President Wayne Raynor welcomed the members of the association and guests to the January Meeting at 1:30 p.m. A quorum of members were present (see attachments for attendance roster).
Elaine Russell of Cherokee County provided fellowship.
Wayne Raynor presented Tim Green with an engraved gavel as "Outgoing President." Wayne thanked Tim for serving as a "good mentor, confidant and for helping the association successfully complete many of its goals!"
The minutes of the December meeting were posted on the web site, ncalhd.org, and approved as written.
Don Yousey presented the treasurer's report with the balances as of January 10, 2002. Account balances were as follows:
Don thanked everyone for being so prompt getting their dues in this year. He reminded everyone that those who had not paid yet had their names listed in bold on the attendance roster.
(See attachments for full treasurer's report).
Copies of the proposed budget as offered by Mimi Cooper were distributed. After some discussion regarding sending Ray Rabe and Leonard Wood to the Annual NCHICA Conference and the desire to send two members to Washington to meet with our legislators, the proposed budget was approved as presented.
(See attachment for full budget).
Doug Urland reported that he, Diane Crouse and Mike Haynes had completed the annual audit of the association's books this morning before the association meeting. He noted that "no exceptions were noted." Doug further reported that Mimi had done such a thorough and professional job that the audit was easy. Wayne thanked Mimi for doing such a wonderful job this past year.
Wayne Raynor reported the numerous changes to the liaison committees, etc. for this coming year. Wayne noted that these would all be updated on the homepage in the very near future. (See association homepage for details) Wayne also asked that all members review the attendance roster and help get the word out that we need to pay our dues for this year. He asked everyone's support in attaining a 100% dues paid rate again this year. Mr. Raynor closed by stating that he would be personally continuing the $100 award to be given to the member with the best meeting attendance this year
Leah Devlin thanked the association members and staff who worked on the Registered Nurse and Health Education Legislative Reports. She also discussed restarting the collaboration between this association and her office on goals to work on with the Legislature this year. Leah spoke of hoping to work closer with the local health directors on these issues than had been the case in the past couple years. Ms. Devlin also reported that there was another budget reduction of $1,400,000 being called for. She noted that she was hoping to absorb the losses at the state level and not affect the money going to local health departments. Lastly, Leah discussed rumors of impending public health reform that have been circulating. She noted that there has been no official work on this issue and said that local health directors would be included if such a process were undertaken in the future.
Steve Cline reported that he had emailed a draft of the Public Health Bioterrorism
Plan, a model local plan (based on Guilford County's plan), and state level
plan regarding the federal pharmaceutical stockpile in the event of a bioterrorism
event to all local health departments. He reminded those present that the local
bioterrorism response plans were due into his office by March 8, 2002. Steve
then reviewed progress being made on the seven regional teams for laboratory
support during a bioterrorism event. Leonard Wood asked if the teams would be
limited to bioterrorism as there were other significant epi needs across the
state. Steve replied that since this initiative was being funded with bioterrorism
money that this should be their focus at first. However, once in place and able
to handle that duty, he thought these resources could also add to the epi core
support. Lastly, Steve noted that emergency contact information was being attached
to the bioterrorism plan but felt this was okay because the plan itself was
a "confidential document."
Dennis Harrington said it gave him great pleasure to announce that Francis Taylor
had been hired to work on the HIPAA process with local health departments. He
noted that her focus will be on security and privacy at first. Dennis said that
Francis would be offering a plan to help those who haven't started the
process. He noted that there is no way for one person to possibly do an assessment
for each individual health department and we needed to work on these assessments
ourselves. Ms. Taylor then passed out a copy of her job description and reviewed
some goals she hoped to focus on. Ms. Taylor also distributed a compliance model
that included mileposts to help gauge progress towards compliance. She cautioned
against leaving compliance to just management staffs and recommended including
key line people to take part in drawing up our compliance plans and gap analysis
efforts. She then provided information on how to contact her and noted that
she hoped to establish a hot line similar to that used by Joy Reed during her
ICD9 work last year. Dennis then closed by stating that agreement addenda were
completed and noted there were no major changes from last year. He asked that
the health directors impress upon their budget directors the importance of getting
reports in on time if health departments expect to get their May earnings paid
before this year's budget closes.
Wayne Raynor stated that Terry Snowden our host for our luncheon wished to make a few comments. Terry reported that St. Pauls had announced that they were getting out of the health liability insurance arena. She volunteered to work with those who will be losing coverage by St. Pauls. Ms. Snowden then invited local health directors to a Dental Presentation that will be taking place in Buncombe County to help people deal with some documentation issues that have been occurring in public health dental programs. She noted that this would be a risk management class with a projected date of April 23rd. Location – to be announced.
Mike Haynes shared a PowerPoint presentation on his recent trip to Mexico. Mr. Haynes shared a personal look at lifestyles in Mexico and how this relates to those coming to the U.S. Mike noted that North Carolina leads the nation with Latino population growth with half a million Latinos migrating to the U.S. annually. Mike noted his health department has hired several Latino staff members who serve as employees and interpreters simultaneously. Mike felt this was a better use of resources versus having dedicated interpreters who cannot add other value to the department.
Mr. Terry Hodges reported that the Civil Rights Office was putting together a plan to help his department meet its requirements to meet Title 6. Mr. Hodges noted that health departments might be able to use the Civil Rights Office plan to develop one of their own. There was some question of what deficiencies the recent survey had found, but Mr. Hodges reported that this information is not available yet. He did note that there will be a grace period for all of us to get into compliance. He further noted that his office accepted responsibility for us not having plans and promised to work with us to get ourselves into compliance. Training on how to get into compliance in providing interpreters will be forthcoming.
Environmental Health -- Terry Pierce and Linda Sewall of EH Division
Due to budget cuts being forced on the EH Division, they are proposing that each health department pay for forms and certificates used within their counties. The first thought was that the money needed for printing these forms ($90,000) be taken from each county"s $6,000 aid to county money. After some thought, it became evident that this would not even cover the cost of some counties' printing. The division then thought that a prorated amount based on how many forms each county ordered could be taken from the shared permit fees that the division collects from served establishments might be the way to go. With that in mind, the committee offered the following:
Motion: Printing costs for Environmental Health forms and other printed supplies be deducted from food/lodging fees allocations before disbursement from the state. There was much discussion on why the State should supply these materials as locals were just carrying out State rules. Some thought that maybe each county could print their own forms, but this was thought to be even more expensive than what the motion offered. If not prorated, the money needing to be made up would come out to $900 per county. After some further discussion with some health directors speaking against the motion, it was voted down.
Policy and Planning -- Jim Baluss and Mike Rhodes of EH Division
Jim Baluss reported that during the Policy and Planning Committee Meeting that it became evident that Environmental Health was planning to give an update to the Commission for Health Services (CHS) on the Restaurant Grading Pilot Project. There was some thought that this proposed report was going to include recommendations and the outcome of the survey that was done on this project. Mr. Baluss noted that the Policy and Planning Committee took issue with a report being offered to the ERC before it was shared with the local health directors. With that mind, the committee offered the following:
Motion: That NCALHD, by letter to Linda Sewall, requests that no report or recommendation on the "pilot projects" for numeric versus alphabetical grades in sanitation grading be brought before the Commission for Health Services without such findings or results of the survey being first provided to all local health directors and liaison committees. Mike Rhodes then spoke to the group stating that he welcomed the chance to share the data with the health directors. He said that he would then brief the Commission. After some questions to Chris Hoke on whether this could be done and his agreement that it could and his assurances that other points of view would also be able to be presented when the final report was made to the Commission, the motion was approved unanimously.
Technology Committee -- Ray Rabe
Ray Rabe reported that the Committee had put together a motion based on some faulty information. He noted that he had reworked the motion to fit the current accurate information and asked the committee members to correct him if they were not happy with his rework of the motion. Ray continued to say that HSIS changes will be necessary as we come into compliance with HIPAA. He pointed out that some health departments had discussed billing Medicaid on their own, but that this would interfere with the maximization process. However, there is no written requirement to use HSIS for Medicaid billing. With that in mind, the following was offered:
Motion: That NCALHD supports the continuation of local health department's billing Medicaid through HSIS at this point in time. This shall be reconsidered in 18 – 24 months to assure the preservation of the current cost-based reimbursement process. There were no corrections of the motion from committee members and it passed unanimously.
Epidemiology -- John Morrow
John Morrow reported that the committee had met via conference call and discussed the following:
- What Steve Cline had discussed earlier in this meeting. He noted that Steve focused on three items:
- development of the State Bioterrorism Team and a list of agents available in North Carolina,
- development of regional bioterrorism teams, and
- State Lab improvements/Info technology development and surveying of local needs.
- Review of the agreement addenda that showed no significant changes from this year.
- The fact that ADAP funds are running short and that participation has been capped for the time being.
- and lastly, that the committee has discussed problems with the distribution of Flu vaccine. The epi committee agrees that the bioterrorism regional teams must work regionally to be effective.
Women and Children's Health -- Wanda Sandele
Wanda Sandele reported that waivers for Family Planning similar to those used in maternity are being looked at. She also reported that the committee continued to look at uncompensated care in maternity and ways to deal with this issue.
Technology Committee -- Ray Rabe
Ray Rabe reminded everyone that Francis Taylor is our "one and only" and asked that we not overburden her or flood her with complaints. He asked folks to refer concerns to him or Leonard Wood rather than bother Francis or Dennis Harrington.
Education and Awards Committee -- Janet Lindbloom
Janet Lindbloom reported that the committee had not met yet, but planned to meet at the Crabtree Grill at 8 am tomorrow. She noted that April 19th is the tentative date for Spring Training. The committee is looking at holding the training at the Sheraton just across the street from the Crabtree Marriott. Right now the topics look like building infrastructure, bioterrorism and HIPAA.
Policy and Planning -- Jim Baluss
Jim Baluss reported that meeting announcement emails did not work in some cases. He asked those interested to contact him with correct email info for future meeting preparation. Jim reported that money will be a tough sell this year, but we need to keep our hopes on the table to keep our issues on the radar screen. He noted there may be a little money coming to help with interpreter funds this year. Realignment of EHS will probably be on the back burner at least for the short session. However, this is still a hot issue especially if something were to happen to Linda Sewall or Malcolm Blalock. Jim also reported that Senator Albertson was still pushing for the ERC to give the CCs more power in regards to hiring and firing health directors. A current list of the ERC was distributed. Jim asked us to contact our representatives on the ERC and voice our concerns and position on this issue. Debra Rowe reported that she would be meeting with Boards of Health and the CC's Association to formulate our position and a plan for us to adopt. Jim Baluss closed by stating that the committee was very energized by a report from Barbara Pullen-Smith on her committee's plans for dealing with diversity and racial disparity in health indices.
Environmental Health -- Terry Pierce
Terry Pierce reported that EHS is still working on the rewrite of the on-site rules. The draft of the proposed rules are available at the EHS website. There is also a synopsis of the changes being put together. Terry reported that he was considering moving the meeting time to relieve the conflict between Policy and Planning and this committee as the committees share some members and this will allow attendance at both meetings. Terry closed by stating that a survey was coming out regarding how we dealt with contaminated wells after the hurricanes and that the issue of how to deal with the EHS liability coverage is still being studied (Who is going to pay for, etc.).
Institute of Government
Jill Moore reported that she and Amy Wall will be providing training on HIPAA. She noted that the IOG is trying to ensure that their training does not duplicate what is being offered elsewhere. They will be focusing on Privacy and are trying to limit attendance to local public health staff. She noted that there will be five 1.5-day sessions in May as follows:
- 13 – 14 May – Hickory
- 16 – 17 May – Asheville Vicinity
- 20 – 21 May – Greenville
- 23 – 24 May – Chapel Hill
- 28 – 29 May – Wilmington
Jill noted that the training will be specific and deal with model consent forms, authorization, etc. Training will be aimed at the "Privacy Officer" position that HIPAA requires. She closed by stating that training may be available via PHTIN later.
Alliance (NCAPHA) -- Barry Bass
Barry Bass reported that Susan Smith-Wharton was resigning to move. He noted that Deborah Rowe had offered to help until someone is hired to replace Susan and there is a hot prospect for the position. Barry emphasized that the Alliance wants to build a better relationship with local health directors as our two associations have so many issues in common. Mr. Bass closed by stating that the Alliance meeting would convene immediately after this meeting.
ANCBH -- Rachel Stevens
Rachel Stevens reported that ANCBH wanted to pass along its thanks to the health directors for our support of them during their financial problems. ANCBH is continuing as an organization with some changes that will be discussed at Friday's meeting. Training of boards of health will continue with support from Leah Devlin and the Institute of Public health. A plea was made for boards of health to continue their memberships in ANCBH as dues will be very important if the work of ANCBH is to continue.
Office of Public Health Nursing -- Joy Reed
Joy Reed reported that transaction and code changes need to be completed to bring us into compliance with HIPAA. She discussed the codes regarding assessment and other work done by nurses and thought the new codes would be in place by July 1, 2002. This date was chosen to help us keep one billing method during the whole fiscal year in support of cost settlement at the end of the year. Joy also reported that since no one had applied for the vacancy caused by Carol Gaddy leaving that she had gotten permission to add another regional consultant with that position. Delivery of medications by non-physician settings is being looked at with the hopes of standardizing how this is done. Lastly, Joy reported that the most recent interpretation by NC OSHA seems to mandate the use of needle stick prevention devices. She warned that this might be a costly change for health departments.
NCPHA-- Deborah Rowe, Executive Director
Deborah Rowe voiced her appreciation for the "great support" she has received since taking the leadership role in NCALHD and NCPHA together. She noted that a web page is being put in place for NCPHA. Deborah also noted that continued problems about finances at the state level increase our fears about how this might affect us this year. Deborah closed by stating that the CC's association has asked the governor to not touch revenues for the inventory tax this year and noted there was some hope the governor will honor this request.
Region 6 -- Jim Roosen
Jim Roosen talked of concerns meeting the HIPAA requirements and the number of redundant emails received during the Anthrax problem. He wondered if these could be filtered by the State.
There being no further business, the meeting was adjourned at 5:30 p.m.
Respectfully Submitted,
Don Yousey
Secretary/Treasurer