Call to Order / David Luchini welcomed all and called the meeting to order at 10:09 a.m.
In Person AM: Van Do-Reynoso, Kathleen Grassi, Tammy Evans, Becky Nanyonjo, David Luchini, Rob Stewart, Ashley Hart.
On Phone AM: Beth Gazarek, Keith Winkler, Dr. Milton Teske
In Person PM: Van Do-Reynoso, Kathleen Grassi, Tammy Evans, Becky Nanyonjo, David Luchini, Rob Stewart, Ashley Hart.
On Phone PM: Beth Gazarek, Keith Winkler, Dr. Milton Teske
Approval of Minutes / The minutes from 7-25-16 were approved by consensus with the correction on from Dr. Garza.
Action Items
Policy System Environmental Change Connections (meets quarterly by Zoom) / David Luchini presented about the PSE Sub-Committee who had their SOW/Framework Development meeting last week. The co-chairs are tentatively Sara Bosse, Fresno, and Rob Stewart, Tulare. They are reviewing and updating their SOW at their next meeting in October and they want to share information with the Consortium at the retreat in November. The next meeting is on October 10th.
Data Subcommittee (meets monthly by Zoom) / David Luchini explained that the Data Sub-Committee drafted a framework with goals for their group and it is included in the meeting documents today. Beth Gazarek explained that the main objective for the data sub-committee is related to data mapping related to poverty and health issues. The members approved the SOW/Framework Development for 2016-2017. The next meeting is on October 14th.
STD Controller and Health Officer Syphilis Updates (meets quarterly by Zoom) / Julie Vaishampayan, M.D., M.P.H., Assistant Health Officer, San Joaquin County Public Health Services presented regarding the STD Controller Meeting on July 28th, 2016 which focused on Syphilis. The group wanted to continue to meet on a regular basis and decided on quarterly by Zoom. They discussed ways to share information with the group and they also shared statistics. There is $5 million split over the state of California, $99,000 for three years in San Joaquin. David Luchini discussed the varied populations in San Francisco/Los Angeles versus the San Joaquin Valley. She also discussed the in-spot notification related to partner notification. The deadline for this money is coming up within two weeks and she recommended that the group collaborate together. Fresno County has had to expand investigations as they have a 25% reinfection rate. Julie explains that most of the diagnoses are from the Emergency Department. The next meeting is on November 28th. / -Julie will send Syphilis article/Peer to Peer information to Ashley to share with members
County Updates / Questions for Other PHDs
· ACA
· Public Health Workforce Capacity
· Accreditation Updates
· Funding Opportunities/ Current Grant Opportunities
· Drought Updates
· Health Equity
· Other Significant Public Health Activities/Events
· Congenital syphilis / Kings: Keith Winkler summarized that they have applied for a grant to help people enroll in health insurance for $100,000/year for 3 years. They are conducting SWOT analyses for all units in their counties, which will lead to the generation of program plans related to various problems related to the programs, legal requirements, objectives, measurable activities, determine personnel needs. They are working on setting up a syringe exchange and are working with their sheriff and police chief. This is an opportunity for education and connecting people with services. The location will likely be the public health department and should start in January 2017. They currently have kiosks within the county for safe disposal of sharps and medications. Kathleen asked whether they will have wraparound services related to needle exchange and Keith explained that there will be many different types of services for those people who participate.
Stanislaus: Becky Nanyonjo explained that they are going to be submitting all documents by March 2017 and they have a full-time accreditation coordinator. They completed their MAPP improvement process this past week. Their four areas are built environment, access to health information, education, and basic needs. They had a board member as a speaker as well as a chief executive officer. They want to focus on re-aligning and providing training related to the importance of the CHIP and public health accreditation. She explained that the CHIP included a data update from the CHA. The PMQI is nearing completion and they are focusing on results-based accountability, which has been good for staff to see their progress over time. They are looking into applying for funding for accountable health communities as the criteria has changed. They have a HIE meeting later this week and are moving forward as fast as possible with assistance and guidance from Kathleen Grassi related to their process. Dr. Walker will retire in March 2017, so they will be hiring for an assistant health officer, public health director, and health officer. Becky participated in a Governing for Racial Equity conference and connected with Gilda, from Madera at the event.
Fresno: David Luchini explained that they will be going to RFP for Correctional Health and they currently have Corizon. They hired an RN related to correctional health, chart review and changes for the future. They have been working with Behavioral Health related to when inmates are released, with goals for a full-time discharge planner. He explained that they are working to create a transition program related to pregnant women being released from jail. Their manager attended a conference and presented related to syphilis. They will have a drive-through flu clinic and have not had one in a while. They are applying to a Medi-Cal oral health grant and are working with a dentist, hygienist, and a few CBOs. They have been working with Fresno Unified School District to increase school-based clinics as there is currently one school-based clinic open to children 0-18 with future goals for all ages. They provide the mapping data related to lack of health services related to various areas. FCHIP is moving forward and there are sub-committees; diabetes, healthy babies, health literacy, roads and planning and mental health. There is also an issue related to lead in the water in northeast Fresno but there has not been any increase in blood lead levels. There are many groups expanding services related to home visits, such as pharmacists and information related to asthma.
Madera: Van Do-Reynoso explained that they are planning for their new building. She discussed a webinar related to low cost tools that PH Departments can use to track documents during the accreditation process, such as Excel and Wiki documents. The document is an expansion of the PMQI Tool. Van recommended that the members buy the document and share the cost, approximately $2,000/year. They are looking to purchase this by November and is interested in partnering with other agencies. They just hired a full-time accreditation coordinator. They also applied for the CMSP grant, similar to Kings County, to expand enrollment to those not enrolled and in addition they are hoping to expand an additional grant to a different population. They identified four areas: diabetes/obesity, child abuse/neglect, mental health, alcohol/drug use and will be developing objectives related to these. The planning director and public health partners participated in the event in Monterey and they will focus on community engagement as a team. The planning director and public health partners are going to focus on data collection, socioeconomic and health data, in Fairmead, 500 households unincorporated near Chowchilla, to develop a strategic plan for this community. She explained that they have also had a large increase in applications based on the salary compensation, compared with the other public health counties.
Merced: Kathleen Grassi explained that there are a few UC Davis medical residents who are interested in starting a needle exchange project in Merced County. The stakeholders are unsure who should be the lead related to the project. She explained that there is a bill that allows for needle exchange to exist without local jurisdiction adoption, similar to Fresno and Modesto. They conducted their CHIP meetings and have 15 meetings scheduled (9 at County Boards of Supervisors and the others are at various community groups within Merced County). Of the top 10 diseases, participants chose 5 and use iClicker technology to determine their priorities. The top issues were diabetes, heart disease, drug/alcohol disease, homelessness, housing, income, education, employment, and access to health care. They worked to develop action plans and goals for each of these areas. The information will be presented to the Board in November and hope to get a proclamation that will be sent to PHAB showing support for accreditation. An interesting finding was related to the lack of cultural sensitivity from medical providers and they hope to have provider training in the future. They have a consultant assisting them with their strategic planning process with an internal focus and hope to submit their documentation to PHAB in 2017. The City of Livingston have opened a school-based clinic at a high school with opportunity for local residents as well. Their Medi-Cal managed care company, Central California Alliance for Health, has an excess in their reserve of 6 times the required amount which has led to the development of a grant program (recruit providers, equipment- upgrades/new, capital improvements, with a possibility of community education/support networks in the future). Their PICH grant and Stephanie Nathan, worked with the City of Merced to not allow businesses to apply for permits that sell tobacco products within 1,000 feet of school sites and where children gather, ie parks, daycare centers. However, this was removed and they are waiting to see how this develops. They have their first CACHI Meeting this Wednesday to develop a governance structure. They are the lead organization for the planning year but would like another organization to take the lead in the future. Kathleen explained that the county is looking into a classification and compensation study.
San Joaquin: Tammy Evans explained that they are also looking into a new building. They are working on getting their planning and identifying needs and a previous estimate recommended 100,000 sq feet at $50 million but these estimates need to be updated. They are hoping to have their application submitted in Spring 2017. They finalized 3 main topics; physical activity/healthy eating, high quality education, and social support services. They had 11 main topics which were all deemed important by stakeholders which are encompassed under these three larger topics. They are waiting to start their strategic planning until their CHIP is completed. They are having issues related to labor relations and collective bargaining. They are involved with the CACHI grant but they are not the backbone organization. They are also involved in the Whole Person Care grant, with SJ Healthcare Services as the lead organization. Tammy explained that although they have not had trouble with recruitment they have had issues with retention.
Tulare: Rob Stewart explained that they have significant workforce challenges, similar to other counties. They have had issues with more focus areas being required to go to the board of supervisors. They have data showing salaries at 20% below other comparable positions within the county. They are focused on physicians within their county and health department, but not other positions at this time. They have looked into the possibility of classifications related to public health administrative assistants and were approved for two of out four positions. There is a current issue with the public employee relations board from 2009-2011 when the county did not meet and confer and they will be penalized, but the amount is not specified. Their accreditation efforts are moving forward and they hope to have their CHIP completed within the next few months. They are currently undertaking their strategic planning, with a goal of Spring 2017 for application submittal. They are using the Al-Fresco software related to organizing their documentation. They have a current fire between Tulare and Kern County. There is a Red-Cross shelter in Porterville and one in Kern County, with more Tulare County residents going to Kern County shelters based on proximity. They are waiting to hear from the CDC Drought Response grant, which was a national opportunity. They are working on the ambulance coverage, Central California EMS Agency as AMR left their county, with a focus on proximity as opposed to coverage areas. Rob also discussed SB 1300, which requests enhancements to Medi-Cal reimbursement rates for ambulance providers and their county sent a letter of support. They are launching a gonorrhea management program as modeled by Fresno County, which one of their CDC associates are working on developing. The other CDC associate is working on accreditation. They applied to Cal-Trans for grants to improve safe routes to school, by meeting with local community leaders. They are working to collect data in order to implement these changes. There is a new detention center in the south of Tulare County by June 2018 with an additional 500 beds, which will affect their jail medical services contract and likely their budget as well.
Calaveras: No representative at the meeting.
Kern: No representative at the meeting. / -Keith will share information related to their needle exchange with the members
-Van will share the link related to the Excel/Wiki Tool to the members
-Rob will forward information related to Al-Fresco documentation software
Lunch Break
California’s 4th Climate Change Assessment / Aleka Seville presented regarding the California Heat and Health Project: Preparing Public Health Officials for Climate Change- A Decision Support Tool. She provided a short summary and requested information from the members. The tool will be available in Summer 2017, through Cal Adapt.
Health Equity Quick Strike Project Update / Van Do-Reynoso reached out to NACCHO and they agreed that making a SJ Valley focused training would be very helpful. She explained that she was able to choose an employee to be the lead for the project, with a focus on 1 unit in 1 hour, with local stories. The goal is to be used for new staff as well as local elected officials.
P21 (Prevention in the 21st Century) Conference Sponsored by the State / Van Do-Reynoso explained that this is chronic disease prevention conference, hosted by the state to launch their 10 year strategic plan. She explained that the next conference is scheduled for May 17th, 2017. Jessica Nunez wanted to get the Consortium’s thoughts regarding a statewide conference. She asked if it was feasible to bring a team of multi-factorial participants (hospitals, FQHCs, and health plans) to the conference. The goal of the conference is to engage local partners at a state level. Jessica needs more people to assist with each of the workgroups/goal areas. This will require conference call meetings to plan presentations, conference flow, and assistance at the convening as a host or note keeper. It is not anticipated that there is going to be travel funds but they are hoping to expand the membership to other health related organizations, such as hospitals, health insurance companies, and community partners. David Luchini might be interested in participating in Goal 3 related to useable data.
CCASSC Next Steps + Joint Meeting / David Luchini presented at their meeting on September 15th regarding mapping where he talked about the Health Disadvantage Index and other Fresno County maps with various overlapping health and economic factors. The CCASSC members were interested in having a joint meeting in the future with a focus on poverty and health intersecting to present to CSAC.
SJVPHC Regional Reports + Data Briefs / Ashley Hart summarized that the regional reports are currently being revised by the graphic designer. She also summarized that county dues have been received by all counties, except Kern. The county data briefs have been distributed to the membership for review. Van discussed the data discrepancy related to MCAH data. / -Members provide feedback to Ashley re: County Briefs and Regional Reports
Retreat Updates, Agenda Prep and Suggestions / The tentative future leadership schedule is as follows; Tulare- 2017, Stanislaus- 2018, Calaveras- 2019, Kings- 2020, San Joaquin- 2021, Merced- 2022, Madera- 2023
The members discussed the option of having two meeting locations for 2017, Merced and Fresno or Fresno and Stanislaus.
Ashley send Doodle Poll regarding meeting dates, 1st, 2nd, 3rd, 4th Wed, Thur, Fri. Most members preferred either Monday or Friday for standing meetings. / -Members bring schedules for 2017 for possible date change for meetings
-Ashley get dates/times from Jason
-Ashley send Doodle Poll re: dates/location
Feedback and Future Agenda Items / None at this time. Members will email future agenda item suggestions to Ashley.
Adjourn / David Luchini adjourned the meeting at 2:40 p.m.
Next Meeting: Strategic Planning Retreat at Cambria Pines