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HomeMy WebLinkAboutApproved Minutes of November 19, 2025 MINUTES ORANGE COUNTY BOARD OF HEALTH November 19, 2025 MINUTES ORANGE COUNTY BOARD OF HEALTH November 19, 2026 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 November 19, 2025, at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC. BOARD OF HEALTH MEMBERS PRESENT: Alison Stuebe— Chair, Tony Whitaker—Vice Chair, Bruce Baldwin, Brian Crandell, Commissioner Amy Fowler, Davia Nickelson, Shielda Rodgers, and Rachel Royce. Aparna Jonnal arrived later. BOARD OF HEALTH MEMBERS ABSENT: Lee Pickett. STAFF PRESENT: Quintana Stewart, Health Director; Dr. Erica Pettigrew, Medical Director; Dana Crews, Community Health Services Director; Dr. Stephanie George, Dental Services Director; Victoria Hudson, Environmental Health Director; Frederick Perschau, Financial and Administrative Services Director; Libbie Hough, Communications Manager; Thomas Privott, Environmental Health Supervisor; Cortney Ragan, Personal Health Clinic Supervisor; and Jean Phillips-Weiner, BOH Strategic Plan Manager. GUESTSNISITORS PRESENT: Linda Killian. I. Welcome New Employees Quintana Stewart, Health Director, introduced the new employee in attendance: Cortney Ragan — Personal Health Clinic Supervisor. II. Public Comment for Items NOT on Printed Agenda: Linda Killian, retired licensed clinical social worker, shared a comment about an upcoming community forum seeking to explore the impact of federal funding legislation on community health and healthcare access. The forum will be held on Wednesday, January 28th, 2026, at the Whitted Human Services Center. She requested that the Board help share information and promote awareness of the upcoming forum. III. Board Comments: Dr. Davia Nickelson Dr. Nickelson said that school cell phone bans are becoming part of a national conversation, sharing that they were the focus of a recent episode of the sitcom Abbott Elementary. Dr. Brian Crandell S:\Managers Working Files\BOH\Agendas &Abstracts\2025 Agenda and Abstracts\ November Page 1 MINUTES ORANGE COUNTY BOARD OF HEALTH November 19, 2025 Dr. Crandell noted that Australia recently passed a ban on social media for individuals under sixteen, and that they are in the process of notifying accounts that are not in compliance that they will be shut down. He wondered if the USA will ever reach a similar point. Dr. Rachel Royce Dr. Royce commented that Immigration and Customs Enforcement (ICE) has been active in the region. She asked if there has been an impact on the Health Department and whether the Health Department is staying up to date on ICE activities. Ms. Stewart replied that there has been a notable increase in cancellations since ICE became active in the area and said that the Health Department is making efforts to keep patients and staff who could be targeted by ICE activities safe, offering telehealth or home visits where appropriate and allowing some staff members to work remotely. Dr. Royce asked about opportunities to alert community members to the presence of ICE agents. Ms. Stewart shared that she has reminded staff of the Health Department's ICE guidelines, as established in the Spring, and that the Orange County Office of Civil Rights & Civic Life are offering additional trainings for county staff. She added that the Health Department is doing what they can to track ICE activities and said that she hopes that community members see the Health Department as a trusted source of support. Dr. Rodgers commented that schools have released information about the impact and that there have been marked increases in school absenteeism due to fear. Tony Whitaker Mr. Whitaker shared that he recently presented to the Board of County Commissioners (BOCC) about community wastewater systems in alignment with the goal of promoting development and increasing the housing supply. Commissioner Fowler applauded Mr. Whitaker, saying his presentation was excellent, he was very knowledgeable, and that the Commissioners asked a lot of questions. IV. Priority Committee Updates Access to Care Committee The committee will next meet in mid-January. Behavioral Health Committee Dr. Crandell provided the update for the Behavioral Health Committee. The committee heard from Cait Fenhagen, Deputy County Manager and Chair of the Orange County Behavioral Health Task Force, and Tony Marimpietri, Chair of the Crisis/Diversion Facility Subcommittee of the Orange County Behavioral Health Task Force, about the plans for Orange County's new Crisis/Diversion Facility. Dr. Crandell shared that the facility is in part an opportunity to help keep people experiencing a mental health episode who don't need to go to jail out of the carceral system, especially people of color, who are incarcerated at disproportionate rates. The facility will have both a Behavioral Health Urgent Care center for individuals in acute crisis and a Facility-Based Crisis Center offering longer-term care of up to two weeks. The facility has been developed in partnership with multiple mental health and community partners, which should S:\Managers Working Files\BOH\Agendas &Abstracts\2025 Agenda and Abstracts\ November Page 2 MINUTES ORANGE COUNTY BOARD OF HEALTH November 19, 2025 increase the likelihood of the facility being successful. The committee will next meet in early February. Connections to Community Support Committee The committee will next meet in early January. Ad Hoc Committee on Well Rules The committee will reconvene in late January to discuss next steps regarding the well rules. V. Approval of the November 19, 2025, Agenda Motion to approve the agenda of the November 19, 2025 BOH meeting was made by Commissioner Amy Fowler, seconded by Dr. Bruce Baldwin, and carried without dissent. VI. Approval of October 29, 2025 Meeting Minutes Motion to approve the minutes of the October 29, 2025 meeting was made by Dr. Aparna Jonnal, seconded by Dr. Rachel Royce, and carried without dissent. VII. Educational Sessions A. Client Satisfaction Surveys Dr. Stephanie George, Dental Health Director, and Victoria Hudson, Environmental Health Director and Interim Personal Health Services Director, presented the results of the annual client satisfaction surveys. Some highlights of their presentation are below: • Dental Health Services received 68 responses, all of which were received electronically. Due to renovations to the dental clinic, client satisfaction surveys were not collected after August 2025. This means that the dental clinic skipped their traditional monthlong period of collecting paper surveys, normally conducted in September. In response to Dr. Nickelson's question, Dr. George said that the number of electronic responses received is comparable to the previous year, though the clinic schedules around 5,000 appointments per year, meaning the overall response rate is very low. • Overall, Dental Health survey respondents gave positive responses, with 95% or more expressing that they were satisfied with their experience and that staff were courteous and responsive. About two-thirds of respondents said that it was easy to schedule an urgent appointment. Dr. George shared some open-response comments, many of which were very positive, and a few of which were more constructive. Dr. Baldwin noted that often people only respond to surveys when they are upset about something and, given the proportion of positive to negative responses, perhaps the response rate was low because most people are satisfied and have nothing to complain about. • Some patients mentioned equipment problems in their responses, and Dr. George explained that there were many technical problems this year, including a chiller that broke, a leaking suction pump, and an X-Ray machine that caught fire, but said that all malfunctioning equipment has since been repaired or replaced. She noted that this was expensive, but that hopefully the clinic should be good for a while now. S:\Managers Working Files\BOH\Agendas &Abstracts\2025 Agenda and Abstracts\ November Page 3 MINUTES ORANGE COUNTY BOARD OF HEALTH November 19, 2025 • Environmental Health Services received 118 responses, which was a somewhat lower response rate compared to previous years. Ms. Hudson shared that there is a year- round live survey link and that each year the division attempts to collect a random sample of surveys from recent clients. • Overall, most responses were positive, with more than 90% of respondents rating their satisfaction with the services received as good or excellent. Ms. Hudson noted that it is common for responses of poor satisfaction to be received from individuals who did not get the outcome that they wanted (e.g., their permit application was denied). • Around a third of respondents said that they were not kept well informed throughout the process, the majority of whom were water sample or septic clients. Ms. Hudson explained that they conducted a focus group to investigate common trends among people who gave negative responses and that the division has drafted an action plan to address some of the common complaints. In particular, Environmental Health will be implementing a hybrid system to deliver results, meaning a staff member reaches out to clients in addition to the automated emails sent through the portal system. Ms. Hudson added that she also plans to create an alias, such as "your-water-sample-results," for the "no-reply" email address that sends the results to help stymie some of the confusion. • Ms. Hudson commented that there are also plans to improve the accessibility of the survey for clients with limited English proficiency (LEP). • Personal Health Services did not have an active satisfaction survey until mid-September, so they have only received 41 responses. However, they invited all personal health service patients who have visited the Health Department since July 1st to participate. • Overall satisfaction was good, with nearly 100% of respondents satisfied with their visit and more than three quarters of respondents planning to return or willing to recommend the clinic to their friends or family, an increase compared to last year's responses. • Ms. Hudson commented that the survey relies heavily on literacy and is not very friendly to LEP patients. She said that she is workshopping the survey to make it more straightforward and accessible to LEP patients in the future. • Ms. Hudson highlighted some efforts to address constructive feedback within the clinic's control, for example, replacing an old toddler table that was worn and dingy. Several issues patients expressed are outside the clinic's control, such as the county phone lines going down and making it hard to reach someone to call the front desk and schedule an appointment. In response to Dr. Royce's question, Ms. Hudson explained that they have limited control over the phones, as they are configured by county information technology (IT) services and that often patients hang up phone calls before the phone message ends, as it is a two-minute-long message. She shared that she plans to work with IT to reconfigure the message system to make it more user friendly. Erica Pettigrew, Medical Director, shared that they try to encourage established patients to stop at the front desk and schedule a follow-up appointment before they leave, but not everyone does. VIII. Actions Items A. ChairNice-Chair Slate Motion to elect Mr. Whitaker as chair and Dr. Crandell as vice-chair for 2026 was made by Commissioner Amy Fowler, seconded by Dr. Shielda Rodgers, and carried without dissent. B. Recommendation of Candidate to Fill Vacant At-Large Seat S:\Managers Working Files\BOH\Agendas &Abstracts\2025 Agenda and Abstracts\ November Page 4 MINUTES ORANGE COUNTY BOARD OF HEALTH November 19, 2025 Dr. Stuebe shared that the Nominating and Operating Procedures Committee, consisting of Mr. Whitaker, Dr. Jonnal, Dr. Royce, and herself, had reviewed approximately fifteen applications for the vacant at-large seat, and that each member of the committee made a list of their top three candidates. The committee then interviewed the two candidates who appeared on all four lists. While both candidates were impressive and more than qualified, the committee felt that Dr. Natalicio "Nat" Serrano's experiences and qualifications best complimented the makeup of the current Board. Motion to recommend to the BOCC that Dr. Natalicio Serrano be appointed to fill the vacant at-large seat was made by Commissioner Amy Fowler, seconded by Dr. Aparna Jonnal, and carried without dissent. C. 2026 BOH Meeting Schedule Ms. Stewart presented the proposed 2026 BOH Meeting Schedule. Due to assorted conflicts with the proposed Board Retreat dates, Board members suggested holding the retreat on Saturday, April 111". In response to Dr. Royce's question, Ms. Stewart affirmed that the Retreat can still be rescheduled so long as at least 30 days' notice is given. Motion to approve the amended 2026 Meeting Schedule was made by Mr. Tony Whitaker, seconded by Dr. Davia Nickelson, and carried without dissent. D. Debt Write-Off and Debt Set-Off Frederick Perschau, Finance and Administrative Services Director, presented the annual debt write-off and set-off to the Board. Some highlights of his presentation are below: • Mr. Perschau reminded the Board of the debt write-off and set-off process. The Health Department sends outstanding debt of$50 or more that is at least sixty days past due to the NC Debt Set-Off Program, where it is collected through garnishment of tax refunds and lottery winnings (Set-Off). Annually, debt of$50 or less that has been outstanding for at least a year is transferred to inactive status and is written off without collection, though the debt can be re-activated and collected later under certain circumstances (Write-Off). In response to Mr. Whitaker's question, Mr. Perschau clarified that debt can remain in inactive status for a while. Ms. Stewart added that it will be re-activated for collection if someone returns to the Health Department for nonessential services. • In fiscal year (FY) 2024-2025, $6,668 was recovered through debt set-off, up from the $3,373 recovered in FY2023-2024. In response to Dr. Crandell's question, Mr. Perschau said he did not know the total amount of outstanding debt offhand, but he could find out. • The amount of money proposed for write-off for FY2024-2025 is $7,511, down from $10,008 in FY2023-2024. Motion to approve the transfer from active to inactive status of$7,511 in bad debt, thus writing it off without collection, was made by Dr. Aparna Jonnal, seconded by Commissioner Amy Fowler, and carried without dissent. E. Board of Health Annual Workplan Jean Phillips-Weiner, Board of Health Strategic Plan Manager, presented the Board of Health Annual Workplan for 2025. She shared that the workplan covers highlights over the past year, including the first phase of the Photovoice project and the three resolutions passed by the S:\Managers Working Files\BOH\Agendas &Abstracts\2025 Agenda and Abstracts\ November Page 5 MINUTES ORANGE COUNTY BOARD OF HEALTH November 19, 2025 Board, as well as plans for action in 2026 and ongoing and emerging health concerns. Ms. Phillips-Weiner concluded by inviting Board members to share any feedback or revisions. Motion to approve the BOH Annual Workplan pending further revisions was made by Dr. Aparna Jonnal, seconded by Mr. Tony Whitaker, and carried without dissent. F. Policy Review Ms. Phillips-Weiner presented policy VII.C. I.C., the Community Assessment Policy, which was held for further consideration and revision during the annual policy review and approval in September. In response to Dr. Royce's question, Ms. Phillips-Weiner affirmed that there will be time for additional revisions before the next Community Health Assessment is conducted in 2027. Motion to approve the revisions to policy VII.C. I.C. was made by Dr. Rachel Royce, seconded by Dr. Aparna Jonnal, and carried without dissent. G. Fee Update Mr. Perschau presented a proposed fee update for the COVID vaccines offered by the Health Department, aiming to bring the fee for each COVID vaccine in line with the out-of-pocket cost of the vaccine. Motion to approve the proposed fee update and forward it to the BOCC for action 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: mental health services for youth, emergency preparedness response planning after Tropical Storm Chantal, and mental health services for first responders. Dr. Stuebe shared that Ms. Hough will be retiring at the end of the year; the Board congratulated her and thanked her for her great work. 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 Ms. Stewart presented her report to the Board. Below are brief highlights of her report. • As previously mentioned, ICE is active in the region and the Health Department remains active in finding ways to serve community members who need healthcare. • Ms. Stewart shared that she and Ms. Phillips-Weiner attended a recent Carrboro Town Council meeting, where they presented the Resolution Promoting the Development of Adequate Affordable Housing. She appreciated that Carrboro was very receptive and S:\Managers Working Files\BOH\Agendas &Abstracts\2025 Agenda and Abstracts\ November Page 6 MINUTES ORANGE COUNTY BOARD OF HEALTH November 19, 2025 supportive to the resolution. Ms. Stewart noted that, given the recent upsurge in ICE activities, she feels the Resolution on Immigration Enforcement and Access to Healthcare is also very salient. • The Advisory Committee for Immunization Practices (ACIP) is considering removing the recommendation of Hepatitis B vaccination at birth. Dr. Steube noted that she recently interviewed a candidate with past work experience in the DRC, where Hepatitis B vaccination is not done at birth and vertical transmission (that is, an infant contracting Hepatitis B from their birthing parent) is common. • There is a growing measles outbreak in the Spartanburg area of South Carolina. North Carolina epidemiologists are engaged to monitor the outbreak, including through wastewater monitoring, but so far, no cases have been confirmed in North Carolina. • There has been an uptick in the number of flu cases, though the overall level remains fairly low. The predominant strand was not covered in this year's vaccine, though the vaccine can still help reduce the severity of illness if contracted. • The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is now fully funded through the end of April 2026. However, there may be changes to the requirements for what can be purchased with WIC funds, e.g., there is consideration of limiting WIC funds to only be used to purchase food from American-owned brands. • Ms. Stewart reminded Board members to consider contacting their state legislators in support of Medicaid Rebase —that is, in support of fully funding Medicaid expansion. • Dr. Stuebe shared that it is Public Health Appreciation Day and that she is thankful for all the work that people are doing to promote public health. X. Closed Session to Discuss Health Director's Annual Review A motion to enter closed session at 8:17 p.m. to discuss the health director's annual review was made by Commissioner Amy Fowler, seconded by Dr. Davia Nickelson, and carried without dissent. During the closed session, the Board of Health discussed Quintana Stewart's job description and annual performance review. A motion to end the closed session at 9:29 p.m. was made by Commissioner Amy Fowler, seconded by Dr. Brian Crandell, and carried without dissent. XI. Adjournment A motion was made by Commissioner Amy Fowler to adjourn the meeting at 9:29 p.m., was seconded by Dr. Brian Crandell, and carried without dissent. The next Board of Health Meeting will be held January 21, 2026, 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\2025 Agenda and Abstracts\ November Page 7