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03/13/1996 I I I 161 Dr. Dennis Jackson, Chairman, called the regular business meeting of the New Hanover County Board of Health (NHCBH) to order at 8:00 a.m. on Wednesday, March 13, 1996, in the Carl Thomas Durham Auditorium, New Hanover County Health Department, Wilmington, North Carolina. Members Present: Dennis L. Jackson, DVM, Chairman Mary Lou Alford, RN Thomas V. Clancy, MD Mary King Dean Michael E. Goins, OD Robert G. Greer Spiro J. Macris, DDS Mark A. Veenstra, PE Estelle G. Whitted, RN Members Absent: John C. Coble W. Keith Elmore, Vice-Chairman Others Present: Robert S. (Bob) Parker, Health Director Frances F. De Vane, Recording Secretary Invocation: Mr. Parker gave the invocation. Minutes: Dr. Jackson called for corrections to the minutes of February 14, 1996. The minutes were approved. Recognitions: Dr. Jackson requested for Mr. Parker to make the staff recognitions. New Employees Mr. Parker welcomed and recognized the following new health department employees: Samuel Britt, Public Health Nurse, Community Health, Jail Barbara Shell, Administrative Assistant, Communicable Disease j 62 Service Awards Mr. Parker commended the following employees for their years of service in the New Hanover County Health Department: I Five Year Service Award April McCullen, Public Health Nurse, Community Health Felicia S. Myott, Public Health Nurse, Child Health Ten Year Service Awards Ruth Roethlinger, X-ray Technician, Communicable Disease Dr. Jackson thanked the above employees for their years of service at the health department. Committee Reports: Budaet Committee Mrs. Dean, Chairman, Budget Committee, announced a Board of Health Budget I Committee Health Department Review Form has been developed. The form which was approved by the Executive Committee and is for the Budget Committee members to use as a guide in their review of their assigned programs. A memo explaining this program review process and a copy of the form is to be mailed today to committee members. Mrs. Dean reiterated that she is available to assist the Budget Committee members with the completion of their budget review of programs. Environmental Health Committee There was no Environmental Health Committee report. Executive Committee Dr. Jackson, Chairman, Executive Committee, advised the Board that the Executive Committee met at 6:15 P.M. on March 5, 1996. Items discussed are on the Board of Health Agenda under Unfinished Business and New Business. Health Promotions Committee Mrs. Alford, Chairman, Health Promotions Committee, announced that the Health I Promotions Committee met at 6:00 p.m. on March 7, to brainstorm and focus on the Health Promotions Committee plans for this year. I I I 1 6~3 Restaurant Sticker Campaian and Smokefree Restaurant Advertisements Mrs. Alford requested for Ms. Cathy Raynor, Health Educator, Project ASSIST, to present from Committee a proposed Smokefree Restaurant Ad and Smokefree Sticker Campaign sponsored by Project ASSIST for the Board of Health's consideration. Ms. Raynor explained that the drafted Restaurant 100% Smokefree Ad thanks and lists 100% smokefree restaurants. The advertisements will be paid for by Project ASSIST and will be placed in local newspapers and other publications thanking restaurants for being 100% smokefree. Approximately 17 smokefree restaurants have been identified in New Hanover County. The ad will be revised to include additional restaurants when they are documented as 100% smokefree facilities. Ms. Raynor displayed proposed restaurant stickers that will be placed on clients' restaurant receipts. The purpose of the stickers is to give consumers an opportunity to voice their opinion regarding their desire for a smokefree environment in restaurants. MOTION: Mrs. Alford, Chairman, Health Promotions Committee, moved from Committee for the Board of Health to endorse the Restaurant Sticker Campaign and the Smokefree Restaurant Ads recommended by Health Promotions Committee and sponsored by Project ASSIST. SUBSTITUTE MOTION: Mrs. Dean made a substitute motion to defer action on the above motion due to the absence of Mr. Coble and his input as a restaurant proprietor. There was no second to the substitute motion. Dr. Jackson called for a vote on the original motion. Upon vote, the ORIGINAL MOTION CARRIED AS FOLLOWS: -ª-- Voting Aye ....£.. Voting Nay (Mrs. Dean, Mr. Greer) Letter to New Hanover County Commercial Realtors Mrs. Alford presented a recommendation from the Health Promotions Committee for a letter to be written including an enclosure of a copy of the New Hanover County Board of Health Smoking Control Regulation (SCR) to New Hanover County Commercial Realtors regarding rental compliance with the SCR. The Board. reviewed a draft letter to commercial realtors from Dr. Jackson. Dr. Goins explained that the letter should state that compliance with the SCR is mandatory for all present and future renters and that the intent of this letter should be to prevent any problems after the rental of commercial property. Mrs. Dean suggested that the letter should specify the SCR exclusions. Dr. Jackson concurred that the letter to commercial realtors should state what is included and excluded in the SCR regarding rental spaces. J64 It was the consensus of the Board that Mr. Parker should revise and clarify the letter to New Hanover County Commercial Realtors regarding SCR compliance for commercial renters and refer the revised letter to the Board of Health for their approval. I Statewide Convocation of Community Leaders to Prevent Heart Disease and Strokes Mrs. Alford announced that "Making It Happen," a Statewide Convocation of Community Leaders to Prevent Heart Disease and Strokes, will be held on April 15-16, 1996, in Research Triangle Park, North Carolina. Board members planning to attend this meeting should notify Mr. Parker. Unfinished Business: Parentina Class Fee Schedule Dr. Jackson recommended from the Executive Committee for the Board to approve the Parenting Classes Fee Schedule. The Parenting Classes will be staffed by Child Health, Women, Infants and Children, Women's Health Care, and Health Promotions Division employees. Mr. Parker explained that the full pay fee for a series of six classes will be $92.38. This is the amount Medicaid I will pay. A sliding fee scale will be applied for non Medicaid patients. Mr. Greer asked if these fees were determined by the health department. Mr. Parker explained that the fees are determined by federal guidelines. Dr. Goins inquired about the percentage of full-pay patients served in the health department. Mr. Parker responded that there are very few full pay patients served. Mrs. Whitted inquired if no fee patients were served in the clinics. Mr. Parker confirmed that patients are not denied services due to inability to pay a fee, but that the sliding fee scale is applied. MOTION: Dr. Jackson, Chairman, moved and seconded by Mrs. Alford from Executive Committee for the Board to approve the Parenting Class Fee Schedule effective April 1 , 1996. Upon vote, the MOTION CARRIED UNANIMOUSLY. Board of Health Sponsored Luncheon for Staff Dr. Jackson, Chairman, recommended from the Executive Committee for the Board of Health to sponsor a staff luncheon from 12 Noon -1:00 p.m. on Tuesday, April 16, 1996, at the health department. MOTION: Dr. Jackson moved and seconded by Mrs. Alford from Executive Committee for the Board of Health to sponsor a luncheon for health department staff. Upon vote, the I MOTION CARRIED UNANIMOUSLY. I I I 1 6~ ! è' Dr. Macris volunteered to be responsible for collecting from the Board the expenses of this staff luncheon. Dr. Goins, Dr. Macris, and Mrs. Whitted volunteered to serve as cooks for the luncheon. Grills will be provided by health department staff. Mr. Parker stated cooks need to be at the health department by 11 :15 a.m. on April 16. Peñormance Evaluation - Robert S. Parker. Health Director Dr. Dennis Jackson summarized the performance ratings on Mr. Parker, Health Director, submitted by Board members and reviewed by the Executive Committee at their meeting on March 5, 1996. He commended Mr. Parker for the following excellent performance ratings: 1. Outstanding - 95 2. Fully Satisfactory - 46 3. Satisfactory - 6 4. Marginal - 0 5. Unacceptable - 0 On behalf of the Board, Dr. Jackson praised and recognized Mr. Parker for his exceptional performance and read the following excerpts from a letter to Dr. Jackson from a fellow staff member regarding Mr. Parker's job performance: "Mr. Parker is an excellent leader. He is energetic and creative. He is a visionary with an appreciation for our history. He provides opportunities for decision-making and growth and fosters team-building. The staff appreciates his fair-minded approach to situations. The comments I wrote in my appraisal are: 'Working in New Hanover County Health Department and for Mr. Parker has given me countless opportunities to develop professionally and personally. I am deeply appreciative of the opportunities to contribute to decision-making as a member of the Management Team. His leadership in our department keeps us energized while striving to improve efficiency and services. I am constantly challenged to do my best and take pride in our department's accomplishments' We are proud of our Health Director and very proud of the Public Health spirit that dwells here." A round of applause followed in recognition of Mr. Parker's performance as Health Director of NHCHD. Dr. Jackson recommended from the Executive Committee for Mr. Parker a merit increase of 1 % to be added to his base salary, and a 4% one-time bonus that will not be rolled into his base salary. 166 MOTION: Dr. Jackson moved from the Executive Committee and seconded by Mrs. Dean to grant Mr. Parker an outstanding performance appraisal and a merit increase of 1 % to I be added to his base salary, and a 4% one-time bonus that will not be added to his base salary. Upon vote, the MOTION CARRIED UNANIMOUSLY. Comments: Board of Health Members Senator Ballentine's Letter Rearadina Health Inspections of Restaurants Dr. Macris inquired about a letter (dated 2/6/96) to Mr. Parker from Senator Ballentine regarding health inspections of restaurants in New Hanover County being more rigid than in surrounding counties. Mr. Parker informed the Board that his written response to Senator Ballentine was that the NHCHD's policies and procedures relative to restaurant inspections are based upon North Carolina General Statutes. Also, Mr. Parker has spoken with Senator Ballentine regarding his letter and offered to review specific health inspection situations with him. He stated that Senator Ballentine has not responded to his letter or request, but he seemed to be satisfied with Mr. Parker's explanation of general health inspections of restaurants in New Hanover County. Health Director Appraisal I Dr. Goins expressed that the Board of Health is unique from other Boards in that the Board is granted an opportunity in performing the Health Director's performance appraisal which enables communication and promotes the longevity for the position. Health Director: Health Director Appraisal Mr. Parker expressed his appreciation to the Board for their support and for his performance appraisal. He stated that the past 13 years as Health Director have been very rewarding. Ombudsman Leaislation Mr. Parker stated that Mrs. Wanda Copley, County Attorney, prepared legislation to establish a separate ombudsman position for New Hanover County. If this legislation passes the North Carolina General Assembly, it may be referred to the Board of Health for action. Mr. Parker said he understands that the Department of Social Services has been I instructed to prepare a job description and to budget for this position. Mr. Greer informed the Board that this matter was not definite. I I I 167 Jail Expenditures Mr. Parker referred the Board to a memo (dated 2/6/96) to Andy Atkinson, Deputy County Manager, regarding expenditures at the New Hanover County Jail. Mrs. Betty Creech, Community Health Director, gave a Jail Medical Program Expenditure Report. Expenditures for Fiscal Year 1995-96 (one-half year) were $57,828 and an additional projected $45,000 is needed to cover medical expenses. She explained that injuries are the primary cause of increased medical expenses and that the lack of space in the jail is a problem which facilitates accidents and injuries. Social Work Month and Tree PlantinQ In celebration of Social Work Month, March 1996, a Tree Planting and Dedication Ceremony in recognition of survivors and victims of violence in the home and community was held at 12:00 Noon, March 4, 1996, at NHCHD. The event was sponsored by Health Department Social Workers. Mr. Parker recognized Mrs. Maryann Adkins, Social Worker, and coordinator for the event. Letters from Raleiah Mr. Parker noted two letters from the Department of Environment, Health and Natural Resources: Board of Health List Mr. Parker distributed a Board of Health list to the Board for their review. Purpose for Chanae in Budaet Committee Mr. Parker distributed to the Board Dr. Jackson's purpose for change in the Budget Committee for this year. Letters. Articles and Reports Mr. Parker referred the Board to the following documents in their Board packets: ~ Thank You letter from Jennifer Lane, participant in Commit To Quit Campaign sponsored by Project ASSIST ~ Piece of a North Carolina Doctor's Mind - Article for the Board from Dr. Clancy ~ Letters written by Mr. Coble regarding Environmental Health issues J 68 ~ Governor Hunt's Work First Welfare Reform Program Putting Thousands Into Jobs. Mrs. Dean inquired why the Board received a copy of this memo and program. Mr. Parker responded that it was for informational purposes plus it contained information involving the immunization of children. I ~ Dangerous Dog Determination Hearings Report - NHCHD Animal Control Services Other Business: Budaet Committee Purpose Mrs. Dean requested for Dr. Jackson's statement of purpose regarding change in the Budget Committee for this year, which was presented to the Budget Committee at their meeting following the Board of Health meeting on February 14, 1996, be attached to the March 13 Board of Health minutes. A copy of this budget purpose is attached and incorporated as a part of these minutes. (Attachments #1 ). MOTION: Mrs. Dean moved and seconded by Mrs. Alford to attach the purpose of change in the Budget Committee Statement issued by Dr. Jackson to be incorporated as a part of March 13, 1996, Board of Health minutes. Upon vote, the MOTION CARRIED I UNANIMOUSL Y. Department Focal: New Hanover Adolescent Health Center Mr. Parker introduced to the Board of Health Mrs. Connie Parker, Chairman, Board of Directors, and Acting Executive Director, New Hanover Adolescent Health Center (NHAHC), who presented the department focal on the Adolescent Health Center. Mrs. Parker explained that this project was envisioned in 1991. In 1994, the NHAHC Steering Committee composed of community leaders and health agencies was formed to make plans for the center. She stated the purpose of the NHAHC is to provide affordable and accessible physical and mental health services to adolescents in the Greater Wilmington area emphasizing a family-centered approach. Illness prevention and health promotion services are to be provided to underserved and unserved adolescents. Parents will be involved in most aspects of the center's services and a sliding fee schedule will be used. Education of health care professionals and the community regarding the needs and concerns of I adolescents will be a component of the center. I I I 16~ Mrs. Parker informed the Board that funding was pursued from the Robert Wood Johnson Foundation, Cape Fear Area United Way, New Hanover Regional Medical Center Auxiliary, and the Duke Endowment. The Cape Fear Area United Way has budged $12,000 to the center; New Hanover Regional Medical Center Auxiliary contributed $7,500; and the Duke Endowment Hospital Division awarded a $225,000 grant for the first year of NHAHC operations and plans to provide a total $550,000 over a three year period. The center has requested $445,000 from the Robert Wood Johnson Foundation. Other financial contributions and inlkind contributions have been made by other health agencies. The site of the proposed NHAHC has not been determined but it will be centrally located and accessible to unserved and underserved adolescents. Mrs. Parker distributed a Fact Sheet, Questions and Answers, and other information about NHAHC, Inc. to Board. A discussion followed regarding the application of a sliding fee scale, involvement of health department and school system, duplication of services, and other specifics regarding the center. Mrs. Parker stated that the center plans to work with the health department and other agencies to provide accessible services to adolescents. Mr. Parker stated the health department will explore anywhere that Public Health services can be maximized in the community. Mrs. Dean questioned the validity of some of Mrs. Parker's statements. Mrs. Dean questioned the validity of some of Mrs. Parker's statements regarding the Adolescent Health Center. Mrs. Dean congratulated Mrs. Parker on securing the funds for the NHAHC. Dr. Jackson thanked Mrs. Parker for her presentation to the Board on the Adolescent Health Center. Adjournment: There being no further business, the regular meeting of the Board of Health was adjourned at 9:35 a.m. ~r Dennis L. Jackson, hairman New Hanover County Board of Health ~W~ Robert S. (Bob) Park!3r, Health Director New Hanover County Health Department Approved: J 70 Attachment #1 NHCBH Minutes March 13, 1996 I PURPOSE: The purpose for the change in the Budget Committee is that changes in funding could also require altering current programs. If this happens, if the Board is to contribute to the formulating of an effective and efficient direction for the Health Department, it will be imperative that we, the Board members, understand the current programs. We, the Board, and the people of New Hanover County are very fortunate to have such an excellent staff of the highest quality here at the Health Department. We can support this staff by far better if we are better informed. We have been handed a budget and asked to approve it. We don't know what we are asking the County Commissioners to fund. This budget is given to us with considerable time restraints. We are asked to make recommendations and send to the County Manager. The County Manager will make adjustments and send back to the Board. I The current mechanism does not work. The budget has requests that would be great but not necessarily essential and may not even be needed. I will recommend that next year the budget be given to the Board as early as possible. Mary Dean will assign the same people to the same department that they have this year studied and are familiar with. We can now be better prepared to assist the administration in preparing a budget and also, we can assist in preparing a list of those additional requests in a prioritized form. I want to thank you in advance for the time each of you spend on this project. Mary Dean has something to add. ~/~ Dennis L. Jackson, DVM:' Chairman New Hanover County Board of Health I I I I Attachment #1 - Continued NHCBH Minutes March 13, 1996 FæRJARY 12, 1996 'lO: MR. PARlCER FR:M: IW« DEAN RE: IIJOOf:r <XMtl'fTEE ASSI<B1ENl'S ŒNrAL HFAUŒ - DR. M1CRIS BFALTH PIODrICNS - MRS. 1iu'I"Im1 IABœA'roRr - DR. CJ:RCY AIJoIINISTPATIœ - MR. vmNSTRA ANIMM. CQll'R)L - DR. J1CKSœ aøUUTY HFALm - MR. EIK>RE tI1l'RITICN/WIC - MRS. DFAN CXJ.M.IaCABIB DISF.ASB - MRS. wm'I"a.u K'Jo1I!N'S HFAL'DI - DR. OOINS amD HEALTH - MRS. ALFOIÐ ENVIROOMmrAL HFALTH - JOHN OOBIE