HomeMy WebLinkAboutBOH Final Minutes of June 23, 2021 MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
June 23,2021
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 June 23, 2021 virtually via Go To
Meeting.
BOARD OF HEALTH MEMBERS PRESENT: Sam Lasris — Chair, Bruce Baldwin —Vice-Chair,
Keith Bagby, Brian Crandell, Jessica Frega, Commissioner Jean Hamilton, Aparna Jonnal,
Shielda Rodgers and Timothy Smith.
BOARD OF HEALTH MEMBERS ABSENT: Lee Pickett and Alison Stuebe.
STAFF PRESENT: Quintana Stewart, Health Director; Rebecca Crawford, Financial and
Administrative Services Director; Michael DeFranco, Personal Health Services Manager;
Victoria Hudson, Environmental Health Director; Kristin Prelipp, Communications Manager;
Ashley Rawlinson, Public Health Program Manager/Healthy Carolinians Coordinator; and La
Toya Strange, Administrative Support I.
GUESTS PRESENT: None.
I. Welcome New Employees
Bruce Baldwin, Co-Chair, called the meeting to order. Ms. Stewart, Health Director, introduced
the new employees: Maria Hernandez and Chinyere Ekenna (not in attendance).
II. Public Comment for Items NOT on Printed Agenda: None.
III. Approval of the June 23, 2021 Agenda
Motion was made by Jessica Frega to approve the agenda, seconded by Aparna Jonnal
and carried without dissent.
IV. Action Items (Consent)
A. Minutes of May 26, 2021 Meeting
Motion was made by Jessica Frega to approve the minutes of May 2021, seconded by
Commissioner Jean Hamilton and carried without dissent.
V. 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 2020, 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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ORANGE COUNTY BOARD OF HEALTH
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Enteric "Foodborne" Illnesses —
• Campylobacter and salmonella make up the greatest amounts of gastrointestinal
illnesses that occur in Orange County. The numbers were less than the previous year,
primarily due to the pandemic.
Vaccine Preventable Diseases —
• Since they are respiratory diseases, school closings, hand washing and mask wearing
has resulted in the decline in the rate of pertussis and influenza.
Vectorborne Illnesses—
• Rocky Mountain spotted fever (RMSF) and Ehrlichiosis are the two most prevalent tick
borne illnesses seen in Orange County. It's speculated that RMSF increased due to
limited social interactions which caused some people to enter the woods more to do
activities such as mountain biking and walking, most likely, in areas endemic to ticks.
Waterborne Illnesses—
• Legionellosis and cryptosporidium numbers have been steady.
Sexually Transmitted Illnesses (STI) —
• Chlamydia and gonorrhea cases are the highest cases of STIs.
• The trend is that STI numbers are going downward.
• New HIV infections were cut by a third. There were no newly identified AIDS infections
for the 4th year in a row.
COVID-19—
• The total number of cases in NC is just over a million at 1,009,198.
• The total number of cases in OC is 8,579. Approximately 8,100 were molecular (PCR)
positive cases and 479 antigen were positive cases.
• Demographics of confirmed cases in OC were presented. Weekly case trends were
provided and broken down by race, ethnicity, and age.
• The COVID-19 vaccination response:
o On December 23, 2020, the first administration of vaccine by the OCHD mobile
team was completed at Apogee group home.
o The first Points of Dispensing (PODs) occurred at Cedar Ridge High School.
Afterwards, more PODs were held at various locations such as the UNC RR lot,
churches and community centers in which larger quantities of vaccines could be
distributed.
o Optum, a state contracted provider, is providing daily vaccinations and testing, at
both, the Whitted and SHSC, health department locations via appointment and
walk-in. Moderna and Pfizer vaccines are being given at both locations.
o The OCHD mobile team continues to remain active and reach out to historically
marginalized areas of the county. Katie Benedyk, from OC EMS, is the mobile
team lead. The OCHD mobile team has provided vaccinations in OC resident's
homes, the detention center in Hillsborough, and mobile parks. They have
worked with our Human Services team in their effort to work with community
partners to reduce some of those barriers that OC's underserved areas are
experiencing so that they can be vaccinated as well as assisting the community
partners when the vaccine is made available for those less thank 12 years of
age.
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o OC population vaccination rates including those that are not eligible to be
vaccinated due to age:
■ 64% vaccination have their first dose
■ 61% fully vaccinated
o The OC community have been very helpful. Over 1500 volunteers have assisted
with phone operations, traffic control, data entry, and being vaccinators.
The BOH members had questions that were addressed by Mr. DeFranco.
B. Community Health Assessment Action Plans Presentation
Ashley Rawlinson, Healthy Carolinians of Orange County (HCOC) Coordinator, presented the
2020 State of the County Health Report (SOTCH). The SOTCH is a report that is produced
every year in between the Community Health Assessment (CHA). Health Behaviors, Helath
Equity and Access to Care are the three priority areas that are focused on in the report. Those
three priority areas are also the names of the committees that were formed as a result of the
CHA. Below are highlights from Ms. Rawlinson's presentation.
• The CHA is a report about the health of the community and the community's capacity to
improve the lives of residents of Orange County. Community involvement helps to
ensure that the true needs of the community are identified, accurately represented, and
addressed. Collection methods for data collection include community input sessions and
opinion surveys that were conducted in 2019.
• The top three leading causes of death in OC remain cancer, heart disease and
cerebrovascular disease. They have remained the same as in prior years.
• OC has a lower age rate of death than the state of NC.
• OC identified its first cases of COVID-19 in March 2020. In April 2020, OC experienced
its first COVID-19 death.
• As of June 2021,
o There were 376,753 COVID tests given in OC; 13,455,767 tests were given in
NC.
o There were 8.576 total cases of COVID-19; 1,007,273 cases total in NC.
o There were 101 deaths in OC; 13,246 total deaths in NC.
o There were 94,009 people vaccinated with at least one dose in OC; 4,287,113 for
the state of NC.
• COVID-19 response efforts included case monitoring and investigation, call center,
testing, communications and vaccinations.
• Ms. Rawlinson completed a Results Based Accountability (RBA) certification course paid
for by DPH. As a result, she assisted and helped facilitate three Area Health Education
Center-led RBA trainings.
• RBA was used in the CHA action planning process:
o Turning the Curve - Is anyone better off?
o Results for each group and what the achieved results would look like
o Story behind the curve —Where we are/What helps to paint the picture?
o Partners —Who should be involved?
o What works— No cost/low cost ideas
o Strategies/intervention/action — Performance measures
• CHA Action Planning
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o Healthy Carolinians of Orange County (HCOC) started the process in 2020 and
the early part of 2021 to identify potential strategies to address, at the community
level, around each priority area. There were delays due to the pandemic.
o The Focus of HCOC
■ Health Behaviors —Work to ensure that all OC supports safe and
responsible use of alcohol by focusing on alcohol access to minors and
alcohol outlet density.
■ Health Equity Council —Work to ensure that all members of the OC
community have meaningful access to resources and supports to define,
maintain, and improve their physical, mental and social health and well-
being.
■ Access to Care —Will serve in more of a support role to help ensure that
all individuals receiving services in OC will have everything they need
with no limitation, as it pertains to transportation, healthcare, prevention,
as well as, intervention and treatment services.
• Ms. Rawlinson stated that they're still working on the SOTCH, making it more
presentable. Kristin Prelipp is putting together timeline of the past 500+ days into the
SOTCH. Ms. Rawlinson will send an updated copy to the Board next week.
• Ms. Rawlinson stated that this report will be desseminated to the NC DPH, BOH, BOCC,
HCOC membership and OC government employees. Electronic versions are available
online via the HCOC and OCHD websites. She noted that per Benchmark 38, Activity
38.2, for accreditation purposes, the BOH minutes should reflect that the BOH members
have received and reviewed the SOTCH report.
The BOH members had questions that were addressed by Ms. Rawlinson.
VI. Reports and Discussion with Possible Action
A. BOH In-person Meetings
Board Co-chair, Bruce Baldwin, led the discussion regarding the Board's stance on returning to
in-person meetings. Mr. Baldwin encouraged the Board to review the May minutes, which
included the notes from the last Board meeting discussion.
Ms. Stewart stated that she spoke with the County Attorney regarding this matter. The State of
Emergency Declaration was extended to the end of July. The Board of Health meets as a result
of a state general statute and is meeting virtually during the State of Emergency. We're also
waiting to find out if Governor Cooper will extend the State of Emergency for the state once
again. In the interim, county IT is looking into hybrid meeting options.
Some of discussion from the Board members included:
• Shielda Rodgers - There's conflicting messaging from our Governor. The mask
mandate was lifted but the State of Emergency was extended. People are wondering
why they should be vaccinated. Ms. Stewart explained some of the reasons as to why
the declaration was extended to July— eviction, telehealth, unemployment benefits, etc.
while acknowledging some challenges of the mask mandate - the honor system,
enforcements, etc.
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• Comm. Jean Hamilton — Requested that the Board set the statute requirement aside for
a minute and asked if they'd like to meet remotely? Mr. Baldwin commented that, based
on the May minutes, there were some that did based on technology being available.
• Keith Bagby— He stated that he personally gets more out of in-person meetings. He
also mentioned that there would need to be thoughts of alternate locations if we're to
meet in-person. Ms. Stewart has stated that the BOCC room is in demand; however,
that we're working with County IT to continue to work in a virtual format. The option of
possibly using both conference rooms and what it would look like logistically was
mentioned.
• Jessica Frega — If we're all vaccinated, other than psychological aspect, she'd personally
prefer to meet in person. As a Board, we would need to be comfortable disclosing
vaccination status. Discussion would also need to occur regarding public attendance.
• Aparna Jonnal — She prefers to meet in person. The science allows us to relax a little. It
would also help to minimize screen time. She understands that Commissioner Hamilton
is a little busier and would have more meetings to travel to; therefore, it's also nice to
respect those that want to remain remote as long as it's allowed.
• Commissioner Jean Hamilton — She expressed how she likes to consider individual
preference regarding meeting remotely. As a psychotherapist, some of her clients prefer
remote while others do not. She likes the option to be open to everyone.
B. Health Director Report
In addition to her report, some of items Ms. Stewart briefly highlighted are below.
• She's starting to transition back to pre-COVID activities including working on the
departmental Strategic Plan using the RBA approach.
• NCALHD is back to having its monthly in-person meetings in Raleigh.
• Legislative bills being watched:
o House Bill 61 — Communicable Disease Funding. COVID has shown how budget
cuts have strained public health infrastructure over the years and affected the
ability to respond to the pandemic.
o House Bill 572 — No Vaccine Mandate by Executive Order, Rule or Agency.
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.
• According to the county alert system, OC is still in the yellow tier, which indicates
significant county spread.
• The State expanded the incentive program that offers a $25 gift card for those
vaccinated for the first time. OC was on the list to be added to this expansion group.
• DHHS has shared that the Delta variant is spreading quickly throughout the US and is
present in NC. As more is learned, Ms. Stewart will send email updates to the Board.
• In OC, 61% OC residents are fully vaccinated and 64% partially vaccinated. This stat is
based on the overall population of OC which includes the 12% that are not yet eligible —
those under 12 years of age.
• Of those vaccinated in OC:
o Only 45% of the men are vaccinated. They make up 48% of the population.
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o Only 14% of the 18-24 year olds are vaccinated. They make up 18% of the
population.
• Targeted outreach continues to be priority. OCHD continues to be responsive to
homebound calls and going into the community with the intent of reducing barriers to
getting vaccinated such as the barrier of transportation.
• There were surveys regarding vaccine hesitancy conducted in Jan and March. There
was a decrease in those that were originally unsure about getting vaccinated indicating
more willingness to get the vaccine. There was no change in the 7% that stated that
they definitely were not going to get the vaccine. The OCHD will continue with
messaging about the benefits of vaccinations.
• The OCHD is trying to integrate vaccinations into the medical clinics and make it part of
the daily operations similar to the flu vaccine.
• Information about booster vaccines hasn't been received yet. According to Secretary
Cohen, they are most likely to occur in 2022.
D. Media Items
Kristin Prelipp, Communications Manager, articles that were included in the Board's packet.
Some of the articles highlighted include:
- An NBC national news story commenting on the similarities among the counties leading
vaccinations, which was the focus on vaccination equity.
- An article from the Fayetteville Observer that mentioned Orange County being number
one in vaccinations in NC.
- A News & Observer article regarding Pfizer's approval for children ages 12 to 15 and the
increased number of new people partially vaccinated that rose more than five-fold
afterwards.
Co-Chair, Bruce Baldwin, announced that Ms. Stewart had her own stamp featured in The News
of Orange. Kristin Prelipp added that the actual portrait used for the stamp of Ms. Stewart is
hanging in the Health Director's suite. Ms. Stewart stated that she was humbled to be included
in the Chapel Hill Art of Science and Hope gallery walk. She also stated that it was an honor to
be included in the stamp collection and in the company of some of the leaders of the pandemic
such as Dr. Anthony Fauci, Dr. Kizzmekia Corbett and DHHS Secretary, Dr. Mandy Cohen.
Media items were in the packet which focused on Orange County's events and our
involvement in various efforts.
VII. Board Comments
Co-Chair, Bruce Baldwin, announced that tonight is the last board meeting for Board member
Timothy Smith. Mr. Smith has completed 2 terms as a Board member— about 6 years. Mr.
Baldwin, the Board members and Ms. Stewart extended expressions of gratitude and conveyed
their appreciation for everything he's done and the time served on the Board. Mr. Smith
revealed the plaque of appreciation that was sent to him in advance of the Board meeting. Mr.
Smith stated that being on the Board has been very educational and a good experience. He
also stated that Ms. Stewart has been such an asset to the county and thanked everyone for
their well wishes.
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Mr. Baldwin informed the Board that the selection committee for the Engineering Representative
will meet either this or next week vs after tonight's meeting.
Ms. Stewart announced that tonight was Rebecca Crawford's last Board meeting. She
congratulated her on receiving the promotion of Deputy Finance Director for the county effective
July 3rd. Ms. Crawford had been an integral part of the Health Department over the last 6 years
in her role as Financial and Administrative Services Director for the OCHD. She will be missed.
Vill. Adjournment
Jessica Frega moved to adjourn the meeting at 8:38pm and Aparna Jonnal seconded.
The next Board of Health Meeting will be held August 25, 2021 at 7:00pm via Go To
Meeting.
Respectfully submitted,
Quintana Stewart, MPA
Orange County Health Director
Secretary to the Board
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