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Health Director’s Report August, 2015 • Board of Health Priorities o We had great meetings with our Orange County State Delegation to discuss raising the minimum age of tobacco sales to 21. Thanks to the BOH members who participated in these meetings, the TRU club youth and school staff who initiated this conversation and Coby for setting it all up. o I attended the Chapel Hill and Carrboro Breastfeeding Friendly celebration to recognize both municipalities for their work in being breastfeeding friendly. o Related to the Family Success Alliance, there has been some angst about the United Way funding process this year and the Family Success Alliance has been a key partner for the United Way in their new process. As such we have worked closely with the United Way and the non-profit agencies that were funded to provide services through our collaborative to make sure they had enough funding to keep operating. That meant we had to divert some of the funds intended for the building of the pipeline to maintaining services and programs that currently exist. The BOCC has heard some concerns as well and we will be sharing with them what non-profit funding looks like when they return in the fall. • Various o I was asked again to serve as a member of the County’s Personnel Hearing Board. After three years of zero activity, things have picked up and this was my 5th one. I’ve encouraged the county to explore another method of reviewing personnel decisions. o We’ve received a lot of attention for our challenge of Durham County Health Department to see who could walk the Appalachian Trail and back the quickest. Unfortunately after a quick start out of the gate into the lead week one, week two had us falling behind. It will be a tight race I’m sure! o You may remember our discussion with the BOCC at our joint meeting regarding our request that they incorporate Health in All Policies approach to their decision-making. Unfortunately, we haven’t made much progress. If we can’t get the issues resolved internally, we may need to return to the Board of Health with a revised plan. Look for an update in October. o At our September Board of Health meeting we’ll devote the entire evening to the accreditation requirement of Board of Health training. This training will be done by Bill Browder from the Institute for Public Health and given the number of new Board of Health members since our last training; it should be a great time for this refresher. o The NC Association of Local Health Directors (where I am President-elect) is very busy right now dealing with a situation with the Division of Medical Assistance. While it is rather complicated, I’ll say that it involves the Medicaid cost settlement and is resulting is a significant delay and potential significant reduction in the 2014 cost settlement payment. Orange County does not budget cost settlement funds in our operating budget, we use it for special projects and construction. However, many smaller health departments rely on those funds to provide services and this delay could result in serious budget and staff cuts in areas that are already struggling to do what they need for public health. I say all this because as an Officer of the HD Association I’m spending a lot of time working on this issue including weekly trips to Raleigh for meetings with DMA and others working on resolving it. o Speaking of Raleigh, we are also monitoring the budget as it makes it way, albeit slowly, through the compromise process. With the total budget figure agreed on, it doesn’t look like local public health or education will be getting any relief from the recession-era spending mentality we’ve been living with for 5 years now. We are monitoring the details and will let you know if there are any specific cuts or issues to be aware of. o We are also working with our lobbyist and partners throughout the state to advocate for the best Medicaid reform package we think we can get. We lost a major battle, however, when the House and Senate agreed to a hybrid entity with the commercial MCOs and the homegrown PLE (provider led entities). In my opinion the MCOs will quickly eliminate any homegrown competition and we’ll be stuck with the MCO-only model. In spite of this, there are a lot of details that we are watching and trying to keep in the reform plan to the benefit of local public health. o We’ve also had a busy couple of days with Communicable Diseases here in Orange County. I’ll update you at the meeting tomorrow.