HomeMy WebLinkAboutBOH agenda 042617ORANGE COUNTY BOARD OF HEALTH
MEETING AGENDA
DATE: April 26, 2017
TIME: 7:00 P.M.
PLACE: Whitted Building, 3rd Floor Meeting Rooms
300 West Tryon Street
Hillsborough, NC 27278
TIME ITEM
7:00 p.m. I. Welcome New Employees
7:00 – 7:05 II. Public Comment for Items NOT on Printed Agenda
Public Comment for Items ON Printed Agenda will be
handled during that agenda item
(Please sign up for both on sheet near the entrance to room.)
Please limit your comments to 3 minutes.
7:05 – 7:10 III. Approval of April 26, 2017 Agenda
7:10 – 7:15 IV. Actions Items (Consent)
A. Minutes of March 22, 2017 Liska Lackey
7:15 – 8:00 V. Educational Sessions
A. Animal Services Update Bob Marotto
B. 3rd Quarter Financial Reports & Billing Dashboard Rebecca Crawford
C. Advisory Board Update Beverly Scurry
8:00 – 8:10 VI. Action Items (Non-Consent)
A. Board Reappointments Liska Lackey
8:10 – 8:15 VII. Reports and Discussion with Possible Action
A. Health Director Report Dorothy Cilenti
B. Media Items
8:15 – 8:45 VIII. Closed Session to Discuss Health Director Recruitment
Closed Session (ref. NCGS 143-318.11(a)6) to consider the qualifications, competence
performance, fitness, conditions of appointment, of an individual public officer or
employee, or prospective public officer or employee; or to hear or investigate a complaint,
charge, or grievance by or against an individual public officer or employee.
8:45 – 8:50 IX. Adjourn to Open Session
8:50 – 8:55 X. Board Comments
8:55 XI. Adjournment
BOARD MEMBERS: To ensure a quorum, SEND E-MAIL to lstrange@orangecountync.gov advising her of
your attendance at this meeting OR CALL 919-245-2411.
Compliance with the “Americans with Disabilities Act” and Title VI - Interpreter services and/or special sound equipment
are available on request. Call the Immigrant and Refugee Health Program Manager at 919.245.2387 to request an interpreter
or other accommodation.
Conforme a la “Ley sobre Estadounidenses con Discapacidades” (ADA) y el Título VI – los servicios de intérprete y/o
equipo de sonido especial están disponibles a solicitud. Llame a la Administradora del Programa de Salud para Inmigrantes
y Refugiados al 919-245-2387 para solicitar un intérprete u otros arreglos o adaptaciones.
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ORANGE COUNTY BOARD OF HEALTH
March 22, 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 March 22, 2017, at the Orange
County Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Liska Lackey – Chair, Susan Elmore, Vice-
Chair, Commissioner Mia Burroughs, Barbara Chavious, Paul Chelminski, Jennifer Deyo,
Jessica Frega, Sam Lasris, Reena Mehta and Timothy Smith.
BOARD OF HEALTH MEMBERS ABSENT: None.
STAFF PRESENT: Dr. Dorothy Cilenti, Interim Health Director; Alan Clapp, Environmental
Health Director; Rebecca Crawford, Finance & Administrative Services Division Director; Ashley
Mercer, Healthy Carolinians Coordinator; Pam McCall, Personal Health Services Director; Dr.
Erica Pettigrew, Medical Director; Kiana Redd, Healthy Communities Healthy Homes
Coordinator; Stacy Shelp, Communication Manager; Juliet Sheridan, Applied Public Health
Informatics Fellow; La Toya Strange, Administrative Assistant II and Allison Young, Health
Informatics Manager.
GUESTS PRESENT: None.
I. Welcome New Employees
Liska Lackey, Chair, called the meeting to order. Dr. Cilenti welcomed the new employees in
attendance: Teresa Clay, Katy Foust, Jennifer Reinert and Iulia Vann.
II. Public Comment for Items NOT on Printed Agenda: None
III. Approval of the March 22, 2017 Agenda
Motion was made by to Mia Burroughs approve the agenda, seconded by Susan Elmore
and carried without dissent.
IV. Action Items (Consent)
A. Minutes of February 22, 2017 Meeting
Motion was made by Susan Elmore to approve the minutes of February 2017, seconded
by Paul Chelminski and carried without dissent.
V. Educational Sessions
A. Strategic Plan/Patient Texting Update
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ORANGE COUNTY BOARD OF HEALTH
March 22, 2017
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Rebecca Crawford, Financial and Administrative Services Director, began by informing the
Board that a new BOH liasion, Beverly Scurry, has been hired and will be starting on April 3rd.
Next, she presented highlights of the achievements accomplished to date centered around the
four priority areas of Social Determinants of Health, Physical Activity and Nutrition, Substance
Abuse and Mental Health and Engagement.
Highlights of Ms. Crawford’s presentation include:
Social Determinants of Health
Focus #1: Family Success Alliance (FSA)
o There will be an update later this fall.
Focus #2: Policies improving access to care
o Patient/Client text messenging
• The contract with the vendor is currently in our finance office awaiting signatures.
The staff has formed superuser groups. We’ve identified the initial phase one
groups (which patients we want to text). The focus will be in the medical and
dental clinics. We will be contacting patients via text, email and use automated
voice reminders of appointments. This low cost contract has the potential for
success as it will decrease patient no show rates and alleviate some of the
workload for the office assistants. We should also see some increased revenue
because of this service.
• On November 30th, UNC Public Policy Capstone students gave a presentation on
the availability of OTC birth control. We are following one of their
recommendations which was to wait to see how OTC birth control plays out in
California. We will revisit this issue in the fall.
Physical Activity and Nutrition
Focus #1: Advocate for policies, practices, partnerships
o Our new partnership is the Summer Feeding Program at Gateway Village
Apartments. We’re partnering with Orange County (OC) Schools, the FSA and local
churches and local non-profits to pilot this program. We’ve also partnered with OC
Libraries as they will offer literacy support during the Summer Feeding Program.
Focus #2: Evidence-based PA/nutrition interventions in schools
o Last fall, members of the Chapel Hill-Carrboro and OC school districts came and
gave presentations on physical activity assessments of their school districts. We are
still in communication with leadership at both school districts to determine how we
can partner with them. The Physical Nutrition and Activity subcommittee will continue
to work on this.
Substance Abuse and Mental Health
Focus #1: Catalyst for integrated care
Focus #2: Advocate for improved services for vulnerable pops
Updates were reported on at the January 2017 BOH meeting.
Engagement
o We’ll have an Advisory Group update at the April BOH Meeting.
Lastly, Ms. Crawford provided two exciting updates.
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ORANGE COUNTY BOARD OF HEALTH
March 22, 2017
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• As of March 2017, 100% of law enforcement agencies in OC are equipped with
naloxone. The Sheriff’s office reported 3 reversals and Carrboro Police have reported 5
reversals with the use of naloxone.
• FIT (fecal immunochemical test) which look for blood in stool are being offered. The test
can be done at home.
The BOH members had questions that were addressed by Ms. Crawford.
B. Dashboard Review
Juliet Sheridan, Applied Public Health Informatics Fellow and Allison Young, Health Informatics
Manager, presented the 2017 annual public health dashboards for OC. The topic areas of the
nine dashboards were:
• Substance Abuse and Mental Health,
• Tobacco and Respiratory Disease,
• Chronic Disease,
• Physical Activity and Nutrition,
• Social Determinants of Health: Poverty Mitigation,
• Social Determinants of Health: Access to Care,
• Sexually Transmitted Infections,
• Maternal and Infant Health, and
• Injury and Violence.
The dashboard are published yearly and posted on the website. Some of the highlights from
the topics they presented on are as follows:
Drug and opioid overdose mortality rates in OC are increasing. More than a ¼ of OC
opioid deaths from 2009-2013 came from Hillsborough which makes up only 5% of OC’s
population. In OC, 1 in 3 high school students have tried e-vapor products; 1 in 5
students is a current user of e-vapor products.
OC performs well on most chronic disease indicators; however, the prevalence has
increased in the last decade. Diabetes mortality rate has increased 30% over the last
two years. Breast cancer mortality has been declining; while the incidence has been
steadily rising with a 15% increase per year.
The percentage of low income children who are uninsured (12%) is higher than in our
surrounding counties, the state and the nation.
OC has one of the highest rate of income inequality. There are fewer people with most
of the wealth.
The incidence of most STIs have increased. Gonorrhea has increased 10% and HIV
infection has increase 27%.
There has been a small decrease in infant mortality. African-American infants are more
than 3 times likely to die as non-Hispanic white babies in OC.
Ms. Young acknowledged some challenges and data gaps. She noted that there may be some
inconsistency as the base population may change year to year. The continuity of data collection
and methodology and data quality were also mentioned as challenges. She also stated that
they would prefer to have information that was aggregated by demographics and place-based
(i.e. where they live).
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ORANGE COUNTY BOARD OF HEALTH
March 22, 2017
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Ms. Young continued by stating that their goals for next year include:
• Expanding the audience for dashboards
• Setting local targets for indicators
• Incorporating more equity measures
• Developing linkage between clinic and county indicators
• Continuing to build relationships with UNC hospitals
• Identifying alternative data sources
The BOH members had comments and questions that were addressed by Ms. Sheridan
and Ms. Young.
C. State of the County Health Review
Ashley Mercer, Healthy Carolinians Coordinator, presented the 2016 State of the County Health
Report (SOTCH). The SOTCH is a report that is produced every year in between the
Community Health Assessment (CHA). Social Determinants of Health, Physical Activity &
Nutrition and Mental Health & Substance Abuse are the three areas that are focused on in the
report. Below are highlights from Ms. Mercer’s presentation.
Social Determinants of Health
o Mortality rates have slightly decreased.
o 12.1% of the population under 65 years old is uninsured compared to 15.3% in 2013.
o 14.7% of our population lives in poverty and approximately 29% of OC families with
children cannot meet their basic needs.
o OC ranks 2nd among all counties in NC in income inequality.
o Pilot a transportation access improvement activity plan that would offer suggestions
such as: designate staff to answer questions regarding transportation or have a
space where this information can be displayed.
Physical Activity & Nutrition
o There are still approximately 50% of our community that is not physically active or
getting the recommended amount of exercise, ¾ of our community are not eating the
recommended servings of fruits and veggies and approximately 50% are not a
healthy weight.
o The BOH has action plans to advocate for and pursue policies, practices and
partnerships aimed at increasing access to healthy foods and safe places for
physical activity. One way of doing this is to explore the option to provide incentives
to food retailers to be present in and/or offer healthier food and beverage choices in
underserved areas (food deserts) with the help from the Orange County Food
Council of which Ms. Mercer is the OCHD representative.
o The BOH also has plans to work to increase physical activity and improve nutrition in
schools by seeking local funding partnerships to provide small grants, for school
staff, to implement in-class or other short activity breaks during the school day.
Mental Health & Substance Abuse
o We are ranked #1in the state when it comes to the number of opioid prescriptions
(.52) or pills prescribed per resident (34.5), in 2016 (this is an average). So for every
100 residents, 52 had an opioid prescription in 2016.
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ORANGE COUNTY BOARD OF HEALTH
March 22, 2017
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o The rate of suicide has decreased from 10.4 to 8.8 in OC. By September 2017,
Healthy Carolinians of OC will implement a county-wide suicide prevention campaign
during Suicide Prevention Month which is in September that will encourage residents
to access 911, the Suicide Prevention Lifeline, and Cardinal Access line more as
sources of intervention, treatment and referral.
o Cigarette use is decreasing among NC youth, overall tobacco use is increasing,
driven in large part by use of e-cigarettes and hookah.
o There is a lot of work being done in this area that the community can benefit from
including:
• In March 2016, you the Board voted & approved – and forward to the BOCC
for action – a request for one additional Clinical Social Worker to provide
integrated behavioral health services as part of the Health Department’s
clinical services. Within its first 10 months, the OCHD served 145 patients,
with 341 patient visits.
• 5 lock boxes: all 3 law enforcement offices, sheriff office and the OC
Courthouse (which is likely going to be transferred to Hillsborough
pharmacy).
• The Health Department’s Medical Reserve Corps (MRC) was awarded
$15,000 in 2016, through the National Association of City and County Health
Officials (NAACHO) to prevent illegal access to opioids through the
distribution of home medicine lock boxes.
• OCHD became the first health department in NC to implement a Naloxone
program with Public Health Nurses providing kits, free of charge, to those in
need
• The Health Department has been exchanging needles for drug users and
patients of diabetes since April 2016. The syringe packages include an
immunity card accepted by local law enforcement, 20 syringes, condoms, and
information on drug abuse and overdose prevention, HIV, AIDS, and HCV
(Hepatitis C Virus) transmission prevention, and referral information for
services offered at the OCHD. In 2016, the Health Department distributed a
total of 22 kits.
Ms. Mercer added that this report is disseminated to the NC DPH, BOH, BOCC, HCOC
membership and OC Government employees. Electronic versions are available online via the
HCOC and OCHD websites. Lastly, Ms. Mercer reiterated that per Benchmark 38, Activity 38.2,
for accreditation purposes, the BOH minutes should reflect that the BOH member have received
and reviewed the SOTCH report.
The BOH members had comments and questions that were addressed by Ms. Mercer.
VI. Reports and Discussion with Possible Action
A. Health Director Report
In addition to her report, Dr. Cilenti added that the County Health Rankings will be released on
March 29th. Historically, OC ranked well amongst the counties in NC. The OCHD will celebrate
National Public Health Week from April 3rd through April 9th. Stacy Shelp will capture what the
OCHD is doing via social media.
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ORANGE COUNTY BOARD OF HEALTH
March 22, 2017
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Dr. Cilenti mentioned the visit to the SHSC by the Office of Population Affairs (OPA) which
administer the Title X program. Dr. Cilenti also spoke about the new BOH appointment of
Johanna Birckmayer. There were also a few other bills of interest Dr. Cilenti mentioned. There
are:
• HB 387 Healthy Corner Store
• HB 250, S131, S24 – Allows restaurants to use outside grills
• SB 290 Medicaid Expansion Bill
B. Media Items
Media items were in the packet which focused on Orange County’s events and our
involvement in various efforts.
Susan Elmore motioned to move into closed session and Jessica Frega seconded.
VII. Closed Session to Discuss Health Director Recruitment
During the closed session, the Board of Health discussed candidates for the health director
position.
VIII. Adjourn to Open Session
Barbara Chavious motioned to move into open session and Paul Chelminski seconded.
IX. Board Comments.
Coby Jansen Austin (via phone) shared an opportunity for the BOH members to attend the
Racial Equity Institute training.
X. Adjournment
Susan Elmore moved to adjourn the meeting at 8:45pm and Sam Lasris seconded.
The next Board of Health Meeting will be held April 26, 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
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: April 26, 2017
Agenda Item Subject: Animal Services Update
Attachment(s): Animal Services Update - presentation
Staff or Board Member Reporting: Guest Speaker Bob Marotto
Director of Orange County Animal Services
Purpose: ____ Action
_ x_ Information only
____ Information with possible action
Summary Information:
Bob Marotto, Director of Orange County Animal Services, will discuss rabies control and
the county’s efforts to more humanely and effectively manage free roaming cats. He will
also identify animal sheltering trends and will explain the recent enactment of a unified
animal ordinance in Orange County.
Recommended Action: ___Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to _______________
_x_Accept as information
___Revise & schedule for future action
___Other (detail):
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: April 26, 2017
Agenda Item Subject: 3rd Quarter Financial Report FY 16-17
Attachment(s): 3rd Quarter Financial Report
3rd Quarter Billing Dashboard
Staff or Board Member Reporting: Rebecca Crawford
Purpose: ___ Action
_X_ Information only
___ Information with possible action
Summary Information:
Total Health Department Revenue: Average YTD monthly revenue in FY17 after the
third quarter is $210k/month or $1.9M YTD, representing 63% of our overall budgeted
revenue for the year. (Multiple sources of revenue from the county and Medicaid
Maximization funds will be transferred in at the end of the fiscal year, but cause our
revenue receipts to look lower than projected at this point in the fiscal year as a result.)
Expenses are higher than revenues and slightly lower than projections for third quarter
at 67%.
Total Billing Accuracy: Continuing with the goal of 90% billing accuracy set in FY 14-
15, the average billing accuracy rate for medical after the third quarter is 89% as
compared to 95% in FY 15-16 and the average rate for dental for third quarter FY 16-17
is 98% as compared to 97% in FY 15-16.
Dental Earned Revenue by Source: The FY 16-17 average monthly revenue
($41k/month) for the third quarter is below our budget projection ($47k/month) and in-
line with our FY 15-16 average of $40k/month but is related to lower patient volume in
August while the dental clinic was renovated and an overall higher volume of patients
this fiscal year that are self-pay and either pay 0% according to our sliding fee scale or
are unable to pay the full charge and are on a payment plan. FY 16-17 dental revenue
totaled $367k at the end of the third quarter.
Medical Earned Revenue by Source: Medical earned revenue is currently slightly
below the budgeted projection for FY 16-17 ($59k/month) at $51k/month. This is
attributed to Maternal Health Medicaid claims that have been held while the state
researched the appropriate way to be reimbursed. Revenue for these claims should be
recognized in the fourth quarter. Medical clinic revenue totals $462k for third quarter FY
16-17.
Recommended Action: ___Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to ____________________
_X_Accept as information
___Revise & schedule for future action
___Other (detail):
Orange County Health Department
Third Quarter Financial Report
FY 2016-2017
TOTAL HEALTH Q3 YTD ACTUAL ANNUAL BUDGET
% OF ANNUAL
BUDGET
Revenue
Donations
Dental Health 0 (338)0 0.00%
Health Promotion & Edu (1,770)(17,630)(18,882)93.37%
Environmental Health (300)(600)0 100.00%
Personal Health (7,325)(9,583)(18,000)53.24%
Donations Total (9,395)(28,150)(36,882)76.32%
Internal Allocations
Finance and Admin Services 0 0 (23,500)0.00%
Dental Health 0 0 (18,000)0.00%
Health Promotion & Edu 0 0 (56,072)0.00%
Environmental Health 0 0 (60,000)0.00%
Personal Health 0 0 (30,000)0.00%
Internal Allocations Total 0 0 (187,572)0.00%
Service Revenue
Finance and Admin Services 0 0 (107,646)0.00%
Dental Health (124,197)(367,795)(570,183)64.50%
Environmental Health (141,968)(391,332)(542,124)72.18%
Personal Health (140,922)(462,116)(715,822)64.56%
Service Revenue Total (407,087)(1,221,243)(1,935,775)63.09%
State Allocations
Finance and Admin Services (7,935)(31,753)(42,885)74.04%
Health Promotion & Edu (17,985)(80,483)(121,953)66.00%
Environmental Health (727)(5,688)(34,000)16.73%
Personal Health (70,758)(317,203)(390,835)81.16%
State Allocations Total (97,404)(435,127)(589,673)73.79%
Grants Project Revenues
NACCHO Grant 0 (15,000)(15,000)100.00%
Piedmont Hlth Srv - Nutr (11,414)(44,804)(40,925)109.48%
CC4C Accesscare (50,652)(112,719)(149,624)75.33%
PCM Accesscare (51,162)(119,104)(147,651)80.67%
Dental Health (2,000)(2,000)(2,000)100.00%
Susan G. Komen Grant 0 0 (45,176)0.00%
Grants Project Revenues Total (115,229)(293,627)(400,376)73.34%
Revenue Total (629,116)(1,978,146)(3,150,278)62.79%
Orange County Health Department
Third Quarter Financial Report
FY 2016-2017
TOTAL HEALTH Q3 YTD ACTUAL ANNUAL BUDGET % OF ANNUAL BUDGET
Expenditures
Salaries 1,269,322 3,893,767 5,559,270 70.04%
Benefits 482,029 1,372,522 1,939,999 70.75%
Travel 1,574 5,003 9,797 51.07%
Training 17,717 37,792 40,208 93.99%
Certifications & Licensing 938 6,245 13,239 47.17%
Mileage 5,314 16,656 34,775 47.90%
Telephone 16,395 61,017 79,878 76.39%
Postage 2,431 8,959 14,902 60.12%
Motor Pool 10,876 34,104 48,807 69.87%
Equip Repairs 2,384 5,600 10,823 51.74%
Equip Rent 443 1,286 1,570 81.88%
Duplicating 5,258 8,774 12,244 71.66%
Printing 5,275 8,280 11,817 70.07%
Advertising 106 9,243 15,795 58.52%
Dues 1,403 2,473 5,070 48.78%
Subscriptions 167 551 1,500 36.72%
Dept Supplies 6,387 13,958 41,873 33.33%
Edu Supplies 2,012 3,895 12,827 30.37%
Office Supplies 5,460 20,170 30,150 66.90%
Medical Supplies 33,264 97,858 140,364 69.72%
Bloodborn Path Supplies (9,058)(7,925)(2,551)310.66%
Pharmacy Supplies 28,949 119,899 188,540 63.59%
Comp Supp/Software 704 1,878 7,454 25.19%
Contracted Srv 187,227 551,794 1,017,180 54.25%
X-Ray 1,880 7,872 23,625 33.32%
Lab Srv 28,847 86,194 105,206 81.93%
Bonds & Insurance 0 0 10,347 0.00%
Uniforms 1,310 5,698 8,333 68.38%
Community Proj 1,483 14,382 66,072 21.77%
Innovations Project 6,554 10,807 20,000 54.03%
Accreditation Project 0 2,750 2,750 100.00%
Family Success Alliance 302 0 35,448 0.00%
Credit Card Exp 1,515 4,475 6,000 74.58%
Capital Exp Under $500 2,564 11,828 12,532 94.38%
Nicotine Replacement Therapy 3,095 8,095 12,797 63.25%
Grant Project Expenditures
Dental Grant 0 0 2,000 0.00%
Susan G. Komen Grant 1,291 11,870 46,620 25.46%
NACCHO Grant 26.49 6,412 15,000 42.75%
Capital Expenditures
Equipment 0 3,658 12,876 28.41%
IT Equipment 0 3,600 3,601 99.98%
Furnishings 0 969 1,101 87.97%
Grand Total 2,125,443 6,452,408 9,619,838 67.07%
Total County Revenue (Appropriation)1,496,327 4,474,262 6,469,560 69.16%
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Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: April 26, 2017
Agenda Item Subject: Orange County Advisory Board Update
Attachment(s): Update Advisory Board Summary
Staff or Board Member Reporting: Beverly Scurry
Purpose: ___ Action
_X_ Information only
___ Information with possible action
Summary Information:
The Board of Health identified action steps related to engagement in the 2016-2018
Strategic Plan. One of these action steps is to receive biannual updates on actions of
other Orange County advisory boards that relate to the BOH strategic plan priorities.
The summary provided is of pertinent actions or information from Orange County
advisory boards from September 2016 to February 2017, as available from the boards.
Beverly will highlight a number of these activities and their connection to the BOH.
Some boards being tracked do not have updates included because they do not pertain
to the BOH’s priorities or they were not available at the time of the report.
Recommended Action: ___Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to ___________________________
_X_Accept as information
___Revise & schedule for future action
___Other (detail):
Submitted April 26, 2017
O RANGE C OUNTY
A DVISORY B OARD
S UMMARY
S EPTEMBER 2016 – F EBRUARY 2017
Board of Health Engagement
4/19/17
1
Biannual Report
Board of Health Engagement
B OARD BOH
P RIORITY
S UMMARY
Orange County
Schools Board of
Education
Engagement
• At the November 28th meeting the Board of Education approved
the Family Success Alliance grant for New Hope Elementary in
the amount of $2,500. The grant is intended to provide support
and funds to help establish a Family Resource Library.
• The BOE Strategic Plan was approved at the January 23rd
meeting. The plan outlined 5 goals:
o Challenge and engage every learner to achieve his/her
full potential.
o Engage in two-way communication with our stakeholders
and community.
o Create a career destination for employees.
o Safe and sustainable operations to support optimal
learning.
o Accountable, equitable, and transparent management of
human and financial resources.
• The Board approved a letter of support to be sent to the Board
of Health in support of the FSA and its importance to the school
district.
• At the February 27th meeting, it was recommended an Equity
Committee of the Board of Education be established to look into
the current climate including symbolic speech issues,
achievement data, and student access in order to inform and
open conversation.
Chapel
Hill/Carrboro
City Schools
Board of
Education
Social
Determinants of
Health; Substance
Abuse & Mental
Health
• Family Success Alliance gave a report to the Board at the
November 3rd meeting
• School-based mental health programs gave an update at the
November 3rd meeting
• The schools held a community forum on December 3rd regarding
the Equity Plan feedback
• Board approved signing bonuses for high need areas
• New Superintendent, Pam Baldwin, began her new position on
April 3, 2017
4/19/17
2
Board of County
Commissioners
Social
Determinants of
Health
SAMH
• At the September 29th meeting, Colleen Bridger gave a
detailed presentation to the BOCC on the Family Success
Alliance.
• During the November 1st meeting, Coby Jansen Austin
presented Five-Year Budget Projections presentation to the
BOCC.
• The board passed a resolution at the November 15th meeting
in support of Equal Rights Amendment which supports equal
rights for all residents of Orange County.
• During the February 21st meeting, Colleen Bridger, presented
the Mental Health Gap Analysis Results and Prioritized
Recommendations to the BOCC.
Chapel Hill Town
Council
N/A
Carrboro Board
of Aldermen
Physical Activity
and Nutrition;
SAMH
• During the September 6th meeting, a resolution of support for
local transportation projects was passed. This resolution included
Carrboro’s interest in bicycle and pedestrian improvements. The
town submitted seven bike-ped projects for funding through the
State Transportation Improvement Program, three of which may
be funding. Those three include bike-ped improvements on
Estes Drive, sidewalk installation on Jones Ferry Rd., and
sidewalk installation on Barnes St.
• Carrboro Farmers Market supports Town Commons proposed
improvement as they will allow the market to be viable for years
to come. The market also has a new manager, LaShauna Austria.
• A motion was made during the January 17th meeting to update
the language in the Community Climate Action Plan –
Transportation Recommendation #2: Improve Bicycle and
Pedestrian Infrastructure. It is essential to improve Carrboro’s
bicycling and pedestrian infrastructure and safety in combination
with stewardship of the forests and creeks.
• Carrboro continues to support and assist Club Nova in
improving the lives of people with mental illness.
• During the February 10th Carrboro released a list of advocacy
goals that plans to support on the state level including:
o Opposing bills that discriminate against LGBT
communities
o Supporting legislation that provide protection for the
LGBT community
o Oppose legislation that eliminates the EPA
o Oppose healthcare reform that would fully repeal the
ACA
4/19/17
3
Hillsborough
Board of
Commissioners
SAMH; Social
Determinants of
Health
• The board was informed at the September 12th meeting that
the Orange Partnership for Alcohol and Drug Free Youth
received a grant for $625,000 over 5 years to focus efforts in
Hillsborough and rural areas.
• The board was also informed that alcohol sales to minors
have decreased significantly in the county.
• The board authorized $5,000 to be allocated to the
Affordable Housing fees in lieu to assist with rental deposits
for income eligible families. These fees will help families who
have Section 8 vouchers pay rental deposits.
• Board members have expressed a lot of interest in racial
equity training and are encouraged to attend training.
• The Parks and Recreation Board is continuing work on
updating the sidewalk, pedestrian, and bike path plan.
• During the December 12th the Board heard information on a
paid parental leave policy and was informed that Durham County
has implemented this policy. The board was supportive.
Orange Unified
Transportation
Board
(OUTBoard)
Physical Activity
Safe Routes to School Plan updates since the September 21st
meeting:
• OUTBoard discussed the Town of Hillsborough is
enforcing their Connectivity Plan which is not consistent
with the Safe Routes to School Plan.
• Concern has been raised about the sidewalks planned in
the Safe Routes to School Plan are not being
implemented. The Board discussed making these concerns
known to politicians and the BOCC.
• A petition was present to OUTBoard by Walkable
Hillsborough Coalition to make the Safe Routes to School
Plan a high priority. OUTBoard accepted this petition and
voted to present the petition to the BOCC.
• Small projects are being implemented such as a little
pedestrian bridge over a creek on Hayes St. for Central
Elementary and a gate at the back of Orange High for
more direct and safe access to school.
Healthy
Carolinians of
Orange County
All • Received an approval on the 2016-2019 action plans submitted
on behalf of its 3 subcommittees
• Submitted the 2016 State of the County Health (SOTCH) Report
and presented it to the Board of Health
4/19/17
4
Family Success
Alliance
Access
• During the October 17th meeting, council members were led in a
mini training to promote and incorporate racial equity in the
work of FSA. The council plans to continue racial equity work by
establishing a workgroup, promoting racial equity training, and
examining the use of racial equity assessment tools.
• During the December 12th meeting, the council went through
exercises on collective impact and will continue to incorporate
these practices into their work and conversations. FSA will be a
part of a collective impact study conducted by Northwestern
University.
• FSA is actively seeking grant support – Kenan Charitable Trust,
Robert Wood Johnson Foundation, and Brady Educational
Foundation.
• Rydell Harrison, CHCCS Assistant Superintendent, is now the
vice chair of the council.
• FSA held anti-harassment trainings and a Post-election
Community Forum.
• The council approved the upcoming FY budget at their February
20th meeting.
• FSA is preparing for Year 3 summer programming.
• There are plans to expand the navigation program. Parents are
applying to be Navigators which is exciting.
Orange County
Food Policy
Council
Nutrition • The Council identified the first two areas that will be
addressed through work groups. Those 2 areas are Food
Access and Local Food Economy.
• The Council hosted 2 community forums (February 20th and
March 23rd) that were targeted around the 2 focus areas of
Food Access and Local Food Economy. The workgroups will
begin working on these issues with the first meeting
scheduled for April 20th.
• The Council is determining who the fiscal agent will/should
be for the upcoming year (2017-2018) and going
forward. The choices are between OC Government and the
Chapel Hill – Carrboro Chamber of Commerce
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: April 26, 2017
Agenda Item Subject: Reappointment Recommendation
Attachment(s): None
Staff or Board Member Reporting: Liska Lackey
Purpose: __X_ Action
____ Information only
____ Information with possible action
Summary Information: The Board of Health will vote to recommend Liska Lackey and
Susan Elmore to their 3rd term and Jessica Frega to her 1st full term.
Recommended Action: ___Approve
_X_Approve & forward to Board of Commissioners for action
___Approve & forward to ___________________________
___Accept as information
___Revise & schedule for future action
___Other (detail):
Health Director’s Report
April 26, 2017
Welcome to Beverly Scurry who will support the Board of Health with the
implementation of its strategic plan. Thank you to Coby for assuring a smooth transition.
Congratulations to the Family Success Alliance for moving to Round 2 of the BUILD
Challenge (25 applicants selected from a pool of 135).
The manager’s office has asked the health department to propose a scope of work and
budget for a contract with a consultant to implement recommendations from the
mental health gap analysis. The contract would replace the health department budget
request for a Behavioral Health Program Manager position at this time.
The BOCC approved funding for contracts with Refugee Community Partnership,
Refugee Support Center, and El Centro Hispano to provide additional services to the
refugee/immigrant communities. Thanks to Susan Clifford for her presentation to the
BOCC and her work to put these contracts in place.
The Dental clinic is expanding its preceptor program for dental hygienists from UNC.
They will pilot having an additional hygienist on-site beginning in August through
December to serve additional clients.
The health department sponsored a successful annual Provider Breakfast on April 12,
2017 highlighting updates to vaccination recommendations, resources for
refugee/immigrant populations in Orange County, and the growing Zika epidemic.
Exciting community prevention efforts are underway, including a new partnership with
Freedom House to offer smoking cessation services to clients, collaboration with the
Town of Chapel Hill to implement smoke-free public housing by July 2018, and the roll-
out of the Spray Before You Play campaign ( to reduce risks associated with mosquito
exposure).
We won a statewide award for video production for our orientation/overview video
from NC3C (NC City and County Communicators). We were up against counties and
municipalities with big budgets and teams that put out some pretty amazing
productions. The award is a second place trophy and is in our awards cabinet , next to
our other NC3C award.
Best of luck to Connie Pixley who plans to retire on June 1, 2017 and to Stacy Shelp who
has resigned her position effective April 28, 2017 to accept a position with the United
Way.
Bills of interest:
House Bill 66 - Carolina Cares. This bill is being led by Representatives Lambeth,
Murphy, Dobson and White. Rep. Lambeth (Forsyth) is the lead sponsor of the bill. This
bill will increase access to insurance for North Carolinians who are working but currently
do not have insurance.
Senate Bill 74 (Rabies bill) and Senate Bill 131 (Regulatory Reform Act of 2017). SB74
passed Senate Rules committee with no discussion. Will likely survive the Senate and
head over to the House. Public health supports this bill in its current language. SB 131 is
on the Senate calendar for concurrence. The House and Senate worked together on
amendments made by the House. The expectation is the Senate will concur and the bill
will then go to the Governor for his signature. Changes were made as requested
eliminating additional work for local health departments regarding inspection of water
line.
UNC qualms about handling of February water crisis surface
3-30-17
Turns out that UNC-Chapel Hill officials have some doubts after all about the handling of
February’s water crisis in Chapel Hill and Carrboro.
As voiced recently to university trustees by Brad Ives, associate vice chancellor for campus
enterprises, they concern what he termed the “rather drastic steps” at the height of the crisis to
order people not to drink or use water from the Orange Water and Sewer Authority’s piping
network. Ives told the trustees’ finance committee that campus officials think that in a similar
situation, it’s “going to be more important to have some senior-level staff” at Orange County’s
emergency operations center.
They also believe they “could’ve worked more closely with state environmental officials” who
they suspect influenced the decision in February to issue the twin alerts. Combined, the Feb. 3
alerts shut down the towns’ restaurants, and prompted UNC to issue a rare advisory of its own
urging students to leave campus for the weekend. Officials believe 50 percent to 60 percent of
the students who reside on campus actually left.
The crisis had its roots in events the day before, when errors at OWASA’s Jones Ferry Road
water treatment plant triggered an “overfeed” of flouride into the plant’s water stockpile that
rendered it useless and took the plant offline.
Matters escalated the morning of Feb. 3 when a water-main break in northeast Chapel Hill
dumped a lot of the utility’s remaining, in-network water supply. Repairs proceeded quickly, and
officials were able to lift the don’t-use/don’t-drink orders mid-afternoon on Feb. 4. Ives, who in
the immediate aftermath of the crisis called OWASA “a trusted partner of the campus,” told
trustees it’s obvious an emergency existed.
OWASA’s water stockpile on Feb. 3 dropped below the 2 million gallons officials consider the
bare minimum needed. But in a later interview, he said campus officials now believe the
decision to call the alerts resulted from “a state determination by” the N.C. Department of
Environmental Quality.
“Had we had more information at the time it was happening, I think we could have stepped in
and talked to” the department, Ives said. “But we didn’t know exactly what was going on at the
time as to who was making the determination. We assumed it was a local determination.”
UNC’s environmental safety director, Mary Beth Koza, in an interview added that “procedures
were followed” in that local officials consulted state regulators and heard back from them that
“we should have a do-not-use.”
Both she and Ives noted that given the situation, the menu of potential responses changes and
often involve less drastic measures. Koza cited the example of an early-March boil-water
advisory in northeast Chatham County, in response to a water leak there and resulting pressure
drop.
“I am not second-guessing the thing, it’s just that each situation is unique and the folks making
the decision have to really understand the impact,” she said.
But OWASA’s executive director, Ed Kerwin, said February’s call was made by local officials,
and was the right one. OWASA’s biggest problem on Feb. 3 was that it was running out of
water, not that low network pressures would’ve sparked disease, he said.
“Had we had a huge fire like the city of Raleigh recently experienced, we would’ve been at real
risk of running completely out,” Kerwin said. “Had that happened, the community would’ve been
affected for days and days, not just 24 hours.”
Kerwin was alluding to the re-start problems that ensue if a water network runs dry. Engineers
have to run a lengthy series of contamination tests before putting mains back in service. The
OWASA boss was adamant that while local officials kept regulators informed, “the state was not
involved” in decision to issue the alerts.
“The state did not say, ‘You better issue a do-not-use/do-not-drink,’” Kerwin said. “That was a
decision made here locally.” He added that DEQ regulators did have some advice for OWASA
about the “remediation” of the flouride issue at the water plant. But about the alerts, there “was
no state advice or guidance.”
Stacy Shelp, a spokeswoman for the Orange County Health Department, said it “was a local
decision,” made by Kerwin and UNC-trained former county Health Director Colleen Bridger.
An investigation by outside engineers found that after the Feb. 3 water main break, water levels
in the tanks that serve the UNC campus and the southern two-thirds of Chapel Hill “all dropped
below minimum [levels] to maintain fire protection,” a fact giving weight to Kerwin’s concerns.
Water pressures — the bigger factor in disease worries, as opposed to supply ones — dropped
briefly in much of the system, but it’s “unlikely that the entire, or even majority of the [zone]
experienced unsafe” conditions, the engineers report said.
More: http://www.heraldsun.com/news/local/counties/orange-
county/article141555659.html#storylink=cpy
NORTH CAROLINA HEALTH NEWS
News. Policy. Trends. North Carolina.
Advocates for Medicaid Expansion
Continue Their Uphill Climb
Photo by Rose Hoban
April 5, 2017 by Rose Hoban Leave a Comment
A broad coalition of health care advocates showed up at the General
Assembly on Tuesday to press - again - for the legislature to expand the
Medicaid program.
By Rose Hoban
Four years have passed since the North Carolina legislature passed Senate Bill 4,
which rejected an opportunity to provide health insurance access to about half a million
low income people in the state: Four years, one governor, one president, and countless
rallies, petition drives, protests, focus groups and meetings with legislators.
All to no avail.
Health care advocate Leslie Boyd speaks to Sen. Floyd McKissick (D-Durham) about
her son, Mike, who was diagnosed with a late stage cancer 10 years ago, but had
difficulty finding treatment because he was uninsured. Mike died soon after. Photo
credit: Rose Hoban
Still, advocates came to the legislature on Tuesday to press l awmakers to take
advantage of an Affordable Care Act provision that would allow for the state to extend
Medicaid coverage to low income North Carolinians who make too much to qualify for
the current program, but not enough to qualify for subsidies to cover the costs of their
insurance premiums.
“Right now we’re turning away $2 billion per year,” Sen. Floyd McKissick (D-Durham)
told a room full of advocates at a press conference Tuesday morning. “That’s $2 billion
that’s being contributed to the federal government in Washington and it’s not coming
back to our state because we have refused to expand Medicaid.”
McKissick noted that Congress’ failure to repeal the law last month means the ACA
remains the “law of the land,” but he said that it might not be the ca se for long.
“They’ll keep working on it, they’ll keep tinkering with it, they’ll keep doing something
with it likely, that at some point may decrease our chance to expand Medicaid,” he said.
Uncovered health care workers
One irony of starting her own business, said Nancy Ruffner, was that even though she
helps people navigate the complicated healthcare system, she is unable to afford
insurance for herself.
Small change
Currently, 31 states have chosen to expand Medicaid, many of those states are
controlled by Republicans who initially opposed the legislation.
But the money was too good for many Republican governors and legislatures to resist.
And now some are even fans, such as Ohio Gov. John Kasich, who told NBC’s Meet
the Press that Republicans in Congress should not kill Medicaid expansion.
“You have to have the ability to subsidize people at lower income levels,” he said.
A report generated by Ohio’s Department of Medicaid found it saved money even as it
improved the health of about 700,000 of beneficiaries.
Under pressure from governors such as Kasich, the Congressional American Health
Care Act would have allowed states that had expanded the program to continue
covering those extra people.
But the states, such as North Carolina, that didn’t expand Medicaid would receive $10
billion to split among themselves over three years. An analysis by North Carolina
Institute of Medicine head Adam Zolotor calculated North Carolina’s share of that
money would come to about $172 million per year, while expansion would have brought
at least $2.5 billion to the state annually.
“I’ve been in the North Carolina workforce since 1973, I’ve been
paying taxes for 44 years” said Ruffner who employs four other
people in her medical case management firm, Navigate NC. “I
work. I pay taxes. I own small business and I’m helping others to
work and pay taxes.”
She said when she worked for someone else, she got insurance through her job. And
when she started Navigate NC in 2014, she got a subsidy t hrough the ACA insurance
marketplace.
But starting a small business often means being the last person to get paid, and some
years the pay is less than in others.
“I’m pouring 100 percent of my income back into the company during its early years and
I received no salary,” she said. “This enrollment year I could not honestly vouch that I
would make the threshold of income necessary to qualify for a subsidy.
“I would not lie in order to make that income threshold.”
Erica Pettigrew said it’s common to see uninsured patients who are health care
workers.
Pettigrew, who serves as the medical director at the Orange County Health Department,
told the story of a patient, who worked for 35 years as a medical assistant. Now the
woman works as a personal health aide, a job that comes without insurance.
When she came in to see Pettigrew for care at the health department recently, she had
a suspicious lump in her throat.
“She really needed to see an ear, nose and throat specialist but she doesn’t have
coverage and there was nothing I could do,” Pettigrew said. “This woman had devoted
her career to helping others and yet she does not have access to affordable health care
and she is not going to be able to get potentially life-saving treatment.”
Dr. Erica Pettigrew told people at the General Assembly about how she frequently treats
patients who work as caregivers, yet have no insurance of their own. Behind her,
Duffner looks on. Photo credit: Rose Hoban
Pettigrew said these situations are frustrating.
“Words cannot express what it feels like as a physician to see a patient possibly dying
before your eyes and not able to get the care that she needs simply because she does
not have health care coverage,” she said.
Not budging
But when asked whether there was any chance of expanding the program, Sen. Tommy
Tucker (R-Waxhaw) was blunt.
“No way,” said Tucker, who is an outspoken member of the Senate Health Committee.
“We can’t take on that kind of a bite of an apple like that, because we don’t know what’s
gonna happen [at the federal level].”
Tucker was dismissive of other Republican-led states that had made the move.
Lee Storrow from the NC AIDS Action Network shows someone who
came to the legislature Tuesday some case studies of working people
who would benefit from Medicaid expansion. Photo credit: Rose Hoban
“They only reason they’re doing it is because the Republicans in
Washington couldn’t get their health care bill through,” he said. “So
they’re going to put a stake in something that we all know potentially is
going to blow up… we’re not going there.”
He said that for this year, budget writers have been told to keep the Medicaid budget on
a “flat line.”
Despite the resistance in the legislature, Lee Storrow from the North Carolina AIDS
Action Network said he’s going to keep organizing days like Tuesday to bring people to
the General Assembly to talk to lawmakers.
“As advocates doing work for people who need health care it’s our job to continue to
raise awareness about the fact that expanding Medicaid and closing the coverage gap
would save hundreds of lives and create thousands of jobs,” he said.
“We’re going to continue to beat the drum the best we can.”
NEWS
Orange County Ranks First in North Carolina for
Health Factors
Posted by Bruce Rosenbloom | Apr 7, 2017 | Health | 0
Residents of Orange County may be among the healthiest in North Carolina according to an annual report on
national wellness profiles from the Robert Wood Johnson Foundation.
Stacy Shelp, the public information officer of the Orange County Health Department, referred to that report
while discussing the two categories in which all counties were assessed.
“Orange County once again does fall right at the top of the charts for the county health rankings,” she relayed.
“We are ranked number one for health factors and number two for health outcomes.”
The report measures the current overall health of nearly every county in all 50 states, with researchers having
used multiple data points to judge which counties are healthier than others.
“Health factors where we are number one are things like health behaviors, clinical care, social and economic
factors,” explained Shelp. “With health outcomes, you’re really looking at length of life and quality of life.”
Impeccable health care may be available in Orange County, but Shelp also mentioned that a high level of
income inequality among residents was cited in the report.
“Some of the nice things that did make us so high on those health rankings are things that our municipalities
[…] have embraced for a long time — bikeability and walkability and making sure there’s crosswalks and bike
lanes and trails accessible to everyone,” she noted. “The outliers of Orange County can’t access the health
services, they can’t access those bike lanes, et cetera.”
According to Shelp, the stellar performance of the county in the report may be the result of a holistic approach
employed by local leaders to account for full spectrum wellness.
“When we’re looking at things like transportation and affordable housing, those all impact health and so much
more,” she claimed. “We really do need to be looking across the spectrum of how we can create access to
health.”
In addition to income disparity, Shelp identified substance abuse and mental health as other concerns that the
Orange County Health Department is seeking to address.
“We just recently completed a gap analysis to see where service issues were and accessibility issues around
mental health services,” she reported. “We’re going to be doing a suicide prevention campaign starting in the
fall, and then have added integrated behavioral health specialists to work hand-in-hand with our medical
clinical staff.”
Superior rankings notwithstanding, Shelp stressed that the Orange County Health Department would continue
to pursue improvements in areas where change can be affected.
“We’ve got a lot of things to work on here in Orange County, and it’s not number one and number two for
everybody,” she offered. “Continuing to address the health disparities and inequities here and everywhere, I
think, is the critical piece of this.”
The report was compiled by researchers at the University of Wisconsin-Madison for the Robert Wood Johnson
Foundation, whose sole philanthropic focus is health.
WRAL.com
Recommended by
LOCAL NEWS
Wake, Orange counties ranked top two healthiest in NC
Posted 12:01 a.m. today
RALEIGH, N.C. — Wake and Orange counties were named the healthiest in North
Carolina in an annual ranking of every county in the nation.
The County Health Rankings report, published by the University of Wisconsin and
Robert Wood Johnson Foundation, ranks counties to help identify problems and ways to
improvement local health. The report accounts for high school graduation rates, access
to healthy food, smoking rates, obesity and teen birth rates, among others.
The report ranked all 100 North Carolina counties in two categories: health outcomes
and health factors.
Health outcomes rankings are based on resident's length and quality of life. Health
factors looked at health behaviors, clinical care, social and economic factors, and the
physical environment.
Top 5 counties for health outcomes:
1 Wake
2 Orange
3 Union
4 Camden
5 Chatham
Top 5 counties for health factors:
1 Orange
2 Wake
3 Union
4 Camden
5 Chatham
Orange, Wake ranked as North Carolina's
healthiest counties in recent report
Erik Beene and Rebecca Ayers | Published 04/10/17 12:18am
Wake and Orange counties are the healthiest counties in North Carolina, according to a recent
report.
The County Health Ranking report by the University of Wisconsin Population Health Institute and
the Robert Wood Johnson Foundation ranked Orange County No. 1 in health factors and No. 2 in
health outcomes.
Orange County Commissioner Penny Rich said she was excited by the report and the health
department’s progress.
“I’m actually really encouraged by the reports and only because our health department has been
doing such a good job thinking outside the box and challenging the norms to try and get our county
healthier,” she said.
The countywide ban on public smoking and focus on green spaces has contributed to the county’s
overall health, Rich said.
Rich said there’s not a better place to go out to hike, walk and enjoy the outdoors than Orange
County.
“We’ve kept a really good hold on preserving some of the beautiful parks that we have and we use
them,” Rich said. “And it’s good — it’s really good.”
Anna Schenck, director of the North Carolina Institute for Public Health, said the report did a good
job of showing the numerous social and environmental factors that contribute to health. The divide
between urban and rural communities in the ranking was also apparent, she said.
“It’s a combination from actors in education, income, health care access and lifestyle factors that will
make a person healthy or not and then those that congregate in counties that are wealthier,” she
said. “In North Carolina, we have a real divide in terms of the haves and the have-nots and the
wealthy counties.”
The report said Orange County ranks as one of the worst in the state in terms of income inequality.
Stacy Shelp, a spokesperson for the Orange County Health Department, said 30 percent of county
families do not earn a living wage.
“That’s a significant issue, especially when you are looking at things like health — because what we
know is that poverty and some of the situations that poverty creates for a family and an individual
and a community create long-term effects, such as chronic disease,” Shelp said.
She said one of the biggest challenges for the health department is educating the public about
income inequality in the county.
“We don’t tend to hang our hats on ‘We’re number one or number two out of a hundred counties,’”
Shelp said. “We hang our hats on we have got a heck of a lot of work still left to do.”
The health department is continuing to work to combat poverty’s effects on health through early
childhood education programs, Shelp said.
“It’s about a holistic approach, giving children the opportunity to start equal to their peers and will
ultimately impact lifelong chronic disease,” she said.
Alice Ammerman, a nutrition professor at the Gillings School of Public Health, said Medicaid
expansion would reduce health disparities and help to provide preventive care for people with lower
income.
“Most of the funding would come from the federal government, so it’d be quite a benefit. But
there’s been a lot of pushback from the legislature, which is very conservative,” Ammerman said.
“They don’t want to take that federal funding. Ultimately it’s a big loss to the state, especially for
lower income classes.”
It is important to understand the rankings don’t indicate everyone is doing well, Ammerman said.
Schenck said the recent county and state rankings reflect a broader problem not only in North
Carolina, but also in the United States.
“The United States ranks (lower) than other countries, we spend a whole lot on expensive hospital
emergency care, rather than spending our money in prevention,” Schenck said.
Carrboro; City of Durham
property vandalized
By Colin Warren-Hicks
April 10, 2017
cwarrenhicks@heraldsun.com
CARRBORO
By administering a dose of an opiate antagonist, naloxone, which reverses the effects of an overdose providing
an opportunity for medical intervention, a police officer Sunday evening recorded the Carrboro Police
Department’s fifth successful overdose reversal since the department started carrying naloxone in October
2014.
The endangered individual was transported to UNC Hospitals for treatment, said police spokesman Capt. Chris
Atack. The incident happened about 9 p.m.
The Carrboro Police Department partnered with Orange County EMS, the Orange County Health Department
and the North Carolina Harm Reduction Coalition to organize an overdose procedure program.
Tobacco resolution passes
Sunday
Posted Apr 16, 2017 at 5:55 AM
By Rebecca Walter
Times-News Staff Writer
The Henderson County Board of Health passed a resolution Tuesday requesting the North Carolina General
Assembly rescind preemption of tobacco regulation to restore local control over its policies.
The seven board members present at the monthly meeting passed the measure unanimously in a symbolic
move.
“Research shows that the strongest, most innovative and most effective tobacco control policies have most
often originated at the local level,” according to background information included with the resolution.
“However, preemptive legislation at the state level prevents local communities in North Carolina from passing
most tobacco control policies related to the retail environment.”
If preemption were lifted, localities would have the ability to increase the minimum legal sales age, as well as
to institute tax strategies to increase the cost of tobacco, the resolution continues.
Henderson County follows a handful of others that have passed such resolutions, including Orange County,
and a joint resolution from Rutherford, McDowell and Polk counties.
Local dentist and board member Dr. Pete Richards said the resolution seems to be a growing trend.
“It is good to be at the head of it,” he added.
The preemption went into effect around 20 years ago when the Youth Access Law was passed. The law was
recently modified to extend to e-cigarettes as well. The general assembly would have to revise the statute for
local control to be regained.
Director Steve Smith the resolution is aimed at getting the attention of the General Assembly so they can
consider legislation.
“We will forward it to the General Assembly, probably through our local elected officials,” Smith said. “It is
just asking essentially to allow more flexibility at the local level to enact rules and regulations we think are
needed specific to our community to prevent tobacco use.”
In other business:
The board received a general outline of the 2017-20. The full proposal will be presented at the May
meeting.
Smith discussed the county’s health rankings, which places Henderson County at No. 13 in the state,
the highest in Western North Carolina. Smith said the measures are not perfect, but several in the
department and the community are working to make the county a healthier place.
The board recognized the Seth Swift for receiving Environmental Health Supervisor of the Year in
North Carolina.
— Reach Rebecca Walter at rebecca.walter@blueridgenow.com.