Board of Health - Regular Meeting

Okay, all set. We're ready to go. Yeah, see me now. You were there for a moment and then you disappeared again. They were streaming now. Just is the weirdest thing. You were there. I saw you very clearly and then it went black. Yeah, I I still see her though. I I I I see again. Well, actually, there's two of them. Yes, there are two. So, it sounds like we're having just a moment of technical difficulty.

But, uh I'm sorry if you're seeing me twice. Glad you can see me at all, but I think we'll get started. And um I'm going to I have my phone on so you can see my face, but my computer on I don't know what's happening. and I had a call this morning and it was fine. So, um, okay. So, we have some followup from our December 3rd meeting. So, uh, I have the minutes for approval. Can I have a motion? So, move. Have a second. Second. Second. Thank you. Uh, any discussion or edits? All in favor? I I

I. All right. Very good. Um, so we do have some followup for the December 3rd meeting. um the timeline for the opening for the um EDHC um and also a steps of the CHIP process and participation. And I'm going to guess that Christina, you're going to follow up on that for us.

Yes, I will. Um so, in our last meeting, uh Pam Howard, the administrator for the Office of Mental Health, um joined us to provide an overview of mental health and uh mental health services and work in Montgomery County. She provided an update on the um development of an emergency behavioral health center um that will be located in King of Prussia. I believe uh there was a question about the timeline for opening the EBHC as a as a request for followup. Um I I did not hear back uh just yet from uh Pam Howard about that. U but I believe um Dr. McCarnen that it's uh this calendar year or is it in the summer of 2027? It the goal is by the end of this calendar year.

Thank you. We're hoping I think my in my head we are looking at a November start but that could be uh you know it's subject to change. They are currently under construction.

Thank you. And with regard to the status of the CHIP process and participation, there was a there were some suggestions and recommendations to engage health systems sooner rather than later in the um community health improvement planning process. Um, some of you um have probably uh noticed that I've uh we've done some additional outreach to our health systems. We've heard back from some of them um not all. We're continuing to work to um to engage our health systems in the the planning process, the community health improvement planning process because uh most of our health systems themselves have a community health improvement plan. So to the extent that we can coordinate with them um you know there's a a benefit for all of our residents. Um so we have engaged some in uh workg groups to help us define uh we're calling them think tanks uh define the goals uh for our community health improvement plan. The next step in the process which I anticipate will begin this fall will be action groups and we'll continue to do outreach to engage uh particularly the community health programs and the population health programs um in those in those processes as we um clarify what our goals will be for the the community health improvement plan. Are there any questions about either of those?

Just one question regarding the behavioral health center which is fantastic obviously. Is there um a connection or an integration with what I've learned are now the transitions programs which basically keep people for I guess two days two nights to maybe 10 to 12 nights shortterm while they're waiting for placement. Would you like I could answer. So, um, thank you. The the intent sort of I think that if I'm clear, the transition centers, I'm not sure. Are you talking about the the the shelter programs that were opening that have been? No, I just was learning from other counties in the state that they have these transition programs where people can go and maybe they are smaller residential programs, but they can in a sense be inatient before they get placed inatient because this behavioral health center as I understand it is much more it's there's plenty of need much more outpatient. Correct.

Correct. Right. So the majority of this is it's as it says it's an emergency behavioral health walk-in center. So the intention is to stabilize people and connect them with the next level of care. So some of that could look like residential services, it could look like outpatient, it could look uh it depends on the the need and presenting issue. Um so the it is not necessarily the same. I know that other counties have stood up uh other diversionary programs in Bucks County specifically last week. Uh but I it is intended to connect people to services to reduce their likelihood of ending up in the emergency room or um or worse. So uh that is it is intended to connect to all systems depending on the presenting need.

Okay. Thank you. Yep.

Any other any other questions out there? Okay. Uh this is the section of the agenda. If it's okay, I can move on to the health administrator report. Um, so during the administrator section of the administrator report section of the meeting, I typically share updates on key personnel changes, particularly those that affect our operations and significant new or renewed contracts and updates on public health funding. So, that's what we'll cover this morning. In terms of key personnel, uh the last time we got together, I believe I reported that we had a vacancy in our director for health equity and epidemiology uh role, that position was vacated in October of 2025. We're very excited to share that we have extended an offer to a candidate and the uh approval for that candidate is pending salary board approval tomorrow morning. So, we expect that by the next uh by the next board of health meeting, we'll be able to introduce you to our new director for health equity and epidemiology, and that that will be starting um by the end of this month. Next, our quality manager. This role was added to our staffing compliment through the public health infrastructure grant and it was filled in 2025. Um this position, however, was vacated in January. Um and we posted the position and expect to fill it by the end of April. The position is primarily responsible for shephering our accreditation process. So the person that held this role made tremendous progress in uh creating the structure and assessing gaps. Uh but the work is paused until the position is filled. We anticipate a bit of a delay in assembling and submitting our application for accreditation this year, but we nevertheless expect to submit the application this calendar year. In terms of contracts, um, OP, the office of public health has extended its contract with summit exercises and training, uh, to support emergency

preparedness and planning. In particular, uh, we are working to solidify roles of health and human services team and in an emergency response and the recovery from um, an emergency. In addition, and you'll hear a little bit more about this later, our environmental health and water quality management teams um have been working towards development of a new data platform or uh procurement of a new data platform uh to house information about things like inspections and the work that uh those teams do. We're expecting approval of that um that that platform provider supporting those two divisions at our commissioner's meeting tomorrow morning with implementation of that uh new platform occurring over the coming year and hopefully completed by this fall. In terms of funding, I want to share a little bit about what we have um what we anticipate as level funding for multiple program areas. Uh over the past year, we've been particularly concerned about um public health funding uh and declines or decreases in public health funding. We've already um heard from some of our points of contact um at state and federal levels that anticipated funding levels for the coming year are will be level. Um however, we have experienced a reduction already in funding for immunizations. Areas that we anticipate will remain level in terms of funding include things like emergency preparedness, healthcare associated infection, disease surveillance, and overdose prevention. So, it's a little bit of a a a mixed picture right now. Uh decreased funding for immunizations already um communicated. Meanwhile, we're um anticipating level funding for some of our other program areas.

What does that actually mean? Like I I get it's a decrease in funding. So, how does that impact the operations of and our ability to administer vaccines?

Absolutely. That's an excellent question. Uh, since the beginning of 2025, we've been taking a very close look at our at our uh fiscal picture and our finances for public health funding. We are very fortunate to have um what we call public health infrastructure funding available to us. uh it's called the public health infrastructure grant and that is specifically geared towards the recruitment, retention and professional uh growth and advancement of public health workforce. Uh so we've been doing quite a bit of planning around um ensuring that we can effectively retain uh our staff uh through uh through other funding streams that being one of them. So right now uh we don't uh we we aren't feeling a staffing impact but we are because we have been doing this planning on the back end to ensure that we can maintain um maintain our services and maintain our staffing levels.

Great. That's very good to hear. Thank you.

A point that is consistently front of mind for us though is is uh what happens at the end of that public health infrastructure grant um in November of 2027. So this, like I said, this grant was awarded to support recruitment, retention, and professional advancement of the public health workforce. It has enabled us locally to add positions in our um communicable disease and environmental health teams that were really experiencing a heavy burden, a growing burden of um daily activities and operations uh without uh without, you know, ability to expand the workforce. So it that enabled us to expand uh the workforce there, create new roles like a data manager position that you'll hear a little bit about later, a quality manager. This is really enabling us also to invest in community health worker programs um that provide health education and connection to health care uh in the communities that we serve. So this is this has been a really important grant uh and funding source for us. And what you'll hear about also as we talk a little bit about the priorities for the year ahead is is continuing to uh diversify our our our uh the funding that supports public health work um going forward into the coming year.

That's great. Any other questions? Okay. Does that con conclude your report, Christina? It does. Okay. All right. So, we'll turn it over to Dr. Patricia Mccernin.

Good morning. Um, I I apologize. I was just here to say hello and welcome. Uh, I am newly to uh newly uh on the job here. I started as the director for health and human services in December. I'm very excited to work along with Christina and her staff uh in the public health space. Um so I my background I've last 30 years have been working with nonprofits specifically uh work assisting people coming home from prison running shelters senior housing uh and most recently spending the last six years working with substance use disorder treatment um all providers being multi-state. So, this has been an exciting uh opportunity here in Montgomery County to uh uh to see all of those place all of those um all of that work experience intersect just like health and human services does. So, uh very excited to be here. Thank you for inviting me to the meeting this morning. Um Christina and I have just as an aside we are taking a um look a look at all things under HHS uh specifically as it relates to u um to public health. I have Christine and I have been looking at utilization data. Um certainly I don't know Christina if you've already communicated some of the uh um changes uh related to space and um where we're going to be allocated. If uh Willow Grove is is under construction, I'm sure you've already or is about to be under construction. You may have already discussed that. Um Health and Human Services has multiple locations. Uh Narstown, we have uh Pottstown, Lansdale, and uh Willow Grove. Willow Grove was a location where public health had um a significant footprint and uh that space is being renovated. So we have some transitional uh plans that we need to work out and uh not only for public health um but the uh and and with that looking at the utilization in all

sites um for both uh for public health and and the other um other offices that are represented there. Uh I have Christine and I got a chance to talk more in depth about the community health assessment. Very excited to lean into the work that's been done so far. Um and um I I I will own that I love disruptive questions. So I am going to be asking some of those of all of you in public health related to that um as we you know co-create the um community health improvement plan. Um we will be spending a fair amount of time on that with our next cabinet meeting within health and human services in March. Um, so, um, I'm just here to to say thank you for your, uh, service on the board of health and, uh, for all of the staff that here are here also on the call. Um, thank you for all that you do. Um, but yeah, thank you, Christina, for the space to just say good morning.

Welcome. We're very excited to have you here. Yes, welcome. Very nice to meet you. Thank you. Thank you.

Okay, so I'm going to move on to the 2025 review and accomplishments. We're actually going to um ask you to look at the program summary and the key open activities. So, we are not going to cover that um as part of the agenda. And so, we'll move into the office of public health priorities um for 2026. Thank you. So our first meeting of the year provides an opportunity for us to communicate the status of the overarching and team specific priorities from the previous year and also to talk a little bit about the specific priorities uh for office of public health and for each of the teams uh for the coming year. As Barbara mentioned, you'll see a summary of uh key points about our work over the past year in the board summary, the program summary. This is where we provide quarterly updates about day-to-day operations. This quarter's report covers the full year of 2025 compared with the same operations data for 2024. So here you'll see for example um numbers of inspections, response to disease reports, community education. I really encourage you to read through this. It it captures um a lot of that day-to-day work uh that this team does. Um for example, you know, our team conducted more than 7,500 inspections of food service facilities, pools, schools, and campgrounds. initiated more than 12,000 inspections, I'm sorry, investigations uh resulting from reports of communicable disease, trained more than 500 people to conduct CPR, AED, and administer the lock zone life-saving skills. Um engaged more than 1700 people and 300 dogs in the 10th annual Montgomery County Trail Challenge. Um we administered more than 5,000 vaccinations, conducted 600 um uh on lot sewage inspections. this team does a lot in a year. Um, and I have just, you know, as a point of recognition, I as both a colleague and a resident of this county, I'm I'm

grateful and I'm proud every single day that I have the honor to work alongside this uh this team. They are incredibly skilled, compassionate, and endlessly dedicated to uh to public health. Um, and so, you know, please take a look through that report. It does capture a lot of what this team does on a day-to-day basis. and we'll use our time instead today to talk about um some of the key priorities that you won't necessarily see covered um in that summary of operations. These are the priorities focused on uh growing and strengthening our work and our infrastructure, our staff and our systems development connection with communities um and and what we are uh some of the work that we're doing um uh looking forward.

Barbara, I just have one question or comment. I agree. It's amazing how much was done by you, the team, and and and others. Um I, you know, I I did and I saw something I don't think I've seen before, and I have other questions, but I will not do it now. The whole wellness initiative with the with employees. I I don't recall that. Is that a new new exercise this year? When you say the wellness initiative came,

it says there's a staff there there was a staff wellness survey completed 550 staff members um you know 349 participated. I agree the engagement rate which is key on that. I guess where where I was going because I'm I'm involved in something in the same space. I I think this is a phenomenal great initiative for the employees and it sort of inspires them you know and all the work that they're doing. I'm just curious as to are we engaging say our health insurance u uh provider uh because I think there's opportunities to to basically think down the line about restructuring even the plan just something to think about for the future because I I didn't see this one I this we haven't done this before have we

so this is actually work that's being done with Pottstown school district oh I thought it was I thought this was it's it implied it was the county employees too no so it's not okay yep Uh, so this this falls under our school health and well school. Fair enough. This is only Pottstown school. Okay, got it. Yep, you got it. Thank you for that clarification. I thought it was our employees, which I thought would be a great idea, too.

Absolutely. And and you may recall, so uh in uh 2024, I had to take a moment to to think back uh with what year it was, but in 2024, we uh we did do a a staff um it was a it was a workforce development survey and it c it covered a variety of topics ranging from um public health competencies to um to wellness. And uh it was really designed to help us design and develop uh staff engagement and staff uh professional growth and development plan uh to really help us set out priorities for building our our human infrastructure. So it might be worthwhile for us to come back to that um at some point. We're going to talk a little bit about some of the priorities that we've covered the past year.

Good. I didn't realize it was Pottstown, but that's a fantastic initiative with Pottstown as well. So to me, broadcasting that to other school districts is would be a plus as well. And maybe that's part of the plan. Sorry. Okay, I'll stop and listen.

I appreciate that. Thank you. I'm just making a quick note. All right. So, um, see, uh, I want to talk a little bit about 2025 priorities. Uh, excuse me for just one second. I need to come back to actually the the webinar here. Great. Uh so over the um for the office of public health broadly speaking and and the way that we'll talk through um this section of the the the meeting, we'll talk through uh OPwide priorities uh for the previous year and then how those connect to our our our priorities for the coming year and then each of our teams will do the same. Uh so we'll start with OP broadly. uh three of our overarching uh priorities were around um community engagement uh staff development and um and and public health resources. So, you know, in 2025 um in that community engagement under that community engagement priority was really launching that community health improvement planning process and launching a campaign around uh public health at work in our community. What what public health does in our community. This is really about um helping to uh illuminate how public health shows up every day. Public health is often in the background. We often don't um see or really notice the work of public health until we um have an emergency of some kind or we have to really come face to face with um public health uh public health workers. Uh so we really wanted to be able to illuminate a little bit more clearly what public health does. So uh in 2025 uh we did initiate that planning process. We created a structure, a process, and a plan. Um, to date, we've actually engaged more than 30 organizations uh to participate in those think tank groups that I that I mentioned. Uh, those think tank groups are um helping us to define goals within the top three priorities that our residents identified uh through that through that community health uh survey. Uh those were mental health and

wellness, chronic disease uh prevention and management, and healthy and safe environments. So we have community- based organizations, partner organizations, and this is where some of our health systems come into play, helping us to really define what our goals uh should look like, what those what the specific areas of focus can be within each of those three broad priorities. In addition, uh we in uh initi started to revise and update our health alert and health advisory framework. So this is this is our response communication framework. uh when there's an emergency of some kind uh this is the structure by which we notify health systems um of of a public health emergency in particular. We also conducted seven community conversations and as I mentioned launched that public health at work in our community campaign primarily via social media. Uh next slide please. In terms of staff development uh we had three uh primary uh priorities or three main main priorities. one expanding our staff capacity uh developing and implementing a training plan and developing an internship program. We really focused on that staff capacity uh priority in 2025. We we were approved to add eight new positions uh to the office of public health. This was this has been a truly remarkable investment in our in our staff. Uh we were able to add two positions to our communicable disease team. As I mentioned, these are folks that are responding to um you know, more than 12,000 uh reports of communicable disease in a year. It is a relatively small team. So, adding capacity there is really really will make a difference in terms of um uh capacity and reducing the overwhelm and the burden on that team. Similarly, our environmental health team, these are inspectors that are out in the community every single day uh ensuring that um u food and beverage facilities are adhering to FDA guidelines for safe food. um we expanded

staff capacity there. That also enabled us to um move from three teams uh covering three regions of the county to four teams and breaking up the the county into four regions instead of three. This really shortens commute times, travel times and really helps to focus folks in in a particular region of the of the county. Um so we are for the first time uh at at in 2025 was the first time we were actually um at full capacity uh with that environmental health team. It was uh truly a change and we're we're very excited about uh the changes that we're seeing going forward. We also added a data manager and we established uh capacity uh established new positions in in quality and workforce development. As I mentioned, this quality manager is the person who's shephering that uh accreditation process and we'll be really be working with all of our teams uh to strengthen the quality quality improvement and quality assurance processes across office of public health. Our workforce development coordinator has been integral um and helping us to uh develop and soon launch uh a new onboarding program for office of public health staff. uh develop uh uh training plans and also begin that the development of that internship program. Next slide. Last is resource development. And I alluded to this a little bit uh during the health administrator report. Uh it is critical for us to really look at how we can expand um public health financial support. Um for us this really means uh in all likelihood insurance billing and I know you know this group here the board of health has really encouraged us to pursue this for quite some time. Um what we're looking at at this point is you know how our EMR uh supports and enables us to conduct billing. What capacity we either need to have on staff

or um contract with to conduct that billing and really do that assessment of of the work that we are doing. uh what is billable and what what processes and protocols do we need to put into place in order to achieve that. Uh so we have initiated the groundwork for insurance billing. Uh we've also started to engage some of our peers across the Commonwealth to understand their policies, their protocols and started to form a work group um so that we can grow and learn together. Are there any questions about some of the work that we've been doing for the past past year on these priorities? Okay. So, looking ahead, um you'll see our priorities for the coming year organized a little bit differently, and that's because HHS, the the Department of Health and Human Services here in Montgomery County, uh launched its uh strategic plan and strategic priorities, uh just last year. And so, we've reorganized our priorities to align with the three primary pillars, uh for the HHS strategic plan. So you'll see here those three pillars are uh centralized information, public relations and community engagement and systems transformation. And what you'll see here largely is um something of a continuation, right? Uh we haven't fully accomplished all of the uh the things that we had set out to do last year. These continue to be priorities for us. Um so you'll see here in terms of centralized information, dashboard development uh that will help to guide our operations and our decision- making. Um so dashboards that will capture some of our key performance metrics. Um and also um you know that third point there uh dashboards that can be public facing to increase access to public health information for our communities who are also doing public health work who are also doing health and human services work so that this can be a resource to them. We really started this with the launch of our uh community health assessment uh last year uh which makes a lot of public health information

available about Montgomery County in one consolidated place and we're really hoping to use that as a a plat a launchpad uh for more work that we can do to share uh information about um health and wellness in Montgomery County. In addition, uh we've uh developed some um uh internal work around facilitating secure um information sharing across HHS and with partner organizations. Um so our solicitor's office for example um has increased capacity. Uh thanks uh Benfield is here as well as uh Christina Tabelloo if they want to say anything more about this. But um we've really been able to work more closely with us our solicitor's office so that when we do have uh data sharing agreements um or work that we're doing in partnership with health systems, academic partners or other community- based organizations that we are uh able to draw upon our solicitor's office to create those uh agreements and arrangements around uh secure and um safe uh data sharing. I'll pause for a second in case Ben wants to say anything more about that.

Yeah. Hi, it's Ben Field and I'm here with Pat. Apologies for not being on camera. Um, but I just wanted to say thank you for the shout out and in this environment data sharing becomes increasingly fraught and so we've expanded our resources and appreciate the way you're working with um largely Kate Dudley on my team who's becoming a real subject matter expert in this area and look forward to continue working with you on it.

Likewise. Thank you. under that public health uh public relations and community engagement pillar. Uh you'll see here that we are moving towards operationalizing that uh health alert health advisory uh system. Um so that's a responsive public health communications framework. Uh what happens when there's an emergency? How are we getting information um out to health systems, out to community partners? Uh we've really started to build out that framework. uh Teresa Harris who is our public health communications manager has really been taking the lead um in this work and um you know we are we are thrilled um at at the progress that has been made and where we are going uh for the coming year. We've engaged a partner organization to uh provide some training to our team um and to do some work with us to really um test protocols for communication during a um during an emergency. So this is this is where we're really looking to turn uh from framework into implementation and operationalizing what we begin to establish. The other large priority for us is really increasing our physical presence in in uh and connection in the communities that we're serving. And you know Pat alluded to this earlier when she mentioned you know really taking a look at our utilization really meeting our our um our communities where they where they are and where they need us to be. Um, and you'll hear a little bit more about that also from Dave Goenova uh later in this uh this conversation. In terms of system trans transformation, uh this is where I'm thinking about our internal infrastructure uh in particular um continuing to build the foundation for billing. again looking at um you know of of the work that we're doing, what is billable, uh what what um you know what what systems need to be uh and protocols need to be put into place in order uh for us to achieve that billing and specifically you know what uh what EMR uh or other um data platforms do we need to have in order to successfully

and and relationships do we need to have in order to uh begin to build that. This is going to continue to be a year of building and I would anticipate that by 2027 uh we should be moving into that uh readiness to to begin billing. Last again strengthening systems for staff growth and retention. Uh we are very fortunate to have Emily Kramer on board. She is our workforce development coordinator. has been absolutely phenomenal. Um really helping us to understand uh where our strength and our gaps are in terms of uh retention uh where we can grow and learn um and opportunities for us to strengthen um strengthen even our job descriptions uh strengthen opportunities for staff to grow uh within their field. Um so this will continue to be a year for strengthening those systems for retention and growth. Are there any questions? I expect that uh I or one of uh one of my colleagues will be reaching out to perhaps some of you just to get some insight um some experiences that you've uh that you've had in your respective spaces, what's worked well for you, uh what lessons learned from all of you um in the work that you've done um that can help to inform some of the work that we're doing here. I'm going to take this moment to pause and turn it over to my colleagues to talk through some of the very specific um uh priorities for each of our divisions.

Thank you, Christina.

Good morning. Uh um each year so along with the day-to-day operations uh divisions identify priorities uh to address and of course to work towards accomplishing them. So now each division directors will first report out their 2025 priority accomplishments and then present their uh priorities for 2026. So with that I'm going to ask Ruth Cole from clinical services to start. Okay. So good morning everybody. Um thank you Jay. Uh so clinical services we really are echoing um some of what Christina just reviewed in terms of our department or office priorities. Uh, one of them being um our assessing our technology um specifically our EMR options. We've been working on that um this past year and we will continue to be working on that as she mentioned into 2026. Um looking for enhancements uh improvements on that realm which is so key to uh uh clinical operations. Uh so that has been something like I said we've been working on this past year and we'll continue to work next year. Um, another thing is, you know, we're trying to always u collaborate within our divisions. Something we wanted to enhance which we've been doing in 2025 with our communicable disease division is to focus on um pregnant women with syphilis. And so we have been able to um you know uh implement protocols that have uh helped us be able to provide antibiotics to um offices OBGYn offices that are treating women with syphilis. Believe it or not, it's often difficult to come by those antibiotics. So, we have been able to be of assistance um with that providing those offices um with those resources also and guidance. Um off, you know, syphilis is kind of tricky and so often we have OBGYn offices that look to us um for

assistance. Dr. Lorraine isn't here today, but he's also been in the mix of um helping to to guide um practitioners in the county as they've needed assistance. The other priority for 2025 um is uh increasing our staffing level, which I I feel that we've been successful. Um right now we're at 83 uh percent. We hired a one full-time uh public health nurse as well as two uh pool nurses. So I feel very uh satisfied that we are you know at a good staffing level although turning to 2026 if we can go to that next slide. Okay. Um so again we are um focusing on uh enhancing our EMR functionality. Uh so that is a long-term project. So we're excited about that. Um but also um a challenge will be um assessing billing services. It's very complicated. Um I'm sure everybody's aware if you've ever credentialed or contracted. So you know waiting into that space is is tricky, but we are we are working on um solutions and uh resources to be able to do that to re recover um any kind of uh revenue that we can. Um and last but not least, as um Pat actually mentioned too, um Willow Grove, we want to be looking for um a presence in Willow Grove when we start our uh renovation there. And so we have some uh prospects in mind of where we can relocate during the construction. Along with that, um, we will need to, uh, further enhance our staffing levels so that when we, uh, expand our services there, but that is what we're looking to accomplish in 2026.

Great. Thank you, Ruth. Next, Michelle Masters from Commun Communicable Disease Control.

Hi, everyone. Happy Wednesday. Nice to see you today. Um, so it's good that I'm going right after clinical services and Ruth because a lot of the goals for last year prior to last year piggyback on Ruth's um, and the things that she relayed. Um, so one of the things that we are hoping to accomplish is having a healthcare associated infection webinar. Um, this is required under our uh, PAH SHARP grant. Um so in 2025 we were able to identify that we're going to be working with our long-term care and acute care facilities to um really advocate and notify them of what our HAI program is or healthcare associated program is um and how we support with multi-drug resistant responses. We are working with PAOH to get up this webinar scheduled for May of this year. Um as well as being able to offer uh continue education credits um with uh our facilities. So we're very excited to have that come in the next uh quarter two of this year. Um like I said piggybacking with Ruth, syphilis is very important and you know our babies, we want to try to prevent central syphilis. So um along with making sure that our pregnant women are treated and using medication through our clinical services, we've identified a target population that um seems to be some gaps in services and then specifically working with uh pregnant women who are incarcerated at our correctional facility in the county and making sure that they are linked to care, receive treatment and then have followup after to make sure that um we don't see congenital syphilis. So the goal in 2026 is to have more partnership and joint uh work with the correctional facility to make sure we can have that continuum of care. And then finally, you know, our division is very big on leveraging technology. Uh so we did uh implement an online Salmonella case investigation

form. So this is a form that we would send to residents that were interested in participating to be able to obtain information about their risk and exposure to Salmonella. Um so individuals can choose to either do uh phone interviewed with our DIS's or disease intervention specialists or complete this form. We rolled it out in October 2025 and as of the last three months of that quarter um we did see a 32% uh completion rate of those that actually completed the form. Um and we actually only saw 3% completion of interviews over the phone. Um, so I think this is uh an entryway into be able to leverage technology and online tools to elicit information um both to meet people where they are and how they're able to give us information um as well as helping our workforce manage the increase of responses. I'm going to go to 2026. So Christina had mentioned this at the beginning of priorities uh but specifically in communicable disease we are looking to fill four vacant disease intervention specialist position. Two in our SC HIV program and two in our infectious disease program. Um, two of these positions are new to our division um, under the public health infrastructure funding that Christina had mentioned previously. And our goal for 2026 is to get people in um, to make sure they're effectively onboarded and ensure that they're prepared to support the changes in infectious, diseases, the surges um, and emerging reemerging of diseases. Uh, next we want to have a focus on our rabies prevention program. So we receive over a thousand suspected rabies exposure reports per year. So these are individuals that are bitten by domestic or or wild animals. Um so we want to improve the efficiency uh of that

program. So, we are looking to introduce a web-based reporting system that will integrate with our current rabies prevention, surveillance, and case management system uh to help increase the timeliness of report, making sure that we're gathering critical information um and be able to support prompt and timely investigation and guidance for prevention. We'll also be working to update all of our communication tools. I know there's been a huge push and a lot of education around making sure that material is um in plain language um incorporates health literacy principles as well as in multiple languages and culturally competent. So our goal is to reassess all the materials that we currently have and making sure that information is accessible and available in the way people want to receive it on written and digital platforms.

So Christina, can I ask a question? um what is our support around IT development and programming because it seems like there's um potentially work that could be done that would be easier done by an internal uh team that had their own I don't know the what all the right titles are but I know we have IT support but I don't know if it comes to the level of what you're what you're sort of mentioning here like I just want if you can remind us

yeah absolutely and And Michelle can certainly speak to um the work that she's done, you know, working very closely with IT um to develop these solutions. Our newly hired well almost year uh with us data manager um has also really been integral in streamlining data process data uh collection processes and data analysis uh processes. So he's been working uh his name is Dave Walsh. He is absolutely phenomenal and very excited to have him. Um, but I anticipate that, you know, he is, uh, involved in some of these, uh, that you see here and is working very closely with Michelle's team and with others to develop dashboards, um, and other, um, other tools to help us really track what we're track, uh, work that we're doing, but, also, you know, track disease trends and monitoring. Um, I believe, uh, Michelle's also been working very closely with Mary Craighead, our GIS analyst, around that same um, that same process. Um and I will say that my staff are very engaged in figuring out how technology can be used. We do use and communicate with other state and territorial and local health departments to see best practices um that they have used by leveraging you know the Microsoft Office suite that we have access to and other platforms um to help you know move forward with the utilization of technology and that's been a great partnership um having access to that information.

Okay. Very good. Thank you, Christine. Uh, or Michelle. Uh, I had a a question. Um, and it's very very down in the weeds, and my apologies for that. Sure.

Um, the the question really has to do with the bird flu, and I'm using the analogy that uh Bucks County with its really bad bird flu situation uh had asked people to collect their own geese, the dead geese in their properties, etc., and had put out information initially about double bagging but didn't uh talk anything about uh like uh personal protective equipment etc. Um, I looked on our website to see if we had any recommendations. Number one, are we able to collect although I assume that since we have such a long border with Bucks County that bird flu and dead geese are uh almost as bad here as it is in Bucks County and B, I couldn't find the policy on the website. Did we come out with a specific policy? Do we recommend double bagging? Are we telling them to use gloves? Because I know Dr. Damsker's office initially uh in Bucks County had not made that recommendation then made the recommendation but didn't make it kind of clear about any kind of personal protective equipment if you're bagging your own geese dead geese on your property.

Um I think you you know identified maybe some work that we need to do on our website. Uh but as for u collecting of animals or or geese uh that is done by the PA Game Commission. Um so there should be a phone number and link to their website. Um, I know we do have infographics on how to handle those animals and what correct PPE to u do when you're handling those animals. Um, so we can take a review of that. But we are not currently uh collecting animals for testing. That's all done through the game commission or department of a and we don't have as much of an issue as they have in bucks with the game commission not being able to collect things. So they were being instructed to collect themselves. That's

not at this time that we've heard of, but definitely keep that in mind. Keep a pulse on what's happening in the region. Barbara, did you have a question? Uh, so last Oh, go. No, I'm good. Thanks.

Okay. Uh, so last is measles. You know, we are seeing a sharp increase of measles um in the nation. There's been over a thousand cases already this year across the nation. um this is more than we typically see in a full year. Um we also are seeing the same trend uh statewide and countywide. So we want to take this next year to really make sure that we take time to have our policies and procedures and response plans um available um with this elevated risk that we're seeing across the nation. um and looking at updating and improving our procedures, enhancing staff training um as well as um you know engaging our community partners to support these responses. Um and this is not really just for communicable. This is a collaboration that we'll see across divisions like clinical services um offering vaccine and postexposure. Um it would be working with you know health promotion to provide education um and different entities to support this. So, we've seen it in the news. We know that it is coming. Um, and we need to do both the preventative work, but also prepare for the large response and case investigation. So, our goal is to continue to work through that response plan and make sure that we are keeping things updated and improving that process.

Great. Thank you, Michelle. Uh, next, uh, Pamlon from Environmental Field Services.

Good morning. Um so I guess I will go over our um 2025 priorities first. Um so in 2025 we did some research to identify a new inspection system so we could that we could use for um housing all of our data for inspections and complaints. Um and we would like to So what we did was um we reached out to um companies and different vendors and actually um some of our other county health departments in the area to find out what they're using and um we were able to find like a candidate that we really like. So hopefully um in 2026 that is something that we're going to be working on is moving forward with um developing that program for um all of our inspection programs and complaints. So that is something that we worked on in 2025 and will continue to work on in 2026. Um the other priority we had is territory and staffing structure. Christina did touch on this a little bit also. We reorganized our territories and staff structure to balance the workload and support the program needs. Um we again became fully staffed in 2025. Um we added two new positions or and a supervisor position. So actually three positions, three full-time positions. So um this was a big help for us. And as Christina had mentioned, we were able to break up the county into four different regions instead of three different regions, which it's been um that was in 2025. We can next slide. So for 2026, um one of our priorities is to develop a new inspection system to improve our efficiency and streamline our processes, as I just said, for our inspection

programs and complaint programs. Um we want to also revise the on call procedure to ensure fairness and consistency. We have staff that are on call um 247. We always we cover you know anything any kind of emergency that might happen after hours. Um it happens a lot because we have you know food facilities that have fires, floods, power outages, whatever it may be. Um that happens quite a bit. So we've always had this on call response. So to continue that um things have evolved over the years and we just want to ensure that um we're being fair and consistent with with the system across the board. Um and then lastly, we want to implement um our plan to conduct two routine inspections for all medium and high-risisk facilities. Now that we are fully staffed, we're able to um get into all of those facilities two times a year. Um, for the past five or six years, we've been going in once a year. Um, and that's what's mandated as per Act 315, but moving forward, we'd like to start going in twice a year to those facilities. So, with our um with our, you know, the increased amount of staff that we have, we should be able to accomplish that this year. Does anybody have any questions about any of those priorities?

Could could you just define medium and high-risisk facilities for us? Sure. So, picture this is the easy way easiest way to do it. So, a CVS that just has retail um prepackaged food items um milk, you know, or bread, that would be low risk. So, everything else would be considered medium or high risk. They're actually prepping food and storing food and, you know, it's just a it's just a a medium and high is basically the theme in a way. It's the low-risk facilities that will only go into one time a year. the CVS's, you know, the right aids. Now, a Wawa, another convenience store, that would be considered um more of a medium or high-risisk facility. Does that make sense? Good. Any other questions?

Great. Thank you, Pam. Uh next, we'll go to health equity and epidemiology. Uh Tokyo Williams.

Good morning. As Christina stated, we are expecting a new director. This division is u of the seven divisions in the newest division, health, equity, epidemiology, and we're still in the building phase. And we brought in a director in the fall of 2024 and um she left within within a year. So we have a new director possibly coming um after of course salary board approval uh next week. So um that new director has a has a lot to do because we are still in the building phase. Our priorities for 2025 included data collection and streamlining that data collection processes as well as building out that health equity framework um and also increasing public access to health data. We're still in the process of doing these things. We completed a process and a form for internal and external data requests. it was completed, created and implemented as well as a data request um standard operating procedure was revised. Our data manager, it has been mentioned um David Walsh came on in May of 2025 and he's helping to streamline some of our data collection processes in house. As far as the health equity framework, we got started on that with the new director, but t but the new um uh director that's coming that that is coming in um will pick up that and under Chantel Mason who was the director before she and her team evaluated more than 20 health equity frameworks and decided that there were two frameworks that align with the Montgomery County objectives. So, the new um health equity

and epidemiology direct would pick up that charge. Dave u Walsh was hired like I said in May 2025 and his role resides in in the office of performance and planning and he exclusively supports OP. We have a couple of positions and Christina mentioned some of those positions that's exclusively support OP but are housed in other HHS offices. Dave's uh position is one of those positions. planning has begun with the OP teams to launch data dashboards in 2026. Um he he's working with the various divisions to determine data the the the metrics that we want to to highlight and um it will be an ongoing process of developing those data dashboards. Next slide please. For 2026, we're still working on that health of the county report. um and to build that is built on the health equity framework that was identified that I just mentioned as well as develop health equity education series that illuminates critical drivers and strategies for addressing gaps in health outcomes. Christina mentioned briefly that we had a workforce development plan, training plan. Uh, and one of the uh things I identified in that plan was staff wanted more information and wanted to um um build their knowledge in health equity. So, we're going to when this new new director comes on, we're going to develop out that series for staff. Any questions? Thank you.

Thank you, Toya. Next, uh David Genova from Health Promotions.

Thank you, Jay. Uh good morning, everybody. Um our uh first priority um was our community health uh assessment and community engagement work. Uh last year we focused on the major health issues uh identified in the community health assessment and improving our outreach. Uh we released the community health assessment report and shared it on our website through social media. Um and uh we conducted seven community conversations. Uh more than 90 people participated giving us helpful uh feedback on community needs. Um we also created the core chip group uh which included 16 dedicated members from health and human services and the office of public health office of public health who help shape our uh next steps. Uh the next priority is prevention and health education. Uh our goal there has been to support the overall health of county residents through proactive education and prevention. Uh we've been collaborating with the division of communicical team uh to distribute their educational education materials uh throughout the the county um ensuring residents receive timely and accurate information. Uh in addition, our staff completed uh HIV STD uh training modules and are now equipped to deliver lessons on communicables uh behalf. Uh we continue to operate the blood pressure uh self-monitoring program. Uh in 2025 we enrolled 24 participants in the program. Uh 14 successfully completed the program during the first year and the remaining 10 participants are on track to finish this year. Uh we also partnered with uh Alamo uh back in October to conduct a car se car seat

check and distribution event. Uh during this outreach effort, uh we distributed 23 car seats and provided hands-on safety uh instruction to 30 caregivers to ensure proper installation and use. Uh finally, our work with uh community health workers uh continues to grow. Um we aimed to increase access to support, education, and service navigation for underserved communities. Uh to support this we established contracts uh with a Clomo um maternity care coalition and the Jon Center. Uh these partnerships um or I should say through these partnerships uh community health workers are offering health education. Uh they're doing outreach and helping residents connect to services uh more easily. Uh Jay, you can uh progress that slide. Thank you. Uh looking forward uh into 2026 uh first um we are launching our community health uh improvement plan. This plan centers around three major areas as Christina um shared at the beginning. Uh they are preventing and managing uh chronic diseases uh strengthening mental wellness and community connected connectedness and promoting safe healthy environments. Uh these focus areas reflect on what we learned from the community health assessment and where we believe we can make the greatest impact. Um so at this time we're facilitating think tank uh meetings for each of those focus areas. Um and these meetings are on track to be wrapped up uh the first week of April. Uh next we're working to increase our physical presence uh in the communities that we serve. Uh that means uh being consistently out in neighborhoods, building relationships, and showing up

in ways uh that are meeting meaningful and dependable uh and dependable. Um our outreach strategy will continue to be uh guided by uh data helping ensure uh we are present where needs are highest and opportunities for engagement are strongest. Um finally we'll continue our community health worker uh partnerships with Alama the JSON center and maternity care coalition uh through these contracts uh like I had shared before uh community health workers are helping residents navigate care uh access uh health education stay connected to community resources. Uh these programs are essential for meeting people where they are and supporting them in more personalized and culturally uh responsive ways. Uh, any questions?

Okay, thank you, David. Next, we have Megan Young from Public Health Emergency Preparedness.

Morning, everyone. Um, so emergency preparedness was very busy in 2025, obviously getting ready for 2026. Um some of our highlights from the last year. Uh we continued to onboard and integrate our points of dispensing program. Um as you all may recall our points of dispensing program is a very critical element to emergency preparedness. It's our process for how we distribute uh emergency antibiotics and vaccines in response to an emergency. So this year uh the team worked very hard. We have five locations that are currently working on uh finalizing or have finalized their agreements. Uh many of these we're proud to report are returning sites. Um so sites that we had had agreements with either before or uh during the COVID pandemic uh have agreed to stay on with us, which is fantastic. We we love to have their continued engagement. We have two additional sites that are working on completing their paperwork and their agreements. Um, and one location is scheduling their initial planning meeting. That will be a brand new location for us. So, we're very excited about that. Um, also, one of our previous locations has agreed to be our host site for our upcoming exercise in a few weeks. So, we're very excited for that re-engagement with them. Um, emergency response planning was a a core, it's a core to our division. It's in our name. Um, so there was a lot of work that was done in the 2025 year around emergency response planning. uh we've updated our incident response plan. Uh so the the guiding document for preparedness um we've aligned that to match the department of public safety's layout. Um this was a recommendation that came out of the initial work with summit um on our roles and responsibilities planning was to have those two documents align. Uh so we did some work to to do that and ensure that we've closed a lot of our gaps between

the two departments. Uh we're working or we developed in 2025 our club cup plan. Um as you may recall, FIFA did a little preview to World Cup in the area in in summer of 2025. So we had a club cup plan that is now the basis for our upcoming World Cup plan. Uh we're also working on a mosquito response plan for this upcoming summer. Um we are also continuing the development of our hemorrhagic fevers response plan. Um hemorrhagic fevers seem to be emerging threat uh in the area. Uh it's we have a lot of travel especially with World Cup coming. Um it's something that we have not um addressed for several years. So that is on the list of of things to do. Um as Michelle mentioned measles continues to be a threat. Um so we are working on uh the response to that event that's ongoing as well. Um medical reserve corps as many of you know is a vital part of our division a vital resource for um office of public health as a whole. We continue to grow and we continue to grow the medical reserve corps uh in 2025 with the recruitment of new members. Unfortunately I could not get the exact numbers uh before this meeting but we can share that out uh with with the board members after this. Um we saw a uptick in volunteers after our community vaccine campaign. We gained I would say probably five to 10 volunteers uh just by uh residents that had frequented our community vaccine clinics and said, "Hey, this is kind of cool. We want to do that. How do how do we join as well?" So that led to a plan of maybe having some QR codes and and resource tables uh this coming year, this coming fall, so that folks have an immediate doorway into the volunteer corps. Um I just would like to take a moment to highlight that five of our MRC volunteers are in Hershey this week

attending the first state MRC conference. Um so they are participating in Hershey and and doing a lot of work around access and functional needs um and volunteer engagement. So, we're excited to get them back later this week and hear all about what they learned at that event. Jay, next slide. Looking ahead to 2026, it's already been a busy year with emergency response and it will continue to be a busy year, I think, right through the end of the calendar year. Um, obviously 2026 and summer 2026 activities are a huge priority for us. um at least I would say for the first three quarters of the calendar year. Um so we have World Cup FIFA World Cup coming to the Philadelphia area in July uh June through July. We also Philadelphia will be hosting the MLB All-Star game in July. We have America 250 events, the Welcome America concert. Um so various activities um that we have started planning for. So, uh, preparedness is hosting, uh, planning meetings internal to the office of public health every two weeks. We have a representative from the department of public safety that sits on those meetings. We are attending many many regional uh, workshops and trainings in order to prepare for mass gatherings. Uh, and looking at what our planning is going to be and what our our response posture is going to be. Right now, seems to be concentrated around the July 4th weekend. Um we suspect there will be a high increase of activity around the July 4th weekend. So actively actively planning for those events. Um as a key component of that training and exercise is taking a huge priority this year. So um as I mentioned we have a biological 200 exercise coming up at the end of this month that is a functionalbased exercise. So we will

actually set up a point of dispensing and we will run simulated um simulated clients through that uh that point of dispensing. Thank you to our clinical team. They are giving us all the nurses for a day um so that we can also use this as a practice for our our clin our community campaign in the fall. Um, something we hope to get to this year, uh, it's on a priority list for 2026, is our closed points of dispensing program development. So, closed pods are points of dispensing that only serve a specific population. You see this a lot with colleges, schools, um, home health agencies, nursing homes, those kinds of settings. They're not necessarily places that would be publicized in an emergency for the public to receive uh medications or vaccines. They would only serve their specific population. Uh pre-COVID, we had a fairly vast network of closed pods uh primarily focused in our long-term care facilities. Um but since COVID, um some of that planning has admittedly uh fallen to the wayside. So the hope is that we can find a model that works best within our community and really start bringing some of those private network uh locations on. Um it will take some time. So this might also turn into a 2027 priority. Um but that is the hope for this year.

Great. Thank you. Thank you Megan. And finally uh Kyle Schmidt uh from Water Quality Management.

Good morning everyone. uh in 2025 uh regionalosis or regionella outbreak response was uh that training was addressed uh by me to my staff. Uh I wanted to ensure they were that were they were trained adequately in in our outbreak response because it's changed over the years. uh it's been 25 years since we first hit our big region uh regionalis outbreak and uh it's changed through federal funding requires that long-term care facilities now uh retain water consultants. So, my staff have been trained adequately in the past for uh facility inspections and uh sampling, but I wanted to make them more aware of all the recommendations and the compliance requirements that I typically had given those facilities. I want them to be able to uh act on my behalf and take my place when uh these these situations arise. uh and as such moving into the succession uh planning and staff development uh as I near the end of my career I I it's needed to train the staff on on many of the activities and tasks that I tend to work solo for some of the smaller programs now the uh regionella just being one of them the giving the recommendations and compliance requirements to the el-term cares is just one of them but I've also uh addressed test some of these smaller programs like wastewater surveillance and super fund site reviews and boil water advisory oversight uh waterborne outbreak response like the Legionella um groundwater large scale groundwater contamination cases and then any environmental issues environmental

health issues that are not necessarily water related. uh these issues sometimes involve the the EPA and the ATSDR and the Pennsylvania Department of Health and the D. I'd like to train my staff um to to act on my behal to address those issues as well. So, um, and then the last one is the the upgrade of software for, uh, similar to what Pan just talked about, a software database for our water quality inspections and complaints and we're we identified a new vendor and uh, we're working with them in in the new in the new year. So, uh, Jay, if you don't mind going to the next slide, please. So in 2026, I'll just uh start with the first or the second and third. Similar to in 2025, I'm going to continue to do the uh secession planning, the the broader program responsibilities and secession planning. Um there's more th those uh topics I just mentioned. Uh I I want to elaborate on them with the staff throughout the year. uh give more Legionella training or refresh our training and then uh third one to implement the new software program as our new DHD system sunsets at the end of the year. We want to make sure that there's a software system in place. So going to the top one, this is a big one for me. the uh those that are familiar with Posafu alkal substances, it's the the media calls it the forever chemicals and they're uh pervasive throughout the environment. um the uh these the health effects are pretty are getting to be

pretty well known now and they're it's it's a little scary and as such the EPA reduced to extreme levels uh the drinking water standards um for POS and drinking water in public water supplies but that's public water supplies not individual water supply sources uh the we or Jay and I have discussed uh considering adding PIFAs to our list of required parameters for newly constructed water supplies and we're debating whether we mandated or or at least recommend it and that's that's that's ongoing discussions but the reason for all of this is that public water supply sampling for POS for the past several years has shown A good percentage of public water supplies do have POS in them at low levels but still will be some have exceeded these extremely low levels of uh four parts per trillion that are required by the EPA and because of the presence of these POS in the public water supplies I have to assume or we're assuming that POS is uh near these supplies as well. So, there it's out there and we're going to if we find it, we're going to address it and make sure that individual water supply owners are protected as well. Any questions?

Thanks. So, Jay, that gets us through your entire team. Yes. Thank you.

Thank you very much. Thanks for your leadership and thanks to the entire team. I would encourage us potentially for next year to um I think the data the bullet points are fine but it could be helpful to have um some actual data with like the number of sessions the number of people we touched the action things that are action items things that are sort of an update from the year prior just um I think have that people certainly mentioned what the the numbers were but I think capturing them and having them in a document would be helpful So, okay, Christina, I'm going to turn it back to you. Do we have time to do the pediatric immunization status?

We do. We did not receive any requests for public comment, so we do have a little bit more time this morning. Um, Kayn Roberts is stepping in for Dr. Lraine. I do want to uh bear in mind that uh we are running behind on our schedule um but we do have until about um 10:25 10:30 for this great thank you thank you all right Kaylin excuse me

excuse me good morning I will make this quick um I knew that I was last so I knew this would would happen um I uh am going to talk to you today about the changing vaccine recommendations that most of you have already heard about. Dr. Lorraine in your last meeting did discuss um that the CDC uh is is breaking away from um other organi uh organizations um immunization recommendations. This is the first time that we've seen this, as far as I know, the first time that we have seen the CDC and the other medical organizations not align with their immunization schedules. And as Dr. Lorraine mentioned last time that the CDC uh late last year deviated from the recommendations of the AAP, they reduced the vaccine targets from 17 to 11. they were uh using Denmark's model which he explained to you at the last meeting. Um but AAP does maintain the established vaccines schedule consistent with prior years. Next slide please. So to address this misalignment, um Pennsylvania has been very very uh active and uh on October 1st, 2025, Governor Shapiro did sign an executive order um state protecting Pennians health and freedom by ensuring access to safe and effective vaccines. And I'm going to talk a little bit about that executive order. So, in the executive executive order, he sets forth many directives, but for today's um presentation, I'm only going to be talking about um directive number one, safeguarding vaccine access for all families. And uh directive number two, updating state policies to ensure

evidence-based vaccine guidance. If I went through all of them, it would take an hour. So I don't have an hour so we're going to just focus on those two. So next slide please. And these are just the remaining um directives. So I'm going to talk to you today about directive one safeguarding vaccine access for all families. So in the directive uh the department of health was tasked to establish a Pennsylvania based program to drive vaccines to those who are eligible for the federally supported vaccines for children program in the event that the ACIP removes or alters vaccine recommendations for certain diseases for the VFC program. I did read that verbatim because I wanted to get that out very clearly. So basically for those of you that are not familiar with the vaccines for children program that vac that program is a federally funded program. So if the ACIP removes uh vaccines and the uh CDC does not recommend vaccines that means that vaccines for children providers would not be able to get those vaccines through this program. So uh with this uh they also wanted us uh directive number two is they want us to follow evidence-based scientific um recommendations for vaccines. So we are collaborating with the American Academy of Pediatrics, the American Academy of Family Physicians and the American College of Obst Obstitricians and Gynecologists. Next slide please. So, what the uh Pennsylvania Department of Health has done is they've um instituted a program called PA Cares. Stands for Pennsylvania Children's Access to Routine and Essential Shots. And this is like I said to address

directive number one. So, what this will do is the Pennsylvania Department of Health has established a program that VFC providers in the state can um enroll in. And if the CDC or the um HHS does um take away recommendations for certain vaccines, we will be able to continue to provide those vaccines by ordering those vaccines through the Department of Health directly. Presently, um the Office of Public Health has completed our enrollment in PA Care. So, if this does come to fruition, we will be able to provide those vaccines that might not be coming to us through the VFC program. Uh, Pennsylvania Department is encouraging all VFC providers to enroll. And to date, um, 500 VFC providers have enrolled in Pennsylvania and 100 are pending. So, very good uptake. So, our our fear uh did come true. So on January 5th the health and human services did uh make recommendations and did have schedule changes. So what they did is they removed routine vaccinations for uh recommendations for hepatitis A and B co 19 roto virus flu and meninja coakal disease. they took away uh recommendations um for all uh folks and and just made certain vaccines for high-risisk groups and made some with shared clinical decisionmaking. They changed the RSV immunization um recommendation. They recommended that the HPV vaccine which was a twod dose series to be only one dose. They did say though that we will they will continue um that these vaccines regardless will be um covered by the affordable care act

at least through this year. So next slide please. So also in addition to that HHS recommendations coming out, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstitricians and Gynecology also put out their 2026 immunization schedules. And again, as I mentioned, all of these schedules are in not in alignment with what the HHS is putting out. And this aligns with uh directive number two. Um and we are uh per the directive, we are to follow evidence-based um vaccine recommendations by our um our uh colleagues at these um these organizations. And so AAP continues to recommend 18 vaccines unlike the HHS and CDC schedule. And therefore in Pennsylvania, including Montgomery County, we are following the AAP, the AFP, and the ACOG immunization schedules. Next slide, please. So, this just came through last uh week. This is brand new. Uh something else that Pennsylvania is doing is that they have joined a multi-state lawsuit to defend vaccine policy. So, our governor um uh signed on to um a a lawsuit that I believe it's about 15 other states. I think Arizona started it. And basically that what they are doing is they are saying that what is happening um at the HHS by removing long-standing universal recommendations and ignoring scientific evidence could undermine public health. Uh, our governor would like to um restore our

evidence-based guidance to protect our families and our ability to make informed health care decisions. Next slide. And in uh the Office of Public Health and our Montgomery County Immunization Coalition, we're um doing our darnest to try to ensure that our residents know what is going on because it's got to be very confusing for everyone out there. What do we follow? we've got these different recommendations. Who are we supposed to listen to? So, Dr. Lorraine spearheaded um something that called what we call ask the experts webinars. And in these ask the experts webinars, we um bring in experts to talk about um the emergency emergence emerging issues and help to clarify um these ongoing issues with our public. Next slide, please. So, our ex ask the expert webinars are planned for next month, April 8th at 7 p.m. we'll be doing an English version and on April 15th at se actually I think it's at 6 pm we'll be doing a Spanish version. Um we'll be we're working with our partner Alamo to to provide a a Spanish version. Um our registration will be coming soon. We'll be getting flyers out and and and promoting those as the expert webinars.

In addition to that, the Pennsylvania Department of Health is doing a video series to help um get the message out about uh vaccinations and the importance and that we have in Pennsylvania there's been no changes in vaccine availability and recommendations in PD. And I believe we're going to show the videos. and then I think I'm done.

I'm a pediatrician with decades of experience treating children and their families. I want to assure you that vaccines to prevent childhood diseases remain available and covered by insurance here in Pennsylvania. There are no changes in vaccine availability and recommendations in Pennsylvania. For school age children, Pennsylvania regulations for vaccines remain exactly the same. I want you to know that pediatricians have always used shared decision-making and consent for vaccines. You can find more information on vaccine recommendations from trusted medical professionals online at pa.gov/vaccines. If you have vaccine questions, please talk to your child's pediatrician so you can decide which vaccines might be right for you and your family. Over the next few weeks, the Pennsylvania Department of Health will be providing more information about vaccines and how they protect children from vaccinereventable diseases. So, stay tuned.

Okay, Kayyn, thank you very much. Uh, thank you for being last and also for being very efficient with all the things you had to share. Um, I have two things. One, I want Oh, do are we going to show another video? We can send this one out.

Yeah. Yeah. I want to make sure we end on time. Sorry. Um, so first I I want to say thank you to the entire team. I think that this has been a really uh comprehensive overview of the work from 2025 which is to be applauded and I I thank you and please extend on behalf of the board our appreciation for the hard work of each of your teams. Um, I am excited about the new positions that you have and that you filled and um, so again, thank you very much. We appreciate that. Um, and if we can build in metrics for next time, that would be terrific. Um, but before we uh, end the meeting and Christina, I'll let you have the last word here. But, um, I just wanted to ask if there our next board of meeting is June 3rd is in person. Um, I want to ask Christina to say like if there are changes that are happening in Washington, um, that we the board should be made aware of. I I I don't think we should wait till June. And I'm not saying that we have in the past, but I would just encourage you to like send us emails and give us updates if there's things that you want us to be aware of that you don't want to assume that we're aware of ourselves. Um, and then if there are things that impact our ability to deliver care to the Montgomery County residents, then our board wants to know and our board wants to be part of that conversation. So, if you need all that to say, if you need us, we are here to support you and to listen and to advocate on behalf of all the residents of Montgomery County. So, um, again, thank you so much for this great, uh, amount of work and we really appreciate it. And I will stop there if anybody else has any other questions and I'll let Christina close us out before I call for an adjournment.

Anything from any of the members? I think we are clear. Uh thanks to all of you for making time and I appreciate the the commitment that you all share uh for health and wellness uh in our county. um you know the the landscape at the federal level of course is evolving um as you all know uh day-to-day week to week uh we can certainly uh come up with a cadence to share out updates as we're receiving them um so that you all have a clearer picture of how how that is uh affecting our work here in Montgomery County. We again appreciate your time. We appreciate your commitment and your support. Thank you.

Thank you Christina. And I will call for a motion to adjurnn. So moved. Second. Thank you. Second. Second. Thank you. All right, we are adjourned. Thank you everyone. Thank you. Have a great day. Thanks.