President Wayne Raynor called the meeting to order at 2:00 pm welcoming all members and guests. President Raynor asked for a head count of members present and there was a quorum for a full association meeting (44 members were present at roll call). He announced that since a quorum was present, that this would be a full association meeting. Please see attached Attendance Roster for actual attendance.
Mr. Parks shared the "Red Skelton Pledge of Allegiance" to mark the grave concerns we all faced at our September Meeting last year.
President Raynor reminded members that the minutes were posted on the web site and asked for a motion to approve the minutes as posted. There was a motion to approve the minutes as posted and a second. With no discussion, the motion was unanimously approved.
Don Yousey presented the treasurer's report (see attachments for full report). The balances are as follows:
There was a motion to approve the Treasurer's Report as given and a second. It passed unanimously. (Please see attachment) Don Yousey added that Mr. Raynor had asked him to update the Health Director Roster. Don said that he had emailed the info he had to each health director, but had only heard back from about half. He asked everyone present to go back and check their data and to email him with updates as needed. Don then said that once these changes were complete he would ask Ms. Rowe to send it to everyone via her abbreviated list. That way only health directors would be privy to the personal information it contained.
Deborah Rowe reported that conference packets would be distributed to those who are registered and noted that it was not too late to register. She also invited everyone present to the hospitality room this evening. Ms. Rowe also reminded everyone of the Glaxo-Smith Kline Awards function the following morning. Deborah then noted that the Legal Conference would be starting at noon the following day and reminded everyone that this was usually limited to health directors and county attorneys. She said that others would be allowed to attend if all the available slots were not taken.
Ms. Rowe then gave a short update on the state budget noting that public health came out better on the final product than we would have in either of the proposed budgets. She highlighted that case management cuts came in at $7,000,000 versus the $20,000,000 originally proposed. Additionally, while we did lose $1,000,000 in aid to counties, the proposed cuts in Medicaid Rates did not make the final budget. Deborah cautioned those present that the final budget was not really a balanced budget and that the Governor was given power to make further cuts as necessary and that public health might still lose more later on in the fiscal year. Lastly, Deborah noted that a lot of this budget contained "one-time dollars" that will not be available next year and that without a better economy, the picture next year looked much worse.
Mr. Raynor introduced Dr. Steve Slott who will be reporting for ANCBH later in the agenda. Wayne also said that he had heard from most regions regarding volunteers to serve on the visioning subcommittees. He asked anyone else still interested and not yet assigned to a committee to contact him.
Ms. Summers provided a handout that contained recommendations from the Task Force (See attachment). She noted that the finance committee still has to meet and recommendations would be coming from them as well. She asked that everyone look over the recommendations distributed and provide feedback to her by November 1st to take back to the Task Force.
Dennis Harrington reporting for Dr. Devlin who would not be in New Bern until the following day as she had to stay in Raleigh to work on the Bioterrorism Bill. Dennis then noted that he had sent out a budget summary via email the previous Friday and distributed hard copies at this meeting (See attachment). Dennis repeated what Ms. Rowe had said earlier about the budget not being balanced and many more millions in cuts still needing to be made. Mr. Harrington also said that $7,000,000 was still to come in case management and noted while this could not all come from public health, our share had not been determined to date. Leonard Wood asked if the new rates for CSC and MCC would affect us? Dennis noted that the rates had been set by the amounts paid out last year and were hoped to be revenue neutral. Joy Reed added that some 90 questions had been asked during the last work session, and that about 35 had been answered thus far. Several present asked that regional consultants stop giving feedback and guidance on this until definitive answers me back from DMA as this just confuses and scares staff. Dennis noted that the budget did replace some TANF funds, but that this had been done with one-time dollars versus continuing money. Also, the PHTIN money had been taken out of the budget but that Dr. Devlin was asking her staff to look for ways to replace it. Lastly, Dennis reported that there had been a recent West Nile Virus email regarding the testing of birds and animals and asked that all health directors be sure to review it. Further, the Institute of Public Health was looking at updating the overview of public health statutes that has needed updating for some time.
Mr. Harrington then introduced Dr. Jim Kirkpatrick who has many years' experience working with bioterrorism and chemical/biological chemicals who will be heading up this effort for public health at the State level. Dr. Kirkpatrick gave short overview of his work with the military and noted that he was glad to be in North Carolina and wants to contribute to the defense of our country in this new capacity.
Environmental Health -- Terry Pierce
Mr. Pierce reported that the committee had discussed the compromise on the restaurant grade cards. He noted that since a motion had been not been sent from the committee, it would need a second, as there had not been a quorum of the committee present. He then asked Mr. Michael Rhodes of the division to come forward to help him present the new proposed grade card. A sample card was held up for all to see (See attachment). The card contained both an alpha and letter grade of approximately two inches in height. Mr. Pierce noted that peal and stick letters and numbers were being looked into to add consistency to the cards. Mr. Rhodes noted that the current grade cards would be used up before the new ones went into effect. Everyone was reminded that this was still a draft and that the restaurant association members on the committee were also carrying it back for their members' approval. Mr. Rhodes reported that since the health directors had asked for a combination alpha and numeric grade that this was a fair compromise. After some discussion, the following motion was offered: That the Association endorse the use of the grade card, with the alpha grade and numeric score to be 2 inches in height beginning July 1, 2003, and that the Pilot Project be terminated Jun 30, 2003. There ensued some discussion on the colors to be used and a friendly amendment adding "black lettering on a white background" was added. After appropriate motion and second, the amendment passed unanimously. Then, the amended motion was seconded and it passed unanimously.
Nomination and Bylaws -- Tom Bridges for Tim Green
Tom Bridges presented a sheet that had been emailed out the previous week regarding the slate of officers (See attachment). The slate of officers was as follows:
- President- Jim Baluss (Edgecombe)
- President Elect -Mimi Cooper (Randolph)
- Vice-President- Don Yousey (Brunswick)
- Secretary-Treasurer- Elaine Russell (Cherokee)
- Past-President- Wayne Raynor (Harnett)
Mr. Raynor announced that coming from committee, the motion (Slate of Officers) needed no second. There was no discussion and the motion carried unanimously.
Mr. Bridges then presented the following proposed changes to the Bylaws as offered by the committee:
- Article Ill, Section 3: "Nominations for elective offices shall be made by the Nominating Committee designated at least sixty (60) days prior to the fall full association meeting and composed of five local health directors.
- All references to "the full association meeting in October "change to" "the fall full association meeting."
- In order to correct a typographical error in Article IV, Section 2: "The Secretary--Treasurer shall also keep the minutes of all meetings as are usually incumbent upon that office and such other duties as the association may by resolution direct.
Mr. Raynor again announced that coming from committee the motion needed no second. There was discussion and it carried unanimously.
Epi Committee -- Dr. Morrow
Dr. Morrow reported that the committee had met via conference call the previous week, but only got through about 1/3rd of the agenda. Dr. Morrow noted that the West Nile Virus (WNV) group continued to meet. The group recommends continuing postmortems on birds until each county has identified a positive bird (to keep local interest up). The committee also discussed the use of "public health nuisance" law and noted that the Attorney General' s Office felt that clear-cut threshold had been set on what constitutes such a nuisance. Some present felt this might be a positive thing in that it allowed some leeway for interpretation. The Epi Committee also discussed whether local health directors could be enrolled in "Epi X" and felt that the PHRST Teams should be the ones connected and then they could pass on information to local health directors as necessary. Dr. Kirkpatrick then reported that the CDC had recently announced the release of the Small Pox Clinic Guide. He further added that State Epi is working on publishing a Small Pox Vaccination Plan by November 2nd but the Preparedness Response Plan would not come out until a later date. He said that they need a federal decision on pre-event vaccination before this can be done. Dr. Kirkpatrick did note that the State had decided that local public health would be carrying out the small pox vaccination plan and recommended that we all look at the CDC Clinical Plan and try to determine how mass vaccination might impact our manning needs if we had to carry it out.
Environmental Health -- Terry Pierce
Mr. Pierce said that he had a few budget items to discuss. On the Food and Lodging Fees issue, he noted that establishments will now be charged $50. Because of this, appropriations to the Division of Environmental Health had been cut by the amount the new fees will generate. He noted that printing costs were lost along with this money. Terry added that one good thing was that the bill included a provision to study the fees to see if they are now adequate (which we know to not be the case) to pay for the services rendered (See attachment for specifics). Lastly, Terry reported that the EH Committee meetings were not being well attended due to travel restrictions and scheduling conflicts.
Health Promotion/Oral Health -- Rosemary Summers
Ms. Summers reported that committee was looking at the performance standards for Health Promotion in local health departments. She noted that many in the field complained that they were hard to understand and that was why the committee felt they needed review. The new standards will be used to make performance based awards starting in FY 03-04. Lastly, Ms. Summers reported that the Policy and Environmental Handbook was being sent to all Health Departments and asked that health directors review them as this is background for standard development. The committee hopes to be completed with this work by the first of the calendar year.
Nominations and Bylaws -- Tom Bridges for Tim Green
Mr. Bridges reported that the odd numbered regions had held their elections. Following are the results of the elections:
Region Regional Rep Alternate Regional Rep I Bob Wood (Haywood) Janice Patterson (Clay) III Danny Staley (Appalachia Dis) David Stone (Surry) V Glenn Martin (Rockingham) Rosie Summers (Orange) VII Louis Latour (Wilson) Gibbie Harris (Wake) IX Anne Thomas (Dare) Jerry Parks (Albemarle Dis) Mr. Rabe then asked that the committee look into making committee chairs full voting members of the Executive Committee sometime in the next year.
Office of Public Health Nursing -- Joy Reed reporting
Ms. Reed repeated what had been said earlier about the first 35 questions from the CSC/MCC work groups had been answered. She noted that the rest of the answers will be coming out, but that we will probably need to negotiate what the answers are. A couple others items that are being reviewed involve whether screening will be deemed as "routine" or not. Additionally, the question on who was required to have completed the TB Course to provide screening has been resolved with this requirement only applying to the lead nurse of the program (not all nurses). Lastly, Joy reported that they were planning a conference on Medicaid Billing Requirements
ANCBH -- Dr. Steve Slott, President
Dr. Slott reported that there were two things he needed help with. First, the Dental Association passed on an idea for February 21st to be "Give Kids a Smile Day." The idea is to provide free dental care on that day. Slott noted that there is no funding, but had asked local health departments with dental programs to look at providing screening, care, etc. that day if possible. He passed around a sign-up sheet asking those interested to provide him with contact information. Dr. Slott also reported that ANCBH was looking at having a representative at each local board of health meeting to pass along information from their organization. Some questioned the feasibility of this and Dr. Slott admitted it may not be doable, but asked that we at least look at the idea. He circulated a second sign-up sheet asking that we provide him with our meeting dates and locations. Lastly, Dr. Slott reported that ANCBH was still working on providing training to all local boards of health and asked those who still needed the training to schedule it.
Region 5: Glenn Martin reporting for the region
Mr. Martin reported that two recommendations had come from Region V for consideration by the association.
Recommendation #1
To better enhance true representation of all county health directors in the decisions before the N.C. Association of Local Health Directors, the Region 5 Directors recommend that the Association hold two full association meetings annually over the PHTIN to improve accessibility due to travel restrictions and/or distance limitations, and that the Technology Committee study other electronic means to conduct or broadcast Association meetings to further participation and member satisfaction (to take affect in 2003).After some discussion with no dissention being noted, Mr. Raynor stated that coming
from region and needing no second, be was asking for a vote. The motion carried 23 for and 16 against.Recommendation #2
To allow district representatives the opportunity to obtain member input on controversial issues before the Association, Region 5 Directors recommend that the Nomination and Bylaw Committee explore the possibility of requiring a two-third majority vote on action items on a first reading to obtain Association approval. If a two-third vote is not secured on the first reading, the action item shall be delayed to the next Association meeting, where on a second reading a simple majority vote will constitute Association approval.Bill Smith noted that this was really a request to change the bylaws and felt it should be referred to the Nominations and Bylaws Committee for consideration before coming to the association as a motion. There was general consensus for this approach and those present agreed to refer the recommendation to the Nominations and Bylaw Committee without it coming to a vote.
Regions 1 and 2: George Bond
Mr. Bond reported that due to recent discussion on clustering and a desire to do this year's together, Regions I and II have agreed to establish a common starting date Flu Vaccination Programs. George noted that with the lack of vaccine availability to local health departments last year and privates being able to get it just by paying more, felt our effort looked "pretty crappy." Although there is not a shortage predicted this year, Regions I and II decided to have a unified approach and chose October 28th as their kick-off to the flu vaccination season. He asked that other regions and counties give some thought to adopting this same date..
There being no further business and after motion and second, the meeting adjourned at 4:30 pm. The next meeting of the Health Directors' Association will be October 17, 2002 in the Wake County Health Center .
Respectfully Submitted,
Don Yousey
Secretary/Treasurer