HomeMy WebLinkAboutBOH agenda 053117ORANGE COUNTY BOARD OF HEALTH
MEETING AGENDA
DATE: May 31, 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 May 31, 2017 Agenda
7:10 – 7:15 IV. Actions Items (Consent)
A. Minutes of April 26, 2017 Liska Lackey
7:15 – 8:00 V. Educational Sessions
A. Innovation Grant Update Victoria Hudson
B. Child Fatality Task Force Report Pam McCall
C. Communicable Disease Annual Report Iulia Vann
8:00 – 8:10 VI. Action Items (Non-Consent)
A. Board Vacancy Recommendation 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 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 April 26, 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 and Sam Lasris.
BOARD OF HEALTH MEMBERS ABSENT: Johanna Birchmayer, Reena Mehta and Timothy
Smith.
STAFF PRESENT: Dr. Dorothy Cilenti, Interim Health Director; Coby Jansen Austin, Director of
Programs and Policy; Jennifer Baker, Accounting Tech I; Alan Clapp, Environmental Health
Director; Donna King, Health Promotions and Education Services Director; Pam McCall,
Personal Health Services Director; Janice Poole, Nursing Assistant; Dr. Erica Pettigrew, Medical
Director; Kimberlee Quatrone, Administrative Officer; April Richard, Senior Public Health
Educator, Tobacco Prevention and Control Coordinator; Beverly Scurry, Board of Health
Strategic Plan Manager; Stacy Shelp; Communications Manager; La Toya Strange,
Administrative Assistant II and Seth Teague, Environmental Health Specialist.
GUESTS PRESENT: None.
I. Welcome New Employees
Liska Lackey, Chair, called the meeting to order. Dr. Cilenti welcomed the new employees in
attendance: Jennifer Baker,Janice Poole, Beverly Scurry and Seth Teague.
II. Public Comment for Items NOT on Printed Agenda: None
III. Approval of the April 26, 2017 Agenda
Motion was made by to Susan Elmore approve the agenda, seconded by Mia Burroughs
and carried without dissent.
IV. Action Items (Consent)
A. Minutes of March 22, 2017 Meeting
Motion was made by Sam Lasris to approve the minutes of March 2017, seconded by
Jennifer Deyo and carried without dissent.
V. Educational Sessions
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A. Animal Services Update
Bob Marotto, Director of Animal Services, gave a presentation on the Animal Services along
with some fun facts. Below are some of the highlights.
• Overview of Animal Services
o Core services
Animal and rabies control, animal protection and animal sheltering
o Scope of service
All of Orange County including municipalities (aside from Mebane)
o Governance
Animal Services Advisory Board
Works with staff to advise commissioners on policies and programs
Animal Services Hearing Panel Pool
Provides appeals of decisions made by the Animal Services Director
Examples include dangerous animal declarations, order for the removal of
nuisance animal, etc.
• Rabies Control
o With delegated authority from the OCHD’s health director to the Animal Services
director to:
Manage animal bites to people (10 day confinement) regardless of
vaccination status and rabies exposure to pets (human rabies exposures is
the health department’s sole responsibility)
Refer all exposures and suspected exposures to Communicable Disease
nurses that assess risk and make treatment recommendations
o In 2016, Animal Services had 242 bite cases and investigated 111 rabies
exposures.
• Rabies Prevention
o Conduct low-cost rabies vaccination clinics throughout the year with 1 and 3-year
rabies vaccinations offered with more than 1000 dogs and cats vaccinated
annually at these clinics
o Microchips are also available
o Promote events such as World Rabies Day and communicates with local
veterinary clinics about rabies and rabies management
• Free Roaming Cats
o Huge issue in the community and have not fared well in community animal
shelters with only 4% being recovered by an owner
o OC Animal Services has developed a 5-year plan for managing “free
roaming cats” that includes several key components:
Encouraging responsible cat ownership (or guardianship)
Spaying and neutering as well as routine vet care
Confinement and environmental enrichment
Collaboration with community partners to provide fosters for the offspring of
feral and semi-feral cats so that they may be socialized and homed as a pet
Area or neighborhood pilot projects that provide spaying and neutering and
rabies vaccinations
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The BOH members had questions that were addressed by Mr. Marotto and Susan Elmore.
B. 3rd Quarter Financial Reports & Billing Dashboard
Pam McCall, Personal Health Services Division Director, gave a report on the 3rd quarter
revenue and billing accuracy. The report is as follows:
• 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.
C. Advisory Board Update
Beverly Scurry, Board of Health Strategic Plan Manager, gave a brief summary of the Orange
County advisory boards’ activities as they pertained to the BOH. Ms. Scurry stated that three
themes were prevalent amongst the advisory boards: support for the Family Success Alliance
(FSA), racial equity work and physical activity and nutrition. Below are some highlights as it
relates to BOH priorities in the Strategic Plan:
• OC Schools Board of Education (BOE) –
o At the November 28th meeting, the BOE approved the FSA 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.
o The BOE approved a letter of support to be sent to the BOH in support of the
FSA and its importance to the school district.
• Board of County Commissioners (BOCC) –
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o At the September 29th meeting, Dr. Colleen Bridger gave a detailed presentation
to the BOCC on the FSA.
o During the November 1st meeting, Coby Jansen Austin presented the five-year
budget projections presentation to the BOCC.
o The BOCC passed a resolution at the November 15th meeting in support of Equal
Rights Amendment which supports equal rights for all residents of Orange
County.
• Carrboro Board of Alderman –
o 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 Road, and sidewalk installation on Barnes
Street.
• Hillsborough Board of Commissioners –
o 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.
o The board was also informed that alcohol sales to minors have decreased
significantly in the county.
o 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.
o Board members have expressed a lot of interest in racial equity training and are
encouraged to attend training.
• Orange Unified Transportation Board (OUTBoard) –
o A petition was presented to the 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.
o 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.
VI. Action Items (Non-Consent)
A. Board Reappointments
Liska Lackey, Chair, conveyed that there were three Board members whose term will be ending
soon. The Board of Health will vote to recommend Liska Lackey to her 3rd term; Susan Elmore
to her 3rd term; and Jessica Frega to her 1st full term. She also mentioned that this was Reena
Mehta’s last meeting and that the search for her replacement is ongoing. She reminded them
that state law requires that the member be an optometrist that lives in Orange County.
Motion to reappoint Liska Lackey was made by Sam Lasris, seconded by Barbara
Chavious, and carried without dissent.
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Motion to reappoint Susan Elmore was made by Barbara Chavious, seconded by Sam
Lasris, and carried without dissent.
Motion to reappoint Jessica Frega was made by Sam Lasris, seconded by Jennifer Deyo,
and carried without dissent.
VII. Reports and Discussion with Possible Action
A. Health Director Report
In addition to her report, Dr. Cilenti added that she met with Bonnie Hammersley, County
Manager, and discussed the recommended budget for FY17-18. Below is a brief summary.
• No new positions without a revenue source will be approved due to the county’s fund
balance declining
• $15,000 reduction to lab services in the clinics.
• $15,000 has been recommended to be allocated to Environmental Health. $18,000 in
fees from the WTMP program are projected to come in.
• A behavioral health consultant was recommended for funding at $80,000.
• A senior public health educator position to support FSA and a data systems manager
position were not approved.
• A small increase for a contractor for interpreter/language services was recommended.
• Dental revenue projected at $50,000 less for next year.
• Increase funding for text system was recommended.
B. Media Items
Media items were in the packet which focused on Orange County’s events and our
involvement in various efforts.
Liska Lackey, Chair, acknowledged Stacy Shelp, Communications Manager, for all of her
contributions to the OCHD and wished her well. This will be her last BOH meeting. Coby
Jansen Austin also reminded the BOH members about the racial equity training.
At 8:02pm, Jessica Frega motioned to move into closed session and Barbara Chavious
seconded.
VIII. Closed Session to Discuss Health Director Recruitment
During the closed session, the Board of Health discussed candidates for the health director
position.
IX. Adjourn to Open Session
The Board of Health adjourned to open session at 9:00pm.
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X. Board Comments.
None.
XI. Adjournment
The meeting was adjourned at 9:00 pm.
The next Board of Health Meeting will be held May 31, 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: May 31, 2017
Agenda Item Subject: Innovation Grants Update
Attachment(s): Innovation Grants Update - presentation
Staff or Board Member Reporting: Guest Speaker Victoria Hudson
Innovation Grants Manager, OCHD
Purpose: ____ Action
_ x_ Information only
____ Information with possible action
Summary Information:
Victoria Hudson, Innovation Grants Manager, will discuss updates to the 2016
Innovation Grant projects, adjustments to the process, the current 2017 projects, and
the process for 2017-2018.
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):
Innovation Grant
Fund Update 2017
Victoria Hudson
Innovation Grants Manager
Purpose
•The Orange County Health Department strives
to empower all staff to identify, study, and
solve problems that impede quality services
delivery and access for clients and the public.
•The Innovation Fund is a great tool that
provides a way for staff to identify innovative
potential solutions and receive funding to
pilot that solution.
History – funding
•Medicaid Cost Settlement dollars were set aside by the
Board of Health, at the request of the Health Director
Colleen Bridger, in order to create a fund for new,
innovative projects. This was formalized in the fall of
2012, with the first year of projects starting in 2013.
History – projects
IMPLEMENTATION YEAR GRANTS
2014 4
2015 5
2016 10
2017 (1/2) 1
2016 PROJECTS
Nutrition Services: Client Feedback as a
Marketing Tool Food Establishment Excellence Program
Technology Access for Patient
Education and Satisfaction
Project Safe Sleep
Corrective Action Stickers Supporting Transportation Solutions for
FSA families
Double Handle Lift Tool Mindfulness Training
Prenatal Oral Health Incentive Program
Septic Maintenance App
Adjustments to the Process
•Encourage team approach
•Know technological limitations
•Be realistic about time for implementation
•Develop stronger evaluations
•Fiscal accounting methods
2017
•One grant for a Pre-k Tooth Brushing Initiative
Jan-Jun.
•Implementation period extended for 3
projects not complete by the end of 2016 until
June.
•Call for applications in May for the 2017-2018
grant period which begins July.
Success – Septic Assist
Septic Assist – the numbers
Success – Pre-k Tooth Brushing
•Consultation and collaboration
–Pre-K program Specialist, Ellen Kaji
–Family Success Alliance staff
–Health/Nutrition Specialist working for Orange County Head
Start, Courtney Latta Sosebee
–CHCCS with OC Environmental Health Staff
•New Hope pre-k was selected as pilot school
•Dental staff went to the school and completed the first
dental education with the three target audiences:
teachers, parents and students.
Pre-K Tooth Brushing
•Consultation
–Pre-K program Specialist, Ellen Kaji
–Family Success Alliance staff
–Health/Nutrition Specialist working for Orange County Head
Start, Courtney Latta Sosebee
–CHCCS with OC Environmental Health Staff
•New Hope pre-k was selected as pilot school
•Dental staff went to the school and completed the first
dental education with the three target audiences:
teachers, parents and students.
Pre-K Tooth Feedback
•When the project was still being discussed with the
teachers, there was resistance to implement the
program, through education and compromising on the
timing, the teachers have now shown enthusiasm for the
project.
•The parents were excited to be part of this project and
showed interest.
•The students have enjoyed dental visits and also seem to
be excited about brushing during school.
Questions?
www.OrangeCountyNC.gov/Health
Submitted May 31, 2017
O RANGE C OUNTY
H EALTH
D EPARTMENT
I NNOVATION G RANT
U PDATES FOR
2016-2017
2016 G RANT
A WARDS P .2
2017 G RANT
A WARDS P .5
May 31, 2017
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2016 Grant Awards
2016 was an exceptional year for our Innovation Grant program by funding ten
projects, as listed below, from a record number of proposals (24 total).
Supporting Transportation Solutions
Granted: $3105
Expended: $1621
Lead Innovators: Meredith McMonigle, Allison Young
This innovation grant supported a pilot project to explore using Uber® as a
transportation solution for low-income FSA families in Orange County. Navigators
were trained and enthusiastic about Uber®. They even saw it as a potential work
option for families and their larger network. FSA staff still does not know what the
impact will be on them and how useful they find it. FSA staff has created a survey
to capture this information when families are ready to complete it.
Mindfulness Training
Granted: $1500
Expended: $1500
Lead Innovators: Kathleen Goodhand, Rebecca Crawford, Pam McCall
This grant contracted with a certified Mindfulness Instructor to offer training to
clinical staff for a period of 8 sessions. Implemented in early 2016 and offered to
employees at location for access at Whitted and SHSC, this project provided
mindfulness and stress-relieving techniques to staff. The enrollment was good and
many employees were able to attend all eight sessions. A pre-program survey, a
post-program survey, and a final survey were used for participants to measure
their progress at making these techniques into good habits.
Establishment Excellence Program
Granted: $750
Expended: $722
Lead Innovator: Victoria Hudson
This innovation grant developed a vinyl window cling and recognition program for
establishments in Orange County who earn a 98 or better on sanitation inspections
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or participated in advanced food safety training. This project was best suited for
implementation after the 2015-2016 inspection concluded. The window clings
were ordered and received in August, and the press release did go out the last
week of August. Consumers started seeing these in September. Evaluation
efforts have not been successful but the approval of operators to display the
graphic and the interest that consumers have about Establishment Excellence
have been very positive. The review process is scheduled annually.
Technology Access for Patient Education and Satisfaction
Granted: $2500
Expended: $1250
Lead Innovator: Teresa Martin, Christy Bridges, Jean McDonald, Robin Gaspirini
This new technology was dedicated to prenatal, postpartum, and newborn-care
patient education in English and Spanish to aid traditional education modalities
which have not reduced ED admissions of our newborns and unnecessary visits to
UNCH by our MH patients. The project was delayed by circumstances of the
community partner, hardware selections, and interactive software. The program
was implemented in the fall of 2016. Educational modules have not yet been vetted
though our patient population. Anticipate actively rolling out to patients this spring.
General FP websites will be loaded onto the Chromebooks this spring for patient
use. Website and use of tablets will be vetted though a formal media review per
state requirements. The evaluation period has been extended to June 30, 2017.
Nutrition Services: Client Feedback as a Marking Tool
Granted: $900
Expended: $209
Lead Innovator:
This project proposed to extend the Kudos concept by developing a note card that
Medical Nutrition Therapy (MNT) and/or Diabetes Self-Management Education
(DSME) clients can write a message to his/her referring medical provider
explaining how he/she benefited from these Health Department services. This
project was delayed by staffing vacancies in the nutrition department. The
evaluation period was extended to June; however, nutrition management indicates
this project was never implemented.
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3
Corrective Action Stickers
Granted: $1800
Expended: $1809
Lead Innovator: Victoria Hudson
This project funded a series of infographic stickers that were affixed in food service
establishments as an education tool and a corrective action for violations of risk
factors associated with hand sink usage, cross-contamination in refrigerated
storage, and cooling foods. Implementation began early in March 2016. The
stickers were very well received by the operators. They do not question or refuse
the use of the sticker as a permanent notice of the violation and the immediate
corrective action. There was a reduction in violations, comparing periods of 9
months from before and after the implementation. It is also important to note that
verification visits for sink misuse, improper cooling, and cross-contamination are
reduced in the short-run because the sticker serves as an immediate correction
and no further site visit is needed, saving up to 30-50 site visits.
Double Handle Lift Tool
Granted: $750
Expended: $750
Lead Innovators: Tracey Langley, John Davis
This grant led to the creation/modification of a common lifting tool for heavy
concrete lids (septic tank lids) for environmental health staff. EHS's have seen
some benefit from using the prototype in discovering its pros and cons in lifting
heavy lids. It does help more with the lifting and positioning of concrete riser lids
more than the heavy concrete inner septic tank lids. This could be a sustainable
alteration to the manhole hook.
Prenatal Oral Health Incentive Program
Granted: $4200
Expended: $4200
Lead Innovators: Dr. Stephanie George, Sallie Fudge, Ana Salas
This grant created an incentive program to encourage families to complete
recommended initial and follow-up prenatal dental visits. 46 new prenatal patients
in the past 10 months; 39 patients (85%) returned for their cleaning or have this
appointment scheduled in the future. OCHD Dental was pleased with this retention
rate, as good oral hygiene is one of the most important aspects of having a healthy
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pregnancy from a dental perspective. 3 patients returned for their 6-month recall
cleaning, and 30 patients who have their 6-month recall appointment scheduled.
Out of the 46 prenatal patients, we had 37 appointments that involved restorations,
extractions, or root canals.
Project Safe Sleep
Granted: $650
Expended: $584
Lead Innovator: LaTosha Scott
This project explored the provision of safe co-sleep and SIDS awareness for
families actively participating in home vising programs. Patients whom completed
evidence based training and newborn post-partum home visit received a safe sleep
certificate and infant basket to support healthy co-sleeping. The impact of Project
Safe Sleep-Cribs for Kids within the Orange County Family Home Visiting
community has been successful thus far. Families openly engaged in discussion
with family home visiting staff with personal stories and perspectives of safe sleep.
Eligible families whom were initially assigned care management due to non-
compliance with medical care were able to regain compliance with care and
received safe sleep material (crib). With the support of the innovation grant funds
the team has been able to provide safe sleep materials to a variety of families.
Patients continue to openly express their gratitude for the assistance received from
the Project Safe Sleep- Cribs for Kids Innovation Grant. At this time Project Safe
Sleep has approximately three safe sleep materials left to provide to families
(cribs). Families will continue to be identified and, offered safe sleep education and
materials as needed.
Septic Maintenance App aka Septic Assist
Granted: $4000
Expended: $4000
Lead Innovators: Tracey Langley, John Davis, John Kase
This grant developed video and promotional materials for “Septic Assist,” for
homeowners on basic tank maintenance, effluent filter cleaning, bio solids or
septage removal guidance, drain field maintenance, inspection, etc. This project
was converted to "Septic Assist," which is a multi-focal approach to educating
landowners about their onsite wastewater systems. The evaluation period has
been extended to June 30, 2017. Videos may be viewed at
http://www.orangecountync.gov/departments/health/septic_assist.php.
May 31, 2017
5
2017 Grant Awards
In order to adjust the project time periods to align with the OCHD budget year, a
short-cycle of Innovation Grand funding was offered to employees with the same
application process. Five applicants submitted projects. One was awarded to
Dental Health staff for a Pre-k Tooth Brushing Initiative.
Pre-K Tooth Brushing Initiative
Granted: $2750
Expended: $2490
Lead Innovators: Dr. Stephanie George, Sallie Fudge, Ana Salas
This project has two components. The first component is to provide each
classroom with the materials needed to implement once-daily brushing in the
classrooms. The second component focuses on education of parents, children and
teachers. Dental health staff wishes to make tooth brushing and oral care a daily
routine for these three groups and increase their awareness of oral care. By
conducting these educational sessions and by having the kids brush in school they
hope that parents will feel more educated and empowered over the oral health of
their children and that the children would want to brush their teeth more often and
use the proper techniques when doing so. An initial education has been conducted
with all three target audiences and we have received po sitive feedback. Another
session will be held towards the end of the school year to hear if these target
audiences felt and what they learned from this project.
2017-2018 Grant Cycle
31-May Idea Phase
15-Jun Applications Due
1-Jul Awards Granted
31-Dec Mid-Year Report
30-Jun End of Year Report
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: May 31, 2017
Agenda Item Subject: Child Fatality Prevention Team Annual Report
Attachment(s): 2016 Child Fatality Prevention Team Annual Report
Staff or Board Member Reporting: Pam McCall
Purpose: ____ Action
_ X_ Information only
____ Information with possible action
Summary Information: The report is a review of 2016 Orange County CFPT activities.
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):
2016 Child Fatality Prevention Team Annual Report
I. Introduction
In 1993, the North Carolina General Assembly established a network of local Child Fatality Prevention Teams
(CFPT’s) across the state to confidentially review medical examiner reports, death certificates and other records
of deceased residents under age 18. Each local team consists of representatives of public and nonpublic
agencies in the community such as law enforcement, Guardian Ad Litem, health departments, among others,
that provide services to children and their families.
The purpose of this report is to give a summary of the causes of death, the number of cases reviewed,
recommendations for prevention, if any, that have been made and to share local team activities and
accomplishments.
II. Role of the Orange County Commissioners and Board of Health
• Receive annual reports which contain recommendations and advocate for system improvements
and needed resources, if requested.
• Appoint members of the local team as identified by the membership.
III. Child Deaths by Cause, System Problems Identified, Recommendations for Prevention &
Proposed Action
In 2016, the Orange County CFPT reviewed 17 child deaths and identified 5 system problems and
recommendations for future prevention efforts. Below are highlights:
Cause of Death System Problem Identified Recommendation Proposed Action
Neurodegenerative
disorder
undiagnosed genetic
disorder
New and potential parents
be counseled and screened
for genetic disorders.
The CFPT chair will contact UNC OB
regarding resources for genetic counseling. The
health department clinic continues to refer
prenatal patients to UNC for genetics
counseling.
Necrotizing
enterocolitis of
newborn;
Extreme
prematurity
Smoking during
pregnancy
Pregnant women should be
given resources to assist
with tobacco cessation.
Support tobacco cessation efforts and promote
classes and Quitline to prenatal clients.
Undetermined
Possible improper use of
infant carrying device
Inform parents about the
risk of using baby sling
carriers
OCHD post information on social media.
Recommend banning the sale of sling carriers.
Pedestrian vs
motor vehicle
accident
Underage alcohol use Teens who use alcohol
receive counseling and
support to stop.
School systems will promote Insight, a drug
and
alcohol counseling program, to parents in the
community
Motor vehicle
accident
Passenger not using seat
belt
Educate the public about
the dangers of not wearing
a seat belt in the back seat
of a vehicle.
Chapel Hill PD will promote rear seat belt use
at passenger safety events.
OCHD post information on social media.
IV. Orange County CFPT Activities and Accomplishments
Examples:
• The annual CFPT Activity Summary was completed and sent by the date requested.
• Team members were invited to participate in a free Mental Health First Aid training sponsored
by the Department on Aging and Cardinal Innovations.
• Information on multiple webinars regarding child safety issues was forwarded to team
members.
• Several team members participated in a webinar on safe sleep sponsored by the Children and
Youth Branch, Division of Public Health.
• Individual reports were completed on child deaths reviewed by the team and were forwarded to
the State Coordinator.
V. Conclusion
Thank you to the members of the Board of Health for the opportunity to share with you the successes
and dedicated work of the local team as we continue to review child fatalities, make recommendations,
and take actions to prevent future child deaths. Please feel free to contact the Chairperson at 245-2402,
should you have any questions about this report.
Pam McCall, Public Health Nursing Director
Chairperson
May 31, 2017______________________________________________________________
Date
May 2017
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: May 31, 2017
Agenda Item Subject: Communicable Disease Annual Report
Attachment(s): Communicable Disease Statistics, January-December, 2016
Staff or Board Member Reporting: Iulia Vann, Public Health Services Manager
Purpose: ___ Action
__ x Information only
__ _ Information with possible action
Summary Information:
Information on Communicable Disease investigation and follow-up for calendar year
2016 will be presented. Information will be included from recent years for comparison.
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 Communicable Disease Report
January-December, 2016
Disease/Condition Total Cases
2016
Total Suspects
2016
Average Cases
2011-2015
Cases 2015
Anaplasmosis 0 0 0
Brucellosis 0 1 0 0
Campylobacter 13 7 22 16
Chikungunya 1 0.4 1
Cryptosporidiosis 4 1 4.6 4
Dengue 1 0.2
Ehrlichiosis 1 (conf), 9 (pro) 6 4 2
Encephalitis, Arboviral 0 0.4 0
Group A Invasive Strep 2 1 2.4 3
Hepatitis A 2 2 0.4 0
Hepatitis B Chronic Reports*
(newly identified/confirmed)
74 1 29.4 38
Hepatitis C Acute 0 5 0 0
Influenza Death 3 0.6 2
Invasive Haemophilus Influenza 5 1 2
Legionellosis 3 1.2 3
Listeriosis 2 0 0 0
Lyme 6 (prob) 18 4 1
Malaria 0 1.2 2
Measles 0 0 1.6 0
Middle Eastern Respiratory Virus 0 0 0
Mumps 0 2 0 0
Paratyphoid 0 0 1
Pertussis 16 15 9.4 6
Rocky Mtn. Spotted Fever 7 38 15.8 12
Rubella 0 1 0 0
Salmonellosis 40 17 22 17
Shigatoxin-producing Ecoli 2 3 3.6 3
Shigellosis 2 2 1.6 1
TB 0 42 2 1
Tularemia 0 .2 0
Typhoid 1 0
Vibrio 1 0.2
West Nile Virus 0 0
Zika 2 39 0
Total 197 201 115
Orange County Communicable Disease Report
January-December, 2016
CD-Related Activities (January –December, 2016)
Jan-Dec. 2016
Bloodborne Pathogen
Exposures
3
Quarantine Orders Issued* 0
Isolation Orders Issued* 11 All for persons with Hepatitis B
Health Law Violators 0
CD Control Measure Orders
Issued*
24 (51) People excluded from school or work due to having symptoms and contact with a reportable
communicable disease.
Hepatitis B Perinatals
Tracked
3
Infants Born to Hepatitis B
Positive Moms
4
Infants Becoming Hepatitis
B Infected at Birth
0
Death Investigation 1 UNC coworkers very concerned re: sudden death of coworker with symptoms possibly consistent with
infectious disease.
Involvement with reptiles
in childcare facility
1
Pinworms at childcare
facility
1
Chicken pox cases in
schools
4 Chicken pox is not reportable, but students are required to be vaccinated against it. This makes
monitoring and control measures to be heightened over typical responses in the past
Follow up to blood donation
by ineligible donor
1 Tracked down blood after donation to prevent its usw.
*Annual reporting is an accreditation requirement
Historical Information*
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Rabies Contacts 15 27 17 4 36 241 398 358 370 268 303 301 333 418 523 466 407
Pertussis Cases 0 4 0 4 2 0 2 0 11 18 2 4 23 4 10 6 16
TB cases 7 5 2 5 (Jail) 5 4 2 7 (Jail) 7 (Jail) 1 4 3 2 3 1 1 0
Latent TB Infections Treated 11 24 32 29 44 53 35 85 72 65 41 64 53 59 50 37 41
Refugee Arrivals/ CD
Screenings
227 118 51 87 78 73 76 58* 146
Orange County Communicable Disease Report
January-December, 2016
Outbreaks 2016
Date Cases Contacts Other
Hand, Foot and Mouth at childcare
center
Jan 2016 ? ? Small outbreak; facility never complied with requests for
info re: exact numbers, etc. They implemented
recommended control measures and incidence declined
GI Illness at childcare center Feb 2016 22/37 37 No confirmed diagnosis; fast moving GI bug, possibly
norovirus
Influenza/Influenza-Like Illness at
long term care facility
March 2016 11 ? Flu death prompted investigation; outbreak not previously
reported
Hand, Foot and Mouth at childcare
center
June 2016 8/17 17 Control measures implemented and incidence declined
Hand, Foot and Mouth at childcare
center
June 2016 6/12 12 Control measures implemented and incidence declined
Hand, Foot and Mouth and
childcare center
June 2016 4 ? Control measures implemented and incidence declined
Salmonellosis from contaminated
cheese produced by Orange County
business
July 2016 22 ? Multi-state outbreak; US Dept. of Agriculture and NC
Communicable Disease Branch led outbreak activities
Sexually Transmitted Disease (STDs)
2011
2012
2013
2014
2015
2016
2016
out-of-county
STDs
Average 2011-
2015
Gonorrhea 122 85 114 123 182 163 224 125
Chlamydia 544 456 470 529 634 636 527
Syphilis 4 3 5 11 15 11 94 8
HIV cases 13 15 17 11 14 11 14
AIDS cases 3 2 7 8 8 4 6
Total 686 561 613 682 964 825 318
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: May 31, 2017
Agenda Item Subject: Board Vacancy Recommendation
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 Optometrist
representative for appointment by the Board of County Commissioners.
Background: The new representative will fill the seat vacated by Reena Mehta.
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
May 31, 2017
• The health department received reaccreditation status on May 19th, 2017. A press
release will be sent announcing the news!
• Board of Health members are invited to a Campus and Community Coalition community
forum to discuss an upcoming campaign to encourage parents to speak with their
children about alcohol and other drugs. If you are interested in participating, please
plan to attend a community meeting to talk more about the campaign on Tuesday, July
27 from 1-2 at the Chapel Hill Public Library, Meeting Room A.
• We are in the process of interviewing for the Communications Manager position and
have a number of exceptional applicants.
• A group of 5 students, calling themselves the Menthol Exterminators, from our Orange
High School TRU club were selected to attend Truth Initiative’s National Summit on
Youth Activism! The National Summit on Youth Activism will take place July 19th –July
22nd at the National 4-H Conference Center in Washington, D.C. The students were
selected from a competitive pool of applications for this all-expense paid (includes
airfare, lodging, and meals) learning opportunity.
• Approximately 50 health department employees participated in a workshop offered by
HR Analyst Vicki Jones called “The Inevitable Change”. Content included change
management strategies and interactive exercises.
• The Family Success Alliance partnered with Empowerment, Inc. to submit a GSK Impact
award worth $40,000. The Health Department cannot receive any of this money directly
because we are a healthcare provider and GSK customer, but, if awarded, the resources
can go towards program implementation through our partners.
• On May 4th, Donna King participated in the Farm to Table Tour at Blackwood Farms
sponsored by DEAPR. Some 305 fourth graders received education on becoming
“Skeeter Defeaters”. Mosquito prevention handouts in English and Spanish went home
with each child.
5/23/2017 UNC Health: Social Security num bers, STD information for 1,300 pr enatal patients may have been leaked | News & Observer
http://www.newsobserver.com/news/local/comm unity/chapelhillnews/article139651453.html 1/3
MARCH 20, 2017 2:33 PM
CHAPEL HILL —
CHAPEL HILL NEWS
UNC Health: Medical info for 1,300 prenatal patients may have been leaked
BY ABBIE BENNETT
abennett@newsobserver.com
UNC Health Care is alerting its prenatal patients that their confidential medical information may have been shared with their home
county, including Social Security numbers, sexually-transmitted disease information and more.
Women seen for prenatal appointments at two UNC Health Care obstetric clinics between 2014 and 2017 may have filled out a form that was sent to
the health department in their county by mistake, according to a news release from UNC Health Care.
On March 20, the University of North Carolina Health Care System sent letters to 1,300 patients who are thought to have completed “Pregnancy
Home Risk Screening Forms” at their prenatal appointments between April 2014 and February 2017. Only patients seen at the Women’s Clinic at
N.C. Women’s Hospital and UNC Maternal-Fetal Medicine at Rex during this time may have been affected.
The forms were used to collect personal information from Medicaid-eligible prenatal patients and were shared with patients’ local health departments
to connect them with support services. But a review of the obstetric clinic practices revealed that forms completed by women who were not eligible
for Medicaid “may have been mistakenly sent to the county health department where they live.”
The forms may have included information about the patients, such as demographic information including name and address; race and ethnicity;
Social Security number; information about physical and mental health; sexually transmitted diseases; HIV status; smoking, drug and alcohol use; and
medical diagnosis information related to pregnancy and prior pregnancy, according to UNC Health Care.
All county health departments that may have received the forms are required by state and federal privacy laws to protect medical information in all
forms, paper and electronic. The clinics have revised their procedure for patients completing the forms to ensure only the correct ones are sent to
county health departments, and employees received training on the new process.
UNC Health Care also is working with all county health departments involved to request that the paper forms be returned to the clinics and that the
counties purge all electronic information about the forms that were mistakenly sent.
While UNC Health Care said in its statement that it does not believe any of the patients will be at financial risk as a result of the release, UNC Health
Care advised patients of options to monitor and review their credit reports and has offered free fraud resolution services for any patient who suffers
from identity theft as a result of this incident.
A call center also has been set up for the possible breach. Patients who have questions or want additional information can call 1-800-596-8362 from
8 a.m. to 5 p.m. Monday through Friday.
Abbie Bennett: 919-836-5768; @AbbieRBennett
SUGGESTED FOR YOU
UNC student tested for probable case of
mumps
May 1, 2017 - 2:43 pm
A UNC student is being tested for a probable case of the mumps. The dates the student
may have been infectious were April 23 through April 30. The student lives off -campus
and the risk to the general population of contracting mumps from this student is low.
However, we want to provide you with information about mumps and provide guidance
on what to do if you suspect you may have become infected.
About Mumps:
Mumps is a viral illness best known for the puffy cheeks and swollen jaw that it
causes. The most common symptoms include fever, muscle aches, unusual tiredness,
loss of appetite, headache, and swollen, tender salivary glands under the ears on one
or both sides. Though medical complications can occur, most people fully recover from
mumps.
How Mumps is spread:
Mumps is spread through direct contact with respiratory droplets (from coughing and
sneezing) and saliva from an infected person. To prevent the spread of this virus, wash
your hands frequently, cover your cough and sneezes, avoid close contact with ill
individuals, and do not share beverages, eating utensils or cigarettes.
What you can do:
Symptoms usually begin 16-18 days after exposure, but the range can be as short as
14 days and as long as 25 days from the exposure. People with mumps are most
infectious 2 days before their symptoms begin but may be infectious as much as 7 days
before onset of symptoms.
Symptoms from exposure to this student would develop between May 7 and May 23,
2017.
If you develop symptoms of mumps, (especially facial swelling on one or both sides),
you should stay home, away from others, and call Campus Health, Employee Health or
your healthcare provider prior to visiting to the clinic.
To help you stay healthy, please check for evidence of your immunity to mumps as
soon as possible. Evidence of immunity includes:
Documentation by the physician who diagnosed you with mumps, if you had the
disease in the past,
Documentation of two mumps-containing vaccines (usually MMR) given on or
after your first birthday and administered at least 1 month apart, or
Documentation of a positive mumps titer (a blood test showing immunity).
If you were born before 1957 you are likely immune to mumps and do not need
additional evidence of immunity. People in this age group have likely had mumps in
childhood.
For questions or concerns, you may call:
Orange County Health Department to speak to a Communicable Disease nurse:
919-245-2400.
Campus Health Services to speak to a nurse: 919-966-6573.
University Employee Occupational Health Clinic -EHS: 919-966-9119 .
Please look at the CHS website for updated information
https://campushealth.unc.edu/. The CDC also has helpful information
https://www.cdc.gov/mumps/index.html
Thank you,
Dorothy Cilenti, MSW, MPH, DrPH (Orange County Health Director)
Thevy Chai, MD (Lead Physician, Campus Health Services)
Mary Beth Koza, MBA (Environment Health and Safety Director)
About Informational Messages: The University sends an Informational Message to
inform the campus community about a situation that is not an emergency, but is
expected to be of significant interest to the campus. An Informational Message is one of
three tiers of communication under the University’s revised emergency communications
plan. Emergency Warning refers to a siren activation for a significant emergency. And a
Timely Warning is issued if there is a continuing danger AND notification will not
compromise law enforcement efforts.
May 2017Volume 16 Issue 4
LETTER FROM THE EDITOR P. 3
ORANGE COUNTY'SHEALTH CARE GAP P. 6
RESTAURANT REVIEW P. 4 HICKORY HOUNDS P. 8
151 E. Rosemary St.Chapel Hill, NC 27514
PRST STD
US POSTAGE
PAID
DURHAM, NC
PERMIT NO.
302
Postal Patron
6 | May 2017
Non-English speaking residents
and K-12 Students in Orange
County have one major thing
in common: a concerning lack of access
to mental health care.
It is crucial to prioritize making sure
that everyone in Orange County has
adequate access to the care they need,
Orange County Commissioner Renee
Price said.
“For the sake of equity and humanity,
we should know where the gaps exist, to
what extent is exists and then design ways
and means to address the gap,” she said.
A gap in mental health care access
among certain demographics was
brought to light recently when the
Orange County Department of Health
submitted a report to the Orange
County Board of Commissioners
identifying mental health care access as
a leading cause of concern in the county.
“We work closely with many
community nonprofits, hospitals and
advocacy groups to plan for Orange
County, and disparities around treatment
and access to mental health are among the
most challenging issues our community
faces,” Orange County Interim Health
Director Dorothy Cilenti said.
While there are a number of
vulnerable groups in Orange County,
the report focuses in particular on two
of the most susceptible to a lack of
mental health care access: K-12 students
and non-English speaking patients.
An assumption that children do not
suffer from mental health problems is
one reason why the K-12 demographic
is underserved, health department
The Focuses of the Orange County Department of Health to Improve Mental Health Care
The two groups most susceptible to a lack of mental health care access
K-12 Students Non-English Speakers
Reasons for a Lack of Services for These Groups
Time commitmentInsuranceTransportationLack of Understanding of Mental Health Issues
Lack of diversity in languages offeredLack of cultural competency training
The Health Care Gap
COUNTY IDENTIFIES GROUPS WITHOUT ACCESS TO MENTAL HEALTH CARE
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spokesperson Stacy Shelp said.
“There’s a lack of services for K-12
for a variety of reasons,” she said.
“Time commitment, insurance,
transportation and a lack of
understanding that children can have
mental health issues are among them.
There needs to be guidance, and having
a clinician in the school is great.”
Janet Cherry, system of care director
for Chapel Hill-Carrboro City Schools,
said that if students are able to be more
open to instruction and able to absorb
material thanks to access to mental
health services, then bringing clinicians
into the school is the way to go.
The North Carolina State Board of
Education recently passed new mental
health policy legislation that aims to
increase the number of mental health
professionals in public schools across
the state.
“(It will) give some direction in
bringing on board mental health
specialists in schools and also give
advice on how to deal with capacity for
access to these services,” Cherry said.
“It should also help with addressing
sustainability.”
A lack of education surrounding the
issue of mental health care seems to be the
stem of much of the stigma concerning
what exactly mental health issues are and
who they can affect. This can be damaging
to the efforts to create policy that benefits
patients in need, Price said.
“This same stigma has kept policy-
makers, corporate interests, media, the
military, schools and the general public at
a distance from accepting mental health
care as a normal part of life,” Price said.
Shelp said the county hopes to
tackle these issues with three main
priorities: restoring funding for mental
health services from birth to age 5,
providing greater in-school mental
health service in K-12 and providing
easier access for all patients. Cilenti also
reiterated the importance of focusing on
0-25 patients.
“Evidence-based behavioral health
research has shown that early intervention
can produce better outcomes for patients
as they age,” she said.
These services will not only help
students but also should give their
families increased access to mental
health care, as well, Cherry said.
The second vulnerable focus group is
the non-English speaking population.
Orange County is home to immigrants
and refugees from many countries.
In addition, the county has a vibrant
Spanish-speaking population, Shelp
said.
Shelp said simply bringing in more
Spanish-speaking therapists would not
be a sufficient solution to the problem.
A recent assessment of Orange
County mental health and substance
abuse services lists two main goals for
increasing access to mental health care
for non-English speakers.
For one, there needs to be more
diversity in the languages that mental
health and substance abuse services are
offered in, including Spanish and Karen,
according to the report. The report also
lists cultural competency training as a
necessity to help health care providers
better understand how to work with
refugee and undocumented populations.
County-wide reform in how
non-English speaking patients are
approached and helped is necessary to
actually tackle the problem, Shelp said.
Moving forward, the next question
to address is how these service
improvements will be paid for. The
Orange County manager is presenting
the budget for the next fiscal year on
May 2.
This report will then be passed on to
the Board of Commissioners for final
approval.
Overall, the county hopes to be able
to begin addressing the mental health
care gap by the next fiscal year, which
starts July 1, 2017.
Mental health care resources are not
just a useful expense, but a necessary
one, Cherry said.
“Our Department of Public
Instruction feels that increasing mental
health care access is very important and
essential to the continued learning and
well-being of our students.”
Source: National Alliance on Mental Illness Orange County
Age 14
50% of all chronic mental healthillnesses begin by this age
10 years
the average time between the appearance of symptoms of mental health issues and intervention
20%
of adults have had a mental health issue
Hispanic, Black, and Asian adults are less than half as likely to use mental health services as white females.
For the sake of equity and humanity, we should know where
the gaps exist, to what extent it exists and then design ways
and means to address the gap.
Renee Price
Graphic by Emily Gregoire
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