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HomeMy WebLinkAbout05-2022 May 3 PHAB Minutes Deschutes County Health Services Public Health Advisory Board MINUTES MINUTES May 3, 2022 12:00 p.m. - 1:30 p.m. via Zoom videoconferencing Facilitator Dave Huntley, Chair Staff Coordinator Tom Kuhn, Community Health Manager Scribe Lisa Michael Next Meeting June 7, 2022, Zoom Topic and Lead Introductions and Approval of the April Meeting Minutes Staff were introduced and Steve motioned to approve the minutes, which were seconded by Rob. Announcement and Unfinished Business th Sara announced there will be a workforce meeting on June 7 and if anyone is interested in attending to let her know. Colleen said FUSE is partnering with Housing Works, Thrive Central Oregon and Reach and working on a grant funding application to the state for a 33-unit housing complex for the homeless and disabled. Health Hero Awards: The Board met as a team to evaluate the list of candidates. The awards will be presented to th the winners on May 17 at Pioneer Park at noon with a light lunch to follow. This year there will be 4 awards presented. Tom noted the winners as Donna Mills, Executive Director of COHC for the individual award. Both Gwen Gist from St. Charles and Dr. Logan Clausen from COPA, won the COVID individual awards, while Mosaic Medical Mobile Community Clinic won the COVID organization award. Tom is expecting 30 to 50 people to attend the awards ceremony in the park, including all three County Commissioners. The County PIO will handle the press release to announce the winners. Sometime in the future this may become a community-wide event. Colleen asked Tom what the format for award presentation is since she has never been to one. Tom also reminded the Board that we cannot vote for other Board members, nor can anyone outside the Board, according to the adopted rules. Two members were nominated by outsiders. Tom did however want to give honorable mention to those who were nominated. Tami Pike was nominated by Dr. Logan Clausen from COPA, while Sarah Baron was nominated by Stacy Shaw, COCC student. “To promote and protect the health and safety of our community.” Updated 11/22/22 National Association of Counties Conference in DC update – Commissioner Chang Commissioner Chang attended the annual National Association of Counties Conference in Washington DC in February. The conference brought together over 2,000 appointed and elected county officials to specifically focus on federal policies that impact counties around the nation and their residents. The Conference was geared towards time-in sessions with emphasis on nationwide social determinants, child care, homelessness, COVID related topics, health modernization and some behavioral health. Commissioner Chang said the conference helped him to better understand what’s going on at a national level. Next year, he would like to bring community input and specific ideas to the conference. President Biden gave a speech there and gave kudos to Deschutes County for childcare efforts. Meeting Theme: Public Health Structure and Operations Dave spoke briefly about the support structure and consistency and wants to circle back to this again soon. He will send out the master agenda and topics spreadsheet for any Board comments and ideas. Responding to COVID at Bend La Pine Schools Tami spoke about all the necessary efforts by school staff focused on COVID and how exhausted all the nursing staff have been struggling to keep up with caseloads. There have been thousands of cases throughout the school district and over 600 alone in January 2022. They had to learn to adapt to distance learning and all the associated issues with that for well over a year. With everything constantly changing, it has been very difficult trying to follow the Ready Schools, Safe Learners Guidance materials sent out by the OHA and ODE. Now with students back in school, nurses have been interviewing students and require quarantining those who are COVID positive. The trends were very challenging; however, meeting with pediatricians from COPA, Mosaic Medical, St. Charles and Summit Health on a weekly basis have been helpful in decision making efforts. Now they are meeting monthly with the decline in caseloads. Tami stated that the school district developed a functional tracking spreadsheet in October that has helped keep them organized. Due to increasing case numbers and adherence to RSSL guidance, 5 contact tracers were hired at the beginning of the school year to help track cases and send out notification letters. Although cases have decreased, tracers are still on site at the schools and need to be ready for any surges. Their hope for the 2022/2023 school year is to retain at least one tracer district wide to send out letters to parents keeping them abreast of any COVID outbreaks. Tami was able to hire a nurse as her assistant, which has helped her tremendously. Flu and COVID cases are starting to creep up recently and Tami said the schools have been giving out lots of test kits that are surprisingly coming back negative for COVID. Residency Program at St. Charles Dr. Ross explained the reasons for wanting a teaching and research IE “Academic” institution. He previously worked as the Academic Director for Klamath County and also worked for OHSU, before moving to Bend about 12 years ago. He noted that we are behind Klamath County in education and health professions. With the population explosion in Central Oregon that is likely to exceed future projections, there is a shortage of primary care physicians and specialists. SCHS is sponsoring a residency program that needs more teaching and support from specialties and others. Not only are they working on a strategy to maneuver the population boom, but they are also striving to provide access to care and address social justice issues for Indigenous and rural populations, while at the same time attempting to improve quality, safety and cost of care. The population forecast in Central Oregon is “To promote and protect the health and safety of our community.” Updated 11/22/22 expected to increase by more than 114,000 residents in the next 25 years. Deschutes County growth has topped Oregon over the past decade with the highest increase in the state at 25% from 2010 to 2018, while Crook County came in second. Dr. Ross spoke next about the GME. Once a student graduates from medical school they become “Graduate Medical Education” students or “residents”. These students were called residents because up until the 1970s they lived, ate and worked at the hospital until their residency was completed. Residency terms vary by field of specialty. By graduation, physicians have at least 2 or more years of direct patient care experience in and out of the hospital. Most GME’s stay within 50 miles of their training site to continue practicing. They are “exempt” employees of the hospital or educational institute while residents and work in excess of 80 hours a week without overtime. Dr. Ross explained that now is the time for such a program because once the door closes, the opportunity for an economically viable GME training site at the hospital will be lost. There is a new bill out with a clause that allows hospitals with limited funding in the residency program that will pay retroactively 3 to 5 years based on the number of residents. Dr. Ross is hoping SCHS will retain up to 140 residents by 2030. It can cost upwards of $180k to host a resident. CMS caps were unintentionally set in 1996 for St. Charles limiting the number of residences that could be funded that year, and preventing any significant expansion of the training program ever since. The ultimate goal is to train more doctors than can be utilized. There is an anticipated shortage of 200 physicians by 2030 and that doesn’t even account for those who are retiring. OHSU and St. Charles are co-developing a rural training track where residents will train in Madras, Prineville or Warm Springs their second year. New federal legislation is prioritizing rural training and may allow for a cap “reset” under certain situations. We are 49 out of 50 states for psychiatric care and working on building up our numbers. Dr. Ross said it might take some time to solve this problem, but we’ve been trying to play catch up for about 30 years and need to start somewhere. Homelessness Standards of Care Dave spoke about the PHAB document recommending minimum standards of care for the homeless in Deschutes County. There were 824 individuals identified as unsheltered during the 2021 PIT, which was considered a low estimate. There have been year over year increases in homeless from 2015 to 2021. Several local agencies are working on providing shelter; however, NGOs and local government should also supply safe drinking water, toilets, trash collection and medical care. Lack of sewage and trash collection impacts neighborhoods and the homeless and a lack of safe drinking water affects the health of the homeless. Since many homeless move around, local mobile health clinics have been reporting a negative impact in their healthcare. It has been difficult to follow up with clients when they relocate to other areas. The international NGO developed minimum standards in humanitarian response and published them in The Sphere Handbook in 1998. The latest edition was updated in 2018 with the current practices. Deschutes County has been conducting a homeless census for the past 7 years. The number has approximately doubled during that timeframe. Commissioner Chang asked about the estimates in cost for providing sewage and trash disposal, clean water, etc. and where would these services be provided? If we provide these services are we inviting more homeless to come here, which will only exacerbate the situation? Dave said the advisory board didn’t identify how care will be delivered or funded so that piece has not yet been looked into. Dave asked if the Board approved of the document to submit to the Commissioners. Steve motioned to approve the document as written, while Rob seconded the motion. The motion was unanimously approved by all Board members. “To promote and protect the health and safety of our community.” Updated 11/22/22 Public Health Accreditation Update (time permitting) Time did not allow for discussion Adjourn at 1:34 p.m. Board Members Present: Dave Huntley, Tami Pike, Dr. Rob Ross, Sarah Baron, Charla DeHate, Renee Wirth, Colleen Sinsky, Steve Strang, Dr. Peter Boehm, Emily Cummins, Tanya Nason, Sharity Ludwig, Staff Members Present: Tom Kuhn, Jacyln Alfaro, Lisa Michael Guess Presenters: Commissioner Phil Chang FUSE – Frequent Users System Engagement COHC – Central Oregon Health Council COPA – Central Oregon Pediatrics Association PIO – Public Information Officer COCC – Central Oregon Community College OHA – Oregon Health Authority ODE – Oregon Department of Education SCHS – St. Charles Health Systems GME – Graduate Medical Education CMS – Centers for Medicare/Medical Services OHSU – Oregon Health & Science University PHAB – Public Health Advisory Board PIT – Point-in-time NGO – Non-Governmental Organization “To promote and protect the health and safety of our community.” Updated 11/22/22