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09/01/1999 I I I 68 Mr. William T. Steuer, Chairman, called the regular business meeting of the New Hanover County Board of Health to order at 8:00 a.m. on Wednesday, September I, 1999. 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 De Vane, Recording Secretary Invocation: Mr. Henry V. Estep gave the invocation. Minutes: Mr. Steuer asked for corrections to the minutes of the August 4, 1999 New Hanover County Board of Health meeting. The minutes of the August 4, 1999 Board of Health meeting were approved. Recognitions: Personnel Mr. Rice recognized and congratulated the following New Hanover County Service Awards recepients: Service Awards Ten (0) Years Service Denise T. Houghton, Health Promotion Director, Health Promotion Fifteen (5) Years Service Frances C. Chandler, Clerical Specialist I, Communicable Disease Mr. Rice introduced the following health department employees: New Emplovees Beverly I. Fussell, Public Health Nurse II, Community Health Pamela (Kay) Tompkins, Licensed Practical Nurse II, Communicable Disease 1 69 Mr. Rice welcomed and introduced Ms. Susan Sigman and Ms. Jill Milligan, UNCW nursing students, I observing the Board of Health meeting. Perseverance and Organization. On behalf of the Board of Health, Mr. Steuer expressed appreciation to Ms. Houghton and Ms. Chandler for their years of service and welcomed new employees and the UNCW nursing students. Department Focal: "Be Skin Smart" - Skin Cancer Awareness Pro2ram Ms. Denise Houghton, Health Promotion Director, gave the department focal on the Be Skin Smart - Skin Cancer Awareness Program sponsored by the North Carolina Cancer Control Program. Carteret, Currituck, Dare and New Hanover Counties and PPCC District participated in the project to provide prevention strategies on recreational sun exposure for children of 4 to 7 years of age. Ms. Houghton reported on July 6-9, 1999, representatives from New Hanover Regional Medical Center, American Cancer Society, Wilmington Health Access for Teens (WHAT), WGNI, Carolina Skin and Vein Center, and the Health Promotion staff distributed educational materials, sunscreen samples, and incentives to promote sun safety on Carolina, Kure, and Wrightsville Beaches. Fifty parents were interviewed to assess their children's sun exposure, sun protection, history of sunburns, and family history of skin cancer. Information from this project will be used to develop skin cancer prevention activities of the North Carolina Cancer Control Program. Ms. Houghton announced the successful skin cancer awareness project is featured in an article in the County Connection Newsletter. Committee Reports: I Executive Committee Mr. Steuer, Chairman, Executive Committee, reported the Executive Committee met at 6:00 p.m. on Tuesday, August 24, 1999. Items are listed under New Business on the Board of Health Agenda. Unfinished Business: Generators/Hookups at Emer2ency Shelters Mr. Steuer reported Mr. Rice and Mr. Steuer attended several meetings with county officials, health department staff, and CP&L representatives to address generator equipment hook-ups at the disaster shelters. He advised CP& L approved a plan to install generator hookups at the four schools in 1999 when the Board of Commissioners declares the county in a state of emergency. CP&L will use their engineers to disconnect power at the schools 4-5 hours before an emergency to allow the connection of the generators at the emergency sites. Mr. Steuer stated a contract needs to be negotiated through Mr. Dan Summers, Emergency Management Director, to address the generator equipment hook-ups. He stated Hurricane Dennis interrupted the timeframe for the generator plans. Mr. Steuer clarified CP&L engineers support the proposal to provide adequate generators at the disaster I shelters to protect public health and safety during emergency events. The cost for this year would be $25,700 without the assistance ofCP&L. CP&L plans to work with us this year; however, by Year 2000 plans need to be made to install permanent manual generator transfer switches at the disaster shelters. 2 I I I 70 MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve the Plan for Generators/Hookups at Emergency Shelters in New Hanover County and to submit the recommendation for generators/hookups to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED UNANIMOUSLY. Ms. Betty Creech, Community Health Director, reported four emergency shelters were opened during Hurricane Dennis. The shelters were located at Codington, Johnson, Trask, and Laney Public Schools. Power was available at Codington Elementary and Dorothy B. Johnson Elementary Schools during the hurricane. When Emma B. Trask Middle School lost power, no one was available to run the generator. Emsley A. Laney High School had power but closed early at 7:30 p.m. Ms. Creech informed due to security officers working at the shelters, behavior problems were decreased and conditions were improved. Mr. Rice explained the Vector Control staff set up the shelter portable generators; however, no one was available to start them. Plans are to address shelter problems and to obtain contractors to maintain and run emergency shelter generators. Mr. Steuer stated during future emergencies, larger generators should be available in the shelters. Mr. Greer inquired about the chance of a generator blowing over. Mr. Steuer advised generators are heavy; therefore, the chance of them blowing over is slight. Mr. Rice advised the proposed Plan for Generators/Hookups at Emergency Shelters in New Hanover County will be placed on September 7, 1999 Board of County Commissioners Agenda. New Business: Animal Control Services Adoption Policy - Spav/Neuter Program Mr. Steuer recommended from the Executive Commimee for the Board of Health to approve the Animal Control Services Adoption Policy including a Spay Neuter Program, to increase of the Animal Control Services adoption fee from $45 to $60, and to submit the adoption fee increase to the New Hanover County Commissioners for their consideration. The proposed increase in the adoption fee is to help defray the expense of the Spay/Neuter Program. Mr. Rice clarified Item #6 of the ACS Animal Adoption Contract was changed to read dogs, cats, and ferrets under 4 months of age must receive a ACS Rabies Certificate for a free vaccination at the time of surgery. Mr. Steuer reiterated he is still concerned about animals under 4-years of age receiving a certificate for a free rabies vaccination and not receiving the vaccination. Dr. Jean McNeil and Dr. Speck concurred the exact rabies vaccination due/deadline date for adopted pets under 4-years of age must be written on each ACS Rabies Certificate. It was the consensus of the Board of Health to revise the ACS Rabies Certificate form to clearly state the pet must be vaccinated for rabies by placing the specified due date on the ACS Rabies Certificate form. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to approve the Animal Control Services Adoption Policy including a Spay Neuter Program, to increase of the Animal Control Services adoption fee from $45 to $60, and to submit the adoption fee increase to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. 3 71 Animal Control Services Advisorv Committee Term of Office Mr. Steuer recommended from the Executive Committee for the Board of Health to appoint members to serve on the Animal Control Services Advisory Committee for a three-year term of office. Mr. Rice referred the Board to a proposal for the rotation of term of office for members serving on the Animal Control Services Advisory Committee. The purpose of the rotation schedule for committee members is to prevent the loss of a full committee. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to appoint members to the Animal Control Services Advisory Committee for a three-year term of office.. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. Mr. Steuer recommended from the Executive Committee for ACS Advisory Committee members who have served two (2) consecutive three (3) year terms shall rotate off the ACS Advisory Committee at the expiration of their present group term. Dr. Goins expressed he endorses having the appointment of Animal Control Services Advisory Committee members mirror the Board of Health Bylaws. He stated it is theraputic to have a committee member rotate off either a committee or board and return to serve invigorated. The Board of Health should appoint committee members and make reappointments at the expiration of one term of office. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to approve that Animal Control Services Advisory Committee members who have served two (2) consecutive three (3) year terms shall rotate off the ACS Advisory Committee at the expiration of their present group term. . Upon vote, the MOTION CARRIED UNAMIMOUSL Y. School Health Lice Grant Application - $4.900 Mr. Steuer recommended from the Executive Committee for the Board of Health to approve the CP&L School Health Lice Grant Application. Ms. Betty Creech, Community Health Director, explained the purpose of the CP&L School Health Lice Grant is to provide funds for combs to eradicate head lice and to provide educational materials on lice control for school children. The combs are effective and cost approximately $10 each. Ms. Creech informed head lice infestation is a tremendous problem in New Hanover County elementary schools. One school has 30 children with lice infestation. Head lice infestation is communicable. The total grant budget is $4,900 that includes $3,600 for metal combs, $1,100 for educational materials and $200 for Interpreter (English to Spanish). Ms. Hunter inquired about the combs used to eradicate head lice. Ms. Creech stated the Lice Mister combs cost approximately $10. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve the CP&L School Health Lice Grant Application ($4,900) and to submit the grant application to the New Hanover County Commissioners for their consideration.. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. I I I 4 I I I 72 Jail Health Issue Mr. Steuer recommended from the Executive Committee for the Board of Health to approve the Jail Health proposal for single-person cells to be built in the (new) New Hanover County Jail to eliminate injuries related to fights in the cells; to eliminate forced sexual activity; to increase ability to watch mentally ill, suicidal, and those suffering with withdrawal; to eliminate the spread of sexually transmitted diseases; to reduce spread of other communicable diseases; to reduce riots and improve control inmates, to improve safety for jail and health staff; to have punishment more equally meted out; to eliminate overcrowding; and to reduce the cost of jail health care; and to submit the recommendation to the New Hanover County Commissioners for their consideration. . Ms. Betty Creech, Community Health Director, explained the proposal from the Jail Health Medical Team is to support the concept of building single cells in the new jail to reduce fighting, injuries, and the spread of sexually transmitted disease among inmates. Single cells should significantly reduce medical expenses and defray the cost of building single cells for the new Jail. Ms. Creech stated beyond the cost involved, there is the issue of responsibility to protect the jail inmates. She reported Mr. Rice, Shenff Joseph McQueen, Major Spell, Captain Smith, and Ms. Creech met to discuss single-person cell concept in the new Jail. Those attending endorsed single cells. Ms. Creech reiterated the goal is to protect the health and security of mmates. Ms. Penny Raynor, Physician Extender, stated segregating inmates can save health care expenses. She advised she sends at least one inmate from the Jail to the hospital emergency room each day. She expressed concern about the inmates' frequent fights, serious injuries, exposure to communicable disease, and increased medical expenses. Dr. Goins concurred single person cells should decrease medical, staffing, and other expenses and should over a period of time should pay for the installation of the single cells in the physical facility. Mr. Steuer and Mr. Estep advised the Board needs to get the projected cost for single cells in the new Jail. Mr. Greer stated the decision regarding whether to build single jail cells will be based upon cost. He stated it might not be feasible to build a new Jail containing totally single person cells; however, there is a need for as many single cells as possible. He stated single person jail cells would not isolate inmates 100% of the time. Ms. Whitted expessed if one person is saved from a communicable disease, as health professionals the Board should consider health needs and issues. Dr. Speck added the inmate although incarcerated should not be exposed to extraordinary circumstances. Dr. Smith concurred this is a health and a political issue, and the Jail population needs to be reduced. Mr. Steuer expressed the Jail health issue is a complex problem and offered the Board of Health's support in addressing the single cell concept. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve a Jail Health proposal for single-person cells in the new New Hanover County Jail to eliminate injuries related to fights in the cells; to eliminate forced sexual activity; to increase ability to watch mentally ill, suicidal, and those suffering with withdrawal; to eliminate the spread of sexually transmitted diseases; to reduce spread of other communicable diseases; to reduce riots and improve control inmates, to improve safety for jail and health staff; to have punishment more equally meted out; to eliminate overcrowding; and to reduce the cost of jail health care; and to submit the recommendation to the New Hanover County Commissioners for their consideration.. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. 5 73 Growin2 Up Buckled Up Grant Application Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve a Grant Application for Growing Up Buckled Up from the National Traffic Safety Administration The goal of the grant is to increase the safety of child passengers by increasing booster seat usage among children ages 5 to 8 and to educate older children about the importance of using a seat belt for their entire lifespan. It is a community project through Safe Communities/Safe Kids of New Hanover County. The total budget is $54,731. Dr. Jewell, Chairman, Health Promotion Committee, explained the Growing Up Buckled Up Grant Application is a directive of the five Injury Prevention Needs Assessment Initiatives passed by the Board of Health. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve the Growing Up Buckled Up Grant Application ($54,731) and to submit the grant request to the New Hanover County Board of Commissioners for their consideratIOn. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. Model Community Assessment Grant Application Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve the Grant Application for Model Community Assessment for $17,375 through the Office of North Carolina Healthy Carolinians. The core function of the grant is to assess community needs through collaboration between the local health department and the Healthy Carolinians Task Force. Representatives from New Hanover County Health Department, New Hanover Regional Medical Center, UNCW, Coastal AHEC, New Hanover County Department of Social Services, New Hanover County Healthy Carolinians, and Cape Fear Area United Way will conduct a needs assessment to improve the social, physical, and mental well-being of people in southeastern North Carolina. The total budget is $17,375 including costs for telephone surveys, face-to-face interviews, focus groups, binders, web site design, and operating expenses. Mr. Rice explained the original grant proposal was for $16,246 and was increased to $17,375 for transportation costs. MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve the Model Community Assessment Grant Application for $17,375 through the North Carolina Community Health Assessment Initiative and to submit the grant request to the New Hanover County Board of Commissioners for their consideration. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. Revision to Fee Policy - Personal Health Flu Immunization Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve a request to increase the price of flu vaccine from $10 to $12 in the Personal Health Flu Immunization Fee Schedule of the New Hanover County Health Department effective October 1, 1999. Mr. Rice explained the price increase for flu injections is based on Medicare Allowance Charges. I I I 6 I I I 74 MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve the increase in the Personal Health Flu Immunization Fee from $10 to $12 per injection and to submit the fee increase to the New Hanover County Commissioners for their consideration to be incorporated as a revision to the New Hanover County Health Department Fee Policy. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. Diabetes Todav Community Implementation Funds ($10.000) Grant Application Ms. Lynda F. Smith, Assistant Health Director, informed the Board the DiabetetesToday/Diabetes Coalition from the Diabetes Today Community Funds ($10,000) Grant Application was received after the August 24 Board of Health Executive Committee meeting. The grant application deadline is September 3, 1999. Ms. Smith presented a proposal to the Board of Health for Diabetes Today Community Implementation Funds. Ms. Smith eXplained the purpose of the grant is to establish a Community Diabetes Coalition. The Coalition is to plan community-based interventions regarding the severity and consequences of diabetes by focusing on education, outreach, and improving access to care. The grant includes a request for a part- time Coalition Coordinator to accomplish the goals and objectives of the Coalition and the New Hanover County Diabetes Today Plan. Community needs will be determined to develop the implementation of the goals, objectives, and strategies related to diabetes. Dr. Smith advised due to overeating and a lack of exercise, the rate of Diabetes has increased even amDng the childhood population. MOTION: Ms. Rowe moved and seconded by Dr. Smith for the Board of Health to accept and approve the Grant Application for Diabetes Today/Diabetes Coalition Implementation Funds for $10,000 from the Diabetes Prevention and Control Unit (DPC), N. C. Department of Health and Human Services, and to submit the grant application to the New Hanover County Board of Commissioners for their consideration. Upon vote, the MOTION CARRIED UNAMIMOUSL Y. Comments: Board of Health Dr. Goins stated he is excited about the Injury Prevention Needs Assessment Initiatives endorsed by the Board of Health. Ms. Whitted emphasized health providers are concerned about public health, and the Board of Health needs to focus on and help with health issues. Health Director Mana2ement Academv for Public Health Mr. Rice stated Mr. Rice, Ms. Smith, and Ms. Cindy Hewett, Business Officer, attended the UNC Management Academy for Public Health from August 8 - 13, 1999, at UNC @ Chapel Hill. He thanked the Board of Health for their support and for sending participants to the academy. He stated it is a wonderful opportunity that will improve the way the health department conducts business. The Management Academy consists of Phase I, II, and III. Phase II on Project Management and Information Management will be completed in February 2000. 7 75 AEIOU Update I Mr. Rice gave an update on the AEIOU Committee. He reported the committee is realizing benefits and positive results from the AEIOU process implemented in March 1998. Health Department Landscapin2 Mr. Rice reported Beth Jones, Community Health Director, coordinated an effort with UNCW students to landscape the front entrances of the health department. He commended Ms. Jones for ajob well done and invited Board of Health members to observe the landscaping enhancements. Hurricane Dennis Mr. Rice reported staff members were recognized for their work and services during Hurricane Dennis. A list of participants, staff services, and a report of the conditions in the disaster shelters is being completed. Mr. Greer emphasized many county employees leave their homes during hurricanes and go the extra mile to serve the citizens in our community. It was the consensus of the Board of Health to recognize and to thank employees for their disaster services through the Health Department Newsletter. NCPHA - September 14-17. Asheville. N. C. Mr. Rice announced the North Carolina Public Health Association will meet on September 14-17, 1999, in Asheville, North Carolina. The first official Wood Lecture will be presented. Mr. Robert S. Parker, I former Health Director, was instrumental in the establishment of the Wood Endowment Fund to fund the NCPHA lectures. Other Information Mr. Rice referred the Board to information in their folders that includes a letter from CP&L agreeing to assist with the emergency generator problems in 1999, a copy of the budget revision for the Model Community Assessment Grant Application ($7,375), and a copy of the Diabetes Grant Application. Other Business: Adjourn: Mr Steuer adjourned the regular meeting ofthe New Hanover County Board of Health at 9:40 a.m. d~ cJ M;-~~ William T. Steuer, PEIRLS, Chairman New Hanover nty Boa d of Health Approved: October 6, 1999 David E. Rice, M.P.H., M.A., Health Director I New Hanover County Health Department 8