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HomeMy WebLinkAboutBOH minutes 062603MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2003 Board of Health Minutes Transcription completed by V. Anne Miles 1 June 26, 2003 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 26, 2003 at the Government Services Center, Hillsborough, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Mel Hurston, Chair; Alice White, Vice-Chair; Barry Adler; Alan Rimer; Jessica Lee; Martha Stucker; Lee Werley; Kate Wilder; Jonathan Klein BOARD OF HEALTH MEMBERS ABSENT: Sharon Van Horn; Moses Carey, Jr. due to a BOCC meeting conflict. STAFF PRESENT: Rosemary Summers, Health Director; Letitia Burns, Central Administrative Services Division Director; Wayne Sherman, Personal Health Services Division Director; Donna King, Health Promotion and Education Services Division Director; Ron Holdway, Environmental Health Services Division Director; John Sauls, Animal Control Services Division Director; Anne Miles, Administrative Assistant GUESTS PRESENT: None I. Welcome and Introductions Mel Hurston called the meeting to order at 7:15 P.M. II. Approval of June 26, 2003 Agenda Motion to approve the June 26, 2003 Agenda was made by Martha Stucker, seconded by Jonathan Klein, 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 22, 2003 Meeting Motion to approve the minutes of May 22, 2003 was made by Martha Stucker, seconded by Barry Adler, and carried without dissent. B. Environmental Health Policies Staff has drafted formal policies in recent months for two areas of operational processes within the Environmental Health Division. The first is an application/fee policy for the onsite wastewater and well program areas. The second is a policy for considering approval of existing wastewater systems for continued use of systems that have not been used for some time. The fee policy incorporates one of the tools the ACEH Committee recently discussed for increasing collection of billed fees, as it will limit future service for some activities if the client has outstanding balances. It also puts into writing some of the current practices for fee assessment and collections. The proposed practices in the fee policy MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2003 Board of Health Minutes Transcription completed by V. Anne Miles 2 June 26, 2003 will not conflict or interfere with any procedures prescribed by the County’s Revenue Department. The existing policy also puts into writing many of the current practices for the services. It also defines what constitutes a septic system that is “in-use.” The “in-use” consideration is critical to some situations where a client wants to reuse or reconnect to a vacant system. “in-use” is referred to in State rules for wastewater systems, but it is not defined, so this policy establishes an official approach to those situations. On June 11th, the ACEH Committee reviewed these policies and approved them to go to the full Board of Health for consideration. The ACEH Committee also asked that staff develop an educational brochure for the public that would simplify these policies and other aspects of the application and field processes for working in the field. Staff developed a draft document for clients 2 – 3 years ago, but its implementation was stalled because of several factors including coordination with the Planning Department requirements, the prospect of a new integrated computer system for all agencies involved in construction activities (not in place) and other factors related to interagency communication. The committee also asked that this document list current fee schedules and address timeframes for service delivery for applicants. Staff will revive the draft document and present it to the ACEH Committee in coming months and will move forward with its approval and use as appropriate. C. After Hours Jail Health Coverage Renewal OCHD began providing jail health services for the Sheriff’s Office in Fall 2001. An experienced Family Nurse Practitioner works 40 hours per week Monday through Friday providing medical services to jail inmates. We have been unable to recruit a weekend nurse as budgeted. To assure necessary after-hours medical and pharmaceutical consultation was available, we entered into a contract with UNC Family Practice on April 1, 2002 to provide such coverage. This contract is a continuation of that service for FY 03-04 at the same rate of $6,000/year. The contract has been forwarded to the Sheriff for review and comment. The motion to approve the Consent Agenda of June 26, 2003 was made by Martha Stucker, seconded by Barry Adler, and carried without dissent. IV. Reports and Discussion with Possible Action A. 03-04 Jail Psychiatric Services Contract A growing number of inmates in the Orange County Jail suffer from serious mental health conditions. The department contracted this past year with Hans Stelmach, MD, a Psych iatric Resident at $65/hour for evaluation, intervention and treatment of the inmates referred by the Jail Health Family Nurse Practitioner. Dr. Stelmach is graduating from his residency and will be going into private practice as of June 30, 2003. He has indicated he can continue with us for a short period of time but at an increased rate of $150/hour. Wayne Sherman reported that the department has been working with OPC Mental Health, and has identified another community psychiatrist who is interested in working with the jail population. Dr. Amy Trivette, MD would work up to 4 hours per week with the jail at $57/hour. The county would provide professional liability insurance MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2003 Board of Health Minutes Transcription completed by V. Anne Miles 3 June 26, 2003 coverage at $736 for the first year and decreasing rate for subsequent years. Motion to approve the Agreement between Dr. Amy Trivette, MD, and the Orange County Sheriff’s Office in collaboration with the Orange County Health Department for psychiatric services in the jail was made by Alan Rimer, seconded by Lee Werley, and carried without dissent. B. Update on Contract Extension for Operation of Orange County Animal Shelter The Board previously considered a contract extension as an addendum to the current contract with the Animal Protection Society of Orange County, Inc. for the operation of the Orange County Animal Shelter. The extension that was approved and forwarded to the Board of Commissioners for consideration basically extended the current contract at the current level of funding for six months to allow for the HSUS study to be received and the recommendations from that study to be considered in a deliberate fashion. During the agenda review process with the county management staff and the county attorney, the extension language was changed to eliminate the trespass provision and to further clarify the language around implementation of interim measures suggested by the HSUS. The Animal Control and Environmental Health Committee reviewed the revised language at its meeting on June 11, 2003. The Board of Commissioners at their meeting on June 17, voted to not approve the extension as presented, rather they directed the attorney to draft an extension for three months with a month-to-month extension at the end of the tree month period. The contract also has a ninety-day notice provision for non-renewal, that the attorney will also be determining how to coordinate those provisions. The APS Board will need to consider this revision as well. In addition, staff has been asked to prepare an analysis of alternative models of shelter operation and staffing and budget projections should the commissioners elect not to renew the contract with the APS. Jonathan Klein suggested the Board of Health go on record and send a letter to the Board of County Commissioners expressing concerns of the Board concerning use of staff resources to complete additional work prior to receiving the HSUS study. Motion for the Board of Health to draft a letter of position for submission to Board of County Commissioners was made by Jonathan Klein, seconded by Alan Rimer, and carried without dissent. C. Health Board Appointments In May the Board sent forward for reappointment Alan Rimer and Alice White. Both of those were approved at the June 17, 2003 meeting of the Board of Commissioners. Both Mr. Rimer and Dr. White will be in their second term of appointment from July 1, 2003 through June 30, 2006. Dr. Matthew Vizithum, the optometrist recommendation, was not appointed that evening because the Commissioners did not get to that item on their agenda. His appointment will be acted on at the next Commissioner’s meeting. During the June 17 meeting, Commissioners questioned the term of Mel Hurston on the Board as well. The Clerk’s office had a different appointment date than our office. The Health Director explored this with the Clerk’s Office and found that Mr. Hurston was first appointed in December of 1997 filling a partial term of office that was set to MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2003 Board of Health Minutes Transcription completed by V. Anne Miles 4 June 26, 2003 expire on June 30, 2000. The Clerk’s Office has this recorded as Mr. Hurston’s second term, with an ineligibility to serve an additional full-term. According to their computer records, his term of office was changed from 0 to 1 after a discussion between the Clerk (Beverly Blythe) and the Health Director. There are no records in the Health Director’s Office in this regard. Since Mr. Hurston is serving as Chair this year, his term will be extended until December 2003, after which time this will be a Board vacancy as well. In addition, the Board has current openings for a physician and for a nurse. Applications are being submitted for these positions and will be reviewed at the July Board of Health meeting. D. Community Assessment Secondary Data Elements The Health Department is required by contract agreement to conduct a community assessment on a quadrennial basis and to establish community health priorities. Our assessment is due to the NC Division of Public Health in December. This is being conducted in conjunction with the Orange County Healthy Carolinians Council. The process has four primary components: a secondary data assessment, focus groups, key informant interviews, and priority setting process. The focus groups and key informant interviews are well underway, as is a planning process for community forums to select priorities. Maria Hitt, the Coordinator of this project, is asking for input on the review of secondary data elements to make sure that the department has covered all the major areas of concern. The Board reviewed the Report and suggested a footnote be added to the report regarding emerging diseases such as SARS, West Nile Virus, and health related environmental issues. Board members were urged to email any additional comments to the Health Director or to Maria Hitt. E. Senate Bill 672: Public Health Infrastructure Senator Hartsell from Cabarrus County introduced a bill to strengthen public health infrastructure in the state. The North Carolina Association of Local Health Directors considered the bill and provided a great deal of input to the Senator and his staff on provisions of the bill that were problematic. The Senator has made a lot of changes to the bill and the bill was passed on to the health committee. At the Health Director’s meeting on June 25, the Senator was accompanied by Speaker Black who also voiced support for this bill. There could be far-reaching implications for health departments with the implementation of this bill. A separate but related piece is the Accreditation Committee Report that was presented to the NC Association of Local Health Directors as well for consideration. These recommendations will be voted on in July by the Association. F. Health Director’s Report Mural at Hargraves Center in Chapel Hill: The development and production of the mural was partially funded by the Healthy Carolinians mini-grant to the Teens Climb High Program, a positive life style program for at risk teenage girls in Chapel Hill. It was also partially funded by a grant from the Board of Commissioners through the Arts Council. MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2003 Board of Health Minutes Transcription completed by V. Anne Miles 5 June 26, 2003 Awards: Notification was received that the Community Health Awareness Program and two other county programs received achievement awards from the National Association of County Commissioners (NaCo). SARS: The final report on the second special interest case has come back from the CDC with a negative diagnosis for SARS, therefore, as far as the investigation is concerned, there were no cases as a result of contact with the one confirmed index case. A detailed epidemiological study of the workers at the Giles Horney Building was conducted jointly by t he state, the University, the regional pubic health surveillance team, and our staff. The purpose of that study was to determine if employees were experiencing a common syndrome, to characterize any syndrome that existed, to identify ill individuals, and to determine if the employees’ illnesses were epidemiologically linked. Each agency responding group has conducted a “lessons learned” session and a joint de-briefing will be held during July as part of a continuing process of planning effective emergency responses. Cooperation among entities was outstanding through this situation and communication improved steadily throughout. The Health Department staff was outstanding in their public health duties and was flexible in adapting to the developing situation. Animal Control Ordinance Revisions: This summer the ACEH Committee will be working with the county attorney’s office to examine possible changes that need to be made to the Animal Control Ordinance for the county. Problems have been experienced with the definitions and regulations around kennel operations. In addition, the vicious dog sections need coordination with relevant state legislation such as the dangerous dog law. The fine structure for violations needs to be updated as well. The last changes in the ordinance were in 1997. Grant Projects/New Grant Funds: 1. Healthy Carolinians – The department received notification that we have received a grant from Kate B. Reynolds Foundation for support of our Healthy Carolinians Coordinator’s salary and benefits. This is three-year funding in diminishing amounts each year. This funding will replace state funds that are no longer available for this support. This stable funding will allow the program to concentrate on showing results rather than seeking funds to support the core salary. 2. Emergency Planning – The department is in the process of preparing a “repeat” application for development of a volunteer Medical Reserve Corps to provide additional capacity for the department and the county in the event of a major event that requires additional medical personnel. We have already begun to lay the groundwork for organizing such a volunteer group through funding from the CDC bioterrorism grant through the state. The state has informed us that funds will likely be available in the coming year to continue these efforts. 3. Disparities Grant Planning – Staff has been working for the past year to define programs and projects that would assist in reducing health disparities among our minority populations. We will be discussing our ideas with staff at Kate B. Reynolds Foundation with an eye to applying for funds in their August grant cycle. 4. Students and Student Projects – This summer we have many students working on important projects for the department. They have provided us with a bright, fresh MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2003 Board of Health Minutes Transcription completed by V. Anne Miles 6 June 26, 2003 look at the work we do and have been a valuable resource in attacking some key projects that are difficult to do when engaged in daily activities. 5. Budget Update – The Board of Commissioners approved the continuation of the Community Health Awareness Program from the safety net funding reserved by the Commissioners to address programs that were cut as a result of state budget cuts. We are very pleased with the support for this program and for the Families in Focus intensive home visiting program that needed some additional funding as well. The Commissioners have been very supportive of retaining safety net programs. V. Board Comments/Announcements Employee Recognition: Board members were in agreement to continue wit h the staff recognition awards given annually to department staff excelling in service. Dr. Sandler: Board members expressed a desire to recognize and thank Dr. Sandler for his long years of service and his contribution to the department’s dental program. When a full time staff dentist is hired, Dr. Sandler’s expertise will no longer be needed to supervise the residents and interns that currently staff the dental clinic. Health Director’s Review: Board members were advised by the Chair that the annual performance review of the Health Director is coming up and they will be receiving the paperwork for their evaluation. VI. Adjournment Motion to adjourn the meeting was made by Martha Stucker, seconded by Barry Adler, and carried without dissent. The next Board of Health meeting will be held on July 24, 2003 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