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Home My WebLink About05-2021 May 26 PHAB Minutes MINUTES Deschutes County Health Services Public Health Advisory Board (PHAB) May 26, 2021 12:00 p.m. - 1:30 p.m. via Zoom videoconferencing Facilitator Keith Winsor, Chair Staff Coordinator Tom Kuhn, Community Health Manager Scribe Lindsay Seibel Next Meeting June 23, 2021 - Zoom Topic and Lead Introductions and Approval of April Meeting Minutes The approval of the April Meeting Minutes is postponed due to never reaching quorum during this meeting. Announcements and Unfinished Business - Group Updates o Keith Winsor updated the group regarding the billboard advertising. Originally, we found some extra money from the County we could use to fund a billboard. However, other agencies like St. Charles are already advertising via billboards, so we may want to focus on other marketing strategies. Tom Kuhn will look into this potential project and provide an update later. o Robert Ross raised concern that all of the hospital space in Central Oregon is 100 percent full. Today, there are 42 COVID patients (9 in the ICU with 8 on ventilators) with many waiting for treatment in the Emergency Department. 97 percent of the COVID patients in the hospital are not fully vaccinated. Tom mentioned that Deschutes Count recently filled the Immunization Coordinator position, so hopefully we can start promoting the COVID vaccine even more. - Legislative Update o HB 2261 (online inhalant sales ban) rd  Just had its 3 reading today on the Senate floor. Looking to move forward for Signature. Expect it to be approved.  Dave Huntley submitted written testimony in support, as did PHAB on April th 26 to the Senate Committee on Health Care. o SB 587 (TRL)  Remains in the Joint Committee on Ways and Means since March 30th. Tobacco advocates continue to check-in with supporters to make sure the bill is in good shape.  Commissioner Adair provided Oral Testimony in support on March 1st to the Senate Committee On Health Care.  PHAB submitted written testimony to support to the BOCC. “To promote and protect the health and safety of our community.” Updated 3/4/22 o HB 2337 (anti-racism)  Commissions a study of the collection of race, ethnicity, language and disability status data of Oregonians to show how racism negatively impacts health outcomes.  Passed unanimously with amendments in the House Committee on Rules on May 25th, where it has remained since March 4th due to a provision in the bill that requires local public health authorities to operate mobile health units in every region of this state and needed language around data collection needed to be clarified.  The amendment changed the provision on mobile health units changed to, “OHA shall provide grants to one or more entities to operate two mobile health units as a pilot program.”  It has been referred to the Joint Ways and Means Committee.  Commissioner Chang submitted written testimony to the House Committee on Rules to support the bill. o HB 5024 (OHA Budget & Modernization)  Advocates for a $69 million investment in modernization in order to fill all the gaps in services that were determined to exist.  Tom Kuhn and Public Health Advisory Board Chair, Keith Winsor, provided oral testimony in support of PH Modernization and HB 5024 on February 9th before the Ways and Means Human Services Committee.  Tom Kuhn also e-mailed local legislators to support Modernization on April 2nd and May 11th. - Video Dispelling the COVID Vaccine Infertility Myth o PHAB played a significant role in gathering providers and our student representative together to create a video addressing the myth that the COVID vaccine causes infertility. The Central Oregon Health Council and Sarah Hutson, the lead for Deschutes County vaccine hesitancy, were integral in putting this video together as well. o Please share these videos widely.  General: Will the COVID 19 Vaccine Affect Fertility - Central Oregon Providers Respond  https://www.youtube.com/watch?v=ec60nS3I2vU  Student Response to COVID 19 Vaccine Fertility Concerns - Central Oregon  https://www.youtube.com/watch?v=I083sFEGSf8  Providers Give Confidence to Families Wondering Whether the COVID-19 Vaccine Affects Fertility  https://www.youtube.com/watch?v=DN-ixu-v6jw  What medical professionals say about the COVID-19 Vaccine Affect Fertility Rumor - Central Oregon  https://www.youtube.com/watch?v=8cGcbDSIM3M American Rescue Plan Funds Update Greg Munn, the Deschutes County Treasurer & CFO, provided an update on the American Rescue Plan Act (ARPA) - ARPA Overview “To promote and protect the health and safety of our community.” Updated 3/4/22 o ARPA is different from the CARES Act funding since it focuses more on recovery, rebuilding, and long-term investments. o ARPA passed on March 11, 2021, which includes a $1.9 trillion funding package. Counties will receive portions of $65.1 billion, based on population size. Deschutes County will receive $38.4 million in two tranches. We received the first tranche of $19.2 million on Monday, 5/24/21. The second $19.2 million will arrive by May 2022. We will have 3.5 years to spend the money. - Eligibility o There are five primary allowable uses  Support Public Health response  Address negative economic impacts  Replace public sector revenue loss  Premium pay for essential workers  Water, sewer, and broadband infrastructure - Greg has a wish list of ways to spend this money totaling $82 million. He plans to talk to the budget committee about creating a framework on which to make these decisions. Commissioner Chang invited the PHAB to provide guidance and recommendations throughout this process. o The BOCC could decide to create a subcommittee to make these decisions. o Greg will communicate with Tom on what he learns from discussions with the BOCC. - This is the first time Greg has seen this much money. He wants to ensure the funds are distributed equitably with the best return on investment, whatever that may mean. - Deschutes County receives additional funds for the COVID response from various grants, State funding from the mass vaccine clinic, leftover CARES Act funding, etc. Greg said funding streams change weekly, almost daily. Harm Reduction and COVID 19 Wrap-Around Services Laurie Hubbard, the Harm Reduction Services Coordinator, and Ashley Jones, the COVID 19 Wrap-Around Services Coordinator and a Harm Reduction Coordinator, provided an update on harm reduction and COVID-19 wrap-around services in Deschutes County. - Harm reduction is based on the philosophy that 1) acknowledges people engage in risk behavior, 2) recognizes potential for harm in high risk behaviors, and 3) meets people “where they are” in order to decrease risk of harm. In practice, this translates to compassionate, non-judgmental partnership, empowering people to keep themselves/community safer, and lowering the incidence of sharing needles and other drug-delivery equipment. - Harm reduction is an evidence based Public Health intervention that prevents the transmission of HIV, Hepatitis B and C; reduces the risk of bacterial infections and overdose/death; and increase proper disposal of used syringes. - Community Benefits to Harm Reduction Programs o Reduces risk of needle stick to first responders and social service providers o Reduces risk of discarded needs in public spaces o Reduces the cost associated with communicable disease, illness, and injury o Connects people to important services o Reduces overdose death “To promote and protect the health and safety of our community.” Updated 3/4/22 - The DCHS Harm Reduction program provides sterile syringes and safe supplies (sharps containers), education on overdose risk and prevention, a one for one exchange for used needles, naloxone, and referrals for medical care and social services. Public Health partnered with Behavioral Health to have a Peer Support Specialist at all sites for needle exchange. - Location and Staffing o Pre-pandemic: DCHS Courtney, Downtown Bend, Downtown Redmond  Coordinator (0.6 FTE) – Laurie Henning  Health Educator (0.2 FTE) – Ashley Jones  AmeriCorps Vista Volunteer  Peer Support Specialist  2-3 Volunteers o Pandemic shut down: Juniper Ridge, Antler Ave, Bend Bottle Drop  Coordinator (0.6 FTE) – Laurie Henning*  Health Educator (0.2 FTE) – Ashley Jones*  *Deployed to COVID investigation team o Pandemic currently: Downtown Bend, Downtown Redmond, Downtown La Pine  Coordinator (0.6 FTE) – Laurie Henning  Health Educator (0.5 FTE) – Ashley Jones  AmeriCorps Vista Volunteers  Peer Support Specialist  Intern - Harm Reduction Program Data o Age Range: 18-70 (largest age group 25-34) o Gender: 63.5% male, 30.0% female, 0.2% trans, 0.3% non-binary o Race/Ethnicity: White, Latinx, Asian, American Indian, Hawaiian/Pacific Islander, Black/African American o Housing: 80.5% unhoused or unstably housed, 24.0% with no tent, car, or anything over their heads o Overdose: 39% have overdosed, 70% have witnessed overdose, 20% have received Narcan, 36% have administered Narcan o Needle Sharing: 57% have shared needles o Hepatitis C: 23% know they are positive, 11% have never been tested o HIV: 1.2% know they are positive o Incarceration: 51% incarcerated in prior 12 months - The Syringe Exchange Program Model is anonymous, uses code-based data collection, and exchanges used syringes for sterile supplies. Clients fill out an intake form, complete a risk assessment, and are referred for support and recovery on site. - The Naloxone Distribution Program Model is confidential but not anonymous and requires both an enrollment and refill form. The enrollment form covers overdose history, substance use, and harm reduction strategies. The refill form records overdose reversals, discusses strategies to improve the response, and reviews harm reduction strategies. o Overdose Trends  80% increase in overdose events among exchanger population between 2019 and 2020, largely correlated to COVID pandemic closures.  Increase in the number of Narcan doses needed to reverse overdose events. This implies either substances are stronger, like fentanyl, or people are using more/combining substances or both. “To promote and protect the health and safety of our community.” Updated 3/4/22  Exchangers are first responders to overdose events. So far, in 2021, 90% of overdose events among harm reduction program participants are handled amongst themselves – 911 is not called. - Harm Reduction Program Highlights o Continued services during pandemic (one year in PPE) o Strong community partnerships with Mosaic Medical Van, REACH, Bend Church o Partnership with Behavioral Health to provide peer support services at all exchange sites o Several fundraising and awarded grants o Multi-disciplinary task force work/representation in DCHS - Harm Reduction Program Challenges o Stable funding source o Staffing o Volunteers o Naloxone o Stable sites (weather) o Multiple locations of unhoused exchangers o Access o Transportation o Storage Questions - Charla DeHate asked who the staff person in South County is working with. Laurie answered that they worked out of the Deschutes County South County office. - Keith asked what the trends have been in overdose deaths. Laurie said that fentanyl being present in opioids was becoming very common in new overdoses. - Keith asked about their penetration in the drug community. Laurie said they are not interacting much with non-needle users. This population is not being reached well by their services. - If you have further questions, feel free to reach out to Laurie or Ashley. Adjourn  1:30 pm Action Items:  None Board Members Present: Charla DeHate, Dave Huntley, Sharity Ludwig, Robert Ross, and Keith Winsor, Rebeckah Berry Staff Members Present: Tom Kuhn, Lindsay Seibel Guest Presenters: Laurie Hubbard, Ashley Jones, Greg Munn ARPA – American Rescue Plan Act ICU – Intensive Care Unit BOCC – Board of County Commissioners OHA – Oregon Health Authority COVID-19 – Coronavirus Disease of 2019 PHAB – Public Health Advisory Board DCHS – Deschutes County Health Services PPE – Personal Protective Equipment FTE – Full-time Equivalent REACH – Relationship Empowerment Action Compassion Heart HIV – Human Immunodeficiency Virus “To promote and protect the health and safety of our community.” Updated 3/4/22