Loading...
HomeMy WebLinkAboutBOH minutes 022217MINUTES-Final ORANGE COUNTY BOARD OF HEALTH February 22, 2017 S:\Managers Working Files\BOH\Agenda & Abstracts\2017 Agenda & Abstracts/ February Page 1 ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To enhance the quality of life, promote the health, and preserve the environment for all people in the Orange County community. THE ORANGE COUNTY BOARD OF HEALTH MET ON February 22, 2017, at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC. BOARD OF HEALTH MEMBERS PRESENT: Liska Lackey – Chair, Susan Elmore, Vice- Chair, Commissioner Mia Burroughs, Paul Chelminski, Jennifer Deyo, Reena Mehta and Timothy Smith. BOARD OF HEALTH MEMBERS ABSENT: Barbara Chavious, Jessica Frega and Sam Lasris. STAFF PRESENT: Dr. Colleen Bridger, Health Director; Coby Jansen Austin, Director of Programs and Policy; Alan Clapp, Environmental Health Director; Rebecca Crawford, Finance & Administrative Services Division Director; Donna King, Health Promotion & Education Services Director; Ashley Mercer, Healthy Carolinians Coordinator; Pam McCall, Personal Health Services Director; Kiana Redd, Healthy Communities Healthy Homes Coordinator; April Richard, Senior Public Health Educator, Tobacco Prevention and Control Coordinator; Stacy Shelp, Communication Manager; Juliet Sheridan, Applied Public Health Informatics Fellow and La Toya Strange, Administrative Assistant II. GUESTS PRESENT: None. I. Welcome Liska Lackey, Chair, introduced the new Board of Health (BOH) member, Jennifer Deyo. II. Public Comment for Items NOT on Printed Agenda: None III. Approval of the February 22, 2017 Agenda Motion was made by Susan Elmore to approve the agenda, seconded by Mia Burroughs and carried without dissent. IV. Action Items (Consent) A. Minutes of January 25, 2017 Meeting Motion was made by Susan Elmore to approve the minutes of January 2017, seconded by Reena Mehta and carried without dissent. V. Educational Sessions A. Surgeon General E-cigarette Presentation MINUTES-Final ORANGE COUNTY BOARD OF HEALTH February 22, 2017 S:\Managers Working Files\BOH\Agenda & Abstracts\2017 Agenda & Abstracts/ February Page 2 April Richard, Tobacco Prevention and Control Coordinator, provided a summary of the Surgeon General’s Report on e-cigarette use among youth and young adults. In advance, Ms. Richard provided background information on e-cigarettes as well as a fact sheet on the Surgeon General’s report entitled ‘’E-cigarette Use Among Youth and Young Adults‘’ that highlighted the public health issue of e-cigarettes and their impact on U.S. youth and young adults. Highlights of Ms. Richard’s presentation include: • Varied terminology presents challenges for assessing use and raising awareness about what these devices are and their health implications. Some common names are e-cigs, cigalikes, vape pens, and hookah pens. • Users refer to themselves as vapers rather than smokers. • The Surgeon General’s Report presented five public health concerns. 1. Considerable increase in usage. 2. Usage strongly associated with use of other tobacco products. 3. Nicotine has a detrimental affect on the developing brain and fetuses. An increased rate of SIDS is another harmful effect. 4. Aerosol and vapor produced is not harmless. 5. Product marketing mimics that of conventional cigarettes. • E-cigarettes can give as high or higher doses of nicotine than conventional cigarettes. • The aerosol, which is not water vapor, contains other toxicants that may be harmful, some of which are known carcinogens. Dual use (use of e-cigarettes and one or more other tobacco products) is common amongst youth and young adults. Amongst high schoolers, as the grade level increases, so does the prevalence of dual use. Dual use amongst young adults is more prevelant than exclusive use of e-cigarettes. Stategies to implement for prevention include: • Employ consistent and accurate messaging to parents, youth, young adults, healthcare providers, educators, and other stakeholders about the dangers of e-cigarette use. • Address point of sale and point of delivery ageverification to minimize the ability for youth to access these products. • Regulate marketing and advertising practices.. Many strategies have been found to target youth and young adults including ad placement and themes of rebellion, sex, and independence. • Restrict flavors as flavors are one of the leading reasons youth and young adults iniatite use of these products. There are more than 7000 flavors available. • Include e-cigarettes in smoke-free indoor air policies The BOH members had questions that were addressed by Ms. Richard and Dr. Bridger. B. Outside Agency Review Process La Toya Strange, Administrative Assistant II, summarized the Outside Agency Review process and the assignments required of Board of Health members for evaluating applications. The Health Department received nine applications to review. Board members are to review the applications assigned to them, record scores on the appropriate scoring cards and send the completed scoring cards back to Ms. Strange by March 17th. MINUTES-Final ORANGE COUNTY BOARD OF HEALTH February 22, 2017 S:\Managers Working Files\BOH\Agenda & Abstracts\2017 Agenda & Abstracts/ February Page 3 VI. Action Items (Non Consent) A. 2017-18 Budget Proposal 2017-2018 Budget, Fee Schedule & Requested Changes Dr. Bridger presented the Board with a summary of the proposed FY 2017-2018 budget for the Health Department which shows an increase in expenditures of $1,037,687; $228,173 of which are expenditure increases related to the FY 16-17 wage increase and county-initiated increases to the staff salaries for compression adjustments, market rate changes, FLSA wage increases, and a temporary position made permanent, which are outside of the control of the department. The remaining $809,514 of the total increase is the amount the Health Department requests from the county, which is made up of increases to staffing and service levels increases such as for the Family Success Alliance (FSA) and enhanced medical services. This also includes budget increases approved during the FY 16-17 budget process for the FY 15-16 wage increases, a Public Health Educator, a men’s Primary Care program, and FSA-related programming among others. Staff projects a $525,116 increase in revenues for FY 17-18, which will offset much of the $809,514 requested expenditure increase. The total FY17-18 Health Department request for County General Funds is $512,571. The proposed total budget is $10,101,460 which includes $32,168 in grant funding for the Susan G. Komen program. In relation to new staff requests, the Health Department requests a total of 4.5 FTE; a new 1.0 FTE Data Systems Manager to provide ongoing data analysis for FSA and Personal Health Services, a 1.0 FTE Senior Public Health Educator to assist FSA, and a 1.0 FTE Public Health Program Manager to Coordinate Behavioral Health Services for the county. In addition, the Health Department requests to make a temporary 0.5 FTE Communications Specialist permanent (as recommended by HR), and to make a time limited 1.0 FTE Property Development Tech permanent. The Health Department will fund all of these new positions with non-County funds except for the Property Development Tech. In relation to state funding, the state has provided us with the FY 17-18 Consolidated Agreement Addenda. Even though we will no longer receive funding for Ebola or Prescription Drug Prevention as we did in FY 16-17, we will receive additional funding for Family Planning and Speech and Hearing. Changes in funding for all other, ongoing Health Department programs equals out to the prior fiscal year. In relation to fee changes, the FY 2016-2017 requested budget includes fee changes for the Personal Health, Dental Health, and Environmental Health divisions. Staff recommends multiple fee changes for Personal Health to add three new fees for Child Health as required by DHHS and Medicaid, and adjust the fees for 340B drugs according to changes in the state and federal policies around 340B drugs. In addition, Medicaid has recently added a new Dental fee to their allowable fee schedule for scaling, which staff would like added to the Dental Health fee schedule. Also, during the FY 15-16 budget cycle, the Board of Health voted to enact Phase I of a three year phased Environmental Health fee increase in order to reach full cost recovery for Environmental Health. Staff recommends enacting Phase III of the three year fee increase by raising fees an additional 11% over last year’s increases. All proposed fee increases are described in more detail in a separate Fee Change abstract. MINUTES-Final ORANGE COUNTY BOARD OF HEALTH February 22, 2017 S:\Managers Working Files\BOH\Agenda & Abstracts\2017 Agenda & Abstracts/ February Page 4 Dr. Bridger facilitated a discussion about the proposed fee changes which touched briefly on the fee changes in Personal Health, add a fee in Dental Health and continue with Phase III of the planned fee increases in the Environmental Health division. Personal Health requests fee increases for three child health fees required by NC DHHS and Medicaid and scheduled adjustments to our fees for 340B drugs (Family Planning drugs not including birth control pills) to make them match the county’s cost to purchase them, as required by the state and federal government. This will have very little impact on both the department and patients as only 10% of self-pay patients pay more than $0 for Family Planning drugs or procedures and of that 10% we had no patients in prior years that have had to pay 100% of the cost. Dental Health requests to add an additional fee for scaling as this is a fee this has just been added to the approved Medicaid list of fees. This will have very little impact on anticipated revenue as staff projects only 30 procedures will be performed per fiscal year. The Board of Health voted to enact Phase I of a three year phased Environmental Health fee increase in order to reach full cost recovery for on-site and well services during the FY 15-16 budget process. Due to declining rate of development in Orange County, we will not reach full cost recovery by FY 2017-18 but will do a full fee review during the fiscal year to study the impact. Motion to approve all fee changes for FY 2017-2018 as presented and forward to the Board of County Commissioners for action as well as to approve the total budget requested in the amount of $10,101,460 for 2017-2018 as presented which includes $32,168 in grant funding for the Susan G. Komen project, and forward to the County Manager or Board of County Commissioners for action without edits was made by Susan Elmore, seconded by Paul Chelminski and carried without dissent. B. Select Topics for BOCC Work Session The Board of County Commissioners (BOCC) will review the Annual Work Plan reports from their advisory boards and commissions, including the BOH, at their March 28th Work Session. Liska Lackey, Chair, stated that she and Dorothy Cilenti, Interim Health Director, will attend and update the BOCC on the Strategic Plan. Susan Elmore, Vice-chair, reminded Ms. Lackey to remind the BOCC about the E-cigarettes rule which prompted Dr. Bridger to inform Ms. Lackey to remind the BOCC that they have no say in the passing of the rule as it is E-cigarette use and not cigarette. VII. Reports and Discussion with Possible Action A. BOH/BOCC Relationship Liska Lackey, Chair, began by mentioning the BOCC’s recommendation for pharmacist at-large position. The BOH does a thorough job in finding a candidate for the open Board positions which includes reviewing all of the applications and interviewing the desired candidates. Paul Chelminski, Susan Elmore and Ms. Lackey were involved with the interviewing process. Vice- chair, Susan Elmore, spoke on the interviewing process. She expressed that it’s important for the interviewees to know what they’re getting involved in, the BOH’s charge, understanding the BOH’s responsibilities. The BOH’s interviewing process ensures that the interviewees have this MINUTES-Final ORANGE COUNTY BOARD OF HEALTH February 22, 2017 S:\Managers Working Files\BOH\Agenda & Abstracts\2017 Agenda & Abstracts/ February Page 5 understanding prior to being recommended for appointment. The interviewee also has the opportunity to “interview” the interviewers. The BOH suggested that a few paragraphs be included with their appointment recommendations to the BOCC to explain why the BOH chose a particular individual. It may also shed light on the selection process that the BOH goes through when recommending a new BOH member. Dr. Bridger suggested that having someone be present at the BOCC meeting may also help. The BOH bylaws stipulate that past OCHD employees can’t serve on the Board of Health. Dr. Bridger added that the individual that the BOCC appointed was a past OCHD employee. Dr. Bridger also shared that the individual was informed that she was not eligible to serve, per the bylaws. Ms. Lackey stated that once the BOCC realized this, they stated that they would ask the appointed individual to resign. The Chair of the BOCC will write a letter asking them to remove their request. Ms. Elmore thanked Mia Burroughs, County Commissioner, for speaking up on behalf of the BOH at the BOCC meeting. The BOH stated that they are fully aware that the BOCC is not required to honor the BOH’s recommendations. For those who may be unaware, Dr. Bridger stated that the BOH bylaws are posted on the BOH’s webpage. Lastly, the Board stated that they will welcome whoever is appointed. B. Health Director Report There were no questions from the Board regarding the Health Director’s Report included in the packet. Dr. Bridger gave an update on the OWASA water situation. She explained that it was partly caused by human and mechanical error. There was a malfunction that resulted in too much fluoride being added to the water which resulted in taking the water production offline. They arranged to get water from Durham. None of the water with too much fluoride was released into the drinking water system. Then there was a major water main break which resulted in the loss of 1.2 million gallons of water. Due to the low water level and concern for the potential of bacterial contamination, a Do Not Use and Do Not Drink Order were issued by OWASA and the OCHD. Environmental Health staff went door to door notifying all food and lodging facilities that they must close. Donna King, Rebecca Crawford and Dr. Bridger also took shifts at the Emergency Operations Center. Stacy Shelp assisted with the communications side of things. She fielded hundreds of call during the 24 hour period, 2pm Friday to 2pm Saturday, in which the orders were issued. Dr. Bridger praised everyone for their assistance during this time. One of the lessons learned was that there should be a hotline for businesses as many of them needed information and support. C. Media Items Media items were in the packet which focused on Orange County’s events and our involvement in various efforts. VIII. Closed Session to Discuss Health Director Recruitment During the closed session, the Board of Health reviewed and selected which applicants to interview for the health director position. Four applicants were selected. IX. Board Comments. None. MINUTES-Final ORANGE COUNTY BOARD OF HEALTH February 22, 2017 S:\Managers Working Files\BOH\Agenda & Abstracts\2017 Agenda & Abstracts/ February Page 6 X. Adjournment Susan Elmore moved to adjourn the meeting at 9:20pm and Mia Burroughs seconded. The next Board of Health Meeting will be held March 22, 2017 at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m. Respectfully submitted, Colleen Bridger, MPH, PhD Orange County Health Director Secretary to the Board