Board of Health

Boards, Commissions & Committees


DECEMBER 14, 2018, 12:00 Noon to 1:00 pm

Chelsey Matter, Chad Peterson, Lyn Telford, John Strand

Chris Anderson MD, Mike Thorstad, Robin Nelson

Others Present:
Larry Anenson, Justin Bohrer, Desi Fleming, Jillian Gould, Heidi Lako-Adamson MD, FAEMS, Grant Larson, Melissa Perala, Holly Scott

Chelsey Matter, Chair called the meeting to order.

Chelsey Matter introduced Chad Peterson as the new County Commission appointed board member. The board members welcomed him.

Approve minutes from October 19, 2018:
Lyn Telford made a motion to approve, Chad Peterson seconded and motion carried.

2019 Meeting Schedule Review after Revision:
Desi Fleming mentioned the change of date of the April meeting because of the Good Friday holiday. It will be April 12th, 2019.

Introduction of Lori Sall
Lori Sall was introduced as Linda Anderson’s replacement.

NALBOH (National Association of Local Boards of Health) Status:
Desi discussed renewing the membership to NALBOH. NALBOH supports BOH in their governance capacity. Since our BOH is an advisory board, Desi felt that the $300 being spent on this was not cost effective for the value. We can still access all of the resources without being formal members. Chad Peterson asked if anyone locally participated and no one here currently does. Chad Peterson does participate on other National boards and conferences and feels that he benefits from involvement. Melissa Perala stated that it is not a line item in the budget after Chad Peterson inquired if it is in the budget. Chelsey Matter feels we have other avenues to explore regarding resources if needed.

Budget Report through October 31, 2018:
Melissa Perala presented the budget. Because of a timing issue, the October grants receipts were a little behind. She looked ahead at November and 84% our revenue will be in so it will no problem to get to 100% and over for our revenue. We are at 89% for our expenses. December will look like a three pay period month, so there will be higher expenses.

Third Quarter Statistics:
Desi Fleming pointed out that the NFP first time mom’s program has changed their data collection system so there are no current statistics and we are missing a month of the RN visits. Grant Larson discussed the different data sets that Environmental Health added so there is no past data on aquatic onsite inspections and childcare inspections.

Larry Anenson said the clinic is still seeing a large number of clients. For some we are the only provider they see so we are touching on some issues that are not family planning like depression and asthma. The clinic will continue to reach high-risk populations and do outreach in the community to eliminate barriers to getting health care. As a Title X funded clinic we cannot turn away individuals. The clinic continues to be a safety net for Health Tracks. The lab technician is extremely busy with STD, HIV and HEP C testing. Chesley Matter wanted to know if we have a touchpoint with other providers to get clients to other resources.

Larry Anenson said the clinic does refer clients to other clinics in the community and as we are family planning experts, we do refer non family planning issues to other more appropriate providers. Family Healthcare started offering HEP C treatment in October 2018. We are attempting to collaborate more with them. Larry Anenson mentioned that the clinic also sees patients for non-family planning services (head lice, blood pressure) and we triage patients that then are referred elsewhere. School health visits were up although direct contract nursing services are consistent we now include presentations in the statistics. The numbers for the clinic appear down and Larry Anenson explained that he gets statistics from Ahlers and that only shows unduplicated users. Ahlers does not track the number of times that patient has come in. These statistics also do not show health tracks, immunizations and other services that run through the clinic.

Numbers throughout the state have been decreasing a little as well. Larry Anenson stated that in 2019 we are pursuing more high-risk people. Also talking in schools trying to reach the underinsured and uninsured individuals. He also pointed out that if people do have insurance we run their bill through insurance. Chad Peterson noticed an error in the third quarter tobacco compliance numbers. Larry Anenson discussed compliance checks for tobacco and that we are stressing education of staff, requesting employers do not fire staff for a mistake on tobacco compliance but educate and train them on spotting fake id etc. He also mentioned we should give kudos to community businesses and their efforts to educate and train their staff on compliance. Chelsey Matter mentioned a bill raising the age for tobacco use to 21. Larry Anenson said he has heard the rumors as well. Many of the conversations have been about raising the tax ($1.50 or more) on tobacco products.

Health Officer Update:
Heidi Lako-Adamson, MD, FAEMS was introduced as the new Health Officer for Fargo Cass Public Health. She stated she has gone to harm reduction meetings as well as hoarding coalition meetings. John Strand welcomed her and stated he wanted the board to advise the commissioners on matters, and that when health legislation comes up, Heidi Lako-Adamson and the board’s input will be trusted.

Winter Sheltering Update:
Jillian Gould was there is Jan Eliassen’s place. The New Life Center has 27 beds and they are usually at full or over flow capacity. (For single, sober men) Churches United in November has been full. (Single women and families) They are renovating their basement so they will have more room. Fraser Ltd. Has been at 6-8 over night they have the capacity for 16 individuals. (For youth 18-24). The Gladys Ray shelter has capacity of 35 but it is not uncommon to have up to 50 individuals needing assistance in an evening. Gladys Ray shelter takes those who do not fit other categories (such as such as mental health issues or substance abuse). John Strand met with the City of Fargo Administration and wants to point out how proud they are of the proactive response by the public health department.

Performance Management/Customer Satisfaction Survey/All Staff Survey/PHAB/The People Project:
Justin Bohrer discussed the customer satisfaction survey. We had expected to get only five responses by this time we are now up to 28 responses. Justin Bohrer mentioned that they want to remove the word satisfaction from the title and that the survey will continue to be tweaked as this is all a process of improvement. The survey information will be at the division level then to leadership level so they can create goals. Fargo Cass Public Health’s action plan was accepted by PHAB for accreditation, so now we will have one year to get documentation submitted. An issue we had at our site review was the amount of activities that did not have formal documentation; many things in our administration were being handled by phone calls or face-to-face meetings. We are working on those documentation goals. Desi Fleming talked about the People Project. We are participating in a pilot project with MN on this to increase employee’s well-being and dealing with mental health at work. The curriculum was developed by a NDSU professor.

Justin Bohrer and Chris Ohman will go through training and then come back and present these tools and concepts to the staff. Chad Peterson asked how the results would be quantified. Justin Bohrer responded that they have identified some areas that need improvement and we have a baseline. So we can revisit in future to see if there is a measurable difference in the responses. We will never have 100% satisfaction but anytime there is improvement we can tell what was working and what does not. Desi Fleming mentioned that it is a pilot project and that it will have evaluation components built into it. Lyn Telford said the when you improve mental health at work you can also see it in less days missed, calling in sick, better job retention and increased productivity. Desi Fleming also mentioned you could see which employees are engaged or not. It is grant funded so there should be quantitative measures. Justin Bohrer thanked Holly Scott on her input on putting the QR code on the surveys.

Chelsey Matter asked if there were any standing items of legislative issues on agenda. Chad Peterson said he is often in Bismarck and involved in the legislative issues. He requested that the board let him know about issues you can call or email him. Lyn Telford mentioned she is on a rapid response team for legislation and wants to be contacted as well. Chelsey Matter said any questions regarding insurance could be referred to her. Desi Fleming mentioned the legislative meet and greet on Monday with West Fargo and Fargo. State aid is the biggest concern for public health from a funding standpoint. Public Health would also be supporting legislation for increasing the tax for tobacco products. Grant Larson mentioned a grass roots movement on septic issues. In areas where there is no wastewater system, there is no state entity that assists in accountability for on-site septic issues. We are monitoring this and are hoping for a uniform code that could be added to the Century Code at some point so there is some state level authority. On-site septic systems are intended to protect not only the homeowner and their investment, but also the regional groundwater.

Desi Fleming mentioned Holiday festivities taking place at Fargo Cass Public Health building on December 19 from 1:30 to 3:00, BOH members are welcome to join.

Meeting adjourned.
Next Meeting: February 15, 2019