- All righty, I'm gonna call to order the meeting today for April the 30th, 2026. Dr. Moore is not able
- to be here today. He had some obligations. So first item actually is that I want to make an amendment
- to the agenda and add
- a voting item for the vitamin angels contract. And I would like to add that after department updates.
- So can I get a motion to do that? You have to put it as number one after the vitamin department updates.
- I'm going to, I would like Kathy to be able to speak first
- Maybe we could do it as number three. Actually, does it have to go under old and continuing business?
- It does. Anyway, we're adding it to old and continuing business. We'll make it number three. Okay. I
- motion to add the vitamin angel prenatal vitamin discussion to number three under old and continuing
- business. I'll second that.
- All in favor. Aye. Okay. So the first item, can we, or can I have an approval of the previous meeting
- minutes if everyone has had a chance? I move that we approve the minutes as written. I second.
- All in favor. Aye.
- Sorry, Kay, who said I? I didn't hear you. I said I. Okay, sorry I didn't hear you. Okay, so Linnea,
- do you have the script for the public comment? It should be in my design. Yes, I got it. The Monroe
- County Board of Health encourages and welcomes public input. Written comments may be submitted at any
- time via email at BoardOfHealth at
- At this time, we would like to invite those who would like to comment on any non agenda items 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.
- 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 rest. So do we have any folks who want to make a public comment?
- Okay seeing as we have none we will move to our next item. I
- asked Kathy, well actually in your packet, I think there is information regarding the SSP program, the
- needle exchange, and I asked Kathy to just come give us an update. So from SNAPS, the changes that the
- new law made are actually going through well.
- If you go to the IRA, the law is listed up on the lower part, right, where the records and the supply
- are distributed. They say that most people are really understanding and just understand that the laws
- changed, and this is the way that it's got to go. So people, while at the IRA, it seems like when they
- go there at the office, it's on Western Street, if you have been where it's at, that people really aren't
- having trouble showing that ID, because most of them have their driver's license if they drive there.
- There's a little bit more problem needing that when they go to Shalom, because not everybody has a note
- either. But they are working with that, and it's getting better and better. Now, one of the changes
- that we got from this case, we got a memo, and they explained that the law actually asked for a valid
- ID. But by DLH, the guidance they have given us, it has to have a picture. So they want a picture ID
- that gives some indication that they're reaching in which person lives.
- So that is the guidelines that we're following. One thing that's really important to know, even if we're
- looking at ID and we're not looking at the name of the person, because we're not collecting, identifying
- information. That's really important to know. We're not collecting that, and we're not supposed to.
- The only time we do have that is when we're doing HIV or HIV testing. And that is information of those
- that are separate.
- These are thinking better about the end-to-end, but they're being very understanding overall. Like if
- they're told, no, I'm sorry, we can't give you money because we need to bring them back now. So they're
- saying, people are saying, no, okay, I'll be back because they have some. People got out of the habit
- of bringing them on a regular basis because having a syringe, they can get a felony charge. Even if
- they got the syringes from the SSP, they could get charged.
- So they got out of the habit. They don't like to carry them, but they're getting better understanding.
- They have to bring something back in order for the SSB to be able to get them. We found a way of dealing
- with local enforcement personnel to help get around that issue. I know that a lot of the community officers
- understand that the rest of the police department, are they on board with the program and why people
- want, why people are bringing and even making sure it's kind of like following. I remember my father
- would be speeding and he'd say, well, I'm going to the hospital. And the police officer would actually
- accompany him to the hospital to make sure that's what he was doing. So do we know,
- But the sheriff and the police department, are they understanding the new law and why people must have
- the syringes in order to? We need to explain that to them. There is, we have an agreement, we have an
- arrangement with the prosecutor's office that if somebody gets arrested just for a syringe, they try
- to drop that if it's only for the syringe. If they have something else that they're getting enlisted
- for, like possession of or some other thing, then they can't.
- But they do try to work with people if it's for a huge building. Thanks. And I did follow up with the
- reagents that we talked about last month. And the reagents, as they are talked about within the statute,
- are referring to drug precursors or anything like I've mentioned when I said that last time, too. Anything
- that can be used to make other drugs. That's what SSPs are about to give out. OK.
- Do you have any questions or? Are we required to have reports per se for the state or only if they would
- come do an audit? Are there reports that are then sent on to the state in terms of ledgers for the exchanges?
- We have a database, a state database, that we have to enter things and we also have a portfolio there
- before. So they can see at a glance what's going on at the SFP's program that we drew up as a list.
- Does anyone else have any other questions? I'll second. Thank you. So Lori, we would love updates. We've
- been missing on your bendogy. I don't think that I captured all of that here. Unfortunately.
- Well, I did want to just touch on the SRF testing report that was in the packet. So this information
- was actually in 2023, our environmental division completed testing throughout this building and they
- identified lead based paint in some of the non remodeled areas of the health department. So that's kind
- of what this
- three fourths goes through. So in some of these areas there's paint that's chipping and falling to the
- ground. We've had a tarp covering the top of the deck area in the back and that recently fell. The paint
- just kind of went everywhere and so we're trying to work on getting that cleaned up but it occurred
- to me to we need to check on the status of getting some of these areas
- you know, they need to do remediation work. So we've reached out to facilities to kind of circle back
- around to touch base on getting some of this work taken care of. And where's Richard on that? I have
- not heard yet. So we're trying to limit people going in and out of that back door right now so that
- we're not tracking that kind of in and out of the building.
- And so that is overseen by the commissioners? The commissioners oversee the facilities director, so
- that would end up being the commissioners. Council then would have to appropriate the funds to do whatever. Okay.
- So otherwise for environmental, the staff met recently with the Student Society Club, Indiana University
- to provide information on the type of work that they do. They are also being trained on entering animal
- bite reports into our NBS system and rabies exposures. So previously our environmental director was the one
- We've been doing all of this and we've run into some instances where we need to have additional people
- trained to be able to enter in that information. So that work is taking place for wastewater. We have
- one ARPA septic system that's already being installed for this year. There are still nine remaining
- systems that need to be installed prior to July 31st of this year with those ARPA dollars.
- And wastewater is also starting on subject installations for the spring. Is that a contractor issue
- that contractors have not completed the work? I think that there's a few different things. I think it's
- problems with getting some of those initial testing and getting the homeowners kind of working with
- them to get that done. And I think some of it is just a lag in the weather.
- of foods now that they transitioning kind of out of the startup for the licensing period at the beginning
- of the year. They're now working on licensing vendors for the farmers markets, working with the market
- managers to provide education for vital records. The director and the assistant director will be attending
- the spring conference in May. So this is hosted
- with statewide vital records, come together, do some ongoing training and development. Last year, all
- six of the vital records employees attended the conferences, but in an effort, again, with our budget
- cuts, we've taken it down just to the two right now, and then we'll kind of reevaluate again,
- moving forward, just depending on funding as we get through the rest of the year.
- Public Health Emergency Preparedness that they recently attended the Preparedness Summit that was done
- virtually again in an effort just to kind of reduce some of our costs. They're distributing tick, mosquito,
- educational materials and prevention kits. I was actually going to ask you if you could say what's in
- the kits. So it is a comparative insect repellent and a tick remover.
- as well as a little information on how to avoid ticks and what to do by the way. They're still providing
- Stop the Bleed trainings to members of the public and for department staff here. Continuing the emergency
- kit building workshops for the public. What was the one that you worked on recently? The most recent
- one was an emergency kit building.
- And then they participated in the district emergency preparedness and planning coalition exercise in
- French lick. Our disease intervention specialists. There continues to be a by selling shortage. It's
- now expected to go through the 4th quarter of 2027, so we have that for.
- Pregnant patients and then special circumstances. The Indiana Department of Health has started a congenital
- syphilis case management pilot program with us. So more information to will be coming forward about
- what that looks like.
- There are currently two case managers at the Indiana Department of Health who are providing support
- to pregnant patients who either have syphilis during pregnancy or prior to pregnancy. Our employees
- right now are not doing any additional work, but they are receiving support for their patients to be
- able to work working with OBs and hospitals with these case managers from the Indiana Department of Health.
- So if we remember in the fall of last year, the Health Department submitted a request to County Council
- for some of the old COVID reimbursement dollars for the purchase of a mobile unit. That request was
- approved last year. However, the unit was not purchased before the end of the year, so that request
- had to be asked again.
- It was voted. They had a 6-1 vote earlier this week, so that has been approved again for this year.
- So now we just need to make sure that the purchase goes through. So we currently have six trustee and
- food pantry community locations that are interested in working with us on some of these mobile clinic outreach.
- just have a partnership with us. So continuing to work on expanding where we could actually be going
- out on the mobile unit and providing some of these services. Can you remind me exactly what services
- do we plan to offer through this? So definitely vaccinations and then our health screenings. So blood
- pressure and cholesterol, we could blood sugar. And then we can provide educational materials
- possibly with our maternal child health to promote the lactation counseling, promote the bean and milk
- bank express location. Smoking, anything smoking for pregnant women. And? She can provide, she could
- go along and provide safe sleep training as well. And ultimately it looks like one of our nurses could
- be in township spaces
- even during the fall training, fall prevention training, and almost anything in any of our outside locations.
- Plus we can go to the county fair and have a presence so that our county knows that we exist at large.
- Of course, most of who come assist people from out of county, but still having our presence there, I
- think would make a difference.
- So if you come up with great ideas for where else we should go, let us know. Absolutely. STI, HIV, and
- hepatitis testing as well. We can look at that. And I've spoken with Indiana University. It's been a
- little while about working maybe in collaboration with them and some of their students on being
- to provide behavioral health assessments and referral services. So whether there's other screenings
- that you can provide and then be able to connect individuals to services as well. And that the trustees
- are. You've been in touch with some of the trustees there on board with having a baby or their mobile
- unit time in their locations and helping us with space.
- I thought I would share some information. The Indiana University, Indianapolis, they conducted a study
- so they were actually examining the startup period of Health First Indiana and the core service data
- that has been submitted statewide compared to some of the funding we've received. So based on some of
- this initial data, there were over 14,000
- that were identified as having undiagnosed high blood pressure, over 7,000 with undiagnosed high cholesterol
- based on just offering these free health screenings from local health departments. So they have
- ended up estimating over $700 million in healthcare cost savings just based on these preventative health
- screenings. So I thought that was interesting information. So hopefully they're no longer working or
- they're not, at least at this time with this stage, but I think interested in finding other ways that
- the outcomes of this funding and what local health departments are doing
- how they can help contribute to that. So I'm happy to answer questions. That's what I had for the report.
- Yeah, it's good to hear the overall introduction like that. And that's good for the legislature to hear
- that as well. Since they cut the funding, which I don't think was
- unexpected by a lot of people. It was a two-year deal, and it really ended up only being like, what,
- one year? But they also cut the funding to the folks who are studying the impact of HFI funding. They've
- totally cut off that funding. So it's like, shoot yourself in the foot, I'm sure. Yeah. But that's another
- part of it.
- They're not engaged anymore because the funding has been cut off. Unfortunate. Well, thank you, Lori.
- I know you've been extremely busy. And we're going to talk more about that, actually. So as part of
- continuing business,
- We had asked Laura to obtain some information on all of the fees that we are trying to sort through
- for these employee positions for their training. If we should have a policy as to whether they're going
- or the person is going to cover their fees or we are going to cover their fees and then how we go about
- putting that in the budget, is that correct? So this is actually a very comprehensive list of all the
- trainings that we're requiring for the physicians, the amounts of those fees. So where are we with this
- in terms of, we probably do not have any consistency with,
- Position based. Correct, OK. And so. You'll see a lot of these are within environmental. It's all the
- different certifications. There have been some with the newer positions that were developed based on
- those additional core services developed first in Indiana.
- but there's quite a few when it comes to ongoing education that there is access to free. And so we get
- on one hand, you're looking at what are the education certification, what are the requirements for someone
- to get a job and then maintain that job. And then you have the other aspect of the jobs that is ongoing,
- just education and development.
- Well, in my opinion, if there is a cross associated with certifications that allow the person to do
- their job and do it adequately and safely, then I think we should go about figuring out how to do all
- the machinations to get that covered for them, for the position.
- I don't know exactly the step-by-step, but I think we should cover those costs. Do we have the funds
- to do that? We have the funds. Yes, for everything that's required this year, we have the funds to cover
- that. So where we've been cutting back are those
- non-essential, non-required, like kind of extras. So kind of limiting the travel and extra. And some
- of it's variable. I mean, it was when we had that huge increase in the Health First Indiana funding
- that allowed more funding to be available for the extra training and conferences. And some of that was
- really needed because of the new
- work and the additional core services? And so I think the question kind of comes down in my mind.
- Yes or no? Are we going to always find or is it going to be a policy that this is a job requirement?
- If you have to be CPR certified, if you have to have a pesticide license that we will cover that cost
- and whether or not we can cover what you go to a three day retreat.
- will depend upon the budget maybe. So some of these you're saying they have to have this finished before
- to apply for the position? Yes, like some of those if it requires a degree CPR certification or the
- feeds they've handler certification, those are required to be qualified for the position.
- So I don't think. I think. That's a level of already commitment to the position that they want. I think
- they should come with those certifications, but if they're ongoing once they're here with us, then I
- think it should be covered. Does that?
- That was exactly what I was going to say. I mean, if it's a requirement for their job, then they need
- to already have it done. We can't be waiting on them to finish their certification, and that may take
- three months, and no. But if it's ongoing, then I think they should. Yeah, so you have to have your,
- you know, Indiana pesticide applicator category H, whatever, for the job, and you should come with that.
- But then when you will come up for renewal,
- We will continue. We will cover it. It sounds like a good idea. So the first step is to so we need to
- make a motion as a board. That we will cover. Renewals renewals for training programs and certificates.
- that are required for the position that the department will cover those. So can I have... Okay,
- so a second? I second. Okay, all in favor? Aye. Aye. Aye. Approved. Okay, June, me too.
- with the public to see if anybody had any comments. Oh, yes. Yes, I did. Somebody thought I'd ask. We
- should change the pause. Yeah, we should change the pause again. Now that we've moved. Oh, anyway, does
- anyone have any discussion about that? You can always go back and redo the motion and the vote. I was
- definitely against it.
- No, I know it. Thank you for that reminder, Sarah. Sure. Okay. Are we finished with that? Is there anything
- else we need to address? Yes. The next issue on our continuing business is our clinical assistant position.
- Lori has worked many hours working on this job description.
- Can you give us the latest update? Yes. So the job description that was finalized has been sent to WIS,
- which is the organization that the county uses to review and classify positions. So that classification
- will then is basically tied to a certain pay rate. We have received the WIS recommendation
- back now. So now the next step is that is taken to the County Council for their review and consideration.
- So it's the complexity with this is we are still in a hiring freeze, so Council did agree that we could
- create a job description, send it to with. But now they will have to agree if they're going to
- accept the new position and then allow the position to be filled during the hiring freeze. And so that
- will be going to Council in May. We were hoping, I think, to receive a higher classification just to
- be able to get the best qualified applicant. But I was
- The classification, I think, that it came back to is really what I was expecting. So that's a comment
- like a clerical position. And when you mail that to the council? I believe the 12th. Set your hope high.
- Set your realization hopes and expect less.
- So this position is really going to be crucial for efficient clinic operations. I just don't see how
- the clinic is really going to operate well without being able to have someone who's
- really managing that front desk and helping to greet patients and the scheduling and the billing processes.
- There's additional services that we could be billing for that we're not right now, just not having a
- person to be able or a physician to be able to do that. Just running into a lot of issues about how
- are you gonna kind of manage these patients coming in and the patient care and then that front office side.
- We're working through it. So are we in fact seeing? We are open and at this point we are open that we
- can schedule patients just start coming in so block right now for these services. So for the health
- screenings and for the vaccinations Mondays and Wednesdays between 1 and 4 PM and then Tuesdays and
- Thursdays between 830 and 12.
- So having some afternoon, some work. Good question, because I was looking, going, there's a lot of things
- that you have this person doing. But knowing the clinical time would be half days, at least plenty of
- time for this other stuff. And really, I think that you have to do that to balance the other duties
- that the nurses have to do. So they can't just be scolding all of their team and the patient.
- Yeah, I'm convinced. We need this position. I mean, it's... We really... It would be nice to be able
- to... We really need another nurse, too. It's a lot of work. And I've been helping to distribute car
- seats to people walking in for cribs. And there's just so much going on and just not enough bodies to
- do all the work. Mm-hmm.
- We're going to continue to work on making a plan to get another RN. And currently with the hiring freeze,
- it's not going to happen. It will start to. Well, this hiring freeze has really put us in, I'm stating
- the obvious, it's really put us in a difficult position because the contract was canceled by IU and
- they were providing
- all these services, and now we're expected to do this, but not expected to hire any additional employees,
- which we had when we had the contract. I mean, I don't know how they can't make an exception. I don't
- understand how they can justify this. We have the money, correct? Yes, correct. I understand. Go ahead.
- No, I understand that if they're
- They're sort of afraid that if they allow us to hire somebody, they have to allow someone else to hire
- somebody who has the money. But this is the county health department. I mean, this is affecting everyone.
- You know, it's not a... This is not a...
- It's not the Highway Department. Yeah, exactly. Well, I mean, it's not the diminished Highway Department.
- No, I'm not. But I mean, health is health. And we have to have enough employees to provide the service
- that was being provided for us before. I'm saying this, obviously, as a public appeal, because I mean,
- the county council has to understand that this is
- imperative that we hire some extra people to cover those positions that our contract was covering with
- IU Health. And they no longer providing for us. And I'm not trying to put them in a bad light either.
- I'm just saying that they were currently, they were in the past providing this service and now our contract
- has ended.
- we need to be providing those services with these people, and we need extra people to do that. Yes,
- if you look at Allen County as an example, so they have 23 full-time employees in the clinical section
- for their health department. And some of those people include environmental and for disease intervention
- specialists, et cetera, but they have 23. And so if you look at their
- population, and you compare to the population of Monroe County, we should have eight full-time employees
- for the clinical section of the health department. With how we have our structured, which is a little
- different, we have right now four to five, and so we really need three more clinical people, and it
- doesn't include support staff.
- to support the health department and we're recreating infrastructure. I mean, that's essentially what
- we're doing. We have to have people for the infrastructure and we're recreating what IU is providing.
- I think that, yes, I think the public needs to understand we have the funds, we can re-appropriate the
- funds, if you will, to support these positions so that we can fill the positions
- So I think we just need to keep making a case with the council and make them continue to be there in
- a presence and help them understand that we have to do this. It's our duty to do this. We have the taxpayer
- dollars to do this. And we have to have some cooperation between ourselves. And we are sort of begging
- for cooperation.
- Do we have enough? This was Aurora brought this. Concern up. Do we have enough people that are doing
- investigations of? Or? Where the STI or the chemicals well? No, and we had the grant funding for another position,
- Council would not approve us to hire, so we had to return those grant funds. And I think that's the
- other challenge is that now- So actually we're returning grant money because of the hiring freeze. Yes,
- and we're ineligible now. We have grants that we're trying to apply for, that we want to apply for for
- positions, and we can't because of the hiring freeze.
- And so the INSS. There was a concern about in the past about us not having providing the service that
- we had a grant for. Yes. But now we're having to send grant money back because of the council. Correct.
- And the council is critical of us for not providing something and letting all those dollars be returned.
- Yes. So I find this a little ironic.
- Yeah, they're trying the best they can to kind of keep up with the workload because the grant still
- says we have to take on those additional counties. You know they gave us the money for the staffing,
- but whether or not we could hire that staffing, the grant terms remain the same. We still have to cover
- that workload, but I can't remember the last time that Miranda was able to actually work a full week
- because she's always hit for 40 hours by the time Friday morning rolls around and
- then she has to leave, she can't finish out the work. There's been some instances where I've had to
- approve her working that overtime because it was just critical that she needed to get treatment to a
- patient or follow up on something. So that's the other unfortunate side is that we also can't not being
- able to have the great funding to help supplement our other funds. I'm curious, does her role as
- the lead for the region affect any of the work she does here? Well, she's the program coordinator, so
- she does a higher classification, more of the work and oversees some of the work and is doing some of
- the supervisor duties of the others. It's great because
- simply details how crucial and how good she is and how lucky we are that she leads, is this seven or
- eight? I can't remember. That's fabulous, but we still need bodies and I'm not quite sure
- how to make council understand that. And the only thing I can think of is maybe after elections on Tuesday,
- maybe some of the council members won't be necessarily running for office. And so might be more willing
- to listen and communicate in ways that are clearer and
- more amenable to hearing real needs. I know I can't be there on the 12th because, and that'll come up
- later, I will be out of the country. But I'm hoping that maybe some of our clinical board members might
- really appear and try to make it clear what it takes to run a clinic or an office.
- Because I don't know that any of the council members really grok that piece of information. I think
- they think that it's superfluous to have somebody answering the phone and doing the insurance and scheduling
- patients and scheduling whatever for the nurses. And that the nurses should be able to do that too.
- So I think it would be helpful.
- It's certainly up to the board whether any. Board members show up, but I think it might be really helpful
- for them to see. A force that tries to help them understand that. We have two venues really for communicating
- with Council and one is Department updates that Lori can give each meeting and then public comment.
- So the key with that is, you know, it's just like our meetings.
- we can all go make public comment before the meeting as long as there's nothing on the agenda that we're
- referencing specifically. So if anyone wants in the public comment is at the very beginning at five.
- But if it's since this if this is really supposed to be on the agenda on the 12th, then indeed it would
- be simply having
- other people sitting at the table with Laurie and hoping to address whatever questions come up and from
- real life experience saying, no, we really can't run a medical office without someone out there to receive
- the patients, to schedule the patients to do all of these things and to be able to bill so that we can
- receive funding
- for the services were provided. And I think they don't, they somehow, I'm not sure why it doesn't quite
- get through their heads, but apparently it hasn't. We shall continue to make a case for sure. Any other
- discussion?
- Next item, we have the Vitamin Angels contract. I'd like to have a discussion about that. We have a
- list of recommended daily allowances for pregnant patients for each vitamin in their packets and then
- the Unimap.
- recommendations, which is what Vitamin Angels is following, is different. So we just have to make a
- decision as a board. We have to vote on whether or not to proceed with the Vitamin Angels contract.
- And again, I'd like the discussion and
- Well, in your mind is the fact that they're folic acid is under, is that significant? It is. Does anyone
- have other comments before we take a vote? I have a question. Yes, please. If we don't do this, the
- choices between doing
- this contract or not offering any prenatal vitamins? Is that what we're? That's correct. So the question
- is, this or nothing? Can we get prenatal vitamins somewhere else that would meet the requirement? Excellent
- question. That's where I'm at. We have not been able to find any that would be free. We get these free
- through that rate. So I think we'd have to look at the cost of prenatal vitamins.
- Have we asked them why they're folic acid is? Dr. McKinley did discuss that with them. I know, but I
- don't know the outcomes. I reached out not for that question specifically, but with the concerns and
- I received a response, I guess should be in your front page. So that was the answer that
- And I received information. But we pay for these. We pay them something. No. No. We get a grant. Oh,
- it's a grant. It's a grant. So they come free to us from the grant. Who's the grant from? The Vitamin
- Angels. So it's their own grant. Yes. In other words, we'll let you take these free of you. Yeah. OK.
- So they just give us the goods, essentially.
- So, you know, as I'm looking at this, I think to myself, I would, given another option, prefer to have
- more folic acid, but if it's a choice between a pregnant woman receiving this or nothing, right, it
- makes me feel differently. Makes me also wonder if the folic acid really is the big one here, which
- it really is.
- Could we get an additional folic acid supplement somewhere that we could pair with it? Is that an option?
- Take this grant, look into, can we put some additional folic acid? Or at the very least, we recommend.
- Point out, yes, we would point out that these are free vitamins, but they are lacking in one key ingredient,
- which is folic acid, and that they may
- want or you're recommending that they get additional. At least I'm with you. If it's this or nothing,
- then I would, I would, I would vote for this. So how do we give these out?
- or the women are coming here to the office, potentially on the mobile unit at some point. Yes, and some
- we have, we provide to the tandem location that they are able to then distribute. And I hate to be really
- stupid, but have we seen a difference between 400 and 600 a day in terms of spina bifida? I think the
- answer would be yes. The answer is yes. Okay.
- I can see it in case the demeanor is, you know, let's say patient comes, we give them these vitamins,
- they have a child who has spina bifida, and then here we are, you know, even if we have a policy change,
- et cetera, sort of feeling responsible in some way, I don't know the, I don't know. It's kind of how
- the patient take two a day.
- So they may be getting 800 of folate rather than 400 of folate. You could do that. My guess is they
- would have some pretty substantial side effects. Right. You'd have some pretty bad nausea with these
- anyway. Right. Well, and then you wouldn't want to double up on some of the other vitamins would not
- be appropriate.
- I'd like to see the drug companies that make the vitamins being contacted and explain to them that we're
- a health department and we're trying to provide vitamins to people that don't have money to buy them.
- Is there any type of grant or any type of leeway they could give us as a health department? Yeah.
- I hear your point. But I also hear your point, because you want them to get, if they get at least some
- folic acid, then that will prevent, hopefully- Yeah, presumably you are preventing some, but there are
- going to be some that may still have. I mean, as a health department, my thought would be you're trying
- to prevent as much as you can as possible, and by doing something that is better than doing nothing.
- I, on the other hand, if we don't say anything to them about it, well, they assume that we're giving
- them a preventive as long as a preventive dose, at least they're giving him adequate and preventive
- dose and adequate dose when in fact we learned. Yeah. And they have somebody that has a problem then
- a baby then. Yeah. I think we would have to specify or.
- figure out a different ways to add 200 folic acid to what we're giving. And I don't know if we have
- enough time to do that research and whatever. Folic acid is the main one, but there's other. There's
- other ones too. Yeah. Well, as a health department, I don't even, could we, could we
- purchase prenatal vitamins and then dispense them? Is that even a possibility that we could get some
- standard? And it's probably gonna honestly cost less than the grant they're asking for for the number
- of patients service. I think for that program it was only, how many patients was it? Like 30 maybe?
- It wasn't very many. So,
- Um, okay. So hold on. So this is, oh, here, maybe this is it. So this, this was only for up to a certain
- number of patients. That changes things. Yes. It was only for X number of patients. I, and I, it wasn't
- very many and I don't even think it was a hundred formulation.
- If my memory is correct, she received $150, I believe. And the grant is for how much? That's what she
- got for the grant. They got $150. And I don't know how many of those. Oh, that's a fair amount. But
- what was the amount of money for the grant? They just give it. Oh, I see. Oh, I see.
- Yeah. Okay, so. They gave us the buy-in for that, but they have a grant money. They give us the grant,
- they give us the bottom. Yeah. Yeah. And that's a great slide for me, almost. I mean, I don't have any
- idea of what it would cost to be purchased.
- If there was certain type that was identified that said, we want to purchase these, we could certainly
- do that. Costs would just depend on how many, I guess, we purchased and back cleaned. How many patients
- potentially would we be passing these out? 150. Well, no, I mean, that's what's covered by the grant, right?
- That's how much they would give to us, how many pregnant women are actually going to come and ask. That's
- the point. Exciting. If they give you 150, are they talking about 150 over nine months? Are they talking
- about 150 bottles, period? Assuming that each one is a 30-day supplement and that that goes over nine
- months. We're talking about very few patients. We're probably covered.
- That's what I'm thinking. But it would be very few patients. So. Well, and then I think if we're going
- to purchase and give them out, then what's the criteria for people who qualify? If we talk to other
- counties about this,
- No, just that there's other counters that do use the program. And this has not become an issue for any
- of them, it sounds like. Not for my knowledge. Yeah, I mean, it might be nice for us to race even with
- the folks at the top. The medical director of IDOH and how
- How is this best dealt with? Because this is a grant program. If this is happening across the state
- and we're trying to ensure the health of infants born in this state, how does using this grant program
- in many counties actually help us prevent preventable disease?
- Maybe the steak should look at it. It is steak. Yeah. You want to come find out? OK, so are we going
- to table this again? It sounds like you're not satisfied with the answers. It's OK. Well, I was going to say,
- It's better than nothing, but now I'm thinking, I'm not so sure. Yeah, it's a complicated question.
- Yeah. Right? Yeah. I mean, yeah. You certainly don't want to give somebody the impression that you're
- giving them what they need when they're not getting what they need. Yeah. But you also don't want to
- not give someone something that they might at least part of it. Partially be. Right, yeah.
- Yeah, I mean, I understand that. But I think if we if we do pass these out, we're giving people the
- impression that it's completely adequate. And in fact, it's not one of the key ingredients. So also,
- if we're going to talk with the state, could we also simultaneously do research into could we get a
- prenatal vitamin? Like, what would the cost be?
- to get prenatal vitamins. We have the recommended amount and could we do that as the Board of Health
- here and say, we'll turn this down. This is reasonable. Let's do this instead. So it looks like it's,
- I mean, I don't know why, but when I'm reading this, it says vitamin angels slash walbrates.
- So I'm wondering, does CVS or some other large
- distributor of pharmaceutical agents in our country have a grant program that actually would allow us
- to give adequate prenatal vitamins at no cost. And I'm sure that there are other funding sources. Again,
- we could even think of going
- to our community funding grant funders and say, you know, we want to make sure that babies born in this
- county to indigent patients have the best chance for survival. And who has a philanthropic fund
- that could help us ensure that we have what we need? Should we go to United Way and say, who in the
- county can help us find the money we want so that we can continue this program, but do it in a way that's
- truly responsible? Some of those organizations can't fund a government entity.
- So they could fund it. They could fund another organization and they would refer maybe to that organization
- would be like a past. We had that. I don't even know if maybe that fund that. Some members of the board
- set up could even be a funding agency for this particular issue, so it's just thoughts.
- that fund that you're referring to was set up to help clinically. It was more of help up to benefit
- employees. So as an action item, if, Laura, you could gather more data about us, maybe just purchasing
- those vitamins outright and then seeing if that process, if we could manage that process, I think would
- be helpful. And then we'll just table it until next board meeting.
- Can I ask one more question? That is, do we know how many women are served by these vitamins being handed
- out every year? Yes. So we collect that data. I just don't have it in my head. Because I think that
- would certainly also help get a bigger picture of what might be needed in terms of funding. Zooming here.
- Is that the question? Like out of this? Okay, okay. If we're distributing these, how many women are
- benefiting? So Vitamin Angels is providing these vitamins free to us. Yes. And it's a grant that they
- have that somehow provides the money for that. And then they buy the vitamins and give them to us. That's
- my interest. I mean.
- Okay, yeah, so, you know, I think that we contact, yeah, well, I mean, a couple, I mean, CVS, I mean,
- see if they have a, I mean, that may have a corporate philanthropic arm that does something like this. C-V-O.
- in some of those places. A lot of the drug companies themselves have programs set up that they provide
- medicine for people who do not have money to get it. So, you know, like, I don't know who might solve
- it. But usually it's actual, not positive, but most of it's not over-the-counter stuff. And this is
- really over-the-counter.
- Rather say I can't fight in the State Department. Is that even a good idea about thing when you get
- back to him about this? Yeah, if they know being done by. OK. So next item is new business. Actually.
- Talking about the schedule for the board meetings.
- Apparently, October 15th is during fall break. So do we want to come up with an alternate date and then
- vote on that? How about the 22nd? Sounds great. That's the next Thursday. That work for everyone? Yes.
- Can someone make a motion? I move that we
- hold the October 2026 Board of Health meeting on October 22nd in lieu of the 15th. Do you need the public
- to vote? Do we need the public to vote? I guess we do so far. Is anyone online with their hand up? No.
- Okay. Motion was made and I'll second it. All in favor?
- Okay, great. Okay, any other items of new business? Well, I will be laid from the 5th through the 13th
- and I will be reachable by, particularly by text. And I don't know if perhaps you Mike would
- be an emergency contact if something urgent came up and they wanted an answer about something. Also
- the board is invited to the IDOH holds leadership symposia a year and the one is coming up on the Wednesday
- the 13th. Any board member is welcome
- I'm happy to send the link from IDOH for that. There is a post for the symposium. It is being held at
- Fort Harrison in India. So if you're interested, let me know and I'd be happy to send you the link to
- sign up. That's the 13th of May. Okay.
- Do we know the topics or what they're? Oh, it's always a whole lot of stuff. It kind of goes through
- many of the departments and you never know quite what you're going to get. There are lots and lots of
- IDOH people there and people from across the state. Again, it's health administrators and health officers
- and anybody else in the county government and
- numbers. Are they doing video? No, they don't. It's it's there. There is lunch, which I guess is why
- you get charged so. Thank you. They provide dinner at Saint Almos. I know you didn't. Alright, any other
- new business items?
- Any other board member or health officer comments? Did you see the council meeting that you're referring
- to was on the 12th? I have a prior engagement that evening with the School of Medicine, so I can't be
- there. But I do agree. It sounds like it would be helpful to have a filmable office voice at the meeting.
- I have a dinner engagement at Greencastle. Why am I going to Greencastle, you say? All right. So seeing
- no additional comments. Going once, twice? Yes. I move for adjournment. Meeting adjourned.
- I know. What the two of you could do would be to send a note to council members prior to the meeting
- explaining your position. I'm sorry. You're formally adjourned. Yes, we're formally adjourned. Thank you.