Harnett County Board of Health Minutes of Regular Meeting November 18, 2021  The Harnett County Board of Health met in regular session on Thursday, November 18, 2021 in the Health Department Board Room, Harnett County Governmental Complex, 307 W. Cornelius Harnett Blvd., Lillington, North Carolina. A virtual Board ofHealth meeting using audio conference call was held for the November 18, 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 attended. As the Board demonstrated compliance with Members present by conference call: Dr. Amanda Langdon, DVM, Ms. Stacie Hogan, RPH, Ms. Gayle Adams, Dr. Kim Fowler, PhD, and Ms. Barbara McKoy. Members present: Ms. Amy. Allen, RN, Vice-Chairwoman, and Mr. John Rouse, Jr., Others present: Mary Jane Sauls, Oliver Tolksdorf, Debra Harris-Hawkins, Ainsley  prudent public health practices.  Health Director.  Johnson, Natasha Johnson and Gail Hobbs.  Vice-Chairwoman Allen called meeting to order at 7:00 p.m.  Announcements Vice-Chairwoman Allen reported that she and Chairwoman Dr. Laura Smith met on November 16, 2021 and performed Mr. Rouse's annual performance evaluation and reviewed his job description. A copy of Mr. Rouse's job description was emailed to the Board members for review, and the Board are not recommending any changes at this time. Mr. Rouse reported Dr. Laura Smith, Chairwoman, and Dr. Catherine Evans, DDS would not be present tonight. Ms. Amy Allen, RN, Vice-Chairwoman will be conducting the meeting tonight. Mr. Rouse announced that Ainsley Johnson has been recognized as the North Carolina Public Health Association (NCPHA) Nursing Section's Direct Service Award recipient at the NCPHA Nursing Section annual meeting held on November 9, 2021. One recipient of the Direct Service Award is recognized each year from the NCPHA Nursing section. The award is presented to a North Carolina Public Health Nurse with at least 3 years of Public Health experience, and spends at least 50% of their time in direct care. Mr. Consent Agenda - Minutes Motion made by Ms. Barbara McKoy, for the September 16, 2021 agenda and minutes to be approved and seconded by Dr.  Rouse congratulated Ainsley on the award.  Kim Fowler, PhD. Motion Carried.    Page 2 Board of] Health November 18, 2021  Harnett County Health Department Board Room  Consider additions and deletions to the published agenda - Vice-Chairwoman Allen called for additions and deletions to the published agenda. Mr. Rouse announced that item 10 for 2021 Infant Mortality Report is not available and has not been released from the state, and item 10 will be replaced and add Establish Fees, an Public Comment - Period of up to 30 minutes for informal comments allowing 3 minutes for each presentation - Vice-Chairwoman Allen opened the floor for informal comments by the public, allowing 3 minutes for each presentation up to 30 minutes. Seeing no one, Vice-Chairwoman Allen closed the informal comments. Nomination Committee Report - Vice-Chairwoman Allen asked Mr. John Rouse to give the Nomination Report. Mr. John Rouse Jr. 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. Vice-Chairwoman Allen opened the floor for any other nominations. No other nominations were received. Ms. Gayle Adams, asked that nominations be closed and accept the slate of officers as presented, seconded by Meeting Schedule for 2022 - Mr. Rouse provided a copy of the Board of Health meeting schedule for 2022, and reminded the Board the March meeting is the first Thursday of the month and all other meetings are scheduled for the third Thursday. Debt Setoff - Gail Hobbs reported we have received an additional $344.46 since the last Board of Health meeting in September. The total amount of Debt Setoff money Bad Debt Write - Offs = Gail Hobbs requested to write-off $3,856.49 through June  action item.  Dr. Kim Fowler, PhD. Motion carried.  received for this calendar year is $5,498.79. 30, 2019 for program services as follows: Maternal ealth/Prenatal Adult Health Family Planning Child Health Tuberculosis STD Total:  $718.77 $735.22 $694.16 $1,532.92 $151.42 $24.00 $3,856.49    Page 3 Board of Health November 18, 2021  Harnett County Health Department Board Room  Motion by Dr. Kim Fowler, PhD., to write off $3,856.49 as presented, seconded Recommendation to Establish Fees: Gail Hobbs presented the following fees for new  by Dr. Amanda Langdon, DVM. Motion Carried.  fees or to established fees: CPT CODE 90674 90686 90694  DESCRIPTION Flucelvax Quad 4> Single Dose  RECOMMENDED PRICE $30.00 (old rate $30.59) $21.00 (old rate $23.59) new: fee $67.00  Fluzone QIV Fluad QIV65+  Motion to approve the established fees and new fee from Dr. Kim Fowler, PhD.  and seconded by Ms. Gayle Adams. Motion Carried.  Health Director's Report and Program Reports - Mr. John Rouse, Jr.  COVID-19 Updates - Ainsley Johnson announced the most recent total of COVID-19 cases in Harnett County, with 18,966 confirmed cases and 267 deaths reported. Cases have begun to decrease since October 2021.In September 2021, 2,416 cases were reported, October 2021 had 1,125 cases, and currently for November 2021 with 366 cases. The most recent COVID-19 reported confirmed death was on November 4, 2021. The most deaths reported was in the month of September 2021 with 36 people dying of COVID-19 related complications. Currently the county has four active outbreaks/Clusters, with two in long-term care facilities and two are linked to educational facilities. The Health Department continues to perform case investigations utilizing staff and contract Community Care of North Carolina (CCNC) staff, and continue to work closely with facilities and institutions involved in outbreaks and clusters to decrease spread and monitor associated cases. The Health Department continues to provide rapid antigen testing clinics in the Commons area. Rapid antigen testing is every Monday and Friday from 9am to 1lam, and we continue to collaborate with Optum Serve to offer two testing sites which are located in COVID- 19 vaccinations are available each week day in the Health Department clinics and weekly at the mass site in the Commons area. The total COVID-19 vaccinations given to date are 27,475 doses, and this includes first, second, and  Lillington and Dunn.  booster doses. The Health Department has    Page 4 Board of Health November 18, 2021  Harnett County Health Department Board Room  transferred approximately 27,199 doses to community partners to increase vaccinations in the county. The Health Department administers all three brands of COVID-19 vaccine Moderna, Pfizer and Johnson & Johnson's Janssen. We are administering to third dose mRNA vaccines for those people that are moderately/severely immunocompromises, booster doses of Pfizer, Moderna, and Janssen vaccine to those who meet the indication for a booster dose, and Pfizer vaccine for children ages 5-11 years old. COVID-19 vaccines for children are administered in the Child Health clinic and they have a dedicated day for pediatric Pfizer vaccination. The COVID-19 vaccine numbers have increased due to the demand for COVID-19 boosters, we have vaccinated 1,197 people since November 3, 2021. Forty-five percent of Harnett County residents Financial Report = Mr. Rouse provided a handout of the First Quarter finance report July 2021 through September 2021. Mr. Rouse explained the expenditure and revenue summary with state and federal money that comes in by programs, and the expenditure summary shows program expenditures through September 30, 2021. Staff have continued to monitor their expenditures within the departments. The Health Department has $1,702,074 available in COVID-19 funds. With those funds, the Health Department is looking into installing a negative pressure room for communicable disease. The Health Department should be receiving the 2020 Medicaid Cost Settlement  over age 12 have been vaccinated.  funds soon.  Clinical Report - Ainsley Johnson  Child Health- Child Health is continuing to provide well child physicals and immunizations. Child Health staff hosted a car seat safety check event on Friday October 1, 2021, the event was very successful with 15 car safety seat checks were preformed, and nine new car seats were installed. Immunization numbers have greatly increased since September 2021, with 1,163 visits for all  clinics.  Employee Clinic - County Employees continue to utilize the clinic for acute care visits and immunizations. Employee clinic visits are steady at 138 visits for October 2021. The Health Department works with county departments to vaccinate all eligible employees with COVID-19 booster doses.    Page 5 Board of Health November 18, 2021  Harnett County Health Department Board Room  Adult Health - Family Planning, Sexually Transmitted Disease (STD) and Prenatal clinics continue to see a steady flow of patients. Family planning visits have increased to 137 for October 2021. We continue to provide COVID-19 and Syphilis - The Health Department's Communicable Disease team continue to focus on syphilis cases. Syphilis infections have increased in the county and in the state ofl North Carolina. The North Carolina Department of Health and Human Services (NCDHHS) issued a Public Health Advisory on November 15, 2021. The Advisory reports that syphilis infections have increased by 32% between January 2021 and October of 2021 compared to the 2018-2020 average for the same period. There was a 29% increase in men and a 46% increase in women. The increase in syphilis infections among women has also been associated with an increase in congenital syphilis infections. The current case count in Harnett County year to date is 41 confirmed syphilis cases. Compared to 17 cases for 2020, and 22 cases for 2019. The Health Department continues to work with Disease Intervention Specialists (DIS) to investigate, identify contacts and treat all cases in our county. We also continue to educate all patients on safe practices. This public health advisory has been Lab - Laboratory patients have remained steady with 604 clients in October 2021. The lab staff have participated in community outreach events with the Health Education. They assisted in HIV and syphilis testing at the City Barbershop on November 9, 2021 and plan to attend another event for testing Flu Update - The Health Department continues to administer flu vaccines in our Adult and Child Health clinics. Flu vaccine is available for all ages- including high dose flu for age 65 and older. We have also vaccinated 1,093 people through our flu community outreach, provided vaccines at senior's nutrition sites, schools, local businesses, and assisted living facilities. The Health Department held a drive thru flu vaccination event on October 4, 2021  flu vaccinations daily in the Adult Health clinic.  sent to all medical providers in the county.  in the coming weeks.  from 2:00-6:00pm and 100 people were vaccinated.    Page 6 Board of Health November 18, 2021  Harnett County Health Department Board Room  Environmental Health - Oliver Tolksdorf reported on the adoption of the U.S. Food and Drug Administration's 2017 Food Code effective October 1, 2021. Some of the main changes made are the cook temperatures and times of foods, clean-up of vomiting and diarrheal events, Salmonella (nontyphoidal) has been added to the Reportable Diagnosis (Big 6 Diseases) and a written emergency Aging & Case Management Mary Jane Sauls announced a Caregiver Appreciation drive-thru was held on November 18, 2021 at the Division on Aging. In recognition of their hard work and dedication in taking care of their loved one, a lunch from Cracker Barrel and an appreciation gift was given to each Caregiver. The Liberty Baptists MOMs group will be sponsoring a Christmas lunch for the Grandparents Raising Grandchildren program on Monday, December 13, 2021 at 1lam at the Lockamy Plantation. This year the Division on Aging started taking appointments for Medicare open enrollment on October 1, 2021 and most appointments were completely full by November 1, 2021. At that time the toll free number to the call center in Raleigh was given out to clients sO the North Carolina Department of Insurance (NCDOI) could assist beneficiaries. During the Medicare open enrollment period October 15 - October 31, 2021 Harnett County served 182 Medicare Beneficiaries with a combined savings of $383,118. The department utilized four Medicare Counselors and Barbara Pope, the South Eastern Regional Specialist with Marketing/Communty Outreach - Debra Harris-Hawkins presented the Health Education Division have a couple of community health and education events scheduled in the coming weeks. Prevent T2 is a lifestyle change program designed to help people who are pre-diabetic reduce their risk for developing type 2 diabetes, the most common type of diabetes. The program focuses on dietary changes, increased physical activity and behavior change strategies. Prevent T2 is a Centers for Disease Control and Prevention (CDC)-recognized lifestyle change program. We do have staff specially trained toi implement and lead the program. This program is a partnership with First Health, in Moore County. The program begins January 4, 2022 from 5:30-6:30pm, the group meet for a year with weekly meetings. From the 2019 Community Health Assessment (CHA) and included in the Community Health Improvement Plans (CHIPs) Diabetes was identified as a concern among residents. For more information regarding the Prevent T2, contact the Health Education Division.  operating plan has to be approved.  NCDOI.    Page 7 Board of Health November 18, 2021  Harnett County Health Department Board Room  The Health Education Division will be sponsoring "The Holiday Challenge" and inviting residents to join the annual Eat Smart, Move More, Maintain, Don't gain! Holiday Challenge. Rather than focusing on trying to lose weight, this free seven-week challenge provides strategies and resources to help maintain your weight throughout the holiday season. The Holiday Challenge begins November 22, 2021 thru January 3, 2022. Residents can register online from our web site; we have approximately 65 persons registered to participate. The session will be provided via zoom and materials provided via email. For more information regarding the Holiday Challenge, contact the Health Education Division.  Closed Session - There was no: need for closed session. none Vice-Chairwoman Allen closed New Business. Vice-Chairwoman Allen adjourned the meeting.  New Business - Vice-Chairwoman Allen opened the floor for New Business. Being  Respectfully submitted, CDV wy John Rouse, Jr. Health Director  Amy Ailen,  &