ADOPTED
- APRIL 10, 2007
AGENDA ITEM NO. 13
Introduced by the Human Services, County Services and Finance Committees of the:
INGHAM COUNTY BOARD OF COMMISSIONERS
RESOLUTION TO AMEND THE PLAN OF ORGANIZATION AND AUTHORIZE A REORGANIZATION IN THE HEALTH DEPARTMENT
RESOLUTION #07-079
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, Bruce B. Bragg recently retired as Health Officer; and
WHEREAS, in Resolution #07-027, the Board of Commissioners appointed Dean G. Sienko, M.D., as Health Officer; and
WHEREAS, the Health Officer has reviewed the structure of the Department and has proposed a number of changes in reporting relationships and job functions; and
WHEREAS, the proposed new jobs have been evaluated by the Human Resources Department which have been made, and concurred with the recommendations that are contained in this resolution; and
WHEREAS, the Health Officer has recommended that the Board of Commissioners authorize the proposed reorganization and the resulting establishment of new positions and changes in job titles and classifications; and
WHEREAS, the Health Officer has advised that no additional funds are required to implement the proposed changes.
THEREFORE BE IT RESOLVED, that the Ingham County Board of Commissioners hereby amends the Ingham County Health Department Plan of Organization, effective April 16, 2007, as attached.
BE IT FURTHER RESOLVED, the Board of Commissioners authorizes the following changes in job titles and classification/salary grades, effective April 16, 2007:
Position/Employee Current Grade Proposed Grade Title
601003 Jaeson Fournier MCF 14 MCF 16 Deputy Health Officer
for Community Health
Care Services
601076 Laura Peterson MCF 14 MCF 16 Deputy Health Officer
for Health Plan
Management
601004 Melany Mack MCF 13* MCF 12 Director, Planning and
Special Services
ADOPTED - APRIL 10, 2007
AGENDA ITEM NO. 13
RESOLUTION #07-079
601079 Jayson Welter PRO 09 MCF 11 Manager, Health Plan
Management Services
*Current employee has been appointed as the Interim Director of Planning and Special Services
BE IT FURTHER RESOLVED, the Board of Commissioners authorizes the following new positions be established in the Health Department:
Position Title Proposed Grade
Deputy Health Officer for Nursing Services MCF 15
and Special Programs
Chief Operating Officer for Health Care Services MCF 13
Assistant Deputy Health Officer MCF 10 (C: Professional)
BE IT FURTHER RESOLVED, that the following positions be eliminated in the Health Department:
Position Grade
601001 Health Officer (Bragg) MCF 18
601146 Public Health Nursing Supervisor (Tannenbaum) MCF 10
601059 Administrative Information Unit Manager (Dalton) MCF 10
601011 Health Analyst (Mack) PRO 10
HUMAN SERVICES: Yeas: Bahar-Cook, Schor, Tennis, Severino
Nays: None Absent: Hertel , Grebner Approved 4/09/07
COUNTY SERVICES: Yeas: De Leon, Tennis, Copedge, Severino, Dougan
Nays: None Absent: Nolan Approved 4/3/07
FINANCE: Yeas: Celentino, Grant, Grebner, Dougan
Nays: None Absent: Hertel, Soule Approved 4/04/07
PLAN OF ORGANIZATION
INGHAM COUNTY HEALTH DEPARTMENT
March 2007
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 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 - 2007
Ingham County Board of Commissioners
Marc Thomas, Chairperson
Dianne Holman, Vice-Chairperson
Mike Severino, 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
Rebecca Bahar-Cook 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
Todd Tennis District No. 7 Michael Severino District No. 15
Marc Thomas District No. 8 Timothy Soule District No. 16
Human Services Committee (Board of Commissioners)
Curtis Hertel, Jr., Chairperson,
Mark Grebner, Rebecca Bahar-Cook, Andy Schor, Todd Tennis, Michael Severino
Ingham County Board of Health
George Rowan, Chairperson
Martha Adams, Jacqueline Day, Patricia Hepp, Mark Kieselbach, June Morse, Maurice Reizen, M.D., Saturnino Rodriguez, Barry Saltman, M.D., Beth Spyke
Health Department Administrative Staff
Dean G. Sienko, M.D., M.S., Health Officer/Medical Director/Chief Medical Examiner
Jaeson Fournier, D.C., M.P.H., Deputy Health Officer for Community Health Services
Laura Peterson, M.A., Deputy Health Officer for Health Plan Management Services
Vacant, Deputy Health Officer for Nursing Services and Special Programs
Vacant, Assistant Deputy Health Officer
Melany Mack, Director, Planning and Special Services
James Wilson, R.S., M.S., Director of Environmental Health
John Jacobs, C.P.A., Chief Financial Officer
Anita Turner, R.N., M.A., Director of Nursing
Judy Williams, B.S.N., M.P.A., Director of Communicable Disease Control
Ingham Community Health Center Board
Margaret Beall, Willie Davis, Patricia Farrel, Angie Garza, Curtis Hertel, Jr., Lonnie Johnson, Anne Smiley, Sara Steele, 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 the 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 Dean Sienko 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. Laura Peterson, M.A., Deputy Health Officer for Health Plan Management
2. Jaeson Fournier, Deputy Health Officer for Community Health Services
3. Deputy Health Officer for Nursing Services and Special Programs (new position)
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.)
Organizational Structure
The Health Department (as shown in the Table of Organization) is organized into three major divisions each headed by a Deputy Health Officer. These direct service units are supported by the Director’s Office and the Financial Services Unit.
Dean Sienko, M.D., M.S. has served as the Department’s Medical Director since 1988 and was recently appointed Health Officer, effective February 2007. Dr. Sienko has served as Ingham County’s Chief Medical Examiner since 1989. In all of these capacities, he serves at the pleasure of the Ingham County Board of Commissioners.
Three other physicians provide a combined 1.0 FTE in administrative support to the Health Department’s operations. Sugandha Lowhim, M.D., M.P.H. serves as the Department’s Chief Deputy Medical Director. Dr. Lowhim is a full-time county employee; she serves half-time in administrative public health and half-time as an internal medicine physician in the Health Department’s clinics. Dennis Jurczak, M.D., serves as a Deputy Medical Director and Chief Deputy Medical Examiner; Dr. Jurczak is a part-time contractual employee who works approximately 10 hours per week. Bonta Hiscoe, M.D. is also a Deputy Medical Director and part-time contractual employee who works approximately 10 hours per week.
Jaeson Fournier, D.C., M.P.H., serves as the Deputy Health Officer for Community Health Care Services. His work area is the largest in the Health Department, with an annual budget of about $15 million and approximately 150 employees. The Clinical Services unit operates a network of Federally-Qualified Community Health Centers (FQHCs) serving people who are eligible for Medicaid; people who do not have health insurance; or people who are enrolled in the Ingham Health Plan, the Medical Access Plan or another health benefit program coordinated by the Department. This unit also houses some categorically funded programs such as family planning. Because of his leadership role for both the Health Department and our FQHCs, Dr. Fournier is jointly appointed by the Health Officer and the Community Health Center Board; he provides staff support for the Community Health Center Board. Recently, this unit took over responsibility for inmate medical services at the Ingham County Jail. Dr. Fournier reports to the Health Officer.
Laura Peterson, M.A. serves as the Deputy Health Officer for Health Plan Management (HPM). This unit operates services to provide outreach to the low-income, at-risk community and to work with this community to find health insurance or a health care benefits program. The HPM unit serves as staff to the Ingham Health Plan Corporation, and 17 County Health Plans in 53 counties in Michigan through its participation with the Ingham Health Plan. Overall the HPM unit 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 HPM unit also operates the pharmacy programs for seven health plans, providing a discounted price for prescription drugs to uninsured persons and those whose health insurance does not provide pharmacy coverage. The Breast and Cervical Cancer Control Program (BCCCP) is located within this unit.
Laura Peterson will also supervise our Environmental Health and Public Health Preparedness units. The Environmental Health (EH) unit directs the Department’s programs to prevent and control environmental hazards; it is managed by Jim Wilson, R.S., M.S. The EH unit 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. The Public Health Preparedness Unit was created to provide leadership within the Health Department and coordination with emergency management and medical care preparedness in the community. Sue McIntosh, M.S., R.S. is the Emergency Preparedness Coordinator.
The third major division of the Health Department will be headed by our Deputy Health Officer for Nursing Services. This unit contains the following programmatic areas: Public Health Nursing, Disease Control, Immunizations, and Planning and Special Services. Virtually all pure public health nursing responsibilities are located within this unit; these responsibilities include home visits, outbreak control, infant mortality prevention, lead poisoning prevention and the hearing and vision program. Key leaders in this area include Anita Turner, R.N., M.A., Judy Williams, B.S.N., M.P.A., and Joy Maloney, R.N.
The Planning and Special Services unit, supervised by Melany Mack, M.S.W., is also located here. This unit conducts our community health assessment and health promotion, Food Bank, and tobacco cessation and control functions. Much of the effort of this unit 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. The Deputy Health Officer for Nursing Services will report to the Health Officer.
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 county policies/procedures and rules and consistent with contractual grant requirements. The Financial Services Unit provides Health Department managers with financial reports necessary to efficiently operate the Department. This unit also coordinates the internal telephone and computer support system, maintaining liaison with the County MIS Department. Mr. Jacobs 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 2007, $1,426,785 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 2007:
• 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 Director of Communicable Disease Control. The Director of Communicable Disease Control reports administratively to the Deputy Health Officer for Nursing Services; he/she works directly with the Medical Director or Chief Deputy Medical Director on all medical matters.
• 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 Deputy Health Officer for Community Health Services; medical matters are brought to the attention of the Medical Director or Chief Deputy Medical Director.
• Infectious Disease – Ingham County operates a Communicable Disease Control Office. This Office is supervised by the Disease Control Supervisor who reports to Deputy Health Officer for Nursing Services on administrative matters. The Medical Director or Chief Deputy Medical Director supervise all medical matters. 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 schools and child care facilities. The Program is supervised by the Public Health Nursing Director who reports to the Deputy Health Officer for Nursing Services.
• 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 Deputy Health Officer for Nursing Services.
• 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 Deputy Health Officer for Health Plan Management.
• 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 Deputy Health Officer for Health Plan Management.
• 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 Deputy Health
Officer for Health Plan Management.