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1990-1994PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES The Paris -Lamar County Board of Health met on January 23, 1990 at the Holiday Inn. Board members present were: Dr. Bercher, Mrs. Ellis, Dr. Strom, and Mrs. Norment. Others present were: Lorrin Scott, T.K. Haynes, Mike Malone, Gene Anderson, Barbra Francis, Anthony Bethel, and Sharon Seals. Dr. Bercher brought the meeting to order at 7:15 A.M. The minutes from the last meeting were approved as read. Increase in Septic Fees was discussed. Anthony said that the committee meeting agreed on $ 125.00 as a reasonable fee. This is a $ 50.00 percolation fee and a $ 75.00 inspection fee, cost -based for mileage and time involved. Dr. Bercher recommended the committee checking back with the board in six months. Dr. Strom seconded recommendation. All were in favor of this. Anthony Bethel presented three bids on mobile phones. The lowest was $ 895.00 per unit and $ 25.00 per month with Mr. Smith. Motorola was comparable at $1,200.00 per unit. Mrs. Ellis made a motion that they accept the low bid. Mrs. Norment seconded the motion. Motion passed. Restaurant inspections are almost completed. The current fee is $10.00 per restaurant. More will be discussed at our next meeting about higher fees. Lorrin Scott will get bids for removing bathrooms and remodeling exam rooms. WIC will bring bids to our next meeting on temporary buildings. Gene Anderson will send out the new budget April 1, 1990. Lorrin Scott announced that we have started Medicaid billing. Anthony and he recently attended a meeting in Tyler and learned more about pre- sumptive eligibility. The Texas Department of Health is running short on funds and is sending fewer supplies now. Dr. Strom announced that he is pleased with our progress at the health department and that our records are excellent. Our OB records are being made available at the hospital this week. WIC has a crew coming up April 22, 1990 to install computers. Due to lack of space, this was postponed earlier and extended until the later date. Our next meeting will be on February 20, 1990 at the Holiday Inn at 7:00 A.M. This meeting was adjourned at 8:03 A.M. Respectfully Submitted, Sharon J. Seals LOCAL HEALTH SERVICES PARIS —LAMAR COUNTY HEALTH DEPARTMENT 740-S.W. 6TH PARKS, TEXAS 75460 MONTHLY REPORT FOR JANUARY, 1990 . PREVIOUS FROM 10/90 From 1.0/89 MONTF1 Y.T.D. to 01 -31 -90 IMMUNIZATIONS.......... 521 273 2636 1385 FAMILY PLANNING.....'.... 72 49 280 421 MEDICAL SERVICES........ 303 213 894 582 B &D CERTIFICATES........ 316 275 1370 1079 VENEREAL, DISEASE TESTS.. 289 68 554 526 TB SKIN TESTS........... 113 54 291 280 INSPECTIONS ............. 92 99 401 276 COMPLAINTS............... 32 31 145 141 BABIES & VT?CTOR CONTROL. 0 4 19 6 WATER SAMPLES,.......... 84 112 420 484 WIC CLIENTS SEEN ..... ...1260 1215 4909 4587 IITLV II`I TESTS DONE..... 7 5 31 16 POSITIVE HTLV TESTS..... 0 0 0 # OF JAIL PA'T'IENTS SEEN. 250, 180 775 564 FEES COLLECTED.......... 5,109.32 FOR JANUARY 91 FEES COLLEC'TED.......... 4686.46 FOR JANUARY 90 F00 TNOTES 1. Family planning figures include visits for famiIy. planning and pre-natal visits. r 2. Medical services include all other, persons seen by Lor.rin Scott for colds, sore throats, etc. PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES The Paris -Lamar Board of Health met.on Tuesday, February 20,1990 at 7:00 A.M. at the Holiday Inn. The board members present were: Rev. Evans, Dr. Strom, Mrs. Norment, Mrs. Ellis, and Dr. Brooks. Others present were: Gene Anderson, T.K. Haynes, Mike Malone, Barbra Francis, Anthony Bethel, Sally Hines, and Sharon Seals. Anthony Bethel passed the monthly report out at 7:20 A.M. Lorrin Scott presented bids for remodeling the ,exam rooms at the health.department. The lowest bid was $ 3800.00. There is $ 8,000.00 budgeted for repairs. The janitor now works 64 hours a month for $5.00 an hour. Dr. Strom made a motion to remodel the exam rooms. Rev. Evans seconded the motion. The motion carried. Dr. Strom also mentioned that Dr. Lucy Fetner would arrive in a few months. Mrs. Sally Hines presented information at 7:45 A.M. about restaurants in Paris. She discussed a conversation that she had with someone at the health department a year ago. She has inquired in surrounding areas about the health requirements in their restaurants. Then she passed around a list of suggestions for our restaurants: Mrs. Hines thanked the board for allowing her to express her views about.our reataurants and left at 7:51 A.M. Anthony Bethel said we do check our restaurants twice a year and require the managers attendance at a Food Handlers School once a year.. Mi. Bethel will write a letter back to Mrs. Hinds. Mr. Bethel passed out copies of suggestions for new fees for restaurants. These were reviewed. Dr. Strom made a motion to raise the fees. Rev. Evans seconded the motion. The motion passed. Lorrin Scott talked about our computer system. The restaurant inspections are already in it. Dr. Strom suggested that with our remodeling we modify and run dedicated lines for the computer. Dr. Strom discussed WIC expansion and asked if an engineer has actually looked at the b4ilding. WIC needs three bids on putting in their computer. The next board meeting will be on March 20, 1990 at 7:00 A.M. at the Holiday Inn. This meeting adjourned at 8:19. A.M. Closed session began at 8:20 A.M. The per present were: Lorrin Scott, Dr. Strom,'Mrs. Ellis, Rev. Evans, and-Dr. Brooks. . Respectfully Submitted, LOCAL HEALTH SERVICES PAD28~LAMAB COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 B00T8[Y DEP0DI FOR JANUARY, 1990 ` � ]AI� P��IIE�� IS SEEN. 250 180 775 564 �� FEES COLLECTED .....,,.., 5409,32 FOR JANUARY 01 FEES COLLECTED ,.....,... 4686.46 FOR JANUARY 90 FOOTNOTES: l. Family planning figures include visits for family planning and pre-natal visits. 2. Medical services include all other pnronua aaeu by Lorriu Scott for colds, sore throats, etc. PREVIOUS F FROM 10/90 F From 10/80 MONTH Y Y.T.D. t to 01-31-90 IMMUNIZATIONS .......,... 5 521 2 273 2 2636 1 1385 FAMILY PLANNING ......... 7 72 4 40 2 280 4 421 MEDICAL SERVICES '^....,^ 3 308 2 213 8 894 5 582 B&D CEDIIFICJ\IES........ 3 316 2 275 1 1378 1 1879 VENEREAL DISEASE TESTS.. 2 289 6 68 5 554 5 526 ID SKIN IDSIS........... 1 112 5 54 2 201 2 280 INSPECTIONS .''...'-'...^ 9 92 0 00 4 401 2 276 COMPLAINTS ........^...,^ 3 32 3 31 1 145 1 141 RABIES & VDSIOB C00ID0L. 0 0 4 4 1 19 6 6 W&2DD SAMPLES........... 8 84 1 112 4 428 4 484 WIC CLIENTS SEEN ........ l l26O 1 1215 4 4909 4 4587 KILV III IDSI8 D00E..... 7 7 5 5 3 31 1 16 POSITIVE 8ILV TESTS..... 0 0 O O 8 8 # OF � �� FEES COLLECTED .....,,.., 5409,32 FOR JANUARY 01 FEES COLLECTED ,.....,... 4686.46 FOR JANUARY 90 FOOTNOTES: l. Family planning figures include visits for family planning and pre-natal visits. 2. Medical services include all other pnronua aaeu by Lorriu Scott for colds, sore throats, etc. LOCAL HEALTH SERVICES PARIS -LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 MONTHLY REPORT FOR FEBRUARY, 1990 PREVIOUS FROM 10/89 From 10/88 MONTH Y.T.D. to 1 -31 -89 IMMUNIZATIONS........... 481 401 1866 1263 FAMILY PLANNING......... 97 60 518 1066 MEDICAL SERVICES........ 395 256 977 - -- B&D CERTIFICATES........ 334 454 1413 1373 VENEREAL DISEASE TESTS.. 140 174 666 434 TB SKIN TESTS........... 77 96 357 307 INSPECTIONS ............. 77 83 353 307 COMPLAINTS .............. 39 23 180 164 RABIES & VECTOR CONTROL. 0 1 6 46 WATER SAMPLES........... 128 111 612 541 WIC CLIENTS SEEN........ 1190 1179 5777 5790 WELL CHILD PAT. SEEN.... 0 0 22 16 HTLV III TESTS DONE..... 4 2 20 29 POSITIVE HTLV TESTS..... 0 0 0 0 # OF JAIL PATIENTS SEEN. 123 205 687 - -- FEES COLLECTED.......... 4473.58 FOR FEBRUARY 90 FEES COLLECTED.......... 1538.33 FOR FEBRUARY 89 FOOTNOTES: 1. Family planning figures include visits for family planning and pre -natal visits. 2. Medical services include all other persons seen by Lorrin Scott for colds, sore throats, etc. Paris -Lamar County.Board of Health Minutes The Paris -Lamar County Board of Health met on Tuesday,..Ra,rch 20, 1990 at 7:00 A.M. at the Holiday Inn. The board members present were: Dr. Bercher, Dr. Strom, Mrs. Ellis, Dr. Cutrell, Dr. Brooks, and Dr. Kraft. Others present were: T.K. Haynes, Gene Anderson, Lor.rin Scott, Mike Patterson, Mike Malone, Anthony Bethel, and Sharon Seals. Dr. Bercher called the meeting to order at 7:15 A.M. The minutes were reviewed and Dr. Strom made some additions. In paragraph eight he explained that we could run dedicated telephone lines for the computer. In paragraph nine Dr. Strom clarified that an engineer has-already looked at the building for WIC expansion. Dr Bercher asked for Anthony to explain more about the restaurant fees. Mr. Haynes said a county law has to be- w -kifte —h regarding fees out in the county. The minutes then were approved. The exam rooms have been remodeled since the last meeting. WIC was given part of our old Laboratory and is being remodel- ed. The health department Lab is almost completed. Dr. Strom has talked with Dr. Lucy Fetner recently. She agreed to work 30 hours a week with 3 or 4 weeks vacation for $25,000. to $30,000. a year. Mrs. Ellis made a motion that the board accept the $30,000.00 salary, package. Dr. Strom seconded. All were in favor. Dr. Strom, Dr. Bercher, and Dr. Cutrell agreed to form a com- mittee and meet soon to establish policies concerning the types of physical examinations that can be given at the health de- partrment. A report will be given at our next meeting. Lorrin Scott said jail services were down on our monthly re- port because he is going early to the jail. He passed around a health department pamphlet that has been put together recently. The board members found it to be very informative. The next board meeting is scheduled for April 24, 1990 at 7:00 A.M. at the Holiday Inn. This meeting adjourned at 8:07 A.M. Respectfully Submitted, Sharon J. Seals LOCAL 8OAL38 SERVICES PARIS-LAMAB COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 MONTHLY 8EP0BI FOR JULY, 1000 ` FEES COLLECTED .......... 5535.91 FOR JULY 00 FEES COLLECTED ......,... 2381,05 FOR JULY 89 FO0I0OIE3/ 1, Family planning figures include visits for family planning and pre-natal visits. 2. Medical services include all other persons seen by Lorcin Scott for colds, sore throats, etc. PBOVI0OG FROM 10/89 From I0/88 MONTH Y.T.D. to 1-31-89 IMMUNIZATIONS '...^,'.... gUO 832 9495 2252 FAMILY PLANNING ......... 182 116 1208 2395 MEDICAL SEDVICDS,,...... 75 55 1265 .... B&D CERTIFICATES ........ 330 239 2965 2771 VENEREAL DISEASE TESTS.. 213 178 1547 1118 ID SKIN TESTS........... 66 71 788 616 INSPECTIONS .........,.,. 122 115 902 874 COMPLAINTS...'.......... 42 47 481 541 BABIES & VECTOR C0@IDUL. 42 36 97 220 WATER SAMPLES ........... 68 18 764 1288 WIC CLIENTS SEEN ........ 1165 1145 11593 13405 WELL CHILD PAT. SEEN .... 8 U 30 46 8ILV III TESTS DONE ..^.^ 6 7 49 46 POSITIVE UILV TESTS ..... 0 0 O 0 # OF JAIL PATIENTS SEEN. DU 195 1401 ..., FEES COLLECTED .......... 5535.91 FOR JULY 00 FEES COLLECTED ......,... 2381,05 FOR JULY 89 FO0I0OIE3/ 1, Family planning figures include visits for family planning and pre-natal visits. 2. Medical services include all other persons seen by Lorcin Scott for colds, sore throats, etc. LOCAL HEALTH 8ERVICE8 PARIS-LAMA8 COUNTY HEALTH DEPARTMENT 740 S.W. 6T8 PARIS, TEXAS 75480 MONTHLY REPORT FOR AUGUST, 1900 ` FEES COLLECTED ..,......, 7367.75 FOR AUGUST 90 FOOC COLLECTED .......... 4340,00 FOR AUGUST 89 , FOOTNOTES: l. Family planning figures include visits for family planning and pre-natal visit!. 2. Medical services include all other persons ueau by Lorrio Scott for colds, sore throats, etc, PREVIOUS FROM 10/89 From 18/88 MONTH Y.I.D. to 1-31-89 IMMU0I%AIIONS ........... llS0 900 10654 FAMILY PLANNING .,,,,.... 125 182 1325 MEDICAL SERVICES .....^.. 58 75 1323 8&D CXDIIFIC&IES...'.... 253 530 3218 VENEREAL DISEASE TESTS.. 117 213 1664 TB SD]0 TESIS,.,.'.,'... 123 66 831 INSPECTIONS ............. 135 122 1037 COMPLAINTS ..,,,.......^, 40 43 458 RABIES & VECTOR CONTROL. 27 42 134 WATER SAMPLDS........... 49 68 813 WIC CLIENTS SEEN ........ l283 1165 12876 BILV III TESTS D0DJE...,. 8 6 57 POSITIVE HILV IESIS..... O 0 D 4 OF JAIL PATIENTS SEEN, I00 88 1501 FEES COLLECTED ..,......, 7367.75 FOR AUGUST 90 FOOC COLLECTED .......... 4340,00 FOR AUGUST 89 , FOOTNOTES: l. Family planning figures include visits for family planning and pre-natal visit!. 2. Medical services include all other persons ueau by Lorrio Scott for colds, sore throats, etc, LOCAL HEALTH SERVICES PARIS-LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 8T8 PARIS, TEXAS 7S460 B0NZBLy REPORT FOR SEPTEMBER, 1990 ` _ __ ____ ________ SEEN. FEES COLLECTED .......... 5593,70 FOR GDPTKDKBED 90 FEES COLLOCTED.......... 3328.07 FOR SEPTEMBER 89 FOOTNOTES,- 1. Family planning figures include visits for family planning and pre-natal visits. 2. Medical services include all other persons seen by Lorrio Scott for colds, sore throats, etc. PREVIOUS F FROM 18/89 From 18/88 M00IU Y Y.I.D. to 0-30-89 IMMUNIZATIONS ........... 4 466 1 1159 1 11108 YAMILY PLANNING ......... 6 65 1 125 1 1390 MEDICAL SERVICDS.,...... 1 137 5 58 1 1460 B&D CERTIFICATES ..,...,, 2 226 2 253 3 3544 VENEREAL DISEASE IE3IS.. 9 92 1 117 1 1756 TB SKIN IE3TS...''....,. 8 80 1 123 9 901 INSPECTIONS ......'...... 1 184 1 135 1 1141 COMPLAINTS .............. 6 62 4 49 5 512 RABIES & VECTOR CONTROL. 4 45 3 37 1 179 WATER SAY{PLES..........- 1 130 4 49 9 943 WIC CLIENTS SEEN ........ l ll42 1 1283 1 14818 HILV III TESTS D00E'..., 1 14 8 8 7 71 POSITIVE RILV TESTS..... O O 0 0 8 8 o O� ]AT/� 9xTT�@7S SDD0' l l20 1 100 1 1621 FEES COLLECTED .......... 5593,70 FOR GDPTKDKBED 90 FEES COLLOCTED.......... 3328.07 FOR SEPTEMBER 89 FOOTNOTES,- 1. Family planning figures include visits for family planning and pre-natal visits. 2. Medical services include all other persons seen by Lorrio Scott for colds, sore throats, etc. A PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The Paris -Lamar County Board of Health met on September 18, 1990, at 7:00 A.M. at the Holiday Inn. Board members present were: Rev. Evans, Dr. Bercher, Dr. Strom, Mrs. Norment, Mrs. Ellis, Dr. Lut- trell, Dr. Kraft, and Dr. Brooks. Others present were: T.K. Haynes, Michael Malone, Gene Anderson, Lorrin Scott, Dr. Fetner, and Sharon Seals. Dr. Bercher called the meeting to order at 7:15 A.M. The minutes from the last meeting were read by Sharon Seals and then approved. Lorrin Scott stated that a noon meeting was held last week with Pete Patterson. Dr. Randall called from Austin inquiring about our proposed expansion program. Region 7 will not be going to Delta county any longer. Dr. Bercher suggested that Lorrin and Dr. Fetner send out letters to the various counties informing them of our services and small fees. Lorrin mentioned that we keep a daily logbook listing each patient's - name, addrdss, - ane'r- service req esteiir '��'t -s- a°�lVs z 1 know were our patients are coming from. Dr. Bercher suggested that Dr. Fetner, Lorrin, and T.K. arrange a meeting with Latricia Miller to discuss how funds are spent on Indigent Health Care. Dr. Kraft made a motion that this meeting be arranged. Rev. Evans seconded the motion. All in. favor. Motion passed. Dr. Fetner stated that the City received a $ 3,000.00 refund check on her insurance. We are having staff meetings bi- weekly. Our appoint- ment system is working well. We also see some walk -in sick people every day. The first Parenting Class went well Thursday at Paris High School. Anthony Bethel passed out the monthly report. He said our State Contracts came in Friday and we may receive less money for the coming year. The next board meeting was set for October 16, 1990 at 7:00 A.M. at the Holiday Inn. This meeting adjourned at 8:31 A.M. Respectfialy Submitted, Sharon J. Seals PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The Paris -Lamar County Health Board met on October 16, 1990 at 7:00 A.M. at the Holiday Inn. Board members present were:. Dr. Bercher, Dr. Strom, Mrs. Norment, Dr. Kraft, and Dr. Lut- trell. Others present were: Lorrin Scott, Dr. Fetner, Gene Anderson, Barbra Francis, Anthony Bethel, and Sharon Seals. Dr. Bercher called the meeting to order at 7:10 A.M. The minutes were read by Sharon Seals and approved as read. Lorrin Scott reported on activity at the health department for the past month. We saw 250 patients last month. There were 155 medical patients and 22 new OB patients. There were 70 OBs in all. We have given 650 flu shots and have ordered 906'; more doses. There were 4 cases of penicillin resistant GC. McCuistion will be doing our GCs for 6 weeks. They will charge $5.00 a culture if negative and $ 12.00 if positive. #' Dr. Fetner received a letter from March of Dimes. Kim Elsom's application was not accepted due to her needing refresher courses. Dr. Fetner spoke for the Kiwanis and did a TV Health- talk Show. She is going to Paris High Parenting Class this morning. Dr. Bercher asked if we have been'-in touch with Region 7. Lorrin has talked with Dr. Crowder. There will be a meeting in Austin two weeks from now for local health department Director's. Anthony Bethel didn't have a monthly report. Region 7 called him yesterday. They discussed hiring an Aids coordinator for. our office. There are currently 8 cases of TB. Barbra Francis went to Austin last week. WIC reported a $ 573.00 savings to newborns on neo -natal care. WIC has a caseload of 1200 clients and is serving 1165 clients. The next board meeting is scheduled for November 20, 1990 at 7 :00 A.M. at the Holiday Inn. A meeting will not be scheduled for December. This meeting adjourned at 8:18 A.M. Respectfully Submitted, Sharon J. Seals LOCAL HEALTH BERVIC18 PAN18-LAMAR COUNTY HEALTH DEPARTMENT 740 QW^ 6TH PARIS, TEXAS 75460 MONTHLY REPORT FOR OCTOBER, 1990 ` FEES COLLECTED .......... 9821.83 FOR OCTOBER 90 FEES COLLECTED ........., 4310.27 FOR OCTOBER 89 F0OI00TO3: I. Family Dluuuiug figures include visits for family planning and pre-natal visits. 2. Medical services include all other persons aaeu by Lorcin Scott For colds, sore throats, oto, PREVIOUS FROM 10/08 From I0/80 60NIU Y.I.D. to 18-31-90 IMMUNIZATIONS ........... l4ll 466 1411 FAMILY PLANNING .'...'... 121 65 I21 MEDICAL SEDVZCES..^.^... 181 137 181 BL8 CERTIFICATES ..^..... 389 326 390 VENEREAL DISEASE TESTS.. 79 92 74 I8 SKIN IDSIS.,^^,...^.. 67 80 67 INSPECTIONS ^.........,.. 02 184 93 COMPLAINTS ...,.......'.. 41 62 41 RABIES & VECTOR C00I80L. 7 45 7 WATER 8&MPLES,.......^.. 90 130 AA WIC CLIENTS SEEN ........ l200 1142 1209 8ILV III TO3I8 D00D..... 12 I4, 12 POSITIVE 8ILV TESTS..... 0 0 O 4 OF JAIL PATIENTS SEEN. 125 120 125 FEES COLLECTED .......... 9821.83 FOR OCTOBER 90 FEES COLLECTED ........., 4310.27 FOR OCTOBER 89 F0OI00TO3: I. Family Dluuuiug figures include visits for family planning and pre-natal visits. 2. Medical services include all other persons aaeu by Lorcin Scott For colds, sore throats, oto, Paris - Lain ar County Health Department 740 SIXTH STREET S.W. - P.0, BOX 938 PARIS, TEXAS 75461 LOCAL HEALTH SERVICES PARIS-LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 MONTHLY REPORT FOR OCTOBER, 1900 PREVIOUS FROM 10/90 From 10/89 MONTH Y.T.D. to 10-31-90 IMMUNIZATIONS ........... 1411 466 1411 FAMILY PLANNING......... 121 65 121 MEDICAL SERVICES........ 181 137 181 B&D CERTIFICA'T'ES........ 399 326 399 VENEREAL DISEASE TESTS.. 79 92 79 TB SKIN TESTS........... 67 so 67 INSPECTIONS ............. 93 104 93 COMPLAINTS .............. 41 62 41 RABIES & VECTOR CONTROL. 7 45 7 WATER SAMPLES........... 99 130 99 WIC CLIENTS SEEN........ 1209 1142 1209 HTLV III TESTS DONE..... 12 14 12 POSITIVE HTLV TESTS..... 0 0 0 4 OF JAIL PATIENTS SEEN. 125 120 125 FEES COLLECTED.......... 9821.63 FOR OCTOBER 90 FEES COLLECTED.......... 4310.27 FOR OCTOBER 89 FOOTNOTES: 1. Family planning figures include visits for family planning and pre-natal visits. 2. Medical services Include all other persons seen by Lorrin Scott for colds, sore throats, etc. PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The Paris -Lamar County Health Board met on November 20, 1990 at 7:00 A.M. at the Holiday Inn. Board members present were: Dr. Bercher, Dr. Strom, Mrs. Norment, Dr. Cutrell, and Dr. Kraft. Others present were: T.K. Haynes, Lorrin Scott, Dr. Fetner, Anthony Bethel, Mike Malone, Gene Anderson, and Sharon Seals. The minutes were read by Sharon Seals. Lorrin sent a report with the agenda to all board members. The report covered one years' service at the Lamar County Health Department. Dr. Bercher mentioned the letter was well written and informative. Lorrin discussed TB skin testing done at the jail recently. Dr. Fetner said the grant for an Aids Coordinator has been submitted. The health department went to Oak Park United Methodist Church Day Care Center and gave 62 gamma globulin shots. We are giving Hib Titer Vaccine to infants starting at 8 weeks of age. She presented a copy of the consent form that we have the parents read, sign, and then attach to our permanent immunization record. She said another grant is due in December on Cancer Screening and would appreciate any ideas on this. She also presented a letter to the board and gave up the title of Medical Director. Dr. Bercher said they would ad- dress this letter in a closed session following this meeting. Anthony Bethel presented the monthly report. We are inspecting an average of 55 restaurants per month. He said the Seventh Street Baptist Church is asking $ 99,500.00 for their property. Dr. Bercher recommended that Lorrin check out any possibilities of the health department using part of the old Lamar County Hospital and report back on this. Gene Anderson discussed our budget. The county budgeted $ 70,000.00 and they should have budgeted about $ 116,000.00. Lorrin asked Judge Loughmiller to attend this meeting. Dr. Strom said he would contact the Judge today about the budget. Dr. Kraft said he also invited Troy Owens to this meeting. Gene sends out a report to all the board members. Dr. Fetner talked about a letter she received from the Department of Human Resources. They asked that we continue to issue free non certified copies of birth certificates to their clients when requested. The board agreed on this. The next board meeting is scheduled for January 15, 1991, at 7:00 A.M. at the Holiday Inn. This meeting adjourned at 7:38 A.M. Respectfully Submitted, f -.,\\ Sharon J. Seals LOCAL HEALTH SERVICES PARIS-LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 6T8 PARIS, TEXAS 75480 MONTHLY REPORT FOR NOVEMBER, 1900 FEES COLLECTED ...,...... 4310.27 FOR NOVEMBER 80 ` FOOTNOTES: l. Family pluouiuC figures include visits for family planning and pre-natal visits. 2. Medical services include all other yerauua aoou by Lacrin Scott for colda^ sore throats, etc. PREVIOUS FROM 10/98 From 10/89 MONTH Y.T.D. to 11-30-89 IMMUNIZATIONS ........... 431 1411 1842 FAMILY PLANNING .....,-.. 38 121 159 MEDICAL SEBVICGS........ 192 181 372 D&D CERTIFICATES .,..^.,. 380 390 779 VENEREAL DISEASE TESTS.. 118 70 197 2B SHIN IE3IS.,.-.....,. 57 67 124 INSPECTIONS ......^..,... 117 93 210 COMPLAINTS .-.......,..., 41 41 82 RABIES & VECTOR CONTROL. 8 7 15 WATER SAMPLES ......,.'., 125 90 224 WIC CLIDUIS SEEN ........ l225 1209 2434 8ILV III TESTS DONE ,..,. 7 12 19 POSITIVE 8ILV TESTS..... 8 8 8 A OF JAIL PATIENTS 3EDN, 220 125 345 FEES COLLECTED .,........ 6569.65 FOR NOVEMBER 90 FEES COLLECTED ...,...... 4310.27 FOR NOVEMBER 80 ` FOOTNOTES: l. Family pluouiuC figures include visits for family planning and pre-natal visits. 2. Medical services include all other yerauua aoou by Lacrin Scott for colda^ sore throats, etc. PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The Paris -Lamar County Health Board met on November 20, 1990 at 7:00 A.M. at the Holiday Inn. Board members present were: Dr. Bercher, Dr. Strom, Mrs. Norment, Dr. Cutrell, and Dr. Kraft. Others present were:'T.K. Haynes, Lorrin Scott, Dr. Fetner, Anthony Bethel, Mike Malone, Gene Anderson, and Sharon Seals. The minutes were read by Sharon Seals. Lorrin sent a report with the agenda to all board members. The report covered one years' service at the Lamar County Health Department. Dr. Bercher mentioned the letter was well written and informative. Lorrin discussed TB skin testing done at the jail recently. Dr. Fetner said the grant for an Aids Coordinator has been submitted. The health department went to Oak Park United Methodist Church Day Care Center and gave 62 gamma globulin shots. We are giving Hib Titer Vaccine to infants starting at 8 weeks of age. She presented a copy of the consent form that we have the parents read, sign, and then attach to our permanent immunization record. She said another grant is due in December on Cancer Screening and would appreciate any ideas on this. She also presented a letter to the board and gave up the title of Medical Director. Dr. Bercher said they would ad- dress this letter in a closed session following this meeting. Anthony Bethel presented the monthly report. We are inspecting an average of 55 restaurants per month. He said the Seventh Street Baptist Church is asking $ 99,500.00 for their property. Dr. Bercher recommended that Lorrin check out any possibilities of the health department using part of the old Lamar County Hospital and report back on this. Gene Anderson discussed our budget. The county budgeted $ 70,000.00 and they should have budgeted about $ 116,000.00. Lorrin asked Judge Loughmiller to attend this meeting. Dr. Strom said he would contact the Judge today about the budget. Dr. Kraft said he also invited Troy Owens to this meeting. Gene sends out a report to all the board members. Dr. Fetner talked about a letter she received from the Department of Human Resources. They asked that we continue to issue free non certified copies of birth certificates to their clients when requested. The board agreed on this. The next board meeting is scheduled for January 15, 1991, at 7:00 A.M. at the Holiday Inn. This meeting adjourned at 7:38 A.M. Respectfully Submitted, Sharon J. Seal LOCAL HEALTH SERVICES PARIS -LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 MONTHLY REPORT FOR NOVEMBER, 1990 PREVIOUS FROM 10/90 From 10/89 MONTH Y.T.D. to 11 -30 -89 IMiiiUNIlATIONE........... 431 1411 1842 FAMILY .PLANNING......... 38 121 159 MEDICAL SERVICES........ 192 181 373 BID CH.RTIIaICA'TES........ 380 399 779 VENEREAL DISEASE TESTS.. 118 79 197 TIC SKIN "TESTS........... 57 67 124 INSPECTIONS ............. 117 93 210 i;OMITAI NTS .............. 41 41. 82 RABIES & VECTOR CONTROL. 8 7 15 WATER SAMPLES........... 125 99 224 WIC CLIENTS SEEN ........ 1225 1209 2434 HTLV III TESTS BONY; ..... 7 12 19 POSITIVE HTLV TENTS..... 0 0 0 8 OF .JAIL PATIENTS SE.RN. 220 125 345 FEES COLLECTED.......... 6569.65 FOR NOVEMBER 90 FEES COLLECTED.......... 4310.27 FOR NOVEMBER 59 FOOTNOTES: 1. Family planning figures include visiLs for family planning and pre natal visits. 2. Medical services include all other persons seen by Lorrin Scott for colds, sere throats, etc. LOCAL HEALTH SERVICES PARIS -LAMAR COUNTY HEALTH DEPARTMENT 740 84. 6TH PARIS, TEXAS 75460 MONTHLY REPORT FOR DECEMBER, 1990 FEES COLLECTED.......... 4101.92 FOR DECEMBER 90 FEES COLLECTED.......... 2874.41 FOR DECEMBER 89 FOOTNOTES: 1. Family planning figures include visits for family planning and pre -natal visits. 2. Medical services include all other persons seen by Lorrin Scott for colds, sore throats, etc. PREVIOUS FROM 10/90 From 10/89 MONTH Y.T.D. to 12 -31 -89 IMMUNIZ.ATIONS........... 273 431 2115 FAMILY PLANNING......... 49 38 208 MEDICAL SERVICES........ 213 192 586 B &D CERTIFICATES........ 275 380 1054 VENEREAL DISEASE TESTS.. 68 118 265 TB SKIN TESTS........... 54 57 178 INSPECTIONS ............. 99 117 309 COMPLAINTS .............. 31 41 113 RABIES & VECTOR CONTROL. 4 8 19 WATER SAMPLES........... 112 125 336 WIC CLIENTS SEEN........ 1215 1225 3649 HTLV III TESTS DONE..... 5 7 24 POSITIVE HTLV TESTS..... 0 0 0 fF OF JAIL PATIENTS SEEN. 180 220 525 FEES COLLECTED.......... 4101.92 FOR DECEMBER 90 FEES COLLECTED.......... 2874.41 FOR DECEMBER 89 FOOTNOTES: 1. Family planning figures include visits for family planning and pre -natal visits. 2. Medical services include all other persons seen by Lorrin Scott for colds, sore throats, etc. The.Paris -Lamar County Health.Board met on January 15, 1991 at 7:OO A.M. at the Holiday Inn. Board members present were: Dr. Bercher, Mrs. Ellis, Mrs. Norment, Dr. Kraft, and Dr. Cutrell. Others present were: T.K. Haynes, Lorrin Scott, Dr. Fetner; Anthony Bethel, Barbra Francis, and Sharon Seals. Dr. Bercher called the meeting to order at 7:12 A.M. He ad- vis.ed that we will change our meeting time to 6:45 A.M. as -of our next meeting; He.,paraphrased the minutes from the November meeting. Minutes were approved as read. Dr. Strom could not attend this meeting, but copies of the Organizational chart are to be presented at the next meeting. Dr. Fetner reported that our Aids Grant was denied. We are waiting for a response from March of Dimes. This grant would fund a third nurse We have not submitted the Cancer Screens ing Grant. Sara Eatherly requested that Dr. Fetner ask board members if she could dispense Tylenol to students. Discussion followed and Dr. Fetner said the school board should set the policy. Pr. Bercher made a motion that the decision be left up to the school board. Dr. Kraft seconded and all were in fa- vor. Lorrin Scott teported- .there are some problems at the jail con cerning inmates who arrive with severe medical problems. Dr. Bercher asked Lorrin to draw up a memorandum on inmates with severe problems and send to the county judge and city attor= ney.about dismissal on recognizance for health reasons. Dr. Fetner advised the board that we will close down in Feb- ruary for one or two days and audit charts for pap smears done in past year. Anthony Bethel passed out copies of the monthly report. He said the State Auditor will come here on February 6, 1991. Dumping complaints out.in the county are increasing. He discussed restaurant inspection fees should be increased. The next board meeting is scheduled for February 19, 1991 at 6:45 A.M. -'at the Holiday Inn. This meeting adjourned at 7:55 A.M. Respectfully Submitted, Sharon J. Seals PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The Paris -Lamar County Health Board met on February 19, 1991, at the Holi- day Inn, at 6:45 A.M. Board members present were: Mrs. Norment, Mrs. Ellis, Dr. Kraft, Dr. Cutrell, and Dr. Strom. Others present were: T.K. Haynes, Gene Andersoh, Dr. Fetner, Anthony Bethel, Michael Malone, and Sharon Seals. Dr. Cutrell called the meeting to order at 7:20 A.M. The minutes were re- viewed and Dr. Kraft moved that they be approved. Mrs. Ellis seconded motion. All in favor. Motion carried. Dr. Fetner'reported that our letters had been written concerning length of time it takes to get Pap reports back. She mentioned that the two day in- ventory on charts was successful. We have not hired another R.N. yet. Anthony gave a report from Lorrin Scott. Lorrin spoke briefly to Dr. Dougherty about our paps being checked here, but has no answer yet. Lorrin also suggested that we meet every two months. Dr. Kraft said things are more consistent if we keep meeting monthly. Anthony passed out copies of the monthly report. There was a noticeable increase in services even though we have only one R.N. Dr. Cutrell mention- ed we might try using the star system on restaurant inspections. Dr. Strom discussed the Organizational Chart of the health department. Dr. Kraft moved that we accept this as drawn up. Dr. Cutrell seconded motion. All in favor. Motion passed. The next board meeting is scheduled for March 26, 1991 at 6:45 A.M. at the Holiday Inn. This meeting adjourned at 7:58. A.M. Respectfully Submitted, Sharon J. � is LOCAL HEALTH MUM PARIS-LAM&R COUNTY HEALTH DEPARTMENT 740 84, 6TH PARIS, TEXAS 75468 MONTHLY DDP0DT FOR FEBRUARY, 1991 ` FEES CULLDCIED.......... 5925,45 FOR FEBRUARY 01 FEES COLLECTED ....,,,.., 4473,58 FOR FEBRUARY 90 F0OI00IDS: I. Family planning figures include visits for family planning and pre-natal visits. 2^ Medical services include all other persons oeou by Lorriu Scott for colds, sore throats, etc. PREVIOUS FROM 10/90 From 18/89 MONTH Y.T.D. to 02-38-90 IHMU0I2AIIONS......,..., 362 521 2998 1866 FAMILY PLANNI0G......... 77 72 357 518 MEDICAL SDDVICES.....,., 169 308 1U57 0977 B&D CBDIIFICAIES........ 348 316 1718 1413 VENEREAL DISEASE ID8IS,. 184 289 738 666 I8 SKIN TESTS ........... 90 113 381 357 I08PDC2IO03...',...''.., 104 92 505 353 COMPLAINTS .............. 44 32 189 180 RABIES & VDCI08 CUNIBOL, 4 O 23 6 AAIDB SAMPLES,.......... 108 84 520 612 WIC CLIENTS SEEN ........ ll90 1260 6099 5777 8TLV III ID8IS DONE .^... ll 7 42 22 POSITIVE 81LV TESTS ..... l O l 0 0 OF JAIL PATIENTS SEEN. 248 250 1165 687 FEES CULLDCIED.......... 5925,45 FOR FEBRUARY 01 FEES COLLECTED ....,,,.., 4473,58 FOR FEBRUARY 90 F0OI00IDS: I. Family planning figures include visits for family planning and pre-natal visits. 2^ Medical services include all other persons oeou by Lorriu Scott for colds, sore throats, etc. LOCAL HEALTH SERVICES PARIS —LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 0TH PARIS, TEXAS 75460 MONTHLY REPORT FOR MARCH, 1991 PREVIOUS FROM 10/90 From 10/89 MONTH Y.T.D. to 03 -31 -90 IMMUNIZATIONS........... 443 362 3441 2508 FAMILY PLANNING......... 62 77 419 645 MEDICAL SERVICES........ 127 169 1184 1019 B &D CERTIFICATES........ 328 348 2046 1800 VENEREAL DISEASE TESTS.. 147 184 885 818 TB SKIN TESTS........... 69 90 450 435 INSPECTIONS ............. 110 104 615 505 COMPLAINTS .............. 35 44 224 228 RABIES & VECTOR CONTROL. 2 4 25 8 WATER SAMPLES........... 107 100 627 740 WIC CLIENTS SEEN........ 1150 1190 7249 6963 HTLV III TESTS DONE..... 8 11 50 24 POSITIVE HTLV TESTS..... 0 1 1 0 # OF JAIL PATIENTS SEEN. 238 240 1403 811 FEES COLLECTED.......... 5061.80 FOR MARCH 91 FEES COLLECTED.......... 5455.70 FOR MARCH 90 FOOTNOTES: 1. Family planning figures include visits for family planning and pre -natal visits. 2. Medical services include all other persons seen by Dr. Fetner or Lorrin Scott for colds, sore throats, etc. PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The Paris -Lamar County Health Board met on Tuesday, March 26,1991, at the Holiday Inn. The meeting was called to or- der by Richard Bercher, M.D. at 6:55 A.M. Board members present were: Richard Bercher, M.D., Wallace Kraft,D.�V.,M;. Gordon B. Strom, M.D., Thomas Cutrell, M.D., Mrs. Francis Ellis, and Mrs. Ann Norment. Others present were: Lucy Fetner, M.D., Lorrin Scott, Gene Anderson, Troy Owens, Michael Malone, Anthony Bethel, and Carl Steffey. The minutes of the previous meeting on February 19, 1991 were. read. Dr. Bercher made a motion ; -that they be approved. Dr. Strom seconded. Motion approved. Lorrin Scott gave a report on the following items:, Shigella outbreak in a local day care, report from.TDH• regarding the high immunization level of PISD students, employment of new nurse, Barbara Ward, R.,N., physical plant improvements at the Clinic, reinspection by TDH /M &CH on April 5,1991, the recent fire and burglary at the Clinic, the need to begin the budget process, and discussion on loss of Psychiatric care in the jail. Anthony Bethel discussed the new fee schedule for Clinic ser- vices. Dr. Strom made a motion to .approve new schedule. Dr. Kraft seconded. Motion was approved. Next was a discussion on new proposal ordinance for the Food Establishment inspect- ion fees for the City of Paris. Dr. Strom made a motion to approve new fees, pending approval of ordinance. Dr. Kraft seconded. Motion approved. Anthony was instructed to present the model ordinance to the Commissioners Court. Dr. Kraft made a motion for Anthony to present this matter. Dr. Cutrell sodonded. Motion carried. Monthly restaurant inspections were discussed. Dr. Strom and Dr. Cutrell requested that periodically the monthly report include information regarding infection rates; such as number of TB reactors in a given time frame. Dr. Fetner reported that she would represent the Health Dept: at a March of Dimes Fund Grant Meeting this week in the Dallas area. A brief discussion was held about the possibility of submitting a grant request in conjunction with Chance,!.Inc. next year. The next meeting was set for Tuesday, April 23, 1991, at the Holiday Inn, at 6:45 A.M. This meeting was adjourned at 7:40 A.M, Respectfully Submitted PARIS - LAMAR COUNTY HEALTH DEPARTMENT Board of Directors Meeting March 26, 1991 The regular monthly meeting of the Board of Directors of the Paris - Lamar County Health Department was held Tuesday, March 26, 1991, in the Holiday Inn. The meeting was called to order by Richard Bercher, M.D. at 6:55 AM. Those in attendance were: Richard Bercher, M.D. Gordon B. Strom ' M D .. Thomas Cuttrell, M.D. Wallace Kraft, D.V.M. Francis Ellis Ann Norment Lucy Fetner, M.D. Lorrin Scott Gene Anderson Michael E. Malone Anthony Bethel Troy Owens Carl Steffey Item 1: Minutes of the previous meeting of February 19, 1991 were read . Motion to approve by Dr. Bercher; second by Dr. Strom. Motion approved. Item 2: Report by Lorrin Scott. Briefly discussed were: A. Shigella outbreak in a local daycare B. Report from TDH regarding the high immunization level of PISD students. C. Employment of new nurse, Barbara Ward, R.N. D. Physical plant improvements at the Clinic. E. Reinspection by TDH/M&CH April 5, 1991. F. Recent fire and burglary at Clinic. G. The need to begin the budget process H. Discussion on loss of pschyatric care in the jail . � ` � �,'`�'� '.^ Item 3: Report by Anthony Bethel. Discussed items were: A. New fee schedule for Clinic services. See attachment. Motion to approve by Dr. Strom; second by Dr. Kraft. Motion approved. B. Discussion on new proposed ordinance for the Food establishment inspection fees for the City of Paris. Motion to approve new fees� pending approval of ordinance/by Dr. Strom; second by Dr. Kraft. Motion approved. C. Discussion of ha t the model ordinance to fW [onMlssloiers Court. Anthony was instructed to present the matter to the Commissioners Court. Motion by Dr. Kraft; second by Dr. Cuttrell. D. Discussion of monthly restaurant inspections. E. Dr. Strom and Dr. Cuttrell requested that periodically the monthly report include information regarding infection rates; such � as number of positive TB reactors in a given time frame. Item 4: Report by Dr. Fetner. A. Dr. Fetner reported that she would represent the Department at a March of Dimes Fund Grant Meeting this week in the Dallas Area. B. Brief discussion was held about the possibility of submitting a grant request in conjunction with CHANCE, Inc. next year. Item 5: The next meeting date was set for Tuesday, April 23, 1991, at 6:45 AM. The meeting adjourned at 7:40 AM. LOCAL HEALTH SERVICES PARIS~LAMAB COUNTY HEALTH DEPARTMENT 740 SO, 6TH PARIS, TEXAS 75460 8U0IDLY DD2UBI FOP APRIL, 1001 ` PREVIOUS FROM 10/00 From 10/89 80NI8 Y.I.D. to 04-30-90 IMMUNIZATIONS .........'. 654 443 4095 2941 FAMILY PLANNING .....'... 114 62 533 770 MEDICAL SERVICES ...... .. 296 127 1160 1075 8&D CERTIFICATES ...... .. 434 328 2480 2090 VENEREAL DISEASE TESTS.. 275 147 1160 984 ID SKIN TOSIS.........,. 99 69 549 505 INSPECTIONS ..'.......... 132 110 747 549 COMPLAINTS .............. 53 35 277 266 RABIES & VECTOR CONTROL. 20 2 35 13 WATER SAM2[OS..,.,...... 133 107 760 748 WIC CLIENTS SEEN ........ l225 1150 8474 8123 HILV III TESTS D00E.,... 5 8 55 31 POSITIVE BILV TOSIS.,..' 0 l l O # OF JAIL PATIENTS SEEN. 226 238 1620 946 FEES COLLECTED ....^.^... 5632.18 FOR MARCH 01 FEES COLLECTED ..,''.',., 4952,97 FOR MARCH 90 y0UINOIES; l. Family yIuuuiug figures include visits for family planning and pre-natal visits. 2. Medical services include all other persons seen by Dr. Fetucr or Lorriu Scott for colds, sore throats, etc. LOCAL HEALTH SERVICES PARIS -LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. GTH PARIS, 'TEXAS 75460 MONTHLY Rl. PORT IT OR Al'1t 11.,, 1991 I NMI ) IV I 'L A `1' I ON S ........... G 511 f-AMILY I'LANNING......... 114 MEDICAL SERVICES ........ 296 I3 &T) CERTIFICATES........ 434 VI:NF'RI'�'Al. DISEASE `1'EsSTS.. 275 TB SKIN TESTS ........... 99 INSPECTIONS ............. 132 COMPLAIN'T'S .............. 63 RABIES & VEC'T'OR CON'T'ROL. 20 WATER SAn1PLI:S........... 1:33 WIC; CLIENTS SEEN........ 1225 llTl,V t 1 1 `T'EST'S UONLe ..... 5 POSITIVE' IITLV TES`1's ..... 0 t1 OF JAIL PATIENTS SEEN. 226 PREVIOUS FROM 10/90 From 10/89 MONTH Y.T.D. to 04 -30 -90 443 4095 2941 62 533 770 127 1160 1075 328 2480 2090 147 1160 984 69 549 505 110 747 549 35 277 266 2 35 13 107 760 740 1150 8474 8123 8 55 31 1 1 0 238 1629 946 1*�ELS COLLRCTED.......... 5632.18 FOR MARCH 91 FEES COI,LLC'1'liD .......... 4952.97 FOR MARCl1 go FOOTNOTES: 1 1'am.ily planning fIguros include visit's for family planning and pre-natal visits. 2. MedIoal services include all other persons seers by Dr. Fetner or Lurriil 8,cutt lur colds, sorry throats, etc. VARIS -LAMAR COUNTY UEAF,.TH BOARD MINUTES The Paris -Lamar County Health Board met on Tuesday, April 23, 1991, at the Holiday Inn. The meeting was called to order by Ricliar.d Bercher, M.D. at 7:03 A.M. Board members present were: Richard Bercher, M.D., Gordon Strom, M.D., Thomas Cutrell, M.D., Mrs, Ann Norment, and Mrs. Francis Ellis. Other'; present were: Gene Anderson, T.K. Haynes, Lorrin ScoLL, Dr.. Lucy FoLner, Anthony Bethel, Michael Malone, and Sharon Seals. The minutes of the previous meeting on March 26, 1991 were approved as read. Dr. Fetner attended the March of Dimes meeting in Arlington and reported that we will hear from them later. She stated that the Health Department needs to work out a new policy for Hepati- tis B screening. The Health Department does not have funds for providing the expensive vaccine. Dr. Strom asked if we have had any request for AZT medication and learned that we have had none. Lorrin Scott..reported that the Health'Depar.tment had a follow -up inspection by Maternal and Child Health from Austin. Dr. Simpson, one of Dr. Fetner's colleagues came up and we were given an ex- cellent report. They also inspected Paris Health Services and they are having trouble with administration—The State has made, changes in the Immunization Schedule agaih and copies were hand ed out. T.K. Haynes suggested that Lorain share the State report with City Council and Commissioners Court. Lorrin attended a medical meeting in Galveston last week. He said that city and county officials need to meet and revise their pre- employment PhYulQalu as bravk x -rays are not recommended now. our nurses attended a Stress Management Seminar in Texarkana last week. Anthony gave the monthly report. Complaints were down.and fees were down from last year. Bonanza has been totally remodeled. Tuberculosis Control has 10 positive reactors on INH and 4 cases now. T.K. Haynes said the city will start requiring grease trap checks with Health Permit Inspections. The next meeting will be Tuesday, May 28, 1991, at 6:45 A.M. at the Holiday Inn. This meeting was adjourned at 7;45 A.M. Respectfully Submitted, Sharon LOCAL HEALTH SERVICES PARIS-LAMAD COUNTY HEALTH DEPARTMENT 740 S.W. 8TH PARIS, TEXAS 75460 MONTHLY BEP0DI FOR MAY, lOAl ` PREVIOUS FROM 18/90 From 10/89 MONTH Y.T.D. to 05-31-90 IMMUNIZATIONS ..'....^... 401 654 4586 7763 FAMILY PLANNING........, 80 114, 613 902 MEDICAL SERVICES ........ Ill 296 1271 1125 D&D CERTIFICATES ........ 298 434 2770 2396 VENEREAL DISEASE TESTS.. 227 275 1387 1156 T8 SKIN TESTS .... ....... 84 09 633 571 I03PEC1I0NS..........,.. 167 132 914 665 COMPLAINTS ..........,.,. 47 53 324 311 BABIES & VECTOR C00IB0L. 27 20 62 10 WATER SAMPLDS,......,.., 132 122 892 748 WIC CLIENTS SEEN ........ 1238 1225 9704 9283 8ILV III TESTS DONE ..... 8 S 63 36 POSITIVE UILV IESI3.,,^. 0 0 l O � OF JAIL PATIENTS SEEN. 227 226 1866 1126 FEES COLLECTED .,,-..,.,, 7588,64 FOR MAY 91 FEES OOLLECZED.,,.,..... 8828,14 FOR MAY gO FOOTNOTES: 1, Family planning figures include visits for family planning and pre-natal visits. 2. Medical services include all other persons aeco by Dr. Fetoer or Lorriu Scott for colds, uurn throats, etc. PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The Paris -Lamar County Health Board met on Thursday, May 30, 1991, at.the Holiday Inn. Board members present were: Dr. Bercher, Dr. Kraft, Rev. Evans, Dr: Cutrell, Dr. Strom, and Mrs. Norment Others present were: Lorrin Scott, T.K. Haynes, Anthony Bethel, Michael Malone, and Sharon Seals. Dr. Percher called the meeting to order at 7:00'A.M.` The minutes were approved as read. The 1990 -1991 Budget was discussed. The total projected figures were reviewed. Under salariestan - additional LVN nurse position may be filled at $7.00 an hour,,i40 hours a week. The hours would be divided between the jail and the health department. They would take care of medicine at the jail and work where needed at the health depart..-.-,: ment— Mosquito spraying was discussed and the board asked that we list the chemical Malathion in the Budget. Under equipment the health department would like to purchase an additional PC for Dr. Fetner,.and a Culposcope.for checking paps. This would require additional training for Dr.,Fetner. and Lorrin. Dr. Bercher asked that we make an addendum to the Budget about this equipment.. The board asked that -mis;- cellaneous items be described better in our Budgetp and that Child Care be changed to Maternal and Child Health. Dr. Cutrell made a motion that the board accept the new Budget. Rev. Evans seconded. All agreed. Motion carried. Dr. Strom asked Anthony to make a graph showing the health department fees before presenting the Budget to the County Commissioners. Last year our board presented our Budget to the County and this year they asked Anthony to, present the Budget. Lorrin reported that the health department had.`another break - in. A TV, VCR, and microwave were taken from the WIC depart- ment and a fan from the front room..We have checked on an alarm system at a cost of $$90.00 which -will be installed soon. Dr. Fetner had a good 'report from March of Dimes.' We had a surprise visit from the:State Pharmicist last week, but their report was good. Anthony presented a report on health department services. A drain was stopped up behind Purrs and Krogers last week. This is being corrected. Our next meeting was ,scheduled for July 30, 1991 at 6:45 A.M. at the Holiday Inn. This meeting adjourned at 8:05 A.M. Respectfully Sjikm-±ed, Sharon 9--S,6als LOCAL HEALTH SERVICES PARIS -LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 MONTI -IIJ REPORT FOR MAY, 1991. PREVIOUS FROM 10/90 From 10/89 MONTIi Y.T.D. to 05 -31 -90 IMMUNCZATIONS........... 491 654 4586 7763 FAMILY PLANNING......... 80 114 613 902 MEDICAL SERVICES........ 111 296 1271 1135 B&D CERTIFICATES........ 290 434 2770 2396 VENEREAL DISEASE TESTS.. 227 275 1387 1156 TB SKIN 'PESTS........... 84 99 633 571 INSPI�,C'I "IONS ............. 167 132 914 665 COMPLAINTS .............. 47 53 324 311 RABIE'S & VECTOR CONTROL. 27 20 62 19 WATER SAMPLES........... 132 133 892 740 WIC CLIENTS SEEN........ 1,230 1225 9704 9283 EITLV III TESTS DONE..... 8 5 63 36 POs I T i VI's iITLV TES'T'S ..... 0 0 1 0 # OF JAIL. PATIENTS SEEN. 237 226 1866 1126 FEES COLLECTED.......... 7588.64 FOR MAY 91 FEES COLLECTED.......... 8628.14 FOR MAY 90 FOOTNOTES: 1. Family planning figures include visits for family planning and Eire -natal visits. 2. Medical services include all other persons seen by Dr. Fetner or Lorrin Scott for colds, sore threats, etc. LOCAL HEALTH SERVICES PARIS-LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 MONTHLY REPORT FOR JUNE, 1991 IMMUNIZATIONS........... 454 FAMILY PLANNING......... 75 MEDICAL SERVICES........ 107 B&D CERTIFICATES........ 266 VENEREAL DISEASE TESTS.. 235 'm SKIN TESTS ........... 79 1 N SPECT I ON S ............. 137 COMPLAINTS .............. 48 RABIES & VECTOR CONTROL. 30 WATER SAMPLES........... 111 WIC CLIENTS SEEN........ 1285 PREVIOUS FROM 10/90 From 10/89 MONTH Y.T.D. to 06-30-90 491 5040 8595 so .688 1018 11.1 290 227 84 167 47 27 1.32 1230 1378 3036 1622 712 1051 372 92 1003 10989 1190 2635 1334 642 780 358 55 758 10428 IITLV 11.1 PESTS DONE..... 7 8 70 43 POSITIVE HTLV TESTS ..... 0 0 1 0 # OF JAIL PATIENTS SEEN. 230 237 2096 1321 FEES COLLECTED.......... 5651.58 FOR JUNE 91 FEES COLLEC'T'ED.......... 5761.04 FOR JUNE 90 FOOTNOTES: 1. Faintly planning figures Include visits for family planning and pre -natal visits. 2. Medical services Include all other persons seen by Dr. Fetner or Lori-in Scott for colds, sore throats, etc. LOCAL HEALTH SERVICES PARIS —LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 MONTHLY REPORT FOR JUNE, 1991 PREVIOUS FROM 10/90 From 10/89 MONTH Y.T.D. to 06 -30 -90 IMMUNIZA'T'IONS..... ..... 454 491 5040 8595 FAMILY PLANNING......... 75 80 688 1018 MI!;DICAL SERVICES........ 107 111 1378 1190 B &D CERTIFICATES........ 266 290 3036 2635 VENEREAL DISEASE TESTS.. 235 227 1622 1334 TB SKIN TESTS........... 79 84 712 642 INSPECTIONS ............. 137 167 1051 780 COMPLAINTS .............. 48 47 372 358 RABIE. & VECTOR CONTROL. 30 27 92 55 WATER SAMPLES........... 111 132 1003 758 WIC CLIENTS SEEN........ 1285 1230 10989 10428 HTLV I I I TI.STS DONE ..... 7 8 70 43 POSITIVE HT'LV TESTS..... 0 0 1 0 # OF .TAIL PATIENTS SEEN. 230 237 2096 1321 FEES COLLECTED.......... 5651.58 FOR JUNE 91 FEES COLLECTED.......... 5761.04 FOR JUNE 90 FOOTNOTES: 1. Family planning figures include visits for family planning and pre -natal visits. 2. Medical services include all other persons seen by Dr. Fetner or Lorri.n Scott for colds, sore throats, etc. LOCAL HEALTH SERVICES PARIS -LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 MONTHLY 17I:I'ORT FOR MAY, 1991 PREVIOUS FROM 10/90 From 10/89 MONTH Y.T.D. to 05 -31 -90 IMMUNIZATIONS........... 491 654 4586 7763 FAMILY PLANNING......... 80 114 613 902 MEDICAL SERVICES........ 111 296 1273 1135 B&D CER'T'IFICATES........ 290 434 2770 2396 VENEREAL, DISEASE TESTS.. 227 275 1387 1156 TB SKIN TESTS........... 84 99 633 571 INSPECTIONS ............. 167 132 914 665 COMPLAIN'T'S .............. 47 53 324 311 RABIES & VEC'T'OR CONTROL. 27 20 62 19 WATER SAMPLES........... 132 133 892 740 WIC CLIENTS SEEN........ 1230 1225 9704 9283 HTLV III TESTS DONE..... 8 5 63 36 POSITIVE HTLV TESTS..... 0 0 1 0 # OF JAIL PATIENTS SEEN. 237 226 1866 1126 FEES COLLECTED.......... 7588.64 FOR MAY 91 FEES COLLECTED.......... 8628.14 FOR MAY 90 FOOTNOTE'S 1. Family planning figures include visits for family planning and pre -natal visits. 2. Medleal services include all other persons seen by Dr. Fetner or Lorrin Scott for colds, sore throats, etc. LOCAL HEALTH SERVICES PARIS-LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 MONTHLY REPORT FOR JUNE, 1991 PREVIOUS FROM 10/90 From 10/89 MONTH Y.T.D. to 06-30-90 IMMUNIZATIONS........... 454 491 5040 8595 FAMILY PLANNING......... 75 so .688 1018 MEDICAL SERVICES........ 107 111 1378 1190 B&D CERTIFICATES........ 266 290 3036 2635 VENEREAL DISEASE TESTS.. 235 227 1622 1334 TB SKIN TESTS........... 79 84 712 642 INSPECTIONS ............. 137 167 1051 780 COMPLAINTS .............. 48 47 372 358 RABIES & VECTOR CONTROL. 30 27 92 55 WATER SAMPLES........... Ill 132 1003 758 WIC CLIENTS SEEN........ 1285 1230 10989 10428 HTLV III TESTS DONE..... 7 8 70 43 POSITIVE HTLV TESTS..... 0 0 1 0 # OF JAIL PATIENTS SEEN. 230 237 2096 1321 FEES COLLECTED.......... 5651-58 FOR JUNE 91 FEES COLLECTED .......... 5761.04 FOR JUNE 90 FOOTNOTES: 1. Family planning figures Include visits for family planning and pro-natal visits. 2. Medical services Include all other persons seen by Dr. Fetner or Lorrin Scott for colds, sore throats, etc. LOCAL HEALTH SERVICES PARIS -LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 MONTHLY REPORT FOR AUGUST, 1991 IMMUNIZATIONS ........... 1796 FAMILY PLANNING......... 82 MEDICAL SERVICES........ 285 B &D CERTIFICATES........ 351 VENEREAL DISEASE TESTS.. 222 TB SKIN TESTS........... 91 INSPECTIONS ............. 90 COMPLAINTS .............. 53 RABIES & VECTOR CONTROL. 38 WATER SAMPLES........... 142 WIC CLIENTS SEEN........ 1475 HTLV III TESTS DONE..... 7 POSITIVE HTLV TESTS..... 0 # OF JAIL PATIENTS SEEN. 231 FEES COLLECTED.......... 8390.58 FOR AUGUST 91 FEES COLLECTED.......... 4340.51 FOR AUGUST 90 PREVIOUS MONTH 505 102 137 306 310 111 117 59 43 131 1485 17 0 235 FROM 10/90 From 10/89 Y.T.D. to 08 -31 -90 7341 10654 872 1325 1800 3693 2154 914 1258 484 173 1276 13949 94 1 2562 1323 3218 1664 831 1037 450 134 813 12876 57 0 1501 FOOTNOTES: 1. Family planning figures include visits for family planning and pre -natal visits. 2. Medical services include all other persons seen by Dr. Fetner or Lorrin Scott for colds, sore throats, etc. PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The September 24, 1991 meeting was called to order at 7 :04 A.M. by Richard Bercher, M.D. Those present were: P. Richard Bercher, M.D. Lorrin Scott, P. -A. -C Gordon B. Strom, M.D. T.K. Haynes Thomas Cutrell, M.D. Billy Joe Burnett Mrs. Prances Ellis Gene Anderson Anthony Bethel Michael Malone Julie Abbott Sharon Seals Minutes of the August meeting were approved as read. Lorrin Scott, P.A., gave the monthly report and said we have cut back on walk -ins because of people having more serious problems. Our OB clinic is doing very well. Anthony Bethel gave his report stating that our immuni- zations tripled in August and that fees have doubled. One positive case of a skunk with rabies was reported. He introduced Julie Abbott.- the new CIDC social worker for the health department. The CIDC Grant is for one year allowing for two positions. Julie will recruit new providers for applicants 0 to 21 years of age. Gene Anderson discussed that the City Council met last night and did a Budget Amendment, to be approved Thursday. Dr. Petner called Gene concerning her pay and being on Maternity Leave. She is a city employee and not a contract. employee. Dr. Bercher said they should review her contract and discuss compensation to keep her on after delivery. The next meeting was set for October 22, 1991, at the Holiday Inn at 6:45 A.M. The meeting adjourned at 7:31 A.M. Paris - Lamar County Health Department 740 SIXTH STREET S.W. - P. O. BOX 938 PARIS. TEXAS 75461 LOCAL HEALTH SERVICES PARIS -LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 MONTHLY REPORT FOR SEPTEMBER, 1991 PREVIOUS FROM 10/90 From 10/89 MONTH Y.T.D. to 09 -30 -90 IMMUNIZATIONS........... 429 1796 7770 11100 FAMILY PLANNING......... 103 82 975 1390 MEDICAL SERVICES........ 211 285 2011 1460 B &D CERTIFICATES........ 334 351 4027 3544 VENEREAL DISEASE TESTS.. 226 222 2380 1756 TB SKIN 'PESTS........... 83 91 997 901 INSPECTIONS ............. 136 90 1394 1141 COMPLAINTS .............. 51 53 535 512 RABIES & VECTOR CONTROL. 27 38 200 179 WATER SAMPLES........... 103 142 1379 943 WIC CLIENTS SEEN........ 1479 1475 15428 14018 iITLV III TESTS DONE A .. 7 7 101 71 POSITIVE HTLV TESTS..... 0 0 1 0 # OF JAIL PATIENTS SEEN. 228 231 2790 1621 FEES COLLEC'T`ED.......... 6022.82 FOR SEPTEMBER 91 FEES COLLECTED.......... 5593.70 FOR SEPTEMBER 90 FOOTNOTES: 1. Family planning figures include visits for family planning and Eire -natal visits. 2. Medical services include all other persons seen by Dr. Fetner or Lorrin Scott for colds, sore throats, etc. PARIS -LAMAR COUNTY HEALTH BOARD ��Ukl jml The Paris -Lamar County Health Board met on October 22, 1991, at 6:45 A.M. at the Holiday Inn. Quorum present was: Richard Bercher, M.D., Gordon B. Strom, M.D., Mrs. Ann Norment, and Mrs. Frances Ellis. Others pre- sent were: Lorrin Scott, P.A.C., Gene Anderson, T.K. Haynes, Billy Joe Burnett, Anthony Bethel, and Sharon Seals. Dr. Bercher called the meeting to order at 7:00 A.M. The minutes were approved as read. Lorrin Scott reported that Dr. Fetner is doing well. Barbara Ward, R.N. went to Dallas recently for training about our drug testing machine. Lorrin has agreed to do physicals on 100 children attending the Head Start Program at Givens Elem- entary School. The board agreed that the Special Olympics physicals should be done by local physicians. The LVN position that was discussed in May was not included in the new Budget. There was a communication problem as Gene Anderson didn't get a copy of the listed personnel. Dr. Bercher asked that Dr. Strom and Lorrin write a letter voicing our present need for the LVN and be placed on the City Council and Commissioner's Court Agendas. Anthony Bethel presented copies of the monthly report. Family Planning was down slightly. V.D., Inspections, and WIC numbers were up. The county has not passed an ordinance yet to collect restaurant inspection fees out in the county. Dr. Bercher asked Anthony to write a letter from our board and send to the County Commissioners. The next board meeting is scheduled for November 26, 1991, at 6:45 A.M. at the Holiday Inn. This meeting adjourned at 7:30 A.M. Respectfully Submitted, Sharon J. Seals LOCAL HEALTH SERVICES PARIS-LAMAR COUNTY HEALTH DEPARTMENT 740 S.W. 6TH PARIS, TEXAS 75460 MONTHLY REPORT FOR OCTOBER, 1991 PREVIOUS FROM 10/91 From 10/90 MONTH Y.T.D. to 09-30-91 IMMUNIZATIONS ........... 1390 429 1390 1411 FAMILY PLANNING......... 96 103 96 121 MEDICAL SERVICES........ 243 211 243 181 B&D CERTIFICATES........ 325 334 325 399 VENEREAL DISEASE TESTS.. 229 226 229 79 TB SKIN TESTS........... 84 83 84 67 INSPECTIONS ............. 98 136 98 93 COMPLAINTS .............. 38 51 38 41 RABIES & VECTOR CONTROL. 15 27 15 7 WATER SAMPLES........... 120 103 120 99 WIC CLIENTS SEEN........ 1382 1479 1382 1209 HTLV III TESTS DONE..... 11 7 11 12 POSITIVE HTLV 'TESTS..... 0 0 0 0 # OF JAIL PATIENTS SEEN. 200 228 200 125 FEES COLLECTED .......... 10009-50 FOR OCTOBER 91 FEES COLLECTED.......... 9821.63 FOR OCTOBER 90 FOOTNOTES: 1. Family planning figures include visits for family planning and pre-natal visits. 2. Medical services include all other persons seen by Dr. Fetner or Lorrin Scott for colds, sore throats, etc. PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The Paris -Lamar County Health Board met on November 26, 1991, at the Holiday Inn. Board members present were: Dr. Richard Bercher, Dr. M. Thomas Cutrell, Rev. Evans, Mrs. Ellis, Dr. Bert Strom, Mrs. Ann Nor - ment, Others present were: Lorrin Scott, Gene Anderson, Billy Joe Burnett, Anthony Bethel, Michael Malone, Barbra Francis, Glenn Stephens, and Sharon Seals. Dr. Bercher called the meeting to order at 7 :03 A.M. Minutes were reviewed and Mrs. Norment made a correction regarding the Head -Start Program' Physicals. Dr. Lucy Fetner had agreed to do the Physicals instead of Lorrin Scott. Dr. Bercher stated that we need to put the nursing position back on the Commissioners Court and City Council Agendas. Dr. Strom seconded. All approved. Lorrin Scott gave his monthly report. He stated some drug test- ing has been done at random with the first OB patient testing positive. He then announced his resignation from the Health Department effective January, 1992. He has accepted:a job in Mitchell County Hospital in Colorado City, Texas. His liabili- ty ends January 8, 1992. He will bring details of the claims made liability to our next meeting. -Mrs. Ellis made motion to accept the resignation. Dr. Cutrell seconded. All reluctantly agreed. Anthony Bethel gave his monthly report. The State is cutting back the STD program at the Health Department. They will send someone here from Tyler-,to work HIV and Syphillis. Dr. Bercher said he will call Dr. Crowder and talk about the much needed Veneral Disease Program here. Anthony stated that on Sept. -1; 1992, the State will not allow our LVN to run water samples. The new restaurant fees were approved and will start Dec.1,1991. All restaurants county wide with 1 to 5 employees will pay $25.00, 6 to 9 will pay $75.00, and over 9 will pay $125.00. Mrs. Norment pointed out that Glenn Stephens got us on the County Commissioner's Agenda for the new restaurant fees. Our next meeting is set for December 10, 1991, at 6:45 A.M. at the Holiday Inn. This meeting adjourned at 8:00 A.M. Respectfully Submitted, Sharon J- Seals LIST OF FETE _A - - - ._B_ _C_. IMMUNIZATIONS - ?5.00 $10.00 ;115.00 FLU SIfOTS $5.00 $10.00 $15.00 PNEUMONIA SHOTS $5.00 $10.00 $15.00 DOCTOR VISIT $5.00 $10.00 $15.00 WATER SAMPLE $6.00 SAME SAME BIRTH CERTIFICATE $3.00 SAME SAME DEATH CERTIFIChTE, $8.00 SAME SAME SEPTIC SYSTEM PERMIT 175.00 SAME SAME HEALTH INSPECTION PERMIT >25.00 $75.00 $125.00 HEALTH CERTIFICATE (V1)RL & MANTOUX) $5.00 $10.00 $15.00 HIV TESTING $15.00 SAME SAME VIENERAL DISEASE TESTING & TREATMENT $1.0.00 $20.00 $30.00 LYME DISEASE TEST $20.00 SAME SAME HEPATITIS SHO'O'S 05.00 $10.00 $15.00 SHOT RECORDS -x5.00 SAME SAME BIRTH CARDS $5.00 SAME SAME PREGNANCY TEST $5.00 $10.00 115.00 HEALTH CERTIFICATE COPIES $5.00 SAME SAME DIABE'T'IC SCREENING $5.00 SAME SAME BIRTH CONTROL PILLS $5.00 $10.00 $15.00 PHYSICALS ;5.00 $10.00 $15.00 RABIES TESTING $20.00 SAME SAME DRUG TESTING $75.00 SAME SAME STREP TEST $7.00 SAME SAME CHLAMYDIA $.00 $10.00 $15.00 SCHEDULE A i FAMILY SIZE ....... .... WEEK" -1 Y ...................L I4UNTHLY I ANNUAL 1 I $ 224 $ 969 11,618 2 300 1,299 15,577 3 376 11628 19,536 4. 452 1,958 23,495 5 528 2,288 27,454 6 605 2,618 31,413 7 681 2 , 94.8 35,372 8 757 3,278 39,331 ..._ ................................................................................. ............................... EACH ADDITIONAL ........................................ ..... .......... .... . ...... ..... .... . ........ ..... ........................................ _ ..... ......................... ._.... ._ ............ __......... FAMILY `MEMBER j + 77 + 330 + 3,959 SCHEDULE B FAMILY SIZE � WEERLY ................ ...... ..... ... .... ........... ......... ....... MONTHLY .... ......_.... _ ........ ........... . .............. ........... ......_...... ANNUAL .. ....... ...................._.._.......... . ..... ... ........ ._._....__...___...._.. 1 $ 336 $1,454 $ 17,427 2 450 1,949 23,366 3 564 2,442 29,304. 4 I 678 2,937 35,243 5 792 3,432 41,181 6 908 3,927 47,120 7 1,022 4,422 53,058 8 1,136 4,917 58,997 .... ............ ........ .......................................................................... ..................................................... EACH ADDITIONAL .... ............................ .... .......... ._ ................ ........_......... . ..... ............... _ .... ............ ... ... _. ....... ..... _ .................... _....__..._.._..._..._...... FAMILY MEMBER + 116 + 495 + 5,939 SCHEDULE C ANY INCOME OVEN THE LIMI'['S LISPED ABOVE FOR SCHEDULE B WILL RESULT IN FEES FROM SCHEDULE C AS LISTED IN FEE SCHEDULE. /� ,F I PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The Paris -Lamar County Health Board met on January 21, 1992, at the Holiday Inn. Board members present were: Dr. Richard Bercher, Dr. Thomas Cutrell, Mrs. Frances Ellis, Mrs. Ann Norment, Dr. Bert Strom, and Dr. Robert Moseley. Others present were: T.K. Haynes, Gene Anderson, Lorrin Scott, Anthony Bethel, Barbra Francis, and Sharon Seals. Dr. Bercher called the meeting to order at 6:59 A.M. He welcomed Dr. Moseley to our board. The minutes were approved as read. Dr. Stephen Burns has agreed to see the jail patients and be reimbursed each visit at $ 150.00 an hour. Anthony Bethel talked to Pete Patter- son about a letter to Austin concerning our STD program. Dr. Bercher talked to someone in Dr. Crowder's office and they don't wish to cut our services. Anthony Bethel stated that Dr. Fetner plans on coming back to work March 1st. Dr. Strom said that Dr. Greg Ski& and Dr. Dan Babe.r might agree to see our prenatal patients in February. T.K. Haynes mentioned our loss of regional funding and supplies. Our T.B. program has been assigned to Pam Schuller, R.N. from Clarksville. He said we need a Nurse Practitioner to replace some of our loss with Lorrin leaving. Anthony mentioned we had already discussed sending Kim Elsom „ R.N., to OB -GYN School in Dallas. Paris Health Services has been doing well lately. Dr. Cutrell said we need to get our representatives on our side, go to Austin and discuss the duplicate services. Dr. Strom, Mrs. Ellis, Anthony, and Mrs. Nor- went agreed to meet and get a statement together concerning Paris Health Services. Dr. Bercher signed the health department contracts. Anthony presented the monthly report. Gray's Cafe complained the most about the new inspection fees. Barbra Francis said she was leaving for Austin after this meeting. WIC is supposed to receive more administrative computers, but have no space for them. The next meeting is scheduled for February 18, 1992 at 6:45 A.M. Meeting adjourned at 8:00 A.M. Respectfully Submitted, PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The Paris -Lamar County Health Board met on Tuesday, February 18, 1992 at the Holiday Inn. Quorum present was: Dr. Cutrell, Dr. Moseley, Mrs. Norment, Mrs. Ellis, Dr. Strom, and Dr. Kraft. Others present were: T.K. Haynes, Anthony Bethel, and Sharon Seals. Dr. Cutrell called the meeting to order at 6:59 A.M. Dr. Bercher called and could not attend. Dr. Cutrell read the minutes and they were approved by all. T.K. Haynes discussed old business. He urged Anthony to send a letter and a copy of these minutes as soon as possible to Pete Patterson. Our Veneral Disease person is being funded directly from the State of Texas. Dr. Strom talked to Ronnie Anderson and Don Peterson in Austin, The new State Health Director has discovered that the right hand does not know what the left hand is doing in our local health departments. Dr. Fetner is supposed to return to work at the health department on March 18, 1992 and work maybe 8 hours a week. Dr. Skie is seeing patients on Tues- day and Thursday mornings at the health department. Dr. Cutrell urged us to overbook our patients, since we have many no shows. Kim Elsom, R.N. at the health department has mailed necessary papers to Aus- tin concerning the OB -GYN School in Dallas. The Sub - Committee, Anthony Bethel, Dr. Strom, and Mrs. Ann Norment met on two occasions since our last board meeting. Dr. Strom checked with the State Health Department on information concerning the Paris Health Services. Mrs. Norment talked with Senator Ratliff. Paris Health Services' building is leased from Nathan Bell. Mr. Ostergren established Paris Health Services here 5 years ago. He was a figurehead and cannot be located now. They are funded with Title XX money and the State of Texas writes the employees' checks. Dr. Cutrell suggested that we start sending a quarterly letter from our chairman to Tyler Region 7 and Austin,stating the goals and aims of our health department. Dr. Cutrell suggested that our board members get together and make a trip to Tyler in March to discuss Title XX money. Anthony will make an Agenda and handle all arrangements for this luncheon meeting. The news about 6 students testing positive for Aids in Bogata was discussed. Dona Spence is being questioned by the State Health Department concerning the validity of her statements. Stewart Blood Drive has not had any positive HIV tests in past 3 years. Anthony gave the monthly report. The next board meeting will be the trip to Tyler the third week in March. This meeting adjourned at 8:00 A.M. PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING The Paris -Lamar County Board of Health met Tuesday, July 21, 1992 at the Holiday Inn of Paris. Board members in attendance were Dr. Cutrell, Ann Norment, Francis Ellis, Dr. Kraft, Dr. Strom, Dr. Moseley. Others In attendance included Troy Owens, Latricia Miller, Alan Weatherford, T.K. Haynes, Gene Anderson, Mike Malone, and Anthony Bethel. The meeting was called to order at 6:55 am. Minutes from the previous meeting were not read or approved. Dr. Strom informed the board that Dr. Beachly had accepted the position offered him at the Health Department, and that Dr. Beachly could start working in two weeks. The board suggested that Dr. Beachly communicate as closely as possible with other local physicians, which was not being done by Dr. Fetner. The board discussed Dr. Fetner's offer for continued employment as a physician at the Health Department. A motion was made by Dr. Strom and seconded by Mrs. Ellis to accept Dr. Fetner's letter of resignation. The board approved this motion. Dr. Cutrell, Mrs. Norment, and T.K. Haynes will meet with Dr. Fetner and advise her of the board's decision. Dr. Strom made a motion and Mrs. Norment seconded the motion to authorize T.K. Haynes to draw up a contract for $125,000.00 plus malpractice insurance to offer Dr. Beachly. This motion was approved. Dr. Strom made a motion and Mrs. Norment seconded the motion that in Dr. Beachly's contract the insurance tail coverage should be pro -rated as follows: The first year the Health Department will pay 20% of the tail coverage. If Dr. Beachly stays the second year, the Health Department will pay 40% of the coverage. If Dr. Beachly stays the third year, the Health Department will pay 60% of the coverage. If Dr. Beachly stays the fourth year the Health Department will pay 80% of the coverage, and if Dr. Beachly stays the fifth ,year, the Health Department will pay 100% of the coverage. This motion was also approved. The time and place for the next meeting will be set when the contract: is ready for the board to review. The meeting adjourned at 8:10 am. Respectfully submitted, Anthony Bethel F� PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The Paris -Lamar County Health Board met on July 9, 1992, at 12:00 o'clock noon, at.the Holiday Inn. Board members present were: Mrs. Ann Norment, Dr. Robert Moseley, Dr. Bert Strom, and Rev. Samuel Evans. Dr. Wallace Kraft, Mrs. Francis Ellis, and Dr. Thomas Cutrell were not present. Others present were: Troy Owens, Allan Weatherford, Gene Anderson, Anthony Bethel, T.K. Haynes,-Dr. Charles Beach - ley, Dr. Lucy Fetner, Latricia Miller, Billy Joe Burnett, Dana Allen, Michael.Malone, Judge Dean Loughmiller, and Sharon Seals. Dr. Bert Strom called the meeting to order at 12:17 P.M. He explained that the purpose of this meeting was to meet Dr. Charles Beachley and see if he might be interested in work- ing full -time at the health department.. He then asked if any- one had any questions. Dr. Fetner stated that she had some- thing to say. She said there should be better communication between the next health department doctor and the city- county officials, also the health board. She stated that she was not informed about several board meetings and did not appreciate not being invited to them. She thought that T.K. Haynes had talked with Anthony Bethel about medical matters that should have been referred directly to her. She suggested that county officials should talk to a new doctor about the major problems that come seeing indigent health care patients. The emergency room doctors and nurses need to know that the health department has some medical records on indigent health patients. -Dr. Pet ner stated there has been lack of communication with her posit- ion and our health board. Michael Malone stated that our health board is a governing board and that the city does not wish to run the health department. Dr. Strom was apologetic about the lack of communication, but said that another doctor who is no longer on our board was supposed to have talked to her. T.K. Haynes said that Dr. Strom should not take all the blame for Dr. Fetner not being informed. Dr. Strom agreed with Dr. Fet- ner's concerns and said that one of the main reasons for try- ing to find a full -time doctor is because of acute problems at the jail. He stated that Dr. Hillhouse did not wish to co- operate with the jail problems or indigent health care. Dr. Fetner urged the board to carefully decide whether they want her to do part -time prenatal care because the prenatal clinics do not make any money for anyone. McCuistion and St. Joseph Hospitals are interested in providing funds for prenatal care. Our WIC program cannot exist without a prenatal program. Dr. Strom said good prenatal care is essential and the program needs to be increased. Dr. Strom said our health board com- mittees are still in the planning stages and are very concern- ed about making things better at the health department, Dr. Fetner mentioned that Paris Health Services is duplicat- ing many of our same services. Dr. Strom stated they are a fore - profit program and their Title XX money should run out by October 1, 1992 and they will have to close their doors. Dr. Beachley gave everyone a copy of his Curriculum Vitae. He stated that he had spent half of his life in Paris and would like to relocate here again. He and his wife now live in Carrollton and work in Dallas. He said up front that he has no plans to be on call for the jail 365 days a year. He sees this job as challenging and believes in preventive med- icine to save society money. His first question was when is the starting date, if he should take the job. Dr. Strom said we would discuss this later in executive session. Dr. Beachley stated he would like to work at least 5 more years before re- tiring. T.K. Haynes said the health department doctor has never been expected to see jail prisoners all hours of the night. They are transported to the emergency rooms at either hospital. Meeting adjourned at 12:58 P.M. Respectfully Submitt EXECUTIVE SESSION MINUTES Executive session opened at 1:00 P.M. Quorum was present with Dr. Fetner. Gene Anderson was asked to join us. Gene stated we were operating on $87,987.00 as of June, 1992. He stated that all our state money was not in. He said we may need to increase the amounts of fees at the health department. Dr. Strom asked Gene to do a projection on increased funds if more people were seen and more services were provided. Dr. Strom explained the Paris Health Services had a windfall of $70,000.00 to start their operation. As soon as their funds run out they will close their doors. Many of the people going there will return to the health department for services. Dr. Strom said -the board is aware that the health department needs a:larger building. The board unanamously agreed to offer Dr. Beachley $125,000.00 total package yearly. We provide malpractice extra. A 1 year contract would be feasible. Dr. Moseley stated an official letter should be sent to Dr. Fetner from the board with an explanation why she was excluded from the meetings. Everyone agreed. Dr. Beachley was invited in to executive session at 1:25 P.M. He asked questions about insurance. He would keep own liability and we provide malpractice insurance. Next, he asked about health insurance. Gene explained the city employees are covered by Blue Cross, but the spouse's insurance is separate. Dr. Beachley said he has medicare. He then asked about the services we provide at the health department. I explained the types of services we offer. He asked if other counties come to.us for services. Dr. Strom explained that Delta, Red River, and Fannin Counties wish to be included, but that we need a co- ordinator to work with Dr. Crowder, Region 7, and Austin to help us get more money. Dr. Beachley said he would visit Dr. Crowder soon. He also will check to see if his insurance will cover him working prenatal clinics when Dr. Fetner is absent. He asked about moving allowances. Gene said this could be managed. T.K. Haynes, Latricia Miller, and Anthony Bethel joined the meet- ing at 1:45 P.M. Anthony asked the board to talk to Dr. Fetner about doing 3 prenatal clinics a week instead of 2. Dr. Strom a- greed to talk to her. The board asked Dr. Beachley if he would join us in 4 weeks. He agreed to give a 4 week notice of resignation to his job in Dal- las. He will come to Paris next Tuesday to visit the health de- partment that morning and tour the jail that evening. Meeting adjourned at 1:47 P.M. PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES The Paris -Lamar County Health Board met on May 12, 1992, at the Holiday Inn. Board members present were: Dr. Cutrell, Mrs. Ann Norment, Dr. Wallace Kraft, Dr. Robert Moseley, Mrs. Frances Ellis, and Dr. Bert Strom. Others present were: T.K. Haynes, Billy Joe Burnett, Latricia Miller, Allan Weatherford, An- thony Bethel, Michael Malone, and Sharon Seals. Dr. Cutrell called the meeting to order at 7:10 A.M. Minutes were approved from meeting on April 29, 1992. Anthony Bethel asked if a couple of board members would look over the 1992- 1993 Budget this Thursday noon, May 14th, at the health department. It must be turned in to City Hall on Friday. Region 7 office has money to pay for mammograms, if the patients are referred by our clinic. These would be done at both local hospitals. McCuistion has contacted us, but St. Joseph has not. The mammograms are $ 55.00 each. A physician's assistant from Greenville came over and toured the health department with Anthony Bethel. The health department must apply thru Medicaid to establish a rural health district here. Anthony talked with Dr. Gregg Skie about working full -time at the health de- partment. He is interested, but would only stay a short term. The total spent on Lorrin Scott, Dr. Lucy Fetner, and insurance totaled $ 87,679.00 last year. Dr. Strom suggested we select a sub - committee and talk about long -range goals for the health department. Mrs. Norment, Dr. Strom, Billy Joe Burnett, Michael Malone, Allan Weatherford, and Latricia Miller volunteered to meet on Monday, May 18, 1992 at 6:30 P.M. at City Hall. T.K. Haynes suggested that all existing cost factors be brought to this meeting. The next health board meeting is scheduled for June 9, 1992, at 6:45 A.M. at the Holiday Inn. Meeting adjourned at 7:55 A,M, Respectfully Submitted, PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES The Paris -Lamar County Health Board met on May 28, 1992, at the Holiday Inn. Quorum present: Dr. Richard Bercher, Dr. Bert Strom, Dr. Thomas Cutrell, Mrs. Francis Ellis, Mrs. Ann Norment, Rev. Samuel Evans, Dr. Robert Moseley, and Dr. Wallace Kraft. Others present: T.K. Haynes, Billy Joe Burnett, Latricia Miller, Allan Weatherford, Troy Owens, Glynn Stephens, Michael Malone, Anthony Bethel, and Sharon Seals. Minutes were read by Sharon Seals and then approved. Dr. Strom said the Sub - Committee met on May 18, 1992 and discussed long - range goals for the health department. They talked about grants and that we will need a full -time physician to seek a health district. The City and County agreed on hiring a full -time doctor for $120,000.00 yearly, with a 4 day week and 6 hours at the jail. Dr. Strom reviewed 300 jail charts and found that documentation was limited and charges were extreme- ly high. He stated we need to establish a Formulary for jail medicines. Latricia Miller said they have a well stocked medicine cabinet at the jail. Dr. Strom`s third point was to have an institutional peer review to save money. Dr. Strom made a motion to establish a full -time doctor and clarify the total package. Dr. Cutrell seconded the motion. Motion passed. Dr. Strom said Dr. Fetner will be offered the full -time position first. The full -time doctor will be given a written job description. Latricia Miller spoke to Pharmacist Bill Lancaster. He is willing to help work up the Formulary. Dr. Bercher announced his decision of resignation from the board effect- ive today. Meeting adjourned at 7:44 A.M. Next meeting is scheduled for June 9, 1992, at 6:45 A.M. at the Holiday Inn. Respectfully Submitted,, PARIS -LAMAR COUNTY HEALTH BOARD MINUTES The Paris -Lamar County Health Board met on Tuesday, March 31, 1992 at the Holiday Inn. Mrs. Ann Norment called the meeting to order at 7:00 A.M. Quorum present: Mrs. Ann Norment, Mrs. Francis Ellis, Rev. Evans, Dr. Bert Strom. Others present were: T.K. Haynes, Michael Malone, Glenn Stephens, Kevin Parsons, Billy Joe Burnett, and Anthony Bethel. Dr. Strom gave a report on the luncheon meeting in.Tyler on March 21, 1992, with Dr. Crowder. He suggested that our board have a workshop with Dr. Crowder and Cheri Williams to discuss how other health boards operate in Region 7. The workshop will be on April 21, 1992 at 6:3.0.; P.M. here in Paris. Long range goals for the health department will be discussed. Dr. Strom suggested that we form a medical review group to look at how Dr. Burns is doing at the jail, then try to trim the medical costs if possible. Indigent Health Care spent $400,000.00 in Lamar County in 1991. T.K. Haynes suggested that screening for Indigent Health Care be placed at the health department and that the qualified indigent be seen there. Anthony suggested that the county hire a doctor at the health department to take care of the indigent. Anthony reported that our copy machine has been in the shop for repairs again. Bids have been taken for a new copy machine. Dr. Strom made a motion that we purchase a new copy machine. Rev, Evans seconded the motion. Motion carried. Anthony gave the monthly report. Fees were down due to fewer medical services. This meeting adjourned at 8:15 A.M. Respectfully Submitted, PARIS-LAMAR COUNTY BOARD OF HEALTh MINUTES OF MEETING THE PARIS- BOARD OF HEALTH HELD A REGULAR MEETING ON SEPTEMBER 29, 1992. THOSE IN ATTENDANCE INCLUDED DR. CUTRELL, DR,, STROM, AND MALONE, ALAN ANTHONY MRS, ELLIS. WEATHERFORD, BETHEL, OTHERS IN ATTENDANCE TROY OWENS, AND JAE DICKINSON. INCLUDED LATRICIA MILLER, T.K. HAYNES, MIKE DR. CHARLES BEACHLEY, THE MEETING MEETING WERE WAS CALLED APPROVED, TO ORDER AT 7:10 AND MINUTES OF THE PREVIOUS TIME FOR MEETINGS WAS DISCUSSED AND CHANGED TO 7:00 AM. APPOINTMENT OF NEW BOARD MEMBER WAS DISCUSSED AND DR. STROM SUBMITTED DR. TED MC LEMORE AND WANTS THE BOARD TO APPROVE. QUESTIONS WERE RAISED BY T.K. HAYNES ABOUT WALLY KRAFT STILL BEING ON THE BOARD,, DISCUSSION ON DR. BEACHLEY'S CONTRACT WAS HELD. DR. CUTRELL STATED THAT HE AND DR. STROM HAD MET AND DISCUSSED THE CONTRACT. DR. CUTRELL READ PARTS OF THE CONTRACT. DISCUSSION WAS HELD ABOUT INSURANCE PROVIDED IN DR. BEACHLEY STATED HE WOULD LIKE TO CARRY 1/2 THE CONTRACT. MILLION/MILLION, DISCUSSION WAS ALSO HELD AS TO WHAT WAS A REASONABLE TIME AWAY AND STILL KEEP THINGS RUNNING SMOOTHLY. DR. BEACHLEY WANTED TO KNOW WHAT OTHER HEALTH DEPT PHYSICIANS GET IN THE WAY OF LEAVE. DR. CUTRELL ASKED IF THERE WERE ANY QUESTIONS OR FURTHER DISCUSSION NEEDED ABOU� iEAVE. DR. STROM SUGGESTED BOARD APPROVAL FOR LEAVE LONGER THAN A HEALTH DEPTS. AND GOING WEEK. DR. BY THAT. MRS. BEACHLEY ELLIS SUGGESTED AGREED. LOOKING NO ACTION AT OTHER WAS TAKEN ON THIS MATTER. T.K. SAID HE WOULD CHECK WITH TYLER-SMITH COUNTY AND REPORT TO DR. CUTRELL AND WHAT KS CUSTOMARY DR, STROM IN FOR FIELD. A DECISION TO BE MADE ON CONTRACT BASED ON DISCUSSION HAVING A PAD WAS HELD MADE UP ON IMMUNIZATIONS. LISTING IMMUNIZATIONS DR. BEACHLEY WITH MADE REFERENCE TO SPACES TO CHECK WHAT CHILDREN NEED AND DISTRIBUTING THEM TO ALL PHYSICIANS. DR. CUTRELL WANTED A LIMIT ON AMOUNT OF TIME ORDER WOULD BE GOOD, POSSIBLY 2-3 DAYS. DR. BEACHLEY STATED HE WOULD LIKE TO HAVE AN AD PLACED IN THE PAPER ABOL|T FLU SEASON AND IMMUNIZATIONS. WOULD LIKE THIS COUNSELING. SHERIFF SAID NO. NOW WILL HAVE TO GET LETTERS FROM OTHER INTERESTED AGENCIES. MIKE MALONE SAID ARK-TEX WAS INVOLVED. DR. BEACHLEY IS PLANNING TO ESTABLISH A RELATIONSHIP WITH AUSTIN IN MID OCTOBER. DISCUSSION OF THE MARCH OF DIMES GRANT WHICH PROVIDES FOR AN OB EDUCATOR AT THE HEALTH DEPARTMENT. IN THE COMING YEAR MCCUISTION HOSPITAL WISHES TO APPLY FOR THIS GRANT AND SEND SOME OF THEIR NURSES TO THE PARIS-LAMAR COUNTY HEALTH DEPT. TO EDUCATE OB PATIENTS. THE DATE AND TIME OF THE NEXT MEETING WAS SET FOR TUESDAY, OCTOBER 20, 1992, AT 7:00 AM, AT THE HOLIDAY INN. RESPECTFULLY SUBMITTED, JAE DICKINSON APPROVED BY ANTHONY BETHEL PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING THE PARIS -LAMAR COUNTY BOARD OF HEALTH HELD A REGULAR MEETING ON OCTOBER 27, 1992. THOSE IN ATTENDANCE INCLUDED DR. CUTRELL, DR. STROM, MRS. NORMENT, DR. KRAFT, AND DR. MOSELEY. OTHERS IN ATTENDANCE INCLUDED T.K. HAYNES, GENE ANDERSON, BILLY JOE BURNETT, ALAN WEATHERFORD, TROY OWENS, LATRICIA MILLER, DR. CHARLES BEACHLEY, ANTHONY BETHEL, AND JAE DICKINSON. THE MEETING WAS CALLED TO ORDER AT 7:00 AND MINUTES OF THE PREVIOUS MEETING WERE APPROVED. DISCUSSION ON DR. BEACHLEY'S CONTRACT WAS HELD. MR. HAYNES SAID THAT THE TERM HAD BEEN CHANGED FROM i TO 2 YEARS AT THE RECOMMENDATION OF THE TEXAS DEPT. OF HEALTH. THE CONTRACT WILL COINCIDE WITH DR. BEACHLEY'S APPOINTMENT. DR. STROM RECOMMENDED THAT THE CITY SHOULD WRITE THE CONTRACT FOR 2 YEARS. DR. CUTRELL ASKED IF ANY BOARD MEMBER OBJECTED TO THE 2 YEAR TERM, AND THERE WAS NONE. DISCUSSION OF PROVISIONS FOR LEAVE AND INSURANCE. MR. HAYNES STATED THAT SMITH CO. GIVES 3 DAYS NOTICE AND A PHONE NUMBER AS OFTEN AS NEEDED WITH NO LIMITATIONS. DR. CUTRELL SAID HE WOULD LIKE LIMITATIONS. THE STATE STARTS WITH 10 DAYS OR 2 WORK WEEKS. DR. STROM WANTED TO KNOW THE PROPOSAL IN THE CONTRACT. IT IS FOR 2 WEEKS VACATION, 10 DAYS SICK AND PERSONAL AND 2 WEEKS CONTINUING EDUCATION. A QUESTION ON INSURANCE COVERAGE AND SALARY WAS RAISED. THE NET SALARY IS REDUCED TO COVER THE INCREASE IN MALPRACTICE INSURANCE. A VOTE WAS TAKEN ON THE CONTRACT. DR. STROM MADE THE MOTION TO ACCEPT AND DR. KRAFT SECONDED. ALL WERE IN FAVOR. BOARD WANTED A LETTER SENT TO CO. JUDGE REGARDING SAFETY AT JAIL. DR. KRAFT MADE THE MOTION THAT THE BOARD FORM A SUB - COMMITTEE TO MEET WITH THE COUNTY AND SET UP GUIDELINES FOR THE JAIL. DR. STROM SECONDED. ALL WERE IN FAVOR. DR. STROM RECOMMENDED THE NEXT MEETING BE HELD THE 3RD TUESDAY IN NOVEMBER AT 7:00 AM. MEETING ADJOURNED AT 8:18. RESPECTFULLY SUBMITTED, J;Alr�� J DICKINSON APPROVED BY ANTHONY BETHEL PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING THE PARIS -LAMAR COUNTY BOARD OF HEALTH HELD A REGULAR MEETING ON NOVEMBER 24, 1992. THOSE IN ATTENDANCE INCLUDED DR. CUTRELL, DR. STROM, MRS. NORMENT, DR. KRAFT, REV. EVANS, AND DR. MOSELEY. OTHERS IN ATTENDANCE INCLUDED T.K. HAYNES, BILLY JOE BURNETT, LATRICIA MILLER, DR. CHARLES BEACHLEY, ANTHONY BETHEL, AND JAE DICKINSON. THE MEETING WAS CALLED TO ORDER AT 7:05 AND MINUTES OF THE PREVIOUS MEETING WERE APPROVED. DISCUSSION ON FEES FOR LAB WORK DONE AT THE HEALTH DEPT. WAS HELD. A MOTION FOR A FEE SCALE WAS MADE BY MRS. NORMENT. REV. EVANS SECONDED. ALL WERE IN FAVOR. DISCUSSION OF MAINTAINING TWO CLERKS IN FRONT OFFICE. NO ACTION WAS TAKEN. ANTHONY MADE HIS MONTHLY REPORT. RESTAURANT INSPECTIONS WERE DISCUSSED. NO ACTION WAS TAKEN. DISCUSSION ON THE JAIL. NOTHING HAS BEEN DONE ABOUT SECURITY. THINGS ARE IMPROVING. DISCUSSION WAS HELD REGARDING GUIDELINES. DR. CUTRELL STATED THAT THE BOARD WOULD NEED TO ELECT A NEW CHAIRMAN AT THE JANUARY MEETING. THE MEETING ADJOURNED AT 8:05. THE NEXT MEETING IS TO BE HELD JANUARY 05, 1993 AT 7:00 AM AT THE HOLIDAY INN. RESPECTFULLY SUBMITTED, qou_6�� J DICKINSON APPROVED BY ANTHONY BETHEL PARIS-LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING THE PARIS-LAMAR COUNTY BOARD OF HEALTH HELD A REGULAR MEETING ON JANUARY 12, 199��. THOS N ATTENDANCE INCLUDED DR. CUTRELL, DR. STROM, MRS. � _�� NORMENT, MRS. �u� S, DR. MCLEMORE, REV. EVANS, AND DR. MOSELEY. OTHERS IN ATTENDANCE INCLUDED T.K. HAYNES, BILLY JOE BURNETT, LATRICIA MILLER, TROY OWENS, ALAN WEATHERFORD, DR. CHARLES BEACHLEY, ANTHONY BETHEL, AND JAE DICKINSON. THE MEETING WAS CALLED TO ORDER AT 7:15 AND MINUTES OF THE PREVIOUS MEETING WERE APPROVED. DR. MCLEMORE WAS WELCOMED TO THE BOARD. EXTENSIVE DISCUSSION OF FEES FOR LAB WORK DONE AT THE HEALTH DEPT. WAS HELD. DR. CUTRELL REQUESTED THAT ANTHONY STUDY THE FEE PAYMENT AND REPORT BACK TO THE BOARD. QUESTIONS WERE RAISED ABOUT MOVING INDIGENT HEALTH CARE EMPLOYEES TO THE HEALTH DEPT. ANTHONY MADE HIS MONTHLY REPORT. ELECTION OF HEALTH BOARD OFFICERS. DR. STROM NOMINATED DR. CUTRELL FOR PRESIDENT. SECOND WAS MADE BY REV. EVANS. DR. STROM NOMINATED DR. MCLEMORE FOR VICE CHAIRMAN. SECOND WAS MADE BY REV. EVANS. ALL WERE IN FAVOR. DR. BEACHLEY STATED HIS CONCERNS ABOUT BEING SECOND GUESSED BY NON-MEDICAL PERSONNEL AT THE JAIL. DR. CUTRELL CIRCULATED A PAMPHLET FROM PARIS LIFE INC. DISCUSSION WAS HELD ABOUT WHETHER TO PLACE IT IN THE HEALTH DEPT. OR NOT. DR. STROM MADE A MOTION TO DISPLAY IT. SECOND WAS MADE BY DR. MOSELEY. ALL WERE IN FAVOR. THE MEETING ADJOURNED AT 8:15. THE NEXT MEETING IS TO BE HELD FEBRUARY 09, 1993 AT 7:00 AM AT THE HOLIDAY INN. RESPECTFULLY SUBMITTED, ^ ' 9ifl-DICKINSON APPROVED BY DR. CUTRELL PARIS-LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING THE PARIS-LAMAR COUNTY BOARD OF HEALTH HELD ITS REGULAR MEETING ON FEBRUARY 09, 1993. THOSE IN ATTENDANCE INCLUDED DR. CUTRELL, DR. STROM, MRS. NORMENT, MRS. ELLIS, DR. MCLEMORE, DR. KRAFT, AND DR. MOSELEY. OTHERS IN ATTENDANCE INCLUDED BILLY JOE BURNETT, LATRICIA MILLER, TROY OWENS, ALAN WEATHERFORD, DR. CHARLES BEACHLEY, ANTHONY BETHEL, AND SAE DICKINSON. THE MEETING WAS CALLED TO ORDER AT 7:10 AND MINUTES OF THE PREVIOUS MEETING WERE READ AND APPROVED. DR. BEACHLEY WANTS BOARD BACKING IN HIS DECISION TO HAVE THE NURSES FROM THE HEALTH DEPT. FILL IN AT THE JAIL WHEN MRS. BEACHLEY CAN'T BE THERE. DR. STROM MADE THE MOTION TO SUPPORT THE DECISION. SECOND WAS MADE BY MRS. ELLIS. ALL WERE IN FAVOR. DISCUSSION OF MEDICAID. WE ARE STILL WAITING ON PAPERWORK. WE ARE MOVING FORWARD. POSSIBILITY OF RSVP VOLUNTEERS BROUGHT UP BY MRS. NORMENT. ANTHONY IS TO MAKE OUT A JOB DESCRIPTION FOR VOLUNTEERS AND PRESENT IT TO THE BOARD AT THE NEXT MEETING. ANTHONY MADE HIS MONTHLY REPORT. AIDS COUNSELING DISCUSSED AS A GROUP AT THE JAIL. DR. BEACHLEY WAS ASKED ABOUT SECOND GUESSING AT THE JAIL. HE THINKS THEY HAVE FOUND THE PROBLEM AND HAVE CORRECTED IT. THE MEETING ADJOURNED AT 8:00. THE NEXT MEETING IS TO BE HELD MARCH 09, 1993 AT 7:00 AM AT THE HOLIDAY INN. RESPECTFULLY SUBMITTED, ~ , &dezllk�� 9 ICKINSON APPROVED BY DR. CUTRELL THE MEETING ADJOURNED AT D : 15 . THE NEXT MEE T I NU 12 TO DE HELD APRIL 09. 1993 AT 7:00 AM AT THE HOLIDAY INN. RESPECTFULLY SUBMITTED, JAE DICKINSON APPROVED BY DR. CUTRELL PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING THE PARIS -LAMAR COUNTY BOARD OF HEALTH HELD ITS REGULAR MEETING ON MARCH 09, 1993. THOSE IN ATTENDANCE INCLUDED DR. CUTRELL, DR. STROM, MRS. NORMENT, MRS. ELLIS, DR. MCLEMORE, DR. KRAFT, REV. EVANS, AND DR. MOSELEY. OTHERS IN ATTENDANCE INCLUDED GENE ANDERSON, MIKE MALONE, BILLY JOE BURNETT, JUDGE DEAN LOUGHMILLER, LATRICIA MILLER, TROY OWENS, ALAN WEATHERFORD, GENE BUSTER, DR. & MRS. CHARLES BEACHLEY, ANTHONY BETHEL, JAE DICKINSON, AND SHERRY LANGSTON. THE MEETING WAS CALLED TO ORDER AT 7:10 AND MINUTES OF THE PREVIOUS MEETING WERE READ AND APPROVED. DISCUSSION OF DR, BEACHLEY'S RESIGNATION. DR. BEACHLEY TALKED ABOUT PROBLEMS AT THE JAIL. HE RECOMMENDED THAT SOMETHING BE IN WRITING IF A PROCEDURE ISN'T GOING TO BE DONE. DR. BEACHLEY GAVE TWO SUGGESTIONS FOR HIRING A NEW DOCTOR. 1. SEPARATE THE JAIL AND THE HEALTH DEPT. 2. ASK COUNTY TO FIND AND HIRE THEIR OWN DOCTOR. JUDGE LOUGHMILLER SAID DOCTOR SHOULD NOT BE SECOND GUESSED BUT TRY TO GET STATE TO MOVE HIGH MEDICAL COST PATIENTS TO STATE JAIL. DR. BEACHLEY CONTINUED BY SAYING A LOT OF THE THINGS HE DOES AT THE JAIL IS TO PRESCRIBE MEDICINE THAT IS OVER THE COUNTER MEDICATION. VERY TRIVIAL THINGS. DR. STROM RECOMMENDED LOOKING AT THE WHOLE SYSTEM, FINANCES, PAST HISTORY AND REESTABLISHING JOINT COMMITTEE THAT LOOKED FOR A DOCTOR ALSO MADE A MOTION THAT DR. BEACHLEY SERVE ON THE JOINT COMMITTEE AND THAT HE GO TO HOURLY PAY AFTER 04 -01 -93 IF RESIGNATION GOES INTO EFFECT. NORMENT SECONDED. ALL WERE IN FAVOR. DR. BEACHLEY EXPRESSED A DESIRE TO STAY IN HIS CURRENT POSITION IF PROBLEMS CAN BE WORKED OUT. DR. KRAFT MADE A MOTION THAT DR. BEACHLEY'S RESIGNATION BE TABLED UNTIL THE APRIL MEETING. STROM SECONDED. ALL WERE IN FAVOR. DR. KRAFT SUGGESTED CITY, CO. AND HEALTH DEPT. HAVE REPRESENTATION AT A MEETING OTHER THAN THE BOARD OF HEALTH MEETING. DR. CUTRELL SUGGESTED DR. KRAFT LOOK AT THE ISSUE AND SEE WHAT A COMMITTEE COULD DO TO KEEP THINGS RUNNING SMOOTHLY. ANTHONY TALKED ABOUT MONEY SET ASIDE TO HIRE LVN TO WORK AT THE JAIL AND MADE HIS MONTHLY REPORT. A DISCUSSION OF MEDICAID AND RSVP HELP WAS ALSO HELD. DR. BEACHLEY HAS SENT IN HIS APPLICATION FOR MEDICAID. T.K. DISc_USSED THE MARCH OF DIMES GRANT OBTAINED BY MCCUISTION. DR. CUTRELL SAID HE WOULD CHECK INTO THE STATUS OF THE GRANT PROPOSAL. THE MEETING ADJOURNED AT 8:10. THE NEXT MEETING IS TO BE HELD MAY 11, 1993 AT 7:00 AM AT THE HOLIDAY INN. RESPECTFULLY SUBMITTED, JAE DICKINSON APPROVED BY DR. CUTRELL PARIS —LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING THE PARIS —LAMAR COUNTY BOARD OF HEALTH HELD ITS REGULAR MEETING ON APRIL 13, 1993. THOSE IN ATTENDANCE INCLUDED DR. CUTRELL, DR. STROM, MRS. NORMENT, MRS. ELLIS, DR. MCLEMORE, MIKE MALONE, T. K. HAYNES, LATRICIA MILLER, DR. BEACHLEY, ANTHONY BETHEL, AND JAE DICKINSON. THE MEETING WAS CALLED TO ORDER AT 7:10 AND MINUTES OF THE PREVIOUS MEETING WERE READ AND APPROVED. DR. BEACHLEY GAVE A REPORT ABOUT THE STAFF MEETING WITH DR. KRAFT. AT THE HEALTH DEPARTMENT. DR. KRAFT SAID AT THE MEETING THAT HE THOUGHT WE SHOULD SEND A LETTER TO JIM CHAPMAN ABOUT FUNDS FOR A NEW BUILDING. DR. STROM GAVE A REPORT ON HIS SUB— r:OMMITTEE MEETING. THE NUMBER ONE CONCERN IS FINANCIAL. AC CORD I Nei TO DR. STROM 'THE ORDER OF SERVICES TO BE RENDERED SHOULD BE: 1. PRENATAL, FAMILY PLANNING AND PREVENTATIVE. 2. JAIL 3. INDIGENT HEALTH CARE DR. STROM MADE A MOTION THAT THE HEALTH DEPARTMENT DO CITY AND COUNTY PREEMPLOYMENT PHYSICALS ONLY. WE SHOULD NOT PREFORM PHYSICALS FOR SPORTS, OTHER JOBS OR ORGANIZATIONAL TYPE PHYSICALS. THE MOTION WAS SECOND BY MRS. ELLIS. ALL WERE IN FAVOR. LATRICIA HAD A QUESTION ABOUT INDIGENT REFERRELS TO THE HEALTH DEPARTMENT. ANTHONY MADE HIS MONTHLY REPORT. DR. CUTRELL WANTS THE HEALTH DEPARTMENT TO DO EPSDT SCREENING EVENTUALLY. THIS DISCUSSION WAS TABLED UNTIL A LATER DATE. DISCUSSION WAS HELD ABOUT AN LVN OR A NURSE BEING PAID TO GO TO THE JAIL. T.K. SAID A NEW PERSON WAS NOT NEEDED UNTIL THE JOB WANTED DONE HAS BEEN DEFINED. PARIS-LAMAR COUNTY BOARD OF HEALTV MINUTES OF MEETING THE PARIS-LAMAR COUNTY BOARD OF HEALTH HELD ITS REGULAR MEETING ON MAY 11, 1993. THOSE IN ATTENDANCE WE INCLUDED DR. CUTRELL, MRS. NORMENT, MRS. CURRENT BUILDING. ANTHONY IS TO MAKE THE INITIAL INQUIRY. DR. CUTRELL ELLIS, DR. MCLEMORE, DR. KRAFT, DR. MOSELEY, LATRICIA MILLER, TROY OWENS, GENE ANDERSON, DR. BEACHLEY, ANTHONY BETHEL, AND JAE DICKINSON. THE MEETING WAS CALLED TO ORDER AT 7:05 AND MINUTES OF THE PREVIOUS MEETING WERE READ AND APPROVED. DISCUSSION OF SPECIFIC ITEMS ON THE BUDGET. PAINTING THE BUILDING INSIDE AND OUT. DISCUSSION OF A NEW BUILDING. DR. KRAFT SAID NEXT STEP SHOULD BE TO SEE MR. CHAPMAN. MRS. NORMENT SUGGESTED WE INVITE MR. CHAPMAN TO SEE THE CURRENT BUILDING. ANTHONY IS TO MAKE THE INITIAL INQUIRY. DR. CUTRELL SAID IT WOULD BE IMPOSSIBLE FOR HIM TO TALK TO MR. CHAPMAN AND POSSIBLY SOME OTHER BOARD MEMBER COULD GIVE HIM A TOUR OF THE OLD HOSPITAL. DISCUSSION OF WIC DOING I1"MUNIZATI8153 AND ANTHONY'S MONTHLY REPORT. ANTHONY IS TO REPORT ON THE AMOUNT OF TIME OUR NURSES SPEND GIVING SHOTS. DISCUSSION OF BUBONIC PLAGUE. ANTHONY GAVE A RECOMMENDATION OF FLEA CONTROL. ANTHONY TO TALK TO CDC IN AUSTIN, DR. KRAFT AND 1 OR 2 OTHER VETS AND GET INFORMATION IN THE PAPER AS SOON AS POSSIBLE. DR. KRAFT AND ANTHONY ARE TO WRITE A LETTER TO THE WATER COMMISSION IN TYLER ABOUT CLASS D IMSPECTION ON CLEAR WATER SYSTEM. DR. BEACHLEY ASKED FOR THE BOARDS OPINION AS TO HIM SERVING ON THE ADVISORY BOARD WITH DELTA HOME HEALTH. BOARD SUGGESTED DR. BEACHLEY TALK TO T.K. ABOUT ANY POSSIBLE CONFLICTS OF INTEREST. DR. BEACHLEY ALSO SAID HE WOULD LIKE TO TAKE HIS VACATION THE WEEK OF JUNE 21ST. THE REGULAR MEETING ADJOURNED AT 7:50. THE NEXT MEETING IS TO BE HELD JUNE 16, 1993 AT 7:00 AM AT THE HOLIDAY INN. BOARD WENT INTO EXECUTIVE SESSION,, RESPECTFULLY SUBMITTED, JAE DICKINSON APPROVED BY DR. CUTRELL PARIS-LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING THE PARIS-LAMAR COUNTY BOARD OF HEALTH HELD ITS REGULAR MEETING ON JUNE 16, 1993. THOSE IN ATTENDANCE INCLUDED DR. CUTRELL, DR. STROM, MRS. ELLIS, DR. MCLEMORE, DR. KRAFT, AND DR. MOSELEY. OTHERS IN ATTENDANCE INCLUDED T. K. HAYNES, LATRICIA MILLER, DR. BEACHLEY, ANTHONY BETHEL, JAE DICKINSON, AND BARBRA FRANCES. THE MEETING WAS CALLED TO ORDER AT 7:10 AND MINUTES OF THE PREVIOUS MEETING WERE READ AND REVISED. DR. STROM MADE A MOTION TO APPROVE THE AMENDED MINUTES AND DR. KRAFT SECONDED. ALL WERE IN FAVOR. DISCUSSION OF RATIFICATION OF WIC IMMUNIZATION PROGRAM. DR. CUTRELL TALKED TO DR. SMITH IN AUSTIN. BARBRA TALKED ABOUT THE IMMUNIZATION PROGRAM FOR WIC. DR. STROM SUGGESTED GOING TO AUSTIN TO SEE DR. SMITH. ANTHONY WOULD LIKE TO GO WHEN IT IS DECIDED. THE STATE IS GOING TO GET MEDICAID TO COVER THE COST OF WIC IMMUNIZATIONS. ANTHONY, DR. STROM, DR. KRAFT, AND POSSIBLY DR. CUTRELL WOULD MAKE THE TRIP TO AUSTIN. DR. KRAFT MADE THE MOTION TO RATIFY WIC IMMUNIZATION PROGRAM AND DR. STROM SECONDED. ALL WERE IN FAVOR. DISCUSSION OF SUMMER IMMUNIZATION PROGRAM. ANTHONY SAID WE WERE GIVEN MONEY BUT WE CAN'T SPEND IT. WE WILL DO AN ESTIMATED 400 ADDITIONAL SHOTS. STROM MADE THE MOTION TO RATIFY THIS PROGRAM AND DR. KRAFT SECONDED. ALL WERE IN FAVOR. DISCUSSION OF RATIFICATION OF HIV GRANT WHICH PAYS FOR THE HEALTH DEPT. PHYSICIAN'S EXAMINATION OF HIV PATIENTS. DR. KRAFT MADE THE MOTION TO RATIFY THIS PROGRAM AND MRS. ELLIS SECONDED. ALL WERE IN FAVOR. ANTHONY MADE HIS MONTHLY REPORT. SOME QUESTIONS WERE RAISED ABOUT HOW TO PAY THE EMPLOYEES WORKING THE EXTRA HOURS TO DO SHOTS. DR. STROM SAID WILL CALL MICHAEL KELLEY ABOUT MONEY. PRISCILLA'S LAST DAY WILL BE FRIDAY. DOES THE BOARD WANT TO HIRE ANOTHER CLERK. DR. KRAFT MADE THE MOTION TO HIRE ANOTHER CLERK AND DR. STROM SECONDED. ALL WERE IN FAVOR. T.K. BROUGHT UP SOME OLD BUSINESS ABOUT THE MARCH OF DIMES GRANT. DR. BEACHLEY REMINDED THE BOARD THAT HE WOULD BE GOING ON VACATION THE END OF JUNE. MRS. ELLIS ASKED DR. BEACHLEY ABOUT THE SITUATION AT THE JAIL. WHETHER THINGS WERE BETTER OR WORSE. THE MEETING ADJOURNED AT 8:15. THE NEXT MEETING IS TO BE HELD JULY 141 1993 AT 7:00 AM AT THE HOLIDAY INN. ULLY SUBMITTED, DICKINSON APPROVED BY DR. CUTRELL PARIS-LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING THE PARIS-LAMAR COUNTY BOARD OF HEALTH HELD ITS REGULAR MEETING ON JULY 14, 1993. THOSE IN ATTENDANCE INCLUDED DR. CUTRELL, DR. STROM, MRS. ELLIS, MRS. NORMENT, AND DR, MOSELEY. OTHERS IN ATTENDANCE INCLUDED T. K. HAYNES, GENE ANDERSON, LATRICIA MILLER, TROY OWENS, MONTY MCLAURIN, ANTHONY DAIGLE, JULIE MADDOX, EVELYN FREEMAN, DR., BEACHLEY, ANTHONY BETHEL, JAE DICKINSON, AND BARBRA FRANCES. THE MEETING WAS CALLED TO ORDER AT 7:15 AND MINUTES OF THE PREVIOUS MEETING WERE READ AND APPROVED. A BRIEF REVIEW OF PROGRAMS AVAILABLE AT THE HEALTH DEPARTMENT WAS GIVEN BY ANTHONY. DISCUSSION OF INDIGENT HEALTH CARE IN COUNTY BY ADMINISTRATORS OF BOTH HOSPITALS. MR. DAIGLE AND MRS FREEMAN TALKED ABOUT THE MARCH OF DIMES GRANT AND THE STATUS OF THAT GRANT Al" THIS TIME. THEY ALSO TALKED ABOUT ANOTHER GRANT THAT WOULD REDUCE THE SOCIOCULTURAL BARRIERS TO HEALTH CARE FROM THE HENRY J. KAISER FOUNDATION WHICH HAS BEEN APPLIED FOR. THIS GRANT IS BASICALLY THE SAME AS THE MARCH OF DIMES GRANT. DR. CUTRELL SUGGESTED THAT MRS. FREEMAN COME BACK AT ANOTHER TIME TO GIVE AN EXTENSIVE OVERVIEW OF THE MARCH OF DIMES GRANT PROPOSAL. MR. MCLAURIN TALKED ABOUT THE INCREASING NUMBER OF PATIENTS SHOWING UP AT THE EMERGENCY ROOMS FOR TREATMENT OF NON-EMERGENCY ILLNESSES. MR. MCLAURIN ALSO TALKED ABOUT WAYS TO HELP THE HEALTH DEPARTMENT SEE MORE PATIENTS AND MAKE IT POSSIBLE FOR THE EMERGENCY ROOMS TO TREAT EMERGENCIES. MR. MCLAURIN SUGGESTED FORMING TASK FORCES IN THE FOLLOWING AREAS TO SEE WHERE HELP IS MOST NEEDED: 1. FACILITIES 2. TRANSPORTATION 3. FUNDING 4. BUSINESS, FINANCIAL 5. GENERAL OPERATIONS(ORGANIZATION) THESE WOULD BE GROUPS WITH DEFINED FUNCTIONS AND PARAMETERS. A QUESTION WAS RAISED BY DR. CUTRELL ABOUT EXPANDING THE NUMBER OF PEOPLE ON THE HEALTH BOARD. DR. STROM THINKS WE SHOULD BE VISIONARY, LOOK AT NEEDS ASSESSMENT. T.K. HAYNES SAID THE BY-LAWS WOULD NEED TO BE CHANGED TO EXPAND THE BOARD. DR. STROM MADE A MOTION TO IMPLEMENT THE TASK FORCE. MRS. ELLIS SECONDED. ALL WERE IN FAVOR. MRS. NORMENT SUGGESTED DELAYING ENLARGING BOARD. DR. CUTRELL ASKED MR. MCLAURIN TO NEED TO IMPLEMENT THE TASK FORCE GROUPS. WANTS TO INVOLVED FELIX GIBSON WITH OUTSI HOW TO BEST GO ABOUT THIS. THE HEALTH LOOK AT HOW WE MR. MCLAURIN )E INFORMATION ON MR. DAIGLE SUGGESTED HE AND MR. MCLAURIN TALKING FURTHER AND THEN TAKING NECESSARY STEPS THEN MEETING AGAIN IN 3 WEEKS. DR. MOSELEY SUGGESTED MEETING IN 4 WEEKS. DR. ST ROM RECOMMENDED THAT THE COUNTY COMMISSIONERS AND CITY OFFICIALS BE INVOLVED ON THE TASK FORCE WITH T.K. INVOLVED IN AS MANY AS POSSIBLE. DR. STROM ALSO SUGGESTED NOT LIMITING GRANT APPLICATIONS TO 2. MR. DAIGLE ASKED TO SEE THE HEALTH DEPARTMENT BUDGET. THE CURRENT ONE AND THE PROPOSED ONE. DR. CUTRELL WANTS A COPY OF THE PROPOSED BUDGET FOR NEXT YEAR AT THE NEXT BOARD MEETING. ANTHONY GAVE HIS MONTHLY REPORT. ANTHONY TOLD THE BOARD THAT A REPRESENTATIVE FROM MR. CHAPMAN'S OFFICE CAME FOR A TOUR OF THE HEALTH DEPARTMENT. AFTER GOING TWO-THIRDS THE WAY THROUGH 71 fl- BUILDING, THE REPRESENTATIVE MADE A PHONE CALL AND SAID THAT WE NEEDED A NEW BUILDING. T. K. HAYNES SAID THE AMOUNT OF TIME INVOLVED IN SEEING TNM�TFq �T TAF 1*4Ir| mFFnFn Tn nF nr�r/t.-*-".C.,�.r::*n nv r1� nnunn THE CURRENT CONTRACT SAYS 6 HOURS A WEEK BUT TIME SPENT IS ACTUALLY 12+ HOURS. DR. STROM MAD A MOTION TO ADJOURN AT 8:03. MRS NORMENT SECONDED. ALL WERE IN FAVOR. THE NEXT MEETING IS TO BE HELD WEDNESDAY, AUGUST 11, 1993 AT 7:00 AM AT THE HOLIDAY INN. � ��T... DICKINSON APPROVED BY DR. CUTRELL PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF EXECUTIVE SESSION THE PARIS -LAMAR COUNTY BOARD OF HEALTH HELD AN EXECUTIVE SESSION ON WEDNESDAY AUGUST 11, 1993. THOSE IN ATTENDANCE INCLUDED DR. MCLEMORE, DR. CUTRELL, DR. STROM, DR. KRAFT, DR. MOSELEY, MRS. NORMENT, MRS. ELLIS, AND REV. EVANS. OTHERS IN ATTENDANCE INCLUDED MIKE MALONE, T.K. HAYNES, GENE ANDERSON, JUDGE LOUGHMILLER, TROY OWENS, LATRICIA MILLER, DR. BEACHLEY, ANTHONY BETHEL, AND JAE DICKINSON. THE MEETING WAS CALLED TO ORDER AT 7:06. THE BOARD IMMEDIATELY WENT INTO EXECUTIVE SESSION. DR. BEACHLEY'S RESIGNATION WAS PRESENTED. THE BOARD DISCUSSED POSITIVES THAT HAVE TAKEN PLACE SINCE DR. BEACHLEY JOINED THE HEALTH DEPARTMENT: THINGS ARE MORE STREAMLINED BETTER RECORDS ARE BEING KEPT THINGS ARE BETTER ORGANIZED BETTER CARE IS BEING GIVEN TO THE INMATES PROCEDURES AT THE HEALTH DEPARTMENT ARE BETTER DISCUSSION OF NEGATIVES: INFLAMMATORY STATEMENTS WRITTEN INTO MEDICAL RECORDS NOT FOLLOWING THE FORMULARY THE COUNTY ASKED THAT THE CITY AND COUNTY NOT BE BLASTED IN AN OPEN FORUM POSSIBLY LETTING A NURSE DO TRIAGE TO SPEED THINGS UP DR. BEACHLEY SAID HE WAS SUBJECTED TO LIABILITY EVERY TIME HE GOES TO THE JAIL BECAUSE THE COUNTY IS STOPPING HIS ORDERS FROM BEING CARRIED OUT. HE IS TIRED OF ALL THE CRITICISM. HE THEN STATED HE WOULD LIKE HIS RESIGNATION TO GO INTO EFFECT AUGUST 31, 1993. DR. CUTRELL ASKED IF THERE WAS NEED FOR ANY OTHER DISCUSSION. DR. STROM SAID THAT THE COUNTY IS NOT STOPPING HIS ORDERS. IF DR. BEACHLEY WANTS TO BLAME SOMEONE THEN HE SHOULD PUT THE BLAME WHERE IT BELONGS ON THE BOARD. IF HE CAN'T ACCEPT BOARD GUIDANCE, THEN PLEASE RESIGN. A SUGGESTION WAS MADE THE CONTRACT SHOULD BE RENEGOTIATED ON A SHORTER TERM. POSSIBLY MONTH TO MONTH OR EVERY 3 MONTHS. DR. BEACHLEY SAID POSSIBLY MONTH TO MONTH. DR. STROM SUGGESTED CONTINUING TO TABLE THE RESIGNATION FOR A COOLING OFF PERIOD. T.K. SUGGESTED THAT THE REVIEW COMMITTEE MEET WITH THE DR. AND GO OVER THE PROBLEMS. DR. BEACHLEY IS ASKED TO BRING THE STACK OF CONSULTATION REQUESTS WITH HIM. TROY OWENS SAID WHEN DR. BEACHLEY FIRST CAME TO WORK HE HAD GIVEN DR. BEACHLEY HIS PHONE NUMBER. HE HAS RECEIVED NO PHONE CALLS REGARDING PROBLEMS WITH EITHER THE COUNTY OR THE JAIL. HE WANTS TO KNOW WHY DR. BEACHLEY IS SO BITTER. MONEY CONSIDERATIONS AT THE COUNTY LEVEL WILL NOT CHANGE IN 1 MONTH, 3 MONTHS OR EVER. THE REVIEW COMMITTEE IS TO REVIEW THE FOLLOWING: 1. CONSULTATION REQUESTS 2. MECHANICS FOR COMPLAINTS IN WRITING (NOT IN THE MEDICAL RECORD) 3. MECHANICS FOR REVIEW 4. DENTAL CARE 5. FORMULARY 6. TIMELINESS 7. OVERALL COMMUNICATION 8. TOTAL EFFICIENCY THE BOARD CAME OUT OF EXECUTIVE SESSION AT 8:35. THE TIME AND PLACE OF THE REVIEW COMMITTEE MEETING IS TO BE TUESDAY, AUGUST 31, 1993 AT 7:00 AM AT THE HOLIDAY INN. THOSE TO BE PRESENT AT THE COMMITTEE MEETING. DR. STROM, DR. CUTRELL, DR. MCLEMORE, DR. MOSELEY, TROY OWENS, LATRICIA MILLER, T.K. HAYNES, DR. BEACHLEY, ANTHONY BETHEL, AND JAE DICKINSON. DR. BEACHLEY WAS ASKED TO BRING ALL THE INMATE FILES STARTING WITH THE LETTER S. THE MEETING ADJOURNED AT 8:40. RESPECTFULLY SUBMITTED, &�k� JA DICKINSON APPROVED BY DR. CUTRELL PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING THE PARIS -LAMAR COUNTY BOARD OF HEALTH HELD ITS REGULAR MEETING ON AUGUST 1 %, 1993. THOSE IN ATTENDANCE INCLUDED DR. CUTRELL, DR. STROM, DR. MCLEMORE, DR. KRAFT, MRS. ELLIS, MRS. NORMENT, DR. MOSELEY AND REV. EVANS. OTHERS IN ATTENDANCE INCLUDED MIKE MALONE, T. K. HAYNES, GENE ANDERSON, DEAN LOUGHMILLER, LATRICIA MILLER, TROY OWENS, MONTY MCLAURIN, ANTHONY DAIGLE, JULIE MADDOX, EVELYN FREEMAN, DR. BEACHLEY, ANTHONY BETHEL, JAE DICKINSON, AND BARBRA FRANCES. THE MEETING WAS CALLED TO ORDER AT 7:06 AND MINUTES OF THE PREVIOUS MEETING WERE READ AND APPROVED. THE BOARD IMMEDIATELY WENT INTO EXECUTIVE SESSION TO DISCUSS DR. BEACHLEY'S CONTRACT. THE BOARD CAME OUT OF EXECUTIVE SESSION AT 7:50. THE BOARD WISHES TO NOT TAKE ANY FORMAL ACTION AT THIS TIME. A SPECIAL EXECUTIVE SESSION WILL BE HELD WEDNESDAY, AUGUST 18, 1993 AT 7:00 AM AT THE HOLIDAY INN. LATRICIA MILLER IS ASKED TO BE PRESENT ALONG WITH ANTHONY BETHEL AND JAE DICKINSON. ITEMS 1, 3, 4, AND 9 FROM THIS AGENDA ARE TO BE ON THE EXECUTIVE SESSION AGENDA. DISCUSSION OF PRIMARY HEALTH CARE BY MONTY MCLAURIN. MR MCLARIN SUGGESTED THE ESTABLISHMENT OF THREE COMMITTEES. (SEE MR. MCLAURIN'S PROPOSAL.) JULIE MADDOX MADE A PRESENTATION ON CHANGING THE HEALTH DEPARTMENT TO A RURAL HEALTH CENTER. (SEE MS. MADDOX'S PROPOSAL.) MR. DAIGLE AND EVELYN FREEMAN TALKED ABOUT THE MARCH OF DIMES GRANT. MS. FREEMAN SAID SHE HAD RECEIVED A LETTER FROM THE MARCH OF DIMES BIRTH DEFECTS FOUNDATION. (SEE ATTACHED LETTER.) MS. FREEMAN TOLD THE BOARD THAT THE LETTER PRACTICALLY GUARANTEED THAT THE HOSPITAL WOULD BE RECEIVING THE GRANT. THE TOTAL MONIES WOULD BE $46,500.00. WHICH WAS THE AMOUNT REQUESTED IN THE GRANT PROPOSAL. ANY CHANGES NEEDED IN THE GRANT WOULD NEED TO BE DONE SOON. THE MONEY WILL BE AVAILABLE JANUARY 01, 1994. THE GRANT FOUNDATION ASKED MS. FREEMAN TO RAISE 612,000.00. DR. KRAFT ASKED MS. MADDOX HOW LONG IT TOOK TO ESTABLISH THE COOPER CLINIC. MS. MADDOX SAID 2 MONTH'S. DR: KRAFT STATED THAT HE WAS CONCERNED ABOUT THE AMOUNT OF SPACE AVAILABLE AT THE HEALTH DEPARTMENTS PRESENT LOCATION. DR. STROM MADE A MOTION TO COMMEND BOTH HOSPITALS AND MOVE ON ESTABLISHING THE COMMITTEES SUGGESTED BY MR. MCLAURIN. DR. MOSELEY SECONDED. ALL WERE IN FAVOR. WE WILL ASSIGN BOARD MEMBERS TO THESE COMMITTEES AT OUR NEXT MEETING. DR. STROM MADE A SECOND MOTION TO PROCEED ON GETTING THE DESIGNATION OF RURAL HEALTH CLINIC AND SET UP THE THREE TASK FORCE COMMITTEES PROPOSED BY MR. MCLAURIN. DR. MCLEMORE SECONDED. ALL WERE IN FAVOR. DR. MOSELEY MADE A THIRD MOTION TO HAVE T.K. AND THE COUNTY COMMISSIONERS REVIEW ALL THE PRESENTATIONS TO SEE IF THERE ARE ANY LEGAL CONFLICTS. DR. STROM SECONDED. ALL WERE IN FAVOR. DR. BEACHLEY HAS A FEE SCHEDULE FOR THE BOARD TO REVIEW AND DISCUSS AT THE NEXT BOARD MEETING ON SEPTEMBER 15, 1993. ANTHONY MADE HIS MONTHLY REPORT. MRS. ELLIS HAS INFORMATION ON AGING IF ANYONE WOULD LIKE A COPY. THE MEETING ADJOURNED AT 8:50. THE NEXT MEETING IS TO BE HELD WEDNESDAY, SEPTEMBER 15, 1993 AT 7:00 AM AT THE HOLIDAY INN. ESPPECQTFULLY SUBMITTED, DICKINSON APPROVED BY DR. CUTRELL LAMAR COUNTY HEALTH DEPARTMENT WORK GROUP FUNCTIONS Facilities This work group is responsible for the evaluation of current facilities regarding their structural ability and functionality in meeting the needs of Lamar County Health Department clients. The group will also be responsible for recommenjing changes in the layout of the building or expansion to meet needs identified by the operations work group. This work group will provide information related to the costs of renovation, expansion and furnishings to the funding work group. Membership : Frank Wallace - Mccuistion Chip Harper Monty McLaurin - St. Joseph's Tony Daigle - McCuistion Architect Funding This work group is responsible for evaluating and applying for any monies which maybe available through state, federal, or private sources to help meet the operating and facility requirements of the Lamar County Health Department. The work group will also monitor the use of these funds to insure they are spent in such a way that is consistent with the grant terms. Membership: Ron Ragan - St. Joseph's Evelyn Freeman - Mccuisti.on Raymond Armstrong Felix Gibson Transportation This work group is responsible for evaluating the available modes of transportation available for Paris and Lamar County residents to access health care at the Lamar County Health Department. The group should also evaluate potential new sources of transportation and shall work with the funding work group to determine if funding is available for transportation. Finally, the work group should recommend communication methods to highlight available services to the people in need and work with the Health Department staff in devising the structure needed to coordinate the provision of transportation services. Membership: Paul Swasko - St. Joseph's Gary Conwell - McCuistion PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF REVIEW COMMITTEE THE PARIS -LAMAR COUNTY BOARD OF HEALTH HELD A REVIEW COMMITTEE MEETING ON TUESDAY, AUGUST 31, 1993. THOSE IN ATTENDANCE INCLUDED DR. MCLEMORE, DR. CUTRELL, DR. STROM, DR. KRAFT, DR. MOSELEY AND MRS. ELLIS. OTHERS IN ATTENDANCE INCLUDED T.K. HAYNES, JUDGE LOUGHMILLER, TROY OWENS, LATRICIA MILLER, DR. BEACHLEY, ANTHONY BETHEL, AND JAE DICKINSON. THE MEETING WAS CALLED TO ORDER AT 7:10. DR. KRAFT AND DR. STROM AND MRS. ELLIS LOOKED AT MEDICAL RECORDS FOR CURRENT INMATES, WHILE DR. MCLEMORE, DR. CUTRELL AND DR. MOSELEY LOOKED AT MEDICAL RECORDS FOR RELEASED INMATES. DR. STROM STATED THAT THE RECORDS FROM PAST TO PRESENT WERE MUCH BETTER. DR. CUTRELL SUGGESTED MAKING CHARTS WHEN REQUEST TO BE SEEN FIRST COMES IN OR PREFERABLY WHEN AN INMATE IS ADMITTED TO THE JAIL. DR. STROM HAD A QUESTION REGARDING MR. SCOTT'S CHART. DR. BEACHLEY PUT IN THE MEDICAL RECORDS THAT A CONDITION WAS (LIFE THREATENING). DR. STROM SUGGESTED NOT PUTTING THAT TYPE OF STATEMENT IN THE MEDICAL RECORD. DR. STROM ALSO SUGGESTED THAT LATRICIA NOT PUT (C0. WILL NOT PAY. IF INMATE CAN PAY, GO AHEAD AND MAKE AN APPOINTMENT). THESE ARE INFLAMMATORY STATEMENTS. DR. KRAFT IS GOING TO WRITE A LETTER TO THE JAIL STANDARDS COMMISSION ASKING WHAT TYPE OF MEDICAL CARE IS (IS /NOT) MANDATORY FOR THE COUNTY TO PROVIDE FOR THE INMATES. DR. CUTRELL SUGGESTED LETTING THE NURSES CALL IN PRESCRIPTIONS TO SAVE TIME. T.K. HAYNES SUGGESTED BRINGING FILES THAT THE COUNTY OR THE DOCTOR HAVE A QUESTION OR PROBLEM WITH TO EACH HEALTH BOARD MEETING. DR. STROM SUGGESTED GOING BACK AND LOOKING, AT THE COST OF THE JAIL IN PAST YEARS AND PRESENT USING THE NUMBER OF INMATES AS THE DENOMINATOR. WHERE IS THE COST? TOTAL MONEY SPENT ON PRESCRIPTIONS, CONSULTATION, X -RAYS, ETC. DR. STROM ASKED THE COMMITTEE TO PLEASE SET UP A LIST OF CRITERIA FOR DR. BEACHLEY. WHAT NEEDS TO BE SEEN NOW, WHAT CAN WAIT, WHAT HE SHOULD TRY TO TREAT. DR. MOSELEY SUGGESTED THE SAME BE DONE FOR DENTAL. DR. CUTRELL SUGGESTED MAKING THE CHARTS DR. MOSELEY SUGGESTED THAT DR. CUTRELL SEE WHAT MIGHT WORK BEST. DR. CUTRELL ON WEDNESDAY, SEPTEMBER 08, 1993. THE REVIEW COMMITTEE ADJOURNED AT 8:10. RESPECTFULLY SUBMITTED, ')OAE DICKINSON APPROVED BY DR. CUTRELL MORE S-TREAMLINED, GO TO THE JAIL TO AGREED AND DECIDED PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING THE PARIS -LAMAR COUNTY BOARD OF HEALTH HELD ITS REGULAR MEETING ON SEPTEMBER 15, 1993. THOSE IN ATTENDANCE INCLUDED DR. CUTRELL, DR. STROM, MRS. ELLIS, MRS. NORMENT, DR. MOSELEY. OTHERS IN ATTENDANCE INCLUDED MIKE MALONE, T. K. HAYNES, DEAN LOUGHMILLER, LATRICIA MILLER, TROY OWENS, ALAN WEATHERFORD, MONTY MCLAURIN, ANTHONY DAIGLE, JULIE MADDOX, DR. BEACHLEY, ANTHONY BETHEL, JAE DICKINSON, AND BARBRA FRANCES. THE MEETING WAS CALLED TO ORDER AT 7:25 AND MINUTES OF THE PREVIOUS MEETING WERE READ AND APPROVED. ANTHONY GAVE HIS MONTHLY REPORT. JUDGE LOUGHMILLER SAID THE LETTER TO THE JAIL STANDARDS COMMISSION HAS BEEN DRAFTED IN THE COMPUTER AND WILL BE SENT SHORTLY. DR. BEACHLEY PRESENTED HIS FEE SCHEDULE. DR. STROM MADE A MOTION TO APPROVE DR. BEACHLEY'S FEE SCHEDULE. MRS. NORMENT SECONDED. ALL WERE IN FAVOR. DR. STROM GAVE AN OVERVIEW OF THE REVIEW COMMITTE MEETING. DR. STROM ASKED LATRICIA IF SHE HAD ANY CONSULTS OR PROBLEMS THAT NEEDED TO BE LOOKED OVER. LATRICIA SAID SHE HAD NONE AT THE TIME. DR. BEACHLEY DIDN'T HAVE ANY PROBLEMS EITHER. LATRICIA SAID SHE WOULD PRESENT THE NUMBERS THAT WERE ASKED FOR IN THE REVIEW COMMITTEE MEETING AT THE END OF THE BOARD MEETING. MR. DAIGLE AND MR. MCLAURIN WERE ASKED IF THEY WOULD LIKE TO UPDATE THE BOARD ON THE OUTCOME OF THE RESPECTIVE MEETINGS WITH THE CITY COUNCIL AND THE COUNTY COMMISSIONERS. T.K. SAID THE CITY COUNCIL MEMBERS HAD NO QUESTIONS AFTER MRS. MADDOX'S PRESENTATION. THE COUNCIL UNNANIMOUSLY APPROVED GETTING RURAL HEALTH CLINIC STATUS. JUDGE LOUGHMILLER SAID THE COUNTY HAD NO QUESTIONS AND ALSO UNNANIMOUSLY APPROVED. DISCUSSION WAS HELD ON SETTING UP THE WORK GROUPS MR. MCLAURIN SUGGESTED AT THE LAST BOARD MEETING. MRS. ELLIS, MRS. NORMENT AND DR. MCLEMORE WILL BE ON THE TRANSPORATION COMMITTEE. DR. STROM AND DR. CUTRELL WILL BE ON THE FUNDING COMMITTEE. DR. KRAFT, DR. MOSELEY, ANTHONY BETHEL AND REV. EVANS WILL BE ON THE FACILITIES COMMITTEE. DR. CUTRELL ASKED IF ANYONE HAD ANY SUGGESTION AS TO WHO ELSE WOULD BE GOOD TO HAVE ON THE TRANSPORATION COMMITTEE. MR. DAIGLE SUGGESTED RICHARD CHAMBERLAIN, EXECUTIVE VICE - PRESIDENT OF THE CHAMBER OF COMMERCE. MRS. ELLIS SUGGESTED BETTY KILDAHL, WITH THE LAMAR CO. HUMAN RESOURCES COUNCIL, INC. DR. CUTRELL SAID HE WOULD LIKE A MAILING LIST OF EVERYONE ON THE RURAL HEALTH CLINIC BOARD AND OF EVERYONE ON EACH WORK GROUP COMMITTEE. JULIE WAS ASSIGNED AS A RESOURCE PERSON FOR THESE COMMITTEES. MR. DAIGLE SUGGESTED THAT THE RURAL HEALTH CLINIC (RHC) BOARD OF DIRECTORS BE IN PLACE BEFORE THE RHC APPLICATION IS MADE. DR. CUTRELL SUGGESTED THAT ONE OF THE APPOINTEES FROM EACH HOSPITAL BE A PHYSICIAN. MRS. NORMENT SUGGESTED THAT THERE BE SOME LAY PEOPLE ON THE RHC BOARD. DR. MOSELEY SUGGESTED THAT MAYBE SOMEONE FROM THE EMERGENCY ROOMS BE ON THE BOARD. A SUGGESTION WAS MADE TO HAVE ONE COMPLETE ORGANIZATIONAL MEETING THEN SPLIT INTO THREE GROUPS. IT WAS DECIDED THAT THE RURAL HEALTH BOARD WOULD MEET TUESDAY, SEPTEMBER 28, 1993 AT 6:45 A.M. AT THE HOLIDAY AND AT 7:15 A.M. THE WORK GROUP COMMITTEES WOULD JOIN THE RHC BOARD FOR JULIE MADDOX'S PRESENTATION ON RURAL HEALTH CLINICS THEN DIVIDE INTO THREE SEPERATE GROUPS. ALL GROUPS TO BE FINISHED NO LATER THAN 8:15 A.M. DR. MOSELEY MADE A MOTION TO CHANGE THE NUMBER OF HEALTH BOARD MEMBERS ON THE RHC BOARD TO THREE. MRS. ELLIS SECONDED. ALL WERE IN FAVOR. DR. CUTRELL SUGGESTED THAT THOSE MEMBERS BE THE PRESIDENT, VICE- PRESIDENT AND ONE OTHER BOARD MEMBER (LAY PERSON). MRS. NORMENT WAS NAMED AS THAT OTHER MEMBER. DR. BEACHLEY ASKED WHEN THE NEXT REVIEW COMMITTE MEETING WOULD BE. DR. CUTRELL SAID HE WOULD GET BACK TO HIM. THE MEETING ADJOURNED AT 8:15. THE NEXT MEETING IS TO BE HELD TUESDAY, OCTOBER 12, 1993 AT 7:00 AM AT THE HOLIDAY INN. PECTFULLY SUBMITTED, DICKINSON APPROVED BY DR. CUTRELL PARIS-LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING The Paris-Lamar County Board of Health held its regular meeting on October 12, 1993. Those in attendance included Dr. Cutrell, Dr. Moseley, Dr. McLemore, Rev. Evans. Others in attendance included Mike Malone; T. K. Haynes, Deane Loughmiller, Latricia Miller, Gene Anderson, Dr. Beachley, Charles Beachley III, Anthony Bethel, Jae Dickinson and Barbra Frances. The Jail review started at 7:15- Dr. Cutrell said the purpose of this meeting was not to decide whether a consultation is needed but to look at any problems. Dr. Cutrell also said he would like to recommend helping Dr. Beachley develop a consultation request form stating how limited or extensive the consultations should be. Dr. Cutrell would like a copy of the formulary sent to all the physicians on the board. The regular meeting was called to order at 7:40. The minutes of the previous meeting were read and approved. Anthony told the board what happened at the Facilities Work Group meeting for the Lamar County Rural Health Clinic held September 28, 1993. Anthony said the members on that work group found the wiring in the current building completely inadequate. They also think the building has asbestos in it and the building is too small. Dr. Cutrell said that the State has money available to lease a building and to do interior remodeling. Dr. Cutrell read the minutes from the Transportation Work Group meeting for the Rural Health Clinic held September, 23, 1993 and talked about what had happened at the Funding Work Group meeting held October 06, 1993. DiscuSsion of Dr. Beachley rescinding his resignation. Dr. Cutrell suggested keeping Dr. Beachley through the end of his contract which is August 31, 1994 as long as things remain agreeable between all parties involved. Dr' Beachley presented the board with a copy of Jail medical expenses for 1991, 1992 and 1993. He also told the board why he changed his mind about resigning. He stated that the new Sheriff has been a big help. A jailer being assigned to the medical division and the nurses going to the Jail have been a great help. Dr. Beachley also said they now have a system for follow-up. They have now seen every inmate that has requested to be seen. He believes he saw 38 inmates October 11, 1993 in 5 1/2 hours. Dr. Beachley's hope is to continue in this job at least until the end of his contract. Dr. Cutrell asked if it would be possible to see the figures once every quarter or every 6 months. Anthony made his monthly report. He told the board that one of the nurses had given him a two week notice. A question was raised as to whether the board wanted to hire an RN or an LVN to replace her. Dr. Crowder, with the Texas Department of Health in Tyler, said the Health Department had to have at least one RN on staff. Since there was not a quorum present, the City Manager and the County Judge could make that decision. Dr. Cutrell asked if there were any other items to be discussed. Barbra Frances brought up the WIC immunizations. Dr. Cutrell said that raised an issue regarding continuity of care. He suggested possibly encouraging patients to see their, medical physician first. Barbra Frances also told the board that WIC will now be registering voters. Dr. Beachley told the board about a booth set up at PJC during Capital for a day. A woman filled out a questionnaire on the Health Department stating she was new in town and had taken her child to the Health Department and was charged less and treated better than at a local physician's office. The meeting adjourned at 8:25. The next meeting is to be held Tuesday, November 9, 1993 at 7:00 AM at the Holiday P-ESPECTFUL.J.-Y SUBMITTED, � J�E DI��INSON APPROVED BY DR. CUTRELL PARIS-LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING T,,e Paris-Lamar County Board of Health held its regular meeting on November 09, 1993. Those in attendance included Dr. Cutrell, Dr. McLemore, Dr. Strom, Mrs. Norment and Mrs. Ellis . Others in attendance included Latricia Miller, Troy Owens, Gene Anderson, Dr. BeachIey, Mike Norby, Anthony Bethel, Jae Dickinson, Amanda Holmes and Barbra Frances. The meeting was called to order at 7:08. Minutes from the previous meeting were read and approved. Dr. Strom made the motion and Dr. Cutrell seconded. All were in favor. Dr. Cutrell suggested reviewing the numbers from the jail quarterly. Mike Norby gave a report from the RHC Board. (see attached recommendations) Dr. McLemore asked why there was a need for an Administrator when Dr. Beachley will be the Medical Director. Mr. Norby said it was needed primarily to have a name to put into the Administrator position on the application. DzscussLon regarding proposed budget for the RHC. Anthony is to get the average cost per visit for the month of November for the next Board meeting. Dr. Cutrell asked about Anthony not being mentioned in the overv1ew. Mr. Norby said Anthony was seen as more of an overseer of the Health Dept. and the RHC. Dr. Cutrell said they would need to look at his duties and how it will effect hi.s salary. Dr. asked if the hospitals will pick up the other $--4,000. Mr. Norby said yes and that the hospitals are planning to follow-up with formaI letters to the Health Dept. and the City and County. Mrs. Norment made a motion to accept the recommendations from the RHC Board. Mrs. El1is seconded. All were in favor. Aothony gave a report about additional monies received for a Nurse Educator. Anthony told the board that Dr. Crowder in Tyler had helped us to get thi� position. Dr. Strom said we need to send Dr. Crowder a letter of thanks. Anthony said there were two options in filling this pusition. The first would be to consolidate this position with the vacant nurse position. The second option would be to hire an LVW and a Nurse Educator. If the first option is chosen, thepe would be one RN that would work full time up front, one LVN to work half of her time in the water lab and half of her time up front and one Nurse Educator to work 2/3 of her time in this position and the rest of the time up front. Anthony gave a report for the facilities work group regarding lead levels and asbestos in the Health Department. The lead levels are fine. Regarding asbestos, the ceiling tiles are fine but there is asbestos W the duct work. Anthony made his monthly report. The Health Department would like to be able to fine restaurants and grocery stores for repeat violation. The question was asked about putting names of establishments in the paper. Anthony said we would have to ask T.K. about the legalities. Mrs. Norment make a motion to ask T.K. to draw up an ordinance to fine eating establishments after repeat violations. Mrs. Ellis seconded. All were in favor. Dr. Cutrell wanted to remind everyone that next month new officers mould need to be chosen. This needs to be put on the agenda. The meeting adjourned at 8:05. The next meeting is to be held Tuesday, December 14, 1993 at 7:00 AM at the Holiday Inn. Respectfully submitted, ~ J�� Dickinson Approved by Dr. Cutrel] PARIS-LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING The Paris-Lamar Cu�nty Boar� of Healt: �e�u its regular meetin� on December z4, l993. Those in a�ten�a�ce jnclu�ed D'. Cu�rellr Dr, McLemore, Dr. S trom, M rs. Norment ano Mrs^ Ell�s` �ev' Evans anU Dr. �osele�' ��hers in a�tendance 1ncluded L-trzcia MilIer, Deane Luu��miller, Bene Anderson, Dr. Beach�ey, Anthony Bethel and Jae Dickinson. r|,e meetin� was called to order at 7;10. �inuLes �rom t�e pre:z�us meeting I�,,ere rea� =nU apprcved. jr' cLe^m/e asked 1f this Board had voted on gozng ahead uith the R(-'C. Dr. McLemore think� we need a long term co:tr�ct drawn up by T'K. with the Hospitals for any leftover munies being made up. pre�enteg �ike Norby's report. TIne N.P, Lntervze turned the job. Ti-'ere is another P. �oter=st n the posit10 o. Judge Luug7miller as�ed why was not interested. Dr. Cutrell sai er leti�r �tated that- s ht the aob would require more time t an he could gi ve' Dr. CutrelI also tulg the �oard a�pl cat a been Sent to John Lombroski's : ce for a $50 rant. Dr. C�trell asked a�out the futu/`e job of thi� �uard and t!�e RHC Board. Dr. Strom said oe did not thiik the/e w, I-) active board�. Dr. Cutrell dzscusse� the traositio: perzod of the o ie to two ye rs dur3.n� u ch t.we we can de de whicn �oard changes �o ma�e. �ny p/esented �is cost per visit figures' Dr. Etram s�id t�e,e are � large number of people ir this community t�af arE no -u gettzng any kind u medical care th�t wiIl hopeful Iy be reacmed ny the RHC. Anthony gave the rest of hi�H monthly report. �lecti on of officer for 1994, Rev. Evan� nom nated Dr. M oseley fc!;r Chairman. Dr. Strom seconded. Dr' Stro IT, made a I Tiotzon that a I nomznations cease, Dr. McLemore secnnded, All were i: IF that Dr. �oseley be the new Chairman. Dr. *3tr0 m numinated Dr. I'll cLemore fnr Vice �ha�r�an. Rev' Evans seconded. Dr. Cutre1l made a motion ChaL aLl nomIna -, Ions cease. Ali mere in favor that Dr. McLemore be the V 1 c e Chairman. J:Jge Loug ler suggested the Boar� taking a tour of t�e old and the new oa�l- Dr. �trom made a motion tnat the �oard accept the inv tation. Mrs. Ellis seconoed, It was decided that the Board eat breakfast at the new jail and then tour the facilities, The date for thi� was set f�r Wednesda�, DecemL)er 22, 199--3 at 7:00 a-m. Dr, Cut'el� toLd the 8oard t�at h� mould be res�gn�ng effective �anuary 1, 1994. The rexso en 1nvoIved both �ersonal and professional, The meetzng adoourned at T|/e oext meet�ng is to �e held Tue�day, January 11, 1994 at 7:00 AM at the Holida� Inn. uIL SItllbmitted, - Dzciinson ApPro�ed by Dr. Cu, trell PARIS-LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING The �ari�-La.nar Co..n�y Boarg uf HeaIth �eld �ts regular m�et�n� on January 1�, l994. Those in atte//dance inc]ude� Mrs, Normeot, �rs. Ellis a oselev. Ot�ers in ��tenda�ce ir.cluded La�ricia Mzller, 'Dear�e L�u�huzller, Truy O�ess, M�ke �alone, D/`. �avid 8r�ck, B�rbra Frances, Beachley, A:��.ony ae Dici'inson. The meeti�� :as calIed to order at 7:Z0 a.m. There as not a quorum present. The minutes were reud and tabled untzl t/�e ne�� meetzng- Dzscu�sion was hel� rega'dzn� the .neet�ng a� McCu��t:on on Janvary 07, 19�4 w�th Ke�neLh !�orn, the �pplzcant f�r the 1-4 F- it�oner. M�ke Nor�y sai� EveIyn Freemun z:� �uiie Mad�nx will c�nvCs the �eople whu met w�th both up�1zc t d h o:e wouId te best. An RH[ Boar� 'o�et�n� was scheduIeL' fur Janua'y I�, 1994 �t �t. Josephs HospitaI. �zke also sa/d that ther� has i-2 no r�s�cnse un the request for t�`e TP50,0��.00 gra:t fr�m the St�te. T�ere �oes '�u� a�pear tu be any pro�lem� w�th �his t|`e,e as been no officIal response. There are al�o Lwo other gran�s uva/lable, One .s fo~ �10�,�0�.�� =oJ on� for� �200,003.00. APplications wilI be sent in for tho�e �y next wee�. Ju��e L�ug�.n�\ler sazd that t�e f the Jazls was succe�sf�]. A �u�gE stIc� was wa�e to do th�s possib]� unce every year. monthly report. D r. Mos e tLld the BcarJ Lhai �e g�es �� Che �ucal two fu each r and teaJ/es a ou� de�ti�try. �e wan�ecl anyone m�ght be ruut� ht up durI n� �o�eley suy�ested tell�og about serv�ce� �vaila��e at t�e �ealt|� Department or �r, �eachleY coul� t�li �u C;e schools about H.D, ser,zces h�mself' Dr, MoseIey a lso n`aybe aIc��ol c1-i u..se1�n� in gr�u�� Sher Iff has toLJ t risk �s too high at this time. ThO 00w�Mg adjuorne, �t 7;40. The ne,t me�liny is La be he:W Tu&sway, Fabra&cy 8, 1594 at 7:nO a,m, at the Holiday !an. Res ' pectlully submitted, i�' C, Approved by Dr. Museiey M I N U T E S OF M E E T I N G The Paris -Lamar County Board of Health held its monthly meeting on Wednesday, January 25th, at the Holiday Inn. Board members present included Dr. Bert Strom, Dr. Robert Moseley, Rev. Samuel Evans, and Mrs. Frances Ellis. Others present included T.K. Haynes, Gene Anderson, Latricia Miller, Anthony Bethel, Bob Ricks, Danise Petticrew, Betsy Chapman, Evelyn Freeman, and Dr. Bill Woodruff. A quorum was established and the meeting was called to order at 7:15 am. Dr. Strom made a motion that was seconded by Rev. Evans that the minutes be approved. The motion carried. Under discussion of the Rural Health Clinic, Dr. Woodruff requested that he be sent a roster of Health Department employees with job descriptions for each employee, and would like to see a flow chart as to what employee does what. Danise Petticrew stated that the Rural Health Clinic was not certified as of yet, and that she needed a 3rd clerk up front. Evelyn Freeman reported that she was notified of receipt of a COPC grant in the amount of $120,000 to cover February through August, 1995, and stated that the grant would be re- applied for in 1996. Dr. Strom made a motion that was seconded by Mrs. Ellis that the Board be advised within 7 working days the status of obtaining the 3rd clerk, and the status of certification for the Rural Health Clinic. The motion carried. Anthony stated the reason that the Health Department has not received a worker from TDH for medicaid screening was that the building will not meet ADA requirements. Anthony passed out monthly reports. The next meeting was scheduled for Wednesday, February 15th, at 7:00 am at the Holiday Inn. The meeting adjourned at 8:25 am. Respectfully submitted, Bob Ricks PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING The Paris -Lamar County Board of Health held its regular meeting on February 22, 1994. Those in attendance included Mrs. Ellis, Dr. Moseley, Dr. Strom, Dr. Brock and Dr. Kraft. Others in attendance included Latricia Miller, Deane Loughmiller, Mike Malone, T.K. Haynes, Gene Anderson, Julie Maddox, Gary Gunder, Anthony Bethel and Jae Dickinson. The meeting was called to order at 7:00 a.m. The minutes were read and approved. T.K. swore in the Board Members. Discussion was held regarding the amount of leave Dr. Beachley has left. Gene said Dr. Beachley has about 4 weeks. Dr. Strom asked if there were any options for an interim physician. Anthony said that Dr. Greg Skie will be having two half day clinics this week and one half day clinic on Monday. Julie said she thought there were two issues. One being coverage at the jail and the second being an interim physician at the Health Department. Dr. Woodruff and his staff will cover the jail three mornings a week after they get off work at St. Joseph's E.R. If it is agreed Dr. Woodruff will act as the Director at the Health Dept. and Kendra Proctor, F.N.P. will see the patients in the three week interim at the Health Dept. Dr. Kraft made the motion to hire Dr. Woodruff and Kendra Proctor for the interim period. Dr. Strom seconded. All were in favor. Dr. Kraft asked why there had to be an M.D. at the jail. Dr. Strom said there has to be according to State regulations. Latricia asked if Dr. Beachley's resignation was still on the table. T.K. said no. It has been withdrawn. Julie asked if Dr. Beachley can come back after his leave is up. The answer is yes. Dr. Moseley asked if this arrangement with St. Joseph is going to be temporary. Julie said yes. She also said that St. Joseph saw this as a chance to get the RHC paper work sent off and the RHC set up. Julie also told the board that there is another Nurse Practitioner very interested and possibly available in a month or so. Discussion was held regarding payment of Dr. Woodruff and Kendra Proctor. It was stated that there would not be money available to pay them in the Health Department budget until Dr. Beachley's leave runs out. T.K. said so that money would be available the Health Department could let someone go. Last one in, first one out. Dr. Strom asked if we were filing Medicaid. Anthony said yes. Dr. Strom asked how much the County was paying for the jail to be seen. Latricia said $100.00 per hour. Dr. Strom said this is the perfect opportunity to get the RHC underway. T.K. asked if anyone was being turned away. Anthony said no. Dr. Kraft said he knew of two people who have been. Anthony said that Dr. Beachley is slow. Gary Gunder asked how fast money comes in from the State. Gene said the time varies. Mike Malone said a budget for the RHC needs to be nailed down. He also said there could possibly have a cut in the budget. Gary Gunder asked if both hospitals would be interested in splitting the cost to hire Dr. Woodruff and Kendra Proctor to prevent having double cost. Julie said as long as the split is 50/50 she didn't think there would be a problem. T.K. asked how many people at the Health Dept. have money coming from the State for their salary. Anthony said all but Dr. Beachley. Julie said the staff needed for the RHC is one LVN or RN if the Health Dept. chooses to keep who is there and one clerical person. Julie made the recommendation not to fill the other RN position at this time. T.K. said he didn't think the Health Department needed the last position filled. Dr. Moseley suggested waiting 30 days to see who or what might or might not be needed. T.K. said there is going to be an evaluation made at the Health Dept. by both hospitals to see who or what is or is not needed very soon so why not wait until after this evaluation. Dr. Kraft said he thought is earlier motion should take effect March 1, 1994. Everyone agreed. T.K. mentioned the idea to extend the Health Board by two members. It was agreed that this is still premature. Latricia asked how many Physicians have to be on the Board. Dr. Kraft said there has to be one M.D., one Veterinarian and one Dentist. Anthony gave his monthly report. The meeting adjourned at 8 :15. The next meeting is to be held Tuesday, March 22, 1994 at 7:00 a.m. at the Holiday Inn. The meeting to be held March 8, 1994 has been cancelled. espectfully ,submitted, Dickinson Approved by Dr. Moseley PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING The Paris -Lamar County Board of Health held its regular meeting on Tuesday, March 22, 1994, at the Holiday Inn. Members present included Dr. Moseley, Dr. Strom, Dr. Brock, Dr. Kraft, Rev. Evans, and Mrs. Norment. Others in attendance included T.K. Haynes, Mike Malone, Gene Anderson, Troy Owens, Alan Weatherford, Latricia Miller, Gary Gunder, Mike Norby, Evelyn Freeman, Julie Maddox, Anthony Bethel, Bob Ricks, and Barbra Francis. The meeting was called to order at 7:10 am, and the minutes from the previous meeting were read and approved. Mr. Norby presented a partial proposed fee schedule for the Health Department, and said that he should have a completed fee schedule to be proposed at the next regular scheduled meeting. Dr. Strom stated he felt that the Health Department needed to have a formal resignation from Dr. Beachley before taking any further action on the status of the Medical Director for the Health Department. Ms. Maddox discussed the role of the Medical Director at the Rural Health Clinic. Under discussion of the proposed Rural Health Clinic, Ms. Maddox presented a review of operations at the Health Department, a copy of which is attached to these minutes. After discussion, Dr. Strom made a motion that was seconded by Dr. Kraft that the Board proceed with the establishment of a Rural Health Clinic for Lamar County, and that the hospitals proceed with the application process. The next meeting was scheduled for Tuesday, April 19, 1994, at 7:00 am, at the Holiday Inn. Respectfully submitted, Bob Ricks Approved by Dr. Moseley PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING The Paris -Lamar County Board of Health held its regular meeting Thursday, May 26, 1994, at the Holiday Inn. Members present included Mrs. Ellis, Mrs. Norment, Dr. Moseley, Rev. Evans, and Dr. Strom. Others in attendance included Mr. Malone, Mr. Haynes, and Mr. Anderson with the City of Paris, Judge Loughmiller, Mr. Owens, and Mrs. Miller with Lamar County, Mr. Bethel, Mr. Ricks, and Mrs. Francis with the Health Department. Also Mr. Norby, Mr. Gunder, Mr. McLauren, Ms. Freeman, Ms. Maddox, and Ms. Proctor with the hospitals. Danise Petticrew was introduced as the new Family Nurse Practitioner for the Health Department. The meeting was called to order at 7:09 a.m., and a quorum was established. Minutes of the previous meeting were approved as submitted. Mr. Norby made a presentation to the Board regarding the progress of the Rural Health Clinic. He passed out a proposed fee schedule for the RHC that is currently in use at St. Joseph's RHCs. A copy is attached to these minutes. Mr. Norby also passed out a survey of clinic activity for the Health Department for the period of 2 -22 -94 through 4 -8 -94. A copy of this survey is also attached. Also passed out were a projected operational budget showing expenses and funding, a copy of the first page of a grant application for the COPC program, and a copy of the application to establish eligibility to participate in the health insurance for the aged and disabled program to provide rural health clinic services. A copy of these are also attached to these minutes. After discussion of these hand -outs, Dr. Strom made a motion that was seconded by Rev. Evans, that four items be placed on the agenda for action to be taken at the next meeting. These items are: 1) purchase of computer system and Medical Manager software; 2) Obtaining a financial eligibility worker with the cooperation of the Department of Human Services for screening of Medicaid eligibility; 3) acceptance of the Rural Health Clinic Application; and 4) discussion of the position of Medical Director for the Health Department. The motion was voted on and approved. Mrs. Ellis made a motion that was seconded by Dr. Strom that the Board accept the resignation submitted by Dr. Charles Beachley. The motion was voted on and approved. Anthony Bethel presented monthly reports for the months of March and April, 1994. The next meeting was scheduled for Wednesday, June 15, 1994, at 7:00 a.m. at the Holiday Inn. The meeting was adjourned at 8:21 a.m.. Respectfully submitted, �f zz� Bob Ricks Approved by Dr. Moseley PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING The Paris -Lamar County Board of Health held its regular meeting on Wednesday, June 22, 1994, at the Holiday Inn. Board members in attendance included Dr. Robert Moseley, Dr. Bert Strom, Dr. David Brock, Ann Norment, and Frances Ellis. City representatives included Mike Malone, T.K. Haynes, and Gene Anderson. County representatives included Judge Loughmiller and Latricia Miller. Health Department representatives included Anthony Bethel, Bob Ricks, Danise Petticrew, and Barbra Francis. Others in attendance included Mike Norby, Monte McLaurin, Julie Mattox, and Evelyn Freeman. The meeting was called to order at 7:09 the previous meeting were corrected to Brock was in attendance at the meeting, approved. am. Minutes from reflect that Dr. and were then Gene Anderson passed out a proposed budget for the Health Department and Rural Health Clinic and discussion was held concerning the budget. A copy of the budget is attached to these minutes. Dr. Strom made a motion that was seconded by Mrs. Ellis that the budget be submitted to the City and County for approval and to go ahead with the Rural Health Clinic application process. The motion carried. Julie Mattox passed out a report of patients seen at the Health Department broken down by diagnoses, age groups, and sex. A copy of this report is attached to these minutes. Discussion was held regarding the purchase of a computer system and software for the Rural Health Clinic. Dr. Strom made a motion that was seconded by Mrs. Norment that the system and software be purchased with grant monies available if the grant does not state that it was solely for Rural Health Clinic start -up. The motion carried. Discussion was held regarding the hiring of a Financial Eligibility Worker. Dr. Strom made a motion that was seconded by Mrs. Ellis that the Board pursue the possibility of hiring a financial eligibility worker to be funded 1/2 by the Texas Department of Human Services and 1/2 by the RHC start -up grant. The motion carried. Dr. Strom made a motion that was seconded by Mrs. Ellis to table the discussion of and action on the position of Medical Director for the Health Department. The motion carried. MINUTES OF MEETING PAGE 2 Dr. Strom requested that discussion of and action on a proposed fee schedule be placed on the next agenda. Anthony Bethel handed out monthly reports. The next meeting was scheduled for Wednesday, July 13th, at 7:00 am at the Holiday Inn. The meeting adjourned at 8:20 am. Respectfully Submitted, 1 Bob Ricks Approved by Dr. Moseley PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING The Paris -Lamar County Board of Health held its regular meeting on Wednesday, July 13, 1994 at the Holiday Inn. Board members present included Dr. Robert Moseley, Dr. Bert Strom, Dr. David Brock, Mrs. Ann Norment, and Mrs. Frances Ellis. Others in attendance included Mike Malone, T.K. Haynes, Judge Deane Loughmiller, Troy Owens, Alan Weatherford, Latricia Miller, Anthony Bethel, Bob Ricks, Barbra Francis, Mike Norby, Evelyn Freeman, Dr. Bill Woodruff, and Danise Petticrew. The meeting was called to order at 7:10 am, and a quorum was established. The minutes of the previous meeting were approved as submitted. Under discussion of the Rural Health Clinic, Mr. Malone stated that the City has given him authorization to sign the application for the Rural Health Clinic if the County signs it. Judge Loughmiller stated that the County would sign the application subject to the approval of the budget for the Rural Health Clinic. Evelyn Freeman reported that preliminary approval has been received for a March of Dimes grant for approximately $38,000.00, and that final approval should be obtained by the Fall. Dr. Moseley introduced Dr. Bill Woodruff to the Board, and asked if members had any questions to ask Dr. Woodruff. Dr. Woodruff stated that he would consider accepting the position of Medical Director if it were offered, and added that he would like to continue seeing jail inmates. Under discussion of a fee schedule, Dr. Strom made a motion that was seconded by Dr. Brock that the fee schedule previously presented by Mr. Norby be implemented as soon as possible. The motion passed. Under discussion of the position of Medical Director for the Health Department /Rural Health Clinic, Mrs. Norment stated that this discussion had been held in executive session in the past and she felt that it should be done in executive session this time. No action was taken on the position of the Medical Director, and a special meeting was called for Monday, July 18th, for an executive session to discuss the position of Medical Director for the Health Department /Rural Health Clinic, and also the position of Administrator for the Rural Health Clinic as Julie Maddox has resigned. Mr. Norby added that Carrie Thompson has been appointed on an interim basis as Administrator of the Rural Health Clinic. Anthony Bethel presented monthly reports for the Health MINUTES OF MEETING PAGE 2 Department for June, 1994. Evelyn Freeman advised the board that the Commissioner of Health, Dr. David Smith, will be in Paris on August 4th at Paris Junior College for a press conference on the Shots Across Texas program. The next regular meeting was scheduled for Tuesday, August 16, 1994, at 7:00 am, at the Holiday Inn. The meeting was adjourned at 7:50 am. Respectfully Submitted, � 6 (LJ� Bob Ricks Approved by Dr. Moseley PARIS -LAMAR COUNTY BOARD OF HEALTH SPECIAL MEETING MINUTES OF MEETING The Paris -Lamar County Board of Health held a special meeting on duly 18th, at the Holiday Inn. Board members in attendance included Dr. Robert Moseley, Dr. David Brock, Dr. Bert Strom, Rev. Samuel Evans, Mrs. Ann Norment, and Mrs. Frances Ellis. Others in attendance included Bob Ricks, Mike Malone, and T.K. Haynes. The meeting was called to order at 7:26 am, and went into executive session. The meeting came out of executive session at 8:00 am, and went into open session. Dr. Strom made a motion that was seconded by Dr. Brock that the Board establish a peer review system to review medical records, the physician, and patient surveys on a quarterly basis to determine the effectiveness of care given at the Health Department. The motion passed. Dr. Strom made a motion that was seconded by Dr. Brock that the Board recommend that a contract be drawn up with Dr. Bill Woodruff to be the Medical Director at the Paris -Lamar County Health Department. The motion passed. Dr. Strom made a motion that was seconded by Rev. Evans that the Board recommend that Carrie Thompson be appointed as the Administrator of the Rural Health Clinic. The motion passed. The meeting was adjourned at 8:06 am. Respectfully submitted, ((� n mac, Bob Ricks Approved by Dr. Moseley PARIS -LAMAR COUNTY BOARD OF HEALTH MINUTES OF MEETING The Paris -Lamar County Board of Health held its regular meeting on Tuesday, August 16, 1994, at the Holiday Inn. Board members present included Dr. David Brock, Dr. Robert Moseley, Mrs. Ann Norment, and Rev. Samuel Evans. Others present included Mike Malone, T.K. Haynes, Gene Anderson, Alan Weatherford, Troy Owens, Latricia Miller, Anthony Bethel, Bob Ricks, Barbra Francis, Bernice Bell, Vella Risinger, Mike Norby, and Ron Ragan. The meeting was called to order at 7:11 am. A quorum was established, and Rev. Evans made a motion seconded by Mrs. Norment that the minutes from the previous meeting be approved. The motion carried. The meeting went into executive session at 7:14. The meeting came out of executive session and no action was taken on salaries for Health Department employees at this time. No action was taken on changing from State of Texas Personnel Policies to City of Paris Personnel Policies for employees of the Health Department. Mr. Norby advised the Board that the computer system and software has been ordered for the Rural Health Clinic, and that the system should be in use by October 1, 1994. Anthony Bethel presented monthly reports. A special meeting to discuss the Health Department budget was called for 7:00 am, Wednesday, September 7th, at the Holiday Inn. The next regular meeting was scheduled for 7:00 am, Wednesday, September 21st, at the Holiday Inn. The meeting was adjourned at 8:14 am. Respectfully submitted, Bob Ricks Approved by Dr. Moseley MINUTES OF SPECIAL MEETING PARIS -LAMAR COUNTY BOARD OF HEALTH The Paris -Lamar County Board of Health held a special meeting on Wednesday, September 7, 1994, at the Holiday Inn. Board members present included Dr. Robert Moseley, Dr. Bert Strom, Dr. David Brock, and Mrs. Frances Ellis. Others in attendance included Mike Malone, T.K. Haynes, Gene Anderson, Troy Owens, Alan Weatherford, Latricia Miller, Anthony Bethel, Bob Ricks, Evelyn Freeman, and Mike Norby. The meeting was called to order at 7:26 am, and a quorum was established. Under discussion of budget, Gene Anderson stated that the proposed budget was basically the same as the one passed out at a previous meeting two or three weeks ago. Mr. Anderson, Mr. Bethel, and Mrs. Miller met regarding a pay schedule for employees. Dr. Strom Made a motion that was seconded by Dr. Brock that the employees of the Health Department be placed under the City of Paris pay plan. The motion carried. Dr. Strom made a motion that was seconded by Mrs. Ellis to adjust Anthony's salary upward to equal the salary of Barbra Francis. The motion carried. Dr. Strom made a motion seconded by Dr. Brock that Dr. Woodruff's contract for supervision of the Nurse Practitioner be effective March 1, 1994. The motion carried. The Board also discussed physicals for City /County employees wanting to participate in the Race for Life Center or Aerofit Center. Dr. Strom made a motion seconded by Mrs. Ellis that the Health Department be allowed to perform these physicals for City /County employees as long as they were done on a regular fee basis, not a reduced rate, but as an office visit. The motion carried. The meeting adjourned at 7 :55 am. Respectfully Submitted, t,� L Bob Ricks Approved by Dr. Moseley Lamar County Rural Health Clinic Board Minutes of Meeting The Rural Health Clinic Board held its first meeting September 28, 1993 at 6:45 AM at PJC in the Alford Learning Center. Those in attendance included Dr. Cutrell, Ann Norment, Deane Loughmiller, Troy Owens, Mike Malone, T. K. Haynes, Evelyn Freeman, Gary Gunder, Julie Maddox, Mike Norby, Jae Dickinson and Carrie Thompson. The meeting was called to order at 6:50. The first item to be decided was what the clinic was going to be called. It was decided that the name would be Lamar County Rural Health Clinic. Discussion was held regarding what is needed in order to get the Rural Health Clinic off the ground. A Nurse Practitioner, 2 nurses and 2 clerks need to be hired. The Rural Health Clinic application requires the name of the Medical Director or Directors. It was suggested the each hospital recruit 1 doctor. Discussion was held as to whether the Administrator should be hired prior to the Nurse Practitioner(s). This deci=sion can not be made until it is decided whether Anthony will be the Rural Health Clinic Administrator or not. The Medical Directors) should be hired first. Evelyn Freeman suggested meeting with the OB /GYN Physicians at McCuistion and get that Director decided. Dr. Cutrell suggested deciding how long they would serve before talking with the OB /GYNS. A suggestion was made that if Anthony was named as -the Administrator, after 1 year he would be reevaluated. Regarding the Medical Director(s), Evelyn Freeman said she would take responsibility to get the OB /GYN Physicians together and decide on an OB /GYN Director. Gary Gunder will be assisting her. Julie Maddox and Mike Norby will be recruiting the Primary Care Physician Medical Director. Julie Maddox said the current personnel files at the Health Department needed to be looked at to make sure they are up to date. The question was raised as to who actually owns the Paris -Lamar County Health Department. Julie Maddox said that there needed to be an agreement between both Hospitals and the Lamar County Rural Health Clinic as to what will be done in accepting the patients from the Rural Health Clinic. Evelyn Freeman said that the OB /GYN Physicians were going to have questions regarding liability insurance for the Medical Director. She said she would contact Texas Municipal Liability Trust regarding this. A question was raised as to who would be the Chairman of the Rural Health Clinic Board. It was suggested that the term for this person be 1 year. Dr. Cutrell proposed that Mike Norby be the Chairman and Gary Gunder be the Vice - Chairman. Everyone seconded. All were in favor. The meeting adjourned at 7:35. The next meeting is to be held October 19, 1993 at 7:00 am, in the Azalea Room at St. Joseph's Hospital. Respectfully Submitted, Ja Dickinson, Clerk Paris -Lamar County Health Department Lamar County Rural Health Clinic Funding Work Group Minutes The Lamar County Rural Health Clinic Funding Work Group held a meeting October 06, 1993 at 7:00 am in the Gold Room at McCuistion. Those in attendance included Ron Ragan, Evelyn Freeman, Raymond Armstrong, Dr. Cutrell, Gene Anderson, Dr. Strom, Mike Malone, Mike Norby and Jae Dickinson. The meeting was called to order at 7:15. Ron Ragan suggested tackling the issues on the first page of the agenda. The first question was who owns the Paris -Lamar County Health Department. Mike Malone is going to check into this. Evelyn Freeman said she had talked with Mr. Butler from the Texas Department of Health in Austin and he had suggested that the Hospital Authority own the Lamar County Rural Health Clinic. Mr. John Dumbroski from the State is over the Rural Health Clinic program. Evelyn also said she had spoken with Dr. Patty Patterson and had been told there was money available to put up walls through the Health Department, and grants. She did not know if equipment was included in this. Dr. Patterson said she would check on this and get back with Evelyn. Other money was available on a loan, $500,000.00 for 20 years at no interest. Mr. Butler also told Evelyn that he had toured the Health Department and taken an exterior look at the old hospital. He said that the existing building would not work and that there might be asbestos in both buildings. Discussion was held regarding services offered at Paris Health Services. Evelyn talked about the March of Dimes grant for $47,500.00 for 2 maybe 3 years. This grant would provide $27,500.00 for half a years salary for a Nurse Practitioner for 2 years, $1,000.00 for publications, and she believed $4,000.00 for clerical help. She also said that McCuistion had been asked to raise $10,000.00 for the community to give back to the March of Dimes. Additional costs for running the Rural Health Clinic will be covered by Mike Norby and Gene Anderson. There may be retroactive money available from the Centers for Rural Health Initiative. Possibly as much as $25,000.00. Discussion was held regarding leadership. Ron Ragan suggested a professional administrator to guide the Rural Health Clinic through. Whether it would take a heavy duty type person or not. Ron thinks it will. Mike Norby suggested a Physicians office manager. Ron Ragan suggested forming a personnel committee to look at the current administrator. Dr. Cutrell suggested a review committee other than from the Health Board. Possibly getting a semi- retired or a retired consultant to handle the start up of the Rural Health Clinic. Someone to keep the ball rolling. Evelyn Freeman asked if a motion could be made to the Lamar County Health Board to take care of getting someone to oversee the start up of the Rural Health Clinic and payment of that person. To handle the administrative duties. Dr. Cutrell seconded. All were in favor. Discussion of what services will be offered. This will be covered by what Nurse Practitioners we have. Dr. Cutrell said that any interest by the County will hinge on the continuing coverage at the jail. Dr. Cutrell said he was trying to sure up and reassure Dr. Beachley and taking care of the jail. Dr. Cutrell suggested possibly trying to keep him on as long as he is doing a good job and desires to stay. Evelyn Freeman said Mr. Butler with the State is aware of this problem. Dr. Cutrell said that the Health Board is looking and the jail problem and thought it best to continue with Dr. Beachley. Ron Ragan suggested to the rest of the work group that they finish looking at the hand out with the agenda. Ron also asked if there were any other items that needed discussion before setting up the next meeting. Time and place of the next meeting will be Thursday, October 14, 1997- at 7:00 am in the Board Room and St. Joseph's. Ron made a motion that the meeting adjourned at 8:10. Mike Norby seconded. All were in favor. spectfully submitted, e Dickinson, Clerk aril -Lamar County Health Department Lamar County Rural Health Clinic Funding Work Group Minutes The Lamar County Rural Health Clinic Funding Work Group held a meeting October 14, 1993 at 7:00 AM in the Board Room at St, Joseph's. Those in attendance included Ron Ragan, Evelyn Freeman, Raymond Armstrong, Dr. Cutrell, Gene Anderson, Mike Malone, Mike Norby, T.K. Haynes, Deane Loughmiller and Jae Dickinson. The meeting was called to order at 7c15 and minutes of the previous meeting were read and approved. T. K. Haynes asked if there was a law or a rule about single ownership regarding the Rural Health Clinic. Mike Norby said it is a hurdle in the application. Mike said he would not say it was impossible, but it is easier with just one. Evelyn Freeman said John Dembroski might be able to come down and answer the big questions about the Rural Health Clinic. Ron Ragan asked again who owns the Health Department. Mike Malone said in March of 1942 the land was deeded to the U.S' government to build the Health Department. In 1952 a county court deed showed the Government deeded the land and building back to the City and County jointly. Ron asked what about the equipment inside. Mike Malone and Deane Loughmiller said it was also jointly owned excluding the State owned equipment. Ron asked if it would be appropriate for this work group to take the issue of single ownership to the Rural Health Clinic board' Gene Anderson stated that single ownership might not be a problem. Mike Norby is going to check and see if single ownership really matters. Discussion regarding services offered at the Health Department not included in the Rural Health Clinic, Mike Norby said WIC is not under RHC but would have to be in close proximity to the location of the RHC due to State guidelines if a move comes about. Sanitation is not included with the RHC, Dr. CutrelI said it would probably be easier to move everything due to funding. Mike Norby agreed. Evelyn suggested making a list of questions and issues and then checking with Mr. Dembroski to see if they complied with Rural Health Clinic guidelines. Mr. Butler, told Evelyn that the State had found some money and that they were so pleased to see the City, County and two competing hospitals come together to form this Rural Health Clinic. Dr. Cutrell asked who serves on the Hospital Authority. T. K. Haynes said appointees of the City Council. It was then asked if the Hospital Authority could legally own the Rural Health Clinic or serve as the figurehead owner. Dr. Cutrell asked if the County was involved. T.K. said no, it is the City of Paris Hospital Authority. Mike Norby said he understood it was designed to get tax exempt bonds to finance the Hospital. Dr. Cutrell asked if the Rural Health Clinic Board could own the Rural Health Clinic. T.K. said it would be easier for them than the Hospital Authority. Mike Norby said he was going to call HCFA regarding this and will pass the information on to the Rural Health Clinic Board. T.K. can get a copy of the rules regarding ownership. Discussion was held regarding estimated budget. Mr. Armstrong asked if money would come from estimated visits' Mike Norby said yes. Mr. Armstrong and Mike Norby said the each hospital would possibly be adding $50,000.00. Discussion was held regarding need for a consultant. Ron Ragan said that the bottom line was someone has got to dot the i's and cross the t's. No one here actually has the time to do this. Ron Ragan suggested taking this problem to the Rural Health Clinic Board to handle this problem. Dr. Cutrell asked if the City or the County has any extra money. T.K. said he was not the person to officially say but, no they do not. Deane Loughmiller agreed. Dr. Cutrell asked about taking money from somewhere else to use. Maybe in the Health Department budget. T.K. said it could be done, but if the money was not recouped then it could end up that someone had to be let go. T.K. said he felt like it was the hospitals place to come up with the start up money. Mike Norby said that was correct. The hospitals approached the City and County. Therefore the money should come from the hospitals. A question was asked as to when the projected start up for the Rural Health Clinic. Evelyn said hopefully January 01, 1994. But possibly as late as March 01, 1994. She said there needed to be an existing budget for recruitment money. Evelyn had a question concerning start up costs and money to hire a consultant. Ron Ragan said there was no bucket to pull any money out of. Mike Norby said yes there is, the hospitals. Dr. Cutrell asked if a Nurse Practitioner could see any kind of patient. Will a Nurse Practitioner help him or put more on him. The answer was any kind of patient. Mike Norby said the majority of patients will be indigent. Not on Medicaid. Ron Ragan asked what was the feeling on how to present this budget to the Rural Health Clinic Board. Dr. Cutrell asked if it should be presented best case/worse case or presented as is and say it is conservative. Mike Norby said he was planning to fine tune it before presentation to the RHC Board possibly with help from Evelyn on grants. T.K. had a question regarding the Nurse Practitioner. How limited is their, ability? Do both have to be hired before the RHC can be started? Can we start with one and wait until the other is needed? Evelyn said the March of Dimes Brant will cover half of one Nurse Practitioners salary. Evelyn also said she has got two leads on Nurse Practitioners. She also has some leads on some N.P.'s going to graduate anywhere from May to December 1994. T.K. asked if they had specific labels (i.e. OB, GP, PED.) The answer was yes. A correction was found from the previous minutes. Change Lamar County Health Board to RHC Board. Evelyn brought up the issue of a consultant to keep the ball rolling. Even if they cost 10,000.00 to 20,000.00, she sees it as up front money now instead of one to two years lost revenue. The cost would not be that great even if it was split four ways. Dr. Cutrell asked couldn't it be someone already here, does it have to be someone from out of town? Evelyn said not necessarily. Mike Norby said he thought it was still too soon. We are still trying to get our stuff together. T.K. said since St. Joseph has already set up two RHC's, couldn't we just ride their coattails. Mike Norby said yes. T.K. asked why couldn't St. Joseph be our expert. Would it be a burden? Mike Norby said St. Joseph would be happy to help but would not rule out the possibility of needing a consultant for a couple of days. Evelyn said John Dembroski was the State expert. Maybe he could come one day and help with any questions we might have and possibly help us set up and agenda. Ron asked what does this committee need to present to the RHC Board. It was decided that a fine tuned budget would be presented, they would ask the RHC Board to approach the hospitals for start up money and talked to the RHC Board about hiring a consultant. Dr. Cutrell said he is worried that an outside consultant uould not understand the needs in this community- Evelyn said she did not think this would be a problem if we used Mr. Dembroski as the consultant since he just got through doing a consultation for a clinic in Booker, Texas. T.K. asked if the RHC has anything to do with the Region. Evelyn said yes. She also added that Tyler is trying to establish an RHC and thinks it would be better to work with the State instead of the Region. Evelyn said she was going to talk to Mr. Butler on Monday about money available from the State. She also said she was going to get some dates from Mr. Dembroski as to when he could come to Paris. Evelyn got a call from Oklahoma Medicaid wanting to know what they could do to help with claims being filed. They a5k,ed what the problem was. Evelyn told them it looked Iike Oklahoma Medicaid had money for Oklahoma physician, but not for Texas physicians. Oklahoma said maybe they needed to learn how to file the claims correctly. Evelyn told them to come down and show us. The meeting adjourned at 8:30. The next meeting is to be held Wednesday, October 27, 1993 at 7:00 AM in the Gold Room at Mccuistion. Respectfully submitted, J Dickinson' Clerk Paris-Lamar, County Health Department Lamar County Rural Health Clinic Board Minutes of Meeting The Rural Health Clinic Board held a meeting October 19, 1993 at 7:00 AM at St, Joseph's Hospital in the Azalea Room. Those in attendance included Dr. Cutrell, Troy Omens~ Mike Malone, T. K. Haynes, Evelyn Freeman, Gary Gunder, TuIie Maddox, Mike Norby and Jae Dickinson. Others in attendance included Monty McLaurin, Dr. Robert Moseley, Ron Ragan, Gary ConweIl and Carrie Thompson. The meeting was called to order at 7:2O. The previous minutes were read, corrected and approved. Discussion was held regarding the RHC application. Mike Norby said there does not seem to be a problem with Joint ownership between the City and County. He said he was going to try to get something in writing. Gary Gunder asked if the RHC needs a legal identity. Mike Norby said no that it would be kept under the City and County' Mr. Gunder then asked if we had to get approval from both the City and County. Dr. Cutrell said basically yes. Evelyn Freeman asked were the people's names from this board taken to the City and County to be approved? The answer was no. T.K. said if there were any expenses outside the current budget then the decisions for those expenses would go back to the City and County, Mr- Gunder asked would any monies added by the hospitals go into the City fund? T.K. said yes but they would be put under the Health Dept. budget and earmarked for a designated purpose. Evelyn said actually this board was working with authority to make plans but not to spend money without the Health Dept. board, City and County approval. Discussion was held regarding the Medical Director position. Evelyn said the four OB/Gyn physicians had a lot of questions regarding liability. No decision was made between the four OB/Gyn physicians as to who would serve as Medical Director. All four of them have serious questions that need to be discussed. The four had talked about possibly shared responsibility meaning possible one every three months. Mr. Butler told Evelyn that there was a new law that might help the situation. Julie Maddox said we would need to find out how it works with rotating Medical Directors. Mike Norby said St. Joseph's has identified one person for the Family Practice Medical Director but they were not sure how it was going to work with the current Medical Director. Dr. Cutrell said that Dr. Beachley is under contract until August 1994. He also said that the Lamar County Health Board needs to make sure that the Lamar County Jail is covered adequately so Dr. Beachley really could not be let go. The negatives for Dr. Beachley serving as a temporary director is the speed at which he is able to see patients. Dr. Cutrell said he thought there were a couple of options available. The first would be the get the OB Nurse Practitioner and let Dr. Beachley be the Family Practice physician. The second would be to hire both Nurse Practitioners and let Dr. Beachley serve as the Director. The cost to duplicate Medical Directors would probably be more than we want to spend. Dr. Cutrell said he would like to stick with Dr. Beachley until his contract runs out. Discussion was held on the revised budget. Monty McLaurin said he would just like to remind everyone that several months ago some people contacted him about Dr. Beachley ending his contract with no one stepping forward to fill his shoes. Due to this, the idea of establishing a Rural Health Clinic came about. Mr. McLaurin suggested getting the two Nurse Practitioners, one 4pecializing in OD and one in Primary Care, and 1eaving Dr. Beachley as the Medical Director for the time being. Mr. McLaurin said this would make it possible to improve billing and collection, increase the number of patients seen and let all of these monies coming in before increasing monies being paid out. Dr. Cutrell said that this was a different situation because the RHC would be working with both hospitals not just a St. Joseph's clinic working with St. Joseph's physicians- Carrie Thompson said hers was not referring to just Bt. Joseph's physicians but both hospitals physicians. Mr. McLaurin said the St. Joseph's Emergency Room physicians have said that they will cover the jail if the need arises. Evelyn Freeman said that the OB/Gyn physicians would probably feel more comfortable stepping in come August 1994. Gary Gunder suggested that Dr. Cutrell approach Dr. Beachley about being the Medical Director of the RHC at least until his contract runs out. Both Mike Norby and Julie Maddox said this would mean that the monies for additional funding would be reduced by $50,000.00 and the RN/LVN salaries would decrease due to loosing one RN. The positions will change from two RNs and one LVN to one RN and two LVNs. T.K. made a motion to approach Dr' Beachley about being the Medical DIrector for the RHC until the end of his contract. Julie Maddox seconded. All were in favor. Mr. McLaurin told the RHC board the results of the facilities work group meeting held Monday, October 18, 1993 at 1:00 PM. The meeting took place at the old Safeway building. It was decided that this building was not a good option. Mr. McLaurin said that there are a number of buildings around depending on the money available. He suggested possibly starting up in the current building and moving to a larger building at a later date. Julie Maddox said she understood that there is possibly a problem with asbestos and/or lead in the building. Mike Norby suggested a present plan to remain where the Health Department is until a better building is found. Evelyn asked the RHC board for their opinion on hiring a consultant to keep everything going. To keep up with the phone calls from the State. To pull everything together, to keep up with all the information coming in. Ron Ragan agrees with Evelyn. Julie Maddox and Troy Owens don't think we need a consultant. Ron Ragan clarified by saying someone other than a volunteer. Evelyn said even if the person was paid $5,000.00 to $7,500.00. Mike Norby asked if possibly someone part-time. Carrie Thompson told the RHC board that she is going to the Nurse Practitioners State Convention and would be happy to take some fliers to be posted about possible positions available. The meeting adjourned at 8:30. The time and place of the next meeting will be decided at a later date. Respectfully Submitted, C4J Di ckinson, Clerk is-Lamar County Health Department Lamar County Rural Health Clinic Board Minutes of Meeting The Rural Health Clinic Board held a meeting November 03, 1993 at 7:00 AM at McCuiStion Hospital in the Gold Room. Those in attendance included Dr. Cutrell, Troy Owens, Evelyn Freeman, Gary Gunder, Julie Maddox" Mike Norby, Ann Norment and Jae Dickinson. Others in attendance included Monty McLaurzn, Dr. Robert Moseley, Dr. Strom, Gary Conwell, Raymond Armstrong, Betty Kildahl and Dr. Beachley. The meetznq was called to order at 7:15. The previous minutes were read, clarified and approved. Discussion was held regarding what the RHC Board wants to present to the Lamar County Health Board. Mike Norby handed out a list of recommendations. They were as follows. * Dr' Beachley be appointed as Medical Director of the Rura1 Health Clinic. This was agreed upon. * The RHC start out in the existing Health Department building until more space is needed. Evelyn told the Board that MR. Dombroski is researching the possibility of lease money. This was agreed upon. * Select personnel from the current Health Department attend the RHC Conference to be held November 18 and 19 in Dallas. Attendees will be sponsored by the Hospitals. They are Dr. Beachley, Kim Elsom, RN, Anthony Bethel, Jae Dickinson and Barbra Frances. This was agreed upon. * The RHC Board be authorized, within budget constraints, to oversee the employment of RHC personnel and recommend budgets for the operation of the RHC to the Paris-Lamar County Health Department. Dr. Cutrell saic things would work basically the same way they are now. He aI50 recommended getting something in writing sayinc that the City and County would remain involved on the RHC Board and on RHC committees- This was agreed upon, * One nurse practitioner be recruited as quickly as possible to be able to commence the operations of the RHC in early 1994. Julie Maddox said a nurse practitioner is coming to interview with the OB/Gyn physicians, Dr. Cutrell and Dr. Beachley on November 12. If anyone else would like to talk to her, please let Julie know as soon as possible so she can try to make time. This was agreed upon. iv N, Lie ,-'ecruIted to replace the RN who recently left the Health Department. Dr. Deachley said the existing LVN is interested in this position. We need to check; with the State to see if she could remain the water lab tech. and an RHC nurse also. This was agreed upon. Recruit an office manager for the RHC to oversee scheduling, billing, collection and coordination of ether office functions. This person will be ultimately responsible for making sure these monies are coming in. This was agreed upon but nothing will be done about this position as yet. Initially, to utilize hospital expertise in the application and start -up phase, with the nurse practitioner (when hired) responsible for the daily oversight. This was agreed upon. The RHC "Administrator" be appointed from the Rural Health Clinic Board by the RHC Board. The Administrator appointed does not have to be an employee of the Health Department. This person basically serves as a sounding board for the nurse practitioner. Dr. Cutrel1. asked what relationship this has with Anthony. iw1iE::e rlor -by said Anthony's duties would not diminish in any way. If anything they would increase due to handling the RHC budget. Mrs. Norment made a motion to recommend to the Health Board that Julie Maddo;: be named the Administrator. Gary Gunder seconded. All were in favor. Evelyn Freeman told the Board about the luncheon with Mr. Dombroski. She said that there was no problem naming the City and County as owners of the RHC. She also told the Board that Mr. Dombroski said there were avenues for uninsured patients but that there is an application process. The State Health Commis loner ,jants to complement the four institutions working together to start this RHC. Mr. Dombroski ;rude a suggestion that we contact Dr. Crowder in Tyler for any help. The meeting adjourned at 8c,05. The time and place of tl_)e next meeting will be decided at a later date. Respec tf1_.il ly- Submitted, Jae Dickinson, Clerk Paris - -Lamar County Health Department Lamar County Rural Health Clinic Board Minutes of Meeting The Rural Health Clinic Board held a meeting January 19, 1994 at 7:00 a.m. at St. Joseph's Hospital in the Azalea Room. Those in attendance included Dr. Moseley, Troy Owens, Evelyn Freeman, Julie Maddox, Mike Norby, Ann Norment, T.K. Haynes and Mike Malone. Others in attendance included Jae Dickinson and Dr. Beachley. The meeting was called to order at 7:15 a.m. The previous minutes were read and approved. Discussion was held regarding the interviews for Nurse Practitioner. Julie Maddox told the Board that Kendra Proctor has been hired by St. Joseph's. Julie thinks Kenneth Korn's education should be checked further and if everything checks out fine then offer him the job. Everyone agreed. Mike Norby told those present that the RHC will be an "Independent" RHC instead of a" Provider Based" RHC. Julie has a chart that shows the difference between the two. Discussed definition of responsibilities for timing of: a. Coordination of NP interviews /hiring. If Kenneth Korn is not hired, Julie and Evelyn will continue to look for other applicants. b, c, d. Job descriptions, Policies and procedures and Clinical Protocols will fall to the NP. This will take place 60 - 90 days after hiring NP. Nurse Practitioner's job description should be posted before hiring. e. Coordination of other position interviews will fall to the NP from a clinical stand point and Anthony Bethel from all others. f. Application process for other positions will be put on hold until the NP is hired. g. Budget development will be handled by Gene Anderson and Mike Norby. h. Equipment /supply purchases will be handled by the NP and Julie, then will be given to Anthony Bethel. i. Grant requests/fund-raising will be handled by Evelyn Freeman. Evelyn told the Board that there is a $25,000.00 grant available from the State without alot of strings. Gary Conwell is going to talk to a woman with the State. It looks like we have everything this grant requires. There is another grant for $180,000.00 from Texas Department of Human Resources. Evelyn said she is going to Dallas to see if a grant for $200,000.00 is an option. This grant is from a private foundation for Primary Health Care. It will help pay for care at the RHC for people who can't afford it. j. Mike Norby suggested possibly getting the Medical Manager System for billing and collection. k. There were no other issues to be delegated Discussion was held regarding future meeting dates. There may be a meeting by phone in the near future if needed to discuss hiring Kenneth Korn. The newt meeting date was set for March 02, 1994 at 7:00 a.m. in the Gold Room at McCuistion. Mike told the Board about the discussion held at the regular Health Board meeting regarding the need for two active boards once the RHC is established. The RHC Board is (ad hoc) for a short time only. The meeting adjourned at 8:20 a.m. Respectfully aubmitted Jhkinson, Clerk Paris-Lamar County Health Department Lamar County Rural Health Clinic Board Minutes of Meeting The Rural Health Clinic Board held a meeting March 02, 1994 at 7:00 a.m. at McCuistion Hospital in the Gold Room. Those in attendance included Dr. Moseley, Troy Owens, Evelyn Freeman, Julie Maddox, Mike Norby, Gary Gunder, T.K. Haynes and Mike Malone. Others in attendance included Mrs. Moseley, Kendra Proctor, Mary Jo Smithco and Jae Dickinson. The meeting was called to order at 7:15 a.m. The previous minutes were read and approved. Mike Norby said Dr. Beachley's status is still indefinite. In the interim, the County has signed a contract with St. Joseph's E.R. physicians and things are going very well. As of March 1, 1994, the Health Department as a Nurse Practitioner working in the interim. Kendra gave a report on the status at the Health Department. Mike Norby said the RHC paperwork is going to sent off now that we have an RHC look - alike. Dr. Moseley asked if this board needed to be sworn in. T.K. said yes if it lasts. T.K. asked what Kendra would say to a prospective applicant for the Nurse Practitioner position about the status or possibility at the Health Dept. Would it be positive or negative. Kendra said very positive. She said at the Health Department she had to rely more on clinical judgment rather than diagnostic testing in treating the patients due to the amount of time it takes to get lab reports back. Julie said she thought the receptiveness of the staff was very good. T.K. said he thought it might help to talk to a Nurse Practitioner seeing patients at the Health Department whether the report was good or bad. Discussion was held regarding the hiring of a Nurse Practitioner. Julie told the RHC board that Danise Petticrew wants the job permanently. Julie also told the board that Danise is originally from this area. The base salary if approved will be $50,000.00 with a bonus system of 20% of the annual salary for number of patients seen, and five days off paid plus $2,000.00 per year for educational purposes. Regarding the cost for relocation, Julie suggested seeing if the Company that hired Mrs. Petticrew's husband would be interested in splitting the cost. Julie asked if the City has any kind of an incentive plan. Mike Malone said not that he knows of but to put a proposal on paper and the City will look at it. Mike Malone said to fax it to City Hall attention Gene. Dr. Moseley asked if the incentive could be based on the amount of revenue brought in. Julie said that it couldn't because the Nurse Practitioner can't set the rates. Mike Norby told the board that the Health Department has started filing Medicaid. He also stated that the fee structure needed to be addressed and that the type of payer needs to be identified. Discussion was held regarding the evaluation of operations. Kendra id doing the clinical and Mike Norby said out the meeting held March 1, 1994 and meetings to come, resolutions will be made. Evelyn asked when Danise will be available. Julie said possibly the first part of April. Julie said she would be drawing up a proposal package for Gene as soon as possible. Gary Gunder asked if a motion needed to be made recommending the City and County hire this Nurse Practitioner. Mike Norby said it had basically already been done. Evelyn seconded that motion. Mike Malone said when the City Department it was basically so could make up the shortfall in really does not want to change said that the objective is for become a stand alone entity and have severe a financial crunch. first took over the Health that the City and County the budget. The City that structure. Mike also the Health Department to that the City is about to Discussion was held regarding the days and hours of operation. Monday - Friday, 8 a.m. to 5 p.m. Evelyn said it would make more sense to run the clinic like other physician offices. Possibly eliminate some of the holidays. T.K. asked if the clinic could adopt its own holidays. Mike Norby said yes. Recommendations will be made at the March 22 Health Board meeting. The application process for the RHC will be sent off to get the RHC off the ground. There may be some people called on the sign official documents. T.K. said the hospitals could get copies of the City and County holidays. Evelyn said John Dombroski will be in Paris the 28th and 29th of March. There is some flexibility in the $50,000.00 grant. There is another grant that totals $3,000,000.00. The State will look at different programs around the State and divide the money between them. Mr. Dombroski said he wanted to pull the RHC into the loop of grants available. Evelyn also told the board that the first payment from the March of Dimes Grant should be here by the end of March. The money cannot be accepted until a Nurse Practitioner is in place at the Health Department. Evelyn is going to start the application process for 1995 March of Dimes Grant now. The money for 1995 will be for $45,000. An oral presentation will be given May 12, 1994. The money from the March of Dimes Grant is to be used for part of the Nurse Practitioner's salary, a clerical person and for a Childbirth Educator two days a week. The clerical position has some flexibility in how the money has to be spent. The next meeting date was set for April 06, 1994 at 7:00 a.m. in the Board Room at St. Joseph's Hospital. The meeting adjourned at 7:55 a.m. Respectful. ly Submitted, - �ae Dickinson, Clerk Paris-Lamar County Health Department