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MINUTES ORANGE COUNTY BOARD OF HEALTH JUNE 25, 1998 Board of Health Minutes Transcription completed by Patsy L. Bateman 3 JUNE 25, 1998 commissioner per county). This item will need to be discussed again by the BOH at a future meeting. The Health Director will keep the BOH informed of any updates. IV. BUDGET UPDATE We were approved for Nurse Practitioner “more time” position, Ruth Efird’s position will go from 3/4 time to full- time and she will be focusing on the area of protocol development and management as our protocols and our relationship with the physicians rotating through the health department clinic. Evelyn Aabel has been filling our Nurse Practitioner I position 1/2 time for about a year now. That position was very difficult to recruit as a ½ time position and could not be filled until Evelyn came out of retirement to fill that position. That position has also been approved to go full-time and we will begin starting a recruitment process to fill that. That position will be key in providing clinic coverage that has been badly needed and we hope it will also be able to generate other revenues dealing with lamaze classes and in-home visiting as well. The not so good news is that the two Health Educator positions and the 1/2 time Office Asst. were not approved. The temporary part-time position that Angenette McAdoo is in has been continued until John Link and Rosemary Summers can discuss a plan to represent to the Commissioners. The Environmental Health fee increases were approved as part of the regular approval process of the budget and all of the operating budgets were approved as well. Rationale used for Health Education positions: It is a total view of the budget. The BOCC tried to approach the departments the same. At this time there are 4 departments without department heads and positions requested from those departments were not funded. The BOCC also felt that departments with “new” department heads needed to look at reevaluating resources, personnel and kind of get their feet on the ground with what they wanted to initiate. The BOCC did not cut anything that had been adopted into their goals. The Healthy Carolinians was never adopted into the BOCC goals. There are so many parts of Healthy Carolinians that are funded in different ways by the BOCC, like child abuse and neglect and poor parenting skills. Questions were raised regarding the adoption of Healthy Carolinians as a BOCC goal, many BOH members remembering that yes, Healthy Carolinians was a BOCC adopted goal as the Interim Health Director and the task forces had to keep the BOCC goal, “healthy carolinians”, updated. This coming year the BOCC will look at the strategies and the implementation of very specific goals to be accomplished by Healthy Carolinians. STRATEGIC PLANNING UPDATE Each Health Department Division has been asked to form a team within their divisions to look at issues that they need to address in a strategic plan. Rosemary Summers will meet atleast once with each of the teams within the division as they proceed. They will be looking particularly at inter-divisional opportunities for working together and by that things like a health promotion team within the division that will help cut the cross-divisional lines so that there is a Environmental Health person on that team as well as Personal Health people and Dental Health people. This is so that we begin to look for opportunities to cross fertilize ideas and efforts. Personal Health started with a Clinic Assessment Group that started meeting to address some concerns raised with clinic crunches, more patients than they could see, practitioners being stressed out, too few a staff for the number of patients seen in clinics especially split between the two ends of the County. Some reshuffling has been done in this group, met twice, have a short-term plan and then are going to take that group and add people in Personal Health and make that the long range planning group for Personal Health. They already have 3 or 4 additional meetings scheduled and they are well into that process. It is in the process of scheduling a meeting with an employee group representatives to see how we can structure more feedback from employees into the strategic planning process. This is to ask them how we can structure that. Regular monthly meetings are scheduled with an informal family practic group at UNC and that group has agreed to look at 2 grants, one the Medicaid population and the system and care for Medicaid population and then another strand being a system of personal health care for the population that falls within the cracks, not Medicaid eligible working for uninsured. We are getting ready to expand this group beyond the initial group. This process is moving forward.