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HomeMy WebLinkAboutBOH minutes 082714MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/August 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 August 27, 2014, at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC. BOARD OF HEALTH MEMBERS PRESENT: Corey Davis, Chair; Susan Elmore, Vice Chair; Tony Whitaker, Liska Lackey, Nick Galvez, Sam Lasris, Michael Carstens, Matthew Kelm, Commissioner Bernadette Pelissier and Paul Chelminski BOARD OF HEALTH MEMBERS ABSENT: STAFF PRESENT: Dr. Colleen Bridger, Health Director; Tersee Flores, Administrative Assistant II; Donna King, Public Health Education Director; Pam McCall, Public Health Nursing Director; Christy Bradsher, Financial and Administrative Services Division Director; Alan Clapp, Environmental Health Director; Stacy Shelp, Communications Manager; Meredith Stewart, Public Health Program Manager; Coby Austin, Senior Public Health Educator; Ashley Mercer, Senior Public Health Educator; James Stewart, Environmental Health Specialist; Susan Wagoner, Patient Account Representative Supervisor; Susan Ward, Accounting Technician I; Darlene Wirag, Accounting Technician I; Denise Shaver, Public Health Nurse III and Andrea Mulholland, Family Nurse Practitioner II. GUESTS PRESENT: Dr. John Graham, UNC I. Welcome Dr. Bridger introduced new staff members: James Stewart, Environmental Health Specialist; Susan Ward, Accounting Technician I and Darlene Wirag, Accounting Technician I. II. Public Comment for Items NOT on Printed Agenda: None III. Approval of August 27, 2014 Agenda Motion was made by Bernadette Pelissier to approve the agenda, seconded by Matthew Kelm and carried without dissent. MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/August Page 2 IV. Action Items (Consent) A. Minutes Approval of June 25, 2014 Meeting Motion was made by Tony Whitaker to approve the June 25, 2014 meeting minutes, seconded by Sam Lasris and carried without dissent. V. Educational Session A. Anna the Avatar & ROI Calculator Dr. John Graham, Adjunct Assistant Professor at UNC Gillings School of Global Public Health and a Senior Investigator at the North Carolina Institute for Public Health presented his work with: • “Anna” the Health Education Avatar • Calculating Return on Investment (ROI) in public health Anna the Health Education Avatar is bilingual, automated health education avatar who engages patients in conversation to learn about their health needs and keep them engaged. She provides resources and asks participants questions to check their understanding and to tailor the information provided. This application tracks and monitors the interactions and provides critical data to WIC Managers. As an education tool, Anna scored higher customer satisfaction scores than a live person or DVD. Dr. Graham introduced the ROI tool for local health departments: A Guidebook: Economic Evaluation of Population-Based Prevention Interventions in an ACO Community (PDF) is designed to assist local health department staff assess the value of their contributions, with a particular focus on population-based prevention interventions. The Guidebook provides a description of steps and things to keep in mind when calculating the economic value of population-based prevention interventions with a particular reference to potential Accountable Care Organization (ACO) stakeholders. The steps include: 1. Engaging key stakeholders in the process 2. Specifying the intervention 3. Planning the evaluation project 4. Identifying and measuring costs and benefits 5. Calculating the return on investment (ROI) 6. Presenting findings The BOH members had several questions that were addressed by Dr. John Graham. MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/August Page 3 B. 4th Quarter Financial Reports Christy Bradsher reported on the 4th Quarter Financial report which was included in the packet. For the reporting period July 1, 2013 through June 30, 2014 the department’s total revenue received was close to 95% of total estimated revenue. Total actual expenditures for the department were slightly over 94% of total budgeted expenditures. In comparison to last fiscal year during the same period, the department’s total revenue received was slightly over 84% of total estimated revenue, and expenditures were close to 96% of the budgeted amount. Overall, we have increased our revenue received from 84% to 95%, and decreased expenditures from 96% to 94% of budgeted amounts. C. 4th Quarter Billing Dashboard Reports Susan Wagoner gave a summary on the 4th Quarter Billing Dashboard Reports. The dashboard shows that we are billing at an average of 84% accuracy. She mentioned that our billing accuracy target for this year was set at 80%, which has been met for the past two quarters. Billing accuracy goal will now be set at 90%. They will continue Billing QI and hope to maintain or make additional gains in their accuracy. Total Health Department revenue was up $400,000 compared to last year. The Dental revenue also showed improvement and Personal Health services revenue nearly doubled. Tony Whitaker requested a report on the state of dental services since the consolidation. Dental’s Quality improvement project should have reportable data by November; Colleen will work with Dr. Day. It was suggested this report be also shared with the Board of County Commissioners. Tony Whitaker asked how we rank or compare to other health departments in regards to billing and accuracy. Dr. Bridger will research and email out the information. The BOH members had several questions that were addressed by Dr. Bridger. D. Early Childhood Mental Health Campaign Meredith Stewart reviewed plans for a consistent messaging campaign focusing on the importance of Early Childhood Mental Health. Advocacy for the importance of and need for childhood mental health services is a focus area for Board’s 2014-2016 strategic plan. MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/August Page 4 Key messages of the campaign were developed based on research by FrameWorks and with local childhood service providers. The messages and specific strategies can be found in the presentation included in the meeting materials. VI. Action Items (Non Consent) A. Maintenance of Effort Requirement Christy Bradsher reported on the Maintenance of Effort Requirement. G.S. 130A-34.4; local health departments must be accredited, and counties must maintain operating appropriations to local health departments from local county appropriations at levels equal to amounts appropriated in fiscal year 2010-2011. The Orange County appropriation for 2010-2011: $5,017,639.00. To be in compliance with G.S. 130A-34.4, each year when the Health Department prepares its annual budget, the total local county appropriation requested will be compared against the baseline year amount of $5,017,639.00. This amount represents the department’s total local county appropriation and is comprised of operational funds only as capital funds will not be included in how the state measures compliance. The local appropriation amount included in the Health Department’s budget request for approval by the Board of Health and the Board of County Commissioners will be at a minimum the 2010-2011 baseline year amounts. Motion was made by Liska Lackey to insure there is a process in place that ensures compliance with G.S. 130A-34.4, second by Bernadette Pelissier and carried without dissent. B. BOH Appointment Recommendations Motion was made by Paul Chelminski to recommend reappointment of Susan Elmore and Liska Lackey, seconded by Sam Lasris and carried without dissent. At Large position recommendation: Esther Tabitha Earbin is an Intern with the Orange County Office of the Public Defender. Esther has 13 years of experience working with the local public health department in Indianapolis, Indiana. A recent NCCU law school graduate, her area of interest is HIPPA law, lots of experience in marketing and communications. Motion was made by Nick Galvez to recommend to the BOCC that Esther Tabitha Earbin be appointed to the BOH, seconded by Susan Elmore and carried without dissent. MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/August Page 5 C. Epinephrine Auto Injectors in Schools Matthew Kelm reported on the North Carolina General Assembly passing a legislation requiring all schools in the state to have two epinephrine auto injectors (aka “EpiPens”) on site at all times. Further the law states that schools are to receive the prescription for these auto injectors from their local health department. To facilitate access to this medication the North Carolina Board of Pharmacy has proposed a rule change that would allow public health nurses to dispense epinephrine auto injectors. This would allow schools to receive both the prescription and the medication from one source. The Board, at the request of the NC Board of Pharmacy considered a resolution in support of adding EpiPens to the formulary of drugs public health nurses can dispense. This resolution will be submitted as public comment to the Board of Pharmacy and will also be shared with other Boards of Health with a request that they take similar action. The BOH members had several questions that were addressed by Matthew Kelm. Motion was made by Paul Chelminski to pass a resolution in support of adding epinephrine auto injectors to the public health nurse dispensing formulary, seconded by Nick Galvez and carried without dissent. VII. Reports and Discussion with Possible Action A. Pre-Exposure HIV Prophylaxis Recommendation Andrea Mulholland, Family Nurse Practitioner II, provided an overview of HIV infections across the US and Orange County. County trends in new infections coincide with national trends. Andrea gave an overview of Truvada (approved by the FDA in July, 2012) showing it to be safe and effective in such trials as the iPrEx and US MSM Safety Trial. Andrea requested to the Board that the Health Department begin offering Daily oral PrEP (pre-exposure prophylaxis) for people at high risk of HIV. Staff recommends that the BOH approve this recommendation to expand services to include prescribing TDF and FTC as HIV pre-exposure prophylaxis. OCHD Medical Director, Dr. Julie Monaco, can call in prescriptions to UNC Hospital Pharmacy, and eligible patients can apply for pharmacy assistance programs to aid in the cost of PrEP. The BOH members had several questions that were addressed by Andrea Mulholland. Motion was made by Liska Lackey to expand services to include prescribing TDF and FTC as HIV pre-exposure prophylaxis, seconded by Matthew Kelm and carried without dissent. MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/August Page 6 B. Health Department Flu Vaccine Requirement Pam McCall reported on the recommendation from the Leadership Team that annual influenza vaccination be required as a condition of employment for staff employed at Orange County Health Department for the following reasons: • Requiring annual influenza vaccination for employees demonstrates a commitment to protect the safety and health of patients, visitors, co-workers and our families. • Mandatory influenza vaccination for healthcare workers is congruent with requiring vaccinations such as MMR (measles, mumps, and rubella), pertussis and varicella to protect patients from these vaccine-preventable diseases. • Maintaining a healthy workforce is essential to meeting the fundamental mission of each department, which is serving the residents, workers, and visitors of Orange County. The mandatory flu vaccination policy will require all Health Department employees to show documentation of current influenza vaccination by October 17, 2014. Employees with medical or religious exemptions will have the same deadline to show proper documentation. Staff will be surveyed regarding this new requirement and will have the opportunity to address the Board in favor of or against this recommendation. The BOH members will vote on this item in September after seeing the results of the survey and hearing from employees at the meeting. C. Health Director’s Report There were no questions from the board regarding the Health Director’s Report included in the packet. Dr. Bridger reminded the Board it is time for her annual evaluation. A review process needs to be agreed upon and completed by the October Board meeting D. Media Items Media Items were in the packet which focused on Orange County’s events and our involvement in various efforts. VIII. Board Comments Meredith reminded everyone of the Healthy Carolinians Annual Meeting Friday September 26th, featuring Dr. Betina Jean-Louis from the Harlem Children Zone. No additional comments given. MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/August Page 7 X. Adjournment Chairman Cory Davis adjourned the meeting at 9:00 p.m. The next Board of Health Meeting will be held September 24 2014 at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m. Respectfully submitted, Colleen Bridger, MPH, PHD. Health Director Secretary to the Board