03.06.19 Board of Health Meeting Minutes1606
Dr. Robert Schiffel, Chair of the New Hanover County Board of Health, called the regular business
meeting of the Board of Health (BOH) to order on March 6, 2019 at 7:58 a.m. in the Thomas
Fanning Wood Conference Room of the New Hanover County Public Health Department.
Members Present:
Melody Speck Evans, DVM
Kim Thrasher Horne, PharmD
Amy McLane, PE
Mark W. Morgan, MD
Michael Musselwhite, Public Member
Candy Robbins, Vice-Chair
Robert J. Schiffel, DDS, Chair
Stephanie D. Smith, PhD, RN
LeShonda Wallace, PHD, FNP-BC
Edward Weaver, Jr., OD
Woody White, County Commissioner
Others Present:
Chris Coudriet, County Manager
Lisa Wurtzbacher, Chief Financial Officer
Bunny McClure, Deputy Chief Financial Officer
Phillip Tarte, MHA, Public Health Director
David Howard, Deputy Public Health Director
Katelyn Matney, Public Health Strategist & Health Promotion Supervisor
Carla Turner, Personal Health Services Manager
Joyce Hatem, Social Worker Supervisor, Public Health Services
PharmD Interns for Ms. Thrasher-Horne
Regina James-Boston, Administrative Manager
Heather Jernigan, Recording Secretary
Approval of Agenda: The agenda was properly moved and seconded for approval as submitted.
Approval of Minutes: Amy McLane moved that the minutes from the February 6, 2019 meeting
be approved as previously amended and submitted. Mark Morgan seconded. Upon vote, the
minutes were approved as submitted.
Public Comments: None
Old Business:
Water Position Statement Update
Phillip Tarte reported that the Water Position Statement has been sent to local lawmakers
and other stakeholders within the county and state.
EnerGov – Phase 2 – Attachment I
David Howard provided an update of the EnerGov implementation, which is currently in Phase 2,
focusing on Environmental Health Services. He commended the staff for their hard work as Phase
II comes to completion at the end of March.
NEOGOV PROJECT UPDATE NHC B OARD OF HEALTH
MARCH 6 , 2019
NOW “COAST ”
(CUSTOMER ONLINE ACC ESS SERVICS TOOL)
BACKGROUND
Planning for this transition began in 2016
Engagement and Development began early 2017
Original go live was October 2018, delayed by Florence, went “Live” February 4th
CFPUA and City of Wilmington are partnering to use same system for seamless service, also the Sheriff’s
Office and other Law Enforcement are being engaged
P HASE 1 COMPLETE
Development of commercial and residential new project system processes: permitting across all NHC
development services departments, including Environmental Health
COAST Portal provides greater efficiencies both in our workflow and for customers: online permit
applications, document submissions, invoicing, payment of fees, delivery of permits, and more
Staff and Customer Training completed prior to Feb 4th Go Live
Biggest Phase I challenge has been conversion of old system projects to new COAST system due to volume of
work in process at all times – dedicated staff, including many in our Environmental Health team, have spent
many late nights and weekend hours to make this a success so far
PHASE 2 IN PROGRESS
Phase 2 involves additional processes across all of development services departments
Phase 2 is also developing our customer requests/complaints processes
When investigation reveals code violation(s) for any jurisdiction, a code case is created
These are being built with flexibility so multiple code violations from same complaint can be worked
We are now completing the Assess and Define work and the Process Mapping work
Most E.H. work in Phase 2 is planned for completion by end of March for 2 reasons:
1)Current IT application will not be supported after June 30, all conversion must be complete
2)Busy season for E.H. begins in April: pools permitting, Vector Control, events permitting, etc.
E.H. has 14 processes we are mapping and defining for development in Phase 2 (see below)
2
Processes identified for Phase 2
(this is the starting list, some may be integrated into larger processes)
NHC - OSWP Re-use of Existing System Septic and/or Well
NHC - OSWP Monitoring Soil Wetness Wells
NHC - OSWP Sewage System Repair Permit
NHC - OSWP Soil Evaluation (Improvement Permit or Site Suitability)
NHC - OSWP Construction Authorization
NHC - OSWP Table V Inspection
NHC - OSWP Water Sample (Bacteriological)
NHC - OSWP Water Sample (Chemical)
NHC - OSWP Well Permit
NHC - OSWP Annual Water Samples
NHC - Commercial FLI Exemption
NHC - Commercial - FLI Change of Ownership
NHC - FLI Body Piercing
OWWP = On-Site Wastewater Protection
FLI = Food, Lodging and Institutional
TAKE AWAYS
The complexity of Environmental Health Services has been brought into sharper focus. This necessary
attention to the details of our workflow and processes has enabled E.H. supervision and staff to assess for the
leanest and most efficient processes possible to build in the COAST system
Simultaneous and joint work of E.H. supervision with all other development services departments has
brought to light for other departments the complexity of our E.H. services and how much we co-mingle in
many types of projects and at many layers of work. Our public health environmental protection services must
co-exist with all our sister development services departments and with other jurisdictions such as COW and
CFPUA
Careful and comprehensive examination of E.H. work processes necessary to build these workflows into the
new system has been beneficial to Environmental Health, along with every development services department
involved with this project – we are all benefiting from a higher level of understanding of our respective work
processes as well as gaining a richer appreciation for the value each department brings to our collective
services
GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2011
SESSION LAW 2012-126
HOUSE BILL 438
*H438-v-5*
AN ACT TO PROMOTE EFFICIENCY AND EFFECTIVENESS IN THE
ADMINISTRATION OF HUMAN SERVICES AND TO STRENGTHEN THE LOCAL
PUBLIC HEALTH INFRASTRUCTURE BY ESTABLISHING A PUBLIC HEALTH
IMPROVEMENT INCENTIVE PROGRAM AND ENSURING THE PROVISION OF
THE TEN ESSENTIAL PUBLIC HEALTH SERVICES.
The General Assembly of North Carolina enacts:
SECTION 1. G.S. 153A-77 reads as rewritten:
"§ 153A-77. Authority of boards of commissioners in certain counties over commissions,
boards, agencies, etc.
(a) In the exercise of its jurisdiction over commissions, boards and agencies, the board
of county commissioners may assume direct control of any activities theretofore conducted by
or through any commission, board or agency by the adoption of a resolution assuming and
conferring upon the board of county commissioners all powers, responsibilities and duties of
any such commission, board or agency. This subsectionsection shall apply to the board of
health, the social services board, area mental health, developmental disabilities, and s ubstance
abuse area board andor any other commission, board or agency appointed by the board of
county commissioners or acting under and pursuant to authority of the board of county
commissioners of said county.county except as provided in G.S. 153A-76. A board of county
commissioners exercising the power and authority under this subsection may, notwithstanding
G.S. 130A-25, enforce public health rules adopted by the board through the imposition of civil
penalties. If a public health rule adopted by a board of county commissioners imposes a civil
penalty, the provisions of G.S. 130A-25 making its violation a misdemeanor shall not be
applicable to that public health rule unless the rule states that a violation of the rule is a
misdemeanor. The board of county commissioners may exercise the power and authority herein
conferred only after a public hearing held by said board pursuant to 30 days ' notice of said
public hearing given in a newspaper having general circulation in said county.
The board of county commissioners may also appoint advisory boards, committees,
councils and agencies composed of qualified and interested county residents to study, interpret
and develop community support and cooperation in activities conducted by or under the
authority of the board of county commissioners of said county.
A board of county commissioners that has assumed direct control of a local health board
after January 1, 2012, and that does not delegate the powers and duties of that board to a
consolidated health service board shall appoint an advisory committee consistent with the
membership described in G.S. 130A-35.
(b) In the exercise of its jurisdiction over commissions, boards, and agencies, the board
of county commissioners of a county having a county manager pursuant to G.S. 153A-81 may:
(1) Consolidate the provisioncertain provisions of human services in the county
under the direct control of a human services director appointed and
supervised by the county manager in accordance with subsection (e) of this
section;
(2) Create a consolidated human services board having the powers conferred by
subsection (c) of this section;
(3) Create a consolidated county human services agency having the authority to
carry out the functions of any combination of commissions, boards, or
agencies appointed by the board of county commissioners or acting under
and pursuant to authority of the board of county commissioners, including
Page 2 Session Law 2012-126 House Bill 438
the local health department, the county department of social services, andor
the area mental health, developmental disabilities, and substance abuse
services authority; and
(4) Assign other county human services functions to be performed by the
consolidated human services agency under the direction of the human
services director, with policy-making authority granted to the consolidated
human services board as determined by the board of county commissioners.
(c) A consolidated human services board appointed by the board of county
commissioners shall serve as the policy-making, rule-making, and administrative board of the
consolidated human services agency. The consolidated human services board shall be
composed of no more than 25 members. The composition of the board shall reasonably reflect
the population makeup of the county and shall include:
(1) Eight persons who are consumers of human services, public advocates, or
family members of clients of the consolidated human services agency,
including: one person with mental illness, one person with a developmental
disability, one person in recovery from substance abuse, one family member
of a person with mental illness, one family member of a person with a
developmental disability, one family member of a person with a substance
abuse problem, and two consumers of other human services.
(1a) Notwithstanding subdivision (1) of this subsection, a consolidated human
services board not exercising powers and duties of an area mental health,
developmental disabilities, and substance abuse services board shall include
four persons who are consumers of human services.
(2) Eight persons who are professionals, each with qualifications in one of these
categories: one psychologist, one pharmacist, one engineer, one dentist, one
optometrist, one veterinarian, one social worker, and one registered nurse.
(3) Two physicians licensed to practice medicine in this State, one of whom
shall be a psychiatrist.
(4) One member of the board of county commissioners.
(5) Other persons, including members of the general public representing various
occupations.
The board of county commissioners may elect to appoint a member of the consolidated
human services board to fill concurrently more than one category of membership if the member
has the qualifications or attributes of more than one category of membership.
All members of the consolidated human services board shall be residents of the county. The
members of the board shall serve four-year terms. No member may serve more than two
consecutive four-year terms. The county commissioner member shall serve only as long as the
member is a county commissioner.
The initial board shall be appointed by the board of county commissioners upon the
recommendation of a nominating committee comprised of members of the preconsolidation
board of health, social services board, and area mental health, developmental disabilities, and
substance abuse services board. In order to establish a uniform staggered term structure for the
board, a member may be appointed for less than a four-year term. After the subsequent
establishment of the board, its board shall be appointed by the board of county commissioners
from nominees presented by the human services board. Vacancies shall be filled for any
unexpired portion of a term.
A chairperson shall be elected annually by the members of the consolidated human services
board. A majority of the members shall constitute a quorum. A member may be removed from
office by the county board of commissioners for (i) commission of a felony or other crime
involving moral turpitude; (ii) violation of a State law governing conflict of interest; (iii)
violation of a written policy adopted by the county board of commissioners; (iv) habitual
failure to attend meetings; (v) conduct that tends to bring the office into disrepute; or (vi)
failure to maintain qualifications for appointment required under this subsection. A board
member may be removed only after the member has been given written notice of the basis for
removal and has had the opportunity to respond.
A member may receive a per diem in an amount established by the county board of
commissioners. Reimbursement for subsistence and travel shall be in accordance with a policy
set by the county board of commissioners. The board shall meet at least quarterly. The
chairperson or three of the members may call a special meeting.
House Bill 438 Session Law 2012-126 Page 3
(d) The consolidated human services board shall have authority to:
(1) Set fees for departmental services based upon recommendations of the
human services director. Fees set under this subdivision are subject to the
same restrictions on amount and scope that would apply if the fees were set
by a county board of health, a county board of social services, or a mental
health, developmental disabilities, and substance abuse area authority.
(2) Assure compliance with laws related to State and federal programs.
(3) Recommend creation of local human services programs.
(4) Adopt local health regulations and participate in enforcement appeals of
local regulations.
(5) Perform regulatory health functions required by State law.
(6) Act as coordinator or agent of the State to the extent required by State or
federal law.
(7) Plan and recommend a consolidated human services budget.
(8) Conduct audits and reviews of human services programs, including quality
assurance activities, as required by State and federal law or as may otherwise
be necessary periodically.
(9) Advise local officials through the county manager.
(10) Perform public relations and advocacy functions.
(11) Protect the public health to the extent required by law.
(12) Perform comprehensive mental health services planning.planning if the
county is exercising the powers and duties of an area mental health,
developmental disabilities, and substance abuse services board under the
consolidated human services board.
(13) Develop dispute resolution procedures for human services contractors and
clients and public advocates, subject to applicable State and federal dispute
resolution procedures for human services programs, when applicable.
Except as otherwise provided, the consolidated human services board shall have the powers
and duties conferred by law upon a board of health, a social services board, and an area mental
health, developmental disabilities, and substance abuse services board.
Local employees who serve as staff of a consolidated county human services agency are
subject to county personnel policies and ordinances only and are not subject to the provisions
of the State Personnel Act. Act, unless the county board of commissioners elects to subject the
local employees to the provisions of that Act. All consolidated county human services agencies
shall comply with all applicable federal laws, rules, and regulations requiring the establishment
of merit personnel systems.
(e) The human services director of a consolidated county human services agency shall
be appointed and dismissed by the county manager with the advice and consent of the
consolidated human services board. The human services director shall report directly to the
county manager. The human services director shall:
(1) Appoint staff of the consolidated human services agency with the county
manager's approval.
(2) Administer State human services programs.
(3) Administer human services programs of the local board of county
commissioners.
(4) Act as secretary and staff to the consolidated human services board under the
direction of the county manager.
(5) Plan the budget of the consolidated human services agency.
(6) Advise the board of county commissioners through the county manager.
(7) Perform regulatory functions of investigation and enforcement of State and
local health regulations, as required by State law.
(8) Act as an agent of and liaison to the State, to the extent required by law.
(9) Appoint, with the county manager's approval, an individual that meets the
requirements of G.S. 130A-40(a).
Except as otherwise provided by law, the human services director or the director's designee
shall have the same powers and duties as a social services director, a local health director,
andor a director of an area mental health, developmental disabilities, and substance abuse
services authority.
(f) This section applies to counties with a population in excess of 425,000."
Page 4 Session Law 2012-126 House Bill 438
SECTION 2. G.S. 153A-76 reads as rewritten:
"§ 153A-76. Board of commissioners to organize county government.
The board of commissioners may create, change, abolish, and consolidate offices, positions,
departments, boards, commissions, and agencies of the county government, may impose ex
officio the duties of more than one office on a single officer, may change the composition and
manner of selection of boards, commissions, and agencies, and may generally organize and
reorganize the county government in order to promote orderly and efficient administration of
county affairs, subject to the following limitations:
(1) The board may not abolish an office, position, department, board,
commission, or agency established or required by law.
(2) The board may not combine offices or confer certain duties on the same
officer when this action is specifically forbidden by law.
(3) The board may not discontinue or assign elsewhere a function or duty
assigned by law to a particular office, position, department, board,
commission, or agency.
(4) The board may not change the composition or manner of selection of a local
board of education, the board of health, the board of social services, the
board of elections, or the board of alcoholic beverage control.
(5) The board may not abolish nor consolidate into a human services agency a
hospital authority assigned to provide public health services pursuant to
Section 12 of S.L. 1997-502 or a public health authority assigned the power,
duties, and responsibilities to provide public health services as outlined in
G.S. 130A-1.1.
(6) A board may not consolidate an area mental health, developmental
disabilities, and substance abuse services board into a consolidated human
services board. The board may not abolish an area mental health,
developmental disabilities, and substance abuse services board, except as
provided in Chapter 122C of the General Statutes. This subdivision shall not
apply to any board that has exercised the powers and duties of an area
mental health, developmental disabilities, and substance abuse services
board as of January 1, 2012.
(7) The board may not abolish, assume control over, or consolidate into a human
services agency a public hospital as defined in G.S. 159-39(a) pursuant to
G.S. 153A-77."
SECTION 3. Article 2 of Chapter 130A of the General Statutes is amended by
adding the following new sections to read:
"§ 130A-34.3. Incentive program for public health improvement.
(a) In order to promote efficiency and effectiveness of the public health delivery
system, the Department shall establish a Public Health Improvement Incentive Program. The
Program shall provide monetary incentives for the creation and expansion of multicounty local
health departments serving a population of not less than 75,000.
(b) The Commission shall adopt rules to implement the Public Health Improvement
Incentive Program.
"§ 130A-34.4. Strengthening local public health infrastructure.
(a) By July 1, 2014, in order for a local health department to be eligible to receive State
and federal public health funding from the Division of Public Health, the following criteria
shall be met:
(1) A local health department shall obtain and maintain accreditation pursuant to
G.S. 130A-34.1.
(2) The county or counties comprising the local health department shall
maintain operating appropriations to local health departments from local ad
valorem tax receipts at levels equal to amounts appropriated in State fiscal
year 2010-2011.
(b) The criteria established in subsection (a) of this section shall be in addition to any
other funding criteria established by State or federal law."
SECTION 4. G.S. 130A-1.1(b) reads as rewritten:
"(b) A local health department shall ensure that the following 10 essential public health
services are available and accessible to the population in each county served by the local health
department:
House Bill 438 Session Law 2012-126 Page 5
(1) Monitoring health status to identify community health problems.
(2) Diagnosing and investigating health hazards in the community.
(3) Informing, educating, and empowering people about health issues.
(4) Mobilizing community partnerships to identify and solve health problems.
(5) Developing policies and plans that support individual and community health
efforts.
(6) Enforcing laws and regulations that protect health and ensure safety.
(7) Linking people to needed personal health care services and assuring the
provision of health care when otherwise unavailable.
(8) Assuring a competent public health workforce and personal health care
workforce.
(9) Evaluating effectiveness, accessibility, and quality of personal and
population-based health services.
(10) Conducting research.
As used in this section, the term "essential public health services" means those services that
the State shall ensure because they are essential to promoting and contributing to the highest
level of health possible for the citizens of North Carolina. The Departments of Environment
and Natural Resources and Health and Human Services shall attempt to ensure within the
resources available to them that the following essential public health services are available and
accessible to all citizens of the State, and shall account for the financing of these services:
(1) Health Support:
a. Assessment of health status, health needs, and environmental risks to
health;
b. Patient and community education;
c. Public health laboratory;
d. Registration of vital events;
e. Quality improvement; and
(2) Environmental Health:
a. Lodging and institutional sanitation;
b. On-site domestic sewage disposal;
c. Water and food safety and sanitation; and
(3) Personal Health:
a. Child health;
b. Chronic disease control;
c. Communicable disease control;
d. Dental public health;
e. Family planning;
f. Health promotion and risk reduction;
g. Maternal health; and
(4) Public Health Preparedness.
The Commission for Public Health shall determine specific services to be provided under
each of the essential public health services categories listed above."
SECTION 5. The Program Evaluation Division of the General Assembly shall
study the feasibility of the transfer of all functions, powers, duties, and obligations vested in the
Division of Public Health in the Department of Health and Human Services to the University of
North Carolina Healthcare System and/or the School of Public Health at The University of
North Carolina and submit its findings and recommendations to the Joint Legislative Program
Evaluation Oversight Committee and the Joint Legislative Oversight Committee on Health and
Human Services no later than February 1, 2013.
Page 6 Session Law 2012-126 House Bill 438
SECTION 6. This act is effective when it becomes law.
In the General Assembly read three times and ratified this the 21st day of June,
2012.
s/ Walter H. Dalton
President of the Senate
s/ Thom Tillis
Speaker of the House of Representatives
s/ Beverly E. Perdue
Governor
Approved 12:20 p.m. this 29th day of June, 2012