HomeMy WebLinkAbout11162010BOHAGENDA ITEM SUMMARY
SPECIAL MEETING DATE: November 16, 2010
AGENDA ITEM TITLE:
Public and Environmental Health Quarterly Update
and 2011 Public Health Budget Review with the
Board of Health
STAFF RESPONSIBLE: Nan Sundeen
ISSUE STATEMENT: This is the fourth Quarterly Update for 2010 between the Board of
Health, Community Health Services, Inc. (CHS) and Pitkin County Environmental Health.
CHS is submitting a 2011 budget totaling $966,156 (an 8.3% increase from 2010) for
approval. They are entering the second year of a three year partnership with the Healthy
Community Fund, with a yearly allocation of $271,205.
As outlined in the Public Health Act of 2008 (25-1-511) paragraph 4, the Board of Health
is required to "estimate the total cost of maintaining the county public health agency for
the ensuing fiscal year and submit an estimated budget to the Board of County
Commissioners for approval." The Board of County Commissioners is then "authorized
to provide any moneys necessary, over estimated moneys from surpluses, grants and
donations, to cover the total cost of maintaining the agency for the ensuing fiscal year by
an appropriation from the County General Fund."
BACKGROUND: CHS, a non-profit organization, has continued in a three year grant
partnership with Pitkin County with an award of $271,205 for 2011, to provide public
health services for the residents and workers of Pitkin County. In addition, Pitkin County
has provided in -kind rent and utilities to CHS in the amount of $43,947. In 2010, CHS
also received a grant of $63,000 from the City of Aspen for the provision of public health
services. Other CHS revenues come from state and federal grants and client fees.
CHS 2011 Budget
The CHS board of directors met on Tuesday, November 9th and approved the proposed
2011 public health budget. Today Liz Stark, Pitkin County Public Health Director, will
be presenting the CHS proposed 2011 budget to the Board of Health. A budget buy -up
for a .5 RN position submitted as part of the 2010 budget process was approved in 2010.
CHS has since made other staffing adjustments, prior to filling this position. The agency
is evaluating further staffing changes for the coming year.
Proposed 2012 Budget Process for CHS
Last year, staff recommended that the Board of Health direct CHS, HHS and Finance to
work together on developing a public health 'base budget', with the goal of having CHS
work within the Pitkin County budget process so that funding could be dedicated at a
certain percentage out of the Healthy Community Fund, in much the same manner as is
1
done with Senior Services. Because Pitkin County contracts with a non-profit agency for
the provision of public health services instead of managing a county department of public
health, the public health budget process has become complicated. First, CHS is required
to submit a grant every three years to the HCF in August. CHS has a finance committee
that recommends an annual budget to their board of directors in November. The CHS
board of directors must approve a budget and submit their recommendations to the Board
of Health with a recommendation to approve. The Board of Health then recommends an
annual public health budget to the Board of County Commissioners, and then, the BOCC
makes final approval.
In the coming year staff intends to work together with CHS to determine a base budget
and evaluate the merits of giving CHS a certain percentage of the HCF fund when it is
renewed in 2012.
Other Public Health Updates
Liz Stark, Carla Ostberg and Tom Dunlop have presented updates in their memo
(attachment A).
Dr. Cohen will also present some key information on the current flu season, pertussis and
meningitis.
LINK TO STRATEGIC PLAN: Goal 1: Pitkin County residents, employees and visitors
will live in a safe, secure and healthy environment; Goal 5: Pitkin County health and safety
staff will successfully partner with other public, private and non-profit entitites (locally,
regionally and nationally); Goal 7: Pitkin County residents will have access to quality
health services.
KEY DISCUSSION ITEMS:
1. Review CHS proposed 2011 budget and recommend 2011 funding for public
health.
2. Review other items in the CHS quarterly report.
3. Receive updates by Dr. Cohen on the current flu season, as well as on pertussis and
meningitis.
BUDGETARY IMPACT: Total CHS 2011 request for $271,205 would come from
the Healthy Community Fund.
RECOMMENDED BOCC ACTION:
1. Approve 2011 CHS budget ($966,156) as well as the level of funding from HCF
($271,205).
2. Review other items presented by Liz Stark, Morris Cohen, Tom Dunlop and Carla
Ostberg
ATTACHMENTS:
A) Memo from Liz Stark, Carla Ostberg, and Tom Dunlop
B) CALBOH information sheet
C) 2011 CHS proposed budget, 2010 Profit and Loss statement, 2010 balance sheet
2
ATTACHMENT A
MEMO FROM LIZ STARK, CARLA OSTBERG, TOM DUNLOP
COMMUNITY
HEALTH SERVICES, INC.
0405 Castle Creek Rd., Suite 6 . Aspen, CO 81611, Phone: (970) 920-5420 . FAX: (970) 920-5419
To: Pitkin County Board of Health
From: Liz Stark RN, Pitkin County Public Health Director; Director, Community Health
Services, Inc.; Carla Ostberg, Pitkin County Environmental Health; Tom Dunlop, Pitkin
County Environmental Public Health Advocate
Date: November 10, 2010
Re: Quarterly Board of Health meeting on November 16`h, 2010
Below please find a summary of our activity since our last meeting.
BUDGET:
Attached is Community Health Services, Inc. (CHS) 2011 budget with a comparison to the 2010
budget. The CHS Finance committee approved the budget on November 9`h. The 2011 budget
shows an 8% increase over 2010. The majority of the increase can be seen in client fees,
specifically prenatal fees for Eagle County. In 2010, we have also seen an increase in the
number of Pitkin County prenatal clients, so we are predicting that this will continue. Year end
financials for 2010 are still unpredictable at this time. We have compared current income and
expenses and included 2011 promised contracts and grants along with trends in program growth
and the economy. At the end of 3rd quarter 2010, we were approximately 5% over budget. We
expect an increase in 4th quarter expenses due to flu clinic activities, prenatal deliveries and
contraceptive expenses. Below is a brief explanation of specific line items in the budget.
INCOME
• 3112: Income/ Family Planning Contraceptive Income: The majority of these funds come
from the Colorado Family Planning Initiative , (CFPI) which constitutes a separate grant
from the State Family Planning/STD grant listed under State of Co Health Dept
Contracts. This grant fluctuates a great deal during the year. The State often gets
additional funds and is able to provide these specifically for the purchase of long -acting
reversible contraceptives (LARC's). We budgeted additional funds for 2011 anticipating
this increase. We are over budget in this line item so far in 2010, illustrating the
variability of this grant. There is also a slight increase due to reallocating some funds
from the State Family Planning Grant to this category which is specific to contraceptive
income. This line item also includes client fees for contraceptives.
• 3150: Flu Shots: Flu shot income has been extremely variable over the last couple of
years due to H1N1 and the circumstances surrounding seasonal flu last year, making it
COMMUNITY
HEALTH SERVICES, INC.
0405 Castle Creek Rd., Suite 6 . Aspen, CO 81611, Phone: (970) 920-5420 . FAX: (970) 920-5419
difficult to accurately predict the outcome. Our budgeted amount for 2010 was low due to
the income we saw at 3`d quarter 2009. Every year the goal is to have enough flu vaccine
on hand to immunize as much of the general public as we can. Every year, the
circumstances change and create fluctuations in the demand. This is our best guess based
on how much vaccine we feel we should have on hand.
• 3155: IncomehPrenatal Fees: These fees represent the fees paid by prenatal clients who
live in Pitkin County. The fee is $1200/client. On average, we receive $800/client. The
budgeted number was calculated on the expectation of seeing approximately 35 women
from Pitkin County in 2011. We are considerably over budget in this line item for 2010
as our numbers are much higher than predicted.
• 3156: Income/ Prenatal Fees/ Eagle: This line item was not in last year's budget. Due to
the multiple sources of income for Eagle County Prenatal clients (client fees, Eagle
County, Aspen Valley Hospital) we chose to make a separate line for this income in
2011. This increase in fees accounts for the largest change in our overall budget. Much of
the funds are passed through to our contracted physician group (approximately
$1000/client.)
• 3251: Local Contracts/Komen Foundation: The Susan G. Komen Grant provides for
clinical breast exams performed at CHS by Family Planning Providers, biopsies
performed at area hospitals and surgical consults with local surgeons. In the current
contract year which runs from April 1- March 30th, Komen reduced their grants across
the board due to a decrease in their contributions. They were no longer able to fund
personnel, supplies, marketing expenses or breast health training expenses. The only
items funded include billable services as mentioned above. We expect a similar grant
amount next year.
State and Co Health Dept Contracts: The contracts that are slightly different next year
include:
• 3212: Women's Wellness Connection: The 2011 contract is based on the number of
women seen in the 2010 contract year. Due to the increase in the number of women seen
this year, the grant amount has increased from $9000 to $13,000.
COMMUNITY
HEALTH SERVICES, INC.
0405 Castle Creek Rd., Suite 6 . Aspen, CO 81611, Phone: (970) 920-5420 . FAX: (970) 920-5419
• 3220: State Family Planning/STD: Again, this amount is decreased from 2010 primarily
due to reallocating the contraceptive funds to line item 3112.
EXPENSES:
• Total Payroll: Wages are up 2% from 2010. This reflects a cost of living adjustment. As
you recall, we requested funding for an additional 0.5 RN position for 2010. After much
evaluation, we decided to hire the Emergency Preparedness Coordinator (EPR) as this
program places a large burden on the Director. The part-time position was contracted
with Eagle County using EPR funds as well as the additional salary funds. We hired this
position on July 1 and as of October 22nd (as mentioned below) we are re-evaluating
whether to refill this position. We have also increased existing staff time. During the past
year we added an additional .5 FTE by increasing the hours of two existing employees,
one administrative person and one RN, and hiring a part-time Women/Infant/Child (WIC)
Educator. This fall we also hired a part-time RN specifically for flu clinics. These
changes have helped facilitate the re -organization of the Director's time by providing
more support from lead staff who would otherwise have been involved in direct client
services.
Also, you will note the slight increase in line item 5515- Insurance/Health. CHS needs to
select a new insurance carrier in the spring of 2011 and we are anticipating additional
costs related to that. We have also added an employee to the plan this year.
• 5655: Prenatal Program: Expenses for prenatal described in this line item are strictly for
direct expenses. There are other expenses related to this program that are not realized in
this item, for example: payroll and administrative expenses. In 2010, we did not
anticipate the Eagle County program therefore, the comparison is not relevant.
OTHER UPDATES:
PRENATAL:
As of 10/22/2010, CHS has enrolled 41 Eagle County women in the prenatal program. There
have been 36 Pitkin County women enrolled so far this year, for a total of 77 women. In
comparison, in all of 2007 we saw 20 women; in 2008 (32) women; in 2009 (23) women.
Obviously, the growth in this program has had a dramatic influence on agency operations. We
COMMUNITY
HEALTH SERVICES, INC.
0405 Castle Creek Rd., Suite 6 . Aspen, CO 81611, Phone: (970) 920-5420 . FAX: (970) 920-5419
have doubled the amount of staff time dedicated to this program compared to 2009. It continues
to run well and plans are in place to continue this agreement into 2011.
Regional discussions continue with prenatal care stakeholders. The Colorado Trust has invested
in this issue through the Western Division of the Rural Resort Region Early Childhood Council
(RRRECC) which includes Pitkin, Eagle and Garfield counties. This became a priority for the
Trust when they identified these statistics: In 2007, 71% of the RRRECC lags behind the healthy
people 2010 goals for low birth weight. In addition, 29% of women across the region did not
receive prenatal care during the first trimester. Consequently, 9% (185) of children are born at
low birth weight. In addition to the healthy people 2010 goals, they also observed the shifts in
local services that have occurred over the last several years including a record low number of
Medicaid and CHP+ providers in the region and the changes that have occurred with Eagle
County. The Colorado Trust's outcome measure is that "women in the Rural Resort Region will
have timely, appropriate prenatal care, post partum follow up and contraceptive care. The
families will be able to access pediatric medical, dental, and mental health care. Families will
have access to a wide spectrum of home visitation, and other types of parenting support and
education services." In October, their Health Integration Grant Coordinator attended the
Regional Indigent Care group to gather information from key stakeholders regarding
perspectives on gaps/challenges. Members of the Indigent Health group include Aspen Valley
Hospital, Valley View Hospital, A Woman's Place, Vail Valley Medical Center, Grand River
Hospital, Mountain Family Health Center and all 3 county Public Health agencies. The hope is
that the Colorado Trust will invest in this issue further once the needs have been prioritized and a
resource plan has been developed. CHS will continue to connect interested parties to continue
the dialogue until a more permanent, stable solution is in place.
PUBLIC HEALTH ACT:
I would like to remind the Board of Health about the newly formed Colorado Association of
Local Boards of Health (CALBOH). CALBOH is the newest public health association, which
works with the State Board of Health to strengthen Colorado's Boards of Health. Current
members include: Costilla, Prowers, Moffat, Ouray, Custer, Mesa, Larimer, El Paso, Tri-County,
Summit, Gilpin, Jefferson, Denver, NE Colorado, Saguache, San Juan Basin, Gunnison,
Alamosa, and Delta counties. Membership can be obtained for an individual or for a group. Dues
for all members of the board are $70/year. Included in your packet is an information sheet about
the association (Attachment B) and below is a link to their website for additional information.
http://www.publichealthal I iance.org/index.php?s=16&item=131.
COMMUNITY
HEALTH SERVICES, INC.
0405 Castle Creek Rd., Suite 6 . Aspen, CO 81611, Phone: (970) 920-5420 . FAX: (970) 920-5419
EMERGENCY PREPAREDNESS and RESPONSE:
At the last quarterly meeting, I informed you of the agreement between Community Health
Services, Inc. and Eagle County for the provision of an Emergency Preparedness and Response
(EPR) Coordinator which took effect July 1, 2010. Rick Miklich, the EPR coordinator for Eagle
and Pitkin, resigned his position in October to take a position with the National Environmental
Health Association in Denver. Eagle County is in the process of determining how they will fill
this position. CHS will evaluate whether we want to return to this model when this decision is
made. In the meantime, CHS will proceed as we have in the past. In the next couple of months,
we will be reviewing comments from the Colorado Department of Public Health and
Environment regarding our Project Public Health Ready (PPHR) application in preparation for
submission to the National Association of City and County Health Officials (NACCHO) on
March 1, 2011. Locally, the Pandemic Flu Incident Management Team will continue to meet to
discuss planning objectives for ESFB (surge capacity and volunteer recruitment).
DENTAL INITIATIVE:
The Aspen to Parachute Dental Health Coalition (APDHC) has recently contracted with JVA
Consulting to refine the business plan that was written by Dental Aid. JVA will be conducting a
detailed market analysis including surveying the future customer base and looking at potential
competitors; researching dental clinic business models across the country in rural resort
communities including fee schedules, reimbursement rates, and funding sources and reviewing
budget numbers in the current plan to ensure the numbers are aligned with the economics of a
rural resort community.
In initial discussions with funders, it was evident that we need more detailed information in the
plan before being considered for the large amount of money needed to start a dental clinic. The
funders were very supportive and impressed with our progress to date and encouraged us to
continue to move forward with our vision. The revised business plan will be completed by the
end of 2010. This may delay our goal of having the clinic in operation by July 2011, but is an
essential step in the process.
The Coalition now has two paid employees. As you know, Kelly Keeffe, a registered dental
hygienist, was hired in April as the Regional Oral Health Consultant. She continues her work in
oral health outreach and education in the Aspen to Parachute region. In August, the APDHC
hired Carolyn Hardin part-time as a grant writer. She is also assisting with the development of a
website for the Coalition.
COMMUNITY
HEALTH SERVICES, INC.
0405 Castle Creek Rd., Suite 6 . Aspen, CO 81611, Phone: (970) 920-5420 . FAX: (970) 920-5419
PITKIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT UPDATE:
Submitted by Carla Ostberg.
1. We will be drafting a follow-up Memorandum of Interest for the Board's review on air
quality topics such as PM-10 and ozone previously discussed in September.
2. We received a Radon Outreach Grant from the Colorado Department of Public Health
and Environment (CDPHE). A public education campaign will begin in December
followed by distribution of free test kits in January. Once the test kits have been sent in,
results will be mapped using GIS.
3. The Onsite Wastewater Treatment System (OWTS) Use Permit program has been in
effect since July 1 and we are finding a number of OWTSs in need of both minor and
major repairs.
4. West Nile Virus activity has been relatively quiet state-wide in 2010. There were 81 total
cases and 4 deaths. 13 of those cases were on the Western Slope, mostly in Mesa
County.
5. The Colorado Medication Take -Back Pilot Project was hosted locally by the City of
Aspen and Town of Basalt Police Departments. This effort resulted in 15 pounds of
medication dropped off at each take -back location.
6. We discovered a local retailer selling raw milk. A compliance advisory was issued by
this department and the retailer is no longer selling the milk. The sale of raw milk is
currently prohibited in Colorado; however, distribution is legal as long as the customer
receiving the milk owns shares in the dairy producing the milk.
PITKIN COUNTY ENVIRONMENTAL PUBLIC HEALTH ADVOCATE UPDATE:
Submitted by Tom Dunlop.
1) I met with the Colorado Environmental Health Directors at their quarterly meeting, held in
Frisco on October 21, 2010. I was asked to tell them a story about opportunities and life
after public service. It was a good occasion to share my activities the past 9 years since I
retired as the Pitkin Co. Environmental Health Director. I mentioned many of my national
involvements with agencies such as Centers for Disease Control and Prevention, Food and
Drug Administration, National Association of County and City Health Officials
(NACCHO), Association of State and Territorial Health Officials (ASTHO), National
Network of Public Health Institutes, National Environmental Health Association and
others.
COMMUNITY
HEALTH SERVICES, INC.
0405 Castle Creek Rd., Suite 6 . Aspen, CO 81611, Phone: (970) 920-5420 . FAX: (970) 920-5419
I paid particular attention to the volunteer work I am doing as the Pitkin Co.
Environmental Public Health Advocate. Examples were representing small local health
departments in national initiatives impacting food safety, toxic chemicals, human disease
and illness trends, local health department accountability and national certifications of
local health departments. I also mentioned the work these and other organizations are
doing trying to address how best to provide basic environmental and public health
services during times of tight budgets and loss of resources.
My concluding message was that there is a good life after Pitkin County that must be,
nurtured and embraced.
2) You may recall at my last update in August that I had attended the National Network of
Public Health Institutes in New Orleans June 7-9, 2010. I have been asked to be on the
program committee for the 2011 conference to be held in June 2011 in New Orleans. I
believe I have been invited to contribute based on my involvement with the national
Environmental Public Health Tracking program funded by CDC. If you are interested in
more detail about NNPHI you can go to www.nnphi.org .
3) I made a presentation via phone conference to the NACCHO workgroup on the
Environmental Public Health Tracking Network. The focus of the update was the status of
the Colorado program that is entering its second year. The sum of the message was that
Colorado is developing environmental indicators to be used as markers relative to illness
and disease in the State. This information will be then shared with the national network.
4) I recently returned from Richmond, Virginia having attended a program sponsored by the
National Environmental Health Association titled; Epi-Ready for Response Teams. I am
an instructor in this course that is funded by the Food and Drug Administration and the
Centers for Disease Control and Prevention. I am a paid instructor, so I do not represent
myself as the Pitkin Co. Env. Public Health Advocate in this role. However, I have been
able to bring reference materials to Community Health and Environmental Health that will
assist them when a food borne illness occurs. I was able to distribute guide books and
reference material to Dr. Cohen and to the City of Aspen Env. Health Department.
When a suspected food borne illness occurs there is little time to organize thoughts,
materials and resources. The text material I am able to provide to Carla, Liz, Dr. Cohen
and others will help prepare their departments should the need arise. I also remain as a
personal resource to them should they feel 1 might be helpful during an investigation.
COMMUNITY
HEALTH SERVICES, INC.
0405 Castle Creek Rd., Suite 6 . Aspen, CO 81611, Phone: (970) 920-5420 . FAX: (970) 920-5419
5) I have been offering constructive help to an effort being undertaken by NACCHO to help
draft national legislation to re -write the 1976 Toxic Substance Control Act. This is a large
and controversial effort that will update this historic approach to managing and accounting
for toxic substances in our environment. I may have more to offer to you in a few months
as this is a very political issue and one that needs careful attention to detail and use of
science in the process.
6) ASTHO is developing a state -to -state sharing project around the Environmental Public
Health Tracking Network. The idea is to assist states that have received funding from
CDC in sharing information with states that have not received funding to be full partners
in the program. This type of effort will aid in distribution of environmental and health
information inclusive of indicators and illnesses and diseases among states with the desire
of providing exchange of information to strengthen linkages for environmental and
medical data. I am not directly engaged with this program through ASTHO, but will
follow it to see if Colorado will participate. I am on an advisory committee to the
Colorado EPHT project.
While this seems like a far distance from Pitkin County, ultimately the program may have
direct impacts to Community Health and Environmental Health Departments in the form
of data sharing and perhaps financial assistance. This is a long shot, but one that should
not be overlooked.
This concludes this quarterly update. Thank you.
Respectfully submitted,
Liz Stark RN
Pitkin County Public Health Director
Director, Community Health Services, Inc.
ATTACHMENT B
INFORMATION SHEET ON CALBOH
CALBOH
COLORADO ASSOCIATION OF LOCAL BOARDS OF HEALTH
CALBOH Purpose
The Colorado Association of Local Boards of Health (CALBOH) is a unique organization strengthening Colorado's
local boards of health, in collaboration with the State Board of Health.
CALBOH Mission Statement
The mission of the Colorado Association of Local Boards of Health (CALBOH) is to strengthen local boards of health
through education, training, networking, advocacy, collaboration and celebration, thus enabling them to effectively
support the core functions and the ten essential services of public health that promote and protect the health of
their communities.
CALBOH Vision
The CALBOH's vision is to remain focused on the health of the public by:
• Recognizing that public health is the foundation on which a successful health care system is built.
• Promoting high standards of comprehensive public health services for the citizens of Colorado.
• Providing consultation and education for, and facilitate the collaboration among, Board of Health members.
• Supporting health policy and finance issues in support of public health in Colorado.
• Encouraging close working relationships between local Boards of Health and other allied agencies, including
the State Board of Health.
• Advancing programs and projects deemed necessary to protect and promote the health of the citizens in
Colorado.
• Supporting public awareness of public health issues and dangers.
v y Form a Colorgdo_A •nc atwn of Local Boards of Health (CALBOH)?
A CALBOH is a professional association, and a key incentive for joining is to strengthen and improve the functioning
of the local boards of health by education, training, collaboration, and advocacy. When local board members
become involved in public health issues, they have the collective ability to influence how political, educational,
business, and community leaders perceive and support local health issues. By creating the CALBOH, board of health
members are able to learn and interact with their peers (commissioners and designated local board of health
members) and public health leaders throughout the state. Local board members also have access to a wide variety
of services, including:
• Educational programs
• Legislative information
• Networking opportunities
• Models for improving local public health programs
• Training to improve board performance
The CALBOH will also provide local board of health members with the opportunity to develop the leadership skills
necessary to participate in shaping health policy at local, regional, and state levels.
Benefits for Colorado Association for Local Board of Health Members
For the public health system, a CALBOH:
Gives local boards of health a strong, unified voice in matters of public health policy and advocacy
Identifies and organizes local board of health members
• Ensures that public health policy makers or advisors optimize the field work of agency staff through
effective policy
• Identifies specific training and education needed for board members to fulfill their oversight responsibilities
For local board members, a CALBOH:
• Provides education and training designed specifically for them
• Represents local boards of health and public health policy at the state level
• Provides local board members with professional development and leadership opportunities
• Tracks legislation that affects public health agencies and boards of health
• Offers governance training and education for local boards of health
• Ensures that local boards of health are effective in public health agency oversight responsibilities
Because of the unique role that local boards of health play in the public health system, state associations are
needed to focus upon and respond to the statewide public health issues. SALBOHs are best suited to advocate on
behalf of local board members because of their knowledge of state and local rules and regulations and their ability
to tailor national educational and training materials and programs to the specific needs of their local boards.
Because the CALBOH leadership is more likely to interact with other state leaders, there is an increased
opportunity for this personal contact with legislators, politicians, and others to positively affect boards of health.
Because of this contact, the CALBOH is better positioned to track and act upon state public health legislation,
protect the local board of health's role in public health agency oversight, and represent the boards' positions.
SALBOHS provide board training and education. Many board members have a sense of isolation regarding public
health.. They may be well informed about their own community but broader, statewide, or national issues often
aren't communicated to them. Most board members take their responsibilities seriously but, unfortunately, in some
regions there is no training or education as to what those responsibilities include. Boards often have to deal with
difficult issues for which there is limited experience. A CALBOH is able to promote communication among boards so
that problems and successes can be shared. A listserv, regional meetings, conference calls, and a newsletter are
some of the ways to accomplish this.
What Other SALBOHs have done
The activities and projects of a SALBOH will vary depending upon the needs, opportunities and resources within
each state. One major effort, of course, is education and training of board of health members, but CALBOHs have
been instrumental in initiation, development and collaboration of other projects that advance that state's public
health initiatives. Each of the following has been accomplished by one or more of the existing CALBOHs:
Education and Training:
• Published a guide of responsibilities for new board of health members
• Developed a complete training manual for board of health members
• Established a website for board of health training resources
• Provided training by workshops and distance learning
• Convened annual statewide conferences for board of health members
• Established a leadership institute for board of health members
• Pilot tested an accreditation program for the board and local public health agency
Collaboration and Partnerships:
• Participated in bioterrorism training exercises
• Guided formation of an organization of public health associations to aid in grant applications
• Worked with the state and CDC to deliver Governance Performance Standards workshops to all boards
• Participated in grant surveys to assess perceived training needs of board members
• Participated in annual statewide joint meetings with other public health associations
Initiatives and Advisory:
• Promoted initiatives for smoke -free cities and states
• Initiated regulation of body art (tattoos, etc)
• Advocated for retention of local board regulatory authority
• Worked with legislators and participated in legislative hearings
• Promoted credentialing of public health administrators and emergency response coordinators
ATTACHMENT C
2011 CHS BUDGET DOCUMENTS
12:48 PM
11/03/10
Accrual Basta
COMMUNITY HEALTH SERVICES, INC.
Annual Budget 2010 to 2011 Comparison
2010 and 2011
Jan - Dec 10 Jan - Dec 11
Ordinary Income/Expense
Income
Client Fees
3000- Adult/Travel Vaccines 61,000 61,352
3110 - Family Planning Fees
3112 - F P Contraceptives Income 22,000 30,000
3113 - F P Sterilization Income 18,000 18,000
3110 - Family Planning Fees - Other 28,000 30,000
Total 3110 • Family Planning Fees 68,000 78,000
3115 • Children's Immunization 7,500 9.996
3150 • FLU SHOTS 19,000 30,000
3155 - Prenatal Fees 8,500 27,996
3156 - Prenatal Fees -Eagle 105,000
Total Client Fees 164,000 312.344
Local Contracts
3251 • Komen Foundation 75,090 42,000
3252 - AVH Medical Foundation 36,000 35000
3255 - City of Aspen Grant 60,000 63,000
3256 • Pitkin County Grant 271,205 271,205
3259 - Srrowmass Village Grant 15,000 15,000
Total Local Contracts 457,295 426,205
State of Co Health Dept Contrac
3205 - Emergency Preparedness Grant 29,392 20,400
3209 - Nursing Immunization Grant 14,000 13,008
3210 - Community Nursing Contract 38,599 38,040
3211 • State TB Action Contract 6,500 5,880
3212 • Women's W89ness Connection 9,000 12,996
3220 - State Family Planning/STD 89,975 48,000
3245 - Woman Infant/Child Nutrition 17,580 22,656
Total State of Co Health Dept Contrac 205,046 160,980
3280 - Donation
3260 • P-rdcin County In -Kind Rent 43,947 43,987
3282 • FP Donations 4,500 4,500
3284 - Town of Basalt 500 500
3285 • General Donations 3,000 3000
Total 3280 - Donations 51,947 51,987
3290.Other Income
3292 - Interest Income 1,500 1,800
3293 - Dividend Income 7,500 8,040
3295 - LT CapGnDst 4,500 4,800
Total 3290 - Other Income 13,500 14,640
Total Income
Gross Profit
Expense
Contract Services
891,788 986,156
891,788 966,156
5645 - Supervising Physcian 2,200
5650 FP Practitioners 38,000
Total Contract Services 40,200
General & Administrative
5210 • Advertising 2,405 2,400
5260 - Computer County Network/Support 9,000 9,000
5275 • Board's expense & Insurance 3,000 2,400
5330 - Cont Education/Recertlerations 3,000 2,400
5400 • Dues and Subscriptions 1,000 1,200
5430 • Volunteer Retention & Training 1,100 0
5531 - Insurance/Liability 5,000 5,400
5590 • Miscellaneous Expenses 0
5600.Office Expense & Copier Leasing 7,000 4,800
2,200
36,000
38,200
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12:48 PM
11/03/10
Accrual Basis
COMMUNITY HEALTH SERVICES, INC.
Annual Budget 2010 to 2011 Comparison
2010 and 2011
Jan - Dec 10 Jan - Dec 11
5610 •Office Supplies 3,000 1,200
5860 • Postage 1,200 1,200
5670 . Professional Fees, Accounting 3,000 4,200
5905 • Telephone County Usage Charges 8,900 8,640
5907 • Travel 2,000 3,600
Total General & Administrative 49,600 48,440
Payroll
Comp FICA 26,009 26,400
Comp MCARE 6,075 6,168
Wages & Salary
Gross 425,796
Leave 0
Wages & Salary - Other 416,757
Total Wages & Salary 416,757 425,796
5110 . Health/Wellness 6,700 6,696
5505 - Health Reimbursement Account 5,000 5,000
5510 • Insurance/Health/Disab 38,000 45,000
5515 • Health Savings Account 6,000 8,000
5520 • InsurancelWorkmans State Comp 3,000 1,800
5800 - Retinnent Plan Contribution/Co 22,750 24,000
66000 • Payroll Expenses 0
Total Payroll 530,291 548,860
Program Expenses
5440 Family Planning Program Expense
5445 ' FP Birth Contraceptives 39,000 48,369
5447 F P Sterilization Cost 18,000 18,000
5440 Family Planning Program Expense - 01... 49,000 36,000
Total 5440 • Family Planning Program Expense 106,000 102,389
5450 - Women's Wellness Connection 3,677 6.00D
5540 • Komen Expenses/Direct 8,400 3,600
5550 - Flu Vaccine & Expense 18,593 24,000
5595 - Nursing Programs Expenses 7,000 3,600
5596 - Adult Vaccine Expenses 48,000 45,000
5655 • Prenatal Program 19,000 92,100
5656 - Emergency Preparedness Expenses 15,580 12,000
5965 - Pidcin County In -Kind Rent 43,947 43,987
Total Program Expenses 270,197 332,656
Total Expense 890,288 966,156
Net Ordinary income 1,500 0
Net Income 1,500 0
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