Approved Minutes of January 21, 2026

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MINUTES ORANGE COUNTY BOARD OF HEALTH January 21, 2026 • Dr. Dorothy Cilenti, former Interim Health Director, was recently named associate dean for practice at the UNC Gillings School of Global Public Health. • There are currently eleven cases of measles in NC — six in Buncombe, two in Polk, two in Cabarrus, and one in Rutherford counties— all related to the outbreak in South Carolina. Buncombe County has changed their vaccine recommendations to allow infants as young as six months to get their first dose of MMR (typically recommended at twelve months). Currently, Chapel Hill wastewater data shows no cases detected and there have been no documented exposures to residents of Orange County, but the Health Department remains in a state of readiness. Health Department staff are reviewing immunization records and conducting outreach. While no quarantine or isolation orders have been issued yet, templates are ready. Orange County is considered a high-coverage county in terms of elementary-age measles, mumps, and rubella (MMR) vaccine coverage, but there are two elementary schools — Emerson Waldorf School and Ephesus Elementary—with low coverage. Immunization data does not include Hillsborough Christian Academy or homeschooled students. • There is still no approved state budget for NC, and cuts to Medicaid provider rates led to a flurry of lawsuits ultimately resulting in those cuts being rescinded. The financial uncertainty is affecting everyone statewide, limiting any expansion of services and forcing everyone to operate on assumptions and guesswork. There are fears that Medicaid will run out of funds in early 2027; Ms. Stewart shared that she does not know what will happen if they run out of funding, but it will likely be a disaster and put more burden on local governments to compensate. Dr. Jonnal commented that Governor Stein is attempting to do a rebase to help balance the shortfall, and asked Dr. Pettigrew for her thoughts. Dr. Pettigrew said that, to her knowledge, NC is the only state that has not passed a budget yet and that things are not looking good. • Regarding respiratory illnesses, Flu is very active, while COVID rates are low and RSV rates are very low. Staff are encouraged to stay home if they are not feeling well. • Dr. Royce asked about the update on the Care Management for At-Risk Children (CMARC) and Care Management for High-Risk Pregnancies (CMHRP) programs. Ms. Stewart explained that the NC Division of Health Benefits (DHB) announced that care management programs would be administered through Advanced Medical Home (AMH) Tier 3 Providers beginning July 1 st, 2026. Though news of the cuts has not yet been formally conveyed in writing, if the decision stands, county health departments that do not offer primary care, will no longer be able to offer these care management services. In response to Dr. Royce's question, Ms. Stewart replied that since the Orange County Health Department does offer primary care, existing staff can most likely be transitioned under the primary care umbrella and continue offering services, but it will depend on the reimbursement rate. X. Adjournment Because there was not a quorum present, Mr. Whitaker adjourned the meeting at 8:58pm. The next Board of Health Meeting will be held February 25, 2026, at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m. Respectfully submitted, Quintana Stewart, MPA Orange County Health Director Secretary to the Board S:\Managers Working Files\BOH\Agendas &Abstracts\2026 Agenda and Abstracts\ January Page 7