Loading...
HomeMy WebLinkAboutMinutes - 19770329MINUTES ORANGE COUNTY BOARD OF COMMISSIONERS MARCH 29, 1977 The Orange County Board of Commissioners met in special session on Tuesday, March 29, 1977, at 7:30 p.m., in the Commissioners' Room of the Courthouse in Hillsborough. Present were Chairman Richard Whitted, Commissioner Norman Gustaveson, Jan Pinney, and Donald Willhoit. Absent was Commissioner Norman Walker. Others present were 5. M. Gattis, County Manager, Neal Evans, County Finance Director, and Agatha Johnson, Clerk. Chairman Whitted opened the meeting by requesting that members from the Berard of Commissioners and the Orange County Health Board introduce themselves. Members of the Health Board present were Nancy Coleman, Ruth Cooper, Evelyn Lloyd, Betsy McAdoo, Dr. William Mayes, Jim Boyd, and Dr. William Nebel. Commissioner Willhoit also serves on the Health Board. Chairman Whitted expressed his appreciation to the Health Board for agreeing to serve on this vital Board. He stated that the Board of Commis° sinners were aware that much wo=k is ahead for the Interim Berard of Health in order to have an on-going Health Department by July 1, 1977. He stated that a tap priority far the Health Board is the hiring of a Health Director and that a job description should be ready by April 15.th, and the Directoz should be hired by Jujne 1, 1977. Mr. Whitted stated that Dr. Charles Harper from the U.N.C. School of Public Health was present and had been asked to present to :.the Boaid his views of a health department, its organization, functions Arid types of services. Dr. Harper stated that those people at the School of Public Health were willing to help the new Board in every .way possible, and the School was hopeful of having a role in making the Orange County Health Department a model for North Carolina. Dr. Harper stated that the Department of Public Health had the broadest legal mandates of any other health or health related organiza- tion. The Department of Public Health is charged with the promotion and protection of the health of the public by General Statutes. This is a broad mandate and not restricted to a set of functions that would restrict its activities. Tn the past, functions of a health department have been the traat- ment of communicable diseases, such as tuberculosis, venereal diseases and childhood diseases. Also, an important function has been that of environmental sanitation and control of environmental conditions. Health Departments services include a collection of vital statistics, as well as a monitor for health status. These are functions one would find in a typical health department. As you continue to look at health depart- ment, there is a thinning out, in terms of frequency, of what a health department does. Detection of chronic diseases has received great _ emphasis in recent years. Hypertension is another program which is an acceptable role of health departments. More recently, health departments have gotten into the medical care area of services. Dr. Harper stated that historically, it has been felt that health departments should not get involved in treatment services, but that this should be left to the private sector, however, today many health depart- ments do provide certain treatment programs for the medically underserved. These programs usually have to do with particular types of illnesses. Nutrition programs have been added to the role of health departments, to attempt to identify individuals who have health problems related to food deficiency. i4~ Another important program is home health services. Dr. Harper stated that there was a range of services for a health department to engage in which would vary, depending on the philosophy of the Health Board, the people in public health, and community leaders. Services will vary also with the amount of resources which aze available. Further, services will depend upon the morals and the thics of the community. Dr. Harper stated that there is nothing to restrict the range of involvement of public health in services. Dr. Harper stated that he thought of a health department as an organi- zation that would be concerned with the total health of the community. The health department does not necessarily have to be a provider of services itself, but should be concerned with whether or not services are available. xhe health department should be a monitor and overseer of health, working with other community groups, private physicians, and calling upon what- ever modality of services might be most appropriate. Dr. Harper spoke of primary care programs. He stated that today many leaders felt it was quite appropriate for the health department to either take the leadership in organizing primary services, or to actually provide these services. Dr. Harper stated that a typical health departmenti would have a director, who could be a physician or a non-physician. A large portion of the organization would be public health nursing, who would be involved in the range of health related activities, or generalized nursing services to the public. Another wing of the health department would be involved in sanitation. The sanitation's responsibilities would range from food protection to involvement of septic tanks. In general, the functions of a health department depend on the needs within the community and the available resources to take care of the needs. Other functions which Dr. Harper mentioned are: 1. Progressive Health Education, an attempt to educate the public about the maintaining of sound health. 2. The control of health hazards in the environment. 3. Intervene in detecting chronic illnesses and provide services or referral programs for these illnesses. 4. Provide certain kinds of services which axe not available in the community, whether they be treatment or other types. 5. Monitor and assess the community to find out what health pro- blems exist is a prime role of the health department. A question and answer period ensued. Dr. Harper stated that there was a lot of money for public health if people were willing to go after it. He informed the Board of Health of standards which will hopefully become effective July 1, 1977. These standards ~ave twenty-one program activities which all health departments will be expected to engage in to meet minimum standards. Dr. Harper stated that there were many advantages for health departments and medical institutions within a community, to become affiliated in the providing of services. He stated that health depart- ments association with local medical institutions could range from having a contractual agreement to actually allowing the institution to operate the department. Other options would be to provide certain services to the health department and supervise the professional aspects of those services, or an arrangement on a spot basis to sent in individuals who are trained to work under the supervision of someone else in the depart- ment. A fourth model would be to have graduate students provide services. Students would receive training and at the same time provide services undex the direction of a preceptor, hired by the University or the health depart- ment. Dr. Harper stated that the School of Public Health does not want to 1~5 operate a health department, but does want to work with the local department by allowing students to participate and by rendering services and training. He added that the control should be with the '.local juris- diction. Chairman TnThitted stated that regardless of what arrangements are made with the School of Public Health, the health department should be identified as a community health department, with the primary purpose of rendering services to the community and not an arm of the University. In response to a question presented by Commissioner Gustaveson, con- ... cerning the position of a health director, Dr. Harper stated that he per- sonally felt that a physician with specialized training should not be in the role of an administrator, but an administrator should be prepared and `- qualified as an administrator. Another point Dr. Harper made is that an administrator does not have to be trained in clinical medicine along with administration in order to direct a health department. He added that there may be an individual wo qualifies in both areas, and he felt this would be good, however, fewer physicians today are going into public health. Commissioner Gustaveson asked what arrangements were possible for small health departments who could not affort both a full time health director and a full time administrator. What arrangements can be made to provide medical advise to certain medical problems? Dr. Harper replied that there were different arrangements. One model would be to hava a non-medical director whc is qualified in administration and at the same time, have an arrangement with practicing physicians to serve as consultants in medicine on a full or part-time basis. The idea is to rely on other specialists for consultation whether the problem be medical or non-medical. Further discussion ensued concerning a health director. Dr. Harper stated that North Carolina had two classes of positions of health directors One is a medical director, which had three classes, and the other is a non-medical director which has five classes. The classes~~are distin- guished by the size of the health department and the population of the county. He stated that since Orange County had a population of 80,000, a Health Director III or zV would probably be needed. Mr. Whitted informed the Boards that George Nelson, the Regional Manpower Director, had made a case where he said that in terms of money, it is least expense to have a non-medical health director. Dr. Harper advised the Boards to think in terms of the highest level of non-medical administrator it can employ and then contract to provide for clinical services threugh some other arrangement. Commissioner Gustaveson stated that with the goals which have been set out for the next few years, it will take someone that is competent and qualified for a unique situation. He added that the aim of the Health Systems Agencies is to incorporate their plan into the programs of the local health departments. Commissioner Pinney stated that he felt the first objective of the Health Board is to become established with a solid operation, and then to look at services to provide. Dr. Harper informed the Beards of an undertaking of the School of Public Health and the Division of Health Services to provide Board training to local health boards. Discussion ensued concerning additional staff personnel to work on an interim basis, until the administrative assistant comes to work. The County Manager was authorized to procede with securing such a person. Commissioner Gustaveson requested that an outline or an inventory of things which need to be done by July 1, 1977, be made, so that nothing is overlooked. He added that it is important to have a senior staff person involved during this transional period. The County Manager will meet with the health department staff to formulate such a list, and to x.46 provide a linkage between the District Health Department and the new Health Board. Commissioner Willhoit stated that the next meeting of the Health Board would be on Monday, April 4, 1977. ~ ~ ~~ C-- ;? ,~ l ,~, ~Ri ar Wh tte , airman Agatha Johnson, Clerk MINUTES ORANGE COUNTY BOARD OF COMMISSIONERS APRIL 4, 1977 The Orange County Hoard of Commissioners met in regular session on Monday, April 4, 1977, at 10:00 a.m. in the Commissioners' room of the Courthouse in. Hillsborough. Members present were Chairman Richard Whitted, Commissioners Norman Gustaveson, Jan Pinney, Norman Walker, and Donald Willhoit. Others present were S. M. Gattis, County Manager, Neal Evans, Finance Officer, Agatha Johnson, Clerk to the Board, and Jeffrey Gledhill, County Attorney, was present for part of the meeting. Chairman Whitted referred to Item 1 on the Agenda: Persons not on this agenda having business to transact with the Board should make their presence known. Raymond Williams stated that he was present to request the County Commissioners to reconsider a rezoning request which was presented to the Board in August of 1976. Commissioner Walker stated that he had advised Mr. Williams that he would bring this request before the Hoard since there were points which the Board were not aware of. The Board agreed to hear Mr. Williams' request after lunch, when the County Attorney and the Planning Staff would be present. Item 2: Minutes of March 15th and March 29th are submitted for the Hoard's consideration. The minutes of March 15, 1977 were reviewed. Upon motion of Commissioner Pinney, seconded by Commissioner Gustaveson, it was moved and adopted that the minutes of March 15, 1977, be approved. The minutes of March 29, 1977 were reviewed, and upon motion of Commissioner Finney, seconded by Commissioner Wil;l.hoit, the minutes of March 29, 1977 were approved. Chairman Whitted referred to Item 3: Receipt of Petitions: (A) Caldwell Fire District and (B) Cedar Grove Fire District. Chairman Whitted asked if there was anyone present from these two districts to present the petitions which is to request the Commissioners to call for a referendum for the two districts. Commissioner Walker stated that he had been informed that the Caldwell Fire bistrict petitions were not completed, however, he would attempt to contact someone from the district to see if the petitions could be presented sometime today. The Gounty Manager stated that he would contact members from the Cedar Grove Fire District to see if they were ready to present their petitions.