CALL TO ORDER - With the executive committee constituting a quorum (See Attachments, pp. 2 - 4 NCALHD Attendance Roster), President Barry Bass called the meeting to order at 1:00 p.m. He thanked Leonard Wood, Chair and the Education Committee, as well as Anne Dillinger and Jill Moore of the Institute of Government for making arrangements for the meeting to convene at the Institute of Government in conjunction with the Health Directors' Annual Legal Conference.

President Bass thanked Tim Green for taking the meeting minutes for Tom Bridges who was out of state due to a death in the family.

APPROVAL OF THE MINUTES - The motion duly made and seconded to approve the September 9, 1997 meeting minutes with correction. The motion passed unanimously.

TREASURER'S REPORT - No report.

SPECIAL REPORT - By Dr. William Roper, Dean of the School of Public Health, UNC, Chapel Hill.

He says he feels he is among friends because he had spent much of his earlier career in local public health in Alabama. He worked in multi-county district health department and was a lobbyist with the state government on behalf of local public health. He looks forward to a long term investment in Chapel Hill and in development of improved public health services in North Carolina through improved relationships with state and local public health sectors. He also saw his role with Prudential Managed Care as the health officer for 5 million clients and he used epidemiological methods in carrying out his role. While working with CDC he always advocated for their need to be more practically focused instead of so much academically focused. He understands that at local level the local health director is the one really responsible and where the rubber meets the road. Academia need to help local health directors in meeting their responsibilities.

His priorities for him and the School of Public Health are:

1. Achieving excellence together. Strengthening the School of Public Health to gain a clear identity of the school as a whole.

2. While long time mission is to improve the health, there are two particular opportunities in this regard:

a. Working with new partners, such as managed care organizations, hospitals, general business communities and other groups who haven't seen themselves in public health arena.

b. To enhance our focus on vulnerable populations.

3. Continued focus on strengthening and transmitting the science base for public health policy and practice -- to build new knowledge and actively engage in transmitting that to new students and programs such as the Legal Conference. To this effort, a recent announcement is the new role of Dr. Richard House to divide half his time as Associate Dean for Government Relations and Educational Outreach with the School of Public Health and half his time with the State Health Director's Office. He will have a liaison role between these two institutions.

He is excited about the PH-TIN and the opportunities that offers in providing training and other needs through this resource.

George Bond raised the concern to Dr. Roper about his observation that the School of Public Health's Health Policy Department is not turning out local health directors as it once did a couple of decades ago. At the preceptors' conference at the School of Public Health last year not one comment was made about the medically underserved or indigent health care. It seemed very narrowly focused. Students' first question to speakers was how much do you make and how long did it take you to get there. It was all about managed care. Dr. Roper agreed that there are things that the School of Public Health could do. He wants to bring some more people to the school who have worked in government and in public health agencies.

Leonard Wood congratulated Dr. Roper for the move to place Dr. Richard House in the pivotal role in both public health academia and public health state government.

Jim Baluss asked Dr. Roper about how the SPH could assist local health departments in dealing with managed care. Dr. Roper believes that managed care is here to stay and will be the dominant method for delivery of health care in the United States. He doesn't think that fees for services were good old days in view of the costs and inefficiencies. A system that rewards providers for doing a good job is a better system. Many issues remain to be resolved, but this is the way we are moving. We need to build systems that further improve the health for everybody. His recommendations are: 1. To get over the notion that managed care is evil and look more positively in how to shape managed care as a constructive force for the good of all the community. 2. Get to know the people that are engaged in managed care. There are a lot of opportunities here for us to get involved.

One question was raised on the status of a Kellogg grant but no information was available. A suggestion was made that the UNC-SPH endeavor to emphasize opportunities for public health law. Deborah Rowe asked Dean Roper to encourage faculty and staff of the UNC-SPH to become active members in the NCPHA.

Dr. Roper plans to convene a focus group of local health directors to learn more about how the UNC-SPH can better serve local public health. His e-mail address is: Bill_Roper@unc.edu

SPECIAL REPORT - President Bass recognized Terrie Snowden to speak about new HCFA requirements for home health programs on Surety Bonds.

Terrie Snowden first wanted to remind everyone about Joyce Benton's expertise in risk assessment for medical liability and that she is available to consult with local health departments through Sedgewick James. Call Terrie Snowden and she can help local agencies get in touch with Joyce.

As of January 1, 1998, Medicare will require that home health agencies have Surety Bonding. The draft of the form has recently made available. Sedwick James' Bonding Department is set up to assist local health departments with home health agencies to get this type coverage. You can take care of this with a simple phone call. Terrie presented a one page information sheet (See Attachments, p. 5, Fact Sheet: Surety Bonding for Home Health Agencies). A local health department need not already be a Sedgwick James client to apply for this coverage. Call Tracy Tucker at 1-800-443-4086. He will put you on a list and take care of coverage whenever the bond form is readied. Cost will be somewhere between $ 500 to $ 1,500 for this coverage, depending upon the financial size of your department. This is not covered under any other current coverage/general bond. HCFA and your health department has to be named on this separate new bond.

Terrie Snowden plans to host another cocktail party Wednesday, January 14, 1998 for local health directors during the State Health Director's Annual Meeting. Please make your plans accordingly.

ANNOUNCEMENTS -

1. At the November 20, 1997 NCALHD meeting, Albert Thompson will give a brief presentation on disaster preparedness of shelters. As a result of experiences with Hurricane Fran, Mr. Thompson chairs a special task force to address many issues on people with special needs and how to obtain more coordination and collaboration among various agencies.

2. President Bass has sent a letter to Secretary Bruton on concerns about Carolina ACCESS. He and other local health directors met with folks from DHHS who include Chris Hoke, Tom Vitaglione, and Barry Goldstein. They will carry these concerns to a meeting with Dick Peruzzi next Friday. President Bass would appreciate any additional input from local health directors to assure that local health departments can be a continued provider to Carolina ACCESS patients.

In that same vein, a letter from the Hospital and County Commissioners Committee (chaired by Jim Baluss) has addressed this concern to DHHS.

3. A letter was sent to Dr. Bruton on behalf of NCALHD, NCPHA and Pride in Public Health in NC to make sure that the Office of Public Health and Communications that the Executive Director and Management Support positions tie to that office continues and that these groups will have access to those offices to continue historical working relationships.

4. There is going to be a Governor's Conference on Brain Development (Smart Start related) and Dennis Retzlaff will represent NCALHD at that meeting.

5. Michael Smith thanks local health directors who spoke to state legislators about needs to support funding of capital improvements for the Institute of Government.

Leonard Wood made a motion that the NCALHD provide a $ 5,000 donation to support the Institute of Government's capital improvement project. Motion was duly seconded. During discussions some concern was raised about the size of this donation and that the NCALHD's goal was to raise enough funds to employ an Executive Director. President Bass said that the time table would be in the next 6 to 9 months to get this individual employed. Also while it is a noble gesture, there is some concern to use funds from one government institution to support another. Other options would be to provide some fund over several years. Still, thought about memorializing a gift to celebrating and committing relationship with the IOG. Amendment to the motion to reduce this amount to $ 1,000. The friendly amendment was accepted by Mr. Wood and the second. Motion as amended motion passed with 22 yes and 8 no. The original motion then to allocate $ 1,000 passed with 29 yes and 8 no.

6. New Health Directors. Lynda Smith, Interim Health Director, New Hanover County Health Department, announced that David Rice will be their new Health Director as of November 10. He has been a District Health Director in Reno, Nevada.

COMMITTEE REPORTS

MANAGED CARE & REIMBURSEMENT - No report.

MATERNAL AND CHILD HEALTH/DENTAL - No report.

POLICY & PLANNING (Legislative) - No report.

STATE & LOCAL RELATIONS - Margaret Dollar reported that the next meeting is scheduled for November 5, 1997 at 4:15 P.M. at the Adams Building, room 158, Dorothea Dix Campus, Raleigh. There will probably be no meeting in December 1997, but January 1998, the new chair, Tom Bridges, will be meeting on the second Wednesdays of every month 9:00 A.M., Adams Building, Room 158.

Harold Gabel had bypass surgery and get well cards can be sent in lieu of telephone calls to Dr. Harold Gabel, #2 Snow Goose Cove, Greensboro, NC 27455. He will be back at work in November.

TECHNOLOGY - George Bond reported the following:

1. At last meeting Technology Committee essentially placed HSMS on hold for state of North Carolina. We also had $ 3 million in Medicaid Maximization funds but heard once again that it may not yet be available until next fiscal year. The SCHS came forward with recommendations for how to spend the money and it seemed very well thought out. The first $ 1 - 1.25 million they proposed would go to go to local health departments for infrastructure and other needs. To date $ $ 100,000 from local health departments, $ 250,000 SCHS Medicaid earnings and $ 70,000 from State Laboratory in place for HSMS development. In the meantime, the Technology Committee sent out Request for Information (RFI) to private software vendors to see what is available and approximate cost to meet needs for a privately developed HSMS. Technology Committee will convene Thursday, November 6, 1997 at 10:00 A.M., Albert Coates Building, Raleigh, to consider these proposals. This is reason Technology Committee chose to place HSMS on hold until these proposals could be looked at. If private vendor software is offered at a reasonable price, then it may be of benefit to go further with them.

The "worker bees" will meet all day on Wednesday, November 5, 1997 to go through these RFIs with a fine toothed comb and bring their recommendations to Technology Committee.

2. Next meeting need to consider proposal on how to get NCALHD homepage established no matter who is Secretary/Treasurer of the NCALHD. Help from the SCHS had been available, but they have had tremendous turnover recently and service provided had much to be desired. The SCHS Director has not been hired.

Joy Reed was told to go ahead and release the $ 100,000 to SCHS since the $ 250,000 is also available.

3. George Bond and Tom Bridges recently attended a Robert Woods Johnson sponsored meeting in Atlanta on computerization and saw that North Carolina is still far ahead of most other states in its computer infrastructure development. Saw Charlie Rothwell there, too.

NACCHO - New Director appointed about a week ago. George Bond will be sending out an appeal to local health departments to send in dues to NACCHO.

# STATE HEALTH DIRECTOR'S OFFICE - Chris Hoke reported the following:

Ten proposals for Carolina ACCESS II for demonstration projects will be considered tomorrow and Chris Hoke will advocate strongly for those that include public health and he will also advocate for having more than three pilot projects. He thinks he has support from the working group for this, and he hopes to have support from Medicaid folks.

Question asked on progress with Child Health Insurance and the Committee chaired by Tom Vitagloine. Chris Hoke said there is a long way yet to go on this issue. A new group of folks in the DHHS will be meeting with Appropriations Committee of the State Legislature to give them input and direction on where that could go.

Some thinking is that some of these funds could be used for school health funds and outreach but no clear idea yet.

Question was asked what is RFP process for Carolina ACCESS II? Was perceived that no information was given to local folks on how to participate. Chris Hoke said that things have been developing at a rapid pace. He did not have an explanation for the process that had been taking place.

NOMINATIONS & BYLAWS -

Election Results for Regional Representatives for the 1998-1999 calendar years were read out by President Bass as follows:

Region II - George Bond, Buncombe County

Region IV - John Shaw, Rowan County

Region VI - Mike Hanes, Montgomery County

Region VIII - Curtis Holloman, Sampson County

Region X - Dr. John Morrow, Pitt County

Slate of Officers recommended for Term 1998 Calendar Year by the Nominations and Bylaws Committee presented at the September 9, 1997 NCALHD meeting were as follows:

Office of Secretary/Treasurer - Tim Green, Alamance County

Vice President - Tom Bridges, Person County

President-Elect - Margaret Dollar, Lincoln County

President - Bill Smith, Robeson County

President Bass asked if there were any further nominations from the floor. It was duly moved and seconded that the nominations for these offices be closed. Motion to approve these individuals for these offices as presented by the Nominations & Bylaws passed unanimously.

EDUCATION & AWARDS - Leonard Wood reported that the E & A Committee is ready to consider nominations for the Ham Stevens, M.D. Award. Forms were available at the meeting and will be also available from the NCALHD homepage.

NACCHO scholarship applications are due March 1 and should be sent to the E & A Committee chair. The application form is available from the NCALHD homepage.

ENVIRONMENTAL HEALTH - EH Committee met on Monday, October 20. Terry Pierce reported as follows:

1. Melva Okum, doctoral student, UNC School of Public Health, made presentation re: ILO Deliverables for local health departments. She plans to provide information on ILO's, primarily re: hog industry, to local health departments as described in the handout and in accordance to the listed topic priority listing. Her work would be funded using lapsed salary funds in the Division of Environmental Health. Other concerns would be addressed by submitting them directly to Ms. Okum. (See Attachments, pp. 6 - 8, Work for Department Re: Deliverables About the Hog Industry)

Motion from Committee: That the NCALHD support the project proposed by Melva Okum, as described in the attached summary and that the deliverable by prioritized as follows: a. Summary of ILO rules and ordinances that were passed; b. Summary of HS 515 c. Summary of statues and regulations concerning the hog industry d. Relevant health studies; e. pertinent environmental issues. Motion passed.

2. Position Paper on Reorganization of DEH. Rick Rowe reported that a rough draft of the paper should be completed by the end of October. Committee is soliciting representatives from the two Departments and from Bill Holman, spokesperson for Sierra club and other groups that favored keeping EH in DENR. The Committee stressed the need to get the paper completed in order to build consensus with County Commissioners, Local Boards of Health, etc. Rick Rowe Emphasized the need to contact Environmental Review commission members.

Organizational charts for DHHS were distributed (See Attachments, pp. 9 - 13, Organizational Chart: NC Department of Health and Human Services)

3. Authorization rules - Proposed Amendments. Proposed amendments to the Authorization Rules will be considered for adoption at November 14th commission for Health Services meeting. Committee was reminded that by specifying the number of hours for individual authorizations the total number of hours of continuing education obtained will exceed the hours required by the R. S. Board. Copy of the proposed amendments to the Authorization Rules are attached. (See Attachments, pp. 14 - 26, Authorization Rules)

Motion from Committee: That the NCALHD support the proposed amendments to 15A NCAC 18A .2301 through .2310 (Authorization Rules). Motion passed.

4. Proposed Revisions of Restaurant Rules. Doug Urland and Michael Rhodes clarified several concerns re: Restaurant Rules as published in the State Registry (See Attachments, p. 27, Memorandum from Michael Rhodes Clarifying Proposed Restaurant Rules Changes). A public hearing is scheduled for November 4, 1997 to review comments. Proposed revisions may or may not be discussed at the November 14, 1997 meeting of the Commission for Health Services. Can not vote on Rules at the 14th, can vote at the February DHS meeting. Michael Rhodes clarified that color of grade cards will not be included in the rules. This will be decided by the Division. After considerable discussion, deliberation, and interchange,

Motion from Committee: That the NCALHD recognize and commend the outstanding work and the dedication to task of the Restaurant Rules Review Committee and that the NCALHD recommend the following changes:

.2606 (b) Revised to replace the system of average grade of A in the last four quarters with sustained grade of A for the previous 4 quarters (previous four quarters is time specific -- not last 4 grades)

.2604 (b) Allow on-the-spot corrections with the insertion of the phrase, "at the Environmental Health Specialist's discretion" after the word spot.

.2618 (b) In Include a definition for "food grade materials.".

.2843 (a) Clarify what is meant by 7 days (in the hands of the Health Director, post marked, whatever)

Motion passed with 30 yes and 8 no.

Much concern was expressed about the appeals procedure taking place at the local level and without any additional funding. Chris Hoke explained the process as a formalization of what has been an informal local appeals process. The question was also raised about instances in counties where there is only one or only a half time foods and lodging EH Specialist who would in essence have to second guess himself. It was suggested that the regional EH Consultant be available to assist in this appeals process.

Motion was duly made and seconded that the NCALHD to take the position in support of the rules with amendments. Motion fails with 13 yes and 20 no.

EPIDEMIOLOGY - Dr. Walter Linz reported that

1. 18 rural counties that have $ 18,000 each for HIV education funds that had been cut from a Mental Health budget. This was brought to the attention to the Secretary who said he would restore that money. To date the money has not appeared.

2. Next fiscal year, Epidemiology is going to take a 1.8 percent cut from all CDC monies which translates to a $ 90,000 decrease. That decrease will be absorbed by the Epidemiology section and if they can't identify enough state level areas, then cuts will be to local agencies. These monies will primarily affect STD and HIV programs. Nothing firm yet, but just expect this.

3. Christine Moe at Chapel Hill has a grant to incorporate resources of UNC to Internet hookup with state and local health departments. This will be a way for students to help in investigations of epidemics. A representative of Technology Committee was on hand to collaborate on this proposal.

Dr. John Morrow made the motion that the NCALHD send a letter to Dean Roper that the NCALHD supports this project with UNC-SPH. George Bond seconded and the motion passed.

4. A Roper Commission has been appointed consisting of Dean Roper, chair, and five other physicians to address the Pfisteria problem in North Carolina. They are to reviewing the evidence. Involves med schools at ECU, Duke and Chapel Hill. On-going project investigation.

5. Trinity Foam Company in Randolph County who makes fiberglass products that has spewed forth tons of toluene blue in the air. Local residents have developed allergic type syndromes.

Company is shut down and is in process of doing something about reducing these emissions.

HEALTH PROMOTION - No report from committee, however Curtis Holloman requested to yield his time to Dr. Sherman Kahn to make a presentation on opportunities to work with the NC Medical Society.

Dr. Kahn reported that the NC Medical Society is planning their Second Annual Tobacco Control Conference in April of 1998 in conjunction with their Annual Spring Meeting and they are asking the NCALHD to be a co-sponsor. They have also asked the American Cancer Society, the American Lung and the American Heart Associations, and the medical schools at UNC and Bowman Gray to co-sponsor. They are not asking for any financial support from their co-sponsors. They are going to focus on environmental tobacco smoke. Topics will include: health hazzards of ETS, legal and policy issues in North Carolina and nationally, and opportunities for protecting patients, their families and the public from the health effects of ETS. Sally Malek from Project ASSIST and Curtis Holloman have been attending the meetings. The motion was duly made and seconded to co-sponsor this conference. Motion passed.

HOME HEALTH ALLIANCE (NCAPHHA) - President Bass said that the NCAPHHA had its first Annual Conference on October 8 - 9, 1997 in Burlington, NC. The Board of Directors include Louis Latour, President; Bill Smith, Vice President; Anne Scott, Secretary; Marian Duncan, Treasurer. Also, Board of Directors elected to three terms are Jim Baluss and Margaret Dollar. The Alliance continues to garner managed care contracts and to move forward.

HOSPITAL & COUNTY COMMISSIONERS ASSOCIATION NETWORK - The committee did not meet, however, Jim Baluss said another meeting was convened to try to develop consensus on how to deal with Carolina ACCESS II. Some interest in developing relationship with Hospital Association to come up with a more effective mechanism to deal with Medicaid managed care.

DMA/Carolina ACCESS furnished Jim Baluss a contract agreement which could be used between PCPs and Health Departments to formalize the contracts and be authorized by DMA/Carolina ACCESS. (See Attachments, pp. 28 - 30, Agreement Addendum for PCP/LHD Contracting Under Carolina ACCESS)

He also hopes to work further with DSS, Aging, and NCACC to look into enhancement of working relationships. Perhaps a conference could be convened on local government issues -- local human services delivery systems/issues as it relates to Medicaid managed care. Jim Baluss hopes to have this meeting planned within the next month.

# INSTITUTE OF GOVERNMENT LEGAL ADVISORY - Jill Moore was welcomed to the NCALHD meeting. She is interested in getting out and visiting local health departments as part of her orientation. She welcomes any invitations from local health directors.

VISIONING COMMITTEE - President Bass wanted to remind the membership of the follow up Consensus Conference scheduled for Thursday, October 30, 1997 at 8:00 A.M. - 5:30 P.M., Wake Commons Building, Raleigh. To date there were 48 registrants. Jeff Koeze and Bill Herzog will be facilitators. This will be the first meeting. It is expected that a series of follow up meetings will ensue next year that will be more and more inclusive. Purpose is to look at local public health governance and funding.

SPECIAL REQUEST - President Bass recognized Tamera Hower, Beaufort County, who requested to have bylaws and procedures by next Tuesday. She wanted examples in writing how this could be done.

LIAISONS & OTHERS

NCPHA - Deborah Rowe reported that some of the state legislators will be returning to Raleigh to work on several items on their agenda. Of particular concern to Public Health and which NCPHA will be closely following are:

1. The Environmental Health Review Commission that will be reviewing the organizational placement of Environmental Health programs. They will hold their first meeting on Wednesday.

2. Blue Cross Blue Shield Conversion Commission. The Senate has already selected their members to that Commission. The House has yet to announce theirs.

OFFICE OF PUBLIC HEALTH NURSING AND LOCAL HEALTH SERVICES - Dr. Joy Reed reported the following:

1. Although the organizational chart for the DHHR is not finalized, she is now the Acting Chief for the New Local Health Improvement Section as well as Director of the Branch which includes Public Health Nursing and Special Development. She will still have the Administrative Consultants, the Medicaid Reimbursement staff, and the Public Health Nursing staff. If you have difficulties with the new organizational changes in knowing who to call, call her office

and they will try to offer assistance.

2. She recently sent out E-mail asking local health directors for emergency contact numbers for outbreak situations. She got 41 responses but needs to hear from the other local agencies.

3. Another survey she needs information on is allied health professionals. How many and categories. To date she has heard from 52 of the 86 health departments have replied.

4. Report on role of consultants. She welcomes input from local health departments on evaluating consultants and how to utilize them more effectively.

5. List of issues of CPT/ICD-9 coding. She is following up on how to get Medicaid reimbursement for nurse screening. The coding system currently doesn't allow. In the state of Georgia the Medicaid agency assigns each health department a code number that they use to bill all nurse screener services. That sounds like the simplest way to go and will be her recommendation.

ANCBH - President Bass welcomed Carmine Rocco, the new Executive Director of the Association of North Carolina Boards of Health. He expressed his appreciation for being invited to the meeting. He has been doing a lot of learning over the past four weeks since taking the position. He comes from the Guilford County Health Department where he served 10 years there in a variety of capacities from septic tanks to computer systems.

He will endeavor to spend the bulk of his efforts with the ANCBH on its goal and purpose which is education. To accomplish that he is working on staffing the organization. He anticipates one additional person to work with him on education efforts. He asks the patience of local health departments as he works on getting this done, which will be sometime after the first of the year.

The ANCBH is looking for nominees to serve on the ANCBH and ask for local health directors to forward names to him. His telephone number is the same number used previously by Pam Horne: 919/677-4135. He also has an e-mail address: crocco@ncha.org

PUBLIC HEALTH AWARENESS PROGRAM - Dr. Christopher Cooke.

1. Wish List. (See Attachments, p. 31, What Local Health Directors Can Do To Support Their Public Health Awareness Program - NC PHAP: The Top Ten) The Awareness program is directed primarily by an advisory committee which meets in Raleigh twice a month. They would like to have a local health director on this committee to represent the NCALHD.

2. Every local health department needs to identify someone to be a media facilitator. This is critical to their mission. Media Facilitator training will be again offered this coming spring. Other than transportation and meals, the training is free and in local AHEC's across the state. He will provide all the materials and other resources to help local media facilitators.

3. If you do not already have a media awareness outreach presentation package, which includes the video "Everywhere, Everyday, Everybody"; the speech, "North Carolina Public Health, the Quiet Miracle," the accompanying overheads and the action steps handouts for people who attend outreach presentations please let Dr. Cooke know. These kits are paid for. The media facilitators are trained to use them to take to the public health message out into the community. In terms of institutionalization, he would ask that you look at the job description of your media facilitators in your health department and try to incorporate into those job description media relations and outreach presentations functions and activities. The only way we are going to get the message about public health into our community is that the people we have assigned to do them are held accountable for that work. We want to provide the training and capacity for them to do that but he is asking your help to do that at the local level in trying to put this work in the agenda in the budgets, in the job descriptions and in the performance evaluations so we can start keeping track of the work that is so important.

Each health director should try to make sure that the outreach presentation, a form of public health awareness presentation, is made in the next twelve months to:

a. Local Board of Health b. Board of County Commissioners Additionally, he asks that the local media facilitators make an outreach presentations over the next twelve months to at least five civic or community groups.

If we are going to reach our target audiences, our voters, the decision makers and policy makers, we are going to have to take our message to them. The message is there, it's been packaged, it's uniform. All we're needing now is to get the mechanics in place to have them go out. To the extent that local media facilitators are making these presentations, he would ask that the local media facilitators are encouraged to complete and return to Dr. Cooke's office the monitoring and tracking forms which gives him data back about who has been given the messages, who has come to hear the presentations, and who the audiences are. This will begin the establishment of a track record and demonstrate that the dollars being used for outreach are actually reaching the intended audiences with the messages to whom they have been designed.

Finally, there is an incentive program in place to encourage local media facilitators to make outreach presentations at the next annual meeting of the NCPHA. A fully configured laptop computer will be awarded to the health department or facilitator who makes the most outreach presentations in the twelve month period, beginning at NCPHA this year. In order to be considered for the award, one must have the necessary documentation (the monitoring and tracking forms) for those presentations into Dr. Cooke's office. Those forms were contained in the kit that went out to local health departments. If you don't have one, please let Dr. Cooke know and he will get those materials to you. As a matter of quality control, the media kits have been sent out only to those agencies who have had a media facilitator trained. If you do not have a kit, the kit can be made available and a consultant can be made available to provide training to that local media facilitator.

MANAGEMENT SUPPORT - Management Support Supervisors Association will be holding its annual meeting in Raleigh November 5 - 7, 1997 and they ask for the support of local health directors to allow for staff to come. Major program areas will include Carolina ACCESS, managed care. Chris Hoke will be talking about state changes.

REGIONAL REPORTS - No reports.

OTHER BUSINESS - None

ADJOURNMENT - With no further business, President Bass adjourned the meeting. The next scheduled meeting of the NCALHD Executive Committee will be held on November 20, 1997, 9:00 A.M., at the Auditorium, Albert Coates Building, Raleigh, NC.

Respectfully submitted,

Tom Bridges, Secretary