HomeMy WebLinkAboutBOH minutes 052715MINUTES
ORANGE COUNTY BOARD OF HEALTH
May 27, 2015
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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 May 27, 2015, at the Orange County
Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Susan Elmore, Chair; Liska Lackey, Vice Chair;
Commissioner Mia Burroughs, Mike Carstens, Paul Chelminski, Corey Davis, Dan Dewitya,
Nick Galvez, and Tony Whitaker.
BOARD OF HEALTH MEMBERS ABSENT: Sam Lasris.
STAFF PRESENT: Dr. Colleen Bridger, Health Director, Alan Clapp, Environmental Health
Director; Pam McCall, Public Health Nursing Director; Coby Austin, Senior Public Health
Educator; Rebecca Crawford, Finance and Administrative Services Division Director; Stacy
Shelp, Communications Manager; Jessica Salerno, Public Health Nurse; La Toya Strange,
Administrative Assistant.
GUESTS PRESENT: None
I. Welcome
Dr. Bridger introduced new staff members: La Toya Strange, Administrative Assistant and
Jessica Salerno, Public Health Nurse.
II. Public Comment for Items NOT on Printed Agenda: None
III. Approval of the May 27, 2015 Agenda
Motion was made by Liska Lackey to approve the agenda, seconded by Tony Whitaker
and carried without dissent.
IV. Action Items (Consent)
A. Minutes Approval of March 25, 2015 Meeting
Motion to approve Consent Agenda without corrections to the March 25, 2015 minutes
was made by Paul Chelminski, seconded by Corey Davis and carried without dissent.
V. Educational Sessions
A. Community Health Assessment Update
Liska Lackey began by encouraging Board members to review the Executive Summary
regarding the 2011 Community Health Assessment and its process. She also specified
purposes for completing community health assessments which included being mandated to
complete a community assessment every four years and that the assessment aids in
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ORANGE COUNTY BOARD OF HEALTH
May 27, 2015
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distinguishing our focus areas for the Board of Health. Currently, those focus areas are Access
to Care, Child and Family Obesity, Mental Health and Substance Abuse.
This joint effort between the Orange County Health Department (OCHD) and Healthy
Carolinians of Orange County collects data to get a sense of the total health of Orange County
and determine the community’s needs in addition to helping establish where the underserved
areas are. This year’s survey will have less than half the questions of the 2011 survey,
approximately 50 questions, and will be collected on laptops. Out of 75 block groups, 799
addresses have been identified to which postcards will be sent to those households requesting
their participation in the upcoming survey. There will be 20 volunteers in teams of 10 that will be
visiting these households over 9 days collecting between 300-400 surveys from June 18th to
July 19th. Ms. Lackey asked each Board of Health member to participate in this process.
The BOH members had several questions that were addressed by Liska Lackey and
Colleen Bridger.
B. Healthy Home Asthma Initiative
Coby Austin and Alan Clapp gave a presentation on asthma and the implications of the non-
management of the disease. They also described the Healthy Homes Approach, the
implementation of models in other communities in North Carolina and provided information for
possible execution in Orange County. They began with statistical data of asthma in North
Carolina and its effect on children in relation to absenteeism, hospitalization and emergency
room visits. An overview of the Healthy Homes Approach was given which consists of four
steps:
1) Referral – By whom (e.g. school nurse, PCP, emergency department)?
2) Home Assessment – What are the triggers? Who performs the visit? How many visits?
3) Address Problems – By what measures (e.g. HEPA vacuums, pillow/mattress covers,
green cleaning kit that consists of various non-toxic households items)?
4) Follow-up and Evaluate Impact
Community-based, county-based and regional models in North Carolina were also discussed.
Next steps include, determining which models to consider and the specific need for Orange
County as well as continuing to collect data to consider how to move forward. This would be a
cooperative undertaking, possibly collaborating with the Family Success Alliance and the school
systems.
The BOH members had several questions including funding sources and cost-
effectiveness that were addressed by Coby Austin, Alan Clapp and Colleen Bridger.
C. Quarterly Financial Reports
Rebecca Crawford reported on the 3rd Quarter Financial report which was included in the
packet. Average YTD monthly revenue in FY15 after the 3rd Quarter is $200k/month or $1.8M
YTD, representing 74% of our overall budgeted revenue for the year. This is an increase from
an average of $174k/month in FY14. Revenue is slightly below budget projection ($207k/m,
$2.5M/y), however, some allocations, such as for Medicaid Maximization, will be transferred into
the budget at the end of the fiscal year only if needed because expenses are lower than
budgeted at 70%.
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After surpassing our billing accuracy goal of 80% in FY 13-14, we set a new goal of reaching
90% in FY 14-15. Current, combined accuracy this quarter in medical and dental clinics is
88.6% (medical: 82%, dental: 95%).
Billing accuracy for most recent month is artificially reduced as many of the claims from the
most recent quarter are still being processed. Monthly numbers from the most current quarter
will increase (and less so with previous quarters) and will be updated on future dashboards as
those back claims receive payment. Progress continues in refining our definition of billable
claims, though the billing accuracy percent presented here always reflects a conservative
estimate of accuracy. Though reducing the proportion of unpaid Self -Pay claims is a work in
progress, it’s not likely we will ever recover 100% of those claims. Therefore, 90% is still an
aggressive, but achievable goal.
Dental earned revenue has consistently increased from year to year, and our current average
monthly revenue ($34k/month) exceeds our budget projection ($32k/month). Medical earned
revenue follows a similar trend as last FY. The monthly average after this quarter
($48.5k/month) is greater than FY14 ($44k/y) and FY13 ($25k/y), but slightly higher than our
budget projection ($48k/month). Both expected seasonal increases in revenue (flu season) and
additional staff filling vacant medical positions contributed to the Q3 increase in revenue. Staff
turnover, however, decreased both expenses and revenues in clinic.
The Board members received the report with no questions.
VI. Action Items (Non Consent)
A. General Public Seat Recommendation
Susan Elmore, Chair, informed the BOH members that there is currently an opening for an At-
Large position on the Board of Health, created by the resignation of Esther Earbin in April 2015.
Jessica Frega was recommended by the Nominating Committee as the new General Public
Seat representative for appointment by the Board of County Commissioners.
Motion to recommend to the BOCC Jessica Frega for the current At-Large position was
made by Michael Carstens, seconded by Nick Galvez, and carried without dissent.
B. Reappointment Recommendation
Susan Elmore, Chair, conveyed that Nick Galvez’ term expires on June 30, 2015; therefore, the
Board of Health will vote to recommend him to his first full term starting June 2015.
Motion to reappoint Nick Galvez was made by Paul Chelminski, seconded by Corey
Davis, and carried without dissent.
VII. Reports and Discussion with Possible Action
A. Child Fatality Prevention Team Annual Report
Pam McCall reported on a review of CFPT/CCPT 2014 Annual Report in Orange County, North
Carolina. It included a description of membership, duties, procedures and activities.
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The BOH members had several questions including those related to the disclosure of the
specificity of the causes of children’s’ deaths that were addressed by Pam McCall.
B. Tobacco Preemption Resolution Update
Coby Austin notified the Board that all local health departments were contacted by Dr. Bridger in
reference to our Tobacco Preemption Resolution. She also informed the Board that Durham
and Cumberland Counties’ Boards have passed the same resolution. Pitt and Chatham
Counties have placed this resolution on their agenda for review by their boards. This will
involve the establishment of a long-term strategy as preemption has been around for 20 years
but yet, there’s been unhurried movement regarding this issue. Ms. Austin mentioned that
Hawaii is poised to become the first state to increase the minimum legal sale age of tobacco to
21 years. She also stated that Durham County will be sending their resolution to their Board of
County Commissioners to adopt it. Ms. Austin requested the BOH forward their passed
resolution to the Orange County BOCC for adoption. She also requested BOH members to visit
the General Assembly members, on a purely educational mission, to share information about
this Resolution and the Institute of Medicine Report. Communication will be sent with potential
dates and times, after the long session adjourns to the BOH seeking volunteers to speak with
General Assembly members.
The BOH members had several questions that were addressed by Coby Austin and
Colleen Bridger.
Motion was made by Corey Davis to forward the BOH Tobacco Preemption Resolution to
the Board of County Commissioners to request adoption of the resolution, seconded by
Liska Lackey and carried without dissent.
C. Professional Engineer, Optometrist, and General Public Seat Recruitment
Susan Elmore, Chair, informed the BOH members that Corey Davis will be leaving in June
2015. She also noted that Tony Whitaker and Michael Carstens’ second terms will be coming to
an end in August 2015. She stressed that as the Engineer and Optometrist professions are
very specific and there aren’t many candidates. Ms. Elmore also noted that Mr. Whitaker and
Mr. Carstens have been kind enough to look within their own professions for candidates to
recommend. Ms. Elmore requested volunteers to be on a selection committee to review
applications for all vacancies including the General Public Seat, and bring recommendations to
the August BOH meeting. Dan Dewitya and Nick Galvez volunteered to be on the committee.
Michael Carstens also offered his assistance as he has reviewed many of the applications
currently on file.
D. Health Director’s Report
There were no questions from the Board regarding the Health Director’s Report included
in the packet. Dr. Bridger gave a brief overview of the Family Success Alliance’s trip to
the Harlem Children’s Zone Practitioner’s Institute. Dr. Bridger stated that primary
takeaway was that it is more important that we build trust right now within our
community than a pipeline. She gave descriptions of the Harlem Children’s Zone
Practitioner’s Institute successful model, practices and partnerships. She also
expressed how they do whatever is required to ensure that every child is successful.
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E. 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.
VIIII. Adjournment
A motion was made by Nick Galvez to adjourn the meeting at 8:30 p.m., was seconded by
Mike Carstens and carried without dissent.
The next Board of Health Meeting will be held June 24, 2015 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