Marys Medicine

January 4, 2016
A Special Call Meeting of the Mayor and Board of Aldermen of the City of Natchez, Mississippi, was held in the Council Chambers at 4:00 p.m. on Monday, January 4, 2016. Mayor Pro Tempore Arceneaux-Mathis presided at the meeting. Elected Officials City Officials & Present Absent Department Larry L. Brown Donnie Holloway, City ClerkMayor Hyde Carby, City Attorney Temple Hendricks, Board Sec Joyce Arceneaux-Mathis Alderwoman, Ward 1 Alderwoman, Ward 2 Danny White Sarah Carter Smith Alderwoman, Ward 3 Ernest "Tony" FieldsAlderman, Ward 4 Mark FortenberyAlderman, Ward 5 Daniel DillardAlderman, Ward 6 Judge Mary Toles was sworn in as Alderwoman of Ward 2 with the oath being administered by Judge Patricia Dunmore. With a quorum present, a motion was made by Alderman Fortenbery, seconded by Alderman Fields,
to call the Special Call Meeting of January 4th to order. The motion carried unanimously.

Kevin Kirby, Tourism Director Mr. Kirby presented a document which he asked that the BOA approve whereby the logo shop would be rolled into the National Park Service's bookstore, to be known as The Natchez Shop. It would be run by Eastern National. Eastern National had great buying power with 900 vendors--the Tourism Department would maintain the rights to approve anything regarding city-related logos before being sold. Staff at the new shop would not be city employees. Alderman Fortenbery asked Mr. Kirby if he could bring this issue up at the 1-26-16 BOA meeting as Alderwoman Toles had just been sworn into office and Alderwoman Carter Smith was ill. Mr. Kirby replied that he had spoken to the BOA members individually, except Alderwoman Carter Smith who was ill, as Eastern National was looking at a tight construction timeline and would like completed before Pilgrimage. Current city staff would now be funneled to the front counters—most employees were part time staff and would rotate their schedule.
A motion was made by Alderman Fortenbery, seconded by Alderman Fields, to table the document
being presented by Mr. Kirby until the meeting of 1-26-16.
Under discussion, Mr. Kirby clarified that
city employees would remain city employees, not NPS. Alderman Dillard asked about the Scope of Sales
Statement which was attached—it was clarified that the Scope of Sales outlined categories of inventory
that Eastern National would sell in the shop; the city logo and Tricentennial logos had been added.
Kathleen Bond, NPS, advised that each Eastern National had a Scope of Sales Statement—Eastern
National was not a gift shop but sold products that people could learn about Natchez history.
The motion carried unanimously.
Getty Israel, Clinton Healthcare Initiative Ms. Israel's report: The health of mothers and children is the most important indicator of the overall quality of health of a community. It's the canary in the mine, so to speak. In Adams County, very little has been done to improve the health of pregnant women and their babies as the numbers indicate. According to federal and state agencies, the following evidence clearly shows that we need to develop community outreach programs to address these health issues: Maternal Health: The health of women before and during pregnancy and access to quality health care are among the multiple factors that contribute to the health of mother and child. Tobacco exposure, maternal obesity, chronic conditions, such as hypertension, preeclampsia, gestational diabetes, the type of birth (vaginal or C-section) and whether or not a baby is breastfed are key areas that influence a mother's health and the infant's health and death. Obesity and Chronic Conditions: Women entering pregnancy who are obese, hypertensive, or diabetic are at risk of preterm births, birth defects, and stillbirth. Mississippi's obesity rate is traditionallythe highest in the nation; currently, it is the 2nd highest rate (35.5%) following Arkansas, 35.9%. Conversely, Adams County has an adult obesity rate of 41.6 percent. Maternal obesity is a leading cause of maternal conditions such as hypertension, gestational diabetes, which can lead to type 2 diabetes, pre-eclampsia, C-sections, birthing injuries, and weight retention after pregnancy. Within the State and Adams County, Black women have the highest rates of obesity (55%), hypertension (22%) and type 2 diabetes (6%). They also have a higher rate of maternal hypertension, gestational diabetes, progression to type 2 diabetes, C-section delivery, and a lower rate of breastfeeding. Smoking: can cause preterm birth, ectopic pregnancy, and placenta eruption. In 2014, 11% of MS women smoked during their pregnancy. Of those who smoked, 20% of their infants died during the first year of life. In District 7, Adams County had the 4th highest rate (11.3) of pregnant women who smoked. An equal percentage of black and white women smoked during their pregnancy in Adams County.
nfant Mortality: is the death of an infant before the 1st year of birth. Half of all infant deaths occur on the first day of life. The State of MS has the nation's highest infant mortality rate, 8.2 per 1000 live births. Adams County's rate, 10.0, is among the highest rate (10.2) in the State, an increase of 3.0 from 2013. In MS, black babies make up only 42% of births but 58% of deaths. The death rate (5.3 deaths per 1000 live births) of white infants has dropped significantly, but the mortality rate among black infants is twice as high as that of white infants.
Preterm birth: is the number 1 killer of infants in MS. It is usually caused by maternal hypertension, gestational diabetes, or elective early delivery that are not medically necessary. Preterm births can lead to a higher rate of C-Sections, which occur between 37 and 39 weeks of pregnancy, infections, breathing complications, brain injury, developmental delay, vision loss, cerebral palsy, hearing impairment, feeding difficulties.
MS has a preterm birth rate of 12.9%, the highest in the nation, followed by LA and AL. It has the 2nd highest racial disparity index. Black women have the highest rate, 16.3%. In 2014, Adams County's preterm birth rate was 12.5%, the 3rd highest in District 7. Low Birth Weight: Premature birth is the leading cause of low birth weight (LBW) babies, babies born weighing less than 5 pounds, 8 ounces. Adams County has a LBW rate of 12.7%, the 3rd highest in District 7. Of the 401 babies born in the County, 14.1% of Black babies were born of LBW.
The average medical cost for a healthy full term baby is $5,085 compared to $55,393 for a preterm infant.
SIDS (Sudden Infant Death Syndrome): is another leading cause of infant mortality in MS. It often occurs while an infant is sleeping in an unsafe environment due to suffocation, strangulation, or overlay. It is the leading cause of death among babies 1month to 4 months of age and is preventable. In2014, 55 babies died in MS due to SIDS, an increase from 23 in 2013. C-Section Birth: is the surgical birth of an infant. While some C-sections are medically necessary for the health of the mother or baby, the high C-section rates in many hospitals are unsupported and lead to unnecessary risk of death and medical costs. It also greatly increases the likelihood (90%) that a repeat C-Section will be necessary for future births. MS has the second (following Louisiana) highest C-section rate (38%) in the nation. It is the 2nd most popular procedure performed in Mississippi hospitals. In 2014, Mississippi hospitals charged a combined total of $223,941,941 for C-Section births. Medicaid was the primary payer, responsible for almost 63% of all charges. Blue Cross and Blue Shield accounted for 20% of all charges. In 2014, previous C-Sections accounted for 13.2 (5,174) of the maternal discharges in Mississippi hospitals.
Natchez Regional Medical Center (432 births) and Natchez Community Hospital (505 births) had the 2nd highest C-section rates (38%) within public health district 7 in 2014. The C-section rates of the two Adams County hospitals exceeded 14 Mississippi hospitals that had significantly higher live births. For instance, Baptist Memorial Hospital performed 1711 deliveries of which only 27.6% were C-sections. Jefferson Anderson Memorial Hospital in Meridian performed 1323 of which 36.1% were C-section deliveries.
Healthy, low-risk women undergoing their first C-section are three times more likely to suffer serious complications—such as severe bleeding, blood clots, heart attack, venus thromboembolism (VTE), kidney failure, and major infections, which may lead to maternal death. VTE occurs more commonly during the postpartum period than during pregnancy and 64% of postpartum VTEs occur after cesarean delivery. The risk of complications increases with each subsequent cesarean delivery.
Pregnancy-Associated Maternal Death: is a death caused by pregnancy complications. The leading causes were infections/sepsis, cardiovascular disease, hypertensive disorders, and venus Thrombotic pulmonary embolism (VTE). Mississippi has one of the highest pregnancy-associated maternal death (PRMR) rates in the US, and that rate has been climbing for more than a decade. The total 3-year (2010-2012) average PRMR for MS was 39.7 deaths per 100,000 live births. The white PRMR was 29.3 and the black PRMR was 54.7. Among Mississippi women who died during or within one year of pregnancy, the most was a black employed female high school graduate, between 20 and 29 years of age. Also, over 70% of the women who died were obese. Three PRMR deaths occurred in district 7. Teen Births: Adams County has the 3rd highest rate (94.3%) of teen births within public health district 7. Black teens disproportionately have the highest rate (97.7) within each county in the district. Also Black women have the highest birth rates of unmarried mothers. In Adams County, the rates of births of unmarried white and black women are 47.6% and 88.5%, respectively. ADULT GENERAL POPULATION HEALTH Over half (55%) of all deaths in Mississippi were due to cardiovascular-related diseases, cancer and diabetes.
In 2013, Mississippi's heart disease death rate was 240 per 100,000 persons. Adams County's heart disease death rate, 239.1, was nearly equal that of the State. As with the State, Blacks in the County have a significantly higher rate (290.1) than whites (195.8). And, Black males in the County have the highest rate (439.2) of all groups.
Diabetes is a leading cause of death among Mississippians. Approximately 15% (3% higher than the State) of Adams County residents have diabetes. It is highest among black populations, especially black women.
Public Health District 7 is a part of the "diabetes belt," a county in which at least 11.7% of the residents have a diabetes diagnosis. People in the diabetes belt are more likely to be black and less likely to have a college degree. The diabetes belt has higher rates of obesity and physical inactivity than other U.S. regions.
THE INTERVENTIONSThe Million Hearts ProgramHeart Disease Prevention and Heart Failure Management ProgramCommunity health advocates will be certified by the University of Mississippi Medical Center, the American Lung Association as tobacco cessation counselors, and American Heart Association CPR/AED/First Aid. They will provide the following services in worksites, educational settings, churches, and retail settings:• Plan and develop heart healthy educational sessions Teach participants about the need to get screened for high blood pressure, cholesterol, and Teach participants to ask for and know their blood pressure and cholesterol numbers and to know what healthy levels should be.
• Teach participants the ABCs of a Healthy Heart Screen at-risk participants' blood pressure and BMI levels.
Encourage participants to establish health goals for obtaining healthy blood pressure, cholesterol, and BMI levels.
• Conduct a minimum of six tobacco cessation group counseling sessions within the year.
The Healthy Mom Healthy Baby ProgramThe mission of the project is to improve maternal health behaviors during and after pregnancy so as to improve pregnancy and birth outcomes among women at risk of maternal obesity and subsequent maternal conditions and outcomes: To reduce rates of maternal obesity, hypertension, gestational diabetes, C-section deliveries; to increase initiation and duration rates breastfeeding; improve mother and infant health; build maternal caretaking skills and improve the quality of mother-child interaction; prevent rapid repeat pregnancy; increase educational achievement; and build social competence.
This program will be delivered on a weekly basis in a group face to face setting in a local house within Natchez, MS. Twenty-five pregnant women will be recruited during their first trimester. They will complete a curriculum composed of maternal and child health education that includes: prenatal nutrition, breastfeeding, prenatal and postpartum exercise, labor and delivery, injury prevention, SIDS, family planning, parenting, and early childhood education. Five doula/coaches will provide coaching throughout the pregnancy and support during labor/birth and postpartum for 3 months. The Diabetes/Heart Disease Prevention ProgramFour community health workers (CHWs) will be responsible for delivering this program, which is an augmentation of the CDC's National Diabetes Prevention Program (NDPP). The NDPP has been modified to include people at risk of heart disease as they share the same risk factors as those at risk of type 2 diabetes. In addition, type 2 diabetes leads to heart disease. The NDPP has demonstrated that pre-diabetics can reduce their risk of developing type 2 diabetes by 58 percent. Also, the Program is more effective and feasible than the popular diabetes drug, Metformin.
CHWs will be trained to administer the year-long NDPP. As lifestyle coaches, they will help participants at risk of developing diabetes and/or heart disease and those who have existing diabetes or heart disease to make controllable lifestyle changes, such as eating healthier, becoming physically active, quitting smoking, which significantly reduces the risk of developing or dying of diabetes as well as heart disease. The coaches will meet weekly with a group (15-20) of participants to educate and support them as they make the necessary lifestyle changes to prevent diabetes and heart disease. Two weekly 1.5-hour sessions will be held for 12 months. This program will be placed in eight churches.
Justin Dollar, Public Works Department A motion was made by Alderman Fields, seconded by Alderman Fortenbery, to approve a
Proclamation of Existence of a Local Emergency for the upcoming flooding of the MS River.

Mr. Dollar advised that he needed an MOU approved between the City and CCA with CCA to provide the labor for sandbags and the city to provide the materials, which would be 100% reimbursable from MEMA. Meg Freeman had been working closely with Lee Ann Mingee to provide accurate and timely paperwork to MEMA. Mr. Dollar handed Alderman Dillard a copy of the MOU to review. Mr. Dollar and Mr. Carby advised that this MOU was the basically the same MOU approved in 2011.
Mayor Pro Tempore Arceneaux-Mathis said in Mayor Brown's absence, the BOA would be running the City legislatively.
Mr. Dollar clarified that the city would not hire extra help nor get rid of any current employees.
The motion carried unanimously.
A motion was made by Alderman Fields, seconded by Alderman Fortenbery, to approve the
Designation of Applicant Agent appointing Lee Ann Mingee in that role. The motion carried

Mr. Carby discussed Thompson Debris Mitigation Plan which utilized before and if could be used this time—it appeared that it was not needed at this time.
Mr. Kirby clarified that the cruise ships were through docking until their new season which would begin in February. JK & S was taking the lead in working with Magnolia Bluffs Casino during the flood. Hayden Kaiser advised that he was waiting for the go ahead from Kevin Preston to proceed with the installation of Hesco baskets and would probably implement one lane of traffic going down Roth Hill. The casino mightalso shuttle customers. He was confident that they could keep the flood waters out of the casino.
Tony Moon, NWW, advised that NWW was doing criteria of waste water at Roth Hill lift station and Silver Street. DA Biglane's lift station was raised after the 2011 flood—it was protected to 65'. NWW would do all it could to help businesses on Silver Street to remain open. Mayor Pro Tempore Arceneaux-Mathis asked that approval of the minutes be held until the 1-7-16 meeting.
James Johnston, Planning Department Mr. Johnston introduced staff members for the upcoming health-related programs to be implemented by Clinton Healthcare Matters and Humana. The $250,000.00 from Humana had been received. Mr. Johnston clarified that Square Roots was looking to also provide a healthy mother program but, as their MOU was declined, they were reevaluating their position in Natchez/Adams County.
A motion was made by Alderman Fields, seconded by Alderman Fortenbery, to hire part-time
employees for Humana Foundation's Adams County Diabetes & Heart Disease Intervention Program –
Program Implementation. The motion carried unanimously.

Mr. Johnston clarified that staff being introduced would serve as program coordinators, coaches, community health workers and there would be one independent Program Evaluator. One hundred percent of the funding would be provided by the Humana Foundation. Each PT independent, contract employee would sign an employment agreement with the city, with copies kept on file in the Personnel Department. The PT contract employees would earn between $10,000.00 and $30,000.00 annually except for the Program Evaluator, who had a PhD, RN, ACNS- BC and was a professor at Grambling State University. The fee for the independent Evaluator, provide by the Humana Foundation, was $50,000.00.
The Program Evaluator would be paid approximately three times--at the end of January, July and at the end of the program. A motion was made by Alderman Fields, seconded by Alderman Fortenbery, to grant Mr. Johnston
permission hire up to fifteen part-time persons retroactive to January 1, 2016, as independent
contract employees subject to their passing a drug test and local background check, to pay the
independent contract employees on the 15th and 31st of each month, except the Program Evaluator,
with the submission of the contract employee's timesheet and approval from their immediate
supervisor. The motion carried unanimously.

Mr. Johnston said that the Clinton Foundation was not providing funding but the Humana Foundation would not be here without the Clinton Foundation. Ms. Getty said that she continued to look for grant funding. During the development of the program concept Mayor Brown pledged the use of the upstairs of the Council Chambers for program training, counseling, etc.
Duncan Park Tennis Center/Restrooms
A motion was made by Alderman Fields, seconded by Alderman Fortenbery, to authorize Mayor Pro
Tempore Arceneaux-Mathis to sign the quarterly report for the period ending 12-31-15.
discussion, Mrs. McClain advised that the money was budgeted to come from a transfer from Capital
Improvements Fund 300—this was a spending project so not in the budget but was in the budget
amendments she had presented in an earlier meeting which had not yet been approved.
The motion carried unanimously.
Auburn Water Intrusion Mitigation Project
MDAH Community Heritage Preservation Grant Program (CHPGP)
A motion was made by Alderman Fields, seconded by Alderman Fortenbery, to accept the MDAH
grant for the Auburn Water Intrusion Mitigation Project, awarded after the last board meeting of
The MDAH grant totaled $103,455.00, city match totaled $25,863.75 and Auburn Antebellum
Home match totaled $8,621.25, for a total local budget of $137,940.00. Funds would come from Capital
Improvements, Fund 300.
The motion carried unanimously.
City Finances A list of grants, matching funds required and possible sources for match funding was discussed. Mr. Johnston also provided a list of grants' matching funds that would be required month to month up to June 2016. Mrs. McClain advised that she still had two questions regarding sources of matching grant funds. Alderman Fortenbery said, regarding the restrooms/concession at Duncan Park, $150,000.00 had been obtained from a Wildlife and Fisheries grant—Mrs. McClain said, simply stated, it would cost $400,000.00 to construct the building so the city needed to decide where the $250,000.00 in funds would come from. The city could decide or not decide to take out a loan. The other unknown was where matching funds would come for the $119,000.00 for the Depot.
Solid Waste Grant—Mr. Johnston reported 100% MDEQ grant for cleaning illegal dumpsites. Mr. Holloway advised that the expenditures were under Public Works.
Tricentennial—a wash. The revenues and expenditures were shown in the budget.
Recycling grant—a wash Senior Citizens' Center—Alderman Dillard advised that $250,400.00 was earmarked to come from the Casino Community Development Fund with $1.6M was in the Community Development Fund. AldermanFortenbery questioned why the transfers needed to be budgeted --Mrs. McClain clarified that the transfer from Community Development to Public Properties had not been budgeted but was in the budget amendments that needed to be approved.
Mrs. McClain reported that the budget amendments must be done three months before the current BOA leaves office. The BOA would address at the 1-26-16 meeting.
SNAP—a wash. The money comes from respective banks.
Auburn Water Intrusion—Mrs. McClain said the City was not approved for the full request so the numbers would change on the sheet. The city's match would change to $60,000.00.
Auburn Kitchen Dependency—Mr. Johnston reported that the grant was still open and he would probably have bills in January, February and March to be paid. He would be requesting $22,000.00 to bepaid at the 1-7-16 Special Call Meeting and money was in place to pay all the invoices. The project was nearly complete. Alderman Dillard asked if Capital Improvements had the money to pay the remaining match. Mrs. McClain advised that Capital Improvements had money to cover the $22,000.00 for the Auburn Kitchen Dependency--this year $300,000.00 would be going into Capital Improvements for matches but three projects' matching funds had already been budgeted to come out of that fund. Alderman Dillard stated that he didn't think that Capital Improvements had enough to cover all the matching funds needed. Mrs. McClain clarified to Alderman Dillard that the budget amendments would address his concerns with how Capital Improvements Fund had been handled. Duncan Park Restrooms/Concession—Alderman Dillard said it was a $150,000.00 grant with a $150,000.00 match. He asked why the city needed to come up with another $100,000.00 for the projectand asked Mr. Johnston where the $150,000.00 match would be coming from. Alderman Fortenbery reported that the restrooms at Duncan Park needed to be addressed—he said perhaps some projects need to be squashed to make Capital Improvements whole. He had only pushed Duncan Park as it was acommunity park. Alderman Dillard said this was a valid project but the issue was the process—matching funds were not in the budget. The city would continue to get to the end of the year and would need to borrow money—the administration was having difficulty in identifying matching funds.
Colonnades-Mr. Johnston advised that the roof would be done with state funds which were in the bank.
North Natchez Drainage 592 program—Mayor Pro Tempore Arceneaux-Mathis said they were still in the process of obtaining ROWs and construction would probably not start until summer. Mr. Holloway stated that the funding was in a separate account. Mayor Pro Tempore Arceneaux-Mathis reported that David Gardner, former City Engineer, said a $339,000.00 local match requirement based on the projected budget of Phase IID—this would be the first time the city had asked for matching funds on this$13M project. She hoped that Representative Robert Johnson could identify some money for streets and the county would provide help if a funding shortfall. James Johnston said the city would probably not need to find the matching funds until summer or the next fiscal year. Historic Trails—Alderman Dillard said the budget was showing $185,000.00 coming out of Capital Improvements. He asked if someone could contact Community Alliance to see if they were still holding $275,000.00 received from Senator Cochran--Mr. Holloway said the money had come to the city and did not go to the Community Alliance. Alderman Dillard advised that the city had bargained with Magnolia Bluffs Casino for $300,000.00 to be used for the Trails but it had been discovered that the money was used for the Bridge of Sighs. Fire Department –a wash Entrepreneur Academy-a wash Senior Citizens Center—Mrs. McClain pointed out that the printout showed the city's match paid to the Senior Citizens Center and Natchez Transit quarterly. Mr. Holloway clarified to Alderman Dillard that $200,000.00 was taken out of gaming revenues for Natchez Transit and this had been going on before he took office.
CVB—Mr. Johnston said the city counted the CVB's $125,000.00 as in-kind marketing. Mr. Johnston forwards the documentation to the funding source. Mayor Pro Tempore Arceneaux-Mathis said the city needed to identify where the $119,000.00 matching funds for the Depot would come from.
Mrs. McClain advised that the city could not borrow any money past March 2016.
Mayor Pro Tempore Arceneaux-Mathis asked Mr. Johnston to bring the BOA copies of any pertinent information he was discussing to each meeting even if the paperwork was handed out at a previous meeting. Page 60, 2008 TIF Bond Construction—Mr. Holloway clarified that the city received revenue of $453,000.00 which comes from sales tax and ad valorem taxes. The TIF was for the Grand Hotel.
The City Clerk's staff would provide Alderman Dillard a schedule of the entire city's indebtedness. Mrs. McClain said staff was working on getting copies of all loans, leases, bonds, etc. Mrs. McClain said the resolution stating the qualifying dates was incorrect regarding the second primary.
The correct one would be sent to the Secretary of State. Mr. Holloway reminded the audience that two voting precincts needed to be changed.
Mrs. McClain reported that Slaughter and Associates was to provide a list of wards by streets tomorrow—this information needed to be provided to the county so that the voter rolls could be updated with the county handling the majority of the election.
A motion was made by Alderman Fortenbery, seconded by Alderman Dillard, to adjourn the Special
Call Meeting of January 4, 2016. The motion carried unanimously
_Joyce Arceneaux-MathisMayor Pro Tempore Donnie Holloway, City Clerk


Oral hydrogen water prevents chronic allograft nephropathy in rats

& 2009 International Society of Nephrology Oral hydrogen water prevents chronic allograftnephropathy in rats Jon S. Cardinal1, Jianghua Zhan1, Yinna Wang1, Ryujiro Sugimoto1,2,3, Allan Tsung1,Kenneth R. McCurry1,3, Timothy R. Billiar1 and Atsunori Nakao1,2,3 1Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; 2Department of Surgery,Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA and 3Department ofSurgery, Heart, Lung and Esophageal Surgery Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA