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ORANGE COUNTY BOARD OF HEALTH
January 26, 2011
Board of Health Minutes Transcription completed by Lisa Smith January 26, 2011 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 January 26, 2011 at the Southern
Human Services Center Chapel Hill, North Carolina.
BOARD OF HEALTH MEMBERS PRESENT: Tony Whitaker, Vice-Chair; Anissa Vines, Chair;
Steve Yuhasz, Commissioner Representative; Mike Carstens; Paul Chelminski; Carol Haggerty;
Susan Elmore; Christopher Cooke; Michael Wood; Chris Harlan
BOARD OF HEALTH MEMBERS ABSENT: Matthew Kelm
STAFF PRESENT: Rosemary Summers, Health Director; Tom Konsler, Environmental Health
Services Division Director; Division Director; Wayne Sherman, Public Health Nursing Director;
Donna King, Health Promotion and Education Services Division Director; Letitia Burns,
Administrative Operations; Lisa Smith, Administrative Assistant; Connie Pixley, Environmental
Health Supervisor; John Kase, Environmental Health Specialist; Joe Alexander, Environmental
Health Specialist.
GUESTS PRESENT: Abbey Moore, UNC Student Journalist; Carter McCall, UNC Student
Journalist.
I. Educational Presentation: Facility Planning for Health Department.
Pam Jones, Director Asset Management Department, gave a presentation on how county
facilities are planned and scheduled for actualization as part of the county’s long-range capital
improvement plan. Ms. Jones talked about the upcoming renovations at the Whitted Building
and plans for future renovations for the Southern Human Services Center. Rosemary Summers
reviewed the past facility planning efforts that the Board of Health had engaged in and
forwarded to Commissioners beginning in 2000 with a major update in 2007 that included
analysis of one and two clinical site models.
II. Welcome and Introductions:
Tony Whitaker, Vice-Chair, thanked Pam Jones for the educational presentation and called the
meeting to order at 7:40 p.m. Dr. Vines requested Vice-Chair Whitaker to chair tonight’s
meeting as she will have to leave early for a family obligation.
III. Approval of January 26, 2011 Agenda
Motion to approve the Agenda of January 26, 2011 as was made by Steve Yuhasz,
seconded by Christopher Cooke, and carried without dissent.
IV. Public Comment for Items NOT on Printed Agenda: Guests Carter McCall & Abbey
Moore introduced themselves. They have recently been assigned to Public Health through the
student journalist program at UNC and are looking forward to working with the Health
Department.
V. Action Items (Consent)
A. Minutes approval of January 26, 2011 meeting
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ORANGE COUNTY BOARD OF HEALTH
January 26, 2011
Board of Health Minutes Transcription completed by Lisa Smith January 26, 2011 2
The Board is required to review and approve minutes of all meetings of the Board of
Health. These minutes were for the regularly scheduled meeting held on January 26,
2011.
B. Accept Additional Funds
The Department has recently been notified of additional funds from several different
sources. These funds will be added to the budget and spent according to program
requirements.
Home Visiting Program-Donation A donation in the amount of $500 was given by a local
citizen to help support the Home Visiting Program. The funds will be used as the donor
requested. These funds are expected to be spent by June 30, 2011.
Dental Program-Donation A donation in the amount of $ 400 was given by a local dentist
to help support the dental clinical program. These funds will be used as the donor
requested. These funds are expected to be spent by June 30, 2011.
Diabetes Capacity Building The Division of Public Health notified the Health Department
that an amount of $1,000 was available for support of the Diabetes Self Management
Education program (DSME). The Division of Public Health (DPH) applied to the American
Diabetes Association to become an “umbrella” recognized program to provide DSME. The
purpose of these funds is to increase access in all areas of the state for people with
diabetes. This additional reimbursement will build capacity at the local health department
to provide DSME for the uninsured or underinsured clients. These funds must be spent
between January 1, 2011 and March 28, 2011.
Language Services-Interpreter Grant On December 15, 2010, the N.C. Office of Minority
Health notified the health department that we had been selected to receive a three-year
capacity grant in the amount of $20,900 per year to support a new full time Interpreter
position. The funding period will begin June 1, 2011 and end May 31, 2014. (Continuation
of grantee funding during the project period will be dependent upon performance and
continued funding from the General Assembly.) Upon approval by the County
Commissioners, the department will use current Contract Services funds and the grant
award to hire a full time Medical Interpreter. Even though the grant starts prior to the
beginning of the fiscal year, we will need to move forward outside of the budget process so
that we can actually begin with a new hire on July 1, 2011.
These supplemental funds for Home Visiting Program, Dental Health, and DSME are in
addition to our current approved budget for fiscal year 2010-2011. The Interpreter grant
will be included in the budget proposal for 2011-2012 and subsequent years. The position
will likely be a time-limited position since these are grant funds and may be at risk for
elimination at the expiration of the grant period.
C. Accept State of the County Health Report (SCOTCH) During the three interim years
between Community Health Assessments, local health departments are required to do
a State of the County’s Health (SOTCH) report that will:
1. track priority issues identified in the Community Health Assessment;
2. identify emerging issues; and
3. highlight new initiatives.
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ORANGE COUNTY BOARD OF HEALTH
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The document provides basic health and demographic data as well as highlights active
health initiatives within our community. Orange County’s 2010 SOTCH is posted to our
department’s website and circulated widely among Healthy Carolinians of Orange County
Partners. Board members also received the SOTCH in December via email.
Motion to approve the consent agenda as presented for items A. B. and C. was made by
Steve Yuhasz, seconded by Anissa Vines, and carried without dissent.
VI. Reports and Discussion with Possible Action
A. 1st & 2nd Quarterly Financial Reports The Quarterly Reports for the July 1- December 31,
2010 were attached to the agenda. The reports showed the revenues and expenditures for
each division. The reports also included additional money received that has been added to
the budget since July 1, 2010 from both the 1st & 2nd Quarters. The additional monies
received were from grants, unspent Federal H1N1 funds, supplemental immunization funds,
TANF, LARC, and environmental health quality improvement project. The Board received
the report with no action required.
B. BOH Education Plan for 2011 Each year the Board of Health considers various educational
topics that it would like to receive more information about to do the work of the Board more
effectively. At the beginning of each year, topics that were previously unable to be
addressed are considered along with new topics the Board may want to focus on. The
Board policy manual states that each Board member will participate in at least three
educational sessions each year. There was a discussion on having staff do a presentation
regarding banning smoking in public parks and to be able to better enforce the current and
new smoking laws. It was agreed this discussion would be on the agenda for March and
Enforcement should be added to the topic Using Data for Policy Development. By
consensus, the Board agreed that the planned topics would be sufficient for the year and
could be added to or changed at a later time.
C. Review of Process for Strategic Plan Development The Health Department’s previous
strategic plan was adopted in the fall of 2005 and covered the fiscal year periods of 2006-
2011. In essence, the current plan “expires” June 30, 2011. The Board has reviewed the
plan each year and has advised staff on adjusting some aspects of the plan. When the
previous plan was adopted, it was “out of cycle” with the Community Health Assessment
(CHA). The CHA should have a significant relationship to the work of the health
department. Since the community health assessment is being developed this year, there is
an opportunity to better coordinate the two efforts.
Accreditation requires the department to have an active plan in place so there is a need for
an interim extension of the current strategic plan for one fiscal year that guides the work of
the department until the new plan can be put into place beginning July 1, 2012. The
the extension of the current strategic plan will be for the period July 1, 2011 through June
30, 2012 and will focus specifically on the areas contained in the first attachment.
This will enable the development of longer term strategic plan during this fiscal year that will
be able to be considered during the budget process for fiscal year 2012-13.
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Rosemary Summers presented a potential concept and process for the development of a
new strategic plan. In the past, the Board has been involved in a variety of ways. Special
retreats, regular agenda items, and adhoc committees have been used in the past to involve
the Board in the development of the plan. Nearly all of the Board members that were part of
the current plan are no longer serving on the Board, so this is an opportunity to start with a
fresh look. The management team at the department has begun work on the internal focus
areas and we will be seeking staff input at a February all-staff meeting. In general, the
senior staff agrees that we would like a more streamlined document that can be in the
forefront of what we do each day so that all staff feels an ownership to achieving the goals in
the document. Dr. Summers offered two examples of “strategic maps” that could be
developed as “quick summaries” of an adopted plan. Tony Whitaker asked for clarification
on when the current strategic plan expires, Rosemary Summers responded that is does not
expire until the end of the fiscal year June 30, 2011. She also added that by adopting the
proposed extension of the current plan would give us one year to develop a longer range
plan to be approved and into place. It would also allow us to have one more budget cycle to
look at what we need for the new plan. Tony Whitaker asked the board if they had any
thoughts on where they wanted to go from here. Paul Chelminski asked Commissioner
Yuhasz if Orange County does any budget projections in terms of when we will finally
emerge from our budget constraints. Commissioner Yuhasz responded that the
Commissioners do budget projections but right now even looking 6 months out is hard to
determine. So much of Orange Counties budget depends on what the State does and the
State has not made any decisions budget cuts yet. Commissioner Yuhasz stated we are just
beginning to see some signs of recovery but with government we usually are behind by 2
years of the going down and coming back up, he said it will be a couple of years before we
will be able to consider any new construction or any large new programs.
Motion to adopt the Strategic Plan for 2011-12 was made by Michael Wood, seconded by
Paul Chelminski, and carried without dissent.
D. Smart Start Grant Applications The Health Department has three projects currently funded
entirely by the Orange County Partnership for Young Children (the local Smart Start
agency). Each of these projects has been on a three year “approved subject to state funding
cycle”. 2011 is a new “bid year” for projects. The Partnership has decided that they are
discontinuing the three year cycle and will accept applications for one year at a time. The
applications are due mid-February and are still in development. The Department intends to
apply for all three projects as continuation projects with only minor projected increases in
expenditures.
The three projects are:
Families in Focus Home Visiting Project that provides intensive social work services to
families at risk for child abuse and neglect. For the next round, the recommendation is to
broaden the pool of parents to include any parents with a child 0-3 that meets the risk
criteria instead of limiting to first time parents. The grant pays the entire salary, benefits, and
travel expenses for a Social Worker II and most of the supply costs for the program. We
have been able to bill Medicaid for services if the families qualify, however this may be
changing next year.
Child Care Health Consultant/NAPSACC Project that provides consultation and education
services to child care centers on health, medical, safety, and nutrition. This grant pays the
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ORANGE COUNTY BOARD OF HEALTH
January 26, 2011
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entire salary, benefits, and travel expenses for a Public Health Nurse II and all of the supply
costs for the program.
Dental Preschool Screening Project that provides dental screening and referral services
for children in child care centers and registered family care homes. This project utilizes
contract and temporary personnel and School of Dentistry hygiene students to accomplish
the screenings. The temporary personnel conduct the follow up activities ensuring that
children with dental needs are referred to a provider. The grant pays for all contract and
temporary personnel and the costs of all supplies.
Dr. Summers reported that while we do not have any budgetary guidance from the state on
specific cuts, it is likely that the state may not fund Smart Start at a level that will allow
projects to be funded at the same level as previously provided. There are state funding
requirements that require a certain level of funding to be placed in child care subsidies but
there is no provision requiring health or family support projects. If funding is not at a level
sufficient to maintain the salary and benefits of the staff members assigned to the projects,
then those staff members may be subject to being reassigned or separated. The
Department does not have sufficient flexibility in funding to be able to supplement these
grant projects. Each of these staff members will receive a letter alerting them to the
possibilities when the grants are submitted.
No action required for this item.
E. Review Process for Outside Agency Funding Applications Rosemary Summers reported
that each year a number of non-profit agencies outside of Orange County government apply
to the county for funding. In years past, the review of these applications was handled by the
Human Services Advisory Commission with recommendations being provided to the County
Manager and to the Board of Commissioners for funding.
Last year in one streamlining effort, the Human Services Advisory Commission was
eliminated and the Commissioners passed the review for these agencies to departments
and their advisory boards that had the most knowledge of the non-profit agency. That
charge came very late in the year and the health director chose to have the review be
conducted by staff rather than delay the review process. Three staff members reviewed and
rated each application and feedback was provided to the County Manager who included
recommendations to Commissioners as part of the County Manager’s Recommended
Budget.
This year, there has been ample time and notification of the receipt of the applications by
the county and the desire to continue the process of review by related Boards and
departments. The applications from agencies are due to the county January 19, 2011. 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. Generally, this happens sometime mid to late March.
Usually the Health Department receives 5-8 applications. The applications will be available
in late January with the task being accomplished by the February Board of Health meeting.
Dr. Summers presented three approaches that are possible for the Board to consider in
accomplishing this task.
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ORANGE COUNTY BOARD OF HEALTH
January 26, 2011
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1) Appoint an ad hoc committee to review the applications, complete the score sheets, and
report to the Board as information.
2) Delegate the task to one or both standing committees. The environmental committee
may need additional members to perform this task effectively.
3) Schedule a special meeting of the whole Board to review all applications. It would be
unlikely that this could be accomplished at the regular February meeting since that will
be our budget presentation.
The agencies that we will be reviewing applications for are Duke Homecare & Hospice,
Piedmont Health Services, Planned Parenthood, Rape Crisis Center, and Ears, Nose and
Paws. [Note: Subsequent to the Board meeting, Ears, Nose and Paws did not submit an
application but Alliance for Aids Services did.] The board agreed to appoint ad hoc groups
consisting of three or four Board members to review the applications and complete the score
sheets. Individual members from the ad hoc group will send their score sheets to Lisa Smith
who will compile a composite score for each application along with comments for Board
discussion at the February 23, 2011 meeting. Board members were asked to consider
whether any members had a conflict of interest with any of the agencies assigned. There
were no declarations of conflict. Board members volunteered for each of the applicant
agencies (Matt Kelm was assigned since he was absent).
F. Central Administrative Services Reorganization Rosemary Summers reported that staff
has been working on this reorganization since late summer/early fall. This reorganization of
the Central Administrative Services newly renamed “Finance and Administrative Operations”
will strengthen our capability to do good business planning for all aspects of the department.
New organizational charts were distributed that reflect the new titles of some positions and
the new reporting relationships. This was for information and required no action.
G. Informational Items Informational items are provided to the Board to cover topics that
Board members should be aware of or for general interest. Items are not discussed during
the meeting unless Board members ask for discussion. No informational items presented
were selected for discussion or questions at this meeting. A synopsis of the items follows.
a. Health Communications Awards: Candice Watkins Robinson was recognized by the
N.C. Association of Government Information Officers (NCAGIO) during their annual meeting
in November. Mrs. Watkins Robinson received First Place in Special Publications for the
department’s 2009 annual report, “Picturing the Past and Present: Orange County Health
Department.” Candice also received First Place in Campaign Media Kits for “Stay in Control
of Your Diabetes: Orange County Diabetes Self Management Education Program” Provider
Tool Kits.
To review the Judges’ comments see:http://www.facebook.com/notes/nc-association-of-
government-information-officers/2010-nc-association-of-government-information-officers-
excellence-in-communicati/147527018630002
NCAGIO was founded in 1968 by a group of public information officers in state government
and under the guidance of the N.C. Institute of Government. Today it includes state and
local public information officers and others working in governmental communications.
b. Media Clips: Newspaper articles of interest.
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c. Pending and Recurring Items 2011: Attached was a tool used for Board planning for
upcoming agenda items.
d. Immigrant Refuge Health Newsletters: The Immigrant Refuge Health Program Manager,
Susan Clifford has developed two newsletters to communicate with internal staff and
contract interpreters. The various newsletters provide language services updates, cultural
competency lessons and professional practice guidelines. Newsletters are distributed twice
a year.
VII. Board Comments/Announcements Carol Haggerty informed the board that the dental
school has a new dean, Jane Weintraub, who has done a great deal of work in public health.
Board members had a brief discussion on going paperless for Board meetings; staff will look
into the best way to send board members documents electronically and also not provide hard
copies at the meeting. Members who are unable to access electronic files will still need paper
copies. Staff will report back in March.
VIII. Adjournment
Motion to adjourn the meeting at 9:35 p.m. was made by Paul Chelminski, seconded by
Chris Harlan, and carried without dissent.
The next Board of Health Meeting will be held February 23, 2011 at the Whitted Building,
Hillsborough, NC at 7:00 p.m.
Respectfully submitted,
Rosemary L. Summers, MPH, DrPH
Health Director
Secretary to the Board