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HomeMy WebLinkAboutBOH Final Minutes of October 27, 2021 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH October 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 October 27, 2021 virtually via Zoom. BOARD OF HEALTH MEMBERS PRESENT: Sam Lasris — Chair, Bruce Baldwin —Vice-Chair, Keith Bagby, Brian Crandell, Jessica Frega, Commissioner Jean Hamilton, Aparna Jonnal, Lee Pickett, and Alison Stuebe. BOARD OF HEALTH MEMBERS ABSENT: Shielda Rodgers. STAFF PRESENT: Quintana Stewart, Health Director; Dana Crews, Community Services Director; Wendi Everson, Famiily Success Alliance Manager; Micah Guindon, Financial and Administrative Services Director; Victoria Hudson, Environmental Health Director; Carla Julian, Compliance Manager; Crystal Kelley, Home Visiting Services Supervisor; Kristin Prelipp, Communications Manager; Kimberlee Quatrone, Business Officer; Caroline Shumaker, Dental Clinic Coordinator; La Toya Strange, Administrative Support I; and Latisha Watson, Social Worker II. GUESTS PRESENT: Michael Duplisea, Rosalind McDonald and Mary Wurzelmann. I. Welcome New BOH Member Sam Lasris, Chair, called the meeting to order. Mr. Lasris introduced new Board member, Tony Whitaker. Mr. Whitaker gave a brief introduction of himself. The Board members introduced themselves. Welcome New Employees Quintana Stewart began by welcoming Tony Whitaker. Ms. Stewart introduced the new employees in attendance: Wendi Everson, Micah Guindon, Crystal Kelley, and Latisha Watson. II. Public Comment for Items NOT on Printed Agenda: None. III. Approval of the October 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 September 22, 2021 Meeting Motion was made by Aparna Jonnal to approve the minutes of September 2021, seconded by Lee Pickett and carried without dissent. S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ October Page 1 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH October 27, 2021 V. Educational Sessions A. Customer Satisfaction Survey Victoria Hudson, Environmental Health Director, began by stating that 90 responses were received during the analysis period of October 2020 to September 2021, which included a hybrid of the old and new consolidated survey. November has the most responses as there was a new survey invitation link sent. There is also a link to the customer service survey on the Environmental Health (EH) webpage and in the signature line of all EH staff. Ms. Hudson stated that she wanted to focus on public perceptions. Below is a summary of the overall responses: • Rating of professionalism — predominately good and excellent • Is EH really making a difference — mostly strongly agreed with 1 strongly disagreed • Is the Onsite Water Protection Program (OSWP) making a difference —the responses were varied ranging from strongly agree, neutral to strongly disagree In relation to the OSWP, Ms. Hudson added she'd like to make the process more streamline and efficient so that the consumer doesn't feel like they're having to wait. Targets for 2020-2021 weren't reached; therefore, they've become a part of the targets for 2021-2022, which include to: • Return to an Environmental Health specific survey • Include the perception measures form the department survey • Increase submittal rate by 10% for OSWP AND 25% for FLI • Use the measures to make policy decision that improve the client experience Caroline Shumaker, Dental Clinic Coordinator, presented the results from the Dental Health Services patient satisfaction surveys that were collected. The OCHD switched to a consolidated survey in November 2020. There was a goal to attempt to collect 20 paper surveys each month at checkout. Surveys were automatically sent using Solutionreach patient engagement software via text or email one day after the client's visit. There were a total of 200 responses received during November 2020 to October 2021. Some of the results included: • 96% (English paper surveys), 98% (Spanish paper surveys) were satisfied with overall experience; • 96% (English paper surveys), 100% (Spanish paper surveys) agreed front desk staff and dentists were courteous and responsive to needs; and • 98% were satisfied with interpretation services. While majority of the responses were positive, English survey suggestions for improvements included shorter wait times for appointments and that "the treatment wasn't explained well. Spanish survey suggestion for improvement also mimics the English ones in that shorter wait times for appointments. Quintana Stewart, Health Director, presented the results from the Medical Clinic surveys. The S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ October Page 2 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH October 27, 2021 Medical Clinic attempted to switch to an electronic survey; there were only 42 responses received. Some of the known challenges and barriers included a change of clinic leadership during the original implementation plan, abbreviated clinic schedules and the workflow process for survey administration was not clearly developed. Some of the results included: • Staff were friendly, respectful and helpful —76% agreed, 2% disagreed, 10% 1 don't know (IDK), 12% does not apply (DNA) • Staff clearly explained information to me in a way I understood — 79% agreed, 2% disagreed, 7% IDK, 12% DNA • 1 didn't have to wait too long to see a staff member—69% agreed, 5% disagreed, 5% IDK, 21% DNA • Free text comments included positive comments about their Covid vaccination experience along with some that praised staff for their kindness and helpfulness. o Comments about helpful staff The BOH had questions that were addressed by the presenters. B. 1St Quarter Financial Reports & Billing Dashboard Kimberlee Quatrone, Business Officer, gave a report on the 1 st quarter revenue and billing accuracy. Her report is as follows: • Total Health Department Budget vs. Actuals: Average YTD monthly revenue in FY21-22 after the first quarter is $243k/month or $765k YTD, representing 8% 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). Revenues are higher than this point last fiscal year (FY 20-21 1st Quarter YTD: $584k) due to the clinic being open to see patients where last year at this time there were limited services due to the pandemic. Expenses are in line with revenues, at 6% of the overall budget. • Dental Earned Revenue by Source: The FY 21-22 average monthly revenue ($49.2k/month) for the first quarter is above our budget projection ($41 k/month) and our FY 20-21 average of$37.1 k/month due to the clinic returning to the pre-pandemic appointment length of one hour vs. one and one-half hours during the pandemic. The dental clinic is also open under the regular schedule of Monday to Friday whereas they were at a reduced schedule this time last year. FY 21-22 dental earned revenue totaled $148k at the end of the first quarter compared $94k at the end of the FY 20-21 first quarter. • Medical Earned Revenue by Source: Medical earned revenue is currently above the budgeted projection for FY 21-22 ($33k/month) at $39.6k/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. We are below our revenue totals compared to last year at this time as we are on a reduced clinic schedule due to staffing issues whereas last year the pandemic didn't affect clinic schedule until mid-March, towards the end of the fiscal quarter. Also, at the time of S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ October Page 3 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH October 27, 2021 reporting, not all medical revenues had been entered and posted to the accounting system. Medical clinic revenue totals $119k for first quarter FY 21-22 compared to $133k in first quarter FY 20-21. • Environmental Health Earned Revenue by Source: Environmental Health earned revenue is slightly above the budgeted projection for FY 21-22 ($53k/month) at $56.3k/month. This is due to construction authorizations being up about 25% and well permitting up about 10%. Environmental Health is now fully open whereas last year at this time they were working under pandemic protocols. Environmental Health revenue totals $171 k for first quarter FY 21-22 compared to $149k in first quarter FY 20-21. • Grants Fund Revenue: Last fiscal year, FSA was given the final installment of the $300k for the multi-year Kenan grant. The Foundation has allowed us to roll the remaining $53k to this fiscal year where it will be used towards sub-grants and community-based events promoting health and well-being, interpreter costs and printing materials. We have been awarded approximately$26k for NC Integrated Care for Kids (NCInCK) program, which will be used towards staff personnel costs to implement the InCK model in Orange County. The BOH had questions that were addressed by Ms. Quatrone and Ms. Stewart. VI. Action Items (Non-Consent) A. BOH Policy Review Quintana Stewart, Health Director, began by stating that a robust review of the policies was completed in 2019. Next, she briefly went over the policies that were sent to the Board members in preparation for tonight's meeting. There were no recommended changes in: • Section I. Policy A. Requests for Environmental Health Services and Assessments • Section I. Policy C. Community Assessment Policy The Fee and Eligibility Policy (Section I. Policy B.) will be reviewed at the next Board meeting in November. Suggested changes: • Changing the language in the Section I. Policy C. Board Review of Reports and Documents to generalize the contracted MCO vs including the name of the entity • Rescinding the separate III.B.d. Evaluation of Health Director policy and incorporate the language into Policy I.E. Operating Procedures under XVII • Updating III.B.d. Evaluation of Health Director to mimic the County's new performance review policy Motion was made by Alison Stuebe to approve the suggested changes to the policies, seconded by Aparna Jonnal, and carried without dissent. VII. Reports and Discussion with Possible Action S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ October Page 4 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH October 27, 2021 A. November BOH Meeting — Hybrid Model Board Chair, Sam Lasris, led the conversation regarding having a hybrid Board meeting. Topics in the discussion included: • Legislative statute requirements • Social distancing and spacing concerns • Indoor mask wearing • Contingency plans for public not adhering to indoor masking policy • Who would attend in person Motion was made by Jessica Frega to have the November 171 meeting in a hybrid format, seconded by Alison Stuebe and carried without dissent. B. 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 Keith Bagby for Vice-Chair. Mr. Lasris informed the Board to email him if there are any other nominations. The vote for Chair and Vice-Chair will take place, next month, at the November 17th meeting. C. Health Director Annual Evaluation Ms. Stewart informed the Board that the County changed their performance evaluation process. All County employees will undergo a focal review. There will no longer be workplans. Position specific competencies and goals are to be uploaded into the new PERFORM system. Ms. Stewart's supervisor, chair of the Board, will need to go into PERFORM, grade her performance and then share it with the remainder of the Board. The offer of sharing feedback was given; although, it won't be in a written format. All County staff will have their focal review between October 1 st and December 1 st; no longer their anniversary date. A mid-point review will need to be completed in March. D. Health Director Report In addition to her report, some of items Ms. Stewart briefly highlighted are below. • A robust and complex public records request from NC Citizens for Constitutional Rights. Information was requested for the period January 2020 thru September 2021 and all COVID-19 related. As a result, the NC Association of Local Health Directors retained an attorney to work with their counsel to figure out what they truly wanted to see with regard to public records. Fortunately, most of the information requested has already been posted on public websites. There are still a few items the OCHD will need to gather to respond to the request. • LME/MCO transition date of Cardinal Innovations to Alliance has changed, at the request of Alliance to DHHS, from December 151h to December 1st S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ October Page 5 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH October 27, 2021 • We are down 20% with staffing, as there are 23 vacancies at the OCHD that are spread out across all of the divisions with the OCHD. Several departments in the county are experiencing similar staffing vacancies including Human Resources, which has slowed the process a little. Interviews are ongoing. Ms. Stewart thanked all of the staff and stated that we are focused on trying to fill all of the vacant positions. The staff was praised as they're dealing with staffing shortages while still responding to Covid-related tasks. Ms. Stewart has also stated that in her 1:1 s with staff, she is having conversations pertaining to what it will take to keep staff. • We're having an All Staff meeting this Friday at Fairview Park, weather permitting. While there will be a costume contest, we will have work to do including reviewing some policies with the staff. Invitation to attend was extended to the Board; however, Ms. Stewart asked that they let her know if they're coming to prevent a quorum from forming. E. 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. • The Delta variant is still dominant in NC. • According to the county alert system, OC went from high to substantial community spread. Substantial range is 50-99 new cases per 100K people. OC is currently in the mid-60s. • As of today, there were 18 new cases and 110 total deaths. Most of the deaths were in those unvaccinated. • OC has 70% fully vaccinated and 73% partially vaccinated. • In regards to boosters, we completely used all of the Moderna vaccines, which were being offered at SHSC, but there are more on the way. • We are awaiting final approval for the 5-11 year olds to be eligible to be vaccinated. We're engaging in planning with partners and school districts. We're also looking to offer clinics in the evenings as the children will be out of school. • As of Tuesday, there is only one outbreak at the OC Detention Center. F. 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 a CBS 17 article on Orange County testing efforts, Chapelboro article on the state's vaccination data error, and a Herald Sun article on the Orange County jail Covid-19 outbreak. Ms. Prelipp also mentioned that will be Halloween guidance posted on the Health Department's website. Media items were in the packet which focused on Orange County's events and our involvement in various efforts. VIII. Board Comments No comments. S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ October Page 6 MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH October 27, 2021 XI. Adjournment Jessica Frega moved to adjourn the meeting at 8:50pm and Alison Stuebe seconded. The next Board of Health Meeting will be held November 17, 2021 at 7:00pm via Zoom. Respectfully submitted, Quintana Stewart, MPA Orange County Health Director Secretary to the Board S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/ October Page 7