Board of Health

City of Columbia, Missouri Meeting Minutes Board of Health Thursday, February 9, 2017 Department of Public Regular Health and Human 5:30 PM Services Training Room 1 1005 W. Worley St. I. CALL TO ORDER The Columbia/Boone County Board of Health met for a regularly scheduled meeting at 5:30 p.m., Thursday, February 9th, 2017 at the Columbia/Boone County Department of Public Health and Human Services. Public Health and Human Services Assistant Director Scott Clardy represented the staff. After determining there was a quorum, Dr. Szewczyk called the meeting to order at 5:40 p.m. Present: 9- Cynthia Boley, Harry Feirman, Elizabeth Hussey, Sally Lyon, Lynelle Phillips, Jean Sax, Mahree Skala, David Sohl and Michael Szewczyk Excused: 2- Colin Malaker and Denise Stillson II. APPROVAL OF AGENDA There were no changes to the agenda. A motion was made by David Sohl, seconded by Cynthia Boley, and carried. The agenda was approved as presented. III. APPROVAL OF MINUTES Dr. Szewczyk requested a change to the minutes. The second sentence of the paragraph on the last page, which refers to information in the draft Animal Control report to Council, should read as follows: The Board believes compliance could be improved through better owner education regarding the licensing requirement and the availability to purchase the license directly from the City. A motion was made by Mahree Skala and seconded by Cynthia Boley and carried. The minutes were approved with this change. Attachments: January 12, 2017 Minutes - DRAFT City of Columbia, Missouri Page 1 Printed on 3/16/2017 Board of Health Meeting Minutes February 9, 2017 IV. REPORTS Director's Report Mr. Clardy reported the latest numbers for mumps cases is 370 total with 334 being students. The remaining are contacts of students. There have been 2,325 University of Missouri students who have received a third MMR. The department is working with Student Health to hold a mass vaccination clinic next week. The State health department has purchased 2,000 doses of vaccine. More can be ordered, if needed. Clinics will be held Wednesday, Thursday and Friday from 10:00 a.m. - 6:00 p.m. at Memorial Union. These clinics are open to any student. Student ID will be verified on the consent form. There was a lengthy discussion regarding the effectiveness of the vaccine and how the outbreak possibly began. Mr. Clardy noted that two-thirds of mumps cases are asymptomatic. Swelling of the parotid gland is a distinct symptom. Those infected are contagious before symptoms occur. There was further discussion regarding some of the more serious symptoms and complications of the disease. Mr. Clardy added that during the clinics, there will be an hourly inventory of vaccine and reports to the state, so that more doses can be requested, if needed. County Commissioner Report None V. OLD BUSINESS PDMP Update Mr. Clardy reported that stakeholder meetings were held on Friday of last week as well as Monday of this week. Information was sent to physicians and pharmacists with a copy of the draft ordinance making them aware of the meetings. While there was not a huge turnout (nine attendees on Friday and two on Monday), several emails were received with all but one voicing agreement with the City joining St. Louis County’s PDMP program. Paperwork has been completed to send the information to Council. The first reading will be on February 20th. There are two bills; one will be to establish the PDMP ordinance and the other will authorize the City Manager to sign the necessary user agreement with St. Louis County. City of Columbia, Missouri Page 2 Printed on 3/16/2017 Board of Health Meeting Minutes February 9, 2017 Second readings will hopefully be on March 6th. Data collection will begin April 25th. This means, if the bill passes, the City will be in the first round of data collection. Mr. Clardy advised the Board that the Council meeting on the March 6th is expected to be very lengthy due to other agenda items. It was recommended that Board members interested in providing feedback to Council, do so via e-mail or phone. The primary concern of the individual who was not in favor of Columbia participating in the program was that this should be done on the statewide level. While Mr. Clardy agreed to some extent, he noted that with Columbia located on a major interstate in the middle of the state, this would still give our healthcare providers and pharmacists more information than they have at this time. He feels it will help protect the community as well. Other concerns dealt with possible exposure of personal medical information. There was a question regarding data collected from this ordinance and access to that data. Mr. Clardy commented that the National Board of Pharmacy operates a platform that can be shared among states. However, states can decide whether or not to share the data as well as putting limits on who can see the data. Since the last meeting, Cole County has passed a PDMP ordinance; however Jefferson City has not yet passed it (they are expected to pass the ordinance). This is the opposite situation as what we have in Boone County. Columbia will pass the ordinance in hopes that Boone County will as well. There are 1,085 providers in Boone County. Of those, 17 are outside the City of Columbia. There was a question regarding City/County jurisdiction. Mr. Clardy explained state law gives authority to the County to cover other areas including smaller municipalities if it is shown to be a dangerous disease, which opioid addiction is. Animal Control Follow-up Attachments: Szewczyk Handout - Draft Animal Control Communication to Council Dr. Szewczyk referred to the draft animal control Council communication he City of Columbia, Missouri Page 3 Printed on 3/16/2017 Board of Health Meeting Minutes February 9, 2017 distributed earlier. Licensing requirements in other communities were discussed briefly. There were questions as to the purpose of the lifetime license and how it relates to the rabies vaccination. For those members who were not at the last meeting, Dr. Szewczyk explained that an animal had to have the one or three year rabies vaccine in order to be licensed. While owners may be getting their pets vaccinated, they are not getting the license. Tying the two together has no effect of who is getting vaccinated and given the extremely low number of cats and dogs that are licensed, it has no effect on licensing. At the last meeting, it was agreed that, for multiple reasons, licensing of dogs should continue. Dogs are more likely to be in the public, bite other dogs and humans, need to be captured by animal control and checked on when in impoundment. Licensing can provide revenue to cover the cost of Animal Control and other services. After a brief discussion, Dr. Szewczyk agreed to review the wording to clarify this information. The Board then discussed the quarantine period requirements and processes. It was suggested that the first requirement be modified to clarify that the rabies vaccination needed to be “up to date”. Dr. Szewczyk will make that change to the report. VI. NEW BUSINESS Legislative Update Mr. Clardy reported the State Legislature has introduced around 1,300 bills this session, which is less than the 2,300 introduced by this time last year. March 1st is the deadline for introducing new bills. The following are those that are related to public health issues: There have been six bills introduced that include some form of a PDMP. Two are House bills, both heard on February 7th. Even though there have been hearings, there has been no other action on these bills. The first Senate Bill is Senate Bill 74 and Senator Schaaf’s version of a PDMP. Some issues with this bill are that a person’s data is only kept for a rolling 180 days and then deleted. Physicians would not see actual data but the State Health Department would identify individuals of concern. This bill was heard on January 25th. Senator Schatz has also introduced Senate Bill 231, which is similar to past PDMP bills and those adopted in other states. Both bills were heard at the same time and had over 200 people attending to testify. Senator Schaaf is chairman of the committee City of Columbia, Missouri Page 4 Printed on 3/16/2017 Board of Health Meeting Minutes February 9, 2017 where these bills were heard and SB 74 has been voted out of committee “Do Pass”. Sen. Schatz refiled his bill as SB 341. It has been referred to another committee, which has voted it out of committee “Do Pass”. There was discussion regarding a filibuster of these bills. Mr. Clardy explained the process for passing bills and the changes made this year related to filibuster and the use of it as a time factor. There was a question on whether or not these bills would limit a city or county from enacting their own program. Mr. Clardy explained that, in general, there is statute that states local ordinances can be more restrictive than State laws, but they cannot be less restrictive. He ended by saying this is clearly a major issue and will be watched. He added that a letter was sent from the Missouri Association of Local Public Health Agencies with information in favor of SB 231 and against SB 74. He then discussed the motorcycle helmet law. Currently, all riders are required to wear a helmet. There have been four bills introduced. All had hearings on Tuesday and all say something slightly different. Some include age requirements and fines. Others modify wording based on age and insurance, education, or license requirements and specifies that a person may not be pulled over by a law enforcement officer solely to determine compliance with the helmet requirements of this bill. One bill includes just this information. None have had any action taken on them beyond a hearing. There was discussion as to the Governor’s stance on this issue. It is unknown, but Mr. Clardy observed that the various state departments will be able to provide recommendations to the Governor. Should it pass out of the legislature, the Missouri Department of Health and Senior Services will provide information at that time. He then reported there is a House Bill and a Senate Bill related to texting and driving. They are both exactly the same and prohibit anyone, regardless of age of sending, writing or reading text messages or electronic messages from a handheld device while operating a motor vehicle. Currently, only those 21 years of age or younger are prohibited from texting and driving. Hands free and voice recognition devices are allowed. These bills have not yet been assigned to a committee. City of Columbia, Missouri Page 5 Printed on 3/16/2017 Board of Health Meeting Minutes February 9, 2017 He reminded the Board that last year, there were bills related to pharmacists’ ability to administer contraceptives without a prescription from a physician. There have been two bills introduced this year that are the same bill and would allow for this prescribing and dispensing of self-administered oral contraceptives. Last year, one of the bills allowed for dispensing of patches. These bills only involve oral contraceptives. These bills also have not yet been assigned to committee. There are stipulations related to who can receive them. Several bills were introduced last year related to advanced practice nurses. So far, there has been one introduced this year. Currently, the collaborative practice arrangement is required to have a provision to maintain geographic proximity. This can be waived for a maximum of 28 days for rural health clinics. This bill would change that and waive any geographic proximity requirement. There have been two new vaccine bills introduced. One bill states that no vaccine containing mercury or other metal preservative shall be administered to a child or adult in a public health clinic in Missouri. This only impacts the multi-dose flu vaccine, which many smaller health departments use. Another bill introduced relates to shingles and varicella vaccine and states that for shingles and varicella, only vaccines which produce the highest available immune response and contain no foreign, human DNA contaminants will be administered in public health clinics in Missouri. The issue is that both these vaccines are grown in material that originated from two human cell lines that originated from a fetus. There are not alternatives to these vaccines. Both bills have been second read and have not been assigned to a committee. Mr. Clardy noted health departments are asked to report the fiscal impact of these types of bills. VII. GENERAL COMMENTS BY PUBLIC, MEMBERS AND STAFF None VIII. NEXT MEETING DATE Thursday, March 9th, 2017 at 5:30 p.m. IX. ADJOURNMENT City of Columbia, Missouri Page 6 Printed on 3/16/2017 Board of Health Meeting Minutes February 9, 2017 The motion was made by Dr. Hussey, seconded by Dr. Lyon, and approved that the meeting be adjourned at 7:00 p.m. Members of the public may attend any open meeting. For requests for accommodations related to disability, please call 573-874-7214. In order to assist staff in making the appropriate arrangements for your accommodation, please make your request as far in advance of the posted meeting date as possible. City of Columbia, Missouri Page 7 Printed on 3/16/2017