Approved Minutes of September 20, 2023

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MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH September 20, 2023 • Moderna COVID-19 Vaccine, Adult (12 years and older) (prefilled syringe): $115.00 • Moderna COVID-19 Vaccine, Pediatric (6 months to 11 years) (single dose vial): $115.00 • Pfizer COVID-19 Vaccine, Adult (12 years and older) (single dose vial): $115.00 • Pfizer COVID-19 Vaccine, Adult (12 years and older) (prefilled syringe): $115.00 • Pfizer COVID-19 Vaccine, Pediatric (5-12 years) (single dose vial): $77.00 • Pfizer COVID-19 Vaccine, Pediatric (6 months-5 years) (3-dose vial): $58.00 • Novavax COVID-19 Vaccine, Adult (12 years and older) (5-dose vial): $113.00 Mr. Whitaker asked how the costs were tabulated. Ms. Julian explained that there is a separate administrative fee of$24.50 and the fee schedule is calculated based on the cost to the health department per dose. Ms. Stewart added that insurance covers 100% of the cost of immunizations under the Affordable Care Act, and individuals who are un/under-insured can be bridged so they still receive the vaccine at no cost under this fee schedule. Dr. Stuebe asked if Medicaid fully covers the cost of a vaccine, and Ms. Stewart replied yes. Motion to approve the fee changes was made by Dr. Shielda Rodgers, seconded by Dr. Alison Stuebe, and carried without dissent. VII. Educational Sessions A. Nutrition Update/Employee Health and Wellness Renee Kemske, Nutrition Program Manager, presented the annual update on OCHD nutrition and employee wellness services. Ms. Kemske provided an overview of the various programs offered by the OCHD nutrition department and their positive impacts. Below are some highlights of her presentation: • Ms. Kemske discussed the Nutrition Counseling/Medical Nutrition Therapy program, which is a medical referral program which helps individuals living with a chronic condition better manage their illness. She shared that over the past two years the demographic makeup has shifted so about two thirds of patients in the program are referred by the OCHD and one third are referred by other providers, but that generally the split is even (50%-50%). The services are available either in-person or through telehealth, depending on the patient's preference, but for a first appointment it is best practice to have an in- person visit. She also expressed that she expected to see an increase in telehealth visits over the winter. In response to Dr. Jonnal's question about 43% of patients being self- pay, Ms. Kemske said that it depends on the patient's insurance coverage, but they can slide the fees when necessary so those who self-pay are not paying full price. • Ms. Kemske shared that the Diabetes Self-Management Education program has resumed in-person classes as of April 2023. The classes are primarily attended by older individuals (45+ years of age) and offer a holistic approach to Diabetes management. The program offers nutrition education between two four-hour classes and one review of the program indicated that over the last fiscal year 82% of patients lowered their Al C levels. Ms. Kemske mentioned that individuals with Pre-Diabetes or Type II Diabetes are eligible for the program, but that Medicaid does not cover individuals with Pre-Diabetes and only covers one Diabetes management course per lifetime. • Discussing the Access to Care/NCCARE360 Grant, Ms. Kemske stated that this involves using a community-based referral platform to increase access to support for self- S:\Managers Working Files\BOH\Agenda&Abstracts\2023 Agenda&Abstracts/ September Page 5