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06/02/1999 I I I 41 Mr. William T. Steuer, Chairman, called the regular business meeting of the New Hanover County Board of Health (NHCBH) to order at 8:00 a.m., WednesdaY6 June 2,1999, in the Conference Room, of the New Hanover County Health Department, 2029 South 171 Street, Wilmington, North Carolina. Members Present: William T. Steuer, Chairman Wilson O'Kelly Jewell, DDS, Vice-Chairman Henry V. Estep, RHU Michael E. Goins, OD Robert G. Greer, Vice-Chair, County Commissioners Gela N. Hunter, RN, Nurse Practitioner Anne Braswell Rowe Philip P. Smith, Sr., MD Melody C. Speck, DVM Estelle G. Whitted, RN Members Absent: W. Edwin Link, Jr., RPH Others Present: David E. Rice, Health Director Lynda F. Smith, Assistant Health Director Frances F. De Vane, Recording Secretary Invocation: Dr. Wilson o. Jewell gave the invocation. Minutes: Mr. Steuer asked for corrections to the minutes of the May 12, 1999 New Hanover County Board of Health Meeting. The Board approved the minutes of the May 12, 1999 Board of Health meeting. Recognitions: Personnel Service Awards Mr. Rice recognized and congratulated the following New Hanover County Service Award recipient: Five (5) Year Service Nikki J. Todd, Public Health Nurse, Communicable Disease Mr. Rice introduced new health department employees: New Emplovees William A. Elliott, Environmental Health Technician, Vector Control, Environmental Health DeAnne Ace, Health Educator Intern, Appalachian State University Mr. Rice introduced Alice Mathews, Trauma Services Coordinator, New Hanover Regional Medical Center. Ms. Mathews will work with the Health Promotions Division on Injury Prevention and Control and will observe health department services. Mr. Steuer welcomed Mr. Elliott, Ms. Ace, Ms. Mathews, and commended Ms. Todd, Service Award recipient. 1 42 Department Focal: School Health - Germ Busters Ms. Evelyn Bowden, School Health Public Health Nurse, presented the department focal on School Health - Germ Busters. She gave a video presentation on the Germ Busters School Health Program. It initiated in Grades K-5 of Sunset Elementary School. The pilot project is a collaborated effort of the Community Health, Communicable Disease, Dental, and Laboratory Divisions of the health department. Ms. Bowden explained due to the need to prevent disease and convey hygiene information to school students, Germ Busters was developed Parents and students participated in the program focusing on proper body and dental hygiene. Items addressed included hand washing, water fountain usage, teeth brushing, and other body and dental hygiene techniques and practices. Instructional hygiene signage was featured throughout the school. Ms. Bowden emphasized proper hand washing and other body and dental hygiene practices are a great solution to the prevention of the spread of communicable diseases. A theme song entitled Germ Busters was written and sung by the school children. Dr. Smith asked if this excellent hygiene program will be available in other schools. Ms. Bowden stated plans are to expand the educational Germ Busters School Health Program that was beneficial to students and parents. Mr. Steuer thanked Ms. Bowden for her presentation. I Committee Reports: I Executive Committee Mr. Steuer, Chairman, Executive Committee, reported the Executive Committee met on Tuesday, May 25, 1999. Items discussed at the meeting are listed under New Business on the Board of Health Agenda. Environmental Health Committee Mr. Steuer reported the Environmental Health Committee met at 6:25 p.m. on Tuesday, May 18, 1999. A draft of the Rules Governing Body Piercing Establishments and Practitioners is listed under New Business on the Board of Health Agenda. Unfinished Business: Generators/Hookups at New Hanover County Emere:ency Shelters Mr. Steuer requested a report on the status of acquiring generator equipment and on the FEMA grant. Mr. Rice referred the Board to a letter addressed to Allen O'NEAL, County Manager, from Dan Summers, New Hanover County Emergency Management Director, regarding the grant status. The letter stated the New Hanover County grant proposal is a category two project and that category one projects are currently waiting for funding. The projected cost for automatic generator switches is $88,000 per facility. Mr. Steuer suggested manual switches might replace automatic switches at less cost. Mr. Greer I advised manual switches are being considered for older schools and automatic switches for new schools that serve dual purposes as emergency shelters. 2 I I I 43 Ms. Hunter emphasized the Board of Health has been discussing the necessity for and the issue of generators and switches in the disaster shelters for more than one year. She expressed a hurricane season is here; the Board needs to actively approach this generator equipment. Dr. Goins stated the needs in the emergency shelters should be addressed. He clarified some disaster shelters do not have either water or power, and county staff and shelter occupants must go into substandard housing conditions. Ms. Janet McCumbee, Child Health Director, reiterated the need for a generator to provide electricity and water. She expressed the great need to improve the conditions in the disaster shelters. Mr. Greer suggested Mr. O'Neal, County Manager; Mr. Steuer; Mr. Dan Summers, Emergency Management Services Director; Mr. Rice; Ms. McCumbee; and Mr. Greer meet to address the issue of generator equipment and usage. He reported generators are available at some disaster shelters, however; the issue of proper generator equipment and usage needs attention. Mr. Rice requested a school representative participate in the generator resolution meeting. Dr. Speck suggested training of appropriate staff on the usage of generator and generator switches. It was the consensus of the Board of Health to endorse a meeting of county officials, health department officials and staff to address the issue of generator equipment and usage and to discuss alternatives to improve conditions in the New Hanover County disaster shelter. New Business: Bodv Piercine: Regulations Mr. Steuer recommended from the Executive Committee for the Board of Health to present the Rules Governing Body Piercing Establishments and Practitioners in New Hanover County to the Board of Health for their consideration and to recommend these rules be accepted and adopted at a future meeting of the Board of Health. Ms. Dianne Harvell, Environmental Health Director, reported the Environmental Health Committee and staff have been working on Rules Governing Body Piercing Establishments and Practitioners since December 1998. Mr. Link, Chairman, and Dr. Smith, Member, Environmental Health Committee, have participated in the process of accessing the need, reviewing, and developing the regulations. The purpose of the rules is to establish standards for the operation of body piercing establishments, to establish performance and training standards for persons engaging in the practice of body piercing, and to minimize the risk of disease transmission. The draft ofthe regulations encompasses provisions of a model code developed in 1998 by the National Environmental Health Association (NEHA), codes from other local jurisdictions, meetings with health department staff and other related agencies, and consultation with the New Hanover County Legal Department. Ms. Harvell reported the State Assistant Attorney General advised body piercing issues should be addressed separately from tattooing issues. Ms. Harvell informed the Board that the draft of the Rules Governing Body Piercing Establishments and Practitioners needs to be presented to the public at a Public Hearing before the full Board of Health. The Public Hearing will give body piercing operators/technicians, clients, and the public an opportunity to address the rules. A Public Notice will be issued two weeks prior to the Public Hearing. Following the Public Hearing, the draft of the body piercing regulations will be presented to the full Board of Health and then to the New Hanover County Board of Commissioners for their consideration of adoption of the regulations. 3 44 Mr. Estep inquired if body piercing operators/technicians were involved with the requirements of the I regulations. Ms. Harvell responded she felt they were receptive to the regulations. Ms. Hunter asked who will provide the training requirements every two years? Ms. Harvell clarified in the past the training has been contracted and that fees may need to be adjusted to cover training. Ms. Harvell expressed she is grateful to the Environmental Health Committee, the physicians in the community, to health department staff, and to those who supported and assisted in developing the body piercing rules. Dr. Smith commended Ms. Harvell for a fantastic job on the needed body piercing regulations. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve the proposed Rules Governing Body Piercing Establishments and Practitioners in New Hanover County at a future Board of Health meeting. Upon vote, the MOTION CARRIED UNANIMOUSLY. Health Homes State Grant Application Mr. Steuer recommended from the Executive Committee for the Board of Health to approve the Health Homes State Grant Application. The Board reviewed the Health Homes State Grant proposal ($20,000) through the North Carolina Childhood Lead Poisoning Prevention Program. The goal of the grant is to educate the registered Family Child Care Homes providers on asthma control and lead prevention. It will combine efforts of staff from the Child Health and Environment Health Divisions in working with Family Child Care Homes. The budget ($20,000) includes 2 Salaries: 1 Part-time Registered Environmental Health Specialist and 1 I Licensed Practical Nurse (20 hours per week for 24 weeks), transportation expenses, medical and office supplies, and other supplies (air filters, and mini blinds). Ms. Hunter stated she would like for the Board to realize the grant contains monetary incentives IE mini blinds and air filters to these Family Child Care Homes. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve the Health Homes State Grant Application and to submit the grant proposal to the New Hanover County Board of Commissioners for their consideration. Upon vote, the MOTION CARRIED. -L Aye -L Nay - Mr. Greer Skin Cancer Health Education Proiect ($10.000) Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve the Skin Cancer Health Education Project ($10,000). The Board of Health reviewed the Skin Cancer Health Education Project. The health department received $10,000 from the North Carolina Cancer Control Program for a pilot project initiative to develop educational methods for sun safety and skin care. The budget includes funding for educational materials, overtime pay for staff on weekends, training, and travel expenses. Dr. Goins asked if any local dermatologists will be involved in this project. Ms. Denise Houghton, Health I Promotion Director, stated they do plan to work with local dermatologists and New Hanover Regional Medical Center on the Skin Cancer Health Education Project. 4 I I I '. tf _ .. 45 MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve the Skin Cancer Health Education Project ($10,000) funded by the Cancer Program of North Carolina and to submit the proposal to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED UNANIMOUSLY. Recommended FY 1999-2000 Budget Appeal Mr. Steuer recommended from the Executive Committee the approval of the Recommended FY1999-2000 Budget Appeal. The items listed below were requested in the Health Department's original FY 2000 Budget Request but were not included in the FY2000 Recommended Budget. Mr. Steuer asked the Board of Health to review these items for reinstatement in the Approved Health Department Budget for FY 2000. The items for reconsideration in the budget appeal are as follows: Proe:rams Positions Increase $ Environmental Health Jail Health 1 Environmental Epidemiologist 1 Medical Office Assistant 51,862 14,993 Animal Control Services Epidemiology Capital Outlay - Equipment Transfer Switch Generator - Vaccine 15,000 15,000 Other Expenditures Administration Temporary Salaries (Dr. Reynolds) Departmental Supplies (Vaccines) Departmental Supplies ( Drugs) Contracted Services (Medical Care) 3,200 5,000 20,000 41,000 Epidemiology Family Planning Jail Health Mr. Steuer reported the Executive Committee felt the above requested items are needed in their respective programs and should be reconsidered. He asked the Board of Health members to review and discuss the budget requests for reinstatement in FY1999-2000 Approved Budget as presented. Mr. Greer asked about the budget request for a generator in Epidemiology for a refrigerator that contains a vaccine inventory of approximately $68,000 during peak times. Mr. Rice explained this generator is needed daily as a backup for power failures as well as during disasters. Staff currently monitors the vaccine and returns to the Health Department following power failures. Dr. Speck added the Animal Control Services transfer switch is needed. Mr. Steuer stated two positions are being requested in the budget appeal: 1 Environmental Epidemiologist and 1 Part-time Medical Records Clerk. Dr. Smith inquired regarding the location and clarification of the Environmental Epidemiologist position request. Ms. Harvell reported when the Epidemiologist position 5 46 was requested, it was a replacement of a General Service Worker position. She explained the General Service Worker position was in the Environmental Health budget for several years. The Recommended I Budget did not include either the Environmental Epidemiologist or the General Service Worker position; therefore, Environmental Health lost a full-time position. Ms. Harvell advised an Environmental Epidemiologist position would work with the other health department divisions, assess health and communicable disease problems and statistics, and would be of greater public health value to our community . Mr. Steuer asked Ms. Creech to address the position request for the Medical Office Assistant (50%) position. Ms. Creech explained the position request was due to the tremendous amount of clerical work in the Jail Medical Program due to the increase of the jail population and due to the loss of state funding for ofthe current clerical assistance effective August 1, 1999. Mr. Rice stated Sheriff Joseph McQueen fully supports the Jail position request. Ms. Lynda Smith, Assistant Health Director, reported the Jail Health Budget for Contracted Services was reduced by $41,000. She stated for the last two or three years other budgets have had to offset jail expenses. Ms. Smith added Administration Temporary Salaries was reduced by $3,200 deleting Dr. Reynolds'salary. The budget appeal request includes the addition of$3,200 to reinstate funds to pay Dr. Reynolds. Mr. Steuer reported revenues were increased in the Recommended Budget for Animal Control Services ($79,806) and Environmental Health ($37,900). Ms. Smith advised these revenues may not be achievable. The recommendation is for Animal Control Services Revenue to be reduced to the original amount of $397,500 and for Environmental Health fees to be reduced to the original amount of $275,000 in the FY2000 Approved Budget Request. Mr. Steuer expressed the Board of Health understands the County Commissioners budgetary problems, I but the Board has studied justifications and has tried to ask for funds to meet the necessary health department needs. He thanked Ms. Rowe, Budget Committee Chairman, the Budget Committee, and those who were involved in the budget process. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve the Recommended FY 1999-2000 Budget Appeal and to submit the budget request to the New Hanover County Commissioners for their consideration at the Budget Hearing on June 7, 1999. Upon vote, the MOTION CARRIED UNANIMOUSLY. Comments: Board of Health FY 1999-2000 Bude:et Process Mr. Steuer expressed his appreciation to Mr. Greer for the consideration of these budgetary issues. He reiterated the County Commissioners have a job and the Board of Health appreciates their efforts during the budget process. Health Promotion Committee: Dr. Jewell announced the Health Promotion Committee plans to meet on Thursday, June 3, 1999. Sunday Star News Article - Mav 23. 199 on Violence Dr. Goins referred to an excellent newspaper article regarding Violence and Criminal Behavior featuring Dr. Thomas C. Clancy, former Board of Health member, and Ms. Denise Houghton, Health Promotions Director, New Hanover County Health Department. The article was regarding the injury prevention work 6 I I I I 47 that Dr. Clancy, Trauma Director, New Hanover Regional Medical Center, and the Health Department, are advocating with more educational programs targeting injury prevention, both violent and accidental. FY 1999-2000 Budget Process Mr. Greer made a few commènts regarding the budget process. He realizes items requested in the different departments are needed. He advised everyone should look at the whole budget. Health Director Eae:le Island Field Trip. June 3. 1999 Mr. Rice advised a field trip to Eagle Island is scheduled at 10:30 a.m. on Thursday, June 3, 1999. The New Hanover and Brunswick County Commissioners, Board of Health, and health department staffwill visit the island to observe the Mosquito Control Program de-watering efforts of Eagle Island. Celebrating 120 Years of Public Health in New Hanover County. June 14.1999 The Board of Health members were invited to attend the 120 Years of Public Health Celebration to be held at 8:00 a.m. on June 14, 1999, in the Health Department Auditorium. Mr. Dan Shingleton, Associate Professor of Social Work, Barton College, Wilson, N. C., is the guest speaker. He will speak on the History of Public Health in New Hanover County. Animal Control Director Update Mr. Rice reported Mr. Allen O'Neal, County Manager, Dr. Speck, and Mr. Rice will hold final interviews today for the position of Animal Control Services Director. A decision regarding the selection for the Animal Control Services Director position will be made by the end of June 1999. County Summer Blood Drive Ms. Smith invited Board members to participate in the New Hanover County Blood Drive to be held from 9:30 a.m. through 3:00 p.m. on Tuesday, Junel5, 1999, in the Health Department Auditorium. Donors may donate blood between May 31 through July 2 at the Red Cross Center located on 161h Street. Hurricane Expo - June 5 Mr. Rice reported a Hurricane Expo will be held on Saturday, June 5, 1999, at Trask Coliseum at the University of North Carolina @ Wilmington. Letter of Appreciation Commending Ms. Ellen Harrison. Public Health Nurse Mr. Rice presented a copy of a letter he received commending Ms. Harrison, Public Health Nurse, Community Health Division, for her professionalism. The letter expressed appreciation to Ms. Harrison and expressed the need for full-time School Health Nurses. Mr. Rice commended Ms. Harrison for her services as a School Health Public Health Nurse. 7 48 Epi Information Mr. Rice referred the Board to the May 1999 edition of the Communicable Disease - EP I Information newsletter. I Other Business: Bodv Piercine: Hearine: at Ree:ular Board of Health Meeting Mr. Steuer requested the Board set a date for the Public Hearing. It was the consensus of the Board of Health to hold the Public Hearing on the Rules Governing Body Piercing Establishments and Practitioners. The Board of Health decided to hold the Public Hearing at 8:00 a.m. on Wednesday, July 7, prior to the regular Board of Health meeting. Adjourn: There being no other business, Mr. Steuer adjourned the regular meeting of the New Hanover County Board of Health at 9:45 a.m. I ~J~ William T. Steuer, PE/RLS, Chairman New Hanover County Board of Health /Úø David E. Rice, M.P.H., M.A., Health Director New Hanover County Health Department I Approved: July 7, 1999 8