Harnett County Board of Health Minutes of Regular Meeting March 14, 2019 The Harnett County Board of Health met in regular session on Thursday, March 14, 2019 in the Health Department Board Room, Harnett County Governmental Complex, Members present: Ms. Patricia Chalmers, Chairwoman, Ms. Judy Herrin, RPH, Vice- Chairwoman, Ms. Amy Allen, RN, Ms. Linda Sturdivant, Ms. Barbara McKoy, Dr. Laura Smith, Ms. Gayle Adams, Dr. Nicholas Pennings, Dr. Catherine Evans and Mr. Other present: Mary Jane Sauls, Oliver Tolksdorf, Debra Harris-Hawkins, Donna 307 W. Cornelius Harnett Blvd., Lillington, North Carolina. John Rouse, Jr., Health Director. Surles, Gail Hobbs, and Natasha Johnson. Chairwoman Chalmers called meeting to order at 7:00 p.m. Announcements - Mr. Rouse reported that Emily Barefoot has accepted to be reappointed for her second term on the Board of Health, her first term expires on May Consent Agenda - Minutes - Motion made by Dr. Nicholas Pennings for the January 17, 2019 minutes to be approved as presented and seconded by Dr. 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. Seeing no one, Chairwoman Chalmers closed the informal comments. FY 2019-2020 Budget Proposal - Mr. Rouse discussed the overall budget proposal and fee schedule for FY 2019-2020 budget. Mr. Rouse reviewed each line item including decreases and increases, and reviewed the programs fee schedule. Mr. Rouse explained the added accounts in the FY 2019-2020 budget. Since the implementation of the county finance system Munis/Tyler, accounts are more detailed. For example in the old HTE: finance system an account would be travel, now in Munis/Tyler the accounts are training-lodging, training-meals, training-mileage and employee expense. Munis/Tyler allows for more tracking capabilities. Mr. Rouse related the overall budget decrease was $1,011,814, the majority is due to carry forward money and state funds for mosquito abatement. Included in the budget is one new proposed position for the Health Department. The position is an 31, 2019. Laura Smith. Motion Carried. Environmental Health Specialist for Food & Lodging. Page 2 Board of Health March 14, 2019 Harnett County Health Department Board Room Mr. Rouse stated we would continue to order our influenza vaccine from Henry Schein Motion made by Ms. Amy Allen to adopt proposed budget FY 2019-2020 which includes the fee schedule as presented and seconded by Ms. Gayle Adams. State of the County Health Report (SOTCHR) - Debra Harris-Hawkins presented a power point on the SOTCHR; it is a requirement for health department with Re- Accreditation and as a part of the Consolidated Agreement with the Division of Public Health. The Health Department provides the report during each of the interim years between the Community Health Assessment (CHA), which was conducted in 2016. The 2018 SOTCH reviews the most recent health statistics, tracks progress made in the last year as it is related to the health priorities, and identifies new initiatives and emerging issues that may impact the health status of residents in Harnett County. The presentation included, the community profile data, including demographics for the county, the mortality data, including the leading causes of death Harnett County's estimated population is 132,754 with a growth rate of 1.42% in the past year according to the most recent United States Census data. Veterans comprise of approximately 14.6 % of the population with approximately 12,870 of the population (2013-2017). Race/Ethnicity Distribution: According to the U.S. Census Bureau, the racial composition of Harnett County residents are predominately White 71.%, African American 21%, and Hispanic/Latino 12.9%. Social determinants of health: Poverty, education level, and housing are three important social determinants ofhealth. These three factors are strongly correlated with individual health. In Harnett, the Persons in Poverty has decreased to 16.4% however about 20 percent higher than the rate in North Carolina: 14.7%. Persons without health insurance under age 65 has decreased to 12.5% slightly lower than the rate for NC 12.6%. The report provided information regarding new initiatives implemented, which included: Hepatitis A Outreach program: North Carolina is one of 16 states experiencing a Hepatitis A outbreak. North Carolina has issued a liberal use policy and has asked for assistance with this outbreak by providing Hepatitis A vaccine to high-risk people. The Health Department collaborated with the Sheriff's Office to implement a jail program by promoting vaccinations, among incarcerated persons. Car Seat Safety: Motor vehicle crashes are the leading cause of death among children ages 2 to 14, due in large part to lack of use or improper use of child seats and seat belts. Through grant funding, provided by Maternal and Child Health Block Grant (Title V funds) the Health Department implemented a child car seat safety program. The goal oft the program is to help decrease infant and child deaths associated with motor vehicle accidents. Health Department staff were trained in the Faithful Families Thriving Communities Curriculum. This program works directly in faith communities toj promote health for individuals, families, and local communities. Medical. Motion Carried. among county residents. Page 3 Board of Health March 14, 2019 Harnett County Health Department Board Room Program facilitators engage each faith community in healthy eating and physical activity education, chronic disease prevention, environmental changes to support health, and community-wide health initiatives. New cold holding temperature, in January 2019 the county began enforcing a new cold holding temperature standard in accordance with the North Carolina Food Code. The new maximum temperature is 41 degrees; at this temperature, food may be kept for seven (7) days before being discarded. This colder temperature allows food to be held for a longer period. Harnett's current priorities include Nutrition & Physical Activity, Maternal Health, Child Health and Motor Vehicle Safety. Two of the three priorities Nutrition & Physical Activity, Maternal Health and Child Health are specifically aligned with the priorities of Healthy NC 2020, while the third priority Motor Vehicle Safety represents a community health concern. Updates including progress made regarding the priorities were presented. Mortality data presented also included the 2017 infant mortality rate. The report provided data on morbidity data for communicable diseases including sexually transmitted infections (STI). Emerging issues identified included HIV Epidemic, Communicable Diseases, Medicaid Transformation, Immunizations, Youth Tobacco Use-E cigarette, and Opioids. Ms. Hawkins stated for the full SOTCH report visit the Health Department's web site located at hamet.or/neatn and copies of the report would be posted on the Health Department's web site for residents to view and placed in the lobby of the health department. A news article with the information will be submitted to the local newspaper. Patient Satisfaction Surveys - Mary Jane Sauls presented a power point with the results of the 2018 Consumer/Communty Satisfaction survey. The survey is completed each year to assess our services and to assist with program planning. The survey was administered December 5th-December 19, 2018. The Board of Health was pleased with the results. Mr. Rouse reported that he had met with the Public Buildings supervisor regarding the cleanliness of the floors and the building, the issue was addressed with the cleaning company. No further recommendations were made. Health Director's Report and Program Reports - Mr. John Rouse, Jr. Medicaid Transformation - Mr. Rouse presented a power point presentation on the current information about the Medicaid transformation. Effective March 1,2019 Community Care of the Sandhills has merged with North Carolina Community Care, the new entity is Community Care Physician Network (CCPN). CCPN will negotiate contracts with the vendors chosen by the State to manage the Medicaid programs, the Health Department signed to be a member oft the CCPN last fall. As of February 2019, the State has selected the following venders: United Healthcare Community Plan, WellCare of North Carolina, Inc., Page 4 Board ofHealth March 14, 2019 Harnett County Health Department Board Room Centene-Carolina Complete Health Network (CCHN) and Blue Cross Blue Shield. Implementation will begin in February 2020 with the exception of New Group Regional 5 will begin in November 2019. Harnett County is in the New Group Regional 5. Medicaid clients will work directly with the vendors when signing up and open enrollment for clients will begin late summer and early fall of2019. Clinical Reports = Donna Surles Child Hcalth/Employee Health clinics continue to see colds and upper respiratory infections, and the number of flu cases have decreased over the past few weeks. Based on the weekly Influenza Surveillance Summary Report, flu cases have been predominately Type A (unknown subtype) and are widespread but have continued to decrease over the past 2 weeks. Our report shows as of weekending March 9, 2019, there have been 135 flu deaths this season, mostly age 65 and over followed by ages 50-64. Last year at this time, there was 276 flu deaths reported. This year's flu season has been milder than the past two We received funding from the State Maternal and Child Health Block Grant that we are using to promote child safety. The Child Health nurses attended training, received certification in car seat safety, and are now scheduling appointments for car seat safety checks and ducating/training parents on proper installation. The Health Department is working with community partners to provide this service at other locations throughout the county. Family Planning/Maternal Health staff are currently working on Title X Training, which is required annually. Title Xi is the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services. The purpose of Title X is to promote positive birth outcomes and healthy families. Women's health also received State funding through the Maternal and Child Health Grant Block, which will allow us to update our clinic rooms and improve services for teens. Our Health Education and women's health staff are also planning to host a Maternal Health Fair in the spring of 2019. Our boys outreach event, "Lace up for Health" which was scheduled for March 9, 2019 has been postponed until August 2019. Annual staff training will be held on April 1, 2019 for all Health Department Women Infant Children (WIC) the State conducted a WIC Program Monitoring event on January 15th though the 17th, The State made some recommendations toi improve the program, which mainly involved staff training. The WIC supervisor has implemented changes and completed the required training with years thus far and we hope it continues. staff. all WIC staff as of February 20, 2019. Page 5 Board of Health March 14, 2019 Harnett County Health Department Board Room Lab the North Carolina Department of Health & Human Services conducted a Clinical Laboratory Improvement Amendments (CLIA) Recertification Survey of the Health Department Lab on March 5, 2019. The survey showed that all CLIA condition-level requirements were met during the onsite survey. The Health Department has a team this year for Relay for Life. The theme this year is board games and our team name is "Connect Four a Cure" with a goal set of $1,000. Our Health Department team has already exceeded the goal with various Environmental Health = Oliver Tolksdorf discussed how onsite wastewater work is still slow due to the amount of wetness in the soil because of the amount of rain. Food & Lodging have been working under the new North Carolina Food Code changes since January and have not had any issues. Since the recent warmer weather, Environmental Health has noticed citizens Aging & Case Management - Mary Jane Sauls reported the 2019 Retired Senior Volunteer Program (RSVP) Senior Fair will be held on Thursday, May 9th, 2019 from 10:00 am to 2:00pm at the Dunn Community Center at 205 Jackson Road in Dunn. The opening ceremonies for the 33rd Annual Mid- Carolina Senior Games will be held April 10, 2019 at Pope Air Field. Marketing/Communty Outreach - Debra Harris-Hawkins reported the Health Department will be partnering with North Carolina Heart and Vascular for a community education session, that will be held on May 1, 2019. Dr. Walker will be conducting a cholesterol education session from 12:00-1:00pm at the Governmental Complex, Commons Area; the program is free and open to the The Health Department will be providing "Eating for Two: Nutrition and Pregnancy" session on Tuesday, March 26, 2019 from :00am-12:00pm at the Governmental Complex, Commons Area. The session will provide demonstrations on how to prepare low-cost, quick, and healthy meal options for expectant mothers. This is a free community health event. Information for upcoming community health sessions and events are posted on the Health fundraising efforts by the staff. coming into the office to receive the mosquito briquetes. public. Department's web site. Page 6 Board of Health March 14, 2019 Harnett County Health Department Board Room Closed Session - There was no need for closed session. none Chairwoman Chalmers closed New Business. Chairwoman Chalmers adjourned the meeting. New Business = Chairwoman Chalmers opened the floor for New Business. Being Respectfully submittéd, COw John Rouse, Jr. Health Director Bisa Gbeso / Patricia Chalmers, Chairwoman