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HomeMy WebLinkAboutBOH minutes 092906MINUTES ORANGE COUNTY BOARD OF HEALTH September 28, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 1 September 28, 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 September 28, 2006 at the Southern Human Services Center, Chapel Hill, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Jessica Lee, Chair; Alan Rimer; Tim Carey; Matt Vizithum; Sharon Freeland; Chris Harlan; Jim Stefanadis; Sharon Van Horn; Anissa Vines BOARD OF HEALTH MEMBERS ABSENT: Moses Carey, Jr., 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; Angela Cooke, Dental Health Services Division Director; Donna King, Health Promotion and Education Services Division Director; Anne Miles Cassell, Administrative Assistant; Sandy Garrett, Quality Assurance/Risk Management Coordinator GUESTS PRESENT: Sarah Donovan, UNC-CH Journalism student I. Welcome and Introductions Jessica Lee called the work session to order at 6:15 P.M. II. Approval of September 28, 2006 Agenda The motion to approve the Agenda of September 28, 2006 was made by Alan Rimer, seconded by Tim Carey, and carried without dissent at 7:15 P.M. II. Dinner and Work Session on Accreditation Standards The Orange County Health Department is scheduled to begin the accreditation process in fiscal year 2007-2008. Last year North Carolina passed a state law making local health department accreditation mandatory. There are many steps in ensuring that the department will meet the accreditation standards and activities. The section that the Board addressed at this meeting pertains to the Board of Health’s responsibilities as defined by the Accreditation Board. Once a health department is accredited it must be re-accredited on a repeating 4-year cycle. The Department has been fortunate to have several staff members serve as site visitors for other health departments undergoing accreditation. Commissioner Carey who serves on the Board of Health has been the Accreditation Board Chair and may be able to offer valuable insights as well. Rosemary Summers reported to Board members that as gaps are identified for benchmarks, standards, activities and related documentation, the Board would need to develop an internal work plan for remediation of any gaps. Sandy Garrett is the Accreditation Coordinator for the Health Department. A state program consultant will be assigned to the department by the state to help as accreditation draws near. Board members discussed items as outlined and offered suggestions to meet the criteria for accreditation. Jessica Lee recommended that statistical reports on infant mortality, infant deaths, STD’s, and teen pregnancies be offered as an educational item at a Board meeting to satisfy the goal that the Board annually review reports provided by the Department on the community’s health. MINUTES ORANGE COUNTY BOARD OF HEALTH September 28, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 September 28, 2006 By consensus the Board agreed to continue discussions on accreditation at a work session prior to the next regular Board meeting. IV. Public Comment for Items NOT on Printed Agenda None V. Action Items on CONSENT Agenda A. Minutes approval of August 24, 2006 meeting. B. Accept Funds for Eat Smart Move More Grant The Board approved the submission of the Eat Smart Move More Grant at the August Board meeting. The Department applied for $15,000 and will receive funds in the amount of $13,500 from the Physical Activity and Nutrition Branch, Chronic Disease and Injury Prevention Section of the NC Division of Public Health. These funds will support a faith-based initiative aimed at improving nutrition and physical activity behaviors. A part-time temporary project assistant is the only staff support included in the project. Orange County Health Department, in collaboration with multiple community partners, will train representatives from local churches to establish health teams at their churches. Teams will develop policies and programs to promote better nutrition and physical activity behaviors. Participating churches will be eligible for mini-grants of up to $500 to fund specific projects. The primary focus of the intervention will be residents in the northern portion of Orange County and will include families and adults affiliated with rural or Hillsborough area churches. A focus will be placed on recruiting African-American churches but the training and program will be open to any interested church within the county. The northern portion of the county is rural, further in distance from service providers, has fewer parks and recreation opportunities and facilities and limited transportation. The population tends to be more isolated and has lower average incomes and educational levels than in other parts of the county. There is also limited access in the north to the types of programs and resources that are available in the southern part of the county where Chapel Hill, Carrboro and the University of North Carolina offer numerous programs and opportunities for recreation and education. We wish to provide assistance to those in the Northern portion of the county to develop new programs that may not currently be available via other means, and to help increase access to health promotion for Northern Orange residents. In a meeting held in July 2006, numerous church representatives stated an interest in having health promotion programs in their churches but they expressed a need for further assistance in getting started. Five churches in the community attended the Eat Smart Move More for African- American churches training held in 2005. Outcomes for the project include an increase in churches that adopt policy and environmental changes promoting healthy food and beverage service and increased physical activity and healthy behavior changes for program participants that include a decrease in the consumption of sweetened beverages; increase in water consumption; increase in level of physical activity; control of food and beverage portions and increase in consumption of fruits and vegetables. Partners for the project include Cooperative Extension Orange County Service Center, Orange Congregations in Mission (OCIM), and UNC Chapel Hill Program on Ethnicity, Culture and MINUTES ORANGE COUNTY BOARD OF HEALTH September 28, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 3 September 28, 2006 Health Outcomes (ECHO) C. Contract Renewal with Early Head Start for Social Worker II The Early Head Start contract represents a collaborative relationship to provide family service coordination services to families eligible for and enrolled in Orange County Early Head Start and Orange County Health Department’s Child Service Coordination Program. The collaboration for one social worker position presents parents with one, unified program case coordinator who provides regular contacts to the family in order to identify and follow-up on child and family needs. The Family Service Coordinator supports the development of family self-sufficiency and promotes skill development in the areas of problem solving, decision making and accessing needed health and human services. The contracts have been in existence since 1999 and are renewed annually. Changes in the contract from 06 include the provision of nutrition consultation services based on referrals from EHS . Monetary payment to OCHD increases to $56,796 ($4733/month) in CY 07 and is sufficient to cover the full cost for the salary and benefits of the social worker position. The contract is in effect from January 1, 2007 to December 31, 2007. D. Accept Additional Funding for FY06-07 • Dental Mouthguard Project: Grant funding from Strowd-Roses, Inc. in the amount of $5,000. Funding will be used to purchase supplies for mouth guards for the Orange Co Schools' athletic teams. This project is in collaboration with the UNC School of Dentistry and Dental students. • Public Health Preparedness (Pan Flu): Originally awarded in June 2006, this money has been reallocated to be used in FY 06-07. Amount of funding = $26,415 to be used to support the Pan Flu Community Forum, purchase hand-held GIS, PC, 800 MHz radios, and other equipment. • PH Preparedness (Pan Flu) Allocation II: New allocation for FY 06-07 is based on a proposal sent in by BT Coordinator, Carla Julian. Amount of funding = $20,000 to be used to address pandemic preparedness gaps identified in our pan flu self-assessment conducted in March 2006. Purchase of additional handheld computers for field epi investigations, GIS software to support fieldwork, educational session for medical providers, and other materials. • Title X - Family Planning Funds: assistance for oral contraceptive purchases. Amount of funding = $7,068. Due to a 790% increase in the cost of birth control pills, the state has allocated money for each county based on their family planning visits. This amount may cover only half of the extra cost needed to purchase oral contraceptives. • Orange Co Partnership for Young Children (Smart Start) Additional Allocations: The local partnership received a 2% increase in funding based on additional funds allocated by the legislature. The Partnership requested that grantees submit proposals for extra funding. Current funds are all allocated toward staff salaries and in most cases do not cover the full cost of salary and benefits; therefore most of the funds are to defray salary costs except for Dental Screening which received money to hire additional contract staff. No funds were requested for the Families in Focus Program because that program has access to third party reimbursements. Child Care Health Consultant = $2,950; Dental Screening Project = $7,500; Help 4 Kids = $2,760. MINUTES ORANGE COUNTY BOARD OF HEALTH September 28, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 4 September 28, 2006 • TANF (Out of Wedlock Funds) have been allocated to Local Health Departments by the NC General Assembly as one-time funding. The purpose of these funds is to assist in the reduction of out of wedlock births. Personal Health plans to use these funds for various methods of contraceptives. Amount awarded to OCHD = $7,650 to be spent by May 31, 2007. E. School Nurse Contracts Each year the Health Department contracts with each school system for the provision of school nurses to the schools. The funds are "pass through" funds allocated by the Commissioners in order to meet the "one nurse per school" standard adopted by Commissioners in 2000. The funds are in a separate line item in the county budget and are not part of the regular Health Department budget. There are no substantive changes to the contracts for this year. These contracts were on the Commissioners agenda on September 19 and have already been approved by them. They were presented for Board review and concurrence as part of contract review responsibilities. Motion to approve the minutes of August 24, 2006 and items on the Consent Agenda was made by Alan Rimer, seconded by Matt Vizithum, and carried without dissent. VI. Reports and Discussion with Possible Action A. Review Primary Care at SHSC Grant Application Wayne Sherman reported that OCHD has been awarded a FY 06-07 continuation grant of $43,346 for the ongoing provision of primary care services in the Hillsborough clinic. We have also been offered the opportunity to apply for an expansion grant to increase access to primary care for uninsured and medically indigent patients. Grants of non-recurring funds up to $75,000 will be awarded for programs/initiatives of a sustainable program or initiative that increases access to care for uninsured and medically indigent patients at existing facilities, develops a new service delivery site; or creates or expands services provided to uninsured and medically indigent patients for medical services, dental services, pharmacy, or mental/behavioral health services. A second category is a capital request that will increase the applicant’s capacity to serve the uninsured by enhancing or replacing necessary facilities, equipment, or technology. OCHD is proposing to expand primary care services to SHSC in line with our Strategic Plan. We will be submitting applications in both categories to cover personnel, supplies, pharmaceuticals, equipment and renovation costs. Notification of awards will be made no later than November 30, 2006 with expenditures to be completed by May 31, 2007. There is a continued need for access to primary care services particularly for the uninsured and medically indigent in Orange County. Piedmont Health Services, a critical safety net provider of health care to low-income clients, has a 1-2 month waiting list to become a new patient at Carrboro Community Health Center. The Central Carolina Health Network, a network of providers serving the Medicaid population and working to build the infrastructure to care for a growing uninsured population, is seeking to add providers to its network. UNC Hospitals has discontinued its Urgent Care Clinic limiting alternatives for those without medical homes who use the Emergency Department for sick care. Clients currently receiving preventive heatlh services at SHSC have been requesting primary care and inquiring as to when we would be providing it at the site. MINUTES ORANGE COUNTY BOARD OF HEALTH September 28, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 5 September 28, 2006 Motion to approve the grant application was made by Tim Carey, seconded by Chris Harlan, and carried without dissent. B. Approval of New Fees Gardacil: Human Papillomavirus (HPV) is the most common sexually transmitted disease in the U.S. Certain HPV strains can cause cervical cancer and genital warts. Gardacil, a new vaccine from Merck and Company, was licensed in June. It protects against 4 strains of HPV that are responsible for approximately 70% of all cervical cancers and 90% of all cases of genital warts. The vaccine is administered as a series of 3 intramuscular injections over a period of 6 months. The State Immunization Branch will be supplying Gardacil only to clients eligible for the Vaccines for Children Program (VFC), leaving many of our clients without access to this vaccine. Since June, we have had three women call to inquire about the availability of the vaccine and they have stated that access to the vaccine has been very difficult to find through their regular medical providers. Orange County Health Department is proposing to offer Gardacil to our non-VFC clients in the Family Planning, Child and Adolescent Health, and Immunization programs. The vaccine is licensed for females from 9 to 26 years of age. Guidelines from the ACIP, the national committee that develops immunization guidelines, are expected next week. The cost for the Health Department to purchase the vaccine is $120.00/dose. We propose to offer it to our non- VFC eligible clients for a flat fee of $130.00/dose, which includes a $10 administration fee ($390 for the full series of 3 doses). The cost of the vaccine is covered by many health insurance providers, so a receipt will be provided for the client to submit to their insurance carrier for reimbursement. Tim Carey requested an educational presentation on this topic at a future Board of Health meeting. He commended the staff for bringing forward this service that will significantly prevent cervical cancer. Mouthguards: Angela Cooke reported on the Mouthguard Project, a collaborate effort between UNC School of Dentistry students, private dentists, high school and middle school athletic departments and the health department. Through the grant from Strowd-Roses most of the cost of this initial project is covered. The staff recommends a flat fee of $10 per student for the mouthguard for this community project. This will help defray the ongoing cost of supplies and encourage students to be responsible in caring for their custom-made mouthguard. It is anticipated that this $10 fee may bring in approximately $4,000-5,000 in revenue that would return to the project for additional supplies. Jessica Lee, Board dentist representative, commented that out of 120 trauma cases involving mouth injuries, only one was wearing a mouthguard. Motion to approve the new fees and forward to the Board of Commissioners for approval was made by Sharon Freeland, seconded by Anissa Vines, and carried without dissent. C. Nominating Committee Report The current engineer's (Alan Rimer) term on the Board of Health expired June 30, 2006. Members serve until a replacement is appointed. Matt Vizithum reported on the current status of the search for a replacement. There has only been one applicant for the position. The committee has spoken with the applicant and explained the scope of the issues the position MINUTES ORANGE COUNTY BOARD OF HEALTH September 28, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 September 28, 2006 would entail. Alan Rimer reported that Mr. Dodson had a lot relevant experience in wastewater and water systems. Motion to forward the recommendation of Ernest Dodson for the Engineer position to the Board of Commissioners was made by Alan Rimer, seconded by Tim Carey, and carried without dissent. D. Draft Quarterly Financial Report One of the accreditation requirements is that the Board regularly review the financial status of the Health Department. Staff recommended that the Board receive a financial report on a quarterly basis. A draft report was provided to the Board for comment and direction. The data in the draft report covered the first two months of the 06-07 fiscal year. The staff requested comments and direction from the Board on this format and presentation. Alan Rimer suggested that a percentage of what has been spent versus the percent of what was expected to be spent would improve clarity. Anissa Vines suggested that a column be added regarding educational expenditures for staff to satisfy the accreditation requirement of support for workforce development. E. Community Awards Project Changes suggested by the Board have been incorporated into the draft provided to the Board. Rosemary Summers suggested that the award be called the Ron Holdway Public Health Service Award. Board members concurred that the name was an excellent choice. Sharon Van Horn inquired about the plans to publicize the award and a suggestion was made to make full use of radio, newspapers, and committees. Motion to accept the guidelines as presented was made by Alan Rimer, seconded by Matt Vizithum, and carried without dissent. F. Report on Water Protection Process Alan Rimer, on behalf of the Chair and Vice-Chair, met with the Co-Chairs of the Commission for the Environment, the Department Heads, the County Manager and the Chair and Vice-Chair of the Board of Commissioners to discuss the next steps for resolving the issues surrounding the two water resources proposals. Alan Rimer reported to the Board on that meeting and suggested the best approach is what is best for Orange County. Subsequent to that meeting, it was agreed by all of the various parties involved that a small group (three members from each board) would be the most expeditious in working through the proposals and forwarding a recommendation to both Boards and subsequently to the Board of Commissioners. Sharon Van Horn commented that she had searched and was unable to find much on the Orange County website on this topic. Matt Vizithum inquired whether the Commission had a website. The Chair recommended that the three members from the Board of Health be Jessica Lee, Matt Vizithum, and Alan Rimer. The Board discussed the impact of the recommended appointment of Ernie Dodson to the Board of Health. The chair proposed that Mr. Rimer should continue for the “life” of the small committee on behalf of the Board of Health if he is willing to do so. Mr. Rimer graciously agreed MINUTES ORANGE COUNTY BOARD OF HEALTH September 28, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 7 September 28, 2006 to do so. Motion to approve the recommendation that Jessica Lee, Matt Vizithum, and Alan Rimer represent the Board of Health was made by Tim Carey, seconded by Sharon Freeland, and carried without dissent. G. Informational Items 1. Water Research Project at Little River State Park Tom Konsler, Interim Environmental Health Services Division Director, explained that Orange County has been identified as one of the counties located in the Carolina Slate Belt region where naturally occuring arsenic in groundwater has become a concern. Studies have shown that arsenic in drinking water can increase the risk of cancer. Rick Bolich, a Hydrogeologist with the DENR Division of Water Quality's Aquifer Protection Section, contacted Environmental Health about Orange County cooperating in a groundwater monitoring project to be located at the Little River Regional Park. The park is located in an area of the county with the type of geology that lends itself to study of arsenic in groundwater. The project would involve the installation of up to 9 wells on the property on 3 different landscape positions. These wells would be used for monitoring arsenic as well as the static level of groundwater and potential groundwater movement. The main subjects of interest to the Division of Water Quality are: · The effects of well construction on groundwater arsenic levels · Studying groundwater recharge and movement down the natural gradient · Evaluating the impacts of housing development on groundwater quality In addition to the research aspect of the project, the site would be used as an environmental education resource at the park. Core samples of rock from the wells would illustrate the underlying geology and would show water bearing fractures. Collaborators in the project would include USGS, Duke University, DWQ, Durham County, possibly NCSU and others. The first phase would involve a non-invasive geological assessment of the park and surrounding areas with water sampling of existing water supply wells. The second phase would require construction of wells using a coring machine to retrieve core columns of the underlying geology. This will assist in determining the depths of the wells needed. The third phase would be the installation of the deep drilled wells at pre-determined depths and the initiation of the sampling project. In addition to the environmental education aspect of this demonstration project, there is valuable information that can be gained in the area of groundwater recharge rates, patterns of groundwater movement, and the occurrence of arsenic in groundwater. If any relationship is established between well construction methods and materials and arsenic, the information gained may help guide the development of well construction regulations to help address water quality and quantity. Matt Vizithum asked about the footprint of the wells and the size of the park. Tom Konsler explained the footprint would be minimal. The majority of the land in this park lies in MINUTES ORANGE COUNTY BOARD OF HEALTH September 28, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 8 September 28, 2006 Durham County. 2. Comprehensive Plan Process The Board developed and submitted comments on the draft Comprehensive Plan Process late this summer along with many other advisory boards. The Board of Commissioners will be considering the next steps to this process in early October. The Planning staff shared the these comments with a staff group late last week in preparation for submitting them to Commissioners. These comments were presented to the Board of Health as information. Commissioners will not be providing their input or making a decision until sometime in October. There is no lead role identified for any of the elements for the Board of Health or the Health Department. 3. Community Flu Vaccination Plans Wayne Sherman reported that the Community Services Staff have been planning for the community flu vaccination clinics for the past few weeks. Plans are to have two primary events. The Department will be testing parts of its mass medication dispensing plans, especially the "just in time" training and the use of volunteers more extensively than in the past. It is offered as a training opportunity for school nurses as well. The plan will test the capacity of the SHSC site to handle a large number of clients through this clinic and be utilizing all of the meeting rooms as well as the clinic space. The Department anticipates receiving 3,500 doses of injectable vaccine and 50 doses of Flu Mist this year. The clinics are scheduled as follows: November 4, 2006 CW Stanford Middle School Hillsborough From 9 am -1 pm or until vaccine runs out November 11, 2006 Southern Human Services Center (SHSC) From 9am -4 pm or until vaccine runs out The approved fee for each vaccination has been established at $28 this year, however, due to slightly reduced vaccine costs, the price will be reduced to #25 to be more in line with other community providers. H. Tracking Form Review The tracking form is for informational purposes and allows Board members a monthly review of upcoming agendas and a snapshot of the status of high priority projects. This month there were several additions to recurring items. VII. Board Comments/Announcements None VIII. Adjournment Motion to adjourn the meeting was made by Tim Carey, seconded by Matt Vizithum, and carried without dissent. MINUTES ORANGE COUNTY BOARD OF HEALTH September 28, 2006 Board of Health Minutes Transcription completed by Anne Miles Cassell 9 September 28, 2006 The next Board of Health meeting will be held on October 26, 2006 at the Southern Human Services Center, Chapel Hill, North Carolina at 6:00 PM. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board