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07/07/1999 I I I 49 Mr. William T. Steuer, Chairman, called the meeting of the New Hanover County Board of Health (NHCBH) to order at 8:00 a.m., Wednesday, July 7, 1999 in the Dr. Thomas Fanning Wood Memorial Conference Room of the New Hanover County Health Department, 2029 South 17th Street, Wilmington, North Carolina. New Hanover County Board of Health Public Hearing: New Hanover County Board of Health Rules Governine: Bodv Piercine: Establishments and Practitioners in New Hanover County. North Carolina The New Hanover County Board of Health met in a Special Session. Mr. Steuer called the Public Hearing to order. He stated the purpose of the hearing is to receive public comments on the proposed draft of the New Hanover County Board of Health Rules Governing Body Piercing Establishments and Practitioners in New Hanover County, North Carolina. Mr. Steuer welcomed attendees. Board members introduced themselves and designated their category of representation on the Board of Health. Mr. Steuer advised the proposed draft of the New Hanover County Board of Health Rules Governing Body Piercing Establishments and Practitioners in New Hanover County, North Carolina, will be considered for adoption by the Board of Health at their regular meeting on August 4, 1999. Copies of the body piercing rules were available for review. Speakers were asked to sign-up for three-minute presentations. Mr. Woody Page, Mr. Darren Blunt, and Mr. Mark Kruea, representing body piercing establishments and practitioners, listed their names to address the Board of Health on this issue. Mr. Steuer explained the Board of Health will not respond t%r entertain questions this morning. He requested any questions for the Board of Health be submitted to Mr. David E. Rice, Health Director, at the New Hanover County Health Department on/or before July 16, 1999. Mr. Steuer advised written questions or remarks regarding the Rules for Body Piercing Establishments and Practitioners will be accepted by the Board of Health on/or before July 16. Mr. Steuer called for public comments concerning a draft of the New Hanover County Board of Health Rules Governing Body Piercing Establishments and Practitioners in New Hanover County, North Carolina. Mr. Woody Page, Manager, Marks of Distinction, addressed the Board of Health. He requested the Board of Health review Section 5011 Requirements for Premises, Subsection (t), of the draft of Rules for Body Piercing Establishments and Practitioners in New Hanover County, North Carolina. He informed the draft of the rules currently state: No animals of any kind shall be allowed in a body piercing establishment except service animals used by persons with disabilities (i.e. Seeing Eye dogs). Fish aquariums shall be allowed in waiting rooms and non-procedural areas. Mr. Page explained he is in favor of the body piercing regulations; however, he opposes not allowing any animals other than fish aquariums in a waiting room or in a non-procedural area of a body piercing 1 50 establishment. Mr. Page requested the Board of Health consider revising the proposed body piercing rules to read: I No animals of any kind shall be allowed in the procedure room of a body piercing establishment except a service animal used by persons with disabilities (i.e. Seeing Eye dogs). Mr. Steuer asked Mr. Darren Blunt and Mr. Mark Kruea, representatives of body piercing establishments, if they had either additional comments, questions, or concerns to present to the Board of Health. Mr. Blunt and Mr. Kruea stated they did not wish to address the Board of Health. Mr. Steuer asked for comments from the floor regarding the Rules for Body Piercing Establishments and Operators. There were no additional comments from the floor. He thanked the speakers and attendees for their interest in the draft of the Rules Governing Body Piercing Establishments and Practitioners in New Hanover County, North Carolina. Mr. Steuer closed the Public Hearing at 8:10 a.m. New Hanover County Board of Health Business Meeting: Following the Public Hearing, Mr. Steuer called the regular business meeting ofthe New Hanover County Board of Health to order at 8: 11 a.m. 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 W. Edwin Link, Jr., RPH Anne Braswell Rowe Philip P. Smith, Sr., MD Melody C. Speck, DVM Estelle G. Whitted, RN I Members Present: Members Absent: Others Present: David E. Rice, Health Director Lynda F. Smith, Assistant Health Director Frances De Vane, Recording Secretary Invocation: Dr. Philip Smith gave the invocation. Minutes: Mr. Steuer asked for corrections to the minutes of the June 2, 1999 New Hanover County Board of Health I meeting. The minutes of the June 2, 1999 Board of Health meeting were approved. 2 I I I 51 Recognitions: Service Awards Mr. Rice recognized and congratulated the following New Hanover County Service Award recipients: Service Awards Five (5) Year Service Harold L. Kelly, Soil Scientist, Environmental Health Fifteen (15) Year Service Lynda F. Smith, Assistant Health Director, Administration Personnel Mr. Rice introduced the following new health department employees: New Emplovees Frankie T. Mincey, Public Health Nurse II, Community Health Cammie C. Marti, Public Health Nurse, Community Health Ms. Esther Adams. Semi-Annual Super Staff Award Mr. Rice recognized Ms. Esther Adams, recipient of the Semi-Annual Super Staff Award. He commended Ms. Adams, Public Health Nurse/Communicable Disease, for her professional and dedicated public health services. Mr. Steuer thanked Ms. Smith and Mr. Kelly for their years of service, welcomed the new health department employees, and congratulated Ms. Adams as winner of the Semi-Annual Super Staff Award. Department Focal: A department focal was not presented. New Business: Appeal of Environmental Health Fees Mr. Steuer reported Mr. Steve Vosnock, New Hanover County Citizen, attended the meetings of the Environmental Health Committee on Wednesday, June 23, 1999, and the Executive Committee on Tuesday, June 30, 1999, to express his concerns about the cost for fees for the Environmental Health Soil and Water Programs. Mr. Steuer advised the Executive Committee recommends the denial of Mr. Vosnock's appeal to restructure the Soil and Water Fee Schedule of the Environmental Health Division ofthe New Hanover County Health Department Fee Policy. 3 52 Mr. Steuer requested Mr. Vosnock present his appeal of the Environmental Health Fees to the Board of Health. I Mr. Vosnock informed the Board of Health he is building his private residence (l,600-sq. ft.) in Castle Hayne, North Carolina, and he is overwhelmed at the cost of permits in New Hanover County. He indicated the total charge of $760 for a lot evaluation ($280), a septic tank permit ($280), and a well permit ($200) is unreasonable and excessive. He stated New Hanover County fees are higher and are not comparable to other surrounding counties. Mr. Steuer explained the fees for soil evaluation, septic tank permits, and well permits were established by the Board of Health by evaluating indirect/direct costs and staff time to perform permitting services in order to recover the cost of services. He stated the established fees are comparable to other comparable counties. Mr. Vosnock reiterated the soil and water permitting fees are too expensive. He added the Environmental Health services are needed; however, the high fees cause an undue financial burden on New Hanover County citizens. He expressed the time involved for an on-site inspection is much less than the fee for services. Mr. Vosnock complimented Ms. Harvell, Environmental Health Director, and the Environmental Health staff on their professional services. Ms. Rowe stated after going on a recent inspection field trip to Figure 8 Island, she was assured the inspections take a great deal of time and the fees are reasonable. Mr. Steuer stated Mr. Vosnock's complaint is the first complaint the Board of Health has received since the establishment of the Environmental Health Fee Schedule. He stated soil evaluations require trained I technicians, and both well and septic tank inspections are time consuming. Dr. Goins expressed the importance of a proper working water and sewer system. He stated the failure of either system would be more expensive. Mr. Vosnock asked the Board of Health to consider his appeal of the Environmental Health fees both now and in the future when considering the revision of fee schedules. Mr. Steuer thanked Mr. Vosnock for bringing his concerns regarding the fees to the full Board of Health. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to deny Mr. Vosnock's appeal to restructure the Soil and Water Programs Fee Schedule of the Environmental Health Division of the New Hanover County Health Department Fee Policy. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. Mr. Greer advised the Board needs to be aware of the fact the fees for soil evaluation and septic tank and well permits for a 1,600-sq. ft. house ($760) are difficult for some homeowners to pay. He stated he receives numerous questions regarding the cost of services and fees. Dr. Goins thanked Ms. Harvell and the Environmental Health Committee and staff for their research and study of the permitting services and fees. Committee Reports: I 4 I I I ^~-....'<" j'";"'~~ 53 Executive Committee Mr. Steuer, Chairman, reported the Executive Committee met at 6:00 p.m., Tuesday, June 30, 1999. Items discussed are listed under New Business on the Board of Health Agenda. Environmental Health Mr. Link, Chairman, Environmental Health Committee, met at 6:30 p.m., Tuesday, June 23, 1999. Items discussed are listed under New Business on the Board of Health Agenda. Health Promotion Dr. Jewell, Chairman, Health Promotion Committee, reported the Health Promotion Committee met at 5:30 p.m. on Thursday, June 3,1999. Unfinished Business: Generators/Hookups at Emere:ency Shelters Mr. Greer reported progress is being made regarding the issue of providing generators/hookups for emergency shelters in New Hanover County. Plans for temporary generator hookups are being developed with representatives from Carolina Power and Light Company, County Engineering, and Emergency Management. Mr. Steuer advised the emergency shelters will have water and will have at least temporary smaller generators. Ms. Whitted asked if police protection would be provided in the emergency shelters. Mr. Steuer responded two security-uniformed officers will be in the shelters on a 24-hour basis. Mr. Estep inquired about how soon an agreement would be concluded between CP&L and EMS for generator equipment. Mr. Steuer informed the Board he is not sure, but CP&L has the control of generator connections during any emergency. He advised a contractor should be hired to assist with the temporary generator hookups for disaster shelters. Mr. Greer stated portable generators for temporary power are now available. Mr. Rice referred the Board of Health to a memo from Mr. Dan Summers, EMS Director, regarding the options for the deployment of county generators in hurricane evacuation shelters. He reviewed these options with the Board. Mr. Summers, Emergency Management Director, the Board of Education, the Department of Social Services, Chairman Bill Caster, Commissioner Bobby Greer, and other county officials and staff, and other agencies are addressing how to improve conditions and deployment of generator equipment in the emergency shelters. A generator deployment exercise for staff is being planned at the disaster shelters. New Business: Community Health Improvement Proe:ram (CHIP) Grant Application Mr. Steuer recommended from the Executive Committee for the Board of Health to approve the Community Health Improvement Program (CHIP) Grant Application. Ms. Betty Jo McCorkle, Women's Health Director, presented a Application for a Healthy Women First Partners Program Community Health Program (CHIP) Grant Proposal ($24,692). This grant proposal is 5 54 a Partners Program of New Hanover Regional Medical Center. Ms. McCorkle advised $25,000 is the I maximum allowance for CHIP grants; therefore, the health department grants committee decided to consolidate grant requests and apply for one grant. Ms. McCorkle stated the mission of Healthy Women First Partners Program Grant is to provide improved and enhanced women's health preventive, pre conceptional, prenatal, and breastfeeding services for low-income women in New Hanover County and surrounding counties. The Budget is $24,692. It includes a Latino Prenatal Project ($12,250) with an interpreter/translator, incentives, a Breast-Feeding Seminar; a Breast-Pump Loan Program, a Preconception/Pregnancy Prevention Program; and educational and operating supplies. Total In-Kind is $51,496. Mr. Greer asked how the health department staff plans to reach the target population. explained referrals are received through Health Department programs and clinics, physicians, and from other agencies. Ms. McCorkle from private MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve the Healthy Women First Community Health Improvement Program (CHIP) Grant Application ($24,496) and to submit the grant proposal to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. Reclassification of Temporary Assistance to Needy Families (TANF )Position Mr. Steuer recommended from the Executive Committee for the Board of Health to approve the reclassification request of a TANF Social Worker position to a Public Health Nurse position in the Women's Health Division. Ms. McCorkle explained the request to reclassify a T ANF Social Worker position to a Public Health Nurse position will compliment the needs of the Department of Social Services and the recruitment of TANF clients for the Health Department Family Planning Program. The Public Health Nurse position will assist with Family Planning recruitment, appointments, and provide follow-up for compliance with concerns about prescribed birth control methods for TANF clients. Mr. Greer inquired about the cost of the reclassification of the Public Health Nurse position. Ms. McCorkle responded the TANF funding is to reduce out of wedlock pregnancies. The Budget is $28,374 and is state funded. The position reclassification request will represent a decrease in the operating budget and an increase in the salary line. Mr. Estep asked what would happen to the funding for the position if the Board does not approve the reclassification. Mr. Rice responded the funding will go to another county. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve the reclassification request of a T ANF Social Worker position to a Public Health Nurse position in the Women's Health Care Division and to submit the reclassification request to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. Injury Prevention Needs Assessment Mr. Steuer recommended from the Executive Committee for the Board of Health to endorse and approve the Injury Prevention Needs Assessment I I 6 I I I .-, ,"'., 55 Dr. Jewell, Chairman, Health Promotion Committee, referrèd the Board of Health to their copy of the Injury Prevention Needs Assessment for New Hanover County. He reported the Health Promotion Committee decided to focus on the following five topics: Bike Safety, Traffic Safety, Falls, Water Safety, and Gun Safety. Ms. Daryani reported copies of the manual for the Injury Prevention Needs Assessment Plan for New Hanover County were sent to the National Safe Kids/Safe Communities Committee. The national committee complimented the injury prevention plan and may consider using it as a model. Ms. Daryani informed she attended a local Safe Communities/Safe Kids meeting to form a local coalition to work on the Injury Prevention Needs Assessment Plan held on July 26, 1999, at New Hanover Regional Medical Center. The local coalition plans to plug into safety issues. Ms. Daryani reported Health Promotions is conducting a survey on the local beaches to raise the awareness of skin cancer risks and to promote proper sunscreen application habits. Ms. Rowe, Dr. Speck, and Mr. Steuer inquired about water safety issues and related injury prevention initiatives. Ms. Daryani stated water safety programs for pools and the ocean are being developed. The Town ofWrightsville Beach is offering a Water Safety training. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to endorse and approve the Injury Prevention Needs Assessment Plan for New Hanover County to focus on five areas of injury prevention: Bike Safety, Traffic Safety, Falls, Water Safety, and Gun Safety as presented by the Health Promotion Committee. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. Dr. Goins emphasized that the system does work and public health benefits. He explained the Board of Health requested the funding several times for the Health Educator position for injury prevention. This year the position was funded, and injury prevention initiatives are becoming a reality. FY1999-2000 Budget Update Ms. Anne Rowe, Budget Chairman, thanked the Budget Committee for their participation in the budget process and for their excellent job on the NHCHD Health Department Budget. She expressed her appreciation to Mr. Greer and to the Board of Commissioners for their efforts in the budget process. Ms. Lynda F. Smith, Assistant Health Director, presented a summary of FY1999-2000 New Hanover County Approved Budget. She stated 8 new positions were requested and 6 new positions were approved. The new positions are as follows: Organization Animal Control Services New Positions $ 2 ACS Officers 1 Clerical Salarv/Frin2;e $ 57,678 26,466 Community Health/School Health fJail Health 37,640 14,993 1 PH Nurse 1 Clerical (50%) Women's Health CarefT ANF 1 *PH Nurse ·Original Request Social Worker Approved as PHN I 19,721 Ms. Smith stated the total for 6 New Positions was $156,478 and for Salaries was $7,056,385. She reported the total for approved Capital Outlay: Other Equipment was $372,946. Vector Control received 1 trackhoe, 1 wheel loader, 1 trailer, 1 dump truck, and 1 steam cleaner. Animal Control Services received 1 portable radio, 2 pickup trucks, and 2 transport units. 7 56 Ms. Smith presented the following Summary of the Requested vs. Approved Budget for FY99-2000: Line Item Salary & Benefits Operating Expenses Capital Outlay Total Expenditures Requested $ 6,823,858 1,427,365 481.746 8,732,969 Approved $ 7,056,385 1,364,347 378.046 8,798,778 I Increased Expenditures 65,809 Total Revenue 3,591,301 3,725,147 Increased Revenues 133,846 Total Increase to County 68.037 Ms. Smith explained the total increase to New Hanover County was $68, 037 and that Salaries includes a 2% Market and 2% Merit increase for eligible employees. Mr. Steuer thanked Ms. Smith for her budget presentation and Ms. Rowe, Budget Committee Chair, for her efforts. Other Business: Cape Fear Foundation Grant Application - Teens AIDS Prevention (TAP) I Mr. Steuer recommended from the Executive Committee for the Board of Health to endorse and approve the Cape Fear Fondation Grant Application for continuation of the Teen AIDS Prevention Program. Ms. Beth Jones, Communicable Disease Director, reported last year the Board of Health funded a TAP Grant which was funded and quite successful; however, the Health Department was notified last Monday the State TAP Grant will not be funded for FY 2000. She is now researching for funding to continue the TAP Grant and requests permission from the Board of Health to continue the TAP Program. Ms. Jones advised the objectives of the TAP Program teach risk reduction strategies, stress HIV and STD prevention, provide an educational program for adolescents that promote changes in attitudes and behaviors, and teach personal risk-taking behaviors that change the lifestyle of high-risk adolescents. She emphasized TAP is a life-skills curriculum that teens may apply to behaviors and experiences throughout their life. Trained peer educators facilitate the successful program. Ms. Jones introduced Ms. Jessica Nakell, TAP Health Educator, and Ms. Cassie Dotson, Peer Educator, who spoke in support of the TAP initiatives. Ms. Nakell reported in the past six months, 16,000 teens were reached through the TAP Program. She expressed we know the TAP Program has an opportunity to change behaviors through peer education. It is a real opportunity for teens to learn and discuss adolescent issues and behaviors. Ms. Dotson advised the Board of Health teens appreciate peer education. They talk about teen issues, I relationships, healthy and unhealthy relationships, STD/ AIDs prevention, and improving their behaviors and attitudes. She advised she would like to see the TAP program continue. 8 I I I 57 Ms. Jones advised she has talked with the Cape Fear Memorial Foundation about possible funding the Health Educator position, so the TAP Program can continue to operate. She presented a request for permission to pursue funding for the continuation of the TAP Program from the Cape Fear Memorial Foundation and from other possible funding sources and a grant request for the Board of Health's consideration. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to support Ms. Jones and the Health Department staff in pursuing funding from the Cape Fear Memorial Foundation and from other alternate funding sources, to accept and approve a Cape Fear Memorial Foundation Grant Application for Teens AIDS Prevention Program for the continuation of the TAP Program in the health department, and to submit a grant request to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. Dr. Speck stated she is impressed with the number of teens the TAP Program has reached. She commended Ms. Jones for her presentation on the TAP Program. Mr. Rice applauded the Board of Health for their support of the teen's initiative. He reiterated this is the fourth time the Board of Health has supported the TAP endeavor. Comments: Board of Health Members Letters of Appreciation Dr. Goins suggested the Board of Health prepare letters of appreciation to the teen TAP volunteers for their participation in the TAP Program and to Mr. Dan Shingleton for his contributions to Public Health and for serving as the guest speaker at the Board of Health the 120 Year Public Health Celebration. Animal Control Services Dr. Speck reported Ms. Jean McNeil, Animal Control Services Director, attended the meeting of Local Veterinarians and represented Animal Control Services well. Mr. Steuer reported plans are being made for the improvement of services, for establishing an on-site veterinary spay/neuter clinic, and for obtaining a generator for the Animal Control Shelter. TAP Proeram Ms. Hunter commended TAP participants for ajob well. She stated she has heard good things about the program. Vector Control/Mosquito Control Mr. Steuer reported the tour of Eagles Island for Boards of Commissioners and Health was informative and most successful. The group observed a mosquito breeding habitat and mosquito control practices on the dredge disposal island. FY1999/2000 Approved Bude:et Mr. Steuer advised his budget presentation to the County Commissioners was a written document eXplaining why the health department needs the items deleted from the Recommended Budget. He apologized to the Board of Health for not sharing the budget information sooner. 9 58 Ms. Rowe again expressed her appreciation to the Budget Committee and to those who participated in the FY 1999- 2000 Health Department budget process. Health Director I Management Academy for Public Health Mr. Rice advised Ms. Smith, Ms. Cindy Hewett, Business Officer, and Mr. Rice plan to attend the 1999- 2000 Management Academy for Public Health. This is an invaluable training program for public health managers will be held August 9 - 13, 1999. Other staff may attend the next Management Academy for Public Health. Selection of Animal Control Director Mr. Rice reported Ms. Jean McNeil began her duties as Animal Control Services Director on June 15, 1999. He expressed his appreciation to Dr. Speck and to Mr. Allen O'Neal, New Hanover County Manager, for their participation in this selection process. Mr. Rice stated Ms. McNeil was selected from a number of qualified candidates. Providine: Public Health Services to Immie:rants Mr. Rice referred the Board to an Update: Providing Public Health Services to Immigrants document (l996 Federal Welfare Reform Act (P.L.I04-193). This update was from the Institute of Government. I Mr. Rice summarized immigrants are eligible for Public Health Services and that citizenship is not a requirement for services according to the interpretation of the term federal public benefit. The term federal public benefit excludes virtually all public health services and has directed agencies receiving any U.S. Department of Health and Human Services funding should adhere to this interpretation. Association of North Carolina Boards of Health (ANCBHO Mr. Rice displayed a Certificate of Institutional Membership to the Association of North Carolina Boards of Health CANCBH) issued to the New Hanover County Board of Health. A reprentative needs to be appointed to the ANCBH. Mr. Rice invited members to become involved in their association. Mr. Rice announced Mr. John Coble, Past Board of Health Chair and Member, has resigned as President of ANCBH. Dr. Goins advised the New Hanover County Board of Health was instrumental under the leadership of Mr. Carl Durham, Past Board Chair and Member, in the organizing and establishing the first ANCBH. Environmental Health Food Talk Newsletter Dr. Goins requested Board members read an article entitled Apply Food Safety Rules @ Home on the back page of the Food Talk Newsletter. It is an excellent article on keeping safe food in the home. Animal Control Services Spay/Neuter Service Update I Mr. Rice reported Dr. Speck, Ms. McNeil, and local veterinarians are addressing and developing a spay/neuter policy. 10 I I I 59 Vector Control Boat Delivered Mr. Rice stated the Vector Control boat was delivered and is receiving a decal today. It is a safe boat to be used in the Mosquito Control Program. Other Business: Rules Governine: Body Piercing Establishments and Practitioners in New Hanover County Mr. Steuer asked Ms. Harvell to compare Section 5011 ReQuirements for Premises. Subsection (t), of the Rules Governing Body Piercing Establishments and Practitioners to the County/State Rules Governing Tattooing Establishments to learn if animals are allowed in the procedure room of tattooing establishments. Mr. Greer expressed he appreciates the input from the body piercing establishments regarding the Rues for Body Piercing Establishments and Operators. Dr. Goins and Dr. Speck concurred their input was beneficial and their request needs to be considered. MOTION: Mr. Link moved and seconded by Ms. Rowe to revise Section 5011 Requirements for Premises, Subsection (t), of the draft of the Rules Governing Body Piercing Establishments and Practitioners in New Hanover County, North Carolina, to read as follows: No animals of any kind shall be allowed in the procedure room of a body piercing establishment except a service animal used by persons with disabilities (i.e. seeing eye dogs). Upon vote, the MOTION CARRIED UNAMIMOUSL Y. Mr. Steuer stated that the draft of the body piercing rules will be presented to the full Board of Health for their consideration at a future meeting. Adjourn: There being no further business, Mr. Steuer adjourned the regular meeting of the New Hanover County Board of Health at 9:55 a.m. ø~J~ William T. Steuer, PE/RLS, Chairman New Hanover County Board of Health David E. Rice, M.P.H., M.A., Health Director New Hanover County Health Department Approved: August 4, 1999 11