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HomeMy WebLinkAboutAgenda - 05-22-1978 MINUTES ' ORANGE COUNTY BOARD OF COMMISSIONERS 2 . MONDAY, MAY 22, 1978 3. The Orange County Board of Commissioners met in regular session on 4. Monday, May 22 , 1978 at 6 :30 p.m. ,in Poppa Joe's Restaurant in Hillsboroug 5. The purpose of the meeting was to hear a budget-program review by the C'oun 6. Health Board. 7 . Commissioners present were Chairman Richard Whitted, Norman Gustaveso 8 . Jan Pinney, Norman Walker and Donald Will.hoit. 9. Health Boa d members present were Chairman Dr. William Mayes , Evelyn Lloyd, Dr. Morr 10. s S n hiffma , and Commissioner Wil.lhoit also serves as a 11- member of the B and of Health. 12• Others preJobinson,ent were S. M. Gattis , County Manager, Neal. Evans, Finance 13. Officer, Jerry Health Director, Tony Laws , Chief Sanitarian, 14 . Margaret McClint ck, Nursing Supervisor, Joe Bradshaw, Administrative Asst. 15 • ant, and Agatha 'ohnson, Clerk to the Board.i 16. Chairman Wh ted opened the meeting by expressing the appreciation of 17• the Board to the Health Board for their first year of service to the Count, 18. Dr. Mayes s ated that the programs which are proposed for the future 19 are necessary to meet the needs of the people of the County. They are so 20 • structured to co rdinate with services which are provided by other health 21. related organizations in the County. He stated that man times one cannot g Y Y 22 . see direct effedts of services immediately, but that definite results are 23. seen years later. 24 . Dr. Mayes asked the Health Director, Jerry Robinson, to review with tl 25 . Board plans of haw the Health Department should be set up for the coming ye 26 . and how needs c arl. be met. 27. Jerry Robinson distributed for the Commissioners' brief review, copies 2B . of Standards for ILocal Health Departments in North Carolina. He stated that 29 . the Health Board would like to be in concert with these standards, however, 30- at present the Orange County Health Department is not meeting these standar i. Page 2 2. but is making efforts to move in that direction. 3. Mr. Robins©n presented to the Hoard comparisons of Orange County's 4 . Health .Departmerlit to -bepartments in nine a�ther counties in the State, with 5 . like populations. The comparisons showed the per capita appropriation per 6 . county, the general tax rate for the counties, the total appropriation per 7. county for Health Departments and the total staff size: of County Departme. 8. as compared to Orange County. Mr. Robinson pointed out that out of the 9 . ten counties compared, Orange County usually is found in number nine posit. 10 . He stated that Orange County has been designated as a medically over-- ll. served county an� this rating does damage to the Health Department, whereas 12 . the Department is not eligible for certain federal reimbursements. He adde 13. that he had been informed that the Health Systems Agency intended to recom 14 . ment in July, 1978 that Northern Orange County be separated from the remair 15 . der of the Cou.nt�, and this will open avenues for other funding of programs 16. Mr. Robinson asked Tony Laws, Chief Sanitarian, to speak of the 17 - Environmental Health Program. 18 . Mr. Laws stated that major services expected from his department are 19 - restaurant inspectionsand sewer disposal inspections. Sanitarians are 20 • responsible for Jhe quality of milk prddu.ced by County farriers . Sanitarian 21- are involved with the milk processing which includes the quality of water a 22 - animal might dri to evaluating the handling and storage of milk and milk 23. products sold in retail, stores . The Health Department is vitally concerne 24.with private water supply. It is estimated that 700 wells will be inspecte+ 25 - during 1978--79, resulting in at least 1000 visits to various sates, and takii 26. about 15 % of staff time. He stated that water supplies and sewer disposal 27-weigh heavily with the Department's concern by the increase number of 28 -migrant camps in he County. This year there will be more than 35 such canj 29 -Another concern o the Sanitarians is to provide a program of control of the 30 . storage , collection, transportation, and disposal of solid waste and the relation of such to rodent control. Page 3 2 . Other programs which the Sanitarians are involved with are : Inspecti 3 . of residential care facilities. Training programs are being planned to 4 . educate workers in these facilities regarding food handling. Public Healt 5. will assist wi problems with locations of green boxes , in the area of 6 . animal control., and also they are interested in housing standards for the 7. County. He add d that all housing should include an approved water supply 8 . and sewage disposal . 9 . In response to a gixestion asked by Chairman Whitted regarding migrant 10 , camps, Mr. Laws tested that migrant workers are the only laborers many 1l , tobacco farmers can get. The workers usually live in tenant houses or 12 . mobile homes located on the farm. There is an average of five worker to 13. each camp. He sated that these workers are in transit and from time to 14. time bring into he area various health problems. The North Carolina 15. Employment Se cur ty Commission has the responsibility for placing migrant 16. workers in the C unty. The Health Director introduced to the Board Mar i 17 . e h o Margaret McClintock, 18 . supervisor of N�rses in the Health Department. 19 . Mr. McClintock stated that the County has a separate population in 2p . the Northern end of the County as compared to the Southern part. The 21. peOple in these two areas have different concerns and different health 22 . problems. The fact is not easily recognized, especially when one is lookin 23. at statistics, that the Chapel Hill-Carrboro area distorts these figures 24. and Orange County usually comes out looking good, which is not the case in 25. the entire county. 26 . As far as in i.cators of health status go, classic indicators are the 27. causes of illnesses and deaths. Ms. McClintock reviewed perinatal mortalit; 28. rates for Orange Lunty, which are rates of children who die, including 29. fetal deaths thro gh the first year of life. The average range of 24.0 to 30. 49.4 is for the years 1970 through 1974 for Orange County. The County�s average, based against the State average is 29 .6 out of 1000 children dip Page 4 1. 2. She stated that most of the problems existed in low income areas and in 3 . rural areas of the County. 4 . The Neonat�l Mortality rate has to do with death which occur between 5. birth through the first 28 days of life. The average range for Grange Cou 6 . is 1.1. 7 through 19 . 0 out of 1000 children. The average mortality rate for 7. the County is 13 .3 out of 1.000 children. g, In Infant ortality, the range is 15.1 to 29 .0. The County' s average 9 . is 18 .2 out of 1. 00 children. Causes of death in all children ages l thro 10 . 4 are due 99 percent of the times to accidents. The mortality rate tends to drop as children row. 11. A g 12 . She informeL the Beard that the major cause of death in adults is due 13. to heart disease and hypertension, however, hypertension is usually not 14 . listed as a direct cause of death. 15. Thirty-thre7 thousand people in Orange County have one disabling dis- � about ease and this number have two disablin 15. Talf g diseases . She informer 17. the Board that since 1958, lung cancer has increased by 345 percent in Orar 18 . County, colon-rectum cancer is up by 30 percent, breast cancer is up 44 per 1g , cent and cancer If the prostate is up by 47 percent. She stated that nranc 20 . County tops all ounties in this area in the incidents of sclerosis of the 21. liver. 22 . Chairman Wh'�tted asked that Ms. McClintock speak of ways in which the 23. mortality rate in .infants can be lowered in the County. 24. The Health Supervisory stated that good perinatal care at an early sta 25. is of great. valu The mother should receive good care and often. she 25 . should have good nutrition, have social support, help in the home when the 27. baby comes home, and that the baby should be a wanted baby. She stated th.a 28. recent studies sh w that the amount of family planning in a community resul 29. in a decline in infant mortalities. Mothers who are considered h..gh risks 30. are mothers over he age of 35 and under the age of 18. The Health Director stated that an agre%sive approach will make nn Page 5 1. 2. impact on the i Kant mortality rate. He added the Family Planning Program 3. was such an app oach and is tailor to the needs of the County. 4. Regarding he Maternal Child Health Program, Ms. McClintock stated g g g , e 5. there are a number of high risk mothers in Northern Orange. The Health 6 . Clinic sees betwen 35 to 50 patients during clinic days . She added that e a� t makes a telephone call. to all mothers of first born, 7. the Health D p I tmen es p 8. babies in the Co nty, and makes a visit if the mother desires this. A vis. s made o all h� h risk mothers . The resent nursing staff is not suf'fi- 9. x a c t 1 g P g 10. cient to follow ip on all the cases in the Maternal Child Health Program. 11. Ms . McClintock informed the Board of a program known, as EPSgT (Early 12, Periodic Screeni g, Detection and Treatment. Children in this program are 13. screened four to es during their first year of life and once each year 14 . thereafter. She stated the County needs to be doing more of this type of 15 . screening. Medicare prevents these children from receiving dental care un- 16. less they have had a EPSDT Screening. Additional nurses are needed in this 17. Program. 18. The Health Director spoke of the great need in the County for school 19. Health. He stated the budget narrative speak to this need and to the effoi Z0 . the Health Department hopes to make in meeting the need in School Health. 21. Other progrms which Mr. Robinson mentioned were School. Dental Health, 22. Chronic Diseases ( Tuberculosis , Venereal Diseases, vital records, and 23. efforts to be male by the administrative staff. 24 . Regarding the Venereal Diseases program, Mr. Robinson stated the Board 25 , of Health hoped o hire a V. D. Control Investigator who will bring to clin 26. infection-source for treatment and education on VD avoidance. Further, 27. the Department h pes to add additional.. clinical services. 28 . Mr. Robinso informed the Board the budget throughout is bias toward 29 , community education in health matters , that the pay off lies in education, 30 . when people take control of their lives. Page 6 1. 2 . Commissioner Custaveson expressed his appreciation to the Health Boar 3- for their concein and their effort. He stated one concern of his was whet 4 - or not the progams are meeting the needs and are making a dent. He asked 3 • if the Health Board is closing the gap in providing needed services. 6 . Chairman itted explained that he felt the Health Board and Departme 7- had make a good start. He reminded the Boards that this is a tight budget 8» year and asked that the Department help the Commissioners by putting into 9 . perspective the priorities which must be provided immediately. 10 . The meeting was then adjourned. 11. 12 • Richard WHitted, Chairman 13. Agatha. Johnson, l.erk 14 . 15 . 16. 17 . 18. 19. 20 . 21. 22 . 23. 24 . 25 . 26 . 27. 28. 29 . 30.