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Geauga Public Health Board

LWV Geauga Observer Corps




Geauga Public Health District (GPHD) – Regular Meeting April 26, 2023


Meeting Details
: The GPHD Board met in Regular Session at the Geauga County Administration Building, 12611 Ravenwood Drive, Suite B303, Chardon, OH, on April 26, 2023 at 5 pm.  The agenda was available on the GPHD facebook page.  Geauga County Automated Data Processing (ADP) live streamed this meeting and the recording is available here. At publication, the recording has been viewed 75 times.


Public Comment Policy:
no separate written policy, but in practice, “Citizens’ Remarks” are included on the agenda and permitted as detailed there.


Board Attendance:
(as seated, from L to R).

  • Carolyn Brakey, President

  • Dr. Ashley Jones, Pro Tem (Absent)

  • Lynn Roman

  • Dr. Mark Rood  

  • Dr. Mark Hendrickson

Staff Attendance:

  • Ron Graham - Lake County General Health District Commissioner

  • Adam Litke - Administrator

  • Daniel Lark - Environmental Health Director (in the audience)

Legal Counsel: 

  • Bryan Kostura, McDonald Hopkins Law firm 


Call to Order
: called to order at 5:00 pm. The Pledge of Allegiance was recited.  

Ms. Brakey announced changes to the agenda. A discussion of the HB110 Audit findings was inserted after the approval of minutes of prior meetings. The Executive Session was moved to follow the Citizen’s Remarks.


Minutes:

  • March 15 Special meeting. Ms. Brakey proposed tabling the approval of the minutes of the Special Meeting of March 15. She said the minutes that were prepared contained many inaccuracies. She proposed having the new employee watch the video and rewrite the minutes.  A motion to table the approval was passed.

  • March 22 Regular meeting. A question was asked whether the minutes included all the reports that were discussed at the meeting. Mr. Litke stated that the minutes that would be posted on the website would include the reports to make everything more accessible to the public. Following a discussion of some other minor details, the minutes were approved with corrections.

As of April 29, 2023, approved minutes are posted online through March 2nd here.


HB110 Audit Findings (not on original agenda)

Bryan Kostura of the law firm McDonald Hopkins gave a presentation about the audit his firm conducted at the request of GPH. Observer Note: See the Observer Report from March 2, 2023 for more information about the HB110 program and the reason for the audit. In short, some of the inspections of semi-public sewage disposal systems in the last several years had not taken place although businesses and other establishments had been charged for these inspections.


Mr. Kostura’s team reviewed the documentation kept by GPH for inspections done between 2010 and 2022. Documentation includes things like applications for inspections, fees paid, inspections completed, etc. There were 5 phases of the review:

  1. Manual audit of hard copy files. There were over 1,000 files for individual businesses.

  2. Review of the on-site database (HDIS system) and cross check with the hard copy files. There were 471 businesses in this database (Mr. Kostura referred to this as database 1).

  3. Review of the off-site database (database 2). This database had 870 businesses.

  4. The team compared the 3 data sources and found a lot of holes in the data. To better understand where the money went, they examined the HB110 fee sheet (ie the general ledger) to track the money trail. They found that GPH had accepted $791,084 in fees for 577 properties from 2010-2022. But only 203 inspections could be documented in the 13 years, and 97 of these happened in 2022 ($33,172 in fees for the 203 inspections). This means that $757,912 in fees were accepted with no inspection.

Mr. Kostura described the deficiencies that were identified, including paper files being misfiled, duplicate records, and the need for file cleanup and file control and security. He said that records had gone missing during the audit period; records his team had reviewed could not be found at a later date while they were still conducting the audit.


There were questions and a discussion of why 3 record systems were needed. Mr. Litke said that database #1 had no way to append documents or inspection forms, while database #2 was primarily for scanning hard copies so they could be available from the field. 


Mr. Kostura’s team created a list of 566 unique addresses unduplicated across the 3 record systems. This is their best guess of how many businesses are actually in the program. They organized everything and found a wide variety of missing applications, payments, signatures, etc. He said there was no method in place for removing an address/business from the system if they became exempt. Also there was no way to confirm the inspection unless there was a report.

    5. 
Recommendations from Mr. Kostura’s team:

    • Have one unified list of addresses/businesses in the program

    • Put policies and procedures in place to document date (time stamp) and person responsible for application, inspection, payment, etc.

    • Checksheet for each address that responsible person signs 

    • Yearly review to look for omissions (internal audit)

    • Determine the best way to store the data

    • Have a policy for exemptions

The Board had several questions about the audit. These were answered by Mr. Kostura, Mr. Litke, and Mr. Lark.

  • Dr. Hendrickson - How many entities are covered in Geauga? Is there some type of certification that businesses have that could be used to identify them?

    • Mr. Litke and Mr. Lark mentioned that PTI could be used for this.  Reviewer Comment: We believe they are referring to the Ohio EPA Permit to Install form.

  • Dr. Rood asked what other counties do.  Mr. Lark said many counties use the HDIS system (database #1). Lake County scans all their hard copies and doesn’t retain them. Mr. Graham said the tools used by the counties are basically the same but are not always used appropriately.

  • Dr. Rood asked whether Mr. Graham is confident that Lake County has a good system, and why Geauga can’t have the same system as Lake. Mr. Graham said Lake has a good system, and there is one staff member who is making sure Geauga is all caught up with their data for 2023.

  • Ms. Roman asked why the audit started with 2010 data. Mr. Kostura said there was a good program prior to 2010, but around that time staff were reduced by 10 and remaining staff didn’t have time to keep up with the program.

  • Mr. Litke said now that the audit is completed they can move forward, he is confident that a good system can be put in place. 

  • Mr. Litke is notifying the state and is providing them with the audit results.

  • Dr. Hendrickson asked what led to the audit? Mr. Litke said he noticed things weren’t getting done so he asked Mr. Lark to look into it.  It was confirmed the work  was not getting done so they requested the external audit.

  • Mr. Litke said they are also getting caught up on nuisance complaints.

  • Mr. Graham said they are trying to get a list of businesses that should be in the program from the state.

  • Ms. Brakey asked what should be done about the $757,912 in fees that were collected for inspections that didn’t happen. Mr. Litke believes the county should refund the money. He said he can do an updated new budget for 2023 taking into account this extra expense.  Mr. Kostura said the county should hire a different legal firm that does class action lawsuits to act as the claims administrator. They would be more experienced in the work that needs to be done to identify the businesses, find out if they’ve moved, etc.  Money for the refunds and to pay the claims administrator would need to come from the GPH reserve fund, which had about $4 million at the end of 2022. Mr. Litke said they would come up with a new staffing plan for this work. Reviewer Comment: per Board Packet Chart 2, for the 3 months ended March 31, 2023, GPH revenues exceeded expenses by $638,110.08, increasing cash reserves to $4,888,464.72.  Reserves are spread across sixteen different funds and must be used for their designated purpose. Fund 6023, Sewage Treatment Systems, has a March 31, 2023 cash reserve balance of $908,935.84.

  • Mr. Roman asked what is the purpose of the reserve fund. Mr. Litke said it is for atypical, unexpected expenses. 

  • Mr. Litke said he spoke with Mr. Walder (Geauga County Auditor) how to handle the funds.

  • There was a discussion about scheduling a special meeting in the next two weeks to discuss this further, but no date was set (possibly May 17).

Presentation: Geauga DDC Clinic, Center for Special Needs Children (this was part of the Administrator report, but was moved up so the visitors would not have to stay through the rest of the meeting). Two staff from the Geauga DDC Clinic were in attendance, Patti Gallagher, Operations Director, and Valerie Sensi (?), a nurse at the clinic. The DDC clinic is located in Middlefield and provides many services to the Amish population.  


Mr. Litke is proposing that GPH provide one full-time and one part time nurse to assist with vaccinations at the DDC clinic every Wednesday. This would be in place of vaccinations that are currently being done for the Amish population at GPH, where transportation is difficult. Since the Amish population are already at the DDC clinic for other things, it would be easier for them to get their vaccinations there. Mr. Litke has spoken with state representatives and met with ODH to discuss possible grants to help the Amish population with vaccinations, eyesight clinics, and more. 


Dr. Rood commented that DDC does great work and this is a huge step forward. Mr. Graham also thanked DDC. The DDC staff said they are booked through September for vaccines, and those appointments are with people who are not regular DDC patients. The GPH Board seemed receptive to this plan.


Mr. Litke also provided the Board with information on a special needs fishing event that is sponsored by Commissioner Dvorak. ODH may provide fishing equipment donations to the children. 


Information Session


Population Health Update - Mr. Litke discussed a few items that were on the written population health report, which was not available to the public at the time of the meeting. Mr. Litke mentioned that the GVO grant (Get Vaccinated Ohio) is one that the State of Ohio will no longer provide to Geauga County because of the population size of the county, so it will be done in collaboration with Lake County, with Lake serving as the Lead Agency.


Environmental Health Update - The Board received a report which was not available to the public at the time of the meeting. Mr. Lark discussed two additional items:

  • Environmental Health hired a new environmental health specialist 

  • On April 15, GPH became the representative for small businesses smaller than the HB110 category, to help them with septic issues

Administration Division Update -  The Board received a report which was not available to the public at the time of the meeting. Mr. Litke discussed a few items from the report. 

  • Parkman Wells: Work on the Parkman Wells is finishing up. ODOT is going to remove the Parkman salt dome and clean up the site. State Representative Steve Demetriou and others played a huge role in making this move happen. 

  • Geauga Amish Population: Mr. Litke met with representatives from University Hospitals and they agreed to fund about $10,000 to resume doing Amish eye clinics at the Amish schools, and they are looking into grants for this. Mr. Litke is meeting with the Amish Superintendent, and Mr. Tiber (Trustee for Claridon Twp who had been in attendance at this meeting but left before this discussion) has been facilitating improved relationships with the Amish population. 

  • Operation and Maintenance: Mr. Lark and his team are getting this program up and running, to be launched in 2023.

  • ADP Technology Audit:  Mr. Litke has requested that ADP do a full technology audit and give recommendations for technology upgrades (for example the laptops are so old that staff find them too heavy to carry around). Ms. Brakey asked whether GPH is better insulated than Water Resources regarding being hacked, and Mr. Litke said GPH is fully on board with ADP as far as doing everything through ADP that they recommend.

  • State Audit: The audit for 2021-22 has started. The HB110 audit will be disclosed to the state and it will increase the cost and the scope of the audit. Ms. Brakey asked about the cost to GPH, GPH pays approximately $15,000 for the audit. Ms. Brakey did not find this cost excessive.

  • May 19 Press Day for Parkman Wells: Will be attended by state representatives, Ohio EPA, possibly the Governor’s office.

Dr. Rood asked how the transition to the new staffing arrangement under the Cooperative Agreement is going. Mr. Litke said the transition has been positive. There is one open position, for a Sanitarian. 


Finance Report (Adam Litke). This report was available to Board members, but not to the public at the time of the meeting. Mr. Litke mentioned that the Ohio EPA may provide an additional $600,000 to replace more Parkman wells and for landscaping. The cost to replace a well is about $30,000 to $40,000. At present Mr. Lark’s team has identified 16-17 wells in total that needed replacement, with one more street to check.


Health Commissioner Report - This report was available to Board members, but not to the public at the time of the meeting. Mr. Graham said that he sits on a grant committee of about 20 people for ODH and he can advocate for funding needs. He did an interview with the National Association of County Officials regarding the shortfall in funding for mental health needs post-COVID. He is working on several grant submissions. He is meeting with University Hospital’s benefits representative to assure staff at both counties can be served.  Staff hiring is going very well, with the best applicant pool they’ve had in two years. So in his opinion the partnership has paid off already.

 

Old Business

  • Adoption of change to Geauga County home sewage treatment rules (Section 3701-29-19e). Mr. Lark described the change that is being requested for the Board to approve. NPDES inspection sampling would be done by GPH rather than external service providers. With the current system, only 8% of the 1,600 systems were sampled last year and less than 25% of them met the criteria for water quality standards. The change will allow GPH to assure that sampling is done more completely and more cost effectively. Ms. Brakey read the first reading of the rule change. There was a motion to approve the first reading and it was approved. Mr. Litke said the Board had the option to waive the second reading to speed up the process. Dr. Rood asked if this was a matter of public health that should be expedited. Mr. Lark said his team won’t be ready to start the inspections until the time it would normally take for 3 readings so there was no need to waive the second reading.

New Business

  • April 2023 Financial Report:  Mr. Litke discussed a few items that were on the report that might need explanation. On the day-to-day current expenses report there was a payment to Farris Excavating for work done as part of the Water Pollution Control Loan Fund. Various Board members mentioned that they had not received this line item current expenses report. Mr. Litke said he would print copies during the Executive session so that this could be discussed and approved afterward.

  • Then and Nows: Mr. Litke requested permission to adopt two resolutions to authorize the payment of two Then & Now Purchase orders. One was for legal expenses, payment to Flannery Georgalis, LLC for $57,928.90. This included work on the cooperative agreement. The other was for a refund for a permit fee. Both resolutions were approved by roll call vote unanimously.

  • Permission to approve appropriations for Increase/Decrease (2023 Budget): This was tabled for possible action following the Executive Session. Mr. Litke said it was being postponed due to the HB110 issue. He did not think it would be appropriate to bring a budget to the board that he would have to change in 30 days.

Reviewer Comment: In addition to the fiscal changes that stem from the HB110 audit findings, 2023 Budget appropriations must be adjusted to reflect the impact of the March 15 cooperative agreement with LCGHD.  Refer to discussions that follow Executive Session.

  • Permission to approve the 2024 budget: Mr. Litke explained that although the Board discussed the 2024 budget and presented it during the March 15 HDAC meeting, the Board never passed a resolution to adopt the 2024 budget appropriations. Mr. Litke said the 2024 budget is a “pie in the sky” budget which does not include the Lake County contract. The budget will have to be heavily amended in December 2023. The budget that was shown to HDAC had a negative $468,000 balance. The 2024 budget was approved by voice vote. Reviewer Comment: Under ORC 3709.28 the GPH Board was required to adopt an itemized appropriations measure for the 2024 budget on or before April 1, 2023. LWVG has been unable to determine the implications, if any, of not meeting this statutory requirement. It is also unclear why GPH’s April 5th budget submission to the Auditor’s Office ignored the impact of the agreement passed 21 days earlier.

  • Resolution of Appreciation for Richard Piraino: Mr. Litke read the resolution and it was approved by voice vote.

  • Permission to appoint Becky Kelly as Registrar: Mr. Litke said the Registrar resigned at the end of March. Becky Kelly is currently the deputy registrar. This particular position requires Board approval. The motion to appoint Becky Kelly was approved by voice vote.

Citizen’s Remarks


Chris Alusheff, President of HDAC and Councilman for Aquilla Village - Mr. Alusheff said that once again the Board was in a tough spot, and he felt that the record should state that no one presently involved was here back in 2010 when the HB110 problems started. It’s the actions of the current board and staff that are responsible for bringing this problem to light and working toward a resolution and they should be encouraged to continue in working to solve the problems. He hopes this doesn’t get blown out of proportion as this board and GPH leadership had nothing to do with causing the problem. He thanked everyone for their work on this.


A private citizen spoke about a comment made by Mr. Piraino at the HDAC meeting that was interpreted to mean he didn’t think population health was important. She said that others have said the same thing that Environmental Health is most of what GPH does. She thinks Mr. Piraino just meant that GPH didn’t have as much work to do on the Population Health side of things. Mr. Graham stated that he would not have taken the position with GPH if they did not believe in Public Health.


Executive Session - The Board entered into Executive session at 6:41  pm to discuss pending litigation. Mr. Kostura, Mr. Litke, and Mr. Graham were invited to join the Board. Mr. Litke stated that there may be action taken after the Executive Session.  At 7:19 pm, the board came out of Executive session.


Continuation of Financial Report: At this time discussion of the April 2023 detail financial report resumed (postponed earlier because the Board did not have the report and Mr. Litke printed copies). Ms. Brakey asked what the Baldwin Group is, and Mr. Litke said that is the HDIS system yearly fee (database 1). She also asked about the Farris Excavating payment. The report was approved by voice vote.


Mr. Litke said he will prepare an updated 2023 budget to include the $850,000 in refunds and Claims Administrator fees, also the Lake County contract, and an increase in the fees for the HB110 audit that was conducted. If there is a special meeting it will be to discuss this revised budget, especially the refunds. Ms. Brakey asked if the refund cost could be calculated two ways, with and without interest payments.


Next regular  meeting: May 24, 2023 at 5 pm. There may be a special meeting prior to the May 24 meeting. All meetings at Geauga County Administration Building, 12611 Ravenwood Drive, Suite B303, Chardon, OH.


More Information
: http://gphohio.org/

Observer: Nina Lalich

Reviewer: Shelly Lewis


 The League of Women Voters of Geauga is a 501(c)(3) nonpartisan political organization that encourages informed and active participation in government, works to increase understanding of major public policy issues, and influences public policy through education and advocacy. They do not support or oppose individual candidates or parties. Learn more about the LWVG at www.lwvgeauga.org.


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