Rock Island County Governance, Health, and Administration Committee met March 13.
Here is the minutes provided by the Committee:
1) Call to order and roll call
Committee members present: Mia Mayberry, Pat Moreno, Kim Callaway-Thompson (arrived at 10:04 a.m.), Mike Steffen, Ron Oelke, Drue Mielke, Scott Terry, Cecilia O’Brien (via phone)
Committee members absent: None
Others present: Kenneth Maranda, Hayleigh Covella, Bill Long, Trent Vandersnick, Darren Hart, Sylvia Gomez, Louisa Ewert, Amanda Van Daele, Chris Payne, Janet Hill, Russell Medley, Sarah Moore, Stephanie Tomes
2) Public comments
There were no public comments.
3) Approval of minutes from the February 13, 2017 meeting
Motion to approve: Mike Steffen
2nd: Pat Moreno
4) Reports to the committee
Ms. Hill from the Health Department reported that the Board of Health voted to delay or table the Family Planning and Women’s Care decision until next month. Ms. Ludwig explained everything to them and they will meet April 6 at the County Health Department.
University of Illinois Extension-
Mr. Medley, the Community and Economic Development Educator from the Illinois Extension presented. He passed out some newsletters so the committee can see what’s coming up. One of the big things is the horticultural series through the Master Gardeners starting this spring.
Ms. Callaway-Thompson is present.
The Extension is also going to be hosting a pork chop dinner to benefit the Rock Island 4-H. Mr. Medley explained that 4-H in this area is very heavily urban and one of the things they definitely do in the Rock Island County region is focus on STEM (Science, Technology, Engineering, and Math) education and leadership development. They do a lot with 3D printers, robotics, Legos, and that sort of stuff. 4-H is not just farm and ag. In the city, it’s way different. They are trying to do that out in the country. They still like to take the cows to the fair, but they’re trying to get them to think about STEM education as well.
Mr. Medley reiterated that his role is community economic development. One thing the Extension has worked on, particularly for the Rock Island County area, is they have a partnership with the Community Foundation of Great River Bend and have a national program called EDEN (Extension Disaster Education Network). The Extension decided to work with nonprofits. The Community Foundation decided that was a great idea in this area. There are a number of programs for businesses, but they decided to work with nonprofits that may not have had this type of assistance. They went out and had some workshops promoting disaster preparedness at nonprofits. They did it with Rock Island County and Scott County and had 20 participants this year. They put grant money aside, about $30,000 through the Community Foundation, and for every nonprofit that went through, they were asked to identify some needs for disaster preparedness services and products. Oftentimes it’s something like a shelter in place kit. They need that kind of stuff. The average grant was about $3,000-$4,000. They are hoping to do that again this year with a more extensive group. Additionally, on September 26-29, EDEN will be having its conference here in the Quad Cities at Stony Creek. Mr. Medley explained that the reason they like it here is because there are four cities cooperating on flood control. It’s a big deal. EDEN was started right after Hurricane Katrina. There will be 200-300 delegates here in town for those three days. He’s sure the County Board will be getting more information about that.
Mr. Medley provided a handout for one more thing the Extension does: the local government education network webinars. Those are free webinars. They are archived on the website. The upcoming ones are FOIA, municipal broadband, and disaster planning.
Ms. Mayberry asked if they can go back and watch past webinars. Mr. Medley said yes. He thinks they archive them for about a year.
Mr. Maranda asked when that pork chop dinner is. Mr. Steffen said April 6 in Milan. Mr. Maranda said they don’t want to miss that.
Ms. Kinney reported that her office just completed the primary. Tomorrow they will canvas. She noted that someone asked her what that involves. That means they bring in election judges from both parties and they will open any absentee ballots that made it into the office by midnight on election night. They will add those totals into the totals they received on the unofficial ballots. That’s why those are unofficial ballots: the absentees haven’t been added in yet. Wednesday, they’ll certify the ballot. Thursday they’ll start voting again in the general election for early voting. Ms. Kinney asked everyone to send their friends in Thursday. They hate to have judges sitting there doing nothing. They want to keep them busy. That’s what they’re there for. Mr. Terry asked Ms. Kinney to reiterate which elections are happening. Ms. Kinney said mayor, township, and school board races. All the vote centers will be open this election.
Ms. Ewert noted that she saw in the newspaper that Mr. McGehee had gone to the state and asked when they will have a decision on that. Ms. Kinney said that was her question, too. She noted that many people saw in the paper that she and Mr. McGehee are trying to create some legislation to prevent people from hijacking absentee applications. It’s very important that they make it to her office in a timely manner. She hopes Mr. McGehee will be successful in his efforts, but she has no idea as far as a timeline. It would be nice to get it done before next year. Mr. Steffen said he read in the paper that it’s 14 days and asked if that’s timely. Ms. Kinney said 14 days would be wonderful. It’s currently the Thursday before the Tuesday election, which really doesn’t give them much time.
Ms. Mayberry asked if Saturday early voting will be open between now and the fourth. Ms. Kinney said it will be on the last two Saturdays as always.
Ms. Ewert reported that the General Fund balance is $1,199,882.77. She noted that she will briefly speak at the Committee of the Whole to tell the full County Board the General Fund cash flow situation. The county had to borrow $750,000 at the beginning of March. They may have to borrow again at the end of March to make that last payroll. She asked everyone to make sure to read the cover letter of the monthly report. She’s now including in there who the General Fund owes. Not only do they owe banks, they also owe working cash, health insurance. They’ve deferred some payments until the county gest money in June. They’ll see how bad the situation is and how bad it could possibly get.
5) Village of a Thousand Elders Covenant FYI
Ms. Mayberry noted that after speaking with Mr. Mielke, she spoke to Berlinda Tyler- Jameson. Ms. Tyler-Jamison said the NAACP doesn’t agree with this initiative both ideologically and practically. They are on the same page as the QC Empowerment Network. Ms. Mayberry offered to provide Ms. Tyler-Jameson’s phone number if anyone would like more information.
Mr. Maranda noted that this has been signed. It was signed last Monday. The mayors and everybody signed it. The County Board’s name wasn’t on there. He believes the Sheriff’s Department was on there but he doesn’t know if it stayed on there or not.
Ms. Callaway-Thompson said it is. There was a huge press conference last week and she believes all the mayors were in attendance. The Regional Superintendent Tammy Muerhoff, all the city police chiefs, and Sheriff Bustos were there. It’s been signed and she has heard Ms. Tyler-Jamison’s perspective as well, but the covenant has been signed. She’d say Rock Island County is represented. The Sheriff did sign it. She understands where there is some disagreement as to the initiative but yet and still, she thinks they need to be collaborative in their thinking and just move forward.
Mr. Terry asked if they should move to postpone this indefinitely if they’re not going to do anything with it. Mr. Maranda said to just put it as an FYI. It’s been signed as of last Monday.
6) Consider Rock Island County Newsletter
Ms. Mayberry offered to pass the newsletter template around on her iPad for anyone who hasn’t seen it. That’s what Mr. Ross and maybe Mr. Davis have come up with as far as putting the newsletter on the website. There was a discussion on if they want it on the front page or under a county newsletter section with a monthly edition. The Sheriff has already asked for a permanent spot in the newsletter for an article each month. Mr. Ross has reached out to Elected Officials to see if they want the same. If the committee wishes to move forward with that, they can vote on it and vote on it at full County Board and go ahead with it. She thinks it will be positive to push information out to the citizens and constituents. She noted that the wording on the template is gibberish; it’s just what it will look like.
Mr. Steffen said he likes it. It’s got good use of white space and a valuable tool. He also saw a hard copy thanks to Mr. Long.
Motion to approve: Mike Steffen
2nd: Kim Callaway-Thompson
7) Consider legislative priority list
Ms. Mayberry noted that the committee talked about this last month. The County Administrator has put together the beginning of a short-term and long-term list. That has been printed out for the committee. The committee is welcome to make suggestions, move things from short- to long-term, or take them off.
Ms. Mayberry noted that she also sent this weekend, and had printed off, these committee reports from the Illinois Association of County Board Members. These are highlights of what they’re looking at and the hot topic issues. The other two items are all the Senate and House bills being considered. Ms. Mayberry noted that she just sent these on Thursday, so the committee may need to take some time to look through them. She asked if anyone had a chance to go through and saw some they’d like to pluck out and add to the list or discuss. No one had anything. Ms. Mayberry noted that it’s not something that has to be done immediately. It’s something they can keep working on. They have this in front of them and have Mr. Ross’s recommendations as far as what he thinks will be valuable. They can keep looking at those in the future and keeping looking toward finding legislation that can help the county revenue-wise. They can make a motion to either move forward with this list so the full County Board can see it this month or continue to work on it in committee. She sees no reason why they can’t move it forward to the County Board to look at for informational purposes.
Ms. Callaway-Thompson asked for confirmation that if they move it forward to County Board, that doesn’t mean they can’t continue to work on it. Ms. Mayberry confirmed and explained that it could just be informative this month at full Board so they can see what the committee has so far and then they can continue to work on it in committee.
Motion to move list forward to County Board: Pat Moreno
2nd: Kim Callaway-Thompson
8) Consider letters to local representatives re: legislation
Ms. Mayberry noted that the drafted letters about this legislation are in the packet. There is one to Ms. Murray at IACBM, and one each to Rep. Halpin, Rep. McCombie, and Senator Anderson. They are all the same. Mr. Terry requested that they send copies to the majority and minority leaders of both chambers as well. Ms. Mayberry said she thinks that’s a good idea.
Motion to approve: Scott Terry
2nd: Mike Steffen
Mr. Steffen asked who is signing the letters. Ms. Mayberry said they are signed by this time by Mr. Ross and there is a place for the Chairman’s signature as well. Mr. Steffen noted that at one time there was discussion about all the Board members signing, but he thinks that’s appropriate.
9) Consider support of the Home Birth Safety Act
Ms. Sarah Moore and Ms. Stephanie Tomes introduced themselves. They are at the committee meeting representing the Illinois Council of Certified Professional Midwives. They work on legislation to provide a pathway for licensure for Certified Professional Midwives in the state of Illinois. This is something that 32 other states in the U.S. have provided. Ms. Moore noted that Ms. Tomes will pass around a flyer. The bill is 118 pages long and they haven’t found many people willing to read 118 pages. South Dakota and Michigan are the most recent states that have passed similar licensure. Every state is different. Michigan passed in January. South Dakota passed just yesterday.
Mr. Oelke asked about Iowa. Ms. Moore said no. She explained that Iowa is interesting in that they don’t have any sort of law against midwifery. They had an Attorney General’s opinion in the 1970s or 1980s saying midwives shouldn’t attend homebirths. They were prosecuting based on that AG opinion. In the last five years, there was a judge said they should be there and they are not prosecuting based on that. They’re kind of an interesting player.
Ms. Moore noted that she only brought one of these flyers because it’s so much paper, and South Dakota isn’t added on here yet, but it is a general map showing where it’s legal. South Dakota’s governor just signed their bill yesterday.
Ms. Moore explained that the current situation for homebirth families in Illinois is dangerous. Families choose homebirth for a number of deeply held reasons – religious, personal, and philosophical. These families are generally extremely committed to having a homebirth and are not deterred by lack of providers. Nationally, rates of homebirth are increasing dramatically. National vital statistics data shows that one out of every 44 births to a non-Hispanic white women is now conducted outside of a hospital. Over a recent period of five years, from 2009-2014, there has been a 77.3% increase in the overall national homebirth rate. There are just over 800 babies born in Illinois at home. Unfortunately, the number of providers is about five. Of course, Chicagoland has a few homebirth providers and in Peoria there are two. Bloomington has a birth center and a birth center is trying to open up in Chicago.
Ms. Mayberry asked if there are none here. Ms. Moore said no. She noted that Mr. Terry sent her a message to come and speak to the committee about this because she had a homebirth here in Rock Island. She lives in Rock Island and was gracious enough to have a nurse midwife come all the way from Arlington, Illinois. That’s about an hour and a half to an hour and forty five minutes away. That midwife has been trying to retire for years. Another issue is these nurse midwives who provide homebirth services can’t retire because they’re leaving these women without care.
Ms. Moore just recently spoke to a doctor down in southern Illinois, right around Carbondale. He’s the doctor who will provide testimony when the bill gets to the committee hearing. After he became a doctor, he’s a family practice doctor, he noticed that women were coming to him and asking for homebirth services. He said he’d do it for low risk women. In order to do that, he had to keep his day job at the office and his office wouldn’t let him do it. That’s statewide. They won’t let doctors do it because of liability for the office and for hospitals. Once again, women are still having this service. Unfortunately, that creates an illegal care system. Ms. Moore noted that she kind of always jokes that any one could be a midwife. They could go on the street and tell people, “I’m a midwife. I’ll attend you at home it’ll be fine.” They can say whatever they want and people do. The unfortunate case is that people do. In this area locally, there was just a mom who came to a hospital with someone who said there was a midwife and they wouldn’t say their name. The baby was in total distress and shouldn’t have been born at home. This licensure will create a way for this family to have a way to look on a website and see that this midwife has a license. This mom couldn’t. It’s all word of mouth right now.
Ms. Tome noted that it creates a black market for midwifery. A lot of these people aren’t trained or don’t have the birth-specific educational background that is proposed in the bill. Just like you would want to find a pediatrician for your child and look them up and look at stats and what they specialize in, this is the same type of thing. Ms. Moore would go out and get a phone call. There would be a database that the licensure would host that tells the midwife’s education background and has a rating system that you’d see for any provider. Right now, because it’s a black market, that doesn’t exist and people aren’t practicing safely. In this area, the Illinois Council of Certified Professional Midwives talks to Genesis and Trinity and providers on both sides of the river are very supportive as long as they follow stats and same criteria as the bill says. Risking out anyone who’s vaginal birth after Caesarean section, anyone who’s carrying twins or multiples, anyone with a history of hemorrhaging or anything risky as far as a homebirth, they would risk those out. They would be seen in a hospital just like they should be. They have talked to theses providers and they are on board. They recently had that mom who had transferred to the hospital and they right away got a call and they had no idea who this person was. That’s what causes risk and why they want safer transfers for moms who need them and that type of communication that can happen between hospitals. Right now if that transition happened and it’s not a safe area, it could cause some legal issues for everyone involved.
Mr. Terry thanked Ms. Moore and Ms. Tome for coming. He noted that he reached out to these ladies after reviewing their article in the paper. This is a hot button issue for a lot of particularly younger women in this area, so he appreciates them coming. He knows it’s already at the state level. They’re working quite feverishly with them in Springfield. Two of the three current state legislators have already signed on as cosponsors for this. Ms. Moore noted that they are chief cosponsors.
Mr. Terry added that he understands that the American College of Obstetricians and Gynecologists (ACOG) are in favor of this. He asked who is against it and why. Ms. Moore explained that they have been trying to push legislation through for 30 years. It doesn’t seem to matter what the bill says, someone always opposes it. Last year this exact same bill, which was co-written by their organization and Dr. Maura Quinland, the ACOG Chapter President last year. Dr. Quinland basically came to them and said she’s not a huge fan of home birth, but she knows it is happening and she knows they should have a licensed provider to care for women. She said they’d be more comfortable if they put in those things Ms. Tome mentioned about the no VBACs, no breach births, no multiples, and things like that. They obliged, but ended last year still not being heard in committee because the pediatricians’ chapter in Illinois first said they’re philosophically opposed to homebirth. The Illinois Council of Certified Professional Midwives said nobody cares; that’s not preventing it. They came back and said they want the bill to have written collaboration with an obstetrician. They said fine, they’ll do that, but then the obstetrician said, “No thank you.” The bill died. They turned around and refiled. In 2007, they got the bill to go through committee and through the Senate floor with 51 yes votes. It seemed very easy to them to say yes. There are 800+ babies born in this state every year and they should provide for them. It’s simple. The House thought it was not so simple. They’ve been working on the House for the last decade. This year, because they’ve had such strong support in the Senate, they decided to go through the Senate again and use that as a leverage point with the House of Representatives. She doesn’t know if that will work. Their consumers are tired of hearing “no” every year. They need a yes.
Ms. Mayberry asked if those groups, the pediatricians and obstetricians, are still opposed at this point. Ms. Moore explained that the obstetricians are neutral. They are never going to get them to say yes to homebirth. They’re happy with their neutral. The American Academy of Nurse Midwifery local chapter is in support. She can’t remember all the supportive organizations, but they have quite a few. She didn’t make a copy because it’s a lot of paper, but she has a packet of letters from medical professionals throughout the state who see they need it. It’s not even a want at this point. Ms. Tomes noted that it’s become more political with pediatricians in Illinois.
Ms. Callaway-Thompson commended the Illinois Council of Certified Professional Midwives’ persistence. She fully supports their efforts in all of this. She is the granddaughter of a midwife who delivered many babies in the 1930s and 1940s. In memory of her grandmother, she supports this and will vote in favor.
Mr. Steffen asked Ms. Moore to help him understand. He noted that there’s probably a cost factor for why people want to do it at home and asked if it is mostly preference. Ms. Moore said she personally didn’t have insurance with her first baby. It was a normal vaginal birth in a hospital, seemingly no big deal. It was $13,000. With her second, she tried to go back to the same obstetrician. She had been paying faithfully on her bill and they said they wouldn’t care for her until she paid in full. She had to pay with a credit card so she could get care. Her first baby was born when she was 21 and her second when she was 23. She was young, naïve, and pregnant and didn’t want to fight with anyone. She was totally terrified she wouldn’t have care. With her third, she just said, “There’s no reason for me to go to the hospital. I have no history of bleeding. My kids were born super easy. There’s no reason.” Then it ended up being, “.and this is only $3,000.” That’s more doable. There’s a variety of reasons. She also has a packet of letters from Amish families where cost is definitely a factor, but they are also not going to go to a hospital and prefer to stay with their families. She served as an assistant to her own midwife for quite a few years and they did a lot of Amish family births. They’re talking about families who have 14 kids that they also have to care for at home. There’s no one to come care for those kids while you’re in the hospital for 48 hours. Definitely, religious ideas are a factor as well.
Ms. Tomes added that Senator Martinez brought up that with the Affordable Care Act teetering and what’s going to happen, that could be at the forefront of that. Homebirth could be an affordable option. Pregnancy is a preexisting condition where someone might not qualify for insurance.
Mr. Moreno asked how insurance companies feel and if they are fighting it. Ms. Tomes explained that for homebirths, clients are paying the midwives. They don’t go through insurance companies so they haven’t taken a stance or said anything about it.
Ms. Moore explained that an economist a few years ago projected that midwives could save Medicaid $5 billion just by providing homebirths. A hospital birth is so much money that they’re paying out. Her one birth was $13,000. Even if she was on Medicaid, they wouldn’t pay that whole $13,000. If they only ask for whatever they’d pay out to a midwife, it’s roughly $3,000 in Illinois. She thinks that’s a win-win for the Medicaid system, especially with the state financial crisis and with Illini Care. For women on Illini Care in this area, good luck finding a provider to accept them. They’re back to having to pay out of pocket anyways. Then the hospital is forced to write some of that off because they do that if you’re in a certain financial bracket. Then the hospital is out money. Maybe obstetricians or nurse midwife will write some of it off and they’re out money. It’s a snowball effect. They could save all of these people so much heartache. When you’re pregnant, you’re so vulnerable and to be having to call around and say you have Illini Care and be continually told no one will care for you, that’s unacceptable. Ms. Tomes added that they do have one provider in the area who will take Illini Care, but it’s tough to get into that provider. You typically have about two to five minutes with that provider. Care is compromised for sure.
Mr. Terry asked if, in this bill, any revenue is coming to the state with this licensure program. Ms. Moore said yes. She noted that it’s just like any other license. Her husband is a plumber and just renewed his license. The state is so broke they won’t print his card. His, for instance, is $100/year. She hates to say it, but midwives are willing to pay anything for the licensing fee. Another estimate is that it would take about $75,000 to get a board started. They would need a specific midwifery board. There is not one in the state. Nurse Midwives are supervised by the Nursing Board. They are more than willing to offset that cost with maybe an initial period of higher fees or something along those lines.
Mr. Terry said then there’s revenue for the state and safer practices for stuff that’s already happening. He mentioned that Ms. Tomes talked a little about protocol for transfers which the state doesn’t currently have. He asked if she could talk more about that.
Ms. Tomes explained that, currently, if you’re transferred in, it’s illegal. In the Chicago area specifically, there are a lot of not friendly hospitals. You transfer in at the door or leave a mom and her family unattended and call 911 and leave. That’s not a safe situation. They talked to Senator Anderson recently and with his EMT and firefighting background, he’d rather have a trained professional sitting there, starting an IV, administering anti-hemorrhaging medications, as well as doing CPR if needed and having training to give infant CPR and resuscitation. He’d rather walk into that situation rather than a mom bleeding out with no one to be seen. Those are scary things that are occurring. Legislation makes it safer for transfer to occur if a midwife can transfer into a hospital with a provider. They give up their rights as the midwife. She becomes a doula, a birth support person, and she can sit here and say, “This is all of our prenatal information,” and give them all of the information she has gathered prenatally and into the birth so far to make that transfer easier and smoother. Then the mother is not getting in as a no-doc into the ER or being transferred via ambulance or the father driving frantically to the hospital. It’s a safer transfer.
Ms. Moore added that licensure also lets them transfer earlier at the first sign. As an assistant, she has never been involved in an emergency transfer because she has always transferred with a licensed professional. That first time they hear a bit of an elevated heart rate with the baby or mom’s blood pressure is getting a little high, they transfer right away. It’s not been a problem at all. Again, the Certified Professional Midwives in the area, though there’s not a license, have good relationships with the hospital providers. That’s happening in this area, but statewide, especially in Chicago, sometimes they’re transferring later. That’s not safe.
Mr. Steffen noted that Ms. Moore mentioned that creating a new board would be $75,000. He noted that RNs have a board and there are other medical boards. He asked why not use an existing board. Ms. Moore explained that homebirth is a different situation. For hospital providers of any sort, there are protocols in line. Pick up this phone, pull this cord, push this button, and a whole team rushes in. It’s the same in the labor room. Even in bathroom, there is a pull string and if that gets pulled, several people come in and are trained and ready to do all of that. With homebirth, there’s no cord to pull. You’ve got your midwife and one or two assistants who are trained to care for whatever is going on. Each person knows their role. Just like how obstetricians didn’t want to collaborate, they also don’t want to oversee a board for a profession that’s so different. It’s a small team. There’s one specific person who calls for an ambulance if it’s needed. Another person grabs the resuscitation equipment. It’s a different thing. Mr. Steffen said it’s like MDs and chiropractic over the years.
Mr. Terry said he’d like to include these bills with the committee’s other letters of support if possible. Ms. Mayberry said if they are approved, the office will send letters to local reps expressing support.
Motion to approve: Scott Terry
2nd: Kim Callaway-Thompson, Mike Steffen
10) Review of pending/proposed state legislation & policy matters affecting Rock Island County
Ms. Mayberry noted that Item 10 was covered under Item 7.
11) Committee member opportunity for brief comments (no decisions will be made)
There were no comments.
Meeting adjourned at 10:43 a.m. by Chair Mia Mayberry