Minutes

North Carolina Association of Local Health Directors
Full Association Meeting

August 14 , 2003

Khoury Convention Center
Greensboro, NC

Call to Order

President Jim Baluss welcomed the members of the association and guests to the August 14th meeting at 1:00 pm. A quorum was identified; therefore the meeting proceeded as a full association meeting. (See attachment for attendance roster)

Fellowship

Louis Latour provided the fellowship.

Approval of the Minutes

The minutes of the July meeting were posted on the web site, ncalhd.org, and approved as posted.

Treasurer's Report

Secretary Elaine Russell presented the Treasurer’s report with balances as of July 28, 2003. Account balances were as follows:

• Checking: $27,564.64
• Savings: $36.51
• Money Market: $364.26
• CD: $40,000.00

President's Report--Jim Baluss

Jim acknowledged Colleen Bridger who in turn thanked everyone for their assistance in the recent outbreak in Gaston County. Next Jim updated the group on the interview plan for Linda Sewall’s replacement. He and Steve Cline will be part of the interview team making recommendations to Secretary Ross. With regard to Smart Start, Ms. Karen Ponder has been formally invited to attend a meeting. We are awaiting her response. In conclusion, Jim thanked Leah for her diligence in keeping the Association involved the groundwork being conducted for S672.

Executive Director--Deb Rowe

Deb provided the group with an overview of pending issues with the Legislature. She had productive meeting with Representative Luebke to review the dynamics associated with the cigarette tax. The House is expected to return for a special session to address restricting. The Senate is expected to return in September to debate the economic boost issue and medical malpractice. The House will not convene at this time, so no action is expected on the part of the Senate. At this time a $300-$800M deficit is anticipated for July 2004. Increases in sales tax and income tax are not viewed as options at this time. The concept of user fees and an increased cigarette tax have some level of support. Three points must be emphasized in relation to the cigarette tax: 1) the health concerns, 2) health care reimbursements, 3) the necessity of additional revenue. Unfortunately, education and health/human services will be more vulnerable to cuts due to the size of their budgets. An additional legislative point is the upcoming “House Freshman Tour,” when many of the freshman Democrats will be touring the State via chartered bus to hear from local constituents. This emerging voting block needs to hear from local public health. Deb also reminded everyone of the upcoming September Legal Conference following the Health Director’s monthly meeting.

State Health Director's Report--Dr. Leah Devlin

Leah opened her remarks with a brief overview of the National Health Director’s Orientation she recently attended at Harvard University. The Co-Speakers of the House will be appointing a Taskforce on Animal Sheltering Issues. Public Health is working on the issue of representation on that taskforce. Leah also addressed the issue of patient identification information in press releases. The recent stance of providing minimal information related to the patient with a focus on preventive measures will be the position of the Division regardless of disease. The intent is to protect the patient and the investigation dynamic of public health. The decision is rooted in NC Communicable Disease Law and is more conservative than HIPAA, which would allow the release of county and zip code for a patient. Further discussion of the issue will be directed to the Epidemiology Committee (See Attachment). Leah also discussed the grant related to the violent death registry. The registry will be an epidemiological database, which draws on vital records and records from the District Attorney offices. This is a 3-year project under the direction of Brenda Motsinger. As a follow-up to inquiries on the Family Planning Waiver, Leah announced that approval is hopeful in early 2004. In conclusion, she discussed the Public Health Task Force 2004. The Charge is: To improve the quality and accountability of the state and local public health system; and to improve public health outcomes and reduce health disparities. The Task Force will be comprised of numerous individuals to include: DHHS Secretary, DHHS Assistant Secretary, State Health Director, NCALHD Executive Committee (officers/regional representatives), several legislators, and numerous other stakeholders. The Task Force will meet 4 times: September 29th, November 19th, February 25th, and April 20th. There will also be 6 subcommittees with the following chairs/co-chairs: Accreditation/Joy Reed; Accountability/Kevin Ryan; Workforce Development/Rick Mumford; Planning and Outcomes/Steve Cline, Structure/Organization/Dennis Harrington; and Financing/Chris Hoke. The subcommittee process is open to all Health Directors. Christopher Cooke will be assisting Leah and the Management Team with their efforts.

Local Technical Support--Dennis Harrington

Dennis reported that 3 health departments had not signed for the retro billing with PCG. Every effort has been made not to interrupt billing. Only claims of 12 months plus 1 day through 24 months will be reassigned and retro-billed. Per Medicaid guidelines, only the provider can reassign the claim. Dennis hopes for a routine process to pull newly lapsed funds on a quarterly basis. The funds can be cost-settled. The needs of local public health are the focus for the State in pursing this entire course of action. In closing Dennis noted that EDS technical problems delayed the June Medicaid check-write. The June and July check-write was anticipated within that week.

Committee Reports (action items)

Health Director of the Year Award

The Health Director of the Year for 2003 was presented to Rosemary Summers, Health Director, Orange County. Throughout her tenure she has introduced and refined numerous programs and policies related to core public health functions and unaddressed indigent health needs. Her work within the Association has been tireless on the Health Promotion Committee and the recent Taskforce for Standards/Efficiencies, Accreditation and Best Practices. She is a consistent model and good-will ambassador for local public health. In accepting the award, Rosemary gave her sincere thanks to her fellow health directors, Orange County staff and her family for their support and faith in her work.

Committee Reports (information items)

State and Local -- Don Yousey

Don Yousey noted that after seven months, he finally had something to report. He said that Jim Baluss had asked him to work with the DSS Director’s Personnel Committee as it reviews the proposed changes to the Sate Personnel Act. He had met with the committee the previous day along with Mr. Patrick McCoy of the State Personnel Office. Don prefaced his comments stating he had no instructions or feedback from the association on what his position should be, but as usual, that did not deter him from offering some inputs. First, he told those present at the committee meeting that the Health Director’s Association (NCALHD) desired to pass a resolution in support of the proposed changes by working out any differences at eh committee level instead of having to go to the Legislature after the fact and fight for anything in which we were in disagreement. Secondly, Don stressed to the committee that the NCALHD wanted the proposed changes to offer at leas the protections that the current Personnel Act provides. He said that Mr. McCoy had stressed that the head of State Personnel, Tom Wright, planned to include both DSS and PH Directors in the proposed bill and also planned on keeping the protections at their current level. McCoy said that felt Mr. Wright would also want to work out any difficulties within the committee so we didn’t all look bad fighting in the Legislature after the fact. Lastly, Don asked that all the health directors review the proposed changes and provide him with inputs to take back to the committee for inclusion in the revision.

Environmental Health -- Terry Pierce for David Rust

Terry reported that centralized training has experienced a low attendance. The CIT committee is considering have CIT twice per year instead of 3 times in 2004. A resource, mainly time of instructors, is the issue when only a few interns are in class. This creates the problem of a longer turn-around for EHS interns to become authorized. Please give the committee feedback to be shared with Mike Kelly for the next CIT committee meeting. With regard to personnel, the new Section Chief (Michael Rhodes’ old position) should be announced very soon. The interviews of the new Director (Linda Sewall’s old position) will start in late August. In conclusion Terry provided an update on the WNV, testing and media. Testing of dead birds for WNV ay be discontinued shortly due to the prevalence of WNV throughout the state. However, the State would like to have reports of dead birds for background data. The role of mosquito control and minimizing personal risk through protective measures must be stressed to the public. It appears to be a high-volume year for mosquito borne diseases.

Health Promotion/School Health Matrix Team

Rick Mumford reported that the oral health survey would be mailed very soon this fall. The School Health Matrix Team had a good meeting in June with a focus on outstanding work in tobacco prevention, physical activity/nutrition, and school health advisory committees. The dental hygienist program plan will be reviewed with each county health director. This is a return to a previous policy.

Regional Motions

Ray Rabe, Region IV introduced the following motion: A NCALHD quorum shall be constituted when 30% of the dues paying members are present. A discussion of the current by-laws was held. Any change to the by-laws requires a 60-day prior presentation to the President before an actual vote can be taken on the change. A substitute motion was introduced: The motion presented by Region IV will be referred to the Nominations/By-Law Committee. The substitute motion was approved by a vote of 21 yes, 7 no.

Adjournment

In closing, Jim acknowledged Jim Blackburn for his attendance at our meeting. With no further business, the motion to adjourn was made, seconded, and approved unanimously at 4:00 pm.

Respectfully Submitted,

J. Elaine Russell, MPH
Secretary-Treasurer