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


            MEMBERS PRESENT:                               Lee Thielen, M.P.A.

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

                                                                                    Judy Robinson, B.S.N., M.P.H.

                                                                                    N. Mark Richards, M.D., M.P.H.

                                                                                    Blair Trautwein, J.D.


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


OTHERS PRESENT:                                   Marie Macpherson, Bruce Peters, Avie Strand,       

Gerald Blehm, Doug Ryan, Amy Smith, and Libby Murphy   (Community Health student)


1.   Call to order


Public Health Hero Award Ceremony:

Lee Thielen presented Dr. Jane Higgins with the Joe Jabaily Health Hero Award.  The meeting was officially called to order at 7:15pm. 


2.   Approval of the Minutes of April 10, 2008


Dr. Richards requested the minutes reflect his serious concern regarding the lack of partner notification and follow-up of certain STD’s by either the state or the local health department.  Lee Thielen had requested the Septic System costs and fees options be added to the minutes.  Dr. LeBailly had these added to the electronic version of the minutes.

The minutes of April 10, 2008 were unanimously approved with the amendments.


3.   Informational Presentation on the Glade Reservoir Proposal – Doug Ryan


Doug Ryan, Environmental Health Planner presented handouts and information concerning the “Northern Integrated Supply Project”, more commonly known as Glade Reservoir.  Mr. Ryan said the purpose of this project is to store water to meet the current and future needs of 15 towns and water districts, primarily in Weld and Boulder counties. The Army Corps of Engineers is currently accepting comments on their draft Environmental Impact Statement, which is an assessment of  the potential environmental effects of this project.   



Mr. Ryan suggested presented some draft Health Department comments to be forwarded to the Commissioners as they prepare their comments on the project.  His four primary recommendations are:


1.  Mitigate the impacts on river morphology, riparian zone, and water quality by requiring commitments for minimum winter stream flow and periodic spring surges. 

2.  Look at cumulative impacts of this project and the proposed Halligan-Seaman project and require regional cooperation from proponents of both projects in mitigating river flow effects to prevent irreparable harm to the lower river system.

3.  Require water conservation measures in the communities using this water to lower the per capita demand and enhance the efficiency and sustainability of the project. 

4.  Develop an analysis for the final EIS to evaluate impacts of reduced river flows on mosquito populations along the Poudre River corridor, with emphasis on those species implicated in the transmission of West Nile Virus to humans. 


At Dr. Richard’s request, Mr. Ryan described the procedure for obtaining a permit from the Corps of Engineers to construct this reservoir, and the role of the county in this decision. Currently, the Commissioners’ role is solely to make comments to the Corps, as the county has not adopted so-called “1041 powers” which would give them a decision-making role in a project such as this. Mr. Ryan stated that Northern Colorado Water Conservancy District would oversee the project if a permit is approved by the Corps.  The Board had no changes or additions to make to Mr. Ryan’s comments.



4.   Budget and Resource Allocation update – Marie Macpherson


Marie Macpherson distributed a Fund Balance Review sheet which showed reductions so far this year in our need to use fund balance.  These have been accomplished by concerted efforts by the department to create savings or increase revenues during 2008.

The department is trying to make very thoughtful decisions about accepting FTE reduction requests,  delaying re-hires or not rehiring at all, and not just doing whatever will save the most fund balance, as was done in 2002 with the unexpected cut in state funding.  The Health Managers want to be careful to minimize harm to our services as these options are reviewed.


Ms. Macpherson also reviewed some guidance our department has beem given regarding the 2009 budget.  The department will not be able to use the three “groupings” of our services (“Core Services,” “Grants that Support Core Services,” and “Special Public Health Projects”) that were used last year for the commissioners prioritization in this year’s budget process.  Our department’s components will need to be broken down into groups of closely-related services.  The scoring criteria to be used by the Commissioners was distributed and reviewed with the Board.


Ms. Macpherson also distributed an updated version of the criteria the department used for our reductions in 2002.  If further cuts become necessary, the department would still use these questions to review our programs, but will also ask should be done that isn’t currently being done, and would also look at all the activities that make up our department’s services to see if adjustments to service levels were possible.   Other cost-saving measures that would be considered would be the potential closing of one of our satellite offices (Loveland, Estes Park).


5.   Discussion of Agenda Items for Joint BOH-BCC meeting in July – BOH


Board members offered suggested discussion items such as: 1) short review of our department’s core services, 2) explanation the importance of local public health services, 3) learn the Commissioners’ expectations for the 2009 budget  4) review some key indicators of the current health status of the community, 5) mention trends the BOH is watching, such as the increase in STD’s  6) hot topics, such as uranium mining, etc. 7) Senate 194 requirements that the Commissioners re-designate our department as the public health agency for Larimer County and re-appoint the Board of Health. 8) learn more about the Commissioners’ thoughts on a sales tax ballot initiative on the November ballot, and whether public health might be included in it if one is proposed. 


6.   Board evaluation tools – Lee Thielen


Lee Thielen distributed a Self-Evaluation tool for Board members and explained the procedure.  She requested they review the form and offer their feedback.



7.   Update on STD reporting/follow-up issues – Dr. LeBailly


Dr. LeBailly informed the members of the Board about her meeting with the Director of the State STD Program, Ralph Wilmoth, and efforts to resolve the issue of partner notification.  The state does not follow-up on many cases, but our department cannot follow up as the state has not been willing to share names of patients with reported STDs. No state general fund dollars go to the STD/AIDS program, and the state is trying to run the program using federal HIV dollars, which limits their role in much of the STD follow-up.   Mr. Wilmoth is working on a way to provide a limited number of reproductive health staff the contact information for syphilis, gonorrhea, and chlamydia patients.

We plan to do a Health Alert to area physicians to make them aware of the recent surge in syphilis cases. 


8.   Director’s report – Dr. LeBailly


Dr. LeBailly informed the members of the Board of the impact the Windsor tornado on Health Department staff whose homes or families were directly affected.  Our department sent food inspectors to assist Weld County in assessing and embargoing products from food establishments that had suffered from power outages.  Jane Viste, Larimer County’s Public Information Office, assisted at the Emergency Operations Center joint Information Center.  The Health Department also provided some tetanus vaccine for emergency workers.


Dr. LeBailly reported that the Pandemic Flu tabletop exercise was held May 2, 2008 and went well.  The after-action report is being reviewed and follow-up on some key issues will be done, with assistance from the Health District.


Dr. LeBailly shared the Fort Collins city council will hold their final official West Nile Virus Committee Meeting.  The Committee was given several options for adulticiding and will vote July 1, 2008.  Dr. LeBailly distributed a chart that showed that exposure to permethrin after a mosquito spray event was a minor contributor to the overall daily exposure to permethrin; most comes from the food we eat and exposure to home and garden pesticides.


Dr. LeBailly mentioned the Citizens’ and Community Leaders’ Surveys of Larimer County Services which were released recently and said she would send the web address to Board members so they would have an opportunity to review these surveys.


Ms. Thielen informed the members of the effects that Senate  Bill 194 will have on Colorado’s public health agencies, especially in counties that currently have county nursing services.


9.   Next meeting – July 10, 2008: 6 PM, joint meeting with BCC; regular BOH meeting at 7PM or at conclusion of joint meeting


10.   The meeting was adjourned at 9:35 PM