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HomeMy WebLinkAboutAgenda - 11-24-2008 Agenda for Joint Board of Commissioners Board of Health Meeting John Link Government Services Center Hillsborough, NC 27278 November 24, 2008 Dinner 5:30 to 6:00 pm 5:30 Welcome and Introductions Barry Jacobs, Chair 5:45 Highlights from the Health Department Rosemary Summers, Health Director 6:00 Topical Presentations 1) Prevention, Investigation and Control of Communicable Disease Dr. Tim Carey, MD 2) Facilities and Technology Dr. Matt Vizithum, OD 3) Advancing the Strategic Plan for the Health Department Chris Harlan, RN 6:40 Questions and Discussion 7:00 Adjourn • Prevention, Investigation and Control of Communicable Disease Provision of Core Public Health Services Mandated Service: Communicable Disease investigation and control is a mandated service of local Health Departments per North Carolina General Statute 130A, Article 6 and North Carolina Administrative Code Communicable Disease Statistics: • In 2007-08, Communicable Disease (CD) activities increased significantly: • 11 cases of active TB disease received 6 months of Directly Observed Treatment • 492 TB contacts of the 11 active cases needed follow-up and evaluation • 90 latent TB cases received 9 months of preventive therapy • 4,341 childhood and adult immunizations were provided (other than flu) • 227 refugees received communicable disease screenings • 3 foodborne illness outbreaks were investigated and controlled • 139 reported CD cases/conditions(other than TB) were investigated and/or monitored with follow-up to 421 contacts provided • 370 rabies exposure consultations were provided Challenges: • 30% increase in workload related to new North Carolina Electronic Disease Surveillance System (NCEDSS) • Growing foreign-born immigrant and refugee population. • 35% increase in demand for childhood immunizations. • Limited opportunities to practice mass vaccination clinics. • Explosion in the number of refugees resettling in Orange County. • Lead testing rates have remained at a very low level with limited ability to focus on gaining compliance from private providers for testing. Response: • Re-directed existing nurse with part time refugee duties to full time refugee health • Re-directed the duties of an adult health nurse to provide part-time communicable disease services and lead-based prevention program initiatives. • Severely limited the chronic disease care coordination program for elderly. • Discontinued the community-based rapid results HIV testing program. • Discontinued the lay health advisor program for community HIV education. • Eliminated community-based flu clinics other than for high-risk populations. Need: Additional communicable disease nurse to: - Assure timely investigation and follow-up of communicable diseases - Provide nursing follow-up and data management of NCEDSS cases - Provide rapid HIV counseling and testing program in high-risk communities - Provide additional childhood and adult vaccinations - Work with private medical providers to increase the number of children receiving blood lead tests Facilities and Technology • Supporting the Delivery of Core Public Health Services Facilities • Renovations needed at Whitted with move of DSS in 2009 • Submitted"Facility/Property Acquisition/Other Infrastructure Needs Annual Operating Impact" to County CIP Team o Health Department move to Hillsborough Commons in 2013 ($10 million) o Dental and medical clinics at SHSC in 2011 ($8.5 million), Questions ➢ Commitment to dual dental facilities in county o Efficiency in 5 day/week operation at both locations o Carr Mill Mall lease and space limitations o SHSC expansion timing and size ➢ Facility planning impacts on service delivery for next 5 years Technology Recent Technology Advancements for Department • Statewide initiatives: Health Information System(HIS),NC Electronic Disease Surveillance System(NCEDSS),NC Immunization Registry (NCIR) • Custom Data Procession(CDP) software for facility inspections • GPS field units for Environmental Health on-site and well programs Continuing and Emerging Needs ➢ Approvals to move forward with digital equipment and software for dental clinics ➢ Replacement of the"Time Study Program"used to account for personnel time in each program area ➢ Mobile hardware for environmental health facility inspections ➢ Training and resource commitment for GPS technology ➢ Replacement needed for Acella Software—Permit Plus for environmental health functionality Advancing the Strategic Plan for the Health Department Related General Statutes and Administrative Code NC General Statutes 130A-1 & 366; 130A-144; NC Administrative Code 10A 45C.0101 & 46.0201- .0216; Title V and Title X Federal Regulations Current Strategic Plan There were four Community Programming focus areas in the Strategic Plan. Three will be addressed this evening. 1) Access to Medical/Dental Services with Emphasis on Disparity Outcomes • Second priority identified by community in 2007 Community Health Assessment • Increasing uninsured/underinsured populations; the 2005 estimate is 32,208 people with no insurance Dental • Patient waiting lists at both locations • 46%of patients are 0-80% of sliding scale & 35.6% Medicaid • Enormous need for interpreter services • Limited access at two sites due to staffing limitations ➢ Next Steps/Needs ✓ Fund permanent staff to support two full-time clinics • Add interpreter to staff to reduce contract interpreter costs ✓ Preventive dental package for local small businesses Medical • 10,000 clinical visits in 2007-08 not counting flu shots • Primary Care medical home for over 400 residents; 75% of sliding scale at 0-40%pay • Primary Care services supplemented by grants ➢ Next steps/Needs ■ Stabilize staffing by transitioning grant funded temporaries to permanent ✓ Collaborate with Piedmont Health Services for preventive service package for small local employers 2) Chronic Disease Prevention • 11,930 children(38.5%) who are obese; 2-4 year olds higher than state average • Diabetes rates are growing in children and adults across the state • Uncoordinated activities throughout county on obesity reduction • Concentrated focus area for all funders both public and private ➢ Next steps/Needs ✓ Collaborate with medical providers to sponsor diabetes self-management programs through Statewide Diabetes Umbrella& on tools for obesity prevention ✓ Work with Healthy Carolinians to adopt and promote a coordinated county-wide plan and messages for obesity reduction using Eat Smart Move More Tools ■ Seek funding resources to increase part time nutritionist to full time 3) Protecting Orange County Water Resources • Continues to address a Board of Health Initiative proposed in the early 1990s • Addresses directly human health impacts of water resources • Next Steps/Needs ✓ Septic System repair fund for low income residents ■ Pursuit of a pilot project to expand WTMP septic system monitoring in critical watershed areas through Clean Water Management Trust Fund grant.