MINUTES

NORTH CAROLINA ASSOCIATION OF LOCAL HEALTH DIRECTORS

Executive Committee Meeting

February 18, 1999

Wake County Public Health Center

Raleigh, North Carolina

CALL TO ORDER - President Dollar called the meeting to order at 9:15 am. (SeeAttachments, pp 1-2, Attendance Roster.)

APPROVAL OF MINUTES - The minutes of the January 20, 1999 Full Association Meeting were approved unanimously.

TREASURER'S REPORT - Wayne Raynor - Motion from Bob Wood to accept Treasurer's Report as presented. Seconded by Barry Bass. Motion carried.

Motion from Bruce Parsons to make a contribution of $100.00 to a local charity in Stokes County in memory of Bill Johnson former Health Director of Stokes County. Seconded by Barry Bass. Motion carried.

Bob Wood - Welcomed everyone and distributed attendance roster.

President Dollar requested that a memo be sent to County Commissioners alerting them to the fact they can now get NCALHD minutes from the WEB page. Secretary/Treasurer will handle.

Dr. Dennis McBride

  • Dr. McBride gave his report - "we should recognize that what's good for the environment is good for personal/public health. We must be more active in environmental issues, we have a broader mission than just restaurants and septic tanks". The issue is "how are we going to be in the dialogue"? It's important that we think more broadly and be at the table.

  • Dr. Bruton now has a good understanding of environmental health program issues. We need to bring the issue of situating Environmental Health to closure so we can move forward.

  • There will be a six month follow up environmental health conference to the one recently held in Charlotte.

  • Tobacco Settlement - hearings are to be held today at 2:00 pm. Requesting 50% for public health for the prevention and control of tobacco use.

  • School Health - continue to promote increases in school nurses and new programs. We really need to be prepared to address the Public Health Study Commission when it convenes after the General Assembly adjourns to emphasize funding for core Public Health functions. We need to really look at credentialling of Local Health Department's. Some counties are somewhat anxious about the idea of credentialling, but it should be viewed as positive.

    Dr. Dennis McBride Continued

  • Lead Screening - Number of children screened has gone down. We need to get those number's up. Will meet with WIC Program to discuss strategies. CDC guidelines have caused some confusion about screening approaches. We're the victim of a very confusing national policy. Dr. Wolfe urged Local Health Departments to look at screening activity in Child Health clinics.

  • Asthma - Medicaid analysis of the extent of asthma problems seem to point to greater problems in the far east and west. There will probably be a bill for school nurses this session.

  • Bioterrorism - attended conference recently in Williamsburg, Virginia. I (Dr. McBride) was the only State Health Director present. Spoke with Attorney General Janet Reno; we can expect that public health will have a very active role in bioterrorism prevention efforts. Funds will be available for infrastructure etc. at the local level. The domestic terrorism issue is very complex.

    ANNOUNCEMENTS

    Maggie Dollar

  • President Dollar recommended the appointment of a parliamentarian position and for the Immediate Past President/Chairman of the Nominating Committee to be that person to keep from having to appoint new people each year. Motion made by Bob Wood to accept President Dollar's recommendations. Seconded by Tom Bridges. Motion carried.

  • Public Hearing on Tobacco settlement in General Assembly today and on February 25, 1999.

  • Bioterrorism group meeting February 19, 1999. Sherman Kahn et al. Sherman cited a draft RFP.

  • Leonard Wood will become the health director of Rowan County March 1, 1999.

  • Legislative day is April 26, 1999, 9:30 to 3:30 at the Brownstone with a $45 registration fee.

  • Thanked Committee Chairs for getting committee membership to her timely.

  • President Dollar expressed desire to compile a history of NCALHD. President Dollar will work with Deborah Rowe on this effort. Danny Staley indicated he has a good history dating back to Dr. Ham Stevens time with the Association.

  • Congratulated Tom Vitaglione for receiving several awards regarding Convenant with North Carolinas Children and Governors Award for Excellence.

    Announcements Continued

  • Charged Barry Bass with pursuing feasibility of hiring an Executive Director for NCALHD and report back in March if possible. Tim Green, Louis Latour, Bill Smith, Dennis Harrington will assist Barry.

  • President Dollar encouraged use of General Assembly WEB site for legislative tracking.

  • President Dollar asked Dr. Wolfe to follow up on vaccine distribution issue.

  • Recommended re-establishing a representative from NCALHD as liaison to Office of Rural Health. Dr. John Morrow volunteered. Barry Bass made motion to accept Dr. John Morrow as liaison to Office of Rural Health. Seconded by Tom Bridges. Motion carried.

  • President Dollar announced that the Special Olympics is coming up and we need to work with the office of communicable disease and referred issue to epi committee and recommended that Sherman Kahn touch base with Joy Reed on the issue.

  • President Dollar commended Secretary Bruton's support of Public Health.

  • Discussed March NCALHD meeting conflict with Public Health Leadership Conference at UNC. Dr. Gabel made a motion not to change NCAHLD meeting date. Seconded by Lois Latour. Motion carried.

  • Bill Smith made a motion to support Legislative Day Conference for $1,000. Seconded by Don Yousey. Motion Carried.

    Committee Reports

    ACTION ITEMS:

    State & Local Relations Committee

    No action

    Technology Committee

    No action

    Nominating & Bylaws

    No action

    Education & Awards Committee

    No action

    Environmental Health Committee

    The committee met and the following motion was presented.

    Motion: That the Association endorse the reorganization resolution as prepared by the committee (including representation from Environmental Supervisors Association and NCPHA). Mimi Cooper read resolution to the membership. Motion passed.

    Epidemiology Committee

    The committee met on February 8, 1999 and the following motions were presented.

    Motion: Needle exchange - That the NCALHD's renew its commitment to supporting local needle/syringe exchange in North Carolina. This motion was defeated 7 to 5.

    Alternative motion: Motion by Bill Smith to support legislation to establish pilot sites for needle exchange program. Alternative motion carried.

    Motion: Rabies - That the NCALHD's support the legislative changes to GS 130A-197, to make it more consistent with current CDC recommendations. Barry Bass spoke on behalf of favoring the motion. Motion carried.

    Community Health/Dental

    The committee met and the following motion was presented.

    Motion: That Local Health Director's Association supports 50% of the tobacco settlement funds go into a professinal foundation focusing on Health. The purpose of the foundation will be to :

  • develop a plan and fund initiatives and research to prevent, reduce and remedy tobacco use, with a major focus on community based programs to reduce youth use rates.

  • increase the capacity of communities to respond to the public's health needs

    All of these endeavors should focus on vulnerable populations (such as youth, blue collar, minorities and low income populations). Motion carried.

    Discussion and presentation by Tom Bridges regarding Adam Searing's report on public hearings. While specific language is still being worked out, NCHAC proposes three general principles to ensure 50% of the tobacco settlement money goes to health: 1) 50% of the tobacco settlement funds shall go to a charitable foundation to improve wellness of the people of North Carolina, 2) The foundation shall develop a comprehensive plan and fund initiatives and research to: (a) prevent, reduce, and remedy the health effects of tobacco use and (b) increase the capacity of communities to respond to the public's health needs, 3) The foundation shall be professional, independent, and focused on the needs of vulnerable and low-income populations.

    Motion: That the NCALHD endorse the three general principles set forth by the North Carolina Health Access Coalition to ensure 50% of the tobacco settlement monies go to health and that this endorsement is to be sent to Senator David Weinstein's Office. Motion carried.

    DHHS's (CVH Branch)

    Motion: The Local Health Directors' Association supports DHHS' (CVH Branch) application to CDC for additional CVH funds which build on the initial funded activities and addresses health disparities of special populations. Motion carried.

    Motion that NCALHD send all congressional delegates of North Carolina letter opposing 25% reduction of preventive services block grant in the Presidents budget. Motion carried.

    N. C. Alliance for Public Health Agencies (NCAPHA)

    No Action

    Hospital Association Network

    No Action

    Managed Care and Reimbursement

    The committee met and the following motion was presented.

    Motion: That NCALHD accept Medicaid 6% rate increases detailed in memorandum to Dennis Harrington from Steven Garner dated February 12, 1999 to be effective March 1, 1999. Motion passed.

    Motion - That NCALHD approve revisions in the consolidated contract as stated in handout "Summary of Revisions, Consolidated Contract FY1999-2000". Motion carried.

    Policy and Planning

    The committee met and the following motion was presented.

    Motion: That NCALHD support legislation to relocate State Environmental Health Services from DENR to DHHS. Motion passed.

    Motion: That NCALHD support a renewed bill funding Healthy Carolinians. Motion passed.

    Motion - That NCALHD support the 1999 legislative recommendations of the North Carolina Child Fatality Task Force. Motion passed.

    Motion - That NCALHD partner with Dr. Dennis McBride, State Health Director, to form a representative group to develop a proposal for funding of local public health services and infrastructure to deliver to the Public Health Study Commission. Motion passed.

    Liaison Reports:

    Dr. Ann Wolfe

  • Exploring transfer of HSIS to the Division of Information Resources.

    Turning Point

    Bill Smith

  • Summit will be September 29th at Friday Center. Under the tentative budget about $70, 000 could be available to RFA's as to alternative systems. Also, there's been some discussion about public health authorities and other models.

    REGIONAL REPRESENTATIVES REPORTS:

    Region I & II - Bob Wood

    Motion: That the first principle of the Vision document be changed from full support for accreditation to conditional support for accreditation if and until the following issues are addressed: 1) It must replace all monitoring by regional consultants for the accreditation, typically three years. 2) Health Department would be allowed to approach accreditation in a modular fashion. 3) Accreditation must be done by an "outside agency" and not the state organization. 4) Some new dollars must be attached to the process so that it brings value along with and in addition to perceived quality improvement. 5) The accreditation process itself must also apply to the relevant areas in state government such as generic consultation and the areas where the state operates programs. 6) The process must be developed in a team approach with heavy involvement by local staff working in consort with state officials. Further, when these issues are resolved in a satisfactory manner to the Health Director's Association, then and only then will the Association's stand on accreditation be changed back to unconditional. Motion passed.

    Region III - Barry Bass

  • Dental health issue was discussed extensively, i.e. local dentists are not doing a lot of pro bono work. This is an opportunity for Public Health to promote dentistry and pro bono work from dentists.

    Region IV - Bruce Parsons

  • "Visioning" recommendation on regionalization in Linde Howel report had substance and merit.

  • Regional collaboration makes sense.

  • Even in the absence of strong support from the health directors association, regionalization efforts will continue with select counties.

  • A good opportunity for regional collaboration in Region IV is for participating counties to share epidemiologist support available in Mecklenburg.

    INFORMATIONAL REPORTS:

    State & Local relations

  • State/Local Providers work group will meet February 22, 1999 at 10:00 am. Adams Building, Room 264. Agenda of interest to Health Departments will include:

  • Governor's Budget Review and Discussion

  • Tobacco Settlement

  • Health Choice dental service coverage - at this time sealants nor extractions are covered. We will emphasize to Dr. Bruton and Dr. McBride this concern.

    Regional Representatives Reports Continued

    Education and Awards

  • Spoke with Barbara Chavious today and she is available to meet with us February 23, in Chapel Hill. We will meet in Room 466 of the Tate-Turner-Kuralt Building next to the School of Public Health at 2:00 pm. Meeting of committee to continue planning . Planning a session on Bioterrorism - Dr. Stringer of Winston-Salem, Special Operations Response Team will be a scheduled speaker.

    Women's & Children Health

  • Managed Care and Reimbursement - CPT/ICD 9 code billing and training is important to Local Health Directors. Directors and staff are encouraged to take advantage of trainings.

    Presentation by Priscilla Laula of Mecklenburg County on Aerobrics for Seniors and video program.

    Curtis Dixon - new health director in Hertford-Gates district health department.

    President Dollar presented retirement clocks to Jim Boehm (Hertford-Gates) and John Shaw (Rowan) in recognition of their retirement from many devoted years in public health.

    Meeting adjourned at 1:30 p.m.

    Respectfully Submitted by,

    A. Wayne Raynor

    Secretary/Treasurer