Approved Minutes of October 23, 2024

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MINUTES ORANGE COUNTY BOARD OF HEALTH October 23, 2024 related to a permit being denied. As an example of an educational program in Environmental Health, Ms. Hudson shared that they piloted a loaner chlorination kit to help provide education and resources when an individual receives a poor water sample, and that this program has been well received by clients. • Several respondents expressed frustration or dissatisfaction with the functionality of the website. Ms. Hudson noted that there is also some confusion among clients owing to automated emails ("noreply@orangecountync.gov") and that there is a need for technological equity, which she hopes to focus on during fiscal year 2024-2025. Dr. Stuebe asked when the website was last updated, as it is not super easy to navigate, and Ms. Stewart explained that Libbie Hough, Communications Manager, is in the process of implementing website updates. Ms. Hudson added that the issue is more with the software being used than with the website itself. Dr. Rodgers applauded Ms. Hudson for acknowledging that not everyone is computer literate, and this is important for justice. • Personal Health Services received 91 satisfaction survey responses. Personal Health Services considered partnering with UNC MyChart to collect surveys, but ultimately determined that it would not meet the clinic's needs. The majority of responses were positive, with 99% of respondents saying they would recommend the clinic to friends and family. However, some clients expressed frustration with wait times or that they wished the clinic had an on-site pharmacy. Ms. Julian mentioned that lower staffing numbers and staff turnover have led to delays in getting appointments. • Ms. Julian also noted that quite a few respondents reported that they were not asked about family planning (e.g., if and when they would like to have a child/another child), and there is a need to review with clinicians the importance of having this conversation. In response to Dr. Jonnal's question, Ms. Julian explained that the family planning coordinator position was a pre-existing position which had been filled but is now vacant. However, she is not sure if the data reflects the position being open, as all providers are supposed to ask about family planning. Dr. Erica Pettigrew, Medical Director, mentioned that patients are asked many questions during appointments, and it is possible that some patients were asked but did not remember amid all the other questions that they are required to answer. Commissioner Fowler asked if family planning is different than contraceptive care, to which Ms. Julian explained that contraceptive care is encompassed within family planning. Dr. Royce suggested hosting a training rather than just reminding staff to ask the question. Dr. Stuebe noted that conversations about family planning are nuanced, and it can be difficult to ask the right questions in an obvious and memorable way without making assumptions; she mentioned that a good approach is to ask "do you plan to become pregnant within the next year?" and go from there, and referenced the One Key Question Framework and the PATH Framework as a useful tool to help guide the conversation. Dr. Pettigrew commented that the clinic often uses the One Key Question Framework but that it in fact requires four questions and doesn't necessarily account for"pregnancy ambivalence," i.e., when a person feels they would be okay either way. She agreed that the clinic has room for improvement and that conversations about reproductive choices are difficult to do perfectly. IX. Actions Items A. Present Chair/Vice-Chair Slate Dr. Jonnal reminded the board that at the end of each calendar year, the board votes on a chair and vice-chair for the next calendar year. Traditionally for the Orange County Board of Health S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ October Page 5