HomeMy WebLinkAboutFinal Minutes of January 26, 2022 MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
January 26, 2022
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 26, 2022 virtually via Zoom.
BOARD OF HEALTH MEMBERS PRESENT: Bruce Baldwin — Chair, Brian Crandell, Jessica
Frega, Commissioner Jean Hamilton, Aparna Jonnal, Sam Lasris, Lee Pickett, Shielda Rodgers,
Alison Stuebe, and Tony Whitaker.
BOARD OF HEALTH MEMBERS ABSENT: Keith Bagby.
STAFF PRESENT: Quintana Stewart, Health Director; Dana Crews, Community Services
Director; Micah Guindon, Financial and Administrative Services Director; Victoria Hudson,
Environmental Health Director; Carla Julian, Compliance Manager; Alvina Long, Public Health
Nursing Director; Dr. Monica Meng-Haggerty, Dental Director; Kristin Prelipp, Communications
Manager; Kimberlee Quatrone, Business Officer; and La Toya Strange, Administrative Support
1.
GUESTS PRESENT: Kimberly Davis and various University students
I. Welcome New Employees: Ms. Stewart introduced the new employees in attendance:
Sequoia Albright, Melissa Childers, Heidy Lopez Parra, Destiny Simmons, Maria Powell, Sarah
Snipes, Sharon Swipes, Charles Taylor, and Valerie Zephyr.
II. Public Comment for Items NOT on Printed Agenda: None.
III. Approval of the January 26, 2022 Agenda
Motion was made by Jessica Frega to approve the agenda, seconded by Alison Stuebe
and carried without dissent.
III. Action Items (Consent)
A. Minutes of November 17, 2021 Meeting
Motion was made by Alison Stuebe to approve the minutes of November 2021, seconded
by Shielda Rodgers and carried without dissent.
IV. Educational Sessions
A. Zoning for Equity
Dr. Andrew Whittemore, Associate Professor, City and Regional Planning, UNC at Chapel Hill,
along with Jo Kwon, Eve Lettau, Lauren Prunkl and Henry Read, provided an excellent
presentation on barriers to wider housing access, actions taken to expand housing access to
date, and possible future actions to expand housing access in Carrboro. Last semester,
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ORANGE COUNTY BOARD OF HEALTH
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graduate students at UNC's Department of City and Regional Planning researched the
relationship between zoning and housing affordability in Carrboro.
The link to the presentation is below.
https://storVmaps.arcqis.com/stories/5bf9817ec5aO4ldl9O4291 bc22b095b3
The BOH had questions and comments that were addressed by Dr. Whittemore and the
graduate students.
B. 2nd Quarter Financial Reports & Billing Dashboard
Micah Guindon, Finance and 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 FY21-22 after the second quarter is $267K/month or
$1.6M YTD, representing 37% of our overall budgeted revenue for the year. Due to the
timing of this report and State funds being reimbursed, another$114K in State revenue
is expected for December expenditures. Revenues are comparable to this point last
fiscal year (FY 20-21 2nd Quarter YTD: $1.6M). Given that State funds have not yet been
received for December, expenses are slightly higher than revenues, at 40% of the
overall budget.
• Dental Earned Revenue by Source:
The FY 21-22 average monthly revenue ($46.4K/month) for the second quarter is above
our budget projection ($41 K/month) and our FY 20-21 average of$37.1 K/month. FY 21-
22 dental earned revenue totaled $279K at the end of the second quarter compared
$188K at the end of the FY 20-21 first quarter. 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. Additionally, the clinic has changed children's cleaning appointment times
from 1 hour to 45 minutes, allowing additional patients to be seen each day. Lastly, the
clinic is working to reduce no show appointments by confirming all appointments at least
24 hours in advance.
• Medical Earned Revenue by Source:
Medical earned revenue is currently above the budgeted projection for FY 21-22
($33K/month) at $55.4K/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. Medical clinic
revenue totals $333K for second quarter FY 21-22 compared to $253K in second quarter
FY 20-21.
• Environmental Health Earned Revenue by Source:
Environmental Health earned revenue is slightly below the budgeted projection for FY
21-22 ($53K/month) at $49.1K/month. There tends to be less demand in November and
December due to clients not starting new projects during these holiday months.
Nonetheless, Environmental Health revenue totals $295K for second quarter FY 21-22
compared to $264K in second quarter FY 20-21 as service demand in all onsite water
protection programs has increased.
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• 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.
• Additionally, 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 and comments that were addressed by Ms. Guindon and Ms.
Quatrone.
C. Salmonella Outbreak
Victoria Hudson, Environmental Health Director, provided a brief summary about the
investigation and monitoring process of the Salmonella outbreak that occurred at the UNC
Hospital Main Campus. Below are some highlights.
• This was a coordinated effort involving approximately 50 people including the OCHD EPI
team, UNC Occupational Health, UNC Nutrition, and NCDHHS staff.
• Salmonella is a foodborne illness associated with gastroenteritis.
• Salmonella Javiana is a Salmonella serotype that is restricted to the Southeastern US.
• Symptoms develop 12-72 hours after the contaminated item has been consumed and
include diarrhea, fever, abdominal cramps, and headaches.
• For most people, symptoms generally last for 4-7 days.
• On November 51", a case of salmonella was reported to the OCHD CD team. The CD
team then contacted Ms. Hudson. A patient at UNC Medical, who had been an in-
patient since October 18t", became symptomatic on November 2nd. The hospital knew it
was Salmonella due to a culture; however, they were unaware of the subspecies at that
time.
• By November 6t", there were 7 suspected cases.
• On November 6t", the OCHD Epi Team, which consists of certain administrative,
Environmental Health, CD and clinical staff, was activated. They reviewed policies,
notified the state epidemiologist and along with the assistance of Dr. Pettigrew, notices
were sent to the providers.
• By November 71", there were 9 suspected cases.
• The patients' food diaries were requested. Directives were given to stop serving the fruit
cups.
• By November 16t", there were up to 15 suspected cases.
• On November 16t", the Department of Agriculture performed environmental swabs of the
area in which the fruit cups were made. All of the environmental samples were negative.
The exact source of the outbreak had not been determined.
• Lessons learned included to not make assumptions and the understand traceability.
Companies need to know where their food is outsourced from when their vendor runs
out.
The BOH had questions and comments that were addressed by Ms. Hudson.
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D. Outside Agency Review Process
La Toya Strange, Administrative Support I, summarized the Outside Agency Review process
and what is required of Board of Health members for evaluating applications. The Health
Department will receive applications to review. Board members are to review the applications
assigned to them, record scores on the appropriate scoring cards, and send the completed
scoring cards back to Ms. Strange by Tuesday, March 1It
VI. Action Items (Non-Consent)
A. Updated BOH Policy Manual
The Board was presented with the updated BOH policy manual. The Board members are to
update their binders with the updated BOH policy. They were reminded to sign the Signature
Page for Receipt of Board of Health Policy and Procedure Manual that was previously emailed
to them.
VII. Reports and Discussion with Possible Action
A. Health Director Report
Ms. Stewart began by introducing Alvina Long, Public Health Nursing Director, as this is her first
Board of Health meeting since being hired. She also gave Kudos to Bruce Baldwin for his
actions regarding alerting Victoria Hudson upon seeing water spurt from the parking lot near the
shelter at the Farmer's Market. Some of the items Ms. Stewart briefly highlighted are below.
• The Preventing Underage & High-Risk Drinking Town Hall was held on December 8m
Local data was shared. Vice-Chair, Keith Bagby, also attended. Ashley Rawlinson
facilitated the event as well as completed a lot of the background work.
• Some of the members from the multi-agency Partner Information Sharing Group have
temporarily reconvened to meet monthly on the 1It Tuesday for the next few months to
discuss needs identified to the COVID response. Those members include
representation from UNC, UNC Hospitals, law enforcement and public health.
• The Budget Kickoff with county finance was held on January 13tn and 14tn
• Last Thursday, we had our 1st Opioid Task Force meeting since the pandemic. Vice-
Chair, Keith Bagby, also attended the meeting. The Task Force is working to identify
what priorities and strategies they'll address in OC and how best to disperse the Opioid
Settlement funding that will be received in the upcoming months. They will also be
working closely with the BOCC once funds are received to ensure compliance with how
the funds are spent and with reporting requirements.
• Governor Cooper extended Executive Order 245 through April 5m
• Ms. Stewart and her assistant, Ms. Strange, have been discussing schedule changes.
Ms. Stewart will have some time blocked on her schedule to be more responsive to non-
COVID related tasks and to get back to some of the pre-COVID public health duties. As
Ms. Stewart will continue to handle COVID tasks, she's hoping this new schedule will
also ensure she's able to be more responsive and engaged with the Board as well as
provide more administrative time.
• Accreditation — OCHD staff will be presenting on Accreditation. Documentation is due
this fall. The Site Visit will occur in spring 2023.
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• Ms. Stewart will be reaching out to the Board regarding getting back on track with BOH
Subcommittee meetings so that the Strategic Plan can be finalized.
A. 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.
• In OC, there were 3 new deaths in the last 2 weeks, which equals a total of 115 deaths.
• There are 21,774 cases COVID cases in OC.
• There's still a surge with Omicron in our community.
• In the last 7 days, there's been 1610 new cases and 4087 new cases in the last 14 days.
• During the week of 12/9-12/15, 33% of new cases were of those fully vaccinated.
• The vaccine is working and is still reducing severe illness and death.
• There have been 116,070 people (78%) who have received at least their 1s' dose. There
are 111,324 people (75%) that are considered fully vaccinated.
• The DHHS website has added new data regarding vaccinations. It provides data on
those that have received an additional dose; however, it doesn't differentiate whether it's
a booster or simply an additional dose due to being immunocomprised. There have
been 64,757 people that have received a 31d shot.
• The guidance has changed on when a booster shot should be given. For Moderna and
Pfizer, it's 5 months. For those that received the J & J vaccine, they should get their
booster after 2 months.
• For the general public, the state is no longer conducting case investigations and contact
tracing. Leadership from DHHS has stated that only 1/3 of those called for contact
tracing answered and only 1/10 of those called for case investigations were answered.
Contact tracing and case investigations will continue for high-risk communities such as
LTCF, K-12 schools and daycares.
• There had been many complaints and issues with the Hillsborough state testing vendor
StarMed. Those concerns were made known to the state. StarMed will be exiting the
end of this month. Mako will be the new state vendor beginning Jan 31sc
• Optum, the state testing vendor in Chapel Hill, is performing satisfactorily as it seems to
have a better registration process than StarMed. There is still high demand and volume.
• The CDC guidance has changed as only 5 days of isolation are required regardless of
vaccination status. After those 5 days, an individual can go back to work/school if
symptoms have resolved but they will need to wear a mask.
• OCHD sent a press release about high quality masks. Ms. Stewart thanked Ms. Prelipp
for getting out the messaging. Ms. Stewart stated that the goal is to have a well-fitted
mask.
• OCHD received a shipment of Makrite N95 masks (approx. 14k) from the state. Dana
Crews volunteered to assist with getting the distribution plan underway. Town &
community partners will get masks to distribute to those that in need. Allowing our
partners to get the masks and distribute them amongst their community members is
best, as they'll be able to provide them to those families in need. The partners did not
want this publicized as this may prevent those in their communities from getting the
masks due to others attempting to obtain masks designated for their community
members in need.
• The Hillsborough Library will serve as a public site for mask distribution. The Inter-Faith
Council for Social Service (IFC) will do the same in Carrboro. Local pharmacies will be
receiving masks from the federal government.
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The BOH had questions and comments that were addressed by Ms. Stewart.
E. Media Items
Kristin Prelipp, Communications Manager, briefly mentioned some of the articles in the Board
packet including articles on the NC FIT program in which OCHD staff, Tommy Green, was
interviewed, OC having the fewest COVID-19 cases per capita in NC, and the 3rd rabies case
reported in OC in 2021.
Media items were in the packet which focused on Orange County's events and our
involvement in various efforts.
VII. Board Comments
Earlier in the meeting, Chair Bruce Baldwin welcomed back Commisioner Jean Hamilton for a
2 d term as our BOCC representative.
Commissioner Jean Hamilton wanted to follow up on a previous conversation regarding trying to
help our community understand the indicators used for some of the COVID policy decisions.
The BOCC looks to the health department and the Board of Health for guidance. Many of the
conversations are held between Ms. Stewart, the BOCC Chair and the mayors. Commissioner
Hamilton would like the Board of Health to bring more ideas to Ms. Stewart and to think more
broadly about how we stay safe even in an environment where enforcement is going to be a
challenge.
Commissioner Hamilton would also like the Board of Health to work on water and sewer issues
as a follow up to the presentation given by a UNC Greensboro student last year. The BOH is
able to make recommendations to the BOCC about what should be done. She thinks that this
would be a good issue for one of the BOH subcommittees to tackle.
Discussion was held by Board members about possibly posting restaurants that require proof of
vaccination on our website. Points made included the consultation of the county attorney and
defining "fully vaccinated".
Mr. Baldwin officially congratulated Ms. Stewart on becoming the Secretary of the NC
Association of Health Directors (NCALHD). Mr. Baldwin also requested to be contacted if
anyone knows Tom Donahue, the person that placed a comment in the chat mid-way through
the Board meeting, as he would like to reach out to him.
As an awareness point, Brian Crandell brought up the topic of radon in OC. This is Radon
Action Month and this week is Radon Week. He's spoken with Ms. Prelipp and is aware that the
OCHD website does provide links regarding radon. The EPA also has an excellent citizens'
guide.
VIII. Adjournment
Jessica Frega moved to adjourn the meeting at 8:57pm and Alison Stuebe seconded.
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ORANGE COUNTY BOARD OF HEALTH
January 26, 2022
The next Board of Health Meeting will be held February 23, 2022 at 7:00pm via Zoom.
Respectfully submitted,
Quintana Stewart, MPA
Orange County Health Director
Secretary to the Board
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