HomeMy WebLinkAboutBOH agenda 102517ORANGE COUNTY BOARD OF HEALTH
MEETING AGENDA
DATE: October 25, 2017
TIME: 7:00 P.M.
PLACE: Whitted Building, 3rd Floor Meeting Rooms
300 West Tryon Street
Hillsborough, NC 27278
TIME ITEM
7:00 p.m. I. Welcome New Employees
7:00 – 7:05 II. Public Comment for Items NOT on Printed Agenda
Public Comment for Items ON Printed Agenda will be
handled during that agenda item
(Please sign up for both on sheet near the entrance to room.)
Please limit your comments to 3 minutes.
7:05 – 7:10 III. Approval of October 25, 2017 Agenda
7:10 – 7:15 IV. Actions Items (Consent)
A. Minutes of September 20, 2017 Liska Lackey
7:15 – 7:45 V. Educational Sessions
A. Customer Satisfaction Survey John Kase/Carla Julian/
Pam McCall
B. 1st Quarter Financial Reports Rebecca Crawford
C. 1st Quarter Billing Dashboard Reports Rebecca Crawford
7:45 – 8:10 VI. Reports and Discussion with Possible Action
A. Budget Amendments Dorothy Cilenti
B. Elections (Chair and Vice-Chair) Liska Lackey
C. Health Director Report Dorothy Cilenti
D. Media Items Dorothy Cilenti
8:10 – 8:40 VII. Closed Session to Discuss Health Director Recruitment
Closed Session (ref. NCGS 143-318.11(a)6) to consider the qualifications, competence
performance, fitness, conditions of appointment, of an individual public officer or
employee, or prospective public officer or employee; or to hear or investigate a complaint,
charge, or grievance by or against an individual public officer or employee.
8:40 – 8:40 VIII. Adjourn to Open Session
8:40 – 8:45 IX. Board Comments
8:35 X. Adjournment
BOARD MEMBERS: To ensure a quorum, SEND E-MAIL to lstrange@orangecountync.gov advising her of
your attendance at this meeting OR CALL 919-245-2411.
Compliance with the “Americans with Disabilities Act” and Title VI - Interpreter services and/or special sound equipment
are available on request. Call the Immigrant and Refugee Health Program Manager at 919.245.2387 to request an interpreter
or other accommodation.
Conforme a la “Ley sobre Estadounidenses con Discapacidades” (ADA) y el Título VI – los servicios de intérprete y/o
equipo de sonido especial están disponibles a solicitud. Llame a la Administradora del Programa de Salud para Inmigrantes
y Refugiados al 919-245-2387 para solicitar un intérprete u otros arreglos o adaptaciones.
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ORANGE COUNTY BOARD OF HEALTH
September 20, 2017
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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 September 20, 2017, at the Orange
County Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Liska Lackey – Chair, Susan Elmore – Co-Chair;
Johanna Birchmayer, Commissioner Mia Burroughs, Barbara Chavious, Paul Chelminski,
Jessica Frega, Sam Lasris and Timothy Smith.
BOARD OF HEALTH MEMBERS ABSENT: Bruce Baldwin and Jennifer Deyo.
STAFF PRESENT: Dr. Dorothy Cilenti, Interim Health Director; Coby Jansen Austin, Programs
and Policy Director; Alan Clapp, Environmental Health Director; Rebecca Crawford, Financial
and Administrative Services Director; Dr. Stephanie George, Dentist; Renee Kemski, Nutrition
Program Manager; Pam McCall, Personal Health Services Director; Kristin Prelipp,
Communications Manager; Ashley Mercer Rawlinson, Healthy Carolinians Coordinator; Kiana
Redd, Healthy Communities Healthy Homes Coordinator; Ana Salas, Dental Assistant; Beverly
Scurry, Board of Health Strategic Plan Manager; and La Toya Strange, Administrative Assistant
II.
GUESTS PRESENT: Chuck Rohre, Springsted Waters, Natalie Santos, UNC Student, Analisa
Sowells, UNC Student.
I. Welcome New Employees
There were no new employees in attendance.
II. Public Comment for Items NOT on Printed Agenda: None
III. Approval of the September 20, 2017 Agenda
Motion was made by Mia Burroughs to approve the agenda, seconded by Johanna
Birckmayer and carried without dissent.
IV. Action Items (Consent)
A. Minutes of August 23, 2017 Meeting
Motion was made by Sam Lasris to approve the minutes of August 2017 with the edit of
removing Paul Chelminski as present and placing him as absent. Motion was carried
without dissent.
V. Educational Sessions
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September 20, 2017
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A. HCOC Update
Ashley Mercer Rawlinson, Healthy Carolinians Coordinator, gave an update on the current and
future activities of the HCOC committees regarding tackling goals that were identified in the
2016-2019 Community Action Plans. Below are some highlights.
Access
By March 2019, the Access committee will produce a transportatoin access
improvement activitiy guide and recruit 5 partner agencies to adopt one or more
activities listed within the guide.
• Transportation Survey
A survey was sent to service providers to get input on the barriers that their
clients/populations are experiencing when it comes to transportation. There
were 25 survey responses collected from providers representing the Health
Dept. PHS, Community Health Centers, UNC Healthcare, UNC Family
Medicine, etc.
Six questions were asked to get input on:
o The type of barriers,
o The type of transportation providers that service their
agency/organization,
o Whether or not their agency has staff that can connect clients to
transportation resources,
o What would they need to know or have on hand to help clients learn
about and use public transportation
o Would they be willing to identify 1-2 transportation champions within their
agencies?
• Transporation Barriers
The barriers that appeared the most were 1) bus stop not within walking
distance, 2) routes not going where people need them, 3) not knowing how to
use the transit system, and 4) cost.
When asked what would you need to know or have on hand, to help your
clients learn about and use public transportation, the highest response
related to information related to local bus service providers. This information
was used to help make the decision to host a Try Transit Week and Transit
Academy. Try Transit Week is October 23rd – 28th. The Try Transit Academy
events will be held at UNC Hospital, Hillsborough Campus on October 10th
and the Seymour Center on October 13th.
Mental Health & Substance Abuse
By March 2019, create a suicide prevention campaign to encourage residents to
access 911, the Suicide Prevention Lifeline, and Cardinal Access line as sources of
intervention, treatment and referral.
• Suicide in Orange County
o #BeThe1To:
This campaign highlights the fact that everyone has a role to play in
suicide prevention.
The campaign is partnering with local radio station K97.5 and with
Chapel Hill Transit.
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September 20, 2017
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The 5 components of the campaign are to:
• Ask
• Keep them safe
• Be There
• Help them connect
• Follow up
September is Suicide Prevention Month. A kickoff event was held on
September 7th to share the importance of suicide awareness and
prevention, and allow participants to hear from those with a personal
connection to suicide. Guests included Jaki Shelton Green and Dean
Smith’s widow, Linnea Smith.
Physical Activity & Nutrition
By March 2019, the PAN committee will increase knowledge and influence behavior
change related to eating smart and moving more by encouraging 10 agency partners
to promote a county-wide consistent messaging campaign that will distribute
messages through a variety of established channels and media, over 6-months.
o There will be 6 messages shared over a 6 month period from October to
March via our campaign participants. They are, respectively, Move More,
Fruits and Veggies, Prepare More Meals at Home, Screen Time, Re-Think
Your Drink and Right Size Your Portions.
o Consistent Messaging Campaign Participants include OC Department on
Aging, CHCCS, OCS, Carrboro Rec & Parks, Kidzu, UNC Healthcare, No Kid
Hungry and OC Head Start/Early Head Start.
B. Employee Wellness-Nutrition Services
Renee Kemske, Nutrition Program Manager, provided an overview of nutrition services and the
new employee wellness nutrition initiatives. Below are some highlights.
Services provided include:
• Nutritional Counseling
Medical Nutrition Therapy (MNT) – provided by a Registered Dietitian who works
with the referring medical provider to improve conditions such as diabetes, heart
disease and obesity by conducting a thorough review of the individual’s medical
history, diet, labs, medications and lifestyle patterns to develop a personalized
nutrition treatment plan/goals to improve health outcomes. It’s evidence-based and
proven to work. Half of the participants’ counseled are referred by their physician.
• Diabetes Self-Management Education Program (DSME)
Patients receive 10 hours of education that include an initial health assessment, 2
four-hours group education classes on basic diabetes care and a follow-up (1 hour
group class) appointment 3 months after the group class. There is an 80% decrease
in A1C blood sugar amongst participants.
There is a sliding scale available and both services are available to Orange County employees.
Ms. Kemske also provided information on the wellness nutrition services. In November 2016,
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ORANGE COUNTY BOARD OF HEALTH
September 20, 2017
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the County Manager approved the proposal to allocate wellness funds ($10,000) to support one
of the Health Department’s registered dietitians’ salaries to provide Nutrition Counseling and
Diabetes Self-Management Education services that are not covered by the County Health Plan.
The County Health Plan only covers nutrition services for people with diabetes, obesity,
hypertension and/or abnormal lipids. The purpose of these funds is to increase access to these
preventive services to keep employees well and to reduce health care costs due to uncontrolled
illness.
FY16-17 Service Data
29 Individual MNT Appointments
45 Group MNT Classes
2 DSME Appointments
FY17-18 Service Data
24 Individual MNT Appointments
8 Group MNT Class
3 DSME Appointment
Next steps include:
Coordinating outreach efforts with HR Wellness Initiatives
o Offering quarterly group MNT appointments
o Continuing individual appointments
o Disseminating promotional emails
o Continuing new employee orientation
Showing the need for continued use of funds as county funds may not be available
C. STOP Act
Dr. Stephanie George, Dentist, provided an update on the Act, which was signed in June,
whose purpose is to decrease the circulation and misuse of opioids in NC, which in turn will
reduce the overall mortality and morbidity from these drugs in this state. The Strengthen Opioid
Misuse Prevention (STOP) Act of 2017, or STOP Act, was intended to reduce the supply of
unused and misused opioids circulating in NC, reduce doctor shopping and improve care by
requiring prescribers to use tools/resources that help prevent inappropriate prescribing. Dr.
George’s presentation summarized the implications of the S.T.O.P. Act on the OCHD Dental
Clinic as well as outlined steps currently taken to reduce opioid dependence and its implications
for the clinic’s patients. Highlights include:
• The Act targets Schedule II and Schedule III opioids.
• Three people die per day in NC from opioid overdose.
• Over 1200 unintentional opioid deaths occurred in 2016.
• Effective September 1, 2017, pharmacists must input controlled substance prescriptions
into the North Carolina Controlled Substances Reporting System (NCCSRS) by the
close of business day. Previously, they had 3 days to do so.
• The NCCSRS database is real time and is updated immediately. Providers can check to
see if a prescription has been issued for a patient prior to writing a prescription.
• Pharmacist can also call provider if they feel a prescription may be fraudulent or if a
patient is misusing opioid.
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ORANGE COUNTY BOARD OF HEALTH
September 20, 2017
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• Effective January 1, 2018, there is a limit on first-time prescriptions for acute pain to no
more than 5 days. Surgical procedures are limited to 7 days. Subsequent consultations
for same pain, can renew, refill, or issue new prescription of a controlled substance.
• Effective January 1, 2020, there will be electronic prescribing of targeted controlled
substances. They will be integrated with the NCCSRS database.
• OCHD Dental Clinic procedures include:
o Checking the NCCSRS before prescribing any opioid prescription.
o The baseline drug given is ibuprofen 800mg
o Opioid prescription is prescribed only if 1) the patient cannot take ibuprofen for
medical reasons; 2) multiple teeth were extracted; and 3) surgical extraction of
teeth with bone removal, requiring extensive healing.
o No more than 15 tabs per procedure.
o No refills within 30 days.
o Flag/monitor patients who may be drug seekers.
The BOH had questions that were addressed by Dr. George.
D. Men’s Primary Care Update
Pam McCall, Personal Health Services Director, began by stating that the program which began
as a pilot program in February 2016 to refer male Orange County residents to Family Centered
Healthcare. The program was designed to provide low-income males, specifically those from
northern Orange County, with access to low-cost primary care. Ms. McCall gave a brief update
on its progress. Highlights include:
• There were 53 men referred between 7/1/16 and 7/30/17. There were 55% that kept
their appointments.
• There were 42 unique patient (unique patient is equivalent to 1 patient) visits in FY 16-17
in which 30% were referred in FY 15-16.
• Most of the patients hear about the program by calling when looking for healthcare
needs. The 2nd most popular method of contact was when a family member called on
their behalf.
• The total amount expended by OCHD is $13,347. The OCHD doesn’t pay for specialist
care. Patients needing these services can apply for charity care through UNC. The
average amount expended by OCHD per patient is $318. The amount was $253 in FY
15-16. The average amount expended by the patient is $28. In FY 15-16, it was $47.
More than half (64%) of patients paid nothing as they slid to 0% on the sliding scale.
• The months with the largest number of visits to Family Centered Healthcare were July,
September, October and March.
• The most frequent diagnoses were primary hypertension, major depressive disorder,
obesity and type 2 diabetes without complications.
• Transportation has been an issue; however, the HCOC, as well as other agencies, is
working on this issue.
• There isn’t enough information as of yet to spot trends; although, the OCHD feels that
this is a successful program and an effective way to treat this population.
The BOH had questions that were addressed by Ms. McCall.
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ORANGE COUNTY BOARD OF HEALTH
September 20, 2017
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VII. Reports and Discussion with Possible Action
A. Health Director Report
In addition to her report, Dr. Cilenti mentioned that this is Alan Clapp’s last BOH meeting as he
is retiring at the end of this month. She thanked him for all of his work as the Environmental
Health Director. Mr. Clapp said that he felt honored and thanked everyone for their support.
John Kase will serve as the interim Environmental Health director effective October 2nd . Dr.
Cilenti also mentioned an article found by Commissioner Mia Burroughs that was distributed to
the BOH members that adds to the information that the BOH has previously received in the past
regarding the harmful effects of vaping.
Coby Jansen Austin gave a brief description of the Department of Social Services (DSS)
process for obtaining child care subsidies while highlighting the struggles/barriers faced by
families needing to obtain those subsidies. She then stated that the DSS board allocated
resources to cover the full fee for all of the OCHD FSA families while requesting documentation
of their income only.
B. Media Items
Media items were in the packet which focused on Orange County’s events and our
involvement in various efforts.
At 8:00pm, Mia Burroughs motioned to move into closed session and Barbara Chavious
seconded.
VIII. Closed Session to Discuss Health Director Recruitment
During the closed session, the Board of Health discussed the recruitment process with
Mr. Rohre.
IX. Adjourn to Open Session
Barbara Chavious motioned to move from closed to open session and Jessica Frega
seconded.
X. Board Comments.
None.
XI. Adjournment
Mia Burroughs moved to adjourn the meeting at 9:00pm and Barbara Chavious
seconded.
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ORANGE COUNTY BOARD OF HEALTH
September 20, 2017
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The next Board of Health Meeting will be held October 25, 2017 at the Orange County
Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m.
Respectfully submitted,
Dorothy Cilenti, MSW, MPH, DrPH
Orange County Interim Health Director
Secretary to the Board
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: October 25, 2017
Agenda Item Subject: Customer Satisfaction Survey 2017
Attachment(s): Personal Health, Dental, and Environmental Health Client Input
Surveys 2017
Staff or Board Member Reporting: Pam McCall, PHSD Director; John Kase, EH
Interim Director; Carla Julian, Dental Clinic Manager
Purpose: ____ Action
_ _X Information only
____ Information with possible action
Summary Information:
Per Board of Health Policy and Accreditation standards, each year the Board of Health
will receive from the staff of the Health Department the results of patient and client input
on services received, including any corrective actions deemed necessary to improve
services.
Personal Health:
The majority of the measures in the last Personal Health client input surveys show
continued high levels of satisfaction with staff and services. The survey asks clients to
agree or disagree to 14 statements regarding location, hours, ease of contact, and
treatment by staff and overall satisfaction with the services. In many cases no response
was recorded and that contributed to less than 100% agreement on the statement. The
survey asks for the client’s opinion on how services can be improved. Client comments
are predominantly positive with a few requests for additional clinic hours.
Dental Health:
The Dental Health Services patient satisfaction survey in September 2017 reflects
patient satisfaction with staff friendliness, dental provider listening skills and
explanations of care. Survey results also reveal 95% trust in OCHD’s dental providers.
Dissatisfaction with wait time for prophylactic hygiene appointments is the number one
complaint per patient comments on surveys and verbally when attempting to schedule
new and existing patients.
Environmental Health:
Environmental Health has used the same 18 question survey tool since 2007. The
questions have not changed in order to compare the most recent survey comments to
our historical data. Hopefully, this will allow us to monitor trends and target areas in
which improvements or corrections to the program can be implemented. The survey
questions and comments are collected using Survey Monkey software package. The
survey data collection period runs from September to September. The survey is
delivered to clients via all email correspondence.
The survey has 4 questions that allow for free form comments. Two questions allow
comments on services. Two questions allow for comments on staff. The other 14
questions are check box type questions. Predominantly, the feedback received on the
September 2016 to September 2017 period was very positive. Environmental Health
management team reviews the comments and results and the results are shared with
the entire Environmental Health staff during a monthly staff meeting.
Recommended Action: ___Approve
___Approve & forward to BOCC for action
___Approve & forward to ___________________________
_X_Accept as information
___Revise & schedule for future action
___Other (detail):
Customer Satisfaction Survey Results October 25, 2017
Personal Health Services
Surveys
•Paper surveys collected mid-December to mid-January
•Surveys available in English and Spanish
•114 surveys collected at SHSC
•309 surveys collected at WHSC
•Response to interpreter questions: WHSC-37, SHSC-63
•Not all respondents answered all questions
Results
% AGREE WHSC
N=309
SHSC
N=114
Convenient Location 99%
4 disagree
99%
1 no response
Convenient Hours 95%
9 disagree
5 no response
100%
Easy to Contact Clinic 98%
5 disagree
2 no response
96%
4 disagree
1 no response
Easy to Make Appointment 97%
5 disagree
5 no response
100%
Waited more than 15 minutes past
appointment time 25%
196 disagree
35 no response
42%
67 disagree
9 no response
Results
% Agree WHSC
N=309
SHSC
N=114
Staff Explained My Care 96%
11 no response
98%
2 no response
Staff treated me with respect 97%
1 disagree
9 no response
98%
2 no response
Staff listened to me 95%
2 disagree
14 no response
98%
2 no response
Understood staff explanations 96%
11 no response
98%
2 no response
Overall satisfaction 91%
2 disagree
25 no response
96%
4 no response
Would recommend to family and
friends 94%
2 disagree
16 no response
96%
1 disagree
3 no response
Results
% Agree WHSC
N=63
SHSC
N=37
Interpreter was professional 95%
3 no response
95%
2 no response
Interpreter clearly interpreted for staff 98%
1 no response
100%
Interpreter clearly interpreted for me 98%
1 no response
100%
Positive Feedback
•Everything is good *
•Everyone is very friendly and courteous
•Great Service!*
•Excellent job*
•Very professional care*
•My family and I have depended on you guys for years and
have received excellent care when we bother to ask for it.
Thank you! We got here late and your receptionist found a
way to let us be seen. We appreciate you tremendously.
•Everything is going well here: nurses, front desk staff and any
residents are always respectful and thorough.
*Repeated multiple times
Constructive Feedback
•Have more options for mental health. A psychologist would be
more beneficial than a social worker
•Faster service and results.
•Be a little more timely
•Walk -ins
•The clinic needs later hours at least 3 days a week.
•Need more staff to reduce wait time
•Had to wait too long for an appointment
•Weekend urgent care hours
•Be available more days
Plan
•Continue to refine clinic flow to reduce wait times
•Discuss adding clinic hours on Friday afternoon
•Offer electronic surveys in addition to paper surveys
•Continue to investigate approaches for continuous
patient feedback data (text surveys)
•Provide additional suggestion boxes in exam rooms
FY2016-2017
Environmental Health
Summary of Customer Service Feedback
John Kase
Interim Environmental Health Director
Survey Overview
•EH has used the same feedback tool since 2007.
•Survey Monkey software used as the collection tool.
•Client responses collected from September through
September (12 month period).
•Surveys are distributed via email correspondence
with clients and link posted on EH Division home
page.
•Survey consists of 18 total questions.
•2 questions allow for free form comment on services.
•2 questions provide opportunity for staff recognition.
Survey Limitations
•Emails sent via Papervision tool
•Limited correspondence with FLI operators via email
•Difficult to analyze historical data
•Anonymity?
Responses: General Feedback
Food, Lodging and Institution Metrics
Source: CDP 10/20/17
Food, Lodging and Institutions Feedback
Well and OSWW ACTIVITY METRICS
Well and OSWW Permitting Feedback
Questions?
John Kase
jkase@orangecountync.gov
919-245-2374
www.OrangeCountyNC.gov/Health
FY2016-2017
Environmental Health
Summary of Customer Service Feedback
John Kase
Interim Environmental Health Director
Survey Facts
•EH has used the same feedback tool since 2007.
•Survey Monkey software used as the collection tool.
•Client responses collected from September through
September (12 month period).
•Surveys are distributed via email correspondence
with clients and link posted on EH Division home
page.
•Survey consists of 18 total questions.
•2 questions allow for free form comment on services.
•2 questions provide opportunity for staff recognition.
Survey Limitations
•Emails sent via Papervision tool
•Limited correspondence with FLI operators via email
•Difficult to analyze historical data
Heading. Heading. Heading.
Content
Questions?
Presenter Name
Email address
Phone number
www.OrangeCountyNC.gov/Health
Dental Health Services Patient Satisfaction Surveys September 2017
Dental Health Satisfaction Surveys
Dental began using Solutionreach patient management software in July 2017
Appointment reminders
Satisfaction surveys
Surveys built into program and sent automatically after patient’s appointment
Survey Results (61 Respondents)
Key Positive Responses
100% rated staff friendliness and courteousness as good, very good, or excellent
95% rated their trust in the providers as very good or excellent
95% rated the providers listening and explanation of condition as very good or excellent
93% rated amount of time providers spent with them as very good or excellent
Key Areas for Improvement
11% rated the ability to make an appointment as fair or poor
Appointment availability continues to be the #1 complaint for adults seeking dental care (especially dental cleanings)
Currently 2 hygienists and 9 month waiting period for dental hygiene appointment
Dental Health Improvement Plan
Wait time for prophylactic hygiene appointment
Demand > Capacity
Added UNC Dental School hygiene students on Tuesdays and Thursdays
Allows rescheduling of patients on the wait list to sooner appointments but does not affect overall wait time
For cancellations, begin using Solutionreach to send text and email message to all patients waiting for hygiene appointments
Request 3rd hygienist position
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: October 25, 2017
Agenda Item Subject: 1st Quarter Financial Report FY 17-18
Attachment(s): 1st Quarter Financial Report
1st Quarter Billing Dashboard
Staff or Board Member Reporting: Rebecca Crawford
Purpose: ___ Action
_X_ Information only
___ Information with possible action
Summary Information:
Total Health Department Revenue: Average YTD monthly revenue in FY18 after the
first quarter is $208/month or $624k YTD, representing 18.7% of our overall budgeted
revenue for the year. The total first quarter revenue is slightly skewed down due to the
majority of state funds not eligible to be drawn in July (this is typical) and allocations of
Medicaid Max funds are not transferred into our budget until the end of the fiscal year.
Expenses are slightly higher than revenues at 19.1% of the total, overall budget.
Total Billing Accuracy: Continuing with the goal of 90% billing accuracy set in FY 14-
15, the average billing accuracy rate for medical after the first quarter is 88% as
compared to 95% in FY 16-17 and the average rate for dental for first quarter FY 17-18
is 98% as compared to 104% in FY 16-17.
Dental Earned Revenue by Source: The FY 17-18 average monthly revenue
($42.9k/month) for the first quarter is very close to our budget projection ($43.4k/month)
and above our FY 16-17 average of $39.8k/month and is tied to our new, automated
patient reminder system, which has decreased the no show rate in the dental clinic from
an average of 19% in FY 16-17 to an average of 15% so far in FY 17-18. FY 17-18
dental earned revenue totaled $129k at the end of the first quarter.
Medical Earned Revenue by Source: Medical earned revenue is currently below the
budgeted projection for FY 17-18 ($58k/month) at $48.2k/month since we have a
provider on maternity leave. Medical clinic revenue totals $145k for first quarter FY 17-
18.
Recommended Action: ___Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to ____________________
_X_Accept as information
___Revise & schedule for future action
___Other (detail):
Orange County Health Department
First Quarter Financial Report
FY 2017-2018
TOTAL HEALTH Q1 YTD ACTUAL
ANNUAL
BUDGET
% OF ANNUAL
BUDGET
Revenue
Donations
Finance and Admin Services (74)(74)0 0.00%
Health Promotion & Edu (1,586)(1,586)(13,886)11.42%
Personal Health (338)(338)(18,000)1.88%
Donations Total (1,997)(1,997)(31,886)6.26%
Internal Allocations
Finance and Admin Services 0 0 (37,144)0.00%
Dental Health 0 0 (18,000)0.00%
Health Promotion & Edu 0 0 (244,756)0.00%
Personal Health 0 0 (30,000)0.00%
Internal Allocations Total 0 0 (329,900)0.00%
Service Revenue
Dental Health (128,630)(128,630)(520,734)24.70%
Environmental Health (153,239)(153,239)(576,100)26.60%
Personal Health (144,611)(144,611)(686,261)21.07%
Service Revenue Total (426,480)(426,480)(1,783,095)23.92%
State Allocations
Finance and Admin Services (7,941)(7,941)(42,921)18.50%
Health Promotion & Edu (8,117)(8,117)(45,174)17.97%
Environmental Health (727)(727)(41,324)1.76%
Personal Health (87,841)(87,841)(539,687)16.28%
State Allocations Total (104,627)(104,627)(669,106)15.64%
Grants Project Revenues
Piedmont Hlth Srv - Nutr (3,420)(3,420)(33,800)10.12%
CC4C Accesscare (37,611)(37,611)(149,624)25.14%
PCM Accesscare (40,340)(40,340)(147,651)27.32%
FIT Grant (9,500)(9,500)(45,093)21.07%
MDPP 0 0 (17,300)0.00%
Community Health Grant 0 0 (122,065)0.00%
Grants Project Revenues Total (90,871)(90,871)(515,533)17.63%
Revenue Total (623,974)(623,974)(3,329,520)18.74%
Orange County Health Department
First Quarter Financial Report
FY 2017-2018
TOTAL HEALTH Q1 YTD ACTUAL ANNUAL BUDGET
% OF ANNUAL
BUDGET
Expenditures
Salaries 1,163,414 1,163,414 5,708,524 20.38%
Benefits 460,759 460,759 2,051,832 22.46%
Travel 2,605 2,605 17,430 14.94%
Training 11,261 11,261 38,014 29.62%
Certifications & Licensing 2,860 2,860 11,276 25.36%
Mileage 4,905 4,905 30,593 16.03%
Telephone 17,106 17,106 86,084 19.87%
Postage 3,868 3,868 14,015 27.60%
Motor Pool 8,175 8,175 53,014 15.42%
Equip Repairs 855 855 11,546 7.40%
Equip Rent 603 603 1,200 50.25%
Duplicating 2,357 2,357 13,350 17.65%
Printing 1,891 1,891 11,668 16.21%
Advertising 5,637 5,637 12,463 45.23%
Dues 2,492 2,492 5,100 48.85%
Subscriptions 0 0 1,500 0.00%
Dept Supplies 4,517 4,517 46,511 9.71%
Edu Supplies 166 166 16,782 0.99%
Office Supplies 4,155 4,155 29,960 13.87%
Medical Supplies 19,297 19,297 134,719 14.32%
Bloodborn Path Supplies 158 158 2,750 5.74%
Pharmacy Supplies 34,888 34,888 191,400 18.23%
Comp Supp/Software 1,137 1,137 7,444 15.27%
Contracted Srv 129,271 129,271 1,319,876 9.79%
X-Ray 4,732 4,732 24,625 19.22%
Lab Srv 34,725 34,725 118,840 29.22%
Bonds & Insurance 0 0 10,815 0.00%
Uniforms 2,788 2,788 8,514 32.75%
Community Proj 2,366 2,366 65,612 3.61%
Innovations Project 728 728 20,000 3.64%
Accreditation Project 2,750 2,750 2,750 100.00%
Credit Card Exp 2,088 2,088 6,000 34.81%
Capital Exp Under $500 484 484 4,500 10.76%
Nicotine Replacement Therapy 0 0 10,000 0.00%
Capital Expenditures
IT Equipment 3,910 3,910 11,172 35.00%
Expenditures Total 1,936,944 1,936,944 10,099,879 19.18%
Grand Total 1,936,944 1,936,944 10,099,879 19.18%
Net County 1,312,970 1,312,970 6,770,359
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Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: October 25, 2017
Agenda Item Subject: Budget Amendments
Attachment(s): Budget Amendment – BCCCP
Budget Amendment – Family Planning
Budget Amendment – MDPP
Staff or Board Member Reporting: Dorothy Cilenti
Purpose: ___ Action
__ _Information only
_X_Information with possible action
Summary Information:
The Health Department receives funding changes periodically throughout the fiscal
year, either through grant opportunities, donations, increased funding from state
sources, and decreased funding from state sources. The department is required to bring
changes to the overall budget appropriation to the Board of County Commissioners for
approval before they can be entered officially in the county’s financial system, Munis.
See below for recommended changes to the FY 17-18 Health Department Budget:
Budget Amendment – BCCCP (Breast and Cervical Cancer Control Program)
The Health Department has received notification of an increase in state BCCCP funds
of $5,610, which will be used for providing and increased number of breast and cervical
cancer x-rays for qualifying patients.
BCCCP Program FY 2017-2018
Original Budget
FY 2017-2018
Revised Budget
Difference
Revenues (State
Funds)
$9,690 $15,300 $5,610
Expenditures (X-Rays
increased)
$38,838 $44,448 $5,610
Budget Amendment – Family Planning Program
The Health Department has received notification of a decrease of $20,095 in funding for
the Family Planning program due to a federal decrease in Maternal and Child Health
funds. These funds would have been used for pharmacy supplies for the Family
Planning program. The Health Department will continue to provide the same level of
service within the Family Planning program and will offset this loss in funding by utilizing
savings from other programs, savings from General Fund funded expenses, and by
seeking additional revenue sources.
Family Planning
Program
FY 2017-2018
Original Budget
FY 2017-2018
Revised Budget
Difference
Revenues (Federal
funds passed through
the State)
$165,788 $145,693 -$20,095
Expenditures
(Pharmacy Supplies)
$85,000 $64,905 -$20,095
Budget Amendment – MDPP (Minority Diabetes Prevention Program)
This technical amendment reduces funding to the Minority Diabetes Prevention
Program by a net of $9,000. In the FY2017-18 Budget Ordinance Amendment #1,
revenues related to the Minority Diabetes Prevention Program were erroneously
increased by $12,050. The Department’s original budget already accounted for this
revenue, as the Department was notified in time to include in its original budget request.
Since the adoption of the FY2017-18 Budget and the approval of Budget Ordinance
Amendment #1, the Health Department has received notification of an additional $3,050
in Minority Diabetes Prevention Program grant revenues. This technical amendment
reverts the revision that was approved in Budget Ordinance Amendment #1 and
includes the addition of the $3,050 in new funding, which will be used to provide
additional training and supplies to members of the program.
MDPP Program FY 2017-2018
Original Budget
FY 2017-2018
Revised Budget
Difference
Revenues (State Funds
passed through
Alamance Co.)
$7,125 $10,175 $3,050
Expenditures (Salaries
and Fringe,
Departmental Supplies,
Travel, Training)
$7,125 $10,175 $3,050
Recommended Action: ___Approve
_X_Approve & forward to Board of Commissioners for action
___Approve & forward to ____________________
__Accept as information
___Revise & schedule for future action
___Other (detail):
Orange County Budget Amendment Fiscal Year 20____ - ____
Fund Function Department Project
From To
Revenue Increase or Revenue Decrease or
Account Code Account Description Expenditure Decrease Expenditure Increase
Total -$ -$
Explanation for Change
Department Approval Date
For Budget Office Use Only
Comments
Budget Office Approval Date
Chief Financial Officer Approval Date
Batch Number Courtesy Copies to
Effective Date
BOA #
Orange County Budget Amendment Fiscal Year 20____ - ____
Fund Function Department Project
From To
Revenue Increase or Revenue Decrease or
Account Code Account Description Expenditure Decrease Expenditure Increase
Total -$ -$
Explanation for Change
Department Approval Date
For Budget Office Use Only
Comments
Budget Office Approval Date
Chief Financial Officer Approval Date
Batch Number Courtesy Copies to
Effective Date
BOA #
Orange County Budget Amendment Fiscal Year 20____ - ____
Fund Function Department Project
From To
Revenue Increase or Revenue Decrease or
Account Code Account Description Expenditure Decrease Expenditure Increase
Total -$ -$
Explanation for Change
Department Approval Date
For Budget Office Use Only
Comments
Budget Office Approval Date
Chief Financial Officer Approval Date
Batch Number Courtesy Copies to
Effective Date
BOA #
Maternal and Child Health Block Grant (MCHBG) Concerns
In FY 2011-12, NC General Assembly (NCGA) began to carve out MCHBG money for specific programs.
• Since 2011, # of programs and amount of money set aside by the NCGA has increased to 39% of the entire
MCHBG in 2017.
• As a result, we will be out of compliance with the following Title V requirements (Sec. 505. [42 U.S.C. 705]
(a)(3)):
(A) at least 30 percent of such payment amounts for preventive and primary care services for
children, and
(B) at least 30 percent of such payment amounts for services for children with special health care
needs
• The total amount of MCHBG reduction needed for legislated reallocations for SFY17-18 is $3,256,458 and
this is the amount that will have to be cut from other programs. Total MCHBG available for SFY 17-18 is
$18,089,519 (a total funding availability reduction of >$500K from prior SFY) and there are no new resources
to fund legislated carve-outs.
Legislated carve-outs include $2.2M each year for at least 3 years for “Every Week Counts” research
project in 2 counties (Robeson and Columbus) to be done by UNC. From previous budget, it is
anticipated that much of this funding will go to UNC salaries and overhead. Even the researchers who
put together the proposal do not want a project like this to take away from critical maternal and child
health infrastructure and would defeat the purpose.
Local Health Departments will take a $2.2M reduction starting October 1, 2017
LHDs have experienced cumulative reductions, now to the point of damaging infrastructure to
provide safety net services and programs for pregnant women, infants/children and women.
Impacts LHDs ability to offer medical services as a safety net provider and evidence-based
programs for maternal and child health.
LHDs are critical, especially in rural areas with limited resources and health care access issues.
Majority of the remaining MCHBG reductions taken from Genetics contracts with medical centers
terminated following the approved budget.
7.65% 6.73%
11.70%
15.72%
23.06% 22.26%
38.73%
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
FY 11-12 FY 12-13 FY 13-14 FY 14-15 FY 15-16 FY 16-17 FY 17-18
Pe
r
c
e
n
t
o
f
t
o
t
a
l
p
l
a
n
Carveouts in Maternal and Child Health
Block Grant state plan
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: October 25, 2017
Agenda Item Subject: Elections (Chair and Vice-Chair)
Attachment(s):
Staff or Board Member Reporting: Liska Lackey
Purpose: ____ Action
____ Information only
_X__ Information with possible action
Summary Information:
Per the Board of Health Policies and Procedures, the Board shall elect a Chair and
Vice-Chair by majority vote each year at the last meeting of the calendar year. This
discussion’s purpose will include getting nominations for each position for a vote that
will take place at next month’s meeting.
Recommended Action: ___Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to ___________________________
___Accept as information
___Revise & schedule for future action
___Other (detail):
Health Director’s Report
October 25, 2017
• NC Onsite Water Protection Hall of Fame
On October 17, 2017 David Ward, Environmental Health Soil Scientist, was inducted into
the NC Onsite Water Protection Hall of Fame at the 33rd annual Onsite Water
Protection Conference in Raleigh. The North Carolina Onsite Water Protection Hall of
Fame was established by the NC Onsite Water Protection Conference Planning
Committee in 1995 to recognize superior contributions of individuals to the onsite field.
Nominees are selected for induction by the Conference Planning Committee who is
responsible for establishing qualifications for this award and recognizing these
individuals at the annual Onsite Conference. David came to OCHD from the Alamance
County Health Department in 2015 and he will be the 5th individual from Orange
County to receive this prestigious honor.
• Emerging Leaders Program
Nick Cordeiro, Communicable Diseases/Refugee Health nurse, has been accepted into
the Emerging Leaders program sponsored by the NC Public Health Association (NCPHA).
The NCPHA Emerging Leaders Program aims to provide emerging leaders in public
health with skills and knowledge to become more effective in their work by successfully
leading teams through change, communicating with diverse stakeholders, and
navigating the complexities of the public health and health care landscape. This year-
long program offers interactive sessions and applied learning and reflection to help
participants heighten self-awareness and strengthen relationships with others. Nick is a
valued contributor to the Personal Health Services team; he is always willing to learn
new things and has very positive relationships with clients and colleagues.
• Family Success Alliance
FSA is launching a new website (www.familysuccessalliance.org)! A “soft” launch was
initiated this month and our original website will be maintained for several weeks until
we fully transition.
FSA is also exploring the idea of convening a delegation to participate in PolicyLink’s
2018 Equity Summit (https://www.equity2018.org), on April 11-13 in Chicago. The
Summit touches on health and the social determinants of health including planning,
infrastructure, inclusive economy, equitable economic and community development,
financial security, housing, and education. The conference organizers encourage
attendees to participate in “delegations” - or peer groups working together to advance
equity, which can range in size from 10 to 100 people. By participating as a delegation,
we would create an opportunity to translate and apply our collective learnings to our
ongoing work. Delegates would be responsible for their own travel and registration
expenses. If Board members are interested in participating in the Summit as part of an
FSA-affiliated delegation, please let La Toya know.
FSA joined with United Way of the Greater Triangle to host volunteers from EY (formerly
Ernst and Young) on 10/6, providing a tour of zone 4, a panel presentation by FSA
navigators and partners, and support to create 12 “little libraries” that will be stocked
and installed in FSA zones.
• Healthy Carolinians Transit Academies
Healthy Carolinians’ Access Committee held two Transit Academies in October with 37
health and human services providers in attendance. The training was well received with
46% of participants reporting that the information presented will be valuable in helping
them connect colleagues and clients to local transportation options. Over 50% of
participants reported that they intend to share what they learned with others.
Speakers from OPT, Chapel Hill Transit, Go Triangle, DSS and Aging provided thorough
overviews of major routes, trip planning, transit apps, ADA/paratransit, non-medical
options, responding to LEP residents, and new routes coming to rural Orange County.
Aging’s Mobility Manager, Lisa Berley, helped several participants to practice their new
knowledge by completing ride-a longs involving at least 1 transfer.
• TB
A UNC undergraduate student who is a resident of Guilford County has been diagnosed
with active TB after routine testing. The patient started treatment with Guilford County
and will be on treatment and out of school for at least two weeks or until his sputum
smear is negative. The Health Department and Campus Health have identified 145
student contacts and six professors in the classes he attended. Forty-five skin tests were
administered on campus by health department staff on Monday, October 16th. Campus
Health administered six skin tests the following day and three other students went to
other providers to receive the skin test. All of the 54 students returned for skin test
readings. Second testing for the 45 students seen by the health department will be
completed on November 28th. A big shout out to the health department team of four
nurses, the Public Health Services Manager and the Preparedness Coordinator for
responding to this situation in a collaborative, timely manner.