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HomeMy WebLinkAboutBOH minutes 012899MINUTES ORANGE COUNTY BOARD OF HEALTH January 28, 1999 Board of Health Minutes Transcription completed by Patsy L. Bateman 1 January 28, 1999 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, JANUARY 28, 1999 AT SOUTHERN HUMAN SERVICES CENTER, CHAPEL HILL, NORTH CAROLINA. BOARD OF HEALTH MEMBERS PRESENT: Tim Ives, Brenda Crowder-Gaines, Ron Cammarata, Barry Adler, Jonathan Klein, Janet Southerland, Beverly Foster, Rick Marinshaw BOARD OF HEALTH MEMBERS ABSENT: Mel Hurston, Margaret Brown, Barbara Chavious STAFF PRESENT: Rosemary Summers, Ron Holdway, Eileen Kugler, Leigh McFalls, Cathy York, Cornelia Ramsey, Patsy Bateman GUESTS PRESENT: Katie Nolan, UNC School of Nursing I. CALL TO ORDER AND INTRODUCTION OF GUESTS Dr. Ives called the meeting to order at 7:30 p.m. Rosemary Summers introduced the staff and guests present. II. ACTION ITEMS - CONSENT A. AMEND / APPROVE MINUTES (November 19, 1998) Page 4, Section B, Paragraph 2, Second sentence. The punctuation should have been a period (.) instead of a question mark (?). The November 19, 1998 minutes were amended/approved as stated above. B. APPROVE/ADOPTION OF EARLY HEAD START CONTRACT The Board of Health approved/adopted the Early Head Start Contract. C. APPROVE/ADOPTION OF MEDICAID MAXIMIZATION PLAN FOR FUND EXPENDITURE The Board of Health approved/adopted the Medicaid Maximization Plan for fund expenditure. D. RECEIVE SYPHILIS GRANT FUNDS The Board of Health voted to receive the Syphilis Grant funds. The motion to approve the items on the consent agenda as stated above was made by Barry Adler, seconded by Brenda Crowder-Gaines and carried without dissent. III. ACTION ITEMS - DECISION A. AMENDMENT TO ORANGE COUNTY SMOKING CONTROL RULES The Board of Health voted to amend the Orange County Smoking Control Rules as stated. The Board of Health requested copies of the amendment be sent to Dr. Philip Singer and Dan Reimer. The motion to amend the Orange County Smoking Control Rules was made by Beverly Foster, seconded by Janet Southerland and carried without dissent. B. APPROVE BOARD OF HEALTH COMMITTEE & LIAISON ASSIGNMENTS MINUTES ORANGE COUNTY BOARD OF HEALTH January 28, 1999 Board of Health Minutes Transcription completed by Patsy L. Bateman 2 January 28, 1999 The Board of Health approved the addition of the Commission on Environment (ERCD Board) as a new liaison role. The Board approved the placement/replacement of Board members as members on or as liaisons only to various other Boards. In the Liaison Only role, each Board member is responsible for receiving minutes from these organizations or otherwise keeping abreast of issues that would be relevant to the health department. The board member is not responsible for attending meetings of these groups unless a specific issue is identified. IV. REPORTS A. CHILDREN’S HEALTH PROGRAMS Surveys were completed by parents of Health Department patients. A meeting was held with another private provider, Chapel Hill Pediatrics. They indicated they would be willing to take children with Medicaid and NC Health Choice, but since they don’t have a sliding fee scale, they didn’t feel they would be able to take uninsured patients. Chapel Hill Pediatrics is possibly moving their practice to the Timberlyne area. Three of the practices met with are willing to take children that are insured either through Medicaid or NC Health Choice and other private insurances. Other practices have indicated they would be willing to take some of the uninsured (Women’s and Children’s Clinic in Hillsborough and Orange Family Medicine in Hillsborough). A focus group was held last week with mothers of young children. Highlights from the focus group included: ♦ Some children would be left without a source of care if we closed children’s clinical services. ♦ Message that Health Department doesn’t care about patients who can’t access other care. ♦ Parents are likely to seek care elsewhere as well or go without. An attempt was made to get some feedback from two community groups who had meetings in January. One group is the Orange County Coalition which is a combination of community members and agency members. The other is the United Voices of Efland and this group is made up of all community members. Both groups understood and appreciated the constraints that the Health Department was facing and support was given to the department to make the best decision based on the information available. Both groups did state that their members did not include parents of young children and they encouraged the Health Department to try and get more input from parents of young children. This generated a move to doing the surveys with parents of young children at churches in northern Orange. The Efland group favors the decision to suspend children’s clinical services only if they could be assured that medical care would be available from private physicians and also that transportation would be a concern if all the available medical care were in the southern part of the county. The Board requested additional data be collected by the Health Department. The Board would like to know how many children are NC Health Choice, how many are Medicaid, and how many are uninsured. Patient information forms will contain a question asking if they are covered through NC Health Choice, Medicaid, private insurance, or no insurance coverage. Recommendation To The Board of Health: While private providers are willing to take children with insurance coverage, placement of children without insurance remains uncertain. Short of having formal agreements with private providers to accept Health Department child patients, the staff cannot recommend discontinuing child health services at this time. It is recommended that child health services continue through the next fiscal year, 1999-2000 and during that time, the MINUTES ORANGE COUNTY BOARD OF HEALTH January 28, 1999 Board of Health Minutes Transcription completed by Patsy L. Bateman 3 January 28, 1999 Orange County Health Department work toward fully integrating clinic services by 6/30/2000. This would mean offering all the different services on an everyday basis. Child health and prenatal programs have already been integrated. The third part of the recommendation is to include the cost for after hour coverage arrangements for all patients in the next fiscal year budget, beginning in July. This is in place for prenatal clients, but not for child health or family planning, etc. UNC Healthlink will be explored as an after-hour coverage option. Rosemary will explore the possibility of having Economic Development conduct a county-wide survey to see how many people are insured and uninsured to get a better sense of what we are faced with county-wide. B. PERSONAL HEALTH REORGANIZATION This reorganization started back in the summer after the strategic planning discussion. A staff group was pulled together representing a variety of levels within Personal Health to look at “clinic assessment.” That group held a series of discussions at which they looked at the core functions and essential services adopted by the Board and the statutory requirements that the Orange County Health Department has for mandated services. This proposed reorganization is at the conceptual level. This is an administrative move that will not increase or decrease current staff members. The goal of the proposed reorganization is to divide the programs and functions into two primary areas, those primarily clinic-based and those primarily community-based. The rationale behind this is that currently the structure includes a mix of both clinic and community programs. Programs have been added over the years and each of the programs added more requirements, etc., but no additional staff was added. Issues, needs, and objectives expressed by administration and staff were discussed. Some of those include: increasing demands on staff, staff working with both clinic and community programs, crosstraining of staff, unclear supervisory lines, authority and responsibility, integrated clinics, efficient and effective utilization of staff, communication among staff and programs, streamlining paperwork, and management support needs. The next step of the reorganization is to identify a “clinical staff” and a “community staff”. There will be some services where staff will work in both areas. Discussions have begun with Personnel as this should be “position neutral” in terms of classification of positions. The goal is not to have budgetary impacts. Eileen Kugler and Rosemary Summers have spoken with John Link and Albert Kittrell in regard to the conceptual plan so they will have a clear understanding. The next step will be putting parameters around this concept to talk with staff about where they would like to be, i.e. clinical or community. There is no guarantee that everyone will get what they want, but consideration will be taken in this regard as to the wants of individual staff. This will be presented to the Personal Health staff at their division meeting in February. C. NEW POSITION REQUESTS The budget process this year is an earlier time frame than it was last year. The new position requests were due into the budget office on January 4, 1999 and the capital improvement plan projects were due on January 11, 1999. There is still the opportunity to withdraw positions that have been submitted or to further develop or change them. This year in April, the Board of Commissioners is going to consider new positions separate from the regular budget process. The entire budget is due into the budget office on March 15, 1999, which means the Board of Health will receive it for review at the February 25, 1999 meeting. MINUTES ORANGE COUNTY BOARD OF HEALTH January 28, 1999 Board of Health Minutes Transcription completed by Patsy L. Bateman 4 January 28, 1999 The new positions being requested were discussed by the Board with concern expressed regarding the organizational placement/supervision of the Personal Health Services Outreach Educator and the Environmental Educator. Several Board members expressed a desire to see these positions more closely aligned with the Office of Community Education, rather than under the supervision of the divisions. D. STUDENT PROJECT REPORTS In the Personal Health Division, there were four Family Nurse Practitioner Students, two Junior Nursing Students, eight Senior Nursing Students, one Masters Social Work Student, and six Maternal and Child Health Graduate Students. There were also two Graduate Nutrition Students and one Graduate Health Behavior and Health Education Student. In October 1998, there was a student Dr. of Pharmacy included. In the Environmental Health Division, there were two Graduate Health Behavior and Health Education Students. Within the Office of Community Education, there were four Graduate Health Behavior and Health Education Students, one Senior Community Health Nursing Student, two Junior Community Health Nursing Students, one Graduate Program Student, and one Post-Doctoral Fellowship Student. There were many activities and events over the last year that included student volunteers. During the La Fiesta del Pueblo there were twenty student volunteers working directly with the Health Department. During the 5K Walk, there were four student volunteers. Other events including student volunteers were the Octoberfest and Health Fairs. V. HEALTH DIRECTOR’S REPORT A. NC HEALTH CHOICE UPDATE Through December 1998 there were 175 children signed up for NC Health Choice. Our target is 450 that the State identified. It is still a little slow in the enrollment, although we are better than some of our surrounding counties. There are also about 175 previously unidentified Medicaid clients that have also been qualified for Medicaid. So there are 350 children that have insurance now that didn’t have it in October. That’s 300 out of our target 900 (450 Medicaid and 450 NC Health Choice estimated by the State). January figures have been requested from the State and are not yet available. B. BOARD OF COUNTY COMMISSIONERS GOAL UPDATE The Board of County Commissioners did not discuss our goals at the retreat. The Board of Health will have that opportunity on March 9, 1999 at the joint meeting. C. 1999-2000 BUDGET PROCESS The 1999-2000 budget process was previously discussed under new position requests. D. LETTER OF INTENT TO CDC The letter in the Board of Health packet was submitted in December and the Health Department should hear in early February whether we made it to the next stage. E. PENDING WORK MINUTES ORANGE COUNTY BOARD OF HEALTH January 28, 1999 Board of Health Minutes Transcription completed by Patsy L. Bateman 5 January 28, 1999 The conflict of interest policy is still pending. No Board of Health seems to have a written policy at this time. Rosemary will get Smart Start Partnership policy and use it as a template. VI. BOARD OF HEALTH CLOSED SESSION: Personnel Matter (Authority G.S. Section 143-318.11 (a) (6)) A motion was made by Brenda Crowder-Gaines and seconded by Janet Southerland to adjourn to a closed session. VII. ADJOURN The Board of Health meeting adjourned at 11:40 p.m. The next regular Board of Health meeting will be held on February 25, 1999 at the Whitted Building, Health Department Conference Room, in Hillsborough, North Carolina. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Health Director Secretary to the Board RLS:plb