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.


COMMISSIONERS PRESENT:                      Commissioner Steve Johnson


           MEMBERS PRESENT:                                  Dr. Mark Richards, M.D., M.P.H.

                                                                                    Teri Olson, R.N., M.S.N.

                                                                                    Lee Thielen, M.P.A.

                                                                                    Judy Robinson, RN, MPH


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


Staff:                                                                Jim Devore, Ed Schemm, Marie Macpherson, Bruce Peters, and Amanda Mozer


 1.     Larimer County Board of Health (BOH) met in a Joint Session with the Board of County Commissioners (BOCC) prior to the Board of Health meeting


         At conclusion of Joint Session, BOH and BOCC celebrated Terri Olson’s last day as a BOH Member and thanked her for participating on the Board for two terms.


    2.     Call to order


The Board of Health meeting was called to order at 7:23 PM.


3.      Approval of the May 13, 2010, Board of Health meeting minutes


            The minutes of the May 13, 2010 meeting were unanimously approved.


4.   Board Governance presentation – Lee Thielen


Ø Lee Thielen presented “Board Governance”, referenced the “Local Boards of Health Orientation” presented by Colorado Department of Public Health and Environment (CDPHE) at the Colorado Association of Local Boards of Health (CALBOH) meeting and distributed CDPHE presentation slides to Board Members


Ø Presentation sources: Boards that Make a Difference by John Carver, “To Ensure Candor at the Top, Begin at the Beginning”, Briefings on Talent and Leadership, Korn/Ferry Institute, “National Public Health Performance Standards”, Local Public Health Governance, “Local Boards of Health Orientation”, Office of Planning and Partnership, CDPHE


Ø Topics addressed in presentation:

·  What can go wrong with the Board (i.e. time on trivial, short term bias, reactive stance, etc.)

·  Carver’s New Governance (i.e. hold and support vision, force an external focus, be concerned with needs and markets, not internal issues and organizational mechanics, etc.)

·  Strategies for Board Leadership (i.e. be obsessed with effects for people, perpetually redefine quality, etc.)

·  Board and Staff from Carver (i.e. Board has only one employee - the CEO, CEO’s role is: job design, leadership, strategic organization, and setting a climate of creative achievement, etc.)

·  National Public Health Performance Standards Program is based on 10 Essential Services of Public Health

·  The Public Health Act of 2008 is legislation that:

    • Restructured the local governmental public health (PH) system
    • Defined the duties of a local public health agency (LPHA)
    • Defined new roles for the state board of health and local boards of health
    • Established a collaborative, five-year planning cycle at the state and local levels
    • Directed the Colorado Board of Health to: establish minimum qualifications for directors, define core services and quality standards and determine a funding formula for LPHAs

·   Local public health agency (LPHA) duties

    • Carry out core PH functions: assessment of health status and risks, development of policies to protect/promote health, and assurance of the 10 Essential Services of Public Health
    • To the extent authorized, administer/enforce laws pertaining to: air pollution, solid and hazardous waste and water quality, vital statistics, and the orders, rules, and standards of the state board
    • Advise the Local BOH on public policy issues necessary to protect PH and environment
    • Providing/arranging for the provision of quality, core PH services as defined by the Colorado Board of Health

·  Local BOH duties

    • Select PH Director
    • Employ/contract with a medical officer(if director not a physician)
    • Hold Local BOH meetings at least every three months
    • Request Director or another serve as board secretary
    • Hold hearings, issue orders and adopt rules
    • Approve the five-year local PH plan, then submit to the Colorado Board of Health
    • Determine necessary services and set priorities according to local needs and resources, staying consistent with the state and local PH plans
    • Certify demands against the PH agency fund (Local BOH President or designee and PH Director)
    • Annually review the costs of maintaining the LPHA for the ensuing year, then submit budget to either the BOCC (county agency), or a committee county board chairs (district agency)

·  Local BOH legal powers

    • Hold hearings
    • Administer oaths, subpoena witnesses, and take testimony in all matters relating to the respective powers and duties
    • Order the removal of nuisances
    • Order unhealthy premises cleaned, structures removed

·   PH Director duties

    • Administer/enforce public health laws of the state and the orders and rules of the county board
    • Exercise all legal powers conferred by the 2008 Public Health Act
    • Act as the local registrar of vital statistics (or contract the responsibility)
    • Direct the resources needed to carry out the county or district PH plan during a PH emergency or threat to personal health
    • The PH Director may issue the following types of orders: quarantine and isolation, water boil order, evacuation and closure of public places

·  Board education, technical assistance and information is available through CALBOH and National Association of Local Boards of Health


Ø Suggestion made for Local BOH to offer a mentoring function where an established Local BOH could offer guidance to a newly formed Local BOH


5.   Budget update - Dr. LeBailly and Marie Macpherson


Ø Dr. LeBailly and Marie Macpherson, Administrative Services Director, provided a budget update to Board


Ø LCDHE anticipates the County cutting an average of 4% to departments in 2011 (a 4% cut to our budget is about $120,000) and as needed, up to another 4% in 2012, rather than a full 8% in 2012.

·  County is predicting property taxes will go down 6-8% in 2012 and 2013

    • Property taxes have not gone down with the recession since taxes being paid this year and next year are based on the value of real property on 6/30/08; property taxes paid in 2012 and 2013 will be based on the value of a property on 6/30/10, which will likely hava a lower valuation.

·  County is considering a merit increase of 2.5% for 2011

·  LCDHE is trying to keep staffing levels whole whenever possible until more is known about grant and County funding

    • LCDHE is looking at trying to bridge a couple of projects to save staff (in the tobacco grant and other grant shortages) during the time when staff is looking at when their grant funds might or might not be continued
    • Human Resources is open to considering budget-saving proposals a department would like to make

·  By early July, LCDHE will know base budget contribution from the County


Ø Dr. LeBailly explained the Health and Well Being Strategy Map to Board Members

·  County’s budgeting system has a new format

·  All of LCDHE programs need to be connected to one of the following five major service area budget:

    • Preventing air, water and environmental pollution
    • Food safety and institutional sanitation and safety
    • PH emergency preparedness and response
    • Providing maternal and child health services
    • Preventing/Controlling communicable and chronic disease

·  Logistically it is very challenging to budget a all of LCDHE’s services in 5 areas


Ø County is thinking about doubling how much sick leave pay out it will give to retiring/terminating employees   

·  There is a proposal to put sick leave payouts into health retirement accounts, which are different than health savings accounts.   

·  LCDHE is concerned on how they would pay for this as they have several staff who are close to retirement and have a lot of sick leave

    • LCDHE will restrict part of their fund balance to budget for the potential sick leave pay outs that they may have to give  


6.   Report from CCI/CALBOH meetings in Vail – Dr. Richards and Lee Thielen


Ø Lee Thielen and Dr. Richards provided an overview of the CCI/CALBOH meeting in Vail

·  First organizational meeting of CALBOH (officers were elected; bylaws were passed)

·  Dr. Richards distributed the CCI/CALBOH Pocket Guide brochure to Board Members

·  Lee was elected Treasurer of CALBOH

·  Next CALBOH meeting is scheduled for November 29th in Colorado Springs


7.   Directors report - Dr. LeBailly


Ø Tobacco program update

·  Due to tobacco grant shortages, some tobacco staff FTE have been picked up by other programs

·  LCDHE accepted the transitional tobacco funding given to departments to use three months at a reduced funded level

    • By piecing together/shifting some funding around, LCDHE is able to keep the 3 people who are currently funded by tobacco on staff and whole until the end of October

·  Revisiting staffing level decisions for November 1st and beyond is dependent on whether or not LCDHE submits a 2010/2011 request for application (RFA).

·   LCDHE is waiting for complete RFA to be released before deciding if LCDHE is going to apply

    • RFA is limited, as it will fund only changes in governmental policies and two of the three policy options available have already been implemented locally
    • LCDHE will be talking to people at City of Fort Collins to gauge any interest, as an ordinance would need to be passed within 1-2 years 


Ø  Healthy Communities program (formally EPSDT) update

·  Program provides outreach to families who are eligible for Medicaid or Child Health Plan Plus and links people into healthcare services

·  Under the new health care reform laws, eligibility for some Medicaid/CHP+ services has expanded and people may not know they are eligible for services

·  Program was previously funded by state Health Department and was recently moved to the Colorado Department of Health Care Policy and Financing (HCPF)

·  State Program has unspent money that we have been offered and will use in part for a media campaign to make people aware of their new eligibility for health coverage.


Ø Interviews for new Board Member are tentatively scheduled to be completed June 18, 2010

·  LCDHE received 5-6 applicants

·  Board needs a member from Loveland,as geographic representation is important. 

·  Dr. LeBailly will send Dr. Richards the BOH applicants’ CVs


Ø LCDHE received a training from Gus Lee on how to courageously resolve conflicts

·  Gus Lee is conducting a “Courageous Leadership” series for Character Fort Collins in 2010

    • He conducted a “Moral Courage in the Workplace” workshop at LCDHE in 2005
    • He is the Chief Learning Officer for Integware (a Fort Collins software company) and also the Chair of Character Development for US Military Academy at West Point


Ø A bill was introduced into the legislature about 5 years ago that allowed people to buy shares of cows to get unpasteurized milk


·  Expanding existing statute may come up in next legislation session

·  Larimer had an outbreak of Campylobacter from cow share milk in 2005, and Utah is dealing with outbreak at this time.

·  Board would like a presentation on the risks of unpasteurized dairy products at a future BOH meeting


8.   Next meeting is tentatively scheduled for July 22, 2010 at 7 PM 


Ø  August BOH meeting is tentatively scheduled for August 19th

·  Dr. LeBailly will confirm July and August BOH meeting dates via email with Board Members



The Board of Health meeting was adjourned at 8:34 PM.













_______________________________                 ____________________________________

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