01/03/1979
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MINUTES OF BOARD OF HEALTH - January 3, 1979
Present: All Members
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Absent: None
Minutes of the December meeting were approved as presented.
Chairman of Board: Dr. James Furr rotated off the Board at the end of December
and was not present at this meeting. Dr. William Eakins presided since he was
past Vice-Chairman. Election of a Chairman was deferred until February since
there is a possibility that Dr. Furr may serve another term on the Board. He
has been asked to serve by the Commissioners and will give his decision within
the next few days.
Report of Committee in Reply to Dr. Eaton's Complaints: The following is a
reply prepared by Dr. Eakins, Dr. Seidel and Mr. Melvin in reply to complaints
made by Dr. Hubert Eaton, Sr. at the December, 1978 Board of Health Meeting:
January 3, 1979
The Board of Health of New Hanover County appreciates any constructive
criticisms. We welcome help from all sources. The following are formal
complaints registered by Dr. Hubert Eaton, Sr. to the Board of Health on
December 6, 1978. The only portion of the complaints to which the Board
of Health can respond is the portion dealing with Health Department Clinics.
Complaint I:
The Health Department's primary care clinics are staffed
by nurse practitioners. The back-up doctor is not present
in the building with the nurse practitioners.
Response:
1st: New Hanover County's Health Department system of off-site
location of a back-up physician for family nurse practi-
tioners in the primary care clinics is in perfect agreement
with Rule I, Section V of the rules and regulations for
registered nurses performing medical acts adopted by the
N. C. Board of Nursing and the Board of Medical Examiners
of the State of N. C. (See attached note). Supervision is
complete and adequate according to this law.
2nd:
The system has the advantage of being located in an area
of need which makes it more convenient for the indigent
of the county to reach.
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3rd: Though we think the present system is effective, we think it
could be even more effective if the back-up doctor was located
closer. We would welcome Dr. Hal Franklin as our back-up
doctor in the Rankin Terrace area since his office is located
within four blocks of this clinic.
4th: We welcome and encourage any advice and help from Black as
well as White physicians.
Complaint II: These nurse practitioners are assumed to be doctors by patients.
Response: The nurses wear a name tag which clearly states who they are.
We will continue to ensure this distinction is made clear.
They do not introduce themselves as doctors.
Complaint III: The medical care and the Health Department primary care clinics
are cut-rate.
Response: The Health Board feels that there must be a source of medical
care for indigent people. The system that we have set up pro-
vides this care. Without these clinics, there would be little
service for the indigent. The service being provided is not
inferior but is good care. It is not designed to take care of
any emergencies or complex illnesses. It is designed to take
care of non-emergency, non-complex illnesses. Patients with an
emergency or serious illness are referred to the proper
facility and physicians.
Furthermore, Dr. Eaton has alleged that poor medical care is
being delivered without one documentation to this Board of
such poor care. If there is any specific evidence of poor
care, this should be brought to the Health Director's atten-
tion so this can be corrected. Also, the family nurse
practitioners are under the supervision and regulations of
the North Carolina Board of Nursing and the Board of Medical
Examiners of the State of North Carolina. It is required
that each FNP be relicensed each year and in order for the
license to be issued the FNP is required to attend a con-
tinuing education course.
Complaint IV:
There is a pediatrician backing up one of the medical clinics.
Response:
Dr. Reynolds backs up only the Pediatric portion of these
primary medical clinics.
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In response to your two requests that the New Hanover County Board of Health
and New Hanover County immediately: 1: Close the two unsupervised clinics
operated by nurse practitioners located in the Black community of Wilmington.
Our response is that we feel strongly that indigent (Black or White) in this
county must have a source of medical care and entry into the medical care system.
We will not close these two medical clinics. We will work to keep them well
supervised and maintain their quality. 2. Make plans in the near future to
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make available to the disadvantaged sick in our community medical care at the
same level as available to others with input from the medical community both
~ - Black and White. Response: At present, we see no way that our county can
finance private medical care to indigents on a completely equal basis with the
non-indigent It may be impractical for the state or the nation to attempt this.
Even if we could finance this, this is still being debated on a national level.
We think that the system that we have through the Health Department is a practical
solution to existing problems even though we are continuously looking for ways to
improve the system.
Sincerely,
THE NEW HANOVER COUNTY BOARD OF HEALTH
CC. Dr. Hubert Eaton, Sr.
Mr. Dan Eller, County Manager
County Commissioners
Letters were read to the Board from the Public Health Nursing Staff and from
some employees of the Department of Social Services endorsing the Family Nurse
Practitioner Clinics. Mr. Melvin also told of talking with patients and members
of the community and their feeling of need for these clinics.
Report from Septic Tank Study Committee: A written report of the findings of the
Septic Tank Study Committee was presented to the Board. (Mr. Reaves, Dr. Furr and
Dr. Seidel make up this committee) Recommendations made by this committee
are as follows:
It is recommended that the Health Department Staff:
1. Have prepared and appropriately distribute a booklet to homeowners on the
simple facts of care and maintenance of septic systems.
2. Maintain an appropriate record of reports on septic tank problems.
It is further recommended that the County be requested through its appropriate staff
to investigate and/or review the following
1. Possibilities of utilizing municipal package plant systems and/or various
alternative on-site disposal systems.
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2. Results of other counties utilizing septic tank maintenance programs.
3. What benefits could be projected for using water-saving devices? What
devices are available? What problems, if any, involved in requirements of
such devices for new and existing dwellings?
4. Ramifications of drainage districts in the County.
Dr. Seidel made a motion that the Department of Health/Board of Health sponsor
a pilot program with the Home Builders Association using water-saving systems
that are available, using flow meters to measure amounts of water being used.
That possibly four (or more) houses be used in the study - an equal number of
houses with and without - for a period of six months with reports to the Board at
that time. Motion was seconded and carried. Motion was made, seconded and carried
that acceptance of the report by this committee be deferred until February to give
the Board time to study the report.
Dr. Seidel mentioned a possible moratorium on building adjacent to shellfish waters
for six months while an extensive study is made to see if anything entering the waters
in injurious to public health. Mr. Fox suggested that we would need evidence that
the public health was being endangered before we could declare a moratorium. He
suggested that possibly a report from the State giving this type of evidence might
be available. Suggestion was made that we request an official reply from the De-
partment of Human Resources concerning lateral flow studies and evidence of very
present dangers to public health in local waters that have been found.
It was suggested that a Number 5 be added to the Septic Tank Committee's recom-
mendations--that we--study lateral flow from septic tanks to see if bacteria, viruses
or noxious chemicals survive until they reach the water--that we gather all information
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available and possibly apply for a grant to do such a study.
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-~Health Cards: Will have report on cost involved in issuing Health Cards in February.
Immunization and Chronic Disease Report: Dr. Finger gave a report on the Immunization
and Chronic Disease Programs now being carried on in the Department.
Revised Certificate of Approval of Water Supply and Sewage Disposal Systems:
The following Certificate of approval to be printed on subdivision plat plans was
recommended by the Board of Health on September 6, 1978, approval was recommended
by the Planning Commission on November 1, 1978. The Commissioners adopted the
Certificate on December 4, 1978:
CERTIFICATE OF APPROVAL OF WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS
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I, hereby, certify that the type of water supply and sewage disposal system
installed or proposed in Subdivision are
approved by this department. The installation of individual, on-site sewage
disposal system proposed for this subdivision mayor may not be approved
subject to lot by lot soil evaluation, subject to New Hanover County Health
Department Sewage Disposal Regulations. The individual, on-site water supply
system proposed for this subdivision must be constructed according to New
Hanover County Health Department private water supply ordinances.
Date:
Signature:
There being no further business the meeting was adjourned.
Respectfully Submitted,
Approved February 7, lq79
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