May 28, 2020
On Tuesday May 26 Foothills Health District (FHD) had their board meeting in the Rutherford County Annex Building. It was streamed live from the Rutherford County Commissioner’s chamber.
Foothills Health District is the organization in charge of the McDowell and Rutherford County Health Departments as well as the organization that handles all the reporting of Covid-19 testing and policy for the State in Rutherford/McDowell counties. As they are a State mandated board they are not under the County Commissioners of either McDowell or Rutherford County however a Commissioner from each county must sit on the Board and nominates members who serve on the Board.
Several members of the Board attended via conference call due to the current Covid-19 situation. There were a total of four (4) members present and three (3) on the phone out of thirteen (13) members.
I presented several written questions via email to the Board to be read during public comments. It was stated at the meeting that the Board did not answer questions during public comments but that the questions were noted for the record. They do not normally accept questions presented in this manner and require the public to be present for comment but did make an exception in this case.
My email was as follows:
“Due to my current health status I will not make a personal appearance at the meeting but will watch the stream. I did not see a Zoom type option to join in for questions so I am sending them to you (Greg Lovelace) as my county representative on the Board. Could you please share the following questions and comments with the Board?
1) I have emailed the entire Board for a response with the emails provided on the web site. I received a response only from you and Lynn Greene, who have separate emails from Foothills Health District. Are the other Board members receiving their emails?
2) I have had great difficulty accessing links on the website, especially concerning meetings of past meetings. Is this something the Webmaster could address.
3) What local enforcement agencies are working with the department when a violation of the Executive Order is noted? Who determines who is charged with misdemeanor violations?
4) How does the District plan to handle violations of the Executive Order such as the recent openings of local gyms and fitness centers? Who determines the regulation and safety of such establishments?
5) Are local businesses notifying Ms. Powell when they have a positive case in their establishment? Are other agencies notifying Ms. Powell of positive cases that reside outside our district that have direct contact with and are employed in local businesses?
6) Recently the Rutherford County Clerk of Court published a notice of closing due to a positive Covid-19 case. Is Foothills Health District encouraging employers to come forward and notify the public when this occurs? Do they plan to notify the public in the future in the interest of public safety?”
One of these questions was answered during Karen Powell, Director of FHD’s presentation to the board. Question #3) What local enforcement agencies are working with the department when a violation of the Executive Order is noted? Who determines who is charged with misdemeanor violations? (Ms. Powell in her report to the board noted that when her office receives a report that someone or some business is in violation of the Governor’s Executive Order she will notify the appropriate law enforcement agency of the area involved and it is their responsibility to visit the person/business, observe and cite them for any violations if they so choose to.)
I will follow up with the other questions as I am sure they will include conferring with other staff members for answers.
Ms. Powell’s report to the board was as follows. She said FHD had started preparing for a response to this virus in January of 2020. There was no concept however of how fast it would grow by March when the plan became active. As of Tuesday FHD was in day 75 of emergency operations. One of the major roles of FHD is to test patients and trace contacts in any type of communicable disease. As Covid-19 became the number one pressing issue all other non-critical functions of the health departments ceased and staff focused exclusively on Covid-19 testing and tracing. As of Tuesday the health departments of both McDowell and Rutherford County opened back up for full services to their clients.
If a person tests or is reported positive to FHD then that person must be quarantined for 14 days and their status is checked on daily. FHD tries to do 2-3 contact tracing. (if a person had direct contact with a positive then that person had direct contact with someone else) When it is only a limited number of positives that is not overwhelming but when cases increase to 10 or more at a time that involves a large number of people that must be individually contacted. The Governor has recently noted that he wants 5% of the population tested per month and that averages aprox. 200/day in Rutherford County.
Testing is done by the Health Department, hospitals and private physician offices but all positives do come in to FHD for reporting. The reported numbers reflect all these test results. There have been some delays in reporting due to different systems being used but the State has streamlined that into a single system that should help which goes online Thursday 5/29.
There have been two business outbreaks that affect both Rutherford and McDowell counties. There were not identified in the meeting. There is a business group being tested in McDowell county and a mass testing event scheduled for Rutherford County on Friday 5/30. One of the parameters of success for FHD is to get as many potentially positive people quarantined as possible to stay safe however it is becoming more apparent that community transmission (no direct contact with a positive) is on the rise and that is very concerning. The message is that everyone must be very careful and use all available precautions.
She also stated that if they were notified of any violations of the Executive Order that it was totally up to local law enforcement to enforce and charge individuals or businesses. They will make sure that law enforcement are aware of any reported violations.
BOH Question: How is staffing.
K.Powell: Staffing is adequate at this time and the department is trying to schedule them some time off as all have been working nonstop during this crisis.
BOH Question: What happens when a positive result is received.
K.Powell: If a person tests positive then the person and their employer is notified. Testing is offered to any contact and all coworkers of the affected employee and FHD helps to provide or make available personal protective equipment (i.e. masks) if needed.
BOH Greg Lovelace’s Question: Are positives retested again for a negative result or are they just considered negative after a period of time?
K.Powell: Certain jobs get a second test. Any positive health care worker must have a second test and report negative before returning to work. She then went on to say it is not as simple as just testing negative. They have had a positive person test negative and then re-test positive. This will not count as a new positive case on the daily count. Any person who has tested positive can request another test to see if they are negative if they ask..
BOH Question: Is antibody testing being done.
K.Powell/BOH Dr. DeLaGarza: Antibody testing is not accurate at the present time so is not considered a useful tool.
The 2020 budget was discussed with Board and the fact that FHD is currently 600k over budget and must make some serious cuts.
K.Powell: We have made some hard cuts (163k) in budget, a possible 25k in misc cuts and are looking at possibly 200k in grants but it still leaves us 200k short. We are working with the counties we represent to try to decrease some of the expenses we pay for or have the counties cover them. We must perform multiple state mandated programs (such as TB and HIV testing) so we are not able to cut those at all.
BOH Question: Will State provide any extra money to cover for Covid-19 expenses?
K.Powell: The money from the CARES act will be paid to the individual counties to disperse. We are hopeful some of that money will be released to FHD.
BOH Question: Can FEMA help?
K.Powell: FEMA is highly restrictive and operates on a “spend money to get money” policy. FHD just does not have the money to spend. Environmental health is another State mandated program that cannot be cut yet is not fully funded. There are lots of obligations tied to State funds that do not cover the cost of operations.
Environmental Health then gave their report: “We are requiring that all items for inspections must be complete before we will come out. We are receiving phone calls about law enforcement issues that have to be referred. We have been decentralizing staff by working at home. Food and Lodging is also doing that with “virtual inspections” showing temps, and viewing via cameras. Food and Lodging will “mirror” their documented performance from last month instead of actual performance of this month due to circumstances so they show they meet 100% compliance.
Face to face inspections are expected to resume 5/28. Restaurants will have to now meet regular compliance as to where food is stored for take-out procedures. A 70k grant from FDA has been applied for and they are seeking a 15k grant for septic.”
It was stated that the budget numbers must be done by June so they all had work to do to get that ready. No future meeting date was given.