Council approves $1.3 million of CARES Act expenditures

$383,000 Mobile Medical Unit included

The County Council and Commissioners held a special meeting to discuss the $1.3 million in CARES Act funding that has to be used by Dec. 31. The Council tabled a motion during their September meeting last week to approve the $1.3 million that can be reimbursable through the CARES Act disbursement through the Indiana Finance Authority (IFA).

Marshall County Health Department (MCHD) Medical Officer Dr. Byron Holm explained to the Council and Commissioners that the mobile medical unit would be used for the COVID-19 mass immunization.

“They’ll probably go to nursing homes first. They’ll go to the elderly second. And then it will just come down in the age range based on what the incidence is and where the death rate is,” Holm said.

As of Sept. 20, there have been 988 total positive cases of COVID-19 and 24 total deaths.

Dr. Holm explained that the mobile medical unit would allow the county to perform COVID-19 rapid testing. “Our main idea is to keep our schools open.”

Holm explained that if a child sneezes or coughs, “they go to the nurse, she sends them. But not only does that child go home, but everybody related to that family goes home. So if you have somebody in high school and the

child in kindergarten sneezes, everybody goes home if it’s a five-member family.”

He added that it’s difficult to determine whether a child sneezes because he/she has an allergy or a runny nose, or COVID-19. With the rapid testing, that would quickly determine the cause and could save all the other kids from going home.

“With this unit, we’ll be able to take testing to all the rural areas. That’s what the Health Department, Indiana State Health Department, is excited about when I talked to them is that we can take all the testing to all the areas and not make them come to one area. So we’re going to be serving all the towns in Marshall County with this unit,” he said.

Besides COVID-19, the MCHD would use the mobile medical unit for mobile flu campaigns where the MCHD can travel to rural areas in the county and do immunizations. They’ll also be able to serve infants to adults due to the capacity to carry everything the MCHD will need.

The mobile medical unit will also be able to provide vision, health, and hearing screenings. The MCHD also plan to take the unit to health fairs and other festivals around the county, the Marshall County Blueberry Festival for example. It will also be able to travel to emergencies.

“We can use it as a mobile medical unit because it will be equipped with exam rooms and necessary things of that sort,” said Holm.

Dr. Holm described this as a “once in a lifetime” opportunity. It’s been something he’s been thinking about for the MCHD for the last 15 years. “The monies are available at the present time. If we don’t use it, we lose it. It’s pretty simple, they (the federal government) take it back.”

He then tackled the question of “Why do you have to have this type of medical unit?”

“I’ve studied that in detail, I’ve talked to the State Health Department. I’ve talked to the various school superintendents. I’ve talked to the hospital, of which they’re all in support of,” Holm said, indicating that the Council has letters of support in front of them. One letter was from Indiana State Health Commissioner Dr. Kristina Box.

The mobile medical unit is a 38-foot unit with a central waiting/registration room, an exam room in the front as well as an exam room in the back, and a chair lift. The unit has a central ventilation unit for the waiting room, a separate unit for each of the exam rooms. “It will be running in a negative pressure… negative pressure is important, we don’t recirculate the stuff.”

The freezers and refrigerators are medical grade with continuous monitoring to protect the vaccines and immunizations. Dr. Holm stated that because the vaccines come in both liquid and frozen forms, both freezers and refrigerators are needed.

“We will meet all the quality standards of handling vaccines and carrying vaccines the state requires for us,” Holm said.

This is important for many reasons, but one reason Holm touched on was that the MCHD will have as much as $60,000 worth of vaccines on site at one time.

“This unit will also have about $30,000 of vaccines on site at one time,” Holm said, explaining that some of the vaccines can cost $600. “You cannot afford to lose it.”

He stressed the importance of maintaining the correct temperature. “If the temperature varies under a certain criteria, the vaccine has to be thrown away because it’s not effective.”

In case of loss of power, the mobile medical unit will have a battery backup.

As previously stated, the funding is coming from the CARES Act through the IFA. “I know that people are concerned: ‘are we using county monies for this?’ We are not,” Holm said.

Holm informed the Council that the proposed purchase has been sent to the law offices of Barnes and Thornburg. They have replied back that it meets the IFA criteria.

The ISDH has expressed its interest in the mobile medical unit and, according to Dr. Holm, would like to visit it and see how it was created and what Marshall County has done with it. “And upon that, they granted me another $100,000 just the other day to staff the unit for the COVID testing for the rest of our community,” Holm said. “Which kind of tells me they’re in favor of.”

“Sounds fantastic,” Council President Judy Stone said.

“Marshall County has always been a leader throughout the state in various things. I’m just really so impressed that you have come up with this and are trying to bring the best quality of care to all of our citizens that you can reach,” said Council Vice President Penny Lukenbill.

“In the last couple of years, we worked for Stellar for quality of life issues for Marshall County. And if this project is not a quality of life improvement for Marshall County, I don’t know what other projects that we put out there would better serve the citizens than to improve the healthcare that we provide and I really thank Doc for his efforts and working on this project. And I want to be the one to say that if we don’t do this now with this money that’s coming through COVID, we will never do it. We’ll lose this opportunity to provide this to the citizens of Marshall County,” said Council Member Jon Vanvactor.

“It just ups the healthcare throughout the county. And it makes it feasible for those it’s not feasible to whether it’s because you don’t have health insurance, a primary care giver. There’s a lot of people that don’t have health insurance,” said Council Member Mandy Campbell.

“The young people are the future here. We have to make sure to take care of them and that’s our responsibility,” said Council Member James Masterson.

“In the beginning when I first heard of it, I was a skeptic and vocal about it. After talking to a couple other people and hearing your presentation, quality of life part really sticks out to me,” said Council Member Heath Thornton. “I think it’s a great asset to the county going forward.”

“I’ve talked to three or four people today and they all say ‘you know I don’t care whether it’s coming from the state or from the federal, it’s still coming out of my back pocket’ and I assured them that I understood the way they felt and I have to say nay,” said Council Member Jack Roose.

The vote to approve the $1,350,000 was approved by a 6-1 vote with Roose opposing.