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03/02/1994 I I I I l J:J Mr. John Coble called the regular business meeting of the New Hanover County Board of Health (NHCBH) to order at 8:00 A.M. on Wednesday, March 2, 1994, at the New Hanover County Animal Control Center, 220 Division Drive, New Hanover County Health Department (NHCHD), Wilmington, North Carolina. Members Present: John M. Coble, Chairman Spiro J. Macris, DDS, Vice-Chairman Mary Lou Alford Thomas V. Clancy, MD Mary King Dean W. Keith Elmore, RPh. Robert G. Greer Dennis L. Jackson, DVM Laura Pitts Maness Edward L. Paul, Jr., OD Mark A. Veenstra,PE Members Absent: Others Present: Robert S. (Bob) Parker, Health Director Frances F. De Vane, Recording Secretary Mr. Elmore presented the invocation. Recognition: Memorial Prayer for Dr. John B. Codington Mr. Coble held a moment of silent prayer in memory of Dr. John B. Codington, physician and North Carolina State Senator. Mr. Coble moved for the Board of Health to write a letter of condolence to Mrs. Codington and Family. Upon vote, the MOTION CARRIED. Mr. Coble called for corrections to the minutes of the meeting on February 2, 1994. The minutes were approved. Committee Reports: Executive Mr. Coble, Chairman, Executive Committee, reported that the Executive Committee met at 6 P.M. on February 18, 1994. The Committee reviewed and recommends to the Board the proposal for health department expanded services and the establishment of four new staff positions. )4 Budget I Mr. Veenstra, Chairman, Budget Committee, stated the Budget Committee met at 5:30 P.M. on February 21, 1994. Environmental Health Dr. Macris, Chairman, Environmental Health Committee, reported th~ Environmental Health Committee met at 7 P.M. on February 21, 1994. A budget analysis of the cost of services versus fees is being addressed. Rules Governing the Operation of Temporary Food Facilities have been drafted and will be presented to the Board. New Business: Expanded Services Report Mr. Parker presented an Improved and Expanded Health Department Services Proposal (Attachment #1) recommended by the NHCHD Visions Committee. He requested that the Board review the Visions Committee plan for improved patient services and endorse a staff work schedule necessary to accommodate the increased services. Mr. Parker suggested April 1994, Public Health Month, as the tentative date for the implementation of increased/improved services for New Hanover County citizens. After discussion of the above plan, Mr. Coble moved from the Executive Committee, for the Board of Health to approve the Improved and Expanded Health Department Services Proposal including an alternate staff work schedule. Upon vote, the MOTION CARRIED. I Approval of Revised Division of Maternal and Child Health Sliding Fee Scale Mr. Parker presented a request to the Board for their approval of the revised Maternal and Child Health Division Sliding Fee Scale for use in the Family Planning and Maternal and Child Health (MCH) Clinics. Mrs. Alford moved for the Board to approve the Revised Division of Maternal and Child Health Sliding Fee Scale to be used in Family Planning and MCH Clinics effective immediately. Upon vote, the MOTION CARRIED. Board of Health Recessed At 8:26 A.M. Mr. Coble recessed the business meeting of the Board of Health for the Groundbreaking Ceremony of the New Hanover I County Animal Control Center, 220 Division Drive, Wilmington, North Carolina. I I I 'u5 Departmental Focal: "Groundbreaking - New Hanover County Animal Control Center" At 8:36 A.M. the Ground Breaking Ceremony of the Animal Control Center sponsored by the New Hanover County Board of Commissioners, the New Hanover County Board of Health and the Animal Control Advisory Committee was held on the site of the new building. Mr. Coble welcomed attendees and introduced the following guests: Mr. Robert G. Greer, Chairman, New Hanover County Commissioners Mr. E. L. Mathews, Jr., Vice-Chairman, N.H. County Commissioners Mr. Allen O'Neal, County Manager Dr. Lee Hunter, DVM, N. C. Department of Environmental, Health and Natural Resources (DEHNR) Mrs. Donna Neal, Chairman, NHCHD Animal Control Advisory Committee Canine Boris and Deputy John Almedia, Special Guests Chairman Greer, and Vice-Chairman Mathews, County Commissioners; Mr. Coble, Board of Health Chairman; and Mrs. Neal, Animal Control Advisory Chairman; assisted by K-9 Boris and Deputy John Almeida broke the ground for the new NHCHD Animal Control Center. Speakers for the groundbreaking ceremony were Mr. Greer, Mr. Coble and Dr. Hunter. A reception followed the ceremony. Board of Health Business Meeting At 9:10 A.M. Mr. Coble reconvened the Board of Health meeting. New Business: Spraying Program for Gypsy Moth in New Hanover County Mr. Coble requested that Dr. Hunter, Public Health Veterinarian, DEHNR, address the proposed Spraying Program for the Gypsy Moth strains introduced last year in portions of New Hanover/Brunswick Counties by military cargo. Dr. Hunter introduced Peter Morris, M.D., M.P.H., Medical Epidemiologist,ODEHNR and Mr. Lloyd Garcia, North Carolina Department of Agriculture (NCDA) to the Board of Health. Dr. Hunter expressed that the moth itself does not pose a true human threat. Mr. Garcia explained that the Department of Agriculture plans to spray for the Asian gypsy moth with two pesticides: Bacillus thuringiensis (Bt) and Gypcheck. During favorable weather conditions pesticides will be applied by airplanes. He stated there will be announcements alerting the public of the exact date of spraying applications if possible. 16 Dr. Hunter stated the regarding the spraying informational memorandum Society. NCDA hosted several public meetings of pesticides and has prepared an to the New Hanover/Pender Medical I Dr. Morris explained that no deleterious health effects to the public resulted from these pesticides in the Pacific Northwest. Mr. Greer inquired if the spraying project responsibility. Mr. Garcia informed the Board that federal responsibility since the infestation of national environmental and economical problem. is a state funding is a moths is a Mr. Coble thanked Dr. Hunter, Dr. Morris and Mr. addressing the Board on the moth eradication issue. Garcia for Request for Five New Health Department Positions Mr. Coble presented from the Executive Committee a recommendation for the Board of Health to approve a request for the establishment of the following four new staff positions: Public Health Nurse II - Home Health Home Care Aide - Home Health Public Health Nurse I - Epidemiology Physician Extender - Maternal and Child Care I Mr. Coble explained that originally five new positions were requested; however, the Executive Committee recommended the postponement of the Home Health Assistant Health Director position. Mr. Coble moved from the Executive Committee for the Board to approve the recommendation for the establishment of four new positions (Public Health Nurse II and a Home Care Aide, Home Heal th; Public Health Nurse I, Epidemiology; and Physician Extender, Maternal and Child Care) and to submit the request for the establishment of these positions to the New Hanover County Commissioners. Upon vote, the MOTION CARRIED. Family Planning " Ms. Betty Jo McCorkle presented a proposal for the expenditure of additional Family Planning state revenues. She stated the primary goal of the proposal is to increase the Family Planning caseload. The plan includes the expansion of clinic hours and space, establishment of an additional Nurse Practitioner position, enhancement of computer capabilities, provision of a better patient plan of care and transportation, improvement of patient health habits and the initiation of a "Well Bucks" incentive at the cost of $6,000, which is to provide gifts to I patients for program compliance. I I I J r¡ Ms. McCorkle informed the Board that the NHCHD Family Planning Program received $27,144 in December and January, $10,727 Maternal and Child Health Block Grant (One-Time Funds for Women's Health Services), and $16,417 FY 1994 Expansion Funds to be expended in the Fiscal Year 1993-94 Budget. She explained that FY 95 Expansion Funding will be used to fund a portion of a full-time Nurse Practitioner position to be utilized in Family Planning, Epidemiology and Child Health Programs. Mr. Elmore moved that the Board of Health approve the proposal for the expenditure of the additional Family Planning funding. Upon vote, the MOTION CARRIED. Comments: Board of Health Members Mr. Coble announced a Home Health Strategic Planning Session will be held on May 25 and 26, 1994 to project the future Home Health needs. Health Director: Mr. Parker encouraged Board members to attend the Boards of Health training session on Health Care Reform to be held on April 28, 1994, from 6:30 P.M. 9.P.M. at the Wilmington Hilton (dinner included). Mr. Parker presented an annual report on the Measurement of Immunization Goals. He commended the New Hanover County Health Department for reaching 78% of their goal. Mr. Parker reported that Ms. Beth Day, Epidemiology Director, and he attended Governor Hunt's Kickoff Breakfast for Immunizations in Raleigh, North Carolina on February 25, 1994. Ms. Day presented a slide presentation on the NHCHD Immunization Program entitled, "The Winning Shots-Immunize". Mr. Parker presented an immunization campaign sweatshirt to Governor Hunt. Mr. Parker invited Board of Health members to participate with staff in health department services and/or clinics. He announced that the Board plans to host and sponsor a staff cookout on Friday, April 29, 1994 during April, Public Health Month. Norplant Clinic Utilization Ms. McCorkle informed the Board that the health department inserted approximately 250 Norplants in FY 92-93 and 59 Norplants in FY 93-94. Depo-Provera injections were started in February 1994, and to-date this method has been provided to three patients. )8 Personnel Evaluation Mr. Coble requested that Board members submit their performance I appraisals on Mr. Parker to Mr. Coble. There being no further business Mr. Coble adjourned the meeting at 10: 00 A.M. £:-Lm"> ~ Mr. John M. Coble Chairman, Board of Health ClQ~M~ Robert S. (Bob) Parker Secretary to the Board Approved: I I / J . DEFINITIONS CH ElI EPI LAB MCC WIC l. EH- 2. CH - Attachment No. 1 NEW HANOVER COUNTY HEALTH DEPARTMENT IMPROVED AND EXPANDED SERVICES AS APPROVED BY THE VISIONS COMMITTEE NEW HANOVER COUNTY HEALTH DEPARTMENT STAFF FEBRUARY 21, 1994 Community Health Division Environmental Health Division Epidemiology Division Laboratory Division Maternal and Child Care Division Women, Infants and Children Supplemental Food Division Open from 12 NOON to 1:00 P.M., Monday - Friday Old - Closed Addi tional Well Baby Clinic in Ogden Area, 5: 30 P. M. every other month initially (M.D. Present) Old - No Ogden Well Baby Clinic Services Offered Services Offered: Growth and Development Evaluations Immunizations Physical Exam Well Child Instruction 3. WIC - Open from 12 NOON to 1: 00 P.M. Tuesday - Friday Old - Open Tuesday - Thursday (added Friday) 4. EPI - Open from 7:00 A.M. - 7:00 P.M. every Thursday Old - 8:00 A.M. - 5:00 P.M. Services Offered: Chest X-rays, Immunizations, HIV Counseling and Testing, Tuberculosis Testing and Medications 5. MCC - Family Planning Evening Clinic Every 4th Thursday from 5:00 P.M. - 9:00 P.M. Old - No 4th Thursday Evening Clinic Services Offered: Teen Walk-In, Adult Annual Appointments, Pill Pick-Up, Health Education 6. EH - Will Open at 7:00 A.M. during Daylight Savings Time Old - 8:00 A.M. 7. WIC - Evening Clinics the 1st, 2nd and 3rd Thursdays from 5:00 P.M. - 7:00 P.M. Old - No 5:00 P.M. - 7:00 P.M. Clinics Services Offered: Food Instrument Issuance I I 8. CH - Neurology Clinic Expanded to 6:00 P.M. (M.D. Present) Old - 5:00 P.M. Services Offered: Diagnosis and Treatment of Neurological Problems, Referrals, Health Education 9. MCC - Healthy Children and Teens Evening Clinic every Thursday (except 5th Thursday) from 5:00 P.M. to 7:00 P.M. (RN Clinic) Old - Only 3rd Thursday Evening Clinics (Added 1st, 2nd and 4th Thursdays) Services Offered: Physical Exam, Lab, Health Education, Vision Screening, Hearing Screening, Developmental Screening, Referrals 10. WIC - Patients Who Miss Appointments for Recertification ¡Voucher Pickup will receive a Telephone Call Concerning Next Appointment Old - No Telephone Call 11. MCC - Five additional Family Planning Patient Appointments on the 2nd and 4th Mondays Old - Five Less Appointments 12. WIC - Hours of Service Posted in WIC Waiting Area Old - No Posted Hours of Service 13. EH - Hours of Service and Charges Posted in EH Waiting Area Old - No Posted Hours of Service or Charges 14. MCC - Family Planning - Open from 12 NOON TO 1:00 P.M., Monday - Friday Old - Closed Services Offered: Pill Pick-Up, Patient Information, Appointments 15. WIC - Will Begin Advertising Services and Hours of Service once Every Quarter in the Wilmington Morning Star and Wilmington Journal Old - Did Not Advertise 16. MCC - Child Health - Child Service Coordination Expanded Hours: 7:30 A.M. - 7:00 P.M., Monday - Friday Old - 8:00 A.M. - 5:00 P.M. Services Offered: Home Visits, Telephone Contacts, Record Documentation 17. MCC - Maternal Health - Maternity Care Coordination Expanded Hours: 7:00 A.M. - 6:00 P.M., Monday - Friday Old - 8:00 A.M. - 5:00 P.M. Services Offered: Home Visits, Telephone Contacts, Record Documentation I I 18. WIC - Certification of Post Partum (After Delivery) Mothers Initiated at New Hanover Regional Medical Center (Waiting Time Reduced) Old - Certification Process Started With Mother's During Next Visit to the Health Department 19. CH - Connnunity Health Expanded Hours - 7:30 A.M. - 6:00 P.M., Monday - Thursday Old - 8:00 A.M. - 5:00 P.M. Services Offered: Telephone Contacts, Home Visits, Neurology Medication Pick Up, Patient Certification 20. MCC - Family Planning - Appointment Reminder Telephone Calls Old - No Telephone Calls 21. EPI - Primary Care Services Expanded (Physician Extender) a. Acute Care Treatment 1. Kindergarten Health Assessment Patients 2. Chest Clinic Patients b. Clinical Evaluations 1. Tuberculosis Patients 2. Communicable Disease Contacts Prior to Medication (Example Meningitis} c. Exams and Treatment Every Day to Sexually Transmitted Disease (STD) Patients d. STD Clinic Services Expanded to Include: 1 . Wet Smears 2. Chlamydia Cultures 3. Pap Smears Old - None of Above Services Offered 22. EPI - EPI INFORMATION NEWSLJS·,rJ:.ISK Published Bimonthly Old - Published Quarterly 23. EPI - Immunizations Added on 1-1-94 by State Law a. Measles, Mumps, Rubella (MMR) Vaccine - Available to Boost 10 and 11 Year aIds b. Second MMR Required for Kindergarten and College Entrance c. Hepatitis B for Infants d. Haemophilus Influenza B (Hib) Vaccine - Available for 3-5 Year Olds Old - None of Above Immunizations J . 24. LAB - CH a. Provide a Laboratory Technician to draw blood lead specimens in Well Baby Clinics during regular working hours. This will average one clinic a week. Provide a Laboratory Technician to draw blood lead specimens during a new Well Baby Clinic to be set up in the Odgen area of the county. This Clinic will begin at 5:30 P.M. once every other month. Provide Cholesterol screening for hypertension outreach activities. This testing will be provided during regular working hours with the specimens being drawn by the nursing staff and the testing being provided by the LAB staff. Provide laboratory services to expanded Neurology Clinic. b. c. d. 25. LAB - EPI a. Expand laboratory services to the Sexually Transmitted Disease (STD) Clinic to include Pregnancy Tests, Urine Cultures, Wet Smears, and Pap Smears. b. Expand laboratory services to cover the new expanded hours of STD services available to the public. The expansion now has STD services available from 8:00 A.M. - 5:00 P.M. Monday - Friday. c. Expand laboratory services to 7:00 P.M. on the first, second, third and fourth Thursdays of each month. This expansion will include HIV testing and laboratory services to the TB clinic. 26. LAB - MCC a. FAMILY PLANNING CLINIC The addition of another night clinic to be held from 5:00 P.M. - 9:00 P.M. on the fourth Thursday of each month. All laboratory services will be available to the family planning clinic. b. HEALTHY CHILDREN AND TEENS (HCT} CLINIC Expanded laboratory services for new Early periodic Screening Diagnosis and Treatment EPSDT/HCT Clinics to be held on the first, second, third, and fourth Thursdays of each month to 7:00 P.M.