Minutes
North
Carolina Association of Local Health Directors
Full Association Meeting
April
22, 2004
Institute
of Government
Chapel Hill, NC
Call to Order
Meeting was
called to order at 1:30 PM
Queen Mimi
announced an addition to the meeting rules. All electronic devices
that ring or sing are to be disabled during the meeting or they
will immediately become the property of the crown.
Approval of the Minutes
Minutes of
the March meeting were approved.
Treasurer's Report
-- Deborah Rowe
Deborah reported that as of this date, 90% of members had paid
association dues, and the rest were in the process of paying.
Thank you all for prompt payment of dues! She has added a Quicken
format to the Treasurer’s report that shows line item expenditures
and gives a clearer view of where the budget stands. Next month
there will be another large check to NACCHO.
President's Report
-- Mimi Cooper
Jim Baluss
has resigned as Health Director of Edgecombe County to accept
a position with the Community Care Plan. He has also therefore
resigned his position in the Association as Past President. Mimi
nominated Tom Bridges to serve out Jim’s Term as Past President.
The appointment was approved by the Executive Committee.
Ann Thomas
will serve as liaison with nursing education. A volunteer is needed
to attend the flu task force in Raleigh since the Association’s
meeting will be on the same day in Asheville. If you are not going
to Ashville and are willing to attend the flu meeting in Raleigh,
please speak to Mimi.
Liaison Reports
Terry
Snowden
Terry urged everyone to let her know if they had any specific
needs in risk management training. The renewal for everyone’s
malpractice policy is being prepared. She had advised everyone
to budget for a 10% increase, but the actual increase is at
8%. Anyone who has not yet submitted the data needed for renewal
(visits, etc.) please get it in, or contact Terry if you need
a new for, Also, please let her know if you need to pay the
premium out of next year’s budget. This will be ok, but
let her know that that is your intention
Institute of
Government -- Jill Moore
Jill introduced
Katherine Pierce, a graduate student who did her capstone paper
on the topic Provision of Prenatal Care in North Carolina –
Coping With Uncompensated Costs. Katherine summarized her findings
for the group. About 27 health departments participated in her
study. A great increase in the amount of uncompensated care has
been experienced since the last time this data was examined. This
has been attributed to increased salaries, and an increase in
the number of immigrants in the state. The findings made it obvious
that additional funding is required and that the issue needs to
be on the public agenda. (see attached summary) Deb Rowe will
receive and distribute an electronic copy of the full paper.
Executive Director's
Report -- Deborah Rowe
May 11th
from 9:30 to noon is advocacy day for the NC alliance for a cigarette
tax increase. If you can not come, please send an email or call
you legislator and urge this increase to improve public health.
Child Health
award nominations are due May 28th, and Health Director of the
Year nominations are due May 31. NCPHA award announcements will
be made on June 1.
The task force
on the companion animal bill met today and their recommendations
are about to come forth. The bill covers: creation of an animal
protection program, a low cost spay neuter program, and for upgrading
of shelters. It requires government shelters to meet the same
standards as private shelters. There would be a tax on dry and
canned cat food. Ten percent of the money raised would be to administer
the program under the Department of Agriculture. The rest would
go to eligible counties for low cost spay neuter programs, then
animal companion programs, then for upgrading of shelters. Participation
by local counties is voluntary. Private shelters must be registered.
The requirement for participation in a differential license fee
was removed.
State Health
Director's Report -- Dr. Leah Devlin
The Institute
of Medicine is looking for participation from dentists who are
interested in policy issued. They are looking for someone to participate
in the IOM as well as being on the editorial board for the journal.
Let her know if you know of a dentist who might be interested.
The Commission for Health Services will meet in Buncombe County
on May 11th. Ray Cope is stepping down from his position with
Kate B. Reynolds.
There were
a few changes in the Public Health Task Force recommendations
made at their last meeting as a result of the town meetings and
web posted comments. They also worked with the Association of
County Commissioners. a result of the last meeting. This is now
considered an interim document and actionable in the short session.
The task force will reconvene in late summer or early fall to
finalize the report.
The revisions
stipulate that nothing should result in an unfunded mandate. The
funding for accreditation is now proposed to be ongoing, but still
withholds program funding after three years of a health department
not achieving accreditation. The division would have to either
help the agency achieve accreditation or find another entity to
provide the service to the citizens of the county.
Other revisions
included environmental health services in Accountability, expanded
references to web based methods in Work Force Development and
in Structure clarified that any consolidation of health department
would be voluntary. The reference to reunification of Public Health
and Environmental Health now makes no reference to which department
that should happen under, but retains the recommendation that
the State Health Director would report directly to the Secretary
of the Department. Planning and Outcomes added environmental health
funding at state and local levels. All of these changes were discussed
with the appropriate committees.
Local Support
-- Dennis Harrington
The Medicaid
cost settlement has not yet been approved by DMA, but no significant
changes are expected. There is work being done on breaking out
the amounts by program, but this is not yet available. Dennis
has continued to work on policies that might get interpreter service
funded in administrative funding. Dental rates should be coming
out. The Random Moment claim is at CMS, but there has been no
response yet. The amount billed per quarter is expected to be
about $350,000.
State Environmental
Health -- Terry Pierce
The Terry
asked for feedback on any innovative products – good or
bad. Bob Uebler is chairing that committee. There are no additional
education requirements for CIT or authorization. Sometimes regional
staff wants an environmental health specialist to take a course
if they are in a new county and have not worked in the area before.
This is an SOP course.
- The review
of the Primitive Camp rules made some changes, and the revision
will be going back to the Commission.
- They are
going back to work on the web based system for food service.
- Remember
that you can not be paid in July for what was expended in June
except out of current year’s funds. There is a letter
from Bart Campbell requesting expenditure reports by May 15th.
Committee Reports
(action items)
No
action items from any committee.
Committee Reports
(information items)
Environmental
Health -- David Rust
The new
score card – black and white, numeric and alphabetic grade
equal in size, goes into effect in August of 2004. The Committee
on Arsenic in Wells will meet on July 14th.
Reimbursement
and Finance -- Scott Harrelson
The committee
reviewed the analysis of CSC revenues by counties. Some counties
are not covering the cost of the program, only a few are doing
well with the new system. The goup is also looking at the CDSA
interpretations of who will do what relative to CSC and Early
Intervention Kevin Ryan sent out a memo clarifying some issues.
Apparently there continues to be some inconsistencies at the
local CDSAs
There was
also clarification regarding applying a sliding fee scale for
non-medicaid clients. This is required because of the cost settlement
system. See attachment (memo dated June 2, 2003) regarding use
of flat fees for sports and camp physicals.
Medicaid
audits of Health Departments were very positive. The charge
of the audit was to look at MCC, CSC and MOW billing. They found
the documentation was impeccable and did not anticipate doing
any more than two or three departments next year.
The committee
also discussed ways to make the green book better.
Epidemiology
-- John Morrow
A letter
was sent to Child Development regarding the fact the TB skin
testing is no longer necessary. Meth labs were discussed in
the committee. These are a growing problem and all are urged
to become acquainted with this issue. NC has done well at spending
Bioterrorism Aid to County Funds. The feds intend to remove
two months of funding, but we don’t know yet which fiscal
year this will impact. Local Health Departments will not lose
money.
Women and
Children's Health -- Jenny Lassiter
A change
in MOW billing is being looked at which would increase reimbursement
per unit from $11.00 to $15.50, but reduce the number of units
allowed from 9 to 7. The number of clients served by MOWs has
dropped by 1/3. It is hoped that this change would make the
service more viable to health departments.
Changes
in the new MCC system are being proposed based upon the pilot
counties.
School health
advisory councils are expected to submit a health plan by July
15th. Jenny asked how many health directors had been contacted
by their school system regarding this plan. About two thirds
of the health directors indicated they had been contacted
Carol Tant
will be sending out information on upgraded equipment for hearing
testing as part of the well child visit.
Health
Promotion/Oral Health -- Curtis Dickson
A dental
survey is to come out regarding contact information for successful
dental programs. Dental programs will be asked if they are interested
in a meeting or a conference call of all health departments
operating or interested in starting a dental program. The CDC
is working with the division on a survey on Diabetes. Funding
is being provided by the CDC. There were questions from the
committee about combining some surveys to reduce the total numbers
sent out. The committee discussed the health and wellness medication
program and wants to know if health directors can have input
into it. The next meeting is on May 10 at 4:00 PM.
Education
and Awards -- Colleen Bridger
Colleen
announced that Wayne Reynor will not be able to go to NACCHO,
so the committee will revisit the applications to re-award the
scholarship. If you are interested let them know. She also reminded
everyone to consider nominations for Health Director of the
Year.
Regional Reports
David
Stone - NCPHA will have two awards of up to 5000 each
from the Ann Wolfe trust fund. The criteria for the grants are
that they must go to a health department and be projects related
to Child Health and Infant Mortality. In the future, these awards
should be larger. This year the money has not had time to be invested
long enough for greater earnings.
Bill
Smith - The NC Alliance for Health is funded by Southern
Neighbors. The organization is looking for help for salary for
their Director. After some discussion, he made a motion that the
Association make a $2,000 donation for this purpose. Don Yousey
seconded the motion. Motion carried.
Liaison Reports
Alliance
(NCAPHA) -- Barry Bass
The last
meeting of the Alliance discussed fiscal issues. They are formulating
a budget in order to establish rates. Workman’s Comp is
going up 35%. They are also working on new contracts. Barry
reminded everyone of the advantage of using a staffing agency
as an alternative for contract employees, which may put you
at risk with IRS regulations.
Adjournment
With no further
business, the motion to adjourn was made, seconded and unanimously
approved at 2:30 PM.
|
