HomeMy WebLinkAboutBOH Minutes of 062420 MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
June 24,2020
ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To enhance the quality
Hof life, promote the health, and preserve the environment for all people in the Orange County
community.
THE ORANGE COUNTY BOARD OF HEALTH MET ON June 24, 2020 virtually via Go To
Meeting.
BOARD OF HEALTH MEMBERS PRESENT: Jessica Frega, Chair, Keith Bagby, Bruce
Baldwin, Aparna Jonnal, Liska Lackey, Sam Lasris, Lee Pickett, Timothy Smith and Alison
Stuebe.
BOARD OF HEALTH MEMBERS ABSENT: Commissioner Earl McKee.
STAFF PRESENT: Quintana Stewart, Health Director; Rebecca Crawford, Financial and
Administrative Services Director; Michael DeFranco, Public Health Services Manager; Victoria
Hudson, Environmental Health Director; Pamela McCall, Public Health Nursing Director; Asuka
Nakamura, Community Outreach Specialist; Kristin Prelipp, Communications Manager; Beverly
Scurry, BOH Strategic Plan Manager; and La Toya Strange, Administrative Support I.
GUESTS PRESENT: Dr. Shielda Rodgers.
Jessica Frega, Chair, called the meeting to order at 7:02pm. Ms. Stewart introduced the new
employee in attendance, Asuka Nakamura.
I. Public Comment for Items NOT on Printed Agenda: None.
II. Approval of the June 24, 2020 Agenda
*Motion was made by Lee Pickett to approve the agenda, seconded by Sam Lasris and
carried without dissent.
III. Action Items (Consent)
A. Minutes of May 27, 2020 Meeting
*Motion was made by Alison Stuebe to approve the minutes of May 2020, seconded by
Aparna Jonnal and carried without dissent.
IV. Educational Sessions
A. Annual Communicable Disease Report
Michael DeFranco, Personal Health Services Manager, gave an overview of the communicable
disease (CD) data for the year 2019 which began with the purpose of the CD program within the
health department. He also noted that this met the Accreditation Benchmark 2.5. Below are
some of the presentation highlights.
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Enteric "Foodborne" Illnesses—
• Campylobacter and salmonella make up the greatest amounts of gastrointestinal
illnesses that occur in Orange County.
Vaccine Preventable Diseases—
• Pertussis—Orange County normally sees consistent rates of pertussis.
• Influenza — Orange County did not have any influenza deaths last year.
Vectorborne Illnesses —
• There was a multivariate spike in 2019.
• Rocky Mountain spotted fever (RMSF) and Ehrlichiosis are the two most prevalent tick
borne illnesses seen in Orange County. The data includes suspected cases. One of the
problems is the confirmation of these diseases because they're serological diseases.
Optimally, acute and convalescent specimens need to be collected. Most practitioners
have been conditioned that if they suspect this disease, to simply treat it versus collect
specimens.
Waterborne Illnesses—
• Legionella hasn't been an issue in Orange County in the last two years. The county only
gets occasional cases of cryptosporidium.
Sexually Transmitted Illnesses (STI)—
• The numbers are strong even with the large amount of education and intervention our
clinic provides.
• Chlamydia and gonorrhea cases are usually the highest cases of STIs.
Other Relevant Data —
• There was an increase in Tuberculosis. Two of the confirmed cases were
nonpulmonary.
COVID-19—
• The first case originated on the west coast of the U.S., Seattle, Washington area, then
traveled across the country, not necessarily in just a west to east motion.
• The COVID-19 initial response included:
o conversations with the OCHD health director, medical director and OCHC CD
team,
o state health department involvement,
o strategic planning at OCHD in February 2020 which involved
■ EOC and partnerships
■ ICS structure
■ Reallocation of OCHD personnel and resources
■ scale-up capabilities
• Incident Organization Chart was shown that provided a diagram of all of the members
and their roles.
• Strike Team was created which consists of a public health CD Registered Nurse (RN),
Emergency Management Services, Personal Protection Equipment expert, community
paramedic and a preventive health medicine doctor. It focuses on long term care
facilities, group homes, recovery homes, assisted living facilities, and vulnerable
populations in Orange County such as migrant farms and the refugee/immigrant/Latinx
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populations by assisting with testing, monitoring, educating, preventive planning, well
checks, etc.
• Case investigation and contact tracing are completed by members of the clinical staff,
environmental health, health educators, Family Success Alliance Navigators,
retired/former OCHD personnel working part time, school RNs and data/IT specialists.
The BOH members had questions that were addressed by Mr. DeFranco and Ms. Stewart.
B. BOH Strategic Plan Discussion
Beverly Scurry, BOH Strategic Plan Manager, led a discussion regarding the three BOH
priorities for the next four years. A brief summary of the discussion is below.
• Terminology was discussed regarding the most effective and inclusive terms for the
priorities.
• The suggestion of aligning with some of the Healthy 2030 goals and objectives was
made.
• The three BOH priorities are Access to Care, Substance Use Disorders and Health
Equity.
• Ms. Scurry will begin researching strategies to use in the BOH subcommittees. The
BOH subcommittees will meet in August. A draft plan will be created for the
subcommittees and the Board as a whole to review in September. Afterwards, work will
begin to finalize a strategic plan. The Board was asked to send any ideas on
strategies/suggestions to Ms. Scurry.
The BOH members had questions that were addressed by Ms. Scurry and Ms. Stewart.
V. Action Items (Non-Consent)
A. BOH Subcommittees
The Board members volunteered to serve on the BOH subcommittees. There is a maximum of
5 members on each subcommittee to avoid having a quorum. The results are below. Only the
vacant position of Pharmacist representative and Commissioner Earl McKee were not included
and will be added later. There was a stipulation that whoever serves on the Health Equity
Subcommittee either has taken or will complete racial equity training.
Access to Care— Bruce Baldwin, Alison Stuebe, Shielda Rodgers
Substance Use Disorders—Timothy Smith, Sam Lasris, Jessica Frega, Aparna Jonnal
Health Equity— Lee Pickett, Keith Bagby, Alison Stuebe, Shielda Rodgers
V. Reports and Discussion with Possible Action Action Items
A. BOH Open Seats Discussion (Pharmacist and Vice-Chair)
Jessica Frega, Chair, led the discussion on the fulfillment of the Pharmacist representative. Dr.
Brian Crandell, board certified oncology pharmacist and clinical pharmacist practitioner, was
recommended. Dr. Pickett and Ms. Frega interviewed Dr. Crandell. Some of the interview's
takeaways were:
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• He works at the UNC Hospital in Hillsborough.
• He put a lot of emphasis on evidence-based medicine, data-driven interventions and
was very interested in getting more educated on racial equity issues.
• He also expressed his concern regarding access to care as he's also a foster parent and
has seen, firsthand, the problems that come with children not having access to care.
As the BOCC is in summer session, it may be September before they're able to review the
BOH's recommended appointment.
Motion to appoint Brian Crandell to the BOCC was made by Lee Pickett, seconded by
Jessica Frega, and carried without dissent.
The Board members voted on selecting a member to fill the vacant Vice-Chair seat. Ms. Frega
nominated Sam Lasris, noting his experience and background knowledge regarding how the
Board operates. There were no other nominations.
Motion to appoint Sam Lasris as the Vice-Chair was made by Bruce Baldwin, seconded
by Keith Bagby, and carried without dissent. Sam Lasris abstained.
B. Health Director Report
Ms. Stewart began by thanking Mr. DeFranco for the CD update report as he covered some of
the items she was going to cover in her COVID-19 update. Some of the items Ms. Stewart
mentioned from her report are below.
• Northern Orange Testing Event at Mt. Zion A.M.E. Church in Hillsborough held on June
51" in which 147 individuals were tested. This was collaboration between the OCHD,
UNC PNC and UNC Health RDC. There's talk to do more mass testing including having
one at the southern end of Orange County.
• The first Long-Term Recover Group (LTRG) meeting occurred. The group, comprised of
local leaders, was established to ensure a coordinated recovery process for COVID-19
as it is understood that this pandemic will have long-term devastating effects on the
aimed at a whole-community approach. The county hired a consultant from the
Haggerty Group to lead this process. The LTRG is divided into 7 Recovery Support
Functions of which there is one specifically for health. While we're trying to address the
recovery, we're still very much in COVID-19 response mode. Ms. Stewart thanked
Aparna Jonnal for participating in the LTRG as the physician representative of the BOH.
• Ed Kerwin, Executive Director of OWASA, will be retiring effective July 6, 2020. OWASA
has shared the BOH's Fluoridation report online and it's open for public comment.
• Pam McCall, our Personal Health Services Director, also known as our Nursing Director,
will be retiring effective August 121". Ms. McCall was congratulated by the board and Ms.
Stewart on her upcoming retirement. Ms. Frega added that she's always been
impressed by her Board presentations and her off the cuff knowledge whenever the
Board had questions for her as Ms. McCall always knew the answer.
• Interviews for the Dental Director position are being scheduled. Sam Lasris was
thanked for agreeing to serve on the interview panel.
C. COVID-19 Update
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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.
• The Governor announced at the briefing today that the state will remain in Phase 2
another 3 weeks until July 17th as we're not meeting the metrics he previously spoke
about. He'll revisit that decision at that time. On this Friday at 5pm, the statewide
mask/face covering mandate goes into effect. The Governor would like to see a
percentage positive ideal rate at 5% for the state. Currently, the state is at a rate of 9-
11%.
• Today,
o NC had a record high 1721 new cases reported today.
o Orange County had a record high of cases last Saturday and Sunday. Both days had
16 new cases each.
o The number of hospitalizations increased over the last 14 days with yesterday having
a record high 915.
o Hospitals state they still have the capacity to see or take care of more covid patients.
• Testing
o Overall the State has completed 17,000 tests a day. Labs are experiencing a
shortage of reagent supplies. The State has reached out to the federal government
for assistance.
• Locally today,
o There are 568 cases.
o As of this morning, there are 29 hospitalizations.
o There have been 1 additonal death since the BOH has met.
o There have been 3 outbreaks in 3 nursing facilities with no new outbreaks. In order
for them to come off of that outbreak status, they must go 28 straight days with no
new cases.
• The DHHS website has a new function. County-specific information can be obtained by
a simple click allowing demographic information to be seen.
• DHHS will also start to report clusters/outbreaks in schools and daycare centers. As of
today, there aren't any in Orange County.
• The OCHD is working on ramping up its outreach and testing in the Latinx community as
hispanic cases are very high. A Spanish website has been created identical to the
English version including the dashboard and all of its data. Public service and radio
announcements have been broadcasted. The Strike Team has also turned focus on
reaching out to migrant workers and immigrant populations.
There was a dashboard titled "Board of Health Dashboard — OCHD COVID-19 Response"
displayed. Ms. Stewart stated the link is on the OCHD website. This dashboard was created by
Rebecca Crawford to show how the OCHD clinics responses have been affected by COVID-19.
Below are some highlights.
• Patient encounters for the medical clinic remain the same as last month; although,
numbers are still down due to the abbreviated schedule.
• 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 are also increasing.
• The Dental Clinic continues to see emergency appointment only.
• In regards to data on communications,
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o Social media, COVID calls and emails increased in volume due to the mask
mandate being introduced in June.
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.
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.
o Our Immigration and Refugee Health program served 350 families in collaboration
with DSS with food boxes over the last five weeks.
Ms. Frega provided guidance to the BOH in reference to responding to emails received from the
public to ensure that consistent messaging occurs, that the proper information is shared and
that Ms. Stewart, Mr. Lasris and Ms. Frega are looped in before replying. It was also reiterated
that the BOH wants to respond to the public in a timely manner and to include the entire BOH so
that everyone is aware of the conversation.
Ms. Stuebe asked if there is a platform we could use such as Microsoft Teams to communicate
as a board versus over email. Ms. Scurry brought up the issue of quorums and meetings. Ms.
Stewart will check on this issue and get back to the Board.
Ms. Pickett would like for the OCHD newsletter to get a wider audience, possibly subscribing to
the OCHD's newsletter as there is a lot of great information in those newsletters.
D. Media Items
Kristin Prelipp, Communications Manager, mentioned that all of the articles were COVID-19
related. The articles were about high school graduations, COVID in nursing homes, a
Hillsborough restaurant praising the guidance they received from the Environmental Health
division, incomplete COVID race and ethnicity data, NC surpassing over 1000 COVID-related
deaths and the face covering requirement. There's a page dedicated to face coverings with
FAQs that include answers on a 6t" grade reading level which is available in 7 different
languages.
Media items were in the packet which focused on Orange County's events and our
involvement in various efforts.
VI. Board Comments.
Ms. Frega stated that Ms. Stewart has been sending out the NALBOH webinars. Board
members were instructed to contact La Toya if they have any difficulties accessing the
webinars.
Ms. Frega commented that tonight is BOH member, Nurse Representative, Liska Lackey's last
meeting. Ms. Frega stated that Ms. Lackey has served the maximum amount of terms as a
BOH representative. She also mentioned that Ms. Lackey served as a representative with the
Healthy Carolinians of Orange County and the Family Success Alliance. Ms. Stewart virtually
presented an appreciation plaque to Ms. Lackey while expressing her gratitude for Ms. Lackey's
service. She also stated how much she appreciated Liska's faith and confidence in hiring her as
the new health director.
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Ms. Lackey expressed that she will miss spending time with the Board, that it's been a privilege,
and will be keeping up with the board's activities.
Dr. Shielda Rodgers, while attending tonight as a guest, will be participating at the next board
meeting as the Nurse Representative.
*Ms. Strange asked Ms. Frega to get a verbal approval from Mr. Bagby on minutes and agenda
as earlier in the meeting, we weren't able to hear him.
VII. Adjournment
Keith Bagby moved to adjourn the meeting at 9:07pm and Alison Stuebe seconded.
The next Board of Health Meeting will be held August 26, 2020 at 7:00pm via Go To
Meeting.
Respectfully submitted,
Quintana Stewart, MPA
Orange County Health Director
Secretary to the Board
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