October 2020 Board of Health Meeting Minutes

Coalition/Group Board of Health Name: Date of Meeting: October 8, 2020 Location: Virtual Meeting over Zoom

1. Purpose of Meeting Approve meeting minutes from July 9th and August 11th meetings, discuss Old and New Business, inform of next regularly scheduled meeting details.

2. Attendees Board members present: Dr. Sally Pyle, Jeannie Mock, Dr. Joel Walz, and Cindy Pic (via phone). Board member absent: Dr. Korsmo. Others present: Debbie Swanson, Javin Bedard, Theresa Knox, Mandy Burbank and Kristie Hegg.

3. Meeting Agenda

1. Call To Order 2. Approval of Meeting Minutes from July 9th and August 11th meetings 3. Old Business 4. New Business 5. Next Regularly Scheduled Meeting details 6. Adjournment

4. Meeting Notes, Decisions, Issues

Call To Order - Sally Dr. Sally Pyle called the meeting to order at 4:16 p.m.

Introductions - All Introductions of everyone present for this meeting were made (see list of attendees above).

Approval of Meeting · ACTION: Sally asked for a motion to approve July’s meeting Minutes from 7/9/20 and minutes. Cindy made a motion, Dr. Walz seconded. All voted to 8/11/20 - Board approve July’s meeting minutes as is. Motion passed.

October 2020 Board of Health Meeting Minutes Page 1 of 4

October 2020 Board of Health Meeting Minutes · ACTION: Sally asked for a motion to approve the August Special BOH meeting minutes. Dr. Walz made a motion. Jeannie seconded. All voted to approve August’s meeting minutes as is. Motion passed.

Old Business – · Theresa provided an accreditation update to board members Accreditation Update - (see Powerpoint presentation or Issue Statement at the end of Theresa the minutes for details). · September 22nd – submitted our accreditation application! · Sally congratulated our department on this great achievement!

Old Business – 610 South · Javin thanked the board members for their work on this issue th 9 Street Follow Up - · Abatement of the outside has been completed: Javin ü Steamatic was hired to complete this task ü Cost of abatement: $1,096.51 ü No contact occurred with Mr. Masse during the abatement process ü Conditions found: rodents were found (dead & alive) as well as spoiling food and a bucket with a toilet seat on it · Reached out to NEHSC for them to follow up with Mr. Masse for any services he would accept · Mr. Masse had been taxed delinquent but as of 10/1 it has been paid · Questions regarding the interior of Mr. Masse’s house ü Orders have in the past been made to clean interiors of properties if said properties were shared units (apartments, condos, etc.) ü Behavioral component of hoarding has to be addressed otherwise problem will continue ü Need demonstrable factors on how it affects neighbors due to interior conditions ü Mr. Masse has had consequences in the past in the form of fines and property abatements (assessed cost) ü Hoarding issues are occurring in other parts of town

Old Business – Covid-19 · Debbie provided a presentation regarding Covid-19 updates (see Update - Debbie Powerpoint presentation at the end of the minutes) · Sally expressed her thanks and asked if board members can do anything to help. Debbie indicated she feels great support from the board but did mention the need to advocate on our behalf when they are communicating with colleagues. · Cindy mentioned that Grand Forks County Commission appreciates all we have done and is proud to have helped in getting our department some much needed funding. · Jeannie expressed her thanks as well for all we are doing and asked how contact tracing has been going and if we are experiencing resistance from the public. Theresa said people

October 2020 Board of Health Meeting Minutes Page 2 of 4

October 2020 Board of Health Meeting Minutes resist helping for a variety of reasons. Mandy further elaborated that when politics interferes with public health it becomes difficult as trust is an issue. Overall, there is a need to have compassion for others.

Other Old Business · NONE

New Business – Blue · Mandy gave a presentation on Blue Zones (see Powerpoint Zones - Mandy presentation at the end of the minutes) · Blue Zone project gave presentation in Grand Forks in September · They were impressed with our level of collaborations · Blue Zone project will give a report in October on how best for us to move forward · The report will be given to NDDOH and then will get sent to us – Mandy will provide update on this at next BOH meeting

New Business – · See Director’s Report attached at the end of the minutes for Director’s Report - Debbie update

Other New Business · Sally asked if there was a need to elect a new chair and vice chair. · Sally indicated she was willing to continue serving as chair of the board when elections are held. · Kristie will research when the last election was and inform Sally of that information. (UPDATE: After meeting ended, Kristie informed Debbie S. that the last election took place on 7/11/19 where Sally was elected Chair and Dr. Korsmo was elected Vice Chair.)

Next Regularly Scheduled · The next regularly scheduled meeting is January 14, 2021 at Meeting 4:15 p.m.

Adjournment · Meeting ended at 5:10 p.m.

October 2020 Board of Health Meeting Minutes Page 3 of 4

October 2020 Board of Health Meeting Minutes

Action Owner Estimated Completion

Election of Chair and Vice Chair for 2021 Board members 1/14/21

6. Next Meeting

Date: January 14, Location/Time Virtual Meeting over 2021 Zoom at 4:15 pm

Agenda: TBA

Attachments:

1. Issue Statement 2. Accreditation Update 3. Covid-19 Update 4. Blue Zone Presentation 5. Director’s Report 6. Branch Accomplishments

October 2020 Board of Health Meeting Minutes Page 4 of 4

BOARD OF HEALTH ISSUE STATEMENT October 2020

Topic: Submission of Accreditation Documents to Public Health Accreditation Board (PHAB)

Contact: Theresa Knox, Accreditation Coordinator, 701-330-6348

Background: Grand Forks Public Health (GFPH) has been working towards national accreditation since the end of 2018. In 2019, we launched the process in earnest with the expectation of submitting documentation electronically on March 17, 2020. By March, the COVID 19 pandemic had required GFPH to stand up an emergency response and the submission deadline was delayed twice, finally to September 22, 2020. After a final review of documents by selected members of GFPH’s Accreditation Committee, we submitted to PHAB at the monthly All-Staff Meeting on September, 22, 2020. Next steps include a newly revised documentation review process by PHAB staff. In the revised process, the assigned Accreditation Specialist, Triona Gately, will conduct the Completeness Review and the Pre- Site Visit Review simultaneously and only measures that score less than “Largely Demonstrated” will be reopened for additional documentation. After that, the Health Department will have 45 calendar days to respond with additional documentation. PHAB will then assign up to two site visitors based on the number of reopened measures. The Accreditation Specialist and site visitor(s) will conduct the virtual site visit and write the site visit report. There will be no “in-person” on-site visit.

Action: For Information only

______

Topic: Blue Zones Project Community

Contact: Mandy Burbank, Grand Forks Public Health Dietitian

Background: In 2019, the ND Department of Health awarded Grand Forks Public Health a grant to carry out a Blue Zones Project Assessment in 2020. The information gathered during the assessment is then used to carry out policy, system and environmental changes to help community members live longer and healthier lives. Over the past two months, a core planning team, consisting of the City of Grand Forks, Altru, NDSU Extension and UND prepared for the assessment week. During the week of September 14-18, Public Health hosted the Blue Zones staff as they gave virtual presentations, held multiple focus groups and one-on-one meetings with community members. Presently, Blue Zones is preparing a formal written assessment for our community to use as we prepare for the next stage of the project. Action: For information only

______

Grand Forks Public Health Accreditation Update Board of Health Meeting 10/8/2020 Accreditation Update

* Date of document submission: September 22, 2020 • Next Steps: – Accreditation Specialist, Triona Gately, will conduct the Completeness Review and the Pre-Site Visit Review simultaneously. – Only measures that score less than “Largely Demonstrated” will be reopened for additional documentation. – The Health Department will have 45 calendar days to respond with additional documentation. – PHAB will then assign up to two site visitors based on the number of reopened measures. – The Accreditation Specialist and site visitor(s) will conduct the virtual site visit and write the site visit report. There will be no “in-person” on-site visit.

All Measures Go Green… Our staff virtually hitting the submit button…

COVID – 19 Update Grand Forks Board of Health October 8, 2020 Major Activities New Staff!

* CARES funding received through December 30, 2020 = $1,056,645 * Grand Forks Public Health has added 13 new staff members for contact tracing, testing, data analysis, communications and other response activities * Working on sustainable funding for 2021 as follows: City - $438,880; County - $260,430; ND Dept. of Health - $188,804; CDBG - $170,000 (pending) Total $1,058,114 Major Activities Testing

* Testing partners meet every two weeks * UND surveillance testing at HPC Tuesdays and every other Saturday – GFPH supports incident command * Regional testing coordination * Altru curbside testing – approximately 200 per day * Spectra Health * Long term care * Northwood Deaconess Health Care

Major Activities Contacting Tracing

* Contact tracing – as of 10/7/20 22 GFPH staff were monitoring 93 cases, 201 close contacts for a total of 294 people * Some cases are investigated by ND DoH, UND MPH students and UND contact tracing group * Additional 32 cases reported since yesterday * Current active cases in Grand Forks 231 (68 cases in 20-29 age group or 29.4% of total active cases) Major Activities Isolation and Quarantine

* Isolation and quarantine is provided at hotels for persons who need a non-congregate setting due to homelessness or security * Intake, transportation, quarantine and isolation, laundry, meals and case management are provided * Intensive operation requiring collaboration with partners School Support

* GFPH School Support Team – attend board meetings, consult with administrators, answer questions, collaborate with Healthy Return to Learning state group, ND School Nurse Organization and more! * Received County funding to hire two school nurses for Manvel, Midway, Emerado and Larimore – in progress * Northwood and Thompson have hired school nurses and will receive County funding

Smart Restart

* Environmental Health Specialists are fielding calls and requests for information on COVID safe business practices, review of temporary food vendors’ operations, special events, and monitoring restaurants and food service operations * Routine inspections continue * Respond to indoor air quality and ventilation concerns Data and Communications

* Health Officer Dashboard * Response to data requests * Social media presence with COVID-19 related information * Response to public inquiries * Convene local joint information center (JIC) and share resources * Presentations at City Council, County Commission, institutional partners, daily meetings with the mayor and city administrator

Preparing for COVID-19 Vaccine

* Provider enrollment available through ND Dept. of Health * Anticipating first vaccines in November or later * Priority groups will be determined * Vaccines require strict cold chain and storage requirements * Planning process and community collaboration will be needed to ensure equitable distribution and coverage Lessons Learned

* The community depends on public health for information, guidance, setting policy and convening partners * Transparency is important and builds trust * Ensure support for all personnel, maintain sense of humor * Create ongoing support for public health from this experience Questions and Closing

“When prevention and public health work…. nothing happens. And then you can have a perfectly healthy day.”

Howard Koh, Harvey V. Fineberg Professor of the Practice of Public Health Leadership at the Harvard T. H. Chan School of Public Health and the Harvard Kennedy School, Former Assistant Secretary for Health, U.S. DHS. Welcome To Our Community Grand Forks Community Lead Presentation September 8, 12 pm Presentation Outline

• Welcome • Ken Vein, GF City Council Member • Partnership History • Kristi Hall-Jiran, Chief Philanthropy & Partnership Officer, Altru • Public Health and County Health Rankings • Debbie Swanson, GF Public Health Director • Community Health Assessment • Audrey Lorenz, Director Planning & Marketing, Altru • Community Interventions • Allen Anderson, Grand Forks Public Health Dietitian

Welcome Welcome To Grand Forks • Our Community • Total population – 70,770 (County) • Grand Forks Airforce Base • Red River

UND

• University of North Dakota • Enrollment of 14,000 • Over 250 programs • Medical school, law school and aviation program

Stronger Together • Strong history of partnership • Existing coalitions and collaboratives • Effective leadership

Community Collaboration

The Greenway Takeover

Art of Giving – Art Show Recognition and Awards • 100 Best Communities for Young People • Main Street Excellence Award – 2018 • Great American Defense Communities – 2016 • Livability for All Ages Award – 2019 • Top Ten Community for Biking • Bicycle Friendly Community

Altru - Hospital in the Park • Park-like setting • Wellness Experience • Community engagement • Accessibility balanced with (South Columbia) safety and security • Healing environment • Convenience • Through-connections • Future programming

Grand Forks Public Health • Vision: Healthy people, healthy environment, healthy community

County Health Rankings

Grand Forks County – 48 Counties 2015 2020 Overall 11 31 Health Outcomes 11 31 Length of Life 8 6 Quality of Life 18 42 Health Factors 12 19 Health Behaviors 7 17 Clinical Care 5 4 Social/Economic Factors 24 16 Physical Environment 43 47 Health Outcomes - 2020

Grand Forks County North Dakota Tobacco use adult 16 % 18% Obesity adults 31% 33% Physical inactivity 23% 24% Excessive drinking 25% 24% Uninsured 8% 9% Mental health providers 320:1 530:1 Unemployment 2.3% 2.6% Children in poverty 11% 11% Severe housing problems 17% 11%

Community Advisory Committee

• Altru Family YMCA • Global Friends Coalition • Cities Area Transit • Grand Forks EDC • City Council • Inspire Pharmacy • Community Violence Intervention Center • Northeast Human Service Center • Grand Forks Parks and Recreation • Northlands Rescue Mission • Grand Forks Public Schools • Northwestern Mental Health Center • Grand Forks Air Force Base • Polk County Public Health • Grand Forks Fire Department • Quality Health Associates • Grand Forks Herald • Simplot • Grand Forks Housing Authority • Spectra Health • Grand Forks Park District • The Chamber • Grand Forks Police Department • Turtle River State Park • Grand Forks Public Schools • University of North Dakota • Grand Forks Senior Center • United Way Purpose

Improve the overall health of the community by focusing on determinants that promote health and wellness (versus treating disease).

Scope

Grand Forks County Polk County Community Survey Results

• People are helpful to others • Respondents feel it is a good place to raise a family • People in Grand Forks and Polk County are open minded • Problems related to employment and economic well-being • Resources available for youth programs in the community • Availability of assisted living for seniors • Community concern for prescription/illegal drug and alcohol abuse • Scarce resources for affordable housing • Barriers exist for access to behavioral health services

Focus Group Results

• Eight themes emerged • Mental Health • Substance us concerns • Health coordination and prevention • Social inequities and income disparities • Holistic health • Transportation • Obesity and nutrition • Cultural acceptance CHA Priorities

1. Substance Use – reduce the prevalence of substance use including alcohol, tobacco and other drugs 2. Mental Health – promote mental health and building resilience 3. Obesity – reduce the prevalence of obesity in our population 4. Transportation – improve the quality of and access to transportation 5. Cost of Health Care – reduce the burden of the cost of health care 6. Housing – increase the availability of affordable housing, including permanent supportive options • Our Vision • Our community will be the healthiest place to live, work and play • Our Mission • We are leading a forum of organizations to create sustainable, healthy environments through fostering partnerships, advocating for health policy and improving health outcomes • Our Goals: • To advocate for health in all policies for our community • To provide information on health and wellness resources and events in Grand Cities • To respond to health priorities identified in the community • To seek funding for the coalition and its programs

Community Interventions • ACHIEVE Grant • Tobacco Free Parks (2015) • EBT at TS Farmer’s Market (2014) • Healthy Foods at GF Park District Concessions (2016)

Community Interventions • Molly’s Trolley • GF Community Garden • Farm to Childcare • Well Fed Program Community Interventions • Complete Streets Policy - 2018 • Main Street Experiment • Active Transportation Demo Project • Bike Share Program - 2019

The Greenway • 2,200 acres of natural open space • 20 miles of multipurpose trail system • Greater Grand Forks - over 60 miles of shared use trails and bikeways Thank You Core Planning Group Photo Credit: Thank You Convention and Visitors Bureau and UND

Director’s Report July – September, 2020

Ø Responding to COVID-19 has been a full time endeavor for all personnel at Grand Forks Public Health the past three months. It has involved significant effort, development of new skills perseverance and many, many overtime hours. As we constantly shift our response efforts to long term sustainability, we have created a COVID-19 Action Group and hold weekly updates for all staff. Rotation of responsibilities, changing roles, and scheduling of staff on weekends has helped to manage stress and burnout.

Ø Several new staff members were added to our team during July, August and September to augment our COVID-19 response efforts. They include Public Health Nurses Angela Bahl, Jessica Stuart, Heather Shimek Theresa Farmer, Kathy Mack and Tylah Wildey. Public Health Program Specialists are Stephanie Williams, Jackie Hoffarth, Jessica Gonitzke, Tyler Manske, Narysse Nicolet, Kerry Anderson and Sarah Kuhn.

Ø Budgets were submitted to the City of Grand Forks for a portion of the City’s CARES funding allocation for COVID-19 response activities in 2021. A proposal was submitted to the Grand Forks County Commission for two school nurses for rural county schools for the 2020-2021 academic year to assist with COVID-19 response and for additional support for the nursing services at the Grand Forks County Correctional Center. This funding is from the County’s allocation of CARES funding.

Ø I attended a few presentations at the virtual NACCHO conference including Dr. Thomas Frieden, former CDC Director, and a panel discussion by local health officials on navigating leadership challenges during COVID-19.

Ø We submitted all of our accreditation documentation on September 22, 2020 and await the period of review by the accreditation specialist. The Public Health Accreditation Board (PHAB) has issued interim guidance during the COVID-19 pandemic designed to provide flexibility for health departments. We anticipate that our site visit in 2021 will be a virtual visit rather than in-person visit by officials from PHAB.

Ø Allen Anderson and I presented portions of the Community Introduction presentation for the Blue Zones national team on September 7 along with City Council member Ken Vein and Audrey Lorenz and Kristi Hall Jiran from Altru. The week long Blue Zones Community Assessment was coordinated by Mandy Burbank, Allen Anderson and numerous community partners and was very well attended.

Ø All of our Public Health personnel have been busy maintaining most of our existing services either virtually or within the community in addition to COVID-19 response activities. This work is necessary to promote health and resiliency, prevent disease, and protect all residents from any existing health hazards in addition to COVID-19. Board of Health Branch Activities Highlights July, August, September 2020

ENVIRONMENTAL HEALTH · The environmental internship wrapped up having assisted with contact tracing efforts as well as nuisance investigation and enforcement. · Environmental health staff have been working hard to keep up on regular duties while assisting the contact tracing efforts as well as doing business smart-restart outreach. · Plan reviews have included the multiple food service operations as part of the Memorial Union rebuild on UND Campus, as well as, other new and remodeling food services and one pool. · Regional work has included 16 septic site reviews and 4 final inspections.

EMERGENCY PREPAREDNESS AND RESPONSE · We continue to coordinate and support COVID-19 response activities throughout the northeast region of North Dakota including the City and County of Grand Forks, Nelson County, Griggs County, Walsh County, and Pembina County. GFPH, partnering with UND, the NDDoH, and the North Dakota Army National Guard, coordinated 21 mass testing events resulting in 17,418 total community members tested. · We have also been actively involved in the planning and asset procurement processes for testing events in each of our supported counties. We reviewed numerous re-opening and Smart Restart plans for various city, county, and regional entities and organizations. · Various community stakeholders attended weekly and semi-weekly meetings convened by GFPH to coordinate COVID-19 preparedness and response activities. · GFPH personnel provided input and planning for the statewide COVID-19 vaccination strategy, including participation in a roundtable discussion and a tabletop exercise for Points of Dispensing operations.

MOSQUITO CONTROL · The Mosquito Control Program has been in the operational phase since the beginning of May. Daily operations during the summer involved larviciding, adulticiding, surveillance, site reduction and community education. · West Nile virus (WNV) activity was very low throughout the state this year. As of Sept. 28th there have not been any human cases of WNV identified in North Dakota. Grand Forks Mosquito Control identified one pool of mosquitoes positive for WNV.

NURSING & NUTRITION · Six Public Health Program Specialists and four RNs were hired in this quarter to assist with contact tracing and other COVID response efforts. In addition, four part-time staff members were added. · The Division has responded to COVID issues such as quarantine and isolation of individuals with unstable housing and all related logistics and transportation required for this operation. · Personnel have provided support for the opening of the schools in Grand Forks City and County and have coordinated and distributed COVID communications to the community. · Programming such as Adult Home Visiting, Jail Nursing, Women’s Way, TB, Ryan White, Chronic Disease Prevention, and Tobacco Prevention have continued. Programs such as Health Tracks and Immunizations, have been suspended but by the end of September began to plan in earnest for the future. · Theresa worked with the Accreditation Committee and the GFPH staff to complete the documentation submission to the Public Health Accreditation Board on September 22, 2020. · In July and August, the Tobacco Prevention Team (TBT) collaborated with ND DHS to educate 80+ retailers in Grand Forks County on Tobacco Retail Compliance, including underage sales and provisions of the smoke-free and tobacco retail licensing laws. · In August, the TBT collaborated for a second time (previously in 2018) with the GF Police Department to conduct local Tobacco Retailer Compliance Checks. A total of 16 businesses were visited and only one failed to assess for proper identification. · In August, after several years of advocacy by GFPH, the Grand Forks Public School District updated their tobacco-related policies and now are considered as a Comprehensive Tobacco Free School. The changes reflect the addition of electronic nicotine devices and cessation referral language. The policy was last updated in 2011.

WITHDRAWAL MANAGEMENT CENTER & OPIOID RESPONSE · Operations have resumed at the GF Withdrawal Management Center with heightened safety precautions to prevent COVID-19. The capacity has been reduced to accommodate social distancing requirements. · A proposal was submitted to the ND Department of Services for continuation of opioid response activities. The plan includes contracting with service providers for medication assisted treatment, peer support, recovery housing and other harm reduction activities.