HomeMy WebLinkAboutBOH agenda 042518
ORANGE COUNTY BOARD OF HEALTH
MEETING AGENDA
DATE: April 25, 2018
TIME: 7:00 P.M.
PLACE: Whitted Building, 3rd Floor Meeting Room
300 West Tryon Street
Hillsborough, NC 27278
TIME ITEM
7:00 p.m. I. Welcome New Employees
7:00 – 7:05 II. Public Comment for Items NOT on Printed Agenda
public Comment for Items ON Printed Agenda will be
handled during that agenda item
(Please sign up for both on sheet near the entrance to room.)
Please limit your comments to 3 minutes.
7:05 – 7:10 III. Approval of April 25, 2018 Agenda
7:10 – 7:15 IV. Actions Items (Consent)
A. Minutes of March 28, 2018 Timothy Smith
7:15 – 7:55 V. Educational Sessions
A. Opioid Update (20 minutes) Paul Chelminski
(relative to BOH Strategic Plan Priority: Substance Abuse & Mental Health)
B. 3rd Quarter Billing Dashboard Reports Rebecca Crawford
C. 3rd Quarter Financial Reports Rebecca Crawford
D. Advisory Board Update Beverly Scurry
(relative to BOH Strategic Plan Priority: Engagement)
7:55 – 8:05 VI. Action Items (Non Consent)
A. Board Reappointments Timothy Smith
B. Fee Change Rebecca Crawford
8:05 – 8:10 VII. Reports and Discussion with Possible Action
A. Health Director Report (5 minutes) Quintana Stewart
B. Media Items Quintana Stewart
8:10 – 8:15 VIII. Board Comments
8:15 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 HEALTH DEPARTMENT MISSION STATEMENT: To enhance the quality
of life, promote the health, and preserve the environment for all people in the Orange County
community.
THE ORANGE COUNTY BOARD OF HEALTH MET ON March 28, 2018 at the Orange County
Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Susan Elmore – Chair, Timothy Smith – Chair,
Johanna Birchmayer, Commissioner Mia Burroughs, Barbara Chavious, Paul Chelminski,
Jennifer Deyo, Jessica Frega and Liska Lackey.
BOARD OF HEALTH MEMBERS ABSENT: Bruce Baldwin and Sam Lasris.
STAFF PRESENT: Quintana Stewart, Health Director; Coby Jansen Austin, Director of
Programs and Policy; Erika Cervantes, Family Success Alliance (FSA) Navigator; Rebecca
Crawford, Financial and Administrative Services Director; Katherine Huamani, Public Health
Nurse I; Victoria Hudson, Interim Environmental Health Director; Donna King, Health Promotion
& Education Services Director; Pam McCall, Personal Health Services Director; Kristin Prelipp,
Communications Manager; Ashley Rawlinson, Healthy Carolinians Coordinator; Ana Salas,
Dental Assistant; Beverly Scurry, Board of Health Strategic Plan Manager; La Toya Strange,
Administrative Assistant II; and Phil Vilaro, Interim Environmental Health Director.
GUESTS PRESENT: Keith Bagby and Jamezetta Bedford.
I. Welcome New Employees
Susan Elmore, Chair, called the meeting to order. Ms. Stewart welcomed new employee,
Katherine Huamani.
II. Public Comment for Items NOT on Printed Agenda: None.
III. Approval of the March 28, 2018 Agenda
Motion was made by Jennifer Deyo to approve the agenda, seconded by Jessica Frega
and carried without dissent.
IV. Action Items (Consent)
A. Minutes of February 28, 2018 Meeting
Motion was made by Johanna Birckmayer to approve the minutes of February 2018 with
edits, seconded by Paul Chelminski and carried without dissent.
V. Educational Sessions
A. El Centro Overview
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Pilar Rocha-Goldberg, Executive Director of El Centro, gave a presentation on El Centro and its
activities and programs. Below are some highlights.
History
• Founded 26 years ago in 1992 in Durham when Latinos were only 1% of the
population; the percentage is currently 13.5%
• In 2000, amidst many robberies due to most Latinos keeping their money on them or
in their home due to documents needed to open bank accounts, a partnership was
created by El Centro Hispano (ECH), Self-Help Credit Union, State Employees
Credit Union and the NC Minority Support Center that opened the 1st Latino
Community Credit Union in NC.
• April 2015, ECH opened the Center for Employment & Leadership in its branch in
Carrboro-Chapel Hill.
Four Program Areas - El Centro has a holistic approach when it comes to helping our
community members.
• Education
o Most adult clientele are 1st generation or have a 3rd grade education level.
o Most children are 2nd generation, stay with relatives versus going to
structured childcare; thus, they’re already behind when entering kindergarten.
There are 4th graders that read on a 1st grade school level.
o El Centro offers: preschool, tutoring for K-12, college preparation, work skills,
ESOL, literacy in Spanish for adults, Spanish as a 2nd language, computer,
citizenship and many other classes.
• Economic Development
o El Centro works with day laborers assisting them with gaining full
employment; however, one barrier is that some really want to be day
laborers.
o El Centro helps them secure better jobs with better pay.
o Financial literacy and worker protection and safety are also taught.
• Health and Well-being
o There are other races that come to El Centro for assistance as well as the
homeless population.
o There are 2 health promoters and connected with low-cost medical centers.
o Health promotion and disease prevention, access to health care and direct
support services are services that we provide to our clientele.
o Other services include HIV prevention, domestic violence and legal clinic. El
Centro partners with 19 attorneys that work pro-bono.
• Community Engagement and Advocacy
o El Centro hired an immigration attorney that works with our families.
o El Centro provides advocacy and community leadership.
o LGBTQ support groups, community outreach workers, Faith ID drives as well
as no driver’s license clinics are some services offered.
The BOH had questions that were addressed by Ms. Rocha-Goldberg.
B. Cardinal Annual Update
Ric Bruton, Senior Community Executive, Cardinal Innovations, presented on how county funds
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are used to support Cardinal Innovations programming in Orange County (OC). Below are
some highlights.
Local Maintenance of Effort (MOE) Funding
• The counties will give monies to support programs. Cardinal Innovations has been
working with the Assistant County Manager in relation to moving around funding
which some programs aren’t in agreeance with. Historically, the programs had been
receiving the same amount of funds every year.
• OC contributes $1.3 million annually which is divided amongst 30 separate line items
and over 12 entities.
• Cardinal Innovations does not buy the services; they pay for it. This year, more
ownership has been given to the county to determine where the funds (and how
much) should go.
Programs that receive funding include Freedom House Recovery, UNC Department of
Psychiatry, Arc of Orange County, Haven House and Carolina Outreach, LLC. Services
that these programs provide include services to undocumented people, assisting DSS
with placements and trauma focused therapy, crisis and language resource center
interpreting.
Mr. Bruton presented graphs that displayed Medicaid and State data pertaining to the:
• Number of members served by age and diagnosis
• Members served and expenses by service category
• Members served and expenses amounts – crisis services
Mr. Bruton also addressed the recent company issues and stated that, with the newly
hired CEO, Cardinal Innovations hopes to show more transparency in the future.
The BOH had questions that were addressed by Mr. Bruton.
C. State of the County Health Review
Ashley Rawlinson, Healthy Carolinians Coordinator, presented the 2017 State of the County
Health Report (SOTCH). The SOTCH is a report that is produced every year in between the
Community Health Assessment (CHA). Social Determinants of Health, Physical Activity &
Nutrition and Mental Health & Substance Abuse are the three areas that are focused on in the
report. Below are highlights from Ms. Rawlinson’s presentation.
Social Determinants of Health
• Poverty
o 12.8% of OC population lives in poverty with 6.2% of all families living below the
poverty level.
o 7.6% of children in OC live in poverty despite a county-wide median income of
$66,423.
• The 1st poverty simulation was hosted by the HCOC on February 9th. There were 92
participants that consisted of various people including service providers, OCHD staff
and a BOH member. After participating in the simulation, participants expressed
feelings and experiences that included frustration, desperation, lack of community
resources and not being able to afford necessary services. One hundred percent
had stated that they would like to see the simulation offered again.
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• Try Transit Week was held October 23rd-28th. Transportation academies were held
on at UNC Hospital and the Seymour Center on October 10th and October 13th,
respectively. Each academy taught the basics of riding transit including how to
connect to low-cost/no cost tranportation services and how to ride the buses.
Physical Activity & Nutrition
• ½ of the OC community isn’t getting any exercise ; ¾ are not eating enough fruits
and vegetables ; ½ are not at a healthy weight.
• HCOC implemented a 6 month Eat Smart Move More campaign in which each
month focused on a different message including topics such meal preparation and
portion size.
Mental Health & Substance Abuse
• During the month of September, the HCOC’s Mental Health & Substance Abuse
committee brought awareness to suicide. Events included :
o Suicide Prevention Kickoff - 40 guests attended and speakers included Dean
Smith’s widow, Linnea, and poet, Jaki Shelton Green.
o ‘’Be the Light’’ Suicide Prevention Awareness Walk which had 100 participants, a
½ mile walk to remember suicide victims and had counselors available.
• Prescription Drug Misuse/Abuse
o There was a slight decrease in dispensing of opioids. There were 4.9 million
opioid pills dispensed in 2016. There are 42.1 opioid prescriptions per 100
residents. The drug overdose rate is 12.7 per 100,000 persons.
o The OCHD ran radio commercials for 4 week between November 20th and
December 16th through Radio One’s K97.5 with messaging about safe syringe
exchange as well as naloxone.
• Tobacco
o State legislature allocated $500,000 to tobacco use prevention of which $37,500
of these funds will be used to support educational and prevention programming
efforts.
Ms. Rawlinson added that this report is desseminated to the NC DPH, BOH, BOCC, HCOC
membership and OC government employees. Electronic versions are available online viathe
HCOC and OCHD websites. Lastly, Ms. Rawlinson reiterated that per Benchmark 38, Activity
38.2, for accreditation purposes, the BOH minutes should reflect that the BOH members have
received and reviewed the SOTCH report.
The BOH had questions that were addressed by Ms. Rawlinson.
D. FSA Update
Coby Jansen Austin, Director of Programs and Policy, and Erika Cervantes, FSA Navigator,
gave an update on the FSA’s activities. Below are some highlights.
FSA is a collective of various people and organizations that work together to ensure
children in OC, whose families struggle to make ends meet, have the opportunity for a
healthy, safe and productive life. It was modeled after Harlem’s Children Zone.
There are 2 neighborhood zones.
• Zone 4 is in Hillsborough and Zone 6 is in Chapel Hill/Carrboro.
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• Zone navigators act as a link between the families and the services they need. Zone
4 has 3 navigators and Zone 6 has 4 navigators. In total, the 7 navigators are
currently assisting 120 families. They’re hired because they know how to navigate
the system and perform intakes and assessments of the family they’re assisting
which helps them to know the families’ needs.
“About the FSA” video was shown. Kristin Prelipp, Communications Manager, had
posted the video on the website, via social media and press release. There’s also a
Spanish version of the video. The FSA has also gained attention from various Spanish
news outlets. The link to the video is https://youtu.be/fDMIcWkq_Qo
Kindergarten Readiness Camp
• For FY 18-19, it is expected that the number of total students per cohort will be 90.
About ½ of each cohort is recruited into the navigator program.
Housing Focus
• The strategic plan priority is a flexible action plan that allows the FSA to prioritize
housing needs. Those needs include Section 8 vouchers and locating landlords that
accept the vouchers, lack of domestic violence shelters and dealing with the fear of
retaliation that some tenants exhibit.
• Addressing mobile home park infrastructure issues as well as working with the town
of Chapel Hill regarding the displacement of mobile home tenants.
• Partnering with the OC Affordable Housing Coalition to address housing concerns.
What’s Next
• Continue with the baby boxes, bike ministry and libraries.
• Continue to change the narrative around people who need our services.
• The first meeting of the Parent Council was held in February and consisted of
Burmese, Spanish and English-speaking parents.
• Continue to look for additional funding by applying for grants, etc.
• Looking for a consultant to assist with strategic planning and will most likely
come back to the BOH for guidance.
The BOH had questions that were addressed by Ms. Austin and Ms. Cervantes.
VI. Reports and Discussion with Possible Action
A. Select Topic for Annual Report/Work Plan for BOCC
As the BOCC will review the Annual Work Plan reports from advisory boards and commissions
at their April 26th work session, the BOH will need to select a topic from their 2017 Annual
Report/Work Plan to present to the BOCC. After some discussion, the BOH determined having
a fresh set of eyes to generally discuss a topic versus speaking from a problem solving stance
on that topic would be best. It was recommended to have the health director, an outsider
coming from another county, present to the BOCC.
Motion to approve Annual Report/Work Plan for presentation to BOCC and to have
Quintana Stewart choose the topic was made by Liska Lackey and seconded by Jessica
Frega.
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B. Health Director Report
Ms. Stewart recapped her director’s report. Commissioner Burroughs commended Ms. Stewart
for her attendance to the BOCC meetings and informed her that it was appreciated. Ms.
Stewart replied that it’s a great learning opportunity. In response to Ms. Frega’s request for a
report on the upcoming Equity Summit in Chicago, Ms. Scurry stated that a report will take place
at the May meeting.
C. Media Items
Kristin Prelipp, Communications Manager, briefly reviewed the article topics included in
the Media Items packet. Media items were in the packet which focused on Orange
County’s events and our involvement in various efforts.
VIII. Board Comments
Ms. Elmore thanked those that serving on the Fluoride committee. She also informed the
BOH that she will not be attending the BOH meeting next month as she will be out of the
country on business.
IX. Adjournment
Paul Chelminski moved to adjourn the meeting at 9:00pm and Johanna Birckmayer
seconded.
The next Board of Health Meeting will be held April 25, 2018 at the Orange County Health
Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m.
Respectfully submitted,
Quintana Stewart, MPA
Orange County Health Director
Secretary to the Board
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: April 25, 2018
Agenda Item Subject: Opioid Update
Attachment(s): PowerPoint
Staff or Board Member Reporting:
Purpose: ____ Action
_ _X Information only
____ Information with possible action
Summary Information: Overview of the national and local opioid crisis.
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):
Opioid Epidemic: Collisions At
The Crossroads
Paul Roman Chelminski, MD, MPH, FACP
Professor of Medicine
University of North Carolina School of Medicine
The non-black box of learning
35 Year Old With Chronic Hand Pain: The
Primacy of Function
A 27 Year Old With Chronic Back Pain
A 17 Year Old With A Drug Overdose, 2002
The triad & the challenge
MENTAL ILLNESS SUBSTANCE MISUSE
CHRONIC PAIN
The
Literature
Our
Patients/Casualties
The Opioid Epidemic: A Metastatic Process
Where: Hot Spots, 2016
Not Just Death
Can You Identify a Drug Misuser?
The ”Straight Shooter”
Opioid Prescribing: “Hunch Free Approach”
How Many Today
Which Drugs
An Everyone Epidemic
The Epidemic and Age: Neonatal Abstinence
Syndrome
Prescription Opioid Prescribing Declines
Prescription Opioid Deaths Decline: Florida
Rebound of Prescription Opioid Deaths
Gallows Humor: Silver Lining
Opioid Epidemic: A “Global”Societal
Catastrophe
•Clinical medicine/Mental health
•Public health
•Criminal justice
•International relations
Remedies
•Naloxone (Project Lazrus)
•MAT (Buprenorphine)
•PMPs
•CDC Guidelines
•(Do not provide an exit strategy for opioids when not effective or harmful)
•NC STOP Act
•Mental health reform
•Clinical trials (test shared decision making, CBT)
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: April 25, 2018
Agenda Item Subject: 3rd Quarter Financial Report FY 17-18
Attachment(s): 3rd Quarter Financial Report
3rd Quarter Billing Dashboard
Staff or Board Member Reporting: Rebecca Crawford
Purpose: ___ Action
_X_ Information only
___ Information with possible action
Summary Information:
Total Health Department Revenue: Average YTD monthly revenue in FY18 after the
third quarter is $211/month and totals $2.1M YTD, representing 61.2% of our overall
budgeted revenue for the year. The total third quarter revenue is slightly skewed down
due to the majority of state funds not eligible to be drawn in July (this is typical) but we
are trending higher than we were at this time last fiscal year ($1.9M). Expenses are
higher than revenues at 66.2% of the total, overall budget.
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 96% in FY 16-17 and the average rate for dental for third quarter FY 17-18
is 101% as compared to 98% in FY 16-17.
Dental Earned Revenue by Source: The FY 17-18 average monthly revenue
($40.9/month) for the third quarter is below our budget projection ($43.4k/month) but
above our FY 16-17 average of $39.8k/month. FY 17-18 dental earned revenue totaled
$381k at the end of the third quarter.
Medical Earned Revenue by Source: Medical earned revenue is currently below the
budgeted projection for FY 17-18 ($57.1k/month) at $51.6k/month since we had a
provider on maternity leave until the end of December. Medical clinic revenue totals
$469k for third quarter FY 17-18.
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):
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‐17
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10
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%
98
%
10
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%
98
%
99
%
10
8
%
85
%
100%105%
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S
O
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D
J
F
M
A
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‐
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(98%)Accuracy Target (90%)
91
%
91
%
90
%
9
0
%
92
%
9
2
%
84
%
80%
JA
S
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g
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%
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M FY
1
6
Av
g
Ac
c
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r
a
c
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(96%)Accuracy Target (90%)
Orange County Health Department
Third Quarter Financial Report
FY 2017-2018
TOTAL HEALTH Q3
YTD
ACTUAL
ANNUAL
BUDGET
% OF ANNUAL
BUDGET
Revenue
Donations
Finance and Admin Services 360 (74)0 0.00%
Health Promotion & Edu (3,005)(14,878)(13,886)107.14%
Personal Health (6,653)(6,991)(18,000)38.84%
Donations Total (9,299)(21,943)(31,886)68.82%
Internal Allocations
Finance and Admin Services 0 0 (37,144)0.00%
Dental Health 0 0 (18,000)0.00%
Health Promotion & Edu 0 0 (244,756)0.00%
Personal Health 0 0 (30,000)0.00%
Internal Allocations Total 0 0 (329,900)0.00%
Service Revenue
Dental Health (134,428)(381,456)(520,734)73.25%
Environmental Health (140,788)(440,438)(576,100)76.45%
Personal Health (139,596)(468,954)(684,386)68.52%
Service Revenue Total (414,812)(1,290,847)(1,781,220)72.47%
State Allocations
Finance and Admin Services (7,941)(31,764)(42,921)74.01%
Health Promotion & Edu (8,785)(43,542)(94,484)46.08%
Environmental Health (727)(3,209)(41,324)7.77%
Personal Health (90,894)(362,280)(525,202)68.98%
State Allocations Total (108,348)(440,795)(703,931)62.62%
Grants Project Revenues
Piedmont Hlth Srv - Nutr (11,783)(20,441)(33,800)60.48%
CC4C Accesscare (39,639)(114,278)(149,624)76.38%
PCM Accesscare (38,400)(119,213)(147,651)80.74%
FIT Grant 0 (9,500)(45,093)21.07%
MDPP 0 (10,175)(10,175)100.00%
Community Health Grant (15,514)(24,688)(122,065)20.23%
Wolfe Mini Grant 0 (8,000)(8,000)100.00%
Grants Project Revenues Total (105,336)(306,294)(516,408)59.31%
Revenue Total (637,794)(2,059,879)(3,363,345)61.24%
Orange County Health Department
Third Quarter Financial Report
FY 2017-2018
TOTAL HEALTH Q3 YTD ACTUAL ANNUAL BUDGET
% OF ANNUAL
BUDGET
Expenditures
Salaries 1,189,674 3,993,459 5,723,022 69.78%
Benefits 432,576 1,443,678 2,002,269 72.10%
Travel 4,003 9,315 25,490 36.54%
Training 11,777 30,925 44,214 69.94%
Certifications & Licensing 2,333 6,370 11,276 56.49%
Mileage 5,568 19,181 31,593 60.71%
Telephone 17,115 67,863 86,084 78.83%
Postage 2,357 8,075 14,015 57.62%
Motor Pool 6,079 28,438 53,014 53.64%
Equip Repairs 1,252 5,103 9,921 51.44%
Equip Rent 112 860 1,200 71.67%
Duplicating 1,872 7,117 13,350 53.31%
Printing 3,348 6,263 11,849 52.86%
Advertising 9,074 15,644 33,683 46.45%
Dues 611 3,402 5,100 66.71%
Subscriptions 711 939 1,500 62.60%
Dept Supplies 5,445 14,447 44,045 32.80%
Edu Supplies 10,664 11,792 30,592 38.55%
Office Supplies 6,086 14,371 30,435 47.22%
Medical Supplies 35,129 88,581 127,542 69.45%
Bloodborn Path Supplies 81 478 2,750 17.40%
Pharmacy Supplies 35,745 110,992 157,655 70.40%
Comp Supp/Software 1,176 2,504 7,444 33.63%
Contracted Srv 216,122 732,609 1,502,196 48.77%
X-Ray 4,707 12,433 30,235 41.12%
Lab Srv 45,982 96,290 133,840 71.94%
Bonds & Insurance 0 0 10,815 0.00%
Uniforms 1,101 5,284 7,014 75.34%
Community Proj 8,806 26,060 63,412 41.10%
Innovations Project 2,106 6,843 20,000 34.21%
Accreditation Project 0 2,750 2,750 100.00%
Credit Card Exp 1,870 5,947 6,000 99.12%
Capital Exp Under $500 865 2,803 4,805 58.33%
Nicotine Replacement Therap 0 17,034 18,000 94.63%
Capital Expenditures
Equipment 5156 5,156 5,156 100.00%
IT Equipment 3,835 8,404 11,172 75.23%
Expenditures Total 2,073,339 6,811,412 10,283,438 66.24%
Orange County Health Department
Third Quarter Financial Report
FY 2017-2018
TOTAL HEALTH Q3
YTD
ACTUAL
ANNUAL
BUDGET
% OF ANNUAL
BUDGET
Revenue
Donations
Finance and Admin Services 360 (74)0 0.00%
Health Promotion & Edu (3,005)(14,878)(13,886)107.14%
Personal Health (6,653)(6,991)(18,000)38.84%
Donations Total (9,299)(21,943)(31,886)68.82%
Internal Allocations
Finance and Admin Services 0 0 (37,144)0.00%
Dental Health 0 0 (18,000)0.00%
Health Promotion & Edu 0 0 (244,756)0.00%
Personal Health 0 0 (30,000)0.00%
Internal Allocations Total 0 0 (329,900)0.00%
Service Revenue
Dental Health (134,428)(381,456)(520,734)73.25%
Environmental Health (140,788)(440,438)(576,100)76.45%
Personal Health (139,596)(468,954)(684,386)68.52%
Service Revenue Total (414,812)(1,290,847)(1,781,220)72.47%
State Allocations
Finance and Admin Services (7,941)(31,764)(42,921)74.01%
Health Promotion & Edu (8,785)(43,542)(94,484)46.08%
Environmental Health (727)(3,209)(41,324)7.77%
Personal Health (90,894)(362,280)(525,202)68.98%
State Allocations Total (108,348)(440,795)(703,931)62.62%
Grants Project Revenues
Piedmont Hlth Srv - Nutr (11,783)(20,441)(33,800)60.48%
CC4C Accesscare (39,639)(114,278)(149,624)76.38%
PCM Accesscare (38,400)(119,213)(147,651)80.74%
FIT Grant 0 (9,500)(45,093)21.07%
MDPP 0 (10,175)(10,175)100.00%
Community Health Grant (15,514)(24,688)(122,065)20.23%
Wolfe Mini Grant 0 (8,000)(8,000)100.00%
Grants Project Revenues Total (105,336)(306,294)(516,408)59.31%
Revenue Total (637,794)(2,059,879)(3,363,345)61.24%
Orange County Health Department
Third Quarter Financial Report
FY 2017-2018
TOTAL HEALTH Q3 YTD ACTUAL ANNUAL BUDGET
% OF ANNUAL
BUDGET
Expenditures
Salaries 1,189,674 3,993,459 5,723,022 69.78%
Benefits 432,576 1,443,678 2,002,269 72.10%
Travel 4,003 9,315 25,490 36.54%
Training 11,777 30,925 44,214 69.94%
Certifications & Licensing 2,333 6,370 11,276 56.49%
Mileage 5,568 19,181 31,593 60.71%
Telephone 17,115 67,863 86,084 78.83%
Postage 2,357 8,075 14,015 57.62%
Motor Pool 6,079 28,438 53,014 53.64%
Equip Repairs 1,252 5,103 9,921 51.44%
Equip Rent 112 860 1,200 71.67%
Duplicating 1,872 7,117 13,350 53.31%
Printing 3,348 6,263 11,849 52.86%
Advertising 9,074 15,644 33,683 46.45%
Dues 611 3,402 5,100 66.71%
Subscriptions 711 939 1,500 62.60%
Dept Supplies 5,445 14,447 44,045 32.80%
Edu Supplies 10,664 11,792 30,592 38.55%
Office Supplies 6,086 14,371 30,435 47.22%
Medical Supplies 35,129 88,581 127,542 69.45%
Bloodborn Path Supplies 81 478 2,750 17.40%
Pharmacy Supplies 35,745 110,992 157,655 70.40%
Comp Supp/Software 1,176 2,504 7,444 33.63%
Contracted Srv 216,122 732,609 1,502,196 48.77%
X-Ray 4,707 12,433 30,235 41.12%
Lab Srv 45,982 96,290 133,840 71.94%
Bonds & Insurance 0 0 10,815 0.00%
Uniforms 1,101 5,284 7,014 75.34%
Community Proj 8,806 26,060 63,412 41.10%
Innovations Project 2,106 6,843 20,000 34.21%
Accreditation Project 0 2,750 2,750 100.00%
Credit Card Exp 1,870 5,947 6,000 99.12%
Capital Exp Under $500 865 2,803 4,805 58.33%
Nicotine Replacement Therap 0 17,034 18,000 94.63%
Capital Expenditures
Equipment 5156 5,156 5,156 100.00%
IT Equipment 3,835 8,404 11,172 75.23%
Expenditures Total 2,073,339 6,811,412 10,283,438 66.24%
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: April 25, 2018
Agenda Item Subject: Orange County Advisory Board Update
Attachment(s): Advisory Board Report
Staff or Board Member Reporting: Beverly Scurry
Purpose: ___ Action
_X_ Information only
___ Information with possible action
Summary Information:
The Board of Health identified action steps related to engagement in the 2016-2018
Strategic Plan. One of these action steps is to receive biannual updates on actions of
other Orange County advisory boards that relate to the BOH strategic plan priorities.
The summary provided contains BOH top priorities related information from various
Orange County advisory boards from October 2017 to March 2018, as available from
the boards.
Some boards being tracked do not have updates included because they do not pertain
to the BOH’s priorities or they were not available at the time of the report.
Recommended Action: ___Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to ___________________________
_X_Accept as information
___Revise & schedule for future action
___Other (detail):
Submitted April 17, 2018
O RANGE C OUNTY
A DVISORY B OARD
S UMMARY
O CTOBER 2017 – M ARCH 2018
Board of Health Engagement
4/19/17
1
Biannual Report
Board of Health Engagement
B OARD BOH
P RIORITY
S UMMARY
Orange County
Schools Board
of Education
Social
Determinants of
Health, Physical
Activity and
Nutrition
• Summer Food Service Program/Universal Free Breakfast Pilot
Update – Child Nutrition Director Valerie Green provided
information about the Summer Food Service Program operated
by the district’s Child Nutrition Services during summer months.
Ms. Green also provided a review of the Universal Free
Breakfast Pilot Program, information to include, by site: for
2015-16, 2016-17, and 2017-18 numbers served for free, reduce
and paid meals.
• Aviva Scully, Social Worker at A.L. Stanback Middle School –
grant in the amount of $2,491.25 from the Family Success
Alliance;
• The Board is working with OpenSource to facilitate racial equity
conversations. This is the same company OCHD is using. The
Board will be receiving a report at the end of the school year.
Chapel
Hill/Carrboro
City Schools
Board of
Education
Social
Determinants of
Health; Substance
Abuse & Mental
Health
• YRBS Report: The YRBS survey is administered every other
year to access youth health risk. The 2017 survey include: a
downward trend among high school students for alcohol,
marijuana and cigarette use, but an upward trend among middle
school students for the same behaviors, an increase in high
school students driving while texting, and a decrease among all
youth in reported bullying incidents.
• Equity/Discipline/Restorative Practices, 1st Quarter
Update: 500 teachers are now trained at Level One in
Restorative Practices and 320 staff (mostly social workers and
counselors) are trained at Level Two. The Student Code of
Conduct, beginning with the work last year by the MSAN
scholars, is being reviewed and revised by the district. The
discussion focused on the dramatic decrease in Office Discipline
Referrals (ODR’s) with the largest decrease, 78%, occurred in the
high schools. Since 2016, ODR’s for black students has
decreased by 58%
• School Counseling Program: In September of 2016, Chapel
Hill Carrboro City Schools posted a Request for Qualifications
and Proposals (RFQ/P) for the purposes of conducting a
program review of its School Counseling Program.
o Three broad objectives were addressed by the reviewers:
1. To inform the Chapel Hill-Carrboro City School
System about its counseling program across all school levels,
focusing on the following areas:
4/19/17
2
• Counseling curriculum and programming
• Resources and organizational structure
• Assessment
• Professional development of counselors
• Beliefs and attitudes of counselors and stakeholders;
and
• Focus on equity issues
2. Provide an American School Counseling Association
National Model audit, as well as a North Carolina school
counseling standards program audit
3. Provide recommendations based on data-supported
findings to improve the efficiency and effectiveness of the
school counselor program
Board of County
Commissioners
Social
Determinants of
Health, Physical
Activity,
Substance Abuse
& Mental Health
• Presentation of the Mobile Home Park Survey Report and
Recommendations: FSA presented their role in gathering and
evaluating surveys. BOCC approved the following
recommendations:
1. Mobile Home Park Improvement and Expansion
Program (Short Term)
Orange County establishes a loan program for
mobile home park owners to improve and/ or
expand their existing park
2. Repair and/or Replacement Program Component
(Short Term)
Orange County establishes, with local funds, a
repair and/ or replacement program
component for residents living in a mobile
home, whether rental or owner-occupied
3. Mobile Home Park Development (Long Term)
Orange County uses designated funds to
pursue the development of a mobile home
park and/ or mixed housing development on
an undeveloped parcel.
4. Greene Tract (Long Term)
Orange County, the Town of Chapel Hill, and
the Town of Carrboro elected officials and
staff continue to explore affordable housing
opportunities on the Greene Tract, with a
focus on alternatives for displaced mobile
home park residents and utilization of a
portion of the Greene Tract
• Durham-Orange Light Rail Transit Project:
1. A Partnership for Transit-Supportive Walkable Places
- supporting walkable neighborhoods in anticipation
of the Light Rail
• Orange County Board Of Commissioners Proclamation
Recognizing December 6, 2017 As Abolition Day:
4/19/17
3
1. We, the Orange County Board of Commissioners, do
hereby proclaim that December 6, 2017 shall be
recognized as ABOLITION DAY throughout the
County, and urge all residents to support and engage
in the ongoing struggle to ensure freedom and justice
for all of humanity…locally, nationally and globally.
• Presentation on Opioids and Legal Issues:
1. The Board received a presentation from attorneys
representing some North Carolina local governments,
and some local governments across the country
regarding litigation against opioid manufacturers and
distributors and provided direction to staff if
appropriate.
• Mountains to Sea Trail (MST) Possible Route Approval for
Orange County Segments:
1. Segment 12
Hillsborough Riverwalk
Trails on Historic Sites to East
Remainder Within Eno River State Park*
Segment is Already Identified…thus…
Not included in planning process
2. Segment 11
Occoneechee Mountain Trails
Southwest to Seven Mile Creek Preserve
Cross-country to Cane Creek and Cane Creek
Reservoir
Exits County toward Saxapahaw
Would Occur in Three Phases
3. A motion was made and passed for the Board to adopt
the “Orange County Mountains to Sea Trail Route”
and that staff report back at a later date on
information gathered on the Multi-modal Trail and on
discussions held with OWASA.
Chapel Hill
Town Council
N/A
Minutes are not available online
Carrboro Board
of Aldermen
Physical Activity
and Nutrition;
SAMH
• The Board discussed progress towards an application for
upgrading the Town’s Bicycle Friendly Community status,
including the bike plan update and possible infrastructure
improvements, and associated cost implications. Carrboro has
the Bicycle Friendly Community silver status, and is working
toward gold. To increase the grades on the Bicycle Friendly
Community report card, the Town can engage in more activities
and education, as well as the bike plan for policy, and
infrastructure updates. The bike plan was adopted in 2009 and it
is time for an update to look at priorities and new technologies.
4/19/17
4
Instead of a lot of new infrastructure they are looking at better
ways to do things.
• A Resolution Supporting Snap And Other Federal Nutrition
Programs: Town of Carrboro asks Senator Burr, Senator Tillis
and Congressman Price to reject any proposals in the 2018 Farm
Bill that cut funding to SNAP or other federal nutrition
programs; shift costs to the states; or otherwise reduce benefits
affecting low-income families, workers, children, the
unemployed, or the elderly.
• A Resolution Supporting Continued Participation In The North
Carolina Department Of Transportation’s Pedestrian And
Bicycle Safety Campaign Watch For Me NC For 2018: The
Carrboro Board of Aldermen that the Board of Aldermen
pledges, in cooperation with the North Carolina Department of
Transportation, to participate in the 2018 Watch for Me NC
campaign.
Hillsborough
Board of
Commissioners
Physical Activity
& Nutrition • The Board discussed very little related to the BOH top
priorities. There were not meeting minutes for February or
March. They have passed a Resolution Supporting Snap And
Other Federal Nutrition Programs.
Orange Unified
Transportation
Board
(OUTBoard)
Physical Activity
& Nutrition • The Bicycle Safety Implementation Subcommittee are
working with The Video Club students at Cedar Ridge
High School to create four bicycle safety video PSAs.
Healthy
Carolinians of
Orange County
All Social Determinants of Health - Access:
• On February 9th HCOC hosted its first ever poverty
simulation exercise with 92 participants. During the poverty
simulation, participants assumed the roles of service
providers and family members. They went through a
“month” that consisted of 4-18 minute weeks where
participants dealt with the everyday barriers of those living in
poverty and the real life experiences that they deal with.
• HCOC’s Access committee hosted its very first Try Transit
Week (TTW) from October 23-28, 2017. The week was
implemented in response to transportation being a priority
for the OCHD, HCOC, and the BOH. Prior to the TTW,
the committee partnered with Orange Public Transportation,
Go Triangle, Chapel Hill Transit and the Department on
Aging and held two Transportation Academies. Together
the Academies educated over 40 service providers. Each
Academy taught the basics of local and regional transit so
that service providers would have the necessary knowledge
and tools to be able to help their clients connect to low-
cost/no cost transportation services and/or serve as a site
for an information kiosk.
4/19/17
5
Mental Health & Substance Abuse
• OCHD ran radio commercials through Radio One’s K97.5,
with messaging about safe syringe exchange as well as
naloxone. Commercials ran for 4 weeks between November
20th and December 16th.
Physical Activity & Nutrition
• HCOC implemented a 6-month Eat Smart Move More
(ESMM) Consistent Messaging Campaign. 15 partners were
trained on this toolkit and campaign and they all pledged to
share the information and messages in it during the 6
months, along with monthly reporting on how they shared
the messages, barriers, successes, and potential reach.
Family Success
Alliance
Access • Educational Partners
o Innovation grants ($10,000 total)
FPG Elementary: MindUP all-staff training and
monthly problem solving; parent sessions (Span
&Eng)
Northside Elem & Culbreth: Weekly art therapy
groups for refugee & immigrant newcomers
Stanback: Restorative Justice training & support
o Afterschool programming (up to $2,500 each)
New Hope Elem, FPG Elem, Carrboro Elem
• Housing Focus
o Strategic Plan Priority
o Affordable Housing Coalition
o Mobile Home Focus
Work Group
Mobile Home Surveys (countywide)
Community engagement:
• Lakeview
• Homestead
Justice Advisory
Council
Substance Abuse
& Mental Health • There have been discussions regarding the new Detention Center
including feasibility study review and sit and design planning.
• OCHD has spoken to the Council regarding the FIT Program
and out re-entry community health workers
• There was a presentation on Court Fines and Fees: Criminalizing
Poverty in NC.
• Alamance County has attended a council meeting to discuss their
Stepping Up Diversion program
• There was a presentation and discussion on Pretrial Justice
Reform
• The Detention Center staff have gone through mental health
training.
Submitted April 17, 2018
O RANGE C OUNTY
A DVISORY B OARD
S UMMARY
O CTOBER 2017 – M ARCH 2018
Board of Health Engagement
4/19/17
1
Biannual Report
Board of Health Engagement
B OARD BOH
P RIORITY
S UMMARY
Orange County
Schools Board
of Education
Social
Determinants of
Health, Physical
Activity and
Nutrition
• Summer Food Service Program/Universal Free Breakfast Pilot
Update – Child Nutrition Director Valerie Green provided
information about the Summer Food Service Program operated
by the district’s Child Nutrition Services during summer months.
Ms. Green also provided a review of the Universal Free
Breakfast Pilot Program, information to include, by site: for
2015-16, 2016-17, and 2017-18 numbers served for free, reduce
and paid meals.
• Aviva Scully, Social Worker at A.L. Stanback Middle School –
grant in the amount of $2,491.25 from the Family Success
Alliance;
• The Board is working with OpenSource to facilitate racial equity
conversations. This is the same company OCHD is using. The
Board will be receiving a report at the end of the school year.
Chapel
Hill/Carrboro
City Schools
Board of
Education
Social
Determinants of
Health; Substance
Abuse & Mental
Health
• YRBS Report: The YRBS survey is administered every other
year to access youth health risk. The 2017 survey include: a
downward trend among high school students for alcohol,
marijuana and cigarette use, but an upward trend among middle
school students for the same behaviors, an increase in high
school students driving while texting, and a decrease among all
youth in reported bullying incidents.
• Equity/Discipline/Restorative Practices, 1st Quarter
Update: 500 teachers are now trained at Level One in
Restorative Practices and 320 staff (mostly social workers and
counselors) are trained at Level Two. The Student Code of
Conduct, beginning with the work last year by the MSAN
scholars, is being reviewed and revised by the district. The
discussion focused on the dramatic decrease in Office Discipline
Referrals (ODR’s) with the largest decrease, 78%, occurred in the
high schools. Since 2016, ODR’s for black students has
decreased by 58%
• School Counseling Program: In September of 2016, Chapel
Hill Carrboro City Schools posted a Request for Qualifications
and Proposals (RFQ/P) for the purposes of conducting a
program review of its School Counseling Program.
o Three broad objectives were addressed by the reviewers:
1. To inform the Chapel Hill-Carrboro City School
System about its counseling program across all school levels,
focusing on the following areas:
4/19/17
2
• Counseling curriculum and programming
• Resources and organizational structure
• Assessment
• Professional development of counselors
• Beliefs and attitudes of counselors and stakeholders;
and
• Focus on equity issues
2. Provide an American School Counseling Association
National Model audit, as well as a North Carolina school
counseling standards program audit
3. Provide recommendations based on data-supported
findings to improve the efficiency and effectiveness of the
school counselor program
Board of County
Commissioners
Social
Determinants of
Health, Physical
Activity,
Substance Abuse
& Mental Health
• Presentation of the Mobile Home Park Survey Report and
Recommendations: FSA presented their role in gathering and
evaluating surveys. BOCC approved the following
recommendations:
1. Mobile Home Park Improvement and Expansion
Program (Short Term)
Orange County establishes a loan program for
mobile home park owners to improve and/ or
expand their existing park
2. Repair and/or Replacement Program Component
(Short Term)
Orange County establishes, with local funds, a
repair and/ or replacement program
component for residents living in a mobile
home, whether rental or owner-occupied
3. Mobile Home Park Development (Long Term)
Orange County uses designated funds to
pursue the development of a mobile home
park and/ or mixed housing development on
an undeveloped parcel.
4. Greene Tract (Long Term)
Orange County, the Town of Chapel Hill, and
the Town of Carrboro elected officials and
staff continue to explore affordable housing
opportunities on the Greene Tract, with a
focus on alternatives for displaced mobile
home park residents and utilization of a
portion of the Greene Tract
• Durham-Orange Light Rail Transit Project:
1. A Partnership for Transit-Supportive Walkable Places
- supporting walkable neighborhoods in anticipation
of the Light Rail
• Orange County Board Of Commissioners Proclamation
Recognizing December 6, 2017 As Abolition Day:
4/19/17
3
1. We, the Orange County Board of Commissioners, do
hereby proclaim that December 6, 2017 shall be
recognized as ABOLITION DAY throughout the
County, and urge all residents to support and engage
in the ongoing struggle to ensure freedom and justice
for all of humanity…locally, nationally and globally.
• Presentation on Opioids and Legal Issues:
1. The Board received a presentation from attorneys
representing some North Carolina local governments,
and some local governments across the country
regarding litigation against opioid manufacturers and
distributors and provided direction to staff if
appropriate.
• Mountains to Sea Trail (MST) Possible Route Approval for
Orange County Segments:
1. Segment 12
Hillsborough Riverwalk
Trails on Historic Sites to East
Remainder Within Eno River State Park*
Segment is Already Identified…thus…
Not included in planning process
2. Segment 11
Occoneechee Mountain Trails
Southwest to Seven Mile Creek Preserve
Cross-country to Cane Creek and Cane Creek
Reservoir
Exits County toward Saxapahaw
Would Occur in Three Phases
3. A motion was made and passed for the Board to adopt
the “Orange County Mountains to Sea Trail Route”
and that staff report back at a later date on
information gathered on the Multi-modal Trail and on
discussions held with OWASA.
Chapel Hill
Town Council
N/A
Minutes are not available online
Carrboro Board
of Aldermen
Physical Activity
and Nutrition;
SAMH
• The Board discussed progress towards an application for
upgrading the Town’s Bicycle Friendly Community status,
including the bike plan update and possible infrastructure
improvements, and associated cost implications. Carrboro has
the Bicycle Friendly Community silver status, and is working
toward gold. To increase the grades on the Bicycle Friendly
Community report card, the Town can engage in more activities
and education, as well as the bike plan for policy, and
infrastructure updates. The bike plan was adopted in 2009 and it
is time for an update to look at priorities and new technologies.
4/19/17
4
Instead of a lot of new infrastructure they are looking at better
ways to do things.
• A Resolution Supporting Snap And Other Federal Nutrition
Programs: Town of Carrboro asks Senator Burr, Senator Tillis
and Congressman Price to reject any proposals in the 2018 Farm
Bill that cut funding to SNAP or other federal nutrition
programs; shift costs to the states; or otherwise reduce benefits
affecting low-income families, workers, children, the
unemployed, or the elderly.
• A Resolution Supporting Continued Participation In The North
Carolina Department Of Transportation’s Pedestrian And
Bicycle Safety Campaign Watch For Me NC For 2018: The
Carrboro Board of Aldermen that the Board of Aldermen
pledges, in cooperation with the North Carolina Department of
Transportation, to participate in the 2018 Watch for Me NC
campaign.
Hillsborough
Board of
Commissioners
Physical Activity
& Nutrition • The Board discussed very little related to the BOH top
priorities. There were not meeting minutes for February or
March. They have passed a Resolution Supporting Snap And
Other Federal Nutrition Programs.
Orange Unified
Transportation
Board
(OUTBoard)
Physical Activity
& Nutrition • The Bicycle Safety Implementation Subcommittee are
working with The Video Club students at Cedar Ridge
High School to create four bicycle safety video PSAs.
Healthy
Carolinians of
Orange County
All Social Determinants of Health - Access:
• On February 9th HCOC hosted its first ever poverty
simulation exercise with 92 participants. During the poverty
simulation, participants assumed the roles of service
providers and family members. They went through a
“month” that consisted of 4-18 minute weeks where
participants dealt with the everyday barriers of those living in
poverty and the real life experiences that they deal with.
• HCOC’s Access committee hosted its very first Try Transit
Week (TTW) from October 23-28, 2017. The week was
implemented in response to transportation being a priority
for the OCHD, HCOC, and the BOH. Prior to the TTW,
the committee partnered with Orange Public Transportation,
Go Triangle, Chapel Hill Transit and the Department on
Aging and held two Transportation Academies. Together
the Academies educated over 40 service providers. Each
Academy taught the basics of local and regional transit so
that service providers would have the necessary knowledge
and tools to be able to help their clients connect to low-
cost/no cost transportation services and/or serve as a site
for an information kiosk.
4/19/17
5
Mental Health & Substance Abuse
• OCHD ran radio commercials through Radio One’s K97.5,
with messaging about safe syringe exchange as well as
naloxone. Commercials ran for 4 weeks between November
20th and December 16th.
Physical Activity & Nutrition
• HCOC implemented a 6-month Eat Smart Move More
(ESMM) Consistent Messaging Campaign. 15 partners were
trained on this toolkit and campaign and they all pledged to
share the information and messages in it during the 6
months, along with monthly reporting on how they shared
the messages, barriers, successes, and potential reach.
Family Success
Alliance
Access • Educational Partners
o Innovation grants ($10,000 total)
FPG Elementary: MindUP all-staff training and
monthly problem solving; parent sessions (Span
&Eng)
Northside Elem & Culbreth: Weekly art therapy
groups for refugee & immigrant newcomers
Stanback: Restorative Justice training & support
o Afterschool programming (up to $2,500 each)
New Hope Elem, FPG Elem, Carrboro Elem
• Housing Focus
o Strategic Plan Priority
o Affordable Housing Coalition
o Mobile Home Focus
Work Group
Mobile Home Surveys (countywide)
Community engagement:
• Lakeview
• Homestead
Justice Advisory
Council
Substance Abuse
& Mental Health • There have been discussions regarding the new Detention Center
including feasibility study review and sit and design planning.
• OCHD has spoken to the Council regarding the FIT Program
and out re-entry community health workers
• There was a presentation on Court Fines and Fees: Criminalizing
Poverty in NC.
• Alamance County has attended a council meeting to discuss their
Stepping Up Diversion program
• There was a presentation and discussion on Pretrial Justice
Reform
• The Detention Center staff have gone through mental health
training.
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: April 25, 2018
Agenda Item Subject: Reappointment Recommendations
Attachment(s): None
Staff or Board Member Reporting: Timothy Smith
Purpose: __X_ Action
____ Information only
____ Information with possible action
Summary Information: The Board of Health will vote to recommend:
Bruce Baldwin to his 1st full term;
Barbara Chavious to her 2nd full term;
Timothy Smith to his 2nd full term; and
Johanna Birckmayer to her 1st full term.
Recommended Action: ___Approve
_X_Approve & forward to Board of Commissioners for action
___Approve & forward to ___________________________
___Accept as information
___Revise & schedule for future action
___Other (detail):
Agenda Item Number
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: April 25, 2017
Agenda Item Subject: FY 2017-18 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, both the Medical and Dental clinics request to add fees outside of the
normal process.
Dental Clinic
The Dental Clinic was awarded a grant from Delta Dental for $2,000 and have elected to use
the funding to treat childhood caries by the Silver Diamine Fluoride technique, which requires
the Health Department to add an associated fee to the fee schedule. We anticipate treating 75
Medicaid eligible children between the ages of 1 and 8 during the term of the grant, which will
end August 31, 2018. Based on our analysis of costs to perform the procedure and fees from
surrounding jurisdictions, we propose to set the fee at $49. Given that the Medicaid
reimbursement rate is $24.18 for this procedure, we only anticipate receiving $1,813.50 in
revenue. The proposed change is detailed below:
Name of Fee 2017-18
Current Fee
2017-18 Proposed
Fee
2017-18 Budget
Impact
Silver Diamine Fluoride (D1354) $0 $49 $1,813.50
Medical Clinic
The Medical clinic recommends this new addition to our Fee Schedule due to the recent
introduction on the market of the new Shingles vaccine - Shingrix. This vaccine will keep the
orange County Health Department Clinic up to date with the newest vaccines available, it will
provide the residents of Orange County with the opportunity to receive protection against the
Varicella Zoster Virus and it will keep our clinic relevant and able to meet the newest federal
guidelines on vaccinations of people 50 years old or above. We anticipate administering five
Shingrix vaccines per year and will charge our cost to purchase the vaccine, $138.60, which
would potentially result in $693 in revenue.
Name of Fee 2017-18
Current Fee
2017-18 Proposed
Fee
2017-18 Budget
Impact
Shingrix Vaccine (90750) $0 $138.60 $693
Recommended Motion:
To approve the proposed fee changes for 2017-2018 as presented and forward to the Board of
County Commissioners for action.
Health Director’s Report
April 2018
• April 3, 2018 – Public Health presentation at the Orange County Government Academy.
• April 4-5, 2018 – Attended the Annual Health Director’s Public Health Legal Conference
at UNC School of Government.
• April 6, 2018 – Budget Meeting with County Manager
• April 10-13, 2018 – Attended Equity Summit in Chicago, Illinois.
• April 18, 2018 – Human Services Informatics Team Meeting
• April 19, 2018 – Campus and Community Coalition Meeting; final MOU between and
among UNC Chapel Hill, Town of Chapel Hill, Chapel Hill Downtown Partnership and
OC Health Department signed.
• April 19, 2018 – Meeting with Vaughn Upshaw – Strategic Planning Process for
departmental programs and Board of Health
Program Updates
• Clinic staff gearing up to transition to EPIC Health Record System in June 2018.
• April 20, 2018 - Family Success Alliance invited to a follow-up call regarding Blue Cross
Blue Shield Letter of Interest for Grant.
• Tobacco Prevention Program
o OCHD is providing technical assistance to Chapel Hill HUD as they implement a
Smoke Free Policy.
o Seeing an increase in smoking cessation class enrollment
o Fresh Start Smoking Cessation now available in Spanish
• Communications- Screen Cloud is up and running in all the waiting rooms; currently
running the “This is Public Health” slide deck created to highlight Public Health Week.
• Central Permitting Project (Energov) making progress; Pool and miscellaneous Food &
Lodging inspection will be added to the Energov software.
Upcoming Events
• April 25, 2018 – “Crafting Richer Messengers: The Public Health Advantage”
Workshop; group of diverse stakeholders brought together to provide input into the
development of a potential toolkit and series that could be used improve public health’s
ability to message in ways that resonate across multiple perspectives.
• April 27, 2018 – Inaugural Local Re-Entry Council Meeting
• May 15, 2018 – NC Association of Local Health Director’s New Health Director
Orientation
• May 24, 2018 – Healthy Carolinians Council Meeting
4/17/2018 Study Reveals Wide Income, Racial Inequality in Orange County - Chapelboro.com
http://chapelboro.com/news/health/study-reveals-wide-income-racial-inequality-orange-county 2/6
Orange County continues to
4/17/2018 Study Reveals Wide Income, Racial Inequality in Orange County - Chapelboro.com
http://chapelboro.com/news/health/study-reveals-wide-income-racial-inequality-orange-county 3/6
living in poverty, 32 percent of Hispanic children and 25
percent of black children. And, according to the
numbers, the vast majority of children born into poverty
stay there.
“It’s estimated that 69 percent of children born into
poverty will remain in poverty unless there is an
intervention and/or a signi
Programa ayuda a combatir la pobreza en las familias latinas - La Noticia
http://www.lanoticia.com/programa-ayuda-a-combatir-la-pobreza-en-las-familias-latinas/[4/9/2018 9:55:49 AM]
Charlotte 43.9 F lunes, abril 9, 2018
Locales Chapel Hill Noticias
Programa ayuda a combatir la pobreza en
las familias latinas
Por Paola Jaramillo - marzo 29, 2018
Como parte del programa están abiertas las inscripciones para los campamentos de verano
educativos/FSA
Chapel Hill- El condado de Orange creó un programa para ayudar a las familias
latinas a combatir la pobreza y a que los niños mejoren su calidad de vida y nivel
Inicio Noticias Programa ayuda a combatir la pobreza en las familias latinas
Compartir Facebook Twitter
Menú Noticias Negocios y Economía VidaSana PrimeraFila
Excelente Awards LatinaCon
Programa ayuda a combatir la pobreza en las familias latinas - La Noticia
http://www.lanoticia.com/programa-ayuda-a-combatir-la-pobreza-en-las-familias-latinas/[4/9/2018 9:55:49 AM]
de educación.
“El condado de Orange es uno de los más saludables, pero tiene la disparidad más
alta de ingresos en el estado”, dijo a La Noticia, Antonia Cortes Sánchez,
navegadora del programa Alianza para el Éxito Familiar (FSA por sus sigla en
inglés).
La Alianza para el Éxito Familiar nació en el 2014 como parte de un esfuerzo
colectivo del Departamento de Salud del condado de Orange para combatir la
pobreza y que este año ha ayudado a 110 familias, mayormente latinas.
“Una de cada diez familias tienen problemas para satisfacer sus necesidades
básicas. Nosotros trabajamos con ellos como un puente entre las diferentes
agencias locales y organizaciones creando metas y trabajando juntos hasta
cumplirlas”, mencionó Cortes.
Plan individual
La FSA es una iniciativa que reúne a padres de familia, funcionarios electos,
organizaciones comunitarias y socios gubernamentales para crear un plan familiar
que les ayude a mejorar las oportunidades educativas y económicas para los niños.
“Damos apoyo moral, mental, los conectamos con recursos para ayudar a suplir
necesidades básicas como comida y para pagar sus facturas básicas de agua o
electricidad. Les enseñamos a navegar en el sistema”, indicó Cortes.
El programa cuenta con siete navegadores, de las cuales cinco son latinos o hablan
español. “Hace unos días trabajé con una familia donde uno de sus niños tenía
malas calificaciones y se portaba mal. Descubrimos que el practicar karate podría
ser una forma de ayudarle.
Conseguimos la beca para pagar la mensualidad y hoy el niño es más disciplinado,
respetuoso y ha mejorado en sus notas”, ejemplificó.
Oportunidades para el verano
Como parte del programa, las familias con niños en edad escolar y que no han
tenido la oportunidad de estar en una guardería tienen la oportunidad de participar
en un campamento de verano donde se preparan para la escuela. “Ahora estamos
aceptando muevas familias y es gratuito. Los invitamos a que se inscriban y
provechen la oportunidad”, mencionó.
Programa ayuda a combatir la pobreza en las familias latinas - La Noticia
http://www.lanoticia.com/programa-ayuda-a-combatir-la-pobreza-en-las-familias-latinas/[4/9/2018 9:55:49 AM]
Los más pobres del condado
Según un reporte entregado por el Departamento de Salud el 21 de marzo, el 32 %
de los niños latinos en el condado de Orange viven en la pobreza. La tasa es la más
alta si se compara con los afroamericanos con el 25 % y los anglosajones en el 4 %.
Basados en el informe anual de Condados Saludables del 2018, algunos
indicadores determinantes de la pobreza son: la educación, segregación racial,
soporte social y bajos nivel de ingreso familiar.
Informes y detalles
Los servicios que se ofrecen a través de la Alianza para el Éxito Familiar son
gratuitos y están disponibles para los residentes en las ciudades de Chapel Hill,
Carrboro y Hillsborough.
Más informes al 919-245-2071 o visite la página de Internet:
www.familysuccessalliance.org
Etiquetas familias latinas Orange pobreza
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Food establishments in Orange County receive high safety inspection scores - The Daily Tar Heel
http://www.dailytarheel.com/article/2018/04/food-inspections-416[4/17/2018 11:21:51 AM]
125 Years of Editorial Freedom
Buy PhotosBski's
LAST UPDATED 14 HOURS AGO
Food establishments in Orange County receive high safety
inspection scores
BY MARIN WOLF
Walking into any restaurant in North Carolina, customers can see a white card with a health inspection
score on it. This score, ranging from 0.0 to 100.0 with an accompanying letter grade, alerts customers to
how safe and clean an eating establishment is in order to mitigate potential foodborne illnesses.
Orange County currently has no restaurants with health inspection ratings below an A.
“That results from our department having a very good relationship with restaurants,” said Victoria
Hudson, an Orange County Health Department food, lodging and institutions supervisor.
Food establishments in Orange County receive high safety inspection scores - The Daily Tar Heel
http://www.dailytarheel.com/article/2018/04/food-inspections-416[4/17/2018 11:21:51 AM]
Restaurants are inspected up to four times per year. The number of inspections a restaurant receives is
determined by a risk-based frequency. Restaurants with intricate menus that require multiple stages of
preparation for the final product are inspected more often than restaurants that offer only a few items.
“A place that makes only sandwiches and smoothies are easier,” Hudson said. “Restaurants are evaluated
for stages that food has to be in for the final product.”
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On Franklin Street, Trolly Stop Hot Dogs is inspected only twice per year, whereas BSki's is inspected
four times.
“We don’t serve any seafood, we don’t serve chicken,” said Eric Martin, Trolly Stop's general manager.
“It’s all beef and pre-prepared items.”
During health inspections, the Health Department evaluates a restaurant’s foodborne illness risk factors,
public health interventions and retail practices. Inspectors check food storage temperatures, the
accessibility of hand-washing sinks, the state of equipment and the restaurant’s use of utensils.
Food establishments in Orange County receive high safety inspection scores - The Daily Tar Heel
http://www.dailytarheel.com/article/2018/04/food-inspections-416[4/17/2018 11:21:51 AM]
Restaurants can get point deductions for seemingly small offenses. BSki's manager Medo Ghon said the
restaurant, which has a score of 98.5, got points deducted on its last inspection because he was drinking
coffee from a cup without a lid.
The rules for hand-washing are equally intricate. Hudson said there are five different kinds of hand-
washing violations, such as turning a faucet off without a paper towel.
Restaurants given a B rating or below can request to be re-inspected within 15 days. Hudson said many
violations are corrected during inspection.
North Carolina requires all restaurants have a certified food safety manager in the facility when food is
being prepared and served. Orange County encourages restaurants to get certified through the ServSafe
program.
Martin said ServSafe is part of the reason why the restaurant has had a score of 100 since it opened three
years ago.
The health department does not tell restaurants when an inspector will come for an evaluation. Though
Martin can guess when Trolly Stop will receive an inspection, he said their preparation doesn’t change.
“We keep things as clean and neat as possible,” Martin said. “Every one of the employees eats here, so we
want the same thing, the same environment. We do everything by the books, and honestly it’s fairly easy.”
Even though Orange County restaurants have overwhelmingly positive health inspection scores, Hudson
encourages customers to evaluate the numerical score, not just the letter grade, when deciding where to
eat.
“I don’t think people use the grade card the way I want them to,” Hudson said. “Look at the number. The
grade, it’s somewhat relative to what the score is and how much prep there is.”
@maringwolf
city@dailytarheel.com
An HIV prevention drug is available in Orange County. Why don't people know about it? - The Daily Tar Heel
http://www.dailytarheel.com/article/2018/04/prep-0402[4/17/2018 11:56:18 AM]
125 Years of Editorial Freedom
Buy PhotosCampus Health Services offers testing for STIs, STDs and HIV.
EMILY CAROLINE SARTIN
4/2/2018, 7:26PM
An HIV prevention drug is available in Orange County.
Why don't people know about it?
BY CLAIRE WILLMSCHEN
Since 2012, the FDA has approved the use of a drug that reduces the risk of HIV infection by 92 percent
— but despite it being widely available in Orange County, not many are taking advantage of it.
Pre-exposure prophylaxis, also known as PrEP, is taken daily as a pill. While it is currently not well
known, PrEP is on the path to save thousands of lives.
PrEP, which is produced by Gilead Sciences under the brand name Truvada for PrEP, is intended for
An HIV prevention drug is available in Orange County. Why don't people know about it? - The Daily Tar Heel
http://www.dailytarheel.com/article/2018/04/prep-0402[4/17/2018 11:56:18 AM]
people at high risk for HIV through sex or drug use. When taken consistently, PrEP has an over 90 percent
prevention rate for those at risk through sex and a 70 percent prevention rate for those at risk through
injecting drugs.
The pill is taken daily and loses efficacy when taken incorrectly. According to the CDC, no serious side
effects from PrEP have been reported.
UNC School of Medicine professor David Wohl said there are large geographic and ethnic disparities in
PrEP usage.
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“It’s just a shame that despite PrEP being totally available, being covered by insurance or by manufacturer
support programs, (being) available at UNC Campus Health, that still a lot of people just don’t know about
it,” Wohl said.
Andrea Mulholland, a family nurse practitioner at the Orange County Health Department, said the primary
people who visit the health department with questions about PrEP are 25-44 year-old gay men. She also
said they mostly see people who are uninsured or underinsured.
An HIV prevention drug is available in Orange County. Why don't people know about it? - The Daily Tar Heel
http://www.dailytarheel.com/article/2018/04/prep-0402[4/17/2018 11:56:18 AM]
“Unfortunately, the South is the region where we have the highest rate of HIV infections, and the highest
rate of STIs, but we do have less people using PrEP,” Mulholland said.
Wohl said in the South, providers might not want to prescribe PrEP because they think it will promote
promiscuity.
Mulholland said education is key to solving this problem.
“We just need more education in the community among patients, and particularly among people who are
at high risk for acquiring HIV,” she said.
The biggest success stories for PrEP are in big cities like New York or San Francisco, where there has
been some kind of government intervention.
“Government involvement requires an investment of time, energy, enthusiasm, money,” Wohl said. “And
we’ve seen that these partnerships have really led to campaigns that have resulted in people being
supported to get their PrEP.”
Wohl said in order for PrEP to be effective in the ways it can be, it needs to be normalized.
“We’ve learned the hard way that condoms aren’t going to solve the HIV epidemic,” he said.
Mulholland said she believes the future is bright for PrEP and that it’s picking up pace in the industry.
Eventually there could be an injectable version of PrEP or an implant.
Wohl said Gilead is starting a campaign for the drug and that PrEP will have a big impact as long as it gets
out there.
“It could really help save some lives,” Wohl said.
@CE_Willmschen
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Food establishments in Orange County receive high safety inspection scores
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Duke Energy aims to reduce energy usage in Orange County
CITY & COUNTY
CAMPUS HEALTH SERVICES
Orange County responds to health barriers for refugees - The Daily Tar Heel
http://www.dailytarheel.com/article/2018/04/refugees-0410[4/17/2018 11:58:43 AM]
125 Years of Editorial Freedom
4/10/2018, 7:35PM
Orange County responds to health barriers for refugees
BY MICHAEL TAFFE
Correction: This article previously mistook the Refugee Support Center for the Refugee Community
Partnership, for their services in providing tutorials on how to use public transit, preparation for
citizenship exams, and educational tutoring. In addition, doctor providers, not telephonic interpreters, that
will mistake Karen for the Korean language. The article has been updated online, and displays the correct
information in print.
There are over around 1,200 refugees living and working in Chapel Hill and Carrboro, and the community
has seen a concerted effort and response to the needs of recently resettled refugees.
“Around 100 (Orange County refugees) from the (Democratic Republic of Congo), around 40 from Syria,
and the rest are from Burma,” said Flicka Bateman, director of the non-profit Refugee Support Center.
The Refugee Support Center is just one of the organizations created in response to barriers to health care
access and a need to familiarize recently resettled refugees with public services. Bateman founded the
center when a family of five refugees, three of them adolescents, moved in across the street from her.
“One of those adolescents now works at the Lineberger Cancer Center, one graduated with a degree in IT
and one got a degree in Chemistry from UNC and is now a researcher there,” said Bateman. “When they
got here they were saying that they weren’t going to go to college. I told them that it wasn’t a matter of if,
but where, and where they could get the money.”
Orange County responds to health barriers for refugees - The Daily Tar Heel
http://www.dailytarheel.com/article/2018/04/refugees-0410[4/17/2018 11:58:43 AM]
EDITORS PICKS
Vice Chancellor for StudentAffairs Winston Crisp talks
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Hispanic community holdsforum to inform residents
following recent ICE
detainments
No. 1 North Carolinawomen's tennis team sweeps
two weekend ACC matches
The Refugee Support Center offers English as a Second Language classes and assistance with job
placement to help resettled refugees integrate smoothly into society. But one of their most successful
programs has been offering preparation for federal naturalization tests.
“Everyone who has regularly attended classes has passed their citizenship test,” Bateman said.
“With determination, help with access to information and a lot of luck, refugees can achieve the American
dream,” Bateman said.
Across town, Meagan Clawar is the program director for Refugee Community Partnership, a non-profit
aiming to minimize the linguistic and cultural barriers to health care access for refugee families by
partnering with residents through their Bridge Builder program.
“We have 70 refugee families partnered with volunteers," Clawar said. "The families and volunteers work
on goals that the family identifies. It’s really a pretty holistic approach to providing services.”
Clawar said language is one of the major barriers to refugee health care.
“Communicating with someone over the phone about something very personal like your health can be
frustrating,” Clawar said. “You aren’t provided with a telephonic interpreter until you are actually in the
exam room, so they often have to navigate check-in and any paperwork on their own.”
While many refugees from Burma natively speak a language known as “Karen,” many doctor providers
mistakenly hear this as “Korean." In this situation, a refugee parent who speaks Karen is trying to
communicate with an English-speaking doctor through a translator who speaks Korean.
“I've had a call from a family saying, ‘The baby is really sick; she needs to go to the hospital.’ So, I went
with them, and we waited through triage and went through the process with them.”
In addition to assistance in accessing health services, the Refugee Community Partnership provides
Orange County responds to health barriers for refugees - The Daily Tar Heel
http://www.dailytarheel.com/article/2018/04/refugees-0410[4/17/2018 11:58:43 AM]
tutorials on how to use public transit, preparation for citizenship exams, and educational tutoring.
The county provides similar services to recently resettled refugees. Susan Clifford, the immigrant and
refugee health program manager at the Orange County Health Department, highlighted in an email some
public health concerns that may not always make the headlines.
“Based on feedback from the last community health assessment and input from Orange County Refugee
Health Coalition partners, the main issues continue to be mental health, access to health care and issues
related to social determinants of health, such as housing, food-security and employment,” Clifford said in
an email.
Despite local non-profits being created out of an apparent need from refugees, Clifford maintains that the
state of refugee support services is strong.
“Orange County’s refugee population is diverse and resilient,” Clifford said. “We often think about what
is lacking, but we also need to focus on the incredible strength, resourcefulness and rich skills and values
brought to Orange County by our newest neighbors.”
@MichaelJTaffe
city@dailytarheel.com
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