The Larimer County Board of Health (BOH) convened its regular meeting at 7:00 PM at the Larimer County Department of Health and Environment (LCDHE), 1525 Blue Spruce Drive, Fort Collins, CO.


           MEMBERS PRESENT:                                   Judy Robinson, R.N., M.P.H.

                                                                        Lee Thielen, M.P. A.

Steve Yurash


      Executive Secretary                                        Adrienne LeBailly, M.D., M.P.H.


Staff:                                                                Marie Macpherson, Bruce Peters and Amanda Mozer


                                                                      Guests:                                                              Commissioner Johnson and Ed Schemm


     1.   Call to order


            The Board of Health meeting was called to order at 7:05 PM.


    2.     Approval of the March 11, 2010, Board of Health meeting minutes


            The minutes of the March 11, 2010 meeting were unanimously approved.


3.   Elections of officers - Board Members


Ø Nominees for BOH officers were Dr. Mark Richards for President and Judy Robinson for Vice President

·  The nominees for officers were unanimously approved


4.   Septic permit fees -  Marie Macpherson, Ed Schemm


Ø Marie Macpherson, Administrative Services Director, distributed and presented “Septic System Program Estimated 2010 Costs and Fee Options” and “2009/2010 ISDS Fees Comparison of Some Other County Health Department Fees” spread sheets to the Board


Ø There is a statutory authority for BOH to set these fees

·  The statute says the fee for such permit shall be set to recover, as nearly as can be practically established, the costs associated with that permit and may not exceed $1,000

o The current cap of $1000 has been in place since 1997


Ø A few years ago LCDHE realized they were not recovering 100% of their expenses due to 1) the number of systems to be permitted was decreasing, 2) personnel costs were raising and 3) permit fee increases were not enough to cover expenses

·  Board decided to embark on a plan to increase the fees to move toward 100% cost recovery or at least an improvement in that direction

·  Septic permitting has decreased due to economy affecting the number of permits we issue and the number of buildable lots in unincorporated Larimer County is decreasing

·  LCDHE continues to see a decrease in number of permits


Ø LCDHE estimates the number of permits issued by the department for septic systems will be flat compared to last year

·  Activities that require a permit: new residential and commercial, vaults, minor and major residential repair, commercial repair and remodels

·  Total program costs were determined by dividing up where the time is spent and where the costs are being utilized by staff

·  Estimate a 5% decrease in 2010 costs and cost per unit is higher

·  Last year’s fee determination recouped 74% of total costs


Ø Motion for Fee Option B was unanimously approved

·  Effective date is June 1st


5.   Follow-up on Physical Activity position statement re: PSD mill levy - Board Members


Ø The Coalition for Activity and Nutrition to Defeat Obesity (CanDO) resolution of support for increased physical education in the Poudre School District (PSD) was distributed to the Board


Ø Dr. LeBailly provided a summary of CanDO’s presentation at March BOH meeting to the Board

·  Resolution says if PSD puts a mill or bond levy on to help address PSD’s financial issues, they have an emphasis on retaining and/or improving physical education

·  Research and information presented showed physical education not only affects your physical fitness but affects your mental acuity and learning

·  At March BOH meeting, Board agreed to consider a resolution of support but did not commit to passing a resolution as Board wanted to wait until BOH members from PSD were present


Ø Agreement made for Board members to vote on CanDO resolution of support by email

·  Dr. LeBailly will send out an email for Board members to submit their vote


6.   Jabaily award discussion - Board Members


Ø Nomination requests for Jabaily award distributed to the Board


Ø Dr. LeBailly presented Jabaily award guidelines to the Board

·  Award honors an individual or group who has contributed in an extraordinary way to public health or made an outstanding contribution to public health over time

·  Nominees must live or work in Larimer County, do not need to be a public health professional, can not be a current BOH member or LCDHE employee and can be for an individual, team or group effort


Ø Motion for Carol Plock, Executive Director of Health District of Northern Larimer County, and the Health District of Northern Larimer County to receive the Jabaily award was unanimously approved

·  Lee Thielen did not participate in motion due to a conflict of interest as she is on the Board of Health District of Northern Larimer County


7.   Follow-up discussion of Board governance training - Board Members


Ø Desire for training stemmed from March BOH meeting when Board requested clarification of their role in relation to a couple of questions on the BOH self-evaluation tool


Ø Agreement made to tentatively schedule Board governance training for July BOH meeting

·  Joint meeting with the commissioners is tentatively scheduled for June BOH meeting

·  Board will address the beginning of budgets at July BOH meeting


8.   Budget process update - LeBailly


Ø Dr. LeBailly distributed and explained the timeline of the Board of County Commissioners (BOCC) budget process


Ø First meeting on April 22nd involves an environmental scan that includes: 1) a countywide picture of what’s happening in the county related to tax revenues, property estimates etc., 2) “big picture” presentations from individual departments and divisions and 3) the results of a county community citizen and leader survey

·  Commissioners anticipate county revenues will be flat for 2011 as it is a non-assessment year and county revenues will decrease 6-8% in 2012 due to the decrease in property values, jail tax and county facility tax

·  Meeting will be available via webcast  


Ø Future meetings involve evaluating the environmental scan, reviewing strategy maps and citizen survey results, a work session to discuss the general budget direction etc.

·  By May 17th BOCC will review and agree on service prioritization criteria 

o LCDHE will write up program descriptions and how they meet the BOCC criteria

·  By June 24th BOCC will rank all of the county services by line based on their priorities

·  By July 1st BOCC will set the budget allocation guidelines 


9.   Director's report – LeBailly


Ø Dr LeBailly distributed and presented a summary of the needle exchange bill to the Board

·  Allows a region under a health department to choose to provide services including clean syringe/needle exchange programs with the goal of reducing the spread of Hepatitis B, C and HIV

·  Focuses on patient receiving referrals to drug treatment centers

·  Has to be approved by the local BOH

·  Requires law enforcement, District Attorneys and public health to be involved

·  Has to be offered by or contracted by the Health Department to another community agency

o Northern Colorado Aids Project (NCAP) is interested in providing program

o Recommended Executive Director of NCAP communicate with the Commissioners about the bill

·  Recommendation made for BOCC and BOH to have a work session on the bill if it passes

·  If bill passes, Board will inform BOCC at Joint Meeting of need for future bill discussion


Ø May BOH agenda items:

·  Presentation of Jabaily Public Health Hero Award

·  Family Planning Program will present teen pregnancy prevention and outreach to the Board


Ø Future BOH agenda items:

·  Environmental Health presentation on how the ozone is driving the air quality commission to re-implement the vehicle inspection program that goes into effect in November


Ø The Health and Human Services Director position was eliminated as a cost-saving measure. 

·  The director of the Workforce Center will be the communications liaison between the four different Human Services Departments, and the Assistant County Manager will be our main contact.

·  The County is trying to save support staff positions that reported to the HHS Director.


Ø  Commissioners are conducting “Larimer County 101”, an 8-week program for 25 interested citizens providing an inside look at Larimer County government’s workings

·  Program will take place on consecutive Thursdays, April 8-May 27, from 6-9 PM

·  April 8th topics: history of Larimer County and general government

·  April 15th topics: Human Services, Work Force and Coroner

·  April 22nd topics: LCDHE, Extension and Surveyors

·  LCDHE and Extension presentation will include: Extension demonstrating food and nutrition by cooking audience’s dinner and educating on individual home food safety, LCDHE educating on retail food safety, the glow-germ exercise and a public health quiz

o Audience will submit their quiz answers electronically and anonymously using a hand-held device connected to a computer that generates a visual poll for audience

o Half of the quiz questions are on food safety and the other half are on the remaining LCDHE programs

·  Dr. LeBailly will bring the public health quiz to the May BOH meeting


Ø  Lee Thielen shared she was invited by Avie Strand, Community Health Services Director, to discuss the role of the BOH at LCDHE Community Health Services staff meeting on April 7th


Ø  Lee Thielen informed Board of the State Association of Local Boards of Health

·  Consists of BOH members and County Commissioners who operate as Boards of Health

·  Primarily led by 22 County Commissioners who have developed a membership fee structure

o Dues for the rest of 2010 are $35 and dues for 2011 are $70

·  First meeting to approve bylaws, elect board etc. is at County Commissioners meeting in Vail on June 1st from 2:30 – 4:30 PM

o Some of the agenda items include: board member’s responsibilities under the Senate Bill Act of 2008, a session on the picture of public health in Colorado and a presentation on national accreditation

·  Lee Thielen will provide Dr. Mark Richards with meeting information  


Ø  Lee Thielen informed Board that under health care reform, non-profit hospitals are required to do a community health assessment every three years and under state law, local BOH are required to have the agency do a community health assessment every five years

·  Health District of Northern Larimer County (HDNLC) completes a community health assessment every three years

·  BOH has an opportunity for synergy in the community and an opportunity to share resources    

·  LCDHE predicts they will implement their public health improvement planning process from January through June 2012.  HDNLC will do their community health assessment in the fall of 2010 and results will not be available until late 2011.  By the end of 2011, we hope that preliminary 2010 Census data should be available for our population, as that is needed for the denominator when calculating rates.


Ø  Dr. LeBailly was asked to be a board member of a project which Banner Health and PVH system are working on together

·   “Transitions of Care” is an effort to keep people who are being discharged from hospitals from being readmitted for preventable complications that could have been avoided.

·  New Medicare laws allow denial of payment for readmissions if the patient’s complications were due to lack of follow-up and understanding of needed actions on the patient’s part. (care instructions not understood, meds not taken as directed, etc.)

·  Proposing model that involves one home visit and three follow-up phone calls

·  Grant application is submitted and will initially fund some paid staff in addition to volunteers/students doing practicum


Ø  Dr. LeBailly distributed and explained “Public Employees/Officials and Political Speech” guidance to the Board

·  Recommendation made to include guidance document in board governance training

·  Board members as a governmental board can take positions on ballot initiatives

·  Dr. LeBailly can and other staff can report Board’s position.  Health Department managers can inform the Board what the effect of certain cuts would be for LCDHE


10.   Next meeting –  May 13, 2010

Ø  Agenda:

Agenda for the Joint Meeting with the County Commissioners in June, 2010 Jospeh Jabaily Award, Teen Pregnancy Prevention Outreach project report



The Board of Health Meeting was adjourned at 8:52 PM.













_______________________________                 ____________________________________

Amanda Mozer, Recording Secretary                    Adrienne LeBailly, MD, Executive Secretary