DeKalb Times

DeKalb County Board of Health met Sept. 27.

Here is the minutes provided by the board:

BOARD OF HEALTH MEMBERS PRESENT 

Derryl Block, RN, PhD, President

Rukisha Crawford

Lorraine Daly

Erik Englehart, MD, Vice President

Patricia Faivre

Lizy Garcia, Secretary

Paul Stromborg, MD

Anita Zurbrugg

BOARD OF HEALTH MEMBERS ABSENT 

Kellen Bosma, DMD

Carlos Dominguez, DVM

Jill Olson

STAFF MEMBERS PRESENT 

Melissa Edwards, MPH, Director of Emergency Preparedness and Health Promotion 

Lisa Gonzalez, MPH, Public Health Administrator 

Erin Frye, MPH, Administrative Support and Marketing Manager 

Greg Maurice, LEHP, Director of Health Protection 

Adriana Milan, MPA, Director of Administrative Services 

CALL TO ORDER 

The DeKalb County Board of Health meeting was called to order at 6:02 pm by Dr. Block, President. Lisa Gonzalez introduced Melissa Edwards as the new Director of Health Promotion and Emergency Preparedness to the Board of Health. Mrs. Gonzalez provided an overview of virtual meeting guidelines.

AGENDA 

On a motion by Ms. Zurbrugg, seconded by Ms. Crawford, the Board of Health Meeting Agenda of September 27th, 2022 was approved. Motion carried.

APPROVAL OF MINUTES 

Full Board 

On a motion by Dr. Englehart, seconded by Ms. Daly, the Board of Health Meeting Minutes for July 26, 2022 were approved. Motion carried.

Finance Committee 

On a motion by Dr. Stromborg, seconded by Ms. Zurbrugg, the Finance Committee Meeting Minutes for September 21, 2022 were approved. Motion carried.

COMMITTEE REPORTS 

Mrs. Gonzalez shared the Personnel Committee will present their report during Executive Session. PERSONS TO BE HEARD FROM THE FLOOR 

None

PRESENTATION 

1. Animal Control 

As part of the ongoing process of Board of Health education on Health Department programs, Greg Maurice provided an informational presentation on Animal Control. He shared the Animal Control program consists of two Animal Control Wardens who are on-call 24/7 every other week. He explained there are contractual arrangements for the Animal Control Administrator, a veterinarian, and for boarding strays and basic vet care.

Mr. Maurice explained the Animal Control Program consists of rabies control through vaccination, patrol, education, bite report follow-up, and warnings, fines and impoundments.

Mr. Maurice shared the Animal Control in DeKalb County is unique in that it is part of the Health Department. He explained most Animal Control departments are standalone or part of the sheriff’s office. He shared most municipalities hold dogs for three days and then turn them over to Animal Control to hold until it can be released for adoption.

Mr. Maurice explained stray control and compliance includes rabies control through vaccination, surveillance, bite quarantine and testing. He shared equipment and techniques used for stray dog control are situational and depend on factors such as whether or not the dog is a threat to the public, the level of threat to the dog, and surroundings. Mr. Maurice explained the situation may require use of a pole, monitoring, trapping, or tranquilizing the animal. He shared approximately 175 animals are impounded through the Animal Control program annually.

Mr. Maurice stated Animal Control assumes temporary custody of animals while other arrangements are made by owners due to accidents, arrests, medical events, evictions, and other unexpected circumstances.

Mr. Maurice explained approximately 60 rabies bat specimens are submitted annually for testing. He stated there have been two rabies-positive bats so far in 2022. He shared Animal Control is often called to remove bats from homes as they are able to enter easily through small spaces.

Mr. Maurice emphasized Animal Control only deals with wildlife that is sick or injured. He explained Animal Control will recommend a wildlife removal service in the case that healthy wildlife needs to be relocated.

Mr. Maurice shared Animal Control is contacted whenever an animal bites a human. He shared typically an immediate care facility or an emergency room will be the notifiers of a bite and that over 200 animal bites are investigated annually.

Mr. Maurice stated animal owners are required to provide shelter, food, water and veterinary care to their animals. He explained cruel treatment is determined by condition of the animal, how long the conditions have occurred, intentionality, and attitude or demeaner of the responsible party. He further explained the willingness to correct the problem versus denial of the problem impacts determination of cruel treatment.

Mr. Maurice explained Animal Control assists Municipal police agencies with criminal cases such as animal cruelty. He shared many of the cases require dogs to be held for an extended period of time which can be stressful for the dogs and is expensive. He stated medical care may also need to be given while the dog is in custody of Animal Control. Mr. Maurice emphasized Animal Control does not receive funding from Municipalities or restitution from the Court system to cover these expenses.

2. COVID-19 Situational Update 

Mrs. Gonzalez provided a COVID-19 Situational Update to the Board of Health. She shared DeKalb County is currently at a low CDC community risk level. Mrs. Gonzalez provided an overview of COVID-19 executive orders and guidance. She explained the Illinois Executive Orders were reissued on September 16th, 2022 and are effective for 30 days. She shared the amendments resulted in discontinuation of vaccine mandates for higher education employees and students and emergency medical service providers but vaccine mandates will remain in place in K-12 schools, daycares, state-run 24/7 congregate care facilities, and any health care facilities not covered under the federal CMS. Furthermore, Mrs. Gonzalez shared required screening testing for unvaccinated staff will be directly tied to the CDC community transmission levels of COVID-19.

Mrs. Gonzalez shared COVID-19 outbreak activity in July and August 2022. She shared in July there were twelve long-term care facilities and group home outbreaks totaling 100 cases. She shared in August there were twelve long-term care facilities and group home outbreaks totaling 77 cases and one school outbreak totaling 4 cases.

Mrs. Gonzalez shared the Health Department has continued administering COVID-19 vaccinations. She explained 412 vaccinations were administered in July and August combined. Mrs. Gonzalez shared beginning Monday, September 12th, 2022 the Health Department began to offer Bivalent Booster COVID-19 vaccines for those ages 12 and older.

Mrs. Gonzalez described the current CDC recommendations; COVID-19 vaccines are recommended for everyone ages 6 months and older, and boosters for everyone ages 5 years and older, if eligible.

Mrs. Gonzalez shared the COVID-19 After Action Report (AAR) was drafted and is in review. She explained the AAR will align with PHEP domains and capabilities to serve as a record of observations, gaps, strengths, and opportunities for improvements as it relates to the Health Department COVID-19 response from the operational period of February 2020 through June 2022.

Mrs. Gonzalez explained the Health Department has been collaborating with Mier Group Consultants to ensure a comprehensive AAR process is completed using COVID Crisis grant funding. She shared the Mier Group has conducted focus group interviews and released an online survey in order to best collect AAR information. Mrs. Gonzalez clarified the AAR draft report is in review to ensure strengths and opportunities for improvement are captured.

COMBINED REPORT 

Mrs. Gonzalez shared if there were any questions regarding the combined report to reach out. FINANCIAL DATA 

On a motion by Ms. Crawford, seconded by Mrs. Faivre, the Financial Statements for the months of July and August 2022 were approved. Motion carried.

On a motion by Ms. Zurbrugg, seconded by Ms. Daly, the Claims for the months of August and September 2022 were approved. Motion carried.

OLD BUSINESS 

NEW BUSINESS 

1. 2023 Health Department Budget

Mrs. Gonzalez provided an overview of the Health Department Budget including the 2022 Approved Budget Compared to 2022 Projected, FY2023 Budget compared to FY2022 Projected, and 2023 Public Health Budget & Fund Balance update.

In reviewing the 2022 end of year projections versus the 2022 Budget for revenues, Mrs. Gonzalez explained the projected increase in the Environmental Health Fees category is due to a projected increase in Animal Control revenue due to rabies tags issued for cats beginning in January 2020. She explained the projected increase in the Grants category is up by approximately $600,000 due to unanticipated COVID-19 grant funds. She shared the projected decrease in the Medicaid category is due to a decrease in immunizations which may be due to COVID-19 related impacts. Mrs. Gonzalez explained the projected decrease in the Fees category is due to impacts of decreased private pay revenue which also may be due to COVID-19 related impacts. She stated the projected decrease in the County Transfers category is due to awardment of the Federal Navigator Grant to the Health Department. She explained this allowed the DeKalb County Mental Health Board to redistribute funds previously given to the Health Department to other community partners in need.

In reviewing the 2022 approved Budget versus the 2022 projected budget for expenditures, Mrs. Gonzalez shared the increase in the Salary/Benefits category was due to staffing for COVID-19 mitigation efforts. She explained the increase in the Capital category was due to COVID-19 grants covering the purchase of new equipment. Mrs. Gonzalez shared the increase in the Commodities category was due to COVID-19 expenses and Federal Navigator grant promotional efforts.

In reviewing the 2022 end of year projections versus the 2022 Budget, Mrs. Gonzalez shared an expected end of year surplus in the amount of $50,950 compared to the budgeted shortfall of $344,180. Mrs. Gonzalez explained since the original 2022 Budget was adopted, the Health Department has projected greater than budgeted revenues in the amount of $793,880 and greater than budgeted expenses in the amount of $398,750 for a projected surplus of $50,950. This projected decrease in fund balance utilization in 2022 is primarily due to increases in grant funding related to COVID-19 and greater than budgeted revenue in the Animal Control Program.

Patricia Faivre asked Mrs. Gonzalez if she anticipated the Inflation Reduction Act to assist the Health Department’s financial standing. Mrs. Gonzalez replied not at this time. She shared there is potential future CDC funding to support Public Health and Public Health infrastructure that she will be pursuing if and when it becomes available.

In reviewing the 2022 end of year projections to the 2023 Budget for revenues, Mrs. Gonzalez explained the increase in the Environmental Health Fees category is due a proposed increase in fees. She shared the decrease in the Grants category is due to an anticipated decrease in COVID 19 funding. Mrs. Gonzalez explained level amounts in the Medicaid category is due to uncertainty surrounding the long-term impacts of COVID-19 on this category. She shared the decrease in the County Transfers is due to expected reduction in County support for FICA and IRMF.

In reviewing the 2022 end of year projections to the 2023 Budget for expenditures, Mrs. Gonzalez shared a decrease in the Salary/Benefits category is due primarily to the decrease in COVID-19 staffing. She explained the decrease in the Capital and Commodities categories are due to an anticipated decrease COVID-19 funding.

In reviewing the 2022 end of year projections to the 2023 Budget, Mrs. Gonzalez shared the 2023 budgeted revenue is down by $526,145 from the 2022 projected amount. She explained this is primarily due to the anticipated end of COVID-19 grants. Mrs. Gonzalez stated the 2023 budgeted expenditures are down by $336,975 from the 2022 projected amount. She explained the expenditures account for a 2.25% salary adjustment and reduced employer contribution to the Illinois Municipal Retirement Fund (IMRF) from 7.49% to 5.76%.

Mrs. Gonzalez presented the proposed 2023 Health Department Budget. She explained the 2023 budgeted revenue sources, not including the public building, include property taxes at 11.5%, grants at 48.7%, fees at 30.1%, other county transfers at 8.5%, and miscellaneous and interest at less than 1% each. Mrs. Gonzalez emphasized between the property tax and contributions from the general fund for FICA and IMRF, the County is expected to provide 19.6% of the Health Departments 2023 budgeted revenue. She explained the 2023 budgeted expenditure sources include salaries and benefits at 81.4%, capital at less than 1%, and commodities and services at 18.5%.

Mrs. Gonzalez explained the 2023 Budget includes an approximate 2% increase in Environmental Fees revenue, a projected 2.25% salary adjustment, benefits estimates, level rates for health insurance, full-time employee changes which provide an additional Public Health RN to support communicable disease functions and move an Environmental Health Practitioner to an Environmental Health Coordinator position, and the County Requests, as proposed.

Mrs. Gonzalez explained the Environmental Fee increases in further detail. She shared the proposed adjustment of fees in Food Sanitation and Potable Water categories of the DeKalb County Health Department Fee Schedule. She shared the overall impact of the 2% fee increase would be approximately $10,000 in increased revenue. Mrs. Gonzalez explained part of the justification for the 2% increase includes a preference for smaller increases by restaurant owners.

Ms. Zurbrugg asked if the increase is something we would consider doing every year for sustainability’s sake. Mrs. Gonzalez shared that the increase has not been done in several years and that she does not anticipate doing an increase annually at this time. She shared this is due to an analysis to determine if the costs of the program are covered and that the most recent analysis shows the 2% fees increase should cover the cost for at two years.

Mr. Maurice added the increase was also determined by comparing the fees of neighboring counties’ health departments for similar services. He shared the proposed added non-community fee is meant to support the program as the reimbursement from the State via a pass-through federal grant is minimal. He explained the program only receives reimbursement of $12.50 for each non community inspection which take a significant amount of paperwork and time.

Ms. Crawford asked for an example of a non-community water sample. Mr. Maurice explained a non-community water sample is from a private well that serves places like businesses, schools, or churches as opposed to a home and the Health Department is required to ensure the water is safe to drink. He further explained in non-community inspections, there are not enough connections to be determined as a community water supply which would be managed by the IEPA.

Mrs. Gonzalez reviewed the overall Budget Summary including a budgeted utilization of $139,220 of our Fund Balance reserves in 2023. Mrs. Gonzalez reviewed a three-year summary of County support funding from 2021-2023. Mrs. Gonzalez shared the Health Department submitted County requests for special projects including new carpeting, security access enhancements and parking lot re-striping.

Mrs. Gonzalez provided an update on the status of the Fund Balance. She explained the restricted fund balance consists of cash flow at the amount of three (3) months of operating estimates, accrued time off, $200,000 for an extreme event, and $100,000 for stabilization of lost revenue. She shared the total restricted fund balance is $1,285,575. She stated the remaining “available” fund balance is $1,260,518.

On a motion by Dr. Stromborg, seconded by Ms. Zurbrugg, the 2023 Health Department Budget was approved. Motion carried.

2. 2023 Solid Waste Budget

Mrs. Gonzalez explained the revenue and expenditures in the proposed 2023 Solid Waste Program Budget. She shared revenue in the budget primarily includes $25,000 contributed from Waste Management for the Household Hazardous Waste Events and $165,000 contributed from the Landfill Host Benefit Funding, an increase recognizing the loss in allocation instituted in 2018.

Under expenditures, Mrs. Gonzalez provided an overview of personnel costs associated with the Solid Waste Program including the salary and fringe for 1 FTE Solid Waste Specialist and 0.10 FTE of the Director of Health Protection. She also provided an overview of expenditures budgeted including Public Notices at $25,000 for promotion of household hazardous waste and electronic recycling events, Educational Supplies at $6,000 for outreach materials to promote recycling in multi-unit housing and Commercial Services at $55,500 for the electronic waste and household hazardous waste events and rural recycling sites.

Mrs. Gonzalez shared a three-year summary of Fund Balance from 2021-2023 for the Solid Waste Program. She explained in 2021 and 2022 funds were added to the Fund Balance and the addition of funds is expected to continue with the 2023 proposed FY 2023 Solid Waste Budget. Mrs. Gonzalez explained the program would not be expected to use the Fund Balance unless there was a need in the community for additional recycling events. Mrs. Gonzalez shared the Solid Waste Fund Balance is estimated to be $281,267 at the end of December 2023.

On a motion by Dr. Stromborg, seconded by Ms. Crawford, the 2023 Solid Waste Budget was approved. Motion carried.

3. Proposed Revisions to Select Job Classifications

a. Public Health Program Coordinator

Mrs. Gonzalez proposed revisions to the Public Health Coordinator Job Classification. She proposed the addition of a Heath Protection Coordinator position. Mrs. Gonzalez shared the proposed addendum which includes, but is not limited to, the proposed coordinator assisting with the planning, development and administration of the Division, including Environmental Health, Animal Control and Solid Waste programs, providing technical assistance and guidance to Division staff, reviewing plans and inspecting facilities, and assist with Health Protection grant reporting and program level audit preparation.

On a motion by Ms. Zurbrugg, seconded by Ms. Daly, the proposed revisions to the Health Protection Coordinator classification were approved. Motion carried.

b. Director of Community Health and Prevention

Mrs. Gonzalez explained in the July Board of Health meeting the Board approved the separation of the Director of Community Health and Prevention, Emergency Preparedness and Health Promotion to two roles; the Director of Community Health and Prevention and the Director of Emergency Preparedness and Health Promotion. She shared very few applicants so far meet the criteria.

Mrs. Gonzalez proposed the Board of Health approve changes to the job classification of the Director of Community Health and Prevention by expanding the requirements for the position to include the option of a candidate with a Master’s Degree in Public Health and direct supervisory experience overseeing clinical programs and staff. She proposed removing special abilities that pertain to nursing theory from the job classification.

Mrs. Gonzalez explained by making the proposed changes, the Health Department may be able to cast a wider net and attract more candidates with leadership experience. Mrs. Gonzalez shared the position has been open for four months and posted for two months. Dr. Block noted there is significant competition for experienced nurses and that she supports the proposed change.

Mrs. Gonzalez explained there are currently approximately ten nurses on staff at the Health Department. She shared she is confident the Health Department has the nursing support and expertise needed to tackle any issues that may arise.

On a motion by Ms. Crawford, seconded by Ms. Garcia, the proposed revisions to the Director of Community Health and Prevention classification were approved. Motion carried.

EXECUTIVE SESSION 

CORRESPONDENCE AND NEWS 

ADJOURNMENT 

On a motion by Mrs. Faivre, seconded by Ms. Daly, the Board of Health adjourned at 7:27pm. Motion carried.

https://health.dekalbcounty.org/wp-content/uploads/2022/11/5-September-27-2022-FINAL.pdf