05/06/1998
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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, May 6, 1998, in the Dr.
Thomas Fanning Wood Memorial Conference Room, 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. Thomas V. Clancy gave the invocation.
I Minutes:
Dr. Jackson called for corrections to the minutes of the April 1, 1998 New Hanover County
Board of Health Meeting. The minutes of the meeting of April 1, 1998 were approved by the
New Hanover County Board of Health.
Recognitions:
Mr. Rice introduced and welcomed the following new employee:
New Employee
Jeri Taylor, Clerical Specialist I, Community Health
Mr. Rice recognized the following recipients of Service Awards given by the New Hanover
County Commissioners:
Service Awards
Five (5) Years
Ms. Kathy C. Bundy, Licensed Practical Nurse, Child Health
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15 Years Service Award
Ms. Penny G. Raynor, Physician Extender, Community Health/Jail
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On behalf of the Board of Health, Dr. Jackson welcomed Ms. Taylor and expressed
appreciation to Ms. Bundy and Ms. Raynor, New Hanover County Service Award recipients, I
for their years of public health service.
Department Focal:
"Recreational Coastal Water Testing"
Mr. George H. Gilbert, Chief, Shellfish Sanitation Section, Division of Environmental
Health, NCDENR, gave the departmental focal on the "Recreational Coastal Water Testing. "
Beginning in the Summer of 1997, state public health officials began testing coastal recreational
waters to ensure safe waters for swimming and water sports. During the tourist season, the
Shellfish Sanitation Section tests 275 sites weekly. Signs are posted in unsafe coastal areas and
local health departments and the media are notified of unsafe sites. Recreational waters are
tested for fecal coliform, enterococcus, salinity, and temperature.
After the first year of recreational sampling, changes will be instituted in the sampling
frequency in estuarine waters and in the surf. New signs will be posted at wastewater treatment
plant outfalls, large storm water discharges, marinas, etc. Mr. Gilbert explained the Health
Director and/or the Environmental Health Director of health departments are the first to be
informed of a swimming advisory.
A discussion followed on treatment plants, pump station locations, and storm water runoff. Mr.
Gilbert explained the closure of Hewlett's Creek is due to malfunctioning of pump stations and
treatment plants. He advised the Division of Water Quality tests for pfisteria.
Dr. Jackson thanked Mr. Gilbert for his presentation on the "Recreational Coastal Water
Testing."
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Committee Reports:
Executive Committee
Dr. Jackson, Chairman, Executive Committee, reported the Executive Committee met at 6:00
p.m. on Monday, April 27, 1998. Items discussed are under New Business on the Board
agenda.
Environmental Health Committee
Mr. Bill Steuer, Chairman, Environmental Health Committee, reported Mr. Link,
Environmental Health Committee member; Mr. Rice; Ms. Lynda F. Smith, Assistant Health
Director; and he attended a presentation to the County Commissioners on A Four-Year
Environmental Analysis of New Hanover County Tidal Creek 1993-1997 by Dr. Michael A.
Mallin, UNC-W, at 6:30 p.m. on Tuesday, April 7, 1998.
Mr. Steuer emphasized water quality is an important issue which must be addressed in New
Hanover County. Mr. Greer informed the Board a report on the County Storm Water Drainage
Study will be presented to the County Commissioners probably at their next regular meeting.
Mr. Steuer announced the next regular meeting of the Environmental Health Committee will be
held at 5:30 p.m. on Wednesday, May 13, 1998.
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I Unfmished Business:
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New Business:
Nurses Day - Wednesday. May 6.1998
Mr. Rice announced today is National Nurses Day. He recognized and expressed appreciation
to the Nursing Staff of the New Hanover County Health Department. An invitation was issued
to the Board of Health to a nursing-memorabilia exhibit and to a reception to be held in honor of
National Nurses Day for staff at 3:30 p.m. today in the Carl Thomas Durham Auditorium.
New Business:
Medicaid Maximization Funding
Dr. Jackson announced the health department will receive additional revenue from a Medicaid
Maximization payment ($250,075); a TANF Grant ($28,734); and Corps of Engineers Grant
($14,900). Dr. Jackson recommended from the Executive Committee the acceptance of the
Medicaid Maximization Funding. He requested Mr. Rice present the budget proposals.
Mr. Rice reiterated New Hanover County will receive an additional $250,056 Medicaid
Maximization payment which is the second payment in a series. The first Medicaid payment
was $60,492. The funds must be expended in the programs where earned.
Mr. Rice presented proposed budget items for Medicaid Maximization Funds of $250,056.
$17,000 to offset the budgeted $17,000 in Administration Budget/Other Improvements
for the remodeling of the reception area.
$50,000 to offset the budgeted in Administration Budget/Capital Outlay Equipment to
upgrade to Human Soft Patient Care Management System.
$183,065 to be budgeted in Administration/Other Improvements for the restructuri~g::O( =:::.:.:.:.:.
existing space and for the purchase of supplies and furniture to facilitate space f~.;:¡:~::: '"
medical records area. . . . . . ..' III '
. . .
...... .... .-.
A discussion followed on the utilization of the Medicaid Maximization funds. Mr. Rice ~tåtëd::: =:: = =:: = =:
the request and need for a medical records area, for a Medical Records Clerk, and fôt: ån: -::: = =:: =:::
improved medical record system was evaluated and reviewed by the Nursing Directors and the
Nutrition Director.
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Ms. Rowe requested the Board of Health be advised of the status of the Medicaid Maximization
project. Dr. Clancy and Mrs. Estep concurred the identification of state monies and the
directive of intention of expenditures would assist the Board in making decisions regarding
budgetary items. Mr. Rice advised he will identify state monies by program and will inform the
Executive Committee periodically of the utilization of the Medicaid Maximization funds and
projects.
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MOTION: Dr. Jackson moved from the Executive Board for the Board of Health to accept
and to approve to budget the Medicaid Maximization Funds ($250,065) as presented, to keep I
the Board of Health updated periodically of the other improvements and utilization of the
funds, and to submit the request to the New Hanover County Commissioners for their
consideration. Upon vote, the MOTION CARRIED UNANIMOUSLY.
Temporary Assistance to Needy Families (TANF)
Dr. Jackson recommended from the Executive Committee the acceptance of TANF Grant
funding to FY99 Budget.
Mr. Rice explained TANF funds ($28,374) were received in FY98 but were not budgeted in FY
99. The health department is receiving the same TANF funding for FY99. The recommended
budget includes a temporary LPN salary ($10,400); rental space for satellite clinics ($3,000);
advertising ($500); and the purchase of pregnancy tests, contraceptive supplies, educational
material, laboratory TF meter, and other incentives and supplies ($14,474). The expenditures
and revenues for FY99 will be increased by $28,374.
Mr. Greer stated he did not realize the health department and DSS were both involved in the
T ANF Grant. Dr. Clancy inquired if this is a duplication of services and if the clientele is
already in the patient system. Ms. Whitted expressed concern regarding people with immediate
monetary needs for necessitates IE medicine and food. Ms. Hunter emphasized the mind set
seems to be set on monetary needs when actually services should be focused on and should be
rendered to middle income people and not just to the indigent population.
Ms. Betty Jo McCorkle, Women's Health Care Director, explained the goal of the TANF Grant
and the health department is to reduce the number of out of wedlock births and to reduce the I
number of welfare recipients. It is a collaborated effort of the Health Department and the
Department of Social Services. State title funds are available through DSS for monetary needs.
A discussion followed on the generic title and the explanation of the T ANF Grant. Dr. Jackson
requested Ms. Rowe, Chairman, and the Board of Health Budget Committee provide additional
information regarding the T ANF Grant.
MOTION: Dr. Jackson moved from the Executive Board for the Board of Health to accept
and to approve to budget the FY 99 Temporary Assistance to Needy Families (TANF) Funds
($28,374) as presented and to submit the request to the New Hanover County Commissioners
for their consideration. Upon vote, the MOTION CARRIED.
~Aye
----1- Nays (Greer, Steuer, Whitted)
Mr. Greer advised the County Commissioners voted to refer the revised proposal, "Project for
Happier Lives, " prepared by Judge Gilbert H. Burnett, back to the Board of Health for study of
the proposal changes.
Corps of Engineers Grant
Dr. Jackson recommended from the Executive Committee the acceptance of the Corps of
Engineers Grant ($14,900).
Mr. Rice reported the health department is receiving an additional $14,900 in revenue from the I
Corps of Engineers for FY99. These funds will offset expenditures in the FY99 Vector
ControllEnvironmental Health Budget Request.
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MOTION: Dr. Jackson moved from the Executive Committee for the Board of Health to
accept and to approve to budget of the additional $14,900 in revenue from the Corps of
Engineers to offset expenditures in the FY99 Vector Control/Environmental Health Budget
Request and to submit the request to the New Hanover County Commissioners for their
consideration. Upon vote, the MOTION CARRIED UNANIMOUSLY.
Request for New Positions in Child Health Child Services Coordination
Dr. Jackson recommended from Executive Committee the establishment of two new positions in
the Child Health Child Services Coordination Program.
Ms. Janet McCumbee, Child Health Director, presented a request to the Board for the
establishment of two Child Services Coordination (CSC) positions in Child Health. She
explained due to a 20% increase in the CSC caseload during the past year, the following two
new positions are needed to provide the required CSC program services:
Public Health Nurse 1(75%)
Clerical Specialist 1(75%)
Ms. McCumbee advised the above two new positions will be self-supporting by Medicaid
reimbursement. Total projected expenditure and revenue increase for FY98 is $3,696 and for
FY 99 is $48,060.
MOTION: Dr. Jackson moved from the Executive Committee for the Board of Health to
approve the establishment of two new positions: a Public Health Nurse I (75%) and a Clerical
Specialist I (75%) in the Child Services Coordination/Child Health Division to be supported by
Medicaid funding and to submit the position request to the New Hanover County
Commissioners for their consideration. Upon vote, the MOTION CARRIED
UNANIMOUSLY.
Computer System for Animal Control Services
Dr. Jackson stated the Executive Committee recommended the approval for the county to
purchase a Chameleon Computer System for the Animal Control Services Division. Total cost
is $64,260 for the ideal package recommended by Mr. Bill Clontz, MIS Director.
Dr. Jackson stated this recommended computer system is still under study. Due to the
possibility of the total package ($64,260) not being funded and the need for further study of the
Animal Control Services Division basic computer needs, Dr. Jackson requested the Board of
Health consider the approval of referring the purchase of the new computer system to the
County Commissioners.
Dr. Jackson reported on Monday, May 4, 1998, Mr. Greer, Mr. Rice, and he went to evaluate the
operation of the Orange County Health Department Animal Control Services computer system
on Monday, May 4, 1998. He expressed there are variables regarding the utilization of existing
computer equipment, computer needs, and the purchase and cost of the new computer system
for the Animal Control Services Division. The actual costs are lower than the original
estimates due to cutting some computer equipment to reduce costs.
" Dr. Goins called for a vote on the recommendation from Executive Committee for the county to
purchase the Chameleon Computer System at the cost of $64,260 for the Animal Control
Services Division.
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MOTION: Dr. Jackson moved from the Executive Committee for the Board of Health to
approve for the county to purchase the Chameleon Computer System for Animal Control I
Services Division at the cost of $64,260. Upon vote, the MOTION DID NOT CARRY.
-L Aye
~ Nays
MOTION: Dr. Goins MOVED, SECONDED by Mr. Link for the Board of Health to
approve for the County Commissioners to purchase and to make the decision regarding the
purchase of the Animal Control Services computer system. Upon vote, the MOTION
CARRIED UNANIMOUSLY.
Board Members
"Project for Happier Lives" Revised Proposal
Dr. Goins asked for clarification of what occurred when Judge Burnett's "Project for Happier
Lives" proposal was referred back to the Board of Health by the County Commissioners.
Mr. Steuer advised the County Commissioners requested Judge Burnett make changes to his
proposal and submit the revised document to the Board of Health for study. The new proposal
~ill include teenage boys. Mr. Rice asked for directive from the Executive Committee in this
Issue.
Mrs. Hunter stated she understands the directive from the Executive Committee was for the I
health department staff not to be involved in the "Project for Happier Lives" proposal during
working hours. Staff could participate in the project on their own time. Ms. Hunter
emphasized the importance of the health department staff supporting and being in the planning
stage of the project in order to have input. Ms. Hunter and Dr. Goins expressed concern over
putting health department staff in a most uncomfortable position relating to this project. Ms.
Rowe stated prevented pregnancies and the proposal could save county dollars.
Dr. Jackson stated until the "Project for Happier Lives" project is approved by the County
Commissioners, he believes health department staff time should not be spent. He thinks the
first time the Board of Health voted on a misrepresented issue and now the Executive
Committee will have an opportunity to revisit the rewritten "Project for Happier Lives"
proposal.
Mr. Rice reiterated the County Commissioners remanded the "Project for Happier Lives"
proposal to the Board of Health and they requested the Board Health study and review the
changes in a rewritten proposal. Ms. Hunter again expressed health department staff should be
given an opportunity to support and furnish input in the planning phase of the proposal.
Dr. Jackson announced when Judge Burnett completes the revised proposal, it will be presented
to the Board of Health Executive Committee for their consideration.
Board of Health Media Coverage
Dr. Jackson suggested probably one Board member should represent the Board of Health with I
the media. Ms. Rowe suggested Dr. Jackson, as Chairman, assume this responsibility. Mr.
Link concurred with the concept that uniform information should be provided to the media. Dr.
Jackson announced he will address this issue at the June 3 Board of Health meeting.
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Health Director
"Treasure Your Health" Health Fair at Independence Mall - April 18. 1998
Mr. Rice reported the "Treasure Your Health" Health Fair was held from 10:00 a.m. - 9:00
p.m. on April 18, 1998, at Independence Mall. Approximately, 1,800 shoppers participated at
the Health Fair showcasing public health services to the community. The Health Department
and WW A Y - TV were sponsors. There were 40 exhibits highlighting health services, 253
hypertension screenings, educational materials, entertainment, and prizes including a shopping
spree. Columbus and Brunswick Counties participated in the celebration.
Azalea Festival Services
Mr. Rice reported during the Azalea Festival held on April 4-5, he visited the foodhandling
booths. He commended the Environmental Health staff for their food safety inspections and
professional strict but fair criteria in working with the foodhandling owners and operators.
APHEXlPH Update
Mr. Rice reported the AEIOU Committee met on April 14, 20,30, and May 4, 1998. To-date,
the committee has identified 36 health department strengths. After the completion of the
analysis of strengths, the AEIOU Team will address the opportunities to improve and submit a
report to the Board of Health and staff.
Mr. Rice stated the Board of Health members completed an abbreviated version of the
Organizational Capacity Assessment Questions. The top five rated indicators were:
1. The health department has a clear and concrete mission statement that all staff is capable
of stating and explaining in relation to their duties.
2. The local government unit uses the policy board and the health director in developing
public policy which may impact public health.
3. The health department is regularly consulted by the local elected officials about aspects
of local policy relating to health issues.
4. The health department is regularly consulted by local schools when setting health policy.
5. The health department director and policy board participate at both the state and local
levels in governmental decision making which may have an impact on local health issues.
New Hanover - Pender County Medical Society Presentation
Mr. Rice reported he made a presentation to the New Hanover-Pender County Medical Society
meeting held on April 15, 1998. - He also addressed the retired physicians of the medical society
on April 30.
Employee Appreciation Luncheon - Thank You
Mr. Rice distributed notes of appreciation to the Board of Health from health department
employees for the Staff Appreciation Luncheon held from of 12:00 p.m. - 1 :30 p.m. on
Thursday, April 9, 1998. He presented a note of appreciation to the Board from Mr. Coble,
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Past Board of Health ChairmanlMember and President of the North Carolina Association of
Boards of Health, for allowing him to again assist with the luncheon.
Letters of Appreciation
On behalf of the Board of Health, Dr. Goins requested letters of appreciation be sent to Mr. John
Coble for his assistance with the Staff Appreciation Luncheon and to the New Hanover County
Training Program and to New Hanover Regional Medical Center Wellness + Program, sponsors
of the program following the luncheon held on April 9, 1998. Board members were requested
to submit payment for the luncheon expenses.
Budget Hearing
Mr. Rice invited Board members to attend the County Commissioners Public Hearing on the Health
Department FY Budget 99 on June 1, 1998.
Environmental Health Food Rating Decision
Mr. Rice informed the Environmental Health Division hopes to be selected by the Division of
Environmental Health as one of seven pilot counties to participate in the new numerical rating
grading system for foodhandling establishments. The pilot program will be for one year. The
decision should be made on May 15.
Performance Evaluation of Mr. Rice, Health Director
Dr. Jackson advised the sixth-month performance evaluation for Mr. David E. Rice, Health
Director, is due. Completed evaluation forms should be submitted to Dr. Jackson.
Other Business:
Adjourn:
There being no further business, the regular business meeting of the Board of Health was
adjourned at 10: lOa. m.
Dennis L. Jackson, V. , Chairman
New Hanover County Board of Health
David E. Rice, M.P .H., M.A., Health Director
New Hanover County Health Department
Approved:
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