Operation & Maintenance Program Now Largest Geauga Public Health Program, Requiring Additional Staff & Potentially More Space;
Two New Spots Becoming Available on GPH Board in 2025
Geauga Public Health (GPH) - November 20, 2024
Meeting Details: The GPH Board met in Regular Session at the Geauga County Administration Building, 12611 Ravenwood Drive, Suite B167-168, Chardon, OH, on November 20, 2024 at 5 pm. This meeting was live-streamed by Geauga County ADP. The Agenda is posted on the GPH Facebook page a few days prior to the meeting and then on the GPH website. Numerals in this document refer to the agenda items. The video is available here and minutes listed in this document refer to the time in the video when the item was discussed. At the time of this report the video had been viewed 61 times.
Public Comment Policy: There is no separate written policy, but in practice “Citizens’ Remarks” are listed on the agenda and are permitted as detailed there.
Board Attendance: (as seated, from L to R).
Absent: Dr. Mark Hendrickson
Staff Attendance:
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Adam Litke, Administrator (end of table left)
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Ron Graham, Health Commissioner for both Geauga and Lake Counties (end of table right)
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Dan Lark, Director of Environmental Health (second from right)
Others Present: A member of the public and this observer (virtually)
1.0 Call to Order
Called to order at 5:00 pm.
2.0 Opening of Meeting
The Pledge of Allegiance was recited. A quorum was declared. Dr. Rood certified the delivery of official notices of meeting.
3.0 Board of Health:
3.01 The Board approved Minutes of the Regular Meeting held on October 30, 2024 after discussion and one change. Dr. Rood addressed citizen remarks made by Dr. Andrea Ward who discussed the lack of OB/GYN care and standard care for the Amish population. Dr. Rood clarified that he thinks Dr. Ward was referring not to “standard care” but to the “standard of care” and the document was adjusted. Dr. Rood also asked if the State Medical Board and State Pharmacy Board had been contacted regarding issues discussed at the October meeting concerning midwives delivering babies in Amish communities. Mr. Litke said former health commissioner Dr. Jeffrey Cameron, who is an OB/GYN, reached out to say that there is no one who governs the process. Dr. Rood asked if the State Medical Board would have jurisdiction, and Mr. Graham said no but that the State Pharmacy Board might. Mr. Graham said he was researching the topic and would provide more information at the December meeting. Dr. Jones added that if medication is being dispensed “I think that’s probably where there’s a line in the sand,” adding that this is just her personal opinion.
Observer Note: Board of Health Published Minutes have previously been up-to-date; however, the most recent minutes published are for the August 28, 2024 Regular Meeting. Use the down arrow under “Select Category” at the top to search for the correct year at the link provided. Please see the October 30, 2024 GPH LWVG Observer Report for more information on Dr. Ward’s comments mentioned above.
4:15 minutes
4.0 Health District Staff Reports
Observer Note: These reports are available with the Agenda on the Geauga Public Health (GPH) website here.
4.01 Population Health Report
Mr. Litke explained that they have hired a new health educator, Ella Ergazos, who will be handling GPH’s website and social media sites, posting information on healthy habits including exercising, cooking and things you can do to improve your health.
Mrs. Brakey noted in the report on communicable disease that there had been one case of monkeypox this year in the county as well as an uptick in cases of gonorrhea. Dr. Jones wondered about the process for reporting cases of the flu, saying that she feels it is misleading to only report data on those hospitalized and not overall cases. Mr. Graham noted that some flu cases are not reportable. Mrs. Brakey wondered if some of the Covid vs flu cases “...kind of switched a little bit” and Dr. Jones said it wouldn’t surprise her due to the way patients are tested with Respiratory Syncytial Virus (RSV), Covid and flu on the same swab in some settings. Dr. Rood noted that most Covid tests are being done at home and with flu tests often a clinical judgement is made (without a positive flu test) since it can take 18 hours to get back test results. He noted that Tamiflu, a flu remedy, must be prescribed quickly as it’s most effective within the first 48 hours. “If you miss that window, you miss the opportunity to help someone,” he added.
7:17 minutes
4.02 Environmental Health Report
Mr. Lark reported that GPH held a joint conference the day before with Lake County Health Department for Sewage Installers, Haulers and Service Providers from both counties that was sold out with 160 attendees. Mr. Lark said attendees gave good feedback on the speakers. Contractors reported that response times from the GPH are shorter now, in some cases dropping from “...four months to four days,” allowing contractors to do more jobs. Dr. Jones noted that she had heard complaints from contractors about timeline delays in the past but she says she no longer hears those complaints.
9:47 minutes
4.03 Administrator’s Report
Mr. Litke explained a variety of financial items that the board would be voting on during New Business. These include amending the 2024 Contract with Lake County General Health District to include specific positions that were approved by the board but couldn’t be funded by the Auditor’s Office without this information. “We couldn’t pay the Lake Geauga bill for the past two months, so we need to redo this and make an amendment to it,” Mr. Litke explained.
Another vote under New Business is approving the Amended 2025 Geauga Public Health Budget. Mr. Litke explained that they are in need of a full time fiscal person due to the increased workload from the Operation & Maintenance Program (O&M) and that 20 hours a week “...won’t cut it.” Observer Note: Currently Mr. Litke is serving in that role as well as the role of Administrator. There is also an item in the budget to hire a sanitarian (public health specialists to manage non-compliance issues with home septic systems) next year, but Mr. Litke said they may push that off until 2026 to be cautious due to the lag in reimbursement with O&M. Mr. Litke explained that O&M is now the largest program in the health department and has the largest cost center and that because of the way the program is structured, the county receives permit fees if residents pay them. When residents don’t pay the fees, Mr. Lark explained they often will have to wait up to a year and a half to receive those funds. Mr. Lark said that typically they receive about 60% of funds upfront with about 40% being in arrears, creating the challenge for budgeting. Mr. Lark said that GPH will be drafting a grant proposal that will offer assistance to homeowners who are having issues maintaining their septic systems due to financial issues. Mr. Lark said they’ll present the grant information at the December board meeting and that, to his knowledge, they are the first in the state to take this action.
Mr. Litke said that overall expenses in the 2025 budget outpace revenue by $268,000 due to the upcoming purchase of vehicles ($200,000) and the addition of a sanitarian ($68,000) as required due to the O&M program; However, he reiterated that this position may be delayed until 2026 if O&M revenues next year are less than anticipated. These additional expenses will be covered by cash carryover from reserves that have been built up over time. Dr. Jones asked if GPH would still be operating at a cost savings in 2025, and Mr. Litke said that they would due to the reduction in personnel resulting from the merger with the Lake County Health Department. Mrs. Brakey asked about the age and trade in value of current vehicles, and Mr. Litke noted that cars for the food staff must be replaced every five years; food service employees receive the new cars and then their old cars are shifted to other staff members and used for various tasks, including those related to sanitary and sewage treatment.
22:30 minutes
4.04 Health Commissioner’s Report - See Agenda for Complete List
Mr. Graham reported that he is gathering research on the situation regarding midwives that was addressed at the October meeting. He noted having sensitivity to the University Hospital workers “... and things that were said out of context or on video.” He said he would have a report at the December meeting and that the Pharmacy Board is being contacted. Dr. Jones noted that this is something people feel passionately about but to remember that comments made are personal stories and personal opinions and not the views of any one entity.
23:08 minutes
5.0 Old Business
5.01 Geauga County Administration Building Rent and Space Discussion
Mr. Litke had nothing new to report on the rent and space issue, as the County has not as yet appointed an attorney for GPH. Reviewer Note: Numerous meetings have discussed how much GPH should pay to the County for GPH’s space in the new County Office Building and how much of the GPH space should be allocated to Automatic Data Processing (ADP). After this GPH meeting was held, the County Commissioners voted not to charge GPH rent at the November 26, 2024 County Commissioners Meeting.
5.02 Resolution to Decrease Certain Fees, Household Sewage Treatment Systems Program, Third and Final Reading
Motion to Approve the Third and Final Reading: Roll Call- Aye: Rood, Brakey, Bowdren; Abstain: Jones
24:56 minutes
6.0 New Business
6.01.01 Financial Reports, Resolution 24–11-06-01-01 - There were several questions related to payments for the cross jurisdictional agreement with Lake County that were answered by Mr. Litke, who said the budget is on track “...for where we expected it to be.”
Resolution to approve Financial Reports passed unanimously by voice vote.
6.01.02 Permission to Approve Appropriations for Increase/Decrease - Mr. Litke said this adjustment included a correction as to the account where funds were being transferred.
Resolution to approve Appropriations for Increase/Decrease passed unanimously by voice vote.
6.02 Permission to Approve the Amended 2025 Geauga County Public Health Budget - Mr. Litke explained the increased costs needed for the 2025 budget during his Administrator’s Report earlier in the meeting. Mr. Litke hopes to push off filling the new Sanitarian position until 2026, but he said they’ll have to see “...how long we can keep (the) status quo without being behind either.”
Resolution to Approve the Amended 2025 Geauga Public Health Budget passed unanimously by voice vote.
6.03 Permission to Amend the Contract with Lake County General Health District for Calendar Year 2024 - As mentioned in his Administrator’s report, Mr. Litke repeated that these costs for the O&M program were approved by the board previously but without listing the specific positions, as required by the County Auditor.
Resolution to Approve the Amend the Contract with Lake County General Health District for Calendar Year 2024 passed unanimously by voice vote.
6.04 Permission to Amend the Contract with Lake County General Health District for Calendar Year 2025 - Again Mr. Litke referred to his previous comments that these costs refer to the O&M program staffing adjustments related to a fiscal coordinator and possibly a clerk, depending on the volume and flow of the workload. Mr. Litke noted that this would be an annual amendment needed to the contract as they track expenses and revenues related to the O&M program.
Resolution to Amend the Contract with Lake County General Health District for Calendar Year 2025 passed unanimously by voice vote.
6.05 Permission to Enter Into a Contract with HS GovTech, $62,256.25 - Mr. Lark explained that this is a new software program that will replace the current software that is from the 1990s. It will allow online payments, remote access by staff and the ability for the public to view health violations online. Mr. Lark said it will take three to six months to get the program up and running. Dr. Jones asked if payments could still be made by check for those without internet access, and he said they could. Mr. Lark said the program is widely used elsewhere to his knowledge and that the cost is half of that for other programs they considered.
Resolution to Enter Into a Contract with HS GovTech for $62,256.25 unanimously approved by voice vote.
6.06 Permission to Purchase Vehicles, Not to Exceed $200,000 - Mr. Litke explained that currently two local dealerships had bid on two different models of trucks which is why exact bids were not presented at this meeting. He asked that the board approve a “lowest and best bid” not to exceed $200,000.
Permission to Purchase Vehicles Not to Exceed $200,000 unanimously approved by voice vote.
40:00 minutes
7.0 No Citizen’s Remarks - At this time, Mr. Litke honored Mrs. Brakey, who is resigning from the GPH board after winning her election to the Board of County Commissioners. Presenting her with flowers and chocolates and with cupcakes for all, Mr. Litke said Mrs. Brakey “...came to us during a stressful time and helped us change a lot of things…and in my opinion has been a force for good.” He said he appreciated her “non-doctor” perspective. He congratulated her for her participation in the board being “...the first ones to kind of fix masking in my opinion within the schools…the first ones to get the kids back.” Dr. Jones added that when she joined the board, “...my head was underwater” and that when Mrs. Brakey came on, she felt “...she kind of pulled me out a little bit and spearheaded the change.” Mrs. Brakey said she felt sad about leaving and that she’d really enjoyed the experience, adding “...I feel like we’ve made a lot of good change.” Mr. Litke noted that the whole board has promoted positive change and that “...it does not go unnoticed” by other counties who he said “...are shell shocked” by everything the GPH board has accomplished in a short time, including getting on track with the O&M program and creating the jurisdictional agreement with Lake County.
Mr. Litke noted with regret that Dr. Rood would also be leaving the board next year as his seat expires in March 2025 and he will not be seeking reappointment. As a result, the GPH board will be seeking two new members in 2025.
8.0 Executive Session - No session requested
Motion to Adjourn at 47:39 minutes
Next Regular Meeting: December 18, 2024 at 5:00 pm. All meetings are held at the Geauga County Administration Building, 12611 Ravenwood Drive, Suite B167-168, Chardon, OH.
More Information: Geauga Public Health
Observer: Anne Ondrey
Editor: Sarah McGlone
Reviewer: Gail Roussey
Submission Date: 12/10/24
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