Healthy Communities and Environment Committee Meeting 07-08-19

Healthy Communities and Environment Committee Meeting 07-08-19


yes thank you madam chair can I ask that
that be number one due to time constraints for everybody else discussion no I I don’t want a second
what somebody what somebody else second no what kind of discussion discussion on
the motion quick question I just like to know why
this wasn’t on the agenda prior to this okay my apologies this was
on a previous agenda and after discussion with Kathy
forcely we decided to postpone it to this meeting however staff wasn’t
properly informed and I take full responsibility for that but now we have
Kathy fourthly and Brinson from honor health here to discuss so and I
understand oversights happened I’ll be voting no though only because I would
like to prior notice an opportunity to ask questions prior to you mean and the change right all in
favor signify by saying aye aye opposed no the eyes have it motion is carried
we’ll move on to public comment is there anyone from the public who would like to
address the committee seeing none I’ll close public comment we need a motion to
receive and file communication items the contingency report the Health and Human
Services Children’s Village National School Lunch Program application and the
mission Michigan Department of Health and Human Services Board minutes from
June 18th motion by Commissioner Powell seconded by Commissioner Nelson all in
favor signify by saying aye aye opposed the motion is carried
we’ll move on to our regular agenda item the first item is a policy to provide
emergency contraception through the Health Department commissioner Gerson’s
and yes I’d like I’m sorry we need a motion all in favor signify by aye opposed the eyes have it thank you so
commissioner Markham and I have brought forth this resolution to have a
discussion with our health department about providing emergency contraception
so I’d like to invite Kathy Horsley to the table and however you’d like to
address it or Commissioner Markham do you have any preference on how this is
presented no I guess if you want to start yes
Brinson she’s the director or CEO see ya Thank You CEO of honoured candy health
thank you which is our federally qualified health center which we are
very much in strong partnership with so at any rate and it’ll see why I’ve
invited her here today because of this partnership we have I think there are
things that we can do together we don’t believe that the health division is
really the place to be providing emergency contraceptives from plethora
of reasons we know that you can go without ID and you can it’s readily
available at major pharmacies you don’t have to have an ID you don’t have it to
have a prescription and we know that it’s available at CVS Walgreens Rite Aid
and Walmart you can even pre-order on line at Walmart for a very very low cost
of ten dollars and the other ones charge I had seen that there were some that
ordered in twenty five but our recent survey said it’s been the forty to fifty
dollar range at all these pharmacies so as I said you don’t have to identify
yourself you just pick up a plan-b box take it to the pharmacy they open it up
take it out give it to you you pay for it and go so other than that if a person
went to a clinical setting which i think is appropriate because this is an
emergency contraceptive there could be a lot of reasons why a person might be
seeking an emergency contraceptive and we believe that
full array of services around this to have the appropriate discussion with the
person seeking this there are a variety of things that could be going on it says
rape is it incest is that human trafficking or is it simply that you
really need to be on a contraceptive but you hadn’t thought about that ahead of
time or something happened that you need this emergency contraceptive well if
this person is really needing contraceptives that opens a whole gamut
of potential solutions that need to really be geared to the individual what
type of contraceptive this is not a business that the health division is in
or did we have the proper staffing to be able to answer all of these questions to
do this work we are very very very busy clinics the deal heavily with STDs and
immunizations this could be something that really we really are working our
level best to get people through in a timely manner in our clinics these are
conversations it could be quite lengthy I just believe if they want to come to a
clinical setting that people like our partners on our community health are the
place to go also it’s also available at Ferndale yep family planning in Ferndale
and also in Planned Parenthood and Ferndale and also in Southfield Northland no they will give birth
control that they don’t have that they maybe couldn’t write a prescription for
it I’m not sure honor can write a prescription for it in honor also
operates on a sliding fee scale but I don’t think I’m the one to speak to that
you can speak to how you might be able to fill gaps so good morning I’m W
Brinson I’m with honor Community Health Center we’re pretty new FQHC we’ve been
in partnership actually with a health department for four years we are very
committed to addressing the high teen pregnancy rate as well as the
contraception access issues here in Oakland County but particularly in the
Pontiac greater area honor does provide contraceptive services to women it’s on
a sliding fee scale will never deny anybody access to services as a
federally qualified health center we’re required to see anybody that walks
through our doors so if somebody comes in seeking family planning services or
emergency contraceptives we’ll take a look at what their their income level is
and we’ll slide them if somebody says that they can’t afford it we’ll still be
able to see them the challenge with the emergency contraception is that it is
available over-the-counter and so it’s it used to be by prescription only and
so it’s very expensive a lot of our health insurance plans or Medicaid
health plans or commercial insurance carriers don’t cover it any longer
because you can get it over that counter and so it’s 40 to 50 dollars per dose
that can be pretty expensive so we’ll work with our partners to make sure that
they either get connected with Planned Parenthood if they can in Ferndale or
anyplace else but our organization provides contraceptive services provides
the whole array of services just as Kathy was talking about we’re interested
in when a woman comes in we want make sure that she’s safe she’s not been
engaged in in anything that has caused her arm harm and that we’re looking at
long-term or situational solutions and resolutions for her so that’s just a
little bit about what we do related to the emergency contraception services they will not only see their students
but any student from any university or college for cost of eighteen dollars for
the visit and the medication the contraceptive is there an age range this
applies to what would be the youngest age you would prescribe this for so for
us we’ll look at if it’s a minor coming in we’re looking at parental consent
what’s involved with that often it’s not a requirement to have parental consent
to give emergency contraceptive or contraceptive by state law they’re
eligible for those services but we also know that a thirteen-year-old doesn’t
wake up and say I’m gonna be sexually active today that there are other issues
going on and that’s where we engage a social worker a counselor engaged make
sure that there isn’t anything going on and often there are other issues going
on on the other hand if a 16 year comes in and is seeking a contraception or
emergency contraception then we’re going to work with that patient as their
individual right in choosing how they seek those services we run the
school-based health centers there and keep in mind you cannot do contraception
in school so there is no delivery yeah they can go anyplace for care
including their primary care doctor thank you Dan for coming I just want to
give you a hurrah for you because I have been to your place behind the mall and
it is as nice as any physician’s office that we have an Oakland County it’s a
beautiful beautiful place the equipment is sparkling rear was sparkling
brand-new your staff doctors are amazing I think you do an incredible incredible
job and again I stress you can walk in there without worrying about having
enough money to get care and that’s a beautiful thing
federally qualified health clinics we have many of them in the county don’t we
you have two in the county so you have the wellness plan that runs through out
of Detroit but they have a location over Woodward they’re open three days a week
and then Covenant is open two days a week over in Southfield
and you are open we are open five days a week plus after hours and we have 11
locations throughout Oakland County ok so so we’re talking about how many total
you have 11 locations we have a lot of commissions that’s 12 right we don’t
operate covenant I understand but I’m trying to put a count in my brain yeah
so covenant has one location and the wellness plan has one location so you
have eleven so there’s 13 places there people are women we put it that way
right okay the thing that concerns me about the health department doing this
is you know I worked I was in the 90s that was a long time ago you probably
all weren’t born there but I worked very hard to make sure and got the first very
first grants that women who were raped or men would have pre-hospital care by
nurses who are trained in this particular modality and we continue that
today in Oakland County and I don’t want young especially young people where
there might be a rape involved not to get the proper care the proper and I
don’t know if we’re set up to do this kind of
stuff I mean and we’re not open on the weekends and we’re not Sundays Mondays
or holidays I truly think this is best left in my personal opinion up to Deb
and her folks or the other two you know the 11 clinics or the other two clinics
and I think you’re also I’m not mistaken you’re in the place over Oakland one of
the mental health places open family service yes okay so so people who would
come to Oakland Family Services would also be able to have this service as
well and okay I just think that it’s more than just taking a pill okay I
think it involves a whole lot more I don’t think that we have physicians do
we have physicians on staff we have one physician he oversees all the TB
patients in Oakland County he does see some syphilis cases and he pretty much
as orchestrating what’s going on in all of our medical services unit
communicable disease units and the laboratory that’s a big load okay so you
don’t have a guy in college essentially no no no and it’s our goal in the Health
Division no matter who we’re seeing in our clinical settings or even in our
home settings is to attach everyone to a primary care physician a home medical
home and we are constantly constantly connecting our clients to honor
community health because they are a federally qualified health center they
can offer a full array of services even specialties under one roof it’s a
beautiful thing and we believe it’s our job to really promote that as much as
possible and connect people to them for a wide variety of sir
yes do you know what it would cost to excluding the cost of the medication but
what it would cost the staff this and it would have to be staffed 24/7 the
problem is I was not able to get my hands on you know how much is this being
utilized because of the fact it’s offered in pharmacies and you know maybe
a few places here and there that are also offering either prescriptions or
the medication it’s on it’s unknown how many of these patients would be coming
through our doors but I do know that we are bursting at the seams and we are
doing our level best to get wait times down to something that’s desirable for
all the other services were providing so I just think that we normally try to
fill gaps and immunizations and STD work is an enormous gap in this community and
we’re mandated to do TB and HIV so between those services they are really
filling our clinics to the max thank you thank you madam chair thank you we would
need another physician or another physician’s assistant
at least Commissioner Bachman thank you madam chair mm-hmm and thank
you both of you for coming and being prepared to to discuss this first of all
I don’t think that this resolution is asking the county to take on providing
emergency contraception the wording specifically is that we shall provide
the public with medically and factually accurate and unbiased written and oral
information about emergency contraception we should supply referrals
and we should this is an important point provide all victims of sexual assault
who are seeking services or referrals to be provided emergency contraception okay
so and and there is a line in here a couple of times that says that it is our
job to provide medically accurate and unbiased and information about emergency
contraception and I’ll tell you what set me off on all of this was a couple of
months ago the county decided they wanted to weigh in on the issue of
family planning in a way that I thought was not medically factual and accurate
and so I started to just look into what do we provide how do we provide it how
do we inform people of what’s out there because as you say you have all of these
clinics and I’m looking at them here and you yourself Miss Brinson said you
mostly serve the Pontiac area which is of course our biggest one of our biggest
low-income concentrations of people and that’s number one where we should be but
we also have low-income women in Oxford and Holly and Lyon Township and lots of
other places in this county and when I went to the County website to say where
can I get help with birth control where can I get emergency contraception if I
have a problem yeah it’s in the pharmacies I know but it’s $50 and a lot
of these people you’re talking about do not necess
they really have access to a lot of information so I then after I looked at
our website and couldn’t really find anything on where to go if you are
looking to access county help with birth control which is federally mandated so
then I went to Macomb County and looked at what they had and I went to Washtenaw
County and looked at what they had and their different of course and they’re
different from us but for example Washtenaw County two clicks and I get a
full spreadsheet table of this place is here this place is here this place is
here none of that is readily accessible on the county website and I think that
this issue of emergency contraception in particular where someone most likely has
had a sexual encounter that they either were forced into or regret immediately
for whatever reason they we are trying to prevent unwanted pregnancies that’s
that’s my goal I think that’s your goal and I think that this resolution to have
the county have per be providing more obvious and more readily available
information about where women in this county can go to get service is very
important and I think frankly right now the information is either if it’s on our
County website it’s really hard to get to because I went looking for it and I
had a really difficult time so that’s what this is intended to address and
specifically to emergency contraception but I think we have a bigger I think we
have a bigger question overall how are we providing help to those low-income
people that aren’t in Southfield Arnon in Pontiac our big low-income centers
but are elsewhere Novi where I come from has 3,000 people in
poverty according to you know the local statistics where do those people go how
do they access the information that they need and I think our County website
needs to be updated and I brought this forward because I think this information
needs to be much more easily available and emergency contraception needs to be
publicized and known for those people who need it thank you at the last be it FURTHER RESOLVED via
for the result that the OCH D shall provide emergency contraception
immediately to each victim who requests it if the emergency receptions in the
form of pills the provision must include the initial dose when the which the
victim can take on-site as well as any follow-up doses for the sexual assault
victim to self-administer later so this this resolution would require the county
to actually provide emergency contraception this idea of the county
being a gap filler essentially filling those gaps of where can we best serve
our constituents and that’s really what but I think everybody here always asked
us ask ourselves how can we best serve our constituents it doesn’t sound like
to me that this is a gap that is best filled by the county in fact it’s being
filled by many other locations and I just question whether damn you said you
have 11 locations for FQHCs and as I recall there’s some type of federal
qualification in order to open an FQHC you just can’t open it in the middle of
Birmingham as an example correct so we’re like as an FQHC you are you have a
rare opportunity here because this FQHC is designated to serve Oakland County it
will not go into Detroit it will not go into Macomb County it will not go into
Livingston the Board of Directors which is made up
of both consumers from Oakland County but also community members have made
that very clear so it can only go it can go anyplace and
it can serve anybody but in order to get dollars federal dollars it is going to
be located in high concentrated areas where there are large Medicaid or
uninsured individuals so that’s part of it it’s not that we won’t serve novi
won’t serve Southfield won’t serve any place else however I do want to share a
couple things if it’s okay for my my public health background to I always
always think it’s important that women and partners have access to
contraceptive care services is the number one predictor for having a
healthy community and to address infant mortality to address school dropout
services if you look at any of those things
it is a significant strategy so whatever this community is doing I’m always
always grateful for the work that this community is doing to address that issue
Pontiac has the third highest teen pregnancy rate in the state of Michigan
the third highest teen pregnancy rate in state of Michigan so contraception
education services morning after a continuum of services important whether
it’s delivered through the County Health Department or through someplace else
it’s important and it can go much broader and wider and should go much
broader and write wider but I hear a couple things that I think that I see
one is there isn’t a lot of knowledge about plan B and where to access
contraceptive services pieces so not being able to go to a website it’s
giving me food for thought does my website say contraceptive
services I’m betting it doesn’t that’s something that we can add to that
educational pieces I was driving by and one of my staff members showed me the
HIV prep billboard discussion it got a discussion going this morning that we
didn’t even know about there are I think other opportune
is that whether the county or the community come together to address that
I think are really good things what you can’t measure is the morning-after pill
or contour Plan B or contraceptive services because individuals are either
not going and getting it and becoming pregnant and we don’t know that we don’t
capture that kind of data or individuals are going and getting it and we don’t
know it pieces what I do know is that it’s very very expensive so if there’s
anything for us to take a look at is how do we work to bring down that cost or to
make sure that that that piece that that that resource is available to women and
their partners pieces so I think it’s great that this discussions going on
from somebody sitting out in the community the first thing that I did
when I came on board five years ago was who’s providing contraceptive when I’m
doing prenatal care services those go hand in hand and there are not a large
number of people doing contraceptive services in this community st. Joe’s
does not do contraceptive services in this community we ended up picking up a
portion of their patients because Dax couldn’t afford contraceptive itself is
very very expensive services the the drug the product piece on that so I just
wanted to kind of share my thoughts on it that I don’t think anything is ever
lost by promoting contraceptive services and letting people know and I don’t
think there’s a lot generally you have Planned Parenthood who is doing that in
a community there in the Ferndale area pieces they’re not globally within the
community we’ve begun having discussions with the state about becoming a title 10
provider services that allows for any woman to receive services but those are
all discussions and policy pieces that are going on and and create interesting
dialogues just like this so whatever the county the health department were right
there in partnership with individuals and I certainly will always promote
women having access to contraceptive services
equally important knowing where to receive those services yes and I just
wanted to comment that a lot of the things that you had talked about
Commissioner Markham is very much what we do you know in the Health Division we
very much agree with providing factual information and services unbiased
everyone that walks through clinic doors there’s no judgement that we really want
to do everything we can to give them services where we can and then refer
them to places where they may need more we took a look at our website after we
spoke to you and we are now in the process of building a woman’s health and
a few we’re going to try to organize it differently we’ve been under some
constraints on how how it structured but we’ve got some great ideas about how we
can manage that we could do some senior health women’s health men’s health and
try to organize things with a lot of links and we agree with you there we do
have a lot of fact sheets that we utilize and although we can’t put
everything on our website that has everything to do with health we do
recognize and stuff that said this is an important area and we agree that that
needs to be out there and we need to be able to show people where they can go
but one thing is we have relied heavily on our nurse on call in the past places
where we think need greater discussion is a wonderful thing when someone calls
nurse on call and we have tens of thousands of people that call every year
to our nurse on call because they can have that more in-depth discussion
they’re very well trained and maybe getting at their the heart of some
issues trying to give them the best referral they possibly can and they will
even keep that person on hold for a minute while they call another
organization if they feel this is something that has to be done today we
need someone someone looking at this person today they’ll make sure that
happens and they have a lot of good contacts in
the community to be able to make sure it does happen so nurse on call is
something we have relied on but you’re right the written word is important as
well and we’re taking we’re already working on an organization for that as
well Commissioner top thank you Kathy would
you be willing to work with Commissioner Markham and kind of go over what’s going
on those pages and and and emergency numbers so you would be able to put the
FQHCs excuse me I’m there as a referral point my concern again I keep stressing
this is that sadly a lot of this quote-unquote activity occurs on the
weekends okay and by the time Monday morning I mean I’m just you know I okay
maybe it happens during the week I’m I’m old-fashioned but the point is the point
is that people people are asking for emergency help okay can I reach you guys
on the weekend am I correct or is the nurse on call always on call we do call
it for lots of reasons okay but what would you be willing to
you know pass it miss Li answer of all the questions that come through that
okay so you’d be willing to pass it by Commissioner Markham and she may have
some good ideas as well as to what to put there I
in all fairness to you I have found that our access to any information
from IT I don’t care if you’re looking for baseball bats it’s very difficult to
access I go crazy with what I’m trying to access right here at the Board of
Commissioners they updated our IT computers and they stink the program
stinks it’s worse than it was then a sconce they just did it okay
and half the time I end up opening the same thing 40 times and writing notes
that’s why I’m always scrolling through it’s not a fun thing to do so with I
would hope that we could figure out how to do it you know IT for dummies you
don’t need all this fancy stuff and how people can actually yeah access stuff
without beating around the bush so thank you Cathy so I wanted to say that more
information that we can get off the better especially serving Pawnee and
growing up there knowing the teen pregnancy rate this has been a challenge
for a lot of years so the more important information in places that they can go
we can let them know it’s great now my second question is if a situation did
happen on a tee weekend like she’s questioning when they call in
do we have referral sites for them to go to over the weekend or do they have to
wait to their Monday it depends on the situation and because you know if it’s
somebody that has been raped or we’re worried about we have specific places
that we would refer someone to so they get a great basement and you know the
rape kit and everything there’s so I know in a situation like Mario’s night
of course because if you go but you know we have a lot of resources I can’t speak
to all of the resources that nurse on call has but honestly they are able to
they’re able to find resources for people in almost every situation yeah I
mean some details you could give specifically
where day was that but I understand that’s fine Thank You Commissioner Koch
endure fer Shur just I am a huge proponent of making sure that the county
is providing accurate objective information and I am all for making
improvements to our website or otherwise I think it’s it’s critical for women’s
health in a lot of other areas for the reasons I say it earlier though I’m not
comfortable with the county taking on this additional role of actually
providing these contraceptives only for the reasons that have been described I
just don’t think it’s a it’s a gap that the county you should be be filling only
because we have so many other providers doing so but I do think that we could
step up our efforts in providing that information the dialogue that’s happened
regarding the information available on the web site and in written material is
a valuable discussion to have they did take note of your comments that your you
and your staff are busy with the task you have to date and in order to do this
you would need additional staffing which is in order to do the website you mean
what are you saying to provide emergency contraception immediately we need more
digital space right I do take note of that and I hear it so I think beginning
with the development of more information on the website and written material is
is where we need to start yes thank you madam chair
and thank you both for being here and thank you guys for being on the front
line and being a true champion for Public Health and then a whole array of
health that honor takes that as well I look at this issue broadly and like
three things I mean there’s the information there’s access to emergency
contraception and there’s the affordability piece and the information
I think that there’s consensus around the table here is like I mean when
someone caught that our health department has an inherent
level of trust built-in because people are accessing public health it’s a it’s
a public entity people come to it for information and we want the public to
come to the public health and then and then trust the information they’re
getting from it to be accurate I mean so I mean so making certain that we have
that medically accurate information a very easy way to consume is absolutely
critical I think there’s consensus around the table around this on the
access point I want to just like to say that we’ve got good enough access to
emerging contraception or contraception in general Oakland County is a false
statement and honor it does an incredible job but some of those clinics
are in schools and you can’t even talk about this stuff in those clinics it’s
automatically off the table as access points and then we’re a 910 square mile
county and so being able to get access to me into a clinic environment isn’t
always easy and frankly due to some new rules going into a fact that the
operation of some title 10 fighters is becoming a big question mark how long
that’s gonna be available and so from the referral point of view of thing
where if someone comes into the health department which I will strongly
encourage people always be able to reach out to the health department to me if
you have know if you don’t have a medical home the public health
department should be a place where you can come to go to to get the information
you need to go find things I think that we do need to kind of take a point on
access points and I kind of get a delivery of these services and I think
honor is it a place to be I mean to make a big dent in that but it’s I mean don’t
only so many limited places that we were a county of more than a million people
and then there’s the aspect of affordability yes you can go into your
CVS and get this over the counter it is very expensive and if we’re serious
about trying to prevent unwanted pregnancies in the first place that
we’ve got a very limited time where this is effective and is proven very
effective to make sure that day to stop a
pregnancy before it happens and so there definitely is some utility I think from
a public health department that we can acquire access to things at a cheaper
cost because of our ability to buy stuff and public agency but also it may be the
conversation is with honor health or whatever to help figure out how we
afford to do this because a sliding scale means the money’s got to be coming
from somewhere in order to operate so there might need to be a conversation
I’m not saying that tonight today that we have the conversation about how
we help pay for it but this idea that well honor healthfully just take care of
it well if it’s going to provide free access or a very low cost below costs
access to emergency contraception that means there’s other healthcare dollars
not available to do other health care things because you’ve got to figure out
how to make the pot work and so there might need to be a conversation about
what is the resource need to make certain that we’re meeting the needs of
the community those with the ability to pay definitely pay those who don’t have
the ability to pay we have to it’s absolutely critical we would make sure
that it’s affordable and accessible because we do I mean I think for all the
reasons that Deb mentioned like how this is interlinked to a overall wellness
Public Health System so I guess I think this conversation is helpful because it
really takes on I mean it’s it’s the informations the access the
affordability issue around this narrow and focus and then we do we have an
incredible partnership with Haven that’s I mean it runs our sexual nurse
examiners program which I know that if a survivor of sexual assault comes to
their facility they make they make the offer make it available to them on-site
I think we’re fortunately down to one site up here in Pontiac now and so again
there’s an access issue to some of this and so there’s more to that but I mean
getting down to the information I mean making if i hearing very good things
that this is a very positive first step and then we can have a further
conversation about how we get to I mean improving access to emergency
reception when it’s needed in the very limited timeframe that it’s effective
and the affordability aspect which is the thing that I’m also incredibly
concerned intimidating for vulnerable populations but anybody I mean anybody I
mean because I mean $50.00 and it’s not always easy for for individuals
particularly young people and so it’s an important issue we have a lot of
important issues on our on our table I think starting with the website and
information would be the way to go my concern about providing emergency
contraception immediately at the Health Department is burdening our health
department with space and additional staff I like to see what our partners
would be able to do with that initially yes madam chair since I am one of the
originators of this resolution and after hearing everybody today maybe we ought
to pare this down to speak directly about the the communication and so on
aspect of it and to do that I would suggest at this point we remove the one
two three four fifth be it resolved be it further resolved that OSI HD shall
provide emergency contraception immediately so take out that paragraph
that says we have to provide it and also the one on the back that’s related to
that and then the rest of it is about beefing up our ability to provide
information and access to victims and I agree that we I think we need to have a
much broader bigger discussion on the whole question of contraception across
the county but not as a part of this today okay and as the co-sponsor I agree with
you I can definitely support that do you want to include something about the
affordability the question of a further discussion I would leave that for the
bigger discussion we don’t have because the whole question of title 10 yeah all
that is okay our chair works for me so I’ll second it any further discussion on the amendment this is for the result of the OSI HD
showing sure that each person who provides care to sexual assault victims
as medically that’s right that’s exactly right there are clinics
in Oakland County today who are saying that they are providing family planning
and birth control information and it is not medically accurate and they are
stalling women from getting the care that they are requesting and need in the
attempt to keep these women pregnant and there are more of them in Oakland County
than there are regular clinics and so the whole point here is we don’t want
any money going to those kinds of folks we want to make sure that the people we
are supporting are people who are providing unbiased accurate information
so could you just one more time which ones for striking just like it would be
the one two three four fifth one down okay and then the one on the back and the one on the back which is related
about if we are providing it then it’s got to be this way okay thank you any further discussion on the amendment
hearing none we’ll have a roll call on the amendment yes yes yes yes that
motion is carried and now we need a roll call for the
motion resolution as amended yes no yes mr. Gerson I just would like to thank
that for rushing here have really appreciated in Cathy for putting this
being so open about having this discussion this is such an important
issue and we really appreciate your willingness to discuss it and then we’ll
discuss whether or not you’re gonna come back and the next meeting right right
okay thank you I need to step back for a minute the
motion for the amendment was made by Commissioner Commissioner Markham who is
not a part of this committee so you’ll make the motion we need a second then my
Commissioner Nelson thank you and if I could just second with member Gerson
sin’ said thank you very much for being here and for being so open and willing
to you know talk about where we need to go with this
thanks for to both of you thank you very much thank you everybody and to our next
item the Department of Health and Human Services Health Division interlocal
agreement with Oakland and Intermediate School District for public public health
nurse services good morning so this is a request to approve an agreement that
we’ve been working with Oakland schools for quite some time now saying I’m an
interrupt you for for a moment I need a motion a second motion by Commissioner
Todd’s seconded by Commissioner Powell thank you sir sorry so this is an
agreement that as I said we’ve been working on for some time the idea is
that we would use an existing and they would pay half the salary our
nurse would move over into Auckland schools and work with all of the school
districts in terms of looking at policies and procedures for a variety of
things that we are concerned about with public health such as what are their
policies regarding the storage and the use of epi pens every school is
different and how they might handle that we’re gonna take a look at those from
through the lens of a public health nurse as to what their policies and
procedures are take a look at where there might be gaps where do we need to
build a consistent policy that’s utilized throughout all of the school
districts in that and it’s not just epi pens it’s a variety of issues and how
they handles sick children and how they handle immunizations and on and on it
goes at the same point at the same time from a public health perspective we also
have key keen interest in this because we’re very interested in how they’re
handling social determinants of health issues as they come across them ah
really even aware of them in the same way in every school district so
eventually that is something that the public health nurse would take a look at
as well there’s a lot of things that we can do to help with policies and
procedures even assessments regarding that as well as bringing back shared
information to our community collaboratives that we facilitate that
are very much interested in how social determinants of health are impacting
everyone in the county but in this case particularly
schoolchildren how is that impacting their six awesome schools so we would
get for now as we’re just getting this going we know this is going to evolve
over time but we will use one of our existing positions and as I said receive
reimbursement for half the salary and the expenses the mileage and all of that
from Auckland schools in this agreement Thank You Commissioner Todd I guess I am
going to stand on a soapbox now Kathy is there any movement at the state to do
more about immunizations because this last measles outbreak was horrendous for
this county for this state and for people in this country is there any
movement at all third required it used to be in the old days everybody had to
go to school they had to be immunized now they can walk in and have every
communicable disease available and it doesn’t matter you’re correct we are
working very hard on trying to inform a community about the importance of
immunizations this is something that’s going on across the country as there’s a
growing number of individuals that are choosing either not to immunize their
children or their choosing to utilize a schedule that they think is more
beneficial for their child that’s a something every state I think
in the United States is working on this problem right now when it comes to our
measles outbreak for us is a very different picture than it was and then
it is in New York or other jurisdictions across America that are experiencing
outbreak for us it was a situation where we discovered that the population that
was most acted was perhaps say from twenty to
fifty even 60s where they either never were vaccinated or they weren’t they
didn’t receive the second recommended dose which was a later recommendation
that came out and they were probably you know in high school or something and
somehow missed it for us that was the population that we had to really direct
all our focus on and when we did that we were able to really encourage our
communities older population to become vaccinated and that’s what we believe
was the success story to being able to end that outbreak Commissioner time as a
follow up do universities and colleges require kids to be immunized today recommendations but it’s not
we won’t enroll you if you’re not vaccinated and in Elementary’s in high
schools and daycares if someone chooses to go against the recommendations you
have to come to the Health Division to receive a waiver and they get an
educational session we found that to be useful and it may not be immediately
effective we’ve seen that our waiver rates are going down any further
discussion on this item roll call please yes yes yes our next item is Health and
Human Services Children’s Village intensive family based re-entry program
creation and need emotion motion by Commissioner Todd seconded by
Commissioner Koch underfur hello hello I’m Jody overall manager for Children’s
Village this is a partnership between the Family Division of the circuit court
and Children’s Village and it’s a new program that we’ve developed that’s
unique and different in the sense that the bulk of the programming will take
place in the the child’s home with their family and in the community instead of
at Children’s Village the program will consist of 30 to 45 days at Children’s
Village Court order and then a transition period home and then between
two and four months of family based programming within the home children’s
village would need to add two full-time clinical positions to our budget as well
as a reentry specialist to provide those services the court has a existing
caseworker that they would assign to this re-entry based program would be
intensive probation we would continue to work very closely with the court on that
component and then there are some materials that would need to be added to
the children’s village budget and the court budget i’m funding for those
materials would come from the Department of Health and Human Services
administrative budget and all of this program would be 50% reimbursed by the
childcare Fund take in the funding professional
services for the fiscal year 2019 is 2400 and no professional services in the
upcoming year what are professional services what’s in that category that is actually before the court your
professional services Thank You Commissioner Todd Thank You
Jodi are you working with Oakland County youth assistance as well because I think
you are in Birmingham too once the kids become have finished their time with you
then they’re going to go I’m trying to follow the path they’re gonna take so
they’re going to go home and they’ll be 30 to 45 days working with so they will
be court-ordered in to Children’s Village for 30 to 45 days okay during
that period of time Children’s Village treatment staff will do risk and needs
assessments meet the family set the groundwork for treatment programming and
then there’ll be a transition period where they may actually transition back
home that’s when the court intensive probation worker also will get involved
and you this is driven from our reentry process which you assistance is very
much a part of they helped us establish it as well as the court and so youth
assistance will be involved in helping provide services and resources for the
kids and the families when they’re at home so they’ll work with the reentry
specialists okay and I mean whatever services y-a provides based on the
community there and they would be engaged by our reentry specialists and
provides those same services to the family okay so if in children’s village
you find or maybe shortly thereafter youth assistance can provide some
funding for say I don’t know a light bill or electrical or water bill or
something of that sort as well as counseling for the kid as the kid
because the child has to go from your shop back into school obviously so there
may be some impediment and that’s where youth assistance comes in am i correct i
we currently use them now they have funding I think approved by the board
and so if we want to send someone re-entry Children’s Village re-entry
specialist I think probably the court also if we want somebody to go to camp
and they can’t afford it or they have a light bill or a car payment something
pay youth assistance has the means for us to be able to make that request but
it’s not provided by the Oakland County Board of Commissioners at all though
that funding is called an angel okay there is somebody who funds those
dollars Oakland County youth assistance board and then the local social workers
know that if they need a car payment made or a rent payment made or you know
heat bill paid for they go to Mary Shuster
Bower and the rest of the money is provided it’s not okay only the social
only the social worker is paid for by this board or by the courts everything
else all the other funding to youth assistance comes from the ordinary the
individual organizations raising the money for it
so that’s it I mean period and in the local communities local school districts
provide an awful lot too but not this board okay just just in regards to the
kinds of assessment tools and materials we have an Assessment Center at
Children’s Village they will provide several I didn’t bring them here we have
MGS which is the Michigan Juvenile Justice assessment and that assesses
criminogenic risk so that is a tool that is probably one of the most important
helps determine the likelihood of a child to recidivate or commit another
crime and then we reissue that assessment throughout the course of
their involvement with the court and certainly during the course of their
placement at Children’s Village we also do the campus we do a substance abuse
assessment and these are these empirically supported yes any further discussion on this item
seeing none roll call please yes yes motion carried thank you
our next item is Area Agency on Aging one be the annual implement
implementation plan for fiscal year 2022 2022 I need a motion motion by
Commissioner Powell seconded by Commissioner Kok underfur they welcome
welcome thank you for having us Michael Carson CEO Area Agency on Aging which
you have acquired director of research policy development and advocacy at the
Area Agency on Aging every year we come here and we talk about our annual plan
and then we’re lucky enough to have a three year plan which is some part of
our funding and today we want to talk about our three-year plan and some
highlights of it and I have some past things to pass out as well I’ll get
those to you before we leave today there are 620 triple A’s our Agency on Aging
throughout the country it was formed by an act of Congress and supported by the
state legislatures in each state as well currently we have over seven hundred and
thirty seven thousand seniors that we care for in our six counties which make
up Oakland Macomb sank there in rolling stone in Washtenaw 30% of the senior
population is in these six counties which really makes up only 5% of the
landmass of Michigan so you can see the room very highly concentrated in doing
so last year we served twenty-two thousand one hundred and sixty seven
people in Oakland County investing just shy of 20 million dollars so we’re
really proud of the work that we’ve done in the partnership that we’ve had with
the county today we just want to talk more about our multi-year plan and
following approval of the Commission then we take this we go to each county
we get approval then we take it to the state in Michigan where
go in front of the Commission on Aging and get their approval and we’re held
accountable obviously to meet this plan as we go forward we had hearings we had
six public hearings and we had one in each County and then we had a final two
hearings we had one in Southfield and one in Ann Arbor to just get some more
information and feedback well anything that we heard was incorporated into our
plane as well anywhere was possible and in doing so we’ve drafted the final
version that we’re coming forward with today we invest our funds in two ways
with grant Awards with community organizations and we provide direct
services we also have this year have done something different within our
categories we’re allowed to spend money and we’ve only had a very small amount
of areas that we identified and this year we’re doing something different
that we’re putting a dollar in many categories which will allow us
throughout the years to either start programs that as we feel the need and to
move funds and this will allow us to do this without going back in front of the
Commission on Aging and Lansing so it gives us a lot more flexibility and to
be more responsive as needs come up for a community and to really make sure that
the money is going in the proper course we’re also doing something called
gap-filling which is something new this year is really for unmet needs we’re
budgeting $10,000 for this fund it’s for a one-time occurrence for people that
have something that really is needed that we can help them with it could be
repair of a front door to make sure that their home is safe it could be anything
from grab bars to helping with a rent it could be whatever’s needed so our goal
is to have almost this emergency fund to help and be responsive to our senior
population and in doing so you know the county has been really helpful and the
six hundred thousand dollars that was put forth to help us to move people on a
community living program has really done wonders who want to thank you for your
support on that as well as we continue to move that forward in 2018 some of our
most popular touches when we did our information and assistant which is our
Resource Center it’s currently open five days a week we have unbiased information
to anybody that calls so it could be on any resources whether it’s public or
private as well as some programs that we have internally so we move that
our counter meal plan is growing we have more needs to or more sites and we’re
looking at those always and of course home delivered meals or meals on wheels
is a great touch and not only do we provide services for that but it’s also
an opportunity for the people delivering the meals to check on the well-being and
to make sure we’re avoiding complete isolation for a lot of the seniors that
are living you know by themselves so again great programs currently our most
funded programs record home delivered meals congregate meals our community
living program and that’s a program for people that call up and they need
additional services that’s what the six hundred thousand had really deals with
our zeros the people with highest need to make sure that people are getting
those services right away and our dementia Adult Day services as well
under the new program we want to do a lot with research and demonstration of
prom you know different projects for evidence-based data we do feel that it’s
important for our advocacy to really talk the story and have the data behind
it to back everything up as we do that we’re moving to more of a strategic plan
with these at the state federal and local level to support our older adults
and we’re a measure of role and reporting outcomes for our contractual
services so as our services go off we want to hold them more accountable and
make sure that we’re getting much more services to be able to justify what
they’re doing and how well they’re performing of course we’re proud to say
that we started a philanthropy program and our agency and first year into it so
that’s moving forwards we want to make sure we continue with our fundraising as
well as grant writing a grant writing program has really taken off under Jim’s
direction and his staff and we’re getting tremendous grants that are
really allowing us to look at different areas of seniors and how we can serve in
all of our different counties and then public transportation which is a huge
issue so again another focus on public transportation and what we can do and
how we can help be a partner with whatever’s going to happen at the local
levels and the funding we do know that you know is
mentions many times when he speaks you know door through door of getting people
helping them get out to the vehicle getting the transportation and getting
them back in and whether that’s meals being delivered to be brought into their
account into the onto their counters or even medication so transportation again
is a big push for us as well and additional resources of caregivers and
family caregivers we have to really start looking at who can provide care
and services there’s a shortage of caregivers in the state of Michigan and
throughout the country the pay is not great it’s not really seen as a
profession and a lot of times there’s family members that are able to provide
care service how can we incorporate using them and their services and help
them so we can provide care more reasonably and make sure it’s a safe and
a safe placement and then a wellness program to make sure it’s throughout our
market and also looking at private funds to see what’s available in that area our
medical nutrition therapy it’s our dietician really looking at
helping people with dietary needs especially diabetes education to help
them leave the help healthier life avoid unnecessary health care and one thing
that we heard a lot at our public hearing with grandparents raising
grandchildren it seems that through the opioid problem and drug abuse and just
bad family units that a lot of grandparents and not just grandparents
could be aunts and uncles and other older members of the family have taken
on the responsibility of raising younger members of the family and in doing so
that it’s really a financial hardship for them a lot of them are making
decisions between their medication and their food and how to get services and
so it’s a lot of work to be doing on advocacy to make sure that if they were
doing adult foster not adult foster care I’m sorry foster care for the children
there’d be funds from Lansing but in this situation there’s not so a lot of
advocacy and promise in that direction so really excited about our plan and
we’re excited about what we’re doing core and then continue with all of our
core programs and everything that we currently do and as we move forward with
our agency in that we’re looking at all different aspects for our future
strategic plans of ways that we can continue to meet the changing needs of
our senior population and disabilities and we’re want to become
the leader obviously in some of these four fronts throughout the state to set
the example in the standard of what needs to happen
thank you I’m not sure about every city in Oakland County in the cities I
represent we have the sharp program which or a group of volunteers that
would assist seniors in putting a bar in where the items you described is the
gap-filling program do you work with the Sharpe programs in the cities currently
it does open up the option the possibility of a sharp program that has
needs to buy paper materials or some identity to go to us that they have no
other local resource that’s what the gap filling is for right the other item
regarding transportation some cities also have senior transport transport
services through some kind of grant for the smaller bus do you work with those
cities to provide transportation you do we have an amazing Transportation
Department and we utilize all the different services that are out there
for medical non-medical trips to the grocery store post office drugstore yes
we do and we’re always looking to partner with even more thank you
Commissioner Tom do you still have a few questions I just wanted to commend you
if you still have the program where you will where you take a look at all the
people who are providing transportation and that that’s them so that people who
can afford to pay for say transportation or home care but don’t know exactly
where to go you can give them some recommendations do you still do that we
do we vet all of our programs we do have some level of standards and we do vet
them and our we have a very dynamic transfer
Asian department at the agency so when people call up we help match that and I
was also reading an article that looks at peers that lift might be doing
something with Medicaid for the first time so that really opened up a
tremendous amount of opportunity for seniors to get much much more enhanced
services but I would say there’s still areas that are not served well well I
think I think for those of us who had who had not have any more parents who
needed wheelchair transportation and could afford to pay for it but just
didn’t want to turn grandma over to you know any old person it was wonderful in
my circumstance and I want to thank you in the resolution that says that there
were some constructive changes in the plan made as a result of some comments
those might have been programs pointed out that there’s a need for respite
there’s a need for respite services where in our current respite services
we’re providing an aid to watch the older individual so the family member
can go but it’s a little whole different ballgame with grandparents raising
grandchildren you need essentially a babysitter for the children so that the
grant grandparents did they have respite and break which those of you that had
children know desperately need under the best of circumstances so that’s
something that we modified in our plan and in a public policy race a lot of
policy issues is whether our dollars could be used for that particular
purpose or not something we have to research and involves federal stuff so
we added that respite issue to the language of the public policy platform
that we intend to address and then I have a final comment if I may madam
chair you sent us a fire that’s a snapshot of the fiscal year 20-22
you know what I’m talking about okay and there are two
boxes below there there’s a circle funding allocation by the service type
and who we are and who we serve okay now if you jump down to a statement you
made it starts an estimated seven hundred and thirty seven thousand older
adults you see that you left a word out remember I read everything so and you
left a word out so you need to put a word in there and reprint it it’s right
here yeah yeah on that point it says an estimated seven hundred and thirty-seven
older adults and live in the Triple A 1 B region either you strike the word and
or you add something before does that make sense
no that’s true that’s a good point we the and should not be there okay so I
think they reprint this thing cuz it shouldn’t be there thank you you could
say work and live but they don’t most of them don’t work sorry Michael you know I
read everything what are your income qualify mean I understand where where do
you draw the line and income and you say to people okay I know you need services
but you’re gonna have to pay 10 percent or 15 percent or 100 percent well how do
you figure that out we have some programs require that you have Medicaid
eligible some programs or a cost share where you could pay what you can afford
so all the programs are a little different I mean most people are below
poverty level that we service but to your point all of our programs are a
little different that way so if I may follow up so somebody say a
couple lives in a kind of a nice house you know and it’s well cared for but
their income level is not high do you then demand that they sell their house
there’s a way that we can calculate looking at just the person that needs
is separate from the spouse but we do look you know we do look at assets one
of our biggest program one of our largest programs is our my choice
program which keeps people out of nursing homes so they have to be nursing
home eligible and to do that you have to have Medicaid so it’s for people that
have Medicaid that had this nursing home eligible eligibility and then we provide
services in the home so the goal is to keep them out of the institutional
setting then we have our Community Living Program which is funded which is
part of that zero fund that you know we’ve always had the ability to ask for
you know pay what you can afford type of program okay it really depends on our
funding if we have a lot of funding coming in from the government here we
might we have to spend our dollars in all that area we don’t always ask for
that but we have the ability to do so so it is a based program specific so at
this point we’re in a good yeah we’re in a good position financially and we’re
able to service as many people as we can okay you’re Mia one more last one Meals
on Wheels I understand there’s been a change in
the program this year the P if somebody has a car in the family they they don’t
qualify or something what did I hear about that then I don’t know you have to
be homebound in order to get the meals okay but if you not somebody who drives
in the family I’m not aware of any kind of but you check on that microphone or
whatever to you Jim because I had heard that if you know family let’s just say
the the wife can’t fix any meals any markers she’s home you know whatever the
reason is that if the husband can drive they don’t get meals on wheels or if
there’s somebody in the household let’s say the mother a driver yeah yeah that
they don’t qualify for Mueller they have to pay I’ll find out if it’s okay I’ll
see ya I probably some people if the paper can people pay for meals on wheels
yeah try to understand they not heard the car
I heard that from someone who I don’t remember and I think I heard it from the
people who are looking to have Oakland County pay for a kitchen in the western
part of the county do you know anything about that well we have a lot of we have
a lot of contracts that we have I’m aware that our nutrition provider that
serves Livingston County and Western Wayne County they they’re losing the
space and the church I believe that they’ve been preparing the meals that so
they’re looking for a new office and they’re a new location to prepare meals
and they were somewhere along that Oakland the county Livingston border I
know they’re talking to the Livingston Board of Commissioners about helping to
provide the financing they want over a million dollars from Oakland County but
then that would leave out everybody else in Oakland County who he works out of
churches or schools or wherever to provide meals we have approximately six
six contracts and Oakland County to provide meals okay we have a lot of
different contractors already one of the things that we have though is the way
the meal program works they kind of bid for how much money they need for the
year and then we take that money and allocated accordingly it’s really
important they spend the money and some of them do not spend the money and if
they’re not serving the area properly then we will start taking money back
that we’ve not done in the past so we’re trying to bring in more competent
contracts if you will contractors to make sure that they’re meeting the need
and then of them also there’s a requirement that they open up congregate
meal sites and some have not been willing to do that in some cities as
well so we’re taking a really hard look at our contracts to make sure that the
ones that are serving are doing a good job new ones coming into the market
we’re always looking for new but at one point we’ve been talking about can we
consolidate Oakland County to one con we have one contractor that can serve
all the county so we’re not dealing with so many different entities different
menus different requirements and everything else so we are looking at
that way but you do have dietary requirements we do absolutely all the
menus have to be approved okay so we have some people okay thank you thank
you we do on-site inspections as well thank you madam chair thank you any
further discussion roll call please table yes yes yes yes
the motion is carried thank you thank you thank you very much
for lying there thank you Hey next I don’t miss a presentation by Clean Water
Action and I want to thank you for your patience thank you very much for having us today
everybody my name’s Sean McCreary good water action and this is Meredith
gillies our southeast Michigan program organizer because most of our work
focused here in Oakland County so first of all I really want to thank you all
for taking a look at you know what we think is a very important issue of
septic waste contaminating waterways that really happens across Michigan and
frankly happens anywhere where there is a septic field thing is there’s
different ways of dealing with it and making sure that a septic system is
working properly and is not contaminating groundwater sources so and
you know I’d also just like to say in Oakland County does have some of the
best septic siting requirements and some of the best requirements to make sure
that when a field is actually being built it’s being done properly after
that there isn’t really follow up and Michigan is currently the only state if
we take a 10,000 foot view of this Michigan is the only state without as
uniform statewide sanitary code that requires inspection of septic systems
statewide about a third of Michigan residents live in a place where they
have a septic system the other two-thirds have sewer systems and you
know right now if you’re living on a sewer system like many of us do you’re
paying the sewer bill to make sure that your waste is being taken care of
properly and not going straight into the river behind your house the same cannot
be said everywhere about septic systems we currently have 11 counties in
Michigan that have their own septic codes and the other 72 counties don’t
have any sort of a requirement that ever requires testing or looking at a septic
system once it’s been installed last year we did an informational
presentation like this to the Oakland County Board of Commissioners and in the
aftermath of that there was actually a state sanitary code bill introduced
and so I did want to give folks a little bit of background on that processes we
get started today so with that bill from last session it was co-sponsored by
representative Lauer from Western Michigan and representative Hammoud from
Wayne County and so started out as a really good bipartisan package that was
strong enough that we with a couple little tweaks we would have been able to
support unfortunately the bill did not run that way by the time it made it to
the floor of the house which was during lame-duck all of the really good
provisions had been dropped out of the bill and it had become a bill that a
preempted counties from having their own regulations and then be created the
statewide septic inspection program that wouldn’t that said that they would
inspect septic systems whenever there was reports of a failed septic system so
roughly the equivalent of inspecting a bridge the day after it falls down and
then telling you what the problem was so that’s sort of the backdrop and we’re
anticipating that a state bill is likely to be introduced again this session and
we hope that they get started you know along the right lines like they did last
time but it doesn’t go off the rails another important parts to work into
this two of the main interest groups sort of involved in septic interests and
I was really glad that last time folks from the Oakland County Board of
commission and brought in the Oakland Realtors
Association because realtors in a lot of cases and in in fact the 11 counties
where we do have septic codes in Michigan all of those counties right now
have point-of-sale ordinances where a tank is only in septic system rather is
only inspected at the point of sale of a home which has been shown to cut down on
the problem of failing septics however you’re missing a lot of the worst
offenders to farm houses that stay in one family for generations are never
getting their systems inspected and those are the most likely to be leaking
or in some cases they’ve actually found a straight pipe running through the far
now straight out to a creek there’s a map to the berry and Eaton County Health
Department put together that has a lot of examples of that
not quite the nicest thing to look at but um so I just wanted to give sort of
that overview of sort of where we are now on septics to enter this
conversation Meredith you want to walk through oh yeah sure um I mean just a
little bit of background on who we are so you know we’re a national
organization and in Michigan we have over 250,000 members an Oakland County
is actually the area where we have the largest concentration of members not
surprising as Oakland County has been you know pretty much a leader on a lot
of environmental issues in the past and that’s one of the reasons why we have
you know focused here in Oakland County and to work on this septics issue so
from the statewide level we currently have nine point four billion gallons of
raw sewage leaking into our groundwater annually and that’s an estimate that
comes from the DEQ and that’s from failing septic system specifically so
it’s a huge problem statewide and that’s supported by the study done in 2015 a
scientist at msu studied specifically wastes from human waste and e-coli
traceable to that was found in the six all 64 rivers that were studied so a
hundred percent of the sample came back with high E coli levels and you know
this region has been seeing an increase in e.coli problems advisories beach
closures really all over the region so it’s clearly a big statewide problem so
how much is it affecting Oakland County specifically so we know that Oakland
County has between 80,000 and 100,000 100,000 septic systems and based on
those statewide failure rates it’s estimated that between between 10 and
25% of those systems in Oakland County are leaking this is a huge problem as
you know Oakland County has the most inland links
any County in the state and it also has all five of the watersheds in Oakland
County have been found to have ecoli levels and at least part of the
watersheds that are exceeding federal standards so we know that there’s high
you Koller levels across the county in all of the different watersheds so we
also know that over 2000 of the septic systems that failed last year not last
year sorry from 2011 to 2015 came from Oakland County so that’s about
10% so extrapolating from that if Oakland County is accounting for about
10% of statewide rates that means just in Oakland County we have about 940
million gallons of raw sewage going into our water I don’t think we really need
to expound upon why that’s a problem but ecoli poses a lot of public health
threats and it also you know prohibits our enjoyment of our waterways which is
a huge problem you know just to stress as well a lot of the numbers that we’ve
used your are estimates that are coming we used MDEQ because deagle has not
actually looked at this yet since it’s been reconfigured into a new department
but a lot of these estimates have not been really tested and proven it would
be very good to do tests dr. Rose’s study from Michigan State that Meredith
referenced the main finding that she had was that there was a direct correlation
between number of septics and a watershed and the amount of e.coli they
were finding in the water so so with all of the numbers in here it’s really hard
to tell until you actually get so for instance in Burien Eaton County they
predicted about 15 years ago that 10% of the septic systems in the county were
failing when they actually did have a septics program for 10 years and looked
at sceptic at the point of death
point-of-sale they found that the number was closer to 30% so it’s really hard to
get actual accurate numbers until you go in and do a study and figure out exactly
what the failure rate is but almost everywhere that they’ve looked at this
has fallen within that 10 to 25 percent in Michigan of a failure rate and and
again you know I guess it is sort of a strength really that you can see it’s
like so with the 10% or so of the reported failures of septic systems
coming from Oakland County at least there’s a strong reporting mechanism
here that they’re likely isn’t in several other counties so just important
things to keep in mind with this and then so county level septic codes like I
said 11 of Michigan’s counties have done this so far and you know I think a big
part of the reason why none of these have really reached up to the state
level and become an example that the rest of the state is following is
because it’s been a contentious issue everywhere it’s been done there’s been
the realtors on one side of the table the environmentalists on the other side
of the table and really the conversations changed a lot recently
because the environmental groups no longer really like the point-of-sale
approach it’s one way to do it it makes the problem a lot easier to deal with
with Realtors don’t like point-of-sale we actually don’t like point-of-sale
either because it’s not really the fairest way to deal with the program if
a house changes hands once every three years
let’s say there’s some property that just keeps selling it so that it just
keeps getting sold you’re going to be looking at the tank constantly where is
the property that sits and what with one owner forever is never being inspected
and that’s likely going to be the offender so getting away from
point-of-sale is important if there is a county that can show that it can be done
correctly I think that would easily become a model that you know the state
would be PA recommendation is to inspect septic systems every time they’re pumped
which they recommend three years now that can vary greatly
also based on occupancy of a house if it’s a house with a septic field
designed for six people and there’s you know a retired couple living there and
it’s just two or whatever the case may be that obviously the time limit can
vary there the EPA recommendation is to inspect every three years along with
pumping and then regular inspections versus point-of-sale the reason why we
prefer regular is that you know it ensures that each system is again being
inspected there are many ways as well to work around point-of-sale ordinances for
instance in Ingham County they recently had to or they’re in the process rather
making an adjustment to their point of sale program because if house is bought
on a land contract they can get around it and different things like that and
then also lifespan of a septic system is generally fifteen to twenty five years
if it’s properly maintained so with point-of-sale many systems are
going twenty years or longer without being inspected period which is again
you know about the lifespan of the system that we’re looking to have
inspected another benefit you know does it regular inspections are the best way
to make sure that septics aren’t posing a threat to public health or damaging
lakes rivers or groundwater regular inspections also promote regular
maintenance which is cheaper for the homeowner in the long run than replacing
a failed system that fails because it’s been hasn’t been properly cared for and
fails really much cheaper for the homeowner to be able to have that
regular maintenance and you know keeping a working system working average
inspections nationally cost two hundred and thirty seven dollars with costs
ranging between seventy and four hundred ninety dollars those numbers hold up
about rig hold up for in Michigan and the eleven counties that require
inspections most of them charge somewhere between two hundred and three
hundred and fifty dollars for that inspection with the higher end in some
counties is closer to forty five hundred dollars depending on the way the county
but then septic replacement on the other hand if the tank fails early can cost
anywhere between ten thousand twenty-five thousand dollars is average
and that’s depending on again what kind of soil you have what kind of a system
you need if there’s heavy clay soils a lot of times left to build big mound
systems whereas like a sandy soil will filter much better so in the counties
that do have septic codes requiring inspection in Michigan it’s done a
couple different ways so there are a couple counties that have Health
Department staff conduct all inspections however that is rather unwieldy for the
health department generally it’s something that requires quite a bit of
staff especially depending on the number of tanks that you have to inspect and
then other counties have a system where they allow private contractors trained
and certified by the Health Department to conduct inspections and that can be
done you know that that can definitely be an efficient system some of the
things that really have to be watched for with the private contractor side of
things is adapting sort of transparency clauses for example making sure that a
contractor who conducts an inspection can’t then go in and do the repairs that
they’re calling for in the inspection and you know on the alternative side of
that doing some sort of quality control to make sure that people aren’t
accepting more money to pass something that’s also believe it or not been an
issue so Health Department oversight is critical with a program like that
because the Health Department would then have the ability to decertify private
contractors who don’t follow the rules and it’s often good to have a strong
financial incentive for them to follow the rules by being able to levy a fine
if they’re not following the rules on how to conduct the inspections
another important thing is so like in one of the changes that we wanted to see
to statewide septic bill from last year was in the initial bill they had
ten-year regular inspections of all septic systems in the state great
but the inspections were only of the septic tank itself not of any of the
other components of the system and the tank is really just a big steel tank
they can fail but they aren’t the likeliest part to fail the drain field
is much more likely to fail first and for that you need to do a percolation
test where they actually just no jaqen dig a hole basically in the in the drain
field fill it with water see how long it takes to seep down make sure it’s still
percolating but so making sure that the entire system is being tested versus
just the tank is also important in here as far as funding goes fee schedules for
inspections and certification of private inspectors can help fund the
administration of a septic code another thing that we objected to in the
statewide bill that when it was originally introduced was there was
preemption there was preemption in there that would have repealed all county
level health codes and also there was no funding to County Health Department’s
but county health departments were supposed to carry out a majority of the
work including collecting the fees to be passed on to DEQ which I know for some
health directors was a little bit galling that they would be not funded to
do any of it expected to do all the work and then expected to collect for the DEQ
as well so fee schedules can definitely help with that on the side on the
administration side of a septic code and then funding you know also needs to be
provided of course for homeowners who can’t afford repair to repair or replace
a failing septic system and there’s actually federal money available right
now that only like I said the 11 counties that have codes in Michigan can
take advantage of because you have to have a septic septic code in order to
that requires inspection to attain the funds that are available
through part three of the Clean Water Act there’s also a Great Lakes
restoration initiative funding available to help with replacing failed septics
and Community Development Block Grants can be helped for senior citizens to pay
for replacement of failing systems so and then another really important part
to have in a septic code is of course a strong definition of failure depending
on how you define the failure of a system you know that really means a lot
if you define a failed system as only you can see there’s a visible giant hole
on the side of the tank then nothing is going to really qualify as a failed
system so this is a really strong definition of on-site sewage system
failure that we pulled I believe from the Ingham County subject code but the
and really the key part here so we also that we did a survey in Oakland County
this was about a year and a half ago now of our of our members and we had we
found that they were supporting to have regular septic inspections every five to
ten years funding for administration of the program and to help low-income
homeowners cover repair and replacement a strong definition of failure and most
importantly 84 percent of the respondents to our Oakland County survey
supported paying an additional 3 to $10 monthly to reduce e coli contamination
and water now it likely would it definitely wouldn’t take that much money
from every resident monthly to be able to fund a to fund a strong septic
program one of the options that we’ve been looking at actually for the state
level bill is so and the theory is basically this I’ll throw this out here
for your folks the all of us who live on a sewer system pay a sewer bill monthly
or quarterly or whatever it is around here in Oh mines monthly and that goes
to maintaining the system when we did renewable energy financing
in Michigan in 2008 it was popular program that got bipartisan
support because there was on bit and on-bill financing was a key component of
this we were able to keep the charges for moving for moving to renewables to
less than three dollars a month and accounted for in everybody’s bills and
the on-bill financing was really a critical part of making that work the
only reason we can’t do on-bill financing for septics is that there is
no bill to attach this to but if a county could theoretically find a
mechanism of collecting even just 50 dollars annually from every owner of a
septic system you could pay for the full inspections every 10 years and also have
money left over to be able to spend on doing no interest or low-interest loans
for low-income homeowners who needed to replace failing systems so that’s sort
of one of the funding options that’s being thrown around figuring out how to
do it that way so that we could have the regular
inspections and all that stuff but again this is a complicated problem lots of
different ways of doing it and I’m just excited they all are
interested in you know working on this issue we think it’s really critical
especially as we look into the future of water here in Michigan if we’re not
taking care of the problems like this the problem of climate change and the
raising the rising water temperatures that we’re going to see in the rising
water amounts that we’ve already seen become a much larger problem when you
have problems like this going on in the background so we enjoy you know we look
forward to working with Oakland County and continuing with you Oakland County
continuing to be a leader for our Environment and Public Health all the
great work you’re doing so far it’s open up if there’s any questions at this
point in time and this is all of my contact info thank you it is an important issue to us
years ago before my time on the Commission I know this was a topic of
concern and a sense beginning with the Commission I’ve heard
from many residents in Oakland County that this is a concern that’s important
to them so we’re gathering all the information reviewing the history
accumulated and I’m I am surprised by the e.coli that’s found in our rivers
and waters including Oakland County so thank you so Commissioner Todd followed
by our Health Department I have some questions Kathy how many beaches did you
close over the weekend I don’t recall any being closed in Oakland County based
on the news are you are you able to test now whether ecoli comes from okay so you
let me get this straight you’ll be able to take a sample of e.coli and know
whether it’s ducks and geese and who knows what or human okay how many
complaints do you have annually about leaking septic because I’ll tell you
what I have one septic in my subdivision and I’ve never would like to convert it
so but the person doesn’t want to but there has never been any leakage he
takes good care of it so you know to me I’ve smelled leaking septic sand they’re
very they are not gardenias or roses can you answer that calf can you speak into yeah it’s hard for
our television people to hear yeah make sure you’re on there yes
so septic systems can leak in a variety of ways it depends if we got straight
pipes or what the issue is but a leaking septic system generally surfaces in most
cases many cases or it backs up into the home nobody wants to live with that and
everybody gets those taken care of those that might be discharged either
intentionally or unintentionally to a lake river or a stream that’s another
story and also it’s something that we generally can catch we start to if we
start to notice something through our Beach monitoring program it has a way of
trickling down to lakes where we’re monitoring and should be coming up with
results that would indicate that and in those cases we do some extensive
follow-up trying to find if there are leaking septic systems I have to say we
have asked repeatedly you keep saying that there’s strong evidence and dr.
Rosa study supposedly indicates that there’s evidence of e.coli in our
Oakland County lakes rivers and streams and yet we never get anything back that
would show us show us that I have to question are those how are those results
tied back to septic systems and why how do we know they’re not the result of
consent combined sewer overflows after wet weather events because that’s
millions of gallons of sewage going out into streams after wet weather events
whereas a septic system we’re talking about a trickle really and so I can
answer the basics and I think what would really be
more than willing to help facilitate and make this happen but for dr. Rose too I
have repeatedly asked for that report and I don’t know why I can’t have it I
can send it to you but you have said that before and we’ve not received it
and we would really like to but yeah I can also see if dr. Rose can come in and
present if that would be useful to folks but I know the way she the way she’d
determined that it was not coming from combined or separated sewer overflows
was that they did the testing of the sixty-four rivers when the rivers were
running at very low flow during a dry during a dry time of year when there
hadn’t been any overflows and there are still issues that happen where we have
pump stations that fail even in during dry periods and sewage is dumped into
streams unintentionally but it happens all the time whether it’s dry or not
doesn’t mean it didn’t come from a municipal system someplace upstream you
can’t you can’t declare that it’s from leaking I take great exception to that I
take exception to how the state has evaluated what the failure rate is
across the state and as you know the reason for wanting to have a statewide
sewage code is because so many jurisdictions have terrible sewage sanitary codes and septic programs
Oakland County has had a gold standard program for years which the state is
constantly providing tremendous accolades about our program here so to
say we have the same failure rate just because it’s found in some other County
I happen to be on an accreditation board for the state of Michigan where DEQ is
evaluating other septic programs and honestly there are counties in this
state they don’t want to pass because they’re subject
programs are so horrible and for us all to pay this enormous price of what
you’re suggesting based on the fact that others have horrible failure rates and
we’re not seeing any evidence of it is it’s very really hard pill to swallow I
live in the Great Lakes region we’re responsible for 20% of the world’s fresh
water I think it’s up to us and all of us to do what we can then we still have
many people living in Oakland County who report concerns regarding the septic
systems all I can tell you is the evidence that we see and I have
evaluated evaluations done in other counties that have point of sale and I
can tell you their evaluations of a septic system are not great so it’s not
you I can’t compare apples to apples here it’s really every jurisdiction is
very very different yeah I I also believe that we have a responsibility
for clean water that goes without saying but sadly you take all the septic
systems in the state and you find out you know and then you average it out
we’re not one of those people I I’ve sat through so many things so many laws
they’ve been passed by state legislatures or state legislatures as
well that you know they have a problem in Benton Harbor so they want the whole
state to comply I’m picking on Benton Arbor okay I can tell you that if we our
our people are pretty astute for the most part we don’t have the farms
anymore that we used to have where it goes unseen or unreported we have people
living cheek to jaw with septics so if your septic is leaking your next-door
neighbor is going to pick up the call Kathy or call the township or the
village of the city were quickly because you can smell the darn stuff pardon my
language being very graphic but Oakland County has put together incredible
programs not just for subjects but in other areas and we get tagged with the
same thing that Alger County and the Upper Peninsula gets tagged with not
fair okay sadly part of this is due to term limits
because people don’t know what came before or what is there I think we do an
incredible job with what we have yeah Kathy you do catch some people moving
but it’s not the numbers that we’re looking at I don’t believe because the
state says that there’s 10% failing whatever there could be 50% over in
Berrien County okay and 1% in Oakland County but we get tagged with that 50%
and we have to start I mean I know that MEC is not pursuing this in Michigan
Association of counties they’re leaving it alone I’ve already asked that because
I’m on their board they feel that each county should handle it as they see fit
and if they’re handling it it ought to be done with I don’t think the
legislature is gonna pass I don’t think it’s on their agenda quite frankly we
all want clean water that goes without saying but I think we’ve brought you
know we’ve brought up a Mack truck to hit a fly okay that’s just I’d like it
to be clean water and I’d like to move forward with doing whatever influence or
persuasion we can to make that think we all the the one thing I do have
to say first Shelley one of your comment says is
Oakland County is kind of the exception given that we have the most England
lakes but any other County here in Michigan so that puts us in a bigger
spotlight of making sure that we are doing what we can do to protect and
preserve not to start lakes in our watershed but literally the essential
one of the most essential things is water and if we don’t do something to
protect it now I fear that in the future it’s gonna cost us more money when you
heard way talk about 20% of our fresh lot are fresh water in our honor earth
on our planet comes from here in Michigan you would think for God’s sakes
that we would have at least a septic code right and giving that we are the
only state that does not have a septic code that’s not accurate from the
research and understanding that I have Michigan is in fact the only state in
the United States that does not have a septic code while there are counties
here in Michigan that have adapted their own form of codes let’s just say that we
know for a fact here in Oakland County we don’t have anything in place to help
preventing a bigger potential problem in our future and I think a lot of things
that we can do presently just start making sure that we are preserving the
cleanliness so I unfortunately have to excuse myself
but definitely wanted to say thank you and I look forward to learning more
about septic codes and what we can do to find solutions that really can benefit
every person and every entity that is involved because it’s a big test
thank you very much commissioner and I just like to say I mean we’re definitely
not here to try to pick on Oakland County in any way if anything we’re here
because Oakland County does things the right way yeah and has been a leader on
environmental issues and if we’re gonna get the state to move forward in a good
dress which is necessary we need somebody to
take the first step thank you thank you and that’s what we’re moving
forward with Commissioner Todd yeah I I have concerns not just for Oakland
County but for other itty bitty counties with five six seven thousand people they
don’t have ability to do this okay they just simply don’t so if you’re
looking for a unified code that is why I believe the state doesn’t wants each
County to do what they think is best and and I feel picked on okay I feel
absolutely picked on I received I hit the jackpot last year or the year before
because I received more letters than the other Commissioner about clean water in
my district okay close to oh I think it was over 300 and I wrote back to every
single one of the people and I didn’t disagree with them I think we need to
have clean water and I know you initiated this this campaign I
understand that but every single one of the people who wrote live on sewers
because I know where they live they left their return address one didn’t have
return to us so we didn’t answer it so I presume everyone lives on sewers it’s
real easy to point the finger up at those dumb farmers living in Oakland
County they’re not dumb and the biggest environmentalists I have found in all my
years are farmers they want to preserve their land they don’t want human waste
or any other kind of waste when they when they have to feed us and get their
living from the land so I think we’re doing a good job in Oakland County could
we improve maybe okay but to what extent we invited them here for their
information we’re gathering information so we can move forward to make sure we
have clean water and a good toy okay the rest of our board has left so you in
effect are talking to the choir here so this might be in Congress
so it’s a plan to put in order so the plan is to put in a septic code is that
correct we we have County the plan is to continue to move forward to influence
and emphasize to clean clean water the way we need the rest of the board to
make this happen well it’s the second time today I’ve been cut off but thank
you madam chair can I respond to I did just want to tell an anecdote that might
be relevant I did / do a presentation about this issue to the North Oakland
Democratic Club and I did have three members of that Club come after me come
up to me afterwards and say I have a septic system and I’ve never gotten it
inspected I didn’t know that that was the thing I was supposed to do
I got it pumped every five years but I’ve never gotten an inspected so I just
want to say I know that that’s you know a very small sample size but in in going
to around the county and talking to folks about this I have seen some some
gaps and folks being unaware of the necessity to inspect their septic tanks
that doesn’t mean that they are leaking but it does mean that they they
certainly could in the future and I don’t think that we’re accusing Oakland
County of anything we we really we want to work with you to continue to be
leaders so that we can bring this to this state and protect our water across
across the state thank you thank you sue this presentation will be included in
the minutes for our next meeting any further BIST thank you very much thank
you so much for the time is there any further business to come before this
committee then without objection I declare the
meeting journeyed at 108

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