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HomeMy WebLinkAboutBOH minutes 022698MINUTES ORANGE COUNTY BOARD OF HEALTH February 26, 1998 Board of Health Minutes Transcription completed by Patsy L. Bateman 1 February 26, 1998 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 26, 1998 AT OWASA COMMUNITY MEETING ROOM, HILLSBOROUGH, NORTH CAROLINA. BOARD OF HEALTH MEMBERS PRESENT: Timothy J. Ives, Melvin Hurston, Beverly Foster, Barry Adler, Jonathan Klein, Margaret Brown, Ronald Cammarata, Richard Marinshaw, Janet Southerland BOARD OF HEALTH MEMBERS ABSENT: Brenda Crowder-Gaines, Barbara Chavious STAFF PRESENT: Rosemary Summers, Interim Health Director; Dr. Marcia Angle, Medical Director; Eileen Kugler, Personal Health Services Division Director; Angela Cooke, Dental Coordinator; Ron Holdway, Environmental Health Division Director; Joyce Lee, Administrative Officer; Cornelia Ramsey, Health Education Supervisor; Patsy Bateman, Administrative Assistant. GUESTS PRESENT: Cleon Currie, Elvira Mebane, and Robert Mebane 1. 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. 2. APPROVE AMENDMENT OF FEBRUARY 26, 1998 AGENDA The February 26, 1998 agenda was amended to add Item 4.4 Breastfeeding Support to the Community and 4.5 Honoring Seal the State Organizers. The motion to amend the agenda of February 26, 1998 was made by Beverly Foster, seconded by Ronald Cammarata and carried without dissent. APPROVE MINUTES OF JANUARY 29, 1998 There were no corrections of the January 29, 1998 Board of Health minutes. The motion to approve the minutes of January 29, 1998 was made by Barry Adler, seconded by Ronald Cammarata and carried without dissent. 3. SEARCH COMMITTEE REPORT, PRESENTED BY BEVERLY FOSTER The applicant pool has been narrowed and the committee has sent out questions to the current applicant pool asking what they consider issues facing health departments and why they feel they are qualified for this job. After receiving responses, the pool will be narrowed again. Division Directors sent a letter to the search committee requesting staff input with the interviewing process in some format. The committee had already planned to include staff as a part of the interviewing process and will let staff know how they will participate. 4. PROSTATE CANCER PREVENTION PROJECT, PRESENTED BY ROSEMARY SUMMERS Issues and concerns were discussed by Board of Health members along with representatives from the Orange County Coalition, the concerned communities, and Dr. Marcia Angle. Board of Health members received the full proposal on the Prostate Cancer Prevention project prior to the meeting. A small group met prior to the Board of Health meeting and had discussion in a more informal setting to clarify some issues. The primary concern from the physicians is that the screening tests are not accurate and predictive. The screening tests yield a lot of false positives and at higher levels of screening, men are placed at increased risk for complications. The grant did not clearly emphasize education and the informed consent of participants prior to the screening. Community members would first be provided education on both the disease as well as the risk factors of screening and then be able to make their own choices. The grant also intended to provide education for health conditions other than prostate cancer. There was acknowledgement that the screening was a requirement in the grant. Screening is a very small portion of the actual grant and would not be done without the full consent and knowledge of the participant. There was also discussion around the lack of consensus around risk factors for prostate cancer. The only known risk factor is family history. The community position on this grant is that they want to be educated about the disease, the risk factors, the screening risks, and have the ability to choose screening or no screening after the education. Several community members have family histories of prostate cancer among multiple members. This grant is not to the Health Department. The grant is being sought by the Orange County Coalition for the community, with the Health Department as a “subcontractor.” MINUTES ORANGE COUNTY BOARD OF HEALTH February 26, 1998 Board of Health Minutes Transcription completed by Patsy L. Bateman 2 February 26, 1998 The following motion was made. The Health Department supports cancer prevention education in the community, especially prostate cancer education with a special focus on the risks of screening and with an emphasis on early detection. The Health Department will act as a technical consultant to develop the educational format and informed consent procedures. The Health Department agrees to perform limited screening called for in the grant. The motion was made by Janet Southerland, seconded by Ronald Cammarata and carried without dissent. RECEIPT OF INTENSIVE HOME VISITING GRANT FUNDS, PRESENTED BY ROSEMARY SUMMERS This grant has come to the Board previously. A final budget is attached. We have received this grant as an amendment to the State contract. The motion to accept the Intensive Home Visiting Grant Funds and authorize the Director to sign the amendment to the consolidated contract was made by Janet Southerland, seconded by Beverly Foster and carried without dissent. ADOPTION OF 1998-99 BUDGET, PRESENTED BY ROSEMARY SUMMERS Departmental Summary There is a requested increase of 11 3/4% in Personnel due to new positions and requests for additional time in current positions. There are 2 Family Nurse Practitioners that are not working full-time and the request is to have them both raised to full-time. Two Health Educators, one a Sr. Health Educator and one Public Health Educator I are requested. The Sr. Health Educator is the project coordinator position in the Efland-Cheeks community and the Health Educator position is the Teens in Power Coordinator that is currently three quarter time. Two additional personnel are requested for Environmental Health, one Environmental Health Program Specialist and another Environmental Health Specialist. In addition, a Public Health Nurse I that would be specific to a program that is focused on home visiting for disabled adults and a Medical Office Assistant position are also requested. The operational increase is 3.96% primarily due to four factors. One is an increase in professional contract services. This year for the first time, the dental director services were contracted through the dental school for a partial year contract in FY 98-99. The Orange County Health Department will pay for the entire year. In addition, there is an increase of professional contract services in anticipation of needing to change clinical services; to become a full ACCESS provider, Orange County Health Department will need 24-hour physician coverage. Orange County Health Department is currently talking with Family Medicine to extend their contract for physician coverage to 24 hours. Increases in medical and pharmacy supplies and in the bonds and insurance category, round out the operational increases. Divisional Budget Summary This shows that the Management/ Vital Statistics area went up 40%. This represents the transfer of two positions from Personal Health into the Management and Vital Records budget. Two Health Education positions that are currently on staff, Cornelia Ramsey and Louise Echols were transferred into a newly configured Office of Community Education. There is an increase in contract services to take care of several things. One is the Board request to develop a crisis preparedness plan. The consultant has given us a figure of $2,000 to do that plan with the staff. Also included are student stipends in the professional contract services line. Orange County Health Department shares a position with other human service agencies for a Systems Analyst position and our portion of that person which had been absorbed in Personal Health is now reflected here. The Dental Health increase of 11% is primarily due to increased building rent in Carr Mill. They will be the sole Health Department occupants in Carr Mill. Dental will have increased space in Carr Mill and therefore their building rent portion will be increased as well. Other increases include the professional contract for the dentist and bloodborne pathogens. Personal Health has the second smallest increase. This is partly because of the transfer of resources from Personal Health into Management. Increases are in the two new positions and in the professional contract section. Environmental Health has the two new positions and that is their primary increase. Animal Control is the least changed. There are no major increases. Revenue Summary Overall revenue is projected to be up by 6.7%. Ron Holdway has proposed a new fee schedule for Environmental MINUTES ORANGE COUNTY BOARD OF HEALTH February 26, 1998 Board of Health Minutes Transcription completed by Patsy L. Bateman 3 February 26, 1998 Health that accounts for most of the increase of revenue. Dental Health has projected a continuing trend of increases in private-pay sliding-scale patients. Management and Vital Records has a decrease because the State consolidated contract has decreased. The Board members asked several questions regarding the outcomes and the budget adoption process. The Commissioners’ adoption of the budget is scheduled for the June meeting. The Orange County Health Department budget is due to the County Budget office on March 16, 1998. After a series of meetings with the Budget Office staff, there will be changes to our budget based on their recommendations. The County Manager makes recommendations in May. New positions were requested in January. The County has a Position Team that looks at all justifications. Each department meets with a budget analyst and they ask many questions about the positions requested. This is the process the Health Department is in now. The Analyst presents the facts as they understand them to the Budget Team who then makes their recommendation to the County Manager and the County Manager makes a recommendation to the Board of County Commissioners. Environmental Health The Board requested that Environmental Health look at formulating plans for the inspections of gravity flow systems. Ron Holdway will gather data and report back to the Board. The motion to approve the 1998-99 Budget was made by Jonathan Klein, seconded by Margaret Brown and carried without dissent. BREAST FEEDING SUPPORT TO THE COMMUNITY, PRESENTED BY ROSEMARY SUMMERS Mini-grants up to $2,000 for community breastfeeding support have been made available on a competitive basis from the Division of Women’s and Children’s Health, N.C. Department of Health and Human Services. A requirement was that applications for funding be coordinated with local health departments, as the money would come through the local Health Department State Consolidated Contract. Karen Metzguer, RN, a perinatal nurse educator based at UNC Hospital, expressed an interest in applying for $1,845 to carry out a project to support breastfeeding continuation for babies in day care centers, and the application was approved. The motion to accept the funds for the Breastfeeding Support to the Community was made by Janet Southerland, seconded by Barry Adler and carried without dissent. HONORING SEAL THE STATE ORGANIZERS, PRESENTED BY ROSEMARY SUMMERS Seal the State in 98 and Seal Orange County Kids are two projects, (the first is a state-sponsored and the second is a county-sponsored project) that were intended to screen and provide sealants for children in Orange County who do not have access to regular dental care. Both projects were coordinated by Wendy Hall, Dental Hygienist from the N.C. Dental Health Section assigned to the Orange County Health Department. Seal the State in 98 involved both the School of Dentistry at UNC-CH and 12 private practice dentists in Orange County. Through this project about 105 students had 943 sealants placed at the Dental School, and about 140 students had sealants placed by private dentists. Dr. Eugene Howden was the lead dentist and was instrumental in recruiting and organizing the private practitioners to participate in this project. The Seal Orange County Kids Project, which continues this effort in April, will enable the health department to provide sealants to those children that were unable to be scheduled in February. Wendy Hall has been outstanding in her efforts at managing the screening in the schools and the massive organization required to get the children to the various locations for the sealants to be placed. The Health Department is requesting that the Board present plaques or certificates of appreciation to Dr. Eugene Howden and Wendy Hall for their efforts in these campaigns to be presented by the Chair, Timothy J. Ives. If arrangements can be made, the plaques can be presented on March 13, 1998 at the Dental Society Meeting. The motion to approve the purchase and presentation of plaques or certificates to Dr. Eugene Howden and Wendy Hall was made by Janet Southerland, seconded by Jonathan Klein and carried without dissent. 5. CHILD HEALTH INSURANCE PROGRAM, PRESENTED BY ROSEMARY SUMMERS This is a hot legislative issue. Included is a summary of the top ten questions asked about this program and the reasons we should support it. It will go to the Legislature in special session in March. There are people who would like to change provisions of the legislation to weaken it by reducing the number of children that are covered. A letter of support to the legislative committee would be helpful from the Board. MINUTES ORANGE COUNTY BOARD OF HEALTH February 26, 1998 Board of Health Minutes Transcription completed by Patsy L. Bateman 4 February 26, 1998 The motion to send said letter of support to the legislative committee was made by Jonathan Klein, seconded by Melvin Hurston and carried without dissent. HEALTH CHECK PROGRAM, PRESENTED BY ROSEMARY SUMMERS There is a danger of the Health Department losing Medicaid reimbursement for those visits. There is a Medicaid Briefing Sheet in your packet that was prepared for John Link when he went to the North Carolina County Commissioner’s Association meeting. Some County Managers were asked to come and give their opinion on Health Check. The numbers on the second page were requested last month on how many visits Orange County Health Department has and what the impact on the budget might be if the Orange County Health Department lost this revenue. Dr. Bruton will extend the waiver at least through February of next year and perhaps through the entire fiscal year. This extension does not change the intent of a primary care home for each child. CORE FUNCTIONS AND ESSENTIAL SERVICES, PRESENTED BY ROSEMARY SUMMERS There were lively discussions at the retreat. All three groups came up with similar ideas. Cornelia Ramsey combined the recommendations from all three groups into the list included in your packet. The motion to approve the Core Functions and Essential Services was made by Jonathan Klein, seconded by Janet Southerland and carried without dissent. 6. RECEIVE: COMMUNITY DIAGNOSIS REPORT, PRESENTED BY ROSEMARY SUMMERS Community diagnosis is in the final stages of being developed and will be submitted to the State with an integration of the Healthy Carolinians priorities into this community diagnosis. A summary of this report will be given to the Board next month. RECEIVE: HEALTHY CAROLINIANS UPDATE, PRESENTED BY ROSEMARY SUMMERS A Steering Committee meeting has been scheduled for March 25, 1998 and that meeting will look at the objectives included in this packet. Cornelia Ramsey and Rosemary Summers will be meeting to draw up a proposed process and organization for that whole structure. It’s been about two years since the beginning of that process. The group has completed the planning phase and is ready to proceed to implementation. The plan will be presented to the Steering Committee for their consideration and the Board will see it at the March meeting. RECEIVE: INFORMATION ON SOUTHERN HUMAN SERVICES MOVE, PRESENTED BY ROSEMARY SUMMERS Orange County Health Department is still scheduled to open services at the new building on March 16, 1998. The County is beginning plans for a grand opening for the public. In the move process, our clinics at Carr Mill will be closed March 5-13, but there will be a nurse who takes walk-in patients and triages patients as needed. Regular appointments will not be held during the move. The furniture is still coming. The computers have been installed. The four human service agencies relocating in the new building have formed a small employee committee to develop policies. Health Department clients will be notified via post cards announcing the change in location with a map on it. As of today there will be no bus service to the front door of the Southern Human Services building. The letter requested by the Board at the last meeting was mailed to the incorrect address. A new letter has been sent to the correct address. A suggestion was made to send a letter to or meet with the Mayor and the Town Council of Chapel Hill requesting bus service to the front door of the Southern Human Services building. A motion was made by Beverly Foster and seconded by Barry Adler to adjourn the meeting. The next regular Board of Health meeting will be held on March 26, 1998 at the Government Services Center in Hillsborough, North Carolina. Respectfully submitted, Rosemary L. Summers, MPH, DrPH Interim Health Director RLS:plb