HomeMy WebLinkAboutBOH minutes 062906MINUTES
ORANGE COUNTY BOARD OF HEALTH
June 29, 2006
Board of Health Minutes Transcription completed by Anne Miles Cassell 1 June 29, 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 June 29, 2006 at the Government Services Center,
Hillsborough, North Carolina.
BOARD OF HEALTH MEMBERS PRESENT: Jessica Lee, Chair; Alan Rimer; Alice White; Moses Carey, Jr.;
DeWana Anderson; Tim Carey;
BOARD OF HEALTH MEMBERS ABSENT: Matt Vizithum; Sharon Freeland; Chris Harlan, vacation; Jim
Stefanadis, out of town; Sharon Van Horn, vacation
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; Anne Miles Cassell, Administrative
Assistant.
GUESTS PRESENT: Alice Gordon, County Commissioner
I. Welcome, Introductions, and Recognition of Service
Jessica Lee called the meeting to order at 7:00 P.M.
Dr. Alice White was recognized for her service to the Board of Health. Dr. White’s second term expires
June 30, 2006. She has offered her services as a Health Department Reserve Corps Volunteer.
Educational Presentation: School and Public Health Collaborations
Judy Butler, RN, Community Services Supervisor, provided a PowerPoint presentation highlighting the
collaborative initiatives and opportunities between School Health and Public Health.
School Health and Public Health intersect on many levels with the ultimate goal of healthier, happier,
and more successful students. The Board of Health and Board of Education can jointly set policy that
influences the health of students in areas such as nutrition, exercise and tobacco use. School Nurses,
for which accountability for funding of new positions passes through the Health Department, are
supervised medically by the OCHD Medical Director and follow OCHD approved policies and
procedures. They are provided continuing education programs by OCHD, consultation on
Communicable Disease, and participate in OCHD emergency shelter and response efforts. Other
services of the Health Department that interact regularly with School Health include Dental Health,
Environmental Health, Health Clinics and Health Education.
State Boards of Health were created in the late 1800’s after a typhoid epidemic. Preventative medicine
and hygiene conditions recognized the need for “medical inspections” of school age children for illness.
Initially there were 6 school nurses for the entire state. It is now mandated 1 nurse per school and a
ratio of 1 nurse per 750 students in the general school population, and 1 nurse per 225 students in the
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ORANGE COUNTY BOARD OF HEALTH
June 29, 2006
Board of Health Minutes Transcription completed by Anne Miles Cassell 2 June 29, 2006
exceptional children population, 1 nurse per 125 students in the severely or profoundly handicapped
population.
Alan Rimer questioned the availability of nurses to fill these positions. Dr. Carey replied that these were
very attractive positions and there was no difficulty filling these jobs. Ms. Butler added that the Health
Department has lost several nurses to the schools. Dr. Summers pointed out that with maintaining
special needs students the school population has a lot more health problems than in the past and the
school nurses are required to do more skilled tasks than in previous years.
Orange County averages 1 nurse per every 662 students. There is one school nurse in every school.
Jessica Lee asked if any districts are using nurse practitioners in a school-based clinic as discussed last
year. Ms. Butler replied that 3 are nurse practitioners but are not practicing in that capacity at this time.
Discussions are continuing on school-based clinics.
The Health Department also consults with the schools on environmental issues, nutrition, exercise,
clinical psychologist consultations, health, air quality, smoke-free tobacco use education, mouth guard
program for sports teams, and routine food safety inspections.
II. Approval of June 29, 2006 Agenda
Jessica Lee requested the addition of Item VI.H. Environmental Responsibility Goal, and IV.I. Clean Water
Management Trust Fund, to the agenda.
The motion to approve the Agenda of June 29, 2006 as amended was made by Alan Rimer,
seconded by Tim Carey, and carried without dissent.
III. Public Comment for Items NOT on Printed Agenda
None
IV. Action Items on CONSENT Agenda
A. Minutes approval of May 25, 2006 meeting.
B. Contract with UNC School of Dentistry for Clinical Dentist
The contract covers the provision of dental clinical services for the Health Department by a UNC
School of Dentistry faculty member. The Health Department with the assistance of the
Personnel Department began recruitment for this position in January, immediately upon notice
that Dr. Rodriguez was vacating the position. The Department has explored all qualified
candidates and made offers to at least two dentists who have accepted other positions at either
higher salaries or with a loan repayment package that is currently not available to Orange
County. The Health Department is currently discussing the development of a loan repayment
option for the dentist position with Personnel, Finance, and the County Attorney. That process
may take some time to develop and in the meantime, the Health Department must be able to
cover the services for county residents.
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ORANGE COUNTY BOARD OF HEALTH
June 29, 2006
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One of the graduate residents that rotated through the Health Department from the School of
Dentistry is completing his residency at the end of June. He indicated that he would be
interested in a one-year commitment to provide dental services to the Health Department. Dr.
Zaritsky holds a Canadian dental license and successfully completed his graduate dental
residency at UNC this June; however, because he does not hold a North Carolina dental license,
he cannot practice dentistry in North Carolina unless he is a faculty member of the UNC School
of Dentistry and providing dental education. The UNC School of Dentistry is offering Dr.
Zaritsky a position as a Visiting Clinical Professor and is willing to contract with the Health
Department to provide clinical dental services for the fiscal year 2006-2007. The dentist under
this contract arrangement would also be supervising the Graduate Dental Resident that typically
provides services to the Health Department and would supervise all dental students, dental
hygiene students, and dental assisting students currently rotating through the Health
Department. This one-year arrangement would give the Department time to work through the
details on a loan repayment option and still provide services to our residents.
C. Acceptance of Grant Funds for Continuation of Primary Care
The Health Department received notification of Community Health Grant Continuation funding
for FY 07 in the amount of $43,346. This is the same amount of funding as in FY 06 and is based
on successful achievement of our 06 projections. We are maintaining the same monthly
projections as in 06 but expanded to 9 months.
The continued funding will be applied to the Primary Care Program. The department will apply
in FY 08 for an expansion grant if available as anticipated.
Motion to approve the minutes of May 25, 2006 and items on the Consent Agenda was made by
Moses Carey, Jr., seconded by Alice White, and carried without dissent.
V. Reports and Discussion with Possible Action
A. Community Water Study Parameters Policy
At the May 24th meeting the Board considered some guidelines on water and septic studies in
response to community requests for special studies. Rosemary Summers reported that staff
developed this into a draft policy that was presented to the Board of Commissioners on June 13.
The Board of Commissioners asked that the Board of Health to further specify and delineate the
items contained in the bullets. Alice White asked for clarification of action to be taken relative
to the bullets.
The Board of Commissioners also asked that the item referring to “studies for the extension of
water and sewer” be eliminated as this is outside the purview of the Health Department. One
Commissioner also asked for an outline of what prospective studies would look like rather than
retrospective studies.
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ORANGE COUNTY BOARD OF HEALTH
June 29, 2006
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Alan Rimer expressed concerns about setting of dollar amounts that would become obsolete in
time. Rosemary Summers explained that dollar amounts were set based on authorization level
of the Health Director.
B. Community Awards Report
Health Department staff met with Matt Vizithum and Stephanie Willis, Healthy Carolinians Chair,
to discuss a potential community awards program. The concept of the awards is to recognize
individuals, agencies, organizations, that make a significant contribution to public health and
increase public awareness of public health. An outline of ideas discussed was provided to the
Board for discussion and feedback. The awards are anticipated to be each April during Public
Health Week.
Alice White questioned the timeline for nominations. Jessica Lee suggested an open
nominations period. Alan Rimer commented on the wording sounding too much like a grant
application. Jessica Lee suggested a “statement of contribution”. She also questioned the
necessity of letters of support. It was agreed that letters of support would not be a requirement.
Board members agreed by consensus to recommend the committee move forward with the
plans and suggested that the awards be taken to the commissioners for endorsement and
participation.
C. Board of Health Accreditation Benchmarks
Orange County Health Department is scheduled for accreditation in 2008.
The Health Department will need to complete a “Self Assessment Instrument” 90 days prior to a
scheduled site visit. It is likely that our site visit will be scheduled for the spring of 2008. Ten
counties are scheduled each year, five in the spring, and five in the fall. The Board will receive a
complete briefing on the process that will be followed this fall; however, the Board has a
complete section of its own in the accreditation document. Board members were provided with
details of the Board requirements. Staff will review the items that are currently “not met” in
preparation for determining how the department can come into compliance over the next year.
Alan Rimer suggested a process to formalize changes to operating procedures by the Board.
Jessica Lee made the offer to set up a subcommittee of board members and work through this
and report to the full Board at the regular meetings.
The Board agreed to hold further discussions on this topic at the August meeting.
D. Summer Meeting Schedule
In past years the Board has occasionally cancelled one of the summer meeting dates if there is
no pressing business. The Chair and Vice-Chair conferred and are recommending that the
Board cancel the July meeting. If the Board concurs, the next regular meeting of the Board of
Health would be August 24, 2006.
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ORANGE COUNTY BOARD OF HEALTH
June 29, 2006
Board of Health Minutes Transcription completed by Anne Miles Cassell 5 June 29, 2006
Motion to approve cancellation of the Board of Health meeting on July 27, 2006 was made by Alan Rimer,
seconded by Tim Carey, and carried without dissent.
E. Addendum to Medical Director Contract for School Nursing Services
Chapel Hill Carrboro City Schools (CHCCS) has again requested medical supervision of one of its
School Nurses, who is a qualified Nurse Practitioner, to provide limited nurse practitioner
services in the Head Start Program. This is a similar request to one several years ago that was
not funded. The School Nurse Coordinator, Stephanie Willis, anticipates that funding will
become available this year to support the cost of Medical Director supervision of Jill Kerr, NP
($2,892). The agreements outline the expectations of each party and the cost and payment of
such service.
Motion to approve Addendum and forward to the Board of Commissioners for action was made
by Alan Rimer, seconded by Moses Carey, Jr., and approved without dissent.
F. Informational Items
a. Budget Update
Rosemary Summers provided an update to the Board of the approved 06-07 Budget. She
reported that the Health Department operational budget with the exception of line items cut
last year did remain intact. The remaining funding for the Healthy Carolinians was approved
and the Environmental Health WTMP staff member was approved. The food & lodging
supervisor was not approved. $50,000 will be put into a reserve fund earmarked for the
water resources initiative. The Commissioners directed that a meeting be set up for the
Chairs of the two Advisory Boards, the Chair and Vice Chair of the BOCC, the Department
Directors and the County Manager to discuss the direction of this position. Medical Reserve
Corps did receive partial funding for the position for the rest of the year.
Jessica Lee thanked Moses Carey for his support during the budget process.
b. Pandemic Flu Community Forum
Board members were given copies of the flyers for the forum. Rosemary Summers discussed
the upcoming Pandemic Flu Forum. Dr. Leah Devlin, State Health Director, will be the
keynote speaker. Panel members will include Dr. Heidi Swygard, PHRST team; Dr. Jeff Engel,
Section Chief Epi, and Dr. Kelley Jeffers, State Veterinarian. Food Lion Corporation
representatives will talk about the plan Food Lion has developed. Duke Energy will also send
someone for the panel and Dr. Ray Hackney will represent UNC. Dr. Fletcher Barber
Cooperative Extension Director, will share the local agricultural plan.
G. Tracking Form Review
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ORANGE COUNTY BOARD OF HEALTH
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Board of Health Minutes Transcription completed by Anne Miles Cassell 6 June 29, 2006
The Board reviewed the Tracking Form and by consensus agreed that no changes were
necessary.
H. Environmental Responsibility Goal
In February 2006 John Link, County Manager, sent a memorandum to Department Heads calling
for the formation of an Environmental Stewardship Action Committee, ESAC. The Committee
will have representatives from each department, and will meet quarterly to share ideas, evaluate
progress, and develop new ideas for programs and events to promote environmental awareness
within County government.
Action strategies to consider 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 was
discussed. Board members agreed that the action strategies for this issue should be directly
applied to the development of the Northern Orange Human Services Center and to other county
facilities. Board members also agreed on the pending need for a water quality specialist within
the department.
Alan Rimer volunteered to organize a response and report back to the Board at the August
meeting.
I. Clean Water Management Trust Fund (CWMTF)
Alan Rimer prepared a draft memorandum in response to developing a proactive policy to deal
with the management of septic tank failures and the impact of such systems on the surface and
groundwater resources of the County. The basis of funding for this project would come through
CWMTF and entail development of a detailed application for submission in the December 2006
round of funding.
Educational efforts have increased the level of homeowner awareness of the need for routine
maintenance; however, the rate of failures has increased in the county due to the aging of older
systems. The Health Department and Board of Health has worked with OWASA to develop a
plan for system management. The project would focus on the areas around University Lake and
Cane Creek Reservoirs as trial areas for the development of maintenance areas.
Most of Orange County’s flowing surface waters originate in the county and the water supply
impoundments for the county are wholly located within the county. This set of circumstances
enable the county government and its citizens the ability and opportunity to protect its source
waters without reliance of other upstream out-of-county governments.
VI. Closed Session (ref. NCGS 143-318.11(a)(6) to consider the qualifications, competence, performance,
fitness, conditions of appointment, of an individual public officer or employee.
Motion to move to closed session was made by Tim Carey, seconded by Moses Carey, jr., and
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ORANGE COUNTY BOARD OF HEALTH
June 29, 2006
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carried without dissent.
Motion to move to open session was made by Moses Carey, Jr., seconded by Tim Carey, and
carried without dissent.
VII. Adjournment
Motion to adjourn the meeting was made by Alice White, seconded by Tim Carey, and carried
without dissent.
The next Board of Health meeting will be held on August 24, 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