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MINUTES ORANGE COUNTY BOARD OF HEALTH February 27, 2019 S:\Managers Working Files\BOH\Agenda & Abstracts\2019 Agenda & Abstracts/ February Page 3 • NCCARE360 is the first statewide coordinated care network that includes a source of shared resources and connects healthcare and human services providers together to collectively provide the opportunity for health to all North Carolinians. • ACEs are significant childhood traumas which can result in actual changes in brain development. These changes may affect a child’s learning ability, social skills, and can result in long-term health problems. Examples of ACEs that a child may experience include physical & emotional neglect, homelessness, and poverty. • The risk for negative health and well-being outcomes increases as the number of ACEs a person experiences increases. • ACEs are the most preventable cause of serious mental illness, drug and alcohols abuse in women and are a significant contributor to chronic diseases such as heart disease and diabetes. • Substance Abuse and Mental Health Services Administration (SAMHSA) describes trauma as events or circumstances experienced by an individual as physically or emotionally harmful or life-threatening, which result in adverse effects on the individual’s functioning and well-being. • SAMHSA states that building resilient and trauma-informed communities is essential to improving public health and well-being. Resilience is the ability to adjust/ bounce back when bad things happen. Research shows resilience helps reduce the effects of ACEs. • Trauma-informed care acknowledges that understanding a patient’s life experiences is key to potentially improving engagement and outcomes while lowering unnecessary utilization. • In order to be successful, trauma-informed care must be adopted at the organizational and clinical levels. • 10 key ingredients for trauma-informed care are 1)lead and communicate, 2)engage patients in planning, 3)train all staff, 4)create a safe environment, 5)prevent secondary trauma, 6)build an informed workforce, 7)involve patient in treatment, 8)screen for trauma, 9)use trauma-specific treatment and 10)engage partners. • Some strategies for encouraging staff wellness in trauma-informed organizations include o Encouraging and incentivizing self-care activities like counseling, meditation and exercise. o Fostering a culture that encourages staff to seek support, keeps caseloads manageable, and provides sufficient mental health benefits. The BOH members had questions that were addressed by Ms. Baker and Ms. Garrison. VI. Action Items (Non Consent) A. FY 2019-20 Budget Request Quintana Stewart, Health Director, and Rebecca Crawford, Financial and Administrative Services Director, presented the Board with a summary of the proposed FY 2019-2020 budget for the Health Department which shows an increase in expenditures of $20,519 from the FY 18- 19 Base Budget; $17,919 of which are related to an increase in staffing (.5 FTE contract Dental Van Driver, supported by re-allocated county general funds and fees for service) and an increase in the Environmental Health temporary staffing ($2,600). Staff projects a $53,094 increase in revenues for FY 19-20, which will fully offset the expenditure increase. The Health Department will request level county funding for FY 19-20. The proposed total budget is $10,575,428.