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HomeMy WebLinkAboutBOH minutes 082510MINUTES ORANGE COUNTY BOARD OF HEALTH August 25th, 2010 Board of Health Minutes Transcription completed by Lisa Smith 1 August 25th, 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 August 25th, 2010 at the Link Government Services Center, Hillsborough, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Anissa Vines, Chair; Chris Harlan, Vice-Chair; Steve Yuhasz, Commissioner Representative; Tony Whitaker; Mike Carstens; Paul Chelminski; Matthew Kelm; Carol Haggerty; Michael Wood. BOARD OF HEALTH MEMBERS ABSENT: Christopher Cooke STAFF PRESENT: Rosemary Summers, Health Director; Tom Konsler, Environmental Health Services Division Director; Carla Julian, Risk Management/Quality Assurance Director; Letitia Burns, Business Officer; Donna King, Health Promotion and Education Services Division Director; Judy Butler, Community Health Services Supervisor; Gwen Harvey Assistant County Manager; Annette Moore, Orange County Staff Attorney; Lisa Smith, Administrative Assistant. GUESTS PRESENT: none I. Educational Presentation: Tom Konsler Tom Konsler, Environmental Health Division Director, spoke on a topic currently of interest to the Board, “Biosolids Primer”. He gave a brief background on the waste water treatment process at municipal facilities. In wastewater industry terminology, sludge is the raw product that is drawn out of the treatment train while biosolids refers to the residual sludge that has gone through the treatment process and is ready for land application or composting. The processes involved can vary depending on the treatment plant, but many follow this basic stepwise approach when land application is used. The power point slides presented at this session are available on request. 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. III. Approval of August 25th, 2010 Agenda Chair Vines requested the addition of IV.D. Accept Additional Funds to the agenda. The motion to approve the Agenda of August 25th, 2010 as amended was made by Steve Yuhasz, seconded by Chris Harlan, and carried without dissent. IV. Public Comment for Items NOT on Printed Agenda None MINUTES ORANGE COUNTY BOARD OF HEALTH August 25th, 2010 Board of Health Minutes Transcription completed by Lisa Smith 2 August 25th, 2010 V. Action Items (Consent) A. Minutes approval of June 23rd, 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 June 23rd, 2010. Motion to approve the minutes of the June 23rd, 2010 meeting was made by Steve Yuhasz, seconded by Michael Wood, and carried without dissent. B. Grant Acceptance for Eat Smart Move More “PLAY” Project In Orange County 29% of children aged 2-18 years are overweight or obese; 31% of youth 12- 18 years of age are obese. Good nutrition and physical activity decreases the likelihood of becoming overweight and obese and developing associated risk factors and chronic diseases. Reducing childhood obesity has become a primary focus for Healthy Carolinians of Orange County. The Health Promotion subcommittee has adopted a comprehensive, multi-level approach to addressing obesity and is coordinating activities with a number of sectors and agencies to maximize resources in the community. This project, Preparing Lifelong Active Youth (PLAY) is funded by a small grant from the NC Division of Public Health and aims to provide regular physical activity options for youth during after school hours. It also seeks to establish a stronger connection between UNC and local schools. Note: With support from Robert Wood Johnson, an evaluation will be conducted by East Carolina University in Year 2. Middle school children registered for the after school program in the Orange County School district will be eligible for the program. The project will link student athletes from UNC at Chapel Hill Recreation and Sport Clubs Program with the Middle School After School program in an effort to provide positive academic and physical role models for at-risk youth. There are five partners who developed and have agreed to participate in this project: UNC Recreation, Orange County Schools, and Community in Schools of Orange County, Orange County Recreation Program, and Orange County Healthy Carolinians. Orange County Health Department will act as the project manager and fiscal agent for the project that is funded for $14,920 for fiscal year 2010-2011 and for $500 for fiscal year 2011- 2012. The second year funding is primarily to complete the evaluation of the project. The majority of the funds are for physical activity equipment and incentives. There is funding for an intern to coordinate the student athlete schedules and activities with the after school program. C. Board of Health Committee Assignments In December or January of each year, the Board reviews committee assignments and finalizes committee membership. With the transition of three board members, reassignments were needed for the remainder of 2010. For the remainder of 2010, it is proposed that new members be placed on the program committee where the previous member was serving. The vacancy on the Awards, Nominations and Bylaws Committee is proposed to be “filled” by Tony Whitaker. MINUTES ORANGE COUNTY BOARD OF HEALTH August 25th, 2010 Board of Health Minutes Transcription completed by Lisa Smith 3 August 25th, 2010 Dr. Chelminski had already agreed to assume the leadership of the Clinical and Community Programs Committee. Dr. Haggerty and Dr. Kelm will serve on the Clinical and Community Programs Committee. D. Accept Additional Funds The Health Department received notification that the annual Family Planning TANF funds (Temporary Assistance to Needy Families) have been allocated. Orange County Health Department will receive $7,650 in federal TANF funds. These funds are reimbursement only, and must be spent no later than May 31, 2011. It is a federal requirement that TANF funds be accounted for by Social Service Directors, as it is part of the federal block grant to social services. The Health and Social Services Directors must concur on the use of these funds. TANF Out-of-Wedlock birth prevention funds will be used to purchase Implanon birth control for high-risk and uninsured clients and some outreach to high- risk clients to encourage use of family planning services. Motion to approve items A, B, C, and D on the Consent Agenda was made by Steve Yuhasz, seconded by Michael Wood, and carried without dissent. VI. Reports and Discussion with Possible Action A. New Fees for Immunizations and Screening Tool With the passage of the 2010-11 NC State budget, funding that made free vaccines available for all children, regardless of insurance status, no longer exists. The federal Vaccine for Children program will continue. The Vaccine for Children program provides selected vaccines at no charge to children between 0-18 years of age who are uninsured, Medicaid eligible, American Indian, Alaskan Native or underinsured (vaccines not covered). Children with insurance plans (Including Health Choice) that cover vaccines after co-payments and deductibles are met are not eligible for vaccines through the Vaccine for Children program. As a result of this change, we anticipate a number of providers will refer their privately insured children to the Health Department for vaccine services rather than incur the risk of ordering and not using vaccine, thus experiencing a financial loss. Additionally, some families of insured children who have traditionally received their vaccinations through the Health Department will no longer be eligible for the free vaccines and will be charged for the vaccine. A fee must be established In order to recover the cost of the vaccine and ancillary costs when possible. The State Medicaid agency instituted a new required screening tool called M-CHAT for 18 and 24 month olds during a well child visit. The screening can be billed separately from the well child visit. A $13.00 fee is proposed that will cover the cost of the additional personnel time for administering the screening tool. The Board was presented with a list of the new fees proposed for the various vaccines and the M-CHAT requirement. OCHD will need to purchase additional vaccine. This was not budgeted as the State budget was not finalized until the passage of the county budget. The proposed vaccine fees cover the cost of the vaccine and some ancillary costs (time of personnel to order, receive, and store vaccine). We anticipate having identified needed policy changes for action by the Board at the September meeting. MINUTES ORANGE COUNTY BOARD OF HEALTH August 25th, 2010 Board of Health Minutes Transcription completed by Lisa Smith 4 August 25th, 2010 Several Board members asked questions about how this change would affect the overall immunization rates for the county. Paul Chelminski asked whether this would mean more children would be entering school unvaccinated. Ms. Butler replied that the required vaccines must be provided or the school must exclude the child. Chris Harlan stated that this is taking public health backwards 50 years. Motion to approve and forward to Commissioners for action, revisions to the fee schedule including new and revised immunizations and CHAT screening as presented was made by Michael Wood, seconded by Chris Harlan, and carried without dissent. B. Recommendation for Veterinary Appointment to BOH There is an opening for a veterinarian on the Board of Health, created by the resignation of DeWana Anderson. There is one application for the position on file with the Board of County Commissioners. Motion to recommend Dr. Susan Elmore to the Board of Commissioners for consideration for appointment as the veterinarian serving on the Board of Health was made by Chris Harlan, seconded by Paul Chelminski, and carried without dissent. C. Review of BOH Policy Manual Each Board member received the policy manual at the June Board meeting and was tasked with reviewing the policies and submitting possible changes to Tony Whitaker for the Committee to consider for Board action. The Manual must be reviewed annually but is not required to be changed. Changes may be presented and considered at a later meeting as well, however the review must be performed annually. Mr. Whitaker reported that he received no changes from Board members. By common consent, the Board agreed that the policies did not need revision at this time. The staff is currently reviewing the fee and eligibility policy and would like to delay action on that policy until either the September or October meeting. A related item on the agenda is the immunization program changes that may require alteration of some areas of this policy. D. Joint BOCC/BOH Meeting Agenda Planning The Board of Commissioners Chair, Valerie Foushee has agreed to schedule a joint meeting with the Board of Health on October 12, 2010. The meeting will be held beginning with dinner at 5:30 pm. The meeting must adjourn no later than 6:30 pm so that Commissioners may hold a work session following the meeting. The Board considered the proposed topics and after considerable discussion decided to focus the meeting on health care reform impacts and perhaps input into topics of interest for the strategic plan. Several Board members requested a speaker on the topic of impacts of health care reform on public health for the September Board meeting. E. Social Justice Implementation Plan In June the Board of Health received the draft Social Justice Goal that was presented to Commissioners by the Human Rights and Relations Commission. The Board of Commissioners asked the Commission to provide some detail around how these goals would be implemented. The draft implementation plan has not yet been presented to MINUTES ORANGE COUNTY BOARD OF HEALTH August 25th, 2010 Board of Health Minutes Transcription completed by Lisa Smith 5 August 25th, 2010 Commissioners but is likely to be considered in early September. Board Committees have had the opportunity to briefly review this plan and minutes from one Committee are attached in the information items section. The Board discussed the impact this implementation plan will have on the work load of the staff. While they agreed that the goal is important, given the staffing reductions and other challenges facing the county, the timing for implementing this is not good. By consensus, the Board agreed to send a letter with comments to the Human Rights and Relation Commission and the Board of Commissioners. Michael Wood volunteered to develop a draft and send it to several Board members for input. He will then finalize the draft and send it to the Board Secretary for distribution. F. Informational Items a. Health Director’s Report: The Health Director included a report of activities of the health director, upcoming events for the department, and news from community agencies. b. 2010-2011 Budget Amendment Actions: The Health Department received “deferred revenue” toward the end of the last fiscal year from grantors that had it been added to last year’s budget would not have been able to be spent appropriately. To avoid a carry forward, that often takes months to accomplish pending completion of a county audit, Financial Services advised to defer the revenue until the start of the fiscal year. $5,000 from the National Association of City and County Health Officials (NACCHO) was received for training and supply costs in support of the Medical Reserve Corps program, and the final $10,000 from the Kate B. Reynolds Foundation to help support the implementation of the community health plan developed by the Healthy Carolinians of Orange County. These two funding sources will increase the Health Department operating budget by $15,000.The Volunteer Program is also currently seeking another grant from NACCHO to provide operating support for these programs. c. State Program Audits: The Board received summaries of the Women’s Health and Medical Nutrition Therapy state audits. d. Committee Reports: Committee minutes for both program committees were available. e. Media Clips: News items relating to health department programs were provided. f. Pending and Recurring Items: A grid of upcoming agenda items was included for planning purposes g. H1N1 Research Brief: Orange County was selected as a research site for several research projects around H1N1 response, partially as a result of participation in the Practice-Based Research Network. A research brief outlined some of the findings and recommendations for change that may be integrated into the Department’s response plans. MINUTES ORANGE COUNTY BOARD OF HEALTH August 25th, 2010 Board of Health Minutes Transcription completed by Lisa Smith 6 August 25th, 2010 VII. Closed Session Motion to adjourn to 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 was made by Anissa Vines, seconded by Chris Harlan, and carried without dissent. Motion to return to Open Session was made by Chris Harlan, seconded by Steve Yuhasz and carried without dissent. VIII. Adjournment Motion to adjourn the meeting was made by Chris Harlan, seconded by Michael Wood and carried without dissent. The next Board of Health meeting will be held on September 22, 2010 at Southern Human Services Center, Chapel Hill, NC at 7:00 PM. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board