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HomeMy WebLinkAboutBOH minutes 111606MINUTES ORANGE COUNTY BOARD OF HEALTH November 16, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 November 16, 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 November 16, 2006 at the Government Services Center, Hillsborough, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Jessica Lee, Chair; Matt Vizithum, Vice Chair; DeWana Anderson; Tim Carey; Chris Harlan; Alan Rimer; Jim Stefanadis; Anissa Vines; Ernie Dodson BOARD OF HEALTH MEMBERS ABSENT: Sharon Freeland, meeting conflict; Sharon Van Horn, out of town STAFF PRESENT: Rosemary Summers, Health Director; Wayne Sherman, Personal Health Services Division Director; Tom Konsler, Acting Environmental Health Services Division Director; Donna King, Health Promotion and Education Services Division Director; Angela Cooke, Dental Health Services Division Director; Letitia Burns, Business Officer; Yvonne Upshur, Child Special Services Coordinator; Darrell Renfroe, Family Home Visiting Services Supervisor; Becky Hermann, Family Home Visiting Coordinator; Anne Miles Cassell, Administrative Assistant; Francine Duguay and Hannah Schrum, Personal Health Services. GUESTS PRESENT: Jerry Passmore, Department on Aging Director; Florence Solsyste, Aging Task Force Co-Chair I. Welcome and Introductions Jessica Lee called the meeting to order at 7:00 P.M. Approval of November 16, 2006 Agenda Rosemary Summers requested item IV.F.1 Space Study be added to the agenda. The motion to approve the agenda of November 16, 2006 as amended was made by Chris Harlan, seconded by Matt Vizithum, and carried without dissent. Swearing in of New Board Member, Ernie Dodson Ernie Dodson, incoming Board member filling the position of Engineer, was administered the Oath of Office by Elvira Mebane, Vital Records Deputy Registrar. Recognition of Service: Alan Rimer Jessica Lee presented Alan Rimer with a plaque in recognition of his many contributions and service to the Board of Health. Recognition of New Staff MINUTES ORANGE COUNTY BOARD OF HEALTH November 16, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 November 16, 2006 Rosemary Summers introduced Hannah Schrum, and Francine Duguay, both new public health nurses working in the clinical services area, to the Board. II. Public Comment for Items NOT on Printed Agenda None III. Action Items on CONSENT Agenda A. Minutes approval of October 26, 2006 meeting. B. Resolution for Food and Lodging Fees In October the Board discussed the introduction of legislation to allow local counties to set and charge fees for food and lodging inspections. The Board directed staff to prepare a resolution in support of this effort and chose to forward the resolution to Commissioners for their consideration. Motion to approve the minutes of October 26, 2006 and items on the Consent Agenda was made by Tim Carey, seconded by Chris Harlan, and carried without dissent. IV. Reports and Discussion with Possible Action A. Master Aging Plan Presentation The Master Aging Plan has been undergoing a revision and updating process over the last year. The Department on Aging is in the final stages of gathering input on the recommendations in the updated draft plan. A major change in this revision is the actual “assignment” of lead responsibility to a particular organization or agency. Ms. Solsyste reported that there are over 18,000 “seniors” in Orange County. That demographic is increasing rapidly. The proposed Master Aging Plan highlighting the major issues was provided to Board members by the Department of Aging. The Board was asked to read the recommendations, review the report, and provide feedback on any questions or concerns by mid-December. Ms. Solsyste recommended everyone complete the online survey that is on the Department of Aging website. A major goal of providing access to better health care for seniors includes access to dental care. A new section, Legislation/Advocacy, was added to the Master Aging Plan. The goal is to form a Committee that would support Orange County’s Bill of Rights for older citizens and be more active politically with better access to the legislature. Tim Carey asked if the Aging Plan is linked to any Healthy Carolinians programs. Mr. Passmore MINUTES ORANGE COUNTY BOARD OF HEALTH November 16, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 November 16, 2006 replied that it is tied to the Wellness Program and the Wellness Program Coordinator serves on the Healthy Carolinians Council. Anissa Vines asked if there is anything in the plan about older citizens caring for younger children. Chris Harlan inquired about a safety net for home health services. Mr. Passmore replied that providing a safety net for home health services would be a coordinated effort with other agencies. B. Help 4 Kids Evaluation Presentation The Health Department has been fortunate to have the services of a Preventive Medicine Fellow, Dr. Christine Lathren, who has worked on several high priority projects for the Department this year. She collaborated with Yvonne Upshur, Child Special Services Coordinator, and other staff members to develop and carry out an evaluation of the Help 4 Kids Program run by the Health Department. Help 4 Kids is a Smart Start grant-funded project that screens birth certificates of newborns for risk factors for developmental delays and works with families and providers to seek services early to minimize delays that might affect a child’s overall development. The program has been in existence since the mid-90’s. Dr. Lathren developed two surveys, one for providers and one for parents of participants to evaluate the program and identify service needs. Anissa Vines raised the question of financial need and accessibility to services. Ms. Upshur replied that health department services are provided at no charge if clients do not qualify for Medicaid. C. Revised Fee and Eligibility Policies The Health Department had its first Administrative Assessment by the Division of Public Health (DPH) Administrative Consultant, Mitzi Parris, on September 26, 2006. DPH was looking at a number of items for compliance with State and federal financial program requirements, including Medical Records, Monthly State Expenditure Reporting, and the Fee & Eligibility Policy. The Department did well on all areas of the Assessment, however, there were five funding conditions that were found related to the Fee & Eligibility Policy. The policy was last reviewed and revised in 2004. The funding conditions outlined in the report must be corrected and submitted to the state no later than November 30, 2006, or OCHD could face potential loss of state funding. Ms. Parris noted in her report that all five of these funding conditions were our common everyday practice, but they were not specifically or clearly defined in the policy. These funding conditions were items, which may have been implied, or not worded exactly as the State or Medicaid requires. With the required corrections to our Fee & Eligibility Policy approved, the funding conditions will be removed. MINUTES ORANGE COUNTY BOARD OF HEALTH November 16, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 November 16, 2006 Board members were presented with a draft revision of the Policy for review and suggested the addition of primary care flat fee and sliding scale to III.A.2. and the deletion of item II.C.3. Motion to adopt the Fee & Eligibility Policy as amended was made by Moses Carey, seconded by Chris Harlan, and carried without dissent. D. No Fault Well Repair Fund Report In 2001, American Stone Company and OWASA applied for and received a special use permit for the continued use of the American Stone Quarry until the end of 2030. After that date, OWASA will operate the facility as a reservoir. The Quarry is located approximately 5 miles west of Carrboro on Highway 54. As a condition of the special use permit American Stone was required to establish a “No Fault Well Repair Fund” (NFWRF) for those residents whose property is within 3,000 feet of the perimeter of the quarry and who experience well failures not directly attributable to the quarry operation. The initial fund amount was $87,500 and can be augmented by $20,000 per year as needed to meet the community needs. Well failures that are a “probable result” of the quarry operation must be handled exclusively by American Stone at their expense. OCHD staff has responsibilities in providing sampling services, technical assistance, consultation regarding remedies, and determination of well failure. Staff has also taken on fiscal administration of the fund. The Board of Health is the avenue of appeals for those residents who are not satisfied with the process. In 2001, the policy was amended by BOH to allow OCHD staff to use judgment to skip the determination of fault by American Stone Company if the deficiency in the well or water quality was clearly not a fault of quarry. In 2004, staff proposed an alternative to well replacement, repair, or water treatment if a well had detectable levels of arsenic but those levels were still below the recommended drinking water limit. If the well were otherwise satisfactory, the homeowner would receive bottled water to be paid by the NFWRF. We currently have 10 homes participating in the bottled water program. The BOH approved this component with the idea it would be reviewed after 2 years for continuation or revisions. Tom Konsler reported that the bottled water purchase program has been successful, however it was discovered that there was at least one case of abuse in which a household had been receiving over twice the allotted amount of water for more than a year. The water vendor was recently instructed not to deliver beyond the allotted amount and all of the recipients were recently contacted to verify number of residents so that an accurate allotment could be determined. Staff is looking into an alternative to address the arsenic level in the well water by using a Reverse Osmosis filtration system that would eliminate the arsenic. Preliminary cost estimates MINUTES ORANGE COUNTY BOARD OF HEALTH November 16, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 November 16, 2006 have ranged from six to nine hundred dollars per unit installed. Tim Carey inquired whether there would be additional upkeep costs of these units to consider. Tom replied that the only recurring cost would be for filter replacement. Jessica Lee asked about the bottled water allotment. Mr. Konsler replied that each family was allotted 15 gallons per month for drinking water. Board members concurred that staff should further investigate the Reverse Osmosis solution further and report back to the Board. To date, approximately $76,000 has been paid out from the fund. Motion to accept the report pending additional information was made by Tim Carey, seconded by Anissa Vines, and carried without dissent. E. Biosolids Site Research Project with UNC School of Public Health Nancy Holt, a citizen from the Bradshaw Quarry Road community, approached the staff with a continuing concern regarding the biosolids application site that is in that community. There are about 38 homes near this site. Staff believes that further study of biosolids application sites is warranted but do not feel that there is sufficient staff time, equipment, or expertise to conduct the studies in the manner required. Tom Konsler and Rosemary Summers met with faculty at the School of Public Health’s Environmental Sciences and Engineering Department (ESE) to assess whether there would be faculty and/or student interest in pursuing such a study. Several faculty members have expressed interest. Dr. Marc Sobsey and Dr. Chip Simmons, two faculty members in the ESE Department are interested in working with us on designing a study that will meet our needs for this community and perhaps will lead to a larger grant proposal for a more extensive study of biosolids application sites. The study design will include air quality sampling at a baseline (prior to application) and at a time shortly after applications of biosolids. In addition, stream sampling at public access areas will be set up so that measures can be taken prior to application and at a time after a significant rainfall. The decision regarding a health questionnaire was not made, pending interest by the epidemiology department in collaboration on this project. It is anticipated that the actual sampling will not occur until sometime this spring due to soil conditions, ground cover, and other technical factors related to the study itself. The School is anticipating both graduate student involvement and faculty oversight. This would be a pilot study. Staff has identified a total of $10,000 from several different budget line items that can be used for this project. Staff believes that this project is related to the Department’s Strategic Plan in the Water Protection Section of the plan. Since Orange County is one of the counties with the largest number of application sites, a larger research study would also help us establish the relative risks associated biosolids application sites and afford better information with which to inform our communities, our policymakers, and our partners. MINUTES ORANGE COUNTY BOARD OF HEALTH November 16, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 November 16, 2006 This area is in the OWASA watershed area and their participation in the study will be explored. Motion to approve the agreement and forward to the Board of Commissioners for approval was made by Matt Vizithum, seconded by Chris Harlan, and carried without dissent. F. Draft BOH Meeting Schedule for 2007 The Board of Health’s operating procedures call for the Board to adopt a regular schedule of meetings on an annual basis. This facilitates public notification as required by the open meetings law. The Board has traditionally met on the fourth Thursday of each month (except for November and December). The Board of Commissioners has asked Boards to consider altering their schedule if a conflicting meeting by the Board of Commissioners has already been scheduled. Avoiding these conflicting meetings allows the Commissioner representative to attend the Board to which they have been assigned. A draft schedule of meeting dates was provided that contains the traditional “fourth Thursday” option and an option for a “fourth Wednesday.” There are currently several conflicts with the fourth Thursday that were identified on the draft. Board members were asked to notify Anne Cassell by email of their preferences and any conflicts so a finalized schedule can be presented for approval at the December meeting. F.1 Space Study Board members were given a copy of a presentation done by Pam Jones, Purchasing Director, for the Commissioners. The BOCC approved purchase of three buildings for the expanded County campus; 1) 22,846 square feet of office space in Gateway Center; 2) 46,716 square feet of office space in the office building; 3) 23,454 square feet in the new main library in addition to a parking deck and additional parking around the buildings. The relocation of departments to the expanded campus should not compromise services in any part of the county. Construction on the Hillsborough campus is projected to be completed by 2008. The earliest space projections allowing anything to be done for Human Services is 2011. One issue to consider is whether the Department will operate a single or two clinical sites. Chris Harlan and Tim Carey stated they felt other providers were accessible to citizens in the southern and that if the Commissioners decided on a single site it should be in Hillsborough to provide access for those citizens most in need of our services. Board members also expressed their strong preference for two clinical sites and also like to see two Dental Health Services expanded to two sites that operate full time. They stressed the need to provide increased access to clinical services. G. BOCC Retreat Discussion Each year the Board of Commissioners meets in “retreat” to consider high priority items for the upcoming budget cycle. This year the Board will hold it’s first retreat meeting on December 7 at MINUTES ORANGE COUNTY BOARD OF HEALTH November 16, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 November 16, 2006 an evening meeting. Boards and Departments have not yet been asked for input. The Board was asked to review the Strategic Plan and give some thought to areas of emphasis for the coming year. A preliminary review of the strategic plan in light of current projects underway might include: • Beginning primary care at SHSC • Further develop the water protection program • Strengthening the food and lodging inspection program by adequate staffing • Expansion of dental health services to full time at both locations • Refugee health program development • Improvement in the lead screening rates • Accreditation/quality improvement progress • Stabilize funding for preparedness and volunteer programs • Buildings/space It was agreed that these were all important and not in any priority order. H. Nomination of Officers The operating procedures of the Board call for a slate of officers to be presented to the Board at the meeting preceding the election of officers that is to occur at the last regular meeting of the calendar year. The Chair and Vice-Chair are to be elected annually. There were no nominations from the floor. Board members interested in serving were asked to contact Matt Vizithum prior to the December meeting. I. Informational Items a. Flu Vaccine - Wayne Sherman reported that despite early delays in shipments of flu vaccine ordered by the Department, nearly 84% of our total order has now been received. The balance of the order has been promised the week of Thanksgiving. Appointment slots were reopened in previously scheduled clinics and additional clinics were scheduled. The Flu Hotline and Website were updated with this new information. b. E.Coli Outbreak – Information was received on November 2nd from UNC Campus Health Services of two UNC students having had E.Coli O157 in recent days with both being hospitalized. Subsequent investigations, an MD alert, media attention, and e-mail alert to UNC students resulted in finding additional cases in Orange, Wake, and Durham Counties. All recovered with no secondary cases identified. A Case Control study was done and no particular food item was implicated. All had eaten at the same restaurant. Both the restaurant and UNC cooperated fully with the investigation. c. A program of “Maintain – Don’t Gain” flyer was passed out to the Board. The focus of the program is not to gain weight during the holidays but maintain weight by healthy food MINUTES ORANGE COUNTY BOARD OF HEALTH November 16, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 8 November 16, 2006 choices. Board members were encouraged to participate. J. Tracking Form Review No amendments were made to the Tracking Form V. Board Comments/Announcements None VI. Adjournment Motion to adjourn the meeting was made by Tim Carey, seconded by Jim Stefanadis, and carried without dissent. The next Board of Health meeting will be held on December 14, 2006 at the Whitted Human Services Center, Hillsborough, North Carolina at 7:00 PM, to be followed by a Holliday Dinner at Saratoga Grill in Hillsborough. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board