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11/03/1999 I I I 84 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, November 3, 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 W. Edwin Link, Jr., RPH Anne Braswell Rowe Melody C. Speck, DVM Gela N. Hunter, RN, Nurse Practitioner Members Absent: Philip P. Smith, Sr., MD Estelle G. Whitted, RN Others Present: David E. Rice, Health Director Lynda F. Smith, Assistant Health Director Frances De Vane, Recording Secretary Invocation: Ms. Anne Rowe gave the invocation. Minutes: Mr. Steuer asked for corrections to the minutes of the October 6, 1999 New Hanover County Board of Health meeting. The minutes of the October 6, 1999 Board of Health meeting were corrected and approved by the Board of Health. Recognitions: Personnel Mr. Rice recognized and congratulated the following New Hanover County Service A wards recepients: Service Awards Five (5) Years Service Judy P. Evonko, Animal Control Supervisor, Animal Control Services Ten (0) Years Service Carol A. Drummond, Clerical Specialist I, Community Health 1 85 Mr. Rice introduced the following health department employees: New Emplovees Deborah S. Goodwin, Public Health Nurse I, Child Health Joyce A. Hatem, Social Worker II, Child Health Diane M. Ihnat, Public Health Nurse I, Child Health Carmen Y. Larkins, Clerical Specialist I, WIC/Nutrition Mr. Rice welcomed a UNCW nursing student who was observing the Board of Health meeting. Mr. Link introduced Ms. Sonya Nagy, Pharmacy Student Intern, University of North Carolina at Chapel Hill, North Carolina. On behalf of the Board of Health, Mr. Steuer expressed appreciation to the Service Award recipients for their years of service and welcomed new employees and guests. Department Focal: Clinical Laboratory Improvement Act (CLIA) and Quality Assurance The department focal was not presented. Committee Reports: Executive Committee Mr. Steuer, Chairman, Executive Committee, reported the Executive Committee met at 6:00 p.m. on Thursday, October 21, 1999. Items are listed under New Business on this agenda. Unfinished Business: Generators/Hookups at Emer!!encv Shelters Mr. Steuer summarized an October 28, 1999 meeting addressing generators/transfer switches for emergency shelters. He reported Mr. Wyatt Blanchard, County Engineer, will schedule and lead the effort for the installation of generators and transfer switches at four schools used as emergency shelters by June 30, 2000. The schools are Trask, Johnson, Codington, and Eaton. The Board of Health reviewed the generator action plan. It includes an engineer's estimate, the follow- up on the County Commissioners' interest in purchasing generators, an assessment of the Board of Education for their participation, the preparation of a generator lease package budget, and a follow-up on the CP&L/W.K. Dickson meeting. Committee updates and summaries will be prepared and distributed. Mr. Steuer advised a funding request for the generator expenses will be presented to the New Hanover County Commissioners on November 15. 2 I I I I I I 86 Mr. Greer inquired whether the plan is to make power available to the whole school. Mr. Steuer stated it will furnish power wherever it is needed in the facility. Mr. Rice advised Mr. Blanchard is studying the feasibility of having newly constructed schools on line to furnish generator power. Mr. Steuer stated permanent generators with hookups are needed at the four schools and in the plans for new schools. Dr. Speck advised the Animal Control Services facility plans called for a generator; however, it was eliminated to save money. She expressed this issue needs to be monitored to assure new schools are equipped with generators during the construction stage. The Board of Health requested Mr. Rice prepare a letter to the Superintendent of Schools, New Hanover County Board of Education, regarding the feasibility of including generator equipment in the construction plans for new schools used as disaster shelters. Mr. Steuer reiterated the need to provide generators in schools with disaster shelters that will provide power to the entire school. New Business: Fundin!! for Healthv Carolinians - $10.000 Dr. Jewell recommended from the Executive Committee for the Board of Health to accept and approve the New Hanover County Healthy Carolinians Task Force Grant Application in the amount of $10,000 from the N. C. Office of Healthy Carolinians. He introduced Ms. Janine Bilodeau, Chairperson, New Hanover County Healthy Carolinians Task Force. Mr. Rice explained the additional $10,000 will supplement the Model Assessment Grant ($17,375) application previously submitted by the New Hanover County Health Department. MOTION: Dr. Jewell moved from the Executive Committee for the Board of Health to accept and approve the New Hanover County Healthy Carolinians Task Force Grant Application in the amount of $10,000 from the N. C. Office of Healthy Carolinians and to submit the grant request to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED UANMIOUSL Y. Monthlv Financial Reportin!! Dr. Jewell recommended from the Executive Committee the distribution of the Health Department Monthly Summary Revenue and Expenditure reports to the New Hanover County Board of Health and for the distribution of both the Monthly Summary and Program Revenue and Expenditure Reports to the Executive Committee for their review. Ms. Cindy Hewett, Business Officer, presented a health department financial summary monthly revenue and expenditure report. She explained cumulative revenue and expenditure reports for each budgeted program. The revenue reports included the type of revenue i.e. county, federal and state, fees and other revenue with budgeted amount, revenue earned, and a remaining balance. The expenditure reports included salary and fringe, operating, and capital outlay expenses with budgeted amount, expenditures, and balance remaining. Ms. Hewett advised prior year revenue and expenditure totals are on the reports. She stated the reports will be updated each month. Mr. Greer asked Ms. Hewett to separate and show the Medicaid Maximization funds on the reports. Ms. Hewitt stated these funds will be shown as separate funds on future reports. She advised current Medicaid Maximization funds have not been received. Upon receipt of this revenue, the budget will reflect the Medicaid Maximization funds. 3 87 Ms. Lynda F. Smith, Assistant Health Director, informed the $192,000 Maximization funds are for the I building renovations. Mr. Estep and Dr. Speck inquired about the omission of Animal Control Services fees from the revenue reports. Mr. Rice advised these fees will be included in the June revenue reports. Ms. Hewitt asked the Board of Health if they would like to receive both the summary reports and the cumulative program revenue and expenditure monthly reports. MOTION: Dr. Jewell moved from the Executive Committee for the Health Department Monthly Summary Revenue and Expenditure reports to be distributed to the New Hanover County Board of Health and for both the Monthly Summary and Program Revenue and Expenditure Reports to be distributed to the Executive Committee for their review. Upon vote, the MOTION CARRIED UNNAMIOUSL Y. CPT/ICD9 Codin!! (Billin!! for Services) - Information Mr. Rice referred the Board to information from A Health Director's Guide to Preparing for Implementation of CPT/ICD9 Coding. He advised the Local Health Directors have been attending workshops and studying the issue of the implementation ofCPTIICD9 billing. Ms. Hewett explained CPT/ICD9 coding is billing for services. A Health Department staff committee is addressing the CPTIICD9 billing system. Ms. Hewett advised the Health Department is preparing to bill third-party pays and must bill insurance companies. Issues being addressed include resources, training in CPT/ICD9 coding, identification of services and codes, and components of established fees. Services have been broken down into codes and fees and will be presented to the Board of Health. Ms. Hewett stated eligibility and fee policies will need to be established. Ms. Hewett announced beginning July 1,2000, Medicaid will be billed by CPTIICD9 codes. She stated CPT billing is a different way of thinking regarding visits, programs, and charges for each service, and the distribution of revenues from services. Mr. Rice stated the health department needs to get reimbursed for services and be in line with the State Consolidated Contract. Ms. Hewitt reiterated the health department will bill by CPT/ICD9 code and not by bundle. I Susan G. Komen Breast Cancer Foundation Grant Dr. Jewell recommended from the Executive Committee for the Board of Health to accept and approve the Susan G. Komen Breast Cancer Foundation Grant ($19,882). Ms. Betty Jo McCorkle, Women's Health Care Director, reported the grant application for the N. C. Triangle Affiliate of the Susan G. Komen Breast Cancer Foundation is titled Operation: Reach Women. It identifies low-income women ages 30-64 in need of baseline cancer screening for breast and cervical cancer and provides free mammograms, pap smears, and clinical exams. The Hispanic population is a primary target for outreach and services. The total budget is $19, 882. MOTION: Dr. Jewell recommended from the Executive Committee for the Board of Health to accept and approve the Susan G. Komen Breast Cancer Foundation Grant Application in the amount of $19,882 and to submit the grant request to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED. I 4 I I I 88 North Carolina Childhood Asthma Initiative Grant Application - $7.500 Dr. Jewell recommended from the Executive Committee for the Board of Health to accept and approve the North Carolina Childhood Asthma Initiative Grant Application ($7,500). Ms. Janet McCumbee, Child Health Director, explained the purpose of the grant is to improve the quality of life for children with asthma, to have community-based programs to reach the large number of children with asthma, and to address their asthma-related problems. The $7,500 grant supplements the Community Lead Poisoning Prevention/Healthy Homes Initiative Grant and will serve more children. She stated 7% of US children have asthma making it the most common chronic disease of childhood. In New Hanover County 16.4% Medicaid children have asthma. MOTION: Dr. Jewell moved from the Executive Committee for the Board of Health to accept and approve the North Carolina Childhood Asthma Initiative Grant Application in the amount of $7,500 and to submit the grant request to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED. Amendment of Bvlaws - Article VII. Section 3 Dr. Jewell recommended from the Executive Committee for the Board of Health to accept and approve a proposed amendment of Article VII, Section 3., of the New Hanover Board of Health Bylaws. He advised the amendment may be presented to the Board of Health in November and voted on by a 2/3 vote in December. . Mr. Rice eXplained the Health Promotion Program is being placed under the Women's Health Care Division of Personal Health. He stated he met with the nursing directors who were in agreement of this reorganization to focus health promotion activities under Personal Health. The words Health Promotion will be changed to Personal Health in the Board of Health Bylaws. Personal Health will expand and include personal health and clinical activities. Dr. Jewell presented the proposed revision of Article VII, Committees, Section 3., of the New Hanover Board of Health Bylaws reflect this organizational change. The revision reads as follows: Section 3. A Personal Health Committee composed of five members shall be appointed by the Chairman in January. It shall be the duty of this committee to act as an advisor to the Board of Health with respect to health promotion and disease prevention. Mr. Rice advised the Board of Health will vote on the above amendment to the Board of Health Bylaws at their December 3 meeting. Nominatin!! Committee Mr. Link, Chairman, Nominating Committee, submitted the following nomInees for the 2000 New Hanover County Board of Health Chairman and Vice-Chairman. Mr. William T. Steuer, Chairman Dr. Wilson O'Kelly Jewell, Vice-Chairman Mr. Steuer stated other nominations will be received and the officers will be elected at the December 1 Board of Health meeting. 5 89 Comments: Board of Health Spay Neuter Pro!!ram Dr. Speck reported statistics are proving that the increase in the adoption fee has not deterred the adoption rate at the Animal Control Shelter. A list of veterinarians participating in the Spay/Neuter Program is available and scheduling problems are being addressed. Mr. Steuer expressed his appreciation to local veterinarians for their participation in the program. Health Director Hurricane Update - Floyd and Irene Mr. Rice commended the Health Department staff for meeting their challenges and going the extra mile for the community during the last three hurricanes. He stated he shared New Hanover County hurricane experiences at the Health Director's Legal Conference on October 19, 1999, in Chapel Hill, North Carolina. Health Director's Le!!al Conference Mr. Rice reported he presented an audiovisual presentation entitled the New Hanover County Health Department: Response and Recovery - Hurricane Floyd at a Local Health Directors' Legal Conference in Chapel Hill, North Carolina. Management Academv for Public Health - November 4-5. 1999 Ms. Hewett, Ms. Smith, and Mr. Rice will attend Phase II of the Management Academy for Public Health on November 4-5, 1999. American Public Health Association Meetin!! - November 6-11.1999 Mr Rice advised he will attend the Annual American Public Health Association Meeting on November 6- II, 1999 United Way Campai!!n Mr. Rice gave the Board members an opportunity to participate in the Health Department United Way Campaign. Christmas Doll Display Ms. Smith displayed several dolls dressed by Health Department employees for needy children at Christmas. The dolls will be displayed in the lobby of the Health Department and then returned to the Salvation Army on December 3, 1999. They will be displayed during the Old Wilmington by Candlelight Tour on December 4 and 5 at the Salvation Army Church. Flu Shots for Board of Health - November 3 Mr. Rice announced flu injections will be offered to the Board members following the November 3 Board of Health meeting. 6 I I I I I I 90 Christmas Party December 9 Mr. Rice reminded and invited Board members of the Health Department Annual Christmas Party to be held on December 9, 1999, in the auditorium. Other Business: Community Draina!!e Floodin!! and Draina!!e Problems Dr. Jewell expressed concern about flooding at Cypress Tree Mobile Home Park that has not receded. The residents of the community did not know how to protect themselves from the dangers of standing waters. Dr. Jewell stated the residents need educational materials on how to protect themselves. Mr. Steuer reported the television coverage was a pitiful site with water up to residents' steps and septic tanks filled with water. Mr. Rice advised Ms. Cathy Timpy, Environmental Health Specialist, and Ms. Beth Jones, Communicable Disease Director, visited the mobile home community in Flemington on Highway 421. The water quality was good and no septic repairs could be made until the water recedes. The staff went from door-to-door distributing educational materials regarding water safety and the safety of septic systems. Ms. Dianne Harvell, Environmental Health Director, is working with other county agencies that will address the drainage problems and the safety of their water and septage systems. Press and media releases have been furnished to the public regarding the dangers of standing water. Dr. Jewell reiterated the importance of making educational materials accessible to the public before, during, and after a storm. Mr. Steuer reiterated New Hanover County needs to prepare their facilities for disasters as soon as possible. Mr. Greer emphasized often citizens do not realize that county employees are called to work during a storm. He commended the staff for going the extra mile to provide emergency services during disasters. Adjournment: Mr. Steuer adjourned the regular meeting of the New Hanover County Board of Health at 9: 17 a.m. P~J£~ William T. Steuer, PEIRLS, Chairman New Hanover County Board 0 ealth David E. Rice, M.P.H.,M.A., Health Director New Hanover County Health Department Approved: December 1, 1999 7