HomeMy WebLinkAboutBOH minutes 032713MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2013
Page 1 of 5
Board of Health Minutes Transcription completed by Lisa Smith March 27, 2013
ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To enhance
the quality of life, promote the health, and preserve the environme nt for all people in the
Orange County community.
THE ORANGE COUNTY BOARD OF HEALTH MET ON March 27, 2013, at the
Orange County Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Matthew Keirn, Chair; Corey Davis, Vice
Chair; Carol Haggerty; Paul Chelminski; Liska Lackey; Tony Whitaker; Susan Elmore;
Michael Wood; Alex White; Commissioner Bernadette Pelissier; Mike Carstens
BOARD OF HEALTH MEMBERS ABSENT:
STAFF PRESENT: Colleen Bridger, Health Director; Pam McCall, Nursing Director;
Christy Bradsher, Finance and Administrative Services Director; Tom Konsler,
Environmental Health Director; Donna King, Health Promotions and Education Director
Lisa Smith, Administrative Assistant
GUESTS PRESENT: Nidhi Sachdeva
I. Welcome
II. Public Comment for Items NOT on Printed Agenda-None
III. Approval of March 27, 2013
Motion to approve the Agenda of March 27, 2013 was made by Liska Lackey
seconded by Michael Wood, and carried without dissent.
IV. Action Items (Consent)
A. Minutes approval of February 27, 2013 meeting
Motion to approve Consent Agenda was made by Tony Whitaker, seconded by
Commissioners Bernadette Pelissier and carried without dissent.
IV. Action items (Non-Consent)
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2013
Page 2 of 5
Board of Health Minutes Transcription completed by Lisa Smith March 27, 2013
A. Dental Fees Adjustments
The Dental Clinic currently bases fees on regional fees on regional fees or Medicaid
fees plus 10% Health Department staff members performed an analysis of the Dental
Clinic’s current fees and compared with the 70th percentile of the usual and customary
fees for Orange county’s zip codes. They found that our rates are set lower than most
and higher than some of these fees. The other safety net dental provider in Orange
County, Piedmont Health Services, also bases their fees on the ususal and customary
method. The Dental Clinic recommends changing its fee structure to the 70th percentile
of Orange County’s usual and customary fees. By setting fees to our costs at the 70th
percentile, we estimate a net monthly impact of $6901.05. We would be able to expand
the number of providers in the dental clinic to see more patients and offer additional
services. We currently have a very limited scope of services for our pediatrics and
senior services.
Motion to approve the Dental fees adjustments forward to th Board of County
Commissioners was made by Liska Lackey, seconded by Susan Elmore and
carried without dissent.
B. Dental Sliding Fee Scale Adjustments
Last fiscal year, due to some technical limitations in HIS, staff recommended and the
Board approved a change to our Dental sliding fee scale that set our zero percent pay
charges to $30.00 per preventive visit and $30.00 per procedure. This change was a
work-around to the limitations in HIS is able to code transactions by sliding to a
minimum of 20% or $30.00 per visit. This would be returning to the way we charged
patients on the sliding fee scale before HIS implementation. It would elimi nate the need
to adjust each patient’s account by hand and would be easier to explain to the patients.
Dental Health is recommending a return to the pre-HIS 20% sliding fee scale with a
minimum fee of $30.00. Considerable staff time is used to manually adjust patient
accounts to the 0% sliding fee scale with $30 minimum per preventive visit and $30.00
per procedure. Staff efficiency and increased revenue can be anticipated by returning
to the 20% sliding fee scale with a $30.00 minimum.
Motion to approve the Dental Sliding Fee Scale Adjustment forward to the Borad
of County Commissioners was made by Carol Haggerty, seconded by Alex White
and carried without dissent.
VI. Reports and Discussion with Possible Action
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2013
Page 3 of 5
Board of Health Minutes Transcription completed by Lisa Smith March 27, 2013
A. NC Substances Issues
Catherine (Kay) Sanford, MSPH, UNC Injury Prevention Research Center provided an
overview of the opioid overdose problem in North Carolina and promising evidenced-
based prevention strategies reduce overdose deaths. Based on the Project Lazarus
model, strategies may include Good Samaritan laws, increased Naloxone access, and
the CSRS (controlled substance reporting system) these are cost-effective interventions
for Health Departments.
These are all part of the Project Lazarus Model
Community Education: Improve the public's capacity to recognize and avoid the
dangers of misuse/abuse of prescription drugs.
Provider Education: Improve effective treatment of chronic pain; support
treatment addiction, mental health, illness, and pain
Hospital ED Policies: Help emergency departments avoid drug seeking behavior
Diversion Control: Reduce the presence of excess medications in the community
Pain Patient Support: Help successfully and safely manage patients' pain
Risk Reduction: Help people who abuse opioids prevent overdose death
Drug Treatment: Help those with addition recover.
Goals of the CSRS
Identify and prevent diversion of prescribed controlled substances.
Reduce morbidity and mortality from unintentional drug overdoses.
Reduce the costs associated with the misuse and abuse of controlled
substances.
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2013
Page 4 of 5
Board of Health Minutes Transcription completed by Lisa Smith March 27, 2013
Assist clinicians in identifying and referring for treatment patients misusing
controlled substances.
Reduce the cost for law enforcement investigating cases of diversion and
misuse.
Inform the public, including health care professionals, of the use and abuse
trends related to prescription drugs
SB20: Good Samaritan Law – in good faith and with reasonable care
Naloxone component
-- Permits practitioners to prescribe, dispense or distribute directly or as a
standing order naloxone to persons at risk of OD or a family member, friend
-- Permits a person who received an opioid antagonist (Naloxone/Narcan)
under the terms outlined above to administer that antagonist to another person
-- Provides immunity from civil and criminal liability for the practitioner and
administrator
911 component
-- Provides limited protection from prosecution for any person who seeks
medical assistance … for a person experiencing a drug-related overdose and/or any
person who has a drug-related overdose and/or any person who has a drug-related
overdose who is need of medical assistance if the evidence for the prosecution was
obtained as a result of the seeking of medical assistance.
Endorsements of community-based distribution of naloxone
NC Board of Medicine
CDC
AMA
ONDCP
SAMSHA
15 states in the US
Enabling legislation in many states underway
Harm Reduction Coalitions
Project Lazarus
See attached presentation
B. National Nutrition Month
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2013
Page 5 of 5
Board of Health Minutes Transcription completed by Lisa Smith March 27, 2013
Renee Kemske Manager of Nutrition Services at the Health Department provided an
overview of National Nutrition Month. National Nutrition Month is a nutrition education
and information campaign in March sponsored by the Academy of Nutrition and
Dietetics. The campaign focuses attention on the importance of making healthy food
choices and promoting physical activity. Registered Dietician Day, celebrated March
13th, increases awareness of registered dieticians (RD) as the indispensable providers
of food and nutrition services and recognizes RDs for their commitment to helping
people enjoy their lives. This year’s theme focuses on the advantages of developing a
healthful eating plan that incorporates individual food choices and preferences.
See attached presentation
C. Informational Items
Informational items are provided to the Board to cover topics that Board members
should be aware of or for general interest.
a. Health Director’s Report
See attachment Health Directors Reports
b. Media Clips
VII. Board Comments
VIII. Adjournment
Alex White made a motion to adjourn the meeting at 9:05 pm seconded by Mike
Carstens and carried without dissent.
The next Board of Health Meeting will be held on April 24, 2013 at the Orange County
Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m.