President Tim Green welcomed the executive committee members and guests to the May meeting at 9:00am. Twelve executive committee members were present with Glen Martin voting proxy for Harold Gabel (see attachments for attendance roster).
Tommy Jarrell of Richmond County provided fellowship with the story of little Johnny.
The minutes of the April meeting were emailed to local directors as well as posted on the web site, ncalhd.org. The minutes were approved as presented.
MiMi Cooper presented the treasurer’s report with balances as of May 7, 2001. Account balances were as follows:
Checking: $32,900.18 Savings: $34.85 Money Market: 340.90 CD: $40,000.00
(See attachments for full treasurer’s report). Dues are still outstanding for 9 health departments.
Dr. Devlin thanked the association members for all the support given to her during this interim period. She announced that a search committee for the position of State Health Director has been formed and members are Leah, Chris Hoke, Tim Green, Jim Bernstein, and Barbara Pullen-Smith. This is an appointed position so it is not subject to the state personnel rules. The plan is to search broadly and involve stakeholders in the process. The hope is to have a new State Health Director by early fall. Leah then reported on several items:
Rachel reminded folks of the Public Health Grand Rounds on May 23rd on WNV. There will be a discussion forum you can link into between the 23rd and the 1st of June. She also reported that Dr. McBride is working at the school of public health on special assignment. Rachel announced that she is retiring in August and we will all get an invitation to her retirement party. Penny Whiteside will represent the SPH after that time with our association.
Joy reminded everyone of the Medicare Billing Workshop on May 30th. Also there will be an Improving Efficiency in ICD-9, CPT Coding workshop in July. A teleconference in mid to the end of July will go over the new expenditure reports. In the early fall there will be another Finance 101 which will include the revised MOU with Medicaid. Jim Baluss asked Joy how the state planned to cover the training needs for specialized clinical training now that Guilford has closed their training program. Kevin Ryan responded that they are looking at more flexible options but there will be a gap in available programs. Leonard Wood asked for an update on immunization reimbursement. Joy said that they were told that would start working on those claims on May 4th but she will check with Dennis Harrington and find out more. Joy later reported that the test tapes should be back from Plano today but the check will be delayed for two weeks. Checks for the 12 million difference from last years reimbursement and the $96,000 incorrectly coded were mailed out yesterday.
Carmine told members that:
- The Boards of Health Association is welcoming two new directors to the Board; Eleanor McGuiness and A.C. Bachelor.
- In the end of this month, departments will be receiving dues statements for membership in the association.
- Chatham County is appealing the latest ruling on their livestock rules.
- June 8th is the Advocacy Conference.
- If you need space for a meeting in the NCHA building, contact Carmine or Catherine.
- Board of Health trainings are all booked up until December. Remember that regional trainings work best.
Jill Moore stated that the Institute has hired a new attorney to work on public health issues and support issues such as animal control and environmental health. She is Aimee Wall, JD, MPH. Aimee worked in Washington in the Department of Health and Human Services during the passage of HIPAA. We will meet her in September at the legal conference.
Policy and Planning -- Jim Baluss for Wayne Raynor
MOTION: To commend the Chatham County Commissioners for petitioning the Supreme Court to hear an appeal to the Chatham County Livestock Rules and ask the North Carolina Association of County Commissioners to file a friend of the Court brief to ask that the case be heard.
DISCUSSION: Chris Szwagiel asked if this was a Board of Health rule or a County Commissioners rule. Rachel Stevens who is a member of the Chatham County Board of Health replied that it was a Board of Health rule first and them adopted by the County Commissioners. Jill Moore was asked if passing the rule by both boards extended the authority. Jill did not think so except in areas of incorporated versus unincorporated which is probably not an issue here. Carmine reminded us that the issue here is, does the State Statute prohibit locals from speaking to more stringent rules in that area. Columbus County is going through the same issue right now. Don Yousey stated that this preemption, if it stands, could affect all Board of Health rules. Chris reminded us that the Smoking rules in Halifax County were struck down because Boards of Health cannot make rules based on financial reasons; they must be based solely on health.
The motion passed unanimously.
MOTION: that NCALHD go on record and request that the NCACC support and affirm its opposition to the General Assembly’s eliminating regional staff in the Office of State Personnel. The effect of such cuts would be to shift costs as unfunded mandates to counties. Elimination of OSP activities related to human service agencies without a change in State law, (which require counties to be in compliance) is simply a blatant cost shift. A majority of counties, which are deemed substantially equivalent to the state personnel system, would face new costs.
DISCUSSION: Elimination of regional personnel offices and staff is currently under serious consideration by the legislature. Eliminating these "HR support functions" resources at the state level, while still mandatory, would require new and additional HR costs at the local level. This is an unfunded mandate and as such should be a serious concern to NCACC.
The motion passed unanimously.
Women and Children’s Health -- Wanda Sandele
MOTION: of the proposed 7 million dollars in HB 788/SB 698, if passed, the funding be dispersed on a fee-for-service basis to be batched and reimbursed monthly. Billing should be continued even after funds are depleted in order to document need.
DISCUSSION: It is clear that the equity formula will not work here and legislators who are interested in this bill have been asking for an idea on how we would disperse the funds.
The motion was approved unanimously.
MOTION: that the Association urge both the Partnership for Children and the Legislature to consider the original role of good health as part of being ready for school and not make any categorical cuts of Smart Start funded health programs.
DISCUSSION: Don Yousey said that we should also remind these two groups that decisions about need were to be made locally not by arbitrary category. Wayne Raynor expressed concern that we may dilute our strength as an association if we try to save the world. This issue may be best handled by departments individually at the local level. Bill Smith reminded the group that family support is also being proposed for cuts. Our intent should be that all three of these categories are needed to function correctly. Kevin Ryan said that this motion is a response to criticism in the legislature that Smart Start should not be in the health business. He agrees that these decisions should not be made categorically. Jerry Parks stated that he feels we should be opposed to any cuts that involve health. He reminded us of the Golden Leaf Fund and the struggle to keep health in the picture. Discussion ended and the motion passed unanimously.
Epidemiology -- John Morrow
MOTION: in recognition of the acute threat of HIV/AIDS virus to NC’s social, financial, and public health status, that the NCALHD ask for the General Assembly’s immediate support (via a letter from our president) in HIV/AIDS prevention efforts including:
- the specific allocation of $1 million dollars for local public health agency and community based organizations efforts in testing, counseling and outreach.
- Clean and safe syringe exchange pilot programs in counties who want to volunteer with the approval of their local Board of Health.
- Raising the income limit for the AIDS Drug Assistance Program (ADAP) from 125% to 250% of the federal poverty level.
The motion was approved unanimously without further discussion.
Technology -- Ray Rabe
Ray asked Leonard to talk about the visit to Rowan County. Leonard said that folks from the state HIPAA office have been to Rowan County to do an evaluation of records and are planning a trip to Cumberland County next. We hope to have feedback from these visits soon. Joy Reed stated that she had gotten calls from the staff in Rowan County concerned because the information given by these evaluators concerning the way to correct an error in the record is in conflict with the legal way they have been taught. Leonard will check on this and report back. Jenny Lassister wondered how school health records would be affected by HIPAA. Barry Blick said that all health records would be affected. Chris Szwagiel said that there are many more affected partners besides schools, DOT for example has health records on all its employees.
Ray also told us that someone in the controllers office would not release our funds for the visioning/steering committee process. They also won’t move our money to an interest bearing account.
Environmental Health -- Terry Pierce
Legislative Update
- Family Foster Homes excluding sanitation inspections — This bill passed and is waiting the Governor’s signature
- Well Construction Standards (HB 609) — This bill clears up issues relating to the distance from sewage systems. It passed and is waiting the Governor’s signature.
- Body Piercing — This bill is in the House Finance Committee as we speak.
- Increasing Food and Lodging Fees — There is currently no bill (it is in a blank technical bill). It will go to the House Appropriations and then to finance committee
- Centralized Training Funds — These funds have some support but we need to continue to contact legislators.
- Technical Amendment — This is to tighten up on occasional foodservice operations. It would require the exemption from the rules to be for non-profit organizations only. This would not apply to political fundraisers.
- Coastal Buffer Rules — The changes made by the coastal buffer rules would not be applicable to permits issued prior to August 1, 2000.
Division Report
- There is a proposal for the State to assume the lead program. This would only impact 4-6 counties in a significant manner.
- Travel restrictions have been relaxed. Now is the time to request EH staff to visit counties up until June 12th.
- Michael Rhodes requested that a member of the Health Director’s Association serve on the pilot grading program committee. There were no volunteers from the EH committee.
- The committee agreed to support the motion of the policy and planning committee to commend the Chatham County Board of Commissioners for the appeal of the court decision.
- There was discussion concerning the Green Swamp/Champion Paper issue concerning improper use of chemicals. Well testing has been negative for pesticides and herbicides. Testing was conducted by government and independent labs contracted by Champion.
- The issue of smart growth was discussed. A request was made for a statement on population growth and its effect on public health and other density issues. Also, there is a request to have a public health representative appointed to the State Smart Growth group if this is still a viable group in the current administration. Environmental Health will revisit this issue when more details are available.
Alliance -- Susan Smith-Wharton
Susan distributed a sensitive pricing list for Alliance members to select a vendor in hopes of getting a good deal on group purchasing. Make your comments know to Susan as she works to select one vendor. Next the Alliance will look at pharmaceuticals. Susan reminded members to look for a change in meeting dates and fees that will be reported in the next newsletter.
Policy and Planning -- Jim Baluss
Jim presented an updated list of bills of interest. This update includes HB 1405. He also reported that the committee did not take action on a request from the Covenant for Children’s to add our association’s name to a list that would be distributed as groups who oppose any cuts to programs for children. The Covenant wants the general assembly to look for additional funds for children’s programs through closing loopholes or raising taxes. Bill Smith commented that this is important decision because the Covenant is calling for a 1-cent sales tax at the State level and most local governments want that increase in local sales tax. Jim brought everyone’s attention to the printed pamphlet that policy and planning put together that outlines the associations legislative agenda 2001-2003.
Health Promotion -- Leah Devlin for Rosemary Summers
Leah told the association about the President’s commission on improving health that deals with tobacco dependent communities. They have made a recommendation to increase the cost of a pack of cigarettes by 17 cents. Leah will put the total of their recommendations on the Divisions web site. Leah also reported that the Health Care Trust Commission met yesterday. It was primarily an organizational meeting. Beverly Purdue will chair this commission. Leah announced that Nina Yeager is the new director of Medicaid and Pheon Beal is the new Social Services director.
There was discussion and concern among the members that the money designated for tobacco prevention and control in the health care trust might be allocated for other purposes.
MOTION: (John Morrow) that the 15 million designated for tobacco prevention and control measures in the health care trust remain focused for that purpose. Second by Danny Staley. The motion passed unanimously.
Education and Awards -- Barry Blick
The summer advocacy conference sponsored by NCALBOH will be a great program to help us sharpen our skills on advocacy. Secretary Hooker-Buell and Lt. Governor Beverly Purdue are both confirmed speakers. Jim Baluss commented that he was concerned that poor attendance at this conference will be misconstrued as indifference when the true problem is budget constraints. Rachel Stevens said that they would make sure that speakers understood the budget problems locals were facing.
Women and Children’s Health -- Wanda Sandele
Wanda passed out the Women’s Health Report Card.
Epidemiology -- John Morrow
John reported the following:
- Lou Turner told the committee that the cost of thin prep Pap smear will increase from $2 to $7.44 each. Money was borrowed to cover this expense last year but is no longer available. It is important to remember that we should have fewer repeat paps with this improved system. We should check the cost at private labs also as they may be cheaper
- WNV educational brochures/check stuffers are ready for distribution. The 1-800 number is ready. Local health departments will be responsible for picking up dead birds and paying to ship them FedEx. Dr. McCormack sent us all information last week that he requested we forward to local physicians concerning WNV.
- There has been some confusion about testing pregnant women for HIV. Every pregnant woman should be tested for HIV as early in the prenatal period as possible. After informed consent, testing should occur. Remember woman can refuse the testing.
- Listeria is now a reported disease.
- Dr. Peter Leone will be the medical director for the HIV/STD branch. The TB physician position is still vacant.
- Dr. McCormack is retiring at the end of June. On June 19th a reception will be held at the Caswell Building. Dr. Kelly McGee will replace Dr. McCormack.
Danny Staley (Region III) reported that in a year of negatives, this region has been focusing on the positives. They have drafted a letter to the Secretary and Assistant Secretary to let them know about the positives they have experienced this year particularly focusing on the work done by Joy Reed and Dennis Harrington.
Jerry Parks (Region IX) reported that their region feels like the time for an increase in restaurant fees is now. Representative Owen put this bill in place and we need to let Sen. Odom, Plyler, Basnight, and Lee know that we support the increase. This places the cost of operating these programs on those who profit from them. It also makes the fees equitable for all permitted establishments, not just restaurants. The Senate Appropriations Committee is reviewing all DENR fees. Decisions will probably be made this weekend. Deborah will get additional information to health directors concerning this issue by email.
June 27-30 NACCHO in Raleigh
July 19 NCALHD meeting at Wake County Health Department
August 9 NCALHD meeting in Fayetteville as a part of the County Commissioners Association Annual Meeting
September 11 NCALHD meeting in Winston Salem as a part of NCPHA
Having no further business, the meeting was adjourned at 11:21am.
Respectfully Submitted,
MiMi Cooper
Secretary