Approved 4/19/99

HUMAN SERVICES COMMITTEE

April 5, 1999

Minutes

Members Present: Anne Smiley, Mary Stid, Michael Severino and Alfreda Schmidt

Members Absent: John Czarnecki

Others Present: John Neilsen, Joe Lessard, Susan O'Shea, Bruce Bragg, Jerry Ambrose and

Paul Pratt

The meeting was called to order by Chairperson Smiley at 7:00 p.m. in Conference Room A of the Human Services Building, 5303 South Cedar, Lansing.

Approval of the February 22 and March 1, 1999 Minutes

MOVED BY COMM. STID, SUPPORTED BY COMM. SEVERINO, TO APPROVE THE FEBRUARY 22 AND MARCH 1, 1999 MINUTES OF THE HUMAN SERVICES COMMITTEE. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Czarnecki

Additions to the Agenda

2f. Robert Wood Johnson Grant Proposal

2g. Otto Health Center Grant Expansion

7. Board of Health - Letter regarding Tobacco Settlement

Limited Public Comment: None

1. Cooperative Extension - Resolution to Authorize Ingham County MSU Extension to Purchase Two Computers

Mr. Lessard explained that the Extension is upgrading a few computers in order to be compatible with the County's system. The Resolution authorizes an additional $2,754 beyond the MIS and Extension 1999 CIP budgets.

MOVED BY COMM. SCHMIDT, SUPPORTED BY COMM. STID, TO APPROVE THE RESOLUTION TO AUTHORIZE INGHAM COUNTY MSU EXTENSION TO PURCHASE TWO COMPUTERS. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Czarnecki

MOVED BY COMM. STID, SUPPORTED BY COMM. SCHMIDT, TO APPROVE A CONSENT AGENDA FOR THE FOLLOWING ITEMS:

2. Health Department

a. Resolution to Authorize an Immunization Registry Subcontract

with the Mid-Michigan District Health Department

b. Resolution to Authorize Contracts for Dental Services

c. Resolution to Authorize a Third "Equip" Grant with the Michigan 4C Association

MOTION CARRIED UNANIMOUSLY. Absent: Comm. Czarnecki

MOVED BY COMM. STID, SUPPORTED BY COMM. SCHMIDT, TO APPROVE THE ITEMS ON THE CONSENT AGENDA. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Czarnecki

d. Resolution to Authorize a Reorganization of Work in the Public Health Nursing and the Registration and Enrollment Unit and to Change the Classification of a Position

Mr. Bragg explained that, since reorganizing work in the Registration and Enrollment Unit, one of the employees has been working out of his/her classification.

In response to Comm. Schmidt, Mr. Bragg stated that this position was vacant at the time the UAW/TOPS Study was conducted. Mr. Bragg explained to Comm. Severino that the Study recommends no change for this position. Mr. Neilsen explained that Mr. Hailey has reviewed this situation and he recommends the change in classification.

MOVED BY COMM. STID, SUPPORTED BY COMM. SEVERINO, TO APPROVE THE RESOLUTION TO AUTHORIZE A REORGANIZATION OF WORK IN THE PUBLIC HEALTH NURSING AND THE REGISTRATION AND ENROLLMENT UNIT AND TO CHANGE THE CLASSIFICATION OF A POSITION. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Czarnecki

e. Resolution to Authorize a Contract with the Michigan Department of Community Health to Implement a Regional Inspection Program of Tobacco Retailers

Mr. Bragg explained that the Michigan Department of Community Health has a contract with the U.S. Food and Drug Administration to implement a monitoring system of tobacco retailers. The retailers will be monitored to determine whether they sell or provide tobacco products to minors. Mr. Bragg explained that as a result of the County's regulations, the opportunity for minors to purchase tobacco has declined. Minors are declined the opportunity to purchase tobacco approximately 90% of the time.

Ingham County will play the lead role in Area 4. The County Health Department will conduct the tobacco monitoring activities in the County and will contract with other agencies to implement the monitoring activities in the other nine counties in the region. The proposed model would employ an adult investigator to accompany youths who will be recruited and trained to conduct 750 compliance visits in the region.

The State will provide the County with up to $64,431 of federal funds to implement the program during the agreement period.

In response to Mr. Neilsen, Mr. Bragg explained that the new system will replace the County's current system to the extent possible. Mr. Bragg also explained to Comm. Stid that he was just actually offered the contract at this time. However, the period of the agreement is November 30, 1998 through September 30, 1999.

Comm. Severino complimented Mr. Bragg for successfully operating the County's tobacco program.

MOVED BY COMM. STID, SUPPORTED BY COMM. SCHMIDT, TO APPROVE THE RESOLUTION TO AUTHORIZE A CONTRACT WITH THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH TO IMPLEMENT A REGIONAL INSPECTION PROGRAM OF TOBACCO RETAILERS. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Czarnecki

Chairperson Smiley informed Mr. Bragg that Cristo Rey and the NYPPP may be interested in this program.

f. RWJ Grant Proposal

Mr. Bragg explained that the County has an opportunity to submit a proposal to the Robert Wood Johnson Foundation for grant funding to support the access to health care initiative. The grant would provide funding for a consultant. This proposal would also be offered to Clinton and Eaton Counties.

The Capital Areal Health Alliance would be the grantee in this matter. The County has two representatives in the Alliance. The representation of the Alliance is very attractive to the RWJ Foundation. Approximately 700 communities inquired about the grant. However, only 20 planning grants will be awarded.

Mr. Bragg stated that the Health Department, on behalf of the Alliance, is requesting a letter of support from the BOC in this matter. The letter of support must be submitted by April 30, 1999.

MOVED BY COMM. STID, SUPPORTED BY COMM. SCHMIDT, TO SEND A LETTER OF SUPPORT TO THE CAPITAL AREA HEALTH ALLIANCE. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Czarnecki

g. Otto Health Center Expansion Grant

Mr. Bragg informed the Committee that the Otto Health Center will be physically expanding its operation. The Junior League will be the principle source of funding for the expansion. The cost of the expansion will be approximately $25,000. The Junior League has proposed to fund most of the cost. However, the League has requested the County to seek other funding sources such as the Greater Lansing Foundation.

(Chairperson Pratt arrived at 7:41 p.m.)

3. Ingham Regional Medical Center - Informational Item- Community Report on Lansing Area Health System

Mr. Bragg stated that he appreciates his appointment to the IRMC Board of Trustees. He explained that the report builds on lasts year's report. Mr. Bragg reviewed the Points of Interest contained in the report.

Chairperson Smiley stated the Committee may want to consider IRMC's Community Benefit Plan. The Plan offers guidelines to help determine which community projects should be supported by IRMC. Mr. Bragg explained that Mr. Bloss may be willing to work with the Commissioners to assist developing a similar process for the County.

Chairperson Smiley stated the Alliance should be involved in discussions regarding the free standing ambulatory centers. Mr. Bragg explained that four centers approached the Alliance for support three or fours years ago and were refused. Mr. Bragg stated that it would be appropriate to request another opinion from the Alliance. The hospitals and insurers also should be consulted in this matter.

Comm. Schmidt stated that the BOC's responsibility is to consider the best interest of the people of the County. She stated that she is pleased both sides of this issue are being explored. Chairperson Smiley suggested that this matter be referred to the Alliance. The Committee held a brief discussion regarding the free standing ambulatory centers and the issue of emergency room capacity.

In response to Comm. Severino, Mr. Bragg explained that IRMC does not receive funding from the Capital City Airport.

4. Medical Care Facility - Update on MCF Issues, Susan O'Shea, Director

Ms. O'Shea explained that the survey team removed 27 of the 32 deficiencies in February. Therefore, the Medical Care Facility was in substantial compliance. The moral of the Facility staff has also improved. The written report regarding the remaining five deficiencies was received in March. The Facility instituted another plan of action to correct the five deficiencies. The surveyors removed the deficiencies on March 24. The Facility is now in full compliance.

Ms. O'Shea stated that as a result of the hold on admissions, the February census was approximately 179-180. The Facility's census normally does not drop below 190. The hold on admissions was looked upon favorably by the State. The Facility slowly began to readmit residents in February. However, the Facility did not admit residents needing services which the Facility was working to improve.

The Facility is in an unfavorable financial situation at this time due to the low census. This situation may not be resolved until June. Ms. O'Shea explained that the Facility has been proactive in regards to reducing costs.

Chairperson Pratt stated his concern that the Facility will return to its past practices. Ms. O'Shea stated that the Facility will be negotiating with the UAW for nursing staff. Chairperson Pratt offered the Ms. O'Shea the assistance of the BOC staff with union negotiations.

In response to Comm. Schmidt, Ms. O'Shea explained that the Facility has not contacted the people who were not admitted to the Facility due to retraining issues. She also explained that the people were probably accepted by other nursing homes.

In response to Comm. Severino, Ms. O'Shea explained that the Facility has worked with a nursing consultant and a social service consultant in an effort to retrain the staff.

Chairperson Smiley thanked Ms. O'Shea for her time and efforts in addressing the Facility's concerns.

In response to Mr. Ambrose, Ms. O'Shea explained that the loss of the Director of Nursing has affected the Facility. A nursing team will be formed to run the nursing department until a replacement is found.

5. Controller - Resolution Establishing Priorities for 2000 Strategic Planning and Budget Activities

Mr. Ambrose reviewed the objectives and guidelines as set forth in the Resolution.

Comm. Severino stated that he believes the capitation model should be included in the objective of assuring accessible health care. Chairperson Pratt stated that Mr. Bragg has been involved with seeking capitated contracts. The Ingham Health Plan is capitated. The Committee held a brief discussion regarding this issue.

In response to Comm. Schmidt, Mr. Ambrose explained that the issue of day care for employees has been raised a few times. Demands for day care have not been made in collective bargaining. The issues of space and the number of County buildings present difficulties in regard to providing day care services. Chairperson Smiley informed Comm. Schmidt that the Office of Young People has an extremely coordinated day care referral system. Comm. Stid informed the Committee that the Women's Commission is addressing the issue of child care.

MOVED BY COMM. STID, SUPPORTED BY COMM. SEVERINO, TO APPROVE THE RESOLUTION ESTABLISHING PRIORITIES FOR 2000 STRATEGIC PLANNING AND BUDGET ACTIVITIES. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Czarnecki

6. Board Referral - Resolution from Washtenaw County Supporting the Restoration of $92.9 Million to the Department of Community Health Budget to Fully Fund the Community Mental Health System in Michigan

Chairperson Pratt explained that the Executive Budget recommends a 0% increase. The national policy regarding Medicaid supports competition. The mental health community is concerned regarding the for-profit bidders. Chairperson Pratt spoke further regarding this issue. He suggested that the Committee may want to consult with Mr. Sheahan regarding the adoption of Washtenaw County's Resolution. Mr. Neilsen stated that he will follow through on this matter with Mr. Sheahan.

7. Board of Health

Chairperson Smiley stated the Board of Health has sent information regarding their efforts on behalf of the tobacco settlement. She suggested the Committee send a letter to the Board thanking them on behalf of their efforts.

Chairperson Pratt stated the census issue should remain on the agenda. The County should develop their position regarding this matter.

Announcements

Mr. Neilsen informed the Committee that information regarding the Market Concentration Increases is included in the agenda packet.

Public Comment: None

The meeting adjourned at 9:00 p.m.

Respectfully submitted,

Debra Neff