July 30, 2024 Board of Health Meeting Minutes

Otero County Board of Health Meeting

July 30, 2024, 11:00 am
Otero County Courthouse, Rm. 107
La Junta, Colorado

Members Present:
Dr. Paul Yoder, President and Medical Officer
Dr. R.J. Nelson, Vice President
Lindsey Hart
Dr. David Trujillo

Member(s) Absent:
Mark McCuistion

Ex Officio:
Amy White-Tanabe, Otero County Administrator
Richard Ritter, BOH Secretary, OCHD Executive Director

Commissioners:
Rob Oquist, Otero County

OCHD Staff:
Marie Mora-Menges, Nursing Program Director
Chris Coffield, RHC
Kristine Phillips, CTC Program Assistant
Donna Starck, Tobacco Control Program Director
Dr. Janell Maier, Disease Prevention & Control/EPR Program Director
John Miller, Business Manager
Gypsy Harviston, AmeriCorps Member

Government:
Tim Knabenshue, Otero County Commissioner

Minutes

Call to Order: A quorum being present, the meeting was called to order by Dr. Yoder.
Public Notice Posting (Pursuant to C.R.S. 25-1-509(2)(f), C.R.S. 24-6-402 (2)(c)(I), & C.R.S. 24-6-402(2)(c)(III)): The 2024 BOH meeting schedule was posted on the BOH website on 11/30/2023, and this agenda was posted in the designated public locations in all OCHD offices and on the BOH website by 7/25/2024.
Public Comment: There were no public comments.
Consent Agenda (ACTION ITEM)
1. Approval of Minutes (previously sent on 6/7/2024 & 7/24/2024)
  1. May 28th, 2024, Regular BOH Meeting
2. Contract Ratification (Pursuant to C.R.S. 25-1-508 (5)(k) & C.R.S. 25-1-511 (3))
  1. 2024-2025 CDPHE Public Health Emergency Preparedness (PHEP) Task Order
    - Task Order #: 2025*0135
    - Purpose: CDPHE direction and support for OCHD’s Public Health Emergency Preparedness and Response Program.
    - Status: Fully Executed
    - Term: 7/1/2024-6/30/2025
    - Amount: $74,116.00
      - Increase of $904 over the previous contract amount of $73,212. This comparison does not include the one-time FY 2023-2024 additional PHEP funds in the amount of $24,500, which was used primarily to purchase deepcycle battery generators.
  2. 2024-2025 CDPHE Immunization Contract Amendment #2
    - Amendment Contract #: 2025*0041 Amendment #2
    - Purpose: CDPHE direction and support for OCHD’s Immunization Program.
    - Status: Fully Executed
    - Term: 7/1/2024-6/30/2025
    - Amount: $58,995.00
      - Decrease of $8,605 over the previous contract amount of $67,600.
  3. 2024-2025 CDPHE Child Fatality Prevention System (CFPS) Contract
    - Contract #: CT FHLA 2022*0285
    - Purpose: CDPHE direction and support for OCHD’s CFPS Program.
    - Status: Fully Executed
    - Term: 7/1/2024-6/30/2025
    - Amount: $7,250.00
      - Increase of $250 over the previous contract amount of $7,000.
  4. 2024-2025 CDPHE Office of Public Health Practice, Planning, and Local Partnerships (OPHP) Contract Amendment #1
    - Amendment Contract #: 2023*0040 Amendment #1
    - Purpose: CDPHE OPHP non-siloed, discretional funding to support OCHD’s public health practice.
    - Status: Fully Executed
    - Term: 7/1/2024-6/30/2025
    - Amount: $237,676.00
      - Increase of $110,462 over the previous contract amount of $127,214.
  5. 2021-2025 CDPHE COVID Immunization #3 Purchase Order (PO) Amendment
    - PO #: PO,FHJA,202100010299
    - Purpose: CDPHE Modification to amend SOW and no-cost extension to 6/30/2025. The contract amount remains the same.
    - Status: Fully Executed
    - Term: 3/24/2021-6/30/2025
    - Amount: $163,081.00
  6. 2021-2025 CDPHE COVID Immunization #4 Purchase Order (PO) Amendment
    - PO #: PO,FHCA,202200003009
    - Purpose: CDPHE Modification to amend SOW and no-cost extension to 6/30/2025. The contract amount remains the same.
    - Status: Fully Executed
    - Term: 8/23/2021-6/30/2025
    - Amount: $163,081.00
  7. 2024-2025 Crowley County Collaborative Management Program (CMP) Memorandum of Understanding (MOU)
    - Purpose: Colorado Revised Statutes (C.R.S.) Section 24-1.9-102 authorizes local agencies to enter into memorandums of understanding to promote a collaborative system of local-level interagency oversight groups and individualized service and support teams to coordinate and manage the provision of services to children and families who would benefit from integrated multi-agency services.
    - Term: 7/1/2024-6/30/2025
  8. 2024-2025 Otero County Collaborative Management Program (CMP) Memorandum of Understanding (MOU)
    - Purpose: Colorado Revised Statutes (C.R.S.) Section 24-1.9-102 authorizes local agencies to enter into memorandums of understanding to promote a collaborative system of local-level interagency oversight groups and individualized service and support teams to coordinate and manage the provision of services to children and families who would benefit from integrated multi-agency services.
    - Term: 7/1/2024-6/30/2025
3. Approval of Consent Agenda and Approval/Ratification of Items Therein: L. Hart moved to approve the consent agenda and ratify the items therein, D. Trujillo seconded, motion carried.
Old Business: None
New Business
1. Budget (Pursuant to C.R.S. 25-1-508 (5)(k) & C.R.S. 25-1-511 (3))
  1. Financial Summary Report (Based upon Tyler Financial Systems reports dated 7/24/2024)
    - May 2024
      - Revenues: $265,853.20
      - Expenditures: $186,989.58
      - Surplus: $78,863.62
      - Fund Balance: $2,786,042.56
    - June 2024
      - Revenues: $159,655.63
      - Expenditures: $179,420.72
      - Deficit: $19,765.09
      - Fund Balance: $ 2,766,277.47
  2. Approval of Expenditures (ACTION ITEM): D. Trujillo moved to approve the May 2024 & June 2024 expenditures in the amounts of $186,989.58 & $179,420.72 respectively, R. Nelson seconded, motion carried.
  3. 2023 WIC Voucher Total: For CY 2023, OCHD’s WIC Program had $706,977.15 of WIC vouchers redeemed. This is an increase of $150,894.31 over the 2022 WIC voucher total of $556,082.84
  4. OCHD 2025 Budget: Last year, Otero County departmental budgets were due to county administration by mid-September. CRS 25-1-511(4) states “On or before September 1, 2008, and on or before September 1 of each year thereafter, a county board of health shall estimate the total cost of maintaining the county public health agency for the ensuing fiscal year and the amount of moneys that may be available from unexpended surpluses or from state or federal funds or other grants or donations. On or before September 1 of each year, the estimates shall be submitted in the form of a budget to the board of county commissioners. The board of county commissioners is authorized to provide any moneys necessary, overestimated moneys from surpluses, grants, and donations, to cover the total cost of maintaining the agency for the ensuing fiscal year by an appropriation from the county general fund.” To satisfy this statutory deadline, R. Ritter will be completing a preliminary (version 1) of the 2025 budget in August (which has no BOH meeting scheduled) and then emailing the budget to BOH members. BOH members are asked to review this preliminary budget and submit any questions via email directly to R. Ritter. After BOH members have had an opportunity to review the preliminary budget, R. Ritter will then submit it to Amy White-Tanabe on or before 9/1/2024, to comply with the statutory provision. Please note, R. Ritter will receive more detailed budget information from county administration later in September, so this preliminary budget will be revised to reflect new information, and this “Version 2” will be brought to the BOH at its regularly scheduled meeting in September for review and approval. This is the same method used in 2023 for the 2024 Budget.
2. Personnel
  1. Status Change
    - Marie Mora-Menges, WIC Program Director: R. Ritter has appointed Ms. M. Mora-Menges to the position of WIC Director, left vacant by the retirement of J. Jancar at the end of June 2024. Ms. Mora-Menges will only serve as WIC Director part-time at .25 FTE. The FY25 CDPHE COWIC fiscal allocation for OCHD will not support a full-time WIC Director. In fact, in order to meet (and not exceed) the FY25 contract allocation of $181,922, OCHD will not be receiving our full, CDPHE-approved 2024 indirect rate recovery of 21.16%, but only 10%. This will translate into a loss of indirect cost recovery in the amount of approximately $16,000.
  2. New Personnel
    - Christopher Menges, SUD Program Director: Mr. Christopher Menges has been conditionally offered, and accepted, the position of SUD Program Director with OCHD. This will fill the vacancy left by the resignation of Arlene Cooke. Mr. Menges will be starting with OCHD within the next couple of weeks. We look forward to working with Chris!
    - David Hensel, Peer Recovery Support Specialist (PRSS) Trainee: Mr. Hensel has rejoined OCHD as a PRSS trainee, we welcome back David!
3. 2024-2025 OCHD WIC Application Conditional Approval: At the 5/28/2024 BOH Meeting, R. Ritter presented information on the WIC Request For Applications (RFA). As mentioned at this meeting, “For decades, CDPHE WIC has not required local WIC programs to apply for annual funding. Established local WIC Programs simply received continuation funding for their local WIC activities. For the next WIC fiscal year (which begins October 1st, 2024), CDPHE WIC is requiring all local providers to submit an application with an accompanying budget.” OCHD completed and submitted the application before the due date. On 7/16/2024, R. Ritter received an email from CDPHE WIC indicating that OCHD’s application has been conditionally approved for 1 year of funding. The email reads, in part, as follows: “Due to the recent change in staff, the qualifications of the new WIC Director (RN without BSN), the high number of findings (9) and repeat findings (8) on previous monitorings, and the minimal time (0.25 of new FTE) dedicated to the Program, authorization is conditional upon the following:
  - Director must complete the required training within the timelines outlined in the Colorado WIC Policy & Procedures Manual.
  - The Director must attend the biweekly COWIC Check-In calls with the State office.
  - Director must attend the full State monitoring visit in 2024 and work with the nutrition consultant to develop an action plan for any findings, particularly any that are repeat findings.
  - Authorization will be reassessed prior to the contract or funding being approved for the next fiscal year and will be contingent upon meeting the above requirements. Discussions or meetings with agency leadership may be required prior to that time if performance metrics or other concerns arise. Acceptance of the contract implies acceptance of these terms.
  R. Ritter and M. Mora-Menges will work closely together to ensure that the conditions are fully met, and the BOH will continue to receive updates at BOH meetings.
4. 6/29/2024 Safety Jam/A Path Forward Event: On 6/29/2024, the Safety Jam/A Path Forward Event was held at the La Junta City Park. It was a resounding success! Activities included a motorcycle poker run; walk-a-thon; emergency vehicle display; helicopter landing, display, and take off; food voucher give-a-ways for mobile food vendors; free pizza and water at lunch; SWAG give-a-ways; bicycle give-a-ways; public dissemination of SUD/OUD information throughout the day; exhibitor booths from various agencies; and a live band in the evening. The event was very well attended by the public, with multiple people stating, “Please do this again next year.”
5. PHEP Deep Cycle Battery Generators: During CDPHE PHEP FY24, additional dollars became available. R. Ritter applied for those funds, which amounted to $24,500, and OCHD was awarded that amount. With those additional funds, OCHD purchased 8 deep-cycle battery generators. Each generator is rated at 3,600 watts, and this can be doubled to 7,200 watts by connecting 2 generators in parallel. They do not require internal combustion, nor do they produce CO as do gasoline generators. They can be placed safely inside a home or building. The main purpose of these generators is for Emergency Support Function (ESF) 8 response. For instance, supporting an extended care facility or a provider’s office during a power outage. Additionally, they can be checked out by BOH members, Crowley and Otero County Commissioners and staff, and OCHD staff members as long as they are not needed for ESF-8 purposes.
6. North La Junta Sanitation District’s Malfunctioning Mosquito Sprayer: On 7/18/2024, R. Ritter received a complaint from a North La Junta citizen regarding the District’s inoperable mosquito spraying equipment. The complainant wondered if there were any grants available to repair said equipment. This individual then sent an email inviting OCHD staff to the North La Junta Sanitation Board meeting on 8/6/2024 at 6 pm at the North La Junta Community Center. After this, R. Ritter had a conversation with a member of the North La Junta Sanitation District. R. Ritter suggested to this person that they reach out to other cities and check if those cities would be willing to share their mosquito spraying equipment. R. Ritter requested financial information on how much it would be to repair the equipment and how much to buy new equipment. R. Ritter then said that if these costs were not astronomically high, OCHD would consider a no-interest loan to the North La Junta Sanitation District to either repair existing equipment or purchase a new unit. The representative from the North La Junta Sanitation District stated that they would get this information to R. Ritter. If this nointerest loan looks feasible, R. Ritter will have N. Shultz draw up the loan agreement. R. Ritter plans to attend the North La Junta Sanitation District’s meeting on 8/6/2024, and he will have larvicide dunks to distribute to the citizens of North La Junta. OCHD has been supplying North La Junta Sanitation District staff with larvicide dunks this season. The BOH voiced no objections to this course of action.
7. Addendum/Addenda: None
Program Reports
1. CTC, Kristine Phillips: General information
2. DCEP/EPR, Dr. Janell Maier: General information
3. Nursing, Marie Mora-Menges: General information
4. STEPP, Donna Starck: General Information
5. RHC, Chris Coffield: General information
6. Vital Statistics, John Miller: General information
7. AmeriCorps, Gypsy Harviston: General Information
Executive Session: R. Ritter requested an executive session with the BOH Members regarding personnel, specifically the BOH’s annual evaluation of the executive director. C.R.S. 24-6-402 (4)(f)(I) was cited as the statute authorizing the executive session. D. Trujillo moved to convene into executive session, R. Nelson seconded, motion carried. The BOH and R. Ritter then moved into executive session at 12:10 pm. The following Executive Session provisions were made explicit:
- For discussion of a personnel matter under C.R.S. Section 24-6-402(4)(f) and not involving: any specific employees who have requested discussion of the matter in open session; any member of this body or any elected official; the appointment of any person to fill an office of this body or an elected official; or personnel policies that do not require the discussion of matters personal to particular employees.
- Participants are to confine all discussion to the stated purpose of the executive session, and no formal action may occur in the executive session.
- If at any point in the executive session, any participant believes that the discussion is going outside the proper scope of the executive session, they are to interrupt the discussion and make an objection.
- After reconvening into regular, public session, if any person who participated in the executive session believes that any substantial discussion of any matters not included in the motion to go into the executive session occurred during the executive session, or that any improper action occurred during the executive session in violation of the Open Meetings Law, they will state their concerns for the public record.
- Discussions that occur in an executive session shall be electronically recorded. The electronic recording shall reflect the actual content of the discussion in the executive session. The sole exception to this requirement is that no electronic recording shall be required to be kept of that portion of an executive session that constitutes an attorneyclient communication, in the opinion of the attorney in attendance at the executive session.
- The electronic recording device shall be tested before going into executive session to determine whether it is operating. In the event the electronic recording device is unavailable or not operating, the BOH shall not convene in executive session until an operating recording device is available.
- Upon completion of the executive session, if a tape recorder is used, the tape shall be labeled with “BOH-Executive Session” and the date, and initialed or signed by the Presiding Officer. If a digital recorder is used, the data file recording of the executive session shall be saved to a secure, confidential storage location and the file shall be labeled with “BOH-Executive Session” and the date.
- Executive session minutes kept by electronic recording device shall stand approved with no further action. If additional written minutes are taken, they shall be approved at a future executive session.
- The electronic recording and any written minutes of the executive session shall be maintained for 90 days after the date of the executive session and shall not be disclosed to any person except as required by law.
Reconvene: The BOH reconvened into regular session at 12:22 pm. The Executive Session was recorded and will be kept on file for 90 days.
Executive Director’s Annual Evaluation: R. Nelson made a motion that, over the course of the previous year, R. Ritter’s performance as executive director has exceeded expectations, and that R. Ritter will be given a 5% annual increase to his current base salary, which equates to $6,125, said increase to go into effect August 1st, 2024. D. Trujillo seconded; motion carried. R. Ritter expressed appreciation for his continued employment and for the generous compensation increase.
Adjournment: With no further business, P. Yoder adjourned the meeting.

Respectfully Submitted,

Richard Ritter
Secretary, Otero County Board of Health
Executive Director, Otero County Health Department

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