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