HomeMy WebLinkAboutBOH minutes 062598MINUTES
ORANGE COUNTY BOARD OF HEALTH
JUNE 25, 1998
Board of Health Minutes
Transcription completed by Patsy L. Bateman 1 JUNE 25, 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, June 25, 1998 AT SOUTHERN HUMAN
SERVICE CENTER MEETING ROOM, CHAPEL HILL, NORTH CAROLINA.
BOARD OF HEALTH MEMBERS PRESENT: Timothy J. Ives, Brenda Crowder-Gaines, Melvin Hurston, Beverly
Foster, Barry Adler, Ron Cammarata, Barbara Chavious, Jonathan Klein, Margaret Brown, Richard Marinshaw
BOARD OF HEALTH MEMBERS ABSENT: Janet Southerland
STAFF PRESENT: Rosemary Summers, Interim Health Director; Ron Holdway, Environmental Health Division
Director; Eileen Kugler, Personal Health Division Director; Joan Terry, Clerk of Court; Cornelia Ramsey, Health
Education Supervisor; Patsy Bateman, Administrative Assistant
GUESTS PRESENT: Dr. Bobby Shopler and Dr. Bob Milliken
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. APPROVE / AMEND MINUTES OF MAY 21, 1998
Minutes of May 21, 1998 should read as follows: The Board of Health went into open session from the closed
session and affirmed in the open session the vote taken in closed session. The Board of Health agreed by a 5 to
4 vote using a secret ballot to offer Dr. Rosemary L. Summers the position of Orange County Health Director.
The motion to amend the minutes of May 21, 1998 was made by Brenda Crowder-Gaines, seconded by
Jonathan Klein and carried without dissent.
SWEARING IN OF HEALTH DIRECTOR
At this time Joan Terry, Clerk of Court, swore in Rosemary L. Summers as the Orange County Health Director.
III. PROPOSAL FOR JOINT MEETING OF BOARDS
Responsibilities of the health department often interact with other policy boards. While the Board of Health has
from time to time met with the Board of County Commissioners, there has been no regularly scheduled time
during the year to either meet with them or with other boards that have mutual areas of interest. In your Board
packet there is a proposed Board meeting schedule.
Regarding the September joint meeting, with Department of Social Services Board, Marti Pryoer-Cooke and
Rosemary L. Summers have discussed the possibility of getting both Boards’ together to do some Board
development and Board training. It has been suggested that a representative from the Institute of Government at
UNC come to a joint trainin session with the Board’s. Also, Board training through the Board of County
Commissioner’s Office with Kathy Baker would be helpful. This would offer Board orientation to new members
and old members alike.
It was suggested that our Board be up to speed on the other Boards’ functions and responsibilities before meeting
jointly.
ORANGE COUNTY BOARD OF HEALTH COMMITTEE ASSIGNMENTS
The Board of Health reviewed the committee assignments for 1997-1998. All committee’s will remain intact and functioning
with the exception of: Solid Waste Committee and Search Committee. Board of Health members were asked to review
the New Liaison Roles and to think about just what are the roles of the Board of Health members as liaison’s to
other Boards’.
The Board of Health has received a request from Home & Community Care Block Grant Advisory Committee to
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ORANGE COUNTY BOARD OF HEALTH
JUNE 25, 1998
Board of Health Minutes
Transcription completed by Patsy L. Bateman 2 JUNE 25, 1998
have a Public Health Liaison member of that group. This block grant comes through a regional arrangement and
is primarily for adult services in the home. Right now, most of that money goes to the Aging Department and
Department of Social Services. If the Health Department had a Home Health Agency, we would be eligible for
funds as well. We have chosen not to enter into that area at this point. The Committee would still like to have a
Public Health Liaison be a member. This meeting would take place twice a year.
EXPANSION OF WTMP
This report is a result of several committee discussions. This is an expansion report in essence. This is not
something the staff is asking to do. This report is a response to questions that came up at the joint County
Commissioners and OWASA meeting and subsequent Board of Health meeting as to what would be involved to
expand out to include all systems in the County. Would we want to go back and revisit the proposal based on
new information?
Tax bills this year will include pieces of education materials for the Environmental Health Department. One piece
of educational material will be septic tank maintenance and well maintenance. Before this material is sent to the
public, we need to have a response plan all ready. There is a graduate student working in Environmental Health
helping develop an educational/informational pamphlet. The student is also working to update the Orange County
Home Page and the Environmental Health Division Home page on the Web. Is it fair to ask the citizens to pay
extra money for inspections on a periodic basis and what is the County willing to pay a percentage of? After
much discussion regarding WTMP, it was decided to further research different areas, including problem areas and
bring this matter before the Board again soon.
This matter will be placed on the Commissioner’s agenda for reports.
VISIONING PROJECT (NCALHD)
The Health Directors’ have met twice with Health Quest, the consulting group which pulled these
recommendations together. We’re going to meet again in July to go over the recommendations and many Health
Directors’ were unhappy because they received the document the day before the meeting. There was not
sufficient time for the Directors’ to review, research, or share this information. At the July meeting we will once
again discuss this information. This report is something requested by Health Director’s and Health Quest was
paid to pull together these recommendations.
Within this document it discusses restructuring of public health rather than a vision for where public health is
going. This is a concern. What this document is pushing is public health integrated service areas, aka, public
health authority. Public health authority is not a BOH, it is a separate legal entity from what is currently a BOH. It
is a separate legislation set up essentially health authorities that can function on their own without the
participation if so wished, of County Commissioners. In one way a public health authority gets public health out
from under and that’s the term often used, “out from under”, local politicians. This is a combination approach that
they are in fact pushing public health integrated service areas as a public health authority but is not on a county
level, it is on a regional level, a multi-county level. They believe this will make public health more competitive,
more able to work in a managed care environment. This is the thrust of why they would like to do this. They’re
recommending that there be no more than 18 across the State, which is a far cry from our 87 health
departments/districts that we have. It is suggested that these integrated service areas be organized around
consumer patterns of care.
They are asking the undefined triangle whether we would be going to act as a demonstration site for this project..
The reason that they think a pilot project would be worth it in the triangle area is because they’re easy access in
relationship to the State.
It looks like they’re proposing a fast track and that all the changes and the structure be completed by the year
2000.
They still would like to have local funding. They are asking the BOCC to fund the local areas. What is being
proposed is that these structures have local programs but all of the rule making authority is at the regional level.
None of the rule making is at the local level, but the local BOCC would fund public health preventive programs.
Each regional board would have 8 county commissioner members on the regionals rule making board (1
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commissioner per county).
This item will need to be discussed again by the BOH at a future meeting. The Health Director will keep the BOH
informed of any updates.
IV. BUDGET UPDATE
We were approved for Nurse Practitioner “more time” position, Ruth Efird’s position will go from 3/4 time to full-
time and she will be focusing on the area of protocol development and management as our protocols and our
relationship with the physicians rotating through the health department clinic. Evelyn Aabel has been filling our
Nurse Practitioner I position 1/2 time for about a year now. That position was very difficult to recruit as a ½ time
position and could not be filled until Evelyn came out of retirement to fill that position. That position has also been
approved to go full-time and we will begin starting a recruitment process to fill that. That position will be key in
providing clinic coverage that has been badly needed and we hope it will also be able to generate other revenues
dealing with lamaze classes and in-home visiting as well.
The not so good news is that the two Health Educator positions and the 1/2 time Office Asst. were not approved.
The temporary part-time position that Angenette McAdoo is in has been continued until John Link and Rosemary
Summers can discuss a plan to represent to the Commissioners. The Environmental Health fee increases were
approved as part of the regular approval process of the budget and all of the operating budgets were approved as
well.
Rationale used for Health Education positions: It is a total view of the budget. The BOCC tried to approach the
departments the same. At this time there are 4 departments without department heads and positions requested
from those departments were not funded. The BOCC also felt that departments with “new” department heads
needed to look at reevaluating resources, personnel and kind of get their feet on the ground with what they
wanted to initiate. The BOCC did not cut anything that had been adopted into their goals. The Healthy
Carolinians was never adopted into the BOCC goals. There are so many parts of Healthy Carolinians that are
funded in different ways by the BOCC, like child abuse and neglect and poor parenting skills. Questions were
raised regarding the adoption of Healthy Carolinians as a BOCC goal, many BOH members remembering that
yes, Healthy Carolinians was a BOCC adopted goal as the Interim Health Director and the task forces had to
keep the BOCC goal, “healthy carolinians”, updated.
This coming year the BOCC will look at the strategies and the implementation of very specific goals to be
accomplished by Healthy Carolinians.
STRATEGIC PLANNING UPDATE
Each Health Department Division has been asked to form a team within their divisions to look at issues that they
need to address in a strategic plan. Rosemary Summers will meet atleast once with each of the teams within the
division as they proceed. They will be looking particularly at inter-divisional opportunities for working together and
by that things like a health promotion team within the division that will help cut the cross-divisional lines so that
there is a Environmental Health person on that team as well as Personal Health people and Dental Health people.
This is so that we begin to look for opportunities to cross fertilize ideas and efforts. Personal Health started with
a Clinic Assessment Group that started meeting to address some concerns raised with clinic crunches, more
patients than they could see, practitioners being stressed out, too few a staff for the number of patients seen in
clinics especially split between the two ends of the County. Some reshuffling has been done in this group, met
twice, have a short-term plan and then are going to take that group and add people in Personal Health and make
that the long range planning group for Personal Health. They already have 3 or 4 additional meetings scheduled
and they are well into that process. It is in the process of scheduling a meeting with an employee group
representatives to see how we can structure more feedback from employees into the strategic planning process.
This is to ask them how we can structure that. Regular monthly meetings are scheduled with an informal family
practic group at UNC and that group has agreed to look at 2 grants, one the Medicaid population and the system
and care for Medicaid population and then another strand being a system of personal health care for the
population that falls within the cracks, not Medicaid eligible working for uninsured. We are getting ready to
expand this group beyond the initial group. This process is moving forward.
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ORANGE COUNTY BOARD OF HEALTH
JUNE 25, 1998
Board of Health Minutes
Transcription completed by Patsy L. Bateman 4 JUNE 25, 1998
V. A motion was made by Margaret Brown and seconded by Ron Cammarata to adjourn the meeting
at 10:15 p.m.
The next regular Board of Health meeting will be held onAugust 27, 1998 at the Southern Human Service Center
in Chapel Hill, North Carolina.
Respectfully submitted,
Rosemary L. Summers, MPH, DrPH
Health Director RLS:plb