Cirque Meadows by Adam Johnson




The Larimer County Board of Health (BOH) convened its regular meeting at 7:00 PM at the Larimer County Department of Health and Environment (LCDHE), 1525 Blue Spruce Drive, Fort Collins, CO.


           MEMBERS PRESENT:                                   N. Mark Richards, M.D., M.P.H.

                                                                                    Lee Thielen, M.P.A.

                                                                                    C.J. McKinney, M.A.


      Executive Secretary:                                       Adrienne LeBailly, M.D., M.P.H.

Staff:                                                                Avie Strand, Jerry Blehm, Ed Schemm, Susanne Murray, Kim Meyer-Lee, Bruce Peters and Amanda Mozer


          Citizen:                                                             Emily Saven, M.P.H. student


 1.    Call to order

            The Board of Health meeting was called to order at 7:00 PM.


2.     Approval of the February 10, 2011 Board of Health meeting minutes  

The minutes of the February 10, 2011 meeting were unanimously approved.


3.   Presentation of Communicable/Reportable Diseases control – Kim Meyer-Lee and Susanne Murray

Ø Susanne Murray, Public Health Nurse, and Kim Meyer-Lee, Environmental Health Epidemiologist, gave presentation on LCDHE’s Communicable Disease reporting, surveillance, investigation, and control measures.


·  Communicable Disease Reporting

-  Colorado (CO) law gives local and state health depts. the authority to collect information and control certain diseases

-  Ms. Meyer-Lee distributed “CO BOH Conditions Reportable by All Physicians and Health Care Providers” and “CO BOH Conditions Reportable by All Laboratories” listing diseases or lab results which must be reported by law

-  CO BOH Rules and Regulations permit public health to access medical records without patient consent and can release information to the extent necessary if they are doing an investigation or intervention. LCDHE releases information in a way so that patients are not identified

-  LCDHE receives most of its reports from laboratories and hospital infection preventionists

-  Reportable diseases are entered into CEDRS, an electronic disease reporting system. State and local health have access to CEDRS and can see cases as soon as they’re entered


·  Communicable Disease Surveillance

-  Involves collecting, analyzing, interpreting and disseminating disease data

-  Surveillance can be used to follow trends in incidents and distribution, estimate the size of health problems, determine priorities and assess effectiveness of regulations and interventions



·  Communicable Disease Investigation and Control

-  Involves monitoring disease reports to see if there are more cases, investigating cases to discover links between cases, and educating those who are ill and those who are at risk of becoming ill

-  LCDHE has communicable disease specialists, a Communicable Disease Team, program specialists and State Health as resources during a case outbreak and investigation

-  LCDHE works on outbreaks in long-term care settings (mostly for norovirus and influenza viruses) and developed a long-term care health and safety network to facilitate communication between long-term care and hospital settings

-  Ms. Murray distributed and explained a summary of Larimer County’s response to the meningococcal disease outbreak that began in June 2010 to BOH

o In a three week time frame in June 2010 approximately 280 hours of nursing time, 90 hours of Public Information Officer’s time and 80 hours of Public Health Director’s time was needed for follow-up

-  Larimer County has approximately nine cases of active Tuberculosis (TB) cases, including two cases that are resistant to or can not tolerate at least one medication

o A typical case of TB is misdiagnosed for and average of 6 months


4.   Report from Colorado Association of Local Boards Of Health (CALBOH) meeting

Ø  Lee Thielen provided a report on CALBOH to BOH

·  CALBOH is the state affiliate for National Association of Local Boards of Health (NALBOH) and its primary function is to provide and share public health information and education

·  CALBOH meets twice a year. It met with Colorado Counties Inc.(CCI)  in November 2010 in Colorado Springs and will meet again in June 2011 in Vail

·  June 2011 CALBOH meeting will have a lot of public health education and discussion available as part of CCI’s public health track

·  November CALBOH meeting had a presentation on Emergency Preparedness and there was discussion around Public Health Ready and how funding should be available to prepare for public health agency accreditation


5.   Election of officers for 2011 – Board Members

Ø  Dr. Richards was nominated as BOH President for a second term and C.J. McKinney was nominated as BOH Vice President

·  Dr. Richards will not be present at April BOH meeting and Mr. McKinney will run meeting


6.   Legislative Update – Dr. LeBailly

Ø  Federal legislation update

·  Dr. LeBailly distributed “Public Health Funding in Final Health Reform Bill” document to BOH

·  Dr. LeBailly is concerned at the federal level as there are proposals that are devastating to public health programs. She has participated in public health conference  calls on federal legislation discussing how important it is to convey to Congress that we can’t be giving up so many public health protections

·  Dr. Richards will draft a letter for BOH on behalf of the public health and prevention fund including what programs need to be maintained and impacts it could have locally and statewide

·  Dr. LeBailly will provide Dr. Richards with talking points for draft letter


Ø  State legislation update

·  Dr. LeBailly provided distributed the  Coalition for Activity and Nutrition to Defeat Obesity’s (CanDo) “Physical Education in the Poudre School District (PSD) Update February 2011” document to BOH.  in 2010 BOH encouraged PSD to think about PE as an important piece of their 2010 mill levy

o  The public and the Board of Education included PE as one of their top priorities for the use of mill levy funds

o  Some principals have decided to reduce PE, as the district has school-based decision making

o  PSD received $880,000 in grant dollars over three years from the Colorado Health Foundation to enhance and improve their PE

·  There is a bill to make electronic cigarettes (electronic devices that vaporize nicotine) equivalent to tobacco in terms of youth access and use

·  The revisions to the state laws regarding on-site wastewater treatment systems has run into opposition from agricultural interests, and may be postponed until next year

·  Medical marijuana ingestible products bill has been modified and such products will likely still be available

·  State will declare another fiscal emergency to use Amendment 35 dollars to meet budget deficit


7.   Director’s Report – Dr. LeBailly

Ø  Dr. LeBailly distributed and discussed CSU meningococcal disease mass vaccination clinics survey results summary, including 20 pages of client comments, to BOH

  • LCDHE surveyed people who were invited to or who were vaccinated at the Larimer County Meningococcal clinics
  • Dr. LeBailly shared survey with CSU and LCDHE staff and will share with State and Health District of Northern Larimer County (HDNLC)
  • Direct cost estimate of LCDHE staff time and materials for two meningococcal clinics was approx. $45,000. Rough estimate cost for all of the volunteers at clinics was approx. $100-150,000, cost estimate for HDNLC efforts was approx. $25,000-30,000 and vaccine cost approx. $1.1 million
  • Larimer County has not had any additional cases of meningococcal disease among students since the case they had in December 2010


Ø  Dr. LeBailly updated BOH on LCDHE’s efforts to develop program performance measurements

·  Dr. LeBailly and Marie Macpherson, Director of Administrative Services, provided a training session for LCDHE staff on developing performance indicators and asked staff to develop an input, output, outcome, satisfaction and efficiency measure

·  By 3/31/11 each LCDHE program needs to come up with at least one performance measure in the above 5 categories for the program to be measured by


Ø  Nomination deadline for the Joseph Jabaily Public Health Hero Award is March 31, 2011

  • Award was created in remembrance and recognition of Dr. Joe Jabaily
  • Nominations have been solicited. Board members may want to encourage others to submit nominations

Ø  2011 version of County Health Rankings will be released March 30, 2011

  • Is a Robert Wood Johnson Foundation effort where all counties are ranked within their State by two broad categories: 1) health outcomes and 2) health risk factors
  • Larimer County ranked 8th in both categories in 2010
  • Dr. LeBailly will send 2011 County Health Rankings to BOH when they come out


Ø  Dr. LeBailly updated BOH on her attendance at the National Academy of Sciences Institute of Medicine meeting that discussed “For the Public’s Health: The Roles of Measurement in Action and Accountability” report on 2/17/11 in Washington, D.C.

  • Committee looked at how to measure and assure accountability in public health. One of their recommendations was to agree on a small number of health indicators for every jurisdiction to address.
  • Committee chairman presented on Institute of Medicine’s (IOM) framework for measurement and accountability and Dr. LeBailly distributed and discussed presentation slides and IOM’s 2003 and 2010-2011 drawing of their vision of the public health system, it’s components and how it all works together to ensure the conditions of populations’ health

- Dr. LeBailly created her revised version of IOM’s 2010-2011 model and shared it with BOH


Ø  Dr. LeBailly updated BOH on LCDHE’s Joint Planning meeting with HDNLC and PVHS

  • Topics discussed were PE in the school systems and Community Transformation Grants
  • Future discussion topic is LCDHE’s effort to do a community health assessment and opportunities to partner with other agencies’ efforts such as HDNLC’s Community Survey. The Department of Human Services, Larimer County hospitals and community health clinics also need to do a community health or community needs assessment, and it would save resources to try to do them together.

Ø  Larimer County is considering moving to a four day work week

  • This would save $225,000 in the county budget
  • Employees may have the choice to either work 4, 10 hour days or 4 8-hour days and telecommute the 5th day, if it’s possible for that employee’s position
  • County would have to be off a Monday or a Friday in order to achieve cost savings from heating and cooling the buildings    
  • Dr. LeBailly is concerned how this will affect LCDHE’s services to the public, access to treatment, medications, services, death certificates, communicable disease follow-up, etc.  Delays in receiving certain services can lead to significant negative public health effects.


8.    Next meeting, April 14, 2011

9.    Adjourn






_______________________________                 ____________________________________

Amanda Mozer, Recording Secretary                    Adrienne LeBailly, MD, Executive Secretary

Background Image: Cirque Meadows by Adam Johnson. All rights reserved.