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HomeMy WebLinkAboutBOH minutes 092707MINUTES ORANGE COUNTY BOARD OF HEALTH September 27, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 September 27, 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 September 27, 2007 at the Government Human Services Center, Hillsborough, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Matt Vizithum, Chair; Chris Harlan, Vice-Chair; Tim Carey; Jim Stefanadis; Sharon Van Horn; Ernie Dobson; Jessica Lee; Anissa Vines; DeWana Anderson BOARD OF HEALTH MEMBERS ABSENT: Sharon Freeland; Moses Carey, Jr., meeting conflict STAFF PRESENT: Rosemary Summers, Health Director; Wayne Sherman, Personal Health Services Division Director; Tom Konsler, Environmental Health Services Division Director; Angela Cooke, Dental Health Services Division Director; Letitia Burns, Business Officer; Donna King, Health Promotion and Education Services Division Director; Anne Miles Cassell, Administrative Assistant; Andy Adams, Environmental Health Supervisor; Connie Pixley, Environmental Health Specialist GUESTS PRESENT: None I. Welcome and Introductions Matt Vizithum called the meeting to order at 7:00 P.M. and recognized two new employees in the Environmental Health Division, Andy Adams and Connie Pixley. II. Approval of September 27, 2007 Agenda The Chair announced the addition of Item IV.B.5) Mouthguard Project Funds to the Consent Agenda and Item V.F. Adoption of State Onsite Wastewater Rules to the Action Agenda. The motion to approve the Agenda of September 27, 2007 as amended was made by Jessica Lee, seconded by Chris Harlan, and carried without dissent. III. Public Comment for Items NOT on Printed Agenda None IV. Action Items on CONSENT Agenda A. Minutes approval of August 23, 2007 meeting. B. Acceptance of Additional Funds The Department received notification of additional funding for four different areas: 1) The Physical Activity and Nutrition Branch has awarded a continuation grant to the Department for the Minority Churches Ministry Project in the amount of $16,858 to be spent MINUTES ORANGE COUNTY BOARD OF HEALTH September 27, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 September 27, 2007 by May 31, 2008. 2) The Family Planning Program was awarded the Department an additional $7,650 in Temporary Assistance to Needy Families. This will be used to purchase additional birth control methods. 3) The Division of Public Health has awarded the Department a one-time allocation of $25,000 to help prepare for accreditation. The Department plans to use half for temporary administrative support for preparing the self-assessment instrument and half to defray other costs of preparation for the site visit. 4) The Division of Public Health has allocated $15,000 to the Department in general “aid to county” funds that will be recurring. The state has not yet advised us whether there are restrictions on the use of these funds. These funds have a provision for non-supplantation of currently allocated county funds. 5) The Department has been awarded $5,000 for the Mouthguard Project from the Strowd- Roses Foundation. Motion to approve the minutes of August 23, 2007 and items on the Consent Agenda as amended was made by Chris Harlan, seconded by Ernie Dobson, and carried without dissent. V. Reports and Discussion with Possible Action A. 2006-2007 Financial Report Letitia Burns reported that the summary report shows that the Department earned 95% of the expected revenue and expended 94% of the budgeted expenditures. This year for the first time, the county adjusted budgets at the end of the year to reflect the mandatory hiring delay adjustments. $248,922 was deducted from our budgeted amount for the hiring delays. For some divisions this was a significant amount. These “adjustments” were used to balance the overall County budget. In the past, the Department has been able to use lapsed salary funds to balance revenue shortfalls, which are usually due to vacant positions. Matt Vizithum asked what it meant when the funds went into the County General Fund. Rosemary Summers explained that the County uses the lapsed salary funds to offset expenditures in the entire County budget and any positive balance would go into the General Fund. One of the things that the County has been concerned about is keeping a set ratio in savings in order to qualify for a higher credit rating and the advantage of lower interest loans. Tim Carey questioned whether the county would repeat taking back the unspent lapsed salary funds again next year. Rosemary Summers commented that this year the county has funded salaries at 96% and theoretically if the department were fully staffed for the year it would fall 4% short. The Department is closely tracking lapsed salary figures in the event the County takes back unspent lapsed salary funds again. B. Joint BOCC/BOH Topics The Board of Health is tentatively scheduled to meet with the Board of Commissioners on MINUTES ORANGE COUNTY BOARD OF HEALTH September 27, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 September 27, 2007 November 13, 2007 from 5:30 to 7:30. Since the time will be limited it is usually good to limit the topics to one or two. This would enable the Board of Commissioners to consider items of mutual importance at their annual retreat. Some suggested topics of discussion the Board considered include: • Facility limitations for clinical services • Update of strategic plan progress • Community assessment priorities • Emerging technology needs. The Board of Health by consensus agreed to alter the regularly scheduled November 14th meeting and meet after the joint meeting with the Commissioners on November 13th moving the Board of Health meeting to the Whitted Health Department Conference Room and beginning at 7:30 PM. Rosemary Summers pointed out that we would have approximately one hour for discussion with Commissioners and therefore it is important to narrow it down to two topics. Jim Stefanadis asked her what she felt were the most important issues. She replied that the facilities issue is the most critical because lack of adequate facilities limits the Department’s ability to serve the healthcare needs of the Orange County community. This could be combined with both software and hardware technology issues. Another issue that came out of the Community Assessment was access to healthcare and the uninsured population. This also ties in with our community facilities. It would be good to use these top issues from the Community Assessment and relate them to what we do as a health department. Dr. Carey asked about the issue of consolidating facilities versus keeping dental and health clinics at both ends of the county. Because of access issues the Board chose to keep both sites operational but they need to be of sufficient size to meet the needs of the community. Ernie Dodson said that developers should be approached by the Commissioners to donate a space for facilities and that this has often been done. He said developers are generally agreeable to this. Dr. Summers commented that this was mostly recognized as donations for open space, green space, and schools. Board members felt that the need for clinic space was on a par with green space and schools. Dr. Carey asked what our message should be and said that he felt it would be best to keep the dental and health clinics together and that the planning process should begin within the next year, otherwise it would be the next decade before this is resolved. Dr. Summers commented that people want to come to one place for preventive and primary care as well as other healthcare and dental services. The Hillsborough clinics need the most work, as the site was not originally built for a healthcare or dental services. For example, the Hillsborough clinic does not have a negative pressure room to use for TB patients. The Department does have funds in Medicare cost settlement that could be used toward any project that may be approved for expansion. The last renovation was in 2000 and was mostly cosmetic. Sharon Van Horn and Jessica Lee agreed that the issue is important and should be talked about. The Board agreed MINUTES ORANGE COUNTY BOARD OF HEALTH September 27, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 September 27, 2007 that the overall focus should be on the core services of the health department. Matt Vizithum asked if there was a chance there would be additional space available to the department in the Whitted Building if some tenants relocate to a new facility. Dr. Vizithum also said that he felt that the Commissioners might have a viewpoint that primary care facilities are not a priority because they felt there were adequate providers available and he felt that this was an important issue. He said the Board needs to have a discussion of how much and where we need the services. Sharon Van Horn asked about the status of discussions going on between UNC and Piedmont Healthcare Services about increasing primary care availability. Dr. Carey said they are aware that the Health Department offers primary care but the capacity is so small that it was not a factor. Piedmont is at capacity with a 3-month wait for an appointment and the UNC emergency room is at capacity. It is going to take a crisis to make the reality known. Angela Cooke stated that the lack of a dentist is severely affecting service delivery. The dental clinics and equipment are outdated and it makes it difficult to attract quality personnel for that position. Dr. Carey stated that in order to have a vibrant county you must have adequate public health infrastructure. Chris Harlan commented that these issues are huge issues being debated nationally at this time. Orange County is wealthy compared to poorer areas around the state and should be in a much better position than some to be able to make headway toward resolving these inadequacies. It is a matter of choosing priorities. Anissa Vines suggested making cost comparisons to counties with a similar population diversity as Orange County. C. Committee Reports The two Board standing committees meet monthly or as needed. This provides a place in the agenda for the committees to report on action or information items for their committee. Jim Stefanadis requested that the minutes of the September 12 Clinical and Community Programs Committee be included for Board members. Angela Cooke reported that there is one dentist applicant that is experienced in the public health field and is interested. Jessica Lee reported that Colgate has a dental van that goes throughout the state and Durham County has a van that goes throughout Durham County providing services, but that they seem to sit idle. Jim Stefanadis asked for update on the TB outbreak in the jail. Rosemary Summers reported that the jail is using the same protocols and process that we set up when we contracted with the Sheriff to do jail health. In addition, the Sheriff has instituted skin testing of jail inmates if it MINUTES ORANGE COUNTY BOARD OF HEALTH September 27, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 September 27, 2007 appears they will be incarcerated for more than 3 days. Continuing education on symptoms for jail staff was also reinforced. There was one positive TB case and all jail staff, public works staff, and other contacts have been tested and are being followed, close to 300 people. Orange County is going to have an increased risk from TB because of an increase in populations that may have been infected in their home country. Wayne Sherman commented that Orange County has a large number of federal prisoners as well and the medical paperwork does not always arrive with the prisoner. Ernie Dodson reported that the Environmental Health, Preparedness & Quality Assurance Committee did not meet in August. D. Informational Items a. Capital Improvement Requests for 08-09 Requests made to the County were attached to the agenda. The budget staff believes the Commissioners will consider requests before the end of the calendar year. b. Hot Topics from Divisions Health Promotion and Education – Donna King reported that Candice Watkins-Robinson has transitioned over from Quality Assurance/Risk Management and several projects are being lined up that will utilize her services. Also, an issue of concern is a demand for nutritionist services both internally and externally. Meeting that demand is a challenge. Environmental Health – Tom Konsler reported that there was a meeting with UNC School of Public Health for the biosolids study design that will take place this year. We have a collaborative agreement from the City of Burlington for this. Possible onsite rules revisions are being looked at. Also, staff is preparing a report on the No Fault Well Repair Fund involving possible changes that will be presented at next month’s meeting. Dental Health - Angela Cook reported that the UNC Dental School is going to incorporate Smart Start pre-school dental screenings into their curriculum. Central Administrative Services - Letitia Burns reported that the quarterly financial report would be available for the next meeting. An issue of concern is storage of inactive medical records. There is no more space available at the facility the department now uses. Personal Health Services – Wayne Sherman reported that the department has experienced an influx of 152 Burmese refugees since July. E. Tracking Form Review MINUTES ORANGE COUNTY BOARD OF HEALTH September 27, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 September 27, 2007 The tracking form contained some minor changes. The form allows the Board a view of upcoming agenda items. F. Scheduling Consideration of State Onsite Wastewater Rules Revisions Tom Konsler reported that since the Board last adopted local regulations governing wastewater systems in 1999, there have been several amendments and changes to the North Carolina Rules for Sewage Treatment and Disposal Systems (15A NCAC 18A.1900). Staff recently met with the county attorney to discuss whether the Board must re-adopt these rules by reference whenever a change is made at the state level. He advised that the Board consider adoption of the state rules so as to avoid any inconsistencies in enforcement. Staff has reviewed the state rules and is recommending adoption of the changes while retaining all of the more stringent requirements previously adopted by the Board in 1999. The next step in the process is to proceed with public notification of intent to adopt at the next Board meeting on November 13, 2007. Motion to schedule for adoption of the current North Carolina Rules for Sewage Treatment and Disposal at the November 13, 2007 meeting was made by Jim Stefanadis, seconded by Anissa Vines, and carried without dissent. VI. Board Comments/Announcements A. None VII. 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 move into Closed Session was made by Anissa Vines, seconded by Jim Stefanadis, and carried without dissent. Motion to move into Open Session was made by Chris Harlan, seconded by Tim Carey, and carried without dissent. VIII. Adjournment Motion to adjourn the meeting was made by Jessica Lee, seconded by Tim Carey, and carried without dissent. The next Board of Health meeting will be held on Wednesday, October 24, 2007 at the Southern Human Services Center, Chapel Hill, North Carolina at 7:00 PM. Respectfully submitted, MINUTES ORANGE COUNTY BOARD OF HEALTH September 27, 2007 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 September 27, 2007 Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board