HomeMy WebLinkAboutFinal Minutes of May 25, 2022 MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
May 25, 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 May 25, 2022 at the Orange County
Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Dr. Bruce Baldwin — Chair, Keith Bagby—Vice-
Chair, Dr. Brian Crandell, Jessica Frega (via phone), Commissioner Jean Hamilton (via phone),
Dr. Aparna Jonnal (via phone), Dr. Sam Lasris, Dr. Shielda Rodgers (via phone), Dr. Lee Pickett
(via phone), Dr. Alison Stuebe (via phone), and Tony Whitaker.
BOARD OF HEALTH MEMBERS ABSENT: None.
STAFF PRESENT: Quintana Stewart, Health Director; Dana Crews, Community Services
Director; Micah Guindon, Financial and Administrative Services Director; Victoria Hudson,
Environmental Health Director (via phone); Carla Julian, Compliance Manager; Rita Krosner,
Alvina Long, Public Health Nursing Director; Ashley Rawlinson, and La Toya Strange,
Administrative Support I.
GUESTS PRESENT: None.
I. Welcome New Employees: Ms. Stewart introduced Kaitlyn Loefstedt.
II. Public Comment for Items NOT on Printed Agenda: None.
III. Approval of the May 25, 2022 Agenda
Motion was made by Dr. Sam Lasris to approve the agenda, seconded by Keith Bagby
and carried without dissent. Dr. Alison Stuebe wasn't included in the voting as there
were technical issues.
IV. Action Items (Consent)
A. Minutes of April 20, 2022 Meeting
Motion was made by Dr. Sam Lasris to approve the minutes of April 2022 with an edit,
seconded by Tony Whitaker and carried without dissent. Dr. Alison Stuebe wasn't
included in the voting as there were technical issues.
V. Educational Sessions
A. OC Partnership for Alcohol and Drug-Free Youth (OCPADY)
Gayane Chambless, Program Coordinator, provided an update on the Orange Partnership for
Alcohol and Drug-Free and its activities. Below are brief highlights.
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• The OCPADY originated in 2008 as a subcommittee of Healthy Carolinians of OC. Its
mission is to prevent youth substance misuse through collaboration, education, policy,
advocacy and youth empowerment. The OCPADY is also concerned about the health
and welfare of the youth without the influence of drugs.
• Accessibility
o According to data from OC High School teens, alcohol is the most easily accessible
product. Tobacco and vaping products are second.
o Teens are getting access to these products mostly from friends/siblings and home
(with and without knowledge of adults/parents).
• OCPADY focuses on cannabis misuse, underage drinking, and prescription drug
misuse.
• There are 7 strategies (3 individually-focused, 4 environmentally-focused) for community
change.
o Individually-focused - Provide information, build skills, provide social support
o Environmentally-focused — Reduce barriers/enhance access, change
consequences/incentives, alter the physical design of the environment, change
policies and rules
• OCPADY's Impact
o The percentage of middle school youth reporting past 30-day use of alcohol
decreased from 16.4% (in 2008) to 1% (in 2018). The rate for high school youth for
the same period decreased from 32.1% to 6.2%.
o The percentage of middle school youth reporting past 30-day use of cannabis use
decreased from 3.8% (in 2008) to 2% (in 2018). The rate for high school youth for
the same period decreased from 10.2% to 6.2%.
o The percentage of middle school youth reporting past 30 day use of prescription drug
abuse did not change from 2008-2018. It stayed at 1.0%. The rate for high school
youth for the same period decreased from 3.8% to 0%.
The BOH had questions and comments that were addressed by Ms. Chambless.
B. Tobacco Update
Rita Krosner, Tobacco Prevention and Control Coordinator, provided an update and summary of
the Tobacco Prevention and Control Program activity. Below are brief highlights.
• Adult Cessation Programs
o Freshstart Group Classes and Individualized Tobacco Treatment (ITT) Services —
■ Tobacco Cessation classes are held quarterly. Since March 2020, they have
occurred virtually, which has allowed more people to access these classes.
■ ITT Services include 12 weeks of behavioral counseling and NRT products.
These services are offered via telephonic meetings.
■ During 2021, 379 NRT products were issued. That's a 46% increase from the
previous year.
• OCHD Youth Prevention and Cessation
o Cessation is not just a service for adults. Vaping education for parents, staff and
faculty, vaping prevention and cessation resources are services needed for the OCS
districts.
o On December 20, 2019, President Trump signed legislation raising the federal
minimum age for sale of tobacco products from 18 to 21 years. Under T-21 federal
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law, it is now illegal for a retailer to sell any tobacco product—including cigarettes,
cigars, and e-cigarettes—to anyone under 21.
o It's suggested that NC raise its minimum age to purchase tobacco products to 21 to
match the new federal age requirement.
o Young people addicted to nicotine struggle with concentration and impulse control,
negatively impacting learning and behavior in school.
o From 2011-2019, NC saw more than a five-fold increase in e-cigarette use among
middle school students and a ten-fold increase among high school students.
• As of December 1, 2022, NC Medicaid Managed Care Standard plans and Tailored Plan
will require contracted providers, not including retail pharmacies, to implement a
tobacco-free policy covering any portion of the property on which the participating
provider operates that is under its control as owner, to include buildings, groups and
vehicles.
• The US FDA announced proposals to prohibit menthol as a characterizing flavor in
cigarettes and to prohibit all characterizing flavors (other than tobacco) in cigars. The
FDA cannot and will not enforce against individual consumers for possession or use of
menthol cigarettes or flavored cigars.
The BOH had questions and comments that were addressed by Ms. Krosner.
C. SOTCH Review
Ashley Rawlinson, Healthy Carolinians Coordinator, presented the 2021 State of the County
Health Report (SOTCH). The SOTCH is a report produced every year in between the
Community Health Assessment (CHA). Access to Care, Health Behaviors and Health Equity
are the three priority areas in the report. Below are brief highlights from Ms. Rawlinson's
presentation.
• OC's Leading Causes of Death
o Cancer, heart disease and cerebrovascular disease are the top 3 causes.
• New & Emerging
o Medicaid Transformation — Starting July 1, 2021, many people started the transition
to standard plans.
o Alliance Health is the new LME MCO for OC.
o Community Health Workers (CHW), essential professionals, lend support and help
expand the reach in marginalized communities.
• OC Access to Care
o COVID-19—vaccines, testing and support
■ Worked with state contractors to provide no cost vaccines. As of February
2022, 79% in OC are fully vaccinated.
o NCCARE360
■ It's a statewide coordinated network focusing on person care and the
relationship with providers, available in all 100 NC counties.
o Family Success Alliance (FSA)
■ FSA has been providing services as CHWs, having served 64 families and
counting.
• Health Behaviors
o Alcohol, tobacco and prescription/opioid drug
■ 19% OC population engage in excessive drinking vs 18% of the NC
population
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■ 36 OC deaths related to the health behaviors vs 28% of the NC population
■ 81 people treated for prescription/opioid abuse
■ Opioid Task Force reconvened
■ 6.8 million over 18 years will be received due to the Opioid Settlement
• Health Equity
o Focused on marginalized communities
o OC Diversity, equity, and inclusion (DEI) focused on building an inclusive and
equitable culture that encourages, supports, and celebrates diverse voices.
o Health Equity Council focused on how to address inequity within OC.
o Racial Equity Commission (REC) is an internal OCHD initiative whose mission is "to
serve as a catalyst to ensure that racial equity is an active agent throughout all
organizational processes of the OCHD." The goals of REC include increasing
participation of staff in racial equity training and conversations.
Ms. Rawlinson added that this report is shared with NC DPH, BOH, BOCC, HCOC membership
and OC Government employees. Electronic versions will be available online via the HCOC and
OCHD websites. Lastly, Ms. Rawlinson reiterated that per Activity 38.1 and 38.2, for
accreditation purposes, the BOH minutes should reflect that BOH members have received and
reviewed the SOTCH report.
The BOH had questions and comments that were addressed by Ms. Rawlinson.
VI. Reports and Discussion with Possible Action
A. Media Items
Ms. Stewart stepped in for Kristin Prelipp, Communications Manager, and briefly mentioned
articles that Ms. Prelipp had included in her media items packet. There was an article about the
COVID-19 NC State of Emergency Declaration expiring and the recommendation by Ms.
Stewart of mask wearing in crowded areas. There was also an article from the Herald-Sun
regarding a proposed property tax raise. The third article was an article from The Daily Tar Heel
regarding UNC closing its testing program.
Media items were in the packet which focused on Orange County's events and our
involvement in various efforts.
B. BOH Health Director Report
Quintana Stewart, Health Director, presented her report to the Board. Before she began, Ms.
Stewart expressed her gratitude and appreciation to the OCHD staff as they have been
stretched with additional duties due to COVID and vacancies. Below are brief highlights of her
report.
• As the Opioid Task Force chose Option B for required deliverables under the Opioid
Settlement, the Opioid Task Force will begin a robust strategic planning process this fall.
There are plans to hire an outside facilitator.
• Fentanyl testing strips will be procured and distributed to partners to assist with harm
reduction efforts.
• The Epi Team has been reinstated and have begun regular meetings.
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• The Campus & Community Coalition (CCC) is preparing for final interviews to replace
former director, Elinor Landess.
• In response to the infant formula shortage, the NCDHHS created and distributed a flyer
to help families understand their formula options. A link to the FAQ and other resources
were included in the submitted Health Director's Report.
• Governor Cooper shared his proposed budget which includes the following highlights
related to public health:
o $10 million for Local Health Departments infrastructure
o Additional $50 million for continuation of critical COVID-19 services
o Recommendation to expand Medicaid
o PFAS Biomonitoring Project
o $510,000 for Onsite Water Protection Training Team
• The County Manager will present her recommended budget to the BOCC, which will also
include the Outside Agencies' recommended amounts. Commissioner Jean Hamilton
added that there is a new law that prevents the BOCC from approving the Outside
Agencies' funding recommendations if Board Members serve on the Boards of the
Outside Agencies. The BOCC has delegated the task of Outside Agency funding to the
County Manager. The total amount for outside agencies is included in the Managers
budget recommendation which BOCC must approve.
• There was a call with the state to discuss the current global Monkeypox outbreak.
Counties are reviewing local SNS plans to ensure all are up to date. At this time, there
are no confirmed cases in NC. It is stated that there may be some protection for those
that had received the smallpox vaccine. Monkeypox can be spread through direct
contact with the infectious sores, prolonged face-to-face contact and intimate sexual
contact.
C. COVID-19 Update
Quintana Stewart, Health Director, gave a brief update on the COVID-19 status in
Orange County (OC) as well as took questions from the Board. Some highlights of her
presentation are below.
• COVID cases are increasing. OC increased from 335 cases per population of 100K last
week to 385 per 100K this week.
• OC has moved from the green tier (low community level) to the yellow tier (medium
community level). Several surrounding counties are also in the yellow tier, which
indicates significant COVID community spread.
• According to the state's dashboard, there are 8 outbreaks total (5 - in nursing homes and
consist of mostly staff members, 2 - in residential centers, 1 — detention center). An
outbreak in a congregate living setting is defined as two or more laboratory-confirmed
cases.
• There has been a change in the COVID death reporting system. The statewide online
electronic system known as NCDAVE (N.C. Database Application for Vital Events) is
used to electronically register death certificates. There has been 1 new death in OC
since March 2022.
• A "COVID-19 death" is defined as a person who:
o Had a positive molecular (PCR) or antigen test for COVID-19, who died without fully
recovering from COVID-19, and who had no alternative cause of death identified.
Or
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o After January 1, 2022, was reported as a COVID-19 case in NC COVID and had
COVID-19 listed as the primary or underlying cause of death on their death
certificate.
• State-funded vendors that provide COVID vaccinations will cease on June 301h. The
OCHD will take on providing COVID vaccinations. The state will re-deploy additional
resources if there is a large surge of COVID cases. The state is advocating for the
usage of at-home COVID tests. They have a stockpile of approximately 2 million at-
home COVID tests.
• The Communications Manager, Kristin Prelipp, has continued to raise awareness about
getting boosters. Of the population in OC, 55% (same percentage as the state) are
boosted.
• Ms. Stewart reiterated that she included the link in her Health Director Report to the Test
to Treat program that provides testing and appropriate treatment options if an individual
tests positive for COVID.
• In response to a question asked by the Board, Ms. Stewart stated that the state and the
CDC update their dashboards on different days of the week.
VIII. Board Comments
There was discussion amongst the Board members regarding the recruitment for the soon to be
vacant At-Large and Dentist Representative positions. Ms. Stewart reminded all that the
recommendations would need to be sent by June 61h to get on the BOCC's agenda; otherwise,
the recommendations would occur on the BOCC's next working session in September. The
Dental Board supplied their database of dentists living in OC to Board Chair, Dr. Bruce Baldwin.
Dr. Baldwin also mentioned adding additional Board members to the Executive Committee.
Lastly, he suggested Board members start thinking about filling the Vice-Chair position which
will be voted on in the fall.
VIII. Adjournment
Keith Bagby moved to adjourn the meeting at 9:10pm and Dr. Sam Lasris seconded.
The next Board of Health Meeting will be held June 22, 2022 at 7:00pm at the Orange
County Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m.
Respectfully submitted,
Quintana Stewart, MPA
Orange County Health Director
Secretary to the Board
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