President Tim Green welcomed the full association members committee and guests to the April meeting at 1:00pm. Thirty-five association members were in attendance (see attachments for attendance roster).
Bruce Parsons of Gaston County provided fellowship with a story concerning typewriter folklore.
The minutes of the March meeting were posted on the new web site, ncalhd.org, and approved as posted.
MiMi Cooper presented the treasurer’s report with balances as of April 11, 2001. Account balances were as follows:
Checking: $36,386.35 Savings: $34.77 Money Market: 339.56 CD: $40,000.00
(See attachments for full treasurer’s report). Dues are still outstanding for 15 health departments.
Dr. McBride stated that as of 4-30-2001, his tenure as State Health Director will end. He thanked the association for their support and the education we have given him in local public health. His visits to the widely diverse departments across the state were very educational and very different from Connecticut. He expressed concern about the strength of the local public health system to be able to respond to the big issues that will confront us in the future. Dr. McBride explained his new role as consultant to Secretary Hooker-Buell working out of the School of Public Health with particular focus on health disparities. He reminded us of comments in the Secretary’s speech last week at the SPH Lecture stating that local public health must change to address new challenges. Dr. McBride stated that he had a great deal of faith in North Carolina communities to meet these new challenges. He stated that he had a lot of respect for some of the directors he has met. There have been personality conflicts but that has not changed the respect he has for the work we do. Dr. McBride said that the mission of the central office is to make local public health successful. He will carry out this mission starting with working with communities surrounding the issues of HIV. In closing Dr. McBride said that he felt we needed to look at the organization of local public health and get to the vision that will serve the emerging issues of the future.
Hugh Tilson, VP for Government Affairs at the NCHA brought us an update of what NCHA is pursuing at the Legislature. The state budget and concerns about Medicaid are some of the biggest issues that NCHA is watching. Medicaid will finish in the red this year. The Hospital Association is helping the State pull down more federal dollars to get the program back in the black. Other issues NCHA is watching closely include:
Tilson also mentioned a study done by an accounting firm to analyze the financial shape of hospitals. The study found that 1/3 will loose money this year, 1/3 will have a positive margin but not enough to do capital investment, and 1/3 will have a positive margin and have enough to do capital investment. Bruce Parsons asked if the analysis just looked at hospitals or included hospital-affiliated ventures. Hugh responded that the study was inclusive. Ray Rabe asked about NCHA’s approach to HIPAA. Hugh stated that they try not to think about it but that their biggest concern is not when they can comply but whether they can comply. Hugh mentioned a bill introduced by Tony Rand that attempts to have the same language as HIPAA but there are problems with enforcement and oversight. In closing, Mr. Tilson thanked local health directors for all the great work they do.
Mr. Whiteside reminded us of the May 23rd Grand Rounds: Preparing for WNV. Hugh Tilson and Bill Roper are the moderators for this live web cast with satellites.
Joy reminded us of the May 30th Medicare teleconference, the April 24th Dental Varnish Training, and the CPT-ICD9 Coding workshop coming up that will cover what we have learned so far. Also if you have Home Health in your health department, there is a May 1st audio conference on mastering coding problems.
Carmen covered several legislative concerns:
SB 1006 — It appears that Sen. Purcell is going to hold this bill and not move forward now. It will be something we need to watch for in the future. The County Commissioners Association said that if asked, they would oppose it.
SB 221 Public Health Authority — The bill crossed over to the house and is in the public health committee where Zeno Edwards is chair.
SB 515 Medically Based cirriculum for Family Life Education — The sponsors are looking for people to testify.
SB 861 License by Credentials/Dentistry— This has already been discussed but it is important to note that it lasts for only 1 and _ years.
Carmen said that the registration for legislative conference is low and they understand it might be due to budget constraints but if possible please come and support the program and speakers. June 8th is the Advocacy Conference and Lt. Governor Beverly Purdue is speaking. Things are moving ahead on the Board of Health training but the association needs up-to-date information concerning board of health members from us. It was noted that Board training is now required in the new consolidated agreement within a board members first term. Catherine Moon reminded everyone that if they needed to reserve meeting space in the NCHA building, to contact Carmen or Catherine at least two weeks in advance.
Dennis stated that he had good news and bad news. The bad news is that as of 3-27-01, local health departments were paid 30 million dollars in Medicaid for services provided. For the same time last year, we were reimbursed 42 million dollars. The good news in that 12 million dollars will be coming back to health departments. Carol and Stephen are working on pro-rating the amount back to us by reviewing billing tapes. Dennis also asked the members present if they would like the cost settlement check before June 30, 2001. The response was no, send it in the new budget year. Don Yousey reminded the members that this was a good time to remember how important Dennis’s work is to local services.
Deborah reminded us to be active with our federal legislators. Mail must come from the constituent's zip code or it will not be recognized. She also reminded us of NACCHO funds for Environmental Health Education at Superfund sites. There was discussion about the "Choosing the Path to Better Health" commitments. There are several strategies for our association and for local public health:
MOTION: Bill Smith moved that the association sign on to promote these goals. The motion passed 34 yeas and 1 nay.
Deborah reported that the issue of publishing a newsletter for the association has been resolved by making a health directors corner in the NCPHA newsletter. This publication will also cover any legislative issues that are of interest to both associations. Deborah has been approached by the leadership of DSS asking that if the 3 million dollar interpreter bill passes, could DSS be included in that distribution. The policy and planning committee said no. Three million is barely enough to cover public health needs. Healthy Carolinians is in trouble again so please contact legislators and ask for support. The Notification to Treat Minors bill will be heard tomorrow but in the middle of our legislative conference. Policy and Planning will make sure someone is there to speak against.
Policy and Planning -- Wayne Raynor
MOTION: to support SB 698 (HB 798), 700 million for uncompensated care, SB 949 (will have a companion HB) 15 million for core and essential public health services.
The motion passed unanimously.
MOTION: to endorse HB 463, Clean Syringe-Safe Syringe with a letter of support from the president.
The motion passed unanimously.
MOTION: to endorse a resolution that promotes the concept of reciprocity of dentist to relieve the dentist shortage in North Carolina.
DISCUSSION: This is also spoken to in SB 861. This bill is said to be a compromise between those who support reciprocity and those who don’t.
Rick Mumford, Director of Dental Health: We have some concerns as the bill was written originally because of the educational requirements but don’t want to loose the reciprocity issues where education is equal. We think they are trying to fix the bill and work toward equal licensing for equal programs. North Carolina is at the bottom in dentist to patient ratio.
Bruce Parsons, Gaston County: It is important that we understand that what will be changed is the clinical exam requirement. If you have been practicing in another state, to be licensed in NC, a dentist would still have to take the written exam, just not the clinical exam.
R. Mumford: Sen. Purcell asked that the bill not be voted on earlier as they try to fix the problems. I would caution the Association from just supporting reciprocity. It does not take into account ADA accreditation.
Bill Smith, Robeson County: Why should it be more difficult for a DDS than for a MD? Reciprocity works for the AMA.
Harold Gabel, Guilford: Lets make sure that we agree that reciprocity means if you are licensed in another state and you have no criminal record, you can get a license in North Carolina.
Discussion concluded and the motion passed unanimously.
MOTION: that the association, local health directors and staff write letters of support to restore $175 million dollars in cuts in the Chronic Disease program in the presidents budget.
DISCUSSION: Letters must be received before April 27th. This is apart from the preventive health block grant. A draft letter will come to us in the email.
Motion passed unanimously.
MOTION: Support all funds currently going to local health departments whether clinical or preventive.
Motion passed unanimously.
Environmental Health -- Terry Pierce
MOTION: to support the introduction of a bill to be entitled an act to amend the fees for food and lodging establishments to be introduced by Rep. Owens. The motion passed unanimously.
Women and Children’s Health -- Wanda Sandele
While not truly an action item, Wanda asked the association for a volunteer for the Children’s Special Health Services Committee that meets every other month in Raleigh.
Technology -- Ray Rabe
The RFP for the understanding phase on the public health enterprise project is underway. As soon as the contract is signed, the clock starts ticking to get things done. We need good representatives of about 12 state and local people to work with this vendor. The best people who really understand business operations need to serve here but the need is great; two-three days per week. It’s not out of the question to use a retired employee to do this. It will last July through September. Ray also reminded us that HIPAA is not changing but moving ahead but the need for this partnership has not changed.
Epidemiology -- John Morrow
Education and Awards -- Barry Blick
Barry met with Jill Moore and Deborah Rowe to discuss having the legislative conference in conjunction with NCPHA to save money and continue the quality of programs that we have come to expect. It will be important to continue to involve county attorneys.
Reimbursement and Finance -- Bill Smith
Bill brought up the idea of saving back some of the money from the cost settlement again for technology issues. He asked the technology committee to look at this and make a recommendation.
Environmental Health -- Terry Pierce
Alliance of Public Health Agencies -- Chris Szwagiel
Jenny Lassiter, Jim Baluss, Sue Gay, and John Morrow attended a meeting concerning HIV issues that Eva Clayton called for the congressional district she serves. There were a great deal of complaints about local health departments not being accessible for HIV issues. The audit tool described in epidemiology’s report may be helpful with this problem. Many community-based organizations are fighting for additional dollars to serve the HIV population.
Having no further business, the meeting was adjourned at 3:50pm.
Respectfully Submitted,
MiMi Cooper
Secretary