Harnett County Board of Health Minutes of Regular Meeting January 21, 2021  The Harnett County Board of Health met in regular session on Thursday, January 21, 2021 in the Health Department Board Room, Harnett County Governmental Complex, 307 W. Cornelius Harnett Blvd., Lillington, North Carolina. A virtual Board of Health meeting using audio conference call was held for the January 21, 2021 meeting. Due to COVID-19 the Board of Health meeting was not open to members of the public to attend in person however, citizens were provided options to listen to the meeting. Only Public Health staff necessary to conduct the meeting or to speak on scheduled agenda items were in attendance. As the Board demonstrated compliance with State law and Members present by conference call: Dr. Amanda Langdon, DVM, Ms. Stacie Hogan, RPH, Dr. Kim Fowler, PhD, Dr. Catherine Evans, DDS, Ms. Barbara McKoy, Ms. Amy Members present: Dr. Laura Smith, Chairwoman, and Mr. John Rouse, Jr., Health Others present: Mary Jane Sauls, Oliver Tolksdorf, Debra Harris-Hawkins, Ainsley  prudent public health practices.  Allen, RN and Ms. Emily Barefoot.  Director.  Johnson, Natasha Johnson and Gail Hobbs.  Chairwoman Smith called meeting to order at 7:00 p.m.  Announcements = Mr. John Rouse reported Ainsley Johnson is joining the meeting tonight as the new Public Health Nursing Director II; she replaced Donna Surles who retired in July. Donna sent a thank you note to the Board of Health members to Consent Agenda - Minutes - Motion made by Ms. Staci Hogan, RPH for the November 19, 2020 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. Ms. Barbara McKoy commented on the process the Health Department has taken with the COVID-19 vaccine distribution to the county, and wanted to thank Public Health  extend the acknowledgement she received when she retired.  Catherine Evans, DDS. Motion Carried.  employees.    Page 2 Board of Health January 21, 2021  Harnett County Health Department Board Room  COVID-19 Updates - Mr. Rouse announced the most recent total of COVID-19 cases in Harnett County, with 7,543 confirmed cases, 1,773 active cases and 106 deaths. Mr. Rouse discussed the COVID-19 public testing sites will be held through ai testing company at the Brightwater building in Lillington, and at the Vyas Center in Dunn. Testing will start the first week in February, and will be a drive-thru event available three days a week and on Saturday mornings from 10am-2pm. The Health Department received the first supply of COVID-19 vaccines December 23, 2020, the following week the Health Department and Emergency Management staff received the vaccine. Emergency Management staff have been vaccinating the first responders throughout the county. Cape Fear Pharmacy has handled vaccinating three long-term care facilities in the county. The Health Department began the week of January 4th vaccinating age group 75 and older along with first responders and medical providers. The following week of January 11th the Health Department began vaccinating the age group of 65 and older. The Health Department staff are calling to schedule appointments in the Governmental Commons and averaging 300 vaccines a day. The second week of February the Harnett County Administration building on McKinney Parkway will be available to use to administer the second dose. Starting January 25th all appointments for the second dose will be made when the patient leaves after receiving the first dose. The Department of Social Services has six employees who are assisting to schedule these appointments. More information to come on aj possible mass vaccination site once more vaccine is available. Scheduling vaccine appointments has worked well for the Health Department; the department has a dedicated COVID-19 vaccine phone line and email. One issue the department has had to deal with is duplicate phone calls and email inquiries from the public wanting to schedule an appointment for the vaccine. Please advise the public to only submit one inquiry by phone or by email to avoid overloading the email and phone systems. We continue to receive weekly shipments of vaccine and prioritize its use as set by North Carolina Department of Health and Human Services (NC DHHS) guidance. Currently we are striving to vaccinate all persons in the 1A and 1B category. The Health Department has started investigating COVID-19 cases using the NC DHHS prioritization guidance. This is to reallocate case investigators to be used in vaccination efforts as recommended by the state. We will focus ouri investigation efforts on reported clusters/outbreaks, cases in K-12 grade settings, and cases known to be living in a congregate or healthcare setting or other high-density setting.    Page 3 Board of Health January 21, 2021  Harnett County Health Department Board Room  Clinical Patient Fees, Eligibility and Bad Debt-Write Off Policy Revision - Gail Hobbs stated the changes to the Clinical Patient Fees, Eligibility and Bad Debt-Write Off Policy. The changes were made due to the recommendations from State auditors. The change was made in Setting Charges for Service. The following was added; In instances of rate increases issued by Medicaid (i.e. COVID-19 Pandemic), the Health Department fees will be reviewed to ensure maximum reimbursement. Ift the Health Department fees are increased to reflect Medicaid reimbursement rates, they will return to the normal fee charged once the Medicaid reimbursement rate increase expires. Motion by Amy Allen, RN to approve the changes to the clinical fee policy as presented and seconded by Dr. Catherine Evans, DDS. Motion Carried.  CPT CODE 90702 0011A 0012A  DESCRIPTION Diphtheria Tetanus  RECOMMENDED PRICE  $55  Administration of Moderna Vaccine Ist Dose $17 Administration of Moderna Vaccine 2nd Dose $29  *Change in Pap Smear CPT Code from 88142 to 88175, CPT Code 88142 will no longer Motion to approve the increased fee and to add new fees from Dr. Amanda Langdon, DVM and seconded by Dr. Kim Fowler, PhD. Motion Carried. Health Director's Report and Program Reports - Mr. John Rouse  be valid after January 1, 2021. No other changes were made.  Financial Report - Mr. Rouse provided a handout of the second quarter's finance report July 2020 through December 2020. Finance is starting to review the six-month budget with supervisors, and they are currently working on the 2021-2022 budget. The revenues for federal and state contract money is coming in as expected. Aging revenues are coming in appropriately at this time also. Medicaid Cost Settlement funds will be available later this year, more information to come. Environmental Health revenues has increased this past year and they have seen an increase of onsite permits. The total amount of COVID-19 funds received have been $757,000 with the department spending $340,000 at this time. COVID-19 funds that were originally allotted only for COVID-19 testing now can be used for COVID-19 vaccination. Mr. Rouse reported the Employee Clinic saved the county $41,196.00 in the first quarter and $41,253.00 in the second quarter for a total of $82,449.00.    Page 4 Board of Health January 21, 2021  Harnett County Health Department Board Room  Accreditation - Mr. Rouse stated Dr. Laura Smith, Chairwoman signed a letter for Accreditation that the Board did not have any adjudications for 2019-2020; The Board of Health has done an evaluation and feels no new or amended rules or ordinances are needed since 2019, and will continue to monitor. Legal Counsel - Mr. Rouse informed the Board that the county has an 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.  Clinical Report - Ainsley Johnson  Child Health (CH) is continuing to provide well child physicals and immunizations.CH had a steady number of 79 well visits in December 2020 and 236 immunizations, which is an increase from November 2020. Sick clinic has increased numbers to 95 for December of 2020. The clinic has had a few influenza cases, with influenza numbers continuing to be low statewide. Employee Clinic for County Employees continues to utilize the clinic for acute care visits and immunizations. Employee clinic visits have continued to be steady and assist county employees with COVID-19 testing and care.  Adult Health (AH), Family Planning (FP) and Sexually Transmitted Disease (STD) clinics are remaining stable and continuing to see clients on a: regular schedule. Prenatal numbers have decreased over the past few months. Prenatal clinic is steady at 163 visits for December 2020, which is an increase from November 2020. We are working with our Community Care of North Carolina (CCNC) Obstetrics Nurse Consultant to increase follow up appointments and the tracing needs in this prenatal clinic, also meeting once a month with CCNC Influenza Vaccine is continuing to be offered as a drive-up flu. The Health Department still has inventory of flu vaccine for all ages, and flu vaccine is offered to persons of all ages to help protect them this season. The North Carolina Immunization Branch has issued new guidance as of December 2020 that allows eligible uninsured adults to receive a state supplied flu vaccine.  to discuss our progress.    Page 5 Board of Health January 21, 2021  Harnett County Health Department Board Room  Environmental Health Oliver Tolksdorf reported that On-site Wastewater is experiencing a steady workload at this time, even with the wetness due to the weather they continue to see an increase of permits with new construction. Food & Lodging staff are getting back to a normal workload schedule with the reopening of facilities that have been closed due to COVID-19. Aging & Case Management Mary Jane Sauls announced free income tax preparation and electronic filing will be available again in 2021 by volunteers of the North Carolina Economic Assistance Center (NEAC) in Coats, Erwin and Smithfield. The Coats Senior Center has volunteers ready to assist with tax returns on Tuesday mornings starting January 26, 2021. The Erwin Public Library has volunteers ready to assist with tax returns on Wednesday and Thursday mornings starting January 27, 2021. Due to COVID restrictions all tax returns will be using drop-off procedures. Taxpayers will be given an appointment the following week to review and pick-up their completed returns. All returns will be electronically filed, no walk-in service will be available and The Harnett County Division on Aging Retired Senior Volunteer Program (RSVP) volunteers participated in many community events celebrating Dr. Martin Luther King in service and remembrance. On Thursday, January 14, 2021, the Harnett County Division on Aging RSVP Program sponsored a community blood drive. RSVP volunteers assisted donors with registration, cleaning the waiting and canteen areas, serving snacks and making appointments in the canteen. The goal for the drive was 42, we exceeded the goal and collected 59 units which had the capacity to save 177 lives. On Monday, January 18, 2021, RSVP volunteers helped serve lunches at the Martin Luther King Service in Lillington. These volunteers work with the Ladles ofLove Ministry, a local soup kitchen. Volunteers prepped, cooked, and served food for the event. On Monday, January 18, 2021, RSVP volunteers serving at the Harnett Food Pantry worked to provide boxes of food to area residents in honor of Dr. Martin Luther King, Jr. serving over 48 families in two hours. They helped distribute pre-packaged Farm to Table boxes provided by the U.S. Department of Agriculture (USDA) as well as boxes of food packed by volunteers with the Infant Mortality Report Debra Harris-Hawkins presented a follow-up report on the Infant Mortality data that was released in November. Handouts were provided, which included 2019 data. Infant mortality is the death of a baby before its first birthday. Infant mortality rates are the number ofinfant deaths for every 1,000 live births within a given time frame, usually a year. An overview of the infant deaths were provided, including the underlying cause of death, the report reviewed risk factors, including trimester care began, the  appointments must be made in advance.  Harnett Food Pantry.    Page 6 Board of Health January 21, 2021  Harnett County Health Department Board Room  age of the mother, and the number of women using tobacco during pregnancy. Areas of concern, included women who do not receive prenatal care early and continuous prenatal care. We will continue to monitor and work with outreach efforts educate on importance of early and continuous prenatal care including promoting the maternal health programs and services offered at the Health Department. Debra Harris-Hawkins provided an overview of the county's Child Fatality Prevention Team (CFPT). The CFPT reviews child fatalities and looks for strategies to prevent future child deaths. Members discuss outcomes of services and circumstances surrounding the child's death. The CFPT team reviews fatalities of Harnett County children 0 through 17 years of age.  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, Owy  John Rouse, Jr. Health Director  Dr.  -  e