Minutes

North Carolina Association of Local Health Directors
Executive Committee Meeting

September 11, 2001

Adams Mark Convention Center
Winston-Salem, NC

Call to Order

President Tim Green welcomed the executive committee members, association members and guests to the September meeting at 1:35pm. Ten executive committee members were in attendance (see attachments for attendance roster) which constitutes a quorum. Tim called on Deborah Rowe to lead a moment of prayer in memory of the victims of the terrorist attacks on New York City and Washington, DC.

Fellowship:

Jerry Parks of Albemarle District provided fellowship by challenging the group to "Apply your faith today."

Approval of the Minutes:

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

Treasurer’s Report:

MiMi Cooper presented the treasurer’s report with balances as of September 7, 2001. Account balances were as follows:

• Checking: $26,178.33
• Savings: $35.17
• Money Market: $346.15
• CD: $40,000.00

(See attachments for full treasurer’s report).

Dues are still outstanding for 5 health departments.

State Health Director's Report/Local Health Services Report -- Dennis Harrington

Congratulations to all North Carolina counties for their contribution to North Carolina having the highest immunization rates in the country. We also heard earlier this month that our infant mortality rates are greatly improved even though there is still work to be done.

• There will be a one million-dollar cut in health promotion funds. The health promotion committee will go over the suggestion for how these cuts will be applied.
• The committee meeting was cancelled today that would have included Senator Albertson’s amendment concerning hiring/firing of local health directors. We were able to see the amendment and he has added directors of Mental Health and Social Services and based the rule on the enabling legislation for Commissioners to abolish human services boards but has lowered the threshold to 150,000 people.
• ADAP funds are available in the amount of 1.4 million additional for AIDS drug treatment but we don’t know if this money will replace State funds or be in addition to.
• You should have received a letter from Gary Fuquay about records disposition. It basically says don’t throw any thing away yet. There is new guidance on the way.
• You will receive a letter from Carol and Steven about Medicaid cost. They need time estimates on services by CPT codes. The time deadlines are critical. If you don’t receive this information, let Dennis know.
• Sept. 17th is the due date for Expenditure and Equivalencies due to Raleigh.
• You have received memos from Dennis about Medicaid claims paid at the wrong code. Medicaid will cut you a check. You will have to do an adjustment or entry. You should have this by the fourth week of September. The print out that comes with the check will show you where to post the revenue.
• In response to your questions about the LHD list serve, Dennis supplied the following information. Rodney Long with DEH at DENR is the list serve manager. There is a filter on this list that should block out anyone that is not a list member. But recently we all got information about aluminum siding! Rodney is not sure how this got through but is looking into it.
• Diane Crouse asked about Chris Hoke’s new position. Dennis said that Chris is back at St. Mary’s street building. He will serve as liaison to the commission for health services, the Public Health Study Commission, and work on drafting rule changes.
• Jerry Parks asked about the search for a new State Health Director. The committee made up of Leah Devlin, Tim Green, Barbara Pullen-Smith, and Jim Bernstein is interviewing the fourth candidate this week. The position is still being actively advertised. If you know of anyone interested, contact a committee member.
• Jim Bernstein informed DIRM that they would develop the business requirements for management systems for public health. The "goodness of fit" effort is on the way. Dennis Williams (formerly with Office of Medical Assistance) is now a special assistant to Jim Bernstein. He is on a fact-finding mission and things are looking up for several issues where we have not been able to make much progress.

Liason Reports:

Special Visitor -- Richard Funderburke, South Health Association

Richard thanked the Health Director's Association for allowing him to speak to an issue that will come up in the business meeting of NCPHA tomorrow. There is a resolution to drop NCPHA from the Southern Health Association membership for financial reasons. Richard explained that the Southern Health Association is made up of eight southern states. He feels that we are a unique family and will not be able to function well without North Carolina. He said it would be like a hand without a thumb. Richard welcomes conversation with individual members.

Executive Director's Report -- Doborah Rowe

Deborah announced that the Health Director’s Legal Conference scheduled for Wednesday and Thursday will be held in the same room as our meeting today. This is a change from the brochure. She also announced that room 975 will be open this afternoon and evening for people to gather and be together as we learn more about today’s tragedies. Deborah also expressed regrets that if you are called back to your county as a result of today’s events, there will be no way for NCPHA to refund your registration.

School of Public Health -- Penny Whiteside

• Grand Rounds – Stand Up and Be Counted, Sept. 28, 2-3pm at 13 sites across the state. You should register on line.
• You should have received a workshop catalogue from the Continuing Education department. Extra copies were distributed at the meeting.

Committee Reports (action items):

Health Promotion and Oral Health -- Rosemary Summers

Motion: that the Association support the Health Promotion million dollars as an inclusionary item in the State budget and authorize the president to write a letter and actively lobby to get this amount included.

Discussion: The committee says that the State has 4.8 million dollars in combination for Health Promotion activities. The House cut one million from the budget, the Senate did not.

Motion passed unanimously.

Motion: if we are unsuccessful in getting funding restored, the committee recommends that each county receive a base funding of $21,000 and those whose allocations are above that would be cut. (See attachment for county-specific cuts)

Discussion: Copies were made of the handout so each county could see what the cut amounts were.

Motion passed unanimously.

Committee Reports (information items)

Epidemiology -- Dr. John Morrow

• Hepatitis C – Concern is that folks who had blood/body fluids exposure would not be able to get source tested for Hep. C. One County had used the general communicable disease law to force someone to be tested for Hep. C. There is a proposed rule change,…0201 Guidelines or recommended actions recommended by CDC may supercede actions recommended in Control of Communicable Diseases Manual. Counties will have to cover costs for Hep. C testing. The state lab does not do Hep. C.
• There is a Hepatitis C Conference coming up this weekend in Winston-Salem, then traveling to Greenville, Fayetteville, Greensboro, and Asheville.
• Bio-Terrorism Task Force – Tom Bridges and Chris Szwagiel are our representatives on the committee. We are in year three of a five-year grant.
• We were sent a copy of the rule changes that allow for 3rd party payors billing for STD with patients consent. This change also incorporates adding chlamydia testing to maternity care as early as possible and at 28-30 weeks of pregnancy. It also adds positive chlamydia to required laboratory reporting.
• If you have been approved for HIV counseling through one of the approved State courses, you can train others without additional training.
• New safe fish eating guidelines for NC – added restrictions on black fish, large mouth bass, and Jack caught south of 85.

Nominations/Bylaws -- Tom Bridges

(See attachment to minutes – Special Report on Regional Configuration)

The proposed by-law changes will be voted on at the October meeting but have been given out at this meeting to allow time for consideration. It was suggested that rather than stating which months will be the full association meetings in the fall and spring, that we just designate every year which fall and spring meeting will be full association ones. Tom presented the slate of officers for consideration. They are:

Immediate Past President: Tim Green
President: Wayne Raynor
President Elect: Jim Baluss
Vice President: MiMi Cooper
Secretary/Treasurer: Mike Hanes

Environmental Health -- Terry Pierce

• The Septage bill that had two amendments to it, now has no amendments. Watch the list serve to see where these amendments may land.
• Senate Bill 312 does have amendments for closing food and lodging establishments tacked on as of now.
• The body-piercing bill seems to be coming back to life.
• Sue Grayson needs a local health director to serve on the food code committee

Health Promotion -- Rosemary Summers

• The State is looking for matching dollars for the legacy (750,000) and diabetes grants (150,000). Leah is considering using the purchase of care funds.
• Rick Mumford is working with the licensure board to do an interim license for those dentists who have not yet passed the board.
• The State is participating in the Behavioral Risk Survey. For a county to be included they must be at least 100,000 people. The cost is $5,000 to participate. There is space available

Technology/HIPAA Committee -- Ray Rabe

Health Alert Network funds are coming to enhance our capacity to be able to communicate with each other across the country.

Regional Reports - No Reports

Announcements -- Tim Green

1. January 30, 2002 is the first meeting of the New Year. This is in conjunction with the State Health Director’s Conference on the 31st and the 1st at the Marriott in Raleigh.
2. Maggie Dollar is representing our association on the task force concerning healthy weight in children.
3. John Morrow is serving as our association first mentor in our new mentoring program.
4. Tim and Bill attended a meeting called by Nina Yeager of DMA. DMA is expected to make considerable cuts in Medicaid expenditures. Now Medicaid is experiencing an 800 million-dollar per year growth rate. That will need to be decreased to less than or equal to 500 million per year. Growth should not exceed 8% per year. Suggested cuts were:
   • Prescription expenses
   • Decrease ICFMR
   • Decrease MD reimbursement rates
   • Increase co-payments
   • Decrease pharmacy filling fees

   The Dental Program was not targeted for decreases. There was a great deal of talk about incentive programs rather than current programs. Bill was concerned that long-term care is still not being considered for cuts even though they have had increases every year. There are no new inflationary increases. We needed to continue to watch for security of wrap-around services. Unless the law changes, Health Departments are cost-based and we must see all comers as opposed to an MD who can refuse to see a Medicaid patient.

General Announcements:

Bruce Parsons has some Dental Anesthesia medicine that will go out of date September 30th. If you can use some for your dental clinic, see Bruce.

There will be an open house in Allegheny County on Friday Oct. 5th to show off their new facility.

Our next meeting is October 18th at 9:00am at the North Carolina Hospital Association Building in Cary.

Having no further business, the meeting was adjourned.

Respectfully Submitted,

MiMi Cooper
Secretary/Treasurer