HomeMy WebLinkAboutBOH minutes 082411MINUTES
ORANGE COUNTY BOARD OF HEALTH
August 24, 2011
Board of Health Minutes Transcription completed by Lisa Smith August 24, 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 August 24, 2011, at the
Government Services Center Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Anissa Vines, Chair; Tony Whitaker, Vice
Chair; Liska Lackey; Steve Yuhasz, Commissioner Representative; Matthew Kelm; Paul
Chelminski; Mike Carstens; Michael Wood; Susan Elmore; Carol Haggerty
BOARD OF HEALTH MEMBERS ABSENT:
STAFF PRESENT: Dorothy Cilenti, Interim Health Director; Wayne Sherman, Personal
Health Services Division Director; Erin Langston Finance and Administrative Operations
Division Director, Tom Konsler, Environmental Health Division Director; Lisa Smith,
Administrative Assistant
GUESTS PRESENT: M Jewel Wray, Human Resources Manager;
Welcome and Introductions
Anissa Vines, Chair, called the meeting to order at 7:10 p.m. New board member Liska Lackey
was introduced and welcomed to the board.
I. Approval of June 22, 2011 Agenda
Chair Vines requested the addition of items VII Closed Session
(ref. NCGS 143-318.11(a) (6) to consider the qualifications,
competence, performance, fitness, conditions of appointment, of an individual
public officer or employee or prospective public officer or employee; or to hear
or investigate a complaint, charge, or grievance by or against an individual
public officer or employee.
Motion to approve the Agenda of August 24, 2011 as amended was made by Michael
Wood, seconded by Mike Carstens, and carried without dissent.
II. Strategic Plan Internal Focus Areas- Erin Langston
Erin Langston presented the Strategic Plan for FY 2012-2013
MAJOR SERVICES
Prevent and intervene in epidemics and the spread of disease
Protect against environmental hazards
Promoted and encourage safe and healthy behaviors
Assure the quality and accessibility of health services
Assure the compliance with laws and regulation that protect health and safety
Assure compliance with state, federal, and local laws, program, and grant requirements
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INTERNAL FOCUS AREAS
1) Technology
a. Implement Electronic Health Record system
b. Support dental software and Permits Plus
c. Maintain IT inventory
2) Workforce
a. Develop leaders
b. Train workers
c. Promote cultural competency
3) Finance
a. Connect budget process to outcomes
b. Create contract management program
c. Improve the internal agency support services
4) Quality
a. Continue assurance efforts
b. Integrate quality improvement into operations
c. Communicate efforts
III. Public Comment for Items NOT on Printed Agenda none
IV. Action Items (Consent)
A. Minutes approval of June 22, 2011 meeting
B. NACCHO/NALBOH/CDC Tobacco Control Award-$5000
The Orange County Health Department applied for and was awarded $5000 from
NACCHO/NALBOH/CDC for sustaining local Tobacco Control efforts. Pam Diggs will lead a
team of 10 community agencies in an intensive planning session with a resulting action plan for
advancing local tobacco policies. Total award $5000.00—distributed over a seven-month period
as grant deliverables are met. Board of Health Chair Anissa Vines will represent the Board of
Health.
C. Community Health Assessment Prioritization Process
By December, the Health Department will complete the 2011 Community Health Assessment
(CHA).
A Community Health Assessment Leadership Team (CHALT), made up of community members
and professionals from across the community, was formed to guide the assessment process.
The CHALT decided to collect data from three sources: 1) a community survey, 2) focus groups,
and 3) a review of secondary data in order to ensure that the assessment included both
statistical data as well as perspectives from the community—especially from those traditionally
hard to reach. Over the past six months, a community survey was developed and administered
to 175 residents; nine focus groups were conducted; and county and state level health statistics
were reviewed. Together, these sources provide a broad persepective of the health of the
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Orange County community and help highlight by which health issues Orange County residents
are most affected. The intention is to use the data gathered to identify the top priority health
issues in the County. The priority issues will then serve as the foundation for the Healthy
Carolinians of Orange County (HCOC) Community Health Action Plan for the next four years.
Attachment 1 outlines the overall CHA process.
HCOC and the BOH will co-host five community forums and one annual meeting from mid-
August until the end of September. The process for selecting the priority health issues will be as
follows:
At the forums, HCOC will present the Top 10 issues in Orange County. These Top 10 issues were
identfied by looking at the intersection of Healthy NC 2020 state objectives, top community survey
issues, top focus group issues, and top 10 leading causes of death in Orange County. At the
forums, HCOC will present issue briefs for each of the Top 10 topics and a snapshot of the
primary data collected. Then forum participants will break into small groups to discuss the data
and share feedback. They will be asked to consider the following questions within their small
groups:
■ What does the data tell us? What new insights do you have?
■ What doesn’t the data tell us and what else might we need to know?
■ What areas of need seem to arise?
■ How does what you heard match up with your personal experience?
■ What in your personal experience was not reflected in the data?
Then, taking a minute to reflect on their group discussions, personal experiences, and the data
presented, each forum participant will vote for their Top 5 issues as individuals using colored dot
stickers. They will be asked to represent their personal choices, but also think of choices their
friends, family, or neighbors may advocate for. Individuals may place up to 2 stickers in each
category and do not have to use all of their stickers. Each small group will count their dots for
each category and then debrief their small group conversations with the large group. Then
HCOC will tally all the individual votes from all the small groups to come up with the Top 5
issues for all forum participants.
This process will be repeated for each of the five forums, so that HCOC will have five sets of
Top 5 issues. Major issues and themes from each forum will be recorded and shared at the
Healthy Carolinians of Orange County Annual Meeting. Here the group will decide on the final
three to five priority issues that the HCOC partnership will focus on for the next four years.
The Annual Meeting prioritization process will be slightly different. The group will take into
consideration the Top 5 issues selected across the five forums and will be asked to rank the
topics on two criteria: Importance and Changeablitiy.
Importance is defined as
■ Issue does not meet Healthy NC 2020 objective or goal;
■ Data indicates that the issues is a problem in community - high incidence/prevalence in
community;
■ Issue is a significant cause of morbidity and/or mortality in community;
■ Community identified issues as a need or it is perceived as a problem; and,
■ Issue is not already being addressed by the community.
Changeabiilty is defined as:
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■ Is it realistic that the HCOC partnership could effectively address the issue;
■ There are resources in community to help address issue;
■ There is expertise in community to help address issue;
■ There is an interest by the community to work on the issue; and,
■ Issue itself is amenable to intervention (i.e. changeable).
Annual Meeting participants will then engage in a brief discussion around the issues. Afterwards,
each participant will be asked to vote on his/her top three priorities. Based on the results of the
voting process, the top three to five priority issues will be selected.
Work groups or sub-committees will be formed to address each priority area, and sub-committee
members will create actions steps to tackle each issue in the Spring of 2012.
Motion to approve the consent agenda items was made by Steve Yuhasz, seconded by
Paul Chelminski, and carried without dissent.
V. Action Items
A. Planned Parenthood of Central North Carolina Contract
The Orange County Health Department will provide to Planned Parenthood of Central North
Carolina (PPCNC) $2,500 to provide low income clients access to long acting contraceptives.
Planned Parenthood of Central NC will provide women this service at its facility in Orange
County. PPCNC will follow the Title X guidelines, including the current sliding fee schedule
when billing for services and assure that all staff receives training required by Title X no later
than October 1, 2011. PPCNC will also submit quarterly reports to the Orange County Health
Director. These funds will allow PPCNC to provide service for approximately 8-10 women.
This Memorandum of Understanding will be effective September 1, 2011-June 30, 2012. Funds
are available through an appropriation from the Board of County Commissioners to PPCNC.
A 20 % Admin fee will be added.
Motion to approve contract with Planned Parenthood of Central North Carolina and
forward to the Board of County Commissioner was made by Paul Chelminski, seconded
by Susan Elmore, and carried without dissent.
VI. Reports and Discussion with Possible Action
A. Health Director Recruitment Update
Four candidates were interviewed on August 17, 2011 by three panels of BOH members, Orange
County Department Head Employees, and other community organizations. The BOH members
discussed bringing back the two finalists for BOH members that were not able to be at the panel
interviews to meet and ask questions. Jewel Wray HR manager is in the process of conducting the
background checks on the two finalists. Tony Whitaker and Anissa Vines will conduct the employer
reference checks. The BOH agreed to bring each finalist in next week individually to meet with
each division and staff, each finalist will tour Whitted and SHSC. The finalist will then meet with
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BOH members at 5:00 pm for dinner and a final interview process. When the BOH meets at its
next meeting on September 21, they will make a recommendation and offer to hire.
Motion to move into closed session was made by Steve Yuhasz, seconded by Paul
Chelminski, and carried without dissent.
Motion to close closed session was made by Steve Yuhasz, seconded by Mike Carstens,
and carried without dissent.
B. BOH Committee Assignments/BOH Vacancies
The Board annually reviews committee assignments for Board members and reviews needs for
various expertises’ on each of the three standing committees. The committees schedule regular
meetings (once per month) but only meet when there are discussion items that warrant a meeting.
There are currently two vacancies on the Environmental Health Committee and two vacancies on
the Awards, Nominating, & Bylaws Committee. BOH members are needed to fill these committee
vacancies.
The Board should also review the charges for each Committee and reaffirm that the charges are
correct and do not need to be changed.
With the recent reorganization of the Health Department and formation of the Finance and
Administrative Operations Section, the Board should discuss the formation of a corresponding
committee or inclusion of the FAO into one of the existing committees. Any resulting changes
should be reflected in a revision of the policy. Tony Whitaker announced that Liska Lackey and
Susan Elmore have agreed to join the Environmental Health Committee. The current vacancies on
the Nominating Committee will be held until the at large position is filled. The Board agreed to add
Erin Langston FOA Division Director to the Environmental Health Committee and the Clinical &
Community Program Committee during budget time.
Motion to approve charges and assignment sand appoint committee representatives was
made by Tony Whitaker, and seconded by Susan Elmore and carried without dissent.
C. 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 Director Report
The NC Association of Local Health Directors will be convening a task force on public
health structure in September to consider the various legislative bills impacting local
health departments and local Boards of Health. It is anticipated that legislators will again
consider regionalization of local health departments and/or consolidation of human
services as options for local government.
A new schedule of charges for services will be developed for consideration by the Board
of Health in the next few months as a result of changes to the methods for calculating
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cost settlement. Beginning FY 2011-2012, the Medicaid cost settlement will be
dependent on the fees/charges for units of service provided. This is a major change for
health departments that have historically set fees lower than actual costs in order to
improve access and affordability for low-income clients. The cost settlement for
administrative activities will no longer be available (accounted for approximately $8
million annually statewide).
The Health Department received notice that the state/federal funds for preparedness
have been reduced by $12,000. While this reduction will have a slight impact on this
fiscal year’s budget, staff will make alternate plans to address a shortfall for next year
should the funds not be reinstated.
Kate B. Reynolds has extended the grant to implement a Diabetes Self-Management
and Education program through December 2012. Health Promotion is currently recruiting
for a nutritionist and program coordinator, and has been working with state consultants
to improve our services and increase integration of the program across the various areas
of the health department.
The Health Department has received a second request to home quarantine a dog whose
rabies vaccination had lapsed and was potentially exposed to a rabid fox. This request
was not granted, and the dog remains under a six-month quarantine at a veterinary
facility until the end of August.
The Health Department was one of six counties to receive the NCEDSS Surveillance
and Reporting Certificate of Recognition. The certificate is given to health departments
for demonstrating commitment to assuring timely entry of required data to support state
communicable disease surveillance activity through NCEDSS. The award was presented
by the NC Communicable Disease Branch.
The Health Department received an additional award for assuring that greater than 90%
of children served were age-appropriately immunized by age 2. This award was given by
the NC Immunization Branch. Kudos to Joan Taylor who conducts tracking for the health
department.
The Health Department will be partnering with the UNC Gillings School of Public Health
on an initiative to expose incoming public health graduate students to public health
practice. The event, called "Pathways to Practice" will take place on Friday, August 26.
Students will convene in Chapel Hill that morning for several presentations and then take
a bus to Hillsborough to meet with staff, learn about the activities of the health
department, and then participate in a scavenger hunt as part of their learning activities.
Renovations update - the Whitted medical clinic reopened for business on July 21.
Renovations to the second floor of the A building are currently on hold until the BOCC
approves the change orders for the bathrooms, classroom, and BOH conference room.
This agenda item is on the Board of Commissioners for Aug. 23. Assuming approval, the
additional renovations should be complete by October 15. A future BOH meeting will
include a tour of the new space.
Dental update: The Carr Mill clinic closed permanently on August 16, with time for staff
to move out before the lease expires September 1st. Clinic renovations at Whitted began
mid-July. There will be eight operatories and an expanded sterilization area to more
efficiently treat clients in the consolidated clinic. All construction/renovation activities in
the consolidated dental clinic will end on August 30. The new space will reopen fulltime
on August 31.
September is National Preparedness Month. The Health Department will partner with
Orange County Emergency Services to sponsor a public information campaign to
promote emergency preparedness. Staff will launch a video contest in September called
“Ready in 60 Seconds” as the main campaign activity. The challenge is for residents
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(ages 18 and older) to submit an original video explaining the following points in 60-
seconds or less: (1) the importance of creating a household/family emergency plan; (2)
the importance of having an emergency plan for pets/animals; (3) ideal supplies for a 72-
hour emergency kit; and (4) the types of emergencies that could occur in Orange
County. The “Ready in 60 Seconds” contest will run from September 1 to October 15. A
panel of judges will select the three most creative and accurate videos. Winners will
receive an award package at the end of October that includes emergency preparedness
supplies. Emergency Services will place winning videos on the ReadyOrange.org web
page for public access.
b. Landfill Area Water Assistance Fund Update
On June 1, 2011, notification letters were mailed out to the 82 owners of wells that are within
3000 of the Orange County Landfill. The letter urged owners to fill out an application if they
were experiencing problems with their well water. Since that mailing, 27 people have sent in
applications for water samples. To date, we have received laboratory results for 18 of the
homes and have reported those initial results. Environmental Health is currently working with
the Finance Department to get quotes from contractors who will implement repairs or further
investigation of the wells.
c. Status Report on Debt Collection-EH Fees
A status report was provided showing results of the collection effort that Environmental Health
has undertaken to recover the delinquent fees associated with the wastewater treatment
management program (WTMP). This collection batch reflects all accounts that were overdue as
of January 15, 2011. The remaining delinquent accounts were referred to the County Attorney
office on August 9 for further notification and pursuit of the funds.
d. Media Clips
Media clips of current events relating to the Health Department and its activities were
provided for information.
VII. Board Comments/Announcements
Susan Elmore briefly mentioned the quarantined dog case that was brought to court. A Chapel
Hill woman filed a lawsuit against the county so her dog could finish his 6 month quarantine at
home. Her dog’s rabies vaccination was 46 days overdue when a raccoon that was retrieved by
animal control tested positive. The dog was outside where the raccoon was found, though
Garrett never saw her dog come into contact with the raccoon. According to N. C General
Statute 130a-197, if the local health director reasonably suspects an animal of being exposed to
the saliva or nervous tissue of another proven or suspected animal, the animal is considered to
have been exposed to rabies. If a pet suspected to have been exposed is not up to date on its
rabies vaccination, the county requires that the animal be quarantined at an approved facility for
up to six months. Owners who cannot afford quarantine have the option of euthanizing the
animal. Garrett had asked for a home quarantine and was denied. The dog was under
quarantine at a local vet when the case went to court. The judge residing in the case made a
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ruling granting Garrett preliminary injunction providing for home confinement of her dog for the
remainder of the quarantine period. Animal Control will do an on-site inspection and perform a
final health inspection on the dog in order for the quarantine to be completed and lifted. Garrett
will be responsible for the isolation of the dog in a secured locked room. The owner will assume
total responsibility for her family’s health.
VIII. Adjournment
Motion to adjourn the meeting at 9:35 p.m. was made by Steve Yuhasz, seconded by Paul
Chelminski, and carried without dissent.
The next Board of Health Meeting will be held September 21, 2011 at the Southern Human
Services Center Chapel Hill, NC at 7:00 p.m.
Respectfully submitted,
Dorothy Cilenti, MPH, MSW, DrPH
Interim Health Director
Secretary to the Board
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ORANGE COUNTY BOARD OF HEALTH
August 24, 2011
Board of Health Minutes Transcription completed by Lisa Smith August 24, 2011 1