Harnett County Board of Health Minutes of Regular Meeting November 21, 2024 The Harnett County Board of Health met in regular session on Thursday, November 21, 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., Vice Chairwoman, Ms. Laurene Maki, Dr. Catherine Evans, DDS, Ms. Stacie Hogan, RPH, Commissioner Barbara McKoy and Ainsley Johnson, Health Director. Others present: Mark Morris, Christopher Appel, Elaine Weeks, Vickie Hicks, Mary Jane Sauls, Debra Harris-Hawkins, Oliver Tolksdorf, Melissa McLamb, Gail Hobbs and Natasha Johnson. Chairwoman Smith called meeting to order at 7:00 p.m. Announcements - Ms. Johnson recognized Health Department's current retirees Elaine Weeks, Vickie Hicks and Debra Harris-Hawkins. Elaine Weeks is retiring with 30 years of services and Vickie Hicks and Debra Harris-Hawkins are retiring with 36 years of service. Ms. Johnson also recognized Commissioner Barbara McKoy who was honored with the 2024 Presidents Lifetime Achievement Award. This prestigious award celebrates individuals who have dedicated over 4,000 hours of volunteer service making a lasting impact in their community. Ms. Johnson welcomed Mark Morris, Executive Director of Good Hope Hospital presenting an update on the Good Hope Hospital Advisory Board, and Christopher Appel, Senior Staff Attorney presenting an update on the Harnett County Opioid Task Force. Chairwoman Smith reported that she and Vice Chairwoman Lori Langdon met on November 21, 2024 and performed Ms. Johnson's annual performance evaluation and reviewed her job description. A copy of Ms. Johnson's job description was mailed to the Board members for review, and the Board are not recommending any changes at this time. Consent Agenda - Minutes - Motion made by Dr. Lori Langdon, M.D., for the September 19, 2024, agenda and minutes to be approved and seconded by Commissioner Barbara McKoy, Motion Carried. 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. Seeing no one, Chairwoman Smith closed the informal comments. Page 2 Board of Health November 21, 2024 Harnett County Health Department Board Room Good Hope Behavioral Health Advisory Board - Ms. Sherrie Byrd is the liaison for the Board of Health and serves on the Good Hope Advisory Board which provides in- patient adult behavioral health services. Mr. Mark Morris, Executive Director provided the Board of Health an update and overview of the Good Hope Behavioral Health Services, and upcoming projects. The facility offers in-patient care for patients age 18 or older who have met the guidelines. This past year they have helped 475 individuals. Daymark Recovery Services will be opening an additional wing at the facility in 2025 that will offer behavioral health urgent care. Harnett County Opioid Task Force - Christopher Appel, Harnett County Staff Attorney and Opioid Task Force Co-Chair presented a power point to the board on the overview of the county's task force. He presented data on the county's overdose crisis and the responsibility of Harnett County to lead the battle against the opioid epidemic in our community. Harnett County will receive over $11,900,000 distributed from FY 2022-23 through FY 2038-39 through a memorandum of agreement with North Carolina; to date the county has received approximately $2,530,000. The county's task force team includes the Executive Committee and three sub-committees, which are Education & Prevention, Treatment & Recovery and Harm Reduction. Mr. Appel reviewed accomplishments and future initiatives of the team. Nomination Committee Report Chairwoman Smith asked Dr. Amanda Langdon, DVM, to give the Nomination Report. Dr. Amanda Langdon submitted on behalf of the nominating committee Dr. Laura Smith will serve as Chairwoman and Dr. Lori Langdon, M.D., will serve as Vice-Chairwoman. The nominating committee submitted no other nominations to the board. Chairwoman Smith opened the floor for any other nominations. No other nominations were received. Dr. Amanda Langdon, DVM, asked that nominations be closed and accept the slate of officers as presented, seconded by Dr. Catherine Evans, DDS. Motion carried. Meeting Schedule for 2025 - Ms. Johnson provided a copy of the Board of Health meeting schedule for 2025, and reminded the board the March meeting is the first Thursday and the September meeting is the fourth Thursday of the month and all other meetings are scheduled for the third Thursday. Recommendation to Established Fees - Gail Hobbs presented the following fees for new fees or an increase to established fees: CPT CODE DESCRIPTION RECOMMENDED PRICE 96381 RSV VACCINE ADMINISTRATION $50.00 Motion to approve the established fees Dr. Catherine Evans, DDS, and seconded by Dr. Lori Langdon, M.D., Motion Carried. Page 3 Board of Health November 21, 2024 Harnett County Health Department Board Room Debt Setoff = Gail Hobbs reported that since the last meeting, the Debt Setoff program has collected an additional $249.02 and the collection year to date total is $4,855.07. Health Director's Report and Program Reports = Ainsley Johnson Financial Reports - Ms. Johnson announced she met with Mr. Brent Trout, County Manager on the crucial need for an additional Environmental Health Specialist for Onsite Wastewater. Ms. Johnson presented the request to the Board of Commissioners (BOC) on November 12, 2024 and discussed the role of the Environmental Specialist and the impact of growth in Harnett County. The BOC approved the position on November 18, 2024 with an effective date of January 16, 2025. Ms. Johnson discussed the Regional ARPA funds from our regional lead in Cumberland County, and we have secured these funds and are able to replace all the carpeting throughout the building, and painting of downstairs and the stairwells; the project should start in January 2025. In October 2024, Department of Health and Human Services (DHHS) issued an amendment to our consolidated agreement. This amendment created some new requirements, which include Environmental Health, now has the requirement to have quality assurance plans for all their programs. The state will begin working on a statewide plan to assist with this in January of 2025; this was updated to meet the requirement in updated GS 143-300.8b. The other change was required reporting certifications for all agreement addendum funds we received. This affects our Finance Department and we are requirement to report all subcontractors and sub recipients of our funds through an online Smartsheet portal. Ms. Johnson provided a Child Fatality update and wanted to share legislative updates surrounding Child Fatality. As of January 1, 2025, all Child Fatality Prevention and Community Child Protection Teams must combine as a single team. Our current team already operate in a conjunction with the Community Child Protection Department of Social Services (DSS) team and meet quarterly. In addition, this team has to choose to remain a single county team or a multi county team. I met with Paul Polinski, DSS Director and we would like to stay a single county team. With the board's support, we will present this request to the Board of Commissioners at the next work session on November 26, 2024. We will receive additional funding in the form of a new agreement addendum in the coming weeks. These funds will be use to prepare for the use of the National Fatality Review Case reporting system. We will be required to use this system in July of 2025. Our next child fatality prevention and community child protection team meeting is on December 5, 2024. Ms. Johnson reviewed the expenditure and revenue summary from July 2024- September 2024. Health's federal and state revenues are a bit under budget at 17%; this is due to COVID funding being budgeted after the first of the fiscal year and not being utilized later in the quarter. Aging's federal revenues are at Page 4 Board of Health November 21, 2024 Harnett County Health Department Board Room 8%, and this is because Aging revenues are usually 2-3 months behind and this results in the low percentage. Revenues for Medicaid and patient fees are steady coming in and have exceeded the 25% quarterly rate at 33%, and CAP Medicaid and Aging donations are above at 27%. At the end of September 2024, we have only utilized 8% of health's county funds budgeted and 22% of Aging's county funds allocated. Total Health expenditures are at 16% and Aging expenditures are below the 25% rate at 17%. Most programs are at or below the 25% quarterly rate; Adult Health is higher due to purchase of Influenza and COVID vaccines for the season. Ms. Johnson requested the support of the board in purchasing a freestanding sharps disposal system. The system will be located in the front lobby of the Health Department, and would allow proper disposal of sharps that can include needles, lancets, blades and auto injector pens. Having access to sites across the county is a goal for the Harm Reduction Committee of the Opioid Task Force. The board acknowledged and supported the purchasing of the freestanding sharps disposal system. Ms. Johnson reported the Employee Clinic saved the county $59,958 in the first quarter. Clinical Report = Melissa Mclamb Clinical Activities Report - Melissa Mclamb reported the health department's clinical programs are staying busy, and numbers are reflective for this time of year. The most common thing seen is the Pediatric Primary Care Clinic over the past two months is cough and upper respiratory illness as we are entering into respiratory illness season. We encourage vaccinations, and we currently have COVID, Influenza and Respiratory Syncytial Virus (RSV) vaccines in stock. The state data shows that the number of emergency department (ED) visits and hospitalizations are low. During the months of September 2024 and October 2024 we have tested a total of 22 children for RSV, 114 children and employee clinic patients for COVID and 96 children and employee clinic patients for flu with results of only two positive COVID. We have had no positive RSV and one positive for Flu A. In addition, during September 2024 and October 2024 we have vaccinated 124 people for COVID and 1,502 people for flu. Our annual Flu Vaccine Drive-Thru event was held on October 10, 2024 at two locations; Harnett County Health Department and Tart Park in Dunn. Forty-eight flu vaccines were given. The health department signed Agreement Addendum 720 CDC Enhancing Seasonal Influenza Vaccine Efforts for Farmworkers. Through this program, we are able to order seasonal flu vaccines at no cost and distribute to livestock workers in our county at no cost to the livestock worker. We are collaborating with Cooperative Extension to advertise this project and visiting farms to administer flu vaccine to workers onsite. Livestock farmers can Page 5 Board of Health November 21, 2024 Harnett County Health Department Board Room come to the health department from 8am-1lam or lpm-4pm, Monday through Friday to receive the vaccine. COVID-19 = We have no COVID outbreaks in Harnett County for November 2024 but we had three outbreaks in the month of October 2025. Naloxone - Health has 416 naloxone kits in inventory; in addition to the 600 kits purchased by the Opioid Task Force, and we have received 300 doses from the state. We have given out 489 kits since this initiative began, and that includes kits given to individuals that come to the health department and kits given to organizations for distribution. Outreach - Since the last meeting, we have participated in a total of 14 outreach events. This week the mobile health unit was taken to the Town of Angier and COVID vaccines were offered on a walk-in basis. Environmental Health - Oliver Tolksdorf presented a slideshow of the devastation of Hurricane Helene on the western part of North Carolina in Mitchell County. Oliver assisted in Mitchell County with water testing and Environmental Health Specialist assisted in Buncombe County accessing nursing homes and water testing. Aging & Case Management = Mary Jane Sauls reported November is recognized as National Family Caregiver Awareness Month, a time to honor the millions of individuals who provide care and support to loved ones. The Harnett County Division on Aging Caregiver Support Program hosted an event to pay tribute to more than 50 million caregivers nationwide who support aging parents, ill spouses and other older and disabled loved ones who remain at home. The event, with 40 people in attendance, began at 10:00 am in the Commons and featured a program focused on educating the public about Living Wills, DNRs, and Health Care Power of Attorneys, presented by Liberty Health. The program concluded with a celebration of caregivers in Harnett County. From October 15, 2024 to October 31, 2024 the Division on Aging assisted 231 Medicare beneficiaries in Harnett County, guiding them through their options and helping them select the plans that best meets their needs. As a result, we were able to provide a total savings of $128,753 for these beneficiaries, showing the impact of making informed decisions during this important enrollment period. Page 6 Board of Health November 21, 2024 Harnett County Health Department Board Room The Annual Family Caregiver Program Holiday Craft Fair is scheduled for Friday, December 13, 2024, from 10:00 AM to 4:00 PM in the Commons area. The fair will feature a variety of handmade items, including baked goods, cosmetics, woodwork, wreaths, and more. Additionally, a lunch option of grilled cheese and chili will be available for $7.00. Proceeds from the lunch will go towards the DSS Christmas Cheer Program, which provides holiday gifts for elderly individuals in need. Health Education/WIC/Community Events = Debra Harris-Hawkins reported Health Education Division continues to provide programs and services that promote healthy lifestyles for Harnett County residents. The following programs took place in September and October 2024. ) Be Heart Smart Lunch and Learn - Health Education Division in partnership with Harnett Health offered the Be Heart Smart: Peripheral Artery Disease Lunch and Learn on September 17th at the Government Complex Commons area. A cardiologist provided the presentation, with an outcome of 57 participants attended. "Fall into Fitness" Move More Challenge ran from September 23-October 20, 2024. This is a virtual program to encourage participants to be physically active. Outcome was 149 registered and participated in this program. Pink Sunday- For this initiative we partnered with the Faith Community to promote breast cancer awareness and highlight the Health Department's screen program. Outcome was 16 churches participated by distributing health information packets with 405 packets distributed. Mobile Mammography -Rex Mobile Mammography was on site October 10th to provide screening mammograms. The show rate was 100% and the next screening date is December 5, 2024. Women Infant and Children (WIC): The WIC program aims to safeguard the health of low-income women, infants, and children up to age 5 who are at nutrition risk. Our WIC program continues to see an increased caseload. The most recent data includes staff providing services and/or issues electronic benefits for healthy foods to 3,500 participants each month. Vickie Hicks, Nutrition Director WIC program will retire January 2025, with 36 years of service. Community Events: Staff will be onsite in Dunn at a barbershop providing HIV testing; the event is scheduled for Saturday, November 23, 2024. Page 7 Board of Health November 21, 2024 Harnett County Health Department Board Room 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. Respectfully submitted, hinglugomws. Ainsley Johnson Health Director Dr. Laura Smith, OD, Chairwoman