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Home My WebLink AboutBOH minutes 022614MINUTES ORANGE COUNTY BOARD OF HEALTH February 26, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/Feb 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 26, 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, Michael Wood, Michael Carstens, Paul Chelminski, Matthew Kelm, Liska Lackey and Commissioner Bernadette Pelissier. 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; Pascal Moore, Administrative Officer; Stacy Shelp, Communications Manager; Meredith Stewart, Senior Public Health Educator and Coby Austin, Senior Public Health Educator GUESTS PRESENT: Lauren Blackburn, NCDOT; Bret Martin, OC Planning Department; Stacey Ray, Michael Ray and Amanda Raymond. I. Welcome II. Public Comment for Items NOT on Printed Agenda: None III. Approval of February 26, 2014 Agenda Motion was made by Susan Elmore to approve the amended agenda including discussion and possible action on two BOH vacancies seconded by Bernadette Pelissier and carried without dissent. IV. Action Items (Consent) A. Minutes Approval of February 5, 2014 Meeting Motion was made by Bernadette Pelissier to approve the February 5, 2014 meeting minutes, seconded by Matthew Kelm and carried without dissent. MINUTES ORANGE COUNTY BOARD OF HEALTH February 26, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/Feb Page 2 V. Educational Session A. Outside Agency Funding Request Review Each year a number of non-profit agencies apply to the county for funding. A review along with a completed scoring sheet needs to be available to the Health Director for presentation to the County Manager when the departmental budget is presented for his review. The Health Department received 8 applications this year. Each BOH member was assigned to review 2-3 applications. BOH members will assess the applications using the Application Scorecard, which rates the program’s mission, customer value, prior year results and implementation plan. The applications, financial information, score cards, and instructions were given to each BOH Member to review and send back to Tersee Flores by March 21st. B. Panel: NCDOT & Active Transportation Lauren Blackburn, AICP Director of the North Carolina Department of Transportation Bicycle and Pedestrian Division discussed the following main points regarding Bike and Pedestrian Planning: • Data Collection and Planning • Promotion and Evaluation • Education and Enforcement • Infrastructure Improvements The current focus areas of the division is on promoting and facilitating active transportation of many varieties in North Carolina through programming and policy. The information presented can be found on the North Carolina Department of Transportation website at the following links: http://www.ncdot.gov/bikeped/download/FinalSummaryDoc110113WalkBikeNC.pdf http://www.ncdot.gov/bikeped/download/WalkBikeNCPlanChapterslowres.pdf http://www.ncdot.gov/bikeped/download/WalkBikeNCPlanAppendixlowres.pdf C. The Local Landscape of Active Transportation Bret Martin, Transportation Planner with the Orange County Planning Department. Mr. Martin's presentation focused on understanding the local context for built environment decision making that is affected by and can affect health outcomes in Orange County. MINUTES ORANGE COUNTY BOARD OF HEALTH February 26, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/Feb Page 3 He discussed planning for active transportation and provided local context to complete streets, transit and bike/pedestrian planning at the local level. Bret’s presentation outlined the following main points: • Current Transit and bike/pedestrians projects in Orange County • County and municipality framework for planning, input, and decision making on projects • An overview of funding and prioritization process for complete streets, transit and bike/pedestrian projects in North Carolina and Orange County. VI. Action Items (Non Consent) A. Orange County Transportation Resolution Orange County community members identified access to health care services and the impact of transportation systems on quality of life among their top ten health priorities in both the 2011 and 2007 Orange County Community Health Assessments. Additional primary and secondary data indicate there are Orange County citizens without access to public transit, especially in the northern and rural areas of the county. Many Orange County Health Department clients are considered “transit-dependent”. These findings led to prioritizing access to care, including transportation, in both the 2011 Community Health Assessment and the 2012-2014 Board of Health Strategic Plan. With ongoing planning for the Orange County Bus and Rail Improvement Plan, this resolution reiterates that the Board of Health and the Orange County Health Department prioritize affordable and accessible transit options for all Orange County residents in current and future transportation plans. Motion was made by Michael Carstens to approve the Orange County Transportation Resolution, seconded by Matthew Kelm and carried without dissent. B. Charge I-693 on sliding fee scale Pam McCall gave the follow up report on the process of completing I-693 forms. (Included in packet) .The I-693 fee and Waiver were not efficient in achieving the intended results. Pam McCall recommended converting the $25 I-693 charge from a flat rate to sliding scale based on financial eligibility. There will still be a fee waiver process, if someone slides to a number they feel they cannot pay, the waiver does not go away it continues to exist. The BOH members had several questions that were addressed by Pam McCall and Dr. Bridger MINUTES ORANGE COUNTY BOARD OF HEALTH February 26, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/Feb Page 4 Motion was made by Susan Elmore to approve charging for I 693 visits on the sliding fee scale, if the individual does not slide to zero and they think it is a hardship for them, they will be made aware and can avail themselves of the fee waiver, seconded by Liska Lackey and carried without dissent. C. 2014-2015 Budget Budget Presentation/Discussion- Dr. Colleen Bridger See attached Budget Packet The proposed FY 2014-2015 budget for the Health Department is essentially a “flat” budget, with minimal increases. Dr. Bridger pointed out the increases in the recommended budget that are county controlled: such as Health Savings Account, the 2% COLA for employees, employee equity adjustments, medical insurance costs, retirement match and county wide 3% bilingual retention program. Motor pool increased 3 cents per mile resulting in a $3000.00 increase. Staffing: New position request focused on childhood poverty whose primary focus will be to assess current programs and resources, partner with critical community stakeholders, and identify pilot communities within the county for the purpose of implementing a Harlem Children’s Zone-like program. We will maintain a partially grant- funded Foreign Language Interpreter position beyond the state funding period which expires at the end of the current fiscal year. We also included a Nurse Retention career ladder payment.  Fee Schedule In reviewing the clinic fee schedules the staff used the following methodology: • Utilized a Clinical Fee Schedule Cost per Service Calculation provided by the NC Division of Public Health to compare charges for services to cost of services. • Compared charges for services with Medicaid’s reimbursement rates and confirmed that all charges for service were equal to or exceeded the Medicaid reimbursement rate. This resulted in an increase of 9 charges in Personal Health for services that were raised to the Medicaid reimbursement rate. Dr. Bridger mentioned that by keeping fees for clinical services below our actual costs, we would be losing some Medicaid cost settlement funds. The challenge is that uninsured patients who pay a percentage of their visit will pay more if we increase our fees. There was some discussion regarding Environmental Health fees. Dr. Bridger committed to completing a cost study for Environmental Health prior to the next fiscal year’s Budget presentation. The BOH members had several questions that were addressed by Dr. Bridger. MINUTES ORANGE COUNTY BOARD OF HEALTH February 26, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/Feb Page 5 Motion was made by Paul Chelminski to approve the total budget requested in the amount of $8,119,439 for 2014-2015 as presented which includes $149,148 in grant funding for Smart Start and Health Disparities projects, also the fee schedule and forward to the County Manager, who will then forward to Board of County Commissioners for action, seconded by Tony Whitaker and carried without dissent. D. New Board of Health Member Selection a. Dentist b. At-Large Dentist position recommendation: Sam Lasris is a licensed Dentist. Sam has been a dentist since 1975, beginning in public health. He has worked with both Virginia and NC Medicaid patients. He has served on the Orange Unified Transportation board (6 years) and Orange County Planning Board (3 years), and could bring a transportation/access angle to Public Health. He has been an Orange County resident for over 10 years. Motion was made by Michael Wood to recommend to the BOCC that Sam Lasris be appointed to the BOH, seconded by Paul Chelminski and carried without dissent. At Large position recommendation: Nick Galvez is a Field Clinician/Physical Therapist with a background in healthcare administration and business management (MBA). He’s worked at the Director level in multiple organizations and has experience expanding services to new market. He has board experience in Florida and is new to the area. Motion was made by Liska Lackey to recommend to the BOCC that Nick Galvez be appointed to the BOH, seconded by Michael Carstens and carried without dissent. VII. Reports and Discussion with Possible Action A. Health Director’s Report There were no questions from the board regarding the Health Director’s Report included in the packet. B. Media Items Media Items were in the packet which focused on Orange County’s events and our involvement in various efforts. MINUTES ORANGE COUNTY BOARD OF HEALTH February 26, 2014 S:\Managers Working Files\BOH\Agenda & Abstracts\2014 Agenda & Abstracts/Feb Page 6 VIII. Board Comments No additional comments given. X. Adjournment A motion was made by Susan Elmore to adjourn the meeting at 9:05 p.m., was seconded by Bernadette Pelissier and carried without dissent. The next Board of Health Meeting will be held March 26, 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