CALL TO ORDER - President Smith called the meeting to order at 9:00 a.m. Full Association meeting. (See Attachments, pp. 1 Ð 3, Attendance Roster and Proxy Letters.)

1. President Smith said according to the Robert's Rules of Orders if anyone objects to the "Call the Question," discussion can continue unless an objection is raised a total of three times. On the third time, the vote will be taken.

 

2. President Smith said he had received two proxies, one from Anne Thomas to Tom Bridges. He called any additional proxies. None were received.

 

3. Tom Bridges discussed changes relating to the Internet since the State Center can no longer support the Association homepage. Procedures are in the works for transferring the files from the State Center to the Person County Health Department. Mr. Bridges will notify everyone by E-mail as soon as everything is ready and if there is a need to use a different address to locate the homepage.

APPROVAL OF THE MINUTES - A motion was duly made and seconded to approve the November 20, 1997 meeting minutes. A couple of edits were noted. With agreement for a friendly amendment that the minutes be approved with corrections, the motion passed unanimously.

TREASURER'S REPORT - Tom Bridges

1. Tom Bridges reviewed the Report of December 9, 1997. Mr. Bridges mentioned that Tim Green would be looking at leaving more money in the money market account in an effort to earn more interest, and as monies are needed, they would be transferred into the checking account.

 

Motion was duly made and seconded to accept the Report as presented with edit corrections. Motion passed unanimously.

 

2. 1998 Budget - Mr. Green commended Mr. Bridges for his work as Secretary/Treasurer during 1997. Copies of the 1998 proposed budget were distributed. Annual dues are determined with a base of $200 with an additional 15 cents per one hundred population. Some line items were reviewed. Contractual Services - $14,905.00: Some monies from this line item could be used to contract a consultant relative to the Vision Committee's work. Bid information has been distributed and we will be accepting proposals. Another possibility to be reviewed in the fall could relate to hiring an Executive Director for the Health Directors' Association. Mr. Green said the 1998 proposed budget is based on dues remaining the same as last year. If any expenses are incurred beyond the 1998 proposed budget, dues paid to the Association could increase. Mr. Bass gave a brief report outlining the Visions Project along with a timetable. (See Attachments pp. 10 Ð 14.)

President Smith circulated the signup sheet for committee assignments. He encouraged everyone to sign up to serve on a committee and requested the committee chairs prepare brief minutes of committee meetings that can be included in the Association minutes.

Members were also reminded to sign the attendance sheet for today's meeting.

Everyone was encouraged to attend the reception to honor retirees at the Velvet Cloak Inn. The Ham Stevens award will also be presented.

President Smith said in the interest of time, action items would be heard first. If additional information is to be provided, this can be shared later in the meeting.

President Smith has been representing NCPHA and the Health DirectorsÕ Association for the North Carolina Governor's Conference on Rural Health March 31 and April 1. Nan Rideout reported there is a preliminary conference planned for March 30 and 31. In response to areas of concern expressed by the health directors, a consultant has been highly recommended by AHEC. This individual has developed other workshops for health care. The directors were asked to complete a survey and return as soon as possible. (See Attachments, pp. 15 Ð 20, Beyond Managed Care: Restructuring Rural Health Care and Local Health Department Technical Assistance Project.)

There were no new health directors, however, Curtis Holloman will be relocating to Scotland County Health Department effective February 9. Since Curtis Holloman will be relocating, the Executive Committee will need to discuss his vacancy in February.

President Smith reported that when treasurers for the Association change an audit is conducted. He requested three regional representatives volunteer to conduct this audit.

President Smith will speak to the Public Health Study Commission representing NCPHA and the Health DirectorsÕ Association providing a public health perspective on issues such as reduction of Medicaid earnings and what this means to the infrastructure. The Medicaid maximization concern was also voiced as an issue.

TECHNOLOGY COMMITTEE - George Bond. The Technology Committee met on two occasions.

Mr. Bond reviewed briefly some of the background involved in making the following motion:

Motion from Committee: That the NCALHD fund up to $2,000 to pay for a contracted technical writer--acquired off the SIPS convenience contract list--to gather information from the Technology Committee to give a price and proposed time frame for the development of an RFP for one or more proprietary software packages for local health departments. Said $2,000 to be reimbursed from the $3 million in Medicaid maximization money if/when released. Motion carried unanimously.

ENVIRONMENTAL HEALTH COMMITTEE - MiMi Cooper

The Environmental Health Committee met and made the following motion:

POLICY AND PLANNING LIAISON COMMITTEE - Maggie Dollar

Motion of Committee that the Health DirectorsÕ Association write a letter to Secretary Bruton advocating that Public Health Services be available across the state and funded regardless of whether or not a particular health department is in the position to be a primary care provider.

All health directors were urged to immediately write a letter to their legislators supporting approval of the Child Health Insurance Plan. Additionally, emphasis was directed to the specific counties of Cumberland, Buncombe, Guilford, Johnston, Mecklenburg and Gaston to write their legislators urging approval of this program.

A motion was made with a friendly amendment that the two committees work together to draft a letter to the Lt. Governor from the Association urging support of the Child Health Insurance Plan and encouraging the development of a comprehensive plan in support of children to include public health and Health Check. The motion carried.

INSTITUTE OF GOVERNMENT LEGAL ADVISORY - Jill Moore

After some discussion

A motion was made and approved that the Association approve a resolution as presented on providing public health services to aliens. (See Attachments, pp. 21 Ð 25, Summary of Resolution on Providing Public Health Services to Aliens.)

Barbara Pullen Smith presented a resolution and after some discussion a

Motion was made and approval given to support the Resolution on Language Services in Public Health. (See Attachments, pp. 21 Ð 25, Resolution on Language Services in Public Health.)

WOMEN'S AND CHILDREN'S HEALTH COMMITTEE - Dr. John Morrow

Committee met and discussed the Lead Screening Program. Currently only 30% of children ages 12 to 24 months are being screened for lead in North Carolina. CDC released new recommendations in November for lead screening. (See Attachments, pp. 26 - 27.)

A questionnaire would be used for children ages 12 to 24 months to determine who would be screened; also zip codes would be used to rule out some children who would not need screening. Screening requirements would be reduced from 15 to 10 milligrams per deciliter for being tested.

The Committee heard an update on the new Office of Women's Health. The Office of Rural Health serves an advocacy role for life cycle issues for women. Some focus groups have been conducted across the state to examine issues and are in the process of developing a women's health report card. The Adolescent Parenting Program has been moved from DSS to public health. Twenty-seven of these programs exist across the state with only one being located in a health department--Robeson County. This program is being reviewed with the possibility of expanding or merging with another program.

A draft of the Contract Addenda was received today. Will try to get this information on the Internet.

ANCBH - Carmine Rocco

Meetings and sharing of ideas continue. The March 19th annual meeting is in Raleigh. Board vacancies in the mountains and on the coast exist. If anyone has board members who would like to serve, let Carmine know.

NCPHA - Debra Rowe

Debra announced public hearing on CHIPS to be held January 15. She announced the upcoming meeting of the Public Health Study Commission and a meeting of the Environmental Health Review Commission to address the White Paper. In regard to Blue Cross/Blue Shield, the next meeting is February 3, with public hearings in March.

STATE AND LOCAL RELATIONS COMMITTEE REPORT - Tom Bridges

The committee had a two-part meeting.

(See Attachments, pp. 28 Ð 29, North Carolina Association of Local Health Directors, State and Local Relations Committee Report.)

STATE HEALTH DIRECTOR'S OFFICE - Chris Hoke

1. Health Check - Discussed accountability system with emphasis on access, quality and high rates of health check.

 

2. Very little to report on recruitment to fill the State Health Director's position. Two interviews have been held.

 

3. Epidemiology Committee - The search committee has proposed the position be open to non-directors, PhD's and other degrees.

 

4. Will continue to keep everyone informed regarding Medicaid maximization.

 

5. Public Health Study Commission Ð Several meetings held with staff. Encouraged attention on infrastructure needs of public health.

 

6. Environmental Health - No final word from DEHNR on the reorganization. Staff pursued hard on the recommendations of the White Paper. Responses were positive concerning on-site sewage program, however, less positive concerning public water supply position.

TECHNOLOGY COMMITTEE - George Bond

George Bond agreed to contact the State Center for Health Statistics regarding the availability of a portion of the $100,000 previously designated from local health departments to help support the cost of our RFP.

EDUCATION AND AWARDS COMMITTEE - Wayne Raynor

Committee Members are: Wayne Raynor, Curtis Holloman, Phyllis Lowry, Eugene Hines and Wayne Sherman. Additional members are needed.

Additional Educational Opportunities for LHD's

1. Joy Reed, Office of P.H. Nursing
2. Governor's Conference on Rural Health in Greensboro: 3/30 - 4/1
3. Women's Health Summit: 3/30 - 4/1

Spring Conference to be held in April 1998.

1. Have hotel rate quotes provided by Barbara Chavious
2. Variety of dates available throughout April
3. Room rates range from $79 to $109 per night
4. Committee will meet with Barbara to finalize plans during this meeting.

NACCHO Scholarships - Forms are on Internet; complete and FAX to Wayne or E-mail your interest.

October Legal Conference - Will schedule in conjunction with the Association's regular meeting.

COMMUNITY HEALTH - Elaine Russell

Major changes will take place in eligibility for the BCCCP Program effective July 1, 1998. Women eligible for Medicaid Part B will no longer be eligible for BCCCP clinical services. (See Attachments, pp. 30 - 39.)

The Guilford County Dental Project funded for three years by the Duke Endowment and the Kate B. Reynolds Charitable Fund will focus on dental screenings for kindergarten children.

The Office of Public Health Nursing - Changes have occurred in the length of the training sessions as well as course requirements. Cost was also reviewed. Jeannie Lassiter announced the upcoming kick-off event of North Carolina Prevention Partners to be held February 20, 1998 from 9:30 a.m. to 11:30 a.m. in Cary. The First NC Prevention Report Card will be released. She requested nominations relating to any prevention programs relating to public health or health departments. Her office will submit the nomination.

President Smith mentioned briefly a concern expressed by a limited number of dental hygienists about appropriate housing and facilities in various counties in North Carolina. He invited Dr. Cline to study the issue.

HOME HEALTH ALLIANCE (NCAAPHHA) - Dr. Louis Latour

Meeting schedule - Second Wednesday of each month.

Surety bond was waived for health departments with home health services.

Suggested we look at accreditation of health departments and credentialing health departments.

Counties in the far west and counties in the east are interested in joining the structure.

Alliance now has three staff members, executive director, marketing staff person, and members working with staffing and contractual needs for home health care.

Marketing Corporate Compliance Plan at $700 with training included. Training to take place on the 20th.

Plans are in the works to reinstate regional meetings for health departments with home health services. The staffing component is to be available to all health departments. (See Attachments pp. 40.)

HOSPITAL AND COUNTY COMMISSIONERSÕ ASSOCIATION NETWORK - Jim Baluss

The Committee met on January 14. The following were discussed:

1. Committee meeting sites were established for the year. The Hospital Association has invited them to hold several meetings at their office site in Cary. Mr. Carmine Rocco, Director of the ANCBH, will be invited to attend those meetings.

 

2. A report was made by Mr. Jeff Spade of the N.C. Hospital Association on the Joint Committee on Medicaid. They are looking at Community Care Networks and Carolina ACCESS II work that is going on. Encouraged networking between Hospital Association and this Association.

 

3. Discussed two issues in a recent letter to the North Carolina Association of County Commissioners: (1) Medicaid Maximization and (2) Retaining Exemption for LHD's under Carolina ACCESS to provide Health Check.

POLICY AND PLANNING (LEGISLATIVE) - Maggie Dollar

Said the following issues will be considered by the committee:

• Collaboration
• Medicaid/Managed Care
• Infrastructure Issues
• Facility Building Issues.

Meetings will be held on the third Wednesday of the month prior to the health directorsÕ meeting on Thursday.

A copy of the updated health directorsÕ roster will be attached to the minutes.

Respectfully submitted,

Tim Green

Secretary/Treasurer