Harnett County Board of Health Minutes of Regular Meeting January 25, 2018  The Harnett County Board of Health met in regular session on Thursday, January 25, 2018 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. Gayle Adams, Ms. Emily Barefoot, Ms. Amy Allen, Dr. Nicholas Pennings, Dr. Laura Smith and Mr. John Rouse, Jr., Health Director.  Public Guest present: Mr. Gerald Temple. Mary Jane Sauls and Natasha Johnson.  Others present: Debra Harris-Hawkins, Donna Surles, Gail Hobbs, Oliver Tolksdorf,  Chairwoman Chalmers called the meeting to order at 7:00 p.m.  Announcements- Mr. Rouse reported Ms. Barbara McKoy will not be attending tonight due the loss of her brother. Mr. Rouse related we have a public guest tonight, Consent Agenda = Minutes - Motion made by Dr. Nicholas Pennings, for the November 16, 2017 minutes to be approved as presented 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 Chalmers opened the floor for informal comments by the public, allowing 3 minutes for each presentation up to 30 minutes. Mr. Gerald Temple spoke of the need for the Environmental Health Supervisor to be familiar with local communities and to have a good working Board of Health Operating Procedures = Mr. Rouse reviewed the Board ofHealth Operating Procedures. For Harnett County Board of Health Public Hearing Procedure, proponents and opponents to the issue before the Board shall each be allowed a maximum ofc one hour for presentations, ai recommendation was made by the Board to change the allowed time to thirty minutes. Motion made by Ms. Judy Herrin, RPH to change the Board of Health Operating Procedure allowed time for presentations to thirty minutes, seconded by Dr. Laura Smith. Motion carried.  Mr. Gerald Temple.  Emily Barefoot. Motion Carried.  relationship with the local installers.    Page 2 Board of Health January 25, 2018  Harnett County Health Department Board Room  Strategic Plan - Debra Harris-Hawkins presented a PowerPoint presentation providing the 2018-2020 Strategic Plan. Through this plan we intend to achieve measurable improvement in critical public health areas. The strategic priority areas included are both internally and externally focused, ensuring continuous quality improvement across the division and the provision ofneeded services and activities to meet the community's needs. This plan includes strategic directions with objectives that represent our firm commitment to assuring a healthy community for all of our residents. Some of the projects that resulted from our previous strategic plan include: Increasing workforce development opportunities for staff, which resulted in staff being cross-trained, immunizations rates meet state benchmarks, WIC program exceeds required enrolled participation partners with multiple agencies and community organizations. Assisting local public housing communities to adopt new policies related to tobacco free environments. The Health Management Team (HMT), guided the strategic process. We utilize the data from the Community Health Assessment (CHA) to identify the health conditions affecting our residents to establish work plans, identify opportunities for partnership and develop action plans. We used health status data and information to set goals and objectives and will continue to monitor progress, and Established Fees/Debt Setoff- Gail Hobbs presented the following fee for an increase  report progress and outcomes. on established fees: INCREASE CPT CODE 90651 90707  DESCRIPTION Gardasil MMR  RECOMMENDED PRICE $195.00 (price was $185.00) $75.00 (price was $70.00)  Motion to approve the increased fee from Ms. Judy Herrin, RPH and seconded by Gail Hobbs reported we received an additional $82.00 since the last Board of Health meeting in November. The total amount of Debt Setoff money received fiscal year 2017 Patient Fee Policy - Gail Hobbs provided a copy of the Clinical Patient Fees, Eligibility and Bad Debt-Write Off Policy with the change made to the policy. The change reflects that we would no longer be mailing letters to patients sixty days past due. Instead the information has been made a part of the statement that is mailed monthly notifying the patient that if they have signed the payment agreement form to please make a payment as soon as possible. Motion to approve the Patient Fee Policy from Ms. Emily Barefoot and seconded by Ms. Amy Allen. Motion Carried.  Dr. Nicholas Pennings. Motion Carried.  is $7,289.93.    Page 3 Board of Health January 25, 2018  Harnett County Health Department Board Room  Bad Debt Write-Off Correction - Mr. Rouse presented the correction to the bad debt write offs that were submitted at the September 21, 2017 meeting. This process is handled once every two years and this was the second time completed on our current Electronic Medical Record (EMR) system, Patagonia. We requested assistance from Patagonia in the process and were given the incorrect instructions. As a result the write off amount is considerably less once the correct process was completed. Original bad debt write off amount was $3,896.95 and the correct write off amount is $1,898.09. This resulted in $1,998.86 less in bad debt write offs. Motion by Ms. Emily Barefoot to write off $1,898.09 as presented, seconded by Dr. Laura WIC Electronic Benefit Transfer - Debra Harris-Hawkins presented a PowerPoint presentation regarding the departmental change for Women, Infant and Children (WIC) program. This is a special supplemental nutrition program. The North Carolina WIC program is moving from a paper based method of WIC benefits issuance to an electronic benefit transfer system, EWIC. Instead of paper food instruments, WIC food benefits will be issued into an electronic benefit account at the local WIC clinic. Families will use their EWIC card and personal identification number (PIN) to access their food benefits at the grocery store. This change will start on February 21,2018 here at the health department. We have information about this departmental change posted on our website and Facebook page, information is posted in the clinic with flyers and through the monitors located in the clinic, in both English and Spanish. The WIC program has established three full service sites across the county located in Dunn, Lillington and the Anderson Creek Medical Center located in Spring Lake. The staffh has worked diligently to increase and keep the caseload, the number of participants increased by 1,128 more clients in 2016 in comparison to 2015 data, over 36,987 participants were seen through the WIC sites. There are income guidelines for the program to qualify for WIC, your household income must be at or below 185% of  Smith. Motion Carried.  federal poverty income level.  Health Director's Report and Program Reports - John Rouse  Financial Report - Mr. Rouse provided a handout of the second quarter's finance report July 2017 through December 2017. Mr. Rouse discussed the amounts being at about fifty percent on expenditures. Staff are being good about spending and staying with their expenditures. The federal and state money is coming in as they should. We will be receiving additional Medicaid Cost Settlement for 2016-2017 that we will be able to carrytorward next year. Aging will be receiving more revenue in the spring. Mr. Rouse reported the Employee Clinic saved the county $59,965.00 in the first quarter and $65,281.00 in the second quarter for a total of $125,246.00. Employee Clinic continues to be a busy clinic especially during flu season.    Page 4 Board of Health January 25, 2018  Harnett County Health Department Board Room  Mr. Rouse stated that the March Board of Health meeting will be discussing the budget. The meeting will be held on the second Thursday in March. Mr. Rouse will be meeting with supervisors next week to review their budgets. Clinical Reports - Donna Surles related that the numbers are based on the Child Health (CH) visits have decreased since the last report, this trend has been consistent throughout the years. Visit numbers drop during the months of December and January and then increase as cold and flu season begins. The CH providers and nurses have been working to help cover the family planning and adult health general clinics. We are in the process of filling the Physician Extender position to work in all clinics. CH will be having a promotional event in the spring and will collaborate with Partnership for Children. We will be reaching out to other county departments to participate in the event. They also plan to do car seat safety checks at the event. Starting Monday, January 29th we have a new Spanish interpreter, Mariam Rodriguez for the CH area. Employee Clinic remains busy with 136 visits in December and 137 visits thus far for January. The employee clinic still remains to have a cost savings for the Immunization numbers are average for this time of year. The regional consultant will be here on February 5, 2018 to review the immunization compliance rates for children 24-35 months. The health department goal for 2017-2018 is 90% and we are currently at 90%. Last year we scored 95%, exceeding our goal. A countywide Call-Em-All regarding vaccines has been completed and letters have been mailed in the efforts to contact those children who are not documented as meeting the vaccine requirements. One of the largest pediatric practices in the triangle has now began entering immunizations in the North Carolina Immunization Registry (NCIR) and we hope this will help us meet our health department and county goals. Flu Reports that we have received from the State Communicable Disease (CD) branch shows an increase in flu cases. According to the most recent report Influenza is widespread across North Carolina. The most prevalent has been Type A. Across the state there have been 67 reported deaths with 21of those being reported in the last week. Most deaths were age 65 and older, followed by age 50-64. The health department ran out of adult Influenza vaccine in November after administering 1,400 doses. CH has given over 800 doses and had reordered the vaccine three times due the rise in flu illness and patients requesting the vaccine. Currently we still have flu vaccine for children.  Activities Summary.  county.    Page 5 Board of Health January 25, 2018  Harnett County Health Department Board Room  Family Planning (FP) providers are training in Intra-Uterine Devices (IUD) placement with Dr. Gray and Johnston County Health Department providers. Once the new Physician Extender is hired FP clinic will be able to open up more appointments for patients. Currently CH providers are staffing the FP clinic. One of our RN's is out on maternity leave and will return in February. Maternal Health Clinic provides pregnancy care services Monday through Friday with 211 visits in December. The department is planning on holding a Maternal Health Fair in May to let the community know about our program and services we provide. The event will be open to all pregnant women. Other departments will be invited as well as community partners to participate in the event. Crystal Sanders, State Dental Hygienist is on site three days a week in the maternal health clinic to evaluate, access and refer pregnant patients for dental concerns or issues they may have. We applied for a grant through the Office of Rural Health and received $34,000 for our Maternal Health program. Currently we are receiving around $5,000 a month from the grant funding. Sexually Transmitted Disease (STD) services are provided Monday through Friday and remains an active clinic. Tammy Smith, RN has completed her Enhanced Role training and is now able to treat clients based on standing orders or per our provider's orders. In February we are planning to open additional STD clinic appointments two days a week. The OSHA/Safety Officer with the health department attended an Infection Control training on January 24th. She will be including some of the information learned in our annual staff Environmental Health = Oliver Tolksdorf reported that Environmental Health staff have just completed training on the new software "Track It" and they are currently working in the new system. The program is linked to the Planning department and will help with accessing records. Mr. Rouse announced the Environmental Health Supervisor position will be posted in February and  training which will be held on April 2, 2018.  interviews will be start shortly after to fill the position.  Aging & Case Management - Mary Jane Sauls stated in 2017 the department of Aging served 987 Medicare beneficiaries and were able to help save $1,650,031.00 in Harnett County in prescription drug plan cost. During open enrollment which was October 15th through December 7th, they saw 691 Medicare beneficiaries. Starting January 25, 2018 through April 13, 2018 locally trained IRS certified volunteers through the Harnett County Retired    Page 6 Board of Health January 25, 2018  Harnett County Health Department Board Room  Senior Volunteer Program (RSVP) will provide free individual federal and state income tax preparation and electronic filing. Tax preparation is available at the Coats Senior Center on Tuesday mornings and at the Erwin Library on Thursday mornings by appointment. Tax preparers will also be available every Wednesday beginning February 7, 2018 from 9:00 am - 3:00 pm on a walk in basis through Wednesday, March 28, 2018 at the Harnett County Public Marketing/Communty Outreach - Debra Harris-Hawkins announced the health department has two upcoming events. The annual Give Kids A Smile program will be held on Saturday, February 3, 2018 from 9:00-1:00 pm. This program provides access to free dental care for uninsured children. The program is a partnership with East Carolina University School of Dental Medicine, Campbell University, Central Carolina and the Harnett County Health Department. The Go Red Lunch and Learn will be held on Wednesday, February 21, 2018, this program is a collaboration with the Harnett Health Hospital which includes an educational session on heart disease and the current heart  Library in Lillington.  health information and recommendations.  Closed Session - There was no need for closed session.  New Business-Vice-Chairwoman Chalmers opened the floor for New Business. Being  none Vice-Chairwoman Chalmers closed New Business. Vice-Chairwoman Chalmers adjourned the meeting.  Respectfully submitted, COLWV John Rouse, Jr. Health Director  yhtina Chelnewl Patricia Chalmers, Chairwoman