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09/01/1993 BOH Minutes I I I 251 On September 1, 1993, at 7:30 A.M., the Board of Health attended a Breakfast held in the Home Health Office recognizing the New Hanover County Health Department Home Health Staff for their achievement of Joint Commission Accreditation with Commendation. Mr. Coble called the regular business meeting of the New Hanover County Board of Health (NHCBH) to order at 8: 10 A.M. on Wednesday, September 1, 1993, in the Carl T. Durham Auditorium, New Hanover County Health Department (NHCHD), Wilmington, North Carolina. Members Present: John M. Coble, Chairman Spiro J. Macris, DDS, Vice-Chairman Mary Lou Alford, RN 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 Dr. Jackson presented the invocation. Mr. Coble called for corrections to the minutes of the meeting on August 4, 1993. The minutes were corrected by Mr. Greer. The Board of Health approved the minutes as corrected. Recognition: 100% Smokefree Establishments On behalf of the Board of Health, Mr. Coble recognized three New Hanover County Smokefree Establishments. Super Staff Winner On behalf of the Board of Health, Mr. Coble congratulated Kathy Nuttall, Computer Systems recipient of the Semi Annual Super Staff Award. recognized and Administrator, Public COlIDDents Mr. Coble requested that the Board consider public comments on two agenda items: (1) Smart Start Request for Letter of Endorsement (2) Wake County Smoking Control Rules. 252 Mr. Coble explained that the above are two sensitive issues. The Smart Start Program is designed to provide children from birth to I five years of age affordable, quality early childhood education and other crucial services. The Wake County Smoking Control Rules are being reviewed for the Board of Health's consideration and possible adoption. Dr. Jackson moved that the comments on the above issues. Board of Health receive public Upon vote, the MOTION CARRIED. Mr. Coble distributed to public participants sign-up lists. Departmental Focal: Dr. Clancy gave the departmental focal on the Impact He explained that trauma crosses the entire spectrum has an emotional, financial, and social impact on us. that injury is a Public Health issue. of Injury. of age and He stated COlIDDittee Reports: Animal Control Advisory Animal Control COIIDDittee Plans Ms. Donna Neal, Chairman, Animal Control Advisory Committee, gave I an update on the Animal Control Advisory Committee plans for promoting public awareness of Rabies. With the support of the Board of Health and the New Hanover County Commissioners, Ms. Neal stated a proactive stand instead of a reactive stand on Rabies can be taken in New Hanover County. The distribution of flyers and vaccination clinics are being funded by donated monies. Ms. Neal stated that the architectural plans for the Animal Control Center are completed. She requested that the Board of Health accept and approve the submitted plans. Ms. Maness moved that the Board of Health accept the archi tectural plans for the proposed Animal Control Center and submit them to the County Commissioners for their approval. Upon vote, the MOTION CARRIED. Environmental Health Proposed Ordinances Dr. Macr is, Chairman, Environmental Heal th Committee, reported that the Environmental Health Committee met on August 23, 1993. The Committee discussed changes to the proposed "Rules Governing the Standards for Operation of Acupuncture, Body/Ear-Piercing, I_- Electrolysis, Tattoos and Other Establishments Conducting Similar Procedure", the "Rules Governing the Operation of Temporary Food Facilities" and the "Rules Governing Private Water Supplies." I I I 253 These issues will be presented to the Board upon completion of the Committee's work. Dr. Macris referred the Board to their copies of the draft of the proposed "Rules Governing the Operation of Retail Seafood Markets and Vehicles" and existing "Shellfish-Seafood Regulation adopted 01/05/83." Ms. Dianne Harvell, Environmental Health Director, explained that the 1983 existing seafood rules for vehicle vendors are not comparable to seafood markets. Proposed seafood rules will require that seafood vehicle vendors have access to toilets and running water. Dr. Macris moved from the Environmental Health Committee for the Board of Health to hold a Public Hearing on the proposed "Rules Governing the Operation of Retail Seafood Markets and Vehicles in New Hanover County" and to advertise for this hearing. Upon vote, the MOTION CARRIED. The Board of Health decided to hold the Public Hearing at 7:00 P.M. on Monday, September 20, 1993, at the NHCHD. Executive Breast and Cervical Cancer Control Program Mr. Coble, Chairman, Executive Committee, reported that the Executive Committee met on Tuesday, August 17, 1993, and reviewed the state proposal for the Breast and Cervical Cancer Control Program. Mr. Parker informed the Board that a year ago they had reviewed and denied the acceptance of this program due to program restrictions and local match funding requirements. The present proposed state project will fund NHCHD approximately $25,000 with a 1:7 match. Mr. Coble moved, from the Executive Committee, that the Board of Health not consider participation in the Breast and Cervical Cancer Control Program until 100% state funding is provided. Upon vote, the MOTION CARRIED. Smart Start Program Mr. Coble stated that the Executive Committee discussed the Smart Start Program. It was proposed by Governor Jim Hunt and enacted by the 1993 General Assembly. The initiative targets children from birth to five years old to ensure they come to school healthy and ready to learn. At this time, Mr. Coble called for public comments concerning the Smart Start Program. 254 Speakers presenting in favor of the endorsement of the Smart Start Program were: Pam Palanza, Chair, New Hanover County Smart Start Team, Child Advocacy Julie Montford, Parent/Student Kathy Sabella, New Hanover County Board of Education Sarah Norris, Child Development Center Lynn Smithdeal, Community Services Coordinator, DSS Connie Parker, President, Cape Fear Community Foundation I Speakers presenting against the endorsement of the Smart Start Program were: Tom Blackstone, M.D., Pediatrician Amy Madsen, Parent Barren Nobles, Administrator, Wilmington Christian Academy Carolyn Bordeaux, Alliance for Better Education Bernard Thomas, Naval Aviator, Senior Citizen Mr. Coble reported that the Executive Committee recommended that the Board of Health decline to endorse the Smart Start Program without a firm commitment of funding and detailed obligations of the NHCHD. After a lengthy discussion, Mr. Coble moved from the Executive I Committee, that the Board of Health decline to endorse the Smart Start Program without a firm commitment of funding and detailed NHCHD staff obligations. Upon vote, the MOTION CARRIED. Voting Nay: Abstained: Dr. Clancy Mr. Greer Health Promotions Mr. Elmore, Chairman, Health Promotions Committee, reported that the Health Promotions Committee met on August 17, 1993. Injury Prevention Proposal Mr. Elmore presented a request to endorse a Inj ury Prevention Proposal to reduce morbidity and mortality from injuries in New Hanover County. He recommended that the establishment of a Health Educator I position be approved by the Board of Health and submitted to the New Hanover County Commissioners for their consideration. Mr. Elmore recommended from the Health Promotions Committee that the Injury Prevention Proposal and Health Educator I position be approved by the Board of Health and submitted to the New Hanover County Commissioners. Upon vote, the MOTION CARRIED. I I I I 255 Wake County Smoking Control Rules Mr. Elmore reported that the Health Promotions Committee reviewed the Wake County Smoking Control Rules. Commi ttee members were split on their recommendation to the Board for the consideration of the adoption of the Wake County Smoking Control Rules. At this time, Mr. Coble called for public comments concerning the adoption of the Wake County Smoking Control Rules. Speakers presenting against the adoption of the Wake County Smoking Control Rules were: Lawrence Davis, Attorney, R.J.Reynolds and Tobacco Industry Ray Taylor, Tobacco Manufacturers Representative Roy Clifton, N.C. Restaurant Association Representative B.C. Hedgpeth, Food Service Industry Sandra Gunter Nina Barentine Speakers presenting for the adoption of the Wake County Smoking Control Rules were: Jennie Lancaster, Project ASSIST Gary Maxwell, M.D., Area Health Education Center Beth Deaton, RN Mr. Elmore moved that the Board of Health adopt the Wake County Smoking Control Rules as the New Hanover County Smoking Control Regulations effective October 15, 1993 and instruct staff to advertise and implement this smoking control regulation. Upon vote, the MOTION DID NOT PASS. Unfinished Business: New Business: Requests for Increase in Vaccine Injection Fees Due to an increase in expenses, Mr. Parker presented a request to increase the flu vaccination fee from $5.00 to $10.00. Ms. Alford moved to charge $10.00 per dose for flu vaccine injections in-the NHCHD. Upon vote, the MOTION CARRIED. Mr. Parker presented a request for an increase in Hepatitis B vaccine from $35.00 to $40.00. Dr. Paul injections. moved to charge $40.00 per dose Upon vote the MOTION CARRIED. Hepatitis for B 256 Smoking Control Regulation Dr. Paul suggested that the Health Promotions Committee dissect the Wake County Board of Health Smoking Control Rules and resubmit a more palatable New Hanover County Smoking Control Regulation to the Board of Health. He stated he would like to endorse a more restrictive smoking control regulation. Dr. Jackson moved that the Wake County Smoking Control Rules be referred back to the Health Promotions Committee for draft, modification and correction and that a modified New Hanover County Smoking Control Regulation be resubmitted to the Board of Health at their September 20, 1993 meeting. Upon vote, the MOTION CARRIED. COIIDDents: Board of Health Members Dr. Macris expressed concern over being under pressure to make important decisions and vote without adequate time to research issues. He stated an example was the General Assembly's passage of House Bill 957 - Regulate Smoking In Public. Dr. Clancy stated that it concerns him that the Board chose not to endorse Smart Start. Ms. Dean stated that she had researched this issue and that her vote was informed. Health Director Mr. Parker requested that the Board of Health complete their Association of North Carolina Boards of Health Exchange Forum Priority List. Mr. Parker reminded the Board to register for the North Carolina Public Health Association Annual Meeting, September 22-24, 1993, at the Wilmington Hilton. Registration forms should be completed today. Mr. Parker stated that the Board of Health had received their copies of the Fiscal Year 1992-93 Annual Report. Mr. Parker presented to the Board a report of 1992 New Hanover County Resident Births. I I I I II I .' 257 There being no further business Mr. Coble adjourned the meeting at 10:45 A.M. ¿~dh$ John M. Coble airman, Board of Health ~--UJ~ Robert S. (Bob) Parker Secretary to the Board Approved: I I I 259 NEW HANOVER COUNTY BOARD OF HEALTH PUBLIC HEARING ON RULES GOVERNING THE OPERATION OF RETAIL SEAFOOD MARKETS AND VEHICLES IN NEW HANOVER COUNTY The New Hanover County Board of Health (NHCBH) met in a Special Session on September 20, 1993, at 7:00 P.M., in the Carl Thomas Durham Auditorium, New Hanover County Health Department, Wilmington, N.C. Mr. Coble, Chairman, called the Public Hearing to order and reported that the purpose of the hearing is to recei ve public comments on the proposed changes in the Rules Governing the Operation of Retail Seafood Markets and Vehicles. Mr. Coble welcomed attendees. Board members introduced themselves and designated their category of representation on the Board of Health. Mr. Coble stated that the proposed changes in the Rules Governing the Operation of Retail Seafood Markets and Vehicles will be considered for adoption by the Board of Health on October 6, 1993, at 8:00 A.M. He stated that copies of the changes to the seafood rules are available for review. Speakers were asked to sign-up for three-minute presentations. Mr. Coble explained that the Board will not respond to or entertain questions this evening. He requested that any questions for the Board, be submitted to Ms. Lynda Smith, Assistant Health Director. Mr. Coble stated that written remarks regarding this ordinance will be accepted by the Board of Health on/or before September 30, 1993. Mr. Coble called for public comments concerning the proposed changes in the Rules Governing the Operation of Retail Seafood Markets and Vehicles. Speakers presenting in support of the proposed rules changes were: Kent Bullard Mike Coleman Jack A. Alford Elsie McDowell Billy Burton Speakers presenting against the proposed rules changes were: Elmore Pate Mitchell Jacobs Geraldine Batson Mr. Coble asked for comments from the floor. Mr. Billy Burton encouraged all seafood dealers and vendors to work together. 260 Mr. Coble thanked the speakers and attendees for their interest in the proposed changes in the seafood rules. Mr. Coble closed I the Public Hearing at 7:30 P.M. BOARD OF HEALTH MEETING Following the Public Hearing, Mr. Coble called the regular business meeting of the New Hanover County Board of Health (NHCBH) to order at 7:40 P.M. on Monday, September 20, 1993, in the Carl T. Durham Auditorium, New Hanover County Health Department (NHCHD), Wilmington, North Carolina. Members Present: John M. Coble, Chairman Spiro J. Macris, DDS, Vice-Chairman 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: Mary Lou Alford, RN Others Present: I Robert S. (Bob) Parker, Health Director Frances F. De Vane, Recording Secretary Wanda Copley, County Attorney Dr. Jackson presented the invocation. Mr. Coble called for corrections to the minutes of the meeting on September 1, 1993. The minutes were corrected by Ms. Dean. The Board of Health approved the minutes as corrected. Recognition: Mr. Parker introduced Ms. Pam Horne, Executive Director, Association of North Carolina Boards of Health (ANCBH), to the Board of Health. Departmental Focal: Committee Reports: Environmental Health Committee Mr. Parker asked the pleasure of the Board of Health regarding I the disposition of the proposed changes in the seafood rules. I I I 261 Ms. Dean moved that the proposed changes in the Rules Governing the Operation of Retail Seafood Markets and Vehicles be sent back to the Environmental Health Committee for further review. Upon vote, the MOTION CARRIED. Health Promotions COIIDDittee Mr. Elmore, Chairman, Health Promotions Committee, reported that the Health Promotions Committee met on September 7, 1993 to review and redraft the New Hanover County Board of Health Smoking Control Regulation (SCR). Mr. Elmore moved from the Health Promotions Committee that the proposed SCR be considered for adoption by the Board of Health effective October 6, 1993. At this time, Mr. Coble called for discussion on the proposed SCR. He informed the Board that he had discussed the SCR with Ms. Wanda Copley, County Attorney, due to concerns from other state Health Directors and Environmental Health Specialists. He requested that Ms. Copley address the Board regarding this issue. Ms. Copley explained that General Statutes, Chapter 130 A-39, give local Boards of Health the power to adopt rules to promote and protect public health. She informed the Board that this is a broad power. However, the validity of the Environmental Protection Agency report could be challenged. Mr. Greer, Chairman, New Hanover County Commissioners, rEquested legal advice regarding the Board of Health passing a smoking control regulation. Ms. Copley explained that the first issue concerned whether the Board of Health has the authority and the second issue would relate to the health effects of second-hand smoke. Then, she stated, it would be one expert against another; i.e., the Environmental Protection Agency against the Tobacco Institute. Ms. Copley stated she represents the Board of Health in legal matters. Ms. Maness stated that on Page 19, Section IX, Part B, of the proposed SCR,' she did not remember a section of the smoking regulation addressing hotels. She stated for the record she didn't think we had previously agreed to this section and that this smoking control regulation was not to be fashioned after the Wake County Health Department Smoking Rules. Mr. Parker stated he drafted the proposed regulation assuming that all places were going to be smoke-free except restaurants. He stated this is just a draft for the Board's consideration. Mr. Elmore stated that the only issue that the Health Promotions Committee had addressed was the restaurant compromise. He explained the SCR was drafted by using and rewording a part of the Wake County Smoking Control Rules. 262 Mr. Coble asked the Board to consider an amendment that would grant restaurants more time and more seating space for I non-smokers. After a lengthy discussion of proposed amendments to the SCR, Dr. Paul recommended that the Board of Health accept the SCR with the following amendments: 1. Add a definition for Bars. 2. Exclude Bars from the proposed regulation. required to display proper signage. Bars will be 3. Include nightclubs and lounges in the Bar definition. 4. Include public and conference areas of hotels and motels in Public Place definition. 5. Include hotel or motel rooms designated as smoking rooms in Private Residence definition. 6. Regulation of Smoking in Eating Establishments would change non-smoking seating as follows: a. Thirty percent (30%) by January 1, 1994 b. Forty percent (40%) by January 1, 1995 I c. Fifty percent (50%) by January 1, 1996 7. Section IX, Part B, concerning hotels would be deleted. 8. The effective date would be changed to January 1, 1995. Mr. Greer expressed concern over the SCR, since the present New Hanover Control Ordinance is now in effect. necessi ty to prepare the County Smoking Pollution Ms. Dean and Ms. Maness expressed concern over taking away the rights of private employers and businesses to make their own decisions. Ms. Dean stated in her opinion the market place will solve this issue. Mr. Elmore expressed that he felt second-hand smoke is a public health issue which needs to be addressed by the Board of Health. Dr. Macris stated he supports this community and national health smoking control health issue, which is costing the nation too much. Dr. Clancy expressed his full support of the SCR since smoking is not safe. He stated he was disappointed that the amended regulation is watered down by restaurants and other I groups. I I I 263 Mr. Coble then presented a statement and proxy from Ms. Mary Lou Alford, Board of Health member. He explained that Ms. Alford had requested that in her absence the Board accept this notarized statement and her proxy as a vote on the SCR. After a lengthy discussion, Ms. Maness moved, seconded by Ms. Dean for the Board of Health to accept Ms. Alford's proxy statement in her absence as a vote in consideration of the SCR. Upon vote, the MOTION CARRIED. After this vote, Ms. Copley informed the Board that she has never seen a proxy vote presented and that there is no provision in the General Statutes which allows a proxy vote. She explained if the Board allows this vote by proxy, the Board will be setting a precedent. She stated that in her opinion a vote by proxy is not valid. Dr . Macr i s - moved, seconded by Dr . Jackson for the Board to invalidate Ms. Alford's proxy based upon the opinion of Ms. Copley, County Attorney, that a vote by proxy is not valid. Upon vote, the MOTION CARRIED. After a lengthy discussion, Dr. Paul moved and it was seconded that the Board of Health consider for adoption the New Hanover County Board of Health Smoking Control Regulation as amended. Upon vote, the MOTION CARRIED. 6 Aye 3 Nay Mr. Coble asked the Board if they desired a Public Hearing before the vote on the adoption of the proposed SCR. Dr. Jackson, moved, seconded by Mr. Greer to incorporate a Public Hearing with limited time for speakers on the proposed SCR at the Board of Health meeting on October 6, 1993 at 8:30 A.M. Upon vote, the MOTION CARRIED. Unfinished Business: New Business: Comments: Board of Health Members Health Director Mr. Parker reminded the Board members to attend Carolina Public Health Association Annual Meeting, 22-24, 1993, at the Wilmington Hilton. the North September 264 There being no further business Mr. Coble adjourned the meeting at 9:00 P. M. ~~.~e Chairman, Board of Health ~%P~ Robert S. (Bob) Parker Secretary to the Board Approved: I I I ·1 $lATE OF NORm CAROLINA, COUNtY or NEW IWfOVD I - PUBLIC NOTICE The New Hanover County Board 01 Heatth will hold e pUblIC heanng on Monday. September 20. 1993 at 7 00 p m. In the New Hanover County Health Department Audltonum The purpose 01 thIS meetIng Is to dISCuss adoptIOn 01 the proposed Rules Gov- emlng the OperatIOn 01 Retad Sea- food Markats and VehICles In New Hanover County Tha posstble adop- bon date 01 these rules IS October 6, 1993 at the regular meetIng 01 the New Hanover County Board 01 Health Copies 01 the proposed rules may be obtamed lrom the New Hano- I ver County Health Department at 2029 South 17th Street and the Office 01 the Clark to the Board 01 CommIs- sIOners at Room 305, 320 Chestnut Street This meebng IS open to the public I· I AFFIDAVIT OF PUBLICATION Befin die 1IIIIImi.... . N~ Public of said Camay aad StIœ. . -: JACOB BRIÑSON wfIo. beia¡ cIaIy swam or úIirmaI. aa:ordiD¡ ID die law. says _ belsbe is CLASS. ADV. MGR. of'l1Œ W1LMJNGI'ON STAR-NEWS. INC.. a Ql¡pr..,di. orpIIizedmd doing business UDder the Laws of die Stale of NordI CmlIiDa. IIId publislúøl a œwspçer IaIowa as WILMINGTON MORNING STAR.t SUNDAY STAR-NEWS iD die City ofWilmiagtma PUBLIC NOTICE RULES WIS iDserted iD the aforesaid DlWSpapet in space. aad an daœs IS CoJIows: 9/12,19/93 and at the time of such pubücmon WilmingtOll Slat-News was a newspaper meeång all the -~?Æ=:;:' CLASS. ADV. MGR. ._ Tide Sworn or afØrmcd 10. md subscribed before me. Ibis 6 TH day / of . OCT A.D..19~3 r: Te:s:im=y W!-.:=i. I have h=wtto Kt ~J b.;¡¡;i ;md ;1f'.:.;d :r:¡ offlcia1 s=I. the day and -rear aforesaid. 'Í7 . ~.~ ~ / Norary Public: My CODIIDÎSsiOD expires 21 day of JUNE 19~ Upon readiøg die aioregoiDg affidavit witb die advertisement dIcmo IIIIIeXI:d it is adjudgai by the Coun Ibat die said pablicaåon _ duly and properly IIIIIde. aøI dJat die SUIIIIIIOIII bas beca cIaIy and lepIIy saved on die de!eadanl(s). This day of MAn. 10: 19_ ~ of Superior COUIt