Loading...
HomeMy WebLinkAboutBOH minutes 102407MINUTES ORANGE COUNTY BOARD OF HEALTH October 24, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 October 24, 2007 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 October 24, 2007 at the Southern Human Services Center, Chapel Hill, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Matt Vizithum, Chair; Chris Harlan, Vice-Chair; Tim Carey; Jim Stefanadis; Sharon Freeland; Jessica Lee; DeWana Anderson; Anissa Vines BOARD OF HEALTH MEMBERS ABSENT: Moses Carey, Jr.; Ernie Dodson due to illness; Sharon Van Horn 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; Carla Julian, Quality Assurance/Risk Management Division; Dr. Michael Fisher, Medical Director; Anne Miles Cassell, Administrative Assistant; GUESTS PRESENT: Karyn Leniek, MD, Preventive Medicine Fellow I. Welcome and Introductions Matt Vizithum called the meeting to order at 7:10 P.M. II. Approval of October 24, 2007 Agenda The motion to approve the Agenda of October 24, 2007 was made by Jim Stefanadis, seconded by Jessica Lee, and carried without dissent. III. Public Comment for Items NOT on Printed Agenda None IV. Action Items on CONSENT Agenda A. Minutes approval of September 27, 2007 meeting B. Quarterly Financial Report Review The Quarterly Report for the first quarter of FY 07-08 was given to the Board for review. C. Child Fatality Prevention Team Report The North Carolina Juvenile Code established a Child Fatality Prevention Team (CFPT) in every county of the state. The CFPT task is to review the records of all child fatalities in the county. Community Child Protection MINUTES ORANGE COUNTY BOARD OF HEALTH October 24, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 October 24, 2007 Teams (CCPT) were established in response to Executive Order 142 in May of 1991. The mandate to the CCPTs is, in part, 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. They are to contain recommendations for resources where deficiencies and gaps may exist. The Board received the report and was asked to approve and forward it to the Board of Commissioners. D. December Meeting Time Change For the past few years the Board has held its December meeting at a local restaurant. This year, the agenda for the December meeting will be quite full, so the staff suggested that the Board have dinner catered this year as part of a working dinner meeting and start the meeting at 6:30 pm and begin the business meeting at 7 pm as usual. The meeting will be at Southern Human Services Center. E. Approve NAPSAC grant with Orange County Partnership for Young Children The NC State Partnership for Young Children recently offered local Smart Start Partnerships the opportunity to apply for additional state funds in three different areas: Behavioral/Mental Health; Parenting; and Nutrition and Fitness. The Orange County Partnership for Young Children (OCPYC) applied for a 2-year Nutrition and Fitness grant and requested to partner with OCHD’s Smart Start-funded Child Care Health Consultant (CCHC) Program to offer NAPSACC (Nutrition and Physical Activity Self-Assessment for Child Care). This was viewed as a natural synergy since the CCHC nurse has already developed constructive relationships with Child Care Centers and obesity is a major concern needing attention in childcare environments. The NAPSACC program aims to improve nutrition and physical activity policies and practices in childcare settings. The heart of the project is the environmental assessment instrument, which was designed to allow childcare centers and family childcare homes to assess their nutrition and physical activity environments. The tool focuses on nine areas of nutrition and six areas of physical activity. Childcare providers then select areas in need of improvement and team up with their CCHC to implement the NAPSACC program. OCPYC was awarded $31,297 in Year 1 of which $27,120 is provided to OCHD to supplement the current CCHC grant ($57,950). In Year 2, the OCPYC award is $32,324 of which $28,329 will go to OCHD. The additional money will cover fully the remaining portion of the salary and benefits of the CCHC position and provide equipment and operating funds. The MINUTES ORANGE COUNTY BOARD OF HEALTH October 24, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 October 24, 2007 CCHD is expected to implement the NAPSACC program with 5 Child Care centers per year. Motion to approve the minutes of September 27, 2007 and items on the Consent Agenda, forwarding such items as required to the Board of Commissioners for approval, was made by Sharon Freeland, seconded by Tim Carey, and carried without dissent. V. Reports and Discussion with Possible Action A. Community Health Assessment Priorities Bobbie Jo Munson reported that the Healthy Carolinians of Orange County held its annual meeting on September 26, 2007 at the Seymour Center in Chapel Hill. At the meeting, participants were presented with data on 10 priority areas from the community health assessment. After being presented with the data and a brief discussion about the issues, participants voted on their top three issues. The five issues that received the most votes were: 1. Health Promotion (chronic disease) = 36 votes 2. Access to Health Care/Health Insurance = 28 votes 3. Adult Substance Abuse and Mental Health = 27 votes 4. Child and Adolescent Health = 23 votes 5. Transportation = 19 votes The next step will be to convene interested partners and discuss strategies to address these issues. Matt Vizithum asked where the transportation issues were centered. Ms. Munson replied that the northern part of the county was most in need. Motion to accept the issues as presented as part of the final draft was made by Jessica Lee, seconded by Chris Harlan, and carried without dissent. B. Assurance Methodology Project The Orange County Health Department provides both Mandated and Non-Mandated Programs and 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. Those 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, we have done an inadequate job of assessing (or certifying) the availability of health services within the community to know whether individuals have adequate access to 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 we MINUTES ORANGE COUNTY BOARD OF HEALTH October 24, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 October 24, 2007 had a special study to determine the need for services. This is becoming increasingly important as we consider the development of program budgets and organizational alignment. It is also an issue relevant to our 2007 Community Health Assessment where Access to Health Care and Health Insurance was the second highest priority. To address this concern, we propose to develop an "Assurance Methodology" or tool to measure the availability of health services, particularly those noted above, within the community. The parameters of this tool are still being defined but may include geographic, economic (Medicaid, Medicare, sliding scale fees), cultural competency (language, staff training), hours of service, etc. considerations. The tool needs to be simple to implement, understandable and utilized on a consistent basis in a pre-determined time frame. Wayne Sherman introduced Dr. Karyn Leniek who is working with us on this effort. Dr. Leniek is a UNC Preventive Medicine Resident. She is taking this on as a special project within the Continuous Quality Improvement Rotation and plans to have a draft document by April 2008. Dr. Leniek reviewed the Assurance Methodology initiative, her progress to date, and plans going forward. Dr. Carey said he was very supportive of this study. C. Fee and Eligibility Policy Amendments Rosemary Summers reported that the Billing Committee reviewed the policy for compliance with all federal and state requirements and made several changes to the policy. In discussion with the County Budget and Finance staff, the entire section on “bad debt” was deleted and will now be in the Department Financial Procedures Manual under “delinquent accounts.” This will fit with the county’s accounting procedures as well. In the future this policy will likely be separated into a “policy statement” that the Board will adopt and a separate document will be created with procedures that can be more easily changed as state and federal requirements change. Motion to approve the policy revision was made by Jim Stefanadis, seconded by Chris Harlan, and carried without dissent. D. No Fault Well Repair Fund Policy Amendments In 2001, American Stone Company and OWASA applied for and received a special use permit for the continued use of the American Stone Quarry until the end of 2030. After that date, OWASA will operate the facility as a reservoir. The Quarry is located approximately 5 miles west of Carrboro on Hwy 54. As a condition of the special use permit, American Stone established a "No Fault Well Repair Fund" (NFWRF) for those residents MINUTES ORANGE COUNTY BOARD OF HEALTH October 24, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 October 24, 2007 whose property is within 3,000 feet of the perimeter of the quarry and who experience well failures not directly attributable to the quarry operation. OCHD staff has responsibilities in providing sampling services, technical assistance, consultation regarding remedies, and determination of well failure. Staff has also taken on fiscal administration of the fund. The Board of Health is the avenue of appeals for those residents who are not satisfied with the process. In 2004, staff proposed an alternative to well replacement, repair, or water treatment if a well had detectable levels of arsenic (>1part per billion [PPB]) but those levels were still below the recommended drinking water limit of 10 PPB. If the well was otherwise satisfactory, the homeowner could receive bottled water to be paid by the NFWRF at a rate of 15 gallons per person per month. The BOH approved this component with the idea it would be reviewed after 2 years for continuation or revisions. In November of 2006, the board provided direction to staff to research available water treatment options for the individuals who have detectable arsenic levels in their well water. Tom Konsler reported that there are currently 10 homes participating in the bottled water program - two are on a shared well. One home will be removed because the well has been replaced and it does not have detectable arsenic levels. A summary sheet of the past expenses paid from fund was provided for the Board. The goal is to provide one point source tap in the home that has adequate treatment to provide water with less than 1 PPB Arsenic. This is best achieved through a reverse osmosis (R/O) filtration unit installed for a drinking water tap. The recommended units cost between $900 and $1000 installed. These are NSF units that will treat up to 75 gallons per day and approximately one-year service intervals. Annual service on the units cost approximately $150. According to the adopted policy, maintenance and servicing of treatment systems is the responsibility of the owner. The R/O units are expected to be effective treatment for Type 5 arsenic, but not Type 3 arsenic. We do not know the species of arsenic in this area. The state lab has equipment to analyze for the speciated arsenic, however not at these low levels. Staff is recommending the following: - That a reverse osmosis unit be installed for the one well that has 9 PPB arsenic. - If follow-up testing after 2 weeks of operation proves that the unit is successful in lowering the arsenic level below 1 PPB, that similar R/O units be installed at the remaining 7 homes. - If the units are found to lower the arsenic levels, that the bottled water purchase program be discontinued. MINUTES ORANGE COUNTY BOARD OF HEALTH October 24, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 October 24, 2007 Matt Vizithum asked how the homeowners felt about this proposal. Mr. Konsler reported that one homeowner was very receptive to the proposal and he did not know of other homeowners’ feelings. Motion to approve the plan of phasing out the bottled water program pending success of the R/O units to lower arsenic levels to <1PPB was made by Jessica Lee, seconded by Tim Carey, and carried without dissent. E. BOH Policy and Procedure Manual Rosemary Summers reported that In order to prepare for accreditation, a comprehensive review of all departmental policies and procedures, including those directly affecting the Board of Health was undertaken by the managers and supervisors. Board members were provided with a draft of the BOH Manual that contains the major elements that are needed to meet standards. This required a compilation of procedures or policies that were already in place but not in a central repository. Along the right side of the Table of Contents, are notations of revisions either earlier on this agenda or a new document that the Board will need to review, modify, and approve. Once the Board approves the individual pieces presented, the formatting and numbering will be completed and a final document presented at a subsequent meeting and as part of the orientation manual. Motion to accept the revisions as presented was made by Tim Carey, seconded by Jim Stefanadis, and carried without dissent. F. Agenda Items for Joint Meeting with BOCC The Board of Commissioners has confirmed the dinner meeting on November 13, 2007 from 5:30 until 7:00 pm at the Link Government Services Center in Hillsborough. The Board agreed that it would focus on facility and technology needs, especially as they relate to the provision of core public health services and on the needs in response to the community assessment priorities, especially as they intersect with the strategic plan for the health department. The board was provided with background information by staff. Board members discussed the presentation and discussion points. Rosemary Summers suggested beginning with a short PowerPoint presentation emphasizing statistics of last year’s health services. Dr. Carey suggested handouts rather than a screen presentation and suggested an emphasis on the consequences of inaction. Tim Carey brought up the question of how to make a point of what we need the most in the way of facilities and technology. He suggested we emphasize the rising immigrant/refugee population and their health needs. Jessica Lee was in agreement. Dr. Carey stated that Orange MINUTES ORANGE COUNTY BOARD OF HEALTH October 24, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 October 24, 2007 County should be one of the leaders in the state based on who and where we are. Chris Harlan stated that she felt the department should not be in a position of having to beg for funds but should be able to clearly state our needs. A funding comparison with similar counties was provided to Board members and Orange County was ranked at the bottom of per capita expenditures for health services. Anissa Vines suggested simplifying the chart for readability. Dr. Vines also voiced an opinion that the Board should not stress the technology need, but make the Commissioners aware that we are not immune to the need to upgrade software. G. Informational Items a. Drought response update: Tom Konsler reported that although the drought continues there has not been an increase in well permits as a result. He said there have been many calls from concerned well owners about conserving water. An effort to educate the public through the media will be undertaken. A joint effort with OWASA will send out information to food services on water conservation without sacrificing sanitation. b. Influenza update: Wayne Sherman reported that the department has 2545 doses of influenza vaccine. Several local flu clinics and community senior centers have scheduled flu clinics. H. Tracking Form Review The Tracking Form had no changes. This form allows the Board a snapshot of upcoming items. VI. Board Comments/Announcements None VII. Adjournment Motion to adjourn the meeting was made by Jim Stefanadis, seconded by Jessica Lee, and carried without dissent. Immediately following a joint dinner meeting with the Board of Commissioners at the Government Services Center at 5:30 PM, the next Board of Health meeting will be held on November 13, 2007 at the Whitted Human Services Center, Health Department Conference Room, Hillsborough, North Carolina at 7:30 PM. Respectfully submitted, MINUTES ORANGE COUNTY BOARD OF HEALTH October 24, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 8 October 24, 2007 Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board