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ORANGE COUNTY BOARD OF HEALTH
March 27, 2019
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ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To enhance the quality
of life, promote the health, and preserve the environment for all people in the Orange County
community.
THE ORANGE COUNTY BOARD OF HEALTH MET ON March 27, 2019 at the Orange County
Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Timothy Smith – Chair, Jessica Frega –Vice-
Chair, Bruce Baldwin, Paul Chelminski, Jennifer Deyo, Susan Elmore, Liska Lackey and Sam
Lasris.
BOARD OF HEALTH MEMBERS ABSENT: Keith Bagby, Barbara Chavious and
Commissioner Earl McKee.
STAFF PRESENT: Quintana Stewart, Health Director; Coby Jansen Austin, Director of
Programs and Policy; Krishnaveni Balakrishnan, Healthy Homes Coordinator; Rebecca
Crawford, Financial and Administrative Services Director; Dominika Gazdzinska, Community
Outreach Specialist; Victoria Hudson, Environmental Health Director; Pamela McCall, Personal
Health Services Director; Ashley Rawlinson; Healthy Carolinians Coordinator; Beverly Scurry,
BOH Strategic Plan Manager; and La Toya Strange, Administrative Support I.
GUESTS PRESENT: Mike and Kim Tyler, Carolyn Brandt.
I. Welcome New Employees
Timothy Smith, Chair, called the meeting to order. Ms. Stewart welcomed new employee,
Krishnaveni Balakrishnan.
II. Public Comment for Items NOT on Printed Agenda: None.
III. Approval of the March 27, 2019 Agenda
Motion was made by Sam Lasris to approve the agenda, seconded by Susan Elmore and
carried without dissent.
IV. Action Items (Consent)
A. Minutes of February 27, 2019 Meeting
Motion was made by Liska Lackey to approve the minutes of February 2019, seconded by
Jennifer Deyo and carried without dissent.
V. Educational Sessions
A. Cardinal Annual Update
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Ric Bruton, Senior Community Executive, Cardinal Innovations, presented on how county funds
are used to support Cardinal Innovations programming in Orange County (OC). Below are
some highlights.
Local Maintenance of Effort (MOE) Funding
• The counties will give monies to support programs per the statute.
• OC contributes $1.3 million annually which is divided amongst 30 separate line items
and over 12 entities.
• This year, there’s nearly an even split between Cardinal and Orange County
managed funding.
Programs that receive funding include Freedom House Recovery, UNC Department of
Psychiatry, Arc of Orange County, Haven House and Club Nova. Orange County also
has set aside a portion of the MOE funding for various programs to address community
interests that include services to undocumented people, assisting DSS with placements
and trauma focused therapy.
Mr. Bruton presented graphs that displayed Medicaid and State data pertaining to the:
• Number of members served by age and diagnosis
• Members served and expenses by service category
• Members served and expenses amounts – crisis services
Cardinal Innovations created the Community Reinvestment Initiative as a way to make
stable, sustainable investments across its 20-county service area. Hundreds of
proposals were received from entities and organizations. Funding totaling more than $4
million was awarded. Recipients include Compass Center for Women & Families, El
Futuro and the YMCA of the Triangle.
Mr. Bruton presented the newly revamped website and all of its new functions such as
the capability to find and access local, statewide and national resources with ease.
The BOH had questions that were addressed by Mr. Bruton.
B. Severe Vision Problems for Children and Adults
BOH member, optometrist and assistant professor at UNC School of Medicine Ophthalmology,
Dr. Bruce Baldwin, gave an excellent visual presentation on case reports of patients with
significant vision problems that are managed with special glasses or contact lenses. Below are
some highlights.
The World Health Organization defines legal blindness as visual acuity of 20/200 or less
in the better eye with best glasses, and/or a visual field of 20 degrees or less.
“Normal" vision is 20/20. This means that a person sees the same line of letters at 20
feet that person with normal vision sees at 20 feet.
A student with a visual impairment, partial sight or blindness, is eligible for Special
Education services. Visual impairment is a low incidence condition, but can have a high
impact on student performance. The Exceptional Children Division of the NC
Department of Public Instruction has developed a Statewide System of Support for
Students with Visual Impairments to help local education agencies understand and meet
the needs of their students with visual impairments.
Some conditions/problems that affect visual acuity
o Stevens Johnson Syndrome
o Cataract
o Congenital cataract
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o Keratoconus
o Eye traumas
Some surgical procedures/devices that aid in correcting vision problems
o Cornea replaced with implanted telescope
o Scleral lenses can improve vision (pair ranges in cost from $1300 to $3000)
o Bandage contact lens
Some visual aids/Prosthetics
o Handheld telescopes, handheld magnifiers [range in price from $4 (low quality) to
$100 (good quality)], desktop video magnifiers (can range in price from a few
hundred dollars to $3000)
o Custom molded scleral lens (retail $7,000/pair)
o Hand painted prosthetic tint soft lens (range in cost from $400 to $1000)
Some funding sources
o NC Services for the Blind
o Medicaid (doesn’t cover cosmetic/prosthetic lenses)
o Some Lions Clubs
o There is a strong need for funding as most insurances don’t cover visual
aids/prosthetics.
Some resources
o NC DHHS Division of the Services for the Blind
• Kim Tyler, Social Worker for the Blind for Durham and Orange Counties
• Rehabilitation agency that can provide magnifiers and sometimes monoscopes to
the low vision population.
The BOH members had questions that were addressed by Dr. Baldwin.
C. SOTCH Review/CHA Process Update
Ashley Rawlinson, Healthy Carolinians of Orange County (HCOC) Coordinator, presented the
2018 State of the County Health Report (SOTCH). The SOTCH is a report that is produced
every year in between the Community Health Assessment (CHA). Social Determinants of
Health, Physical Activity & Nutrition and Mental Health & Substance Abuse are the three areas
that are focused on in the report. Below are highlights from Ms. Rawlinson’s presentation.
The top 3 leading causes of death (cancer, heart disease and cerebrovascular disease)
hasn’t changed over the last couple of years.
In Orange County, people of color have higher death rates, when compared to whites,
in relation to cancer, heart disease and diabetes.
Social Determinants of Health
• Poverty
o 14% of OC population lives in poverty with 6.5% of all families living below the
poverty level.
o 9.5% of children in OC live in poverty despite a county-wide median income of
$69,940.
• Although rich in resources, Orange County has one of the highest measures of
income inequality in NC.
• In 2017, the first Try Transit Week was held October 23rd-28th to bring awareness to
public transportation and encourage use. In 2018, Orange County Public
Transportation (OCPT) held 3 community meetings to discuss proposed transit
changes and to gather community input on OCPT priorities. In 2019, the OCPT
plans to host a Try Transit month with different activities occuring each week of the
month.
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Physical Activity & Nutrition
• The OCHD nutrition department offers Medical Nutrition Therapy (MNT) and a
Diabetes Self-Management Education Program (DSME) to help prevent and manage
certain medical conditions. The MNT program had 782 encounters. The DSME
program had 364 enrollments of which 44 were new.
• HCOC partners with and serves on the School Health Advisory Council (SHAC).
The partnership’s goals include incorporating exercise and healthy eating into
daily/weekly activities and encouraging school age youth to get the recommended
amount of physical activity to prevent childhood obesity.
Mental Health & Substance Abuse
• From 2013-2017, there were 66 suicide-related deaths.
• The 2nd Annual ‘’Be the Light’’ Suicide Prevention Awareness Walk was held. There
were 100 community residents present and local support included the BOH, BOCC,
OCHD Health Director, Hillsborough police department and Mayor Tom Stevens.
• Alcohol
o The Campus and Community Coalition (CCC) which includes the Town of
Chapel Hill, OCHD and Chapel Hill Carrboro City Schools partnered and pulled
together research on alcohol’s impacts on the underage brain to bring resources
to families in our community so they can start a conversation about adolescent
substance use.
• Tobacco
o New bilingual Tobacco Free Signs replaced the outdated and weathered signs
which also support the local public school’s 100% Tobacco Free Policy providing
a reminder that e-cigarettes are prohibited on school grounds.
Ms. Rawlinson stated that this report is desseminated to the NC DPH, BOH, BOCC, HCOC
membership and OC government employees. Electronic versions are available online via the
HCOC and OCHD websites. She noted that per Benchmark 38, Activity 38.2, for accreditation
purposes, the BOH minutes should reflect that the BOH members have received and reviewed
the SOTCH report.
Lastly, Ms. Rawlinson spoke briefly about the upcoming 2019 CHA. The CHA is a report about
the health of the community and the community’s capacity to improve the lives of residents of
Orange County. Community involvement helps to ensure that the true needs of the community
are identified, accurately represented, and addressed. Collection methods for data collection
include focus groups, online surveys and surveys conducted door-to-door. She continued to
explain the CHA process which involves 8 phases and takes place over a 12-14 month period.
She encouraged the Board member participation in any or all of the CHA process.
The BOH members had questions that were addressed by Ms. Rawlinson.
D. FSA Strategic Plan Update
Coby Jansen Austin, Director of Programs and Policy, and Dominika Gazdzinska, Community
Outreach Specialist, gave an update on the FSA’s 2019-2022 Strategic Plan. Below are some
highlights.
FSA is a collective of various people and organizations that work together to ensure
children in OC, whose families struggle to make ends meet, have the opportunity for a
healthy, safe and productive life. It was modeled after Harlem’s Children Zone.
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Entering its fifth year this summer, FSA has successfully recruited four cohorts of
students and their families into the navigator program and will begin recruiting the fifth
cohort this fall.
There are 2 neighborhood zones.
• Zone 4 is in Hillsborough and Zone 6 is in Chapel Hill/Carrboro.
• Zone navigators act as a link between the families and the services they need.
There are a total of 9 navigators (4 in Zone 4 and 5 in Zone 6) assisting over 130
families within both zones. There is also a new Manager of Family Engagement,
Dana Crews.
• Zone navigators will be transitioning to county employees effective FY 19-20.
One size doesn’t fit all as there are families with different level of needs. The Parent
Council was created which allows parents to learn from each other.
The 6 FSA values are to 1)Be outcome-oriented, 2)Understand that relationships are
“the work”, 3)Trust the wisdom of families, 4)Racial equity and inclusion, 5)Community
power, and 6)Accountability to the community.
There are 3 goals: 1)Children are healthy and prepared for school, 2)Children and youth
are healthy and succeed in school, and 3)Families, neighborhoods and institutions
support the healthy development of children.
Using Results Based Accountability, strategic areas with measures of success were
created. Those strategic areas are family empowerment, partnership, systems change
and foundational work.
VI. Reports and Discussion with Possible Action
A. Review of Board of Education Letter of Support
BOH member, Jennifer Deyo, presented the proposed letter of supporting Orange County
Schools’ Equity Policy. The letter of support summarizes the BOH’s connection to the policy
through data and health equity. After brief discussion, the BOH decided to take a vote. Ms.
Deyo thanked Beverly Scurry and Quintana Stewart for their assistance with the letter.
Motion to move forward with the letter of support was made by Paul Chelminski,
seconded by Liska Lackey and carried without dissent.
B. Health Director Report
In addition to her report, Ms. Stewart highlighted that, on March 19th, the Leadership Team
completed its final day of the Results Based Accountability (RBA) Strategic Planning Workshop
series with consultant, Deitre Epps, Race for Equity, LLC. The Leadership Team is tasked with
thinking about performance measures to be used in the new Strategic Plan as we want to
ensure that what we’re doing is making an impact.
Ms. Stewart also mentioned that the County Health Rankings were released. This year, Orange
County ranked #2 for Health Outcomes and #1 for Health Factors.
On April 1st, Rebecca Crawford and Ms. Stewart will meet with the County Manager to discuss
the BOH approved budget. On April 4th, the BOH work plan will be co-presented at the BOCC
work session. Lastly, Ms. Stewart will be graduating from the Municipal and County
Administration course on April 12th. She expressed her gratitude for the training and great
networking opportunities.
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C. Media Items
Quintana Stewart briefly mentioned Annual Report for the Health Department that was passed
out to the BOH members as well as the article topics of the FSA and the computer virus that
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.
VII. Board Comments
Paul Chelminski mentioned that he was asked, last Thursday, to speak at a community
forum at the Calvary Church in Charlotte, NC regarding the opioid epidemic. There was a
panel discussion that included a psychiatrist, the mom of an IV drug user and a local
news anchor. After some brief presentations, the attendees broke into discussion
groups. There has been an increase in fentanyl and heroin deaths in Charlotte. Dr.
Chelminski provided some statistics regarding fentanyl and heroin deaths. There are
15.3 deaths per 100,000 people per year. West Virginia has a rate of 44 deaths per
100,000 people which is the nation’s highest; the lowest was Nebraska with 2.2 per
100,000 people. Dr. Chelminski added that he frequently conducts polls in relation to the
epidemic and mentioned one he’d conducted amongst Allied Health students in which
40% knew 3 or more people affected. A similar poll was conducted at the community
forum in Charlotte. Over 50% of attendees knew at least 3 people that were affected by
the epidemic.
VIII. Adjournment
Jessica Frega moved to adjourn the meeting at 8:58pm and Susan Elmore seconded.
The next Board of Health Meeting will be held April 24, 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