Board of Health

Skokie Board of Health November 12, 2015 Present Absent Excused Dr. Drachler Ms. Urbanus Mr. Abbasi Ms. Langguth Ms. Varma Dr. Dave Dr. Luka Dr. Vernon Dr. Gaynes Mr. Nidetz Dr. Werner Ms. Jones Thorne Dr. Prince Dr. Williams Ms. Nikitsch Duggan Mr. Pandya Dr. Topouzian Dr. Sood Guests, Dr. Usman Khalid Sabzwari, AHS Alex Mukanda, AHS Dr. Counard, Director of Health David Clough, Staff Call to Order - The meeting was called to order at 7:31 p.m by Dr. Drachler, Chairman. Approval of Minutes – Minutes from previous meeting were approved. Asian Human Services Mr. Sabzwari reported on the history of Asian Human Services. Asian Human Services (AHS) began 35 years ago as a translation service to help immigrants apply for Social Security, Medicaid, and their green cards. The first clinic was housed in a two bedroom apartment on Peterson and Western and has grown into an independent facility serving over a hundred patients per day. AHS has opened additional locations in Skokie and Niles within the last two years. AHS now owns four Federally Qualified Health Centers two of which include dental clinics. Insurance is accepted at all locations but a sliding scale fee is provided for those without coverage. Individuals coming to the clinic only need a photo ID and documentation of their monthly income. AHS will assist those who qualify for WIC (Women, Infants, and Children), Medicaid and Medicaid Presumptive Eligibility (MPE) programs in applying for these programs so they can see the doctor for free. The first visit costs $35 for a medical visit and $50 per dental visit. AHS will assist clients with applying for Medicare, Medicaid and insurance through the Affordable Care Act. The $35 is refunded once the client receives a medical card. In addition to medical services they provide GED programs, employment programs, mental health programs and Passages charter school for immigrant and low income families. Mr. Mukanda reported on the insurance assistance process. The first thing a client is asked when they come in for an appointment is if they have insurance. After they receive services they are directed to Mr. Mukanda or one of his colleagues and receive assistance in determining their insurance eligibility. A lot of their work involves de-stigmatizing Medicaid for their clients. Since the Affordable Care Act, Medicaid has expanded in Illinois and AHS spends a lot of time explaining to clients that it covers more than it used to. Much of their population has never had insurance before and requires education in how to use it. Many don’t even recognize the Medicaid card when they receive it in the mail. AHS requests that clients bring in any insurance related letters they receive so clients don’t miss redetermination deadlines and other things they might not be familiar with. All children under the age of 18 are eligible for All Kids regardless of their family immigration status. Medicaid Presumptive Eligibility means that pregnant women can be enrolled in Medicaid and receive services from a Federally Qualified Health Center within ten days. Many undocumented immigrants are afraid to apply for insurance because they think they will create a paper trail of their immigration status that might lead to deportation. One woman was afraid of the Holiday themed pen Mr. Sabzwari was using because she thought the light on it would transmit her information to INS! Dr. Drachler asked how they were received in Skokie. Mr. Sabzwari reported that it was a very easy process. The inspectors were very thorough and helpful in explaining how they could comply with all regulations. Mr. Mukanda reported that the Skokie Park District and school districts were very accommodating with promoting the clinic. Many high school students refer their parents to Asian Human Services. Review of 2011 Survey (copy of presentation attached) Sara Waller reviewed the community health survey results from the 2012 IPLAN. Over the course of six weeks 1,361 respondents filled out the survey, 67% of whom were Skokie residents. Although not a representative sample of Skokie residents, the demographic information was similar to that of the overall population. This was the first time that the Health Department widely engaged community members in the community health plan process. A very important finding for Skokie was that foreign born residents were twice as likely to report poor health, difficulty accessing medical care, and inability to pay for basic necessities. People across all age ranges were concerned about heart disease, obesity, and a healthy environment. With the exception of the environmental questions (now being handled by the Skokie Environmental Sustainability Commission), there will be similar questions on the 2016 survey so we will be able to compare results. The survey was one method used to gather information to serve as the basis for establishing the 2012 community health priorities for Skokie. The Health Department also conducted focus groups and one-on- one interviews with key informants, to ensure that individuals who were unlikely to complete the survey had an opportunity to give input (for example, limited-English speakers and people with mental illness). In addition, the IPLAN Committee and Board of Health carefully reviewed public health data, such as tobacco use rates for high school students and mortality data. Next steps for the 2017 IPLAN are to finalize the community survey tool and submit to Village Manager John Lockerby for approval. The document will then be translated into the top five languages spoken in Skokie. We expect to release the survey on February 1 (paper and electronic) and have the survey open for six weeks. Dr. Werner asked about the return rate for the survey. Dr. Counard reported that it was broadly distributed through an electronic link forwarded by businesses, schools, religious entities and Village leadership so we are unable to obtain that data. However, the number of responses received was very high. Open Discussion Board members reviewed the survey and agreed on the contents. Dr. Drachler pointed out that this survey collected some new data but was close enough to the original survey to make direct comparisons. Dr. Counard also pointed out that some health questions would be in the Village’s Citizen Survey this year. Dr. Williams recommended partnering with Asian Human Services and Erie to increase survey distribution. Dr. Drachler agreed that was an excellent idea. Dr. Williams reported that the FDA will be providing regulations on electronic cigarettes. Currently 80 to 90 percent of e-cigarette devices on the market will not meet FDA requirements. Dr. Drachler reported that he would be meeting with Mayor Van Dusen to discuss raising the minimum age to purchase tobacco to twenty one. Director’s Monthly Report (copy of presentation attached) The annual Health Department community flu shot clinics went well. Dr. Counard acknowledged the Board of Health members who volunteered for the clinics. NorthShore University HealthSystem donated $10,000 for a Rethink Your Drink Program. This is an obesity prevention goal of the Skokie Community 2012 Health Plan and will be featured in the December edition of NewSkokie. Dr. Counard elaborated on the current grant situation given the lack of a state budget. There are signed grant agreements for $222,275 worth of State grants and to date none of the $86,550 billed has been paid. Dr. Counard reported that Skokie is in a better position than a lot of health departments who have been forced to lay off staff. Dr. Drachler suggested that some form of consciousness raising needs to be done to promote funding for public health. Dr. Williams proposed planning a massive flu shot vaccination clinic in Springfield and having only one nurse there to administer the vaccines. This would show the final results of staff being laid off due to lack of state funding. Dr. Counard reported that the Illinois Public Health Association (IPHA) has been protesting and trying to raise awareness by meeting with state legislators. She also reminded Board members that Village Manager John Lockerby and Mayor Van Dusen felt that it was better for the Village to take a comprehensive approach, unified with other municipalities, rather than advocating solely for public health funding. The lack of state funding is affecting many Village departments and programs, and many organizations that provide services for Skokie residents. Old Business Dr. Drachler suggested that we follow-up on last month’s recycling presentation. The Board would like to bring the message that money can be saved by recycling to Skokie businesses. Dr. Drachler reported that Highland Park has a new recycling provider that will recycle computers and linens. Dr. Drachler asked if there were questions about recycling in the survey. Mr. Clough responded that many questions about recycling are included in the Village citizen survey. New Business Dr. Counard mentioned that a new state tobacco coalition is being put together to revise the state tobacco plan, and she was hoping that Dr. Williams would agree to serve. Dr. Williams said he would be happy to serve on the coalition. Dr. Drachler brought up the issue of marijuana dispensaries. He asked if Skokie needs to do anything to prepare for the possibility of one opening up in Skokie. Dr. Counard responded that there are no plans for a dispensary in Skokie at this time. Dr. Williams said that there may be some harm reduction if chronic pain patients switch from opioids to cannabis. Adjournment The meeting adjourned at 8:52 p.m.