Harnett County Board of Health Minutes of Regular Meeting March 3, 2022  The Harnett County Board of Health met in regular session on Thursday, March 3, 2022 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 March 3, 2022 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 attended. As the Board demonstrated compliance with prudent public health Members present by conference call: Dr. Amanda Langdon, DVM, Ms. Stacie Hogan, RPH, Dr. Kim Fowler, PhD, Dr. Catherine Evans, DDS, Ms. Linda Sturdivant, Ms. Members present: Dr. Laura Smith, Chairwoman, and Mr. John Rouse, Jr., Health Others present: Oliver Tolksdorf, Ainsley Johnson, Debra Harris-Hawkins, Mary Jane  practices.  Gayle Adams, Ms. Amy Allen, RN, and Ms. Emily Barefoot.  Director.  Sauls, Natasha Johnson and Gail Hobbs.  Chairwoman Smith called meeting to order at 7:00 p.m.  Announcements - Mr. Rouse reported no announcements for tonight's meeting. Consent Agenda = Minutes - Motion made by Linda Sturdivant, for the January 20, 2022 minutes to be approved as presented and seconded by Ms. Stacie Consider additions and deletions to the published agenda = Chairwoman Smith called for additions and deletions to the published agenda. Mr. Rouse announced that line item 8 for the State of the County Health Report (SOTCH) is not available and line item 8 will be replaced with Marketing Plan Update. The SOTCH report will be presented at the May 19, 2022 Board of Health meeting. Motion by Dr. Catherine Evans, DDS, to approve the addition to the agenda as presented and seconded by 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.  Hogan, RPH. Motion Carried.  Gayle Adams. Motion Carried.  Hearing no one, Chairwoman Smith closed the informal comments.    Page 2 Board of Health March 3, 2022  Harnett County Health Department Board Room  FY 2022-2023 Budget Proposal - Mr. Rouse discussed the overall budget proposal and fee schedule for FY 2021-2022 budget. Mr. Rouse reviewed each line item including decreases and increases, and reviewed the fee schedule. Mr. Rouse related the overall budget decrease for FY 2022-2023 is $2,508,703. COVID-19 funds have been removed from the budget due to not being guaranteed in the upcoming FY as well as carryforward money being deducted. The Local/County Appropriations additional funds needed are $14,348, the largest part of these funds are to provide a maintenance agreement on the respirator fit testing machine. Included in the budget for FY 2022-2023, is an Expansion Request to unfreeze a previous frozen position for the Health Department; the position is al Processing Assistant IV for Women, Infants & Children (WIC). The position was frozen several years ago due to budget cuts from the federal government, and for FY 2022-2023 the Health Department will be receiving additional funds from the federal government. The WIC program averages serving 3,500 clients monthly in Harnett County and serves three locations throughout the county. The Aging overall budget increase for FY 2022-2023 is $22,454. The AmeriCorps Seniors Retired Seniors Volunteered Program (RSVP) currently manages 255 active volunteers serving at 23 different volunteer sites throughout Harnett County. The AmeriCorp Senior grant has funded the RSVP program the past 19 years, Harnett County was not funded for FY 2021-2022 but they did provide a one-time six (6) month extension of funds in the amount of $23,750. For FY 2021-2022, the budget was reduced by $15,000+ and a request was: made in the FY 2021-2022 Expansion Request for the remainder from county funds. An Expansion Request is included in the FY 2022-2023 Aging budget for the RSVP program. The RSVP program will need to be completely funded by the county to remain an active program. Mr. Rouse recommended the fee schedule remain the same. Mr. Rouse requested that we be allowed to purchase influenza vaccine using one vendor for adults. Henry Schein continues to be the Health Department's vendor for influenza vaccine, the Health Department pre-books before March with Henry Schein and are guaranteed the Motion made by Ms. Emily Barefoot to adopt proposed budget FY 2022-2023 which includes the fee schedule as presented and seconded by Dr. Amanda Patient Satisfaction Surveys = Mary Jane Sauls presented the results of the Harnett County Health Department 2021 Consumer and Community Satisfaction survey. The surveys were administered on December 17, 2021- December 30, 2021. The surveys are completed each year to assess the quality, accessibility and effectiveness of our health services. The Health Management team discussed the survey results and recommended providing information to clients to promote the patient portal. Survey data found that 24% of respondents had accessed their patient portal. The Board had no further recommendations. Information and recommendations will be shared with  influenza vaccine.  Langdon, DVM. Motion Carried.  the staff.    Page 3 Board of Health March 3, 2022  Harnett County Health Department Board Room  Marketing Plan Update = Debra Harris-Hawkins announced the 2022-2025 Marketing Plan has been completed and a copy was emailed to the Board of Health members. Over the next three years the Harnett County Health Department has identified three marketing goals, we will work towards: 1. Broaden community awareness of public health purpose and services. 2. Promote the use of evidence- based strategies to reduce at-risk behaviors. 3. Utilize the Harnett County Health Department logo on imprinted items and communications. The marketing plan is one of the overall group of plans which includes but is not limited to the following the Community Health Improvement Plan (CHIP), the Quality Improvement Plan and the Strategic Plan. We will continue to provide the Board of Health update regarding Marketing and Community Outreach programs and activities at your regular meetings. A copy of the plan will be located on Share(S) for our staff to access and review. COVID-19 Updates = Ainsley Johnson discussed Harnett County has begun to see a downward trend in COVID-19 cases since the second week in February 2022. Our total historical COVID-19 cases in the county as of today are 31,197 cases with 312 associated deaths reported. In December 2021 we reported 1,216 cases, January 2022 we: reported 3,579 cases and in February 2022 we reported 3,198 cases. The Health Department is beginning to catch up on back log of paper reporting that we have received via fax, that will start seeing a reflection in numbers. The last COVID-19 reported confirmed death was on February 18, 2022. Currently Harnett County has a total of 10 active outbreaks or clusters in our county with two outbreaks in correctional facilities and eight in assisted living or skilled nursing facilities. The Health Department continues to work closely with facilities and institutions involved in outbreaks and clusters to decrease spread, assist with testing and monitor cases. COVID-19 testing demand has decreased in the county and the state. Last week there was an estimated 1,476 COVID-19 tests performed in Harnett County. The positivity rate for testing has decreased, from the peak of 38.5 % to our current positivity rate of 8.9%. Harnett County's community transmission risk remains high. Community transmission risk is determined by the amount of cases per 100,000 of the population and positivity percentage. The Health Department continues rapid antigen testing clinics in the Governmental Commons area, and we continue to test daily in our Child Health (CH) and Employee Clinic as needed. In February 2022, the Health Department tested approximately 715 individuals in the Governmental Commons and in outbreak testing and we continue to collaborate with Optum Serve to offer two testing sites; one in Lillington and one in Dunn. The Health Department also collaborated with Ameritech Diagnostics to provide a testing site at Victory Tabernacle Church on Highway 27 to provide testing six days per week. COVID- 19 vaccinations continue to be available every day of the week in the clinics. COVID-19 vaccine numbers have decreased over the last two months. The Health Department continues to encourage everyone to be up to date with their COVID-19 vaccinations. Next week the Health    Page 4 Board ofHealth March 3, 2022  Harnett County Health Department Board Room  Department will transition to daily walk-in clinics in Adult Health (AH) and CH and pause the mass vaccination clinic in the Governmental Commons every Wednesday due to the decrease in demand. Total COVID-19 vaccinations given to date are 28,202 doses (this includes first, second, third and booster doses). The Health Department continues to transfer vaccines to vaccinating providers in the county and have transferred approximately 31,240 doses to community partners to increase vaccinations in Harnett County. Updates to COVID-19 vaccines are new recommendations that were released this week regarding the interval between Ist and 2nd doses of mRNA vaccines. Intervals between 1st and 2nd doses of Pfizer can now range from 3 weeks to 8 weeks. Intervals between 1st and 2nd doses of Moderna can now range from 4 weeks to 8 weeks. A minimal interval is recommended for people who are moderately-severely mmunocompromses, age 65 or older, and people with underlying medical conditions. An 8-week interval between Ist and 2nd dose is recommended for males age 12-39 who do not fall into other categories and all others  age 12-64, that do no fall into other categories.  Health Director's Report and Program Reports = Mr. John Rouse, Jr.  Resuming in person Board of Health meetings - Mr. Rouse discussed resuming in person meetings with the Board of Health members. Due to the decrease in COVID-19 cases Mr. Rouse will continue to monitor the decrease and or increase of COVID-19 cases in Harnett County and will discuss with the Board of Health members closer to the May 19, 2022 meeting if the meeting will Child Health - CH has noticed a decrease demand for COVID-19 testing and vaccination appointments. CH had 141 sick visits in the month of January 2022. CH physicals have increased in the past month due to letters being sent to parents of children who are in need of a well-child physical. CH performed 105 physicals in the month of February 2022. CH continues to provide car safety seat assessment and education one day each week by appointment. This program installed and provided education to 15 participants since the beginning of 2022. Interviews will be conducted this month for the vacant CH Immunizations - The Health Department's immunization program received our Annual Immunization Assessment visit on January 25, 2022. The rates for the assessment were based on all children age 24 to 35 months being up to date on  be held in person.  Public Health Nurse II position.    Page 5 Board ofHealth March 3, 2022  Harnett County Health Department Board Room  all required vaccinations. The Health Department's rate was at 81% compared to the statewide average of 79%. The Health Department has staff to work on the program to ensure all children are up to date in Harnett County, and the Health Department goal for 2022-2023 is 84% and the county goal for 2022- Employee Clinic - The County Employee clinic continues to operate well, with Adult Health - Family Planning (FP), Sexually Transmitted Disease (STD) and Prenatal (PNC) clinics continue to increase with monthly numbers. PNC numbers have increased to 134, and STD clinic visits increased with 82 in the month of. January 2022. Communicable Disease (CD) cases decreased slightly and the CD nurses are tracking trends and identifying contacts to rapidly test and treat clients. In the past two weeks, two Food and Drug Administration (FDA) alerts and recalls have been received. The FDA issued a voluntary recall of dried plum fruit and candy due to lead levels exceed allowable amounts. The FDA also issued a recall of three brands of powdered infant formula for possible Cronobacter contamination. These alerts were disturbed to community medical Laboratory - Laboratory patients have increased to 847 during the month of January 2022. Influenza testing has increased, with 332 patients tested for influenza in the past two months. The positivity rate ofi influenza remains low. Flu Update - The statewide respiratory surveillance report released today, reports influenza like illness has remained low and the geographic spread of flu is local. Influenza A continues to account for the majority of cases. The southeastern United States proportion of visits due to flu-like illness was at 1.47% compared to the national baseline of 2.5%. The Health Department continues to administer flu vaccines in our AH and CH clinics. Flu vaccine is available for all ages, including high dose flu for age 65 and older. We continue to urge everyone to receive his or her annual flu vaccine. Flu vaccines are  2023 is 64% up to date.  177 employees seen in the month of January 2022.  and childcare providers by fax and email notification.  available at no charge for uninsured individuals.  Training - The Health Department staff is currently completing annual Title X training requirements. Title X: is a federal program designed to provide comprehensive and confidential family planning and preventative health services. All staff that work in programs supported by Title X are required to    Page 6 Board of Health March 3, 2022  Harnett County Health Department Board Room  complete Human Trafficking Training and Mandatory Reporting of Child Abuse and Neglect Annually. The Health Department staff will participate in an annual staff training in April 2022. Trainings include Occupational Safety and Health Administration (OSHA), Safety, Diversity/Cultural Competency, Title X, Health Insurance Portability and Accountability Act (HIPAA), Policy Review, and  Preparedness.  Environmental Health - Oliver Tolksdorf reported Environmental Health staff have been busy with seasonal inspections of migrant housing in the county, with inspections for public swimming pools to begin shortly. The new Environmental Health Specialist will start on March 21, 2022 and interviews for the vacant Environmental Health Specialist position will start soon. Onsite Wastewater staff have received the new county vehicles that were in the FY 2021-22 Budget; the Environmental Health division has received four Aging & Case Management - Mary Jane Sauls reported the North Carolina Assistance Program, formerly known as Volunteer Income Tax Assistance Program (VITA) uses Internal Revenue Service (IRS) certified and trained volunteers to prepare taxes free of charge for the elderly and disabled. These volunteers are part of the Retired Senior Volunteer Program (RSVP) managed through the Harnett County Division on Aging. This vital program prepares tax returns during February through April every year at the Erwin Public Library and the Coats Senior Center. This year there are seven volunteers helping with the program. An average tax return cost around $300, and last year our volunteers helped prepare 900 returns in Harnett County saving residents $270,000. Most of these individuals are on a fixed low income. The North Carolina Seniors' Health Insurance Information Program (NC SHIIP) for Harnett County is housed at the Division on Aging where trained Medicare Counselors are on hand year round to assist Medicare beneficiaries and family members with Medicare options. On March 5, 2022, there will be a "New to Medicare" class for individuals going on Medicare in May 2022. This class is facilitated by Aging staff and in partnership with the North Carolina Department of Insurance. The class will be held at the Harnett County Resource Center Training Room from 3:00pm-4:30pm. Medicare volunteers will be onsite to assist Aging staff and personnel from the North Carolina Department of Insurance to provide general Medicare information and options  county vehicles.  for supplemental and prescription drug coverage.    Page 7 Board of Health March 3, 2022  Harnett County Health Department Board Room  March 10, 2022 there will be a Red Cross Blood Drive from 1:00pm-5:30pm in the Governmental Commons area. Aging staff, the Red Cross and volunteers Marketing/Communty Outreach - Debra Harris-Hawkins presented the Health Education Division has a community health and education event scheduled in the coming weeks. "Step into Fitness" will be held starting March 28-April 24, 2022. Physical activity and exercise can have immediate and long- term health benefits. This program works to promote and increase physical activity. This is a free program and registration can be completed by calling or online. COVID-19 testing is now being held at a location on the western side of Harnett County, Ameritech Diagnostics Lab is providing a COVID-19 testing site at Victory Tabernacle Church at 7330 NC-27W Lillington. The event is a drive thru testing site and is available Monday-saturday from 9:00am-4:00pm,  will assist 62 donors scheduled to give blood.  rapid and polymerase chain reaction (PCR) are available. 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, wwwl John Rouse, Jr. Health Director  Dr. Laura Smith,