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22 N. Georgia Ave. Suite 300 • Mason City, IA 50401 • Phone: 641-421-9300 • Toll Free: 1-888-264-2581 • Fax:
641-421-9350
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Administration
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Board of Health Minutes Present: Staff: Guests: The meeting was called to order at 12:20 pm. 2007 Board Meeting Calendar: June and August’s meeting dates were changed. June’s meeting date is now the 15th and August’s meeting date the 24th. Both meetings will still begin at 12:15. Service Award: Dr. Johnson presented Karyn Shaver with an award for 15 years of service. Consent Agenda: Moved by Kellogg, second by Schickel to approve the consent agenda. Passed. FY 06-07 Budget Amendment: Dorene Christensen presented the FY 06-07 budget amendment. The publishing deadline for the budget amendment is today, May 11, 2007. The Board of Supervisors has already given their approval but Board of Health approval is needed as well. The department’s FY 06-07 amended budget includes an increase in expenditures from $2,730,446 to $2,884,847 equaling a total increase of $154,400 in expenditures. The budget also includes an increase in revenue from $1,824,209 to $1,924,330 for a total increase of $100,121 in revenue. Additional the budget includes a tax dollar funding increase of $54,280 with the tax dollar request going from $906,237 to $960,517. The department’s FY 06-07 budget experienced both unexpected expenses as well as necessary expense that were not known during last year’s budget preparation process totaling $94,596. These include: IPERS Repayment ($9,642); Health Insurance ($28,497); Generator Installation ($15,389); Office Panels ($5,300); N-95 Respirators ($2,200); Business Continuity Plan ($18,315); Pandemic Awareness Initiative ($3,200); and Medicaid Overpayment ($12,053). Of the $94,596 increase in expenses, $40,316 has been absorbed in the amended budget. Of the remaining $54,280, the department is requesting $38,139 in additional tax dollar funding to cover unexpected increases in IPERS and health insurance. The balance of $16,141 will be paid from the department’s Special Fund balance. We were able to obtain the generator from Homeland Security at no cost but due to a number of reasons, the installation was not a part of the package. Moved by Kellogg, second by Schickel to approve the FY 06-07 budget amendment. Passed. Development of Nonprofit Organization: Pat Galasso stated the Exploratory Committee met with the Board of Supervisors on May 8th to discuss the idea of forming a Public Health Foundation. Committee members emphasized the fact that such foundations are not commonplace and reviewed the reasons why establishing a foundation is a good idea. There was very little discussion regarding any foreseen obstacles. The discussion centered primarily on the benefits. The Board of Supervisors asked if start up money was needed for the foundation. Galasso estimates an initial start up cost of $2,500 for fees associated with the incorporation of a non-profit foundation and to obtain identification as a tax-exempt 501(c) 3 organization. The Board of Supervisors had no qualms supporting the start up costs. Galasso voiced her opinion that she does not want the tax payers to pay for the start-up costs for the formation of a non-profit foundation. Galasso felt individuals could be found to pledge funds to cover those fees. The Health Department currently has funding that they can assign to the foundation until such time as pledges begin to come in to support the foundation. Once the foundation has begun to receive the pledges, the foundation can reimburse the health department. Kellogg agreed it is a good idea to have funds in place for start up costs and was in favor of accepting the initial start-up costs from the Board of Supervisors because she felt that the establishment of the foundation would end up benefiting all of the citizens of Cerro Gordo County. She asked if the foundation could accept the initial start up funds from the Board of Supervisors and then repay the Board of Supervisors as pledges are receiving. Galasso felt that as a taxpayer she views it to be more ethically acceptable for us to start the foundation without tax payer funding from the Board of Supervisors. Galasso feels that there is a way to design the budget to get this done. She outlined an example of a high-profile CPA who has already dedicated a years worth of in-kind bookkeeping to the foundation. Galasso feels that there are more individuals who will be willing to write a check to help start a foundation. If there is any way we can do that she would prefer to keep the tax payers money out of it. Schickel felt it is cleaner not to use tax payers backing. Kellogg questioned if $2,500 was too low a start up cost; she wondered if a target of $3,000-$3,500 would be more realistic. Galasso felt as the Exploratory Committee moves forward, things will fall into place and the true start up costs can be determined. The next step in the process is to look for individuals to serve as voluntary board members. It was suggested that we start with a minimum of 5 board members and a maximum of 7 board members. If the board wants to increase its membership in the future, that will be their decision to make. Schickel was concerned with whether or not the CPA who was volunteering to help in the formation of the foundation was familiar with the bookkeeping requirements of a 501(c) 3 non-profit organization. Galasso commented that we will also need an attorney for the initial 501(c) 3 set-up. Dr. Johnson concurred with the need for a paid attorney and suggested that it was not fair to expect that of someone who was providing an in-kind service. He also suggested that it would be appropriate for this person be our attorney for the long-term. Osterholm suggested the use of the Pappajohn Law Firm and will approach Randy Nielsen with the Board’s approval. Osterholm indicated they have a working relationship with our department and have worked with us successfully in the past. It may not be Randy who is assigned to work with the foundation, but someone else within the firm who is familiar with the 501(c) 3 process. For clarification and for the purposes of expediting the process – Osterholm asked if we want to use donations over tax dollars, do we need to wait for the donations to begin the process? Or can we begin the process using the health department funds and then recover those costs with contributions that are received to support the foundation? Galasso suggested getting a realistic feel for what will be needed in the way of start up costs and then going out to acquire pledges. If she understands it correctly, there may be money in-house that can be utilized and the foundation can pay back the department. Osterholm confirmed that this is the way he would prefer to move forward. Trying to obtain funds first from outside sources before moving forward could delay the process too long. Dr. Johnson suggested informing the Board of Supervisors that their resources won’t be needed long-term and that we’d prefer to borrow the funds from them short-term. This would provide them to meet their accountability standards and demonstrate the idea that we worked together as a team to implement the formation of the foundation. Osterholm hopes that by-laws can be presented to the Board by June for approval and plans to compile a list of potential Foundation Board members that can be narrowed down at that time. This information then can all be forwarded to the law firm in June. Galasso and Dr. Johnson felt that someone needs to represent the Board of Health on the Foundation Board of Directors. Kellogg stated she would be interested. Schickel stated she would also be interested depending on how much time is involved. Osterholm stated that most of the board documents (by-laws, budget, and mission/vision statement) will be created for the new Foundation Board to review and approve at their first meeting. Osterholm’s intent is for them to come on to the board in a functional capacity versus a design capacity. Free Clinic Update: Barb Kellogg stated she has heard nothing more regarding the free clinic. Schickel concurred; it has totally gone off the radar. The last they knew the task force members were waiting for the survey results from the Regional Planning Coalition’s community survey. The consultant from Des Moines University has intern students entering survey data. Osterholm asked Kellogg what questions were on the survey that would relate back to the free clinic and what answers the free clinic group is looking for that would be crucial for decision making. Kellogg did not recall specific questions; most of the questions were related to people’s perception of how accessible health care is to them and if they thought their health care coverage is adequate. The responses will be coming from a 14 county area, not just Mason City or Cerro Gordo County. Kellogg offered to e-mail Osterholm the questionnaire. Galasso questioned what the next step is. Schickel stated after the survey is done the Free Clinic task force will plan another meeting - it’s been 3 months (the end of January) since they last met. Dr. Johnson feels that the issue is less about a free clinic and more about access. Kellogg stated a second strategic planning meeting has been set for the Regional Planning Coalition on June 13. The results of the survey will be provided to coalition members at that meeting. Kellogg will share the results with Board of Health members. Empowerment Board Update: Ron Osterholm stated approximately a year and a half ago the Empowerment Coordinator position left the Health Department and was consequently housed under the supervision of Mercy Medical Center – North Iowa. We had housed the employee for seven years and felt it was time for another agency to take on that responsibility. Since that time apparently Mercy no longer wants to be the fiscal agent and/or employer of record for that position. The Board of Supervisors was approached about taking on the responsibility but preferred not to house that position at the county level. At the same time, the Board of Supervisors voiced their concern that the $700,000 plus dollars that come in each year for the three county area for children’s programs not be lost. They have asked the Health Department to consider taking back the Empowerment program but no commitments have been made at this time. There are issues with taking the program back. Osterholm has some real concerns about taking the program back related to funding the time required for supervision. The Board of Supervisors were wondering if Osterholm would consider taking the program back, but have not indicated they’d like him to do so. There seem to be questions on the budget history but Osterholm does not know the extent of the potential problems that we would be taking on; he also feels that the leadership ability and knowledge level of the current Program Coordinator are additional barriers to a successful transition back to the Health Department. Dr. Johnson asked for monthly updates regarding this program. Schickel asked if Mercy would be running the program until a new home is found. Mercy set June 30 as the drop dead date. Of the $700,000 that comes into the 3 county area annually. This issue has been in the news several times lately. Moved by Schickel, second by Dougherty to draft a letter to Jim Fitzpatrick of Mercy Hospital to resolve the Empowerment program matter at hand. Passed. Mental Health Initiative Opportunity: Ron Osterholm brought up the issue of the mental health vacancies in the Mason City area – of the five psychiatric positions, three are currently vacant. Osterholm was approached by a concerned retired psychiatrist who asked whether public health could assist in initiating an invitation to the group from Iowa City, in order to bring them to Mason City to begin dialogue. The University of Iowa has introduced a new system that was originally implemented in Wisconsin. Essentially, they developed a Mental Health specialty “tag team” (including doctors and nurses as well as other mental health professionals) and instead of seeing patients every 15 minutes the idea would be to keep the team available during a crisis. From that dialogue – it might be possible for us to somehow create a community network approach to recruitment while re-designing the mental health system in this community differently so that is more appealing to potential Psychiatrists and Psychologists that might be recruited to our area. Core Team Dialogue: Brian Hanft mentioned the legislature passed a 35% fee increase for food inspections. This increase was not included in the department’s original budget, so Hanft wanted the Board to be aware that it is now present. Hanft plans to conduct assessments to address issues such as quality versus quantity, number of inspections conducted, how well and how fast inspections are done, and the services provided those establishments. Hanft and Osterholm have discussed the possibility of bringing on another staff member as the fee increase ($82,000) would more than fund an additional staff position. Hanft plans on assessing the region as a whole based on each county, not only for food inspections and the revenue it generates, but also a complete picture of the entire region for all services we provide. The core team was dismissed at 1:44 p.m., leaving the Health Director to meet with the Board one-on-one. Miscellaneous: The Board followed up on the issues of the free clinic and mental health professional shortfall. Osterholm and the Board discussed the upcoming strategic planning process and established a tentative date of October 5, 2007. The meeting was adjourned at 2:15 pm. The next meeting is scheduled for Friday, June 15, 2007 at 12:15 pm. Respectfully Submitted, Barb Kellogg Secretary
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