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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 S:\Managers Working Files\BOH\Agenda &Abstracts\2023 Agenda &Abstracts/ May Page 1 MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH 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 S:\Managers Working Files\BOH\Agenda&Abstracts\2023 Agenda&Abstracts/ May Page 2 MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH May 24, 2023 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). S:\Managers Working Files\BOH\Agenda&Abstracts\2023 Agenda&Abstracts/ May Page 3 MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH May 24, 2023 • 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 S:\Managers Working Files\BOH\Agenda&Abstracts\2023 Agenda&Abstracts/ May Page 4 MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH May 24, 2023 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. S:\Managers Working Files\BOH\Agenda&Abstracts\2023 Agenda&Abstracts/ May Page 5 MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH May 24, 2023 • 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 S:\Managers Working Files\BOH\Agenda&Abstracts\2023 Agenda&Abstracts/ May Page 6