HomeMy WebLinkAboutBOH minutes 082505MINUTES
ORANGE COUNTY BOARD OF HEALTH
August 25, 2005
Board of Health Minutes Transcription completed by Anne Miles Cassell 1 August 25, 2005
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 25, 2005 at the Southern Human Services
Center, Chapel Hill, North Carolina.
BOARD OF HEALTH MEMBERS PRESENT: Alan Rimer, Chair; Tim Carey; Sharon Freeland; Chris Harlan;
Matt Vizithum; Jim Stefanadis; Sharon Van Horn; Alice White.
BOARD OF HEALTH MEMBERS ABSENT: Jessica Lee, out of town; Moses Carey, Jr.
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; Wayne Sherman, Personal Health Services Division Director; Anne Miles
Cassell, Administrative Assistant.
GUESTS PRESENT: None
I. Welcome and Introductions
Alan Rimer called the meeting to order at 7:00 P.M.
II. Approval of August 25, 2005 Agenda
The motion to approve the Agenda of August 25, 2005 was approved by consensus.
III. Public Comment for Items NOT on Printed Agenda
None
IV. Action Items on CONSENT Agenda
A. Minutes approval of July 28, 2005 meeting.
Motion to approve the minutes of the July 28, 2005 meeting was made by Alice White, seconded by
Sharon Freeland, and carried without dissent.
B. New Fee Approval for Personal Health
Glycated hemoglobin has become the preferred standard for assessing glycemic control in
diabetics. The glycated hemoglobin test has been shown to predict the risk for the
development of many of the chronic complications in diabetes. The Health Department recently
acquired two analyzers that test for this and hope to begin using them in September on
prenatal clients and primary care clients. The recommended fee is $19.00 for the test.
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Fee Approval for Personal Health was approved by consensus.
V. Reports and Discussion with Possible Action
A. 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, staff has worked on developing or revising the
internal focus areas portion of the strategic plan. The revised drafts were distributed for Board
review along with a revised Table of Contents. Workforce Development area of the plan was
extensively re-worked. Rosemary Summers invited comments and suggestions from the Board
on the internal focus areas.
The goal of the department is to have a well-developed audit system in place for every program.
Alan Rimer suggested the addition of Board member who has experience in a particular field be
included in the Quality Assurance and Risk Management oversight or audit committee because
there is a great amount of expertise on the Board.
Alan Rimer made the point and Board members agreed that Technology Development and
Support was an extremely important issue that has been ignored for too long, The importance
of being able to quickly access patient records and medical data from a common database and
improved communication technology during an outbreak was stressed, along with the increased
productivity benefits this would provide. Sharon Van Horn suggested the use of the recent UNC
meningitis outbreaks or a possible avian flu outbreak to illustrate the need for these
improvements.
Overall capacity: Wayne Sherman noted that the 2004 utilization data was forthcoming and was
not included as part of the Workforce Development study. Based on the available information
the department’s staffing needs are not keeping pace with the growth of the county. We do not
have capacity for anything other than the basics. Alan Rimer suggested the use of a table or
graph to give a visual on the staff ratio to the growth number in the county.
Training and Development: The question was raised of whether there is a source within the
public health field for computer based training via the web that could be done at a pace
convenient to workforce schedules. The department does have access to UNC School of Public
Health and some of the homeland security training required with a national incident
management system is online. Some of the ones the department would like to see developed
on-line are county required training, especially for new employees.
Cultural Competency: Wayne Sherman reported that the goal of having a workforce that was
capable and competent of serving individuals in a multicultural and changing community was
close to being accomplished. Department is leading of the county in accomplishing this goal.
Facilities and Space: Alan Rimer commented that it would be useful to make the point if there
was a way to relate what our existing space needs are and relate that to the number of patients
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we see and the number of staff and space that have to support those patients and then look at
the projected growth of what the patient load is going to be graphically. The point was made
that the number of underserved population is growing in the county and the department has
limited space to serve these needs. One way to do this is extended hours, which would mean
increased staffing.
It is anticipated that the Board will discuss the complete draft of the plan at the September
meeting. The goal would be to forward a complete copy to the Board of Commissioners for a
possible joint meeting this winter. This would allow the staff to utilize the strategic plan for
budget preparation beginning in December.
B. Food, Lodging, Institutional Inspection Program Review Report
The state office periodically conducts program reviews to assess the quality of service provision
and compliance with rules although there has been no review for the Food and Lodging
Program in over 20 years. It is recommended that a review be done every 5 years. The
Environmental Health Director requested a program review of the Food, Lodging and
Institutional Inspection Program in 2004-2005. The Regional Environmental Health Specialist
conducted the program review from January through April of 2005. The report was distributed
detailing the findings of the program review.
Several recommendations were made by the Regional Specialist as a result of the review to
strengthen the program, most of which can be accomplished quickly and easily. The major
recommendation made is that the program needs an adequate number of staff to carry out an
effective program. The recommendation in the report is for two additional staff positions. The
point was made that three additional staff positions would be ideal, one supervisor and two
environmental health specialists, to do some of the prevention that we need to be doing. During
an epi investigation, environmental health specialists, especially in the food and lodging area,
have been key in all of our investigations because they have the interviewing and questionnaire
construction skills that are core to our epi team.
C. Health Department Buildings as Non-Smoking Campuses
The legislature passed a law that allows local governments to establish policies that prohibit
smoking within 50 linear feet of the local health department. Current county policy establishes
smoke-free environments within county buildings, however allows smoking outside the
buildings. This would allow the county to establish policies that restrict smoking within 500
linear feet of the buildings where the health department is located. That would, at this point in
time, include the Whitted Building, the Southern Human Services Center and the Carr Building.
All three of these buildings have other county departments located in them as well. The county
is governed by an Ordinance passed in 1993 by the BOCC and subsequently “Smoking Control
Rules” were established and passed by the Orange County Board of Health in 1993 and
amended in 1999.
The staff of the Health Department has approached management staff many times with
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complaints about patients, clients and staff walking through smoke to get to the entrances to
the buildings. Staff is concerned about the effects of secondhand smoke not only on the public
but also the staff that works in the buildings.
The Health Director consulted with the County Attorney, who advised that the best approach
would to be to amend the county ordinance rather than the Board of Health rules. This is in
light of the recent court decisions regarding Board of Health rules in the smoking areas.
Motion was made by Alan Rimer that the Board send a letter to the Commissioners requesting an
ordinance revision, seconded by Alice White, and carried without dissent.
D. Board Education Plan
Board members discussed options and determined an educational plan for FY 05-06. One of the
DHHS agreement addenda specifies that each Board of Health should receive regular education
to enhance their decision-making in discharging their duties. Last year was the first year a full
year’s agenda of educational topics was planned. Because of the press of business and the
development of the strategic plan, the schedule was too ambitious. The following schedule of
topics was agreed upon by consensus as a starting point for discussion and possible
modification:
October Public Health Funding Streams
January Septic and Well Approvals: From Application to Construction
February The Collaboration of School Health and Public Health
April Services to Residents in the Home
June The Whole Story on Food, Lodging, and Institutional Inspections
E. Informational Items
a. Legislation
A brief summary of outstanding legislative issues of Board interest remains unchanged
due to the delay in passage of the state budget. Several of these bills will be affected by
the outcome of the final budget.
b. Budget
The Manager was directed to find another $500,000 to cut from the overall county
budget that has as yet not been identified. Budget staff has met with Department Heads
to identify where funds may be cut. The Health Department identified approximately
$30,000 in savings through a delay in hiring the Chronic Disease Nurse. This will impact
the services that had been planned for the year, especially flu clinics, Fit Feet Clinics for
the elderly, and services to senior centers.
c. Veterinarian Recruitment
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Over 80 recruitment letters were sent to all veterinarians in Orange County and
surrounding areas to fill the Board vacancy for the veterinarian position.
F. Tracking Form Review
The Board requested two additional items be added to a future agenda that were of concern:
1) Sudafed behind the counter legislation
2) Impact of meth labs on public health.
VI. Adjournment
Motion to adjourn the meeting was made by Alice White, seconded by Matt Vizithum, and carried
without dissent.
The next Board of Health meeting will be held on September 22, 2005 at the Government Services
Center in Hillsborough, North Carolina at 7:00 PM.
Respectfully submitted,
Rosemary L. Summers, MPH, DrPH
Health Director
Secretary to the Board