HomeMy WebLinkAbout02-2020 FEBRUARY 26 2020 MINUTES
Deschutes County Health Services
Public Health Advisory Board
MINUTES
MINUTES
February 26, 2020
12:00 p.m. - 1:30 p.m.
Stan Owen Conference Room
2577 NE Courtney Dr, Bend
Facilitator Rebeckah Berry, Vice Chair
Staff Coordinator Tom Kuhn, Community Health Manager
Scribe Lisa Michael
Next Meeting March 25, 2020 – Stan Owen Conference Room
Topic and Lead
Introductions and Approval of January meeting minutes
The Board went around the room to introduce themselves to guests. Jim motioned to approve
the minutes as submitted, which were seconded by Dave.
Brief Announcements & Unfinished Business
Commissioner Henderson informed the Board that he will be attending future PHAB meetings
when possible and will act as liaison for the BOCC. Commissioner Adair will be acting liaison
for the BHAB and attending their meetings.
Dr. Conway announced that DCHS has officially hired Nahad Sadr-Azodi to replace Hillary as
st
the new Public Health Director. He starts on April 1 and holds three master degrees with one
in health economics and has an extensive background in health equity. He is leaving his
current position as the Regional Immunization Coordinator for UNICEF and has held positions
for the CDC and the WHO, amongst others. He strongly supports immunization work.
Charla, Peter and Sharity met with Amy from the Bend-La Pine School Board regarding SBHC
contracts and reproductive healthcare. With the current superintendent leaving soon, Amy said
they will introduce the idea during interviews for the new superintendent and seek out
candidates in support of the program. The school board also discussed gun safety and the use
of gun safes but received push back from the school superintendent.
Peter and Rebeckah also met with Liz Goodrich from the Redmond School Board to discuss
SBHC’s and reproductive healthcare. Currently this topic is not on the school board’s agenda.
Peter and Rebeckah brought up the fact that it could help improve graduation rates and
decrease teen pregnancy. With elections coming up soon, it’s a wait and see what happens
scenario. Liz was open to the discussion and wants more information. She is fairly new to the
school board and will try and introduce the idea to other board members.
“To promote and protect the health and safety of our community.” Updated 8/4/20
Member Update:
Tom announced that Stacey has officially resigned since it has been too difficult for her to
attend the meetings on Wednesdays. Tom is in the process of recommending Tanya Nason
from PacificSource to the BOCC. Alison Perry, founder of COVR, is here with us today and
interested in becoming a member. COVR won a health hero award a few years ago. Tom said
we have 11 current members and that will increase to 13 if Tanya and Alison become board
members.
Legislative Update:
Tom gave an update on the current legislature noting that SB 1577 morphed from a flavored
vaping products ban to a statewide required licensure for tobacco retailers. Dave testified on
th
February 6 at the legislative short session, along with Karen Ard (DCHS Tobacco Education
and Prevention Specialist) and Gabriella Shirtcliff, Teen Community Health Advocate, in support
of the bill. Tom also mentioned that the Republican Party walked out during the short session.
Dave gave a quick rundown of his experience while testifying and said the Timber Alliance was
there, along with several members of the trucking industry, who were holding a rally in protest
of SB 1530 (Cap & Trade bill). He said Cheri Helt was there in support of banning the flavored
th
vaping products also. Karen testified that data shows in 2016, 17% of 11 graders vaped in
the last 30 days, while that percentage rate went up to 28% in 2018. Vaping is the new
smoking and addiction rates are climbing. Dave also mentioned that more people in England
are vaping over smoking; however, they are way more regulated than we are here.
Health Hero Update:
Dave is putting a historical list of nominations together for the board’s review. Tom mentioned
that Health Services staff can be nominated only by someone outside the agency. For now, we
are going to stay with the current process, but will work on a more streamlined system starting
next year in order to make the process more meaningful. Tom will be attending the BHAB
meeting tomorrow and will ask for their participation. There will be a survey monkey set up for
voting online for those interested. Tom suggested inviting some BHAB members to the PHAB
meeting in March to discuss the candidates. Rebeckah suggested we discuss the nominees
first, then vote via survey monkey.
Coronavirus Update
Jill Johnson, CD Supervisor, gave a status update on the current global Covid-19 crisis. DCHS
is knee deep in preparations in case the virus spreads to Central Oregon. Jill explained that
coronaviruses are actually quite common and that the common cold is a coronavirus. The CDC
has reported there are more than 30 coronaviruses on record, however, most are very mild.
There are seven affecting humans and even more in animals.
Covid-19 background:
The Covid-19 virus originated in China in December 2019 and has rapidly spread around the
globe, including the United States. Fourteen cases tested positive in the U.S. (12 had travelled
to China, while 2 were from household contact with those who had travelled to China). The
mortality rate for now is 2.3% and the virus is spreading faster in a shorter time than SARS
and MERS ever did. The mortality rate for SARS (2002) was 10%, while MERS (2012) was
40%. Most of the deaths reported have been elderly and immunocompromised patients and
has spread by person to person contact through droplets (coughing/sneezing, etc.) mostly
within 6 feet of contact. The incubation period is 2 to 14 days with 5 days being the median.
“To promote and protect the health and safety of our community.” Updated 8/4/20
The CDC reports that symptoms include fever, coughing and shortness of breath. As it stands,
there is no vaccine available; although, there are 12 pharmaceutical companies working
diligently around the clock to develop one.
Jenny Faith, DCHS Epidemiologist, is putting out a daily surveillance map. As of today, there
are more than 80,000 cases globally, with more than 2,700 deaths in China. Three-thousand
of these cases have been reported outside China in 37 different countries resulting in 44
deaths. The first case in South America was reported in Brazil today and every continent has
been affected except for Antarctica. Travel is being restricted, especially to and from China,
and Jill noted that U.S. citizens can travel from China back to the states but will be quarantined
for 14 days. There are no cases in Oregon; however, there are 59 total cases in the U.S. thus
far of which 42 were passengers on the Diamond Princess Cruise line. Three were evacuated
from China on repatriation flights from Wuhan. The OHA will be sharing current figures
starting next week and every week thereafter of those being monitored and investigated.
As part of preparation and surveillance, staff has been listening in on CDC and OHA calls for
the most up-to-date information every week and channeling that information through the Alert
Network to area providers and partners. Staff with be hosting a meeting next week with
partners to respond to inquiries and discuss logistics. DCHS is implementing OHA investigative
guidelines as required by law. Jill shared a chart showing the risk designation and
recommendations for monitoring various levels of infected patients. DCHS has developed an
algorithm for health care providers to serve as a guideline for evaluating ill patients. Testing is
currently being conducted by the CDC only, and patients must first meet the criteria in order to
be tested. Jill said DCHS is trying to squash all the rumors flying around and will inform the
public if a case shows up in Deschutes County.
Commissioner Henderson asked if the caseload will taper off by summer due to the warmer
weather. Experts says it’s too soon to tell; however, H1N1 slowed significantly during summer.
Regional Health Improvement Plan (RHIP) update
Rebeckah spoke about the latest update to the RHIP and explained that COHC is a non-profit
community governance entity that is dedicated to improving the health of the residents of
Central Oregon. COHC provides oversight of the CCO’s and the Medicaid population, and is
responsible for Regional Health Assessment (RHA) and the RHIP as required by SB 648.
Rebeckah explained that a health assessment is a snapshot of community health and wellness
at a given point in time. The assessment describes an array of health issues, as well as social
and economic factors that impact health. The complied data is the foundation for the
development of the RHIP and many organization’s strategic plans. The RHA is often referred to
as a Community Health Assessment, and in Central Oregon, it is a collaborative regional
approach that meets the requirements for many organizations. Several agencies and partners
were involved in helping to create the RHA in 2019, which includes of qualitative and
quantitative data, along with multiples surveys that were conducted and collected by focus
groups. Rebeckah gave examples of conditions that affect health to include:
1. Counseling and education – advice to eat healthy and physical activity.
2. Clinical interventions –medications for high blood pressure, cholesterol, diabetes, etc.
3. Long-lasting protective interventions – immunizations, smoking cessation, various
interventions.
“To promote and protect the health and safety of our community.” Updated 8/4/20
4. Changing the context to make individual’s default decisions healthy – Fluoridation, 0g
trans-fat, iodization, smoke-free, cigarette tax.
5. Socioeconomic factors – poverty, education, housing, inequality
Rebeckah spoke about the RHIP, which was just launched in 2020, and will continue through
2023. The benefits of having a health plan in place are the ability to identify strengths and
weaknesses in existing services and locate gaps that we can improve upon. Periodic
benchmarks are used in keeping on task. The RHIP was developed using quantitative data
acquired from the RHA and use of a modified Hanlon prioritization process. Data was collected
from 24 focus groups with over 240 participants throughout the region and from telephone
surveys conducted by St Charles Health System. Final priorities were selected at a combined
meeting with the COHC Community Advisory Council and Board of Directors. Community
volunteers, content experts, and health equity reviewers create the actual document, which
included 30 organizations and 75 individuals. Who uses the RHIP? CCO’s, hospitals, grant
writers, public health, organizations who align their own strategic plan with the RHIP and those
who address health issues in Central Oregon.
The six priority areas that have been identified are:
1. Address poverty and Enhance Self-Sufficiency
Metrics:
a. Increase high school graduation rates among economically disadvantaged students.
b. Decrease food insecurity.
c. Decrease percent of residents living at poverty level and income constrained.
d. Decrease housing and transportation costs as a percent of income.
2. Behavioral Health: Increase Access and Coordination
Metrics:
a. Increase availability of BH providers in marginalized areas of the region.
b. Increase timeliness and engagement of referrals from primary care to BH specialist.
c. Standardize screening processes for suitable levels of follow-up care.
3. Promote Enhanced Physical Health Across Communities
Metrics:
a. Decrease asthma, cancer, heart disease, and diabetes rates.
b. Decrease obesity rates in adults.
c. Increase fruit/vegetable consumption and physical activity in youth.
d. Decrease STI’s
e. Increase amount of individuals receiving an annual wellness and preventative dental
visit.
4. Stable Housing and Supports
Metrics:
a. Reduce rent and mortgage-burdened households.
b. Increase housing choices for choice voucher holders seeking a residence to lease.
c. Accurately capture those experiencing homelessness in Central Oregon.
“To promote and protect the health and safety of our community.” Updated 8/4/20
5. Substance and Alcohol Misuse: Prevention and Treatment
Metrics:
a. Reduce adult binge drinking.
b. Reduce vaping and e-cigarette use among youth.
c. Increase additional services for alcohol or drug dependent individuals that have been
newly diagnosed.
6. Upstream Prevention: Promotion of Individual Well-Being
Metrics:
a. Increase letter name recognition at kindergarten level.
b. Increase third-grade reading proficiency.
c. Increase proportion of pregnancies that are planned.
d. Increase immunization rates for two-year olds.
e. Increase the number of people who feel they belong in their community.
Rebeckah explained the implementation process and what happens next. Six workgroups are
being formed to address each of the six priority areas. The COHC Board of Directors provides
investment funding to each workgroup for projects that impact the priority area metrics.
Approximately 25 to 65 people will work on each workgroup with two assigned COHC Project
Managers supporting their efforts. Each COHC Project Manager will facilitate focused
conversations, consensus, and structured problem-solving meetings. This process is done on a
4-year cycle. More information is available at cohealthcouncil.org.
Adjourn at 1:29 P.M.
Board Members Present: Rebeckah Berry, Jim Powell, Charla DeHate, Jason Jundt, Peter
Boehm, Dave Huntley, Steve Strang, Tami Pike, Sharity Ludwig, Robert Ross
Staff Present: Dr. George Conway, Tom Kuhn, Hillary Saraceno, Heather Kaisner, Lisa Michael
Guests: Phil Henderson, Deschutes County Commissioner
PHAB – Public Health Advisory Board BOCC – Board of County Commissioners
BHAB – Behavioral Health Advisory Board DCHS – Deschutes County Health Services
UNICEF – United Nations International Children’s Emergency Fund
CDC – Center for Disease Control WHO –World Health Organization
SBHC’s – School Based Health Centers COVR – Central Oregon Veteran’s Ranch
SB – Senate Bill CD – Communicable Disease
SARS – Sudden Acute Respiratory Syndrome MERS – Middle East Respiratory Syndrome
OHA – Oregon Health Authority H1N1 – Hemagglutinin Neuraminidase
RHIP – Regional Health Improvement Plan COHC – Central Oregon Health Council
CCO’s – Coordinated Care Organizations RHA – Regional Health Assessment
STI’s – Sexually Transmitted Infections
“To promote and protect the health and safety of our community.” Updated 8/4/20