Board of Health Meeting Minutes
August 6, 2009
The meeting of the Board of Health was called to order by Chair Bill Hance at 4:00 p.m. in room 212 of the Lentz Public Health Center.
Present
Bill Hance, JD, Chair
Ruth Stewart, MD, Vice Chair
Samuel Okpaku, MD, PhD, Secretary
Henry Foster, MD
Sam Felker, JD
Carol Etherington, MSN, RN, FAAN
Keri Fowler, JD, Metro Legal
Stan Romine
Rob Raney
Mr. Hance welcomed and introduced Carol Etherington, RN, who was recently appointed by Mayor Karl Dean to replace Janie Parmley, R.N. Ms. Etherington currently serves as the Director of Global Health Studies at Vanderbilt and Assistant Professor of Nursing at Vanderbilt University School of Nursing. She has received many prestigious awards for her years of local, national and international health service including the Florence Nightingale Medal from the International Red Cross and the Clara Barton Award from the American Red Cross. Ms. Etherington served nearly 30 years with the International Medical Humanitarian Aid agency known as Doctors Without Borders.
Director’s Order O-09-002
Rob Raney, Pollution Control Division (PCD) Director, presented a brief timeline of events leading to the Director’s Order O-09-002 to Home Depot, Hermitage.
The Pollution Control Division (PCD) sent the respondent an invoice for the fees incurred during 2008 with required forms for the gasoline thruput report and a reminder that the fee and report were due March 31, 2009.
The PCD issued a Notice of Violation to respondent for failure to submit the gasoline thruput report and annual emission fee in a timely fashion. A new invoice for the fee and penalty were included with notice, and the respondent was notified that the report and fees were due April 30, 2009.
The PCD received the report and the fee May 28, 2009, but despite reminders and calls, the PCD did not receive a counter-proposal or the signed copies of the Consent Agreement.
PCD issued Director’s Order O-09-002 to Home Depot assessing a civil penalty of $500.
On July 8, 2009 the PCD received a letter from Home Depot indicating that the company would not appeal the Order but would appreciate any reduction to the penalty granted by the Board.
In order to resolve this violation, Mr. Raney recommended that the Board approve Director’s Order O-09-002 for Home Depot with a $500 civil penalty.
Dr. Stewart made a motion to approve Director’s Order O-09-002 to Home Depot. Dr. Okpaku seconded the motion. The motion passed unanimously.
Approval of Red Flag Rules Compliance Policy
Stan Romine explained that the Red Flag Rules are implemented for the purpose of reducing the likelihood of identity theft. The Federal Trade Commission requires agencies that establish accounts for patients to have rules and procedures in place. The implementation date is November 1, 2009. Mr. Romine stated that MPHD clients are at a low risk for identity theft. He asked the Board to approve the Red Flag Rules Compliance Policy.
Dr. Foster made a motion to approve the MPHD Red Flag Rules Compliance Policy. Mr. Felker seconded the motion. The motion passed unanimously.
Approval of Grants/Contracts
Stan Romine referred to the Grants/Contracts Summary which was submitted to Board members for their review. The grants and contracts were as follows:
- Grant Award from the State of Tennessee, Department of Health. Compensation: $815,200
- Grant Award from the State of Tennessee, Department of Finance and Administration, Governor’s Office of Children’s Care Coordination. Compensation: $201,961
- Grant Award from the State of Tennessee, Department of Finance and Administration, Governor’s Office of Children’s Care Coordination. Compensation: $170,636
- Grant Award from the State of Tennessee, Department of Health. Compensation: $659,700
- Contract with Second Harvest Food Bank of Middle Tennessee. Compensation: $125,000
Dr. Stewart made a motion to approve the Grants/Contracts. Dr. Foster seconded the motion. The motion passed unanimously.
Report of Chair
Mr. Hance stated there would be a reception held in honor of Janie Parmley at 3:00 p.m. on Thursday, September 3, 2009. He asked that the reception be held in Room 212 instead of the Lentz Auditorium.
Approval of July 9, 2009 Minutes
Dr. Foster made a motion to approve the July 9, 2009 minutes as written. Mr. Felker seconded the motion. The motion passed unanimously.
Report of Director
Copies of the Director’s update were provided to Board members. Dr. Paul gave a brief summary of this report (Attachment I).
Dr. Paul noted that Sarah Vaughn, RD, LDN, of MPHD’s Civil Service/Employee Wellness division was featured on the cover of the Summer 2009 issue of the ADA Times, a publication for members of the American Dietetic Association. The article in which she was featured highlighted the work she and the Employee Wellness division have accomplished with the Nashville Fire Department/Metro Nashville Police Department Wellness Initiative.
Dr. Paul also noted that Tracy Buck was invited and recently presented the Board of Health’s work regarding Menu Labeling at the Centers for Disease Control’s Conference, The Weight of the Nation, which addresses obesity, healthy eating, and active living. Tracy Buck is director of MPHD’s Health Promotion Division.
CIVIL SERVICE BOARD
Public Hearing of Proposed Civil Service Rule Changes
Mr. Hance called the hearing to order at 4:30.
There were no employees or outside parties asking to be heard.
Leslie Robeson invited questions from the Board. She stated that the purpose of the proposed changes was to bring MPHD into closer alignment with Metro’s Civil Service Rules.
Mr. Felker made a motion to approve the proposed changes to the Civil Service Rules. Dr. Okpaku seconded the motion. The motion passed unanimously.
Personnel Changes and Exit Interviews
Personnel changes and exit interviews were unremarkable.
Next Meeting
The next meeting of the Board of Health will be held at 4:00 p.m. on Thursday, September 3, 2009 in room 212 of the Lentz Public Health Center.
The meeting adjourned at 4:45 p.m.
Respectfully submitted,
William N. Hance, JD
Chair
ATTACHMENT I
Director’s Update to the Board of Health
August 6, 2009
Prevent, detect, and alleviate outbreaks and emergencies
We are preparing significant updates in information on H1N1 influenza to be posted on the MPHD Website. We are planning for seasonal flu vaccine campaign as well as likely H1N1 vaccine campaign. Meetings are being held with Metro School officials and other partners to provide information and guidance on dealing with H1N1 during the upcoming flu season.
Sexually Transmitted Diseases
The number of inmates testing in the jail continues to grow.
To date, in the CJC, 128 HIV tests and 140 syphilis tests have been done: 53 white, 103 A/A, 15 Hispanic, 1 A. Indian.
On August 6, testing will expand to the Hill Detention Center.
On September 1, testing will expand to the CDC-Female facility.
The second Early Intervention Services position is up and running. This position will spend at least 50% of the time in the jail system, assessing HIV positive inmates, and linking them to care while in jail and upon release.
Reduce tobacco use and increase physical activity and healthy eating in Nashville
Menu Labeling
Tennessee House Bill 950 (introduced by Representative Susan Lynn) and Senate Bill 1092 (introduced by Senator Paul Stanley) would prohibit any county or metropolitan board of health from enacting an ordinance or regulation pertaining to food nutritional information at food service establishments. The Tennessee General Assembly passed these measures. Governor Bredesen vetoed the legislation. The Tennessee General Assembly could override the Governor’s veto when it reconvenes in 2010. Unless and until there is an override, the menu labeling regulation passed by you, the Board of Health, stands and plans are underway to implement the regulation on March 31, 2010. Sponsors of the preemption ordinance pending in the Metro Council have indicated they will not move that measure forward before the General Assembly reconvenes in January.
We will inform you if there are any changes. Should the Metro Council decide to undertake this issue, we would recommend a formal resolution by the Board that summarizes and communicates your findings and recommendations to the Metro Council.
At this time we understand that Federal menu labeling legislation is moving forward, which is very similar to the regulation this board passed. The Tennessee Menu Labeling Coalition, of which MPHD is a member, has officially endorsed the Federal legislation. Included on the attached sheet are some talking points issued by the Coalition regarding the Federal legislation.
Improve access for everyone to needed preventive, medical, and mental health services
Immunizations
The Back to school fast track clinic will be August 7 and August 10-14 in the Lentz auditorium from 8 until 3. Immunizations are free to Davidson County residents. Parents are asked to bring shot records with them.
Ryan White HIV/AIDS Program
The Ryan White HIV/AIDS Community Planning Council completed its yearly responsibility of determining what services and how much funding each service will get for the upcoming grant year. The Council utilized information gained from the yearly needs assessment to make their decisions on how to allocate $3,575,364. Services are available for persons who are HIV+, low income and do not have other resources to pay for care. Allocation decisions were as follows:
- The largest allocation went to HIV outpatient medical care and HIV meds (38%).
- Twenty-four percent (24%) went to Medical Case Management which is targeted toward helping people engage in medical care and adhere to their course of treatment, as well as connecting them to other needed services.
- Oral health services received 12.7% of funds.
- Services to work with newly diagnosed persons and those who have dropped out of HIV medical care received 10.8% of funds.
- Eleven percent (11%) of funds were allocated for outpatient mental health services and outpatient substance abuse services, two of the most common reasons why people are unable to effectively engage in HIV medical care or adhere to treatment.
- Food, transportation, translation, short term housing and utility assistance received 4% of the funds.
Additional funds were added to mental health this year to fund a pilot project which in addition to providing care, is designed to increase collaboration between the HIV and mental health systems and help to better define the mental health needs of persons living with a serious chronic disease.
Health Care Access: Bridges to Care
Bridges to Care began linking the uninsured to primary health care through its new website on July 1. It has been successful. As of July 27, 772 new uninsured persons have been linked to care. During this same period in
2008, the number linked to care was 266.
Management and Accountability
On July 15, 2009, the first meeting of the Metro Animal Care and Control Advisory Council convened at the invitation of the Director of Health. The twelve member Advisory Council will meet quarterly to gain awareness, provide advice, and become a voice within the community to share information about issues related to animals. Members of the group voiced appreciation for the opportunity to serve the community in this capacity.
House Health Reform Talking Points
Tennessee Menu Labeling Coalition
- As you know, high rates of obesity, heart disease, diabetes, and other chronic diseases are some of the biggest drivers of high health care costs.
- For example, obesity costs American families, businesses, and governments more than $79 billion a year in health care costs, half of which is paid through Medicare and Medicaid.
- Enactment of the prevention section of the bill would ensure that health reform helps to protect Americans' health and prevent debilitating diseases, which drive up health care costs.
- One example of an effective, no-cost prevention strategy included in the bill is menu labeling. Requiring calorie disclosures on chain restaurant menus supports healthy eating and allows people to make informed decisions about their own health and watch their weight.
- A Los Angeles study estimated that menu labeling could avert about 1/3rd of the 6.75 million pounds Americans gain on average each year.
- In New York City, where menu labeling has been in effect since last summer, 82% of residents say menu labeling has changed the way they order.