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HomeMy WebLinkAboutBOH Agenda 092320 ORANGE COUNTY BOARD OF HEALTH MEETING AGENDA DATE: September 23, 2020 TIME: 7:00 P.M. PLACE: Go to Meeting Please join my meeting from your computer, tablet or smartphone. https://global.gotomeeting.com/moin/671375029 You can also dial in using your phone. United States: +1 (872) 240-3412 Access Code: 671-375-029 New to GoToMeeting? Get the app now and be ready when your first meeting starts: https://global.gotomeeting.com/install/671375029 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 September 23, 2020 Agenda 7:05—7:10 III. Action Items (Consent) A. Minutes of August 26, 2020 7:05—7:25 IV. Educational Sessions A. Department of Aging Update Janice Tyler (20 minutes) 7:25—7:35 V. Action Items (Non-Consent) A. Policy Approval Beverly Scurry/ (10 minutes) Rebecca Crawford 7:35—8:05 VI. Reports and Discussion with Possible Action A. Present Chair/Vice-Chair Slate Jessica Frega B. Health Director Report Quintana Stewart C. COVID-19 Update Quintana Stewart D. Media Items Kristin Prelipp 8:05—8:10 VII. Board Comments 8:10 Vill. Adjournment BOARD MEMBERS: To ensure a quorum, SEND E-MAIL to Istrange((Dorangecountync._gov advising her of your attendance at this meeting OR CALL 919-245-2411. Compliance with the"Americans with Disabilities Act"and Title VI-Interpreter services and/or special sound equipment are available on request. Call the Immigrant and Refugee Health Program Manager at 919.245.2387 to request an interpreter or other accommodation. Conforme a la"Ley sobre Estadounidenses con Discapacidades"(ADA)y el Titulo VI—los servicios de interprete y/o equipo de sonido especial estan disponibles a solicitud. Llame a la Administradora del Programa de Salud para Inmigrantes y Refugiados al 919-245-2387 para solicitar un interprete u otros arreglos o adaptaciones. MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH August 26,2020 ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To enhance the quality (of life, promote the health, and preserve the environment for all people in the Orange County community. THE ORANGE COUNTY BOARD OF HEALTH MET ON August 26, 2020 virtually via Go To Meeting. BOARD OF HEALTH MEMBERS PRESENT: Jessica Frega — Chair, Sam Lasris—Vice-Chair, Keith Bagby, Aparna Jonnal, Lee Pickett, Shielda Rodgers, Timothy Smith and Alison Stuebe. BOARD OF HEALTH MEMBERS ABSENT: Bruce Baldwin and Commissioner Earl McKee. STAFF PRESENT: Quintana Stewart, Health Director; Rebecca Crawford, Financial and Administrative Services Director; Victoria Hudson, Environmental Health Director; Renee Kemske, Nutrition Program Manager; Asuka Nakamura, Community Outreach Specialist; Erica Pettigrew, Medical Director; Kristin Prelipp, Communications Manager; Beverly Scurry, BOH Strategic Plan Manager; and La Toya Strange, Administrative Support I. GUESTS PRESENT: Cheryl Wray. Jessica Frega, Chair, called the meeting to order. There were no new employees in attendance. I. Public Comment for Items NOT on Printed Agenda: None. II. Approval of the August 26, 2020 Agenda Motion was made by Alison Stuebe to approve the agenda, seconded by Lee Pickett and carried without dissent. III. Action Items (Consent) A. Minutes of June 24, 2020 Meeting Motion was made by Sam Lasris to approve the minutes of June 2020 with the edit of changing Ms. Bagby to Mr. Bagby on the last page of the minutes, seconded by Alison Stuebe and carried without dissent. IV. Educational Sessions A. Nutritional Update/Employee Health and Wellness Renee Kemske, Nutrition Program Manager, gave an update on the OCHD's Nutrition Services section. Below are some highlights of her presentation. • Nutrition Services ➢ Nutrition counseling also known as Medical Nutrition Therapy (MNT), is a service provided by a registered dietitian nutritionist (RDN) who works with a referring S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ August Page 1 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH August 26,2020 medical provider to improve a variety of conditions such as diabetes, heart disease, and obesity. Referrals are received from medical providers within and outside of the OCHD. The RDN conducts a review of the medical history, medications, diet, and lifestyle patterns and together with the referred client or a family member, if it's a young child. A personalized plan is developed to help them meet their nutrition goals. There were 852 encounters in FY 2019-20. The payment type for these visits is almost even: insurance at 34%, Medicaid at 33% and self-pay at 32%. • Diabetes Self-Management Education Services (DSME) ➢ This is an American Diabetes Association recognized program in which a client will receive 10 hours of education on the basics of diabetes prevention and management. There's an initial health assessment. They also sign up for 2 of the group education classes on the basics of diabetes care. Then the client will come back in 3 months for a follow-up appointment where knowledge is measured as well as any change in blood sugar management. Nutrition Services have partnered with local experts in the different areas of diabetes management including partnering with Walgreens to provide the medications and utilizing an exercise physiologist who's been working with Nutrition Services since 2005. ➢ The OCHD DSME program was awarded the 2019 John Bowdish Community Award from the North Carolina Diabetes Advisory Council at the Division of Public Health for providing outstanding service to community members with an emphasis of increasing access to care. ➢ OCHD DSME was selected by the North Carolina Diabetes Recognition Program, NC Diabetes Smart, to be featured in a statewide marketing initiative. Some of the OCHD staff were involved as mock participants in the video. ➢ Due to COVID-19, DSME classes went to a telehealth format on May 14th using Doxy.me and Zoom. In June, simultaneous Spanish interpretation via Zoom began. • Community Health Grant (CHG) ➢ In 2017, the CHG was awarded by the Office of Rural Health. A 2nd award was provided for an additional 3 year period. The purpose of this award is to increase access to primary care and self-management support services for residents with chronic disease. Groups specifically targeted include adults who are uninsured, on Medicaid or Medicare. The focus is on the chronic conditions of obesity, pre- diabetes and diabetes abnormal lipids, which is cholesterol and hypertension. ➢ A voucher program has been developed for some of the clients in which the $20 fee is a barrier. Diabetes tests and supplies are offered at no cost to help clients manage their diabetes. ➢ Some of the specific objectives and outcomes of the CHG include: o Working on increasing accessibility of interpretation services for the L.E.P. clients of the MNT and DSME programs. o Offering behavior change incentives by providing water bottles, calories tracking books, scales, exercise DVD's and step trackers. o Piloting a transportation assistance program for adults and pregnant women in which 45 rides were provided pre-COVID-19. Those funds have since been reallocated for telehealth services. • Primary care bag initiative ➢ The goal is to help people that have high blood pressure or diabetes self-monitor at home. Funds are used to purchase blood pressure cuffs and diabetes testing S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ August Page 2 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH August 26,2020 supplies, etc. to help them keep well at home. Participants are scheduled for a lab only appointment and then are scheduled for a MNT telehealth appointment. • Community partnerships include establishing relationships with people individually to better help them linked to services and working with the OC Department of Aging as they wanted more health promotion and nutrition services. Nutrition Services is also partnering with UNC to enhance the community health worker role. • Diabetes Prevention Program (DPP) ➢ DPP is a 16-week class for people with prediabetes or who are at risk for Type 2 diabetes make realistic and achievable lifestyle changes that can cut their risk of developing Type 2 diabetes by 50%. The goal is to help them lose at least 5% of their body weight and/or to achieve 150 minutes or more physical activity per week. Grant funding is used to provide prizes to aid in behavior change. • Employee Wellness ➢ Background — Human Resources agreed to give a portion of their wellness funds to pay for one of the OCHD's registered dietitian's salary. A small portion of that allows the nutrition services to be able to provide services to employees that are not covered under the employee county health plan. ➢ 100 appointments (61 individual and 39 group) have occurred. A variety of topics including meal planning and New Year's weight management have been offered as well as department-specific presentations conducted. The BOH members had questions and comments that were addressed by Ms. Kemske. B. Child Fatality Task Force Report Quintana Stewart, OC Health Director, provided a summary of the 2019 Child Fatality Prevention Team (CFPT) Annual Report. Before she began, Ms. Stewart, filling in for Pam McCall as she recently retired, stated that the CFPT meets on a quarterly basis, now virtually due to COVID-19, and briefly explained its purpose which included reviewing medical records, discussing outcomes, identifying deficiencies and carrying out recommendations to prevent further child deaths. The CFPT members' composition is defined by statute and includes members of law enforcement, school, mental health, EMS and providers. In 2019, the CFPT reviewed 7 child deaths. There was 1 system issue identified — unsafe sleep environment. The team's recommendation was to strengthen the message of safe sleep habits to parents. A plan was developed to produce a video on Safe Sleep to run in waiting rooms and other places where caregivers will be able to view. There was discussion amongst BOH members related to suggestions of running the video at the REC centers and partners' websites and including messaging in the video that mentions the correct and not so safe sleeping habits for caregivers to view. The BOH members had questions and comments that were addressed by Ms. Stewart. C. 4th Quarter Financial and Billing Dashboards Rebecca Crawford, Financial &Administrative Services Director, gave a report on the 4t" quarter revenue and billing accuracy. Her report is as follows: S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ August Page 3 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH August 26,2020 • Total Health Department Budget vs. Actuals: Average YTD monthly revenue in FY19-20 after the fourth quarter is $271 k/month or $3.3M YTD, representing 91.8% of our overall budgeted revenue for the year compared to last year, which was 91.6%. Expenses are above revenues, at 92% of the overall budget. This shows how well staff did in reducing expenditures in order to match decreased revenues during office closures. Additional state and federal funding to offset revenue shortages and support the pandemic response contributed to an almost equal percent of overall revenue received of what was budgeted to the prior fiscal year. • 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 ($39k/month)for the fourth quarter is below our budget projection ($45k/month) and our FY 18-19 average of$46.6k/month. As anticipated, the dental clinic saw a more immediate, negative impact on revenues than the medical clinics as a result of the severely decreased operations and very limited appointments. We began seeing more patients in June when PPE was more readily available, which led to slightly higher than anticipated revenue totals for that time period. FY 19-20 dental earned revenue totaled $468k at the end of the fourth quarter compared to $559k at the end of the FY 18-19 fourth quarter. • Medical Earned Revenue by Source: Medical earned revenue is below the budgeted projection for FY 19-20 ($57k/month) at $40.1 k/month. Our billing team worked hard over the last quarter to correct and submit outstanding claims in the medical clinic in order to bring in as much revenue as possible, which helped insulate the medical clinic from the large revenue decrease experienced by the dental clinic. The medical clinic continued to have many telehealth visits and some in-person visits, which contributed to revenue receipts. Medical clinic revenue totals $482k after the fourth quarter FY 19-20 compared to $487k after fourth quarter FY 18- 19. • Environmental Health Earned Revenue by Source: Environmental Health earned revenue is below the budgeted projection for FY 19-20 ($54k/month) at $46k/month. Permanent staff in EH added WTMP inspections to their current workloads in order to complete them as required by the end of the fiscal year. EH staff did an amazing job and continued to inspect where able during the Stay at Home Order, which resulted in only a slight decrease in projected revenue for the remainder of the FY. FY 19-20 YTD revenue totals $552k compared to FY 18-19 YTD revenue of $594k. • 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. The BOH members had questions and comments that were addressed by Ms. Crawford. S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ August Page 4 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH August 26,2020 V. Action Items (Non-Consent) A. Policy Review Beverly Scurry, BOH Strategic Plan Manager, briefly discussed the minor changes that were previously made. There were some suggested changes including better placement for the statement regarding family planning on page 7 of 8 in the Fee and Eligibility Policy in the Billing Cycle for the Health Department Section I, Number 2 Dental Health Divisions. The Board will review the proposed changes and will vote at next month's Board meeting in September. VI. Reports and Discussion with Possible Action Action Items A. Health Director Report In addition to the Ms. Stewart's report, highlights of the non-COVID related items are below. • Ms. Stewart virtually participated on the State Health Coordinating Council public health hearings on July 81h and 10th • NC Association of Local Health Directors are still meeting virtually. Ms. Stewart serves as the chair of the education subcommittee and partakes in new health director orientation. The orientation will have a virtual platform and will occur on the 2nd Friday of each month over 8 months with the 1st session taking place last Friday. • Ms. Stewart started attending the CFTF meetings in July. • The dental director position recruitment process has been completed. Sam Lasris was thanked for sitting on the panel as the dental representative on the BOH. An offer was made to the candidate last week and accepted; although, the candidate has to give a 90 day notice to get out of her contract with her current employer. She'll start on December 7th • The Dental Mobile Van has arrived and is parked at the Fleet department. Currently, construction is underway at the SHSC. The van will be stationed at the SHSC once construction is done. Ms. Stewart stated that pictures of it can be sent to the Board and hopefully, once in-person Board meetings are able to occur again, the van can be brought over for them to see. Staff are still working on the logistics. B. COVID-19 Update Quintana Stewart, Health Director, gave an update on the COVID-19 status in Orange County as well as took questions from the Board. Some highlights are below. • As of today, o There are 158,985 confirmed cases in the state and 2,009 cases specifically in Orange County. o There are 2,606 deaths in the state and 50 deaths in Orange County. o We are actively monitoring 128 cases in Orange County. o There have been 6 outbreaks with 3 occurring in nursing homes, 2 in residential facilities and 1 in a correctional facility, the county jail. In order for them to come off of outbreak status, they must go 28 straight days with no new cases. S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ August Page 5 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH August 26,2020 • As of last Wednesday, approximately 33,126 people have been tested in Orange County which equates to roughly 22% of our population. • A testing event was held on July 22nd in Carrboro which tested over 200 community members using an outside vendor named StarMed from the Charlotte area. We have another testing event on Friday to be held on Martin Luther King, Jr. Blvd in Chapel Hill across from Root Cellar in the big parking lot that belongs to the campus. The goal behind the test is to attempt to capture UNC students that reside in some of the apartment complexes and off campus housing. • The OCHD has been all hands on deck with getting the word out on some of these testing events due to the short turnaround time. We've, literallly, walked down Franklin Street promoting the testing events. Other advertising, posting the info on social media outlets as well as worked with UNC to ensure that they've included these events on their listservs to promote these testing events. • DHHS announced they awarded contracts to vendors in this state to assist some counties with some additional testing resources. Orange County is one of those counties. • Despite new CDC testing guidance regarding asymptomatic close contacts to a positive case, our state guidance hasn't changed and we'll continue to test close contacts. • DHHS is in the process of creating Regional Prevention Support Teams for long term care facilities within the counties across the state. This is similar to what we've already done in Orange County with our Strike Team that includes a CD nurse, EMS staff and a community paramedic. Each region will receive funding to create teams with the focus on prevention, not outbreak management with the goal of spreading a lot of education regarding infection control. We're in region 5 which will receive $198k for 6 months to get these teams up and going. Ms. Stewart will be the fiscal agent for this region with the help of other members of the OCHD staff that will lead to coordinate this for our region. • Age demographic of 18-24 year olds have seen an increase in positive cases. • UNC has under 1000 students living on campus. There is a hardship application process required in order to remain in the residential dorms. There was a dashboard titled "Board of Health Dashboard — OCHD COVID-19 Response" displayed. This dashboard was created by Rebecca Crawford to show how the OCHD clinics responses have been affected by COVID-19. Below are some highlights. • Patients are still being seen at both the SHSC Clinic, deemed the "well clinic" where primary care visits occur, and the Whitted Clinic, deemed the "sick clinic" for those symptomatic patients. Telehealth appointments continue to increase monthly. • The Dental Clinic continues to see emergency appointment only. • In regards to data on communications, o Communication is pretty steady with COVID nurse calls. COVID info line is Monday through Friday from 8-5pm. There hasn't been enough demand for a 24 hour or weekend shift. o COVID testing numbers include those patients that had a telehealth appointment and were instructed by the provider to come into the office for testing based off of their symptoms and those tests performed by the Strike Team. We continue to send referrals to the UNC RDC. o With the COVID funds we've received, we plan to increase testing. o We still have a strong social media presence thanks to Kristin Prelipp and the Joint Information Center (JIC). They're still doing a great job. S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ August Page 6 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH August 26,2020 C. Media Items Kristin Prelipp, Communications Manager, mentioned that all of the COVID-19 articles were related to the University of North Carolina. Ms. Prelipp stated that she did not compile all of the articles as there were too many to gather. Media items were in the packet which focused on Orange County's events and our involvement in various efforts. VI. Board Comments. Ms. Frega mentioned that, on September 101h, the BOCC is planning to vote on the BOH's pharmacist seat recommendation. In hopes of the BOCC approving the recommendation, she also stated to Ms. Scurry that they'll need to think about subcommittees for them to join. VII. Adjournment Sam Lasris moved to adjourn the meeting at 8:47pm and Alison Stuebe seconded. The next Board of Health Meeting will be held September 23, 2020 at 7:00pm via Go To Meeting. Respectfully submitted, Quintana Stewart, MPA Orange County Health Director Secretary to the Board S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ August Page 7 Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: September 23, 2020 Agenda Item Subject: Department on Aging Overview Attachment(s): PowerPoint Presentation and OC Master Aging Plan Year Three Highlights Staff or Board Member Reporting: Janice Tyler, Director Orange County Department on Aging Purpose: Action X Information only Information with possible action Summary Information: Janice Tyler, Director of the Department on Aging will discuss the aging population in Orange County, services of the Department on Aging, and the department' Master Aging Plan. 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 NORTH GAROLINA OOrange County Department on Aging Age-Friendly Orange County A Vision with Endless Possibilities 2017-22 Orange County Master Aging Plan and COVID-19 Response Orange County Board of Health September 23, 2020 • Age- Friendly Community — Joining a national network • Why now and What's happening locally • 2017-22 MasterAging Plan • Orange County Department on Aging Programs and Services • COVI D- 1 9 response ORANGE COUNTY NORTH CAROLINA Great Places for People of All Ages AARP Livable Communities supports the efforts of neighborhoods, towns, cities and rural areas to be great places for people of all ages. We believe that communities should provide safe, walkable streets; age-friendly housing and transportation options ; access to needed services ; and opportunities for residents of all ages to participate in community life. ORANGE COUNTY NORTH CAROLINA Ina I Ivable community, people of all ages can ... Go fora walk Crossthe itmets Ride a bike INa k� GeFaroundwithoufa€ar tNesafeivarrd Workorvcdurneer eomfort Wy tnJoypubiicpla€es Socialize Spendtlmeoutdoors �t ;r Be entertained Goshopping Buyhealthyfood 9 %AAW* -+ F2sa�Ppalhllnlp n Find the services they need ...and ma ke their city town or neighborhood AARPtorg;LMvab6 a lifelong home i ORANGE COUNTY NORTH CAROLINA why Now? • By 2030 one in five Americans will be older than 65 . • The real change will happen in 2035 when there will be more people over the age 65 in the US than under age 18 . ORANGE COUNTY NORTH CAROLINA Seniors in Orange County • 5.4% of people age 65+ live below 100% of the poverty level. 15.4% of people age 65+ live between 100% and 199% of the poverty level. 100% — 199% of poverty levels for one person = annual incomes between $11 ,770 and $23,539. (2016) • People over 65+ are the most cost-burdened age group for housing. 28% of homeowners and 56% of renters are paying more than 30% of their income on housing. • In case you are interested. . . .The 5-year (2012-2016) estimated median annual household income for householders 65+ in Orange County is $52,897. ORANGE COUNTY NORTH CAROLINA Aging in Orange County Orange County, NC Census 2010 Blocks Distribution of Persons 60 Years of Age and Older • • •• • •• • • • • rJ • • • • • • • • • - • •• • Legend • • • •• • • Age 60 and over per block •� • • • • •. • • 10 • • 50 •• 100 • • • ®MJnklpnMln9 • ,g zo'oc•neuro— NOTE:Lac -W persons dhm • • o censusaixa;ticesnor mamas: • • • • anuaisrrrna�aeeres:euiwsrmn • • � • • • w=anon or m�adwck nnm m• • census ORANGE COUNTY NORTH CAROLINA Orange Aging profile, 2018 Ages 2018 2038 % Change # % # % (2018-2038) TOta 1 145,574 175,664 20.7% 0-17 26,695 18% 28,168 16% 5.5% 18-44 61,760 42% 70,838 40% 14.7% 45-59 27,916 19% 31,332 18% 12.2% 60+ 29,203 20% 45,326 26% 55.2% 65+ 20,346 14% 36,885 21% 81.3% 85+ 1,883 1% 61418 4% 240.8% ORANGE COUNTY NORTH CAROLINA So what are we doing in Orange County to prepare for this growing older adult population ? ORANGE COUNTY �ri�irtial �tntr� re�ar� ••� Willa u r tntt �ertiiar �nteF �hbp�l F�lil I �utni�F�e�ae hl�rth�ida`��n iar �n�• ; 1 1 r■ I I IJ 1 I 1 1 C 1 ORANGE NORTH ' ' Master Aging Plan Process ORANGE COUNTY Framework : Age Friendly Communities • Started in 2006 to WHO Age Friendly Community Framework help communities 4�1' re are fora inp paging population u, �ac Age f Friendly • Comprised of 8 .NI S 'Ina co domains Orange County was the first in NC to join the network ORANGE COUNTY NORTH CAROLINA Needs Assessment • S u rveys • Focus groups • Community meetings • Key informant interviews ORANGE COUNTY NORTH CAROLINA Work Groups • Transportation and Outdoor Spaces & Buildings • Housing • Social Participation and Respect & Social Inclusion • Civic Participation & Employment • Community Support & Health Services ORANGE COUNTY NORTH CAROLINA MAP Authority/ PlanningStructure Board of County Commissioners Advisory Board on Aging MAP Steering Committee LMAP Leadership Team Work Work Work Work Work Group 1 Group 2 Group 3 Group 4 Group 5 ORANGE COUNTY NORTH CAROLINA 2017-22 Master Aging Plan is on our website along with quarterly updates . ORANGE COUNTY NORTH CAROLINA ORANGE COUNTY NORTH GAROLINA So that's the big picture . . . . What happens on a daily basis at the Orange County Department on Aging? Mission • To provide leadership in planning and operating a system of integrated aging services through state of the art senior centers, serving as focal points for coordinated community and individualized programs designed to educate seniors and their families and maximize the health , well-being , community engagement, and independence of older adults at all functional levels. ORANGE COUNTY NORTH CAROLINA Program Divisions • Senior Center Operations — Seymour Center — serves 450+ persons daily — Passmore Center — serves 250+ persons daily • Aging Transitions • Volunteer Connect 55+ — 400+ volunteers A One Stop Shop for Aging Services! ORANGE COUNTY NORTH CAROLINA u S p:. FP The One Stop Shop for AgIng Sevvlces A%%le!"ress Center L4 mill q;mj owl JV 49 i. ORANGE • NORTHA'O Aging Transitions One-Stop-Shop for Aging In Place Supports Information & Assistance: Telephone and office consultations about age-related issues, such as housing options, insurance, community resources, transportation, advocacy, etc. Individual Consultations: Confidential sessions to assist with age- related transitions. Medical Equipment Loan Program/Medical Supply Closet: Canes, wheelchairs, walkers, tub benches, etc. available for short-term loan. Donations of equipment are appreciated. Telephone Reassurance: Supportive telephone calls made Monday through Friday to check on individuals who live alone. Alzheimer's /Dementia Caregiver Support Group: Three different support groups are held monthly. Care Partner Collaborative: Respite for caregivers one day a week. DSS applications: Help with filling out applications for food stamps, low-income energy assistance, Medicaid, etc. Community Presentations: Educational sessions, support group senior discussion groups, etc. are available on request. ORANGE COUNTY NORTH CAROLINA Volunteer Connect 55 + A variety of peer-led and department directed programs to provide diverse, flexible and structure volunteer opportunities. Senior Based Programs — Senior Center Support, Wellness programs, Chinese Connections, Arts, Entertainment, VITA Community Based Programs — Aging Well Supports, Dementia Support Teams, Volunteer Driver Program, Board and Committee Project EngAGE is a senior leadership program that trains Orange County seniors to become resource leaders and make their communities ideal place to age. Currently there are 13 Senior Resource Teams, ex, End of Life Options, Community Visiting, Faith Outreach, Fall Prevention, Caregiver Support, LGBTQ, Neighborhood Connections, etc. ORANGE COUNTY NORTH CAROLINA Then . . . . COVID - 19Arrived • Overnight everything changed ! • We met one of our MAP goals and became a Senior Center without Walls ! ORANGE COUNTY NORTH CAROLINA Offering Services, programs and resources to support older adults through the Orange County COVID-19 crisis and beyond. Department on Aging See a few of our COVID-19 Resources for Seniors endless possihillileS below.To view all we have to offer,visit us online at www.orangecountync.gov/Aging. For information, program registration or assistance, please call: *Aging Helpline (919) 968-2087 Passmore Center (919) 245-2015 Seymour Center(919) 968-2070 *Aging Helpline: For information, assistance or to talk to trained staff about any aging-related issue, please call (919) 968-2087 or email agingtransitionsPorangecountync.gov. We try to find answers to your age-related questions and link you to the services that you need; 9 am-4 pm, Mon - Fri. • English Aging Helpline: Call 919-968-2087 • Chinese Aging Helpline: Call 919-245-4275 • Spanish Aging Helpline: Call 919-245-4245 Staff Appointments: Aging Transitions, Senior Center and Volunteer Connect 55+ staff are available to meet by phone,email,virtually,or if needed in person. Contact the senior centers or helpline above. Lunch Program distributes curbside meals 3-times a week.A hot meal plus a boxed lunch will be distributed on Mondays,Wednesdays and Fridays,ensuring that our lunch participants continue to receive 6 meals weekly.At this time we are only accepting new applications for those county residents age 60 and over and who can pick up a meal at either the Seymour Center or Passmore Center. Only those in group quarters or within the county will be considered if they can identify someone to come and pick up their meal. FREE Food Boxes: Commodity Supplemental Food Program Provides a monthly 43 lb.box of food to supplement the nutritional needs of Orange County low-income residents,age 60 and over.Annual household income guidelines are: 1 member- $1,383 per month or less/ 2 members - $1,868 per month or less/other household members may be eligible to qualify. Grocery Delivery Service: If you are in need of grocery delivery, or if you know an older adult who would benefit from this service,Volunteer Connect 55+is now offering this to Orange County residents age 60 and over. Ordering requirements apply. ORANGE COUNTY NORTH CAROLINA Emergency Plan &Serious Illness Plan: When we make health decisions ahead of time and put those wishes in writing,we bring peace of mind to our families and to ourselves. This document is intended to aid in beginning your process for emergency planning during this COVID-19 health crisis. This form is not intended to be or to replace your advanced directives document, but as a tool to provide additional information for quick access should you need it. Telephone Reassurance: As we continue to enforce social distancing, and social gatherings aren't possible,we want to make sure you're doing okay. Would you like a daily phone call just to check on you? We are actively enrolling new Orange County adults age 55 and over. If interested, contact us today! Durable Medical Equipment: Our occupational therapist is available should you need durable medical equipment, or a phone consultation Volunteer Driver Program continues to provide rides for older adults to essential services. This service has become even more important as Orange County Public Transit and Chapel Hill Transit have limited service Employment Services for Older Adults: Job seekers, right now,there are part-time and full-time jobs available. Be sure your resume and cover letter are current, strong and compelling. Be confident and knowledgeable about interviewing -- how best to answer questions, and what questions you should ask. Call or text employment specialist, Mike Komives, for help: (919) 616-8778. Tax Assistance -Virtual and Drop-Off Services: The Orange County VITA (Volunteer Income Tax Assistance Program) has transitioned to a Virtual/Drop-off Service providing assistance with 2019 tax returns for some taxpayers. The tax filing deadline for both Federal and NC State returns has been delayed to July 15, 2020. Call 919-245-4242 to learn more, or visit www.orangecountync.gov/ocncvita. ORANGE COUNTY NORTH CAROLINA Care Partner Collaborative: A social gathering for care partners and their loved ones experiencing cognitive and/or physical challenges. We create a flexible space for sharing and connection, with all participants welcome to join in simple, enjoyable group activities according to individual ability levels. Available via GoToMeeting by phone or online. Caregiver Support Group: Virtual meeting with other caregivers to share experiences, learn new skills, and get answers to questions about dementia and other long-term disabilities via GoToMeeting by phone or online. Memory Cafe: A monthly opportunity for persons with dementia and their care partners to relax over a "virtual" cup of coffee and socialize, available via GoToMeeting by phone or online. Fit Seniors offering "at home" options designed to help keep you fit and healthy. Exercise with your favorite OCDOA fitness instructor. Discover methods for staying safe and healthy at home or on the go. Senior Center Programs have transitioned to online. Our new online programming offers a wide variety of classes and experiences including: museum tours, music lessons and sing-alongs,technology, educational, health and so much more. The opportunities are continually being updated as new programs come online. COVID-19 Volunteer Opportunities: Would you like to share your skills and gifts with older adults in Orange County. Find your volunteer opportunity to help meet the needs and changing circumstances of individuals and organizations that serve older adults. Call us to find your volunteer match. CONTACT: Aging Helpline: (919) 968-2087 1 agingtransitions@orangecountync.gov Passmore Center, 103 Meadowlands Dr., POB 8181, Hillsborough, NC 27278 1 (919) 245-2015 Seymour Center, 2551 Homestead Rd., Chapel Hill, NC 27516 1 (919) 968-2070 Website: www.orangecountync.gov/Aging ORANGE COUNTY NORTH CAROLINA What are we worried about? The health risks of social isolation — Social Recession - an epidemic of isolation and loneliness stemming from months of not being able to interact in person with friends, family, co-workers and neighbors. — Launching an initiative to connect with hundreds of past participants • Deconditioning of our older adults • Access to technology • When , if ever, will daily life return to "normal" ORANGE COUNTY NORTH CAROLINA Orange County Department on Aging -endless possihil+l%e _ - - .�•�..-ems..`-��+w- - -w- .r-r r _ 1 m Janice Tyler ityler(d)-orangecountync.gov 919-245-4255 www.orangecountync.gov/departments/aging www.facebook.com/orangeCountyDepartmentOnAging _ ORANGE COUNTY NORTH CAROLINA Orange County Master Aging Plan Year 3 (2019-2020) Highlights ...Lmm" Y OUTDOOR SPACES • OCDOA and Carrboro Parks and Recreation held regular guided nature walks until COVID-19. • Hillsborough agreed to hang up movement posters at bus stops. • Held a planning meeting around starting the volunteer workgroup focused on advocacy for outdoor spaces. COMMUNITY SUPPORTS AND HEALTH SERVICES • VolunteerConnect55+ and Community Based Services Teams continued to provide food assistance programs: —300 CSFP participants are served monthly with the support of CHPD/CPD/HP/CFD/CHFD/OCSO. Congregate Lunch program was transitioned to a drive-through program and serves —140 individuals per week with support of CHPD/CPD/HPD/OCSO. • OCRA and Chapel Hill Meals on Wheels merged on July 1, 2020 to expand service to older adults throughout the county. • After COVID-19, Aging Transitions successfully transitioned multiple support groups to a virtual format with no interruption of service for our older adults. New COVID- 19 Emotional Wellness support group to begin in September. • Sheriff's Office received a $5000 grant from the Alzheimer's Foundation to expand participation in the Life Track program; the Sheriff's Office is currently serving —35 residents throughout the county. ro SOCIAL PARTICIPATION, RESPECT, AND INCLUSION • Increased bilingual, Spanish, and Mandarin language programming, including working with Piedmont Health to create Spanish language health series. • Seymour Center expansion construction started for the expansion of programs. • The OCDOA switched many programs to virtual offerings and expanded the Senior Center Without Walls initiative after the start of COVID-19. HOUSING • Community Connections: PeeWee Homes, Inc received funding from Carol Woods Charitable Giving Fund, the Town of Chapel Hill, and the Oak Foundation to build a home for 2 more seniors moving out of homelessness. • Community Development: With support from UNC's Partnerships in Aging Program, Charles House Association, and the Triangle Community Foundation, a team from the Marion Cheek Jackson Center is working to coordinate services/supports and intergenerational care networks to support aging in community in the Northside Neighborhood. • Evaluation: Successfully funded an MPH practicum to formally evaluate the OC Housing Preservation Coalition work through the SEEA grant. • Education: Springboarding from our OT students program plan, the OC Housing Preservation Coalition initiated a very active Education and Outreach Sub-committee that is beginning a whole home repair education series over the next year. ENGAGEMENTCIVIC • L� • Employment Specialist helped over 300 mature job seekers! Survey feedback has been very positive. After COVID-19, continued to help people via phone and email, and telling them about virtual events of interest. • Held many workshops,job fairs, and courses in person and virtual ones after COVID- 19. Events were organized both individually by the OCDOA Employment Specialist and in partnership with community groups like Hillsborough libraries, the National Caucus/Center on Black Aging, Department of Social Services, Durham Library, Durham Tech, Orange Correctional Center, Cedar Grove and Efland-Cheeks Community Centers, and NC Works. • Developed Mature Job Seekers Resource Guide and updated information on OCDOA website. Updated resources with topics related to COVID-19. Used Endless Possibilities newsletters to communicate and provide links to additional resources, websites, and information sources. TRANSPORTATION • The OCDOA Volunteer Driving Program (VDP) provides necessary trips for seniors that have no existing public or non-public transit options that meet their needs. The program has grown from 9 to 15 volunteer drivers and has provided 426 one-way rides this past year. The VDP is currently working with a non-profit partner to develop a rideshare web/mobile app to help meet the demand of current and expected growth as we expand our reach to more rural areas and the population continues to age. If successful, we could become a model for the rest of the state. • A dedicated Transportation Help-line is available M-F 8am-5pm. The Help-line receives an average of 85 calls per month from clinicians looking for transportation resources for a patient or a resident who is becoming temporarily or permanently transit dependent. A large percent of these callers are referred to para-transit partners and/or provided application assistance. EZ Rider has 20 new vans and OC Public Transit scheduled to add a second bus to the circulator route. • The MAP Transportation Workgroup serves as a hub for improving transportation in the area by bringing together social service, transit, and health organizations for regular meetings to improve transit.The UNC Department of City and Regional Planning has invited the MAP Transportation Workgroup to participate in its research Data Analytics to Identify and Address Transport Barriers to Care, providing workgroup members the opportunity to participate in the design and testing of developing their data platform. COMMUNICATION AND INFORMATION • Established the OCDOA YouTube Channel: https://www.youtube.com/channel/UCEE18VtoBeTylgBOYGI OmQ, another method for reaching new participants and sharing information. • Adapting and keeping up with communication and information throughout COVID. After COVID-19, additional efforts have been made to share information via paper fliers that are distributed through food assistance programs. • The Senior Times Improvement Project data collection was completed, analyzed, and reported to the workgroup. Results were used to inform the team's goals to improve organization, design and readability. Weekly workgroup sessions to begin in July. • UNC PiAP intern hired to help get the word out about OCDOA services, events, and learning opportunities, and to advance aging readiness through social media. Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: September 23, 2020 Agenda Item Subject: BOH Policy Approval Attachment(s): Fee and Eligibility Policy Staff or Board Member Reporting: Rebecca Crawford Purpose: _X_Action Information only Information with possible action Summary Information: The Fee and Eligibility Policy was updated to reflect a change in the Billing Cycle for the Health Department (page 7). Recommended Action: _X_Approve Approve & forward to Board of Commissioners for action Approve & forward to Accept as information Revise & schedule for future action Other (detail): ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy B: Fee and Eligibility Policy Reviewed by: Financial Review Committee,Health Director Approved by: Board of Health,Health Director I. Purpose A. Public health services are increasingly costly to provide. The Health Department serves the public's interest best by assuring that all legally required public health services are furnished to all citizens. The department provides recommended and requested public health services based upon the priorities established by the Board of Health. B. Fees are a means to help provide services to the residents of Orange County. Fees help finance and extend public health services when government funding is not sufficient to support the full cost of providing all required and requested services. C. Fees for Orange County Health Department services are authorized under North Carolina G.S. 130A-39,provided that: 1. They are in accordance with a plan recommended by the Health Director and approved by the Board of Health and the Orange County Board of Commissioners. 2. They are not otherwise prohibited by law. 3. They are deposited to the account of the local Health Department for public health purposes in accordance with the provisions of the Local Government Budget and Fiscal Control Act. D. Fees for services must also be in compliance with N.C.Administrative Code,Title X Regulations, and Women's and Children's Health Program Rules. E. There will be no charge for Title X Services provided for individuals with income less than 100%of the Federal Poverty Level(FPL.) II. Policy Implementation The implementation of this policy is delegated to appropriate financial or support staff in each division of the health department. III. Income Eligibility A. Definitions 1. Definition: A family is defined as a group of individuals who are living together as one economic unit. Individuals are considered members of a single family or economic unit when their production of income and consumption of goods are related. A pregnant woman is counted as a family of two in determining family size. 2. Income eli ig bili , requirements apply to: Dental Health,Family Planning, Child Health,Maternal Health,Adult Health,Nutrition Services,Family Home Visiting, and Primary Care Services. 3. The Health Department utilizes a sliding fee scale based on Federal Poverty Guidelines in accordance with the Fee Schedule approved annually during the County Budget process. NC DPH updates and issues the scale yearly. Specifically, Page 1 of 8 Original Effective Date:January 25,2001 Revision Dates:, n�1^Tz015,4�,4/2016,9/2018,10/2019,10/2020 ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy B: Fee and Eligibility Policy Reviewed by: Financial Review Committee,Health Director Approved by: Board of Health,Health Director the health department uses the 101%-250%Federal Poverty Level sliding scale. Determination of Sliding Fee percentage is based on gross income and family size. 4. Verification of income is required at time of enrollment for services, at the annual financial interview,or if there is a change in the work status in the family unit for clients to be eligible for the sliding fee scale. a. An annual gross income statement is preferred for evaluation. i. Gross income is defined as the total of all cash income before deductions for income taxes, employee social security taxes, insurance premiums,bonds, etc. For self-employed applicants,net income after business expenses. Gross income does NOT include money earned by children for babysitting, lawn mowing and other tasks. ii. In engross income includes: salary,wages,commissions,fees,tips, overtime pay,unemployment compensation,public assistance money, alimony and child support payments, Social Security benefits,VA benefits, Supplemental Security Income(SSI)benefits,retirement&pension payments,worker's compensation,bonuses,prize winnings and other sources of cash income except those specifically excluded. B. Sources 1. Sources of income verification may include,but are not limited to: a. Current pay stub b. Self-employment accounting records c. Letter documenting current employment and wages from employer d. Recent income tax return e. Unemployment or workers compensation receipt f. Public assistance letter g. Prior income verification through enrollment in other Health Department programs 2. If an individual claims"no income"(except for minors consenting to specific services under G.S. 90-21.5), a signed"Verification of Income and/or Residency" form(Attachment A)indicating financial support from another party must be submitted. 3. Failure to provide verification within 30 days or less of date of service will result in charges being assessed at 100%of sliding fee scale. The client will receive notification of required income verification at the time the initial appointment is made. 4. The client must read, sign and understand the"Determination of Eligibility Payment Plan for Clinical Services"and"Statement of Financial Responsibility Payment Plan"form(Attachment B)at their initial visit and annual financial reviews. C. Environmental Health Persons seeking Environmental Health services must obtain and properly complete an application for service and pay the corresponding fee for service(all applicants pay at the 100%pay status)before an appointment for a field visit will be scheduled. Sometimes Page 2 of 8 Original Effective Date:January 25,2001 Revision Dates:, n�1^Tz015,4�,4/2016,9/2018,10/2019,10/2020 ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy B: Fee and Eligibility Policy Reviewed by: Financial Review Committee,Health Director Approved by: Board of Health,Health Director additional fees may be necessary if during service delivery it is determined that the correct fees were not initially paid, or services requested are more than applied for. Wastewater Treatment Management Program(WTMP)and Mobile Home Park fees are the only Environmental Health services invoiced after the inspection. These inspections are not application based but occur on a regulated,recurring schedule. IV. Residency Requirements A. Any individual,Orange County resident or non-resident,may be eligible for services provided by the Health Department. Exceptions include non-STD Communicable Disease cases, designated Family Home Visiting programs (Orange County residents only), and when prohibited by law or regulation. B. Proof of Residency may be determined b, u�the US Postal and/or Orange County GIS website and one of the following: Driver's License, Government-issued identification,Pay Stub (Within the last 30 days),Utility bill(Within the last 45 days); Current rental or lease agreement; Personal or property tax bill; Student identification, and Matricula Consular(Mexican ID Card'). Clients without one of the above identifying information sources but reportedly living within the county will be required to produce a written statement or letter from the head of household,verifying that the person resides in their home. Special cases will be referred to the Clinic Manager or Supervisor. Failure to provide proof of residency may result in referral to another resource. C. Proof of Residency in Orange County is required for self-pay patients to be eligible for the sliding fee scale when requesting Maternal Health,Child Health,Primary Care, Nutrition Services,and Dental Health Services. Out-of-county residents will be assessed at 100%of charges not covered by a third party payer source. V. Service Limitation/Denial A. Services will not be denied based solely on the inability to pay,with the exception of those services that require a flat or minimum fee. Emergency dental services and urgent primary care services will be provided to clients regardless of any outstanding balance due. B. Otherwise, services may be denied if the department does not have the resources needed to provide a quality non-mandated service or the individual does not meet the residency or financial requirement. 1 The Matricula Consular de Alta Seguridad(MCAS)(Consular Identification Card)is an identification card issued by the Government of Mexico through its consulate offices to Mexican nationals residing outside of Mexico.Retrieved from hiip://en.wikipedia.org/wiki/Matr%C3%ADcula_Consular on October 14,2012. Page 3 of 8 Original Effective Date:January 25,2001 Revision Dates:, n�1^Tz015,4�,4/2016,9/2018,10/2019,10/2020 ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy B: Fee and Eligibility Policy Reviewed by: Financial Review Committee,Health Director Approved by: Board of Health,Health Director C. Family Planning,Maternal Health, and Child Health clients will never be refused service or be subject to variations in service due to an outstanding balance or inability to provide proof of income. Health Department clients are eligible to receive these services regardless of their participation in other programs. Family Planning,Maternal Health, and Child Health services are voluntary to all clients. D. Falsification of eligibility by the client may result in denial or limitation of services. E. The Health Department shall not deny a service due to religion,race,national origin, creed, sex,marital status,familial status, sexual orientation,veteran status or age. F. The Health Department shall assure that no otherwise qualified handicapped individual, solely by reason of his/her handicap,be excluded from participation in,be denied the benefits of, or be subjected to discrimination under any program or activity covered by this agreement. G. The Health Director can override any decision to deny or limit services to a client in accordance with the existing fee waiver process. VI. Fees for Services A. In order to facilitate early entry into prenatal care or family planning services,pregnancy test charges will be adjusted to 0%on the sliding fee unless they are required as part of another service. B. Fees are not charged to self-pay clients for diagnosis and treatment of sexually transmitted diseases,or investigation and control of communicable diseases. There is also no charge to clients for any State-provided vaccine. C. Fees are charged for health and dental services provided to individuals unless prohibited by law or regulation. Fees are established based upon cost analysis,Medicaid and Medicare rates, comparable provider rates and/or state or contractual agreements. The Health Director shall inform the Board of Health and the Orange County Board of Commissioners of these adjustments in a timely manner. D. Fees may be charged to clients for"non-program" specific services without being adjusted on a sliding fee scale(flat fees). E. Fees may be charged for education,community-based limited clinical services (such as influenza shots)and screening services provided to individuals or groups. The following applies to these services: Page 4 of 8 Original Effective Date:January 25,2001 Revision Dates:, n�1^Tz015,4�,4/2016,9/2018,10/2019,10/2020 ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy B: Fee and Eligibility Policy Reviewed by: Financial Review Committee,Health Director Approved by: Board of Health,Health Director 1. They include orientation, field training,dental screening and education, and/or other health promotion activities such as infant and toddler car seats,bike helmets, or equipment rental. 2. The Health Director will negotiate fees for services where fees have not been previously determined. 3. Income eligibility requirements do not apply to these services. F. Per NC General Statute Chapter 713, Subchapter 4,Article 35,and confidentiality regulations, emancipated minors and other individuals requesting confidential services will be considered a family of one for determination of charges. Private insurance will also not be billed for minors receiving services for which they can consent unless permission is received from the minor. G. Persons requesting any program services may be encouraged to apply for Medicaid, as applicable. H. The Personal Health Services Division clinical and nutrition services will use the appropriate sliding fee schedule for services when adjustable fees are allowed; all other fees will be charged at 100%. 1. Clients,who require services provided on the sliding fee schedule, are expected to pay the appropriate fee in full based on sliding fee guidelines. 2. This schedule will require assessment of the client's financial status on an annual basis or when a financial status change occurs, as specified in section III. I. Dental Health Services,Primary Care Services,and Nutrition Services will use a sliding fee schedule for all services,with a minimum charge to be established at the annual fee review during the budget preparation process. 1. The minimum charge for dental,primary care,and nutrition services will apply regardless of the determination of the client's financial status. 2. If a client is determined to fall at the 0%pay level,the minimum charge will be the only charge levied and collected unless the client is deemed homeless. 3. Minimum charge is due at time of service. J. Fee schedules will be reviewed annually during the budget process and adjusted as appropriate; a complete cost analysis for purposes of fee adjustments will be performed every five years. The process for this cost analysis includes a review of the following elements: a. Most recent vaccine and drug purchase costs b. Most recent lab pricing lists c. Most recent Medicaid Cost Settlement data for procedure costs d. Environmental Health equipment, labor, and staff costs e. Review of fee schedules of surrounding jurisdictions £ Analysis of existing self-pay client base and how increased costs would affect their ability to get necessary care Page 5 of 8 Original Effective Date:January 25,2001 Revision Dates:, n�1^Tz015,4�,4/2016,9/2018,10/2019,10/2020 ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy B: Fee and Eligibility Policy Reviewed by: Financial Review Committee,Health Director Approved by: Board of Health,Health Director K. Based on G.S. 130A-41,the Health Director is authorized to enter into contracts,which may include negotiated reimbursement rates. L. The Health Director may not make exceptions to the Fee Policy except to accommodate specific situations through the fee waiver process(Attachment Q. M. Any minimum administrative fee or flat fees shall be applied without discrimination to all patients. N. There will be no"schedule of donations",bills for donations, or any other implied coercion for donations from clients as a condition for being seen at the Health Department. Donations to the health department can be made through the Orange County Community Giving Fund. Fees for services will not be waived because of client donations. O. Fees for 340b drugs dispensed to Medicaid patients will be reviewed and set annually based on the average,annual cost to the County to purchase the drugs. VII. Fee Collection A. Environmental Health service fees are paid before an appointment is scheduled. Field staff cannot accept fees in the field. B. Fees collected from Medicaid and Medicare and other third party insurance for a covered service, combined with payment of any applicable co-pays and co-insurance, constitutes full payment for that service. C. A co-payment, deductible,or balance of charge can be collected at the time of service from individuals covered by other third party insurance plans when OCHD is a member of their provider panel(exception family planning). For Family Planning clients, family income should be assessed before determining whether co-payments or additional fees are charged; if their family income is verified to be at or below 250%FPL,they should not pay more (in copayments or additional fees)than what they would otherwise pay when the schedule of discounts is applied.With regard to other insured clients,payments towards a deductible for clients whose family income is verified to be at or below 250% FPL should have the appropriate sliding fee schedule applied. D. If OCHD is not on the insurance provider panel,the client will be charged for the service(s)based on the Health Department's fee schedule. The client will be provided with documentation of services for submission of a claim to their insurance company. E. After charges are processed,the client will be given a statement showing the cost of services for that visit as well as their total account balance upon request. F. Payment is due at the time services are rendered. Page 6 of 8 Original Effective Date:January 25,2001 Revision Dates:, n�1^Tz015,4�,4/2016,9/2018,10/2019,10/2020 ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy B: Fee and Eligibility Policy Reviewed by: Financial Review Committee,Health Director Approved by: Board of Health,Health Director G. When the client is unable to pay in full at the time services are rendered,a payment plan is established, and the client must sign a"Payment Agreement Form"(Attachment D) except for minimum-fee or flat-fee charges. Client must then make a payment in any amount in order to activate the payment plan. H. When a client requests"no mail", discussion of payment of outstanding debt shall occur at the time the service is rendered. A remark regarding"no mail"is entered into the medical data system. No letters or other correspondence concerning insurance or past due accounts will be sent to any client that requests"no mail". Reasonable efforts will be made to collect charges without jeopardizing client confidentiality. IThe Billing Cycle for the Health Department(by Division)is as follows: If a debt is not paid,when the client attempts to make another appointment,the client will be told they have a previous balance, and they must have an active payment plan or make a payment at time of next service except for Family Planning clients. 1. Personal Health Division a. Billing statements will be sent no more than three days after charges post to client ledger. Statements will be sent to clients for the next two consecutive months for balances due. After three consecutive months with a past due balance,accounts will be forwarded to the County Attorney Office and pursued through debt set-off in accordance with the county policy. Accounts with a balance of less than$50 will remain delinquent until paid or written-off. 2. Dental Health Divisions a. Bill statements will be sent monthly by the tenth of the month for two months after services have been rendered indicating a statement of balance due. Every quarter, all accounts with a balance$50 or more that are more than 60 days past due will be forwarded to the County Attorney Office and pursued through debt set-off in accordance with the county policy. Accounts with a balance of less than $50 will remain delinquent until paid or written-off. ts"Ot paid,when the elient a#effirts to Make another appoi"tMent,th— payment plan or-make a"Moftt at tim- Family Planning 3. Environmental Health Division a. An initial invoice for additional or miscellaneous Wastewater Treatment Management Program(WTMP) charges is mailed with the inspection form. b. If no payment is received within 90 days, a second notice is mailed. c. If no payment is received after an additional 30 days and the debt is $50 or greater,the account is forwarded to the County Attorney's Office,which will pursue it through the county's debt set-off procedure. d. Debt owed by a corporation or non-individual is dissolved upon sale of property. Page 7 of 8 Original Effective Date:January 25,2001 Revision Dates:, n�1^Tz015,4�,4/2016,9/2018,10/2019,10/2020 ORANGE COUNTY HEALTH DEPARTMENT Board of Health Policy and Procedures Manual Section I: Board Adopted Policies Policy B: Fee and Eligibility Policy Reviewed by: Financial Review Committee,Health Director Approved by: Board of Health,Health Director e. The county attorney's office has deemed debt that becomes part of an estate will become dissolved. £ If the client presents and voluntarily wishes to pay on the account, any amount the client offers will be accepted, documented in the client file, and a receipt will be provided. g. Mobile Home Parks are billed annually on the calendar year. The procedure is the same as noted above. -10_Insurance and Third Party Billing 1. Where a third party is responsible,bills are to be submitted to that party; 2. Third parties authorized or legally obligated to pay for clients at or below 100%FPL are properly billed. 3. Third party bills(including Medicaid) show total charges without any discounts unless there is a contracted reimbursement rate that must be billed per the third parry agreement. 4. The health department will bill insurance and managed care organizations for which provider approval has been established. The patient will be responsible for all deductibles, coinsurance and non-covered charges. 5. Patient or parent/guardian signature is required to give authorization to file claims and provide necessary information to the insurance company(Attachment E). 6. Patients, or the accompanying parent/guardian of an un-emancipated minor with appropriate insurance benefits,who receive public health services will be given the opportunity to choose whether to have insurance filed in order to avoid breach of confidentiality or pay the associated fee according to where the patient falls on the sliding fee scale. VIII. Review and Approval A. This Policy shall be reviewed annually by members of the Financial Review Committee. The committee shall have representatives from each division, and must also include the Health Department's Finance and Administrative Services Director B. Any policy revisions must be approved by the Health Director and the Board of Health. Page 8 of 8 Original Effective Date:January 25,2001 Revision Dates:, n�1^Tz015,4�,4/2016,9/2018,10/2019,10/2020 Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: September 23, 2020 Agenda Item Subject: Present Chair/Vice-Chair Slate Attachment(s): Staff or Board Member Reporting: Jessica Frega Purpose: Action Information only X Information with possible action Summary Information: Per the Board of Health Policies and Procedures, the Board shall elect a Chair and Vice-Chair by majority vote each year at the last meeting of the calendar year. This discussion's purpose will include getting the nomination committee together to prepare the slate of officers. A vote that will take place at next month's meeting. Recommended Action: Approve Approve & forward to Board of Commissioners for action Approve & forward to Accept as information Revise & schedule for future action Other (detail): Health Director's Report September 2020 • September 2, 2020—FSA Governance Committee Meeting • September 2, 2020 - COVID-19 Update for Chamber Minority Business Owners • September 2, 2020—Operations Meeting for DHHS Regional Support Teams • September 2, 2020—Interview with Beatrice Parker—Table Joy Talks; COVID-19 Update • September 11, 2020 - Solid Waste Department Staff Meeting; COVID -19 Update • September 11, 2020—NCALHD New Health Director Orientation(Virtual) • September 14, 2020—NCALHD Executive Committee Call • September 17, 2020—NC Association of Local Health Directors Meeting (Virtual) • September 18, 2020—Meeting with Brian Toomey, CEO Piedmont Health Services—Flu Vaccination Planning & COVID-19 Testing for Community • NCDHHS is developing a COVID-19 exposure notification app called S1owCOVIDNC. The app will help North Carolinians slow the spread of the virus by alerting them when they may have been exposed to someone who has tested positive for COVID-19. S1owCOVIDNC uses Google and Apple's Exposure Notification System(ENS) and will alert users that have the app if they have been in close contact with an individual who later tests positive for COVID-19. The app is completely anonymous and does not collect, store or share personal information or location data. S1owCOVIDNC is voluntary to download and use and designed to enhance the state's existing contact tracing efforts. The app is currently in Beta testing and will be free of charge. Stay on the lookout for more information about this. • I have agreed to serve on the Carolina PROSPER Board; Carolina PROSPER will offer technical assistance to facilitate the safe re-opening of businesses during the pandemic while promoting worker health. It is a rapid-response program of the North Carolina Occupational Safety and Health Education and Research Center, part of the UNC Gillings School of Global Public Health. I will need to participate in two 2-hour long meetings this fall. • The team and I continue to work with UNC,both the school districts, and several community agencies to discuss re-opening plans. We are currently working out details for fall vaccination plans for flu and COVID-19 once it becomes available. • House Bill 1105, now Session Law 2020-97, was recently signed by the Governor. Section 3.19 will re-allow licensed soil scientists to be able to evaluate, inspect, and approve on-site wastewater systems under the provisions of 130A-336.2 without the rules or certifications from the North Carolina On-Site Wastewater Contractors and Inspectors Certification Board in place, and this expires 90 days after Executive Order No. 116 is rescinded. The common form and guidance are the same as sent out earlier this year for Session Law 2020-3 (with a few minor edits to reflect the updated Session Law number and expiration date). Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: September 23, 2020 Agenda Item Subject: COVID-19 Update 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. 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): 'It's been hard:'Chapel Hill mayor Pam Hemminger speaks to GMA about coronavirus impact on downtown,UNC community-ABC 11 Raleigh-Durham FloodWEATHER ALERT Warning V •g In fobIc EDIT CHAPEL HILL NEWS Chapel Hill mayor speaks to GMA about COVID- 19's impact on downtown,, university community SHARE Y • L y J� GMA3 WHAT YOU NEED TO_KNOW. a CHAPEL HILL, N.C. (WTVD) -- As COVID-19 clusters on the University of North Carolina campus bringing Chapel Hill into the national spotlight, mayor Pam Hemminger spoke to Good Morning America about the impacts of the virus on her town and community. UNC-Chapel Hill reopened to students in early August but had to pivot to remote learning amid multiple COVID-19 clusters in on and off-campus housing. Prior to the university moving classes online, the town council sent a letter to UNC stating concerns about an increase in cases. Hemminger said they wanted campus to conduct remote learning at the start. The https://abcl l.com/education/chapel-hill-mayor-talks-covid-19s-impact-on-university-community/6397394/[9/l/20, 10:41:33 AM] 'It's been hard:'Chapel Hill mayor Pam Hemminger speaks to GMA about coronavirus impact on downtown,UNC community-ABC 1 Raleigh-Durham Orange County Health Department had also written a letter to university officials recommending the first five weeks of class be conducted remotely. "We wanted the campus to go virtual. We know that if you bring that many students back in and pack them into dorm situations and Greek life, that we were going to see an increase in cases," said Hemminger. "So we wanted the university to work with us and figure a way to go virtual. And so that we would contain this virus more easily." FULL CORONAVIRUS COVERAGE Classes are now virtual at UNC, but that doesn't mean all students have left Chapel Hill. Mayor Hemminger said she's working with the university trying to keep the community safe while some students remain in town. "It's been hard, we love our students. They bring this vitality back to our community when they come back every year. But we also know they like to congregate. They like to celebrate," said Hemminger. "They have signed a pledge saying they understood community safety measures were (in place). We meet with the university almost on a daily basis trying to figure out pathways forward. We increased our foot patrols and the university has sent their public safety officers into the community. And we write warnings and we actually write citations when students aren't paying attention to the safety standards we asked them to. And then the university has the right to take action as well." 'I'd just rather not live like that:' Students move out of UNC-Chapel Hill dorms after just https:Habcl l.com/education/chapel-hill-mayor-talks-covid-19s-impact-on-university-community/6397394/[9/l/20, 10:41:33 AM] 'It's been hard:'Chapel Hill mayor Pam Hemminger speaks to GMA about coronavirus impact on downtown,UNC community-ABC 11 Raleigh-Durham one week of classes Last week, Chapel Hill police said four citations were issued to people violating COVID-19 safety regulations. Mayor Hemminger said the university can take action against violations in many ways. "They range the gamut from warnings all the way to de-enrollment from classes if students are having egregious behavior against the community standards," said Hemminger. The pivot to virtual learning in Chapel Hill has reduced foot traffic to local businesses, but the town has made adjustments on Franklin Street to facilitate the changing economy downtown. "So we are intertwined with a university that is that is the lifeblood of our economy here. And when we go virtual, it means there's fewer people coming and going from campus, fewer conferences, fewer sporting events. That hurts businesses, mostly in the downtown area as people come into our community to partake in those events. Our businesses are struggling," said Hemminger. "We did expand our sidewalks, increase outside dining so that we could help our restaurants and businesses be more successful. That's been an improvement, but it is hard. It's hard to balance the economy." With all of the rapid developments, Mayor Hemminger said even though many will have to make big personal sacrifices, the main priority is keeping people safe. "At the end of the day, the number one thing governments do is try to keep people safe," said Hemminger. "People are having to make sacrifices https://abcl l.com/education/chapel-hill-mayor-talks-covid-19s-impact-on-university-community/6397394/[9/l/20, 10:41:33 AM] 'It's been hard:'Chapel Hill mayor Pam Hemminger speaks to GMA about coronavirus impact on downtown,UNC community-ABC 11 Raleigh-Durham some more than others. And it's a really tough situation. But it's about what the virus can do to the community. We are partners with the university and we're trying to work on this together." 'A lot of uncertainty:' UNC Chapel Hill Student Body President on school's COVID-ig challenges Report a correction or typo RELATED TOPICS: education chapel hill nc gma chapel hill news unc coronavirus college covid 19 SHARE TWEET EMAIL Copyright©2020 WTVD-TV. All Rights Reserved. NorthHome Raleigh Weather Durham Carolina _ . HIFICNEWS photos : videos Traffic Fayetteville I-Team Watch Surrounding Area Troubleshooter • -• Entertainment Influencers Apps Events Calendar TV Listings Jobs Follow Privacy Policy Do Not Sell My Info Children's Privacy Policy Your California Privacy Rights Terms of Use Interest-Based Ads Public Inspection File Copyright 0 2020 ABC, Inc.,WTVD-TV Raleigl-Durlam.All Rights Reserved. https:Habcl I.com/education/chapel-hill-mayor-talks-covid-19s-impact-on-university-community/6397394/[9/l/20, 10:41:33 AM] Column:Local officials discuss how they're leading Orange County through crisis-The Daily Tar Heel Serving the students and the University mmun' since 889 LAST U IN THE NEWS FOOTBALL THE OC REPORT 2020 CORONAVIRU5 OUTBREAK CHAPEL HILL-CARRBORO CITY S LUXURY LIVING AT OiL C PI NTE LAST UPDATED 22 HOURS AGO Column: Local officials discuss how they're leading Orange County through crisis No, thank you r �j 1 I Carr ti Ste - the Carrboro town council member Damon Seils(left)interviewed Quintana Stewart(middle),the Orange County health director,and Dinah Jeffries(right),the Orange County emergency services COu director,about the county's pandemic response.Photo courtesy of Damon Seils. The SHARE The OC Voice is a portion of the OC Report newsletter where local residents may have a platform to talk about local issues they care about. Damon Sails is abo O SHARE a member of the Carrboro Town Council. As we begin Phase 2.5 of North Carolina's response to the COVID-19 © TWEET pandemic,it's hard to avoid feeling like we're entering another for Close if 0 MAIL unknowns.What we do know is the end isn't yet in sight.We have — We h continue our collective work to slow the spread in our community. Q PRINT Rather than offer a traditional opinion column, I wanted to highlight the Ra work of the two people leading Orange County's pandemic response. rg Ora Quintana Stewart is the Orange County health director,and Dinah Jeffries is nah Jeff the Orange County emergency services director. They agreed to answer a few questions. Seils:You are the leaders of the local response to the pandemic.What are r your roles,and how do you work together? ` https://www.dailytarheel.com/article/2020/09/city-oc-column-damon-0914[9/15/20, 10:47:03 AM] Column:Local officials discuss how they're leading Orange County through crisis-The Daily Tar Heel Stewart: As the county health director, I promote public health and prevention activities. I'm also charged with communicable disease control. This requires my team and I to investigate cases and outbreaks and to implement control measures to slow the spread of the disease. EDITORS PICKS kiihL I k Survey: We're looking to Heel Talk Episode 21: 'Making history': UNC's hear from those who have Sports in the pandemic Asian American Center lived in Chapel Hill public officially opens after 25 housing years of work Jeffries: The key words are "working together." Our teams have different missions, and the two of us communicate frequently to assure our teams have the support they need. My team's role is to ensure the safety of residents and responders and the continuity of services. We connect all the response partners and agencies so they complement each other and avoid duplicating efforts. We are also the county's connection to state and federal assistance. Seils: How is Orange County different from or similar to other communities in North Carolina when it comes to the pandemic response? Stewart: Orange County has a diverse population. We must be mindful of language and other cultural differences as we share public health messages. We are also home to the UNC System's largest school, which means we have a robust college town. Like other communities across the country, ours is concerned about economic stability and the social norms that have been affected during this unprecedented time. Our differences afford us the opportunity to be creative and innovative in our approaches as we work on our common goal of suppressing the virus. Jeffries: Orange County is fortunate to have the resources we have and the support of government leaders and partners. I think every community has unique challenges, but I strongly believe every community is recognizing how dependent we are on one another. The pandemic has challenged my team to be creative and flexible while continuing to provide the excellent service the community has grown to expect. Seils: We're six months into the state of emergency. What are the most important things residents can do now? https://www.dailytarheel.com/article/2020/09/city-oc-column-damon-0914[9/15/20, 10:47:03 AM] Column:Local officials discuss how they're leading Orange County through crisis-The Daily Tar Heel Stewart: This pandemic is very different from what North Carolina experienced with H1N1 in 2009. As difficult as it is, I ask everyone to remain vigilant in practicing health and safety precautions. If we remember to move in a way that honors and protects our neighbors, I'm confident we'll get through this a stronger, more united community. The health department has created a COVID-19 website with a wealth of knowledge, including health information, mental health resources, housing assistance and much more. Jeffries: This has been one of the most difficult crises our community has faced, because the impact is not restricted to an area, and it's invisible. Our residents are definitely the "leaders" in the community by encouraging and practicing the guidelines. I've always used the African proverb "It takes a village" when referring to raising a child. It applies to this pandemic and taking care of one another more than ever. Our nonprofits can use your help, too. Consider donating to local food pantries and other nonprofits in the area. Consider volunteering, and continue checking on neighbors who are in vulnerable and at-risk populations. Seils: I'm one of about 40 local elected officials in Orange County. We're used to residents bringing us questions and advocating for the community. In a public health emergency, how can local elected officials be most useful? Stewart and Jeffries: Keep pushing the pandemic precaution messages, and stay consistent. Encourage everyone to continue practicing the three Ws. Continue representing your community by being a voice of reason. The most important part our elected officials play is maintaining calm and making sure the community has accurate information about the response and recovery. There you have it: Know your three Ws, stay informed and help your neighbors. We're in this together. If you have questions about how you can help Orange County battle the COVID-19 pandemic,please contact the county's COVID-19 hotline at 919-245-6111. If you live in Orange County and want to make your voice heard on something you care about locally, email city@dailytarheel.com. @DTHCityState I 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 I Email` https://www.dailytarheel.com/article/2020/09/city-oc-column-damon-0914[9/15/20, 10:47:03 AM] NC Coronavirus:COVID-19 cases in universities contribute to spikes in county totals-ABC 11 Raleigh-Durham tic menu CORONAVIRUS COVID- 19 cases at North Carolina universities cause county totals to spike 4i By Samantha Kummerer and Maggie Green SHARE TWEET EMAIL CHAPEL HILL, N.C. (WTVD) -- With ljol reported student cases to date and COVID-19 clusters in 10 residence halls, it's clear to Orange County officials that the decision to reopen UNC, even for just a few weeks, had an effect on the spread of COVID-19 in the county. "The 18-24 age group as a percent of cases doubled in about three weeks so clearly that was the driving factor. We can't specifically say X amount of cases were from UNC but that age group being the one that exploded as the number of positives is kind of an indicator," said Orange County Community Relations Director Todd McGee. In the weeks following Memorial Day weekend and as https://abcl I.com/nc-coronavirus-cases-covid-19-unc/6419029/[9/15/20, 10:58:16 AM] NC Coronavirus: COVID-19 cases in universities contribute to spikes in county totals-ABC 11 Raleigh-Durham North Carolina entered Phase 2, Orange County kept cases rising at a slower rate than the rest of the state. However, in mid-August, as the rest of the state started to stabilize, Orange County saw a sharp spike in cases-- in the week of August 19, cases rose 15%. The following week, that rate of increase more than doubled to 34%• To date, there are more than 1,16o cases connected to the university. McGee said it's hard to say what percentage of Orange County's cases are associated with UNC, because many professors live in surrounding counties and students may use their home address instead of their address while at school. WATCH: Chapel Hill mayor speaks to GALA about COVID-i9's impact on downtown, university community Chapel Hill mayor discusses challenges, working with UNC amid COVID-19 pandemic However, several weeks after both UNC made the decision to transition classes online and move students out of residence halls, the county's case increase rate has decreased to a level more in-line with the rest of https://abcI l.com/nc-coronavirus-cases-covid-l9-unc/6419029/[9/15/20, 10:58:16 AM] NC Coronavirus:COVID-19 cases in universities contribute to spikes in county totals-ABC 11 Raleigh-Durham the state--just a 5% increase between September 2 and September 9. McGee said the county is still in contact with UNC officials and is hosting a weekly testing event in Chapel Hill. Furthermore, the university began voluntary daily testing for students without COVID-19 symptoms this week at the Campus Health to preemptively identify cases in residence halls. In a statement, UNC Provost Robert A. Blouin said a similar program will be set up of students who live off-campus in the next few weeks. "We just want to keep those numbers driving down," McGee said. Wake County and Pitt County, home to North Carolina State University and East Carolina University respectively, also saw similar spikes in cases in August. For comparison, Johnston County, which has no major universities, did not have a spike in cases in August. In Wake County, the number of new cases added each week had been decreasing in early August. However, by August 26--two weeks after NC State students started classes, the county reported more than 1,200 new cases, compared to 744 the week before. "As we saw the spike, we began to identify cases and follow our proper procedures and doing the assessments on them and monitoring and isolating for those cases," said Dr. Nicole Mushonga, a representative for the Wake County Health Department. Though the spike in cases at NC State didn't have the https://abcl I.com/nc-coronavirus-cases-covid-19-unc/6419029/[9/15/20, 10:58:16 AM] NC Coronavirus:COVID-19 cases in universities contribute to spikes in county totals-ABC 11 Raleigh-Durham same magnitude of an effect on Wake County's numbers as UNC had on Orange County, McGee said the difference in county population could explain why Orange County's cases increased at a much higher rate than Wake County's. "You look at Wake County and the population is about a million, so you know NC State's 30,000 students is 3% of the population," McGee said. "When you look at Orange County, our population is around 150,000 or so and 30,000 UNC students, that's 20% of the population. I think it was just a matter of numbers." RELATED: NC State students pack up, start moving out after less than a month on campus This week--two weeks after NC State Chancellor Randy Woodson moved courses online, Wake County only reported 624 new COVID-19 cases. But Mushonga warned that decrease isn't an excuse to become complacent. "We really just have to continue to be vigilant in those preventative measures and to not let our guards down and just to continue with the three W's," Mushonga said. RELATED: Meredith College credits app with helping COVID-ig cases stay low amid in- person learning However, Durham County did not see an increase in cases in August--in fact, cases declined throughout the month, even though the county is home to both Duke University and North Carolina Central University. Duke University is still operating in-person classes, https://abcl I.com/ne-coronavirus-cases-covid-19-unc/6419029/[9/15/20, 10:58:16 AM] NC Coronavirus:COVID-19 cases in universities contribute to spikes in county totals-ABC 1 Raleigh-Durham however, the school was one of just a few that required students and faculty to be tested for COVID-19 before returning to campus, and is still conducting ongoing testing. To date, the university has reported 52 cases since the start of the school year. Report a correction or typo RELATED TOPICS: health &fitness chapel hill orange county raleigh wake county durham durham county nc nc state university coronavirus unc duke university nc state SHARE TWEFT EMAIL Copyright©2020 WTVD-TV. All Rights Reserved. Home Raleigh U.S. &World About ABC 11 YEWITNESS Weather Durham North Carolina Send us your . .Traffic Fayetteville I-Team photos &videos NEWS PhotosWatch Surrounding Area Troubleshooter ABC1 1 Together . . .. Calendar FollowTV Listings Jobs RightsPrivacy Policy Do Not Sell My Info Children's Privacy Policy Your California Privacy Copyright o 2020 •: . Raleigh-Durham. Rights -. https://abcI l.com/nc-coronavirus-cases-covid-l9-unc/6419029/[9/15/20, 10:58:16 AM] Op-ed:Local response to a global pandemic-The Daily Tar Heel 01 4r Serving the students and the University community since 1893. IN THE NEWS 2020 CORONAVIRUS OUTBREAK THE OC REPORT FOOTBALL THE DAILY TAR HEEL ELECTION We in O Second Stimulus Poll to the C( Question:Do you need a second stimulus check to get by?See what America had to say workmoney needed mas 8/30/2020,5:48PM Now Op-ed: Local response to a global cam pandemic Becaus No, thank you commu SHARE We in Orange County,including Carrboro,Chapel Hill and Hillsborough, are disas six months into our response to the COVID-19 pandemic.The community prov © SHARE has responded well, doing what has been asked and what is needed to keep the community safe. From the stay-at-home order issued in March to the appr © TWEET three Ws(wear a mask,wait 6 feet apart,wash your hands), the community worked has stepped up, and the numbers have shown it. shelt 0 MAIL Now,we face a new challenge, as local numbers have jumped due to clusters OPRINT on the UNC-Chapel Hill campus.We must meet this moment,and we will. T Because an end date isn't yet in sight, it is more important than ever that the key p public understand how communities respond to a public health crisis. Orange County uses national best practices for managing disasters and Our emergencies. In March, county and town Emergency Operations Centers Serv* were activated to provide resource support to the community and addressll coordination to effectively respond to the pandemic. This approach also enables us to request support from the state and federal governments.The county c EOC staff have worked around the clock to support the whole community's response to the pandemic -- from feeding to sheltering. These countywide emergency protocols exist to streamline cl Close Ition and translate the expertise of key players into action. Who are Y E I players? la ers? Our pandemic response is led by County Health Director Quintana Stewart and County Emergency Services Director Dinah Jeffries. They and their teams bring expertise that is essential to effectively addressing the pandemic at the local level. Every week since March,the three mayors,the chair of the county commissioners and others meet to share information and help guide the countywide response. https://www.dailytarheel.com/article/2020/08/local-elected-oped[9/l/20, 10:35:42 AM] Op-ed:Local response to a global pandemic-The Daily Tar Heel We are so fortunate to have this group of professionals working together for an effective pandemic response. While COVID-19 may bring unprecedented challenges, those working in public health, emergency response and county and town management have trained and planned for crisis situations. They are ready to guide us through it, and it is important we listen to them and heed their guidance. One thing the pandemic has laid bare is our mutual dependence on each other. To get to the other side of this crisis, we need everyone to do their part. We depend on our emergency response leaders to direct the response. We depend on our residents to practice the three Ws and follow our emergency orders. We depend on business owners to follow directives and guidelines from the state and the county. Local elected officials also have a role to play. Each of us must support the work of the operational leadership team and make sure they have the resources they need. Decisions must be made based on the insight and knowledge of that team, best practices and what is within our legal authority. As elected officials, we all should use our public platform to amplify messages from the public health specialists, with the goals of consistency and clarity. Each time county leaders issue a new order, we carefully weigh whether adding or changing a rule will actually help efforts to control the pandemic or hinder efforts by creating confusion about what residents and businesses are supposed to do. For us, our purpose is clear: lead by helping the public understand what they need to do, and let the local public health and emergency services professionals lead the way. Perhaps most important, your council members and commissioners are supporting town and county staff to ensure that basic municipal and social services continue to be delivered. And they are thinking and acting creatively to apply lessons from the past six months to manifest the equitable and thriving Orange County to which we all aspire. Local public health and emergency services officials have stepped up their efforts even more in response to the spike at UNC-Chapel Hill. Likewise, we all need to step up our own efforts as well. Each of us in Orange County is integral to the identity and success of this community. We are in this together. Let's do this together. Penny Rich is the chairperson of the Orange County Board of Commissioners. Pam Hemminger is the mayor of Chapel Hill. Lydia Lavelle is the mayor of Carrboro. Jenn Weaver is the mayor of Hillsborough. https://www.dailytarheel.com/article/2020/08/local-elected-oped[9/l/20, 10:35:42 AM]