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HomeMy WebLinkAboutMinutes - 20020403APPROVE 616102 MINUTES ORANGE COUNTY BOARD OF COMMISSIONERS WORK SESSION April 3, 2002 The Orange County Board of Commissioners met far a work session on Wednesday, April 3, 2002 at 6:30 p.m. at the Southern Human Services Center in Chapel Hill, North Carolina. COUNTY COMMISSIONERS PRESENT: Chair Barry Jacobs and Commissioners Margaret W. Brown, Moses Carey, Jr., Alice M. Gordan and Stephen Halkiotis COUNTY ATTORNEY PRESENT: Geoffrey Gledhill and S. Sean Borhanian COUNTY STAFF PRESENT: County Manager John M. Link, Jr., Assistant County Manager Rod Visser and Clerk to the Board Beverly A. Blythe (All other staff members will be identified appropriately below) BOARD OF HEALTH MEMBERS PRESENT: Chair Jonathan Klein and members Melvin Hurston, Janet Southerland, Martha Jane Stucker, Lee D. Werley III, Alice White, Edith Wilder and Sharon E. Van Harn BOARD OF HEALTH MEMBERS ABSENT: Barry Adler and Alan Rimer BOARD OF HEALTH STAFF PRESENT: Health Director Rosemary Summers NOTE: ALL DOCUMENTS REFERRED TO IN THESE MINUTES ARE IN THE PERMANENT AGENDA FILE IN THE CLERK'S OFFICE. 1. DISCUSSION ISSUES FROM THE BOARD OF HEALTH Healthy Carolinians Report Card and Activity Update Introductions were made and Dr. Jonathan Klein talked about the Healthy Carolinians Report Card. Mary Beck, Coordinator of the Healthy Carolinians, made this PowerPoint presentation. She said that Orange County was the first county in the state to publish a report card of the health status of the citizens. The grade far tobacco use for adults was `B', which is considered a celebration. Orange County rated far better than most other areas of the states. Almost 56°~ of Orange County residents have never smoked. The greatest concern in the adult category is substance abuse. Over the past few years, hospitalization rates for alcohol and drug-related causes for Orange County citizens increased by 11 %. There were also significant increases in the number of DWI and drug arrests. Nutrition received a grade of `C', overweight adults a `D', and physical activity a `D'. In the youth category, tobacco use received a grade of `B', which is also a celebration. The survey did not include high school students, only middle school students. There are concerns with regard to child abuse and neglect and obesity, bath of which received a grade of `D'. There are now 23 agencies participating in child abuse prevention. April is Child Abuse Prevention Month, and Mary Beck spoke about the activities for the month. With regard to youth obesity, there are multiple efforts to address this problem. The schools are participating in trying to improve the nutrition. There are also several initiatives to address the issues for overweight adults. There are also initiatives for mental health and substance abuse. There is a task force to discuss the effects of the mental health reform. There is still a need for more agencies to participate in solutions to some of the problems. Commissioner Carey asked about the institutional rate for substance abuse compared with other counties. Mary Beck will look at this and report back that data. Commissioner Halkiotis asked what the County Commissioners could do to help the Board of Health to help the state understand the significance of the smoking prevention campaign. Health Director Rosemary Summers said that the members of the Board of Health did write letters when the fund was being developed. A major portion of the fund has been designated far the prescription drug program. There is now some talk in Raleigh that the fund will be used to balance the budget. She said that the County Commissioners could write letters to the legislative delegation and to the foundation board on the State using that fund to balance the budget. Commissioner Halkiotis said that he believes that there are more high school kids smoking now than ever before. Chair Jacobs asked that the Board of Health provide to the County Commissioners their legislative agenda. Chair Jacobs asked if there was any data on elder abuse and Rosemary Summers said that the Health Department does not have any of this information. Mary Beck said that they could get some figures from UNC-Hospital and compare that data over a period of time. However, not all elder abuse leads to reporting at a hospital. She said that an educational process that encourages identification and reporting would help. Chair Jacobs made reference to obesity and said that on the front page of USA Today, there was an article about more people using drive-in food than ever before and right beneath that was the rise in obesity. He said that the way that we develop our communities is contributing to the obesity of this generation. Martha Jane Stucker said that she just heard that there is federal income tax relief available for the obese. Rosemary Summers said that in other counties, in an effort to lower the budget, the schools have been cutting out sports at the middle school level, which would lower the level of activity for this age group. Commissioner Brawn asked if there is data on how Orange County's grades compare to the state. Mary Beck said that Orange County could be compared to the target grades, but not all the data is available for the state. In general, the health status of Orange County is good compared to the rest of the state. Commissioner Gordon asked how Orange County compared with other counties. Rosemary Summers said that in the area of teenage pregnancy, Orange County compared favorably to other counties. One of the other areas of concern from the last risk factor survey was alcohol use, particularly in binge drinking in youth/college age. Commissioner Brown asked how they would use the indicators from year to year. Mary Beck said that they would like to use the same indicators and possibly add some each year. Summary of Health Department Strategic Plan Accomplishments At this time, different members of the Board of Health spoke about the accomplishments of the strategic plan. Martha Stucker spoke about communicable disease. There were grant funds awarded for TB reduction and these are being used for clinician education. There is now an expanded list of physician practices for rapid fax communication. Sharon Van Horn spoke about childhood immunizations. Forty-six percent of children in Orange County are age-appropriately immunized by 24 months of age. This is up from 16°~ last year. This is partly due to the fact that they are coordinating with WIC to obtain immunization records. They are trying to develop an Internet record sharing program with private providers and to continue cleaning the records -aiming for over 60% age-appropriate immunizations in 2002. Lee Werley spoke about sexually transmitted infections. He said that there was a rise in syphilis from three cases to 24 cases in 2001. The good news is that mini-RIOT (Rapid Intervention Outreach Team) addressed the outbreak. The integrated clinics have been increased to five days per week. They have also been using providerlnurse teams. There will be an increase in outreach efforts to communities, screening and treatment in jails, researching of new software programs for improved clinic management, and HIV case management services. Mel Hurston spoke about Clinical Support Services, or Central Administration Services. The denial rate for Medicaid was less than 15°~ this year. There has been an increase in appointment slots per day since January. There have also been huge increases in third party billing and payments and workload. The revenues far this fiscal year are over budget. Some of the needs are inventory and pharmacy software, improvement in Medicaid and insurance reconciliation, and improvements in client financial screening and collections. Regarding medical interpreter services, they have hired an additional bilingual staff member and they would like to hire one more staff member. Three staff members will be attending immersion training this spring and the language voice mailbox has been set up. There are 23 interpreters on contract. Chair Jacobs made reference to the summit held at UNC, which was about the lack of interpreter service for the Hispanic community in North Carolina. He asked Rosemary Summers if Orange County was an tap of things compared to other places or if we were just starting. Rosemary Summers said that she thinks we are just starting with regard to the Health Department. She said that they have not experienced the pressure in the Health Department as much as Piedmont Health Services has. The community pressure is definitely growing to provide mare interpreter services. She said that there are four bilingual staff members and three additional staff members that are at an intermediate Spanish level. The demand is exceeding the ability to serve the clients. Jonathan Klein spoke about Orange County residences needing specific guidance on nutritional education. A half-time position was approved by the County Commissioners last year and the employee began work on March 5, 2002. Regarding Cardiovascular Health, the Health Promotion Coordinator was replaced. The Health Department received supplemental funds from the state for lay health advisor training utilizing the Women's Health Passport. Mel Hurston spoke about Dental Health Clinical Services. In the last five years the number of Hispanic clients increased from 56 to 140 - a 250°~ increase. The number of visits also increased from 159 to 393 - a 247°~ increase. The revenues have also increased. Some challenges are to replace a dental hygienist that resigned in January. Also, there are problems with retaining dental "attending", and funds will probably be lost from the dental school. They are also participating in the planning for mobile dental care far senior citizens. Alice White talked about environmental health noting that two new positions were approved last year by the Board of County Commissioners. The group has participated in the Heart-Health dining survey and they also continued ServSafe classes far restaurant workers and managers. These classes are available in Spanish and English. Regarding wells and on-site wastewater, a new specialist began work on January 7th. There is currently a backlog of 2-3 weeks for inspections of wells and septic tanks. There is a vacant position, which was advertised in February. They will be assessing some issues around a low interest loan/grant program for repairing failing septic systems. They will soon begin a No Fault Well Repair Fund program, which was a result of the American Stone Company mitigation. Edith Wilder spoke about animal control. They are learning a new software program, which will improve the registration of animals. There was a software glitch, which diverted some revenues to towns and away from the County. This will be tracked and fixed. APS is giving rabies vaccines to age-appropriate new adoptees. Animal sheltering is a large concern at this time. They are developing shelter replacement plans. Regarding dog and cat population control, a barn cat spay/neuter program has been started and there are three interested farmers to date. Chair Jacobs suggested that they work with the Agricultural Preservation Board. Jonathan Klein outlined the other accomplishments including instituting jail health services, performance standards for home visiting staff, the lowest staff vacancy rate in five years, and successful response to a biaterrorism threat. The critical needs include surveillance and communication for bioterrorism and emergency response, response to continual increases in communicable disease, HIPAA Compliance Officer/Billing and Medicaid Specialist, staffing for primary care clinical services, space needs for dental and personal health clinical services and animal shelter, stabilizing dental health staff, and replacing "lost" funding (Smart Start and state funding). Commissioner Gordon asked for mare information an the surveillance system. Rosemary Summers said that the system may include some things such as an automatic reporting system at the hospital of unlikely symptoms (i.e., 20 flu cases in June, etc.). Rosemary Summers presented some photos of the Whitted Center, which showed some of the needs. She said that there needs to be some consideration in the CIP for an intermediate plan to meet the needs. The appointment slots have increased from 96 to 171 just in the Whitted Center. Patients often have to wait an hour for services. Commissioner Carey made reference to the lead abatement method and asked about the specifics of this. Ron Holdway said that if the presence of lead is identified, they would need to correct it or vacate the affected premises. 2. RESOLUTION - Commissioner Carey said that, as indicated last night, the work group has made considerable progress, but has a little more work to do. He said last night that another resolution would be presented to the Board at a later time asking for an additional two months to finish the work of the group. He said that a tremendous amount of work needs to be done after the group determines the use of the Greene Tract. He said that the issue of the 11 acres and the designation is the sticking point right now. Carrboro would prefer to designate it for affordable housing and Chapel Hill would like it to be designated as green space. The compromise was to not cover it by a conservation easement, but to leave it open for designation by future boards of elected officials. The decision about where the sewer line could run could help with the resolution of this issue. Commissioner Gordon asked about the amount paid by Carrboro and Chapel Hill. John Link said that the staffs have prepared the estimated amount that would have to be repaid by all three jurisdictions based on certain interest rates, etc. Everyone knows that it is going to be a significant amount of money. They have also talked about whether or not all jurisdictions need to pay it back all at once or pay it back over afive-year period. This resolution is an effort to adhere to the agreement, which is that by April 17t" we came to an agreement an a use plan for the Greene Tract. The group has almost come to a decision, but it needs another two months to develop a general land use plan. Commissioner Brown noted that if the group determines to use same of the Greene Tract acreage for affordable housing, it would still take years for it to happen. Commissioner Halkiotis made reference to a newspaper article that painted a bad picture of what was happening in the work group. He said that the article mentioned a 300-unit affordable housing complex. Commissioner Carey said that the group went through several scenarios for affordable housing because one of the groups of elected officials had a perception that there should be at least 300 units being built in the area designated as affordable housing. This was discussed as well as maximizing the affordable housing on a certain number of acres on the site. Chair Jacobs said that it would be good if Commissioners Brown and Carey could make a list of next steps. Commissioner Carey said that he feels it appropriate for the present work group to make a recommendation on the next steps. A motion was made by Commissioner Brown, seconded by Commissioner Halkiotis to adapt and authorize the Chair to sign the resolution as stated below: A RESOLUTION AUTHORIZING THE MANAGER TO CONTRACT FOR PROFESSIONAL SERVICES ASSOCIATED WITH CONDUCTING A SURVEY TO DETERMINE FEASIBILITY OF LOCATING A SEWER LINE TO THE GREENE TRACT WHEREAS, the Greene Tract Work Group has indicated an interest in extending the sewer line constructed by Habitat for Humanity and OWASA to the Greene Tract; and WHEREAS, the Greene Tract Work Group has stated a preference that the sewer line be routed from the existing line off the north end of the cul-de-sac on Jubilee Drive, to Purefoy Road, then east along Purefoy Road to the Greene Tract; and WHEREAS, the terrain of the proposed route calls into question the feasibility of constructing the sewer line in the requested location; and WHEREAS, an elevation profile of the proposed route must be prepared by a surveyor in order to determine the feasibility of the proposed route; NOW, THEREFORE, BE IT RESOLVED THAT the Orange County Commissioners authorize the County Manager to contract for services necessary to produce the elevation profile of the proposed sewer line route to determine the feasibility of the proposed route; and BE IT FURTHER RESOLVED THAT County exempt itself from the selection requirements for surveyors as cited in GS 143 Article 3D in order to expedite the timetable by which the survey results are produced; and BE IT FURTHER RESOLVED THAT the County Manager be authorized to fund the survey work from available Solid Waste funds as he deems appropriate. This, the 3~d day of April 2002. VOTE: UNANIMOUS 3. UPDATE OF STUDENT CAPACITY, MEMBERSHIP AND PROJECTION METHODOLOGIES John Link said that the jurisdictions are now grappling with approving the school adequate public facilities ordinance and the issue of student capacity, membership, and project methodologies is a big part of this. There has been discussion at the latest meeting of the school superintendents and Manager's staff on which methodology to be pursuing of the five different methods. He said that the County Commissioners need to set parameters for what they expect of this issue. He said that the purpose of this item being on the agenda tonight is for the County Commissioners to articulate questions that the School Facilities Task Force could address in its work. Planning Director Craig Benedict said that in order to understand projections, you must also understand capacity and membership issues. Part of the APFO is pressing all parties involved to be consistent in their reporting of capacity. Regarding membership, the Schools and Land Use Council discussed which date would be the best to use for official membership numbers. Regarding the student generation rate, the staff is suggesting the use of the Tischler Report, which calculates the number of students generated from certain housing types. There are five models of projection methods, which were developed in the spring. Each model was gauged against what actually happened in November 2001. It is recommended that the memorandum of understanding in the APFO say that each year's membership information gets turned over to a technical advisory committee made up of planning directors and a school representative from both districts. Chair Jacobs made reference to page two and how the School Facilities task force suggested using the 40t" day enrollment figures far membership and then on page 20 it has the Schools and Land Use Council recommending a different methodology. He asked when and who would be deciding this. Craig Benedict said that the Schools and Land use Council recommended the use of the membership figures compiled on November 15t" Commissioner Gordon said that the reason the Schools and Land Use Council adopted November 15t" is because that is what is in the memorandum of understanding. She said that this is what the staff work group recommended. Geoffrey Gledhill said that the reason that staff recommended November 15t" is because it is the same day for both school systems (40t" day is not the same day) and that November 15t" is close enough to the 40t" day enrollment when the student membership is stabilized. Craig Benedict said that there would be an annual review that would update membership, capacity, and growth rates. The technical advisory committee would give an update to all of the parties in January for them to review and the school systems would use it in their capital investment planning. The new model or updated information would be certified by the Board. The decision would be the County Commissioners' in the following years. Commissioner Gordon said that one thing about the charts is that they use the two-month average daily membership (ADM.) The numbers from the School Facilities task farce are the three- monthADM. She said that the School Facilities task force needs to continue where it left off and finish the report. John Link said that he feels that one outcome of the Schools Facilities task force should be absolute understanding and agreement on capacity, membership, and projections so that when the report is presented to the County Commissioners for the Capital Improvement Plan, that the County Commissioners feel comfortable with committing the amount of money it takes to build the schools. If there is disagreement and fractured understanding, then the County Commissioners cannot be comfortable spending the money for new schools. Commissioner Brown made reference to the Bond task force and said that there was an incredible rush that both elementary schools (Chapel Hill-Carrboro City Schools) had to be on the bond and that both had to be built simultaneously. Then two months later, it is another high school and Elementary School #10 is not needed right away. She asked if this process {the APFO} would prevent this type of situation from occurring again. Craig Benedict said that it should make it better than it is now. John Link said that this question needs to go back to the School Facilities task force. He said that there is no state law that requires County Commissioners to do any of the things that they are doing regarding the schools. The County Commissioners need to be comfortable with these decisions. Commissioner Halkiatis made reference to an article that he found in his garage about projection methods and how they are so important because they mean money to school systems. He said that the bottom line is the dollar sign with the school systems. He said that we need to take the emotionalism out of this and make it as scientific as possible. If the APFO is to be successful, everybody must agree to it. He commended the staff for developing this ordinance. Commissioner Carey said that this process for determining membership has been important and it will contribute to better planning for school facilities. He feels that the County Commissioners need to decide on one method for determining student membership and the model that will be followed. Commissioner Gordon made reference to the Student Capacity by School District chart that was in the agenda packet. She said that two things you will need for the APFO are the membership numbers and the capacity numbers. She would like to authorize the distribution of these sheets in the format that was suggested (figure 5, page 10) and pass it on to the school boards. She suggested at the bottom of the page to put a note that reads, "These charts show membership and capacity data from fall 2001." Also, it could be mentioned that Cedar Ridge High School is opening and membership information will be updated when fall 2002 data becomes available. Chair Jacobs said that there are some issues about how capacity is defined and adjusted and the School Facilities task force should discuss it. Commissioner Gordon said that last time the School Facilities Task Force went with the capacity of the schools using state criteria. Chair Jacobs agreed to sending this on to the school boards with the stipulation that we are referring the issue of how capacity is defined and adjusted to the School Facilities task force for review. Commissioner Gordan will give this student capacity information to the staff to be sent to both school boards. Commissioner Gordon explained the reasoning behind the change in Elementary School #10. Chapel Hill-Carrboro did not have as big an increase as expected in the elementary schools. Commissioner Halkiotis suggested that the School Facilities task force visit facilities in both systems to see how the rooms are being used. He said that there are some 1250 square foot rooms with three severely physically and mentally handicapped children and three teachers in both school systems. There is also an issue with the pre-K program and how it fits into capacity. Commissioner Carey said that when we sell the public on paying for these schools, we tell the public what we are going to do and we ask them to buy a package with a certain amount of capacity. When this capacity is significantly below what we told the public, then the public does not understand how it happened. He thinks that this cannot be addressed by unilateral decisions without the other parties being involved or at least being aware because the Commissioners are still the ones that have to answer to the public. Chair Jacobs said that he thinks the SAPFO will in some ways resolve the issue of capacity because it will be very difficult to change it unilaterally. 4. COMPREHENSIVE PLAN SCHEDULE AND LAND USE COMMITTEE (CPLUC) Craig Benedict made this PowerPoint presentation, which is incorporated by reference. He said that Orange County has grown 26°~ in the last 10 years. A 40-year population projection was created, which is the possible timeframe for the new comprehensive plan. Build out of Chapel Hill and Carrboro is expected in the near future. The GOOD Plan encourages development where there are services and discourages development where there are environmental sensitivities. The next step is to establish the Comprehensive Plan Land Use Committee. This item will be on the decision agenda for the next Board of County Commissioners' meeting. 6. EFLAND/BUCKHORN EDDICHEEKS SMALL AREA PLANNING STUDY This item was postponed. 6. 2002-2003 BOCC GOALS This item was postponed. 7. ADJOURNMENT With no further items for the County Commissioners to consider, a motion was made by Commissioner Halkiotis, seconded by Commissioner Carey to adjourn the meeting at 10:10 p.m. VOTE: UNANIMOUS The next meeting is scheduled far April 16, 2002 at 7:30 p.m. at the Southern Human Services Center in Chapel Hill, North Carolina. Barry Jacabs, Chair Beverly A. Blythe