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HomeMy WebLinkAboutBOH minutes 052297BOARD OF HEALTH MAY 22, 1997 1 MINUTES ORANGE COUNTY BOARD OF HEALTH MAY 22, 1997 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, MAY 22, 1997 AT THE ORANGE WATER AND SEWER AUTHORITY BUILDING IN CHAPEL HILL, NC. BOARD OF HEALTH MEMBERS PRESENT: Timothy Ives, PharmD, MPH, Chair; Barry Lynn Adler, OD; Ronald J. Cammarata, DVM; Barbara Chavious, MPH, At Large; Cleon Currie, BS, At Large; Beverly Foster, RN, PhD; Jonathan E. Klein, MD; and Richard J. Marinshaw, PE. BOARD OF HEALTH MEMBERS ABSENT: Brenda Crowder-Gaines, MSA, Vice Chair and Janet Southerland, DDS, MPH. STAFF PRESENT: Marcia Angle, Personal Health; Ron Holdway, Environmental Health Director; Eileen Kugler, Personal Health Services Director; Cyndi Loughner, Administrative Assistant; Daniel B. Reimer, Health Director; and Ron Wall, Personal Health. VISITORS PRESENT: Joan Barnhardt, Association of North Carolina Boards of Health; Phil Bisesi, Alternative Energy Corporation; Elaine Holmes, Orange County Personnel; Melissa Jarrell, County Attorney’s Office; and Bill Whitaker, Whitaker Souteast Drilling. 1. CALL TO ORDER AND APPROVE AGENDA Dr. Ives, Chair, called the meeting to order at 7:30. In reviewing the proposed agenda, Dr. Ives noted that time had not been given to Dr. Foster for an HSAC report at the last meeting and suggested that Number 7 become her report, moving Mr. Reimer’s report to Number 8 and Adjournment to Number 9. Ms. Chavious motioned and Dr. Cammarata seconded the motion to approve the agenda as amended. The motion carried without dissent. 2. CLOSED SESSION IN TERMS OF G.S. 143-381.11(6) The motion was made by Dr. Adler and seconded by Ms. Chavious to move to a closed session pursuant with the General Statute 143-318.11. The motion carried without dissent. 3. INTRODUCE GUESTS AND APPROVE MINUTES OF 3/11/97 AND 4/24/97 The motion was made by Dr. Cammarata and seconded by Dr. Foster to approve the minutes of March 11, 1997. The motion carried without dissent. The motion was made by Dr. Klein and seconded by Ms. Chavious to approve the minutes of April 24, 1997. The motion carried without dissent. Mr. Reimer asked the guests present to introduce themselves. Comment [AVMC1]: BOARD OF HEALTH MAY 22, 1997 2 4. APPROVE GROUNDWATER PROTECTION RULES Ron Holdway presented the revised Groundwater Protection Rules for the Board’s review and approval. The motion was made by Dr. Klein and seconded by Dr. Adler to approve the Groundwater Protection Rules as submitted. The motion carried without dissent. 5. REPORT ON MEN’S HEALTH IN ORANGE COUNTY Dr. Angle gave a presentation on Men’s Health in Orange County, noting that handouts had been provided for the Board members in their packets. Her primary focus was the mortality rate, its causes and preventions. Education is the key to prevention. We can address unintentional injury, cancer, heart disease and firearms and these are the top four causes of death for men in Orange County. Mr. Currie stated that, if you look at the figures realistically, the black male is an endangered species. The question is, in Orange County, what is being done? Mr. Reimer responded that some creative ways are being implemented, particularly with the Kellogg money, to focus on young black men. The Efland project, Teens in Power, is really focused on young men at the middle and high school age. This is a group that is doing some excellent things for themselves academically and for their future. Teens in Power has had mentoring programs, summer camps, exposure to a variety of professions, and career training. There are a lot of things in that model and it would be good to see that model exposed to other areas in the State. The adult health clinics have senior citizens coming in for blood pressure checks, cholesterol checks, and a variety of other chronic conditions. Those are general, not necessarily targeted to African-American males, but African-American males do come to them. Senior citizens also have access to screening programs and nutrition education. There is not a categorical program for black males. Mr. Currie asked what is being done to encourage African-American men to go to physicians and not fear them . Mr. Reimer noted there is a teen clinic that sees kids of all backgrounds that is supported by school nurses who refer kids to the clinic. Within the Career Development Program of Teens in Power, Marian Phillips spoke to the teens, exposing them to health careers. Arrangements have been made for a summer camp at the University where teens spend time in the various health profession schools. The goal is to open their minds to careers in health professions and expose them to the kinds of course work they need to take during the middle and high school years to prepare themselves for pre-medical and other health related studies. In the process of that exposure, some of the fears about medical care are being desensitized. Dr. Klein observed that, if there were no physicians or other health care providers in Orange County, and only a huge number of health educators who were effective in getting people to quit smoking, understand the importance of avoiding other toxic substances, exercise regularly, store firearms appropriately, not drink and drive, and be careful with farm equipment, there would be far fewer deaths than if the number of physicians was tripled. Getting the word out to the public that health is dependent on one’s lifestyle is imperative. Health does not just happen by chance. It happens deliberately to people who live a healthy lifestyle. Dr. Ives commented that many of these issues are already being addressed and others are beginning to be addressed. The strategic planning process is looking at areas there really needs to be a vision for and this needs to be considered. A marketing plan for the Health Department is already in the Health Director’s work plan. Men’s health is an issue which will continue to be addressed. BOARD OF HEALTH MAY 22, 1997 3 6. SMOKING CONTROL COMMITTEE REPORT Dr. Foster reported that the sub-committee of Barry Adler, Dan Reimer and Bev Foster, met five times. The sub-committee met and talked with a variety of groups and individuals and attended a local presentation by Mr. Ed Sweda, attorney with the Tobacco Resource Center & Tobacco Liability Projects, Boston, MA. Dr. Foster provided attendees with a preprint of an article being submitted for publication regarding the impact of the Orange County Smoking rules on local restaurants. She also provided attendees a memo summarizing the sub-committee’s recent work and recommendations. The three primary recommendations made by the sub-committee include: 1) endorse a smoking cessation campaign as one of our top priorities for the coming year; 2) collaborate with other interested parties to support a working meeting for interested boards of health, health directors and others to engage in mutual learning and problem solving; and 3) following the actions described in #1 and #2, further consider the advisability of legal approaches to either challenge or change the current law, particularly weighing the benefits and costs for Orange County. Dr. Adler questioned whether or not the manpower is available to do the work if the recommendations are endorsed by the Board. Is the Board of Health capable of pursuing this with staff? Mr. Reimer responded that the position of health educator has been offered to a dynamic individual, who certainly has the skills to implement these recommendations. She has experience in this arena and would be useful as a member of an inter-agency team. She could probably play a leadership role, but, for this to be effective, a lot of community buy-in is needed. Dr. Foster noted that the Institute of Government has an intern assigned to pull together the current case law, which would then be available to the public. There are probably legal interns or public health interns that could also be used. Dr. Ives stated that perhaps the new health educator would be able to devote some time to this, provided the Board gives the commitment to it. What is our level of commitment as a Board to start this process off? A clear recommendation needs to be given to the Health Director as to where the Board wants to take this. Does the Board subscribe to these three recommendations and recommend specifically that this be a focus of the Department that the health educator would then take the lead role in? The motion was made by Dr. Klein and seconded by Dr. Foster that the Board adopt the three recommendations of the sub-committee, prioritizing them as 1, 3 and 2 and that the Board charge the sub-committee, with the inclusion of a couple of key staff members, to develop an action plan which will be brought back to the Board at the July, 1997 meeting. The motion carried without dissent. 7. HSAC REPORT Dr. Foster provided handouts containing information on the Skill Development Center to serve the County, the entities to be involved and the floor plan. She noted that there is a great opportunity as it develops for health to be involved in terms of screening, prevention and referral. HSAC has a flock of new recruits and membership and they are very excited. A policy forum is being planned for the fall which will look at the impact of welfare reform on various aspects of our lives. Dr. Ives asked guest, Joan Barnhardt, to talk to the Board about services available from the Association of North Carolina Boards of Health. Ms. Barnhardt stated that the Association is primarily an information resource for Boards of Health. Questions regarding policies, current issues before the legislature, etc. can be directed to her at 919-677-4137. BOARD OF HEALTH MAY 22, 1997 4 8. HEALTH DIRECTOR’S REPORT Employee Committee -- Mr. Reimer provided attendees with a written report on the issues raised by the Employee Committee and actions taken to address these issues. The ad-hoc committee recommended that the Employee Committee be made permanent and that it have a revolving membership. The purpose of the Committee will be to address employee concerns, their issues and interests; to recommend specific action to the Health Director; and to plan activities designed to enhance employee morale. Budget Update -- In his initial meeting with the County Manager, the Health Director requested a temporary health educator be made permanent and two 8 or 10-hour temporary nurse practitioner positions be consolidated into one 20-hour position. The committee that reviewed the request recommended that it be a full-time position and that the current temporary health educator not be made a permanent position. When Mr. Reimer met with the Manager on May 6th, the Manager’s team did not recommend continued funding for Community Based Public Health because the Health Department did not have the Kellogg Phase II Grant in hand, which was due last October. The team would reconsider the request following receipt of a detailed account of the money flow. Mr. Reimer was able to go to the second meeting on May 19th with the check and the contract in hand and a step-by-step explanation of what money was expected last year, what actually came in, how costs were allocated, what money was left, etc. The Manager’s team was then able to see that the money was there to carry over for next year. With this background, the Manager decided to recommend the continuation of the Community Based Public Health Initiative. Activities Report -- Mr. Reimer noted, that, in light of the Board’s earlier discussion regarding the importance of health education to meet its long-term goals, this is an area where the Board could help in developing a strategy and in orienting the County Manager. Among the things that came up in the earlier discussion was that the main reason the Manager supported the Nurse Practitioner over the Health Educator is because they know what a nurse practitioner does -- they see patients in the clinic. People in the street understand that; but, who knows what health educators do? The Manager might be more responsive to the kind of community support and professional input that the Board could bring than to hearing it from staff. Mr. Reimer stated that he would like to develop a strategy and ask different individuals to work with him so that by next year John Link will have input from the Board that might make him more open to considering this. It will be necessary to increase the health education staff if the Board is going to adopt the kind of programs recently discussed. Ms. Chavious commented that it is necessary to overcome the image that the only thing health educators do is create pamphlets and posters and hold fairs with balloons and things. That is a visible part of the health educators job, but not the substantive planning, etc. which is also a part of the role of the health educator. The Board needs help in understanding the role of the health educator beyond development of materials, etc. Dr. Foster noted that there are actually many health professionals who would be able to provide the services of health education and that there are actually multiple professional routes to accomplish what is needed by looking at skill level, background and training that people have. A health educator is not the only one who can design health education programs. Dr. Klein stated that this would be health marketing. Business people market their services. The Health Department is competing against McDonalds -- and we are losing. Dr. Ives noted that Glaxo-Wellcome has changed its focus from selling medications to selling health. Dr. Klein suggested that, since the funds are not available to hire multiple staff, perhaps a point person can be BOARD OF HEALTH MAY 22, 1997 5 identified who can locate those resources and say, “This is what Orange County wants, can you develop that for us?” Perhaps funding from Glaxo could be obtained. In the area of Dental Health, the Director previously distributed a memorandum regarding options for Carr Mill services. This will be brought to a later agenda, but the Director wanted to get it out early for discussion. It has gone to John Link and Pam Jones, Purchasing Director in charge of facilities. Mr. Reimer reported that the medical back-up contract arrangement is going very smoothly. The physicians are showing up on time and working well with staff. Everyone is pleased with the way it’s operating. Staff is collaborating with Family Medicine to reorganize the clinic so that a new and innovative approach will exist by July 1. Eileen Kugler and her group deserve the credit for this. Mr. Reimer reminded attendees that the next meeting of the Orange County Healthy Carolinians Task Force is Tuesday, May 27th and that BOH members should have received invitations. Other Highlights -- Mr. Reimer noted that a very exciting staff meeting was held on Wednesday regarding the Strategic Plan. The list of issues developed at the April Board of Health Meeting was reviewed and worked over from several different perspectives. There is a lot of excitement about the prospect of moving in new directions and there was more interest in taking a new direction than Mr. Reimer anticipated. Many who have been involved in the community based public health retreats are really seeing a new vision for the Health Department and are anxious to get more out into the community and less involved in clinical activity. Staff is seeing where our strengths are and seeing that some of the things being done inside our walls might be better accomplished by somebody else. Staff in interested in participating in a “SWOT” team, which is a process that analyzes Strengths, Weaknesses, Opportunities and Threats and is going to run that exercise in their next team meeting scheduled for early June. Mr. Reimer will be coming back to the Board in June with feedback from the staff. The first case of rabies inside Chapel Hill was reported. A call was also received regarding some dead raccoons by the theater on campus. There has been quite a flap over it because the State lab has had such a huge spiking of lab requests that testing has had to be prioritized. The lab only accepts those cases where there has been an exposure. Commissioner Margaret Brown has expressed her concern about the rabies issue and wants to know what type of emergency plan is in place. Mr. Reimer told Ms. Brown that Dr. Cammarata and John Sauls have been meeting with APS and that he will be briefed on May 23rd regarding recommendations. Ms. Brown asked that serious consideration be given to having free rabies clinics. This was a suggestion she made at the Commissioners’ Meeting in April. This issue is being considered at tomorrow’s meeting. 9. ADJOURN In preparation for adjournment, Dr. Ives said that next month there would be a brief commentary on the appointment/reappointment process, which has never really been clarified. There needs to be a set policy among the Board members as to how replacements will be looked for. He requested that Board members provide Cyndi with their e-mail addresses to be included on the Board roster. Dr. Ives suggested that the Board give some thought as to whether or not this is still a good time to hold Board Meetings. He also suggested thinking about the style of the meetings and whether the agenda needs to be cut down, etc. His final admonition to the Board was, “Get an attitude! We’re doing some pretty innovative things and we’ve never really given ourselves credit or applied for awards.” With no further business, the motion was made by Dr. Klein, seconded by Dr. Foster and carried to adjourn the meeting. BOARD OF HEALTH MAY 22, 1997 6 The next regular Board of Health meeting will be June 26, 1997, at 7:30 p.m. at the Government Services Building in Hillsborough, NC. Respectfully submitted, Daniel B. Reimer, MPH Health Director l:\cyndi\bohmin\52297.doc