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HomeMy WebLinkAboutBOH Minutes of 102820 MINUTES ORANGE COUNTY BOARD OF HEALTH October 28,2020 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 October 28, 2020 virtually via Go To Meeting. BOARD OF HEALTH MEMBERS PRESENT: Jessica Frega — Chair, Sam Lasris —Vice-Chair, Keith Bagby, Bruce Baldwin, Brian Crandell, Aparna Jonnal, Commissioner Earl McKee, Lee Pickett, Shielda Rodgers, Timothy Smith and Alison Stuebe. BOARD OF HEALTH MEMBERS ABSENT: None. STAFF PRESENT: Quintana Stewart, Health Director; Rebecca Crawford, Financial and Administrative Services Director; Karen Graham, PHN II - CD; Victoria Hudson, Environmental Health Director; Jennifer Jensen, PHN II — Preparedness Coordinator; Donna King, Health Promotion & Education Services Director; Kristin Prelipp, Communications Manager; Beverly Scurry, BOH Strategic Plan Manager; and La Toya Strange, Administrative Support I. GUESTS PRESENT: Mikayla Gaspary, Community Engagement Manager, NCCARE360 and Unite Us. I. Welcome New Employees Jessica Frega, Chair, called the meeting to order. Ms. Stewart, Health Director, introduced the new employees in attendance, Karen Graham and Jennifer Jensen. II. Public Comment for Items NOT on Printed Agenda: None. III. Approval of the October 28, 2020 Agenda Motion was made by Timothy Smith to approve the agenda, seconded by Bruce Baldwin and carried without dissent. IV. Action Items (Consent) A. Minutes of September 23, 2020 Meeting Motion was made by Aparna Jonnal to approve the minutes of September 2020 with the edit of changing Ms. Bagby to Mr. Bagby on page 6 of the minutes, seconded by Bruce Baldwin and carried without dissent. V. Educational Sessions A. NCCARE360 Mikayla Gaspary, Community Engagement Manager, NCCARE360 and Unite Us, gave a S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ October Page 1 MINUTES ORANGE COUNTY BOARD OF HEALTH October 28,2020 presentation on NCCARE360, its network status update and how to get involved. Below are some highlights. • NCCARE360, which was rolled out in 2019, is the first statewide electronic referral network that unites healthcare and human services organizations and enables a coordinated, community-oriented, person-centered approach for delivering case management in NC. Any organization that is providing services that impact health or the social determinants of health can onboard to the platform to better streamline their referral process. Partners include the NC DHHS (the brainchild behind NCCARE360), the Foundation for Health Leadership and Innovation (provided the funding), Unite Us (developed the network platform), NC 211 and the United Way. • The main goal of the network is to make sure that North Carolinians are getting connected to the agencies that can help them and are ultimately getting the help that best fits their needs. • There are over 200 service types in the platform. • NCCARE360's referral process is different from the traditional referral process in that: o Information is stored and transferred on United Us' HIPPA, FERPA, FIPS, VAWA and 42 CFR Part 2-compliant platform. All data is encrypted, secure and compliant with security and data storage standards and breach and enforcement rules. o Informed consent is requested by the system once before the first referral is made which gives their consent to have their information shared in order to receive services from network partners. o Clients are matched with the provider(s) they qualify for. o Providers have insight into the entire client journey. o Longitudinal data is tracked to allow for informed decision-making by community care teams. Reports can be pulled to understand information about the clients you serve, services you provide and the referrals you send and receive. o If the client wants to be notified of their referral(s) status, once they give permission, they can be enrolled to receive notifications whether via phone or email. o Clients also have the option of looking for resources themselves. They're able to do so and the referral request is sent to NC 211. • There are entities that are required to use NCCARE360 for their referrals including Healthy Opportunities Pilot grantees, PHPs for Medicaid Transformation and community health workers. • Network status update: o NCCARE360 is live in all 100 counties in NC. o There are over 1,700 organizations onboarded, over 4,134 users and over 5,600 referrals have been sent. • To become a partner: o You'll need to submit a partner registration form. o Determine how you want your organization to be set up in the network. o There are webinars every Tuesday at 2pm, self-guided and in-person trainings available. B. 1ST Quarter Financial Reports & Billing Dashboards Rebecca Crawford, Financial &Administrative Services Director, gave a report on the 1st quarter revenue and billing accuracy in FY 20-21. Her report is as follows: • Total Health Department Budget vs. Actuals: S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ October Page 2 MINUTES ORANGE COUNTY BOARD OF HEALTH October 28,2020 Average YTD monthly revenue in FY20-21 after the first quarter is $195k/month or $584k YTD, representing 17% of our overall budgeted revenue for the year. As usual though, the total first quarter revenue is skewed down due to the majority of state funds not eligible to be drawn in July (this is typical) and allocations of Medicaid Max funds will not be transferred into our budget until the end of the fiscal year. Revenues were only slightly below this point last fiscal year (FY 19-20 1 st Quarter YTD: $216k). Expenses are in line with revenues, at 18% of the overall budget. • Dental Earned Revenue by Source: The FY 20-21 average monthly revenue ($31.3k/month) for the first quarter is below our budget projection ($41 k/month) and our FY 19-20 average of$39.7k/month due to longer than anticipated dental clinic closures during the pandemic and the Dental Division Director vacancy. PPE shortages had a negative impact on the dental clinic and its ability to re-open to increased capacity, as Dental staff are required to wear a higher level of PPE for most procedures. The clinic is working with Duke Hospital to sanitize N95 masks, which have allowed staff to see more patients. FY 20-21 dental earned revenue totaled $94k at the end of the first quarter compared to $160k at the end of the FY 19-20 first quarter. • Medical Earned Revenue by Source: Medical earned revenue is currently above the budgeted projection for FY 20-21 ($33k/month) at $44.3k/month due to greater than anticipated revenue during the pandemic. Telehealth visits have been very successful and allowed the clinic to continue to see patients and bill for services even as in-person visits were limited. Billing staff have also worked diligently to collect as much revenue as possible from Medicaid and insurance companies from older accounts. We anticipate this trend toward increased revenue will continue to improve as the medical clinic gradually adds more in-person visits based on PPE availability and staff capacity. Medical clinic revenue totals $133k for first quarter FY 20-21 compared to $130k in first quarter FY 19-20. • Environmental Health Earned Revenue by Source: Environmental Health earned revenue is slightly below the budgeted projection for FY 20-21 ($53k/month) at $48.4k/month. It is a seasonal trend to see lower revenue in the first quarter of the year than in later quarters due to spring pool inspections. EH staff have worked hard to continue OSWP inspections during the pandemic with little to no in- person required of residents. • Grants Fund Revenue: FSA has drawn $200k of the multi-year Kenan grant. Expenditures are tracking as anticipated and will continue to increase as we fill the vacant Navigator position in November. The BOH members had questions and comments that were addressed by Ms. Crawford and Ms. Stewart. C. Advisory Board Update Beverly Scurry, Board of Health Strategic Plan Manager, made reference to the Advisory Report and stated that COVID-19 related issues were a topic of discussion for most boards. She directed the Board to review the Advisory Report and asked if there were any questions. The Board had none. S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ October Page 3 MINUTES ORANGE COUNTY BOARD OF HEALTH October 28,2020 VI. Reports and Discussion with Possible Action A. BOH Chair and Vice-Chair Slate The Board members shall elect a Chair and Vice-Chair by majority vote each year at the last meeting of the calendar year. It is customary for the current Vice-Chair to occupy the Chair position because of the experience gained as Vice-Chair. There was a nomination for Bruce Baldwin for Vice-Chair. Ms. Frega informed the Board to email her if there are any other nominations. The vote for Chair and Vice-Chair will take place, next month, at the November 18th meeting. B. Health Director Annual Evaluation Jessica Frega, Chair, reviewed this year's process for the annual review. Ms. Stewart will send her send her updated work plan to Ms. Frega. Ms. Frega will be in contact with the County Manager and human resources. A survey will be sent to Ms. Stewart's direct reports and a random sampling of staff at the OCHD. The annual review will occur during a closed session at the November 18th meeting where the results will be discussed as well as her performance. Ms. Strange will create a new Go To Meeting link for the closed session. C. Health Director Report In addition to her report, Ms. Stewart spoke briefly on the items below beginning with a brief overview of the information displayed in the COVID Dashboard created by Ms. Crawford as well as took questions and comments from the Board. • The Medical Clinic patient encounters for October were low. One of the reasons may be attributed to a new clinic schedule that began this month that only has one clinic location operable per day. The SHSC and Whitted locations alternate days in which they are open. The schedule was instituted out of caution and patient safety as we were short staffed. We are currently in the process of hiring and orienting additional staff. • In-house COVID testing numbers decreased which correlates with our increased community testing opportunities across the county while working with state partners. • The Communication team continues to be responsive to community questions and requests even though call line volume and email activity has decreased a little. • As a result of Mr. Bagby's request at the last Board meeting for a COVID update for the community, a Public Health Chat series was created with a plan to do one monthly. It started last month with Ms. Stewart and others including EMS director, Dinah Jeffries, participating. Kudos was given to Ms. Prelipp for her excellent video editing skills. Ms. Prelipp also facilitated another video that involved Ms. Stewart, the mayor of Chapel Hill and the UNC Chancellor that encouraged safety while enjoying Halloween. • The OCHD has had some key staff, the Dental Director and the Personal Health Services Director, retire. A departmental reorganization was recently implemented. There are still five divisions. There were no changes in the Environmental Health and Financial and Administrative Services divisions. There was a minor change in the Dental Clinic. Carla Julian served a dual role as our Compliance & Quality Assurance (QA) manager and Dental Clinic manager. Now, her full-time focus is on compliance & QA. She is also the liaison for the congregate facilities in reference to COVID as well as the supervisor for our interpreters as Susan Clifford has made the transition to Human Rights and Relations due to the County Manager's vision of making the work Susan does available on a countywide level vs only at the OCHD. Personal Health Services S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ October Page 4 MINUTES ORANGE COUNTY BOARD OF HEALTH October 28,2020 now consists of the medical clinic, communicable disease and nutrition teams. The newly created Community Health Services division consists of family home visiting, Family Success Alliance and Health Promotion & Education Services. A new director will be hired for this division. • Ms. Stewart congratulated Victoria Hudson on receiving the Bill Broadway award from the NCPHA. Ms. Hudson expressed her appreciation for being honored with the award and thanked Ms. Frega for the kind words she provided in the nomination packet. • The new Dental Director, Dr. Monica Meng-Haggerty, will be joining the OCHD sooner than expected. She will be starting on November 9t" D. COVID-19 Update Quintana Stewart, Health Director, gave an update on the COVID-19 status in Orange County (OC) as well as took questions from the Board. Some highlights are below. • As of today, o There are 3,088 confirmed cases and 58 deaths in OC. o There were 111 new cases in the last 7 days, an average of 15-16 cases daily. • We've seen a steady increase in cases; however, they're widespread all across the county in both rural and urban areas. There are no potential clusters or indication of a single source that we're aware of based on the information we're getting from case investigations. The increase has mostly been with the younger population and working age groups, specifically the 18-24 year olds with the 25-49 year old age group following slightly behind. • There are some new outbreaks in long term care facilities with most of them being employees. • There's a steady increase in hospitalizations in OC and the state. UNC Main is at 95% capacity. • The percent positive tests percentage for OC is currently at 3% which is below the ideal percentage of 5% or less; however, OC has been as low as 1.3%. • There have been 64,372 tests conducted. This does not translate into the number of individuals tested because some community members have been tested multiple times. Roughly 44% of the population, an increase of 3%, has been tested in Orange County. • We are attempting to make sure there are assessible testing sites in all parts of the county. StarMed consistently sets up a Wednesday testing site in the Chapel Hill area. Through state resources, we've also onboarded a new vendor, Optum Health, which will focus on testing in the Efland area. We also have testing in the northern part of the county in Hurdle Mills. The fourth Saturday of the month, we're testing in Chapel Hill at St. Thomas More. This Sunday, there is a testing event at McDougle Elementary School in Carrboro. This week, we've started daily testing at the OCHD in Hillsborough at the Whitted site. All testing is free. We've also offered free flu shots at some of the community COVID testing events. So far, 412 flu shots have been administered. • At today's Governor's press update, the eviction moratorium was extended until the end of the year for those unable to pay their rent. It was announced last week that the HOPE (Housing Opportunity to Prevent Evictions) federal funds are another resource that can assist with some emergency housing needs. For our community members that are undocumented, they are not eligible for those funds. Our housing director is aware of this and is in the process of requesting some additional resources to support community members not eligible for the HOPE funds. S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ October Page 5 MINUTES ORANGE COUNTY BOARD OF HEALTH October 28,2020 • Also at the Governor's briefing, they debuted a new PSA about the importance of wearing masks especially as there will be more family gatherings due to the holidays. The question isn't how well you know someone, it's whether this person a part of my immediate household. If the answer is no, you'll need to wear a mask. E. Media Items Kristin Prelipp, Communications Manager, mentioned that the articles in the Board packet were just a selection of the numerous COVID-19-related articles. Included in the Board's packet were articles regarding UNC-Chapel Hill's fall reopening, the Hurdle Mills COVID-19 testing and Halloween health guidance. Media items were in the packet which focused on Orange County's events and our involvement in various efforts. VII. Board Comments Mr. Bagby stated that he'd completed the orientation with the Family Success Alliance. Ms. Stewart thanked him for being the Board's liaison. Ms. Stuebe and Ms. Pickett stated that the County's Diversity, Equity & Inclusion (DEI) training in which they participated was great. Vill. Adjournment Bruce Baldwin moved to adjourn the meeting at 8:48pm and Alison Stuebe seconded. The next Board of Health Meeting will be held November 18, 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/ October Page 6