Harnett County Board of Health Minutes of Regular Meeting May 18, 2017  The Harnett County Board of Health met in regular session on Thursday, May 18, 2017 in the Health Department Board Room, Harnett County Governmental Complex, Members present: Ms. Patricia Chalmers, Vice-Chairwoman, Ms. Amy Allen, Ms. Emily Barefoot, Ms. Judy Herrin, RPH, Ms. Barbara McKoy, Ms. Linda Sturdivant, Dr. Laura Smith, Dr. Nicholas Pennings and Mr. John Rouse, Jr., Health Director. Others present: Graham Byrd, Debra Harris-Hawkins, Donna Surles, Gail Hobbs,  307 W. Cornelius Harnett Blvd., Lillington, North Carolina.  Natasha Johnson and Mary Jane Sauls.  Vice-Chairwoman Chalmers called meeting to order at 7:00 p.m.  Announcements - Mr. Rouse reported Dr. Auston "Trey" C. Williams, III, Chairman, and Mr. C. Tyrus Clayton, Jr. will not be attending tonight. Mr. Rouse related Dr. Laura Smith had received Board of Health orientation. Mr. Rouse reported Ms. Patricia Chalmers, Vice-Chairwoman will be conducting the meeting tonight in the Consent Agenda - Minutes - Motion made by Ms. Judy Herring, RPH for the March 2, 2017 agenda and minutes to be approved and seconded by Dr. Nicholas 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 Chalmers opened the floor for informal comments by the public, allowing 3 minutes for each presentation up to 30 minutes. Seeing no one, Vice-Chairwoman Chalmers closed the informal comments. Accreditation - Ms. Debra Harris-Hawkins related that our Re-Accreditation would be upcoming this fall, we received official notification that Harnett County's site visit is scheduled for September 14-15, 2017. We are preparing and working towards another Re-Accreditation and additional information will be provided. Mr. Rouse stated Ms. Patricia Chalmers, Vice-Chairwoman signed a letter for Accreditation that the Board  place of Chairman Williams.  Pennings. Motion Carried.  did not have any adjudications within the past four years.    Page 2 Board of Health May 18, 2017  Harnett County Health Department Board Room  Health Disparities Report - Ms. Debra Harris-Hawkins presented a power point presentation for the annual Health Disparities report. A major goal of public health is to: reduce health disparities. Health disparities are differences in the incidence, prevalence and mortality of a disease and the related adverse health conditions that exist among specific population groups. These groups may be characterized by gender, age, race or ethnicity, education, income, disability, geographic location, and other indicators. The purpose of the report is to highlight programs and services and the impact on the community, along with interventions for reducing health disparities. Data from services by underserved, at risk or vulnerable populations were presented. The timeline presented included anuary-December 2016. Data was presented, which included a review of several programs and services, they included clinical, Women Infant and Children (WIC) and the Mammography screening program. The report also provided information regarding interventions for reducing health disparities. The data provided included the total client visits, participation data and uninsured populations. Various programs and efforts to address health disparities were presented. The data was compared over two consecutive years. A few of the examples of efforts to address health disparities included, providing services in offsite locations through the WIC program in Dunn and Anderson Creek, also providing extended hours. The mammography screening program provided access for low-income and underserved  women access to breast cancer screenings.  Recommendation to Establish Fees: Ms. Gail Hobbs presented the following fees for  newi fees or an increase to established fees:  NEW CPTCODE J3490 58300 58301 96161  DESCRIPTION  RECOMMENDED PRICE  Unclassified Drug- Intrauterine Device $900.00 (340b pricing billing to Medicaid $235)  (IUD) Insertion of IUD Remova/Reinsertion ofl IUD Postpartum Depression Screening  $225.00 $250.00 $13.00    Page 3 Board of Health May 18, 2017  Harnett County Health Department Board Room  INCREASE J1725  17P (Maternal Health)  $900.00 (current $125)  Motion to approve the new and increased fees from Ms. Emily Barefoot and Debt Setoff- Ms. Gail Hobbs reported that we have received $6,437.07 this year on  seconded by Ms. Barbara McKoy. Motion Carried. patient accounts through the debt setoff program.  Health Director's Report and Program Reports = Mr. John Rouse  Financial Reports = Ms. Hobbs reviewed the Expenditure Summary from July 2016 -] March 2017 and Revenue Summary from July 2016 - March 2017. Ms. Hobbs explained the expenditure and revenue summary. Revenues within our programs in the Health Department are doing very well at this time. Family Planning and Child Health are exceeding in Medicaid earnings and patient fees received. Expenditures for programs are at or below 75%, nothing noted as Home Health - Mr. Rouse stated we are in the process of closing out the remaining billing. Looking at closing out everything and doing the final cost Employee Clinic - Mr. Rouse provided a chart demonstrating the three quarters showing the amount of savings that insurance would have been billed for those services. The first quarter showing $62,675, second quarter $77,988 and third quarter $94,175 the total savings supports the salary for mid-level  being over budget in spending.  report for Home Health by end ofJune 2017.  provider.  Clinical Report and Activity Summary - Donna Surles  Child Health - The Child Health Well Clinic visits remain constant and sick visits are consistent for this time oft the year. We will soon be into the summer months when back to school physicals increase. In June we are planning to open up a well-child clinic in Dunn for physicals and immunizations. We will schedule appointments two days a week to help eliminate the rush in the Lillington office. Kindergarten physicals begin to increase during the summer  months.    Page 4 Board of Health May 18, 2017  Harnett County Health Department Board Room  The Employee Clinic remains busy in March with over 200 employees being seen but that number drastically decreased in April with only 109 visits. Adult Health - The. Adult Health (AH) clinic numbers remain fairly consistent throughout all clinics. Rebecca Unger Physician Extender started in March, she is in orientation and is rotating throughout all clinics. She is currently working in Family Planning, STD, Child Health, and Employee Health. She has expressed to us that she likes working at the health department and continues to become familiar with the practice. Brittney Faircloth RN will begin working with us on Monday, May 22, 2017. She will work among various clinics as well. Maternal Health - The patient numbers for the clinic remains steady with Family Planning - Since we began offering the Nexplanon contraceptive in Family Planning (FP) clinic we have seen an increase patients interested in long acting contraceptives. The FP clinic has placed approximately ten Nexplanons each month. In July we will begin offering the IUD contraceptive called Kyleena. Kyleena is a hormonal device that will provide contraception for 5 years. On May 3rd our providers completed a training on insertion and removal of the Communicable Disease -The clinic has received an increase in Hepatitis cases. The North Carolina State Lab is now testing for Hepatitis C. Clients being tested must meet specific criteria for testing. The AH Supervisor will attend a Hepatitis training May 19th the state is providing. We have had a few facility outbreaks recently. One long term care facility had an outbreak of Norovirus and then scabies, while another facility had a flu outbreak. All outbreaks are now resolved and the facilities did what we asked them to do to manage those outbreaks. We continue to receive updated guidance from the state and Centers for Disease Control (CDC) on Zika. We have not seen any cases here in our In April the state consultant was here for the Women's Health Program Review. We have updated some of our manuals to meet their recommendations. We are working with our pharmacist to implement a more effective and efficient pharmacy inventory system on June 1. According to the North Carolina Flu Surveillance report, thus far there have been 210 influenza associated deaths in the state with the majority being age 65 and over. The most significant type identified overall has been Type A. We have had four reported flu deaths in  approximately 120-130 new prenatal clients each month.  device.  clinic.  Harnett County, all of which had underlying conditions.    Page 5 Board of Health May 18, 2017  Harnett County Health Department Board Room  On April 12th some of our staff attended Mental Health First Aid Training and received certification. The course trained staff how to recognize a mental health emergency and how to provide initial help to people experiencing problems such as depression, anxiety, psychosis, and substance use disorders. On May Ist we conducted Annual Staff training for all health department staff. We have been  working diligently to prepare for accreditation.  North Carolina Child County Data Cards - Mr. Rouse provided copies of the 2017 County Data Card, which included information specific to Harnett for key data points regarding children's well-being. The data cards presented a variety of indicators ranging from prenatal care, income, insurance coverage and infant mortality. Environmental Health - Mr. Graham Byrd reported they are busy with Food & Lodging Program at this time due to swimming pool permits. Onsite wastewater applications have been coming in steady throughout the month. Environmental Health Specialist Andrew Currin has passed the Registered Sanitarian exam and is also Aging - Ms. Mary Jane Sauls related that May is Older Americans Month and the theme this year is, "Age out Loud."The 23rd annual Senior Health Fair "Sailing into Better Health" Senior Fair sponsored by Harnett County Retired and Senior Volunteer Program (RSVP) was held on Thursday, May 11th, 2017 from 10:00 am to 2:00pm at the Dunn Community Center. They had 325 seniors in attendance and 36 Vendors exhibited. We offered Medicare counseling and Social Security was available to answer questions. Carolina Packers donated hotdogs and the Coats Kiwanis club served them. AI Matter of Balance is a program designed to manage falls and increase activity levels. The free program will be held on May 23, 2017 June 20, 2017 (Classes will meet on Tuesdays and Thursdays) from 10:00 am to 12:00 pm at the Governmental Complex- Commons Area. The Blood Drive held on May 10th exceeded its goal with a collection of 44 units. The next drive will be held on Thursday, July 13, 2017 and we will have Current/Upcoming Events - Ms. Debra Harris-Hawkins provided an overview of the lunch and learn that was held on Tuesday, May 16, 2017 for National High Blood Springsted Salary Study - Mr. Rouse stated the increase of salaries to market rate really impacted our staff greatly. The salary adjustment will also help in the process of future hiring positions that are hard to fill within the health department.  training in the Food & Lodging program.  homemade Ice cream in the canteen.  Pressure month with North Carolina Heart and Vascular.    Page 6 Board of Health May 18, 2017  Harnett County Health Department Board Room  General Assembly - Mr. Rouse related one bill that affected Environmental Health (EH) was for EH inspectors to provide the electrical inspections on new septic pumps. Due to the staff not being electricians they would have to be certified. This bill was tabled, Building and Inspections will continue to do the inspections. The new outdoor grill bill for restaurants has passed allowing restaurants to use outdoor grills. The Mosquito Briquets - Mr. Rouse reported the mosquito briquets have been purchased and will be passed out to the public. The bags contain four briquets, information sheet with instructions and a tip & toss brochure. The information will be posted in the  House will release their budget at the end of May.  newspaper next week.  Closed Session - There was no need for closed session. Being none Chairwoman Chalmers closed New Business. Vice-Chairwoman Chalmers adjourned the meeting.  New Business - Vice-Chairwoman Chalmers opened the floor for New Business.  Respectfully submittedA 0 Ml John Rouse,Jr. Health Director  AME Ms. Patricia Chalmers, Vice-Chairwoman