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

Lee Thielen, M.P.A.

Steve Yurash

C.J. McKinney, Ph.D.


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


Commissioner Liaison:             Steve Johnson


Staff:                                         Marie Macpherson, Jerry Blehm, Avie Strand, Paula Lady


Public:                                       Jeff Basinger, NCAP, Taj Schimek, Regis Nursing Student

                                                  Erin Hauser, Regis Nursing Student



1.   Call to order The Board of Health meeting was called to order at 7:00 PM.


2.   Approval of December 15, 2011 meeting minutes - amendment to the minutes regarding the evaluation of Dr. LeBailly, to reflect that the BOH expresses their appreciation for her extraordinary leadership and quality of her work to the citizens of Larimer County.  Minutes were then approved with this amendment.   


  1. Discussion of next steps in considering NCAP proposal to offer a syringe exchange program (SEP)  - Commissioner Johnson presented information regarding syringe exchange programs. He shared with the BOH the document he prepared document titled “Review of the Scientific Literature”.  Commissioner Johnson indicated that the WHO study “Effectiveness of Sterile Needle and Syringe Programming in Reducing HIV/AIDS Among Injecting Drug Users” was an outstanding review.  Commissioner Johnson indicated that, as he had opposed needle/syringe exchange programs in the past, he had really tried to find studies that did not support the benefit of syringe/needle exchange.  However, all the research he has found strongly speaks to the effectiveness of utilizing a SEP.


Dr. Richards asked the BOH what the next steps should be and the most efficient way to move forward.  Dr. LeBailly indicated that we are required by statute to gather input from certain stakeholders if the Board considers approving NCAP’s request.  The BOH has not been asked to have the Health Department create a syringe exchange program; the Board has been asked not to prevent NCAP from providing this service to a population who are already their clients. Jeff Basinger has agreed to help organize the gathering of input from area stakeholders, under the guidance of the BOH and Dr. LeBailly.  There is currently an intern who is working with NCAP to

collect 500 surveys of what are local residents’ attitudes and beliefs about SEP’s.  The goal is to compile information about issues, barriers and concerns regarding SEP’s.  Mr. Basinger  has indicated NCAP will fund and operate the SEP under the BOH oversight and approval. He will put together a proposal of goals and objectives to get community input.  Mr. Basinger indicated that funding must be in place by July 1st, and that he will provide a proposal on community feedback to the BOH by the February meeting. 


  1. Review of proposed Goals for 2012 as revised - BOH reviewed the goals report for 2012.  Changes to the proposed goals are highlighted in red ink on the report.  Mr. Yurash indicated that it does not seem to make sense to keep the Environmental Health goal of about monitoring uranium mining since the Powertech proposal has been withdrawn..  With the BOH’s agreement, this will be removed from the goals. Mr. Yurash questioned the status of vehicle emissions testing in our county.  He indicated he would be interested in monitoring how this is going since Larimer County residents pay for this testing and the BOH should assess whether this is working.  Other board members expressed a desire for an broader report annually on air quality in Larimer County.  The proposed revised goal would read as follows “Report to the BOH on air pollution programs, with specific attention to the status of ozone.” 

The 2012 Goals were approved with the amendments discussed.


  1. Review of Board of Health Self-Evaluation tool – Dr. Richards asked the BOH if there were any ideas for amending the self-evaluation tool.  The last time the self-evaluation was completed was 2010.  Mr. Yurash indicated that the section under policy should be worded differently.  The decision of the BOH was  to “review and affirm the mission”, and “review and manage new and existing policies that support our mission and vision.”   Dr. LeBailly  will make the updates, get the updated tool to the BOH.  The deadline to return the tool to Dr. LeBailly for compilation is Monday, February 6th.  Dr. LeBailly will present the results of the self-evaluation at the BOH meeting on Thursday, February 9th.


  1. Update on Commissioners’ process for dealing with Budget shortfalls relating to failure of the Jail tax ballot initiative -  Dr. LeBailly shared with the BOH a handout from the Commissioners office, ”Developing a High-Level Budget Plan” which describes the process the BCC wil use to make budget reductions to prepare for the jail tax ending in 2014  Another tax initiative is not expected to be put forward to the voters.  A prioritization process to evaluate all county major service areas is being used by the commissioners.  A citizen’s committee is being formed with the help of the County’s Information Officer, Deni LaRue.  Commissioner Johnson indicated that they would need to cut about $3 million a year for the next three years from the County’s budget. Commissioner Johnson said that the County has cut $8 million in the last three years that he has been in office. 

    The commissioners will compile their list of priorities for the senior management team to review, then get feedback from the citizen’s committee, then back to the commissioners for final decisions.  Dr. LeBailly said that ultimately it will be the BOH’s decision how to implement losses of general fund dollars for the Health Department.  The cuts to the county budget reflect a little over 10% of the total general fund expenditures. Commissioner Johnson indicated that going back to the voters has not totally been ruled out, but the commissioners are making plans assuming that another ballot initiative is not going to happen.  The BCC has to budget for the worst case scenario.  If property taxes fall it could be even worse.  The BOH will follow the process as it moves along.


7.   Update of Community Health Assessment and Public Health Improvement Planning process – Dr. LeBailly provided a handout on the community assessment effort and reported on the initial organizational meeting.  She also presented the BOH the “Guiding Principles Worksheet” that the leadership team was asked to complete.  A meeting schedule for January -  March has been developed for both the data subcommittee and the leadership team.  The leadership team will meet again on February 22nd from 10:30 am –noon and March 22nd from 10:30 am–noon, if any additional Board members are interested. Dr. Richards is part of both the leadership team and the data subcommittee.  Dr. Richards said the assessment is very well organized.


8.   Director’s report – Dr. LeBailly reported on a bill that is being introduced regarding foods being prepared in home kitchens.  She handed out a copy of the House Bill and Senate Bill, along with information from CALPHO related to home food preparation.  The Health Department’s Food Supervisor indicated to Dr. LeBailly that he is extremely concerned about these bills. Comments from CALPHO are from a similar bill from last year, but relevant to the new bills.  Dr. LeBailly also informed the BOH that the Colorado Restaurant  Association wants to pass a bill that says a Health Department cannot suspend or revoke a restaurant license without going through the civil penalties process.  Our concern is that if an immediate hazard is found and the restaurant will not close voluntarily, we would be unable to suspend a license without going through the courts, which is very arduous and time-consuming.  This is strongly being opposed by CALPHO and the State Health Department.  


Ms. Macpherson provided a document summarizing 17 customer service complaints received in 2011.  Out of the thousands of clients that are served by our department in a year, this number is actually quite small, but we always try to minimize the number of complaints.  She will bring this report to the BOH annually. 


9.   Next BOH meeting:  February 9, 2012 at 7 PM. Dr. Bruce Cooper will present on the 2010 Community Survey done every three years by the Health District.

  1.  Adjourn – meeting was adjourned at 8:55 PM.


_______________________________           _____________________________________

Paula Lady, Recording Secretary                    Adrienne LeBailly, MD, Executive Secretary