Grand Forks Public Health Department


Thursday, October 14, 2010

I. Call Meeting to Order

The Grand Forks Board of Health meeting was called to order at 4:15 p.m. on Thursday, October 14, 2010, at the Public Health Department conference room. Members that were present: Don Shields, Judy DeMers, Cynthia Pic, and Dana Sande. Others present: Theresa Knox, Haley Thorson, Kathy Dunn, Todd Hanson, Tim Haak, and Keith Westerfield.

II. Approval of Minutes of Regular Meeting, July 8, 2010

A motion was made and seconded to approve the July 2010 minutes as submitted. All approved and the motion passed.

III. Old Business

A. Fall Flu Shot Update (school/community clinics): Kathy D. gave an update on Public
Health’s upcoming school influenza clinics.

· It is a giant undertaking that Public Health has agreed to do this year. The State Health Department is funding to provide vaccinations for all school-age children in North Dakota, grades K-12. Public Health is looking at providing vaccination to 50% of the 8,500 school children in Grand Forks, but more vaccine would be available from the state if needed. This will require an enormous amount of work and manpower from Public Health. As a result of this, other flu items we have done previously have had to be cut back on.

· The schools have been a great partner for us, giving us their full support. Public Health put together 8,500 packets for each child to take home in order to have the opportunity to be vaccinated. The schools helped out by sending them with the child or mailing them out. We are currently making the schedule out for the school clinics, and are anticipating getting about 1,000 more doses of vaccine to have our full compliment. The deal with the schools was that Public Health would wait until we received all the doses, so that we can start with one school and just continue until finished with all the schools. The goal is that parents would be less likely to be upset that their school was not first.

· Nurses are currently screening the school forms returned, which is taking a little longer than anticipated, but will help to move the process more quickly when at the schools. From timing students last year during the H1N1 vaccinations, we anticipate doing about 150 vaccinations an hour at the Junior High, Middle, and Senior High schools, and 100 vaccinations an hour at the elementary schools. This process will take a minimum of four nurses from the health department. We are targeting school children because they are the ones that get the flu, and also they are the transmitters.

· A shortage of vaccine is not expected this year, and one of the components of the vaccine this year is H1N1. Every student who wants a flu shot will be able to get one. There are also other ways to get vaccinated besides the school program, and one way is through the parent’s health care provider. The state is providing the vaccine, but the Health Department has a $13.90 administrative fee. If the child has health insurance or medical assistance, we will ask those two agencies to pay the fee. If the child does not have any insurance, we will not ask for a payment.
· The parents choose if the child gets an influenza shot or the FluMist.

· Public Health will hold five county sites, and will combine the school clinics and the Healthy Community Clinics on the same day when they go out into the community.

· The Public Health Department has done two clinics after receiving only a couple small shipments: a City and County employee clinic, and the first community clinic which was held in the County Building. Other clinics planned: November 2nd at Schroeder and Valley Middle Schools, and December 5th for a ‘Drive-Thru’ clinic at Public Works with a cooperative effort with the Public Works Department, and is being held during “National Influenza Immunization Week.”

B. Tobacco Ordinance Implementations August 15th Update: Theresa K. and Haley T. gave the update briefing.

· Public Health collaborated with the Mayor’s office, Convention and Visitor’s Bureau, and the Chamber of Commerce to begin informing local businesses of the resources that were available to them at Public Health to assist in the transition. The Mayor’s office did a direct mailing to introduce Public Health, and what resources we had to offer. The Convention and Visitor’s Bureau, and the Chamber of Commerce did newsletter articles and gave up-to-date information on what Public Health had available at that time, and what would be available in the future.

· We are beginning to see more municipalities in North Dakota that are adopting ordinances, but they are finding that Convention and Visitor’s Bureau, and the Chamber of Commerce in their communities are not as willing to work with Public Health because of the strong business aspects of those agencies. Grand Forks Public Health was very fortunate when our agencies decided to help with the transition. By working with us, they were truly helping business owners by getting them connected with resources.

· Public Health offered signage to post at local businesses; both pre-implementation and post-implementation of the ordinance. This was to get customers acclimated to what would be happening on August 15, 2010.

· Public Health provided public education, using both traditional and social media, such as Facebook. Grand Forks Public Health’s Facebook page had over 1,800 new members join in seven days, which was a great avenue to get information out, both prior to the ordinance and after.

· There was a lot of good, positive media coverage, and a digital billboard was utilized with a countdown to the ordinance effective date. Business owners in the community took advantage of this by having celebratory events in their venue, to help their patrons get acclimated to a smoke-free environment. The transition has gone smoothly.

· Haley T. thanked the Board of Health that earlier had signed a resolution supporting the smoke-free ordinance, which was the first initial step in getting the community started working towards a smoke-free work environment. They appreciated support in the past, and would ask if the Board of Health would be interested in sending a letter to the editor. This letter would thank the City Council for adopting the policy that protects the health of the citizens of Grand Forks and those that visit here. It would also express our appreciation to business owners that are taking advantage of the opportunity and creating a positive atmosphere. The Board of Health members approved to send a letter to the Editor of the Grand Forks Herald.

· Haley handed out copies the National Association of Local Boards of Health (NALBOH) NewsBrief magazine (see attached). She pointed out an article titled, “Aligning Tobacco Control Efforts at the Local Level with State and National Movements,” and how the Board of Health can be involved in the alignment of those efforts to facilitate that movement. Haley also included a copy of the State Tobacco Control Plan (see attached), because the article asked if your Board of Health has reviewed this document.

IV. New Business

A. Welcome Dana Sande, new City Council Representative Appointment: Judy D. introduced and welcomed Dana S. who was recently appointed to represent the City Council, as the new member to the Board of Health. Don S. had the Public Health employees attending the meeting introduce themselves.

B. Election of Chairperson and Vice Chairperson:

· Cynthia P. expressed interest in the Chairperson’s position, Don S. nominated her, Dana S. seconded the nomination, and all approved election of Cynthia P. for Chairperson (one-year term).

· Dana S. expressed interest in the Vice Chairperson’s position, Don S. nominated him, Cynthia P. seconded the nomination, and all approved election of Dana S. for Vice Chairperson (one-year term).

· Judy D. congratulated the newly elected officials. Judy said she enjoyed all her years as the past Chairperson, and that she has been committed to Public Health since her first job as a Public Health nurse in the District of Columbia. Her other positions were as a Public Health nurse in Minneapolis, MN, and she taught Public Health nursing before she went over to the medical school at the University of North Dakota.

C. Mosquito Control Seasonal Update: Todd Hanson gave a briefing on the season.

· The season started early, in May, with wet ground and temperatures in the 80’s and 90’s. They are still spraying, in October, in high traffic areas, such as the golf course, bike trails, football fields. They have done 18 city-wide mosquito sprayings this season.

· No West Nile Virus (WNV) cases have been identified in Grand Forks County this year. They did test for Culex mosquitoes, which are the carriers of WNV, with all mosquitoes testing negative. North Dakota had eight human cases of WNV this year. Although it has been declining in the country, this area is more prone to WNV due to our species of mosquitoes which are more efficient at transmitting the disease.

· The U.S. Air Force Reserve Spray Team from Youngstown, OH, was scheduled to do aerial spraying of Grand Forks twice, but had to cancel both times because of bad weather.

· Dana S.’s mother was part of the foundation of the mosquito program, back in the 90’s, being on the committee to take the vote to the people in 1996. The vote was 91.8% to have a nuisance-control program for mosquito control. Todd H. said that they had a good year, and are fortunate to have the support of the community, which is what makes it work.

· Don S. said that Todd and his crew are doing an outstanding job. It has been an expensive year for Todd, who has burned through most of the $800,000-a-year program budget for nuisance and disease control. With the education to protect yourself and all the mosquito control programs in the communities of North Dakota, the number of WNV have gone down, and we do not know how many cases have been prevented. Don S. knows Public Health colleagues in other communities that had WNV. It took them eight to nine months to recover enough to work a full day, and their expenses were over $50,000.

· Why do a city-wide spray when the mosquito count is low? Todd said they are looking at the species. There could be a low count, but a high percentage of Culex mosquitoes, and to be proactive they still have to spray, especially if they identify positive pools of mosquitoes. Construction started this month on a laboratory, with unique equipment that cannot be found elsewhere in the region. With this lab, Todd will be able to tell within 24 hours whether a pool of mosquitoes has WNV in it, and not have to wait a month or two to get a report from a reference lab.

D. Valley Community Health Centers Dental Clinic Open House for Policy Makers:
Debbie Swanson is currently attending the Dental Clinic Open House this evening.

· The dental clinic has served over 1,400 children, plus adults, and served people not just from Grand Forks, but also surrounding communities. They are maxed out with more patients than they can handle, but dentists in Grand Forks are glad they are doing it.

· They currently now have two dentists, and use a sliding fee scale for payment. The clinic would have more stability if they had legislated state funding.

· They also accept Medicaid patients. In Polk County, prior to this facility being available, the closest clinic accepting clients on Medicaid was a five-hour drive away. Only a few dentists in Grand Forks currently see patients on Medicaid, such as Dr. Clayburgh and Dr. O’Connell, who were at the forefront of the planning stage for the community dental clinic.

E. Health Care Access Meeting, and Potential Grand Forks Community Health Center:
Don S. briefed on the Community Health Center.

· One of the top six issues, from the United Way’s 2010 Community Needs Assessment was the lack of affordable health care, and access to health care in Grand Forks. It had 66% of providers, and 32% of residents flag that as an issue.

· A meeting was held at the Alerus Center on September 24, 2010, with over 20 community leaders, from health care and human service agencies. It lasted for two hours, but they want to continue meeting because there are a number of issues to still discuss, like funding constraints, and health care access. A meeting is scheduled for December 1, 2010, 9:00 a.m. at Bremer Bank to continue this dialog. A number of community leaders, such as Altru Hospital, Third Street Clinic, and Valley Health are interested in trying to make a difference.

F. North Dakota Public Health 2011 State Legislative Issues Update: Don S. briefed on
Legislative Issues, and a folder of material was given out (see attached).

· One of the issues coming up in the State Legislature is a need to increase state aid. North Dakota is one of the states that put a lot less into support of local public health units. In other states, the national average is 20%, but in North Dakota it is 9%. Because of this, in terms of chronic disease; whether it be physical activity or healthy environments, we do not get sufficient funding. In terms of family health; home visits, childhood issues, and parenting skills, in other states you may see a high level of funding. Part of the state aid increase would help in these areas. There will probably be an initiative at the state level to put in some grants for school nursing programs.

· Tim H. commented on Environmental Health programs that the Local Health Services State Aid helps support. The North-East region of the state, the local public health units do not provide environmental health services, so state funding is very important. Regionally, the state provides support for only one-fourth of a full-time employee (FTE), which equals about ten hours per month, per county. What they try to do with that time is handle serious nuisances that can cause health issues, indoor air quality, and trash situations. Since the state has no swimming pool ordinance, they are doing evaluations, and inspections of public pools. Grand Forks has an Environmental Health person funded out of county general fund, but we also have two more, plus Tim as a supervisor, that are funded by the City of Grand Forks. What this state aid would do is help counties such as; Pembina, Cavalier, Walsh, Nelson, Griggs, etc. that do not have the support.

· Most of the funds are used locally and regionally for education purposes of businesses and the general public; training for the staff and staff support; to maintain and purchase new equipment used to test environmental issues, whether it be odor or mold. Tim thanked the state for all the additional funding, but it does not go very far.

· Haley T. talked on the Legislative issue of tobacco. In regards to the article on “Aligning Tobacco Control Efforts at the Local Level with State and National Movements,” the state plan that North Dakota has now was developed after the 2009 legislature session. The Tobacco Prevention and Control Program saw an increase in funding during the 2009 session due to the Measure 3 ballot initiative, and was funded to a level recommended by the CDC.

· Haley also discussed the handout information; how Measure Three has helped locally and state-wide; information on smoke-free environments; and the Tobacco Excise Tax. Smoke-free bills have been brought before the legislature many times before and been defeated. So the focus has been on the community level, with the goal of having five cities having smoke-free work environments by November 2013. With Bismarck’s implementation around the corner, Bismarck will be number five, two years ahead of this goal. Hopefully, after seeing communities being successful, the legislature will readdress the issue at the state level, and they can see that it can be successful, it can save lives, and save money. Raising the price of tobacco products is also effective in reducing tobacco use. The tobacco excise tax would be solely to prevent youth initiation, and would go into the state’s general fund. Currently we are just educating about the excise tax as a health benefit.

G. NE Regional Epidemiologist (new item): Don S. commented that the position is being
advertised, with a closeout of October 22, 2010. This individual helps Public Health
with rabies, H1N1, and any other disease outbreak. This position will be filled with a
state employee.

V. Next Regular Scheduled Meetings – 4:15 p.m., Thursday, January 13, April 14, and July 14, 2011 at the Public Health conference room.

VI. Other: None

VII. Adjournment – The meeting was adjourned at 5:20 p.m.

Attachments: Issue Listings
Division Activity Reports (July – September 2010)
Calendar of Special Health Events (October – December 2010)
Mosquito Weekly Update handout, dated September 18, 2010
NewsBrief Publication
Legislative Issues: Measure 3, Smoke-free Environments, and Tobacco Excise Tax

Respectfully submitted,

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