Minutes
North
Carolina Association of Local Health Directors
Full Association Meeting
January
29, 2003
Sheraton
Raleigh Capitol Center
Raleigh, NC
Call to Order
President
Jim Baluss welcomed the members of the association and guests
to the January meeting at 1:30 pm. Fifty-five members were present
(see attachment for attendance roster) which constitutes a quorum.
Fellowship
Bob Wood of
Haywood County provided the fellowship.
Approval of the Minutes
The minutes
of December 2002 meeting were posted on the web site, ncalhd.org,
and approved as posted.
Treasurer's Report
Given the
transition status of January, Past Secretary/Treasurer Don Yousey
presented the Treasurer’s report with balances as of December
18, 2002. Account balances were as follows:
- Checking:
$20,195.58
- Savings:
$36.16
- Money Market:
$360.20
- CD: $40,000.00
Past Secretary/Treasurer
Don Yousey also presented the proposed budget for 2003 that had
been provided to members via e-mail prior to the meeting. The
motion was made and seconded to approve the 2003 budget as presented.
The motion passed unanimously.
State Health
Director's Report--Dr. Leah Devlin
Leah thanked
all members for their support, work and accomplishments during
2002. She asked that agencies be aware of the recent release of
the “Minorities Health Disparities Report Card.” Another
current issue is the importance being placed on Access II/III
as means of providing responsive, yet cost-effective, healthcare
to the Medicaid population. Leah also addressed some concerns
associated with the “Bioterrorism Workforce Needs Assessment”
being conducted by UNC-CH. The Division has a financial interest
in the assessment because it meets a federal grant deliverable
of assessing the training needs of the public health workforce
in relation to bioterrorism preparedness. Participation in the
survey is not a requirement for receiving bioterrorism funding
through the Division. Further discussion regarding the survey
would take place with Penny Whiteside later in the meeting. Leah
provided the group with an update on the smallpox vaccinations
for public health. Upon leaving this meeting, she would join several
others from the Division, PHRST staff, and the public health response
team from Wake County for the media event to screen and vaccinate
the first public health professionals receiving the smallpox vaccination
for NC. In closing Leah shared her decision to have the Health
Promotion funding allocations for FY03-04 remain consistent with
those of FY02-03. This decision is in contrast to a vote of the
association in December 2002 to allocate Health Promotion funding
equally among all counties. Any change in the allocation formula
will cause significant changes at the local level. Changes to
improve accountability and deliverables must be brought about
in the program. Leah encouraged all members to work with the Health
Promotion Committee and the Division throughout the coming months,
as those changes, and the associated funding, were resolved.
Local Health
Services--Dennis Harrington
Dennis reviewed
the expansion budget for the next biennium. (See attachment) As
the issue of cuts has arisen, protection of local public health
has been the priority. For the next biennium, a cut of 8.4% of
total funds has been discussed. With regard to Medicaid cost settlement,
he advised health directors to anticipate receiving a settlement
amount similar to that of last year. Items of note remaining on
Dennis’ “Critical Needs List”: $14,000 pending
from last June and PHTIN line charges.
Special Report:Update
on Task Force on Standards and Efficiencies--Tim Green
Tim shared
a review and update of the work to-date by the Task Force. He
commented on the good participation and dialogue of the process.
Tim acknowledged Dr. Leah Devlin’s strong support for the
work of the Task Force. Today, Health Directors have an increasing
visibility and accountability. There is a growing demand for systems
innovations and increased outcomes. A weakening economy, and an
increased focus at the local and national level on environmental
and health conditions, has the potential to increase the scrutiny
under which local public health operates. The Accreditation Committee
has one set of standards to be shared and discussed regionally.
The Missouri model is not a panacea, but it is a starting point.
It is based on support and rewards, not penalties. President Jim
Baluss asked all Regional Representatives to e-mail Rosemary Summers
with a list of meeting dates and encouraged the discussion of
the work at the regional meetings. The minutes will be provided
to regional representatives for distribution in that region. (See
attachment).
Past-President
Business--Wayne Raynor
Past President
Wayne Raynor discussed the importance of returning the focus of
the January conference to a joint vision of the State Health Director
and local Health Directors. The financial support of the association
is appreciated in achieving this goal. Wayne introduced the following
motion. Motion: The association will provide $1,000 in
support of the 2002 Annual State and Local Health Directors Meeting.
The motion was seconded and supported unanimously.
HIPAA--Francis
Taylor
Francis Taylor,
HIPAA Consultant, reminded the group of the looming date of April
14, 2003, at which point compliance should be achieved with the
privacy standard of HIPAA. She reminded the group that she is
home based and can be reached through the hotline (919.715.3358)
or her home office (704.784.2758). To date she has provided 20+
policy templates which can revised per agency need. She feels
most agencies at a similar level of readiness for the privacy
standard. She encouraged anyone that needed extra help to contact
her office. The HSIS privacy related training will occur in March.
Information for the training will arrive in electronic and hard
copy format. Please be certain it reaches the appropriate staff.
The security regulations should be in the Federal Register in
2-3 weeks. Compliance will be due in 2 years. Security is expected
to focus on technology. Don Yousey expressed his thanks to Francis
for her work on this difficult subject area.
Committee Reports
(action items)
Environmental
-- David Rust
The public
comment period for grade card changes has closed. The letter
and number will be the same color. The wording of the regulation
is still a work-in-progress. On matters of technology, IBEAM
is a web-based system for environmental health data. Child daycare
will be the first component tested with the system. Another
proprietary system is also under review in the State (Garrison).
There was extensive discussion about the need to identify software
to serve Environmental Health. The need to communicate early
and often in the process was also discussed.
Motion:
The software products under review in the state to serve Environmental
Health will be reviewed with the Technology Committee to better
determine their potential and communicate these findings to
the association. The motion was seconded and approved unanimously.
Policy
and Planning Committee -- Mimi Cooper
Motion:
To oppose any legislation that would establish a mechanism for
LHDs to accept soil and site evaluations prepared by a licensed
soil scientist that would serve as the basis for a wastewater
permit.
The motion was supported unanimously.
Mimi Cooper
explained two legislative goal lists to the group. For legislative
goals identified as “Seek” public health will be
leading the push with the legislature. For legislative goals
identified as “Support” public health will be a
voice of advocacy, but not the lead voice in brining the issue
before the legislature. Extensive debate on the inclusion of
several other legislative goals ensued. Of concern was the reunification
of Environmental Health with the Division of Public Health and
health disparities with the funding to address those disparities.
Legislative
Goals to Seek:
- funding
for local public health infrastructure;
- legislation
authorizing counties to set EH fees (restaurant inspection)(NCACC*);
- funding
for uncompensated care;
- funding
for interpreters/bilingual staff;
- funding
for FP, APPP, Healthy Carolinians. (*A goal shared by NC Assoc.
of County Comm.)
Legislative
Goals to Support:
- tobacco
tax increase;
- legislation
to clarify BOH rule-making authority (NCALBH*);
- restoring
Medicaid eligibility for pregnant teens;
- legislation
to implement the National Beaches Environmental Assessment
and Coastal Health Act (DEH*);
- legislation
that mandates PE as part of the curriculum for k-8 (AHA);
- legislation
to increase school health nurse ratio to 1:750 with State
funding;
- AIDS
drugs assistance program (DPH);
- legislation
that addresses health disparities;
- re-organization
of programs in DEH into DHHS (*Goals shared by other groups.)
Motion:
To accept the legislative goals as presented.
1st
Amendment to Motion: Re-organization of programs in DEH into
DHHS should be made a “Seek” goal.
The first amendment was seconded and approved unanimously
2nd
Amendment to Motion: Legislation that addresses health disparities
would include funding and should be made a “Seek”
goal.
The
second amendment was seconded and approved unanimously.
The
initial motion, as twice amended, was seconded and approved
unanimously.
Technology
-- Jerry Parks
Jerry Parks
and Dennis Harrington provided an overview of the management
information system proposed in the goodness of fit study report.
It is time to go forth and replace HSIS! The input of local
health directors is critical. The new system can’t be
designed for us, without us. Secretary Hooker Odom and Jim Bernstein
realize the current system must be replaced, however we must
back Dr. Leah Devlin as she continues to remind them of this
critical matter. The product at hand is a great financial bargain.
Many key points are aligned that will support this venture.
Dennis stressed the importance of making the most of this opportunity.
Concern was expressed from several members over the availability
of State funds and the contractual agreement. Dennis assured
the association that a State funds commitment would be assured
prior to the use of escrowed funds.
Motion:
The NCALHDs commits its strong and unqualified support of the
Division of Public Health to move forward to purchase the information
system detailed in the Goodness of Fit final report including
the commitment of our escrowed funds (up to approximately $2.8
million) as matching funds for the contract to purchase the
approximately $12.5 million dollar system with the understanding
that DPH will seek out and obtain the balance of funding needed
to complete the system. Use of escrowed funds is contingent
on NCALHD's review of contract deliverables.
The
motion was approved unanimously. (See attachment)
Committee Reports
(information items)
Epidemiology
-- John Morrow
See attachment.
Women and
Children's Health -- Wanda Sandele
WIC computers
have been ordered and should arrive in 2-3 weeks for local delivery.
The Infant/Toddler issue with DEC is still emerging. Bob Wood
and Duncan Munn will be leading a breakout session on the topic
during the conference.
Policy
and Planning -- Mimi Cooper
See attachment.
Environmental
Health-- David Rust
David provided
information on a motion that would be forthcoming from Policy
and Planning. The matter of privatization of on-site has emerged
again and is being addressed through a committee. Representatives
for on-site from the public health perspective are included
in the committee, which also has members from the private sector
and professional soil scientist community. The perspective of
the soil scientist community appears mixed. Don Yousey expressed
his concern that the matter would not fall to the wayside. It’s
driven by the demand for on-site permits on a quicker turn-around
time. Of critical concern is the issue of liability. Who assumes
the liability for a permit drafted by a private entity and issued
by a public entity? This is a key concern for public health
in this discussion.
Executive Director
-- Deborah Rowe
Deb Rowe
reviewed the purpose of the message board included in the NCALHD
website. All communication from Deb on sensitive items, such
as legislative business, will post exclusively to the message
board. She plans to send a prompting e-mail when such material
is posted. Routine and public correspondence will continue to
be posted via the LHD list-serve. Deb reminded everyone of the
public nature of e-mail and the 300+ recipient list associated
with the LHD list-serve. She also spoke briefly to the role
of a $0.75 sales tax on cigarettes. Taxation in that amount
would generate a projected $550M. These are funds that could
easily address the Medicaid match issue and free other dollars
at the local level.
Liaison Reports
UNC-SPH
-- Penny Whiteside
Penny discussed
the role of the on-line survey to assess local public health
staff training needs as related to bioterrorism. Although the
survey is somewhat time consuming, Penny encouraged participation,
as a means of better documenting the training needs at the local
level. He remains, as always, open to any dialogue about the
process.
Office
Public Heath Nursing -- Joy Reed
See attached
report.
NCALBOH
-- Barbara Ann Hughes
Barbara
thanked everyone for their support and invited them to the NCALBOH
reception that evening. An open board meeting NCALBOH will be
held at 6:30pm. Steve Slot is the incoming president for NCALBOH.
Regional Reports
Region
IV -- Ray Rabe
Ray shared
the concern from the region regarding the Task Force process
and the communication regarding its progress and recommendations.
The earlier statement by President Jim Baluss that the minutes
would be sent to regional representatives and then forwarded
within the region was seen as addressing the concern from Region
IV.
Adjournment
With no further
business, the motion to adjourn was made, seconded and unanimously
approved at 4:30 pm.
Respectfully
Submitted,
J. Elaine
Russell, MPH
Secretary-Treasurer
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