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HomeMy WebLinkAboutBOH minutes 052208MINUTES ORANGE COUNTY BOARD OF HEALTH May 22, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 May 22, 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 May 22, 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; Sharon Van Horn; Ernie Dodson; DeWana Anderson; Matt Vizithum; Moses Carey, Jr.; BOARD OF HEALTH MEMBERS ABSENT: Tim Carey; Sharon Freeland, family illness; Jessica Lee, 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; Jeff Jones, Environmental Health Specialist; Marietta Fort, RN, Personal health Services; Dr. Michael Day, Dentist, Dental Health Services. GUESTS PRESENT: Dr. Karyn Leniek I. Welcome and Introductions Chris Harlan, Chair, called the meeting to order at 7:00 P.M. II. Approval of May 22, 2008 Agenda The motion to approve the Agenda of May 22, 2008 was made by Matt Vizithum, seconded by Anissa Vines, and carried without dissent. III. Public Comment for Items NOT on Printed Agenda None IV. Volunteer Board Recognition by BOCC Moses Carey, Jr. expressed thanks to the members of the Board of Health from the Board of County Commissioners for volunteering their time in an effort to make Orange County a better place to live for all citizens. V. Action Items on CONSENT Agenda A. Minutes approval of April 24, 2008 meeting. B. Approval of Ad for Well Rules Adoption in June On July 1st of this year, Environmental Health staff will begin enforcement of state rules that govern drinking water wells 15A NCAC 2C .0300 et. Seq. These rules will overlap some of the rules and requirements contained in the Orange County Groundwater Protection Regulations currently in effect. MINUTES ORANGE COUNTY BOARD OF HEALTH May 22, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 May 22, 2008 The staff proposed an update of those regulations so that they mesh with the new state regulations. Staff will work with the EH regulations so that they mesh with the new state regulations. Staff will work with the Environmental Health PHP committee over the next month and will have a draft to be considered by the Board for adoption at the June 26th meeting. The Board was requested to approve the advertisement announcing the adoption of those rules in accordance with NCGS 130A-39. If approved, the advertisement will be posted in the Herald Sun on or about June 11th. Motion to approve the minutes as read and accept 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. Assurance Methodology Project Report The Orange County Health Department provides both Mandated and Non-Mandated Programs/Services. Administrative Rules state that the Health Department is to “provide, contract for the provision of, or certify the availability of services for all individuals within the jurisdiction of the local health department” for certain mandated programs. These programs include Adult Health, Home Health, Maternal Health (including MCC), Child Health (including CSC), Family Planning, Dental Public Health, and Public Health Laboratory Support. In the past the department has done an inadequate job of assessing or certifying the availability of health services and whether OCHD needs to encourage other providers to increase service availability or to directly provide the services. The exception to this was primary care where a special study was conducted to determine the need for services. This is becoming increasingly important as the development of program budgets and organizational alignment is considered. It is also an issue relevant to the 2007 Community Health Assessment where Access to Health Care/Health Insurance was the second highest priority. To address this concern, an “Assurance Methodology” tool was developed to measure the availability of health services for Home Health, Adult Health, and Dental Health within the community. Board members were provided with the Final Reports for the three different programs and the tool that was administered for each. Dr. Karyn Leniek, MD, presented the results of the study with a power point presentation. Moses Carey, Jr. asked Dr. Leniek if Orange County was the only county doing assurance methodology. Rosemary Summers stated that Orange County was at the forefront in doing this kind of study to assess the need for additional services to the community at this time. Dental Health Assurance: A point was made that the Dental Services Division had a low percentage of dental patients from the Cedar Grove, Efland areas of the county. The research determined that there are inadequate safety net providers to serve the MINUTES ORANGE COUNTY BOARD OF HEALTH May 22, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 May 22, 2008 population in these areas. The report stated that no safety net providers had a cap on Medicaid or uncompensated dental care however, 78% of non-safety net providers did have a cap on Medicaid and uncompensated care. 25% of safety net providers reported a cap on uninsured. Dr. Sharon Van Horn asked if there was a follow up system in place on the patients we cannot serve. Angela Cooke stated that Dental Health Services does not track those patients. Rosemary Summers questioned what the accessibility would show if the OCHD data were pulled out of the statistics and that it would be of benefit to the department to have the data presented with and without the statistical data from OCHD to get a clearer picture of health assurance for the underserved. Home Health Assurance: OCHD does not currently provide or contract for Home Healthcare services. An objective of the report was to determine whether or not the need exists for OCHD to begin to provide or contract for HHC services for Orange County residents. The report found that the community’s needs for adult HHC are being adequately met. One area of concern noted in the report is the lack of care provided to children and recommended further evaluation. Adult Health Assurance: OCHD currently provides primary care for adults in Hillsborough and limited primary care in Chapel Hill. The study found that the safety net practices in the study, of which OCHD is included, provide adequately accessible care for adults in Orange County in terms of geography, age group, spectrum of care, hours of service, timeliness of care, culture (language used), insurance and finance. Non-safety net practices were rated inadequate due to limitations in hours of service, language, insurance, and financial accessibility. The study concluded that the community’s needs are being adequately met with the inclusion of OCHD in the safety net pool. The study recommended continuing the present level of care at the Hillsborough and Chapel Hill locations. The Board would like to look at the tools being used further and recommended that staff examine the tool and methodology to make sure an accurate picture is being provided for both availability and quality. B. Rule Adoption – Orange County Wastewater System Rules 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. 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 MINUTES ORANGE COUNTY BOARD OF HEALTH May 22, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 May 22, 2008 consultation with the county attorney and the NC Attorney General’s office deletion of the two sentences regarding levels of certification and taking action on a contractor’s registration was recommended. 2. The procedure for abandonment of septic tanks in the current rules specifies the use of powdered chlorine for disinfection of the excavation before backfilling. Staff recommended removing the reference to chlorine and replacing it with hydrated lime, which is the current acceptable method of treating sewage contaminated area. These amendments to sections .1937 and .1961 of the Orange county Wastewater System Rules were presented for adoption by the Board. Motion to accept the revisions to the Orange county Wastewater System Rules as presented was made by Ernie Dodson, seconded by Jim Stefanadis, and carried without dissent. C. Accreditation Site Visit Recommendation The Accreditation Site Visit Team completed their site visit on May 1, 2008. The Board received the comments made during the exit conference. The final report with recommendations to the NC Local Health Department Accreditation Board was submitted to the Accreditation Administrator by May 15. The NC Local Health Department Accreditation Board will make the final decision at its Board meeting scheduled for July 18. Rosemary Summers thanked the Board of Health and staff for their hard work in preparation for the Accreditation Site Visit. She reported that the site visit team was complimentary and noted many positives in their final assessment report. The department met all but one activity and one benchmark; these are being disputed to make sure the findings are correct. If accepted, the department will have met 100% of all activities and benchmarks. The Accreditation Site Visit Team recommended the Orange County Health Department for accreditation to the Accreditation Board. D. Help 4 Kids Funding Recommendation and Action The Orange County Partnership for Young Children (OCPYC) has funded the Help 4 Kids Program since 1996. The initial funding for the program covered the entire salary and benefits for the nurse hired to work in the program. The program has provided a single intake source for children 0-5 with developmental needs and provided referral services to families and providers for specialty services. In 2006, the NC Division of Public Health recognized the increased need for some of the services to this population and created the Child Development Service Agencies (CDSA’s) to provide intake, assessment, and referral services for children 0-3 years of age who are diagnosed with a developmental disability. Last year OCPYC had some questions about whether the services OCHD provided through this grant were duplicative of the CDSA’s responsibilities and wanted additional tracking by our program of intake and referrals, especially data on families making appointments after a referral has been made. Over time, with no changes in MINUTES ORANGE COUNTY BOARD OF HEALTH May 22, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 May 22, 2008 state funding, the county has assumed an increased share of the position’s salary and benefits. During the grant process this year the Department requested full funding for the position’s salary and benefits ($70,000). The OCPYC Board approved the recommendation from their allocation committee for funding at $35,000 and requested that the program be refocused to include more outreach and data collection and reporting. This is $21,760 less than last year’s allocation and would require OCHD to seek additional county funding to support the project. Since this is not a mandated service and the Department does not have the resources to absorb the cut in funding along with the same or additional work requirements, the Health Director made the decision to return the funding to OCPYC for FY 08-09. The Public Health Nurse III currently filling the position has been offered an internal transfer to an open position in the Health Department. The aspects of the position that relate to current Health Department programs will continue to the extent that other staff members are able to integrate those functions into their current duties. For example, birth certificates will continue to be screened for referral to health department programs such as Families in Focus or Child Services Coordination. Collaboration with community providers will continue through staff service on coordinating committees, however regular meetings organized by OCHD will no longer be scheduled. The Health Director asked for the Board’s concurrence with the decision to discontinue this program on the basis of insufficient funding to sustain the program. Motion for concurrence to discontinue the Help 4 Kids program was made by Moses Carey, Jr., seconded by Anissa Vines, and carried without dissent. E. Board of Health Summer Meeting Schedule In past years the Board of Health has taken a summer meeting break to accommodate Board member’s vacation schedules. The Board will need to meet in June to take action on the local well rules, but if it so chooses could decide not to meet in July. The Board of Commissioners will not meet in July or the first part of August. After the Board of Commissioners meet on June 24, they will not meet again until August 19. The Board members discussed their vacation schedules to determine whether a quorum would be present for the July meeting. Motion to cancel the July Board of Health meeting was made by Matt Vizithum, seconded by Anissa Vines, and carried without dissent. F. Budget Public Hearings The Board of Commissioners has two opportunities available to the public to comment on the county budget through public hearings. The first public hearing is Tuesday, May 27 at 7:30 pm in Hillsborough at the Battle Courtroom, and the second public hearing is Thursday, May 29 in Chapel Hill at the Southern Human Services Center. MINUTES ORANGE COUNTY BOARD OF HEALTH May 22, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 May 22, 2008 The Board of Health has afforded itself of the opportunity in the past to speak at these public hearings to emphasize the needs of the health department. There are critical requests this year for the health department that include: 1. Senior Public Health Educator (Volunteer Coordinator) for the Medical Reserve Corps and CERT Programs. Without this position, these programs would be lost entirely. There are currently 200 active volunteers in the Reserve Corps and classes are scheduled for CERT volunteers through the summer. 2. Public Health Nurse II for the Communicable Disease Program to provide additional coverage for the increased refugee population. 3. Half-time Family Nurse Practitioner to provide services for the increased numbers of refugees. 4. Administrative Assistant I to provide office support for refugee and immigrant health, health promotion and education, and the quality assurance/risk management office. 5. Dental Hygienist (Community Dental Care Coordinator) to manage the preschool screening project, including education and follow-up and to provide clinical services to prenatal women. 6. Unfunded capital requests from previous years. Board members consulted their schedules for availability. Dr. Sharon Van Horn volunteered to speak at the Tuesday, May 27 Commissioner’s meeting and Chris Harlan volunteered for the Thursday, May 29 meeting. G. Nominating Committee Report Two Board members have terms ending June 30, 2008 that are eligible for reappointment to a second three year term: Chris Harlan, nurse representative; and DeWana Anderson, veterinarian representative. Recommendation for reappointments can be forwarded to the Board of Commissioners along with an attendance record showing participation by members seeking reappointment. Both members eligible for a second term have agreed to serve if reappointed. Motion to forward a recommendation for reappointment of Chris Harlan and DeWana Anderson to the Board of Commissioners for action was made by Anissa Vines, seconded by Matt Vizithum, and carried without dissent. H. Public Health Study Commission Report The 2008 Public Health Study Commission completed its work in April. This legislative study commission considered all of the recommendations from the 2008 Public Health Improvement Plan that was submitted by the NC Division of Public Health. The Commission endorsed all of the recommendations contained in the improvement Plan and has developed a series of legislative initiatives that will be introduced into the short session for consideration. MINUTES ORANGE COUNTY BOARD OF HEALTH May 22, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 May 22, 2008 Of special note is the request for $23 million dollars for essential services for local health departments. This is also the top request of the NC Health Director’s Association and the NC Public Health Association. This has the potential to afford local health departments with an infusion of funds to support core services. Last year with a $2 million statewide allocation, health departments saw the first increase in these funds since 1972. Orange County received $15,000 that was used to develop a DVD for the Burmese/Karin refugee population on communicable disease screening and physical assessment and to support increased interpreter costs. The Study Commission Report was offered for Board discussion and possible follow-up action by Board members as the General Assembly has recently convened and will be considering these pieces of legislation. I. Committee Reports The Board’s two standing committees meet as needed to discuss upcoming issues of importance or to gain feedback from Board members on various topics. The Personal Health, Dental Health and Health Promotion Programs Committee met on May 14. Wayne Sherman reported that a Primary Care Grant application for $70,370 in funding had been submitted. If the funds are received the department would continue providing primary care services at the Chapel Hill office. Funds would help supplement costs of interpreter services and provide care for the increasing number of refugees/immigrants. In addition, the male member of households of clients currently receiving services that contribute financially to the family unit will be able to be seen for preventive/primary care services. Donna King reported that the committee explored the Diabetes Umbrella Initiative, a state-sponsored opportunity for local Health Departments to provide diabetes self- management instruction to clients and to bill under a state certificate. It was determined that the State needs more time to work out the billing issues and OCHD needs to develop a plan for incorporating this initiative internally, including identifying the lead person to implement and management the initiative. The Environmental Health, Preparedness & Quality Assurance Committee did not meet this month. J. Informational Items a. Comprehensive Land Use Plan Comments: Based on direction from the Board, staff met with Tom Altieri with the OC Planning Department and submitted the comments to him for consideration on the first draft of the Comprehensive Land Use Plan. He will be submitting the comments along with all of the other comments to the Board of County Commissioners and the Planning Board for the May 19th hearing. He will also submit the comments to David Stancil, the Element Manager for the Natural and Cultural Systems Element. b. Invitation to Present at National Meetings: MINUTES ORANGE COUNTY BOARD OF HEALTH May 22, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 8 May 22, 2008 Donna King announced that Bobbie Jo Munson Healthy Carolinians Coordinator, has been selected to present at CDC’s Annual Conference on Assessment Initiative – August 18 – 20, 2008. The conference will be held in Atlanta, Georgia and will focus on sharing information on innovative systems and methods that improve the way data is used in public programs, services, and policies at the local and state levels. Sessions will address data dissemination, health assessment research, applied data analysis, presentation techniques, and community health-assessment processes and outcomes. Participants will include staff members from local and state health departments, federal agencies, and community organizations interested in the collection, analysis, and dissemination of data for community health assessments. Ms. Munson will be representing Orange County, as well as the N.C. Office of Healthy Carolinians and has been recognized for coordinating an innovative community assessment process and producing a consumer-friendly executive summary. K. Pending and Recurring Items – May The pending and recurring items review allows Board members to plan future agendas and direct the staff on special work items. There were no comments or changes on the May chart. V. Board Comments/Announcements A. None VI. Adjournment Motion to adjourn the meeting was made by Jim Stefanadis, seconded by Ernie Dodson, and carried without dissent. The next Board of Health meeting will be held on June 26, 2008 at the Town of Hillsborough Town Barn, Hillsborough, North Carolina at 7:00 PM. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board