Loading...
HomeMy WebLinkAboutBOH minutes 082406MINUTES ORANGE COUNTY BOARD OF HEALTH August 24, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 August 24, 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 August 24, 2006 at the Southern Human Services Center, Hillsborough, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Jessica Lee, Chair; Matt Vizithum, Vice-Chair; Alan Rimer; DeWana Anderson; Tim Carey; Chris Harlan; Jim Stefanadis; Sharon Van Horn; Anissa Vines BOARD OF HEALTH MEMBERS ABSENT: Sharon Freeland, schedule conflict; Moses Carey, Jr., meeting conflict; 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; Maria Hitt, Healthy Carolinians Coordinator GUESTS PRESENT: Milan Pham, Orange County Human Rights and Relations Director I. Welcome and Introductions Jessica Lee welcomed Anissa Vines, new at-large representative to the Board, and called the meeting to order at 7:00 P.M. II. Approval of August 24, 2006 Agenda Rosemary Summers requested the addition of Section V. Item H. Workforce Collaborative Funding to the agenda. The motion to approve the Agenda of August 24, 2006 as amended was made by Jim Stefanadis, seconded by Chris Harlan, and carried without dissent. III. Public Comment for Items NOT on Printed Agenda None IV. Action Items on CONSENT Agenda A. Minutes approval of June 29, 2006 meeting. B. Eat Smart Move More Grant The Physical Activity and Nutrition Branch of the NC Department of Health and Human Services offered health departments and community organizations the opportunity to apply for grants related to the “Eat Smart Move More” effort organized by the State. As a direct result of the MINUTES ORANGE COUNTY BOARD OF HEALTH August 24, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 August 24, 2006 Orange County Healthy Carolinians breakfast this spring, this grant application is focused specifically on engaging African American churches in increased education and programming in this area. This will also aid in addressing the overwhelming need to reduce health disparities. If approved, the grant will provide $15,000 for project expenses. No permanent staff will be added through the grant, however a small amount is designated for a part time project assistant. The Health Promotion Coordinator will manage the project. We anticipate that the grant award announcements may be made in early September with an October 1 start date. If the Department is the recipient of the grant award, we will need to request a budget amendment by the County Commissioners before these funds can be spent. C. Acceptance of Additional Family Planning Funds Ortho-McNeil Pharmaceutical, Inc. dramatically increased the price of most of their oral contraceptive products beginning in July. They began at that point charging the maximum price allowed by law for its Public Health Service (340B) prices for all of its multi-source contraceptive pills. For some of the most widely used oral contraceptive pills this was a 6 or 7 fold increase in price. Ortho representatives relate the price increase for these oral contraceptives to the recent availability of generics of these products. With the increased competition for these products, Ortho decided to raise prices from the lowest to the maximum allowed and reduce production of these products. Alternate oral contraceptive supplies have been difficult to identify, as other manufacturers did not increase their supplies. Health departments are restricted from writing separate prescriptions for these pharmaceuticals because they are considered to be part of the “bundled” service provided. As budgets were fixed as of July 1, 2006, it leaves health departments in a particularly difficult situation, faced with providing services to fewer patients than in previous years. This could also result in higher pregnancies and increased overall costs to the health care system. In FY 05-06, 1191 clients total were seen in the OCHD family planning program. 704 (59%) were on oral contraceptives. The Health Department staff has diligently searched for alternatives to the current medicines provided, seeking out the lowest prices possible. The clinicians have met and considered all of the possible options for patients. Finally, the numbers of packets of pills provided to patients at a single visit have been limited to three months to ration our supply. This will present an additional barrier for some women who will need to return every three months for additional supplies. In addition, there is some preliminary indication that other providers in the community will be referring women to the health department rather than bearing the burden of this increase themselves. The state has been providing some assistance to local departments in finding suitable generics and making sure that the state contract price is the lowest available. They are still negotiating with Medicaid to see if the reimbursement rate could be raised or to remove the contraceptive method from the bundled service so that a separate prescription could be written. The State also has received performance increases from the federal government as a result of higher numbers of women being seen in family planning last fiscal year. Those performance dollars are being distributed to local health departments based on the percentage of total family planning MINUTES ORANGE COUNTY BOARD OF HEALTH August 24, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 August 24, 2006 patients seen in the past fiscal year compared to those seen statewide. For Orange County, our additional allocation will be used to defray the increased costs of oral contraceptives. Rosemary Summers noted that the department has not been notified of the amount of funding we will receive as of this date. Motion to approve the minutes of June 29, 2006 and items on the Consent Agenda was made by Tim Carey, seconded by Matt Vizithum, and carried without dissent. V. Reports and Discussion with Possible Action A. Social Justice Goal Exercise and Discussion Rosemary Summers introduced Milan Pham, the Director of the Human Rights and Relations Department. Milan explained that in 2004 the Board of Commissioners charged the Human Rights and Relations Commission (HRRC) with the task of developing a social justice goal for the county. Research showed that this had not been done anywhere else in the country. The staff of the HRRC has been engaged in a process with county residents and many advisory boards to determine high priority areas for inclusion for further development. The “pennies for justice” exercise is one method used to determine priorities. Milan facilitated this exercise with Board members and sought the Board’s input on the development of the social justice goal. Tim Carey inquired about how the different categories of focus were derived. Milan replied that the HRRC determined the categories. Elimination of oppression thus far Is the largest concern of participations. One high interest and priority area that emerged is “affordable health care” as a social justice need. The Board considered the aspects of affordable health care that could be woven into a long-term (10 years) goal for social justice. Ms. Pham will return and report to the board when the final results of the study have been compiled. B. Comprehensive Land Use Plan Process Comments The Board was given a copy of a 7/14/06 memo from the Planning Department. Staff met with Alan Rimer to discuss possible areas of input and the draft results of that discussion was presented in memo format to the Board for discussion and approval. Alan Rimer explained the additions and changes made to the draft. The planning board memo encouraged starting with a plan that was 25 years old. The review committee chose to look forward and made suggestions on that basis. Motion to endorse the memo draft was made by Alan Rimer, seconded by Anissa Vines, and carried without dissent. C. Environmental Responsibility Action Strategies MINUTES ORANGE COUNTY BOARD OF HEALTH August 24, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 August 24, 2006 The BOCC adopted the environmental responsibility in county government goal and asked the Environment and Conservation Resource Department to coordinate with relevant boards and departments to develop action strategies to accomplish this goal. The intent of the Commissioners was that this should be focused on county government itself and not on services to the public. Rosemary Summers reported that some Boards/Departments have had a hard time separating county government from services that governmental agencies provide to the public in distinguishing their recommendations for action strategies. The Board considered all the objectives, however, it was asked to focus on Objective #8: 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. Staff met with Alan Rimer to discuss alternative strategies that could be presented to the Board for consideration and Board members were given a copy of the draft memo of the strategies that were discussed at that meeting. The Board commended the development of the strategies as written. There was no further discussion or additions to the memo. Motion to approve and forward the memo to ERCD was made by Alan Rimer, seconded by Matt Vizithum, and carried without dissent. D. Community Assessment Outline and Timeline The Health Department is required to engage in and produce a comprehensive community health assessment every four years that is intended to guide a community health improvement plan for the county. Our next required date of submission to the state is December 2007. A well-developed, comprehensive community assessment is also a key component of accreditation for local health departments. Maria Hitt, Healthy Carolinians Coordinator, is the designated project manager for the comprehensive community assessment. She prepared an outline for the Board’s consideration along with a preliminary timeline and discussed the significant points all along the timeline and process that engage various sectors and members of the community directly in the process. She will begin to pull the community partners together in September to begin work on the project. For this community assessment, staff is very interested in emphasizing the links between environmental factors and how they impact health conditions. Tim Carey made the point that environmental health is a broad topic and asked about how the most important questions would be determined for this area of concern. Maria replied that the last assessment determined what the issues are in Orange County. These issues have not changed. This assessment will take the issues identified in the previous assessment and ask more specific questions targeting those issues. Maria reported that Ron Holdway went with her to a Commission for the Environment meeting to seek their input and collaboration in this effort, especially since they publish a bi-annual MINUTES ORANGE COUNTY BOARD OF HEALTH August 24, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 August 24, 2006 “State of the Environment Report.” They decided that they would be happy to review our data but did not feel more intensive collaboration was needed at this time. Alan Rimer suggested brainstorming with academics from the School of Public Health’s Environmental Health Department for their academic perspective on this study. He also suggested that Smart Growth webpage online has an entire section on environmental health issues as they relate to the environment. The Board was asked to consider approving this process that recognizes and encourages community participation in the entire assessment process. Motion to approve the outline for the comprehensive community assessment as presented was made by Matt Vizithum, seconded by Anissa Vines, and carried without dissent. E. Community Water Study Parameters Follow-up In May the Board considered some guidelines on water and septic studies in response to community requests for special studies. 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 further specify and delineate the items as presented. In addition, the Board of Commissioners 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. In June, the Board of Health asked staff to meet with Alan Rimer as the engineer representative to the Board and review the draft for recommended changes and come back in August with those changes. Rosemary Summers discussed the changes and explained the funding approval levels. A draft including the recommended changes was distributed to the Board for review and approval. Jessica Lee asked for cost figures for the Mill Creek Study. Rosemary Summers replied that direct operational costs were approximately $2000. To add in the cost of staff time the cost would be around $30,000. The Board was concerned with staff time being consumed by studies to the point where they were unable to devote enough time to their regular duties. There were no further recommendations or changes by Board members. Motion to approve and forward the Community Water Study Parameters Report to the Board of County Commissioners was made by Tim Carey, seconded by Chris Harlan, and carried without dissent. F. Options for Accreditations Benchmark Analysis Meeting The Health Department is scheduled for accreditation in 2008 and there are several items that will need the Board’s attention before the deadline. It would be difficult to schedule sufficient time during a regular agenda to give the attention that is needed to examine the Board of MINUTES ORANGE COUNTY BOARD OF HEALTH August 24, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 August 24, 2006 Health benchmarks and activities for accreditation. There are several options for the Board to consider: • Option 1: Schedule September meeting (9/28) to begin at 5 pm and devote 2 hours for review of the benchmarks (dinner included); • Option 2: Schedule September (9/28) and October (10/26) meeting to begin at 6 pm and devote 1 hour each for review of benchmarks (dinner included); • Option 3: Schedule a separate additional meeting on an alternate evening for this purpose. After discussion the Board agreed that Option 2 would work the best for most members. Motion to approve Option 2 schedule was made by Alan Rimer, seconded by Chris Harlan, and carried without dissent. G. Tracking Form Review The tracking form allows a monthly review of upcoming agendas and a quick view of the status of high priority projects. Rosemary Summers reported a change in the status of the Contract for School Nurses item. The Health Department will again administer the school nurse contract for this school year, and this item will be on next month’s agenda. Also Environmental Health rules review will most likely be deleted as this item is waiting for the state’s changes prior to proceeding. H. Workforce Collaborative Funding The Health Department is engaged with 9 other counties in a collaborative arrangement called an “incubator.” The legislature designated $2 million dollars of the budget to go to public health incubators. The concept of incubators is that they are a regional collaborative to assist health departments in those regions to do projects that they could not do on their own. Our collaborative chose to focus on workforce development to improve the recruitment and retention of our workforces to do succession planning because some of our key staff are approaching retirement age. We had an initial grant from the Institute of Public Health to do the planning around workforce development. The committee reviewed the application for year 2 funding and decided against funding. Rosemary Summers distributed copies of a letter received recently from Guilford Board of Health to the institute addressing the funding refusal as an inappropriate decision. Board members were asked for recommended actions. Alan Rimer suggested that a letter be written on behalf of the Board by Jessica and Dr. Summers emphasizing the need to outline review criteria for proposals ahead of time and provide a copy of the letter to members at the next Board meeting. VI. Board Comments/Announcements MINUTES ORANGE COUNTY BOARD OF HEALTH August 24, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 August 24, 2006 None VII. Adjournment Motion to adjourn the meeting was made by Alan Rimer, seconded by Tim Carey, and carried without dissent. The next Board of Health meeting will be held on September 28, 2006 at the *Government Services Center in Hillsborough, North Carolina at 6:00 PM. This will be a dinner meeting with a one-hour workshop on accreditation benchmarks prior to the regular 7 PM business meeting. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board *Location has been changed.