HomeMy WebLinkAboutApproved Minutes of March 27, 2024 MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2024
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 March 27, 2024, at the Orange
County Health Department, 300 West Tryon Street, Hillsborough, NC.
BOARD OF HEALTH MEMBERS PRESENT: Aparna Jonnal — Chair, Alison Stuebe—Vice
Chair, Keith Bagby, Bruce Baldwin, Commissioner Amy Fowler, Davia Nickelson, Lee Pickett,
and Tony Whitaker.
BOARD OF HEALTH MEMBERS ABSENT: Brian Crandell, Shielda Rodgers, and Rachel
Royce.
STAFF PRESENT: Quintana Stewart, Health Director; Dana Crews, Community Health
Services Director; Victoria Hudson, Environmental Health Director; Carla Julian, Public Health
Nursing Director; Frederick Perschau, Finance and Administrative Services Director; Thomas
Privott, Environmental Health Supervisor; Marcy Williams, Health Promotion and Education
Services Manager; McKayla Creed, Healthy Carolinians Coordinator; Bianca Rodriguez, Public
Health Nurse I; and Jean Phillips-Weiner, BOH Strategic Plan Manager.
GUESTS/VISITORS PRESENT: Samantha Luu, Heather Pack, and Elizabeth LoFrese.
I. Welcome New Employees
Quintana Stewart, Health Director, introduced the new employee in attendance: Bianca
Rodriguez— Public Health Nurse I.
II. Public Comment for Items NOT on Printed Agenda: None.
III. Board Comments
Dr. Davia Nickelson
Dr. Nickelson shared that there are new radiation shielding recommendations for dental x-
rays from the American Dental Association (ADA), which are less stringent than past
requirements and involve less shielding. She added that these have not yet been instated in NC
but that they may be in the future. In response to Dr. Baldwin's question about why the
recommendations have been loosened, Dr. Nickelson explained that the radiation exposure
amount from dental x-rays is very low, with a single x-ray containing less radiation than what the
average person is exposed to in a day. She also said that new technology allows the radiation
to be targeted much more precisely, reducing the need for stringent shielding outside of the
immediate area of the x-ray.
Dr. Jonnal agreed that the use of x-rays has been liberalized in medicine because radiation has
become more targeted, mentioning that pregnancy tests are no longer mandatory before every
x-ray.
Dr. Bruce Baldwin
S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/
March Page 1
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2024
Dr. Baldwin apologized for missing the previous meeting and explained that he was helping
care for his wife who had broken her leg. He added that he read the meeting's minutes in detail
and thanked the board members for recommending him to the Board of County Commissioners
(BOCC) for reappointment and that he hopes to be allowed to serve on the Board of Health
(BOH) for another three years.
Keith Bagby
Mr. Bagby reminded board members of the upcoming Orange Partnership event, Take
Down Tobacco Day, which will be held at A.L. Stanback Middle School from 1-3pm on April 12,
2024. He shared that there would be three major activities: an educational presentation about
tobacco, games, and a kickball tournament, for which Mr. Bagby will be refereeing. He added
that 120 middle schoolers have signed up to play kickball and that Orange Partnership will be
inviting the Orange County BOCC and Hillsborough Board of Commissioners, and that the
Mayor of Hillsborough is planning to throw the opening pitch.
Jean Phillips-Weiner, BOH Strategic Plan Manager, chimed in to let board members know that
details of this event, as well as other upcoming community events, are listed on the back of the
meeting agenda.
In response to Dr. Baldwin's question, Mr. Bagby explained that visitors are required to sign in
when they arrive at the school but not to pre-register for the event, and that the school has
rearranged the normal schedule to allow students and guests to participate.
Commissioner Amy Fowler
Commissioner Fowler provided an update on the movement to amend the Orange County
Unified Development Ordinance (UDO) to restrict the opening of new tobacco and vape shops
near schools and parks in unincorporated areas of the county. She said that it is moving along
in the planning department and is expected to move forward in about three months. She added
that she has been in touch with the mayors of Carrboro, Chapel Hill, and Hillsborough, and that
they all plan to follow suit once the county UDO has been amended.
IV. Priority Committee Updates
As none of the priority committees have had the opportunity to meet since their formation at the
Board Retreat, there were no updates on committee activities.
Instead, Ms. Stewart provided a one-page document to board members summarizing the new
committees and an overview of a potential tool to help committee members center equity/justice
in their work. Ms. Stewart emphasized that this tool was a rough draft sourced from the One
Orange framework and from a tool from the Assistant Secretary for Planning and Evaluation at
the Office of Human Services and that she expects it will evolve over time.
Dr. Stuebe commented that she is reading the book Equal Care: Health Equity, Social
Democracy, and the Egalitarian State by Seth A. Berkowitz, which discusses how the common
view of the goal of health equity is to eradicate disparities, but that this goal does not consider
the possibility of the dominant group getting worse and reaching the same lower levels of well-
being as the oppressed groups —an outcome which is not truly equitable. She presented the
alternate construct of health justice, with everyone getting the best possible health outcomes.
S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/
March Page 2
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2024
Ms. Stewart said that this reminded her that the focus for the board is meant to be health
equity/justice, rather than health equity alone.
The new priority committees are as follows:
Behavioral Health — Bruce Baldwin, Brian Crandell, Amy Fowler, Davia Nickelson
Access to Care — Lee Pickett, Shielda Rodgers, Rachel Royce
Connections to Community Support— Keith Bagby, Aparna Jonnal, Alison Stuebe, Tony
Whitaker
Dr. Jonnal thanked Ms. Stewart for the draft of the tool and expressed that she believes it will be
enormously helpful as committee work moves forward.
Ms. Phillips-Weiner reminded board members to please complete the polls to help schedule the
upcoming committee meetings if they have not already done so.
V. Approval of the March 27, 2024 Agenda
Motion to approve the agenda of the March 27, 2024 BOH meeting was made by Dr.
Alison Stuebe, seconded by Dr. Lee Pickett, and carried without dissent.
VI. Approval of Minutes
Motion to approve the minutes of the February 28, 2024 BOH meeting was made by
Commissioner Amy Fowler, seconded by Dr. Alison Stuebe, and carried without dissent.
Motion to approve the minutes of the March 2, 2024 Board Retreat was made by Dr. Davia
Nickelson, seconded by Commissioner Amy Fowler, and carried without dissent.
VII. Educational Sessions
A. Campus Community Coalition Update
Samantha Luu, Director of the Campus Community Coalition (CCC), provided an update on the
CCC's strategic planning process and activities over the past year.
Some highlights of her presentation are below:
• Ms. Luu gave an overview of her presentation and explained that it would encompass
the coalition's strategic planning process, a dive into four relevant policies, and a quick
look at some non-policy related activities. She then reminded the board of the goals and
vision of the coalition: to serve as a catalyst to change the environment and reduce the
harms of high-risk drinking, both to the individual and the community.
• Due to an increase in reported polysubstance use (i.e., alcohol being used concurrently
with another substance), the coalition is expanding its focus. Ms. Luu clarified that most
commonly, polysubstance use consists of alcohol with cannabis.
• Ms. Luu provided an overview of the CCC's strategic planning process using a garden
metaphor, including initiatives that are flowering, still seedlings, and those moved to
S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/
March Page 3
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2024
compost. She explained that the coalition has employed more than two dozen strategies
in the past four years, many of which aim to reduce the availability of alcohol on or
around UNC's campus. An example of one such strategy is a "last drink" initiative, in
which Chapel Hill police officers ask individuals pulled over for a DUI where they got
their last drink, which then provides an opportunity for retailer education around
responsible alcohol service. Ms. Luu added that this initiative has been so successful
that it is being adopted in Carrboro as well.
• Speaking more towards alcohol on campus, Ms. Luu shared that alcohol availability on-
campus is steady in all areas other than athletics, where vendors have been increasing.
She also mentioned that, though alcohol marketing is banned on campus, there have
been some "grey area" incidents, such as gardens sponsored by alcohol companies.
• During strategic planning, coalition members were asked to name some initiatives that
they were excited about. Responses included substance-free spaces, treatment and
recovery support, updating the campus alcohol policy, and working closely with retailers
around responsible beverage service. Some challenges identified included working on
the campus alcohol policy and engagement of school-aged children and their families.
• Ms. Luu shared that one of the specific challenges around the UNC campus alcohol
policy, which covers any UNC business or property, is that drugs and alcohol are under
two separate policies, with separate remedial processes. The CCC aims to combine
alcohol and other substances under a single policy and streamline the adjudication
process, creating more consistent opportunities for intervention and treatment. However,
this change would need to go through several big decision-makers to pass, including the
Board of Trustees.
• Some other policies Ms. Luu highlighted included a proposed provision to instate happy
hour availability in NC, which did not pass, and NCAA Name, Image, and Likeness laws
which create opportunities for alcohol branding, e.g., "ECU Boneyard Vodka."
• Ms. Luu discussed the Social Host Ordinance, which is meant to prevent underage
access to alcohol and mitigate associated complaints with comprehensively disruptive
house parties. She added that CCC submitted a petition related to this policy to the town
council earlier this year, putting the CCC in a holding pattern around this topic. Students
in particular have expressed opposition to the policy, though it would be a municipal
policy and affect everyone in the Town of Chapel Hill, not just students. Ms. Luu also
said that there have been concerns about inequitable enforcement of this policy, though
there are also some concerns about historically Black neighborhoods being
disproportionately impacted by disruptions caused by party rentals. Dr. Jonnal asked
about past "farm parties", for which college students rented barns in rural areas and
threw large parties. Dr. Jonnal wondered if there were concerns about new regulations
leading to parties relocating from a regulated area to another, less regulated one. In
response, Ms. Luu explained that these parties appear to be ongoing but, as Dr. Jonnal
observed, many of them have since moved into Person County, limiting jurisdiction. She
went on to explain that, because many of these parties were hosted by fraternity or
sorority organizations at Duke University, they are not covered under the jurisdiction of
the university, making enforcement tricky. She added that students should have the
opportunity to socialize, as this is important for psychological health and social
development, but that CCC wants to encourage people to socialize responsibly and
safely. Some examples of interventions to promote responsible socialization include
party registration, safe host training, and encouraging hosting parties at licensed venues.
• In response to Dr. Stuebe's question about the party situation in newly constructed
apartment housing near campus, Ms. Luu explained that every Monday morning, the
Chapel Hill police notifies the CCC of any noise complaints accrued over the weekend
S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/
March Page 4
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2024
and Ms. Luu and some representatives from the university go to these homes and
provide motivational interviewing and education to the party hosts to reduce the
likelihood of another incident. She added that they also provide education to property
managers and owners about code enforcement, party registration, noise mitigation, and
safe host training.
• Ms. Luu briefly touched on social districts (i.e., designated open container drinking
zones) and explained that there currently are no official considerations for social districts
in Chapel Hill, Southern Village, or Carrboro, though there have been some murmurs on
the topic in downtown Hillsborough. Ms. Luu said that Durham, Raleigh, and Cary
currently have social districts, and that social districts present a problem for public health
because they can normalize social drinking, increase accessibility of alcohol, and raise
the likelihood of underage drinking due to increased accessibility and increased barriers
to enforcement. She added that social districts may also present equity issues, as
historically marginalized communities are more likely to live near areas that become
zoned as social districts.
• The Good Samaritan Law failed to be updated last year in the legislature, though the
CCC is hoping to see it come back in the future, as Good Samaritan Laws help protect
individuals who may be wary of law enforcement and thus less likely to seek help for
either alcohol or drug overdose.
• Dr. Jonnal asked if Ms. Luu ever feels existentially crushed by the difficulties of working
at the local level against the lobbying of big alcohol companies, to which Ms. Luu replied
that yes, she sometimes does, in part because the funding for public health comes
nowhere near what the lobbyists have access to. However, she added that she works
with a lot of passionate people who are great at what they do, which is re-energizing,
and that she and her team lean hard into the existing data and evidence to support their
work. Ms. Luu shared that she hopes to complete a Capstone project with MPH students
next year focused on qualitative data around alcohol use to expand the breadth of the
data available to support alcohol control.
• In response to Mr. Whitaker's question about the CCC's relationship with local
businesses, Ms. Luu explained that the CCC is housed under the fiscal sponsorship of
the Downtown Chapel Hill Partnership, which gives them an interesting relationship with
local businesses. She added that, whenever possible, she prefers to find "carrots" to
motivate change (rather than "sticks") and seeks to collaborate with and educate
business owners, emphasizing that responsible alcohol service makes better economic
sense than irresponsible service. She went on to say that the CCC incentivizes
responsible beverage service training for servers and bartenders, both in English and
Spanish, and subsidizes ID scanners for local businesses to help remove barriers to
responsible alcohol service.
• Dr. Stuebe asked if Ms. Luu could comment on trends in binge drinking and sexual
assault on campus related to the pandemic; Ms. Luu explained that during the
pandemic, binge-drinking trended down when students were sent home and right back
up when they returned to campus and that overall drinking levels increased among
women in their 30s during the pandemic. Otherwise, local data is unfortunately limited on
this topic, so she is unable to comment meaningfully at this time, though her hunch is
that both have returned to pre-pandemic levels based on national data.
• Mr. Bagby noted that many ABC stores hired teachers and bartenders early in the
pandemic due to the increased demand for alcohol and decrease in ability to perform in-
person jobs. He said that many of these bartenders are continuing to work at ABC stores
even now. Ms. Luu agreed and said that many people were drinking to cope, especially
young people, which is worrying. However, she observed that from a retail perspective
S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/
March Page 5
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2024
there has been an increase in the demand for non-alcoholic beverages and shared that
North Carolina's first alcohol-free bottle shop, Boro Beverage Co., has opened on
Franklin Street.
• Dr. Jonnal commented that treatment is often considered more lucrative than prevention
and that she feels this is manifesting in the nation's approach to mental health care. Ms.
Luu said that alcohol and mental health are bidirectional, meaning that they exacerbate
each other, and it is difficult to tease out that relationship. She added that institutions are
starting to recognize this relationship and moving towards a more holistic approach to
treat overall well-being rather than just preventing and treating substance use. She
added that the CCC aims to decrease the barriers to screening and intervention, though
treatment is not her particular area of expertise. She said that culture change and
building up social skills are the two approaches she believes will be most effective to
address this issue, but that neither are quick fixes.
• In response to Commissioner Fowler's question about funding sources for the CCC, Ms.
Luu replied that they receive equal parts funding from the ABC Board, Orange County
Health Department, UNC Student Affairs, and the Town of Chapel Hill. She added that
they have received a small Substance Abuse and Mental Health Services Administration
(SAMHSA) grant as well.
B. 2023 Community Health Assessment Results and Data
McKayla Creed, Healthy Carolinians of Orange County Coordinator, provided an overview of the
data and results of the 2023 Community Health Assessment (CHA).
Some highlights of her presentation are below:
• Ms. Creed began her presentation by reviewing the Social Determinants of Health
(SDOH), which are the conditions of the environments where people are born, live,
learn, work, play, worship, and age that affect a wide range of health, functioning, and
quality-of-life outcomes and risks. These include things like healthcare access,
neighborhood environment, social context, financial stability, and education. She also
shared that all figures and data in her presentation came directly from the CHA
document.
• Ms. Creed provided an overview of the CHA survey timeline and a preview into the
upcoming Community Health Improvement Plan (CHIPs) process. She also thanked the
board members for their support during the community listening sessions.
• To assess well-being in Orange County, data is compared against peer and neighboring
counties. Ms. Creed explained that peer counties are counties with similar demographics
such as population, income or education levels, or age or race distributions, while
neighboring counties are ones that are geographically close.
• Ms. Creed underscored again that affordable housing and mental health were
consistently voiced as concerns by those who completed the survey or participated in
listening sessions.
• While reviewing disparities around life expectancy for different genders and different
racial groups in Orange vs comparison counties, Mr. Bagby asked what factors
explained the discrepancies between counties. Ms. Creed replied that she did not know
the exact factors and that it could possibly be explained by things such as a higher
number of medical facilities in Orange County or Orange County having a larger number
of retirees who have moved into the county compared with other counties, skewing the
results.
• Ms. Creed shared that mental health is an area of particular priority as suicide is the
ninth leading cause of death in Orange County but does not rank in the top ten for the
S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/
March Page 6
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2024
state. She added that Emergency Department (ED) visits related to mental health
decreased over the course of the pandemic, even though self-reported mental health
challenges increased during the same period. Ms. Creed highlighted this as an apparent
access issue.
• Despite Orange County commonly being considered an affluent county, Ms. Creed
shared that it has the highest percentage of adults living in poverty (-15% countywide)
of any county in the state. Mr. Bagby wondered if the population concentrations in
various areas of the county might be distorting the figures, and Ms. Creed agreed that it
was possible that the large student population relative to permanent residents in the
county could be skewing the data. While looking at a map of the county comparing levels
of poverty in each census tract, Victoria Hudson, Environmental Health Director, said
that the most densely impoverished area appeared to be central Carrboro, which is a
high-density housing area with a high number of residents who are refugees.
• Orange County has an overall Gini coefficient of 0.5, which means that the county falls
right in the middle between perfectly equal income distribution (0.0) and perfectly
unequal income distribution (1.0). This score is higher than the Gini coefficients for the
state of NC or the comparison counties. Ms. Creed went on to say that a fifth of Orange
County residents are spending more than half their monthly income on their housing,
leaving less money for things like healthcare, healthy food, education, and exercise
opportunities.
• Dr. Jonnal commented that income inequality is a behemoth issue and commended Ms.
Creed for considering how access to money and health outcomes intertwine. She added
that this is often a missing link in conversations about health and, though there's likely
not a quick fix, it's important to acknowledge how this affects health. Dr. Stuebe added
that there are many fraught policies in Orange County related to zoning and affordable
housing (e.g., construction of single family vs. multi-family housing units) which the BOH
can learn about and comment on; she added that affordable housing also needs to be
safe and humane. Ms. Creed replied that Orange County is blessed with a large
immigrant and refugee population but that unfortunately many of these people arrive to
the county without the knowledge and ability to access resources such as money, jobs,
or housing. She added that Chapel Hill is full of housing units but many of these units,
especially new construction, are expensive and targeted primarily towards students. Dr.
Stuebe chimed in that this is a complicated issue, but new housing built for students can
free up existing housing for permanent residents. She added that Matthew Desmond's
book Poverty, By America, weighs in on affordable housing and discusses how
mortgages are subsidized by taxes in a way that rental housing is not, leading to
inequitable outcomes. Dr. Stuebe suggested that all board members might benefit from
reading this book.
• Ms. Creed provided an overview of how the CHA team narrowed in on the priority areas
identified by the CHA. She explained that the original CHA survey produced fifteen
potential priority areas, which obviously could not all realistically be prioritized. These
fifteen priority areas were then voted on by community members (during the listening
sessions and at community events) and by the CHA leadership team. Both votes
produced the same top four areas of concern, which were then funneled into the three
identified priority areas: Behavioral Health, Access to Care, and Connections to
Community Support.
• In response to Mr. Bagby's question about how the participants for the CHA focus
groups consisting of formerly incarcerated individuals and individuals with a history of
substance use were recruited, Ms. Creed explained that the health department worked
within existing partnerships to invite community members with specific lived experiences
to participate. She added that those who did participate were excited to do so, though
S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/
March Page 7
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2024
she could not share the specific partnerships for privacy reasons. She said that these
focus groups were intended to center perspectives that are often left out of
conversations about community health and well-being.
• Ms. Creed mentioned that Medicaid expansion has not reached as many people as
initially hoped for and told a story about a series of clinics the health department recently
hosted to ensure that school-aged children were meeting school requirements for
immunizations. At these clinics, many parents were concerned about how they would
afford the care, as they did not have insurance. She expressed that many new residents
to Orange County have not gotten connected enough to access insurance.
• Dr. Stuebe said that it is heinous how difficult it is for patients to receive all the benefits
that their health plans supposedly offer. She wondered if this was an issue of
Connections to Community Support or Access to Care, to which Ms. Creed replied that it
could be either or both, and that many of the committees are likely to have overlap.
Several board members also expressed that technology is a barrier for many people,
especially older adults, to accessing things like insurance and insurance benefits. Mr.
Bagby suggested that family members might be able to assist older adults with
enrollment. Ms. Stewart added that she has been voicing concerns about Prepaid Health
Plans (PHPs) being held accountable for actually providing the services they claim to
offer.
• Dr. Jonnal clarified that the Healthy Carolinians of Orange County and BOH will have
separate committees that will be working in parallel to achieve similar goals; Ms. Creed
affirmed this to be the case and said that board members are encouraged to volunteer
on the Healthy Carolinians of Orange County committees, so long as they do not form a
quorum.
At the conclusion of her presentation, Ms. Creed gave each of the board members in
attendance a printed copy of the CHA. Copies for the three members not in attendance were
given to Ms. Phillips-Weiner to distribute later.
Vill. Reports and Discussion with Possible Action
A. Media Items
Marcy Williams, Health Promotion and Education Services Manager, briefly summarized the
articles in the meeting packet. Article topics included that sports gambling is now legal and
available in NC with related concerns about gambling addiction, that the first over-the-counter
birth control pill, OPill, is now available at pharmacies, the launch of a peer warmline in NC to
supplement the 988 suicide lifeline, and an update on Wake County Schools joining a lawsuit
against social media companies due to mental health concerns in youth.
In response to Commissioner Fowler's question about how to contact the warmline, Ms.
Williams explained that there is a phone number, 1-855-PEERS NC (1-855-733-7762), that can
be called or texted.
Media items were in the packet, which focused on Orange County's events, our
involvement in various efforts, and various public health topics.
S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/
March Page 8
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2024
B. Health Directors Report
Ms. Stewart presented her report to the Board. Below are brief highlights of her report.
• Ms. Stewart thanked the board for reviewing and scoring the outside agency applications
and explained that those are currently under review for funding.
• The Orange County Countywide Five-Year Strategic Plan has been completed and
focuses on similar priority areas as those identified by the CHA: Environmental
Protection and Climate Action, Healthy Community, Housing for All, Multi-Modal
Transportation, Public Education/Learning Community, and Diverse and Vibrant
Economy. The full plan can be found here:
https:HorangecountVnc.gov/DocumentCenter/View/26972
• Ms. Stewart shared that, due to ongoing interest from board members, she will resume
including COVID wastewater surveillance in her monthly reports. She added that the
numbers are beginning to trend down, which she hopes signals the end of respiratory
illness season.
• Bars that serve food in NC are being pulled back under the authority of health
departments after a period of ten years without being evaluated by health inspectors to
the same standards as restaurants. Bars with kitchens will now need to be inspected
and permitted by October 1, 2024. As of March 20, 2024, Orange County Environmental
Health Services has already received applications and completed inspections for all 34
bars that serve food in the county.
• UNC's Student Health Action Coalition (SHAC) requested help from the health
department to get school-aged children up to date on school-required vaccinations and
physical exams. Carla Julian, Public Health Nursing Director, held three special clinics in
the last week with assistance from all the divisions of the health department to help
serve approximately 50 students.
• There have been 64 cases of Measles in 17 US states since the beginning of the year.
So far, none of these cases have been in NC, but there have been cases in nearby
states including Georgia and Virginia. Ms. Stewart emphasized the importance of
vaccines to help curb the spread of vaccine-preventable illnesses such as Measles.
• Starting July 1 st, 2024, tobacco-free policies will be taking effect at healthcare providers
contracted with Medicaid. This includes both combustible (e.g., cigarettes, cigars) and
non-combustible (e.g., vapes, smokeless tobacco) products. Ms. Stewart clarified that
exceptions to this regulation include but are not limited to retail pharmacies and non-
emergency medical transport. Dr. Stuebe asked who is responsible for enforcement of
smoke-free policies, to which Ms. Stewart clarified that it falls under the jurisdiction of
local law enforcement.
• The Orange County Opioid Settlement Community Meeting will be held at 10am-3pm on
Saturday, April 271h in the Donna Baker Meeting Room of the Whitted Building, 300 West
Tryon Street, Hillsborough, NC 27278. Ms. Stewart provided a preview of the new funds
Orange County will be receiving from the Walmart settlement, $459,509.50, with an
overall payout of$51,430,837 from Walmart to all of NC.
• Ms. Stewart shared that there is an appeal pending, though she has not yet received the
formal request. Through a brief discussion, the board members agreed to hold the
evenings of April 10th and April 11th as potential dates for an adjudication hearing. Ms.
Stewart explained that it was possible for board members to videoconference in, as Dr.
Jonnal said that she would be out of town on both those days. In response to Dr.
Baldwin's question as to whether the appellant wins their appeal by default if the board
fails to schedule the hearing in time, Ms. Hudson said that this would not influence the
judgement of the case, but board members would be in violation of state law and subject
S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/
March Page 9
MINUTES
ORANGE COUNTY BOARD OF HEALTH
March 27, 2024
to misdemeanor offenses if they fail to schedule the hearing within the mandated
window. Mr. Whitaker asked if the appellant's availability needs to be considered during
scheduling, to which Ms. Stewart explained that the board is only responsible for having
a quorum present and providing 10 days' notice before the hearing.
IX. Adjournment
Dr. Jonnal thanked Ms. Phillips-Weiner and the Environmental Health Staff on behalf of the
BOH for their work at the board retreat.
A motion was made by Dr. Alison Stuebe to adjourn the meeting at 9:05 p.m., was
seconded by Dr. Bruce Baldwin, and carried without dissent.
The next Board of Health Meeting will be held April 24, 2024, 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\Agendas &Abstracts\2024 Agenda and Abstracts/
March Page 10