HomeMy WebLinkAboutBOH minutes 091708MINUTES
ORANGE COUNTY BOARD OF HEALTH
September 17, 2008
Board of Health Minutes Transcription completed by Anne Miles Cassell 1 September 17, 2008
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 17, 2008 at the Southern Human Services
Center, Chapel Hill, North Carolina.
BOARD OF HEALTH MEMBERS PRESENT: Chris Harlan, Chair; Anissa Vines, Vice-Chair; Jim Stefanadis;
Tim Carey; Moses Carey, Jr.; Matt Vizithum; Sharon Freeland
BOARD OF HEALTH MEMBERS ABSENT: Ernie Dodson; DeWana Anderson; Jessica Lee;
STAFF PRESENT: Rosemary Summers, Health Director; Wayne Sherman, Personal Health Services
Division Director; Donna King, Health Promotion and Education Services Division Director; Angela
Cooke, Dental Health Services Division Director; Dr. Michael Day, Dentist; Anne Miles Cassell,
Administrative Assistant; Kathleen Goodhand, Family Home Visiting Supervisor; Beckie Hermann,
Family Home Visiting Coordinator;
GUESTS PRESENT: None
I. Welcome and Introductions
Chris Harlan, Chair, called the meeting to order at 7:00 P.M.
I. Approval of September 17, 2008 Agenda
The motion to approve the Agenda of September 17, 2008 was made by Matt Vizithum,
seconded by Moses Carey, Jr., and carried without dissent.
II. Public Comment for Items NOT on Printed Agenda
None
III. Action Items on CONSENT Agenda
A. Minutes approval of August 28, 2008 meeting.
B. Healthy Carolinians Grant Submission
The grant application to the NC Office of Healthy Carolinians is for $5727. Orange
County’s 2007 Community Health Assessment (CHA) shows that while Orange County
has great resources and programs in place, children and adults continue to fall short of
recommendations for physical activity and healthy eating. In addition, the County’s
obesity rates continue to be among the worst in the state. The state funds will be used
to implement elements of a comprehensive approach to reduce the obesity problem.
These elements are not currently in place in Orange County. These new elements will
compliment and support other efforts that are in place in our county, within the
preschools, schools, community, hospitals and faith communities.
As a result of these funds, Orange County will have a greater capacity to impact the
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obesity problem in the county by:
• Working at the problem from various angles
• Involving all sectors of the community in solving the problem
• Identifying and promoting consistent messages around healthy lifestyle
behaviors so that residents hear consistent messages where they work, live and
plan
• Providing agencies the tools needed to make policy and environmental
changes to improve health behaviors
Motion to accept the minutes of August 28, 2008 and items on the Consent Agenda was made
by Tim Carey, seconded by Matt Vizithum, and carried without dissent.
IV. Reports and Discussion with Possible Action
A. Approved Budget 2008-2009
In June the Board of County Commissioners approved a county-wide budget for FY 08-
09. The approved budget for the Health Department includes changes to the
department’s original request that was presented to the Board of Health in February.
The summary of the approved budget was distributed to Board members at the August
Board meeting but not discussed. Rosemary Summers said that the personnel increase
in the FY 08-09 budget was due to the resumption of wage increase program and cost
of living increase that took effect July 1, 2008.
B. Capital Improvement Plan 2009 - 2019
The County is beginning the budget process very early this year. The first phase of this is
the long-range capital investment plan, usually prepared for a 10-year horizon. It has
been several years since the Commissioners have approved a full 10-year plan. Most
recently they have only approved the upcoming fiscal year plan.
The majority of the capital that the health department requests is operating capital and
does not meet the definitions established for inclusion in the capital investment plan.
This year, however, with the approval of the Commissioners to move forward with
relocating health department services in northern Orange and expansion of space at
SHSC, the preliminary worksheets for these projects have been completed. There will
be discussions regarding these projects again in October with the Commissioners for
projected action before the end of the calendar year. Board members were provided
with ledger sheets for these projects, however, the sheets still have many blanks as the
estimates are beyond the scope of health department staff expertise. The Board
discussed the CIP submissions that have been submitted to the County Manager.
• 2009-10: Renovation of office space on the 3rd floor of Whitted when Social
Services vacate that space to move to the old Wal-Mart Building. This will also
include the purchase of new office furniture, conference room furniture, and
furniture and equipment for a PH Operations Center. Estimated cost of $300,000.
Medicaid Max funds will complete the project.
• 2010-11: New building at SHSC to include 15,000 sq. ft. of space for dental clinic
that is currently at Carr Mill Mall with lease to expire 6/30/2011, and office space
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plus 10,000 sq. ft. of current DSS space in SHSC to expand/up-fit the medical
clinic. This will also include the purchase of computers and software, office
furniture, dental and medical equipment. Operating costs include an additional
Dentist, Hygienist, 2 Office Assistants, and 3 Dental Assistants to provide dental
services full time at SHSC and Whitted. Total cost would be approximately 8
million dollars.
• 2012-2013: Renovate the Lowe’s Foods Store in Hillsborough Commons (~30,000
sq. ft.). This building would include space for the medical and dental clinics and
administrative offices. This would also include computers and software, office
furniture, equipment, and operating costs adding 1 FNP, 1 Nurse, 1 Lab Tech, 1
Nursing Assistant and increasing the medical Director to full-time. Total cost
would be approximately 10 million dollars.
Board members inquired as to the likelihood of these projects moving forward given the
current fiscal climate.
C. Joint BOCC/BOH Agenda Items
After discussion at the August Board of Health meeting, staff prepared fact sheets and
a draft agenda for consideration. Talking points will be prepared based on further
discussion and approval. The final report will be sent to the Board members presenting
each item.
D. Child Fatality Protection Team Report
The North Carolina Juvenile Code established a Child Fatality Prevention Team (CFPT) in
every county of the state. The purpose of the CFPT is to review the records of all child
fatalities in the county. Community Child Protection Teams (CCPT) were established in
May of 1991. The duties and responsibilities of the CCPT were adopted as North
Carolina Administrative Code 4111.0400. The mandate to the CCPTs is to review
selected active cases in which children are being served by child protective services.
Both teams are required by statute to submit reports annually to the State of North
Carolina and to the local Board of Health and Board of County Commissioners
containing any recommendations, and an advocacy for system improvements and
needed resources where deficiencies and gaps may exist.
Beckie Hermann, Family Home Visiting Coordinator, gave a brief summary of the annual
report to the Board. Anissa Vines expressed appreciation for the information. Sharon
Freeland asked if there was any formal way an agency can report a suspicion of child
abuse. Ms. Hermann replied that a call can be made to the Department of Social
Services and that all calls are anonymous.
Moses Carey inquired about the coordination of the recommendations. Ms. Hermann
stated that all counties report to the state level and it goes from there to legislation.
Dr. Summers also noted the large jump in infant mortality in Orange County from
previous years. Tim Carey asked if the records indicated whether the increase was due
to post-hospital care or other factors. Ms. Hermann responded that these will not be
reviewed for another year.
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Anissa Vines asked about the findings for autopsy.
E. Committee Reports
The Environmental Health and Quality Assurance Committee did not meet prior to the
Board meeting.
The Clinical and Community Programs Committee met on September 10. Jim
Stefanadis gave a synopsis of the agenda.
Dental Student/Resident Rotations: The Health Department has student rotations in all
disciplines of healthcare and is part of our mission. Angela Cooke discussed student
rotations from the Dental School and the question arose over what the Health
Department’s obligation in training students vs. efficiency, production and patient
satisfaction with deliverable services.
The program began in 1980 with a grant from Robert Wood Johnson to open two
dental clinics in Orange County to serve the indigent population in addition to meeting
the Hospital Dentistry accreditation requirement for General Practice Resident treating
ambulatory patients. The OCHD pays for one resident to work 4.5 days per week. Each
resident generates approximately $15,000 in revenue for a total of $120,000 per year. In
the summer, from May through the first week in September, three dental students in the
DISC rotation are scheduled for four-week rotations at the Health Department. Both the
dental students and residents need considerable assistance from our dentist and dental
assistants. Dr Day commented that training students is both time consuming and less
efficient. Dental appointments and procedures take longer in addition to the quality of
work of services being provided per appointment. In addition to the regular student
rotations, we contracted with the UNC Pediatric Dentistry Department to pay $50 per
day for one third year Pediatric Resident to work and supervise one day per week in the
Hillsborough Dental Clinic. On Friday mornings both dental clinics were scheduled with
six dental students and one pediatric dentist from UNC School of Dentistry supervising
the students. A meeting was scheduled with the chair of the pediatric department and
concerns for the programs were discussed. At that time both programs were
discontinued because the dental school requested that we pay $500 per day (two
days per week) to have the pediatric resident and the dental students. At that time the
budget had already been submitted and the department did not have the funds to
support the programs.
In June 2008 the dental staff had a retreat and discussed the dental hygiene student
rotations. At that time, the staff decided not to continue with the rotations for the
following reasons:
• Each week there would be two new students to orient and train
• Difficulty in scheduling children due to school schedules
• Adult patients could not spend two hours for a cleaning appointment
At this time the dental program would like to continue with the General Practice
Resident, dental student summer rotations and the dental hygiene student practicum
rotation (6 weeks of two students in the spring semester). Staff feels it is important to
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continue relationships with the dental school and suggest a meeting between health
directors, dental directors, and the dean of the dental school be scheduled to discuss
student rotations so that both parties benefit.
Tim Carey asked for clarification from Angela Cooke and Dr. Day regarding the dental
school request of $500 per day. Dr. Day explained that the resident and dental
students would be using OCHD equipment and dental supplies plus considerable
supervisory time from staff. Dr. Carey voiced his agreement to not pay $500 per day for
the pediatric resident and dental students.
Sharon Freeland said that the wait time was a major issue and that it would be
traumatizing for children to be in treatment for two hours.
Angela Cooke and Dr. Day support ongoing discussions with the dental school.
Rosemary Summers will set up a meeting with the dental school.
Primary Care Grants: A 3rd year continuation grant for SHSC in the amount of $44,769.
A response to and RFP by October 15 is being planned to restart the primary care grant
at Whitted. The department will be applying for up to $75,000 for Program and Small
Capital Funds. This would include adding an FNP, Nurse, Nursing Assistant and Lab Tech
at 16 hr/week at Whitted. The department may also be requesting computer, hi-lo
exam table, and wall workstations. The Committee recommended proceeding with
the grant proposal.
F. Informational Items
a. Accreditation Award to Moses Carey: Recently Moses Carey won the first Craig
Michalak Award of Excellence from the NC Accreditation Board. The
presentation was done at the same meeting the Board approved Orange
County’s accredited status. Board members were given a copy of the
announcement from the Accreditation Board website. Board members offered
their congratulations to Mr. Carey.
b. News Clips: News articles of interest on recent events or health department
activities were distributed for informational purposes.
G. Pending and Recurring Items Review
The pending and recurring items review allows Board members to plan future agendas
and direct the staff on special work items. There are significant alterations, especially in
the budget approval schedules. Rosemary Summers called attention to all the items
marked as changed and emphasized that Budget Review would be in December
reflecting the change in the Budget Department’s calendar.
V. Board Comments/Announcements
A. None
Motion to move to Closed Session was made by Jim Stefanadis, seconded by Sharon
Freeland, and carried without dissent.
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ORANGE COUNTY BOARD OF HEALTH
September 17, 2008
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VI. 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.
Motion to return to regular session was made by Sharon Freeland, seconded by Jim Stefanadis,
and carried without dissent.
VI. Adjournment
Motion to adjourn the meeting was made by Moses Carey, Jr., seconded by Tim Carey, and
carried without dissent.
The next Board of Health meeting will be a joint dinner meeting with the Board of County
Commissioners and held on October 14, 2008 at the Government Services Center, Hillsborough, North
Carolina at 6:00 PM.
Respectfully submitted,
Rosemary L. Summers, MPH, DrPH
Health Director
Secretary to the Board