Harnett County Board of Health Minutes of Regular Meeting January 20, 2022  The Harnett County Board of Health met in regular session on Thursday, January 20, 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 January 20, 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. Barbara McKoy, Ms. Linda Members present: Dr. Laura Smith, Chairwoman, and Mr. John Rouse, Jr., Health Others present: Oliver Tolksdorf, Ainsley Johnson, Natasha Johnson and Gail Hobbs.  practices.  Sturdivant, Ms. Gayle Adams and Ms. Emily Barefoot.  Director.  Chairwoman Smith called meeting to order at 7:00 p.m.  Announcements - Mr. Rouse announced Debra Harris-Hawkins and Mary Jane Sauls are unable to attend tonight's meeting and he will address their departmental reports. Consent Agenda - Minutes Motion made by Dr. Catherine Evans, DDS, for the November 18, 2021 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 Vice-Chairwoman Allen opened the floor for informal comments by the public, allowing 3 minutes for each presentation up to 30 minutes. Hearing no one, Vice-Chairwoman Allen closed the informal comments. Recommendation to Establish Fees: Gail Hobbs presented the following fees for new  Barbara McKoy. Motion Carried.  fees or to established fees: CPT CODE 86328 90697  DESCRIPTION COVID-19 Antibody Rapid Testing  RECOMMENDED PRICE  $45.23 $140.00  $9.75 $121.88  Vaxelis    Page 2 Board of Health January 20, 2022  Harnett County Health Department Board Room  Vaxelis is a combination vaccine (Diphtheria, Tetanus, Pertussis, Polio, Hep B and HIB) to decrease the number of shots children get per visit. Itis approved for use as a Motion to approve the new fees from Ms. Emily Barefoot and seconded by Dr. COVID-19 Updates - Mr. Rouse discussed the emergence of the new COVID-19 variant and the holiday season Harnett County has seen a surge in cases. Our total historical COVID-19 cases in the county as of January 19, 2022 are 23,733 with 288 deaths reported. Harnett County's case count reflects confirmed cases that have been acknowledged in NCCOVID by our staff. Staff are continually working to ensure cases are acknowledged in NCCOVID and case faxes are accounted for. Cases have increased since December 2021, and the trends are as follows: November 2021 reported 621 cases, December 2021 had 1,216 cases, and January 2022 had 2,918 cases. The last COVID-19 reported confirmed death was on January 17,2022. Currently Harnett County has 11 active outbreaks or clusters, and 8 outbreaks are in skilled or assisted nursing facilities, 1 is with an educational institution, and 2 are with a correctional facility. We continue to perform case investigations utilizing Health Department staff and contract Community Care of North Carolina (CCNC) staff, and we utilize North Carolina Department of Health and Human Services (NCDHHS) prioritization guidance in interviewing cases. The Health Department continues to work closely with facilities and institutions involved in outbreaks and clusters to decrease spread and monitor associated cases. COVID-19 testing demand has far exceeded supply in the county and the state. Testing numbers have increased in the county and last week was an estimated 5,500 COVID-19 tests performed in Harnett County. The positivity rate for testing has increased from 5.1 % the week of December 3, 2021 to 31.2% the week of. January 14, 2022. The Health Department provides rapid antigen testing clinics in the Governmental Complex-Commons Area. On January 7, 2022, we performed our mass testing as a drive thru in the employee parking lot with 180 people tested. The week of January 10, 2022, the Health Department depleted our supply of rapid antigen tests, and we are working with NCDHHS to replenish our supplies to resume mass testing sites and provide outbreak testing. A shipment was received today of the rapid antigen tests from NCDHHS. The Health Department's pediatric and employee clinic continue to COVID-19 test daily. In December 2021 and January 2022, 1,625 people were tested at Health Department sites. We continue to collaborate with Optum Serve to offer two testing site locations in  3-dose series in children 6 weeks thru 4 years of age.  Kim Fowler, PhD. Motion Carried.  the county; one is located in Lillington and one located in Dunn.    Page 3 Board of Health January 20, 2022  Harnett County Health Department Board Room  Mr. Rouse discussed the monoclonal antibodies (mAbs) treatment of COVID-19 clinic managed by the NCDHHS and FEMA that was located in Lillington closed November 2021 due to recent studies that the treatment was not working for the COVID-19 Omicron variant. The state received 600 packets of the COVID-19 pills to distribute throughout the entire state, it is only available by prescription. Mr. Rouse will continue to send a weekly COVID-19 report to Board of Health members. Health Director's Report and Program Reports - Mr. John Rouse, Jr.  Accreditation - Mr. Rouse stated Dr. Laura Smith, Chairwoman signed a letter for Accreditation that the Board did not have any adjudications for 2020-2021; The Board of Health has done an evaluation and feels no new or amended rules or ordinances are needed since 2021, and will continue to monitor. Legal Counsel - Mr. Rouse informed the Board that the county has attorneys and that the Board of Health has access to legal counsel. Harnett County Staff Attorneys, Christopher Appel and Thomas Royer are accessible to the Board and Health Department for any legal issues, and is readily available to our COVID-19 Rate Increases Expirations - Mr. Rouse reviewed the 5% and 40% rate increase expired on December 31, 2021. The fee schedule has been updated to reflect this change. The original recommendation to increase fees to reflect 40% increase due to the North Carolina (NC) Division of Medical Assistance (DMA) Medicaid Reimbursement Rates for Health Departments Financial Report - Mr. Rouse provided a handout of the second quarter's finance report for July 2021 through December 2021. Finance will begin to review the six-month budget with supervisors soon, and start working on the 2022-2023 budget. The revenues for federal and state contract money is coming in as expected. Aging revenues are coming in appropriately at this time also. Aging FY 2021-22 COVID-19 funds are $117,389 and are being used for the Nutrition program, providing meals for the Meals on Wheels Program. The Health Department FY 2021-22 COVID-19 funds are $2,033,776 and will be used for the following: to install handicap accessible doors at the front entrance of the Health Department and the Commons, installing a negative pressure room in the Adult Health clinic for Communicable Diseases, and hiringa contract Registered Nurse to assist Harnett County school nurses and assist with the COVID-19 vaccines. Revenue for the Family Planning and Prenatal programs have decreased due to more patients currently eligible for the 0%  department on an as needed basis.  during the pandemic.    Page 4 Board of Health January 20, 2022  Harnett County Health Department Board Room  sliding fee scale, staff will continue to monitor. The state has formed a Medicaid Transformation workgroup to monitor any issues with the process of Medicaid Transformation, such as claim denials and providers receiving payments. Mr. Rouse reported the Employee Clinic saved the county $75,312.00 in the first quarter and $81,361.00 in the second quarter for a total of$156,673.00. Mr. Rouse would like to thank Ms. Barbara McKoy, County Commissioners and Interim County Manager George Wood for approval of the Job Classification and Compensation Plan, which is part of the FY 2022 Budget. Under the plan all county positions will be reclassified (that were not included in a previous reclassifications) up two grades and move the salaries in these positions to the  same place in the new grade effective January 16, 2022.  Clinical Report = Ainsley Johnson  COVID-19 Vaccinations - COVID- 19 vaccinations continue to be available every day of the week in the Health Department clinics and weekly at the mass site in the Governmental Complex-Commons Area. Total COVID-19 vaccinations given to date are 28,881 doses; this includes first, second, third and booster doses. We continue to transfer to vaccinating providers in the county and have transferred approximately 30,285 doses to community partners to increase vaccinations in the county. Currently we are administering all three brands of COVID-19 vaccine Moderna, Pfizer and Johnson & Johnson's Janssen. The Health Department continues to educate the public and encourage COVID-19 vaccinations to everyone who is eligible. Child Health - Child Health (CH) remains steady with sick visits and COVID-19 testing. In December 2021, visits increased to 179. There has been an increase in COVID-19 and flu cases in the CH clinic. CH continues to provide car safety seat assessments and education one day per week by appointment. Employee Clinic - County Employees continue to utilize the employee clinic and this clinic has been very busy for the last two months. Their visits have Adult Health - Family planning (FP), Sexually Transmitted Disease (STD) and Prenatal (PNC) clinics are continuing to do well. There was a slight decrease in PNC due to prenatal visits across the state being lower during December 2021; however, visits have increased for January 2022. Communicable Disease (CD) cases have increased in the last two months. Currently the Health Department has one active tuberculosis case in the county. STD cases have increased including syphilis cases. We continue to work with the North Carolina CD Branch to investigate cases, provide assessments, express visits, and rapid  increased to 151 visits in December 2021.    Page 5 Board of Health January 20, 2022  Harnett County Health Department Board Room  treatments. The Health Department operates STD clinic five days per week and the ability to perform express STD visits. In the Adult Health general clinic, COVID-19 vaccinations, flu vaccinations, and all other needed immunizations Laboratory - Laboratory clients have remained steady with 644 clients for the month of December 2021, and lab staff have assisted with COVID-19 testing at Flu Update - The Health Department continues to administer flu vaccines in our. Adult Health and Child Health clinics. Flu vaccines are 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 available at no charge for uninsured individuals. The state Respiratory Surveillance Report released on January 20, 2022, showed influenza like illness has decreased the week ending January 15, 2022. The geographic spread of flu remains to be widespread, and Influenza A accounted for the majority of the cases; this is also  are offered.  the Governmental Complex-Commons Area.  the case worldwide.  Environmental Health = Oliver Tolksdorf reported a projected increase in revenues for both Onsite Wastewater and Food & Lodging sections due to the increase in construction of homes and businesses opening in Harnett County. Mr. Rouse reported the Onsite Wastewater staff has received one new county vehicle and will still receive three additional vehicles that was included in the FY 2021-22 Budget; however, the manufacturing has been delayed due to Aging & Case Management - Mr. Rouse reported the 2021 Medicare Open Enrollment Period ended on December 7, 2021. Open Enrollment with Medicare runs October 15th. - December 07th every year. This is the busiest time of year for Medicare Counselors and Volunteers nationwide serving in the Medicare Program. Volunteers with the Harnett County Medicare and Seniors' Health Insurance Information Program (SHIIP) served 556 Medicare Beneficiaries with ac combined savings of $684,702.00 for this reporting period. There were three Aging staff and one retired Aging staff providing Medicare counseling during this open enrollment period along with two Medicare Volunteers. As the North Carolina Department of Insurance closes out the open enrollment period reporting the end of January 2022, these numbers may be higher as Harnett  COVID-19.    Page 6 Board of Health January 20, 2022  Harnett County Health Department Board Room  County residents served through the call center with the NC Dept. of Insurance The North Carolina Economic Tax Assistance Program, formerly known as Volunteer Tax Assistance Program (VITA) is now making appointments to prepare income taxes free of charge for seniors and the disabled in Harnett County. There are currently six volunteers helping with the program. Taxes will be prepared at two Harnett County locations. On Tuesdays, beginning, January 25, 2022, volunteers will be available at the Coats Senior Center and on Wednesdays and Thursdays beginning January 26, 2022, volunteers will be working at the Erwin Library. These sites require appointments that are made through the Harnett County Division on Aging and the Coats Senior Center. Due to COVID-19, tax returns will be handled on a drop off basis with a return appointment for pick up given the following week. Students from the Campbell University School of Business will be helping prepare simple income taxes every Wednesday beginning February 9, 2022 from 11:00am - 4:30pm at the Harnett County Resource Center Library in the training room on the first floor, and no Marketing/Communy Outreach - Mr. Rouse presented the Prevent Type 2 Diabetes Program, this is part of our Regional collaboration with Moore County First-Health for the Prevent Type 2 Diabetes. The previous session was postponed and the new start date for the sessions are every Tuesday beginning, February 15, 2022 from 5:30pm-6:30pm at the Governmental Complex-  will be included in Harnett County's outcomes.  appointment is necessary.  Commons Area. This is a yearlong program.  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.    Page 7 Board of Health January 20, 2022  Harnett County Health Department Board Room  Chairwoman Smith adjourned the meeting.  Respectfully submitted,  John Rouse, Jr. Health Director  Dr.  gb