Harnett County Board of Health Minutes of Regular Meeting November 17, 2022  The Harnett County Board of Health met in regular session on Thursday, November 17, 2022 in the Health Department Board Room, Harnett County Governmental Complex, 307 W. Cornelius Harnett Blvd., Lillington, North Carolina. Members present: Dr. Laura Smith, Chairwoman, Ms. Amy Allen, RN, Ms. Linda Sturdivant, Ms. Emily Barefoot, Ms. Barbara McKoy, Dr. Amanda Langdon, DVM, Dr. Kim Fowler, PhD, Dr. Brandon Washington, DDS, Dr. Catherine Evans, DDS and Mr. Other present: Mary Jane Sauls, Oliver Tolksdorf, Debra Harris-Hawkins, Ainsley  John Rouse, Jr., Health Director.  Johnson, Gail Hobbs, and Natasha Johnson.  Chairwoman Smith called meeting to order at 7:00 p.m.  Announcements Chairwoman Smith reported that she and Vice Chairwoman Amy Allen met on November 14, 2022 and performed Mr. Rouse's annual performance evaluation and reviewed his job description. A copy of Mr. Rouse's job description was mailed to the Board members for review, and the Board are not recommending any changes at this time. Mr. Rouse reported Dr. Kim Fowler, PhD, and Dr. Amanda Langdon, DVM, have been reappointed their second term with the Board. Mr. Rouse introduced the new Board of Health member Dr. Brandon Washington, DDS. Dr. Washington was appointed on September 6, 2022, and he will fill the physician vacancy on the Board. Mr. Rouse announced Ms. Gayle Adams is out of town and will Consent Agenda = Minutes Motion made by Dr. Amanda Langdon, DDS, for the September 15, 2022 agenda and minutes to be approved and seconded by Ms. 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. Nomination Committee Report - Chairwoman Smith asked Ms. Emily Barefoot to give the Nomination Report. Ms. Emily Barefoot submitted on behalf of the nominating committee Dr. Laura Smith will serve as Chairwoman and Ms. Amy Allen will serve as Vice-Chairwoman. The nominating committee submitted no other nominations to the board. Chairwoman Smith opened the floor for any other nominations. No other nominations were received. Ms. Emily Barefoot, asked  not be attending tonight's meeting.  Emily Barefoot. Motion Carried.  Seeing no one, Chairwoman Smith closed the informal comments.    Page 2 Board of Health November 17, 2022  Harnett County Health Department Board Room  that nominations be closed and accept the slate of officers as presented, Meeting Schedule for 2023 - Mr. Rouse provided a copy of the Board of Health meeting schedule for 2023, and reminded the Board the March meeting is the first Thursday of the month and all other meetings are scheduled for the third Thursday. Debt Setoff- - Gail Hobbs reported we have received an additional $145.37 since the last Board of Health meeting in September. The total amount of Debt Setoff money Strategic Plan 2023-2026 - The 2017-2020 Strategic Plan was extended, since many of us were involved working with COVID-19 response activities. Many of the 2020 goals were not fully addressed therefore were extended into 2021 and a few were included in the current plan for 2023-2026. The management team discussed the 2023-2026 plan and reviewed factors that impact the delivery of service. The team identified Strengths, Weaknesses, Opportunities and Threats (SWOT). Since the completion of the community health assessment (CHA), the Health Department has created a Strategic plan using the CHA results. The Community Health Survey for Harnett County is a collaboration between Harnett Health, the Harnett County Health Department, the Healthy Harnett Coalition, and the Department of Public Health at Campbell University. The survey for Harnett County residents was conducted in Spring-Summer 2022, this was one of the tools used to gather community input, and approximately 568 individuals participated in this process. Initiative outlined in the strategic plan are tied to the community priorities, identified from the Community Health Assessment surveys and information obtained from community focus groups, along with data relative to health status indicators for the community. The strategic plan includes define goals, set timelines, identify strategies and assign responsibilities. The Health Department will provide an annual updates of this strategic plan while continuing efforts to implement activities to reach goals and objectives. The Board adopted the Strategic Plan 2023-2026 on November 17, 2022. Printed materials were  seconded by Dr. Catherine Evans, DDS. Motion carried.  received for this calendar year is $4,899.13.  provided for the Board.  Health Director's Report and Program Reports - John Rouse, Jr.  COVID-19 Report - Mr. Rouse discussed the decline in COVID-19 testing and positive cases, and the steady increase in influenza testing and positive cases.    Page 3 Board of Health November 17, 2022  Harnett County Health Department Board Room  Harnett County COVID-19 testing sites located in Lillington and Dunn, will continue to provide services through the month of November and will close on November 30, 2022. The distribution of the COVID-19 home testing kits are continuing to do well, and we have received additional shipments. Kits are available to the public every weekday from 8am-llam and 1pm-4pm. The Health Department has seen an increase from the public for test kits due to the holiday seasons approaching. Mr. Rouse discussed having how to videos available to the public on using the different types of COVID-19 test kits we distribute. The Board supported the at home testing kit program and the use of Financial Report - Mr. Rouse provided a handout of the First Quarter finance report July 2022 through September 2022. Mr. Rouse explained the expenditure and revenue summary reviewing the top half of the revenue summaries is our State and Federal money that comes in by programs. All program money collected is coming in as expected. Staff have continued to monitor their expenditures within the departments, and keeping expenditures below the 25% in the first quarter. State and federal contracts for the Health and Aging Departments are coming in as expected. Prenatal and Family Planning revenues have decreased for this quarter, however this is expected due to those clinics will increase and decrease from one quarter to the next during the fiscal year. Adult Health revenues are currently at 12%; however, this will increase because we have billed a large amount of our billable influenza vaccine to insurance companies and payments are starting to come in. Mr. Rouse provided an update to the Board on the status regarding the purchasing of the mobile health unit. Since receiving approval from the Board of Commissioners: in October to proceed with the purchase, the next step included the county's legal and finance departments to post a Request for Proposal (RFP). The unit will have to be received and purchased by May 31, 2023 due to using COVID 546 Communicable Disease Pandemic Recovery funds. Dr. Smith and the Board acknowledged support of the Health Departments on-going efforts to educate the public, elected officials and various boards about community health issues.  online videos to demonstrate.  Clinical Reports = Ainsley Johnson  COVID-19 Cases & Testing - Harnett County is at a low COVID-19 Community Transmission level per Centers for Disease Control (CDC). The overall total reported case count as of November 17, 2022: is 40,813 with 362 reported    Page 4 Board of Health November 17, 2022  Harnett County Health Department Board Room  associated deaths. During the month of October 2022, Harnett County reported 456 new cases. At home tests are not included in the case report due to the vast majority not being reported. Currently Harnett County has two active outbreaks, one in a long-term care facility and one in a public school. COVID-19 Vaccination Update - The Health Department continues to encourage COVID-19 vaccination for all ages. Bivalent COVID-19 boosters are available every day of the week by appointment or on a walk in basis. Bivalent COVID-19 booster uptake has increased in our community. Since September 2022, we have administered 997 Bivalent boosters, and have noticed an increase of walk-in COVID-19 vaccinations during the early voting in the Commons. Bivalent boosters are available for ages five years and older. We currently carry all authorized brands of primary and booster vaccines: Moderna, Pfizer, Novavax, and Janseen. The Health Department staff have participated in outreach events in the last month in our communities to offer Flu Update - Current surveillance in our county and state has shown an early increase in respiratory viruses including influenza, RSV, and rhinovirus. The Health Department has reported over 102 Flu A cases in our child health and employee health clinic. Compared to years prior when 1-4 cases were reported in september-November. So far this season, we have seen more positive cases than our usual peak time of anuary-rebruary in both 2021 and 2022. This early increase is statewide. North Carolina Department of Health and Human Services (NCDHHS) has transitioned to an interactive dashboard to view respiratory surveillance data. The data can be viewed at https://covid19.ncdhhs.gov/dtshboard/respiratory-virus-survellance Statewide influenza cases increased in the last week with the majority of cases being Type A (H3N2). Emergency department visits for influenza like illness also increased throughout the state and are at the highest point since the pandemic began. Young children and older adults over age 65 years old are more likely to be associated with severe illness with this subtype. We have reported one cluster in a public school and one in a long-term care facility this season. We are: monitoring five other potential clusters. Clusters of respiratory illnesses are required to be reported to the Health Department. So far this season, North Carolina has reported 22 influenza associated adult deaths and one pediatric death. An increase in respiratory illness memo was issued by NCDHHS and was sent via blast fax to all medical providers in our county. In addition, we have worked closely with Harnett County school nurses to assist in outbreak management and infection control. In December 2022, Ainsley Johnson, Director of Nursing, will be presenting to the Partnership for Children Board on flu and respiratory syncytial virus (RSV) in our community.  the Bivalent booster.    Page 5 Board of Health November 17, 2022  Harnett County Health Department Board Room  Flu Vaccination - We encourage everyone to receive his or her annual flu vaccine. Flu vaccines are available by appointment or as walk-in visits. Since September 2022, we have administered over 1,754 vaccines. We have provided off-site vaccines to assisted living facilities, schools, local fire/emergency management/law, enforcement, private businesses, and county offices. In addition, we offer daily drive up flu vaccinations in the front parking lot of the Health Department. On October 3, 2022, we held a drive thru event in the back parking lot area that was very successful. We vaccinated 70 individuals at the event. On Target Preparedness and our NC Preparedness and Response Regional Pharmacist, Dawn Goodwin joined us for the event. The exercise was well executed and positive feedback was received from clients and staff. Overall, this season our flu expense for vaccines has been $54,861.49. We have limited inventory and may have decreased supplies in the coming weeks. We currently only have Quardrivalent vaccine for all ages and no high dose flu (65 Employee Clinic - Employee Clinic visits have increased to 156 for the month of October 2022. This clinic has seen an increase in respiratory illnesses. Child Health - Child Health has been very busy over this last two months. Sick appointments nearly doubled in September 2022 and October 2022 compared to prior months. An additional sick appointment schedule has been added each afternoon to ensure availability of same day sick appointments. Well physicals have also been in high demand in Child Health. Child Health hosted a back to school vaccination clinics on September 26th - September 28th, and during Adult Health - Our Adult Health clinics have been busy as well with Family planning visits being consistent at 132, Prenatal clinic has increased to 175 visits and Sexually Transmitted Disease (STD) services with an increase to 103 visits. We have one Adult Health nurse starting the STD enhanced role nurse training this December. This will allow our department to have three enhanced role STD nurses to handle this increased demand. Syphilis and STD cases remain elevated at 34. In order to offer increased availability of STD appointments, we have implemented Express STD clinic appointments back into Adult Health every week, in addition to our regular STD clinic. Previously this had been paused due to staff having COVID-19 responsibilities. We are also working with Disease Intervention Specialist (DIS) to contact all cases and contacts for treatment. In addition, our general clinic services have increased  years and older).  those three days 665 vaccines were given.    Page 6 Board of Health November 17, 2022  Harnett County Health Department Board Room  client visits due to COVID-19 and flu vaccine demand. Immunization numbers are at 1,368 and 453 for COVID-19. An update on Monkeypox is currently Harnett County has no active cases to report and are continuing offer testing as needed in our STD clinics. We are able to vaccinate contacts and those that met Laboratory - The lab continues to serve all the Health Department's clinical areas. Since September 2022, the lab staff have performed over 400 flu test and 80 RSV tests, with this rate being higher than our previous peak seasons. In addition, our staff continue to offer rapid antigen COVID-19 testing in the Environmental Health = Oliver Tolksdorf: reported an increase of tattoo artists and shops in Harnett County with currently 30 artists, this also includes license for permanent makeup. Food & Lodging also have seen a large increase of food truck inquires for Harnett County. Once a food truck has been permitted in the county where the unit is stored, they are able to travel throughout the state. Onsite Wastewater staff have noticed a small decrease in new permits for new construction homes. The Onsite Wastewater division currently has one vacant position, and they hope to fill that vacancy soon. Aging & Case Management - Mary Jane Sauls announced the Caregiver Support program met on November 16, 2022, and in honor of National Caregiver Awareness month, Manna Church provided food boxes for each individual in attendance. Marianne Chanti-Ketteri, MSPH, PhD and Latorius Adams, MS from the UNC Department of Neurology provided tips from the latest research regarding healthy living for your brain and body. The Harnett County Division on Aging hosted a blood drive on November 10, 2022, to honor Veterans and Harnett County employees who are veterans. Harnett County Commissioner Weatherspoon read a proclamation from the Board of Commissioners designating November 11th as Harnett County Veterans Day. In attendance were Veterans from the county, community and Red Cross staff. Homemade pie was provided and served in the canteen, and this blood drive yielded 43 pints. The next blood drive is scheduled for During the reporting period of October 15, 2022-October 31, 2022, the Harnett County Division on Aging SHIIP/Medicare program served 160 Medicare beneficiaries with a savings of $94,286. This was accomplished with three Medicare Counselors on staff at the Division on Aging as well as additional help from the North Carolina Department of Insurance SHIIP staff. The Harnett County Volunteer Program currently has 189 active volunteers serving at 22 volunteer sites across Harnett County. The Courthouse has recently reopened the information desk for volunteers to come and help provide  criteria for vaccination with Jynneos vaccine.  Commons every Friday from 9am-llam.  Thursday, January 12, 2023 in the Commons.    Page 7 Board of Health November 17, 2022  Harnett County Health Department Board Room  information about the courts and offices in the Courthouse. The elderly nutrition sites will be closed December 19, 2022-January 3, 2023 for the holidays, during this time COVID-19 funds will be used to provide shelf meals. CAP/DA currently has 102 beneficiaries being served, and have received three new referrals in the past month. We have had two transfers to other counties due to moving and one death. Aging Department is fully staffed with one new employee, Chekimbrell "Kim" Wigington, and she has assumed a full caseload. The. Annual Family Caregiver Holiday Craft Fair will be held on Friday, Marketing/Communty Outreach = Debra Harris-Hawkins presented the Health Education Division have a couple of community health and education events scheduled in the coming weeks. Overweight and obesity are major risk factors for a number of chronic diseases. People who have overweight and obesity, compared to those with healthy weight, are at increased risk for many serious diseases and health conditions. This outreach program aligns with our current Strategic plan, to reduce the number of persons who are at risk for Chronic Diseases. The Holiday Challenge is designed to help individuals maintain their weight during the holiday season; this program provides strategies and resources to maintain healthy eating and physical activity. The CDC recognized National Diabetes Prevention Program (National DPP) lifestyle change program to learn how to make lasting lifestyle changes to prevent or delay type 2 diabetes. The Health Department provides the "Prevent Type 2 Diabetes Lifestyle Change Program" which is a program designed for people who have prediabetes to help make lifestyle changes necessary to delay or prevent developing diabetes. Our next session begins January 19, 2023 from 5:30pm-6:30pm the program is in collaboration with First Health through grant Through the Integrated Targeted Testing Services (ITTS) Project, HIV/Syphilis testing is offered in community settings. Health Department staff will be at Another Barbershop on Saturday, November 19, 2022 from 11:00am-2:00pm during their annual Customer Appreciation Day. We will be providing health  December 9, 2022, from 10am-4pm in the Commons.  funding provided by the Health Education Division.  information, along with free HIV & Syphilis testing.  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.    Page 8 Board of Health November 17, 2022  Harnett County Health Department Board Room Chairwoman Smith adjourned the meeting.  John Rouse, Jr. Health Director  Z  Dr.