GALVESTON COUNTY HEALTH DISTRICT
Protecting and promoting the optimal health and well-being of Galveston County.
Galveston County Health District’s United Board of Health convened for its regularly scheduled April 29, 2020 meeting by utilizing Zoom, which allowed for Board members and the public alike to partake in and/or view the meeting either online or over the phone.
Board Members Staff Present on Call: Ben Raimer, MD Present: Kathy Barroso Patrick McGinnis, MD Randy Valcin Eric Froeschner Andrea Cortinas Della Brown, RN Eileen Dawley Dr. Annette Jenkins Ashley Tompkins Holly Lilley Richard Mosquera Mary Jo Godinich, MD Dr. Ripsin Curtis Klages, DVM Amanda Wolff Dewey Brunt III, PE John Hackbarth, DDS Dr. Chad Clause Philip Keiser, MD, Ex -Officio Local Health Authority
Excused Absence(s): Barry Terrell
Unexcused Absence(s): None
Dr. Raimer called the meeting to order at 6:03 pm and a rollcall was done to confirm a quorum.
Items # 1-6 Consent Agenda A motion was made by Dr. Klages to approve the consent agenda items one through six. Dr. Jenkins seconded the motion and the Board unanimously approved the consent agenda items one through five.
Item # 7 Comments from the Public There were no comments made from the public.
Item # 8 Report on COVID-19 Activities from a. Chief Executive Officer and b. Local Health Authority a. Kathy Barroso, Chief Executive Officer provided the attached updates to the Board. See page 3 and 4 of the minutes for the full report.
b. Dr. Keiser gave an update on the status of COVID-19 cases in the County and advised the Board that Galveston County is projected to peak in the beginning of May.
Item #9 Consider for Approval March 2020 Financial Report Andrea Cortinas, Chief Financial Officer, presented the March 2020 financial report to the Board. A motion to approve the March 2020 financial report as presented was made by Dr. Godinich. Dr. McGinnis seconded the motion and the Board unanimously approved the March 2020 financial report.
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Item #10 CEO Emergency Approvals Due to COVID-19 for Ratification by the United Board of Health Andrea Cortinas, Chief Financial Officer presented the current expenses accrued due to COVID-19. Ms. Cortinas asked the Board to ratify the current emergency approvals. Dr. Hackbarth made a motion to approve the request and Mr. Froeschner seconded the motion. The Board unanimously approved the motion.
Item #11 Comments from Board Members • Mr. Froeschner requested a Public Service Announcement be put out reminding people to wear a mask to protect each other and to remind people if they feel sick to immediately get tested. Dr. Raimer agreed this is a great idea and requested Kathy and Dr. Keiser look into making these PSA’s to remind the public to wear masks and wash hands. • Dr. Hackbarth commended Galveston County in doing great in controlling the spread of COVID-19. • Dr. Raimer, Mr. Froeschner and Dr. Hackbarth commended staff on how well they are working together.
Dr. Klages made a motion to adjourn the meeting at 7:12pm and Mr. Brunt seconded the motion. The Board unanimously approved the motion.
______Chair/Vice-Chairperson Secretary/Treasurer
______Date Date
Page | 2 April 2020 Executive Report
As expected, the Health District’s focus this month has been centered around COVID-19 related activities.
From 3/25/20 – 4/25/20, our Epidemiology and Public Health Emergency Preparedness teams have:
• Made more than 4,200 monitoring calls to COVID positive cases in Galveston County
• Over 263 positive cases were monitored and ultimately deemed recovered through assessment with an RN as per CDC guidelines.
• More than 200 calls have been made coordinating with hospitals on admits and discharges
• Approximately 1,689 notifications were made related to contact tracing. In addition, a significant amount of resources this month were devoted to the setup of free mass testing sites. 1. On April 9th, our first mass testing site was opened at GCHD offices in Texas City to those who met specific criteria. 2. A second mass testing site was setup in Galveston on April 16th at the fire station on 57th & Broadway and it was decided that testing would be offered to all with or without symptoms at both testing locations. 3. A third mass testing site was added in League City on April 23rd with no restrictions.
• To date, 3,774 tests have been conducted through the Health District’s free mass testing efforts. • Since March 9th, our phone bank has handled over 10,000 calls related to questions about COVID-19 such as symptoms, testing and appointment scheduling. Due to the high demand for testing and impact on our phone system, our IT department deployed a cloud-based phone system that included separate lines for Texas City, Galveston and League City. • Staff from all areas (public health, Coastal and GAAA) have been utilized in the COVID- 19 response effort. Multiple employees have assisted with staffing the phone bank, scheduling appointments for testing, assembly of forms and test kits, traffic control and of course our testing teams who have been on the front lines collecting the samples. • GAAA staff have also assisted in this effort by testing those that are homebound. • In addition, a multitude of volunteers have also provided assistance to us. UTMB medical students have been assisting in the notification of test results and our medical reserve Corp volunteers have assisted in traffic control and in our testing teams.
As you can imagine, the logistics involved in coordinating this type of large-scale operation is quite extensive. Many thanks to UTMB for making the test kits available to us and to our entire Health District team for going above and beyond to provide this testing to our community. We have received many positive comments about the setup and efficiency of the testing process.
Communications Communication team (2 people) continues to focus on COVID-19 with daily case updates, testing information and overall education on this ever-changing situation.
The communications department puts out a case update daily around 5 p.m. that includes an update on all our case numbers with graphics focused on total cases and those who have recovered. There are also various charts and graphs that break down that same information. This is all shared with communication stakeholders at the county and cities, media and on the health district’s website and social media channels.
Media coverage includes multiple Houston stations, Houston Chronicle, The Morning Bull radio show, Houston NPR, The Daily News, i45NOW, and many others.
The GCHD website continues to evolve. There is a specific testing page that includes the schedule for the health district’s free testing sites along with testing FAQs, a page dedicated to information on the county’s confirmed cases, background on COVID-19, resources and communication materials. Messages from the CDC and Department of State Health Services are also shared.
As expected, we have seen a significant increase in traffic to the website. By comparison, we have seen 5 times the number of users and pageviews over the course of the last two months. January were 14,361 and new users were 13,221. Pageviews were at 58,514.
• Website visitors – March There were 80,449 total users in January and 77,990 of those were new users. Pageviews totaled 248,532. Visitors stayed on the website for an average of 1 minutes, 29 seconds. Top pages visited, along with the number of visitors includes: COVID-19 homepage: 66,382 Homepage: 34,772 COVID-19 Galveston County confirmed cases: 21,420 Johns Hopkins COVID-19 heatmap: 10,791 ARC: 5,224
• Website visitors – April 1-25 There were 95,652 total users in January and 82,663 of those were new users. Pageviews totaled 259,787. Visitors stayed on the website for an average of 1 minutes, 37 seconds. Top pages visited, along with the number of visitors includes: COVID-19 Galveston County confirmed cases: 214,666 Homepage: 69,200 COVID-19 homepage: 51,959 COVID-19 testing: 11,232 News and events: 6,445
We are really happy that people are viewing this information and keeping up to date on latest developments.
Update on other Health District programs:
Breast Cancer Screenings- • All breast cancer screening services have been put on hold due to the Covid response operation and the current inactive status of the mobile mammography van. • The HHSC BCCS Request for Application which is submitted every 5 years is due May 21 (this is the solicitation for BCCS program funding) and is currently being compiled.
TB Program- • We currently have 7 confirmed TB Cases and 1 new Suspect case which are being treated. • We continue to provide Directly Observed Therapy (DOT) and Directly Observed Preventive Therapy (DOPT) to clients.
Public Health Nursing-
• All public health nursing traditional duties have been put on hold due to the Covid response. The public health nurses are part of the operation monitoring all Covid positive cases within Galveston County, which includes daily calls to each case assessing signs and symptoms, offering ER referrals as needed, and highlighting community resources for those that require it. In addition, the PHNs clear Covid positive cases from home isolation as per CDC guidelines, and monitor and update all hospitalized Covid positive cases.
HEAL & Community Health Worker- • All HEAL activities have been suspended during the Covid operation. The CHS Community Health Worker (who has an MPH) has been working full time on the Covid operation with Epidemiology staff.
Healthy Concepts STI Clinic and STD/HIV • HCC staff have been working on Covid operation activities. Testing & treatment of HCC patients has been scaled back due to Covid, though a few patients have been treated. • The HIV/STD Prevention Team continues to perform services, although somewhat reduced, as outlined in grant requirements and is assisting in the Covid response.
Immunizations- • Immunization services have been scaled back and staff is assisting with the COVID response. Clerical staff have been assisting with the phone bank and the nurses have been assisting with monitoring positive COVID cases. WIC- • All WIC sites are currently providing curb side services under the HHS disaster operation policy. All nutrition and breastfeeding consults are taking place via phone, and teleconferencing is available for high-risk breastfeeding clients who are in need of visual assistance. All laboratory services such as weights, heights and iron screenings are being waived until normal services resume. Due to the impact of increased layoffs in the community related to Covid, the WIC program is experiencing a dramatic participation increase across Texas. Following the temporary closure of the Island Community Center, the WIC program manager was able to secure an alternate temporary location in Galveston so that services could continue on the island. • Snap-Ed (Obesity) Grant projects temporarily suspended– In mid-March, HHS recommended that local agencies halt face-to-face obesity projects due to the demands of the Covid response. Starting in May, HHS will provide training/guidance on how agencies can implement their projects using virtual platforms. • Community partnership programs such as The Incredible Years and Galveston’s Own Farmers Market cooking classes have been placed on hold. When normal operations resume, WIC will re-evaluate all programs to ensure safe resumption for all staff and clients. • HHS is currently surveying local agencies on the need for the Summer Meal Program. If approved, WIC will distribute meals curb side starting on June 1.
Environmental/Consumer Health The Central Texas Coastal Area Committee’s Community Air Monitoring Plan was revised for the final time on March 27th, during a conference call with all the contributing parties. The final version of the plan was scheduled to be routed for approval on April 6, 2020.
The Water Pollution Division is continuing to work on its deliverables under its contracts with the cities and water districts. In order to keep with social distancing and safety procedures, the GCHD's wastewater treatment inspections have been significantly modified by working with plant operators to determine the best methods for obtaining samples while also keeping everyone safe. The Pollution Control staff, many working from home, continue to prepare for state air inspections, respond to citizen complaints, deliver samples to the Houston laboratory, collect beach water samples and answer citizens questions about air and water pollution.
Health District sanitarians continue to inspect food establishments that have remained open during the COVID 19 pandemic. Many facilities have closed, at least temporarily, some opting not to offer take-out, pick-up, drive-thru or delivery options. Sanitarians have seen a greater occurrence of facilities that are not open and available for inspection.
The current Food Inspection Backlog is 164 inspections. Of these 164 facilities, 44 are mobile units, 23 are farmer market booths and 97 establishments were closed due to COVID-19 closures, seasonal closure or other remodeling issues.
Animal Services
• In order to minimize public interaction, The Animal Resource Center has moved to appointment only and has implemented virtual meet and greets and online adoptions. • The ARC is also acting as a donation HUB for citizens in need of pet food. • Community support has been great, allowing a large majority of animals to be moved into foster homes. • On April 15th, the ARC transported 34 cats to Helen Woodward Animal Center in California o ARC cats = 23 o Bayou Animal Services cats = 5 o Galveston Island Humane Society cats = 6 • Since news of COVID-19, the Animal Resource Center has been following all recommendations from the National Animal Control Association as far as field control and intake measures.
UBOH - Human Resources Update 03/19/20 – 04/22/20
• Employee Onboarding – Human Resources conducted new employee orientation for the following employee(s): o Jesus Morales – Animal Care Technician part-time 3/19/20 o Jennifer Jones – Administrative Assistant ARC 3/19/20 o Seth Elliott – EMT Basic 04/16/20
• Job Offers – The following candidate(s) were extended job offers and future start date has been determined. • C. Rivera EMT Basic
• Current Vacancies: o Public Health vacancies: • Animal Services • Animal Care Technician part-time (3) • Animal Care Technician full-time (1) • Consumer Health • Sanitarian (1) • Epidemiology • Epidemiologist I (temp) (1) • Immunizations • TVFC Quality Assurance Coordinator (1)
o GAAA Field vacancies: • EMT Advanced full-time (4) • Paramedic full-time (4) • P3 Team Captain (internal posting) (4) • Training Officer (1)
UBOH Contract Reports: April 2020
1. The Health District Immunization grant through the Department of State Health Services, was renewed at level funding through August 31, 2021 ($251,837.00).
2. The Health District HIV Surveillance grant through the Department of State Health Services was renewed at level funding through August 31, 2021 ($55,027). 3. The Health District Cities Readiness Initiative grant through the Department of State Health Services was renewed at level funding through June 30, 2021 ($70,922)).
4. The Health District’s PHEP Cooperative Agreement from the Centers for Disease Control and Prevention (CDC) was extended through June 30, 2021. Funding increased by $2,077 from the prior year. (214,025).
5. The Department of State Health Services (“DSHS”) and the Galveston County Health District have agreed to a no cost extension of the Foodborne, Waterborne and Environmental disease grant in accordance with the 2018 Public Health Crisis Response (PHCR) Project. The grant is extended through June 30, 2021.
6. The Department of State Health Services (“DSHS”) and the Galveston County Health District agreed to amend the District’s Women, Infant and Children’s program. This amendment reduces the total contract amount for FY20 by $49,594 by way of redistributing between the projects. This amendment also increases the amount earned per participant from $13.52 to $13.93. This amendment becomes effective on July 1, 2020.
7. The Health District was notified of an amendment to the DSHS grant to fund COVID-19 related expenses, which increased the original grant funding by $261,439. This funding will be utilized in our response efforts related to COVID-19. Total funding received to date has been $516,197.
As the governor’s stay at home order expires on Thursday, the Health District is currently making plans to resume services in all areas as we transition back into standard day to day operations. COVID-19 will continue to be a top priority for us as we transition into the next phase of this pandemic.