Loading...
HomeMy WebLinkAboutBOH minutes 052709MINUTES ORANGE COUNTY BOARD OF HEALTH May 27, 2009 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 May 27,, 2009 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 May 27, 2009 at the Government Services Center, Hillsborough, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Anissa Vines, Vice-Chair; Matt Vizithum; Steve Yuhasz, Commissioner; Michael Wood, Jessica Lee; Ernie Dodson BOARD OF HEALTH MEMBERS ABSENT: Chris Harlan, Chair, out of town; Sharon Freeland; DeWana Anderson; Jim Stefanadis, meeting conflict; Tim Carey; 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; Jenny Grover, Nutritionist; Jaymin Patel and Erik Johnson, Environmental Health Specialist GUESTS PRESENT: Brother’s Keeper’s Representatives – Jerry Ann Gregory, RN; Eddie Eubanks, Keith D. Cooke; Dr. Eugenia Eng, UNCCH; Mohamed Jalloh, UNCCH; Sharon Sanders, United Voices of Efland- Cheeks Executive Director; Elvira Mebane, United Voices of Efland-Cheeks President; Welcome and Introductions Anissa Vines, Vice-Chair, called the meeting to order at 7:00 P.M. and introduced guests present and Rosemary Summers introduced 2 new staff members. I. Are We Our Brother’s Keeper? Wayne Sherman introduced members of the Brother’s Keeper’s representatives and Dr. Geni Eng, UNC Gillings School of Global Public Health. Eddie Eubanks gave a brief power point presentation providing some highlights of the program. Brother’s Keeper is a continuation of the Man for Health program and is a program aimed at education and improvement of men’s health in the African American community. UNC is partnering with Brother’s Keeper. The program works through area churches to establish a church-based navigator/mentor system within the community, to bring awareness and provide support to an at-risk segment of the population. It will assist diagnosed men to adhere to the prescribed program. Heart disease is the leading cause of death in the United States and black men are 30% more likely to die from heart disease than whites in North Carolina. Jerry Gregory stated that the project will last until 2010 but is setting in place a navigator program of educated leaders within the community that will carry on with the work. Training manuals have been prepared for the navigators for on-going training of others in the community. Blood pressure cuffs have been purchased for all navigators to use and 4 defibrillators have been purchased to be placed in four rural churches. The goal is the have 4 Navigators and 6 “Keepers” in each church, 120 total, who will be trained in cardiovascular health and meet once a month to explore ways to include heart- MINUTES ORANGE COUNTY BOARD OF HEALTH May 27, 2009 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 May 27,, 2009 healthy activities into church functions and daily activities. Matt Vizithum asked if this program is an original model or has been done elsewhere. Dr. Eng replied that this program is one of the first programs working with African American men on cardiac related health issues. Other programs have been done involving women. The program has found that men are more receptive to a one on one mentoring approach, whereas, women are more receptive to group activities so that is the approach the program is using for optimal results. Dr. Summers questioned the goal of 120 navigators and keepers being an ambitious number to recruit from the churches. Mr. Eubanks replied that not all navigators and keepers will come from the churches; many community members that are not church participants will also be trained. Dr. Summers also asked if there is a plan for continuation after the grant is over. Dr. Eng replied that another grant is in the process of being applied for and several of the larger churches are setting a plan in action to continue this program as part of their ministry. Anissa Vines asked if women were involved in this program and if so, what role the women are playing in this project. Keith Cooke replied that the women were needed and a very important part of the program. The Chair thanked the Brother’s Keeper project participants for their informative presentation. II. Approval of May 27, 2009 Agenda The Chair requested the addition of Item V. H. Resolution Against Section 10.26 of Senate Bill 202 “Public Health Improvement Plan” to the Agenda. The motion to approve the Agenda of May 27, 2009 as amended was made by Matt Vizithum, seconded by Steve Yuhasz, and carried without dissent. III. Public Comment for Items NOT on Printed Agenda None IV. Action Items on CONSENT Agenda Minutes approval of April 23, 2009 meeting. A. Contract Renewal with Person County for Preparedness Coordinator The State of North Carolina has received federal funds from the Centers for Disease Control and Prevention (CDC) to ensure that North Carolina is prepared in the event of a public health emergency. Allocated pass-through funds enabled Orange County to employ a full-time public health preparedness coordinator (Public Health Nurse II) from 2003-2008. Reductions in funding since 2006 make it impossible to support a full-time nursing position with these funds. An agreement with Person County in 2008 to share a Preparedness Coordinator position ensures that the deliverables as mandated are met. Pat Gentry, the Preparedness Coordinator hired by Person County spends 2 to 2 ½ days per week in Orange County. The Agreement began on December 1, 2008 and MINUTES ORANGE COUNTY BOARD OF HEALTH May 27, 2009 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 May 27,, 2009 renewal is sought for the upcoming fiscal year. The amount of the agreement for fiscal year 2009-2010 is $38,000. There are sufficient federal funds allocated by the State to Orange County to pay for this agreement. B. Accept Medicaid Cost Settlement Funds Each year the Health Department receives a cost settlement based on the previous year’s Medicaid claims. The cost settlement is only on the federal portion of the Medicaid payment and is intended to provide the agency the difference between the actual costs of providing the service versus the reimbursed amount. North Carolina Division of Public Health performs the annual cost reimbursement analysis to determine the amount each county will receive. The Association of Local Health Directors has agreed that costs across the state will be averaged and then determined on a basis that is either above or below the cost for each service code. OCHD has received funds annually for all programs that earn Medicaid reimbursement since 1998. The amount of funds varies from year to year based on the costs across the state and the reimbursement levels for various services; our average has been around $200,000 annually. These funds are placed in a capital account and are utilized for renovation projects and emergency equipment needs. For example, funds from this account were used to renovate the clinical space at Whitted in 2002; funds were used to make alterations at Carr Mill required to meet accreditation standards; and to purchase privacy screens for desktop computers for accreditation standards. These funds must be used in the programs that actually earned the revenues (child health, family planning, dental, and maternal health, etc. Last month it was reported the State is withholding $3 million from the 07-08 settlement funds to balance the state budget. This would have preserved the recurring fund gains we have recently made in Aid to County Funds. The DHHS Medicaid Office refused to withhold funds from this allocation as they determined that it was not legal to do so. Therefore, the allocation for Orange County Health Department for the 07-08 settlement year is for the entire amount earned for the year, $320,193.81. The Department had a substantial service count increase for the 07-08 year with a corresponding increase in our settlement amount. We will be requesting to budget approximately $250,000 for limited renovations to Whitted and SHSC after the Department of Social Services moves, to enable us to continue to provide services until a final decision is made regarding the Mayo Street property in 2012. The remaining funds will be placed in the capital account and will be available for the larger projects scheduled for future years. Motion to accept items on the Consent Agenda was made by Steve Yuhasz, seconded by Matt Vizithum, and carried without dissent. V. Reports and Discussion with Possible Action A. Nominating Committee Report The Board has an upcoming vacancy in an at-large slot with the first term service MINUTES ORANGE COUNTY BOARD OF HEALTH May 27, 2009 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 May 27,, 2009 completion of Sharon Freeland. Rev. Freeland has declined a 2nd term. There were several applicants with experience in the public health arena. Steve Yuhasz stated that he knew one of the applicants and felt he would be a good prospect for consideration. The Board reviewed all of the available applicants for this position and recommended the Nominating Committee contact two of the selected applicants and report their findings at the June meeting. The Board will also have an upcoming vacancy in the Engineer position as Ernie Dodson has declined a 2nd term. A Professional Engineer, Tony Whitaker, has recently applied for this position. Both Steve Yuhasz and Ernie Dodson know the applicant and stated they felt he would bring valuable experience in the environmental arena to the Board. The physician vacancy resulting from Dr. Tim Carey’s resignation was also considered. Dr. Paul Chelminsky was personally recruited by Dr. Carey to fill this slot. The Nominating Committee has reviewed this application along with other eligible applicants and recommends Dr. Chelminsky for this position. Matt Vizithum is completing his second term in the Optometrist position. He has recruited an applicant to be considered as his replacement. Dr. Vizithum stated he felt that Dr. Carstens is well qualified and would be an excellent replacement. The Nominating Committee has reviewed the application by Dr. Mike Carstens, O.D. and recommends him for this position. Motion to recommend Dr. Paul Chelminsky, MD, MPH, for the physician position, Dr. Mike Carstens, OD, for the optometrist position, and Tony Whitaker, PE, for the engineer position, and forward these recommendations to the Board of County Commissioners for action was made by Ernie Dodson, seconded by Matt Vizithum, and carried without dissent. B. A Resolution to Address Permitting of Public Swimming Pools and Spas Tom Konsler reported that the Virginia Graeme Baker (VGB) Act prompted a federal law that requires public pools to install drain devices designed to prevent suction hazards and entrapment. Compliance was required for all public pools effective December 19, 2008. The North Carolina Division of Environmental Health issued guidance to local health departments to issue permits for the 2009 season for multiple drain pools even though they may not be in compliance with federal law. At the April meeting the Board requested that the County Attorney draft a local swimming pool rule to be considered for possible adoption. The rule incorporates the elements of the VGB Act for all pools permitted in Orange County. If the Board elects to adopt the rule, it would not take place until the June 2009 meeting in order to allow for required public notice. Because staff continues to process applications and permits for pools, a resolution was proposed for endorsement of the current policy and procedure that requires the applicant for a pool permit provide evidence that the pool is in compliance with the VGB Act. Tom Konsler reported that of all of the 103 applications he has received to date 53 have already met compliance and the rest are in various states of having the drain modifications done to be compliant. It appears that all applicants are well on the MINUTES ORANGE COUNTY BOARD OF HEALTH May 27, 2009 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 May 27,, 2009 way to be compliant. He stated that he has not received any refusals or negative feedback from pool owners. Rosemary Summers noted that when a Board of Health passes a local rule that is more stringent than State regulations it takes the County out of the umbrella of protection from state Torte claims and Orange County would be liable for any outcomes. Anissa Vines stated she felt it was important to have a Resolution or Rule in place. Steve Yuhasz asked what was involved in creating a Rule. Tom Konsler replied that advertising costs and required time (10 day advertisement) prior to adoption would have to be followed. He also stated that the state is preparing a draft of regulatory procedures of the VGB that will be ready in the fall. In the meantime, all of the Orange County pools should be in compliance within the next three weeks. Board members felt a Resolution in support Environmental Health policy was preferable because it would be able to be passed and put into immediate use, whereas a Rule would need time for public advertising before it could be ruled on by the Board. Motion to adopt a Resolution Requiring Compliance with the VGB Act and not to pursue passage of a Rule was made by Michael Wood, seconded by Matt Vizithum and carried without dissent. C. Healthy Food and Physical Activity Policy Donna King reported that our contract agreement with the State of North Carolina on health promotion calls for the adoption of healthy food and physical activity policies. The department has been targeting county wide policies that would help employees stay fit, however have been unable to move the county staff who are responsible for implementing changes to make them. The department has worked with purchasing staff to improve vending machine options for the public and staff and have been unable to get the vendors to comply with even those options that public schools currently have. Various options or considerations for improving catered food offerings were also proposed. In addition, Human Resources has not been supportive of proposing altered policies to enable employees to engage in physical activity outside of the normal one hour lunch policy. She stated that walking meetings have been held at the Department’s Chapel Hill location as a healthy alternative. Anissa Vines commented that she liked the idea of walking meetings and encouraged staff to continue to try to motivate purchasing and human resources to encourage and enable healthy food choices and exercise policies within the county. Steve Yuhasz stated that Commissioner Jacobs strongly encourages selection of local food sources as a priority when exploring healthy food choices. In order to fulfill state agreement requirements and to provide a model for the remainder of the county, the department is proposing a Health Department Administrative Policy that begins to put in place options for improving food, beverage, and physical activity choices. MINUTES ORANGE COUNTY BOARD OF HEALTH May 27, 2009 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 May 27,, 2009 Motion to approve the Healthy Food and Physical Activity Policy was made by Matt Vizithum, seconded by Ernie Dodson, and carried without dissent. D. H1N1 Response Report Rosemary Summers reported that the Department had approximately a two and a half week active response to the H1N1 nationwide outbreak. As of the Board of Health meeting date there has only been 1 confirmed case in Orange County. That individual is in self isolation and all close contacts have been given precautionary antivirals and are monitoring themselves for symptoms. Community education messages were distributed through churches and daycares. Daily conference calls were held with community partners and the State. Health Alerts were issued regularly to health providers as updates occurred. The Department received 25% of the Orange County Strategic National Stockpile, which was received and distributed under protocols developed for such an event. Antivirals were distributed to agencies requesting supplies to treat the uninsured that were ill with suspected H1N1. All time accounting expenses associated to the H1N1 outbreak are being tracked by the department and will be used to draw down state and federal funds. The April departmental expenditures for H1N1 response is estimated at $37,000. These expenses were incurred prior to today’s confirmed Orange County case. This was collected to illustrate how expensive a response of this type can be. Matt Vizithum asked whether there were any associated cases to the Orange County case. Dr. Summers stated that at this time there were none and that the exposure time limit would expire in 2 days. He also asked what affect on the budget a vaccine for the H1N1 in addition to the usual annual flu vaccine would have. Dr. Summers stated that she did not know at this time. The department orders vaccine in the spring for flu season in the fall and reduces the order in the spring as the need is more closely calculated. This year the order will not be reduced as an increase in citizen requests for vaccination is anticipated. Steve Yuhasz asked what effect the H1N1 response has had on the Health Department budget. Dr. Summers replied that the response to the outbreak is part of what the Department is designed to do, therefore expenses are included within the framework of the budget. She went on to say that several things, such as a TDAP vaccination at local schools could not be done because staff was redirected due to the H1N1 outbreak, as well as other work that was delayed due to the response. The staff have worked long hours without compensation during a response such as this. The CDC has stated that the incidence of seasonal flu has decreased; therefore anyone exhibiting symptoms at this time would most likely have H1N1. Rosemary Summers stated that she was invited to the UNC Administrative office to meet via teleconference with representatives from all 17 of the UNC campuses. E. Biosolids Research Project Tom Konsler reported that he and Rosemary Summers met recently with representatives MINUTES ORANGE COUNTY BOARD OF HEALTH May 27, 2009 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 May 27,, 2009 from UNC School of Public Health to discuss the future of the biosolids research pilot project for which $10,000 was appropriated from the OCHD budget in 2006. The project has been hindered by multiple obstacles over the past 2 years and it was concluded that a suitable study site cannot be located within Orange County. Landowners have been hesitant to participate due to repercussions from their neighbors. Orange County and UNC have mutually agreed to terminate the contract. The $10,000 has been encumbered and Rosemary Summers will consult with finance to see if we can use the funds for another event. There is still interest in furthering the knowledge scientific base regarding biosolids. Staff will explore the potential of co-sponsoring a biosolids symposium or forum to allow an open exchange of science-based information by experts in the industry. Anticipated participants include representatives of regulatory agencies, policymakers, utilities, operators, landowners, and interested members of the public. Input from the Board was requested regarding the altered plan. Rosemary Summers stated that Tom Konsler will meet with North Carolina State University to see if they would be interested in organizing a symposium to study the issue. One of the things the department is hoping to do is refocus on science. Steve Yuhasz observed that application of biosolids is something that seems to be occurring nationwide and questioned if there were any other studies being done or public interest elsewhere. Tom Konsler said there is not a lot of good data available. F. Report on UNC Hillsborough Hospital Meeting Rosemary Summers and Pam Jones, Purchasing Director, had a meeting with the Director of Strategic Planning and the Associate Vice President for Planning to discuss the proposed UNC Hillsborough Hospital. The hospital is planned as an extension of the current hospital and will involve “transferring” beds from the main facility to the Hillsborough Hospital. It will be more of a “specialty” hospital than a typical community hospital. The estimated operational date is 2013. The benefits of a co-location of a health department primary care/prevention center close to the hospital were discussed at that meeting. Both parties agreed to further discussions of the possibilities. The staff sought input from the Board regarding their thoughts on possible collaborations between the two organizations that could be considered to guide these discussions. UNC is still in the early planning stages of this expansion project. Steve Yuhasz stated that he felt the Department should continue to explore possible collaborations between the two organizations. Anissa Vines said that ideas should be fleshed out about what could be at this location, as well as budgetary considerations. She also pointed out that the merging of a state and county healthcare system could present problems. Rosemary Summers responded that a merger would likely be too strong; however co-location and collaboration on service delivery could be beneficial to both parties and the community. MINUTES ORANGE COUNTY BOARD OF HEALTH May 27, 2009 Board of Health Minutes Transcription completed by Anne Miles Cassell 8 May 27,, 2009 G. Informational Items a. Media Clips: Chapel Hill Carrboro Chamber of Commerce article regarding emergency preparedness for businesses presentation in which the Health Department was a joint participant. Donna King represented the Department. b. Legislative Items of Interest: House Bill 2, Smoking in Public Places, passed and has been signed into law with an effective date of January 1, 2010. This may have implications for the staff for enforcement purposes, although Orange County has existing local rules that have similar enforcement steps. The law also has provisions for local Boards of Health to adopt additional rules in this area. It requires that any Board of Health rule in this area also be passed by the Board of Commissioners before being enacted. The Senate Budget bill still has the Public Health Improvement Plan provision in it and suspending the accreditation program for local public health. This calls for a special task force to be appointed to study and recommend public health funding for the 10 essential health services. There already is an officially approved Public Health Improvement Plan that was developed by the existing Public Health Study Commission. Staff believes that if these provisions remain in the bill it will destroy the accreditation program and shift the funding even more dramatically to the local level to be able to accomplish the 10 essential services. c. Pending and Recurring Items Review: This is intended to provide the Board a forward look at upcoming agenda items and remind the Board of items that may have been requested but have not yet been requested. H. Resolution Against Section 10.26 of Senate Bill 202, “Public Health Improvement Plan” The 2009 Senate Appropriation Bill (Senate Bill 202) contained a special provision (Section 10.26) to establish a Public Health Task Force that would develop a Public Health Improvement Plan. The entire provision was added without input from local government officials or local and State public health professionals. The Public Health Improvement Plan includes the establishment of the flexible spending formula and the flexible spending account would be based upon funds already received by public health. The flexible spending account is equivalent to single stream funding which would disrupt the reallocation in funding streams and be unnecessarily stressful to an already fragile public health system, a system that is funded with too few dollars. Commissioners will be asked to approve the same resolution. Motion to approve a Resolution Against Section 10.26 of Senate Bill 202 “Public Health Improvement Plan” was made by Anissa Vines, seconded by Ernie Dodson, and carried without dissent. VI. Board Comments/Announcements Rosemary Summers brought the Board’s attention to the 2009 NC Women’s Health Report Card which was included as part of the Board packet but was not on the agenda. The study was done by UNC Center for Women’s Health Research. Key findings of the study were MINUTES ORANGE COUNTY BOARD OF HEALTH May 27, 2009 Board of Health Minutes Transcription completed by Anne Miles Cassell 9 May 27,, 2009 presented for information purposes to the Board. VII. Adjournment Motion to adjourn the meeting was made by Michael Wood, seconded by Matt Vizithum, and carried without dissent. The next Board of Health meeting will be held on Thursday, June 23, 2008 at the Link Government Services Center, Hillsborough, North Carolina at 7:00 PM. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board