WEBVTT 00:00:00.034 --> 00:00:13.478 - All righty, I'm gonna call to order the meeting today for April the 30th, 2026. Dr. Moore is not able 00:00:13.478 --> 00:00:26.922 - to be here today. He had some obligations. So first item actually is that I want to make an amendment 00:00:26.922 --> 00:00:29.822 - to the agenda and add 00:00:30.850 --> 00:00:41.585 - a voting item for the vitamin angels contract. And I would like to add that after department updates. 00:00:41.585 --> 00:00:52.636 - So can I get a motion to do that? You have to put it as number one after the vitamin department updates. 00:00:52.636 --> 00:00:58.846 - I'm going to, I would like Kathy to be able to speak first 00:00:58.946 --> 00:01:08.039 - Maybe we could do it as number three. Actually, does it have to go under old and continuing business? 00:01:08.039 --> 00:01:17.042 - It does. Anyway, we're adding it to old and continuing business. We'll make it number three. Okay. I 00:01:17.042 --> 00:01:26.046 - motion to add the vitamin angel prenatal vitamin discussion to number three under old and continuing 00:01:26.046 --> 00:01:28.542 - business. I'll second that. 00:01:30.274 --> 00:01:43.207 - All in favor. Aye. Okay. So the first item, can we, or can I have an approval of the previous meeting 00:01:43.207 --> 00:01:55.253 - minutes if everyone has had a chance? I move that we approve the minutes as written. I second. 00:01:55.253 --> 00:01:57.662 - All in favor. Aye. 00:02:00.002 --> 00:02:08.922 - Sorry, Kay, who said I? I didn't hear you. I said I. Okay, sorry I didn't hear you. Okay, so Linnea, 00:02:08.922 --> 00:02:17.754 - do you have the script for the public comment? It should be in my design. Yes, I got it. The Monroe 00:02:17.754 --> 00:02:26.763 - County Board of Health encourages and welcomes public input. Written comments may be submitted at any 00:02:26.763 --> 00:02:29.854 - time via email at BoardOfHealth at 00:02:30.018 --> 00:02:42.604 - At this time, we would like to invite those who would like to comment on any non agenda items to speak. 00:02:42.604 --> 00:02:54.706 - For those attending in person, please sign in at the front of the room and those joining us online, 00:02:54.706 --> 00:02:58.942 - please use the raise hand feature. 00:02:59.138 --> 00:03:09.878 - indicate you would like to provide comment. Each speaker will have three minutes and we ask that you 00:03:09.878 --> 00:03:21.256 - please begin by stating your name for the rest. So do we have any folks who want to make a public comment? 00:03:21.256 --> 00:03:27.742 - Okay seeing as we have none we will move to our next item. I 00:03:27.874 --> 00:03:39.147 - asked Kathy, well actually in your packet, I think there is information regarding the SSP program, the 00:03:39.147 --> 00:03:50.420 - needle exchange, and I asked Kathy to just come give us an update. So from SNAPS, the changes that the 00:03:50.420 --> 00:03:55.454 - new law made are actually going through well. 00:03:55.874 --> 00:04:01.552 - If you go to the IRA, the law is listed up on the lower part, right, where the records and the supply 00:04:01.552 --> 00:04:07.230 - are distributed. They say that most people are really understanding and just understand that the laws 00:04:07.230 --> 00:04:12.963 - changed, and this is the way that it's got to go. So people, while at the IRA, it seems like when they 00:04:12.963 --> 00:04:18.864 - go there at the office, it's on Western Street, if you have been where it's at, that people really aren't 00:04:18.864 --> 00:04:24.542 - having trouble showing that ID, because most of them have their driver's license if they drive there. 00:04:24.898 --> 00:04:31.331 - There's a little bit more problem needing that when they go to Shalom, because not everybody has a note 00:04:31.331 --> 00:04:37.516 - either. But they are working with that, and it's getting better and better. Now, one of the changes 00:04:37.516 --> 00:04:43.825 - that we got from this case, we got a memo, and they explained that the law actually asked for a valid 00:04:43.825 --> 00:04:50.073 - ID. But by DLH, the guidance they have given us, it has to have a picture. So they want a picture ID 00:04:50.073 --> 00:04:54.526 - that gives some indication that they're reaching in which person lives. 00:04:54.626 --> 00:05:01.501 - So that is the guidelines that we're following. One thing that's really important to know, even if we're 00:05:01.501 --> 00:05:08.375 - looking at ID and we're not looking at the name of the person, because we're not collecting, identifying 00:05:08.375 --> 00:05:14.922 - information. That's really important to know. We're not collecting that, and we're not supposed to. 00:05:14.922 --> 00:05:21.666 - The only time we do have that is when we're doing HIV or HIV testing. And that is information of those 00:05:21.666 --> 00:05:22.910 - that are separate. 00:05:25.442 --> 00:05:30.707 - These are thinking better about the end-to-end, but they're being very understanding overall. Like if 00:05:30.707 --> 00:05:36.075 - they're told, no, I'm sorry, we can't give you money because we need to bring them back now. So they're 00:05:36.075 --> 00:05:41.340 - saying, people are saying, no, okay, I'll be back because they have some. People got out of the habit 00:05:41.340 --> 00:05:46.501 - of bringing them on a regular basis because having a syringe, they can get a felony charge. Even if 00:05:46.501 --> 00:05:49.598 - they got the syringes from the SSP, they could get charged. 00:05:49.826 --> 00:05:59.504 - So they got out of the habit. They don't like to carry them, but they're getting better understanding. 00:05:59.504 --> 00:06:09.370 - They have to bring something back in order for the SSB to be able to get them. We found a way of dealing 00:06:09.370 --> 00:06:19.518 - with local enforcement personnel to help get around that issue. I know that a lot of the community officers 00:06:20.578 --> 00:06:28.063 - understand that the rest of the police department, are they on board with the program and why people 00:06:28.063 --> 00:06:35.548 - want, why people are bringing and even making sure it's kind of like following. I remember my father 00:06:35.548 --> 00:06:43.181 - would be speeding and he'd say, well, I'm going to the hospital. And the police officer would actually 00:06:43.181 --> 00:06:49.406 - accompany him to the hospital to make sure that's what he was doing. So do we know, 00:06:49.538 --> 00:06:55.813 - But the sheriff and the police department, are they understanding the new law and why people must have 00:06:55.813 --> 00:07:02.027 - the syringes in order to? We need to explain that to them. There is, we have an agreement, we have an 00:07:02.027 --> 00:07:08.180 - arrangement with the prosecutor's office that if somebody gets arrested just for a syringe, they try 00:07:08.180 --> 00:07:14.333 - to drop that if it's only for the syringe. If they have something else that they're getting enlisted 00:07:14.333 --> 00:07:18.110 - for, like possession of or some other thing, then they can't. 00:07:18.402 --> 00:07:25.473 - But they do try to work with people if it's for a huge building. Thanks. And I did follow up with the 00:07:25.473 --> 00:07:32.752 - reagents that we talked about last month. And the reagents, as they are talked about within the statute, 00:07:32.752 --> 00:07:40.169 - are referring to drug precursors or anything like I've mentioned when I said that last time, too. Anything 00:07:40.169 --> 00:07:45.854 - that can be used to make other drugs. That's what SSPs are about to give out. OK. 00:07:47.234 --> 00:07:54.702 - Do you have any questions or? Are we required to have reports per se for the state or only if they would 00:07:54.702 --> 00:08:02.526 - come do an audit? Are there reports that are then sent on to the state in terms of ledgers for the exchanges? 00:08:02.526 --> 00:08:09.781 - We have a database, a state database, that we have to enter things and we also have a portfolio there 00:08:09.781 --> 00:08:16.894 - before. So they can see at a glance what's going on at the SFP's program that we drew up as a list. 00:08:17.058 --> 00:08:32.447 - Does anyone else have any other questions? I'll second. Thank you. So Lori, we would love updates. We've 00:08:32.447 --> 00:08:46.078 - been missing on your bendogy. I don't think that I captured all of that here. Unfortunately. 00:08:46.242 --> 00:08:54.984 - Well, I did want to just touch on the SRF testing report that was in the packet. So this information 00:08:54.984 --> 00:09:03.727 - was actually in 2023, our environmental division completed testing throughout this building and they 00:09:03.727 --> 00:09:12.729 - identified lead based paint in some of the non remodeled areas of the health department. So that's kind 00:09:12.729 --> 00:09:13.854 - of what this 00:09:14.370 --> 00:09:22.361 - three fourths goes through. So in some of these areas there's paint that's chipping and falling to the 00:09:22.361 --> 00:09:30.507 - ground. We've had a tarp covering the top of the deck area in the back and that recently fell. The paint 00:09:30.507 --> 00:09:38.266 - just kind of went everywhere and so we're trying to work on getting that cleaned up but it occurred 00:09:38.266 --> 00:09:43.774 - to me to we need to check on the status of getting some of these areas 00:09:44.066 --> 00:09:52.148 - you know, they need to do remediation work. So we've reached out to facilities to kind of circle back 00:09:52.148 --> 00:10:00.152 - around to touch base on getting some of this work taken care of. And where's Richard on that? I have 00:10:00.152 --> 00:10:08.076 - not heard yet. So we're trying to limit people going in and out of that back door right now so that 00:10:08.076 --> 00:10:12.830 - we're not tracking that kind of in and out of the building. 00:10:14.914 --> 00:10:28.041 - And so that is overseen by the commissioners? The commissioners oversee the facilities director, so 00:10:28.041 --> 00:10:43.006 - that would end up being the commissioners. Council then would have to appropriate the funds to do whatever. Okay. 00:10:45.090 --> 00:10:55.020 - So otherwise for environmental, the staff met recently with the Student Society Club, Indiana University 00:10:55.020 --> 00:11:04.856 - to provide information on the type of work that they do. They are also being trained on entering animal 00:11:04.856 --> 00:11:15.070 - bite reports into our NBS system and rabies exposures. So previously our environmental director was the one 00:11:15.202 --> 00:11:22.351 - We've been doing all of this and we've run into some instances where we need to have additional people 00:11:22.351 --> 00:11:29.430 - trained to be able to enter in that information. So that work is taking place for wastewater. We have 00:11:29.430 --> 00:11:36.370 - one ARPA septic system that's already being installed for this year. There are still nine remaining 00:11:36.370 --> 00:11:42.686 - systems that need to be installed prior to July 31st of this year with those ARPA dollars. 00:11:43.618 --> 00:11:51.491 - And wastewater is also starting on subject installations for the spring. Is that a contractor issue 00:11:51.491 --> 00:11:59.678 - that contractors have not completed the work? I think that there's a few different things. I think it's 00:11:59.678 --> 00:12:07.551 - problems with getting some of those initial testing and getting the homeowners kind of working with 00:12:07.551 --> 00:12:13.534 - them to get that done. And I think some of it is just a lag in the weather. 00:12:15.810 --> 00:12:24.075 - of foods now that they transitioning kind of out of the startup for the licensing period at the beginning 00:12:24.075 --> 00:12:32.105 - of the year. They're now working on licensing vendors for the farmers markets, working with the market 00:12:32.105 --> 00:12:40.448 - managers to provide education for vital records. The director and the assistant director will be attending 00:12:40.448 --> 00:12:44.190 - the spring conference in May. So this is hosted 00:12:44.322 --> 00:12:51.313 - with statewide vital records, come together, do some ongoing training and development. Last year, all 00:12:51.313 --> 00:12:58.304 - six of the vital records employees attended the conferences, but in an effort, again, with our budget 00:12:58.304 --> 00:13:04.746 - cuts, we've taken it down just to the two right now, and then we'll kind of reevaluate again, 00:13:04.746 --> 00:13:10.366 - moving forward, just depending on funding as we get through the rest of the year. 00:13:12.322 --> 00:13:20.066 - Public Health Emergency Preparedness that they recently attended the Preparedness Summit that was done 00:13:20.066 --> 00:13:28.186 - virtually again in an effort just to kind of reduce some of our costs. They're distributing tick, mosquito, 00:13:28.186 --> 00:13:35.855 - educational materials and prevention kits. I was actually going to ask you if you could say what's in 00:13:35.855 --> 00:13:41.118 - the kits. So it is a comparative insect repellent and a tick remover. 00:13:41.410 --> 00:13:50.346 - as well as a little information on how to avoid ticks and what to do by the way. They're still providing 00:13:50.346 --> 00:13:59.367 - Stop the Bleed trainings to members of the public and for department staff here. Continuing the emergency 00:13:59.367 --> 00:14:07.963 - kit building workshops for the public. What was the one that you worked on recently? The most recent 00:14:07.963 --> 00:14:10.942 - one was an emergency kit building. 00:14:11.426 --> 00:14:21.473 - And then they participated in the district emergency preparedness and planning coalition exercise in 00:14:21.473 --> 00:14:31.520 - French lick. Our disease intervention specialists. There continues to be a by selling shortage. It's 00:14:31.520 --> 00:14:38.782 - now expected to go through the 4th quarter of 2027, so we have that for. 00:14:39.650 --> 00:14:49.355 - Pregnant patients and then special circumstances. The Indiana Department of Health has started a congenital 00:14:49.355 --> 00:14:58.341 - syphilis case management pilot program with us. So more information to will be coming forward about 00:14:58.341 --> 00:15:00.318 - what that looks like. 00:15:00.770 --> 00:15:08.006 - There are currently two case managers at the Indiana Department of Health who are providing support 00:15:08.006 --> 00:15:15.242 - to pregnant patients who either have syphilis during pregnancy or prior to pregnancy. Our employees 00:15:15.242 --> 00:15:22.551 - right now are not doing any additional work, but they are receiving support for their patients to be 00:15:22.551 --> 00:15:30.366 - able to work working with OBs and hospitals with these case managers from the Indiana Department of Health. 00:15:32.418 --> 00:15:41.139 - So if we remember in the fall of last year, the Health Department submitted a request to County Council 00:15:41.139 --> 00:15:49.524 - for some of the old COVID reimbursement dollars for the purchase of a mobile unit. That request was 00:15:49.524 --> 00:15:57.909 - approved last year. However, the unit was not purchased before the end of the year, so that request 00:15:57.909 --> 00:15:59.838 - had to be asked again. 00:16:00.418 --> 00:16:08.213 - It was voted. They had a 6-1 vote earlier this week, so that has been approved again for this year. 00:16:08.213 --> 00:16:16.164 - So now we just need to make sure that the purchase goes through. So we currently have six trustee and 00:16:16.164 --> 00:16:24.894 - food pantry community locations that are interested in working with us on some of these mobile clinic outreach. 00:16:25.186 --> 00:16:32.607 - just have a partnership with us. So continuing to work on expanding where we could actually be going 00:16:32.607 --> 00:16:40.028 - out on the mobile unit and providing some of these services. Can you remind me exactly what services 00:16:40.028 --> 00:16:47.523 - do we plan to offer through this? So definitely vaccinations and then our health screenings. So blood 00:16:47.523 --> 00:16:54.430 - pressure and cholesterol, we could blood sugar. And then we can provide educational materials 00:16:54.626 --> 00:17:03.982 - possibly with our maternal child health to promote the lactation counseling, promote the bean and milk 00:17:03.982 --> 00:17:13.156 - bank express location. Smoking, anything smoking for pregnant women. And? She can provide, she could 00:17:13.156 --> 00:17:22.512 - go along and provide safe sleep training as well. And ultimately it looks like one of our nurses could 00:17:22.512 --> 00:17:24.510 - be in township spaces 00:17:25.058 --> 00:17:34.464 - even during the fall training, fall prevention training, and almost anything in any of our outside locations. 00:17:34.464 --> 00:17:43.271 - Plus we can go to the county fair and have a presence so that our county knows that we exist at large. 00:17:43.271 --> 00:17:51.907 - Of course, most of who come assist people from out of county, but still having our presence there, I 00:17:51.907 --> 00:17:54.558 - think would make a difference. 00:17:55.298 --> 00:18:02.790 - So if you come up with great ideas for where else we should go, let us know. Absolutely. STI, HIV, and 00:18:02.790 --> 00:18:10.136 - hepatitis testing as well. We can look at that. And I've spoken with Indiana University. It's been a 00:18:10.136 --> 00:18:17.118 - little while about working maybe in collaboration with them and some of their students on being 00:18:17.378 --> 00:18:25.253 - to provide behavioral health assessments and referral services. So whether there's other screenings 00:18:25.253 --> 00:18:33.443 - that you can provide and then be able to connect individuals to services as well. And that the trustees 00:18:33.443 --> 00:18:41.476 - are. You've been in touch with some of the trustees there on board with having a baby or their mobile 00:18:41.476 --> 00:18:45.886 - unit time in their locations and helping us with space. 00:18:48.098 --> 00:18:56.498 - I thought I would share some information. The Indiana University, Indianapolis, they conducted a study 00:18:56.498 --> 00:19:04.735 - so they were actually examining the startup period of Health First Indiana and the core service data 00:19:04.735 --> 00:19:13.053 - that has been submitted statewide compared to some of the funding we've received. So based on some of 00:19:13.053 --> 00:19:16.478 - this initial data, there were over 14,000 00:19:16.578 --> 00:19:27.686 - that were identified as having undiagnosed high blood pressure, over 7,000 with undiagnosed high cholesterol 00:19:27.686 --> 00:19:37.470 - based on just offering these free health screenings from local health departments. So they have 00:19:37.730 --> 00:19:45.789 - ended up estimating over $700 million in healthcare cost savings just based on these preventative health 00:19:45.789 --> 00:19:53.542 - screenings. So I thought that was interesting information. So hopefully they're no longer working or 00:19:53.542 --> 00:20:01.371 - they're not, at least at this time with this stage, but I think interested in finding other ways that 00:20:01.371 --> 00:20:06.974 - the outcomes of this funding and what local health departments are doing 00:20:07.394 --> 00:20:18.122 - how they can help contribute to that. So I'm happy to answer questions. That's what I had for the report. 00:20:18.122 --> 00:20:28.647 - Yeah, it's good to hear the overall introduction like that. And that's good for the legislature to hear 00:20:28.647 --> 00:20:35.326 - that as well. Since they cut the funding, which I don't think was 00:20:36.034 --> 00:20:45.013 - unexpected by a lot of people. It was a two-year deal, and it really ended up only being like, what, 00:20:45.013 --> 00:20:54.347 - one year? But they also cut the funding to the folks who are studying the impact of HFI funding. They've 00:20:54.347 --> 00:21:03.859 - totally cut off that funding. So it's like, shoot yourself in the foot, I'm sure. Yeah. But that's another 00:21:03.859 --> 00:21:04.926 - part of it. 00:21:05.730 --> 00:21:17.994 - They're not engaged anymore because the funding has been cut off. Unfortunate. Well, thank you, Lori. 00:21:17.994 --> 00:21:30.017 - I know you've been extremely busy. And we're going to talk more about that, actually. So as part of 00:21:30.017 --> 00:21:32.542 - continuing business, 00:21:34.306 --> 00:21:43.687 - We had asked Laura to obtain some information on all of the fees that we are trying to sort through 00:21:43.687 --> 00:21:53.442 - for these employee positions for their training. If we should have a policy as to whether they're going 00:21:53.442 --> 00:22:03.198 - or the person is going to cover their fees or we are going to cover their fees and then how we go about 00:22:04.130 --> 00:22:15.559 - putting that in the budget, is that correct? So this is actually a very comprehensive list of all the 00:22:15.559 --> 00:22:27.211 - trainings that we're requiring for the physicians, the amounts of those fees. So where are we with this 00:22:27.211 --> 00:22:33.822 - in terms of, we probably do not have any consistency with, 00:22:34.146 --> 00:22:44.647 - Position based. Correct, OK. And so. You'll see a lot of these are within environmental. It's all the 00:22:44.647 --> 00:22:55.044 - different certifications. There have been some with the newer positions that were developed based on 00:22:55.044 --> 00:23:01.118 - those additional core services developed first in Indiana. 00:23:06.818 --> 00:23:15.461 - but there's quite a few when it comes to ongoing education that there is access to free. And so we get 00:23:15.461 --> 00:23:24.439 - on one hand, you're looking at what are the education certification, what are the requirements for someone 00:23:24.439 --> 00:23:33.249 - to get a job and then maintain that job. And then you have the other aspect of the jobs that is ongoing, 00:23:33.249 --> 00:23:35.934 - just education and development. 00:23:37.762 --> 00:23:48.367 - Well, in my opinion, if there is a cross associated with certifications that allow the person to do 00:23:48.367 --> 00:23:59.185 - their job and do it adequately and safely, then I think we should go about figuring out how to do all 00:23:59.185 --> 00:24:06.078 - the machinations to get that covered for them, for the position. 00:24:06.274 --> 00:24:18.136 - I don't know exactly the step-by-step, but I think we should cover those costs. Do we have the funds 00:24:18.136 --> 00:24:30.467 - to do that? We have the funds. Yes, for everything that's required this year, we have the funds to cover 00:24:30.467 --> 00:24:36.222 - that. So where we've been cutting back are those 00:24:36.482 --> 00:24:45.227 - non-essential, non-required, like kind of extras. So kind of limiting the travel and extra. And some 00:24:45.227 --> 00:24:53.886 - of it's variable. I mean, it was when we had that huge increase in the Health First Indiana funding 00:24:53.886 --> 00:25:02.805 - that allowed more funding to be available for the extra training and conferences. And some of that was 00:25:02.805 --> 00:25:05.662 - really needed because of the new 00:25:05.762 --> 00:25:13.393 - work and the additional core services? And so I think the question kind of comes down in my mind. 00:25:13.393 --> 00:25:21.257 - Yes or no? Are we going to always find or is it going to be a policy that this is a job requirement? 00:25:21.257 --> 00:25:29.199 - If you have to be CPR certified, if you have to have a pesticide license that we will cover that cost 00:25:29.199 --> 00:25:34.494 - and whether or not we can cover what you go to a three day retreat. 00:25:34.722 --> 00:25:44.482 - will depend upon the budget maybe. So some of these you're saying they have to have this finished before 00:25:44.482 --> 00:25:53.777 - to apply for the position? Yes, like some of those if it requires a degree CPR certification or the 00:25:53.777 --> 00:26:02.142 - feeds they've handler certification, those are required to be qualified for the position. 00:26:03.554 --> 00:26:12.350 - So I don't think. I think. That's a level of already commitment to the position that they want. I think 00:26:12.350 --> 00:26:20.892 - they should come with those certifications, but if they're ongoing once they're here with us, then I 00:26:20.892 --> 00:26:24.190 - think it should be covered. Does that? 00:26:24.962 --> 00:26:31.309 - That was exactly what I was going to say. I mean, if it's a requirement for their job, then they need 00:26:31.309 --> 00:26:37.657 - to already have it done. We can't be waiting on them to finish their certification, and that may take 00:26:37.657 --> 00:26:43.942 - three months, and no. But if it's ongoing, then I think they should. Yeah, so you have to have your, 00:26:43.942 --> 00:26:50.476 - you know, Indiana pesticide applicator category H, whatever, for the job, and you should come with that. 00:26:50.476 --> 00:26:53.214 - But then when you will come up for renewal, 00:26:53.506 --> 00:27:07.321 - We will continue. We will cover it. It sounds like a good idea. So the first step is to so we need to 00:27:07.321 --> 00:27:21.406 - make a motion as a board. That we will cover. Renewals renewals for training programs and certificates. 00:27:22.434 --> 00:27:35.288 - that are required for the position that the department will cover those. So can I have... Okay, 00:27:35.288 --> 00:27:47.070 - so a second? I second. Okay, all in favor? Aye. Aye. Aye. Approved. Okay, June, me too. 00:27:47.682 --> 00:27:56.812 - with the public to see if anybody had any comments. Oh, yes. Yes, I did. Somebody thought I'd ask. We 00:27:56.812 --> 00:28:06.121 - should change the pause. Yeah, we should change the pause again. Now that we've moved. Oh, anyway, does 00:28:06.121 --> 00:28:15.251 - anyone have any discussion about that? You can always go back and redo the motion and the vote. I was 00:28:15.251 --> 00:28:17.310 - definitely against it. 00:28:18.626 --> 00:28:30.069 - No, I know it. Thank you for that reminder, Sarah. Sure. Okay. Are we finished with that? Is there anything 00:28:30.069 --> 00:28:41.513 - else we need to address? Yes. The next issue on our continuing business is our clinical assistant position. 00:28:41.513 --> 00:28:47.870 - Lori has worked many hours working on this job description. 00:28:48.034 --> 00:28:57.649 - Can you give us the latest update? Yes. So the job description that was finalized has been sent to WIS, 00:28:57.649 --> 00:29:07.265 - which is the organization that the county uses to review and classify positions. So that classification 00:29:07.265 --> 00:29:15.678 - will then is basically tied to a certain pay rate. We have received the WIS recommendation 00:29:15.778 --> 00:29:24.807 - back now. So now the next step is that is taken to the County Council for their review and consideration. 00:29:24.807 --> 00:29:33.666 - So it's the complexity with this is we are still in a hiring freeze, so Council did agree that we could 00:29:33.666 --> 00:29:41.758 - create a job description, send it to with. But now they will have to agree if they're going to 00:29:42.082 --> 00:29:51.841 - accept the new position and then allow the position to be filled during the hiring freeze. And so that 00:29:51.841 --> 00:30:01.411 - will be going to Council in May. We were hoping, I think, to receive a higher classification just to 00:30:01.411 --> 00:30:06.622 - be able to get the best qualified applicant. But I was 00:30:08.034 --> 00:30:17.811 - The classification, I think, that it came back to is really what I was expecting. So that's a comment 00:30:17.811 --> 00:30:27.876 - like a clerical position. And when you mail that to the council? I believe the 12th. Set your hope high. 00:30:27.876 --> 00:30:32.094 - Set your realization hopes and expect less. 00:30:34.114 --> 00:30:42.864 - So this position is really going to be crucial for efficient clinic operations. I just don't see how 00:30:42.864 --> 00:30:50.142 - the clinic is really going to operate well without being able to have someone who's 00:30:50.306 --> 00:30:57.913 - really managing that front desk and helping to greet patients and the scheduling and the billing processes. 00:30:57.913 --> 00:31:05.027 - There's additional services that we could be billing for that we're not right now, just not having a 00:31:05.027 --> 00:31:12.071 - person to be able or a physician to be able to do that. Just running into a lot of issues about how 00:31:12.071 --> 00:31:19.678 - are you gonna kind of manage these patients coming in and the patient care and then that front office side. 00:31:24.386 --> 00:31:33.361 - We're working through it. So are we in fact seeing? We are open and at this point we are open that we 00:31:33.361 --> 00:31:42.160 - can schedule patients just start coming in so block right now for these services. So for the health 00:31:42.160 --> 00:31:50.958 - screenings and for the vaccinations Mondays and Wednesdays between 1 and 4 PM and then Tuesdays and 00:31:50.958 --> 00:31:53.598 - Thursdays between 830 and 12. 00:31:54.082 --> 00:32:01.768 - So having some afternoon, some work. Good question, because I was looking, going, there's a lot of things 00:32:01.768 --> 00:32:09.164 - that you have this person doing. But knowing the clinical time would be half days, at least plenty of 00:32:09.164 --> 00:32:16.414 - time for this other stuff. And really, I think that you have to do that to balance the other duties 00:32:16.414 --> 00:32:23.230 - that the nurses have to do. So they can't just be scolding all of their team and the patient. 00:32:23.586 --> 00:32:32.583 - Yeah, I'm convinced. We need this position. I mean, it's... We really... It would be nice to be able 00:32:32.583 --> 00:32:41.581 - to... We really need another nurse, too. It's a lot of work. And I've been helping to distribute car 00:32:41.581 --> 00:32:50.667 - seats to people walking in for cribs. And there's just so much going on and just not enough bodies to 00:32:50.667 --> 00:32:52.894 - do all the work. Mm-hmm. 00:32:54.946 --> 00:33:03.873 - We're going to continue to work on making a plan to get another RN. And currently with the hiring freeze, 00:33:03.873 --> 00:33:12.548 - it's not going to happen. It will start to. Well, this hiring freeze has really put us in, I'm stating 00:33:12.548 --> 00:33:20.970 - the obvious, it's really put us in a difficult position because the contract was canceled by IU and 00:33:20.970 --> 00:33:22.654 - they were providing 00:33:22.754 --> 00:33:31.307 - all these services, and now we're expected to do this, but not expected to hire any additional employees, 00:33:31.307 --> 00:33:39.536 - which we had when we had the contract. I mean, I don't know how they can't make an exception. I don't 00:33:39.536 --> 00:33:47.927 - understand how they can justify this. We have the money, correct? Yes, correct. I understand. Go ahead. 00:33:47.927 --> 00:33:50.590 - No, I understand that if they're 00:33:50.818 --> 00:34:00.559 - They're sort of afraid that if they allow us to hire somebody, they have to allow someone else to hire 00:34:00.559 --> 00:34:10.584 - somebody who has the money. But this is the county health department. I mean, this is affecting everyone. 00:34:10.584 --> 00:34:14.462 - You know, it's not a... This is not a... 00:34:14.562 --> 00:34:23.060 - It's not the Highway Department. Yeah, exactly. Well, I mean, it's not the diminished Highway Department. 00:34:23.060 --> 00:34:31.317 - No, I'm not. But I mean, health is health. And we have to have enough employees to provide the service 00:34:31.317 --> 00:34:39.574 - that was being provided for us before. I'm saying this, obviously, as a public appeal, because I mean, 00:34:39.574 --> 00:34:43.582 - the county council has to understand that this is 00:34:43.778 --> 00:34:52.841 - imperative that we hire some extra people to cover those positions that our contract was covering with 00:34:52.841 --> 00:35:01.815 - IU Health. And they no longer providing for us. And I'm not trying to put them in a bad light either. 00:35:01.815 --> 00:35:11.318 - I'm just saying that they were currently, they were in the past providing this service and now our contract 00:35:11.318 --> 00:35:12.286 - has ended. 00:35:12.770 --> 00:35:20.507 - we need to be providing those services with these people, and we need extra people to do that. Yes, 00:35:20.507 --> 00:35:28.475 - if you look at Allen County as an example, so they have 23 full-time employees in the clinical section 00:35:28.475 --> 00:35:36.598 - for their health department. And some of those people include environmental and for disease intervention 00:35:36.598 --> 00:35:42.014 - specialists, et cetera, but they have 23. And so if you look at their 00:35:42.210 --> 00:35:51.484 - population, and you compare to the population of Monroe County, we should have eight full-time employees 00:35:51.484 --> 00:36:00.492 - for the clinical section of the health department. With how we have our structured, which is a little 00:36:00.492 --> 00:36:09.324 - different, we have right now four to five, and so we really need three more clinical people, and it 00:36:09.324 --> 00:36:12.062 - doesn't include support staff. 00:36:12.482 --> 00:36:19.976 - to support the health department and we're recreating infrastructure. I mean, that's essentially what 00:36:19.976 --> 00:36:27.471 - we're doing. We have to have people for the infrastructure and we're recreating what IU is providing. 00:36:27.471 --> 00:36:35.039 - I think that, yes, I think the public needs to understand we have the funds, we can re-appropriate the 00:36:35.039 --> 00:36:40.990 - funds, if you will, to support these positions so that we can fill the positions 00:36:41.602 --> 00:36:50.806 - So I think we just need to keep making a case with the council and make them continue to be there in 00:36:50.806 --> 00:37:00.647 - a presence and help them understand that we have to do this. It's our duty to do this. We have the taxpayer 00:37:00.647 --> 00:37:10.033 - dollars to do this. And we have to have some cooperation between ourselves. And we are sort of begging 00:37:10.033 --> 00:37:11.582 - for cooperation. 00:37:12.738 --> 00:37:25.634 - Do we have enough? This was Aurora brought this. Concern up. Do we have enough people that are doing 00:37:25.634 --> 00:37:40.318 - investigations of? Or? Where the STI or the chemicals well? No, and we had the grant funding for another position, 00:37:40.802 --> 00:37:48.486 - Council would not approve us to hire, so we had to return those grant funds. And I think that's the 00:37:48.486 --> 00:37:56.478 - other challenge is that now- So actually we're returning grant money because of the hiring freeze. Yes, 00:37:56.478 --> 00:38:04.393 - and we're ineligible now. We have grants that we're trying to apply for, that we want to apply for for 00:38:04.393 --> 00:38:08.542 - positions, and we can't because of the hiring freeze. 00:38:08.674 --> 00:38:17.227 - And so the INSS. There was a concern about in the past about us not having providing the service that 00:38:17.227 --> 00:38:25.947 - we had a grant for. Yes. But now we're having to send grant money back because of the council. Correct. 00:38:25.947 --> 00:38:34.752 - And the council is critical of us for not providing something and letting all those dollars be returned. 00:38:34.752 --> 00:38:37.854 - Yes. So I find this a little ironic. 00:38:38.818 --> 00:38:44.732 - Yeah, they're trying the best they can to kind of keep up with the workload because the grant still 00:38:44.732 --> 00:38:50.705 - says we have to take on those additional counties. You know they gave us the money for the staffing, 00:38:50.705 --> 00:38:56.856 - but whether or not we could hire that staffing, the grant terms remain the same. We still have to cover 00:38:56.856 --> 00:39:02.829 - that workload, but I can't remember the last time that Miranda was able to actually work a full week 00:39:02.829 --> 00:39:07.678 - because she's always hit for 40 hours by the time Friday morning rolls around and 00:39:07.906 --> 00:39:15.356 - then she has to leave, she can't finish out the work. There's been some instances where I've had to 00:39:15.356 --> 00:39:22.880 - approve her working that overtime because it was just critical that she needed to get treatment to a 00:39:22.880 --> 00:39:30.628 - patient or follow up on something. So that's the other unfortunate side is that we also can't not being 00:39:30.628 --> 00:39:37.854 - able to have the great funding to help supplement our other funds. I'm curious, does her role as 00:39:38.626 --> 00:39:49.797 - the lead for the region affect any of the work she does here? Well, she's the program coordinator, so 00:39:49.797 --> 00:40:00.969 - she does a higher classification, more of the work and oversees some of the work and is doing some of 00:40:00.969 --> 00:40:07.102 - the supervisor duties of the others. It's great because 00:40:08.770 --> 00:40:23.862 - simply details how crucial and how good she is and how lucky we are that she leads, is this seven or 00:40:23.862 --> 00:40:37.310 - eight? I can't remember. That's fabulous, but we still need bodies and I'm not quite sure 00:40:38.498 --> 00:40:50.573 - how to make council understand that. And the only thing I can think of is maybe after elections on Tuesday, 00:40:50.573 --> 00:41:02.201 - maybe some of the council members won't be necessarily running for office. And so might be more willing 00:41:02.201 --> 00:41:08.350 - to listen and communicate in ways that are clearer and 00:41:09.730 --> 00:41:19.792 - more amenable to hearing real needs. I know I can't be there on the 12th because, and that'll come up 00:41:19.792 --> 00:41:30.051 - later, I will be out of the country. But I'm hoping that maybe some of our clinical board members might 00:41:30.051 --> 00:41:38.238 - really appear and try to make it clear what it takes to run a clinic or an office. 00:41:38.754 --> 00:41:47.405 - Because I don't know that any of the council members really grok that piece of information. I think 00:41:47.405 --> 00:41:56.835 - they think that it's superfluous to have somebody answering the phone and doing the insurance and scheduling 00:41:56.835 --> 00:42:05.486 - patients and scheduling whatever for the nurses. And that the nurses should be able to do that too. 00:42:05.486 --> 00:42:08.254 - So I think it would be helpful. 00:42:08.450 --> 00:42:16.375 - It's certainly up to the board whether any. Board members show up, but I think it might be really helpful 00:42:16.375 --> 00:42:24.600 - for them to see. A force that tries to help them understand that. We have two venues really for communicating 00:42:24.600 --> 00:42:32.077 - with Council and one is Department updates that Lori can give each meeting and then public comment. 00:42:32.077 --> 00:42:36.862 - So the key with that is, you know, it's just like our meetings. 00:42:37.026 --> 00:42:46.108 - we can all go make public comment before the meeting as long as there's nothing on the agenda that we're 00:42:46.108 --> 00:42:54.844 - referencing specifically. So if anyone wants in the public comment is at the very beginning at five. 00:42:54.844 --> 00:43:03.840 - But if it's since this if this is really supposed to be on the agenda on the 12th, then indeed it would 00:43:03.840 --> 00:43:05.310 - be simply having 00:43:07.138 --> 00:43:16.485 - other people sitting at the table with Laurie and hoping to address whatever questions come up and from 00:43:16.485 --> 00:43:26.102 - real life experience saying, no, we really can't run a medical office without someone out there to receive 00:43:26.102 --> 00:43:35.360 - the patients, to schedule the patients to do all of these things and to be able to bill so that we can 00:43:35.360 --> 00:43:36.798 - receive funding 00:43:37.410 --> 00:43:50.070 - for the services were provided. And I think they don't, they somehow, I'm not sure why it doesn't quite 00:43:50.070 --> 00:44:02.729 - get through their heads, but apparently it hasn't. We shall continue to make a case for sure. Any other 00:44:02.729 --> 00:44:04.190 - discussion? 00:44:08.898 --> 00:44:22.728 - Next item, we have the Vitamin Angels contract. I'd like to have a discussion about that. We have a 00:44:22.728 --> 00:44:36.834 - list of recommended daily allowances for pregnant patients for each vitamin in their packets and then 00:44:36.834 --> 00:44:38.494 - the Unimap. 00:44:39.362 --> 00:44:49.991 - recommendations, which is what Vitamin Angels is following, is different. So we just have to make a 00:44:49.991 --> 00:45:00.621 - decision as a board. We have to vote on whether or not to proceed with the Vitamin Angels contract. 00:45:00.621 --> 00:45:04.766 - And again, I'd like the discussion and 00:45:09.154 --> 00:45:22.681 - Well, in your mind is the fact that they're folic acid is under, is that significant? It is. Does anyone 00:45:22.681 --> 00:45:35.564 - have other comments before we take a vote? I have a question. Yes, please. If we don't do this, the 00:45:35.564 --> 00:45:38.398 - choices between doing 00:45:39.042 --> 00:45:46.588 - this contract or not offering any prenatal vitamins? Is that what we're? That's correct. So the question 00:45:46.588 --> 00:45:54.350 - is, this or nothing? Can we get prenatal vitamins somewhere else that would meet the requirement? Excellent 00:45:54.350 --> 00:46:01.753 - question. That's where I'm at. We have not been able to find any that would be free. We get these free 00:46:01.753 --> 00:46:07.646 - through that rate. So I think we'd have to look at the cost of prenatal vitamins. 00:46:07.842 --> 00:46:18.236 - Have we asked them why they're folic acid is? Dr. McKinley did discuss that with them. I know, but I 00:46:18.236 --> 00:46:28.631 - don't know the outcomes. I reached out not for that question specifically, but with the concerns and 00:46:28.631 --> 00:46:37.790 - I received a response, I guess should be in your front page. So that was the answer that 00:46:38.466 --> 00:46:46.683 - And I received information. But we pay for these. We pay them something. No. No. We get a grant. Oh, 00:46:46.683 --> 00:46:54.982 - it's a grant. It's a grant. So they come free to us from the grant. Who's the grant from? The Vitamin 00:46:54.982 --> 00:47:03.281 - Angels. So it's their own grant. Yes. In other words, we'll let you take these free of you. Yeah. OK. 00:47:03.281 --> 00:47:06.942 - So they just give us the goods, essentially. 00:47:08.898 --> 00:47:18.442 - So, you know, as I'm looking at this, I think to myself, I would, given another option, prefer to have 00:47:18.442 --> 00:47:27.707 - more folic acid, but if it's a choice between a pregnant woman receiving this or nothing, right, it 00:47:27.707 --> 00:47:36.973 - makes me feel differently. Makes me also wonder if the folic acid really is the big one here, which 00:47:36.973 --> 00:47:38.270 - it really is. 00:47:39.618 --> 00:47:48.415 - Could we get an additional folic acid supplement somewhere that we could pair with it? Is that an option? 00:47:48.415 --> 00:47:56.963 - Take this grant, look into, can we put some additional folic acid? Or at the very least, we recommend. 00:47:56.963 --> 00:48:06.009 - Point out, yes, we would point out that these are free vitamins, but they are lacking in one key ingredient, 00:48:06.009 --> 00:48:09.246 - which is folic acid, and that they may 00:48:09.762 --> 00:48:22.853 - want or you're recommending that they get additional. At least I'm with you. If it's this or nothing, 00:48:22.853 --> 00:48:32.478 - then I would, I would, I would vote for this. So how do we give these out? 00:48:33.346 --> 00:48:42.055 - or the women are coming here to the office, potentially on the mobile unit at some point. Yes, and some 00:48:42.055 --> 00:48:50.932 - we have, we provide to the tandem location that they are able to then distribute. And I hate to be really 00:48:50.932 --> 00:48:59.474 - stupid, but have we seen a difference between 400 and 600 a day in terms of spina bifida? I think the 00:48:59.474 --> 00:49:03.326 - answer would be yes. The answer is yes. Okay. 00:49:04.930 --> 00:49:13.497 - I can see it in case the demeanor is, you know, let's say patient comes, we give them these vitamins, 00:49:13.497 --> 00:49:22.316 - they have a child who has spina bifida, and then here we are, you know, even if we have a policy change, 00:49:22.316 --> 00:49:30.798 - et cetera, sort of feeling responsible in some way, I don't know the, I don't know. It's kind of how 00:49:30.798 --> 00:49:33.150 - the patient take two a day. 00:49:34.082 --> 00:49:41.346 - So they may be getting 800 of folate rather than 400 of folate. You could do that. My guess is they 00:49:41.346 --> 00:49:48.683 - would have some pretty substantial side effects. Right. You'd have some pretty bad nausea with these 00:49:48.683 --> 00:49:56.020 - anyway. Right. Well, and then you wouldn't want to double up on some of the other vitamins would not 00:49:56.020 --> 00:49:57.182 - be appropriate. 00:49:59.170 --> 00:50:08.896 - I'd like to see the drug companies that make the vitamins being contacted and explain to them that we're 00:50:08.896 --> 00:50:18.344 - a health department and we're trying to provide vitamins to people that don't have money to buy them. 00:50:18.344 --> 00:50:27.422 - Is there any type of grant or any type of leeway they could give us as a health department? Yeah. 00:50:27.554 --> 00:50:35.035 - I hear your point. But I also hear your point, because you want them to get, if they get at least some 00:50:35.035 --> 00:50:42.516 - folic acid, then that will prevent, hopefully- Yeah, presumably you are preventing some, but there are 00:50:42.516 --> 00:50:50.070 - going to be some that may still have. I mean, as a health department, my thought would be you're trying 00:50:50.070 --> 00:50:57.406 - to prevent as much as you can as possible, and by doing something that is better than doing nothing. 00:50:57.890 --> 00:51:05.743 - I, on the other hand, if we don't say anything to them about it, well, they assume that we're giving 00:51:05.743 --> 00:51:13.519 - them a preventive as long as a preventive dose, at least they're giving him adequate and preventive 00:51:13.519 --> 00:51:21.372 - dose and adequate dose when in fact we learned. Yeah. And they have somebody that has a problem then 00:51:21.372 --> 00:51:25.726 - a baby then. Yeah. I think we would have to specify or. 00:51:26.434 --> 00:51:36.368 - figure out a different ways to add 200 folic acid to what we're giving. And I don't know if we have 00:51:36.368 --> 00:51:46.402 - enough time to do that research and whatever. Folic acid is the main one, but there's other. There's 00:51:46.402 --> 00:51:54.846 - other ones too. Yeah. Well, as a health department, I don't even, could we, could we 00:51:55.938 --> 00:52:05.130 - purchase prenatal vitamins and then dispense them? Is that even a possibility that we could get some 00:52:05.130 --> 00:52:14.413 - standard? And it's probably gonna honestly cost less than the grant they're asking for for the number 00:52:14.413 --> 00:52:23.515 - of patients service. I think for that program it was only, how many patients was it? Like 30 maybe? 00:52:23.515 --> 00:52:25.790 - It wasn't very many. So, 00:52:26.178 --> 00:52:37.035 - Um, okay. So hold on. So this is, oh, here, maybe this is it. So this, this was only for up to a certain 00:52:37.035 --> 00:52:47.788 - number of patients. That changes things. Yes. It was only for X number of patients. I, and I, it wasn't 00:52:47.788 --> 00:52:54.302 - very many and I don't even think it was a hundred formulation. 00:52:58.850 --> 00:53:09.380 - If my memory is correct, she received $150, I believe. And the grant is for how much? That's what she 00:53:09.380 --> 00:53:19.703 - got for the grant. They got $150. And I don't know how many of those. Oh, that's a fair amount. But 00:53:19.703 --> 00:53:28.478 - what was the amount of money for the grant? They just give it. Oh, I see. Oh, I see. 00:53:28.802 --> 00:53:40.152 - Yeah. Okay, so. They gave us the buy-in for that, but they have a grant money. They give us the grant, 00:53:40.152 --> 00:53:51.502 - they give us the bottom. Yeah. Yeah. And that's a great slide for me, almost. I mean, I don't have any 00:53:51.502 --> 00:53:56.350 - idea of what it would cost to be purchased. 00:53:56.642 --> 00:54:05.684 - If there was certain type that was identified that said, we want to purchase these, we could certainly 00:54:05.684 --> 00:54:14.813 - do that. Costs would just depend on how many, I guess, we purchased and back cleaned. How many patients 00:54:14.813 --> 00:54:24.382 - potentially would we be passing these out? 150. Well, no, I mean, that's what's covered by the grant, right? 00:54:24.514 --> 00:54:31.606 - That's how much they would give to us, how many pregnant women are actually going to come and ask. That's 00:54:31.606 --> 00:54:38.631 - the point. Exciting. If they give you 150, are they talking about 150 over nine months? Are they talking 00:54:38.631 --> 00:54:45.456 - about 150 bottles, period? Assuming that each one is a 30-day supplement and that that goes over nine 00:54:45.456 --> 00:54:50.206 - months. We're talking about very few patients. We're probably covered. 00:54:52.962 --> 00:55:06.600 - That's what I'm thinking. But it would be very few patients. So. Well, and then I think if we're going 00:55:06.600 --> 00:55:19.841 - to purchase and give them out, then what's the criteria for people who qualify? If we talk to other 00:55:19.841 --> 00:55:22.622 - counties about this, 00:55:23.714 --> 00:55:34.732 - No, just that there's other counters that do use the program. And this has not become an issue for any 00:55:34.732 --> 00:55:45.751 - of them, it sounds like. Not for my knowledge. Yeah, I mean, it might be nice for us to race even with 00:55:45.751 --> 00:55:52.062 - the folks at the top. The medical director of IDOH and how 00:55:52.738 --> 00:56:03.936 - How is this best dealt with? Because this is a grant program. If this is happening across the state 00:56:03.936 --> 00:56:15.471 - and we're trying to ensure the health of infants born in this state, how does using this grant program 00:56:15.471 --> 00:56:22.526 - in many counties actually help us prevent preventable disease? 00:56:24.002 --> 00:56:37.679 - Maybe the steak should look at it. It is steak. Yeah. You want to come find out? OK, so are we going 00:56:37.679 --> 00:56:52.574 - to table this again? It sounds like you're not satisfied with the answers. It's OK. Well, I was going to say, 00:56:53.058 --> 00:56:59.108 - It's better than nothing, but now I'm thinking, I'm not so sure. Yeah, it's a complicated question. 00:56:59.108 --> 00:57:05.278 - Yeah. Right? Yeah. I mean, yeah. You certainly don't want to give somebody the impression that you're 00:57:05.278 --> 00:57:11.389 - giving them what they need when they're not getting what they need. Yeah. But you also don't want to 00:57:11.389 --> 00:57:16.894 - not give someone something that they might at least part of it. Partially be. Right, yeah. 00:57:18.050 --> 00:57:25.705 - Yeah, I mean, I understand that. But I think if we if we do pass these out, we're giving people the 00:57:25.705 --> 00:57:33.437 - impression that it's completely adequate. And in fact, it's not one of the key ingredients. So also, 00:57:33.437 --> 00:57:41.092 - if we're going to talk with the state, could we also simultaneously do research into could we get a 00:57:41.092 --> 00:57:44.766 - prenatal vitamin? Like, what would the cost be? 00:57:44.930 --> 00:57:53.532 - to get prenatal vitamins. We have the recommended amount and could we do that as the Board of Health 00:57:53.532 --> 00:58:02.219 - here and say, we'll turn this down. This is reasonable. Let's do this instead. So it looks like it's, 00:58:02.219 --> 00:58:10.139 - I mean, I don't know why, but when I'm reading this, it says vitamin angels slash walbrates. 00:58:10.139 --> 00:58:14.142 - So I'm wondering, does CVS or some other large 00:58:14.754 --> 00:58:27.642 - distributor of pharmaceutical agents in our country have a grant program that actually would allow us 00:58:27.642 --> 00:58:40.910 - to give adequate prenatal vitamins at no cost. And I'm sure that there are other funding sources. Again, 00:58:40.910 --> 00:58:44.574 - we could even think of going 00:58:45.026 --> 00:58:59.418 - to our community funding grant funders and say, you know, we want to make sure that babies born in this 00:58:59.418 --> 00:59:12.702 - county to indigent patients have the best chance for survival. And who has a philanthropic fund 00:59:12.962 --> 00:59:23.122 - that could help us ensure that we have what we need? Should we go to United Way and say, who in the 00:59:23.122 --> 00:59:33.892 - county can help us find the money we want so that we can continue this program, but do it in a way that's 00:59:33.892 --> 00:59:41.918 - truly responsible? Some of those organizations can't fund a government entity. 00:59:42.562 --> 00:59:53.320 - So they could fund it. They could fund another organization and they would refer maybe to that organization 00:59:53.320 --> 01:00:03.680 - would be like a past. We had that. I don't even know if maybe that fund that. Some members of the board 01:00:03.680 --> 01:00:12.446 - set up could even be a funding agency for this particular issue, so it's just thoughts. 01:00:13.346 --> 01:00:21.217 - that fund that you're referring to was set up to help clinically. It was more of help up to benefit 01:00:21.217 --> 01:00:29.323 - employees. So as an action item, if, Laura, you could gather more data about us, maybe just purchasing 01:00:29.323 --> 01:00:37.509 - those vitamins outright and then seeing if that process, if we could manage that process, I think would 01:00:37.509 --> 01:00:42.782 - be helpful. And then we'll just table it until next board meeting. 01:00:43.618 --> 01:00:53.466 - Can I ask one more question? That is, do we know how many women are served by these vitamins being handed 01:00:53.466 --> 01:01:02.758 - out every year? Yes. So we collect that data. I just don't have it in my head. Because I think that 01:01:02.758 --> 01:01:12.606 - would certainly also help get a bigger picture of what might be needed in terms of funding. Zooming here. 01:01:12.802 --> 01:01:21.905 - Is that the question? Like out of this? Okay, okay. If we're distributing these, how many women are 01:01:21.905 --> 01:01:31.190 - benefiting? So Vitamin Angels is providing these vitamins free to us. Yes. And it's a grant that they 01:01:31.190 --> 01:01:40.838 - have that somehow provides the money for that. And then they buy the vitamins and give them to us. That's 01:01:40.838 --> 01:01:42.750 - my interest. I mean. 01:01:43.426 --> 01:01:56.588 - Okay, yeah, so, you know, I think that we contact, yeah, well, I mean, a couple, I mean, CVS, I mean, 01:01:56.588 --> 01:02:10.782 - see if they have a, I mean, that may have a corporate philanthropic arm that does something like this. C-V-O. 01:02:10.946 --> 01:02:19.115 - in some of those places. A lot of the drug companies themselves have programs set up that they provide 01:02:19.115 --> 01:02:27.204 - medicine for people who do not have money to get it. So, you know, like, I don't know who might solve 01:02:27.204 --> 01:02:35.135 - it. But usually it's actual, not positive, but most of it's not over-the-counter stuff. And this is 01:02:35.135 --> 01:02:37.118 - really over-the-counter. 01:02:37.378 --> 01:02:48.380 - Rather say I can't fight in the State Department. Is that even a good idea about thing when you get 01:02:48.380 --> 01:02:59.603 - back to him about this? Yeah, if they know being done by. OK. So next item is new business. Actually. 01:02:59.603 --> 01:03:05.214 - Talking about the schedule for the board meetings. 01:03:05.602 --> 01:03:17.603 - Apparently, October 15th is during fall break. So do we want to come up with an alternate date and then 01:03:17.603 --> 01:03:29.488 - vote on that? How about the 22nd? Sounds great. That's the next Thursday. That work for everyone? Yes. 01:03:29.488 --> 01:03:34.334 - Can someone make a motion? I move that we 01:03:35.618 --> 01:03:47.405 - hold the October 2026 Board of Health meeting on October 22nd in lieu of the 15th. Do you need the public 01:03:47.405 --> 01:03:58.859 - to vote? Do we need the public to vote? I guess we do so far. Is anyone online with their hand up? No. 01:03:58.859 --> 01:04:05.086 - Okay. Motion was made and I'll second it. All in favor? 01:04:05.186 --> 01:04:19.310 - Okay, great. Okay, any other items of new business? Well, I will be laid from the 5th through the 13th 01:04:19.310 --> 01:04:32.062 - and I will be reachable by, particularly by text. And I don't know if perhaps you Mike would 01:04:32.354 --> 01:04:44.385 - be an emergency contact if something urgent came up and they wanted an answer about something. Also 01:04:44.385 --> 01:04:57.378 - the board is invited to the IDOH holds leadership symposia a year and the one is coming up on the Wednesday 01:04:57.378 --> 01:05:01.950 - the 13th. Any board member is welcome 01:05:02.818 --> 01:05:13.320 - I'm happy to send the link from IDOH for that. There is a post for the symposium. It is being held at 01:05:13.320 --> 01:05:23.822 - Fort Harrison in India. So if you're interested, let me know and I'd be happy to send you the link to 01:05:23.822 --> 01:05:27.838 - sign up. That's the 13th of May. Okay. 01:05:29.922 --> 01:05:38.370 - Do we know the topics or what they're? Oh, it's always a whole lot of stuff. It kind of goes through 01:05:38.370 --> 01:05:46.901 - many of the departments and you never know quite what you're going to get. There are lots and lots of 01:05:46.901 --> 01:05:55.767 - IDOH people there and people from across the state. Again, it's health administrators and health officers 01:05:55.767 --> 01:05:59.614 - and anybody else in the county government and 01:05:59.810 --> 01:06:12.479 - numbers. Are they doing video? No, they don't. It's it's there. There is lunch, which I guess is why 01:06:12.479 --> 01:06:25.649 - you get charged so. Thank you. They provide dinner at Saint Almos. I know you didn't. Alright, any other 01:06:25.649 --> 01:06:28.158 - new business items? 01:06:30.210 --> 01:06:39.988 - Any other board member or health officer comments? Did you see the council meeting that you're referring 01:06:39.988 --> 01:06:49.487 - to was on the 12th? I have a prior engagement that evening with the School of Medicine, so I can't be 01:06:49.487 --> 01:06:59.358 - there. But I do agree. It sounds like it would be helpful to have a filmable office voice at the meeting. 01:07:00.706 --> 01:07:13.231 - I have a dinner engagement at Greencastle. Why am I going to Greencastle, you say? All right. So seeing 01:07:13.231 --> 01:07:24.190 - no additional comments. Going once, twice? Yes. I move for adjournment. Meeting adjourned. 01:07:25.570 --> 01:07:37.996 - I know. What the two of you could do would be to send a note to council members prior to the meeting 01:07:37.996 --> 01:07:51.038 - explaining your position. I'm sorry. You're formally adjourned. Yes, we're formally adjourned. Thank you.