Grand Forks Public Health Department


Thursday, April 19, 2012

I. Call Meeting to Order

The meeting was called to order at 12:18 p.m. by Don Shields.

Members present at the meeting: Corey Mock, Brenda Severson, Kate Kenna, Terry Hanson, John Packett, Jon Green, Tara Dupper, Gretchen Graf, Col. Jane Denton, Lynette Flage, Dr. James Hargreaves, Mark Lambrecht, and Don Shields. Other individuals attending the meeting: Dave Molmen (CEO, Altru), Clint Urvand (University of ND senior student interning at Public Health), and Keith Westerfield (Public Health).

II. Old Business

A. Review and Approval of Minutes of the January 19, 2012, Meeting: The January meeting minutes were motioned and approved with no changes.

B. Grand Forks “Detox” Community Facility Initiative Update: Kate Kenna gave an update.

· Kate had contacted a few places to see if anyone was interested in providing social detox for Grand Forks, ND. She contacted Glenmore, a program that provides detox for Minnesota. They were interested in meeting with the detox group because Glenmore would have the capacity to do it. It would cost about $500 per person, per day, but the detox group thought they would need a better deal than that.

· Kate also talked to Centre, Inc. They do the detox program in Fargo, ND. Northeast Human Service Center (NEHSC) contracts with Centre, Inc. to provide housing for people in the NEHSC Addiction Program, and also for people with mental illness that are in-between the state hospital and independence. Centre, Inc. does not have a program up and running in Grand Forks, ND.

· Using Douglas Place in East Grand Forks, MN, is currently on hold. The detox committee was close to contracting them since they provide social detox services for Polk County, MN. Douglas Place recently had some programming and administrative changes, so they are not going to be able to provide their services at this time.

· The primary reason of not finding a place that offers social detox is because it is a specialized service and somewhat risky. It is important that if something goes wrong with the people who are detoxing, that they would have access to a hospital. The detox group is looking for more than just a place for a person to sleep it off. The group wants the detox to be an intervention where they can let the person know that there are programs out there to help them. The group wants to move them in the right direction by having a facility that is comfortable and safe, not just a drunk tank.

· Centre, Inc. could walk right in and provide a service similar to what they do in Fargo, if there was a place for them to do it. They have the expertise to do the job. Glenmore also has the expertise, but there are 25 miles between them and Grand Forks. The old jail was looked at, but it would have required very extensive renovation to meet code due to air, electrical, and sprinkler issues. It was determined that it would just be too cost-prohibited to use the old jail facility.

C. Alliance for Healthcare Access (AHA) Update: Cory Mock gave the latest update on the Community Health Center (CHC).

· The reason the AHA is moving forward with the CHC is because 20 percent of the community lives in poverty, with half classified as low-income. Whether a person is insured, uninsured, under-insured, on Medicaid, or not eligible for Medicaid, there is an access problem. It is a challenge, but the Third Street Clinic and Altru cannot serve everybody. There is still a large number of people who go to the emergency room for non-emergency needs. There is a better way we can deliver care in this community. That is why the Alliance came together.

· The Alliance received a planning grant. Plus they have received two grants from the United Way. The Alliance just received an additional grant for $14,400 for this year that will help fund their coordinator’s position through 2012. This will keep their work moving forward until they find out whether or not Grand Forks will be awarded a federal grant to create a new access point in the community with a CHC.

· The CHC facility would be managed and operated by Valley Community Health that is out of Larimore and Northwood, ND. They currently oversee a health clinic in each of those communities, and a dental clinic in Grand Forks.

· Check out the Alliance’s new website at for information on what a CHC is, and what they do all across the country. Sign-up on the website for a presentation to keep your agency informed by the AHA coordinator, Mara Jiran from Public Health at 701-787-8100. Mara J. will also be giving a presentation at the next Mayor’s Cabinet meeting in July 2012.

· The Alliance is applying for a $650,000 grant for a new access point in Grand Forks. The application will be turned in this summer, and they should find out sometime early in 2013 on whether or not they will receive the grant.

III. New Business

A. Presentation - Altru Health System Update: Dave Molmen, Altru CEO, gave an update of the Altru Health System and shared information on Altru’s future planning.

· Dave was excited and proud of what is going on in the community, and glad that Altru can participate in the success that is happening in this community. He sees some challenges the community is facing and that we need to work together to address some of those challenges. Dave wanted to share some of Altru’s successes, but also successes yet to be.

· Altru has been working hard on access to care for the last four to five years, and it is finally bearing fruit. Grand Forks is not unique among communities with problems of access to care. There are problems for members of the community accessing the services they want and when they want or need them. There are also populations within the community that have additional access barriers that they experience. It is one of the greatest frustrations that our population in the community has had in the past. Altru has been working on many things related to helping solve these issues. Their idea is that if someone wanted or needed services, Altru wants to provide it today.

· It used to be normal that everyone may not get in as soon as they would like, but eventually everybody would be worked in. Dave does not believe in that. He thinks if you are not able to service people when they want it, people tend to either go without services or go elsewhere. That is not good for anybody when that happens. It is not good to have a line of people waiting for a service, because things can happen while waiting. People could get sick while waiting, or people could get better and no longer need your services.

· Managing a waiting line uses resources. One thing that can be done to address this line is to build services. Altru started putting this into high gear four to five years ago. It takes a long time to get the flywheel turning, but once it does, the results start showing. They have been aided by their relationship with the Mayo Clinic. It has helped considerably with recruiting physicians since 2011 for Altru, adding 40 new physicians by the end of 2012.

· Altru is concentrating on deepening and broadening the services they currently have. There are many persistent shortages in basic services that people access in the community, such as Gastroenterology services. Altru has one, but they know there is a need for four or five. Neonatal care is a service that was not in our community a few years ago. Now Altru has three neonatologists, and they have a neonatal intensive care unit that is staffed 24 hours a day, 365 days a year. The result is they are able to take care of babies that are born at an earlier age than they previously were able to. That is important to the families of those babies so they do not have to go elsewhere in the country for care and they can be close to their family support system. If a family has to live in another community for a period of time, or one parent has to stay home to earn a living, it could be a difficult situation for those families. It can cause great economical and emotional stress. These are the areas that Altru has been working on.

· Addressing this problem takes more than a supply of providers though. It involves other kinds of work in the community. One initiative that many have been involved in is trying to provide services that did not have easy access before. Working with agencies in the community such as Third Street Clinic and other social agencies is very important in solving this problem. A significant group in the community has been working on the development of a community health center. This is a big deal to Altru. It would be a service that can provide a medical home for
folks that do not have one, or do not have the on-going support of services and they fall through the cracks. They may not be poor enough for medical assistance, but also not able to afford insurance. There are a lot of people in a pretty healthy community like ours that are not able to get the services they need or know where to get these services, so our working together is very important.

· Another big piece to solving the access problem is trying to reduce the disease burden in the community. Medical care is not the answer to all the health problems we have in the community. A considerable amount of the disease burden in North Dakota and Minnesota relates more to behavioral and other factors than it does to the presence or absence of health care social services. To change some of those problems, Altru is getting involved in grassroots projects, such as what the Y is doing to bring people in for a healthier lifestyle, or with the Park District creating a new facility there. These are long-term investments that do not have direct dollars that come in to support them.

· As a community, the requirements for medical care are going to be increasing rapidly over the next decade. This is driven mostly because of the demographics of the state and not the population. We are fortunate to have a healthy and growing senior group in our part of the country that is going to continue to grow. ND has the second-highest group of 85 years of age and older in the country, so we have to prepare and gear up for additional services in the future.

· Altru’s long-range Master Site Facility Plan was finished last year. It showed that there needed to be a considerable expansion and renovation of facilities. Many of Altru’s facilities in Grand Forks would need to be replaced in the next decade or two. Much has changed since the facilities were built in the mid-1970s. Surgeries used to be in-patient, but now are out-patient and minimally invasive. Much larger surgical suites are needed now due to more technology and imagery equipment, and personnel needed in the rooms than in earlier years. Semi-private rooms were state-of-the-art then, compared to wards in other hospitals. Expectations are different now. There are challenges that impact the patient’s care related to not having a private room. Noise makes patients at Altru dissatisfied; for example, noise from roommates getting their care, watching television, etc.

· Altru plans to use the newly acquired Doctor’s Hospital facility in a slightly different way. They believe it will help them address and solve a number of issues; namely Altru’s aging infrastructures. Although Altru’s facilities have been lovingly maintained, there are increasing costs as time goes on, relative to the cost of building new facilities. Even patients expectations of their experience in a building have changed. These days they concentrate on trying to create an environment that is light, inspiring, and calming. Patients coming to a medical facility are usually stressed and tense, which affects their healing.

· Altru developed their master plan, and came up with a great approach where they can renovate and build some additional expansion to the west of current facilities. It would not require them to demolish anything they currently have, and would allow Altru to build piece by piece at a rate as they could afford it. Once it was all built, then they would probably be ready to take down some of the facilities that are here right now. The new campus would emerge over a period of time, directly to the west of where the current buildings are. This will allow Altru to offer better parking and better access in the future.

· The problem is that this growth is starting to happen now, with the success of recruiting physicians and the building of new programs. The facility at the south end of town will give another point of access to patients. It will give more space for physicians, and create a better environment for patients. It will give patients more choices of providers and services.

B. Member Update:

· Lynette F. – The Grand Forks County NDSU Extension Office has been telling people to be cautious out in the sun and “Be Sun Savvy.” Lynette gave out bookmarks as a reminder (see attachment).

· Col. Jane D. – The 319th Medical Group has grown since the last meeting by 200 to 300 active duty and their families. They are expecting 600 to 700 total due to the Global Hawk buildup at the base.

· Gretchen G. – Don S. thanked Gretchen for her editorial regarding her serving as pastor for the First Presbyterian Church for more than 18 years. The editorial was printed in the Grand Forks Herald newspaper on April 18, 2012.

· Tara D. – The New American Services (NAS) office will have their 90th refugee arrive next week, which will put them at their fiscal year target goal. One of the best parts of their job is family unification. A little seven year old girl will also be arriving, who has not seen her mother for years.

· Terry H. – The Housing Authority is still keeping about 2,000 families from being homeless since there is a 20.4 percent poverty level in Grand Forks, according to latest American Community Survey.

· Kate K. – Northeast Human Service Center has an exciting new program for children, called TIP; Transition for Independence Program. This program is for children ages 16 to 24 who need a little extra case management support and encouragement to be able to live independent. It is also for children with mental health or suicidal issues. A staff member will help them with their housing and educational plans. This program is offered at no cost. They currently have four enrolled in the program, with room for ten total.

· Brenda S. – The Red River Valley Community Action (RRVCA) agency has received extra funding. They have seen an increase of people from out-of-state looking for jobs. They are still seeing families from the American Crystal plant lockout. There is still a lot of homelessness that the RRVCA is helping with.

· Cory M. – Cory thanked Col. Denton and everyone at the Grand Forks Air Force Base (AFB). When there were tornados over Kansas and Nebraska last week, many of the tankers returned to our base. Col. Denton stated that starting last Friday night, Offutt AFB in Nebraska brought eight RC-135 tankers. McConnell AFB, Kansas, followed with 16 KC-135 tankers Saturday morning. The base received 100 personnel and 24 aircraft within a 24-hour period. At one point an aircraft was landing every 15 minutes. The downtown hotels were wonderful since the base did not have the capacity to house the personnel at such short notice.

Corey stated that the pilots and navigators had nothing but good things to say about their experience in Grand Forks. They said it was the nicest place, they were treated well, the people were so friendly, they had a great experience, and the hospitality was second-to-none.

* April is Donate Life Month. There is a significant need for organ donors.

IV. Other: None

V. Adjournment – The meeting was adjourned at 1:18 p.m.

VI. Next Meeting: Thursday, July 19, 2012, at 12:00 noon,
Altru Hospital (Lower level, Multi-media room) Conference Room
(Lunch will be provided by Altru Health System).

1. Be Sun Savvy! bookmark