Board of Health

Boards, Commissions & Committees

Board of Health - April 16, 2021

Regular Meeting: April 16, 2021

Present: Arlette Preston, Chelsey Matter, Chair, Amy LaValla, DNP,PMHNP-BC, APRN, PHN, Lyn Telford MSN, RN, CEN, Kayla Nelson NDP, APRN, FCNP-C , Pearl Mell Ferguson, BBA, MSOL, MHA, Duane Breitling
Absent: Tracie Newman MD, MPH
Others Present: Melissa Perala, Desi Fleming, Robyn Litke Sall, Larry Anenson, Suzanne Schaefer, Justin Bohrer, Samuel Swenson, Erika Spanjer, Grant Larson, Doug Murphy, Jan Eliassen, Lori Sall

Approve minutes: February 12, 2021 motion by Duane Breitling. Seconded by Lyn Telford. Unanimously approved.

Change in agenda adding alcohol density also the budget meeting was scheduled for May 28 want to move to May 27th. Since the passing of Heidi Lako-Adamson, Douglas Griffin, CMO has been our interim health officer. We are posting a RFQ for that position.
Desi’s medical leave in Minneapolis will start on Monday, April 19th. If you have questions please email you can also call the office.

Fargo Youth Initiative Presentation
Erika Spanjer and Samuel Swenson presenting Policy Analysis for Improving Youth Mental Health in Fargo. They defined the problem, looking at the fact that 20% of Fargo residents are under the age of 18, they face unique challenges and that mental health affects all aspects of life. 50% of mental health issues start by the age of 14. Freshman highest respondents on their survey. They identified the top elements that were identified as causing problems: school related stress, lack of access to professional support, too much stigma and faculty underprepared to deal with mental health issues in students. 45% of respondents do not discuss mental health in the home and feel unsupported by their parent(s). Transportation and finances also is a barrier to mental health help. Brainstormed ideas to help with mental health. Reduce homework, mandatory mental health appointments, free in school therapy, mental health clubs, free texting therapy program, parent education campaign, survey check –ins from counselors, anonymous encouragement dropbox, teacher mental health training.
The next steps is to get feedback and create a task force of stakeholders to see if they pilot programs in 2022. Lyn Telford remarked on the timeliness of this report and research. The BOH supports this work and appreciates the group sharing this with them.
Amy LaValla appreciated that the students are taking steps to do actually do the research inside the schools. The rate of mental illness have significantly increased have almost doubled in the last 5 years and now since the pandemic the rates have increased exponentially. Arlette feels that this is a really important issue, especially with pandemic, the information is well thought out.
Desi Fleming behavioral health is an issue that has been identified previously but it usually isn’t broken down between adult and youth. It is in the plan, but we may need to break it down so it has activities for youth. Sanford is spearheading the process of this and we should be getting the data back from the survey they sent out soon.
Current programming for mental health would be at Southeast. It is woven into a lot of our programs but we don’t have anything specifically for youth mental health. We don’t have any group activities here currently. Justin Bohrer mentioned that we working on the Rethink Mental Health initiative with Clay County Health and then COVID-19 forced us all to set the program aside. Chelsey mentioned the lack of professional support maybe the school nurses can encourage that connection. Desi Fleming said soon the community health assessment will be back and then we can talk more about behavioral health for the youth. Larry Anenson mention that in the public health clinic they do depression screening and they do have adolescents at the clinic. It is unfortunate that there is still a stigma. 1 in 6 feel they have no one to talk to about mental health, at the clinic we discuss mental health and depression. The clinic provide those services rather funded or not. Amy LaValla added in the chat box that NAMI is a good resource for mental health support and advocacy. Also if we could train teachers to support kids in seeing the school counselors that could also be an inexpensive help. Kayla Nelson also mention that Family HealthCare in Fargo can almost always provide affordable health care and mental health care to anyone in need. So if there are financial concerns they are a great place to check out. Arlette wants to work on some collaboration. Chelsey feels we need to make a connection with DHS and that the Board of Health would gladly throw formal support behind this youth initiative and that the Board would like to be involved in the meeting once it is scheduled.

Alcohol Outlet Density (AOD)
Larry Anenson introduced Robyn Litke Sall, FCPH’s substance abuse coordinator, who has put together a presentation on the alcohol density in the City of Fargo. Robyn explained that alcohol outlet density is the concentration of retail alcohol establishments, including bars and restaurants and liquor or package stores in a given geographic area. Problems stemming from high AOD: excessive alcohol consumption, health consequences, social consequences, violence, alcohol impaired driving, neighborhood disruption, public nuisance activities. Regulate AOD, CDC Community Guide mentioned it and strategies to prevent. Four options: limit geographic units per area, population limit (limit per population), commercial (cap% of total per total retail in geographic area), space (limit location, set minimum distance between outlets), time (limit the time they can operate). Cass County Coroner statistics showing that alcohol related deaths have increased in 2020 to 72 in 2013 it was 41. 2018 assessment data:
Downtown has 42 establishments, 45th St S has 36, 13th Ave S has 29. Establishments per person, we have a very high AOD, much more than the CDC discusses. Prevention recommendation was not more than 1 alcohol outlet per 1,000 people. Showed property incidents in the area with high AOD and their corresponding time of incidents. Violent crime increasing with younger people when alcohol is involved. Comparing downtown with 45th St S area they are equal or even more in downtown, which is a much smaller area but much higher AOD. Violent incidents, Thursday through Saturday from 6:00 pm to 6:00 am, takes a marked jump in downtown up to 23 incidents in a six month time frame 09/20/17 to 03/20/2018. A lot of people in a small location when they are moving from establishment to establishment gives an arena for violent interactions. Incident totals are also high from the Fargo Police Department. In summary, high AOD leads to excessive consumption and serious health and social consequences. Fargo has high AOD and correlating consequences, regulation of AOD can lower excessive consumption and reduce the negative consequences, and there are regulatory options and a community action guide from the CDC.
This information has been shared with the liquor control board and the City Commission also with the Mayor, but it was a while ago. Also went to a neighborhood association.
Arlette Preston wants everyone to know they are going through some major changes with the liquor control board. Whole new board and new members. Once members get feet on the ground it would be great to get this information to the new control board. This research based study is very important, high density increases consumption. When we had the Mayor’s task force on addiction and alcohol was driving it. We have been struggling with this issue for a long time. Let’s get it back up on the table and get it discussed again.
Lyn mentioned that the planning and development committee or commission could benefit from this information especially with the growth in south Fargo. How do they take that in to account and have prevent a high density area in the southern part of town?
Robyn hasn’t spoken to the planning committee. Maybe if the planning committee had some say in granting liquor licenses? They zone something as retail and the Liquor Control board recommends it and the city commission grants the license.
Desi mentions that we hope to discuss alcohol use as an issue for adults in this community. It’s so woven into our culture that it is difficult to approach. We need to do messaging around that and start to get a harm reduction system for our relationship with alcohol. Community health assessment data might give us some backing so that we can discuss the impact of alcohol on our community.
Chelsey stated that the density is a big issue. All of these establishments with alcohol cause more people to be clustered around we will naturally have more problems. Chelsey would like to see comparisons from West Fargo and other places. Give people a different perspective.
Regarding the budget you can email any questions and we can address any concerns and answer any questions. Regarding the vaccine, Suzanne provided an update that the last percentage of our population to be vaccinated will be difficult and the Johnson and Johnson news won’t make it easier. The side effects are very rare. We are shifting our focus a little bit to less mass vaccinations and more to downscaling to clinics and mobile clinics. There has been a decreased demand for vaccination. Arlette mentioned that we need to get that last 10-15% and they will be difficult, if we don’t achieve we will be living with COVID for quite a while. Chelsey mentioned that companies are tracking the rates of immunization. Desi mentioned that we are continuing our vaccinations and we will up our general messaging for vaccinations and continue trying to reach special populations. Board would like to help promote efforts to increase vaccination.

Bylaws We updated the responsibilities in 2018 for BOH so now we updated the bylaws so they match the responsibilities and include virtual meetings. We are already functioning under them we just need the official approval.
Motion to approve by Duane Breitling and seconded by Kayla, all voted aye.

Vice chair election: Chelsey nominated Lyn Telford. She accepted. Arlette Preston seconds it. Unanimously passed.

Duane Breitling. Question about revenues for Cass County, why isn’t there more money showing up in there? Melissa responded that it is more timing than anything else. January is smaller month, because of a chunk of payroll gets pushed back to December 2020. So it’s a matter of when things have been submitted, and when things get back to us. You are only seeing January right now.

Next Meeting: May 27, 2021

Meeting Adjourned