Board of Health - September 20, 2024 Minutes
Regular Meeting: September 20, 2024
The regular Meeting of the Board of Health of the City of Fargo, North Dakota, was held in person at City Hall Commission Chambers at 12:00 p.m., on Friday September 20, 2024.
The Board members present or absent during roll call were:
Present: Jayme Steig, PharmD; Avish Nagpal, MD; Kayla Nelson, DNP, APRN, FNP-C; Lyn Telford, MSN, RN, CPHQ (Chair); Grant Syverson, MD; Jim Kapitan
Virtual: Nyamal Dei, MPH
Absent: John Strand; Bernie Dardis
Others: Jenn Faul; Melissa Perala; Tracie Newman, MD, MPH, FAAP; Holly Scott; Larry Anenson, PhD, RN; Grant Larson, RS, EHP; Amber Slevin, PharmD, BCACP
Announcements: No announcements.
Approval of Agenda: Dr. Steig moved the agenda for approval and Mr. Kapitan seconded this motion. This motion was declared carried.
Approval of Meeting minutes: Dr. Steig moved the minutes for approval and Ms. Nelson seconded this motion. This motion was declared carried.
Ms. Telford requested introductions from the board members as well as the present staff from the department. Roundtable introductions were given by the present members including virtual.
Budget Recap 2025
Ms. Faul begins by discussing the budget updates which includes reduction in staff and operations. Ms. Faul explains the 4.2 eliminated positions as requested. Ms. Faul notes that only 1 of these 4.2 positions is currently filled, and the responsibilities of these positions will be divided among other qualified staff members including department leadership. She also notes the reduction in operations and elimination of the Nurse Family Partnership program in the Nursing division of the department. Dr. Steig asks Ms. Faul about the responsibilities of the Public Health Analyst position, which is the one filled position being terminated. Ms. Faul responds by noting that the duties of this position will be delegated to managers among the department, as they were before the position was created. Ms. Telford shares her concerns with how the workforce reduction was communicated to the Board and the importance of how the Board can advise without bias or objectivity for the department following conversations with department leadership and city leadership. She also notes that the Board can assist the department in many ways, like funding or strategic planning. Ms. Dei questioned the positions that are being eliminated from the department and is looking to better understand why long-term positions are not being filled. Dr. Anenson responds by addressing two of the positions that are not being filled by explaining that the responsibilities were reassigned to other positions, which has been able to be maintained. Ms. Telford clarified that two of the vacant positions were not posted for applications. Ms. Dei adds that the two departments facing cuts in the current budget process can relate to one another, including the cut of the Department of Diversity, Equity and Inclusion (DEI), does collaborate with public health community. Ms. Telford notes that the work from a DEI department is a focus of public health from a national level. Ms. Telford asks how FCPH’s budget compares to like agencies in terms of percentage of grants, general funding, service fees in terms of operations.
Grant Application
Ms. Faul notifies the board that three divisions in the department (Emergency Preparedness and Response, Public Health Nursing and the Clinic) recently completed a grant application for staff and staff time to focus on immunizations confidence and education.
Community Health Collaboration
Ms. Faul begins this conversation by introducing the Community Health Assessment Plan which analyzes the demographics of clientele. Ms. Faul requests that agencies work together more centrally on this plan since the needs across the area are the same, though agencies may approach them differently. Ms. Telford notes the opportunity to gather data is important and voices her support. Dr. Steig agrees the idea is important and in past, collaboration was beneficial. Ms. Nelson also voices her agreement.
FCPH/BOH Collaboration
Ms. Faul discusses the need for better collaboration among the department and the board and requests department management being present and considering roundtable like discussions for the board meetings as she hopes this partnership should be more of a working hour. Ms. Nelson agrees this importance of communication and ensuring collaborators are on the same page. Ms. Telford agrees this could increase advocacy for public health.
North Dakota Hep C Elimination Council
Amber Slevin, chair of the North Dakota Hepatitis C Elimination Council, presents to the board an update of the councils’ work and plan. The presentation begins with current Hepatitis C data. Dr. Slevin displays the current data for 2019-2023 in North Dakota and notes the downward trend. Dr. Nagpal and Dr. Slevin both discuss that the data may be an undercount as there may be missed cases due to several factors and that this problem could be worked through. Following a display of various data points, the presentation continues with background and information of the council’s work, primarily their 5-year total elimination plan as tasked by the North Dakota Department of Health and Human Services after forming in 2022. This plan, as noted by Dr. Slevin’s, is based off a national plan through various workgroups and strategic goals. The presentation concludes with discussion about areas of opportunity among the council and other agencies and goals to implement guidelines that focus on places that serve disproportionately affected populations.
Dr. Nagpal states his appreciation for the work being done by the council, Ms. Nelson echoes this support and notes the amount of progress done thus far is important work. Ms. Telford asks if FCPH provides universal screening and Dr. Anenson answer by noting that FCPH does provide a rapid and a confirmatory test while staff has been focusing efforts on outreach steps and providing best directions.
Ms. Telford tells Dr. Slevin’s that the board can provide a letter of support in hopes of gaining commercial payers and additional support. Ms. Nelson asks about the universal barriers through the corrections department in screenings and Dr. Selvin’s notes that due to funding, various insurance requirements, and liability for positive results, it has caused barriers to that demographic. Dr. Nagpal asks the presenter what the biggest barrier is for enrolling more providers for treatment and Dr. Slevin notes that insurance requirements, provider time, modernizing of treatment, could be barriers for having providers treat Hepatitis C. But she hopes simplified pathways could help overcome these barriers. Ms. Nelson notes that interest and time of primary care providers, especially from large healthcare systems that focus on metrics, may be barriers for providers. Dr. Syverson asks about the amount of residency programs are receiving curriculum for this practice and Dr. Slevin’s discusses that there is currently only one.
Health Officer Update
Dr. Newman provides the Health Officer update that focuses on the fall 2024 respiratory virus season by displaying various data regarding the current viruses and vaccines. Dr. Newman also discusses the ongoing pertussis outbreak being experienced throughout the state of North Dakota, and the uptick in cases being experienced in Cass County. The presentation by Dr. Newman is concluded with a Covid-19 update. Dr. Nagpal asks the consideration for a vaccine blitz for long-term care facilities and Ms. Perala notes that the current plan is to provide multiple types of immunizations to various facilities including long-term care facilities. Dr. Nagpal asks specifically about the RSV vaccine and if there is consideration to focus efforts on this vaccination among long-term care facilities. Ms. Nelson asks about the longevity and considerations for timing of the vaccine and Dr. Nagpal notes that currently there is no known evidence regarding timing, but there is a need and Dr. Newman agrees. Ms. Telford asks about the requirements of the vaccine in schools and daycares and Dr. Newman notes that there are requirements for licenses facilities.
Public Comments: None.
Next Meeting: December 6, 2024
Adjourn: 1:31 pm