Loading...
HomeMy WebLinkAboutBOH minutes 062310MINUTES ORANGE COUNTY BOARD OF HEALTH June 23, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 June 23, 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 June 23, 2010 at the Link Government Services Center, Hillsborough, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Anissa Vines, Chair; Steve Yuhasz, Commissioner Representative; Jim Stefanadis; Tony Whitaker; Christopher Cooke; Mike Carstens BOARD OF HEALTH MEMBERS ABSENT: Jessica Lee, out of town; Paul Chelminski, meeting conflict; Chris Harlan, out of town; Michael Wood, meeting conflict STAFF PRESENT: Wayne Sherman, Personal Health Services Division Director; Tom Konsler, Environmental Health Services Division Director; Carla Julian, Risk Management/Quality Assurance Director; Letitia Burns, Business Officer; Anne Miles Cassell, Administrative Assistant; Pat Gentry, Preparedness Coordinator; Judy Butler, Community Health Services Supervisor GUESTS PRESENT: Elysse Thebner and Breana Lai, UNC School of Public Health students I. Educational Presentation: Tom Konsler Tom Konsler, Environmental Health Division Director, spoke on a topic currently of interest to the Board, Geothermal Wells. The Orange County Board of Health in 1980 was the first Board to adopt local well regulations. In the mid-1990’s that was expanded to groundwater protection regulations. Approximately 40% of Orange County population relies on groundwater for drinking water source. In 2008 all North Carolina counties were required to implement drinking water well rules and the majority began enforcing state rules rather than adopting a separate county policy with the exception of 10 counties that enacted their own local regulations. The Orange County Groundwater Program provides well regulations for permitting, consisting of site approval, specifications, construction observation, and regulates approval of drinking water wells, irrigation and agricultural wells, monitoring wells, geothermal wells and well abandonment. Use of geothermal wells is on the increase. Mr. Konsler noted that applications for geothermal well permits are at mid-year, nearing the total permits for last year. He gave a brief overview and illustrations of the different well types and construction methods. Geothermal systems include open systems and closed systems. An open system known as a “pump and dump” is a water supply well that discharges to the surface and requires a traditional well permit. A water supply well that is a re-injection system requires local permits and a state DWQ permit. Geothermal systems are efficient due to a constant ground temperature of 50 – 55 degrees. System cost is approximately $2,500 per ton with a five to six year pay-back plus tax credits and incentives. Examples of geothermal wells in Orange County include Chapel Hill public works facility (85 wells), UNC Botanical Garden (28 wells), Orange County justice facility (68 wells), and increasing residential use. Jim Stefanadis asked how closely the wells are spaced MINUTES ORANGE COUNTY BOARD OF HEALTH June 23, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 June 23, 2010 when there are so many. Tom Konsler stated that the wells are approximately 20 feet apart. There are two types of closed loop geothermal systems; a vertical loop using water and a vertical loop using mixed fluid. Closed loop geothermal systems are regulated as a protection to groundwater resources. Every well is considered a “wound” in that protection. Protection needs to be assured primarily during the construction process for contractor accountability. Orange County generally has more stringent setback regulations than the state. Orange County Environmental Health will continue to participate with the state in rulemaking, information gathering, adherence to current standards and preparation for amendments to Orange County Rules. Tony Whitaker asked if the direct exchange wells were still grouted and Tom Konsler replied that they are. II. Welcome and Introductions Anissa Vines, Chair, thanked Tom Konsler for the educational presentation and called the meeting to order at 7:30 P.M. She introduced the guests present. III. Approval of June 23, 2010 Agenda Wayne Sherman requested the addition of Item IV.J. Fee Revision. The motion to approve the Agenda of June 23, 2010 as amended was made by Steve Yuhasz, seconded by Christopher Cooke, and carried without dissent. IV. Public Comment for Items NOT on Printed Agenda None V. Reports and Discussion with Possible Action A. Minutes approval of May 26, 2010 meeting. 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 May 26, 2010. Tony Whitaker requested a correction under Item V.D. paragraph nine to change “C&G” to “CNG”. Motion to approve the Minutes of May 26, 2010 meeting as amended was made by Christopher Cooke, seconded by Tony Whitaker, and carried without dissent. B. Annual Communicable Disease Report An annual report on the status of communicable disease issues is provided by the Community Health Services Supervisor per accreditation requirements to keep the Board of Health informed. Judy Butler, RN, Supervisor of the Communicable Disease MINUTES ORANGE COUNTY BOARD OF HEALTH June 23, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 June 23, 2010 program at Orange County Health Department (OCHD) provided a retrospective report on communicable disease activities for CY 2009 and updated the Board of current on communicable disease issues being addressed in 2010. North Carolina has over 70 reportable diseases. She pointed out the number of Hepatitis B cases, the majority did not speak English. For those not familiar with the follow up procedures, it is very time consuming, especially when there is an interpreter required. Another big issue during the year was whooping cough (pertussis) cases. Over the school year we had 26 cases. A significant number were not vaccinated, however many were. It is now known that vaccination protection wanes with time and therefore protection is not guaranteed. Christopher Cooke asked if vaccination information is public information. Ms. Butler stated that vaccination information is on the school records and that information is not public. Steve Yuhasz noted that the pertussis outbreak was in SY 08-09 and that no cases have been reported to date, and asked for confirmation of his understanding that the outbreak was just an unusual situation. Ms. Butler replied that 2 or 3 cases a year is not unusual. What happened with the outbreak in 08-09 is that when the first reported case was received and staff began tracing back 6 weeks (the period of time that child was contagious with pertussis), it was discovered that there were 7 other children that were contagious in the schools and undiagnosed. These children had been to many social events and were in contact with many other children during this time. There were 10 schools with reported cases. She stated that the school nurses deserve a lot of credit and that Orange County is very lucky to have a nurse in every school. Any reported possible contact with a potentially rabid animal or suspected rabid animal is investigated. Since it is not always possible to locate or capture a suspected animal all contact with that animal must be treated as possible rabies. The department provides 24/7 call coverage for rabies consultations. The staff nurses work closely with animal control officers to receive reports of possible exposures. TB cases have decreased this year. It requires six to nine months treatment and is labor intensive for communicable disease staff that must personally administer and witness the patient take every dose of the antibiotic. The medical provider breakfast that was held at Southern Human Services Center in the spring highlighted the current outbreaks and was well received. Providers have expressed interest in repeating this event and found it useful and informative. There was a good turnout from the medical community and the department is planning to repeat this event in the fall. Anticipated challenges for the last half of 2010 are continued reduction in money for free vaccine from the state and not knowing what to expect for the next flu season. Mike Carstens asked where the one reported case of plague came from. Ms. Butler explained that the reported case was due to an accidental exposure in a research lab. MINUTES ORANGE COUNTY BOARD OF HEALTH June 23, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 June 23, 2010 Christopher Cooke asked why Lyme Disease did not require a contact history. Ms. Butler said that Lyme Disease is a reportable disease but it is not transmittable from person to person, therefore a follow up on contacts is unnecessary. C. Annual Public Health Preparedness Update Pat Gentry, Preparedness Coordinator, reported that Orange County Public Health Preparedness efforts thus far in 2010 have been focused on the NC Division of Public Health’s onsite review of OCHD’s recently updated Strategic National Stockpile (SNS) Plan, continued response to H1N1 influenza pandemic, the revision of OCHD’s Continuity of Operations Plan (COOP) and beginning revisions to the Pandemic Influenza Plan. The SNS Plan update is an annual state Division of Public Health submission and this year, Orange County Public Health was selected as one of seven statewide onsite plan assessments conducted in April 2010. The SNS Plan describes Orange County’s systematic organization used to request, receive, store, distribute and dispense SNS assets (large quantities of medicine and medical supplies). It sets forth lines of authority, roles and responsibilities, and organizational relationships between Federal, State and local governments. The Orange County SNS Plan as chosen for a random onsite review by the state and scored 88.1, the highest score in the state. The average score throughout the state was 69. The plan was successfully activated for the H1N1 Flu event, as all North Carolina counties received SNS supplies (anti-virals, masks) from the federal government. At the mass vaccination event in November, 1,084 citizens were vaccinated in a 6-hour period. One lesson learned was the need for prepackaging of supplies for rapid deployment to dispensing points prior to an event. This is a goal for 2011. Other goals are development of a radio communications plan and identification of “at risk” populations. The Continuity of Operations Plan (COOP) and Pandemic Influenza Plans are additional annexes to OCHD’s overall Public Health Emergency Operations Plan, which follows Orange County’s Multihazard Plan and the National Incident Management System (NIMS). Christopher Cooke asked if there was also a security plan for the warehouse since a security plan for the points of dispensing was mentioned. Ms. Gentry stated that there is a security plan for the warehouse and that she does a monthly inventory of supplies that are warehoused. The estimate of a pandemic influenza disease burden was based on an attack rate of 20%. Christopher Cooke asked for clarification on the meaning of “attack rate”. Ms. Gentry explained that attack rate is based on how many in a given population would be affected by a pandemic, 20% being a mild pandemic. She further explained that the attack rate also takes into account how virulent the outbreak is. Orange County is basing their planning on a 40% rate for the COOP plan. Anissa Vines asked if a 2011 goal is to expand training to local law enforcement in the MINUTES ORANGE COUNTY BOARD OF HEALTH June 23, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 June 23, 2010 area. Ms. Gentry stated that they would like to train with every law enforcement agency and then start training with the fire departments because as the plan evolves, the fire departments will be a bigger player. The Chair also asked what sort of progress has been made in reaching the at-risk groups. Ms. Gentry replied that communications with Emergency Management has determined that Social Services would be the best source to begin identification of those with special needs and further study will be done. Rosemary Summers stated that Emergency Management would be the most likely to be responsible for the special needs individuals rather than the Health Department. Steve Yuhasz asked what method of alert notification is followed for public officials. Rosemary Summers stated that EMS would be the one to make the decision on the level of alert and would then coordinate the contact efforts. D. Social Justice Goal Implications In 2005 a student group approached the Board of Health about sponsoring a “health care as a social justice” goal with the county. The Board discussed the proposal and determined that this was broader than the scope of the Board’s expertise and authority and encouraged the students to approach the Human Rights and Relations Commission. Over the intervening years, the Human Rights Commission has worked on crafting a social justice goal that reflects Orange County residents’ values. The Board of Commissioners has discussed several versions of the goal, most recently this past spring. From that discussion, it appears that this goal is reaching completion and may be acted on by Commissioners this fall. A draft was provided for Board of Health members so that they could discuss the implications of the material in the goal for the future work of the health department. Discussion by the Board for future directions could be included in the strategic plan that will be updated in 2011. Christopher Cooke asked Steve Yuhasz if he thought the Commissioners were planning to act on the Social Justice Proposal this fall. Commissioner Yuhasz stated that a presentation had been given to the BOCC a month ago however he said he did not know if the Commissioners were planning any action on it at this time, however, there had not been any opportunity for discussion. Christopher Cooke also stated that he found it ironic that the group came to the Board of Health to talk about health equity and when looking at the Social Justice Goal there is little or no mention of health. Without looking at Appendix A and Appendix B which is a complete explanation of the data that was collected, it is hard to know why they organized the different elements of social justice the way they did. Looking at it without any of that information the first reaction is where is the health goal and why health, shelter, clothing, or food are subsumed under economic self-sufficiency. He stated that health should be as important as safety or elimination of oppression. Rosemary Summers explained that when the group first approached the BOH they were interested in health equity more on a global scale in terms of things they felt made up MINUTES ORANGE COUNTY BOARD OF HEALTH June 23, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 June 23, 2010 health equity. The first draft that came back from the Human Rights and Relations had more state-wide policy implications than they did local, such as making sure there was health insurance for everyone. Many of the things that came back to the Board the second time were outside of the scope of what a single county government can do. Since then the only thing noted was a change in focus to medical care instead of health care. It does have some enormous implications for the county, both financial implications as well as policies. Tony Whitaker stated that in reading through the social justice goals use of the word “ensure” waved a red flag at him. It implies the highest level of execution and funding towards that particular goal and that may not be the reality we live in. Steve Yuhasz added that he had also noted the wording usage when he read the document. Jim Stefanadis said the document as it stands has serious implications for the county and needs to be looked at more closely. He suggested a letter to the BOCC expressing these thoughts would be in order. Both BOH subcommittees agreed to look at this more closely. Motion to refer the draft Social Justice Goals to committees for discussion was made by Jim Stefanadis, seconded by Christopher Cooke and carried without dissent. E. Budget Update The final work session on the FY 2011 was June 8, 2010 and the Board of Commissioners adopted the budget at their regular meeting on June 15th. Rosemary Summers reported on the outcome of the county budget. It included additional resources back to the department. Permission was received to recruit to two vacated retirement positions and also $100,000 in funds for dental health equipment. One unexpected item was the transfer of one position to the health department of the breastfeeding outreach worker from Cooperative Extension. This new staff member is fully bilingual and will be a good fit with our maternal health care program. The House and Senate Budget Conference Committees have met to come to consensus on differing provisions within the state budget bill. At this point no final vote has been taken. Childhood vaccination funding is in question. Also, the accreditation program was being zeroed out. Representative Insko was able to replace $350,000 in the budget for accreditation this year. These are big concerns right now. Smart Start funding is also questionable at this point and the department stands to lose two of its programs if funding is eliminated. Christopher Cooke stated that the idea of going to a national accreditation standard is unreasonable because North Carolina’s accreditation standards is ten years in development now and is really very advanced. He stated that the national standard is a watered down copy of what North Carolina already has in practice. This would affect the state’s ability to achieve its 2020 health goals and that he hopes the MINUTES ORANGE COUNTY BOARD OF HEALTH June 23, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 June 23, 2010 legislature will continue to fund the NC system. Motion to send a letter to Representative Verla Insko from the Board of Health thanking her for her advocacy for public health funding for accreditation and immunization was made by Christopher Cooke, seconded by Tony Whitaker, and carried without dissent. F. July Meeting Cancelled The Board generally does not meet in July, however a meeting is usually on the books in case there is pressing business. Since a meeting is officially on the calendar, the Board must formally vote to cancel the July meeting if it so desires. The next meeting would then take place on August 25, 2010 at a Hillsborough location. We will be looking for an alternate location. Motion to cancel the July 28, 2010 Board of Health meeting was made by Steve Yuhasz, seconded by Mike Carstens, and carried without dissent. G. BOH Policy Manual Review Pre-Review July is the annual review month for the Board of Health Policy Manual. The Manual was distributed as part of the Board packet so that all Board members would have sufficient time to review the contents, make notes on recommendations for changes, and communicate recommendations for changes to a committee member prior to August first. The committee charged with review and recommending changes is Chris Harlan, Chair of the Committee, Christopher Cooke, and Jim Stefanadis. Ms. Harlan will not return from Guatemala until July 1st and asked that one of the other committee members volunteer to be the gathering point for comments from other Board members. Jim Stefanadis will also be leaving the Board as his term expires on June 30, 2010 and a volunteer from the Board to temporarily assist with the review was requested. This committee will meet and be ready to make specific recommendations for change to the Board of Health at the August meeting. Tony Whitaker agreed to join the committee and Christopher Cooke agreed to receive the recommendations for changes in the absence of Chris Harlan. H. Joint BOH/BOCC Meeting The Board of Health (BOH) usually requests an annual meeting with the Board of Commissioners (BOCC) to discuss items of mutual interest. Last fiscal year the meeting was in the spring. The published calendar of meetings for the Board of Commissioners shows a dinner meeting scheduled for October 12, 2010. Chair Vines can send a formal letter requesting such a joint meeting. Topics could include the two-service model (since the data has been sent) and/or Commissioner input on focus areas for the next strategic plan for the Health Department. MINUTES ORANGE COUNTY BOARD OF HEALTH June 23, 2010 Board of Health Minutes Transcription completed by Anne Miles Cassell 8 June 23, 2010 Motion to request at joint Board of Health/Board of Commissioners meeting on October 12, 2010 was made by Mike Carstens, seconded by Christopher Cooke, and carried without dissent. I. Informational Items a. Media Clips: Media clips of current events relating to the Health Department and its activities were provided for information. b. Pending and Recurring Items: Pending and recurring items are regularly included to identify upcoming agenda items. The 2010 education topics have been added. c. TRU Newsletter: Tobacco Reality Unfiltered (TRU) Students from all five area high schools have had a very productive year. FY 09-10 highlights were summarized in a year-end newsletter Orange Country TRU News and included for Board members information. Major projects included the Franklin Street cigarette butt pick up, Tobacco 101 classes for middle school students, Video PSA, Merchant Education, Kick Butts Day Celebrations, and more. d. Letter of Appreciation: A letter of appreciation for the Health Department was written to the Board of Commissioners by a Health Department medical and dental client in support of no budget cuts and a copy attached for information. e. PHRC June 2010 Newsletter: Public Health Reserve Corps June 2010 newsletter was attached for information. f. CERT June 2010 Newsletter: Community Emergency Response Team June 2010 newsletter was attached for information. VI. Board Comments A. None VII. Adjournment Motion to adjourn the meeting was made by Jim Stefanadis, seconded by Christopher Cooke, and carried without dissent. The next Board of Health meeting will be held on August 25, 2010 at a Hillsborough, NC location to be determined at 7:00 PM. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board