Board of Health - February 10, 2023 Minutes

Regular Meeting: February 10, 2023

Opening: The regular Meeting of the Board of Health of the City of Fargo, North Dakota, was held in the City Commission Chambers at City Hall at 12:01 o’clock p.m., Friday, February 10, 2023. Meeting is called to order by Chair Lyn Telford.

Present: Jayme Steig, PharmD; Avish Nagpal, MD; Arlette Preston; Kayla Nelson, DNP, APRN, FNP-C; Lyn Telford, MSN, RN, CPHQ; Nyamal Dei, MPH; Bernie Dardis; Grant Syverson, MD.

Absent: Tony Grindberg

Others: Tracie Newman, MD, MPH, FAAP, Justin Bohrer, Holly Scott, Greg Schildberger, Ian McLean, Peter Monsrud, Melissa Perala

Announcements: Welcomed new members and did introductions.

Approval of Agenda: Motion to approve by Ms. Telford, move to approve by Mr. Dardis, seconded by Ms. Preston. Requested a move on the agenda to move the eighth agenda item (the voting for chair and vice chair) to the top of the agenda. Ms. Telford made a motion to approve the change, Ms. Dei seconded. All members voted aye, and the motion was declared carried.

Meeting Minutes Approval: From December 16, 2022; motion to approve by Ms. Telford, move to approve by Ms. Preston, seconded by Dr. Nelson. All members who were present at the December meeting voted aye and the motion was declared carried.

Nominations for officers: Position of Chair: Nomination for Chair, Lyn Telford by Dr. Nelson, Ms. Preston seconded. All members voted aye, and the motion was declared carried.
Position Vice Chair: Nomination for Vice Chair, Kayla Nelson by Ms. Preston, Ms. Dei seconded. All members voted aye, and the motion was declared carried.

FCPH Building Rehab Update: Melissa Perala
On December 28th, a water pipe burst in the Nursing suite at 1240 25th St South location, which impacted nursing suite, hallway, admin area, two conference rooms, Health Protection Promotion suite, supply rooms etc. accounting for roughly a quarter of our building. Forty staff have been relocated into other areas of our building; twenty cubicles were taken down. Cabinets on the floor have been removed, sheetrock two feet up have been removed as well as the carpet pulled up. Original estimate is about $200,000 to repair. We need a contract in place before we can begin repair work.

Orientation for new Board of Health members:
Welcoming statement read from Public Health Director, Desi Fleming.
Ian McLean, Assistant City Attorney with a short primer on ND Open Meeting and Record Law. ND has the broadest sunshine laws meaning that almost every record and every meeting is open. What is a record according to the State’s Attorney General? All recorded information regardless of physical form that has a connection with how public funds are spent, or with the public entity’s performance of its governmental functions or public business regardless of format or location. Any notes you take for a meeting, emails, text messages, videos, and photos. Anything can be considered a record if it is about public business. If it about the substantive business of the Board of Health, it is a record that is subject to this rule. Does not matter if it is on a personal or work device. Please do not delete things. The City would reach out to the members if there has been a request for their records. They would review and redact where necessary and release what has to be released. Meetings are defined as any gathering of a quorum of the members of the governing body of a public entity regarding public business, which includes committees, sub committees, informal gatherings or work sessions and discussions where quorum of membership are participating by phone or other electronic communications. It does not matter if its phone, video call or in person, it counts. If there is a quorum of members anywhere you should not be talking about business of the Board of Health. Even if there is not a quorum and say a member is approaching other members trying to build consensus one by one, that would also be a violation. We need to provide public notice. Try to conduct all public business at the public meetings where notices have been posted, minute takers are present. You may talk to other members if there is not a quorum about the business of the board as long as you are not attempting to build consensus.

Communication Orientation:
Greg Schildberger started the presentation explaining the role of the COMMSGA team and their staff. Communications and Governmental Affairs Division encompasses broadcast services, creative services, community engagement, and public information. Doing more listening to social media, gaining intelligence and actionable items. We get feedback from the community. We are mindful of what and how we release information as well as monitoring stories that involve us. We ask for corrections and attempt to correct any mistakes/misinformation. Trying to build/foster a strong reputational brand for Fargo Cass Public Health. Peter Monsrud provided some examples of projects including Vax Up ND campaign, 4-6-3 suicide prevention and mental health awareness, and filming all-staff meetings. Justin Bohrer spoke regarding the connection between the City Comms department and the development of the liaison team at Fargo Cass Public Health that includes himself and Holly Scott (Public Information Officer for FCPH). Holly Scott spoke regarding her role at FCPH. They use a critical eye not criticizing so they can provide feedback and suggestions. The goal is to maintain the integrity of the brand/logo of Fargo Cass Public Health. Our content experts (staff) create the social media posts and press releases and Ms. Scott polishes them. We have over 150 unique website pages. We do a lot of social media posts as part of our grants as well. Mr. Schildberger wants to discuss social media and the board members current role. You are responsible for what you post. Your opinions are not the official opinion of Fargo Cass Public Health, City of Fargo or Board of Health. Remember that members of the media may seek and follow your posts/comments online. Anything you can post online can be captured and republished by anyone including members of the media, even if you post and erase. You cannot use social media and then block people when they ask questions. Ms. Scott will assist with media training. Our job is to disseminate accurate and relevant information to members of our community. The PIO will process the media request, ask them about the questions they want answered and then find our content expert on the topic. She will then collaborate with the person with some media training and make sure that you are well-prepared to speak on the topic. She will also practice with you if you do not have the answer to the question so you can sound out how it will feel responding that you do not have the answer at that time. Mr. Monsrud had some interview tips: come in with key messages you want to get across and work into your answers, if you do not know the answer, be honest and do not speculate, if a reporter begins a statement with an inaccurate statement, correct the information. Be cautious throughout all parts of the interview and accidental, unplanned or off the cuff thoughts will be utilized in the story. Media is our partner; they help us convey information to the public. Try to have talking points: short, easy to understand and memorable. For the general public, if its complex information be willing to make it easier to digest. Keep jargon out of the answer. Circle back to main points to keep on topic. Never say anything “off the record”, there is no such thing. Remember you are part of a team, and you should conduct yourself as a part of the organization. The members of the public are putting their trust in you. Be honest and accurate, if you make a mistake correct it as quickly as possible. Be careful not to post rumors and be mindful that you represent the community, and you need to realize they come from all walks of life, so you need to be open and embracing to all the community. Every person in the community matter and we want them to be engaged in our work. Ms. Preston wanted to remind everyone that if the members are contacted by the media to send it to Lyn Telford and she will work with the Communications Team. Ms. Preston inquired about the Governmental Affairs portion of the Comms department. They are struggling with staffing at the moment but their goal is within two years that they would have two people that could be a conduit to bring the issues to the Communications department so we could be more involved with legislation. It is not for lobbying it is for a unification of efforts because we have twenty-two departments in the City that have strong identities of their own. When members of the Board Health are active in state legislation, do not identify yourself as a BOH member, use your employment and other designations. Stating your name and what your roles is when speaking that day.

Health Officer Update: Tracie Newman, MD, MPH, FAAP
School vaccination rates. CDC released MMWR National Vaccination Coverage showing that nationwide, more than 9 in 10 babies and young children are receiving recommended vaccines. For children up to age two, coverage remained high for most vaccines. There are still disparities with children that are rural areas and below federal poverty level showing declines in vaccinations. For kindergarten vaccinations for MMWR the rate of state-required vaccines in US for kindergartners declined from 95% to 94% in 2020-2021 school year and from 2021-2022 school year it decreased to 93%. Exemptions remained low at 2.6% another 3.9% without exemption were not up to date with MMR vaccine. For North Dakota, the non-medical school entry exemption is now above 5%. (Non-medical-moral, philosophical, religious).
North Dakota immunization rates: our goal is 95% however for 2022-2023 for kindergarteners we have MMR at 92.19%, Polio at 92.08%, DTaP at 91.99%, Hepatitis B at 93.65%, and Chickenpox at 91.64%. the exemption rate for philosophical has increased to 3.21%, with religious exemption at 1.64% and medical exemption at .20%. Since 2007 when it was 1.17% percent of nonmedical exemptions to now at 5.06%. ND 7th grade immunization rates for 2022-2023 is at Tdap 90.83%, Meningococcal at 90.17%, Polio at 95.46%, MMR at 95.48%, Hepatitis B at 95.79% and Varicella at 95.19%. For 11th grade in ND, Polio at 94.47%, MMR at 96.62%, Hepatitis B at 96.78%, Varicella at 95.98%, Tdap at 95.43% and Meningococcal at 89.45%.
Discrepancy of immunizations happening at state schools that exclude students without the proper vaccinations versus school that do not exclude students, it shows the effect of holding people accountable to have their children vaccinated. Seasonal flu is starting to decline nationwide now. We saw six new pediatric deaths giving us a total of ninety-seven deaths. For this season we had twenty-five million illnesses, 280,000 hospitalizations and 17,000 deaths.

Community Engagement Unit/NDDHHS: Krissie Guerard/Katarina Domintrovitch
The community engagement unit’s mission is to understand and reduce health disparities. There was a merger with Department of Human Services and the Public Health Division on September 1 of 2022. Slide show that detailed staff and their positions. There was a time that the state did not have any state health equity team. They lost funding and ceased the health equity portion, then they were just doing tribal work but now they are back and are looking at expanding the program. Positions: Kristie Guerard is the Community Engagement Director. Alicia Belay is in Fargo (she is split funded between MCH and disease control) and supervises all liaisons. Sara Upgren is the administrative assistant. Jorden Laducer is the community engagement training coordinator and does more with the LGBTQ2s+ population along with HIV, Harm Reduction. The state was awarded a 31-million-dollar COVID grant that was specific to health equity that is when Katarina was brought on and she also works with the youth. Roger Bryant, immunization coordinator. He is funded through the immunization program. He serves as a bridge between immunization and health equity. Ruth Nwatu is our CDC Public Health Associate. They come here in two-year stints, and we are applying for a couple more. They also have four tribal health liaisons that are specific to our tribal populations. Jamie Thongphet for Spirit Lake and Sisseton Wahpeton, Hunter Parisien for Turtle Mountain, Sonya Abe for Mandan, Hidatsa and Arikara Nation (MHA) and Cheyenne Smith for Standing Rock Nation. Then there are five NDSU graduate and undergraduate assistants. The mission is to improve the length and quality of life for all North Dakotans. One of the ways is to improve health equity by using evidence-based practices and make data-driven decisions. There are two strategic plans that this unit operates under, one for COVID-19 items and one community engagement unit strategic plan. Part of this process is to have the right people around the table. They have advisory boards: New American/Foreign Born/Immigrant (NFI), BeYOU LGBTQ2s+, Youth (YAB) and Tribal Health. Some of the impact that the Community Engagement Unit has had in Fargo: training and presentations, FM Wellness Coalition, First Link (Neighborhood Network), FM Coalition to End Homelessness, BCBSND- Social Determinants of Health Round Table, partnered with LIRS & ESHARA for vaccine events, town halls and other community events, education provided to the Mosque, New American Consortium, Indigenous Association, Indigenous Legacy. They also have a quarterly newsletter that is available on their website,
hhs-engagement@nd.gov. Ms. Dei says that this shows that the ND Department of Health is taking responsibility for including the entire population and when you get the right people, you will get the right information.

Legislative Update: Justin Bohrer
131 current bills that we are tracking. COVID vaccine bills that we are concerned with as well as funding, mental health, LGBTQ2s+, and vaccination bills. Aaron Johnson from Environmental Health gave testimony for the septic system bill (Senate Bill 2253 and 2256) and did a fantastic job. House Bill 1229 Cigar Bar Bill has been worked on by Annabel DuFault of our Health Protection Promotion area, but unfortunately that has made it through. SACCHO is the ND State Association of County and City Health Officials covers all our public health units and they attend a lot of our meetings, and we provide testimony as a group. We have a partnership with UND and NDSU. Larry Anenson Jr. tracks Family Planning, Melissa Markegard on mental health. It really is a group effort. Ms. Fleming handles the legislative call. SACCHO call is attended by Mr. Bohrer and Suzanne Schaefer. Ms. Preston mentioned that there was a ban on COVID vaccines with mRNA that got voted on yesterday and has been amended to become a study and then passed the senate. Mr. Syverson mentioned said the debate turned it into a study, so removing it from the legislative branch and move it, hopefully, to Health and Human Services.

Review of proposed 2023 meeting schedule:
Dr. Nagpal made a motion to approve the schedule, Mr. Syverson seconded. All members voted aye, and the motion was declared and carried.

No Public Comment

Adjournment: 1:31 p.m.

Next Meeting: May 12, 2023