MONTEREY BOARD OF HEALTH MEETING MINUTES
Date: November 7, 2011
Present: Peter Kolodziej, Stephen Enoch, Robert Annelli and John Makuc
Also present: Kathie Tryon
The meeting began at 3:30pm
1. The minutes from 9.12.11 & 10.17.11 were approved as written.
2. Kathie Tryon came in to present her proposal to the Board of Health for a Town Nurse. Kathie stated that she went before the Select Board and they wanted her to get the approvals from the Board of Health and Finance Committee first. She stated that the nurse would be in town for 20 hours a week to handle calls and assist the elderly. She provided numbers of the elderly in Monterey based on the 2000 & 2010 censuses. The Board felt that the poverty numbers given are probably skewed because a large percentage is most likely from Gould Farm. Kathie stated that she and Wendy Tryon are interested in this position and the Maven training/reporting. She said this position wouldn’t replace the current VNA but would cover the elderly whose Medicare benefits have run out.
Bob asked if there was anyone in Monterey right now that Kathie knew of that couldn’t get care. She provided a few examples from the summer that she was aware of. She stated that Medicare doesn’t cover chronic care anymore. Bob stated that he’s never heard of any issues in Monterey that our current VNA wasn’t handling. Peter stated that before any new program were to be put in place you’d really need to have an extensive needs assessment to see if there are any gaps or needs not being met rather than being assumed from census data. Peter stated there may be other services (some free) that you could piggyback with rather than creating an entirely new position. This is challenging because there are a lot of small organizations out there meeting different needs. There aren’t any towns in Berkshire County besides West Stockbridge/Richmond that have a town nurse; they all utilize the local VNA’s. She’d like to help try to improve the general health of the elderly in Monterey.
Steve asked where the office would be located; right now there isn’t a space. The front room could be used during the day but most visits would be in home. Storage space would be an issue. Steve asked about the breakdown of the 20 hours which Kathy stated she’d split through the day, evening and weekend to meet the needs of full time and 2nd homeowner residents in Monterey. This nurse would not respond to emergency calls but rather try to teach preventative care to reduce the number of emergency calls the fire department currently gets. The Board felt there were a lot of unknowns in the proposal. Peter also stated that once a needs assessment study/feasibility study was done there may be grants available to pay for a position like this. Kathie felt strategically it was better to have the town accept it first to show sustainability to any grant programs. Peter stated that there could be an endorsement
letter from the Select Board to show interest to a grant program which might then help with a needs assessment so that the town isn’t locked into something without first knowing if it’s needed in Monterey. None of this proposal would be billable to insurance companies. The proposal consists of a primary nurse with several backup nurses that come from different nursing specialties. John noted that if the community is currently unwilling to go to the doctor what makes you think they’d be interested in having a town nurse help them. Peter stated that this is a reality that just because you create it, it doesn’t mean people will use it. The Board felt it was a nice proposal but didn’t know how workable it was. The fact that the last town meeting wasn’t too receptive for employee raises and that the highway department has been looking for another employee for several years were all issues mentioned. The Board
felt that they might be able to support bringing an article to town meeting vote for a needs assessment to determine if this was something Monterey needed before creating a new position. Stephen explained that if this is taken to the town meeting vote without having a defined set of services people will vote based on what they think they personally will be getting but might not actually be available. John also asked how you’d draw the line when a person wants the town nurse instead of the VNA which the insurance companies would pay for rather than the town footing the bill for and they’d be picking up the tab where insurance companies should be. Kathie stated that for a VNA to come to your home through Medicare, Medicaid and private insurance you have to be homebound. The Board wanted to look at the proposal further and talk about it more at their next meeting. The Board also noted that if Kathie is hoping to be a candidate for this
position someone unrelated to the proposal should really do the needs assessment so it doesn’t look like it’s skewed. Liability issues to the town were questioned and what types of additional insurances would be needed were brought up and the answers were unknown.
3. The next Board of Health meeting will be on Monday, November 21st at 3:30.
The meeting adjourned at 5pm
Submitted by,
Melissa Noe
Inter-Departmental Secretary
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