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Home My WebLink AboutBOH Agenda 042220 ORANGE COUNTY BOARD OF HEALTH MEETING AGENDA DATE: April 22, 2020 TIME: 7:00 P.M. PLACE: Go to Meeting Please join my meeting from your computer,tablet or smartphone. https://qlobal.gotomeeting.com/moin/431298877 You can also dial in using your phone. United States: +1 (872) 240-3212 Access Code: 431-298-877 New to GoToMeeting? Get the app now and be ready when your first meeting starts: https://qlobal.aotomeeting.com/install/431298877 TIME ITEM 7:00 p.m. I. 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 the chat section of the screen.) Please limit your comments to 3 minutes 7:00—7:05 II. Approval of April 22, 2020 Agenda 7:05—7:10 III. Action Items (Consent) A. Minutes of March 25, 2020 7:05—8:05 IV. Educational Sessions A. Cardinal Annual Update Lynn Inman & Ric Bruton (20 minutes)(relative to BOH Strategic Plan Priority: Substance Abuse and Mental Health) B. 3RD Quarter Financial & Billing Dashboard Reports Rebecca Crawford (15 minutes) C. Accreditation Review/Update Ashley Rawlinson & (20 minutes) Rebecca Crawford D. Advisory Board Report Beverly Scurry (5 minutes)(relative to BOH Strategic Plan Priority: Engagement) 8:05—8:15 V. Actions Items (Consent) A. Physical Activity and Nutrition Grant Award Jessica Frega 8:15—8:25 VI. Reports and Discussion with Possible Action A. Health Director Report Quintana Stewart B. COVID-19 Q &A Quintana Stewart C. Media Items Kristin Prelipp 8:25—8:30 VII. Board Comments 8:35 Vill. Adjournment BOARD MEMBERS: To ensure a quorum, SEND E-MAIL to Istrangle(borangecountync.glov 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 Titulo VI—los servicios de interprete y/o equipo de sonido especial estan disoonibles a solicitud. Llame a la Administradora del Proarama de Salud oara Inmiarantes v Refuaiados al 919-245-2387 oara MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH March 25, 2020 ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To enhance the quality Hof 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 25, 2020 virtually via Go To Meeting. BOARD OF HEALTH MEMBERS PRESENT: Jessica Frega, Chair, Jennifer Deyo, Vice-Chair, Keith Bagby, Bruce Baldwin, Liska Lackey, Sam Lasris, Commissioner Earl McKee, Aparna Jonnal, Lee Pickett, Timothy Smith and Alison Stuebe. BOARD OF HEALTH MEMBERS ABSENT: None. STAFF PRESENT: Quintana Stewart, Health Director; Rebecca Crawford, Financial and Administrative Services Director; Victoria Hudson, Environmental Health Director; Kristin Prelipp, Communications Manager; Ashley Rawlinson, Healthy Carolinians Coordinator; Beverly Scurry, BOH Strategic Plan Manager; and La Toya Strange, Administrative Support I. GUESTS PRESENT: Mary Tiger, OWASA. I. Welcome New Employees Jessica Frega, Chair, called the meeting to order at 7:00pm. There were no new employees in attendance. II. Public Comment for Items NOT on Printed Agenda: None. III. Approval of the March 25, 2020 Agenda Motion was made by Alison Stuebe to approve the agenda, seconded by Bruce Baldwin and carried without dissent. IV. Action Items (Consent) A. Minutes of February 26, 2020 Meeting Motion was made by Aparna Jonnal to approve the minutes of February 2020, seconded by Bruce Baldwin and carried without dissent. V. Educational Sessions A. COVID-19 Update Quintana Stewart, Health Director, provided high level updates on COVID-19 in Orange County. Below are some highlights. S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ March Page 1 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH March 25, 2020 ➢ The current positive case count for Orange County is 13. There were 2 deaths in Cabarrus County. One is attributed to North Carolina and the other, the state of Virginia. The case count for the county is based on the person's home county of residence. ➢ On March 18t", the State announced there was community transmission in the state. They relaxed the need for contact tracing; however, the OCHD continues to do contact tracing as Orange County's case county isn't as high as other counties. ➢ The State's guidance on testing is that we can't test everyone. Due to the shortage of personal protection equipment (PPE), those with mild symptoms (e.g. cough and a mild fever) will not be tested. The treatment course would remain the same for those individuals whether they're tested or not. Difficulty breathing and shortness of breath are considered severe symptoms. ➢ The OCHD still has the ability to test but we are referring patients to the Respiratory Diagnostic Center (RDC) at UNC as the results come back quicker than the labs being sent to the State Lab. LabCorp results have a reported 24 hour turnaround time. ➢ Emergency Management Services (EMS) has found some vendors to fill PPE orders and is working regionally with surrounding counties to make one large order. ➢ Today, screenings started at the Health Department and Department of Social Services sites as these places have the most traffic. EMS is also actively screening daily. People will have their temperature taken and will be given a bracelet once screening has been completed. ➢ OCHD is now conducting telehealth appointments. ➢ Some challenges of the current COVID-19 response include: o Multiple media requests and citizens that want to know specific demographic information (specifically the infected person's address). o Threats to be sued because that very specific information isn't being disclosed to the public. o We've consulted our County Attorney's office. We have to adhere to HIPPA laws and handle COVID-19 cases in the same manner we handle all our other communicable diseases as covered under the Communicable Disease law. ➢ What's working well: o Dinah Jefferies, Director of EMS, along with Kirby Saunders and Sarah Pickhardt of EMS, have been a great team to work with and excellent partners to co-lead. o Kristin Prelipp, OCHD Communications Manager and Public Information Office (PIO), established a Joint Information Center (JIC) which is structured with multiple OCHD and county staff. There's a backup for each position which handles several tasks to include the Call Center, Emergency Preparedness, Equity, the COVID email address/texting service, Graphics, Social Media, Rumor Control (Facts vs Myths), Refugees and a Business Liaison. o Victoria Hudson and the Environmental Health staff posted informative flyers about social distancing and other messaging at grocery stores in attempt to reach those without internet service. o The OCHD Communicable Disease (CD) Team has been extremely productive and is doing a great job with contact tracing. o OCHD has been practicing social distancing with the majority of staff(about 60%)working from home. The BOH members had questions that were addressed by Ms. Stewart. S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ March Page 2 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH March 25, 2020 VI. Action Items (Non Consent) A. Environmental Health Rules Approval At the last Board of Health meeting, Victoria Hudson, Environmental Health Director, thoroughly reviewed the proposed rules. Since her presentation, the Orange County Attorney's Office has conducted a legal sufficiency review of the Rules which included 133 points. All points have been cleared. There was one change in the rules; the section on variances was removed. Motion to approve and adopt the revised Orange County Groundwater Rules was made by Bruce Baldwin, seconded by Alison Stuebe, and carried without dissent. B. Fluoride Recommendation Approval The Board of Health received the full fluoride report as part of the agenda packet. The Board of Health voted on the recommendation below. There was one grammatical error in the 3rd paragraph (which can be found on page 8 in the full report). The word "lead" was changed to "led". Board of Health Recommendation The Orange County Board of Health supports the continued fluoridation of Orange Water and Sewer Authority's water supply at the current levels as deemed effective for prevention of tooth decay and for promotion of good oral health. The Board of Health Ad Hoc Fluoride Committee conducted a process of: ➢ Obtaining public feedback on community water fluoridation ➢ Reviewing public feedback given at an OWASA public meeting ➢ Reviewing the latest recommendations from national health organizations including, but not limited to, the Centers for Disease Control and Prevention (CDC), North Carolina Department of Health and Human Services (NC DHHS), and American Dental Association (ADA) ➢ Reviewing medical, dental, and toxicological expert responses to public opposition of community water fluoridation The committee also considered the lack of naturally occurring fluoride in OWASA's reservoirs. This detailed process and the recognition by the CDC that community water fluoridation is one of the greatest public health achievements of the 201" century, led to the support of OWASA continuing community water fluoridation. Motion to approve the Board of Health Recommendation on OWASA fluoridation of water, including the corrected grammatical error, was made by Liska Lackey, seconded by Sam Lasris, and carried without dissent. Jessica Frega, Chair, thanked Beverly Scurry for all of her hard work. Mary Tiger, OWASA, also thanked Ms. Scurry and the Board of Health. C. BOH Appointments Liska Lackey will be vacating her seat as the Nursing representative because her 3rd term ends in June 2020. Jessica Frega, Chair, mentioned that a small ad hoc committee was formed to S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ March Page 3 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH March 25, 2020 look at applications and conduct interviews to fill the Nursing position. They recommended Dr. Shielda Rogers, a passionate nurse and academic who's firmly grounded in nursing with experience in working with the public and social determinants of health for the Nursing position. Liska Lackey added that Dr. Rogers would be a wonderful addition and would add to the diversity of the Board of Health. Ms. Frega thanked Lee Pickett for encouraging Dr. Rogers to apply. The Board of Health also voted to recommend Lee Pickett to her 1st full term and Jessica Frega to her 2nd full term. Commissioner Earl McKee abstained from all voting and recused himself as he has to vote on the final appointments with the BOCC. Ms. Frega explained that tonight's vote was to recommend the appointments to the BOCC as they have the final decision and make appointments to the Board of Health. Those that were up for reappointment recused themselves from voting on their respective reappointments. Motion to recommend Dr. Shielda Rogers to the BOCC was made by Liska Lackey, seconded by Alison Stuebe, and carried without dissent. Motion to reappoint Lee Pickett was made by Alison Stuebe, seconded by Sam Lasris, and carried without dissent. Motion to reappoint Jessica Frega was made by Aparna Jonnal, seconded by Alison Stuebe, and carried without dissent. After the voting commenced, Commissioner McKee stated that, as the BOCC representative, he will proceed with this at the BOCC level. VII. Reports and Discussion with Possible Action A. Health Director Report Highlights of Quintana Stewart's Health Director Report are below. ➢ Census 2020 was highlighted. She encouraged the Board to urge everyone they come in contact with to complete the Census. ➢ The Opioid Task Force has been temporarily suspended due to COVID-19 response efforts. ➢ There are no upcoming events as most have been postponed due to social distancing. Those that are taking place are doing so virtually. ➢ The mobile dental unit is ready for a final walk through. Due to travel restrictions, there's uncertainty of when that will occur. ➢ OCHD staff has shifted many parts operations into a virtual setting; thus, we are still able to provide services to the community. The BOH members had questions that were addressed by Ms. Stewart. B. Media Items Kristin Prelipp, Communications Manager, briefly mentioned that all of the articles were COVID- 19 related. S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ March Page 4 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH March 25, 2020 Media items were in the packet which focused on Orange County's events and our involvement in various efforts. Vill. Board Comments. Aparna Jonnal spoke about encouragement for healthcare workers, etc. Jessica Frega and the Board reiterated that; although they are available for any assistance needed by Ms. Stewart, they do not want to create any unnecessary burden on her. Bruce Baldwin thanked Ms. Frega for doing a great job with tonight's meeting and thanked Beverly Scurry for doing a fantastic job with the fluoride committee. Mr. Baldwin also informed the Board that China and South Korea's numbers are declining. Jennifer Deyo thanked the fluoride experts for their work as the biggest challenge was actually recruiting the experts. IV. Adjournment Aparna Jonnal moved to adjourn the meeting at 8:28pm and Alison Stuebe seconded. The next Board of Health Meeting will be held April 22, 2020 at 7:00pm with location TBD. Respectfully submitted, Quintana Stewart, MPA Orange County Health Director Secretary to the Board S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ March Page 5 Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: April 22, 2020 Agenda Item Subject: Cardinal Innovations HealthCare Update Attachment(s): Orange BOH End of Year Report - 2020-03-04 Staff or Board Member Reporting: Lynn Inman Purpose: Action X Information only Information with possible action Summary Information: Review of Medicaid and State Funded Services Review of Local Maintenance of Effort Monies and Services Review of Local Aunt Bertha Searches 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): ORANGE COUNTY BOARD OF HEALTH YEARLY REPORT 2019 Cardinal innovations HEALTHCARE - Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. Medicaid and S Funded Services Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 2 Number of ■ by Age and Diagnosis Child Members Served by Diagnosis Adult Members Served by Diagnosis Ages 3 through 17 Ages 18 and over 700 599 599 �1 790 600 558 565 goo 7 719 753 708 735 764 752 736 650 702 500 444 492 458 467 700 395 600 400 327 333 500 300 400 312 320 324 329 324 322 327 323 327 323 316 310 200 200 268 271 246 255 251 206 227 244 251 255 271 242 100 36 48 44 52 45 36 36 45 41 37 37 33 100 0 2 2 0 2 3 2 4 3 2, 0 MH ID❑ SUD +MH IDD SUD Number of Members Served All Age and All Diagnosis RegistrV of Unmet Needs All Members Served I nnovations Registry of Unmet Needs Ages 3 and over All diagnosis 212 215 215 1600 1.300 210 245 208 1400 1075 1104 1114 1197 1190 1148 1169 1200 -E 199 2d0 198 199 1000 cu 210 195 193 193 800 G 195 189 600 348 368 368 381 369 358 563 368 368 360 353 343 v 190 400 1 ]ffi 200 270 273 246 257 254 tog 231 247 255 259 276 244 v 0 180 CU .1 r■ _■ 1 a CD+ � Y ¢ g E �o a " ' m m ,MH IDD SUD i a z° ¢ 2 NOTE-This is a distinct count of members served-Members with multiple diagnosis will only NOTE:Innovations slots a nd fundi ng are allocated by the state-MCOs have no ability to fund be counted once-The sum of the previous graph will not be equa I to the total in this graph. or expand the number of Innovations slots- Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 3 Members Served and Expenses by Service Categoi-V Distinct Members Served-Medicaid Funding Expenses by Service Category- Medicaid Funding 2490 411,202 Outpatient 2415 Outpatient 298,337 1915(b)(3)Services 2 93 1915;b);9]Services $2,290,750 $1,844,813 Emergency Department 23B Emergency Department $209,138 245 $753,637 Inpatient 233 Inpatient $2,077,398 240 $2,572,346 Outpatient FD 212 Outpatient ED $29,055 $30,186 Innovations 185 1B9 Innovations i $9,143,149 127,6;2 ACTT(Assertive Community 131 ACTT{Assertive Community Treatment Team) $1,610,853 Treatment Team) 145 $1,700,610 INS 9 IIHS 169 $723' crisis Services 84 Crisis Services $108,276 ICF 73 ICF $11,090,617 76 $10,630,303 72 P Rehab $497,661 P h Rehab 71 $462,535 17 072 BH Lang Term Residential BH Long Term Residential $29is $438,139 MST 16 MST $145,351 11 s129,013 CommunitySu 16 Community Support $54,776 Support 10 $22,381 PRTF(Psychiatric Residential 10 PRTF(Psychiatric Residential Treatment Facility) $ '706 Treatment Facility) 17 $821,691 5 Partial Hosp/Day Tx 555,576 Partial Hasp/Day Tx 6 $84,619 515,258 Community 2 Community $18,275 1 Residential $14450 Residential 1 $5,595 0 500 1000 15M 2" 2500 -90M so $4,000,000 $8,000.CU0 $12,000,CCo ■Jul'1&-Jun'19 ■Jul'17-Jun'18 ■Jul,1"Un'19 Jul'17-Jun'18 Members Served is based on Members County of Medicaid Eligibility not an the Provider's physical Expenses by Service Categories is based cnthe Total Paid Amount. Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 4 Members Served and Expenses by Service Category Distinct Members Served -State Funding Expenses by Service Category-State Funding Outpatient 700 Dutpatient $554,483 641 $433,988 285 $440,798 Crisis Services 299 Cr sis Services $497,214 Community MOMM225 $584,588 Community 1jr- $579,377 106 $1,353,519 Residential110 Residential _A $1,304,675 ACTT;Assertive Com munity 23 ACTT(Assertive Communrty $219,368 TreatmentTeam) 18 TreatmentTeamJ $140,182 Psy&Rehab 28 Psydi Rehab 1 7,859 ,997 Inpatient 15 Inpatient $77,291 12 $74,938 IIHS 3 INS $32,430 2 $9,553 Community Support 2 Community Support $2,642 0 $0 Partial Hosp/Day Tx 0 Partial Hosp/Day Tx 1 $926 0 200 400 600 800 $0 $500,000 $1,000,000 $1,500,000 Jul'18-Jun'19 Jul'17-Jun'18 Jul'18-Jun'19 Jul'17-Jun'18 Members Served is based on member's County of Residence not on the Provider's physical Expenses by Service Categories is based on the Total Paid Amount. Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 5 Mern bers Served a ndExpense ■ kCr i s i si k Distinct Members Receiving FBC & MCM Crisis Services Expenses by FBC& MCM Crisis Service Medicaid Medicaid 60 54 $120,000 �1oa,aaz 50 47 41 $100,000 $83,311 40 $84,444 31 30 $64,004 ■ 20 $44,444 $21,516 $20,691 10 $24,004 I - 0 54 Facility Based Crisis Mabile Crisis Management Facility Based Crisis Mobile Crisis Management Jul'17 Jun'18 ■Jul'18 Jun'19 ■Jul'17-Jun'18 ■Jul'18-Jun'19 Medicaid Member served for Facility Based Crisis&Mabile Crisis Services are based on the Expenses by Facility Based Crisis&Mobile Crisis Services are based on the total Adjudicated Consumers Eligibility. Amount_ Distinct Members Receiving FBC&MCM Crisis Services Expenses by FBC&MCM Crisis Service State State 300 264 $504,004 $451,077 245 W3,986 25a $404,004 200 $304,044 15❑ 100 73 79 $204,004 50 $104,004 $43,104 $37,979 0 $4 Facility Based Crisis Mobile Crisis Management Facility Based Crisis Mobile Crisis Management Jul'17-Jun'18 Jul'18-Jun'19 Jul'17-Jun'18 Jul'18-Jun'19 Members Served is based on members County of Residence not an the Provider's physical Expenses by Service Categories is based on the Total Paid Amount. location. Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 6 PROVIDER INFORMATION ,III Cardinal In novations Providers by Entity Type Taal Prorid-rs 996 Agency 460 LIP 205 UP Group i 1s8 Haspiital 61 Ph 50an's Group of Hospitals 36 Inpatient 27 Comprehensive Communky Clinics 06 PsKh State Institution 04 ICFMR State Institution 03 Inpatient/Outpatient 03 A DATC State Institution 02 Neuro Behaviml Center State Institution .01 0 200 4-00 600 80O 1000 Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 7 PROVIDER INFORMATION Top 10 Pr-ouiders by Members Served - Ora rage E ritty Type Freedom House Recowery Center'Inc Comprehensive Corn rri unit}Clinics LINC Faculty Physicians Agency Carolina Behavioral Care P-A. UP Group Carolina Outreadir LLC Agency UNC Hospitals at Chapel Hill I spat ient Renaissance Wellness Service.5. LLC �Agency UNC Schwl of Medicine(SOM) Agency The Arc of the Triangle, Inc- Agency Duke Universily Health System, Inc_dba Duke University Hospit Inpatient 0 Futuro+Jrraar xxVed Agency Note: The Top 10 P rnvi der s by Me m tiers served is based on mernbe is Co u my of Medicaid Eligibility not on the Prcrvider's ph ysicaI location. Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 8 Local of Effort ( MOE ) Fundin Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 9 LOCAL MAINTENANCE OF EFFORT (MOE) FUNDING § 122C-115. Duties of counties; appropriation and allocation of funds by counties and cities. (b) Counties shall and cities may appropriate funds for the support of programs that serve the catchment area, whether the programs are physically located within a single county or whether any facility housing a program is owned and operated by the city or county. Counties and cities may make appropriations for the purposes of this Chapter and may allocate for these purposes other revenues not restricted by law, and counties may fund them by levy of property taxes pursuant to G.S. 153A-149(c)(22). (d) Except as otherwise provided in this subsection, counties shall not reduce county appropriations and expenditures for current operations and ongoing programs and services of area authorities or county programs because of the availability of State-allocated funds, fees, capitation amounts, or fund balance to the area authority or county program. Counties may reduce county appropriations by the amount previously appropriated by the county for one-time, nonrecurring special needs of the area authority or county program. (1977, c. 568, s. 1 ; c. 679, s. 7; 1979, c. 358, ss. 5, 23; 1981, c. 51, s. 3; 1985, c. 589, s. 2; 1989, c. 625, s. 14; 1995 (Reg. Sess., 1996), c. 749, s. 1 ; 1999-202, s. 1; 2001-437, s. 1 .8; 2004-124, s. 10.26(a); 2006-66, s. 10.32(c), (d); 2007-504, s. 1.3; 2011-264, s. 2; 2012-151, ss. 1, 6; 2013-85, s. 4(a)-(c); 2013-363, s. 4.12(a); 2013-378, s. 11; 2013-410, s. 23(a).) Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 10 LOCAL MAINTENANCE OF EFFORT (MOE) FUNDING Orange County contributes —$1.3 million annually Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 11 ORANGE LOCAL MAINTENANCE OF EFFORT (MOE) CONTRIBUTION ORANGE Program/Comments FY20 Cardinal Managed MOE Club Nova Community, Inc. Orange County $ 163,000 Freedom House Orange County Crisis $ 60,000 Freedom House Orange Indigent Labs/ Meds $ 80,500 Freedom House Orange County SA Supplement $ 40,000 Freedom House Orange County Psychiatric Supplement $ 38,499 Freedom House Orange, Chatham & Person Forensic Screening $ 1,500 Freedom House Language Resource Center Interpreting $ 10,000 UNC Dept. of Psychiatry- Inpatient Physician Services Inpatient $ 31,374 UNC Dept. of Psychiatry-Outpatient Crisis Outpatient $ 261,450 TOTALS $ 686,323 Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. ORANGE LOCAL MAINTENANCE OF EFFORT (MOE) CONTRIBUTION FY20 Orange ORANGE Program/Comments Managed MOE Arc of Orange County(The) Volunteer Coordination $ 33,320 Art Therapy Institute Treatment Services $ 16,600 Art Therapy Institute Language interpreting $ 10,000 Art Therapy Institute Add'I funds at County request $ 1,000 Carolina Outreach,LLC School Based MH CMH $ 5,000 Chapel Hill Training Outreach Project,Inc. CMH $ 15,000 Haven House $ 19,000 Freedom House formally Mental Health America of the Triangle Pro-Bono Orange $ 17,508 Freedom House formally Mental Health America of the Triangle Compeer Orange County Funds $ 9,000 Freedom House formally Mental Health America of the Triangle Orange County Services for Latino Community $ 4,000 Freedom House formally Mental Health America of the Triangle Family Advocacy CMH $ 30,000 Freedom House formally Mental Health America of the Triangle Majors $ 5,000 New Destinations,Inc. Orange County Apartments $ 35,100 Oxford House Housing Supports $ 15,600 RHA CMH School Based MH $ 5,000 UNC Dept.of Psychiatry UNC Center for Excellence and Community Jail services Mental Health Center-XDS $ 20,000 Previous Orange MOE Carve Out $ 208,500 Housing $ 300 Specially invoiced services(flexible) $ 9,386 Trauma Focused therapist through Cardinal provider DSS $ 50,000 New initiative-residential children in foster DSS $ 55,000 TOTALS $ S64,314 Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 13 OTHER COUNTY MANAGED ITEMS • Orange County also has set aside a portion of the MOE funding for various programs to address community interests • Examples include: • Services to people who are undocumented • Assisting DSS with placements and trauma focused therapy • Flex funds Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. BRIDGESBUILDING IMPACT REPORT ■ ■ A Journey Forward f • cardinaIinnovations.org/About/Impact-Report-2019 Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 15 What does this mean? µ' FlNAHCIALS ,; = Net position refers to the total resources available at a point in time to support operations. Our net position is at a loss for the fiscal year 2019. Net position change Despite significant cuts to our budget . ' - Why is there a negative change in net position? $226 this year,we continue to provide our 'f k members with the best supports and ,; 2018 "'` The loss in our net position from fiscal year 2018 to fiscal year 2019 is services possible. f91 due to a few factors: s• 1��iffm V- FY 2019 = Additional spending on member services I pact of legislative cuts to single-stream (state)funding Total Net Position i'� _ $9 million less in funding in millions : - 19 million more in care costs $226 FY 2018 -: FY 2019 $36 -— Net Loss $3 � %L Net Lass q0 FINANCIALS Single-Stream Funding What is single-stream funding? System-wide reduction Cardinal reduction Single-Stream Funds are state dollars that LMElMCOs use to cover behavioral health services and supports for people who do not FY 2016 1 : 0 . have health insurance and do not qualify for _ Medicaid. FY 20T7 •, •, i Single-stream funds allow LME/MCOs to cover IN ngs that Medicaid does not, such as housing, FY 201$ : • � ` � • vocational programs,jail diversion activities, transportation,or supporting the cost of building • ; FY 2019 9 r 11 , _ _ * _ a mental health facilities. In short, single-stream dollars are an important safety net for at-risk North Carolinians. In FY 2019, Cardinal provided coverage for more than 26,500 people using single stream funds. Tote f • r r The NC General Assembly decides how much 'The i7gures for FY2020 represent re nsinthe final budgetPossedbyt eNCHouse single-stream funding to provide LMEfMCOs - and Senate,which was vetoed by Governor Cooper in June 2019.TVs of February2020,the sing stream reductions for FY20 remain in flux as the budget sfolemate between the NC each year. Between 2016 and 2020 the General GeneraiAssembfy and the Governor persists. Assembly has cut single-stream funding by more than $500 million while requ ring LME/MCOs to y� Xv maintain the same level of state-funded services as before the funding reductions. •" due ` fi`4 App- Orange County County Stats CompassCenter for Women and Families Population 0 Community Reinvestment Initiative (CRI) Outcomes 144,E r Eligible The Compass Center in Chapel Hill serves individuals and families in Orange County. They provide three main areas of support—teen health education, domestic violence support, and self-sufficiency services. Their CRI project focused on providing crucial mental health and Receiving services housing support for survivors of domestic violence and their children. 31899 CRI funds helped support the first 9 months of a larger two-year project—a housing micro-grant program for longer-germ housing and a mental health services program. Over this two-year Training attendance project, Compass Center hopes to provide at least 54 victims of domestic violence and/or their 428 children with therapy services. Innovations Waiver 174 "Information about the effects of trauma can be a heaver topic to digest, but the Cardinal Innovations team helps staff memibers understand the important details while also enjoying the training session. Our staff is worlding more effectively with students, resulting in a lower referral rate and higher academic performance" — Kristin Rosario,orange CGunty Schools LOCAL RESOURCES SEARCH Cardinal innovations Powered by Aunt Bertha HEALTHCARE - Fiscal Year 2019 (July 2018 —June 2019) Overview Copyright 0 2019 Cardinal Innovations Healthcare.All rights reserved. AUNT BERTHA AND LOCAL RESOURCES Cardinal In—tinns Healthcare 9 Support Sign Up Log In (X Search for free or low cost services for housing,food,transportation,job training,and more. • In May 2018 we published a Local Resources Zip°rke, Pro9ramname search on our external website to enable members ■ I o - . , tosearch for resources themselves online. FOOD HOUSING GOODS TRANSIT HEALTH MONEY CARE EDUCATION WORK LEGAL • This search is powered by Aunt Bertha. 1351 programs Cardinal serve people in Innovations • This data represents cumulative data from 2019 Charlotte, NC {28202} HEALTHCARE,,. and searches only made on our version of Aunt Type a search term, or pick a category Bertha: localresources.cardinalinnovations.org Suggest Program I Claim Programs I Accessibility I Terms I Privacy ®20,2-2019.Po_ dby Aunt Bertha.. Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 20 TOP SEARCHED CATEGORIES The most searched categories in all 20 counties are: Searches by Category S,F6°lo;sa 1,69%; 6%:aducaiion war 8 22%tronsii 0.04%amergoncy 1-49%:morLe 11.74%:load 1,61% legal b^AS 4 5996;foods 32.6M hausin 3 2.6 5% 2 5.31% 11.7 4% 26.31%: health Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 21 CENTRAL REGION Rockingham Stokes Ft rsyt D vie Rowan lenburg Union • . # of searches: 470 # of searches: 27 # of searches: 131 # of searches: 676 # of searches: 133 # of users: 129 # of users: 9 # of users: 41 # of users: 159 # of users: 37 Top 3 categories: Top 3 categories: Top 3 categories: Top 3 categories: Top 3 categories: 1. Housing 1. Housing 1. Housing 1. Housing 1. Health 2. Health 2. Food 2. Health 2. Health 2. Housing 3. Food 3. Health 3. Food 3. Care, Food & 3. Transit Transit (Tied) Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. 22 PROGRAM COVERAGE Total Program Inventory 2000 Totalprograms avail . • 1800 in our catchment: 1600 1400 2018 2019 1200 (May 2018— (Jan 2019— 1000 Dec. 2018) Dec. 2019) 800 600 Local 1,598 1,988 400 200 State 211 457 0 �� J�C� National 613 682 �P �Q� PCBJNO Total 2,422 2,670 ■ 2018 2019 Data as of January 9, 2020 Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. TOP SEARCHED ZIP CODES Zip Code City County Searches Aamgoon■ 28027 CONCORD, NC CABARRUS 828 johnson 28025 CONCORD, NC CABARRUS 404 rrlatown City - > '�reen5boro 28110 MONROE, NC UNION 372 Cnoxviile °f7t'rham Raleigh28208 CHARLOTTE, NC MECKLENBURG 343 Hickory °Ashewiile �O f L �1 Caro I in °Greenville OOF�n 27536 HENDERSON, NC VANCE 289 aF, . m Goldsboro 28269 CHARLOTTE, NC MECKLENBURG 268 _ +Fayettevilie New Bern fl Greenville < Hill Havelock 27215 BURLINGTON, NC ALAMANCE 247 if °WaIhalla --- a Jacksonville Lumberton 28202 CHARLOTTE, NC MECKLENBURG 240 -Anderson 28205 CHARLOTTE, NC MECKLENBURG 238 ¢F larence °Wilmington 27320 REIDSVILLE, NC ROCKINGHAM 230 Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. Cardinal Innovations HEALTHCARE® THANK YOU Copyright©2019 Cardinal Innovations Healthcare.All rights reserved. Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: April 22, 2020 Agenda Item Subject: 3rd Quarter Financial Report FY 19-20 Attachment(s): 3rd Quarter Financial Report 3rd Quarter Billing Dashboard Staff or Board Member Reporting: Rebecca Crawford Purpose: Action X Information only Information with possible action Summary Information: Total Health Department Budget vs. Actuals: Average YTD monthly revenue in FY19-20 after the third quarter is $220k/month or $2.OM YTD, representing 56.3% of our overall budgeted revenue for the year. As usual though, the total third quarter revenue is skewed down due to the majority of state funds not eligible to be drawn in July (this is typical) and allocations of Medicaid Max funds will not be transferred into our budget until the end of the fiscal year. Expenses are above revenues, at 62.7% of the overall budget but on trend with prior fiscal years. Total Billing Accuracy: The medical and dental billing accuracy measure continues to be a challenge as we work with UNC and the Dental EHR, Eaglesoft, 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 19-20 average monthly revenue ($49.4k/month) for the third quarter is above our budget projection ($45k/month) and our FY 18-19 average of $46.6k/month. We are seeing the direct impact of adding the additional Dental Hygienist in FY 18-19 and will potentially exceed our projected annual revenue related to this position ($72,157) since the dental clinic is fully staffed. The dental clinic will most likely see a more immediate, negative impact on revenues than the medical clinics as a result of the severely decreased operations and very limited appointments. FY 19-20 dental earned revenue totaled $445k at the end of the third quarter compared to $393k at the end of the FY 18-19 third quarter. Medical Earned Revenue by Source: Medical earned revenue is currently below the budgeted projection for FY 19-20 ($57k/month) at $42k/month due to provider turnover and as clinic staff continue to work through issues with the billing in the Epic EMR. Most appointments returned to 30-minute lengths in January as the medical clinic is almost fully staffed. Our EMR Quality Improvement team called the "Epic Optimization Team" along with clinic staff have made a large amount of progress in improving revenue from medical clinic services from the Epic system and the monthly average revenue of $42k/month is already higher than it was in FY 18-19 at $35.5k/month. This improvement in billing processing will most likely help insulate the medical clinic from experiencing large revenue deficits until early FY 20-21. Medical clinic revenue totals $378k after the third quarter FY 19-20 compared to $320k after third quarter FY 18-19. Environmental Health Earned Revenue by Source: Environmental Health earned revenue is currently below the budgeted projection for FY 19-20 ($54k/month) at $44.6k/month. It is a seasonal trend to see lower revenue in the first half of the year than in later quarters due to spring pool inspections; however, the decreased revenue is directly related to the limited number of temporary staff available to complete WTMP inspections. EH had 7 temporary Environmental Health Specialists (EHS) working regularly to complete the inspections at this time last year and now have only 3 temporary EHS working irregularly. We found it difficult to recruit and retain the temporary EHS this summer given the heat. As a result, permanent staff in EH are adding WTMP inspections to their current workloads in order to complete them as required by the end of the fiscal year. EH staff continue to inspect where able during the Stay at Home Order, which will result in only a slight decrease in projected revenue for the remainder of the FY. FY 19-20 YTD revenue totals $401 k compared to FY 18-19 YTD revenue of $404k. Grants Fund Revenue: FSA has drawn $200k of the multi-year Kenan grant. Expenditures are tracking as anticipated and will continue to increase since we filled the vacant Navigator position in November. This position was dependent upon additional United Way funds in order to hire at the full time equivalent level, which were approved by the BOCC in September. 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): Orange County Health Department Third Quarter Financial Report FY 2019-2020 General Fund % OF TOTAL HEALTH Q3 YTD ACTUAL ANNUAL BUDGET ANNUAL BUDGET Revenue Donations Health Promotion &Edu 0 (400) (5,310) 7.53% Personal Health (3,487) (5,002) (4,000) 125.05% Donations Total (3,487) (5,402) (9,310) 58.02% Internal Allocations Dental Health 0 0 (41,477) 0.00% Personal Health 0 0 (334,658) 0.00% Internal Allocations Total 0 0 (376,135) 0.00% Service Revenue Dental Health (140,106) (444,544) (541,000) 82.17% Environmental Health (157,534) (401,017) (648,761) 61.81% Personal Health (127,583) (377,640) (681,125) 55.44% Service Revenue Total (425,222) (1,223,201) (1,870,886) 65.38% State Allocations Environmental Health (770) (3,381) (44,600) 7.58% Finance and Admin Services (7,896) (31,584) (42,921) 73.59% Health Promotion &Edu (11,326) (43,919) (63,706) 68.94% Personal Health (97,924) (366,749) (591,491) 62.00% State Allocations Total (117,916) (445,634) (742,718) 60.00% Grants Project Revenue AFDO Grant (2,845) (2,845) (3,000) 94.82% CC4C Accesscare (32,773) (100,279) (147,686) 67.90% Community Health Grant (28,912) (58,681) (145,914) 40.22% MDPP (2,062) (8,974) (18,174) 49.38% PCM Accesscare (35,692) (109,676) (167,334) 65.54% Piedmont Hlth Sry- Nutr (9,593) (24,202) (33,800) 71.60% FIT Grant (1,765) (9,504) (24,397) 38.96% Dental Grant (2,500) (2,500) 0 100.00% Grants Project Revenue Total (116,141) (316,660) (540,305) 58.61% Revenue Total (662,767) (1,990,897) (3,539,354) 56.25% Orange County Health Department Third Quarter Financial Report FY 2019-2020 General Fund % OF TOTAL HEALTH Q3 YTD ACTUAL ANNUAL BUDGET ANNUAL BUDGET Expenditures Salaries 1,401,739 4,273,052 6,549,378 65.24% Benefits 550,203 1,650,271 2,355,378 70.06% Travel 2,879 11,441 25,773 44.39% Training 15,077 31,568 61,598 51.25% Certifications&Licensing 11899 4,832 10,987 43.98% Mileage 7,993 24,634 56,126 43.89% Telephone 3,277 53,200 113,249 46.98% Postage 3,199 9,654 14,273 67.64% Equip Repairs 1,549 4,314 15,100 28.57% Equip Rent 290 1,134 1,200 94.47% Duplicating 1,308 5,358 12,250 43.74% Printing 509 2,209 14,604 15.12% Advertising 704 817 10,035 8.14% Dues 760 5,031 6,300 79.85% Subscriptions 621 1,229 1,600 76.79% Dept Supplies 8,773 21,788 44,390 49.08% Edu Supplies 89 2,503 15,824 15.82% Office Supplies 5,387 13,624 26,834 50.77% Medical Supplies 28,325 89,394 146,240 61.13% Bloodborn Path Supplies 422 942 1,200 78.54% Pharmacy Supplies 9,292 86,558 172,308 50.23% Comp Supp/Software 1,316 3,778 6,433 58.73% Contracted Sry 123,987 460,358 1,029,161 44.73% X-Ray 2,567 3,983 22,625 17.61% Lab Sry 18,551 60,323 133,669 45.13% Bonds&Insurance 0 0 10,815 0.00% Uniforms 0 2,638 6,100 43.24% Community Proj 61685 18,794 49,956 37.62% Innovations Project 77 5,201 15,000 34.68% Accreditation Project 0 3,250 3,250 100.00% Credit Card Exp 3,134 8,661 11,000 78.74% Nicotine Replacement Therapy 3,903 3,903 10,000 39.03% Capital Exp Under$500 4,111 11,333 9,774 115.96% Equipment 7,973 9,709 8,728 111.24% IT Equipment 210 1,178 600 196.30% Expenditures Total 2,216,810 6,886,661 10,971,758 62.77% Orange County Health Department Third Quarter Financial Report FY 2019-2020 Grants Fund YTD ANNUAL % OF ANNUAL TOTAL HEALTH Q3 ACTUAL BUDGET BUDGET Revenue Kenan Grant 0 0 (100,000) 0.00% United Way Grant 0 (15,905) (31,809) 50.00% Revenue Total 0 (15,905) (131,809) 12.07% YTD ANNUAL % OF ANNUAL TOTAL HEALTH Q3 ACTUAL BUDGET BUDGET Expenditures Salaries 27,593 59,446 168,361 35.31% Benefits 12,306 25,347 49,125 51.60% Training 2,635 3,220 4,096 78.61% Mileage 817 875 11,639 7.52% Contracted Sry 0 0 27,568 0.00% Community Proj 0 0 7,335 0.00% IT Equipment 0 0 2,150 0.00% Expenditures Total 43,351 88,888 270,275 32.89% TOTAL HEALTH DEPARTMENT REVENUE ENVIRONMENTAL(EH)EARNED REVENUE BY SOURCE vs.Budget Projections&Prior Year vs.Budget Projection&Prior Year $350 $80 $70 F $300 ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ~ 248 239 $60 52 55 $250 226 233 ■ ■ ■ 147■ ■ ■ ■ ■ ■ ■ � ■ ■ ■ W100 ■ ■ ■ ■ ■ ■ ■ ■ 209 212 207 213 + A. $50 191 $200 $40 37 33 $150 $30 $100 $20 $50 $10 Ir $0 ' i M � ■ , $0 8 • ■ • 1w ■ ■ ■ ■ 1 1 A S 0 N D 1 F M A M 1 1 A s O N D 1 F M A M 1 -Wells Tattoo Parlors Personal Health iiiiiiiiiiiii■HPES Septic Samples iiiiiiiiiiiii■Public Pools iiiiiiiiiiiii■Food and Lodging = FAS Environ Health Fees • Total Earned Revenue($401k YTD) Dental • Total OCHD Revenue($2.M/y) . ■ ■FY19-20 Budget Proj($54k/m,$649k/y) YTD Mth Avg($44.6k/m,-$535k/y est) YTD Mth Avg($220k/m,-$2.6M/y) . ■ ■FY19-20 Budget Proj($294k/m,-$3.5M/y) FY18-19 Mth Revenue($594k/y) FY18-19 Mth Revenue-Avg($49.5k/m) DENTAL EARNED REVENUE BY SOURCE MEDICAL(PH)EARNED REVENUE BY SOURCE $70 vs.Budget Projection&Prior Year N $60 55 vs.Budget Projection&Prior Year ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ 58 58 $60 54 $50 47 50 49 41 2 42 4 $50 47 ■ ■ 4ti■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■\ $40 34 \ $40 $30 $30 $20 $20 $10 . $10 $0 $0 1 A s O N D J F M A M 1 J A S 0 N D 1 F M A M 1 SELF PAY �INSURANCE SELF PAY INSURANCE MEDICAID • Total Earned Revenue($445k YTD) MEDICAID • Total Earned Revenue($378k YTD) a ■ ■FY19-20 Budget Proj($45k/m,$541k/y) YTD Mth Avg($49.4k/m,-$593k/y est) ■ ■FY19-20 Budget Proj($57k/m,$681k/y) YTD Mth Avg($42.k/m,-$504k/y est) FY18-19 Mth Revenue($559k/y) FY18-19 Mth Revenue-Avg($46.6k/m) FY18-19 Mth Revenue($487k/y) FY18-19 Mth Revenue-Avg($40.6k/m) Board of Health Dashboard - OCHD COVID-19 Response Q1 Patient Encounters, 2019 vs. 2020 Telehealth Services Expenditures 1200 1017 991 1047 977 loos loo0 92 Com pfetedvisits $ 149,424 Total Exp. 800 58 Video March $ 137,794 651 664 678 605 668 655 34 Phone Only April $ 11,630 600 400 353 COVID Testing 200 47 Tests completed in-house 0 January February March Whitted Southern ■Medical 2019 ■Medical 2020 Dental 2019 ■Dental 2020 March 13 6 April 28 0 OCH D Covid-19 Response Work 250 Communications - Phones and Email Social Media Translations 200 196 Week Posts 150 159 3-16 to 3-22 191 3-23 to 3-29 230 Translations completed 150 3-30 to 4-5 219 in the last six weeks 100 95 4-6 to 4-12 293 alone. 62 50 38 Views Follows/Likes For comparison, in FV17- 0 43.4k 211 18, the team completed 0 142 translations in the March April 200 130 whole year, and 228 COVID Nurse Line COVID Info Line Emails 265.5k 273 total in FY18-19. Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: April 22, 2020 Agenda Item Subject: Roles of BOH in Accreditation Attachment(s): Roles of the BOH in Accreditation Staff or Board Member Reporting: Rebecca Crawford and Ashley Rawlinson Purpose: Action X Information only Information with possible action Summary Information: To provide a review of how the N.C. Local Health Department Accreditation program specifically addresses Board of Health roles and responsibilities. We will review the purpose of accreditation, discuss specific Board of Health-related activities around five domains and clarify how the Board is involved in these activities. 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): �OytH CARQZ/ry9 North Caroll* na O � 0 A d � � LOCAL HEALTH DEPARTMENT ACCREDITATION a �oPAdtment P �ea Roles and Responsibilities of Boards of Health Related to North Carolina Local Health Department Accreditation (NCLHDA) Version Update: 1.1.20 Presentation Overview 1 . Review of purpose of accreditation 2. Identification of activities related to Board of Health involvement 1. Finance 2. Community Health 3. Health Director/Staff 4. Rules and Ordinances 5. Board Function 3. Questions and Comments PH • SS Organization and Governance Resolutions ofJuly ` III 5 NOOL C GOVERNMENT 1 I F7SS &PH agencies with appointed governing boards Option 1 with both SS&PH agencies governed by BOCC(Graham, Stokes, Sampson, Pamlico) # ❑ Option 1 with SS agency governed by BOCC, PH agency with appointed governing board(Cherokee,Ashe, McDowell, Cleveland, Mitchell, Watauga, Wilkes, Surry, Columbus) Option 2 with consolidated HS agency includingS.S & PH, appointed CH5 board(Haywood, Buncombe, Palk, Gaston, Davie, Union, Forsyth, Stanly, Rockingham, Wake, Nash, Edgecombe, New Hanover, Carteret, Dare) ❑ Option 3 with consolidated HS agency including SS & PH, governed by BOCC, health advisory committee (Clay, Swain, Alexander, Yadkin, Mecklenburg [no advisory comm.], Guilford, Montgomery, Richmond, Bladen, Brunswick, Pender, Onslow) Option 3 with consolidated HS agency includingSS & other human services but not PH, governed by BOCC(Cabarrus) Carolinaorth DEPARTMENTLOCAL HEALTH All LHDs in North Carolina have been accredited and reaccredited at least once . 0 0 0 -0 0 0 0 0 0 ALL NORTH 84 CAROLINA HEALTH DEPARTMENTS REACCREDITED AS OF MAY 16. 2018 Basl* c Components of the rocess • Self-Assessment by the Agency • 147 Activities & 41 Benchmarks • Site Visit • Peer volunteers - Administration, Environmental Health, Nursing, Board of Health (BOH� • Review documentation, tour facilities and conduct interviews • Site Visit Report — recommendation • Board Adjudication North • Activities and ScoringRequirements • Agency Core Functions and Essential Services • Assessment: Department must meet 26 of 29 activities • Policy Development: Department must meet 23 of 26 activities • Assurance: Department must meet 34 of 38 activities • Facilities and Administrative Services • Department must meet 24 of 27 activities • Governance • Department must meet 24 of 27 activities y�tN CAR04, u North Carolina DEPARTMENTLOCAL HEALTH ACCREDITATION NCIPH The notifies LHD LHD uploads that HDSAI evidence into is due within the dashboard 90 days o f Accreditation s� Notification to Site visit y v official award LHD is between takes 9.5 conducted accreditation months Preparation cycles for next accreditation cycle begins NCLHDA Board Reports finalized votes on and sent to LHD accreditation with recommendation accreditation . and awards recommendation status ®o 1 LHD has 10 MP days to provide written - response to findings Carolinallorth DEPARTMENTLOCAL HEALTH Pur ose of NCLHDA Programp The focus of NCLHDA is on the , capacity of the local health p Y Assure department (LHD)to perform at wo a prescribed, basic level of Link . y jf#�qw, .: f= , quality =i�ffv Laws +, SO Nofth Carolina LOCALHEALTHDE .A. • Connectingthe ots Nc STATE a. ti4r y ` n 9 0 0 *�aun�4 KRf, NCDHHS Current public Existing contractual and program health practice 'I monitoring requirements for the Division of Public Health NCLHD ~,,sss3 Accreditation foilProgram NOT a wholly new State statutes and Essential Services Core Functions accountability system administrative code North • • identify "The process is one performance that will challenge the Accreditation improvementprovides a g opportunities health department to framework • improve think about what management business it does and health • develop leadership how it does that department t • • improve •1 p relationshi s with business. the community AM Public Health Accreditation Board, 2013 DEPARTMENTNorth Carolina --low LOCAL HEALTH Results of 2019 Surveyqb : Quality Improvement Stimulates QI and Improves Specific Performance 80% Processes and Policies 69% Improvement within Agencies Opportunities within Our Agency 73% Helps Our Agency Become 60% Helps Our Agency More Effective Become More Efficient Results of 2019 Survey: Relationships I Gives Our Agency I 70% Credibility with Our Partners Gives Our Agency 50% Improves Relationships 65% Credibility with Our with Our Community Community Results of 2019 Survey4P : Strategy O 66% Helps Our Agency Focus on Key Priorities �•7 Challenges Our Agency Gives Our Agency 72% to Think About How It C2% Objective Information to Does Business Request Funding and/or Other Resources Better documentation across agency _ � Credibility with County Manager, Board of Health, and County Commissioners � � Strengthens agency policies and Staff collaboration across understanding of them departments � Confidence building within � Advanced ability to advocate for public Results of 2019 Survey:, Other Ident*lf*led Sources of Value Internal External organization and pride of staff health funding North Carolina LOCAL HEALTH DEPARTMENT ACCREDITATION Being accredited helps position health departments and give them credibility as a respected player in the future of integrated healthcare and population health initiatives. ooiA caRoz,,� - PROVIDE RS. O ACHC = f� (p C o�pd G�ea. ''gym ant P� AAAHC I ACCREDITATION ASSaCuATiON �.`� Joint � ii � AF AMBULATORY HEALTH REd FNC. Carolinallorth LOCALHEALTHDEPARTMENTAcCREDITATION The Law • Senate Bill 804 - Established NCLHDA Board within N.C. Institute for Public Health (17 members appointed by N.C. Department of Health and Human Services Secretary) - Directs Commission to adopt rules establishing standards for LHDs - Mandates all LHDs to obtain (by December 1, 2014) and maintain accreditation • 10A NCAC 48B § 130A-34.4. Strengthening local public health infrastructure. - Defines scoring requirements by (a) By July 1, 2014, in order for a local health department to be eligible to receive State and federal public health funding from the Division of Public Health. the following criteria core function shall be met: (1) A local health department shall obtain and maintain accreditation pursuant to - Describes Benchmarks and Activities `'` t InA-;" North • LOCAL HEALTH DEPARTMENT ACCREDITATION North Carohna i Roles and Responsibililies of Boards-ul H-calth ReWed 4a N-C "I Health D- parlment Accmditalion(NCLHDAM Guide :;fir"ft.�guide k;gTli.lalq w aA Fd d;4 kwF h k 6�nwn2 w art mwee r-w i Ftawd(Pvdh 0r qmoc&TFrn4wvimkwgn of the AdI6m vryCamrra mm gn H&tM(ACH)bmg able to nxvt du t amvicy Uw*M%. v ir«requi-ed A w4wr4e;w Stand(trxdibwwd DOM csuoe emirtm,diimwL vi c rmb"ced Hffat 5ernors(0155 Boa.Y4 or B&ud M Craurin OWfttMlW ryas CQI.Ms,LMx s dhe posti,rr duties e4 Cbe traditiurwJ Mird cid I*aldt Sm the MDSAY"9 HDSA!lntupFetiiare t'ds mor*de[as7k+d MbftmUGaCL Etistetwe-U>olkv. HeAecw Review L7iKtiv6a1orl Appr vjJ C46trAdLkm of 3nd-Ikr. US 2".' -M nunurt c17&dcri in •'� I 13 N :� �t P0.1k "a1 l relectmg drnmmiDa Gf sery ce oamptuaer nyth LHD's rurresgondemr valb B CC 14w cw is p t'vp p*11#WP AA'P vilmu awilm A •�lY-�rv3f`+**i+ URD frrl+W en 6eireEmIm t rL-V&t* asscrcmes�Faf admmU ution) 6ound3bOMMsugPorIEW f D4nC 1 LFfD dkn s Ga mcum 39 3 cru k9 3.76. FCf M 4 R fIs Err 17US 376 Iscloi rmimm 0{cr in I7rcw Ls== p;iw"pr �H rq,"de,c o m. q chf s 2;ha.%.trar FifLUM? wd hpprussa]ad &ad;p=4r grmd O.(d lu9er mrreipuademrm r." depJIftrCIr tl!! 31 uxweai is ad&4w mwnt(pri{ fLM7.11 Wq 6r M7 ad&2%j rx+r� wrri 33 7 �w w btid�4 fraj.a.dp;"aPrWLr n6may 39 3: mlmrle4 n4kLq,." rrt-.OW LOCI+wfld4 orth Carolina t�°THcur'""s LOCALHEALTHDE .A. Important otes Italics: requirement may apply depending on governance structure, whether other documentation options are chosen/not chosen and whether there is a Health Director vacancy. 'Health Director may serve, or be directed by the Board to serve, as the designee for the BOH for correspondence. However, it is expected that there be some type of link to and from the BOH showing their involvement and engagement. y�TN CARpV u North Carolina DEPARTMENTLOCAL HEALTH ACCREDITATION Board 1 . Ensure you have required policies, procedures or materials. 2. Hear or review LHD reports. 3. Discuss service costs, need for new/amended rules or ordinances. 4. Approve fees and budgets. 5. Take other actions or be involved with efforts to assure the health department has what it needs to do its job. y�TN CARpV u North Carolina DEPARTMENTLOCAL HEALTH ACCREDITATION Finance The Board must: • Review financial reports. • Discuss service costs as well as approve fees and final budget. • Advocate with a wide array of funders in support of LHD efforts to secure financial resources to provide essential services. CommunityHealth The Board must: • Ensure input on community health improvement efforts. • Hear reports on community health. • Support partnership and coordination of resources. • Educate and advocate with community leaders about community health issues and support for these issues. t North • LOCALHEALTHDEPARTMENT ACCREDITATION Health Director/Staff The Board must: • If the Health Director position becomes vacant, make and implement plans to recruit and secure a credentialed and qualified new Health Director. • Review and approve the Health Director's job description and performance evaluation. Board Function • Board members must receive initial (within the first year of appointment) and ongoing training on BOH roles and responsibilities. • Board must have Operating Procedures, an annually updated handbook and a training policy/procedure. Rules & Ordinances The Board must: • Have access to legal counsel and statutes. • Have policies for rulemaking and appeals and demonstrate It is following said policies. • Along with the LHD, evaluate the need for additional or amended rules/ordinances. • Support prohibition of tobacco within 50 feet of all LHD facilities. North10,0 • What can you do to be a "good" BOH member? 1 . Attend meetings re ularly, so quorums are reached and, thus, required items can ge approved on schedule. 2. Document your activities regarding community health and contribute to discussion during Board meetings. a. Carefully review meetin minutes to make sure your comments were capture. 3. Complete required trainings promptly. r I. S Questl* ons & Comments !1,77777' � North Carolina LOCAL HEALTH DEPARTMENT ACCREDITATION � +Y �F a •Y. .} :' •_ _ ,:� r -- �� . 'fir .� { For additional information about the NCLHDA 4 a RR¢ u Program visit: NCLHDaccreditation.unc.edu For questions please email: - 71 NCLHDaccredit ` .4+ • ; + 1 The North Carolina Local Health Department Accreditation Program part of the North Carolina Public T PublicHealth at the Gillings School of Global Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: April 22, 2020 Agenda Item Subject: Biannual Advisory Board Report Attachment(s): Biannual Advisory Board Report Staff or Board Member Reporting: Beverly Scurry Purpose: Action X Information only Information with possible action Summary Information: The Board of Health identified action steps related to engagement in the 2018-2020 Strategic Plan. One of these action steps is to receive biannual updates on actions of other Orange County advisory boards that relate to the BOH strategic plan priorities. The summary provided contains BOH top priorities related information from various Orange County advisory boards from October 2019 to March 2020, as available from the boards. 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): ORANGE COUNTY ADVISORY BOARD SUMMARY OCTOBER 2019 - MARCH 2O20 Board of Health Engagement Submitted April 14, 2020 O 04/14/2020 Biannual Report Board of Health Engagement \RT BOH SUMMARY PRIORITY Orange County Substance Minutes only current online up to October 2019* Schools Board of Abuse and Education Mental Health, • The Board chair attended OHS meeting in Physical association with the Health Department in regards to Activity and drugs and alcohol. Nutrition, • The Board intends to go through a Board Equity Equity Training in Jan 2020. • Dr. Felder was welcomed as the new Superintendent of Orange County Schools Chapel Currently no updates related to the Board of Health. Hill/Carrboro City Schools Board of Education DEAPR — Parks Physical • Blackwood Farm Park update — Sketches for the and REC Council Activity and next phase with possible facilities are being Nutrition developed including a disc golf course and amphitheater. • Orange County recently acquired land near Cane Creek that will provide a section of the Mountain to Sea corridor and trailhead. There is also additional work to connect Occoneechee Mountain to Seven Mile Creek (Phase 1) and Phase II will connect Cane Creek area to Seven Mile Creek. Board of County Social In October 2019, Commissioner Price petitioned the Commissioners Determinants Board to support a collaborative effort between the of Health, Orange County Health Department and UNC Medical Physical regarding the opioid epidemic. Later in the month, the Activity, Board approved expressing support for an Opioid Substance Task Force to coordinate efforts to address opioid Abuse & overdose in Orange County and will be facilitated Mental Health jointly by the Orange County Health Department and the UNC Medical Center. • In October 2019, the Board approved a contract with Lifeline Mobile for $445,748 to purchase a mobile dental clinic, and authorized the Manager to sign the contract. • In November 2019 the Board approved changes to the volunteer application for advisory boards and 04/14/2020 commissions. • The Board approved creating a full time Deputy Sheriff I Position in the Orange County Sheriff's Office for assignment to Eno River Academy. • In December 2019 the Board to certified seven (7) farm properties totaling 375 acres and designated them as Voluntary Agricultural District farms within the Caldwell, Cedar Grove, High Rock/Efland, Schley/Eno, White Cross, and Cane Creek/Buckhorn Voluntary Agricultural Districts; and enrolled the lands in the Orange County Farmland Preservation Program; Voluntary and Enhanced Voluntary Agricultural District (VAD and EVAD) programs. The Orange County Farmland Preservation program has enrolled 121 farms totaling 12,868 acres in the VAD and 2,566 acres in the EVAD for a total of 15,434 acres in the program. • The Board approved the creation of a full time time- limited position at DSS to provide assessment and case management for homeless persons with mental health needs. Chapel Hill Town Physical . The Council received a presentation on current bike Council Activity and and pedestrian projects, funding streams, the Town's Nutrition, implementation process, and allocations in October Equity 2019. Carrboro Town Physical . In October2019, the Board of Alderman received an Council Activity and update on the Town's Affordable Housing Goals and Nutrition; Strategies. The board recognized the high rental Social costs relative to the market and the need for more Determinants affordable housing. of Health . In November 2019, the board discussed increasing the diversity of town boards by reviewing the application process. • In November the board also officially will be known as a council and not Alderman in order to be gender neutral. • The council authorized contingency funding to support the Sankofa African-American Museum on Wheels event scheduled for Jan. 2020. • The council received a report on the comprehensive bicycle transportation plan. Hillsborough Social . In December 2019, the Hillsborough Town Council Board of Determinants welcomed the first woman mayor for the Town of Commissioners of Health Hillsborough, Jenn Weaver. 04/14/2020 Transit Advisory Social . OCPT introduced two new staff members Services/OCPT) Determinants . OCPT is now doing mobile ticketing to pay for ride — riders can set up an account and add a credit care. Cash will still be accepted. • OCPT developed a Safety and Security Plan found here. Healthy All . Conducted six focus groups with populations that Carolinians of were under-represented in the data collection Orange County process. • Those populations were Karen speakers, Spanish speakers, Burmese speakers, Kinyarwanda speakers, individuals experiencing homelessness and youth. • Conducted three community input sessions to gather input and feedback from community members in regards to the health of OC • Input sessions were held at Cedar Grove Community Center, Southern Human Services Center and Chapel Hill Public Library. • The fourth session was cancelled due to inclement weather • Collected and analyzed all of the collected data (primary and secondary) • Currently working on compiling all of the information from collected data, community partners and content experts to produce the 2019 CHA • The 2019 CHA will be finalized and submitted to NC DHHS (Dept. of Health and Human Services) on May 1 st Family Success Social . Impact: We have changed our program assessment Alliance Determinants mechanism to better identify improvements we've of Health made in the lives of our participants. We anticipate these new measures (such as food security, mental health needs, feeling confident in ability to assure child's school meets child's learning needs, and understanding participant goals for family empowerment) will more easily show our impact in future reporting periods. Of the 146 families who responded to the family assessment 81% (118) said they spend more than 30% of their income on housing compared to 18% (27) who said they spend less than 30% on their housing. • Navigator Program: We have enhanced the FSA navigator program by creating FSA Connections. The FSA Connections program was designed to support 04/14/2020 families upon graduation or completion from the Family Navigator program. The FSA Connections program allows FSA to maintain contact with families formerly assigned to a navigator as well as to provide services to those families on the Family Navigator waitlist to ensure that needs are addressed pending a navigator assignment. • NC Cares360: We are excited to now be a part of the statewide NCCARE360 care management system and see this as a way to improve our ability to connect FSA families to the services they need through warm handoffs and follow-ups while also accurately capturing the data we need to show success and challenges. • Kindergarten Readiness: FSA has sponsored a Kindergarten Readiness camp in each zone for 5 years. To date, 378 rising kindergarteners have participated in the program. As a result of receiving Oak Foundation funds, Chapel Hill Carrboro City schools will extend their Ready to K program for 60 to 140 students. • Partner Network: FSA coordinates a partner network. We recently expanded the network from 10 to 16 partners. We use the network to center parent expertise and priorities as we problem-solve and work towards outcomes for families. We aim to provide a space for natural partnership and accountability to assist each other in identifying strengths and gaps in service provision. • Community Council: FSA has re-tooled the Parent Council and it is now called the Community Council. Navigators worked together to recruit parent representatives from larger communities from both zones. The council currently consists of 10 FSA parents and other individuals of specific communities who are currently active or have a strong interest in advocating and making changes for and with their neighbors. It is FSA's mission to learn from these parents about the strengths and needs of each community that FSA will be serving and to also provide information and resources to these parents in a way that can be redistributed by these parents to 04/14/2020 their respective communities. FSA will offer an incentive to active participants for the funding and support of smaller community project proposals. The community project proposals will be created, with assistance from the navigator team, by each interested council member and be specific to their residential community. The group will meet quarterly. Justice Advisory Substance The Jail/Mental Health Workgroup met in December 2019 Council — Abuse & and March 2020. Jail/Mental Health Mental Health • In collaboration with the Sherriff's Office, the group Workgroup updated the Jail Intake form to be more streamlined and to more easily track data. Data tracking began January 1, 2020. • Familiar Faces Workgroup — • Behavioral Health Task Force subcommittees include: o Familiar Faces — chaired by Alison Zirkel o Diversion/Crisis Center chaired by Tony Marimpietri o Day Center chaired by Corey Root o All have begun meeting and gathering data. Subgroups will provide quarterly updates to the main task force. • The Jail Psychiatry program underwent a warm hand off from Criminal Justice Resource Department to Freedom House; it's going well with better care coordination. • Jail Budget update: Re: Medication Assisted Therapy- Health Department will fund pregnancy tests and naloxone kits for the coming year. Drug screens and additional MD time probably through ABC grant. • New jail- opening is currently slated for May 2021. • Dr. Tim Daelman (FP) will begin a drop in clinic at University Methodist Church on Franklin St. UNC FP department is giving him the time and UMC is giving him the space. • Community Resource Court will be celebrating its 20th Anniversary. Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: April 22, 2020 Agenda Item Subject: Physical Activity and Nutrition Grant Award Attachment(s): None Staff or Board Member Reporting: Jessica Frega Purpose: Action Information only X Information with possible action Summary Information: The Physical Activity and Nutrition subcommittee annually provides community support grant funds to both county school systems. The schools have an opportunity to apply for funds up to $1000 for projects that address physical activity and nutrition. The Board will present applicants who applied and announce the school who will receive the funding. 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): Health Director's Report April 2020 • March 31,2020—OCHD had our FY 20-21 Budget meeting with County Manager; in lieu of COVID-19 we received new information to support economic contingency plans for the remainder of this fiscal year and into next year. We were asked to reduce purchasing/spend rates, closely monitor revenue and expenditures, and implement the hiring freeze for positions that are not mandatory and/or essential to Health at this time. We are updating our budget and looking to make a few changes in response to this contingency plan. Revisions/reductions will not impact staff or any of our essential services. • April 9,2020—Pursuant to Executive Order 119, and the sub delegation of authority granted by the NCDHHS Secretary Mandy Cohen,MD,MPH,the NC Local Health Department Accreditation Board waived accreditation scheduling requirements for twelve(12)months effective May 9,2020. This grants all fully accredited health departments in NC an accreditation extension of twelve(12)months. • April 15,2020—Secretary Cohen,MD,MPH issued a public health waiver to all local health departments per Executive Order 119.Local health departments received six waivers that will not endanger public health and will provide necessary relief to allow us to focus efforts on responding to the COVID-19 pandemic. Specific activities waived include: • Requirement to conduct a yearly Quality Review of clinical and non-clinical records in all administrative, environmental, clinical, and educational services and activities mandated by the Commission for Public Health o Amendment to inspection frequencies for certain establishments, including food and lodging institutions, public swimming pools, spas,child day-care facilities and camps. This does not waive complaint investigations, emergency responses,consultative visits and related public health activities,including enforcement actions. • Requirement to offer a vaccine clinic at least once each month accessible to working parents. • Requirement to provide the Venereal Disease Control provisions(diagnostic testing&exams for syphilis and gonorrhea,treatment services, counseling/education, follow-up and referral) each weekday. • Requirement for public health nurses without a nursing degree from an accredited,baccalaureate-degree- granting program to complete an introductory course in principles and practices of public health nursing within one year of employment; a 12 month extension has been granted. • Assistant Secretary for Public Health or his designee has authority to provide written guidance to local health departments as to how to provide mandated and essential public health services during this pandemic in compliance with requirements found at 10A NCAC 46, Section.0200. • Census 2020—For Week Ending April 12,2020 this is how Orange County,NC has responded: 0 54.8%of households in Orange County have self-responded to the 2020 Census between March 12 and April 12,2020,above the state response rate of 44.9%. Orange County is currently ranked 1 out of 100 counties in NC. 0 54.4%of Orange households responded to the census online versus 38.4%of all NC households. 0 0.4%of Orange households responded to the census by phone or mail versus 6.5%of all NC households. *I've attached the full report for Orange County: Census 2020 Real-Time Response Rates- Week Ending April 12m Upcoming Events Many of our events have been postponed in an effort to implement social distancing during this phase of the COVID-19 event. Orange County: Census 2020 Real-Time Response Rates - Week Ending April 19 How is Orange County performing? 56.8% of households in Orange County have self-responded to the 2020 Census between March 12 and April 19, 2020, above the state response rate of 46.6%. Orange County is currently ranked 1 out of 100 counties in NC. How are people responding to the 2020 Census in Orange County? 56.3% of Orange households responded to the census online versus 39.9% of all NC households. 0.5% of Orange households responded to the census by phone or mail versus 6.7% of all NC households. Where are people responding in Orange County? (Top 5 Tracts) Rank Tract Number Self-Response Rate 1 107.06 75.9% 2 112.02 65.3% 3 119.01 64.9% 4 119.02 64.6% 5 122.02 64.0% Where are people not responding in Orange County? (Bottom 5 Tracts) Rank Tract Number Self-Response Rate 27 116.02 35.9% 26 113 44.2% 24 114 45.1% 24 117 45.1% 23 108.01 50.2% How many households in Orange County self-responded in past census counts? Historic census self-response rates for Orange County were 66.0% in 1990, 68.0% in 2000, and 73.0% in 2010. NC COUNTS COALITION C A R O L I N A J� Vrwm DEMOGRAPHY https://ncdemography.org I demography@unc.edu How are target groups responding in Orange County? Young Children - 5.9% of NC population ages 0-4 % Young Children #of Tracts Average Response Rate Less than 4.1% 13 55.5% 4% to 5.5% 6 57.4% 5.5% to 7.2% 6 58.3% 7.2% or higher 2 53.6% Immigrant Population - 7.9% of NC population is foreign-born % Foreign-Born Residents #of Tracts Average Response Rate Less than 2.9% 0 n.a. 2.9% to 5.7% 3 50.5% 5.7% to 9.8% 6 53.9% 9.8% or higher 18 58.2% Minority Population - 34% of NC population is American Indian, Asian/Pacific Islander, Black, or Hispanic/Latinx Minority Residents # of Tracts Average Response Rate Less than 14% 2 55.3% 14% to 28% 15 58.7% 28% to 50% 10 53.2% 50% or higher 0 n.a. No Internet - 21% of NC households do not have Internet at home % HH with no Internet # of Tracts Average Response Rate Less than 12% 14 58.7% 12% to 21% 11 56.3% 21% to 31% 1 45.1% 31% or higher 1 35.9% NC COUNTS COALITION C A R O L I N A DEMOGRAPHY https://ncdemography.org I demography@unc.edu Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: April 22, 2020 Agenda Item Subject: COVID-19 Q & A Attachment(s): Staff or Board Member Reporting: Quintana Stewart Purpose: Action X Information only Information with possible action Summary Information: Quintana Stewart will give an update on COVID-19 status in Orange County. She will also take questions from the Board. 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): 4 i agenciesHere ' s how local law enforcement / enforcingre the stay at � home ''. . . ' � � � �.� �� F�{, , 4 {�� Y �t •a�!4� ��•zt�'.t'17A+t- � � h� � �t4� ti� '�.""S�` , � pOLICE Chapel Hill Police vehicles standby at the Chapel Hill Police Department on FW Buy Photos Tuesday, Jan . 28 , 2020 . Chapel Hill Police Chief Chris Blue said his own department has focused on educating , not punishing , residents who they find may be in �'��, .'�! F M • * ' - its �Y',y,.. • :p' �' ? � • �� i;: , , i „'� �' •� fr �}w� ,�, • ,emu x, t, l _�- " � • ,�f ,- -ice ! ` � 7 _ r - violation of - order . CHASE • PERRY In the wake of stay � at � home orders mandated by the county and the state , Orange County law enforcement agencies are prioritizing education over punishment to slow the spread of • • Following Orange County' s stay - at - home order going into effect on March 27 , Gov. Roy Cooper issued a state order that became effective on March 30 . The order mandated that all North Carolinians stay home except for essential travel until April 29 and limited gatherings to 10 people . Kristin Prelipp , the communications manager for Orange County's Health Department , wrote in an email that ignorance of the social distancing mandated by this order would increase COVID - 19 cases . " The number of COVID - 19 infections depends on how we all behave , " Prclipp said . " In the case of this virus , if people stay at home , only leaving the house to carefully conduct essential business , the number of infected community members will go down . " Chapel Hill Police Chief Chris Blue said his own department has focused on educating, not punishing, residents who they find may be in violation of the order . Blue said upon checking on the residence of a suspected violation , an officer may deliver an informational flier about the importance of the order without making any arrests . " Our position has not been to go out and take enforcement action unless we absolutely have to , but instead to remind folks of the order and what it means , what' s permissible and what' s not , " Blue said . Although there have been at least two incident reports filed where people broke the stay- at - home order , the Chapel Hill Police Department has yet to charge anyone in relation to breaking the order . Blue said responding to complaints by concerned neighbors and observing violations were both common ways for officers to find violations . He said officers may monitor certain areas or businesses where violations of the order have been observed to ensure that no further enforcement actions must be taken . "We've had a number of people calling on their neighbor , calling on neighborhood kids , but we have not charged anybody, " Blue said . Blue said to his knowledge , there have been no repeat calls for the same violators in Chapel Hill . Although he said the department has thus far been warning first - term violators instead of seeking charges , any violation may be charged as a class two misdemeanor . In Hillsborough , a man was charged on April 5 for violating the governor' s executive order after officers responded twice to the same block party of 30 - 50 people . However , Andy Simmons , a lieutenant for the Hillsborough Police Department , said repeated violations like this are not the norm . "We typically show up and assess the situation , and if we need to give a warning we " give a warning, " Simmons said . " If there' s no violation , we continue to move on . Alicia Stemper , a spokesperson for the Orange County Sheriffs office , said the county is warning residents found in first violation of the order and asking them to go home . " Our goal is to have the community comply with the stay- at - home order , " Stemper said . " That' s what' s safest for all of us . We' d much rather educate and encourage folks to comply than need to resort to anything like enforcement . " Blue said in addition to contacting CHPD at its headquarters or calling 911 , concerned community members can reach out to the Orange County Health Department if they suspect a violation of the order . Officials are hopeful the stay - at- home order will outlast the worst of the pandemic and slow the virus' spread . Blue said the low number of reported violations make him hopeful that the policy will be effective in Chapel Hill . "We've been successful as a community . Not just the police department , or town hall or the health department or the county , " Blue said . " It' s all of us . We are being successful because people are complying and holding each other accountable . " @sclaire _perry @DTHCityState 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 Custom Search 4) INDY : Menu BEST OF THE TRIANGLE NEWSLETTER SIGNUP NEWS ARTS & CULTURE MUSIC FOOD & DRINK GUIDES EVENTS INDY WEEK PRESS CLUB MY ACCOUNT THE INDY IS FREE . MAKING IT ISN ' T . Support fearless independent local journalism . Join the INDY Press Club today . More Than 60 COVID 19 Cases Reported at Orange County Assisted Living F a 61 1 ity BY SARA PEQUENO APR . 08 , 2020 6 : 53 P . M . Governor Cooper announced Wednesday that more than 60 cases of COVID - 19 have been reported at a long-term assisted living facility in Orange County . Two people there have died, he said . The home, on Mount Sinai Road in Durham, is currently operated by the for-profit group PruittHealth. State representatives Graig Meyer and Verla Insko and state Senator Valerie Foushee released a joint statement shortly after Cooper' s press conference, saying they have full faith in the Orange County Health Department, Duke Health, and UNC Health. "We want to express our most sincere care for the residents and staff at PruittHealth' s Carolina Point facility," they said. "We also understand how this must feel to their concerned families who are learning this news . " An April 2 press release from the Orange County Health Department said that two cases had been reported at the facility : a staff member and a resident. Both individuals were moved to a separate facility . The county government ' s website has not reported any new cases there since. The health department did not immediately respond to the INDY' s request for clarification. When the INDY reached out to PruittHealth' s facility for comment, a staff member hung up after a reporter mentioned the COVID- 19 cases . It did not respond to subsequent phone calls or written requests for comment. In 2008 , while operated under a different for-profit company, the facility shut down after state investigations detailed severe health and safety concerns . A 2019 inspection reported that a resident with dementia had been found outside lying in a drainage ditch with a body temperature of 90 . 5 degrees Fahrenheit. The resident was then taken to the hospital . The inspection found that there was no threat of immediate harm to other residents . Contact digital content manager Sara Pequeno at spequeno@indyriwk. coin . DEAR READERS, WE NEED YOUR HELP NOW MORE THANEVER. Support independent local journalism by joining the INDI' Press Club today. Your contributions will keep our fearless watchdog reporting and essential arts and culture coverage viable in the Triangle, coronavirus be damned TAGS ORANGE COUNTY HEALTH DEPARTMENT ASSISTED LIVING GOVERNOR ROY COOPER CORONAVIRUS ORANGE COUNTY COVID- 19 NEWS PRUITTHEALTH BY SARA PEQUENO APR . 08 , 2020 6 : 53 P . M . RECOMMENDED STORIES SPONSORED CONTENT l f , 4 Retirement The Scene That Chiropractors Communities Near Ended " I Dream Of Baffled : Simple Durham - Here ' s the Jeannie " For Good Stretch Relieves Yahoo Search I Hooch I Sponsored healthbenefits .vip Legend Who Bought The Cost To Rent A Photos Of Meghan Apple at $ 1 . 42 , Private Jet Might The Royals Wanted Surprise You To Keep Private c(le [ccalD $uu - IMPACT2020 �fje �e�•aYD • �un s - CORONAVIRUS North Carolina hits 4 , 000 COVID49 cases as long- term care facilities experience outbreaks BYJONATHAN M. ALEXANDER APRIL 10, 2020 07:53 PM, UPDATED APRIL 11 , 2020 05:41 PM lI f u P► VOW f Under 10 10to24 - 25 to 49 50 to 99 100 to 199 200 or more Beginning on Mar. 3, 2020, with the first reported case of COVID-19 in Wake County, the coronavirus has spread across North Carolina . Here 's a look at the cumulative number cases by day as reported by NC DHHS and county health departments. BY KEVIN KOSTER This article has Unlimited Access. For more coverage, sign up for our daily coronavirus newsletter. To support our commitment to public service journalism: Subscribe Now. Nearly six weeks after North Carolina reported its first coronavirus case, the state has reached another dark milestone . County health departments have reported more than 4, 000 positive cases of COVID -19 as of Friday night , according to a News & Observer record of the state 's cases . TAKE A BREAK d � i ! F Y ,fl 1 Thousands pledge to break Joe Exotic out of Fort Worth prison in Facebook event As outbreaks continue to pop up at congregate living facilities across the state, including nursing homes and prisons, the number of people infected has steadily increased. North Carolina became the 2oth state to reach 4, 000 cases, according to a New York Times map of every case in the country. Neighboring Virginia has at least 4,500 cases . Local news has never been more important Subscribe for unlimited digital access to the news that matters to your community. 1 _ j is i North Carolina reported its first case on March 2 . One month later, it reached 2, 000 cases . Eight days after that, those cases doubled. The virus has reached 92 of North Carolina's ioo counties , according to data reported from the N.C . Department of Health and Human Services and county health departments . As of Friday at 6 p .m . , 84 people have died and 423 remain hospitalized . The number of cases likely is higher, as some counties, including Wake , are not testing people with mild symptoms, asking them to instead stay at home and self-isolate . Wake County reported 410 total cases of COVID -i9 Friday, 14 more than Thursday. Four people tested positive at Wellington Rehabilitation and Healthcare in Knightdale, the first Wake County long-term care facility to report an outbreak. An outbreak is considered two or more cases , according to the state . There are now 23 ongoing outbreaks at nursing homes across the state . PruittHealth- Carolina Point in Orange County reported 86 positive cases alone . And Signature Healthcare, also in Orange County, reports at least 31 cases , according to the Orange County Health Department . "The fact that we have an outbreak is not indicative that (the nursing homes in Orange County) have done something wrong or were negligent," Quintana Stewart, the Orange County health director, told the N&O in an interview Friday. "This is just a highly contagious virus ." The NC DHHS reported Orange County had iO4 positive cases of COVID -19, six more than Thursday. Durham County reported i8 new cases, bringing its total to 263 . Mecklenburg County tops the state in cases : 9i3 cases with 12 deaths . Friday night, Mecklenburg health officials reported two cases of coronavirus in children "less than a year old," The Charlotte Observer reported. Their conditions weren't released. Both Wake and Durham counties say they will spend millions of dollars to help their homeless populations, who are highly susceptible to contracting the disease, the News & Observer reported. Johnston County reported 91 cases Friday, 14 more than what was reported Thursday. Johnston County also has a long-term care facility experiencing a fast-moving outbreak. Springbrook Rehabilitation and Nursing Center in Clayton reported 36 cases — 27 residents and 1i staff members, according to the Johnston County Health Department. DEMOGRAPHIC DATA Johnston County released statistics that show at least 27% of the 9i cases are African American. The race of 27 cases is either unknown, or pending update . Only 15. 6% of Johnston County 's population is African American. The numbers follow nationwide trends showing African Americans are diagnosed with COVID-19 at a disproportionately higher rate than other races . North Carolina's case breakdown is 55 % white , 39 % black, 9 % Hispanic, 2% Asian and 4% labeled as "other." Wake, Durham and Orange counties do not break down their data by race . North Carolina is preparing for tighter guidelines on social distancing, which take effect Monday at 5 p .m. under anew order from Gov. Roy Cooper. A violation of the new order maybe prosecuted as a Class 2 misdemeanor, subject to up to 6o days in jail and a $i, 000 fine. Retail stores may only admit 20 percent of the customers allowable under the local fire code — or five people per 1, 000 square feet. The order also includes new mandatory requirements for long-term care facilities . They include stopping group meals and activities; screening employees before they enter the building; and increasing the monitoring of residents' temperatures . NC CORONAVIRUS CASES Number of reported coronavirus cases by county as reported by NC DHHS and county health departments . Figures for the number of people who have recovered after testing positive are not available. Not all cases of COVID -19 are tested , so this does not represent the total number of people who have or had the virus. man Under10 10to24 25 to 49 50 to 99 Y 100 to 199 200 or more Map: David Raynor • Get the data NC CORONAVIRUS DEATHS Number of reported deaths due to COVID -19 by county as reported by NC DHHS and county health departments. Figures for the number of people who have recovered after testing positive are not available. in z I t a � z s � 2 -21 I z z z 3 7 3 2 I 3 ssq i B t z I 3 3 Z 1 3 � z I 1 -, 1 43 2 I 2 3 4 t t 5 I 7 8 10 16 NC CORONAVIRUS CASES BY DAY f The "Total " line shows the total cumulative number of cases over time. The " Daily Count" line shows the number of new cases by day. Figures for the number of people who have recovered after testing positive are in not available. Not all cases of COVID-19 are tested , so this does not represent the total number of people who have or had the virus . — Daily Count Total 5,261 fir 4000 3500 3000 - z 25002000 1500 1000 500 50 118 03/08/2020 03/15/2020 03/22/2020 03/29/2020 04/05/2020 04/12/2020 Chart: David Raynor • Source: The News & Observer compilation of NC DHHS and county health departments reporting of cases • Get the data FOLLOW MORE OF OUR REPORTING ON CORONAVIRUS IN NORTH CAROLINA CORONAVIRUS CORONAVIRUS Corona-virus spread slows in NC ; cases First wave of coronavirus stimulus grow by fewer than 100 Wednesday payments crashes websites for banks , IRS APRIL 15, 202011:14 AM APRIL 15, 202011:11 AM SEE ALL 10 STORIES JONATHAN M. ALEXANDER f u , 919-829-4822 Jonathan M . Alexander has been covering the North Carolina Tar Heels since May 2018 . He previously covered Duke basketball and recruiting in the ACC. He is an alumnus of N . C. Central University. Support my work with a digital subscription COMMENTS j } � t `4 r 490 CORONAVIRUS Coronavirus spread slows in NQ cases grow by fewer than 100 Wednesday BY JOSH SHAFFER AND BROOKE CAIN APRIL 15, 202011:14 AM, UPDATED 1 HOUR 49 MINUTES AGO 0 f u & COVID-19/coronavirus in NC grew by a smaller rate than previous days seeing only a double-digit increase reported by NC DHHS health officials see social distancing working in NC as stay- home order continues. KEEP READING 4 Subscribe for unlimited digital access to the news that matters to your community. # ReadLocal MORE CORONAVIRUS f4YID- 'D 1$' ! r '°°°' i . posit ivc ncaaniva _ l7 Pay t � \ CORONAVIRUS the order _ I ' ! Coronavhvs live updates: Here's what to know ul North Carolina . ,, on April 15 CORONAVIRUS CORONAVIRUS First wave of coronavirus stimulus How many coronavirus patients payments crashes websites for on ventilators survive? Scientists banks, IRS race for an answer UPDATED 1 HOUR 51 MINUTES AGO UPDATED 1 HOUR 51 MINUTES AGO UPDATED 2 HOURS 1 MINUTE AGO \- - - - Pay tojig APART- � :. , • _ the order j IF IV C*s ! CORONAVIRUS CORONAVIRUS CORONAVIRUS Mecklenburg coronavirus cases No, you don't have to pay back Social distancing may be needed top 1,000 . Daily reports of new coronavirus stimulus money. until 2022 without coronavirus cases have fluctuated. Other myths debunked , too vaccine, researchers say UPDATED 2 HOURS 16 MINUTES AGO APRIL 15, 202011:08 AM UPDATED 3 HOURS 14 MINUTES AGO Taste Us With You Real- time updates and all local stories you want right in the palm of your hand . ) URHAM HERALD SUN APP � VIEW NEWSLETTERS 4 SUBSCRIPTIONS Start a Subscription Customer Service eEdition Vacation Hold Pay Your Bill Rewards LEARN MORE About Us Contact Us AMPACT2020 • . • Orange BY JOSH SHAFFER MARCH 20, 202011:02 AM, UPDATED MARCH 20, 2020 11 :11 AM ago L _ _ hgoo gas oft WX0 yi f :r - - - - . 464 There are more than 150 cases of the coronavirus in North Carolina as of March 20, 2020. •) I JOH N D. SI MMONS HILLSBOROUGH This article has Unlimited Access. For morecoverage, sign upforour dailyI / I 1 support our commitmentto public I / I ' Now. Orange County has reported its first patients testing positive for coronavirus, confirming the pandemic 's • • to all three Trianglecounties . Health officials in Hillsborough said Friday that four people there have the virus . TAKE A BREAK r g , �p Thousands pledge to break Joe Exotic out of Fort Worth prison in Facebook event The patients are well and recovering in isolation at home, said Kristin Prelipp, county spokeswoman . " I know that people are worried about this virus, and I want to assure the Orange County community members that we are prepared ," said Orange County Health Director Quintana Stewart in a press release . "With the global spread of this virus we anticipated that we would eventually identify a case herein Orange County." Local news has never been more important Subscribe for unlimited digital access to the news that matters to your community. Health officials said most patients experience mild symptoms with a week 's recovery time, and they urged continued hand-washing, covering coughs and sneezes and keeping social distance . On Thursday, Gov. Roy Cooper announced the first "community spread " case in the state , meaning that a patient tested positive without any history of travel to an impacted area or contact with a known carrier. " This new information has shifted our response efforts from containment to mitigation ," Stewart said. " The goal is to slow the transmission of disease and protect our high-risk population and healthcare and critical infrastructure worldorces . " As of Friday morning, North Carolina had 137 total cases with 25 in Wake County and 35 in Durham County. This is a developing story and mill be updated. Looking for regular updates on the Coronavirus in NC and across the nation? Sign up for our daily newsletter at newsobserver. com/coronavirusnews to get a daily email summary. NC CORONAVIRUS CASES Number of reported coronavirus cases by county as reported by NC DHHS and county health departments. Figures for the number of people who have recovered after testing positive are not available. Not all cases of g COVID-19 are tested , so this does not represent the total number of people who have or had the virus . Own trz L Under10 10to24 25 to 49 50 to 99 100 to 199 200 or more Map: David Raynor • Get the data NC CORONAVIRUS DEATHS Number of reported deaths due to COVID -19 by county as reported by NC DHHS and county health departments. Figures for the number of people who have recovered after testing positive are not available. 2 1 1 1 1 4 � 22 3 i 2 1 1 2 2 2 1 � 2 1 3 . 3 �t 8 1 7 2 1 3 3 2 1 3 2 . � 2 1 1 1 1 2 3 1 2 1 1 3 1 4 5 1 1 7 1 8 10 16 NC CORONAVIRUS CASES BY DAY The "Total' line shows the total cumulative number of cases over time. The " Daily Count" line shows the number of new cases by day. Figures for the number of people who have recovered after testing positive are not available. Not all cases of COVID -19 are tested , so this does not represent the total number of people who have or had the virus. Daily Count — Total 5,261 4000 3500 3000 2500 2000 1500 1000 500 50 118 03/08/2020 03/15/2020 03/22/2020 03/29/2020 04/05/2020 04/12/2020 Chart: David Raynor • Source: The News & Observer compilation of NC DHHS and county health departments reporting of cases • Get the data CORONAVIRUS CASES Click or touch the map to see cases in the North Carolina area. Pan the map to see cases elsewhere in the US. The data for the map is maintained by the Center for Systems Science and Engineering at the Johns Hopkins University and automated by the Esri Living Atlas team. Data sources are WHO , US CDC , China NHC, ECDC, and DXY. o 0 0 + c o ° ° ° 0 0 0 o O 0 ° O 0 ° 0 O o 0 0 O 000 0 0 o 0 0 o ° O ° 0 O 0 O O O O ° 0 o O o O O o o ° O OO 0 0 O ° O ° o 0 O O o 0 o O 0 ° 0 o 0 0 . 0 0 . 0 O 0 0 0 0 c, D O o � 0 . 0 o O 0 0 01 0 0 0 0 0 ° 0 0 . O O O O 0 0 O 0 0 00 O ° O 0 0 0 0 0 O 0 0 O O 0 0 0 0 O 0 0 ° o ° ° 0 ° 0 0 00 0 O ° 0 ° 0 ° County of Florence, Esri , HERE, Garmin, FAO . . . STEVE WILSON SWILSON@STAR- TELEGRAM.COM Open Cam' FOLLOW MORE OF OUR REPORTING ON CORONAVIRUS IN NORTH CAROLINA CORONAVIRLIS I I CORONAVIRLIS Coronavirus spreadslowsof • • grow by fewer than 100 Wednesday payments crashes websites for banks, IRS APRIL • • • • 11:11 AM SEE ALL • STORIES STORIESRELATED • • CORONAVIRLIS NC governor lifts unemployment Here are the 41 known cases of coronavirus restrictions due to coronavirus closures in North Carolina counties MARCH 17, • • • • 230 • COMMENTS R • Reopen NC protesters sound car horns calling for end to coronavirus restrictions 1 s NC health director sees no current projected peak in coronavirus cases VIEW MORE VIDEO ct 01 J T: CORONAVIRUS Coronavirus spread slows in NC ; cases grow by fewer than 100 Wednesday BY JOSH SHAFFER AND BROOKE CAIN APRIL 15, 202011 :14 AM, UPDATED 1 HOUR 50 MINUTES AGO V f u & COVID-19/coronaviru5 in NC grew by a smaller rate than previous days seeing only a double-digit increase reported by NC DHHS health officials see social distancing working in NC as stay- home order continues. KEEP READING Subscribe for unlimited digital access to the news that matters to your community. � '. #1READLOCAL # ReadLOCal � (�cicra[d dun IMPACT2020 �lje �eiar1 • butt : - CORONAVIRUS NC and Triangle counties aren ' t releasing coronavirus test details . Why that matters . BY ANNA JOHNSON AND DANIELLE BATTAGLIA MARCH 24, 2020 05 :18 PM, UPDATED MARCH 24, 2020 05 :28 PM �I` f u P► SHARE - , 1 Under 10 10 to 24 25 to 49 50 to 99 100 to 199 200 or more Beginning on Mar. 3 , 2020 , with the first reported case of COVID -19 in Wake County, the coronavirus has spread across North Carolina . Here 's a look at the cumulative number cases by day as reported by NC DHHS and county health departments . BY KEVIN KEISTER RALEIGH This article has Unlimited Access. For more coverage, sign up for our daily coronavirus newsletter. To support our commitment to public service journalism: Subscribe Now. North Carolina and Triangle county health officials are not providing as much information about coronavirus patients as other states and even in other parts of North Carolina . After mounting public pressure , Mecklenburg County released demographic information on Sunday that showed nearly So % of cases were in people under the age of 40 , The Charlotte Observer reported . TAKE A BREAK i Thousands pledge to break Joe Exotic out of Fort Worth prison in Facebook event Open-government experts told The Charlotte Observer that the county was " withholding more information than legally necessary, potentially missing opportunities to raise public awareness of the coronavirus . " The News & Observer requested similar demographic information — age or age range , gender, race and zip code — of COVID -19 patients across North Carolina and , specifically, in Wake , Durham , Orange , Chatham and Johnston counties . Local news has never been more important Subscribe for unlimited digital access to the news that matters to your community. So far, North Carolina and Wake County have said they are working to provide the data , but after multiple requests the data had not been released by 5 p . m . Tuesday. " Wake County is committed to openness and transparency, " said Dara Demi , Wake County communications director. " However, before we share the information you requested , we need to analyze the data , which is coming in from multiple sources , to make sure it ' s as accurate and informative as possible . " The other local counties claim it violates patient privacy laws , like the Health Insurance Portability and Accountability Act (HIPAA) or their own policies . " HIPAA protects personally identifiable healthcare information , but it does not in any way prevent the disclosure of aggregated data and does not prohibit the disclosure of aggregated data descriptives , " said Amanda Martin , attorney for the N . C . Press Association . " More granular information like a zip code or race would not be considered personal health care information unless or until they can describe for me a community that is so small that identifying someone as Asian or Latina or white or black, in and of itself, becomes an identifier. " Proponents say releasing data points like these can broaden understanding of the virus and give them information that might help them know whether they fit the profile of someone who is at high-risk of becoming sick with the disease . But John Wallace , an epidemiologist with the N . C . Institute for Public Health , said the numbers don ' t necessarily give the full story. " These demographics reflect known cases at this time , and they shouldn't be used to determine who is at risk and where , " Wallace said . He said the data does not give insight to where the infected individuals may have gone , how the individual became infected and who is at risk of getting it . He added that there has so far been little community spread . Wallace said the public needs to be careful to not stigmatize or parse out who might have the virus . He said it makes less sense for smaller counties to report the data because it 's easier to violate patient privacy laws . " People are naturally going to want to do that when there is a time of uncertainty and a little bit of fear and worry, " Wallace said . Wallace said the state is collecting the information to do contact tracing to find close contacts and reach out to them to warn them they may have come into contact with the disease . Wallace said the numbers are being put out publicly in some places for no other reason than people want to know. The first case reported in Wake County and the state was about three weeks ago . The number of confirmed cases has swelled to over 6o in Wake County and more than 7o in Durham County. There were more than 450 confirmed cases across the state as of Monday afternoon . These numbers only reflect officially confirmed cases . Testing is limited and there are likely more unreported cases . HOW NC IS RESPONDING During a news conference Tuesday, N . C . Department of Health and Human Service Chief Medical Officer Elizabeth Tilson said her staff is culminating the curves and trends in the data to be more transparent with residents and plans to release that information soon . She added that she needs to find a balance between releasing data needed to protect public health and data that could easily identify a patient . Tilson said releasing information on a county level risks a person's privacy more than releasing information on a broad level . Other states across the country have been sharing far more detailed data publicly. Florida health officials release a daily report with extensive data demographic data on all reported cases . Public health officials need to be " mindful of sharing information that is critical to achieving an effective public health response , " said Brooks Fuller, N . C . Open Government Coalition . " Public officials are rightly concerned about sharing any information that might be considered ifiable information , " he said . "At the end of the day, information related to the personally ident government 's response to the current public health crisis is squarely in the public interest . There has certainly been a lot of inconsistency in the responses from across the state . " HOW OTHER COUNTIES ARE RESPONDING Representatives in Durham , Chatham , Orange and Johnston counties all declined to provide the requested information . " It is not in the best interest of our citizens affected by COVID - iq to release this information , " said Melanie Proctor, Johnston County spokesperson . Orange County spokesperson Kristin Prelipp referred questions to the NC Department of Health and Human Services , and said it was not the county ' s policy to release the demographics . " Demographic information may be sufficient to make the information individually identifiable , even without the name , " she said . " Therefore , the information must be managed in a way that complies with these laws . " Putting out location information will likely increase calls from " worried well " people who only " tax already burdened health department and medical staff, " said Kara Dudley, spokesperson for Chatham County. " Mapping only confirmed cases may lead residents to misinterpret risk and not follow guidance on social distancing that is so critical to slowing the spread of COVID - iq , " she said . NC CORONAVIRUS CASES Number of reported coronavirus cases by county as reported by NC DHHS and county health departments . Figures for the number of people who have recovered after testing positive are not available . Not all cases of COVID -19 are tested , so this does not represent the total number of people who have or had the virus . •fir � � : �_y� �. ,� Under 10 10to24 25 to 49 50 to 99 100 to 199 200 or more Map: David Raynor • Get the data NC CORONAVIRUS DEATHS Number of reported deaths due to COVID - 19 by county as reported by NC DHHS and county health departments . Figures for the number of people who have recovered after testing positive are not available . 2 1 1 1 1 000 4 2 2 3 1 1 2 2 2 1 2 g 1 � 2 1 3 1 8 1 1 2 1 3 3 2 1 3 2 2 1 1 2 3 1 2 1 1 3 1 4 5 1 1 1 8 10 16 NC CORONAVIRUS CASES BY DAY The " Total " line shows the total cumulative number of cases over time . The " Daily Count " line shows the number of new cases by day. Figures for the number of people who have recovered after testing positive are not available . Not all cases of COVID - 19 are tested , so this does not represent the total number of people who have or had the virus . — Daily Count Total y ` 5 , 261 4000 3500 3000 2500 2000 1500 1000 500 118 50 03/08/2020 03/15/2020 03/22/2020 03/29/2020 04/05/2020 04/12/2020 Chart: David Raynor • Source : The News & Observer compilation of NC DHHS and county health departments reporting of cases • Get the data FOLLOW MORE OF OUR REPORTING ON CORONAVIRUS IN NORTH CAROLINA CORONAVIRUS CORONAVIRUS Coronavirus spread slows in NC ; cases First wave of coronavirus stimulus grow by fewer than 100 Wednesday payments crashes websites for banks , IRS APRIL 15, 202011 :14 AM APRIL 15, 202011 :11 AM SEE ALL 10 STORIES ANNA JOHNSON , 919-829 -4807 i Anna Johnson covers Raleigh and Wale County for the News & Observer. She has previously covered city government , crime and business for newspapers across North Carolina and received many North Carolina Press Association awards , including first place for investigative reporting. She is a 2012 alumna of Elon University. Support my work with a digital subscription NC health director sees no current projected peak in coronavirus cases VIEW MORE VIDEO -� READ NEX for 4�^cy T CORONAVIRUS Coronavirus spread slows in NC ; cases grow by fewer than 100 Wednesday BY JOSH SHAFFER AND BROOKE CAIN APRIL 15, 202011 :14 AM, UPDATED 1 HOUR 51 MINUTES AGO V f u ?+ COVID -19/coronavirus in NC grew by a smaller rate than previous days seeing only a double - digit increase reported by NC DHHS health officials see social distancing working in NC as stay- home order continues . KEEP READING Subscribe for unlimited digital access to the to 000 -- 1 i Pay to ` 1 the ordef� CORONAVIRUS CORONAVIRUS No , you don ' t have to pay back Social distancing may be needed until coronavirus stimulus money. Other 2022 without coronavirus vaccine , myths debunked , too researchers say APRIL 15, 202011 :08 AM UPDATED 3 HOURS 16 MINUTES AGO Tate Us With You Real -time updates and all local stories you want right in the palm of your hand . UURHAM HERALD SUN APP � VIEW NEWSLETTERS 4 SUBSCRIPTIONS Start a Subscription Customer Service eEdition Vacation Hold Pay Your Bill Rewards LEARN MORE About Us Contact Us �fjc (cratd $un AMPACT2020 !fje *Crd1a • Zun s - POLITICS & GOVERNMENT NC governments find ways to work in coronavirus era, but will the public be shut out ? BY DANIELLE BATTAGLIA AND DAWN BAUMGARTNER VAUGHAN APRI L 03, 2020 06:00 AM, UPDATED APRI L 03, 2020 03:58 PM !� f u P► (j Ft a 1 North Carolina Governor Roy Cooper reminds people that his coronavirus stay-at-home order is in effect and that obeying it could save lives. Cooper spoke to reporters Tuesday, March 31 , 2020 in Raleigh. BY WUNC-TV RALEIGH In the era of coronavirus , the way state lawmakers and local elected officials meet and make decisions is changing . At the local level, government boards are grappling with staying compliant with open meetings laws that leave room for interpretation . And at the North Carolina General Assembly, lawmakers are getting regular informational briefings from the state Department of Health and Human Services via conference call . While lawmakers say those calls share similar information as at DHHS ' daily news briefings that are streamed online and recent House special COVID-i9 meetings, they are not accessible to the news media and the public. TAKE A BREAK a; . Thousands pledge to break Joe Exotic out of Fort Worth prison in Facebook event Another conference call this week was led by the National Conference of State Legislatures and the entire General Assembly was invited, Rep . Pricey Harrison said . She said other groups have hosted conference calls with lawmakers, too, on various topics including unemployment . Local news has never been more important Subscribe for unlimited digital access to the news that matters to your community. 4REA►iLOCAL "None of us have dealt with a pandemic," Harrison said. Open meeting laws require the public to be able to attend, minutes to be taken and a prior public notice of meetings . Attorney Mike Tadych of Stevens Martin Vaughn & Tadych law firm is an expert in media and First Amendment law. He said once there is a quorum of certain legislative committee members on a teleconference, it triggers the state's open meetings law. Their only purpose on the call is to transact the public business by gaining information. It should be accessible to all, he said . Tadych, who is also counsel to the North Carolina Press Association and whose firm represents The News & Observer, said it doesn't matter if DHHS calls the meeting. g " They 're not there to talk about the nonexistent football game," he said. " There aren't any other reasons to get together." "We're here talking about a global pandemic; we need to err on the side of openness," he said. BIG DECISIONS, POTENTIAL LIABILITY The North Carolina Association of County Commissioners is seeking flexibility from the General Assembly on open meeting laws and remote participation. Specifically, Kevin Leonard, the association's executive director, told the legislature that the open meetings laws are vague on whether votes and public comments have to be done in person . He is also seeking a temporary modification to the law that would allow a shorter public notice period of meetings to allow action to be taken quicker. The League of Municipalities also sought clarification on holding remote meetings or public hearings. �G I The league's chief legislative counsel, Erin Wynia, addressed the league 's concerns Tuesday in a meeting of the House Committee on COVID -19 Continuity of State Operations . " The state law is not clear on this and it's one of the first issues that surfaced a few weeks ago," Wynia said. " The types of meetings we're talking about are full council meetings , their board meetings, as well as public hearings." I The league's president, William Pitt, also asked lawmakers in a letter to consider providing "legal and regulatory flexibility" to hold remote meetings. He noted that this time of year is important for cities ' officials to meet because they are mandated to balance their budget by July 1 and now they have to do it without knowing whether their normal revenue streams still exist. In a blog post, N.C. School of Government Professor Freyda Bluestein noted that neither the governor nor county or city officials have authority to waive statutory requirements and that lawmakers left open to interpretations whether a quorum means that elected officials need to be physically present to vote or whether they can meet electronically. She said if these boards fail to comply it could leave them open to a lawsuit and a judge would then have to interpret the law. BOARDS MEET REMOTELY She added that in most circumstances, city and county boards can authorize their appointed boards to meet electronically. That's something being done within Orange County. "If we're asking the public to stay at home and work from home we feel like we need to do the same," said Kristin Prelipp, spokesperson for the Orange County Health Department. The department is using GoToMeeting, a platform like Google Hangouts or Zoom, but that is compliant with medical privacy laws . Prelipp said as the county braced for its first COVID -i9 case and watched other counties' officials hold news conferences, Orange County looked for innovative ways to make the announcement without being in the same room. Their solution was to edit together a video of health officials and the board of commissioners . The health department is holding meetings through video chats too. And like everyone else, participants are dealing with crying babies, dogs barking and, in one case, turkeys in the background . They 're also trying to balance the restrictions of open meeting laws and making sure that the public can comment. In Raleigh, the city council is planning to broadcast meetings as it always does on YouTube, the Raleigh Television Network and through a livestream on the city 's website. But instead of a video of the council chambers, said Julia Milstead, the city 's spokeswoman , they will see the speaker or the speaker's presentation. Milstead said the council still wants to include the ability for public comments. Speakers have until 5 p .m. Friday to sign up for the April 7 meeting and will then get an invitation to join an audio feed through WebEx. TELEWORKING Johnston County officials have also been trying to comply with social distancing. "We are encouraging department heads to be creative in the methods by which we can provide essential governmental services while taking proactive measures to limit the spread of disease by reducing the opportunities for close contact between people," said Paulette Williams, spokeswoman for Johnston County. She said employees are using both video and conference calling and encouraging online, telephone and drop -off services. Many employees are teleworking, avoiding travel and being told to stay home if they 're sick. Those who are coming into work are using staggered schedules to cut down on time they 're with other people . STATE LAWMAKERS House Speaker Tim Moore formed four committees to focus on the state's needs prior to the session scheduled to begin April 28 . Those committees are also meeting digitally. Moore told the committees last week that he knew COVID -i9 had created needs that needed to be addressed by the state as soon as possible . " This is an unprecedented time in our state and an unprecedented time in our legislature," said Moore, a Cleveland County Republican, during one of the first meetings . " I was urged by quite a few of you attending this meeting remotely and others who said it felt like the legislative branch needed to be engaged sooner rather than later and I completely agree." Just a few people are there in person at the House committee meetings, including Moore. The rest of the lawmakers watch on a video conference call and submit questions via the call or in writing. Those meetings are accessible to the public, who can listen to the live stream on the legislature 's website . There is limited space in the room for the press and public to attend because of social distancing measures. But there are also conference calls with state lawmakers that are not available to the public. Sen. Jeff Jackson, a Mecklenburg County Democrat, has told the N&O that the entire 170 -member legislature was getting almost daily briefings via conference call from DHHS. Jackson sends out regular emails to constituents with updates about the coronavirus in the state. Pat Ryan, spokesperson for Senate leader Phil Berger, a Rockingham County Republican, said it's good for the executive branch and the legislature to be able to communicate during the crisis . Harrison, a Guilford County Democrat, said the legislature 's briefings from DHHS are now down to one or two a week and include DHHS Secretary Mandy Cohen and often Emergency Management Director Mike Sprayberry. She said the North Carolina congressional delegation is on those calls, too . She said lawmakers are allowed to ask questions, but there isn't any strategy discussion. "I didn't seen anything necessarily untoward about this," Harrison said, saying it's a way for agencies to convey information to legislators and keep them up to speed. She said the calls start off the same as DHHS ' press briefings with the case count and other information. Tadych said that a state agency briefing lawmakers is good in a public health crisis. " The issue is the rest of us should be able to be there listening," Tadych said . Even if the information is similar to what's provided elsewhere, the question is if the legislators are being told the information in a different way, receiving additional information or being told more clearly. Lawmakers will receive another update from DHHS on Friday, again via conference call . For more North Carolina government and politics news, listen to the Domecast politics podcast from The News & Observer and the NC Insider. You can find it on Megaphone, Apple Podcasts, iHeartRadio, Stitcher or whereveryougetyourpodcasts. Domecast Domecast No . 199 : Virus Pol . . . 00:00:00 I SHARE SUBSCRIBE COOKIE POLICY DESCRIPTION IN THIS PLAYLIST 197 EPISODES Domecast No . 199 : Virus Politics 21 min Domecast No . 198: Coronavirus Concerns 24 min Domecast No . 197 : Election Surprises 24 rnin Domecast No . 196: Primary Preview 26 min Domecast No . 195 : The Lindberg Case 26 min NC CORONAVIRUS CASES Number of reported coronavirus cases by county as reported by NC DHHS and county health departments. Figures for the number of people who have recovered after testing positive are not available. Not all cases of COVID -19 are tested , so this does not represent the total number of people who have or had the virus. SAM Under10 10to24 25 to 49 50 to 99 100 to 199 200 or more Map: David Raynor • Get the data NC CORONAVIRUS DEATHS Number of reported deaths due to COVID-19 by county as reported by NC DHHS and county health departments. Figures for the number of people who have ry recovered after testing positive are not available. 2 1 1 t t 4 2 2 3 i 2 2 2 2 t t 3 1hr1 32 2 1 3 t 8 1 t 2 t 33 2 t 3 2 2 t 1 2 t 3 3 1 2 t 4 1 5 7 t t 8 1 10 16 Map: David Raynor • Get the data NC CORONAVIRUS CASES BY DAY f The "Total " line shows the total cumulative number of cases over time. The " Daily Count" line shows the number of new cases by day. Figures for the number of people who have recovered after testing positive are 10 not available. Not all cases of COVID-19 are tested , so this does not represent the total number of people who have or had the virus. Daily Count Total 5,261 4000 3500 3000 2500 2000 1500 1000 500 50 118 03/08/2020 03/15/2020 03/22/2020 03/29/2020 04/05/2020 04/12/2020 Chart: David Raynor • Source: The News & Observer compilation of NC DHHS and county health departments reporting of cases • Get the data FOLLOW MORE OF OUR REPORTING ON CORONAVIRUS IN NORTH CAROLINA CORONAVIRUS I I CORONAVIRUS Coronavirus spread slows in NC; cases First wave of coronavirus stimulus grow by fewer than 100 Wednesday payments crashes websites for banks , IRS APRIL 15, 202011 :14 AM APRIL 15, 202011:11 AM SEE ALL 10 STORIES w4 DAWN BAUMGARTNER VAUGHAN , 919-829-4877 Dawn Baumgartner Vaughan covers North Carolina state government and politics at The News & Observer. She previously covered Durham , and has received 10 North Carolina Press Association awards, including an award for investigative reporting and the McClatchy President's Award. COMMENTS 'This should never ever happen to another president again' says Trump after impeachment acquittal VIEW MORE VIDEO TRENDING STORIES GOP lawmakers slashed NC's unemployment compensation. Are they proud now? UPDATED APRIL 13, 2020 06:45 PM Three nursing homes in Durham now have coronavirus outbreaks UPDATED APRIL 13, 2020 02:07 PM Durham reports second coronavirus death as Triangle cases rise UPDATED APRIL 14, 2020 08:22 PM Protesters rally for NC to reopen. One woman arrested for violating governor's order. UPDATED 3 HOURS 42 MINUTES AGO Wake County reports 2nd coronavirus outbreak at a nursing home . Durham cases top 300 . UPDATED APRIL 13, 2020 09:13 PM �. 2AD NEv 1 i I Y ♦ o AA ve- I i NATIONAL POLITICS Factory shutdowns near WWII demobilization levels in US PAUL WISEMAN AP ECONOMICS WRITER APRIL 15, 202011:05 AM, UPDATED 2 HOURS 34 MINUTES AGO V f u ?# American industry collapsed in March as the pandemic wreaked havoc on the U . S. economy. KEEP READING Subscribe for unlimited digital access to the news that matters to your community. Neadi_ ocal MORE POLITICS & GOVERNMENT COLLEGE SPORTS NATIONAL POLITICS New York hoops Newcastle takeover coaches unite in fight link puts spotlight on t;ticicca[l $uu - IMPACT2020 fje *erafl • 6un s - CORONAVIRUS NC governor tightens coronavirus rules . Orange County nursing home reports 3rd death. BYTAMMY GRUBB VIRGINIA BRIDGES, AND JONATHAN M. ALEXANDER APRIL 10, 2020 05:30 AM, UPDATED APRI L 10, 2020 05:11 PM f u r► y dd 10 I North Carolina Governor Roy Cooper outlines new rules for nursing homes in response to outbreaks of coronavirus. Cooper spoke to reporters Thursday, April 9 , 2020 in Raleigh. BY wUNC-Tv HILLSBOROUGH This article has Unlimited Access. For more coverage, sign up for our daily coronavirus newsletter. To support our commitment to public service journalism: Subscribe Now. N . C. Gov. Roy Cooper tightened rules for skilled nursing homes this week as more COVID -19 outbreaks in long-term care settings , including the first in Wake County, surfaced across the state . TAKE A BREAK Thousands pledge to break Joe Exotic out of Fort Worth prison in Facebook event Skilled nursing facilities must close common areas, require employees to wear face masks, and test residents and employees daily when Cooper 's new executive order takes effect at 5 p .m . Monday. The state already has restricted visitation at nursing homes , except for family members with a dying loved one . The rules do not apply to continuing care retirement communities, adult homes and assisted-living centers, but they are being encouraged to also follow them . Local news has never been more important Subscribe for unlimited digital access to the news that matters to your community. "We know that transmission of a virus in a nursing home or skilled nursing facility can pass very quickly among the residents , and we need to take a lot of preventive measures to try to prevent the virus from being introduced into these types of settings ," Cooper said. The N . C . Department of Health and Human Services as of Friday afternoon had reported over 3 ,900 coronavirus cases and 74 deaths across the state . There were 23 outbreaks reported in nursing homes as of Friday, including one in Durham County and two in Orange County. Another four outbreaks were reported in residential care facilities , which are not included in the executive order. The state defines an outbreak as two or more positive test results . One of the latest outbreaks was reported soon after the governor 's announcement in Chatham County, where The Laurels of Chatham, a 140 -bed skilled nursing and rehabilitation center, had four people test positive for COVID -19 . Then Thursday night, Wake County announced its first outbreak in a long-term care setting after two nurses and two patients tested positive at Wellington Rehabilitation and Healthcare in Knightdale . The new rules follow Cooper's announcing Wednesday that an Orange County nursing home had at least 6o coronavirus cases and two deaths. By Friday, the count there had risen to 86 cases and three deaths. Orange County officials said Thursday 's announcement of the then-two deaths caught them by surprise. Efforts to get more information about that and related reporting issues from state and local officials left several questions unanswered. 4 oil 3 ! _ 41 � ra i 77 Health N.C. Governor Roy Cooper and state health director Dr. Mandy Cohen are asked about gaps in communicating outbreaks of coronavirus in nursing homes after an outbreak at a Chapel Hill facility. svwuN&TV REPORTING CONFUSION Kristin Prelipp, a spokeswoman for the Orange County Health Department, said the county learned about the then- 6o COVID -ig cases at PruittHealth- Carolina Point on Wednesday but only learned of the two deaths there when Cooper announced them at a news conference. "The reason that we didn't know about (the deaths) is because they were reported to Durham County," Prelipp said. " The state is the one who alerts the counties that one of their residents has passed or that one of their residents is positive for COVID -i9 ." The confusion stems in part from Carolina Point's location on the Durham-Orange county line, Prelipp said. While Orange County Environmental Health inspects the facility, Durham County works with its nurses, she said. In addition, each COVID -19 case is reported to the patient's home county, so if a Durham resident living in an Orange County nursing home is infected or dies, the state reports the case in Durham County, she said. But, if the two initial deaths were reported to Durham County, that's not reflected on the state's website, which as of Friday afternoon showed one death each in Durham and Orange counties. The Durham County death was reported Saturday, and the family of the woman who died told The News & Observer she was not a resident at Carolina Point. The Department of Health and Human Services did not return emails and phone calls from The News & Observer seeking clarification. Alecia Smith, a spokeswoman for the Durham County Health Department, said by email Thursday night that her department is working with Orange County and the state "to understand how residence will be determined in the event of COVID -19 deaths of individuals residing in long-term care facilities ." Without state clarification, it also remained unclear Friday whether the confusion in Orange and Durham counties may be happening elsewhere and whether deaths being reported for one county on the state 's website actually have happened in another county. Prelipp directed questions about how reporting infections and deaths might affect a county 's ability to track infections to the state Department of Health and Human Services , Meanwhile, Quintana Stewart, the Orange County health director, said Friday that a third resident at Carolina Point died April8. The resident was in his or her 70s . The two other residents there died earlier this month, she said, one on April 3 , another on April 4. Nine Carolina Point patients were hospitalized as of Friday, two more than Wednesday. As of Friday morning, Orange County had io4 coronavirus cases. Durham County had 259 cases, according to the state's website . https ://www.scribd . com/document/455764861 / NC - Gov- Roy- Cooper- s-April - 9 -2020 -order ORANGE COUNTY OUTBREAK COVID -i9 may have taken root at Carolina Point in mi&March, according to information provided by a company spokesperson and Orange County Health Department news releases. That's when the county 's Communicable Diseases team — the county 's health director, medical director and other medical professionals — responded to a request from the facility. A "strike team" from UNC Health Care and Duke University Medical Care then worked with staff to isolate potentially infected patients, teach employees recommended practices and make sure masks, gloves and other protective equipment were being used. Stewart noted those contacts in an April z news release about Carolina Point's first confirmed case . "We have been in daily communications with the facility since it became concerned about a resident with respiratory symptoms over two weeks ago," Stewart said. " Together, we have been monitoring symptomatic residents and testing suspected close contacts as needed." When asked whether that meant Orange County knew of potential infections at Carolina Point at least two weeks before the first positive test, Prelipp said she would reach out to the Communicable Diseases team to get an answer. The News & Observer wants to feature stories about NC people on the frontlines of the battle against COVID -ig. Tell us about your healthcare heroes here. The state determined who got tested, Prelipp noted , and those guidelines, in the beginning, strictly limited testing. When the two positive cases were confirmed April 1, the UNC and Duke team returned to Carolina Point, and the company placed the facility under a Code Red order. All residents were tested, a company spokesperson said in an email, although neither Prelipp nor PruittHealth's spokesperson could confirm exactly when that testing took place. PruittHealth has notified the residents ' families, the company spokesperson said. Fi North Carolina Governor Roy Cooper announces that a skilled nursing facility in Orange County near Chapel Hill, N.C. has become a "hotspot" for coronavirus cases with several hospitalized and two deaths reported. BY WUNC-TV DAUGHTER WAITS FOR TEST RESULTS Durham resident Teala Spitzbarth learned from the news that someone at her father's nursing home had tested positive for the coronavirus . She worried about never being able to see him again, she said Thursday. " Then I had to make a decision. I am just going to pray," Spitzbarth said. " I am just staying in touch with family and friends, and we are trying to help." Her father, 79, has been at PruittHealth-Carolina Point since September, said Spitzbarth, 56. He has been tested for the virus, but she doesn't know the result yet. She and her 15-year-old son, Josiah Moore, started making face masks as part of a local church team and recently delivered i5o masks to Carolina Point. She doesn't have any concerns about how PruittHealth has handled the situation or with how staff' has communicated with her, she said. She sensed that the numbers had jumped significantly when her father was moved to different rooms, away from where residents who had tested positive were being housed. "I feel like they are doing the best that they can do," she said. t Allowroo b Under10 10 to 24 25 S t 49 S(1� to 99 100 to 199 200 or more Beginning on Mar. 3, 2020, with the first reported case of COVID19 in Wake County, the coronavirus has spread across North Carolina. Here's a look at the cumulative number cases by day as reported by NC DHHS and county health departments, BY KEVIN KEISTER NURSING HOMES AFFECTED STATEWIDE Both Carolina Point and Signature HealthCARE in Chapel Hill, where another outbreak of initially three cases was reported Wednesday, have been rated as "much below average""by the S. Department of Health and Human Services . By Friday, confirmed cases as Signature HeathCARE had risen to 31, with two hospitalizations, Stewart said. Inspections show problems at both facilities, including one incident last year in which a resident was found in a drainage ditch near Carolina Point early on a cold morning. Prelipp said Carolina Point was receptive from the beginning to the Communicable Diseases team's recommendations, telling Stewart that it already had implemented a recommendation "or they were working on it or it was in progress." She referred specific questions about what happened at Carolina Point and the residents and staff who were infected to the Communicable Diseases team. The leader of that team has not yet responded to a request through Prelipp for an interview. It is common knowledge that long-term care facilities would face a higher risk from the virus, Prelipp said. Everyone in a facility can be tested once there are two infected people, she noted. "It's an added complication that this is a disease that presents as respiratory accompanied by fever, and you've got people in long-term care facilities with many health complications, and we're still in flu season, we really still are at this point, pollen season, you name it," she said. " It's just so complicated." Here's how you can send us your news tips securely. Staffwriters Steve Wiseman and Brian Murphy contributed to this story. NC CORONAVIRUS CASES Number of reported coronavirus cases by county as reported by NC DHHS and county health departments. Figures for the number of people who have recovered I after testing positive are not available. Not all cases of COVID -19 are tested , so this does not represent the total number of people who have or had the virus. own Under10 10to24 25 to 49 50 to 99 100 to 199 200 or more Map: David Raynor • Get the data NC CORONAVIRUS DEATHS Number of reported deaths due to COVID -19 by county as reported by NC DHHS and county health departments. Figures for the number of people who have recovered after testing positive are not available. 2 1 1 1 1 ON 2 2 3 1 z . 7 2 1 1 IhV2 3 1 7y -� 2 1 � 3 ` � 8 1 `476� z 1 33 2 1 3 2 1 1 2 1 � 3 3 1 z 1 4 1 5 1 1 8 1 10 16 Map: David Raynor • Get the data NC CORONAVIRUS CASES BY DAY The " Total' line shows the total cumulative number of cases over time. The " Daily Count' line shows the number of new cases by day. Figures for the number of people who have recovered after testing positive are i not available. Not all cases of COVID -19 are tested , so this does not represent the total number of people who have or had the virus . Daily Count E Total 5,261 4000 3500 3000 2500 2000 1500 1000 500 118 50 03/08/2020 03/15/2020 03/22/2020 03/29/2020 04/05/2020 04/12/2020 Chart: David Raynor • Source: The News & Observer compilation of NC DHHS and county health departments reporting of cases • Get the data FOLLOW MORE OF OUR REPORTING ON CORONAVIRUS IN NORTH CAROLINA CORONAVIRUS CORONAVIRUS Coronavirus spread slows in NC ; cases First wave of coronavirus stimulus grow by fewer than 100 Wednesday payments crashes websites for banks , IRS APRIL 15, 202011:14 AM APRIL 15, 202011 :11 AM SEE ALL 10 STORIES -w> COMMENTS =f 3 fT 66.� A 0 k ' ;, APRIL 15, 202011 :11 AM, UPDATED 1 HOUR 55 MINUTES AGO V f u & As the first wave of coronavirus stimulus checks from the federal government began showing up indirect deposit accounts, heavy online traffic creates problems for bank and IRS sites. KEEP READING Subscribe for unlimited digital access to the news that matters to your community. I #READLOCAL # Readl_ Qcal MORE CORONAVIRUS h - q1 oesitive rteoativo /� _ . CORONAVIRUS CORONAVIRUS CORONAVIRUS How many coronavirus patients Coronavirus spread slows in NC; Coronavitus live updates : Here ' s on ventilators survive ? Scientists cases grow by fewer than 100 what to know in North Carolina race for an answer Wednesday on April 15 UPDATED 1 HOUR 55 MINUTES AGO UPDATED 1 HOUR 53 MINUTES AGO UPDATED 2 HOURS 5 MINUTES AGO I - OIL OR OIL dd IN s�►r o� h vim °°° - Pay to X . CORONAVIRUS `�OOcd ; Mecklenburg coronavirus cases 4 �� ` . top 1,000 . Daily reports of new cases have fluctuated. CORONAVIRUS CORONAVIRUS No , you don't have to pay back Social distancing may be needed coronavirus stimulus money. until 2022 without coronavirus Other myths debunked , too vaccine, researchers say UPDATED 2 HOURS 20 MINUTES AGO APRIL 15, 202011:08 AM UPDATED 3 HOURS 18 MINUTES AGO Take Iris With You