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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 MINUTES ORANGE COUNTY BOARD OF HEALTH September 17, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 September 17, 2008 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 MINUTES ORANGE COUNTY BOARD OF HEALTH September 17, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 September 17, 2008 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. MINUTES ORANGE COUNTY BOARD OF HEALTH September 17, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 September 17, 2008 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 MINUTES ORANGE COUNTY BOARD OF HEALTH September 17, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 September 17, 2008 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. MINUTES ORANGE COUNTY BOARD OF HEALTH September 17, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 September 17, 2008 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