CALL TO ORDER - President Smith called the meeting to order at 1:30p.m. (See Attachments, pp.1-2 Attendance Roster.)

APPROVAL OF MINUTES - The minutes of the August 20, 1998 Executive Committee Meeting were approved unanimously.

TREASURER'S REPORT - Tim Green

Mr. Green presented the Treasurer's Report. Account balances as of September1, 1998: checking $9,703.65; savings $32.49; money market $11,171.19; certificates of deposit $40,000.00. Proposed budget revisions were approved unanimously. All dues have been paid with the exception of one county. The Treasurer's Report was presented for information. (See Attachments, pp. 3-4.)

ANNOUNCEMENTS

President Smith said he had sent a letter regarding funds for Madison County to help them with their waste system and a letter was sent to each of the General Assembly members regarding the extension of the moratorium. He said he received a few calls and several letters of support.

President Smith introduced Judy Avery of Lincoln County and President of the Western NCPHA. Also introduced was Gene Light, PHTIN Director working with Joy Reed. Mr.Jim Jones will assume the health director position in Stanly County in October.

ACTION ITEMS

MANAGED CARE - Dennis Retzlaff

Motion # 1 from Committee that Access Care (formerly known as the Ponzi Group Model) place a local health director on its board of directors and the Board of Access Care work with the NCALHD to create subcommittees and vigorously pursue integrating public health efforts into their Access Care Program. The recommendation from Committee was that Wayne Sherman be the health director to serve on this board. The motion carried unanimously.

Extensive discussion took place regarding managed care and case management through health departments. Case management in this case was defined as being different from the role of care coordination.

Motion #2 from Committee that the North Carolina Alliance of Public Health Agencies is the major player in interacting with the Carolina ACCESS II counties in terms of developing strategies, contracting, etc. and to strongly encourage all health departments to join the North Carolina Alliance of Public Health Agencies. The motion carried unanimously.

Dennis Harrington spoke to the Committee regarding Health Choice and the activities that have taken place in preparation for the implementation of this program October1, 1998. A handout was distributed. (See Attachments, pp. 5-26.) A training session has been scheduled by teleconference for health departments on September30, 1998 from 9:00a.m. until 1:00p.m. An encounter form should be developed by each health department that lists CPT/ICD 9 codes and charges. The HCFA 1500 forms will be used for billing BC/BS for reimbursement or billing can be done electronically. Everyone was reminded that implementation of these fees would require the approval of local boards of health and county commissioners. Tom Vitaglione mentioned that each health department that does not have a provider number should complete and submit the provider application as quickly as possible and be sure to check the medical director box. Enrollment starts October1, 1998. BC/BS will automatically mail remittance advice statements to the address given. A concern was expressed regarding client confidentiality and the remittance advice that is mailed to the home address.

Motion #3 from Committee was to request that Dr.Bruton allocate any possible resources to emergency technical assistance to help local health departments in implementing the billing of Health Choice. The motion carried unanimously.

POLICY AND PLANNING - Maggie Dollar

Motion #1 from Committee to reiterate Association support of the Governor's recommended funding level of 16 million dollars for the HIV/AIDS medication funding program and a letter sent by our president to the budget conference. Motion carried unanimously.

Motion #2 from Committee that the Public Health Association support block grant funding at the 154 million dollar level as is proposed by the House Appropriations Subcommittee and that a letter outlining the urgent need to maintain adequate funding for Preventive Health Services be sent to the N.C. delegates as well as appropriate key state delegates. Motion carried unanimously.

Motion #3 from Committee that the Association request specific input from the State Health Director at the appropriate time on the recommendations forthcoming from the Vision Committee and likewise that the Association request local health director representation and participation in any process to develop a state health plan and state reorganization with the desired goal that any such reorganizational plan will ultimately enhance public health's visibility, impact, and participation within the department and statewide. The motion carried unanimously.

(See Attachment, p. 27.)

INFORMATION ITEMS

STATE AND LOCAL RELATIONS - Tom Bridges

The local providersÕ work group comprised of DSS directors, mental health directors, public health directors, county managers who meet with Dr.Bruton, and staff of DHHS met on September2, 1998. Two key areas of concern were equity and a balanced playing field and the question arising involving public versus private providersÕ costs, standards, accountability and quality of care. The group agreed to look into getting representation by each of our disciplines, to work with Dr.Bruton's office, and to possibly involve the County Commissioners Association and the Institute of Government in studying the issue of public versus private and where it is appropriate for private versus public. They also agreed to work together to achieve more positive working relationships.

TECHNOLOGY COMMITTEE - George Bond

A meeting was held last week to discuss the RFP. Three sub-committees were appointed -- Alternatives Analysis Committee, Interface Committee, and Finance Committee -- each of which have met and reported. The Committee will seek the assistance of Terry Pierce because they wish to include Environmental Health as a part of the package as well as the WIC Program. The Technology Committee will meet on the 15th and at that point will be ready to hire a technical writer. Any departments that need but do not have the accounts receivable package on HSIS, may want to go ahead. We may have to wait nine months to one year before this will be ready to start.

NOMINATION AND BY-LAWS COMMITTEE - Barry Bass

Mr.Bass reminded everyone of the regional elections and to get the information to him by October16. The slate of officers was reviewed. Additional nominations against the slate nominated must be submitted within the next several days. These must be filed by petition by at least nine members of the Association thirty days from the October meeting. Tim Green will need to mail the other ballots by the 15th prior to the October meeting.

VISIONING COMMITTEE - Barry Bass

Linda Howell was asked to assemble some advantages and disadvantages of some of the models she wanted to review. She recommended that small groups begin again. Shared vision and mission statements need to be developed as well as seeking leadership in terms of how to do the model portion. Leadership can come from the County Commissioners AssociationÕs, working with the State and within ourselves, participation if someone is willing to establish a model. The Kellogg Foundation has expressed an interest in helping fund a model if someone is willing to participate. (See Attachments, pp. 28-39.)

Debra Rowe invited everyone to stay for NCPHA. She mentioned several opportunities for networking. The health directors were invited and encouraged to attend a reception hosted by the Cumberland County Commissioners and a reception hosted by Christopher Cooke and the Public Health Awareness Program. Other receptions were also mentioned.

Barry Goldstein mentioned the school-based and child health issues that are under discussion in the legislature and encouraged health directors to contact their representatives to ask them not to vote for anything that would weaken or repeal the law. (See Attachments, pp. 40-41.)

Wayne Raynor reminded the Association of the Legal Conference next month. The Hamm Stevens Award nominations will be mailed in early October.

HOME HEALTH ALLIANCE (NCAPHHA) - Dr. Louis Latour

The next meeting of the Home Health Alliance will be on September16, 1998 at 1:30p.m. Those who have not joined are encouraged to attend. He stated the Alliance has signed and put in place more contracts in the last several months than a private provider would have done in several years. He stressed the need to sell public health. The Alliance is moving to a twelve-member board, adding two members -- a nursing director and a home health director. By-laws were changed where no more than two board members can be from the same county.

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

Dr.Morrow attended a medical society meeting that focused on asthma and case management for asthma patients. Now that the division has picked this up, they have come together to form a committee to work jointly on this issue. Tom Vitaglione mentioned asthma is the number one reason children are absent from school and contributes to a large number of emergency room admissions. Carolina ACCESS has joined this coalition stating they have already identified this as a great concern.

EPIDEMIOLOGY COMMITTEE - Jenny Lassiter for Dr. Sherman Kahn

A meeting was held on September3, 1998. A teleconference will be held on October8, 1998 at 9:00a.m. (See Attachments, pp. 42-45.)

Chris Hoke spoke about the concerns and issues that have arisen due to the State Budget not having been adopted.

Dennis Harrington introduced Carl Eugene Light, PHTIN Director. He announced the new health director orientation session is scheduled for October9, 1998 from 9:00a.m. until 5.00p.m.

ANCBH - Carmine Rocco

Mr.Rocco requested nominations for board membership and mentioned the nominations for the Outstanding Board of Health Award and the Carl Durham Award. He encouraged nominations for these awards.

Mr. Smith mentioned the NACCHO Conference to be held next week.

Respectfully submitted,



Tim Green
Secretary/Treasurer