Harnett County Board of Health Minutes of Regular Meeting January 16, 2020  The Harnett County Board of Health met in regular session on Thursday, January 16, 2020 in the Health Department Board Room, Harnett County Governmental Complex, Members present: Dr. Laura Smith, Chairwoman, Ms. Amy Allen, RN, Vice- Chairwoman, Ms. Emily Barefoot, Ms. Gayle Adams, Dr. Catherine Evans, Nicholas Pennings, Ms. Linda Sturdivant, and Mr. John Rouse, Jr., Health Director. Others present: Debra Harris-Hawkins, Donna Surles, Oliver Tolksdorf, Gail Hobbs,  307 W. Cornelius Harnett Blvd., Lillington, North Carolina.  Mary Jane Sauls, David Tillman, PhD and Natasha Johnson.  Chairwoman Smith called meeting to order at 7:00 p.m.  Announcements - Mr. John Rouse reported applications for new board members have been submitted to the County Commissioners. The positions of a Pharmacist, Engineer and Veterinarian will be filled soon. Mr. Rouse announced that David Tillman, PhD, from Campbell University will be attending tonight's meeting and Consent Agenda - Minutes = Motion made by Ms. Emily Barefoot, for the November 21, 2019 minutes to be approved as presented and seconded by Dr. Consider additions and deletions to the published agenda - None made. 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. Community Health Assessment - David Tillman, PhD presented a PowerPoint presentation Community Health Assessment which is a health assessment that identifies key health needs and issues through systematic, comprehensive data collection and analysis. This document was produced through the collaboration between the Department of Public Health at Campbell University, the Healthy Harnett Partnership, Harnett Health, and Health Department. The Health Department uses the Community Health Assessment to identify priority health issues and to plan interventions to build healthier communities. The data collected was compared with  presenting the Community Health Assessment.  Catherine Evans. Motion Carried.  Seeing no one, Chairwoman Smith closed the informal comments.  other peer counties and state rates in North Carolina.    Page 2 Board of Health January 16, 2020  Harnett County Health Department Board Room  Debt Setoff - Gail Hobbs reported we have received an additional $80.80 since the last Board of Health meeting in November. The total amount of Debt Setoff money  received for 2019 is $9,282.36.  Health Director's Report and Program Reports - Mr. John Rouse  Medicaid Transformation - Mr. Rouse announced that the General Assembly met on January 14, 2020 and Medicaid Transformation is still suspended at this time. The General Assembly will meet again in May 2020 on the issue. Vendor meetings with providers will continue as scheduled and a call center is available for information. The Health Department has met with AmeriHealth Caritas of North Carolina, Inc., WellCare and also on the Managed Care  Program.  Senate Bill 199 - Mr. Rouse explained that Senate Bill 199 which is Mandatory Reporting to Law Enforcement about Juvenile Victims of Crime; any person 18 years of age or older who knows or should have reasonably known that a juvenile has been or is the victim of a violent offense, sexual offense, or misdemeanor child abuse shall immediately report the case of that to local law enforcement in the county where the juvenile resides or is found. The Health Department is governed under Health Insurance Portability and Accountability Act (HIPAA) and prior to December 1, 2019 the reporting was done with the Department of Social Services (DSS). Starting December 1, 2019 the Health Department will contact law enforcement and can still continue to contact DSS as well. The Bill also states some exemptions however it does not include Nurses, Physician Assistants (PA), Nurse Practitioners, Dentist etc. The Bill does not handle the issue with privacy such as HIPAA and medical records. Tobacco 21 - Mr. Rouse reported the spending bill signed on December 20, 2019 by the President which included the Federal Tobacco 21 Bill; the federal law to raise the sales age for all nicotine and tobacco products to 21. The Food and Drug Administration (FDA) will have 180 days to write the rules and  There will be more information to come on the regulation.  regulations.  Financial Report - Mr. Rouse provided a handout of the second quarter's finance report July 2019 through December 2019. Finance is starting to review the six-month budget with supervisors, and they are currently working on the 2020-2021 budget. The expenditures by program, we try to stay around 50%, which staff has kept the amount below the 50%. The revenues for federal and state contract money is coming in as expected. Aging program revenues are typically a month behind, which is still on target and March report will show    Page 3 Board of Health January 16, 2020  Harnett County Health Department Board Room  updated numbers. Medicaid cost settlement was $600k roughly for this year, however Medicaid will withhold 10%. The Health Department has received several 10% withheld amounts for previous years in this fiscal year, however we have several years of the 10% withheld amounts left to receive. Mr. Rouse reported the Employee Clinic saved the county $52,719.00 in the first quarter and $65,228.00 in the second quarter for a total of$117,947.00. Employee Clinic continues to be a busy clinic especially during flu season. Accreditation = Mr. Rouse stated Dr. Laura Smith, Chairwoman signed a letter for Accreditation that the Board did not have any adjudications for 2018-2019. The Board of Health has done an evaluation and feels no new or amended rules or ordinances are needed since 2018, and will continue to monitor. Legal Counsel - Mr. Rouse informed the Board that the county has hired a new attorney and that the Board of Health has access to legal counsel. Harnett County Staff Attorney, Christopher Appel is accessible to the Board and Health Department for any legal issues, and is readily available to our department on an as needed basis. Mr. Appel recently participated in a webinar at the Health  Department regarding the recent Senate Bill 199.  Clinical Report - Donna Surles  Child Health and Employee Clinic visits have increased during December. The clinic has seen a lot of upper respiratory illnesses and flu. This flu season we have been seeing more type B. The flu season extends well into the spring. We have four Child Health ERRNS (Enhanced Role Registered Nurses) who have completed their continuing education hours to meet the re- rostering requirements. The State Consultants will be conducting the three year Child Health program review on January 24, 2020. During that review they will observe each ERRN perform a Well Child Physical to demonstrate competency and to complete the re-rostering requirements. Flu Reports received this week from the State Communicable Disease branch shows a decrease in flu cases in North Carolina. According to the report received, the most prevalent has been Type B. There have been 33 reported flu related deaths across the state with 11 of those being in the past    Page 4 Board of Health January 16, 2020  Harnett County Health Department Board Room  week. The Health Department continues to give the flu vaccine and encourage  our patients to get it.  Adult Health, Family Planning and Maternal Health providers are serving as clinical preceptors in the Health Department's clinics for Physician Assistant (PA) and Nurse Practitioners (NP) students from Campbell University, Duke, East Carolina and other colleges. We receive positive feedback from the students and the schools. Family Planning clinic continues to offer long acting contraceptives Mirena and Nexplanon and possibly offering other types of Intrauterine Contraceptive Devices (IUDs) in the future. The Sexually Transmitted Disease (STD) clinic has two STD ERRNS who have completed the re-rostering requirements. The Women's Health State Consultant is scheduled to come in February 2020 for a pre-audit visit with the three-year program review coming up in April 2020. The Health Department has used the Family Planning Title X funds to put up billboards across the county which will be up soon. The billboards are similar to the ones the Board of Health members viewed at the November 21, 2019 meeting, and will promote our Family Planning Clinic services. Health Information Exchange (HIE) has five pilot counties to test the HIE Minor Opt Out process and Harnett County Health Department is one oft the counties participating. Minors who receive confidential services can now choose to opt out of sharing visit data through HIE by signing the Opt Out form at the time of the visit. The "go live" date is scheduled for February 4, Lab now has two outside lab companies the Health Department uses for testing. The submissions to Mako Lab began around the beginning of January and they have been successful. For labs that are not processed in Communicable Disease (CD) Two Harnett County Schools recently had a Pertussis outbreak. The information was on the news, in the newspaper and on social media. The Health Department investigated 20 cases with only four being confirmed cases. All confirmed cases were treated as well as their contacts, and all confirmed cases were vaccinated. The Centers for Disease Control (CDC) and the Advisory Committee on Immunization Practices (ACIP)  2020.  house we use LabCorp and Mako Lab.    Page 5 Board of Health January 16, 2020  Harnett County Health Department Board Room  are in the process of approving Tdap vaccine to be given every 10 years rather than just a Td booster given. The Harnett County Health Department's Epidemiology (Epi) Team met to discuss the Pertussis outbreak and team members were. kept informed of updates through frequent emails. Donna presented a PowerPoint presentation about Pertussis to the Board. Preparedness that includes the Health Director, Director of Nursing and the Preparedness Coordinator met with OnTarget Preparedness to begin planning for a full-scale exercise in the fall of 2020. The Health Department is looking at doing a drive thru flu clinic as an event for this exercise and in March 2020, hold a table top exercise in collaboration with Fort Bragg, in Harnett County. This event is in the planning stages and will likely be a respiratory event. In December 2019, Donna Surles, Nursing Director, and Patricia Davis, Adult Health Supervisor attended a workshop on KI Potassium Iodide Distribution Planning. The Health Department will receive a new shipment of KI in March/April 2020, and will conduct a distribution event in April 2020 for citizens who reside in the 10-mile emergency planning zone. Environmental Health Oliver Tolksdorf discussed Food & Lodging staff have started the rotation of establishments this quarter. This is done periodically to avoid the same staff from doing the same establishment each time and to prevent any presumed favoritism. Food & Lodging will be setting up a schedule with the State for individual pertormance reviews. On-site Waste Water is continuing to work on new permits and they have an increase of repairs this Aging & Case Management Mary Jane Sauls reported Medicare open enrollment was held from October 15, 2019 through December 7, 2019. During open enrollment, there were three Medicare Counselors at the Harnett County Division on Aging providing Medicare counseling. The counselors saw 607 beneficiaries and a combined savings of $333,805.60. Several Saturday and evening clinics were held to assist people who were working. Clinics were held in the Western Harnett area and in Dunn at Harnett Health. Two nontraditional clinics were held this year at the Dunn Kidney Center and at' Total Body Therapy and Wellness in Lillington, to meet the needs of people with chronic health issues. Locally trained and Internal Revenue Service (IRS) certified volunteers will provide free individual and state income tax preparation and electronic filing from January 28, 2020 through April 14, 2020. Tax preparation will be available at the Coats Senior Center on Tuesday mornings and at the  time of the year.    Page 6 Board of Health January 16, 2020  Harnett County Health Department Board Room  Erwin Library on Thursday mornings. Starting February 1, 2020 through April 1, 2020, assistance will be offered every Wednesday from 9:30am to 3:00pm on a first come first serve basis at the Public Library in Lillington. Tax help will be provided by volunteers from Campbell University School of Business working Marketing/Communty Outreach Debra Harris-Hawkins announced Women Infant and Children (WIC) Anderson Creek location has a site change effective January 1, 2020. The WIC clinic will be relocating to the Anderson Creek Fire Station starting February 2020. Currently we are providing services for those families in Lillington. Families impacted by the change have been notified. The month of February is recognized as heart month. The Health Department along with community partner Harnett Health System, will be working to raise awareness about heart disease. The "Go Red Lunch and Learn" will be held on Friday, February 21, 2020, from 12:00-1:00pm. This is a free community health and education event and is open to the public. Go Red (Go Red for Women) Sunday is designed to increase awareness that heart disease is the number one killer for women, causing one in three deaths each year. Churches and other faith based organizations are encouraged to conduct heart health awareness activities. The Health Department provides participating churches with a "Have Faith in Heart" toolkit from the American Heart Association, along with heart health packets to distribute to the women in their churches. An average of ten churches participate each year in this community outreach campaign. The vaping and E-cigarettes information session that was scheduled for Tuesday, January 7, 2020 at 5:30pm has been postponed. More information to come on a rescheduled date and time. The PreventT2 (the prevention of type 2 diabetes), is part of the National Diabetes Prevention Program, led by the Centers for Disease Control and Prevention. Our class began on November 14, 2019, there were nine participants, to date participants have lost a combined weight loss of 41 pounds. Classes are held on site at the Health Department each week from 5:30-6:30pm. The Holiday Challenge began on November 25,2019 and concluded on January 6, 2020, this year 88% of the participants maintained or lost weight. The Holiday Challenge was provided by the Harnett County Health Department and Harnett County Employee Wellness.  with the IRS's Volunteer Income Tax. Assistance program.    Page 7 Board of Health January 16, 2020  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, 9wl John Rouse, Jr. Health Director  Dr. Lauras Smith, Chairwoman  PR6