HomeMy WebLinkAbout10-2020 OCTOBER 22 2019 MINUTES
Deschutes County Health Services
Public Health Advisory Board
MINUTES
MINUTES
October 22, 2019
8:30 a.m. – 1:00 p.m.
Planning Retreat
Road Department Conference Room
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61150 SE 27 St, Bend OR
Meeting Facilitator: Keith Winsor, Chair
Staff Coordinator: Tom Kuhn, Community Health Manager
Scribe: Lisa Michael
Next Meeting: December 4, 2019 – location TBD
OBJECTIVES:
Review 2020 priorities identified through email survey
Review data related to priorities identified
Plan any activities or actions to be undertaken in 2020
Keith started off the meeting with introductions and reminded the board to pick up a copy of the
2020 meeting calendar. The September meeting minutes were deferred for approval until
December.
Keith gave a quick recap of PHAB’s past focus areas and on-going ad hoc activities. In the fall
of 2017, when Susan Keys was still involved with PHAB, she devised a plan to hold a yearly
retreat in order to prioritize PHAB’s goals for the following year. The list of goals became more
expansive last year to include homelessness, immunizations, air quality, senior health, and
women and children’s health, etc. This year Tom suggested using a matrix scoring system
borrowed from COHC to evaluate PHAB’s new priorities in order to align with the BOCC and
DCHS goals. Rob and Dave worked on immunizations in 2019 and expressed their interest in
continuing to do so in 2020. Keith mentioned that the Smoke and Public Health Collaborative
made some policy changes, which several groups are continuing work on. A Wildfire Mitigation
Advisory Committee was established by the BOCC making it one of their top priorities.
Survey Results, Top 10 & Public Health Funding:
Hillary spoke about funding resources for Public Health and said 33% comes from County
general funds, while 40% comes from other sources like state and federal grants and fee
collecting departments within DCHS (e.g. Environmental Health, Vital Records). DCHS does not
have a fiduciary board; however, the BOCC is one. DCHS has taken over some areas that used
to be funded by the state. Hillary also noted that we are unique to public health as a lot of the
services we provide are not necessarily available elsewhere and we are not able to bill for many
of these services like other providers do. It is essential that we partner with other agencies to
coordinate our work.
“To promote and protect the health and safety of our community.” Updated 8/4/20
Tom explained the matrix scoring system and presented survey results to the Board. The top
three categories were (there was a 3-way tie for third):
1. Immunizations (87 points)
2. Adolescent vaccines (82 points)
3. Prenatal care (74 points
Tobacco retail licensure (74 points)
Youth tobacco and vaping prevention (74 points)
Dave asked about harm reduction like syringe exchange, which can reduce the risk of disease
transmissions. Heather jumped on board and said medications that reduce or reverse overdoses
can also be referred to as harm reduction.
Jim asked if there was anything on the list that the BOCC might want to explore.
Commissioner Adair expressed concern about state funding limits and the growth in our
population. She is also taking a personal interest in trying to open a few warming shelters
around town and is passionate about endorsing immunizations.
Hillary mentioned local high school graduation rates, which is not in our lane, but there are
groups working on it. We should leave room for ad hoc items that may come up so we can
make adjustments if needed. Tom listed the ad hoc items as: engaging the BOCC, legislative
action, emergency health threats, support PH funding and PH accreditation and triennial
reviews.
Hillary told the board that a state audit is conducted every three years and we had zero findings
on our most recent one, which is extremely rare. Only one other county in the state also had
zero findings.
Tom said PHAB should agree on 2 or 3 exploratory topics to discuss and schedule experts to
come speak throughout the year.
Data Overview for Top PHAB Priorities:
Jenny gave a PowerPoint presentation on the data she collected in relationship to PHAB’s
priority list. The top priorities come from the RHA.
IMMUNIZATIONS:
Jenny went over the results of the immunization rates for 2 year olds, which have slightly
increased over the past few year. However, there is still room for improvement in rates for all
age categories. The rate for Deschutes County is 69%; 1% higher than the statewide average.
PRENATAL CARE:
The percentage of births when prenatal care began in the first trimester was higher in
Deschutes County than overall statewide over a 7 year period from 2010 to 2017. Alcohol
consumption during pregnancy has also increased over recent years in Central Oregon with
pregnant women drinking more frequently and in higher volumes. Adequate care during
pregnancy is right on track with statewide averages and preterm births are lower overall.
Deschutes County is also in the middle of the pack statewide for low birth weight. Pamela
mentioned that Deschutes County has one of the most robust prenatal/perinatal care systems in
the state. The state is so impressed by our program, they want to model us.
“To promote and protect the health and safety of our community.” Updated 8/4/20
SMOKING/TOBACCO RETAIL LICENSURE:
A higher percentage of residents that live under the federal poverty level tend to smoke and are
classified as obese compared to those who live above the federal poverty level. Overall, 17% of
residents in Deschutes County smoke and 1/3 of these are lower income. Deschutes County
reported a lower tobacco related death rate than the statewide average. The highest rates are
seen in those who are American Indian and Hispanic.
YOUTH TOBACCO AND VAPING:
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In a study amongst 8 and 11 grade students, e-cigarettes are the most widely used device
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right now. Ten percent of 8 graders are using any kind of tobacco, while 8% use tobacco
products other than cigarettes. Three percent smoke cigarettes only. Sixty seven percent of
those who are vaping use flavored products.
SEXUALLY TRANSMITTED DISEASE:
Deschutes County has seen an increase in chlamydia cases, but not near as high as Jefferson
County. Syphilis and gonorrhea cases are also on the rise. Jefferson County has been
documenting the most STD cases in the tri-county region.
TEEN PREGNANCY PREVENTION/REPRODUCTIVE HEALTH ACCESS:
Warm Springs has a rate of inadequate prenatal care that is nearly three times the state
average. Madras, La Pine and portions of north Klamath County also have higher rates than the
state as a whole.
CHRONIC DISEASE (CVD, DIABETES, OBESITY):
Chronic diseases have been known to be linked to various income levels and a higher
percentage of those who live below the FPL smoke and are categorized as obese compared to
those who live above the FPL. The mortality rate for heart disease has improved some;
however, mortality rates for men are almost double the rate compared to women. Deschutes
County figures are lower than Jefferson and Crook Counties.
SUICIDE PREVENTION:
Central Oregon recorded 66 deaths by suicide in 2017, of which 57 were in Deschutes County.
This is the highest rate since 2008. Suicide ranked highest among 15-44 year olds overall
statewide. More than 50% of these suicides were caused by firearms, while suffocation and
poisoning came in at almost 20% and 15% respectively. Oregon has one of the highest suicide
rates in the nation. Would the BOCC be interested in gun safety related to suicide?
YOUTH ALCOHOL PREVENTION AND YOUTH MARIJUANA PREVENTION:
Focuses on youth including the prevention of ACEs, reducing school dropout rates, alcohol,
tobacco and drug use. From 2013 to 2015 there was a decrease in use overall; however, there
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was an increase in alcohol consumption by 8 graders and 8 and 11 graders reported the
highest percentage of use in the entire state.
Since the BOCC is considering resurrecting the opt out referendum in November, Jim asked if
there was a lower incidence of youth marijuana use in those counties who have opted out of
allowing local dispensaries/grows. Jenny didn’t have any data on this.
What can PHAB do?
Hillary said that topics reviewed by PHAB should make an impact, be feasible, realistic,
achievable and most importantly, endorsed by the BOCC. Rob also added measurable.
“To promote and protect the health and safety of our community.” Updated 8/4/20
Staff recommended the following as higher priorities:
Immunizations and Adolescent Vaccines
Youth Vaping Prevention
Sexually Transmitted Infections
Teen Pregnancy Prevention and Reproductive Health
Chronic Diseases
Lower Priorities/Exploratory:
Prenatal Care
Tobacco Retail License
Suicide Prevention
Youth Alcohol Prevention
Youth Marijuana Prevention
Youth Tobacco (not including vaping)
Ad hoc items:
Food Cart Safety
Harm Reduction Practices
Emerging Public Health Threats
Veteran Homelessness and Health
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Tom mentioned there is a meeting with the BOCC on November 4 regarding tobacco retail
licensing.
Commissioner Adair explained there is state funding available to build duplexes for veterans; but
finding affordable property to build on is another story. A homeless veteran count was recently
conducted and 22 were reported; however, COVO said there are at least 100 or more homeless
veterans by their count. Keith said this topic may be out of our lane, but maybe PHAB can
carve out some time to review this issue sometime in 2020.
Chuck asked why we would limit immunizations solely to adolescents when we can include all
age groups that need vaccinations.
Jim said PHAB should look at homelessness in the community as a whole if possible. He
explained there are many different situations that cause homelessness, such as those who lose
a spouse, resulting in lost income, unforeseen circumstances like health issues, taxes,
unplanned events, and unemployment, etc.
Should PHAB provide feedback to the BOCC on these types of issues? Commissioner Adair said
she would like to hear from us. Hillary said she could bring ideas to the table.
Hillary also mentioned when working on strategies, PHAB should consider criteria like the
current state, any gaps, needs or issues and our role and how we can assist in exploring any
topics we review. What items do we want to take action on now and what do we want to
review as exploratory?
“To promote and protect the health and safety of our community.” Updated 8/4/20
Finalizing 2020 Priorities & Strategies:
Channa lead the group in brainstorming ideas for the 2020 calendar year. She asked the Board
to think about priorities that will not only be effective, but feasible as well, and to pick 2 or 3 top
priorities. After some discussion about several topics, the Board came up with the list (please
refer to attached reports submitted by Chana).
PHAB Lunch Options & Recommendations:
Keith will work with Lisa offline on catering options for future meetings.
Meeting adjourned at 1:00 p.m.
Board Members Present: Keith Winsor, Rebeckah Berry, Jim Powell, Steve Strang, Robert
Ross, Sharity Ludwig, Peter Boehm, Tami Pike, Charla DeHate, David Huntley, Jason Jundt
Staff Present: Tom Kuhn, Hillary Saraceno, Pamela Ferguson, Heather Kaisner, Lisa Michael,
Guests and Guest Speakers: Commissioner Patti Adair (BOCC), Chuck Frazier (ex-officio
PHAB member), Channa Lindsay (staff), Jenny Faith (staff)
PHAB – Public Health Advisory Board BOCC – Board of County Commissioners
DCHS – Deschutes County Health Services COHC – Central Oregon Health Council
PH – Public Health RHA – Regional Health Assessment
STD – Sexually Transmitted Disease CVD – Cardiovascular Disease
FPL – Federal Poverty Level ACEs – Adverse Childhood Experiences
COVO – Central Oregon Veteran’s Outreach
“To promote and protect the health and safety of our community.” Updated 8/4/20