Board of Health - April 4, 2025 Minutes
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 12:00 o’clock p.m., Friday, April 4, 2025.
Board of Health – April 4, 2025
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 April 4 , 2025.
The Board members present or absent during roll call were:
Present: John Strand (interim chair); Jayme Steig, PharmD; Avish Nagpal, MD; Bernie Dardis; Jim Kapitan; Valentina Bamfowaa Asiedu, MPH, CHES; Meg Forde, MS, RD, LRD; Andrew McLean, MD, MPH; Grant Syverson, MD; Timothy J. Mahoney, Mayor, City of Fargo
Virtual: none
Absent: none
Others: Brenton Nesemeier; Jenna Beilke; Jessie Lindemann, MD; Beth Wiegman; Brandi Deutsch; Jan Eliassen; Brenda Derrig; Nancy Morris; Jenn Faul; Melissa Perala; Suzanne Schaefer; Kim Vance; Holly Scott; Grant Larson; Larry Anenson
Introduction of all Board of Health members. Election of Officers:
John Strand opens nominations from the table for the position of chair of the Board of Health. Jim Kapitan nominates Bernie Dardis. Bernie Dardis nominates John Strand. Vote for nominee: Bernie Dardis: Nays: Andrew McLean, Bernie Dardis, Grant Syverson, Jayme Steig, Meg Forde, Valentina Asiedu. Yeas: Avish Nagpal, Jim Kapitan, John Strand. Vote for nominee: John Strand: Nays: none. Ayes: Andrew McLean, Avish Nagpal, Bernie Dardis, Grant Syverson, Jayme Steig, Jim Kapitan, John Strand, Meg Forde, Valentina Asiedu. John Strand becomes the acting chair of the Board of Health.
John Strand opens nominations from the table for the position of Vice Chair of the Board of Health. Bernie Dardis nominates Dr. Andrew McLean. Jim Kapitan moves to cast a unanimous ballot, Jayme Steig seconds. All members, excluding Dr. McLean, vote aye. Dr. McLean becomes the acting vice chair of the Board of Health. Bernie Dardis thanks the former board members for leading us through COVID and wants to thank them for their service. John Strand thanks the previous chair and vice chair for their courage and steadfast focus on their values. It is appreciated.
Approval of Agenda:
Jim Kapitan moved the agenda for approval. Avish Nagpal seconded this motion. All members voted aye. This motion was declared carried.
Approval of Meeting minutes from the January 19, 2025, meeting:
Jayme Steig moved the agenda for approval. Grant Syverson seconded this motion. All members voted aye. This motion was declared carried.
Announcements:
Ms. Faul gives updates on Fargo Cass Public Health work being done, a food grant that has been used to create a garden at a local elementary school, support existing previously purchased hydroponic food towers that were distributed to five local daycares, along with veggie peelers. An upcoming Bike Rodeo on May 3, 2025, that we are hosting with Bike & Walk North Dakota. Getting helmets fitted and learning about traffic safety on bikes. An immunization campaign was launched. An outreach to the Arbors apartment complex to increase the number of immunizations and let them know about clinic services. The CredibleMind expansion occurred with the Southeast Regional Public Health units merging onto the platform. QR codes will be developed for emergency workers so you can receive support. Another region had magnets for kids’ lockers, so we plan on moving ahead with that as well. Fargo Cass Public Health is hosting NAMI support family groups at their 1240 25th Street location on the last Thursday of the month. FCPH has been hosting internships, such as with students who work with health information management and communications (who have been working on an immunization education packet). We are happy to be hosting them. FCPH wants to thank Avish Nagpal for agreeing to host a new intern who is working with prevention and disease control. We will be hosting an intern for this spring who will assist with the Community Health Assessment. Winter warming operations are wrapping up on April 30. Public Health Week kicks off with Madison Verghis and Larry Anenson presenting on a panel at NDSU regarding HIV and reproductive health. Nursing and Environmental Health will be presenting at the Horace career fair. We hosted a Tobacco Youth Action Summit in Fargo at the Avalon. New software implementations for Environmental Health, Finance, and EPR. We have also been participating in Measles tabletop exercises across the state. Grant applications have gone in for a Sanford community grant and a grant for opioid interventions.
John Strand noted that there were no unhoused deaths this season because of severe weather. It is safety and security for those who are most vulnerable. Jayme Steig asked about the age range for the Bike Rodeo. The response is that there isn’t a real age range; the course is for kids, so roughly up to middle school, or if they are inexperienced bicyclists.
Health Officer Announcement:
Jessica Lindemann was chosen as the contracted health officer. It was approved by the Commission on March 31, 2025. Dr. Lindemann grew up in Fargo and got a master's in organic chemistry. Then, in her thirties, she changed her focus, went to UND, then UW-Eau Claire for family planning residency, then came back to Fargo and worked at Sanford, then at Community Health Service Inc. as their medical director and now owns her independent practice called Willow Health in South Fargo.
Budget:
Ms. Faul noted that there will be no new positions and no new operational expenses to the general fund for 2026. Mentioned that we have newly realized revenue. Environmental Health started charging a $100 flat fee, like other communities that increased revenue. The nursing services have changed a CPT code for home visits, which is generating more revenue. Consistent budget moving forward from 2024, 2025 and into 2026 despite a 4.5% COLA in 2025. In January, FCPH began cross-division training to reduce overtime in areas where there have been staffing shortages. FCPH Clinic and Nursing divisions met with Blue Cross Blue Shield Executive Director of Government Programs Health Integration to examine CPT codes utilized and what may be available for our use. There were changes to the funding for Health and Human Services, which impacted their insurance navigator program and decreased their availability of being on location at FCPH to help the underinsured and uninsured. We are looking at having a staff member who could assist in signing up individuals for insurance, which would get more people insured. If these individuals get signed up for insurance, it helps them have the ability to get more care and to utilize other partners in health care. We have some federal funding changes; the CDC and other federal agencies issued immediate stop-work orders. Impacted programs, ELC: Immunization, ELC: Epi and lab capacity, COVID-19 Health Disparities Grant, Community Health Workers for COVID Response and Resilience, Mental Health Block Grant, Substance Use Prevention, Treatment, and Recovery Services. We had a 10% reduction in the State Opioid response grant ($29,000) and we lost the SE Regional Block grant, which now becomes a competitive grant. We lost $104,000 for media campaigns, staffing, and outreach for boosting the immunization grant. We are trying to keep the work going so we don’t lose any of the services we provide to the community. Melissa Perala reviewed the budget numbers. We are exactly where we were last year; a couple of expenses were a little higher, though that will level out. We have about 60 programs under 10 different divisions. Expense items of note are interpreter services, health officer cost, computer services, marketing expenses, contract services, mileage, guest bus/hotel, office supplies, medical supplies, pharmacy, lab supplies and general supplies. We should have firmer numbers at the next Board of Health meeting in July. For revenue budget. We have applied for the opportunity to work as the nursing assistance for the Fargo Public Schools and the County schools for 2026. We are anticipating an increase in the 3rd party/insurance billing area, so that we will increase our revenue. The Cass County Jail Contract ended in 2024, reducing the Fee for Service $516,000. We are in a state of flux right now with federal and state changes. Division directors meet with Commissioner Strand, the Accountant, and the Director to discuss budget needs for the year. Ms. Perala encouraged the members of the board to contact her if they want to review the budget in more detail or if they have questions. Most temporary seasonal workers are in the Harm Reduction division (at least 16 staff). We have been requesting to move them to full-time; the benefits do not change, it is just that they are not listed in the City of Fargo budget. Ms. Faul and Mr. Strand agree that the temporary variable staff that are in “permanent positions” (some serving over nine years) should be considered full-time employees, not temporary variable. Mr. Dardis asked about the time lag that results from grant funding and about what support the Board could lend in case of any grants being targeted. Ms. Perala stated that we will address them as they occur and that we currently have a workforce grant that is helping us limp along to any program that is reduced in funding. Jayme Steig had a question about the state opioid funds and the SOR. The SOR is a grant and the opioid funds are settlement dollars that we already have, we are just moving the funds over, and we keep close tabs on it. Mr. Steig wanted to make a comment regarding the uncertainty of funding, hoping that the dollar amounts are floors not ceilings, because we need to support our people locally, then he asked about the morale of staff. Staff is working hard to put in for grants, we do not have a specific grant writer at FCPH.
CHA/CHIP:
Maggie Ridl is an MPH contractor who is working with us to create our CHA and CHIP. Grant Syverson and Jayme Steig volunteered to participate in the development of the plans. Ms. Ridl will present to the Board of Health on July 11. We paused work on this so we could get participation from a full Board of Health. We welcome all BOH to volunteer for this opportunity. We would like to begin strategic planning with stakeholders in September, with the completion of plan development in November.
Legislative Updates:
The increase of taxes on tobacco (HB 1570 & SB 2281) in the state of North Dakota received testimony from Abby Lange, Jenn Faul and Larry Anenson. Both bills were defeated; last time there was an increase was in 1967. HB 1541 & SB 2267 are about septic systems. Aaron Johnson, Grant Larson, and Jenn Faul provided testimony on these bills. They will be merging into a new bill. HB 1012 DHHS Budget for Public Health state aide, Jenn Faul gave testimony on behalf of this bill. HB 1425 Deflection/Diversion/Re-entry, Jenn Faul spoke with the Mayor, Chief of Police, and Governor Armstrong regarding the bill. HB 1605 was regarding fluoridation of water and the Board of Health and Fargo Cass Public Health submitted letters of support to keep fluoridation. The bill did not pass and we continue to have fluoridation in our water supply. Ms. Faul had an opportunity to participate in the Public Health Day at the Capitol in Bismarck with SACCHO (State Associations of County and City Health Officials).
Measles Update:
Dr. Lindemann presented on Measles. It is a highly contagious viral illness. There has been a recent rise in cases in the US. The measles vaccine that was approved in 1963 basically eradicated Measles from the US. She reviews the stages of infection, when to suspect measles and what to do. Brenton Nesemeier presented a snapshot of current measles cases nationwide. There were currently 607 cases and there were two deaths. Outbreak states include Texas (422 cases), New Mexico (48 cases), Kansas (24 cases), Oklahoma (10 cases), and Ohio (10 cases). ND has not reported a measles case since 2011. If you suspect a case of measles, call 701.328.2378 immediately. He showed slides showing the Cass County Coverage Rates that showed the different reasons for exemptions and the coverage rates. You can see individual school rates on their dashboard. Dr. McLean offered information regarding the algorithm that DHHS has about who should get immunized for measles. Get your MMR dose or check your status with a titer. Grant Syverson points out that some people can’t be vaccinated so those of us who can receive vaccine should, so we protect others. Also, vitamin A will not cure or treat a case of measles. There are no proven treatments for measles, the best practice is to get immunized and if ill, make sure no one else is exposed. Federal only reports on definite cases and some states report the probable cases as well. Avish Nagpal stated that the risk group is anyone who is unvaccinated and the treatment is plenty of fluids and rest and isolate from others to avoid exposing others. FCPH works with Childcare Aware and Department of Education to let them know what the guidance is. If you are wondering what you are immune to, you can get your titers done. Texas had immunization rates in the 60-70% range; herd immunity is 95% vaccination. If you were born before 1957, you are considered immune as measles is one of the most infectious diseases known (for every 1 case, there is a spread to 18 more individuals).
Director Update:
Ms. Faul was asked to speak to the Fargo Forum articles. The first article is one that included data over a three-year time frame so Ms. Wiegman (Assistant Director of Human Resources) will respond. She discusses employee exit interviews as a way to gather unique experiences. Employees are not required to participate. Shows a slide regarding the reason for employees leaving who participate in the exit interview. Then shows a slide showing exit interview responses regarding job satisfaction. Retirement is a natural driver to individuals leaving. She discusses what happens after the exit interview if steps are necessary. They have done things such as pay adjustments, benefit package adjustments, and conflict resolutions. A slide was presented regarding when current employees have concerns. Employees are encouraged to discuss with the immediate supervisor if this has occurred and if the issue remains or if it cannot occur then HR will discuss it with the supervisor’s manager or department head. HR, the supervisor and the department head will discuss and come up with strategies to address the issue. City Administration would be engaged/informed if applicable. Ms. Faul addressed the second article clarifying on the term expiration date for the previous board members. The Assistant City Administrator Brenda Derrig reached out to them and invited them to stay on until the new board members were found and they chose to opt out. Ms. Faul restated her desire to work closer with the board in or out of the official meeting so she could tap their expertise. Addressed the cuts in positions that were made due to budget reasons and Ms. Faul stated that historically, we do not review position changes (increases, salary changes, decreases). Our services have not decreased and in fact have increased and continue to expand (Mobile Medical Unit, outreach to Lake Region Health Unit, and foot care clinics.
Public Comment: None
Adjourn Meeting at 1:46 pm
Next Meeting: October 3, 2025