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.

                                                                                    C.J. McKinney, M.A.

                                                                                    Steve Yurash

                                                                                    Debbie Healy, R.N., B.H.S.                                                                                                                                                               


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

      Commissioner Liaison:                                     Steve Johnson

Staff:                                                                Avie Strand, Marie Macpherson,

                                                                          Bruce Peters, Linda Diede and Paula Lady



 1.    Call to order

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


2.   Introduction of new Board of Health member, Debbie Healy.  Ms. Healy’s background is in health care, health care administration, and pharmaceuticals.  Debbie was introduced to everyone attending the meeting.


3.   Presentation of Maternal Health Services/Nurturing Program – Linda Diede, BSN
Linda Diede, Public Health Nurse, gave a presentation on LCDHE’s Maternal Health Services / Nurturing Program.   The Nurturing Program serves pregnant teens ages 13 to 18.  Many of these clients are referred to Maternal Health Services by the Department of Human Services and the judicial system, as well as area clinics.  These clients are seen throughout their pregnancy with visits extending through the baby’s second birthday.  One of the differences between the Nurturing Program and the Nurse Family Partnership Program is that the mother does not have to be a first-time mom.  The program advocates for pregnant teens to stay in the parent’s  home if it is a safe environment; otherwise, the program will offer resources to help the teen become emancipated. 


Ms. Diede also reviewed the Prenatal Plus Program.  Prenatal Plus serves low income women that qualify for Medicaid and meet program-specific risk criteria.  These clients are seen throughout their pregnancy, up to 60 days after delivery.  They are served by registered nurses, a social worker, and a registered dietician.


Both programs include risk reduction services, prenatal and postpartum teaching and follow-up, and appropriate referrals for substance abuse or mental health issues.  Other need areas are assessed and appropriate referrals and instruction are provided throughout the length of the specific program.


Ms. Diede also shared information Church Women United, a local women’s group that donates needed items to the Maternal Health Services program.  This group of women knit and crochet caps and blankets for Linda and her staff to share with clients in need.  The BOH was invited to look after the meeting at the “Maternity Closet” to see what kinds of items are available for workers to share with clients.


4.   Discussion of NCAP visit  - The BOH discussed their visit to NCAP of the previous day and their understanding of the syringe exchange program.  What might our next steps be?  Dr. LeBailly said that she will email the Board all information from received from Jeff  Basinger, and that he said he will have all information that the BOH requested in time for the next BOH meeting on August 11th.  Dr. LeBailly shared some additional materials available from the Institute of Medicine/National Academy of Sciences and other sources.  If the BOH is interested, Dr. LeBailly can email that information to the board as well.  The BOH would like to look at analysis of similar area programs before moving forward with any decision.  There was discussion about the Board’s on-going role if it decides to support NCAP’s request.  Dr. LeBailly said there would at minimum be reporting requirements, a core set of which are being developed by the state. It was suggested that a representative from the Boulder County Board of Health and the Boulder Works program, which has provided such services for about 20 yrs., present information—possibly at the BOH meeting in October.  The BOH agreed that they are in the learning process at this time. The BOH will need to see more evaluation data and get additional input before considering to move forward with this issue.  This will need to occur sometime in the fall if there is a decision to move forward. 


5.   Update on 2012 budget process and internal assessment efforts  – Dr. LeBailly reported that over the past few years, the County has focused on budgeting for outcomes, performance measures, and refining a tool for the Commissioners to rank programs according to highest, middle and lowest priority.  Guidelines were recently received for the budget process, which  Dr. LeBailly shared with the Board.  Dr. LeBailly mentioned the County’s “strategy maps” which describe what Larimer County hopes to accomplish.  One of the county strategies relates to the health and well-being of the county’s citizens: “We will provide opportunities for all members of our community to be healthy and self-sufficient.

 Dr. LeBailly informed the BOH that the Commissioners have approved a pay increase for employees in 2012.  There have been no increases in employee pay for two years.  The county’s goal is to try to keep Larimer County salaries in the fiftieth percentile of front range counties, and we have been falling behind.  The decision was made to increase the salary range of all employees by 1.5% which all employees would receive in January.  If an employee was not at the top of their salary range they may be eligible to receive another 1% merit increase at their merit review.  The most any employee could receive would be a 2.5% increase.


Dr. LeBailly also informed the Board that the Commissioners had decided not to change the county work week from five 8-hour days to four 10-hour days.  Their assessment determined that the savings in building heating and cooling costs currently did not outweigh the concerns of several departments and the public about access to needed services five days a week.  This does not mean that the 4-day work week will not be considered for certain program areas or in the future based on budget needs. 


Ms. Macpherson reported she hopes to have a draft budget prepared for the August 11th BOH meeting but it will be too early to have it completely finished.  She does hope to have the personnel costs and operating budget prepared as a first draft to have a sense of the level of fund balance usage we may be looking at.  She indicated a second meeting will be needed in the fourth week of August for review and approval of the budget by the BOH.    


Ms. Macpherson distributed a tool to be used to gather information about the department’s programs and services and collect staff input into an assessment of Health Department programs and services. Our next step is to develop our own internal scoring tool to be able to assess the relative importance of our programs from the staff point of view.  This tool reflects nearly all the major programs of our department, not just the five “Major Service Areas” listed in the 2012 budget guidelines.  She hopes that at least a preliminary report of this information will be available for the BOH meeting on August 11th


6.   Update on planning for Community Health Assessment/County Public Health Improvement Planning Process – Dr. LeBailly distributed a projected timeline for the community health assessment/county public health improvement plan we must complete to be in compliance with the Public Health Reauthorization Act of 2008 We will be getting $25,000 from the state to help with the assessment, which won’t cover the total cost of this effort.  Our target for the Community Health Assessment is July 1st through December 31st.  The timeline to develop a county health improvement plan, based in part on the community health assessment, is January 1, 2012 – June 30, 2012.  The written final plan will be completed by September 2012. If any one from the BOH would like to be involved let Dr. LeBailly know of your interest.  There will be a number of community agencies with a special interest in health data as part of the community assessment, but even more stakeholders will take part in working on the county public health improvement plan.


7.   Director's Report – Dr. LeBailly reported that every year we are required by state regulations to update our Public Health Emergency Operations Plan (PHEOP) and share this information with the Board of Health in July.  She distributed a list of items that had been updated in 2011. Dr. LeBailly also reported that the National Association of County and City Health Officials has recognized that the department has achieved Project Public Health Ready (PPHR).  Ms. Thielen asked if we could have a short presentation of what this plan includes. Dr. LeBailly suggested that it could focus on areas where we still feel we need make changes and improvements, as it is an on-going process.


Dr. LeBailly forwarded to the Board an e-newsletter from the National Association of Local Boards of Health of which this BOH is a part.  There is an annual meeting in Coeur d’Alene, Idaho,  September 7th – 9th.  If there is any interest from anyone on the BOH of attending, Dr. LeBailly said there may be a very small budget to help fund one member’s attendance. Please let her know of interest. 

8.   Next meeting, August 11 2011.  A second BOH meeting in August will be needed for budget approval.  It was decided this meeting will be Wednesday, August 24, 2011 at 7:00 pm. 

9.    Adjourn - meeting was adjourned at 9:10 pm




_______________________________           ____________________________________

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