Hertford County Public Health Authority

Board of Health Meeting

May 26, 2015

Members Present Members absent Staff/Visitors

Rebecca Greene Howard Hunter III Ramona Bowser

Dr. Terry Hall Katina Eley Mitchell McLean

Charles Reynolds Susan Mitchell R ita Boone Dr. Jamie Udwadia Colette Smith Westelle Cherry

Rhonda Harrington

Call To Order- Mrs. Westelle Cherry, called the meeting to order at 6:35 PM. She welcomed Board members, staff, and visitors to the meeting.

Invocation-The invocation was given by Mrs. Westelle Cherry.

Roll Call-Mrs. Rita Boone, called the roll. A quorum was established.

6:40 Dr. Hall came into the meeting and assumed Chair responsibility.

Conflict of Interest– The Board of Health reviewed the agenda and no conflicts were identified.

Approve Agenda- Mrs. Westelle Cherry made a motion to approve the agenda. The motion was seconded by Mr. Charles Reynolds and approved by the Board.

Approve Minutes- Mr. Charles Reynolds made a motion to approve the April 27, 2015 Board of Health Meeting minutes. The motion was seconded by Mrs. Westelle Cherry and approved by the Board.

Board Absences- Mr. Charles Reynolds made a motion to approve the absences of Ms. Susan Mitchell, Mr. Howard Hunter III and Ms. Katina Eley. The motion was second by Dr. Jamie Udwadia.

Recognition of New Employees – None

Public Comment- None

Agency Update- Mrs. Ramona Bowser updated the board on the following: QA Indicator Report Review- Mrs. Ramona Bowser asked if there were any questions. Prevent the spread of communicable diseases by monitoring disease and syndromic reporting to detect trends and implement control measures - o An MOU with the Hertford County Sherriff’s office will be put in place to address the responsibilities of Animal Control in relation the control and prevention of Rabies. This is a State requirement for those counties in which Animal Control is not a part of the Health Department. Hopefully it will also address some issues we have had along these lines recently as well. State Update: Communicable Disease

Assure access to mandated and essential public health services that includes expansion of services- All Agreement Addenda have been returned to the State for the 2015/2016 FY. Efforts continue to secure clinical coverage with a FNP. Dr. Khoury has agreed to provide supervision for Anne Laskin assuming she takes the position. If so she will cover the clinical services as well as HIV clinics. A proposal will be submitted to RCH Foundation for support of our car seat program. Specifically we will ask for money to purchase car seats. The proposal to RCH Community Benefits was funded for BCCCP services at $20,000. Maintain fiscal management of agency, including Home Health- HH revenues for April 2015 = $100,181.80. Shamieka continues to bill and follow-up on claims. Emily and Deneen will focus on completing the necessary documentation so that Home Health billing can be submitted. No money has been lost during the time in which Emily and Deneen were providing patient care. We’re still working with Blue Cross Blue Shield HMO (which is a Medicare replacement policy) to become a participating provider. Currently no agency/companies in this area are participating providers with BCBS HMO. We are still accepting BCBS HMO patients on a contract by contract basis. We continue to focus on methods to increase all billable services including increasing our patient census. We’re talking with Signature Health Care (formerly Creekside) discharge planner Amanda regarding the services we provide to see how we may strengthen our partnership which will increase our patient census. Our patient census is currently at 283. Agency continues to operate with a substantial deficit. We are still awaiting word on the issuance of the FY 15 Medical Cost settlement funds, which are relied upon heavily to sustain clinical programs. Combined these programs account for $172,082 of the $286,182 deficit. Home health has been directed to send all outstanding patient debts eligible to the NC Debt Set-off program for collection. We have had some success in recovering delinquent clinical accounts using the program. The FY 16 budget will be discussed during the May board meeting. The budget request will include a requested increase in county appropriation (which seems promising); the request will also include an increase in health insurance costs. Due to change in carriers will anticipate a 6% increase in premiums versus the 33% that was proposed had we stayed with our current plan. The one drawback in going with the new carrier is the loss of retirement coverage for our 6 retirees currently covered under the agency group plan. Individual policies will have to be obtained for these employees with the agency either covering the premium entirely or offering a subsidy. There is one proposed RIF that affects clinical services. This position had been recommended for RIF in FY 15 but due to using fund balance we were are to continue for another fiscal year, however circumstances do not allow for this to continue. Advocate to implement policy and environmental changes related to physical activity, nutrition and tobacco and collaborate on related programs in the county: Continue to work with the CHANGE project…The group is in the process of defining the role of the Community Health Worker. A meeting is scheduled for May at the Winton Health Dept. to discuss the role, work plan, etc. for the community health worker. Plans are to hire someone in Aug. Sub-group is working on completing the Resource Directory. The tobacco free living (PICH Program) meeting was rescheduled to May 8th in Edenton.

Crystal attended the monthly Healthy Communities Conference Call. The call included presentations made regarding Diabetes programs, Fall Prevention for Seniors, standing orders for naloxone. Address adolescent risk behaviors- Crystal attended the Project Lazarus breakfast meeting and during the strategic planning process discussion centered around providing resources in the school so that Health Teacher can include Rx abuse as one of the lessons. The next meeting is scheduled for May 18th. Increase access to child birth, parenting, and breast feeding classes- Jessica and Ann Marie have attended workshops and continue to receive guidance in the provision of breast feeding classes and emphasis through WIC. There have been no new developments in regards to a collaborative effort with RCH. Needs are currently being met as is. Sharon has reached out to hospital regarding child birth and parenting. There are currently no plans to expand those services. Appears needs are being met there as well. Betty Corum, RN has been trained in Phase One of Triple P which serves as a resource for parenting concerns with very young children up to age 5. Triple P is an excellent program but there has not been a lot of interest on the part of other sister agencies to get involved. DSS, CADA, and Hertford County Schools were all invited to participate initially. They certainly see a lot more children than we do and would have more opportunity to utilize the resources. Develop and market Medical Nutrition Therapy - Jessica is currently taking referrals for this service and has marketed the services to local practices. Maintain the process for managing revisions of admin. policies and procedures: Continue to review policies monthly with management team. Integrate community health strategic planning and priorities and budgeting process through existing program budgets when possible - getting through the budgeting process will be extremely difficult in FY 16 as funding streams continue to dwindle. As a result of strategic planning and as identified in our SOTCH and annual report the agency will continue to focus on the leading causes of mortality for our county. Subsequently the agency will pursue funding for expanded breast cervical cancer screening as well as car seat funding to augment our infant mortality efforts. The agency’s focus will continue to be to streamline its dependence on fund balance and will further make the necessary changes to have program operating at optimal efficiency. Educate the staff and community about the responsibilities and services of Public Health - Crystal continues to publish weekly ads in the news herald regarding the services and responsibilities of public health. Support and grow community collaborations/partnerships: Continue to work with the CHANGE project (UNC). Continue to meet with HHMA on monthly bases. We are not a part of the PICH project regarding tobacco prevention. Accreditation- The agency was recommended for re-accreditation. Ramona and Crystal received official re-accreditation status in May 2015. The Agency is accredited for another 4 years.

Potential Grant Opportunities – Ramona Bowser reviewed with the board the grant application to be submitted to Roanoke Chowan Foundation to provide car seats to needy families. This is but one step towards addressing infant mortality and safety in the county. Grant request is for $2,400.00 for 1 year.

BOH Executive Committee Report- Dr. Terry Hall stated no report.

BOH Finance Committee Report- Mrs. Westelle Cherry stated that the finance committee did not meet. Mrs. Ramona Bowser presented the financial reports.

PHA Balance Sheet- April 2015 – Mrs. Ramona Bowser reported that cash in deposit for assets was $479,938.74. Accounts receivable-general was $25,160.44 and accounts receivable for Home Health was $59,817.13. Total assets were $616,695.46. Total liabilities were $83,865.42 and total fund balance was $532,830.04.

Financial Summary Report- April 2015 – Mrs. Ramona Bowser reported the year to date revenues were 66.58% of the budget and year to date expenses were 72.62% of the budget. Accounts Receivable with allowance for bad debts totaled $282,171. Home Health had a deficit of $12,528 for April 2015, and without transfers had a deficit of $12,528. Year to Date Home Health has a deficit of $92,993 and without transfers a profit of $15,431. Home Health cash balance is negative $288,015 for April.

Budget Amendment #9

FY 2015 Budget Analysis

Mrs. Ramona Bowser also presented and reviewed the Budget Ordinance for the Annual Budget FY 2016, The Budget Summary by Major Areas of Revenue and Expense FY 2016, FY 2016 Budget Comparison by Area of Service and FY 2016 Budget Revenues by Major Sources.

Mrs. Ramona Bowser presented the Health insurance renewal, rates increased 33% ~ $19,933.00 per year. The agency has also changed to Blue Cross Blue Shield Direct. Also General Property Liability Insurance came in approx. 0.184% decrease and Workers’ Comp Insurance came in approx. 0.1% decrease.

Mrs. Westelle Cherry made a motion to approve the Finance Committee Reports, Employee Health Insurance Renewal, General Property Liability Insurance Agreement and the Workers Compensation Agreement. The motion was seconded by Mr. Charles Reynolds and approved by Board.

BOH Personnel Committee Report- Dr. Terry Hall stated no report.

Reduction in Force – The position of a full-time Billing Clerk currently working in the Personal Health Services Division will be abolished effective June 30, 2015 due to unavailability of or insufficient funding to continue the services for the 2015-2016 budget year.

Mrs. Westelle Cherry made a motion to approve the Reduction in Force. The motion was second by Ms. Rhonda Harrington and approved by the board.

BOH Policy and Program Committee Report- Mr. Charles Reynolds stated no report.

Old Business- None

New Business- None

BOH Re-appointments: Dr. Terry Hall- is willing to be re-appointed. Ms. Susan Mitchell – resigned effective June 26, 2015. Ms. Katina Eley –will follow up on her re-appointment wishes.

Next meetings-

Executive, Wednesday, June 10, 2:30 pm, Ahoskie

Personnel, Thursday, June 11, 2:00 pm, Ahoskie

Policy, Thursday, June 4, 2:30 pm, Ahoskie

Finance, Monday, June 22, 6:00 pm, Winton

Full BOH Mtg., Monday, June 22, 6:30 pm, Winton

Adjourn- Mr. Charles Reynolds made a motion to adjourn the meeting at 7:37pm. The motion was seconded by Mrs. Westelle Cherry and approved by the Board.