Approved Minutes of April 24, 2024

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MINUTES ORANGE COUNTY BOARD OF HEALTH April 24, 2024 Commissioner Fowler added that both Marilyn Carter, BOCC candidate, and Commissioner Phyllis Portie-Ascott had mentioned attending Take Down Tobacco Day to her and spoke highly of the event. IV. Priority Committee Updates The new Access to Care Committee met on April 22, 2024. Dr. Rodgers provided an update on the committee meeting, explaining that the committee has elected to maintain a focus on reaching community members who are newly eligible for expanded Medicaid, as addressing this will likely help with other barriers to care. The committee will also be conducting a photovoice project with community members to learn more about pain points that prevent people from accessing care, as recruitment for this project and promoting Medicaid expansion can be easily combined. Regarding equity/justice, Dr. Rodgers explained that the group is planning to intentionally target much of their efforts on reaching out to and building trust with those who have been largely insufficiently served, such as communities in rural northern Orange. Dr. Royce added that the committee is looking at demographic data for everyone who has been enrolled in expanded Medicaid vs. the population. She underscored that the committee is also planning to compare enrollment data with the demographics of individuals who are eligible to ensure that outreach is equitable and inclusive of any populations who may be underrepresented. Dr. Rodgers observed that the fact that Hispanic is considered an ethnicity rather than a race presents a wrinkle in examining demographic uptake of Medicaid expansion. Dr. Royce concluded by saying that the next meeting will involve drafting a formal plan for outreach. Board members brainstormed several ways to reach out to community members who may be eligible for expanded Medicaid: • Dr. Jonnal mentioned that Person County is seeing extremely high success in Medicaid enrollment, which she largely attributed to their system of automatic referral of all patients and aggressive follow-up. She suggested that healthcare facilities in Orange County such as UNC, Piedmont Health, and OCHD, should also automate their process, to which Ms. Stewart replied that UNC has a similar auto-referral system, but she is unsure about the aggressiveness of their follow-up. Dr. Jonnal noted that it is possible eligible people are not interfacing with the medical system as they don't have insurance. • Dr. Rodgers suggested that UNC's Student Health Action Coalition (SHAC) could be a good place for outreach, as they serve a lot of un- or under-insured community members. Dr. Nickelson pointed out that the SHAC has separate clinics for medical and dental services, increasing the possibility for outreach. • Dr. Royce recommended sharing information through schools and at PORCH and TABLE to better reach individuals who are food insecure. Dr. Royce noted that Medicaid expansion alone does not solve the issue of access, as there are individuals in Orange County who are undocumented and thus are not eligible for Medicaid but may still be uninsured. Dr. Jonnal added that even with expansion, many people make too much to qualify for Medicaid but not enough to afford to pay for insurance. In addition, Dr. Stuebe wondered whether people know how to even get to/navigate the healthcare system regardless of insurance status. She mentioned that the Chapel Hill and Carrboro School System (CHCSS) has added a mandatory financial literacy class for high school students but suggested that there should be a required healthcare literacy class as well. S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ April Page 2