Raleigh, North Carolina

CALL TO ORDER - President Bill Smith called the meeting to order at 1:30p.m.

APPROVAL OF MINUTES - The minutes of the May18, 1998 Full Association Meeting were approved unanimously.

TREASURER'S REPORT - Tim Green

Mr. Green presented the Treasurer's Report. Account balances as of May21, 1998 were: Checking - $21,600.94 Savings - $32.28 Money Market - $11,033.19 CD - $40,000.00. (See Attachments, pp. 1-2).

ANNOUNCEMENTS

Mr. Barry Bass has assumed the position of health director of the Davie County Health Department effective July1, 1998. There is a vacancy in Stanly County.

Mr. George Bond presented the following motion concerning Bio Terrorism: That the Association write a letter to Senator Faircloth thanking him for supporting the cause relating to Bio Terrorism. The motion carried unanimously.

NOMINATING & BY-LAWS COMMITTEE - Barry Bass

Mr. Bass reminded everyone that if they have resolutions to please get them in as soon as possible. Cut-off date is July 5th.

ENVIRONMENTAL HEALTH COMMITTEE - Mimi Cooper

Managers of foodhandling establishments will soon be able to receive two points added to their quarterly sanitation inspection grade if they have successfully completed approved training. The Extra Points Education Committee is in the process of establishing the criteria for the managerial training courses. In order to determine the training currently available, the Extra Points Education Committee would like to survey local health departments. (See Attachments, pp. 6-10).

Motion from Committee: That the NCALHD support the Extra Points Education CommitteeÕs request for information on current Foodhandler Education Programs and its request for comments on criteria for approved training. The motion carried unanimously.

STATE HEALTH DIRECTOR'S OFFICE - Dr. Andrew McBride

Dr. McBride addressed the group and mentioned several issues where he has concern such as reduction of the lead hazard and asthma in children, especially in rural areas, and indicated one way to address those issues would be through the community housing education approach. He also expressed support of strong community involvement, protection of water tables in regard to proper location of septic systems, and the mission of public health. Other issues discussed were Public Health Authorities, the structure of public health, and the lack of involvement of public health in this decision. He expressed a desire for a stronger link between public education and public health in North Carolina. He also indicated that other areas of concern such as substance abuse, mental health, heart conditions and facilities would be brought to the table in January. George Bond commended Dr.McBride on his efforts during his first month in office.

NCPHA COMMITTEE - Debra Rowe

Ms. Rowe mentioned the itinerary for the NCPHA Conference September 16-18, 1998 was mailed to health directors on June17, 1998. She encouraged early registration. NCPHA registrations should be mailed to Ms.Rowe's home address, 5025 Harbour Towne Drive, Raleigh, NC 27604. Ms.Rowe mentioned the building where the NCPHA office is located has been sold and the office may be relocating. The NCPHA Membership Committee made a recommendation that health departments be included in membership and organizational dues. She encouraged the Association to give this some thought and feedback.

COMMUNITY HEALTH COMMITTEE - Elaine Russell

Ms. Russell reported the Community Health Division will be submitting a cardiovascular disease grant to the CDC which will be a community based initiative. Only two grants will be awarded nationwide. (See Attachments, pp. 11-14).

Motion from Committee: That the NCALHD write a letter to the CDC supporting the Community Health DivisionÕs efforts in seeking the Cardiovascular Grant. The motion carried unanimously.

HOME HEALTH ALLIANCE COMMITTEE - Louis Latour

Dr.Latour mentioned dues will be coming due for next year which are divided into three categories-- Clinical only, $2,000 Home Health only, $2.500 both Clinical and Home Health, $3,000. He mentioned the End of Life Grant will have a significant impact on the Alliance. He also encouraged the health directors to use the Alliance staff who are contract employees.

Mr. Smith said the Association for Home Care has had changes in its Board of Directors. Betty Lewis and Jackie Pulley will remain on the Board as the public board member slots decrease significantly.

HOSPITAL & COUNTY COMMISSIONER ASSOCIATION COMMITTEE - Jim Baluss

Mr. Baluss mentioned that as a part of the Balanced Budget Act and Medicare reduction, the National Home Care Association Administration has learned there could be a reduction of 4 million dollars coming from the government in support of this area.

Motion from Committee: 1) That the Health DirectorsÕ Association write a letter requesting that the Association of County Commissioners write our federal congressional delegation to request they intervene in any way possible to seek formal opposition to the IPS methodology that could result in a 4 million dollar loss to the Home Care Association in North Carolina. The motion carried unanimously.

Mr. Baluss said the County CommissionersÕ Association is in need of being briefed on problems health departments are experiencing in their attempts to get on panels addressing clinical and preventive services.

Motion from Committee: 2) That the Health DirectorsÕ Association write a letter to request a briefing of the Human Resources Sub-Committee Association in an effort to make them aware of the problems experienced by health departments in getting on panels. The motion carried unanimously. (See Attachments, pp. 15-16).

President Smith mentioned the new Health Check brochure that includes health department services. He also expressed appreciation to Debra Rowe for her efforts in Legislative Day. (See Attachments, pp. 24-25).

POLICY AND PLANNING COMMITTEE - (LEGISLATIVE) - Maggie Dollar

Motions from Committee: 1) Support SB 1215 - Funds for Cancer Testing. The motion carried unanimously. ($1.9 million dollars, the majority to be used for supplies with $400,000 for equipment for early detection of cervical cancer and to allow our State Lab to upgrade to a different type of equipment for pap smear testing.)

2) Support HB 1620 - Funds for School Nurses. The motion carried unanimously.

Effort to get funding to local school administrative units to support a minimum of one more school nurse position. It would require 50/50 State and local match, with a local plan in place. Monies can be used to contract with local health departments for nurses or other public providers or to hire its own nurses. All school nurses employed with the use of these funds must be certified by the American Nurses Credentialing Center of the National Association of School Nurses that raises a question since many of our school nurses are not certified.

3) Support Top Legislative Priorities: #1. Healthy Carolinians #2. SB1215 Funds for Cancer Testing and support the Governor's Expanded Budget (which includes Hepatitis B, Chicken Pox, Clean Water and Environmental initiatives). The motion carried unanimously.(See Attachments, pp. 17-23).

President Smith introduced Attorney ElizabethL. Oxley with the Attorney General's Office. She is assigned to DHHS and works with the Commission for Health Services.

Dr. Rosemary Summers has been appointed as health director for the Orange County Health Department effective July1, 1998.

VISION RETREAT FOLLOW-UP MEETING - Barry Bass

A meeting was held on May 14, 1998 wherein notebooks were distributed. Any health department not receiving one of these notebooks should let Mr.Bass know. Also, copies of recommendations from the committee were mailed. Mr.Bass mentioned the structure of the meeting scheduled for the 19th including a survey that will be distributed.

EDUCATION & AWARDS COMMITTEE - Wayne Raynor

Mr. Raynor reported the committee is in the process of reviewing nominations for Health Director of the Year. Attendance at the Health DirectorsÕ Spring workshop was fewer than anticipated. Considerable expense was incurred by the Association given the limited number of attendees. Health directors are encouraged to discuss this at their regional meetings to determine if more concentration should be placed on the Eastern and Western meetings.

The State Health DirectorsÕ Meeting is scheduled for January 21-22, 1999. The Association will meet during the afternoon of January 20, 1999. The calendar is in the process of being revised.

TECHNOLOGY COMMITTEE MEETING - George Bond

1. Bill Cox, Director of Information Resource Management of DHHS, is leading our efforts statewide to develop an RFP that will allow us all to buy proprietary software to run our offices and to download relevant information into the state reporting system. He has a meeting set with Dr. McBride which will also include Jim Edgerton from Budget and John Booker from the State Center. That meeting will be on June 26 and will be pretty much in the form of an update and sign-off by those key officials. He has agreed to continue in his lead role utilizing both his staff and staff from a contract agency such as Keane to bring the RFP together. He has met with officials from the Attorney GeneralÕs office who negotiated the SIPS convenience contract for Year 2000 compliance and they are comfortable with what we are doing as a group.






2. George is putting together a "specifications committee" which will work with staff from Bill CoxÕs office as well as the contract agency when bids have been solicited from software vendors. Five work days have been tentatively set aside for the committee to meet. The first session will be on July 20, 21 and the final session will be on August 18, 19, and 20. He will be reactivating the work group expanded by additional local employees from various professions as well as a substantial contingent of state employees representing each of the programs that derived data from HSIS.






3. The goal is to have the RFP out on the street by August 31 and to bid the project first on a statewide purchase arrangement where we would actually own the software and have unlimited user access across North Carolina. The second alternative would be to purchase it so each site could be licensed and our last alternative would be individual user licenses at the local level.






4. HSIS now appears to have a limited life span of perhaps three to five years. Currently over one-half of the encounters on HSIS are coming to it through proprietary software. As more and more health departments buy proprietary software, and I would anticipate that virtually everyone in the state will do that, then there will be less and less support available to keep HSIS alive. George encouraged health departments to take seriously this RFP process and the opportunity it will present for them to acquire new software at little or no cost. Arrangements will have to be made for the DECÕs, some stand-alone WIC programs, and high- risk maternity programs since they also use HSIS but the committee pointed out that is an issue which will have to be resolved at the state level and is outside the control of the Association of Local Health Directors.






5. George reported he is sending a letter to all Health Directors in North Carolina summarizing what is going on and letting them know there will be additional costs at the local level for many of them to develop their own local infrastructure. We will be using actual setup costs for a small county (Anson), a moderate size department (Rutherford, Polk, McDowell District) and a metropolitan health department (Durham County). Each of these three have set up their own network so we thought we would use them as an example just to let local Directors know what they can expect in terms of infrastructure costs.

Terry Snowden, a representative of Sedgwick Company, polled the group as to whether they would like to remain with CNA or change to Travelers for insurance coverage. The majority of those members present who currently have coverage with Sedgwick and CNA voted to remain with CNA and, in turn, the Executive Committee voted to remain with CNA.(See Attachment, p. 26).

Dr. Joy Reed reported on behalf of the Office of Public Health Nursing and Professional Development. (See Attachment, p. 27).

The next meeting of the Technology Committee will be Wednesday, July 15, at 1:00p.m. at the Albert Coates Building.

Respectfully submitted,



Tim Green
Secretary/Treasurer