02-24-2020 Meeting Minutes BOH - 1 -
MINUTES PERSON COUNTY BOARD OF HEALTH MEETING
CLASSROOM OF THE PERSON COUNTY HEALTH DEPARTMENT February 24, 2020 A regular meeting of the Person County Board of Health was held in the Classroom in the Person
County Health Department. The following members constituting a quorum were present: Patsy Clayton, Dr. Jeffrey Noblett, Phillip Edelblute, Steven Bailey, Ted Michie, Dr. Barbara Harris, Dr. Stephen Saunders, and Ray Jeffers. Board members Dr. Ben Tillett, Dr. Kimberly Yarborough, and Dr. Christopher Atkins were absent. Also present were Tabatha Philpott, Nursing Supervisor, Harold
Kelly, Environmental Health Supervisor, Jennifer Melton, Administrative Assistant, and Janet
Clayton, Health Director. A. Call to Order Steven Bailey, Chairman of the Board of Health called the meeting to order at 7:00 p.m.
Commissioner Ray Jeffers was welcomed to the Board of Health.
B. Public Comment Period No public members were present
C. Consent Agenda A motion to approve the consent agenda as presented was made by Dr. Stephen Saunders, seconded by Dr. Jeffrey Noblett, and the motion carried unanimously.
D. Financial Reports: January 2020
Janet reviewed the Board of Health report which shows the January 2020 financials as well as July 2019-January 2020 YTD budget and monthly budget. Janet pointed out that the July 2019 - January 2020 column shows a difference of expenditures over revenue of $139,006 but stated that we have not received our Medicaid cost settlement which is predicted to be approximately $250,000. The
cost settlement is usually received in May or June. County finance is changing the process of
debiting the health department for the insurance cost of vacant positions, which was mentioned in the last meeting. There will be a budget amendment to remove of $42,000 from the Group Health Insurance expense line. The quarterly Fund 10 will be appropriated the end of March, and our Fund Balance is appropriated at the end of the fiscal year. A motion to approve the financial report
was made by Dr. Stephen Saunders, seconded by Phillip Edelblute, and the motion carried
unanimously. E. BOH Annual Operating Procedures – Revised Board of Health Operating Procedures were reviewed at the January 27, 2020, Board of Health
meeting, and no changes were made. During the Accreditation site visit on February 12, 2020, the
site visitors provided recommendations for improvements. Janet highlighted the revisions in the document. On page 4 section 6, a statement was added to indicate the Board will follow the appeals procedure as defined in the North Carolina General Statutes (NCGS) 130A-24. Also, a question was asked regarding the procedure followed for rule making; therefore, number 7 was added to
state that the Board shall follow NCGS 130A-39 and the Person County Board of Health Public
Hearing Rules of Procedure. Also added are Attachment A, NCGS 130A-39, and Attachment B,
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Person County Board of Health Public Hearing Rules of Procedure; this allows for all referenced
documents to be found in one document. On annual review, Janet will review the NCGS to verify
the current language and will update as needed. Dr. Jeffrey Noblett asked if we had been following these procedures already, and Janet stated that we have been following the NCGS, but the site visitors recommended the procedures to be specifically mentioned by number. A motion to approve the Person County Board of Health Operating Procedures as amended was made by Patsy
Clayton, seconded by Ted Michie, and the motion carried unanimously.
F. Communicable Disease Report Janet presented Board of Health members with copies of the 2019 Communicable Disease Summary. In 2019, of the 265 Communicable Diseases, 95% were Sexually Transmitted
Infections, 3% were General Communicable Diseases, and 2% were Foodborne Illnesses. The
foodborne illnesses included 1 case of campylobacter and 6 cases of salmonella. The salmonella cases occurred throughout the calendar year 2019 and were not linked. The General Communicable Diseases included 2 cases of Carbapenem-resistant Enterobacteriaceae (CRE) which is antibiotic-resistant bacteria, 2 Pertussis cases, and 3 Strep A cases. The three Strep A
cases were all in a long-term care facility; however, the first case occurred in the winter of last
year and the other two cases occurred mid-summer and late summer; therefore, the cases were not within the window of time to require the facility to stop admissions. Due to the latter 2 cases being within a few months, the facility was required to do six months of surveillance. Initially, the facility tested all employees and residents to eliminate the possibility of a carrier, and tests were negative.
The facility has followed through with providing monthly reports on any employee or patient
illnesses. Chlamydia and gonorrhea cases made up the majority of 2019 Sexually Transmitted Infections. There were 193 chlamydia cases and 45 gonorrhea cases. Additionally, there were 11 syphilis
cases, 1 HIV, 1 PID, and 1 non-gonococcal urethritis cases. Janet also included demographic
information for the cases of chlamydia and gonorrhea. Top percentages for chlamydia and gonorrhea are found in the age groups of 15-19 and 20-24 with the majority being female for both diseases. For chlamydia, the distribution by race includes 45 % Black or African American, 33% White, 2% other, and 20% unknown, while gonorrhea was 38% Black or African American, 38%
White, and 24% unknown. Janet noted that some medical providers do not fully complete the
Communicable Disease Reports resulting in the race being documented as unknown. Janet shared that PCHD is planning additional outreach and education for our teen population. LeighAnn Creson has met with students from Roxboro Community School and has an upcoming meeting with students from Person High School to gain insight about the most effective ways to deliver
messaging to youth.
There was an increase in syphilis cases by 7 cases from 2018 to 2019. There have been increases in our larger neighboring counties for the past several years, so this increase is not a total surprise as our population can be transient. Janet also presented a 2006-2019 Communicable Disease
comparison which began in 2006. This comparison shows trends in the data. There were 22 more
sexually transmitted infection cases in 2019 than in 2018, and 10 more total communicable diseases. Steven Bailey asked how Coronavirus (COVID-19) would be classified. Janet stated that those cases would be considered general communicable diseases. Dr. Jeffrey Noblett asked why Hispanic is not listed under race for the demographic information. Janet stated that Hispanic is
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listed under ethnicity as it is not considered a race but an ethnic group. Also, Hispanic ethnicity is
one of the common blanks not completed on the report forms.
G. Staff Liaison Updates
• Environmental Health o There are 35-40 pending applications for new construction with a 5-6 week waiting
period.
o Thanks to Bonnie Holt and staff with all the help with Accreditation.
o EnerGov meetings restart tomorrow. This is the new software that the county is
implementing to help Planning and Zoning, Building Inspections, and
Environmental Health.
o Exploring alternative software specifically for Environmental Health that may help
facilitate that transfer.
o Have started new procedure for water samples. They were finding that some sample
results were being delayed or lost in the mail due to courier service, so now
Henrietta accesses the state lab data portal each week and downloads all the results
for bacteria and organic samples.
o Looking at different ways to ship water samples due to the cost of sending through
courier mail. It costs about $20 per sample to send by courier to the state lab.
Researching going through UPS for better rate.
o Attended Coal Ash meeting last Wednesday for DEQ for the closure of the Roxboro
Plant. There are two basins. They are looking at moving about 20,000,000 tons of
coal ash and creating two new basins that are lined and is approximately a 30-year
project. One of the basins will be 700 ft. above sea level. Point was made that none
of the coal ash will be trucked on public roads.
Steven Bailey asked about backlog for expiring permits that was mentioned in the last
meeting. Kelly stated in January they had 47 applicants and it’s continuing into February.
• Personal Health o New Maternal Health coordinator Casey Carver started on January 31st. She has
completed a lot of training and has been cleared to begin in clinical areas.
o PHN II position has been offered and accepted. H. Department Services Update PCHD is recruiting clinic staff to rebuild. We are working with Duke to resume services with the
projected date of May 1, 2020. Our disease surveillance system is showing that more patients are
presenting in the Emergency Department for STD services. We are still assuring services with PFMC for family planning and STD, and with DCHD for maternal health. Patsy Clayton asked if patients are referred back to us from the ED. Janet stated that patients are informed to contact Person County Health Department if symptoms are not resolved. If they contact us, we would refer
them to PFMC.
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I. Health Director’s Report
• Please join us for our annual Public Health Month celebration on Wednesday, April 1 at 8:15 am in the FEMA room!
• Accreditation- The site visit was conducted February 12. Thanks to Dr. Noblett and Dr. Yarborough for serving as the BOH representatives for the interview! PCHD has been recommended for Reaccreditation with Honors!
• Budget- o Meetings have been held with Management Team members. o 1/31-Personnel Budget - Submitted
o 2/20-Operating Budget –
o I have coordinated the submission of the local mental health budget requests.
• Various Updates- o Tabatha and I are monitoring the Coronavirus Disease 2019 (COVID-19) updates.
This includes at least weekly conference calls and correspondence. EPI Team has
met for a situational update. Correspondence has been distributed to our local
medical providers.
o On January 30, I attended the regional Cardinal Innovations HD Operations Council
meeting in Burlington.
o Graham Bundy is assisting our department with emergency preparedness. He will be
coordinating a COVID-19 tabletop for the EPI Team on 2/26.
o Staff are continuing to purge and scan files and various areas.
o On 2/12, I attended the quarterly PC Animal Services Advisory Board meeting.
o I attended the monthly NCALHD meetings and the quarterly NCAPHA meeting. I
also participated the NC Preventive Health and Health Services Block Grant
Advisory Council on 2/20.
• Personnel-
o Casey Carver, joined our staff on 1/31 as the PHNIII- Maternity Program Coordinator. o PHNIII-PH Emergency Preparedness Coordinator, is being reclassified. o The following positions are vacant:
• Community Health Technician I
• Public Health Nurse II- Clinic (Posted twice; accepted pending background check)
• Public Health Nurse II- Clinic
• Public Health Nurse II- Care Management
• Public Health Nurse III- FP/STD Program Coordinator (Posted, no applicants; requested reposting)
• Med Lab Technician I
• Social Worker II- CC4C (Posted twice; position offered, accepted, then declined; reposted)
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Ray Jeffers asked who the default Medicaid provider is for children in Person County. The
complaint has been through DSS, Person County Schools, and Partnership for Children that the providers who are seeing Medicaid patients for well child checks are not identifying delays and problems that should be identified during these visits. Ray stated that Person Family Medical Center and Dr. Terri Cates are doing more referrals than our
default Medicaid provider. Ray asked who decides who the default Medicaid provider is.
Janet stated that she is not aware how that is decided, but she will contact DPH and will let him know. J. Adjournment Having no further business to discuss, a motion to adjourn was made by Dr. Stephen Saunders,
seconded by Dr. Jeffrey Noblett, and the motion carried unanimously. Respectfully submitted,
Janet Clayton Health Director/Secretary