STATE OF NORTH CAROLINA                    )                    OFFICE OF THE COMMISSIONERS

                                                            )                    STOKES COUNTY GOVERNMENT

COUNTY OF STOKES                                    )                    DANBURY, NORTH CAROLINA

                                                            )                    MAY 9, 2006




            The Board of Commissioners of the County of Stokes, State of North Carolina, met


for special session to discuss the proposed Stokes Health Services Alliance Strategic Plan in


the Commissioners’ Chambers of the Ronald Wilson Reagan Memorial Building


(Administrative Building) located in Danbury, North Carolina on Tuesday, May 9, 2006


at 6:00 pm with the following members present:


                                                Chairman Leon Inman

                                                Vice-Chairman Joe Turpin

Commissioner Sandy McHugh

Commissioner John Turpin

                                                Commissioner Jimmy Walker


                                                County Personnel in Attendance:

                                                Clerk to the Board/Interim County Manager Darlene Bullins


Stokes Health Services Alliance Board Members in Attendance:

                                                Chairman Frank Duncan

                                                President Doug Atkinson

                                                Vice President Mike Kimel

                                                Interim Secretary Darlene Bullins

                                                Commissioner Sandy McHugh – Member

                                                Mr. Crow McGee – Member


                                                Other Alliance Attendees:

                                                Lance Labine – Administrator –Stokes Rey. Mem. Hospital

                                                Heather Hayes – Strategic Planner -NC Baptist Hospital

                                                Director Meghan Shapiro – Outpatient Services-SRMH

                                                Health Director Don Moore – Stokes County

                                                Cathy Long – Director Stokes Opportunity Center/CenterPoint

                                                Jim Graham – Central Piedmont Access II

                                                EMS Director Monty Stevens



Chairman Leon Inman called the Special Session to discuss the proposed Stokes


Health Services Alliance Strategic Plan.


Chairman Inman delivered the invocation.




            Chairman Inman opened the meeting by inviting the citizens in attendance to


join the Board with the Pledge of Allegiance.



Chairman Inman welcomed those in attendance for the special meeting.





            Chairman Frank Duncan – Stokes Alliance expressed appreciation to the Board


for the special session to discuss the proposed Stokes Health Services Alliance Strategic


Plan.  Chairman Duncan, on behalf of the Stokes Health Services Alliance, requested the


Board’s consideration for approval of the Strategic Plan.


            Ms. Heather Hayes, Strategic Planner -NC Baptist Hospital has been working with


the Health Alliance during the development of the Strategic Plan.  Ms. Hayes briefly


explained the process of getting to the final product- proposed Strategic Plan.  Ms. Hayes


explained the proposed Health Services Alliance Strategic Plan:




Ms. Hayes presented and discussed the following Ranked Action Item List


developed at the recent Board Retreat held in January 2006:


Stokes HSA Planning Retreat

Ranked Action Item List


1.   Evaluate the most appropriate use of the three Stokes Reynolds health care facilities.

=> Can they be used to house new services needed in the County that various agencies can provide?

2.   Centralize and distribute ALL available Stokes County health care information.

=> Healthy Carolinians can be used as a central point from which information can flow regarding available providers, health screenings, educational opportunities, etc.

=>Improved community knowledge of and access to mental health services among all   

       populations (including coordination among the new providers)

        i.   Limiting patient confusion re: available services, providers, and


ii   Challenge: to serve ALL parts of Stokes County

=> Raise awareness of/increase access to services provided by Hospice of Stokes County for

      Stokes County patients in the Novant and Wake Forest University Baptist Medical Center

       health systems.

i.     There are many benefits to providing hospice care close to home,

ii.    Would reclaim lost revenue for Stokes-Reynolds.

               => Educational Program

                      i.   Lunch and Learns throughout the County relating to the 5 Priority

             Health Issues

 => Physical Activity Resource Guide

i.    Assessment of county for opportunities and barriers to physical


ii.   Collection of updated information, development of brochure, and distribution

3.               Provision of Emergency and Crisis Mental Health Services/Suicide Prevention 

đ             Implementation of Proposed Crisis Response Network

đ             Continued Emergency Responder Training

đ      Improved efficiency of Involuntary Commitment Process

đ      Partners: Healthy Carolinians and CPA II, who has a goal of improving behavioral health service quality and access

4.   FQHC in Stokes County

=> Potentially a joint venture with Stokes-Reynolds in Danbury


5.   Decrease EMS unit response times

=> Restructure ambulance response districts and/or deploy additional units

(Emergency Response vehicles, not ambulances)

=> Obtain EMS Model System Status.

=> Certify all EMS personnel to National Registry Standards.

6.   Garner grassroots support of the Stokes HSA

=> Informing the citizens, eliciting their input, and getting their buy-in

7.   Resources inventory and gap analysis for Stokes County

=> An inventory of ALL healthcare services in the County, not just Public Health

i.   May include the Medical Manpower plan that has already been


ii.   Will involve a broad definition of "health," which is impacted by economic development, etc.

8.   Pursue investigation of the feasibility for an outpatient clinic in King for eligible Stokes County veterans.

9.   Dental Care

=> Providing access to Dental Care i.e. Dental Clinics/Bus at Health Fairs, Senior Centers and/or Health Department

10. Support a health care needs assessment of Stokes County veterans, in cooperation with the VMAC in Salisbury, NC.

11. Increase utilization of existing inpatient hospice beds in Stokes County.

12. Develop a communication strategy between hospitals, community providers and service organizations to facilitate improved access to healthcare services via the CPA II program.

đ             Community Care Steering Committee

đ      Medical Management Committee

đ      Elect officials of these committees and formulate policy on their action and meeting frequency

13. Collaborate with State initiatives on management of Aged, Blind, and Disabled enrollees (CPA II).

=> This is a population that is new to the Medicaid program.




            The Board discussed the following regarding the proposed Strategic Plan:


·         Urgent need to get valuable health information out to the Public

·         Ways to get the information out to the Public

·         Explaining the Health Alliance to the Public

·         Selling the Health Alliance to the Public

·         Stokes Hospice being utilized by Stokes County citizens

·         Mental Health services in Stokes County  (Danbury, King)

·         Mental Health Reform – the past, present and the future

·         Alliance being a non-profit organization

·         EMD Training for EMS and Communication

·         Funding to be available through the Alliance that might not be funded by the County

·         Non-profit Funding possibly being provided to County Departments that would otherwise not be available to County Departments

·         Competition between the two major hospitals (NC Baptist and Forsyth)

·         Need for Veteran Health Care Outpatient Clinic in Stokes County

·         Using existing facility in Stokes County  for VA Outpatient Clinic to possibly serve Stokes, Surry, Yadkin, and Rockingham Veterans



Commissioner Walker directed the following question to the Alliance members:


“Is there any chance that there is anything the Health Alliance is doing that will in anyway restrict or limit any options a Stokes County citizen has to any source of medical care?”


President Atkinson responded that the Alliance is trying to create “more options”


through greater communication and cooperation between all Health care providers in Stokes


County. Vice President Kimel also noted that services are being brought to Stokes County


instead of Stokes County going to the services (most likely Winston Salem). Vice President


Kimel also referenced the Stokes Health Services Alliance Mission statement:


·         The Health Services Alliance, a non-profit organization, was established as

a collaboration among the health care providers, county governments, and community of Stokes County, in conjunction with the partnership between North Carolina Baptist (NCBH) and Forsyth Medical Center (FMC) to expand health care access for rural populations in Stokes County.  The Alliance is charged with exploring and recommending appropriate organizational models that will support quality, cost-effective sustainable community based health care in Stokes County.  Models well be selected

based on the health care priorities of the community and the availability of resources.


            Commissioner Walker directed the following question to President Doug Atkinson


and Vice President Mike Kimel:  “Why the County (government) should be involved with


Forsyth and NC Baptist Hospital”.


            President Atkinson responded:


·         Major health care assets in Stokes County

·         Utilization of assets in the County and getting the most from those assets

·         To partner and collaborate to help leverage assets in a better manner

·         To help absorb losses in order to help keep Stokes Reynolds Memorial Hospital


Vice President Kimel responded:


·         Critical in keeping the collaboration together, focused, and being successful

·         County government involvement keeps the collaboration together



President Doug Atkinson briefed the Board on the next steps for the Alliance:


·         Alliance has received its 501(c) (3) non profit status from IRS retroactive to July 8, 2004

·         Non-profit status allows access to grants, donation, and special funding such as Kate B Reynolds, etc.

·         Free Grant writing to be provided by NC Baptist

·         Taking the information to the citizens in the County

·         Assisting with getting the best available health care to all citizens of the County

·         Reminder that this Alliance operates at the pleasure of the Board of Commissioners


President Atkinson concluded by requesting the Board of Commissioners endorse


the submitted proposed Stokes Health Services Alliance Strategic Plan, which will allow


the Alliance to begin work to help deliver the best available health care to all residents of


Stokes County.




            Vice Chairman Joe Turpin moved to approve and accept the Stokes Health Services


Alliance Strategic Plan and Planning Retreat Ranked Item List.  Commissioner John Turpin


seconded the motion.


            The Board discussed the motion to approve the proposed Strategic Plan.


            Commissioner Walker expressed concerns regarding voting on the issue


immediately.            Commissioner Walker requested to postpone the vote until the next regular


meeting in order to allow members to review the Strategic Plan which was given to the


Board in February 06. 


            Chairman Inman reiterated voting on the issue at the next regular meeting in order to


allow members to review the proposed Strategic Plan. 


            Commissioner McHugh expressed appreciation to NC Baptist and Novant Health


officials giving up their time to work together to help the citizens receive the best health


care available.  Commissioner McHugh noted the need to vote on the issue immediately in


order to allow the Alliance to get started on their goals.


            Commissioner John Turpin expressed appreciation to the Alliance for their efforts


to help access better health care for Stokes County residents. 


            Vice Chairman Joe Turpin expressed appreciation to the Alliance and both hospitals


for working together provide better health care for Stokes County.


            The motion carried (4-1) with Commissioner Walker voting against the motion.


            Chairman Inman expressed appreciation to all those in attendance and the work


that has been done to help provide better health care access to the citizens of Stokes County.


Chairman Frank Duncan concluded with the following:


·         Being appointed as the citizen on the Alliance, I was not associated with either hospital or Board and  had many questions as did Commissioner Walker and others

·         Being on the Board has been a very educating experience to find out what the Alliance is really about and what is going on in the County regarding health care services

·         No agenda at any meeting has been pushed by Baptist or Forsyth Hospitals

·         Alliance plans to apply for grants to save tax dollars

·         Pulling organizations together to apply to grants not otherwise available

·         Everything that I have seen is positive

·         In my opinion, Alliance is wanting to provide better health services to Stokes County residents



Chairman Inman expressed appreciation to all those in attendance.




            There being no further business to come before the Board, Chairman Inman


entertained a motion to adjourn the special session.  Commissioner John Turpin moved to


adjourn the special session.  Commissioner Walker seconded and the motion carried











_________________________                                  _____________________________

Darlene M. Bullins                                                         J. Leon Inman

Clerk to the Board                                                     Chairman