TABLE OF CONTENTS
                                 BOARD OF HEALTH
                                    May 16, 2011

1.0     Call Meeting to Order, Lynn A. Smith, M.D., President

2.0     Opening of Meeting

        2.01   Declaration of Quorum
        2.02   Citizen’s Remarks
        2.03   Certification of Delivery of Official Notices of Meeting

3.0     Board of Health

        3.01   Minutes, April 18, 2011

4.0     Health District Staff Reports

        4.01   Community Health Services Report - Ron Graham
        4.02   Environmental Health Report - Nancy Niehus
        4.03   Manager’s Report - Jeffrey Campbell
        4.04   Health Commissioner’s Report – Frank Kellogg

5.0     Committee Reports

        5.01   Child and Family Health Services Advisory Council, Meeting Held April 12,
        5.02   Personnel Committee, Meeting Held May 16, 2011

6.0     Old Business


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7.0     New Business

        7.01   Resolutions
               7.01.01 Certification of Monies, Resolution 11-05-07-01-01-100

        7.02   Permission to Accept United Way Grant, $800

        7.03   Permission to Accept Bike Day Lake County Corporate Sponsorship, $2,000

        7.04   Permission to Accept Lake Health ―JUST RUN‖ Lake County Sponsorship,

        7.05   Permission to Submit Child and Family Health Services Grant, $88,000

        7.06   Permission to Submit Public Health Emergency Preparedness Grant (PHEP),

        7.07   Permission to Submit Community Development Block Grant – Newborns
               FY2011, $20,000

        7.08   Permission to Submit Reproductive Health and Wellness Program Grant, $45,000

        7.09   Permission to Submit Child Safety Seats – Lake County Community
               Development Block Grant, $4,000

        7.10   Permission to Purchase Six (6) 2012 Ford Focus Automobiles

        7.11   Recommendations from the Personnel Committee

8.0     Adjournment

May 16, 2011                                                                          -2-
1.0     Call to Order

The regular meeting of the Board of Health of the Lake County General Health District was
called to order at 3:00 p.m. on Monday, May 16, 2011 by Dr. Lynn Smith, President. The
meeting was held at the Health District Offices located at 33 Mill Street, Painesville, Ohio.

2.0     Opening of Meeting

2.01    Declaration of Quorum

The following members were present constituting a quorum:

Roger Anderson                        Patricia Fowler                    Randy Owoc
Tim Brennan                           Marc Garland                       James Pegoraro
Alvin Brown, VMD                      Dr. Juan Hernandez                 Dr. Lynn Smith
William Catania                       Brian Katz                         Anthony Vitolo
Edward Currier                        Patricia Murphy

Minutes were recorded by Vicki Estep, Administrative Secretary/Registrar.

There were no Board Members absent with prior notification.

Also present from the Health District staff:

Frank Kellogg                        Laura Kuns
Jeff Campbell                        Nancy Niehus
Kathy Durchik                        Tim Snell
Ron Graham

Other guests present:

Josh Pennock

2.02    Citizens’ Remarks

Josh Pennock was in attendance to address the Board of Health regarding the drip mound septic
systems, and requesting that the Board consider not allowing the installation of additional drip
mound systems until the problem he is having with his system is figured out and corrected. Mr.
Pennock has had his system freeze three times in the last five years and this latest repair could be
as costly as $3,200. The other 25 homes in his Subdivision have gravity systems and are having
no problems.

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Frank Kellogg noted that the ET systems, the systems that were previously installed, were having
a 25% failure rate, so the Health District spent a great deal of money to come up with other
workable systems.

Laura Kuns gave an overview of the Bellmore Subdivision and its severe soil changes. Mr.
Pennock owns the first lot of five, of the changed soil portion of the area. There were problems
with the aquifer and the builder had to build up the five lots with sand in order to have the
required four-foot distance from the aquifer. Ms. Kuns explained the drip systems and how we
installed the first four systems in 1998 and monitored them for two years. To date there are 184
drip systems within Lake County, and 600 in Ohio. In 2007 we had two drip mound systems in
Lake County freeze. These were the only two frozen systems until winter of 2008, when Mr.
Pennock experienced his first freeze

Mr. Pennock has experienced three freezes and his neighbor has experienced two freezes. The
manufacturer had made a design change, and the system will now alarm if the temperature in the
box drops below 38°. Stream Key placed new heaters (with a new design) in the five elevated
systems in 2009.

Ms. Kuns has been working with the manufacturer to assist Mr. Pennock – American
Manufacturing has agreed to sell Mr. Pennock a new hydraulic rack for $1,000; the company
will also supply a new heater free of charge as well as a battery backup and temperature readout
equipment free of charge.

Ms. Kuns noted that Mr. Pennock has a radon extraction unit around the base of his house, which
moves air to take radon out of the house. With the extra air movement, this may make the unit
cooler. We have not had issues with other units; Pine Valley and River’s Edge are similar
properties, but there have been no issues. Dan Sinclair goes to Mr. Pennock’s house every week
to check the unit and we will also be addressing his neighbor’s soggy grass areas issue.

Dr. Smith asked how many drip systems are going to be installed; Ms. Kuns responded that
currently there are none due to wet weather but there may be some by the end of the year.

Mr. Pennock restated his purpose for addressing the Board of Health today – to bring attention to
the Board that this system has not been a good system for him. He wants a system to work for
ten years with minimal maintenance. The system was very expensive initially, almost $17,000.
Should the Board consider adding the temperature probe to the requirements for this type of
system installation?

The Board took no action on Mr. Pennock’s request; Dr. Smith asked Laura Kuns to keep the
Board updated on this issue.

2.03    Certification of Delivery of Official Notices

Certification of delivery of the official notices of the regular meeting of the Board of Health on
May 11, 2011 was made by Health Commissioner Frank Kellogg.

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3.0     Board of Health

3.01    Approval of Minutes

       James Pegoraro moved and Patricia Fowler seconded a motion that Minutes of the
April 18, 2011 Board of Health meeting be approved as written; motion carried.

4.0     Health District Staff Reports

4.01    Community Health Services Report

       Division Director’s Report
       New Business/Updates/Special Topics

Obesity on Stage
The Lake County General Health District will seek to support a county-wide childhood obesity
awareness play in conjunction with the Willoughby Fine Arts Association. An effort will be
made to educate parents, businesses, and partner organizations about the impact childhood
obesity has on children; ranging from diabetes, depression, bullying, and barriers to physical
activity. The Director of Community Health will seek sponsorships to offset the costs and the
play will be a great highlight for the Action Communities for Health, Innovation, and
EnVironmental ChangE and Lake County Childhood Obesity Prevention initiatives. The Health
District approached the Fine Arts Association seeking to expand the scale of their current
Theater for a Healthy Living project.

Staff Workforce Development Survey Results
The Director of Community Health Services assisted with the implementation of a state-wide
workforce training needs assessment with the Ohio State University’s Center for Public Health
Practice and the University of Cincinnati’s Department of Public Health Sciences. The report,
received in late April, will be made available at the Board of Health meeting. The results will be
utilized by the Director of Community Health Services as documentation for Public Health
Accreditation and to assist with planning staff in-services and quality improvement planning.

Carol M. White Physical Education Progress Grant
After implementing the We Can! Media Smart Youth program pilot in Perry Schools the
Director of Community Health Services made contact with the National Institute of Health’s
(NIH) national partners to pursue potential funding opportunities. Ms. Ellen Ormsby, of the NIH
SPARK program, introduced Mr. Graham to Advance Fitness Solutions, a company that seeks
grants on behalf of the SPARK and NIH organizations, and offered the Health District an
opportunity to apply for the much sought after federal Carol M. White grant. This three year
grant program will assist in implementing new research based physical education curriculum and
with meeting new state/national requirements for all K-5 and middle schools in Lake County.
The Health District will act as the lead Project Coordinator and lead Program Evaluator for the

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project, if funded. Funded agencies in the past have received national recognition for their work.
The pre-submittal will be brought to the Board of Health once the budget has been established
for this complex program.
       Meeting Highlights

The Deputy Health Commissioner attended the Northeast Ohio Regional Health Commissioner’s meeting
on behalf of the Health Commissioner, who had scheduling conflicts. The Deputy Commissioner had the
pleasure and opportunity to meet with Dr. Ted Wymslyo, Director of the Ohio Department of Health.
The discussion focused on the fact that numerous counties in Ohio have more than one health district due
to city health districts and is this beneficial given the current economic concerns and redundancy. Dr.
Wymslyo also shared that his vision is to make Ohio competitive against other states for federal funding
and is putting his support behind Voluntary Public Health Accreditation to accomplish this. The
accreditation project/process is being viewed as they best long term goal to improve public health funding
for Ohio.

       Clinical Services Unit Report
       Unit Supervisor’s Report

Program Highlights
To celebrate Public Health Week, the Nursing staff wished to recognize the contributions to
public health by identifying a local Public Health Hero. Ms. Kathy McElveny, a long time Lake
Health Microbiologist was their choice. Ms. McElveny and her staff are often the first to
recognize and report diseases or an unusual pattern of illnesses. She was responsible for assisting
with our county-wide disease surveillance system, and the activation of a rapid H1N1 testing and
surveillance system two years ago. We wish to recognize her commitment to promoting and
protecting the health of Lake County.
In April, the Health District was represented by the Director of Nursing on several advisory
committees for various local health care programs. Lakeland Community College reviewed it’s
curriculum of the College Tech Prep Health Programs. This included secondary and college
pathways for Nursing, Radiology, Surgical Technology, and Respiratory Therapy. Local
representatives provided input and ideas to help shape the curriculum by reviewing program
content standards and competencies. The Auburn Career Center Patient Care Technician
Advisory Committee met to provide information to modify, update, expand and improve the
quality of their Health Technology programs. Both programs look to local representatives to
help shape the future of the healthcare workforce.
       Communicable and Environmental Disease Report

Based on Class A reportable disease by physicians, clinic and other service providers, the
following types and numbers of cases were noted during the past month.

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           2011 COMMUNICABLE                                                  2011
                                                    JAN   FEB   MAR    APR
           DISEASE REPORT                                                     YTD
           Campylobacter                              1    0     1       3       5
           Chlamydia                                 52   35    37      45     169
           E. Coli Not O157:H7                        0    0     1       0       1
           Giardia                                    0    0     1       2       3
           Gonorrhea                                 13   10     6       2      31
           Haemophilus Influenza                      0    1     0       1       2
           Hepatitis A                                1    1     1       1       4
           Hepatitis B                                2    2     1       0       5
           Hepatitis C                               17   13    13      10      53
           Influenza- Hospitalized                    4   12    16       2      34
           Legionnaires Disease                       1    0     0       0       1
           Lyme Disease                               0    1     0       0       1
           Meningitis – Aseptic/Viral                 1    1     1       0       3
           Meningitis - Bacterial (not Neisseria)     0    1     0       0       1
           Mumps                                      1    1     0       0       2
           Mycobacterium Avium                        0    1     0       3       4
           Mycobacterium – Gordonae                   0    0     0       2       2
           Mycobacterium – Other than TB              0    0     0       1       1
           Mycobacterium – Tuberculosis               0    0     1       1       2
           Pertussis                                  0    2     1       1       4
           Salmonella                                 2    1     5       1       9
           Streptococcal Group A                      2    0     2       1       5
           Syphilis                                   2    1     0       3       6
           Varicella                                  6    3     4       4      17
           TOTALS                                   105   86    91      83     365

       Health Promotion and Planning Unit Report
       Unit Supervisor's Report

Safe Communities
The 8th Annual Mixers & Shakers Contest was held on Thursday, April 28th from 5 p.m. - 7:30
p.m. at St. John Vianney Social Center. Thirteen police departments competed against each
other to see who could create the best non-alcoholic beverage. Winners of the event were: Best
Mocktail Name: Jersey S’mores from the Lakeland Community College Police Department,

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Best Display: (tie) Willoughby Police Department and Perry Village Police Department, Best
Mocktail: Kirtland Hills Police Department with TrainWreck, and People’s Choice Award:
Mentor Police Department with their Super Sober Slider. Students in attendance also had the
opportunity to participate in Traffic Safety Twister, use the fatal vision goggles in a timed event,
participate in karaoke, and win door prizes. The evening was highlighted by the premier of the
winning video for the Safe Communities Coalition’s Teen Driver Safety Prom PSA Contest.
Four students from Madison High School created the video and one was present at Mixers &
Shakers. Approximately 120 students representing 11 schools attended.

Action Communities for Health, Innovation, and EnVironmental ChangE (ACHIEVE)
Five hundred ACHIEVE Worksite Wellness Workshop brochures were distributed to businesses
and community members in Lake County. An ACHIEVE presentation was given to the
members of Painesville Rotary on April 19.

Medical Reserve Corps (MRC)
A Core Leadership Group for Lake County MRC was formed. The group will be assisting the
Health Educator/Preparedness Specialist during 2011with recruitment of volunteers, community
presentations and outreach, and volunteer recognition.

Matter of Balance (MOB)
Thirteen senior citizens completed the class at Eastlake Senior Center. A new national database
for MOB was launched this month. The Health Educator/Preparedness Specialist will be
entering class data rather than mailing forms collected to Seattle, Washington. A training on
April 14 to learn how to utilize the database was attended. A brief presentation and thank you
was provided to Willoughby Elks on April 20 for their $500.00 grant for the MOB program.

Emergency Preparedness
The Preparedness Specialist held a meeting on April 4, 2011 at Lake County General Health
District (LCGHD) with staff that are part of the Strategic National Stockpile (SNS) Response
Team to review the Lake County Emergency Operation Plan SNS Plan. The LCGHD planned,
coordinated, and assisted in the execution of an SNS and BioWatch Training and Tabletop that
occurred on April 8, 2011 at the Lake County Emergency Management Agency. Lake County
officials representing the agencies that are part of the Lake County Emergency Operations Plan
for SNS attended and were trained on the plan, given an overview of BioWatch, and engaged in
breakout groups generating valuable discussion related to SNS operations in Lake County.
Representatives from over 48 local agencies attended the training. A Multi Agency Radio
Communication System radios check of Cleveland Metropolitan Statistical Area local health
departments in the Northeast Ohio Regional Public Health Partnership took place. The
Preparedness Specialist hosted a meeting for the Northeast Ohio Regional Public Health Public
Information Officer Workgroup on April 19, 2011 at LCGHD. The Preparedness Specialist
attended the Cities Readiness Initiative Funds Allocation conference call on April 20, 2011. The
Preparedness Specialist arranged to meet with Jared McQuiston, CRI Project Director for the
Cleveland Department of Public Health, on April 29, 2011 at LCGHD to prepare for LCGHD’s
May assessment by Ohio Department of Health (ODH).

May 16, 2011                                                                              -8-
HIV Prevention/Education
A mass HIV Testing Clinic was held at Lakeland Community College. Dawn Nickerson,
Michele Melnick, Rachel Klco, and three peers participated in this clinic. Sixty-two students
were tested. This is the second time the testing has been offered and has been well received.
Plans are in place to hold another mass testing clinic in fall, 2011. One hundred people were
tested in the month of April. Also, a conference call was held to explain the changes in the new
Ohio HIV testing law, the Centers for Disease Control and Prevention recommendation for
routine HIV testing in healthcare settings, and the ODH Expanded HIV testing program.

HIV Peer to Peer / Outreach
LCGHD ―Peer to Peer‖ continued to be active in the month of April. This program is designed
to help train and facilitate the utilization of grounded and healthy HIV+ individuals as a mentor
to an out of care, erratically in care, newly diagnosed HIV+ person. New members are
continually being sought to train as peer mentors. This April’s monthly training opportunity was
at the AIDS Task Force of Greater Cleveland with a focus on how to mentor couples. Peer
mentors were also encouraged to attend the educational groups presented by LCGHD with their
peer counterpart.

This month three of the peer mentors were able to attend groups with their peers. Peer mentors
were also encouraged to attend the Lakeland HIV testing event this month. Three mentors
attended and assisted in giving out information and education about HIV awareness.

The Outreach program is looking forward to starting a new grant year and eagerly awaits the
2011/2012 funding allocations.

HIV Early Intervention / Education
Each month Lake County General Health District – Case Management collaborates with other
agencies to conduct an education/support group for the HIV/AIDS population. This month’s
group was held in collaboration with Bristol-Myers Squibb Pharmaceutical Company. Clients
were able to discuss ways to be part of their medical team, how to have a voice in their
treatment, and how it relates to medical adherence. This month’s group resulted in a wonderful
turnout of 20 plus clients and supportive counterparts. Great Job - Michele and Rachel!

       Help Me Grow (HMG) Healthy Families Unit Report
       Unit Supervisor’s Report

Program Highlights
Finally longitudinal research on our services! The National Governors Association (NGA)
Center for Best Practices has published a new issue brief, Maximizing the Impact of State Early
Childhood Home Visitation Programs, Showed the following outcomes for EC home visitation
and nurse partnership programs:
         48% reduction in officially verified cases of child abuse and neglect.
         84% of program participants graduated high school.

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              5% decrease in low birth rate from a 10% average (50% less).
              20% less time on welfare.
              43% less likely to have arrests by age of 19.
              58% less likely to have convictions by the age of 19.

        The next free community developmental screening is on June 21, 2011.

Partnership Highlights
This month’s community Autism Symposium was a big success. Those in attendance included
participants from the medical community, mental health, childcare, parents, caregivers, service
providers and Ohio Center for Autism and Low Incidence Rates.

The presentation included data on the success of the ODH project in partnership with the
American Academy of Pediatrics and Help Me Grow. The project’s aim:
        90% of children have a documented screening for autism at 24 month well child
        90% of children have a documented developmental screening at 9, 12, 18, 24 (or 30),
           and 36 month well child visits.
        90% of children identified as at risk or with delay are referred for diagnosis and
        90% of families report practice receptive to developmental concerns.
The project includes strategies to increase timely access to a standardized, comprehensive
diagnostic evaluation with a psycho-educational component and medical component that builds
on existing local, community-based resources and requires collaboration and communication
among families, local physicians, HMG, and LEAs/ESCs. The project incorporates learning
during Grand Rounds and web based learning modules that strengthens coordinated care using a
systems approach.

Staff Spotlight:
Julie Gembus carries a Master’s Degree and has been with HMG for six years. Her focus in
HMG is serving families in the Home Visitation Program/Great Gains with multiple risk factors.
She is Service Coordinator credentialed and is working towards the Home Visitation
credentialing. She is a certified Parent’s-As-Teachers Educator. She brings a strong background
in child welfare and working with diverse families to our program.

       Women, Infants and Children (WIC) Unit Report
       Unit Supervisor’s Report

Program Highlights
During the month of April we offered a nutrition education class where we taught the children
The ABC's of Healthy Eating. This class taught children how to identify fruits and vegetables
starting with each letter of the alphabet. The class was well received and new fruits and
vegetables were introduced to our families.

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Our breastfeeding team has been working diligently to increase our breastfeeding rates. Our
peers created Bios to handout to moms letting them know what each peer's individual
breastfeeding experience was. Our team has also been preparing and organizing for a
breastfeeding support group held in our Madison office. Our prenatal mailings have increased to
help moms learn about breastfeeding early on in their pregnancy. We are excited for some
upcoming scheduled events to help promote breastfeeding in Lake County.

Program Outreach
Throughout the month of April we participated in some outreach events to help increase our
caseload. We offered our information for the Week of the Young Child, Crossroads and the
Madison Food Bank. We also worked with Help Me Grow to provide breastfeeding information
to those new moms on their home visiting program.

Clinic Caseload-April

CLINIC                    Assigned Caseload     Caseload        % of Assigned Caseload
Central                           2133              2092                  98%
Willoughby                        1517              1402                  92%
Madison                            451               448                  99%
TOTAL CASELOAD                    4101              3942                  96%

Clinic Activity –April

Activity                       Scheduled          Attended         Show Rate %
Certifications                    301                244                81%
Re-certifications                 708                545                77%
Individual Educations             382                316                83%
Group Educations                  420                309                74%
High Risk Clients                 152                106                70%

Ron Graham, Community Health Services Director provided a brief update on the following
    - This has been a grant writing month for CHS staff since CHS runs on grants –
       Reproductive Health Grant, the 1.7 million Carol White Grant
    - The PHEP Grant audit was conducted with all partners present. The auditors were
       overwhelmed by how well the partners came together. The last two years the Health
       District has scored 73 – Mr. Graham is looking for at least an 80 score this year.

May 16, 2011                                                                       - 11 -
    -   The Health District met with Geauga County regarding their participation in the Drug
        Repository Program. We have asked them to work tohelp find a supply of medications
        as well.
    -   There are two corporate sponsorships in this month’s packet – Bike Day and the Lake
        Hospital System Just run project.
    -   WIC was flat funded for the upcoming year, with no reduction of $70,000 as anticipated.

Mr. Vitolo asked how the Matter of Balance program was progressing – Mr. Graham responded
That the program is going just fine; we will teach approximately 60 people this year.

        Environmental Health

4.02.01        Ohio Environmental Health Association Honors Laura Kramer Kuns

The Ohio Environmental Health Association awarded Laura the Ray Watts Outstanding
Sanitarian Award at their Annual Educational Conference in Worthington. This award is
presented annually to an active member of the organization who has made an outstanding
contribution to the field of environmental health. Laura was nominated, in part, for her tireless
efforts to influence the passage of contemporary sewage legislation. In the fall she received the
Northeast Ohio district award, qualifying her for consideration for the statewide award.

Laura is a decorated Sanitarian who has been recognized on numerous occasions for her 30+
years of accomplishments. Stop in her office and check out her wall of fame!

4.02.02        Rabies Task Force Meeting and Rabies Update Program Held April 14th

The annual meeting of the Lake County Rabies Task Force was held on April 14th at the Health
District office. Several affiliated disciplines have membership in this task force, including
veterinary practices, Lake County Auditor, nuisance animal trappers, law enforcement, Lake
Metroparks animal rehabilitation and Ranger, and members of the medical community. In
addition, Drs. Brown and Smith attended the meeting.

The two most important agenda items were meeting our new Lake County ODNR Wildlife
Officer, Jason Keller, and receiving a presentation from John Paul Seman, USDA APHIS
Wildlife Services Assistant District Director regarding the present state of raccoon variant rabies
in northeast Ohio. He described the decrease in the numbers of positive animals the past few
years and attributed it to successful ORV and TVR programs. The audience was reminded of the
significant number of rabies cases in Pennsylvania (400+) and the alarming number of domestic
animals that were positive for rabies (60). This is reason enough to continue the diligent rabies
control efforts.

After the meeting adjourned, a second presentation was offered by USDA to update Sanitarians
from several counties and cities in Northeast Ohio on the rabies status. Dr. Kathy Smith, DVM,
of ODH added information about some recent, concerning rabies cases and also gave a sobering
account of the elimination of all rabies prevention funding in Governor Kasich’s budget. Health

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districts that had received money for surveillance efforts and oral raccoon vaccine (ORV)
distribution will not have any subsidy beginning FY 2012. Dr. Smith also used the well-attended
presentation as a pre-baiting conference prior to the May ORV project. John Paul made a plea to
local health districts to continue to assist and support USDA in the absence of ODH grant

4.02.03        Spring Oral Rabies Vaccine (ORV) Baiting May 2-20, 2011

USDA Wildlife Services, at the direction of the National Rabies Management Program, provided
LCGHD with approximately 20,000 fishmeal polymer rabies baits (Raboral V-RG®) to be
distributed throughout the urban and suburban areas of Lake County. The spring baiting
previously was sponsored by ODH, but in the absence of funding, USDA took the project and
modified it slightly to eliminate aerial dispersal. Lake County’s participation was a part of a
limited baiting event occurring in Northeast Ohio at the leading western edge of raccoon variant
rabies. The Environmental Health staff aggressively began the ground baiting on May 2nd and is
projected to complete the bait distribution ahead of schedule.

ORV has been utilized in the United States since 1990, in Canada since 1985 and in Europe since
1980. Currently, there are 15 states distributing oral vaccines for raccoons in the U.S. There have
been nearly 48 million doses of Raboral V-RG® distributed in the U.S. and Canada, and 63
million doses have been dispersed worldwide. Raboral V-RG® is currently the only effective
oral vaccine licensed for use in free-ranging raccoons, gray foxes, and coyotes in the United
States. USDA and Lake County are anxious to receive results of U.S. field trials of a companion
vaccine/bait that is designated for use in skunks. It is hoped we will be able to utilize this
vaccine in the very near future to immunize the skunks that continue to plague Lake County with
raccoon variant rabies.

4.02.04        Health District Participates in Earth Day 2011 Activities

The Health District created two displays to educate visitors of the Earth Day observance on April
17th at Penitentiary Glen in Kirtland. Lake Metroparks’ theme for this year’s Earth Day was ―I
Can Help the Earth by Using our Resources Wisely‖ with a focus on water as a resource. The
Health District display contained information on maintaining a home septic system, well
maintenance, properly disposing of trash and chemicals, and the pharmaceutical drug disposal
program to educate the public on how to keep our waterways safe and clean. The display also
contained information on beach sampling at Mentor Headlands and Fairport Harbor.

Through the Health District’s contract with the Lake County Stormwater Management
Department to provide education, the Health District also created the Stormwater Department’s
display. This display was geared toward children by portraying ―If I Were a Water Drop, Where
Would I Go?‖ The display tracked a water droplet from a rain cloud, through the stormwater
system, and eventually to Lake Erie. It also contained information on how to keep stormwater
clean to prevent water pollution. A game wheel was used where the kids could spin the wheel
and see different places where stormwater drains, like a river, rain barrel, catch basin, or rain
garden. Laura and Susan manned the booth and were available to engage participants and

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answer questions. Despite the cold weather, 850 hardy people visited Penitentiary Glen for Earth

4.02.05        ODA Completes Food Establishment Operation Survey

The final report is not in, but preliminary results indicate the food protection program and staff
fared well in Ohio Department of Agriculture’s survey of Food Establishment Operations, which
included convenience and grocery stores, meat markets and pizza shops. The survey began with
an administrative review of plan review, licensing, and fee remittance. Then each Sanitarian
conducted two inspections with the ODA surveyor to demonstrate their understanding of the
food code and compliance of the facility. The surveyors also studies past inspection reports and
compared them with the findings during the current inspection to determine that there was
uniformity among the staff. As with surveys in other programs, we welcome the opportunity to
have our programs evaluated and learn how and where we may improve.

4.02.06         ODH Adopts New and Improved Swimming Pool Rules, Effective April 1st

As part of the mandatory five year rule review process, the swimming pool rules were recently
reevaluated. The most prominent feature of the newly-effective swimming pool rules is that they
have been reorganized and are in a form that is much easier to follow. Secondly, one of the most
significant changes is that the rules have caught up with industry and technology and now
address spraygrounds, which previously were unregulated. The rules also now require pools
and spas to be compliant with the provisions in the Virginia Graeme Baker (VGB) Act, which
previously was enforced by the Consumer Product Safety Commission. This federal law went
into effect in 2008 and the swimming pool operators have been notified of this law and have
been encouraged to comply. This portion of the rules makes it mandatory that pools take
specific measures to assure there is no danger of entrapment, entanglement, or evisceration at
any point where a vacuum occurs, such as at drains. Interestingly, the rules also clarify that dog
swims may not be permitted during the swimming season.

There are some significant fee changes incorporated into the new rules. The state increased the
amount of their fee that is paid upon licensure and also raised the fees for plan review to reflect
the amount of time the engineering staff spend reviewing plans and inspecting installations.

The Health District invited all swimming pool, spa and/or sprayground licensees to attend an
informal meeting on May 13th to discuss the rule changes. During the meeting the operators were
also informed that the Health District will take an aggressive stance particularly regarding
compliance with the rules which pertain to compliance with the VGB Act.

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  4.02.07         Board Action Status

  Note: New entries are bold faced

Program          Name             Pol. Sub.     BOH Ref.   Status
Sewer Tie-In DiVincenzo           Willoughby    1/22/07    House is connected waiting for ST
                                  Hills                    abandonment and internal plumbing
                                                           corrections. The City of Willoughby
                                                           Hills is behind with their internal
                                                           plumbing inspections and dye testing
                                                           for infiltration/exfiltration issues.
Sewer Tie-in     Milosevic        Willoughby    3/17/08    House is vacant. House is going back
                                  Hills                    for sheriff sale in 3-4 months.
Sewer Tie-in     Kazandjieff      Willoughby    08/17/09   Kazandjieff was required to obtain
                                  Hills                    permit by March 31st., no permit
                                                           obtained, Prosecutor to make contact.
                                                           Prosecutor gave him until May 31st.
                                                           or file motion to show cause.
Sewer Tie-In Kondrat              Willoughby    9/21/09    Has connected to sanitary sewer, must
                                  Hills                    still abandon septic tank & obtain
                                                           internal inspection from Willoughby
Solid Waste      Molyneux         Painesville   7/19/10    Prosecutor has filed suit. Prosecutor
                                                           has not been able to achieve service,
                                                           will pursue accordingly.
Sewer Tie-In Mack                 Willoughby    7/19/10    Prosecutor has talked to attorney
                                  Hills                    regarding bankruptcy and loan
                                                           modification. The bankruptcy has
                                                           ended and loan modification for
                                                           mortgage has proceeded, however
                                                           bank would not include sewer
                                                           connection cost in loan. Prosecutor
                                                           will contact Mack require deadline to
                                                           pay for permit.
Sewer Tie-In DeWitt/Wasson        Fairport      09/20/10   Prosecutor has filed suit. Prosecutor
                                                           has not been able to achieve service,
                                                           will pursue accordingly.
Solid Waste             Duane     Madison       1/18/11    Prosecutor has contacted Mr. Lester to
                        Lester                             require plan (due 3/31/11) for solid
                                                           waste removal. No plan was submitted,
                                                           Prosecutor to contact Lester. Mr.
                                                           Lester submitted brief plan with no
                                                           deadlines, requested Health District
                                                           to reinspect for any progress.

  May 16, 2011                                                                     - 15 -
Nancy Niehus, Environmental Health Supervisor first apologized for the EH report arriving to
the Board unfinished.

She then updated the Board on the following items from her report:
           - Laura Kuns received the Ray Watts Outstanding Sanitarian Award from the Ohio
              Environmental Health Association.
           - The rabies baiting was finished last week with 20,000 baits distributed. Holden
              Arboretum and Lake Metro Parks will use all terrain vehicles to finish baiting the
              parks this week. There have been zero positive cases of raccoon strain rabies this
           - New swimming pool rules went into effect April 1, 2011. EH invited pool
              operators in to discuss the new regulations; two additional workshops will be held
              this summer and another later in the year for indoor pool operators.

May 16, 2011                                                                         - 16 -
        Manager’s Report

  Lake County General Health District
  MONTHLY FINANCIAL REPORT                      Apr-11

                                                                              %        YTD LESS
  RECEIPTS                                  YTD              BUDGET           RECD     BUDGET
  Environmental Health Receipts             $     424,374    $    852,299       50%    $ (427,925)
  Public Health Nursing                     $      53,421    $    123,181       43%    $     (69,760)
  Federal Grants                            $     443,814    $  1,603,894       28%    $ (1,160,080)
  State Grants                              $     197,942    $    642,399       31%    $ (444,457)
  Local Contracts                           $      54,513    $    194,286       28%    $ (139,772)
  Vital Statistics                          $     109,928    $    290,000       38%    $ (180,072)
  Family and Children First                 $      55,110    $    151,955       36%    $     (96,845)
  Miscellaneous                             $      26,921    $     80,164       34%    $     (53,243)
  Tax Dollars                               $   1,077,044    $  2,154,088       50%    $ (1,077,044)
  TOTAL RECEIPTS                            $   2,443,068    $   6,092,266     40%     $ (3,649,198)
  Beginning Cash Balance                    $    2,193,326   $    2,193,326    100%    $           -
  TOTAL - ALL FUNDS                         $   4,636,394    $   8,285,592     56%     $ (3,649,198)

  Salaries                                  $      973,455   $    3,302,827    29%     $ (2,329,371)
  Fringe Benefits                           $      329,243   $    1,290,150    26%     $ (960,906)
  Contract Services                         $      122,387   $      474,431    26%     $ (352,045)
  Program Supplies, Marketing, Health Ed.   $      113,671   $      485,297    23%     $ (371,625)
  Office Supplies and Postage               $       28,047   $      107,311    26%     $     (79,264)
  Transportation and Travel                 $       22,370   $      116,225    19%     $     (93,855)
  Building Expense                          $       67,376   $      225,836    30%     $ (158,459)
  Equipment                                 $        2,263   $      106,820    2%      $ (104,557)
  Returns                                   $          540   $       39,884    1%      $     (39,343)
  Operating Expenses                        $       95,596   $      393,358    24%     $ (297,761)
  Contingency                               $            -   $      139,497    0%      $ (139,497)
  SUB TOTAL                                 $   1,754,949    $   6,681,634     26%     $ (4,926,685)
  Obligations from previous year            $      219,847   $    1,603,958    14%     $ (1,384,111)
  TOTAL DISBURSEMENTS                       $   1,974,796    $   8,285,592     24%     $ (6,310,796)

  # MONTHS & % OF YEAR                            4                12         33.33%

Jeff Campbell, Senior Manager stated that under New Business the Health District is requesting
to purchase six new vehicles instead of just one, as approved last year. The Health District
replaced the SUV using the State bid schedule and has not yet replaced the regular automobile.
We received the State bid on the Ford Focus; Mr. Campbell went to Classic Ford and they
quoted $30 under the State bid and they are bidding 2012 vehicles. The Health District can

May 16, 2011                                                                                     - 17 -
receive $3,400 as a trade in on the 2004 vehicle and $200 - $400 additional on each of the 2005
vehicles. Each of the six vehicles will cost approximately $10,000.

The audit is finished and has been submitted to the State; when it is released, Mr. Campbell will
forward copies to the Board of Health.

        Health Commissioner’s Report

4.04.01        Ohio’s H1N1 Vaccination Efforts Saved Deaths, Hospitalizations & Illness

On April 20, 2011, the ODH released a study that Ohio’s H1N1 vaccination efforts in 2009-2010
prevented 64 deaths, 1,400 hospitalization and 310,402 cases of influenza. The study also
estimates that Ohio’s vaccination efforts saved the State $8.4 million in H1N1 related
hospitalization costs. The study was completed using a model published by researchers from the
CDC to compare what occurred in Ohio to what could have occurred without vaccination efforts.
More information can be found at and
If the Ohio data is extrapolated to Lake County’s population (2009), then between 6,367 and
11,673 H1N1 cases were averted, between 29 and 53 hospitalizations were averted and between
1.3 and 2.4 deaths were averted.

 Estimated Cases, Hospitalizations and Deaths Averted by H1N1 Vaccination in
                    Ohio & Lake County (4/12/09-4/10/10)
Group            Age       Ohio (min) Lake (min)(a) Ohio (max) Lake (max)(a)
                 0-17        2,712,522       52,327 2,712,522          52,327
                 18-64       7,225,696      147,511 7,225,696        147,511
   2009 Pop
                 65+         1,604,428       36,937 1,604,428          36,937
                 Total      11,542,645      236,775 11,542,645       236,775
                 0-17           96,692        1,983     177,269         3,636
                 18-64         180,829        3,709     331,519         6,800
                 65+            32,882          675      60,283         1,237
                 Total         310,403        6,367     569,071        11,673
                 0-17              430            9         789            16
                 18-64             819           17       1,501            31
                 65+               151            3         277              6
                 Total           1,400           29       2,567            53
                 0-17               6.0         0.1        12.0           0.2
                 18-64            49.0          1.0        90.0           1.8
                 65+                9.0         0.2        16.0           0.3
                 Total            64.0          1.3       118.0           2.4

May 16, 2011                                                                          - 18 -
4.04.02        Smoke Free Ohio (4 Year Results-Lake County)

May 1st marks the beginning of the 5th year of enforcement of Ohio’s Smoke Free Law since
enforcement began in 2007. To date, the program has seen 1,159 complaints concerning 399
separate business facilities. In the second year of the program (5/1/08-4/30/09) complaints were
reduced 60% from the prior year. The third year has seen a further 10% reduction and the fourth
year a 28% reduction. Overall, complaints have been reduced 74% from the program’s first
year. See chart below:

                             Smoke Free Ohio Statistics for Lake County
                                                          Years starting 5/1 thru 4/30
Year #                                          1            2          3          4       Total
# Complaints                                   574          230        206        149      1159
% Reduction From Previous Yr                                -59.9%     -10.4%     -27.7% N/A
% Reduction From Yr #1                                      -59.9%     -64.1%     -74.0% N/A
# Separate Facilites Subject to Complaint         225          132        113         96      566
# Warnings                                          37           9          8         11        65
# Fines #1 ($100)                                     8          7          4          1        20
# Fines #2 ($500)                                     2          4          4          2        12
# Fines #3 ($1,000)                                   1          0          3          0         4
# Fines #4 ($2,500)                                   0          0          1          1         2
Total Fines                                         11          11         12          4        38

4.04.03        State Budget Bill HB 153 Changes

At the time of this writing, the 4,000 page Ohio budget bill still remains to be voted on by the
Ohio Senate and thus remains in a state of flux. Further, the House passed version is not yet
completely available. Changes that we are aware of appear to be follows:

    a) Help Me Grow— We have received word that this program (statewide) may receive an
       additional $750,000 in state funding, although this is somewhat unclear at this writing.
       With all federal, state and local cuts considered, funding may be reduced (as anticipated)
       by as much as $200,000 for the LCGHD.
    b) Smoke Free Enforcement—although sufficient funds are allotted for this, it is likely that
       funds will be depleted after 6/30/2013.
    c) Manufactured Homes Parks—inspection will now fall under the auspices of the Ohio
       Manufactured Home Park Commission who shall first offer inspection authority to local
       health districts (LHD’s)
    d) Agricultural Labor Camps-the previous budget bill gave authority for inspection of these
       facilities to LHD’s. The most current version appears to return authority and inspection
       to ODH.

May 16, 2011                                                                               - 19 -
    e) Marinas—the previous budget bill removed ODH authority for this program and gave
       LHD’s optional regulatory and fee setting authority. The most current version appears to
       return authority and inspection to ODH.
    f) PERS Share—In the previous version, employer PERS share would be reduced from
       14% to 12% and employee share would increase from 10% to 12%. This provision has
       been removed from the current version. It may reappear in the soon to be rewritten PERS

4.04.04        American Lung Assoc. Issues State of the Air Report 2010

On April 27, the American Lung Assoc. (ALA) issued its annual The State of the Air Report for
2011 ( The report shows that the air quality in many places has
improved, but that over 154 million people—roughly just over half of the US population, still
suffers pollution levels that are too often dangerous to breathe. Last year’s comparative figure
was 58% and 175 million people—so there has been improvement. The report looks at levels of
ozone and particle pollution found in monitoring sites across the United States in 2007, 2008,
and 2009. The report uses the most current quality-assured nationwide data available for these

The strongest improvement came in the year-round (annual) particle pollution levels, but most of
the cities with the highest ozone and short-term particle levels improved as well, including Lake
County and the Elyria-Cleveland-Akron SMSA.

For particle pollution, the report separately ranks the areas with high year-round (annual average)
levels and high short-term levels (24-hour) found in monitoring sites across the United States.
The Cleveland area (including Lake County) ranks 12th worst in year-round particulate pollution
(up from 19 in last year’s report) but continues to be out of the top 25 lists for ozone and short-
term particulate pollution. Of Ohio Counties, Lake County still receives an ALA grade of ―F‖
for having 18 ozone days in 2007 to 2009 (down from 26 days in the last report) that are
unhealthy for sensitive populations. Lake County also received a grade of ―C‖ for having 4 high
particle pollution days that are unhealthy for sensitive populations. Despite these grades, both
ozone and particulate matter levels have been steadily improving in Lake County since 2003 and
are nearly in compliance with current federal standards.

The same week that this report was being released State Senator Grendell visited our Auburn Rd.
(Geauga County) Notre Dame School ozone monitoring location along with a News-Herald
reporter. The LCGHD was alerted by the school operators and EH Director Nancy Niehus and
Air Pollution Sanitarian Doug Mehls met the Senator at the site. The Senator did not appear to
be critical of our efforts and was apparently trying to highlight his efforts to promote legislation
that would allow decentralized E Check automobile test sites. A News-Herald story should
appear on May 10 that will cover the Senators efforts as well as ozone issues in Northeast Ohio
and its relation to the E Check program.

May 16, 2011                                                                            - 20 -
4.04.05           LCGHD Program Highlight

For May’s meeting, Nursing Director Kathy Durchik will highlight the Health District’s
Newborn Home Visiting Program. This program targets first time parents, teen-parents, and
their newborn infants. Public Health Nurses make a one-time home visit in the first few weeks
after the baby is born to provide an assessment of mother and child, answer questions, link
families to services and resources within our community and provide information to keep babies
healthy and safe. In 2010:

              A total of 192 newborn referrals were received from various hospitals.
              Public Health Nurses made 117 newborn home visits.
              A $17,000 Lake County Community Block Grant was awarded to support this project
               from October 2010 through August 2011.

4.04.10           Vital Statistics Sales and Services Rendered - April

                                                         April      YTD
                  Birth Certificates Issued              454        2021
                  Death Certificates Issued              675        3052
                  Fetal Death Certificates Issued          0          1
                  Burial Permits Issued                   54         265
                  Birth Certificates Filed               129         628
                  Death Certificates Filed               138         634
                  Fetal Death Certificates Filed           2          3

Health Commissioner Frank Kellogg provided an overview of his monthly report:
    The State issued its H1N1 report; the Health District took their data and extrapolated
       numbers for Lake County. We helped save lives and prevent excess hospitalizations by
       vaccinating 30,000 people at a cost of $415,000.
    This is the 4-year anniversary of the Smoke Free Ohio Legislation and the complaints
       continue to drop. We have collected only one-third of the fines issued, and the State is
       the enforcer of the fine collections. There are four establishments that have not yet paid
       their fines.
    Changes were made to the State Budget last month, which has now gone through the
       House. Help Me Grow was cut by $750,000. Mobile Home Parks revert to the Mobile
       Home Park Commission. We are not sure yet if we should begin regulating agricultural
       camps and marinas. The 12%/12% PERS split for employers/employees was taken out.
    The American Lung Association issued its “State of the Air in the U.S.” Lake County
       received and “F” for ozone.

May 16, 2011                                                                          - 21 -
5.0     Committee Reports

5.01    Child and Family Health Services Advisory Council, Meeting Held April 12, 2011

                 Child and Family Health Services Advisory Council
                                  Meeting Minutes
        Our Goals:
        1. All children are wanted and born to healthy families
        2. All children are born well
        3. All children and families are educated about health and health care systems
        4. All children are healthy and experience optimal childhood development

                                         April 12, 2011
                               Lake County General Health District

        Barb Moran                      Lake Health Hospitals
        Christine Kettunen              Ashtabula County Health Department
        Colleen Weaver                  Lake Geauga United Head Start
        Dawn Nickerson                  Lake County General Health District – Breathe Well, Breathe Free
        Gabrielle Zaler                 Lake County Free Medical Clinic
        Jerry Ranally                   Lake County Juvenile Court
        Joyce Zadd                      Mentor GRADS
        Kathy Durchik                   Lake County General Health District – Well Child
        Lauren Henderson                Lake County General Health District - WIC
        Mary Wynne-Peaspanen                   Family Planning Association
        Peggy Meros                     Auburn GRADS
        Stacy Rihaly                    Crossroads Early Childhood Services
        Judi Waite                      Lake County General Health District

        Guest: Tori Luyster             Lake County General Health District – ACHIEVE

The Child and Family Health Services (CFHS) Advisory Council meeting was called to order by Chair,
Stacy Rihaly at 8:31 a.m. at the Lake County General Health District. Roundtable introductions were

A motion was made by Mr. Ranally to approve the minutes of January 11, 2011 and seconded by Ms.
Wynne-Peaspanen. Minutes approved as written by Council.

  Family Planning (FPA) - Ms. Wynne-Peaspanen: Quarterly (1/1/11–3/31/11) report distributed and
  statistics were reviewed. FPA had 54 prenatal patients for 129 visits this quarter. Approximately 90%
  of the clientele are of Hispanic Ethnicity which is an increase and now have some Chinese clients. All
  clientele seen are uninsured. Funding has been decreased by the State. Clients are referred to a private
  physician for their 3rd trimester but several clients owe the physician’s offices money and cannot be seen
  until their bill is paid so FPA continues to provide 3rd trimester visits. During the 3rd quarter 402
  pregnancy tests were performed and 121 of the tests had positive results.

May 16, 2011                                                                                 - 22 -
    Well Child Clinic (WCC) - Kathy Durchik- Quarterly (1/1/11-3/31/11) report distributed and
    reviewed. Six clinics were held this quarter for a total of 43 visits. Thirty-five percent of the clientele
    were Medicaid and our Hispanic clientele have increased. Referrals made to other agencies for
    further follow up after our clinic assessments were as follows: 5 for vision; 2 for hearing; 3 for social
    services; 1 for dental and 1 for nutrition. 100% of the children seen in WCC were up-to-date or
    brought up-to-date with their immunizations. Ms. Durchik noted that over the last 5 years the
    statistical data (target population, payment status, etc.) have remained the same.

    Newborn Home Visiting Program has had 126 visits from 7/1/10 through 3/31/11.

    Childhood Immunization Program has seen 1440 children from 7/1/10 through 3/31/11. The Health
    District has 5 child immunization clinics a month. 573 children received flu vaccinations through the
    Health District.

    Child Fatality Review (CFR) Board met in March to review 12 child deaths. Two additional cases
    will be completed next year when additional information becomes available. Four deaths were
    preventable. A copy of the meeting minutes was distributed to members. Ms. Durchik will provide
    previous years CFR data for members.

    A request for proposal (RFP) is to be written for Well Child and FPA Prenatal Clinics. This grant will
    begin 7/1/11. The deliverables have changed from previous grant years. This RFP is targeting the
                        1.      Direct Care for Prenatal and Well Child
                        2.      Obesity. Work with schools, daycares etc.
                        3.      Infant Mortality. Safe sleep positions, prenatal care, cultural sensitivity.
                        4.      Assessments and Infrastructure building activities.

    Ms. Waite will send each member of CFHS Advisory Council a copy of the Community Health
    Assessment Survey results once available for the members to review for maternal child focuses. Ms.
    Durchik reviewed several current CFHS Infrastructure building activities as well as the community
    awareness events that occurred this reporting quarter.

    WIC-Lauren Henderson- Quarterly report distributed. Ms. Henderson reported that the new RFP for
    WIC should be forthcoming and hopefully funding will not be cut more than 5%. There has been a
    steady decline in caseload this past quarter. The goal caseload for Lake County is 4321 and would like
    to increase that. Outreach activities had been suspended since 2008 when caseloads were increasing
    but lately with the decline, outreach will be a focus for Lake County WIC. Several health fairs were
    attended by WIC staff. Trying to rid the stigma of being on WIC and show that it’s also for working
    mothers. Phone interviews prescreen clients so referrals are always accepted. The clinic show rate
    remains high due mainly to reminder phone calls. The number of WIC Breastfeeding (BF) mothers
    has slightly increased. About 36% of WIC moms are breastfeeding their infants. BF peers and
    education classes are provided. WIC would like to be the primary resource for breastfeeding mothers
    with counseling, support groups, resources and supplies. WIC BF Coordinator has a phone for 24/7
    questions/concerns. We currently mail prenatal women BF information. Ms. Henderson distributed an
    Executive Summary: The Surgeon general’s Call to Action to Support Breastfeeding. Several things
    noted in the Summary are:
                 1.      Minimize marketing of infant formula.
                 2.      Utilize/create support groups.
                 3.      Educate family and friends of BF mom.

May 16, 2011                                                                                     - 23 -
                4.      Promote and support breastfeeding with obstetricians, pediatricians and maternity
                        care personal.
                5.      Provide a clean, safe area in the workplace for BF mothers.

    Lake County WIC would like to see Lake County as a BF friendly county. (Ms. Moran from Lake
    Health Hospitals noted that the hospital is expanding its BF support peers and education groups.
    Both GRADS teachers (Ms. Zadd and Ms. Meros) thanked Ms. Henderson for the In-service provided
    by WIC’s Lactation Consultant to their students. Ms. Henderson assured both ladies that any student
    can call WIC for support or even to have the baby weighed or if they have any concerns.

    Lake County WIC received 650 Farmer’s Market vouchers (same as last year) to be given to WIC
    clients at the Painesville and Willoughby Farmer’s Market this summer. Lake County WIC had the
    3rd highest Farmer’s Market Nutrition Program redemption rate in the State in 2010.

    Ms. Henderson distributed a list of infant formulas available with WIC coupons.

    WIC will be doing a Smoking Cessation Program for pregnant women. After the initial assessment,
    WIC will track the number of women who smoked initially, quit smoking and continued to stop
    smoking after the baby was born.

    Breathe Well, Breathe Free - Dawn Nickerson: Report distributed on her three programs. Ms.
    Nickerson reported that the Breathe Well, Breathe Free (Asthma/Obesity) Program has received three
    new referrals and that three families have completed the program. Those completing the program
    receive a new vacuum cleaner. A nutritionist makes three visits to the family for diet changes. Ms.
    Nickerson will see the family for nine visits. Journals are kept by the asthma client to track
    environmental and/or health changes. Ms. Nickerson noted that there are behavioral changes as well
    as diet changes for her clients and their families. Siblings also receive education and information so
    they can assist and encourage the client.

    HIV testing is held at the Health District in Painesville every Tuesday from 2:00 – 6:00 p.m. Also testing
    is done in Ashtabula and Conneaut. Always looking for other testing sites. There will be a HIV Testing
    Clinic and educational in-service at Lakeland Community College on April 13, 2011. There has not been
    a positive HIV client from our testing since 2008.

    The Drug Assistance Program continues to receive new clients monthly. This program can offer certain
    drugs to the public who financially qualify at a reduced rate. Drugs come from a controlled environment
    such as a nursing home or hospital (Karon’s Law). Ms. Nickerson qualifies the client and then the Drug
    Repository (at another site) ensures the delivery of the drugs.

  Crossroads – Stacy Rihaly: Ms. Rihaly distributed a draft of a resource guide brochure she has
  created for Lake County moms. This brochure is mainly mental health facilities that could assist
  women experiencing any kind of mental health issue, such as depression, postpartum depression or
  just feeling overwhelmed. It was suggested that the title state ―Behavioral Health Resource Guide‖
  and that Lake-Geauga Recovery Center be added. Ms. Rihaly would like to distribute this brochure
  to pediatricians, obstetricians, hospitals, and other agencies. The changes will be made and brought
  back to Council in July.

  Help Me Grow – Sandy Allison: Ms. Allison distributed a Help Me Grow (HMG) Service
  Coordination Program Goal packet that explained the purpose, goals, funding, and a profile statistical

May 16, 2011                                                                                 - 24 -
    report. This report explained the areas of delays eligible for the program showing speech and hearing
    ranking the highest. Lake County HMG currently is serving 800 families.
    Home Visiting Program is another program of HMG. The program serves with first-time parents or
    military families and requires a weekly visit.             It is not service coordination but an
    educational/teaching program. Funding and manpower is an issue at this time. Referrals have come
    in for this program. Discussion ensued on families in need.

    Autism Informational Symposium is scheduled for April 28, 2011 at Lakeland Community College.
    Ms. Allison distributed a flyer and plans to invite local pediatricians and family practitioners. There
    has been a good response from the medical community for attendance. Dr. Turell from Lake Health
    Pediatrics will also speak at this Symposium.

    Fatherhood Initiative Program is a collaboration of HMG, Judge Lawson and Job & Family Services
    and will partner for this. This project provides grant monies for training leaders for the initiative.
    This is to have the father be emotionally, physically, and financially involved with their children.
    Training should be in the fall. HMG planning on a Fatherhood Summit to identify players and have a
    faith-based organization involved.

    Ms. Allison noted that there was a State study done on adolescents who had home visiting services as
    a child and that they had better school graduation rates and better life outcomes. Ms. Allison was
    asked to bring that data to the next CFHS Advisory Council meeting in July.

    ACHIEVE – Tori Luyster: Health Educator/Preparedness Specialist from the Lake County General
    Health District, Tori Luyster gave a presentation to Council on Action Communities for Health,
    Innovation, and EnVironmental ChangE (ACHIEVE). Ms. Luyster distributed her Power Point
    presentation, ACHIEVE food and nutrition classes’ information, and Worksite Wellness Workshop
    Brochure. Her presentation was an overview of the purpose, vision, policy and funding. Lake County
    is funded from the National Association of Chronic Disease Directors though September 2012.
    ACHIEVE breaks down by Schools, Worksites, Community Institutions/Organizations, and
    Community-at-Large sectors. Each has a committee that oversees projects/plans that will lead to
    healthy lifestyles that include consuming nutritious foods and engaging in higher levels of physical
    activities. This is accomplished through policy changes (changing of rules, laws, procedures),
    environmental changes (alter physical & social environments - i.e. installation of bike racks, walking
    paths), and system changes (change in social norms).

    Ms. Luyster noted there is a Wellness Worksite Workshop held at TriPoint Hospital on May 20,
    2011. Ms. Luyster noted that the Lake County Engineers’ Office was inadvertently left off the
    Brochure and noted they are a partner involved with ACHIEVE.

    ACHIEVE also assisted the YMCA in obtaining a Diabetes Grant to have educational classes and
    help with maintenance of diet and physical activities.

    ACHIEVE has a website that contains upcoming events, plans and

SPECIAL NOTE: The CFHS Advisory Council congratulated Ms. Joyce Zadd, GRADS Mentor, for
   her recognition by the Lakeland Community Women’s Center for making a difference by helping
   other women improve their lives.


May 16, 2011                                                                                  - 25 -
        1. Jerry Ranally – Juvenile Court: Mr. Ranally noted the Restitution Program in cooperation
           with the Painesville YMCA and the Juvenile Court for younger juvenile offenders, is where
           young juveniles make restitution to pay respective victims for property damage or victim
           injury expenses through a work program. The juveniles work at the YMCA on Saturday's
           under the Court supervision. Secondly, Judge Lawson's Achievement Program is a
           specialized Court docket addressing juveniles with substance abuse issues. The program is
           very active and busy with eight participants and their parents. Mr. Ranally also stated that the
           Lake County Juvenile Court "A-TEN-D Program" is working collaboratively with eight of
           the nine Lake County School Districts to address school truancy. Most school districts have
           reported a reduction in truancy filings as a result of this program.
        2. Colleen Weaver – Lake Geauga Head Start: Ms. Weaver noted that all classes are full for
           this year and they are not accepting any new applications. Applications for next year have
           already been coming in and nearly full. A lot depends of the funding available next year as to
           how classes will be filled. A Federal Site Review will be May 2–6, 2011.
        3. Barb Moran – Lake Hospital System: Ms. Moran stated the hospital’s franchisee fee will be
           increased next year. This is based on the number of beds and the money goes to the General
           Fund for the State.
        4. Mary Wynne-Peaspanen – Family Planning Association: Ms. Wynne-Peaspanen asked
           members of Council to call their Federal legislator to support Title 10 funding that supports
           family planning. Title 10 funds do not support abortion. She noted that family planning
           should be available to those who want to avoid an unwanted pregnancy.
        5. Stacy Rihaly – Crossroads Early Headstart: Ms. Rihaly noted that Crossroads is very busy
           and that the Early Headstart has full enrollment.

    Council asked Ms. Zaler of the Free Clinic to bring statistical/clinical information to future meetings.

    There was further discussion on the lack of services/providers for uninsured clientele. Too many
    utilize the hospitals’ emergency rooms for non-emergency issues or they do not have a medical home.
    Meeting Adjourned:       10:35 a.m.

NEXT MEETING:                 Tuesday, July 12, 2011 at 8:30 a.m.
       Lake County General Health District, Boardroom, 33 Mill Street, Painesville, OH 44077

Respectfully submitted,
Judi Waite

5.02    Personnel Committee, Meeting Held May 16, 2011

                                          Personnel Committee
                                            Meeting Minutes
                                              May 16, 2011

A meeting of the Health District’s Personnel Committee was held on May 16, 2011 at the offices
of the Lake County General Health District. The meeting was called to order at 1:54 p.m. In
attendance were:

Board of Health Members                   Others
William Catania, Chair                    Frank Kellogg

May 16, 2011                                                                                    - 26 -
Roger Anderson                        Jeff Campbell
Tim Brennan                           Ron Graham
Marc Garland
Brian Katz
Randy Owoc
Jim Pegoraro
Dr. Lynn Smith (Ad Hoc)

Mr. Catania called the meeting to order and asked Frank Kellogg to begin discussion of the
topics of the meeting. The purpose of the meeting was to discuss four issues as follows:

    1) Permission to Hire a Part Time Licensed Social Worker for 12 hours per week

Mr. Kellogg noted that permission for this hire is for additional grant/contractual obligations for
the Ryan White Part A Medical Case Management program. Ron Graham added that this
program was funded to $55,000 in fiscal year 2009 (.6 FTE) , $78,000 in 2010 (1.0 FTE),
$108,000 in 2011 (1.2 FTE), and it is anticipated that the Lake County General Health District
will receive a potential funding level of $150,000 dollars or more, of the $189,000 request for
fiscal year 2012. To meet the deliverables outlined in the grant a Licensed Social Worker will
need to be hired. The 2012 grant request supports the Medical Case Management program,
Medical Nutrition Therapy, Transportation, Outreach (previously the Peer to Peer program), Risk
Reduction (coordination of HIV testing with our current Portsmouth City Health District
funding), and adds a new Psychosocial Support Program. Additional funds also help support the
salary of the Health Promotion and Planning Supervisor and the Director of Community Health
that oversee the greatly expanded program. The additional funding has stemmed from the
documentation that the Lake-Geauga-Ashtabula do not have any other specialty service
providers in the tri-county area if it were not for the Lake County General Health District. Mr.
Anderson asked if there were other LSW positions being potentially laid off that might affect this
position—the answer was no. It was noted in response to a question that part time positions are
subject to the union contract and that this would be a union position. Mr. Pegoraro asked if such
positions required Board of Health approval. Mr. Kellogg noted that the Board has typically
reviewed such positions in the past as they constitute an addition to the organizational chart.

       Mr. Pegoraro moved and Mr. Katz seconded a motion to recommend to the Board
of Health that this position be approved, followed by a unanimous vote in favor of the

    2) Permission to hire a Casual Registered and Licensed Dietitian

Mr. Graham explained that currently, Tabitha Richards, serves as a contract position with the
Lake County General Health District and supports the Breathe Well, Breathe Free (Asthma and
Obesity Education and Prevention) program as the Clinical Dietitian for at-risk and overweight
children. The contract position also supported the Nutrition Educational component of the
WeCan "Smart Media Youth" program funded by the National Institute of Health and the Lake
Academy "At-risk" Youth Health and Wellness classroom series. The FY12 Child and Family
Health grant as reduced lead screening as a funded service, does not allow for Medicaid families

May 16, 2011                                                                           - 27 -
to be counted as in the past, and has increased its focus on community obesity prevention. The
Director of Community Health Services will utilize the exiting JUST RUN program, We Can
program, and develop a day care "train the trainer" program as readily expandable programs that
will meet the new grant requirements. The current contract rate is $40.00 per hour and changing
the position to a casual position will allow for flexibility while reducing the cost per hour
incurred by the position. Funding for the position currently exists in the 2011 budget under the
Asthma and Obesity program line, has anticipated funding under the FY 2012 Children and
Family Health Services grant, and is aligned to be a supported by a contract with the Lake
County Education Service Center for the provision of the Lake Academy "At-risk" Youth Health
and Wellness classroom series in the 2011-2012 school year. Per the Lake County General
Health District "casual" positions are exempt from the Union. It was noted that such casual
positions are different from part time positions in that funding is less stable, somewhat seasonal
(depending when schools are in session) and there are no set hours each week so as to provide
maximum flexibility. The rate for this position would be $20.10 per hour with up to 20 hours per
month expected.

      Mr. Brennan moved and Mr. Pegoraro seconded a motion to recommend to the
Board of Health that this position be approved, followed by a unanimous vote in favor of
the motion.

    3) Help Me Grow FY 2011 and FY 2012 Comparisons and Staffing

Mr. Kellogg noted that the HMG program is the largest LCGHD program with CY 2009
expenditures of $977,000 including $214,000 in property tax dollars. He noted that anticipated
federal, state and local funding cuts will amount to $235,000 and will necessarily mean that
staffing cuts must be made on or about July 1, 2011. He noted that despite these program losses,
the program will still remain as one of the largest LCGHD programs. He noted that Board of
Health approval was not required but was simply informing the Personnel Committee members
of our plans to deal with these funding cuts. Mr. Graham passed out a summary sheet of funding
cuts by source and likely staffing cuts including one clerical and two service coordinator
positions. Additional monies will be saved by some voluntary staff reductions and/or
retirements. These cuts are however; still dependent upon the final outcome of the state budget
process and pending talks with a local funding source (Lake County Jobs & Family Services).
Mr. Graham noted that dependent upon final funding, some of the positions lost may be able to
be brought back as reclassified ―home visitor‖ positions. It is anticipated that cuts in services
will translate into the loss of 100 client families (a 40% service reduction), although it was noted
that some of these families will be able to pick up private payments for similar services on their
own. Additionally, it was noted that Ron will draft a final action plan on this subject and that we
have consulted with Tom Grabarczyk. Funds have been budgeted and placed within the LCGHD
Capital budget to assist with expected unemployment compensation costs.

    4) Management Staff Retirement Policy

Mr. Kellogg noted that this item was only meant for discussion purposes and that no
recommendations for Board of Health action are being offered at this time for adoption. He
reviewed many of the pending changes that may occur within the PERS laws within the budget

May 16, 2011                                                                            - 28 -
bill (HB 153), HB 69, SB 3 and HB 202. Many of these changes may adversely affect staff and
more specifically management staff that are currently eligible for retirement. He noted that the
Board of Health already has a policy in place concerning parameters for the retirement and rehire
of management staff. The main parameter of this policy allows retirement and rehires to occur
except that rehire is by the acceptance of a contract which exposes the staff involved to risk of
dismissal in case of lay off of other reason. He noted that there are 4 such staff members
currently eligible for reduced or full retirement. It is likely that with forecast changes to PERS
laws that some of these staff may request retirement and rehire under the current policy before
the effective date of such changes. Although there appeared to be some consensus to continue
with the current policy, it was also suggested that we should survey additional entities to
determine if there are other options.

      Mr. Katz moved and Randy Owoc seconded a motion to adjourn the meeting at
approximately 2:40 p.m.; motion carried.

6.0     Old Business

Brian Katz stated that he and Roger Anderson had met with the Web Site Committee regarding
the development of the new web site. Mr. Kellogg responded that the new site is approximately
70% ready and should be rolled out by the end of June. We could have put it out there but we
wanted to have it closer to completion.

7.0     New Business

7.01    Resolutions

       Certification of Monies, Resolution 11-05-07-01-01-100

       Brian Katz moved and James Pegoraro seconded a motion to adopt Resolution 11-05-
07-01-01-100 to approve payment of bills, as listed in the recapitulation sheets attached to
these minutes; motion carried.

        Permission to Accept United Way Family Support Funds, $800

       Patricia Fowler moved and Anthony Vitolo seconded a motion to accept from the
United Way of Lake County the United Way Family Support Funds in the amount of $800;
motion carried.

The Grant period is March 2011 to March 2012. Funds will be used to assist families with
transportation needs not met by the public transportation system and for funding to have care for
their child while attending a parenting group.

May 16, 2011                                                                          - 29 -
        Permission to Accept Bike Day Lake County Corporate Sponsorship, $2,000

       Dr. Alvin Brown moved and Brian Katz seconded a motion to accept from the
Cleveland Clinic the Bike Day Lake County Corporate Sponsorship in the amount of $2,000;
motion carried.

There is no grant period since this is a one-event sponsorship. This is a corporate sponsorship
for Bike Day Lake County scheduled for September 10, 2011.

        Permission to Accept Lake Health “JUST RUN” Lake County Sponsorship, $5,000

       Roger Anderson moved and Randy Owoc seconded a motion to accept from Lake
Health System the JUST RUN Corporate Sponsorship in the amount of $5,000; motion

The grant period is April 25, 2011 to June 30, 2011. Funds will be used to pay for the JUST
RUN 5K entrance fees.

        Permission to Submit Child and Family Health Services Grant, $88,000

      Dr. Juan Hernandez moved and Randy Owoc seconded a motion to submit to the Ohio
Department of Health the Child and Family Health Services Grant in the amount of $88,000;
motion carried.

The Grant period is July 1, 2011 through June 30, 2012. Funds will be used for the provision of
Well Child and Prenatal Care and other related infrastructure building activities in Lake County.

        Permission to Submit Public Health Emergency Preparedness Grant (PHEP),

      Anthony Vitolo moved and Dr. Alvin Brown seconded a motion to submit to the Ohio
Department of Health the Public Health Emergency Preparedness (PHEP) Grant in the
amount of $169,405; motion carried.

The Grant Period is August 10, 2011 to August 10, 2012. These grant dollars are to support and
enhance local public health infrastructure that is critical to public health preparedness and
response, such as strengthening and sustaining the public health workforce, strengthening disease
surveillance activities, planning and implementing possible large scale mass vaccination
activities, developing effective community mitigation guidance, community and personal
preparedness activities.

May 16, 2011                                                                          - 30 -
        Permission to Submit Community Development Block Grant – Newborns FY2011,

       Dr. Alvin Brown moved and Randy Owoc seconded a motion to submit to the Lake
County Commissioners (U.S. Department of Housing and Urban Development) the
Community Development Block Grant – Newborn FY 2011 in the amount of $20,000; motion

The Grant Period is October 2011 through September 2012. The Health District is submitting an
application for assistance to support the Newborn Home Visiting Program. This project
contributes to building family resiliency among 200 very low, low and moderate income Lake
County households. Registered Public Health Nurses provide first-time parents, including
adolescent mothers, a health and environment assessment, education and training on maternal
and infant health issues.

        Permission to Submit Reproductive Health and Wellness Program Grant, $45,000

      Dr. Alvin Brown moved and Anthony Vitolo seconded a motion to submit to the Ohio
Department of Health, Division of Family and Community Health Services, Bureau of Child
and Family Health Services, the Reproductive Health and Wellness Program Grant in the
amount of $45,000; motion carried.

The Grant Budget Period is July 1, 2011 through June 30, 2012. A Reproductive Health and
Wellness Program improves the overall health and wellbeing of women and men by promoting
healthy lifestyles and encouraging the establishment of a reproductive life plan. A reproductive
life plan allows individuals the opportunity to determine when and if they are physically,
emotionally and financially prepared to become parents. Additionally, the plan can help lower
the risk of adverse perinatal and birth outcomes by assuring access to health care services to low-
income, uninsured and under-insured and others. The Health District will establish a contract
with The Family Planning Association of Northeast Ohio, Inc. to provide these services.

        Permission to Submit Child Safety Seats – Lake County Community Development
        Block Grant, $4,000

      Brian Katz moved and Anthony Vitolo seconded a motion to submit to the Lake County
Board of Commissioners the Child Safety Seats – Lake County Community Development
Block Grant in the amount of $4,000; motion carried.

The Grant Period is October 1, 2011 through August 31, 2012. The funds will be used to
provide child safety seats and/or booster seats to low-income families living in Lake County.

May 16, 2011                                                                           - 31 -
        Permission to Purchase Six (6) 2012 Ford Focus Automobiles

        James Pegoraro moved and Roger Anderson seconded a motion to update our
automobile fleet by replacing one (1) 2004 Pontiac Sunfire and five (5) 2005 Pontiac Sunfires
with six (6) 2012 Ford Focus automobiles from Classic Ford in Mentor; motion carried.

The price per vehicle is $13,843. Trade in value will be a minimum of $3,250 per vehicle. Net
cost after trade-in will not exceed $63,558 ($10,593 per vehicle after trade-in). The funds for
this purchase have been budgeted and are available from the Health District’s capital budget.

The 2004 vehicle was scheduled to be traded in 2010, but no bids were received. The other five
vehicles are scheduled to be replaced this year. The winning bid from the State of Ohio for a
compact car is a 2011 Ford Focus at a price of $14,449 (Includes minimum delivery charge of

Classic Ford was asked to submit a bid for the Ford Focus. Two bids were submitted, each bid
was for a 2012 Ford Focus. The bid meeting the State Specifications was $14,415 per Vehicle.
We are recommending the second bid which is $13,843 per vehicle. This lower priced bid does
not include cruise control and does not include power windows in the back seat, all other specs
are the same. Both bids are less than the bid accepted by the State.

We have been quoted a trade-in amount of $3,250 for the 2004 Pontiac Sunfire. At that price the
trade-in value of all six vehicles would be $19,500. The dealer has not yet inspected the 2005
models but estimates the actual trade in will be from $3,450 to $3,650 per Vehicle. $63,558 is
the maximum cost and assumes an average trade-in of $3,250, actual cost may be less.

        Recommendations from the Personnel Committee

        William Catania moved and James Pegoraro seconded a motion to hire one Part-Time
Licensed Social Worker for 12 hours per week and to hire one Casual Registered Licensed
Dietician; motion carried.


      Edward Currier moved and Randy Owoc seconded a motion to adjourn the meeting at
approximately 4:12 p.m.; motion carried.

________________________________             _______________________________
Secretary                                    President

May 16, 2011                                                                          - 32 -

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