Board of Health Meeting Minutes May 9, 2013 The meeting of the Board of Health was called to order by Vice-Chair Dr. Ruth Stewart at 4:00 p.m. in room 212 of the Lentz Public Health Center. Present

Ruth Stewart, MD, Vice Chair Henry W. Foster, Jr., MD, Member Sam Felker, JD, Member Alicia Batson, MD, Member Carol Etherington, RN, Member William S. Paul, MD, MPH, FACP, Director of Health Stan Romine, MPH, Director of Finance and Administration Bureau Tom Sharp, Director of Policy and Governmental Affairs Chris Taylor, RN, APRN, Director of Community Health Bureau Dr. Kimberlee Wyche-Etheridge, MD, Director of Family, Youth and Infant Health Bureau Latissa Hall, M.S., Director of Adolescent Programs Marlesa Sims, Youth Advisory Board Chair Josh Lee, JD, Metro Legal

Youth Advisory Board Update

Latissa Hall, MS, Director of Adolescent Programs and facilitator of the Youth Advisory Board (YAB), introduced the chairperson of the YAB, Ms. Sims, who presented “Teens ‘n’ Weed” to the Board members (Attachment I).

050913 Youth Advisory Board prese Resolution endorsing July 7-July 13, 2013 as School Immunization Week in Davidson County

Tom Sharp presented a resolution endorsing July 7-July 13, 2013, as School Immunization Week in Davidson County (Attachment II). Dr. Kimberlee Wyche-Etheridge read the resolution into the record.

050913 Resolution School Immunization W Ms. Etherington made a motion to approve the resolution endorsing July 7- 13, 2013 as School Immunization Week in Davidson County. Mr. Felker seconded the motion, which passed unanimously.

May 9, 2013 Board of Health meeting minutes | Page 1 of 4

Metropolitan Government of Nashville and Davidson County Animal Control Fees Per Metro Code of Ordinances Section 8.04.130 (A)

Tom Sharp presented the Metropolitan Government of Nashville and Davidson County Animal Control Fees Per Metro Code of Ordinances Section 8.04.130 (A) for Board approval (Attachment III).

Mr. Sharp explained that the only fee change from current ordinance is the license fee increase from $4.00 to $6.00, and that authority to increase or decrease fees continues to rest with the Board of Health and the Metro Council.

050913 Animal Control Fees Per Metr

Dr. Foster made a motion to approve the Metropolitan Government of Nashville and Davidson County Animal Control Fees Per Metro Code of Ordinances Section 8.04.130 (A). Dr. Batson seconded the motion, which passed unanimously. Approval of Revision to Metro Animal Care and Control Adoption Fees

Tom Sharp presented a revised schedule of adoption fees for Board approval (Attachment IV). He explained that the Board had approved the schedule of fees at the March 19, 2013 meeting, but two of the fees had been listed incorrectly and were corrected in this revision.

He further explained that the Metro Council would be presented with a fee schedule that would include additional discounts for organizations approved as Certified MACC Adoption Partners and asked that the Board move to approve adding those fees subsequent to Metro Council’s approval of them.

050913 MACC Adoption Fee Schedul Dr. Batson made a motion to approve the Revision to Metro Animal Care and Control Adoption Fees and to add the language for the discounted fees to MACC Certified Partners following the Metro Council’s anticipated approval of the fees. Dr. Foster seconded the motion, which passed unanimously. Approval of Grants and Contracts

Stan Romine referred to the Grants and Contracts Summary, which was submitted to Board members for their review. The grants and contracts were as follows:

1. Grant from the State of Tennessee, Department of Health, Compensation: $107,100.00 2. Grant from the State of Tennessee, Department of Health, Compensation: $116,000.00 3. Grant Amendment from the Department of Health and Human Services

Administration for Children and Families, Compensation: $2,441,777.29 4. Clinical Affiliation Agreement with University of Tennessee, Compensation: $0

May 9, 2013 Board of Health meeting minutes | Page 2 of 4

5. Grant Award from the State of Tennessee, Department of Health, Compensation: $725,200.00

6. Memorandum of Understanding with Vanderbilt University, Compensation: None 7. Grant Award from the State of Tennessee, Department of Health, Compensation:

$904,300.00

Mr. Felker made a motion to approve the grants and contracts as written. Dr. Batson seconded the motion, which passed unanimously.

Ms. Etherington asked that the information on the number of schools engaged in clinical affiliations with MPHD be provided at the July 11 meeting rather than at the June 13 meeting as she had requested at the April meeting. Approval of April 11, 2013 Meeting Minutes

Ms. Etherington made a motion to approve the minutes of the April 11, 2013 meeting as written. Dr. Batson seconded the motion, which passed unanimously. Report of Director

Copies of the Director’s Update to the Board were provided to Board members. Dr. Paul gave a summary of this report (Attachment V).

Mr. Felker asked that the Board be provided with Metro Animal Care and Control metrics at a future meeting. Dr. Paul noted that an update on MACC was planned for the July 11 or the August 8 meeting, as requested at the March 19 meeting.

CIVIL SERVICE BOARD Personnel Changes and Exit Interviews

Stan Romine presented the personnel changes and exit interviews, which were unremarkable. Mr. Romine noted that good progress had been made in filling positions vacated by the Voluntary Retirement Incentive, and that seven of the 20 positions cannot be filled until July 1.

Consideration of Proposed FY14 Pay Plan

Stan Romine presented a resolution adopting a new pay plan for the employees of The Metropolitan Board of Health effective January 1, 2014 (Attachment VI).

050913 Pay Plan Resolution.pdf

Dr. Foster made a motion to adopt the proposed pay plan for the employees of the Metropolitan Board of Health effective January 1, 2014. Dr. Batson seconded the motion, which passed unanimously.

May 9, 2013 Board of Health meeting minutes | Page 3 of 4

Next Meeting

The next meeting of the Board of Health will be held at 4:00 p.m. on Thursday, June 13, 2013, in room 212 of the Lentz Public Health Center. The meeting adjourned at 5:33 p.m. Respectfully submitted, William N. Hance, JD Chair

May 9, 2013 Board of Health meeting minutes | Page 4 of 4

Teens n Weed Marlesa Sims YAB Chairperson May 9, 2013

How did we get here?

Who took this survey? 382 surveys total Sex

Female = 59.4% Male = 40.6

Age 14 or younger = 7.8% 15 = 11.7% 16 = 22.3% 17 = 35.5% 18 = 22.6%

Ethnicity Black = 52.8 % White = 20.8% Asian = 5.9% Native Hawaiian or Other Pacific

Islander = 2% American Indian or Native Alaska – 4%

Next Steps…. Develop opportunities to conduct peer-

to-peer educational sessions in the schools.

Participate in community outreach events to raise awareness.

Partner with the PG-13 Players and do skits, poems or songs that increase the community’s awareness of marijuana use.

Recommendations for the Board of Health Be visible and come support future YAB

sponsored events. Appropriate funding to support YAB

initiatives. Establish an ongoing platform for youth to

serve in the advisory role to the Board of Health.

Special thanks goes to… Dr. Sanmi Areola Mrs. Nichelle Foster Dr. Celia Larson Mr. Jorge Luna Dr. Burns Rogers Dr. Kimberlee Wyche-Ethridge

-:= ib) ~~P:~ ~~~~!~ ~~~!t~Pue!?~ Ill Promoting and Protecting Health

3ae~olution A resolution endorsing July 7·July 13, 2013, as School Immunization Week in Davidson County and encouraging the Metropolitan Council to so proclaim it

WHEREAS, more than 300 children in the United States die each year from vaccine preventable diseases; and

WHEREAS, vaccines are among the most successful and cost-effective public health tools for preventing disease and death; and

WHEREAS, high immunization rates protect the entire community by interrupting transmission of disease-causing viruses; and

WHEREAS, Tennessee state law requires all children entering 7th grade to show proof of vaccination with a tetanus, diphtheria and pertussis {Tdap) booster and verification of immunity to varicella {chicken pox) through either two doses of vaccine or history of varicella; and

WHEREAS, fewer than 50 percent of MNPS students entering 7th grade in 2011 and 2012 had the vaccine or the proper documentation for these mandated immunizations; and

WHEREAS, a declaration of the importance of immunizations and a reminder of the legal requirements for 7th graders is needed to reduce the number of students who arrive at school without either the proper vaccinations or proof of same;

NOW, THEREFORE, BE IT RESOLVED by the Nashville Davidson County Board of Health that July 7 through July 13, 2013, is endorsed as School Immunization Week, and that the Metropolitan Council of Nashville and Davidson County is encouraged officially to proclaim it as such. Further, the Board of Health strongly recommends that all school age children have their immunization documentation reviewed and updated as needed to comply with public health practice and state law.

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Metropolitan Government of Nashville and Davidson County Animal Control Fees Per Metro Code of Ordinances Section 8.04.130 (A)

Impound fee* ................................................................................. $50.00 per animal

Boarding fees/per day*

Dogs .............................................................................................. $18.00

All others ......................................................................................... $4.00

Duplicate Tag .................................................................................. $2.00

Rabies vaccination ........................................................................ $10.00

License fee ...................................................................................... $6.00

Microchip implant ......................................................................... $25.00

Animal trap security deposit

Dogs ............................................................................................ $100.00/each

Cats ................................................................................................ $50.00/each

Kennels

1) For each kennel of less than ten dogs, twenty dollars per year or any fraction thereof; 2) For each kennel of from ten to twenty dogs, twenty dollars per year or any fraction thereof; 3) For each kennel of over twenty dogs, thirty dollars per year, or any fraction thereof.

* Per Metro Code 8.04.130 (E) the department may discount or waive these fees “when the dog has been impounded through no fault of the owner as determined by the director of health.”

Metro Animal Care and Control Adoption Fees Effective May 9, 2013 Adoption Fees

Dogs: Single Adoption .............................................................................................................. $90.00

Dogs: Litter Mates and double adoptions ............................................................................ $135.00

Cats: Single Adoption .............................................................................................................. $60.00

Cats: Litter Mates and double adoptions .......................................................................................... $90.00

Birds (Exotic birds are an additional charge) ...................................................................................... $15.00

Rabbits ...................................................................................................................................... $5.00

Ferrets ..................................................................................................................................... $10.00

Snakes and Lizards .................................................................................................................. $10.00

Guinea Pigs and Hamsters ........................................................................................................ $5.00

Livestock ................................................................................................................................. $50.00

Dog Seniors for Seniors (Senior Citizens age 60 or older or Dogs age 5 or older) ................... $45.00

Cat Seniors for Seniors (Senior Citizens age 60 or older or Cats age 5 or older) .................... $30.00

Special Community Adoption Events ...................................................................................... $30.00

Special Needs Animals ............................................................................................................ $15.00

Adoption fees include spay or neuter, rabies vaccination, medication and first series of shots Note: All fees on this schedule with exception of the two highlighted were approved by the Board of Health March 19, 2013. These were listed as $50 and $45.

Director’s Update May 2013 | Page 1 of 2

Director’s Update to the Board of Health May 9, 2013

Improve the health and well-being of children

WIC Mobile Vans

We have started a “soft” roll-out of the Mobile WIC program at several of the new sites. Overall the reaction from our clients has been very positive. One mom took the time to contrast her Mobile WIC experience with her previous visit to a clinic, which had been by bus, with child and stroller and related gear in tow, on a rainy day. Suffice it to say she was grateful the mobile WIC was made available.

Immunizations

Our Vaccines for Children program has been recognized by the Tennessee Department of Health for its outstanding work. The Hot shot awards are given by the Tennessee Immunization Program at the Annual Spring Immunization Review. They are given to VFC (Vaccine for Children) providers who meet certain stringent criteria.

The South Nutrition Center received a 100 percent compliance score on its 2012 VFC provider site visit, reflecting its adherence to vaccine storage and handling protocols, screening of patients for eligibility, documentation and vaccine accountability.

The East Public Health Center received the Immunization Excellence Silver Hot Shot Award for reaching 90 percent coverage levels for six of seven antigens in a series for patients up to two years old.

And Woodbine received the Immunization Excellence Bronze Hot Shot Award for achieving 90 percent coverage levels in five of the seven antigens in the series (the 4-3-1-3-3-1-4 coverage series).

Increase physical activity and healthy eating and reduce tobacco use in Nashville

State Tobacco Funding

In the recently adopted state budget, the state Department of Health allocated a $15 million sum of tobacco settlement revenue for a 95-county tobacco control effort. Local and regional health departments and health councils will submit proposals for funding. We do not yet know what amounts will be available for Davidson County and are awaiting guidance from the state.

Director’s Update May 2013 | Page 2 of 2

World No Tobacco Day

May 31 has been designated by the World Health Organization as World No Tobacco Day. We are partnering with the Parks Department and possibly others on an education campaign to combat cigarette butt litter.

Ensure cleaner air and a safer environment

We have issued a Notice of Violation against a property owner for a dump site on 26th Avenue North. Inspectors have determined that the dump site contains asbestos. This is an ongoing matter.

Management and accountability

Mayor Dean released his FY14 budget proposal last week. The Mayor’s proposal includes the full 2% budget reduction as presented to the board, and the addition of 3 new animal control officers, paid for with $150,000 raised by a $2 increase in the license fee. As you may recall, this restores staffing at MACC to levels present in 2007.

The Mayor’s budget does not include the planner/grant writer, IT position, or NashVitality coordinator in the Board of Health budget. At the time of this writing, we are developing a recommendation as to how to support these functions.

The Net impact of the Mayor’s budget is a reduction of $204,500 (1.15%) and a gain of 1 FTE.

The Tennessee Department of Health budget includes a cut of $118,000 in tuberculosis prevention services.

RESOLUTION NO. _________

A resolution adopting a new pay plan for the employees of The Metropolitan Board

of Health effective January 1, 2014.

WHEREAS, the Metropolitan Board of Health, acting in its official capacity as a Civil Service

Commission, has, pursuant to Sections 12.09 and 12.10 of the Metropolitan Charter, assigned each

employment classification to a salary grade as of July 1, 2013, with such assignments being equitably

related to each other; and,

WHEREAS, the Board of Health’s Civil Service Commission has adopted the salary ranges for each

grade; and,

WHEREAS, the Director of Personnel for the Board of Health has recommended, after the

Commission’s approval, desirable salary ranges for each grade to the Director of Finance; and,

WHEREAS, due to the economy, the Metropolitan Government experienced the need to implement

cost saving measures for FY10, FY11, FY12, and FY13 by delaying employee increment advances

each year; and,

WHEREAS, in light of the necessity to implement cost saving measures but still address the financial

needs of employees of the Metropolitan Government, increments were replaced in FY11 by a two

(2%) percent salary lump sum payroll adjustment, by passage of Resolution No. RS2010-1230, in

FY12 by a one and one-half (1.5%) percent salary lump sum payroll adjustment, by passage of

Resolution No. RS2011-1675; and in FY13 by a two (2%) percent and four (4%) percent across the

board salary increase, with the amount of increase depending upon the level of the classification, by

passage of Resolution No. RS2012-275; and,

WHEREAS, due to the economy, the Metropolitan Government once again needs to implement cost

saving measures for FY14 yet recognize the financial needs of all government employees; and,

WHEREAS, under current economic times, there are limited funds available each year to use for

salary increases for Metropolitan Government employees; and,

WHEREAS, the Board of Health’s Civil Service Commission has approved and recommended to the

Director of Finance to give a salary increase to all Metropolitan Government employees of the

Metropolitan Board of Health; and,

WHEREAS, the recommended increase for all employees of the Metropolitan Board of Health is one

and one-half (1.5%) percent, with such increase becoming effective as of January 1, 2014; and

WHEREAS, the Director of Finance has approved the recommendation of the Board of Health’s

Civil Service Commission and forwarded the same with a statement of full budgetary implications to

the Mayor for his approval; and,

WHEREAS, the Mayor has approved the plan and recommends its adoption by the Metropolitan

County Council.

NOW, THEREFORE, BE IT RESOLVED BY THE COUNCIL OF THE METROPOLITAN

GOVERNMENT OF NASHVILLE AND DAVIDSON COUNTY:

Section 1: The pay plan for the employees of the Metropolitan Board of Health, from and after

January 1, 2014, shall be as provided in Exhibit A. Exhibit A reflects a one and one-half (1.5%)

percent across the board pay increase. Exhibit A is incorporated into this Resolution as if fully set out

herein.

Section 4: This Resolution shall take effect on July 1, 2013, the welfare of The Metropolitan

Government of Nashville and Davidson County requiring it.

RECOMMENDED BY: INTRODUCED BY:

________________________________ ______________________________

Rita Roberts-Turner, Director

Metropolitan Department of Human Resources

______________________________

________________________________

Bill Hance, Chairman

Metropolitan Board of Health ______________________________

Members of Council

APPROVED AS TO AVAILABILITY

OF FUNDS:

________________________________

Rich Riebeling, Director

Metropolitan Department of Finance

APPROVED AS TO FORM

AND LEGALITY:

________________________________

Metropolitan Attorney

APPROVED AND RECOMMENDED TO THE

METROPOLITAN COUNTY COUNCIL FOR

ADOPTION:

________________________________

Karl Dean

Mayor

Ms. Etherington asked that the information on the number of schools engaged in clinical affiliations with MPHD be provided at the July 11 meeting rather than at the June 13 meeting as she had requested at the April meeting.Stan Romine presented the personnel changes and exit interviews, which were unremarkable. Mr. Romine noted that good progress had been made in filling positions vacated by the Voluntary Retirement Incentive, and that seven of the 20 positions cannot ...Stan Romine presented a resolution adopting a new pay plan for the employees of The Metropolitan Board of Health effective January 1, 2014 (Attachment VI).20130509YABpresentation.pdfTeens n WeedHow did we get here?Who took this survey?Slide Number 4Slide Number 5Slide Number 6Slide Number 7Slide Number 8Slide Number 9Slide Number 10Slide Number 11Slide Number 12Slide Number 13Next Steps….Recommendations for the Board of HealthSpecial thanks goes to…