APPROVED 11/1/95

September 19, 1995
Commissioners' Conference Room -- 1:30 p.m.

BOARD OF COUNTY COMMISSIONERSConference RoomChair Ellie Dumdi presided with Bobby Green, Sr., Jerry Rust and Cindy Weeldreyer present. Steve Cornacchia excused. Sharon Giles, Recording Secretary.10. HEALTH AND HUMAN SERVICES a. ORAL REPORT/Maternal and Child Health/High Risk Infants.Karen Gillette, Patti Guthrie, Susie Kent and Michele Clasen-Copely were present for the discussion. Gillette distributed handouts related to risk criteria, recent referrals that have been refused due to caseload limitations and staffing reductions, and the number of cases for Babies First, CaCoon and Maternity Case Management. Kent reported that there is a phone triage system. Guthrie observed that eight years ago all referrals were accepted, but that that is not the case now. Weeldreyer suggested the possibility of attempting to get some endowments for Public Health from local groups who are supportive. Rust expressed his belief that this is a general fund program, noting that there are already lots of charities in competition. Guthrie reported on the loss of skilled nurses over the last few years due to lack of funding, concerns regarding the budget and cuts/layoffs. Responding to Rust's questions about seeking interns from nurses in training to help with the caseload, Clasen-Copely stated that there are a lot of skills required to learn all of resources and to develop working relationships with agencies.

Rockstroh noted that Healthy Start does some initials visits, but the problem is with taking care of the serious cases that need referral.

Clasen-Copely reviewed a specific case noting how intervention occurred and what was done, observing that it is important to teach parents to be the child's advocate. Rust again encouraged internships for LCC student nurses, with Rockstroh observing that the U of O is initiating a paraprofessional bachelor's degree. Kent remarked that the problem with grants is usually that they are limited in scope and have a limited time frame, noting that the Healthy Beginnings grant ends next October. Kent reported that a physician-diagnosed "failure to thrive" is the only guarantee of being seen by Public Health. Green suggested looking to retired RN's. He emphasized the need to develop ways to get the word out, perhaps using the cases described today as an opportunity to educate the community on the needs. He pledged his support to help get the word out. There was agreement on the need to determine whether endowments and/or internships are viable. Rust, agreeing that the statistics need wider circulation, suggested the use of a press release to inform the public of the failures in the system. Clasen-Copely, provided an overview of the CaCoon program which has 30 clients and keep kids until they're 5 years old. Guthrie observed the potential for joining forces with teachers, asking them to be strong spokespersons for public health involvement. Weeldreyer stressed the challenge with regard to creating a new model where Lane County is a partner and not necessarily the sole provider. Rust indicated that he is personally looking to maintain the status quo support from the General Fund for next the fiscal year and encouraged the search for new models and working with schools. Responding to comments regarding involving the schools, Gillette recommended addressing the Health Advisory Committee and asking for their expertise. Teresa Wilson, County Counsel, clarified that there is the ability to receive outside donations. Responding to Guthrie, Rust encouraged working with the Health Advisory Committee to create a strategic plan. Dumdi suggested presentation to local organizations. Weeldreyer recommended making make a 5-to-10 minute video tape, incorporating a recent KVAL news story, to explain the current situation in Public Health.

There being no further business, this meeting adjourned into Executive Session as 2:55 p.m.

Sharon Giles, Board Secretary