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HomeMy WebLinkAboutBOH minutes 113016MINUTES-Final ORANGE COUNTY BOARD OF HEALTH November 30, 2016 S:\Managers Working Files\BOH\Agenda & Abstracts\2016 Agenda & Abstracts/ November 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 November 30, 2016, at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC. BOARD OF HEALTH MEMBERS PRESENT: Nick Galvez – Vice-Chair, Commissioner Mia Burroughs, Barbara Chavious, Paul Chelminski, Dan Dewitya, Susan Elmore, Reena Mehta, Sam Lasris and Timothy Smith. BOARD OF HEALTH MEMBERS ABSENT: Jessica Frega and Liska Lackey. STAFF PRESENT: Dr. Colleen Bridger, Health Director; Coby Jansen Austin, Director of Programs and Policy; Shannon Barnes, Social Work Supervisor; Alan Clapp, Environmental Health Director; Rebecca Crawford, Finance & Administrative Services Division Director; Donna King, Health Promotion & Education Services Director; Pam McCall, Public Health Nursing Director; Kimberlee Quatrone, Administrative Officer; 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 Dr. Bridger introduced the new employees in attendance: Shannon Barnes, April Richard and Juliet Sheridan. II. Public Comment for Items NOT on Printed Agenda: None III. Approval of the November 30, 2016 Agenda Motion was made by Mia Burroughs to approve the agenda, seconded by Dan Dewitya and carried without dissent. IV. Action Items (Consent) A. Minutes of September 28, 2016 Meeting B. Minutes of October 26, 2016 Meeting C. 2017 Board of Health Schedule Motion was made by Susan Elmore to approve the minutes of September and October 2016 and the 2017 Board of Health schedule, seconded by Reena Mehta and carried without dissent. MINUTES-Final ORANGE COUNTY BOARD OF HEALTH November 30, 2016 S:\Managers Working Files\BOH\Agenda & Abstracts\2016 Agenda & Abstracts/ November Page 2 V. Educational Sessions A. 1st Quarter Financial Reports and B. 1st Quarter Billing Dashboard Reports Kimberlee Quatrone, Administrative Officer, gave a report on the 1st quarter revenue and billing accuracy. Her report is as follows: • Total Health Department Revenue: Average YTD monthly revenue in FY17 after the first quarter is $193k/month or $579k YTD, representing 18.2% of our overall budgeted revenue for the year. The total first quarter revenue is slightly skewed down due to an error made by the central Finance Office. We are working to have this error fixed, which will bring our total revenue for the first quarter to $672k and 22% of our overall budgeted revenue. Expenses closely match revenues at 21%. • Total Billing Accuracy: Continuing with the goal of 90% billing accuracy set in FY 14-15, the average billing accuracy rate for medical after the first quarter is 88% as compared to 92% in FY 15-16 and the average rate for dental for first quarter FY 16-17 is 99% as compared to 101% in FY 15-16. • Dental Earned Revenue by Source: The FY 16-17 average monthly revenue ($38k/month) for the first quarter is below our budget projection ($48k/month) our FY 15- 16 average of $40k/month but is related to lower patient volume in August while the dental clinic was renovated. FY 16-17 dental revenue totaled $114k at the end of the first quarter. • Medical Earned Revenue by Source: Medical earned revenue is currently slightly below the budgeted projection for FY 16-17 ($58k/month) at $56k/month. Medical clinic revenue totals $168k for first quarter FY 16-17. C. Town/Gown Alcohol Coalition Update Elinor Landess, Campus & Community Coalition Director, Chapel Hill Downtown Partnership, gave a brief overview on the Coalition. The Coalition is a collaborative effort funded jointly by the Town of Chapel Hill, UNC-Chapel Hill, the Orange County Health Department and the Orange County ABC Board. It’s tackling the problem of high-risk drinking that exists in Chapel Hill and surrounding communities. She began by stating some facts from Spring 2015. • There were 341 alcohol related EMS transports from Chapel Hill. There was a high percentage of underage transports. • There were 246 citations were given. • There were 241 loud noise complaints. • 65% of students reported drinking. Ms. Landess stated that the Coalition isn’t trying to remove alcohol from the collegiate community, just reduce risky drinking behaviors which is defined as the consumption of alcohol that decreases personal safety, property values, etc. Some of the challenges mentioned included • Getting community engagement and investment in transforming the culture; MINUTES-Final ORANGE COUNTY BOARD OF HEALTH November 30, 2016 S:\Managers Working Files\BOH\Agenda & Abstracts\2016 Agenda & Abstracts/ November Page 3 • Changing the student perception of inconsistent enforcement and seeming lack of consequences for repeat offenders; • Developing strategies to maximize consistent training for servers and maximize certainty, timeliness, consistency and equity in consequences for bar/restaurant violations. The Coalition is taking a comprehensive public health approach that utilizes a community organizing framework and environmental strategies. A taskforce met during 2013 and developed a set of 22 recommended strategies to reduce the negative impacts of high risk drinking in 3 areas: the University, Neighborhoods/Community and Downtown Chapel Hill. There has already been some change. Chapel Hill has hired 2 new code enforcement officers. UNC has re-written, passed and implemented a new alcohol policy. That policy includes provisions that delineate where alcohol can be consumed and treats student organizations the same as students. Ms. Landess also spoke of other ways to reduce risky drinking such as having viable alternative to socializing with alcohol on weekends and educating parents/families about the negative consequences of underage alcohol use. Also mentioned was the use of Intellicheck software which aids in ID authentication by scanning the barcode. It has helped confiscate many fake IDs used by those who are underage. The BOH members had questions that were addressed by Ms. Landess. D. Accreditation Presentation Dr. Bridger provided the Board with an overview of the accreditation process. The basic components of the process are: • Self-Assessment by the Agency  Health Department Self-Assessment Instrument (HDSAI) is completed by all Health departments and submitted with all accreditation evidence. • Site Visit  Site Visit will be January 12th and 13th. A team of 5 local public health professionals familiar with health departments, Environmental Health and the Board of Health will conduct a site visit and interviews. • Board Adjudication  After the visit, the OCHD will receive a written report with their findings which will go to the statewide accreditation Board for official approval. Dr. Bridger also briefly spoke on the activities and scoring requirements. They are: • Agency Core Functions and Essential Services  Assessment – OCHD must meet 26 of 29 activities  Policy Development – OCHD must meet 23 of 26 activities  Assurance - OCHD must meet 34 of 38 activities • Facilities and Administrative Services - OCHD must meet 24 of 27 activities • Governance - OCHD must meet 24 of 27 activities MINUTES-Final ORANGE COUNTY BOARD OF HEALTH November 30, 2016 S:\Managers Working Files\BOH\Agenda & Abstracts\2016 Agenda & Abstracts/ November Page 4 Dr. Bridger reiterated that the purpose of accreditation is to ensure that all NC health departments are meeting the 10 essential services. She added that one of the benefits is that it assures a minimum standard for all health departments. Dr. Bridger also reviewed the Board’s role which includes that policies and procedures on how to handle finance, community health, health director/staff, Board function and rules and ordinances. The BOH members had questions that were addressed by Dr. Bridger. E. UNC Capstone Presentation Coby Jansen Austin, Director of Programs and Policy, began by stating that the 2016-18 Board of Health Strategic Plan requested research on the appropriate pathway and necessary partners to pursue policy change to make birth control pills available over the counter (OTC). UNC public policy undergraduate students Shivangi Amin, Hannah Eichner, Charlotte Henry and Rob Poston prepared a literature review, compiled a series of case studies and interviewed a few key stakeholders to evaluate the pros and cons of moving this policy proposal forward while identifying the key partners in making that happen. They began by informing the Board that only the FDA can determine whether a drug can be available OTC vs behind the counter. Statistics provided included that half of all pregnancies are unintended and 74.8% of 2010 NC unplanned births were publicly funded costing the federal and state government a combined cost of $858.3 million. Costs and a required clinician visit reported as barriers to access oral contraceptives. Barriers to contraceptive use included costs (insurance) and side effects (blood clots, weight gain, nausea). Next, the students spoke briefly about the safety of OTC birth control. Oral contraceptives were found to be safe. Research found that women are able to self-identify whether they are good candidates for oral contraceptives. There have been many arguments for and against making oral contraceptives available OTC. Some arguments against it include lower likelihood of women receiving preventive screenings and higher risk of blood clots. Arguments for it include reduced abortions and reduced Medicaid costs. The students used four states (California, Oregon, Tennessee, Missouri) as case studies as they either have laws or bills regarding this topic. • California passed a bill in September 2013 that was implemented in April 2016 which allows self-administered hormonal contraceptives to be distributed without a doctor’s prescription. The policy is optional for pharmacists. • Oregon passed a law in July 2015 that was implemented in January 2016, set to expire in 2020, in which the two types of hormonal contraceptive available under this law are the oral contraceptive pill and the hormonal patch. • Tennessee passed a bill in January 2016 which authorizes pharmacists to provide hormonal contraceptives to patients OTC so long as they adhere to a valid collaborative pharmacy practice agreement. • Missouri currently has a bill that passed the House, but not the Senate. This bill included a requirement that health insurance plans cover contraceptives. The plan must cover an initial 3-month supply and then a 12-month supply for any subsequent dispensations of the same contraceptive. Also discussed were factors that affected policy choices such as: MINUTES-Final ORANGE COUNTY BOARD OF HEALTH November 30, 2016 S:\Managers Working Files\BOH\Agenda & Abstracts\2016 Agenda & Abstracts/ November Page 5 • Mechanisms - protocols, collaborative practice agreements • Age - whether there should be an age requirement and • Payment - currently prescriptions by pharmacists are covered by insurance as it still falls under the ACA’s contraceptive mandate; reimbursement for pharmacist evaluation could pose a critical problem in the future. The students interviewed Anna Stein, Legal Specialist at NC DHHS, Danny Staley, Director of DPH, DHHS, and Dr. Jay Campbell, Executive Director, NC Board of Pharmacy. Overall, they recommended: • Discussing the issue early on and gaining support Medical Society, NC Association of Pharmacists, ACOG and other key organizations; • Having the OC Board of Health write a resolution; and • Consider waiting to see how OTC birth control works in California and Oregon. The students’ conclusion included careful issue framing and incorporating lessons from other states. The Board congratulated the students on a great presentation. Board directed staff to continue to gather additional research from other countries and states that have made birth control available over the counter. Within the next couple of years, staff will bring this topic back to the Board. VI. Action Items A. Elections (Chair and Vice-Chair) For the year 2017, Nick Galvez and Dan Dewitya were in que to be the next Chair and Vice- Chair, respectively. Mr. Galvez announced that he and Dan Dewitya will be vacating their positions on the Board as both of them will be moving out of Orange County. He continued by thanking Mr. Dewitya for his time on the Board. This is Mr. Dewitya’s last meeting while January’s meeting will be Mr. Galvez’ last. Motion was made by Barbara Chavious to appoint Liska Lackey as Chair and Susan Elmore as Vice-Chair, seconded by Reena Mehta and carried without dissent. VII. Reports and Discussion with Possible Action A. Health Director Report There were no questions from the Board regarding the Health Director’s Report included in the packet. Dr. Bridger mentioned that her term as NCALHD President is coming to an end. She also mentioned that it’s been an eventful year that included teaching for the first time, her daughter’s wedding and preparing for accreditation. B. Media Items MINUTES-Final ORANGE COUNTY BOARD OF HEALTH November 30, 2016 S:\Managers Working Files\BOH\Agenda & Abstracts\2016 Agenda & Abstracts/ November Page 6 Media items were in the packet which focused on Orange County’s events and our involvement in various efforts. VIII. Board Comments None. IX. Adjournment A motion was made by Susan Elmore to adjourn the meeting at 8:40 p.m., was seconded by Dan Dewitya and carried without dissent. The next Board of Health Meeting will be held January 25, 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