INGHAM COUNTY BOARD OF COMMISSIONERS

Transcription

1 CHAIRPERSON MARK GREBNER CHAIRPERSON PRO TEM CHRIS SWOPE VICE-CHAIRPERSON PRO-TEM MIKE SEVERINO HUMAN SERVICES COMMITTEE JOHN CZARNECKI, CHAIR LISA DEDDEN MICHAEL SEVERINO CURTIS HERTEL JR. VICTOR CELENTINO INGHAM COUNTY BOARD OF COMMISSIONERS P.O. Box 319. Mason, Michigan Telephone (517) Fax (517) THE HUMAN SERVICES COMMITTEE WILL MEET ON TUESDAY, OCTOBER 23, 2001, AT 7:20 P.M., IN THE FIRST FLOOR CONFERENCE ROOM, INGHAM COUNTY COURTHOUSE, MASON. Agenda Call to Order Approval of the August 27, September 18 and October 1, 2001 Minutes Additions to the Agenda Limited Public Comment 1. Health Department a. Resolution to Authorize an Agreement with the Michigan Fitness Foundation b. Resolution to Establish a Clinical Physician Position Announcements Public Comment Adjournment The County of Ingham will provide necessary reasonable auxiliary aids and services, such as interpreters for the hearing impaired and audio tapes of printed materials being considered at the meeting for the visually impaired, for individuals with disabilities at the meeting upon five (5) working days notice to the County of Ingham. Individuals with disabilities requiring auxiliary aids or services should contact the County of Ingham in writing or by calling the following: Ingham County Board of Commissioners, P.O. Box 319, Mason, MI Phone: (517) A quorum of the Board of Commissioners may be in attendance at this meeting.

2 HUMAN SERVICES COMMITTEE August 27, 2001 Minutes Members Present:: Members Absent: Others Present: John Czarnecki, Lisa Dedden, Mike Severino, Curtis Hertel Jr. and Victor Celentino John Neilsen, Jerry Ambrose, Bruce Bragg, Terri Younger, Judy Garvey, Bob Sheehan, Joe Lessard, John Jacobs, Susan O Shea, Mary Shalaman, Joan Nelson, Rick Kibbey, and Randy Marwede The meeting was called to order by Chairperson Czarnecki at 7:05 p.m. in the Personnel Conference Room of the Human Services Building, 5303 South Cedar, Lansing. Additions to the Agenda: Limited Public Comment: 1. Budget Overview - Human Services Mr. Ambrose stated the Controller s Recommended Budget is status quo. A few departments may disagree with this statement. In response to Comm. Dedden, Mr. Ambrose explained that the distribution of the community agency allocation will be determined at a future meeting. 2. Budget Hearings a. Community Agency Appropriation MOVED BY COMM. HERTEL, SUPPORTED BY COMM. CELENTINO, TO APPROVE THE CONTROLLER S RECOMMENDED BUDGET FOR THE COMMUNITY AGENCY APPROPRIATION. MOTION CARRIED UNANIMOUSLY. b. Community Mental Health Mr. Sheehan distributed information regarding CMH s budget to the Committee for their review. He thanked the Committee for its cooperation and commitment to CMH. He asked the Committee to reconsider an increase in the allocation for jail services. Mr. Sheehan reviewed the information regarding the $2.9 million deficit CMH faces in This information was received by the Committee. (Comm. Severino arrived at 7:13 p.m.) MOVED BY COMM. DEDDEN, SUPPORTED BY COMM. CELENTINO, TO APPROVE THE CONTROLLER S RECOMMENDED BUDGET FOR COMMUNITY MENTAL HEALTH. MOTION CARRIED UNANIMOUSLY.

3 MOVED BY COMM. DEDDEN, SUPPORTED BY COMM. HERTEL, TO PLACE $57,450 ON THE Z LIST FOR JAIL-BASED SERVICE FOR COMMUNITY MENTAL HEALTH. MOTION CARRIED UNANIMOUSLY. c. Cooperative Extension Mr. Lessard stated he appreciates the support and commitment the Cooperative Extension has received from the Board of Commissioners. Cooperative Extension accepts the Controller s Recommended Budget on all activity areas with the exception of the Community Development Agent position. The Extension has requested $41,783 to continue the Agent position on an annual basis for the next three years. This position was developed in support of an extensive community collaboration which emanates from the Human Services Advisory Committee. The position has supported fundamental work within area communities. Mr. Lessard further explained the financial implications of this position. The City of Lansing probably would not be willing to continue its funding for this position at the Controller s recommended amount. Ms. Garvey asked the County to join a strong partnership within the community. The Network Center system consists of five network centers in economically disadvantaged neighborhoods throughout the City of Lansing. The Center receives support from the Family Independence Agency, Strong Family/Safe Family State and Federal grants. The Center also receives funding from the Health Department through the Access to Health grant. A portion of the Agent s budget is supported by the City of Lansing. The Agent position provides oversight to the development of the Network Centers. The position provides technical assistance and resource development to the Centers. Ms. Garvey further explained the duties of the Agent. She requested the County continue to assist the Agent in meeting the needs of the Centers. Ms. Nelson explained that the Agent plays a critical role in overseeing the growth and development of the Centers. The Centers would not run as smoothly as they do without the Agent position. Mr. Kibbey, Chair of Network Advisory Board, stated the County is a major player in the older neighborhoods within the County. The Centers are portals of the County programs. Mr. Kibbey requested the continued support of the Agent Position from the County. In response to Comm. Celentino, Ms. Garvey stated many people utilize the services of the Centers. The Centers do not track the number of people they serve at this time. People are often referred to the Ingham Health Plan. Ms. Nelson explained that young adults who are dropped from their parents insurance policies are served by the Centers. They are referred to the appropriate agencies. Ms. Nelson spoke regarding specific programs for this population. The Center has also set up programs to assist youth that have dropped out of school. Comm. Severino expressed his support for the Network Centers. In response to Comm. Severino, Mr. Lessard stated the City of Lansing is a good partner. The Extension is asking for a three-year extension. It is not asking for a permanent position. 2

4 In response to Comm. Hertel, Ms. Garvey stated she would be happy to work with the Meridian Township Resource Coordinator regarding its needs. In Response to Comm. Dedden, Mr. Lessard stated he did not know what would happen if the County did not approve this funding request. Mr. Lessard explained that the Agent position was born out of an early conceptualization from the Human Services Advisory Committee and others. A coordinator is needed to move the work of the Centers and to bring the community forward. The Extension challenged MSU to become involved with the Network Centers. Non-recurring funds were identified in the Extension s regional administrative office. MOVED BY COMM. HERTEL, SUPPORTED BY COMM. DEDDEN, TO APPROVE THE CONTROLLER S RECOMMENDED BUDGET FOR COOPERATIVE EXTENSION. MOTION CARRIED UNANIMOUSLY. MOVED BY COMM. HERTEL, SUPPORTED BY COMM. CELENTINO, TO PLACE $16,783 ON THE Z LIST FOR THE NETWORK CENTER COORDINATOR POSITION. Chairperson Czarnecki stated he agreed with Mr. Ambrose that the Committee should be very cautious as it proceeds through this budget hearing. He further stated this is truly a Lansing staff position. The City should want to continue this position as it is a City function. He stated he will support this for However, he has serious reservations. The City should step up to the table regarding this position. MOTION CARRIED UNANIMOUSLY. d. Family Independence Agency Ms. Shalaman stated the Family Independence Agency accepts the Controller s Recommended Budget. MOVED BY COMM. CELENTINO, SUPPORTED BY COMM. SEVERINO, TO APPROVE THE CONTROLLER S RECOMMENDED BUDGET FOR THE FAMILY INDEPENDENCE AGENCY. MOTION CARRIED UNANIMOUSLY. Chairperson Czarnecki stated the Committee is also approving the Capital Improvements Budget when it approves the Controller s Recommended Budget. e. Health Department Mr. Bragg stated the Health Department accepts the Controller s Recommended Budget. He distributed an Analysis of the 2002 Controller s Recommended Budget to the Committee. Under the Recommended Budget, the Health Department s $23 million budget will grow to approximately $24 million. The one million increase continues the Health Department s 3

5 workforce, the services and the activities of the Department through The increase is supported by revenue generated by the Department. Mr. Bragg reviewed the information contained in the Analysis. The actual Decrease in General Fund Expenditures for FY2001 to FY2002 is approximately $29,000. Mr. Bragg explained that the Department has some arrangements which specifically prohibits substitution of revenue from other sources. If revenue comes in better than projected, the Department may present recommendations for one-time expenses in In response to Comm. Dedden, Mr. Bragg stated he does not know at this time if all the Department s General Fund dollars have been used as County matches. A strategy will have to be developed to address this issue. Mr. Bragg reminded the Committee that the County Budget operates on a calendar year. The Department s fund works on an October 1 through September 30 budget year. MOVED BY COMM. HERTEL, SUPPORTED BY COMM. CELENTINO, TO APPROVE THE CONTROLLER S RECOMMENDED BUDGET FOR THE HEALTH DEPARTMENT. MOTION CARRIED UNANIMOUSLY. g. Medical Examiner Mr. Bragg stated the uncontrollable cost for the Medical Examiner s Office is associated with autopsy rates. A major expense of the office is associated with fees paid to physicians who act as deputy medical examiners. MOVED BY COMM. HERTEL, SUPPORTED BY COMM. CELENTINO, TO APPROVE THE CONTROLLER S RECOMMENDED BUDGET FOR THE MEDICAL EXAMINER S OFFICE. MOTION CARRIED UNANIMOUSLY. f. Medical Care Facility Ms. O Shea reminded the Committee that the Facility is not independent from the County. It relies on the Controller s Office for advice and support. The Facility is appreciative of this support. Medicaid is the major source of funding for the Facility. A decrease is expected in the Medicaid rate for This will create a challenge for the Facility. Ms. O Shea also informed the Committee the Facility has received its second deficiency free survey in two years. This is outstanding. Ingham County has received state-wide recognition for this accomplishment. In response to Comm. Dedden, Ms. O Shea stated Michigan residents do not qualify for Hillburton funds because they are eligible for Medicaid. However, each Facility resident receives information regarding Hillburton funds. In response to Chairperson Czarnecki, Ms. O Shea stated the Facility would support the Parks Board s use of some Facility property. 4

6 MOVED BY COMM. HERTEL, SUPPORTED BY COMM. CELENTINO, TO APPROVE THE CONTROLLER S RECOMMENDED BUDGET FOR THE MEDICAL CARE FACILITY. MOTION CARRIED UNANIMOUSLY. h. Substance Abuse MOVED BY COMM. CELENTINO, SUPPORTED BY COMM. HERTEL, TO APPROVE THE CONTROLLER S RECOMMENDED BUDGET FOR SUBSTANCE ABUSE. MOTION CARRIED UNANIMOUSLY. Mr. Neilsen stated Robin Reynolds, Executive Director, stated she could not be present this evening as she had a board meeting to attend. She did inform Mr. Neilsen that she is happy with the Controller s Recommended Budget. Mr. Ambrose informed the Committee that if the County did not appropriate these funds to Substance Abuse, the County would have to roll back taxes. i. Transportation Millage MOVED BY COMM. DEDDEN, SUPPORTED BY COMM. HERTEL, TO APPROVE THE CONTROLLER S RECOMMENDED BUDGET FOR THE TRANSPORTATION MILLAGE. MOTION CARRIED UNANIMOUSLY. j. Tri-County Aging Consortium In response to Comm. Hertel, Mr. Ambrose explained that the Controller s Recommended Budget contains the amount as requested by the Tri-County Aging Consortium. Mr. Ambrose stated Ms. Peterson could not be present tonight due to a family emergency. She is happy with the Controller s Recommended Budget. Chairperson Czarnecki stated Comm. Hertel should speak with Ms. Peterson regarding his concerns. k. Veteran Affairs Mr. Marwede stated Veteran Affairs is a tri-county agency which consists of 4.5 FTE s. Veteran Affairs deals with many quality of life issues. MOVED BY COMM. HERTEL, SUPPORTED BY COMM. CELENTINO, TO APPROVE THE CONTROLLER S RECOMMENDED BUDGET FOR VETERAN AFFAIRS. MOTION CARRIED UNANIMOUSLY. 5

7 l. Women s Commission MOVED BY COMM. HERTEL, SUPPORTED BY COMM. CELENTINO, TO APPROVE THE CONTROLLER S RECOMMENDED BUDGET FOR THE WOMEN S COMMISSION. MOTION CARRIED with Comm. Czarnecki voting NO. 3. Final Ranking MOVED BY COMM. HERTEL, SUPPORTED BY COMM. CELENTINO, TO RANK COOPERATIVE EXTENSION S NETWORK CENTER COORDINATOR POSITION ($16,783) AS NUMBER ONE AND TO RANK COMMUNITY MENTAL HEALTH S JAIL- BASED SERVICES ($57,450) AS NUMBER TWO. The Committee discussed this motion briefly. Chairperson Czarnecki stated he could not support the motion. He believes the Jail-Based Services is a much higher priority to the citizens of this County than the Network Center Coordinator position. The City of Lansing should cover the true costs of the Network Center position. MOTION CARRIED with Comm. Czarnecki voting NO. Announcements: Public Comment: The meeting adjourned at 8:40 p.m. Respectfully submitted, Debra Neff 6

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9 HUMAN SERVICES COMMITTEE September 18, 2001 Minutes Members Present:: Lisa Dedden, Mike Severino, Curtis Hertel Jr. and Victor Celentino Members Absent: Others Present: John Czarnecki John Neilsen and Bruce Bragg The meeting was called to order by Vice Chairperson Dedden at 7:20 p.m. in the First Floor Conference Room of the Ingham County Courthouse, Mason. Approval of the August 20, 2001 Minutes MOVED BY COMM. HERTEL, SUPPORTED BY COMM. CELENTINO, TO APPROVE THE AUGUST 20 MINUTES AS PRESENTED. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Czarnecki Additions to the Agenda: Limited Public Comment: MOVED BY COMM. SEVERINO, SUPPORTED BY COMM. CELENTINO, TO APPROVE A CONSENT AGENDA FOR THE FOLLOWING ITEMS: 1. Cooperative Extension - Resolution Proclaiming 2002 as the Year of 4-H 2. Health Department a. Resolution to Amend Resolution and Authorize the Health Department to Obtain Services from Nextel Communications b. Resolution to Authorize a Contract with the Barry-Eaton District Health Department for Medical Direction and Program Consultation MOTION CARRIED UNANIMOUSLY. Absent: Comm. Czarnecki MOVED BY COMM. SEVERINO, SUPPORTED BY COMM. CELENTINO, TO APPROVE THE ITEMS ON THE CONSENT AGENDA. MOTION CARRIED UNANIMOUSLY. Absent: Comm. Czarnecki 3. Board Referrals a. Mid South-Substance Abuse Commission s Financial Audit for Fiscal Year 1999/2000 b. Letter from Marquette County Health Department Regarding the City of Marquette s Smoke-Free Ordinance

10 The Board Referrals were received and placed on file. Announcements: Public Comment: The meeting adjourned at 7:21 p.m. Respectfully submitted, Debra Neff 2

11 HUMAN SERVICES COMMITTEE October 1, 2001 Minutes Members Present:: Members Absent: Others Present: John Czarnecki, Lisa Dedden, Mike Severino, Curtis Hertel Jr. and Victor Celentino John Neilsen, Mark Grebner, John Jacobs, Richard McNulty, Bob Sheehan and Bob Godbold The meeting was called to order by Chairperson Czarnecki at 7:00 p.m. in the Personnel Conference Room of the Human Services Building, 5303 South Cedar, Lansing. Additions to the Agenda 2d. Resolution to Authorize the Purchase of a Prefabricated Household Hazardous Waste Storage Facility from Safety Storage, Inc. d. CMH - Resolution in Support of Comprehensive Coverage for Medicaid Recipients in the State of Michigan s Medicaid 1115 Waiver Request Limited Public Comment: 4. CMH - Resolution in Support of Comprehensive Coverage for Medicaid Recipients in the State of Michigan s Medicaid 1115 Waiver Request Mr. Sheehan apologized for the lateness of this item. He explained the Mental Health and Substance Abuse system in this State currently operates under the 1915 Waiver. This Waiver allows the State to retain the Mental Health public system and to keep the mental health and substance abuse separate from the fiscal health benefit fund. The Federal Government has also stated the States should discontinue the use of special financing which totals $700 million to one billion dollars in Michigan. The elimination of these funds from Michigan s budget will occur over a four-year period, from 2003 through Waiver 1115, known as a superwaiver will be used in place of Waiver The Health Insurance Flexibility Demonstration Act has called for expedited Waiver approval. CMH has several concerns regarding this issue. Waiver 1115 opens many restrictions on Medicaid programs. However, it also allows incredible harm to Medicaid recipients. This harm can include significant reductions in the health care benefits to optional beneficiaries. This is a large segment of Medicaid recipients who are currently covered by Michigan s Medicaid program. Another harm can include significant decreases in cost sharing requirements for the indigent persons who are enrolled in Medicaid. The Waiver 1115 application and approval process is purely administrative. It requires no oversight by the State legislature nor by Congress. Michigan officials are actively working to complete the Waiver

12 application process. The Resolution ensures the following: That Waiver 1115 not supercede the existing waivers; Categories of beneficiaries currently receiving Medicaid services retain their eligibility for the full range of benefits; All specialty services that covered under the current waivers continue to be covered; The existing funding base for the Medicaid specialty services system be preserved in its entirety; The projected budget deficits that are driving Waiver 1115 be resolved within the context of the entire State budget and not be limited to the Medicaid program and its enrollees; The process be opened to public discourse. Comm. Severino stated he appreciates Mr. Sheehan s position. However, this issue is disappointing because people within the healthcare community are trying to resolve the parity issue. Parity is probably more important to the mental health community. Comm. Severino stated he would not support this matter. In response to Comm. Severino, Mr. Sheehan stated he appreciates Comm. Severino s position. Waiver 1115 means a $4 million budget cut for Michigan. The Parity bill is a huge issue for CMH. In response to Comm. Dedden, Mr. Sheehan explained that another special financing mechanism is being considered. MOVED BY COMM. DEDDEN, SUPPORTED BY COMM. HERTEL, TO APPROVE THE RESOLUTION IN SUPPORT OF COMPREHENSIVE COVERAGE FOR MEDICAID RECIPIENTS IN THE STATE OF MICHIGAN S MEDICAID 1115 WAIVER REQUEST. MOTION CARRIED with Comm. Severino voting NO. 1. County Attorney - Update on Litigation with Granger Corporation MOVED BY COMM. CELENTINO, SUPPORTED BY COMM. HERTEL, TO ENTER INTO CLOSED SESSION FOR THE PURPOSE OF DISCUSSING LITIGATION WITH GRANGER CORPORATION. THE MOTION WAS APPROVED WITH THE FOLLOWING ROLL CALL VOTE: YEAS; COMMS. CZARNECKI, DEDDEN, SEVERINO, HERTEL AND CELENTINO. The Committee returned to regular session. 2. Health Department a. Resolution to Authorize a C Agreement with the Family Independence Agency MOVED BY COMM. CELENTINO, SUPPORTED BY COMM. HERTEL, TO APPROVE THE RESOLUTION TO AUTHORIZE A C AGREEMENT WITH THE FAMILY INDEPENDENCE AGENCY. MOTION CARRIED UNANIMOUSLY. b. Resolution to Authorize a Agreement with the Michigan Department of Environmental Quality 2

13 In response to Comm. Dedden, Mr. Godbold explained that Non-Community Public Water Supply users are small restaurants and party stores which use well water. The users serve more than 15 customers but less than 25 customers. MOVED BY COMM. CELENTINO, SUPPORTED BY COMM. HERTEL, TO APPROVE THE RESOLUTION TO AUTHORIZE A AGREEMENT WITH THE MICHIGAN DEPARTMENT OF ENVIRONMENTAL QUALITY. MOTION CARRIED UNANIMOUSLY. c. Resolution to Authorize an Agreement with Lansing-Mason Ambulance for Medical Examiner Transports MOVED BY COMM. CELENTINO, SUPPORTED BY COMM. HERTEL, TO APPROVE THE RESOLUTION TO AUTHORIZE AN AGREEMENT WITH LANSING-MASON AMBULANCE FOR MEDICAL EXAMINER TRANSPORTS. d. Resolution to Authorize the Purchase of a Prefabricated Household Hazardous Waste Storage Facility from Safety Storage, Inc. Mr. Neilsen stated the Board originally approved this project with Resolution # However, the State was anxious to receive the order for the Facility. Therefore, this item should be approved at the next Board meeting. Only a limited number of vendors offer this service. The matter was submitted through the normal Purchasing process. MOVED BY COMM. HERTEL, SUPPORTED BY COMM. SEVERINO, TO APPROVE THE RESOLUTION TO AUTHORIZE THE PURCHASE OF A PREFABRICATED HOUSEHOLD HAZARDOUS WASTE STORAGE FACILITY FROM SAFETY STORAGE, INC. MOTION CARRIED UNANIMOUSLY. 3. Controller s Office - Resolution Authorizing Adjustments to the 2001 Ingham County Budget Mr. Neilsen explained that the Resolution authorizes standard adjustments to the 2001 Budget. He also responded to technical questions from Comm. Dedden. A memorandum will be issued to Comm. Dedden further clarifying her concerns regarding the Community Corrections item in the Adjustments. MOVED BY COMM. SEVERINO, SUPPORTED BY COMM. DEDDEN, TO APPROVE THE RESOLUTION AUTHORIZING ADJUSTMENTS TO THE 2001 INGHAM COUNTY BUDGET. MOTION CARRIED UNANIMOUSLY. Announcements Mr. Neilsen informed the Committee that Ingham Regional Medical Center will host the next committee meeting which is scheduled for October 15, Directions will be included in the agenda packet. 3

14 Chairperson Czarnecki suggested Mr. Neilsen contact Sparrow Health Systems regarding the possibility of holding a meeting at their facility. Public Comment: The meeting adjourned at 8:00 p.m. Respectfully submitted, Debra Neff 4

15 Agenda Item 1a RESOLUTION STAFF REVIEW DATE October 9, 2001 Agenda Item Title: Resolution to Authorize an Agreement with the Michigan Fitness Foundation Submitted by: Health Department Committees: Ad.Ser/Per., H.S. *, Law & Cts., Finance * Summary of Proposed Action (see attached letter of explanation) This resolution will authorize a contract with the Michigan Fitness Foundation during FY Through the agreement, the Health Department will provide staff support for the Mid-Michigan Regional Fitness Council. The Mission of the Fitness Council is To educate residents in the seven county service area on the benefits of physical activity and provide them ways of becoming physically active, regardless of age, physical health, or socioeconomic status. Financial Implications The total budget for the agreement is $67,500 with the Michigan Fitness Foundation reimbursing Ingham County up to $37,500; $5,000 which will come from contributions of several parties and Ingham County contributing $25,000 of in-kind services. The funds are anticipated and included in the Health Department s 2002 budget. Other Implications Staff Recommendation: JA JN * HH This resolution should be approved.

16 Agenda Item 1a MEMORANDUM To: From: Human Services Committee Finance Committee Bruce Bragg Date: October 16, 2001 Subject: Agreement with the Michigan Fitness Foundation This is a recommendation to authorize a contract with the Michigan Fitness Foundation. Through the agreement, the Health Department will provide staff support for the Mid-Michigan Regional Fitness Council. The Mission of the Fitness Council is To educate residents in the seven county service area on the benefits of physical activity and provide them ways of becoming physically active, regardless of age, physical health, or socioeconomic status. By supporting the activities of the Mid-Michigan Regional Fitness Council, the Department accomplishes an important function of support of physical activity and physical fitness. Sedentary lifestyle and obesity are important risk-factors for people of all ages. It is estimated that 12% of all deaths could be prevented each year by having people increase their physical activity levels. The Regional Council meets monthly and supports a number of initiatives to promote physical activity and sports in the Mid-Michigan area. Three statewide initiatives are promoted each year. Two address the serious problem of childhood obesity. The Health Department s work to support the Regional Fitness Council enhances its ability to promote physical activity in residents of all ages. I recommend that the Board of Commissioners adopt the attached resolution and authorize the agreement with the Michigan Fitness Foundation. Attachment cc: Bob Glandon w/attachment John Jacobs w/attachment Don Diskey w/attachment

17 Agenda Item 1a Introduced by the Human Services and Finance Committees of the: INGHAM COUNTY BOARD OF COMMISSIONERS RESOLUTION TO AUTHORIZE AN AGREEMENT WITH THE MICHIGAN FITNESS FOUNDATION WHEREAS, the Ingham County Health Department has provided staff support to the Mid-Michigan Regional Fitness Council for several years; and WHEREAS, the Michigan Fitness Foundation administers funds under the guidance of the Governor s Council on Physical Fitness, Health and Sports to broaden statewide awareness of the health benefits of physical fitness and to increase the level of physical activity of Michigan citizens; and WHEREAS, the Michigan Fitness Foundation has contracted with Ingham County for several years to provide administrative support to the local chapter, Mid-Michigan Regional Fitness Council, and proposes to continue that arrangement during FY ; and WHEREAS, the Health Officer recommends that the Board of Commissioners authorize the agreement with the Michigan Fitness Foundation and advises that the funds are anticipated and included in the Health Department s 2002 budget. THEREFORE BE IT RESOLVED, that the Ingham County Board of Commissioners authorizes an agreement with the Michigan Fitness Foundation to provide administrative support for the activities of the Mid-Michigan Regional Fitness Council for the promotion of physical fitness, health and sports in Michigan. BE IT FURTHER RESOLVED, that the agreement period shall be October 1, 2001 through September 30, BE IT FURTHER RESOLVED, that the total budget for the agreement shall be $67,500 with the Michigan Fitness Foundation reimbursing Ingham County up to $37,500; $5,000 which will come from contributions of several parties and Ingham County contributing $25,000 of in-kind services.

18 Agenda Item 1b RESOLUTION STAFF REVIEW DATE October 9, 2001 Agenda Item Title: Resolution to Establish a Clinical Physician Position Submitted by: Health Department Committees: Ad.Ser/Per. *, H.S. *, Law & Cts., Finance * Summary of Proposed Action (see attached letter of explanation) This resolution will authorize the establishment of a fourth clinical physician position in the Health Department. The Department currently employs three full-time clinical physicians. This fourth position would replace the relationship we have with Michigan State University for coverage 20 hours per week. Financial Implications The costs would be absorbed through the existing Health Department budget through the existing MSU contract and vacant nurse(s) positions. Other Implications Staff Recommendation: JA JN * HH This resolution should be approved.

19 Agenda Item 1b MEMORANDUM To: From: Human Services Committee Administrative Services/Personnel Committee Finance Committee Bruce Bragg Date: October 16, 2001 Subject: Recommendation to Establish a Clinical Physician Position This is a recommendation to establish a fourth clinical physician position in the Health Department. The Health Department operates a network of eight health centers that provide managed care/ primary care services to about 7,000 Medicaid eligible persons enrolled in two health plans under contract with the State of Michigan: McLaren Health Plan and Physicians Health Plan. Additionally, these health centers are responsible for managed care/primary care services for about 10,000 persons enrolled in the Ingham Health Plan. And, these same health centers provide categorical health services to about 15,000 persons through the Family Planning and Sexually Transmitted Disease Programs. The primary care providers in the health centers are employed and contracted physicians (about five full-time equivalent) and employed Nurse Practitioners (about 10 full-time equivalents). The Department currently employs three full-time clinical physicians. This fourth position would replace the relationship we have with Michigan State University for coverage 20 hours per week. Michigan State University's College of Osteopathic Medicine, Department of Family Medicine is going through some transition. The MSU Health Team, the unit at the University now directing the clinical practice for both medical colleges, has proposed that the County employ its own family practice/internal medicine physician as quickly as possible. MSU Health Team will continue to provide the pediatric physician services established in the existing contract. The Department's Health Centers are struggling to meet patient demand. In addition to the challenge of working with the MSU situation, one and onehalf Nurse Practitioner positions are vacant and the County is unable to recruit and fill these positions. I am proposing that the Board of Commissioners establish a fourth clinical physician position effective November 1, I propose that the Human Resources Director be authorized to post the position as part-time and as full-time. If it is possible to recruit and employ a full-time physician, it could be funded from the savings of the contract with MSU and from savings from the vacant Nurse Practitioner positions (either of them), and one of the vacant Nurse Practitioner

20 Agenda Item 1b positions would not be filled. If the Nurse Practitioner positions are both filled prior to the employment of a physician, then the physician position would be only available as a part-time position. Attached is a resolution to authorize the establishment of a fourth clinical physician position. I recommend that the Board of Commissioners adopt the resolution and establish the position. Attachment cc: John Jacobs w/attachment Bruce Miller w/attachment Terri Younger w/attachment Charlyn Stratton w/attachment Greg Wilhelm w/attachment

21 Agenda Item 1b Introduced by the Human Services, Administrative Services/Personnel and Finance Committees of the: INGHAM COUNTY BOARD OF COMMISSIONERS RESOLUTION TO ESTABLISH A CLINICAL PHYSICIAN POSITION WHEREAS, the Health Department operates a network of community health centers, providing managed care services to approximately 7,000 Medicaid eligible persons enrolled in Physicians Health Plan and McLaren Health Plan, and about 10,000 persons enrolled in the Ingham Health Plan, and provides categorical family planning, sexually transmitted disease control and other services to an additional 15,000 persons; and WHEREAS, the primary care providers for the network of community health centers are employed physicians and contracted physicians and employed nurse practitioners; and WHEREAS, the MSU Health Team has proposed that the contractual relationship be modified to terminate the half-time family practice physician services it provides; and WHEREAS, the County has been unable to fill two vacant Nurse Practitioner positions; and WHEREAS, the Health Officer proposes that the Board of Commissioners establish a fourth clinical physician position within the Health Department, which will be posted as both full-time and part-time. THEREFORE BE IT RESOLVED, that the Ingham County Board of Commissioners establishes a fourth clinical physician position, effective November 1, BE IT FURTHER RESOLVED, that the Human Resource Department is authorized to post the new position as both part-time and full-time. BE IT FURTHER RESOLVED, that the Health Officer is authorized to fill the full-time clinical position if funds are available through salary savings from one of the vacant Nurse Practitioner positions.