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ORANGE COUNTY BOARD OF HEALTH
March 26, 2014
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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 March 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, Paul Chelminski, Matthew Kelm, Liska Lackey
Nick Galvez, Sam Lasris and Commissioner Bernadette Pelissier.
BOARD OF HEALTH MEMBERS ABSENT: Michael Carstens
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, Senior Public Health Educator; Coby Austin, Senior Public
Health Educator; Rika Klein, Licensed Practical Nurse; Nikki Thorpe, Nursing Assistant
and Katy Johnson, Registered Nurse
GUESTS PRESENT:
I. Welcome
Dr. Bridger and Chairperson Corey introduced the new Board of Health members, Nick
Galvez, Member at Large and Sam Lasris, Dentists.
II. Public Comment for Items NOT on Printed Agenda: None
III. Approval of March 26, 2014 Agenda
Motion was made by Matt Kelm to approve the amended agenda including
discussion and possible action on the Maternal Health Global Fee change
request, seconded by Bernadette Pelissier and carried without dissent.
IV. Action Items (Consent)
A. Minutes Approval of February 26, 2014 Meeting
Motion was made by Tony Whitaker to approve the February 26, 2014 meeting
minutes, seconded by Susan Elmore and carried without dissent.
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March 26, 2014
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V. Educational Session
A. Smoke Free Public Places Update
Coby Austin presented recent successes related to the Smoke Free Public Places rule,
passage of one of the most comprehensive smoking bans in the nation. The Orange
County Smoke Free Public Places Rule prohibits smoking on all publicly owned or
maintained property including parks, bus stops, and sidewalks. The SFPP Update
(handout) described activities and some next steps related to communication, signage,
enforcement, cessation, and evaluation. During the presentation, Coby provided
information on public feedback gathered during Smoking Response Teams.
Coby reported a meeting has been schedule with the Chapel Hill Police Department to
discuss joint messaging. There has been good collaboration with police department,
including active participation on the Smoking Response Teams and sharing of
information on social media.
All five high schools in Orange County celebrated Kick Butts Day with activities in their
schools on March 19th. The Chapel Hill - Carrboro youth also did a cigarette butt pick-
up on Saturday, March 15 on Franklin St. and Main St., collecting 10,533 butts.
Coby is beginning to explore interest among owners and managers of multi-unit housing
in having smoke-free policies. Property managers are often able to reduce their
insurance costs by implementing such policies. This entails site-specific policy change
and would not require any action from the board.
The Health Department continues to promote and provide cessation services. It has
partnered with the Department of Social Services to integrate the Fresh start tobacco
cessation class into the Work First program, which is a 12-week program that happens
quarterly each year. Coby is also starting a conversation with local mental health and
substance abuse agencies to assess their current practices related to nicotine addiction
to see if there are opportunities to better integrate tobacco use screening, referral to
cessation services, integration into treatment plans, or smoke-free campus policies.
In an effort to evaluate the health effects of the rule, UNC is submitting a proposal to the
Robert Wood Johnson Foundation due April 15. They are asking the Board to endorse a
Letter of Support for their application.
The BOH members had several questions that were addressed by Dr. Bridger and Coby
Austin.
Motion was made by Liska Lackey for an authorized representative of the Board
of Health to sign a letter of support for this grant, seconded by Michael Wood and
carried without dissent
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March 26, 2014
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B. Integrated Care
Meredith Stewart, Program Manager presented information on the integration of mental
health and primary care services as an identified BOH priority, local, state, and federal
priority in providing quality care. Integrated care includes a wide range of behavioral
health issues, screening, brief intervention, and targeted referrals. It is not a
replacement for specialty mental health/substance abuse services.
Meredith reviewed local examples of mental health and primary care integration, with a
discussion of the successes and challenges of each, and recommended steps to
consider in preparation for Board of Health strategic planning related to integration of
care.
Meredith reported that the Health Department is exploring multiple avenues to increase
access to integrated behavioral health and primary care services in the county. Two
main ways are:
• The Health Department submitted a grant to the Office of Rural Health to create
a mobile team, consisting of a behavioral health provider and a public health
nurse, to provide limited primary care and behavioral health services and care
coordination in the high-poverty areas previously identified in Orange County.
This grant builds on our successful family home visiting model, and fits with the
Health Department’s increasing focus on poverty and access to care as root
causes of chronic disease over the lifetime. The initial grant is for $150,000 from
July 1, 2014 – June 30, 2015, with the potential for two additional years of
funding based on results. A decision is expected by May 1, 2014.
• Meredith recommended that the BOH Mental Health and Substance Abuse sub-
committee consider including action steps related to examining the feasibility and
logistics of integration of behavioral health services in the BOH 2014-2016
Strategic Plan. These include assessing organizational readiness and developing
a business and operations plan for integration of behavioral health care into the
Health Department’s primary care services. If included in the 2014-2016
Strategic Plan, the subcommittee will work with department staff and community
partners to provide recommendations to the full Board for consideration in the
2015-2016 fiscal year budget.
Board members had several questions that were addressed by Dr. Bridger and
Meredith Stewart. They expressed interest in the grant application, and
commented on its good fit in addressing BOH priorities and the focus on poverty.
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March 26, 2014
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C. “Speed Storming”
The Board of Health members participated in a one-hour speed storming session. The
purpose of this session was to create thinking and ideas, around the upcoming BOH
strategic plan. Speed storming is a combination of brainstorming and speed dating that
creates a situation where the creative process is sped up, facilitating new and
innovative ideas in a shorter period of time. It identify challenges and to think of the
wildest and best solutions without constraints.
Speed storming, when used as a form of brainstorming, benefits by explicitly
sanctioning a discussion focused on generating boundary-spanning ideas. It is a social
form of idea generation based on the belief that groups will be most creative when
criticism is forbidden, freewheeling is encouraged, the goal is to produce more (but not
necessarily better) ideas, and there is an explicit goal to combine and improve upon the
ideas of others.
Stacy Shelp facilitated speed storming session which developed the following main
points from BOH members:
• Communication is the Key
• Need to engage as many people as possible via various methods
• Creating an open environment, personal contact
• Incentive for change and critical mass
• Surround yourself with problem solvers
• Technology
• Engagement including:
Motivating
Contributing
Making a commitment
Collaboration
Capturing attention
Two way street
Stacy will develop a complete report of all the input she received in writing and will
share that with the Board at their next meeting.
VI. Action Items (Non Consent)
A. Maternal Health Global Fee Change Request
Under the new Medicaid Cost settlement methodology, which became effective with the
current fiscal year (2013-2014), Medicaid now bases their cost settlement payment on
what an agency charges for each service rather than what their cost for the service is as
they did in the past.
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March 26, 2014
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To meet the intent of the Medicaid cost settlement process and maximize our cost
settlement payments we are recommending setting the charges for the two codes for
Maternal Health Global billing (Antepartum Care) at our actual cost. This change will
not adversely affect our self-pay patient populations. (Self-Pay patients are billed on an
individual basis.)
The BOH members had several questions that were addressed by Dr. Bridger.
Motion was made by Matt Kelm to approve the requested fee changed for the two
Antepartum Care billing codes, seconded by Susan Elmore and carried without
dissent.
Chairperson Corey reminded all members the Outside Agency Funding Request
scorecards are due Friday March 28, 2014.
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.
VIII. Board Comments
No additional comments given.
X. Adjournment
A motion was made by Susan Elmore to adjourn the meeting at 9:00 p.m., was
seconded by Tony Whitaker and carried without dissent.
The next Board of Health Meeting will be held April 23, 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