Wake County Human Services Board Minutes August 23, 2012

Members Present: Executive Staff: Guests: Dr. Dianne Dunning, Chair Mr. Ramon Rojano, Human Services Director Bd. Candidates for Interviews Mr. Pablo Escobar, Vice Chair Mr. Joseph Threadcraft, Environmental Services Director Mr. Frank Eagles Ms. Denise Foreman, Assistant to the County Manager Dr. Sharon Foster Mr. Paul Gross, HS Finance Officer Ms. Leila Goodwin Ms. Jonica Hinton, Executive Assistant Quorum Present: yes Dr. Burton Horwitz Ms. Sue Lynn Ledford, Public Health Administrator Dr. Paul Norman Ms. Rebecca Linthicum, County Budget Office Mr. Benny Ridout Dr. Peter Morris, Medical Director Mr. Julian Smith Ms. Regina Petteway, Office of Community Affairs Mr. Bob Sorrels, HS Deputy Director Members Absent: Ms. Katherine Williams, Human Capital Development Dr. Osama Said Commissioner James West Staff Absent: Mr. Joe Durham, Deputy County Manager Mr. Scott Warren, County Attorney

Agenda Item Discussion, Conclusions, Recommendations Action, Follow-up Responsible Due Party Date I. Call to Order Chair Dianne Dunning called the meeting to order @ 7:35 a.m. and led the N/A Board in a moment of silence. II. Approval of Minutes Mr. Frank Eagles motioned, seconded by Mr. Benny Ridout, to approve the N/A July 26, 2012, Board meeting minutes. Motion passed unanimously.

III. Confirmation of Next The next Board meeting is scheduled for September 27, 2012, 220 Swinburne N/A Board Meeting Street, 2nd Fl., Rm. 2132, 7:30 a.m. – 10 a.m.

REGULAR AGENDA

No. 240 Agenda Item Discussion, Conclusions, Recommendations Action, Follow-up Responsible Due Party Date IV. Overview of Top Mr. Ramon Rojano presented the top Social Services and Public Health Issues See Next Steps. Social Services and (FY 2012-2017 Coordinating Strategies and Master Plan) for the Human Public Health Issues Services Department. Mr. Rojano said this is to help the Board think about the structuring of social services and public health activities. Mr. Ramon Rojano, HS Director Process to Develop the Coordinating Strategies:  Select the issues and gather data  Identify existing WCHS resources  Identify additional public, private and community resources  Recruit champions inside and outside  Align with Agency Strategic Plan and work with staff to assure progress on outcomes  Develop the data collection system  Develop an evaluation and monitoring process Next Steps:  Mr. Rojano will figure out a way to integrate the issues and develop a process to help the Board roll the issues into the Board’s identified priorities.  Mr. Rojano will figure out how to synchronize obligations with the Strategic Plan. Then Board members choose where they have energy to get engaged with staff and the community (could be done individually or through committee). Align Board members’ or committees’ choices with the agency priorities. Then organize the new Board agenda.  Mr. Rojano said the Board would help determine and foster development of the public, private, or community partnership response to the issues.  Mr. Rojano asked Board members to start exploring how they want to get engaged. He believes this will re-energize the Board. He said the Board’s role is not only to manage tasks, but to also join and help people do things.  The strategies are the same for each issue.  Mr. Escobar requested that Mr. Rojano share reference materials or resources that show this work having been done in other communities and alerts on any conferences on this issue that are coming to the area that Board members could attend.

No. 241 Agenda Item Discussion, Conclusions, Recommendations Action, Follow-up Responsible Due Party Date V. Overview of Top Mr. Joseph Threadcraft presented the Environmental Services FY 2013 Environmental Key/Horizon Issues. He said the goal is to link the top issues to the Services Issues Department’s daily workload via the PDMS (employee evaluation) process. Mr. Joseph FY 2013 Key/Horizon Issues were presented in the following program areas: Threadcraft, ES Director  Animal Services  Environmental Health & Safety  Solid Waste  Water Quality

Highlights included:  Working on the Memorandum of Agreement (MOA) with Wake County and N.C. State’s College of Veterinary Medicine.  Capacity has been reached at the Animal Shelter.  Coordinating with the National Association of Counties (NACo) on a grant to supplement funding for inspections in the Health & Safety Division.  Solid Waste Division: Mr. Threadcraft said the landfill is a big contributor on the impact of air quality. It also impacts water quality (leaching agents, methane gas).  Mr. Threadcraft said some of the aspects to improve air quality go beyond the county’s capabilities. For example, the U.S. Supreme Court overturned the EPA’s ruling on air pollution on adjacent states. Another example was that the cost of coal versus natural gas is a major determinant to which fuel power plants use to generate energy. The power plants have dual power mechanisms in order to switch fuel sources. Mr. Threadcraft said his staff can focus on and discuss with the Board those things that we can impact or have some minor return on investment.

No. 242 Agenda Item Discussion, Conclusions, Recommendations Action, Follow-up Responsible Due Party Date VI. Board Interviews The Board interviewed the following candidates. These candidates were Recommended Ms. screened and selected for interview in 2011, but put on hold until after approval Margaret Raynor for of the new legislation and amended Board composition. the Registered Nurse Board Position. The 8:00 am Chandra Banner, General Public Category recommendation will 8:30 am Margaret Raynor, Registered Nurse Category be submitted to county commissioners Handouts: for consideration of  Applications official appointment.  Rubric and Interview Questions  Current Board Diversity Profile and Board Member Terms The Board is conducting interviews Vice Chair Escobar led the interview process and assigned interview questions twice a month: at the to Board members. Executive Committee meetings and at the Dr. Burton Horwitz excused himself from participation in the interview with regular Board Ms. Margaret Raynor because of their friendship. meetings. All Board members are urged to After the Board conducted the interviews, they discussed the candidates and the participate. process. Highlights and understandings included:  Consider rephrasing some of the interview questions.  Candidates are expressing interest through various avenues and the Board is trying to keep the process open until September 15. However, the Board could go ahead and make a recommendation on a strong candidate.  The Recruitment Ad Hoc Group agreed that the Board would start to make recommendations at the September 27 meeting, which would allow time for the September 15 application deadline.  The Recruitment Ad Hoc Group meets after the interviews and reviews the rubrics to see if there is some consensus.  “Reversion to the Mean” is a decision based on feedback from evaluations and discussions.  Hard to change the rules once you get started. Process needs to be fair.  Important to complete your rubric score cards.  Suggestion to hold the general public and consumer categories closer to the end because these positions provide some flexibility.  Reminder to solicit for candidates at the committee level.

Dr. Dunning motioned, seconded by Mr. Frank Eagles, that the Board recommend Ms. Margaret Raynor for the Registered Nurse position. Motion

No. 243 Agenda Item Discussion, Conclusions, Recommendations Action, Follow-up Responsible Due Party Date VII. Behavioral Health Ms. Denise Foreman gave a brief update on the Wake County Behavioral Project’s Next Steps: Review Update Health Review. -Finalize agreements Ms. Denise Foreman,  Presented an update at the August 13 County Commissioners’ Work before approval by Assistant to the Session on the status of the UNC, Wake County, and Alliance Behavioral governing bodies of County Manager Healthcare project (handout). between Wake  Had hoped to have an agreement to the Wake BOC this week. However, County, Alliance, and the project is much more complex than the timeframe set. UNC Healthcare.  As UNC began to learn about Wake’s programs and gaps and then began to -Implement the figure out how to prioritize what they will bring to the table, and how that approved plans. matches with what Wake has and what the community needs are, it became apparent that the group needed more time for in-depth study and review. -Address care  Moving forward. UNC is visiting staff and reviewing data. UNC needs continuum needs. time to understand Wake’s clients, business processes, revenues, expenditures, staff talents and credentials, facilities, and community.  The group has moved to bi-weekly meetings in order to get the work accomplished. There are 45 stakeholders at the table.  UNC is studying the best way to operate, utilize, and maximize the WakeBrook Facility. UNC is interested in operating the entire function. The group is also studying the implications of changes and the associated costs. Ms. Foreman said the group has not yet talked about other services. UNC is helping Wake develop a temporary solution to the services that will be a conflict of interest as of January 1, 2013. Mr. Escobar said that at a meeting he attended, UNC said WakeBrook is the gateway to the delivery of mental health services in Wake County.  To operationalize the WakeBrook plan, Wake may need to use some of the resources allocated to outpatient services.  Over 230 Wake County Behavioral Health employees are affected.

No. 244 Agenda Item Discussion, Conclusions, Recommendations Action, Follow-up Responsible Due Party Date VIII.Update on Local/ Mr. Paul Gross, HS Finance Officer, gave an update on the WCHS FY 2013 Mr. Gross will State Budgets Adopted Budget (handout). County staff are processing the FY 2012 budget address suggestions books/closeout. by the Board. Mr. Paul Gross, HS Finance Officer FY 2013 highlights included:  Projected Expenditures/Revenues  Chart of Revenue Sources  Chart of Percent of Overall Budget by Division  Chart of Historical Trend Analysis  Relevant Issues/Current Events: o Holding select positions for possible Wake Behavioral Health Services (WBHS) reduction in force placements. o Salary reserve balance of ($91,000). Actual salaries exceed budgeted salaries. Should make this up by year’s end. o Food & Nutrition Services (FNS) resource needs for NC Fast and Document Imaging Implementation. (Redeployment of staff, overtime, temps. interns, retirees all being looked at as options to assist.) o WCHS Budget & Program staff are working with the Wake County Manager’s Office and UNC to assist in the WBHS transition plan. o LME Closeout. Staff is still processing IPRS (state funding) claims. o IV-E Funding cuts (for high risk children in foster care). Partial cut in FY 2013 (potential of $500,000), and an annualized cut in FY 2014 (as much as $1 million). Staff is meeting to develop strategies to address cuts.

Board discussion:  Dr. Dunning asked if the budgetary distribution was in alignment with the agency’s priorities.  Mr. Escobar said there is a mandated aspect to the funding allocations as well as a policy. Dr. Dunning said the mandated priorities are usually ranked higher in the agency’s matrix. Mr. Gross said he would follow up and present an analysis to the Board.

 Dr. Dunning said Ms. Caroline Harper provides a breakdown of costs of people versus programs in the WCHS Quarterly Data Report. She requested that a correlation be added in the next report between the people and program percentages to the budget percentages. She believed the Board would be able to follow/compare where the funding is going, how

No. 245 Agenda Item Discussion, Conclusions, Recommendations Action, Follow-up Responsible Due Party Date

DIRECTORS’ REPORTS

IX. Human Services and Environmental Services – Mr. Joseph Threadcraft, Director Environmental Services Directors’  The Stony Hill neighborhood has some groundwater contamination. EPA Reports Region IV and the N.C. Division of Water and Waste Management are involved.  Coordinating a methamphetamine (meth) lab cleanup. This is the second meth lab discovered within the last 45 days. There has been a rise in meth labs.  Involved in an animal hoarding case where the owner surrendered 26 of 29 animals to Wake County Animal Services.  Conference call today at noon with N.C. State’s College of Veterinary Medicine on a team assessment for Animal Services.  Collaboration opportunity with N.C. State’s College of Engineering and Wake County GSA on building assessments. Also want to invite Wake Technical Community College students to participate.  Mr. Julian Smith suggested that focus groups be conducted to get feedback on any environmental or animal media campaigns before launching them to the public.

Human Services – Mr. Ramon Rojano, Director  The August Issue of WCHS Headlines was distributed.  Four years ago, the National Association of Counties (NACo) implemented prescription cards, which provides discounts on prescriptions. NACo is currently launching a dental card (discount on dental services). Mr. Rojano is working with Dr. Burton Horwitz (Board Member) and Dr. Johanna Irving (WCHS Dental Services) to explore a dental card. Mr. Rojano said some of the Wake County Commissioners are very interested.  Will soon present an update on the NC FAST implementation.

CHAIR’S REPORT

No. 246 Agenda Item Discussion, Conclusions, Recommendations Action, Follow-up Responsible Due Party Date X. Board Chair’s Chair Dunning announced that she would resign from the Board in November Chair Dunning Report 2012, with a year remaining on the Veterinarian term. She said she has been announced her Board vice chair and chair for the past four years, and as the Board moves resignation from the forward, she believes this is a good time to step off. She said she would be Board in November active in finding a replacement. 2012.

XI. Adjournment With no other business, the Board meeting was adjourned at 10:00 a.m. Board members were offered complimentary Tdap (pertussis) vaccine and flu vaccine.

Board Chair Approval Dianne Dunning, Chair, DVM, MS, DrPH, DACVS

No. 247