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HomeMy WebLinkAboutBOH minutes 032306MINUTES ORANGE COUNTY BOARD OF HEALTH March 23, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 March 23, 2006 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 March 23, 2006 at the Government Services Center, Hillsborough, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Jessica Lee, Chair; Matt Vizithum, Vice-Chair; Moses Carey, Jr.; Chris Harlan; DeWana Anderson; Jim Stefanadis; BOARD OF HEALTH MEMBERS ABSENT: Sharon Van Horn due to illness; Alan Rimer, Alice White, Sharon Freeland, out of town. STAFF PRESENT: Rosemary Summers, Health Director; Angela Cooke, Dental Health Services Division Director; Ron Holdway, Environmental Health Services Division Director; Donna King, Health Promotion and Education Division Director; Wayne Sherman, Personal Health Services Division Director; Anne Miles Cassell, Administrative Assistant; Sandy Garrett, QA-Risk Management Coordinator GUESTS PRESENT: Gwen Harvey, Assistant County Manager I. Welcome and Introductions Jessica Lee called the meeting to order at 7:00 P.M. II. Approval of March 23, 2006 Agenda The motion to approve the Agenda of March 23, 2006 was made by Moses Carey, Jr., seconded by Matt Vizithum, and carried without dissent. III. Public Comment for Items NOT on Printed Agenda None IV. Action Items A. Minutes approval of February 23, 2006 meeting Motion to approve the minutes of February 23, 2006 was made by DeWana Anderson, seconded by Moses Carey, Jr., and carried without dissent. B. Department of Health and Human Services Consolidated Agreement The 06-07 NC Consolidated Agreement stipulates the provisions for receiving state and federal support for the programs conducted by the department. At this point in time the state anticipates funding at the same levels approved this year. Potential shortfalls may occur in Health Promotion (cut of $24,641) and a 15% cut in public health preparedness funds. Final MINUTES ORANGE COUNTY BOARD OF HEALTH March 23, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 March 23, 2006 guidance on budgetary amounts will be available in July. The programs impacted are: General Aid to Counties Child Health Maternal Health Child Service Coordination AIDS (Federal) Immunization Action Plan Family Planning Public Health Preparedness Food and Lodging Communicable Disease Environmental Health Immunization Health Promotion The state consolidated agreement is anticipated to provide $478,229 federal and state dollars to the county to provide specific services for fiscal year 2006-2007. The total amount funded represents less than 9% of the overall health department budget. This does not include Medicaid revenue, which is earned separately for services provided. A summary sheet outlining specific changes in the agreement was provided with the actual agreement. Board members were asked to please note that WIC program is contracted to Piedmont Health Services, Inc. and is not provided by the Health Department. Motion to approved the 06-07 NC Consolidated Agreement and forward it to the Board of County Commissioners for action was made by Moses Carey, Jr., seconded by Matt Vizithum, and carried without dissent. C. Upcoming Board Vacancies On July 1, 2006 the Board will have two vacancies through fulfillment of maximum terms as established by the Board of Commissioners. Alice White, currently filling an at-large position and Alan Rimer, currently filling the engineer position will complete their terms of office. The Nominating Committee reviewed the current applications and recommended Dr. Anissa Vines for the at-large position. Dr. Vines is currently an epidemiologist with the UNC School of Public Health and lives in northern Orange. The committee felt her background as an epidemiologist would be advantageous to the Board and recommended Dr. Vines for the at-large position. There are currently no qualified applicants for the engineer position. In addition to these vacancies, Sharon Freeland is completing a partial term on June 30, 2006 and is eligible for reappointment to a first full-term. Matt Vizithum is also completing his first term on June 30, 2006 and is eligible for a second term. Both Board members have agreed to continue serving on the Board of Health. Motion to recommend Dr. Anissa Vines for the At-Large position and forward this recommendation to the Board of County Commissioners for approval was made by Chris Harlan, seconded by Jim Stefanadis and carried without dissent. Motion to recommend Matt Vizithum and Sharon Freeland for reappointment to the Board of Health was made by Chris Harlan, seconded by Jim Stefanadis, and carried without dissent. MINUTES ORANGE COUNTY BOARD OF HEALTH March 23, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 March 23, 2006 D. 2006-2007 Health Department Budget Presentation Board members were provided with copies of the proposed 2006-2007 Budget for the Department. This provided the Board with a look at the overall performance of the Department and each Division in meeting both revenue and expenditure projections. Staff members presented information on line items that had significant changes during the fiscal year and answered questions from the Board. The proposed Budget for 2006-2007 totals $6,712,952, an 11% increase overall in the budget, including approximately $250,000 in capital items. An increase in revenue income will offset some of the increase. Moses Carey, Jr. requested staff include the summary statistics by division that was provided to the Board as part of the budget request. Three major items are new this year. The first is the transition of the Volunteer Coordinator for the Medical Reserve Corp, a grant-funded position with the grant ending September 2006. The budget includes a request to transition this position to county funding. Second is the remaining 25% of the Healthy Carolinians Coordinator salary. This is the final year of the Kate B. Reynolds grant, a decreasing-fund grant, which ends September 30, 2006. Last year the county picked up an additional 25%. Third, the Environmental Health budget includes two new staff positions to meet existing demands for service; one of those is fee supported in its entirety. Revenues are projected to be $2,067,014, an increase of 4% over the current year. The proposed budget includes several small fee increases in dental and personal health services to cover increases in the cost of medical and dental supplies and two additional fees in environmental health services. The cost of dental and medical supplies have risen 52% in the past 4 years. Staff members in response to questions from the Board further clarified the proposed medical and dental fee increases. Two positions have been added to environmental health, a food and lodging supervisor, and an environmental health specialist for the WTMP program. The environmental health specialist position for the WTMP program would be fee supported. Ron Holdway explained the increase in environmental health fees is primarily to offset the costs of an additional position for the WTMP program. The food and lodging position is a result of the state assessment that we needed two positions. The Board was provided with information for 2 additional positions for water resources. The position sheets along with the costs were developed but were not included in the budget. This was directly in response to the water resources initiative set forth in the Health Department Strategic Plan. They were not included due to the increases for the two mandated positions. In Personal Health Services a 2-month salary increase for the last school nurse that is being transitioned back to the Health Department. This position will be responsible for tracking and follow-up in case management for some of the prevention programs. This will relieve the clinic nurses of these duties and allow them to be more productive in the clinic. Moses Carey, Jr. questioned the phrasing of “2-month salary increase” and requested clarification. Dr. Summers MINUTES ORANGE COUNTY BOARD OF HEALTH March 23, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 March 23, 2006 explained that all school nurses are on a 10-month salary schedule. When the position transitions back to the Health Department it will be a 12-month salary schedule, hence the increase of 2 months salary. Moses Carey, Jr. suggested it be phrased differently. Quality Assurance/Risk Management has a large increase due to the addition of a respiratory fit protection program that is part of the Department’s overall preparedness effort. Several staff members are trained to do a respiratory fit for the N-95 mask. The increase will enable the department to purchase more bloodborne pathogen test kits and N-95 masks so the department can have a small stockpile internally in the event of a major outbreak. The Department will also be fit-testing Animal Services and Public Works employees through this program to assure the preservation of these infrastructures. State funding is projected to be stable although there may be two reductions as mentioned. In 05-06 the department also brought in $90,000 in one-time funding opportunities, which helped supplement needed funding. It is anticipated the Department will apply and obtain additional grant funding opportunities in the upcoming fiscal year. Moses Carey, Jr. asked if the new program grant for Child Health Care Consultant funded through Smart Start would cover a full time salary. Dr. Summers explained that the grant was intended to cover the full salary, however the department transferred a nurse into the position that was making more than the grant amount, so the grant does not cover the full salary. Moses Carey, Jr. also requested an explanation of the tiers as presented with the budget. Dr. Summers stated that the budget staff requested the Department identify increases in tiers so they could separate out whether a budget increase was requested because it was related to a mandated service or requirement (tier A or 1), BOCC goals and initiatives (tier B or 2), service level increase (tier C or 3), and other increases (tier D or 5). Gwen Harvey requested background information on the food and lodging program regarding the constraints on charging fees and that this position is not supported by revenue. Ron Holdway responded that inspections of food and lodging and other institutional facilities is a state mandate and explicit in its statutes that no fees are to be charged for that service nor can we adopt local rules to charge a fee for that service. Restaurants do pay a fee to the state and the county receives a small portion of that fee. Moses Carey, Jr. asked the amount each restaurant; motel, hotel, or lodging facility pays to the state. Ron Holdway stated that to the best of his knowledge each pays an annual fee of $50 to the state. The state uses half to administer the program, and the other is redistributed to the counties, of which Orange County receives about $9000 per year. Gwen Harvey questioned the percentage of cost this is to run the program for Orange County. Motion to approve the Environmental Health fee for contractor registration and septic tank inspections as presented was made by Moses Carey, Jr., seconded by Chris Harlan, and carried without dissent. Motion to approve Environmental Health fees (excluding contractor registration and septic tank MINUTES ORANGE COUNTY BOARD OF HEALTH March 23, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 March 23, 2006 inspections) only if the county commissioners approve the additional environmental health specialist position was made by Moses Carey, Jr., seconded by Chris Harlan, and carried without dissent. Motion to approve the fee schedules for Dental Health Services and Personal Health Services was made by Matt Vizithum, seconded by Chris Harlan, and carried without dissent. Motion to approve the budget as presented and forward the FY 2006-2007 Health Department Budget to the Board of County Commissioners for approval was made by Chris Harlan, seconded by Jim Stefanadis, and carried without dissent. V. Reports and Discussion with Possible Action A. Mill Creek Road Preliminary Report In the summer of 2005, two residents of the Mill Creek Road area approached environmental health staff with concerns about their water and the water in their neighborhood and the perception of a high incidence of cancer in their neighborhood. The Board of Commissioners authorized the Health Department to undertake a special water study and to gather data on frequency and type of cancer experienced in the neighborhood. The study design included 133 homes and consisted of two separate and distinct parts: 1) total suite of water samples for each household that completed an application and 2) a telephone survey to discover the incidence and type of cancers. There are about 25 water samples that still need to be drawn as the State Public Health Laboratory has had difficulty in processing the samples quickly. The survey portion of the study has been completed. Ron Holdway provided the Board with an updated report on the study and gave a Power Point presentation summarizing the results to date. The final study results will be sent to the NC Cancer Registry for expert analysis and comparison with their database. In addition, it will be included as part of the NC Cancer Registry study which encompasses a larger area but encompasses the Health Department defined area. This study was designed only to discover whether the incidence of cancer in this geographical area is higher than North Carolina rates of cancer. Results from both the cancer rate study and the water quality study will be reported to both the community and to the Board of Commissioners. Expected completion of the study, pending the final water bottles from the NC Public Health Laboratory, is anticipated to be at the end of March. Final analysis and presentation of the final report is expected by May 1 and is dependent on the NC Cancer Registry’s report as well. B. Tracking Form Review The Tracking Form is a preview of upcoming actions or topics the need Board action or discussion. It is intended as a Board planning tool. There were no changes. MINUTES ORANGE COUNTY BOARD OF HEALTH March 23, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 March 23, 2006 VI. Board Comments/Announcements Board members were provided with a copy of a letter from Representative David Price in response to the Board’s Influenza Vaccine Resolution that was approved at the November 2005 Board of Health meeting and sent to federal government representatives. No responses were received from Senator Elizabeth Dole or Senator Richard Burr. VII. Adjournment Motion to adjourn the meeting was made by Chris Harlan, seconded by Matt Vizithum, and carried without dissent. The next Board of Health meeting will be held on April 27, 2006 at the Southern Human Services Center in Chapel Hill, North Carolina at 7:00 PM. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board