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ORANGE COUNTY BOARD OF HEALTH
July 28, 2005
Board of Health Minutes Transcription completed by Anne Miles Cassell 1 July 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 July 28, 2005 at the Government Services Center,
Hillsborough, North Carolina.
BOARD OF HEALTH MEMBERS PRESENT: Alan Rimer, Chair; Jessica Lee, Vice-Chair; Sharon Freeland;
Alice White; Tim Carey; Matt Vizithum; Jim Stefanadis; Moses Carey, Jr.
BOARD OF HEALTH MEMBERS ABSENT: Sharon Van Horn; Chris Harlan
STAFF PRESENT: Rosemary Summers, Health Director; Angela Cooke, Dental Health Services Division
Director; Ron Holdway, Environmental Health Services Division Director; Donna King, Health Promotion
and Education Division Director; Kathy Glassock, Personal Health Services Division; Anne Miles Cassell,
Administrative Assistant; Albert Mills and Jane Andrews, Environmental Health Services
GUESTS PRESENT: Joan Pellettier, CJCOG, Area Agency on Aging
I. Welcome and Introductions
Alan Rimer called the meeting to order at 7:00 P.M. and introduced guests present.
Oath of Office for Jim Stefanadis.
Melody Dees, Clerk of Court’s office, administered the oath of office to Jim Stefanadis, pharmacist
representative to the Board of Health.
II. Approval of July 28, 2005 Agenda
Jessica Lee requested that item V.F. be added to the agenda, Board Vacancy to hear a report by the
nominating committee.
The motion to approve the Agenda of July 28, 2005 was made by Sharon Freeland, 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 April 28, 2005 meeting.
Motion to approve the minutes of April 28, 2005 was made by Alice White, seconded by Tim
Carey, and carried without dissent.
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ORANGE COUNTY BOARD OF HEALTH
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Board of Health Minutes Transcription completed by Anne Miles Cassell 2 July 28, 2006
B. Verification of Actions of April 28, 2005 Meeting.
Board of Health Operating Procedures defines a quorum of the Board as more than half the
members of the Board, excluding any vacancies. The April 28 meeting had exactly 50% of the
Board (excluding one vacancy) in attendance; therefore a quorum did not exist. The Board took
the following actions in principal:
• Approved March 24, 2005 minutes.
• Forwarded the Pharmacist Renewal Agreement to Commissioners
• Forwarded the Renewal for a Social Worker funded by Chapel Hill Training and Outreach,
Inc. to Commissioners.
• Forwarded the acceptance of additional funds in the amount of $15,435 for various
purposes.
• Forwarded recommendations to Board of Commissioners on renewed terms for Chris
Harlan, Sharon Van Horn, and consideration of an appointment for James Stefanadis as
the Pharmacy representative to the Board.
• Adjourned the meeting.
Motion to accept the actions taken by the members in attendance at the April 28, 2005 meeting of
the Board of Health as documented in the minutes of the April 28, 2005 meeting of the Board of
Health was made by Jessica Lee, seconded by Matt Vizithum, and carried without dissent.
C. School Nurse Contracts: Renewals
During the budget deliberations in FY2001-2002, the Board of Commissioners agreed to a four-
year plan for achieving a goal of a full-time school nurse in every public school in both Chapel
Hill Carrboro City Schools (CHCCS) and Orange County Schools (OCS).
The total cost of the contracts is $505,289 and was authorized in the approved budget for FY
2005-2006, the final year of the four-year plan. The Orange County Schools will receive a total
of $167,001 for three nurses and the Chapel Hill Carrboro City Schools will receive a total of
$338,288 for six nurses.
Motion to approve the renewal agreements and forward to the Board of Commissioners was
made by Moses Carey, seconded by Matt Vizithum, and carried without dissent.
D. Dental General Practice Resident Contract Renewal
The Orange County Health Department annually contracts with UNC School of Dentistry for
services of one full-time equivalent dental resident for four and one-half days per week. The
residents provide services at both the Hillsborough and the Carrboro dental clinics. The total
cost of the contract for July 1, 2005 through June 30, 2006 is $47,192. This amount was included
in the 2005-06 dental budget. This contract cannot be fully executed until the state legislature
passes their budget.
Motion to approve the renewal of the contract with the UNC School of Dentistry for the General
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Practice Resident for FY 2006 and forward to the Commissioners for approval was made by
Jessica Lee, seconded by Moses Carey, and carried without dissent.
E. Behavioral Health Counseling Contract: CHCCS (new)
In the past year, Jennifer Sharpe, the Licensed Clinical Social Worker at the health department
began providing behavioral counseling services to children and adolescents referred to her by
school nurses in both school systems. The Chapel Hill Carrboro City Schools have requested
additional services to be provided primarily for students identified by student services teams in
three middle schools in the system who are at-risk for or exhibiting behavioral issues. Due to
prior commitments, the health department currently does not have the capacity to divert Ms.
Sharpe’s resources to provide the level desired by the school system. CHCCS has identified a
one-time source of funds through the Safe Schools money allocated to school systems to pay
for these services. The Health Department will hire a part-time temporary licensed clinical social
worker specifically to provide these services for the 05-06 academic year. The contractor will be
supervised by the Family Home Visiting Supervisor. The maximum amount available is $15,000
for the year. It is anticipated that this will pay for slightly less than half time services for the
school year. The Health Director discussed this project with the Social Services Director to
determine whether this service should be provided through that department rather than the
Health Department. It was mutually agreed that these services should be coordinated through
the Health Department at this time.
Motion to forward the agreement for Board of Commissioners approval subject to county attorney
review was made by Tim Carey, seconded by Alice White, and carried without dissent.
F. Acceptance of Medicaid Cost Settlement Funds
The Cost Settlement is calculated by the Medicaid Division based on the average cost across the
state in local health departments to provide a particular service. Health departments receive
payment based on the provision of each service and their reported costs. Only the federal
portion of Medicaid is eligible for the adjustment, therefore the reimbursement is calculated
only on the federal share of Medicaid. Since Medicaid rates are not at a level to fully reimburse
the departments, there is an adjustment made each year to more closely capture the full cost of
providing services to the Medicaid population. Reimbursement of these funds usually occurs a
year after the completion of an audit by the state of service costs for the FY.
These funds are placed in a special account that allows the department to expend these funds
for capital, furnishings or renovations in the program areas that they were earned in. The
department generally uses these funds only for emergency purposes or for planned long-term
purchases. In the past, these funds have been used to renovate the clinical space in Whitted and
to purchase new equipment and furniture for that space. It is anticipated that this fund will be
needed to manage the local costs for data conversion and other expenses as the state switches
to a new system to replace the current HSIS data system. The Medicaid Cost Settlement for FY
03-04 services is a reimbursement of $190,805.22.
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Motion to approve the Cost Settlement money and forward their recommendation to the Board of
County Commissioners for approval was made by Alice White, seconded by Sharon Freeland, and
carried without dissent.
V. Reports and Discussion with Possible Action
A. Mill Creek Road Environmental Assessment
Earlier this spring, Environmental Health staff met with a small number of residents from the Mill
Creek Road area located in Cedar Grove Township. These residents voiced concerns at that time
about well water problems in their neighborhood and what options were available for relief
including well repairs, well replacements and the extension of public water lines.
Subsequent to that meeting, one community member in attendance at a Board of County
Commissioners meeting asked the board for a groundwater study as he stated that several
community members had developed cancer as a result of the water. The BOCC members
agreed to attend a community meeting to further discuss the matter with the residents and to
authorize a study of the problems. That meeting occurred on June 29th. All five commissioners
were in attendance as was Environmental Health staff, the Orange County Engineer and a
Planning Department representative. Local media was also present.
The commissioners committed to the community that the health department would spearhead a
study of the water problems and other possible environmental exposures in the area and
whether it is related to the disease incidence. They asked for a list of past cancer patients in the
area and that has now been provided to health department staff.
The county manager has committed to provide a plan of action to the BOCC at its first meeting
in August and to meet that obligation, staff provided a draft for the Board’s review and input.
Board members expressed concern about raising the community’s expectations that there would
be a cancer cluster identified or a link between cancer and the water. Dr. Carey identified the
difficulty in conducting such studies with reliability. The staff acknowledged that this would be
difficult and that the intent was to keep the community informed at each step of the process.
Examining the data that is available and helping to interpret that to the community is hoped to
assist with understanding. Findings from the water study, even though they may be unrelated
to cancer will also hopefully help individual well owners with possible improvements in their
water quality. Rev. Freeland asked about the cost of the water samples and staff replied that the
proposal was for the county to pay for those samples for this study. This is a practice that has
been followed in the past with other communities that the Commissioner’s have authorized.
B. Orange County/TJCOG Active Senior Project Summary
Ellen Young, Health Promotion Coordinator, presented a report on the Active Seniors Project,
highlighting recommendations to help promote walking and biking in the neighborhoods
surrounding the new Southern Orange Senior Center on Homestead Road in Chapel Hill. It is a
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result of an eight-month project that brought public health educators, land use planners, and
senior services professionals together with senior citizens and other community members.
The project team conducted five main tasks over an eight-month period, including: 1) receiving
orientation and training from project staff; 2) reviewing existing plans for the project area; 3)
conducting assessments of the pedestrian and bicycle infrastructure in the area; 4) identifying
existing pedestrian and bicycle routes; and 5) developing recommendations for improving the
pedestrian and bicycle network in order to help seniors and others be more physically active. In
addition, the Project Team provided input on the site design of the Senior Center itself to help
connect it with the surrounding pedestrian and bicycle network.
This project was funded through a grant from PAN Community Grants Program, NC DHHS for
$19,710. Partners in the grant were Orange County Health Department, Triangle J Council of
Governments, and Orange County Department on Aging.
C. Strategic Planning
The Health Department has been working on elements of a strategic plan to cover the period
2005-2010. Based on input from the Board at the retreat in June, staff worked on revising the
community focus areas portion of the strategic plan. The revised drafts were provided for Board
review.
The goal is to have a complete draft for review and approval by the Board at the September
meeting. The goal would be to forward a complete copy to the Board of Commissioners for a
possible joint meeting in October or early November. This would allow the staff to utilize the
strategic plan for budget preparation beginning in December.
The Board felt that the items in the packet were very strong and had no suggestions for
improvements or change. It was agreed that if Board members had comments, they would
forward them via email to the Health Director.
D. Informational Items
The approved 05-06 departmental budget was given to the Board for review. Significant cuts
were made in dental operations for supplies and in operating capital. It is also unclear at this
time, whether any additional capital items that were requested were funded as the county keeps
that in a separate budget. Personal Health had several critical capital items that would support
primary care and increased services in the chronic disease area. The county’s IT budget was
severely curtailed by the Manager such that virtually no IT departmental requests will be fulfilled
this budget year. One issue of concern is the needed software completion of the Accela system
that Environmental Health has never been able to fully utilize for permitting purposes. The
Manager has been directed to find another $800,000 to cut from the overall county budget and
that has as yet not been identified.
A legislative update was provided of legislation that the Board was interested in. Board
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members were reminded that it is not too late to let legislators know of their continued support
of a 75 cent cigarette tax and that Health and Wellness Trust Funds should be reserved first for
tobacco prevention efforts.
E. Tracking Form Review
The Board reviewed upcoming work and agenda items.
F. Board Vacancy
Jessica Lee reported that no applications for the vacant position of Veterinarian representative
have been received and recommended an active recruitment. Staff will prepare a letter to be
mailed to all county veterinarians soliciting applications. Board members are encouraged to talk
to vets that they know as well.
VI. Board Comments/Announcements
None
VII. Adjournment
Motion to adjourn the meeting was made by Matt Vizithum, seconded by Jessica Lee, and carried
without dissent.
The next Board of Health meeting will be held on August 25, 2005 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