ADOPTED - JANUARY 25, 2005
Agenda Item No. 28
Introduced by the Human Services Committee of the:
INGHAM COUNTY BOARD OF COMMISSIONERS
RESOLUTION TO AMEND THE INGHAM COUNTY HEALTH DEPARTMENT PLAN OF ORGANIZATION
RESOLUTION #05-013
WHEREAS, the Board of Commissioners establishes the Plan of Organization for the Health Department, with the concurrence of the Michigan Department of Community Health; and
WHEREAS, a new Board of Commissioners has been elected, appointments have been made, new employees hired to fill key positions in the Health Department and certain programs have been shifted within the Department’s management structure; and
WHEREAS, the Health Officer has recommended that the Board of Commissioners authorize an amendment to the Health Department’s Plan of Organization to recognize the changes.
THEREFORE BE IT RESOLVED, that the Ingham County Board of Commissioners hereby amends the Ingham County Health Department Plan of Organization, effective January 1, 2005, as attached.
PLAN OF ORGANIZATION
INGHAM COUNTY HEALTH DEPARTMENT
January 2005
The Ingham County Health Department exists as a unit of Ingham County government. The Department is one of many departments/offices/units which operate under the direction of the Ingham County Board of Commissioners. There are sixteen Ingham County Commissioners who are elected for two year terms. The Board of Commissioners appoints the Health Officer to serve as the Director of the Health Department and establishes through its annual budget process the personnel and other resources available to the Health Department to carry out its statutory mission and any other duties assigned by the Board of Commissioners.
The Board of Commissioners has established a number of administrative policies/procedures and rules for the operation of all county departments. These include the operation of the personnel functions and the financial management functions (budgeting, general ledger, purchasing, etc.). These functions are overseen by the County Controller, who is appointed by the Board of Commissioners as the County’s Chief Administrative Officer. The Health Department is bound by these policies/procedures and rules and utilizes the resources of the Controller’s Office to implement all such functions ( that is, Human Resources Department, Financial Services Department, Purchasing Department, Budget Office and MIS Department, etc.).
Through its administrative processes, the Board of Commissioners negotiates agreements with several collective bargaining units and establishes a compensation plan for managers and confidential employees. Through these mechanisms, the job titles, classifications, wages and other terms of employment are established for all positions in the Health Department. The Board of Commissioners charges the Controller, and through him, the Human Resources Director with the responsibility of implementing the collective bargaining
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agreements and the managerial compensation plan. The Health Officer utilizes these documents to employ and direct the staff of the Health Department.
The Board of Commissioners appoints the Ingham County Board of Health. The Board of Health serves as an advisory body, assisting the Health Department staff and the Board of Commissioners.
The Board of Commissioners appoints the Ingham Community Health Center Board. The Community Health Center Board oversees the operation of the network of community health centers operated by the Health Department.
Board of Commissioners/Board of Health/Community Health Center Board/Administrative Staff - 2005
Ingham County Board of Commissioners
Mark Grebner, Chairperson
Andy Schor, Vice-Chairperson
Randy Schafer, Vice-Chairperson Pro Tem
Victor G. Celentino District No. 1 Curtis Hertel, Jr. District No. 9
Debbie De Leon District No. 2 Mark Grebner District No. 10
Tina Weatherwax-Grant District No. 3 Dianne Holman District No. 11
Chris Swope District No. 4 Deb Nolan District No. 12
Andy Schor District No. 5 Randy Schafer District No. 13
Dale Copedge District No. 6 Steve Dougan District No. 14
Lisa Dedden District No. 7 Michael Severino District No. 15
Marc Thomas District No. 8 Don Vickers District No. 16
Human Services Committee (Board of Commissioners)
Curtis Hertel, Jr., Chairperson
Tina Weatherwax-Grant, Victor G. Celentino, Lisa Dedden, Dianne Holman, Michael Severino
Ingham County Board of Health
George Rowan, Chairperson
Martha Adams, Jacqueline Day, Patricia Hepp, Guillermo Lopez, Mark Kieselbach, June Morse, Maurice Reizen, M.D., Saturnino Rodriguez, Gordon Spink, M.D., Beth Spyke
Health Department Administrative Staff
Bruce Bragg, M.P.H., Director
Dean Sienko, M.D., M.S., Medical Director
Jaeson Fournier, Director of Community Health Services/Primary Care Director
Laura Peterson, Director of Health Plan Management Services
Robert Glandon, Ph.D., Director of Planning and Special Services
James Wilson, R.S., M.S., Director of Environmental Health
John Jacobs, C.P.A., Chief Financial Officer
Judy Williams, B.S.N., M.P.A., Director of Disease Control
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Agenda Item No. 28
RESOLUTION #05-013
Ingham Community Health Center Board
Margaret Beall, Andrea Collier, Patricia Farrel, Mahbuba Fidda, Angie Garza, Curtis Hertel, Jr., Lonnie Johnson, Anne Smiley, Robin Turner
Health Department Mandate
The Constitution of the State of Michigan includes the following declaration:
"The public health and general welfare of the people of the State are hereby declared to be matters of primary public concern. The Legislature shall pass suitable laws for the protection and promotion of public health."
In 1978, the Public Health Code was passed by the Legislature and signed by the Governor. The "Code" establishes a State/Local system to carry out the responsibility to protect and promote public health.
The Code establishes the Michigan Department of Public Health with the responsibility to:
". . .continually and diligently endeavor to prevent disease, prolong life, and promote the public health through organized programs, including prevention and control of environmental health hazards; prevention and control of diseases; prevention and control of health problems of particularly vulnerable population groups; development of health care facilities and health services delivery systems; and regulation of health care facilities and health services delivery systems to the extent provided by law."
The Michigan Department of Public Health is charged in the Public Health Code to:
". . .promote an adequate and appropriate system of local health services throughout the state."
The Public Health Code requires every county to provide for a local health department. County Boards of Commissioners are required to organize county or district health departments.
The Public Health Code charges the local health departments with the same basic responsibilities as are given to the State:
"A local health department shall continually and diligently endeavor to prevent disease, prolong life and promote the public health through organized programs, including prevention and control of environmental health hazards, prevention and control of disease; prevention and control of health problems of particularly vulnerable population groups; development of health care facilities and health services delivery systems; and regulation of health care facilities and health care delivery systems to the extent provided by law."
The Ingham County Board of Commissioners has responded to this mandate by establishing the Ingham County Health Department as a Department of Ingham County Government. Each year, through the County budget process and through contracts established with the State, the Board of Commissioners determines which programs and services will be established and maintained to respond to the legal requirements to promote and protect the public health of the citizens of Ingham County.
Chain of Command
The Health Officer is appointed by the Board of Commissioners with the concurrence of the Director of the Michigan Department of Community Health. The Health Officer acts as the chief administrative officer and must “Have powers necessary or appropriate to perform the duties and exercise the powers given by law to the local health officer and which are not otherwise prohibited by law.” The most serious of these powers relate to
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declaration of “imminent danger to health or lives” which could lead to orders to restrain a condition, practice or person, and the issuance of emergency orders and procedures to include involuntary detention and treatment of persons in the event of an epidemic.
To assure that a proper representative of the Health Department is always available to exercise the power and duties of the Health Officer, the following Chain of Command is established in the Health Department and through the adoption of this Plan of Organization supported by the Ingham County Board of Commissioners and by the Director of the Michigan Department of Community Health.
In the event that Bruce Bragg cannot be reached, or is absent from Ingham County, and there is a need to act with the authority of the Health Officer, the following chain of command shall be in effect:
1. Dean Sienko, M.D., M.A., Medical Director
2. Judy Williams, R.N., M.P.A., Communicable Disease Supervisor
3. Jim Wilson, M.P.H., Environmental Health Director
In the event that the chain of command is activated, there will be no official Acting Health Officer. However, the above list identifies the person authorized to act with the authority vested in the Health Officer via statute, rule or policy.
(SEE NEXT PAGE FOR ORGANIZATION CHART.)
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Organizational Structure
The Health Department (as shown in the Table of Organization) is organized into four service bureaus and the Disease Control Office. These direct service units are supported by the Director’s Office and the Financial Services Unit.
Bruce Bragg, M.P.H. has served as Health Officer and Health Department Director since January 1977. He was appointed by the Board of Commissioners and serves at its pleasure. Dean G. Sienko, M.D., M.S. serves as the Health Department Medical Director and is separately appointed by the Board of Commissioners to serve as the Chief Medical Examiner. Dennis Jurczak, M.D., M.P.H. serves as the Deputy Medical Director and Deputy Medical Examiner; Dr. Jurczak is a part-time contractual employee. Sugandha Lowhim, M.D., M.P.H. serves as a Deputy Medical Director; Dr Lowhim is a full-time County employee and serves half-time as an Internal Medicine Physician in the health centers. Geoffrey Linz, M.D. also serves as a Deputy Medical Director. Dr. Linz serves as the Chief of Staff for Ingham Regional Medical Center and supports Ingham County through a contract. Jennifer Dalton, M.S. is the Administrative Information Unit Coordinator.
Jaeson Fournier, D.C., M.P.H., services as the Director of the Bureau of Community Health Services/Primary Care Director. The Bureau Community Health Services is the largest of the Health Department units, with an annual budget of about $15 million and approximately 150 employees. The Bureau operates a network of community health centers serving low-income persons who are Medicaid eligible, uninsured or enrolled in the Ingham Health Plan, the Medical Access Plan or another health benefit program coordinated by the Department. The Bureau is the home of a public health nursing unit and a number of public health categorical programs, such as Family Planning, Breast and Cervical Cancer Control Program, Hearing and Vision Screening, etc. The Bureau Director is jointly appointed by the Health Officer and the Community Health Center Board and is responsible for providing staff support to the Community Health Center Board. This unit reports to the Health Officer.
The Bureau of Health Plan Management is directed by Laura Peterson, Ph.D. It operates services to provide outreach to the low-income, at-risk community and to work with this community to find health insurance or health benefit programs to provide coverage. The Bureau serves as staff to the Ingham Health Plan Corporation, the Kent Health Plan Corporation, the Kalamazoo Health Plan Corporation, the Jackson Health Plan Corporation, the Upper Peninsula Medical Access Program, the Barry-Eaton Health Plan Corporation, and serves the Mid-Michigan Health Plan through its participation with the Ingham Health Plan. Overall the Bureau provides the administrative services for health plans that have enrolled more than 28,000 previously uninsured persons into health coverage plans that provide primary care, specialty care physician services, a pharmacy benefit, laboratory services and radiology services. The Bureau also operates the pharmacy programs for Ingham, Eaton, Clinton, Livingston, and Jackson Counties, providing a discounted price for prescription drugs to uninsured persons and those whose health insurance does not provide pharmacy coverage. This unit reports to the Health Officer.
The Bureau of Planning and Special Services is directed by Bob Glandon, Ph.D. This Bureau operates the Community Health Assessment and the Health Promotion units which provide support to all of the programs and services the Food Bank Project. Much of the effort of this Bureau is directed at engaging the community in learning experiences about the status of health and the causes of disease and disability with an outcome of community planning to improve health status. This Bureau represents the Department’s effort to extend beyond direct services and to engage the entire community in learning, strategy development and actions to improve the quality of life. This unit reports to the Health Officer.
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The Bureau of Environmental Health directs the Department’s programs to prevent and control environmental hazards. The Bureau is managed by Jim Wilson, R.S., M.S. The Bureau operates three program areas: Planned Programs (which includes the food service sanitation program), Demand Program (including the water supply services and on-site sewage programs) and the Special Projects unit which includes the planning for solid waste management, environmental toxicology, lead and radon services. This unit reports directly to the Medical Director.
The Disease Control Office is managed by Judy Williams, BSN, M.P.H. Ms. Williams reports directly to Dean Sienko, M.D., Medical Director. The Office includes a Communicable Disease Unit and the Immunization Program, which is composed of the Immunization Clinic and also efforts to coordinate community resources and provide outreach to assure high levels of immunization for vaccine preventable diseases. This unit reports directly to the Medical Director.
The Public Health Preparedness Unit was created to provide leadership within the Department and coordination with emergency management and medical care preparedness in the community. Sue McIntosh, M.S., R.S. is the Emergency Preparedness Coordinator. This unit reports directly to the Medical Director.
The Financial Services Unit is managed by John Jacobs, C.P.A. This unit is responsible for operating the financial aspects of the Health Department within the guidance of the County policies/procedures and rules and consistent with contractual grant requirements. The Unit provides Department managers with financial reports necessary to efficiently operate the Department. The Unit also coordinates the internal telephone and computer system support, maintaining liaison with the County MIS Department. This unit reports to the Health Officer.
Local Public Health Operations (LPHO) –
Annually, the appropriations bill for the Michigan Department of Community Health establishes funding for a set of public health services which are supported through a Local Public Health Operations line item. In State Fiscal Year 2005, $1,447,006 of that funding is allocated to support Ingham County services. The County is required to describe how those services will be delivered. The following statements serve as the LPHO plan for 2005:
· Immunizations – Ingham County operates a full-time Immunization Clinic in the Human Services Building and offers childhood and adult immunizations through all of the outlying community health centers. The Immunization Program operates under the supervision of the Communicable Disease Supervisor who reports to the Medical Director.
· Sexually Transmitted Disease – Ingham County operates a full-time Sexually Transmitted Infection (STI) Clinic in the Human Services Building and provides for STI diagnosis and treatment through all of its community health centers. The dedicated STI Clinic in the Human Services Building operates within the Adult Health Clinic. The STI Program is supervised by the Primary Care Director.
· Infectious Disease – Ingham County operates a Communicable Disease Control Office. This Office is supervised by the Communicable Disease Supervisor who reports to the Medical Director. The Office is staffed with full-time Disease Control Nurses and support staff.
· Hearing Screening – Ingham County operates a Hearing Screening Program within the Public Health Nursing Unit. The Unit employs trained Hearing Technicians who conduct the screenings at all Ingham County
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· schools and child care facilities. The Program is supervised by the Public Health Nursing Director who reports to the Medical Director.
· Vision Screening – Ingham County operates a Vision Screening Program within the Public Health Nursing Unit. The Unit employs trained Vision Technicians who conduct the screenings at all Ingham County schools and child care facilities. The Program is supervised by the Public Health Nursing Director who reports to the Medical Director.
· Food Protection – Ingham County operates a Food Sanitation Program within the Bureau of Environmental Health. The Bureau utilizes Registered Sanitarians with specific training in food service sanitation to implement the plan review, education, inspection, enforcement and outbreak investigation functions of the Program. The Program operates within the Planned Program Unit of the Bureau. It operates under the direct supervision of the Planned Program Supervisor who reports to the Environmental Health Director. The EH Director reports to the Medical Director.
· Private and Public Water Supply – Ingham County operates a Drinking Water Program within the Bureau of Environmental Health. The Bureau utilizes Registered Sanitarians to implement the Program. The Program operates within the Demand Services Unit of the Bureau, under the direct supervision of the Demand Services Supervisor, who reports to the Environmental Health Director. The EH Director reports to the Medical Director.
· On-site Sewage Management – Ingham County operates an On-site Sewage Program within the Bureau of Environmental Health. The Bureau utilizes Registered Sanitarians to implement the Program. The Program operates within the Demand Services Unit of the Bureau, under the direct supervision of the Demand Services Supervisor, who reports to the Environmental Health Director. The EH Director reports to the Medical Director.
HUMAN SERVICES: The Human Services Committee will meet 1/24/05