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MINUTES <br />ORANGE COUNTY BOARD OF HEALTH <br />May 26, 2010 <br />Board of Health Minutes Transcription completed by Anne Miles Cassell 9 May 26, 2010 <br />thinking because the topic of additional revenue options is included in the report <br />as an appendix rather than a formal recommendation. <br /> <br />Tony Whitaker said he had a question regarding the risk factors; whether it is <br />because there are many good providers available or because many very sick <br />people have moved here from other parts of the country to live in this area <br />because of the availability and proximity of good medical care. He asked if a <br />county like Orange would be penalized because we have per capita some very <br />sick people that are here because we have really good health care; that the risk <br />factor could possibly be misapplied. Rosemary Summers stated that it could be. <br /> One thing from the last Community Health Assessment that staff is trying to <br />research is the higher than usual breast cancer rates in Orange County. What is <br />not known is if it is a result of better screening programs or is it something else. <br /> <br />Commissioner Yuhasz also observed that since NC health rankings are low on a <br />nationwide scale, it should follow that federal public health funding in the state <br />would be higher and he raised a question on data supplied regarding what is <br />spent per capita on public health and if those figures included federal funding. <br />Rosemary Summers stated that $14.13 per capita is only state allocated funds. <br /> <br />Steve Yuhasz asked for clarification of exactly what single purpose advocacy is <br />and what that influence could have on the final budget result. Rosemary <br />Summers gave several examples of advocates that would be focused on only <br />one single issue and requesting funding specifically for that issue. Rosemary <br />Summers said that flexibility, the ability to identify primary needs and shift funding <br />into the areas of most need is ideally what would work best. It would be <br />dependent on what each community identified as their primary needs. <br />Commissioner Yuhasz commented that this report as it stands did not seem to <br />give any flexibility to local public health and Dr. Summers agreed. <br /> <br />Commissioner Yuhasz also expressed his unfamiliarity with how other states fund <br />public health and asked if there was more responsibility placed on municipalities <br />for funding so that the state itself doesn’t have a larger role. Rosemary Summers <br />stated that some large municipalities have their own public health department, <br />however nationally other states all have similar public health structures as North <br />Carolina. Massachusetts is the only state that has the most disperse system <br />known. Every municipality and every county has a public health agency in that <br />state. They have a totally different system than anyone else. She stated that <br />there are three types of systems; <br />1. Disperse system, such as Massachusetts <br />2. State operated system, such as South Carolina <br />3. Locally operated system, such as North Carolina <br />It was pointed out that as late as 2001 there were states such as Nebraska with <br />no public health presence. <br /> <br />Steve Yuhasz asked if it is anticipated that Orange County would receive any of <br />the federally funded Health Information technology money. Rosemary Summers <br />stated that North Carolina will receive some of that money but most of the <br />money will go toward bridging technology to enable healthcare providers to