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HomeMy WebLinkAboutBOH minutes 022416MINUTES-Final ORANGE COUNTY BOARD OF HEALTH February 24, 2016 S:\Managers Working Files\BOH\Agenda & Abstracts\2016 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 24, 2016, at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC. BOARD OF HEALTH MEMBERS PRESENT: Liska Lackey, Chair; Nick Galvez, Vice Chair; Commissioner Mia Burroughs, Paul Chelminski, Susan Elmore, Jessica Frega, Sam Lasris, Reena Mehta and Timothy Smith. BOARD OF HEALTH MEMBERS ABSENT: Barbara Chavious and Dan Dewitya. STAFF PRESENT: Dr. Colleen Bridger, Health Director; Alan Clapp, Environmental Health Director; Rebecca Crawford, Finance & Administrative Services Division Director; Dr. Michael Day, Dentist; Michael Futch, Public Health Nurse II; Donna King, Health Promotion & Education Services Director; Pam McCall, Public Health Nursing Director; Meredith McMonigle, Senior Public Health Educator; Kimberlee Quatrone, Administrative Officer; Stacy Shelp, Communications Manager; and La Toya Strange, Administrative Assistant II. GUESTS PRESENT: None. I. Welcome New Employees Dr. Bridger introduced new staff member: Matthew Futch, Public Health Nurse II. II. Public Comment for Items NOT on Printed Agenda: None III. Approval of the February 24, 2016 Agenda Motion was made by Susan Elmore to approve the agenda, seconded by Paul Chelminski and carried without dissent. IV. Action Items (Consent) A. Minutes Approval of January 27, 2016 Meeting Motion to approve Consent Agenda with corrections to Liska Lackey’s title in the January 27, 2016 minutes was made by Susan Elmore, seconded by Jessica Frega and carried without dissent. V. Educational Sessions A. Family Success Alliance Update Meredith McMonigle, Senior Public Health Educator, began by stating that the Family Success Alliance (FSA) was in its 2nd year. The FSA has two zones in which it jointly works with schools, MINUTES-Final ORANGE COUNTY BOARD OF HEALTH February 24, 2016 S:\Managers Working Files\BOH\Agenda & Abstracts\2016 Agenda & Abstracts/ February Page 2 community partners, faith-based groups and advocates to build a cradle to college and career pipeline of supports for children and families living there. Ms. McMonigle shared that the FSA had piloted a k-readiness program that served 67 incoming kindergarteners. There were four navigators hired to engage directly with the families located in the zones. The navigators also assist in bridging some of the gaps in communication and trust. They are natural leaders in their communities and either live or have children that live in these zones. The four goals associated with the FSA are: • Children are healthy and prepared for school. • Children and youth are healthy and succeed in school. • Youth graduate from high school and college. • Families and neighborhoods support the healthy development of children. Each zone has different priorities based on discussion with parents, service providers and other community members at zone meetings held in April 2015. The participants voted and chose priorities to guide the FSA to initial areas for action. The zone 4 priorities are transportation, kindergarten readiness, childcare and family support. The zone 6 priorities are housing, family support, kindergarten readiness and childcare. Nine service provider partners are offering additional wrap around services including ESL and GED classes, school-based mental health services and early education programs. Dr. Bridger added that the UNC Frank Porter Graham Institute will be creating a children’s data center. She also mentioned that many community organizations/potential partners have reached out and offered their assistance including a recent donation from the Doval and Theresa Watson Foundation. The BOH members had questions that were addressed by Ms. McMonigle and Dr. Bridger. B. Outside Agency Review Process La Toya Strange, Administrative Assistant, summarized the Outside Agency Review process and the assignments required of Board of Health members for evaluating applications. The Health Department received seven applications to review. Board members are to review the 2- 3 applications assigned to them, record scores on the scoring cards and send the completed scoring cards back to Ms. Strange by March 18th. The BOH members did not have any questions. C. Annual Report Stacy Shelp, Communications Manager, provided the Board with highlights of the 2015 Annual Report which included: • Environmental Health’s Food and Lodging completed 100% of their required inspections • Naloxone Access Program resulted in 4 overdose reversals. • Healthy Carolinians conducted their four year Community Health Assessment with over 1700 responses. MINUTES-Final ORANGE COUNTY BOARD OF HEALTH February 24, 2016 S:\Managers Working Files\BOH\Agenda & Abstracts\2016 Agenda & Abstracts/ February Page 3 • 100% of clients in the Diabetes Self-Management classes rated the program as “Excellent” or “Very Good” on their evaluations. The 2015 Annual Report can be found online at http://www.orangecountync.gov/Annual_Report_2015_FINAL.pdf The BOH members had questions that were addressed by Ms. Shelp and Dr. Bridger. D. Debt Set-Off Program Update Rebecca Crawford, Finance & Administrative Services Division Director, notified the Board that the Personal Health, Dental Health, and Environmental Health continue to participate in the NC Debt Set-Off Program, which allows the county to collect debts on delinquent accounts with a balance between $50 and $4,000 through the customer’s tax refund. This has proven to be a successful way to recoup funds from overdue accounts, although FY 14-15 total amounts are much higher than FY 15-16 amounts as the prior year included multiple years of delinquent accounts whereas FY 15-16 is from July 1, 2015 through January 31, 2016. The Personal Health division has also found that letters sent to delinquent accounts that warn of the potential to be sent to debt set-off have netted $1,796.40 for the period of July 1, 2015 through February 11, 2016. The BOH members did not have any questions. E. Population Health Dashboards Dr. Bridger reminded the Board that the dashboards can be found on the Orange County Health Department’s website. Included were the Board of Health priorities, Substance Abuse & Mental Health, Child and Family Obesity and Access to Care dashboards. The dashboards show what the trend is as well as compares data between Orange County and the US overall. The dashboards are updated annually. The BOH members had questions that were addressed by Dr. Bridger. VI. Action Items (Non-Consent) A. 2016-2017 Budget and Fee Schedule & Requested Changes Dr. Bridger presented the Board with a summary of the proposed FY 2016-2017 budget for the Health Department which shows an increase in expenditures of $590,561; $379,468 of which are expenditure increases related to the FY 15-16 wage increase and increases to the medical insurance and retirement insurance rates, which are outside of the control of the department. The remaining $241,093 of the total increase is due to new and expanded services including $105,000 for the Family Success Alliance and $75,000 for Primary Care services for uninsured men. Staff projects a $328,611 increase in revenues for FY 16-17, which will offset all of the $241,093 increase and leave a balance of revenue of $87,518. This additional revenue decreases the general fund burden of the wage increase and makes the total FY 16-17 Health Department requested increase for County General Funds $291,951. The proposed total budget is $10,062,417 which includes $103,536 in grant funding for the MINUTES-Final ORANGE COUNTY BOARD OF HEALTH February 24, 2016 S:\Managers Working Files\BOH\Agenda & Abstracts\2016 Agenda & Abstracts/ February Page 4 Susan G. Komen and Health Disparities projects and $705,000 (level funding) for school nurses in both Orange County school systems. In relation to new staff requests, the Health Department requests a total of 1.4 FTE; a new 1.0 FTE Public Health Educator to serve as a community liaison and a 0.4 FTE for the Healthy Homes Asthma program, which will be added to the existing 0.6 FTE Public Health Preparedness position to total 1.0 FTE. The Health Department requires no additional funding to support these positions as they will be absorbed within the existing budget. In relation to state funding, the state has provided us with the FY 16-17 Consolidated Agreement Addenda. Even though we will no longer receive funding for Ebola, the Maternal and Child Health Planning grant, or the Oral Health grant we received in FY 15-16, we will receive additional funding for Prescription Drug Overdoses. Changes in funding for all other, ongoing Health Department programs equals out to the prior fiscal year. With regards to fee changes, the FY 2016-2017 requested budget includes fee changes for the Personal Health and Environmental Health divisions. Staff recommends multiple fee changes for Personal Health to cover the increased cost of vaccines, add a minimum lab fee for self-pay clients, and adjust the fee for 340B drugs according to changes in the state and federal policies around 340B drugs. 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 II of the three year fee increase by raising fees an additional 11% over last year’s increases. Motion to approve to approve the total budget requested in the amount of $10,032,417 for 2016-2017 as presented which includes $103,536 in grant funding for the Susan G. Komen and Health Disparities projects, and forward to the County Manager or Board of County Commissioners for action without edits was made by Paul Chelminski, seconded by Susan Elmore and carried without dissent. Dr. Bridger facilitated a discussion about the proposed fee changes which touched briefly on the fee changes in Personal Health and to continue with Phase II of the planned fee increases in the Environmental Health division. The proposed changes are: Personal Health proposes the implementation of a minimum charge for laboratory procedures to recoup a small portion of labs performed for primary care patients. The average primary care patient requires multiple labs per visit, equating to between $24 and $185, or an average of $102 in charges. Patients pay for these labs according to where they fall on the sliding fee scale; however 0% pay patients do not pay anything for labs. The proposed minimum fee of $20 would be equal to other minimum fees within the Health Department for MNT and DSME services, which have both proven to not be cost prohibitive for clients. Personal Health also requests fee increases for multiple vaccines that are rising in cost and 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. MINUTES-Final ORANGE COUNTY BOARD OF HEALTH February 24, 2016 S:\Managers Working Files\BOH\Agenda & Abstracts\2016 Agenda & Abstracts/ February Page 5 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. Motion to approve all fee changes for FY 2016-2017 as presented and forward to the Board of County Commissioners for action without edits was made by Susan Elmore, seconded by Reena Mehta and carried without dissent. The BOH members had questions that were addressed by Dr. Bridger. VII. Reports and Discussion with Possible Action A. Health Director Report Dr. Bridger’s report acknowledged that NC has one confirmed case of the Zika virus which was contracted when the individual traveled to one of the affected countries. Dr. Bridger stated that the state will continue to increase monitoring/surveillance. She also added that the Zika virus can be spread by a man through unprotected sex. In other news, Dr. Michael Day announced that Dr. Ashley Mann has offered to donate a panoramic dental x-ray machine to the Orange County Health Department. This donation is valued at approximately $30,000. The BOH members had questions that were addressed by Dr. Bridger. B. Media Items Media items were in the packet which focused on Orange County’s events and our involvement in various efforts. VIII. Board Comments No additional comments given. IX. Adjournment A motion was made by Nick Galvez to adjourn the meeting at 8:20 p.m., was seconded by Susan Elmore and carried without dissent. The next Board of Health Meeting will be held March 23, 2016 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