Approved Minutes of September 20, 2023

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MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH September 20, 2023 checks for medical diseases that would exclude the individual from entering the US and may not provide routine vaccinations; and 2. An elective (but recommended) refugee health assessment completed upon entry to the US, which provides the opportunity to screen for communicable diseases (CDs), administer routine vaccinations, and offer continuity of care for refugees. • Per requirements from DHHS, OCHD currently performs a CD screening for refugees within 30 days of their arrival and provides laboratory testing for immunity to varicella, hepatitis B&C, TB blood test, Syphilis, HIV and blood lead level for infants and children under 16 years of age. The health department also provides abnormal lab results follow up, treatment if needed, and referrals for physical examinations. Ms. Ekenna shared that in the past fiscal year, OCHD has treated three refugee patients for lead and TB. • Ms. Ekenna recommended that OCHD consider establishing a full-scale refugee clinic to provide both communicable disease screening and physical examination to this population, as currently OCHD is only able to provide screening services and refugees are referred to Piedmont Health for primary care services (i.e., physical exams). • Ms. Ekenna added that implementation of a refugee clinic would benefit OCHD because providing the entire assessment including a physical examination would increase reimbursement through Medicaid or Refugee Medical Assistance (RMA). Ms. Stewart clarified that there is currently not staff capacity to provide primary care services for refugees and OCHD would need to hire additional clinicians to move forward with such a clinic. Dr. Jonnal asked how the health department can screen for communicable disease without performing a physical examination and Dr. Crandell suggested symptoms may be self-reported, which Ms. Ekenna confirmed. Dr. Rodgers pointed out that even among citizens, healthcare provision is often siloed and fragmented, as healthcare practitioners tend to focus more on immediate symptoms than whole health. VII. Reports and Discussion with Possible Action A. Media Items Marcy Williams, Health Promotion and Education Services Manager, briefly summarized the articles. Article topics included pending Medicaid expansion, legal disputes around the Swimply pool rental app, local mental health support training opportunities, Carrboro's Coronato Pizza closing due to secondhand smoke from a neighboring cigar bar, and a possible action in Wake County to ban tobacco and hemp stores within 1,000 feet of schools or parks. Dana Crews, Community Health Services Director, added that Rita Krosner, Tobacco Prevention and Control Coordinator, has done similar environmental checks at tobacco retailers. Media items were in the packet, which focused on Orange County's events, our involvement in various efforts, and various public health topics. B. Community Health Assessment Update Ashley Rawlinson, Compliance Manager, shared a brief update on the ongoing Orange County Community Health Assessment. She stated that the surveys are now closed, and that we received a total of 582 responses. Ms. Rawlinson added that there have been some technical difficulties with extracting the raw data from Redcap, creating obstacles in data aggregation and tabulation. Once this is resolved, the team will be able to move forward with the listening sessions in October and November; listening sessions may be available in a mix of in-person S:\Managers Working Files\BOH\Agenda&Abstracts\2023 Agenda&Abstracts/ September Page 7