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12_06_2017 BOH Meeting1563 Dr. Stephanie D. Smith, Chair, New Hanover County Board of Health, called the regular business meeting of the Board of Health (BOH) to order on December 6, 2017 at 8:00 a.m. in the Thomas Fanning Wood Conference Room of the New Hanover County Health Department. Members Present: Stephanie D. Smith, PhD, RN, Chair Robert J. Schiffel, DDS, Vice-Chair James Barker, Public Member Mark W. Morgan, MD Candy Robbins, Public Member Melody Speck Evans, DVM Kim Thrasher Horne, PharmD Edward Weaver, Jr., OD LeShonda Wallace, PHD, FNP-BC Rob Zapple, County Commissioner Members Absent: Amy McLane, PE Others Present: Phillip Tarte, Health Director Lisa Wurtzbacher, Chief Financial Officer Bunny McClure, Deputy Chief Financial Officer Carla Turner, Personal Health Services Manager Katelyn Matney, Health Promotion Supervisor Anne Wrenn, WIC Supervisor Marie Hemmen, Vector Control Supervisor Susana May, Administrative Technician Sheila Irrera, Public Health Nurse, School Health Marissa Notarangelo, Administrative Technical Regina James-Boston, Recording Secretary Heather Jernigan, Administrative Specialist Approval of Agenda Commissioner Rob Zapple moved to approve the meeting agenda. Dr. Robert Schiffel seconded. Upon vote, the motion passed unanimously. Approval of Minutes: 11/1/2017 Dr. Melody Speck Evans moved to approve the minutes from the November 1, 2017. Dr. Robert Schiffel Seconded. Upon vote, the motion passed unanimously. Approval of Consent Agenda 1. Fiscal Year 2017-2018 Zika Funding $23,500 – Purchase of sprayer Dr. Robert Schiffel moved to approve the items on the consent agenda. Mr. James Barker seconded. Upon vote, the motion passed unanimously. Public Comments: None Recognitions and Service Awards Phillip E. Tarte, Health Director Ambassador and Consultant Customer Service Awards Marissa Notarangelo, Administrative Technical Five (5) Year Service Award Nina Rivenbark 1564 Fifteen (15) Year Service Award Larry Grimsley, Public Health Nurse, Clinic Services Susana May, Administrative Technician, Customer Care Maria Turnley, Public Health Nurse, School Health New Hire Sheila Irrera, Public Health Nurse, School Health Old Business Election for 2018 Chair and Vice-Chair Dr. Stephanie Smith announced the nominations of Dr. Robert Schiffel and Ms. Candy Robbins for the Chair and Vice-Chair of the Board of Health respectively, and opened the floor for additional nominations. Mr. Tarte distributed the ballots for election. The Board of Health unanimously elected Dr. Robert Schiffel as Chair, and Ms. Candy Robbins was elected as Vice-Chair for 2018. New Business: Opioid Activities and NHCHD – ATTACHMENT I Ms. Katelyn Matney, Health Promotion Supervisor, presented to the Board an overview of the efforts in 2017 of the NHCHD for participation in the prevention and management of the opioid epidemic.  Participation on the Community Partners Coalition – participation in opioid prevention, risk reduction, treatment and support.  Participation on the Data Action Team – intervention strategies  Participation in Cape Fear Drug Free Tomorrow Coalition – alcohol/drug prevention among youth in NHC  Partnership with NC Harm Reduction – condom distribution sites/HIV program  Distribution of Naloxone to the Public – media promotion resulting in 34 kits left to give out of 200 total kits available.  Promotion of permanent medication drop boxes/medication drop events via marketing efforts (6 in county); NHRMC is constantly having to rotate weekly; all are being used.  Distribution of personal medication lock boxes – via grants, distributed along with Naloxone and CC4C & at Senior Center.  Partnership with NHC jail to provide long term birth control and sex education to inmates, if they choose in hopes to see a decrease in babies being born addicted to opioids.  Creation of NHC opioid navigation page to provide online education and local resources; targeting community at large, parents, seniors, caregivers, healthcare providers, law enforcement With regards to the NHC jail birth control program, Dr. LeShonda Wallace questioned the type of birth control that would be used and the continuity of the program. Phillip Tarte stated that last year, NHRMC saw approximately 100 babies born with some substance abuse. He explained that Judge Corpening had approached him about a program in Tennessee, focused primarily on females, who have been incarcerated for drug offenses. It mandated they complete a court ordered sex education class for those individuals. It also offered long term, voluntary contraception to those women, should they choose. Tennessee saw a dramatic decrease in the births of babies born addicted to opioids. Judge Corpening and DSS met to discuss the possibility of implementing the same type of program in NHC. They see a need for such a program in the future. Continuity of care and tracking methodology, Mr. Tarte stated, would have to be worked into the program. Ms. Wallace thanked them for their progressive thinking. Dr. Stephanie Smith commented that she has seen the Southeastern Area Health Education Center (SEAHEC) SEAHEC model and questioned if there is a planned community update, especially regarding programs and outcomes. Katelyn stated that it is the hope of the navigation page, that the community may have access to see what different agencies are doing and the outcomes. 1565 Dr. Smith also questioned if the Harm Reduction Hub has a needle exchange in Wilmington? Katelyn stated yes and they are the only one in Wilmington to do so. Departmental Focal “E-WIC” - ATTACHMENT II Anne Wrenn, WIC Supervisor, presented to the Board, information regarding the implementation of the new NC eWIC Pilot Program in October 2017 at the NHCHD. NHC has issued approximately 1,600 eWic cards to date at a continued 3-month issuance, with no rollover. Ms. Wrenn explained how the cards work like regular bank debit cards, with PINs and accessibility to their balance via an #800 phone number, online, and on their store receipt. The cards are accepted at any store which displays the “eWic” signs throughout the entire state. This allows families greater convenience to the previously issued paper vouchers. Following a question from Commissioner Zapple, Ms. Wrenn stated that the federally funded program did not produce any cost to NHC. Dr. LeShonda Wallace commended the department on their work and stated this will be much more convenient for the public who uses this program. Health Director Report Public Health & Medicaid Managed Care - ATTACHMENT III Mr. Phillip Tarte presented information regarding the possible future of the Medicaid program following new legislation and how it could potentially impact our department. A hard copy of the full presentation was given to each Board member. On behalf of himself and the Board, Mr. Tarte presented a plaque to Dr. Stephanie D. Smith for her service as the 2017 Chair for the Board of Health. Board of Health Comments Dr. LeShonda Wallace thanked the Board and Dr. Smith, stating that she has learned a lot this past year and, is inspired by her leadership. Dr. Mark Morgan thanked Dr. Smith for all she has done this past year. Dr. Melody Evans also thanked Dr. Smith. Dr. Robert Schiffel thanked Dr. Smith for setting the bar so high and thanked her on a job well done. Mr. James Barker stated that based on his perspective, Stephanie has done a great job and he has enjoyed being on the Board this past year. Ms. Candy Robbins commented how she is very appreciative of Dr. Smith’s guidance in encouraging her to be more vocal this year and thanked her for her service this past year. Dr. Kim Thrasher Horne shared with the Board that she is with Community Care of the Lower Cape Fear (CCLCF), and recently received information on the timeline from the revisions that were asked by the Centers for Medicare and Medicare Services (CMS). She has been told that CMS has lost key staff members who review and approve the waivers. There are also two other states who are ahead of NC, which could further delay the federal government. She also stated that CCLCF has a lot of activities ongoing with regard to the prevention and hopeful decline of the opioid status in NHC. They have done presentations to prescribers in several counties in the area. Dr. Thrasher Horne stated she took part in an Opioid Abuse task force in Columbus County, alongside local law enforcement, DSS and the school system, which was very interesting with regards to the impact on the kids in that area. New Hanover County Health Department Efforts in 2017 for prevention and management of the Opioid Epidemic  Participation on the Community Partners Coalition o At forefront of making decisions on community initiatives for opioid prevention, risk reduction, treatment and support  Participation on the Data Action Team o Compiled health data with other regional and county level data to assist in intervention strategies  Participation in Cape Fear Drug Free Tomorrow Coalition o At forefront of making decisions on initiatives in NHC for alcohol/drug prevention targeting youth  Partnership with NC Harm Reduction o Condom distribution site  Distribution of Naloxone to the public o 34/200 kits remaining o Promotion through media  Promotion of permanent medication drop boxes/medication drop events o Marketing of locations, events through social media, magnets and media outlets  Distribution of personal medication lock boxes o Distribution though clinic, CC4C and PCM programs and Senior Center  Partnership with NHC Jail to provide birth control and sex education to inmates  Creation of NHC opioid navigation page o Provide education and local resources o Target community at large, parents, seniors, caregivers, healthcare providers, law enforcement 1 New Hanover County NC eWIC Pilot Program  New Hanover County Health Department New Hanover County Slide 2 New Hanover County Department of Health North Carolina is moving to an electronic benefit  transfer(EBT) system for issuing WIC benefits The North Carolina WIC Program’s EBT system is known as eWIC 2 New Hanover County Slide 3 New Hanover County Health Department Why is North Carolina switching to eWIC? Federal Mandate states that by October 1, 2020,  every State WIC agency shall implement EBT  statewide, unless granted an exemption New Hanover County Slide 4 New Hanover County Health Department Changes have been made to the North Carolina  Administrative Code for provisions regarding  eWIC New policies and procedures are in place for  local clinics and vendors  Vendors have been certified to accept the new  cards 3 New Hanover County Slide 5 New Hanover County Health Department New Hanover County Slide 6 New Hanover County Health Department 4 New Hanover County Slide 7 New Hanover County Health Department WIC participants can monitor their  accounts with several methods: •online at www.mybnft.com •customer service at 1‐844‐230‐0813 •mobile app BNFT   New Hanover County Slide 8 New Hanover County Health Department 5 New Hanover County Slide 9 New Hanover County Health Department As of 11/28/2017: •All pilot groups combined have issued 7917  cards •98% of all vendors are eWIC certified •17 have been replaced via mail •40 cards have been replaced in clinics •The average person spends $34.57  New Hanover County Slide 10 New Hanover County Health Department In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, theUSDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: • Mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410 • Fax: (202) 690-7442; or • Email: program.intake@usda.gov This institution is an equal opportunity provider 6 New Hanover County Slide 11 New Hanover County Health Department Questions?