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Home My WebLink About12-2020 DECEMBER 9 PHAB Minutes Deschutes County Health Services Public Health Advisory Board MINUTES MINUTES December 9, 2020 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 January 27, Zoom Topic and Lead Introductions and Approval of October Meeting Minutes Tom Kuhn will send the October meeting minutes to the group for approval over email. Updates and Unfinished Business Jim Powell resigned from the board for reasons undisclosed, but has only positive comments about his time on the PHAB. Durlin Hickock will become a PHAB member after we ask the BoCC to add him officially. The 2021 PHAB calendar will be ready toward the end of December and will follow the same pattern of scheduling as the 2020 calendar. Keith Winsor requested that Tom include a PHAB retreat in the 2021 calendar. Tanya Nason was able to schedule more Traditional Health Worker trainings for January, February, March, and April of 2021. Please let Tanya know of anyone who may be interested in these trainings, especially for Doulas. In particular, Tanya would like to recruit Spanish language speakers and empathetic people. Durlin asked if PHAB members are able to join other committees and advisory boards, such as the COVID-19 Advisory Committee. This is permissible as long as board members identify their involvement as individuals and not as representatives from the PHAB. COVID 19 Update Carissa Heinige, the Deputy Director for Case Investigation and Contact Tracing, provided a COVID-19 update to the board. Data As of 12:00 pm on December 9, Deschutes County had 20 new COVID-19 cases with more to come. The total case count was 2,939. In the past 7 days, there were 472 new cases. There were 168 new cases during the metric period. On December 9, St. Charles had 43 COVID-19 hospitalized patients with 24 from Deschutes County, 11 from Jefferson County, 3 from Crook County, and 5 out of the tri-county area. There were 7 COVID-19 patients in the Intensive Care “To promote and protect the health and safety of our community.” Updated 1/26/21 Unit with 4 from Deschutes County, 2 from Jefferson, and 1 from out of the tri-county area. There were 5 patients on a ventilator with 3 from Deschutes County, 1 from Jefferson County, and 1 from out of the tri-county area. Trends Trends are showing that highest case count coming from people ages 20 to 40. Transmission is mostly occurring in households, workplaces, and social events, especially if they take place inside. Surge Response and Back Log Protocol Deschutes County Health Services (DCHS) is currently in phase 3 of the surge response. This includes ramping up staffing and onboarding new hires as quickly as possible. DCHS is following the Oregon Health Authority’s guidance for a surge protocol where case investigators scale back on the questions asked during case interviews, asking households to notify their own close contacts, and providing quarantine information to cases for them to distribute to their close contacts. The case investigators provide follow-up for close contacts considered at high risk (medical risk factors, demographics, etc.). DCHS has also engaged businesses to help with contact tracing if they have an employee who tested positive. Backlog Protocol DCHS created a plan for mobilizing an extension of the Health Services staff to help with backlog cases. The normal case investigator team did not have the capacity to complete the work from the surge of cases. Last week there were 129 new cases on one day. The backlog team completed 221 calls between Friday, Dec. 4, and Tuesday, Dec. 8. Q&A and Open Forum - Carissa does not believe St. Charles has implemented their surge protocol yet due to concerns around capacity, but this could change quickly due to the influx of cases we are seeing. - Keith asked about Deschutes County’s testing capacity. Carissa does not know specifics about the testing capacity, but expects more testing to be completed since OHA changed their investigative guidelines for COVID testing. Previously, OHA recommended testing for exposed individuals with symptoms or at high-risk. Now, OHA recommends testing within 3-14 days of exposure regardless of symptoms or risk level. Some clinics require a provider’s referral for testing. Individuals who are uninsured and/or undocumented face barriers to testing. Keith will reach out to Steve Strang, the Testing Branch Director for Deschutes County, for more details. - Tom is inviting a presenter for the next PHAB meeting to provide an overview of the results from a study on testing for COVID in wastewater. - The rate of false negative COVID test results is high. The rapid test has a higher likelihood of a false negative result than a PCR test. The criteria for a confirmed COVID case is either a positive test result or meeting the presumptive case definition of having exposure and at least two out of the four main symptoms. - Before the new DCHS Incident Command Structure, the Communicable Disease program staff were working on both COVID cases and all other infectious diseases. This became too taxing, so now the Communicable Disease program is split into non-COVID and COVID sections. - About 68 percent of COVID cases were considered sporadic in March; in November, the sporadic cases are at 45 percent and going up. Much of the spread is occurring without “To promote and protect the health and safety of our community.” Updated 1/26/21 known sources of exposure, but many exposures occur during in-person gatherings like parties. Other COVID-19 Resources St. Charles COVID-19 Data OHA Testing Strategy OHA False Negatives OHA Viral False Positives PHAB 2021 Priorities Review The PHAB 2020 priorities were set aside to focus on COVID-19. Instead of rolling the 2020 priorities over to 2021, the workgroup decided to draft new priorities with a special focus on COVID-19 concerns. Tom sent the PHAB 2021 priorities to the group members for approval via email on Monday, December 7, but decided they should be discussed live during the PHAB meeting. 1. COVID-19 Considerations. a. Support CDC Guidelines – “Hands (wash), Face (mask – covering nose and mouth), and Space (social distancing)” Do not recommend wearing face shields b. Support COVID-19 Vaccination when available c. Health Screenings and Care during COVID – With early COVID disruptions to healthcare, many appointments were canceled. The healthcare community has put COVID protections in place had have resumed appointments. We need to encourage people to seek and follow up with preventive health care including at least the following:  Child wellness doctor visits & childhood vaccinations.  Maternal and child health  Oral health  Preventive tests  Ongoing follow up care for chronic conditions  Seek help for alcohol and drug dependencies  Mental health  Not delaying emergency concerns or conditions  Eye exams 2. Immunizations and Vaccinations (general, non-COVID) Other topics for consideration if time allows or needs immediate attention: 3. Sexually Transmitted Disease/ Infection (Including Harm Reduction Strategies) 4. Teen Pregnancy/ Reproductive Health Access Group members discussed pediatric healthcare as particularly important with the upcoming universal childcare for two to five year olds. Other areas highlighted included telehealth, which is especially important for mental health visits, and chronic healthcare. Sharity Ludwig mentioned that data from items two through four need monitoring in order to know if they need immediate attention. Additionally, immunization messaging is important to emphasize. It would be beneficial if providers reviewed patients’ immunization records when “To promote and protect the health and safety of our community.” Updated 1/26/21 they inquire about the COVID-19 vaccination to help ensure up-to-date immunizations for diseases other than COVID-19. Tom questioned if the PHAB should focus primarily on non-COVID immunizations since many other entities will prioritize the COVID-19 vaccine. The group will follow up on this topic at the next meeting. The group discussed asking for the Commissioners’ support and guidance in mid-January regarding the PHAB’s immunization messaging strategy. To prepare for a meeting with the Commissioners, a PHAB workgroup will come up with a presentation before the next PHAB meeting that highlights messaging strategies as well as provides recommendations for next steps. Durlin will send Tom some resources on the history and best practices for Public Health messaging to be distributed to the group. The group moved to accept the 2021 PHAB Priorities. Public Health Strategic Planning Channa Lindsay shared a presentation on Strategic Planning with the PHAB during the last meeting. Since then, the DCHS staff developed draft Strategic Planning priorities for funding year 2022. These priorities are active for three years but include annual revisions. During this meeting, the PHAB provided input to refine these priorities. DCHS leadership chose the department level outcomes as 1) improve outcomes, 2) assure quality, and 3) increase sustainability. Based on staff input and data, the Public Health Strategic Priorities for fiscal years 22 through 24 are Public Trust and Public Health Service Area Resilience. The COVID-19 response and recovery is a primary priority for FY22 and is integrated in Public Trust and Public Health Service Area Resilience. The two priorities for fiscal years 23 through 24 are Built Environment and Land Use Planning as well as Injury Prevention. FY22 Strategic Priorities Public Trust includes advocacy and communication, such as evidence-based decision-making, health literacy and promotion, and branding and social marketing. Public Trust also includes partnership and engagement, such as community voice and empowerment, collaborative coalitions, and equity and representation. Public Service Area Resilience includes culture, workforce, and sustainable funding. Culture focuses on support, purpose, and shared accountability for staff. Workforce includes recruitment and diversity, competency and staff development, and engagement and internal communication. Sustainable funding includes diversity of funding, maximizing revenues, and legislation and modernization. PHAB Input on FY22 Strategic Priorities The group suggested some ways to operationalize Public Trust. - Education that explains Public Health activities, its impact on communities, present and past accomplishments, and historical events could help improve Public Trust. This could also include sharing local stories for a qualitative impact. - Community Health Workers are the representatives from the community who can meaningfully improve Public Trust since they understand, advocate, and can relate with “To promote and protect the health and safety of our community.” Updated 1/26/21 their communities. Tom and Channa requested that any board members email them any known organizations or groups who can leverage CHWs. Public Service Area Resilience - Public Health is the reason our society is as healthy as it is today, and this needs to be emphasized with the PH staff so they can communicate this back to the community and through their work. - Successful healthcare depends upon more than just a provider; it is imperative that all health communicators work as a team to address needs. - Public Service Area Resilience needs buy-in from the Commissioners, so they need education on its subject matters. - The programs funded primarily through grants are not sustainable. These programs need more regular and reliable funding, especially for remote counties. The group emphasized that community partnerships are integral for Public Trust, Resilience, and sustainability. Adjourn 1:31 Action Items:  PHAB schedule for 2021 Board Members Present: Keith Winsor, Dave Huntley, Sharity Ludwig, Tami Pike, Tanya Nason, Alison Perry, Durlin Hickock, and Peter Boehm Staff Members Present: Tom Kuhn, Lindsay Seibel Guest Presenters: Channa Lindsay (staff), Carissa Heinige (staff) PHAB – Public Health Advisory Board THW – Traditional Health Worker CHW – Community Health Worker PSS – Peer Support Specialist PWS – Peer Wellness Specialist YSS – Youth Support Specialist FSS – Family Support Specialist PHN – Personal Health Navigator OHP – Oregon Health Plan FFS – Free For Service CHE – Community Health Excellence BOCC – Board of County Commissioners PH – Public Health DCHS – Deschutes County Health Services RHA – Regional Health Authority RHIP – Regional Health Improvement Plan BAR HII – Bay Area Regional Health Inequities Initiative SWOT – Strengths, Weaknesses, Opportunities & Threats CD – Communicable Disease EH – Environmental Health DCPH – Deschutes County Public Health CDC – Center for Disease Control “To promote and protect the health and safety of our community.” Updated 1/26/21