Loading...
HomeMy WebLinkAboutBOH minutes 042706MINUTES ORANGE COUNTY BOARD OF HEALTH April 27, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 April 27, 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 April 27, 2006 at the Southern Human Services Center, Chapel Hill, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Jessica Lee, Chair; Matt Vizithum, Vice-Chair; Sharon Freeland; Chris Harlan; Alan Rimer; Alice White; Moses Carey, Jr.; Jim Stefanadis; DeWana Anderson; Sharon Van Horn BOARD OF HEALTH MEMBERS ABSENT: Tim Carey, out of town STAFF PRESENT: Rosemary Summers, Health Director; Wayne Sherman, Personal Health Services Division Director; Ron Holdway, Environmental Health Services Division Director; Anne Miles Cassell, Administrative Assistant; GUESTS PRESENT: None I. Welcome and Introductions Jessica Lee called the meeting to order at 7:00 P.M. Educational Presentation Septic and Well Approvals from Application to Approval Ron Holdway, Environmental Health Services Division Director, gave a PowerPoint presentation explaining the processes involved in approval of septic and well applications. In Orange County approximately 35% of properties are served by septic and well systems. State and local statutes apply to regulation of septic and well systems. Field visits and inspections are done throughout the approval and construction process. In response to a question from the Board, Ron explained that Environmental Health does not recommend contractors but does provide a list of approved contractors to the property owner. He also explained that well drillers are licensed at the state level and Environment Health is preempted by law from taking action against well drillers. Alice White questioned whether this was the situation in other states or if it was only in North Carolina. Ron Holdway did not have the answer to that question. Jessica Lee asked if the state had a system in place for complaints against septic or well contractors. Ron replied that at this time the state will take complaints against well contractors but has no list of contractors involved in a revocation or suspension of license process. Local rules require contractors to be at the site during an inspection. Jim Stefanadis asked about the approval of septic tanks. Soil site evaluations have replaced the perc test and evaluates soil texture, structure, how aerobic and permeable the soil is, and how impermeable it is. All that can be determined in a basic way in the field. If it is close to the approval range we can ask for a lab analysis. The blacks, gray, and olive colors of soil indicate an anaerobic condition of poor drainage. MINUTES ORANGE COUNTY BOARD OF HEALTH April 27, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 April 27, 2006 Ron explained the construction process in drilling a well and that wells are sealed off between the casing and the earth with cement to prevent contamination of the well from surface water. Once a well is installed we do not require periodic water testing. This was originally a requirement when well rules were drawn up by the Board, but has since been dropped due to resistance by the homeowners. Many counties are requiring periodic testing and increased acceptance of this requirement would be worth considering in reinstatement of this rule by the Board. Matt Vizithum inquired if the Department has a record of ground water conditions in the county that would indicate acceptable locations for wells. Ron stated that no records are available for site-specific data and that conditions can change dramatically within a tract of land. Several meetings have been held on ground water and surface water availability/sustainability issues. The county is in the concept phase of looking into putting in some monitoring wells in the county to get baseline measurements on groundwater levels for planning purposes. Ron is working with the regional hydrologist on this project. II. Approval of April 27, 2006 Agenda The motion to approve the Agenda of April 27, 2006 was made by Matt Vizithum, seconded by Chris Harlan, and carried without dissent. III. Volunteer Appreciation Moses Carey, Jr. read a resolution of appreciation of volunteers from the Board of County Commissioners to Board of Health members and thanked them for their participation as a volunteer. IV. Public Comment for Items NOT on Printed Agenda None V. Action Items on CONSENT Agenda A. Minutes approval of March 23, 2006 meeting. B. General Practice Resident Contract Renewal with the UNC School of Dentistry The Orange County Health Department annually contracts with UNC School of Dentistry for the services of one full-time equivalent dental resident for four and one-half days per week. The residents provide services at both the Hillsborough and the Carrboro dental clinics. The total cost of the contract for July 1, 2006 through June 30, 2007 is anticipated to be $47,192. This amount was included in the 2006-07 dental budget. This contract cannot be fully executed until the state legislature passes their budget and the rate may be higher as a consequence. MINUTES ORANGE COUNTY BOARD OF HEALTH April 27, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 April 27, 2006 C. Medical Director Contract Renewal with the UNC Department of Family Medicine The Orange County Health Department annually contracts with UNC Family Practice for Medical Director services for a number of years. Dr. Michael Fisher has served in this capacity for the past four years with back up from Dr. Lauren Lingley and other physicians. The 06-07 contract continues to have the Medical Director work in clinics 20 hours per week with 8 hours of administration/consultation/on-call time. The contract has been strengthened by including language outlining the ongoing monitoring and evaluation of the medical acts of FNPs, regular review of all prenatal records, and overall responsibility for medical residents and students working in the clinics. The contract cost includes a 4% increase to $135,745 per year. D. Pharmacy Services Contract Renewal The issuance of pharmaceuticals through our clinics or during epidemics/disasters necessitates the services of a registered pharmacist. Robert Dupuis, Pharm.D. a Clinical Associate Professor in the Division of Pharmacy Practice at the UNC School of Pharmacy, has served as our Pharmacist the past four years. He has fulfilled his responsibilities well and is interested in continuing to serve in this capacity. The 06-07 contract includes a 4% increase to $11,235 per year. E. WIC Agreement with Piedmont Health Services, Inc. WIC, a federal supplementary nutrition program for women, infants and children, is operated by Piedmont Health Services (PHS) in Chapel Hill at Carrboro Community Health Center and in Hillsborough at OCHD clinic. OCHD provides space (two offices and a measurement room) for two WIC staff and Hemoglobin testing of all WIC clients (lab tech time and supplies). We are providing over 1000 hemoglobin tests to WIC patients per year. The supplies and labor cost to provide this service is about $7,500/year with supplies costing nearly $4,000. In the WIC renewal agreement for 06-07, we have requested reimbursement of $4,000 from Piedmont Health Services for hemoglobin supplies. We have also noted that a copier provided to Piedmont Health Services for copying immunization records will be returned to OCHD since PHS has joined the online documentation of immunizations through the NC Immunization Registry. F. Head Start Dental Contract Renewal In 2003, Chapel Hill Training and Outreach, Inc. approached the health department with a request to provide required dental screening and treatment services to all children enrolled in the Head Start program located in Hillsborough. The first contract for MINUTES ORANGE COUNTY BOARD OF HEALTH April 27, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 April 27, 2006 services was developed and issued in the fall of 2003 and the program has worked well for both entities. Chapel Hill Training and Outreach, Inc. desires to renew this contract for services for the coming fiscal year. They pay the health department $10,000 per year to provide screening and education services. The department also files for Medicaid or private pay insurance when treatment becomes necessary. Motion to approve the contracts on the Consent Agenda and forward to the Board of Commissioners for action and approve the minutes of March 23, 2006 was made by Alan Rimer, seconded by Moses Carey, and carried without dissent. VI. Reports and Discussion with Possible Action A. Water Protection Update Alan Rimer shared information with the Board regarding funding possibilities for water protection in the Cane Creek and University Lake watershed test area of Orange County. The Clean Water Management Trust Fund has funded similar programs in North Carolina. The water protection program proposed by the Committee would be fee supported and entitle the property owners to a free inspection and reduced rates for septic pumping. OWASA has agreed to accept no charge or cut-rate the sludge for no disposal fee. In addition, the program would also help those families that meet the criteria pay for any necessary repairs. Moses Carey, Jr. asked for clarification of the fee structure that would be used. Alan Rimer explained that the fees would apply only to those properties on septic systems within the test area. Board members also raised concerns regarding public education and incentives to make the program work and all agreed that education of the public would be critical to its success. Mr. Rimer asked the Board for their permission to move forward and by consensus the Board agreed that this is consistent with the Strategic Plan. B. Action Strategies for Environmental Responsibility Goal In March of this year Barry Jacobs, Chair of the Board of County Commissioners, sent a letter to all County departments regarding Identifying Action Strategies for an Environmental Responsibility Goal for Orange County. Along with the goal statement, 10 objectives were identified to achieve this goal. Departments were asked to identify actions strategies that relate to their area of expertise. Objective 8 applies to the Health Department. It states, “Consider innovative new technologies for conserving and protecting ground water, indoor air quality and wastewater, to lessen impacts on the natural environment, and promote water conservation, collection and reuse in both current and future County facilities.” Alan Rimer described the system to use reclaimed water that is currently being used at MINUTES ORANGE COUNTY BOARD OF HEALTH April 27, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 April 27, 2006 Oak Island and detailed how the collection system works along with the collection facilities used and applications. The Oak Island project was funded by the Clean Water Trust Fund and Mr. Rimer suggested this system could be used throughout the county at various locations. The Committee will do further work in this area. C. Regional Workforce Planning Project The NC Legislature has provided funds for public health “incubator” projects for the past several years. Generally these projects are proposed by a regional group of health departments that want to work on common areas of interest. Nine counties make up the membership of the Central Carolina Incubator Project. The first phase of the project is to gather data from each of the participating health departments and then to develop a potential action plan that the region would work on together. The selected project that the group decided to work on is to develop a regional workforce development plan that would allow the region to examine needs in the area of recruitment and retention of public health staff. Health directors expressed interest in some of the following topics: recruitment of Spanish speaking staff; creation of career ladders for environmental health and nursing personnel; creation of training modules that address required training; common training for certain personnel to enable work back-up; a shared pool of “scarce” staff for back-up purposes; and various other ideas that may emerge from the data collected. The Alamance County Health Department is the fiscal agent for the project. A consulting firm has been hired with the grant funds to manage the data collection phase of the project. The UNC Institute for Public Health is also gathering some of the data for the project. Data includes secondary data as well as primary data through staff surveys and focus groups. Data collection should be completed by mid-May. Staff will provide further information to the Board as the project progresses. Jessica Lee asked if the Board would be able to see an executive summary of the study. Dr. Summers replied that two levels of analysis will be done, county specific for feedback to the county and a broader regional view. As reports are made available, they will be shared with the Board. D. Informational Items a. TB Research Grant The Orange County Health Department has been invited to participate in the second phase of a CDC study to determine the factors associated with acceptance of and adherence to treatment for Latent TB infection (LTBI). The study will review 13 of 38 TB medical records of clients served through the Health Department’s Chapel Hill clinic in 2002. Research Triangle Institute will be abstracting demographic and treatment data from the random selection of records and conducting a survey of the clinic. There will be MINUTES ORANGE COUNTY BOARD OF HEALTH April 27, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 April 27, 2006 no patient contact and no personal identifiers will be used. The Request for Participation in Research Projects checklist has been completed by the Personal Health Services Director and approved by the Health Director. b. Eno River Confluence Meeting Report The Board of Commissioners sponsored a meeting on April 11, 2006 that brought together various stakeholders and parties interested in the health of the Eno River. Alan Rimer from the Board of Health and Rosemary Summers and Ron Holdway from the Health Department attended the meeting. Ron Holdway reported briefly on the meeting. One topic discussed was the interaction of ground water and surface water as well as minimum flow in the river and other related topics. Alan Rimer reported the meeting was well attended by the various entities affected. Moses Carey, Jr. explained past events leading up to this meeting and how this meeting brought many issues to the table that many participants were unaware of. Alice White questioned the impact of the Oakdale development on water. Moses Carey, Jr. replied that the town of Hillsborough considered the impact before approving the development. Alan Rimer commented that the Piedmont region is the most fragile water short area in the entire southeast because we all sit at the top of a watershed. In another ten or twenty years there will not be enough water for everybody that is here and we need to do something about it now, conservation, land use, and all the things that the County Commissioners are working on. Establishing policies now will benefit the county in the future. Alan also stated that North Carolina was the first state to have river basin plans published. Every river basin in this state has a detailed water management plan over time and set the principles nationally by which this is done. Water management plans must be renewed every five years. He also commented that North Carolina considers this an important issue and has some of the best ground water resource management personnel in the country. c. Budget Public Hearings The Board of Commissioners holds two public hearings on the county budget each year. One hearing is on Tuesday, May 30, 2006 at Southern Human Services Center and the other is on Thursday, June 1, 2006 at the Gordon Battle Courtroom in Hillsborough. Both meetings are at 7:30 pm. The Board usually sends several representatives to each of the public hearings to highlight important budget issues in the health department’s budget. The Board discussed what approach they wished to pursue and reserved the time on their calendars to attend. This will be further discussed at the May meeting. MINUTES ORANGE COUNTY BOARD OF HEALTH April 27, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 April 27, 2006 E. Tracking Form Review Rosemary Summers pointed out that the Mill Creek Road Study was complete and the final report will be ready for presentation to the next Mill Creek community meeting on May 15. The Commissioners will receive the report in advance of the community meeting. The additions of the “Dental Mouth Guard Project” and “Pets in Schools/Petting Zoos in Schools” were added for the May agenda. Also, several dates were altered to more closely reflect when the topics would appear before the Board. F. Articles: “Massachusetts State Health Plan” and NC Health Report “Why Massachusetts Isn’t North Carolina.” The Board was provided copies of both articles for informational purposes. Massachusetts will become the first state to provide nearly universal health care coverage with a bill passed recently. The bill requires all Massachusetts residents to obtain health coverage by July 1, 2007. Individuals who can afford private insurance will be penalized on their state income taxes if they do not purchase it. Government subsidies to private insurance plans will allow more of the working poor to buy insurance and will expand the number of children who are eligible for free coverage. The major differences between Massachusetts and North Carolina are addressed in the second article. They are: 1) There are many more uninsured people in North Carolina, 17% (14% in Orange County) versus 11% in Massachusetts. 2) The median household income in NC is $39,000 versus $52,354 in Massachusetts. 3) NC has a higher percentage of low-income residents (under 200% FPL), 40% versus 30% for Massachusetts. 4) Infant death rate per 1000 births in NC is 8.1 versus 4.8 in Massachusetts 5) Stroke deaths per 100,000 population is 67.9 in NC and 48.3 in Massachusetts. 6) NC is a low tax state. Tax collections per capita in NC are $1941 and $2,602 in Massachusetts. This article points out that there are many more barriers to insuring NC’s entire population but it did not mean NC should not try. G. On-Site Wastewater Treatment Facilities in North Carolina Article Board members were provided an article published in Fall 2005 of Popular Government was co-written by Adrienne Simonson, a graduate student who worked with the Environmental Health Division of the Health Department. The article was based on the research she did when she was with us. MINUTES ORANGE COUNTY BOARD OF HEALTH April 27, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 8 April 27, 2006 V. Board Comments/Announcements None VI. Adjournment Motion to adjourn the meeting was made by Alan Rimer, seconded by Alice White, and carried without dissent. The next Board of Health meeting will be held on May 24, 2006 at the Government Services Center, Hillsborough, North Carolina at 7:00 PM. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board