Harnett County Board of Health Minutes of Regular Meeting September 19, 2024  The Harnett County Board of Health met in regular session on Thursday, September 19, 2024 in the Health Department Board Room, Harnett County Governmental Complex, 307 W. Cornelius Harnett Blvd., Lillington, North Carolina. Members present: Dr. Laura Smith, OD, Chairwoman, Dr. Amanda Langdon, DVM, Dr. Kim Fowler, PhD, Dr. Brandon Washington, DDS, Dr. Lori Langdon, M.D., Ms. Laurene Maki, Ms. Kandi Tudor and Ainsley Johnson, Health Director. Others present: Emily Barefoot, Oliver Tolksdorf, Melissa McLamb, Gail Hobbs and  Natasha Johnson.  Chairwoman Smith called meeting to order at 7:00 p.m.  Announcements - Ms. Johnson recognized Emily Barfoot, for her years of service. Barefoot served as a member of the Harnett County Board of Health. She has been an appointed member of the board since May 2016. The board members and health department staff expressed their appreciation of her commitment and service to public health in our community. Ms. Emily Barefoot has served as the Public Member on the board. Ms. Johnson announced Ms. Kandi Tudor and Ms. Laurene Maki are the newest members on the Board of Health and was appointed at the Board of Commissioners meeting on August 19, 2024. Ms. Kandi Tudor has filled the Registered Nurse position and Ms. Laurene Maki has filled the Public Member position on the Board. Ms. Johnson also announced they completed their Board of Health Ms. Johnson announced the update on the John Rouse Memorial Scholarship Fund; the scholarship is now endowed and the current amount is $35,000. Consent Agenda - Minutes - Motion made by Dr. Lori Langdon, M.D., for the July 18, 2024, agenda and minutes to be approved and seconded by Dr. Amanda 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. Nomination Committee - Chairwoman Smith appointed Dr. Amanda Langdon, DVM, as Committee Chair, and Dr. Catherine Evans, DDS, as Committee Member to serve on the Nominating Committee. The committee will report at the next regular meeting in November 2024 and at the January 2025 meeting, the officers will be nominated.  Orientation training on September 3, 2024.  Langdon, DVM, Motion Carried.  Seeing no one, Chairwoman Smith closed the informal comments.    Page 2 Board of Health September 19, 2024  Harnett County Health Department Board Room  Election of Officers = Chairwoman Smith submitted on behalf of the nominating committee that Dr. Lori Langdon, M.D., was nominated as Vice-Chairwoman. Vice Chairwoman Amy Allen's third term ended on August 31, 2024. The nominating committee submitted no other nominations to the Board. Chairwoman Smith opened the floor for any other nominations. No other nominations were received. Motion made by Dr. Kim Fowler, PhD asked that the nomination be closed and accept the slate of Vice Chairwoman as presented, seconded by Dr. Brandon  Washington, DDS. Motion Carried. new: fees or an increase to established fees:  Recommendation to Established Fees = Gail Hobbs presented the following fees for  CPT CODE 90656 90653 90661 91320 G0008 G0009  DESCRIPTION Fluzone 6 months + Fluad 65 yrs + Flucelvax 6 months + COVID 12 yrs + Administration Fee Administration Fee  RECOMMENDED PRICE $23.00 $84.00 $37.00 $164 $31.01 $31.01  The rates for flu vaccines and administration fees are based upon the 2024 seasonal flu vaccine pricing provided by the Centers for Medicare & Medicaid Services (CMS). Motion to approve the established fees from Laurene Maki and seconded by Dr. Debt Setoff- - Gail Hobbs reported that since the last meeting, the Debt Setoff program has collected an additional $859.43 and the collection year to date total is $4,606.05.  Lori Langdon, M.D. Motion Carried.  Accreditation Activities Report - Ainsley Johnson  Review of Operating Procedures - Ms. Johnson presented and reviewed the Operating Procedures with the Board. Copies of the slides were provided in the member's packets. After the review, there were: no recommended changes. Ms. Johnson reviewed the Rule Making/Procedures and Authority section, the Board of Health has not had a need for any ordinances or local ruling since the last Operating Procedure review on September 21, 2023. Ms. Johnson stated that we would have the Chair sign the Operating Procedures annual review log.    Page 3 Board of Health September 19, 2024  Harnett County Health Department Board Room  Communicable Disease Report - Melissa McLamb provided a power point presentation with incidence data of confirmed reportable disease cases made during 23-24 FY. Data was obtained from the North Carolina Electronic Disease Surveillance System (NCEDSS) and North Carolina Department of Health and Human Services (DHHS) Communicable Disease Branch. Reportable diseases fall into the following categories: Gastrointestinal, Vector-Borne, Water-Borne & Streptococcal, Hepatitis, Vaccine Preventable, Sexually Transmitted Infection, HIV/AIDS, Tuberculosis, and Mpox. All events were individual cases and not related to an outbreak. The Health Department staff monitor events reported in NCEDSS and complete investigations to ensure sufficient education, treatment and notifications are handled properly. Influenza and COVID cases are not required to be reported in North Carolina, however deaths and outbreaks from these infections are required to be reported. Prevention, identification and treatment are offered through multiple departments' within the health division Workforce Development - Melissa McLamb provided a presentation for the 2023 Workforce Profile Data. In 2023, the Health Department had approximately 69 full-time positions. Data reflected that 90% of the employees were female, 67% were White/Caucasian, 20% were Black/Atrican American, and 7% were American ndian/Asians/Other, The public health workforce is multidisciplinary and consists of nurses, environmental health professionals, public health laboratory personnel, nutritionist, health administrators, social workers health educators, and others from a wide range of occupations. Approximately 22% of the department's employees hold advanced degrees. Turnover rate for the Health Department in 2023 was 9.9 which was a slight increase from 2022 and a 2-fold increase from 2021. Majority of employees have been with Harnett County for 6-20 years. Harnett County Health Department is dedicated to ensuring that our future workforce needs are met. There is a focus on attracting a diverse public health workforce as well as training the  tol help control the spread of communicable diseases.  current and future workforce.  Health Director's Report and Program Reports - Ainsley Johnson  WIC Food Expenditures Report - Ms. Johnson presented aj power point presentation for the 2023-2024 Economic Impact Food Expenditures Report for Women, Infants, and Children (WIC) program. WIC serves low to medium income families (up to 185% of federal poverty level) that include aj pregnant or    Page 4 Board of Health September 19, 2024  Harnett County Health Department Board Room  postpartum woman, an infant, or a child under the age of five years. WIC is an important resource for many Harnett County families. The report included programmatic data, regarding the caseload and included information on food expenditure and the economic impact for the WIC program in the county. WIC served approximately 38,131 participants in 2023-24. WIC food package benefit redemptions infused $3,093,726 in revenue into the local economy. There were approximately 19 WIC approved retail vendors in Harnett County from July 2023 until June 2024. The WIC program faces the following challenges, the caseload continues to increase, ongoing need for services the monthly active participants is at 3,300 as ofJuly 31, 2024. We continue to strive to meet the needs of our participants by providing extended clinic hours, Tuesday- Thursday, and walk-in appointments. We are working diligently to recruit and keep a skilled staff. Currently we have a Nutritionist position that remains Financial Report 2023/2024 Year Ending - Ms. Johnson reviewed the closeout revenues and expenditures summary reports for FY ending June 30, 2024. The Health Department has only utilized 46% of county funds and Aging utilized 34% in FY 23-24 at the year-end in part because of the additional COVID-19 funds. Ms. Johnson discussed the regional A621-ARPA covid-19 Public Health Regional Workforce funds available to fund workforce infrastructure, the Health Department will receive $62,000; the infrastructure includes building updates and staff leadership training. The board expressed its support for the A621 funds. Health currently has COVID funding C716 that is being used for staff salaries that are administering COVID-19 vaccines and C719 funding is COVID-19 Bridge Vaccination funding for uninsured patients to receive COVID-19 vaccines, these funds allow for staff salaries and administration fee reimbursements. PH117 funds will continue to be used for staff retention pay for 2025, staff training and contract positions.  vacant since June 2024.  Clinical Report - Melissa Mclamb  Child Health - the activity summary shows that the clinics are reflecting typical visit counts for this time of year. North Carolina Public School and college requirements are leading to increased number of well visit and immunization  appointments completed.    Page 5 Board of Health September 19, 2024  Harnett County Health Department Board Room  Prenatal -1 the Health Department's prenatal clinic is planning a Pregnancy Health Fair for October 23, 2024, this event is for expecting mothers and fathers and will include community vendors, resources, education and  refreshments.  Flu Vaccine - The clinics have also started administering seasonal influenza vaccinations and will continue to offer this during the 24-25 flu season. Flu vaccine is given in the Health Department clinics daily and provided at off-site area businesses, county departments and community groups. COVID-19 Vaccine The Health Department will be offering the 24-25 COVID- 19 vaccine as soon as inventory arrives. Announcements will be made on the Health Department website and social media sites once it is available. Anne Wolfe Mini Grant - At the July 18, 2024 Board of Health meeting it was mentioned that an application had been submitted for the Anne Wolfe Mini Grant. Unfortunately, the Health Department was not selected as a recipient Naloxone - The Health Department continues to distribute naloxone to individuals and organizations. Currently, there are 495 kits in the department's inventory. Since the last Board of Health meeting, 89 kits have been distributed Aging & Case Management - Oliver Tolksdorf reported on behalf of Mary Jane Sauls, on September 3, 2024, the Harnett County Board of Commissioners acknowledged the exceptional work of the Senior's Health Insurance Information Program (SHIIP) Medicare program counselors and volunteers for their commitment to helping seniors navigate the Medicare system and make informed decisions about their coverage. The Medicare open enrollment period will take place from October 15, 2024 through December 7, 2024. During this time, Medicare beneficiaries have the opportunity to review and adjust their Medicare coverage. The Division on Aging will start scheduling appointments on October 1, 2024 to assist beneficiaries, offering both phone and in-person consultations, including some after-hours and Saturday clinics. The Health Department has visited eight senior sites to administer flu vaccines The Nutrition Program Coordinator participated in the Community Partners Fair at Campbell University on September 12, 2024 to recruit student  this year.  at community events worked by Health Department staff.  and provide information about Covid-19. volunteers for meals on wheels.    Page 6 Board of Health September 19, 2024  Harnett County Health Department Board Room  The Senior Games for 2025 are scheduled to begin on Wednesday, April 9th, Environmental Health = Oliver Tolksdorf discussed the recent changes in SL2024-49 that included significant changes to the Onsite Waste Water rules, and creation of the position Private Compliance Inspector to inspect the installation of privately permitted septic systems. He explained to the board the design daily flow of various establishments in contrast to what is in the rules. Marketing/Communy Outreach - Ms. Johnson reported on behalf of Debra Harris-Hawkins, and reviewed upcoming community health events sponsored by the Health Department information was located on pages 20-21 in the  2025.  packet which included the following flyers:  Flu Shot "Drive-thru" clinics; As flu season begins, we are urging all residents to prioritize their health by getting vaccinated. Our drive-thru flu shot clinic provides a safe and convenient way for residents to get vaccinated without leaving their cars. "Drive thru" flu shot clinic will be held Thursday, October 10, 2024, from 3:00pm-6:00pm. Two locations will be available, the Health Department's rear parking lot and Clarence Lee Tart Memorial Park in Dunn. No appointment is needed. Additional information is available on the Health Department's web site and social media pages. We encourage everyone to take advantage of this opportunity to safeguard their health this flu season. The annual "Fall into Fitness" Move More Challenge begins September 23, 2024 -October 20, 2024, to align with Community Health Assessment priorities. The purpose of a Fall into Fitness challenge is to motivate people to get active and enjoy the benefits of physical activity. As part of the Health Department's Strategic Plan, one of the goals is to improve the health status and prevent premature death for residents. Our Health Education Division coordinates this.  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.    Page 7 Board ofHealth September 19, 2024  Harnett County Health Department Board Room  Chairwoman Smith adjourned the meeting.  Respectfully submitted, Pvduyoer Ainsley Johnson Health Director  Dr.Laura Smith, OD,  &h