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01/07/1998 'ì 0S -I Dr. Dennis L. 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, January 7, 1998", in the Dr. Thomas Fanning Wood Library, New Hanover County Health Department, Wilmington, North Carolina. Members Present: Dennis L. Jackson, DVM, Chairman William T. Steuer, PE/RLS, Vice-Chairman Thomas V. Clancy, MD Henry V. Estep Michael E. Goins, OD Robert G. Greer, County Commissioner Gela N. Hunter, Nurse Practitioner Wilson O'Kelly Jewell, DDS W. Edwin Link, Jr., RPH Anne Braswell Rowe Estelle G. Whitted, RN Members Absent: Others Present: David E. Rice, Health Director Lynda F. Smith, Assistant Health Director Frances F. De Vane, Recording Secretary Invocation: Dr. Jewell gave the invocation. 1 Minutes: Dr. Jackson called for corrections to the minutes of the December 3, 1997 Board of Health Meeting. The minutes of the meeting of December 3, 1997 were approved by the New Hanover County Board of Health. Recognitions: New Board of Health Members On behalf of the Board of Health, Mr. Rice introduced and welcomed the following new Board of Health members: Mr. Henry V. Estep, Public Citizen, Regional Manager, Blue/Cross Blue Shield Ms. Gela N. Hunter, Nurse Practitioner, Children's Clinic Mr. W. Edwin Link, Jr., RPH, Medicine Shop Oath of Office 1 Oath of office was administered to Mr. Estep, Ms. Hunter, and Mr. Link by Ms. Frances De Vane, Notary Public. Dr. Jackson congratulated newly installed Board of Health members. He recognized Mr. Andy Atkinson, Deputy County Manager. 106 Governor's Volunteer Service Award Ms. Vivian Mears, Public Health Nurse Communicable Disease, recognized Mr. Marcus A. I Wnorowski, recipient of the Governor's Volunteer Service Award presented by the HIV/STD Prevention and Care Section, Department of Health and Human Service at the World AIDS Day Governor's Volunteer Awards Celebration on December 4, 1997, in Raleigh, North Carolina. She explained Mr. Wnorowski, serves as a volunteer and Vice-Chairman for the Coastal AIDS Resource Effort (C.A.R.E) and participates in the Saint Jude's ministry. Ms. Mears stated Mr. Wnorowski has given of himself, his experience, and his energy to the community for three years. He sponsors and hosts support groups for those infected by HIV and facilitates HIV prevention programs. Mr. Wnorowski thanked the health department staff and the Board of Health for their support and assistance in his endeavor. Mr. Rice congratulated and commended Mr. Wnorowski for his services to the needs of HIV infected and affected individuals. Emereency Mosquito Control Article Mr. Rice announced Mr. Jeff Brown, Environmental Health Technician, Vector Control Division, authored an article entitled Chronology of A Mosquito Control Effort After Hurricane Fran published in the December 1997 Environmental Health Journal. He stated the article was our Mosquito Control Program's response following Hurricane Fran. Mr. Rice recognized and commended Mr. Brown for his article published in the national mosquito magazine and the Mosquito Control Program staff for outstanding performance. Personnel I Mr. Rice introduced and welcomed the following health department employees: New Employee Carmen G. Potter, Medical Office Assistant, Child Health Division Student Intern Trish Jones, Student Intern, Appalachian State University On behalf of the Board of Health, Dr. Jackson expressed his welcome to the new employees, his congratulations to Mr. Wnorowski, Volunteer, and to Mr. Brown for publishing the mosquito control article and for his educational efforts. Department Focal: Ms. Ruth Foy, Public Health Nurse, Communicable Disease, gave the departmental focal on "Winterize. .. Immunize.". She explained Governor Jim Hunt declared October 12-15, 1997, "Adult Immunization Weeks and Senior Vaccination Season." In 1995, more than 2,400 North Carolinians died of influenza and pneumonia. The Communicable Disease Division held expanded immunization clinics to provide flu and pneumonia vaccinations to adults age 65 and older, distributed educational brochures, and planned news media coverage on influenza and pneumonia. Ms. Foy reported 4,317 influenzas and 804 pneumonia vaccinations were administered by health department staff from July 1997 through December 1997. The cost is $10 for the flu vaccination and $15 for pneumonia. Dr. Jackson thanked Ms. Foy for her presentation on "Winterize ... Immunize "and on the I 1_07 I Senior Vaccination Season for Influenza and Pneumonia, a Communicable Disease Division project. Committee Reports: Health Promotions Committee Dr. Goins, Chairman, Health Promotions Committee, reported the Health Promotions Committee met at 6:00 p.m. on Monday, December 22, 1997. The 1998 Community Diagnosis was reviewed. Dr. Goins recommended from Committee for the Board of Health to approve and submit the 1998 Community Diagnosis to the North Carolina Office of State Statistics. Ms. Lynda Smith, Assistant Health Director, reported 269 opinion surveys were compiled by Ms. Sandra Diehl, Coastal Area Health Education Center (AHEC) Research Assistant, and Ms. Trish Jones, Student Intern, Appalachian University, compared state and county statistics. Ms. Smith explained this is an effort to provide input into the Community Diagnosis document. She advised the Community Diagnosis is used to determine health needs by the State Health Director and is due into the State Department of Health and Human Services on January 15, 1998. The Community Diagnosis process identified and prioritized New Hanover County's Five Health Problems: ~ 1. ~ 2. 1 ~ 3. ~ 4. ~ 5. Personal Health (Including Maternal and Child Health; and Teenage Pregnancy) Safety Environmental Health Concerns Mental Health (Substance Abuse) Knowledge and Access to Services Mr. Rice presented resources needed to implement the Community Diagnosis Priorities which would include additional staff positions, staff time, and computers, printers, and software. Dr. Goins advised the Community Diagnosis is not a strategic plan but is an attempt to identify and prioritize community needs. Priority #5 of the Community Diagnosis addressed New Hanover County does not have adequate medical services to take care of the indigent population. A discussion followed regarding a prior Board of Health's decision to accept the transition of the Rankin Terrace Clinic to the New Hanover Community Health Center, Inc. Dr. Jackson explained when the Board of Health decided to privatize the Rankin Terrace Clinic, he understood the Community Health Center would receive a grant and would serve the indigent population. I Dr. Goins and Ms. Creech, Community Health Director, concurred with Dr. Jackson that the establishment of the Community Health Center occurred during the county's 10% downsizing and was established as means of expanding services to provide better health facilities and to provide quality health care for the indigent population. Dr. Clancy stated many indigent patients required to pay prior to service at the Community Health Center are going either to St. Mary's Catholic Church Clinic or to the hospital emergency clinics for health care. Dr. Jackson requested the Board of Health's concerns regarding Rankin Terrace Clinic and health care service for the indigent be referred to the Health Promotions Committee for further study. l 108 Mr. Greer inquired if lead poisoning and water quality could be included in the Community Diagnosis as an environmental priority. He emphasized health services should be provided to I indigent clientele and health services should not be duplicated. Mrs. Rowe suggested that the Community Diagnosis document submitted as prepared. MOTION: Dr. Goins Chairman, moved from the Health Promotions Committee for the Board of Health to adopt and to submit the 1998 Community Diagnosis to North Carolina Department of State Statistics. Upon vote, the MOTION CARRIED. -º-- Aye --Í- Nay Executive Committee Meetine Dr. Jackson scheduled two Executive Committee meetings to be held at 6:00 P.M. on Thursday, January 22, and at 6:00 p.m. on Monday, February 2, 1998. The Committee will review the Health Department Fiscal Year 1998-99 Budget on February 2. Unfinished Business: Budget Schedule Update Dr. Jackson announced Mrs. Rowe is Chairman of the Budget Committee. He stated each Board Member will be assigned a program budget. Ms. Smith reviewed the timetable for the health department and county budget process. After division directors finish their budgets, they will contact and meet with Board members to review I budgets. The budget is to be reviewed by the Board of Health Executive Committee. A memo from Mrs. Rowe and budget information is to be distributed to the Budget Committee. Ms. Smith recognized Mr. Andy Atkinson, Deputy County Manager. New Business: Appointment of Board of Health Chairpersons and Committees Dr. Jackson appointed the following 1998 Board of Health Chairs and Committees: Executive Committee: Dr. Dennis V. Jackson, Chairman Dr. Michael E. Goins Dr. Wilson O'Kelly Jewell Mrs. Anne Braswell Rowe Mr. William T. Steuer Environmental Health Committee: Mr. William T. Steuer, Chairman Mr. Henry V. Estep Mrs. Gela N. Hunter Dr. Wilson O'Kelly Jewell Mr. W. Edwin Link Budget Committee: Mrs. Anne Braswell Rowe, Chairman Dr. Thomas V. Clancy Mr. Henry V. Estep Dr. Michael E. Goins Mrs. Gela N. Hunter Dr. Dennis L. Jackson Dr. Wilson O'Kelly Jewell Mr. W. Edwin Link Mr. William T. Steuer Mrs. Estelle G. Whitted Health Promotions Committee: Dr. Michael E. Goins, Chairman Dr. Thomas V. Clancy Mrs. Gela N. Hunter Mr. Henry V. Estep Mrs. Estelle G. Whitted I 1 I I ~ 09 Comments: Board Members Dr. Goins inquired whether the Health Promotions Committee should address the cost of the Community Diagnosis implementation or the feasibility of reestablishing a clinic similar to the Rankin Terrace Clinic. Dr. Jackson responded the committee is to investigate the history of the closing of the clinic and the cost for the reestablishment of a clinic with services similar to the Rankin Terrace Clinic focusing on health care services for the indigent population. Dr. Jackson asked Mr. Greer to serve as a resource for the Committee addressing this issue. Dr. Jackson asked the minutes be researched regarding the closing of the Rankin Terrace Clinic. Board members extended their welcome Mr. Estep, Ms. Hunter, and Mr. Link, newly elected Board members. Health Director Animal Control Services Advisory Committee Term of Office Mr. Rice advised the Board the Animal Control Services Advisory Committee members are appointed by the Board of Health to serve a three-year term of office. The terms of office are not staggered and begin on January 1 and end on December 31 three years later. Mr. Rice requested the Board consider staggering the terms of office for the Advisory Committee members to provide more coherence and consistency. In December 1999 four terms of office expire and in December 2000, four additional terms of office expire leaving a total of eight vacancies on the Advisory Committee. Mr. Rice stated if the Committee staggers their terms, this problem should be eliminated. Dr. Jackson expressed staggering the terms of office would provide continuity for the Advisory Committee. He referred the issue regarding the terms of office (staggered or non-staggered) for Animal Control Services Advisory Committee members to the Executive Committee for further study. Safety Belt Usage Sign Mr. Rice presented Mrs. Denise Houghton, Health Promotions Director, who reported on the status of the seatbelt signs which are displayed in New Hanover County. Dr. Clancy had advised the Board of Health the highway seatbelt usage signs are not current statistically. He requested data regarding the inaccuracy of seatbelt usage statistics posted on these signs. Ms. Houghton reported she contacted Ms. Kimberly Jorris, Director of External, Governor's Highway Safety Program, regarding the signs remaining statically inaccurate displaying the same seatbelt usage rate. Ms. Houghton advised, according to Ms. Jorris, the reason the signs remain the same is that the usage rate is the same and that the program is simply an awareness tool for the public regarding seatbelt usage rate. She stated the usage rate in New Hanover County is high. Ms. Houghton advised statistics are furnished to the Department of Transportation by the Wilmington Police Department. She is planning media coverage regarding the seatbelt signs and seatbelt usage in New Hanover County. 110 Elected Officials List Mr. Rice distributed an Elected Officials List from the New Hanover County Board of Elections I to the Board of Health. Status of Grant Proposals Mr. Rice reported the New Hanover County Board of Commissioners approved the following health department grant proposals: · Elementary Handwashng Program (CHIP) · Smoking IS Not Your Friend (NCDHHS) · Breast and Cervical Cancer Control Program (NCDHHS) · Buckle Up Kids in New Hanover County · Firearm Injury Prevention (CHIP & Cape Fear Memorial Foundation) Mr. Rice reported the Project for Happier Lives (CHIP and Cape Fear Memorial Foundation) Grant Applications were tabled on January 5, 1998 by the County Commissioners. Food Safety Mr. Rice referred the Board of Health to a December 16, 1997, Wilmington Morning Star News article entitled For Health Ratings, A-B-Cs Beat Numbers and to a Letter to the Editor responding to this article from Ms. Dianne Harvell, Environmental Health Director, and from Mr. Rice explaining whether food establishments are graded with letters or numbers, the I purpose of health ratings is to report the level of compliance with food protection and safety standards. Mr. Rice advised the North Carolina Commission For Health Services adopted amendments to rules governing restaurants and other similar type food service operations effective in August 1998. This regulation allows seven counties in the state to field test a numerical score rather than an A, B, C letter grade. The current grade scores for food establishments are: an A score is from 90-100, a B score is from 80-89, and a C score is from 70-79 percent. A score below 70 is failing until compliance is met for renewal of the health permit. He stated Mr. Coble, President-Elect of the Association of North Carolina Boards of Health, and a member of the North Carolina Restaurant Association, has studied this issue. Mr. Coble recommended the Board of Health endorse an application for Environmental Health Division to participate as one of the seven counties in this pilot program. He stated numerical grades are more precise and accurate than letter grades. Ms. Dianne Harvell, Environmental Health Director, advised North Carolina is the only state which displays A, B, C letter grades and a change to numerical scoring would promote uniformity across the nation. Numerical grades would give the exact health/sanitation score. Dr. Clancy stated the public needs to be educated regarding what the numerical grading system means in terms of criteria and measurements. Mrs. Harvell advised research is to be completed to measure the effectiveness of grade scores compared to numerical scores, the Pilot Program will be monitored and evaluated, and the public will be allowed input and educated on the new I grading system. ~ 1 1 1 MOTION: Dr. Goins moved, seconded by Ms. Whitted for the Board of Health to submit an application to participate in the State Commission for Health Service Pilot Program to field test a numerical score in the posting of health/sanitation scores for a period of one year. Upon vote, the MOTION CARRIED UNANIMOUSLY. Pictorial Display Mr. Rice inquired if the Board of Health is interested in obtaining a pictorial display of the Board members, Health Director, Assistant Health Director, and Program Directors. The pictures are to be displayed near the Administration front entrance or reception area of the health department. Ms. Smith advised Mr. Joe Johnson, Coastal Area Health Education Center, is available to take 5" x 7" pictures of the Board members immediately following the February Board of Health meeting if the Board decides to approve pictorial display. The Board of Health voted obtain the pictorial display for the health department entrance. Health Department Stationery Mr. Rice displayed a draft of the newly designed letterhead for the health department stationery. The Board of Health accepted and approved the letterhead stationery as presented with the New Hanover County seal and the North Carolina Public Health emblem. I Other Business: Invitation to Association of North Carolina Boards of Health Traininl: Mr. Coble issued an initiation to the Board members to attend the training sessions sponsored by the ANCBH. He stated that additional information will be furnished on these sessions by Mr. Carmine Recco, Executive Director, ANCBH. Adjourn: There being no further business, the regular business meeting of the Board of Health was adjourned at 9:35 a. m. Q~o~e~ New Hanover County Board of Health David E. Rice, M.P.H., M.A., Health Director New Hanover County Health Department I Approved: