Approved Minutes of June 26, 2024

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MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2024 • In response to Dr. Nickelson's question, Ms. Perry explained that there are a total of four managed care plans like Alliance in North Carolina, and each county in the state is served by one of the four programs. Commissioner Fowler added Alliance's board includes at least one representative from the Board of County Commissioners (BOCC) for each county served. • Dr. Crandell mentioned that he was interested in learning more about any bottlenecks Alliance might identify in the mental health provider network, as finding these may assist with connecting people to mental health providers. Ms. Perry clarified that this is examined by Provider Network Services, which also examines locations of providers, whether they're accessible by public transportation, whether they are culturally appropriate, and other similar gaps. • Commissioner Fowler mentioned that one quality measure for mental health providers is the numbers for completing a seven-day warm handoff to a mental health provider when an individual is discharged from a psychiatric hospital, which was low about a year ago; Ms. Perry said that these numbers are still low, which could reflect an insufficient number of providers but may also reflect an issue with data reporting requirements. B. Annual Communicable Disease Report Carla Julian, Public Health Nursing Director, presented the annual communicable disease report for Orange County. Because of changes to accreditation requirements, this presentation put most of its focus on atypical incidence of communicable diseases. Some highlights of her presentation are below: • Over the past year, atypical incidence was observed in Orange County for Vibrio, Hepatitis B, and syphilis. • Victoria Hudson, Environmental Health Director, clarified that the two Vibrio cases observed in Orange County originated when individuals dined at an unlicensed location outside of Orange County. • Ms. Julian shared that there were six recent cases of Pertussis (Whooping Cough) in the last few weeks of the school year. • Hepatitis B cases increased by about 15 compared to previous years. Ms. Julian clarified that these cases are largely seen among individuals who immigrated to the United States and were neither vaccinated for Hepatitis B nor aware that they had contracted it; typically, it is screened for and identified during the immigration process. She added that Hepatitis B is generally a chronic illness. • While reviewing vector borne illnesses, such as Lyme Disease, Ms. Julian explained that the numbers do not accurately reflect the cases, as two appointments are required to confirm diagnosis of vector borne illnesses, and many patients fail to show up for the second appointment. • Demand for the COVID vaccine at the health department has been low. The health department still offers free antigen testing and has free rapid COVID tests available. Ms. Stewart added that the bridge program to assist with COVID vaccine cost among uninsured individuals will be ending in August. • Case numbers for measles and syphilis are both trending in the wrong direction, though as of this meeting there have been no reported cases of measles in Orange County. However, there were two cases of congenital Syphilis. Ms. Julian added that sexually transmitted infection (STI) cases are investigated by communicable disease teams at the state level, rather than the county level. • Commissioner Fowler asked if syphilis cases are generally evenly distributed or if they tend to cluster. Ms. Julian invited Desmond Wallace, an MPH student from UNC Gillings, S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ June Page 7