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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. iMINUTES-Draft ORANGE COUNTY BOARD OF HEALTH March 28, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ March Page 1 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 iMINUTES-Draft ORANGE COUNTY BOARD OF HEALTH March 28, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ March Page 2 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 iMINUTES-Draft ORANGE COUNTY BOARD OF HEALTH March 28, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ March Page 3 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. iMINUTES-Draft ORANGE COUNTY BOARD OF HEALTH March 28, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ March Page 4 • 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. iMINUTES-Draft ORANGE COUNTY BOARD OF HEALTH March 28, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ March Page 5 • 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. iMINUTES-Draft ORANGE COUNTY BOARD OF HEALTH March 28, 2018 S:\Managers Working Files\BOH\Agenda & Abstracts\2018 Agenda & Abstracts/ March Page 6 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 $469k for third quarter FY 17-18. Recommended Action: ___Approve ___Approve & forward to Board of Commissioners for action ___Approve & forward to ____________________ _X_Accept as information ___Revise & schedule for future action ___Other (detail): BO H  GO V E R N A N C E  DA S H B O A R D Q3  FY17‐18 * NO T E  : FY 1 7 ‐18  Bi l l i n g  Ac c u r a c y  no  lo n g e r  co m b i n e s  de n t a l  an d  me d i c a l  pa i d  cl a i m s  & un p a i d  cl a i m s .    Be c a u s e  tw o  di f f e r e n t  ac c o u n t i n g  sy s t e m s  ar e  be i n g  us e d  (M e d i c a l :  Ac c r u a l ;  De n t a l :  Cash) the two clinics are shown separately. Bi l l i n g  Ac c u r a c y  Fo r m u l a s :  Me d i c a l  = Pa i d  cl a i m s / ( #  en c o u n t e r s  mi n u s  no  ch a r g e  cl a i m s ) .  Un ‐cl a i m e d  ap p o i n t m e n t s  ar e  no  lo n g e r  fa c t o r e d  in ;  De n t a l  = Pa i d  Cl a i m s / #  ke p t  ap p o i n t m e n t s .   Cl a i m s  ca n  ta k e  a qu a r t e r  to  re a l i z e  pa y m e n t  ‐   bi l l i n g  ac c u r a c y  fo r  al l  mo n t h s  in c r e a s e s  wi t h  ti m e  as  cl a i m s  ar e  fi n a l i z e d  an d  er r o r s  ar e  re w o r k e d 42 50 42 42 38 20 34 47 53 0204060 JA S O N D J F M A M J Thousands DE N T A L  EA R N E D  RE V E N U E  BY  SO U R C E vs .  bu d g e t  pr o j e c t i o n  & pr i o r  ye a r ME D I C A I D IN S U R A N C E SE L F  PA Y To t a l  Ea r n e d  Re v e n u e  ($ 3 6 8 k  YT D ) Bu d g e t  Pr o j e c t i o n  ($ 4 3 . 4 k / m ,  $5 2 1 k / y ) YT D  Mo n t h  Av g  ($ 4 0 . 9 k / m ,  ~$ 4 9 1 k / y  es t ) FY 1 6 ‐17  D Re v e n u e  ($ 4 7 8 k / y ) FY 1 6 ‐17  D Re v e n u e  ‐   Av g  ($ 3 9 . 8 k / m ) 48 50 50 74 69 34 35 56 49 020406080 JA S O N D J F M A M J Thousands ME D I C A L  (P H )  EA R N E D  RE V E N U E  BY SOURCE vs .  bu d g e t  pr o j e c t i o n  & pr i o r  year ME D I C A I D INSURANCE SE L F  PA Y Total Earned Revenue ($469k YTD) Bu d g e t  Pr o j e c t i o n  ($ 5 7 . 1 k / m ,  $6 8 6 k / y ) YTD Month Avg ($52.1k/m, ~$619k/y est) FY 1 6 ‐17  M Re v e n u e  ($ 6 6 0 k / y ) FY16‐17 M Revenue ‐ Avg ($55.k/m) 20 9 23 6 18 0 25 2 25 9 13 0 21 3 23 9 18 5  ‐  50  10 0  15 0  20 0  25 0  30 0  35 0  40 0 JA S O N D J F M A M J Thousands TO T A L  HE A L T H  DE P A R T M E N T  RE V E N U E vs .  bu d g e t  pr o j e c t i o n s  & pr i o r  ye a r Pe r s o n a l  He a l t h De n t a l En v i r o n  He a l t h Gr a n t s St a t e Ot h e r To t a l  OC H D  Re v e n u e  ($ 2 . 1 M  YT D ) YT D  Mo n t h  Av g  ($ 2 1 1 k / m ,  ~$ 2 . 5 M / y ) Pr i o r :  FY 1 6 ‐17  To t a l  OC H D  Re v e n u e  ($ 2 . 9 M / y ) Pr i o r :  FY 1 6 ‐17  Re v e n u e  ‐   Av g  ($ 2 4 0 k / m ,  $2 . 9 M / y ) FY 1 7 ‐18  Bu d g e t  Pr o j e c t i o n  ($ 2 7 9 k / m ,  $3 . 3 M / y ) 10 6 % 98 % 10 8 % 98 % 99 % 10 8 % 85 % 100%105% JA S O N D J F M A M J De n t a l  Bi l l i n g  Ac c u r a c y * vs  pr e v i o u s  ye a r  & go a l D FY 1 8  To t a l  Ac c u r a c y  (Y T D  av g  10 1 % ) D FY 1 7  Ac c u r a c y  ‐   Av g  (98%)Accuracy Target (90%) 91 % 91 % 90 % 9 0 % 92 % 9 2 % 84 % 80% JA S O N D J F M A M J Me d i c a l  Bi l l i n g  Ac c u r a c y * vs  pr e v i o u s  ye a r  & go a l M FY 1 7  To t a l  Ac c u r a c y  (Y T D  av g  89 % ) M FY 1 6  Av g  Ac c u r a c y  (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 Like 17 Paola Jaramillo Compartir Tweet Artículo anterior Trabajador decide entrar en huelga por supuesto abuso de su empleador Artículo siguiente Más de 2,000 estudiantes fueron suspendidos en las escuelas primarias de Wake Artículos relacionados Más del autor  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.” EDITORS PICKS Vice Chancellor for Student Affairs Winston Crisp talks new mental health task force Hispanic community holds forum to inform residents following recent ICEdetainments No. 1 North Carolina women's tennis team sweeps two weekend ACC matches 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. EDITORS PICKS Vice Chancellor for StudentAffairs Winston Crisp talks new mental health task force Hispanic community holdsforum to inform residents following recent ICE detainments No. 1 North Carolinawomen's tennis team sweeps two weekend ACC matches “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 city@dailytarheel.com     Next up in Food establishments in Orange County receive high safety inspection scores Hispanic community holds forum to inform residents following recent ICE detainments 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 new mental health task force 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     Next up in Food establishments in Orange County receive high safety inspection scores Hispanic community holds forum to inform residents following recent ICE detainments Duke Energy aims to reduce energy usage in Orange County CITY & COUNTY The Daily Tar Heel welcomes thoughtful discussion on all of our stories, but please keep comments civil and on-topic. Sorry, the browser you are using is not currently supported. Disqus actively supports the following browsers: Firefox Chrome Internet Explorer 11+ Safari