HomeMy WebLinkAboutBOH minutes 092017MINUTES-Draft
ORANGE COUNTY BOARD OF HEALTH
September 20, 2017
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ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To enhance the quality
of life, promote the health, and preserve the environment for all people in the Orange County
community.
THE ORANGE COUNTY BOARD OF HEALTH MET ON September 20, 2017, at the Orange
County Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Liska Lackey – Chair, Susan Elmore – Co-Chair;
Johanna Birchmayer, Commissioner Mia Burroughs, Barbara Chavious, Paul Chelminski,
Jessica Frega, Sam Lasris and Timothy Smith.
BOARD OF HEALTH MEMBERS ABSENT: Bruce Baldwin and Jennifer Deyo.
STAFF PRESENT: Dr. Dorothy Cilenti, Interim Health Director; Coby Jansen Austin, Programs
and Policy Director; Alan Clapp, Environmental Health Director; Rebecca Crawford, Financial
and Administrative Services Director; Dr. Stephanie George, Dentist; Renee Kemski, Nutrition
Program Manager; Pam McCall, Personal Health Services Director; Kristin Prelipp,
Communications Manager; Ashley Mercer Rawlinson, Healthy Carolinians Coordinator; Kiana
Redd, Healthy Communities Healthy Homes Coordinator; Ana Salas, Dental Assistant; Beverly
Scurry, Board of Health Strategic Plan Manager; and La Toya Strange, Administrative Assistant
II.
GUESTS PRESENT: Chuck Rohre, Springsted Waters, Natalie Santos, UNC Student, Analisa
Sowells, UNC Student.
I. Welcome New Employees
There were no new employees in attendance.
II. Public Comment for Items NOT on Printed Agenda: None
III. Approval of the September 20, 2017 Agenda
Motion was made by Mia Burroughs to approve the agenda, seconded by Johanna
Birckmayer and carried without dissent.
IV. Action Items (Consent)
A. Minutes of August 23, 2017 Meeting
Motion was made by Sam Lasris to approve the minutes of August 2017 with the edit of
removing Paul Chelminski as present and placing him as absent. Motion was carried
without dissent.
V. Educational Sessions
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A. HCOC Update
Ashley Mercer Rawlinson, Healthy Carolinians Coordinator, gave an update on the current and
future activities of the HCOC committees regarding tackling goals that were identified in the
2016-2019 Community Action Plans. Below are some highlights.
Access
By March 2019, the Access committee will produce a transportatoin access
improvement activitiy guide and recruit 5 partner agencies to adopt one or more
activities listed within the guide.
• Transportation Survey
A survey was sent to service providers to get input on the barriers that their
clients/populations are experiencing when it comes to transportation. There
were 25 survey responses collected from providers representing the Health
Dept. PHS, Community Health Centers, UNC Healthcare, UNC Family
Medicine, etc.
Six questions were asked to get input on:
o The type of barriers,
o The type of transportation providers that service their
agency/organization,
o Whether or not their agency has staff that can connect clients to
transportation resources,
o What would they need to know or have on hand to help clients learn
about and use public transportation
o Would they be willing to identify 1-2 transportation champions within their
agencies?
• Transporation Barriers
The barriers that appeared the most were 1) bus stop not within walking
distance, 2) routes not going where people need them, 3) not knowing how to
use the transit system, and 4) cost.
When asked what would you need to know or have on hand, to help your
clients learn about and use public transportation, the highest response
related to information related to local bus service providers. This information
was used to help make the decision to host a Try Transit Week and Transit
Academy. Try Transit Week is October 23rd – 28th. The Try Transit Academy
events will be held at UNC Hospital, Hillsborough Campus on October 10th
and the Seymour Center on October 13th.
Mental Health & Substance Abuse
By March 2019, create a suicide prevention campaign to encourage residents to
access 911, the Suicide Prevention Lifeline, and Cardinal Access line as sources of
intervention, treatment and referral.
• Suicide in Orange County
o #BeThe1To:
This campaign highlights the fact that everyone has a role to play in
suicide prevention.
The campaign is partnering with local radio station K97.5 and with
Chapel Hill Transit.
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The 5 components of the campaign are to:
• Ask
• Keep them safe
• Be There
• Help them connect
• Follow up
September is Suicide Prevention Month. A kickoff event was held on
September 7th to share the importance of suicide awareness and
prevention, and allow participants to hear from those with a personal
connection to suicide. Guests included Jaki Shelton Green and Dean
Smith’s widow, Linnea Smith.
Physical Activity & Nutrition
By March 2019, the PAN committee will increase knowledge and influence behavior
change related to eating smart and moving more by encouraging 10 agency partners
to promote a county-wide consistent messaging campaign that will distribute
messages through a variety of established channels and media, over 6-months.
o There will be 6 messages shared over a 6 month period from October to
March via our campaign participants. They are, respectively, Move More,
Fruits and Veggies, Prepare More Meals at Home, Screen Time, Re-Think
Your Drink and Right Size Your Portions.
o Consistent Messaging Campaign Participants include OC Department on
Aging, CHCCS, OCS, Carrboro Rec & Parks, Kidzu, UNC Healthcare, No Kid
Hungry and OC Head Start/Early Head Start.
B. Employee Wellness-Nutrition Services
Renee Kemske, Nutrition Program Manager, provided an overview of nutrition services and the
new employee wellness nutrition initiatives. Below are some highlights.
Services provided include:
• Nutritional Counseling
Medical Nutrition Therapy (MNT) – provided by a Registered Dietitian who works
with the referring medical provider to improve conditions such as diabetes, heart
disease and obesity by conducting a thorough review of the individual’s medical
history, diet, labs, medications and lifestyle patterns to develop a personalized
nutrition treatment plan/goals to improve health outcomes. It’s evidence-based and
proven to work. Half of the participants’ counseled are referred by their physician.
• Diabetes Self-Management Education Program (DSME)
Patients receive 10 hours of education that include an initial health assessment, 2
four-hours group education classes on basic diabetes care and a follow-up (1 hour
group class) appointment 3 months after the group class. There is an 80% decrease
in A1C blood sugar amongst participants.
There is a sliding scale available and both services are available to Orange County employees.
Ms. Kemske also provided information on the wellness nutrition services. In November 2016,
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the County Manager approved the proposal to allocate wellness funds ($10,000) to support one
of the Health Department’s registered dietitians’ salaries to provide Nutrition Counseling and
Diabetes Self-Management Education services that are not covered by the County Health Plan.
The County Health Plan only covers nutrition services for people with diabetes, obesity,
hypertension and/or abnormal lipids. The purpose of these funds is to increase access to these
preventive services to keep employees well and to reduce health care costs due to uncontrolled
illness.
FY16-17 Service Data
29 Individual MNT Appointments
45 Group MNT Classes
2 DSME Appointments
FY17-18 Service Data
24 Individual MNT Appointments
8 Group MNT Class
3 DSME Appointment
Next steps include:
Coordinating outreach efforts with HR Wellness Initiatives
o Offering quarterly group MNT appointments
o Continuing individual appointments
o Disseminating promotional emails
o Continuing new employee orientation
Showing the need for continued use of funds as county funds may not be available
C. STOP Act
Dr. Stephanie George, Dentist, provided an update on the Act, which was signed in June,
whose purpose is to decrease the circulation and misuse of opioids in NC, which in turn will
reduce the overall mortality and morbidity from these drugs in this state. The Strengthen Opioid
Misuse Prevention (STOP) Act of 2017, or STOP Act, was intended to reduce the supply of
unused and misused opioids circulating in NC, reduce doctor shopping and improve care by
requiring prescribers to use tools/resources that help prevent inappropriate prescribing. Dr.
George’s presentation summarized the implications of the S.T.O.P. Act on the OCHD Dental
Clinic as well as outlined steps currently taken to reduce opioid dependence and its implications
for the clinic’s patients. Highlights include:
• The Act targets Schedule II and Schedule III opioids.
• Three people die per day in NC from opioid overdose.
• Over 1200 unintentional opioid deaths occurred in 2016.
• Effective September 1, 2017, pharmacists must input controlled substance prescriptions
into the North Carolina Controlled Substances Reporting System (NCCSRS) by the
close of business day. Previously, they had 3 days to do so.
• The NCCSRS database is real time and is updated immediately. Providers can check to
see if a prescription has been issued for a patient prior to writing a prescription.
• Pharmacist can also call provider if they feel a prescription may be fraudulent or if a
patient is misusing opioid.
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• Effective January 1, 2018, there is a limit on first-time prescriptions for acute pain to no
more than 5 days. Surgical procedures are limited to 7 days. Subsequent consultations
for same pain, can renew, refill, or issue new prescription of a controlled substance.
• Effective January 1, 2020, there will be electronic prescribing of targeted controlled
substances. They will be integrated with the NCCSRS database.
• OCHD Dental Clinic procedures include:
o Checking the NCCSRS before prescribing any opioid prescription.
o The baseline drug given is ibuprofen 800mg
o Opioid prescription is prescribed only if 1) the patient cannot take ibuprofen for
medical reasons; 2) multiple teeth were extracted; and 3) surgical extraction of
teeth with bone removal, requiring extensive healing.
o No more than 15 tabs per procedure.
o No refills within 30 days.
o Flag/monitor patients who may be drug seekers.
The BOH had questions that were addressed by Dr. George.
D. Men’s Primary Care Update
Pam McCall, Personal Health Services Director, began by stating that the program which began
as a pilot program in February 2016 to refer male Orange County residents to Family Centered
Healthcare. The program was designed to provide low-income males, specifically those from
northern Orange County, with access to low-cost primary care. Ms. McCall gave a brief update
on its progress. Highlights include:
• There were 53 men referred between 7/1/16 and 7/30/17. There were 55% that kept
their appointments.
• There were 42 unique patient (unique patient is equivalent to 1 patient) visits in FY 16-17
in which 30% were referred in FY 15-16.
• Most of the patients hear about the program by calling when looking for healthcare
needs. The 2nd most popular method of contact was when a family member called on
their behalf.
• The total amount expended by OCHD is $13,347. The OCHD doesn’t pay for specialist
care. Patients needing these services can apply for charity care through UNC. The
average amount expended by OCHD per patient is $318. The amount was $253 in FY
15-16. The average amount expended by the patient is $28. In FY 15-16, it was $47.
More than half (64%) of patients paid nothing as they slid to 0% on the sliding scale.
• The months with the largest number of visits to Family Centered Healthcare were July,
September, October and March.
• The most frequent diagnoses were primary hypertension, major depressive disorder,
obesity and type 2 diabetes without complications.
• Transportation has been an issue; however, the HCOC, as well as other agencies, is
working on this issue.
• There isn’t enough information as of yet to spot trends; although, the OCHD feels that
this is a successful program and an effective way to treat this population.
The BOH had questions that were addressed by Ms. McCall.
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VII. Reports and Discussion with Possible Action
A. Health Director Report
In addition to her report, Dr. Cilenti mentioned that this is Alan Clapp’s last BOH meeting as he
is retiring at the end of this month. She thanked him for all of his work as the Environmental
Health Director. Mr. Clapp said that he felt honored and thanked everyone for their support.
John Kase will serve as the interim Environmental Health director effective October 2nd . Dr.
Cilenti also mentioned an article found by Commissioner Mia Burroughs that was distributed to
the BOH members that adds to the information that the BOH has previously received in the past
regarding the harmful effects of vaping.
Coby Jansen Austin gave a brief description of the Department of Social Services (DSS)
process for obtaining child care subsidies while highlighting the struggles/barriers faced by
families needing to obtain those subsidies. She then stated that the DSS board allocated
resources to cover the full fee for all of the OCHD FSA families while requesting documentation
of their income only.
B. Media Items
Media items were in the packet which focused on Orange County’s events and our
involvement in various efforts.
At 8:00pm, Mia Burroughs motioned to move into closed session and Barbara Chavious
seconded.
VIII. Closed Session to Discuss Health Director Recruitment
During the closed session, the Board of Health discussed the recruitment process with
Mr. Rohre.
IX. Adjourn to Open Session
Barbara Chavious motioned to move from closed to open session and Jessica Frega
seconded.
X. Board Comments.
None.
XI. Adjournment
Mia Burroughs moved to adjourn the meeting at 9:00pm and Barbara Chavious
seconded.
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ORANGE COUNTY BOARD OF HEALTH
September 20, 2017
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The next Board of Health Meeting will be held October 25, 2017 at the Orange County
Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m.
Respectfully submitted,
Dorothy Cilenti, MSW, MPH, DrPH
Orange County Interim Health Director
Secretary to the Board