked at a place where it was expected. You just always did
- your own. It was never provided. That's how it was always been for me. If it's been provided, I mean,
- once you've
- been able to provide it, and then you have to take it away for some reason. That creates a lot of discord
- with the employees. Yeah, so I think that's one of the big challenges with this makeshift in the health
- first. You have this huge influx and all these opportunities, and then it's taken away, and how do you
- readjust? I think having all that information in one document would be a good start. I agree.
- And is this something that you could imagine the commissioners might want to help address because it
- sounds like policy and that they may have, you know, across the county have some kind of ideas. Well,
- I wish that the county did have a policy on it because I think it would be
- easier if there was a standard policy across the county, but there's not. So maybe that is something
- the commissioners really need to address. That would be the council, right? No, commissioners need policy.
- Council runs money. So it would have to go to commissioners to really develop a policy that they might
- want to talk to council about, but it would be their policy that they would direct
- counsel would be paying for, I guess. Yeah. To me, it sounds like your point about people leaving after
- you've paid for their certification. Well, having certification to work here should be one
- of the requirements. They should expect that. So what I would suggest is that maybe we have some sort
- of cost sharing.
- so that everyone has some skin in the game, that the employee gets some assistance paying for certifications,
- but the county paying for all of it, I think, is like, hey, I've never worked anywhere where somebody
- paid for my continuing education to get my, renew my license. Did you? I mean, you did, yeah. So maybe
- having some kind of stipend
- Oh, I say stipend or some set amount for, and then they pay the rest of it. Yeah. I mean, my, my license
- was a trivial amount because the state, you know, has states cheap and you know, that they make it cheap
- for everybody. But, but the getting the, you know, paying for the, for the continuing ed was not necessarily
- inexpensive. So,
- Are you helping the providers? And I believe the nurse is also gonna, so I've been like, my license,
- certain amount of CME per year provided by organization. So I think it depends on the umbrella that
- you're working under. So it's a perk. So it's a cost sharing thing or? No, no, they, for license renewal,
- DEA renewal. So they pay for all. Do you think that's required to work
- they pay for and then they also provide a certain amount of money per year for CME that I can use however
- I see fit as long as it's requirement. Yeah, it's an iceberg. So that's all in an Excel spreadsheet
- so we can submit that with the next board package. Okay, thank you very much. Very good job. I'm a little
- bit tired.
- That's what I was doing all day. Were you going to address the HIP? Oh, sure. Great Medicine is well
- in here? Yeah, we can. So I think this is, I think you saw this at the December meeting. Let me find
- it, I guess. It looks like this. Oh. This is the Great Medicine theme.
- This was the pilot program that we started with Health Net. So when this came about because we were
- looking at ways to reduce the emergency visits and emergency response calls that were going to the Wheeler
- mission and then to the emergency department. So we took a portion of the Health First Indiana funds to
- help cover personnel expenses for Health Net staff to begin really focusing on trying to intervene to
- provide services. And so this is just some of the outcomes that we've seen since that program started
- and how it's reduced the emergency department visits. And can you remind us how much we contribute
- this program? So 135,000 I believe last year and this year. Okay. So we as a health department, we've
- contributed that amount to this program. Yes. Do we have any idea how much IU Health has contributed
- to Health Net for this program? That I do not know. Would you be able to find that out?
- For us, that would be really interesting information. Since we're improving things for your emergency
- room. So the numbers, sorry, the numbers, so if you take $135,000 and divide by 92, so that's $14.60.
- On the other side, there's a three. Yes, but that's $1400, $14.67 per person.
- So yes, it would be that, you know, we're contributing. So it would be interesting to see, you know,
- what IU contributed as well. Yeah. So we'll continue to get some of these updates and information of
- these services. So I think there's a little bit of a slow start, again, just because people at the Wheeler
- Mission weren't
- they weren't aware and it was a new system, but as word got out, they began to start seeing more individuals.
- So really great program and I think it's great that we've been able to continue supporting them. Okay,
- so the next item is older continuing business. I just want to say that behind the scenes,
- the amount of machinations that Lori has had to do to get us transitioned to doing the vaccines on site
- as opposed to those occurring at the clinic at IU, or rather at Miller Drive. It's been a lot, and she's
- done an awesome job. So we kind of meet.
- barriers more along the way than, than I would like to see. Um, and I don't know how to improve our
- relationship with council and with our, um, liaisons. I don't know if, uh, you know, we go even publicly
- individually to the meetings and you know, say, Hey, we,
- We kind of need some help and some collaboration. Peter Iverson, we actually have not met with him once
- since January 1st. And that would be helpful. And we're going to also talk about that. I guess I'm skipping
- ahead a little bit. But on item three, we were on the agenda for a council. And then to work on this position,
- that we desperately need to provide services for Monroe County and we were taken off the agenda with
- no notification and found out at a later time. So I. So anyway, we're we're we're moving ahead planning
- on giving the vaccines and everything is. Mostly in place and we just need people. I mean, you can't
- provide health care or health services that part of things without
- without people who are trained. And so, and that's, you know, physically we've been challenged to try
- to get that rolling. I don't know if Dr. Moore knows this, but you know, the county has a hiring freeze.
- I've heard of that. Yeah. Yeah. So, and they're rabidly sticking to that, even though we,
- IU decided not to continue our contract at the clinic, which put the onus on us to hire employees to
- run that clinic. Well, they're not letting us do it. So I don't know how they expect us to continue
- as we were, but with no extra people. I mean, that's basically
- the road we're running into. And we have money to pay these people. So it's not like we're asking for
- extra. And I guess I'll just add that Laurie's been incredible in making sure that we have two individuals
- who have been helping us immensely track core services, which we're very grateful for. But she's also
- had to deal with the
- The tech people who were very slow in giving us phones and internet to this new section. The physical
- plant people who painted things but then didn't get stuff moved and we've been slowing. We got a generator
- contract but then it turned out that no, they needed to do something else because it doesn't work.
- So there have been so many elements. Unfortunately, it's not only counsel. It's been one headache after
- another. And Lori has been just a godsend because we would not be where we are now without her diligence.
- So kudos to you.
- We won't fail. Can I ask, where are the two nurses located now? I know we had a space. So right over
- in the area. And that's also where our maternal infant care person will be dealing with moms. Yeah.
- So it's a little chilly because there's still some holes like in the roof. The roof is kind of OK, but
- the ceiling, they're just, but they're, I mean,
- reverse, right? You know, we're all here because we're dedicated to serving my county. And I think we're
- that's what I try to focus on every day is how fortunate we are to have people who come into this office
- every day, despite all the barriers that we face. And so is that
- Do we go to the commissioners over? We have the holes in our roof where we're trying to be patient.
- I think it's on the list. The roofing people have been here forever. The physical plant people know
- what's going on. It's just, they're dealing with the whole county. It's. All right, well, moving on
- to new business.
- So we have the 2025 annual report for all of our core services and all of our divisions. I won't go
- through all of them. We have the vital records, food protection, chronic disease management, immunizations,
- trauma, et cetera. And so does anyone have any questions about the report or comments
- So at the end, we have goals for 2026 are to work on securing additional funds since we've met with
- those challenges and to continue to meet criteria for the health first funds. I think our goals have
- had to change because physically things are just difficult
- just to try to get more funding. So I think that we need to ask for public, or well, I need actually
- a motion to, let me back up. Any questions about the report or discussion? I always enjoy reading it.
- I think it's the together well.
- Everybody worked on. Yes, that's a lot of information. It's impressive. We have a lot of people come
- through our door that we serve, which is awesome. Thank you. So do I have a motion to approve the annual
- report? So moved. I second.
- Okay, so prior to the vote, we take public comment regarding the annual report. Any hands? Okay, so
- we'll vote on the approval of the 2012-2025 annual report. Okay.
- So then we have the vitamin angels grant renewal. So this is 50 clients to be served those who needed
- vitamins. I'll let Laurie speak a little bit about that.
- don't have a whole lot. I mean, we, we essentially started this program shortly after we developed and
- hired the maternal child health coordinator. So this, um, just allows us the opportunity to get these
- vitamins in for free that then we can distribute to the community. Um, so through partners or through
- individuals and just hoping to be able to continue providing access. Um, I have a question back.
- maybe September or October, we talked about the prenatal vitamins that we were giving out. And Dr. McKinley
- at that time actually looked at the vitamins and found out that they weren't recommending the allowances
- on the vitamins that were being given out weren't necessarily recommended by the FDA or whoever does
- that recommendation. Are these vitamins the same ones?
- I'd have to look and see whether it's the same formula. We talked about it and we all agreed that in
- fact they were going to check with the company to see if, I can't remember which vitamin it was. Do
- you remember, Steve? No. I remember Dr. McMaster saying he reached out to someone
- to discuss it, to see if they would change their allowances to fit what should be on it. And I don't
- know what happened with that. Yeah, I'd have to ask. I think I remember, and that's what, gosh, this
- goes back more than a year, I think, Kay. It seems like an eternity, because I know I was on the board
- then. Time goes fast. What I'm remembering is that we got an answer back
- and that he was satisfied with the response that we got in terms of the vitamins that were being distributed.
- I don't remember that. That's the part I remember, and I may be wrong. Can we check through our minutes
- or something? All right, and I can call and do it. Oh, OK. We really want to make sure the vitamins
- we're giving out meet all the recommended requirements. Absolutely. And I can't admit that. It seems
- funny that they wouldn't have
- A cog recommended levels. Anything is possible, so I think then we should table this until next meeting.
- OK. Then Steve real. I call him and ask him. The next item is regarding.
- clinical office assistance, and we're gonna have two agenda items here. So first, I'm gonna have Lori
- address item number three. Is this regarding the letter? Well, so I mean, essentially, I think we've
- gotten a little bit further along than when I originally created the agenda. So ultimately, I think
- the goal is that the board would be approving
- this job description so that we could then hopefully move forward. But essentially, well, you know,
- we've been working since late 2025 to try to get, you know, staffing and positions in place. So I can't
- remember the exact date, but earlier this year, I had submitted a request to the County Council to discuss
- being able to develop a position.
- Well, that was actually after I got the notification that they removed the request. So this goes back
- to like January. Did we get an explanation as to why they removed your foot resource? The email that
- I received was from one of the county attorneys that says, Lori, hello. I wanted to make you aware that
- the health department agenda request was removed. Yeah. So that's not an explanation.
- So I just kind of sat on it for a while because I knew that we were going to be running into some resistance.
- And then wanted to circle back around just because, again, we're trying to get services in place to
- start scheduling and providing services. So let's see. We've had communications with Kim Schell. Dr.
- Robinson is
- both in the theater about, you know, how can we get this request back in front of the full council for
- discussion about how we can develop and receive approval for this position. So that's kind of a guess
- for that. And my perception was, so I spoke to both Kim, Michelle, and then Peter, and Peter just,
- Kim said, you know, they wanted,
- Well, it was very confusing because they sort of wanted job descriptions that were related
- to job descriptions that were for Futures Clinic just because they would have some kind of template
- for things that had been approved before. But I said, well, we don't have Futures Clinic and so that's
- kind of obsolete and we need very specific things for the clinical assistant. So she said, talk to Peter.
- So I spoke to Peter and he said, well,
- you know, you work with Kim to work on getting us the language. So I took from that, well, I think they
- just want something in front of them. And then I guess it's unfortunately gonna have to go before I
- can miss no matter what, because it's a new position and a new job description. So we're back to, it's
- just a lot of,
- And PAC is currently paused, so they're not taking requests. So the council would first have to unanimous,
- well, I don't know, maybe they've changed some of theirs, so I don't wanna speak, but all I know is
- the council would first have to approve that something could go to PAC for PAC to consider to send it
- to WIS and then WIS to the full council. And then I think the hiring, part of me would assume that then
- the hiring freeze would
- be in addition to that. Okay. So I assumed when I saw it was removed that it was because they weren't
- going to approve a new position anyway. And so they just took it off their agenda. So they would have
- one less item. That was my assumption. So I didn't necessarily take it personally. So, you know,
- so it was, uh, but I could see how they want,
- to have a full job description if they're going to consider it. So that's, Lori worked on this and we
- did a few revisions. She did a few revisions. We worked on it and feel that this is appropriate language.
- So we would like to present this. And at some point we have to have them understand that we are not, you know,
- county roads and we're not the county. We're not any. We're different than any of their department and
- say, you know, these are vital services. You can't really provide services without. The staff members,
- so I'm not sure how else to get that across to Council. And I did. Reach out to.
- Again, to try to try to get additional information from other local health departments to help explain
- that we're not asking for anything that's out of the norm. So I was able to capture information from
- other health departments so that that's available as well. Let's see. Let me ask for this job job because
- we finished last
- We finished last year, and we had a grant for those employees that now we no longer have. Does that
- grant money extend into this year, and how far into this year does that grant money go? So I guess I'm
- trying to think about which grant. Well, the grant that would cover
- this employee. Okay, so I think that there's a couple different ways that it could be funded. We have
- not fully used the amount that originally was intended for the IU Health contract. So that is one option.
- I would say that they would not prefer that option because it's local. They would come from local county
- dollars, but that is an option. We could pull from
- the school liaison grant that were remaining to use down those balances, or we could submit to use one
- of our other state funds for this position. But we were paying to support a front office position as
- part of our contract obligation with IU Health, so essentially we would be just
- be taking another portion of those funds that were originally set aside for the contract and moving
- it to cover these expenses. And it would not fall into HFI so then we wouldn't be getting kind of in
- the weeds with that hole. So now we have somebody at the front desk who has to make sure that checking
- the residency and such. It would seem like the school liaison would be great because this person might also be
- working to schedule our outreach to schools for vaccinations, to the community with the trustees in
- the different townships for outreach and visits across the community into the more rural parts of our
- county to provide screening and vaccinations. So it would seem that
- would really work well for us, at least in this moment. And I mean, ultimately, would it take, in answer
- to Lisa's question, would it take our showing up again at council to show our solidarity with our health
- administrator that, indeed, we need a front office person
- to be the voice, at least as far as the clinic goes, for the county to show our commitment to our county
- residents that indeed we want you to come in, we want you to be vaccinated, we want to provide the care
- that you want and need in this county rather than getting a machine that says, oh, we'll call you back
- someday, maybe.
- And it may take our showing up. And the sarcastic part of me wants to say, well, would each one of you
- come in on a daily basis and fulfill that role for us if we can't hire someone? But that's my sarcastic
- side. When is the next opportunity to give a department update to the council?
- Is that a 24 and that does that have to be on their agenda or if, you know, okay. So maybe we should.
- So you, so you're looking tonight for a, for a, a motion to that says, go ahead and, and submit this
- for approval or is this, or are you the revised version?
- Or do you need to take this to Kim first to have her look at it and, well, you know, smith it and,
- you know, I think that the process changes. So I'm not sure. Uh-huh. So Kim shell being the secretary
- for the, for the council who you meet with her and she does
- She changes things and she's a, she's a wizard at that. I spoke with her and I spoke with her and she
- sent me these and said, well, you know, cross out edit, you know, what is not applicable because it
- relates to futures and then add in what you need. So, um, was she happy with the order? Because again,
- Molly and Kim,
- It had issues with you. You know, I can't even go there, honestly. Yeah, OK. Got it. They have the unrevised
- version, and so that was submitted to the council office. The revised version just adds some additional
- language around job requirements and makes sure there's a little bit more specific. I understand your
- hesitation.
- Yeah. So, so, well, I mean, so what, what do we, are we, are we going to submit the revised version
- or, okay. I mean, I think in my opinion, again, I think that all I would like, I feel as though all
- we can do is try to proactively take all of the steps we can to say, we approve this job description.
- We approve it going to the council for review to go to pack and, um,
- I'm trying to take some action. But I think this is one of the challenges because of how long the process
- takes. It could be, you know, we're going to have several months. But we want to get it in before budget
- time. So then I would move that
- that we submit the revised version to the appropriate county officials, whether that be PAC or the council
- for their approval to submit to PAC. And then to WIS. Steve, you might want to include an approval by
- the board of this.
- Yeah, I think we should maybe. Maybe the first one be. That we approve the revised version as a bowl
- as the board and maybe the second one that we request. I don't know. Can we ask that request as a board
- to be added to discuss the position at the next Council meeting? Is that out of line? Is that? Allowed or
- I can just say no. Oh, they can just say no. So that would be my... Do we have to have a resolution
- to discuss it or can't we just get on, try to get on their agenda to discuss it? Hopefully it is on
- the agenda. It was submitted for the 24th. I see. Oh, okay. So maybe we just do one motion. It should
- certainly include the approval. Yeah, well, the approval of the clinical assistant position. Revised version.
- So that's the motion that we approve the revised version of it. Say it again. Is that the motion that
- we approve the revised version? Yes. For submission? That is the motion. Well, that would be either
- one of our motions or not. I would second that. I would second his. Okay. We're in this together. Yeah,
- here we go. I'm so sorry. I just wanted to be very clear on what the motion is.
- to approve the revised version and submit it to the appropriate company official for next steps? No,
- I disagree with that. I think we should approve it. And? And then do a second one. We haven't approved
- this clinical health
- clinical assistant position. You approved it back when we were making the changes with the health services
- director, but this is now revised. Okay, so we approved those. We just voted on them and approved them.
- I think that's what we do with this one. Yeah, I think we just so let's change the notion to
- Well, I can't do whatever you want. OK, well, the motion will be to approve as the board the clinical
- assistant position. Job description job description that is revised. We have in front of us and we can
- get a copy of that to linear. So do I? That's the motion. OK. I said that's I.
- Will you second it? I submit that as my motion then. OK. I retract my first motion and I submit that
- one. Now second that. All in favor. Aye. OK. Now, do we have to submit this revised version or? The
- county council. Yes. I say we make a second motion.
- to put the revised version before council for approval. So moved. Sorry. All in favor. Wait, we need
- public comment on it. Oh, I'm so sorry. Yes, we need public comment. Seeing no public comment.
- All in favor. Aye. Okay, great. Okay.
- And so the item under new business, and I want to apologize, Kathy, because I should have put you higher
- up on the schedule so you didn't have to wait. I've been entertained by this. Just for a background,
- there was a law change this session. And the details are that for the
- Needle exchange. It has to be one to one and the second. Well, I saw really three changes. The second
- is that you have to have a valid ID ID and the third is you have to be. Essentially, and it says it's
- the language is vague, but at least in the county and maybe surrounding counties that language is vague.
- once you have this proof of residence. So please Kathy give us your update. So the key updates are the
- long was extended until July 1st, 2031. So that's a five year extension before it was always two years
- at a time. So that's a benefit.
- It did go to the one-for-one model, which means people will need to bring in syringes in order to get
- the same number of syringes when they go. Before we did as needed basis or how many they needed to use
- a clean syringe each time they came back. Definitely before they came back up to a certain level, but
- now it's got to be a one-for-one.
- So staff has really been doing a lot of education in the last couple of weeks, giving out a lot of sharps
- containers and informing people on a work on a top basis. It's going on on social media as well to let
- everybody know. They're for citizens. So they have some things now too. So you were talking about they
- have to be and it is vague. They must be from
- Um, a resident of a county within the Indiana housing and community health development authorities balance
- a state continuum of care region. So, um, so basically those are like the housing regions of which all
- the counties are in sections. We are actually in region 10. I brought this to bathroom so you can see
- where we're at. Um, in our region is Martin, Bowen, Green, Lauren, and Morgan.
- along with Monroe. So it's a six county region. So participants are supposed to be from one of those
- counties and they have to show a valid ID when they come in. So the law did say we do not have to collect
- information. So I do not want to collect information, but what I'm requiring people to do is staff have
- to check an ID.
- You have to see where the person is a resident of one of those counties, document the counties, document
- the checked ID, and then sign their initials. So we have a log that they're supposed to track on every
- other person or every person. And for the one for one, they do an air table. So it's tracking counters
- that everybody who comes in and the service that they receive is anonymous.
- But they have to check certain design instructions out and I'd like to get the back end access to the
- back end of the air table program. But if I can't, I can also always get a report from them on a minimum
- of once a week basis so I can see what's going on in that.
- Another big change is that Indiana Department of Health will now be responsible for determining if the
- program is in compliance. So we are expecting an update and guidelines from Indiana State Department
- of Health. We thought they would be out last Friday, but we were told that they've delayed. So I think
- their leadership is looking at it on what, you know, carefully thinking about what guidance they want
- to give us. So we're waiting for that.
- And once we get that guidance, we can update what we have now, share it with the board, and share it
- with the legal. And as long as that's approved, well, it's to get those procedures too. Kathy, I'm just
- curious. Will our unhoused folks be able to show some kind of documentation from, for instance, Wheeler
- or Beacon that they are getting services from those folks to
- show that they live within this region rather than because obviously even if they actually own an ID,
- it may not be from this local area. I checked with the DMV and there are procedures where somebody who
- isn't housed, if they are going to get services at Beacon or Wheeler,
- Beacon or Wheeler can sign up, write a letter on letter hat saying that this person is getting services
- from us and they can get their mail there. So that address will become their legal address. So that's
- one they can do. And also get letters from other official government sites or other to say that they
- got a letter from them and that can suffice as presidency. Thank you. So Kathy, are you doing onsite?
- It will also be doing on-site checks. Nico is there three days a week too, so I hear from that. Plus,
- I'll do on-site checks as well, drop-ins too. Excellent. Okay. Great. Thank you so much. There's a few
- more changes. Oh, yes, please. Okay.
- syringes service programs who operate a fixed site that can't be within a 1,000 feet of a school, a
- licensed daycare, or a building that's primarily used as a church without written permission from that
- establishment. But that doesn't pertain to distribution of loxome, providing referrals, education, or
- accepted syringes for safe disposal. So the other thing they want tracked is efficacy of treatment.
- We give referrals out for
- many services, especially for drug treatment services, but they want efficacy of that treatment tract.
- So we're talking about getting word of mouth and asking people, like people always volunteer when they
- go to treatment. So just checking in with them and seeing how they're doing and giving support and then
- tracking what they say that they're doing. So the other thing or
- they said was that we can't distribute chemical reagents or precursors. Nobody does that now that I
- know about. So we were kind of discussing like how that came to be. We're meeting at SEP or syringe
- exchange programs, administrators. And that was definitely a conversation that we had in our group.
- So they're talking about that they can't distribute like suboxone. Is that what they're saying?
- What are they? No, they were talking about epinephrine. So, you know,
- Yeah. I wonder if they're talking about the tests, the point of care tests that people can use to determine
- if what they're about to ingest slash inject has contained fentanyl. If those tests exist, there's opposition
- to those being distributed with public funds. That's my guess. The things like the zine test or the
- fentanyl test, is that what you mean? Yeah, that's my guess. They made them legal last year. I begin
- to think they took it back out this year.
- not to check for that. Are you all anticipating a drop off in what we've seen in terms of the decreasing
- HIV and hep C numbers? I mean, we've seen a lot of people come through and things were improving.
- with the amount of needle exchange we have, are we expecting those numbers to go back up now that these
- restrictions are in place? I'm really hoping not. I'm hoping with a lot of education and after they
- see how it's still being supported, even with these new changes, that they don't need to worry. It's
- still something that we're there to serve them and to help them and to help them get the things that
- they need. Now, you're also hoping that we won't get as many
- requests to come pick up needles. Actually, those have greatly gone down. I track them every month for
- like one of our reports, and we do not get, you know, as much of that the ones we used to get. That's
- seriously gone down the last few years. Oh, thank you. So we don't get ready-made requests to go pick
- up needles?
- That is many, not like we did, especially like in the beginning. The article was talking about the Southside
- businesses, make it sound like they're inundated with abandoned syringes on their property. And I have
- no doubt that they find some down there and in their mind that maybe that means a lot.
- where people say, oh, you have to come. There's like a million syringes, and you get there, and there's
- one. I think they expand sometimes. We're happy to go if people need it, but they really have gone down.
- That's something that I think. Interesting to know that. And I think our hepatitis C numbers have gone
- down, but I think there's a rise in HIV cases that we were concerned about.
- At some point we need to address that. Okay, are there any other comments from board members or from
- help officer? Yes, I'll be your help officer tonight. I'm curious, what's happened with our mobile unit?
- I'm sorry, I don't mean to open a can of worms, I'm just curious.
- has the individual who was looking at it and telling us what was available, have they come forth? And
- what's going on with that now that we may have some nurses? Well, so we need to go back to the council
- to have that re-appropriated because it's changed budget years. So that has been submitted.
- for their review and approval this month. So hopefully that continues and it has still been. Still on
- the list of that is being the units are being looked at or purchase for the fleet person is still looking
- for us. It's still on the list of things that need to be done, but we really if we can get
- The approval again for the appropriation, we need it to be done so we don't have to do this again. Is
- that also something that's going to be going up before council in like maybe this next week? So hopefully
- next week. So indeed it might be helpful to have board members present to support you in the request.
- Hopefully it's smooth sailing. Just thought I'd ask. Yeah, there's a lot of excitement in the department
- for being able to have that unit and start providing services. So hope we can get that done soon. I
- guess I'll only share that since it doesn't appear on here, the idea we created this rural
- outreach funding. But we are not all happy because we have this large urban floor. So some of our surrounding
- counties may or may not receive funding, but it may sort of float west eventually, possibly. It's still a child.
- Peter just expired. We won't let them get you. You have to wait. They're there right now. They're waiting.
- Any other comments? Okay, well I make the motion to adjourn. Second.