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January Board of Health Minutes 506 Dr. Melody C. Speck, Chairman, called the regular business meeting of the New Hanover County Board of Health (NHCBH) to order at 8:00 a.m. on Wednesday, January 7, 2004 in the Thomas Fanning Wood Conference Room of the New Hanover County Health Department located at 2029 S. th 17 Street, Wilmington, North Carolina. Members Present: Melody C. Speck, DVM, Chairman Marvin E. Freeman, Sr. Donald P. Blake, Vice-Chairman Cheryl Lofgren, RN Sandra L. Miles, DDS Stanley G. Wardrip, Jr. Philip P. Smith, Sr., MD James R. Hickmon, RPh John S. Tunstall, PE Edward Weaver, Jr., OD Robert G. Greer, Chairman, County Commissioners Members Absent: None Others Present: Barbara Perilla, Administrative Support Technician, Administrative Support Services Sharon Neuschafer, Administrative Support Supervisor, Administrative Support Services Nicole Cullen, PHN, School Health, Personal Health Services Marilyn Howe, PHN, School Health, Personal Health Services Laurie Parks, PHN, School Health, Personal Health Services Patricia Crouch, PHN, School Health, Personal Health Services Cynthia Winthrow, PHN, Clinic, Personal Health Services Tina Ragin, Health Check Coordinator, Personal Health Services Geoffrey Zuckerman, Health Educator, Health Programs Administration Elisabeth Constandy, Senior Health Educator, Health Programs Administration Scott Harrelson, Health Programs Administrator, Health Programs Administration Nancy Nail, Public Health Division Manager, Nutrition Stephen Watson, Shelter Attendant, Animal Control Services Janet McCumbee, Personal Health Services Manager Cheryl Welch, Star News Reporter David E. Rice, Health Director Cindy Hewett, Business Manager Marilyn Roberts, Recording Secretary Invocation: Dr. Sandra Miles gave the invocation. Minutes: The minutes of the December 3, 2003 meeting were approved. 1 507 Recognitions: New Board of Health Members On behalf of the Board of Health, Dr. Melody C. Speck welcomed and introduced the following three new Board members to the New Hanover County Board of Health: Mr. Stanley G. Wardrip, Jr. Mr. James R. Hickmon Mrs. Cheryl Lofgren Oath of Office Oath of office was administered by Ms. Sharon Neuschafer, Notary Public. Dr. Speck congratulated newly installed Board of Health members. Personnel Service Awards Mr. David Rice recognized the following Service Award recipients and introduced new employees. 5 Years of Service Cynthia W. Hewett, Human Services Agency Business Manager, Administration Nancy Nail, Public Health Division Manager, Nutrition 20 Years of Service Barbara J. Perilla, Administrative Support Technician, Administrative Support Services New Employees Nicole Cullen, PHN, School Health, Personal Health Services Stephen Watson, Shelter Attendant, Animal Control Services Marilyn Howe, PHN, School Health, Personal Health Services Laurie Parks, PHN, School Health, Personal Health Services Patricia Crouch, PHN, School Health, Personal Health Services Cynthia Winthrow, PHN, Clinic, Personal Health Services Tina Ragin, Health Check Coordinator, Personal Health Services Other Recognitions Super Staff Award – January 2004 Mr. David E. Rice recognized Pamela R. Cooke, Social Worker, Maternal Health Team, Personal Health Services as being the recipient of the Super Staff Award for January 2004. 2 508 Dr. Melody C. Speck congratulated the long-term staff and welcomed the new staff to the Health Department. Departmental Focal: Injury Prevention and Control – Risk Watch Program Mr. Geoff Zuckerman, Health Educator, Health Programs Administration presented the January 2004 Department Focal entitled “An Injury Prevention Program from the National Fire Protection Association (NFPA). Mr. Zuckerman explained that Risk Watch has been made possible through grant monies from the National SAFE KIDS in partnership with US Fire Administration and FEMA so therefore NHC SAFE KIDS will be partnering with City of Wilmington and NHC Fire Services. Mr. Geoff Zuckerman gave a brief power point presentation in which he explained that this program draws on NFPA’s 20 years of success with “Learn Not to Burn”. NFPA has been working with schools and communities for decades, so they were in a good position to take the lead in creating Risk Watch. Areas expanded outside of what NFPA could do such as provide technical, accurate information on any risk areas outside their own expertise of fire and burn prevention, and so NFPA needed assistance with the other issues. “Risk Watch” is a comprehensive school-based injury prevention curriculum aimed at the major risk areas that affect children in preschool through grade eight, their families, and their communities. Mr. Zuckerman stated that for children ages 14 and under, the #1 health risk isn’t kidnapping, drugs, or disease, it’s injuries. The eight major Risk Watch topics included: ?? Motor Vehicle Safety ?? Fire and Burn Prevention ?? Choking, Suffocation, and Strangulation Prevention ?? Poisoning Prevention ?? Falls Prevention ?? Firearms Injury Prevention ?? Bike and Pedestrian Safety ?? Water Safety Mr. Zuckerman explained that the “Risk Watch Program” 1) helps kids beat the odds; 2) teaches them to analyze situations and weigh consequences; 3) promotes safe decision-making; and 4) instills positive values and health self-esteem. Mr. Zuckerman stated that training sessions were held for teachers in 2003 and the Risk Watch Kickoff was in October 2003 in which Mr. Jim Long, State Fire Marshall was in attendance. Schools that are now participating are: ?? Forest Hills Elementary (K-5) ?? Ogden Elementary (K-5) ?? Eaton Elementary (K-5) ?? St. Mary's School (K-8) Mr. Zuckerman stated that Risk Watch will be targeting more “at risk” schools and encouraged everyone to visit the website at www.riskwatch.org. After further discussion, questions and comments, Dr. Melody C. Speck and Board of Health members thanked Mr. Zuckerman for his presentation. 3 509 Monthly Financial Report – November 2003 (Including Grant Status Report) Ms. Cindy Hewett, Business Manager, presented the November Health Department Revenue and Expenditure Summary Report that reflects an earned revenue total of $2,473,064 with a remaining revenue budget of $3,583,676 and an expenditure total of $3,049,831 with a remaining expenditure budget of $7,857,346. A summary of the financial report is below: Budgeted Actual % FY 03-04 FY 03-04 Expenditures: Salaries & Fringe $ 9,938,494 $ 3,339,266 Operating Expenses $ 1,532,820 $ 541,731 Capital Outlay $ 335,863 $ 68,834 Total Expenditures $ 11,807,177 $ 3,949,831 33.45% Revenue: $ 6,330,073 $ 2,473,064 39.07% Net County $$ $ 5,477,104 $ 1,476,767 26.96% Ms. Hewett reported: 1) Federal and State reimbursements - will pay what is billed - no longer limited to 1/12 of payment, controls have been lifted this year; 2) Medicaid earnings a little down at this time but after system charges are complete with state, this will clear and revenues should come in; 3) Animal Control Services - collections have been good and $17,000 has been received so far through County Legal. Ms. Hewett explained that expenditures are in line. County appropriations are in line at 26.96%. Grant Status Report Ms. Hewett reported the Health Department Grant Status Report. Totals for grants requested $1,126,759; received $614,792, and denied $331,253. To date pending grants are Cape Fear Memorial Foundation-Funds needed to cover dental services for needy children as identified by School Health Nurses ($3,000); NC Medical Foundation-Through the Good Shepherd Ministries for nursing services to the population frequenting the shelter ($25,000); Duke University-To provide 10 hours of nursing services for TB Outreach ($10,388); and NC Tobacco and Control Branch, DHHS- Continuation of Tobacco Prevention Program ($100,000); and New Hanover County Safe Schools – Uniting for Youth “U4Youth” (funding will be received over a 3-year grant period) ($49,000). Ms. Hewett explained since this report was printed, we have received the Cape Fear Memorial Foundation-Funds of $3,000 and $64,000 will be received yearly for the next four years from the NC Tobacco and Control Branch, DHHS-Continuation of Tobacco Prevention Program from the $100,000 amount previously requested. Mr. David E. Rice commented that the additional monies received from the NC Tobacco and Control Branch will allow us to expand into Pender County. 4 510 Committee Reports: Executive Committee Dr. Melody C. Speck reported the Executive Committee met at 6:30 on December 16, 2003. Items for consideration are listed under New Business on the Board of Health Agenda. New Business: Reclassification Requests Dr. Melody C. Speck brought forth from the Executive Committee the proposal for reclassification requests. Mr. Rice explained that these changes are made necessary by recent changes to the New Hanover County Health Department organizational structure and recommended from the New Hanover County Human Resources Department. Mr. Rice also explained that there are seven positions to consider but only the first five listed will go to the County Commissioners for consideration. Incumbent From To Nancy Nail Public Health Division Manager Nutrition Services Supervisor – – MG07 PT09 Janet McCumbee Public Health Division Manager Personal Health Services – MG07 Manager – MG09 Jean McNeil Public Health Division Manager Animal Control Manager – – MG07 MG07 Dianne Harvell Public Health Division Manager Environmental Health Manager – – MG07 MG07 Elisabeth Constandy Senior Health Educator – PT04 Health Education Supervisor – PT07 Diane Vosnock Medical Lab Supervisor – PT07 Medical Lab Supervisor – PT09 Betsy Summey Public Health Nurse – PT06 Physician Extender – PT08 Motion: Dr. Melody C. Speck moved from the Executive Committee for the Board of Health to approve the reclassifications requests and for the Board to submit the appropriate reclassifications to Upon vote, the MOTION the New Hanover County Commissioners for their consideration. CARRIED UNANIMOUSLY. Budget Amendment – Purchase of FluMist Vaccine and Revision to Fee Policy – Personal Health Services CPT Codes and Fees: Change Needed CPT Code Fee Justification Addition 90660 $40.00 Establishing fee for FluMist intranasal flu vaccine Addition 90473 $20.00 Establishing fee for Administration of FluMist intranasal flu vaccine 5 511 Ms. Janet McCumbee, Personal Health Services Manager stated that there are limitations on the people that take the FluMist. Highlights of FluMist vaccine: Standing Order Covers ?? 2003 – 2004 Formula – Live Intranasal (FluMist) – live attenuated virus, trivalent, cold-adapted, nasally administered vaccine. ?? Each 0.5 ml dose of FluMist contains the flu strains recommended by the US Public Health Service for the 2003-2004 flu season: (A/New Caledonia/20/99 (H1N1, A /Panama/2007/99 (H3N2), A/Moscow/10/00-like), and B-Hong Kong/330/2001 viruses. Indications ?? Flu Mist is indicated for active immunization for the prevention of disease caused by influenza A and B viruses in healthy children and adolescents 5-17 years of age and healthy adults 18-49 years of age. ?? FluMist is NOT indicated for immunization of individuals <5 years of age or 50 years of age. ?? Healthcare providers only can administer this vaccine ?? Health Medicaid recipients age 5 to 49 who share a house with another Medicaid recipient who is at high-risk for flu complications: 1. children 6 to 23 months of age 2. people who have chronic health conditions 3. women in their second or third trimesters of pregnancy 4. seniors over 65 Eligibility ?? Healthy children and adults from age 5 to 49 ?? High risk Medicaid recipients who are household contacts of healthy children and/or adults Mr. Rice explained that the Health Department after clearing it with Ms. Pat Melvin from the County th Manager’s Office placed an order with the state on December 15. Motion: After further discussion, Dr. Melody C. Speck moved from the Executive Committee to the Board of Health to accept and approve the Budget Amendment – Purchase FluMist Vaccine for $10,000 and to revise the Fee Policy and to submit to the New Hanover County Commissioners for Upon vote, the MOTION CARRIED UNANIMOUSLY. their consideration. Other Business: Pediatric Dental Health - Update Dr. Melody C. Speck and Mr. David E. Rice updated the Board of Health as to the continuing interest in Pediatric Dental Health. Brunswick County has also expressed interest in the mobile unit visiting their schools. Mr. Scott Harrelson explained briefly the demand for pediatric dental needs for low-income children in New Hanover County. The New Hanover County Health Department along with several other local providers have looked in to utilizing the mobile dental unit concept that has been successful in several other counties in the state. These counties include Duplin, Craven, Pamlico, Jones, Pitt, Columbus and Carteret to name a few. This unit would be set up at local elementary schools to treat that school's population as well as other children. There is also the prospect of collaborating with the Community Health Center, New Hanover Regional, Tileston Clinic and local dentists to provide free care to under served individuals. 6 512 During preliminary conversations with the Cape Fear Memorial Foundation and Kate B. Reynolds Charitable Trust, they both seemed supportive, as did the other stakeholders in the community. Some of the highlights discussed: ?? Mobile unit would be curbside service ?? Reduce poor show rate of children to dentist’s offices ?? More efficient way to treat indigent children ?? Dr. Sandra Miles checked with members of dental community – very favorable ?? Parent permission, initial work-up and who is responsible for paperwork involved ?? School staff involvement ?? Medicaid percentages ?? Timelines and stakeholders involved ?? Meeting with Tri-County Dental Society ?? Resulting from Strategic Planning recommendations Mr. Bobby Greer expressed concern as to this being the most economical way or is there a less expensive way. Dr. Edward Weaver, Jr. expressed concern that there is the same “no show” rate in eye care and his office is considering a one-day walk-in clinic. Mr. Harrelson explained that grant monies could be available through Kate B. Reynolds Charitable Trust and the Cape Fear Memorial Foundation in July and September 2004. Comments: Board of Health Members The three newest Board of Health members Mr. Stanley G. Wardrip, Jr., Mr. James R. Hickmon and Mrs. Cheryl Lofgren introduced themselves and gave brief description of background affiliations and expressed interests. Board of Health members welcomed newest members and Mr. Bobby Greer thanked each Board of Health member for their willingness to serve their community and looks forward to working with all. Health Director Other Business: Mr. David E. Rice stated that Mr. Garry Garris, Cape Fear Memorial Foundation, contacted him with interest in expanding the concept of Diabetes Today into other health topics for example cardio- vascular issues and getting information/education to the community. Mr. Rice will be having a conversation with Cape Fear Memorial Foundation today, Wednesday, January 7, 2004 and is asking approval to accept endeavor. Motion: Dr. Melody C. Speck moved and Mr. John S. Tunstall seconded to accept and approve expanding on other health topics and providing information and education to the community with Upon vote, the MOTION CARRIED UNANIMOUSLY. Cape Fear Memorial Foundation. 7 513 Accreditation Update Mr. Rice reported that on December 30, 2003 ten (10) staff members met at Coastal AHEC for th training. Three state consultants were in the Health Department on January 6 and will continue to meet with staff to assist through the accreditation process. Mr. Rice also presented each Board of Health member with an outline of his/her involvement. Mr. Rice stated that by April 2004 we should be accredited. Influenza Update Mr. David E. Rice applauded Health Department staff. Flu season started in October and Health Department staff as well as Bioterrorism staff did good job of getting information out to community regarding influenza and SARS. Mr. Rice gave each Board of Health member a copy of the Influenza Sentinel Surveillance Program Update #6 for the General Communicable Disease Control Branch, Epidemiology Section, Division of Public Health, DHHS. National Association of Local Boards of Heath (NALBOH) Mr. David E. Rice gave each Board of Health member a copy of the newsletter entitled “NewsBrief” from the National Association of Local Boards of Health. Adjournment: Dr. Melody C. Speck adjourned the regular business meeting of the Board of Health at 9:10 a.m. ___________________________________ Dr. Melody C. Speck, Chairman New Hanover County Board of Health ___________________________________ David E. Rice, M.P.H., M.A., Health Director New Hanover County Health Department Approved: February 4, 2004 8