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HomeMy WebLinkAboutBOH minutes 022410MINUTES ORANGE COUNTY BOARD OF HEALTH February 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 February 24, 2010 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 24, 2010 at the Government Services Center, Hillsborough, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Anissa Vines, Chair; Chris Harlan, Vice-Chair; Tony Whitaker; Mike Carstens; Jessica Lee; Steve Yuhasz; Christopher Cooke; Michael Wood BOARD OF HEALTH MEMBERS ABSENT: Paul Chelminski; DeWana Anderson due to illness; Jim Stefanadis due to work conflict STAFF PRESENT: Rosemary Summers, Health Director; Wayne Sherman, Personal Health Services Division Director; Tom Konsler, Environmental Health Division Director; Donna King, Health Promotion and Education Division Director; Angela Cooke, Dental Health Services Division Director; Letitia Burns, Business Officer; Carla Julian, Quality Assurance/Risk Management Director; Anne Miles Cassell, Administrative Assistant; Dr. Michael Fisher, Medical Director; Annette Moore, Staff Attorney; Jamie Land. GUESTS PRESENT: Joan Davidson, Homeowner; Emily Leazer, Carolina Journalism Network; I. Welcome and Introductions Anissa Vines, Chair, called the meeting to order at 7:00 P.M. and welcomed guests. I. Approval of February 24, 2010 Agenda The motion to approve the Agenda of February 24, 2010 was made by Chris Harlan, seconded by Jessica Lee, and carried without dissent pending confirmation at the April BOH meeting. II. Davidson Appeal Hearing Discussion Mrs. Joan Davidson filed an appeal with the Health Director in accordance with NC GS 130A- 24. The documents for Board members to review prior to the appeal were included with the Agenda packet mailed the week prior to the meeting. Ms. Davidson waived the 10 day notice prior to the hearing and agreed to have the appeal at this meeting. In her appeal letter Ms. Davidson requested the addition of an emergency provision to the Orange County Water Protection Rules and/or the Orange County Environmental Health Division Policies that would allow for default to the NC State Geothermal Well Construction Standards in special cases that are brought before the board where the use of these less stringent rules would not cause potential hazards to environmental degradation or public health and would allow for fairer or more cost efficient geothermal installation than the current County standards allow. She asked approval of her case as one such exception. The Board of Health is governed by NCGS 130A-24 (c): The local board of health shall hold a hearing within 15 days of the receipt of the notice of the appeal. The board shall give the person not less than 10 days’ notice of the date, time and place of the hearing. On appeal, the board shall have authority to affirm, modify or reverse the challenged action. The local board of health shall issue a written decision based on the evidence presented at the hearing. The decision shall contain a concise statement of the reasons for the decision. MINUTES ORANGE COUNTY BOARD OF HEALTH February 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 February 24, 2010 The Board does not have the legal authority to alter the adopted rules of the Board at the meeting. Altering the adopted rules must follow the procedure for local rule adoption as specified in NCGS 130A-39. Please see attached Addendum A. to the minutes for the full transcript of the hearing. Anissa Vines reminded the Board that the decision before the Board is whether or not staff applied the rules appropriately and that the Board could either modify, affirm or reverse the staff’s decision. Michael Wood stated that he felt the Board could make a decision based on the testimony and clarified that only a decision on staff’s performance in accordance with current well rules was being decided. Steve Yuhasz asked if Ms. Davidson would have relief available if the Board decided that staff applied the rules appropriately. Anissa Vines replied that Ms. Davidson could appeal our decision in District Court. Commissioner Yuhasz said that without getting to get a sense of the Board as to what other remedies there might be if we decide, then Ms. Davidson couldn’t come back to this Board and regardless of what other considerations the Board may want to have as far as what the rules are and what they say, and what they should say; it would foreclose any opportunity for this Board to provide any relief for this particular applicant if we make a decision tonight. Anissa Vines said that that was correct. Steve Yuhasz expressed the opinion that before a decision is made a discussion should be held as to whether the rules as they are currently stated need to be modified in some way to meet specific conditions. Anissa Vines stated that she was going to defer that to the County Attorney, Annette Moore. Annette Moore asked Commissioner Yuhasz if he was considering modification of the rule before making a decision and he affirmed that was his question. Ms. Moore stated that the Board could not modify a rule without following due process for rule amendments and further; that “a rule is a rule as applies on the day that she took the action.” Christopher Cooke asked for clarification that what the Board had to work with was a decision on a technicality, whether or not the staff applied the rules as written appropriately. In other words, were they able to tell the difference between 21 feet and 25 feet? Is that what it comes down to? Anissa Vines replied that basically it is whether or not Tom Konsler reviewed the rule that we have approved as a Board and applied those rules correctly so that he appropriately measured and did all the things contained in the rules. Christopher Cooke asked if it would actually pose a threat to the water quality, if the contractor who drilled the well has any liability and if we could give her a waiver. MINUTES ORANGE COUNTY BOARD OF HEALTH February 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 February 24, 2010 The Chair confirmed her understanding of the issue in question. Michael Wood stated that those options were never brought to the table. Christopher Cooke stated he was going by the language in Ms. Davidson’s appeal letter. Anissa Vines said that the only thing the Board could address was whether the rules were applied correctly. Chris Harlan said that this was apparent frustration expressed by Ms. Davidson if she was reading it correctly. I am not sure that is what Ms. Davidson was asking to begin with and so it is kind of frustrating to spend all the time coming down to whether the rule was actually applied correctly when there’s so many other issues around it and we don’t have any voice in any of that. Anissa Vines stated that she felt that this was explained to Ms. Davidson. The goal of the Question and Answer session to determine was whether or not there was something that was missed in applying the rule that could work out in her favor. Ms. Vines then asked the Board for a motion to modify, affirm, or reverse the decision of the staff. Motion to affirm the decision of the staff was made by Michael Wood, seconded by Christopher Cooke and carried without dissent. The Chair thanked Ms. Davidson and everyone for their testimony. Steve Yuhasz asked for confirmation that staff has had discussion with Chapel Hill planning and inspections to assure that this type of issue would not reoccur. Tom Konsler replied that the day he became aware of Ms. Davidson’s issue he set up a meeting with both Chapel Hill planning and Chapel Hill building inspections and made them aware of all the activities of environmental health across the spectrum from food and lodging to permitting of subdivisions where we needed to be involved. They invited us back to talk with their staff and that is scheduled for February 25 (tomorrow). Commissioner Yuhasz stated that he felt a strong statement of our dissatisfaction with the way that they handled this particular situation would be in order. Rosemary Summers said that the County Manager has already communicated with Mr. Stancil in Chapel Hill but this Board can certainly choose to do that as well. If you would like for the Board to send a letter to the Town of Chapel Hill, we can certainly do that. Steve Yuhasz said he felt that would be appropriate. Chris Harlan asked if the contractor was licensed in Orange County. Tom Konsler stated that the project contractor had to be licensed in Orange County for building inspections, but the well driller he hired to drill the geothermal well had to be licensed in North Carolina and registered with Environmental Health in Orange County. Motion by Steve Yuhasz for the Board of Health to communicate to the Town of Chapel Hill our dissatisfaction with their inability to appropriately inform citizens of the requirements of the Orange MINUTES ORANGE COUNTY BOARD OF HEALTH February 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 February 24, 2010 County Health Department when that is necessary was seconded by Christopher Cooke, and carried without dissent. Rosemary Summers introduced new staff member, Jamie Land. III. Public Comment for Items NOT on Printed Agenda None IV. Action Items and Reports A. Minutes approval of January 27, 2010 meeting. Minutes of the previous regularly scheduled Board of Health meeting were provided for review and approval. Motion to approve the minutes of January 27, 2010 Board of Health meeting was made by Chris Harlan, seconded by Tony Whitaker, and carried without dissent. B. Rogers Road Water and Septic Survey Results In June of 2009, Orange County was interested in pursuing an application for Community Development Block Grant funding from the State of North Carolina for water and sewer infrastructure improvements to the Rogers Road neighborhood. The Orange County Health Department was asked to provide a statement of need based on widespread septic system failures in this area. A statement was prepared, but it lacked information that could only be provided by conducting an onsite survey of septic system performance and failure rates. UNC had earlier conducted a collaborative investigation of water quality; however, those results were not available for consideration because of confidentiality promises made to residents and the Institutional Review Board. Tom Konsler reported that staff met several times in 2009 with community representatives, the UNC Student Chapter of Engineers without Borders, UNC Epidemiology faculty, and others to explore the neighborhood’s concerns and seek out remedies. In October of 2009, Minister Robert Campbell submitted a request to the Health Director to conduct a survey of the area to document well and septic system failures. In November the Board of County Commissioners approved funding to pay for water sampling costs for the survey. Staff subsequently received approval for reimbursement of the sampling costs to be paid by the state’s Bernard Allen Memorial Emergency Drinking Water Fund. Tom Konsler briefly presented PowerPoint slides and a preliminary report showing the results of the well and septic system survey which was conducted during the first two weeks of 2010. A total of 45 homes participated in the survey and another 25 were unable to be reached. Of those contacted all were served by septic system and 11 were served by well water. Out of the 11 wells tested only one well met all of the EPA recommend limits across all of the bacterial and chemical parameters tested. Testing revealed that 10 of the 11 well water supplies exceeded one or more water quality MINUTES ORANGE COUNTY BOARD OF HEALTH February 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 February 24, 2010 standards and six of them exceeded one or more health related standards. The average age of the wells in the survey area is approximately 35 years old. It is expected that individual water quality problems noted during the survey could be remedied by either repairing the wells with liners to seal off contaminants, by installing water treatment equipment, or by connecting the homes to the public water supply system. Michael Wood asked for clarification on whether the Habitat for Humanity homes that are part of this community have well and septic or city water and sewer. Mr. Konsler said that the Habitat part of the neighborhood had city sewer and water. Of the 45 septic systems assessed, 21 were compliant, 10 were non-compliant, 2 needed maintenance, and 12 were malfunctioning. Of the 12 malfunctioning systems, seven were found to be in need of replacement. Of these seven, further investigation revealed that there is no suitable soil for an on-site repair. The average age of the septic systems in the survey area was 32 years. Steve Yuhasz asked if the wells and septic systems that were shown to be failing were fixable. Tom Konsler replied that some of the failing septic systems may be remedied by performing maintenance to restore functionality. For others, connection to the public sewer may be an option, but this will require crossing other parcels of land, obtaining easements, installing private sewer lift stations, or extending the sewer mains at a considerable cost. Mr. Konsler stated that there is still a need to work with the task force to identify funding sources for a long-term solution. He stated that the Bernard Allen Memorial Emergency Drinking Water Fund will most likely be one source available to help people connect to the OWASA drinking water system that is already there. The No Fault Well Repair Fund that the County Manager is proposing may be another source for either repair or connections to OWASA. He stated that due to the topography it would be approximately a $2 million fix. Mike Carstens asked if the homeowners have received the reports. Mr. Konsler stated that they are working on it but have not provided the individual homeowners with a report on their systems yet. Plans are to provide those reports soon. A community meeting is under consideration to present the findings to the homeowners. Michael Wood asked if those homeowners with an end-of-life septic system were aware of the repercussions. Tom Konsler replied that they were aware and that a question in the survey dealt with this. Of the 45 surveyed all but two stated they would be willing to connect to the OWASA system if funds were available. Mike Carstens asked if the homeowners were obligated to act on the reports, especially the homeowners with end-of-life septic systems and wells with water quality issues. Tom Konsler replied that the reports should be presented along with finding solutions to address the repairs needed. Tony Whitaker asked whether there was a difference between what was considered acceptable drinking water standards and wells that posed health issues. Tom replied that the 3 wells that had bacterial contamination posed health issues. Tony said he MINUTES ORANGE COUNTY BOARD OF HEALTH February 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 February 24, 2010 found it interesting that the average percentage of wells containing coliform bacteria was lower than Orange County at-large, although he realized that it was too small of a sample to provide a sound scientific comparison. Tom Konsler emphasized that no conclusions should be drawn regarding water quality with this small of a sample. Tom Konsler stated that this report would be presented to the Board of County Commissioners on March 16. It will also be presented to one of the Assembly of Governments task forces. Board members were requested to send any comments or suggestions to Tom Konsler prior to the presentation to the BOCC. Christopher Cooke asked what the students that helped with the study were doing with the study results. Tom Konsler replied that two students that worked closely with him were using it for their practicum. C. 2010-2011 Budget Request Rosemary Summers presented the annual budget request to the Board for review. The budget was prepared as directed by the County Manager. Departments were directed to examine services being provided and consider reductions or adjustments in non-core service programs. Dr. Summers pointed out that the proposed budget request has no increases in operating expenses for the year. There are no new positions. The budget reflects reductions in personnel experienced by the department this year with proposed permanent reductions for some of those positions. Last year departments were directed to budget personnel at 96%; this year personnel costs are budgeted at 100% and therefore personnel costs appear higher, especially in the smaller divisions which remain fully staffed, but it is a more accurate reflection of costs. Budget and personnel reductions were summarized by division. Jessica Lee asked if budget shortfalls are taken into consideration in the projected revenues. Dr. Summers stated that current revenues were used and then staff tried to anticipate whether those revenues would remain stable, increase or decrease. This year the capital request is only for the upcoming year. Most of the capital items requested have been requested in previous years, approved by Commissioners and then frozen due to budget shortfalls. Conversion of the CNG (compressed natural gas) vehicles to gas powered vehicles is new this year. In previous year’s purchases, the department was directed to purchase previously owned CNG vehicles to improve energy efficiency. The county has not been able to successfully sustain a fueling station for these vehicles and they have not been able to be used for a number of months. The future of the fueling station in uncertain and these vehicles are needed by field staff. Not included in this request are renovation costs associated with the Whitted Center reassignment of space to the Health Department. The fee schedule including new fees was provided as part of the budget request documents. Environmental Health does have an increase in several fees but clinical MINUTES ORANGE COUNTY BOARD OF HEALTH February 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 February 24, 2010 fees for both dental and personal health services are not being recommended for general increases this fiscal year. It was pointed out that the “Fee and Eligibility Policy” adopted by the Board, calls for fees to be increased by the Consumer Price Index for the year. The CPI for 2009 was .7%. The increase is minor enough that the increases would not significantly affect revenues for the department. A few items in environmental health including public swimming pools and septic tank yard inspections have increased. Motion to approve the fee schedule as presented was made by Michael Wood, seconded by Chris Harlan, and carried without dissent. Motion to accept and forward the budget request to the Board of County Commissioners for action was made by Chris Harlan, seconded by Michael Wood and carried without dissent. D. Review of Joint BOCC/BOH Agenda Items The Board of Health will be meeting with the Board of Commissioners on March 4 beginning at 5:30. At the January meeting the Board indicated that they would like to discuss two topics with the Commissioners: 1) Recession impacts on service; 2) Two- service model and the impact on the budget; i.e. the costs of providing services in two locations without dedicated staff for both locations (dental); plus the commitment of the county to adequately fund equipment for a two service model. Statistics will be finalized and available before the meeting. At one of the BOCC work sessions earlier this month, Commissioners discussed the two service/two facility model that is currently the practice for some services the county delivers. They requested more information about service delivery by zip code of those currently being served to determine whether one or two service locations were necessary and where a single service site should be located. They would also like to consider options for contracting for service delivery with a provider rather than maintaining two facilities in different locations and it was suggested by at least one Board of Commissioner member that a contract for dental services could be developed with the UNC School of Dentistry to serve low income residents at the School of Dentistry. In addition, the Board of Commissioners discussed whether they were committed to exercising the option to buy on the lease currently held for the Hillsborough Commons property (re-location site for Social Services). The option to buy the property according to the agreement signed by the county must be exercised by April 2012. In discussion at the work session, Commissioners indicated that they did not believe that there would be sufficient funds available to exercise that option to buy. This leaves the county without a plan to relocate the Health Department out of the Whitted Building for the foreseeable future. The Board of Health discussed and refined points that they would like to discuss with Commissioners and determined who would be in attendance to present to Commissioners. Christopher Cooke volunteered to be a spokesperson on behalf of the Board of Health. Jessica Lee stated that she would be out of town on the date of the joint meeting. MINUTES ORANGE COUNTY BOARD OF HEALTH February 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 8 February 24, 2010 Christopher Cooke stated that he felt that a comparison between results versus spending would be a good talking point. Steve Yuhasz asked where Orange County ranks on local per capita spending within the state. Rosemary Summers said that it is broken down into state and local funds and she would provide that information for the joint meeting. E. County Health Rankings Rosemary Summers directed the Board to the PowerPoint slides and the attached report summarizing Orange County’s health rankings. The Robert Wood Johnson Foundation funded the University of Wisconsin Population Health Institute to develop a ranking system for all local counties across the country. The ranking compares counties to each other within a state. The rankings are intended to help counties compare the multiple factors that influence health so that people can see where they are doing well and where they need to improve. The rankings show that Orange County is first in health factors and second in health outcomes. These rankings were determined by examining data sets from certain points in time. North Carolina is in a four year cycle of community assessment and continually examines and updates some of the same data points contained in this report. Most of the achievements in Orange County’s health rankings can be attributed to the strong partnerships that exist between both school systems, UNC Health Care System, UNC, non-profit agencies, the business community and governments. One place all of these partners come together is through Healthy Carolinians of Orange County. These partners collaborate to address high priority health issues for county residents. In the last ten years focus has been on mental health services, prevention of child abuse and neglect, reducing obesity in children, and improving access to health services. Despite being higher in rankings overall, there are areas for improvement. The lowest scores for Orange County were in physical environment factors that contribute to health. These measures were ozone and particular matter days in 2005 and access to healthy foods and the density of liquor stores. Work has already occurred in these areas and this is an indicator that more work is needed. The availability of multiple farmers’ markets across the county and the growing movement to start and foster community gardens has already started to improve access to healthy foods. This also may provide new opportunities for economic development of full service groceries in areas of the county that have limited access to fresh fruits and vegetables. It should be noted that Orange County is in the lower third of all counties for per capita expenditures for public health and falls below the statewide average for per capita. The Department will work with partners to examine these results and use them to further increase the health of our residents and ensure that we do not become complacent by these achievements. F. Informational Items MINUTES ORANGE COUNTY BOARD OF HEALTH February 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 9 February 24, 2010 a. Media Clips: Media clips of relevant topics were provided for the Board. b. Pending and Recurring Items: The pending and recurring items chart provides the Board the opportunity to preview upcoming items that will be on future Board agendas. V. Adjournment Motion to adjourn the meeting was made by Chris Harlan, seconded by Steve Yuhasz, and carried without dissent. The next Board of Health meeting will be held on March 24, 2010 at the Southern Human Services Center, Chapel Hill, North Carolina at 7:00 PM. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board