Harnett County Board of Health Minutes of Regular Meeting January 16, 2025 The Harnett County Board of Health met in regular session on Thursday, January 16, 2025 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. Amy Brown, Dr. Catherine Evans, DDS, Ms. Stacie Hogan, RPH, Commissioner Barbara McKoy, Ms. Kandi Tudor and Ainsley Johnson, Health Director. Others present: Belinda Rayner, LaVonda Avery, Mary Jane Sauls, Oliver Tolksdorf, Melissa McLamb, Gail Hobbs and Natasha Johnson. Chairwoman Smith called meeting to order at 7:00 p.m. Announcements - Ms. Johnson announced Ms. Amy Brown has been appointed by the Board of Commissioners to serve on the Board of Health on December 16, 2024, she will move into the public member position. Ms. Brown completed her Board of Health Orientation on January 10, 2025. Ms. Johnson introduced guests Belinda Rayner and LaVonda Avery. Belinda Rayner is the interim Local Public Health Administrator and LaVonda Avery is the interim Nutrition Program Director. Ms. Johnson reminded the board that the next meeting will be the budget meeting and is scheduled for March 6, 2025. Consent Agenda - Minutes - Motion made by Commissioner Barbara McKoy for the November 21, 2024, agenda and minutes to be approved and seconded by Commissioner Dr. Lori Langdon, M.D., 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. Consumer/Patient Satisfaction & Community Survey Report - Mary Jane Sauls presented the results of the 2024 Consumer/Patient Survey, which was conducted from December 17, 2024 to December 30, 2024. A total of 482 surveys were completed, either fully or partially. Surveys were available in clinics and other locations, including the Division on Aging and Environmental Health. The survey demographics showed that 18% of respondents were men and 81% were women. The racial and ethnic breakdown included 35% Caucasian, 26% African American, 34% Page 2 Board of Health January 16, 2025 Harnett County Health Department Board Room Hispanic, 1% American Indian, and 1% Asian. Regarding survey responses, 94% of participants indicated that the operating hours (8 AM - 5 PM, Monday through Friday) were convenient. Additionally, 99% of respondents reported feeling respected during their interactions. The results were reviewed by the management team and staff, and after a final review by the Board of Health, no follow-up action was recommended at this time. The survey data will be used to inform future program planning and to ensure that services continue to meet the needs of the community. Recommendation to Established Fees = Gail Hobbs presented the following fees for new fees or an increase to established fees: CPT CODE DESCRIPTION RECOMMENDED PRICE 86480 QuantiFeron TB Blood Test $80.00 Motion to approve the established fees Dr. Catherine Evans, DDS, and seconded by Dr. Lori Langdon, M.D., Motion Carried. Child Fatality Prevention/Infant Mortality Report - Belinda Rayner presented the 2024 Child Fatality Prevention Report. The Child Fatality Prevention (CFPT) and Community Child Protection Team (CCPT) is a multidisciplinary group charged to review all child fatalities in Harnett County occurring in children ages of birth through seventeen. The purpose of the CFPT/CCPT is to review causes of child deaths and to make recommendations based on the team's findings to reduce future child fatalities. Approximately 22 child death reports were received for review in 2023. This was a slight increase from 2022 in which there were 17 child deaths for Harnett County. Males contributed to the majority of fatalities at 64%. Cases reviewed by ethnicity: 50% were identified as Caucasian, 41% were identified as African American, and 9% were identified as Other. Approximately 13 of the 22 deaths (59%) were Infants, two deaths (9%) were ages 1-4 years, three deaths (14%) were ages 5-9 years, and four deaths (18%) were ages 15-17 years. The CFPT/CCPT identified system issues that may have played a role in these deaths which included inadequate prenatal care, perinatal substance abuse, improper use of booster seat and children having access to a loaded weapon at home. The Child Fatality Prevention Report also included the latest Infant Mortality Data released in October 2024 for Harnett County. Infant mortality is the death of an infant before his or her first birthday. Infant mortality rates are the number of infant deaths for every 1,000 live births within a given time frame, usually a year. In 2022, the infant mortality rate in North Carolina was 6.8 per 1,000 live births. Harnett County's Infant mortality rate was 7.7 per 1,000 live births. The number of infant deaths reported was fourteen (14). The total live births reported was 1,829. Page 3 Board of Health January 16, 2025 Harnett County Health Department Board Room Health Director's Report and Program Reports = Ainsley Johnson Accreditation = Ms. Johnson 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 2023-2024, no new or amended rules or ordinances were needed. The Board will continue to monitor. Legal Counsel = Ms. Johnson 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 our department on an as needed basis. Financial Report - Ms. Johnson reminded the board that W2's for this year's tax season are available and can be accessed in the employee vendor service of Munis. If you need assistance, please let her know. We are working on filling several vacancies this month- this includes the Local Public Health Administrator, WIC Nutrition Program Director, Accounting Technician, Environmental Health Program Specialist, Environmental Health Specialist Food & Lodging and our new Environmental Health Specialist Onsite Wastewater position. These interviews are taking place throughout this month. We have finalized the process to obtain the free-standing sharps disposal unit that we discussed at the last board meeting in November 2024. A proof of the unit is located for you to view in the center of the table. The North Carolina Association of Local Health Directors has established the legislative priorities for this session. The priorities are: I. Seek legislation providing 25 million in recurring state funding for local public health foundational capabilities and essential services II. Support proposed legislation to amend NC's youth access law to protect children and youth from vaping and nicotine addiction III. Support legislation that restores state funding for accreditation for local health departments IV. Seek legislation to direct 2.5 million of the currently appropriated community health grant funding to support local health departments that provide primary and maternity care for uninsured patients As part of our efforts on the Harnett County Opioid Tasktorce, we are working to provide educational programs to grandparents raising children and the Department of Social Services foster parents to increase awareness of substance use, education of talking to children about prevent of substance use and use of naloxone. Mary Jane Sauls will share an upcoming event in her Page 4 Board of Health January 16, 2025 Harnett County Health Department Board Room report. Ms. Johnson will also attend the North Carolina Summit to Reduce Overdose in March 2025 with the members of the Opioid Taskforce. Ms. Johnson provided an update on the Care Management Program; when Medicaid transitioned to managed care plans, a timeline was set for PHPS to decide whether to contract with local health departments or provide the services independently. In the upcoming fiscal year, Prepaid Health Plans (PHPs) are expected to partner with local health departments that meet their established benchmarks. Starting next year, PHPs will have the option to either continue contracting with local health departments or explore other options. We will be actively working on advocacy efforts, reaching out to each PHP to discuss the importance of these programs Ms. Johnson reported the Employee Clinic saved the county $63,019 in the second quarter, with a total of $122,977 for this FY 24-25. Ms. Johnson provided a handout of the second quarter's finance report for July 2024 through December 2024. Expenditures for Health and Aging are both at 39%. Federal revenue for the Aging programs are lower at 39% because federal reimbursement from Mid Carolina is several months behind. Aging total revenue received is at 49% while utilizing 23% of our total county allocation. Federal revenue for Health is only at 40% due to COVID-19 federal funds are not being utilized as much now since the decrease in the need for COVID-19 vaccinations, resulting in budgeted funds that will not be received. Total revenue received for Health is at 54% and we are only utilizing 24% of our total county allocation. Clinical Report = Melissa Mclamb Clinical Activities Report = The clinic activities summary is on page 15 of the packet. Health department clinical programs are staying busy. There is a decrease in the number of well visits performed in our Child Health Clinic and this is due to a vacant Public Health Nurse position. The vacancy was filled on January 6, 2025, and she is currently orienting to the clinic. This nurse will be eligible to begin training for Enhanced Role Certification when the next cohort begins, and this is expected to be in August 2025. After completing this certification, the clinic will be able to open all well child appointment slots. Respiratory Surveillance - Melissa McLamb presented a PowerPoint of the state and Harnett County specific data graphs from North Carolina Department Page 5 Board of Health January 16, 2025 Harnett County Health Department Board Room of Health and Human Services (NCDHHS) Respiratory Surveillance Dashboard and the NC DETECT. This included emergency department visits and diagnosis related to general respiratory viruses, influenza like illnesses, and COVID. From December 1, 2024 through January 16, 2025 the health department pediatric primary care and employee clinic performed 41 RSV test (8 positive), 94 flu test (12 positive), and 70 COVID test (0 positive). Communicable Disease - The health department received a memo from NCDHHS regarding an increase in brucellosis cases in Johnston County. This memo was faxed to all Harnett County medical providers. There was one COVID outbreak in December 2024 in a long-term care facility that has been resolved and the outbreak was closed. There is currently a flu outbreak (4 residents and 3 staff members) at a long-term care facility. Narcan - As of today, the health department has 306 naloxone kits on hand. Since January 2024, the health department has distributed 370 kits to individuals and 860 kits for organizational distribution. Environmental Health - Oliver Tolksdorf reviewed the Onsite Wastewater section has been very busy performing migrant house inspections. Currently Environmental Health has the following vacancies: Food & Lodging has two Environmental Health Specialist positions, one Environmental Health Program Specialist position, and the Onsite Wastewater section has one Environmental Health Specialist position. Oliver and Ainsley Johnson will be meeting with Soil & Water Conservation soon to create a new mosquito spraying map for the county. Aging & Case Management - Mary Jane Sauls announced volunteers from the Harnett County Volunteer Services Program and the Volunteer Income Tax Assistance (VITA) Program will start preparing and electronically filing federal and state income taxes in early February. At the Coats Senior Center, VITA volunteers will be available to prepare taxes every Tuesday from 9:00 AM to 1:00 PM. VITA volunteers will also be available at the Erwin location on Wednesdays and Thursdays from 9:00 AM to 1:00 PM. Appointments for this site can be made by calling the Harnett County Division on Aging at 910-893- 7578. Additionally, Campbell University will be offering tax preparation services at the Harnett County Resource Center/Library every Thursday starting February 6, 2025. These services are provided on a first-come, first-served basis, with no appointment needed. The sessions run from 11:00 AM to 5:00 PM. Further details are available by contacting the Harnett County Public Library. The Division on Aging is partnering with the Harnett County Sheriff's Department to host a presentation titled "Hidden in Plain Sight. Lieutenant Page 6 Board of Health January 16, 2025 Harnett County Health Department Board Room Josh Christensen, the Narcotics Supervisor at the Harnett County Sheriff's Office, will lead the presentation. The event will take place on February 18, 2025 at 10:00 AM at the Harnett County Library. This presentation is tailored for grandparents raising grandchildren and foster parents, in response to a need identified by the opioid task force. The session will also include naloxone training. Health aieton/Ic/Commuly Events - Belinda Rayner reviewed the Women Infant & Children (WIC) section has been preparing for an upcoming audit. The onsite audit will take place on January 29th and 30th. In the coming months, WIC will be making efforts to increase participation numbers in their evening clinics through community outreach and increased media. The Health Education Division is preparing for American Heart Month initiatives in February: I. Go Red Lunch and Learn on Tuesday, February 18, 2025 from 11:30am- 1:00pm in the Commons Area. This program is conducted in partnership with Cape Fear Valley Harnett Healthcare II. Go Red Sunday- Go Red Sunday raises awareness that heart disease is the #1 health threat of women. One Sunday in February churches are invited to participate in Go Red Sunday by encouraging members to wear red to increase awareness of heart disease in women. The participating churches are provided with heart health information packets to distribute to members of their congregation III. Heart Health session will be provided for the members of Lillington First Baptist Church on Sunday, February 23, 2025. 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 16, 2025 Harnett County Health Department Board Room Respectfully submitted, frinduylonvo Ainsley Johnson Health Director 1 - Dr. Laura Smith, OD/ Chairwoman