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Board of Health Minutes 03-16-1994 SUMMARY MINUTES OF THE SAINT PAUL BOARD OF HEALTH WEDNESDAY, MARCH 16, 1994 Room 330 City Hall and Court House SAINT PAUL, MINNESOTA The meeting was called to order by Board President Thune at 6:35.p.m. Present - 6- Blakey, Grimm, Harris, Megard, Rettman, Thune Absent - 1 - Guerin 1. Resolution - 94-314 - approving annual City signatures on documents and contracts with the Minnesota Department of Health (MDH). This resolution designates Katherine Cairns as the person authorized to sign documents on the Board of Health's behalf for certain documents and Diane Holmgren for certain documents. Councilmember Megard moved approval. Adopted Yeas - 6 Nays - 0 2. Resolution - 94-315 - approving City signatures on a contract with MDH to accept funding for Hepatitis B services. Councilmember Megard moved approval. Adopted Yeas - 6 Nays - 0 3. Resolution - 94-316 - approving City signatures on a contract with MDH to accept funding for development of a model provider-based immunization registry. Councilmember Megard moved approval. Adopted Yeas - 6 Nays - 0 4. Resolution - 94-317 - approving City signatures on a contract with MDH to accept funding for maintaining a community chronic disease coalition. Councilmember Megard moved approval. Adopted Yeas - 6 Nays - 0 5. Saint Paul-Ramsey County Community Health Services Advisory Committee Update • Health Care Reform Katherine Cairns, Public Health Director, provided background information on the Board of Health. She stated that the Board of Health is included in Minnesota State Statutes, Chapter 145A, where every community health board designates its board. In St. Paul, the St. Paul City Council is designated as the Board of Health. Public health functions in St. Paul were in existence in 1858. The resolutions which were adopted (Items 1-4) are requirements of state and federal government. When contracts or money are coming from the federal or state level to provide services in St. Paul, the Board of Health must approve the receipt of those funds. Ms. Cairns noted that there is a diversified funding base for St. Paul March 16, 1994 Public Health with decreasing reliance on the property tax base and increasing reliance on federal, state, and private sources. Ms. Gairns introduced Bruce Larson, Chair of the St. Paul-Ramsey County Community Health Services Advisory Committee. This committee is also included under the Statute for advice to the Board of Health. Mr. Larson provided a briefing on the working papers from the Citizens Advisory Committee. This information will be passed on to the Legislative Delegation for their consideration along with the Minnesota Health Care Reform Legislation. As citizens, Mr. Larson said the committee has some simple facts about how the Board of Health exercises stewardship over some very valuable public health assets in the city. This was the motivation behind the three resolutions. One of these assets is the community clinics. If the clinics do not have contracts with the designated payor sources, there is a concern that they may cease to eausts. There must be a contract and there must be a source of payment. They are very concerned that the advisory bodies and citizen constituencies may become public relations vehicles where some HMOs or other entities will control who sits at the table and what services will be provided. He stressed the importance of "real people" sitting on the boards and that the concerns of individuals, particularly in the under-served communities, surface and that the needs of these individuals are not overlooked. Mr. Larson stated that it does not do much good to have health reform if there is no way of knowing if money is being saved and whether or not the citizens are being short-changed. They are attempting to get a handle on some basic benchmarks that have been developed in the public health culture. It is hoped that the groups managing the money and deploying the services will adopt them. • Ad-Hoc Smoking Committee Kent Reese, Chair of the Environmental Health Subcommittee, discussed issues related to the Ad Hoc Smoking Committee. He stated that the scope of smoking encompasses more than just environment; it also involves personal and community health which is how the ad hoc committee came about. Discussion started out originally from talking about a total ban on smoking in all public areas and is now focused more closely on looking at only restaurants. A draft resolution was presented to the Committee basically making a switch in the percentage of seating in restaurants from the current 30/70 to 70/30. Discussions have been held with the Minnesota Restaurant Association, and they have been communicating with their members. A meeting is upcoming with the Restaurant Association for further discussion regarding this issue. Mr. Reese said he has met with staff from the Minnesota Department of Health and they aze in support of this change. Councilmember Blakey asked about smoking statistics for young people. Mr. Reese responded that the committee has not focused on this issue but stated there are some statistics which indicate an up and down fluctuation of minors smoking. 2 March 16, 1994 Councilmember Megard commented that the issue of improving the health of St. Paul citizens is one that has frequently come before the Council. One concem is licensed vendors selling tobacco products to minors. She questioned whether the Ad- Hoc Smoking Committee has addressed this issue to which Mr. Reese replied "no". Megard asked that the Committee address this problem in their discussion and possibly come up with a policy recommendation at some time. Councilmember Rettman stated that the City does have a matrix on selling to minors which includes criteria and penalties of which the committee should be aware. 6. Managed Care Update Ms. Cairns stated that St. Paul Public Health is the contract provider for managed care services to the medical assistance population in St. Paul. In addition, there are many other health care organizations that are billed by the Health Department for health services that are provided. 7. Funding and Service Profiles Ms. Cairns reviewed graphs that were provided on Financing for St. Paul Public Health, Special Fund Revenue, Public Health Staffing, Trends in Housing Code Complaint and Response Data, Trends in Housing Code Enforcement, Clients/Visits for Medical and Dental; WIC; and Total Visits. Councilmember Harris asked about consolidation of Public Health with Ramsey County. Bruce Larson said that the Committee will continue to look at possible merger. He stated that if this was an easy task to undertake, he felt merger would have taken place many years ago. He said they will address which options appear to have the best interests of the citizens of St. Paul. Councilmember Harris suggested they might want to identify just one element such as a particular service delivery item that may be delivered more efficiently and serve the public better if they were merged. Councilmember Rettman suggested this could be discussed further at the next Board of Health meeting. 8. C�zstomer Service Initiative • Housing Services Diane Holmgren, Public Health, briefed the Board on some of the customer service initiatives they have been undertaking. A telephone survey is planned for this spring with individuals who have been involved in the housing complaint areas to determine the levels of satisfaction with responding to complaints and where improvements can be made. • Clinic User Services The spring quarter survey has been completed. There were 250 respondents which is about 20% of the clients that visit the Public Health Center during any given week. 3 Questions asked in the survey included the level of satisfaction with the services, why people use the Public Health facility, what other resources they use for health care, and the type of insurance they have. • Health Information/Education Public Health conducts many presentations in the community on a variety of health issues, Ms. Holmgren stated. Public Health will begin to send survey cards to people to seek input on their satisfaction with the programs. The Public Health Center answers approximately 700 calls per day from the public. Twenty-six percent of the ca11s received are refened to another service. Ms. Cairns concluded the meeting by saying that she is willing to address District Councils and neighborhood groups on health issues. D T 7: 2 P.M. oard Presi nt, avid Thune ATTEST: � Minutes approved by Board of Health Nancy An on � � Assistant ouncil Secretary 4