Harnett County Board of Health Minutes of Regular Meeting November 21, 2019  The Harnett County Board of Health met in regular session on Thursday, November 21, 2019 in the Health Department Board Room, Harnett County Governmental Complex, 307 W. Cornelius Harnett Blvd., Lillington, North Carolina. Members present: Ms. Patricia Chalmers, Chairwoman, Ms. Judy Herrin, RPH, Vice- Chairwoman, Ms. Amy Allen, RN, Ms. Emily Barefoot, Ms. Gayle Adams, Dr. Catherine Evans, Ms. Barbara McKoy, Dr. Nicholas Pennings, Ms. Linda Sturdivant, Dr. Laura Others present: Debra Harris-Hawkins, Donna Surles, Oliver Tolksdorf, Gail Hobbs,  Smith and Mr. John Rouse, Jr., Health Director.  and Natasha Johnson.  Chairwoman Chalmers called meeting to order at 7:00 p.m.  Announcements - Chairwoman Chalmers reported that she and Vice Chairwoman Judy Herrin met prior to tonight's meeting and performed Mr. Rouse's annual performance evaluation and reviewed his job description with him. We are not making Mr. John Rouse announced that Chairwoman Patricia Chalmers and Vice Chairwoman Judy Herrin, third term on the Board of Health expires on December 31st Consent Agenda - Minutes Motion made by Ms. Barbara McKoy, for the September 19, 2019 agenda and minutes to be approved and seconded by Ms. Consider additions and deletions to the published agenda = Mr. Rouse announced that item 8: for Revenue Collection Policy Revision is not an action item, only an Public Comment - Period of up to 30 minutes for informal comments allowing 3 minutes for each presentation - Chairwoman Chalmers opened the floor for informal comments by the public, allowing 3 minutes for each presentation up to 30 minutes. Seeing no one, Chairwoman Chalmers closed the informal comments. Nomination Committee Report - Chairwoman Chalmers 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 Chalmers opened the floor for any other nominations. No other nominations were received. Dr. Catherine Evans,  any recommended changes at this time. 2019, and tonight will be their last meeting.  Emily Barefoot. Motion Carried.  informational item.    Page 2 Board of Health November 21, 2019  Harnett County Health Department Board Room  asked that nominations be closed and accept the slate of officers as presented, Meeting Schedule for 2020 - Mr. Rouse provided a copy of the Board of Health meeting schedule for 2020, and reminded the Board the March meeting is the first Thursday of the month and all other meetings are scheduled for the third Thursday. Revenue Collection Policy Revision = Mr. Rouse stated the revision to the policy was staff changes in positions and titles, also vacant positions were corrected under the section for staff authorized to accept funds. The policy will be signed by the Harnett County Health Director, Health Department Accounting Specialist I and the Harnett Debt Setoff - Gail Hobbs reported we have received an additional $674.41 since the last Board ofHealth meeting in September. The total amount of Debt Setoff money Recommendation to Establish Fees: Gail Hobbs presented the following fees for new  seconded by Dr. Nicholas Pennings. Motion carried.  County Finance Director.  received for this calendar year is $9,201.56. fees or an increase to established fees:  CPT CODE 90651  DESCRIPTION Gardasil  RECOMMENDED PRICE $240.00 (old rate $195)  This increase is a result of purchase price increase from $192.78 to $204.30/dose. Motion to approve the increased fee from Ms. Emily Barefoot and seconded by 2019 Infant Mortality Report - Debra Harris-Hawkins presented a report through a power-point presentation which included 2018 data. Infant mortality is the death ofa 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. Harnett County data was presented with the total number of live births from 2018 which included 1,845, which was decrease in comparison from the 2017 data with 1,886 births - The number ofinfant deaths included fifteen (15), which was a slight decrease from the previous year which included a total of sixteen (16) deaths. Harnett's infant mortality rate was 8.1 per 1,000 live births. In comparison with the North Carolina rate of 6.8 per 1,000 live births. A review of the previous year's infant mortality rate was  Ms. Judy Herrin. Motion Carried.  provided.    Page 3 Board of Health November 21, 2019  Harnett County Health Department Board Room  The report reviewed the following three risk factors, trimester care began, the number of women using tobacco during pregnancy and maternal pre-pregnancy BMI. Areas of concern, included women who do not receive 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 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. The number of child deaths in 2018 for Harnett County was a total of 25 deaths. The largest number of the deaths occurring in the under 1 age group. The leading cause of death was listed as Birth Detects/Perinatal and Sudden Infant Death Syndrome (SIDS) with a total of 11 deaths. The CFPT has reviewed several motor vehicle accidents with over-correcting being an issue among adolescent drivers. The CFPT meets quarterly at the Health Department. Health Director's Report and Program Reports - Mr. John Rouse Medicaid Transformation - Mr. Rouse announced the Medicaid Transformation go live date of February 2020 has been suspended at this time. Vendors are currently not signing up beneficiaries and a call center is available for information. Vendor meetings with providers on Case Management will continue as scheduled. The General Assembly has adjourned until January 14, Financial Report - Mr. Rouse provided a handout of the first quarter finance report July 2019 through September 2019. 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. Aging funds are currently delayed but are coming in. Environmental Health revenues are increasing due to the amount of permits that are coming in. Due to the past amount of wetness in the soil, onsite wastewater work was slow but since the soil has dried they  services offered at the Health Department.  2020, with more information to come.  are steady and busy.    Page 4 Board of Health November 21, 2019  Harnett County Health Department Board Room  Finance has been working on the Medicaid Cost Settlement 2019 report, we are currently waiting on one report from the state to complete the report. Mr. Rouse reported the Employee Clinic saved the county $52,719.00 in the first quarter and continues to be an active clinic among county employees. Family Planning Billboards = Mr. Rouse presented a power point of Family Planning billboards that are used in Anson, Hoke, Columbus, Lincoln, Scotland and Swain counties. The Health Department has received money from the Title X: funds, and are planning on advertising Family Planning services on available  billboards throughout the county.  Clinical Report - Donna Surles  Clinical Report is based on the Activities Summary for September 2019 and October 2019. The Health Department has a Processing Assistant IV: from Management Support who will retire effective January 1st 2020. Billing positions have been cross trained in Adult and Child Health to provide coverage Lab has started working with Mako Lab to provide laboratory services that we currently do: not do in-house at this time. Mako will be onsite December 2, 2019 to test the process. The Health Department will also continue to use LabCorp. Child Health (CH) sick and well clinic visits are where they usually are this time of the year. They are seeing more children and employees for sick visits as the cold weather approaches, which means al lot of flu and strep tests.  during the hiring process.  Currently we have had one positive Flu Type. A.  Adult Health (AH) clinic visits remain consistent. Family Planning and Maternal Health clinics have increased in the last 2-3 months. In December, the Health Department will host a You Quit Two Quit smoking cessation training for clinical staff who work with pregnant women.  Employee Clinic visits were down slightly in September to 97 visits, but  increased to 131 visits in October.    Page 5 Board of Health November 21, 2019  Harnett County Health Department Board Room  Immunizations numbers increased significantly in September and October due to the outreach flu clinics and back to school immunizations. Staff also provided Hepatitis B vaccine for school staff and high risk county employees. CH conducted an after-hours clinic for back to school immunizations on September 19, 2019, 32 children were seen for immunizations during that time. The total amount of immunizations given that day was 91. Flu Report this season we have given over 1,850 flu shots, which is an increase from this' time last year. Over 1,300 of those flu shots given were during the outreach sites which included senior centers, assisted living facilities, county offices, and Harnett County School employees. According to the most recent flu report received form the Centers for Disease Control (CDC), 2 confirmed flu deaths have been reported, both in seniors over the age of 65. The Health Department encourages everyone 6 months and over to get the flu shot. Preparedness has been working with Fort Bragg and other regional partners on al Hepatitis A tabletop exercise. The Preparedness Coordinator and two Communicable Disease (CD) Nurses have participated in an Ebola tabletop exercise at Campbell University, conducted by North Carolina Public Health  Preparedness & Response (PHP & R).  Health Information Exchange (HIE) Update, In 2014, the Health Department connected with HIE to share health data with other health practices and hospitals. In 2016, the state asked public health to cease sharing due to the Minor Consent Law. Anyone is able to opt out of sharing their health information, however minors were not legally able to opt out. All sharing stopped until the Minor Consent could be resolved. The Harnett County Health Department is now participating with 4 other health departments in a pilot to test submission of the opt out forms. The pilot should be over at the end of  December, and then we will go live with HIE.  Outreach with the Health Department's first boys event took place at the Boys and Girls Club in Lillington on November 20, 2019 and was for males ages 8- 12. We are planning to collaborate with the club and the Sherriff's Athletic League to conduct an event for older youth, and reaching out to boys and girls. This is an educational and fun event to promote positive and safe behaviors.    Page 6 Board of Health November 21, 2019  Harnett County Health Department Board Room  Environmental Health Oliver Tolksdorf discussed the proposed development along the area of highway 401 from Lillington to the Wake county line. The proposed developments will cause an increase in permits for onsite in the Since the Legionnaires disease outbreak linked to the Mountain State Fair in Fletcher, North Carolina during September, the CDC has provided information regarding the safe display of1 hot tubs at fairs/events to the Environmental  future.  Health staff.  Aging & Case Management Mr. Rouse reported that Medicare open enrollment The Harnett County Caregiver Support Program will host the 8th Annual Holiday Craft Fair on Friday, December 6, 2019 from 10:00am-4:00pm at the Governmental Complex Commons area. This includes shops from local artists which are handmade items such as candles, skin care, baked goods, clothing, cosmetics, fragrances, jewelry, wreaths and many more items. A hot dog luncheon will also be available for purchase during the event. The Health Department will administer the Patient/Consumer Satisfaction Survey and the Community Survey starting December 9, 2019 through December 20, 2019. Information obtained from the survey will be used for program planning. Marketing/Community Outreach Debra Harris-Hawkins reported on "The Holiday Challenge" is a free six-week program provides participants with education on nutrition, fitness tips, and ideas to help maintain your weight throughout the holiday season. There will be two sessions in the community in Lillington at the Library from 5:30 until 6:30pm. The Holiday Challenge is a free program, provided by the Health Education Division. The Health Department, and the Harnett County Employee Wellness Committee, will be providing the Holiday Challenge program for county employees as well. The program will begin on November 25, 2019 thru January 6, 2020, this is also a free six-week The Vaping and E-Cigarettes: What Parents Should Know is a session that will be held on January 7, 2020 at :30pm-6:30pm. The focus will provide information on the dangers of vaping for adolescents and talking to your teen about vaping. Staff from the Regional Office will be conducting the session.  continues through December 7, 2019.  program.    Page 7 Board of Health November 21, 2019  Harnett County Health Department Board Room Closed Session - There was no need for closed session.  New Business = Chairwoman Chalmers opened the floor for New Business.  Being none Chairwoman Chalmers closed New Business. Chairwoman Chalmers adjourned the meeting.  Respectfully submjtted,  Mvw  C6  John Rouse, Jr. Health Director  Ms.  Chalmers,