Board of Health
Meeting Minutes for September 10, 2019
The following board members were present: Dr. Zahi Kassas MD., Dr. Leo Cusumano MD, Dr. David Brubaker, Timothy LaFever, and Judy Hopkins, Legislative Representative.
Others present: Lori Ballengee, Tyler Shaw, Cynthia Paxhia, Brittney Schuld, Breeyan Barnes, County Administrator Debbie McDonnell, and County Attorney Carissa Knapp
Members absent: Dr. Joseph Felsen, Dr. Willard Simons DDS
Medical Director Absent: Dr. Christopher Depner.
The meeting was called to order by Dr. Cusumano at 7:03 p.m.
A motion was made by Dr. Kassas to approve the minutes from the June 11, 2019 meeting.
This motion was seconded by Tim LaFever. All in Favor, Motion Carried.
Lori Ballengee reported on personnel changes within the Health Department: Brittney Schuld has been hired as the Director of Patient Services. Interviews have been conducted for the RN vacancy, management staff will be meeting to make a decision. The Environmental Health Department had one Public Health Technician resign in August, interviews will begin 09/11/19 to fill that position. There will be an opening for a Public Health Educator as of 09/11/19.
Corporate Compliance – There have been no compliance issues, complaints, billing errors, or reports of fraud, waste, or abuse for the county, in the last quarter.
Accident/Incident Reporting – There have been no reports in Children’s Services.
Conflict of Interest Statements – As appointed board members by the Legislature, all Board of Health members must complete a Conflict of Interest Statement annually.
Lori reported that there are now reported cases in WNY of vaping related illness. To date, there are no deaths in New York State attributed to vaping related illness. The national death toll is up to 6 individuals. The FDA and CDC are currently working to pinpoint the cause of this illness.
Cynthia Paxhia reported that LHCSA has participated in and completed a hurricane drill as part of Emergency Preparedness requirements for Allegany County. An upcoming audit of the LHCSA program is expected to take place soon.
Immunization Program – In June 2019 Governor Cuomo signed a bill denying religious exemptions for school vaccination requirements. This has resulted in a significant increase of patient volume. Due to the absence of previous vaccinations, many patients are receiving up to 6 immunizations in a single visit. There have been additional immunization clinics scheduled to accommodate any vaccination needs. The CDC has issued a statement identifying a significant shortage of flu vaccine this year. ACDOH has preordered flu vaccine in an effort to avoid shortage for Allegany County, however flu vaccine will not be shipped until the end of September. Clinic staff is also encouraging patients to go to their local Pharmacies to receive vaccines. Pharmacies are permitted to provide the flu vaccine beginning at 2 years of age, with properly trained staff, although some choose not to vaccinate before 8 years of age.
The Immunization/TB intake form has been updated; the Immunization Intake form is now its own document and a separate TB Form has been created. This will allow for clearer patient documentation. Copies of ‘Allegany County Department of Health Immunization Intake Form’ and ‘Allegany County Department of Health Tuberculin Skin Test’ form were handed out to Board members for review. Suggested corrections and stipulations were made. Motion to approve use of new forms, once typos and questions have been addressed and corrected, made by Dr. Brubaker. This motion was seconded by Judy Hopkins. All in Favor, Motion Carried.
Reproductive and Sexual Health – There were only 8 clinics held last quarter due to contract restraints with the Nurse Practitioner. Clinics will continue to be held based on the NP’s availability. A Policy was presented to the Board for review: STI Screening - Syphilis, Gonorrhea, and Chlamydia, Non- Patient Specific Orders, signed by the Medical Director. This Policy will allow ACDOH RNs to order and obtain specimens for screening and treatment purposes of Syphilis, Gonorrhea, and Chlamydia. Motion to approve the Policy supporting this order, once typos and questions have been addressed and corrected, made by Dr. Kassas. Motion seconded by Dr. Brubaker. All in Favor, Motion Carried.
Lead - There are 12 current lead cases that are being managed by the Public Health Nurse. Lead letters are sent out to parents of 1 & 2-year-old children as a reminder to be tested, many of these letters are returned as undeliverable. Clinic staff would like to send mailings on a quarterly basis to Healthcare Providers, also. In addition to reminder letters, the Public Health Educator visits preschools and hardware stores to provide lead testing education. WIC staff encourages lead testing with their clients. Discussion on other means to reach the public and remind parents to have their children tested for lead at ages 1 and 2: Posters in grocery stores, billboards, blanket mailings, and press releases were suggested. Dr. Kassas would like to see the Health Department continue to send letters to parents. Discussion will occur internally to look for more cost and time efficient ways to educate parents.
Communicable Disease – 311 reports in the last quarter; Hepatitis, TB, Campylobacter, Salmonella, Giardia, E. coli, and Shiga 1 & 2. There were also 63 STI reports.
Accidents/Incidents/Complaints – There have been no accidents, incidents, or complaints in the Medical/Clinical Division.
Measles Update – Wyoming county had 5 cases of measles in a family with 8 children. The husband of one of the older children was exposed to Measles during a visit to NYC and upon returning had exposed the 8 children. The 3 oldest children had all been vaccinated and did not contract Measles, the 5 younger children had not been vaccinated and contracted Measles. This outbreak has been contained. Allegany County currently has no documented cases of Measles.
Tyler Shaw reported that, to date, there have been 3 positive rabies cases: 2 horses and 1 cow.
The Rabies Control Manual has been updated – no information has changed; flyers and brochures have been replaced with up to date copies. Motion to approve Rabies Control Manual updates made by Tim LaFever. This motion seconded by Dr. Cusumano. All in Favor, Motion Carried.
Environmental Health Fee Schedule Approval – ACCEL Water Lab Fees have been added, to include: Private Water Sample - $60.00, Bottle Charge (if sample is rejected) - $3.00, and Emergency/Weekend Testing - $100.00. No other changes noted. Motion to approve the Fee Schedule made by Judy Hopkins. Motion seconded by Dr. Kassas. All in Favor, Motion Carried.
Policy and Procedure Manual for Conducting Sanitary Surveys – Change to manual made to include the water sample fee.
ACCEL Water Lab– NYS ELAP (Environmental Laboratory Approval Program) Assessment was completed on 06.04.2019, Advised to make some corrections to Quality Control Manual items, corrections made. Lab has now been certified and running for 2 months. ACCEL has been able to provide 1 day turn around on water sampling, without incident.
Lead – NYS is passing legislation to lower the current lead levels in children that require further action down to 5, to take effect in October 2019. These children are then followed up with and monitored until their venous lead levels are below 5. This will significantly increase the number of lead cases managed by both the nursing staff and Environmental Health staff.
Tobacco 21 Update – The legal age to purchase tobacco products will go from 18 to 21 in November 2019.
Harmful Algal Bloom Update – 1 Algal bloom at Rushford lake that lasted 1-3 days, dissipated following a rain event. Algal blooms can be caused by several events, such as surface runoff from farms or illegal sewage systems running into bodies of water. The goal for next Spring is to issue a press release, attend town meetings to bring about discussion, and to begin a campaign advising people not to swim through any algae, do not allow your pets to swim through it, regardless of whether it is confirmed or suspected to be harmful.
Dr. Cusumano motioned to move into Executive Session for medical history of a particular person and proposed, pending, or current litigation. Dr. Brubaker seconded the motion. All in Favor, Motion Carried.
Judy Hopkins motioned to move out of Executive Session, Tim LaFever seconded the motion. All in Favor, Motion Carried.
The next Board of Health meeting will be held on December 10, 2019.
A motion was made to adjourn the meeting by Tim LaFever, motion seconded by Dr. Kassas. All in Favor, Motion Carried.
The meeting was adjourned at 8:53pm.
Respectfully submitted,
Breeyan Barnes
Confidential Secretary to the Public Health Director
