Dent County Health Center Board of Trustees
Call to Order and Roll Call
Bob Parsons, Chairman of the Board of Trustees, called the meeting to order at 5:00 p.m.; in attendance were Bob Parsons, Sandra Headrick, Dennis Floyd, Kim Smith, Zach Moser and Roma Jones.
Minutes and Agenda
The agenda for the meeting was reviewed and approved by unanimous consent.
The minutes for the December regular board meeting were reviewed. Bob Parsons noted a mistake which had Kim Smith listed as making a motion when she was not present. Kim Smith moved to approve the minutes with the noted change. Dennis Floyd seconded, and the motion carried.
Bob Parsons then made an announcement regarding the kitchen remodel. He thanked Zach for the work on the kitchen and invited all the Board members to stay and take a look at the kitchen after the meeting. The floor was then turned over to Zach for the regular agenda.
Old Business:
SERVICE STATISTICS AND REPORTS:
Communicable Disease – Reported by Zach Moser
- COVID19 – In December, 79 new cases of COVID-19 were reported.
- Lead – 31 cases were active in December. Zach explained that this number is higher due to a change in reporting. In the past, only cases which were completed in a given month were reported. Going forward, the number of active cases will be reported. There is a backlog of cases due to reprioritization during the COVID-19 pandemic. The new Communicable Disease Nurse, Trisha O’Neil, is currently working through the backlog.
- Sexually transmitted infections – 4 screenings were conducted in December. The Health Center conducts free screenings for common sexually transmitted diseases.
- Influenza – Cases have increased early in the season. 101 total influenza cases were reported in December.
- Animal Bites – 2 Animal bites were reported in December.
Diagnostics – Reported by Zach Moser
- 153 appointments for blood draws in the lab were held in December. 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 – 196 COVID tests were conducted in December.
Immunizations – Reported by Zach Moser
- 89 COVID-19 vaccine doses were administered in December.
- Influenza vaccine: 67 doses administered in December. Free flu vaccine is still available at the Health Center.
- 56 Other vaccines were given in December.
All Appointments – reported by Zach Moser
- 613
WIC appointments
- 333
Other
- 113 Urine drug screenings for Treatment Court were conducted in December
Environmental – Roma Jones
- 4 total inspections, 0 recalls, and 5 environmental questions answered during the month.
Administrator Report – Zach Moser
- Childcare Program – $417,121 has been spent since August 2022 for childcare subsidies. There are currently 289 children enrolled and 16 providers.
- Kitchen/Office – Zach reported on the short wall added to separate the kitchen from the other room to create a new office for the BCBH project manager, Janelle Moore.
- Cashflow – Zach reported on the 1 CD which was cashed in late December for approximately $150,000 and an interest penalty of $174.98 to cover expenses while waiting for the large payment from DHSS for the Health Disparities program, which only pays quarterly. Zach reported that due to being on a Cash basis of accounting, the year end report will show a net loss because the payment of about $300,000 was not received until 1/17/23.
- Accounting – Started with Quickbooks Online January 1st to improve collaboration and reporting. 2021 AUP and 2022 Audit are underway.
- Board Filings – Dennis Floyd and Robert Gravley were the only filers for the two open positions. No election will be held as a result.
- Future Events – Health Fair – Date TBD – Vision screenings – walk-in heart-healthy screenings, and walk-in vaccines will be offered.
- Website revision – Restaurant inspections are now online. Access to certain financial reports and minutes has been improved. The overall look has been changed. A “Healthcare Directory” is being compiled and listed on the website. A dotgov domain name has been requested (dentmohealth.gov). The website can be found at any of the following urls: dentcohealth.org, dentcountyhealthcenter.com, dentcountyhealthcenter.org
Expenses
DCHC expenses for December were reviewed. Sandra Headrick moved to accept the report. Kim Smith seconded and the motion carried.
New Business:
Budget Hearing
The budget was created and presented by Zach. The documents titled “2023 Budget Summary” and “DCHC 2023” are incorporated herein as presented to the Board.
Revenue for 2023 is projected as $2,171,574.14, with $1,105,143.20 from the Health Disparities grant for Childcare Subsidies. $180,000 in local property tax revenue is budgeted. For expenses, $1,782,265 was requested for a projected surplus of $389,309.14, part of which will offset the $109,089.46 loss from 2022. The projected surplus will be allocated at a future date. Zach noted that in 2024 the budget will be much tighter due to the expiration of several COVID-19 funding sources and that spending was purposely not matched to projected revenue in case revenue does not match what is projected.
In anticipation of a surplus, $10,000 was budgeted to cover costs for those who can’t afford services.
Salaries and fringe benefits remained the greatest expense at $988,200, followed by childcare subsidies at $425,000.
Much discussion was held and each budget line item was evaluated. Dennis Floyd moved to approve the budget with changes noted during the discussion. Kim Smith Seconded and the motion carried.
In a related action, Kim Smith moved to direct Zach to evaluate options for accounting services. Sandra Headrick seconded and the motion carried.
Clinical Services Discussion
The floor was opened for continuing discussion regarding the scope of clinical services offered at DCHC. Sandra Headrick reiterated her opinion and concern that the Health Department should not be offering primary care, and that she felt she would be unable to continue on the Board if that was the direction of the Board due to her position as a Family Nurse Practitioner at Phelps Health Clinic in Salem.
Dennis Floyd presented a copy of RSMo 205.060 which prohibits a local board of health from entering into contracts for private practice of medicine or other actions for personal gain of the Board. Zach discussed that this statute does not appear to apply in this circumstance because it is not for personal gain nor is it private medical practice, and that there appeared to be no case law on the statute and that DCHC services are in line with what is offered at some other Health Departments.
Kim Smith discussed her opinion agreeing that the Health Center should not be in competition with local businesses as a tax-funded organization, stating that it was unfair to the other businesses that did not have tax dollars.
Robert Parsons expressed the opinion that on every major issue, the Board has always been in agreement, and due to the lack of agreement, he could not be in favor of expanding the role of the nurse practitioner to include primary care services.
The Board made no motion on the subject, since primary care services had not previously been authorized, there was no need for a new motion.
Available Property
Zach reported on the properties for sale adjoining the property of the Health Center at 1010 E. Scenic Rivers Blvd. Zach discussed possible uses of the property but made no recommendation on making an offer or not. He did discuss potential future needs, including the possibility of adding a drive-through for vaccines and covid tests as well as a larger foyer and overhang for patient drop off.
Closed Session pursuant to RSMo 610.021 (2) Real Estate
Sandra Headrick moved to enter closed session at 7:24 pm pursuant to RSMo 610.021 (2) to discuss real estate. Dennis Floyd seconded. A roll call vote was held with results as follows: Bob Parsons – Aye, Dennis Floyd – Aye, Sandra Headrick – Aye, Kim Smith – Aye
At 7:43 pm, the board resumed open session having approved terms of an offer on adjoining property.
Next Meeting and Adjournment
The next regular board meeting date was set for Thursday, February 16th, 2023 @ 5:00 p.m.
With no further business Dennis Floyd moved to adjourn the meeting at 7:44 p.m. This was seconded by Sandra Headrick and all were in favor. Meeting adjourned.
