HomeMy WebLinkAboutBOH agenda 082218
ORANGE COUNTY BOARD OF HEALTH
MEETING AGENDA
DATE: August 22, 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 August 22, 2018 Agenda
7:10 – 7:15 IV. Actions Items (Consent)
A. Minutes of June 27, 2018 Susan Elmore
7:15 – 8:35 V. Educational Sessions
A. Cybersecurity (30 minutes) Jim Northrup
B. 4th Quarter Financial and Billing Dashboard
Reports (15 minutes) Rebecca Crawford
C. Fluoride Ad Hoc Committee Update (15 minutes) Liska Lackey
(relative to BOH Strategic Plan Priority: Engagement)
D. Family Success Alliance Update (20 minutes) Coby Austin
8:35 – 9:00 VI. Action Items (Non-Consent)
A. FY 17/18 Delinquent Accounts (15 minutes) Rebecca Crawford
B. BOH Policy Review (10 minutes) Quintana Stewart
9:00 – 9:05 VII. Reports and Discussion with Possible Action
A. Health Director Report (5 minutes) Quintana Stewart
B. Media Items Kristin Prelipp
9:05 – 9:10 VIII. Board Comments
9:10 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 June 27, 2018 at the Orange County
Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Susan Elmore – Chair, Timothy Smith –Vice-
Chair, Bruce Baldwin, Johanna Birchmayer, Barbara Chavious Paul Chelminski, Jennifer Deyo,
Jessica Frega and Liska Lackey.
BOARD OF HEALTH MEMBERS ABSENT: Commissioner Mia Burroughs and Sam Lasris.
STAFF PRESENT: Quintana Stewart, Health Director; Barbara Hawksworth, Environmental
Health Technician; Victoria Hudson, Interim Environmental Health Director; Lisa Lowe, Public
Health Nursing Supervisor II; Pam McCall, Personal Health Nursing Services Director; Kristin
Prelipp, Communications Manager; Ashley Rowe, Public Health Nurse I; Scurry, BOH Strategic
Plan Manager; La Toya Strange, Administrative Assistant II; Lisa Yourko, Public Health Nursing
Supervisor I; Iulia Vann, Public Health Services Manager and Phil Vilaro, Environmental Health
Supervisor.
GUESTS PRESENT: Lucretia Hoffman.
I. Welcome New Employees
Susan Elmore, Chair, called the meeting to order. Ms. Stewart welcomed new employees, Lisa
Lowe and Ashley Rowe.
II. Public Comment for Items NOT on Printed Agenda: None.
III. Approval of the June 27, 2018 Agenda
Motion was made by Barbara Chavious to approve the agenda, seconded by Jessica
Frega and carried without dissent.
IV. Action Items (Consent)
A. Minutes of May 23, 2018 Meeting
Motion was made by Jennifer Deyo to approve the minutes of May 2018, seconded by
Liska Lackey and carried without dissent.
V. Educational Sessions
A. Innovation Grant Update
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Victoria Hudson, Interim Environmental Health Director, provided updates on the 2017-2018
projects, process adjustments and the process for 2018-2019. Below is a summary:
• The grant cycle was moved to a fiscal year in 2017. There was a mini cycle that
occurred during this transition move.
• During the mini-cycle, Pre-k Tooth brushing initiative finished full implementation in June
2017.
• There were 3 projects funded in 2017.
- “Be the 1 To” Suicide Prevention Campaign submitted by Ashley Rawlinson.
Multiple agencies were involved. Activities included a kickoff event and an
awareness walk.
- Front of the House (FOH) Food Safety Training submitted by Victoria Hudson.
FOH refers to from the plate to the table and includes the hostess, wait staff,
silverware roller, etc. Although video and booklet production has taken more
time than expected, the first measure of implementation will be in July with
training provided free of charge to every establishment in Orange County.
- Onsite Water Protection Calendars submitted by Barbara Hawksworth.
Calendars were distributed to BOH members. The calendars include informative
photos and helpful tips.
• Adjustments to the process include encourage team approach, know technological
limitations, be realistic about time for implementation and develop a rubric for grading
grant proposals.
• Out of 9 proposals submitted in the 2018-2019 cycle, 5 were selected for full application
and were funded. Implementation will begin as early as July 1st.
- Transportation Assistance submitted by Renee Kemske, et al.
- Patient Education submitted by Julie Johnson and Meghann Johnson.
- Intraoral Cameras submitted by Dr. Stephanie George.
- 41 or Below submitted by Angela Sowers, et al.
- Art for OCHD submitted by Kristin Prelipp.
The BOH had questions that were addressed by Ms. Hudson.
B. Annual Communicable Disease Report
Iulia Vann, Public Health Services Manager, gave an overview of the communicable disease
data for the year 2017. Ms. Vann noted that this meets Accreditation Benchmark 2.5. Some of
the highlights from the information she gave during her presentation include:
Foodborne Illness – Salmonella decreased. The spike in 2016 was due to the Chapel Hill dairy
outbreak. Many of the foodborne illnesses resulted from people having traveled out of the
country.
Vaccine Preventable Diseases – There was an increase in Hepatitis B cases. Testing for
Hepatitis B had increased. Some of the cases were not new and some stats were based on
prevalence not incidence as the CD team receives a report every time a positive case occurs
even if the individual already knew their status. It is required to report flu deaths not actual
cases.
Waterborne Illnesses – Ms. Vann explained that the 2014 spike was from a case when Durham
swimmers used OC facilities. One of the legionellosis cases was identified as deriving from a
hot tub at a rental. The 2nd case’s exposure source was not identified.
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Sexually Transmitted Diseases – Chlamydia is on the rise. Syphilis is also very high. HIV cases
have stayed constant and are low in comparison to national and state numbers.
Outbreaks – There were four in 2017. There was a school influenza outbreak that resulted in 38
cases over 3 months. There were also 2 separate Noro Virus-like outbreaks at a sorority and a
fraternity house. The last outbreak involved Pertussis.
The BOH members had questions that were addressed by Ms. Vann.
C. Fluoride Ad Hoc Committee Update
Jessica Frega, BOH member, gave an update on the first ad hoc fluoride committee meeting.
Highlights are below:
• OWASA requests - have medical/dental experts weigh in by recruiting experts outside
of the OCHD, public comments by having an online poll/survey and one public comment
hearing, address those that oppose fluoridation, receive a clear understandable final
report that is comprised once the ad hoc committee synthesize themes, forward it to the
experts and reports to the BOH
• Discussion was had amongst BOH members regarding methods to fulfill OWASA’s
requests.
• The next ad hoc meeting will be held on July 18th.
The BOH members had questions that were addressed by Ms. Frega.
D. NALBOH Annual Conference
Quintana Stewart, Health Director, gave an overview of the upcoming 2018 NALBOH
conference scheduled for August 8-10, 2018 at the Marriot Raleigh Crabtree Valley in Raleigh.
There will be great networking opportunities, public health governance, national attendees and
discussion on the roles and responsibilities of local BOH. This year’s topics include the opioid
epidemic and Accreditation. Registration rates vary dependent on whether you attend the pre-
conference, full conference or just one day.
Ms. Susan Elmore added she goes every year and leaves energized. As a member on the
ANCBH, she stated that there are $500 scholarships that assist with registration. She
requested that those interested notify her. She also stated that it’s the first time it’s being held in
Raleigh and is a great opportunity.
VI. Action Items (Non-Consent)
A. Strategic Plan 2018-2020
Beverly Scurry, BOH Strategic Plan Manager, revealed the final look for the 2018-2020
Strategic Plan. BOH members commented that the Strategic Plan was visually appealing.
Thanks were given to Kristin Prelipp, Communications Manager, for the new look and branding
of the Strategic Plan.
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Motion to adopt the 2018-2020 Strategic Plan was made by Jessica Frega, seconded by
Jennifer Deyo and carried without dissent.
VII. Reports and Discussion with Possible Action
A. Health Director Report
Ms. Stewart began by revealing that it’s been a great six months, that she’s getting into a
routine and more familiar with the OCHD’s partners. In addition to her report, Ms. Stewart gave
the following highlights:
• The clinic staff went live with Epic on Tuesday. She’d visited both clinics and found that
administrative staff were very helpful to patients.
• Ms. Stewart also mentioned that the DSS and Health Management Teams had a joint
meeting hosted by DSS which was part of the county manager’s office initiative. It was
a great meeting in which information sharing about programs occurred and everyone
was able to put a face with a name. A lot of positive feedback was received.
• Ms. Stewart was accepted into the NC Public Health Leadership Institute. The one year
commitment will include face to face trainings, webinars, etc.
• On June 19th, the BOCC passed the budget. There is a change to the Performance Pay
System. In place of the one time payment that it received, the monetary amount will be
added to the employee’s base salary. A new performance evaluation tool is expected to
roll out in January 2019.
• It is now legal to sell raw milk as the legislature passed a bill stating so.
B. Media Items
Kristin Prelipp, Communications Manager, briefly mentioned the article topic of the case of
chicken pox that was 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
It was announced that Bruce Baldwin, Barbara Chavious and Timothy Smith were reappointed
by the BOCC. Johanna Birchmayer was not reappointed. The BOCC wanted to increase
diversity on the Board; therefore, Keith Bagby was appointed in Ms. Birchmayer’s place. The
BOH has always been aware that our recommendations for reappointments are simply that, with
the BOCC having the option to consider the recommendation and make their own decision on
the Board’s appointments. Mr. Bagby will attend the next BOH meeting.
Ms. Birchmayer was informed that she was a very important contributor, thanked for her service
and encouraged to keep her application on file. Ms. Birchmayer said a few words of gratitude.
She also mentioned that she learned that it takes such intentionality to obtain diversity and be
mindful of diversity in all decisions. Discussion was had regarding ensuring diversity and
getting the word out to recruit diverse applicants.
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IX. Adjournment
Jessica Frega moved to adjourn the meeting at 8:45pm and Barbara Chavious seconded.
The next Board of Health Meeting will be held August 22, 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: August 22, 2018
Agenda Item Subject: Cybersecurity
Attachment(s):
Staff or Board Member Reporting:
Purpose: ____ Action
_ X Information only
____ Information with possible action
Summary Information: Chief Information Officer, Jim Northrup, will share information
about Cybersecurity and the County’s plan to address vulnerabilities.
Recommended Action: ___Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to ___________________________
_X_Accept as information
___Revise & schedule for future action
___Other (detail):
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: August 22, 2018
Agenda Item Subject: 4th Quarter Financial Report FY 17-18
Attachment(s): 4th Quarter Financial Report
4th Quarter Billing Dashboard
Staff or Board Member Reporting: Rebecca Crawford
Purpose: ___ Action
_X_ Information only
___ Information with possible action
Summary Information:
Total Health Department Budget vs. Actuals: Average YTD monthly revenue in FY18
after the fourth quarter is $276/month or $3.5 million for the entire fiscal year,
representing 98.5% of our overall budgeted revenue for the year. This is an increase of
~$600k over FY 16-17. Expenses were lower than revenues at 94% of the total overall
budget due to multiple contracts that crossed into the beginning of FY 18-19 and will be
spent out by August 2018, which was $9.8 million compared to year end FY 16-17,
which was $9.2 million.
Total Billing Accuracy: Continuing with the goal of 90% billing accuracy set in FY 14-
15, the average billing accuracy rate for medical for FY 17-18 was 91% as compared to
the year-end average of 96% in FY 16-17. The average billing accuracy rate for dental
for FY 17-18 was 101% as compared to 100% in FY 16-17.
Dental Earned Revenue by Source: The FY 17-18 average monthly revenue
($42.5/month) for the fourth quarter is below our budget projection ($43.4k/month) but
above our FY 16-17 average of $39.8/month. FY 17-18 dental earned revenue totaled
$511k at the end of the fiscal year, compared to $478k at the end of FY 16-17.
Medical Earned Revenue by Source: Medical earned revenue for the fiscal year was
below the budgeted projection for FY 17-18 ($686k) at $609k since we had a provider
on maternity leave until the end of December, provider turnover at the end of the fiscal
year, and reduced appointments available to allow for Epic preparation.
Grants Fund Revenue:
FSA received a multi-year grant for $100k per fiscal year for 3 years at the end of FY
17-18. These funds will carry through FY 18-19 and FY 19-20. We’ll track these and any
other multi-year grants through this section of the financial report on an ongoing basis.
Note for FY 18-19 Revenue:
FAS (Finance and Administrative Services Division) anticipates medical revenue will be
delayed for the first 3 months of FY 18-19 as we close out billing in the Patagonia
Electronic Medical Record System (EMR) and begin billing in the new Epic EMR. UNC
has built an incredible billing system for the Health Department, however it is the first
system like it they have ever built and we continue to work through anticipated system
issues, which will delay billing to commercial insurance and Medicaid. Patients are still
being seen so revenue will catch up in the latter part of the Fiscal Year.
FAS also anticipates a potential delay in Environmental Health revenue as the division
transitions to a new Central permitting system in October. Staff are training frequently
now to reduce the impact on county residents and prepare for the upcoming Go Live.
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):
BOH GOVERNANCE DASHBOARD Q4 FY17-18
*NOTE :FY17-18 Billing Accuracy no longer combines dental and medical paid claims & unpaid claims. Because two different accounting systems are being used (Medical: Accrual; Dental: Cash) the two clinics are shown separately.
Billing Accuracy Formulas: Medical = Paid claims/(# encounters minus no charge claims). Un-claimed appointments are no longer factored in; Dental = Paid Claims/# kept appointments.
Claims can take a quarter to realize payment - billing accuracy for all months increases with time as claims are finalized and errors are reworked.
42
50
42 42
38
20
34
47
53
42
48
36
0
20
40
60
J A S O N D J F M A M J
Th
o
u
s
a
n
d
s
DENTAL EARNED REVENUE BY SOURCE
vs. budget projection & prior year
MEDICAID
SELF PAY
Budget Projection ($43.4k/m, $521k/y)
FY16-17 D Revenue ($478k/y)
INSURANCE
Total Earned Revenue ($511k YTD)
YTD Month Avg ($42.5k/m, ~$511k/y est)
FY16-17 D Revenue - Avg ($39.8k/m)
48 50 50
74
69
34 35
56
49
72
44
29
0
20
40
60
80
J A S O N D J F M A M J
Th
o
u
s
a
n
d
s
MEDICAL (PH) EARNED REVENUE BY SOURCE
vs. budget projection & prior year
MEDICAID INSURANCE
SELF PAY Total Earned Revenue ($609k YTD)
Budget Projection ($57.1k/m, $686k/y)YTD Month Avg ($50.8k/m, ~$609k/y est)
FY16-17 M Revenue ($660k/y)FY16-17 M Revenue - Avg ($55.k/m)
209 236
180
252 259
130
213 239
185
289
460
655
-
100
200
300
400
500
600
700
J A S O N D J F M A M J
Th
o
u
s
a
n
d
s
TOTAL HEALTH DEPARTMENT REVENUE
vs. budget projections & prior year
Personal Health
Environ Health
State
Total OCHD Revenue ($3.5M YTD)
Prior: FY16-17 Total OCHD Revenue ($2.9M/y)
Dental
Grants
Other
YTD Month Avg ($276k/m, ~$3.5M/y)
Prior: FY16-17 Revenue - Avg ($240k/m, $2.9M/y)
FY17-18 Budget Projection ($279k/m, $3.3M/y)
95%95%93%93%94%95%94%94%92%88%84%80%
J A S O N D J F M A M J
Medical Billing Accuracy*
vs previous year & goal
M FY18 Total Accuracy (YTD avg 91%)M FY17 Avg Accuracy (96%)Accuracy Target (90%)
107%101%107%99%100%108%85%99%109%103%106%87%
J A S O N D J F M A M J
Dental Billing Accuracy*
vs previous year and goal
D FY18 Total Accuracy (YTD avg 101%)D FY17 Accuracy - Avg (100%)Accuracy Target (90%)
Orange County Health Department
Fourth Quarter Financial Report
FY 2017-2018
General Fund
TOTAL HEALTH Q4 YTD ACTUAL ANNUAL BUDGET
% OF ANNUAL
BUDGET
Revenue
Donations
Finance and Admin Services 0 (74)0 0.00%
Health Promotion & Edu (3,226)(18,876)(13,886)135.93%
Personal Health (4,497)(11,825)(18,000)65.70%
Donations Total (7,723)(30,775)(31,886)96.52%
Internal Allocations
Finance and Admin Services (37,144)(37,144)(37,144)100.00%
Dental Health (18,000)(18,000)(18,000)100.00%
Health Promotion & Edu (244,756)(244,756)(244,756)100.00%
Personal Health (182,361)(182,361)(182,361)100.00%
Internal Allocations Total (482,261)(482,261)(482,261)100.00%
Service Revenue
Dental Health (125,298)(511,236)(520,734)98.18%
Environmental Health (182,208)(624,736)(576,100)108.44%
Personal Health (144,892)(618,138)(684,386)90.32%
Service Revenue Total (452,399)(1,754,110)(1,781,220)98.48%
State Allocations
Finance and Admin Services (7,186)(42,921)(42,921)100.00%
Health Promotion & Edu (31,844)(92,226)(94,484)97.61%
Environmental Health (41,951)(45,824)(46,548)98.44%
Personal Health (116,905)(521,113)(525,202)99.22%
State Allocations Total (197,887)(702,084)(709,155)99.00%
Grants Project Revenues
Piedmont Hlth Srv - Nutr (11,069)(31,510)(33,800)93.22%
CC4C Accesscare (36,494)(150,771)(149,624)100.77%
PCM Accesscare (40,141)(159,354)(147,651)107.93%
FIT Grant (14,504)(24,004)(45,093)53.23%
MDPP 0 (10,175)(10,175)100.00%
Community Health Grant (62,070)(113,642)(122,065)93.10%
Wolfe Mini Grant 0 (8,000)(8,000)100.00%
Dental Grant 0 (2,000)(2,000)100.00%
Grants Project Revenues Total (164,279)(499,456)(518,408)96.34%
Revenue Total (1,304,548)(3,468,686)(3,522,930)98.46%
Orange County Health Department
Fourth Quarter Financial Report
FY 2017-2018
General Fund
TOTAL HEALTH Q4 YTD ACTUAL ANNUAL BUDGET
% OF ANNUAL
BUDGET
Expenditures
Salaries 1,650,256 5,643,715 5,620,566 100.41%
Benefits 582,974 2,026,652 2,087,406 97.09%
Travel 8,969 20,165 24,220 83.26%
Training 11,813 43,202 40,997 105.38%
Certifications & Licensing 1,479 7,849 11,499 68.26%
Mileage 8,136 27,077 31,893 84.90%
Telephone 24,851 100,539 85,879 117.07%
Postage 3,548 12,429 14,015 88.68%
Motor Pool 12,893 44,211 53,014 83.40%
Equip Repairs 1,692 7,244 9,921 73.02%
Equip Rent 0 1,150 1,200 95.83%
Duplicating 2,220 9,683 13,350 72.53%
Printing 9,462 15,738 20,671 76.13%
Advertising 17,997 33,642 39,234 85.75%
Dues 365 3,767 5,100 73.87%
Subscriptions 189 1,128 1,500 75.20%
Dept Supplies 13,070 27,407 44,735 61.27%
Edu Supplies 15,526 27,279 36,010 75.75%
Office Supplies 8,564 23,296 28,640 81.34%
Medical Supplies 35,935 132,811 137,677 96.47%
Bloodborn Path Supplies 81 559 2,750 20.34%
Pharmacy Supplies 38,944 149,763 159,105 94.13%
Comp Supp/Software 1,905 4,409 5,142 85.74%
Contracted Srv 416,002 1,151,010 1,651,457 69.70%
X-Ray 4,471 17,189 20,235 84.95%
Lab Srv 35,625 133,329 139,785 95.38%
Bonds & Insurance 10,815 10,815 10,815 100.00%
Uniforms 1,565 6,923 7,014 98.70%
Community Proj 13,676 40,215 61,361 65.54%
Innovations Project 5,542 12,385 15,000 82.57%
Accreditation Project 0 2,750 2,750 100.00%
Credit Card Exp 3,937 9,884 11,000 89.86%
Capital Exp Under $500 5,300 8,103 6,072 133.44%
Nicotine Replacement Therapy 2,585 19,618 20,000 98.09%
Returned Checks 175 175 0 100.00%
Capital Expenditures
Equipment 1,998 7,154 7,154 100.00%
IT Equipment 2,482 10,887 13,150 82.79%
Expenditures Total 2,957,394 9,796,504 10,442,668 93.81%
County General Fund Total 1,652,845 6,327,818 6,919,738 91%
Orange County Health Department
Fourth Quarter Financial Report
FY 2017-2018
Grants Fund
TOTAL HEALTH Q4 YTD ACTUAL ANNUAL BUDGET
% OF ANNUAL
BUDGET
Revenue
Grants Project Revenues
Kenan Grant (100,000)(100,000)(300,000)33.33%
Komen Grant 0 (7,588)(46,620)16.28%
Grants Project Revenues Total (100,000)(107,588)(346,620)31.04%
Revenue Total (100,000)(107,588)(346,620)31.04%
Expenditures
Kenan Grant
Salaries 0 0 184,249 0.00%
Benefits 0 0 60,996 0.00%
Training 0 0 3,496 0.00%
Mileage 0 0 3,061 0.00%
Contracted Srv 0 0 27,568 0.00%
Community Proj 0 0 10,730 0.00%
IT Equipment 0 0 9,900 0.00%
Kenan Grant Total 0 0 300,000 0.00%
Komen Grant
Salaries 0 1,179 1,179 100.00%
Benefits 0 438 438 100.00%
Contracted Srv 0 1,152 1,152 100.00%
X-Ray 0 14,634 30,285 48.32%
Komen Grant Total 0 17,403 33,054 52.65%
NACCHO Grant
Dept Supplies 0 1,258 1,263 99.63%
NACCHO Grant Total 0 1,258 1,263 99.63%
Expenditures Total 0 18,661 334,317 5.58%
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: August 22, 2018
Agenda Item Subject: Fluoride Ad Hoc Committee Update
Attachment(s):
Staff or Board Member Reporting: Liska Lackey
Purpose: ____ Action
_ _ Information only
__X_ Information with possible action
Summary Information: Liska will present the latest plan on how the committee will
fulfill OWASA’s request. This will include information on the expert panel, community
feedback, and final reporting. The Board will be asked to approve the plan.
Recommended Action: _X_Approve
___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: August 22, 2018
Agenda Item Subject: Family Success Alliance: Strategic Planning Update
Attachment(s): FSA Update Presentation
Staff or Board Member Reporting: Coby Jansen Austin
Purpose: ____ Action
_ X_ Information only
____ Information with possible action
Summary Information: Coby Jansen Austin will provide an update on Family Success
Alliance (FSA) programming and on its strategic planning process. FSA was created at
the initiative of the Board of County Commissioners in June 2014 in response to a
growing number of children and families living in poverty in Orange County. Drawing on
evidenced-based models such as the Harlem Children’s Zone and Promise
Neighborhoods, FSA is an initiative of the Health Department that works collaboratively
with schools, community partners, faith-based groups, advocates and others to build a
cradle to college and career pipeline of supports for children and families in two
selected “zones”; one in the New Hope area south of Hillsborough and one in the
downtown Chapel Hill/Carrboro area.
Now in its fourth year, FSA has successfully recruited three cohorts of students and
their families into the navigator program (120+ families) and is actively recruiting the
fourth cohort. In 2018, FSA reached more than 230 students with summer enrichment
programming by sponsoring school-based camps with both school districts and
partnering with the Department of Social Services to extend summer camp scholarships
to students and their siblings. We continue to partner with 10 nonprofits to provide
services to zone families, including financial literacy, girl scout troops, mentors, mental
health services, parenting support, and more.
Coby will review progress made by the Strategic Planning Committee and proposed
evolution of the family empowerment model, partnerships, systems-level change, and
expansion.
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):
Board of Health Meeting, August 22, 2018
Coby Jansen Austin
The Family Success Alliance is…
… a group of caring and proactive
Organizations
Local Government Agencies
Community members
working together to ensure children in
Orange County, whose families struggle
to make ends meet, have the
opportunity for a healthy, safe, and
productive life.
Elected Officials
Parents
Through the power of
community
collaboration, we have
the ability to address
structural inequities
so that all Orange
County families can
succeed.
Collective Impact
Our Partners
Neighborhood Poverty Index
Orange County
Zone 4
Hillsborough
Zone 6
Chapel Hill/
Carrboro
Where we’re working…
Fiscal
Year
K Ready
Summer Cohort #
Zone 4
(OCS)
Zone 6
(CHCCS)
Total Students
per Cohort
Cumulative Total
(Students)
FY 14-15 2015 1 27 39 66 66
FY 15-16 2016 2 29 43 72 138
FY 16-17 2017 3 26 44 70 208
FY 17-18 2018 4 40 49 89 297
FY 18-19 2019 5 30 60 90 387
Summer Enrichment: Ready for K Camp students are provided opportunities for afterschool
programming and summer enrichment in subsequent summers – through grade 2.
About half of each cohort is recruited into the navigator program.
Kindergarten Readiness Camp
Zone Navigators
Zone 4
Zone 6
•Connection between
families and resources
•Peer coaches
•Help families engage in,
and advocate for,
educational success
Recruiting 2 more!
Plus, hiring a Manager of
Family Engagement, with
grant funding.
Keeping community
voice at the center of our
work
Antonia
Mariela
Claudia Angela
Erika LaKaya Oy
Navigator Program
Fiscal
Year Cohort #
# new
families/
cohort
Total
families
% Reach
(families)
Addl
Navigator
per new
cohort
Navigator
FTE Total
FY 15-16 1 34 34 4% 2 2
FY 16-17 2 41 75 10% 1.75 3.75
FY 17-18 3 45 120 15% 2.25 6
FY 18-19 4 45 165 20% 2.25 8.25
Navigator Program Modifications made in FY 17-18: Provided benefits to navigators; adjusted
caseload to increase capacity for community organizing and leadership activities; hired Burmese
bilingual navigator
Updates
•Innovation grants
•Summer enrichment partnerships
•FPG Bilingue
•Arts Center
•DEAPR
•New Hope Elementary
•DSS
•Parent Council
•Partner Activities
•2016-18 Strategic Plan Updates
•External Evaluation
•Development
Art Therapy Institute, FSA Innovation Grant – Culbreth and Northside
Strategic Planning
•Foundational Assessment
•Mission, Vision, Values
•Three -Year Strategic Framework
–Family Empowerment Model
–Systems Change
–Foundational Stratgies
•Expansion
Lenten Service Partnership
Family Fun Day!
Family Fun Day!
Memorial Day – FSA End of Year Celebration
https://vimeo.com/284808623
Strategic Planning
2019-2022
FSA Strategic Planning Committee :
Quintana Stewart, Health Director
Michele Woodson, Interim Chief Academic Officer, OCS
Charlos Banks, Senior Executive for Student Support, CHCCS (and Janet Cherry, Systems
of Care Director)
Angela Clapp, Zone 4 Navigator
Mariela Hernandez, Zone 6 Navigator
LaKiera Grimes, Compass Center for Women and Families
Mark Marcoplos, County Commissioner
April Oo, Refugee Community Partnership (Former Zone 6 Navigator)
Delores Bailey, Executive Director, Empowerment, Inc
Latoya Manning, Parent representative (from Parent Council)
Linda Hindman, Orange County Partnership for Young Children
Foundational Assessment:
FSA contracted with SPG Associates to facilitate the strategic planning process. In May
and June, data were collected to draft a Foundational Assessment that included
interviews, focus groups, and an online survey. These data informed the work of the
committee:
Parents: 2 focus groups conducted (in Spanish and Burmese) and interviews with
11 parents who are currently enrolled with FSA.
Other Stakeholders: focus group with ten agencies who receive funding from
United Way as a part of FSA and interviews with 14 other key stakeholders.
Staff: Interviews with five Navigators
Online Survey: An online survey was distributed through FSA’s listserv and by
email directly to other key stakeholders in mid-May and was open for 2 weeks.
There were 58 respondents.
The committee met on July 10 and August 8 to draft a strategic plan framework. During
August, the committee is gathering input from the Board of Health, FSA Advisory Council,
and parents, and then the committee will meet again on September 5 to finalize the
draft. We will gather additional feedback throughout September and then present a final
draft for review and approval to the Council in October.
There will be a public loopback session on September 17 from 2-4pm, location TBC.
Mission, Vision, and Values
CURRENT
VISION: All children and families have the
opportunities and support they need to thrive
in school, jobs and the community.
MISSION: The Family Success Alliance is a
collective impact initiative to close the
achievement gap and end generational
poverty in Orange County, North Carolina. A
diverse group of parents, elected officials,
community organizations, and government
partners have come together to improve
children’s chances for educational and
economic opportunities with a seamless
“pipeline” of evidence-based programs,
services, and supports from cradle to college
and career.
FUTURE
VISION: Break the cycle of poverty so
that children and families in Orange
County thrive in school, jobs, and life.
MISSION: Through collective impact
approach, connect families to
resources and empower them as
change leaders so that all families in
poverty have the opportunity to be
successful.
Values
Work collaboratively towards a shared mission and vision of FSA
Embrace the family (2Gen)
Be committed to racial equity and inclusion
Guided by the wisdom of families
Be outcome-oriented
Understand that relationships are “the work”
Actively participate and be accountable
Primary Strategies
In order to reach FSA’s desired Vision, Mission and Goals for the organization, we will
focus on three key areas:
Family
Empowerment Systems Change Foundational
Support
How can we proactively
CHANGE SYSTEMS OF
INEQUITY that are
holding back families?
How will we work with and
EMPOWER FAMILIES
throughout Orange County
to break the cycle of poverty
and support children so that
they are successful from
cradle to college and career?
What are the
FOUNDATIONAL aspects of
our work – including the
backbone work and the
infrastructure - fundraising,
communications, process,
evaluation, and technology –
that sustain this work and
help meet our goals?
Family Empowerment
Expand FSA
Reach and
Impact
Systems Change
Foundational Strategies
Deliver
Tiered
Support
Proactively Address
Systems of Inequity
Cultivate a
Responsive
Partnership
Network
Generate
Sustainable
Resources
Optimize
Infrastructure
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: August 22, 2018
Agenda Item Subject: Bad Debt Write-Off: Transfer of Uncollectible
Debt from Active to Inactive
Attachment(s): Delinquent and Uncollectible Accounts Policy
Staff or Board Member Reporting: Rebecca Crawford
Purpose: _X_Action
___ Information only
___ Information with possible action
Summary Information:
Per the department’s Delinquent and Uncollectable Accounts policy (15.0), uncollectible
accounts must be administratively written off of the general ledger. The purpose of this
accounting function is to precisely account for funds which are truly unrecoverable. The
last administrative write-offs were performed by the Board of Health in August 2017
(Personal Health, Dental Health, and Environmental Health) for FY 2016-2017.
Personal Health, Dental Health, and Environmental Health continue to participate in the
NC Debt Set-Off Program, which allows the county to collect debts on delinquent
accounts with a balance between $50 and $4,000 through the customer’s tax refund.
The Health Department anticipates collecting payments on delinquent accounts being
pursued through the NC Debt Set-Off program; therefore, those accounts are not
included in this write-off request.
Based on the definitions of uncollectible accounts in the department’s policy, the
following table represents all uncollectible debt from clients for FY 2017-2018.
Division
Number of
Uncollectable
Accounts
Write-Off
Amount
Personal Health 98 $1,750.60
Dental Health 76 $1,843.21
Environmental
Health 2 $300.00
Total $3,893.81
We request to administratively move a total of $3,893.81 in uncollectible debt from
‘active’ to ‘inactive’ status for the reasons indicted in the table above.
The customer will never be informed that a debt has been written off. If a customer
whose account had been determined uncollectible returns to clinic within three years,
the delinquent write-off amount will be reactivated and the billing process resumed.
Likewise, if a customer requests a non-required service from Environmental Health, the
delinquent write-off amount will be reactivated and the billing process resumed.
Recommended Action: _X_Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to ____________________
___Accept as information
___Revise & schedule for future action
___Other (detail):
Section II:
ORANGECOUNTYHEALTHDEPARTMENT
Administrative Policy and Procedure Manual
Financial Practices
Delinquent and Uncollectable Accounts Policy 15.0
Reviewed by:
Approved by:
Finance and Admjnistrative Services Director I . { 1
HealthDirector ~ Ai uf20fte6 f0.,212j19-
Policy 15.0 Delinquent and Uncollectable Accounts
The Orange County Health Department (OCHD) charges fees for its services. Many services are
billed on a sliding scale. The sliding scale is a calculation based on economic unit and income. Most
clients are assessed at less than 100% ofOCHD's regular fee; however, some are still unable to make
payments. In order to have a better understanding of OCHD true accounts receivable amount,
delinquent and uncollectible accounts shall be administratively written off the books. OCHD shall
assure that all requirements for state, local and in-house budgeting, fmancial reporting and auditing
are followed.
As directed by the Orange County Board of Health at the October 23,2013 meeting, Orange County
citizens will not be refused medical services provided by the department solely based on inability to
provide verification of income or verification of permanent residence. This is to ensure a barrier is
not created to Women's Health services, the homeless population, migrant workers, and other persons
residing in the county who cannot provide verification of income or permanent residence.
Purpose
The purpose of this policy is to provide guidance regarding handling delinquent and uncollectible
accounts.
Procedures
15.1. Delinquent Accounts: defmed as an account with an outstanding balance that is 30 days
past due.
15.2. Uncollectable Accounts: defined as an account having an outstanding balance where the
client falls into one or more of the following categories: deceased, moved and cannot be
found, or declared bankruptcy. Delinquent accounts that do not have a payment for more
than 12 months shall be considered uncollectible accounts. For Enviromnental Health
accounts, uncollectable accounts include those in which the property was owned by a
corporation, trust or non-individual and has been sold to another party. There may be other
definitions of uncollectible accounts.
15.3. Bad Debt Write-Off: Removing Delinquent and Uncollectable Accounts less than $50 from
the Accounts Receivable system
15.3.1. For uncollectable account balances, a list will be prepared for the Health Director's
review annually. For Medical and Dental, this Jist will be prepared by the Billing
Manager or designee. The Jist ofuncollectable Environmental Health account
balances will be prepared by the Enviromneutal Health Division Director or
designee.
15.4. Debt Set-Off
15.4.1. For delinquent accounts more than $50 and over 60 days past due, all divisions will
follow the County's NC Debt Set-Off policy and procedures.
Original Effective Date: July 2006
Revisions: 11/2013,9/2014, 9/2015,9/2017
Page 1 of2
Section II:
Policy 15.0
Reviewed by:
Approved by:
ORANGE COUNTY HEALTH DEPARTMENT
Administrative Policy and Procedure Manual
Financial Practices
Delinquent and Uncollectable Accounts
Finance and Administrative Services Director
Healtb Director
15.4.2. The Accounts Receivable system shall indicate the recording of the account as
"uncollectible" and moved to an "inactive" status after Healtb Director l;lpproval.
Documentation and evidence of account status shall be on file in the event of an
audit.
15.5. A client who has had tbeir account moved to "inactive" status shall not be informed oftbis
administrative function. Any activity in the account shall re-activate the account. If the
client returns within 3 years from tbe last date of service, tbe account may be reinstated and
moved back to "active" status.
15.6. Debt incurred for services provided to minors where the parent/legal guardian has
authorized the client's care by taking full responsibility for charges incurred from services
rendered, is not reactivated when tbe client presents for services as an adult, but remains
the responsibility of the parent/legal guardian.
15.7. If the health department's database becomes obsolete or otherwise unusable, the Health
Director may use a different write off schedule. This especially pertains to outdated
software that cannot be upgraded or change in programs where access from one to the
other cannot be easily accomplished by Office Assistants' who wonld need to check the
client accounts.
15.8. This policy shall be reviewed annually and updated as needed by tbe FAS Director.
Original Effective Date: July 2006
Revisions: 11/2013,9/2014.9/2015,9/2017
Page 2 of2
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: August 22, 2018
Agenda Item Subject: Board of Health Policy Review
Attachment(s):
Staff or Board Member Reporting:
Purpose: ____ Action
_ Information only
__X__ Information with possible action
Summary Information: The Board will review and discuss the Board of Health
Operating Procedures to ensure processes are efficient and in compliance with NC
General Statue 130A. Any needed revisions will be made and the Board will be asked to
approve the policy.
Recommended Action: _X_Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to ___________________________
___Accept as information
___Revise & schedule for future action
___Other (detail):
ORANGE COUNTY HEALTH DEPARTMENT
Board of Health Policy and Procedures Manual
Section III: Board Processes
Process A: Operating Procedures
Reviewed by: Health Director
Approved by: Health Director, Board of Health
Review Annually (July) Page 1 of 6
Original Effective Date: February 8, 1979
Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12,
11/5/13, 11/14, 8/15
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Procedures_FINAL Oct 2015.doc
Purpose
To outline operating procedures for the Board of Health in accordance with pertinent state,
local and federal requirements for the operation of the Board.
I. Name and Office
The name of this organization is the Orange County Board of Health (hereinafter
“Board”). The principal office of the Board is located at 300 West Tryon Street,
Hillsborough, NC 27278.
II. Charge to the Board
The Board is the primary policy-making and adjudicatory body (NCGS 135A-25(a))
for the health department and is charged to protect and promote the public health of
Orange County (NCGS 130A-39).
III. Composition
A. The composition of the Board of Health is governed by NCGS 130A-35(b)-
(d)
IV. Terms of Office
A. By NCGS 130A-35 (c), members shall serve three year terms and no member
may serve more than three consecutive three-year terms unless the member is
the only person residing in the county who represents one of the professions
designated in subsection (b) of NCGS 130A-35.
B. It is the policy of the Orange County Board of Health that members may serve
three, three-year consecutive terms. Members appointed to fill unexpired
terms are eligible to subsequently be appointed to three additional terms.
V. Officers and Committees
A. Chair and Vice-Chair
The Board members shall select a Chair and Vice-Chair by majority vote each
year at the last meeting of the calendar year.
B. Secretary
The Orange County Health Director shall serve as Secretary to the Board, but
the Director is not a member of the Board. The Health Director may delegate
the duties of the secretary that are set forth in these operating procedures to an
appropriate local health department employee.
ORANGE COUNTY HEALTH DEPARTMENT
Board of Health Policy and Procedures Manual
Section III: Board Processes
Process A: Operating Procedures
Reviewed by: Health Director
Approved by: Health Director, Board of Health
Review Annually (July) Page 2 of 6
Original Effective Date: February 8, 1979
Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12,
11/5/13, 11/14, 8/15
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Procedures_FINAL Oct 2015.doc
C. Committees
The Board shall review the existing committee structure annually and make
decisions regarding the number and types of standing committees. Board
members are appointed to committees in January of each year. Only Board
members may serve as committee members of standing Board committees and
the number of Board members on any single committee must be at least two
members and may not exceed five members.
The Board shall have the following standing committees:
1. Executive Committee
To provide the structure for the work of the Board of Health and act as an
advisor to the health director and senior management staff as needed.
Chair and Vice-Chair are committee members.
2. Nominating and Bylaws Committee
To develop and present an annual slate of officers for Board consideration,
to oversee the board recruitment process, and to recommend operating
procedure changes as needed. Members are appointed by the Chair on an
ad hoc basis.
3. Access to Care
To oversee the action steps and deliverables outlined in the Access to Care
section of the Board of Health Strategic Plan
4. Mental Health and Substance Abuse
To oversee the action steps and deliverables outlined in the Mental Health
and Substance Abuse section of the Board of Health Strategic Plan
5. Childhood and Family Obesity Prevention
To oversee the action steps and deliverables outlined in the Childhood and
Family Obesity Prevention section of the Board of Health Strategic Plan
All standing committees are subject to the North Carolina open meetings
laws and shall comply with the provisions of those laws.
6. Temporary Committees
The Board may establish and appoint members for temporary committees
as needed to carry out the Board’s work. Temporary committees must
limit their work to the specific charge outlined by Board motion and may
include members that are not serving on the Board of Health.
All temporary committees are subject to the North Carolina open meetings
laws and shall comply with the provisions of those laws.
VI. Meetings
ORANGE COUNTY HEALTH DEPARTMENT
Board of Health Policy and Procedures Manual
Section III: Board Processes
Process A: Operating Procedures
Reviewed by: Health Director
Approved by: Health Director, Board of Health
Review Annually (July) Page 3 of 6
Original Effective Date: February 8, 1979
Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12,
11/5/13, 11/14, 8/15
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Procedures_FINAL Oct 2015.doc
A. Regular Meetings
The Board shall hold regular meetings no less than quarterly. As a general
rule, the Board will meet monthly. A calendar of regular meetings and
location of each meeting will be established at the last regular meeting of the
calendar year for the next calendar year. The dates may be adjusted annually
based on Commissioner meeting dates for the year to enable the
Commissioner member of the Board to attend. The requirements of the open
meetings law shall apply to all regular board, regular or ad hoc committee or
task for meetings. Notification of the public will be in compliance with open
meeting law notification.
B. Agenda
The Secretary to the Board shall prepare an agenda for each meeting. Any
board member who wishes to place an item of business on the agenda shall
submit a request to the Secretary at least five working days before the
meeting. For regular meetings, the Board may add items to the agenda or
subtract items from the agenda by a majority vote. The agenda for a special or
emergency meeting may be altered only if permitted by and in accordance
with the North Carolina open meetings laws.
C. Presiding Officer
The Chair of the Board shall preside at Board meetings if he or she is present.
If the Chair is absent, the Vice-Chair shall preside. If the Chair and Vice-
Chair are both absent, another member designated by a majority vote of
members present at the meeting shall preside.
D. Quorum
A majority of the actual membership of the Board, excluding vacant seats,
shall constitute a quorum. A member who has withdrawn from a meeting
without being excused by a majority vote of the remaining members shall be
counted as present for purposes of determining whether or not a quorum is
present.
E. Voting
Each Board member shall be permitted to abstain from voting, by so
indicating when the vote is taken. A member must abstain from voting in
cases involving conflicts of interest as defined by North Carolina law. If a
member has withdrawn from a meeting without being excused by a majority
vote of the remaining members, the member’s vote shall be recorded as an
abstention.
ORANGE COUNTY HEALTH DEPARTMENT
Board of Health Policy and Procedures Manual
Section III: Board Processes
Process A: Operating Procedures
Reviewed by: Health Director
Approved by: Health Director, Board of Health
Review Annually (July) Page 4 of 6
Original Effective Date: February 8, 1979
Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12,
11/5/13, 11/14, 8/15
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Procedures_FINAL Oct 2015.doc
F. Minutes
The Secretary shall prepare minutes of each Board meeting. Copies of the
minutes shall be made available to each Board member before the next regular
Board meeting. At each regular meeting, the Board shall review the minutes
of the previous regular meeting as well as any special or emergency meetings
that have occurred since the previous regular meeting, make any necessary
revisions, and approve the minutes as originally drafted or as revised. The
public may obtain copies of Board meeting minutes at the Board of Health
website
(http://www.orangecountync.gov/departments/health/agendas_and_minutes.p
hp).
VII. Contract Negotiations
The Health Director is authorized to enter into a contract with any governmental or
private agency or with any person, for the provision or receipt of public health
services. The Board of Commissioners or its designee must approve contracts
requiring payment for services rendered to the Health Department. The Health
Director will discuss with the Board contracts that represent significant deviation
from current Board of Health policy prior to authorizing that contract.
VIII. Amendments to Operating Procedures
These operating procedures may be amended at any regular meeting or at any
properly called special meeting that includes amendment of the operating procedures
as one of the stated purposes of the meeting. A quorum must be present at the
meeting at which amendments are discussed and approved, and any amendments
must be approved by a majority of the members present at the meeting.
IX. Other Procedural Matters
The Board shall refer to Bell, II, A. Fleming. Suggested Rules of Procedure for Small
Local Government Boards, Second Edition, Institute of Government, The University
of North Carolina at Chapel Hill, 1998 to answer procedural questions not addressed
in this document, so long as the procedures prescribed in Suggested Rules of
Procedure for Small Local Government Boards do not conflict with North Carolina
law.
X. Rules Development Procedure
The board shall evaluate the need for adoption of rules to protect and promote the
public health. In addition, existing rules should be evaluated periodically for the need
for revisions to respond to new risks, advances in technology, or changes in statutes
or state regulations.
A. The Board will follow the procedures outlined in NCGS 130A-39.
ORANGE COUNTY HEALTH DEPARTMENT
Board of Health Policy and Procedures Manual
Section III: Board Processes
Process A: Operating Procedures
Reviewed by: Health Director
Approved by: Health Director, Board of Health
Review Annually (July) Page 5 of 6
Original Effective Date: February 8, 1979
Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12,
11/5/13, 11/14, 8/15
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Procedures_FINAL Oct 2015.doc
1. Not less than 10 days before the adoption, amendment or repeal of any
local board of health rule, the proposed rule shall be made available at
the office of the county clerk, and a notice shall be published in a
newspaper having general circulation within Orange County. The notice
shall contain:
a. A statement of the substance of the proposed rule or a
description of the subjects and issues involved.
b. The proposed effective date of the rule, and
c. A statement that copies of the proposed rule are available at
the local health department.
A local board of health rule shall become effective upon adoption
unless a later effective date is specified in the rule.
2. Copies of all rules shall be filed with the secretary of the local board of
health and will be made available to all Board of Health members.
3. A local board of health may, in its rules, adopt by reference any code,
standard, rule or regulation, which has been adopted by any agency of
this State, another state, any agency of the United States or by a
generally recognized association. Copies of any material adopted by
reference shall be filed with the rules.
XI. Adjudication Procedures
A. The Board will follow all procedures as specified in NCGS 130A-24. In the
case where a member of the public is appealing a decision on the application
of an Orange County Board of Health adopted rule or concerning the
imposition of administrative penalties by a local health director, the process
will include the following steps:
1. The aggrieved party shall provide written notice of appeal to the Health
Director within 30 days of the challenged action. The notice shall
contain the name and address of the aggrieved person, a description of
the challenged action and a statement of the reasons why the challenged
action is incorrect.
2. The Health Director shall notify the Board within five working days of
receipt of the appeal and transmit all documents upon which the
challenged action was taken.
3. The Board of Health shall hold a hearing within 15 days of the receipt of
the notice of appeal from the health director to the Board. The Board
will give the person not less than 10 days notice of the date, time and
place of the hearing. The local board of health shall issue a written
decision based on the evidence presented at the hearing. The decision
shall contain a concise statement of the reasons for the decision.The
hearing must meet the requirements of procedural due process.
ORANGE COUNTY HEALTH DEPARTMENT
Board of Health Policy and Procedures Manual
Section III: Board Processes
Process A: Operating Procedures
Reviewed by: Health Director
Approved by: Health Director, Board of Health
Review Annually (July) Page 6 of 6
Original Effective Date: February 8, 1979
Revision Dates: 12/18/1980, 4/16/1981; 4/26/1984; 11/16/2000; 2/23/2007; 10/24/2007; 4/23/2009, 7/24/12,
11/5/13, 11/14, 8/15
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Procedures_FINAL Oct 2015.doc
a. No contact outside the hearing with parties involved or
between board members.
b. Board members with any bias must not participate.
c. Board must allow the appellant’s attorney to attend and
advise his/her client.
d. Board must take sworn and relevant testimony.
e. Board must provide for cross-examination of witnesses.
f. Board must keep detailed or verbatim minutes.
4. The proceedings shall be recorded and a transcript of the hearing shall
be prepared and be available to the appellant and/or the Board upon
request.
5. At the next regularly scheduled Board meeting following the hearing,
the Board must issue a written decision based on the evidence presented
at the hearing. The decision shall contain a concise statement of the
reasons for the decision and the Secretary will transmit the final written
decision of the Board to the person appealing via certified US mail.
6. A person who wishes to contest a decision of the Board of Health shall
have a right of appeal to the district court having jurisdiction within 30
days after the date of the decision.
XII. Annual Review of the Health Director
The Board will annually review the performance of the Orange County Health
Director using the process detailed in the Board of Health Policy and Procedure
Manual, Section III, B.d. Annual Performance Review Process for Health Director.
XIII. Compliance with North Carolina Law
In conducting its business, the Board shall comply with all applicable North Carolina
laws, including but not limited to open meetings laws, public records laws, and the
laws setting forth the responsibilities and duties of local boards of health. To assist
the Board in compliance, the local health director shall maintain a current copy of
relevant North Carolina General Statutes and make them available to Board members
on request.
Health Director’s Report
August 2018
• July 10th & August 8th 2018 – Family Success Alliance Strategic Planning Workshop.
I’ve had a chance to spend two full days with the FSA Strategic Planning team; very
diverse team of staff and community partners. We’ve had very good conversation about
the program and the future direction for our Community.
• July 11, 2018 – Meeting with Dr. Pamela Baldwin, Chapel Hill-Carrboro City School
Superintendent; this was an introduction meeting since I had not yet had a chance to meet
Dr. Baldwin since I started back in December.
• July 12, 2018 – Meeting with Orange County Head Start/Early Head Start Staff
(Tremaine Riley, Disabilities/Mental Health Manager & Jacqueline Wilson, Health &
Nutrition Specialist). Head Start is really interested in partnering with OCHD in
implementing Dental Screenings for their children and they would like to ultimately plan
a Co-Sponsored Community Health Fair at the Whitted location in 2019.
• July 18, 2018 – Human Services Informatics Team Meeting; the Human Service Team
discussed ways in which we would continue to collaborate on departmental/program
informatics. The recent staff change with Juliet Sheridan joining Health and leaving DSS
prompted a conversation on how to best utilize staff in the DSS position that is hard to fill
and retain. We came up with a plan to keep the Human Service data staff in contact
throughout the year with a systematic way to scale up when needed to address special
projects.
• July 19, 2018 – Orientation Webinar for NC Public Health Leadership Institute 2018-19
Cohort. Our first 2-day in-person Class was held on August 9th -10th in Chapel Hill. I
have thoroughly enjoyed the course thus far. I’ve had the opportunity to network with
other new Health Directors in the State in addition to other Public Health leaders at both
the State and County level. The first 2 days of class focused on our Meyers-Briggs
Assessments and how that translates into our Leadership Style. We’ve formed Peer
Coaching groups and began a deep dive into our text, “The Leadership Challenge” by
Kouzes & Posner.
• July 23, 2018 – Meeting with AMS to discuss office renovations for PH Staff in Housing
Department in Whitted Building. We are working with the Criminal Justice Resource
Department and have agreed to house 2 new Coordinator positions here at the Health
Department so they may be co-located with our FIT Program Coordinator Henry Green.
In an effort to make this happen, our CD staff will move from the 2nd floor of Health to
the 3rd Floor in the Housing Department, where there are vacant offices.
• August 2, 2018 – Meeting with Chatham County Health Director and Piedmont Health
Services CEO to discuss clinical services in the area. This was a brainstorming session to
think about how to prepare for Medicaid Transformation in a way that is financially
sound for our respective agencies.
• The Racial Equity Commission has started their Strategic Planning Process. To date
approximately 15 staff has participated in individual interviews to share their perspective
on department culture, operations and leadership. We are now preparing for a staff focus
group and a community focus to get additional information. An online survey will also be
sent to all department staff.
• I was accepted into the next Municipal and County Administration Program at UNC
School of Government. Classes start September 18, 2018 and run through April 12, 2019.
I’ve heard nothing but great things about this program. Faculty at UNC feels this will
complement the NC Public Health Leadership Institute work really well.
Upcoming Events
• September 18-21, 2018 – NCPHA Conference in Charlotte, NC.
o OCHD Environmental Health will participate in Poster Presentation; Victoria
Hudson, Interim EH Director also wrote an article that was featured in the July
2018 NCPHA Newsletter; “Environmental Health Readies for a Historic
Temperature Change: Keep Cold Foods 41°F or Below”
o Nicholas Cordeiro, Public Health Nurse II, will participate n a Panel Presentation
titled, Oral Health: Identifying Dental Practices in Ten NC Counties Accepting
Pregnant Women Within the Medicaid Population.
FIT Program Provides Critical Medical Support For Former Inmates | WUNC
http://www.wunc.org/post/fit-program-provides-critical-medical-support-former-inmates[8/14/2018 11:18:39 AM]
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The State of Things
FIT Program Provides Critical Medical Support
For Former Inmates
By DANA TERRY & FRANK STASIO • JUN 13, 2018
TweetShareGoogle+Email
While incarcerated it is a constitutional right for
inmates to receive medical care. But what
happens when inmates are released and no
longer have access to health services? The
reality is they often go without medication or
treatment. Considering prisons have become the
largest mental healthcare providers in America, it
is in the interest of public safety to remedy that
gap in coverage.
19:45
Host Frank Stasio speaks with Dr. Evan Ashkin, director of the Formerly Incarcerated Transition (FIT) program
Listen
Jessica Romine (right) was recently released from jail and
is receiving assistance through a partnership with Tommy
Green (left) that was established by the North Carolina
Formerly Incarcerated Transition program, or NCFIT, led
by Dr. Evan Ashkin (center).
CREDIT GABRIELLA BULGARELLI / WUNC
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FIT Program Provides Critical Medical Support For Former Inmates | WUNC
http://www.wunc.org/post/fit-program-provides-critical-medical-support-former-inmates[8/14/2018 11:18:39 AM]
TAGS: THE STATE OF THINGS UNC SCHOOL OF MEDICINE FORMERLY INCARCERATED TRANSITION FIT
DR. EVAN ASHKIN JESSICA ROMINE TOMMY GREEN INMATE REHABILITATION TRANSITION
NC PRISONS PRISON REENTRY NC FIT PROGRAM
Dr. Evan Ashkin is a professor of family medicine at the University of North Carolina’s School of
Medicine. While working in low-income health care he observed these gaps and created his own
solution. He is now the director of the Formerly Incarcerated Transition (FIT) program which provides
funds for healthcare as well as resources for jobs, education and integrating back into society.
Modeled after a successful program in San Francisco, Ashkin pairs former inmates with recently
released inmates. Together they work to lower the recidivism rate.
Dr. Ashkin joins Frank Stasio to talk about FIT and what inspired it. He is joined by Jessica Romine
who was recently released from jail, joined the FIT program and is fnally getting the support she
needs. Tommy Green works for FIT, but before that he spent 11 years and 8 months in prison. Green
is Romine’s community health worker.
which provides funds for healthcare as well as resources for jobs, education and integrating back into society. Also
joining the conversation is FIT community health worker Tommy Green and FIT participant Jessica Romine.
TweetShareGoogle+Email
RELATED CONTENT
Is the North Carolina Department of Public Safety breaking its own
rules? A 2016 policy change prohibits inmates with mental health
issues from being held in solitary confnement for more than 30
days. So why was Devon Davis, who is developmentally delayed
and has mental illness, kept in solitary for more than fve months
last year?
Solitary Confnement And Mental Health: The Case of Devon Davis
By DANA TERRY & FRANK STASIO • MAY 31, 2018
Most state prison employees charged with crimes while on duty get
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By LAURA PELLICER & FRANK STASIO • APR 24, 2018
COURTESY OF ROSE HOBAN
8/14/2018 Orange County Health Dept. takes needle exchange program public | News & Observer
https://www.newsobserver.com/news/local/community/chapel-hill-news/article90175387.html 1/8
CHAPEL HILL NEWS
Health Dept. sets up used needle drop, offers clean
ones
HILLSBOROUGH —
BY TAMMY GRUBB
tgrubb@newsobserver.com
July 20, 2016 03:53 AM
Updated July 20, 2016 08:34 AM
The Orange County Health Department has been quietly exchanging needles
for drug users and diabetic patients since April.
The Safe Syringe Program only became official when Gov. Pat McCrory signed a new state law
July 11 outlining the requirements under which local agencies could offer needle, or syringe,
exchanges.
8/14/2018 Orange County Health Dept. takes needle exchange program public | News & Observer
https://www.newsobserver.com/news/local/community/chapel-hill-news/article90175387.html 2/8
It’s exciting to be able to offer a program that’s addressing “a large but hidden and stigmatized
public health issue,” said Robin Gasparini, county nursing supervisor.
“Having this law passed allows us to really go out there and actively partner with the community
about our program and share information,” she said, “and I think it’s really critical for people to
know that there’s a safe avenue.”
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They are still working with the state to amend a portion of the law that prohibits using public
money to buy needles, hypodermic syringes and other injection supplies.
The law also requires programs to address the spread of HIV, hepatitis and other bloodborne
diseases; reduce needle-stick injuries to public safety workers; and encourage drug users to seek
treatment.
The N.C. Harm Reduction Coalition reports that one out of every three officers will be stuck
accidentally with a needle during their careers, potentially exposing them to HIV and Hepatitis B
and C. Roughly 28 percent will be stuck more than once, the group repor ted.
Gasparini noted North Carolina has had a significant problem with hepatitis, with the Centers for
Disease Control and Prevention reporting the number of cases had increased more than 200
percent between 2007 and 2011. More than half of the hepatitis transmissions reported are
traced to shared needles, she said.
Low-income residents and those with chronic illnesses or who face stereotypes when buying
needles through a pharmacy also may reuse needles, she said, which raises the risk of infections
and bruising.
The new law also is expected to help officers stay safe as they patrol the streets, Chapel Hill Police
Chief Chris Blue said.
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8/14/2018 Orange County Health Dept. takes needle exchange program public | News & Observer
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“Law enforcement officers, I think, pretty universally support the notion that a needle exchange
program can help people get directed to resources they need to perhaps address their addiction,”
he said, “and can also reduce the likelihood that dirty needles are out there that can harm people
out in the community or officers that may encounter users.”
Five people have visited the Hillsborough and Chapel Hill clinics since April to drop off dirty
needles and pick up a bag of 20 clean ones, Gasparini said. Now, dirty needles can be dropped
into white metal boxes located in both buildings.
They aren’t tracking personal details or the reasons someone might trade their needles, she said,
but they do know at least one client is diabetic and has had trouble buying needles through a
pharmacy. Two others who picked up needles also got tested for HIV, she said.
Law enforcement officers “play a huge role in helping us build trust with our clients,” Gasparini
said. “I would ask for their support to help us connect to the community and help the community
members connect to our program based on need.”
The state law requires programs to include educational materials about the prevention of
overdoses; HIV, AIDS and viral hepatitis transmission; and drug abuse. The materials also must
address treatment and referrals for mental illness and substance abuse.
Business cards with information about Orange County’s Safe Syringe Program have been sitting
on the front desk of the Orange County Sheriff’s Office for months. The Carrboro Police
Department also has received the cards, police spokesman Capt. Chris Atack said.
Tammy Grubb: 919-829-8926, @TammyGrubb
NEEDLEEXCHANGE
The Orange County Health Department has set up white, metal dropboxes for depositing dirty
needles at its clinics. The boxes can be found at 2501 Homestead Road in Chapel Hill and 300
W.Tryon St. in Hillsborough. A bag of clean needles and other items is available at each clinic’s
front desk.
More information is available by calling 919-245-2400.
8/14/2018 Orange County Health Dept. takes needle exchange program public | News & Observer
https://www.newsobserver.com/news/local/community/chapel-hill-news/article90175387.html 4/8
SUGGESTED FOR YOU
Orange County Health Department officials are collecting dirty needles in the white, metal boxes located in the
lobby of the health clinic inside the Whitted Building, 300 W. Tryon St. in Hillsborough. Another box is located at
the Southern Human Services Center health clinic, 2501 Homestead Road in Chapel Hill. Tammy Grubb -
tgrubb@newsobserver.com
Raccoon near Finley Golf Course in Chapel Hill has rabies | The Herald Sun
https://www.heraldsun.com/news/local/counties/orange-county/article214434384.html[8/14/2018 11:13:45 AM]
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ORANGE COUNTY
She picked up a baby
raccoon with her bare
hands. Now she may need
rabies shots.
A Chapel Hill woman may need post rabies exposure
shots after handling a baby raccoon without gloves
Sunday, July 1, 2018, near Finley Golf Course. Travis
Heying - File photo, The Wichita Eagle
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Raccoon near Finley Golf Course in Chapel Hill has rabies | The Herald Sun
https://www.heraldsun.com/news/local/counties/orange-county/article214434384.html[8/14/2018 11:13:45 AM]
CHAPEL HILL —
BY CHRISTY KUESEL
ckuesel@heraldsun.com
July 06, 2018 03:15 PM
A Chapel Hill woman may
need medical treatment after handling a rabid
raccoon without gloves, Orange County Animal
Services officials said.
The raccoon marks Orange County’s third
confirmed case of rabies this year, according to
the N.C. State Laboratory of Public Health.
The woman heard her dogs barking Sunday.
She went outside and found a sick baby raccoon
in her yard. She placed it in a carrier and called
Animal Control, which removed it for rabies
testing. The incident took place near UNC’s
Finley Golf Course.
A nurse from the Orange County Health
Department contacted the woman, who may
need post-exposure shots, county officials said.
Her dogs were not exposed since they were
confined away from that part of the yard.
If a dog, cat or ferret with a current vaccination
history has been exposed to rabies, that animal
must receive a booster shot within 96 hours
(four days). An unvaccinated animal must be
destroyed or quarantined for up to four
months, or six months for a ferret.
Raccoons and bats are the most common hosts
of rabies in the area.
Last year, Orange County had nine confirmed
cases of rabies, Animal Services officials said. In
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Raccoon near Finley Golf Course in Chapel Hill has rabies | The Herald Sun
https://www.heraldsun.com/news/local/counties/orange-county/article214434384.html[8/14/2018 11:13:45 AM]
2016 they recorded six.
In 2016 the N.C. Department of Health
recorded 251 rabies cases across the state,
including 26 bats, two beavers, 10 cats, four
cows, one deer, two dogs, 51 foxes, 117 raccoons
and 38 skunks.
Rabies is a preventable viral disease in
mammals, most often transmitted through the
bite of a rabid animal. Symptoms in people
include fever, headache and general discomfort,
progressing to death within days of showing
symptoms. However, rabies is rare in people.
Of the few cases in humans in the country in
recent years, most have been traced to bats. If
there is any possibility of exposure to a bat, the
affected person should contact Animal Control.
If any incident involving a bat or other animals
susceptible to rabies, like raccoons or skunks,
takes place outside of regular Animal Control
hours, an Animal Control officer can be reached
at 911.
Editor's note: The following video contains graphic content. Peter
Costa, with the Global Alliance for Rabies Control, explains how to
properly clean and treat a wound from a bite from a possible rabid
animal. The video is an except from a video
By
Raccoon near Finley Golf Course in Chapel Hill has rabies | The Herald Sun
https://www.heraldsun.com/news/local/counties/orange-county/article214434384.html[8/14/2018 11:13:45 AM]
Vaccination clinic
Animal Services will hold a low-cost rabies
vaccination clinic from 10 a.m. to noon
Saturday, July 21, at Schley Grange Hall, 3416
Schley Road in Hillsborough.
Animal Services will offer one and three-year
rabies vaccines for $10 and microchips for $35,
including registration fees. Three-year
vaccinations require printed proof of a previous
vaccine. A tag alone is not sufficient. Dogs must
be leashed and cats must be in a carrier.
Another rabies vaccination clinic will be held
from 3 to 6 p.m. Aug. 16 at Orange County
Animal Services, 1601 Eubanks Road in Chapel
Hill.
For more information go to
tinyurl.com/y7vx3ama or call 919-942-PETS
(7387).
READ MORE
5 fast facts about rabies and how
to protect your pets and family
Helpful facts
North Carolina requires dogs, cats and
ferrets older than 4 months to have a current
and valid rabies vaccination at all times.
Pets with current rabies vaccinations that
may have been exposed to rabies must be
revaccinated, or they will be treated as
unvaccinated pets.
Rabies can be transmitted through secondary
exposure as well. Do not touch your pet
without gloves if it has had any possible
Raccoon near Finley Golf Course in Chapel Hill has rabies | The Herald Sun
https://www.heraldsun.com/news/local/counties/orange-county/article214434384.html[8/14/2018 11:13:45 AM]
exposure to rabies.
If a suspected rabid animal is alive, do not
try to capture the animal. Keep it in sight
visual until Animal Control arrives.
If you find a bat in your house, do not release
it, but do remove yourself and any animals
from the area. Always call Animal Control
immediately if you find a bat in your home,
even if there is no evidence of a bite.
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