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HomeMy WebLinkAboutAgenda - 02-23-1978 Ange Co. t{l141 7�edtl1 TepQr`t.hliel1f, 14-* F,.. MAgZARET LANE. 12 LASTGATE sHo°P)N6 CEti^mR H)LL5eOROVGH. N C. 27270 CHAPEL WLL.. N C 179)4 PHONE: 732.6161 P.%T 2)3 PHONE: 947-4I56 (FROM CHAPEL HILL 667.9231) Orange County Board of Health Public Notice of Meeting DAVE: February 23 , 1978 TIME: 7:30 P.M_ PLACE: Orange County Courthouse Pft6POSED AGENDA 1. Di.scussia with the Orange County Commissioners: A. Fees for selected Environmental Health. Services. B. Relationship of Commissioners to Board of Health. C. Relationship of Commissioners to the Health Director. D. Other subjects as may be desired to be discussed. Time Permitting 2. Consider Lion of 1st draft of Environmental Health Budget for Fiscal 1179. 3. Consider tion of lst draft of Family Blanning Budget for Fiscal 1979. _ MINUTES 1. ORANGE COUNTY BOARD OF COMMISSIONERS 2 . FEBRUARY 23 , 1978 3. 4. The Orange County Board of Commissioner met jointly on February 23, 5. 1978 with members of the Orange County Board of Health, in the Commissione G. Room of the County Courthouse at 7 :30 p.m. 7. County Commissioners present were Chairman Richard Whitted, members 8 . Norman Gustavesin, Jan Pinney, and Donald Willhoit. 9 . Health Board members present were Chairman Dr. William Mayes , James 10 . Boyd, Nancy Coleman, Betsy McAdoo, Ruth Cooper, Donald Willhoit and at thi 11. meeting Dr. Morris Shiffman was sworn in as a Health Board member by Mrs . 12 . Kathyrn.. Hester. Dr. Shiffman will replace Kathy Parker, who has resigned. 13. Staff pers nnel present were Neal Evans, Assistant County Manager, 14 . Jerry Robinson, Health Administrator, Tony Laws, Chief Sanitarian, and 15 . Agatha Johnson, Clerk to the Board of Commissioners. 16. Dr. Mayes, presiding over the meeting, welcomed Dr. Shiffman as a 17. member to the Health Board. Dr. Mayes then proceeded to review the agenda 18. The first item for discussion with the County Commissioners was: 19. A. Fees for selected Environmental Health Services 20 . The Chairman recognized Jerry Robinson and Tony Laws , and asked that 21. they discuss wit I h the two Boards proposed fees for land development servic 22 . Mr. Robinson stated that the proposed fees were in concept with North 23 . Carolina Law. Fes may be implemented upon recommendation of the Health 24. Director, by adoption of the Board of Health and then by the approval of 25. the Board of Commissioners . Fees for environmental services are not to 26 . exceed cost incurred. The Health Director stated that a cost analysis has 27. been conducted which included all direct cost and some indirect cost. The 28. results received �' s an average mandated total cost, which are the figures 29 . which have been presented to the Boards. He added that his department was 30 . attempting to ba e the .fees on the ability to recapture cost for services rendered. -2- l. 2 . Mr. Robins n asked Tony Laws to review the proposed fee schedule with the two Bolyds. Areas of services for which fees Ana b law be charc 3. I may, by .. 4 . are: Freliminar Lot Evaluation, Soil Analysis on Each .Lot, Inspection fox 5 . Improvement Per� t5 r Inspection for C ertificat e of Completion and ins ecti 6 of Restaurant, :eiat Market, Day Care (for profit) , Rest Home and Tem orar 7. Food. Stands . 8 . A preliminary Lot Evaluation fee is based on an average man day total 9 , cost of $.77.91. The average travel time and evaluation of the first acre 10 . is estimated to take one hour at a cost of $9 . 75 , and the average analysis 11. time for remaining acres at approximately three acres per hour on the same 12 . trip would cost $3. 25 per acre after the first acre. 13. Every lot iequires three services, soil analysis, inspection for im- rovements permits and inspection for certificate of completion, therefore 14 . P P A P 15 . it is estimated that every lot costs a minimum of $64 .93 16 . Mr. Robinson stated that large subdivisions would require four steps 17 . which would increase the cost. He pointed out that consumers would pay 18 . for the service they requested and could stop whenever they wished. UndE 19 . the old plan, consumers paid a.. lump sum whether or not all services were 20 . used. Further, persons owning an existing tract and where there is no 21. division of tae would bypass the first step and go on to the soil analysi 22. Commission r Gustaveson stated that he und6rt-'bood fees for services 23 . rendered to large developers who were using large amounts of Health staff, 24 . time by assisti g in developing their projects,' however, he felt it is 25 . Part of the Coulty' s responsibility to cover the cost of inspections of 25 . Day Care Centers and Rest Homes. 27, Commissioner Whitted stated he agreed with Mr. Gustaveson that the 28. activity of Day care and Rest Homes should be looked at and not necessaril 29 . their profits. 30. Mr. Robinson informed the Board that the Health Department could not by law assess for any licenses or permits issued, therefore , the Board is -3- 1. ' 2. left with the cost analysis of per trip, per service concept for collectir 3. fees. 4. Commissioner Pinney stated he felt the cost for one lot subdivision 5. is too high for one person. He suggested this cost be estimated on a slid 6 . scale to aid the low income persons. 7. It was poijted out that it would cost the Health Department more to 8. evaluate a single isolated lot than to evaluate twenty or thirty lots in a 9. subdivision. 10. Members of the Board of Commissioners stated they felt the need was 11. pressing for es ablishing fees for large developers at this time rather 12. than levying fe s for operators of restaurants, meat market, day care, 13. r rest home and �,emporary food stands. 14 . Information distributed to those present stated that fees for restaur 15 . ants, meat market, day care, rest home, and temporary food stands are base 16 . on the State Public Health Division recommended visits and procedures. 17 . Chairman Mayes commented regarding charging fees for such establishme 18 . He stated that he would go along with charging fees for rest homes and day 19 . care, and he felt operating a restaurant was a pr4:vile ge, not a right. 20 . These are profit making establishments and should be charged a fee which 21. could be a part of their overhead expense. 22 . Commissions Whitted responded by stating this is a service to protec 23. the general publ' c and should be view in this light as well as being a 24 . profit making or anization. 25 _ Mr. Boyd pointed out the need to visit rest homes more than two times 26 . a year. He also suggested that some policy be developed which would allow 27. the sanitarian tD charge for inspecting trash dumped on private property. 28 . The general consensus of the Board of Commissioners was to agree with 29. the concept of charging fees for land development services , however, the 30. Commissioners asked the Health Board to investigate the fee schedules of other counties throughout the State, and see how thnsa --4w 2. size and population, and etc. to Orange County. The Commissioners asked 3. the Health Board to study the analysis of assessing fees further. 4. Chairman Mayes brought to the Health Board's attention a resolution 5. adopted by the �oard, of Commissioner regarding the N. C. Open Meetings Law 6 . The Resolution urged and encouraged all County appointed Board to comply 7. with the Open Meetings Law as done previously. 8. The second item discussed by the two Board was the relationship 9. of the County C mmissioner to the Board of Health and to the Health 10. Director, and how all interact with one another. 11. Dr. Mayes r eviewed a brief history of the County Health Department 12 . since its establ ishment of March, 1977 . In September, 1977 , .ferry Robinso 13. was named as County Health Director. Dr. Mayes pointed out that since Mr. 14. Robinson has be n. in this position the Northern Fairview sewage problem 15. has come to lig t. With the new septic tank .regulations adapted by the 16. State increased services are expected of the County sanitarians as develop 17 . ments continue. The Health Department is attempting to "beef up" services 18. in the health clinics. The Board felt it was wise to turn its home health 19. patients over to the Home Health Cooperation of Chapel Hill, since there 20. are other agencies which provide this service. This is on a five month 21. trial basis. The Health Board is also Looking into radiological services 22. which would pro ide better care for patients. Dr. Mayes stated that he 23. felt the Board had come along way, but still is anxious to go further. He 24. stated that it is important to establish open communication between the 25. Health Board, Health Director and the County Commissioners, and he hoped 26 . this would be an ongoing process . 27. Chairman Wh tted stated the Board of Commissioners attempted to meet 28. with County Boards and agencies once a year, other than at budget time . 29 . This is helpful in assessing where the Board stands and what direction it 30 . is going, and wh�t new issues need to be attacked. Mr. Whitted mentioned the establishment of Drimary hPa l i-h npn+�Arc in Heals-.h i"AnA r+-mAni-c Am 4-hcA 1. 2 . State is advocating. Mr. Whitted stated that public health is one of thot 3. services, by Ge eral Statutes , Counties must provide . Therefore, the 4 . Count Com issi�ners doshave is Y this responsibility and the relationship 5 . between the Com�issioners and Health Board should be strong. The Board of 6 . Health does have latitude in its expenditures of funds after the line iten 7. budget has been approved. Major shift of funds must come before the Board 8 . of Commissioners for approval. . Commissioner Whitted stated the Health 9 Department is a intricate part of Orange County's government, He stated 10, he felt great sirives have been made and the Commissioners are supportive 11.. of the Board's and the Director' s efforts . 12 . Chairman Mayes spoke of a .program which had been brought to the Board' 13. attention by Superintendent Michael Simmons, and that is the need for Z4 . additional healh support for the Orange County School system. He stated 15 . the Health Board was interested in establishing a countywide school plan. 16 . The Health Director is looking into this possibility. 17. Dr. Mayes further stated he was concerned with the vast number of 18 . pre-school chil ren who were not innoculated. 19 . Dr . Mayes concluded these remarks by stating that he did not feel the 20. Board of Commissioner intended the Health Board to be a rubber stamp board 21 • but that all we e working for the betterment of the people of Orange Count 22- and therefore, he people should be served to the best of the Board' s 23 . ability. 24 . Mrs. McAdoo stated that she served on the Health Board to represent 25 . the people of the County. She stated that she feels strongly about educat 26 . people regarding health services, particularly the services of providing 27. X-Rays to patients without patients being sent to Chapel Hill. 28 . Mr. Will.hoit stated that the primary reason for not "providing X'-Ray 29. ­'seyvices Was not because of- the excessiv; radiation, but t at�- fl. X Rays 30. provided imi ed. .diagniosis infarmation... -6- l. 2. Commission. r Gustaveson expressed his appreciation to the Health 3- Board for their I time and efforts to make the Department a reality. He 4. spoke of the ne�d for agencies to coordinate their knowledge of needs of 5- the people to o her agencies and to optimize the limited resources of the 6 . County. He stated that he felt it is important to call attention to healt 7. hazards in the County. Mr. Gustaveson mentioned the development of the 8- H5A plan which will require action and involvment of the Health Board. HE 9. concluded his remarks by stating that health is an important area of respc 10. sibility to the County Commissioners, and the Health Board is the body to 11. at times push t e Commissioners . He stated that the Commissioners may not 12- always agree with the Health Board, however, the Health Board should procE 1:3. to investigate neglected matters. 14. Commissioner Pinney expressed his appreciation to the Board and 15 - encouraged the Board to continue their efforts. He stated that he was 16 • impressed with the Board' s decision to "back off" from the Hoene Health 17- Program, that it is important to take a realistic look at programs . 18. Some areas of concern mentioned by members of the Health Board and 19 - which may becom priorities are : 2 a) Continued analysis of all facets of the Health Department by the 21. Health Director in order that the Department may be more efficient.. 22. b) Finding ways of bringing in new monies to facilitate expenditures 23, and create new services to meet the needs. 24. c) Assessment of needs to identifiy target population. there 25 . d) Nancy Coleman stated4appears to be a gap in the .northern end of the 26. County for primary health care. These needs need to be documented. 27. e) Need to bring existing agencies together in order that services might 28- be better coordinated. 29. f) Mr. Boyd s ated he feat all wells in the County needed to be tested 30- for contamination. _7_ 2 . g) Dr. Shiffm n stated he sees the need to use the Director in programat 3 . development and to use the Board as a responsive group for public sentimen 4 . or for special channels for different publics. 5. h) Dr. Mayes tested he envisioned the Health Department as concentrating on Environment] Health Services nd coordinating 6 . t I ces da.nat�.ng exzst�.ng services among 7, the resources iri orange County. 8 . i) Have an intricate part in implementing the HSA Plan in Grange County. 9 . k) initiate a ountywide school health plan. 10. The two Boards discussed accounting problems which have been encounte 11. since the State has requirements which differ from the County Accounting 12 . system. 13. The Financ Director stated he had talked with State representatives 14. regarding this roblem and as of this date has received no response . 15 . The County Commissioners asked that he pursue this dialogue with the 16. State Accounting Department farther. 17 . Mr. Robinson, the Health Director, stated from an administrative view Dint it is no difficult to identify the unmet needs in 18. point, y n e Orange County. 19. He stated further that one had to be cautious in identifying these needs 20 . because of the ong range impact and the distribution and spread of resour 21 . He stated he di not consider the Health Director as representative of the 22 . public, but this is the -function of the Board of Health. 23, Mr. Robinson asked what is the best mode of communication between 24 . the Commissioners, the Health Board, the County .Manager and the Finance 25 , Director. How does one keep everyone informed to the extent to which they 26 . want to be informed? 27. Commissions Gustaveson responded that the governing board of the 28 . County is a political body which is accountable to the citizens of the 29. C=ounty. They are a policy making Board who shape priorities . 30 . Commissioner Whitted stated the Commissioners did .have certain legal responsibilities) under the law. The rol(m of f--h4m rniini-v M;;nAffor i a 4-1,a4- 1. 2 . he is that pens n who has the overall responsibility of all of County .3 . government whic relates to the County Commissioners. He is the one to 4 . whom the Commissioners look to carry out the County' s programs and pol.iciE 5 . Mr. W fitted sta ed that this relation is very firm, and he added that the 6 . County Manager has a broad team of department heads who perform certain 7. functions. 8 . The Finance Officer is responsible to see that the budget which is 9 . adopted is dispIr-sed as intended by the Board of Commissioners. He con- 10 . tinued by stating that it is important that the County Manager be aware of 11 . how all departm nts are functioning so that services and resources can be 12. coordinated and]overall., objectives are accomplished. The County Manager a 13. the Finance bir ctor are usually aware of situations existing within the 14 . different boards , agencies, and departments which other departments may nc 15 . be aware of. 16. C;omm.ission tion properly r Pinney added that in order for County government to func ro er 17 . p P Y e l y on e must work together. 18 . Mr. Robins n spoke of primary health care in Orange County. He state 19 . that the County does provide primary health care service through a fee for 20 . service and thr gh OCC:HS. There is a significant case load in the Count 21. The role in whicE the County will play, if new regulations are required by 22 . the State, will e the role of cooperative or fill_ in the gap. Services 23. may have to be redistributed in some areas of the County. Mr. Robinson 24 . stated he felt help could be received in manpower and resources from the 25 . School of Public Health at Chapel. Hill.. 26. The C:ommiss 'oners requested the Health Board to inform them of the 27. primary health care regulations as soon as information is received from the 28. State. He added that it is important that citizens understand that the 29 . thrust of this new legislation is coming from the State. 30 . The meeting adjourned. oz_/-� / T4Z E. NARC NRET LANE 19 EAS;'CA7E SHOPPING CENTZR H:!L:7D��L1GF4. N.� C•�27Z70 CH.aPM HILL. N C 27514 T1 i40Nc: '7322 5t8! E-Y.. ^I5 PHOM— 942 (FROM CHAPEL HILL 487-72]1) ;KE L 10 TO: Orange County Board of Health FROM: Jerry Robi I son DATE: February I6, 1978 REGARDING: Cost Analysis for the Consideration of Assessing Fees for Environmental Health Services. We may by States- statute, with recommendation by the Health Director, by adoptioi by the Board of Health and by a facilitating action of the County Commissioners asses: fees for selected environmental services not to exceed our cost. The following analy: results in fee levels that would recapture our costs as best as I can project such co! I furthermore recommend, equal application of these set fees to all persons using such services. In con�ert with the State Statutes these fees are recommended to be assess= for services rendered and not for licensure. All permits and licenses resulting from the sanitation wotlk will be issued at no cost. The detailed cost analysis which re- sulted in these fee levels has been placed on file in the Hi ll.sborough Office of the Health Department for public inspection. Those services singled out for fee assess-.- meat are those co is presently b=n by the general taxpayer from which private profit diarectl.y or indirectly is facilitated. Fees for Land Development Services Preliminary Lot E aluation Average man day total cost equals $77.91 Average travel. ti �e and eiraluation of lst acre takes 1 hour: cost $9.75 Avera©e analysis ime- for :remaining acres at approximately 3 acres per hour on sane trip: cost $3.25 per each acre after 1st acre. Therefore: 1st acre cos per job order per day 9.75 Analysis of" d acre on per job order on same day 3.25/acre Soil AnAzsis On each Lot Average man day total cost equals $77.91 Average number of actual field work , Lest soil analysis possible per day equals 4, however, 1/4 of day oh average is required in' office for every 3 lots done. Therefore, t e cost per lot is figured at 3 lots per day into the man-day aver ge cast- which will cover office time .. .... ... . . .. . .... $25.97 Inspection for lm xovenent Permits Average number of actual field work inspections . . possible per day equals 5. An additional 1/5 of day is neede for every 4 lots done for office tire. Therefore , t e cost per lot is figured at the total average man_�av cost divided by 4 . .. . . .... .. .. _.. . ... _.. .. .. . .. _ Pacre 2 jxispt -`rtion for Ce,,rt!I:.catE! of Completl.on The coat of this in calculated exactly as is inspection for Improvements Permits . . . . . . . . . . . . . .$19-48 Summary Conments T Every lot requires three services , i .e. , soil aralysis , inspection for improvemi pernits and insp-ction for certificate of completion , therefore , every lot costs a n: mum of $6 .93_ Lots in sub ivisions .covesred by the subdivision ordinance costs additional due t the preliminary lot analysis cost. The actual additional cost is a function of hoax Many acres a lot consists of and how many acres a developer has us evaluate in one ji E.,amples: a two lot subdivision (riinor subdivision.) tAth each lot being, only one act, would cost $9.75 lst acre plus $3. 25 second acre or $13.00 divided by two lots or $6 additional each lot; a twenty acre subdivision with 10 lots would add $3. 58 to each cost. This 7-s a ini.mal cost risk compared to a developer spending marry thousands ii survey and other development work and then involving the Health Department at the so: analysis stage only to find their effortto have been totally to some extent wasted. Therefore, ue would urge persons to use the preliminary analysis stage in acres not covered by the subdivision ordinance and for single lot developments not covered by such an ordit ce. Other Sanitation Activities These figures are based on the State Public Health Division recommended visits and procedures , cur average man-day cost of $77.91 and with the daily visits total adjusted to allo� 15% compliance, plan review and educational time as per State recommended procedures. EstabIishemaents Visits inspections Cost. Per Total. Cost 1]er Per Yr. Per Day visit Yr. Per Establ Restaurant 4 3.4 $22.91 $91. 64 Meat Market 4 3.4 22.91 91. 64 Day Care (four pr fit) 1 2.55 30. 55 30. 55 Rest Home 2 1 .7 45.83 91.66 Temp. Food Stands 1 6.8 11_46 11.46 Reimbursement` Potential A. Preliminary Lot Evaluation Large tr ck 1,000 acre estimate 3,575 Small tracks 1,000 acre 650 H. Inspection fo Soil Analysis Estimat 1 ,240 lots at 25.97/lot 31,164 C. Inspect7ion for Septic Improvements Permits Estimate 6010 .lots at 19_48 11,688 D. Inspections. for Septic Certificate of Completion Estimate 400 lots at 19.48 7,792 E. Restaurants �"14 148 Establishments at 91. 64 13,563 Page '3 2S EstabIisb.1et'ts at 91 . (4'+ 2,291 G� Day Care 33 Estab xstiments at -M 55 1 ,006 H. F:est ilo-mes 8 Establishments at 91 . 66 733 Temporary Fooj Stands 36 Estab i.shmeats at 11.46 413 SUBTOTAL 72,877 Comments For the calendar year ending December 31 , 1977 , the department accomplished 12571 lots. The figures estimating lot inspections activities above are scaled dorm to reflect an exp cted drop in such activity if fees are assessed. The drop may be even greater or not occur as greatly; we have little base for accurate prediction. Additional Reimbursement Potential A. Inspection I fol Well improvements Permit — 300 Lots at 19.48 — 5,844 if separate trip from septic improvements trip . No cost if both tasks in same trill. B. Inspection fo Wall Certificate of Completion — 700 lots at 19.48 13 ,636 tests lost of sample bottle aisd handling) 1004 at .75 - '750 G. [later ( P Grand Total 93 ,107 Additional Cb=en s i The Fiscal 1979 Environmental Health plan will recommaextd enacting a local ordinance to enable the department to regulate private and semi—private (up to 9 taps well water- supply installations. 'therefore, this addition reimbursement is con tingen upon that event..