Hertford County Public Health Authority

Board of Health Meeting

September 6, 2017

Members Present Members absent Staff/Visitors

Howard Hunter III Ramona Bowser

Dr. Terry Hall Rita Boone

Charles Reynolds Shamieka Carey

Dr. Jamie Udwadia

Westelle Cherry

Susan Brinkley

Katina Eley-Hardy

Monte Thompson

John D. Horton

Call To Order- Mr. Howard Hunter III, called the meeting to order at 6:30 PM. He 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.

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- Mrs. Westelle Cherry made a motion to approve the August 28, 2017 Board of Health Meeting minutes. The motion was seconded by Dr. Terry Hall and approved by the Board.

Approve Closed Minutes- Dr. Jamie Udwadia made a motion to approve the August 28, 2017 Board of Health Closed Meeting Minutes. The motion was seconded by Mr. Charles Reynolds and approved by the board.

Recognition of New Employees – None

Home Health Update:

Mr. Howard Hunter III made a motion to go into closed session to discuss Home Health Concerns at 6:45pm. The motion was seconded by Mr. Charles Reynolds and approved by the board.

Mrs. Westelle Cherry made a motion to return to open session at 7:30pm. The motion was seconded by Ms. Susan Brinkley and approved by the board.

Actions from Closed Session:

Mrs. Bowser stated that by December if there is no progression, then we should close Home Health, but if there is progression, then we will continue with Home Health.

The board has directed Shamieka to make sure before the nurses that have resigned leave, they are to close all of their documentation. The board also suggested that Ramona give them weekly updates on the nurses. Mr. Hunter added by next month he would like to see more nurses hired.

Mr. Hunter shared that the employees that have gone through the storm with Home Health, after the storm is over, that the agency should give them a week off or add a week to their vacation. Mrs. Bowser and the board agreed.

Agency Update- Mrs. Ramona Bowser updated the board on the following: QA Indicator Report Review- Mrs. Ramona Bowser asked if there were any questions.

Community Objectives:

Prevent the spread of communicable disease by monitoring disease and syndromic reporting to detect trends and implement control measures. Patricia Riddick reports:

June 2017

Had a Salmonella case and a Pertussis case. The Salmonellosis case seems to have been an isolated case involving someone who is immunocompromised due to receiving chemotherapy. The Pertussis case was reported and investigated. Phone call was made to on-call epidemiologist, Connie Weant who felt this was not a true pertussis case due to testing method. A blood test was done at provider office and Communicable Disease branch prefers a PCR mucous test be done to confirm true pertussis diagnosis. This pertussis case did not have close contact with any children and per instructions of epidemiologist the contact person’s husband, parents, or other family members could get treated.

Have a resident that started treatment for TB on 11/27/16 and was instructed to receive direct observational therapy with medications. Meds was refused, vomited up or resident was not home on numerous occasions. Resident refused to sign isolation order. Consultant informed and advised to serve with warrant for arrest d/t violation of N.C. GS 130A-144 for failing to comply with taking prescribed meds and warrant was issued.

Betty, Esther & Jeannette went June 13th to Rivers Correction for TB administration and administered a total of 192 and no positives noted.

Had 6 confirmed cases of Chlamydia.

July 2017

Had 2 confirmed cases of Chlamydia (1 male and 1 female)

Rivers Correctional Institute have 1 case of Hep B that is currently under investigation.

Advocate to implement policy and environmental changes related to physical activity, nutrition, and tobacco and collaborate on related programs in the county. Crystal Dempsey reports:

June 2017

CHANGE Project

· Number of new participants recruited for this month: 2

· Number of home visits made this months: 10

· Number of participants that completed the program this month: 2

· Total number of completion since program started: 29

· Total number of participants currently in the program: 13

· Please note that recruitment for this program has ended. The community health worker (Shanta Howard) will be working with current participant to finish out their program activities. The program will be ending Sept. 30.

· Crystal Dempsey met with Chapel Hill staff via conference call to discuss program outcomes, barriers, dos/don’ts, and suggestions for the next county (Nash) who will be implementing the program.

Healthy Communities

· Crystal Dempsey attended the Healthy Communities conference call and the discussion focused on the additional healthy communities’ monies that were given to each county. Hertford County was given an additional $3,810 dollars to work on healthy communities’ activities per our action plans.

· Crystal Dempsey submitted the 4th quarter healthy communities report to the state. 4th quarter covered activities from April-June.

Partnership to Improve Community Health (PICH)

Crystal Dempsey attended the PICH sustainability meeting in Edenton to help establish a sustainability plan for the project. The funds for the original PICH program is now exhausted but additional funding has been obtained to continue with the activities. The Active Living and Healthy Eating funding will come from Kate B. Reynolds Foundation. The Tobacco Free Living funding will be picked up by the state.

July 2017

CHANGE Project

· Number of new participants recruited for this month: 0

· Number of home visits made this months: 5

· Number of participants that completed the program this month: 1

· Total number of completion since program started: 30

· Total number of participants currently in the program: 9

Healthy Communities

· Completed the Fruits and Veg. outlet inventory for Hertford Co. and submitted the data to the State. The information will be put in a database that can be used by all as a resource for the entire State.

Actively participate in Healthcare Reform by exploring partnership opportunities as it relates to Provider Lead Entities, Affordable Care Organizations and Accountable Health Communities: Ramona Bowser reports:

June 2017

On June 22nd, the Senate's bill to repeal and replace the Affordable Care Act was unveiled.

The "Better Care Reconciliation Act of 2017" includes the following:

• Elimination of the Prevention and Public Health Fund starting in FY2018 (October 2017)

• Cuts in Medicaid, including phasing out of the Medicaid expansion starting in 2020

• A shift in responsibility for Medicaid to the states and counties ― leaving governors, state legislatures, and local governments to make tough decisions about the health of people in their communities.

Market and implement the Infant Mortality Reduction Program.

Patricia Riddick reports:

June 2017

· Received approval for Activity 165 budget FY 17-18.

· CM has completed the UNC Chapel Hill IT-SIDS train the trainers to become a state certified IT-SIDS trainer.

· Conducted multiple visit to local OBGYNs’ offices as well as the 3-local pediatrician office and the OB department at VROH to inform staff of resources for safe sleep offered at Hertford County Public Health Authority.

· Distributed flyers in the community regarding Safe sleep class and information on how to reduce the risk for SIDS/SUID.

· Collaborated with local OBGYN office to possibly start in office SIDS basic education for expectant mothers.

· Brainstorming ways to incorporate Cease action into training if possible.

Safe Sleep Class

· Began the planning phase for upcoming Safe sleep classes held at Hertford County Public Health Authority: Dates & times TBA.

July 2017

· CM has completed the UNC Chapel Hill IT-SIDS train the trainers to become a state certified IT- SIDS trainer and is working on submitting state application to become training site.

· Plan to exceed last year’s Safe sleep class (last year was 28). Working on developing fliers for these classes.

Dates for safe sleep class: Times for classes are 6:30pm to 7:30pm

September 1, 2017 November 3, 2017

January 26, 2018 March 2, 2018

May 11, 2018

All class will be held at the Hertford County Public Health Authority Ahoskie Boardroom

(incentives for the classes was ordered and received)

· Beginning discussions has taken place with local OBGYN office re: possibility of starting in office SIDS basic education for expectant mothers. Also, will be providing literature and basic education to appropriate clients seen in clinic.

Agency Objectives:

Establish and convene a workforce development/work relation committee. Ramona Bowser reports:

The Employee Relations Committee (ERC) met on 7/21. 5 Members were present and 2 members were absent. Discussion included: policy review, guidelines and procedures review, establishing a mission statement and calendar of meetings. The next meeting is scheduled for 8/18.

NENCPPH Workforce Development Conference Planning Team

Notes from July 28, 2017

Shepard-Pruden Memorial Library, 106 W. Water Street, Edenton

Present: Sheila Davies, Roxana Ballinger, Angela Moody, Ashley Stoop, Crystal Hoggard, Claire Mills, Julie Tunney

Overview of Purpose and Progress to Date: Sheila provided to the group an update.

Conference Items Discussed:

Dates and Times: May 3-4, 2018 8:15 am Registration and Continental Breakfast; Conference 8:45- 4:30 (or 4:45 to keep folks engaged until 4:30)

Location: EAHEC Building, Greenville (Claire reserved)

Title: Many possibilities considered. The latest iteration I noted was “We are the Champions…Moving Public Health Forward”

Target Audience: LHD staff – ALL, including Health Directors, front desk clerks, environmental health workers, nurses, health educators, billing staff, etc. Question raised about expanding to social services or behavioral health?

Registration: EAHEC will handle registration electronically. EAHEC will provide each LHD a promotional code which they can use to sign up individuals (must have 3 or more from each LHD to bill). The LHD will be billed.

Credit Hours: EAHEC will provide credit hours for the instructional time.

Agenda Topics and Presenters (Draft Agenda below)

· Leading in Place – Public Health Champions Panel

o Two panels of non-traditional leaders: one for each day. Nominations from LHDs (Health Director) for each category (need name, position, and 2-5 sentences as to WHY person is a public health champion and leader). Planning team to make selections representing different counties.

o Ashley Stoop to moderate

Budget and possible sponsors

Food and Beverage: EAHEC organize box lunch, coffee and water (requested quote); Breakfast and snack food to be purchased by NENCPPH/LHD (request funds from NENCPPH).

Advertising: design and sharing: EAHEC will design a Save-the-Date and brochure and provide to NENCPPH. NENCPPH will send out to LHDs.

Other – Briefly discussed possible pre-reading and/or assessment.

- Claire to reserve “Catch Boxes” (microphone Nerf boxes)

Next NENCPPH Board Meeting

· Encourage HD participation (mention that someone will get called upon)

· Ask HDs for commitment (numbers)

· $ for snacks and breakfast

· Contract/fiscal agent

· Reminder about scheduling clinics and staff to allow attendance

Next Planning Team Meeting Date: October 20 at 9:30 am at the Shepard-Pruden Memorial Library in Edenton

Maintain fiscal management of agency, including Home Health: Shamieka reports:

June 2017

Home Health generated $122, 100.66 in revenues for the month of June 2017. Home Health will end FY 2016-17 with a deficit which has brought the viability of the Home Health Dept. into question. We will continue on with the corrective action plan that was submitted on May 18, 2017 as well as implementing additional requirements: the staff will work a mandatory 4 hrs. of overtime weekly until billing is current and no additional leave request will be granted until Dec. 2017 and any Sick Leave time and doctors’ appointments have to be accompanied by a doctor’s note. The Board of Health will meet in July to review the progress and monitor the accounts receivable to validate stability. Disciplinary actions will be taken and additional corrective measures will be implemented with regards to productivity levels that will be expected moving forward. To assist in budgetary deficiencies (1) Full-time Community Health Tech position will be RIF (Reduction in Force).

The deficiencies founded during the Dept. of Health & Human Services have been corrected and the agency is back in compliance with the Medicare Conditions of Participation effective June 9th.

I attended the Adult Aging Task Force hosted by the Gates Co. Dept. of Social Services where I was able to market home health services and acquire information pertaining to Gates Community Health provider services. Current Census: 233

July 2017

Home Health has generated $133,283.17 in revenues for July 2017. We have been accepting all referrals with the exception of United HealthCare. United HealthCare has a contract with Interim HealthCare and requires that recipients utilize contracted providers. As a result of the corrective action plan that was submitted on May 18 and July 7, 2017 HH billing, revenues and expenses are being monitored closely. Weekly reports are being discussed with the staff to determine/ ensure that billing is being submitted as quickly as possible and all outstanding documentation needed for billing is being followed-up on daily. The (4) hours of mandatory overtime continues to be in effect to ensure that all documentation is completed within 24 hours as well as monitoring the nurse’s productivity. The number of days from admission to rap have decrease as is reported on the Admission to Rap report Ramona and I discussed and I've forward a copy of that excel spreadsheet as well. There are currently charges on the A/R that are not recoupable therefore I have submitted those accounts to Ramona to have them written off, in an effort to focus on only the amounts on the A/R that are reimbursable.