Grand Forks Public Health Department

Thursday, January 8, 2009

I. Call Meeting to Order

The Grand Forks Board of Health meeting was called to order at 4:20 p.m. on Thursday, January 12, 2009, at the Public Health Department conference room. Arvin Kvasager (Honorary Chairperson) called the meeting to order. Members present: Don Shields, Mike McNamara, Dr. James Hargreaves, and Cynthia Pic. Others present: Debbie Swanson, Haley Thorson, Theresa Knox, Myron Larson, Mrs. Kvasager, and Keith Westerfield.

- Prior to the start of the meeting, Arvin Kvasager was thanked by the Board, and presented a plaque by Dr. Hargreaves for his 26-year service on the Board of Health committee, which started back when the city and county first combined to make one city/county Health Department (see attached photo). Arvin described the board as “A well-led bunch of dedicated health professionals.”

- Don S. welcomed the board’s new member, Cynthia Pic (County Commissioner).

II. Approval of Minutes of Regular Meeting, October 9, 2008

A motion was made and seconded to approve the October minutes as submitted. All approved and the motion passed.

III. Old Business

A. ND Immunization Update: Debbie S. briefed the members on the significant changes to the administration of our immunization program during the past year. This has created additional administrative burden such as creating new forms and billing private insurance, but the staff rose to the challenge.

- The changes have made it difficult to provide some of our off-site services that we did before because of registration requirements and the need to have insurance information each time we give a vaccine.

- We did receive some upfront funding from the ND Department of Health, however we are subsidizing the immunization program with local tax dollars.

- There is still $700,000 that was allocated in House Bill 1435. The PROtect ND Kids Advisory Committee is looking at how they may be able to utilize some of that remaining funding to help health departments with the additional administrative costs and billing.

- We are current with all of our payments from Blue Cross/Blue Shield of ND. UND has paid claims for member liable and other insurance claims except for the last three months. UND is requesting that we enter into an agreement to accept TriCare military insurance.

- This new implementation has created a need for an integrated software program. We currently have one program for billing, another program for data entry, and another for patient registration, but none of them are integrated with one another. Hopefully, some of the $700,000 allocation will be able to be used for software to make this a smoother process.

- Sen. Judy Lee has expressed an interest in submitting a bill to the ND legislature this year, to support immunization funding for state supplied vaccine.

- A discussion followed this briefing.

Board of Health Minutes
January 8, 2009
Page 2

B. ND Ballot Measure 3, Comprehensive Tobacco Prevention and Cessation: Haley T. gave handouts and briefed on the ND Tobacco Prevention and Control Advisory Committee (see attachments).

- The voting in Grand Forks county passing ND Ballot Measure 3, was at 57% in favor, which was about the same state-wide, at 54%. This measure ensures that bonus payments from the cigarette companies’ settlement will be allocated to the state’s tobacco prevention program, to bring its funding up to the CDC recommended level. The first payment received into the Tobacco Prevention and Control Trust Fund will be after April 15, 2009.

- The governor has chosen the members of the ND Tobacco Prevention and Control Advisory Committee, which they had their first meeting on 8 January 2009. They will also be meeting with the ND Department of Health. The Committee has 180 days after their first meeting to develop the CDC-based plan.

IV. New Business

A. Retired County Commissioner Arvin Ksvager Outstanding Board of Health Service: see above.

B. Nuisance Control Program and Performance Measure/Metric: Mac L. briefed on Grand Forks County nuisance complaint procedures.

- The benchmark goal in Environmental Health (EH), when they get a complaint, is to respond to the issue within 24 hours.
-- EH will go out to verify that the complaint is legitimate, send out a notice of violation the same day, give the owners enough time to correct the complaint (48 hours minimum), then recheck to see if the complaint has been taken care of (long grass/weeds is the #1 complaint—not mowed, too tall, etc.). EH will check around the area of complaint also for other owners not in compliance.
-- If the complaint has not been taken care of:
--- for grass: EH will order it mowed (and bill the landowner).
--- for junk cars: a certified letter will be sent. If still not taken care of EH will have it towed.
--- for junk in yards: a certified letter will be sent. If still not taken care of, EH may take that complaint to the court (only a few each year, but they work with police, fire, or relatives to try to resolve it first).

- The Target benchmark is to have 100% investigated within 24 hours, and 90% Resolved within 30 days (see attachment)—EH did 100% for both in 2008.

C. Grand Forks Public Health 2009 Budget Update: Don S. passed out handouts and went over some budget items (see attachments).

- The budget that was approved by the County Commission and the City of Grand Forks was $3.1M for the Public Health Department.
-- Out of that amount: $1M is the City/County General Fund portion; Grants and Revenues makes up the largest portion at 41% ($1.2M), and Mosquito Control, with $780,000 (25%).
-- From the City & County General Fund, 94% is for Salary and Benefits (Health Care Services).

D. ND 2009 Legislative Priorities Update: Don S. reviewed items on the Issues Listing concerning Governor’s budget (see attachment).

- For the Community Health Grant programs, in the Governor’s budget, he put in $18M as a placeholder
for the Measure 3 money.

Board of Health Minutes
January 8, 2009
Page 3

- Don S. briefed on a few bills coming through the Legislature and being discussed:
-- Additional funding for the Community Dental clinic in Grand Forks (also in Bismarck and Fargo).
-- Increase state aid to support immunizations, home visits to elderly and children, emergency readiness,
and environmental health. The local public health departments in ND will be providing testimony to
the Senate Appropriations Committee on June 20th, 2009, when the state Health department’s budget
is being heard. The Board of Health voted to send a letter of support (see attached letter to Senator
Holmberg), requesting an increase in state aid.

- Grand Forks hosted Emergency Readiness Pandemic Flu Preparedness seminar on December 10, 2008, for local businesses. This was just published in the January/February 2009 issue of Homeland Security News (see attached article).

V. Next Regularly Scheduled Meeting4:15 p.m., Thursday, April 9, 2009, at Public Health conference room.

VI. Other:
- Cynthia P. noted that with the mobile unit ready in month or so, federal transit teams could be bringing in more federal prisoners to the correctional facility (and an increase in public health nursing hours there).

- Don S. congratulated Debbie Swanson on receiving the ND Public Health Worker of the Year award. This is the third consecutive year that someone from Grand Forks Public Health has received that award.
(last year’s winner was Theresa Knox, and prior to that, Carrie Kaltenberg).

VII. Adjournment – A motion was made and seconded to adjourn the meeting. The meeting adjourned at
5:05 p.m.

Respectfully submitted,

James Hargreaves, MD, Secretary
by: Keith Westerfield
Office Specialist, Senior
Public Health Department

Attachments: - Arvin Ksvager photo
- Issue Listing (Budget Update & Nuisance Investigation Procedure)
- Nuisance Complaints slide
- ND Ballot Measure 3 Update & ND Tobacco Prevention and Control Advisory Committee handout
- 2009 Health Department Budget slides
- Issue Listing (ND Public Health 2009 Legislative Priorities Update)
- Senator Holmberg letter, 9 January 2009
- Homeland Security News, Jan/Feb 2009