HomeMy WebLinkAboutBOH agenda 062619ORANGE COUNTY BOARD OF HEALTH
MEETING AGENDA
DATE: June 26, 2019
TIME: 7:00 P.M.
PLACE: Southern Human Services Center
2501 Homestead Road
Chapel Hill, NC 27516
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 June 26, 2019 Agenda
7:10 – 7:15 IV. Actions Items (Consent)
A. Minutes of May 22, 2019 Timothy Smith
7:15 – 8:50 V. Educational Sessions
A. Public Health 3.0 Vaughn Upshaw
(45 minutes)
B. Formerly Incarcerated Transition Program (FIT) Update Tommy Green
(15 minutes) (relative to BOH Strategic Plan Priority:
Substance Abuse and Mental Health)
C. Annual Communicable Disease Report Michael DeFranco (15 minutes)
D. Innovation Grant Update Victoria Hudson
(10 minutes)
E. Strategic Plan Update Beverly Scurry (10 minutes) (relative to BOH Strategic Plan Priority: All)
8:50 – 9:00 VI. Reports and Discussion with Possible Action
A. Current BOH Recruitment Jessica Frega
B. Health Director Report Quintana Stewart
9:00 – 9:05 VII. Board Comments
9:05 VIII. 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 May 22, 2019 at the Whitted Human
Services Center, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Timothy Smith – Chair, Jessica Frega – Vice-
Chair, Bruce Baldwin, Keith Bagby, Paul Chelminski, Jennifer Deyo, Susan Elmore,
Commissioner Earl McKee, and Sam Lasris.
BOARD OF HEALTH MEMBERS ABSENT: Barbara Chavious, Liska Lackey
STAFF PRESENT: Quintana Stewart, Health Director; Krista Burnette, Lab Technician; Victoria
Hudson, Environmental Health Director; Donna King, Health Promotion and Education Services
Director; Pam McCall, Public Health Nursing Director; Kristin Prelipp, Communications
Manager; April Richard, Public Health Education Program Manager; Beverly Scurry, BOH
Strategic Plan Manager; and La Toya Strange, Administrative Support I.
GUESTS PRESENT: None.
I. Welcome New Employees
Timothy Smith, Chair, called the meeting to order. Quintana Stewart, Health Director, introduced
the new employee in attendance: Krista Burnette.
II. Public Comment for Items NOT on Printed Agenda: None.
III. Approval of the May 22, 2019 Agenda
Motion was made by Susan Elmore to approve the agenda, seconded by Jennifer Deyo
and carried without dissent.
IV. Action Items (Consent)
A. Minutes of March 27, 2019 Meeting
B. Minutes of April 24, 2019 Meeting
Motion was made by Jennifer Deyo to approve the minutes of March and April 2019,
seconded by Susan Elmore and carried without dissent.
V. Educational Sessions
A. CATCH Year One Report
Richard Lewis, School Community Relations (SCR) Coordinator, Co-Chair of the Orange
County Schools Health Advisory Council (SHAC), provided an update on the Coordinated
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Approach to Child Health (CATCH) activities over the last year. Below are some highlights.
• CATCH targeted obesity and chronic disease by increasing physical activity and
increasing nutritional education for children and their parents.
• The curriculum is based on the CDC Whole School, Whole Community, Whole Child
model in which health education, school environment, and family/community
involvement work together to support youth in a healthy lifestyle. It includes small
exercises with lessons that children will want to participate but not so structured to make
it seem as if they’re still attending class.
• It takes place afterschool with the benefits including addressing a child’s
social/emotional needs first, focusing on academics during the school day and enabling
children to be able to take those lessons home to parents. It’s been proven that adults
are more prone to listen to their children about better eating habits and the importance of
physical activity.
• Currently, CATCH occurs at 3 elementary school locations (Central, New Hope and
Pathways) with approximately 30 children. It involves 30 minutes of physical activity and
30 minutes of nutrition education.
• Feedback from volunteers included that they wanted more time with the children to help
them learn and expressed enthusiasm when the program started. After participating,
children would look at the cafeteria food differently.
• Goals included expanding to more schools and rotating (and recruiting) volunteers to
different sites.
• Lastly, Mr. Lewis thanks the BOH for their support and for the award which allowed them
to implement this program.
The BOH had questions that were addressed by Mr. Lewis.
B. Chapel Hill-Carrboro Schools (CHCCS) Equity Update
Lee Williams, Executive Director of Equity and Inclusion, CHCCS, gave an update on the
activities regarding equity at the CHCCS. Below are highlights.
• CHCCS is number 1 for student enrichment but 57 for the gap for students of color – a
very large disparity.
• Strategic Plan incorporates their equity plan focus areas.
o SS Goal 2: Empower and support all student groups to meet growth and
achievement goals.
o SS 2.3 Review district programs and re-design to ensure a continuum of services to
meet the needs of all learners.
o SS Goal 5: Create a culture and system of support which empowers, inspires,
engages, and encourages the school community to embrace diversity, inclusion, and
different learners.
o EE Goal 2: Create a culture and system of support to empower, inspire, and engage
talent, including an inclusive work environment that embraces and values equity and
diversity.
o FCE Goal 1: Engage families in the entire educational process.
o FCE 1.2 Broaden Parent University to offer more course options designed from
parent input and include more parents.
o OE Goal 2: Directly align district resources with student needs.
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• Equity scope of work entails:
o Equity Audit
Equity audit was conducted to identify items such as who was an equity coach,
who was on the equity team, whether the school had an equity coach or team,
gender fluidity, gender expression, etc., all while taking into consideration implicit
biases. Data was examined related to achievement and discipline.
o Equity Advisory Committee (EAC)
The EAC Leadership team meets monthly. EAC workgroups project topics
comprise of academic achievement, student support and community outreach.
o Blue Ribbon Mentor-Advocate (BRMA)
A CHCCS support program designed to improve the achievement of students of
color. It focuses on achievement and enrichments and provides students with
mentoring, advocacy and college and career preparations. Currently, there are
93 mentors with most of them being white females. More mentors of color are
needed as Mr. Williams stated that research shows that seeing people of color in
positions increase the promotion of students of color.
o Office of Equity and Inclusion
The office includes 2 elementary equity specialists, 1 middle and 1 high school
school equity specialist and the Parent University.
o Minority Student Achievement Network (MSAN)
MSAN is a national coalition of multiracial school districts that have come
together to understand and eliminate opportunity/achievement gaps that persist
in their schools. Requirements for MSAN membership include that the school
district must be close to a college town and that there be a large gap/disparity.
CHCCS has the 2nd largest gap in the nation. Currently, MSAN serves 37 high
school students, 16 males, 21 females.
o Parent University
It’s a collaborative effort between CHCCS, local non-profit organizations and
community leaders and educators which allows for parents to engage and
increase the confidence and skills needed to support their child’s success and
how to navigate the public school’s system. We also encourage the white
families to talk about race. There were 57 participants in 2017-2018.
o Next Steps/Goals
Racial Equity Impact Assessment to ensure equitability in CHCCS’s practices.
Ensure each school has an equity coach and equity team.
Double the number of participants in the Parent University and have a parent
ambassador at each school.
Recruit more BRMA mentors, recruit a more diverse pool of BRMA mentors and
provide high quality training that is rooted in a racial equity lens.
Provide foundational equity professional learning for all leaders.
The BOH members had questions that were addressed by Mr. Williams.
C. Child Fatality Task Force Report
Pamela McCall, Public Health Nursing Services Director, gave the highlights of the 2018 Child
Fatality Prevention Team (CFPT) Annual Report. Before she began, Ms. McCall, also chair of
the CFPT, stated that they meet on a quarterly basis and briefly explained its purpose which
included reviewing medical records, discussing outcomes, identifying deficiencies and carrying
out recommendations to prevent further child deaths. The CFPT members’ composition is
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defined by statute and includes members of law enforcement, school, mental health, EMS and
providers.
In 2018, the CFPT reviewed 5 child deaths. No systems issues were identified. Ms. McCall
revealed that the CFPT has had some challenges in attendance. The members were urged to
adhere to their commitment. The CFPT did lose one of their parent members (requirement is
that they must’ve lost a child under age 18). Ms. McCall notified the BOH that they are seeking
members for the CFPT.
D. Tobacco Update
April Richard gave a brief update on the tobacco program. Below are some of the highlights.
• Ms. Richard completed an intensive 4-day training offered by Duke and UNC on
intensive tobacco treatment. It focused on how nicotine works in the brain, how
pharmacology can improve rates of quitting and on providing treatment to the complex
population of people with addictions to tobacco complicated by pregnancy, mental health
and substance abuse disorders, chronic stress and trauma.
• Freshstart is a 4-week long tobacco cessation class that meets for 1 hour and focuses
on not just quitting tobacco but provides coping skills to prevent relapses. Since 2018,
there have been 5 classes that reached 40 participants. Freshstart has been revamped
as they’re at different host sites with the intent to be where the people are, not
necessarily make the people come to the OCHD.
• Freshstart classes were also held at UNC Horizons where there were about 45 pregnant
and parenting women over the last 1½ years that participated. The classes were offered
during their typical UNC Horizon program sessions. Support was provided to their
prescriber to avoid under dosing tobacco treatment.
• At Lutheran Services Carolina, there was 1 class with 6 participants. There is stigma
that people with mental health disorders can’t quit or that smoking helps them control
their behaviors. Group counseling was provided as well as direct access to free Nicotine
Replacement Therapy (NRT).
• Tobacco cessation and counseling was provided to 30 clients attending Project Connect
with 12 participants receiving 4 weeks of free NRT (e.g. gum, patches, lozenges). When
following up, it was discovered that one of those 12 had already quit using the NRT
given to them.
• NRT works best when combined (e.g. gum and patch). There were 392 boxes of NRT
dispensed. Cessation referrals were integrated into OCHD Dental and Medical Clinics
implementing the 5A’s - Ask (about tobacco use), Advise (tobacco users to quit), Assess
(readiness to make a quit attempt), Assist (with the quit attempt) and Arrange (follow up
care).
• There is consistent signage at agencies as our tobacco-free signage has been updated.
E-cigarettes are now on the signage.
• Ten presentations on emerging products were given to youth influencers and young
adults. There are nicotine pods and delivery devices such as Juul being used amongst
youth. Prevention and cessation movie ads were created, in the past, by Tobacco
Reality Unfiltered (TRU) clubs and were played at every showing in movie theaters in
Durham, Burlington, Greensboro and Chapel Hill. There has been inconsistent
implementation at the 5 schools that have TRU clubs. Ms. Richard noted that there is a
proposal in the works to create a youth health advisory council for Orange County.
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• Lastly, Ms. Richard stressed that this is a county initiative not just a health department
initiative.
The BOH members had questions that were addressed by Ms. Richard.
VI. Action Items (Non Consent)
A. Board Reappointments
Due to the absence of a quorum at April’s board meeting, the BOH voted on member
reappointments.
Motion to reappoint Jennifer Deyo was made by Susan Elmore, seconded by Jessica
Frega, and carried without dissent. Jennifer Deyo abstained.
Motion to reappoint Sam Lasris was made by Paul Chelminksi, seconded by Jennifer
Deyo, and carried without dissent. Sam Lasris abstained.
Mr. Smith thanked both members for their continued service. He then announced that BOH
member, Barbara Chavious, has notified him that, due to caring for her ill husband, she will,
regretfully, issue a letter of resignation.
Susan Elmore announced that, as of tonight’s meeting, she will be stepping down from both the
OCHD BOH and Animal Services Boards. She has held her position on the Animal Services
Board for 13 years, 9 years on the OCHD BOH and still serves on 2 other state boards. She
stated that it has been a pleasure working with everyone. Everyone thanked her for her service.
After serving 11 years (3 full three-year terms and having finished the term of the person before
him) BOH member Paul Chelminski’s last meeting will be next month, June. The BOH
members stated that they’ll miss him and thanked him for his service.
Timothy Smith and Jessica Frega (Chair and Vice-Chair, respectively) will form a subcommittee
that will review applications for the physician seat held by Paul Chelminski and conduct phone
interviews. They asked for volunteers to which Jennifer Deyo and Sam Lasris offered to do so.
As time is of the essence, Vice-Chair Jessica Frega suggested that the board informed any
interested applicants to complete their application for the physician seat by Friday, May 31st to
allow for interviews to be scheduled and a recommendation turned into the clerk’s office by June
7th for the BOCC’s agenda review. The BOH can send their comments on the physician seat
candidates via email to the 4 subcommittee members.
Quintana Stewart stated that she’ll speak with Bob Marotto, Animal Services Director, regarding
a Veterinary liaison.
B. Fluoride Update
BOH member, Bruce Baldwin, substituted for BOH Liska Lackey and provided a brief update on
the progress of the Fluoride Ad Hoc Committee. He began by stating that many documents
dating back to November 2017 have been reviewed. He also read a summary of what’s
occurred since November 2017 to the present. Baldwin commented that OWASA not being
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involved in the process avoids any potential influence. OWASA Executive Director, Ed Kerwin,
has instructed the BOH to proceed as it sees fit. Various BOH members agreed with Mr. Kerwin
noting that there was no need to be hasty in the continuation of the Committee’s process.
VII. Reports and Discussion with Possible Action
A. Health Director Report
In addition to her report, highlights given by Ms. Stewart are below.
• The NC Attorney General, Joshua Stein, announced that the state of NC is suing Juul
over allegations that it’s marketing its products to youth and misled the public about risks
associated with its products.
• Thanks were given to those that assisted with the Community Health Assessment (CHA)
surveys including BOH member Bruce Baldwin and BOH member Susan Elmore’s
daughter. Mr. Baldwin encouraged all to volunteer. Ms. Stewart noted that there are
more opportunities for those that are able to volunteer and that there may be a change in
the proposed schedule.
• June 6th is the budget session with the BOCC.
• On June 21st at the SHSC, the Health Equity Commission Forum will take place from
9am-12pm with breakfast starting at 8:30am. There will be a gallery walk that will
display health equity data and provide a visual image.
• Earlier today, Ms. Stewart met with Elinor Landess, Director, Campus & Community
Coalition. She felt that HB 536, which includes language that would create a new
exception to authorize the issuance of permits for the sale of alcoholic beverages at
stadiums, athletic facilities, or arenas on the campus or property of a public college, will
most likely pass; however, it will be up to the UNC trustees to decide if they will sell
alcohol at collegiate sports facilities. It was mentioned that some other state universities
use some of the proceeds from the alcohol sales to go towards funding other school
programs. A letter of support from the BOH detailing best practices will probably be
requested by Ms. Landess.
• Ms. Stewart referred to the NALBOH newsletters that were on the table and revealed
that the national conference will be held in Denver, Colorado this year. She indicated
that there are funds available if a BOH member would like to attend. BOH Chair, Timothy
Smith stated that the NALBOH conference is a very good event.
B. Media Items
Kristin Prelipp, Communications Manager, briefly mentioned articles regarding the whooping
coughs cases at Glenwood Elementary and the Family Success Alliance were 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
None.
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IV. Adjournment
The meeting ended at 9:10pm.
The next Board of Health Meeting will be held June 26, 2019 at the Orange County Health
Department, 2501 Homestead Road, Chapel Hill, 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: June 26, 2019
Agenda Item Subject: Public Health 3.0
Attachment(s): PowerPoint presentation (to be provided following the meeting)
Staff or Board Member Reporting: Vaughn Upshaw, EdD, DrPH
Purpose: ____ Action
_ X Information only
____ Information with possible action
Summary Information:
Vaughn Upshaw Professor at UNC Gillings School of Public Health will be presenting
on Public Health 3.0.
The term “Public Health 3.0” was coined in 2016 by Karen B. DeSalvo, MD, MPH, MSc
Acting Assistant Secretary for the US Department of Health and Human Services (HHS)
and is meant to describe a progression or “modernization” of public health goals and
missions.
Public Health 3.0 is a more sharply defined focus on addressing ALL the factors that
affect a person’s overall health — the social determinants of health or “the conditions in
which people are born, live, work, and age.”
Vaughn’s presentation will show the evolution of public health and describe
opportunities for public health leaders under 3.0.
Recommended Action: ___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: 6/26/2019
Agenda Item Subject: Formerly Incarcerated Transition Program (FIT)
Attachment(s): FIT Presentation
Staff or Board Member Reporting:
Purpose: ____ Action
_ x_ Information only
____ Information with possible action
Summary Information:
Update on Formerly Incarcerated Transition Program by Tommy Green. Updates will
include successes, challenges, expansion, and case load.
Recommended Action: ___Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to ___________________________
___Accept as information
___Revise & schedule for future action
___Other (detail):
The FIT Program is designed to connect formerly incarcerated people with chronic illness to health care services.
Community Health Worker from the FIT program will work to connect the participant to appropriate health services.
Other community re-entry resources are made available to help with a comprehensive re-entry plan
Initial seed grant from NC DPH to partially fund CHW hire by Durham Health Department.
Further funding from the Duke Endowment to secure 3 years of support in Durham and add a second CHW in Orange County.
Further expansion to Wake and Mecklenburg
Study of 1,100 people returning home = 80%
men and 90% of women had a chronic
disease that required management
High percentage of:
›Heart failure
›Diabetes
›Kidney disease
›Serious life-limiting diseases
›Dementia
›HIV, Tuberculosis, and Hepatitis C
Homelessness
No source of income
Food insecurity
Recidivism
Hopelessness
Other medical problems: anxiety
depression, bipolar disorder, PTSD,
Schizophrenia, hypertension, asthma,
seizures
PROGRAM RELATED
•NC Medicaid Non Expansion
•People coming from
incarceration are uninsured
•Linkages to stable Housing
•Lack of MH/SU Treatment
•Identifying people that would
benefit from FIT
Total number of clients 32 (25 active)
Recidivism rate – 15.4% (compared to
state average of 40%) **
Number of overdoses – 0
Chronic disease stable at the time of
report - 100%
Initial Contact - Met client during a visit to the
Inter-Faith Council while doing outreach in the
community.
History before F.I.T – In and out of incarceration
(County Jails and State prison) last 5 years.
Suffered from severe alcoholism. Never took
medications on a consistent basis.
Diagnoses -Bipolar Disorder, Schizophrenia,
Manic Depression, Substance abuse disorder
Goals met through FIT :
›Photo ID
›SS card and benefits
›Accepted into an Oxford House
›Substance abuse programs (NA, AA
›Private Sessions with Psychiatrist (pro bono)
›Community Resource Court hearings
›Found employment.
Challenges
›Oxford House was not a good fit for the client
›One substance abuse relapse.
Initial Contact – Client got CHW’s contact info
off a flyer at CEF (Community Empowerment Fund)
and reached out.
History before F.I.T – In and out of incarceration
(County Jails and State prison) last 3 years.
Suffered from severe alcoholism (long history of
DWIs) and opioid (heroin) abuse.
Diagnoses – Manic Depression, Substance
abuse disorder, Hepatitis C, Pregnant
Goals met through FIT
›Prenatal Care
›Substance abuse programs (NA, AA)
›Housing
›Tobacco cessation counseling (nicotine patches, gum)
›G.E.D
›Psychiatrist for private therapy sessions
Challenges
›Several DWIs -> challenging to get a Driver’s License
›Housing due to her criminal record
Orange County Local Reentry Council
(Chairman – Housing and Health
Subcommittees)
Community Empowerment Fund (CEF)
NCWorks
Interfaith Council (IFC)
Dr. Price
Orange County Correctional
Wake County Correctional
Orange County Jail
1.Orange County Resident – due to
county funds
2.Recently released from prison or jail –
the last 2 years
3.Diagnosed with a Chronic Illness to
include Mental Health and Substance
Use/Misuse
Increase utilization of Primary Care and Behavioral Health services
Improve client health outcomes and satisfaction with health care services
Increase Adherence with use of Medications and Treatment Plans
Decrease Recidivism
Decrease rates of Emergency Room visits and Hospitalization
Empower clients to become knowledgeable about their health and take control
By 2020 County Funds will represent 100% of the funding for the Program which demonstrates the commitment that the leadership is doing for this program.
The Governor’s Reentry Council has taken a special interest in the FIT program and we are expecting this program to be included on the Final Reentry Report as a top recommendation for the Statewide Reentry Effort.
*FIT study has officially launched*
***Orange County FIT CHW to be lead FIT CHW for NC***
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: 6/26/19
Agenda Item Subject: Annual Communicable Disease Report
Attachment(s): Presentation
Staff or Board Member Reporting:
Purpose: ____ Action
_ x Information only
____ Information with possible action
Summary Information: Annual Communicable Disease report to the Orange County
Board of Health for the 2018 calendar year that includes updates for VPD, Vector
Borne, Enteric, STI, and TB.
Recommended Action: ___Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to ___________________________
___Accept as information
___Revise & schedule for future action
___Other (detail):
2018
MIKE DEFRANCO, MPH, BSN. RN
COMMUNITY HEALTH MANAGER
COMMUNICABLE DISEASE COORDINATOR
COMMUNICABLE DISEASE PROGRAM
Purpose of the CD branch of OCHD:
Reduce morbidity/mortality resulting from communicable
diseases that pose a significant threat to the public health in
Orange County
Investigate events in a timely manner to rapidly identify and
implement pertinent control measures
ANNUAL CD REPORT
Best practice – share with involved stakeholders and with the
Board of Health
LHD Accreditation Benchmark 2.5 – it is the responsibility of
the LHD to investigate reports of communicable diseases,
analyze their incidence, and communicate these findings to
stakeholders, the public, and the BOH when there is an
indication that a disease is outside the normal or expected
incidence.
Iulia Vann, MD, MPH, 2018
ENTERIC “FOODBORNE” ILLNESSES
21
5
0
27
1 1
16
5
0
17
1 0
13
2 2
40
2 1
29
9
0
31
5
1
32
4
0
33
5
0 0
5
10
15
20
25
30
35
40
45
2014 2015 2016 2017 2018
VACCINE PREVENTABLE DISEASES
10
0
12
2 6 2
38
2
16
3
74
5
10
4
22
4
28
1
21
2
0
10
20
30
40
50
60
70
80
Pertussis Influenza Deaths Hepatitis B - Chronic Haemophilus
Influenzae
2014 2015 2016 2017 2018
VECTORBORNE ILLNESSES
5
3
19
4
1 2
12
2
6
0
7
10
6
0
8 7
4
0
14 15
0
2
4
6
8
10
12
14
16
18
20
Lyme Malaria RMSF Ehrlichiosis
2014 2015 2016 2017 2018
WATERBORNE ILLNESSES
7
2
4
3
4
3 3
2
7
0 0
1
2
3
4
5
6
7
8
Cryptosporidium Legionellosis
2014 2015 2016 2017 2018
SEXUALLY TRANSMITTED INFECTIONS
472
112
17 14 10
684
183
13 12 8
636
163
11 11 4
768
229
33 11 0
690
189
32 6 0 0
100
200
300
400
500
600
700
800
900
Chlamydia Gonorrhea Syphillis New HIV New AIDS
2014 2015 2016 2017 2018
OUTBREAKS…
Date Cases
Pertussis Outbreak – multiple Middle and
High Schools in Orange County
Jan – May 2018 23
OTHER RELEVANT DATA
523
1
50 76
466
1
37 58
407
0
41
146
404
1
41 23
437
2 40 26
0
100
200
300
400
500
600
Rabies
Investigations
TB cases LTBI Refugee Arrivals
2014 2015 2016 2017 2018
A FINAL LOOK…
Aspects of 2018 deserving highlight:
Two active TB cases with complications
Dengue case at UNC
Emergence of CRE
MOVING FORWARD
•Collaboration between OCHD and UNC Campus
Health/University for planning of Meningococcal
outbreak
•Hepatitis A initiative in OC jail and prison
•Measles Symposium June 2019
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: June 26, 2019
Agenda Item Subject: Innovation Grant Update 2019
Attachment(s): Innovation Grant Update 2019 presentation
Staff or Board Member Reporting: Victoria Hudson, Innovation Grants Manager
Purpose: ____ Action
_ _X Information only
____ Information with possible action
Summary Information:
Victoria Hudson will discuss updates to the 2018-2019 Innovation Grant projects, the
status of the process for 2019-2020, and the sustainability of former projects.
Recommended Action: ___Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to ___________________________
_X__Accept as information
___Revise & schedule for future action
___Other (detail):
Innovation Grant
Fund Update 2019
Victoria Hudson
Innovation Grants Manager
Purpose
•The Orange County Health Department strives
to empower all staff to identify, study, and
solve problems that impede quality services
delivery and access for clients and the public.
•The Innovation Fund is a great tool that
provides a way for staff to identify innovative
potential solutions and receive funding to
pilot that solution.
Trauma-Informed Services for
Immigrants & Refugees
•Service Provider Training: Trauma & Resilience
•Attendance: 104 people attended, plus 5 trainers
–Evaluation (n=57): 53 people agreed or strongly agreed that the presentation met their expectations and they would use the information learned in their job or role in the community.
–Comments included: 1) need for more refugee/immigrant voices and presence at future trainings; 2) more interactive training next time, 3) logistical (hard to see slides), 4) requests & suggestions for future training topics: racial trauma, racial concordance with therapist, effective methods when addressing intersectionality within trauma.
–As a result of our experience and feedback, in 2019 both the Refugee and Latino Health Coalitions are planning to dig deeper into issues of race, ethnicity, power, privilege and equity as our coalition work moves forward.
Trauma-Informed Services for
Immigrants & Refugees
•Interpreter Training: Breaking Silence: Interpreting for
Victim Services:
•Attendance: 25 interpreters attended, who represent 15
different agencies, and speak 15 different languages
•Pre/Post Tests Revealed: Average improvement of 5 questions
(34 points) from pre to post test. Pre Test scores ranged from
13-73% correct, and Post Test scores ranged from 47-100%
correct.
•Evaluation (n=25): 24 people agreed or strongly agreed that
the presentation met their expectations and they would use
the information learned in their job or role in the community
Trauma-Informed Services for
Immigrants & Refugees
•Individual Comments revealed that the support received during the
training, and opportunity to learn from one another was particularly
meaningful to attendees. Examples of comments include:
–“I will say thanks a lot for this training. It is very important for us as
interpreters to get the chance to learn more and meet others.”
–“It was very helpful and resourceful….giving me more confidence in my work
as an interpreter.”
–“This training as very informative and well-run. I really enjoyed every
presenter and will use what I learned daily.”
–“Knowledgeable presenters and also great Interpreters in the group who
shared experiences and we were all able to learn from each other.”
•All expressed interest in more trainings and opportunities to come
together, and also to meet with service providers for shared learning
experiences.
Intraoral Cameras for Improved Dental
Education and Treatment
•Dental staff feel as though patients have very much
enjoyed having the real-time photos of their mouths to
discuss treatment. They use them daily for various
reasons, and they have been extremely helpful in
treating our patients or any patient who has a more
complicated issue that would be better explained or
documented with a photo. Dental staff offer better
care to our patients with these cameras. They are
excited to campers coming this summer for a dental
exploration afternoon and they will utilize the cameras
in some of our activities with the campers.
Transportation Assistance
•Implementation of this transportation
assistance program process took a very long
time to organize.
•Vendor contracts were complicated.
•There were some very important pieces of
confidentiality and equity.
•This grant was not fully implemented and is
seeking new funding.
Patient Education Tool Kit
•The tool kit reinforces education to patients.
•The tool kit provides a way for a patient to practice in
front of a health care provider allowing provider
feedback and correction improving patient outcomes
and adherence to best practices.
•The tool kit alleviates fear and/or build self confidence
in one’s ability to control their own health.
•The tool kit includes planning an “in-service” for staff
to go over all of the supplies in our tool kit and how to
use it in clinic with patients.
41 or Below
•This was an education campaign to held food
service establishments into the new
requirement for refrigerated temperatures.
•The intent was to use a simple campaign that
was memorable.
•Funds were utilized for art setup and printing
of magnets, stickers, temperature placards,
thermometers, and printed bags for all
materials to be deliverable.
Art for OCHD
•This endeavored to bring fresh looks to
common spaces for clients and staff.
•Lessons learned included working with groups
and working on a thrifty budget.
•https://vimeo.com/341679247
2019-2020 Cycle
•Call for ideas- 11 ideas submitted
•11 selected for full applications
•Grant announcement early July
•Implementation can begin early July
•Mid-year progress is due December 31
•Final report is due June 30
2019-2020 – proposals
Name Lead
Transportation Assistance Renee Kemske, et al
Readiness Kits Kristy Bassili &
LaTosha Scott
Cell Phone Study Angela Sowers
Randomized Lunch Beverly Scurry
WTMP Repair Cost Share Tracey Langley &
John Davis
REC Library Ashley Rawlinson
2019-2020 – proposals
Name Lead
Mapping with Drone John Davis
Decorative Lighting for
Dental
Dr. George
Digital Questionnaire Karen Kyes and
Christy Bridges
Language Justice
Summit
Susan Clifford
Exercise Subsidy Karen Kyes, et al
Sustainability of Ideas
•Fitness Trackers
•Baby Box
•Septic Assist
•Employee Health Cards
•Suicide Prevention
•REI
•FOH Food Safety Training
Questions?
www.OrangeCountyNC.gov/Health
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: June 26, 2019
Agenda Item Subject: Board of Health Strategic Plan Update June 2019
Attachment(s): 2 documents: Current BOH Actions Steps & Proposed Updates to the
Action Steps
Staff or Board Member Reporting: Beverly Scurry
Purpose: __X_ Action
_ _ Information only
____ Information with possible action
Summary Information:
Some BOH subcommittees have been addressing slight changes to their sections of the
Strategic Plan throughout the year. These changes have been reflected in the attachment.
Documents can be used to compare the current action steps with the proposed updates.
~ PAN Subcommittee – Changes were made to the first Focus Area and a third focus area
was added to address racial equity as discussed in meetings.
~ SDH Subcommittee – Changes were made to the first Focus Area regarding trauma-
informed care. Minor changes made Focus Area #2 and a third Focus Area was added to
address racial equity.
~ SAMH Subcommittee – Minor change made to the first Focus Area. Changes were made to
Focus Area #2 regarding mental health screenings and a third Focus Areas was added to
address racial equity.
Everything else was kept the same in the Strategic Plan and will not be updated until the new
strategic process in 2020.
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):
BOH Strategic Plan Action Steps
Updates 2019 – 2020
June 2019
Priority: Social Determinants of Health
Focus Area #1: Serve as a catalyst and advocate in addressing drivers of health that can greatly influence the
health and quality of life of individuals, populations, and communities.
1) By June 2020, the Board of Health will continue to further explore policy and funding options to
support the Family Success Alliance Strategic Plan.
2) By June 2020, the Health Department will explore trauma informed options designed to increase
staff awareness and improve the work environment.
Focus Area #2: Advocate for and pursue policies and practices aimed at improving access to care.
1) Annually, the Board of Health will offer support to the efforts engaged in by the Healthy Carolinians
Access to Care Committee.
Focus Area #3: Pursue the highest level of health for all by addressing underlying determinants many of which
are shaped and perpetuated by bias, injustice and inequality.
1) By June 2020, the SDH Subcommittee will support racial equity work in the Orange County by
collaborating with community partners who are working to address drivers and determinants of
health through an equity lens.
Priority: Physical Activity and Nutrition
Focus Area #1: Advocate for and pursue policies, practices, and partnerships aimed at increasing access to
healthy foods and safe places for physical activity.
1) By June 2020, the BOH will explore and/or support food policies that are feasible to
implement in the Orange County community.
2) By June 2020, the PAN Subcommittee will support the Orange County Food Council (OCFC),
Department of Environment, Agriculture, Parks and Recreation (DEAPR), and other organizations in
the county and NC that work to improve nutrition and physical activity for residents. Examples of
support include, but is not limited to:
a. Letters of Support
b. Sharing information online and/or social media
c. Attending community events
d. Attending organizational meetings of OCFC, DEAPR, and others as applicable
Focus Area #2: Advocate for and pursue evidence-based policies, practices, and partnerships that increase
physical activity and improve nutrition in schools.
1) Each fiscal year for the school systems in Orange County, the Board of Health will offer a
formalized small grant opportunity to all schools to implement in-class or other physical activity
programs.
Focus Area #3: Pursue the highest level of health for all by addressing underlying determinants many of which
are shaped and perpetuated by bias, injustice and inequality.
1) By June 2020, the PAN Subcommittee will support racial equity work in the Orange County
community by collaborating with partners who are working to address food systems issues.
Priority: Substance Abuse & Mental Health
Focus Area #1: Serve as a catalyst and advocate for policies and practices that promote integrated care in the
Orange County Health Department and other medical providers in the county.
1) By June 2020, Health Department staff will investigate the feasibility, follow-up referral options,
and reimbursement barriers for primary care providers to provide and bill for Screening, Brief
Intervention, and Referral to Treatment (SBIRT), telephone and face-to-face consultation with
behavioral health providers, and care provided by a behavioral health and primary care provider on
the same day in the same clinic.
Focus Area #2: Advocate for and pursue policies, practices, and partnerships that improve substance abuse and
mental health services in Orange County, especially to vulnerable populations such as the homeless and those
connected with the criminal justice system.
1) By June 2020, the SAMH Subcommittee will explore options for mental health screening for OCHD clients
with the Local Management Entity and other local mental health providers.
2) By June 2020, the Health Department staff will continue to partner with criminal justice and jail partners to
explore options for collaborative opportunities.
Focus Area #3: Pursue the highest level of health for all by addressing underlying determinants many of which
are shaped and perpetuated by bias, injustice and inequality.
3) By June 2020, the SAMH Subcommittee will support racial equity work in the Orange County
community by collaborating with substance abuse and mental partners who are also working on
equity within their organization and community.
Priority: Engagement
Focus Area #1: Actively engage with local government, advisory boards, and the community on Board of
Health Strategic Plan priority areas.
1) The Board will receive summaries on the activities of applicable local boards or governing bodies at
meetings two times per year, or as necessary for timely board action.
Current BOH Strategic Plan Action Steps 2018 – 2020
Priority: Social Determinants of Health
Focus Area #1: Serve as a catalyst and advocate for health outcomes in the Family Success Alliance.
1) By January 2019, the Board of Health will further explore policy and funding options to support the
updated Family Success Alliance Strategic Plan.
2) By August 2019, Health Department staff will explore the use of clinical tools, such as ACEs
screening, to use in OCHD clinics to identify important social determinants of health and appropriate
interventions.
Focus Area #2: Advocate for and pursue policies and practices aimed at improving access to care.
1) Annually, the Board of Health will offer support to the Healthy Carolinians Access to Care
Committee to raise awareness and utilization of transportation and NC 211 in Orange County.
Priority: Physical Activity and Nutrition
Focus Area #1: Advocate for and pursue policies, practices, and partnerships aimed at increasing access to
healthy foods and safe places for physical activity.
1) By December 2018, the BOH will collaborate with the Orange County Food Council and UNC
Students to explore food policies that are feasible to implement in the Orange County community.
2) By June 2019, the PAN Subcommittee will explore the creation of a health app, to highlight safe
places for physical activity and nutrition options in Orange County.
Focus Area #2: Advocate for and pursue evidence-based policies, practices, and partnerships that increase
physical activity and improve nutrition in schools.
1) Each fiscal year for the school systems in Orange County, the Board of Health will offer a
formalized small grant opportunity to all schools to implement in-class or other physical activity
programs.
Priority: Substance Abuse & Mental Health
Focus Area #1: Serve as a catalyst and advocate for policies and practices that promote integrated care in the
Orange County Health Department and other medical providers in the county.
1) By March 2019, Health Department staff will investigate the feasibility, follow-up referral options,
and reimbursement barriers for primary care providers to provide and bill for Screening, Brief
Intervention, and Referral to Treatment (SBIRT), telephone and face-to-face consultation with
behavioral health providers, and care provided by a behavioral health and primary care provider on
the same day in the same clinic.
Focus Area #2: Advocate for and pursue policies, practices, and partnerships that improve substance abuse and
mental health services in Orange County, especially to vulnerable populations such as the homeless and those
connected with the criminal justice system.
1) By October 2019, the SAMH Subcommittee will explore with Cardinal Innovations Healthcare
Solutions and other local mental health stakeholders the evidence-base, feasibility of, and follow-up
referral options for mental health screening and referral kiosks in target community locations.
2) By March 2020, Health Department staff will partner with criminal justice and jail partners to
explore a pilot system to ensure continuity of behavioral health care during and after incarceration.
Engagement
Focus Area #1: Actively engage with local government, advisory boards, and the community on Board of
Health Strategic Plan priority areas.
1) The Board will receive summaries on the activities of applicable local boards or governing bodies at
meetings two times per year, or as necessary for timely board action.
2) By August 2019, the Board will support racial equity work in the Orange County community by
collaborating with and establishing partnerships with local community partners who are also
working on racial equity within their organization and community.
Agenda Item Number:
ORANGE COUNTY BOARD OF HEALTH
AGENDA ITEM SUMMARY
Meeting Date: June 26, 2019
Agenda Item Subject: Current BOH Recruitment
Attachment(s): None
Staff or Board Member Reporting: Jessica Frega
Purpose: __ __Action
____ Information only
_X__ Information with possible action
Summary Information: The Board of Health will discuss recruitment of the Veterinary vacant
position.
Recommended Action: ___Approve
___Approve & forward to Board of Commissioners for action
___Approve & forward to ___________________________
___Accept as information
___Revise & schedule for future action
___Other (detail):
Health Director’s Report
June 2019
• June 3-4, 2019 – Successful completion of NC Public Health Leaders Institute Course
• June 4, 2019 – Participated in a Directors focus group hosted by County Human
Resources as the County begins the Diversity, Equity & Inclusion (DEI) Training for all
staff. Three health department staff have been asked to join the County DEI Leadership
Team.
• June 5, 2019 – Family Success Alliance (FSA) Governance Committee Meeting; in depth
discussion about zone based expansion that will allow families that currently reside in the
zone to be part of the FSA program even if their child(ren) do not attend a FSA zone
school.
• FSA – in accordance with County Ordinance, all the navigator positions were posted and
interviewed for; priority remains hiring residents with the lived experience from the
community. Offers are expected to be made by Friday, June 21, 2019. During the interim
I will work more closely with FSA staff to fill some gaps during the recruitment period
for a new FSA Program Director. There are no plans to rush the hiring of a new director,
as we want to ensure we hire the right person and we want to prioritize the staff transition
as county employees.
• June 14, 2019 – Medical Director, Dr. Erica Pettigrew, and Communicable Disease
Coordinator, Michael DeFranco, facilitated a Measles Symposium for staff and
community partners. Dr. Pettigrew gave an overview of the measles disease, trend of
cases in U.S., steps for testing/reporting suspected cases, and vaccine requirement for
adults and school aged children. There were about 25 participants with representation
from both school districts, UNC (hospital & university), and local primary care practices.
Great discussion with plans to follow up with additional meetings to do additional
sharing of information as it relates to responding to measles in Orange County.
• June 14, 2019 – All Staff meeting preceded by an ice cream social hosted by the Spirit
Committee. This meeting included a presentation by County AMS and Transportation
Departments to share information about a fairly new program, Car Share, which allows
county employees to reserve and use county vehicles for work-related travel. Staff also
received training and updates on department policies and the Consolidated Agreement
from NC DHHS. The Racial Equity Commission (REC) also facilitated an exercise to
help staff get to know each other better using a racial equity lens that considered each
individual’s unique background and life experience.
• June 18, 2019 – As co-chair of the NCALHD Education & Awards Committee, I
co-facilitated New Health Directors Orientation in Raleigh at DPH.
• June 18, 2019 - The Orange County Board of County Commissioners (BOCC) voted to
approve the Fiscal Year 2019-20 Budget Ordinance, County Grant Projects, and County
Fee Schedule. (Approved 6-1 with Commissioner McKee dissenting)
• June 18, 2019 – BOCC appointed two new Board of Health Members; Dr. Aparna Jonnal
appointed to the physician seat (full 3-year term) and Dr. Alison Stuebe appointed to the
community member at-large seat (partial term ending 6/30/21).
• June 19, 2019 – Kristin Prelipp participated in the OWASA workshop/tabletop exercise
which focused primarily on public information capabilities. County Emergency Services
and multiple partners have been working with OWASA to enhance the communication
process for utility impacts.
• As a result of AA 474 CLAS work, the health department has updated service brochures
and community clinic brochures. Health Department service brochures and Community
Clinic brochures are available in Arabic, Burmese, Chinese, English, Karen,
Kinyarwanda and Spanish. PDFs of all brochures are located on 2 of our webpages:
o http://www.orangecountync.gov/204/Health-Department
o http://www.orangecountync.gov/304/Immigrant-Refugee-Health
• Medicaid Transformation – we are in the final stretch of reviewing and signing contracts
with PHPs. The PHP contracts as presented do not fully address all the specialty services
of local health departments as outlined in the RFP from DHHS. We continue to work
closely with County Attorney’s office to find resolution.
• NCCare360 - the statewide coordinated network that includes a robust data repository of
shared resources and connects healthcare and human services providers together to
collectively provide the opportunity for health to North Carolinians; 12 counties have
now launched the system; 9 counties have started implementation; Orange County
scheduled for Fall 2019 Implementation.
Upcoming Events
• June 21, 2019 – Health Equity Forum, 9am -12noon at Southern Human Services in
Chapel Hill.
• June 21, 2019 – Annual County Service Awards Luncheon
• June 25, 2019 – Joint Management Team meeting with DSS
• June 25, 2019 – Finance Director, Rebecca Crawford, will give a presentation to the
Orange County Behavioral Health Task Force sharing the findings of the Behavioral
Health System Analysis conducted in 2017-2018.
• July 1, 2019 – I will participate on the Complete County Committee as the Health
Department representative. This committee will develop a 2020 Census awareness
campaign to encourage residents to respond, with a major focus on hard-to-reach
communities.
• July 5, 2019 – Meeting with Bob Marotto, Animal Services Director and Susan Elmore to
discuss veterinarian candidates for BOH and Animal Services Board dual position and
potential public health policy with regard to primates.
• July 10th & July 24th – As a member of the State Health Coordinating Council, I will need
to attend Public Meetings in Greensboro and Raleigh.