MINUTES

NORTH CAROLINA ASSOCIATION OF LOCAL HEALTH DIRECTORS

Full Association Meeting

January 20, 1999

Wake County Public Health Center

Raleigh, North Carolina

CALL TO ORDER - President Dollar called the meeting to order at 1:10 pm. (SeeAttachments, pp 1-2, Attendance Roster.)

APPROVAL OF MINUTES - The minutes of the December 17, 1998 Executive Committee Meeting were approved unanimously.

TREASURER'S REPORT - Tim Green/Wayne Raynor

Mr. Green presented the Treasurer's Report for information. A summary of budget activities was presented. Mr. Raynor will be sending out the Association Dues for payment. Mr. Green requested an audit be performed on documentation and reports for 1998. Harold Gabel and Regional Representatives were appointed to the Audit Committee. PROPOSED BUDGET - Mr. Raynor presented the proposed budget for 1999. There is a substantial decrease in contractual services due to VISIONING CONTRACT discontinuation. The $1,000 Legislative expense: Barbara Chavis will determine if needed and a budget amendment will be done later. Motion to accept proposed budget by Bob Wood. Seconded by Louis Latour. Motion carried.

ANNOUNCEMENTS

Jill Moore

  • Ms. Moore will be on maternity leave beginning sometime in March 1999 and she distributed a list of other legal resources for public health professionals. Listed were the names and telephone numbers of Institute of Government contacts for legal questions on a variety of issues and areas. (See Attachment).

    Dr. Dennis McBride

  • Dr. McBride commended Curtis Holloman for an excellent annual report in Scotland County presented jointly to the Board of Commissioners and the Board of Health. The Public Health Study Commission met on January 15, 1999 and went very well. Dr. McBride is requesting that half of the tobacco settlement dollars go toward public health needs. Need strong School Health infrastructure to leverage tobacco funds. Attorney General said nothing definitive yet on tobacco settlement funds. Many people/groups have an interest in the money. Dr. Wolf commented that we need a long range plan for school health expansion, long range plan includes advocacy for additional nurses in our schools, momentum is good. Hopefully money will come to public health instead of DPI whether new dollars come from the General Assembly or Tobacco Settlement. Public Health must continue to educate the educators with regard to the importance of the essential services for children in schools. Some concern raised regarding other states having already received funds for health, North Carolina may have already lost the battle because of the fact that funds for health are not already a settled issue.

    Dennis Harrington

  • State Summary Detail report made available. Each Division will send out FY 2000 budgetary guidance summary by February 15, 1999. Health Departments will return all budgetary guidance to the Office of Local Health Services.

  • Resubmit Health Department Grant to Kate B. Reynolds accreditation exploration. Dennis is getting lots of questions regarding single class health director. Healthy Carolinians funding is back on the County Commissioners agenda to support.

  • Health Director Orientation day has tentatively been scheduled for new health directors on April 21st and 22, 1999, if needed. Mr. Harrington has tried to meet with all new local health directors who have accepted that position since our last orientation.

  • Retreats are in process to develop disease protocols with strong public health emphasis. Retreats are scheduled through the end of March on hypertension, diabetes, obesity, asthma, teen pregnancy, lead base paint, and pneumonia. There is still funding available for 2-3 more topics. Please give your feedback to Joy Reed.

  • The ICD-9/CPT code workshops have been scheduled, be sure clinical staff are registered, three per county, two per district. Workshops will be held on February 15, 1999 in Goldsboro and February 18th, 1999 in Morganton.

  • A memo has been sent out to each health department's director of nursing asking them if training is needed on "Dispensing of medicine by RN's" where agencies have lost their "eligible trainer". If your agency would like a second "trainer" you should respond so that we can schedule the appropriate number of sessions and locations.

    Dr. Ann Wolf

  • Introduced Dorothy Cilenti as Barry Goldsteins replacement at Womens and Childrens Health.

    Maggie Dollar

  • Jenny Lassister will testify before the national subcommittee on Rural Public Health in Washington, D. C. on February 6th, 1999.

  • Bruce Parsons was elected Regional Representative in Region 4 to replace John Shaw when he retires.

  • Turning Point will meet on February 11, 1999, Bill Smith will represent the association.

  • Distributed list of executive committee, committee chairs, and liaisons for 1999. Please forward any update information to Ms. Dollar.

  • The vaccine distribution survey is suppose to report back to general assembly by April 1st. Appreciate those who filled out the survey and returned them.

  • Chris Hoke is going to Washington to serve on ASTHO committee.

    ACTION ITEMS

    ENVIRONMENTAL HEALTH COMMITTEE

    The Committee met on January 20, 1999 and the following motion was presented.

    Motion: to ask the Association to endorse the Stakeholders request as the letter to Dr. McBride and Bill Holman describes; and to send a separate letter to each supporting that meeting. Motion carried. (See Attachments, Minutes, 10/20/99)

    EPIDEMIOLOGY COMMITTEE

    The committee met on January 11, 1999 and the following motion was presented.

    MOTION: that NCALHD's fully endorse and support the Public Health Division's current position with regard to name reporting of new HIV cases; and, in accordance with current state policy, anonymous HIV counseling and testing need not be considered as an option by Local Health Departments in North Carolina at the present time. (See Attachments, Minutes of Epidemiology Liaison Committee)

    MOTION -Alternative Motion Accepted- Health Directors association reaffirms its support for name based HIV reporting and surveillance. Motion made by Dr. John Morrow. Seconded. Motion carried.

    WOMEN'S AND CHILDREN'S HEALTH

    The committee met on January 20, 1999 and the following motion was presented.

    MOTION: That additional Maternal Child Health Block Grant funds be disbursed to Local Health Departments based upon the equity formula. Motion carried.

    INFORMATIONAL REPORTS

    Women's and Children's Health Liaison Committee - Wanda Sandele

  • School Health Funds were available to children eligible for subsidized school lunches and was predominantly used to obtain dental and vision care for children. This fund was identified as one of the programs that would be replaced by Health Choice. There will be no School Health Funds in the FY 99-00 budget.

  • Accountability in Child Service Coordination: The level of performance of counties is meeting their contractual commitments for non-Medicaid. The chart provided is divided into 8 levels. Eleven counties are in the level 1 category, justifying less than 20% of the grant funding that they are receiving for CSC, twenty-nine counties are in level 8 category, justifying 80% or more of their grant dollars. It was originally proposed that all counties in Levels 1-4, that is, those justifying less than 50% of their funds would be visited by their Nurse Consultant to either, (a) explain what the problem was in the past year, and why they would increase this workload next year or (b) negotiate a reduction in this funding for FY 99-00. Following discussion about the difficulties of being informed about funding reductions after local budgets are prepared, it was decided that Level 1 and Level 2 counties would be contacted to negotiate reductions, and that the Nurse Consultants would do that during the month of February, so that local budgets could be properly prepared.

  • Taniff Funds: Federal Guidelines have finally been received for the use of Taniff funds. This money is used for the purpose of reducing out of wedlock births. Guidance now makes it clear that if you are using these funds for direct services, they can only be used for Taniff clients. If the money is used to do outreach, marketing or public awareness it is acceptable to target the population at risk generically, and is not restricted to Taniff clients. The Division is working on guidelines that will be included with funding guidelines. We will be required to have a reporting plan in place.

  • Federal MCH Block Grant Increase: There has been an increase in the MCH block grant that will amount to $190,000 for this fiscal year. This funding is for reduction of infant mortality. Thirty percent is designated for Childrens Special Health Services. The balance $133,000 is left for Aid to County dollars.

    Policy and Planning - Tom Bridges

  • No action items. Items that we are looking at are: Healthy Carolinians; School Health Funding for nurses; lay groundwork for funding of core public health programs; Tobacco Settlement funds; Dental for Child Health, Adult Health, and translation services.

  • Keith Patton will e-mail WEB address regarding computer assisted Spanish Translation for clinic encounters.

    Managed Care and Reimbursement - Jim Baluss

  • CPT Coding/unbundling system for Medicaid Managed Care will be ready in 7-9 months.

  • Committee will monitor Managed Care Models.

    Alliance for Public Health Agencies - Louis Latour

  • Alliance met twice over the last month. The Alliance is a staffing agency. Share the Alliance's capabilities with your staff. The number for the Alliance is 1-888-691-4967 or you can contact Sharon Helsher, the Alliance's Staffing Director, directly at 828-682-9544. The next meeting date is February 17th , 1999 in Burlington.

    Community Health/Dental

  • If interested in serving on committee contact Harriett Duncan.

    Epidemiology - Sherman Kahn

  • Local Health Directors and STD Clinic Managers should have received a memo titled "Administering Hepatitis B vaccine in STD Clinics" dated January 15, 1999.

  • In late June 1999, numerous North Carolina communities will be hosting delegates from various countries just prior to the beginning of the Special Olympics competition. Local Health Departments will be notified and made aware of when these visitors will be arriving and where they will be staying.

  • The committee did discuss "White Paper" on Hog odor and asked Dr. McBride to discuss this issue with the full association.

    Environmental Health Committee - Mimi Cooper

    The (RS) Board of Sanitarians met with Environmental Health Committee the morning of January 20, 1999 to discuss needed changes that they are proposing in the legislature that create the board and its responsibilities. (See Attachments, Minutes, NCALHD Environmental Health Committee)

    Education and Awards - Curtis Holloman

  • Planning Spring Education Conference, April 13 and 14, 1999, Location TBA.

  • Select Health Director of the Year, June 1999.

  • Plan Fall Legal Conference, October 19 and 20, 1999, Friday Center, Chapel Hill.

  • Award NACCHO Scholarships, $1,500 available, Annual Conference scheduled for July 14th through 17th in Dearborn, Michigan.

  • Select Ham Stevens Award Recipient, November/December.

  • Awards/Retirement Clocks, notify Curtis Holloman.

  • Any other awards NCALHD association would like them to look at?

    Technology - Marc Kolman

  • Continuing the quest to secure local health departments new software. RFP in draft.

    State and Local Relations - Tim Green

  • Welcome input on policies/issues to bring before the Local Providers Work Group.

  • Encouraged participation on the Local Providers Work Group.

    NCPHA - Debra Rowe

  • Health Access Coalition - Tobacco Settlement is the top priority - Local Health Departments are strongly encouraged to join.

    MOTION: by Bill Smith for "NCALHD Association to join Health Access Coalition and designate a representative from the Association. Seconded by Bob Wood. Motion carried.

  • Secretary directed to process membership application at a cost of $50.00.

    Visioning - Barry Bass

  • About 2 years ago we started a process to deal with the changes we perceived would be coming about in public health and how we wanted ourselves to be able to be competitive in the health care market. Lot of time and money expended to address services, funding structure and governments.

    Motion: To adopt Visioning Principles as amended by member input i.e. Making population advocacy number one ."

    Discussion: John Shaw reported that Region IV discussed principles and determined that principles are not futuristic but a commitment to the status quo. We did not meet our obligation to present a report.

    VOTE: 38 FOR - 14 AGAINST. Motion Carried.

    Meeting Adjourned.

    Respectfully submitted by,

    A. Wayne Raynor

    Secretary/Treasure