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HomeMy WebLinkAboutBOH minutes 112496BOARD OF HEALTH 1 NOVEMBER 21, 1996 MINUTES ORANGE COUNTY BOARD OF HEALTH NOVEMBER 21, 1996 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, NOVEMBER 21, 1996, AT THE OWASA CONFERENCE ROOM IN CARRBORO, NORTH CAROLINA. BOARD OF HEALTH MEMBERS PRESENT: Timothy Ives, PharmD, MPH, Chair; Brenda Crowder-Gaines, MSA, Vice-Chair. Jonathan E. Klein, MD; Barry Lynn Adler, OD; Cleon Currie, BS, At Large; Richard J. Marinshaw, PE; Ronald J. Cammarata, DVM; Beverly Foster, RN, PhD; Brenda Crowder-Gaines, MSA, Vice-Chair. Alice Gordon, PhD, Commissioner. BOARD OF HEALTH MEMBERS ABSENT: Janet H. Southerland, DDS, MPH; Barbara Chavious, MPH, At Large STAFF PRESENT: Daniel B. Reimer, MPH, Health Director; Eileen Kugler, RN, MPH, Personal Health Services Director; Ron Holdway, BA, RS, Environmental Health Director; John Sauls, B.A.; Animal Control Director; Angela Cooke, Dental Health Coordinator; Ann Hill, Administrative Assistant. VISITORS PRESENT: none 1. CALL TO ORDER AND RECOGNITION OF GUESTS Dr. Ives, Chair called the meeting to order at 7:30 and asked Health Director, Mr. Reimer, to introduce the above staff who were present. 2. ADDITIONS OR CHANGES TO THE AGENDA A motion was made by Ms. Crowder-Gaines to accept the agenda. The motion was seconded by Dr. Adler and passed unanimously. 3. REVIEW OF THE MINUTES The visitors were from UNC-Greensboro School of Nursing. Item 5.1, remove Dr. Foster from Personal Health committee assignment. Item 5.2, b. change the word personal to public. A motion was made by Dr. Foster to accept the minutes as amended. The motion was seconded by Ms. Crowder- Gaines and passed unanimously. 4. PERSONAL HEALTH SERVICES REPORT - Eileen Kugler 4.1 Smart Start Grant Application Ms. Kugler reviewed a memorandum from Michele Rivest, Executive Director of the Orange County Partnership for Young Children, informing the Health Department that Glaxo Wellcome had made $1,000,000 available to the State Partnership for Children for grant to local partnerships. Grant amounts to be awarded to local partnerships will range from $5,000 to $25,000 for programs focusing on improvement of maternal and child health for one year. However, there is a possibility of funding for three years with annual reapplication. Ms. Rivest was aware of previous efforts, in collaboration with Joint Orange-Chatham Community Action Agency (JOCCA), Piedmont Health Services (PHS) and the UNC Department of Obstetrics and Gynecology (UNC-OB/GYN) to develop a grant proposal for the reduction of infant mortality in the minority population in Orange County. The grant development process also included the formation of a Coalition for the Prevention of Poor Pregnancy Outcomes. This coalition was very interested in continuing to work on the issue of minority reduction even though the grant proposal was not funded; however it has been very difficult to sustain any activity without funding for personnel and other resources. The core group met on Monday, November 18, 1996, to discuss the submission of the proposal and will continue forward if the Board approves. Dr. Gordon questioned the use of temporary part- time/ time-limited personnel. Dr. Ives suggested contacting the Department of Family Medicine to see if they were also interested in being part of this process. Dr. Foster motioned to authorize the Department to proceed with the application for funding in the amount of $25,000 to implement a minority infant mortality reduction project. The motion was seconded by Dr. Klein and was passed unanimously. BOARD OF HEALTH 2 NOVEMBER 21, 1996 4. 2 Family Resource Center Proposal Ms. Kugler informed the Board that funding for a network of family resource centers in Orange County has been provided for 2 1/2 years by the Orange County Partnership for Young Children (OCPYC) the local Smart Start agency and the North Carolina Department of Human Resources (DHR). The HEARTH Family and Community Resource Center served as the central administrator until October 15, 1996. OCPYC in collaboration with DHR recently initiated a bid process for the continued operation of these centers for the remainder of the fiscal year with a possibility of further funding. The Family Resource Centers are currently located in the Pine Knolls and Trinity Court/Pritchard Park neighborhoods in Chapel Hill and in the Northern Orange Human Services Center in Cedar Grove serving the communities of Cedar Grove, Efland and Perry Hills. OCHD has had a very close relationship with the Northern Orange Family Resource Center since the initial grantwriting stage. Chapel Hill Training and Outreach Program originally established the center in Pine Knolls. When the Health Department learned that CHTOP was also interested in bidding on the FRC’s, staff approached them about a partnership arrangement whereby they would be the fiscal agent responsible for hiring the staff and the overall administrative aspects of the program and OCHD would have primary, but not exclusive, responsibility for the programming aspects. $12,876 would be reserved in the this year’s budget for OCHD. This money would be used to hire a temporary, part time health educator to serve as liaison to the project and for supplies and professional services rendered by the department. The contract will go to CHTOP as fiscal agent and the OCHD as partners with others as agreed upon. Dr. Klein motioned to authorize the Health Department to participate in this partnership arrangement with Chapel Hill Training Outreach Project, Inc. as fiscal agent to administer and develop family resource centers in Orange County and accept funding in the amount of $12,876. The motion was seconded by Dr. Foster and passed unanimously. 5. HEALTH DIRECTOR’S REPORT 5.1 Healthy Carolinians Task Force Report Mr. Reimer reviewed preliminary priorities of the Healthy Carolinians Task Force. The task force ranked the pressing health issues in Orange County first by impact on the health of the community. Then, they ranked the issues again based upon their personal willingness to act on each issue. The next step is for the task force to meet again to chose which items from the priority list the task force would like to pursue. Mr. Reimer also reviewed health status problems submitted by each Orange County Health Department division for the community diagnosis in January of 1996. Attachment four in the Board packet is an attempt to show how the Healthy Carolinians priority health issues relate to the community diagnosis health status problems identified by the health department staff. The task force at this date has not chosen which priorities to purse and have not developed action plans. Therefore, it is difficult to formulate goals for the Commissioners Retreat. It is clear that issues chosen by the Healthy Carolinians Task Force will require the Health Department to focus more of its efforts into outreach and partnering with other organizations. This item will be discussed again in conjunction with Item 5.3. 5.2 Human Services Advisory Commission Report Dr. Foster informed the Board that the HSAC met on November 18th and reached an agreement on recommendations, but the draft report is not ready for publication yet. There will be several recommendations that look at the County and the United Way joining forces in a collaborative effort to provide both funding, collaboration, training and the use of outcomes for funding and the use of outcomes for evaluations purposes, with organizations that are funded by the County and United Way. This will be done through several strategies that the HSAC will recommend; one is the use of a resource person to assist with training and a model that was used in Wake County as a mentor program of developing agencies and their skills that are further along in the process, to serve as mentors for agencies that are in the development process. Dr. Foster also informed the Board that an additional page has been added to the United Way funding application grant and the County application. The additional page asks for information regarding the agencies goals for the previous year and what the agency did towards achieving those goals; and what the agencies proposed to do in the next funding year. BOARD OF HEALTH 3 NOVEMBER 21, 1996 5.3 Board of Commissioners Goals Mr. Reimer informed the Board that since the Healthy Carolinians Task Force has only completed the identification of the top eleven priorities, it would be appropriate to continue last years goal of “Develop a Consumer Involvement Mechanism for Human Services Program Planning” as a top priority goal this year. The task force has not yet selected which of the top eleven priorities to pursue or which strategies to employ. When it does, it would be appropriate to ask the Board of Commissioners to support those strategies that are appropriate for the Health Department to pursue. Board members discussed the Healthy Carolinians Task Force goal; the smoking control rules as a goal and the possibility of engaging in a strategic planning process which would define the role of the health department in providing clinical services as another goal. Following discussions of the proposed goals, Dr. Klein motioned to adopt the Healthy Carolinians Task Force goal and forward it to the Commissioners. Dr. Foster motioned that the Board support the top priorities that are to be set by the Healthy Carolinians Task Force and they will become the Board’s primary agenda for the year. Dr. Klein accepted the friendly amendment. The motion was seconded by Dr. Cammerata and was passed unanimously. 5.4 Annual Reports, 1995-96 The Board received the annual reports for the previous fiscal year. The Chair would like for Board members to review and study the materials and have further exploration of the annual reports at the January meeting in conjunction with key outcomes and performance measures as well as the preliminary plans for the next fiscal year. Dr. Gordon would like for the divisions to use the same format and show what kinds of performance outcomes they anticipate for this year. 5.5 Report of Activities- Daniel B. Reimer Employee Committee Mr. Reimer, Pam Jones, Purchasing Director, and some employee committee members met with Nathan Milian, Carr Mill Mall Manager to survey and discuss issues raised by the committee. The Health Department will arrange for DEHNR Industrial Hygienist, Will Service, to test the air handling system for pathogens. Mr. Service will direct whatever needs to be corrected. Mr. Millian will have broken tiles fixed during December. Parking was also an issue, and Ms. Jones pointed out in the lease that it specifies that parking will be at the Farmer’s Market, not in the immediate area. Mr. Millian noted that additional security staff will be added and any employee wishing an escort at night need only ask. Also discussed with Ms. Jones was the single door entrance to the Environmental Health office. The addition of another door is in the process of being estimated now and construction will begin thereafter . Mr. Currie questioned the renovation for the receptionist. This issue was discussed with Ms. Jones and has been submitted in the Capital Improvements Plan. Carpeting and additional tile in the clinical areas is also in the CIP. Discussion was raised regarding office housekeeping. This issue will be discussed further at the next Employee Committee meeting. Animal Control Ordinance This item will be on the December 2, 1996, Board of Commissioners agenda . Wolf Attack Board members were made aware of a problem situation that occurred around the occurrence of Hurricane Fran. The owner of wolf hybrids had his pen hit by a tree during the storm and the several animals escaped. The animals were loose in the neighborhood and were joined by a neighbor’s dog. The dog barked at the animals and was attacked and killed. The department did an immediate investigation and found that the owner of the wolf-hybrids had made a special appeal to the Commissioners in 1991 to be allowed to keep one wolf hybrid. The owner is a professional animal trainer and has been using the animal as a training instrument to show even the most difficult animal can be trained. The Commissioners did not permit it but asked the Manager to find a way to return the animal to its owner. Unbeknownst to the department, the owner acquired a mate, has bred pups and these were the animals that were involved in the attack. The owner has been issued a vicious compliance order and is under specific orders to remove these other animals from the county however, he has had a hard time moving them. The issue has been discussed with the county attorney and will be addressed further. 6.1 BOARD OF HEALTH ISSUES 6.1 Election of Officers for 1996-1997 Mr. Currie motioned to nominate Dr. Tim Ives as Chair and Brenda Crowder-Gaines as Vice-Chair. Ms. Crowder-Gaines would like the minutes to show that she would be willing to relinquish her seat on the Environmental Health Committee to anyone interested. The board unanimously accepted the motion for nominations. Dr. Gordon moved to accept by acclimation Dr. Ives as Chair and Brenda Crowder-Gaines as Vice- Chair. The motion was seconded by Dr. Foster and passed unanimously. BOARD OF HEALTH 4 NOVEMBER 21, 1996 6.2 Appointments for Board Committee Assignments for 1996-97 Executive Committee Timothy Ives, Chair Brenda Crowder-Gaines, Vice Chair Environmental Health Richard Marinshaw Brenda Crowder-Gaines Animal Control/APS Ron Cammerata Dental Janet Southerland Personal Health Jonathan Klein Barbara Chavious Human Services Beverly Foster Advisory Council Employee Committee Cleon Currie Barry Adler Assoc. of NC Boards of Health Tim Ives, Chair Brenda Crowder-Gaines Healthy Carolinians Task Force Beverly Foster Solid Waste Committee Richard Marinshaw Mr. Reimer will call Ms. Chavious and Dr. Southerland regarding their choice of committee assignments. 6.3 Board of Health Calendar - 1997 If possible, the Board members would like to schedule the September meeting at the Homestead Center and the October 23rd meeting at the Chapel Hill Library. Dr. Gordon motioned to approve the 1996-97 Board of Health Calendar as amended. The motion was seconded by Ms. Crowder-Gaines and was unanimously passed. 6.4 Evaluation Process of the Health Director - Dr. Timothy Ives Board members discussed the evaluation process which will take place at the December meeting. 7. ADJOURN With no further business, a motion was made by Dr. Gordon and seconded by Ms. Crowder-Gaines to adjourn the meeting. The motion carried unanimously. The next regular Board of Health meeting will be December 12, 1996 at 7:30 p.m. in the Orange County Library Conference Room in Hillsborough. Respectfully submitted, Daniel B. Reimer, MPH Health Director l:admin/ann/boh/1196mins.doc BOARD OF HEALTH 5 NOVEMBER 21, 1996 TO: Dr. Tim Ives Health Director’s Evaluation Materials and envelopes have been mailed. Everything will get returned to the Chair and it will be tallied in advance. Rick Marinshaw raised the question regarding DBR’s self evaluation. DBR suggested he would complete the self evaluation and fax to board members. Mr. Reimer will get it out on Monday. Rick and Dr. Adler would like to get the self evaluation. Alice and Dr. Foster stated they did not need it. Rick questioned? We have the workplan, objectives. His understanding was the Health Director’s self evaluation was more than needed - it was explaining how he rated himself. He thought this was one of the things agreed upon in head of time. Alice - if we agreed on it. Do it. Rick’s understanding that Board agreed on. Dr. Foster thought each of us would come to December meeting with that information and a rationale in mind for why we had done certain ratings as well as Dan would have that and we all would dialogue about Dan’s seeing it as a 3 and someone else seeing it as a 4, and talk about those things. She thought this. Tim read minutes approved tonight. - The Director will send out his self-evaluation by November 6, 1996, based upon the modified workplan. So that reviews can be scheduled thereafter. Dan will do this weekend and fax on Monday. Rick thinks we need to keep to the schedule. Dr. Klein thinks that there is input here. He feels comfortable with the input he has. If you don’t want to see what Dan sends. Draw your conclusions and then read it. Rick thinks it is to Dan’s benefit to send it. It was decided that this was an important piece of information that we needed to have. At the beginning, not after we had talked to our liaison, more or less reached a conclusion about what your evaluation rating is. Dr. Adler - thinks its each persons option to look at or not. Depending on what each person feels about it. Alice - He says he will get it out.. Tim - Question of when. Is everybody in agreement. The plan stays the same as we are doing it. This will just be another piece of information. Brenda - Dan has suggested he will do it this weekend and fax it to everybody on Monday. Alice - When you get to the meeting - then what are you going to do with it. How will you handle actual session? Tim - Brenda and I are going to present accumulative data that is sent to us by board members. You have my home address so, it will not go anywhere else. It will be confidential. We will tally all the numbers and present it to the group. That for each one the mean is ____number. Then we will have to approve that. Either each individuals point or accept it in total. So we will also have the final numbers rapped up as well. You will compare and contrast each up front or at that meeting to what Dan’s opinions are. If there are any great discrepancies then it may be worth discussion. Then we approve it. BOARD OF HEALTH 6 NOVEMBER 21, 1996 Alice - How are you going to get the final number? Mathematical average or discuss ??? Tim - Some numbers will have to be put down up front. We did not discuss last time that we would accept at mean or remember last time we had 2.25. Does that equal a two or three? But, simply put the numbers. But by some common consensus whatever that number is. Say it comes out to 2.24. Well, do we as a group say that means 2 or 3? We will have to come to that consensus or we just say that its up front that we go with whatever the number is 3.7 equal 4. We never discussed that at the last meeting and we basically discussed that at last year’s meeting. Dr. Adler thought it should be decided now. Dr. Klein - 10 items on workplan - How scored? The average of all those ten numbers or it is going to be some overall impression. Tim - We said this year at last month’s meeting. That we added an extra category. For terms that Peg Carlson suggested we put in for administrative activities or skills. But that weighted equally. We said for this year they would all basically be a mean. If there were any weighting they were all weighted equally. Tell me if there is anything different from that interpretation. They were weighted equally, so therefore there was a mean. A mean of all of the scores for each particular one and then a mean of all the different categories and that was what the final number would be. It would not be a separate thing like we had last time. It was simply racking the numbers up. Dr. Foster - If we crunch the numbers and we agreed how we are going to round then. Which we have not talked about. We crunch the numbers and we come up with figure. What will you do with the subjective remarks that may come from each of our interviews and perspectives. Are you going to present those also in anonymous form? Tim - that was also brought up - that everybody would be providing those as well. Either in margins or separate sheet of paper and we would tally all those. If point #7 had six commentaries we would just simply list them. To put it in a greater context for the larger picture of what the mean would look like. Dr. Foster - So if we do the numbers and then you also remove the subjective remarks by category . Then when we get into meeting. First of all, the easiest thing would be the numbers are in there. You have a 3.6 or whatever. But, then I would think that we would need to have a dialog about each one of those and the comments. Because I would think that the comments would show consistency, inconsistency and so forth and to me that is the most valuable part of the potential feedback for Dan is those remarks and discussion of those. I think that should be part of the process. Dr. Klein - question on mean - last year some our numbers we able to allowed to change back and forth and that’s when we got confused. Alice - We crunch all the numbers and it could be 1 , 2 ,3 4 ,5. Why don’t you say that you are going to come up with a number. Say that the number is between 3 and 4 then we decide on 3 or 4. but we will not decide on 2 and 5. Let’s say that when we come to the numbers you are going to come up with some kind of number, which will presumably will say between 3 and 4 , so then that’s what you go on, is whether it should be a 3. Dr. Foster - yes and do that following the discussion of the remarks and the perceptions and the after thoughts that somebody learned but forgot to write down or whatever. BOARD OF HEALTH 7 NOVEMBER 21, 1996 Alice - You would not actually go through and start changing numbers. Dr. Foster - liked idea. Dr. Adler - like idea. Brenda - Some of the numbers will be clear cut. So that they will not need to require a lot of discussion, but may require some feedback in terms of what Dan might need to hear. So if the number is 4 across the board and that is what it is - then this is the feedback you need. The discussion comes when Tim and I look at that and there is some discrepancy or disparity between the numbers. Then I think that’s what we bring back to the group and say this warrants discussion. This is clear cut because of -----, but this requires discussion. Tim - I recommended last time that we would provide both the mean and the range. Remember we went through where Peg had just sat there and ran up numbers and it took so long. Us putting that together would be a simple way of getting right to the real issues as you are describing and that would take a lot of this out. But then it’s simply compilation on Dan’s part. Let me cover this. But we put in here, in the process that we would meet with Dan first. Up front everything on the table and we would discuss that because that was the way he was to really change and to continue to improve. You have to give him that type of information the number plus the commentaries. That’s the reason everyone would send in the commentaries as well. But then we would as a group sit down in Dan’s absence to then go to the point of whether it’s 3.47 does that equal 3 or a 4 as his final number that then goes to the Manager’s office. That we would do exclusive of Dan as we all agreed upon. But e would hear from Dan what his perspective is and maybe put it into sharper focus. But if there were discrepancies we as a group with Dan present would discuss it for that very purpose. We realize that there are differences. Maybe he could clarify an issue. But that was it. Not to bounce about as you are mentioning. Barry - We discussed the difference between average and the mean - it seems to me like if six people voted 3 so four that is more meaningful than averaging all the numbers together and coming out with between 3 and 4. If you a mean what’s the common consensus of what the number should be? Tim - I’m using average and mean together. There is a mean - medium and mode. The medium is the middle number and mode is the most frequently used. Which one do you want to use. Barry - Isn’t mean also the number that comes up the most. Tim - That’s mode. Barry - Which number has the most relevance? Tim - If you have four that have a 3 on them and you have three with a 4 on them - the mode is going to be three - because it has one more than that. The average. Alice - if you had the mean, the mode and the range - the raw range - that would be probably all you need. I was thinking about a mean. Tim - we can put all the numbers down - that (x) number had a three - this many had four. Barry - But, on the average is going to be considered. BOARD OF HEALTH 8 NOVEMBER 21, 1996 Alice - but it is important. Which average are we referring to. The mode would not make sense. It would only made sense is we are taking about the mean. Dr. Foster - for the simple stuff we are dealing with. I think that mean and range are a plenty. Because the range you are going to see that actually it went from a one to a five, even though your mean is a three. You are going to see that people disagree. Tim - We can put in the distribution as well. ok