Lake County Community Health Center Governing Council met April 14.
Here is the minutes provided by the council:
1. Call to Order
Chair Withem-Voss called the meeting to order at 5:32 p.m.
Chair Withem-Voss, Vice Chair Fornero, Member Brown, Member Tarter,
Present 8 - Member Bejster, Member Cunningham, Secretary Smith and Member Argueta
Absent 2 - Member Washington and Member Vargas
2. Pledge of Allegiance
3. Approval of Minutes
3.1 March 10, 2020 Meeting Minutes
A motion was made by Member Cunningham, seconded by Member Fornero, that this item be approved. The motion carried unanimously.
Chair Withem-Voss, Vice Chair Fornero, Member Brown, Member Tarter,
Aye: 8 - Member Bejster, Member Cunningham, Secretary Smith and Member Argueta
Absent: 2 - Member Washington and Member Vargas
4. Public Comment to the Council
None
5. Executive Director's Report
Mark Pfister, Executive Director, welcomed everyone to the first virtual Governing Council meeting and stated that whether or not subsequent meetings will be conducted this way depends on if the Governor will continue to waive the Open Meetings Act (OMA) physical meeting requirement. He commended the LCHD team on how hard they've been working over the last four weeks. He announced that the North Chicago clinic has now been designated as a special respiratory illness clinic specifically for COVID-19 and staff are doing telehealth to route people who may have COVID-19 symptoms to that clinic. The value of doing that is twofold: (1) we're bringing in individuals who may be positive, so staff can be prepared and in the appropriate PPE; (2) this minimizes the risk of exposure to individuals who may be positive at the other clinic sites. As of today, only 4 LCHD employees out of 1,000 have tested positive for COVID-19. At this point in time it is uncertain as to where those individuals were exposed, but the assumption is being made, for Worker's Compensation, that their exposure occurred at work. We have received some new COVID-19 related grants from HRSA, one over $100,000 and one over $1,000,000. All vaccinations are currently being done at the Zion clinic and well visits are being done through telehealth as much as possible. Member Cunningham echoed Mark's comments regarding all of the hard work being done by LCHD staff and specifically commented on the testing they provided in partnership with the churches due to the revival event in North Chicago. Member Tarter thanked Mark and Chair Withem-Voss on behalf of the Council members for all the work they've been doing in regard to COVID-19. He also asked if a message of "job well done" can be sent to LCHD staff on behalf of the Council. Mark stated that Communications can put it together and send to staff on behalf of the Council. Mark also informed the Council of a full-page ad that he and some of the other Northern Illinois Public Health Consortium (NIPHC) Directors ran in the Sunday, April 12, 2020 edition of the Chicago Tribune thanking all public health professionals for the work they're doing, and that he would have Lisa Kroeger send the ad to the Council members. Member Tarter asked if there is an enhanced death rate in the minority communities due to COVID-19. Mark explained that in the Lake County community, the highest rate of death is in the long-term care facilities where over 50% of the COVID-19 related deaths in Lake County have occurred. The highest number of cases, 300+, is in Waukegan so an increase among the disparities is expected. Also, between females and males, females have less COVID-19 infection than males, but not by a large margin. The majority of hospitalized cases in Lake County have underlying health conditions. He then asked Jefferson McMillan-Wilhoit to talk about some of the data looked at to-date. Jefferson stated that a trend in disparities has been seen in Lake County's case count, which the team has been working on in-depth. Some of the things they've noticed are that there are a lot more cases in Waukegan and North Chicago, with more factory workers in Waukegan getting sick than would be expected. Currently the team is working on what the messaging needs to be to our internal patients as well as within our broader community as a whole. There are definitely patterns being observed with disparities in the community and we are starting to recognize that those patterns very well model the disparities we already knew existed within our communities. This is bringing to light in the pandemic some of the large health disparities we have across our communities already. Member Smith asked if the numbers reflect that more testing is available and being done. Mark stated that in the beginning the hotspots were in Highland Park and Lake Forest, and that there was some testing bias at that time because it was people who had more access to testing. Also, those individuals had potentially traveled abroad or had contact with someone who traveled abroad. Now that we have community acquisition of the virus, more people are being tested, but we're still very limited as to who can be tested, which are those individuals who have been exposed and have symptoms, are high risk or are in a congregate setting.
6. Action items
6.1 Provider Credentialing and Privileging - Dr. Zun
Personnel Committee Chair Bejster informed the Council that the credentialing information for the providers noted in the agenda packet was reviewed in the Personnel Committee meeting which took place just prior to this regular meeting and the Committee recommends approval.
A motion was made by Member Bejster, seconded by Member Fornero, that this item be approved. The motion carried unanimously.
Aye: 8 - Chair Withem-Voss, Vice Chair Fornero, Member Brown, Member Tarter, Member Bejster, Member Cunningham, Secretary Smith and Member Argueta
Absent: 2 - Member Washington and Member Vargas
6.2 Ratification of Change in FQHC Hours of Operation - Pfister
Member Bejster noted that she did not see the potential change of the North Chicago Respiratory Illness Clinic (RIC) listed and asked if it needed to be. Mark clarified that what is listed in the agenda item is what was brought forth to and approved by the Governing Council Executive Committee because we needed to ensure changes in hours as a result of the pandemic were being approved in a timely manner in case HRSA questioned it. So the Council now needs to approve the hours of operation, not the type of operation.
A motion was made by Member Tarter, seconded by Member Fornero, that this item be approved. The motion carried unanimously.
Aye: 8 - Chair Withem-Voss, Vice Chair Fornero, Member Brown, Member Tarter, Member Bejster, Member Cunningham, Secretary Smith and Member Argueta
Absent: 2 - Member Washington and Member Vargas
6.3 Approval of Change in Operating Hours and/or Location for Vaccination Clinics - Dr. Zun
Dr. Zun explained that this item is a change in the vaccination clinic hours. All vaccination clinic hours will now be held at the Zion health center. This change is a result of a review done by the Patient Access Center (PAC) as to where the majority of vaccination clinic patients with the greatest need are located.
A motion was made by Member Brown, seconded by Member Fornero, that this item be approved. The motion carried unanimously.
Aye: 8 - Chair Withem-Voss, Vice Chair Fornero, Member Brown, Member Tarter, Member Bejster, Member Cunningham, Secretary Smith and Member Argueta
Absent: 2 - Member Washington and Member Vargas
6.4 Proposed Change to 2020 Committee Appointments - Pfister
A motion was made by Member Tarter, seconded by Member Brown, that this item be approved. The motion carried unanimously.
Aye: 8 - Chair Withem-Voss, Vice Chair Fornero, Member Brown, Member Tarter, Member Bejster, Member Cunningham, Secretary Smith and Member Argueta
Absent: 2 - Member Washington and Member Vargas
7. Presentations
None
8. Discussion Items
None
9. Medical Director's Report
9.1 Medical Director’s Report - Dr. Zun
Dr. Les Zun, Medical Director, reviewed his report as presented in the agenda packet. Member Smith asked if there are alternate ways to serve the behavioral health patients in the day programs, the drop-in centers, the Addictions Treatment Program (ATP), and the Crisis Care Program (CCP). Dr. Zun explained that CCP is still providing services to it's clients and still has walk-in service available, but that some of the programs have been suspended. The Medication Assisted Treatment (MAT) program and the Methadone program have been extended and been given waivers to administer the medication while seeing the patient less frequently. Mark added that the substance abuse counselors have been moved in to the CCP and are doing counseling through telehealth. For the patients currently in LCHD's system, they completed rehab and were then sent home or back to jail. He stated that it was a very good idea that LCHD shut down it's residential programs because, as reported by WGN, Haymarket Center in Chicago now has two staff members who have died from the virus and over 40 individuals who have come down with COVID-19. He also added that LCHD's psychiatrists are at the most productive they've ever been by using telehealth because the no-show rate is the lowest it's ever been. Individuals are being given the choice of receiving behavioral health services via phone or video, as not everyone has access to video. And the medications for those individuals continue to be prescribed as a result of those "visits." Chair Withem-Voss stated that she personally knows someone who is having difficulty contacting their LCHD behavioral health provider and, therefore, is not getting the referrals they need, so who should this person now contact. Mark stated they can contact the PAC and the PAC can assure they receive the appropriate service. Member Bejster asked if the supply of PPE and testing equipment is a current concern at LCHD. Mark stated that LCHD is ordering what it needs through the Lake County Emergency Management Agency (EMA) for long-term care facilities, for the FQHC's, and for the behavioral health services. LCHD also had a cache of it's own as a result of emergency preparedness. AbbVie has also donated PPE which has been pushed out to first responders. Having the RIC also helps because by having those services centralized we're not going through as many gowns and masks. LCHD also recently received an Anonymous Foundation grant of $100,000 for the purpose of purchasing PPE. A local company, Vantage, is now producing hand sanitizer of which LCHD has received 12 gallons and those empty gallon containers can be taken back to Vantage to be refilled at no cost. Screening procedures have been implemented at every LCHD operational site and are being done on everyone who enters. If someone answers "yes" to any of the questions regarding shortness of breath, cough, or sore throat, and/or they register a fever, they are being sent home. That includes staff, who are then being paid to stay at home, as we do not want them working with symptoms. Dr. Zun added that LCHD has been struggling with getting enough testing kits for the clinics and has been relying on Quest. Unfortunately, Quest is not replacing the testing equipment, swabs and media, after it's sent in and there is a long wait to get additional supplies. There is a similar problem with IDPH and significant delay in getting the results back. Through a hospital collaborative group set up by Mark, it was discovered that Northshore Health System has testing ability and some additional capacity, so we are working on an arrangement with them for the testing of LCHD employees. Mark added that there are over 15,000 cases in Illinois but in Lake County it is only 0.2% of the entire population that has tested positive to-date and that's due to so little testing being done. Member Smith asked what kind of behavioral health services are being provided to those on the frontline. Mark stated that information on LCHD's Employee Assistance Program (EAP) is being pushed out to staff regularly along with the message of self-care and taking advantage of working remotely. Dr. Zun added that the Chair of Psychiatry at Rosalind Franklin University has offered Zoom sessions for colleagues, small to large groups, so that she can meet with staff and talk with them about daily stressors, issues, and problems. It has been offered to LCHD providers and will be offered to practice managers, leadership, and all clinical staff.
10. Director of Finance's Report
10.1 Director of Finance’s Report - Riley
Pam Riley, Director of Finance, introduced Flo Redmond, LCHD's new Grants Manager, who started on Monday, April 20, 2020. She pointed out that the COVID-19 related grants recently received have gone a long way in helping with the purchase of needed PPE, computers for the providers doing telehealth, and numerous other expenses related to the pandemic response. She then reviewed her report as presented in the agenda packet. Chair Withem-Voss asked if the previous amount of excess due to vacant positions is now being used to hire staff and for COVID-19 related expenses. Pam confirmed that it is.
11. Added to Agenda
Member Smith asked if LCHD staff are using surgical masks or N-95 masks. Dr. Zun stated that there is a protocol for PPE. Surgical masks are indicated for all staff, all the time, N-95 masks for when they are seeing a potential COVID-19 patient, and eye protection is only needed when staff are providing a respiratory treatment and obtaining aerosolized products. For staff conducting the screening procedures at the entrance to a facility, they wear a surgical mask and gloves. We are also ensuring that all patients coming in have facial covering and if they don't we are providing them with a mask.
12. Old Business
None
13. New Business
None
14. Executive Session
None
15. Adjournment
A motion was made by Member Brown, seconded by Member Cunningham, that this meeting be adjourned. Meeting adjourned at 6:33 p.m.
Aye: 8 - Chair Withem-Voss, Vice Chair Fornero, Member Brown, Member Tarter, Member Bejster, Member Cunningham, Secretary Smith and Member Argueta
Absent: 2 - Member Washington and Member Vargas
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