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MINUTES ORANGE COUNTY BOARD OF HEALTH March 25, 2009 Board of Health Minutes Transcription completed by Anne Miles Cassell 6 March 25, 2009 insurance is limited – including the immigrant population and socially at- risk women. • Women smoking during pregnancy • Adults co-sleeping with infants • Ongoing availability of guns to people who will misuse them • Barriers to access of supportive mental health services for teens suffering substance abuse, depression, and other mental health issues. Ms. Hermann reported that the Community Child Protection Team (CCPT) had reviewed the cases of 13 families with 27 children who were actively involved with Child Protective Services (CPS). The review found that: • Mental Health was an issue for 9 families and 4 children • Substance abuse was an issue for 8 families and 1 child • Domestic violence was an issue for 5 families • There was sexual abuse of one of these children • Medical factors were present for one child • Severe long term abuse and neglect were present for 3 children Potential system problems were identified: • Barriers to accessing supportive comprehensive mental health services. • Challenges in maintaining substance abusers in treatment • Limited resources for medical involved children requiring substitute care • Limited resources for the abusers in domestic violence cases • Limited resources for children who have experienced severe abuse/neglect where the children manifest serious mental health problems as well as complex medical challenges. Rosemary Summers stated that previously the mortality rate of infant deaths had been as low as 8 in previous years; therefore this is a large increase. Dr. Carey asked if any of the infant deaths had been multiple births. Ms. Herman replied there was a combination of twin and single births; two were twin births where one infant survived. Steve Yuhasz noted that there were several people that were supposed to be members of this group and are not and wanted to know is there was a problem recruiting. Ms. Hermann replied that the district attorneys and judges are difficult to get to the table. Across the state, Orange County has a high percentage of the required representation and good representation of groups compared to other counties. He also asked about the community action organizations. Ms. Hermann replied that they have recently identified several new members from community organizations that will be joining the Team. Jim Stefanadis asked for clarification of the definition of Orange County residents. Ms. Herman replied that if a child was a resident of another county but died at UNC Health Care; the death record would go to the county of residence. Chris Harlan asked if there was a tracking system for a pregnant woman that had been determined to be high-risk and moved to the county for healthcare at UNC but may have only been here for a few months. Ms. Hermann replied that these were difficult to break out and therefore were not