HomeMy WebLinkAboutApproved Minutes of May 24, 2023 MINUTES-Draft
ORANGE COUNTY BOARD OF HEALTH
May 24, 2023
ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To promote and protect
health, enhance quality of life, and preserve the environment for everyone in Orange County.
THE ORANGE COUNTY BOARD OF HEALTH MET ON May 24, 2023, at the Orange County
Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Keith Bagby— Chair, Aparna Jonnal —Vice-
Chair, Bruce Baldwin, Commissioner Jamezetta Bedford, Lee Pickett, Rachel Royce, Alison
Stuebe, and Tony Whitaker.
BOARD OF HEALTH MEMBERS ABSENT: Brian Crandell and Shielda Rodgers.
STAFF PRESENT: Quintana Stewart, Health Director; Dana Crews, Community Health
Services Director; Dr. Stephanie George, Dental Director; Victoria Hudson, Environmental
Health Director; Carla Julian, Public Health Nursing Director; Ashley Rawlinson, La Toya
Strange, Administrative Support I; Marcy Williams, Public Health Education Manager; and Lena
Wegner, Communications Manager.
GUESTS/VISITORS PRESENT: None.
I. Welcome New Employees
Quintana Stewart, Health Director, introduced the new employees in attendance: Jaimie Kidd —
Public Health Services Manager and Kimberly Jean Phillips-Weiner— Senior Public Health
Educator/BOH Strategic Plan Manager.
II. Public Comment for Items NOT on Printed Agenda: None.
III. Board Comments
Dr. Alison Stuebe
Dr. Stuebe suggested the book Poverty by America by Matthew Desmond as a great read.
The book speaks on how the US has more poverty than other advanced democracies. It also
highlights how the root causes of poverty are not addressed in America despite the many
governmental programs aimed at those living in poverty.
Keith Bagby
Mr. Bagby spoke about the Be Well event that occurred on May 20' at Hargraves
Community Center. He stated that there was representation from various agencies and
organizations. Some of those included the Family Success Alliance, Department of Aging, El
Futuro, Department of Social Services, and Alliance Health. He also mentioned that
Commissioner Bedford manned a table. Ms. Crews added that there was a Zumba instructor
and a DJ present.
Rachel Royce
Ms. Royce suggested the book Weathering: The Extraordinary Stress of Ordinary Life in an
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May 24, 2023
Unjust Society by Dr. Arline T. Geronimus as a great read. This book discusses stress and race
and how health is affected by both of these topics. Ms. Royce also mentioned an article
regarding crash deaths. She expressed that she's an avid reader and would like to share
articles. Ms. Stewart replied that Google Drive can be used to share resources such as books
and articles by simply dropping them into the folder. Ms. Stewart reminded them that the
Google Drive's purpose is not for doing business, conversations or leaving comments; it is
solely for sharing resources.
As a member of the Community Health Assessment (CHA) subcommittee, Ms. Royce
asked how the Board was going to find out what was going on with the CHA as she hadn't
shared any information. Ms. Stewart responded by stating the comments period at the
beginning of the Board meeting is the optimal time for doing so.
IV. Approval of the May 24, 2023 Agenda
Motion to approve the agenda of the May 24, 2023 BOH meeting was made by Dr. Aparna
Jonnal, seconded by Dr. Lee Pickett and carried without dissent.
V. Action Items (Consent)
A. Minutes of April 26, 2023
Dr. Lee Pickett commented that the minutes of the last meeting had the old mission statement
at the top. Ms. Stewart informed her that since the statement was officially adopted during the
April meeting, the new mission statement will be on the minutes of the May Board meeting.
Motion to approve the minutes of the April 26, 2023 BOH meeting was made by Dr. Alison
Stuebe, seconded by Dr. Aparna Jonnal and carried without dissent.
B. Dental Seat Nomination Vote
Mr. Bagby began by noting that there was a total of 3 candidates interviewed. He continued by
stating that Dr. Stephanie George, OCHD Dental Director, was consulted and asked for
feedback on the candidates. Dr. George provided positive feedback for all candidates. Mr.
Bagby declared that the BOH Nominations Committee felt that all 3 candidates could fulfil the
required needs of the BOH Dental Seat position. He offered Dr. Katrina Mattison-Chalwe to the
Board as the recommendation. He gave some background information on her including that
she works at Piedmont Health as the Dental Director and lives in Cedar Grove. Mr. Bagby
explained that her area of residence was a positive as it's good to have representation from all
parts of the county. He proceeded to speak on how many Board members reside in Chapel Hill
and in Hillsborough.
Ms. Stewart added that she enjoyed the interview, agreed that Dr. Mattison-Chalwe brought a
lot of energy and appeared great with community engagement; however, she felt that that there
was a conflict of interest. Ms. Stewart voiced that, when thinking administratively, having an
executive leader from an agency that offers the same programs/services as the health
department is a conflict. We compete for staffing, patients and some pots of funding. Her
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presence on the Board would give her access to information we wouldn't traditionally share with
competitors. In addition, Piedmont Health is one of the agencies that our Board reviews for
outside funding. Although Ms. Stewart did not have a vote on the candidate's recommendation,
she noted that she just wanted to make her apprehensions known to the Board.
A lively discussion was held in which Board members expressed their opinions and concerns on
Ms. Stewart's apprehensions. Commissioner Bedford reminded all of the BOCC's meeting
schedule. She also mentioned that there is a possibility that the BOCC will choose a candidate
if one isn't submitted. It was determined that Dr. Jane Weintraub did not have a NC license,
which is required according to state statute. It was concluded that Dr. Davia Nickelson was also
an exceptional candidate. A vote ensued to recommend Dr. Nickelson to the BOCC as the
Dental Seat Representative.
Motion to recommend the appointment of Dr. Davia Nickelson and forward to the Board
of County Commissioners was made by Aparna Jonnal, seconded by Dr. Lee Pickett, and
carried without dissent.
VI. Educational Sessions
A. State of the County Health (SOTCH) Report
Ashley Rawlinson, Healthy Carolinians of Orange County (HCOC) Coordinator, presented the
2022 State of the County Health Report (SOTCH). The SOTCH is a report that is produced
every year in between the Community Health Assessment (CHA). Below are highlights from
Ms. Rawlinson's presentation.
Leading Causes of Death
• Since the 2019 CHA, the 3 leading causes of death (cancer, heart disease and stroke)
have not changed.
• As of March 1, 2023, there were 27 COVID-related deaths in OC.
o Confirmed COVID case percentages were provided separated by race, sex, and age.
- Rachel Royce had questions regarding statistics and a breakdown of the rates in terms
of numbers. Ms. Rawlinson stated that she will follow up.
• In 2021, there were 29 Opioid overdose deaths and 110 emergency department visits.
Health Behaviors
• The number of alcohol-related calls from those under 21 had decreased yearly.
- Rachel Royce asked for the nature of the calls. Ms. Rawlinson stated that she will follow
up.
• The highest suicide rates were females in the age groups of 45-54 years and 55-64
years.
Rachel Royce asked if there were females over the age of 74 that committed suicide to
which Ms. Rawlinson confirmed that this was accurate as of 2021. Ms. Royce also
wanted to know the actual numbers of suicides in OC vs just having the percentages.
• Some suicide prevention and awareness campaigns include "Be the 1 To" and "Be the
Light" Suicide Awareness Walk (the walk did not occur during COVID).
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• The highest method of self-inflicted injury seen by the emergency department by youth
ages 10-17 during the years 2017-2021 was poisoning.
Tony Whitaker asked if the information was based on 5 years of cumulative data. Ms.
Rawlinson confirmed.
Health Equity
• Ms. Rawlinson provided the number of equity trainings provided over the past 5 years.
There was a decline between 2020 and 2022 due to COVID.
Rachel Royce spoke about an article on structural racism, which she sent that she
believes would be beneficial to OCHD staff.
In response to Tony Whitaker question regarding the accuracy of metrics, Ms. Stewart
mentioned that the Health Equity Subcommittee could tackle that task.
Emerging Issues
• The OCHD, along with other governmental agencies, have experienced significant staff
turnover and vacancies. Currently, the vacancy rate is 10.4%.
• Vaping is increasing amongst OC middle and high school students. The greatest risk of
harmful substances among the students is prescription drugs.
2023 CHA
• Ms. Rawlinson reviewed the 8 phases of the CHA assessment process.
• The benefits of the CHA are gaining a basic understanding of the demographics of OC,
health status, major health risks/problems, and how health status and health risk findings
support, contradict, and relate to residents' perceptions.
• The incentives to data collection include internal analysis with public health
professionals, knowing the community, tailoring it to our community, and creating a
descriptive and simple analysis.
• Obtaining more community engagement is key. The data will be collected during various
community events, surveys, and door-to-door. There will be a call for volunteers to
assist with data collection. The Board of Health was also encouraged to be present at
the focus groups helping to facilitate conversations with the community.
- Rachel Royce mentioned that the purpose is to get statistical samples according to
census block and attempting to oversample those areas where the response rate has
been low.
- In response to Mr. Bagby's concern about safety and going into certain neighborhoods,
Ms. Rawlinson stated that volunteer shifts occur during daylight, they work in teams of 2
in mapped out areas, and training is provided. Ms. Crews added that it's important to go
into all communities, especially the ones that don't trust us or feel that they're not being
heard.
B. Child Fatality Task Force Report
Dana Crews, Community Health Services Director, gave the highlights of the Child Fatality
Prevention Team (CFPT) Annual Report. Before she began, Ms. Crews stated that they met 6
times; although, they're only required to do so quarterly. She briefly explained the team's goals
and purpose which include reviewing medical records, discussing outcomes, identifying
deficiencies and carrying out recommendations to prevent further child deaths. The CFPT
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members' composition is defined by statute and includes members of law enforcement, school,
mental health, EMS and providers.
Ms. Crews mentioned that Orange County received $804.00 for FY 22-23. The funding is
allocated from the NC Legislature through the DPH, Children and Youth Branch and the county
health department via an agreement addenda. The local CFPT decides how the money is
spent; the funding does not roll over.
In 2022, the CFPT reviewed 16 child deaths. While no system issues were identified, the CFPT
engaged in discussion regarding:
- The need for grief support for parents after the loss of a child;
- Recognition of mental health needs in adolescents to prevent suicide;
- The importance of continued mental health support within schools and training for staff;
- Follow up with those who have experienced an overdose requiring the administration of
naloxone; and
- Promoting the use of gun locks and other forms of firearm safety.
During 2021, some of the trainings completed during 2021 included:
- "Back to Sleep Safe" webinar;
- "Melatonin" — Marketing Magic webinar; and
- "Tik TOX—Overview and Interpretations of Positive Tox Findings in Child Deaths".
VII. Reports and Discussion with Possible Action
A. Media Items
Lena Wegner, Public Health Communications Manager, briefly summarized the articles. Some
of the topics included both houses of the NCGA overriding Governor Cooper's veto of the 12-
week abortion restriction law and OC Animal Services' caution regarding canine flu cases in
Chapel Hill and Durham.
- Rachel Royce mentioned a JAMA Pediatrics article on firearms storage. She offered to
share it.
Media items were in the packet, which focused on Orange County's events, our
involvement in various efforts, and various public health topics.
B. Health Directors Report
Some of the highlights provided by Health Director Stewart are below.
• Governor Cooper has proclaimed the first week of June as NC SAFE (Secure All
Firearms Effectively) Week of Action to raise awareness about the importance of safe
gun storage. The OCHD will also be promoting this as well.
• On May 19th, the Accreditation plaques were received. We plan to celebrate the
distinction of Accreditation with Honors with staff.
- Rachel Royce offered to bake some items for the celebration.
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• County Manager presented the FY 23-24 Recommended Budget. Some highlights
include:
o Recommending adding a new Accounting Technician to address the new workload
by Medicaid Transformation and a Billing Technician position to work on billing and
payment denials associated with Medicaid Transformation.
o Prioritizing staff retention with an across the board wage adjustment of 6% for all
employees effective July 1st
o An increase in county-funded health insurance with no additional cost to employees
as the county picked up the increased amount.
o A new mental health benefit which will provide access to clinical assessments,
therapists, and mental wellness resources.
o An increase to mandated retirement contribution by 0.75% for general employees.
o A living wage increase from $15.85/hour to $16.60/hour.
• The County is developing a comprehensive 5-year Strategic Plan. A survey has been
created to get feedback to ensure the plan reflects the values and needs of the
community.
• The Opioid Advisory Committee (OAC) submitted a proposal requesting $64,200 of the
Opioid Settlement funds to support a Syringe Service Program. The OAC also heard
from the UNC Student Health Advisory Coalition.
• Monkeypox
o There's an increase of cases with a total of 12 confirmed cases as of May 5'n
There's a cluster of monkeypox cases in the Chicago area, of which all were men.
The OCHD is preparing and is pushing vaccination and education on monkeypox.
As June is Pride Month, we want to be intentional with our messaging.
o Legislative Update — SB 20("Care for Women, Children, and Families Act")
The NC General Assembly voted to override Governor Cooper's veto on Tuesday,
May 16, 2023. The bill will add $3.5 million in recurring funds for the 2023-2025 fiscal
years for competitive grants for reversible, long-acting contraceptive drugs or
devices.
Vill. Adjournment
A motion was made by Dr. Aparna Jonnal to adjourn the meeting at 8:44 p.m. was
seconded by Dr. Alison Stuebe and carried without dissent.
The next Board of Health Meeting will be held June 28, 2023 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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