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HomeMy WebLinkAboutBOH minutes 102303MINUTES ORANGE COUNTY BOARD OF HEALTH October 23, 2003 Board of Health Minutes Transcription completed by V. Anne Miles 1 October 23, 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 October 23, 2003 at the Government Services Center, Hillsborough, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Mel Hurston, Chair; Alice White, Vice-Chair; Matt Vizithum; Alan Rimer; Jessica Lee; Chris Harlan; Sharon Van Horn; Lee Werley; Kate Wilder. BOARD OF HEALTH MEMBERS ABSENT: Moses Carey, Jr., due to a conflict with BOCC meeting; Tim Carey, due to a work conflict. STAFF PRESENT: Rosemary Summers, Health Director; Wayne Sherman, Personal Health Services Division Director; Angela Cooke, Dental Health Services Division Director; Ron Holdway, Environmental Health Services Division Director; John Sauls, Animal Control Services Division Director; Anne Miles, Administrative Assistant; Kathy Glassock, Clinical Services Nursing Supervisor; Aviva Scully, UNC School of Public Health Intern. GUESTS PRESENT: Bob Scully, citizen of Orange County I. Welcome and Introductions Mel Hurston called the meeting to order at 7:05 P.M. II. Approval of October 23, 2003 Agenda The Medical Reserve Corps Grant was received after the distribution of the agenda packet to Board of Health members. Item V.E., Acceptance of Medical Reserve Corp Grant funds, is added to the agenda for action. The motion to approve the Agenda of October 23, 2003, as amended, was made by Lee Werley, seconded by Alice White, and carried without dissent. III. Public Comment for Items NOT on Printed Agenda None IV. Action Items on CONSENT Agenda A. Minutes approval of September 25, 2003 meeting. Motion to approve the minutes of September 25, 2003 was made by Alice White, seconded by Lee Werley, and carried without dissent with Jessica Lee abstaining. V. Reports and Discussion with Possible Action A. Draft Chapters on Community Assessment The Health Department through its contract agreement process with the state is responsible for conducting a community assessment once every four years. That assessment must meet certain criteria, including widespread community involvement MINUTES ORANGE COUNTY BOARD OF HEALTH October 23, 2003 Board of Health Minutes Transcription completed by V. Anne Miles 2 October 23, 2003 and it must include both secondary and primary data analysis. The Orange County Healthy Carolinians Council has taken on the task of managing the community assessment process this year. Maria Hitt, the Coordinator of Healthy Carolinians, has worked very hard to ensure that a broad spectrum of community agencies and residents are involved in this process. More than 35 agencies have participated by joining in the assessment team, conducting focus groups with interested individuals, and are continuing to assist with planning community forums in October and November. During the spring of this year, energy was focused on conducting focus group training, constructing a standard focus group instrument, and beginning to gather secondary data. The summer months were consumed with conducting focus groups that included traditionally under-represented groups, such as the homeless shelter residents. Hispanic residents, and African American residents. In addition, many of the partnering agencies also conducted focus groups of specific interest to their agency. The focus group data was analyzed and summarized for themes that were common across groups. That list was narrowed into the list that is on the attached survey. In order to further narrow that list using the broadest input possible, the survey was placed on the Orange County website for citizens to respond electronically. In addition, hard copies were placed in public venues such as public libraries, waiting rooms, doctor’s offices, tax office, etc. Three community forums will be held to further discuss the four or five priorities chosen. This will be the first step in developing action plans towards addressing each priority. The assessment is due to Raleigh on December 1. A draft will be available for the Board’s review at the November meeting. The final report will be presented on January 22 to the Healthy Carolinians Council. The Board of Health is requested to be in attendance at this presentation from 5 to 7 pm. B. Strategic Planning Process and Timeline The Health Department’s current strategic plan has objectives and activities through the end of this fiscal year. The focus of that plan adopted in 2002 was on strengthening the mandated services of the health department. Many of the activities delineated in the plan have been initiated and results are positive. The plan has been an effective tool in focusing the direction of the department and in defining resources needed to provide mandated services effectively. A core group of senior management staff and supervisors has met several times to do some preliminary work on developing a process and timeline and choosing a potential focus for the new plan. Input was sought from all employees at an all-staff meeting in August and the Director is scheduled to meet with each individual staff as a group for further input. While the department will maintain its efforts to provide high quality mandated services, the overall focus of the plan is anticipated to be on INTEGRATION. For the MINUTES ORANGE COUNTY BOARD OF HEALTH October 23, 2003 Board of Health Minutes Transcription completed by V. Anne Miles 3 October 23, 2003 next several months, this focus will be further defined. C. Discussion on Animal Services Reports For the past year, the Board has been engaged in the discussions regarding animal sheltering services in Orange County. Several reports have been issued in the past several months including the Interim Report issued by the Humane Society of the United States (HSUS) at the Board of Commissioner’s request; the final Report of the HSUS, and the Interim Report prepared by staff at the request of the Commissioners which begins to detail the options surrounding a possible county operation of sheltering services. On September 12, the Board of Commissioners and the County Manager received communications from the APS regarding continuation funding. Also at the Commissioner’s regular meeting on September 16, a proposal for a task force to address the HSUS recommendations was discussed. No action was taken on that proposal; rather several commissioners were to discuss that further with the county manager. The Board discussed both the Board’s role and the Health Department’s role in these matters. The Board has previously not had time to engage in a discussion of the whole animal services area and where it belongs and the consequences of those various choices in light of all the recommendations that have been made. The county has several options to manage the shelter: 1) form a separate department in the county to manage animal services and shelter management, 2) leave the structure as it currently exists using a private non -profit contractor to manage the shelter; or 3) create a division within the Health Department for animal services that would contain both animal control and shelter management. The Board agreed that a continuation of the current situation is unacceptable where the Board has some responsibility but little authority. The Board discussed accountability issues in terms of what would have to happen within the department for accountability to be at a higher level and how the organizational structure of the shelter management group would have to mesh with the Board of Health should the Commissioners decide on the second option. Board members felt that Board of Health members and staff should be directly involved with the organizational processes and the shelter director would answer to the Health Director and the Board of Health would have a role in selecting the Board of Directors of the shelter. The Board also discussed option 3 that a new unit be formed within the health department, animal services, with the director of animal control and the director of the shelter reporting through this unit to the Health Director. This structure was proposed in the department’s report of a county takeover of the shelter, of creating a unit, a division within the health department where the staff all reports to that division. The Board looked at additional alternatives that have been presented and expressed concern. One alternative would be to put animal shelter services in the sheriff’s department. The Board was equally concerned about putting it under the county manager as a separate stand-alone department because there were concerns about the MINUTES ORANGE COUNTY BOARD OF HEALTH October 23, 2003 Board of Health Minutes Transcription completed by V. Anne Miles 4 October 23, 2003 connectivity between the Health Department and a separate department with respect to the issues that are health related. According to statistics, 40% of counties in North Carolina have animal shelter services in the health department. Board members agreed that no matter what jurisdiction animal shelter services falls under it won’t work unless there is effective communication and that there will have to be more oversight no matter who is responsible. There will also have to be increased oversight on a regular basis, regular meetings with the shelter director and shelter staff, regular meetings with the board of directors of whatever the organization is that is running the shelter, and they are going to have to carefully receive and monitor all reports, financial as well as activity reports. That’s going to have to be done on a monthly basis, not just semi-annually or quarterly basis, because of the level at which the public in this county expects the operation to occur. Concern was expressed about the county running the animal shelter because a government tends not to foster volunteers. The backbone of the non-profit agencies is its volunteers. That is how they can make it work and stay within a budget. Typically governments do not invest the resources in managing volunteers the way nonprofits do because that is the lifeblood of nonprofits. D. Primary Care Needs Assessment The Health Department has been concerned about access to care availability for low- income uninsured and underinsured residents. This concern is echoed in the most recent Community Health Assessment where access to health care is one of the top concerns of Orange County residents. The Health Director has begun discussions regarding a Community Care Network with neighboring health departments and medical providers to look at ways to address this issue. Within OCHD, there have been discussions about whether the focus on preventive clinical services results in fragmented care and loss of continuity of care for the vulnerable populations we serve. It has been suggested that by expanding clinical services to include primary care we would be providing a medical home and comprehensive care to traditionally served populations that often do not have access to such services. To address this, we requested an MSW-MPH candidate, Aviva Scully, to undertake a needs assessment by interviewing or surveying clients, staff and community stakeholders and reviewing secondary data. Her assessment and recommendations are in the paper entitled ‘Primary Care Needs Assessment for Orange County Health Department 2003.’ Aviva Scully presented the assessment report to the Board for discussion. E. Medical Reserve Corps Grant In fall of 2002, the department applied for a grant to the US Department of Health and Human Services to establish a Medical Reserve Corps of volunteers that could be utilized during emergency situations. That grant was not awarded, however staff reapplied for the grant this spring and we received notice of award recently. The award is for a total of $50,000 each year for a three-year period and is intended to hire a volunteer coordinator who will recruit, train, and coordinate volunteers for emergency response. The initial award is for the federal period of September 1, 2003 MINUTES ORANGE COUNTY BOARD OF HEALTH October 23, 2003 Board of Health Minutes Transcription completed by V. Anne Miles 5 October 23, 2003 through August 30, 2004. Subsequent year funding will depend upon progress toward outcomes. Carla Julian, our contract Public Health Preparedness Coordinator has already begun this work through funding provided by the CDC through the state Division of Public Health and has successfully conducted orientation sessions for 130 interested nurses. About 24 of those nurses have agreed to be volunteers. She is currently preparing to recruit social workers and then physicians. Additional work will need to be done in terms of developing active job descriptions and then conducting specific training for volunteers that will be utilized in various roles. We anticipate at this time recruiting and hiring either a health educator or a social worker for the volunteer coordinator role. Ms. Julian will then be able to switch her focus to completing appendices for the Public Health Preparedness Plan and in updating the bioterrorism response plan and addenda. Motion to approve the receipt of the grant funds in the amount of $50,000 and authorize the staff to develop a position for a volunteer coordinator to implement the grant was made by Kate Wilder, seconded by Alan Rimer, and carried without dissent. VI. Closed Session (ref NCGS 143-318.11(a)(6) to consider the qualifications, competence, performance, fitness, conditions of appointment, of an individual public officer or employee. Motion to move to closed session was made by Alan Rimer, seconded by Alice White, and carried without dissent. Motion to move to open session was made by Alan Rimer, seconded by Alice White, and carried without dissent. VII. Adjournment Motion to adjourn the meeting was made by Alice White, seconded by Lee Werley, and carried without dissent. The next Board of Health meeting will be held on November 20 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