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HomeMy WebLinkAboutBOH minutes 092210MINUTES ORANGE COUNTY BOARD OF HEALTH September 22, 2010 Board of Health Minutes Transcription completed by Lisa Smith 1 September 22, 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 September 22,, 2010 at the Southern Human Services Building, Chapel Hill, 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; Christopher Cooke. BOARD OF HEALTH MEMBERS ABSENT: None STAFF PRESENT: Rosemary Summers, Health Director; Tom Konsler, Environmental Health Services Division Director; Carla Julian, Risk Management/Quality Assurance Director; Letitia Burns, Business Officer; Wayne Sherman, Public Health Nursing Director; Donna King, Health Promotion and Education Services Division Director; Aine Carney LPN; Lisa Smith, Administrative Assistant. GUESTS PRESENT: I. Educational Presentation: Pam Silberman, JD, DrPH NC Institute of Medicine Pam Silberman, spoke on a topic currently of interest to the Board, “Health Care Reform and Public Health. Ms. Silberman provided a power point presentation on Using the Affordable Care Act to Improve Population Health. Power point slides presented at this session are available on request II. Welcome and Introductions Anissa Vines, Chair, thanked Pam Silberman for the educational presentation and called the meeting to order at 8:00 P.M. III. Approval of September 22, 2010 Agenda Chair Vines requested the addition of Item V.D. Accept Additional Funding to the agenda. Motion to approve the Agenda of September 22, 2010 as amended was made by Tony Whitaker, seconded by Carol Haggerty, and carried without dissent. IV. Public Comment for Items NOT on Printed Agenda V. Action Items (Consent) A. Minutes approval of September 22, 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 September 22, 2010. Tony Whitaker asked that his name be taken out and replaced with Michael Wood for the letter to the Human Rights and Relations Commission and Board of County Commissioners. Motion to approve the minutes as amended of August 25, 2010 meeting was made by Steve Yuhasz, seconded by Chris Harlan, and carried without dissent. MINUTES ORANGE COUNTY BOARD OF HEALTH September 22, 2010 Board of Health Minutes Transcription completed by Lisa Smith 2 September 22, 2010 B. The NC Accreditation Learning Collaborative, part of the Robert Wood Johnson Multi-state Learning Collaborative, is making funds available to local health departments for implementation of an advanced quality improvement project that will benefit outcomes and business practices. There is a total of $25,000 available for this mini-collaborative statewide. Projects will be funded for amounts ranging from a minimum of $2,500 up to a maximum of $10,000. Only one award will be given at the maximum level of $10,000. The mini-collaborative grant would give OCHD an opportunity to address a long recognized need to allow Environmental Health services to be more efficient and streamlined, particularly with regard to customer service. The process of applying for environmental health permits and services has become cumbersome and frustrating for many clients who are not familiar with the process and the number of approvals required by various agencies. Because there are collaborative agencies involved, it is necessary to have a third-party expert lead the effort to gain consensus among the stakeholders. This project would be a prime opportunity to conduct a “Lean Kaizen” quality improvement event with analyses of the current process so that we can have a “one-stop” centralized permitting application. OCHD has submitted a proposal for the maximum award of $10,000 to cover the cost of the Lean Kaizen Event consultation fee and a high-speed document scanner for scanning all existing paper permits. C. Annually, the NC Public Health Association announces the Wolfe Mini Grants to reduce Infant Mortality and enhance Children’s Health programs in North Carolina Local Health Departments. Four grants of $5,000 each will be awarded in honor of Dr. Ann F. Wolfe, past Section Chief of the Division of Public Health’s Maternal and Child Health Section. OCHD is applying for one of the grants to provide Tdap vaccine (Tetanus, Diphtheria, Pertussis) to household contacts and to caregivers of infants (less than 6 months of age) who are uninsured and ineligible for Tdap vaccine funded through the Vaccines for Children program. Extra outreach will be made to caregivers of infants in Orange County Child Care Centers and child care homes. This project will increase the community level of protection for pertussis and help prevent infant mortality from a vaccine-preventable disease. Orange County experienced a pertussis outbreak during the 08-09 year with 26 known cases and hundreds of contacts having to take preventative antibiotics after exposure. As children age into adolescence and adulthood, immunity to pertussis obtained from early childhood vaccination wanes. One dose of Tdap vaccine is recommended for all adolescents and adults to boost their waning pertussis immunity. VFC eligible children between 10 and 18 are able to receive the recommended Tdap vaccine at no charge due to VFC funding. The only adults who are eligible for Tdap at no charge are postpartum women served by the Health Department or those with insurance to cover the vaccine. Previously, funding provided to the North Carolina Immunization Program paid for any adult needing a Tdap to receive the vaccine at no charge. Now, that funding is no longer available. Adults without insurance to cover the cost of Tap have to pay for the vaccine. Our goal is to protect the household contacts and caregivers of infants most at risk, those who are too young to have received 3 doses of pertussis-containing vaccine. By vaccinating these household contacts and caregivers against pertussis, infants will be less likely to be exposed and develop disease. MINUTES ORANGE COUNTY BOARD OF HEALTH September 22, 2010 Board of Health Minutes Transcription completed by Lisa Smith 3 September 22, 2010 D. Accept Additional Funds The Health Department has received grant award notification from the NC Center for Public Health Quality (NCCPHQ) as part of our participation in the first wave in the Public Health Quality Improvement (QI) 101 course. The new Public Health QI 101 course is an interactive 6-month learning opportunity for local health departments interested in improving the quality of the services they provide. Participants learn about QI methods and tools and apply what they are learning to specific local projects. To ensure that all local health departments have the opportunity and resources to participate in QI training, each health department that participates in the QI 101 course receives grant money to support their QI activities. Non-district health departments receive $13,729. This money is to pay for travel associated with the QI training course, additional QI trainings, and any supplies/materials needed to support and carry out the QI work. The following is a breakdown of the monies the Health Department received from the NCCPHQ: Kaizen Event (4-day rapid improvement project) Consultant Fee: $6360.00* *Funds paid directly by NCCPHQ to NC State Kaizen consultant. Check for Environmental Health quality improvement project: $7,369.00. Motion to approve the remaining items of consent agenda, Items B, C, and D of September 22nd, 2010 meeting was made by Steve Yuhasz, seconded by Chris Harlan, and carried without dissent. VI. Reports and Discussion with Possible Action A. Well Rules Amendments Tom Konsler reviewed the background and proposed changes to the Orange County Groundwater Protection Rules. He noted that the proposed changes were properly noticed to the public through the publication of an advertisement in the Raleigh News and Observer. North Carolina General Statute (Chapter 130A) grants boards of health the authority to adopt rules necessary to protect public health. Additionally, Article 7 of NCGS Chapter 87 gives boards of health specific authority to adopt rules that are more stringent than those adopted by the Environmental Management Commission (EMC) in the area of well construction when necessary to protect public health. Orange County Board of Health adopted well construction rules in 1980 which have been administered by the Environmental Health staff since that time. From time to time, the board reviews and adopts revisions to the rules to bring them into alignment with state rule changes and changes in the industry. In the summer of 2010, the Division of Water Quality (DWQ) convened a series of stakeholder meetings to discuss and formulate amendments to their rules governing construction of injection wells [15A NCAC 02C .0200], which include geothermal wells. Recognizing that Orange County was one of few counties in the state that already regulated the location and construction of these wells, DWQ invited Orange County Environmental Health staff to sit at the table and help draft these rule amendments. In order to remain as stringent as the state rule amendments proposed, as well as to fill a present need for clarification in areas such as geothermal well setbacks and construction issues, the Orange County Board of Health proposes changes to the “Groundwater Protection Rules for Orange County”. Tony Whitaker asked Tom Konsler to explain further, why we would adopt rules now if the new state rules will be released soon. Mr. Konsler explained that the state process is likely to take at MINUTES ORANGE COUNTY BOARD OF HEALTH September 22, 2010 Board of Health Minutes Transcription completed by Lisa Smith 4 September 22, 2010 east a year before the rules become finalized and Orange County is experiencing increasing numbers of applications for geothermal wells now. In particular, the issues surrounding the definitions of an appropriate setback from house and property lines are presenting issues as was illustrated with the appeal hearing heard last spring. Motion to approve the revisions to the Orange County Groundwater Protection Rules as presented and forward to the Department of Environment and Natural Resources was made by Tony Whitaker, seconded by Chris Harlan, and carried without dissent. Motion to approve the resolution adopting the Orange County Groundwater Protection Rules as presented with an effective date of September 22, 2010 was made by Tony Whitaker, seconded by Chris Harlan, and carried without dissent. B. Joint Board Meeting Plan The Board of Commissioners will be meeting with the Board of Health at a dinner meeting on October 12, 2010 beginning 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. At the Board meeting in August it was decided that the discussion would focus on the impacts of health care reform on public health and some general input from commissioners on the health department’s new strategic plan. The Board of Commissioners has expressed an interest in this topic as well. The Board discussed the approach to use and it was decided that an overview using some of the slides from the presentation on Health care reform given by Pam Silberman. It was discussed and decided the BOH should extract some main points on what we should be watching, assurance, and overview of Healthcare Reform and how it will affect Public Health. Several members made the point that much of the public health impacts are still unknown, but that points should focus on what we do know, rather than what we do not know. The Health Director will send a first draft to Board members for their use in preparing for the discussion. C. Customer Service Survey Results Motion to delay until the next BOH meeting due to the late hour was made by Chris Harlan, seconded by Tony Whitaker, and carried without dissent. D. 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. Reminder Annual Healthy Carolinians Meeting Healthy Carolinians Annual Meeting is September 24 from 8-10 am at the Seymour Senior Center (2551 Homestead Road) in Chapel Hill. Breakfast is served; no registration fee. Hear about the NC Institute of Medicine Preventive Services Report. b. Impact of Changes in NC PH Dental Program the State Health Director made a decision to reduce staff in the Oral Health Program Section subsequent to budget cuts made by the General Assembly. Dr. Engel decided to cut six public health hygienist positions. The six hired most recently were subject to a reduction in force. The MINUTES ORANGE COUNTY BOARD OF HEALTH September 22, 2010 Board of Health Minutes Transcription completed by Lisa Smith 5 September 22, 2010 remaining hygienists were placed in low-wealth counties with higher dental needs. As a result, Wendy Schwade, our State assigned public health hygienist has been reassigned to Granville- Vance District Health Department and Franklin County. As a result, Orange County will not have screening statistics available for elementary school children in both school systems. The State typically conducted screenings for K and 5th grade to determine caries rates. Utilizing dental hygiene students from UNC Chapel Hill, Orange County in addition screened the 2nd and 4th grades (this was not recognized in the state database for oral health). Orange County will no longer have county specific data on caries rates for kindergarten or fifth graders through the state database. c. Closure of Medicaid Audits for 2005 and 2007. In 2005, the Health Department had a “bench audit” conducted for our Medicaid reimbursable services that was never closed because OCHD held some of the Division of Medical Assistance audit findings in dispute. We were also selected randomly for an audit for our 2007 Medicaid services. We received no feedback on the 2007 submitted material until we received the attached letter. Both attached letters show that the audits were dismissed. Beginning in July 2010, cost settlement will be performed on a quarterly basis and will be paid on an individual county basis and not on a statewide average. d. Landfill Area Assistance Policy Development The BOCC has authorized the County Manager and staff to develop a policy to address failing wells that are located within 3000 feet of the Orange County Landfill. The enterprise funds from the landfill operation will be the source of the repair funds. Environmental Health staff has developed a draft policy based on the No Fault Well Repair Fund policy which was adopted in 2002 for similar well failures located near American Stone quarry. A draft will be prepared by a working group comprised of representatives from Health, Planning, Solid Waste, Community Development, and the Manager’s office. Staff anticipates presenting the draft policy to the BOH for action at the October meeting. The BOCC will consider the final product for adoption. e. Media Clips provided to the Board are available upon request. f. Pending and Recurring Items A chart of upcoming agenda items for Board meetings was provided. It is available upon request. VII. Board Comments/Announcements VIII. Adjournment Motion to adjourn the meeting at 9:30 pm was made by Chris Harlan, seconded by Tony Whitaker, and carried without dissent. The next Board of Health meeting will be held on October 27, 2010 at Government Services Center, Hillsborough, NC at 7:00 PM. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board