Riley County - Manhattan
Board of Health Report
Wednesday, September 28 2011

The department highlight for the education of the board members was presented by Patti Grub, RN, Communicable Disease Nurse. Her specific activity is to investigate all reported communicable diseases in terms of causes and prevention as well as maintenance of records for future study and use. Her investigations vary from season to season and year to year. At the present time, the issue seems to be bats which could be rabid and that are getting into houses. One child was bitten, and so far, one bat has been found to be rabid. Her job also provides education to clients as to what to do, in this case, if bitten by a bat. She is usually informed first by Animal Control in the case of bats but receives reports from doctors and other clinics as well. A lively discussion followed concerning the cost of the vaccinations required if a bite from a rabid animal is suspected, which seems to hover around $2,000 or more. Dr. Hesse, board member from Fort Riley, reminded the board that Fort Riley has had a recent death from rabies in a soldier who was bitten in Afghanistan, and thus, are seeking all soldiers who could have been infected while on deployment. He noted that the supply of vaccine could become limited locally.

Next Michelle Crew from Varney’s & Associates presented the audit of the 2010 financial records. She delivered the assessment as “the best you can get,” or in other words “on a strong financial footing.” She commended Shelly Hays, Financial Officer for the department, for her excellent work and helpfulness during the audit. Her only suggestion was to consider doing periodic reviews. Charles Murphy noted that the state also performs audits, as do some of the grants, such as WIC (stands for Women, Infants, and Children). Discussion followed as to the audit procedure next year when the Health Department will be county only.

Charles Murphy, Department Administrator, reported on the possible purchase of a new pharmacy refrigerator to house vaccines if it becomes necessary. The cost would be $4,826.43. At present, the new temperature control monitor has been installed and seems to be working well. Susanne Kufahl, Assistant Administrator, stated that it was of primary importance that care be taken that vaccines are kept properly. Dr. Hesse suggested that careful power back-up is important. Loren Pepperd, representative of the City Commission, suggested looking into an emergency device that is hooked directly to the refrigerator and comes on automatically. Charles Murphy will look into this in terms of possibly replacing the present generator now in use for this purpose.

The major item of business was the discussion of whether the Health Department should begin accepting Medicaid clients in the Primary Care Clinic. Susanne Kufahl presented a great deal of information about Medicaid itself and the department’s ability to provide care for this population. If anyone is interested in having this information, the Kansas Health Institute’s web site, www.khi.org, is a good place to find it. Ms. Kufahl reported that she had contacted all other Medicaid providers, all of whom were supportive of the idea. It is expected that the numbers of Medicaid clients will increase. Access for Medicaid clients to the medical community is limited, and many are turned away. Dawn Searls, Clinical and Nursing Supervisor, stated that it is very hard to have to turn away Medicaid clients.

The present Primary Care Clinic, begun 20 years ago, is designed to serve poor and uninsured residents of Manhattan and Riley County who could not access care at private physician practices, Fort Riley or Lafene Student Health at Kansas State University. Dr. Cary Herl, who is the supervising physician for the clinic, stated that he was for allowing the Health Department to accept Medicaid clients and felt the department was well able to accommodate the additional patients. He stated that this would be phased in gradually and can be limited at any time it seemed necessary. Children would not be part of the Medicaid clients as they are already taken care of by the pediatricians in town.

Dr. Paul Hesse, who had indicated earlier that he is philosophically opposed as he believes the department will be overwhelmed, indicated that accepting Medicaid patients will be a distraction to the major requirements for providing for public health. He stated that it would be better to have a FQHS (Federally Qualified Health Clinic) for this purpose. Susanne Kufahl noted that she differed on the definition of public health practices in that, though public health focuses on connecting people to the care that they need, that when that is not possible, the Public Health Department should be providing that care.

The Health Department voted to begin to accept Medicaid patients using a phased-in process and with continued reviews. Dr. Hesse and Debbie Nuss voted no.

There is some disagreement between Charles Murphy and the city on the interpretation of the ordinances dealing with nuisances. Clancy Holeman, attorney for the county, will be

at the next board meeting to discuss the issue.

Finally, the board was given a preview of the new brochure produced to encourage Riley County’s long term investment in KIDS.

Submitted by Sue Cohen