Harnett County Board of Health Minutes of Regular Meeting July 19,2018  The Harnett County Board of Health met in regular session on Thursday, July 19, 2018 in the Health Department Board Room, Harnett County Governmental Complex, Members present: Dr. Catherine Evans, Ms. Emily Barefoot, Ms. Barbara McKoy, Dr. Laura Smith, Ms. Linda Sturdivant and Mr. John Rouse, Jr., Health Director. Other present: Mary Jane Sauls, Oliver Tolksdorf, Debra Harris-Hawkins, Donna  307 W. Cornelius Harnett Blvd., Lillington, North Carolina.  Surles, Gail Hobbs, and Natasha Johnson.  Announcements - Mr. Rouse announced we do not have enough board members for a quorum tonight. Several members are out of town or had prior conflict with the meeting date. We will add the approval of the May minutes to the September agenda. Debt Setoff - Gail Hobbs reported that since the last meeting, the Debt Setoff program has collected an additional $1,563 and the total collection for 2018 is $9,454. Health Director's Report and Program Reports - Mr. John Rouse  Health Director's Report - Mr. John Rouse announced with the adopting of the county budget the Health Department has received a new position Breastteeding Peer Coordinator in the Women, Infant & Children (WIC) Program. Recently we have interviewed for the Processing Assistant IV position in' WIC, hoping to have that position filled soon. The position of Soil Scientist in Environmental Health has been downgraded to an Environmental Health Specialist position and the position is currently being advertised. The General Assembly has passed the State budget. They have cut money from the Women and Children's block grant, this is money that is received through the Family Planning and Prenatal clinics at the Health Department. Over the past eight years, 8 million have been cut from the grant and given to other A new bill that has passed is the Raw Milk Bill, allowing the dispensing of raw milk and raw milk products to independent or partial owners of lactating Another new bill that passed allows private Soil Scientist to approve waste water systems and make the county liable for the work. The General Assembly isstill working on Medicaid Transformation. Any changes to the current Medicaid Program will have to be approved by the federal government.  entities.  animals for personal use or consumption.    Page 2 Board of Health July 19, 2018  Harnett County Health Department Board Room  The most recent information on behavioral health is cutting out some of the Regional Local Management Entities (LME's) and having only four that will cover the state. The state has decided to have four vendors who will contract with Hospitals and Providers who will provide Medicaid services to Medicaid  clients.  Clinical Report - Donna Surles  Child Health (CH) visits are consistent for this time of the year. Visits usually decrease during the summer, then increase as the school year approaches for physicals and immunizations. CH will be conducting an after-hours immunization clinic at the Health Department around the start of the new school year. Last year CH began offering physicals in the Dunn clinic twice a week based on client need to eliminate the need for multiple visits and improve access to services. All appointments are scheduled at the Lillington Health Department for both locations. We are not seeing a lot of interest as clients are not scheduling appointments like we had hoped. Since we began, we have scheduled 21 appointments and seven of those either cancelled or were no shows. We will continue to monitor this program. In other efforts to improve access to services, from February 1 to July 1,2018 we offered immunizations on Mondays to clients who had appointments for WIC pick-up in the Dunn office. During that period, we only gave vaccines to four children, two of whom only received the flu vaccine. There were on average 30 appointments for children at the Dunn WIC clinic and approximately 25% of those children needed vaccines. An estimated 99% of those already had an appointment with their Primary Care Physician (PCP) within 1-2 weeks for a physical and/or vaccines, therefore they decline vaccines during the WIC visit. Due to the small number of vaccines given, we no longer provide. immunizations during the WIC Our newborn and post-partum home visiting nurses are doing a great job with trying to schedule visits as soon as possible after hospital discharge. In August, the three newbom/post-partum home visiting nurses will be attending a class Adult Health Our Family Planning (FP) and Maternal Health (MH) clinics continue to stay busy with patient appointments. Dr. Gray, our Obstetrics (OB) Medical Director will be retiring later this year and Harnett Health has hired  visit in Dunn.  on Maternal and Newborn Assessment in the Home.    Page 3 Board of Health July 19, 2018  Harnett County Health Department Board Room  another OB/Gynecology (GYN) that we plan to meet with next week. She will be working with our providers and will serve as our new OB Medical Director. Communicable Disease (CD) the health department has been working with other county departments to administer Hepatitis A and B vaccines to those who need it. One of our CD nurses attended the Foodborne Illness Conference and four of our CD staff attended the annual CD Conference in May. Flu vaccine has been preordered and is expected to arrive by September. We have already scheduled 28 flu clinics throughout the community for September and October, and will administer to county employees during the annual Employee Health Fair on October 4, 2018. Due to the measles outbreak in Wake County that affected several counties, we did some contact investigations and those are now complete. We also followed up with one possible contact to the hepatitis A outbreak in Mecklenburg County and we have not received any further reports. The Health Department has a few Tuberculosis (TB) cases that we are following and these are very time consuming for our staff. Daily home visits are required to administer medications until test results are negative. Some of these cases are followed for 9-12 months. In 2017, 46 NC Counties have had at least one TB case. Adult Health and the Lab continue to work with the Health Education staff on Human Immunodeficiency Virus (HIV) and Syphilis testing in the community. There are several scheduled testing events for the upcoming weeks. These community outreach programs provide opportunities to educate and inform the The Department of Public Health (DPH) State Consultant conducted a Current Procedural Terminology (CPT) record review on June 6, 2018 for nurses and providers. As a follow-up to the review, she did an onsite Continuing Nurse Education (CNE) Documentation and Coding Training for all nurses and providers on June 25. The record review went well overall and the training was well received by our staff. An update to the Board on where we are with NC Health Information Exchange (HIE), HIE: now known as NC HealthConnex allows access to patient information across multiple health care providers who sign up to participate such as hospitals, clinics, and medical offices. This system was designed to improve care coordination and allow for more efficient and accurate diagnoses. Participation with HIE: is required for Medicaid Meaningful Use. We signed a participation agreement in 2016 and in early 2017 DPH advised health departments to cease data sharing through HIE until the minor consent issues were resolved. Under Title X, minors may seek confidential health care for maternity, family planning and sexually transmitted disease (STD) services without parental consent. Adults may opt- out of data sharing but HIE does not allow minor's to opt-out which could allow for a break in confidential services, therefore we are not sharing data  citizens on services provided by the Health Department.    Page 4 Board of Health July 19, 2018  Harnett County Health Department Board Room  through HIE. DPH is working with electronic medical record (EMR) vendors to find a solution to resolve the problem with minor consent. Various health departments will be asked to serve as pilot sites to test the system once a  solution has been identified.  Environmental Health Oliver Tolksdorf reported that once a year the Food & Lodging staff rotate the facilities they currently inspect. This helps in each employee getting a new area of facilities to inspect each year. On July 16, 2018, Environmental Health went live with the new Track It software system. The system is in conjunction with Planning and Central Permitting  Departments.  Aging & Case Management - Mary Jane Sauls reported the blood drive sponsored by the Retired Senior Volunteer Program was held on July 12-2018 and 37 units of blood was collected. The next blood drive will be held on Thursday, September 13-2018 from 1:00 pm - 5:30pm. During this event, we will host a reception to honor our first responders and those that lost their lives on 911. The Harnett County Division on Aging -Family Caregiver Support Program is sponsoring a back-to-school supply drive for the Grandparents and Relatives as Parents (GrasP). This drive is important to help reduce the cost for randparents/relatives served through the program by providing much needed school supplies for their children. Donations will be accepted at the Division on Federal Law requires that hospitals and those delivering babies inform Department of Social Services (DSS) when a baby has a positive urine, meconium or cord segment drug screen. They must also inform DSS when the mothers medical evaluation or behavioral health assessment indicates an active substance use disorder during the pregnancy or at the time of birth. The Care Coordination for Children (CC4C) Care Management program is also notified and creates a plan of Safe Care to support the mother and the baby. Since implementation of this requirement in August 2017, the Harnett County Health Department care management program has received 53 referrals. Marketing/Communty Outreach - Debra Harris-Hawkins announced that the Health Department will have a Community Day- Back to School Bash event, that will be held on Saturday, August 25, 2018. Community organizers along with the Health Department are sponsoring the third annual Community Day/Back to School Bash event on located at the Lillington First Missionary Baptist Church in Lillington from 10am to 1:00pm. Community Day is a free event, which will include exhibits, resources, health information, food, and fun  Aging.  activities along with free school supplies and/or book bags.    Page 5 Board of Health July 19, 2018  Harnett County Health Department Board Room  Various departments, community agencies and resources will be on site and available for families. This event is free and open to the community. All backpacks and school supplies are made possible through donations. "Healthy Habits for Life" program beginning on Tuesday, August 7-28, 2018 from :00pm-2:00pm. This program consists of four weekly sessions that will cover various topics including nutrition and physical activity. AI Matter of Balance: Managing Concerns About Falls is a program designed for empowerment to reduce the fear of falling and increase activity levels among older adults. A Matter of Balance includes eight two-hour sessions for a small group, we will be providing session in Lillington starting on Wednesday, September 11, 2018 at the Lillington Community Center. Employee Clinic - Mr. Rouse presented the County Employee Clinic FY 2017- 2018 report. Showing the total amount of savings for the County was $250,376 Active Shooter Drill - Mr. Rouse reported on the information that was received from the Active Shooter Drill that was held on June 22, 2018, involving Health, Social Services and Sherriff's Department. The drill provided insight to employees on how they would handle an active shooter situation.  that was not billed to Blue Cross and Blue Shield.  The staff did well with the situation.  Respectfully submitted, uh  John Rouse, Jr. Health Director  Ms. Patricia Chalmers, Chairwoman chhw