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A
B
A
A
C
There
were
three
grants:
the
original
first
grant,
which
was
the
advanced
nursing
education
program,
grant
that
was
scheduled
to
end
June
30th
of
this
year.
There
was
a
bit
of
carryover,
so
the
university
has
asked
for
an
extension.
They
received
one
from
the
federal
government
and
that
41,
which
actually
should
be
51,
so
I'd
like
to
amend
the
the
request
that
41,000
is
the
leftover
funds
that
will
help
for
that.
We're
in
addition
to
that,
we're
billing
for
services
currently
through
the
through
that
grant
through
the
clinic
the
second
carryover
was
for.
D
C
I
guess
the
best
way
to
surmise
that
would
be.
Is
it's
a
primarily
it?
It
is
a
primary
care
clinic
staffed
by
nurse
practitioners
with
social
workers,
so
there's
an
integrated
aspect
of
mental
health
services
and
counseling.
That's
involved
with
that,
as
well
as
other
social
work
services,
where
we
try
to
match
folks
that
have
needs
that
can't
be
met
in
the
community
to
their
needs
or
to
the
resources
that
are
available
throughout
the
community.
C
Some
of
them
have
some
mild
and
moderate
mental
health
conditions,
but
they
may
be
on
behavioral
medicine
or
psychotropic
drugs,
but
their
physical
health
needs
haven't
been
met.
They
may
have
a
doctor
quote-unquote
on
paper,
but
they
haven't
seen
that
doctor
in
many
many
years,
if
at
all
so
when
they
get
to
our
clinic.
C
For
example,
heart
disease
and
emphysema
and
they've
got
in
some
cases,
substance,
abuse
conditions,
maybe
they're
alcoholics,
maybe
they're
drug
users,
or
they
may
just
have
other
different
conditions
that
exacerbate
their
conditions
as
well.
So,
in
addition
to
that,
the
the
clinic
is
staffed
by
a
nurse
that
will
often
do
case
management.
Do
referrals
constantly
calling
and
a
medical
assistant
that
will
assist
the
PAS
and
and
others
as
well.
E
C
E
C
Are
starting
to
grow
and
see
more
patients,
we've
added
another
nurse
practitioner,
Chris,
Chaney,
who's
well
known
throughout
the
community.
She
ran
the
home
care
at
bay
bay
health
systems
and
that
the
Midland
Hospital
she's
recent
about
two
years
ago
received
her
NP
degree
and
as
a
certified,
NP
and
so
she's,
bringing
some
expertise
in
as
well
as
extra
resources
and
we're.
C
You
know,
starting
to
really
formalize
the
way
that
we
do
treat
treatment
here.
It's
a
good
if
I
just
could
say
this.
This
is
a
good
experience
overall
because
it
provides
the
community
and
people
with
the
community
in
the
community
that
would
not
have
or
don't
access
to
primary
care
with
the
primary
care
that
they
need.
D
C
A
C
C
E
C
C
E
F
Picnic
yeah
just
want
to
mention
that
the
Nicholas
Fleming's
has
seen
an
increase
lately.
No,
we
did
open
it
up
now.
They're
coming
up
beside
an
economy,
so
I
think
they
sell
30
last
week,
19
the
week
before.
So
these
people,
who
don't
have
insurance,
so
you
do
take
some
that
don't
have
insurance
to
say,
also
Fleming
care,
but
generally
it's
Medicare
Medicaid.
It's.
C
Medicare
or
excuse
me
Medicaid,
we
don't
really
do
a
lot
of
Medicare
right
now,
we're
in
Pratt,
it's
quite
an
ordeal
to
to
be
certified
to
do
have
care
through
Medicare
plus
in
some
most
conditions.
You
have
to
have
a
doctor
out
staff
in
order
to
do
that,
but
it's
mostly
Medicaid,
but
we
do
see
a
variety
of
other
third
party
payment.
Our
third
party
payers,
the
one
thing
I
do
want
to
mention
about
this,
and
one
thing
that
we
do
have
to
keep
into
account
is
with
Medicaid
expansion.
C
We've
really
been
able
to
through
various
collaborative
efforts
in
the
community,
reduce
the
number
of
uninsured
people
quite
substantially
here
in
Bay
County.
We
did
a
telephone
survey
about
a
year
ago,
year
and
a
half
ago,
and
we
discovered
that
the
uninsured
rate
was
5%,
that's
substantially
lower
than
many
communities,
including
Midland,
which
at
the
time
was
about
nine
ten
percent,
but
with
the
Medicaid
expansion.
If
you
remember
there
were
limit
as
to
how
long
you
can
stay
on
Medicaid.
If
it,
you
were
through
the
new
expanded
coverage.
C
F
F
C
You
know
not
really
I
mean
anyone
can
choose
to
be.
We
don't
there's
no
income
level
or
anything
like
that.
If
you
want
to
get
care
at
the
clinic,
you
can
call
eight
nine
five.
Two.
Oh
three,
five
get
an
appointment.
If
you
don't
have
insurance,
we
will
work
with
the
people
to
see
if
they're
covered
through
Medicaid
expansion
or
if
they
can
obtain
coverage
through
the
marketplace.
Bay
health
plan
helps
us
with
that.
They've
done
a
great
job.
C
You
know
they
they've
signed
up
literally
thousands
of
people
in
the
last
four
years
and
they
will
continue
to
do
that.
But
there
may
be
some
people
for
one
reason
or
another
that
either
don't
qualify
or
don't
choose
to
get
coverage,
but
even
then
we
will
try.
You
know
it's
in
our
best
interest
to
make
sure
that
this
clinic
is
sustainable.
We
don't
other
than
the
grant
funds
that
we
receive
in
the
reimbursements
from
Medicaid
and
other
third-party
providers.
We
want
to
make
sure
that
this
is
a
success.
C
C
Yes,
it's
yeah
they'll
need
to
make
an
appointment,
it's
not
a
walk-in
clinic,
it's
not
a
a
merchant
care
center.
You
know.
If
you
get
a
broken
arm,
you
really
need
to
go
to
the
emergency
room
or
you
know
if
you
cut
yourself
or
something
like
that,
this
is
really
the
clinic
is
designed
for
people
with
multiple
chronic
conditions
that
need
to
have.
You
know
physical
health
and
mental
health
coverage
combined.
D
A
A
D
C
We've
been
able
to
manage
fairly
well
and
as
it's
going
faster
than
we
expected,
things
are
moving
faster
and
I.
Think
the
biggest
challenge
is
we're
not
we're
not
prepared
to
go
move
so
fast.
Actually,
but
within
we're,
hoping
that
by
the
end
of
November
at
the
latest,
that
the
entire
project
will
be
complete
and
you
know
we'll
encourage
everyone
to
come
and
see
and
take
part
we're.
C
C
A
Two
officers
full-time
road
patrol
and
from
due
to
the
pink
panic,
township
contract
effective.
As
of
September
the
12th
row,
clitoral
positions
are
budgeted
for
the
17
budget
and
the
sheriff
is
requesting
to
be
filled
in
order
to
maintain
an
adequate
staffing.
The
contracts
for
that
have
been
signed
yesterday,
according
to
Sheriff
I,
was
out
to
the
township.
Yesterday,
don't
support
any
other
discussion
questions.
A
A
B
D
A
A
For
motion
and
support
questions
concerns
follows
in
favor,
hi
folks,
don't
you
carry
a
personnel
director,
I
see
office
of
assigned
counsel
me.
This
is
from
the
office
of
assigned
counsel
monthly
report
for
July
2017.
Won't
you
to
receive
some
support
or
warship
support,
any
questions
or
concerns.
Mr.
chairman,.
B
G
Is
I
believe
that,
according
to
that
reporting,
my
memory
serves
me
correctly.
I
believe
that
there
was
less
than
1%
of
the
cases
that
were
referred
to
outside
attorneys
for
the
month
of
July,
which
is
what
we
intended
to
keep
the
majority
of
those
matters.
In-House
I
have
spoken
with
the
office
of
assigned
counsel
administrator
and
she
didn't
indicate
she
does
not
have
the
August
report
numbers
ready.
G
Yet
August
was
a
much
busier
month,
so
both
of
our
felony
attorneys
actually
capped
out
on
the
amount
of
cases
that
they're
allowed
to
take
in
August,
which
it
happens
maybe
once
a
year.
So,
even
though
it's
been
busy,
they
still
have
managed
to
keep
the
amount
of
cases
that
they've
referred
out
to
a
minimum.
So
yes,
I
think
that
it
has
it's
intended
result.
Thank.
A
E
E
The
article
talks
about
a
study
that
was
done
by
the
Niagara
University
and
it
was
pretty
alarming
the
amount
of
types
of
fishes
that
are
having
issues
because
of
the
pharmaceuticals
that
are
being
dumped
into
our
systems.
The
wastewater
treatment
plants
don't
have
the
ability
to
pull
some
of
these
pharmaceuticals
out
of
the
wall.
So
I
just
like
to
encourage
everyone
to
look
and
see
what
medicines
they
have
and
before
they
decide
to
put
it
in
the
toilet
and
flush
it
out.
So
it's
gone
from
them.
E
That's
that
that
isn't
what
we
would
like
to
have
done
and
that
they
can
physically
bring
the
stuff
to
you
and,
of
course
they
want
to
highlight,
with
a
marker,
their
name
and
and
all
the
information
that's
on
the
bottle,
but
that
will
be
properly
disclosed
on
and
I
would
encourage
individuals
to
take
advantage
of
that
opportunity.
Yeah.
H
C
A
A
Also
I
know
if
it
was
that
study,
but
I
also
read
that
even
people
with
septic
tanks,
they're
flushing
this
stuff
down
it
gets
into
the
fields
that
not
only
if
it's
an
antibiotic
and
can
kill
the
good
bacteria.
That's
in
your
septic
tank,
but
again
it
permeates
into
the
sand
and
stuff.
The
next
thing
you
know
50
feet
away.
It
got
your
well
there
you
go
and
you're
drinking
it
and
also
that's
a
great
point.
So
take
get
the
stuff
to
the
sheriff's
department.
Thank
you
for
permission
and
Krieger
any
other
miscellaneous
Commission
again.
A
F
More
reminder
about
the
gold
star
memorial
ceremony
at
Saturday,
September
30th
at
11
a.m.
Battery
Park
will
be
the
dedication
of
the
pool
star
families,
monument
they're,
still
collecting
money
for
it.
If
you
want
to
do
any,
they
have
a
Facebook
page
and
their
online
also
hope
you
all
committed
Thank
You,
commissioner.
Anyone.