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HomeMy WebLinkAboutBOH Final Minutes of February 24, 2021 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH February 24, 2021 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 February 24, 2021 virtually via Go To Meeting. BOARD OF HEALTH MEMBERS PRESENT: Sam Lasris — Chair, Bruce Baldwin —Vice-Chair, Jessica Frega, Brian Crandell, Commissioner Jean Hamilton, Lee Pickett, Shielda Rodgers, Timothy Smith and Alison Stuebe. BOARD OF HEALTH MEMBERS ABSENT: Keith Bagby and Aparna Jonnal. STAFF PRESENT: Quintana Stewart, Health Director; Kyra Colson, Nutrition Services Office Assistant; Rebecca Crawford, Financial and Administrative Services Director; Cristina Greeson, Dental Assistant; Victoria Hudson, Environmental Health Director; Carla Julian, HIPAA Privacy and Security Officer, Compliance/Risk Manager; Dr. Monica Meng-Haggerty, Dental Director; Kristin Prelipp, Communications Manager; Beverly Scurry, BOH Strategic Plan Manager; and La Toya Strange, Administrative Support I. GUESTS PRESENT: None. I. Welcome New Employees Sam Lasris, Chair, called the meeting to order. Ms. Stewart, Health Director, introduced the new employees in attendance, Kyra Colson and Cristina Greeson. II. Public Comment for Items NOT on Printed Agenda: None. III. Approval of the February 24, 2021 Agenda Motion was made by Jessica Frega to approve the agenda, seconded by Bruce Baldwin and carried without dissent. IV. Action Items (Consent) A. Minutes of January 27, 2021 Meeting Motion was made by Shielda Rodgers to approve the minutes of January 2021, seconded by Alison Stuebe and carried without dissent. V. Educational Sessions A. Campus & Community Coalition Update Elinor Landess, Director of the Campus & Community Coalition to Reduce the Negative Impacts of High Risk Drinking (the CCC), presented an update on the status of the Coalition's activities. S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ February Page 1 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH February 24, 2021 Below are some highlights: • A historical timeline of the CCC and its formation were provided. The CCC was formed in 2014 as a collaborative effort between the Town of Chapel Hill, UNC Chapel Hill, the Orange County Health Department and the Orange County ABC Board with a focus on high risk drinking in Chapel Hill. • There are 21 recommended strategies responsive to the environment in Chapel Hill and Carrboro. In 2019, the 2020 Action Plan strategic planning began using the Results Based Accountability framework. It was approved on March 7, 2020; however, its rollout was halted due to the COVID pandemic. • CCC Successes: o Compliance checks have increased to 92% o CHCCS high schoolers and UNC student drinking has decreased • Some research data linked to high-risk drinking o Collegiate research data ➢ The majority of sexual assault cases at UNC involved alcohol, which is a national trend at various colleges and universities. ➢ Students of color disproportionately impacted by other students' drinking at predominately white institutions. ➢ Neighbors living near college campuses report secondhand effects of alcohol use including noise disturbances, public drunkenness, vomiting and urination in their neighborhoods. o COVID-19 and high-risk drinking research data ➢ College students are reporting drinking more during COVID-19. This is similar to what is being reported population-wide, as there have been increased alcohol sales during COVID-19. ➢ Community spread happening at locations associated with alcohol. ➢ High profile university-community conflict related to alcohol, parties and COVID- 19. • 2020 Action o The focus is on a harm reduction approach vs a prohibitionist approach. CCC is trying to change the culture and the environment around alcohol. o Has 8 principles: ➢ Evidence-based, public health approach; high-risk focus; culture/environmental change; fully informed; active deterrence; consistent accountability; town/gown collaboration; centralized effort o Selected strategies ➢ Educating students and parents ➢ Responsible beverage service training ➢ Outlet compliance monitoring ➢ Place of last drink data collection ➢ Social host ordinance ➢ Restrict alcohol marketing The BOH members had questions that were addressed by Ms. Landess. S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ February Page 2 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH February 24, 2021 VI. Action Items (Non-Consent) A. FY 2020-21 Budget Rebecca Crawford, Financial and Administrative Services Director, presented the Board with a summary of the proposed FY 2021-2022 budget for the Health Department. The FY 2021-2022 budget presents an increase in expenditures of$319,615 from the FY 21-22 Base Budget; the majority of which is related to an additional allocation from NCDHHS for the Regional Prevention and Support Team to continue infection prevention education in long term care facilities next fiscal year. Staff projects a $359,615 increase in revenues for FY 21-22, which will fully offset the expenditure increase. The balance of$40,000 was incorrectly included in the Health Department's base budget for FY 2021-2022 and will not be used. The Health Department will request a County General Fund budget in FY 21-22 of$7,255,918. The Health Department proposes to create a new division in FY 2021-2022 called the Community Health Services division. This division will combine programs from the Personal Health and Health Promotion and Education Services divisions that do not have a medical clinic focus in order to isolate all medical clinic-related services in the Personal Health division. The new division will include the following programs: • Health Promotion and Education Services (Healthy Communities, Healthy Carolinians, Board of Health, Tobacco Prevention, CLAS Grant) • Family Success Alliance • Family Home Visiting (Newborn/Postpartum, Health Behavior Interventions, Care Coordination for Children, Pregnancy Care Management) There is no additional financial impact with this change. The proposed total budget is $10,759,555. New Staff Requests The Health Department requests to extend time limited status for an additional fiscal year for a 1.0 FTE Community Health Aide, 1.0 FTE Property Development Specialist, and additional 0.3 FTE for a permanent part-time Office Assistant II. The Community Health Aide position was originally grant funded in a partnership with UNC in the Formerly Incarcerated Transitions (FIT) program, which ended last fiscal year and was fully absorbed into the Health Department budget. We have seen many benefits to the residents of Orange County through this program and have reallocated County General Funds to support keeping the position on a permanent basis. The Property Development Specialist has been crucial to ensuring timely and accurate data entry in the Energov system so licensed Environmental Health staff are able to perform On Site Well Program (OSWP) inspections in a time sensitive way. Finally, the additional 0.3 FTE for the permanent part-time Office Assistant II will be funded by regional Minority Diabetes Prevention Program (MDPP) grant funds to assist the Nutrition Program in the MDPP grant requirements. State Funding The NC Department of Health and Human Services (NCDHHS) has provided us with the FY 21- 22 Consolidated Agreement Addenda. We received an increase in the Refugee Health Assessment program of$978 for a total allocation of$5,200 (related to an increase in S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ February Page 3 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH February 24, 2021 anticipated Refugees resettled in Orange County) and an additional allocation of COVID-19 funding for the Regional Prevention and Support Team (RPST) program totaling $434,052 (regional team providing Infection Prevention training and support to long term care facilities in a nine county region, including Orange County). We also received a decrease of$1,950 in the Breast and Cervical Cancer Control Program (BCCCP) (related to the anticipated decrease in eligible BCCCP screenings by the state), and the Healthy Communities program of$180, which will not impact service delivery. Motion was made by Alison Stuebe to approve the total budget requested in the amount of$10,759,555 for FY 2021-2022 and forward to the County Manager and Board of County Commissioners for action, seconded by Jessica Frega and carried without dissent. Commissioner Hamilton abstained. Proposed Fee Changes The FY 21-22 requested budget includes fee changes and additions for the Personal Health and Environmental Health divisions. In reviewing Health Department fee schedules, which are done on an annual basis, the Department would like to make multiple fee changes in Environmental Health and Personal Health. Environmental Health Environmental Health requests to adjust multiple Onsite Well and Septic Program (OWSP) fees. The division proposes to discontinue the Wastewater Treatment Management Program (WTMP) specific fee in order to conduct those time consuming inspections during a typical Existing System Inspection. This will save on staff time and create efficiencies. The Existing System Inspection fee would increase from $175 to $200 to offset the additional staff time costs for that inspection. The division also proposes to increase the fees for Existing System Authorizations (office visit only), Septic Tank Contractor Annual Renewals, and Follow-Up Inspections, which have not been increased since 2017 and will offset staff costs. The total financial impact from Environmental Health fee changes is projected to be a decrease of$1,665. Personal Health Personal Health requests to increase the fee for prescription drug dispensing by $1 (to reflect the minimum fee charged by Walgreens for prescriptions as the medical clinics finalize the move to outsource primary care medication dispensing to Walgreens to prevent duplicated data entry as Epic does not have an outpatient dispensing platform), to add fees to charge for telehealth (this is happening but hasn't officially been added to the county fee schedule) and to continue scheduled adjustments to the fees for 340B drugs (Family Planning drugs not including birth control pills) to equal the county's cost to purchase them, as required by the state and federal government. The total financial impact from Personal Health fee changes is projected to be a maximum increase of$2,809. S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ February Page 4 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH February 24, 2021 The BOH members had questions and comments, including a calculation error and the number of inspections conducted by Environmental Health, were addressed by Ms. Crawford, Ms. Hudson and Ms. Stewart. Motion was made by Alison Stuebe to approve all fee changes for FY 2021-2022 as presented and forward to the County Manager and Board of County Commissioners for action, seconded by Jessica Frega and carried without dissent. Commissioner Hamilton abstained. Vill. Reports and Discussion with Possible Action A. Health Director Report Before presenting her report, Ms. Stewart began by apologizing for the delay in the sending of the BOH agenda packet which was due, in part, to our OCHD team coordinating the COVID response and vaccination processes all while working on the budget. She extended her many thanks to the OCHD team. In addition to her report, Ms. Stewart highlighted the items below. • The Family Success Alliance (FSA) met with their resource development group. The FSA will not be applying for United Way funds this year. The main two reasons are: o Adherence to budget guidelines to try to move away from time-limited positions. There were not any job losses because of the decision to not apply as some of our navigators found other permanent full-time positions elsewhere. o It gives our community partners a chance to apply directly to United Way and receive funding. We are still working with our community partners and will be signing letters to support their individual application process to United Way. • Virtually, the Cooperative Extension had their 23rd agricultural summit. Ms. Stewart delivered the intro for day 2. It was a 3-day conference. Dr. Kizzmekia Corbett, OC native, one of the lead doctors that helped develop the Moderna vaccine also presented. • Last month, NCALHD submitted a request for another extension for Accreditation. It was approved for an additional 12-month delay effective May 9, 2021. • Ms. Stewart and Commissioner Hamilton briefly spoke on the BOCC's decision to disengage Cardinal Innovations as our Local Management Entity— Managed Care Organization (LME-MCO). Secretary Cohen makes the final decision after a lengthy process concludes that also includes gathering public comments. B. 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, • There are 7,623 confirmed cases and 93 deaths in OC related to COVID. • The percent positive tests percentage for OC is currently at 1.1%, below the ideal percentage of 5% or less; however, community spread is still high. The state's percentage is around 6%. • County Alert System S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ February Page 5 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH February 24, 2021 o OC is still maintaining at the orange level, which indicates substantial community spread. The state numbers are getting better. The number of counties in red decreased from 61 to 27. The number of counties in orange increased from 33 to 40. There was an increase in counties, from 6 to 33, that are now in the yellow level. • In regards to the COVID vaccine: o The OCHD have vaccinated 4,296 individuals with the 1st dose and 2,979 individuals with their 2nd dose of COVID vaccine. The OCHD is in compliance with all reporting measures and uses 1 It dose allocations within 7 days. o In the last 3 weeks, the OCHD received 600 doses (200 1st doses and 400 equity doses to distribute). Last week, the OCHD was informed that the new base allocation amount for the next 3 weeks would be 500 doses (400 1 st dose and 100 equity doses to distribute). Doses are still below demand. o School and childcare workers are eligible to be vaccinated effective today. o It is anticipated that the Johnson & Johnson, 1 time dose, vaccine will be approved sometime this weekend. It is easier to store, manage and transport. It has an efficacy rate of 70% which is comparable to the seasonal flu vaccine. The state pharmacist stated that NC might receive doses as early as March 9tn The process for distribution hasn't been determined yet. • Vaccination Data o There are 2 options to obtain data. The state has demographic information on their website. There is an option to choose county-specific data. Their data is pulled from the vaccinated person's home county of residence not where the vaccine was administered. The OCHD's data is based on the people we've vaccinated regardless of their county of residence. 0 The BOH members had questions and comments that were addressed by Ms. Stewart. B. 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 that were gathered. Included in the Board's packet were articles regarding the COVID cluster at UNC's Avery Residence Hall, OCHD receiving more COVID allocations after not receiving any for three weeks, UNC's handling of the fall session, students rushing Franklin Street and EMTs protocols changed at the state level allowing them to assist with the vaccination process in a manner similar to paramedics. Media items were in the packet which focused on Orange County's events and our involvement in various efforts. VIII. Board Comments None. S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ February Page 6 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH February 24, 2021 IX. Adjournment Jessica Frega moved to adjourn the meeting at 8:53pm and Alison Stuebe seconded. The next Board of Health Meeting will be held March 24, 2021 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\2021 Agenda &Abstracts/ February Page 7