Call to Order and Roll Call
Bob Parsons, Chairman of the Board of Trustees, called the meeting to order at 5:01 p.m.; in attendance were Bob Parsons, Sandra Headrick, Dennis Floyd, Shirley Larson, Zach Moser and Roma Jones.
Minutes
The minutes for the October 2022 regular board meeting were reviewed. Dennis Floyd moved to approve the minutes. Kim Smith seconded, and the motion carried. No meeting was held in November due to lack of quorum.
Old Business:
SERVICE STATISTICS AND REPORTS:
Communicable Disease – Reported by Zach Moser
- COVID19 – In October, 39 new cases of COVID-19 were reported. 51 were reported in November.
- Lead – The new CD nurse has been working through a backlog of elevated blood lead cases. 14 cases were closed in November.
- Sexually transmitted infections – 2 screenings were conducted in November. The Health Center conducts free screenings for common sexually transmitted diseases.
- Influenza – Cases have increased early in the season. 66 total influenza cases were reported in November.
Diagnostics – Reported by Zach Moser
- 184 appointments for blood draws in the lab were held in October, and 141 in November. The Health Center can conduct most blood tests at a reduced cost for those without insurance. Anyone can have their labs done at the Health Center.
- COVID tests – 23 COVID tests were conducted in October, 41 in November.
Immunizations – Reported by Zach Moser
- 184 COVID-19 vaccine doses were administered in October, 141 in November.
- Influenza vaccine: October – 300. November – 108. Free flu vaccine is still available at the Health Center.
- 127 Other vaccines were given from October to November.
All Appointments – reported by Zach Moser
- October – 759. November – 524
WIC appointments
- October – 340. November 345
Other
- 130 urine drug screenings have been conducted on behalf of the Dent County Treatment Court since October.
Environmental –
- Roma Jones reported on 14 total inspections, 0 recalls, and 18 environmental questions answered during the month.
Administrator Report – Zach Moser
- Zach reported on the Childcare subsidy program. 273 children are enrolled in the program and $298,143 has been provided so far toward the program.
- A survey was conducted with the Dent County Childcare providers. 56 new children have been added to daycare rolls since the implementation of the program. The Program goal was 50.
- Zach reported on past events that the health center hosted or participated in: Parade of Lights (Christmas Parade) – DCHC won the float contest in the non-commercial category.
- Zach reported on insurance collections of $13,000 in October and $16,000 in November, which he reported showed sustainability of the Nurse Practitioner program.
- Zach reported on the breakroom improvements that were completed by him.
- Zach reported on the movement of cash to cover the $300,000 in payments expected from DHSS in the next month. Zach asked for authority to cash a CD if necessary. Sandra Headrick moved to authorize Zach to cash a Bank of Salem CD in the amount of $156,062.37 to cover cashflow while waiting for the payments.
- Zach reported on the move to Quickbooks Online in partnership with HR Block/Stack Financial starting January 1st.
Expenses
DCHC expenses for October were reviewed. November expenses were not available at the time of the meeting. Sandra Headrick moved to accept the report. Shirley Larson seconded and the motion carried.
New Business:
New Income Sources
- Zach Reported on a new grant from the State of Missouri for $132,336 for 21 months starting 10-1-22 meant to augment the workforce in response to the COVID-19 pandemic. Two positions were created at the previous meeting and have been filled at this time.
- Zach reported on the Building Communities for Better Health grant, which was awarded to DCHC to start 1-1-23. A position was created at the last meeting and has been filled at this time.
- Zach reported on the Public Health Infrastructure grant that the Department of Health and Senior Services was recently awarded from the CDC. Over the next year more information is expected on that grant, which will be passed down to local health departments.
- Title X – Missouri Family Health Council – Zach reported on an expected award of $58,000 for the Title X program, which supports family planning activities.
Personnel Manual Changes
- Zach proposed changes to the way sick and vacation time accrues. Instead of a stair-stepped accrual method, it would be awarded on a straight hour-by-hour basis. The effect on most employees will be negligible. It is meant to better interface with computer software. Sandra Headrick moved to approve the change. Shirley Larson seconded and the motion carried.
- Zach recommended reviewing the COVID leave policy given the changes in CDC guidelines and the COVID pandemic situation. Board members felt it was important for DCHC as a health department to continue to set the example for paid leave for employees. Ultimately, Sandra Headrick moved to keep the policy in place but reduce the paid leave amount to 5 days to align with the CDC isolation guidelines. Shirley Larson seconded and the motion carried.
Requirements
- Missouri Ethics Commission – In October, DCHC revenue surpassed $1m for 2022, thus all board members, the administrator, and candidates for the board must file a personal financial disclosure.
- Single Audit – After expending more than $750,000 of Federal funds in 2022, DCHC will be required to undergo a Federal “single audit”, which is a more intensive audit that examines the usage of Federal dollars. Bids for audit services for agreed upon procedures for 2021 and Single Audit for 2022 were reviewed from Maloney, Wright, and Robbins in the amount of $2,900 for 2021 and $9,900 for 2022. Sandra Headrick moved to approve the audit proposals. Shirley Larson seconded and the motion carried.
Purchases –
- Zach discussed an offer from the Missouri Immunization Coalition to pay for a secondary vaccine/medical grade refrigerator. Bids for several compatible models were reviewed. The Missouri Immunization Coalition approved 30” glass door model plus shipping for $6,422.86. Dennis Floyd moved to approve the purchase of the refrigerator and Sandra Headrick seconded. The motion carried.
- Zach reported on a recommended purchase from nursing staff regarding the blood lead screening program. Currently, DCHC sends blood samples to the State Lab for analysis, which is free, but takes time and samples often get rejected. In addition, it requires a blood draw. Leadcare II is a point-of-care analyzer that uses only a few drops of blood and results in 3 minutes. Dent County has a very low lead screening rate and nursing staff recommend purchase of this machine to help improve that rate. Tests for the machine are about $8 each. Two quotes were received for the machine at $2936.10 from McKesson and $2767.50 from Cardinal. Sandra Headrick moved to approve the quote from Cardinal Health. Shirley Larson seconded and the motion carried.
Clinical Services Scope
The floor was then opened for discussion regarding the scope of services being offered at the Health Center. Board members expressed concern that it was not the place of the Health Center to be in competition with the various clinics in the area by providing primary care. Concern was brought up about the liability involved with providing this type of service as well. Zach voiced his view that while other care options were available, there were reasons that people were still seeking out primary care at DCHC, and that DCHC was not the only Health Department providing this kind of service. He mentioned that April carries her own malpractice insurance and that the Health Center is covered under their own policy as well as by Sovereign Immunity in their capacity as a Health Department. No motions were made on the subject, but Zach did consent to cease any advertising or marketing of primary care as service at the Health Center.
Closed Session pursuant to RSMo 610.021 (3) Personnel
Sandra Headrick moved to enter closed session pursuant to RSMo 610.021 (3) to discuss personnel. Shirley Larson seconded. A roll call vote was held with results as follows: Bob Parsons – Aye, Dennis Floyd – Aye, Sandra Headrick – Aye, Shirley Larson – Aye.
At 6:45pm, the board resumed open session having approved the 2023 Employee compensation plan in which employees received a prorated cost of living adjustment based on the amount of time they have been employed at DCHC.
Next Meeting and Adjournment
The next regular board meeting date was set for Thursday, January 19th, 2023 @ 5:00 p.m.
With no further business Dennis Floyd moved to adjourn the meeting at 6:46 p.m. This was seconded by Sandra Headrick and all were in favor. Meeting adjourned.
Recorded by:
_________________________________ ____________________________
Zachary Moser, Administrator Bob Parsons, Chairman
