HomeMy WebLinkAboutFinal Minutes of September 21, 2022 MINUTES
ORANGE COUNTY BOARD OF HEALTH
September 21, 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 September 21, 2022 at the Orange
County Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Bruce Baldwin — Chair, Keith Bagby*—Vice-
Chair, Brian Crandell, Commissioner Jean Hamilton, Aparna Jonnal, Lee Pickett, Shielda
Rodgers, Alison Stuebe, and Tony Whitaker.
BOARD OF HEALTH MEMBERS ABSENT: Lee Pickett**.
STAFF PRESENT: Quintana Stewart, Health Director; Dana Crews, Community Services
Director; Michael DeFranco, Public Health Services Manager; Chinyere Ekenna, Communicable
Disease/Refugee Health Nurse; Micah Guindon, Financial and Administrative Services Director;
Victoria Hudson, Environmental Health Director; Alvina Long, Public Health Nursing Director;
Thomas Privott, Environmental Health Supervisor; and La Toya Strange, Administrative Support
1.
GUESTS PRESENT: None.
I. Welcome New Employees: Ms. Stewart introduced Logan Sanders and Destiny Max.
Chair, Dr. Bruce Baldwin, introduced new Board member, Dr. Allessandra Lowery, Dental
Representative. Dr. Lowery was appointed on yesterday. Dr. Baldwin also welcomed Board
member, Shielda Rodger, to her first in-person Board meeting.
II. Public Comment for Items NOT on Printed Agenda: None.
III. Approval of the September 21, 2022 Agenda
Motion was made by Dr. Aparna Jonnal to approve the agenda, seconded by Dr. Alison
Stuebe and carried without dissent.
IV. Action Items (Consent)
A. Minutes of June 22, 2022 and August 24, 2022 Meetings
Motion to approve June's and August's meeting minutes was made by Dr. Bruce
Baldwin, seconded by Dr. Alison Stuebe and carried without dissent.
V. Educational Sessions
A. Refugee/Immigrant Update
Chinyere Ekenna, Communicable Disease/Refugee Health Nurse, provided an update on the
Immigrant & Refugee Health (IRH) program in OCHD. Below are some highlights of her
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presentation.
• Purpose of the IRG program
➢ State level tasks include:
o Notifying LHDs of refugees; providing administrative funds for LHDs receiving the
majority of refugees
o Ensuring that health problems of newly arrived refugees are promptly identified
and treated; monitoring health assessments, providing technical assistance and
reporting collected health data on newly arrived refugees to the federal
government
➢ LHD level tasks include:
o Scheduling and providing health assessments and follow up; arranging for
interpreters
o Checking CDC data to determine if the refugees have been screened
• OCHD partners in refugee
➢ Meet on a regular basis for planning purposes; partners also notify the LHD when
refugees arrive
➢ Include Church World Services, Interfaith Refugee Ministry, Piedmont Health
Services, Planned Parenthood of Central NC and UNC School of Dentistry
• Since July 2021,
➢ There have been 55 refugee arrivals (including 11 parolees from Ukraine)
➢ There have been 26 refugees helped completing the 1-693 form (Report of Medical
Examination and Vaccination Record) and 4 asylees helped with vaccinations
• Ms. Ekenna attended the North American Refugee Health Conference that occurred
June 23-25t" in Cleveland, OH. It was a great networking opportunity as there were over
100 attendees.
• Future IRH program goals include:
➢ Seeking further collaboration with partners; seeking more refugee health screening
and support
➢ Identifying changemakers that can serve as agents of change and role models in
refugee communities in OC.
The BOH had questions and comments that were addressed by Ms. Ekenna.
VI. Action Items (Non-Consent)
A. OC Groundwater Rules Section IIIB Revised
At the last Board of Health meeting, Victoria Hudson, Environmental Health Director, thoroughly
reviewed the proposed changes to the rules. There was a 10-day public comment period which
resulted in only one comment being received. That comment spoke about another matter, not
the proposed changes to the rules. Ms. Hudson reviewed the proposed changes including
some formatting, followed by a request to the Board to vote on their approval.
The BOH members had comments and questions that were addressed by Ms. Hudson.
Motion to approve and adopt the changes in the revision of the Orange County
Groundwater Rules was made by Dr. Alison Stuebe, seconded by Tony Whitaker, and
carried without dissent.
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B. Debt Write Off
Micah Guindon, Financial and Administrative Services Director, began by providing a 5 year
historical review of bad debt write-off trends and the number of uncollectable accounts
displayed by division.
Per the department's Delinquent and Uncollectable Accounts Policy (15.0), uncollectible
accounts must be administratively written off of the general ledger. The purpose of this
accounting function is to precisely account for funds, which are truly unrecoverable. The last
administrative write-offs were performed by the Board of Health in October 2019 (Personal
Health, Dental Health, and Environmental Health) for FY 2018-2019. Per the County Manager,
the yearly delinquent and uncollectable processes were temporarily paused due to the COVID-
19 pandemic in FY 2019-2020 and FY 2020-2021 and have recently been restarted.
Personal Health, Dental Health, and Environmental Health continue to participate in the INC
Debt Set-Off Program, which allows the county to collect debts on delinquent accounts with a
balance between $50 and $4,000 through the customer's tax refund. The Health Department
anticipates collecting payments on delinquent accounts being pursued through the INC Debt
Set-Off program. Therefore, those accounts are not included in this write-off request, but a
summary of the amounts received through the INC Debt Set-Off program for the periods of FY
2019-2020, FY 2020-2021, and FY 2021-2022 are below.
FY 2019-2020
Number of Amount
Division Accounts Set- Received
Off through NC Debt
Set-Off
Personal Health 33 $3,629.53
Dental Health 32 $3,828.79
Environmental Health 7 $947.05
Total 72 $8,405.37
FY 2020-2021
Number of Amount
Division Accounts Set- Received
Off through NC Debt
Set-Off
Personal Health 31 $3,620.90
Dental Health 27 $3,780.64
Environmental Health 3 $396.83
Total 61 $7,798.37
FY 2021-2022
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Number of Amount
Division Accounts Set- Received
Off through NC Debt
Set-Off
Personal Health 12 $1,356.04
Dental Health 18 $2,016.13
Environmental Health 4 $466.00
Total 34 $3,838.17
Based on the definitions of uncollectible accounts in the department's policy, the following table
represents all uncollectible debt from clients for FY 2019-2020, FY 2020-2021, and FY 2021-
2022.
Number of
Division Uncollectable Write-Off
Accounts Amount
Personal Health 0 $0
Dental Health 134 $3,683.81
Environmental 3 $470.00
Health
Total 137 $4,153.81
The customer will never be informed that a debt has been written off. If a customer whose
account had been determined uncollectible returns to clinic within three years, the delinquent
write-off amount will be reactivated and the billing process resumed. Likewise, if a customer
requests a non-required service from Environmental Health, the delinquent write-off amount will
be reactivated and the billing process resumed.
The BOH members had comments and questions that were addressed by Ms. Guindon.
Motion to administratively move a total of$4,153.81 in uncollectable debt from "active"to
"inactive"status was made by Shielda Rodgers, seconded by Dr. Aparna Jonnal and
carried without dissent.
C. BOH Policy Review
Health Director, Quintana Stewart, began by stating that an annual review of BOH Policies and
Procedures is required every year per Accreditation. Next, Ms. Stewart discussed the
recommended changes that were also outlined in the Board agenda packet. The Board will
review the proposed changes and will vote at next month's Board meeting in October.
VII. Reports and Discussion with Possible Action
A. Media Items
In lieu of the absent Communications Manager, Kristin Prelipp, the Health Director, Quintana
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Stewart, presided over the media items portion of the agenda. The majority of the media items
included in the board packet were COVID-19-related. Ms. Stewart briefly mentioned two articles
— 1) an article on the first confirmed monkeypox case in OC and 2) an article on the bivalent
booster and the omicron variant.
Media items were in the packet which focused on Orange County's events and our
involvement in various efforts.
B. Health Director Report
In addition to her report, some of the highlights Ms. Stewart gave are below:
• The NCPHA Fall Educational Conference occurred September 14-16th, in Wilmington. It
was a great and informative conference with many topics discussed including Medicaid
Transformation. Dr. Elizabeth Tilson, State Health Director and Chief Medical Officer,
DHHS, gave a presentation that recapped the past 2.5 years, including information on
lessons learned from COVID-19, the different levels of stress and reducing burnout.
• OCHD continues to prepare for Accreditation with November 1 st as the date documents
are due to be uploaded. The Accreditation Site Visit has been scheduled for January 12,
2023. Two Board of Health members will need to be interviewed.
• OCHD continues to offer evaluation, testing and treatment for suspected monkeypox
cases. The vaccine eligibility criteria has been updated. Currently, OC has three
confirmed monkeypox cases.
• In collaboration with the Durham County HD, the OCHD will be hosting a suicide
prevention and awareness walk on September 29th from 6:30p-8pm at Leigh Farm Park
in Durham. Gently-used shoes are in need. Durham and Orange Counties had a
combined number of 206 suicides from 2016 to 2020.
• As of last Thursday, OC was considered to be at a medium community level. There's
been a decrease in hospital admissions. In the last seven days, there's been
approximately 150 cases per 100,000 people in OC.
• The bivalent booster is being offered at the SHSC on Mondays, Wednesdays, and
Fridays from 8-4:30pm by appointment only. The booster is also being offered at the
Bonnie B. Davis Center in Hillsborough on Fridays and Saturdays with the added option
of walk-in availability.
The BOH members had comments and questions that were addressed by Ms. Stewart.
C. Health Director Annual Evaluation
At 8:32pm, Dr. Bruce Baldwin, Chair, motioned to move into closed session, seconded by
Commissioner Jean Hamilton and carried without dissent.
Vill. Closed Session to Discuss Health Director's Annual Review
During the closed session, the Board of Health discussed Quintana Stewart's job description
and annual performance review.
At 9:29pm, a motion was made to issue an "exceptional"performance rating for Quintana
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Stewart as Orange County Health Director by Shielda Rodgers and seconded by Dr.
Alison Stuebe. The motion carried unanimously.
The Board asked Ms. Stewart to rejoin the meeting at 9:31 pm. At 9:45pm, Dr. Bruce
Baldwin, Chair, moved to end the closed session and return to open session followed by
a second and unanimous consent.
IX. Board Comments
None.
X. Adjournment
Dr. Bruce Baldwin, Chair, moved to adjourn the meeting at 9:46pm, seconded by Dr.
Alison Stuebe and carried without dissent.
The next Board of Health Meeting will be held October 26, 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
'Vice-chair, Keith Bagby,arrived late and did not partipate in the voting on agenda items VI.A.and VI.B.
**Although absent from this meeting,Dr. Lee Pickett expressed,via email, her approval of Micah Guindon's
recommendation regarding the Debt Write Off and her acceptance of the revision of the Groundwater Rules.
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