HomeMy WebLinkAboutCommunity Health Board - Board Packet 11.22.2024 Supporting Documents - 11/22/2024
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Partnership4Health Community Health Board
11/22/2024
9:00 a.m.-11:30 a.m.
In Person option: Otter Tail County Government Services Center Otter Tail Lake Room 500 W Fir Ave Fergus Falls, MN 56537
Virtual Option: Microsoft Teams Join the meeting now Meeting ID: 288 907 057 077
Agenda
9:00 Call to Order
♦ Establish Quorum ♦ Approval of Agenda– November 22, 2024 (action)
Approval of Consent Agenda (action)
♦ August 16, 2024, Partnership4Health CHB Meeting Minutes 9:10 Regional Dental Access Updates, Jane Neubauer, Dental Outreach Coordinator
9:20 Financial Update, Brandon Nelson
♦ Financial Report (Grants)
♦ CHB Audit & Risk Assessment
♦ CHB Budget Resolution {2025.1} (action)
9:40 Community Health Assessment Update, Ashley Wiertzema 9:45 SCHSAC October 9-10, 2024, Retreat Report, Wayne Johnson/Jody Lien
9:55 Otter Tail County CHB Assessment Update, Wayne Johnson/Jody Lien 10:30 Appointment of Authorized Agents, Kathy McKay (action) ♦ Authorized Agents Resolution {2025.2}
10:35 2025 At Large Community Member, Becky Tripp (action) 10:40 2025 Officers, Administrative & Program Management, Jody Lien (action) 10:45 Annual By-Laws Review, Jody Lien 11:00 2025 P4H CHB meeting dates, Kathy McKay (action item)
♦ Proposed dates: Feb 21, May 16, August 15, November 21
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11:05 Other General Updates & Discussion
♦P4HCHB webpage
11:30 Adjourn
Next Meeting Date: TBDLocation: Clay County
Partnership4Health Community Health Board
Friday, August 16, 2024
9:00 -11:30 a.m.
In Person Option:
Becker County; Lake Melissa & Lake Sally rooms
712 Minnesota Ave.
Detroit Lakes, MN 56501
Virtual Option:
Microsoft Teams Link
Quorum Established
Call to Order 9:03 am by Commissioner Wayne Johnson
Introductions were made by way of role call.
Attendees Present were:
• Amanda Kumpula
• Katie Vasey
• Kathy McKay
• Commissioner David Ebinger
• Kathy Anderson
• Jody Lien
• Kristi Goos
• Melissa Duenow
• Commissioner Wayne Johnson
• Becky Tripp
• Ashley Wiertzema
• Commissioner Rick Busko (Virtual)
Guests Present were:
• Chris LeClair
• Lynne Penke Valdes
• Morgan Villarreal
• Kent Severson (Virtual)
• Rebecca Schmidt (Virtual)
• Abigail Laubenstein (Virtual)
• Greta Ziegler (Virtual)
• Andrea Demmer (Virtual)
• Jason McCoy (Virtual)
Approval of Agenda (action Item)
Approval of Consent Agenda
May 17, 2024, CHB Meeting Minutes
July 11, 2024, CHB Special Meeting Minutes
Motion made to approve the agenda as printed, and the consent agenda as printed by
Commissioner David Ebinger
Second to the motion by Commissioner Rick Busko
Discussion- None
Roll Call Vote
Commissioner David Ebinger-Yes
Commissioner Rick Busko-Yes
Katie Vassey- Yes
Kathy Anderson- Yes
2025 Food, Pools & Lodging Program Fees, (action item)
Discussion:
Kathy presented the license fees from 2024 that increased the base fees by 25 dollars across
all license types other than Youth Camps
The VHR fees are listed on page 11 to show the increases in 2024.
Shown the listed fees from 2023 to 2024 years on the following attachments.
The P4H Directors are requesting to not change the fee schedule in 2025 and leave it as it is
currently in 2024.
Commissioner Wayne Johnson noted that it is a good idea to talk about the fees every year to
report on what the constituents are talking about. Also to look at what it takes to maintain
the programs with fees and not subsidizing the program.
Motion to approve the Food, Pool, and Lodging fees as they are on our screen and in our
packet, which is no change from the last 2024 for the year 2025.
Motion made by-Commissioner Rick Busko
Second to the motion by-Commissioner David Ebinger
Roll Call Vote
Commissioner David Ebinger-Yes
Commissioner Rick Bucko-Yes
Katie Vassey- Yes
Kathy Anderson- Yes
CHB Data &Epidemiology Infrastructure Grant Overview,
Becky Schmidt
Becky presented a PowerPoint presentation that was a short overview of the work that has
been done through the CHB Data & Epidemiology Infrastructure Grant in the last two years.
The team consists of members of each of the four P4H counties.
The infrastructure funding became available in 2022. These projects were intended to be
innovative. 16 projects were awarded funding in 2022.
The project goals were to create a shared staffing model across P4H that would build
capacity. Develop a procedure around data collection and analysis. Establish sources of data
that are timely and to facilitate information exchange on applicable public health data within
P4H healthcare systems, including ND.
This team was the pilot for testing new ways to provide shared staffing across the four P4H
counties. The team worked with an external consultant to develop written agreements.
These agreements will provide a foundation for other areas within the CHB in the future.
The Data/Epi team has been working with Syndromic Surveillance which is real time pre-
diagnostic, de-identified data for public health reporting and investigation. We are currently
receiving data from 3 local ER facilities while the other 3 are in the onboarding phase.
Community Health Assessments (CHA) are a requirement of CHBs to submit the top health
priorities identified to MDH at lease every 5 years.
The Data/Epi team has taken the lead on collecting the data for the CHA by assisting in the
distribution of the healthcare survey, collections of server sources of secondary data, and
conduction community focus groups in each county.
The Data/Epi team is available to help fulfill data requests for program areas. Some data
requests that have been submitted were in Environmental Health, C&TC, WIC, and Family
Home Visiting.
Ashley presented on the Child and Teen Checkup (C&TC) one pager that was included in the
packet. This came from an internal data request that was received from Annie in Becker
County. She wanted to present data to clinics about immunizations. The data complied
created this infographic.
P4H Shared Services Charter and Program Addendums Overview,
Ashley Wiertzema
Shared Services Charters Overview
Contracted with Renee Frauendienst to assess current workflows in each county. She helped
find the strengths and opportunities of the partnership and evaluated on those findings. The
foundational public health responsibilities across the CHB was also emphasized.
The Shared Services Charter that goes through the joint power structure requirements was
the initial document.
Shared Services Charter Addendums were then created as a way to delegate work through
mutual agreements, review and revise shared policies, procedures, processes and practices
that cross the CHB, and to assure consistency around polies, procedures, and practices.
Additional addendums will be created to focus on the standards and the foundational public
health responsibilities.
The Data Analytics Service Addendum helps build internal P4H staff capacity to understand
and relate data to the public, highlight health inequities by finding ways to identify local and
timely data, and assist any of the four counties or program staff with data collection.
The Community Health Assessment Addendum addressees how to collect and analyze data
for the Community Health Assessment (CHA), to communicate with community members
about the data, and to present the CHA results.
The Disease Prevention and Control (D&PC) Services Addendum begins to delineate out work
that can be distributed such as Health Alert Network (HAN) messages to appropriate partners
across the CHB, maintain and implement a risk communication plan during a public health
emergency, and assist with case management of active and latent tuberculosis clients across
the CHB.
Legislative Updates, Kathy McKay
Kathy provided brief highlights on the MN Legislative session. Public Health Agencies can now
distribute Naloxone. Cannabis funding was reduced for local public health prevention
education starting in FY 26. Jason McCoy from Clay County spoke briefly on the cannabis
ordinance work being done in Clay County and impacts to zoning.
SCHSAC Report, Commissioner Wayne Johnson
The minutes from the last SCHSAC meeting on June 13th, 2024, are included in the meeting
packet. Highlights include the SCHSAC retreat coming on October 9th & 10th. The location of
this retreat is TBD.
CHB Finance Staffing Update, Kathy McKay
Carmen has resigned and is working variable hours to help get us though. Offer was made
yesterday and hopes to start end of August.
Communications Capacity Building innovation grant with Polk, Norman, Mahnomen (PNM)
CHB, Jody Lien (action item)
P4H would like to build out communications capacity to help tell the story of Public Health.
P4H and PPNM were successful in a grant application with to help build this capacity in a
regional approach. Grant award is $308,000 over 2 years, with an end date of June 30th,
2026.
No questions regarding the MOA for the Communication Capacity Building Innovation Grant
with PNM CHB.
A Motion was moved to appropriate signature on the memorandum of understanding for the
receipt of the grant and the implementation of the communication grant by Commissioner
David Ebinger
Second made by Commissioner Rick Busko
Roll Call Vote
Commissioner David Ebinger- Yes
Commissioner Rick Busko- Yes
Katie Vassey- Yes
Kathy Anderson- Yes
Community Representative Terms
Alternating Community Reps-
Wilkin County is up for Community Rep- 2025
At the November meeting Wilkin will bring a recommendation for community representative.
Melissa will make Certificate for Kathy Anderson’s time on the board along with any outgoing
board members.
Otter Tail County CHB Assessment, Jody Lien
4 sessions to be held with the OTC BOC regarding P4H CHB.
The first session will include MDH coming to overview CHB governance structure and Chapter
145.
Second session will be a bit a history and context of our partnership and by-laws and how
P4HCHB works together within the shared services Charter and Addendums.
The 3rd and 4th session will be able to bring in context of the programs and how they are
funded.
Review November 15th Meeting Date
*Conflict with LPH-MDH fall conference, propose meeting date of November 22nd
Discussion:
Annual Meeting has been moved to November 22nd as no conflicts
Motion to move the next meeting to November 22nd at 9:00 am by Commissioner Rick Busko
Second by Kathy Anderson
Roll Call Vote
Commissioner Rick Busko- Yes
Commissioner David Ebinger- Yes
Kathy Anderson- Yes
Katie Vassey- Yes
General Discussion
Cannabis Ordinance work discussion was had
Adjourn (action Item)
Commissioner Wayne Johnson Adjourned the Partnership4Health Community Health Board
meeting at 10:53am on 8/16/2024.
Upcoming P4H CHB Meetings
11/22/2024 Otter Tail County Public Health Government Services Center
Otter Tail Lake Room
500 Fir Ave West
Fergus Falls, MN 56537
*all meetings are 9:00-11:30 unless otherwise specified.
Becker County Clay County Otter Tail County Wilkin County 712 Minnesota Ave 715 11th St N #303 560 Fir Avenue West 300 5th St S
Detroit Lakes, MN 56501 Moorhead, MN 56560 Fergus Falls, MN 56537 Breckenridge, MN 56520
218-847-5628 218-299-5220
Co- CHS Administrator:
Kathy McKay
218-998-8320
Co- CHS Administrator:
Jody Lien
218-643-7122
PARTNERSHIP4HEALTH
COMMUNITY HEALTH
BOARD
2023 SINGLE AUDIT RESULTS
2023 SINGLE AUDIT
•Office of the State Auditor
•Required if federal awards are greater than $750,000
•Audit commenced in May 2024
•Report issued September 20, 2024
RISK
ASSESSMENT
Partnership4Health
Community Health Board
FINANCIAL RISKS
Risks:
1.Inappropriate expense charged to grant
2.Recording error
3.Late submittal of grant invoices
4.Lack of expense substantiation documents
Mitigations:
•Request backup documentation from
subrecipients to substantiate expenditure
(including salary and benefits)
•Check and balance system
MANAGERIAL RISKS
Risks:
1.Lack of appropriate approvals
2.Contracts
1.Incomplete contracts
2.Contracts with debarred individuals/company
3.Arms length contracts
3.Circumventing internal controls
4.Lack of segregation of duties
Mitigations:
•Ensure invoices contain proper authorization via
appropriate level of signature
•Contracts store in one place and reviewed by
director of finance
•Ensure staff follow proper procedures/processes
for procurement and expenditure
•Small counties struggles
•Additional approval or procedures follow to mitigate
as much risk as possible
OVERALL RISKS
Risks:
1.Lack of understanding of grant
2.Frequent change of staff
3.Lack of following procedure/processes
4.Lack of staff back-up
Mitigations:
•Training on grant financials/budget
•Ask questions and review of new staff
performance/work
•Management making sure procedure/processes
are followed
•Annual review of procedure/processes to ensure
staff understand them
•Training more than one person to do a duty/job or
cross-training
Grant Name Grant Period CHB Grants Clay Wilkin Otter Tail Becker
Blue Plus Dental 1/1/2025 - 12/31/2025 75,000 - - 75,000 -
Cannabis To be determined 183,513 59,269 26,013 56,148 42,083
CDC Public Health Infrastructure 1/1/2025 - 12/31/2027 510,589 178,670 33,255 183,994 114,670
Child and Teen Checkups - C&TC 1/1/2025 - 12/31/2025 406,881 195,385 19,213 114,639 77,645
Children and Youth with Special Needs - CYSHN *
Birth Defects (fee for service)1/1/2025 - 12/31/2025 - - - - -
City Readiness *7/1/2024 - 6/30/2025 15,312 15,312 - - -
COVID-19 Implementation *1/1/2025 - 12/31/2025 543,081 152,637 24,238 69,642 296,564
Strong Foundations (replaces MIECHV and EBHV)1/1/2025 - 12/31/2025 1,245,530 245,286 48,259 653,229 298,757
Family Planning Special Projects (Mahube-Otwa) *1/1/2025 - 12/31/2025 4,500 - - 4,500 -
Follow Along Program - FAP *10/1/2024 - 9/30/2025 8,400 2,100 2,100 2,100 2,100
Local Public Health Act - LPHA (estimated award)01/01/2024 - 12/31/2024 977,002 418,451 36,993 327,751 193,807
Maternal Childhood Health - MCH *10/1/2024 - 9/30/2025 199,452 78,508 7,568 71,389 41,988
IPI/ IQIP / PEAR / Perinatal Hep B * (fee for service)7/1/2024 - 6/30/2025 - - - - -
Public Health Emergency Preparedness - PHEP *7/1/2024 - 6/30/2025 122,667 59,171 6,638 37,742 19,116
Response and Sustainability Grant (RSG) 7/1/2024 - 6/30/2025 199,939 58,089 57,658 41,726 42,466
Foundational Public Health Responsibilities (FPHR)1/1/2025 - 12/31/2025 204,632 51,756 51,690 50,000 51,185
Refugee Health 7/1/2024 - 6/30/2025 2,866.00 - - - -
Statewide Health Improvement Project - SHIP 11/1/2024 - 10/31/2025 397,414 397,414 - - -
Temporary Assistance for Needy Families - TANF *7/1/2024 - 6/30/2025 225,837 98,056 9,858 87,724 30,199
Women, Infants, and Children - WIC *10/1/2024 - 9/30/2025 950,000 400,498 31,852 337,295 180,356
TOTALS 6,272,615 2,410,603 355,333 2,112,879 1,390,934
* denotes federal funding source
2025 Shared CHB Expenses - Paid using the LPHG CHB Expenses
Salary/fringe financial management 30,000 Allocates 33% of financial managers time to the CHB based on 2025 Salary and Fringe
Audit 32,000
MCIT Liability Insurance 7,700
CHB Meeting Expenses 200
Total 69,900$
Resolution Adopted date:
P4H CHB Chair ______________________________________________________________
Partnership4Health CHB Budget
2025 Grants
Resolution 2025-1
P4H Focus Group Results
Questions that were asked:
1.What brought you here and/or what has
motivated you to stay?
2.What health related issues are you seeing or
experiencing in your community?
3.Out of the issues we discussed above, what
do you believe are the 2-3 most important
ones that must be addressed to improve
health in your community?
4.What ideas do you have that could help your
community move forward with addressing
these health priorities?
Main themes:
1. Family, quality of life (cost of living, safety and
rural environment) and job.
2 and 3. Healthcare access and affordability
(dental, physical, mental), transportation, and
community engagement/supports.
4. Expand public transportation options and
hours, increase access to care (physical and
mental/behavioral), and provide more
community education on services/resources in
plain language.
State Community Health Services Advisory Committee (SCHSAC) Retreat Overview
Oct. 9 and 10, 2024 | River’s Edge Convention Center, St. Cloud, MN
The goal of the 2024 SCHSAC Retreat is to deepen the connection between SCHSAC members, local, and state public health leaders, build on our collective knowledge and experience, and inspire us to continue strengthening and transforming the public health system for all Minnesotans for the 21st century. Our aim is to unify elected officials, Minnesota Department of Health, and local public health
leaders to efficiently and effectively promote and protect the health of all people in Minnesota.
Welcome, approval of consent agenda, and opening remarks
Presenters: Tarryl Clark, Stearns County Commissioner, SCHSAC Chair; Melissa Huberty, CHS
Administrator, Stearns County; Janet Goligowski, Public Health Director, Stearns County; Dr. Brooke
Cunningham, Commissioner, Minnesota Department of Health
Highlights
▪ Chair Clark opened the SCHSAC retreat by reading the Tribal-State
Relations Statement. Vice Chair Malterer and Past Chair Kiscaden
reflected on the importance of SCHSAC retreats in building
relationships and the uniqueness of SCHSAC’s makeup.
▪ Vice Chair De Malterer (Le Sueur-Waseca) moved approval of the
consent agenda consisting of approval of the meeting notes from the
June 13, 2024 SCHSAC meeting and approval of the reauthorization of
the Member Development Workgroup. It was seconded by Steve
Barrows (Crow Wing) and the motion carried.
▪ Melissa Huberty and Janet Goligowski led a trivia-style activity
focused on Stearns County and St. Cloud.
▪ Commissioner Brooke Cunningham opened her remarks by saying public health is challenging but
also fun. She expressed her appreciation for the opportunity to engage with local public health this
year, with visits to 65 counties and 22 more to go. Dr. Cunningham emphasized the need to
support the local public health workforce. She shared her vision for a stronger public health
system, one that collaborates across systems, geographies, and populations, including Tribes. She
recognized the challenges that remain, such as addressing public health issues preemptively,
securing competitive grants despite staffing challenges, and the need to reimagine funding to make
it more accessible and equitable.
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Our path so far… celebrating our progress together
Presenters: Sheila Kiscaden, Olmsted County Commissioner & Past SCHSAC Chair; Kim Milbrath, Director, Center for Public Health Practice, MDH
Activity led by Planning Committee members: Michelle Clasen, Washington County Commissioner; Amy Bowles, CHS Administrator, Beltrami County
Highlights
Slides from the presentation on the history of Minnesota’s public health system transformation can be
found on the SCHSAC Member Portal on Basecamp.
▪ Transformation started back in 2010. COVID highlighted ongoing gaps in the system and led to the
conclusion that our system, which was designed over 50 years ago, is outdated. We need a new
approach.
▪ 2021 state investments and Joint Leadership Team formed. Tribes are also looking at their capacity
and what gaps in their tribal health systems. This is generational work, working to address
inequities between rural and metro areas.
▪ Small groups discussed: What are 3 things related to public health that you do differently than you
did 3 years ago? Is there a project, activity or service related to public health in the works (may be
in any stage from idea to ready to launch) that you are most excited about?
Small groups reported out common themes across the two questions. Some of the common themes
across the groups included:
▪ Communication:
▪ Present across nearly all groups, emphasizing
different facets like virtual communication,
cross-county and organizational
communication, and hiring communication
staff.
▪ Future focus includes more structured
communication pathways and improving
communication resources for public health.
▪ Staffing & Workforce Development:
▪ Multiple groups address hiring, particularly in
communication roles and specific workforce
structures.
▪ Community Health Workers (CHWs) play a
significant role, being integrated across various health issues.
▪ Building networks, partnerships, and strengthening teams for better service delivery.
▪ Data and Performance Management:
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▪ Groups highlight different approaches to data usage, whether for tracking overdose data, using
data across counties, or improving data-related roles.
▪ Improvements in the use of data in performance management and measurement systems.
▪ Equity and Policy:
▪ Equity, particularly racial equity in public health, is a key concern, especially around infant and
maternal mortality.
▪ Some groups are integrating equity into policy-making processes aiming to address broader
systemic issues in public health.
▪ Public Health and Emergency Services Resources:
▪ Emergency services, from EMS preparedness to emergency response strategies, and the
improvement of communication resources for these services, are critical across groups.
▪ Future directions involve enhancing local services and decreasing travel/wait times, while
improving systems like telehealth and remote care.
▪ Opioid Crisis and Substance Abuse:
▪ Several groups are focused on the opioid crisis, from opioid settlement fund development to
policy work and surveillance of opioid-related fatalities.
▪ Substance abuse prevention funding and community partnerships play into this as well.
▪ Health Outcomes and Chronic Disease:
▪ There's emphasis on chronic disease, maternal and child health, and improving environmental
health, particularly regarding issues like water quality.
▪ Future aims include raising awareness of chronic diseases and environmental health issues.
▪ Partnerships and Collaboration: Collaboration, whether through community partnerships or with
different teams and data sources, is a recurrent theme.
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Keynote: Partners in Progress: Elected Officials and Public Health Staff Leading Minnesota’s Future
Speaker: Dr. Brian Castrucci, DrPH, MA, President & CEO, de Beaumont Foundation
Highlights
Slides and resources list are available on the SCHSAC Member Portal on Basecamp.
▪ Partnership Between Elected Officials and Public Health
▪ Public health and elected officials are complementary, working together like "peanut butter
and jelly" rather than opposing forces.
▪ Elected officials can make a greater impact on health through policy than can be made through
direct medical interventions.
▪ Health as an Economic Indicator
▪ Framing health as an economic issue resonates with
broader audiences, including business leaders.
▪ You can’t industrialize the nation unless you (fill in any
public health intervention – water, living quarter, workers
protection, etc).
▪ When we invest in health, we get that money back. We
used to be a nation of innovation and entrepreneurialism.
That’s how we built this nation. The number one reason
we aren’t anymore: half of our nation has a chronic
disease. They need health insurance. They can only work at
large employers.
▪ Socioeconomic Factors Shape Health
▪ Socioeconomic conditions have the greatest impact on health outcomes, yet interventions at
this level often receive the least funding.
▪ Health is shaped 40% by socioeconomic factors, 10% by the physical environment, 30% by
health behaviors, and only 20% by health care itself.
▪ Social Needs vs. Social Determinants, the importance of policy over medicine
▪ Policies addressing social determinants of health, such as housing and environmental
conditions, can have a more substantial impact on population health than medical treatments
alone.
▪ Social needs vs. social determinants:
▪ Programs, patients, individuals = social needs.
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▪ Populations, policies, systems = social determinants (health care confuses these two
concepts all the time.)
▪ The solutions to our health issues are not in our clinics.
▪ Truth 1: Electeds can have a greater impact on people’s health than health care providers.
▪ Truth 2: Lower health care costs does not necessarily mean people are healthier. It means
they cost less to the system.
▪ Truth 3: Good community health indicators do not mean everyone shares in health equally.
▪ Public Health Messaging and Communication
▪ Public health professionals need to improve how they communicate their role and impact. If
people don't understand what public health does, it becomes harder to gain support for critical
interventions.
▪ Messaging should focus on universal benefits (e.g., "thriving" rather than "healthy") and reject
language that alienates, like "vulnerable communities."
▪ Building Trust and Partnerships
▪ Trust in public health comes from showing up consistently and building relationships during
times of peace, not just during crises.
▪ Public health should align itself with business, schools, and religious organizations, as these
areas are inherently connected to health outcomes.
▪ Policy as Preventive Medicine
▪ CDC Health Impact Pyramid (https://www.cdc.gov/policy/hi-5/index.html): this is how we build
health. Example of bad meat vs. asthma. We go all the way down to the farm if there is bad
meat. If I have asthma – you just treat the asthma.
▪ Policy interventions are often more effective at preventing health issues than treating them
after the fact. For instance, instead of only treating asthma, policies that improve housing
conditions can address root causes.
▪ There is a cultural discomfort in addressing preventive measures—people are more willing to
pay for medical bills than to invest in prevention.
▪ What you can do
▪ If you want to have a business conversation, a school conversation, a religious conversation –
you’re talking about public health. We are not powerful enough to dictate the music. So, we
have to learn to dance. And electeds – you need to invite us to the dance. You have to make
these relationships at times of peace. At times of quiet. Get your micro-influencers ready now.
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Inspiring partners: Speaking the same language
Presenters: Mandy Meisner, Anoka County Commissioner; Allie Hawley March, MDH
Highlights
Slides are available on the SCHSAC Member Portal on Basecamp.
The messaging toolkit can be found here: Message Toolkit: Inspiring Partners to Strengthen Public
Health in Minnesota (https://www.health.state.mn.us/phmessagetoolkit)
▪ This session was an introduction to the messaging toolkit that has been developed to provide a
framework to help us all communicate more effectively about our work.
▪ Do=Care + Know: People do things when they care and when they know what to do.
▪ Talking about public health is challenging. We need to tell a different story: How do we do that?
Speak to hopes and aspirations. This increases engagement. This can inspire action. Our brains are
built for stories. We learn through narrative. How we tell is as important as what we tell.
▪ Move away from talking about programs, data, activities. Speak instead about hopes and dreams.
▪ Notice the commercials tonight. You are not buying a credit card. You are buying a world traveler
identity. You aren’t buying deodorant for your daughter. You’re buying confidence.
▪ This isn’t a script. It’s a recipe. It’s a formula. The product you create with these ingredients, will be
talking points. Bullet points.
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Lessons from Indiana
Presenters: Pam Pontones, Deputy Health Commissioner of Local Health Services, Indiana Department of Health; Rachel Swartwood, Director, Legislative and External Affairs, Indiana Department of Health
Highlights
Slides are available on the SCHSAC Member Portal on Basecamp.
▪ Indiana is a largely rural state with 6.9 million people, a decentralized public health system, and
faces declining health metrics, including a life expectancy two years below the national average.
Disparities in life expectancy based on location led to the creation of the Governor’s Public Health
Commission (GPHC) to assess and improve Indiana’s public health system.
▪ Governor’s Public Health Commission (GPHC) and Recommendations
▪ The GPHC gathered data from public comments, listening tours, and multi-sector stakeholders
and released 32 recommendations for improving the state’s public health system.
▪ Indiana adopted a collaborative approach, creating new leadership roles They created new
positions, including the Chief Strategy Officer, to oversee agency and quality improvement
efforts, and the Deputy Health Commissioner of Local Health Services. This position oversees
tech assistance teams and local health dept outreach divisions, serves as agency representative
to local health departments and related partners.
▪ Indiana created “Health First Indiana”, an agency model to guide the state’s public health
transformation which passed the legislature in 2023. It focused on several key areas:
▪ Governance, infrastructure, and services
▪ Public health funding (emphasizing stable, recurring, and flexible funding for foundational
public health capacities; providing support to leverage all available funding sources; establishes
consistency in tracking of resources and calculating return on investment of additional funding
allocations)
▪ Workforce development
▪ Data and information integration
▪ Emergency preparedness
▪ Child and family health
▪ Passing the legislation required several key strategies.
▪ Beginning the process: original budget asks (see slide)
▪ Met with every representative to explain what Public
Health is (more than masks and vaccines).
▪ Defining Core Services for Legislation
▪ Communication and transparency were important throughout the process.
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▪ The speakers were asked “What were the 3 compelling arguments that persuaded the
Legislators to make this decision?” They answered:
▪ Problem from an economic perspective. Economic benefit. PH is the only sector working on
prevention efforts.
▪ Money is not used to grow government, but to build partnerships and fill gaps
▪ Preserving local control
▪ Indiana passed historic public health funding laws SEA 4 and HEA 1001, which included:
▪ $75 million for 2024 and $150 million for 2025 for county public health funding.
▪ Additional funding for trauma system quality improvement, EMS readiness, and a state
strategic stockpile.
▪ Counties were given the choice to “opt-in” to the enhanced funding, maintaining local control
while focusing on core services.
▪ 86 counties opted in for 2024, covering 96% of Indiana’s population, and by 2025, 100% of
counties opted in.
▪ Counties were allowed to decide how to invest and use the funding as long as it supported core
public health services.
▪ Transparency, Accountability, and Core Services
▪ A “county health scorecard” was provided to help with decision-making around public health
indicators.
▪ An “activity tracker” was established to report on core services, encouraging partnerships with
community organizations.
▪ Local public health departments report key performance indicators twice a year, ensuring
transparency and accountability.
▪ Over 80% of funding went to preventive services, with less than 20% going to regulatory
services.
▪ Indiana prioritized communication and transparency throughout the process, including:
▪ A dedicated GPHC website
▪ Public Health Day at the statehouse
▪ Webinars, regional calls, and regular engagement with stakeholders (elected officials, partner
organizations, and local health departments).
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Workshop: Inspiring partners: How to create messages with impact
Trainer: Allie Hawley March, MDH
Highlights
Slides are available on the SCHSAC Member Portal on Basecamp.
This session was a workshop on using the message toolkit introduced on day one of the Retreat.
Attendees used the message toolkit to create a one minute message on the issue and audience they
identified.
Element 1: People: talk about who creates health; what we do. What you say about the people in the
story can make or break it. Whether they seem capable, confident, unsure, helpless, exhausted. When
we talk about the people who create health: we need to use asset framing, not deficit framing. Deficit
framing creates negative associations, “helpless, overworked.” Asset framing creates positive
associations. We want to define the people that we’re talking about according to their aspirations,
their strengths – like ‘experts’ or ‘problem solvers.’
Element 2: Goals: Move away from performance
measures, capabilities, etc. Think about goals in
terms of common and less common aspirations,
like enjoying life every day. Connect health to other
aspirations. Show how a healthy community is
connected and supports other hopes and visions.
Ask yourself, what do the people in your story
aspire to be or do? How does that intersect with
public health? When it comes to your issue for
today – what does that look like in your
community, in ways that connect with the group
you’re talking to?
Element 3: Problems: So, when it comes to your
issue for today, what barriers stand in the way of
your people achieving their goal? Notice we aren’t
starting your pitch with your problem. When we
don’t start with the problem – rather than who we
are and what we’re trying to achieve – it gets us on
the same page. When you name your problem,
keep it super simple. To be motivated to solve a
problem, people need to understand it, care about
it, and believe change is possible. When it’s easier
it is to understand, the more likely we are to believe it. Don’t get too far in the weeds. Don’t use
jargon. Don’t use acronyms.
SCHSAC members shared some of their examples:
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10
▪ Schools are really reluctant to share the Minnesota student survey.
▪ Turning people away who are late to a clinic appt have unintended consequences
▪ Food insecurity at home; picky eater kids; when it’s 20 below zero, kids can’t go outside/get
exercise
▪ Rural emergency services – don’t have adequate funding and reimbursement not enough
▪ Lack of funding at the state level for EMS; slow response or no response for vital needs – like
mental health, public health, clean water issues.
▪ Incorporating protections in cannabis policies
Element 4: Solutions: Show solutions and benefits: state specific solutions to your problem and how
they benefit individuals and society. Don’t just say how it makes public health better – make sure the
solution makes the lives of the audience’s better. Sharing stories can make this feel real. It can be
helpful to share how your solution can scale: smaller or bigger, depending on community, funding, etc.
Provide clear examples of what the change will look like. The solution should go beyond what we
traditionally think about as health.
Element 5: Value of Public Health: We are still learning what the value of public health is. One thing
we can do is get on the same page: why is public health important? When it comes to your issue for
today, how does public health make a positive impact in your community in a way that your audience
understands?
Taking it home
Led by: Tarryl Clark, SCHSAC Chair; DeAnne Malterer, SCHSAC Vice Chair; Nick Kelley, CHS
Administrator, Bloomington & Chair, Local Public Health Association (LPHA); Chelsie Huntley,
Community Health Division Director, MDH
Highlights
▪ Attendees spent three-four minutes on their own to think about: what can you do (in your
organization) in the next six to 12 months?
▪ Then came together as a group by role to answer: what do we need to collectively (as MDH, as LPH
directors, as elected officials) in the next year?
▪ What do we need from the other groups (MDH, LPH directors, electeds) to be successful?
Groups shared a summary of their discussion, noted below.
MDH:
▪ We have heard and understand that the way we do grants and reporting is burdensome and we
need to figure that out in partnership with locals;
▪ We really need you and your relationships to bring us in and explain how MDH can add value;
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▪ We need you to continue to give us feedback both positive and constructive – give us solutions and
continue to engage with us to find that sweet spots that allows us to be good stewards of resources
and doesn’t burden you.
Local public health:
▪ Business coalitions and partner development;
▪ data systems to support local public health – how can we restructure that;
▪ consistent messaging and capacity building;
▪ sustainability of funding that we can look toward our elected officials;
▪ we would like to see that new education and onboarding of staff;
▪ we need to highlight successes more often;
▪ we need to start thinking more about policy work.
▪ Local public health needs to work a whole lot more together – it is happening more with
infrastructure funding but we need to do more.
▪ We need better data, and MDH pushes it back with higher level evaluation;
▪ improved state statute for how we do public health.
Electeds and community members:
▪ We need to continue to be educated about the many things that are connected with public health
but that we don’t always think of as connected – transportation for instance.
▪ How can we partner for opioids and cannabis education?
▪ It’s the health of the herd that matters. We are talking about herd health (not just one person);
▪ Return on investment. Public health is an economic issue. If we want to thrive economically, we
need a healthy workforce.
▪ Realigning what we do with data so that it’s timely, it’s relevant, it’s locally driven, so we can find
the places that we have to find and know about them.
▪ Ordinance samples to know how we should do this locally.
▪ The grants can be so burdensome, we have to find a simple way.
▪ Local public health, please invite us to your day on the hill. We think it’s important for legislators to
see that your commissioners support your work.
▪ Work with us to build community relationships.
▪ We need you to tell us what to do. Point us in the direction.
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Optional panel presentation: Stearns County Community Connectors share their stories!
Featuring: Leana Sagere, Abdukadir Abdullahi & Bethany Berthiaume
Three Community Connectors from Stearns County
joined us to share the powerful stories of the path
that drew them to the work and prepared them for
the challenges that they face every day as they serve
their community in this important role.
Three simple rules of the state-local public health partnership
I.Seek First to Understand
II.Make Expectations Explicit
III.Think About the Part and the Whole
Slides and materials can be found on the SCHSAC Member Portal on Basecamp
(https://public.3.basecamp.com/p/yeG84jdJ9jaPNBuhNbD8wqiv/vault).
Minnesota Department of Health
State Community Health Services Advisory Committee (SCHSAC)
651-201-3880 * health.schsac@state.mn.us * www.health.state.mn.us/schsac
Updated October 23, 2024
To obtain this information in a different format, call: 651-201-3880.
11/20/2024
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Otter Tail County
CHB Assessment
Fall 2024
Highlights from session #1
•Minnesota’s public health system, a state and local partnership, referred to as the community health
services system, enables state and local governments to combine resources to serve in an efficient,
cost-effective way.
•Minnesota statutes and rules identify two governance options for counties and cities to organize
themselves to do the work of public health:
•Community Health Boards (County assumes role or joins Joint Powers), OR
•Human Service Boards organized under Minn. Stat. §402
•Cities or counties determine the organizational structure of their local health department and define
how responsibilities are distributed and managed.
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Highlights from session #1 (cont’d)
•The powers and duties a community health board (CHB) "must" and "may" carry out are in statute;
Minnesota Local Public Health Act: Stat. §145A.
•While CHBs and boards of health have broad powers related to public health, cities and counties
also have powers relating to public health responsibilities.
•The Local Public Health Association (LPHA) is the Public Health affiliate to AMC, just as MACSSA is
the affiliate for Human Services.
Highlights from session #2
•It was identified that working cross jurisdictionally had a positive impact on maximizing funds and
creating content experts vs. many staff knowing a little content.
•A decision was made to formalize this cross-jurisdictional work as P4HCHB.
•P4HCHB has had 10 Years of regional partnership: 2014-2024.
•Review of governance documents, including the Joint Powers Agreement, that allows work across
political boundaries.
•P4H Directors SWOT identified opportunities for improvement within the P4HCHB, inclusive of
finance and CHS administration.
•Overview of major Community Health Board funding sources.
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4
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Highlights from session #3
•Reviewed the Public Health framework that identifies the work that local public health is responsible for.
•8 Capabilities: Assessment & Surveillance, Policy Development & Support, Partnerships,
Performance Management, Equity, Emergency Preparedness/Response, Organizational competency,
and Communications
•5 Areas: Communicable Disease Control, Chronic Disease & Injury Prevention, Environmental Public
Health, Maternal/Child/Family Health, Access to and linkage with clinical care
•Discussed impacts to staffing, funding, and workflow for current vs. other CHB states.
•Recognized that P4HCHB staff across responsibilities function well; improvements are desired for CHS
administration, finance, and joint powers board.
Highlights from session #4
•Reviewed several Community Health Board Governance options.
•Considered the following should OTC recommend a change in governance:
•What are the opportunities/efficiencies of the proposed structure?
•What are the barriers/disadvantages of the proposed structure? Potentially, what are the unintended
consequences?
•Determined next steps and necessary conversations to be held to inform any recommendation to P4HCHB.
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Recommendation to P4HCHB
Commit to changes (as identified in Directors SWOT) in how
P4HCHB is organized and begin to implement in 2025.
*From P4H Directors SWOT April 2024
Examples Identified in SWOT
•Decision-making
•Example: needs improvement and clarity; action steps at meetings; how are JPB and CHB
Director decisions made if there is not consensus?
•Need a shared understanding of the CHS role
•Example: Concern brought forward in identifying who is leading what regarding CHS Co-
Administrator roles.
•Increase timeliness and frequency of finance grant reports
•Example: Financial picture delayed within the CHB. Unsure where we are at with spending,
and how much is left. Last minute requests for grant reporting needs.
•Finance Status/Transparency
•Example: JPB request for CHB budget inclusive of revenues & expenses not received.
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Discussion & Next Steps
9
Becker County Clay County Otter Tail County Wilkin County
712 Minnesota Ave 715 11th St N #303 560 Fir Avenue West 300 5th St S
Detroit Lakes, MN 56501 Moorhead, MN 56560 Fergus Falls, MN 56537 Breckenridge, MN 56520
218-847-5628 218-299-5220
Co- CHS Administrator:
Kathy McKay
218-998-8320
Co- CHS Administrator:
Jody Lien
218-643-7122
Resolution 2025-2
EFFECTIVE 1-1-2025 THRU 12-31-2025
The Partnership4Health Community Health Board (P4HCHB), by virtue of its authority under Minnesota Statutes 145A and by this Resolution of the Board adopted at a scheduled meeting of the P4HCHB on
November 22, 2024, hereby appoint and authorize the following persons to act on the Board’s behalf
effective January 1, 2025, and bind the Board for the following purposes:
A. To serve as the Board’s Community Health Services Administrator according to Minnesota Statue 145A.02, Subd. 2 to act on its behalf. The CHS Administrator shall communicate with the Commissioner of Health between Board meetings, including receiving information from the Commissioner and disseminating that information to the Board; provide information to the Commissioner on the Board’s behalf; submit grant applications, sign, and execute contracts on behalf of the Board for funding opportunities administered by the Department of Health and other entities Name: Jody Lien, Otter Tail County Public Health Director B. To serve as the Board’s Fiscal Agent to submit progress and financial reports in accordance with funding contracts and to execute documents on behalf of the CHS Administrator when needed.
Name: Kathy McKay, Clay County Public Health Director C. To serve as the Board’s representative on the State Community Health Services Advisory Committee to advise, consult with, and make recommendations on the duties under 145.04 Subd. 1 a. Representative: Wayne Johnson, Otter Tail County Alternate: ________________________________ D. To delegate to each County Board within its jurisdiction to appoint a Medical Consultant to provide advice and information, to authorize medical procedures through protocols, and to assist the community health board and its staff in coordinating activities with local medical practitioners and health care institutions.
E. To authorize each County Board and their respective Public Health Department within its jurisdiction to continue to carry out duties to fulfill community health board responsibilities in the delegation agreement approved by the Commissioner of Health March 15, 2015. This resolution authorizes the above referenced appointees to act on behalf of and bind the Board to the extent and for the purposes indicated in this resolution. Resolution adopted date: November 22, 2024 _____________________________________________________ Frank Gross, Partnership4Health Community Health Board Chair
Partnership4Health Community Health Board
Administrative & Program Management (Article VI)
Administration Clay/Otter Tail Clay/Otter Tail Clay/Otter Tail Clay/Otter Tail Otter Tail
Legal Otter Tail Otter Tail Otter Tail Otter Tail
Finance Clay Clay Clay Clay
Assessment & Planning HOLD ALL ALL ALL
Performance
Management
HOLD HOLD HOLD Per County
2021 2022 2023 2024 2025
Officers (Article III)
Chair Frank Gross Frank Gross Frank Gross Frank Gross
Vice Chair Wayne Johnson Wayne Johnson Wayne Johnson Wayne Johnson
Exec. Secretary*
* 2023 bylaws appoint
recording secretary
Neal Folstad Neal Folstad OTCPH staff OTCPH staff OTCPH
At Large Community
Member (1)
Bill Adams
Otter Tail
Bill Adams
Otter Tail
Cheryl Walter
Becker County
Katie Vasey
Becker County
Katie Vasey
Becker County
At Large Community
Member (2) *new 2022
Kathy Anderson
Clay County
Kathy Anderson
Clay County
Kathy Anderson
Clay County
Wilkin County
ANNUAL REVIEW:
BYLAWS
P4H CHB Bylaws
Article I Name/Purpose
•Chapter 145A
•Six functions of Public Health governance
Article II Membership
•Currently 6-member board
•One County Commissioner & One Alternate
•Two At-Large Community Members
•Consider Updated Language to section 2
•From " made by January 31 of each year" to
•“the first meeting of each year.”
P4H CHB Bylaws
Article III Officers/Decision Making
•Chairperson and Vice-Chairperson
•Elected annually
•Consider language change to section 1
•From "at the last meeting of the calendar year" to
•“at the annual meeting.”
•Recording Secretary to be furnished
•Voting
•1 vote per CHB member
•Voice Vote
•Quorum: 3 counties represented
•Actions are simple majority
Article IV General/Meetings
•Statutory Minimum 2 per year
•P4H CHB meeting quarterly in 2024
P4H CHB Bylaws
Article V Agents
•CHS Administrator
•Fiscal
•SCHSAC appointments
Appointments have been made at the annual meeting.
Article VI Administrative & Program Management
•Administration & Legal Consult
•Fiscal
•Assessment & Planning
•Performance Management
•Consider updated language section 1,2,3,4
•From "prior to December 31st“ to
•"at the annual meeting”
•From "set forth in a separate document" to
•“set forth in appendix A”
Appointments have been made at the annual meeting.
P4H CHB Bylaws
Article VII Records, Accounts, and Reports
•P4H currently uses State auditor
Article VIII Budget and Accounting Services
•CHB carries liability insurance through MCIT
•Review CHB determination "administrative fee"in section 2
Article IX Bylaws Review & Amendment