Health Department Director Jason Tiller briefed Saline County Commissioners on recent screenings for elevated blood lead (EBL) levels conducted on June 22 and 23.

• In all, 384 adults and children were screened. Forty-two individuals did not identify any risk factors to proceed with blood screening.
• On June 22 and 23, 300 blood screenings were completed, involving 147 children and 153 adults. As supplies ran low, an additional 42 individuals will be called back to complete the blood screening.
• Results will come from the Kansas Department of Health and Environment in 10-14 business days.

In March, the Pediatric Environmental Health Specialty Unit at Children’s Mercy Hospital contacted KDHE about EBL in Saline County.  Local health departments are advised when EBL levels indicated 10 micrograms of lead or higher per deciliter of blood (10 ug/dL).  Tiller said the HD had not been advised when lower levels of lead were detected.

On May 20, KDHE’s Bureau of Epidemiology and Public Health Informatics provided an update.  During a 15 month period (1/1/15 to 3/31/16), 32 Saline County residents were found to have elevated blood lead levels.  Of these, 27 lived with the Salina City limits.

Conference calls helped state and local officials coordinate actions.  The State is paying for the screening blood tests.  Should an individual’s test show elevated results, a confirmation test is warranted, as it can provide “definitive information to help guide next steps in treatment”, said Tiller.  Lab costs for these tests could range from $31-62; there might be additional charges for office visits.  Tiller estimated that $10,000-21,000 might be spent on confirmation tests.

Tiller said Kansas recommends that all children be screened for blood lead levels at age 12 and 24 months.  As part of Kan Be Healthy Screenings, children on Medicaid are required to be screened at age 12 and 24 months.  For children, cases with results of 10 ug/DL or higher are referred to the HD for case management; adults are referred with levels of 25 ug/dL or higher.  (Source 2009 Kansas Blood Lead Testing and Case management Guidelines for Children and Adults.)

The local HD will assist KDHE with lead investigations.  In the meantime, Tiller and others will:

• Compile options to address findings from lead screenings and investigations
• Continue case management of presently assigned cases

Chairman Monte Shadwick said many citizens have asked him where the lead is coming from.  Tiller replied, “Industry, possibly water; when KDHE conducts family interviews” they hope the answers capture information that will suggest a cause.

Tiller said there is “no ready funding source” to address the situation, given what is known already.  He said the State has no dedicated source of funding; previous programs have been largely defunded.

Tiller also updated Commissioners on the Zika virus.  A fifth case has been identified in Kansas; all cases have involved individuals who have traveled to areas with local Zika virus transmission.  Tiller encouraged individuals to take precautions by:

• Wearing clothing that covers limbs; using insect repellant with DEET.
• Taking steps to dump any standing water, where mosquitos can breed (like inside tires).
• Treating larger bodies of water with tablets that kill mosquito larvae.
• Reviewing the Center for Disease Control’s travel page and taking precautions if traveling.

Budget and Mill Levy Discussion

County Administrator Rita Deister presented Commissioners with a summary of budget decisions made to date.  She then sought input on where Commissioners wanted to set the mill levy.  John Price said he’d like to see it decrease by 2 mill.  Dave Smith wanted to see a decrease of at least 1 mill.

Deister cautioned that once the State imposed “tax lid goes it, it can hurt” the County “forever”.  She described the presence of extra revenues this year as a “fluke”.  Deister continued, “It would be a good year to set aside money for capital improvement or a safety net”.  She noted that a stabilization plan had not been funded “at a percentage it could be”.

Alicia Weiland, at Assurance Partners, submitted premiums for multiple insurance policies held by the County.  For 2016, total premiums were $247,249; in 2017, premiums will be $265,359.  Smith commented on the near 10% increase.  Weiland wrote that “Travelers had a 3.9% rate increase, within the parameters of Stewardship.  The County had a 6.3% overall exposure increase.  The County had a 158% loss ratio with $310,700 in claim expenses.”  Two large claims have yet to be decided.

Unexpected Bill Not Welcome

The Sheriff submitted a bill for $2,700 and requested it be paid by the Commission out of a possible improvement fund.  Later, County Counselor Mike Montoya clarified that if the Sheriff desired to spend money on something discretionary, that had not been budgeted, the Sheriff should have first appeared before the Commission to seek approval.  Commissioner Luci Larson repeated a comment that if it had been “anyone from another department, they would have been written up” for exceeding their budget authority.  Montoya responded that once the budget is set, the individual should not be allowed to exceed it, but “Commissioners allow this to occur”.  Montoya recommended letting the Sheriff pay the bill out of the Sheriff’s existing budget.  Commissioners then discussed if the Sheriff’s budget was adequate to last the year.

Concealed Carry

Shadwick began the Open Forum discussion by saying three Commissioners represented the County at the City-County Building Authority, which oversees the joint use of the building.  The City has two representatives, the Courts have one, and there is a memberat-large.  Shadwick said no votes would be taken at the meeting, but County Commissioners since 2013 generally supported concealed carry.

County Commission candidate David Nichols spoke in favor of a “citizen’s right to self-protection”.  He is authorized by the State to conduct the training required for concealed carry.  Nichols wrote that in the past few years, “the Building Authority was supposed to come up with a plan to enact adequate security.  Adequate security, by law, will consist of equipment such as metal detectors, metal detector wands and personnel to operate them to ensure that no one enters the building with a weapon.”

During last week’s Building Authority meeting, Nichols wrote “it was made clear that due to expense, there would be no plan to provide adequate security.”  Nichols said “I could show up at the State Capitol today and lawfully enter the building, armed.  I should be afforded the same consideration in my own community.”

Smith and Price have said they favor taking down the signs that prohibit concealed carry.

Commissioners also:

• Signed documents for Riley Construction to serve as general contractor for improvements to the Road & Bridge Shop; work is scheduled to be completed in November 2016.
• Announced, after being asked, that Road & Bridge’s administration had been re-organized. Instead of a Director, these responsibilities will be shared between the County Engineer and R&B Superintendent.  Superintendent Darren Fishel’s new responsibilities have been submitted to Archer Company for re-classification; a recommendation on a salary is forthcoming.
• Voted 4-0 to give Rural Fire Department #2 “the go ahead” to proceed with using Tevis (and Wilson) as architects for a “design build” fire station in Assaria. Larson and Deister attended Monday evening’s Board Meeting and observed architects’ proposals.
• Said no to a policy drafted by Marilyn Leamer, HR Director, regarding starting salaries for “truck drivers”. Leamer had more broadly included other positions in the draft, saying she didn’t want to “single out one department”, noting similarities between “truck drivers and heavy equipment operators”.  Price responded that “Commissioners could single out” certain positions.
• Discussed how the County might proceed with leasing oil and gas exploration on the Oliver Hagg property as one entity had submitted a lease agreement.
• Were given a copy of the City of Salina’s requirements for Personal Opinion and Political Campaign Signs by Judy Larson. It is marked PLF-134 and was approved July, 2012.  She noted that one political sign may be placed on each residential lot for EACH candidate and EACH ballot question.
• Heard updates from the EXPO Center and Community Corrections. The State has cut $50,000 from a $250,000 budget request for services for those with mental health and substance abuse challenges.

Monte Shadwick was absent for the first 90 minutes.  There were two executive sessions.

Maps of blood lead cases in Salina and Saline County. Click to Enlarge.