President Tim Green welcomed the executive committee, association members and guests to the July meeting. Tim provided fellowship with a story about his Aunt Edna and Uncle Jack. Eleven executive committee members were present which constitutes a quorum (see attachments for attendance roster).
The minutes for the June meeting were posted on the web site and approved as posted.
MiMi Cooper presented the treasurers report with balances through July 9, 2001. Account balances were as follows:
(See attachments for full treasurer’s report).
Mr. Wade gave the association an update on what is going on in rural health
now and in the future.
Questions from the floor:
Harold Gabel: Are case management programs under scrutiny?
Wade: Everything is under review.
John Morrow: Is there expansion planned for Access II and III?
Wade: Now I,II, and III will be funded at 8 million with a mandate from
the legislature to expand. In the short term, some of the I payments will be
reduced to allow for expansion.
Chris Szwagiel: Are Health Departments still going to be cost-based
reimbursed?
Wade: I haven’t heard anything different.
Bill Smith: Access was a pilot project though the evaluation of the
project was never done. What are the savings with Access?
Wade: Every two years projects must submit an evaluation. The only savings
so far is reduced emergency room use which is offset by the increase in use
and cost in other areas. But in recent years, emergency room use is up. The
secretary is directing changes in this area.
Jim Baluss: Thanks for helping us recruit a dentist.
Wade: Out of 30 dentist we recruited, 20 went to health departments.
Jerry Parks: I’m worried that in the interest of saving money we
may be endangering prevention and protection programs in areas of public health.
Wade: The original goal of Access I was to match Medicaid patients with
a primary care provider and in that respect, the program succeeded. It was not
meant to be a cost savings .
John Morrow: We need to move the focus back to where the real money in Medicaid is being spent; long-term care, not the small amount in public health.
This discussion continue around Medicaid issues. The president referred the problems brought to light to the Policy and Planning committee with connection to Women and Children’s Health and Reimbursement Committee.
- On July 20th, additional expenditure reports are due.
- If you have not sent in your agreement addenda, you will be receiving email letting you know to get it in. NO ONE gets any reimbursement until all agreements are signed. This includes those that are out due to some dispute with the program staff. Those counties who have not originally turned in all agreements are Forsyth (Tim Monroe said theirs went in this week), Cherokee, Cabarrus, Gaston, Nash, Lenoir, Jones, and Pender. There are still others out due to program problems but Joy doesn’t have that list. There was significant discussion concerning this change in doing business.
MOTION: John Morrow made the motion that the association take a stand protesting this change of doing business (holding up payments to all counties until all agreements are signed) and send a letter to the Secretary stating our objections with a copy to Gary Fuquay. Motion was seconded by Don Yousey. [This motion was originally stated to send the letter to Gary Fuquay and a copy to the Secretary but the maker of the motion and the member who provided the second changed the motion as it now reads].
DISCUSSION: This is a big change in the contract/agreement process that we were not notified of. In fact, when we asked if changing from contract addenda to agreement addenda included any changes we were told it would make things easier because it would not have to go through the contract process. This is not easier. Even though the deadline for addenda is May, many health departments didn’t send them in until August when the county books were closed out for the previous year and final figures were available. This has never been a problem in the past. Also by holding up everyones funding for one county’s dispute with a program issue is forcing the county with the dispute to settle or hurt the services to the citizens across the state.
VOTE: Motion passed unanimously.
- New expenditure report training is scheduled for August 6th. Make sure you have staff coming. The reports are very different.
- July 24th is the date for the Efficiency in CPT coding workshop.
- If you have noticed an increase in your counties SIPS charges these last few months, respond to Dennis’s memo.
- Joy is looking specifically at the impact of the nursing shortage in public health. If you have information about the impact and strategies for dealing with it that are unique to public health, please send your comments to Joy.
Education and Awards -- Harold Gabel and Barry Blick
Harold was happy to announce that Wayne Raynor was selected as Health Director of the Year. Wayne has worked at the National, State and Local level. He has served as Harnett County Health Director since May 1996. There he has been part of a team that put together a model OB program, received joint accreditation for Home Health, and wrote intensive livestock rules. Wayne is also active in his community. Wayne received a standing ovation from the Association. Wayne said, "I'm honored. My management team is here as well as my wife and my daughter, Rachel. Team work is the key here and I'm glad to have my team here to share this moment with me."
Technology -- Ray Rabe
The technology committee presented a resolution to the executive committee (see attached resolution).
MOTION: recommends that the executive committee pass the resolution as presented from the technology committee.
DISCUSSION: John Morrow presented a question concerning number 4 on the resolution and why we would give discretion to the president to do that (#4: Authorizes expenditure by the President of the Association of up to $50,000 of the funding previously committed to this project for the evaluation or assessment of one or more functionally limited software packages to be identified and considered.) Ray said in case something comes up quickly, this allows us to take action between meetings. Anne Thomas asked how this relates to the RFP and are there systems out there that could be evaluated for $50,000. Ray replied that there are small software pieces that would meet part of HIPAA that could be evaluated for $50,000. We are hoping it won’t cost us at all. We think EDS will evaluate them but we want to retain the option to evaluated for "fit". Discussion continued focused on the members problems with #4 with the final discussion centering on the need for the committee to decide, not the president.
MOTION: (Danny Staley) to delete number four from the resolution. Second by Tom Bridges. The motion passed unanimously.
Vote was taken on the original motion without #4. It passed unanimously..
Alliance -- Susan Smith-Wharton for Chris Szwagiel
- Susan distributed a Healthcare Enterprises fact sheet along with information about connecting with NCHA’s contract with Healthcare to participate in their contracts. Alliance members can sign up for these benefits. More information will be provided at the Alliance meeting immediately following the Association meeting. There will be a sign up meeting on August 3rd at the NCHA office.
- Alliance dues have been reduced to $500 without/with home health agency.
- Alliance members can also participate in the NCHA’s translator services contract that covers 125 languages.
Nominations and Bylaws -- Tom Bridges
Even regions vote for representatives this year. Tom will be mailing a ballot 60 days before we vote at our full association meeting in October.
Environmental Health -- MiMi Cooper for Terry Pierce
- Environmental health committee discussed an on-going court case involving Brunswick County. If you are interested in the details, see Don Yousey.
- Jim Hayes updated the committee on the passage of SB 541 that went into effect May of 2001 that removes health departments from inspecting family foster homes and therapeutic homes. There are however some of these type homes that we will continue to inspect. Respite care homes that are licensed to care for adults (listed in the 5100 rules) will still need inspection as will the Supervised Living Foster Homes that also care for adults (5600 rules).
- The Body Piercing Bill is still alive but it has a fiscal note with it that may cause it problems. Also there is a move to attach to the body piercing bill a section that would provide greater protection from liability for EHS. Rep. Thompson is holding on to this bill. It would be good if members would let him know how important we feel this added protection is for EHS.
- Even though HB 1026 (fencing for private pools) is dead, as a part of writing this bill, a study was done concerning drowning and children. The study showed:
- most victims of drowning are < 5 yrs old.
- 72% are boys
- the number of drowning deaths have doubled in the last 2 years which correlates to an increase in the sales of above-ground swimming pools
- The May 25, 2001 MMWR gives advice on handling fecal accidents in swimming pools. North Carolina will use adopt this information as our policy.
- The committee also heard information on the company that makes INFILTRATOR and it’s effort to get legislation that would allow the company to market their product as a space saving system up to 40% reduction.
Technology -- Ray Rabe
- Training for HIPAA compliance is today and next week on PHTIN. Encourage your staff to attend. Francis Taylor will come out in a few weeks with a gap analysis tool for HIPAA.
- Twenty-five health departments have not designated a HIPAA coordinator. See Ray to find out if you are in that 25.
- The state office on HIPAA compliance is doing amazing things. Check out their web site at dirm.state.nc.us/hipaa
Education and Awards -- Harold Gabel
The committee is adding two new awards this year. They are public health partner and Legislator of the Year. More information will be coming at a later date.
Region 9 - Jerry Parks reported that region 9 has been discussing guardianship and the new tendency to dump them on public health. Anyone with information about this issue should contact Jerry. Tim Green asked Jim Baluss to look into this issue for the association.
Region 3 - Danny Staley reported that region 3 has been discussing mentoring new health directors. Any information or suggestions you have should be sent to Danny.
Region 2 - Tom Bridges reported that region 2 has been sharing HIPAA information and working toward compliance.
Bill Smith reported on the actions of two committees he is serving on for the association. The first is the WNV committee and Bill is proud to say that the draft plan is nearly complete and should be to us within the month.
Bill also reported on the Health and Wellness Trust Commission where there is great pressure from the governor to use the 45 million to pay for a prescription drug program for seniors. Bill pointed out that if they spent the whole 45 million on prescriptions, it would only meet 5% of the demand. Committee members who were not appointed by the governor are rebelling to put the bulk of the money in tobacco use prevention and cessation. Association members should contact people on this commission and express your concern.
Having no further business, the meeting was adjourned at 12:03 pm.
Respectfully Submitted,
MiMi Cooper
Secretary