Hertford County Public Health Authority
Board of Health Meeting
February 27, 2012
Members Present Members Absent Staff/Visitors
Howard Hunter III Dr. Joselito Almario Ramona Bowser
Dr. Terry Hall Diane McLawhorn
Al Goddard Mickey McLean
William Stephens Lashana Bond
Charles Reynolds Barbara Earley
Nettie Evans James Madson
Katina Eley William Mitchell
Westelle Cherry Johnny Farmer
Call To Order- Mr. Howard Hunter, III, Chair, called the meeting to order at
6:37pm. He welcomed Board members, staff, and visitors to the meeting.
Roll Call- Mrs. Lashana Bond called the roll. A quorum was established.
Invocation- The invocation was given by Mr. William Stephens.
Approve Agenda #2- Mr. Hunter stated that the February 27, 2012 agenda
Conflict of Interest: The Board of Health reviewed the agenda and no conflicts
Approve Minutes #3- Mrs. Cherry made a motion to approve the January 23,
2012 Board of Health minutes. The motion was seconded by Mr. Goddard and
approved by the Board.
Approve Closed Session Minutes #4 – Mrs. Cherry made a motion to approve
the January 23, 2012 Board of Health Closed Session minutes. Mr. Goddard
seconded the motion and approved by the Board.
Approve Excused Absences- Dr. Joselito Almario. Ms. Eley made a motion to
approve the excused absences. The motion was seconded by Mr. Reynolds and
approved by the Board.
Recognition of New Employees – None
Mrs. Earley stated that the SOTCH report, which is the State of the County
Health Report, is a yearly report that is done to show the health statistics in the
county. Mrs. Barbara Earley reviewed the State of the County Health updated the
Board of Health, County Commissioners, visitors, and employees with the 2011
Latino community is growing in Hertford County.
Fewer deaths from Heart Disease – State Health Director states that this
may because of the State’s efforts to reduce smoking in public areas.
Obesity – State is looking at children currently in WIC & Child Health
program. Out of 410 Hertford County children aged 2-4 assessed through
the NC Nutrition and Physical Activity Surveillance System (NC_PASS) in
2010, 70 were found to be overweight and 53 obese; 260 were found to be
at a healthy weight. .
Deaths from Diabetes are slowly on the decline.
Strokes deaths are happening less within the county.
Breast Cancer deaths have decreased. Vidant Roanoke Chowan Hospital,
the Community Center, and Hertford County Public Health Authority work
closely with the BCCCP (Breast and Cervical Cancer Control Program) to
assist uninsured women with screenings and other diagnostic tests.
Teen pregnancy is down within the county. Hertford County currently ranks
#39 in the state for incidence of teen pregnancy. Our Adolescent Parenting
Program helps address Teen Pregnancy in Hertford County: To prevent
second pregnancies, high school drop-outs and future child abuse.
Infant Mortality – there was only 1 in Hertford County. Mr. Hunter
encouraged HCPHA to submit an application for an outstanding county
program award to the Association of County Commissioners. The
Reproductive Life Planning Preconception Health project was submitted. If
selected, we will be invited to share the project with other counties.
Hertford County – Syphilis has been fortunately low. Mr. Hunter asked was
this for the County or the Prison. Mrs. McLawhorn stated that this was a
Mrs. Earley stated that the March of Dimes grant, to expand our
preconception social marketing campaign was not approved so we hope we
do not see an increase in infant mortality as a result.
Mrs. Evans asked if there was any 2011 data received yet. Mrs. Earley
stated that the Agency will not receive any 2011 data until mid 2012.
Mr. Hunter asked if teenage pregnancy was low because Adolescent
Parenting Program. Mrs. Fitzhugh’s program has decreased 2nd pregnancies
among teenagers. Mrs. Earley stated that the average is 290-310 births
per year, and in 2011 there was only a reported 257 births and may be on
of the reasons for the decrease in the teenage pregnancy rate. Mr. Hunter
asked if the APP coordinator was involved with the schools. Mrs. Earley
stated that findings concluded that there were issues with educators talking
to kids without parent’s permission. Mrs. Earley stated that the State’s teen
pregnancy prevention program had not been allowed in the schools
because of a required pre-test that asks students about condoms, etc.
Addressing Preconception Health and therefore infant mortality in Hertford
County are the following HCPHA programs:Coordination of the Hertford
County Preconception Coalition (HCPC); Family Planning Clinical Services;
Pregnancy Care Management (PCM) and Community Health Advocacy
services; Care Coordination 4 Children (CC4C) and Family Care
Coordination (FCC) programs; and extended hours for the Women, Infant
and Children (WIC) Supplemental Nutrition Program.
HIV Disease Incidence: For the three years average 2008-2010, Herford
County’s HIV incidence rate was 15.7 compared to the State at 17.6
ranking #30 in the State for HIV incidence. Mrs. Earley stated that this is
up from 2010 because we are diagnosing HIV earlier before it progresses
Sexually Transmitted Diseases – In 2010 there were 82 cases of Gonorrhea
in Hertford County; compared to 89 cases in 2009. In 2010 there were 194
cases of Chlamydia in Hertford County; compared to 189 in 2009. There
was 1 case of Syphilis in 2010; there have been 2 cases total (1 in 2006
and 1 in 2010) in the past five years. STD encounters in the Hertford
County Public Health Authority STD clinic increased from 260 in 2008 to
387 in 2010. There were 394 encounters in 2011.
Addressing Communicable Diseases in Hertford County – Health In Motion
(HIM) – Mobile medical van provides education and testing in the county;
Jail Education and Testing; Community Testing; STD Clinics; and an
Mrs. Earley stated the Agency’s New Initiatives: Implementation of a
Preconception Health Campaign to raise community awareness, promote
reproductive life planning and improve Family Planning volume and
retention; Implementation of a Teen Health Summit to prevent Teen
Tobacco Use and provide education information and entrainment to prevent
other risky behaviors; Campaign for smoke-free recreation parks and
recreation facilities in Hertford County; Partner with other agencies
represented in the Hertford Health Maintenance Alliance to provide
healthcare for the underinsured and uninsured population.
Mrs. Earley asked if there were any questions or comments. Mr. Bill Mitchell,
Hertford County Commissioner stated that he wanted to thank the Board of
Health for inviting the County Commissioners. Mr. Mitchell stated that statistics
show that progress is being made and that it’s a process and it will not happen
overnight. It shows that the Agency is meeting its goals. Good work to the Board
of Health members and it shows that you are making progress.
County Commissioner, Ronald Gatling, stated that he would like to extend an
invitation to a forum on March 29, 2012, from 10am – 2pm at the Roanoke
Chowan Community College - Community Room, and he will place Hertford
County Public Health Authority on the agenda. Mrs. Earley stated that Nikki
Moore, Health Promotion and Marketing Coordinator, will attend.
Mrs. Earley concluded that once the SOTCH report is published, she will network
out to everyone.
Mr. Hunter thanked the County Commissioners for coming to the Board of Health
Public Comment- None
Closed Session - BOH met in closed session.
Dr. Hall made a motion to go into closed session @ 7:05 pm to discuss a
personnel issue. Ms. Evans seconded the motion and approved by the Board.
Mrs. Cherry made a motion to return to regular session @ 8:00. Ms. Evans
seconded the motion and approved by the Board.
Actions from Closed Session – Mrs. Westelle Cherry made a motion to offer
James Madson the position of Hertford County Public Health Authority Health
Director and directed management to draft letter per Closed Session discussion.
Mrs. Evans seconded the motion and the motion was approved by the Board.
Agency Update- Community Health and Strategic Priorities (#6), Mrs.
McLawhorn gave the update on the agency:
Mrs. McLawhorn stated there are a total of five employees out on Medical
Munis upgrade was completed on the 17th of January. Home Health
continues to use Barnstorm and McBee for billing review. Staff is
appreciative of this service. The service has been effective.
Mrs. McLawhorn gave the Board of Health a handout about the Nurse-
Family Partnership which is an evidence-based, community health program
that helps transform the lives of vulnerable mothers pregnant with their
first child. Each mother who is involved with the program is partnered with
a Registered Nurse and receives home visits that will continue throughout
the pregnancy and until the child is two years of age. This will improve
pregnancy, improve child health, and improve economic self-sufficiency of
Mrs. McLawhorn also gave a handout on Communicable Diseases FY2010 &
FY2011. No trends are noted. STD screening has increased. There has been
one confirmed case of rabies in a bobcat.
There has been a bat situation in one of the dorm rooms in Chowan
College, PEP was recommended and received by the student. Further
inspection of facilities revealed bats in gymnasium. The gym was closed to
students until removal of bats by the Wildlife Damage Control Agent which
should take place next week. We remain in close contact with the State
and Chowan representatives.
Community Transformation Grant: The North Carolina Division of Public
Health (DPH) has been awarded Community Transformation Grant (CTG)
funding to work with state and local partners to implement policy, systems
and environmental changes that support tobacco free living, active living,
healthy eating and high impact evidence-based clinical preventive services
over a five-year period. Funding for CTG is authorized through the
Affordable Care Act 2010. DPH will fund approximately 10 multi-county
collaboratives through a non-competitive process. These collaboratives will
align with the regional structure currently used by the North Carolina
Association of Local Health Directors. Albemarle Regional Health Services
will serve as the lead/fiduciary agency for Region 9.
Department of Public Health (DPH) is anticipating a $6 million cut. Public
Health has been cut from 197 million to 153 million over the past 3 years.
ADAP, Local Aid to County, CDSA, and a few other small programs will be
impacted. Mrs. McLawhorn pointed out that cuts in local aid to county and
the manner in which our Medicaid Cost Settlement is adjusted along with
any increases in health insurance cost could have serious financial
implications for the agency. These are areas of which we have no control
Mrs. McLawhorn asked if there were any questions in reference to the handouts,
the monthly report, or QA/QI report. The Board of Health had no questions.
Capital Expenditure – The Capital Expenditure report was discussed during the
January 2012 Board of Health Meeting. Dr. Hall made a motion to approve the
Capital Expenditure report. Mrs. Cherry seconded the motion and approved by
Executive Committee Report- No Report.
Finance Committee Report- Mrs. Cherry stated the Finance Committee did
meet in January. Mrs. Bowser presented the following reports:
PHA Balance Sheet January 2012 (#9) - Mrs. Bowser reported that cash in
central depository for assets was $512,722.13. Accounts receivable-general was
$66,241.99. Accounts receivable for Home Health was $391,981.72 with
accounts receivable doubtful for Home Health at $132,104.22. Total assets were
$866,712.26. Total liabilities were $64,603.61 and total fund balance was
Financial Summary Report January 2012 (#10) - The year to date revenues
were 53.40% of the budget and year to date expenses were 54.62% of the
budget. Revenues should be at 58.33% of the budget. Accounts Receivable with
allowance for bad debts totaled $350,449. Home Health had revenues of
$160,866 for January, without transfers had a deficit of $1,442 for the month.
Year to Date Home Health has a deficit of $112, 026, and without transfers a
surplus of $56,099. Home Health has a cash balance of $95,995 for January.
Budget Amendment #6 (#11) – Mrs. Ramona Bowser reported that Budget
Amendment #6 increases the current Agency budget by $6,525.
Infection Control: $2,330 – New State funds received in February 2012 which will
cover training for Agency employee, Beverly Pierce, Lab Tech.
Family Planning: $4,195 – Additional Stated dollars received and it was specified
to be a one time amount.
Budget Calendar (#12) – Mrs. Ramona Bowser stated the FY 2013 Budget
Calendar is tentative and changes may be made periodically. Mrs. Bowser is
requesting the BOH be involved with all processes that are in the 2013 Budget
Budget Discussion: Ms. Evans asked Management to look at referrals being
turned down in Home Health. Mrs. McLawhorn stated that Home Health has
stopped providing supply only(diapers) services since this no longer requires an
assessment by an RN and no longer accepts pill tray only visits as they are cost
prohibitive. She stated that to her knowledge there have only been two referrals
that were turned down one was for a client in Northampton County who had
been released in the past due to abusive behavior toward staff and for whom
Northampton County also refused to provide services for the other was a wound
care client that needed to be seen on the upcoming weekend for which our
agency was already maxed out and could not handle. Ms. McLawhorn stated she
would check with Emily and review the situation. Ms. Evans asked about utilizing
temp staff. Mrs. McLawhorn stated that there is too much involved to train
temporary employees with no Home Health experience on a short term basis.
Mrs. Cherry made a recommendation that the Board approve the above finance
reports. The Board approved by consensus.
BOH Personnel Committee Report – No Report.
BOH Policy & Programs Committee Report –
Board of Health Policy on Policies (#13)
Mr. Reynolds stated that the Policy and Programs Committee did not meet and
they did receive prior notification for a change in the Board of Health Policy on
Policies. Dr. Hall asked who determines the significance of the policy to bring to
the Board. Mrs. Bowser stated Management determines what policies go before
the Board. Mrs. McLawhorn added that the policy portion of the policy, if
changed, must go before the Board of Health and that there may be significant
changes to the policy and the policy portion may not change, and it will still go
before the Board of Health.
The Hertford County Board of Health shall approve all Hertford County Public Health Authority (HCPHA)
policies and significant procedures that address the agency’s administration of the public health standards;
assessment, policy development, assurance, facilities and administrative services and governance. The Health
Director and Division Directors are responsible for approving program specific policies and procedures.
Dr. Hall made a motion to accept the revisions to the Board of Health Policy on
Policies. Mr. Reynolds seconded the motion and approved by the Board.
Old Business – None
New Business –
BOH/County Commissioners Joint Meeting: Mrs. Bowser asked the Board of
Health if they would like to schedule a meeting for 2012. Mr. Hunter stated that
tonight’s Board of Health meeting was sufficient. The Board agreed by
NALBOH Conference 2012 – Mrs. Bowser asked if any Board member wanting to
attend this years NALBOH Conference to contact Lashana to make arrangements.
Closed Session - BOH met in closed session.
Mrs. Cherry made a motion to go into closed session @ 8:30 pm to discuss a
personnel issue. Mr. Stephens seconded the motion and approved by the Board.
Mrs. Cherry made a motion to return to regular session @ 8:42. Mr. Reynolds
seconded the motion and approved by the Board.
Actions from Closed Session – The Board of Health reviewed and discussed
the Health Director evaluations and the evaluations were filed in Human
Next Meeting- Personnel, Thursday, March 8, 2:00 pm, Ahoskie
Policy, Thursday, March 1, 2:30 pm, Ahoskie
Executive, Tuesday, March 6, 2:30 pm, Ahoskie
Finance, Monday, March 26, 5:30 pm, Ahoskie
Full BOH Mtg., Monday, March 26, 6:30 pm, Winton
Adjourn- Mrs. Cherry made a motion to adjourn the meeting at 8:45 pm. Mr.
Goddard seconded the motion was approved by the board.