CALL TO ORDER Ð President Tom Bridges called this meeting of the Executive Committee to order at 1:00 p.m. This meeting was held in conjunction with the Annual NCPHA meeting.

APPROVAL OF MINUTES Ð The minutes from the August 2000 meeting were approved as submitted.

TREASURERÕS REPORT Ð Jim Baluss presented the TreasurerÕs report through September 18, 2000. Account balances were as follows:

Checking-$24,557.23 Savings-$34.18 Money Market-$328.13 CD-$40,000.00

Tom Bridges made the following announcements:

• There were no new or relocating Health Director positions to announce.
• Tom recognized Rachel Stevens from the UNC-SPH. Rachel introduced Sheila Pender from the Institute of Public Health, and Pennington Whiteside, who will be coming to the Institute in October from Alabama. He is a former Local Health Director in North Carolina some years ago in Pender County. Tom read a letter addressed to Tom and Dr. McBride from Dean Roper, proposing quarterly meetings between UNC-SPH; NCALHD, and Dr. McBrideÕs office. Tom thanked those Health Directors who recently met with Rachel Stevens and Dr. Roper to discuss ways in which UNC-SPH and Local Health Departments can work more collaboratively and exchange resources to enhance the practice of Public Health at all levels.
• Tom announced and invited attendance at the reception this evening at the Wilmington Hilton in honor and recognition of Dr. Ann Wolfe upon her recent retirement.
• Tom announced that he received word from Jill Moore at the IOG that a Public Health Law specialist will be hired to replace Ann Dellinger.
• It was announced that "orientation for new Health Directors" will be held on September 27 & 28 in Raleigh at the 1330 St. MaryÕs Street building, room G-1-B.
• Tom encouraged registration and attendance at the upcoming "Health Directors Legal Conference" at the Friday Center in Chapel Hill, October 18 & 19.
• Sandra Wood, from Franklin County, liaison to Management Support SupervisorÕs Association, reported on the upcoming Management Support Annual meeting in Raleigh. (See Attachments).

Dennis Harrington, Chief, reported the following:

• Dennis announced that the previously discussed "advance" on Medicaid earnings will be received on September 20, 2000.
• Dennis again expressed appreciation to all local staff who has been so patient and tolerant with all the editing and conversion processes taking place in the HSIS/EDS systems. On-line data entry is scheduled to be underway by mid October.
• October 2^nd is still the target date for conversion to new Medicaid dental data entry. New dental rates will be received soon. Training for vendor counties has occurred.

Susan Smith-Wharton greeted those present and reported the following:

• She called attention to the importance of the recently e-mailed "strategic planning survey". Responses will be used to inform and direct President-elect Tim Green in planning for next year. Health Directors were urged to complete the surveys.
• Susan has been working closely with our affiliate organizations to identify commonalities in legislation and policy goals, seeking an alignment of priorities for the "long session" of the General Assembly.
• Susan has been working on a cost containment project, negotiating vendor agreements, group purchasing proposals, etc. for Alliance members.
• On the "revenue enhancement side", she has been continuing to work towards negotiated contracts with the "big four" managed care companies in North Carolina for alliance clinical services (BCBS, Partners, United, AETNA). Discussions with Partners, in particular, point to significant potential "business" for Public Health in primary care and "urgent care". Additionally, Cigna is interested in urgent care services contracts with Public Health clinics.

Policy & Planning Ð No Action Items.

WomenÕs & ChildrenÕs Health Ð Chair Wanda Sandale provided handouts of a document reporting and recommending criteria for "extension of Health Check services to all counties" . The WCH committee has had a work group looking at this very challenging issue expanding DMA funded Health Check positions statewide. The reality is no "new money" will be available for several years. Hence, a proposal has been made in conjunction with DMA to develop a recommended methodology to redistribute currently allocated positions between "haves and have-not counties". After much discussion and debate, the methodology in the report was made as a MOTION. Bob WoodÕs offered amendment to reassess in 1 year (as apposed to two) was accepted and MOTION PASSED. (See Attachments).

Education & Awards Ð No Action Items.

Environmental Health Ð Chair Mimi Cooper brought 2 items for action as motions from committee:

1. MOTION: To support legislation for expanding recreational water quality monitoring to inland waters and ask the policy and planning committee to consider adding this to our legislative priorities. MOTION PASSED.
2. MOTION: To support the establishment of recurring funds for 3 sessions of Centralized Intern Training for local Environmental Health Specialists. MOTION PASSED. Malcolm Blalock then announced that DHS has identified funding to increase the frequency (to almost monthly) of offerings for Centralized Training for Environmental Health Specialists. Tom thanked Malcolm and the Division for efforts to work this increased frequency.

Epidemiology Ð No Action Items.

Nomination & By-Laws Ð Chair Maggie Dollar presented the slate of NCALHD officers for the CY 2001 as recommended by the Nominating Committee. They are:

Past President Ð Tom Bridges, Henderson County

President Ð Tim Greene, Alamance County

President Elect Ð Wayne Raynor, Harnett County

Vice-President Ð Jim Baluss, Edgecombe County

Secretary/Treasurer Ð Mimi Cooper, Randolph County

Maggie stated that the elections will be held at the next meeting. Nominations prior to that meeting may be made by petition of nine members. Parliamentarian Bill Smith then pointed to the "60 day" requirement between presentation of the slate and the elections. To comply with by-laws, a petition was created which resulted in the requisite number of signatures by NCALHD members to enable a vote on the same candidates as presented by the Nominating Committee. (See Attachments).

Maggie then reported on the results of the recent nominations for "Regional Reps" (or lack thereof). Due to an insufficient response, the Nominating Committee is asking all current Regional Reps. to meet and submit nominations to the Secretary by October 1, 2000. Thus, enabling election at the October meeting of NCALHD.

Managed Care & Reimbursement Ð No Action Items.

State & Local Relations Ð Chair Wayne Raynor brought a motion from the committee which had met on this date. MOTION: To support the expedient recruitment of the NC Division of Public Health Director position, a position of strategic historical importance to the NCALHD. The motion reads as follows:

Technology Ð Ray Rabe brought two action items from committee. These were:

1. Draft Resolution previously e-mailed for NCALHD support of funding in the DepartmentÕs expansion budget (no specific dollar amount) for HIPPA compliance. MOTION: Support Resolution. MOTION PASSED. Bill Cox, DHHS, was present at the meeting and stated DHHS has prioritized HIPPA compliance as its #1 priority within the expansion budget request. (See Attachments).
2. Draft Resolution, previously e-mailed to Health Directors, in support of the MOA between the Division of Public Health , DIR, DEH, and NCALHD, with amendments (as shown in attachments). MOTION: Adopt MOA as amended on September 19, 2000. MOTION PASSED. Appendix is the same as that which was given to Health Directors at the special meeting of NCALHD on the MOA in July. (See Attachments).

Alliance for Public Health Agencies (NCAPHA) Ð No Action Items.

Community Health Ð Chair Elaine Russell brought a recommended action item as a MOTION from the Committee that NCALHD President Tom Bridges appoints a committee representative of state and local Public Health interests to develop priorities for funding under the Tobacco Settlement Health Trust legislation. MOTION PASSED. Tom then recognized Dr. Leah Devlin who introduced Dr. Deborah Porterfield, new Branch Head for Chronic Disease Control.

County Commissioners Association Network Ð No Action Items.

Nominating & Bylaws Ð No Information Items.

Policy & Planning Ð Chair Tim Green distributed an updated list of NCALHD legislative goals and priorities for 2001. It is a very similar list to that discussed and adopted at the August Association meeting. Item #4, relative to "Technology", was added to the list, as were two items dealing with funding for Core Public Health Functions.

The new listing, items 1-5 in priority order, have been sent to our affiliates Ð the NC Association of County Commissioners Ð for processing within their structure of committees leading to prioritizing their legislative goals for 2001. (See Attachments).

In discussion, Dr. Gabel, region 5 NCALHD Representative, stressed the need for legislative attention to the serious problem of funding for services to indigent/immigrant populations, especially in WomenÕs and ChildrenÕs Services (non Medicaid populations). A statewide approach which recognizes the inability of local governments to fund these services alone.

Dennis Harrington spoke in favor of an NCALHD-led "Blue Ribbon" study and a multi-disciplinary taskforce for study and advocacy on this problem.

Don Yousey asked about adding several Environmental Health goals and priorities to the list. Tim responded that the list was designed to meet the deadline for NCAC prioritization, but that additional goals and priorities can and will be added to NCALHDÕs list

The discussion then returned to the concern about indigent care. A MOTION was made and PASSED for NCALHD to support a Blue Ribbon taskforce on indigent care. Upon discussion, the importance and opportunities afforded by the Public Health Study Commission, Tom asked the Managed Care and Reimbursement Committee to assist him in advancing this issue.

In summarizing the report on NCALHDÕs 2001 Goals and Priorities, Tim Green encouraged all the members to focus on the ultimate goal in developing the list Ð and that is their successful adoption and ratification into law.

WomenÕs & ChildrenÕs Health Ð Chair Wanda Sandele reported that the Asthmas Grant RFPÕs will be coming out soon. Counties may either resubmit proposals from last year or send new ones. Five localities will be funded up to $23,000 to develop specific models and interventions using an existing or established coalition; and fifteen localities up to $9,000 to develop a local Asthma Coalition.

Education & Awards Ð Chair Jenny Lassiter reported that the Health Directors Conference in January is being planned and will be at the Radison at RTP.

Environmental Health Ð No Information Items.

Epidemiology Ð Chair George Bond reported that attempts are still being made to include agency medical directors in Epi Committee conference calls. Response has been sporadic. He also provided an update on surveillance and incidence of arboviral illness across the state in recent months. The Epi Committee has also been kept advised of efforts of the state to organize state and county level response teams (SART and CART) to provide emergency response to large numbers of animals following natural disasters.

Managed Care & Reimbursement Ð No Information Items.

State & Local Relations Ð No Information Items.

Technology Ð No Information Items.

1. Tom spoke for Debra Rowe of NCPHA in welcoming everyone to the annual convention and in inviting everyone to Dr. Ann WolfeÕs retirement reception.
2. Catherine Moon with the NC Association of Local Boards of Health greeted Health Directors and thanked the group for the 85% membership rate among local Boards in the Association. She advised of the nominating process for annual awards in the January 2001 Annual meeting of ANCBH at the RTP Radison on January 11 & 12.
3. Bill Smith reported at the NC Continuing Education Training and Advisory Committee for Social Workers (CETAC), on which he has served several years, is seeking a Health Director Representative. They meet quarterly in Asheboro.
4. Dr. Harold Gabel asked for Health Directors to please send him copies of Health Director evaluation" instruments used by Boards of Health to evaluate Health Directors, to be used in training at ANCBHÕs Annual meeting in January.
5. Tom Bridges advised that the Technology Committee is considering modifications and enhancements to the NCALHD web page. Anyone with any suggestions is urged to submit those to Ray Rabe or Susan Smith-Wharton.

There being no further business coming before the NCALHD Executive Committee, the meeting was adjourned at 3:00 p.m.

Respectfully Submitted by,

Jim Baluss, Secretary/Treasurer