12/22/05 — Health Board eyes proposed legislative changes

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Health Board eyes proposed legislative changes

By Phyllis Moore
Published in News on December 22, 2005 1:50 PM

The effects of legislative actions on public health for the coming year were discussed at the Board of Health meeting Wednesday.

Health Director James Roosen said 39 proposals were made during 2005 that could potentially impact community health, although not all were passed into law. He selected a few that were most pertinent, including a program that could result in bringing more school nurses to the county.

The child and family support initiative will create a partnership between school systems, social services, public health and mental health, he said. The goal of the program is to identify youths at risk of academic failure, with $11 million budgeted to provide registered nurse and social worker teams in schools.

That's enough to fund 100 teams statewide, Roosen said. Thirty-three school systems have been asked to apply, Wayne County among them. Of those, 20 will be selected to receive funds.

"We have about a two-thirds chance of getting selected in Wayne County," he said. If chosen, it will augment the school nurse program already in place at several schools, he said.

Other changes that will directly affect families with children are an early childhood vision care effort and a shift in care for families unable to afford insurance.

The vision care program stipulates that children entering kindergarten must have a comprehensive eye exam to attend school. The exam must be done by an optometrist or opthamologist at least six months prior to the start of school, he said.

Roosen said he sees a bottleneck because there are only eight months to accomplish this. Another problem area concerns families unable to pay for the exam. The state is budgeting $2 million for the uninsured and families below the poverty level, he said.

Public health officials are advocating for a 30-day grace period to ensure children will not be delayed in starting school, he said.

A pretty significant change is also going to occur after Jan. 1, when children from birth to 5 years old under N.C. Health Choice will be moved to Medicaid. While nearly 30,000 children will be affected statewide, the difference locally will be negligible, he said.

Roosen explained the rules apply to "kids who were in families too wealthy to qualify for Medicaid but not wealthy enough to buy insurance or go to a doctor."

Possible implications include an extra cost to counties and few dental providers for Medicaid patients in Wayne County.

"I wonder if all these kids are going to be seen if they have the need," he said.

Laws to restrict smoking, ATV regulations and the cigarette tax increase were also mentioned during the monthly board meeting.

In 2005, he said, the law allowed Health and Social Services departments to establish a 50-foot no smoking boundary around the perimeter of the grounds.

ATV regulations were also big news, he said.

"It was significant for us," he said. Among the guidelines were required training for people born after 1990, a minimum age for ATV operation of 8 years old, helmet use for all riders and machine size restrictions for ages 8-11 and 12-15.

A lot of pediatricians are behind the legislation, he said, although there are many loopholes. Among the exemptions are a grandfather clause for ATVs owned prior to the rule being implemented and a provision stating that ATVs operated as part of a farm activity or hunting do not have to comply.

The cigarette tax, which jumped from 5 cents to 35 cents in 2005, is expected to generate $200 million a year for the state, Roosen said. Money will be earmarked into the general fund, with no designation for use made as yet, he said.

"Before it was passed, North Carolina was the second lowest in the nation for cigarette tax," Roosen pointed out.

Two other areas requiring action from the Health Department include accreditation and restrictions on the collection and use of Social Security numbers from patients.

Accreditation for Health Departments across the state is mandatory, Roosen said. With $700,000 in state funds, the Health Department stands to receive $25,000.

Proposed rules for accreditation were approved Dec. 15, he said, with the Wayne County department looking at becoming accredited by 2008.

What really "threw us for a loop" back in November were changes to how governmental agencies collect Social Security numbers, he said.

"It kind of took us by surprise," Roosen said. The internal policy to address Social Security use states that patients must be notified of how the number will be used.

Specifically, the department can no longer have the number listed on every page of medical records, he said.

"We can still collect numbers but cannot have it scattered throughout the records. It has to be in one place."

While staff can still collect Social Security numbers, Roosen said, "We're just careful about how we do it."

Other areas mentioned in Roosen's legislative report fell under environmental health. They included a proposal to authorize charging restaurants a fee for the local inspection, which did not pass, and a proposal for department contractor licensing that is still active but has not yet been passed into law.

A privatization rule allowing professional engineers and soil scientists to do a design system and make permitting decisions was also mentioned.

"Right now, it is only done by environmental specialists," Roosen said. "The main problem that we have is the liability issue."

He said the initiative has the potential to make the Health Department responsible for system failures, even though the department staff didn't design the system. It is therefore causing a lot of controversy, he said.

"We don't want to be sued for somebody else's decision if something goes wrong out there," he said.

In other business, the board also has changed leadership for the new year. At its meeting on Wednesday, Jeffrey Kornegay, an engineer, was voted in as chairman, succeeding Cynthia Wiley, a dentist.

Charles T. "Tommy" Gibson, a pharmacist, was elected vice-chairman. The 11-member board is made up of different factions from the community, including two public members.