HomeMy WebLinkAboutBOH Agenda 091819
ORANGE COUNTY BOARD OF HEALTH
MEETING AGENDA
DATE: September 18, 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 September 18, 2019
7:10 – 7:15 IV. Actions Items (Consent)
A. Minutes of August 28, 2019 Timothy Smith
7:15 – 8:45 V. Educational Sessions
A. BOH Member Training Wayne Raynor
8:45 – 8:55 VI. Reports and Discussion with Possible Action
A. Health Director Report Quintana Stewart
B. Media Items Kristin Prelipp
8:55 – 9:00 VII. Board Comments
9:00 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.
Upcoming Events
• September 20, 2019 - “Be the Light” 3rd Annual Suicide Prevention Walk; 6pm – 7:30pm
Carrboro Town Commons, 301 W. Main Street at Carrboro Town Hall
• September 24 – 27, 2019 – NCALHD Meeting & NC Public Health Association Fall Education Conference,
Greensboro, NC
• September 30, 2019 – Orange County Opioid Task Force Meeting
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
August 28, 2019
S:\Managers Working Files\BOH\Agenda & Abstracts\2019 Agenda & Abstracts/ August Page 1
ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To enhance the quality
[of life, promote the health, and preserve the environment for all people in the Orange County
community.
THE ORANGE COUNTY BOARD OF HEALTH MET ON August 28, 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, Keith Bagby, Bruce Baldwin, Jennifer Deyo, Aparna Jonnal, Sam Lasris and Alison
Stuebe.
BOARD OF HEALTH MEMBERS ABSENT: Commissioner Earl McKee and Liska Lackey
STAFF PRESENT: Quintana Stewart, Health Director; Janis Barney, Certified Medical
Assistant; Antonia Cortes Sanchez, Family Navigator; Erika Cervantes Munoz, Family
Navigator; LaKaya Craig, Family Navigator; Rebecca Crawford, Financial and Administrative
Services Director; Jena Dolby, Family Navigator; Victoria Hudson, Environmental Health
Director; Pam McCall, Public Health Nursing Director; Rhonda Morales, Family Navigator; Ling
Oy, Family Navigator; Kristin Prelipp, Communications Manager; Maria Pahuamba, Public
Health Nurse I; Thomas Privott, Soil Scientist; Beverly Scurry, BOH Strategic Plan Manager; La
Toya Strange, Administrative Support I; Debra Wright, Public Health Nurse I and Claudia
Yerena.
GUESTS PRESENT: None.
I. Welcome New Employees
Timothy Smith, Chair, called the meeting to order at 7pm. Quintana Stewart, Health Director,
introduced the new employees in attendance: Janis Barney, Antonia Cortes Sanchez, Erika
Cervantes Munoz, LaKaya Craig, Jena Dolby, Rhonda Morales, Ling Oy, Maria Pahuamba,
Thomas Privott, Debra Wright and Claudia Yerena.
Next, Mr. Smith welcomed the new BOH members, Aparna Jonnal and Alison Stuebe. The BOH
members introduced themselves including their appointed Board position and current
employment.
II. Public Comment for Items NOT on Printed Agenda: None.
III. Approval of the August 28, 2019 Agenda
Motion was made by Bruce Baldwin to approve the agenda, seconded by Keith Bagby
and carried without dissent.
IV. Action Items (Consent)
A. Minutes of June 26, 2019 Meeting
Motion was made by Jennifer Deyo to approve the minutes of June 2019, seconded by
Keith Bagby and carried without dissent.
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
August 28, 2019
S:\Managers Working Files\BOH\Agenda & Abstracts\2019 Agenda & Abstracts/ August Page 2
V. Educational Sessions
A. Orange County Schools (OCS) Equity Update
Dr. Dena Keeling, OCS’s first Chief Equity Officer, Sherita Cobb, Student Support Services
Director, presented an update on OCS’s progress of creating an equitable school system.
Below are highlights.
• During year one, the focus was on identifying disparities, inequities and barriers and
developing, implementing, and monitoring strategies to address them.
• Students Organized for Anti-Racism (SOAR) is being used, beginning with high
schoolers, to empower students to address issues of race.
• There is an Equity Task Force Team includes community leaders, parents, and school
system staff to advise the school system on equity-related issues, concerns, and
initiatives.
• There will be a new Code of Conduct launched in January 2020. The goals are to:
o Create a blueprint for promoting good conduct, good citizenship, and good character
for every student in the district.
o Implement a district-wide approach to discipline and student support that is
restorative, accountable, and equitable for students, families, and staff.
o Amend current disciplinary policies and practices in order to reduce over use and
disproportionate use of referrals and suspensions that adversely impact students of
color and students with disabilities.
o Ensure equitable treatment of every student, recognizing the uniqueness and
strengths of each student and allowing for differences in time, attention, instruction,
and support so that every student can succeed academically and participate
responsibly in our shared community.
o Implement consistent consequences, interventions, and classroom disciplinary
practices across schools.
o Support students’ development of social and emotional competencies linked to
readiness to learn, academic engagement, and college, career, and life success.
• There’s a focus on equitable treatment in the classroom that focuses on adult behavior.
Before a student is suspended, let’s figure out what’s causing the behavior so that they
can be successful and to show the student to know that they’re supported.
• There was discussion regarding being aware that factors outside of school such as
home life and food insecurity affects what occurs in the schools.
B. 4th Quarter Financial and Billing Dashboard
Rebecca Crawford, Financial & Administrative Services Director, gave a report on the 4th
quarter revenue and billing accuracy. The report is as follows:
• Total Health Department Revenue vs Actuals: Average YTD monthly revenue in FY19
after the fourth quarter was $275/month or $3.3 million for the entire fiscal year,
representing 91.7% of our overall budgeted revenue for the year. This was a decrease
of $161k from FY 17-18. Expenses were higher than revenues at 93% of the total
overall budget but lower than the percentage of total budget expenditures from FY 17-
18, which reflects department-wide efforts to decrease expenditures in anticipation of
lower revenue. The total overall expenditures were $10.2 million compared to year end
FY 17-18, which were $9.7 million.
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
August 28, 2019
S:\Managers Working Files\BOH\Agenda & Abstracts\2019 Agenda & Abstracts/ August Page 3
• Total Billing Accuracy: Continuing with the goal of 90% billing accuracy set in FY 14-
15, the average billing accuracy rate for dental for FY 18-19 was 90% as compared to
101% in FY 17-18. Please note the change in billing accuracy from FY 17-18 to FY 18-
19 is because of the change in calculations to connect payments made back to the date
of service (accrual basis of accounting) rather than the date of payment (cash basis of
accounting) to help staff track true billing accuracy and compare to the medical billing
accuracy measures. The medical billing accuracy measure continues to be a challenge
as we work with UNC to improve the accuracy of the reporting system for Health
Department revenue and is not included in this quarter’s dashboard.
• Dental Earned Revenue by Source: The FY 18-19 average monthly revenue
($46/month) for the fourth quarter was above our budget projection ($45k/month) and
above our FY 17-18 average of $42.5k/month. FY 18-19 dental earned revenue totaled
$552k at the end of the fiscal year, compared to $511k at the end of FY 17-18.
• Medical Earned Revenue by Source: Medical earned revenue for the fiscal year was
below the budgeted projection for FY 18-19 ($55.6k) at $40.6k due to weather related
county office closings, extended appointment times, and system billing delays with the
Epic Electronic Medical Records system. FY 18-19 medical earned revenue totaled
$487k at the end of the fiscal year, compared to $618k at the end of FY 17-18.
• Environmental Health Earned Revenue by Source: Environmental Health earned
revenue for the fiscal year was below the budgeted projection for FY 18-19
($53.1k/month) at $49.5k/month) due to weather related county office closings this past
fall and wet weather this past spring, which resulted in an inability to perform as many
onsite well and septic inspections. Environmental Health earned revenue totaled $594k
for FY 18-19, compared to $616k at the end of FY 17-18.
• Grants Fund Revenue: FSA has drawn $200k of the multi-year Kenan grant. We will
receive the third allocation of $100k after third quarter FY 19-20. Expenditures totaled
$61.5k at the end of FY 18-19.
The BOH members had no questions.
VI. Action Items (Non-Consent)
A. Child Fatality Prevention Team (CFPT) – Health Care Rep Appointment
Pam McCall, Personal Health Services Director, gave a brief background on recommended
local health care provider appointee, Holly Warner, as her CV was included in the Board’s
packet. Ms. McCall included some of Ms. Warner’s achievements and current activities.
Motion was made by Alison Stuebe to approve the request to appoint Holly Warner to the
health care provider position on the Orange County Child Fatality Prevention Team,
seconded by Sam Lasris and carried without dissent.
B. BOH Policy Review
Beverly Scurry, BOH Strategic Manager, led the discussion of the annual review of the BOH
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
August 28, 2019
S:\Managers Working Files\BOH\Agenda & Abstracts\2019 Agenda & Abstracts/ August Page 4
Policies and Procedures. Suggestions made included:
• Adding diversity into the policy
• Consolidating policies
• Adding language regarding removal from the Board
• Adding language regarding compensation
• Addind language regarding special meetings and closed sessions
Ms. Scurry will send out a draft copy of the policies without the tracked changes for the Board to
review. The Board will vote at the next meeting. Quintana Stewart thanked the Board for their
work in reviewing the policies. She expressed that it’s easier to have comprehensive policies as
they are to be reviewed annually.
C. BOH Subcommittees
Beverly Scurry, BOH Strategic Manager, presented the 3 subcommittees [Substance Abuse and
Mental Health (SAMH), Social Determinants of Health (SDOH), and Physical Activity and
Nutrition (PAN)] that associate with the Community Health Assessment Priority areas.
Subcommittees are limited to no more than 5 BOH members. The Board was asked to consider
which subcommittees they’d like to serve on. This discussion will be revisited annually
according to policy. Timothy Smith removed himself from the PAN. Alison Stuebe joined the
SAMH; Aparna Jonnal joined the PAN. The North Carolina Association of Boards of Health
(NCABH) is in need of a representative. It was requested that the remaining Board members
notify Ms. Scurry of any change they wish to make regarding their subcommittee membership.
She will also reach out to those Board members not in attendance.
VII. Reports and Discussion with Possible Action
A. Fluoride Update
BOH member, Jessica Frega, gave a brief update on the fluoridation panel process. There are
four experts – a toxicology expert, medical expert and 2 dental experts. All except one dental
expert (who volunteered their time) have submitted their W -9s as they will be receiving an
honorarium payment. Todd McGee, Orange County Community Relations Director, was
consulted as an expert asked if they could use the raw survey data. Permission was given as
there’s no identifying information included in the data. There were 164 online surveys which
resulted in 71% supporting fluoridation and 29% in opposition. There were 7 hard copy surveys
which resulted in 5 in favor of fluoridation, 1 not in favor and 1 that circled that they were both in
favor and in opposition. Going into September, the public comments will be reviewed and
themes will be created. In November, the experts will write a response to the themes. Quintana
Stewart added that there will be a compilation of the experts’ opinions which will be sent to
OWASA. OWASA will then make their final decision.
B. NALBOH Annual Conference
BOH member, Jessica Frega, attended the NALBOH 2019 Annual Conference that was held in
Denver, CO on August 14-16, 2019. Below are some highlights of the conference.
• There was discussion on parliamentary procedures and making sure that they’re
Comment [RC1]: Did Jessica use the phrase
“fluoridation process”? Typically that means adding
fluoride to something. I guess we have to keep if if
that’s what she said but if she didn’t we could use
“fluoride panel process” instead.
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
August 28, 2019
S:\Managers Working Files\BOH\Agenda & Abstracts\2019 Agenda & Abstracts/ August Page 5
followed to ensure that voted items remain irrevocable.
• The keynote speakers’ presentations focused on health equity, educational and
geographical equity and how it affects life, health, and income.
• There was a great presentation on Tobacco 21, a national campaign aimed at raising the
minimum legal age for tobacco and nicotine sales in the United States to 21. While the
law does not make it illegal for youth under 21 to buy tobacco, it does make it illegal to
sell to youth under 21. The responsibility is placed on the business. It’s been very
effective as a consequence of violation to the business is that their license can be
evoked.
• Other topics discussed included legislative preemption. Ms. Frega strongly
recommended BOH members attending the annual NALBOH conference.
C. Health Director Report
In addition to her report, Ms. Stewart mentioned the following:
• She’s serving on the Complete Count Committee which is charged with developing a
2020 Census Awareness Campaign to encourage residents to respond. She mentioned
that there has been a lot of fear regarding the proposed citizenship question. Ms.
Stewart stated that the Census is also important as it affects our dollars for infrastructure
not just for legal citizens but the entire county. As a health department representative,
she’ll serve on the subcommitte that will focus on hard-to-reach populations. She
alerted the Board to anticipate a future ask regarding this task.
• She continues to work with the Campus & Community Coalition (CCC). The Coalition
Leadership recently submitted a letter to UNC Leadership to express support for gradual
implementation of changes to HB381, which allows alcohol sales in athletic facilities on
game days, so that they can study its effects in our community and to keep the dialogue
open between UNC and the CCC.
• She thanked Victoria Hudson and Kristin Prelipp for their participation when the OCHD
hosted International Delegation from Egypt to discuss Human Trafficking and the role of
a local health department in NC. The delegation included 8 emerging leaders from
Egypt. She also thanked BOH member, Sam Lasris, for the opportunity to host the
delegation.
D. Upcoming Events
Below are the upcoming events for the Orange County Health Department.
• September 18, 2019; 1pm – 3pm
Pool Operator’s Meeting
Southern Human Services Center
2501 Homestead Road, Chapel Hill, NC
• September 20, 2019; 6pm – 7:30pm
“Be the Light” 3rd Annual Suicide Prevention Walk
Carrboro Town Commons
301 W. Main Street
at Carrboro Town Hall
• September 25 – 27, 2019
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
August 28, 2019
S:\Managers Working Files\BOH\Agenda & Abstracts\2019 Agenda & Abstracts/ August Page 6
2019 NCPHA Fall Education Conference
Grandover Resort & Conference Center
1000 Club Road
Greensboro, NC 27407
BOH, Keith Bagby, requested that the upcoming events be added to the back of the agenda.
E. Media Items
Kristin Prelipp, Communications Manager, briefly mentioned articles regarding how healthy and
wealthy Alamance County is in comparison to Orange County and the state lab confirming its 4th
positive rabies case for Orange County, which 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.
IX. Adjournment
Alison Stuebe moved to adjourn the meeting at 8:55pm and Jessica Frega seconded.
The next Board of Health Meeting will be held September 18, 2019 at the Southern Human
Services Center, 2501 Homestead Road, Chapel Hill, NC at 7:00 p.m.
Respectfully submitted,
Quintana Stewart, MPA
Orange County Health Director
Secretary to the Board
Health Director’s Report
September 2019
• Orange County Opioid Task Force - Via request from Commissioner Price, I will Co-Chair the Orange
County Opioid Task Force with UNC Director of Emergency Services, Christian Lawson. There is a
meeting planned for Monday, September 30th for task force members. Lawson and I have met to discuss
the overall mission of the task force, potential stakeholders and partners and time/resource needs for our
work. I will provide further updates as the group is formalized and we solidify plans for our work.
• Board of Health Veterinarian Member - The nomination committee interviewed Dr. Lee Pickett for the
Veterinarian seat. The committee unanimously agreed to forward an official recommendation for Dr.
Pickett to the Board of County Commissioners. BOH appointment is tentatively listed on BOCC Agenda
for the September 17, 2019 meeting.
• Medicaid Transformation Update: On Monday, September 3, 2019, the Department of Health & Human
Services announced that we will move to a statewide transition to managed care on February 1, 2020.
The timeline has been adjusted because DHHS could not implement critical actions to go-live November
1st with managed care under the unresolved budget. This means Managed care will now launch in one
phase instead of two. Open enrollment will be extended for beneficiaries in our region until December
13, 2019. We will continue to work towards the February 1, 2020 implementation date by working with
stakeholders and PHPs to finalize contracts.
• Diabetes Program Award: Our Diabetes Self-Management Education Program has been selected for the
2019 John Bowdish Community Award from the Division of Public Health for the North Carolina
Diabetes Advisory Council. This award focuses on the innovative ways our program has addressed
community needs for improving diabetes management (voucher program, transportation, marketing,
Spanish LEP needs). We will accept the award at the NC Diabetes Council Meeting on November 8th.
• Vaping /E-cigarettes – The Trump Administration announced plans to ban flavored e-cigarettes.
(https://www.cnbc.com/2019/09/11/trump-to-consider-e-cigarette-policy-amid-outbreak-of-lung-
disease.html) .
The Centers for Disease Control and Prevention reports 380 confirmed and probable cases of vaping-
related lung illnesses in 36 states. Six people so far have died.
(https://www.usatoday.com/story/news/health/2019/09/11/vaping-lung-illness-what-we-know-spate-cases-
and-deaths/2264610001/).
Foster care bill could allow for faster termination of parental rights - North Carolina Health News
https://www.northcarolinahealthnews.org/2019/08/27/foster-care-bill-allows-faster-parental-rights-termination/[8/28/2019 9:53:12 AM]
NORTH CAROLINA HEALTH
NEWS
News. Policy. Trends. North Carolina.
F In R T
Search NC Health News...
Menu
Foster care bill could allow for faster termination of parental rights - North Carolina Health News
https://www.northcarolinahealthnews.org/2019/08/27/foster-care-bill-allows-faster-parental-rights-termination/[8/28/2019 9:53:12 AM]
Photo by drothamel, courtesy flickr creative commonsAugust 27, 2019 by Rose Hoban —Leave a Comment
Facebook Twitter LinkedIn Email
Advocates point to new brain science on the importance of early childhood bonding, but those
involved in the child welfare system say it could allow for a too-easy severing of important
family connections.
By Rose Hoban
The way Rachel Lankford puts it, as a girl, she didn’t spend hours playing in the sandbox,
hoping to become addicted to opioids, or alcohol, or marijuana.
But she did.
Foster care bill could allow for faster termination of parental
rights
Foster care bill could allow for faster termination of parental rights - North Carolina Health News
https://www.northcarolinahealthnews.org/2019/08/27/foster-care-bill-allows-faster-parental-rights-termination/[8/28/2019 9:53:12 AM]
By the time she was 20, Lankford had lived hard. Her adolescence, in particular, had been
hard. First came a divorce between parents who couldn’t be in the same room without fighting.
She was separated from her mother because of her mother’s mental illness. Later, she was
removed from her father’s custody after stepbrothers molested her.
By the time she was 20, she had spent years strung out on a combination of drugs, but mostly
opiates. She was living out of her car, abandoned by her boyfriend, who was also her drug
dealer.
By the time she was 20, she was seven months pregnant, too far along to have an abortion.
She had felony charges against her for embezzling from her employer. Every member of her
family was angry with her. By her own account she was miserable to be around. She was
waiting for a referral to get into a drug treatment program and determined to give up that baby
for adoption.
Then, she went to a prenatal appointment at the Orange County Health Department, where she
had her first ultrasound.
“When I looked at the screen, there was this perfect little girl and she was doing her kissy face,
she had 10 fingers and 10 toes and she was perfect,” Lankford recalls. “I walked out that
hospital that day and I was having a baby and I was keeping her and I really needed to get
help. I needed to do what I needed to do to be right and have this kid.”
But a new bill that’s been making its way through the General Assembly could affect women
like Lankford. At issue is the tussle between the rights of children who have troubled parents to
live less chaotic lives, in foster care, or with perhaps adoptive parents, and the rights of birth
parents to take the time to get their lives in order, to win back their rights to raise those
children.
Years in limbo
It’s a brutal balance to strike. Currently, it can take years for a baby born to mothers using
illegal substances to become eligible for adoption. Children living with a substance abusing
Foster care bill could allow for faster termination of parental rights - North Carolina Health News
https://www.northcarolinahealthnews.org/2019/08/27/foster-care-bill-allows-faster-parental-rights-termination/[8/28/2019 9:53:12 AM]
Rachel Lankford’s daughter Marleigh spent several
years in foster care while Lankford pulled her life
together. Photo courtesy: Rachel Lankford
parent or parents often end up in the custody of county child protective services, especially if
they are deemed to be in danger of abuse of neglect. Those children go to foster care,
sometimes with family members, if they can be found. Often, foster care is with people who are
not kin, while the child welfare and family court systems grind their wheels.
Currently, there are about 11,000 children in North Carolina’s child welfare system, a number
that’s exploded in recent years as opioids have taken their toll throughout all tiers of society.
Sometimes the outcome is a “termination of parental rights,” a process that currently takes
several years.
House Bill 918 would create a provision to expedite that process to nine months, allowing foster
parents to have standing almost equal to family members, treating them as “nonrelative kin,” so
that they could petition for termination and expedite permanent placement of the child.
“Federal statute requires permanency within 18
months and we have children who have been in the
system for five or six years,” said Karen McLeod, a
lobbyist and advocate for children’s and family
services. “These are young children who would be
deemed very adoptable, that have been in the system
for years and have families, foster families, and
adoptive families that are willing to adopt them.”
McLeod said that without termination of parental
rights, the children have been “languishing in the
system,” and she called the bill drafters’ concerns
valid. But she also worried about the process HB 918
would establish, especially the speed of the
termination process and the short timelines to find a
willing relative to care for the child.
Growing brains
Both the bill’s supporters and opponents cite an
exploding body of research that points to the critical importance of early childhood years. More
Foster care bill could allow for faster termination of parental rights - North Carolina Health News
https://www.northcarolinahealthnews.org/2019/08/27/foster-care-bill-allows-faster-parental-rights-termination/[8/28/2019 9:53:12 AM]
and more research emphasizes the critical ages of 0 to 3, where bonding with caring, attentive
adults helps to promote neurological development. Research is also showing how trauma
during those years sets up children for a lifetime of psychological and physical challenges.
Currently, the law favors family members over non-relative foster families, and once a child is in
the state system, a hunt can ensue for a relative who’ll care for him or her.
Chris Carr, an attorney with the Cumberland County Department of Social Services said that
finding kin can be challenging.
“We’d love to think that every time a case gets filed, that mom and dad will call all family
members and say please come in. We’d love to tell you that the DSS is always able to find
family members to bring them to the table at the first nonsecure hearing within the 7 days that
statute requires,” he told the Senate Judiciary Committee on Thursday. “But in the real world,
sometimes even the relatives are somewhat reticent because they want to see the mother, the
father or both do well and reunify.”
Carr also detailed how it can be challenging to find relatives who live in other states and
detailed the byzantine paperwork trail that can take months, at best, to permit an out-of-state to
take custody of a child.
Paula Reinhart, a clinical social worker from Wake County who supports the bill, told the
judiciary committee this can be an injustice to the children, and to foster parents who care for
the child in the interim, who may want to adopt.
“To see a child who is three or four years year old… who has lived with a family who has loved
that child, included that child, wanted to adopt that child, those are his parents, ripped out of the
arms of those people, and sent screaming and crying to somebody he hardly knows, that
everybody knows in the picture really cannot care for him, but there’s a blood connection and
that’s all.”
Lankford recalls her daughter months-old Marleigh screaming and crying too. Lankford was still
abusing drugs and alcohol and struggling to parent when her father called child protective
services after she stole her grandmother’s credit card.
Foster care bill could allow for faster termination of parental rights - North Carolina Health News
https://www.northcarolinahealthnews.org/2019/08/27/foster-care-bill-allows-faster-parental-rights-termination/[8/28/2019 9:53:12 AM]
Marleigh was placed into foster care and Lankford was allowed only an hour’s visitation each
week.
“It was so painful to see her,” she said. “Having to give her back and then wait a week to see
her again, it destroyed me, it was the worst thing I ever had to go through in my life. And having
to put her back in her car seat and hear her scream and all because she didn’t want to lose
me.”
Often, after those meetings, Lankford said she would go out and use, to dull the pain.
Legal labyrinth
The bill would add several changes to North Carolina’s legal code. It would change the law to
allow for removal of a child born to a woman who was using drugs that are “not medically
based,” who a judge deemed “unable to discharge parental responsibilities due to a history of
chronic drug abuse.” The bill also adds requires an assessment by a “licensed health care
provider with substance abuse disorders experience,” that the mother would continue using
substances “for a prolonged or indeterminate period” for removal of custody.
“These babies have an addiction because their mothers abused them while they were in the
womb, in utero,” said Tami Fitzgerald, head of the North Carolina Values Coalition. “These
mothers have already demonstrated a lack of responsibility to parent their child, because the
child has to overcome an addiction when the child is born and they languish in NICU units and
hospitals across the state for months.”
Others spoke against that same provision, including Evette Horton, a psychologist at the UNC
Horizons Program, a substance abuse treatment program for women and their children.
“I have been doing this for 10 years,” she told the committee. “I have seen, literally, hundreds,
thousands of women come through our program, and I’ve seen many women with opioid use
disorders and other substance use disorders get better.”
Foster care bill could allow for faster termination of parental rights - North Carolina Health News
https://www.northcarolinahealthnews.org/2019/08/27/foster-care-bill-allows-faster-parental-rights-termination/[8/28/2019 9:53:12 AM]
This week, Rachel Lankford’s daughter Marleigh starts
kindergarten. The two have been reunited for several
years after Marleigh spent time in foster care. Photo
courtesy: Rachel Lankford
But Horton said that it can be hard to predict who will be successful. Lankford, who eventually
got to Horizons, was one of them, but it didn’t look that way at first. Even after her daughter
was born, Lankford struggled, at times leaving Marleigh with her own parents. She was in and
out of treatment, and relapsed several times. Eventually she landed in jail after her father called
the police.
Lankford was remanded to Orange County’s drug
court, where she encountered a handful of social
workers and jurists doling out tough love and
tough justice. It took her a couple months to get
with the program.
“When Judge Buckner looked at me and told me
I’ll take that kid and I’ll adopt her out, something
snapped that day,” she said. At the time, Marleigh
was about a year and a half old.
She wanted to go to Horizons’ program for
inpatient treatment. Finally, in 2015, a place for
her opened up, she graduated the program nine
months later, spending almost six months without
seeing her child. Later, she graduated from drug
court and regained custody a few months later.
Not ideal parenting
Reggie O’Rourke, the assistant counsel for the
state’s guardian ad litem program. also objected to provisions in HB 918. He reminded the
committee that termination of parental rights is considered the “civil death penalty.”
“It is the most serious thing we do in the law,” he told the judiciary committee members. “It
Foster care bill could allow for faster termination of parental rights - North Carolina Health News
https://www.northcarolinahealthnews.org/2019/08/27/foster-care-bill-allows-faster-parental-rights-termination/[8/28/2019 9:53:12 AM]
needs to be the last thing we look at for children.”
Lankford has had custody of Marleigh for several years now, and she said that the hope of
reunifying with her was one of the things that kept her going, even as she learned to love and
forgive herself.
“If reunification had never been put on the table for Marleigh, I could honestly say that I’d be in
a casket, buried right now,” she said. “If you take away anything that I have the will to live for,
then why am I here?”
Jamie Hamlett, a DSS attorney from Alamance County, noted that parents have rights
enshrined in the Constitution, and that if a child is not being abused or neglected, the state has
to tread carefully as it intrudes on families.
“The parent doesn’t have to prove that they can parent as well as or better than a foster parent.
They have to prove that they can meet a minimal level of care,” Hamlett said. “If you say ‘Okay,
we’re going to allow this foster family or anyone to file a [termination of parental rights],’ you still
have to develop the case and prove the grounds by clear, cogent and convincing evidence to
terminate that parent’s rights.”
Carr pointed that the foster care system is not a simply pipeline to adoption, but rather a
system intended to be a safe and nurturing haven for kids with troubled families.
“I have said to many of them, ‘I could not do what you do,’ because when they take the role on
of a foster parent, they are trained that they’re taking care of that child and making it child
healthy. But there’s a strong chance that it’s going to be returned to a parent or family,” he said.
“That’s a hard thing for a foster parent.
“I don’t know that I could do it, and God bless them. And I understand why they feel this way.
But that’s the role that they have.”
Lankford said she’s doing her best now that she’s been reunited with Marleigh. She’s been
clean for four years. She’s a counselor at Horizons. She keeps in touch with the foster parents
who cared for daughter when she was unable. This week, Marleigh starts kindergarten.
She said she wanted to be a mother when she was high on drugs, but she didn’t know how,
Foster care bill could allow for faster termination of parental rights - North Carolina Health News
https://www.northcarolinahealthnews.org/2019/08/27/foster-care-bill-allows-faster-parental-rights-termination/[8/28/2019 9:53:12 AM]
and the idea of HB 918 bothers her.
“They’re saying women like me don’t deserve a chance,” she said. “They’re taking any type of
chance we may have away.”
She argues that women like her are not disposable.
“Yes, it took awhile for me to get to where I needed to get, to love my child the way I love her
now,” she said. “But if you take that away … there is no reason to try, there is no reason to
want to fight this fight we have inside of us.
“We can’t survive and recover and heal.”
Members of the judiciary committee did not vote on the bill Thursday. Some members have
suggested it be converted to a study, for further review. For now, the bill’s fate remains
uncertain.
Facebook Twitter LinkedIn Email
Filed Under: Children's Health, Featured, State Health Policy, Substance Use
Tagged With: adoption, adverse childhood experiences, Alamance County, alcohol abuse, Cumberland County,
Department of Social Services, drug court, foster care, foster family, marijuana, NC General Assembly, NC Values
Coalition, opioid, Orange County, Orange County Health Department, parental rights, parenting education, social services,
substance abuse, substance dependency, substance use recovery, termination of parental rights, UNC Horizons Program,
Wake County
About Rose Hoban
Rose Hoban is the founder and editor of NC Health News, as well as being the
state government reporter.
Support quality journalism that matters! Donate today.
Orange County Habitat for Humanity talks home, health and safety in a new panel series - The Daily Tar Heel
https://www.dailytarheel.com/article/2019/09/habitat-housing-healthcare-panel-0906[9/9/2019 7:08:59 PM]
Buy PhotosKrishnaveni Balakrishnan, left, and Ceila Loughlin speak on a panel about the
intersection between housing and health on Sept. 4, 2019.
DIANE ADAME
9/5/2019, 10:08PM
Orange County Habitat for Humanity talks home, health
and safety in a newpanel series
BY DIANE ADAME
Habitat for Humanity of Orange County hosted a housing and health panel Wednesday to discuss the
safety and health risks posed in some United States homes.
Habitat said, 45 percent of U.S. homes exhibit a health or safety risk, such as mold, broken stairs or Privacy - Terms
Start the Presses!
No, thank you Donate Now!
×
Help The Daily Tar Heel start
Orange County Habitat for Humanity talks home, health and safety in a new panel series - The Daily Tar Heel
https://www.dailytarheel.com/article/2019/09/habitat-housing-healthcare-panel-0906[9/9/2019 7:08:59 PM]
windows and exposure to lead and other toxic chemicals.
This discussion was the first of a panel series, called Home is the Key, which is being hosted in
celebration of its 35th anniversary. The series will continue through October and November with two more
panel discussions.
“I would say it affects almost all of the patients that I see in one way or another,” said Dr. Ceila Loughlin,
medical director of the N.C. Children’s Allergy & Asthma Center. “Mold is a big one, but then
cockroaches and rodents can also affect children with asthma.”
Krishnaveni Balakrishnan, coordinator for the Orange County Health Department's Healthy Homes
initiative, is a certified inspector who conducts house visits. Balakrishnan said during these inspections,
she searches for potential health hazards, such as mold, improper drainage, pests and vermin as well as wet
spots on the ceiling.
EDITORS PICKS
Student Governmentlaunches Red Zone Initiativeto battle sexual assault oncampus
Where do 2020 presidentialcandidates stand on studentdebt?
UNC men’s soccer ‘lockedin’ for 6-0 win over Harvard
“Usually there’s the telltale sign,” Balakrishnan said. “Usually what I ask the family as well is, ‘Are you
having any issues breathing? Have you been to the hospital lately or have anything related to asthma?’”
Balakrishnan said a common issue she finds is that landlords don’t take care of the property or handle
hazardous situations properly.
“One of the homes that I actually looked at last year was a family of five that had just moved to
Greensboro, and the home was beautiful, but the landlord had not been keeping up the property,”
Balakrishnan said. “When they moved, they didn’t know that he had painted over all of the mold that was
in the house.”
Two weeks after the family moved into the house, the walls began to turn dark green, causing them to
have allergies and breathing problems.
Orange County Habitat for Humanity talks home, health and safety in a new panel series - The Daily Tar Heel
https://www.dailytarheel.com/article/2019/09/habitat-housing-healthcare-panel-0906[9/9/2019 7:08:59 PM]
When this happens, Balakrishnan said she refers these families to various housing agencies, such as
EmPOWERment, Inc., to help them find new housing.
Loughlin said if the county has resources available, she will try to pair families with North Carolina
Healthy Homes, an organization that works to identify environmental issues in the home and educate
families about inexpensive cleaning products without asthma triggering fumes.
Loughlin said there are some solutions she is working on integrating within the community to improve this
issue, like home repairs and education. Balakrishnan said she plans to get these families extra support by
working closely with doctors.
“When I go in, I find out that patients are either not able to keep up with the medication or decided not to
get it again because they can’t afford to purchase it,” Balakrishnan said. “What I try to do is sit down with
the family and try to provide that extra support, that extra health education.”
@diane_adame
city@dailytarheel.com
Sign up for the OC Report and get all the Chapel
Hill, Carrboro, Hillsborough news delivered to your
inbox every week!
First Name
Last Name
Email*
The OC
Report/Orange
County News