Harnett County Board of Health Minutes of Regular Meeting January 18, 2024  The Harnett County Board of Health met in regular session on Thursday, January 18, 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. Lori Langdon, M.D., Dr. Catherine Evans, DDS, Ms. Staci Hogan, RPH, Ms. Amy Allen, RN, and Debra Other present: Janice Lane, Harnett County Human Resources Director, Mary Jane Sauls, Oliver Tolksdorf, Ainsley Johnson, Gail Hobbs, and Natasha Johnson.  307 W. Cornelius Harnett Blvd., Lillington, North Carolina.  Harris-Hawkins, Interim Health Director.  Chairwoman Smith called meeting to order at 7:00 p.m.  Announcements - Ms. Hawkins introduced Janice Lane, Human Resources Director, is attending tonight's meeting. Dr. Fowler, PhD, Linda Sturdivant and Dr. Brandon Consent Agenda - Minutes - Motion made by Dr. Catherine Evans, DDS, for the November 16, 2023 and December 12, 2023 meeting agenda and minutes, and December 12, 2023 closed session minutes, to be approved and seconded by 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 Smith opened the floor for informal comments by the public, allowing 3 minutes for each presentation up to 30 minutes. Hiring Process for Health Director Position - Janice Lane, Harnett County Human Resources Director provided an update regarding the Health Director's position vacancy. The job posting closed on January 8, 2024. All applications have been sent to the Office of State Human Resources for qualification purposes. The list of qualified candidates has been sent back to the county Human Resources department. Chairwoman Smith has appointed an interview committee, which includes four Board of] Health members, one county Department Head and the Human Resources Director. The committee will set a: meeting to review qualified candidate applications and set  Washington, DDS, are unable to attend tonight's meeting.  Commissioner Barbara McKoy. Motion Carried.  Seeing no one, Chairwoman Smith closed the informal comments.  dates for interviews.    Page 2 Board of Health January 18, 2024  Harnett County Health Department Board Room  Consumer/Patient Satisfaction & Community Survey Report - Mary Jane Sauls shared the results of the 2023 Consumer and Community Satisfaction surveys through a PowerPoint presentation. These surveys were conducted from December 11th to December 29th, 2023, and are part of the annual planning process. They not only gauge the effectiveness of our health services but also play a pivotal role in shaping the trajectory of our future programs. After a thorough review oft the survey data, no specific recommendations for follow-up actions were put forth by the board. Recommendation to Established Fees - Gail Hobbs presented the following fee for  an increase to an established fees:  CPT CODE 90732  DESCRIPTION Pneumovax  RECOMMENDED PRICE  $180  Motion to approve the established fee from Emily Barefoot, and seconded by Dr.  Amanda Langdon, DVM, Motion Carried.  Health Director's Report and Program Reports - Debra Harris-Hawkins  Accreditation = Ms. Hawkins announced Dr. Laura Smith, OD, Chairwoman signed a letter regarding Adjudication as part of the Health Department's Accreditation process. The Board has not had any Adjudications for 2022-2023, no new or amended rules or ordinances were needed. The Board will continue Legal Counsel - Ms. Hawkins informed the Board that the county has attorneys, and 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 are readily available to Financial Report = Gail Hobbs provided a handout of the second quarter's finance report for July 2023 through December 2023. At this time, we should be at or near 50% of their budgets. Federal and State revenues received are drawn down based on spending requirements. Revenues for Aging programs are low because reimbursement is several months behind. Revenue received for services are coming in well above 50%. Adult Health has had great collections for the flu outreach this year as well as earnings for the rabies vaccines for  to monitor.  our department.    Page 3 Board of Health January 18, 2024  Harnett County Health Department Board Room  Central Carolina Community College students in the Veterinary Medical Technology program. In 22-23, Adult Health budgeted $78,500 and received $92,193 for the fiscal year. As you can see this year, we have budgeted $103,860 and received $141,989. Overall, expenditures are running at 35% for the six-month mark, which is well below the 50% mark. The following programs are running over the 50% mark. Adult Health is over, but this is due to the purchase of COVID vaccines that the state previously supplied. Communicable Disease (CD) expenses, mainly salaries and fringes are higher because we have had an increase in CD cases. COVID 546 budget is over due to contract staff used for flu outreach. This budget uses special funding received from the state. We have only utilized 5% of the local appropriations (county funds) budget through December. Ms. Hawkins reported the Employee Clinic saved the county  $86,194.00 in the second quarter.  Clinical Report - Ainsley Johnson  Respiratory Virus Update - The Health Department continues to monitor statewide trends for COVID-19 and work with congregate care settings to assist with COVID-19 outbreaks. Currently, we have six outbreaks in these settings. staff continue to report this information to North Carolina Department of Health and Human Services (NCDHHS) and assist facilities by providing guidance in outbreak management. The NCDHHS respiratory virus surveillance dashboard showed an increased rate emergency room visits for individuals that had symptoms of a respiratory virus (this includes COVID-19, Influenza, and RSV) during the first week of January. These rates have decreased by 5% over the last week. Hospital admissions in our state increased for COVID-19 in the last week and decreased for flu. Influenza deaths have increased across our state and currently NCDHHS reports NC has had 146 influenza-associated deaths. We continue to monitor statewide data as we enter the typical peak month of February. Here at the health department, we have seen a positivity rate of 29% for the month of December 2023 in clients tested for influenza, compared to last December 2022 when we had a positivity rate of 4% of clients tested for influenza. We continue to promote everyone six months and older to receive their annual influenza vaccine. We have worked with other divisions and provided outreach at our Harnett Food Pantry to offer flu vaccines on December 14, 2023 and flu and COVID vaccines on January 11, 2024. These outreach events were successful, and we plan to visit the Dunn United Ministries food  pantry on January 23, 2024.    Page 4 Board of Health January 18, 2024  Harnett County Health Department Board Room  COVID-19 Vaccine Update - Adult Health fees earned during the flu season exceeded our budgeted expectation. This allowed us to use the additional revenue to purchase COVID-19 vaccines. We have been able to order 50 additional Moderna vaccines and are scheduling individuals and allowing walk- ins for those vaccines. In addition, we have Bridge COVID-19 vaccine for individuals that are uninsured or underinsured, as well as vaccine for our pediatric clients. We continue to encourage everyone to receive their updated COVID-19 vaccine this season. We have increased community outreach to  promote Bridge COVID-19 vaccine.  Child Health and Employee Clinic - In your activity summary on page 26, you will see our clinics numbers. Our child health clinic has seen an increase in sick appointments in the month of December 2023 (241). Respiratory illnesses were a great number of these visits. Employee health and well child appointments continue to be steady as well. A legislative update regarding child health is Session Law 2023-106 Part 3. Clinical supervisors and the Director of Nursing have attended online webinars regarding this new law. This session law includes three parts and is known as the Parents' Bill of Rights. In this law, we are looking at Part III as it relates to a: minor's consent to treatment. This law requires a health care practitioner to first obtain written or documented consent for the minor's parent or guardian before providing, soliciting, or arranging treatment. Even though this consent is required, there are still six situations in which care may be provided to a minor without prior parental consent. One of these is a law that we follow at the health department is G.S 90-21.5, which is often referred to as "North Carolina's minor's consent law". This new law will not change the ability of a minor to consent to certain health services for the prevention, diagnosis, and treatment of venereal and other reportable disease, pregnancy, abuse of controlled substances and alcohol, and emotional disturbance. We have reviewed our current consents for treatments with UNC School of Government staff and will continue to meet all requirements of this Adult Health - Adult Health numbers have been steady as well. Prenatal continues to enroll new clients and the transition with the labor and delivery shutdown at Harnett Health Hospital in Dunn has settled. We have clients deliver at Cape Fear Valley Medical Center and surrounding hospitals. Our prenatal clinic currently has 95 active clients. The after-hours family planning clinic continues to go well. We offer this service on the first Thursday of each month until 7 pm. This month we had a show rate of 75%. Our next after-hours clinic is February 1, 2024. Sexually Transmitted Disease (STD) services continue to be busy. We reported eight syphilis cases in our  new legislation.    Page 5 Board of Health January 18, 2024  Harnett County Health Department Board Room  county last month. We have shared public health alert regarding the continued rise in congenital syphilis with community medical providers and continue to work with our region Disease Intervention Specialist (DIS) to reach cases and Opioid Overdose/Narcan - We have distributed 91 kits to individuals since September 2023, and distributed 219 kits to community organizations - this includes the Sheriff's Office, local pharmacies, and Harnett County Schools. We still have kits available to the public every day of the week by walk-in and have offered the kits at our recent offsite events at Brookside Hills Apartments and North Carolina Public Health Association (NCPHA) Grant - The update on the grant that we received from NCPHA in September 2023; we have been able to use the funds to purchase gunlocks and medication lock bags. Our goal for the mini grant was to reduce access to harmful items and prevent accidental child deaths. Each lock device comes with educational handouts and is available free to community members and clients. We currently screen each child health, care management client for risk, and offer these locks. We have Environmental Health Oliver Tolksdorf discussed the latest onsite wastewater rules implementation, 15A NCAC 18E, became effective January 1, 2024. The new rules have not changed a lot for the soil rules however; it does have a large influence from the private sector such as for repairs and their documentation. The NCDHHS currently has a vacancy for the Onsite Water Aging & Case Management - Mary Jane Sauls announced The Elderly Nutrition Program currently provides an average of 45 congregate meals and 150 home-delivered meals daily. Additionally, preparations are underway at the senior sites for the upcoming Senior Games scheduled for April. Interviews for the Nutrition Project Coordinator II position have concluded, and our recommendation has been submitted to the county. The Division on Aging is in the process of applying for a $5,267.00 grant under the Medicare Improvement for Patients and Providers Act (MIPPA). This grant aims to assist Medicare beneficiaries with limited income and assets in understanding programs that can potentially reduce their Medicare costs. The board has expressed its support for securing this funding, and the proposal will now: move forward to  identify and treat contacts.  the Harnett Food Pantry.  also offered these locks off site at community events.  Protection Branch Head.  the Board of Commissioners.    Page 6 Board of] Health January 18, 2024  Harnett County Health Department Board Room  Medicare Open enrollment is ongoing for beneficiaries enrolled in Advantage Plans seeking to make changes. This enrollment period spans from January 1 to March 31. Medicare counselors are actively comparing existing plans with others of a similar nature, updating medications, and providing beneficiaries with the necessary information to confirm plan acceptance with their healthcare providers. Not all providers accept all Medicare Advantage Plans, and facilities may vary in their acceptance of different plans. Nominations are currently open for the 2024 Governor's Volunteer Service Award. Each county has the opportunity to select up to 10 individuals, businesses, groups/teams, and one paid director of volunteers for recognition of their outstanding contributions to the community. From the nominees, one will be put forward for the Governor's Medallion Award for Volunteer Service, a prestigious honor given to the top 20 volunteers in the state. Nomination forms must be completed and returned to the Harnett County Division on Aging by 5:00 pm on Monday, February 12, Marketing/Community Outreach = Debra Harris-Hawkins announced the "Go Red" Lunch and Learn will be held on Tuesday, February 13, 2024. The program is a collaboration with Harnett Health Hospital, which includes an educational session on heart disease and the current heart health information and recommendations. The luncheon speaker will be Dr. Sirisha Reddy, Cardiologist with Harnett Health and Vascular Specialists.  2024.  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.    Page 7 Board of Health January 18, 2024  Harnett County Health Department Board Room  Respectfully submitted, Debra Hatris-Hawkins SLT Interim Health Director  RpB