HomeMy WebLinkAbout06-15-2006 Board of Health MinutesBoard of Heath Minutes
June 15, 2006
Board Members Present: Neal Burnett, Cinde Ebeling, Sidney Ontai
MD, Belinda Pena, Rita Robertson, RN, and Judy Shannon, RN
Others Present: Benny Cantwell, County Commissioner
Staff Members Present: John Castro, Director of Community
Services, Laura Mason, Public Health Nurse, and Jamie Harrington,
Secretary.
Dr. Sidney Ontai called the regularly scheduled meeting of the
Plainview -Hale County Board of Health meeting to order at the
Rocking R Steakhouse on June 15, 2006 at 12:30 p.m.
First Item on Agenda: Invocation, given by John Castro.
Second Item on Agenda: Reappointment of board members and Oath
of Office. Rita Robertson was reappointed to the Board of Health,
and sworn in by Dr. Ontai.
Third Item on Agenda: Approval of April 13th, 2006 minutes. Dr.
Ontai asked if there were any additions or corrections to the
minutes. Seeing none, the minutes were unanimously approved.
Fourth Item on Agenda: Review of Expenditures. The expenditures
for March and April 2006 were reviewed. Dr. Ontai asked if there
were any expenditures that the Board should be aware of. John
Castro informed the Board that everything was normal. Mr. Castro
also noted the addition of the account for Bio -Terrorism. He
pointed out that it is a grant -funded budget that is separate from the
general funds. Neal Burnett moved that the Board approve the
financial reports for March and April 2006. Belinda Pena seconded
the motion. Motion carried.
Fifth Item on Agenda: Update and discuss communicable disease
reports. Laura Mason, LVN reported that there were no
communicable diseases to report, except for the rise in Gonorrhea,
and the presence of Chlamydia. Dr. Ontai
also reported that the Syphilis in St. Louis has gone through the roof
and that Hale County may need to keep an eye on the disease.
Sixth Item on Agenda: Health Department news. Laura Mason
informed the Board that the Health Department shared a booth at
the Senior Citizens Spring Health Fair.
Mrs. Mason also explained to the Board that Merck, a
pharmaceutical company had come to the Heath Department to give
a presentation about the new HPV vaccine. She added that the
vaccine was approved and available for order soon.
Laura Mason stated that Texas Vaccine for Children program has
now added the Menningoccal vaccine to the State supplied
immunizations. Dr. Ontai asked if the doctors could send patients to
receive the vaccine. Mrs. Mason explained that the Health
Department had a limited supply of the vaccine. She speculated that
the State had been hit with a higher demand for the vaccine than
expected, and therefore, the requirements needed to receive the
Menningoccal vaccine and the supply available have changed. Laura
added that it has been very helpful to have the vaccine here in
Plainview, rather than having to refer everyone to Lubbock. Dr.
Ontai asked about possibly having an outreach clinic at Wayland
Baptist University. Laura Mason replied that it might be possible in
the future.
Finally, Mrs. Mason told the Board that the Health Department had
been busy with STD exams and that the Immunizations had died
down until time for school to start. John Castro brought to the
Boards attention that the Heath Department would be closed on
June 201h from 8:00 a.m. until 4:00 p.m., for training on emergency
management systems. Mr. Castro explained that the reason for the
training was to allow the Health Department staff to understand
their role in the event of a major disaster.
John Castro also explained that the Bio Terrorism grant, funded
through a subcontract with Region One, was under review. He
reported that the State was requesting that the City take the grant
on its own rather being a subcontractor. He stated that he was
working with Julie Erving at Grants Management to figure out what
the process is to get our name on the grant, rather than Region One.
John Castro also added that Kelli Shurbet, RN had made the budget
projections for the end of the year, and the budget projections for
the following year.
Additionally, Mr. Castro informed the Board that the air conditioning
at the Health Department had gone out during the first week of
June. He explained that the repair of the unit was the responsibility
of the building owner and not the responsibility of the Health
Department, as agreed upon in the Lease.
Mr. Castro also told the Board that he would like for the Health
Board to go through an Open Meetings training session. He
explained that the training would be one entire meeting and would
have to be held in the Library basement in order to use the
technology available at that location. He added that it would be
beneficial for everyone.
The board then discussed the reverse 911 systems and SPAG. Neal
Burnett asked John Castro if Plainview was connected with Lubbock
in the system. Mr. Castro confirmed that Plainview was indeed
connected with Lubbock. Don Williams stated that all of the rural
areas outside of Plainview would eventually have the capabilities of
reverse 911. Mr. Williams added that Abernathy had been doing
some negotiations with SPAG to get onto the system. Dr. Ontai
asked if by reverse 911 it was meant that when a disaster is
reported, 911 calls all of the people to be directly affected. Benny
Cantwell explained that if there was to be a chemical spill or
disaster, you could go in and specify the area of residents that you
would like to notify. Then the 911 system would automatically start
to call everyone within that area, and would tell them what has
occurred and the necessary actions to take. Mr. Neal Burnett added
that the system would not be all that expensive and that there are
three counties that were going to pilot the system, Hale county not
being one of them.
Seventh Item on Agenda: Discuss the time, place, and meal served
for the Health Board Meeting, The Board decided that the Rocking
R was a suitable place for the next meeting.
Eighth Item on Agenda: Discuss future scientific medical
presentation that the Board would he interested in. Dr. Ontai stated
that there are all kinds of things that the Health Board could get
involved with. He asked if the Board had any kind of preference as
to which topics that they would like to deal with.
Dr. Ontai brought up STD's increase in senior citizens with the
increases use of Viagra. Dr. Ontai added that some of the hot topics
in public health were, childhood obesity, and FDA warnings on the
use of Ritalin in kids. He asked if the use of Ritalin was perhaps a
school district issue or something the board could look at. He
further explained that in his practice he gets referrals from teachers
who have identified students who give them a hard time and pushed
for medication. He explained to the Board that to his knowledge
there had been a law put on the books that teachers, and the school
system, could not push parents to get medication to deal with ADD.
Ms. Rita Robertson added that the way her school treats similar
situations is to discuss the behavior with parents. If they have
additional questions the teacher then refers the parent to the school
nurse. The nurse then gives the parent advice about how to
proceed. Ms. Robertson said that she advises the parents to go to
their family Doctor and talk about what is going on, the behavior at
school and at home. She further tells the parents that there are
many different treatments. Dr. Ontai added that there are many
different types of disease as well. Such things as depression could
also be a factor.
Rita Robertson said that as a school nurse, she could not tell a
parent that their child needed to be medicated for ADD. Dr. Ontai
said that teachers and schools don't want disruptive students. Rita
Robertson added that it is not as much of a disruption to the class,
as it is to the student himself or herself. Ms. Robertson said that it
is a problem when a child misses a dose of Ritalin at school and the
teacher cannot tell the difference, medicated or un -medicated. Dr.
Ontai added that America prescribes Ritalin at least ten times more
often than other countries, and that if you put anyone on Ritalin they
are going to be calmer. The medication is going to work. He said
that the question remains, is medication the best way to go about
helping children, and is it the least harmful way.
John Castro asked if the Texas Department of State Health Services
had any training that school nurses and teachers could take part in
to educate them further on the issue. Mr. Castro suggested that the
Health Department staff look on the Internet for educational tools
that could help serve the school district. Ms. Judy Shannon added
that there are all kinds of things at the service center. She said that
they have meetings all the time on this subject for teachers.
Dr. Ontai said that what filters to him in his practice from patents, is
a push for medication to be prescribed. He added that he cannot
know how the conversation from teacher to parent goes, but he felt
that parents had been pushed toward medication as the solution.
Judy Shannon said that she feels sometimes that the parents already
have the idea of medication in their own mind, and that the parent
may feel that the teacher is insinuating that medication is the
answer. Then the parent takes that as the teacher is telling them
that their child needs to be on medication. Dr. Ontai said that all he
knows is what he gets. He added that most of the time it turns out
to be some disruption in the family setting that has caused the
problem. Dr. Ontai further speculated that sometimes problems
could be because of hearing loss or other medical conditions, and
stressed the importance of looking at all of the possibilities. He
asked that Mr. Castro seek some resource information on the
subject.
Dr. Ontai said that the Board could look into different topics of
discussion and decide if there are any other issues of Health that
affect the City and County that the Board should be looking into. He
added that everyone has their own unique perspective as to which
topics of Health are important. John Castro said that a memo could
be sent out to the Board members with several different issues that
are hot topics, and a blank place for members to add any topics of
interest for discussion. Dr. Ontai said that that would give members
to think of things important to their workplace and community. John
Castro said that upon receipt of the memo it could be decided which
topics to discuss. Dr. Ontai said that the Board could also bring in
their ideas at the next meeting.
Ninth Item on Agenda: Presentation by Dr. Ontai about the Texas
State Health Information Technology Advisory Committee to The
Governor. Dr. Ontai explained to the board that electronic medical
records could be a way to improve medical care, and cut down on
skyrocketing costs. He explained that a committee had been
formed to represent all the different "players" of the topic. Dr.
Ontai said that if there were some automated way to transform
information so that nothing gets lost, duplication of services or tests
could be reduced and therefore could save money. He added that
with a complete medication list on patients there might not be as
many medical disasters from medication interference. Dr. Ontai told
the Board about the 1998 National Institute of Health study that
estimated that between forty and ninety thousand people are killed
in hospitals every year. That is just in hospitals, and does not
include nursing homes or outpatient services. He compared this to
traffic deaths each year, and stated that it is a big problem.
Dr. Ontai shared a draft that the committee had come up with. He
said that with the electronic medical records, patients and insurance
providers could save money by not duplicating services such as CT
scans. He conceded that this would cut down on some of the
revenue of the doctor's offices. Cinde Ebling added that it was an
efficiency thing. Dr. Ontai said that the only people who are
adopting it are the Doctors who just want to help patients. He said
that unfortunately if things do not get paid for they do not get done.
Dr. Ontai shared that he was on the finance committee, and they
were trying to find a way to fund the program.
The question was raised how do you get the people who are going
to benefit from the program, patients and insurance providers, to
see that they will benefit from the program, and get them to then
pay for it. Dr. Ontai then said that if doctors and hospitals were
charged to install and adopt the program, then patients would be
handed the bill from the provider. Dr. Ontai said that an authority in
the health care system of some kind needs to be established.
Dr. Ontai used the example of the first reported cases of Aids in the
United States. He speculated that had a system such as the
proposed, been in place, perhaps Aids could have been detected
five years earlier. Dr. Ontai stressed the importance of putting all
the medical information into some computer system to detect
abnormalities, and having the data easily accessible. He said that
the problem is getting the data in the first place, and having
everyone report in the same format that the computers can read.
Cine Ebeling asked if this program is put in place, is there any plans
to help get it going in rural communities. Dr. Ontai responded that
the committee had considered the rural places, and that they were
well represented in the conferences. Ms. Ebeling compared the
program with cell phones. She said that the phones are in place but
there are still some areas that cell phone signals do not pick up.
She also asked if the committee had taken into consideration that
the people in rural communities might have different perceptions
about the new program. Dr. Ontai confirmed that he had spoken to
the committee about just that. He reported to the committee that in
rural areas, such as Hale County, if a computer is broken it might
take some time before it is either repaired or replaced.
Dr. Ontai asked if the Board had any ideas of how to finance the
system that the committee had not considered that members though
the public could live with. Cinde Ebeling suggested a general tax
entity that was evenly weighted, so that the funding is there as long
as it is distributed ethically and efficiently. Dr. Ontai said that the
committee talked about taxing. He brought the Boards attention the
profit margins of hospitals, and the number of rural hospitals that
have been closed due to lack of funding. Dr. Ontai suggested that
the funding needs to come from the people who were going to
benefit, and the hospitals would not benefit from the system. He
said that patients and Health plans would benefit. Neal Burnett
added that where the people are, the money is as well. He sited the
cell phone program that provides 911 services to cell phones that
are inactive.
Cinde Ebeling also asked with the rapid change of technology, would
the rural communities who may receive help in purchasing the initial
equipment to use in the system, would also be assisted in
purchasing additional upgrades in software and equipment. Dr.
Ontai said that one good thing is that the Texas Medical
Association, which is a pretty political savvy organization, and well
represents rural communities. He said that the Association really
tries to pay attention to rural members. He said they really seem
to care what the rural folks think.
Dr. Ontai concluded that there is some hope, but it seems to be an
uphill battle. Cinde Ebeling brought the Boards attention to the
rural communities need for medical professionals. She stated that
the small towns are wasting away, and the younger generations are
moving on, but the older generations and the land are still here. Ms.
Ebling further stated that the rural individual is just as important as
anyone sitting in the middle of Dallas. She said she loved the
connective-ness and the efficiency that the system may bring, if it
will work.
Laura Mason brought up the example of the Imm -Trac program
that the Health Department works off of that allows children's shot
records to be compiled in a database that is accessible to other
Health Departments and health professionals. Cinde Ebeling agreed
that the Imm-Trac system is great because the records are right
there, but conceded that the kicker was if the records were
accurate. She said that with such transient children, the system was
a great way to track them, with the accuracy in question at times.
Dr. Ontai said that there is not a way for all of the systems to talk to
one another at this time, and getting that underway is in process.
The big question is how to pay for it. Ms. Ebeling asked if the
system was going to be proposed to the public. Dr. Ontai said that
the final draft was due on the Governor's desk sometime in July.
Ms. Ebeling reminded the Board about the Veterans information that
had been taken. She indicated that the public might be
apprehensive about the security of their information. Dr. Ontai said
that a consumer group had been formed, and that they were
spending about ninety percent of their time working on things like
that. Dr. Ontai concluded that if anyone came up with any thoughts
they could e-mail him or John Castro with input.
Dr. Ontai stated that a big issue now is childhood obesity. John
Castro said that he thought a law had been passed about the food
available in schools. Dr. Ontai sited the New England Journal, by
reporting that the magazine suggested banning all advertising of
junk food to children. Benny Cantwell reminded the Board of a time
when all snacks containing sugar except for chocolate were banned
from schools. Cinde Ebeling said that it was a marketing thing and
that lobbyist were what it boils down to. Ms. Ebeling said that some
teachers and students suffered from the ban because teachers used
marshmallows when studding molecular structure in chemistry.
Cinde Ebeling said that there had been some improvement here in
Plainview, in the dietary options provided to students. Rita
Robertson reported that the PTA candy stores were no longer
allowed. Ms. Robertson said that it was a dental issue as well as an
obesity issue. Cinde Ebeling suggested that as an area, education
should be provided to parents about nutrition, and sugar -laden
drinks in bottles. She asked if an impact with the doctors in the
area could be done to promote nutrition.
Seeing the interest in the subject, Dr. Ontai said it sounds like
childhood obesity should be an agenda item for the next meeting.
John Castro said that an educational program in place may help but
people will continue to argue that the healthier options are more
expensive and less appealing to children. Cinde Ebeling said that it
becomes a parenting issue. As a parent they can choose to enforce
good eating habits, or give in and allow poor habits to avoid an
argument. She posed the question, who is controlling the
household, the infant or the parents? John Castro said that if Public
Health started campaigns against some products, it could cause
problems. Dr. Ontai said that it should be a positive push. He
suggested getting with the pickle manufacture's and the produce
departments, and be positive, and let them push the products. He
also suggested getting with the skating rink, golf courses, and the
YMCA to promote health. Rita Robertson said that places such as
Mc Donald's, put healthy foods such as salads, on their menu, but do
not put them at a price range suitable to most people.
Tenth Item on Agenda: Adjourn. Dr. Ontai adjourned the June
meeting of the Board of Health.
Secretary