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11/02/1983 0096Z The New Hanover County Board of Health met on Wednesday, November 2, 1983 at the New Hanover County Health Department. Members Present: ~~ Carl Durham, Chairman Larry Neal, D.D.S., Vice Chmn. Ted Bagley Jean Credle J. William Eakins, M.D. James Strickland Hobart Whaley Members Absent: Donald Blake William Grathwol Others Present: Robert S. Parker, Secretary to the Board Robert Pope, County Attorney Mabel Price, Recording Secretary Mr. Durha~, Chairman, called the meeting to order at 8:00 A. M. and called for corrections to the October 5, ]983 minutes. Dr. Neal moved the minutes be approved. Mr. Strickland seconded the motion and it carried unanimously. Mr. Parker introduced Dr. Ronald Levine, State Health Director, and Dr. George n1.Jdney, C~licf, Dental Health Section. D:r:. Levine a.nd Dr. Dudney were in Wilmington to observe the Dental Health Sealant orogram and the Fluoride Mouth Rinse pr)9r~~ both of which are being administered by our Dental Health program. "'-- Hypertension Program Upd~te: The staff wo~kinq with the Hypertension progro.m were introduced to--tha Boara. Ruth Fay, Public Health Nurse, working with this p:;:-ogI",-"-."TI gave a short sllin~ary of the New Hanover County Health Department Hypertension program. Fee Cornmitt~e Repar!.: Dr. Neal reported that the Fee Corrunittee had met wit.h State and Regional staff to try to work out some of the existing problems wit.h the Fr:e System that was adopted by the Board a year ago. The main problem was with w'110unt: of fees to charge. The Fee Committee recommends that the Board approve using Medi- caid rates whjch have been set for Health Departments and Medical Doctors. 2) ttut we request a cashier position to do the eligibility screening and collection, and 3) that Mr. P~rker develop a policy for unpaid balances. During the discussion questions were raised as to 1) whether enough reve~ue would be generated to cover cost of additional personnel 2) publi.c should he educated before fees are implement- ed in order that we not create ill will 3) by using the fee scale indigents!t,'0uld still receive free service and people who can pay will pay for services. Dr. Neal m0ved that 1) the Health Department charge fees which would be the Medicaid rates for Local Health Departments and Physicians 2) that procedures which do not follow these specific codes be charged a flat fee 3) that a sliding fee scale be used except for Environmental Health and Animal Control fees 4) thJt we request one cashier position and 5) that the Health Director formulate a policy for collection of unpaid balances. Mrs. Credle seconded the motion. Motion carried with a five to one vote. The Board requested that Mr. Parker pull the whole fee package together and give the Board of Health copies for discussion at the December meeting before it is sent to the County Co~aissioners for approval. ~ q;9f)3 ....,\".1 -2- Storm Water Management Committee: Mr. Durham wrote a letter to the County Commis- sioners advising them that the Board of Health had endorsed the report of the Storm Water Management committee, outlining a few changes the Board had made in the origi- nal report. These changes are in the October minutes. Mr. Durham reported that he had not had a reply but would call the Chairman of the Commissioners to find out what they have done. ~ - Home Health Care Report to County Commissioners: Mr. Durham and Mr. Parker had attended a County Commissioners meeting and presented the Home Health Policy which had been adopted by the Board of Health. They felt that our Home Health Care Pro- gram has the total support of the Commissioners. The Commissioners have asked that a progress report be given them in one year. Animal Control Advisory Committee Membership Policy: After discussion of the Animal Control Advisory Committee Membership Policy it was concluded that the policy should remain the same, but the number of members should be increased, to include members of several State chartered animal and welfare organizations that are not represented. The following names were submitted: Betty Rullman, Cat Breeders; Bill Huffine, Field Trail and Hunters and Joe Filion, Azalea Dog Training Club. Dr. Neal moved the above names be approved as members of the Animal Contrel Advisory Committee. Mr. Whaley seconded the ~otion and it carried unanimously. Norninating Committee AppoinG~ents: Mr. Durham ?ppointed Mr. Blake, Dr. Eakins and Mrs. Credle to a corrmittee to recommend officers for the Board of Health for the year 1984. Policy on New positions: Mr. Parker asked the Board if they wished to approve new ... position requests before they are submitted to the County Commissioners. After some discussion, Dr. Eakins moved that the Board approve all new positions before they ... are submitted to the County COITWtissioners. Mr. strickland seconded t:he rr.otion and it carried unanimously. Mr. Parker then asked the Board for approval of the following positions: 1. LPN, Part time for Tuberculosis Program, Eakins muved the position be approved. carried unanimously. to be paid for by State funds. Dr. Mr. ~fualey seconded the motion and it 2. Two Home Health Aides, to be paid for by the Adult Health Services Branch. One will begin January 1, 1984 and the other April 1, 1984. Dr. Eakins moved these positions be approved. Mrs. Credle seconded the motion and it carried unanimously. 3. FNP position, half-time, to be paid for with half cf the salary formerly paid to Betsy Summey who recently went half-time. Mr. Whaley moved this position be approved. Dr. Neal seconded the motion and it carried unanimously. Committee Appointment - Fee Committee: vices Analyst with the County Manager's Mr. Durham appointed Cam McAbee, Human Ser- Office to the Fee Committee. New Fee Scale for Family Plcnning: Mr. Parker presented a new Family Planning Fee Scale from the Family Planning Branch, dated October 1, 1983. Hr. strickland moved ___ the Scale be adopted. Mrs. Credle seconded the motion and it carried unanimously. - D096~ Billing Policy - Home Health Care: Mr. Parker told the Board that they must adopt a billing policy for Home Health in order for the Health Department to receive funds from the state for Home Health Care. The suggested policy is as follows: 1) Each patient shall be billed three times, on a monthly basis 2) A waiting period of 30 --- days after the final billing shall be observed, then the bill is to be submitted to the State Grant, if applicable, or written off as a bad debt 3) for ongoing accounts: A portion of bill that has been billed three times and a waiting period of 30 days has been observed, shall be submitted to State Grant if applicable, or written off as a bad debt. Dr. Eakins moved the policy be adopted. Mr. Whaley seconded the motion and it carried unanimously. Staffing of Environmental Health Division - State Recommendations: Copies of a study of Environmental staffing needs had been done by State Environlnental Staff and was sent to the Board for study. After discussion of the study, Mr. Durham appointed a committee to look at these recommendations and make a study of their own, then bring their recommendations b~ck to the Board. The committee is as follows: Mike &~odes, Mr. Grathwol, Mr. Strickland, and Mrs. Credle. Mr. Durham asked Mike Rhodes to serve as temporary chairman and call the first meeting. Animdl Control Director: r~J::.. Parker report.ed that he had comple ted in terviews fo.!" the Animal Control DirectG~ and would have ~ new director aboard i~ approximately one month. Social Work Cont~ac~~it0 !~ew Hanover Mc~orial Hospital: Mr. Parker reported that we are in the process 0 F cent):: acting wi th Nt'N Hanover Memorial Hospital for Social Work Services for: our H~)n~e Heal tiJ. progra:r, ......... Board of Health M~IrJJership~ i<'1r. Parker 1~e[>'2.rt.ed that the new legi sla'ticn r8~arding BOclrd of Health members .;:e'""IlJi:r~3 that the ~\errbership of the B~ard includ(~ "::1 CF,tomi- t.~if,-i:, 2. Vet'2'rinarian, a NUY.3S, and -th:lt the public spirited citizens be cu-t: f!:"o!i1 fi~Je to four. Tot.al rl'.L."'t1ber of ~r.ember:'3 wi.ll he eleven. Sub Division ReVlf?\'JS: Michael Rhodes repo!:'ted that he had been advised hy the PianflinqD~~par-tm~-;)t--and C;)unty :'1anager I s Office tha.t it is no longer necess;:rry for the Bealth DE:partr.:e!lt tc eVdlu::::ice land that is classl.fied as. 2 mine!' :3ub-divisLon unt.il the person is ready tQ build cn the F7operty. He also reported T:.hat tl'?e \'.'1.11 be doing a more detailed study on rna~io.c silL-djvisions. Mr. Rhodes also reported that ?lanning had devcl.oped a Drainage Program for new su:b-divisions t;-l.~:t. is very good. The plan must: be reviewed by various agencies before i.t is a part of thE 81ill-division ordinance. There being no further b~si~ess, Dr. Eakins moved th2 meetlng be adjourned. Mr. t{haley seconded the ~oticn ~nd the meeting was acjo~rned at 10:20 A. ~. Respectfully submittedt ,~~::~~ ~~~p~ Secretary to the Board ........-- Approved: ,J:~_ . '7 , / 'i S'3