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HomeMy WebLinkAboutBOH minutes 102606MINUTES ORANGE COUNTY BOARD OF HEALTH October 26, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 October 26, 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 October 26, 2006 at the Southern Human Services Center, Chapel Hill, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Matt Vizithum, Vice-Chair; Moses Carey, Jr.; Tim Carey; Alan Rimer; Chris Harlan; Sharon Freeland; Jim Stefanadis; Sharon Van Horn; Anissa Vines; BOARD OF HEALTH MEMBERS ABSENT: Jessica Lee, out of town; DeWana Anderson, out of town STAFF PRESENT: Rosemary Summers, Health Director; Wayne Sherman, Personal Health Services Division Director; Tom Konsler, Interim Environmental Health Services Division Director; Donna King, Health Promotion and Education Services Division Director; Sandy Garrett, Quality Assurance/Risk Management Coordinator; Letitia Burns, Business Officer; Anne Miles Cassell, Administrative Assistant; and Darryl Renfroe, Becky Hermann, Dawn Green, Kathy Glassock, Yvonne Upshur, the OCHD Child Health Audit Team. GUESTS PRESENT: None I. Welcome and Introductions Matt Vizithum, Vice-Chair called the workshop and meeting to order at 6:20 P.M. A. Accreditation Standards & Activities (Working Dinner) The Board began the process of reviewing the Governance standards and activities last month so that appropriate actions could be planned to come into compliance with the requirements. Sandy Garrett reviewed the balance of the standards for the Board at the work session and members made suggestions to document compliance. B. Environmental Health Responsibilities for BOH Tom Konsler gave a power point presentation of an overview of Environmental Health Services and its role within the Department. Areas of authorization include: • Food and Lodging Establishments • On-site Wastewater Systems • Migrant Housing • Childhood Lead Poisoning Prevention • Childcare Centers • Tattoo Establishments • Public Swimming Pools • Private Drinking Water Wells MINUTES ORANGE COUNTY BOARD OF HEALTH October 26, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 October 26, 2006 • Embargo Authority (new) Environmental Health staff also assists in food borne outbreak investigations as part of the EPI team and offer Serve-Safe educational programs with Cooperative Extension to staff of county restaurants in an effort to eliminate outbreaks. II. Approval of October 26, 2006 Agenda The motion to approve the Agenda of October 26, 2006 was made by Alan Rimer, seconded by Chris Harlan, and carried without dissent. III. Staff Recognitions Rosemary Summers introduced the Orange County Child Health Services Audit Team: Kathy Glassock, Dawn Green, Darrell Renfroe, Rebekah Hermann, Yvonne Upshur, and Sandy Garrett. The Team won the Outstanding Team Achievement Award recently at the NCPHA/NCALHD Conference. The team approach mirrored the way child health services are provided in the county and was responsible for assuring the Department was prepared for the State Child Health Audit in September. Some of the innovative programs described in the audit are felt to be agency strengths. Auditors informed staff their services were considered the “gold standard.” Darrell Renfroe was also introduced as the recipient of the State Public Health Social Worker of the Year at the NCPHA/NCALHD Conference. He was recognized for his excellent supervisory relationships and for his service statewide. Darrell serves on the statewide Social Work Continuing Education Committee. Board members congratulated the staff and commended them on their achievements. IV. Public Comment for Items NOT on Printed Agenda None V. Action Items on CONSENT Agenda A. Minutes approval of September 28, 2006 meeting. Motion to approve the minutes of September 28, 2006 was made by Alan Rimer, seconded by Tim Carey, and carried without dissent. B. Quarterly Financial Report Letitia Burns presented the first quarterly financial report for review. The report incorporated changes asked for by the Board at the last meeting. Alan Rimer asked if there was a way to display expected budget versus expended budget because some divisions have a more linear budget while others do not. He also suggested taking MINUTES ORANGE COUNTY BOARD OF HEALTH October 26, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 October 26, 2006 personnel expenses out of the budget and displaying that separately since personnel vacancies causes variances and can give an unclear picture. Ms. Burns responded that we don’t have a history of expenditures by quarter so it would be difficult to report it in expected/expended in a meaningful way. Motion to approve the Quarterly Financial Report as presented was made by Moses Carey, jr., seconded by Sharon Freeland, and carried without dissent. VI. Reports and Discussion with Possible Action A. Governor’s Grove Water Study Report Citizens of the Governor’s Grove Community had expressed concern over the well water quality during the department’s Mill Creek area water survey. The Board of Commissioners authorized the Health Department to proceed with a limited water study for the Governor’s Grove Community. Tom Konsler outlined the findings to the Board. No health survey was done because there were no health concerns stated by the residents. A sampling of wells was done and tested for coliform and fecal coliform bacteria, inorganic chemicals, and radon. Based on the sampling, the groundwater quality in the subdivision is not atypical to that of the rest of Orange County. With the exception of one positive coliform bacteria sample, none of the health indicators (radon, arsenic, and lead) were elevated. The problems experienced by some of the homeowners are largely aesthetic and there were no long-term health risks identified. Matt Vizithum asked about the use of the video well camera on the well identified with coliform contamination to identify any possible structural problems. Staff met with the owner and using the camera were able to locate an area of the well that was a possible source of the contamination Jessica Lee asked about the depth of the well. Tom Konsler recalled that the property owner had a shallow water source at a depth of 70 feet and another very good source at 120 – 140 feet. The staff’s recommendation was to seal off the shallow water source, that is usually the source of any contamination, and use the deeper water source. A contractor would need to come and install a liner to seal off the more shallow water source. Homeowners were provided with information needed to pursue individual remedies. Environmental Health staff will continue to work with concerned residents as needed to resolve water quality concerns. Motion to accept the Governor’s Grove Water Study Report was made by Jim Stefanadis, seconded by Alan Rimer, and carried without dissent. B. Resolution on Food and Lodging Fees MINUTES ORANGE COUNTY BOARD OF HEALTH October 26, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 October 26, 2006 Rosemary Summers reported that the Brunswick County Board of Health and the New Hanover County Board of Health are spearheading an effort to have legislation introduced that would allow local counties to set fees for food and lodging inspections. Currently, each restaurant pays the state an annual fee of $50. The state returns approximately 60-75% of this fee to local health departments, depending on the local department’s compliance rate. Because this fee is “charged” at the state level, there is a prohibition for local health departments to charge a fee. The amount Orange County receives annually from the state for this program ranges from $7,500 to $10,000. Roughly $360,000 each year is spent in personnel and operating costs for this program, with nearly all of the cost being in personnel. This cost estimate does not include capital expenditures such as vehicles and computers. Included in this resolution is a provision for the state to be “held harmless” in the amount of money they currently receive from this process should the responsibility shift to the local level. The state currently maintains staff to manage the statewide database and provide consultative services in the program to all areas of the state. This would require some form of “rebate” to the state by local health departments from the fees collected by local agencies, or retention of state “Aid to County” funds. The NC Association of Local Health Directors is asking local Boards of Health to consider passing similar resolutions in support of legislation such as this being introduced. Previous attempts to introduce and pass similar legislation have met with stiff resistance from the restaurant association. Staff has discussed this proposal and feel that the cost of billing and collection will outweigh the cost of recovery process. Even if only 50% of the cost can be attributed to restaurants, the fee would be approximately $400 - $500 per year for each restaurant. This would not include additional staff needed for billing and collection purposes. Staff feels that an alternative that urges the state to raise the current fees to a more appropriate level and distribute that across the state would be a better alternative for this county. Alan Rimer expressed the opinion that the fee for service, at an increased inspection fee of $500, is a cost of doing business and would amount to pennies per customer and would not impact the at-large population of the county that does not frequent restaurants. Rosemary Summers stated that the department feels that fees should be raised but the question remained of whether it should be collected at the state or local level. Moses Carey, Jr. agreed that fees needed to be increased for cost recovery at both state and local levels. Sharon Van Horn asked about when and how the fees are paid. Tom Konsler replied that the state invoices once per year and fees are remitted to the state. Staff is also concerned that legislation if passed would contain limitations on fee amounts, hampering local attempts to recover costs. MINUTES ORANGE COUNTY BOARD OF HEALTH October 26, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 October 26, 2006 By consensus Board members agreed that a resolution should be drafted similar to the Brunswick County resolution and put on the November agenda. C. Consolidation of Human Service Departments The Buncombe County Commissioners are seeking to have the population limit removed from the legislation that authorized Commissioners to create a consolidated human service agency. Removing this population cap could potentially affect the entire structure of public health across the state. Currently only two counties meet the population requirement for this model: Mecklenburg and Wake. Boards of Health have independent authority from Boards of Commissioners. Boards of Health utilize the professional expertise of members of Boards of Health to make recommendations and rules that are based on science and best practices. The intent was to help Boards of Commissioners be able to separate health decisions from political considerations. The Buncombe resolution cites efficiencies in programs, cost effectiveness, and streamlined access for citizens as reasons that they wish to consolidate. For the most part, each agency has specific program requirements that will not change regardless of the structure. While coordination can always be improved, most human service departments already have mechanisms for coordination and access in place to smooth the process for residents. In the Mecklenburg and Wake models, the Board of County Commissioners acts as the Board of Health, retaining only a Human Services Advisory Board in an advisory capacity. Mecklenburg has contracted with Carolinas Medical Center to provide all of the clinical services required by health departments. It retains a very small staff for communicable disease and a separate environmental health unit. Wake is a very large consolidated Human Service Agency that combines mental health, public health and social services. The Agency currently has more than 600 employees. The Board of Commissioners acts as the Board of Health, the Board of Social Services, and the Mental Health Board. At this time, no specific legislation has been introduced, however it is likely that the legislators from the Buncombe area will introduce such a bill. Tim Carey recommended the Board take no position at this time, but watch developments closely. D. Public Health Task Force Report and Recommendations The first Public Health Task Force Report was developed in 2004 and formed the basis for a statewide public health strategic plan. Dr. Devlin, the State Health Director, reactivated the original task force and requested that they update the 2004 Report and develop any additional recommendations that would then form the North Carolina Public Health Improvement Plan. The Report was provided to Board members and contains a list of accomplishments since 2004 and additional MINUTES ORANGE COUNTY BOARD OF HEALTH October 26, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 October 26, 2006 recommendations that are needed to improve public health across the state. Elimination of health disparities and chronic disease prevention are two large areas of focus. Rosemary Summers pointed out the $40 million set aside for immunization to keep North Carolina as a universal vaccination state, which means that if the state requires a vaccination they must be able to provide the vaccine to participating providers at no cost. Very few states have that mandate. North Carolina is at the top of immunization rates across the country because the legislature puts significant money into buying vaccine for this program. Moses Carey, Jr. is a member of the 2006 Public Health Task Force and commented that the prior reports helped in past years to secure an increase in funds from the legislature. Rosemary Summers suggested the Board review and forward the report to Commissioners for their information in formulating their own legislative agenda. E. Joint Meeting Request with BOCC The Board of Health has requested an annual joint meeting with the Board of Commissioners in the past. There are a number of topics that might be of mutual interest this fiscal year that are directly related to the Department’s Strategic Plan. Possible topics include 1) Central Carolina Health Network (access to health care), 2) accreditation of local health departments; 3) expansion of dental health and primary care services; 4) chronic disease programs (obesity, African-American churches project); and 5) employee Health and Wellness Programs. Rosemary Summers asked the Board for input on choice of topics. The Commissioners may also have specific topics they wish to address or hear about. Moses Carey said that the Commissioners calendar had already been set, so the Board of Health could be added to one of the work session dates. Chris Harlan and Tim Carey expressed their opinion that access to health care should be the main topic. Environmental issues and policy direction or financial implications and additional positions were other suggestions. No decisions were made concerning topics. Early spring next year would be a target date for the joint meeting. F. December BOH meeting For the past several years the Board has chosen to meet in December at a local restaurant for the regular meeting with dinner following to celebrate the holiday season. Because reservations fill up fast at this time of year, the Board was asked to provide direction to the staff. The December meeting is scheduled for Thursday, December 14 due to the holidays. MINUTES ORANGE COUNTY BOARD OF HEALTH October 26, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 October 26, 2006 Typically the agenda includes officer elections, review of retreat materials to be forwarded to the Board of Commissioners, and any pressing funds acceptance or program approvals. By consensus Board members agreed to meet in Hillsborough prior to adjourning to the Saratoga Grill for dinner, pending securing a reservation. G. Informational Items 1. Assessment Report on Mental Health Needs of Adolescents Healthy Carolinians conducted and published an assessment this month on Mental Health Needs of Adolescents. Donna King briefly summarized the report and stated that the knowledge of the risk factors faced by our adolescents can help promote prevention programs and work to ensure that all children with mental health and substance abuse challenges have access to effective, high quality mental health and substance abuse treatment. The committee is meeting with school systems to review the findings and develop recommendations based on the report. Rosemary Summers said the report would be sent to Commissioners for informational purposes. Tim Carey stated the report was excellent and thought it should be sent to mental health providers. 2. Child Health Report Card Rosemary Summers reported the findings of the 2006 NC Child Health Report Card. Overall Orange County has a long way to go to improving child health. One major concern is the large number of uninsured children. We experience the same disparity issues as the rest of the state. Dental Health in Orange County is far better than other parts of the state. This is in large part due to the excellent program in place at the health department. Orange County has one of the highest overweight and obesity rates for children in the state. The Orange County Partnership for Young Children has made this a priority issue for the next two years and is taking on a major fund-raising project in order to fund local projects to address childhood obesity. Tim Carey commented on how the issue was handled in Arkansas and the positive results that were obtained by developing a social will to do what was necessary. It took about three years to see the positive results. Moses Carey reported that there was a movement two years ago to eliminate sodas and unhealthy snacks from schools. Schools have been reluctant to eliminate the soda and snack vending machines due to revenue received from MINUTES ORANGE COUNTY BOARD OF HEALTH October 26, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 8 October 26, 2006 them. There is a plan at the state level to make it revenue neutral for the first three years for schools to change to healthy alternatives. Teen pregnancy is one of the lowest in the state but it is anticipated to increase. 3. Water Resources Matt Vizithum reported that the committee would meet on November 21, 2006. This will be the first meeting of the small group. 4. Little River Park Water Research Project Tom Konsler reported that representatives from the group walked the property and inspected possible locations for two of the test wells. Compatibility with conservation easements is being investigated. 5. Community Flu Events/Influenza Vaccine Wayne Sherman reported that the Department would provide vaccinations in the senior centers, rest homes and nursing homes, and to homebound. We have received about 25% of our order and have received word that shipments are delayed. The Department hopes to receive additional vaccine next month. The information from the manufacturer is that production has taken longer than expected to grow the vaccine cultures. Two flu blitzes are scheduled for November 4 and November 11 pending receipt of additional vaccine by those dates. Information has been made available to the public on the Health Department website, an influenza hotline, and the media. 6. Recent Program Audit Reports Rosemary Summers reported that Women’s Health, Children Health, and Administrative audits were conducted last month and all programs did well, with only minor language changes in documentation needed. H. Tracking Form Review The tracking form allows the Board to keep track of recurring or non-recurring projects. Mental Health Update was added to Non-Recurring projects for the spring. VII. Board Comments/Announcements None MINUTES ORANGE COUNTY BOARD OF HEALTH October 26, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 9 October 26, 2006 VIII. Adjournment Motion to adjourn the meeting was made by Tim Carey, seconded by Anissa Vines, and carried without dissent. The next Board of Health meeting will be held on November 16, 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