001like for us to go ahead and get started. We'll start with the welcome everyone. Thanks for coming. We'll start with the pledge of >> allegiance to the flag of the United States of America and to the republic for which it stands. One nation under God, indivisible, with liberty and justice for all. I'd like to start with a moment of silence and reflection and think about and accept the responsibility that we have here before this board for decisions that are made that can influence health, safety, and well-being of children, families, youth, and older adults across May we approach tonight's work with humility, with wisdom, and with a commitment to the public good. Let us remember that those in our community who are struggling, those who are facing illness, poverty, disability, addiction, loneliness, and those in crisis.
002May they exp their experiences guide our discussions. May their needs remind us of why this work matters. Grant us the patience in our dialogue, clarity in our thinking, compassion in our decisions, may we listen respectfully to one another, and remain focused on solutions that strengthen our community as a whole. as we express our um gratitude for coming here tonight, being able to serve um as providers, advocates, and families who work here every day, those who do great work for this county. So, we thankful them for their dedication, and it's the foundation of the system that we serve under the Consolidated Human Services Board. May this meeting be guided by integrity from all, collaboration from all, and a shared commitment for well-being. Amen. >> Amen. We're going to start with approval of the minutes. Everyone had
003a chance to do this. >> Thank you. We have a second. All those in favor? >> All opposed. minutes have passed. Thank you very much. Um, next on the agenda is the approval of tonight's agenda. We have a motion that we have a chance to review. Make a motion to approve the agenda. Thank you. We have a motion to approve the agenda. Have a second. Second. Um, all those in favor say >> I. >> All opposed. So it is. Thank you. Next up is the executive director's report. Good evening. Uh, tonight I have the pleasure of bringing to you all the opportunity to review two applications for participation on the consolidated human services board. Both of those are for existing members. Uh so if an existing member is a part of this, they will not
004be uh eligible to to vote in in in this process. Um but we have two applications, one for Amy Dicky and one for Brandy Smith uh holding the consumer of human services and other person position for second terms. And so if you all uh would like to take a look at those and consider them for recommendation to the board of county commissioners for reappoint, that would be welcome. And any questions or comments or concerns to >> you can Oh, actually, you know what? Do it separately. one motion to approve. >> I second. >> All those in favor? >> I opposed approved for a second. >> I make a motion to approve Amy Dicki. >> Do we have a second for that? Motion to approve Amy Dicki as a recommendation. All those in favor? I all
005>> opposed. >> Great. So, we will move that forward to the board of county commissioners. And uh just for reference because it has come up recently, if you have an interest or know of someone who has an interest in applying to the board, um you can go on the Union County website and under boards and committees, if it's unionnc.gov of and under boards and committees there is a section that has the application and it has information about the current vacancies and then just a word document that is the application. I know you all have filled that out but it may have been a while and so um if it has and you know anyone that might be interested um in a position that is currently vacant or that is going to be vacant um Dr.
006Otherwise, no thinking about you specifically. Um, we would love to have somebody already in queue potentially to take that or at least for consideration to take that slide. Next up, we have the division report. It's going to be Tracy and I. We are tag teaming this as we are the co-chairs of your child fat local child fatality prevention team. And each year we get to talk to you all about the most terrible meeting that we attend every quarter and that is our child tally uh prevention team. Um Tracy's going to explain a lot of the background and ins and outs but to put it in the most layman terms every quarter we get together and we review um child deaths from that same quarter from the year before. We go through them. We see if
007we can figure out trends if there's anything that could have should have would have been done to make a difference and then we submit to the state our recommendations for those. So I'll let Tracy give you a little bit of the whole team background because a lot of things have changed with our team over the last year. >> There is a handout also. Sorry y'all. Yeah, we provided a handout and a paper copy of the report just for your information. Some of the processes associated with the child fatality uh team have changed recently due to some legislation. Legislation was passed in 23, went into effect in 24. Um and it adds a lot of detail uh data collection um and specifics around how the uh task force will operate not only at the local level
008but at the state level. So um it's a good thing it's a good thing to capture more data so we can dive into more detail of the cause of of of the deaths of these children. But at the same time, it is quite a heavy lift for the teams that are serving um on the committees and it's it's going to have an impact long term as far as you know, navigating the new uh software system, reporting uh time set aside for the reviews. Um but I just wanted to talk with you a little bit about um um the composition of the teams and also uh what what the different levels of reviews mean. So, just as a snapshot, in 2025, uh that that's the report. Although we're we're uh documenting the deaths that occurred the
009year prior, uh the Union County local team reviewed nine, excuse me, 19 child fatality cases, four of which met the requirements for escalated reviews. Um the North Carolina prevention team at the state level requires escalated reviews for specific categories of child deaths and these re uh reviews address complex cases involving child maltreatment or proud prior child protective services involvement. So, the mandatory reviews for uh uh child fatalities fall under uh specific categories as laid out in general statute 7B-146.5C. Um and those include the following. Undetermined cause of death, unintentional injury, violence, motor vehicle accidents, deaths related to child maltreatment or child deaths involving a child or child's family who is reported to or known to child protective services that meet some specific criteria um in the law. uh sudden unexpected infant deaths, suicide, deaths not
010expected in the next six months, and additional infant deaths based on criteria um set aside by the state office under uh legislation. Um so for deaths related to child maltreatment or involving a applicable uh parts of the article of the law. So for the specifics of that one is uh the deedent that the child that's passed was known to be reported as being abused or neglected under general statute 7B-301 regardless of the disposition of the report. So even though the case may be investigated and dismissed, it would still it would still meet that requirement and be investigated at the escalated level. um uh there was a known report involving child abuse or neglect under that same uh statute within the three-year uh period preceding the time of the child's death that involved the child's family
011regardless of the dis disposition of the report report. Again, regardless of whether or not, you know, the abuse was substantiated or dismissed. And then three, the deedent or deedants's family were involved with child protective services within three years preceding the child's death. And then finally, uh, available information that the county may access social services public health uh, indicates a possibility that child abuse or neglect as defined by that general statute may be a direct or contributing cause of the child's death. So, as Ashley mentioned, these are very, very difficult meetings. Um, we're very grateful for those uh in the community that, you know, um are willing to serve. Um it's it's a it's a difficult it's a difficult time when we get together. Um so, we're happy to answer any questions. Just know that the
012reporting uh there's an annual report that's made to you all and to the board of county commissioners. That copy of that report is also sent to the state um for documentation as well. >> So as part of our reporting out to you all and in our team meetings, first of all, just to give a shout out to Eric. Um, Eric serves on this human services board, but I don't know if y'all know this, he also serves on our child fatality prevention team. So, um, thank you for serving on both of those with us. Um, he is actually, uh, in the role, um, in regard to his work that he does with EMS. Um, so through that at each meeting after we've reviewed the case or during review of the case, we try to come up
013with, as I told you earlier, our own recommendations for systemic improvements that we think could prevent this type of child death in the future. And so, as part of our report out annually, um, we send to the state this this list of recommendations again, but we also report that out to you all and to the board of county commissioners. So, I'm going to I know that you can read, but I'm very proud of the work that we've done around this over the past year. And so, I'm going to go through um the recommendations that we made over the past calendar year for the cases that we reviewed. First of which was um we requested someone look into legislative change for juveniles to receive escalated penalties for repeated gun offenses. felt like DJJ wasn't necessarily taken
014as seriously as we wanted them to and we thought that that could help prevent other um deaths of children. Um increasing funding to the Department of Juvenile Justice to drive more effective treatment options. They are way underfunded. Um increasing resources in schools to focus on prevention services and linkage to additional support and resources. developing targeted prevention programs for elementary and middle school. Uh recommended that the North Carolina Department of Transportation conduct an evaluation of a certain section of road, the NC DOT and the regional traffic engineers office conducted a formal investigation to identify potential safety enhancements. Following our recommendation, the regional child welfare consultant is trying to obtain approval from the state office to change the current district attorney referral form. This change would allow district attorney's office to track specific patterns, thus strengthening the
015community's approach to the safety of children by being more coordinated with complex cases. We asked for more gun safety training for homeowners who have children and at risk children. um took steps to involve the DJJ to strengthen the community's approach for adolesccents involved with DJJ and the state should create some educational materials involving the dangers of placing children on farming equipment. um that was directly related or all of these are direct regularly related to ones that we reviewed but that as well. Um from that uh we took it a step further um as we are tasked to do in our role on this team and we came up with what we felt like were critical resource gaps in the current system and in our community. Um there was a lack of available or adequate services
016for some of those things that were referenced earlier in our recommendations. limited services for youth with co-occurring mental health and developmental disabilities. Um there's limited access to health care and lack of health insurance. You either meet the Medicaid guidelines or you hope that your parents um or the family has insurance related to their job because it's really hard to get if you're in between those. A limited community awareness of existing services. just getting the word out about the things that we actually do offer so that people know how to utilize and access those and then insufficient financial resources. I think that will forever and always be on this report. Um I don't know that there would ever be enough funding to get us out of uh or to prevent all child deaths, but there are
017some things that we mentioned in the recommendations where funding would definitely definitely be helpful. specifically. I think I know I'm biased, but in regards to DJJ, um I think they could really use it. So, those are the recommendations that we made based on this past year's cases that we reviewed. Tracy, was there anything else you wanted to add in regards to our report for you all? I don't think so. >> Does anyone have any questions about our report? I don't know that it has to be voted on to be approved. Just to acknowledge, >> endorse it. >> I just have a question. I know you used to do a survey through NC State. Is the new platform now gonna that'll take that over a new form of that? >> And so will it be a
018dashboard then? Now >> we'll see. I think in the I think they've talked about that and uh I don't remember if it specifically stated that in the legislation, but I know that that's what they're working towards with almost everything at HHS. Yeah. >> Okay. I will add that the reports that we submit across the counties to the state uh new department that's been created, those reports are summarized and also sent to the legislature as part of the new legislation. >> Yeah. And I believe they do a statewide annual report as well based on all the counties reports that are submitted. >> And it's still consolidated child fatality and child welfare. >> So it used to be two different ones. the child fatality prevention and community child protection team and we had a combined team. They've
019just formally combined that across the state. So yeah, now everyone's is together. So we also at these meetings review difficult u child protective services cases um so that we can seek multiddisciplinary input from everyone on the team and the outside perspective is very helpful on some of these cases where we feel like we've just done as much as we can um to figure out how to help them. we can get outside perspective from folks like Eric and other team members to help us kind of see other things that potentially we could do with the case. >> You know, that's another way that Union County is unique that that actually is not required, but it's a it's an extra step that we take to talk through some of these more difficult cases. I think it also
020gives the folks that are involved, the social workers and so forth, a chance to talk through these things in a confidential way to get feedback and work through some of the challenges. Um, so >> these reports available to the public? >> Uh, this is available to the public, but none of the data that's behind it. Yes, this this will this was given to you. here a public board and a copy will be given to the board of county commissioners >> and then statewide they'll compile all 100 counties and put together a state report. >> Can you remind me how those numbers compared to last year's? >> I would love to do that in a follow-up email. >> Sounds good. >> I can't remember. I'm not sure. I wasn't even guess >> there will be some
021changes with that just because they did change some of the criteria particularly for infants that you know passed for you know birth defects or something like that. Um so they um made the age a little increased the age a bit for an infant. So just so you know that we may not be comparing apples to apples. Do they still have that requirement that it was written to have someone to try to have someone with with experience in the two domains? >> Yes. And we and we have had um a member of our team. She she recently resigned. She'd served on our team for several years. So, we're currently looking for a new member to our team um who has lived experience in that their their child has passed and so they they can bring that
022experience to the table. It's one of the most difficult positions on that team to feel. I mean, we all understand that. Um but yes, we are actively looking for someone to fill that position. Are there any more questions? >> Next up is the overview of human services business operations. I don't know that I've ever presented to y'all on the Can you hear me without the mic? >> So, I'm not sure if I've had a chance to present to y'all on business operations. So, Janet asked me to present tonight. So, I'm happy to brag on my team. I think I have um some some fantastic talent who does a lot of work across all of human services. This is the family photo. This is our org chart. As you can see, it's pretty big and we
023cover a lot of territory. And the whole reason we Whoops, skipped once. The whole reason that operations exists is to help operationalize and support all of the rest of human services that are front-facing. We do support several programs and services within our own work chart, but we're to be a strong foundation for all of our clients and employees. And a lot of times our clients are other employees. We're established infrastructure of managers and teams that focus on the front of the house and the back of the house and all the support that happens in between. And we have the workflows to engage both um the monetary, fiscal and human resources to ensure that quality services are accessible, safe and delivered in efficient, culturally competent, welcoming manner. So that's our mission and vision that we try
024to work through. By function and staff there are 66 FTEEs across all of human or across business operations um working in 12 programs and services. The team members on this slide are my direct reports. Sarah Castrian is the admin three that supports operations but she really does work across all of human services. A lot of it is in laser fish and workflows and surveys and data collection and things of that nature but she supports wherever she can. As you all know, Carla um is in operations and she is in charge of public health accreditation and she her actual title is compliance coordinator. She does a lot of other things. I'll get to that when I get to her slide. Emergency preparedness, Jason Garion is presented to you all. He is a shared um resource between
025public health and um the rest of human services, customer service. Kenda Griffin is the program manager and that's the front of the house, back of the house and a lot of the heavy lifting that happens to keep the building going. Finance is Mary Chery. Um she's our program manager and finance officer for human services. Business processes is Katie Coffee and that's um a very short title for a lot of work that happens in that space. And program integrity and training is Dave Flity. He's a program manager. So there's Miss Carla. Um public health accreditation um public health has been accredited from 2010 14 18 and 24. Carla did 18 and 24 serving as our agency AAC or accreditation coordinator and Sarah back her up in that role. She's also in charge of all of orientation
026and onboarding for um human services. She does assign the universal homework which is the work that we expect everybody to take participate in when they come into the organization. so they have a broad understanding of what all the programs and services are on some level. Um Daniel Paya who's also a compliance coordinator is her backup for that. She also is in charge of routing all of the contracts which is a massive lift in human services. We have lots of contracts that um get routed through the system. She is considered our contract um business officer for that function. And she does also work in RFP initiation and vendor engagement, which is not always fun. A lot of times she's tracking down signatures and making sure contracts are renewed timely and that things can keep happening as
027they're supposed to. She serves as the administrative hearing officer for program integrity. um she's clerked to this board and she assists me with RFPs, continuity of operations and any other of the workflows that are in support of accreditation. Jason um it's a shared resource. Um one of the main functions he does is the agreement addendum 514 which is the public health function and that's public health funding that pays for that. And all of the plans that are down here, I counted. There's many. Then they go on to the next slide, are all tied to that AA514. They have different timelines that are associated with them, but they all have to be time. They're regulatory and focused, most of them, and are timebased. Because we are adjacent to Charlotte, we're considered a um readiness Charlotte readiness
028or city readiness initiative. So, we get additional dollars, but to do all of these functions, we only get $46,72 from the state. So, the county has to pick up some of the um rest of the finance. These are some more of the associated requirements for the 514. He also supports the um county emergency operations center. Whenever they open, if there's a role for him to play, he does get called over to do that. He's in charge of charge of the shelter support. We just recently had the shelter um open and he came and presented to you all. So he's in charge of recruiting the volunteers, training, implement and implementation for shelters. Uh he also does the functional needs registry which used to be connected to emergency management. It's no longer a mandate but we do
029it because it's best practice. That's where we reach out to the community and try to identify folks that if they were to come to the shelter, they would not be able to operate independently in the shelter on their own. So, we like to try to know who they are and if we can redirect them to another resource, we do so with in their best um initi well for their well-being in a shelter environment. And then he's also in charge of all the human service building safety plans. I've held to list fire drills, but he does fire drills, lockdowns, the shelter in place. Anything for anything in the building safety realm is in his bucket of work. Miss Kenda Kenda and her team are in the back. That's Kenda Griffin and Dora, Lisa and Amanda. They
030are the front of the house, the back of the house, and a little bit of everything in between. So, Kenda has 16 and a half team members that she has in her shop. They do the mail, the dock, the courier, anytime there's a room set up, which is often, they set the room up, break it down. They do meal routes for senior nutrition. They're in charge of the county, the fleet. that are assigned to human services in this building. Not environmental health, but just the um public health and DSS fleet vehicles that are here. And Stephanie got a vehicle. So CSO's the vehicle. Um they also manage the shred um shred contract, keep the building supplied with paper and they do what we call navigation. So if you come in in the building during business
031hours, someone will greet you, ask you what you're here for, and help direct you. Switchboard, they answer all of the calls that come in. They make any copies for the front desk which is what keeps the client flowing moving so people aren't waiting and they do the um they back up our mail room and they also do navigation the front desk and client relations which is Amanda's team. She also has switchboard. I should have said that. Um they do checkin for all the DSS programs. They assign them to a worker into a space so that they can um get that workflow going and they do administrative assistant work scanning and they also navigate uh language support is door's team. They provide mandated language services to human service departments as needed. Um mostly covering DSS. They
032do have someone on call for CPS at night. So if CPS goes out and there's a need for an interpreter, they go out with them. um but they can do anything any of the different departments. They also assist in um written translation as needed. There's um four and a half team members. We have some that retired and came back. So we have four and a half folks that work on that team um andor Lisa. So there's a program manager, two human service supervisors, and one administrative support bilingual floater that she's able to go around and supports all the different needs. Mary Chory is our finance manager who is in St. Lucia right now probably having an ice beverage and forgetting about budget. Mary um is has accounting, billing, patient relations and customer service. And those
033um are are what they say payables and receivables. She also helps with or her team helps with grants. Um the 1571 which is how we get reimbursement for DSS work that's done. The worm which is how the state reimbures public health. We do draw downs for their funding. She supports they support contracts, um paying of all of our PE cards, managing debt and purchase orders, budget preparation and management, which is significant lift. There's eight team members in accounting that work in that space. In billing, um they do the fee schedule. When we bring you all fees, that is a collaborative effort between public health clinical team and the billing team. So, she manages the fee schedule. They do billing for clinical, dental, and lab. They support the cost settlement submission for Medicaid. They do reporting
034and then they do the pro they take cash payments. They set up payment plans, schedule the appointments, um collaborate with clinical staff as needed to answer patient questions. There's six folks that do all of that. One is assigned to dental and the rest are assigned to the clinic. Customer service. Um this is brand new. We're super excited about this. We transferred another position from another department in business ops that may focus this new position will be solely focused on debt. So when I talked to you recently about the um bad debt and that set off we'll be talking about this position will focus on that as well as the program integrity debt. So there's two human service supervisors and a customer service supervisor in that space. Mary has 21 folks on her team. Uh Katie's
035team is business processes. She has IT. Richard in the back is on Katie's team. They do IT um support, help desk, procurement, imaging, deployment, asset tracking, hardware and software, phone support, and human service support in general for all of our systems. We have three um information system coordinators that are focused on security and non-disclosure. They do the onboarding of our our team members and making sure that people sign proper documents. They manage the HIPPA compliance and the investigations of HIPPA um with the state and do HIPPA training annually. And vital records, we have two vital records clerks. They do birth and death certificates which includes a lot of complexities with home birth registrations, affirmation of parentage. oftentimes that these involve lengthy appointments with clients because there's a lot of information involved and they support Tracy
036as our local registar for vital records. They are her deputy registars and they can help with burial transits to move deedants across state lines. They help manage with our subregistars who do things after hours on our behalf and all of these processes are timebound and regulatory. So it's very important that we have folks that are well trained in this space. Okay. Heat also has records management which is all of the records and human services of all manner. That can be x-rays from dental all the way to just your normal um patient records or client records. So they manage the security and retention schedules and timely disposition. So one of the things when she first took on this space we realized was that we had records stored in um offsite that weren't being disposed of. We
037had to bring those back in, go through them and set up schedules and make sure things were being shredded and managed on a timely um in a timely way and according to proper retention schedules and with proper state permissions. Um so she has two to three staff that work on and off in that space. Um she also has human service evaluators, all four of them, and a business process manager, Cheryl Bowers, that manages that team. They focus on CQI, quality assurance, as well as data analysis. We did have a data analyst. Unfortunately, we don't have that position any longer, but they do collect a lot of data and man man monitor trends and set up dashboards. We have a lot of performance measures that we have for the county, but we have some internal. And
038we have a quality council that Cheryl's team leads in different departments. And Dave is compliance and training. Program integrity is one of his buckets. He has four program integrity investigators that investigate fraud in mainly in our um Medicaid and food and nutrition and that's because those two programs have the most public assistance and that's where the referrals come from. We can do it in other buckets but that's where those referrals are coming from. Um they conduct those administrative hearings. They to validate or refute the findings of the team and then they pursue the repayment of the fraud. That can be through an intentional program violation, an inadvertent household error, or agency error. And then they initiate what's called a voluntary repayment agreement that returns those dollars to the county. And then those dollars go back,
039some to the state and some to the feds. And we get to keep a small percentage of that. And then Daniel Pana is the um compliance coordinator and training person that works in Dave's space. He backs up Jason as the preparedness coordinator. He helps with sheltering operations and training in that space. Um they also he also supports orientation with Carla and backs her up as the PI hearing administrator. And he also does um he's fantastic with creating videos. we have to work with public communications downtown to make sure that what we're doing is in line with what's needed and what's allowed. But he most recently did a lot of work at the opioid settlement videos with that program and working on that. So some of the special projects that we've done recently um as Ashley
040and Tracy talked about the child fatality team Dave has taken on the role of the review coordinator for those um for that space and has been able to help them um tremendously in that space. the opioid settlement. Um several team members have worked in that area with facilitation, the videos, survey development and data entry. Um strategic planning, we work on the the human service strategic plan every three years, the voice of the customer. We're required to do that by the county at the enterprise level. So we do that. Canvas team leads that effort out front with our clients. It's we're trying to get input from it's a standard survey that we use for all of the clients regardless of program and we try to get enough from each bucket so that we have some um
041some valid answers that we can work on. The human service continuity of operations that was new. We each had one but the county required a different look to that this year. So we worked on that in 2025. And then laser fish um form development and workflows is something that we work a lot to support across human services. Some recent accomplishments in our billing space. This has been a huge help. We had one certified coder or two previously counting the the human service supervisor in that space. We have recently had two other ladies get certified as billing coders and one person is now a public health um certified biller. So that's um many kudos to them for doing that. It's a big exam to become certified coder in the vital record space. In 2025, they were
042fourth in the state for efficiencies in processing our death certificates which is huge when you consider there's only two of them and um we're competing with all of the counties and some of them have much larger departments. um the compliance coordinator trainer or training position um Daniel passed his HC this year which is the um homeland security exercise evaluation program so he's now can conduct exercises with that certification and then two of our um human service evaluators are in their certifications in healthcare quality so that when they do work in CQI or QA in public health on that side they have that knowledge to fall back on and they um are all lean and certified six sigma. So these are the performance measures that we're required to do that are associated with budget because of
043the nature of the work in business operations. A lot of ours are out outputs and outcomes versus actual measures just because of the type of work. Um we try to make them time bound so they are measurable. I'll call out just the one in it. Um we have a three business day um goal of responding and responding to and closing all IT tickets which is pretty good considering how large the department is and they've done very well with doing that. They're um on track for where we need them to be. We track how many um contracts Carla processes. Most recently in um 25 there was 126 contracts. Um this year she's already done 62. um for the hours of language services provided in Doris's program in 24 5,747 hours. So that's a lot. Um we
044have all of her team speaks Spanish. We do have one person that can do Russian, but she's not that's not her full-time job. So the hours that you see up there are um combination of interpreting and written Spanish. So so far just this year, I don't have the number for this year. Um, oh, I'm sorry. It's 1527 for this year so far. If we didn't have that capability in house, we would have to pay the contract line to do that service. So, it's a savings of money for the county. Um, the quality assurance team, they did in 25 708 projects. They can be small or they can be ongoing. It depends on obviously the nature of a project, but that's a lot of projects with four team members and one manager. um program integrity, that's
045the dollar amounts that were brought back in through those payment um repayment agreements in 2591,86642 was brought back in that can be done through tax intercepts or just payments. Um even lottery intercepts. So there's lots of ways that we're bringing the dollars back into the community. Then it does get repaid. We don't unfortunately get to keep everything that comes back. Um in billing we have a goal set for to process all bills um within 30 days of time of service. We have 180 days. We initially started with a goal of 10 days and that was a bit aggressive. So we've backed off of it to 30 and they do very well with that. Um the weed and lag measure that we've chosen to take on as a combination or is in conjunction with the maternity
046clinic and we were hoping to be able to get that off the ground earlier this year but we had some staffing challenges so we had to push that off. So we'll we'll come back to that after we've had a chance to collect some data. But the intent of that was to kind of invert the way we were dealing with clients. So if it was a new maternity intake and they came in for service, there was a lot of paperwork on the front end that had to be done. So I'm just make example, it was a 1:30 appointment, it might take the team 30 minutes to get them back for their appointment and that messed up the integrity of the schedule. So to avoid that, we flip the process. So we just check check them in
047at the front, check with the their demographics, and then they're able to get to their appointment. and then we're able to do the paperwork on the back end which should help save some time and give the majority of the time to the provider. So, just some stats and measures from 2025. Navigation, that's just who came through the front door. 94,429 folks came through the front door and were navigated an average of 382 per day. of a front desk check in 28,29 clients and switchboard took 21,070 calls. So there's a lot happening at the switchboard. The receiving dock 6312 packages um the dropbox. So if people come after hours and they want to leave us some paperwork, they can put it in the dropbox that will then get routed to the program or scanned in. And
048then 22,997 docs were documents were scanned in by the team and centralized scheduling which schedules public health appointments. 2,238 calls were made and 3008 voicemails were received and returned. So what are some of our challenges? To be able to support the needs across all the departments. Every department that we support is important and all the work that they do is important. So trying to balance those priorities and make sure we meet the needs and as the best that we can to support them for success. Um unfunded mandates um interpreting is an unfunded mandate. So we do have positions for it but as that space and that need grows so does the um the cost to provide that service. Our HIPPO risk assessment is a requirement that we do. We used to do it just for
049public health, but we've tried to do it for the whole of the organization and cyber security obviously is becoming a bigger issue. And the cost of that we went out with an RFP and I think the cheapest one that came back was $90,000. So it's quite expensive to to again it's an unfunded mandate that's quite expensive. Um increased complexity of client needs which increases the complexity of the questions that the front team gets and that come through the calls. the impact of federal and state funding fluctuations on programs and the evolution of our workforce. When people come and apply for positions, a lot of times one of the first things they ask is, "Is this remote?" Well, no. Front desk isn't typically remote. So, there's um it's try trying to find the folks that have
050the servant um servant mindset to to work in human services opportunities. Um the human services academy is something that we're trying to get off the ground. It's been an initiative for a couple of years. We had some staffing changes when strategy and innovations came to into play. So some of the team members that should have been able to do that weren't able to do so. So that's the idea of having human services team members understanding each other's programs better so that we can have more informed referrals and have more frequent referrals across programs. Um meeting the escalating needs of preparedness which a lot of them do require multi-depal trainings and even countywide initiatives. So we have a responsibility in that space without the authority. But they may ask about what what is the ability for
051you all to respond to a certain type of emergency. Well, we don't if we don't have that in the program, we can't necessarily short it. So there's just those kinds of challenges. And then strengthening the recruitment, retention of staff by developing career opportunities with internships and succession planning. How can we keep the great team that we have challenged and engaged and growing and retain them if not within operations at least within human services if not human services at least uni county and then continuing to work toward being a standard for success as a consolidated agency that we really take pride in that is being the support that we need to be for the other divisions and departments that's business operations >> bless you Should does anybody have any questions? There was a lot. Thank you
052for your patience. I had a question on your stats and measures. Congrats to the teams that y'all are doing great. Thank you. Um, this is 6 months in, right? It was July to December. So, on some of the ones there was a pretty drastic change, but there wasn't an expected target. Was that something that we did predict? >> Can you pull that back up? She's asking about the sets of measures. Was there one in particular? >> Yeah. So, for example, um like some of them are pretty obvious on the um internal quality assurance. The target was 300, you're at 678 already, right? Um so that's a increase. But like the language, you know, it was down from 24 to 25 and then now if you were to double it, you know, it'd be pretty significant
053drop again. Is that But there wasn't a predictor on that. Just curious. >> No. Well, the language is on demand, so it depends on who comes through our door or what appointments are set. And what you see here is only the ones that we're providing. So, in addition to my team, there's an entire separate team in public health that focuses solely on their clinic. Um, they do the dental, but we do wick. So, we just never know who's going to come through the door and what we're going to be asked to support. Um, and there's the language line, which is a contract language service that if we if it's a language we can't support or if for some reason the team is already occupied, then we have to use the language line. So, in addition
054to that, there's a lot of other interpreting that's happening, >> right? That that's where I was just curious. I mean, it's not a bad thing. I was just curious cuz that's not the direction. We're not trending down as a county in that. So, that's a pretty stark drop, right? Like if you figure I mean 30 something% drop would be anticipated. So, but we're going up as a county on the need for that. So, >> well, it also it depends too. we had to change um with one when our employees that came into the position we had switched public health took back over dental and that was a big space that we had been doing a lot of work in. So with them carrying the dental that decreased what we were doing in that space and
055our interpreters also their admin on paper that's their title and we did that intentionally because we want them to be able to grow and learn other things. So when they're not interpreting, they can be navigating. They can do switchboard and um do other written interpret interpretations as other translations, excuse me, as needed. >> So it sounds like they're just in different places and you know, >> yes, they get, like I said, >> it's not a decrease in the amount of people that we're serving, you know, that are multilingual. It's just different. >> Or do you have anything you want to add to that? Yeah, usually we have Russian, Ukrainians, and we could also Yes. A huge uh difference. Right now we have a lot of Portuguese coming in our doors. We have other dialects that
056sometimes we have not. Sorry. Thank you. Um we have some other uh clients coming into our doors that they speak some other dialects that even in even in Spanish we have experienced um clients coming to our door like saying I speak K and um it's not Spanish actually is their second language um so population language is growing definitely is impacting our community in our services every day um we see a huge growth Definitely. Um and then we don't take it as a challenge. It's it's the way we are evolving. Uh people are coming, people are moving from different places and bringing um our culture languages. So that's the beauty. Um we wish we can have more um interpreters like speaking other languages, but our biggest population is still u Spanish speaking. Um so but we
057do what we can. We serve our community. We're very passionate and and we come to you know work every day and prepare for the unknown. Uh we usually are not our day can be from just not an easy but not challenging and serving families going out to CPS's and and from navigating. It's just exciting to me. is from from the time that I've been in this position, I am learning. Uh we have a very good team, more family. Um and I'm still more to learn. >> Thank you for your work. >> Absolutely. >> I just wanted to make sure that everyone still had the access they needed. Thank you. >> Thank you. for that presentation. Next on the agenda, we're going back to Miss Colleague for the communicable illness. So I respatory measles update. Um,
058so this will be the last one for the season since it's spring coming up. I'm glad to see that. I know you all are as well. So, as of March 6, the acute respiratory illnesses causing people to seek health care generally across the US are low is now low now considered to be low, which is good. Um influenza rates remain elevated overall nationally uh with influenza A activity decreasing in most areas of the country while trends in influenza B uh vary by region across the country. Um for RSV the activity has started uh later than expected in most regions of the US though severity is not uh higher compared to recent seasons overall. Um let's see. Typical season indicates that higher levels of RSV activity may continue into April in many regions. Uh emergency department
059visits and hospitalizations for RSV are highest among infants and children less than four years of age. Um for COVID 19 activity is decreasing nationally but remains elevated in some parts of the country. This is just a graph showing respiratory illnesses in the US. Uh percent of tests positive for respiratory viruses. You can tell it's starting to especially flu starting to trend downward along with CO 19. Uh this is a graph showing uh data for wastewater monitoring that we've talked about previously. Uh overall viral activity rates in wastewater monitoring um in North Carolina are low or very low, very low. Influenza uh and RSV and low for CO 19. Uh just know that Union County uh does not uh have a wastewater monitoring site anymore. We used to, we don't have that anymore. The closest one
060uh is in Meckllinmber County. Moving on toward measles where we've had a little more activity. Um, as of March 5th of this month, there have been uh 1,281 confirmed measles cases in the US. 1,277 of the cases were reported by 31 jurisdictions and four measles cases were among international travelers. So, you know, if you think about all the counties across the US, so it's really compacted into just 31 jurisdictions. There have been 12 new outbreaks, uh, with 89% of the confirmed cases being outbreak associated. South Carolina, um, unless you're living out under a rock, we know that there's a lot happening in South Carolina. Thank Thankfully the rates are starting to trend downward for new cases. Um but overall it's been a record-breaking time for measles cases in South Carolina. Um there have been reports
061of complications in South Carolina with infection uh including pneumonia and seph and sephilitis. Most recent outbreak totals there are approximately 990 cases. So really extraordinary. Um the rates that we have that we report on are updated by the state um at noon each Tuesday. It's just a graph showing the weekly measles cases by rash onset date. Uh you you can see the uh some peaks in that curve in March of 2025. You know, I'm thinking that's Texas. And then moving on towards March, you know, January, December, December 2025, January, February is likely South Carolina. So, measles in North Carolina. Now, you can see the it's hard to see the graph there, but that's the state of North Carolina. You can see Union County represented there. Those are the counties that have uh reported measles cases.
062There have been 24 reported cases overall in North Carolina just since December of 2025. There have been multiple responses for exposure sites across uh our county and state jurisdictions. And one thing to, you know, kind of keep in mind is we're very close to South Carolina, Lancaster County, um Meckl, we're kind of all in that Meckllinmberg County metropolitan area and we're impacted by that. a lot of travel across the state, across county lines. Um, so that movement of people makes us a little bit more vulnerable to cases. Um, want to remind everyone, uh, Megan mentions this. Typically, uh, the North Carolina measles dash data dashboard is up updated twice weekly to reflect new cases and guidance that may have changed or been updated uh, since the prior time frame. So that brings us to Union
063County. Um on February 8th, Union County confirmed its first measles case. A second case was confirmed on February 26th of that same month. Upon initial investigation, there's no epidemiological link to other measles cases on either occasion. This indicates a probable community transmission. There were no reported exposure sites other than medical facilities in that with that second case um where the patients were seen for medical care. Um you know we are in a position where we're encouraging businesses, schools, child care facilities, everyone to be prepared. preparedness using our surveillance and our data to help folks to prepare so that we can minimize impacts to businesses and lives. Um keep kids in schools, kids in child care facilities. Um so on uh March 26th uh we are planning to uh host a uh vaccination clinic for MMR
064that's going to be in this room. Um and uh so we're glad to be offering offering that to the community. We won't be doing tighters at that uh clinic. We will be offering MMR um to those that don't have documented uh proof of immunity. Um, as I mentioned, and you know, we talk about this all the time, we continue to work closely uh with the state and our uh wonderful community partners to share information um and learn from one another as we're responding to these issues across the state region um so that we can uh meet the needs to of Union County and be more efficient and effective with our responses. These are resources where this uh data and information was pulled. Um these are live so you can click on them if you uh
065have this information in your uh email with the PowerPoint presentation. Any questions or anything I missed? Ashley? >> Yes. One question. Could you explain what the wastewater monitoring for respiratory viruses does? Like how is it? It seems to track closely the positive cases. What extra value does that give? >> So that gives us a um almost like a heads up that a virus is within an area or within a metropolitan area. You know, it doesn't it's it's a sign. It's another way of surveilling the data that can give us an indication. Hey, you've got measles in this area. If you know, if you notice, I don't know if you all are, you may not be following the news related to measles as as much as I am, but I recall when Mecca County put out
066a news release that they uh detected measles in wastewater. It was a very short time after that they started having cases and then we had our first case. So the assays for illnesses, diseases have expanded beyond just co 19. They can also uh look for for measles in this case which I think the science and the um opportunities with that are very interesting and helpful in the public health realm so that we can be prepared when things like this uh the diseases such as this come into our area. surge planning like for hospitals. Um if they get a little bit of a heads up, they can start preparing for getting more cases, more patients in. >> So I I apologize. I thought I was silence. I had to step out. You had said previously there
067was a testing site here in Union County and it's there were two of them. >> Did they close because they were no longer valid? Is it a funding issue? Were they of no value? as the population growth continues. >> So, uh, initially they were funded with, uh, ARPA funds, grant funding. And I don't know what, you know, what happened with the funding, but I I expect that the change was based on funding changes or some other decision that was made at the higher level. Janna, do you have any information on that? >> I think that is correct, though. >> And they were through a university, weren't they? Yeah, they were >> in fact all of them started in partnership with universities, right? >> UNC Charlotte was the >> I actually think that funding may have
068initially been through something that had to do with CARES like for the testing that that was initially how it was >> the CARES Act >> approved. Yeah. >> Yeah, that's what I thought. I thought it was through a research project which has taught us that this really is ahead and this science works but hazard circle back to us >> and again it only measures what is uh being um discharged into a public sewer. It doesn't capture septic systems and that kind of thing but gives you a little little snippet of of or a glimpse into what may be circulating in the community. >> Thank you. Great question. Any other questions for us? >> Thank you. >> You next on our agenda, we have any are there any announcements? We didn't have anyone sign up. Do
069we have any for public comments? Do we have any announcements? >> I know I had a chance to speak earlier, but I have a couple of other things that I would love to hear. Stephanie, do you have anything? Um, so two things. One, the Union County Board of Commissioners is having its FY27 budget retreat uh this coming Thursday from 8:30 a.m. until 100 p.m. That will be held out at Cane Creek Park, but it will be livereamed on YouTube. And so, um, since that ties to all of the work, you all may be interested as part of this as well as, um, as well as just as part of your role as human services board as well as just, uh, residents of Union County. And the second thing is I wanted to say that I
070had a chance this last week to visit with several of our congressional offices to uh advocate on behalf of transportation and in partnership with the North Carolina Public Transportation Association and Community Transportation Association of America. and we met with the FTA and had uh meetings with a number of different senator and representative offices including um Mark Harris's office who's obviously here as well as Ted Bud and Alma Adams. So some very local entities as well. Um, and we were advocating for all of the national priorities, but really North Carolina specific ones, which some of that is funding in transit and some of that is uh just reduced regulatory reform and reduced administrative burden. And as a part of that, I was able to share a video uh that one of our shining stars, Miss Teresa
071Torres, who is the director of transportation, uh was able to help facilitate. And you might recall that either at the last meeting or meeting before, Teresa mentioned that uh our transportation team was highlighted in um a magazine article recently, which is actually referred to in what I'd like to show you. If you'll give me just two minutes to make that happen. Are we good with it, Richard? You think? >> Great. Um, so Richard's got something queued up and it was kind of cool because WSOC said uh they wanted a positive news story for a change and so they came out about two weeks ago roughly and um you'll see what they did and I think it's just a nice highlight for some of the good work that we do um and and that is supported
072by everybody from from Jackie's team in part um just really all across the county and Theresa and her team just knock it out of the park and as as does everybody else in human services. I'm really proud of this and really proud of the ability to serve and just wanted to share this with you guys. >> Covering Union County tonight, more people are hopping on buses just like this to get where they need to go without paying a dime. The service is now so popular the county wants to expand, making it even easier for people to get a ride. Argina Espazito got on board with a woman who says she relies on the buses to get where she's going. >> This is Judy Kiml. >> Oh, I got my wheels on right that time. >>
073I love what you were doing. >> I feel like I've done this once. >> She started riding the bus four years ago. >> Last bump. after an accident left her wheelchair bound. She says she left Charlotte to move in with family in Union County and need to find a way to get around on her own. It's a one phone call deal to sign up for it and all I have to do is is remember to call in and schedule my appointments. Um, and I'm ready to go. >> Klaw says she uses the Union County bus to get to doctor's appointments in Charlotte and Monroe, but also to go shopping and get a haircut. You know, it really helps me feel more independent, uh, more in charge of what I'm doing. >> Union County's bus system
074is open to any resident of Union County. It has a fleet of about 25 vehicles that make more than 400 rides a day. It goes as far as the VA in Salsbury and is free for most riders. Over here though, the county needs to serve families with young children. So now, parents with children under the age of 15 can ride the bus. And you can see they have seat belts where you can even put a car seat in. Recently the transportation system was featured in Business View magazine for its investment in the community. >> We have grown by 10% in the last 3 years for our ridership. Um we've increased our vehicle size. Um and just having more funding available has allowed us to do that and help more people. >> Teresa Torres is the
075transportation director. She says they're working on ways to improve the system and expand. That includes a new software system coming soon so riders can make same day appointments through an app. Right now, riders have to call 48 hours in advance to book a ride. >> I'm all for that. >> Klaw says that change would give her more flexibility when booking trips to and from her house, but for now, she says the system works. >> So, I can make my own schedule, make a phone call, the bus shows up on time. And the unique thing I think is after riding for 4 years, uh, I have never been late to an appointment. >> I think that's it. >> In Union County, Gina Espazito, Channel 9 Eyewitness News. >> The transportation director says next year they plan
076to get more feedback from riders about how to expand the bus system. Right now, there are no bus stops. All riders must register to ride and have to book an appointment. The idea of creating a five-year plan would help determine how this transportation system can grow. >> Autographs, that's awesome. >> I don't know, Dave. Nothing. Anyone else? Hello. I have just two quick things. Um, I wanted to mention that the Veteran Service Office has been given grant number two, which is awesome, for $20,000. The first grant was about $18,000 and we purchased really nice client chairs. We got a scrolling display system in our lobby. Uh, we got audiovisisual equipment. We got flags, Jackie. We got flags. Um, and so we're excited about grant two. And with with that grant, we have designated it to
077um we had to provide a scope of work and one of the scope of works was to have an event. So, we are planning an event for veterans on Saturday, May 30th. It'll be like a resource fair. We're going to have a walk through the uh trail by the Simpson Event Center. So, I'd love for all of you to come if you're able to make it. Uh, but in true fashion, I promise to give an updated great story. And I have notes that don't even make sense to me. Um, so imagine how a veteran might feel trying to explain or navigate the VA system. But in essence, this Vietnam veteran um was um it's so difficult to explain sometimes, but the VA adds new rules to the disability lists. And as some of you may
078know, the Agent Orange toxic exposure list was expanded um and added HARP. So they went back and reviewed files and this gentleman had filed previously for a heart condition served in country in Vietnam. Um and they gave him an initial retro payment of 32,700. However, we did not feel like that was sufficient enough because it went back to 2002 and from 2002 to 2025, his heart condition had sub substantially de decreased, increased um gotten worse. Um, so we provided medical evidence to show that it had substantially gotten worse and therefore he was awarded a supplemental claim. And so the total award was $537,072. That's awesome. I have a question on the expansion on the agent orange, but I can ask it afterwards. I didn't know if the expansion included any of the descendants. It did
079not. It was just crazy. >> Thank you. >> Do you have anything else there? >> A motion to the certificate. >> Motion to adjurnn. >> Second. All those in favor?