MINUTES
NORTH CAROLINA ASSOCIATION OF LOCAL HEALTH DIRECTORS
Executive Committee Meeting
December 17, 1998
Wake County Public Health Center
Raleigh, North Carolina
CALL TO ORDER - President Bill Smith called the meeting to order. Margaret Dollar chaired the meeting beginning at 9:00 a.m. (See Attachments, pp. 1-2, Attendance Roster.)
APPROVAL OF MINUTES - The minutes of the November 19, 1998 Executive Committee Meeting were approved unanimously.
TREASURER'S REPORT - Tim Green
Mr. Green presented the Treasurer's Report as information and requested action. As of December 9, 1998, balances are as follows: checking $938.99; savings $32.70; money market $1,248.23; and certificate of deposit $40,000.00. A summary of budget activities was presented. The proposed budget amendment was approved as presented. (See Attachments, Treasurer's Report, pp. 3-4.)
ANNOUNCEMENTS
President-Elect Dollar announced the following:
Jim Roozen is the new health director for Anson County.
Mr. John Shaw was recognized upon his upcoming retirement after 40 years of service in public health. President-Elect Dollar expressed appreciation to Mr. Shaw for his contributions, leadership, and guidance over the years.
The 1999 Tentative Calendar was reviewed. (See Attachment, 1999 Meeting Schedule, p. 5.)
Dr. Anne Wolfe and the Association recognized Mr. Barry Goldstein, who is retiring, and expressed appreciation to him for his contributions over the years.
Mr. Jim Baluss will serve as representative for Region VII for 1999/2000. There will be a vacancy in Region IV with the retirement of Mr. John Shaw.
President-Elect Dollar introduced Mr. John Frank of the Kate B. Reynolds Charitable Trust. Mr. Frank stated health care grants make up three-fourths of the trust with grants being limited to North Carolina and with assurance the funds are directed to the financially needy. Applications are accepted twice a year, March 15 and September 15. In developing a request for the grant, funds can be startup funding, seed money, or expansion money. The foundation encourages collaboration with other agencies in the community and likes to see a plan that indicates there will be local commitment with contributing dollars once the initial funding has been supplied. Mr. Frank said staff welcomes visits or calls to the foundation office and welcome the opportunity to assist applicants before assembling information for grant applications. He stated foundation satellite offices are established at different times during the year in various locations in the State. The foundation can also be accessed on the Internet. (See Attachments, Brochure, pp. 6-7.)
ACTION ITEMS
TECHNOLOGY COMMITTEE - George Bond
The Committee met on Tuesday, December 1, 1998. Mr. Bond stated the RFP process is continuing. Motion from Committee to authorize the State to enhance HSIS to add a billing screen to allow health departments to bill CPT codes or Health Choice and any other third-party carrier and to do this immediately. The motion received a second and was approved. (See Attachment, Technology Meeting Minutes, pp. 8-9.)
Mr. Bond said the next meeting of the Technology Committee would be January 20, 1999 beginning at 10:00 a.m.
STATE HEALTH DIRECTOR'S OFFICE - Dr. Andrew McBride
Dr. McBride mentioned that he and Dr. Bruton have been touring health departments in the western portion of the state and how impressed he was with the very positive programs he saw.
He issued a charge to the health departments in North Carolina to assemble themselves as a public health entity and to continue to look at health issues relating to asthma, school health and particularly school health nurses. He indicated another area where he would like to see public health emphasis placed is in the tobacco settlement funding and school health. Dr. McBride said he would be meeting with the leadership of the Public Health Study Commission about issues of public health and seeking support for core issues. He stated he has concern about the lack of knowledge of public health on local levels. Other areas mentioned were the organizational plan by Dr. Wolfe; Super Commission; Smart Start and School Health. Other concerns relate to Adult Care Homes and demonstration projects where mental health, public health and departments of social services would work jointly.
President-Elect Dollar offered that Tom Bridges, Chairman of the Policy and Planning Committee, coordinate Dr. McBride's strategy on the tobacco settlement and share with the Association as to how to advocate and assist.
Tim Green inquired of Dr. McBride if there are any continuing initiatives or issues relating to dissolving local boards of health. Dr. McBride said this has not been brought up and emphasized the key role that local boards of health play.
VISIONING WORKGROUP - Barry Bass
Five Visioning Principles for NCALHD were reviewed.
I. ACCREDITATION - To assure that quality services are provided in a consistent and standardized manner with accountability tied to funding.
II. ENHANCING INTERCOUNTY PARTNERSHIPS - To enable counties to collaborate on a variety of activities and develop governmental structures to foster such relationships.
III. ADDRESSING COMMUNITY HEALTH ISSUES LOCALLY - To address public health issues within local communities through a local administration that is responsible for identifying and addressing health issues.
IV. POPULATION ADVOCACY - To assure that a "safety net" is available to improve the health status of every citizen within each community.
V. SECURED FUNDING STREAM - To develop stable and equitable funding resources that ensure an infrastructure for public health services and availability of core public health services.
It was stated that these principles form a mechanism to get representatives to the table and allow networking and partnering, etc.
Motion to the Association for the Executive Committee to accept these principles on the basis of presenting to the Full Association in January for consideration. Motion received second and was approved.
A suggestion was made that this information be e-mailed to all health directors to afford them an opportunity to review and be prepared to take action at the January meeting. (See Attachments, Visioning Principles for NCALHD; North Carolina Association of Local Health Directors, Vision for the Future of Public Health Project; pp. 10-25.)
#IOC LEGAL ADVISORY - Jill Moore
Anne Dellinger will be notifying health directors that she will be taking a six-month research leave (January through August) to work on the legal aspects of teen pregnancy.
Ms. Dellinger will suspend her leave temporarily to work with the planning of the Legal Conference scheduled for October 1999.
There will also be a twelve-week period when a health institute lawyer will not be available at the institute; however, many others at the institute are qualified to assist with questions. A list of individuals to be used as resources during this time will be shared with the health directors.
Debra Rowe mentioned no additional Health Choice monies will be received this year. She inquired if health directors were getting the numbers of children enrolled in Health Choice in each county.
January 1, 1999 begins a new fiscal year for NCPHA. Applications have been mailed for renewal. Individuals were encouraged to become members of the Health Access Coalition as well as this Association being represented on this Coalition. The Annual Meeting of NCPHA is scheduled for September 15 - 17, 1999, at the Radisson Hotel in Asheville. (See Attachments, Health Access Coalition Information, pp. 31-32.)
ANCBH - Carmine Rocco
Mr. Rocco mentioned the ANCBH Annual Meeting is scheduled for January 21, 1999. Health directors will receive a copy of a 16-page supplement.
INFORMATION ITEMS:
WOMEN'S AND CHILDREN'S HEALTH COMMITTEE - Dr. John Morrow
The committee members reviewed the contract addenda for next year and made additional recommendations. One area in the immunization section states that by June 1999 the State should be able to provide local health departments with a monthly report of immunizations being provided by private providers who participate in the State vaccine program. Starting in March 1999, health departments will be required to pay for vaccine wasted through their fault with payment going to the State. The Immunization Branch will send individual histories of vaccine wastage and common causes of wastage to health departments. Partial vials are not considered wasted and health departments will not be held accountable for acts of nature.
The Division is working with Smart Start and those counties with Smart Start initiatives. A brochure has been developed which will be shared.
A social work survey will be coming out soon for social workers to complete and return. Everyone was reminded that all surveys are to come before the Association.
COMMUNITY HEALTH COMMITTEE - Elaine Russell
The Committee has been working with the Tobacco Community Project focusing on the core principle statement supported by the public health community and tobacco producers. Ms. Russell introduced Mr. Gerry Cohn who works for the Rural Advancement Corporation. Mr. Cohn distributed copies of a newsletter and core principle statement.
Many things are happening quickly with tobacco and tobacco farmers. Mr. CohnÕs organization is working with seven counties and farmers to help them adjust to changes and to assist them in looking at alternatives for the farmer. Community forums have been set up with participation in the Southern Tobacco Community Project.
Mr. Cohen shared the following five points of the Core Principle Statement.
The Robert Wood Johnson Foundation has available grants for new innovative ways to decrease farmersÕ dependency on tobacco as income. Studies have shown the smaller the farm, the more dollars are spent locally.
The following five issues relating to public health were mentioned:
Mr. Cohn encouraged health departments to seek ways to connect with farmers on these issues and to demonstrate support for agriculture in the local community. (See Attachments, Tobacco Communities Project, Vol. 2.1, Nov. 1998; Core Principles Statement, The Public Health Community and The Tobacco Producers Community, pp. 26-30A.)
Dennis Harrington stated health departments need to be together as much as possible on this issue. Ms. Devlin said this support is appropriate.
Motion from Committee that the NCALHD stand in support of the core principles as documented and presented today.
Mr. Bond stated these issues would be better addressed in a full Association meeting.
John Shaw noted that a number of Boards of Health had adopted rules prohibiting the use of tobacco products by informed adults in certain public places. The group agreed the full membership should discuss.
A motion was made to table the recommendation and present to the full membership for discussion at the January Full Association Meeting. The motion received a second and carried.
EPIDEMIOLOGY COMMITTEE - Dr. Sherman Kahn
The Epidemiology Committee met by conference call on December 14, 1998. Dr. Kahn encouraged health directors to review the information that will be mailed to them in the minutes relating to Hepatitis C; Orasure and SUDS Tests for HIV Antibodies; Hepatitis B Vaccine in STD Clinics; Proposed Changes in Hepatitis B and HIV Control Measure Rules; and Legislative Update. (See Attachments, Minutes Epidemiology Committee Meeting, Conference Call, pp. 33-45.)
OFFICE OF PUBLIC HEALTH NURSING AND PROFESSIONAL DEVELOPMENT TO NCALHD
(See Attachment, Report of Office of Public Health Nursing and Professional Development, pp. 46.)
EDUCATION AND AWARDS COMMITTEE - Wayne Raynor
Mr. Raynor mentioned that an individual has been selected to receive the Ham Stevens Award and a gift has been purchased for the outgoing President of the Association.
STATE AND LOCAL RELATIONS COMMITTEE - Tom Bridges
Mr. Bridges said they are down to three consultants from the original five working on the health educatorsÕ salary structure study. Questionnaires and surveys are being done.
Joy Reed for Dennis Harrington
The Association has requested Disease Management Protocols with incorporation of public health. In the very near future, she will lead retreats focusing on those issues.
Physical assessments for adults - A portion of this training will be on-site as well as the bulk of the training offered through teleconferencing.
Dr. Reed stated she is involved with the Department of Aging and has a list of day health care specialists in all health departments. She is developing an educational session for these nurses that will deal with this issue on the local level.
President-Elect Dollar said the committee lists will be completed in January. There may be a need for some changes.
She also mentioned the need to hear from the Association regarding having liaisons as a more significant part of the agenda.
President-Elect Dollar said she would be calling an organizational meeting of officers, committee chairmen, and regional representatives in January. This meeting will be held in Burlington.
Respectfully submitted,
Tim Green
Secretary/Treasurer