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HomeMy WebLinkAboutBOH minutes 032410MINUTES ORANGE COUNTY BOARD OF HEALTH March 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 March 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 March 24, 2010 at the Southern Human Services Center, Chapel Hill, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Anissa Vines, Chair; Chris Harlan, Vice-Chair; Jim Stefanadis; Paul Chelminski; Mark Carstens; Steve Yuhasz; Tony Whitaker; Christopher Cooke BOARD OF HEALTH MEMBERS ABSENT: DeWana Anderson; Jessica Lee, out of town; Michael Wood STAFF PRESENT: Wayne Sherman, Personal Health Services Division Director; Tom Konsler, Environmental Health Services Division Director; Donna King, Health Promotion and Education Services Division Director; Angela Cooke, Dental Health Services Division Director; Carla Julian, Risk Management/Quality Assurance Director; Letitia Burns, Business Officer; Anne Miles Cassell, Administrative Assistant; GUESTS PRESENT: Emily Leazer, UNC Journalism School; Rebecca Putterman, Daily Tar Heel I. County Health Rankings Rosemary Summers gave a Power Point presentation of county health rankings. This report was funded by the Robert Wood Johnson Foundation and the ranking system developed by the University of Wisconsin. This system ranked approximately 3,000 counties across the country, however, the ranking only compared 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. As a result of this study, the rankings show that Orange County is first in health factors and second in health outcomes in the state. Nationally, another study funded by the Robert Wood Johnson Foundation ranked states and North Carolina ranked 37 out of 50. North Carolina through its four year cycle of community assessment continually examines and updates some of the same data contained in the report. Most of the achievements in Orange County’s health rankings can be attributed to the strong partnerships that exist between the two Orange County school systems, UNC Health Care, UNC, non-profit agencies, the business community and governments. Despite being higher in overall rankings 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 but 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. MINUTES ORANGE COUNTY BOARD OF HEALTH March 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 March 24, 2010 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 state wide average per capita funding. The department will work with partners to examine these results and use them to further increase the health of our residents to improve further in all areas. II. Welcome and Introductions Anissa Vines, Chair, called the meeting to order at 7:00 P.M. III. Approval of March 24, 2010 Agenda The motion to approve the Agenda of March 24, 2010 was made by Paul Chelminski, seconded by Mike Carstens, and carried without dissent. IV. Public Comment for Items NOT on Printed Agenda None V. Action Items on CONSENT Agenda A. Minutes approval of February 24, 2010 meeting. The Board must review and approve minutes of all meetings of the Board of Health. The transcript from the Joan Davidson Geothermal Well Hearing was included as an attachment to the minutes. B. Consolidated Agreement Renewal with NC DHHS The Consolidated Agreement stipulates provisions for receiving state and federal support funds for programs. At this time most program areas are funded at the same levels approved for the current budget year. There is a reduction in refugee health assessment funding since the incoming numbers of refugees has declined. In addition the Health Check Program was transferred to Community Care Networks in January 2010 representing a reduction of $35,000. The employee in that position was transferred to another position in the Department. Availability of federal public health preparedness funds are unknown but anticipated to be at the same level as the current year. The General Aid to County funds from the “Random Moment Time Study” has not been determined but is anticipated to be the same or greater than the current year ($24,994). The Division of Environmental Health with the Department of Environment and Natural Resources has not sent budgetary estimates but has indicated there will be cuts in the amount allocated to counties. Orange County currently receives approximately $6,000 for the Wastewater Program and receives basic funds for the Food and Lodging Program of $2,000 with supplements determined by performance throughout the year. MINUTES ORANGE COUNTY BOARD OF HEALTH March 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 March 24, 2010 Additional supplemental funds become available during the fiscal year in various programs depending on state ad federal action and on performance by the county. The total anticipated amount of funding as of July 1, 2010 represents between 8 – 10 percent of the overall health department budget. Amounts for specific program areas will not be finalized until after July 1 and will depend on budget discussions at the state level. The state consolidated agreement is anticipated to provide $528,211 federal and state funds to the county to provide specific services for fiscal year 2010-11. The Board was provided a spreadsheet detailing the amounts anticipated by program area. C. Renewal for Head Start Family Home Visiting Social Worker The Head Start contract between Orange County Health Department (OCHD) and Chapel Hill Training and Outreach, Inc. represents a collaborative relationship to provide family service coordination services to families eligible for and enrolled in Orange County Head Start and Orange County Health Department’s Child Service Coordination program. The collaboration for one social worker position presents parents with one unified program case coordinator who provides regular contacts to the family in order to identify and follow-up on child and family needs. The Family Service Coordinator supports the development of family self-sufficiency and promotes skill development in the areas of problem solving, decision making and accessing needed health and human services. The contract with Chapel Hill Training and Outreach, Inc has been in existence since 1999 and is renewed annually. During a recent Head Start federal review, the contract was tagged by reviewers and questioned as to the cost and value to Head Start. Although collaboration is regarded highly by Head Start, the salary and benefits of OCHD’s Social Worker fulfilling this role are substantially higher than what other Family Service Coordinators receive within the pay structure of Chapel Hill Training and Outreach. The Head Start Director has indicated that they would like to maintain the contract for the services of the current Family Service Coordinator because of her commitment and experience working with Head Start families but are asking for several enhancements or changes to the contract: 1) Cap the contract at the proposed rate of $60,831 (current salary and benefits for Family Service Coordinator). The Head Start Director initially requested to cap the contract at $50,000 but the Department indicated that would not be possible and recommended the current rate. Any future increases in contract costs will be paid out of Child Service Coordination revenue earned by the Family Service Coordinator. 2) The Head Start Director requested that OCHD provide lead testing on approximately 50 children. Medical providers are not testing children enrolled in Early Head Start and Head Start programs despite requests from the programs. Consequently the program was cited by federal reviewers for being out of compliance with the lead testing requirement. It was noted that some of MINUTES ORANGE COUNTY BOARD OF HEALTH March 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 March 24, 2010 the children may opt to receive ongoing medical care (preventive and primary) at OCHD. 3) Expect the Family Service Coordinator to stretch and expand her role since Head Start and OCHD supported her in earning her Masters degree. This may include serving more children with CSC services and taking on some of the duties of the vacant Head Start Health Coordinator position. It is felt by her supervisor at OCHD that the Family Service Coordinator is ready for the additional responsibility and has been indicating that she wants to equitably carry her load. A plan for expanded duties and expectations will be developed. Other changes in the contract from 2009 include identification of new personnel in key positions (Betsy Knop, Social Work Supervisor I) and a $711 increase in payment to OCHD from $60,120 per year to $60,831 ($5010 to $5069 per month). The contract is in effect from January 1, 2010 to December 31, 2010. The contract has been flagged for renewal discussion in October 2010 for CY 2011. Staff requested approval from the Board for these changes. D. Accept Additional Family Planning Funds The Department has been advised that an additional $2308 is available for the Family Planning Program. The funds will be used to purchase additional birth control devices. This amount has been forwarded to the Financial Services Department for a budget amendment to expedite spending the funds by May 31 as required. Motion to approve items on the Consent Agenda was made by Steve Yuhasz, seconded by Christopher Cooke, and carried without dissent. VI. Reports and Discussion with Possible Action A. Board Education Plan for 2010 Accreditation standards require the Board of Health to engage in regular education that pertains to the specific duties of the Board of Health. Each year, the Board adopts a general topical plan and schedule for addressing this standard. The Board generally tries to have six educational topics throughout the year. The Board policy manual requires each board member be present for three educational sessions. The schedule is flexible depending on the length of a particular agenda. Each year the Board discusses various educational topics it is interested in or feels that members need to further understand issues that confront the Board on a regular basis. This is an opportunity for the Board to express interest in various topics. Anissa Vines suggested NC CATCH as a topic. Rosemary Summers stated that a staff member is well versed in this topic and could prepare a presentation for the Board. A study of Board advocacy strategies and a discussion on limitations and MINUTES ORANGE COUNTY BOARD OF HEALTH March 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 March 24, 2010 boundaries, specifically to clarify the Board’s role in advocacy was suggested by Tony Whitaker. Chris Harlan suggested a session regarding the Health Care Bill and its implications for public health. School health/nursing programs was added by Chris Harlan and Anissa Vines along with air quality and environmental/geothermal wells systems. Christopher Cooke said that a case study approach to technical data would be informative. Rosemary Summers mentioned that DeWana Anderson, being the Board Liaison to the Animal Services Board could develop a presentation on rabies and public health. B. Board of Health Committee Assignment The Board annually reviews committee assignments for Board members and reviews need for various expertise on each of the three standing committees. The committees schedule regular meetings but only meet when there are discussion items that warrant a meeting. Christopher Cooke asked for further clarification of why Board members were assigned to specific committees. Rosemary Summers explained the need for expertise in the various fields that Board members are involved in and their role in advising the department of the best course of action. The Board reviewed the charges for each committee and reaffirmed that the assignments were correct and did not need to be changed. C. Follow-up to Joint Meeting At the joint meeting between the Board of Health and the Board of County Commissioners on March 4, there was significant discussion regarding the dual service model for dental health services. This was spurred by the impending expiration of the Carr Mill lease in October 2011. The Board of Commissioners requested that the Department consider various options for service provision to county residents along with a financial analysis. Zip code information for clients currently being served was recently received from the IT Department and was included in the report to the Board of Health. Staff members have worked on possible service model options and have estimated costs associated with each of the options. Commissioners indicated that they would welcome the Board of Health providing a recommendation for both a short term and long term solution. Board direction on the materials prepared by staff and possible recommendations would be useful in the decision-making process. The Board was asked to focus on: • Recommendations for the period beginning fiscal year 2011-2012 through 2019-2020. • Long-term facility recommendations that would be “ready for move-in” MINUTES ORANGE COUNTY BOARD OF HEALTH March 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 March 24, 2010 by the beginning of FY 2020-2021 The Department is in a position to need a decision on the renovation of the Whitted space for dental purposes no later than this summer in order to ensure that space would be ready prior to the lease expiration for Carr Mill. The Commissioners meeting agendas are busy with budget deliberations in May and June and then begin a summer break from the end of June through mid-August. Steve Yuhasz stated that as a Commissioner, a joint meeting is an important tool to utilize so Commissioners are aware of needs and long range planning for the Health Department. The more recent members of the Board volunteered favorable impressions of their experience. Paul Chelminski commented on the interest shown by the Commissioners in what the Board member had to say and he noted that this is not always the case with meetings of other groups he has experienced. Rosemary Summers distributed GIS data maps statistical data that show services and unduplicated patient visits data by zip code for Hillsborough, Carr Mill and Chapel Hill locations. The data maps enabled the Board to see more clearly where the Department’s patient base is located and also surprisingly showed that many patients live in one part of the county and seek service in another part of the county. The Board was asked to refer to the Dental Health Services map and relate it to the data provided on the spreadsheet from Angela Cooke, Dental Health Division Director. Angela Cooke answered questions and provided clarification of the spreadsheet of available options for the dental clinic to help the Board in the search for the best solution financially for the Department and for provision of services for the patients. Christopher Cooke noted that the maps and data indicate to him that travel may not be the barrier to clinic location as previously thought. Paul Chelminski asked about the percentage of total patients living in the Carrboro and Chapel Hill area and locations of safety net practices. Rosemary Summers stated that approximately 60 per cent of patients live in that area of the county. She also noted that the maps indicate that the services do cover all parts of the county well. Paul Chelminski stated that he would value Jessica Lee’s professional credibility and input on the various options offered for the dental clinic, however she was unable to attend this meeting due to a prior commitment out of town. Steve Yuhasz suggested staff provide additional data analysis and statistics and provide that along with the GIS data maps and spreadsheets from this meeting to the Board of Commissioners for a BOCC work session. D. Informational Items a. Davidson geothermal well appeal: At the February, 2010 BOH meeting, the Board held an appeal from Ms. Joan Davidson requesting that her geothermal well that had been constructed without a permit from the Health MINUTES ORANGE COUNTY BOARD OF HEALTH March 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 March 24, 2010 Department be accepted despite being located too close to the house foundation. The Board upheld the staff decision to issue a permit requiring that a new well be located in an acceptable location and that the improperly located well be abandoned. The following week, Ms. Davidson’s contractor returned to complete the job in accordance with the permit and the project has been issued a final approval. b. Follow-up letter to Town of Chapel Hill: The Board was provided with a copy of the letter sent to the town of Chapel Hill as directed by the Board of Health at the February meeting. c. Biosolids Summit Update: On March 16, 2010, the Board of County Commissioners was provided an update on the planned Biosolids Summit sponsored by NC State University. Health Department staff have participated in the planning committee meetings for the summit. The Summit will be held April 27 – 28, 2010. d. March is National Nutrition Month: National Nutrition Month® is a nutrition education and information campaign created annually in March by the American Dietetic Association (ADA). The theme for this year is “Nutrition from the Ground Up”. During National Nutrition Month®, the ADA reminds everyone that an easy way to focus on eating better is to start with the basics and build nutritional health from the ground up. Health can be improved with even minor weight reduction (5-10% weight loss). Also health can be improved by adoption of a healthy lifestyle, eating smart and moving more even if no weight loss occurs. ADA recommends starting slowly and building a good foundation to become healthier for a lifetime. Further information can be obtained by contacting Renee Kemske, MPH, RD, LDN, Registered Dietitian, Orange County Health Department, rkemske@co.orange.nc.us e. April is Public Health Month: April is NC Public Health Month – a chance to promote the role of public health in the state and the community. The Department will be releasing a series of public service announcements (PSAs). Each division has been asked to develop a PSA script promoting their section and services. The Board of Health was also encouraged to write and voice a script that explains their role in protecting health of county residents. We will use the PSAs throughout the year to tell the public about our role and services. f. Media Clips: Media clips relative to current issues were distributed to Board members. g. Pending and Recurring Items: A table of pending and recurring Board of Health agenda items is provided for reference on future planning. h. Rosemary Summers called the Board’s attention to an additional informational handout of a draft copy of “Public Health Improvement Plan Draft – Task Force Report” and noted that it would likely be finalized by the state legislature in April. MINUTES ORANGE COUNTY BOARD OF HEALTH March 24, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 8 March 24, 2010 VII. Board Comments Rosemary Summers reminded Board members that the Board of Commissioners would be holding public hearings on the budget for FY 2010-11 on May 20, 2010 (Hillsborough)and May 25, 2010 (Chapel Hill) and encouraged all Board members to attend one of the meetings as their schedules permit. VIII. Adjournment Motion to adjourn the meeting was made by Steve Yuhasz, seconded by Paul Chelminski, and carried without dissent. The next Board of Health meeting will be held on April 21, 2010 at the Government Services Center, Hillsborough, North Carolina at 7:00 PM. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board