Loading...
HomeMy WebLinkAboutBOH minutes 082218MINUTES-Final ORANGE COUNTY BOARD OF HEALTH August 22, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ August Page 1 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 August 22, 2018 at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC. BOARD OF HEALTH MEMBERS PRESENT: Susan Elmore – Chair, Timothy Smith –Vice- Chair, Keith Bagby, Bruce Baldwin, Commissioner Mia Burroughs, Barbara Chavious, Paul Chelminski, Jessica Frega and Liska Lackey. BOARD OF HEALTH MEMBERS ABSENT: Jennifer Deyo and Sam Lasris. STAFF PRESENT: Quintana Stewart, Health Director; Coby Jansen Austin, Director of Programs and Policy; Hannah Baldwin, Dental Hygienist; Lakaya Craig, Temporary FSA Zone Navigator; Rebecca Crawford, Financial and Administrative Services Director; Dominika Gazdzinska, Community Outreach Specialist; Victoria Hudson, Interim Environmental Health Director; Donna King, Health Promotion & Education Services Director; Kimberly Powell, Advance Practice Practitioner; Kristin Prelipp, Communications Manager; Juliet Sheridan, Health Informatics Manager; Beverly Scurry, BOH Strategic Plan Manager;and La Toya Strange, Administrative Assistant II. GUESTS PRESENT: None. I. Welcome New Employees Susan Elmore, Chair, called the meeting to order. She began by introducing new BOH member, Keith Bagby. Mr. Bagby gave a brief introduction of himself including that he recently became the chair of the ABC Board and is recently retired. The rest of the BOH members introduced themselves to Mr. Bagby. Quintana Stewart, Health Director, welcomed new employees Hannah Baldwin, Lakaya Craig, Dominika Gazdzinska, Kimberly Powell and Juliet Sheridan. II. Public Comment for Items NOT on Printed Agenda: None. III. Approval of the August 22, 2018 Agenda Motion was made by Barbara Chavious to approve the agenda, seconded by Liska Lackey and carried without dissent. IV. Action Items (Consent) A. Minutes of June 27, 2018 Meeting Motion was made by Jessica Frega to approve the minutes of June 2018, seconded by Bruce Baldwin and carried without dissent. MINUTES-Final ORANGE COUNTY BOARD OF HEALTH August 22, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ August Page 2 V. Educational Sessions A. Cybersecurity Jim Northrup, Chief Information Officer, shared information on how Orange County tackles cybersecurity and vulnerabilities. The presentation was a general overview as to not disclose any confidential security information. Below is a summary: • Data must be protected. The OC servers are backed up at 2 different locations and the tapes are moved offsite at least 25 miles away which is the recommended minimum distance. • The number 1 reason that hacking occurs is due to people clicking on links. • OC has a fairly sophisticated filtering system. Every message is filtered. Currently 70% of spam does not get delivered to employees’ mailboxes. • Multiple audits are completed throughout the year. • OC IT is big on user-education. OC IT conducts phish testing, provides video training on key cybersecurity access for all staff and minimizes known vulnerabilities such as poor passwords. Eventually, OC IT will not allow the individual to log in if they don’t complete the cybersecurity training. • OC IT is working on a continuity operation plan. A restoration process/plan is also in place. After the County’s 4th cyberattack, restoration was completed in 12 hours which is a big improvement from the 2 ½ weeks (24 hours/day) it took for restoration during the 1st attack thanks to the OC IT restoration plan. • Six years ago, OC didn’t pay the ransomware when it was attacked and 99.98% of data was restored. Restoration takes the most time as there are millions and millions of files. To restore 1 serve driver takes 1 day. • OC IT has a web tracking system that can track what an individual clicks. Trying to identify people that are already on our network is an issue, not necessarily those that are trying to get in. OC IT needs to protect from the inside. Penetration testing is conducted and the reports are analyzed. • In response to the question of protecting healthcare data, it was shared that OCHD is one of the earliest partners of IT in terms of being proactive. • These measures have been critical in preventing a Mecklenburg County government situation. The BOH had questions that were addressed by Mr. Northrup. B. 4th Quarter Financial and Billing Dashboard Reports Rebecca Crawford, Financial & Administrative Services Director, gave a report on the 4th quarter revenue and billing accuracy. The report is as follows: • Total Health Department Budget vs. Actuals: Average YTD monthly revenue in FY18 after the fourth quarter is $276/month or $3.5 million for the entire fiscal year, representing 98.5% of our overall budgeted revenue for the year. This is an increase of ~$600k over FY 16-17. Expenses were lower than revenues at 94% of the total overall budget due to multiple contracts that crossed into the beginning of FY 18-19 and will be spent out by August 2018, which was $9.8 million compared to year end FY 16-17, which was $9.2 million. MINUTES-Final ORANGE COUNTY BOARD OF HEALTH August 22, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ August Page 3 • Total Billing Accuracy: Continuing with the goal of 90% billing accuracy set in FY 14- 15, the average billing accuracy rate for medical for FY 17-18 was 91% as compared to the year-end average of 96% in FY 16-17. The average billing accuracy rate for dental for FY 17-18 was 101% as compared to 100% in FY 16-17. • Dental Earned Revenue by Source: The FY 17-18 average monthly revenue ($42.5/month) for the fourth quarter is below our budget projection ($43.4k/month) but above our FY 16-17 average of $39.8/month. FY 17-18 dental earned revenue totaled $511k at the end of the fiscal year, compared to $478k at the end of FY 16-17. • Medical Earned Revenue by Source: Medical earned revenue for the fiscal year was below the budgeted projection for FY 17-18 ($686k) at $609k since we had a provider on maternity leave until the end of December, provider turnover at the end of the fiscal year, and reduced appointments available to allow for Epic preparation. • Grants Fund Revenue: FSA received a multi-year grant for $100k per fiscal year for 3 years at the end of FY 17-18. These funds will carry through FY 18-19 and FY 19-20. We’ll track these and any other multi-year grants through this section of the financial report on an ongoing basis. • Note for FY 18-19 Revenue: FAS (Finance and Administrative Services Division) anticipates medical revenue will be delayed for the first 3 months of FY 18-19 as we close out billing in the Patagonia Electronic Medical Record System (EMR) and begin billing in the new Epic EMR. UNC has built an incredible billing system for the Health Department, however it is the first system like it they have ever built and we continue to work through anticipated system issues, which will delay billing to commercial insurance and Medicaid. Patients are still being seen so revenue will catch up in the latter part of the Fiscal Year. FAS also anticipates a potential delay in Environmental Health revenue as the division transitions to a new Central permitting system in October. Staff are training frequently now to reduce the impact on county residents and prepare for the upcoming Go Live. The BOH members had questions that were addressed by Ms. Crawford. C. Fluoride Ad Hoc Committee Update Liska Lackey, BOH member, began by reminding the Board that the role they have in reviewing a policy in which they have no authority is due to their duty to protect the public’s health while recognizing that OWASA has that authority. Ms. Lackey then reviewed the proposed plan for addressing key components in the November 3, 2017 letter in which OWASA requested a review of fluoridation. Ms. Lackey acknowledged and praised the fluoride committee members that provided input into this proposed plan. Board suggestions included making sure there is focus on the at-risk population and having local experts (e.g. those in the triangle area) participate. The Board came to a general consensus and all agreed on the proposed plan. Ms. Lackey will generate a letter for the Board chair’s signature to be sent to OWASA. The BOH members had questions that were addressed by Ms. Lackey. MINUTES-Final ORANGE COUNTY BOARD OF HEALTH August 22, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ August Page 4 D. Family Success Alliance Update Coby Jansen Austin provided an update on the Family Success Alliance and its strategic planning process. Below are highlights: • Currently, navigators are still assisting families in zone 4 and 6. They are actively working to recruit their 4th cohort of students and their families into the navigator program. • Recruiting for two more part-time navigators (with benefits) has occurred. The Social Worker Supervisor II position was reposted. Full-time navigators work with 20 families. There are 596 participants and 147 families that the navigators are assisting. • There are still 10 non-profit agencies that are working with the Family Success Alliance. • Parent Council was launched and has been meeting since February. They’re also going to give input on the strategic plan. • An external evaluation will be developed to determine if the families were satisfied with their services. • The strategic planning process has involved 2 full day retreats where discussion regarding the mission, vision, values and primary strategies (family empowerment, systems change and foundational support) occurred. Ms. Austin asked the Board for their feedback. • Goals of the primary strategies are to have parents be change leaders, expansion which may possibly take a year and to start building relationships as it’s harder to engage with other partners not already involved with the Family Success Alliance. An invitation for new partners has been extended. The BOH members had questions that were addressed by Ms. Austin. VI. Action Items (Non-Consent) A. FY 17/18 Delinquent Accounts Per the department’s Delinquent and Uncollectable Accounts policy (15.0), uncollectible accounts must be administratively written off of the general ledger. The purpose of this accounting function is to precisely account for funds which are truly unrecoverable. The last administrative write-offs were performed by the Board of Health in August 2017 (Personal Health, Dental Health, and Environmental Health) for FY 2016-2017. Personal Health, Dental Health, and Environmental Health continue to participate in the NC Debt Set-Off Program, which allows the county to collect debts on delinquent accounts with a balance between $50 and $4,000 through the customer’s tax refund. The Health Department anticipates collecting payments on delinquent accounts being pursued through the NC Debt Set-Off program; therefore, those accounts are not included in this write-off request. Based on the definitions of uncollectible accounts in the department’s policy, the following table represents all uncollectible debt from clients for FY 2017-2018. MINUTES-Final ORANGE COUNTY BOARD OF HEALTH August 22, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ August Page 5 Division Number of Uncollectable Accounts Write-Off Amount Personal Health 98 $1,750.60 Dental Health 76 $1,843.21 Environmental Health 2 $300.00 Total $3,893.81 We request to administratively move a total of $3,893.81 in uncollectible debt from ‘active’ to ‘inactive’ status for the reasons indicted in the table above. The customer will never be informed that a debt has been written off. If a customer whose account had been determined uncollectible returns to clinic within three years, the delinquent write-off amount will be reactivated and the billing process resumed. Likewise, if a customer requests a non-required service from Environmental Health, the delinquent write -off amount will be reactivated and the billing process resumed. The BOH members had questions that were addressed by Ms. Crawford. Motion to administratively move a total of $3,893.81 in uncollectable debt from “active” to “inactive” status was made by Mia Burroughs, seconded by Jessica Frega and carried without dissent. B. BOH Policy Review Quintana Stewart began by informing the BOH members that she has reviewed the Operating Procedures to ensure that all Accreditation requirements were met. Suggested edits/revisions discussed regarding the Operating Procedures were: • In section “C. Committees”, the current subcommittees that are in the Strategic Plan need to be listed. • Language needs to reflect diversity and the benefits of including such language into the Board’s Operating Procedures. A draft will be formed and will be voted on at the next BOH meeting. VII. Reports and Discussion with Possible Action A. Health Director Report In addition to her report, some of the highlights Ms. Stewart gave are below: • There are multiple strategic plans in process. The Racial Equity Commission will have staff and community focus groups to assist with their process. The Family Success Alliance had 2 days of strategic planning that discussed the program and its future direction. The Leadership Team is working on individual department plans. • Fulfilling a request by the Board, Ms. Stewart was accepted into the Municipal and County Administration Program at UNC SOG. She also expressed excitement about MINUTES-Final ORANGE COUNTY BOARD OF HEALTH August 22, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ August Page 6 being accepted into the NC Public Health Leadership Institute and has already started coursework. • The NCALHD presented the OCHD the Challenge Award for its 2013 work on tobacco policy. • Ashley Rawlinson and Healthy Carolinians will host its 2nd Suicide Prevention Walk on Friday, September 21st in Hillsborough at Gold Park. • The NCPHA will take place in Charlotte. Several of our staff are on the agenda including Victoria Hudson (a poster presentation), Nicholas Cordeiro (oral health) and Iulia Vann and Tommy Green (F.I.T. Program). Susan Elmore added that the ANCBH also has awards. She encouraged staff to go to their website and complete an application next year as it’s a great opportunity to reward for a job well done. B. Media Items Kristin Prelipp, Communications Manager, briefly mentioned the article topics of the F.I.T. Program, a radio interview hosted by Frank Stasio in which Dr. Evan Ashkin and Tommy Green participated, rabies and the Safe Syringe Program that were included in the Media Items packet. Media items were in the packet which focused on Orange County’s events and our involvement in various efforts. VIII. Board Comments None. IX. Adjournment Jessica Frega moved to adjourn the meeting at 9:05pm and Commissioner Mia Burroughs seconded. The next Board of Health Meeting will be held September 26, 2018 at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m. Respectfully submitted, Quintana Stewart, MPA Orange County Health Director Secretary to the Board