McLean County Board Health Committee met April 6.
Here is the minutes provided by the committee:
The Health Committee of the McLean County Board met beginning at 4:30 p.m. in Room 404 of the Government Center Building 115 E. Washington Street, Bloomington, IL.
Members Present: Chairman Susan Schafer, Members: Carlo Robustelli, George Gordon, George Wendt, Randall Martin, Catherine Metsker and Sharon Chung (all via remote attendance)
Members Absent: None
Other Members Present:
Staff Present: Ms. Camille Rodriguez, County Administrator; Ms. Cathy Dreyer, Assistant County Administrator; Ms. Julie Morlock, Recording Secretary; Ms. Jessica Woods, Assistant State’s Attorney – Civil Division (remote attendance)
Department Heads/Elected Officials Present: Ms. Jessica McKnight, Health Department Administrator; Ms. Cindy Wegner (remote attendance)
Others Present: Ms. Dianne Cochran, Director of Nursing and Ms. Rhonda Crowley, McLean County Nursing Home
Chairman Schafer called the meeting to order at 4:30 p.m. and declared a quorum.
Chairman Schafer presented the minutes from the March 2, 2020 regular meeting for approval.
Motion by Chung/Metsker to approve the minutes from the March 2, 2020 regular meeting.
Motion carried.
Chairman Schafer confirmed there were no members of the public to appear before the Committee.
Ms. Jessica McKnight Health Department Administrator presented the Health Department’s monthly reports to the Committee. Ms. Chung asked for a status update on the testing facility. Ms. McKnight went over number of tests from the weekend, how many tests they could provide each day and the change in criteria so the first responders and health care workers do not need to be symptomatic and the general public who are symptomatic can be tested. Ms. Schafer asked if it could be that people are taking care of themselves, treating symptoms and not going to be tested. Ms. McKnight indicated that is a possibility as we are encouraging individuals to stay home if they have symptoms as there is no treatment that can be given to them. Ms. Rodriguez reminded them this is not solely the health department’s responsibility as the County is not the decision maker and direction comes from the Federal Government. Ms. Schafer asked her to explain monitoring and contact tracing. Ms. McKnight indicated they are notified of positive test and personnel contact individual to see where they have been for the last 2-3 days and then they work out and contact those who have been in close contact. Mr. Robustelli asked about those presumed positive and if those are being tracked. Ms. McKnight indicated they are not given that information for tracking as they are only notified of laboratory confirmed cases. Ms. Schafer asked her to defined close contact. Ms. McKnight indicated it means to be closer than 6 feet to someone for between 6-10 minutes. She indicated that is why they stress washing hands as it could be someone sneezes or coughs and then you touch your face. Ms. Schafer asked about food safety and ordering out. Ms. McKnight indicated they are still doing inspections. She indicated that is not as much of a concern as foods are being cooked, and food packaging should not be concern as long as you are washing your hands. Mr. Gordon asked for difference between positive and presumptive positive. Ms. McKnight indicated that presumptive positive is an assumption and not necessarily a diagnosis.
Ms. Metsker asked for clarification on numbers reported and why presumptive numbers are not included. Ms. McKnight indicated there is a list of reportable diseases through Illinois Department of Public Health and COVID is one but it is only reported through lab testing. She indicated that presumptive cases are not reported to the Health Department and may only be in the notes at the doctor’s office, but no confirmation. Ms. Metsker asked her to confirm it is not for lack of wanting the information but a lack of it being required. Ms. McKnight confirmed. Ms. Metsker asked her to confirm this is not being treated any different than other reportable viruses. Ms. McKnight confirmed. Ms. McKnight indicated they hope in the future they have reporting from hospitals on COVID like symptoms but don’t have that now.
Mr. Robustelli thanked her for information. He felt that physicians and hospitals should keep track of presumptive positives. Mr. Robustelli asked about number of beds that are available at hospitals and capacity. Ms. McKnight indicated the EOC has communication with the hospitals on that. Ms. Schafer asked Mr. Martin if he had information. Mr. Martin indicated both hospitals are below regular capacity, and both have plans for surge capacity but are not close. Ms. Schafer asked about clusters and others being infected. Ms. McKnight indicated that is we are trying to flatten the curve which is saying that the same number of individuals may become infected but spreading that out over a period of time so there is the medical capacity to handle it. Ms. Metsker asked them to confirm the County is not responsible to keep track of beds that are available. Ms. McKnight confirmed the health department does not keep track of that but the EOC is made aware of those numbers so we can make sure we have alternate sites should the need arise. Mr. Martin indicated they report twice daily to several state agencies on available beds and equipment they have.
Mr. Gordon asked if that information then is forwarded to County level. Ms. Rodriguez indicated not necessarily because it is not the health department’s responsibility. She stated the EOC is the one that would get the information to help with alternate sites. Mr. Robustelli asked how our health department is disseminating information to other departments. Ms. McKnight indicated there are internal county wide calls to determine needs, the EOC also has a call three times a week to determine needs, and there is a joint information center that our communication specialist at the Health Department is manning that has public information officers there with him from different agencies so all can get same information and push out to their agencies. Ms. Rodriguez indicated that several weeks ago she implemented calls with department heads at JDC, Nursing Home, Jail Medical, Sheriff to make sure we had policies and procedures in place for any possible cases. She also indicated that long term care calls are occurring for with state agencies. Ms. Schafer asked her to provide information on when they have Facebook live, etc. Ms. McKnight indicated it is every Tuesday and Thursday at 2:15 and there are media calls on Monday, Wednesday, and Friday at 2:15 p.m. to keep social distancing in place. Ms. Schafer thanked her for the information she provided.
Ms. Cindy Wegner, Director, McLean County Nursing Home presented her monthly reports. Ms. Schafer asked about changes they had made because of COVID-19. Ms. Wegner indicated they have shut down to visitors and are busy entertaining residents providing hair services since beautician cannot come in the facility, assisting families with electronic communications with their families, and doing extra cleaning. She also indicated they are screenings and educating employees. Ms. Schafer asked for an update on revenue and a possible escrow account. Ms. Wegner indicated they had a meeting with the outside auditor and Ms. McNeil and the outside auditor indicated they cannot put money into another account to hold for possible fees. Ms. Metsker asked about a plan to avoid needing to come up with large amount when we are audited again. Ms. Wegner indicated they are marking accounts that show overages and continue to contact Medicaid about updating their system. Ms. Rhonda Crowley indicated auditor stated they are reporting funds the way they should as we do not know when audit will occur and the span of time they will audit.
Mr. Robustelli asked about the employee screening process during COVID. Ms. Wegner indicated the Illinois Department of Public Health provided a screening tool and our nurse liaison is assisting with monitoring employees as they come in, which includes completing a check list, having their temperature taken and if 100 or higher or symptomatic they are sent for testing and home until no longer symptomatic. She indicated they have had three tested and all came back negative. Mr. Robustelli asked about testing all employees even if not symptomatic. Ms. Wegner indicated that is not recommended at this time. She indicated that they are all wearing masking, doing extra cleaning, and taking vitals multiple times a day to be proactive. Mr. Robustelli asked if there were things the community could do to help. Ms. Wegner indicated most families have been keeping in touch by Facetime, putting decorations on windows and visiting outside their resident’s windows. She also indicated there have been donations to help with morale of staff as well with donated meals and masks. Ms. Schafer asked if they are keeping up with PPE’s. Ms. Wegner indicated they continue to have what they need.
48:00 Ms. Metsker again asked about revenue and over payments from Medicaid and plans for future repayment of overages. Ms. Crowley went over what they are doing to keep Medicaid information up to date and noting on the system. She indicated it is not that they are putting information in the system wrong it is that we are getting paid wrong by the State. Ms. Metsker again asked if there is a way to figure a line item we can budget for a possible overage. Discussion about not knowing amount as they do not know when they will be audited or what timeframe they will be audited for, possible bookkeeping, ways to prepare for payment amount of overage in the future and involving the Finance Committee.
Ms. Schafer indicated exception expenses and expenses have been tracked and if those are going to be steady. She also asked about disparity in expenses in certain months. Ms. Wegner indicated it has to do with payroll and the pay periods and how they fall with closing of books for each month. (59:03) Discussion about the pay periods for the Nursing Home. Mr. Robustelli indicated he felt it is about revenue and not about payroll and expenditures but the need to bring in more revenue and focus on building census which will be difficult over the next few months. He felt we needed to focus on that and not on the peaks and valleys in expenses and payroll. Mr. Robustelli also indicated hard to put aside a line item when we do not know amount or when it would be paid out. Ms. Metsker indicated that revenue has peaks and valleys as well, so felt difficult to determine what we can and cannot do. Ms. Rodriguez suggested having the Treasurer provide quarterly report to Health Committee.
Ms. Metsker talked about reports in Health Committee and Finance Committee regarding Nursing Home Fund. She asked for clarification on Medicaid and Medicaid Pending. Ms. Crowley explained Medicaid versus Medicaid Pending entries in the system. Ms. Metsker thanked her for her efforts with the Medicaid system and accounting. Mr. Gordon asked about a resident on their report who has been waiting on Medicaid for four years. Ms. Wegner indicated that is an unusual situation. Ms. Schafer asked if there were any other questions from the nursing home, hearing none, she thanked them.
Ms. Michelle Welch, Adult Detention presented her report to the Committee. Ms. Schafer asked about processes they have in place for COVID. Ms. Welch indicated all come through one door, everyone must answer questions and have their temperature taken and everyone is wearing masks, she indicated they are also doing extra cleaning of stations and exam rooms. Ms. Welch went over process if they feel someone might have the virus. Ms. Metsker asked her to confirm they are doing same process as at the Nursing Home. Ms. Welch confirmed. Mr. Robustelli asked if all inmates were tested. Ms. Welch indicated they are screened. Mr. Robustelli asked them to confirm only testing when symptoms. Ms. Welch confirmed. Mr. Robustelli asked that now that first responders can be tested without any symptoms if they are taking advantage of that. Ms. Rodriguez indicated that Ms. Welch could speak to her employees. Ms. Welch indicated you could test negative today and then the next day be exposed. Mr. Rodriguez also indicated she would have to check on policy as to what that would mean for fit for duty status and affect workflow. Mr. Gordon asked them to confirm difference between screening and testing. Ms. Rodriguez confirmed difference and confirmed they are not testing at the facilities only screening.
Mr. Jason Tabb, Juvenile Detention presented his monthly report. Chairman Schafer asked Mr. Tabb to go over the processes they have in place at the JDC. Mr. Tabb indicated they are doing the same as adult medical and nursing home. He indicated they have not had a lot of new residents but the few they have they are isolating them for 14 days to make sure they are symptom free. He indicated they are limiting outside access as juveniles in the facility are communicating with family via a web cam app. Mr. Robustelli asked if they are charged for the video conferencing. Mr. Jason indicated it is a free app families can download. Ms. Schafer asked him to confirm maintaining social distancing. Mr. Tabb confirmed. Ms. Metsker asked if school is online. Mr. Tabb indicated a teacher comes in. Ms. Metsker asked him to confirm no one has received special releases. Mr. Tabb confirmed that numbers are low just because they are low and not that they are screening them out. Ms. Metsker asked about the numbers for TB testing. Mr. Tabb indicated that numbers went up in late January/early February as we took extra juveniles from Peoria County at that time and numbers included staff yearly check. Chairman Schafer asked if there were other questions; hearing none, she thanked them.
Ms. Camille Rodriguez, County Administrator presented for action a request to approve Emergency Appropriation Ordinance amending the McLean County Fiscal Year 2019 Combined Annual Appropriation for departments under the purview of the Health Committee. She indicated this is for year-end clean-up for the 2019 ledger. Ms. Schafer asked how many FTEs at the Nursing Home were moved to part-time instead of paying for temporary employees. Ms. Rodriguez indicated she would gather that information.
Motion by Martin/Robustelli to recommend approval of Emergency Appropriation Ordinance amending the McLean County Fiscal Year 2019 Combined Annual Appropriation for departments under the purview of the Health Committee. Motion Carried.
Ms. Rodriguez presented her recent employment activities report. Chairman Schafer asked if there were any questions, hearing none, she thanked her. Chairman Schafer confirmed there was no other business.
Chairman Schafer then presented for approval the Nursing Home bills with a prepaid total $428,116.01
Motion by Chung/Robustelli to approve prepaid bills for the Nursing Home as presented.
Motion carried.
Chairman Schafer presented the bills for the Developmental Disability Board with a prepaid total of $59,737.04.
Motion by Metsker/Gordon to approve prepaid bills for the Developmental Disability Board as presented.
Motion carried.
Chairman Schafer presented for approval bills for Jail Medical and JDC Medical with a prepaid total of $29,128.03.
Chairman Schafer presented for approval bills for the Board of Health with a prepaid total of $127,526.76.
Motion by Chung/Martin to approve prepaid bills for the Board of Health as presented.
Motion carried.
Chairman Schafer asked if there was any additional business to come before the Committee; hearing nothing, she adjourned the meeting at 6:12 p.m.
https://www.mcleancountyil.gov/ArchiveCenter/ViewFile/Item/7256
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