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HomeMy WebLinkAboutBOH minutes 042408MINUTES ORANGE COUNTY BOARD OF HEALTH April 24, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 April 24, 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 April 24, 2008 at the Town of Hillsborough Town Barn, Hillsborough, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Chris Harlan, Chair; Anissa Vines, Vice-Chair; Tim Carey; DeWana Anderson; Matt Vizithum; Jessica Lee; Sharon Freeland; Jim Stefanadis; Sharon Van Horn BOARD OF HEALTH MEMBERS ABSENT: Moses Carey, Jr.; Ernie Dodson, out of town; STAFF PRESENT: Rosemary Summers, Health Director; 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; Anne Miles Cassell, Administrative Assistant; Barbara Hawksworth, Environmental Health Technician; Carla Julian, Quality Assurance/Risk Management Manager GUESTS PRESENT: None I. Welcome and Introductions Chris Harlan, Chair, called the meeting to order at 7:00 P.M. There were no guests present to be introduced. Rosemary Summers introduced Barbara Hawksworth, Environmental Health Technician, who is now a permanent full-time employee. Barbara has worked with the Health Department in the same capacity as a temporary employee for several years. I. Approval of April 24, 2008 Agenda The motion to approve the Agenda of April 24, 2008 was made by Matt Vizithum, seconded by Tim Carey, and carried without dissent. II. Public Comment for Items NOT on Printed Agenda None III. Action Items on CONSENT Agenda A. Renewal of Head Start Contract with Chapel Hill Training & Outreach Chapel Hill Training and Outreach, Inc. approached the Health Department in 2003 with a request to provide required dental screening and treatment services to all children enrolled in the Head Start Program located in Hillsborough. The first contract for services was developed and issued in the fall of 2003 and the program has worked well for both entities. Both parties wish to renew this contract for services for the coming fiscal MINUTES ORANGE COUNTY BOARD OF HEALTH April 24, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 April 24, 2008 year. The contract amount is reduced by mutual agreement to $8,000 per year since more of the children than planned have private dentists providing their care after the initial screening. Staff requested the contract be approved and forwarded to the Board of Commissioners for action. B. Renewal of Graduate Program Resident Agreement with UNC School of Dentistry The Orange County Health Department annually contracts with the UNC School of Dentistry for services of one full-time equivalent dental resident for four and one-half days per week. The residents provide services at both the Hillsborough and the Carrboro dental clinics. The total cost of the contract for July 1, 2008 through June 30, 2009 is anticipated to be $52.914, a 3% increase. We will not know the exact amount until the legislature establishes state salary increases. C. Approve Minutes of February 28, 2008 Meeting (March agenda) Minutes from the regular Board meeting of February 28, 2008 were presented for approval at this meeting due to a lack of a quorum at the March meeting. D. Approve Minutes of March 27, 2008 meeting. Minutes from the regular Board meeting of March 27, 2008 were presented for the Board’s review and action. E. Accept Additional Funds (March agenda) 1) The Health Department received confirmation of additional allocation of Family Planning (Title X) funds. These funds are calculated on a minimum basis per county and additional funds based on performance. Orange County Health Department has been allocated $9,772 in Family Planning funds to be used by May 30, 2008. It is expected that the Department will use these funds to purchase additional tablet PC’s that will be needed as the new Health Information System (HIS) is deployed late this fall. 2) The Health Department received confirmation of a “scholarship” of $250 that has been awarded to send an additional staff person to the annual Child Health Update training in May. This staff person must be in a different discipline than the nurses that usually attend. This is a mandated requirement. 3) The Health Department received confirmation that the Environmental Health Division’s compliance for Food and Lodging Inspections for FY 06-07 was 90%. This program is receiving an additional allocation, which has already been partially budgeted. The full allocation is MINUTES ORANGE COUNTY BOARD OF HEALTH April 24, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 April 24, 2008 $8,128.33. The balance to be budgeted and spent is $628.33. F. Renewal of Consolidated Agreement (March agenda) The Consolidated Agreement for FY 08-09 stipulates the provisions for receiving state and federal support for the programs offered by the Health Department. Most programs will be funded at the same levels approved for the current budget year; however Health Promotion funds In the amount of $24,461 are dependent upon inclusion of the preventive services Federal Block Grant by the U.S. Congress. Availability of federal public health preparedness funds are unknown but anticipated to be reduced by 10% to all counties, a loss of $2,700 for Orange County. Each year supplemental funds become available during the fiscal year in various programs depending on state and federal action and on performance by the county. The total anticipated amount of funding as of July 1, 2008 represents less than 8% of the overall Health Department budget. The state consolidated agreement is anticipated to provide $426,340 federal and state dollars to the county to provide specific services for fiscal year 2008-2009. This includes an additional $15,000 in aid to county funds for essential services and slight increases in refugee health funds ($1,830). G. Renewal of Dental Provider Agreement with Dr. Krzysztoforska Dr. Krzysztoforska has been working with the OCHD Dental Health Service for over fourteen years and provides expertise in treating children patients on Mondays in the Carrboro Dental Clinic. The Agreement between OCHD and Dr. Krzysztoforska is to provide dental services one day per week for fifty weeks in fiscal year 2008-2009. H. Renewal of Medical Director Contract and Addendum OCHD has maintained a contract with UNC Family Practice for Medical Director services for a number of years. Dr. Michael Fisher has served in this capacity for the past six years with back-up from Dr. Lauren Lingley and other physicians. The 08-09 contract has no significant changes this fiscal year. It continues the contract at 28 hours per week; 22 hours in clinic and 6 hours providing phone consultation, administrative duties, and back-up on-call responsibilities. In addition, Chapel Hill Carrboro City Schools (CHCCS) is seeking renewal of its contract with the Medical Director for medical supervision of one of its School Nurses who is a qualified Nurse Practitioner to provide limited nurse practitioner services in the Head Start Program. The contract was in MINUTES ORANGE COUNTY BOARD OF HEALTH April 24, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 April 24, 2008 effect this past year has been considered successful. I. Renewal of Pharmacy Services Contract The issuance of pharmaceuticals through our clinics or during epidemics/disasters necessitates the services of a registered pharmacist. Robert Dupuis, Pharm. D., a Clinical Associate Professor in the Division of Pharmacy Practice at UNC School of Pharmacy, has served as the Department’s Pharmacist for the past six years. He has fulfilled his responsibilities well and is interested in continuing to serve in this capacity. There is no significant change in the 08-09 Pharmacy Contract except for a 3.5% increase. Motion to accept items on the Consent Agenda was made by Anissa Vines, seconded by Jim Stefanadis, and carried without dissent. IV. Reports and Discussion with Possible Action A. Advertisement of Notice of Upcoming Department Rule Adoption: OC Wastewater System Rules Tom Konsler reported that in November 2007, the Board voted to adopt the revisions that have been made to the North Carolina Rules for Sewage Treatment and Disposal Systems (15A NCAC 18A.1900). This act of adoption retained all of the Orange county (more stringent) requirements previously adopted. Staff recommended approval from the Board to proceed with a public advertisement of the Board’s intent to make the following two changes to the Orange County wastewater system regulations. Adoption will be considered at the May 2008 meeting. 1. Upon submittal of the compiled rules to the State, a potential inconsistency was noted regarding the ability for local staff to take action upon a state certified septic contractor’s local registration. After consultation with the county attorney and the NC Attorney General’s office, it is recommended to delete the two sentences regarding levels of certification and taking action on a contractor’s registration as these two items are handled at the state level. 2. The procedure for abandonment of septic tanks in our current rules specifies the use of powdered chlorine for disinfection of the excavation before backfilling. Staff recommends removing the reference to chlorine and replacing it with hydrated lime, which is the current acceptable method of treating sewage contaminated areas. Chris Harlan asked for clarification that both of these changes would be covered on the one published notice. MINUTES ORANGE COUNTY BOARD OF HEALTH April 24, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 April 24, 2008 Motion to move forward with the advertisement of Notice of Upcoming Rule Adoption – Orange County Wastewater System Rules was made by Jessica Lee, seconded by Sharon Van Horn, and carried without dissent. B. Adoption of 2008-2009 Health Department Budget, Fees, and Positions (March Agenda) The budget request was included in the March agenda packet but due to a lack of a quorum the Board was unable to take action on the request. The members at the March meeting endorsed the budget request. The budget request has been forwarded to the County Manager for consideration in preparing the total county budget request to the Board of Commissioners but is able to be altered by this Board’s action. Chris Harlan requested a discussion of the highlights of the budget request. Dr. Summers stated that a large part of the 15% increase is due to capital requests that have been requested in previous years but not funded. The other is new position requests that are not all revenue producing. Jessica Lee asked if it would be possible to modify the position description for the dental hygienist to maximize service possibilities. Sharon Freeland asked if the 15% increase is in line with the other departments. Dr. Summers replied that there is no way of knowing at this point. She commented that there were 64 new position requests submitted to the County Manager from the various county departments. The County Manager submitted 37 of those requests to the Commissioners. All of the Health Department position requests were included with those submitted. Chris Harlan said that the Board of County Commissioners should be aware of the department’s need for new positions from our reports and discussions with them of space needs to meet the growing demand for services. Three separate actions are needed for approval and submission of the budget to the County Manager and Board of Commissioners: 1. Approval of fee schedules as presented in the 2008-2009 budget request. 2. Approval of the budget request for fiscal year 2008-2009 3. Approval of new positions requested for fiscal year 2008-2009 with associated revenues, directing that if positions are not approved, revenues associated with earnings by these positions be removed from the budget. Motion to approve the fee schedules as presented in the 2008-2009 budget request and forward to Commissioners for approval was made by Sharon Freeland, seconded by Matt Vizithum, and carried without dissent. MINUTES ORANGE COUNTY BOARD OF HEALTH April 24, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 April 24, 2008 Motion to approve the budget request for fiscal year 2008-2009 for the Health Department and forward to the Commissioners for approval was made by Tim Carey, seconded by Anissa Vines, and carried without dissent. Motion to approve new positions requested for fiscal year 2008-2009 with associated revenues and forward to Commissioners for approval; directing that if positions are not approved, revenues associated with earnings by these positions also be removed from the budget was made by Jim Stefanadis, seconded by Matt Vizithum, and carried without dissent. C. 3rd Quarter Financial Report Letitia Burns presented the Financial Report for the Third Quarter. Additional funding, including funding needing approval at the April meeting has been accounted for in the total Budgeted Revenues and Expenditures for each division. She pointed out that there is a large cost involved in contract interpreters. Dr. Summers reported dental revenues were down due to lack of a dentist, however, a dentist has been hired to begin work May 5, 2008. A significant amount of State funding must be spent before the May 31, 2008 deadline and includes Accreditation, Pan Flu, Aid to County Medicaid Admin Reimbursement and Aid to County Essential Services funds. The Medicaid Cost Settlement estimate for Orange County Health Department is $289,172. The County Financial Services Department has been notified to expect an electronic deposit from DMA. D. Nominating Committee Report Three Board of Health members have terms ending June 30, 2008. Chris Harlan, nurse representative; DeWana Anderson, veterinarian representative; and Sharon Van Horn, at-large representative. Dr. Van Horn is completing her second three-year term and is not eligible for reappointment. Since she is serving in an at large slot, the Committee requested direction from Board members on potential applicants for this slot. Tim Carey requested information on the link to the County’s volunteer application. The Nominating Committee consists of Anissa Vines, Sharon Freeland, and Jim Stefanadis. They received the listing of current applicants for Board of Health positions that are on file with the County. Rosemary Summers noted that the Commissioners do not always follow the Board’s recommendations for appointments and are able to appoint representatives of their own choosing as they have done in the past. E. Informational Items MINUTES ORANGE COUNTY BOARD OF HEALTH April 24, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 April 24, 2008 a. CCPC Minutes There was no April meeting of the Clinical and Community Programs committee. b. EHPQA Minutes Tom Konsler reported on the April 9th committee meeting. A meeting has been scheduled with Tom Altieri, Planning Department, to make suggestions to the Comprehensive Land Use Plan Draft and has scheduled a meeting with him to discuss this. Also inclusions of Board suggestions of the department’s role in groundwater protection will be addressed. Mr. Altieri suggested the committee draft a paragraph of the Board’s suggestions to be included in the final report. Jessica Lee stated that the original document was absent of any reference to the Health Department’s role in addressing these issues in their work. Tom said that a 2nd phase draft will be available in May for additional comments. By consensus the Board encouraged pursuing inclusion of comments. c. Comprehensive Land Use Comments from Committee Included in the EHPQA Committee meeting minutes is a discussion of the opportunity to provide input on the Comprehensive Land Use Plan Draft. By consensus the Board recommended inclusion/addition of the Board of Health and Orange County Health Department’s part in water resources/groundwater protection. Rosemary Summers asked if there was any discussion in the Comprehensive Land Use Plan Draft of biosolids and if it was in the plan that it be discussed in the future. Tom Konsler reported that the Division of Water Quality has approached the county in the past year to explore the possibility entering into an agreement with DWQ to provide services on behalf of DWQ in Orange County. Motion to move forward with the recommendations of the Committee was made by Jim Stefanadis, seconded by Jessica Lee, and carried without dissent. d. Brochure Rosemary Summers handed out the 2006-2007 Annual Report prepared by Donna King and Candice Watkins-Robinson and complimented them on them on the publication. F. Tracking Form Review MINUTES ORANGE COUNTY BOARD OF HEALTH April 24, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 8 April 24, 2008 The tracking chart helps both the Board and staff keep track of upcoming agenda items and projects that will need attention in the coming months. Dr. Summers called the Board’s attention to items coming up on next month’s agenda. Tim Carey recommended the addition of mental health issues to the tracking form. V. Board Comments/Announcements A. Rosemary Summers stated that the Accreditation Site Visit team would be on site April 29, 30, and May 1. The Department is prepared and confident that the accreditation process will go well. VI. Adjournment Motion to adjourn the meeting was made by Tim Carey, seconded by Anissa Vines, and carried without dissent. The next Board of Health meeting will be held on May 22, 2008 at the Southern Human Services Center, Chapel Hill, North Carolina at 7:00 PM. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board