Wake County Human Services Board

Wake County Human Services

And Environmental Services Board

Minutes

April 26, 2012

Members Present:
Dr. Dianne Dunning, Chair
Mr. Frank Eagles
Dr. Sharon Foster
Ms. Leila Goodwin
Mr. Rich Greb
Dr. Burton Horwitz
Ms. Melissa Jemison
Dr. Paul Norman
Mr. Benny Ridout
Mr. Jeffrey Smith
Mr. Julian Smith
Ms. Stephanie Treadway
Commissioner James West
Members Absent:
Dr. Kent Earnhardt
Mr. Pablo Escobar, Vice Chair
Dr. Osama Said / Executive Staff:
Mr. Scott Warren, County Attorney
Ms. Denise Foreman, Assistant to County Manager
Mr. Ramon Rojano, Human Services Director
Mr. Joseph Threadcraft, Environmental Services Director
Ms. Ida Dawson, Division Director of Health Clinics
Mr. Paul Gross, HS Finance Officer
Ms. Jonica Hinton, Executive Assistant
Dr. Peter Morris, Medical Director
Ms. Regina Petteway, Office of Community Affairs
Mr. Andre Pierce, Environmental Health & Safety Director
Presenters:
Mr. Brian Gunter, Consumer Affairs
Ms. Annemarie Maiorano, Manager, Housing Division
Ms. Katherine Williams, Human Capital Development
Staff Absent:
Ms. Sue Lynn Ledford, Public Health Administrator
Mr. Bob Sorrels, Human Services Deputy Director / Guests:
Dr. George Corvin, MCO Board
Quorum Present: yes
Agenda Item / Discussion, Conclusions, Recommendations / Action, Follow-up / Responsible Party / Due Date /
I. Call to Order / Chair Dr. Dianne Dunning called the meeting to order @ 7:35 a.m. and recognized Dr. Burton Horwitz to give remembrance of Dr. John B. Sowter. / N/A
II. In Remembrance / Dr. Burton Horwitz and other Board members spoke in remembrance of Dr. John B. Sowter of his friendship, leadership and accomplishments.
Dr. John B. Sowter passed on April 10, 2012, after a brief illness. Dr. Sowter was a long-time member of the faculty at the UNC School of Dentistry and a practitioner in Raleigh. He won the “Teacher of the Year” award for almost 20 straight years. He was a leader on the State Board of Dental Examiners and the N.C. Dental Society. Dr. Sowter was the chair of the Wake County Public Health Board before the agency consolidation in 1996. He was a “Founding Member” of the HS&ES Board, serving eight years in the Dentist Category from 1996 – 2004. He served his first four years as Board Vice Chair and was instrumental along with the Board Chair in leading the Board through the consolidation and transition. He also served as Board Chair from 2003-04. Dr. Sowter remained active on the Environmental Services Committee and the Human Rights/Consumer Affairs Committee until recently. / N/A
III. Approval of Minutes / Mr. Frank Eagles motioned, seconded by Mr. Rich Greb, to approve the March 22, 2012, Board meeting minutes. Motion passed unanimously. Dr. Horwitz clarified his comments from last month that the Medicaid Adult Dental Services at the state level has not being completely cut, but has been severely reduced. / N/A
IV. Confirmation of Next Board Meeting / The next Board meeting is scheduled for May 24, 2012, 220 Swinburne Street, 2nd Fl., Rm. 2132, 7:30 a.m. – 10 a.m. / N/A
V. Introduction of Environmental Services Director / The Board welcomed Mr. Joseph Threadcraft. Mr. Threadcraft joined Wake County as the new Director of Environmental Services on March 26, 2012. Mr. Threadcraft introduced himself. He said he foresees the need to build strategic relationships, be focused, and incorporate the expertise of qualified citizens and agencies. The Board engaged in individual introductions at the end of the meeting. / N/A
REGULAR AGENDA
VI. Public Health Quarterly Report (#2.4)
Public Health Committee:
Mr. Benny Ridout, Chair
Dr. Peter Morris, Medical Director / Mr. Benny Ridout, Chair, Public Health Committee, gave an overview of the Wake County Human Services Public Health Report (4th Quarter, October – December 2011). The Board reviewed and discussed the report. The Board commented on decreases and increases in public health activities and data. The Board discussed the distance required for smokers to be from the front door of buildings. Dr. Peter Morris, Medical Director/Compliance Officer, answered that the requirement for smokers is 50 feet from the building. However, if a public sidewalk is closer, it cannot be enforced. Dr. Foster noted that Ms. Ledford, Health Administrator, has put into place a new initiative to identify and treat Sexually Transmitted Diseases in the schools through the school health nurses. Mr. Julian Smith asked if the reporting mechanism for STDs raises issues for HIPAA. Mr. Greb asked what the health departments’ role is in monitoring childhood immunizations and suggested that the health department take a lead advocacy role to encourage proper immunization. Dr. Peter Morris answered Board members’ questions about the powers and responsibilities of public health departments versus HIPAA laws and questions about child immunization rates. The state currently has a statewide campaign on childhood immunization. Mr. Rojano answered that if the community is at risk, the public health director is empowered to protect public health safety. Mr. Rojano offered to email a compilation of the key Public Health General Statutes explaining powers and responsibilities to the Board. County Attorney Scott Warren offered to explain the powers of the local public health boards if requested.
Mr. Benny Ridout motioned, seconded by Dr. Burton Horwitz, to receive and accept the Wake County Human Services Public Health Report (4th Quarter, October – December 2011). Motion passed unanimously. / Received and accepted the Wake County Human Services Public Health Report 4th Quarter.
Accreditation #2.4
VII. State of the County’s Health Report 2011 (#39.4a & 1.3)
Public Health Committee:
Mr. Benny Ridout, Chair
Dr. Peter Morris, Medical Director / Mr. Benny Ridout, Chair, Public Health Committee, gave an overview of the Wake County State of the County’s Health Report 2011. The Board reviewed and discussed the report.
Mr. Ridout noted the agency’s top two priority issues and activities being used to address them:
#1 Overweight and Obesity
#2 Access to Healthcare
The Board also reviewed and discussed the data on health indicators, significant public health issues, and emerging issues.
Mr. Benny Ridout motioned, seconded by Dr. Burton Horwitz, to receive and accept the Wake County State of the County’s Health Report 2011. Motion passed unanimously. / Received and accepted the Wake County State of the County’s Health Report 2011.
Accreditation #39.4a & 1.3
VIII. Board Letter in Support of Proposed Changes to 15A NCAC 18A .2650- 2676 (Food Protection and Sanitation of Food Establishment)
Environmental Services Committee:
Ms. Leila Goodwin, Chair
Mr. Andre Pierce, Environmental Health and Safety Director / Ms. Leila Goodwin, Chair, Environmental Services Committee, gave an overview of the Proposed Changes to 15A NCAC 18A .2650-2676 (Food Protection and Sanitation of Food Establishment) 2009 FDA Food Code and requested endorsement of the Board’s position. The Executive Committee discussed the issue and approved a Board Letter of Support at its April 12 meeting, giving Ms. Goodwin authorization to present oral comments and the Board letter at the April 12 Public Hearing at the Department of Public Health Office.
Adoption Schedule:
·  The rules comment period runs from March 15 – May 14. Several other public hearings and town hall meetings are scheduled.
·  Approval by the Commission for Public Health is scheduled for May 16.
·  If approved, it will go to the Rules Review Commission on June 21.
·  The proposed date for adoption is July 1, 2012, with an effective date of September 1, 2012 (or later if necessary).
Ms. Goodwin summarized the handouts:
·  Commission for Public Health summary of the proposed rule changes
·  April 12, 2012 Board Letter of Support
·  Schedule for Adoption of Regulations
·  May 2010 Board Letter of Support and Fact Sheet
The current North Carolina rules do not adequately address:
·  bare hand contact of ready-to-eat foods
·  employee health policy
·  consumer advisory for undercooked foods
·  date marking
·  cold holding at 41° F
·  specialized food processes
·  variances
The N.C. Restaurant Association endorses the rule changes.
(Cont.) / Endorsed Board Support of the Proposed Changes to 15A NCAC 18A .2650-2676 (Food Protection and Sanitation of Food Establishment) – 2009 FDA Food Code.
Send Contact List for Commission of Public Health.
The Board noted that this does not affect commercial foods. Wake County Public Health only regulates prepared food at retail food establishments. / Ms. Leila Goodwin
VIII. Board Letter in Support of Proposed Changes to 15A NCAC 18A .2650- 2676 (Food Protection and Sanitation of Food Establishment) (Cont.)
Environmental Services Committee:
Ms. Leila Goodwin, Chair
Mr. Andre Pierce, Environmental Health and Safety Director / FDA Food Code (Cont.):
Dr. Dunning said several Wake Legislative Delegation members expressed concerns of the financial impact on consumers and the industry. She said there is some confusion.
Mr. Andre Pierce answered that the two concerns being expressed are costs for staff training and cold holding. He said online training and exams will be more accessible for food workers, and the N.C. industry will get three years to come into compliance with cold holding.
Mr. Rojano said a change in bacteria resistance and mutations have occurred in the last 20 years. It has been found that bacteria can still grow at cold holding of 45° F. One of the changes would reduce the cold holding to 41° F.
Dr. Sharon Foster, Chair of the Board’s Advocacy Workgroup, read aloud her email sent to a State Legislator supporting the rule changes. She encouraged all Board members to write to at least one legislator.
Ms. Goodwin noted that it is the Commission for Public Health that adopts the rules. She said support expressed to the Commission would be helpful. She agreed to circulate a contact list of Commission members to the Board.
Ms. Leila Goodwin motioned, seconded by Mr. Frank Eagles, to endorse Board Support on the Proposed State Rule Changes to 15A NCAC 18A .2650-2676 (Food Protection and Sanitation of Food Establishment – 2009 FDA Food Code). Motion passed unanimously.
IX. Recognition of Departed Board Member
Dr. Dianne Dunning, Board Chair / Dr. George Corvin was appointed to the MCO Board in March and submitted his resignation to the HS&ES Board after the March Board meeting due to a conflict of interest.
Ms. Stephanie Treadway made remarks about Dr. Corvin’s service and leadership as a Board member. He was a member of the LME Advisory Committee, the Board’s Advocacy Workgroup, and the County/Holly Hill Hospital Advisory Committee.
On behalf of the Board, Chair Dianne Dunning presented Dr. Corvin with a plaque commemorating his leadership and service on the Board from July 6, 2010 – March 22, 2012.
Dr. Corvin thanked the Board. He said the MCO Board is off to a good start and is involved with a lot of board training. He commended the passion and consumer focus of Ms. Ellen Holliman, the CEO of the new MCO entity.
X. Updates on Alliance Behavioral Healthcare (new MCO name) Transition/HS Board Structure/and Wake County Behavioral Health Services
Ms. Denise Foreman, Assistant to the County Manager / Ms. Denise Foreman gave the following updates:
·  Alliance Behavioral Healthcare is the new name for the MCO.
·  Actions by the Wake County Board of Commissioners on April 16, 2012:
o  Appointed Ms. Barbara Gardner as its 6th member to the Board. Ms. Gardner is a retired Assistant Hospital Director of Dorothea Dix Hospital.
o  Approved a joint resolution with Durham County to establish the multi-county area authority to manage MH/DD/SA services for Durham/Wake counties. The joint resolution allows the new area authority to become a legal entity with the powers to formalize their Board, obtain a tax ID number, approve a budget and other actions necessary to begin operations as a LME/MCO on July 1, 2012. The Durham County Board of Commissioners approved the joint resolution on April 23, 2012.
o  Accepted $2 million of revenues from the Wake County ABC Commission and appropriated the revenues to be applied to Wake County’s $4 million start-up funding commitment to the multi-county area authority. Approved the schedule of disbursement and repayment.
o  Authorized the county manager. . . to execute a Tripartite Funding Agreement with Durham County and the new area authority.
·  The MCO Board will appoint the remaining two designees from Cumberland County and Johnston County once they enter into the interlocal agreement on July 1.
·  Continuing to meet on a regular basis on the LME closeout. The LME Advisory Committee is also working closely with Dr. Carlyle Johnson. She commended staff. She also acknowledged Mr. Rojano for shifting resources to help cover the closeout efforts.
·  Update on LME staff placement: MCO – 40 staff. Human Services – 29 staff. Retirement and/or severance – 17 staff. Have three staff left to place.
(Cont.) / Received updates.
X. Updates on Alliance Behavioral Healthcare (new MCO name) Transition/HS Board Structure/and Wake County Behavioral Health Services (Cont.)
Ms. Denise Foreman, Assistant to the County Manager / Ms. Denise Foreman gave the following updates (Cont.):
·  Received preliminary determination from the state that Wake County Behavioral Health Services would be in violation of federal rules if we continue to provide Medicaid Billable Services. The county is still researching the effects and possible flexibility. The county will need to develop a workplan to transition out Medicaid Billable Services by January 1, 2013, and to determine how that impacts our other Behavioral Health Services because many services are integrated.
·  Received the UNC Study Final Report on Wake County Behavioral Health Services on April 23. She will be sharing the results with this Board and the Wake County Board of Commissioners. She believes the report will be helpful in moving to what the future of Wake County’s support of Behavioral Health Services looks like (dollars, consumers, services, partnerships) and how it relates to the MCO. The MCO is a huge part of figuring out the next steps, because the MCO will manage all of it.
·  County management met with Wake County Behavioral Health Services staff during April. County management believed it was important to be inclusive with staff at an early stage.
·  Mr. Greb said in the first stage of the process all the anxiety and confusion was with staff. He said now he is getting feedback about anxiety from providers because they have been asked to resubmit their applications. Ms. Foreman said all providers who have current contracts will continue to have a contract for the first year. Some contracts are expiring now and are up for renewal. These contracts will be rolled over into the MCO. All current contract providers will come in under new contracts as of July 1.