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HomeMy WebLinkAboutBOH minutes 092696 BOARD OF HEALTH 1 SEPTEMBER 26, 1996 MINUTES ORANGE COUNTY BOARD OF HEALTH SEPTEMBER 26, 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, SEPTEMBER 26, 1996, AT THE OWASA CONFERENCE ROOM, CARRBORO, NORTH CAROLINA. BOARD OF HEALTH MEMBERS PRESENT: Timothy Ives, PharmD, MPH, Chair; Jonathan E. Klein, MD; Barry Lynn Adler, OD; Cleon Currie, BS, At Large; Janet H. Southerland, DDS, MPH; Richard J. Marinshaw, PE; Ronald J. Cammarata, DVM, Barbara Chavious, MPH, At Large; Alice Gordon, PhD, Commissioner. BOARD OF HEALTH MEMBERS ABSENT: . Beverly Foster, RN, PhD; Brenda Crowder-Gaines, MSA, Vice-Chair. STAFF PRESENT: Daniel B. Reimer, MPH, Health Director; Eileen Kugler, RN, MPH, Personal Health Services Director; John Sauls, BS, Animal Control Director; Ron Holdway, BA, RS, Environmental Health Director; Dr. Eugene Sandler, Dental Director; Angela Cooke, Dental Health Coordinator, Ann Hill, Administrative Assistant; Patricia Zook, PHN I, Lori Ann Shapiro, Social Worker II, Ava Cavenaugh, PHN II. VISITORS PRESENT: Wendy Hall, NC Dental Hygienist for Orange County; Geoffrey Gledhill, County Attorney; Jane Gledhill, Pat Sanford, APS Director; Cynthia Wise, APS ; Rebecca Holdway, Helen Stiffler 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 and visitors who were present. 2. ADDITIONS OR CHANGES TO THE AGENDA A motion was made by Dr. Southerland to accept the agenda. The motion was seconded by Dr. Cammarata and passed unanimously. 3. REVIEW OF THE MINUTES Item 3a., First sentence, Change their to its. Item 3a. #4, change is to if. Item 3a. #5, last sentence should read: Nomination forms were distributed to Board members. Item 6.3, correct spelling of Dr. Arthur Axelbank. A motion was made by Ms. Chavious to accept the minutes as amended. The motion was seconded by Dr. Cammarata and passed unanimously. 4. DENTAL HEALTH REPORT - Dr. Eugene S. Sandler 4.1 Presentation of Outstanding Program Award Mr. Reimer and Dr. Ives presented a plaque to the Dental staff from the North Carolina Association of County Commissioners for winning the NCACC Outstanding County Program Award for its Smart Start Dental Program. A Resolution that was adopted by the Board at the August Board of Health meeting, was also presented to the Dental staff. Dental staff present to receive the plaque and resolution were: Dr. Eugene Sandler, Dental Director; Angela Cooke, Dental Coordinator; Wendy Hill, NC Dental Hygienist. Also recognized, but not present was Shannon Mitchell, Dental School Hygiene Coordinator. Board members thanked and praised the Dental staff for their outstanding work. 5. SMOKING CONTROL RULES - Geoffrey Gledhill , County Attorney Mr. Gledhill updated the Board on the status of legal action regarding smoking control rules in North Carolina. A memorandum from Mr. Gledhill was distributed to the Board. Mr. Gledhill does not think it would be prudent for Orange County or the Orange County Board of Health to initiate enforcement actions while the questions of the authority of boards of health to adopt smoking control rules is pending before the North Carolina appellate courts. Once the authority question is favorably resolved, the County and Health Department will be in a strong position to move ahead with whatever BOARD OF HEALTH 2 SEPTEMBER 26, 1996 enforcement tools the Board is comfortable with. Pending final resolution of the authority question, Mr. Gledhill sees no reason why site visits can’t occur, particularly those related to establishing smoke free areas in qualifying restaurants. 6. ANIMAL CONTROL REPORT - John Sauls 6.1 Proposed Changes in Animal Control Ordinance Mr. Sauls reviewed the proposed changes in the Animal Control Ordinance that were developed in consultation with the Animal Control Director, the Animal Shelter Director and the Director of the Animal Protection Society. Also, on hand were Pat Sanford, APS Director and Cynthia Wise, APS Board member. Dr. Cammarata motioned to endorse the changes in the Animal Control Ordinance and recommend them to the Orange County Board of Commissioners. The motion was seconded by Dr. Adler and was unanimously approved. Rabies Announcement Mr. Reimer announced that on the evening of September 24, 1996, the State Public Health Laboratory confirmed (2) two additional cases of rabies from Orange County. Both cases were found in raccoons from the northern portion of the county. This bring the county’s total number of cases to (4) four. In each incident, the family’s pet dogs were involved in capturing or killing raccoons on the owner’s properties. There was no exposure to humans. Both dogs had been vaccinated against the rabies virus and were re-vaccinated following the exposure. 7. Personal Health Services Report - Eileen Kugler 7.1 Reduction in Maternal and Child Health Funds from DEHNR Ms. Kugler informed the Board that the Health Department has received notification of cuts in Federal funding which affects the family planning and maternal and child health programs. The cuts are in two categories: 1) North Carolina’s Title X funding for family planning. 2) Federal funding for the Social Services Block Grant for North Carolina was cut by 15%. In addition, federal funding for the Maternal and Child Health Block Grant was reduced by 1%. These cuts coupled with the reduction in Title X funds mentioned above result in reductions for local providers of maternal, child and family planning services of approximately $1.8 million. Orange County Health Department’s share of the cut is $28,910. Mr. Reimer has met with Marti Pryor-Cooke, DSS Director and Jerry Passmore, Aging Director earlier this week to discuss the possibility of using local funding previously allocated in the current year’s budget for the Home Health Agency. Upon not getting support from these groups, Mr. Reimer withdrew the recommended action. Mr. Reimer handed out a Revenue Summary from the previous year and summarized the revenue that was generated in excess of budgeted outcomes. Rather than cutting services at this time, the Health Director recommended that the Board of Health request that the Federal cuts be restored using local funding of Medicaid revenue from the previous year in excess of what was budgeted. Ms. Chavious motioned that the Board of Health requests to the County Manager that the Federal cuts be restored by using local funding of Medicaid revenue from the previous year in excess of what was budgeted. The motion was seconded by Dr. Klein and was unanimously approved. 8.1 HEALTH DIRECTOR’S REPORT - Daniel B. Reimer 8.1 Report of Activities Mr. Reimer reviewed the report that had been distributed with the Board packet. He also amplified the report on Hurricane Fran. Mr. Reimer reported that the Multi-Hazard Plan developed by Department Heads does have a debriefing. There are several phases to the plan: the immediate response, damage assessment and the recovery period. Once the recovery period is over, there is a debriefing of all the people involved to see what lessons are learned and what things can be set in place to improve the response for the next time. Nothing this widespread has occurred or been anticipated. Dr. Gordon questioned who was in charge of getting out water to people during the hurricane and whether there is a systematic plan for making water available in future disasters. The Health Director informed the board that both Nick Waters, EMS Director, and Bob Lockwood, Red Cross Director, were seeking “water buffalo”, steel tanks that could have provided water during the storm, but they were slow in coming. They will be looking at how this can be lined up in advance BOARD OF HEALTH 3 SEPTEMBER 26, 1996 more readily than happened this time. Dr. Gordon voiced concerns regarding the abundance of chainsaw accidents and recommended having more post-disaster and safety education training. Dr. Klein recommended including the Health Director’s Activities in whatever packet is given to the Board in regards to what is being done outside his regular evaluation duties. 8.2 Healthy Carolinians Task Force Report Mr. Reimer reported the results of the Healthy Carolinians Task Force meeting that took place on September 16, 1996. He reviewed materials and overheads that were distributed with the Board packets. He also provided a summary handout. The task force next step plans involve: 1. Task force members digesting the data and seeking input from others; 2. The task force will meet in October to engage in a discussion followed by a electronic priority-setting process; 3. Adopt at least two priority problems, analyze the factors contributing to the problems, and establish measurable objectives; 4. Establish working groups to prepare action plans. These recommendations will be formulated into a final report that will come back to the Board of Health for approval and then will be passed onto the Commissioners for their Goals Setting Retreat in December. If the task force agrees to continue working as a Healthy Carolinians project, a plan will have to be developed for ongoing structure, support and staffing as well as funding for the action plans. Several Board members reported they did not receive the reports in the mail. Mr. Reimer will see that they are sent out. Mr. Reimer reviewed the Human Services Consumer Involvement Goal that is part of the Board of Commissioners Goal packet. The Manager has asked each Department Head to update the goal for a status report to the Commissioners in October. Board members were asked to review the revised time table and plan of action, and approve it for submission to the Commissioners. Dr. Klein motioned to approve the Human Services Consumer Involvement Goal as written and forward it to the Commissioners. The motioned was seconded by Dr. Southerland and was passed unanimously. 9. HSAC ANNUAL FORUM 9.0 Human Services Advisory Commission (HSAC) Annual Forum Report Mr. Reimer reported that the HSAC Forum for 1996 focused on outcome and performance measures. Jack Vogt, a Assistant Director from the Institute of Government, presented a very effective overview of the subject and reported work that he is doing with other counties and cities in North Carolina. A panel of funders spoke about the importance of these concepts in their fields and a panel of agency heads reported on their efforts to develop objectives and performance measures locally. The Health Director invited the Division Directors to attend the Forum and also arranged for the Institute of Government to provide a half-day supplemental training to the Division Directors and Supervisors of the Health Department on outcomes measures and performance indicators. If Board members have any additional comments or concerns please get back to the Health Director or Dr. Foster, the HSAC representative on the Board. 10. BOARD OF HEALTH GOALS 10.1 Board/Staff Relations - Cleon Currie, Committee Chairperson Mr. Currie reported that the committee was at a stand still. They had hoped to hoped to meet with the Employee Committee prior to the Board of Health meeting, but was unable to do so. The committee is now in the formation stages but will meet with the committee after they get more organized. Mr. Reimer reviewed a memorandum regarding Division Director responses to Board of Health Goals. The Division Director’s expressed their appreciation for the Board desire to have their input. They expressed their willingness to meet with the committee intending to get to know staff, their jobs and concerns, in order to come together around common interest. The Division Directors had a mixed reaction to the draft memorandum to All Health Department Staff from the Board of Health. Some felt there would be no problem or harm to come from it while others felt it was a duplication of what the Employee Committee is doing and could cause confusion among staff. Still others felt that the unannounced visits could be BOARD OF HEALTH 4 SEPTEMBER 26, 1996 a problem if busy staff felt pulled in two directions. One felt that the suggestion box was more appropriate to use with clients than it was with staff. Mr. Reimer has spoken with a representative on the Employee Committee Representative and informed her of the Board’s interest in meeting with them. This meeting will take place as soon as the Employee Committee is more organized. Dr. Ives questioned whether Board members were staying active in their assigned liaison committee groups. This is an area where Board members could participate more with either individuals or the heads of their assigned areas. The Board will seek comments from the Division Directors and discuss the option further at the next meeting. 10.2 Board Organization - Dr. Beverly Foster, Committee Chairperson Dr. Klein reported that the document created by this committee was distributed at the last Board meeting for Board members to review and to the Division Directors for their input at this meeting. Mr. Reimer summarized the discussion of the Division Directors with the following points: 1. The Division Directors support the goals and can commit to them because they are basic public health goals. 2. The Board could use these goals to assure that the staff are operating programs that address these goals. 3. The structure of goals could be used as a format for our reports. 4. The goals could be used as a basis for setting priorities, much as the Board of Commissioners does. 5. The goals could be used to screen new proposals to assure that they are goal directed. 6. When combined with the mission statement, the goals could form an effective foundation for a strategic planning process. 7. The Division Directors observed that there is a certain amount of overlap in that certain community diagnosis statements are repeated in more than one goal. 8. If these goals are to be used to organize our plans and reports, the next stage in development would be to add outcome indicators that are measurable or observable. Mr. Reimer then summarized the feedback of the Division Directors regarding the committee structure. 1. It would be difficult for staff members to work with Board committees organized along the proposed structure because most of the programming is by division. 2. The committees would be more useful if they were developed along the lines of the divisions. 3. One new, interdisciplinary committee that would be useful because it would span several divisions would be a communicable disease committee. This could include animal control and environmental health representatives as well as personal health. 4. Another useful, new committee would be one to focus on long range or strategic planning, using a process similar to the retreat which involved Division Directors and supervisors. Questions were raised about the focus of the goal. Should the goal direct the work of the Board, the staff, or the direction of the whole department? What are the relative responsibilities of the Board and staff to accomplish the goals? It was suggested, as a practical matter, that there not be more than four committees because of the number of Board members to serve, and that the division of labor by divisions within the department could create discreet entities. It was recommended that the Board committee meet with the Division Directors to come up with a joint proposal for how the Board goals could be used and how the Board could be effectively organized to help meet those goals. It was also suggested that the Division Directors insert into the goal statement other activities currently undertaken that address the goals. 10.3 Evaluation of Health Director- Dr. Timothy Ives Dr. Ives asked the Director to review the changes in the draft evaluation process for the Health Director dated September 20, 1996. Mr. Reimer highlighted changes in items 2, 3, 8, 9, and 10. Concerns were expressed about number 2, BOARD OF HEALTH 5 SEPTEMBER 26, 1996 “Information and sources will be shared with the Health Director.” Dr. Gordon questioned whether this item had been approved by the Board. Mr. Reimer distributed a proposed instrument to be used for evaluation of the director’s performance, as mentioned in Item #7. This instrument was modified from the document used last year. It was updated to incorporate the work objectives previously approved by the Board for the period April 1996 - November 1996. The discussion highlighted differences of opinions among Board members whether the category “Unable to Rate” should be removed in favor of a column for, “Score.” Finally, there was discussion about the “binary” nature of some of the objectives which do not lend themselves to a five point scale. While no formal action was taken, it was agreed that this item would be discussed at the beginning of the next meeting. The Chair pointed out that this evaluation is based on a workplan that was approved for the period April - November of 1996. This workplan would not be a good model for future years. He referred to the model of the City Manager Workplan provided by Dr. Margaret Carlson several months ago, and recommended that the Board members study that model for discussion at the next meeting. Finally, the Health Director distributed the Orange County Board of Health Schedule of Agenda Items for 1996 and pointed out that the agenda for the October meeting was light enough to accommodate an extended discussion about the Board goals. 11. Board Member Concerns Due to the late time, this item was forwarded to the next meeting. 12. ADJOURN With no further business, a motion was made by Dr. Gordon and seconded by Dr. Cammarata to adjourn the meeting. The motion carried unanimously. The next regular Board of Health meeting will be October 24, 1996, at 7:30 p.m. in the Planning/Agriculture Building Conference Room in Hillsborough. Respectfully submitted, Daniel B. Reimer, MPH Health Director