HomeMy WebLinkAboutBOH agenda 012517
ORANGE COUNTY BOARD OF HEALTH
MEETING AGENDA
DATE: January 25, 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 January 25, 2017 Agenda
7:10 – 7:15 IV. Actions Items (Consent)
A. Minutes of November 30, 2016 Liska Lackey
7:15 – 8:10 V. Educational Sessions
A. 2nd Quarter Financial Reports Rebecca Crawford
B. 2nd Quarter Billing Dashboard Reports Rebecca Crawford
C. FY 2016-17 Fee Schedule & Requested Changes Rebecca Crawford
D. Integrated Behavioral Care Update Karen Kyes & Andrea Mulholland
E. Mental Health Survey – Report Rebecca Crawford & Sabrina Willard
8:10 – 8:20 VI. Action Items (Non Consent)
A. Selection of New BOH Members Liska Lackey
B. Selection of Interim Health Director Liska Lackey
8:20 – 8:40 VII. Reports and Discussion with Possible Action
A. Planning for Health Director Recruitment Liska Lackey & Susan Elmore
B. Health Director Report Colleen Bridger
C. Media Items
D. Other
8:40 – 8:45 VIII. Board Comments
8:45 IX. 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
November 30, 2016
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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 November 30, 2016, at the Orange
County Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Nick Galvez – Vice-Chair, Commissioner Mia
Burroughs, Barbara Chavious, Paul Chelminski, Dan Dewitya, Susan Elmore, Reena Mehta,
Sam Lasris and Timothy Smith.
BOARD OF HEALTH MEMBERS ABSENT: Jessica Frega and Liska Lackey.
STAFF PRESENT: Dr. Colleen Bridger, Health Director; Coby Jansen Austin, Director of
Programs and Policy; Shannon Barnes, Social Work Supervisor; Alan Clapp, Environmental
Health Director; Rebecca Crawford, Finance & Administrative Services Division Director; Donna
King, Health Promotion & Education Services Director; Pam McCall, Public Health Nursing
Director; Kimberlee Quatrone, Administrative Officer; April Richard, Senior Public Health
Educator, Tobacco Prevention and Control Coordinator; Stacy Shelp, Communication Manager;
Juliet Sheridan, Applied Public Health Informatics Fellow, and La Toya Strange, Administrative
Assistant II.
GUESTS PRESENT: None.
I. Welcome
Dr. Bridger introduced the new employees in attendance: Shannon Barnes, April Richard and
Juliet Sheridan.
II. Public Comment for Items NOT on Printed Agenda: None
III. Approval of the November 30, 2016 Agenda
Motion was made by Mia Burroughs to approve the agenda, seconded by Dan Dewitya
and carried without dissent.
IV. Action Items (Consent)
A. Minutes of September 28, 2016 Meeting
B. Minutes of October 26, 2016 Meeting
C. 2017 Board of Health Schedule
Motion was made by Susan Elmore to approve the minutes of September and October
2016 and the 2017 Board of Health schedule, seconded by Reena Mehta and carried
without dissent.
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November 30, 2016
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V. Educational Sessions
A. 1st Quarter Financial Reports and B. 1st Quarter Billing Dashboard Reports
Kimberlee Quatrone, Administrative Officer, gave a report on the 1st quarter revenue and billing
accuracy. Her report is as follows:
• Total Health Department Revenue: Average YTD monthly revenue in FY17 after the first
quarter is $193k/month or $579k YTD, representing 18.2% of our overall budgeted
revenue for the year. The total first quarter revenue is slightly skewed down due to an
error made by the central Finance Office. We are working to have this error fixed, which
will bring our total revenue for the first quarter to $672k and 22% of our overall budgeted
revenue. Expenses closely match revenues at 21%.
• 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 first quarter is 88% as compared
to 92% in FY 15-16 and the average rate for dental for first quarter FY 16-17 is 99% as
compared to 101% in FY 15-16.
• Dental Earned Revenue by Source: The FY 16-17 average monthly revenue
($38k/month) for the first quarter is below our budget projection ($48k/month) our FY 15-
16 average of $40k/month but is related to lower patient volume in August while the
dental clinic was renovated. FY 16-17 dental revenue totaled $114k at the end of the first
quarter.
• Medical Earned Revenue by Source: Medical earned revenue is currently slightly below
the budgeted projection for FY 16-17 ($58k/month) at $56k/month. Medical clinic
revenue totals $168k for first quarter FY 16-17.
C. Town/Gown Alcohol Coalition Update
Elinor Landess, Campus & Community Coalition Director, Chapel Hill Downtown Partnership,
gave a brief overview on the Coalition. The Coalition is a collaborative effort funded jointly by
the Town of Chapel Hill, UNC-Chapel Hill, the Orange County Health Department and the
Orange County ABC Board. It’s tackling the problem of high-risk drinking that exists in Chapel
Hill and surrounding communities. She began by stating some facts from Spring 2015.
• There were 341 alcohol related EMS transports from Chapel Hill. There was a high
percentage of underage transports.
• There were 246 citations were given.
• There were 241 loud noise complaints.
• 65% of students reported drinking.
Ms. Landess stated that the Coalition isn’t trying to remove alcohol from the collegiate
community, just reduce risky drinking behaviors which is defined as the consumption of alcohol
that decreases personal safety, property values, etc. Some of the challenges mentioned
included
• Getting community engagement and investment in transforming the culture;
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• Changing the student perception of inconsistent enforcement and seeming lack of
consequences for repeat offenders;
• Developing strategies to maximize consistent training for servers and maximize
certainty, timeliness, consistency and equity in consequences for bar/restaurant
violations.
The Coalition is taking a comprehensive public health approach that utilizes a community
organizing framework and environmental strategies. A taskforce met during 2013 and
developed a set of 22 recommended strategies to reduce the negative impacts of high risk
drinking in 3 areas: the University, Neighborhoods/Community and Downtown Chapel Hill.
There has already been some change. Chapel Hill has hired 2 new code enforcement officers.
UNC has re-written, passed and implemented a new alcohol policy. That policy includes
provisions that delineate where alcohol can be consumed and treats student organizations the
same as students. Ms. Landess also spoke of other ways to reduce risky drinking such as
having viable alternative to socializing with alcohol on weekends and educating parents/families
about the negative consequences of underage alcohol use. Also mentioned was the use of
Intellicheck software which aids in ID authentication by scanning the barcode. It has helped
confiscate many fake IDs used by those who are underage.
The BOH members had questions that were addressed by Ms. Landess.
D. Accreditation Presentation
Dr. Bridger provided the Board with an overview of the accreditation process. The basic
components of the process are:
• Self-Assessment by the Agency
Health Department Self-Assessment Instrument (HDSAI) is completed by all
Health departments and submitted with all accreditation evidence.
• Site Visit
Site Visit will be January 12th and 13th. A team of 5 local public health
professionals familiar with health departments, Environmental Health and the
Board of Health will conduct a site visit and interviews.
• Board Adjudication
After the visit, the OCHD will receive a written report with their findings which will
go to the statewide accreditation Board for official approval.
Dr. Bridger also briefly spoke on the activities and scoring requirements. They are:
• Agency Core Functions and Essential Services
Assessment – OCHD must meet 26 of 29 activities
Policy Development – OCHD must meet 23 of 26 activities
Assurance - OCHD must meet 34 of 38 activities
• Facilities and Administrative Services - OCHD must meet 24 of 27 activities
• Governance - OCHD must meet 24 of 27 activities
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Dr. Bridger reiterated that the purpose of accreditation is to ensure that all NC health
departments are meeting the 10 essential services. She added that one of the benefits is that it
assures a minimum standard for all health departments. Dr. Bridger also reviewed the Board’s
role which includes that policies and procedures on how to handle finance, community health,
health director/staff, Board function and rules and ordinances.
The BOH members had questions that were addressed by Dr. Bridger.
E. UNC Capstone Presentation
Coby Jansen Austin, Director of Programs and Policy, began by stating that the 2016-18 Board
of Health Strategic Plan requested research on the appropriate pathway and necessary partners
to pursue policy change to make birth control pills available over the counter (OTC). UNC
public policy undergraduate students Shivangi Amin, Hannah Eichner, Charlotte Henry and Rob
Poston prepared a literature review, compiled a series of case studies and interviewed a few
key stakeholders to evaluate the pros and cons of moving this policy proposal forward while
identifying the key partners in making that happen.
They began by informing the Board that only the FDA can determine whether a drug can be
available OTC vs behind the counter. Statistics provided included that half of all pregnancies
are unintended and 74.8% of 2010 NC unplanned births were publicly funded costing the
federal and state government a combined cost of $858.3 million. Costs and a required clinician
visit reported as barriers to access oral contraceptives. Barriers to contraceptive use included
costs (insurance) and side effects (blood clots, weight gain, nausea). Next, the students spoke
briefly about the safety of OTC birth control. Oral contraceptives were found to be safe.
Research found that women are able to self-identify whether they are good candidates for oral
contraceptives.
There have been many arguments for and against making oral contraceptives available OTC.
Some arguments against it include lower likelihood of women receiving preventive screenings
and higher risk of blood clots. Arguments for it include reduced abortions and reduced Medicaid
costs. The students used four states (California, Oregon, Tennessee, Missouri) as case studies
as they either have laws or bills regarding this topic.
• California passed a bill in September 2013 that was implemented in April 2016 which
allows self-administered hormonal contraceptives to be distributed without a doctor’s
prescription. The policy is optional for pharmacists.
• Oregon passed a law in July 2015 that was implemented in January 2016, set to expire
in 2020, in which the two types of hormonal contraceptive available under this law are
the oral contraceptive pill and the hormonal patch.
• Tennessee passed a bill in January 2016 which authorizes pharmacists to provide
hormonal contraceptives to patients OTC so long as they adhere to a valid collaborative
pharmacy practice agreement.
• Missouri currently has a bill that passed the House, but not the Senate. This bill
included a requirement that health insurance plans cover contraceptives. The plan must
cover an initial 3-month supply and then a 12-month supply for any subsequent
dispensations of the same contraceptive.
Also discussed were factors that affected policy choices such as:
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• Mechanisms - protocols, collaborative practice agreements
• Age - whether there should be an age requirement and
• Payment - currently prescriptions by pharmacists are covered by insurance as it still
falls under the ACA’s contraceptive mandate; reimbursement for pharmacist evaluation
could pose a critical problem in the future.
The students interviewed Anna Stein, Legal Specialist at NC DHHS, Danny Staley, Director of
DPH, DHHS, and Dr. Jay Campbell, Executive Director, NC Board of Pharmacy. Overall, they
recommended:
• Discussing the issue early on and gaining support Medical Society, NC Association of
Pharmacists, ACOG and other key organizations;
• Having the OC Board of Health write a resolution; and
• Consider waiting to see how OTC birth control works in California and Oregon.
The students’ conclusion included careful issue framing and incorporating lessons from other
states. The Board congratulated the students on a great presentation.
Board directed staff to continue to gather additional research from other countries and
states that have made birth control available over the counter. Within the next couple of
years, staff will bring this topic back to the Board.
VI. Action Items
A. Elections (Chair and Vice-Chair)
For the year 2017, Nick Galvez and Dan Dewitya were in que to be the next Chair and Vice-
Chair, respectively. Mr. Galvez announced that he and Dan Dewitya will be vacating their
positions on the Board as both of them will be moving out of Orange County. He continued by
thanking Mr. Dewitya for his time on the Board. This is Mr. Dewitya’s last meeting while
January’s meeting will be Mr. Galvez’ last.
Motion was made by Barbara Chavious to appoint Liska Lackey as Chair and Susan
Elmore as Vice-Chair, seconded by Reena Mehta and carried without dissent.
VII. Reports and Discussion with Possible Action
A. Health Director Report
There were no questions from the Board regarding the Health Director’s Report included in the
packet. Dr. Bridger mentioned that her term as NCALHD President is coming to an end. She
also mentioned that it’s been an eventful year that included teaching for the first time, her
daughter’s wedding and preparing for accreditation.
B. Media Items
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Media items were in the packet which focused on Orange County’s events and our
involvement in various efforts.
VIII. Board Comments
None.
IX. Adjournment
A motion was made by Susan Elmore to adjourn the meeting at 8:40 p.m., was seconded
by Dan Dewitya and carried without dissent.
The next Board of Health Meeting will be held January 25, 2017 at the Orange County
Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m.
Respectfully submitted,
Colleen Bridger, MPH, PhD
Orange County Health Director
Secretary to the Board
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: January 25, 2017
Agenda Item Subject: 2nd Quarter Financial Report FY 16-17
Attachment(s): 2nd Quarter Financial Report
2nd 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
second quarter is $203k/month or $1.2M YTD, representing 39% 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 but in line with projections for mid-year at
45.4%.
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 second quarter is 87% as
compared to 92% in FY 15-16 and the average rate for dental for second quarter FY 16-
17 is 99% as compared to 101% in FY 15-16.
Dental Earned Revenue by Source: The FY 16-17 average monthly revenue
($37k/month) for the second quarter is below our budget projection ($48k/month) and
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
$224k at the end of the second quarter.
Medical Earned Revenue by Source: Medical earned revenue is currently slightly
below the budgeted projection for FY 16-17 ($58k/month) at $53k/month. Medical clinic
revenue totals $319k for second 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
Second Quarter Financial Report
FY 2016-2017
TOTAL HEALTH Q2 YTD ACTUAL ANNUAL BUDGET
% OF ANNUAL
BUDGET
Revenue
Donations
Dental Health 0 (338)0 0.00%
Health Promotion & Edu (9,900)(15,860)(18,882)83.99%
Environmental Health (300)(300)0 100.00%
Personal Health (2,008)(2,258)(18,000)12.54%
Donations Total (12,207)(18,755)(36,882)50.85%
Internal Allocations
Dental Health 0 0 (18,000)0.00%
Finance and Admin Services 0 0 (23,500)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
Dental Health (109,951)(224,581)(570,183)39.39%
Finance and Admin Services 0 0 (107,646)0.00%
Environmental Health (101,470)(218,065)(542,124)40.22%
Personal Health (151,381)(319,723)(715,822)44.67%
Service Revenue Total (362,801)(762,369)(1,935,775)39.38%
State Allocations
Finance and Admin Services (11,902)(23,804)(42,885)55.51%
Health Promotion & Edu (37,254)(62,499)(102,464)61.00%
Environmental Health (1,091)(4,960)(34,000)14.59%
Personal Health (109,058)(210,007)(390,835)53.73%
State Allocations Total (159,305)(301,270)(570,184)52.84%
Grants Project Revenues
NACCHO Grant 0 0 (15,000)0.00%
Piedmont Hlth Srv - Nutr (6,360)(11,600)(33,800)34.32%
CC4C Accesscare (25,021)(62,066)(149,624)41.48%
PCM Accesscare (24,939)(61,936)(147,651)41.95%
Health Disparities 0 0.00%
Susan G. Komen Grant 0 0 (46,620)0.00%
Grants Project Revenues Total (56,320)(135,602)(392,695)34.53%
Revenue Total (590,633)(1,217,995)(3,123,108)39.00%
Orange County Health Department
Second Quarter Financial Report
FY 2016-2017
TOTAL HEALTH Q2 YTD ACTUAL ANNUAL BUDGET
% OF ANNUAL
BUDGET
Expenditures
Salaries 1,450,763 2,589,665 5,510,423 47.00%
Benefits 521,918 925,273 1,981,371 46.70%
Travel 1,774 3,429 9,997 34.30%
Training 6,483 13,863 44,208 31.36%
Certifications & Licensing 2,408 5,307 10,239 51.83%
Mileage 7,410 11,342 35,575 31.88%
Telephone 15,577 30,775 79,878 38.53%
Postage 2,541 5,822 15,402 37.80%
Motor Pool 7,467 20,243 48,807 41.47%
Equip Repairs 1,013 1,013 450 225.16%
Equip Rent 0 843 1,200 70.21%
Duplicating 1,768 3,364 12,244 27.48%
Printing 1,843 3,005 9,251 32.48%
Advertising 7,558 8,795 15,793 55.69%
Dues 645 1,070 5,370 19.93%
Subscriptions 245 384 1,500 25.60%
Dept Supplies 4,222 7,913 40,419 19.58%
Edu Supplies 998 1,883 13,325 14.13%
Office Supplies 6,888 16,658 39,379 42.30%
Medical Supplies 31,506 64,593 146,317 44.15%
Bloodborn Path Supplies 704 1,133 3,000 37.78%
Pharmacy Supplies 44,320 90,950 217,030 41.91%
Comp Supp/Software 25 1,174 2,854 41.12%
Contracted Srv 172,727 323,178 966,245 33.45%
X-Ray 3,153 5,992 23,625 25.36%
Lab Srv 28,262 57,347 73,206 78.34%
Bonds & Insurance 0 0 10,347 0.00%
Uniforms 1,274 4,388 8,333 52.66%
Community Proj 861 2,470 50,953 4.85%
Innovations Project 1,866 4,253 20,000 21.26%
Accreditation Project 0 2,750 2,750 0.00%
Family Success Alliance 38,559 59,034 0 0.00%
Credit Card Exp 1,531 2,960 10,000 29.60%
Capital Exp Under $500 5,941 9,265 4,906 188.84%
Nicotine Replacement Therapy 5,000 5,000 5,000 100.00%
Grant Project Expenditures
Health Disparities 0 (0)0 0.00%
Susan G. Komen Grant 8,191 10,579 46,620 22.69%
NACCHO Grant 5,837 6,386 15,000 42.57%
Capital Expenditures
Equipment 3,658 3,658 3,660 99.96%
IT Equipment 0 3,600 3,601 99.98%
Furnishings 0 969 1,101 87.97%
Grand Total 2,394,938 4,310,326 9,489,379 45.42%
Total County Revenue (Appropriation)1,804,305 3,092,331 6,366,271 48.57%
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Agenda Item Number
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: January 25, 2016
Agenda Item Subject: FY 2016-17 Fee Schedule & Requested Changes
Attachment(s): Fee Schedule & Requested Changes
Staff/Board Member Reporting: Rebecca Crawford, Finance and Administrative
Services Director
Purpose/Recommended Action: ___ Action/Approve
_x_ Action/Approve & forward to Board of Commissioners
___ Information with possible action
___ Accept as information
___ Revise & schedule for future action
Summary Information:
The Health Department reviews fee schedules on an annual basis through the budget approval
process; however, multiple procedures in Dental Health and labs in Environmental Health have
increased in frequency of use this fiscal year and it is necessary to add them to our fee
schedule in an effort to recover costs. The proposed changes are detailed below:
Dental Health
Dental Health requests the addition of two new fees for Provisional Splinting, intracoronal and
extracoronal. These procedures have been used more frequently this fiscal year and are costly
due to the supplies necessary to perform the procedures. Dental Health estimates performing
2-4 of each of these procedures per month for the remainder of FY 16-17. The fees were
determined based on the Delta Dental and Cigna reimbursement rates for these procedures as
the Usual, Customary, and Reasonable rates for this area for these fees were much higher
($252 and $316 respectively) and viewed as cost prohibitive for our 100% payers on the sliding
fee scale.
Name of Fee 2016-17
Current Fee
2016-17 Proposed
Fee
2016-17 Budget
Impact
Provisional Splinting, intracoronal $0 $115 $2,070
Provisional Splinting, extracoronal $0 $115 $2,070
Environmental Health
Environmental Health requests to add two additional fees for well water testing for Hexavalent
chromium and Coal Ash following the release of the October 2016 study by Duke University.
This study noted that Hexavalent Chromium occurs naturally in the Piedmont area of NC with a
higher prevalence than previously thought. Environmental Health has had 7 requests for
Hexavalent chromium tests and two requests for Coal Ash panels as of December 2016 and
anticipates sending off 6 samples each for these tests for the remainder of the fiscal year. The
cost of the fees were determined based on the cost for sample bottles, shipping, and staff
collection time.
Name of Fee 2016-17
Current Fee
2016-17 Proposed
Fee
2016-17 Budget
Impact
Hexavalent chromium $0 $90 $540
Coal Ash Inorganic Panel $0 $110 $660
Recommended Motion:
To approve the proposed fee changes for 2016-2017 as presented and forward to the Board of
County Commissioners for action.
Your source for the latest research news
Date:
Source:
Summary:
Hexavalent chromium is widespread in North Carolina wells
but not linked to coal ash
October 26, 2016
Duke University
Hexavalent chromium, a carcinogen made famous by the movie Erin Brockovich, is far
more abundant in drinking water wells in North Carolina than previously thought, a new
study finds.
FULL STORY
Groundwater testing revealed that nine out of ten
drinking water wells in North Carolina's Piedmont
region contain detectable levels of the carcinogen
hexavalent chromium, and that the contamination
stems from natural sources.
Credit: Avner Vengosh, Duke University
Hexavalent chromium, a carcinogen made famous by the movie Erin
Brockovich, is far more abundant in drinking water wells in North Carolina than
previously thought, a new Duke University study finds.
The contamination doesn't, however, stem from leaking coal ash ponds as many people feared after
state officials tested wells near coal plants last year and detected potentially harmful levels of
hexavalent chromium in the water.
Instead, it's caused by the natural leaching of mostly volcanic rocks in aquifers across the Piedmont
region.
"About 90 percent of the wells we sampled had detectable levels of hexavalent chromium, and in many
cases the contamination is well above recommended levels for safe drinking water. But our analysis
clearly shows it is derived from natural sources, not coal ash," said Avner Vengosh, professor of
geochemistry and water quality at Duke's Nicholas School of the Environment.
Page 1of 4Hexavalent chromium is widespread in North Carolina wells but not linked to coal ash --ScienceDaily
12/16/2016https://www.sciencedaily.com/releases/2016/10/161026111400.htm
"This doesn't mean it poses less of a threat," Vengosh stressed. "If anything, because the
contamination stems from water-rock interactions that are common across the Piedmont region, people
in a much larger geographic area may be at risk. This is not limited only to wells near coal ash ponds.
"The bottom line is that we need to protect the health of North Carolinians from the naturally occurring
threat of hexavalent chromium, while also protecting them from harmful contaminants such as arsenic
and selenium, which our previous research has shown do derive from leaking coal ash ponds,"
Vengosh said. "The impact of leaking coal ash ponds on water resources is still a major environmental
issue."
To conduct the new study, the researchers collected groundwater samples from 376 wells located both
close to and far from coal ash ponds across the Piedmont region of central North Carolina. Using
forensic geochemical tracers, they analyzed each sample for a wide range of inorganic chemicals,
including hexavalent chromium.
The tracers, which were developed by Vengosh and his team, allowed the scientists to identify the
geochemical fingerprints of contaminants in the groundwater and trace each contaminant back to its
source.
"Our analysis showed that groundwater samples with high levels of hexavalent chromium have very
different geochemical fingerprints than what we see in groundwater contaminated from leaking coal ash
ponds," Vengosh said.
"This, combined with the wide geographic distribution of samples containing elevated hexavalent
chromium -- regardless of proximity to a coal ash pond -- points to the natural leaching of chromium
from aquifer rocks in certain Piedmont geological formations," he said.
Piedmont formations with volcanic rocks are common across the southeastern United States and other
areas worldwide, Vengosh noted, so millions of people in regions outside North Carolina with similar
aquifers may be exposed to hexavalent chromium without knowing it.
The Duke team published its findings October 26 in the peer-reviewed journal Environmental Science
and Technology Letters.
In 2015, water-quality officials in North Carolina issued temporary "do not drink" recommendations to
residents living near coal-burning plants after tests detected potentially harmful levels of hexavalent
chromium in their well water samples. Because elevated levels of chromium typically occur in coal ash,
many people assumed the contamination was linked to the coal ash ponds.
Vengosh's team's study is the first to show otherwise.
The current drinking water standard for chromium in the United States is 100 parts per billion. This is
based on an assumption that most chromium contained in drinking water is composed of a less toxic
form known as trivalent chromium. Only California has set a statewide standard of 10 parts per billion
for the much more toxic hexavalent form.
Vengosh hopes his study's findings will lead more states to establish hexavalent chromium standards of
their own. "One of the most striking outcomes of this study is that it shows the concentration of
hexavalent chromium in groundwater is almost identical to the concentration of total dissolved
Page 2of 4Hexavalent chromium is widespread in North Carolina wells but not linked to coal ash --ScienceDaily
12/16/2016https://www.sciencedaily.com/releases/2016/10/161026111400.htm
Cite This Page:
Duke University. "Hexavalent chromium is widespread in North Carolina wells but not linked to coal
ash." ScienceDaily. ScienceDaily, 26 October 2016.
<www.sciencedaily.com/releases/2016/10/161026111400.htm>.
chromium, measured by a totally different technique" he said. "That means when you will find chromium
in groundwater, it is actually composed of its toxic form of hexavalent chromium, not the less toxic
trivalent form."
Story Source:
Materialsprovided by Duke University. Note: Content may be edited for style and length.
Journal Reference:
1.Avner Vengosh, Rachel Coyte, Jonathan Karr, Jennifer S. Harkness, Andrew J. Kondash, Laura S.
Ruhl, Rose B. Merola, Gary S. Dywer. Origin of Hexavalent Chromium in Drinking Water Wells
from the Piedmont Aquifers of North Carolina. Environmental Science & Technology Letters,
2016; DOI: 10.1021/acs.estlett.6b00342
MLAAPAChicago
Page 3of 4Hexavalent chromium is widespread in North Carolina wells but not linked to coal ash --ScienceDaily
12/16/2016https://www.sciencedaily.com/releases/2016/10/161026111400.htm
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: January 25, 2017
Agenda Item Subject: Integrated Behavioral Health Program Update
Attachment(s): Powerpoint Presentation
Staff or Board Member Reporting: Karen Kyes, Clinical Social Worker & Andrea
Mulholland, FNP
Purpose: ____ Action
_ X Information only
____ Information with possible action
Summary Information: Karen Keyes and Andrea Mulholland will provide an update on
the implementation of integrated behavioral health services as part of the Health
Department’s primary and preventative care services.
Background: On March 23, 2016, the BOH voted to approve - and forward to the Board
of Commissions (BOCC) for action - a request for one additional FTE for a Clinical
Social Worker to provide integrated behavioral health services as part of the Health
Department’s clinical services. At the April meeting, the BOCC approved the request to
add one FTE to provide integrated behavioral health services.
In June 2016, the Health Department hired bilingual (Spanish speaking) Clinical Social
Worker Karen Keyes to provide full time integrated behavioral health services at Whitted
and SHSC medical clinics.
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):
INTEGRATED BEHAVIORAL HEALTH &
THE ORANGE COUNTY HEALTH
DEPARTMENT
January 25, 2017
Overview
•Tonight We Will Review:
•Goals of Integrated Behavioral Health Program
•Case Studies
•Data and initial Outcomes
•Provider feedback
•Next Steps
OCHD Integrated Behavioral Health:
Goals
1.Increase client access to and utilization of
behavioral and mental health services.
2.Improve patient health outcomes, by
integrating behavioral and mental health
services as part of OCHD clinical services.
Jackie
•44 year old African American woman
•First visit to OCHD clinic
•In for STD testing after her partner told her he had an
infection. She had taken some of his antibiotics
before coming to her appointment.
•Our clinic staff informed Jackie she had tested
positive for an infection. They provided her with two
medications and 20 condoms. She became very
sad and tearful. The nurse came and got me.
OCHD Integrated Behavioral Health:
Goals
1.Increase client access to and utilization of
behavioral and mental health services.
2.Improve patient health outcomes, by
integrating behavioral and mental health
services as part of OCHD clinical services.
Conditions/Issues Addressed
•Anxiety and Depression
•Substance Use
Trauma and PTSD
Psychosocial risk factors such as economic stress, underemployment, relationship stress, acculturation
Conditions/Issues Addressed
Children with family stress, child
abuse/neglect, substance use, self-
mutilation, learning disabilities, bullying,
acculturation issues, trauma,
developmental delay
Mental Health conditions including
bipolar disorder, other psychotic
disorders, personality disorders, eating
disorders
•Medication Adherence and Healthy
Goal Setting.
Patient Population Served (July 2016 –
mid January 2017)
199 Patients Referred
•69% Uninsured
•44% Whitted
•56% Southern
145 Patients Served (73% of referrals)
341 Patient Visits
Initial Outcomes: PHQ-9
OCHD Integrated Behavioral Health:
Goals
1.Increase client access to and utilization of
behavioral and mental health services.
2.Improve patient health outcomes, by
integrating behavioral and mental health
services as part of OCHD clinical services.
Medical Provider Feedback
•Providing mental health services to
marginalized patients
•Overcoming barriers
•Improving health and vitality of patients
Than
•A 17 year old Asian immigrant boy
•First visit to OCHD
•Presented with 11 year old brother for vaccines. Was
found to have anemia, insomnia and poor appetite.
Next Steps
1.Initiate internal work group;
2.Introduce universal screening of all patients for
depression and substance use;
3.Develop standard clinical pathways for suicidality,
depression, and substance use;
4.Collaborate with community partners (Freedom
House, Compass Center, etc.) to strengthen ties
and work collectively to meet the health needs of
marginalized members of our society.
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: January 25, 2017
Agenda Item Subject: FY 2016-2017 Mental Health Gap
Analysis Update
Attachment(s): Mental Health Gap Analysis
Presentation (powerpoint)
Orange County Access to Mental Health
Services Assessment
Staff or Board Member Reporting: Sabrina Willard, UNC MPA Intern
Rebecca Crawford, FAS Director
Purpose: ____ Action
_ X Information only
___ Information with possible action
Summary Information:
The 2016-2018 Board of Health Strategic Plan requests advocacy for and the pursuit of
policies, practices, and partnerships that improve substance abuse and mental health
services in Orange County, especially to vulnerable populations such as the homeless
and those connected with the criminal justice system. Beginning in the fall of 2016, the
Health Department engaged a Master of Public Administration intern from UNC to
undertake an analysis of the barriers to mental health care in Orange County for
residents 0-25 years old. Sabrina Willard, the intern, reviewed UNC Emergency
Department data, interviewed key stakeholders, surveyed providers and community
advocates, and held focus groups to determine the barriers and then create an action
plan for prioritizing needs and meeting them. This presentation will include a summary
of her findings and next steps for preparing a budget request for the FY 17-18 Budget
process.
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):
ASSESSMENT OF ORANGE COUNTY MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES AN ASSESSMENT OF COMMUNITY ASSETS AND NEEDS IN ORANGE COUNTY, NC
BACKGROUND The North Carolina Institute of Medicine (NCIOM) stated in an October 2016 publication that “mental health and substance use are at the forefront of health policy issues today, both at the national and state levels, due to rising visibility of the costs of not addressing mental health and substance use treatment needs” (NCIOM, 2016). North Carolina’s transition to a managed care system 15 years ago brought fresh challenges for local officials seeking to implement comprehensive, coordinated community-based prevention, treatment, and recovery services to meet the needs of their residents. Though progress is evident in some areas, NCIOM reported that this level of care “remains an elusive goal for many North Carolinians with mental health and substance use disorders.” Like the rest of North Carolina, Orange County struggles to meet the need for mental health and substance abuse services for residents, especially those ages 0-25. This assessment was initiated by the Orange County Health Department (OCHD) to determine what barriers professionals face as they seek to refer county residents to mental health and substance abuse treatment services. The results of this assessment will be shared with the Board of County Commissioners prior to their strategic planning session in January 2017. According to the U.S. Department of Health and Human Services, the majority of adolescents in North Carolina with mental health and substance use needs do not receive treatment services. Orange County is home to more than 141,000 residents, including up to 2,200 residents aged 3-17 that are currently being treated for these conditions through the managed care organization Cardinal Innovations. In Orange County, hospitalization records from 2009-2015 demonstrate the percentage of visits due to mental health for youth 0-24 years is increasing as a proportion of all mental health visits (an increase from around 18% to 24% of all mental health visits). Data from the same period show that between 27% and 31% of all mental health visits for 0-24 year olds are a result of mental and behavioral disorders due to psychoactive substance abuse. OCHD sought a clearer understanding of the extent patients in the 0-25 age group have access to resources for prevention and early intervention, as well as follow-up care and other support systems for recovery. Simultaneously, we sought to identify the areas where these services could be improved by pinpointing significant barriers to treatment. UNC Master of Public Administration student Sabrina Willard conducted the assessment from August to November 2016. Ms. Willard interviewed ten prominent figures in the mental health community, surveyed more than 150 individuals based in the fields of healthcare,
social services, criminal justice, behavioral therapy, K-12 education, and others, and analyzed UNC Chapel Hill Emergency Department records.
BARRIERS TO ACCESSING TREATMENT The primary findings of the assessment showed that existing levels of service do not adequately address the needs of this population although there are many examples of successful collaborations taking place across the county in an attempt to address the gaps. Responses from key opinion leaders around the barriers to accessing treatment for mental health and substance abuse helped to inform the findings included in the below table. These common themes were also incorporated into the survey questionnaire as a method for confirming their validity with a larger group.
BARRIERS TO MENTAL HEALTH (MH) AND SUBSTANCE ABUSE (SA)
TREATMENT AND RESOURCES
Theme Description
Affordability - #1 Gap The #1 gap in the OC mental health system is affordability. Many low-income residents either do not have insurance or find their coverage inadequately covers treatment services for MH and SA (e.g. must meet a high deductible before any coverage is provided, lack of reimbursement options, restricted to a low maximum number of appointments, etc.). This issue is exacerbated when adolescents age out of the Medicaid system at 18. There are very few sliding scale or pro bono options to fill this gap. Children and adolescents have difficulty with recovery if parents with mental health issues aren’t treated as well, but parents run into these same issues with affordability.
Location/Transportation - #2 Gap
Transportation was ranked as the 2nd largest barrier to MH/SA services in Orange County. Services are especially scarce in the northern part of the county (i.e. Hillsborough and unincorporated areas). Public transportation helps somewhat with the older patients in the southern sector, but the younger ones still have unmet needs. This dilemma emphasizes the need for more accessible treatment centers and in/near-school care, especially when parents are unable to take their children to necessary appointments due to busy work schedules or other conflicts.
Language/Cultural - #3 Gap
For the most part, services for non-English speaking patients are either difficult to obtain or virtually inaccessible. 60% of respondents said it was difficult for non-English speaking
Language/Cultural - #3 Gap (cont’d)
residents to access services for any of the listed disorders (Major Depressive, Generalized Anxiety, Bipolar, Personality, Eating, Substance Abuse, or Schizophrenia Spectrum), making this the #3 gap identified in the survey. There is need for more diversity in the languages MH and SA services are offered in (i.e. Spanish, Burmese/Karen… etc.), as well as cultural competency training to help providers better understand how to work with refugee/undocumented populations. Culturally-relevant practices that provide support for LGBTQ teens are also needed.
Education to combat stigma (adolescent
and family) - #4
Awareness initiatives in the community are helping combat the stigma associated with MH conditions. More could be done to continue the dialogue encouraging people to seek appropriate treatment. Parents also need to be educated about the importance of ensuring their child gets the help they need. Barriers exist where parents are either unaware of the importance of taking their child to appointments or have busy schedules that conflict with their ability to do so. Knowing how to navigate the Cardinal system and properly enroll their child in MH and SA services is a barrier to accessing treatment.
Post-diagnosis maintenance of care - #5 Non-emergency treatment options are non-existent or scarce. Psychiatric care in particular is a critical need for adolescents yet this type of therapy is largely unavailable to this population, especially if uninsured. In general, there is a need for more varied types of therapy (i.e. cognitive behavioral therapy, other types of counseling), as well as therapists trained to do trauma work both in the school systems and in the community.
Preventive/Early intervention care - #6 Preliminary efforts to incorporate MH services into the school system are showing success. More robust systems for identifying issues earlier within the primary care and school settings are still needed. There is also a need for more variety of screening tools.
Citizenship status – barrier identified
through stakeholder interviews and survey
responses
Cardinal Innovations does not provide behavioral health services to residents without proof of US citizenship. Undocumented immigrants have to rely on the scarce services provided by other community organizations.
Inpatient Care Usage/Access – barrier
identified through stakeholder interviews
and survey responses
2009-2015 UNC Hospital data obtained shows that after an initial decline in mental health-related Emergency Department (ED) visits
Inpatient Care Usage/Access – barrier
identified through stakeholder interviews
and survey responses (cont’d)
between 2009 and 2012, we have begun to see a large increase in visits for patients 0-24 (51%). This increase supports reports of ED overcrowding we’ve received from UNC Hospitals. The percentage increase of youth mental health ED visits is also increasing at a faster rate than overall mental health ED visits (25% compared to 18%.) In the case of substance abuse, 29% of all mental health ED visits for 0-24 year olds are substance abuse related.
Disorder/Diagnosis Type - barrier
identified through stakeholder interviews
and survey responses
Survey data indicates that generalized anxiety disorder and major depressive disorder are the two mental illnesses that most frequently affect residents aged 0-25 in Orange County (93% and 89% respectively) and are also the easiest to refer for treatment. Drug and alcohol abuse were also frequent diagnoses (80% of respondents for both) however, only 39% of respondents found them easy to refer for treatment. Schizophrenia spectrum and other psychotic disorders were deemed the most difficult to refer for treatment (25%) and treatment for eating disorders was said to be the most inaccessible (11%). CONCLUSION The most common barriers for people in Orange County aged 0-25 who need mental health and/or substance abuse treatment services were affordability and accessibility.
Affordability
One of the biggest barriers to accessing services, even when they are available, is the lack of services that are provided based on a person’s ability to pay. Any improvement to the mental health system in Orange County will need to address the affordability of these services.
Accessibility We found that the ability to access services depends on a variety of factors (service type, location, eligibility and cultural/linguistic appropriateness) all of which have gaps. Certain types of services such as substance abuse treatment and psychiatric care are hard to find. The location of mental health services in the population centers makes them difficult for this age group to access. Restrictions on who can receive services (e.g., age, citizenship, diagnosis) results in decreased access. Finally, the inability to provide needed mental health services in a linguistically and culturally appropriate manner significantly limits access.
Next Steps:
The Health Department will convene a group of stakeholders to review the detailed results of this gap analysis (survey results attached). This group will prioritize which specific gaps to address first and identify potential programs and services to meet those prioritized needs by February 15, 2017. ACKNOWLEDGEMENTS Thank you to all of the participants who generously gave their time to this assessment. Special thanks to: Orange County Criminal Justice Resource Office (Caitlin Fenhagen) | Orange County Health Department (Allison Young, Juliet Sheridan, Coby Austin, Jennifer Sharpe, and Karen Kyes) | Freedom House (Trish Hussey) | El Futuro (Luke Smith and Karla Siu) | Cardinal Innovations (Debra Farrington) | UNC Healthcare (Tammie Stanton) | UNC Pediatric Psychiatry (Jack Naftel) | UNC School of Social Work (Josh Henson).
Assessment of Orange
County Mental Health
and Substance Abuse
Services
An assessment to identify community assets and needs
in Orange County, NC
PHASE 1: GAP ANALYSIS
August to December 2016
Background
Initiated by the Orange County Health Department to
determine what barriers professionals face as they seek
to refer county residents aged 0-25 to mental health and
substance abuse treatment services.
18 to 24%
increase in 0-25
mental health visits
as a proportion of all
mental health visits
27 to 31%
increase in mental
health visits due to
psychoactive
substance abuse
Youth hospitalization
records from 2009-
2015 indicate:
Research Methodology
10 informational interviews with prominent
figures in the mental health community
150 individuals surveyed based in the fields
of healthcare, social services, criminal justice,
behavioral therapy, K-12 education, and
others
Barriers to Accessing Treatment
The most common barriers for Orange County residents aged 0-25 who need mental health and/or substance abuse treatment services were:
Affordability: Many low-income residents either do not have insurance or find their coverage inadequately covers these services.
High deductibles, few sliding scale/pro bono options, low maximum number of appointments… etc.
Accessibility: Based on a variety of factors, all of which have gaps.
Citizenship status, language/cultural, location, type of condition… etc.
PHASE 2: FOCUS GROUPS
January 2017
Purpose & Format
Health department hosted 39 survey
participants at a session to strategize two
overarching priorities for improving the mental
health system in FY 2017-18.
Small groups
•Educators
•Citizen
activists/partners
•Law enforcement, etc.
•Mental Health
Providers
Large group
All participants
reconvened to
align on strategic
priorities.
Feedback
The majority of focus group participants were in
favor of increasing the capacity for three
overarching priorities:
Restore funding for early intervention care from birth
to age 5
In-school services in K-12th grade (i.e. 1+ mental
health therapist per school)
Community-wide education to navigate accessibility
issues
Next Steps
Present top 2 priority areas to BOCC at their
February 21st meeting
Use BOCC feedback as applicable to seek
funding for programs and services that
support the priority areas for the FY 17-18
budget
Questions?
Sabrina Willard
willards@live.unc.edu
(480) 353-7101
www.OrangeCountyNC.gov/Health
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: January 25, 2017
Agenda Item Subject: Selection of Interim Health Director
Attachment(s):
Staff or Board Member Reporting: Liska Lackey
Purpose: __X__ Action
_ _ Information only
____ Information with possible action
Summary Information:
Colleen Bridger’s final day as Health Director is February 23, 2017. The Board is
responsible for hiring an interim director until it has recruited and hired a new Health
Director.
Dorothy Cilenti, DrPH, MPH, MSW served as interim director for the Orange County
Health Department 2011, prior to Dr. Bridger’s hire, and she is available to serve in this
position again. She has worked in local and state public health agencies in North
Carolina for more than 20 years and was previously health director in Alamance and
Chatham counties. Dr. Cilenti is currently a Clinical Assistant Professor in the
Department of Maternal and Child Health at UNC and the former Administrator of the
NC Local Health Department Accreditation Program at the UNC Gillings School of
Global Public Health in Chapel Hill.
Recommendation: The Board of Health select Dr. Cilenti as Interim Health Director and
delegate to the county manager responsibility for negotiating the terms of employment
and completing the hire.
Recommended Action: ___Approve
___Approve & forward to Board of Commissioners for action
_X_Approve & forward to County Manager
___Accept as information
___Revise & schedule for future action
___Other (detail):
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: January 25, 2017
Agenda Item Subject: Selection of New BOH Members
Attachment(s):
Staff or Board Member Reporting: Liska Lackey
Purpose: ____ Action
____Information only
_X__Information with possible action
Summary Information: The Board of Health will vote to recommend a new Pharmacist and a
General Public Seat representative for appointment by the Board of County Commissioners.
Background: The new representatives will fill the seats vacated by Dan Dewitya and Nick Galvez.
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
January, 2017
• December 1st I joined Ron Johnson for a live interview on WCHL recognizing World AIDS
Day. Ronald is the Vice President of Policy and Advocacy for AIDS United.
• Health Department Staff and I worked hard to recruit talented applicants for the two
BOH vacancies. It worked! Susan and Liska report multiple great applicants for both
positions.
• Coby Austin and I are working with a multidisciplinary team including members from
UNC Hospitals and FSA to plan and submit a BUILD grant. This national competition
requires local health departments, community members and local hospitals to work
together to address social determinants of health. The application is due at the end of
February.
• We had yet another early January snow storm. Thankfully there were no major power
outages, so Health Department staff was not needed to staff the shelters.
• We had our Accreditation Site Visit two weeks ago. The site visitors were quite
complimentary of our documentation, facilities, BOH members and staff. I hope to have
the results of the visit in the next few days. They left 4 hours early which is generally a
good sign. Special thanks to Susan, Liska and Sam for agreeing to be interviewed by the
site visit team.
• Last week I oriented our newest Commissioner, Mark Marcoplos to the OCHD. He is very
interested in the services we provide and was especially pleased with the Family Success
Alliance.
• Last week was also the State Health Director’s Conference. It was a nice opportunity to
see colleagues with whom I have worked for the last 20 years one last time before
heading out to Texas. Susan was there representing the NC Board of Health Association
and did great!
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: January 25, 2017
Agenda Item Subject: Planning for Health Director Recruitment
Attachment(s):
Staff or Board Member Reporting: Liska Lackey and Susan Elmore
Purpose: ____ Action
_ _ Information only
_X__ Information with possible action
Summary Information:
The Board will discuss planning for the recruitment of the new health director.
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):
CHAPEL HILL: OPINION
NOVEMBER 27, 2016 7:20 AM
A new approach to an old problem:
Chapel Hill takes on dangerous
drinking
BY COLLEEEN BRIDGER, WINTON CRISP, ROGER STANCIL AND ELINOR
LANDESS
Issues related to college students and alcohol use are hardly new. In fact, in 1355
a fight over the quality of wine served to two Oxford University students escalated
into a riot that left over 100 people dead.
The Mayor of Oxford complained to the King of England about the students, and
the king responded by ordering the mayor to attend a mass every year on the day
of the riot in remembrance of the students killed. This practice continued for 470
years.
While we have not had riots related to the quality of a glass of wine in Chapel
Hill, our community is affected by high-risk drinking. So, unlike Oxford where
the mayor sought relief from the king, in 2013 the mayor of Chapel Hill and the
Chancellor of UNC came together to address high-risk drinking in our
community. Today, that effort exists as a new organization called the Campus &
Community Coalition.
The Campus & Community Coalition to Address the Negative Impacts of High-
Risk Drinking is doing just what its name suggests – working to mitigate the
harmful effects of risky alcohol use in our community.
We define high-risk drinking as drinking in a way that increases the likelihood of
negative consequences. Because state law prohibits alcohol use by those under 21,
underage drinking is high-risk drinking, as is binge drinking. Negative
consequences include such impacts as unplanned or unsafe sex, accidents, fights,
or injuries. Additionally, secondhand effects of high-risk drinking can also impact
peers and the wider community with disruptive neighborhood behaviors like
noise, trash, vandalism, or property damage.
Rather than an adversarial relationship like the one in our Oxford example, the
Chapel Hill Campus & Community Coalition is proof of true collaboration
between not just the town and university, but also between partners from across
Chapel Hill. Our coalition is funded equally by the town of Chapel Hill, UNC, the
Orange County Health Department, and the Orange County ABC Board.
Additionally, the coalition members are business owners, neighborhood
residents, students, and representatives from our funding groups. All of us
recognize that to create change, we must work together.
We are approaching this work with a public health mindset. This framework
allows us to see the issue as one of policies and systems, rather than just
problems with individuals. To use a popular analogy, when you come across a
sick fish in a river, the public health model doesn’t just treat the sick fish and
move on. Rather, the public health model encourages us to examine the river to
determine the cause of the fish’s illness. So, when we’re thinking about high -risk
drinking, our coalition looks at the entire community.
To change the culture of high-risk drinking in Chapel Hill our Coalition is using a
set of 22 comprehensive strategies. These strategies came from a year of
researching national best practices and collecting local data to determine the
issues we needed to address. Research tells us that no single program or
intervention alone is sufficient to effectively reduce high-risk drinking in a college
community. However, by addressing dangerous drinking with multiple tactics, we
are better able to have a real impact in our community.
The strategies we are using include policy recommendations, educational
initiatives, and an enhanced level of collaboration between organizations that
allows us to communicate and act consistently with a unified message. The most
significant coalition strategy already in place is the new Campus Alcohol Policy at
UNC. It focuses on education, prevention and accountability, as well as treatment
and recovery for those who need it. Other approaches include engaging in a
comprehensive set of strategies that are jointly administered and enforced by the
town and university to address off-campus parties and raising the awareness of
alcohol-related impacts among parents of high-school students, parents of
university students, and alumni of the University.
The Chapel Hill Campus & Community Coalition is committed to working
collaboratively using a public health approach to reduce the negative impacts of
high-risk drinking in our community. We know that alcohol misuse among
college students is hardly a new issue. However, we believe that with this strong
collaborative framework we can make a difference in our town.
For further information see the Campus & Community Coalition
website: www.downtownchapelhill.com/coalition.
Dr. Colleen Bridger is the director of the Orange County Health Department,
Winston B. Crisp is UNC’s vice chancellor for student affairs, Roger L. Stancil is
Chapel Hill’s town manager and Elinor Landess is the director of the Campus &
Community Coalition.
Read more here: http://www.newsobserver.com/news/local/community/chapel-hill-news/chn-
opinion/article116798873.html#storylink=cpy
WCHL ON DEMAND
Orange County Health Director Leaving for San
Antonio Post
Posted by Blake Hodge | Dec 19, 2016 | Health | 0
Orange County health director Dr. Colleen Bridger has announced her resignation effective February 23, 2017.
The announcement came in a release on Monday saying that Bridger had accepted the position of public health
director with the San Antonio Metropolitan Health District.
Bridger said in the release that it was not an easy choice to leave Orange County.
“This was a difficult decision. I love it here! I love the Board of Health, the Board of County Commissioners,
and most of all; the Health Department staff. They make my job easy, fun, and fulfilling. It is because of the
great work we have done in Orange County, that I am ready for this next big challenge.”
Bridger has been with the Orange County Health Department for more than five years.
An interim director will be appointed while a national search for Bridger’s replacement is conducted.
“With Colleen at the helm, Orange County has been able to adopt and implement many progressive policies
and programs. The Board of Health and health department’s dedicated staff are committed to continuing her
legacy in our search for the new Director,” said Liska Lackey, chair of the Board of Health.
Bridger will begin her new position in San Antonio on March 6.
Chapel Hill News
December 20, 2016 10:10 AM
Orange County’s health director is leaving for San Antonio job
HILLSBOROUGH
Health Director Colleen Bridger announced this week she will resign Feb. 23 to take a new job in San
Antonio, Texas.
Bridger will begin her new role as public health director of the San Antonio Metropolitan Health District
– the nation’s seventh largest city health department – on March 6.
It was a difficult decision to leave, Bridger said in a news release.
“I love the Board of Health, the Board of County Commissioners, and most of all; the Health Department
staff. They make my job easy, fun, and fulfilling. It is because of the great work we have done in Orange
County, that I am ready for this next big challenge,” Bridger said.
She has led the Orange County Health Department for more than five years, implementing such
programs as the comprehensive Smoke-Free Public Places Rule, the Family Success Alliance anti-poverty
program, the town-gown high-risk alcohol collaborative, and overdose prevention and harm reduction
projects, including naloxone access and safe syringe disposal and acquisition.
“With Colleen at the helm, Orange County has been able to adopt and implement many progressive
policies and programs,” said Liska Lackey, Board of Health chairwoman. “The Board of Health and health
department’s dedicated staff are committed to continuing her legacy in our search for the new
director.”
Bridger plans to complete the health department’s reaccreditation and budget processes before leaving.
The Board of Health will post the vacant position and seek applicants early in the new year. An interim
health director will be named before Bridger leaves, health officials said.
Read more here: http://www.newsobserver.com/news/local/community/chapel-hill-
news/article121943113.html#storylink=cpy
Orange County health director leaving
December 19, 2016
HILLSBOROUGH – Orange County Health Director Dr. Colleen Bridger is leaving to become public health
director with the San Antonio Metropolitan Health District in Texas.
Her resignation is effective Feb. 23, 2017. The Board of Health will name an interim health director while
conducts a national search.
Bridger will begin her new role with the 7th largest city’s health department on March 6.
Bridger called her decision difficult. “I love it here! I love the Board of Health, the Board of County
Commissioners, and most of all; the Health Department staff.\,” she said. ‘”They make my job easy, fun,
and fulfilling. It is because of the great work we have done in Orange County, that I am ready for this
next big challenge.”
Bridger has led the Orange County Health Department for more than five years and pioneered several
innovative, public health initiatives.
“Orange County has implemented programs that have not only created access to, and improved
opportunities for, a culture of health beyond the clinic walls, but opened doors for other health
departments to do the same,” the department said in a release announcing Bridger’s departure.
Those inititives included a comprehensive Smoke-Free Public Places Rule; the county’s collective impact
anti-poverty program, The Family Success Alliance; the town/gown high-risk alcohol collaborative; as
well as overdose prevention and harm reduction projects related to safe syringe disposal and acquisition
and naloxone access.
“With Colleen at the helm, Orange County has been able to adopt and implement many progressive
policies and programs. The Board of Health and health department’s dedicated staff are committed to
continuing her legacy in our search for the new Director,” said Liska Lackey, chair of the Board of Health.