MINUTES OF THE INFORMAL MEETING OF THE JOHNSON COUNTY BOARD OF SUPERVISORS:
MAY 7, 2008
TABLE OF CONTENTS
Page
Executive Session: Sixth Month Evaluation and Goal Setting of Mental Health and Developmental Disabilities Director Kris Artley........................................................................................................ 1
Site Visit – Discussion with Public Health Director Doug Beardsley, 1105 Gilbert Court, Iowa City 1
Chairperson Sullivan called the Johnson County Board of Supervisors to order in the Johnson County Administration Building at 9:30 a.m. Members present were: Pat Harney, Larry Meyers, Terrence Neuzil, Sally Stutsman, and Rod Sullivan.
Motion by Harney, second by Stutsman, to enter into Executive Session at 9:31 a.m. for an annual evaluation of Mental Health and Developmental Disabilities Director under section 21.5(1.i), Code of Iowa, “to evaluate the professional competency of an individual whose appointment, hiring, performance or discharge is being considered when necessary to prevent needless and irreparable injury to that individual’s reputation and that individual requests a closed session.” Roll call: aye: Harney, Stutsman, Sullivan, Neuzil, Meyers.
Motion by Neuzil, second by Meyers, to leave Executive Session at 10:13 a.m. Roll call: aye: Harney, Stutsman, Sullivan, Neuzil, Meyers.
Recessed at 10:15 a.m.; reconvened at 10:35 a.m.
Johnson County Public Health Director Doug Beardsley introduced Deputy Director Tricia Kitzmann, Community Health Division Manager Raymond Steltzer, WIC/Maternal and Child Health Manager Nadine Fisher, and Business Manager Becky Mills. Beardsley said that over the past 100 years, the average life expectancy has increased by 30 years. He said 25 of those years can be directly attributed to public health ordinances, vaccinations, safety, and food control. Beardsley said that public is the key word in public health. He said that through public health they are trying to create an atmosphere and a community in which people can be healthy. Beardsley said public health is all about disease prevention.
Beardsley said the Department of Public Health has core functions and performs essential services. He said that the core functions include assessment and policy development. The assessment function refers to making sure that limited resources are used effectively. Beardsley said when a program is created, it is important to assess what the problem is, what the resources are, and how to most effectively use the available resources. He said that once the assessment is completed they begin policy development. Beardsley said a lot of the problems identified can be addressed through simple changes of policy and do not necessarily require the implementation of new programs. He said he believes in raising questions other people will not or cannot ask. He said once an activity is started, they analyze if it's really affecting what they thought it was going to affect. Beardsley said it is important to have the courage to try something else if the existing system isn’t working. Beardsley said Iowa has done a pretty good job of staying up-to-date with new thoughts. He noted that the most essential public health services, which include monitoring, diagnosing, investigating, evaluating the effectiveness and quality of programs, policy development, and assurance, have been codified.
The Johnson County Public Health Vision Statement leads community prevention efforts by advocating for the optimal health of all citizens, forging partnerships, and ensuring access. Beardsley said his department hopes to be the catalyst in the community to pull the community together. He said that the Department of Public Health wants to take responsibility for coordination with the understanding that they can't provide everything in the way of the advancement of public health. Beardsley said that the law is a public health entity from their perspective. He noted that the police and other law enforcement agencies are enforcing safety on the roads and investigating crimes, things that affect the health of the community. He said that pulling all the entities together is part of their vision.
Beardsley noted that the Public Health Mission Statement provides leadership in promoting environmental, personal, and public health through community-based programs in health promotion, disease prevention, and assurance of access to primary care. Beardsley noted that the Department of Public Health has done some reorganizing in the past year and broken up into different divisions. He said the Deputy Director is in charge of most operations and emergency response. He said the Administration Staff handles grants, contracts, and other administrative duties. Beardsley said the Preparedness Program and Disease Prevention Program are under the supervision of Kitzmann and encompass all aspects of the department. Beardsley said the Community Health Division and anything having to do with wellness, health promotion, tobacco control, environmental programs, and screenings, falls into Steltzer's area.
Beardsley said the Community Health Needs Assessment is a big part of what Public Health will be doing over the next few years. He said every five years the department does a Community Health Needs Assessment and a Health Improvement Plan. Beardsley said the 2005 plan focused on wellness, mental health, and illness-related school absences. Beardsley said the next Community Health Needs Assessment Plan is due in 2010. He noted that the Department of Public Health plans to start pulling teams and data together in 2009. He said his vision for the future is working in conjunction with other agencies to create true community plans, something communities are aware of, buy into, and put efforts toward achieving. He noted that United Way has started a Database Sharing Initiative to reduce fragmentation and work duplication.
Beardsley said he is really interested in innovative policy community standards. He said that Worksite Wellness Programs are great, but he doesn't know how to convince the community to implement them. Beardsley said people get too program-centered and lose focus of the community norms and standards. He asked how to make the community understand that the programs are worthwhile.
Beardsley said they have maternal and child health services, WIC programs, and other more clinical-like services for specialized populations. He said most of the services are grant funded. Beardsley said that in Iowa there are standards being developed for Local and State Public Health. Beardsley said that the redesign project goes hand-in-hand with the National Public Health Accreditation Standards. He said there is a big push for the national accreditation of public health entities.
Beardsley said that the standards are meant to create a consistent and accountable approach to promoting the health of Iowans. He said that people in different counties have different expectations from their public health agencies. Beardsley said they are trying to bring the standards to an acceptable level for all Iowans. He said that National Public Health Performance Standards are voluntary. Beardsley said Iowa have set a goal that by July 1, 2011 the State Department of Public Health and at least one county health department will be accredited. He said that he put Johnson County Public Health on the list for becoming an accredited department. He said he thought it will take a lot of work, but that it would be worth it.
Beardsley said Public Health is faced with increasing language and cultural challenges and changing demographics. He said the Hispanic and migrant population is growing substantially every year. He added that Johnson County, as well as the rest of Iowa, has a high aging population, being beyond the projections of percentage of population above 65. Beardsley said they need to capitalize on new technologies and keep up-to-date. He mentioned that the Department of Public Health is striving to be more efficient by going paperless.
R. Sullivan stated that he and Stutsman had an opportunity to attend an Iowa State Association of Counties (ISAC) Session on pubic health redesign. He said he left the session amazed at the number of supervisors that saw public health as an expense and seemed not to care about it. He said that a lot of smaller counties do not want to comply with the redesign. Stutsman asked if all of the counties would have to comply with the redesign. Kitzmann said she had been on the Redesign Team for three years. She said that when she came to Johnson County she told Beardsley that she wanted to remain on the committee. Kitzmann said that the Redesign Team is not an Iowa Department of Public Health Program. Kitzmann said nothing was passed. She noted that they are currently in the implementation and information gathering phase. She said there are workgroups working on developing evaluation tools. Kitzmann said she currently serves on the group that deals with the Iowa Code and the Iowa Administrative Code. She said they are trying to determine which code changes will be needed at the State level to ensure the standards are implemented. She said there are five subgroups working on getting public and official support for the redesign. She said the redesign is coming and added that the Federal Government will dictate it. She noted that Iowa wants to be a proactive state and have the program in place before it is mandated. Kitzmann mentioned that Iowa has 99 independent local public health agencies. She said that no state can realistically support that many independent agencies. She said Iowa is in the forefront for public health standards and what they do; however, she added that the Federal Government doesn't take Iowa too seriously because there are so many independent agencies. Kitzmann predicted there will be a regionalization of public health. She said she thinks regionalization will force partnerships since they are talking about spending millions of dollars just to bring them up to standard. Kitzmann said during the past three years they have been slowly bringing in some of the smaller health agencies. She said the redesign is a way to ensure that all Iowans have access to the same public health services as those living in areas with larger health departments. She said that they are doing a lot of education and outreach. Kitzmann said that 2008 is the first time in 10 years that there were two huge State level changes and the redesign continues to be pushed forward. She said that changing the Code language will be the first push during the next legislative session. Kitzmann noted that there will be more discussion on redesign in the next year.
Stutsman said that there is a lot of opposition to the standard of appointing a health director with a master's degree. Beardsley said they can not get 99 master's level directors. He explained that would be where the regionalization concept comes in. He said that they could form partnerships rather than abolish the idea altogether. Fisher said they assist smaller agencies that don't have the staff.
Stutsman asked Beardsley his thoughts on the Board of Supervisors being on the Board of Health. Beardsley said that the only requirements are that the Board of Health is appointed by the Board of Supervisors and that there is one licensed physician. He said that the Supervisors could legally appoint themselves to the Board of Health. Beardsley said that they need to be accountable to the citizens and voters, but noted that public health should not be a political issue. He said that if people need vaccinations and disease prevention, the decisions driving that should be done from a scientific, politically disassociated point of view. Beardsley said he didn't want to spend any of the taxpayers' money unless it needed to be spent, and that is an issue of trust.
R. Sullivan stated that there are so many good applicants for the Board of Health that it wouldn't make any sense to appoint himself or another Supervisor. Neuzil said that if the Board of Health wants a Supervisor to be part of the Board of Health or attend the meetings all they have to do is ask. Neuzil said that the Board is looking for collaboration with the Board of Health to ensure that they are not applying for grants because they are offered, but cause they are needed.
Neuzil asked if Public Health is ready for the move to the Health and Human Services (HHS) Building. Beardsley responded that each division is separated in teams and ready to move. He said that they are in the phase of looking through files and getting rid of duplicates and files that are no longer needed. Beardsley said that Public Health has some concerns in terms of communication and team work due to the fact that the Department will be on two different floors. He said that he thinks it will work-out fine. He noted that they are proposing some structural changes by getting rid of a wall and a door, which would save the County some money.
Neuzil said that each Supervisor is attending the HHS Building Construction Meetings. He said that the construction is a little behind schedule, but with nice weather they should catch up in no time. Beardsley said the delivery day is scheduled for October 31, 2008. He said that Public Health does not have to move on the first day. He said they are looking at December 1, 2008 as their moving date.
Steltzer said the department is responsible for real estate transactions outside the urban core. He said they are trying to get a handle on that. He said there might be a need for increasing staff. Steltzer added that another option is to contract out the work. Beardsley said the work does not have to be done by County employees, but by someone qualified. He said that at a minimum there would be an increased number of phone calls.
Beardsley said he received a memo from the University of Iowa in regards to how the University will react to the smoking ban. He said that the ban is meant to protect the public from second-hand smoke; however, he added, those smoking will still be out in the open air.
Stutsman asked if the Board is paying for vans and trucks needed for relocation to the HHS Building. Beardsley said that Facilities Manager Dave Kempf has everything figured out. He added that Kempf has arranged for a company to bring in (Portable on Demand Storage) PODS on wheels. He said Public Health would load the PODS and have them transferred to the new offices.
Harney said that there is a great opportunity for having a small pool of cars for each department to utilize. Neuzil stated that each department requests its own vehicle. He said that some department vehicles get used only once a week. Stutsman said it might be cheaper to rent a car. Neuzil said that the car pool is an issue that the previous Budget Coordinator was trying to put together before he left. He added that the Board hadn't picked up the issue since then. Harney said that once they get everything centrally located they can bring everything together.
R. Sullivan said that all departments need to coordinate to create a shared conference room system. He mentioned that Information Services Director Jean Schultz is creating an online reservation system. He added that the details of the new system have not been addressed yet. Beardsley mentioned that the conference rooms in the HHS Building will have moving walls. He said Public Health will have a bigger education room. Stutsman said that everyone in the county who is short on meeting space will want to meet in the conference rooms of the HHS Building. Harney said he thinks the site should be used solely for County business.
Steltzer asked if the HHS Building would have an Iowa Communication Network (ICN) System. Kitzmann said that she is on the Phone Committee for the HHS Building. She noted that by law, a county government cannot have an ICN site. She said they are trying to determine if there could be an exception because the Department of Human Services (DHS) would be located in the HHS Building. Neuzil said the new Readiness Center would have an access point. R. Sullivan said that the Iowa City School District needed space and took their ICN site out. He noted that the Iowa City Public Library has a site.
Kitzmann said that if the Board needs clarification in regard to the public health redesign she would try to assist them. Harney said that he has a hard time perceiving how the larger counties would benefit from the merger. He said that a merger is in the benefit of smaller counties. Kitzmann agreed and urged everyone to ask questions.
Adjourned at 11:35 a.m.
______________________________________________________________________
Attest: Tom Slockett, Auditor
By:
On the _______ day of _____________________, 2008
By Bogdana Rus, Recording Secretary
Sent to the Board of Supervisors on June 25, 2008 at 3:01 p.m.