Grand Forks Public Health Department


Thursday, October 11, 2012

I. Call Meeting to Order

The Grand Forks Board of Health met at 4:20 p.m. on Thursday, October 11, 2012, at the Public Health Department conference room. Members that were present for this meeting: Cynthia Pic, Don Shields, Dr. Sally Pyle, Dana Sande, Dr. James Hargreaves, and Dr. James O’Connell. Others present: Debbie Swanson, Javin Bedard, Aly Barclay, Haley Thorson, and Keith Westerfield (all from Public Health). Also in attendance was Mackenzie Schommoer (nursing student from the University of North Dakota).

II. Approval of Minutes of Regular Meeting on May 10, 2011.

A motion was made and seconded to approve the May 2012 minutes as submitted. All approved and the motion passed.

III. Old Business

A. Alliance for Healthcare Access (AHA) Update: Debbie S. briefed on the latest AHA update,
and handed out the Greater Grand Forks Community Health Needs Assessment Final Report (see attachment):

· The Alliance was formed a couple years ago to improve health care access in our community, with the overall goal of establishing a Community Health Center (CHC) in Grand Forks.

· The Alliance held a Technical Assistance training session on September 19, 2012. Board of Health Chairperson, Cynthia Pic was in attendance to learn about CHCs. In the evening there was a speaker from the National Association of CHC in Washington D.C. The Alliance also had a Legislative Forum in the evening where they informed legislators about the plans for a CHC in Grand Forks.

· Much has been accomplished in the past year since the Alliance had received the Planning Grant. The group did a Community Health Needs Assessment to learn a little more on health care access issues in Grand Forks. The report is available at

· The Alliance has developed a budget. They have a $300,000 commitment for community development block grant funding to build the health center if successful with the federal application. The funding opportunity announcement will be sometime in late November or early December 2012. The Alliance’s Planning Grant will end in December, and the personnel hired for the program will be finishing up their work with the budget.

A. Environmental Health Data Management System Update: Javin B. briefed on the update:

· Environmental Health purchased a data management system called ‘Digital Health Department’ from Garrison Management Company last year. Since the first of July, all the inspectors have been entering their inspections. They are beginning to use SamSung Galaxy Tablets to enter inspections in the field.

· Environmental Health will begin working on a website that the public can access to look up the latest inspection information on their favorite restaurants. The first step is a survey questionnaire, as to what information from the inspections to make available on the public site. The website will link directly into their new data system, and get the most current information. The current public health website shows food establishment’s critical and non-critical violations. The new public website could include as much or as little information from the inspections as

wanted, such as: inspector’s comments, item codes, or the entire form. Fargo’s public health is utilizing the same data system, and their website lists what the code violations were, but not the inspector’s comments nor the entire form. Inspections of public schools and institutional places may also be included, like the restaurants. The Board discussed the website, and recommended including the entire inspection form and comments for the public.

· Environmental Health offers food safety training by hosting ServSafe courses from the National Restaurant Association. The ServSafe course is offered twice a year, and is now a requirement that at least the restaurant manager or owner complete the training, according to the new City Food Code. Inspectors also provide some training during the review with the establishment’s manager of any code violations, so the managers know what they need to do to be in compliance.

C. CHAMP Software Update: Debbie S. provided the following update:

· The Grand Forks Public Health Department (GFPHD) Nursing and Nutrition Branch is using the Champ software, which is public health and home health specific. GFPHD went live this summer with the new software, and since the first of August have entered 508 clients into the system. Immunization clients are not being entered into the Champ system yet. A couple of the programs use specific forms, such as Women’s Way and Care Coordination have not gone live yet either.

· The program is being used with home visits and Health Tracks program. Since the system is mobile, nurses can enter information on their patients at remote locations using i-Pads.

· The new Champ system is working out well, and it will improve efficiency and the quality of care tremendously because the digital record will be more accessible than a hard-copy chart.

IV. New Business

B. Public Health Staffing Changes: Don S. briefed on the latest changes at GFPHD. There has been quite a few staffing changes since the last time the board met:

· Javin B. is the new Environmental Health Supervisor, who replaced Timothy Haak. Aly B. is the new Administrative Supervisor, replacing Marlene Johnson. Brenda Bergman Veitz went from being the Regional Environmental Health Specialist to Environmental Health Specialist for the city/county. Pierre Freeman was hired for the regional job, and started this month. Tristi Reller, who worked at Housing Authority, started last month to fill Aly’s previous position of Administrative Specialist.

· Public Health Nurse Team Leader, Joni Tweeten took a job at UND, College of Nursing; Nancy Compton was promoted to the team leader position. GFPHD is still working on filling Nancy’s home visiting nursing position.

C. Smoke-Free ND Resolution: Haley T. briefed on the resolution (see attachment).

· The Grand Forks Board of Health passed a resolution back in 2008, supporting the work of the GFPHD and the Grand Forks Tobacco-Free Coalition, to strengthen the ordinance in the city to protect people from the dangers of second-hand smoke.

· There are folks gathering across the state in a coalition called, Smoke-Free North Dakota. This coalition is asking for support again from the local boards of health, in momentum of the November 6, 2012 vote for a comprehensive smoke-free law in the state. There are now 37 organizations across the state, supporting the proposed smoke-free law.

· The proposed smoke-free law is a comprehensive smoke-free law, and is a little stronger than the law in Grand Forks. The way the Century Code is written, the city cannot have a law weaker than the state law. State law would supersede local ordinance.

· The resolution is in support of comprehensive smoke-free laws. The main idea of the resolution is that the local board of health recognizes that second-hand smoke is hazardous to one’s health, and the only way to protect people from that is provide comprehensive smoke-free policies. Currently, only 11 communities in North Dakota have comprehensive smoke-free laws.

· Dr. Eric Johnson’s Impact Study was done in Grand Forks, ND, and mirrors about 17 other studies done across the nation. The local study done four months prior to the ordinance, and four months post-ordinance shows heart attack rates decreased by 30.6 percent after the ordinance was enacted.

· Use of electronic cigarettes (e-cigarettes) is one of the additions to the comprehensive law. Because e-cigarettes have not been evaluated by the FDA, they cannot be promoted as cessation devices. It also creates a negative social norm, which is one of the easiest ways kids can develop a habit, by seeing them used. E-cigarettes are marketed to mimic an actual lit cigarette, which is one of the concerns the CDC has about promoting them as a cessation device. Also, since e-cigarettes have not been approved by the FDA, these cigarettes are not able to be regulated as real ones are. Some businesses are adopting internal policies concerning the use of these devices. It is more about changing the social norm than enforcement.

· It was motioned that the Grand Forks Board of Health support the Smoke-Free ND Resolution. All approved and the motion carried. Board members then signed the resolution (see attachment).

D. ND 2013 Legislature Issues: Don S. briefed on the latest issues (see Issue Listing, and
Legislative Issues Affecting ND Public Health attachments). Four items proposed by the ND Department of Health:

· The first item is an increase of $1.5 million for local public health state aid. This would be used locally to reduce the pressure on the city/county general fund. Currently $3 million is given to all public health units across ND. The increase would mean $35,000 per year additional revenue for Grand Forks, used to subsidize what public health does. The Board of Health recommended supporting this initiative.

· The second item is to increase Universal Immunizations by $1.1 million. There has been a reduction in federal 317 funds, and there are a number of local health departments in ND that use the universal vaccine monies. Grand Forks, Fargo, and five other cities do not use the universal vaccine though, because they have high insurance levels. GFPHD chose not to participate using the universal immunizations because the public has good access to immunizations and physicians.

Starting the first of October, there were additional 317-funded vaccines for adults; pneumococcal, tetanus, and TDaP. By public health departments not participating, there is more money available for the people who do not have money for these vaccines. Public Health will continue to monitor this initiative.

· The third item is $4 million for Regional Networks, which is an interesting program that Pubic Health recommend be monitored. In 2009, the legislature provided $275,000 for a pilot test, but did not provide any money for it in 2011. It was referred to an interim legislative committee for study, and they are now drafting a bill for continuation of this program for $4 million (based on six dollars per capita).

· The fourth and last item proposed is $3.6 million for oil impact; $2.4 million to increase state Environmental Health staffing, and about $1.2 million dollars spread out between Minot, Dickinson, and Williston to help out the local public health units with some of the oil impact and demands in the western part of ND. Public Health recommends monitoring this initiative also.

E. Mosquito Control 2012 Seasonal Update and West Nile Virus: Don S. briefed on the
Mosquito Control season (see attachment) for Todd Hanson, who is on a well-deserved vacation after a successful, mostly mosquito-free season.

· There were only two cases of West Nile Virus (WNV) in Grand Forks County; one in Larimore, ND, and one in Grand Forks, ND (see attachment).

· Mosquito Control has not found a positive pool of WNV-carrying mosquitos in the city this year. Mosquitos are caught and tested to see if there is any WNV disease present in them, and then Mosquito Control staff would treat the area where those mosquitos were found. The type of mosquito that carries WNV does not like wet conditions.

· Todd has saved $170,000 by not having to do city-wide treatment spraying in the city.

V. Next Regular Scheduled Meeting – 4:15 p.m., Thursday, January 10, 2013 at the Public Health conference room.

VI. Other: Don S. mentioned as a follow-up from the last board meeting on accreditation for GFPHD, that Altru has a community group coming together with their first meeting on
November 1, 2012. The agencies will put together a Community Needs Assessment. The outcome of that assessment will be a Community Health Improvement Plan, focused on priorities to address in the community.

VII. Adjournment: The meeting ended at 5:15 p.m.

1. Greater Grand Forks Community Health Needs Assessment Final Report
2. Smoke-Free ND Resolution, Signed October 11, 2012
3. Issues Listing
4. Legislative Issues Affecting ND Public Health Handout
5. Mosquito Control Activity Report
6. West Nile Virus Activity Report

Respectfully submitted,

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