On Thursday, May 24, 2007, the Health District celebrated EMS week with a Memorial Dedication to former EMS Medical Director, Dr. Russell Miller.  Dr. Miller served as the EMS Medical Director from 1984 to his death in August 2006.  Using donations made at the time of his death, staff purchased a granite bench engraved with “In loving memory of Russell K. Miller, MD.  He stood behind his medics so his legacy will live on through us”.    The bench will be placed in the yard of the Galveston EMS Main Station at 2602 Avenue Q.  Additional recognition and bonuses were given to fulltime line-level staff members who worked hard during a challenging year for their steadfast dedication and loyalty to serving the citizens of Galveston County. Challenges during the past year include managing an EMS service expansion, staff , and the death of long-time employee, Rocky D. Clare  

This event was held on Saturday, May 26, 2007 at Carbide Park, 4102 Main St. (FM 517) in La Marque from 9:00 am to 3:00 pm and was sponsored by the Front Door Social and Charity Club.  Several of the Galveston County Health District’s Community Health Programs including Immunizations, WIC, EMS, and Dental Health participated in this event by providing health presentations, iron screenings, and immunizations for community participants.  These programs provided general information on the services provided by the Galveston County Health District.  Though there was no official head count by those sponsoring this small event, Health District personnel encountered around 50 participants.   

On May 7, 2007, the Health District received a report on a laboratory confirmed measles case in a 3 year old female that resided in San Antonio.  The case was visiting Texas City when she became ill and taken to a local hospital for evaluation.  The case was referred to the appropriate jurisdiction and epidemiology staff undertook an investigation to identify contacts in Galveston County.  All contacts were notified of exposure, contacts immunization status for measles was verified, and educated on the vaccine preventable disease.  Galveston County has not had a documented case of measles in over 10 years.   One contact was encouraged to not pursue travel until after the observation period was completed and agreed to comply.   A Health Authority letter was written by Dr. Guidry so the contact could provide verification of the need to cancel travel and seek flight reimbursement.

Executive staff has completed a proposed budget for contracted animal services.   The interlocal agreement defines the formula for county and city contributions to the overall operations of both the shelter and field services which respond to complaints about stray dogs and cats.   The Animal Advisory Committee will review the budget at the next scheduled meeting on June 21.  For most cities the proposed cost is essentially unchanged from the previous fiscal year.  Factors impacting the proposed budget include: two new part time positions, salary adjustments, increase in annual group health insurance, purchase of two new computers, replacement of broken cages, portable AC unit, industrial size washing machine, a storage building, replacement of one animal control vehicle, an animal dart pistol and additional live animal traps.

  Administrative Planning

The Month of May involved many administrative meetings planning for future operations.  Meetings were held with Dickinson and La Marque city managers regarding EMS Medical Direction; with County officials regarding the status of Health District facilities; with staff for exploring new software proposals, guidelines for working with HMO patients in 4C’s clinic, and staff discussions regarding a Primary Health Care grant opportunity through the Texas Department of State Health Services. 

• Dates for upcoming mammogram screenings were submitted to the Community Bulletin Board in the Galveston Daily News found at www.gchd.org/pages/chn/dfeet.htm.
  
• A statement was issued by the District upon the loss of longtime Galveston EMS supervisor Rocky Clare who passed away after a brief illness, located at www.gchd.org/press/2007/05Rocky.htm.
  
• After a dog fight in Texas City between two animals that resulted in one needing veterinary care the District’s Public Information Office fielded several media calls.   Interest was high due to a recent ordinance in the city prohibiting the chaining or tethering of animals.  In this case the District actually has no enforcement authority and all calls were referred to the proper officials at the city. 
  
• A Houston Chronicle correspondent contacted the District on May 11^th while working on a story about the need for a household chemical collection facility in Galveston County.  Environmental Services Director Ronnie Schultz contributed to the story which was published on May 15^th. The entire article can be found at www.gchd.org/press/2007/05HouseholdWasteHChronicle.htm.
  
• The May 17^th Galveston Daily News had a guest column submitted by the Galveston Branch of the American Red Cross.  ARC’s Tom Duke discussed their plans for assisting communities preparing for Pandemic Flu.  In the column explains the role of the Galveston County Health District.  See www.gchd.org/press/2007/05RedCrossFlu.htm.
  
• Animal Services manager Kim Schoolcraft was interviewed on May 15^th by the Galveston Daily News .  The News is working on a supplement that will contain useful information for residents in case an evacuation is ordered.  Ms. Schoolcraft offered tips on how to prepare and evacuate animals. 
  
• A 91 year old Dickinson resident was the victim of a dog bite after being attacked by two animals that are still on the loose. Animal Services manager Kim Schoolcraft was interviewed by they Galveston Daily News discussing efforts being made to locate the at-large animals so they may be brought in for rabies testing.  See http://www.gchd.org/press/2007/05DogsWanted.htm.

• Staffing Update – The 4C’s has filled one medical provider position with Howard Baade, a Nurse Practitioner, who will begin work towards the end of June 2007.  Staff continues to search for qualified medical providers.  Sheila Coleman, RN, 4C’s Nursing Director, will resign on June 20^th.  The Nursing Director and all other Health District positions are located at http://www.gchd.org/hr/job.htm
  
• Donations to 4C’s – The 4C’s has been awarded two donations in May for an estimated total savings of $443,420. (1) Through Direct Relief, Schering-Plough recently has made an additional donation of 500 Albuterol inhalers for an estimated savings of $10,655.00, 4C’s is expected to receive these in early June, and (2) Direct Relief has made a donation on 05/22/07 of various items from medications to hand sanitizers for an estimated savings of $432,765, these items have been received and distributed to both clinics.
  
• Pharmacy RFP – Executive Management has completed the Pharmacy RFP which was posted in the newspaper over the weekend of May 26^th and was distributed to prospective candidates on May 29, 2007.  This proposal will be open until July 10, 2007 at 3:00 p.m.
  
• Blue Cross/Blue Shield Site Visit - On May 4, 2007, an initial site visit to establish a contract to see BC/BS covered patients was conducted to review access and compliance with expected standards.  Sixty elements were reviewed and there was one minor finding.  The reviewer commented on the excellence of our medical records.  We anticipate being able to bill for BC/BS patient visits in the near future.
  
• 4C’s Dental Review– The Health District has initiated a proactive internal review to identify ways to improve dental services to Galveston County residents. Several executive staff members will participate in reviewing various aspects of 4C’s dental services.  Findings and recommendations are expected to be shared with the Governing Board in a future meeting.
  
• Clinic Leadership Team (CLT) – The CLT approved to send a request from UTMB to the 4C’s Governing Board for approval of a new study, Best Adjustment Strategy for Asthma in the Long Term (BASALT).  This study is designed to provide doctors with a valid, experience-based strategy for adjusting asthma medications.
  
• Base Grant Adjustment - On May 23, 2007, 4C’s received notification from CMS of a $35,000 federal base grant adjustment.  This adjustment was a result of increased Health Center funding in the FY 08 Federal budget and the large numbers of uninsured/underinsured patients seen in the 4C’s Clinics.

• Tuberculosis Prevention and Control – The CDC has issued a rescission on the Federal FY 2007 Cooperative Agreement for Tuberculosis Prevention and Control funds. To reflect this, DSHS has reduced the FY2007 amount from $44,718 to $44,047, a total reduction of $671. Adjustments were submitted to DSHS on May 14, 2007.
  
• The Galveston County Housing Authority - hosted two weeks of health awareness through a group of health fairs on May 1-3 and May 8-10 at several housing developments on Galveston Island.  The Health District was represented by Immunization staff and Community Health Nurses.  Immunizations participated in four of the health fairs by giving out information on vaccines, our clinics, and ImmTrac, a state-wide immunization registry.  Community Health Nurses participated in all six, giving out information on the Health District and all of our services, doing blood pressure screenings, and giving personalized preventive health education on the importance of diet and exercise to the participants.  Through these activities our staff educated and/or provided services to between 200 - 250 individuals in publicly funded housing in Galveston.   
  
• Senior Health Advisory Council – Activities of the Senior Volunteer Program are partially funded by the Mainland Communities United Way.  This funding will end on 12/31/07, and the United Way has determined that they only fund 501c3 organizations.  SHAC carried a motion to take this opportunity to form a 501c3 that would address issues not only related to seniors, but those of all ages.  This will give the Health District an opportunity to apply for funding that is reserved for non-profit organizations, and become more active in the community.   A meeting will be held in June to finalize the bylaws and start the application process.
  
• Immunizations- DSHS requested that we submit a contract revision to reallocate excess salary funds.  A total of $41,634 was moved from personnel and fringe benefits to equipment, supplies, and other needs including displays for presentations, advertising, and incentives for the community.   These one time funds are available because of the lag time between the start of the grant year, contract award and hiring of personnel.
  
• STD/HIV - As of April 2007 there is a total of 14 reported cases of syphilis in Galveston County.  For the same time period in 2006, there were 12 reported cases.    The total reported cases of syphilis for 2006 were 39.  At this time, it does not appear to be a significant increase as efforts have been made increase the reporting of cases.  We will continue to monitor reported cases.
  
• Program Business Meeting - Some key topics were discussed this month. The STD/HIV Program’s quarterly report for the Real AIDS Prevention Project (RAPP) was reviewed by the group, as was the WIC programs client complaint policy.  WIC also presented changes to iron screening policy which allows children to be screened prior to nine months of age in situations were there is concern the child may not be able to return between 9 and 12 months of age.  Upcoming events discussed briefly were Breast Feeding Awareness Day, scheduled for August 1^st and Kids Health Fest 2007, our yearly immunization outreach, to be held through the month of August.

• Texas Commission on Environmental Quality Audit - An annual performance evaluation of the Air Program consisted of an assessment of contract compliance and applicable TCEQ guidelines.  No contract deficiencies were noted for FY06 and concerns and issues identified by TCEQ Region 12 staff were addressed in a timely manner.  The overall work products for the fiscal year have been noted as satisfactory by the Region 12 state agency staff.


• Animal Bites – Animal Services is actively investigating two dog bite cases both in the City of Dickinson.  The first case involves a 91-year-old female who was attacked by two pit bulls in her yard.  She sustained several puncture wounds and to date the animals have not been located.  The second case involves a young female who was bitten several times on the face requiring multiple stitches.  The dog was quarantined and the owner was ticketed and arrested on the scene for other outstanding warrants.  The dog involved in this case was relinquished by the owner following the quarantine period and was euthanized.  Bite investigations for calendar year 2006 were tallied at 221.


• Annual Water Oversight Committee Meeting – The annual meeting with our local contracted political entities was held on May 23^rd to discuss the 2007 highlights and accomplishments, upcoming water pollution prevention programs, and rules and regulations that may impact our contracted cities.  In addition, the committee discussed contract costs and the scope of work for the coming contract year, 2008. 


• Community Development Grant for High Island Approved - The County of Galveston applied for a Community Development Block Grant (CDBG) through the U.S. Housing and Urban Development Agency for $350,000 to address the issue of 28 homes connected to an unapproved sewage collection and treatment system.  Marty Entringer, Ronnie Schultz and the County's grant coordinator Connie Nicholson presented a convincing argument for the grant program to Houston-Galveston Area Council grant scoring panel.  Of the 32 presented programs, the High Island proposal ranked 8th.  The rankings were sent for funding and our project was funded.  We were notified by Curtis Brown, Community Services Director, County of Galveston, that the project will be funded in either FY 07 or FY 08 depending on the amount of funding available in FY 07.  If we are not funded in 07 we will be funded in 08.  Once funded the Health District will provide board-approved in-kind services to support the grant project.  The CDBG program is a flexible program that provides communities with resources to address a wide range of unique community development needs.

• Staffing Update – There are currently 33 vacant full time positions in the EMS area.  We are awaiting drug test results on 1 applicant and are checking references on another applicant.  10 applicants are scheduled for testing and 7 are being notified to come in for testing. 
  
• Hurricane Preparedness – Galveston EMS staff are actively involved in the City of Galveston planning activities for hurricane season (June – November).  Staff attended the warm up meeting for the annual town hall meeting on Tuesday, May 29, 2007 at the Galveston City Hall.  EMS Staff are an integral part of emergency operations for Galveston Island.
  
• Senior Team Captains Named – Four staff members were recently named to the position of Senior Team Captain.  This position is filled by persons who have significant EMS experience and are ready to move into a management role.  Senior Team Captains fill in for Supervisors on an “as needed” basis, as well as participating in management meetings and developing operational procedures.  The New Senior Team Captains are:  Carlos Alexander, Tamara Barringer, Kathy Kirkpatrick, and Aaron Pounds.

• Emergency Readiness Meetings with City Leaders - In the month of May, Public Health Preparedness staff met with city leaders from the cities of La Marque, Santa Fe, Galveston, Texas City, and Friendswood. In each meeting, city leaders were provided a brief overview of health district preparedness activities.  The overview was followed by a discussion of staffing resources for emergency medication point of dispensing (POD) clinics in their community, coordination of security between the city and schools where the PODs would be located, logistical support for POD operations, and distribution of medications to their first responders such as Police, Fire and EMS. Preparedness staff will use the information from these meetings to strengthen plans, and make contact and train potential volunteers in a POD site.
  
• Planning for Regional Pandemic Flu Exercise - On May 3^rd, the Public Health Planner met with other planners from health departments in the region to plan a regional pandemic flu exercise. The exercise will take place on August 16^th from 8:30am to 4:00pm at the Lone Star Convention Center in Conroe. Exercise objectives were discussed and the need for regional protocols to share information and resources in the event member counties are faced with a pandemic.
  
• British Petroleum Occupational Health - On Monday, May 15, 2007, Brian Rutherford, the Public Health Planner, attended a meeting of BP occupational health providers at the Moody Gardens Hotel and Convention Center in Galveston. The 15 attendees were from BP locations around the US and Canada. Dr. Mary deVignes-Kendrick, from the University Of Texas School Of Public Health in Houston conducted a presentation on planning considerations in pandemic planning. In her presentation, Dr. Kendrick emphasized the importance of working with local public health in developing plans. Throughout the session there were numerous questions directed to Dr. Kendrick and the Planner regarding social distancing measures, distribution of antivirals, the role of industry in a pandemic, and other concerns. Public Health Preparedness staff will collaborate with BP occupational healthcare providers in Texas City in planning discussions and in the upcoming regional pandemic flu exercise.
  
• Regional Epidemiology and Bioterrorism Meeting - Epidemiology Services attended the Regional Epidemiology/Bioterrorism Meeting on May 24, 2007 at Harris County Public Health and Environmental Services building in Houston.  The meeting is a forum for epidemiologist and public health preparedness staff to exchange information regarding epidemiology and bioterrorism activities.
  
• The Texas State Hurricane Conference - The Texas State Hurricane Conference took place in Galveston at the Galveston Convention Center on May 6^th through the 10^th. The Public Health Planner attended the conference and was able to learn about resources in emergency planning for special needs individuals, animal sheltering after a disaster, and the evacuation fuel plan for coastal counties.
  
• Training in Curriculum Design for Public Health - On May 7, 2007, the Galveston County Health District (GCHD) hosted a Texas Department of State Health Services on-site training titled “Maximizing Learning Through Creative Curriculum Design”. Approximately 15 people attended the training that provided resources and tools to utilize within planning an educational activity and skill in developing and enhancing curriculum development design. Continuing Education hours were offered for social workers, certified health and educational specialist, and medical professionals.
  
• Pandemic Influenza Preparedness for Schools - On May 17, 2007, the GCHD hosted a live satellite broadcast titled Pandemic Influenza Preparedness for Schools. Seven participants attended the training, which was sponsored by California Distance Learning Health Network. The broadcast covered topics such as school closure, continuity of education, average daily attendance, issues specific to certain populations, and ways schools can incorporate pandemic flu planning into their existing safe school plans. 
  
• Maritime Awareness Security and Terrorism Training - On May 23, Dr. Dana Beckham, Chief Epidemiologist, presented “A Case Study: Public Health Investigation of A Communicable Disease Onboard Cargo Ship” at Maritime Awareness Security and Terrorism Training (MASTT).  There were over 170 port public safety participants registered to receive information and training on terrorism prevention, response and post-incident issues, and overview of new regulations in the Maritime Transportation Security Act.

• GAAA Ambulance Service Contract with Seabreeze Nursing & Rehabilitation, L.P. was signed by the COO in May.  However, the commencement date was January 1, 2006.  The contract expires on September 30, 2008.  The rates for patients being transported into or out of the facility one-way at Level One is a base rate of $195.00 or at Level Two a base rate of $75.00.  There is a $50.00 per hour fee for wait time.  And, a mileage fee of $5.00 per mile for traveling outside of Galveston County
  
• GAAA Ambulance Service Contract with Air Ambulance Forum, Inc. was signed by the COO on May 21, 2007. GAAA will provide ambulance ground transportation for patients of Air Ambulance aircraft to and from clinics and local hospitals.  Regardless of the date of execution, the term is January 1, 2007 through September 30, 2008 with a renewable one year term by mutual written consent. The rate for patients being transported from air ambulance has a base rate of $300.00.   There is a $50.00 per hour fee for wait time.  And, a mileage fee of $5.00 per mile for traveling outside of Galveston County.
  
• Amendment to AMERIGROUP Texas, Inc. Participating Provider Agreement was signed by COO on May 21, 2007.  The amendment added an attachment to the agreement titled CHIP Managed Care Reimbursement to Physician Services.
  
• Houston Area Readiness and Emergency Management for Schools (H-REMS) Partnership Agreement with Friendswood ISD was signed by CEO on May 16, 2007 and with Dickinson ISD on May 17, 2007. These agreements establish the parties’ roles and responsibilities to strengthen and improve emergency operations plans.