CALL TO ORDER - President Smith called the meeting to order at 12:30 p.m. (See Attachments, pp. 1-2, Attendance Roster.)

TREASURER'S REPORT - Tim Green

Mr. Green presented the Treasurer's Report for information. Account balances as of October 1, 1998:  checking $6,724.41; savings $32.56; money market $5,212.44; certificate of deposit $40,000.00. A summary of budget activities was presented. The Treasurer's Report was presented for information. (See Attachments, pp. 3-4, Treasurer's Report.)

President Smith said each health director should have received an updated listing of health department addresses and E-mail addresses. He asked that these addresses be reviewed, and if revisions are needed, forward these to Tim Green .

Mr. Marc Kolman is the Health Director for Person County and Mr. Doug Urland is the Health Director for Greene County.

NOMINATION & BY-LAWS COMMITTEE - Barry Bass

Mr. Bass stated no other nominations had been received. The following slate of officers was presented:

President - Maggie Dollar

President-Elect - Tom Bridges

Vice-President - Tim Green

Secretary-Treasurer - Wayne Raynor

The following individuals have been elected to serve a two-year term as regional representative to the Executive Committee:

Region I - Bob Wood

Region III - Barry Bass

Region V - Harold Gable

Region VII - (no report received)

Region IX - Anne Thomas

ENVIRONMENTAL HEALTH COMMITTEE - Mimi Cooper

At the October meeting of the NCALHD, the Environmental Health Committee presented a motion to support the proposal from the Environmental Health Supervisors' Association on a model for the "Super Commission." Because the proposal is lengthy and needs local input, President Smith suggested that the vote not be held on this proposal until the November meeting. Copies of the proposal will be provided to each regional representative. (See Attachments, pp. 5-12, Super Commission Proposal.)

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

The Committee met on October  19, 1998 to discuss several items. The following motions were presented.

STATE HEALTH DIRECTOR'S OFFICE - Dr. Andrew McBride

Dr. McBride presented a draft of a handout relating to the Childhood Asthma Management Initiative. Copies of this draft will be provided to all health directors. (See Attachments, pp. 19-35, Draft, Childhood Asthma Management Initiative.)

Dr. McBride mentioned that Information Resource Management has made a bid to take on HSIS management. This is being reviewed. He stated one of the goals for the Center for Health Statistics is to be more analytically oriented. HSIS may be in another setting in the future.

HEALTH CHOICE - Dennis Harrington

A meeting was held with Blue Cross/Blue Shield regarding other staff being recognized as providers, other than the physician or medical director. Blue Cross did agree to cover services provided by the physician and nurse practitioners. PAs (physician assistants) are not recognized under the State Health Plan and can only provide the service if the physician is on site. Joy Reed mentioned that nurses should not be listed on the application. She also mentioned there would be follow-up to the questions raised at the CPT/ICD 9 Teleconference. She also clarified that individual CPT codes should be assigned to individual lab services. This corrected information will be included in a memo to health departments. Another issue clarified was a code (90700 series) for vaccine that is listed on the HIFC form. Health Choice monies must go back into the program where the money was generated. (See Attachment, pp. 36-38, Clarification Re: NC Health Choice.)

Dot Bon, Chief Public Health Social Worker, addressed the Association regarding issues related to clinic social work certification for public health social workers. The Continuing Education and Training Advisory Committee for social work (CETAC), in conjunction with the Office of Public Health Social Work and the Office of Continuing Education at the UNC School of Public Health, are planning two courses to be offered in the Spring of 1999. The two courses are Public Health Social Work Orientation and Social Work Basic Skills Training. The plan is to repeat the courses on an ongoing basis, offering them at least two times a year.

The overall purpose of the two courses is to improve the equality of social work services provided within the public health system and to provide a basic level of knowledge of public health principles and the basics of social work practice.

Ms. Bon requested the support of the Local Health Directors in assuring that the social workers or social work related staff they employ, be able to participate in these courses. (See Attachments, pp. 39-42, Issues Related to Clinic Social Work Certification for Public Health Social Workers.)

ANCBH - Carmine Rocco

Mr. Rocco indicated nominations for the Outstanding Board of Health are due October 26, 1998.

VISION WORKGROUP - Barry Bass

The Vision Workgroup will meet at St. Mary's Street, Raleigh, Room GI-A, Wednesday, October 28, 1998. A motion was made and seconded in Committee to formulate a resolution to forward to the Visioning Committee of the Local Health Director's Association supporting the Alliance Model to act as the State Model for the future collaborative health care delivery model for North Carolina representing all Health Departments.

Dennis Harrington said a memo mailed to health departments on October 5, 1998 from Charles Reed relating to participation in state contract for influenza and birth control has a response date of October 21, 1998.

POLICY AND PLANNING COMMITTEE - Maggie Dollar

Committee looked into translation services and funding issues in the counties. The Office of Minority Health has developed a proposal and would like to request the State to fund (and is a part of their budget). The positions will be distributed according to whether the counties are high, medium or low density in population. Ms. Dollar requested that Mr. Smith authorize the Office of Minority Health to seek more accurate and current data relating to numbers of Hispanic individuals being served in each area in the counties.

Three of the resolutions passed by the Association have been forwarded to the County Commissioners Association: 1) future of public health, 2) Healthy Carolinians, and 3) computer technology for health departments. Jim Baluss will represent the Association in a meeting on October 28, 1998. A fourth resolution on the well standard program is being referred to the environmental steering committee of the County Commissioners Association.

MANAGED CARE/ACCESSCARE - Wayne Sherman

Mr. Sherman reported that he, Chris Hoke, and Jim Baluss attended a meeting with the Accesscare Board and medical providers on Saturday, October 3,1998, at RTP Sheraton. The Board approved the appointment of a local health director to the Board of Directors. Mr. Sherman had the opportunity to present to providers the potential and value of working with Health Departments to assure that quality and cost goals are achieved and comprehensive care is offered. It was noted that many medical providers do not know what services Health Departments provide and that we have an educational and coordination responsibility to embrace, particularly utilizing the web-based computer system being employed within Accesscare. (See Attachments, pp. 43-51, Report on Accesscare, Carolina Access II Model.)

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

Dr. Morrow gave an update concerning Health Choice. A total of 2,693 children have been enrolled with one claim being paid. It was stressed that schools need to be involved with the local coalitions. Smart Start coalitions are to be trained soon. Also, we will be receiving a short survey from the Immunization Branch asking about our ability to be a local distribution site for vaccine for private providers. This information is being requested by the General Assembly. He addressed improved accountability system for Women's and Children's Health. Kevin Ryan reviewed some proposed changes including deleting immunizations from children's and youth section and deleting kindergarten assessments since there is little deviation among health departments. Also being considered is reorganizing the groups of counties, Urban, Western, Eastern and Piedmont. Mr. Smith is being requested to appoint four representatives from existing categories to meet and discuss this, possibly by conference call.

EDUCATION & AWARDS COMMITTEE - Wayne Raynor

Wayne Raynor expressed appreciation to Anne Dellinger for an excellent legal conference. He shared information relating to two conference opportunities, Improving Preventive Service Delivery, December 11, 1998, and the 21st Annual Minority Health Conference.

A notice of the Ham Steven's Award nominations has been mailed.

ENVIRONMENTAL HEALTH COMMITTEE - Mimi Cooper

Ms. Cooper said a law was passed that addressed access devices and effluent filters on septic tanks which would go into effect January 1, 1999. Don Yousey represented the Association on this committee and felt everything was fine, however, the N.C. Septic Tank Association sent out a letter to their members and supporters that has received much attention. A public hearing will be held October 28, 1998. Ms. Cooper indicated there may be a much deeper issue than formerly thought.

EPIDEMIOLOGY COMMITTEE - Dr. Sherman Kahn

Dr. Kahn stated the Committee met by conference call on October 8, 1998 at 11:05 a.m. The following items were discussed:

• Revised Communicable Disease Rules: This item was placed on the agenda to provide members of the committee an opportunity to ask questions or seek further clarification of a memo from Dr. MacCormack dated September 21, 1998.

• HIV Post-Exposure Prophylaxis Protocol for Local Health Departments: It was reported by Dr. MacCormack that recommendations for health departments to use in establishing their protocols for handling possible HIV exposure of local health department staff are now ready to be mailed out. The only significant changes to the earlier draft relate to more information on the SUDS HIV-1 test.

• 1998-99 Flu Surveillance: Dr. MacCormack reminded the members of the committee that his office is actively seeking volunteer primary care physicians (i.e. Family Practice, Pediatrics, Internal Medicine) from across the state willing to participate in a weekly reporting system from now through mid-May, 1999. Participating physicians will also have access to kit with transport media for collecting throat swabs, provided by the State Public Health Laboratory, for influenza virus isolation.

• NC Lead-Based Paint Hazard Management Program: A new Lead-Based Paint Hazard Management Program (LHMP) was implemented in North Carolina on August 1, 1998. (See Attachment, p. 52, The NC Lead-Based Paint Hazard Management Program.)

• Special Olympics World Games: Dr. MacCormack informed the committee that he is serving on a Health Committee chaired by Mr. Dick Perruzzi, Director, Division of Medical Assistance, DHHS, to help plan for the 1999 Summer Special Olympics to be held in the greater Raleigh area next June/July. Additionally, many of the more than 7,000 foreign visitors (athletes and volunteers) will be spending time in numerous host communities across the state prior to the time of the actual events. (See Attachments, pp. 53-54, Epidemiology Committee Minutes, October 8, 1998.)

Dr. Kahn said the next meeting of the Epidemiology Committee has been set for Wednesday, November 18, 1998, 3:00 to 5:00 p.m., Cooper Building, Third Floor Conference Room, Raleigh.

NC ALLIANCE FOR PUBLIC HEALTH AGENCIES (NCAPHA) - Louis Latour

The Alliance now has 37 members with plans to incorporate more of the clinical aspect. The clinical member fee has been reduced from $2,000 to $1,000 per year. Those who have paid in $2,000 will be credited for one year. Dues currently stand at $2,500 for home health agencies, $1,000 for clinical, and $3,000 for both. Board membership was increased from ten to twelve, adding a clinical nurse director, filled by Barbara Stanley from Henderson County, and a home health director, filled by Kate Cherry, from PPCC. The Alliance continues to look at consolidation of the state in developing a mapped prospective that can be shared with contractors. A proposal is being assembled for the Visioning Committee to consider the Alliance serving as the model for the state. Next meeting is November 9, 1998 in Burlington. (See Attachments, pp. 55-66, Report for NCALHD Meeting.)

Respectfully submitted,

Tim Green

Secretary /Treasurer

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