Harnett County Board of Health Minutes of Regular Meeting March 7, 2024  The Harnett County Board of Health met in regular session on Thursday, March 7, 2024 in the Health Department Board Room, Harnett County Governmental Complex, Members present: Dr. Laura Smith, OD, Chairwoman, Ms. Emily Barefoot, Commissioner Barbara McKoy, Dr. Amanda Langdon, DVM, Dr. Kim Fowler, PhD, Dr. Brandon Washington, DDS, Ms. Amy Allen, Ms. Staci Hogan, RPH, Ms. Linda Sturdivant, Dr. Catherine Evans, DDS, Dr. Lori Langdon, M.D. and Debra Harris- Other present: Mary Jane Sauls, Oliver Tolksdorf, Ainsley Johnson, Gail Hobbs, and  307 W. Cornelius Harnett Blvd., Lillington, North Carolina.  Hawkins, Interim Health Director.  Natasha Johnson.  Chairwoman Smith called meeting to order at 7:00 p.m.  Announcements - Ms. Hawkins announced Dr. Catherine Evans, DDS, was re- appointed her third term by the Board of Commissioners on March 4, 2024. Dr. Kim Fowler, PhD, reported to the board, the interview team is in the process of interviewing candidates for the Health Director position and a candidate will be selected by next Consent Agenda - Minutes - Motion made by Commissioner Barbara McKoy, for the January 18, 2024 agenda and minutes to be approved and seconded by Dr. Consider additions and deletions to the published agenda = None made.  week.  Lori Langdon, M.D. Motion Carried.  Public Comment - Period of up to 30 minutes for informal comments allowing 3 minutes for each presentation - Chairwoman Smith opened the floor for informal comments by the public, allowing 3 minutes for each presentation up to 30 minutes. Debt Setoff - Gail Hobbs reported that since the last meeting, the Debt Setoff program FY 2024-2025 Budget Proposal - Gail Hobbs discussed the overall budget proposal and fee schedule for FY 2024-2025 budget. In regards to the Employee Clinic we have requested one increase and asking for additional funding in medical supplies. These funds will be used to purchase COVID-19 testing units; on May 31, 2024, funding that originally paid for purchasing test kits will no longer be available. We have maintained the request for non-cap asset-large equipment; these funds will be used to purchase a  Seeing no one, Chairwoman Smith closed the informal comments. has collected $469.22 and the collection year to date total is $469.22.    Page 2 Board of Health March 7, 2024  Harnett County Health Department Board Room  CBC machine if needed since the current machine is dated. Each department reviewed their equipment needs for the upcoming fiscal year. The Aging budget shows an overall increase due to our Information Technology (IT) Department allocating shared costs to all departments within the county. This allows for a better picture of funding needs each department needs to operate. The only increase we are requesting for is additional funds in our Retired Senior Volunteer Program (RSVP) program to offer an appreciation breakfast for the RSVP volunteers. Some changes to the budget include adding a Medicare Improvement for Patients and Providers Act (MIPPA) budget; MIPPA is a part of the Senior Health Insurance Information Program (SHIIP). To receive the funds for MIPPA we are required to submit a budget when applying for these grant funds, this allows us to better track the specific expenses for MIPPA. Nutrition ARPA and Aging ARPA budgets have been added. These special multi-year COVID-19 funds have been budgeted for the last three years (Nutrition ARPA) and two years (Aging ARPA). Typically, these funds have been budgeted after the start of the fiscal year when we know the amount remaining. Since the funds are set to expire on December 31, 2024, we budgeted a portion of funds to be available to spend when the new year starts. The Jack Wells trust has been added to the budget this year, these funds are a For the Health budget, we are requesting an overall estimated $245,000 additional funds from the county. A portion of this increase is the breakout of sottware/nardware expenses from the IT department for $122,000; leaving Health requesting an estimated $123,000. This request is in part due to reductions in federal funding in several of our programs; Women, Infants & Children (WIC) being the largest reduction at $103,584 due to the WIC wavier ending. WIC budgets were reduced a total of $42,893 to offset this reduction. During COVID-19 the WIC program was allocated funding based on active participants would receive benefits regardless of fulfilling mandatory appointments. This waiver ended on July 31, 2023 and the 2024-2025 WIC allocation was based on the number of active participants for a 3-month period shortly after this We are requesting additional funding for several programs because of increased costs ofv vaccines. We are now: required to purchase COVID-19 vaccines that were provided by the state at no charge previously. RSV vaccines will be offered this year, which also will incur additional costs. Health has added several new programs that were not included in the last budget. The mobile health program was added because we could accurately track expenses related to the mobile health unit. Most of the funds requested are taken from other programs; Human Resources and Fleet have added expenses for insurance, repairs and maintenance. The budget includes two expansion items. One expansion is for a 5% salary adjustment for two Environmental Health Specialists whose duties now include lead roles in the Food & Lodging section. The second expansion item is for two additional positions in Environmental Health; this  bequest from an estate to support the nutrition program.  resulting in lower federal funding.  request is due to the increase of growth in the county.    Page 3 Board of Health March 7, 2024  Harnett County Health Department Board Room  Ms. Hobbs requested that we be allowed to purchase influenza vaccine using one vendor for adults. Henry Schein continues to be the Health Department's vendor for flu vaccine, the Health Department pre-books before March with Henry Schein sO that we are guaranteed the influenza vaccine. Ms. Hobbs announced the fee schedule including Clinical and Environmental Health fees have been reviewed during the annual budget process. The recommended fee increases were included in the Board of Motion made by Dr. Kim Fowler, PhD, to adopt proposed budget FY 2024-2025 which includes the fee schedule as presented and seconded by Dr. Amanda  Health packet for review and approval.  Langdon, DVM, Motion Carried.  Health Director's Report and Program Reports - Debra Harris-Hawkins  Clinical Report- Ainsley Johnson  Respiratory Virus Update - Centers for Disease Control and Prevention (CDC) has released updated COVID-19 guidance for the community as of March 1, 2024. This updated guidance streamlines actions for the respiratory viral illnesses, including COVID-19, Flu, and RSV. The new guidance is below. Stay home and away from others. Symptoms of a: respiratory virus may include fever, chills, fatigue, cough, runny nose, and headache, among You can go back to your normal activities when, for at least 24 hours, both  others. are true:  Your symptoms are getting better overall, and You have not had a fever (and are not using fever-reducing When you return to your normal activities, take added precaution over the  medication). next 5 days, such as Enhancing hygiene practices Wearing a well-fitting mask actions to prevent spread to others.  Keeping a distance from others, and/or getting testing to inform your  *Ify you develop a fever or start to feel worse after you have gone back to normal activities, stay home and away from others again, for at least 24 hours, both are true: your symptoms are improving overall, and you have not had a fever (and are not using fever-reducing medication). Then take added precautions for the next 5 days.    Page 4 Board of Health March 7, 2024  Harnett County Health Department Board Room  In addition to acting when you are sick, CDC provides active recommendations  on core prevention strategies:  Staying up to date with vaccinations. We still have COVID-19 and Flu vaccine available. We also continue to participate in the COVID-19 Bridge Access Program that offers vaccines at no cost to uninsured or underinsured adults. In the past two months, we have participated in events at the Harnett Food Pantry, DUMA food pantry, Harnett County schools, and Head Start parent meetings to encourage vaccination. We have additional outreach scheduled for March. Practicing good hygiene by covering coughs and sneezes, washing hands often, and cleaning frequently touched services. Taking steps for cleaner air, such as purifying indoor air, or gathering  outdoors.  COVID-19, Flu and RSV emergency room visits have decreased over the last couple of weeks. However, this flu season has resulted in 281 adult deaths and 14 pediatric deaths, which was a great increased from last year with 196 deaths and 3 pediatric deaths. We continue educate the community on the following Child Health and Employee Clinic In the activity summary you will see our clinic numbers. We have continued to see an increase in our sick and well visits. We are working on a plan to offer additional well child appointments to Adult Health - Adult Health services continue to operate well. The after-hours Family Planning clinic services continue to have a good and high show rate. Our reportable disease cases are listed on your report. We have had five syphilis cases in the last month. We continue to report with our county Disease Intervention Specialist (DIS) case manager to ensure adequate treatment and follow up. In addition, we have one active tuberculosis case that we are providing daily direct observation therapy. We are working with North Carolina Department of Health and Human Services (NCDHHS) TB consultants to obtain American Lung Association incentive funds to assist. Until these funds are available, we have been able to utilize communicable disease funding to assist Narcan We have been able to purchase additional Narcan nasal kits through our aid to county funding. We have increased distribution to community partners. Harnett County Veterans Services and the non-profit organization 2 Out Rally Foundation have received doses for distribution this month.  updated CDC recommendations and prevention strategies.  keep up with demand.  with additional chronic disease medications.    Page 5 Board of Health March 7, 2024  Harnett County Health Department Board Room  Workforce Development - During our workforce development presentation in the fall of 2023, we presented information to the board regarding our retention, and turnover rates. In 2022, we had a staff turnover rate of 8.7%. In the year 2023, we had a staff turnover rate of 9.99 %. To help staff retention, we are working with NCDHHS and Harnett County Finance department regarding implementing an employee retention bonus for health department employees. The retention bonuses will occur in two phases and rewarded by years of service using AA 117: Public Health Infrastructure: Local Workforce Development Funds. AA 117 funds were issued by the CDC to NCDHHS for a five-year period. No matching funds or county dollars would be required. Environmental Health - Oliver Tolksdorfreported after the latest onsite wastewater rules implementation, 15A NCAC 18E, that became effective January 1, 2024, and the restructured restaurant inspection schedule everything has been relatively quiet and flowing smoothly. Aging & Case Management - Mary Jane Sauls reported March celebrates Social Work Month, recognizing the invaluable contributions of the Social Workers at the Harnett County Health Department in advancing healthcare accessibility and quality. These dedicated professionals tirelessly support families and foster healthy development across various life stages. Their impactful initiatives, such as the Community Alternatives Program for Disabled Adults (CAP/DA), Care Management for At-Risk Children (CMARC), and Care Management for High-Risk Pregnancies (CMHRP), strive to empower individuals by conducting comprehensive assessments of social determinants of health and providing corresponding resources. In conjunction with the North Carolina Public Health Association (NCPHA), efforts are underway to raise funds for the John Rouse Memorial Scholarship. Despite raising an impressive $7,000 to date, additional contributions are essential to establish the scholarship as an endowment. A memorial ad in the Eastern District North Carolina Public Health Association (EDNCPHA) program will pay tribute to Mr. Rouse, honoring his memory while raising awareness of departmental programs. I will be serving on the Capital Area Metropolitan Planning Organization (CAMPO), specifically regarding the Northwest Harnett County Transit Study, commencing this month. This collaborative effort between CAMPO and Harnett County aims to gauge residents', visitors', and employees' needs concerning public transportation access and feasibility. The initial phase will concentrate on evaluating the transit market, engaging the public and assessing support from stakeholders and elected officials. Phase two will leverage phase one outcomes toi identify feasible transit opportunities and propose an implementation plan.    Page 6 Board of Health March 7, 2024  Harnett County Health Department Board Room  Starting February 16, 2024, individuals seeking service under CAP/DA will be waitlisted. The Family Caregiver Program Specialist is expanding community outreach to raise awareness about program services, particularly respite care, which offers caregivers temporary relief from their duties. Volunteers with the Volunteer Income Tax Assistance Program (VITA) have been actively assisting at various locations, providing tax preparation services to citizens. Their dedication has resulted in significant savings for Harnett county residents. Plans are underway to recognize and appreciate these volunteers throughout April, coinciding with National Volunteer Appreciation Month. The SHIIP/Medicare Program continues to support new Medicare beneficiaries and their families. The next Medicare 101 Class is scheduled for March 22, 2024 in the Commons area. During the 2023 Open Enrollment Period, the Division on Aging SHIIP staff and volunteers served 471 beneficiaries, generating Marketing/Community Outreach - Debra Hawkins shared on behalf of Sherrie Byrd the liaison for the Board of Health and she serves on the Good Hope Advisory Board, aj program flyer announcing Good Hope Behavioral Health Hospital in Erwin announced Coastal Carolina Neuropsychiatric Center will begin seeing patients in Erwin. This will provide outpatient care for those who have behavioral health need in our area and will provide a continuum of care for those who have been hospitalized for their behavioral health needs. The office is located at the corner of 10th street and Denim Drive. This office will enhance outpatient care for our citizens needing Mental Health care and other types of services. An open house will be scheduled in April 2024.  substantial savings.  Community Outreach events include:  "Girls are Great" and Teen Girls Conference, will be held Saturday, April 20, 2024, from 9:00am-1:00pm at the Harnett Health Sciences Center. For more information regarding this event, please contact the "Step into Fitness" will be held March 25, 2024-April 21, 2024. This program works to promote and increase physical activity. This is a free program and registration can be completed by calling the Health Department or online registration is also available. This is one of the programs being offered to address areas in the Strategic Plan to improve the health status and prevent premature death for residents. Chronic Disease Prevention- the Health Department provides the Prevent Type 2 Diabetes Lifestyle Change Program, which works to emphasize the overarching goal of preventing type 2 diabetes. This program is offered in partnership with First Health as part of the NC Minority Diabetes  Health Education Division.    Page 7 Board of Health March 7, 2024  Harnett County Health Department Board Room  Prevention Program. The sessions begin April 4, 2024, from 5:30-  6:30pm here at the Health Department.  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. Chairwoman Smith adjourned the meeting.  Respecttully submitted, daw Dpbrg-Haris-awkains Interim Health Director  eg