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Iredell County Health Department Board of Health Minutes

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Iredell County Health Department Board of Health Minutes Iredell County Health Department Board of Health Minutes Regular Meeting Special Meeting February 22, 2018 318 Turnersburg Hwy, Statesville, NC 28625 Members Present Commissioner Thomas Bowles, Dr. Tim Burgiss, Sylvia Chapman, Dr. Heather Day, Ben Loftis, Candace Reeves, Jerry Turner and Lisa Warren, RN Members Absent Lance Desmarais, Dr. Tiffany Hubbs, Dr. Robert Monson Staff Members Jane Hinson, Health Director; Bill Griffith, Director of Finance & Administration; Jessica Present Ridgway, Administrative Officer; Brady Freeman, Environmental Health Director; Susan Johnson, Director of Clinical Services; Norma Rife, Director of Public Health Development & Promotion; Megan Redford, Health Promotion Manager; Renee Holland, Executive Assistant Others Present Susan Robertson, Assistant County Manager I. Call to Order, Invocation, and Introductions Sylvia Chapman called the meeting to order at 7:00pm and Lisa Warren provided the invocation. Susan Johnson introduced Autumn Royal, who is a student at Western Carolina University completing her 60 hours of clinical studies with the Health Department this semester. II. Public Comment Sylvia Chapman asked if there were any representatives in attendance for public comment. Seeing none present, it was noted there were no public comments. III. Employee of the Month Recognition Sylvia Chapman recognized the following staff that were in attendance and introduced them for being selected as Employee of the Year, recipient of the 2017 Firestarter Award and the January Employee of the Month. She also recognized the December 2017 and February 2018 employees but noted they were unable to attend: 2017 Employee of the Year Award – Ronnie Moore, Security Guard 2017 Firestarter Award – Lynn Hendrix, Deputy Registrar, Vital Records – Administration December 2017 – Lisary Martinez, Processing Assistant – Clinical Services Division January 2018 – Ronda Hart – Environmental Health Division (Government Center South) February 2018 – Melissa Josey – Clinical Services Division (Dental Clinic) IV. Consent Agenda Items for Action (Attachment 1 ; Attachment 2) Sylvia Chapman asked the board members if they had reviewed the consent agenda items for approval. She then asked if there were any questions or concerns with regards to the minutes from the December 14, 2017 Board of Health Meeting (noted as Attachment 1) or the addition of new codes and fees for Clinical Services (noted as Attachment 2). Hearing no comments, Sylvia then asked for a motion to approve the consent agenda items. A motion to approve the Consent Agenda items was made by Candace Reeves and seconded by Lisa Warren. Voting: Ayes- 7 ; Nays- 0. Iredell County Health Department Board of Health February 22, 2018 Page 2 of 12 V. Items for Discussion and Action a. Request Approval of 2018-2019 ICHD Budget (Attachment 3 – presented by Jessica Ridgway) Jessica Ridgway presented the 2018-19 ICHD Budget and briefly highlighted some of the proposed items listed in the budget. She also provided a PowerPoint presentation highlighting the process of how the budget is created for the Health Department. She also referred to the detailed copy of the proposed 2018-19 Budget which was included in the mailing packet for each board member to review in preparation for discussion, questions or concerns. She explained that data from the Community Health Assessment, Workforce Development Plan, Strategic Plan and the SOTCH Report is used to ensure that we have the resources necessary to reach our strategic goals. She also explained how the Health Department budget packet describes what we do in Public Health specifically related to the clients served and the services/programs provided. Resources in this budget assure essential services of public health are being provided in accordance with local, state, and federal requirements (Accreditation Benchmark 39.5). Funding in the budget is provided for recruitment, retention, and workforce development through financial allocations in training, salaries, and advertising line items (Accreditation Benchmark 37.6). She reported just a few highlights in comparison of the 2017-18 budget with the projected 2018-19 budget noting the following increases and decreases in revenues and expenditures (Accreditation Benchmark 33.6A): Increases (Revenues): Dental Insurance payments is expected to increase by $23,000 General Fees by $33,000 Medicaid Max by $154,710 Healthy Communities Grant by $13,275 Decreases (Revenues): Medicaid payments - $88,000 – this is a total based on actuals EH Fees - $50,000 – this is based on actuals Child Health State Grant - $20,150 Increases (Expenditures): Salaries – There is a 5% merit included in the proposed budget. BOH Wages will be increasing to $75/meeting. Contracted Services- Software is increasing by $57,365 due to required purchases of a Door Server ($11,490) and 16 SQL Standard Servers ($37,680). Decreases (Expenditures): Contracted Services: We’ve cut out a temporary position and some interpreting services. We’re also not purchasing vehicles this year so that has decreased by $39,000 Jessica then highlighted that we have 110 FTE’s and are not asking for any new positions in the budget for 2018-19. Although she did note some significant changes with regards to reclassifications of the positions listed below: 2 Current Processing Assistance IV’s 2 Processing Unit Supervisor V’s 1 Vacant Public Health Nurse I Patient Relations Representative V 1 Current FPF Environmental Health Specialist FPF Program Specialist Jessica continued to inform of several new and ongoing projects scheduled for next fiscal year, including Dentrix Dental Software, Health Information Exchange, Marketing for Dental and Family Iredell County Health Department Board of Health February 22, 2018 Page 3 of 12 Planning, Drug-Alcohol Abuse Free Iredell (DAFI), 2018 Accreditation Site Visit and Medicaid Transformation. In conclusion, Jessica reported the percentage differentiation between the 2017-18 budget and the proposed 2018-19 final budget. She states there is an increase of 3.49% in the 2018-19 budget compared to the 2017-18 budget. She also reported an increase of 1.26% in County appropriations in the 2018-19 budget in comparison to the 2017-18 budget. (See attached copy of slides) Jessica then asked if there were any questions with regards to the proposed 2018-19 budget. Ben Loftis questioned the decrease of $50,000 in Environmental Health fees. Brady Freeman responded this number is based on the decrease in residential development septic verses the direction of municipalities. Jane emphasized that this is a conservative budget and revenues were annualized by calendar and fiscal year. This revenue projection was based on actual and projections related to commercial and residential construction. Commissioner Tommy Bowles added that Central Permitting Division noted their trend is Board Development in municipalities. Lisa Warren questioned the slide associated with the Personnel/Reclassifications. Susan Johnson explained the first position is a promotion and is the same person. She added this has already been sent to State Personnel and has been approved. The second position would be a new position that we would post internally. She stated that the goal would be to move someone in-house into that role and then that would leave a Processing Assistant IV position open. Lisa then questioned the Public Health Nurse I position being reclassified to a Patient Relations Representative V. Susan Johnson explained this is actually a vacant nursing position that she has given up to the Administration Division due to future needs related to Medicaid transformation. Staff will have to work with several Managed Care organizations related to Medicaid billing and appeals when now we only work with DMA. Jane added that we are strategically trying to look ahead for succession planning as we have several employees who are nearing retirement. Dr. Tim Burgiss questioned the emerging issues listed on page 41 of the budget packet related to Dental Health in Clinical Services. He noted the potential loss of Med Max funding. Jane responded that with the Dental Program, it is exempt from the Medicaid Reform and we should continue to receive cost settlement dollars for the dental program. Sylvia Chapman then asked for a motion to approve the proposed 2018-19 ICHD Budget as presented. A motion to approve the proposed 2018-2019 ICHD Budget was made by Dr. Tim Burgiss and seconded by Jerry Turner. Voting: Ayes- 8 ; Nays- 0. b. Request Approval of SOTCH Report (Attachment 4- Megan Redford ) Megan Redford presented the most recent State of the County Health Report (SOTCH) and noted that she is seeking approval of this report by the Board of Health before it is submitted to the state (See attached copy of slides). She informed that this report is self-audited by the Health Department to assure accreditation standards are met. She also noted that once it is approved by the BOH, then it is shared with stake holders, community partners, and the general population by hardcopy as well as posted on the health department website. She further explained that the State of the County Health Report focuses on changes related to the County’s health data, our top health issues, and it also details Iredell County Health Department Board of Health February 22, 2018 Page 4 of 12 work that has been accomplished during the last year to address these selected health priorities. She then referred to page 2 of the document highlighting the County demographics. She noted a slight increase in population and median household income while noting a decrease in the unemployment rate and poverty level. She also referred to the social determinants of health and highlighted some of the most impacted vulnerable and at-risk populations. Megan then referred to page 3, Mortality and Morbidity Data noting that cancer, heart disease, and chronic lower respiratory disease are still the leading causes of death, and over half of all total deaths are related to preventable chronic conditions in Iredell County. Next, she highlighted on page 4, the rates for sexually transmitted diseases, stating these numbers have remained relatively stable over the past few years.
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