Harnett County Board of Health Minutes of Regular Meeting November 16, 2017  The Harnett County Board of Health met in regular session on Thursday, November 17, 2016 in the Health Department Board Room, Harnett County Governmental Complex, 307 W. Cornelius Harnett Blvd., Lillington, North Carolina. Members present: Dr. Auston "Trey" C. Williams, III, Chairman, Ms. Patricia Chalmers, Vice-Chairwoman, Ms. Emily Barefoot, Mr. C. Tyrus Clayton,Jr., Ms. Judy Herrin, RPH, Ms. Barbara McKoy, Ms. Linda Sturdivant, Dr. Laura Smith, Dr. Others present: Graham Byrd, Debra Harris-Hawkins, Donna Surles, Gail Hobbs,  Nicholas Pennings and Mr. John Rouse, Jr., Health Director. Mary Jane Sauls, Natasha Johnson and Carla Harris.  Chairman Williams called meeting to order at 7:00 p.m.  Annoucements - Mr. Rouse reported Ms. Amy Allen had another meeting to attend tonight and Ms. Gayle Adams was sick. Mr. Rouse related we have two retirees from the Health Department, Graham Byrd and Carla Harris who are. joining tonight's Chairman Williams reported that he and Vice Chairwoman Patricia Chalmers and Ms. Judy Herrin met prior to tonight's meeting and performed Mr. Rouse's annual performance appraisal and reviewed his job description with him. We are not making any recommended changes at this time. Chairman Williams, Vice Chairwoman Patricia Chalmers and Ms. Judy Herrin were trained on the new 2017 Performance Appraisal tool on Monday, November 13, 2017 by Heather Pollard, Director of Harnett County Consent Agenda - Minutes - Motion made by Dr. Nicholas Pennings, for the September 21, 2017 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 - Chairman Williams opened the floor for informal comments by the public, allowing 3 minutes for each presentation up to 30 minutes.  meeting.  Human Resources & Risk Management.  Linda Sturdivant. Motion Carried.  Seeing no one, Chairman Williams closed the informal comments.    Page 2 Board of Health November 16, 2017  Harnett County Health Department Board Room  Retirees - Mr. Rouse introduced the following retirees with the Health Department, Carla Harris, Processing Unit Supervisor V with the Women, Infants & Children (WIC), started November 21, 1988 and retirement date is January 1, 2018 she has twenty- nine years. Graham Byrd, Environmental Health Supervisor I, started May 26, 1987 and retirement date is January 1, 2018 he has thirty years and seven months. Nomination Committee Report = Vice Chairwoman Chalmers submitted on behalf oft the nominating committee that she was nominated as Chairwoman and Ms. Judy Herrin will be nominated as Vice-Chairwoman. The nominating committee submitted no other nominations to the Board. Vice-Chairwoman Chalmers opened the floor for any other nominations. No other nominations were received. Motion made by Dr. Nicholas Pennings asked that nominations be closed and accept the slate of officers as presented, seconded by Ms. Linda Sturdivant. Motion Carried. Meeting Schedule for 2018 - Mr. Rouse provided a copy of the Board of Health meeting schedule for 2018, and reminded the Board the January meeting is scheduled for the fourth Thursday and the March meeting is the second Thursday of the month. Motion by Ms. Patricia Chalmers, Vice-Chairwoman to approve the meeting schedule for 2018 as presented and seconded by Ms. Emily Barefoot. Motion Debt Setoff- Gail Hobbs reported we have received an additional $216.00 since the last Board ofHealth meeting in September. The total amount of Debt Setoff money Accreditation - Mr. Rouse related that our accreditation letter came and we are being recommended for Re-Accreditation. Mr. Rouse reviewed the Site Visitor's Report with aF PowerPoint presentation to the Board. The North Carolina Local Health Department Accreditation (NCLHDA) site visit team was able to designate 140 activities out of 147 Infant Mortality/Chid Fatality Prevention Report - Debra Harris-Hawkins presented the 2017 Infant Mortality Report through PowerPoint presentation. Harnett County data was presented with the total number ofl live births from 2016 which included 1,861, which was a slight increase in comparison from the 2015 data. The number ofi infant deaths included eleven, which was a slight decrease from the previous year which included a total of thirteen deaths. Harnett County's infant mortality rate was 5.9 per 1,000 live births, which was the lowest it has been in sometime. In comparison with the North Carolina rate of7.2 per 1,000 live births. A review of the previous year's infant mortality rate were provided. Areas of concern included women who do not receive prenatal care and the number of women using tobacco during pregnancy. We will continue to monitor and work with outreach efforts  carried.  received year to date is $7,207.93.  met. The Accreditation Board will meet on December 19th.    Page 3 Board of Health November 16, 2017  Harnett County Health Department Board Room  educated 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. The North Carolina 2016 Infant and Child Death report was presented. The number of child deaths in 2016 for Harnett County was a total of 24 deaths, which was an increase in comparison to the previous year with 19 deaths occurring. The largest number of the deaths occurring in the under 1 age group. The leading cause of death was listed as birth defects/perinatal and sudden infant death syndrome (SIDS). The CFPT unites local agencies and individuals such as the Health Department, the Department of Social Services, the District Attorney's office, and the Guardian Ad Litem program, Harnett County Schools and other child advocacy organizations. The CFPT meets quarterly at the Health Department. Board of Health Operating Procedures - Mr. Rouse reviewed the Board of Health Operating Procedures. Changes in the Procedure include the regular meeting hours which are typically held the third Thursday of the month, unless otherwise posted, the March Budget meeting may be held on the first or second Thursday. A tie vote means that the motion fails and when adopting rules, the Board shall follow General Statue 130A-39. For Harnett County Board of Health Public Hearing Procedure, proponents and opponents to the issue before the Board shall each be allowed a maximum of one hour for presentations, a recommendation was made by the Board to change the allowed time to thirty minutes. Revisions will be made to the Operating Procedures  and presented at the January 25, 2018 meeting.  Health Director's Report and Program Reports - John Rouse  Financial Report - Mr. Rouse provided a handout of the first quarter finance report July 2017 through September 2017. 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. The bottom half are the fees that we collect. All program money collected is coming in as expected. The Division on Aging's Community Alternative Program for Disabled Adults (CAP/DA) has received an extension on funds for a Dementia program. Mr. Rouse reported the Employee Clinic saved the county $59,965.00 in the first quarter and remains to be an active clinic among county employees. Mr. Rouse reviewed the Opioid Federal money that states are receiving to assist with the Opioid Prevention Programs, stating that the guidelines involved are being followed already in North Carolina and each of the fifty states will receive  $1,000 in funds.    Page 4 Board of Health November 16, 2017  Harnett County Health Department Board Room  Clinical Reports - Donna Surles related that the numbers are based on the Child Health (CH) visits are at their usual this time of the year. Well visits tend to decrease after the back to school rush in August and September. Sick visits will start to increase as cold and flu season begins. Our welcome baby and postpartum home visiting programs continue to serve families through physical assessments, referrals, follow up appointments, information and community resources. CH lead visiting nurse also helped conduct flu clinics throughout the Employee Clinic numbers include those employees who were seen for flu shots as well as the episodic clinic. Our county employees continue to provide positive Immunization numbers were significantly higher in September and October due to our community flu clinics and back to school vaccine requirements. We are out of adult flu vaccine with nearly 1,400 adult doses given. That total does not include infant and children's flu given. We still have a small amount of children's flu vaccine remaining. Through the Employee's Benefit Fair and other county offices we have given 253 flu shots to county employees in the month of Family Planning (FP) clinic numbers have decreased slightly due to a provider position that was vacated by Rebecca Unger, Physician Extender II. Next week we will be interviewing for that position and we hope to have it filled shortly. The CH providers have been working together to help cover the FP clinic until the vacant position is filled. Last week we received the Intrauterine devices (IUD) shipment of Mirena which is a long acting reversible contraceptive (LARC)  Activities Summary Report for September and October.  county.  feedback from services they receive in the clinic.  October.  good for five years. We will be offering two types ofLARC's.  Prenatal (PNC) continues to be busy clinic. In efforts to improve birth outcomes we continue to work hard to get our prenatal patients in during their first trimester. In an effort to decrease the infant mortality rate and improve birth outcomes, therefore we encourage our patients to keep prenatal appointments, avoid smoking during pregnancy and seek dental care when needed. We partner with the state and East Carolina University Dental School toj provide dental care to pregnant women. Participation is on a voluntary basis and a state dental hygienist is available three days a week providing screenings toj patients while they are here for their prenatal care. The hygienist also works  as a care manager to arrange dental care as needed.    Page 5 Board of Health November 16, 2017  Harnett County Health Department Board Room  Sexually Transmitted Disease (STD) continues to see patients Monday through Friday with the STD Enhanced Role Nurse. Tammy Smith, Registered Nurse (RN) will complete Enhanced Role training next week, which will allow us to offer more STD appointments. We continue to offer urine nucleic acid amplification test (NAAT) for chlamydia on asymptomatic male patients. We hope this will help to decrease the number of females who test positive for Flu Reports that we have received from the Centers for Disease Control (CDC) and Department of Public Health DPHI-CommunicaDe Disease Branch show that the number of hospital admissions for fever and acute respiratory infections continue to increase over the past few weeks. There have been three Influenza associated deaths in North Carolina this season which began October 1,2017. The reported deaths were adult cases. Most of the reported flu case have been Type A. We typically see more Type A early in the season. Itis encouraged for everyone six months and older to get the influenza vaccine. Staff Training was held on October 2, 2017 and is held annually. On Target Preparedness conducted Emergency Shelter Training for all staff. We have formed a Privacy Workgroup who is working to update our Health Insurance Portability and Accountablity (HIPAA) Privacy and Security Policies. The North Carolina Public Health HIPAA Alliance is working with each health department Environmental Health Graham Byrd reported that on site wastewater has had an increase in repairs due to system age and maintenance on septic systems. The state recommendation is maintenance every three to five years. Food and Lodging are fully staffed and remaining busy this time of the year due Aging & Case Management - Mary Jane Sauls stated that Annual Medicare Open Enrollment period started on October 15th and runs through December 7th. The Medicare counselors are assisting beneficiaries with enrollment, making changes to their prescription drug plans and assisting clients that are new to Medicare. A Saturday Medicare clinic and evening clinic was held in October. In addition, assistance was provided throughout the county in a variety of1 locations to include, Betsy Johnson Hospital, Dunn Dialysis Center and the Anderson Creek Senior Center. Currently all appointments are booked and we are providing the Raleigh Seniors Health Insurance Information Program (SHIIP) Office and the main Medicare number to beneficiaries for assistance. During the time of October 15- October 31, 2017 the Division on Aging served 237 Medicare beneficiaries and helped save $264,384.00.  chlamydia.  to use best practices for improving privacy policies.  toe events changing with the seasons.    Page 6 Board of Health November 16, 2017  Harnett County Health Department Board Room  The health department will be conducing our annual Patient/Consumer and Community Survey in December. The data will be used as a guide to improve or change the health department services as deemed necessary. Upcoming Events - Debra Harris-Hawkins presented the "Maintain, Don't Gain Holiday Challenge", rather than focusing on trying to lose weight this free six week program provides participants with education on nutrition and fitness tips and ideas to help maintain your weight throughout the holiday season. There will be two sites in the community, one in Erwin and one at the new site, Boone Trail Community Center. The health department, Cooperative Extension and the Harnett County Employee Wellness Committee will be providing the Recognition - Dr. Auston "Trey" C. Williams, III, Chairman was recognized by the members of the Harnett County Board for his years of service and leadership. Dr. Williams was appointed for his first term in January 2009 and served a total of three terms as a member of the Board of Health.  program for county employees as well.  Closed Session = There was no need for closed session.  New Business - Chairman Williams opened the floor for New Business.  Being non Chairman Williams closed New Business. Chairman Williams adjourned the meeting.  Respectfully submitted, Couh John Rouse, Jr. Health Director  Cahica Chhsu Dr. Auston "Trey"C. Williams, III, Chairman