SCOTANDONTY HEALTH DEPARTMENT Amanda Deaver, MPA Health! Director  Scofland mCoumy.Nc,  AGENDA PACKET  FOR  FEBRUARY 21, 2023  REGULAR MEETING OF THE  SCOTLAND COUNTY BOARD OF HEALTH    SCOTLANDOOUNTY AHEALTH DEPARTMENT Amanda Deaver, MPA Health Director  Scofland FOTUREFOCUSED County-NC  MEMORANDUM  February 21, 2023  TO: FROM: CC: SUBJECT:  Board of Health Members  Sharon Alford-Leach, Clerk to the Board of Health Amanda Deaver, MPA, Health Director AD February 21, 2023 Board of Health Meeting  The next Board of Health meeting is scheduled for Tuesday, February 21, 2023 at 6:00 pm in the Scotland County Health Department Education Room. If you are unable to attend please contact  Sharon Alford-Leach at 910-277-2440. You may also send an email to  salford@scotlandcounty.org.  Sincerely, Sharon Alford-Leach    SCOILANDOOUNTY HEALTH DEPARIMENT Amanda Deaver, MPA Health Director  Scofland FUTUREFOCUSID County-NC  Scotland County Health Department 1405 West Boulevard . Post Office Box 69 Laurinburg N.C. 28353-0069 Phone (910): 277-2440-Faxi (910): 277-2450  Agenda  Item  Presenter  Call to Order Invocation Discussion of the Agenda Approval of the Agenda Regular Session Minutes three-minute time limit) Administrative Reports 1. Fiscal Update 2. Monthly Activity Summary 3. Department Reports Unfinished Business New Business  Nicole Monroe, RN, BSN, Chairman Commissioner Gibson, Vice Chairman  Approval of the October 18, 2022 & December 13, 2022 Public Forum (please state name and address and observe the  Tim Martin, Finance Supervisor Amanda Deaver, Health Director Various Departments  1. Performance Evaluation Policy Local Health Director 2. Tobacco Free Policy a. Guest Speaker  Sharon Alford-Leach, Human Resources Amanda Deaver & Sanquis Graham Sanquis Graham Amanda Deaver Tim Martin  a. New Performance Evaluation Process fori the  3. Conflict of Interest Policy & Policy Acknowledgement Amanda Deaver & Sharon Alford-Leach  4. "Test and Go" COVID-19 Test' Vending Machine 5. New Family Planning Funding $1049  Informal Discussion Adjourn    SSOTANDOOUNTY AHEALTH DEPARIMENT Amanda Deaver, MPA Health! Director  SCOTLAND COUNTY HEALTH DEPARTMENT 1405 West Boulevard. Post Office Box 69 Laurinburg, North Carolina 28353-0069 Phone (910)2 277-2440 Fax (910)277-2450 BOARD OF HEALTH MEETING MINUTES Tuesday, October 18, 2022 6:30P.M.  Cs t  The Scotland County Board of Health met on Tuesday, October 18, 2022i int the Education Room. Thef following board members were in attendance: Diann Beane, Dr.. J. Earl Bowling, Charles Todd, Dr. Ralph Carter, Dave Raley and Nicole Monroe. Absent from the meeting: William Matthews, M.M. Labib, Commissioner Gibson and Beth Hobbs. Staff present: Amanda Deaver, Sharon Alford, Dawntashia Harris, Dr. Jonathan Rowson, Thomas McAllister, Janna Blue, Tim Martin, Donna Page, Kathie Cox, Deborah Rogers and  Valentina Oxendine. Call Meeting to Order Discussion There was no discussion about the agenda. Adoption of Agenda  Dr. Ralph Carter, Chair, called the meeting to order at 6:30 pm. Invocation was led by Diann Beane.  Board members reviewed the agenda and there were no changes noted. The Board Chair moved to adopt the agenda as presented. The Board Chair motioned to approve the August 16, 2022 regular session minutes. Dave Raley moved to approve the minutes. All  Nicole Monroe seconded the motion. There was not further discussion. All were int favor; motion was carried.  Approval of the August 16,2 2022 Regular Session Minutes werei inf favor; motion was carried. There was noi further discussion.  Public Comment There was no public comment. Administrative Reports  A. Financial Reports as of September 30, 2022 1. Expense Report  Tim Martin presented the Expense Report as of September 30, 2022. Tim Martin stated that we: should be at: 25% used, but currently only 18.8% was used. He noted that the Administration total and the percentage spent were incorrect after verifying it with the County office. He further stated that all other programs were under budget with Tim presented the Revenue Collections Report. Tim Martin stated that we are currently 6% collected. Tim stated that State systems were down since last Wednesday: so he was unable to provide certain financial reports.  the exception of Immunizations. 2. Revenue Collections Report  Monthly Activities Summary members. Department Updates  The Monthly Activities Summary for August and September was presented before the board. There were no questions from board The Health Director presented the Administrative Report (refert tot the PowerPoint slides for the Health Director's report). Thel Health Director stated that she met with Dr. Legrande to discuss coordination and hiring a School Health Liaison representative using available COVID funding. She also mentioned that her and Dr. Legrande talked about the health department providing sports physicals for athletes. Diann Beann mentioned that Scotland Occupational health pulls providers during late April or early May. She also mentioned that she met with Robert Sampson and April Snead to update the County's Emergency Operation Plan. She also mentioned the Dress Code Policy, Confidentiality Policy, Workplace Visitation Policy, and the New Hire Orientation process were updated. She also mentioned the 1980 Seafood Ordinance was updated ands sent tot the County Attorney for review. She went ont to    Page 2 of3 October 18, 2022 Board of Health Minutes  say the Strategic Plan, Purchase Requisition and Travel Request form and procedure for overnight travel were also updated. She mentioned several renovations at the health department. Next, she presented COVID updates and mentioned that the data trend was trending downward for the month of September. She also mentioned the community risk level was low. Shen went on to say there were thirty positive cases and the positivity rate was 7.2%. Sher mentioned there were three new hospitalizations fort the week ending 10/6/2022. She mentioned there were no deaths and 64.9% of the Scotland County residents received one dose of the vaccine and! 50.2% were fully vaccinated. Shet thens stated that approximately 5000 COVID test kits were handed out. Dr. Carterasked about the positivity rate due to COVID testing at the health department. Amanda responded that the positivity rate is based on health department or provider datas submitted tot the state. Next, she stated there was one Monkeypox case in Scotland County. She further stated that Fiscal Management and Clinical staff received additional Superbill training. Next, she stated that the Health Department would be closed October 31 for Staff Development Day. She then stated that Janna Blue provided information to first year students at St. Andrews University regarding services offered at the Health Department. Next, she mentioned a Lead Child Health Nurse, two Processing Assistant IV and ar new Administrative Assistant. Dr. Carter asked about the position classification levels and how they were arranged. Amanda responded the higher the number the more qualified. She also mentioned the goals for next quarter whichi include: fillings staff vacancies, continuing to move items intor new storage: space, establishing the new billing procedure and installing new security cameras. Diann Beann asked would clearing out storage space create more: space in the building. Amanda Kathie Cox mentioned that Scotland County has an Opioid Prevention and Education Network stemming from settlement funding. Next, she talked about the Opioid Community Forum that will discuss the opioid numbers and thei impact that opioids has had with Scotland County families. Diann Beann asked who was supplying the Narcan. Kathie responded to EastPoint, Stevens Outreach Ministries and EMS. Dr. Carter asked, "willl local Opioid issues be discussed at the Opioid Community Forum"? Kathie responded, "yes in addition to the State level". Diann Beann asked ift they had data on what the identifying overdose agent in Scotland County was.  responded, "yes it has".  Kathie responded that Robert Sampson mayl know thati information.  Unfinished Business There was no unfinished business. New Business 1. Seafood Ordinance  Valentina Oxendine was present to discuss the Seafood Ordinance. Valentina stated thatt the! Seafood Ordinance was al local ordinance. Other than the addition of definitions, Valentina mentioned there were no significant changes made tot the updated version oft the Seafood Ordinance. She mentioned that the walls and ceilings andt the way the seafoodi is stored plays ani important role with seafood markets. Diann Beann asked how longa a fish market would bei inspected. Valentina Diann Beann moved to adopt the updated version of the Seafood Ordinance: as written. All were int favor; motion was  responded that a fish marketi isi inspected every six months. carried. There was no further discussion. 2. FY2022-2024: Strategic Plan  Jannal Blue presented the FY: 2022-2024: Strategic Plan.. Janna stated that thel health department has presented five goals to helpi improve services offered toi the public, meet the needs of the community and growt the organizational structure. Next, Janna went over each goal outlined in the Strategic Plan andp provided a brief summary of each. Dr. Carter askedf for clarification ofa' "threat" item notedi in the SWOT analysis of the Strategic Plan.. Janna Blue responded that this wasa compilation of some observations that the Senior Management Team put together. Dr. Carter went on to aski ift this item was Diann Beann moved to adoptt the 2022-2024: Strategic Plan as written. All were int favor; motion was carried. There wasno  part of the plan.. Janna responded that they were only observations.  further discussion. 3. Requesting approval fori the following: a. Fluarix: Current $19.00; New $20.00    Page 3 of3 October 18, 2022 Board of Health Minutes  Diann Beann moved to approve the new fee fort the Fluarix immunization. All werei ini favor; motion was carried. There Dave Raley moved to approve the Meningococca immunization.. All were int favor; motion was carried. There was no Dave Raley asked, how dot the customers feel aboutt the administration fee? Sharon Alford-Leach responded, as long as customers are properly informed and educated about the processing of the Administration Fee its shouldn'tbe: ap problem. Nicole Monroe moved to approve the re-establishment oft the COVID-19 Vaccine administration fee. Five board members  was noi further discussion. further discussion.  MenngococalMenguadn, CPT Code 90619)$157.00  4. Re-establishment of COVID-19 Vaccine Administration Fee  Amanda also added as long as the customer understands thati iti is no cost tot them.  werei inf favor; One board member opposed.  Informal Discussion  Dr. Carter asked what booster would be used at the vaccine clinic. Amanda responded, "the Bivalent booster would be used". Diann Beann asked how the accreditation process was going. Amanda stated that there were: some things left undone, but her and  Janna Blue were working to complete them and addi themt tot the accreditation dashboard.  Adjourn  Dave Raley moved to adjourn the meeting. All werei int favor; motion carried. Ther meeting was adjourned at 7:20 pm.  Board Chair Signature  Date  Health Director Signature  Date    SCOLADCANTY FEALH DEPARIMENT Amanda Deaver, MPA Health Director  SCOTLAND COUNTY HEALTH DEPARTMENT 1405 West Boulevard. Post Office Box 69 Laurinburg, North Carolina 28353-0069 Phone (910): 277-2440 Fax (910): 277-2450 BOARD OF HEALTH MEETING MINUTES Tuesday, December: 13,2022 6:30P.M.  NCPE  The Scotland County Board of Health met on Tuesday, October 18, 2022 int the Education Room. The following board members were in attendance: Commissioner Darrel Gibson, Betty Ghoulston, Stephanie Littles, Diann Beane, Charles Todd, Dr. Ralph Carter, and Nicole Monroe. Absent from the meeting: Dave Raley, Dr.. J. Earl Bowling, William Matthews, and M.M. Labib. Staff present: Amanda Deaver, Sharon Alford-Leach, Dawntashia Harris, Dr. Jonathan Rowson, Janna Blue, Tim Martin, Donna Page, Kathie Cox, Deborah  Rogers, Paige Mclnnis, and Valentina Oxendine.  Calll Meeting to Order Discussion There was no discussion. Adoption of Agenda Public Comment There was no public comment. Administrative Reports  Dr. Ralph Carter, Chair, called the meeting to order at 6:31 pm. Invocation was ledl by Commissioner Darrel Gibson.  Sharon Alford-Leach asked the Board Chair to amend the agenda to include Nicole Monroe's oath of affirmation. The Board Chair  made ar motion to amend the agenda. All were int favor; motion was carried.  A. Financial Reportsa as of November 30, 2022  1. Expense Report  Tim Martin presented the Expense Report as of November 30, 2022. Tim Martin: stated the current budget for the health department was 4.3 million dollars. He further stated as of November 30, 2022 the health department has only spent 1.3 million. He also stated that we should be at 42% expended, but currently we are at 31.2% under budget. Dr. Carter needed clarification about the COVID-19 response and Advancing Equityi funding. Tim stated only a small portion of the Advancing Equity funding was spent and explained what can be purchased with grant funding. He also stated that the health department would be getting ready to spend the COVID-19 funding by hiring for the positions based on the COVID-19 funding. Commissioner Gibson asked Tim ift the health department was in jeopardy of returning any of the funding if it is not used. Amanda Deaver responded that we were in jeopardy of losing the COVID-19 grant funding for the School Health Llaison position, but the position was filled withal Public Health Educator. Tim also mentioned that $83,000 was being reserved for the Mobile Unit. Tim presented the Revenue Collections Report. Tim Martin stated that we should be at 42% collected, but currently we are at 20%. He did ask the board to notice the figure for HIV. Tim mentioned this was due to a current uptick in HIV cases. Dr. Carter asked if the HIV numbers were only being observed in Scotland County versus statewide.  2. Revenue Collections Report  Donna replied that she would answer that question during her updates.  Monthly Activities Summary members. Department Updates  The Monthly Activities Summary for October and November were presented before the board. There were no questions from board    Page 2 of4 December 13, 2022 Board of Health Minutes  The Health Director presented the Administrative Report (refer toi the PowerPoint slides for the Health Director's report).  Security cameras through Spectrum Enterprise have beent fullyi installed ont thei inside and Health Department logo with operating hours havel beeni installed on entrance doors of the Family Planning Grant for $46,169 that was submitted last month has been awardedi to Scotland County Health Department fort thei fiscal year of July 2023-June! 2024. Staff turnover andy vacancies stille exist. Health Director spoke witht the County Manager about offering sign on bonust that would be paid through the program addendums buti it was denied because the county does not offer sign on bonus to other departments within the county. As slot has been secured with thel NC: Senior program. They are providinga a part time staff person to assist with front registration 20 hoursa week. This position isf funded through the NC Senior program and provides thel Health Department with af free partt time worker. The Employee Recognition committee helda a few events for stafft this month toi improve staff morale. The staff weret treated toa a Thanksgiving meal on November 15"" andt the students from Sandhill's Community College provided free 15 minute massages to staff on November Staff training this month consisted of Management Support and Fiscal Management Conference, NCI Perinatal Conference and Respiratory Protection training.  outside of thel building anda are fully operational.  Health Department.  21.  Received numerous complaints involving Environmental Health (Captain Larry's and Meat Market fore example). The Health Director shadowed the Environmental Health Supervisor on the inspection for Captain Larry's. Captain Larry was approved to open.. The Health Director has put a complaint form online for the public to send any complaints to the Health Director for follow up with the Environmental Health Department. Measures are being put in place to educate the public on the procedures for permitting and a tracking form is being initiated tol keep up with the Av vaccination clinic was held on October 26, 2022. 76 people received Fall Covid Booster and 44 Billing has improved. Billing was behind 61 months when the Health Director started and iti is now current. The "Superbill" within the EMRI has assisted in processing claims more efficiently. Breast Cancer Awareness educational luncheon was held on October 13, 2022 with approximately The Health Director with the assistance of a small group of staff completed and submitted the following grants: RFA A378 Reducing Infant Mortality within Communities, RFA A404 Adolescent Pregnancy Prevention and RFA A403 Family Planning Services. Staff turnover and vacancies still exist within the Health Department. The Health Director participated in 5 interviews this month. Thei following vacancies still exist: WIC Director/Nutritionist II, Accounts Payable, Environmental Health Specialist, Nutritionist 1, Public Health Educator, Public Health Nurse I, Social Worker Il, (2) Processing Assistant IV positions. Staff training completed this month: Bloodborne Pathogens, Superbill reports, and Reproductive  process once an application is being completed.  fluv vaccines were given. 25 participants.  Oral Health. Unfinished Business There was no unfinished business. New Business  1. 2021 Communicable Disease/STD Update  Donna Page, Director of Nursing, presented the 2021 Communicable Disease/STD update. She mentioned that we: are an accredited agency that goes through accreditation every foury years. She referenced accreditation activity number 2.4: as the reason the report was being presented. She also mentioned that due to COVID, accreditation would take place ins six years, but woulds still be accountable for some things that happened in thet two years COVID-19 was being covered. She reported that Chlamydia is always the leading andr most prevalent STD. Next, sher mentioned that Gonorrhea was the second leading STD. She said that the current rates arei for age ranges 151 to 39. She did mention that the age range had broadened from age data given in 2020, which was 15 to 29. She stated that rates for African. American females were! high. This was most likely due to females getting checked regularly than males. Next, she presented STD rates that were compared to the State. Next, Donna presented HIV data and mentioned that Scotland County had begun seeing a risei in HIV cases. She mentioned    Page 3of4 December13,2022 Board of Health Minutes  there were eight HIV cases (three AIDS and 51 HIV) ati the beginning of 2022. She mentioned that the Southeastern part of North Carolina is typically higher. Shei talked about funding that we receive for HIV as a subcontractor andi how we contracted with Robeson County Health Department to receive state funding under Part B. Donna stated that we currently were tapped out of funding and could no longer accept new HIV patients at the health department. She did mention that Robeson County was expected to give more funding in the new budget year. Diann Beann askedi if Donna was hearing this news from other health departments int the area. Donna replied, no and that patients are referred to other closer places. Dr. Carter asked ifp patients are turned away and Donna replied that the health department finds other places for them to go. Dr. Carter then asked what happens ifa new AIDS patient hits the hospital system. Dr. Rowson responded, "we: see them with every possibility that we can, butt the problem they run intoi is unavailable resources". Next, she presented COVID-19 data and statedt there were 2,687 cases in 2020, 1,989 deaths in 2021, 62 deaths in 2020, and 57 deaths in: 2021. Most cases  were between the ages of 30 through 59. 2. Reduction-in-Force Policy  Amanda Deaver presented the draft policy and stated the purpose oft the policy and asked the board if they had any questions. Diann Beann moved to adopt the policy as written. Nicole Monroe seconded the motion. All werei in favor;  motion was carried. There was no further discussion. 3. Orientation and Ongoing Training Policy  Sharon Alford-Leach presented the draft policy and explained the purpose for the policy and the importance fori training of existing and new members. Commissioner Gibson moved to adopt the policy as written. Diann Beann seconded the motion. All were ini favor; motion was carried. Dr. Carter wanted to know the timeframe to complete electronic trainings. Dr. Carter suggested that the board members implement 10t to 15 minute training sessions. There was noi further discussion.  2022- -23 By-Laws and Standard Operating Procedures  Diann Beann motioned" to adopt the updated. 2022-23 By-laws and Standard Operating Procedures as written. Commissioner  Gibson seconded the motion. All were in favor; motion was carried. There was no further discussion.  . 2023 Meeting Schedule and Proposed New Meeting Start Time motion. All were in favor; motion was carried.  Commissioner Gibson moved to adopt the 2023 Meeting Schedule and the 6:00 pm start time. Diann Beann seconded the  5. Discussion of 2023 Chairman and Vice Chairman Nominations & Selection of Nominating Committee  Dr. Carter nominated Diann Beann and Nicole Monroe ast the nominating committee. He also mentioned there would be a called meeting in January 2023 to announce the new Chair and) Vice Chairappointments. Diann Beann asked Dr. Carter ifhe would consider serving as Board Chair for another year. Dr. Carter replied that he would buti it was ar matter of being  reappointed by the County Commissioners.  Informal Discussion  Dr. Carter addressed the current board vacancies. Dr. Carter mentioned that the Dentist and Public Member appointments are vacant. Sharon Alford-Leach stated that Betty Gholston was temporarily serving as a public member in the Dentist appointment. It was also mentioned that William Matthews would be resigning from the Public Member appointment. Dr. Carter stated that he would reach out to Mr. Matthews. Commissioner Gibson stated that he was working with Katherine Cox to recruit for the vacant Dentist appointment. Dr. Carter mentioned that he had spoken with Dr. Labib and had gotten the impression that he wanted to remain as a board member. The board appointment process adopted byt the County Commissioners was discussed.  Adiourn  Dr. Carter requested for ar motion to go into closed session in accordance with General Statute 143-318.11(a) (6) to consider the qualifications, competence, performance, character, fitness, conditions of appointment, or conditions ofi initial employment of an individual public officer or employee or prospective public officer ore employee; or to hear or investigate a complaint, charge,or    Page 4of4 December13,2022 Board of Health Minutes  grievance by or against an individual public officer or employee at 7:32 pm. Commissioner Gibson moved to go into ciosed session.  Diann Beann seconded the motion. All were int favor; motion was carried.  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B E 3 1 B I 5 5 D 8 D  B 5 6 $  10 1n e e 33 3 8 8 D 6 6 D G) A a D - - C o e  5 09 2 W S 2 a 8 - B 3 D a 2 a -  a  ) 0  0 o  E B  / DE la E 8 3 3 m à  9 - N  <  0  -  o  9 a 2 o I a a I  C 3 D 6 a = 2  a 8 o : 2 E  le a  €    5 . o n 8 - 9 lD a 3 o - o 5 S o 5 o - D a 5  S o 5  ) 5 e  e o  3  A 2  3  D 3 Q  a E    Scotland County Board of Health Activity Summary  July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total  Front Desk Check-Ins Switchboard Tracking Calls Child Health Clinic EIC-PAOnly EIC-RNO Only Family Planning Foster Kids Clinic General HMVTests Immunizations Newborn Homevisits Physical Clinic Postpartum Homevisits STD Soreenings TBI Nursing Contacts Clinical Community Outreach Clinical Services Totals Social Work Services Pregnancy Care Management (PCM) Pregnancy Test Counseling Social Work Services Totals Reportable Disease Cases  423 539 434 547 428 321 379 2258 2587 2286 2459 864 1404 1395 0 0 0 0 0 0 0 11 13 18 10 7 11 6 8 10 13 7 5 11 8 34 47 42 31 53 31 48 0 0 0 0 0 0 0 86 163 158 152 163 121 138 83 118 89 106 122 73 115 57 103 198 201 82 113 75 4 2 3 7 6 5 4 asses 0 9 3 8 7 6 4 0 0 0 0 0 0 0 2 3 2 0 1 0 1 0 0 0 0 0 0 0 66 96 69 90 104 55 95 78 72 38 32 7 0 0 1 2 2 7 1 0 1 141 180 195 189 173 127 163 6 6 6 0 2 5 5 0 1 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 52 60 36 49 55 39 53 0 0 1 0 0 0 0 2 3 0 0 1 0 3 1 9 5 4 3 4 2 409 391 286 104 77 303 326 0 0 1 0 1 0 1 568 1133 996 1157 260 844 1220 1538/1497 1510 1495 1442 1417 1437 0 1 2 0 0 0 0 11 25 67 84 74 78 85  3071 13253 0 76 62 286 0 981 706 829 31 37 0 9 0 575 227 14 1168 817 30 2 2 0 344 1 9 28 1896 3 7813 10336 3 424  Clinical Services  430 638 635 651 558 426 495 0 0 0 0 0 3833 July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total  Care Coordination For Children (CC4C) 114 125 115 107 126 109 121  261 311 316 296 301 241 289 0 0 0 0 0 2015 July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total  TB HIV AIDS STD's Vaccine Preventable Diseases Foodborne Diseases Bloodborne Pathogens Diseases COVID-19 Cases Other  Reportable Disease Cases Totals 465 464 330 157 137 347 385 0 0 0 0 0 2285  abora VTotais WIC Services  July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total  WIC Caseloadlouchers) Outreach WIC (Breastfeeding Program) WIC Services Totals  1549 1523 1579 1579 1516 1495 1522 0 0 - 0 0 0 10763 July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total  Vital Statistics    Births In County Births- - Outo of County Residents In County Deaths Fetal Deaths  68 78 82 75 65 68 76 49 45 57 45 48 48 55 34 40 44 43 46 57 47 0 1 0 0 0 0 1 243 483 512 2,784 368 100 210 9 25 17 17 14 12 15 0 0 0 0 0 0 0 15 18 11 12 24 10 24 8 - 10 10 8 2 9 13 19 12 6 9 3 7 7 12 10 4 6 0 6 5 10 9 10 13 1 1 1 3 1 3 5 1 14 2 4 5 2 2 0 4 12 0 - 1 13 11 5 0 0 15 16 36 25 24 16 43 8 8 8 11 4 5 6 4 1 15 7 6 1 0 0 0 1 0 0 1 0 3 1 1 2 7 2 5 11 3 1 3 0 4 3 11 3 1 1 4 2 1 7 0 4 1 0 0 0 0 3 3 3 0 6 0 0 2 2 0 5 1 7 0 0 0 1 0 1 1 000 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 1 1 0 3 0 0 0 0 0 1 3 0 0 0 0 0 1 1 0 0 2 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0  512 347 311 2 4700 109 0 114 60 63 43 45 29 29 30 175 50 34 2 21 25 23 12 15 17 3 0 3 2 4 4 3 2 0  Vital Statistics Totals  151 164 183 163 159 173 179 0 0 0 0 0 1172  Health Promotion/ /School Health Liaison July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total  Participants (Combined) Outreach Events (Combined) Health Promotion Totals On-Site Wastewater Applications Received Site Visits Improvement Permits Construction Authorization Operations Permits Existing Systems Renewed Repairs Applications Received Establishments Inspected Establishments Visited New Permits Establishments Closed Applications Received Well Permits Issued Well Site Visits Well Grout Inspections Samples Collected Child Daycare Inspections Child Lead Exposure Meth Lab Inspections Clean Up Applications Received Applications Received Swimming Pool Inspections Applications Received Tatoo Artist Inspection Sewage Food Water  252 508 529 2,801 382 112 225 0 0 0 0 0 4809  A4y  Oet  Joc at Feb Mar ou  Food & Lodging  July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total  Other  July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total  Complaints  July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total    Livestock Other Complaints Received Larvaciding nimal Control Calls Animals Impounded Field Euthanasia Dogs Cats Other Bite Investigations Dangerous Dogs Violations Humane Society Euthanasia Dogs Cats *N/R=N No Report  0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 04 a 122 178 250 175 260 152 140 145 84 82 57 108 22 61 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 2 0 1 1 0 0 0 0 0 0 0 9 17 20 22 10 10 8 19 33 27 30 14 NR NR 42 16 19 61 5 NR NR  0 0 0 0 808 1300 459 0 0 0 7 0 96 123 143  Mosquito Control Ehvrommental Heallals  Julyl Aug Sept! Oct Nov Dec Jan Feb Mar Apr May June Tofal  nail Control Tolals  July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total  July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total    Policy Title  Performance Evaluations (DRAFT)  GFATH  Control Number ADM039 Department Health Administration Approved By  Effective Date 02/21/2023 Program All  Revision Date 01/12/2023 Division All Date  Approved By  Health Director Background and Purpose  Date  Board Chair  Scotland County Health Department (SCHD) enforces the completion of performance evaluations as the best practice that affords both supervisors and employees time to review job performance, share successes, establish goals, discuss professional development, and open lines of communication. Employees typically both want and need feedback on their performance in order to feel successful at  their job. Scope  This policy is applicable to all probationary and permanent employees. This policy does not apply to  temporary employees. Policy and Procedure the following objectives:  Ine establishing this Performance Evaluations Policy, Scotland County Health Department seeks to achieve  Facilitate effective communication between employees and supervisors; and Ensure employees have a clear understanding of the performance expected of them andl how their individual work contributes to achievement of the organizational mission. Performance evaluation results should not be a surprise to the employee as open communication with clear expectations between employees and: supervisors should occur throughout the year. SCHD encourages all supervisors to seeki initial and refresher training on completing evaluations, coaching/mentoring: employees, and improving communication skills. Additionally, supervisors should  avoid thet following rating pitfalls:  The "Halo Effect": Employees that are liked are seen as excellent in every area; if disliked, Overweighting of Recent Occurrences: Thisi includes either favorable or unfavorable one. "Central endency"Supervisor, reluctant to rate an employee either high or low, rates the The Sunflower Effect": All employees are rated high in order to look good to the supervisor's  deficient in every area.  employee average to avoid the need forj justification.  supervisor or manager.  Last Reviewed: 7/15/2021 Revision No. 7  Last Revised: 731/910/9/87/2/7/2/71/2/65/5/5  Performance Evaluations Policy,1    Documentation of Performance  Scotland County Health Department utilizes the cloud-based module, NEOGOV, to develop and administer performance evaluations to all individuals covered by this policy. The Board of Health is responsible for developing and/or administering the probationary and annual performance evaluations  of thel Local Health Director. Evaluation Meeting  The supervisor and employee should select a meeting time and place when a relaxing, uninterrupted, private discussion can take place once the self-rating and rating are completed. Supervisors should use discretion to avoid outlining areas needing improvement in an overly empathic manner and should attempt, when possible, to offer strong or positive examples to provide al balanced review. Additionally, employees should feel comfortable providing the supervisor feedback and/or discussing potential inaccuracies in the performance evaluation. If there are items that are left open for whatever reason, the Supervisor should make every effort to follow-up and close thei item in at timely manner.  Work Improvement Plan  When behavior and/or performance fall below standard, supervisors may implement a specific unacceptable, and what the desired result should be within a clearly established time frame. Work improvement plans should be both objective and measurable. The plan may specify the consequences  forr not meeting stated objectives within the prescribed time frame.  Frequency of Performance Evaluations Probationary Employees  Employees, with the exception of the Local Health Director, serving a probationary period will be subject to a three (3), six (6) and nine (9) month performance evaluation during the probationary period. The supervisor will schedule an evaluation meeting with the employee to provide performance feedback  before each probationary evaluation is completed.  Permanent Employees  After successful completion of the nine (9) month probationary period, the permanent employee will be  evaluated on an annual basis based on position hire date.  Job Descriptions  During each annual evaluation meeting, the supervisor and employee will review the employee's current job description. Once the job description has been reviewed and/or updated, the supervisor will electronically send the job description to the Personnel Officer for final review approval. Once final review approval has been obtained, the Personnel Officer will process the job description for final  approval. Local Health Director  Last Reviewed: 10/09/2018 Last Revised: 07/31/2019 Revision No.7  Performance Evaluations Policy, 2    The Local Health Director will be subject to a six (6) and nine (9) month performance evaluation during the probationary period. After successful completion of the probationary period, the Local Health Ini the case of the Local Health Director, the "supervisor" of the Local Health Director is the entire board. The Chair assumes the responsibility of managing the information flow and input into the performance evaluation. This may include the formation of an ad-hoc committee to assist in the completion of the  Director willl be evaluated on an annual basis based on position hire date.  probationary and annual pertormance evaluations.  The Local Health Director will complete a self-assessment and prepare performance notes relevant to the probationary or annual performance period and email them to all Board The Chair schedules a meeting with the County Manager to obtain input on the Local Health The Chair may or may not solicit additional feedback, including from senior management staff and direct reports at the Health Department through electronic or in-person methods each The Chair presents these findings to the full Board at a closed session oft the Board and a general. discussion of performance is then held. The Board reaches agreement on a recommendation and then the Local Health Director is called into the room and the Chair guides the discussion by The Board is required to keep minutes during the closed session, including any motions made and actions resulting from such motions and transmit them to the Clerk to the Board for the Board members indicate changes they would like to see included in the following performance period work plan and those areas are discussed with thel Local Health Director in the meeting. Following the meeting, the Chair writes the performance period summary, finalizes the paperwork, obtains the Health Director's signature and sends it to the Personnel Officer. The Personnel Officer processes the remaining paperwork. The goal should be to have the robatonaiyperommante and the annual performance evaluation completed within thirty (30) days of the position hire date.  members thirty (30) days prior tot the evaluation due date.  Director's performance fifteen (15) days prior to the evaluation due date.  performance period.  Board members. permanent record.  Thel Local Health Director current job description will alsol be reviewed.  Performance Ratings 1-Unacceptable  The performance ratings for probationary evaluations are as follows:  2-N Needs Improvement  3-Satisfactory  Ifa rating of "Needs Improvement" or "Unacceptable" are chosen there must be sufficient documentation in the comments section to substantiate the performance rating. A performance improvement plan must be developed for an overall performance rating of "Needs Improvement". 4-E Exceeds Standard 3-Area of Strength 2- Meets Standard 1-Area ofl Improvement  The performance ratings for annual evaluations are as follows:  0-B Below Standard Last Reviewed: 10/09/2018 Last Revised: 07/31/2019 Revision No.7  Performance Evaluations Policy, 3    Ifa rating of "Exceeds Standard" or "Below Standard" are chosen there must be sufficient documentation in the comments section to substantiate the performance rating. A performance improvement plan must be developed for an overall performance rating of "Below Standard".  Forms None References  On September 5, 2022 the Board of Commissioners changed the probationary period from twelve (12) months to nine (9) months effective. January 1, 2023. Employees hired before. January1 1, 2023 will remain under a twelve (12) month probationary period and are subject to all probationary evaluations  implemented during this time. Definitions  Performance Evaluation- at formal and productive procedure to measure an employee's work and results based  on theirj jobi responsibilities.  Last Reviewed:: 10/09/2018 Last Revised: 07/31/2019 Revision No.7  Performance Evaluations Policy,4    Policy Title Administrative  Tobacco Free Policy Control Number Department Health Approved By  FEALH  Effective Date April1,2023 Program All  Revision Date Division All  Approved By  Health Director Signature Purpose:  Date Board Chair Signature  Date  The purpose oft this policy is to eliminate/prohibit the use of tobacco products on the premises of Scotland County Health Department. Health Departments must come into compliance with the Tobacco Free Medicaid Requirement by April 1, 2023. Tobacco use is a major cause of preventable disease and death. Scotland County Health Department is committed to providing a safe, clean, and healthy environment for their staff, contractors, clients, and visitors within the community. Scotland County Health Department serves as a model for our community in promoting the good health of its staff and influencing public attitudes about tobacco use. Scotland County Health Department is dedicated to the promotion of tobacco-free living for employees, clients and the community and minimizing exposure to environmental tobacco smoke. In addition, Scotland County Health Department is committed to protecting the health and environment of individuals, children, and employees in Local Government Buildings, Local Government Grounds, Local Government Vehicles, and Local Government Parks by eliminating exposure to secondhand smoke, e-cigarette aerosol, and eliminating the amount of litter caused  by discarded cigarette butts.  Scope: Department Policy:  This policy is applicable to all staff, patients and visitors of the Scotland County Health  1. For purposes of this policy, "tobacco product" includes any product containing tobacco or nicotine that is intended for human consumption, irrespective of whether the nicotine is tobacco-derived or synthetic, including but not limited to: cigarettes, cigars, pipe tobacco, electronic cigarettes, hookah, smoked or vaped tobacco substitutes, chewing tobacco, snuff, snus, dissolvable tobacco products, and heated tobacco products. Tobacco products do not include nicotine replacement products approved by the FDA for treatment of tobacco use and 2. The use of tobacco products is prohibited in and on all the property owned, leased, or controlled by Scotland County Health Department, including the following: a. Buildings b. 3. This policy applies to all persons while in or on Scotland County Health Department property,  dependence.  Vehicles C. Outdoor grounds and walkways d. Parking lots    including staff, contractors, vendors, clients, and visitors.  4. Staff members are prohibited from using tobacco products while at off-site activities conducted by Scotland County Health Department, including during services provided virtually. 5. Staff members are prohibited from accepting tobacco products as donations for client or staff 6. Staff members are prohibited from purchasing tobacco products for or distributing tobacco  use.  products to clients. Procedures: conspicuous places. tobacco-free policy. employee orientation materials.  1. Signs declaring this property "tobacco-free" shall be posted at each entrance and in other 2. Outside groups using Scotland County Health Department property will be informed of the 3. Staff will be informed oft thet tobacco-free policy when it is first enacted and through new 4. Staff will be made aware of the availability of quitting support services provided by the North Carolina Tobacco Use Quitline at -800-QUIT-NOW (1-800-784-8669). Staff will also be made aware of tobacco treatment and pharmacotherapy options available through their health 5. A staff member who encounters other staff members, contractors, vendors, or visitor not adhering to the tobacco-free policy should politely explain the policy and advise his/her 6. A staff member who encounters a client who is not adhering to the tobacco-free policy should 7.A staff member who does not adhere to this policy is subject to disciplinary action as 8. Non-adherent contractors, vendors, visitors, and other individuals may be excluded from the  insurance plan. supervisor.  politely explain the policy. determined by his/her supervisor.  property. References: NCALHD  NC Tobacco Prevention and Control Branch Tobacco Free Medicaid Requirement County Ordinance, Tobacco Free 50ft Perimeter Accreditation Benchmarks 30.9 and 30.10  Community Preventive Services Task Force (CPSTF-) Smoke Free Policies  Definitions: meaning.  The following words, terms and phrases, when used in this policy, shall have the meanings ascribed to them in this section, except where the context clearly indicates a different Smoking means the use or possession of a lighted cigarette, lighted cigar, lighted pipe, or E-cigarette - means any electronic oral device that employs a mechanical heating element, battery, or electronic circuit regardless of shape or size and that can be used to heat a liquid nicotine solution or any other substance, and the use or inhalation of which simulates smoking. The term shall include any such device, whether manufactured, distributed, marketed, or sold as an e-cigarette, e-cigar, e-pipe or under any other product name or descriptor.  Smoker- means a person who is smoking any other lighted tobacco product.    Policy Title  Conflict of Interest Revision Date 2/14/2023 Division All  HEALTH  Control Number BOH005 Department Governance  Effective Date 2/21/2023 Program All  Approved By  Approved By  Health Director Background and Purpose  Date  Board Chair  Date  The work of the Scotland County Board of Health is a public trust. It is essential that board members be independent and impartial in order to maintain the confidence and trust of Scotland County citizens. All board members have a duty to the people of Scotland County to uphold that publici trust, prevent conflicts of interest, avoid appearance of a conflict ofi interest and work at all times to use their position for the public good. Iti isi int the publici interest that Scotland County Board of Health establishes a policy on conflict of interest which sets forth a code of behavior to be followed by all board members. The purpose of this policy is to provide guidance to board members on the maintenance of the public trust and the avoidance of conflicts ofi interest in accordance with G.S.: 143-6.1.  Scope  This policy is being updated due to the repeal of G. S. 143 = 6.1 (July 2005) and covers all Board of Health Members in order to avoid any conflicts of interest that may appear to be improper or be perceived as improper in making decisions regarding disbursement of funding or services being The Scotland County Board of Health board members are to avoid any conflict of interest, even the appearance of a conflict of interest. Board members are obligated to always act in the best interest of the health department. This obligation requires that any board member in the performance of board duties seek only the furtherance of the health department's mission. At all times, board members are prohibited from using their position or board appointment for private profit or benefit. A. In order to avoid conflicts of interest or the appearance of impropriety should instances arise where a conflict may be perceived, any board member who may benefit, directly or indirectly, from the entity's disbursement of funds or services shall abstain from participating in any decisions or deliberations by the entity regarding the disbursement of funds. B. Its shall be recognized that when funds or services are received that they are allocated consistent with the purpose and goals of the Scotland County Board of Health. When such allocations are made, board members must strive to see thati funds or services are expended in such a manner that no board member will benefit directly ori indirectly from the expenditure of Board members will be aware of the process of fund allocation by the management, employees, members of the Scotland County Board of Health or other governing body, instances may arise which may have the appearance of a conflict of interest or appearance of  administered through the Boards jurisdiction.  Policy and Procedure  such funds or services to a greater extent than the general public.  impropriety.    D. Duty to Disclosure Any conflict of interest, potential conflict ofi interest, or the appearance of Board Action When a conflict of interest is relevant to the disbursement of funds or services that require action by the board, the board member must disclose the existence oft the conflict of interest and be given the opportunity to disclose all material facts to the full board. After disclosure of all material facts, and after any discussion with the individual, the board member shall leave the meeting while the determination of a conflict of interest is discussed and voted upon. Remaining board members shall decide if a conflict of interest exists. In addition, the person(s) shall not participate in the final decision regarding the matter under consideration ands shall leave the meeting during the discussion ofa and vote of thet full board. Acknowledgement of the Conflict of Interest Policy All board members will be provided a copy of the Conflict of Interest policya and will ber required to sign and/or update their signature during theiri initial appointment or reappointment to the Scotland County Board of Health. This policy shall be reviewed bi-annually or more often ift the need arises.  aconflict of interest is to ber reported to the Board Chairman immediately.  Forms References G.S.143-6.1 Definitions None  Conflict of Interest PolicyAcknowledgment Form  Last Reviewed: 12/12/22;10/19/21,7/1/19:5/27/14 Last Revised: 2/52/5/15/5/07  Revision No. 4  Conflict of Interest Policy, 2