Harnett County Board of Health Minutes of Regular Meeting May 16, 2024  The Harnett County Board of Health met in regular session on Thursday, May 16, 2024 in the Health Department Board Room, Harnett County Governmental Complex, Members present: Dr. Laura Smith, OD, Chairwoman, Commissioner Barbara McKoy, Dr. Amanda Langdon, DVM, Dr. Kim Fowler, PhD, Dr. Brandon Washington, DDS, Ms. Amy Allen, Ms. Staci Hogan, RPH, Ms. Linda Sturdivant, Dr. Catherine Evans, DDS, Dr. Lori Langdon, M.D. and Ainsley Johnson, Health Director. Other present: Mary Jane Sauls, Oliver Tolksdorf, Melissa McLamb, Debra Harris-  307 W. Cornelius Harnett Blvd., Lillington, North Carolina.  Hawkins, and Natasha Johnson.  Chairwoman Smith called meeting to order at 7:00 p.m.  Announcements - Ms. Johnson announced the guests joining tonight's meeting and thanked them for attending. Monica and Campbell Rouse, wife and daughter of former Harnett County Health Director John Rouse, Barry Blevins, General Services Director and Chance Torain, Transit Services Manager. Ms. Johnson introduced Melissa McLamb, Physician Extender, who is serving as interim Public Health Director of Consent Agenda -1 Minutes Motion made by Dr. Catherine Evans, DDS, for the March 7, 2024 and April 4, 2024 agenda and minutes to be approved and seconded by Commissioner Barbara McKoy. Motion Carried. Consider additions and deletions to the published agenda - None made.  Nursing.  Public Comment - Period of up to 30 minutes for informal comments allowing 3 minutes for each presentation = Chairwoman Smith opened the floor for informal comments by the public, allowing 3 minutes for each presentation up to 30 minutes. John Rouse Memorial Scholarship Fund - Campbell Rouse discussed establishing the scholarship fund with the assistance of the North Carolina Public Health Association (NCPHA) to honor the former Health Director, John Rouse. Mr. Rouse had ahuge impact on Public Health throughout the county and state. The eligibility requirements for the scholarship include attending Campbell University and pursuing a degree in Public Health. Contributions through individual donors, businesses and  Seeing no one, Chairwoman Smith closed the informal comments.  fundraisers has currently raised $15,000.    Page 2 Board of Health May 16, 2024  Harnett County Health Department Board Room  Harnett Area Rural Transit System - Barry Blevins, General Services Director, delivered a PowerPoint presentation on transportation services within Harnett County. He shared data detailing the number of requested rides, declined rides, and rides categorized by funding source. Blevins also addressed the challenges associated with recruiting and retaining drivers, particularly with part-time staff. He highlighted a decrease in ridership among seniors following the COVID-19 pandemic. Blevins mentioned the Division on Aging's utilization of Harnett Area Rural Transit System (HARTS) to facilitate social activities for seniors, such as trips to markets, restaurants, and other events. He expressed gratitude to the board for the opportunity to present State of the County Health Report - Debra Harris-Hawkins presented the "2023 State of the County's Health" report, which is a requirement for Health Department with Accreditation and part of the Consolidated Agreement with the Division of Public Health. A State of the County Health (SOTCH) report is submitted annually between Community Health Assessment (CHA). The 2023 State of the County's Health Report is compiled to provide updates related to the Community Health Assessment and the work surrounding health priorities. The health priorities as identified by county residents include chronic disease prevention and substance abuse/overdose prevention. This report provides a brief overview and update for the selected health priorities, changes in mortality and morbidity data since the CHA, information on Priority 1: Chronic Disease Prevention: Diabetes is the seventh leading cause of death (age-adjusted) in Harnett County. The Health Department continues to implement evidence-based practices to address risk behaviors such as unhealthy eating, lack of physical activity, and tobacco use. Examples include the Health Education Division in partnership with First Health continues to provide the Diabetes Prevention Program. The Prevent Type 2 Diabetes (T2) Lifestyle Change Program is part of the NC Minority Diabetes Prevention Program. Initiatives have included "Step into Fitness" walking challenge, which promotes physical activity. We continue to provide ongoing educational and community outreach programs with a focus on risk reduction for residents. Cancer ranks as the second leading cause of death in Harnett County. COVID-19 did have an impact on the mobile mammograply-screnng program by reducing the number of screening appointments. However, for the past three years 2023-2021 we have screened approximately 521 women through mobile Priority 2: Overdose Prevention. Opioid overdose deaths have been increasing in North Carolina and Harnett County. In 2021, there were 71 overdose related deaths. The number of emergency department visits linked to opioid incidents has doubled since 2016, reaching 280 in 2022. The Harnett County Opioid Task Force is a group of community members, local organizations, health care professionals, law enforcement, educators, and other relevant stakeholders, working together to prevent overdoses and harmful substance abuse. For more information about the Opioid Task Force, it is  his program.  emerging issues, and information on any new initiatives.  mammography program.  posted on the county's website.    Page 3 Board of Health May 16, 2024  Harnett County Health Department Board Room  Emerging Issues: The Department of Health and Human Services announced the expiration for the Public Health Emergency for COVID-19 as May: 2023. In Harnett County, COVID-19 moved from the ninth (9th) leading cause of death to the sixth (6th) leading cause of death. For maternal health, Betsy Johnson Hospital discontinued labor and delivery services in October 2023. The Women, Infants and Children (WIC) program resumed in person appointments in August 2023. Since the 2022, CHA Harnett infant mortality rate slightly decreased from 6.7 per 1,000 live births (2016- New Initiatives: The Health Department's Mobile Health program was initiated in May 2023. Mobile clinics can successfully reduce barriers in access to healthcare; provide more opportunities for underserved populations. In September 2023, the Health Department implemented the Naloxone Distribution Project (NDP) to combat opioid overdose-related deaths. The 2023 State of the County Health Report will be disseminated to key stakeholders and community partners and posted on the Health Clinical Patient Fees, Eligibility and Bad Debt Write Off Policy Revision - Ms. Johnson announced the update to the Clinical Patient Fee Policy is to reflect recommendations in our 24-25 Family Planning Agreement Addendum. The Addendum states if a patient refuses to provide verbal declaration ofi income and income cannot be verified thru access in another program within the agency the patient will be charged 100% of the cost of services and the patient would be informed Motion by Amy Allen, to approve the changes to the clinical fee policy as presented and seconded by Dr. Amanda Langdon, DVM. Motion Carried. Debt Setoff- Ms. Johnson reported that since the last meeting, the Debt Setoff program has collected $2,350.91 and the collection year to date total is $2,820.13. Health Director's Report and Program Reports - Ainsley Johnson  2020) to 6.4 per 1000 live births (2017-2021).  Department's website.  of this.  Narcan - Ms. Johnson presented a Narcan Dose Distribution by zip code map to the board. The map shows the amount of Narcan given to individuals who voluntary provided their zip code during distribution, data provided since September 2023. Ainsley Johnson, Mary Jane Sauls and Debra Harris-Hawkins assist with the Harnett County Opioid Task Force. The county has plans to purchase $20,000 in Narcan, which the Health Department Pharmacy will manage. Commissioner Barbara McKoy, who also serves on the Opioid Task Force, commended the Health Department for their distribution of Narcan in the community, acknowledging its importance in  addressing this critical issue within Harnett County.    Page 4 Board of Health May 16, 2024  Harnett County Health Department Board Room  Policy Updates - Ms. Johnson discussed the Board of Health was presented with the following revised policies: Policy on Policies, Board of Health Delegation of Duties to Health Director and Board of Health Orientation and On-going Training Policy. All policies were adapted and approved by the Board of Health. Board of Health Chairwoman, Dr. Laura Smith, OD, signed all three revised policies. Ms. Johnson presented the board with information of an upcoming virtual meeting for leaders of a governing board. The topic of the meeting is The Role of the Local Board of Health as a Critical Public Health Institution. The training will be held on Tuesday, May 28, 2024, at 7pm, an email with the information has been sent to all board ofhealth members. Financial Reports = Ms. Johnson reviewed the expenditure summary and revenues summary from July 2023 - March 2024. Quarterly revenue report ending March 31, 2024 shows the department is receiving Medicaid and patient fees at or above 75%. Federal and state funds are coming in as expected. The Health Department has only utilized 19% of the county funds budgeted and Aging has utilized 32%. Expenses for the Health Department and Aging are all running mostly at or below 75%.  Clinical Report- Melissa McLamb  Respiratory Update - Since the last board of! health meeting, we had two COVID-19 outbreaks at long-term care facilities in the county. Both outbreaks have been resolved and closed. Harnett County had one flu death for five known Child Health - Primary care sick clinic numbers went down only slightly for April 2024. Employee clinic visits increased slightly. The most common acute illness diagnosis we have seen recently are cough, pharyngitis, and nasal congestion. Well visits in the child health primary care clinic were increased in April 2024. We are planning a three-day well child/kindergarten physical event in August 2024. We will do this at three different elementary schools in the county in partnership with Harnett County school nurses. We will be using our mobile health unit for these events. This will also be a back-to-school vaccine Adult Health - The clinic continues to remain busy. Family planning and sexually transmitted disease numbers remain about the same and prenatal clinic numbers increased in April 2024. We had five syphilis cases in April 2024 and we currently have one new tuberculosis case and continue with an additional case that we have had since January 2024, and the nurses conduct a video daily observation therapy with the patients, and things are going well.  deaths for the 23-24 flu season.  event as well. Both events are in the planning stages.    Page 5 Board of Health May 16, 2024  Harnett County Health Department Board Room  Narcan Distribution Update - We are continuing to distribute to individuals, non-profit organizations, and community partners. We have also offered Narcan training to community organizations with plans to offer more in the near future. Environmental Health - Oliver Tolksdorf reported as of today, 55% of pools have been permitted; this includes seasonal and year around pools in the county. The county has an additional fourteen pools with no actions yet and four pools have applications submitted but have not: requested inspections. Aging & Case Management - Mary Jane Sauls reported the new Elderly Nutrition Program Coordinator began their role on May 6, 2024 after vigorous recruiting efforts. Elderly Nutrition Program site managers underwent training for the Senior Farmer's Market Program on May 9, 2024. This initiative will offer vouchers for fresh fruits and vegetables to seniors starting in June 2024. In April 2024, during National Volunteer Appreciation Month, the Harnett County Volunteer Services Program expressed gratitude to volunteers for their invaluable service. They were treated to Sherry's Bakery Doughnuts and a small gift. Last year, volunteers contributed 17,584 hours of unpaid service, amounting to a total savings of $588,888.16 based on the national average hourly wage for volunteer service. To commemorate Older Americans Month, The Harnett County Division on Aging SHIIP/Medicare Program is organizing a SCAMJAM Event on Thursday, May 23, 2024, from 10am-12pm in the Commons. The event aims to educate the public on Identity Theft, Fraud, and Scams. Various offices including the NC Attorney General, NC Secretary of State, NC Department of Insurance, Harnett County Sheriff Department, and the NC Ombudsman Program will present information on detecting, preventing, and reporting scams. A shred truck will be available on-site from 10am-2pm for shredding papers. There is no limit to the boxes or bags to be shredded. The Health Department intends to apply for the Dr. Ann F. Wolfe mini-grant. This funding opportunity is provided through an endowment from the estate of the late Dr. Ann Wolfe and is managed as a component fund of the North Carolina Community Foundation. The fund's goal is to address infant mortality and enhance child health by offering mini-grants to local health departments to support their initiatives in these areas. The board acknowledged agreement to Marketing/Communty Outreach - Debra Hawkins announced an upcoming community outreach event for Narcan training. The event will be held on Saturday, June 15, 2024, from 12pm-lpm at the Shawtown High School  pursue this opportunity.  Alumni Association Building, Lillington.    Page 6 Board of Health May 16, 2024  Harnett County Health Department Board Room Closed Session - There was no need for closed session.  New Business = Chairwoman Smith opened the floor for New Business. Being none  Chairwoman Smith closed New Business. Chairwoman Smith adjourned the meeting.  Respectfully submitted, Ongagomm Ainsley Johnson Health Director  DrLaura Smith,pp,Chairvoman  pogb