Arapahoe County Board of Health - Regular Meeting

One flying overhead.

So one of the things, Jennifer, it says when I joined is that because I'm not part of the organization, some of the capabilities are limited. I don't know exactly which ones that is, and so as how to facilitate this, no. I don't know what that means, you know, as we get started, but it just gave me a warning sign because I'm not part it says members outside the organization have limit capability. Some functions are disabled.

Okay. I don't know that y'all need any of the functions, but if

Okay.

So we'll we'll troubleshoot. Thankfully, we don't do too many of these virtually. I think I think everyone's here.

Okay. Let me okay. I'm going to call the the Arapahoe County Board of Health meeting to order. Miss Smith, would you oh, miss Banks, would you please call the roll?

You're gonna get me one last time. I'm gonna call.

Oh, okay. Director BB Klimen.

Here. Director Sean Davis.

Here.

Director Christine Burrows. Here. Director Mark Levine.

I'm here.

Director Mark McMillan?

Here.

Director Terrence Walker?

Here.

And director Michelle Weinrub?

I'm here.

So

we're going to before the because of the time, normally, we would let the directors in the room introduce the staff. But because of the agenda and the virtual nature, we're going to bypass that today. The next item is to approve the May meeting minutes. Can I get a I move for the board of health to approve the May 2025 meeting minutes as presented? Can I get a second?

Can I offer an amendment? Yes. Absolutely. I noticed in that there's a missing word on item number five. A motion was made by Davis, seconded by Burroughs that this blank be approved. Doesn't say what the blank is.

Motion?

No. It was the the waiver. We approved the the no. I'm sorry. The wastewater

The variance? Yeah. The variance. It was a variance.

Yeah. So we need to in insert that word, variance.

Okay.

Can I move to approve the minutes with doctor Levine's suggestion?

And I second it. All in favor, say aye. Aye. Any opposed, say nay. Hearing none, the motion passes. Do we have anybody for public comment, Abby?

No. We just signed up.

Okay. Okay. The next is the director's comment. And and I would just ask the directors to keep their comments, this meeting brief, because we have a fully packed agenda, and we've had to cut a few things out. So normally, I would give my director's discretion. But this time, we're gonna ask if you could keep it to a minute or two starting with Christine since she's on the treadmill exercising for us.

I, like, can barely sit still.

So No.

That's what pad is the best invention. And I figured out that I can do it without feeling like an elephant. No big updates for me. I can skip for time sake. So thank you.

Okay. Mark Levy?

Hi. Just some of my work with Medicaid has enabled us to begin a work group that's looking at coordination of care for special populations including the older and particularly the infirm as well as the disabled populations and how that fits in to the medical management that they have at Colorado Medicaid. So that's a nice development that enables us to study that issue and come up with some recommendations if they're needed.

Thank you for that, Mark. Great work. Michelle?

Hi, everyone. Real quickly, two things on my mind in our world today. One is a a thank you given everything that we are concerned about as it relates to measles. First of all, I wanna thank the the Arapahoe County Public Health team for all they are doing so quietly and so well as it relates to all of the cases that are coming their way. I know they were anticipating it, and it wasn't necessarily a surprise, but we all know it's a just a ton of work to do it well and thoughtfully and safely.

And we'll look back on this time, I hope, the rearview mirror at some point and and be very, very grateful and proud of of CDPHE, but especially ACPH and what how they're how they're working this because I see it up close, and I know Jennifer is keeping this board very well apprised and grateful for that because we wanna be able to help when it's appropriate. So I just wanna give that shout out. And also to our continuing partnership, I think we're up to 10 immunization with an emphasis, obviously, on measles clinics that we'll be doing together with Cherry Creek Schools, Aurora Public Schools, and and ACPH through the next several months as we get ready for the next school year. And, also, just so that you all know, Aurora Public Schools, and we are partnering to issue common guidance and common call for for science, to two separate groups, one to our staffs and then the next to our families, giving them real science about what measles could mean to them and their families as a health crisis, but also as a work crisis. Because if people are not vaccinated or if they can't prove it through titer or records, they will miss work.

And so we wanna make sure they're clear. And for families who have chosen not to have their kids vaccinated, their students will miss school, and we're not in a position to offer asynchronous online learning for those kids that we have to exclude because they've chosen not to. And so we're really, we're proud to align with Aurora Public Schools, but it comes from our public health department in terms of that evidence based guidance. So I just wanna put that out there that in spite of other things, we keep moving forward.

And I would say during these times, we're gonna lean on you, Michelle, as the head and representing the full board in a lot of that work. So thank you for all of your hard work and to Jennifer's team on that. Terence, any updates from you?

No big updates in my world, but I just wanted to really quickly just recognize that tomorrow is Juneteenth. And and as a day that is very near and dear to my heart, I just didn't wanna let this moment go by without saying just Juneteenth tomorrow and whatever you do to celebrate. If you do, whatever. But it's important to me. So happy Juneteenth.

Happy Juneteenth. Mark McMillan?

Good afternoon. I wanna see you in virtual land. Briefly continue to work in the city county Denver with developing our department strategic plan. We're really kind of in the final throes. I love the fact that our executive director, Karen McGowan, is is encouraged us to not lose sight of the community and the needs of the communities.

And so good discussions related to health equity, environmental justice, and from from my world work in terms of environmental health. So excited for the progress there, recognizing to sort of a holistic approach to the work of this strategic plan, including efforts around diversity. I'm also recognizing the importance of workforce engagement and development. Thank you.

And then baby.

I just returned from vacation, so I'm not totally back yet. I don't have any comments.

Yeah. When they said the rule of the board is when you're on vacation, you're not allowed to give any updates. You were having too much fun.

That's right. I I didn't learn anything.

So Yeah. And just in my update, I wanna encourage my other board members to give a shout out to Christine, our board member. She gave a presentation to myself and Mark Levine and Arapahoe County staff on older adults and a lot of the myths and ways that we can better support older adults in the aging process. And so I think it was a fantastic training. It was really engaging.

And so good shout out for her for being a champion for older adults. And for me, Mark, Bebe, for us seniors on the group, we really appreciate it. So thank you for that, Mark McMillan. You and that group, you're not getting away. So we really appreciate that.

And then also to the harm reduction team at Arapahoe County, they partnered with Street Fraternity, which is another organization I'm on the board, which is at Colfax. Yosemite have done a great job providing education, providing other things, and so a shout out to the harm reduction team and thank them thank them for being present in the community for organization that's technically in Denver, but they're right on the border. And so the feedback from the youth was they love the staff, and everything is going great. So and then the other thing is just be mindful with everything similar to what Mark Levine said. For me, the biggest issue is the cuts to Medicaid and how that could impact us.

And so that's something that I'm, you know, actively involved in. We're trying to ensure that I think that'll really hurt the public health department. So just ask my fellow board members to keep that on your radar and then to the extent possible, keep it front and center, think about the impact, and do what you can in that area. So thank I thank all of my directors for all of their input. There is no general business, but we're gonna we have to move into our study sessions. We have five study sessions today. The first one is a financial report and a draft fiscal year twenty six budget presented by Brianna.

Thank you. And I meant to ask earlier, am I doing slides, Jennifer, or is Abby? Okay. Yay. Thank you, Abby. You would all be really sad if I had to go find these slides and share them. Alright. I am going to actually be kinda clipping through this real quick. So first things first on the agenda, we're gonna kinda jump over the federal landscape. Everyone knows the doom and gloom there. There's nothing new. It's nothing that you would necessarily not have already heard. And then we'll do a policy update from CalFo. I do wanna highlight some wins. We'll review, first quarter financials and then start talking about our 2026 budget.

Next slide please. Truly, am gonna skip over these. We all know how how sad that situation is. I do wanna take a moment and highlight the wins from our Colorado state legislative session this year. So there's three very specific ones and it's it's lumped in as CALFO because CALFO was a very yeah.

A huge part of this. The first one is protecting the local public health infrastructure funds. So between the initial November governor's budget, which included a 5% reduction to our infrastructure I'm sorry. Our local public health funds, which is kind of our infrastructure funding. And then a real last minute change to the marijuana tax cash fund, disbursement, there was up to a possible 15% reduction.

One was a five and one was a 10 reduction. And at the end of the session, neither passed. And so we remained flat, which was a huge win and actually a large testament to how much work has been done by CALFO to really integrate with legislators. We had very strong advocates on the joint budget committee this year. And hearing them say things like this is critical funding to local public health was very rewarding in the work that CALFO is doing and those of us that support CALFO.

We also passed the graduated retail food fee increase bill. This was a huge lift. It was has not been done since, I believe, 2015. And so, this was a joint effort between industry, CALFO, the state, and, locals. They came to an agreement. It's actually slightly more than in total, a 70% increase because each year builds on itself. The first year's increase is projected to be about a $220,000 increase for Arapahoe County. So, again, this was a huge win. It had, bipartisan support in the legislature. So all the way around, this just, was a good win for public health.

And then defeated the retail the ex I'm sorry. The expansion on the Cottage Food Act. And so this act, or this bill would have allowed the sale of refrigerated foods under the Cottage Food Act. Calvo was the only group that came out in opposition of this bill. It did fail in committee.

I actually think the bigger win here though is that Kalfos forming a group of local public health, e h specialists that are going to be working with and hopefully engaging with the bill's proponents to find that middle ground. And that's sort of how how the retail food increase bill works so well is because we worked with both sides. So, that actually is the bigger win in my mind, and so I hope that really does, pan out the way that Kafu is trying to work through that. So alright. Onto the quarterly financial update.

This is the first quarter, so January 1 through March 31. 25% of the way through the year, We've collected 25.4% of revenue, so that's perfect. Of that is 1.9% of our county contribution I'm sorry. 1,900,000.0 per of our county contribution, which is just over 7,000,000. And then, three, I'm sorry, 3.1 in reimbursable grant revenue and the remainder would be in our fees for service.

On the expense side, we're at 25, I'm sorry. 26.5% of the budget. This doesn't concern me. We have a couple of just, like our I'll go into it in more detail, but, our rent payments are in here and stuff like that. So we're on track and in good shape.

Go to the next slide. So I did wanna just highlight a couple of, anomalies showing up here. So on the first line, have 60% of our we're 60% of our way through the budget with our fees for service. This is not unusual. What this is is that our retail food license fees are collected in November and December of the previous year primarily and deferred into the first month of our new year. And so we're kinda seeing this big peak and then we'll trail off and level out. So this is not unusual and is not concerning.

And then if you look at the

state grant line, we're at 17.5% of the budget. This also is not concerning. So in our state grants, we are on the state fiscal year, July through June. However, if that state grant has federal funding associated with it, that spending is actually done July through March. And so we have to spend the federal portion in nine months when the contract is for 12.

So we, at within ours processes, spend on the federal portion first, and so then we're just finishing that up and we'll start finishing up spending the state portion. So that's why you're seeing that lower than the rest of them. And then, under expenditures, you'll see services and others were at 35.7% of funding. That's the rent payment. So again, that's almost the inverse of what I just explained with the state grants.

That payment, because we're now in Lima and we're almost done with Willow, that rent payment ends in August. And so we've made that for the eight months of the year and then we'll stop. So it's a heavy load in the services line and then it'll all taper off. On to the next slide. So just the graphical representation of this.

I do wanna call out the 50% of grant revenue. This is a a trend we are seeing where we're seeing our grant revenue come down, and you'll actually see this in the budget, and we'll talk about it a little bit more. But, historically, our percentage of grant revenue is tends to be higher, and we're seeing that come down more. And so, Jed, I do the comment I wanted to make here is that Jennifer and I are engaging in conversations with the county to come up with long term plans around this trend and how we can kinda navigate this unusual circumstance that we're starting to see.

Right.

So we are going to move into the 2026 budget. So I did wanna just as a reminder, the Board of Health is statutorily is required to adopt a budget by September 1. Since Arapahoe County is the department within I'm sorry. Since public health is a department within Arapahoe County, the board of county commissioners also must approve our budget and they actually approve our spending authority. And so we kind of align these two timelines.

Today, we'll go over our timeline, our our asks or packages, and then some preliminary budget. I do wanna kind of and you're gonna hear me say this multiple times. This is preliminary. I we may well maybe presenting a completely different budget in August for you to approve. So things are changing by the day quite literally. And so things that are already projected in here, we have new information. And so we're just gonna keep working through with going with the the best that we know at the moment and and keep plugging along. So alright. Reviewing our timeline quickly. Sorry, Abby.

Next slide, please. So this meeting, there's no action required. We're just gonna review the preliminary budget. We will meet again with the budget subcommittee, which as a reminder is myself, Jennifer, Tracy Jervis, our financial operations manager, and Mark McMillan, to just review any changes that may have come up and and at least at that time our anticipated, draft. And then in August, during that meeting, we'll review whatever budget we are at for to ask you to adopt.

During, September, the budget subcommittee will present to the executive budget committee, which is the budgeting arm of the BOCC. So it consists of two board of county commissioners and three directors, I believe, from within the county. And then they present their recommendations to the board of county commissioners, which, we will receive that at the September, then it moves to the county commissioners, and then they will adapt adopt the budget in December. Alright. So the county's budget guidance this year has been to align our budget priorities and our asks with what was presented on our one a presentation.

So you'll see a lot of information in here about, like, three year plans and stuff like that, and that's aligning with how it was presented in one in our one a presentation. So our first priority ask is going is for, increased capacity within our WIC program. Currently, caseload for our WIC educators is significantly higher than the recommended standards. So over three years, we've asked to add one or recommended to add one FTE per year. So aligning with that, this is the salary benefits as well as an FTE for our WIC program.

Moving on to our second priority. This is in our environmental health unit. It is for an industrial hygienist or healthy building specialist. During, 2003, we actually asked for this position and we received the position, but we did not receive the funding. So this is a follow-up request.

We've tried for several years to find a way to fund this and we have not been able to, and it's critical in just workload capacity for our staff to be able to fund this. So we're asking for the funding of salary and benefits for this FTE. Moving on to our third priority ask, it is for two FTE to focus on our community health improvement plan priorities, specifically around economic mobility and security and safety. Funding within these areas has been or grant funding has been extremely limited and we're as you know, our general funds are extremely limited. So again, this ask is associated to FTE and the, associated salary and benefits ongoing.

Our priority for ASK is again in our division and it says, a land use and built environment specialist. So aligning with our social determinants of health that kind of impact how your built environment can influence your health and your access. Again, the FTE and associated salary and benefits. And finally, our priority for ask is for one FTE in a Medicaid enrollment specialist. Sorry, Abby.

Onto the next slide. I apologize. Thank you. It's an access to care. So it's a Medicaid enrollment specialist, to be housed within the public health department to help navigate the access to care.

Alright. So on to this chart. So this is a year over year comparison of 2023 and 2024 actuals, our current 2025 budget, and then our baseline projected '26 budget. So this the third column from the right does not, include our budget asks. And I did this intentionally because I wanna call out several things that are trending and get kind of lost in the noise if we add the packages in right now.

So the first thing is that first line of our reduced of reduced grant revenue. So the primary reduction of that is within the loss of our adults protective service line and our TANF line and the significant reduction of our children, protect our child protective service contract all within our human services, partnership. There's additionally reflected there is a reduction in family planning title 10 that we've received an option letter showing a reduction. Cancer protection goodness. Cancer Prevention and Early Detection grant, and then our Ryan White grant.

So all of those we've received option letters with reductions and are reflected in that number. Also, you'll see the reduction in public health funds. That's actually just the difference between our increase with our ongoing merit and comp county contribution, and then the loss of the one time funding to pay for our rent expenses. And b b, I have tried for a very long time to get that put into ongoing, but they wouldn't go for it. And then you'll see the reduction in salary and benefits that aligns with the loss of funding for the NLP contract and our tariff contract.

On to the next slide. So at this time, the middle column, the f y 26 with budget asks, is essentially the budget that we are, proposing and hopefully will be coming forward in August to ask you to approve. And so that includes our, an additional 684,000 from the county and that is reflected in the salary and benefits. So all of the FTE we're asking for adds up to that. Onto the next slide.

So if you look here, this is I alluded to this in our, quarterly financial projection. So if you look at the total grant revenue of 55.8 and the fees for service of 11.2, we're coming out at 67% projected. Again, historically, we were built on 70% of our grants and fees for service making up our revenue. And so while 3% maybe doesn't seem like a lot, it's a trend that we're seeing and it is continuing to go down and we're not necessarily seeing the, equal increase on the county's contribution side or in other places. Medicaid revenue has been a huge, help to us, but that's risky, and we'll talk a little bit more about that.

So it's again just something I wanna call out as a cautionary, note because I think it might be a continued trend. If we move over to the expense side, nothing really has changed here in our percentages. Sorry. Abby, next slide, please. We're again sitting at about 80 just over 85% of our expenses sit within our, salaries and benefits line.

So as always, we're heavy people. I know this is not an unusual story for, any LPHAs, but, something I'd like to continue to call out. So finally, on the last slide, do wanna talk about kind of the ongoing funding challenges. Sorry, Abby. Next slide, please.

So as you all know, the federal funding uncertainty is continuing, and so that makes budgeting incredibly difficult. Compounding that is that the state budget was not structurally balanced this year with enough changes, they kind of they kicked the can to be quite honest. And so as we go into the next budget cycle, I'm extremely concerned specifically about Medicaid even if the federal government doesn't cut the rate, which I think we all anticipate they will. It's one of the few places that the state can actually start to structurally budget. And so, that's why when we're talking about other ways to make up our revenue, looking to Medicaid is great right now, but I don't know that it's necessarily a long term option at this time.

So, and then we have continued concerns around, DEA related funding changes, specifically in and again, all of you know this, but specifically in places of changes in our requirements for service and things like that. So, we are reviewing our contracts very carefully as they do trickle in to make sure that we're not seeing changes in their language. Then finally, it's not necessarily a a funding challenge, but it is a department challenge that, we have a significant amount of staff anxiety around funding and the changes. And so we are doing our best to be transparent and and kind of explaining our thought process and what actions we are taking, but it does continue to show up. And I can't say I blame staff.

So on that very positive note, are there any questions?

Brianna, you you mentioned you alluded to the DEI cuts. Is it the case that the federal government or is it the state sends the contract to you and say, this is problematic or this is because I I thought from our previous conversation that we have went ahead and reviewed all of our programs and contracts and adjusted the language as a result.

Yeah. What we're concerned about is, like, scopes of work changing. So eligibility requirements showing up, things like that that aren't necessarily within our purview to change. And the state is aware of them, but I don't know to what extent they might call them out to us. We're just eagle eyes on these contracts.

Okay. That makes sense. Thank you.

Any

other questions from any other directors? Michelle?

Yeah. Thank you so much. Brianna, question for you about the asks. Do you have do you have a sense of where where the the county commissioners are in that? And what can what, if anything, can this board do to advocate? Because I think and they may very I think they get it. I think they get it. Look. But I think one of the things we learned in our budget process for this year, which I'm sure is true for everyone who works in this world on this call and everywhere else, is everything that happens creates a chain reaction. Right?

And so the one thing that happens leads to this, and then that leads to that, and that leads to this. And so, literally, you're I I loved your justification, not the rationale. Sorry. Your rationale for the asks, if that was a rehearsal for the county commissioners with us, perfect. Because I thought you actually led that you alluded to that.

I would I would depending on how Jennifer feels about it, I would be very bold in terms of laying that out that the the reason we're asking for this is because these five things have happened since January or since May or whatever the timeline is because you're just catching your tail. I mean, to your point, why this could change is because you're, you know, you're just trying to catch it with every day. I mean, today, you know, the Trevor Fund lost all you know, the Trevor Foundation lost all its funding for, to be a part of the suicide hotline and the mental health hotline. So, like, it's on the daily. So I guess I might ask my my those are my comments.

But my ask is, is there anything that we can do to help support those asks so that public health gets what it needs?

I was gonna say, I'm gonna ask Jennifer to chime in here.

Possibly. And Brianna and I have been talking about and thinking about advocacy just at the county level with the commissioners, but also state and federal with but it's hard at this point knowing what to ask you to fight for and when, because there's still so much that has to happen, especially with the budget. And when which basket do we put all of our eggs in, and when do we ask you to do that? So we've been watching closely and thinking about, you know, when when does the board of health elevate? They ask, and where is that?

So definitely have been thinking about that. As Brianna mentioned, we will be meeting with the county's finance director on Monday to just brainstorm how do we this is not just a one year thing. How do we do this year over year for the next few years until we get back to where either,

you

know, the funding is stable and we know it's coming in even if it's less, but that it's not as volatile? We also have been I have been working working with human services and community resources in the commissioner's office because it's our three departments that are impacted the most by the uncertainty of the funding. And we are starting to strategize, and we have, I believe, a a study session in August with the commissioners. Once I know more about what that will look like, if it's appropriate, you might bring in board of health or even a board of health recommendation or the voice of the board of health because I do think they honor and respect and want to hear from the board. So keeping that in mind, but at this exact moment, we don't because we're not really sure where it is that we really need to advocate.

Yeah. It Mark McMillan?

Thank you, Sean. I love the the question, and I love the the feedback. I did have the the pleasure to participate in the state of the county event. I should think it was last last week, maybe the week before. And I do see those informal opportunities as a way to continue to highlight the importance of of public health, and I did have some one on one time, you know, with the commissioner.

So even, you know, at this stage, you know, to Jennifer's point, that there's not a a specific ask for, you know, certain FTE, for example, I think there are informal opportunities to tell our story. And so I did take advantage of that last week and was very receptive. Not not not not surprised to with the with the commissioner, but I think it's just incumbent on us as a board to continue to remind folks of the importance of the funding and and public health as a whole thinking. Yeah.

Thank you for that, Mark. Any other comments for Melissa related to the financial report? Seeing none, our second study session is a chip update from Heather. Heather?

Hi. That actually is coming from Wendy Needing today. This is within our access to care to priority area and specifically to an exciting program that's getting kicked off. So look forward to hearing that update.

Mhmm. Family's And

I'll pass it off, actually, one more time. I will pass it off to Rebecca who is gonna do the presentation, and I just have the fortune of being her supervisor and here to just cheer her on. So I think Rebecca would like to share her own slides though, Abby, if that's okay, so she can have her notes. Does that work okay?

Yes. Of course. Please share, Rebecca. Okay. Thanks, Navi, and fun to have you here. Okay. Let me see if I can get my setup right. I can't see my notes, but that's okay. I think I can wing it.

Mhmm.

Well, thanks everyone for joining this conversation today. I'm gonna talk a little bit about a new evidence based public health program that we're launching here in Arapahoe County in collaboration with a number of other local public health agencies. It's called Family Connects and how that aligns with our community health improvement plan.

Okay.

So as hopefully, this graphic about the community health improvement plan priorities looks familiar to you. One of those priority areas is access to affordable physical and behavioral care. And within that, there's a specific objective to launch this new home visitation program to at least one family using the Family Connects model. And so that's what we're in the process of building right now with the goal of actually doing our first home visit by the end of the summer. I think it's important to note that even though Family Connects is one activity in the chip, it really touches many different I would say every single priority area in the CHIP.

And on this slide, you're seeing some of the different activities that are touched on objectives, activities in different sections of the CHIP that relate to Family Connect. So one piece, for example, is screening resource and referral. You'll hear in just a minute how Family Connects requires a really comprehensive screening resource and closed loop referral process so that clients are getting clear communication on what programs they might be eligible for and how to actually enroll in them rather than just getting a resource list. So that's one example of ways that Family Connects fits in with other areas of the CHIP. We also, through this program, aim to address food insecurity, help folks build financial security, provide resources safety resources.

So we'll talk a little bit more about that. Okay. Hopefully, this is a ninety second video that I think just gives such a nice overview of the program. So I'm gonna go ahead and share my screen. I can see you all, so just give me a wave if you can't hear it. Probably. Can you hear that? No?

No. Okay.

Give me one sec. And if it takes too long, then we can just skip it for time. Let me try one thing. Thanks for letting me know, Sean.

No problem.

Let's try this. Can you hear it?

No sound? No.

Okay. That's okay. I think in the interest of time, knowing how full your agenda is, we'll skip this. But you all have, I believe, a copy of the slides in your board packet, and there should be a link in there. And Wendy or Michelle, who I know is on, maybe you can throw a link to this video in the chat from the Family Connects Colorado website so people can take a look at it later. This is why they have Abby share the slides. Okay. So brief overview of the Family Connects model. What is it? It is a home visit that's done three weeks after typically, three weeks after any family brings a baby home from the hospital.

So that doesn't mean a person gay doesn't always mean a person gave birth, and then the baby comes home three weeks later. That can be three weeks after they were discharged from the NICU. That can be in the situation where there's an adoption or a kinship, placement or maybe a family unfortunately lost a baby. We still would do a home visit. With any of those families, they're all eligible, for a visit. It's for everyone. The home visit is done by a registered nurse, and it is free to families. And the important thing to know about Family Connects is that anyone is eligible. It doesn't matter if this is someone's first pregnancy or or first birth or their fifth. It doesn't matter what income level they have.

It doesn't matter what language they speak. It is aimed to be a designed to be a universal program to reduce the stigma of having a home visit, receiving evidence based education, and receiving connection to resources at a really critical time for families. This diagram shows even in the most ideal world for the most picture perfect patient, this is what prenatal and postpartum care looks like. So in the first trimester of pregnancy, someone could be getting prenatal visits every four weeks, then it becomes every two weeks, then it becomes every week in the third trimester. Then once they deliver their baby or get their baby, they are typically in the hospital for two one to three days depending.

And then that birthing person goes typically six weeks with no interaction, from the medical system or potentially anybody else. So they've gotten a lot of support throughout the pregnancy, and then all of a sudden, nothing. And this is a really critical time where people's lives are changing a ton. I think we have quite a few parents, I think, on the board of health and also on the staff in the room, and I think you all know. Right?

Like, this is a really hard time, and you're just trying to figure things out, whether it's your first child or maybe a later child. And so Family Connects aims to provide that intervention at a really critical time when a family may otherwise not be super connected to support resources and supports. So, again, that connection from the start, it's at this really critical time, and it helps sites, including ourselves, build relationships with community partners because a critical piece of the puzzle is that we're not only going into a home and assessing the needs, but we're ensuring that they're getting connected to resources after that visit. That is part of the model that's built in. This is an evidence based program.

It came from, the University of North Carolina, I believe. It's been around for, I think, twenty or thirty years at this point. Pretty new in Colorado, but has been in many other states. And the evidence shows that I think it's important to highlight the program has a pretty significant impact on reducing postpartum anxiety and depression, on reducing referrals to the child welfare system. And not only that, it helps to close the racial disparity gap in things like postpartum depression and referrals to the child welfare system, well as unnecessary emergency room visits, and lots of other things.

So it's a really important intervention. The program has a set of required roles, that have to be included in order to implement the model. Again, this is to ensure that we're not just doing a home visit with a family, but we're providing comprehensive connection to resources. So right now, these roles are all filled by funding and staff from the maternal and child health program, including myself, as well as some funding that we're getting from the Colorado Department of Early Childhood that's flowing through a subcontract from the Public Health Institute of Denver Health. We have another grant from Colorado Access that's helping us launch the program.

So none of it is general funds at this point in time. It's all grant funded from existing programs that we already had at the health department or new funding we've received to help launch the program. That said, we are looking for more money to expand, and we'll talk a little bit about that at the end. So what happens during the home visit? Family Connects uses what they call a matrix model.

This is an evidence based tool that addresses really critical areas for the family that includes assessment for the person who has given birth, a full infant physical assessment, lactation support. We talk to them about their health insurance and ensure that both the birthing person and the new baby have all their follow-up doctor's appointments scheduled. We provide education on per on crying, managing crying, providing comfort to infants, bonding, assessing household safety, including assessing for lead based paint, ensuring the family, if they have a firearm, that the firearm is kept locked and not loaded. Talk to them about maybe their own parenting history and if that was difficult and what fears they have about parenting and how we can support them. And then any assessing, like, what's their support system like?

And do they have people that they can rely on? And if not, what resources are available to help build that network? As well as a postpartum depression screening and asking about substance use and screening for domestic violence. There's a couple standard evidence based screening tools that we use, but most of it is a conversation style model that's really driven by the priorities of the family. So what's important to them, and what do they wanna talk about?

I think I forgot to say this earlier. The model is really designed to only be one visit. So it's one visit, about ninety minutes where you're assessing all of these things, having conversations, and then the follow-up really happens by the nurse and then the program support specialist role to ensure the family is able to get connected to important resources. We don't wanna become, as Family Connects, like their care provider. The goal is to say, here's all these important resources that exist in our community, both in the medical care, in social services, in community based organizations.

And how are we making sure that families are connected to those existing partners and resources and other home visitation programs? That's where this element of community alignment comes in. So this is another piece of the Family Connects model. We are required to have a community advisory board that meets at least quarterly. We're getting started on launching that.

That is a mix of folks who are, in roles where they're serving this the birthing community and then also people with lived experience. We have a tool that's called Family Connects calls it an agency finder. So this is a system that we're required to keep updated on a regular basis to assess find and assess resources in our community that meet the needs of the clients that we're hearing about when we go out on home visits, engaging with our community partners, a weekly case conference to say, you know, here's what's going on with my clients, and they're able to connect to resources or they're not. And when we identify a gap and a theme, how do we fill that resource need? Every family has at least one post visit connection call where we're asking, were you able to get to con connected to the resources?

Why or why not? How do we continue to follow-up with you until you can get what you need? And also do a satisfaction survey so that we're getting pretty close to real time feedback on was that visit valuable, why or why not, and what can we do to improve. And then Family Connects requires just a constant review of our data. Are we and there's a bunch of key performance indicators and metrics that they're asking us to follow that I think are in the slides, where we're always trying to reach certain goals of ensuring that we're connecting families to resources.

Yep. Here it is. So the the model has three primary key performance indicators. So we must when once we determine our eligible population, which I'll talk about in just a minute, at least 60% of people in our eligible population will receive a home visit. That's one of our metrics.

Another one is that 70% of the visits are done between 14 and thirty four days of life for the infant. So it's really happening at that critical time. And then the third one is that at least fifty percent of our referrals that are identified as a a resource is needed are result in a connection. So the matrix that I showed you earlier has a scoring system. And if that score in the matrix is a three or above, that means, yes, the family wants a resource to address that need, and at least 50% of those have to result in a connection.

And these are the things that we're required to do to be part of the program. I'm gonna skip over this one on program evidence because I've talked a little bit about it, but it is in your slide deck. So in Colorado, I mentioned we're part of a group of local public health agencies rolling out this program. The way that it works is that I said Family Connect is a national model. It's run out of North Carolina, but it's all over The United States.

In Colorado, Family Connects has a state intermediary. So, like, if folks on the call are familiar with nurse family partnership, for example, they have a state intermediary invest in kids that helps provide technical assistance and support and even some funding to their local program. That's how Family Connects. And I'm sure there's many other examples that folks have on the call, but that's how Family Connects is rolling out here. Four local public health agencies have already been implementing the program, most of them for a year, somewhere between one and three years.

Some of those are our neighbors, so Jefferson County and Denver County. And then this year, we're part of a cohort of expanding sites building on the original model. The way that we're able to be part of these expansion sites is based on the hospitals who have elected to participate in Family Connects. So a critical piece of the model is that families are consented to participate when they are on the postpartum unit at a hospital, typically. That's the most kind of the gold standard, they say, for Family Connects recruitment, although there's some other options there.

So for us, the so in Colorado, this list of hospitals are the ones who have said, yes. We definitely wanna participate and refer our clients into the Family Connects program. Of these hospitals, the one that really has a reach and a lot of residents from Arapahoe County is Denver Health. So for our initial pilot year that we're getting ready to launch, our catchment area or our eligible population, as I mentioned before, will be folks who live in Arapahoe County and give birth at Denver Health. That's about 850 families a year.

That was a lot more than I expected. I was pretty surprised by that number, but it is quite a significant population. And based on the metrics from Family Connects, we anticipate that will be our goal is to do about 500 home visits with that group in the next year. So the really, the only exclusion criteria is if they're already a participant in nurse family partnership and they have a relationship with that nurse. So that's kind of what we're looking at for this first year.

We are hopeful that we will get to expand the eligible population and who we can take referrals from in the coming year. We've talked a little bit about our funding sources, MCH title five block grant, a subcontract from the Colorado Department of of early childhood from the governor's budget. That's kind of where that list of hospitals came from. We are initiating a subcontract through Illuminate from federal office of minority health funds, and then the Colorado Access Community Giving Grant. We're also working some of the current sites just started billing Medicaid for clients who are enrolled in Medicaid for some of the services that they provide during Family Connects, including substance use screening, postpartum depression screening, tobacco cessation counseling, things like that.

So we'll be hopefully applying to get Medicaid reimbursement as well. Just where are we at in this process? We're in the summer, so we're working on our deliverables, continuing to seek funding. All of our staff is really going through training. We're putting together our workflow of what is this really gonna look like.

We've been meeting with existing sites, and we're hoping to do our first home visit in September. So what can you potentially do to help as board of health members? The first is if you hear of funding opportunities that might be a good fit for this work, please let us know. I think you can all understand when we decided to really commit to training and launching this program, it was about a year, year and a half ago, and the funding landscape has changed significantly since then. So, it is even more challenging to find money for, but I think there's a lot of positives in the program, and the universal reach could be a good fit for some funding opportunities as well.

If you have a connection to a hospital OB department, especially, we've heard or postpartum unit, that's sort of the best place to start conversations with hospitals. We have talked with a couple hospitals already. I think the challenge there has been we don't have enough funding to extend our nursing capacity quite yet. So that would have to be a conversation with that hospital around. Do they wanna contribute funding, or how would that work?

Training opportunities for our home visitors. So for example, myself and our my fellow nurse, Kenna, are gonna go shadow with Stride Health Center a couple times to learn how they do infant assessments and postpartum assessments so that we're really prepared to go into the home. So if you have training opportunities that you think could be a good fit for us, please let us know. And then continuing to help us build our agency finder or provider directory with community based resources. So we're always looking for programs and resources to support families, especially in this really critical period.

And another thing about Family Connects is we do provide resources for other folks in the home. So if there are other children in the home who need a resource or another adult, we can help make some referrals in that space as well. So it's not just, like, the the first few months of life, but that is the focus. And I see there's a question. I'm gonna go ahead and stop sharing, and I would love to hear a question.

Mark? Yes. Hi. Thank you. It's a terrific program, and it has a lot of potential to really help a lot of people as well as fit with our priorities as Department of Health.

Your search for funding, as well as identifying hospitals that want to contribute, particularly those with OBGYN departments, is an opportunity, particularly if we can attach to hospital community benefit. Each hospital is required actually to hold a community meeting in which people from the community including the health department have the opportunity to explain why they might be able to spend their money on programs that are of import to us. And I don't know if in the past we have been aggressive at approaching that kind of community benefit, but if you have a particular hospital to target, we might want to consider sending a team of people to their community benefit thing and ask them for specific support for a particular program such as this very worthwhile one. So it's just just a thought of something that we might think about.

I wanna say that Arapahoe Public Health was very well represented at the Littleton Hospital at I think we were 90% of the room, to be honest. No. Were we were heavily represented. I do have a comment. Doctor's care would love these babies and love these children, especially if they are uninsured or if they're Medicaid or a product that we take. If the team wants to shadow our pediatric providers to see how we engage newborns, it's a real favorite activity for

Mhmm.

I know for my team at that's really their favorite thing that they do. Today, I had a group of volunteers that made new baby, new mom, incredible big packages of, like, everything you can imagine. So we're really excited. So this is definitely a child. We're not obviously, we don't want family young families to have to drive an hour to get services. But if if you can identify those that could get to us or if

we could help them get

to us with bus passes and we do some Uber rides and stuff. So I just wanna put a plug in for that. But if you, Rebecca, your team want to come and chat or just follow-up with me.

Absolutely. We do.

Adults wasn't the target puppy. How come they're not the favorite? Why is it babies?

It's it's I'll tell you. Right now, we have tons of capacity for children. There's just so much capacity, and yet there we'll we'll take older adults, but they're not there seems to be plenty of complex older people who need care and not enough babies and young families stepping up because of fear and other things that are happening. But I I can't

I'm joking.

Know. I we'll take the older people too, but they want the babies. Trust me. I hear about it all the time. They want the babies.

Thanks, Phoebe. I'll definitely follow-up with you if that's okay. We did have Denver Health map for us where, like, where in the county are family do families live, who would be referred to us.

And I would say

it was pretty even. Like, half of them were from the more eastern side of the county around Aurora. Well, that's not really the Eastern side, but you know what I mean. And then about half were in the Tri Cities area, which I think could be a really good fit for doctor's care. So thanks for the opportunity.

I had a question about our can we Okay. Can we oh, sorry. Can I

No? Yeah. Go ahead. Yeah.

I was just

Heather had her name, but you can go first.

Oh, did I cut in front

of you, Heather?

No. Go ahead. Go ahead, Christine.

The I'm curious about, like, what our vital records office says about where babies are born in Arapahoe County. Is there a way that we can get that information and start taking that to hospital like, how can it can can you give the Board of Health that information and we can start looking at our our resource lists?

That's a great question. We got that from c d from the State Department Vital Records Office, and it was they were like, this is confidential data. You can't share it. So I think I'm looking at Wendy. We would probably need to go back to them and make that request. And, like, if it was a closed meeting, could we share that? As you can imagine, the hospitals are sensitive about the data. One of I will say, it won't be a surprise, I don't think, to folks on this call. One of the top hospitals in the top five is Anschutz, and we have met with their community develop their community benefit team and then also their OBGYN. And it was sort of like a, we'll ask them, we'll ask them, which was a great start.

I think they were really bought in and agree that it's a good initiative and want us to be able to bring a little bit more resource to the table, and we just weren't quite ready to do that yet. But it's not. I think they were very open to the conversation, and it will continue continue moving forward. I don't know. Wendy and Michelle, would you add anything to that?

Okay. Well, this is a great program. I'm excited to be able to support it in any way I can.

Yeah. And I would say related to that, Rebecca, if you have specific data about African American parents, I sit on children's African American subcommittee for children's hospital, so I can present it to our subcommittee if you have specific data for African Americans.

Thanks. I don't offhand, but we, I think, can make that request. I do know that maternal and infant health is a priority in the children's hospital community benefit plan for the next year. So that would be a great connection to make as well. Thanks for offering that. And, Heather, do you wanna?

Yeah. I wanted to thank Doctor. Levine for your comment and share that we are part of a collaborative of those community benefit leads from the area hospitals as well as other nearby LPHAs and get together regularly. We started with a crosswalk maybe about six months ago to see where do we have aligned priorities between community benefits plans and CHIPS and, in some cases, HTP goals to help us identify where there might be some synergy in places where we could leverage funding. And the group decided some areas to start with.

Behavioral health was the one that they decided to have initial conversations around. So I will circle back. We have two reps on that, Laura Donner, Regional Health Connector, and Brooke Wiegenssela, our health planner. And I'll check to see if this is something that we can, you know, maybe put closer to the head of the list or just identify and do some targeted outreach. And it's possible that that has already been happening, and I'm just not aware.

I can also mention that I I think most everyone knows we've been working for about the past six months to really increase our we'll build on the great relationship and work that's already been happening with Colorado Access and add some new strategies. And this is one we have at the top of the list for commitment on both sides to see what we can do in in that realm to advance this work too. So I'll look into that, the partnership, and and circle back.

Thank you, Heather. I'm glad to hear that it's so well organized. It does make sense however to prioritize our asks so that we're not asking multiple things to different people, but really targeting where we're going. I also want to appreciate the fact that we're starting with Denver Health, which means that it's probably a more needy population than the population that would be in some of our other hospitals. And I think that's a very nice place for us to start and get our feet, know, steady steady on our feet before we consider expansion.

So that's very nice. I wanna thank the team. It's a great program. Yeah.

Phoebe? I wanna just comment. If you ask Sky Ridge, they'll tell you they birth more babies in this part of of the side of town, but it's mostly the Kaiser babies. They have the Kaiser contract. Now that's changing. I have a good contact at Parker Hospital. I know it's physically located in Douglas County, but it really does serve that whole side. So if you're interested in that, follow-up with me on that contact and see. They do birth a lot of babies at Parker.

So And just to just to add on to that, I used to work at Sky Ridge in administration, so I have tons of contacts in OB, in women's, and all that. Again, it's Douglas County, but happy to help how I can.

Thank you, Terrence. Wendy?

I just had a couple of thoughts to share. One is that we are excited about Denver Health and, wanna recognize what Brianna shared about Medicaid uncertainties, but we did get information from Denver Health that it's almost almost every person that births there is covered by Medicaid. So our potential for Medicaid reimbursement because we're starting with Denver Health is high, so we're encouraged by that. And there's a new lactation benefit that rolled out, and our staff is gonna be certified as lactation consultant. So we're hopeful that that might even be another opportunity to bill Medicaid that current Family Connect sites haven't gotten around to doing yet.

And then it would I would be remiss if I didn't just point out that this team, is Michelle, Rebecca, Mikayla, we are the only Family Connect site that got our way into that r o six funding through the governor's budget without I mean, we just were persistent. There's not another county that got added, and somehow we, like, wiggled our way in because it's been on Rebecca and Michelle's radar for, you know, going on a year and a half and it's been really impressive. Grand Junction, Mesa County was added because of their legislator. And we were added because of just sheer will and grit of the team. So just so proud of them.

Go team.

Congratulations. Yes. Congratulations, team. Do you still have your hand up, Wendy? Oh, okay. And I apologize. I don't wanna say thank you for the presentation. We're gonna skip the third and fourth study session and move those to the next to the next monthly meeting for the study session. So Jennifer the fifth study session, Jennifer is gonna give her update, and we're gonna hear the director's report, and then we have to go into executive session. So that's part of the reason for the changes.

So, Jennifer, you wanna do your director's report? And I wanna say once again, thank you to Rebecca and Wendy and the team for presentation. That's a wonderful program, and we look forward to supporting it and helping any way the board can. So thank you for that.

Yeah. Thank you. We are really, really excited about Family Connects and have been for a long time. And as Rebecca was saying, you know, the the funding landscape looked a lot different when we were pulling this together and thinking through launching the program, but we were committed. I and we will do everything that we can to find the funding to keep it going because I I really believe this is true prevention at work, and we're all very excited about the program.

So I just wanna give a a huge shout out. So one of the reasons why we are moving the measles update, even though I all of my emails said we would give an update in June, The team is extremely buried with an investigation of another probable case and just overwhelmed, which isn't also why you don't have a communicable communicable disease report in the report. Part of that is all that they're doing pretty much is measles, and the state picks up the overage when we are in kind of a surge capacity. But we have a couple of options and would like to ask the board your preference. We do want to give an update on measles, and we could call a special meeting of the board in July, and that would just be the topic.

Since we recess in July, we don't have a meeting scheduled, but we could hold a special session just for that. Or we could use your time in August, the two to three informal study session time, to focus on measles. That meeting, you also have to do my midyear review. So we could do both from two to three, or we could do my review at the end of the business meeting. So is is there a preference of what you would prefer?

What are the chances everything's gonna slow down by July? Will they still be inundated and

come that that time frame?

It could

be guess, I mean,

it's probably

it's probably possible for you to know. I guess my point is maybe August will give us them more time to

Can we change?

Let things kinda settle down.

Yeah. Thank you for that. And, absolutely, it could, you know, kick up again, but each, you know, each single case is a significant amount of work. And I knew we needed to go into executive sessions, so I was also buying some time. So and August, I and it is hard to know. I mean, I'll I'll knock on every laminate wood that I have in my office to say that it's gonna be quiet by August.

Do we need to skip July? I myself am gonna be in town. And if our agenda is so full, should we reconsider that gap?

Which I'm I'm not I'm traveling on that day, so I won't have access to

I don't to

computers. Yeah. We don't have one even scheduled in July. It would have to be a new special session that we would have to we'd probably do a doodle to find out what when we can get the majority.

Yeah. I think unless, Jennifer, you have a compelling reason for us to to spend time today or in July, I think let's let your folks do their jobs and and then you guys can get with us. You can also get with us if you need to at any time. Like like I said, if you need us to do something, then then we're ready. I'm ready. I shouldn't speak for the others, but I bet they are too because I know them. Yeah. But, otherwise, I feel like we should just let you guys roll.

Thank you.

Okay. That's what I was thinking.

We'll roll, and the staff will appreciate that. They always appreciate your support. And we'll just plan to use this informal study session time in August. If things get worse and we need to pull you together for policy decision, I will we will do that. But at this point, we we've got it. It's just they're whole team is busy. So it's the communicable disease team. The emergency preparedness and response team has been coordinating and leading the meetings. They have been a lifesaver. Nursing have done a ton.

They've taken they've done surge, they've been going out and getting samples for testing, they've been going and doing home visits for immunization. So everybody has really kicked in and it's really been phenomenal. So I just wanna, even though none of them are are on today, don't think I want to shout out to all of the teams who've been working on the measles response. And then Penny is on vacation, so she can't give an update on the move, but I do wanna give a shout out to Penny and Camille, who Camille has been our project manager for the move, and just amazing. I cannot we would not have been able to get in and do what we did without her.

And the facility staff could not say enough about Camille and how amazing she was to work with and her organization. True she is truly a project manager. And we we got in. It was great. So I just wanna give them kudos and recognize them. And my light just went out. Hold

on. I

need the treadmill light, Christine, so that my light doesn't go out. Just a couple of quick things, and then we can move into executive session. Mission moments, always love to share. We broke them out this time in, like, delivery service and then some innovation. One of our guiding principles and values is innovation and not fearing trying things.

And so we really embrace failing and because it means we've we've tried something, and we've learned from it, and we do something more. So I wanted to pull out something of of an innovation. But first, with our exceptional service, Harm reduction, you know, we have a lot of people who come in and visit and are in need of things that might be toiletries, they might need food, they might need mittens, a hat, shoes. And we don't have a supply of those items, and sometimes our staff were giving their own shoes to clients who may have needed them. So we took up or started what we're calling Kids Closet, and we started with just internal staff donating to Kids Closet to fill it up with clothes, ready to eat food, things that, you know, don't have to be prepared that can be eaten on the street.

We needed women's clothes, men's clothes, toiletries, hats, socks, all kinds of things. Really started harm reduction, kicked it off, and we're naming it Kit's Closet in honor of Kit Matzke, who's one of our harm reduction health educators. And she's leaving us because she's going to medical school. So we're really, really excited for And in honor of her and her caring heart and her kindness and her generosity. We've named it kids closet. So it's up and running, and we just kicked it off earlier this month or last month, but excited about that.

And then Jennifer, how do

we contribute to it? When I read your report, we went through our house and have begun to accumulate a few things. Do we just drop them off at the health department? Or

Absolutely. Melissa, do you wanna

Yeah. Actually, Mark, I love that. I was gonna say, anyone can contribute. I just sent a box this morning. So the kids closet is at our our our Altura Building, but you can really drop off anything, any any of our buildings, and we'll get it there for you. So Okay. Thank you in advance. That's awesome.

And something for Tara.

I'm so Jennifer, I'm sorry to interrupt. I just wanna say, when you guys have an emergent need, especially for kids stuff or food or formula or diapers and you don't have them, you've gotta let me know because we have 20 resource pantries.

Oh, that's great. We'll just pull stuff.

Like, if you've got a family that is like you said, because that happens to us too. They'll show up to school for the first day of school from as an immigrant family with with no shoes, no coats, no nothing, and we just we just work to outfit them, and we also do school supplies. So just let please, please, please let us know. And and soon, we're gonna have hopefully, soon, we're gonna have that really nice resource center on the Overland campus next to our Stride clinic, and that'll be a centralized place too where we could distribute.

Wonderful. Thank you. Mark?

What a wonderful program. Actually, the answer just came up. So new and used are being accepted with a focus on adults. So thank you so much. Excellent work. Excellent program.

Thank you. Yeah. We were we're excited about it. And then the next one, just a shout out to our Altura WIC program. One of our RD supervisors emailed out to all of the WIC team at Altura that they had been receiving compliments from out of state transfers that they felt so much more supported at their Colorado WIC clinic by coming to us than they had in their previous clinic.

So a lot of those who are coming out of state have found us, and they have just embraced our our culture and and how we we treat our WIC clients and really see them as a person. So that felt good to get a lot of kudos from our clients directly. And then the innovation that I wanna share, our consumer protection field staff, that those are the team that go out, inspect restaurants, childcare, daycare, water. They worked with our data team to build out maps to help, like, their interactive maps to help assign areas, whether it's assigning a regular routine schedule or complaints. As you know, we get lots of complaints, whether it might be a housing complaint or a restaurant complaint, and we look into every single complaint.

So these interactive maps had to be built from scratch, and it is making our work more efficient, more effective, more responsive, and more immediate. So it took quite a bit of work to, you know, get it to where it was, but James Swank is phenomenal and builds some incredible mapping tools. He's done some for nursing, and now he's done it with a consumer protection program. So we're really excited to get that up and running. And it's still in production a little bit, but we thought once it's fully launched and they've worked out all the bugs, that maybe we'll do a quick demo for anybody who wants to see or for board of health because we're proud of the mapping work that our team does.

And the collaboration with our data team, which is under Heather's division, working across the board with all divisions, really, is phenomenal. So wanted to point that out. And then the last thing I wanna point out, because it's it's along the lines of technology and really embracing new tools that we have is our community pulse survey. So you might remember that we do employee pulse surveys quarterly, and we started that when we opened the health department in '23. So we have now two years worth of pulse survey data on our employees.

And some of that data I use in my performance evaluation because I think it matters how employees feel about leadership, that we are living our values, that we are true to our core, and that they're engaged. And now we're going to start doing that with our customers. So we built up a small customer base, but we use Qualtrics, and we purchased the platform when we opened. And there's so much more that Qualtrics can do with on the customer side that we just not have engaged with. So we're starting these, like, one question poll surveys to get a sense about, you know, how do our our how does our community feel about food?

And, you know, we use the word food security because it's so public health. But, you know, what about can you afford food? Can you get food on your table? What do you think about food? Just simple language to learn, and we're doing web I've got the not web browsing. There's a certain term. I can't think of it right now. But just tracking Media monitoring? What are the what is it? Media monitoring?

No. It's a different it's different than that. It sounds really, like, under the radar. It I'll come up with it. But it's just to track, like, what are how are what words are the community using that aren't so public healthy that so that we can connect better with our community and be a lot more responsive.

So we're kicking that off soon. And as we learn from that, we'll we'll be sharing with you all what we're learning, how it's going. But it's just a a way to engage, to use the technology, and to get some kind of, like, instant feedback and results and information from our community in either way that we we don't in our clinics or at community events. So we're trying it. We'll see how it how it plays out.

And unless there are any other questions, I'm gonna stop with a shout or not a shout out, but a recognition of one of our nurse supervisors, Renee Lenthy, in our sexual health program. So Renee was instrumental in going out and helping with the field delivery treatment for syphilis. She has been instrumental in building up the sexual health program. Phenomenal nurse supervisor. She was nominated and selected as Denver Regional Nightingale Award nominee.

She didn't win, but she was a finalist in the Excellence in Nursing Award for Community Health Nursing. And there's a picture of her in the report. So just wanted to recognize one of our nurses. Yeah.

Yes. Good. Great job. So

I'll stop there.

Does she also Jennifer, she also spearheaded the effort at street fraternity to partner harm reduction with sexual health. So great job. Mark, you have a I'm sorry.

Jennifer, please go ahead and finish your thoughts there.

Yeah. I'm done. I'm done.

Speaking of shout outs that I've indicated earlier in the today's meeting, was really very appreciative of Dylan Dylan Garrison as it related to the legislative session. I think his expertise was really critical around things like the food bill, the fee food restaurant fees, basically. And and also, I think he was involved in some of the cottage food act activities as well. So I didn't see his his presentations directly, but really great things. And and having experts like like Dylan to be able to tell our story is really critical. So thank you to Dylan for his important work in those spaces this last session.

Good job, Dylan. So thank you for your update, Jennifer. Y'all have a lot going on. Congratulations to you and the team. We had to move into executive session, and so I moved at the Board of Health go into session executive section pursuant to section 24 dash six dash four zero two subsection four b of the Colorado revised statute to discuss personnel matters related to grant funding.

Can I get a can I get a second? Second. Seconded by Bibi and Mark. So motion made by myself and seconded by Bibi Kleinman. All in favor, say aye. Aye. Any opposed? No hearing none. So motion passed. So we're now in executive session.

Right. Thank you. We're gonna ask

all staff except

for