Minutes

North Carolina Association of Local Health Directors
Executive Committee Meeting

August 9, 2001

Charlie Rose Agri-Expo Center
Fayetteville, NC

Call to Order

President Tim Green welcomed the executive committee, association members and guests to the August meeting. He thanked Cumberland County Health Department for hosting the Association and reminded those present that the Association was meeting in conjunction with the Annual Conference of the County Commissioner's Association. Wayne Raynor will be recognized as "Health Director of the Year" at a later time during the Commissioner's conference. Mr. Green also acknowledged the attendance of two county commissioners, Lee K. Allen and Jimmy Clayton, at the Executive Committee Meeting. Mr. Green also introduced Rebecca Troutman of the NC Association of County Commissioners, who welcomed the association to Fayetteville.

Dr. Mark Swedenburg was introduced and welcomed as the new health director for Wayne County. It was noted that Elaine Russell provided Tom Bridges with her written proxy. It was also announced that Glen Martin will represent Region V for Dr. Harold Gabel. A quorum was established (see attachments for attendance roster). Don Yousey provided the fellowship.

Approval of the Minutes:

The minutes for the June meeting were posted on the web site and approved as posted.

Treasurer’s Report:

Deborah Rowe presented the Treasurer's Report for Mimi Cooper. Account balances were as follows:

(See attachments for full treasurer’s report).

Special Guest: Vickie Newell, N.C. Partnership for Children

Ms. Newell provided the association an overview of the Smart Start Program and announced the upcoming Smart Start Conference 2002 which will be held on January 28-30, 2002 in Greensboro, NC. Ms. Newell expressed the importance of local public/private partnerships, especially with the impact of proposed budget cuts from the General Assembly Currently, there are differing proposals in the House and Senate for funding cuts. Health is an important component of Smart Start as evidenced by the fact that health directors are mandated Board positions of the local partnerships. Ms. Newell encourages local partnerships to look for linkages and supporting data of how it impacts the Performance-based incentive system (PBIS) when looking for fund the program. See attachments for Ms. Newell's slide presentation.

Questions from the floor:

Bill Smith: Last year there was an allocation of $260 million with an additional $50 million from which totals about $310 million. This year, the allocation is expected to be about $250 million. How does that equate to a 50% cut on the local level?
Ms. Newell: The full allocation of last year was never received. Their office is being cautious and only allocating a six month budget until the budget is finalized by the General Assembly and then the budgets will be increased accordingly.
A $10 million cut equates to approximately 5% cut for every local partnership.

Terry Pierce: Local partnerships can fund at 100% and cut back on something else.

Ms. Newell invited health directors to call her (919-821-9575 or 919-821-7999) if additional information is required.

Local Health Director Mentor Project

In January, 2001, this association adopted a goal of implementing a mentoring system for new health directors to assist them in the understanding of current issues/practices. Danny Staley presented the benefits of a Mentor Project, which are:

He is proposing a Resource Guide that would consist of:

Who should be a mentor:

Topics to be covered will depend on the experience of the new health director. The NCALHD should annually review the Resource Guide and structure of the mentoring project. Feedback from new health directors and mentors would be helpful in the evaluation process.

See attachments for full report.

Discussion: Tom Bridges stated that the Regional State Personnel Office previously provided consultation/resources, but with the elimination of these positions, it will be important for the Association to provide this assistance to new health director. He suggested that the Resource Guide may be posted on the NCALHD web page. The Mentor Project may have an impact on the current Bylaws. Assignments will need to be made.

State Health Director’s Report: Dennis Harrington for Leah Devlin

Liason Reports:

School of Public Health -- Penny Whitesides

Office of Public Health Nursing -- Joy Reed

Association of NC Boards of Health -- Carmine Rocco

Public Health Nursing Administrator -- Blanche Hardee

Executive Director's Report: Deborah Rowe

Committee Reports (action items):

Environmental Health -- Terry Pierce

The temporary rule governing well construction rules reverses the intent of the permanent rule which was passed by the General Assembly. The temporary rule will serve as the 60-day notice for permanent rulemaking. (See attachments)

Motion: A letter be sent from the Association to the Division of Water Quality, Groundwater Section, stating objections to the language of the proposed permanent Rule 15A NCAC 2C.0107(a)(3) which would require a minimum horizontal separation distance between wells and onsite sewage disposal systems of 100 feet, unless there is "an existing single family dwelling" located on the property; and that local health departments be encouraged to submit comments within the comment period.

No discussion. Motion passed unanimously

Policy and Planning -- Wayne Raynor

Mr. Raynor reported that Secretary Hooker-Buell stated to the Minority Health Advisory Council that DHHS is committed to diversifying the workface within the department and alluded that should be expected in local health departments as well.

Motion: that the NC Association of Local Health Directors values diversity in the public health workforce and its importance in eliminating health disparities and offers its full support in the form of a resolution to work in cooperation with the Department of Health and Human Services and other agencies to address the issue.

Discussion: Dr. Morrow asked for clarification of the motion. Mr. Raynor responded that, as an association, we recognize the importance of diversity in the workforce as a means in which to address and eliminate health disparities. Mr. Bridges added that we have the opportunity to work with ANCBH and UNC SPH on this issue. An effort will be made from DHHS to capture current employment statistics to ascertain the make-up of the workforce on a county-to-county level.

Vote taken on motion. All votes affirmative. Motion passed.

Women and Children's Health -- Dr. John Morrow for Wanda Sandele'

There had been a verbal message from the Feds that there would be no new states given Medicaid waivers for family planning services and that existing states would not be renewed when their five-year agreements expire. Due to strong public reaction, another verbal message was given that existing agreements would be renewed and all pending applications approved. Legislation was introduced by Chafey and Lowery call the Family Planning State Empowerment Act which would permit any state to access the waiver to expand Medicaid eligibility for family planning.

Motion: that the NC Association of Local Health Directors restate its support for the NC application for the Medicaid waiver that would improve eligibility for coverage in Family Planning Services to the level now applied to Maternity and support the Chafey and Lowery Family Planning State Empowerment act that would allow any state to use this waiver.

All votes affirmative - motion passed

The state has received an additional $230,000 for Family Planning due to an increase in workload. Five years of data was examined, with an average being calculated for the first three years. A comparison was then made between that average and the last two year's workload. Forty-two (42) counties exceeded their own three-year average in at least one of the last two years. These counties would be contacted to see if additional funding would allow them to further increase workload. Nineteen (19) counties would receive additional funding. The committee requested that counties with downward trends be contacted to find out if their decrease was due to lack of funding to support the services. Some may have had to move MCH money into child health or maternity, and recommended that such counties also be considered for the additional funding. State staff agreed, stating they intend to work with these counties to see if something could be done to increase Family Planning services. Those counties receiving additional funding would be required to commit to and meet the additional workload, or lose the extra funding.

Motion: that the Association endorse the proposed methodology to distribute $230,000 additional Family Planning funds which would invite counties to chose to receive additional funding if they felt they could further expand the service.

Discussion: Mr. Staley asked why the state does not use the Equity Formula for distributing the additional funds. Mr. Bridges responded that the funds have to be spent quickly and those counties that have demonstrated their ability to expand numbers will be provided the opportunity. Mr. Staley asked if there will be any proposed reductions for Family Planning in the budget cycle. Mr. Hoke responded that the Conference Committee is recommending a 10% reduction in the TANF fund for unwed Family Planning patients.

A vote was taken - all votes affirmative - motion carried.

 

Committee Reports (information items)

Women's and Children's Health -- Dr. John Morrow for Wanda Sandele'

Epidemiology -- Dr. John Morrow

State and Local -- Chris Hoke

Alliance -- Barry Bass

Nominations/Bylaws -- Tom Bridges

Environmental Health -- Terry Pierce

Technology -- Tom Bridges for Ray Rabe

Regional Reports - No Reports

Other Reports

Ed Regan, NC County Commissioner's Association

Announcements -- Tim Green

Having no further business, the meeting was adjourned.

Respectfully Submitted,

Deborah Rowe (for MiMi Cooper)