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HomeMy WebLinkAboutApproved Minutes of August 27, 2025MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2025 S:\Managers Working Files\BOH\Agendas & Abstracts\2025 Agenda and Abstracts/ August Page 1 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 August 27, 2025, at the Drakeford Library Complex, 203 South Greensboro Street, Carrboro, NC. BOARD OF HEALTH MEMBERS PRESENT: Alison Stuebe – Chair, Tony Whitaker – Vice Chair, Brian Crandell, Commissioner Amy Fowler, Davia Nickelson, Lee Pickett, and Shielda Rodgers. Rachel Royce and Aparna Jonnal arrived later. BOARD OF HEALTH MEMBERS ABSENT: Bruce Baldwin. STAFF PRESENT: Quintana Stewart, Health Director; Erica Pettigrew, Medical Director; Dana Crews, Community Health Services Director; Victoria Hudson, Environmental Health Director; Frederick Perschau, Financial and Administrative Services Director; Libbie Hough, Communications Manager; Thomas Privott, Environmental Health Supervisor; Samantha “Sammie” Mizelle, Public Health Nurse II; Molly Chadbourne, Advanced Practice Provider; Chrystal Whitley, Community Health Aide for the FIT Program; Chiletta Collins, Public Health Nurse with the CMARC Program; Ebonie Wilborn, Environmental Health Specialist; and Jean Phillips-Weiner, BOH Strategic Plan Manager. GUESTS/VISITORS PRESENT: None. I. Welcome New Employees Quintana Stewart, Health Director, introduced the five new employees in attendance: Samantha “Sammie” Mizelle – Public Health Nurse focused on Maternal Health, Molly Chadbourne – Advanced Practice Provider, Chrystal Whitley – Community Health Aide for the Formerly Incarcerated Transitions (FIT) Program, Chiletta Collins – Public Health Nurse with the Care Management for At-Risk Children (CMARC) Program, and Ebonie Wilborn – Environmental Health Specialist. II. Public Comment for Items NOT on Printed Agenda: None. III. Board Comments: Dr. Davia Nickelson Dr. Nickelson shared that High Point University’s dental school just completed their first year, and Wake Forest University opened a new campus for their medical school in Charlotte. Tony Whitaker Mr. Whitaker announced that the Health Department has received the District Court decision on the Gurlitz appeal regarding an application to construct a car port on the appellant’s property, first heard by the Board of Health in May of 2024. The appellant won the appeal on two counts: 1. The Orange County Health Department applies extra-stringent rules for groundwater protection that the court found without adequate evidence supporting their MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2025 S:\Managers Working Files\BOH\Agendas & Abstracts\2025 Agenda and Abstracts/ August Page 2 necessity for public health; and 2. The rules as written were determined to be subject to interpretation due to grammatical issues and a lack of clarity. Ms. Stewart said that staff have been notified of the results of the appeal and that Victoria Hudson, Environmental Health Director, will be able to provide an impact analysis to the Board as early as the September Board of Health meeting. In response to Dr. Crandell’s question, Ms. Hudson replied that the Board will be required to make a motion and vote to issue a permit to the appellant, Mr. Richard Gurlitz, allowing the construction of a car port on his property. Commissioner Amy Fowler Commissioner Fowler commented that the impact of Tropical Storm Chantal continues to be a concern for the Board of County Commissioners (BOCC), particularly for individuals who were living in Camelot Village Apartments. She noted that there has been a disproportionate impact on those with disabilities – e.g., those who use wheelchairs, who use prosthetics, or have cognitive disabilities. The BOCC have approved $20K in funding for bridge housing for those displaced by the storm, while the Town of Chapel Hill has allotted $100K, but it’s costing around $2,000 per day to keep people in temporary housing until something more permanent can be found. She noted that the upheaval has limited many people’s ability to access needed medications, that some people lost their IDs and have been unable to replace them, and that overall, it has been very stressful for residents. Because Camelot Village was constructed in a flood zone, she added that this is likely severe weather events like this will continue to happen until either the owners or the Town of Chapel Hill condemn the buildings. Dr. Stuebe commented on the possibility of the Board of Health drafting a resolution on the impact of climate change on public health, offering Tropical Storm Chantal as an example. Dr. Royce arrived during this conversation. Dr. Rachel Royce Dr. Royce thanked the Board and shared that she has been awarded the Carl Durham Award by the Association of North Carolina Boards of Health for her work promoting Medicaid expansion to the people of Orange County. She invited any interested Board Members to attend the awards ceremony luncheon on September 11th. Commissioner Amy Fowler shared that Ms. Stewart was recently recognized through the Heroic Hands initiative as a public servant who goes above and beyond in service of her community. IV. Priority Committee Updates Access to Care Committee Dr. Pickett provided an update for the Access to Care Committee. The committee has been working on a resolution promoting access to public health resources for vulnerable populations considering immigration enforcement, which they plan to present to the Board at the September meeting. Additionally, the Summer Photovoice project has wrapped up, and the committee MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2025 S:\Managers Working Files\BOH\Agendas & Abstracts\2025 Agenda and Abstracts/ August Page 3 plans to discuss next steps once they have completed the resolution draft. The committee will next meet in mid-September. Behavioral Health Committee The committee will next meet in early September. Connections to Community Support Committee Mr. Whitaker provided the update for the Connections to Community Support Committee. The committee is ready to present a draft and request feedback on their resolution in support of promoting affordable/attainable housing. He shared that the resolution will be presented tonight for initial review and will be presented for a vote at the September meeting. The resolution serves as a statement from the Board of Health to local elected officials and zoning boards encouraging them to consider the public health implications of attainable and affordable housing as they make policy decisions. The committee will next meet in early October. Dr. Jonnal arrived during this conversation. Ad Hoc Committee on Well Rules The committee will reconvene after the updates provided at the September meeting. V. Approval of the August 27, 2025, Agenda Motion to add a vote to the agenda regarding the issuance of a permit allowing Mr. Richard Gurlitz to construct a car port on his property was made by Commissioner Amy Fowler, seconded by Dr. Shielda Rodgers, and carried without dissent. Motion to approve the amended agenda of the August 27, 2025 BOH meeting was made by Commissioner Amy Fowler, seconded by Dr. Rachel Royce, and carried without dissent. VI. Approval of June 25, 2025 Meeting Minutes Dr. Pickett requested the removal of the word “vaccines” from her quote on page 7, as she had not been speaking specifically to vaccines in that comment. She added that she is unsure about the government’s ability to promote more stringent local regulations around vaccines. Motion to approve the amended minutes of the June 25, 2025 meeting was made by Dr. Lee Pickett, seconded by Commissioner Amy Fowler, and carried without dissent. VII. Educational Sessions A. 2024 Annual Communicable Diseases (CD) Report Dr. Erica Pettigrew, Medical Director, presented the 2024 Annual Communicable Diseases (CD) Report. Some highlights of her presentation are below: MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2025 S:\Managers Working Files\BOH\Agendas & Abstracts\2025 Agenda and Abstracts/ August Page 4 • Dr. Pettigrew reminded the Board that the CD branch of the Health Department is charged with investigating incidents and reducing morbidity and mortality related to communicable diseases. • There were no notable trends in foodborne illnesses, though there have been some outbreaks which help keep the team busy. In response to Dr. Pickett’s question, Dr. Pettigrew explained that, as of this meeting, the reporting requirements for North Carolina have not been changed and foodborne illnesses will continue to be monitored in Orange County despite upheaval at the Center for Disease Control (CDC). • Dr. Royce asked if campylobacter was seeing an upward trend since 2020, to which Dr. Pettigrew clarified that none of the analyses were completed to the degree of determining statistical significance, but a general impression of trends in communicable diseases in Orange County over the past seven years. She said that she compared the data to national trends and didn’t see anything concerning and added that it’s likely more important to compare data from pre- and post-COVID, as 2020 and 2021 were unusual years and may not accurately reflect trends. • Regarding vaccine-preventable diseases, pertussis and measles are seeing definite upward trends nationwide. While pertussis numbers in Orange County trended significantly higher in 2024, this report does not include the recent outbreak of pertussis in the schools, as it will be captured in the 2025 report. Dr. Pettigrew reiterated that measles is a huge threat, per her presentation to the Board in April. • Most cases of vectorborne illnesses in Orange County are travel related, though Rocky Mountain Spotted Fever and Ehrlichiosis are tickborne and transmitted locally. While these infections are typically more concentrated in western NC, they will likely become more pervasive as climate change increases the spread. Commissioner Fowler clarified that the reported cases included both lab-confirmed and diagnosed/suspected cases, which Dr. Pettigrew confirmed, saying that often patients receive initial testing but fail to return for follow-up testing. Dr. Jonnal noted that, as an emergency room doctor, she has anecdotally seen more patients showing concern about tickborne illnesses and requesting testing than in the past, which may also be driving the increase in case numbers. In response to Dr. Jonnal’s question about communicable disease reporting requirements, Dr. Pettigrew explained that both the lab and the clinician who made the diagnosis are legally required to report cases to the county in which the diagnosis was made – county staff will then work to determine the location where the case originated. • The case numbers for waterborne illnesses are so low that it’s difficult to identify trends. • For sexually transmitted infections (STIs), case numbers for chlamydia and gonorrhea have stabilized, possibly related to improved modalities for treatment and prevention. Syphilis cases, particularly congenital syphilis, are on the rise, and are usually related to vertical transmission when a birthing parent receives late or no prenatal care • Dr. Pettigrew shared that the FDA recently changed approval for the COVID vaccine, restricting it to those who are 65+ years old or who have certain underlying conditions. She said that this presents a lot of concerns about insurance coverage and provider liability if the vaccine is administered to someone for whom it is not recommended; in response to Dr. Jonnal’s question about how this compares to other vaccines that are primarily recommended for older populations, such as Numavax or Shingrix, Dr. Pettigrew clarified that these new FDA recommendations do not align with the scientific data, i.e., the benefits and risks of the COVID vaccine are not notably different for different age groups, leading to conflicting recommendations from various health organizations. Dr. Pettigrew added that, though COVID is no longer a reportable condition, we are still seeing spikes. MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2025 S:\Managers Working Files\BOH\Agendas & Abstracts\2025 Agenda and Abstracts/ August Page 5 • Commissioner Fowler commented that even if the vaccine costs aren’t covered by the insurance company, the liability to the provider may be curbed so long as the provider is following a standard of care that is aligned with an overseeing organization’s recommendations (e.g., the American Pediatric Association’s vaccine guidelines). • In response to Dr. Royce’s question, Dr. Pettigrew said that potential complications related to receiving the COVID vaccine such as multisystem inflammatory syndrome (MIS-C) are not tracked at the local level. Dr. Pettigrew commented that it is very worrisome that data and experts at the federal level are being restricted, as this makes it much harder to conduct good public health at the local level. • Dr. Stuebe shared a breaking news headline from the New York Times that the CDC director has left the organization abruptly. • Dr. Royce asked about the wording of the purpose of the Communicable Disease branch of the Orange County Health Department, which did not include anything about prevention. Dr. Pettigrew noted that there are multiple other branches of the Health Department focused on prevention. Ms. Stewart added that the language likely came from the Health Department’s agreement addenda with the state government, which are infrequently updated; she said that she had made a note that these should be revised to include prevention. B. 4th Quarter Financial Reports Frederick Perschau, Financial and Administrative Services Director, presented the 4th Quarter Financial Reports for FY2024-25. Some highlights of his presentation are below: • Mr. Perschau reminded the Board that the aim each year is to use up the annual budget, and that this year was better for this than some prior years. • Service revenue, or revenue generated by services provided to community members, is something that the Health Department can influence or increase. • Mr. Perschau provided an overview of the annual revenue and drew attention to a spike in May due to Medicaid cost settlement reconciliation. • Environmental Health Services revenue remained relatively stable. • Dental Health Services resolved the data breach from FY2023-24 that prevented Dental Services from collecting Medicaid payments, leading to resources being recovered in October. However, Dental Health Services still came in a little under the projected revenue in part due to staffing shortages. • Personal Health Services saw an increase in revenue. They have a team focused specifically on revenue/billing, leading to a rise in the total number of billing transactions and an increase in “clean claims,” or claims submitted without any errors or other issues, such as incomplete documentation. • Community Health Services saw an increase in revenue, but Mr. Perschau said that it can be hard to predict trends when working with the populations served by this division. • Financial and Administrative Services have been working to improve the Epic billing and vital records processes. Additionally, Dominika Gazdzinska, Community Records Specialist, has begun a semi-annual newsletter, The Vital Chronicles, providing updates about state and local changes for funeral homes. Mr. Perschau provided copies of the most recent newsletter to the Board members for their review. Ms. Stewart commended Ms. Gazdzinska and shared that she had recently attended a conference where she learned and brought back a lot of good ideas, including this new newsletter. Dr. Jonnal applauded the newsletter and said that she regularly sees bereaved patients struggling and she thinks something like this could help reduce stress at a painful time. MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2025 S:\Managers Working Files\BOH\Agendas & Abstracts\2025 Agenda and Abstracts/ August Page 6 • Mr. Perschau highlighted accomplishments of the various divisions, including new funding partnerships in Community Health Services, increases in data in Environmental Health Services, increased service delivery in Personal Health Services including by hiring a new registered nurse to address STIs and increased promotion of the Diabetes Self-Management Education Program, and the mobile dental clinic providing ongoing service delivery for Dental Health Services during clinic renovations. • The forecast for FY2025-26 is for the Health Department to continue to promote approaches to increase service revenue and to keep an eye on funding and the Medicaid cost settlement process, as procedures around these may change amid future political upheaval. Ms. Stewart clarified that all Medicaid cost settlement funds are legally required to be used in the same program where they were generated. • Mr. Whitaker asked about how billing work queues and reimbursement strategies work, to which Mr. Perschau explained that it is very systematic and that the Financial and Administrative Services division is working to streamline the process. Mr. Whitaker inquired as to whether this is institutional knowledge or if a select few staff members know it, to which Mr. Perschau explained that they are working to document the procedures and train staff on how to use them. Dr. Pettigrew added that the current billing team only has billers, not coders; she explained that coders help fix errors and would likely prove more efficient and pay for themselves. Ms. Stewart shared that two staff members recently took a course on medical coding and learned a lot, though neither passed the certification exam. Mr. Whitaker asked if it would be possible for a region of health departments, such as Region 5, to share coders, to which Mr. Perschau replied that local health departments do share knowledge but generally not staff. Dr. Stuebe suggested some potential ideas to help streamline some of the Epic processes for billing, which Dr. Pettigrew expressed support for. • Dr. Jonnal asked about Medicaid cost settlement and how the Big, Beautiful Bill will impact the health department. Ms. Stewart explained that the Health Department receives an annual reimbursement from the State for provided Medicaid services every year and has used those reimbursements to set aside a fund of $12M for capital improvements and renovations at the Southern Human Services Center. She clarified that while those funds could potentially be used to support staff and provision of programs (it is mandated by law that Medicaid cost settlement funds must be used in the same program where they were generated) this would not be sustainable, and capital improvements are still being planned somewhere down the line. Mr. Perschau added that the Health Department would never turn anyone away for not having insurance and that self-pay and sliding-scale payments are available. C. BOH Policy Review Jean Phillips-Weiner, Board of Health Strategic Plan Manager, presented the proposed changes to Health Department policies for the 2025 BOH Annual Policy Review. The recommended policy changes are as follows: 1.0 Mission Statement and Scope of Services • No Changes. I.A. – Requests for Environmental Services and Assessments • Some minor updates throughout for readability. • Contemporized Environmental Health to focus this policy on the matters Environmental Health can address as opposed to every kind of possible environmental issue. MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2025 S:\Managers Working Files\BOH\Agendas & Abstracts\2025 Agenda and Abstracts/ August Page 7 • Updated formatting to align with the formatting of the policy on policies. l.B. – Fee and Eligibility Policy • Some minor updates to wording and punctuation throughout, including substituting the word “client” for “patient”. • Section III.A.4.b: Updated income verification details for Family Planning services. • Section IV: Clarified eligibility for services for non-Orange County residents, added GIS mapping as a form of eligibility verification, and added information about service referrals for non-Orange County residents. • Section V: Updated wording to clarify practices to ensure Family Planning Services are offered in an equitable and non-coercive manner. • Section V.H: Clarified language about exceptions to the Fee and Eligibility Policy allowable by the Health Director. • Section VI: Clarified language around Nutrition Services Fees. • Section VII.E: Clarified language around the mailing of statements. l.C. – Community Assessment Policy • Some minor updates to wording and punctuation throughout for clarity. • Section 1.m: Clarified that the Community Health Action Plans have been renamed Community Health Improvement Plans (CHIPs). • Several links were updated. l.D. – Review of Reports and Documents • Revised 2.d Board of Health Strategic Plan to reflect incorporation of the Board’s priorities and goals into the department strategic plan. The board approves and adopts the department plan and provides updates to the Board of Commissioners during the annual work session for boards and commissions. I.E. – Operating Procedures BOH Manual • No Content Changes. Formatting issues corrected. I.E. – Operating Procedures BOH Manual – Appendix H – Confidentiality and Conflict of Interest • No Changes. There were no comments or further modifications recommended during the meeting. The Board will vote to approve these changes at the September meeting. VIII. Actions Items A. October Meeting Logistics Ms. Stewart shared that she and Dr. Stuebe will be out of town for the Board of Health Meeting on October 22, 2025. She suggested rescheduling or meeting in a “hybrid” format. Board members agreed to reschedule to Wednesday, October 29, 2025. Motion to reschedule the October 22, 2025 meeting to October 29, 2025 was made by Commissioner Amy Fowler, seconded by Dr. Aparna Jonnal, and carried without dissent. MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2025 S:\Managers Working Files\BOH\Agendas & Abstracts\2025 Agenda and Abstracts/ August Page 8 B. Ad Hoc Committee: Board Retreat Planning Dr. Stuebe called for the formation of a committee to help plan the upcoming annual Board Retreat in March. Dr. Royce spoke enthusiastically about her experiences working on the committee the previous year and encouraged board members to consider volunteering. Dr. Jonnal shared that her current work schedule is overwhelming due to mass resignations at her hospital, but if things calm down, she’d be happy to volunteer. Dr. Stuebe encouraged any interested Board members to reach out to Ms. Phillips-Weiner. C. Resolution on Affordable Housing Supply Ms. Phillips-Weiner presented the Resolution Promoting the Development of Adequate Affordable Housing on behalf of the Connections to Community Support Committee. Ms. Phillips-Weiner explained that the resolution’s argument is that housing is a public health issue, a human right, and that it is significantly more cost-effective for governments to house people than to allow them to remain unhoused, but despite this there are not enough housing units in Orange County. The resolution makes recommendations for ways for local land use plans and municipal zoning ordinances can encourage increased supply of affordable housing, such as reducing minimum lot sizes, implementing density bonuses, and promoting “Missing Middle” housing such as duplexes, fourplexes, and cottage-court style units. In response to Ms. Stewart, Commissioner Fowler said that the BOCC will be working on the Land Use Plan until at least November, so voting on the resolution in September should allow adequate time to get it before the County Commissioners. In response to Dr. Crandell’s question, Ms. Phillips-Weiner explained that the intended audience is local lawmakers in Orange County and Carrboro, Chapel Hill, and Hillsborough, all of whom are currently revising their Land Use Plans and/or Municipal Development Ordinances. Mr. Whitaker added that it is also aimed at local advisory bodies, including planning boards and boards of adjustment; he added that many of the recommendations are the most in-line with the work of the Orange County government. Dr. Crandell asked if the committee has checked with other departments to ensure that the work is aligned with their recommendations, to which Commissioner Fowler said that most of the recommendations look very similar to items that the BOCC has been considering – for example, increased density in certain areas and conservation districts. Mr. Whitaker commented that many of the items were taken from the draft Orange County Land Use Plan. He added that many items have tradeoffs – for example, increased density in protected watersheds may not be desirable. Dr. Stuebe shared that the committee heard from Blake Rosser, Orange County Housing Director, as part of the discovery process before drafting the resolution. Dr. Royce applauded the achievement of the resolution, noting that when the Community Health Assessment (CHA) results initially came out, the Board had expressed that there was nothing that could be done about affordable housing – now, the Board is able to take a position and hopefully positively influence local lawmakers. The Board will vote on the resolution at the September meeting. Ms. Phillips-Weiner invited Board members to send any additional feedback to her by September 15th to allow time to compile and present to the full Board at the time of the vote. MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2025 S:\Managers Working Files\BOH\Agendas & Abstracts\2025 Agenda and Abstracts/ August Page 9 D. Issuance of a Permit to Construct a Car Port Motion to issue a permit to Mr. Richard Gurlitz allowing the construction of a car port on his property as required by the recent district court decision was made by Commissioner Amy Fowler, seconded by Dr. Shielda Rodgers, and carried without dissent. IX. Reports and Discussion with Possible Action A. Media Items Libbie Hough, Communications Manager, presented the media packet to the board. Topics included: legislation to protect workers from heat stress, several articles about youth mental health, the elimination of funding for programs in the Fairview community, new funding for the Great Trails State Program, recovery efforts after Tropical Storm Chantal, disproportionate levels of homelessness among individuals who have been incarcerated, increased naloxone trainings among law enforcement, and an update on the Chapel Hill Crisis Assistance, Response, and Engagement (CARE) Team which partners clinicians with law enforcement to address mental health issues. Ms. Hough suggested revising the format of the media packet in the future, providing hyperlinks alongside short summaries rather than a packet of articles; Board members expressed support for this idea. Ms. Hough also presented some updates that she has made to the website and thanked Board members for providing feedback. Media items were in the packet, which focused on Orange County’s events, our involvement in various efforts, and various public health topics. B. Upcoming Health Director’s Annual Review Ms. Stewart reminded the Board that her annual review will be on the agenda at the September meeting. She shared that the survey has been streamlined based on past feedback from the board. Board members will receive an email link to NeoGov allowing them to log in and complete her annual evaluation, which must be done in advance of the September meeting. C. Health Directors Report Ms. Stewart presented her report to the Board. Below are brief highlights of her report. • Ms. Stewart applauded Dr. Rodgers for receiving the Visionary Pioneer award from her alma mater, the University of Maryland School of Nursing. • Ms. Stewart included some information in her report about Medicaid rebates and what they mean. She shared that there is a committee which is trying to watch and anticipate potential impacts of the Big, Beautiful Bill. So far, state tobacco control has taken a big hit, with most of the staff being let go, but no program impacts are yet anticipated for the Orange County Health Department. • In July, the Department of Health and Human Services (DHHS) informed the General Assembly that they need $819M to maintain Medicaid as-is for FY2025-2026, not including Medicaid Expansion; the General Assembly allocated $500M, $319M short. To keep Medicaid operational, there will be cuts to the Medicaid reimbursement rate for MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2025 S:\Managers Working Files\BOH\Agendas & Abstracts\2025 Agenda and Abstracts/ August Page 10 providers beginning on October 1st, 2025, reducing the rate the Health Department receives in reimbursement from 10% to 8%. Ms. Stewart clarified that this will not change anything about staff or clinician operations, the Health Department will simply receive less reimbursement for services provided to individuals with Medicaid. She added that, as the Health Department receives annual Medicaid cost settlement, the change in reimbursement may still even out. In response to Dr. Royce’s question, Dr. Stuebe and Commissioner Fowler explained that private practice providers do not receive Medicaid cost settlement, and will simply receive less money, likely leading to caps on the number of Medicaid patients that they are willing to see to minimize the loss. • Regarding Dr. Royce’s question about potential cuts to Medicaid expansion due to reductions in Federal funding, Ms. Stewart said she would review and get back to her. • There have been reductions in service rates and pre-paid health plans, and the re- procurement of Care Management Programs such as CMARC is being pushed out until 2029 due to the cuts. • DHHS has ended optional coverage of weight-loss medications such as Ozempic except with certain existing conditions such as a heart condition or diabetes. • NC wastewater monitoring shows an increase in respiratory viruses, including COVID, among the community with a moderate level statewide. • The Whitted Human Services Building has experienced a lot of expected and unexpected disruptions, including renovations, a power outage, and issues with the HVAC system. Due to renovations at Southern Human Services Center, currently only the Whitted medical clinic is active, and the mobile dental unit is the only dental clinic currently active. Ms. Stewart added that having only one clinic is a blessing in disguise, as they are rebuilding staff after several significant clinic resignations. • Dr. Stuebe suggested that the Board members could all get their flu shots together to promote vaccine uptake. Dr. Royce recommended inviting the News of Orange to cover it. Dr. Stuebe also suggested a future volunteer event with Habitat for Humanity to promote affordable housing. Ms. Stewart noted that at the recent Opioid Summit, Commissioner Green shared that the presence of a quorum at a community event is less of an issue so long as board members remain separated and do not interact. • In response to Dr. Royce, Ms. Stewart shared that the Board of Health will be attending the Last Friday event on September 26th to promote Suicide Awareness Month. X. Adjournment A motion was made by Commissioner Amy Fowler to adjourn the meeting at 9:17 p.m., was seconded by Dr. Lee Pickett, and carried without dissent. The next Board of Health Meeting will be held September 24, 2025, at the Southern Human Services Center, 2501 Homestead Road, Chapel Hill, NC at 7:00 p.m. Respectfully submitted, Quintana Stewart, MPA Orange County Health Director Secretary to the Board