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HomeMy WebLinkAboutBOH Final Minutes of January 27, 2021 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH January 27, 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 January 27, 2021 virtually via Go To Meeting. BOARD OF HEALTH MEMBERS PRESENT: Sam Lasris — Chair, Bruce Baldwin —Vice-Chair, Keith Bagby, Jessica Frega, Brian Crandell, Aparna Jonnal, Commissioner Jean Hamilton, Lee Pickett, Shielda Rodgers and Alison Stuebe. BOARD OF HEALTH MEMBERS ABSENT: Timothy Smith STAFF PRESENT: Quintana Stewart, Health Director; Rebecca Crawford, Financial and Administrative Services Director; Faith Claman, Advanced Practice Provider I; Matthew Gilley, Environmental Health Specialist; Victoria Hudson, Environmental Health Director; Carla Julian, HIPAA Privacy and Security Officer, Compliance/Risk Manager; Zin Lyons, Public Health Nurse Supervisor I; 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: Maggie Sloane. I. Welcome New Employees Sam Lasris, Chair, called the meeting to order. Ms. Stewart, Health Director, introduced the new employees in attendance, Faith Claman and Matthew Gilley. II. Public Comment for Items NOT on Printed Agenda: None. III. Approval of the January 27, 2021 Agenda Motion was made by Alison Stuebe to approve the agenda, seconded by Jessica Frega and carried without dissent. IV. Action Items (Consent) A. Minutes of November 18, 2020 Meeting Motion was made by Bruce Baldwin to approve the minutes of November 2020, seconded by Jessica Frega and carried without dissent. V. Educational Sessions A. Immigrant and Refugee Updates Zin Lyons, Public Health Nurse Supervisor I, shared updates on the Immigrant and Refugee Health (IRH) program. Below are some highlights. S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ January Page 1 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH January 27, 2021 • OC Health Department data: o LEP = 35% Medical Encounters and 40% Dental Encounters o Refugee arrivals — FY 19-20 = 18 and FY 20-21 = 13 so far • 1-693 Process o USCIS provides a blanket designation for local health departments to function as civil surgeons for refugees to assist them with the adjustment of their immigration status. This blanket designation applies only to the vaccination status of refugees. It does not apply to applicants for adjustment of status who are asylees or other types of immigrants. They must go to a physician who has civil surgeon status and undergo complete medical evaluation. o Total served with this process in FY 19-20 = 57 • The OCHD has many language resources including language services policies & coordination, 2.5 Staff Spanish medical interpreters/translators, 15 contractors, ASL, and telephonic & video interpreters. • The IRH program is an IRH community liaison, a part of the OC Interagency Coalitions and participates on the Racial Equity Committee and the CLAS AA. • OCHD was the lead department that coordinated the community IRH Coalition, and Latinx Equity subcommittee, both coordinated by Susan Clifford. When Susan's position moved to the OC Human Rights and Relations department, so did these two community groups, but OCHD maintains a very close relationship with the groups in order to inform our work and connection to the immigrant and refugee community. • During 2020, the IRH Coalition met weekly to address the COVID-19 pandemic. The group has really helped OCHD in the following ways during the pandemic: o Provided support and information to members regarding face masks, food options, employee rights, and COVID updates on latest guidance and multilingual information, and updates related to housing and school issues. o Assisted the COVID communications group with messaging to the immigrant and refugee communities. This included suggesting food distribution locations and mass testing sites to reach our vulnerable populations. o Other activities of the IRH Coalition included: ■ Organized Food Box Assistance which on a weekly average helped 68 families with food boxes, 22 families with diapers, and 5 families with formula. ■ Organized speakers at meetings to disperse more information to community partners including presentations on the eviction diversion program, OC Housing programs, mental health topics, school systems, OC Recovery and Transformation, refugee services for Burmese and Karen families, etc. o The coalition reaches about 200-400 people via their Iistserv. The coalition is expanding in 2021 to include more marginalized groups and community voices. • What's new for 2021? o The newly named OC Changemakers group has transformed to be more inclusive of other People of Color communities. It gives opportunities for leaders in People of Color (POC) communities to emerge, giving space for POC to tell their stories, and hopefully making systemic change for the betterment of everyone in Orange County. The BOH members had questions that were addressed by Ms. Lyons. B. 2nd Quarter Financial Reports & Billing Dashboard S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ January Page 2 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH January 27, 2021 Rebecca Crawford, Financial &Administrative Services Director, gave a report on the 2nd quarter revenue and billing accuracy. Her report is as follows: • Total Health Department Budget vs. Actuals: Average YTD monthly revenue in FY20-21 after the second quarter is $286k/month or $1.6M YTD, representing 41% of our overall budgeted revenue for the year. As usual though, the total second 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 are higher than this point last fiscal year due to state allocations for the COVID-19 pandemic response (FY 19-20 second quarter YTD: $209k). Expenses are in line with revenues, at 43% of the overall budget. • Dental Earned Revenue by Source: The FY 20-21 average monthly revenue ($31.3k/month) for the second 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 in the first quarter. 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 $188k at the end of the second quarter compared $304k at the end of the FY 19-20 second quarter. • Medical Earned Revenue by Source: Medical earned revenue is currently above the budgeted projection for FY 20-21 ($33k/month) at $42.1 k/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 $253k for second quarter FY 20-21 compared to $250k in second 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 $44k/month. It is a seasonal trend to see lower revenue in the second 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. FY 20-21 second quarter YTD revenue ($264k) is higher compared to second quarter YTD FY 19-20 ($243k). • Grants Fund Revenue: FSA has drawn $200k of the multi-year Kenan grant. Expenditures are tracking as anticipated but we will most likely not fully expend the Kenan grant and thus will not request reimbursement for the full grant amount as many FSA staff have been re- deployed for the COVID-19 pandemic response. The BOH members had questions that were addressed by Ms. Crawford and Dr. Meng- Haggerty. S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ January Page 3 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH January 27, 2021 C. Outside Agency Review Process Ms. Stewart began by thanking the Board for their flexibility. She summarized the Outside Agency Review process as it had changed. This year, the applications will be reviewed by the advisory boards and their input given to the County Manager before she meets with the outside agencies. The Health Department received eleven applications to review. Board members are to review the applications assigned to them, record scores on the scoring card, and send the completed scoring card back to La Toya Strange by February 22na The BOH members had questions that were addressed by Ms. Stewart. VI. Action Items (Non-Consent) A. Updated BOH Policy Manual Mr. Lasris presented the Board with the updated BOH policy. Ms. Stewart added that we review and update the BOH manual annually as required per the Accreditation process. The Board members updated their binders with and/or saved an electronic copy of the updated BOH policy. Ms. Stewart briefly highlighted the minor changes that occurred since last year's BOH manual update. The BOH members had questions that were addressed by Ms. Stewart. Vill. Reports and Discussion with Possible Action A. BOCC Work Plan Review Beverly Scurry, BOH Strategic Plan Manager, spoke briefly on the Annual Work Plan which will be reviewed by the BOCC during a work session in the spring of 2021. Some of the work outlined in the Annual Work Plan included work performed around the BOH priority areas, which changed mid-year to be in alignment with the Community Health Assessment priorities, Environmental Health rules, and COVID-19. Ms. Stewart added that, traditionally, the Board Chair and Vice-Chair joins her when she presents the Annual Work Plan to the BOCC. She welcomed them to do so. The BOH members had questions and comments that were addressed by Ms. Stewart. B. Health Director Report In addition to her report, Ms. Stewart highlighted the items below. • Medicaid Transformation is scheduled to go live July 1, 2021. • Last week, NCDHHS announced that Legal Aid of INC will provide Medicaid Managed Care Ombudsman services for many of the state's Medicaid recipients starting this spring. They'll help answer questions and navigate the Medicaid recipients through the process. S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ January Page 4 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH January 27, 2021 • The NCIPH has some new free virtual online Board of Health Trainings. It is required, for Accreditation purposes, that all new members complete the training within their first year. • Last week, the NCALHD formally sent a request to NCDHHS for another extension for the Re-Accreditation process to allow the LHDs continue their focus on COVID. The current COVID extension is due to expire in April 2021. If the request is not approved, the OCHD will receive our 90 day letter towards the end of this year, with the site visit occurring early 2022. • NCALHD set their priorities for the year 2021. The priorities include the intent to focus on some recovery items related to the COVID-19 pandemic, provide healthcare for uninsured North Carolinians and to continue lobbying to restore the women's and children's health block grant funding to the LHDs. In 2011, there were some reappropriations done that resulted in a 2.2 million dollar reduction across the state to LHDs. C. 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 6,501 confirmed cases and 80 deaths in OC related to COVID. o Over the last 14 days, our case count is 446 per 100,000 residents. o There were 342 new cases in the last 7 days, an average of 49-50 new cases daily. • The percent positive tests percentage is currently at 3.6%, below the ideal percentage of 5% or less; however, community transmission is high. • Last week, Mecklenburg County detected the new variant strain of COVID. Although this strain is highly transmissible, we are currently being told that the current vaccines are still effective against this new strain. • Last week, the State updated the COVID County System Alert. We are currently considered orange status. We now have substantial community spread. • CDC made an official statement about students returning to school for in-class instruction. We've been in communication with the Orange County and Chapel Hill- Carrboro City Schools districts. They are working with the ABC Collaborative, which completed a comprehensive study across the state with the schools that already have in- person classroom instruction. They found that it is possible for children to attend school and be safe but it only seemed possible for that to occur in schools that are very rigid and strict about following the masking requirements, social distancing and practicing good hand hygiene. It was also found that there was low transmission in the schools. • In regards to the COVID vaccine: o As of yesterday, Orange County (inclusive of UNC Health & the OCHD) have vaccinated 15,860 individuals with the 1st dose and 3,994 individuals with their 2nd dose of COVID vaccine. o The OCHD has administered 1st dose vaccinations to 3,018. We began administering 2nd doses this past weekend where there were 305 doses given. o Ms. Stewart referenced the OCHD's recent press release. The OCHD has exhausted all of our 1st dose allocation of COVID vaccine. We've been without 1st dose allocations for the last 3 weeks. The state took a large portion of the vaccine allocation and committed it to the some of the mega vaccination events that took place in the state which resulted in several counties and hospitals S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ January Page 5 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH January 27, 2021 across the state receiving very little or no allocations. The NCALHD were very concerned about the state's allocation process and sent Secretary Cohen a letter Sunday afternoon. She called a meeting with local government officials and LHDs for Monday afternoon where she apologized and stated that she wanted to acknowledge that she wasn't totally transparent in explaining what the state was doing regarding allocations. She stated that decisions were made in the allocation process in an attempt to show the federal government that if they allocated more vaccines to NC, we would be able to distribute them quickly and get people vaccinated. o Starting this week and for the next 3 weeks, Secretary Cohen has committed to guaranteeing each county a minimum base allocation amount based on the county's population. NC receives 127K doses each week which is now being distributed across the state amongst hospitals, HD, other multiple providers, family qualified health centers, etc. o The CDC has noticed that we've expended 95% of our 1 st doses allocation. The CDC ranked NC 9th in total vaccines administered and 28th in vaccines administered per 100K people. o Ms. Stewart revealed that we weren't prepared for the Governor's announcement of starting the next phase when we hadn't completed vaccinating the 75+ population; however, the OCHD has made major changes to the process. ■ Phone lines have been staffed with live people; it's not just an online process. ■ One of the forms has been removed from the sign up process. The newly revised interest survey is the only form that needs to be completed online. ■ Registration at the PODs (Point of Dispensing) ➢ When people are getting your 1st vaccine, we schedule them for the 211 dose while they're waiting. ■ We continue to send out blast emails as we continue to communicate with the public. ■ While we don't have enough vaccines, we have enough people to help administer them. The community has really assisted by volunteering at the PODs. We've also received 30 volunteers from the state to help. ■ We continue to view and review our processes through an equity lens, looking for ways to reach our marginalized communities. We're working with our community partners and finding ways to assist those that have transportation barriers. We're also asking what the barriers are. In addition to transportation, we're looking at the education piece of the process. ■ We've gone to the long term care facilities that didn't have contracts with CVS and Walgreens and have vaccinated their residents. On December 23rd, we started going into 8 smaller group homes and vaccinated them with their 1 st dose. We will start administering the 2nd doses soon. ■ We're looking at software to track OCHD data. The BOH members had questions and comments that were addressed by Ms. Stewart, Ms. Julian and Ms. Crawford. D. 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 S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ January Page 6 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH January 27, 2021 Board's packet were articles regarding the COVID cluster at UNC at Carmichael Dormitory and a Daily Tar Heel story about the new phases/groups of the vaccination plan. Media items were in the packet which focused on Orange County's events and our involvement in various efforts. Vill. Board Comments Sam Lasris, Chair, thanked Jessica Frega for her work last year as Board Chair and for helping him to get ready for this year. Mr. Lasris mentioned that many years ago, the Chair ended the Board meeting by asking the Board if they had anything nice happen to them or anything to share. Mr. Lasris asked the Board if they had anything good to share with the Board. Several Board members replied. *After the BOH Policy Manual agenda item, Ms. Stewart and Mr. Lasris apologized for not acknowledging/introducing newly appointed Commissioner Jean Hamilton at the beginning of the meeting. Mr. Lasris welcomed Commissioner Hamilton and asked her to introduce herself to the Board. Commissioner Hamilton spoke briefly about herself including that she was elected to the BOCC in November 2020, previously on the Chapel Hill-Carrboro City Schools Board, and is currently a Licensed Clinical Social Worker with a private practice in Chapel Hill. IX. Adjournment Jessica Frega moved to adjourn the meeting at 8:40pm and Shielda Rodgers seconded. The next Board of Health Meeting will be held February 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/ January Page 7