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Board of Health

Meeting Minutes
March 10, 2009

12:00 Noon
Rice Conference Room

Present: Dr. Francis Fox; Mr. Brooke Greenhouse; Dr. James Macmillan, President; Michael McLaughlin, Jr.; Ms. Janet Morgan; Dr. Jeffrey Snedeker; and Dr. William Tyler
Staff: Mrs. Sylvia Allinger, Director of CSCN; Mrs. Liz Cameron, Director of Environmental Health; Mrs. Brenda Grinnell Crosby, Public Health Administrator; Dr. William Klepack, Medical Director; Mr. Jonathan Wood, County Attorney; and Mrs. Patty Stamm, Administrative Assistant
Excused: Mr. Greg Stevenson; Mrs. Alice Cole, Public Health Director; and Mrs. Sigrid Connors, Director of Patient Services
Guests: Theresa Lyczko, Director Health Promotion Program; Karen Bishop, Community Health Nurse Supervisor; and Steven Kern, Sr. Public Health Sanitarian


Dr. Macmillan, President, called the regular meeting of the Board of Health to order at 12:02 P.M.

Dr. Macmillan welcomed Ms. Janet Morgan, who will be filling the vacant Consumer position on the Board of Health.  Introductions were made around the room.

Approval of Minutes: 

Dr. Snedeker moved to approve the minutes February 10, 2009 Board of Health meeting.  This was seconded by Dr. Tyler.  Carried with one abstaining vote from Ms. Morgan.

Financial Summary:

A Supplemental 2008 Financial Summary, which includes Fourth Quarter State Aid, was included in Board of Health packets.  Mrs. Grinnell Crosby discussed an area still being addressed: Preschool Special Education (Mandated) and the Early Intervention Program, stating some of the billing is still being posted, as well as revenues that can’t be claimed until late March/early April.  Mrs. Grinnell Crosby stated at this point the department should be in fairly good shape.  She added the department may be eligible for rollover money, although the final figure has not been finalized.  These funds are typically used for one-time expenses such as equipment and things that can’t normally be purchased in the routine budget.  Mrs. Allinger added the AVL (Automated Voucher Listing) will be going out in March and their portion of that will be just over $900,000 which will put the Preschool Special Education account in great shape.  

Administration Report: 

Mrs. Grinnell Crosby announced Mrs. Cole was out on leave and expects to be back to work on Monday, March 16th. 

Mrs. Grinnell Crosby stated she had nothing to add to Mrs. Cole’s written report; however there was one item she would like to add to the agenda:

Resolution No. - Dedication of the Conference Rooms at 55 Brown Road – Tompkins County Health Department.  This resolution will honor years of service to Tompkins County Board of Health and the Health Department by James Rice, Clara Goodman, Joanne Brazo, and John Andersson by dedicating various conference rooms in their name.  Mrs. Grinnell Crosby stated suggestions and a vote by staff was taken and these were the resulting recommendations.  If the Board of Health approves this resolution, it will go on to the Health and Human Services Committee, then to the Government Performance and Workforce Relations Committee, and then on to the full Legislature for action. 

Dr. Tyler moved to accept the resolution as presented, seconded by Dr. Snedeker, and carried by a unanimous voice vote.

Medical Director’s Report: 

Dr. Klepack discussed the most recent seasonal map he had on influenza outbreaks in New York State, adding it is mimicking last year whereby influenza cases were peaking in late February/early March.

Dr. Klepack also discussed his involvement with the community group on Pandemic Flu preparedness.  This group is made up of staff from the hospital, Cornell University, Ithaca College, and the Health Department.  The group is expanding their activities into a larger county-wide planning committee in order to increase communication and coordination.  As part of this, they plan to reach out to private practitioner offices and offices in general to talk about Pandemic Flu planning.  Two ways they plan to reach out is use of the Finger Lakes Office Managers Association and another is to do a presentation to the Medical Society on Pandemic Flu as it affects offices.  Dr. Macmillan suggested a power point presentation that could be reviewed on the Health Department’s website as a possible resource.  Dr. Klepack stated the power point presentation he is using for the Officers Managers Association could be put out as a resource if the department felt it appropriate to have offices access it.    

Division for Community Health:

Due to Mrs. Connor’s excused absence, there was no additional report.

Children with Special Care Needs:

Mrs. Allinger reported the Children with Special Health Care Needs and Physically Handicapped Children’s Programs were audited last week by the Department of Health.  No major or minor issues were found; a few suggestions were made.  Mrs. Allinger added although that these suggestions were not mandated, it was helpful advice in some areas.  In addition, the auditor was very complimentary about what has been done with these programs, in particular the work done by JoAnn Horton, the full-time Public Health Social Worker in the Children with Special Care Needs Program. 

County Attorney’s Report: 

Mr. Wood stated he had nothing to report.

Environmental Health Report:

Mrs. Cameron stated she had nothing to add to her written report.

Approvals and Actions

Approval of Revised Policy: Hepatitis A Vaccine Policy:

Dr. Tyler moved to accept the revised policy as written, seconded by Janet Morgan, and carried by a unanimous voice vote.

Approval of Revised Policy: Menactra Vaccine Policy:

Dr. Tyler moved to accept the revised policy as written, seconded by Janet Morgan.

Dr. Snedeker stated according to the AAP (American Academy of Pediatrics), Menactra is recommended for 2 year olds and up.  He pointed out there may be an issue with this policy in that if you give the vaccine to a child who doesn’t have any of the listed indications (B.1.) it could still be appropriate.  According to ACIP (Advisory Committee on Immunization Practices), this vaccine is recommended for children ages 11 and older.  TCHD follows ACIP recommendations and not the AAP.  Dr. Klepack suggested an option would be to approve the Revised Menactra Vaccine Policy and then charge Health Department staff with looking into practical issues regarding changing the ages.  This was acceptable with Dr. Snedeker.  Carried Unanimously.

Approval of Revised Policy: Rabies Post-Exposure Vaccine Policy:

Dr. Tyler moved to accept the revised policy as written, seconded by Janet Morgan, and carried by a unanimous voice vote.

A brief discussion on adult vaccinations followed. The discussion then turned to the ever growing problem private practitioners have with reimbursement for vaccine delivery.  Mr. Greenhouse questioned if it would be appropriate for the Board to consider sending a resolution to the appropriate powers that this is a concern being seen in the community.  Following a short discussion on insurance reimbursement for the private practitioner sector, as well as vaccine issues, it was determined to be a private sector economy issue.  Dr. Klepack stated if the Board was inclined, for the public’s good, they could support that vaccines need to be reimbursed at a reasonable level, as well as needing to be adopted in a reasonable speedy manner by insurance companies.  Dr. Macmillan felt it might be premature to be making too many detailed recommendations at this point and also a letter of support for adequate reimbursement might be insipid.  He felt he would like to see what evolves before knowing who to write to.  The question is where can we have an impact and not just be another supportive voice. 

Ms. Debby Halpern, Manager, Brookton Market, T-Caroline; Compliance with NYS Sanitary Code – Groundwater Under the Direct Influence of Surface Water (GWUDI):

Mr. Greenhouse moved to accept the Resolution as written, seconded by Dr. Tyler, and carried by a unanimous voice vote.

D KGB Corp., C/O Glenwood Pines, T-Ulysses; Compliance with NYS Sanitary Code – Groundwater Under the Direct Influence of Surface Water (GWUDI):

Mr. Greenhouse moved to accept the Resolution as written, seconded by Dr. Tyler, and carried by a unanimous voice vote.

Flanders Ventures, LLC/Tenney Brook Properties, LLC, Owner, Newfield Estates MHP, T-Newfield; Violations of NYS and Tompkins County Sanitary Code (Water and Sewage); Revisions to previous Resolution: 

Mrs. Cameron reported that Mr. Andersson, Consulting Engineer for Newfield Estates MHP, had given Mr. Keith Hoffman, Manager of Newfield Estates MHP, a letter which Mr. Hoffman forgot to mention at last month’s Board of Health meeting asking for some changes in the time frame.  Mrs. Cameron reported these changes are acceptable to her Division.  She also added they are pleased with the work currently in progress.

Dr. Tyler moved to approve the revisions to the previous Resolution, seconded by Dr. Snedeker, and carried unanimously.

Everyone wished Dr. Fox a “Happy Birthday!”     


At 12:50 P.M. Dr. Snedeker moved to adjourn the meeting.  Carried.


Tompkins County Health Department - 55 Brown Road - Ithaca, New York 14850
Brenda Grinnell Crosby - Interim Public Health Director 
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