Topic Area - California State University, Fresno



|Topic Area |Overview of Discussion |Member Action / Follow-up |

|Call to Order |David Luchini welcomed all and called the meeting to order at 10:03 a.m. | |

| | | |

| |In Person AM: Jason Britt, Van Do-Reynoso, Beth Gazarek, Keith Winkler, Kathleen Grassi, Becky Nanyonjo, David Luchini, | |

| |Donna DeRoo, Ashley Hart. | |

| | | |

| |On Phone AM: Alvaro Garza | |

| | | |

| |In Person PM: Jason Britt, Van Do-Reynoso, Beth Gazarek, Keith Winkler, Kathleen Grassi, Becky Nanyonjo, David Luchini, | |

| |Donna DeRoo, Ashley Hart. | |

| | | |

| |On Phone PM: Alvaro Garza | |

|Approval of Minutes |The minutes from 3-28-16 were approved by consensus. | |

|Action Items |

|Policy System Environmental Change |David Luchini presented a suggestion from Sara Bosse, Fresno County Public Health, to form an additional sub-committee |-Members send name/email to Ashley/David/Becky |

|Connections |focused on policy and planning. | |

| | |-Members agreed on the formation of the Policy System|

| |Members discussed the opportunity for staff to collaborate and communicate in terms of policy and planning. Jason Britt |Environmental Change Strategists Sub-Committee |

| |agreed with the suggestion and suggested focused on individual county barriers, challenges and successes. The focus can be| |

| |on what others are doing and how sharing the information can benefit everyone. Kathleen suggested a quarterly phone call | |

| |and the members can determine the focus of the group. Becky explained that many of the grants that they receive require | |

| |PSEC and they are doing a large amount of research in terms of this topic. She also suggested some consultation in terms | |

| |of data sharing/PSEC. Jason Britt explained that they are working within their own counties | |

|Data Subcommittee |Becky discussed the data sub-committee phone meeting that was held on Friday, May 13th. The members discussed a |-Dr. Garza suggested other indexes for the Data |

| |governance structure that would be created by email |Sub-Committee to review, (1) Human Development Index |

| | |looks at health, education and income; (2) Distressed|

| |The sub-committee was created in order to determine the scope of work, with volunteers from Kings, Merced and San Joaquin. |Communities Index, 100 biggest cities in the country;|

| |They will meet with Becky and possibly UC Merced representatives as a group in order to draft a framework. The group is |(3) Education Equality in America, education equality|

| |determining what platforms for data-sharing are available to all counties as the IT Departments have different |index. |

| |restrictions. The members discussed common reports, such as Cal-Redi; however, the frequency and focus is different from | |

| |other counties. The members also discussed the roles of various data managers/epidemiologists as it varied across the |-Donna will determine the amount that Kern County |

| |counties, ie. some focus on chronic disease and other focus on communicable disease. |will be invoiced |

| | | |

| |David brought up the subject of Kern County participating in the Data Sub-Committee and the members agreed that Kern County| |

| |should be sent an invoice. This invoice can be in addition to the current county dues. | |

|Return on Investment Training Debrief |Van Do-Reynoso, Becky Nanyonjo and Beth Gazarek participated in the Return on Investment training and Van explained the |-Van will work with CDPH to determine next steps and |

| |positive value of wanting to be able to calculate this data. The CDPH staff focused on reviewing the ROI tool. It also |possible future funding |

| |incorporates quality improvement and accreditation which the CDPH staff appreciated and they will create a project in order| |

| |to continue this work. The goal is to have a local data analyst to focus on inputting the data and championing the focus | |

| |at the county level. Becky explained that there were various perspectives and that it would be helpful at the programmatic| |

| |level as well as the fiscal/managerial level. Beth stated that there were some people who were focused on programmatic | |

| |details and others focused on data. She suggested some homework for some people prior to the training. The participants | |

| |had to present about how to justify a program in front of the board of supervisors, which provided them with a background | |

| |of information they didn’t have before. Van will work with CDPH to determine next steps and possible future funding | |

| |related to Return on Investment. | |

|Health Equity Quick Strike Projects |Van Do-Reynoso explained that the health equity funds have been planned to be combined to create a NACCHO health equity |-Donna will send MPH grad information to Van |

| |presentation that can be shared with each county. They found a local producer/film maker that can help create the local |-Jason will send information about a videographer to |

| |videos that are related to the NACCHO modules. He is currently working with a larger video project and is committed to the|Van |

| |project but he will be much busier in the future. | |

| | | |

| |The local videographer is David Jenkins. There will be 5 videos for each of the 5 modules, based on local stories. David | |

| |Jenkins wanted to start the county interview in June with a completed video project by August. The counties discussed the | |

| |possibility of including their participants from the Health Equity Cohort. Fresno and Kings will share module 3, Merced | |

| |and Stanislaus will share module 4. | |

|County Updates / Questions for Other |Kings: Keith Winkler summarized that they have many recruitments within their health department. The fire department and |-Kathleen will send the PPT slides from the Climate |

|PHDs |police department have free collection boxes for unused medications/used sharps sites. Kettleman City has a hazardous |Change in Public Health |

|ACA |waste site and they was an application for expanding the site. There was a committee created to review the issues related | |

|Public Health Workforce Capacity |to birth defects and cancer. They are contracting with the Public Health Institute to provide a survey of the residents of|-Health Officers and STD Controllers: suggestion for |

|Accreditation Updates |Kettleman City. They recently met with representatives for the future city of Quay Valley, which will be a new |a regional discussion on syphilis |

|Funding Opportunities/ Current Grant |sustainable/off-the-grid community. One of the main issues related to construction and use of the area is related to | |

|Opportunities |Valley Fever. There is a whole-person care pilot and they are meeting with various organizations and discussing issues for|-Dr. Garza will send San Joaquin County report to the|

|Drought Updates |the emergency department frequent fliers. The grant requires a local governmental match, which they currently do not have |members |

|Health Equity |within Kings County. He suggested that they have all of the right partners and they just need to work to determine the | |

|Other Significant Public Health |roles of each organization. They have the employee health clinic and it has been very popular with employees. |-Becky will share the internal epidemiologist scope |

|Activities/Events | |of work |

|Congenital syphilis |Beth Gazarek updated regarding their CHA and their updates related to accreditation. They completed their strategic plan | |

| |in December based on the Baldridge Principles. They are working in groups for each of the domains for accreditation. They |-Becky explained that the HIE Vendor Exchange Meeting|

| |have 6 groups working on things in the CHIP, one group is working on policies and procedures. They noticed that there are |will not be able to include other participants at |

| |many people who have information in their heads and they are working on finalizing/writing information down. They are also|this time, Ashley will send an email to the Data |

| |working on branding, data/dashboard, job duties, and business continuity. They are also hoping to add health in all |Managers to let them know |

| |policies as well as return on investment to their future strategic planning efforts. | |

| | |-Van send Communication Award information to Ashley, |

| |Stanislaus: Becky Nanyonjo updated that they hired a health promotion manager and were able to work with HR as she is not a|possible application within SJVPHC |

| |RD. They are hiring two additional epidemiologists, one new position and one vacancy. They are creating an internal scope| |

| |of work for the epidemiologists. They completed their first public health newsletter, moving from internal public health |-David will send Fresno poverty news article to |

| |to other agencies, to outside agencies. They are bringing cultural competency to the staff through training. They just |members |

| |completed the accreditation training and they recently completed their PMQI and Becky will be reviewing the final version. | |

| |They are realigning their CHIP to focus on prevention and have had a few roadblocks but are positive. They are going to | |

| |conduct a RICE Evaluation (Reduce, Increase, Complete, or Eliminate). Becky explained that the HIE Vendor Exchange Meeting| |

| |will not be able to include other participants at this time. | |

| | | |

| |Fresno: David Luchini explained that they added 8 positions in April. They were hoping that the new positions will allow | |

| |investigators to spend more time in the field. The cases are still piling up and the jail has been screening people and | |

| |found more cases, mostly related to meth. They are trying to work with the correctional health department related to | |

| |pregnant women who are being released with syphilis. They also have a shortage of the antibiotics. They are looking into | |

| |a transition program where they can connect the patient with programs as they are released from jail. They are a finalist | |

| |for the CACHI grant and expect a site visit within the next few weeks. The contract with correctional health is going to | |

| |expire and they are looking into other options. David Pomaville is focused on tree mortality at the state level. They | |

| |have trouble filling PHN positions but have had better luck with RNs. They are working on worksite wellness and a new | |

| |employee orientation to include videos, presentations, and a self-assessment related to health equity. | |

| | | |

| |Madera: Van Do-Reynoso explained that they complete their CHA and had their first town hall meeting related to the CHIP. | |

| |They have been working with UC Merced to validate their findings as they do not have an epidemiologist. The Google | |

| |Innovation Lab teams within their county are looking at ways to improve government. Google will work with the teams to | |

| |determine solutions for government, such as partnering with Uber for transportation to appointments. Van explained that | |

| |CCLHO/CHIAC have the public health communication awards that are due Friday, May 27th and Van suggested a nomination with a| |

| |focus on a regional STD prevention campaign. Van asked about the Health Equity Awards and what to showcase as a region and| |

| |she suggested the option for a regional honor for the valley. Becky explained that they are having issues within their | |

| |department about health equity and cultural competency. Jason explained that they had a Diversity Works program within | |

| |their county which led to issues related employee relations. They are working on hiring an epidemiologist for their | |

| |department. | |

| | | |

| |Merced: Kathleen Grassi explained that there were a few counties that presented about climate change and public health. | |

| |They are looking into the Building Healthy Communities extra module and suggested a multi-county shared option. Merced | |

| |County is featured in the NACCHO publication and they are presenting at the NACCHO presentation in Phoenix. They have | |

| |completed a large amount of community engagement to get input about walkable/bike-able communities. They have a group of | |

| |UC Davis medical residents focused on needle exchange and the lead will either be the City of Merced or Merced County. | |

| |They have a BHC site in Merced and they have decided that Health for All in Merced is the priority. There was a rally | |

| |outside their health department to focus on health care for the undocumented adult population. They have a consultant who | |

| |is looking into other health care services for the undocumented and she hopes to present this information to the group in | |

| |the near future. | |

| | | |

| |San Joaquin: Alvaro Garza discussed syphilis and the possible coordination within the San Joaquin Valley. The group could | |

| |consist of the health officer and the STD controllers. Van explained that there will be 5 full-time infectious disease | |

| |physicians at Valley Children Hospital. They suggested a possible STD prevention campaign throughout the region. He asked| |

| |about other members’ issues with jail health inspections, as related to temporary jails/holding centers that were built | |

| |before 1978. The temporary holding facilities are exempt from inspections but not exempt from health inspectors. Keith | |

| |explained that the health and safety code includes the option to make a recommendation, but they do not have any authority.| |

| |Dr. Garza asked if the counties had been charging for inspections. Tulare and Stanislaus charge for kitchen inspection but| |

| |not the jail. Dr. Garza explained that other counties charge and he will be looking into other options. Dr. Garza asked | |

| |about opioid overdoses and Fresno county explained that they are focused on this issue as well. Fresno EMS wanted to track| |

| |the use of Narcan and the effectiveness of it being delivered in the field. San Joaquin asked for a report from emergency | |

| |rooms related to overdoses which they have been tracking over time. Dr. Garza recently conducted a report of public health| |

| |services in their county, which hadn’t occurred in a few years. The report is focused on general information and it not | |

| |too technically. Dr. Garza will share the report with the members. John, Emanuel Alcala and Tania Pachecho-Warner | |

| |presented about the operational and statutory capacity report at the advisory committee meeting for the Office of Health | |

| |Equity of CDPH. Dr. Garza wanted to discuss with John Capitman about becoming academic health departments. He likes the | |

| |health policy leadership program and wants to be able to expand the institute into the rest of the San Joaquin Valley. Van| |

| |suggested the issue related to the MPH at Fresno State and the Doctoral Program at UC Merced. He also suggested the Sierra| |

| |Health Foundation, and their satellite office in Merced, related to their funding to various organizations. | |

| | | |

| | | |

| |Tulare: Jason Britt explained that they have their final steering committee meeting for their MAPP process. They are | |

| |choosing 3 or 4 priorities for their CHIP in order to be realistic. They just released their CASPER survey for the | |

| |drought, Mariposa was the other test county. This survey required a large amount of extra staff time. They will also be | |

| |applying for the CDC drought grant. They have created their domain teams for accreditation in order to take inventory. | |

| |They are struggling with recruiting PHNs but have had plenty of RNs in the past. They were able to find a few RNs and were| |

| |able to assist them in becoming PHNs. Their lab director is contracted out of the City of Long Beach. | |

| | | |

| |Kern: No representative at the meeting. | |

| | | |

| |Calaveras: No representative at the meeting. | |

|Lunch Break |

|Citizens’ Climate Lobby |Connie Young and Dr. Don Gaede presented in-person about the Citizen’s Climate Lobby. | |

|Kings Partnership for Prevention |Julie LeFils, the Executive Director of KPFP, presented in-person about the Kings Partnership for Prevention. She |-Ashley send link for Kings County strategic plan to |

| |discussed the holistic view of health from people. They are funded by the San Joaquin Valley Health Fund from the Sierra |members |

| |Health Foundation. | |

|Health Disadvantage Index |Kathryn Jeanfreau, Merced Epidemiologist, presented through Zoom Meeting about the Health Disadvantage Index. Dr. Garza |-Ashley send notes from Kathryn and suggestions from |

| |suggested other indexes, (1) Human Development Index looks at health, education and income; (2) Distressed Communities |Dr. Garza, HDI Map, Cal EnviroMap |

| |Index, 100 biggest cities in the country; (3) Education Equality in America, education equality index. | |

|CCASSC Next Steps |Their next meeting will be in September, where David Luchini and other interested members will present the mapping reports | |

| |to the CCASSC members. The goal was to have regional data showing the impacts of poverty and health/social issues. | |

|Feedback and Future Agenda Items |Calaveras County agreed to be a member of the San Joaquin Valley Public Health Consortium. They will not be paying dues | |

| |form 2016-2017, but they will pay dues starting 2017-2018. | |

| | | |

| |New agenda item related to public health nurses, clinical faculty at a future meeting. | |

| | | |

| |Van suggested having the meetings in a more central location, such as Fresno, Madera or Visalia. | |

|CHEAC Updates |They will be meeting with stakeholders to get thoughts related to shaping the new 586 related to CCS. They are looking | |

| |into changing the language. The two-plan model is back on the table, it is still in place and counties can still apply to | |

| |be a pilot. There are several counties that are interested; however, given the new administration in January the waiver | |

| |process will be much longer. It will require a waiver but it is still available. | |

| | | |

| |Jail claiming, October 2016, go live date for reimbursement; however, CHEAC is requesting that the department give | |

| |milestones so they can see and anticipate. | |

| | | |

| |Whole person health care— What is the risk to the county? They are not sure about the risk, except based on what you | |

| |actually perform. She is going to ask regarding start-up costs, infrastructure, and capital costs but it is very unlikely.| |

| | | |

| | | |

| |Medi-Cal—There was a letter that probation is not eligible for TCM activities. CHEAC asked the department and the | |

| |department will take 12 months to review. Some probation activities can be construed as necessary case management | |

| |activities. Re-entry- no, Probation- maybe | |

| | | |

| |CHDP changes—because SB 75 gives schools full-scope coverage then why would CHDP be needed as well. Departments have to | |

| |justify the need for CHDP. At her level there is no change in CHDP right now. Counties need to monitor caseloads and | |

| |monitor the changes from SB 75 on the caseload. Does the state need to pay for CHDP program? | |

| | | |

| |There is a dental RFP out related to a waiver. The question is to ask is First 5 can be the applicant? They will check. | |

| | | |

| |Van volunteered to take notes at the CHEAC monthly meetings and distribute them to the members. | |

|Adjourn |David Luchini adjourned the meeting at 3:15 p.m. | |

Next Meeting: Monday, July 25th, 2016, Tulare County

4031 W. Noble, Visalia, 93277

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