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504 -2- Mrs. Tapia spoke next and said she had called around to the different towns to see how they function with the nursing duties. Some offer health promotion, others do not. The nurses discussed what they felt were the needs of their patients and the Board discussed what they feel are the Board of Health duties and responsi- bilities are as far as paying for V.N.A. patients are concerned. Dr. Goldmann feels the whole program should be more structured and it certainly could not be defended to the Appropriations Committee as it is now being conducted and the Board said they cannot find out from the nurses what and how the program is run. The Board feels the whole program should be reviewed in depth Glenda Green, R.N. questioned the Board about their decision to cut health promotion visits, wants to know who will pay for home flu injections, high risk babies, home evaluations, etc. The Board said if people are financial able, have a health insurance, it certainly is not the Board of Health's function to pay for these visits. We are not a welfare agency. Anyone not able to pay should check with Medicaid and see what they will do. Mr. Smith said the Board of Health's function is for flu clinics, premature babies, etc. He said the Visiting Nurses program originally was before people had insurance to cover their illnesses when people were not able to afford the help. After some discussion Mrs. Tapia, R.N. was questioned about the method used in determining who would become a client under the Board of Health Program. It finally was discussed and the nurses said they "DO NOT" conduct a means test such as Minute Man Home Care or other agencies and NEVER question if a person can pay themselves for the visit by the Visiting Nurses. Dr. Goldmann told the nurses to go to any home they want to but do notbill the Board of Health for the visits. He told them to provide a systematic plan to take care of the needy. The Board told the nurses not to add any new health promotions to their list of clients. They want this type of visit stopped. They said any Housing authority referrals should come to the Board of Health before anything is done and if they have areas that are questionalbe about pay- ment, visits, etc. notify the Board of Health and they will advise you. Ilene White, R.N. asked if they could visit the Board of Health patients once a month instead of every two months. The Board said only if the doctor ordered that. After further discussion the Board thanked the nurses for coming into the meeting and the nurses retired. 1 1