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HomeMy WebLinkAboutBOH minutes 022201MINUTES ORANGE COUNTY BOARD OF HEALTH February 22, 2001 Board of Health Minutes Transcription completed by V. Anne Miles 1 February 22, 2001 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 THURSDAY, February 22, 2001 at the Government Services Center, Hillsborough, North Carolina. BOARD OF HEALTH MEMBERS PRESENT: Jonathan Klein, Janet Southerland, Barry Adler, Mel Hurston, Alan Rimer, Martha Stucker, Lee Werley, Kate Wilder, and Alice White. BOARD OF HEALTH MEMBERS ABSENT: Sharon Van Horn, and Barry Jacobs, due to icy roads. STAFF PRESENT: Rosemary Summers, Health Director; Ron Holdway, Environmental Health Services Division Director; John Sauls, Animal Control Services Division Director; Angela Cooke, Dental Services Coordinator; Kathy Glassock, Interim Personal Health Services Division Director; Donna King, Health Promotion and Education Services Director; Leticia Burns, Central Administrative Services Division Director; and Anne Miles, Administrative Assistant. GUESTS PRESENT: Lauren Mann, Erin Clayton, Sallie Evett, and Helen Mitchell, UNC School of Nursing students; Wayne Sherman, Chatham County Health Director. I. CALL TO ORDER AND INTRODUCTION OF GUESTS Jonathan Klein called the meeting to order at 7:30 p.m. II. ACTION ITEMS A. Approval of February 22, 2001 Agenda Rosemary Summers requested a change in the March meeting location be added to the agenda as Item II.B. Motion to approve the agenda as amended was made by Kate Wilder, seconded by Barry Adler, and carried without dissent. Minutes Approval of January 25, 2001 Meeting. Motion to approve the minutes of the January 25, 2001 meeting was made by Mel Hurston, seconded by Janet Southerland, and carried without dissent. B. Change in Venue for March Board of Health Meeting The Board of County Commissioners needs to access the meeting room at Southern Human Services Center at the time of the next scheduled Board of Health Meeting. They requested we move the March 22, 2001 meeting to the Government Services Center. Motion to change the location of the March 22, 2001 Board of Health Meeting to MINUTES ORANGE COUNTY BOARD OF HEALTH February 22, 2001 Board of Health Minutes Transcription completed by V. Anne Miles 2 February 22, 2001 the Government Services Center was made by Kate Wilder, seconded by Barry Adler and carried without dissent. III. PUBLIC COMMENT FOR ITEMS NOT ON PRINTED AGENDA None. IV. REPORTS AND DISCUSSION WITH POSSIBLE ACTION A. Presentation of 2001-2002 Budget Request Rosemary Summers presented the proposed budget request to the Board and highlighted the additions and changes from last year's budget. Changes from last budget year to this budget year would be due to new programs that were added or changes in outcomes due to new positions. Changes linked to new position requests will come out of the budget if the new positions are not approved. The total budget request this year is $5,741,753. Requests include eight additional positions; 2 medical office assistants; a medical interpreter; environmental health specialist for the wastewater program; an environmental health program specialist for food and lodging; an environmental educator and clinical nutritionist and dental program coordinator, although the dental program coordinator is 100 per cent grant funded, and then 4 positions with partial time increases. An increase for dental program coordinator, dental office assistant, and increase in public health nurse, from a 10 month to a 12-month position, and a half-time office assistant. A half-time office assistant is actually an existing position that is currently grant funded. We are asking to move that to full time and have it half county funded and half remain grant funded. The personnel increases are approximately 12 %. The operations increase is about 11.64%. Much of the increase is for new programs or new positions. There are also increases for motor pool, pharmaceutical, and laboratory cost. Capital outlay is all related to new positions. Total expenditure increase is just under 13%. Offsetting revenue including, an increase in the environmental health fee schedule, and new positions will bring in increased revenue. If the positions requested are not approved then this revenue figure will change. The County net costs are a 15% increase. State and federal revenues will be decreasing. Programmed into this budget was a 10% decrease in some of our state consolidated contract revenues. We do not know if that is going to occur. At this time the State has indicated they are not going to reduce our MCH block grant or our other larger block grants, but it is too early to say whether they are or are not going to do that. Animal Control Services: The 5.79% increase is a result of; 1) software program costs, 2) a new program for barn cats, and 3) the animal shelter. MINUTES ORANGE COUNTY BOARD OF HEALTH February 22, 2001 Board of Health Minutes Transcription completed by V. Anne Miles 3 February 22, 2001 $7,500 in funding will be provided for testing, sterilization, and vaccination for approximately 150 cats in order to reduce the feral cat population. Title XIX, Medicaid, is increased from last year, primarily a result of adding two new medical office assistants to help with some of the Medicaid billing and reconciliation. If these positions are not approved, the Medicaid revenue may not be that high. The Health Department fee and tax income is projected to be quite a bit higher next year as a result of the increase in Environmental Health Services fees. It is important that we continue to recognize that the County funds the majority of our expenditures. On a per capita expenditure basis, we are in the lower 25% of all health departments. Revenue predictions for state funding is unstable right now. It will not be clear until May what funds will be available. The fee increases that are proposed in Environmental Health Services are for two purposes, 1) to have a greater cost recovery. Approximately 60% of our environmental health fees are now recovered. The proposed fee increase will cover 90% and pay for one position. Most of our revenue increases are tied to new position requests. Central Administrative Services: Some of the impacts that we have found in charging for services has been that it has really strained our billing staff. The increase of two positions should help with that and we are projecting that each of those new positions will bring in an additional $10,000 in revenue which will help subsidize both positions as well as make our revenue balance better. The medical interpreter position is also included in this division although that will function department wide. In the next two years, the department will need to be HIPHA compliant. (Health Insurance Portability and Accountability Health Act) That Act has some stiff requirements that are going to require some additional resources. Dental Health: Revenue continues to increase in the fee for service as well as insurance reimbursement categories. The Medicaid revenue is not going to be at the same reimbursement level as when bundled charges were in effect. There has been a dramatic increase in the number of Latino/Hispanic patients that are being seen in Carrboro. Two days a month are devoted to services for Hispanic clients. Currently, the dental clinic has contracted with an interpreter to handle that load on those days only. With a medical interpreter on staff, there would be no need to have that contract. Orange County Health Department currently provides service to about 18% of the Medicaid-eligible children in the county. The clinics are at capacity. If there is an additional increase, we will have to look at additional clinic days and increasing staff. Environmental Health: Three new positions are requested, two for workload issues, one for the WTMP implementation. There are also fee MINUTES ORANGE COUNTY BOARD OF HEALTH February 22, 2001 Board of Health Minutes Transcription completed by V. Anne Miles 4 February 22, 2001 schedule changes. The WTMP implementation is part of our strategic plan. We also have a little bit of money included in the budget to support training for a possible CDC position we have applied for…a public health prevention specialist that CDC assigns on a 2-year basis. CDC pays for their salary for two years. The host agency is responsible for providing continuing education, travel support, and general office support while they are here. The position that we asked CDC for would be working in Environmental Health primarily to identify properties and homes that have no indoor plumbing, and to begin to work on building the WTMP database. Health Promotion and Education Services: A new position request that is partially fee supported is in response to Core services identified in the long-range plan. Clinical services currently do not have health education plans that are well developed and this position would be able to focus on that as well as additional community nutrition education. This budget request also includes the start of a loan library for equipment for educational programs. This represents a shift from direct provision of some health education services to a more "train the trainers" approach and becoming a resource base for people who are doing health education in the community. Personal Health Services: There is an increase in the budget for an OSHA required "needle-less" system that is expensive. The pap smear increase is also significant due to the $2 to $8 escalation in lab cost. We provide 700 to 800 pap smears per year, which adds up to a significant cost. Lab, medical, and pharmacy supplies have risen faster than any other cost item. A new fee is to be established for meningococcal vaccine that is now a recommended vaccine for college students before they enter college. Since we have the UNC population, this might be a service we could offer to the college students and recover 100% of our costs. This budget also includes additional flu vaccine that we are anticipating for next year. The flu vaccine is always a zero-based expenditure because the cost is recovered. The renovation of the Whitted building is still pending replacement of the heating and air conditioning system. When that gets on schedule, then the renovation is ready to go. A one-time rent expenditure may be added to this budget as well to cover temporary relocation. The Sheriff and County Manager would like to have a business plan for a jail health program that would begin next year. Therefore, we will be in the process in the next month or so of trying to put together a business plan of what that service will cost. We need to separate out the various aspects, the pharmacy, medical lab, nursing, and medical coverage, and see which pieces are going to fit together with what we have and which may need to be contracted. Included in the Smart Start Grant, are the Community Health Awareness Project, Child Service Coordination, and Intensive Home Visiting. The MINUTES ORANGE COUNTY BOARD OF HEALTH February 22, 2001 Board of Health Minutes Transcription completed by V. Anne Miles 5 February 22, 2001 Intensive Home Visiting positions are time-limited positions due to funding sources and we are asking the Board of Commissioners to make these permanent positions. The Preschool Dental Screening Project will have a change when it goes to Smart Start, in that we are asking for a Dental Program Coordinator who will be full time and will oversee the coordination in the preschools as well as the follow up in education, making this a much more complete project. The Healthy Carolinians Fund is partially university funded, state funded, and 50% county funded. Total budget request figure represents a 12.83% increase over the previous year. Motion to accept and forward the 2001-2002 Budget Request to the Board of County Commissioners was made by Mel Hurston, seconded by Martha Stucker and carried without dissent. Motion to recommend the new fee increases reflected on the fee schedule was made by Alan Rimer, seconded by Mel Hurston, and carried without dissent. B. Comments on Shaping Orange County's Future Committee reports on how the document "Shaping Orange County's Future" as well as the "Master Aging Plan" and to some extent "Healthy Carolinians of Orange County" meshes with the long-term plan of the health department. The staff was commended for the excellent job in research and report preparation. Motion to forward the document to the Board of County Commissioners as amended was made by Alan Rimer, seconded by Martha Stucker and carried without dissent. C. Health Department Long Range Plan Jonathan Klein recommended the addition of an executive summary or abstract to the document and a focus on those things that are going to be requested in the budget. Board of Health members were urged to be involved in the areas of their individual expertise. Motion to approve the Long-Range Plan as amended was made by Mel Hurston, seconded by Janet Southerland and carried without dissent. V. BOARD COMMENTS None VI. ANNOUNCEMENTS MINUTES ORANGE COUNTY BOARD OF HEALTH February 22, 2001 Board of Health Minutes Transcription completed by V. Anne Miles 6 February 22, 2001 Rosemary Summers announced that Laurie Garrett, author of the book "Betrayal of Trust", written about the public health, will be a guest speaker at UNC on March 26. She encouraged all Board members to read the book and attend the lecture if possible. Ron Holdway announced that the Asthma Coalition would have a booth at University Mall on March 15, 2001 from 5:30 p.m. - 7:30 p.m. VII. ADJOURNMENT Motion to adjourn was made by Mel Hurston, seconded by Martha Stucker, and carried without dissent. The meeting adjourned at 9:20 p.m. The next Board of Health meeting will be held on March 22, 2001 at the Government Services Center in Hillsborough, North Carolina at 7:30 PM. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board