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11/04/1998 I I I l87 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., Wednesday, November 4, 1998, in the Conference Room of Wilmington Access For Teens (WHAT), 4005 Oleander Drive, Wilmington, North Carolina. Members Present: Dennis L. Jackson, DVM, Chairman William T. Steuer, PE/RLS, Vice-Chairman Thomas V. Clancy, MD Henry V. Estep, RHU 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 Pat Melvin, Assistant County Manager Frances F. De Vane, Recording Secretary Invocation: Mr. William T. Steuer gave the invocation. Minutes: Dr. Jackson asked for corrections to the minutes of the October 7, 1998 New Hanover County Board of Health Meeting. The minutes of the meeting of October 7, 1998 were approved by the New Hanover County Board of Health. Recognitions: UNCW Nursing Students Mr. Rice introduced and welcomed Amanda Chance, Jennifer Douglas, Alice Mathews, and Catherine Smith, UNCW School of Nursing students. Personnel New Employees Mr. Rice introduced the following new health department employees: Rosalyn H. Bauerlein, Public Health Nurse I, Community Health Sheila S. Irrera, Public Health Nurse I, Community Health Keith A. Studt, Crew Leader II, Vector ControllEnvironmental Health Susan E. Diamond, Nutritionist II, Nutrition Marsha G. Williams, Public Health Nurse I, Communicable Disease 1 188 Service Awards Mr. Rice presented and commended the following New Hanover County Service Award recipients: I Twenty (20) Year Service Awards Ruth E. Foy, Public Health Nurse II, Communicable Extender, Women's Health Care Avery G. Rollinson, Physician Extender, Women's Health Care On behalf of the Board of Health, Dr. Jackson welcomed the nursing students and new employees and expressed appreciation to Ms. Foy and Ms. Rollinson for their years of public health service. Wilmington Access for Teens (WHAT) Dr. Jackson introduced Ms. Connie Parker, Director, WHAT. She welcomed the Board of Health and presented Ms. Brenda Boey, Finance Director, Ms. Beth Deaton, R.N., and other staff members. Ms. Parker explained WHAT provides affordable, accessible physical and mental health services to unserved teens, emphasizing a family-centered approach, while coordinating care and referrals with area providers. She presented a FACT SHEET to the Board containing a brief history and information on WHAT which was initially visualized in 1991. In 1994, a Steering Committee was formed to plan for the center. The Duke Endowment Hospital Division committed funding pending successful community collaboration in the planning effort. WHAT was opened in March 1997. Ms. Parker stated other community and health agencies including the health department have provided in-kind support, financial support, and leadership to the WHAT Board of Directors and the Leadership Advisory Council. I Ms. Parker reported since the opening of the adolescent comprehensive health care center, teen visits to WHAT are more than 3,000. A Wellness Clinic with a physician extender will be opened at Lakeside School. Ms. Parker summarized WHAT continues to meet a need in the community, to grow beyond projections, and to evaluate the impact of its services in the community. She thanked the Board of Health, Mr. Rice, and the Health Department staff for support of the adolescent center. Ms. Rowe thanked Ms. Parker for the opportunity for the Board of Health to meet, visit, and learn more about the adolescent center. Dr. Jackson invited Board members to tour WHAT at the conclusion of the business meeting. Department Focal: Safety in the Health Department Ms. Susan O'Brien, Laboratory Director, presented a department focal on "Safety in the Health Department". She advised the Occupational Safety and Health Act of 1970 created the Occupational Safety and Health Administration (OSHA) within the Department of Labor and encourages employers and employees to reduce workplace hazards and to start safety and health programs. It gives employees workplace rights and responsibilities and includes civil penalties for violations. Copies of the New Hanover County Safety Manual were distributed to the Board. Ms. O'Brien stated Mike Winebar, is Safety Director for New Hanover County. The two safety committees are the I 2 I I I ~"";...~~h.k. "'" ~ .rr:'.-:J..~,.~ :..J,~'- ]. 890 New Hanover County Safety Committee and the Health Department Safety Committee. Each County Department Director is responsible for êstablishing a Safety Program within their department. Ms. O'Brien is the health department representative on the County Safety Committee and Chairman of the Health Department Safety Committee. Ms. O'Brien informed the County Safety Program is designed to comply with OSHA of North Carolina and Federal, State, and Local laws and regulations, to provide not only a safe physical working environment, but an atmosphere of safety awareness through safety education, training, and employee involvement. Two educational OSHA training sessions for health department employees are planned at 12:00 noon on November 16, 1998, and at 8:00 a.m. on November 23, 1998. Employees must attend required OSHA training. Ms. O'Brien advised OSHA Standards Governing the Health Department are Fire and Emergency, Personal Protective Equipment, Bloodborne Pathogens, Hazard Communication, Laboratory Standard, Ergonomics, TB, and Workplace Violence. Ms. O'Brien advised Safety Awards were awarded to the Health Department for nine consecutive years and to New Hanover County for five years. Dr. Jackson thanked Ms. O'Brien for the department focal on Safety in the Health Department. Committee Reports: Executive Committee Dr. Dennis Jackson, Chairman, Executive Committee, reported the Executive Committee met at 6:00 p.m. on October 27, 1998. Items of business are on the Board of Health Agenda. Environmental Health Committee Mr. Steuer, Chairman, Environmental Health Committee, reported the Environmental Health Committee met at 5:30 p.m. on Tuesday, October 14, 1998. He stated he met with Howard Varnum, US Corps of Engineers; Ken Scholar and Keith Studt, Vector Control, to ask funding for a new boat for the Mosquito Control Program. Mr. Steuer stated the Corps of Engineers cannot fund the boat but will reimburse Vector Control for services and equipment use. Mr. Steuer explained a 18' boat will suffice for waterway use. A hovercraft will be more useful on Eagle Island. The Corps of Engineers plans to dredge more soil sites and increase the area for dredge disposal. Mr. Steuer emphasized additional mosquito control measures will require more equipment, more work, and more staff. Mr. Steurer reported the Environmental Health Committee reviewed Environmental Health Fee Schedule. The committee's idea was to increase fees to cover the cost of services without burdening citizens. A cost analysis based on services and projected revenue was prepared to establish the Recommended Changes to the Environmental Health Fee Schedule. In 1994 the graduated fee schedule was implemented and was phased in over a three-year period. The fee schedule has not been adjusted in more than two years. Mr. Steuer reported the Environmental Health Committee is studying the Orange County Environmental Impact Ordinance. Ms. Harvell reviewed the following Recommended Changes to the Environmental Health Division Fee 3 'íJ (~, A, .1 ;¿; ,_, t:.J Schedule as proposed by the Environmental Health Committee and recommended by the Executive Committee: Service Current Fee Proposed Fee ReissueIRevise Construction Authorization 0 $140 Land Record Review 0 $100 + $50Æach Additional Hour Septic System Repair Permit 0 $ 50 Installer License Change Unrestricted No Change To Installer Registration $ 28 Restricted/Job Seafood Market Permit 0 $100 Seafood Vehicle Permit 0 $ 50 Swimming Pool Permit $100 $150 - (1/99) $200 - (1/00) Swimming Pool Plan Review $200 $250 Tattoo Artist Permit 0 $200 Temporary Food Facility Application $30 $30 Each Day Operation Well Permit $140 $200 I Additional projected revenue for FY1998-1999 for a six-months period beginning January 1999 is $30,500. Projected revenue for FY1999-2000 based on the entire budget year is $76,900. Ms. Harvell advised the proposed new fees are primarily in water and septic systems, seafood market I and vehicle permits, and tattoo artist permits. A study of fees in similar counties was conducted to compare fees for services. North Carolina General Statutes do not allow Environmental Health to charge for foodservice facility permitting or inspections. Dr. Jackson advised the Board he will call for a vote on the Recommended Changes to the Environmental Health Fee Schedule under New Business on today's Board of Health Agenda. Unfinished Business: Generators at Emergency Shelters Dr. Jackson emphasized the Board should keep informed regarding the availability and wiring of generators at emergency shelters. Mr. Greer is to advise the Board on the logistics of generators and hookup for the emergency shelters. New Business: Reclassifications Community Health Assistant to Clerical Specialist I Dr. Jackson recommended from the Executive Committee for the Board of Health to approve a request to reclassify a Community Health Assistant position to a Clerical Specialist I position in the I Communicable Disease Division. He advised Ms. Beth Jones, Communicable Disease Director, requested to reclassify a Community Health Assistant position to a Clerical Specialist I position in the 4 I I I 1 C., J_ ~.. Communicable Disease Division due to a need to use staff for medical records duties. Funding for the position is by appropriated salary. MOTION: Dr. Jackson, Chairman, Executive Committee, moved from the Executive Committee for the Board of Health to approve the request to reclassify a Community Health Assistant (Grade 108) to a Clerical Specialist I (Grade 111) in the Communicable Disease Division of the New Hanover County Health Department and to submit the reclassification request to the New Hanover County Board of Commissioners for their consideration. Upon vote, the MOTION CARRIED UNANIMOUSLY. Clerical Specialist II to Administrative Assistant I Dr. Jackson recommended from the Executive Committee for the Board of Health to approve the reclassification of Ms. Betty Rauth, Clerical Specialist II, to Administrative Assistant I in the Child Health Division. He explained the request was submitted by Ms. Janet McCumbee, Child Health Director, and is based upon program growth and the position's increased functional responsibility. Funding is by Child Service Coordination generated revenues. MOTION: Dr. Jackson, Chairman, Executive Committee, moved from the Executive Committee for the Board of Health to approve the request to reclassify Ms. Betty Rauth, Clerical Specialist II (Grade 112), to Administrative Assistant I (Grade 113) in the Child Health Division and submit the request to the New Hanover County Board of Commissioners for their consideration. Upon vote, the MOTION CARRIED UNANIMOUSLY. Revision of Environmental Health Fees Dr. Jackson moved from the Executive Committee for the Board of Health to approve the Revision of Environmental Health Fees as submitted. A discussion followed on the Recommended Changes to the Environmental Health Division Fee Schedule. Mr. Greer asked if the well permit fee applies to all potable drinking water wells in New Hanover County. Ms. Harvell responded the proposed $200 fee applies to new wells. The service includes at least three visits to a site for placement of well, water sample, and completion of a well. Dr. Clancy asked where the funding for the fees came before charging fees. Mr. Steuer replied from county tax revenue. Dr. Jackson advised the concept of the changes to the fee schedule is user fees. Mr. Steuer added the proposed septic system repair permit fee was not entirely based on cost of services since it was possible some septic systems may not be repaired. The cost of septic system repair is listed as $191.85 and the proposed fee is $50 which does not cover cost for service. Mr. Steuer advised the $50 charge could be a burden for some citizens and could be waived in hardship cases. Mr. Greer expressed concern regarding the increase in water and septic system fees. He emphasized since the hurricanes, people are concerned about water and septic systems and drainage problems in New Hanover County. He asked why septic system repair permits are $191.85. Ms. Harvell explained two inspections are required, repair options must be discussed and decided upon, and solutions agreed upon. Dr. Clancy inquired if they insure septic systems. Mr. Stuer informed the systems are not insurable, the owners must pay the total expense, and septic systems are dependent upon soil conditions. 5 192 Dr. Jackson reiterated costs should be based on cost for services and paid by the users. Mr. Link and Mr. Steuer acknowledged users should at least offset a portion of charge for service. Mr. Steuer I stated the committee considered the whole spectrum in the proposed changes to Environmental Health Fee Schedule. MOTION: Dr. Jackson moved from the Executive Committee for the Board of Health to approve the Revision of the Environmental Health Fee Schedule as presented to the Board of Health and to submit the revised fee schedule to the New Hanover County Commissioners for their consideration. Voting: -2- Aye -L Nay (Mr. Greer) Nominating Committee Report Mr. Estep, Chairman, Nominating Committee, presented the following nomInees for the 1999 Chairman and Vice-Chairman of the New Hanover County Board of Health: Mr. William T. Steuer, Chairman Dr. Wilson O'Kelly Jewell, Vice-Chairman Dr. Jackson advised the election of officers will be at the December 2, 1998 Board of Health Meeting. The floor will be opened for additional nominations. Other Nominating Committee members were Mr. Greer and Mr. Link. Dr. Jackson thanked the members of the Nominating Committee for serving. New Hanover County Health Department Annual Report - FY1997-98 Mr. Rice referred the Board to a newly designed New Hanover County Health Department Annual Report for FY 1997-98. The report features the Board of Health members, a Health Director's Message, a report from the divisions of the health department, a financial management report, and includes the health department mission statement, motto, and logo. I Mr. Rice recognized Ms. Denise Houghton, Health Promotions Director; Julie Macie, Graphic Artist; Coastal Areal Health Education Center; and staff for the preparation of the annual report. He advised the annual report will raise the visibility ofthe health department in the community. Comments: Board Members: Health Director: Annual Health Directors Legal Conference Mr. Rice stated Kemp Burpeau and he attended the Annual Health Directors Legal Conference on I October 21-22, 1998, in Chapel Hill, North Carolina. The following items were addressed at the Legal Conference: . 1998 General Assembly Health Legislation . Basic Legal Documents a Health Director Needs 6 I I I 11 r- ('¡ · · · · · · Managed Care and The Law (Consumer Protection) Independent Contractor or Employee? New IRS 20 Factor Test Legal Remedies to Enforce Environmental Programs in Tough Cases New Law of Sexual Harassment Law of Communicable Disease Control Medical Information Law (Right to Know Versus Confidentiality) NHCHD Christmas Party Mr. Rice invited Board of Health members to attend the Annual Christmas Luncheon from 12 Noon until 2:00 p.m. on Wednesday, December 16, 1998, as guests of the health department staff. The Christmas Committee is planning the luncheon and entertainment. AEIOU (Assessing. Evaluating. Improving. Our Opportunities are Unlimited) Update Mr. Rice presented an AEIOU Update. He reported the AEIOU Team met on October 5, 19, and 26, 1998. In the past seven and one-half months, the Team met 24 times and identified strengths and opportunities to improve. A priority list of opportunities to improve includes Public Information, Internal Communication, Internal Evaluation, Community Involvement, and Personnel Issues. Three action teams have been assembled to address public information, internal communication, and internal evaluation opportunities. Each action team will be responsible for establishing goals and objectives, assigning responsibilities, and specifying methods. Nutrition Program Director Interviews Mr. Rice reported interviews for the Nutrition Director position were conducted by Ms. Janet Bryant, Nutritionist Consultant; Ms. Lynda F. Smith, Assistant Health Director; and Mr. Rice. Response to recruitment notice was excellent as the Department of Human Resources submitted nine applicants. Animal Control Services Solutions Team Mr. Rice announced an Animal Control Solutions Team has been formed. The team is to look at the way Animal Control Services does business, to look internally at the division, to analyze organizational strengths and opportunities to improve, and to work together. Shigellosis Outbreak Since October 14, 1998, Mr. Rice reported 42 cases of Shigellosis have been identified by stool culture. The Divisions of Communicable Disease, Laboratory, Environmental Health, and the EPI Team have been working with child care centers and public schools with symptomatic children. Ms. Beth Jones, Communicable Disease Director, explained Shigellosis is a diarrheal illness caused by the Shigella group of bacteria. One child care facility has 24 cases and many other cases are associated with the child care cases of Shigellosis. At least 8 child care centers and 8 public schools have symptomatic children. The single most effective practice to prevent the spread of this germ is good handwashing by child care providers, children, and others. Strict diapering, toileting, and handwashing practices are being reinforced. The health department notified child care facilities, physicians, and school personnel of the Shigella infection. Ms. Jones stated outbreak control efforts will continue through active monitoring of cases. Mr. Rice stated that signing an isolation order for a child care facility today may be necessary. 7 Jl ,r\ , _ i:1 -.:c' -. Other Business: Injury Prevention Trauma Care Exhibit Mr. Rice reminded the Board to visit the Injury Prevention Trauma Health Care exhibit prepared by Ms. Denise Houghton, Health Promotion Director. Dr. Clancy suggested the exhibit focusing on injury prevention and trauma care. Adjourn: There being no other business, Dr. Jackson adjourned the regular business meeting of the Board of Health at 9:25 a. m. ~ David E. Rice, M.P .H., M.A., Health Director New Hanover County Health Department Approved: 8 I I I