Meeting Minutes

March 18, 2021 Minutes

Health Improvement Alliance of St. Joseph County

Meeting Minutes Thursday, January 22, 2021

Location: Remote/Zoom\

Find slides from this meeting’s presentations, several COVID-19 resources, a list of members, upcoming events, and past minutes at www.healthalliancesjc.org.

1. Mayor James Mueller of South Bend greeted the group and offered thanks for the many Alliance members whose work in the past year has aided South Bend Covid-19 response.
2. Dawn Wilkins of the Nurse Family Partnership, gave an overview of this program, which assigns nurses to first-time parents living in poverty for two years in an effort to assure healthy development of the child and to help families cope with and improve life challenges. The program was new to St. Joseph County in 2011 and initiated by Goodwill Michiana. In St. Joseph County, it serves some 100 families. It replicates a program that has been developing nationally for 40 years and whose longitudinal data indicates a high degree of full-term births, breastfeeding and immunization. Parents enrolled in the program also report improved employment situations. Alliance members are encouraged to refer clients to this program (referral information included in attached slides). Participants can sign up themselves as well.

• Joally Canales and Carolina Avendado are establishing an Indiana Covid Registry through the University of Notre Dame. Individuals can register for the registry at https://healthregistry.nd.edu. Initiated in September, the registry is capturing individuals’ Covid-related health experiences through a survey that delves into socioeconomic demographics, the economic impact and quality of recovery, and the mental health effects of the virus. A second survey on Covid vaccines is now live. This aggregate data will help communities understand where help is most needed and where vaccine hesitancy might be strong. Some 350 residents of St. Joseph County have joined the registry. Alliance members are encouraged to join the registry and to disseminate registry information among their clients.

15. Waldo Mikels-Carrasco reported on the Alliance’s survey on member interests. Slides on the findings are provided. Among findings, members see networking as the most valuable Alliance service. Education, also, is valued, and “advocacy,” regarding equity and racism, also registered as strong interests. Apropos of equity, the Alliance data committee has completed a tool designed to help institutions examine health equity within their organizations. This tool will be previewed in a special Alliance meeting from 10 to 11 a.m. Thursday, April 15.

January 21, 2021 Minutes

Find slides from this meeting’s presentations, several COVID-19 resources, a list of members, upcoming events, and past minutes at www.healthalliancesjc.org.

1. Jim Baxter opens the meeting with a welcome and encouragement to contact him if there is a need to share information with Alliance members. He and executive board member Waldo Mikels-Carrusco ask members to be on the lookout for a member survey on a Survey Monkey tool. The survey will gauge members’ working projects and what members would like to see from the alliance. The survey will be delivered via Survey Monkey.
2. Patty Willaert, Beacon Health community impact executive director, and Mark Stevens noted that the Beacon community health needs assessment will soon be underway and will include a survey of needs by groups such as Alliance members, data analysis and focus groups. The final report will be submitted at year’s end. The assessment drives community outreach priorities such as the B.A.B.E. Stores, sickle cell anemia programming and health and wellness programming. Many current programs have had to go virtual, but Willaert noted that diaper distribution has brought some 19,000 diapers to those in need during Covid. She added that Beacon is experiencing a decrease in Covid hospitalizations.

• Joseph County Health representatives Dr. Bob Einterz and Robin Vida asked Alliance members for help spreading the word on a number of Covid related issues. Vaccine distribution has not been without hiccups, but the following information is essential to communicate:

1. The local Health Department does not influence vaccine eligibility guidelines, allotments or distribution, which currently serve groups including residents 70 and over. No date has been established for dropping the service age to 65 or 60, as demand outstrips supply in the current guidelines. Physician offices are not distributing vaccines.
2. The Health Department has confidence, and Alliance members should communicate confidence, that the second dose of vaccines will be available for those who have received the first.
3. Latinx and Black communities are demonstrating significant hesitation to vaccinate. All Alliance members can play a positive role in emphasizing the importance of the vaccination among their clients.
4. How one registers for the vaccine can be found online at in.gov. Registration can be made at this site. The state’s 211 hotline can handle registrations on behalf of those who cannot access technology, but it is often overwhelmed. The St. Joseph County Public Library has begun helping register people for vaccines and will do so over the phone by contacting 282-4646. Members of the City of South Bend Americorps team has joined library personnel in providing this service.
5. County residents can and should seek vaccines at locations outside of the county including Plymouth and Elkhart.
6. In St. Joseph County, vaccinations are administered at St. Hedwig (managed by the health dept) and St. Joseph Health System out of its Cedar Street campus. The latter is proving too small and St. Joseph is seeking a larger venue. Some Healthlink clinics are also offering the vaccines; patients are to make a reservation by phone.
7. Per Latorya Greene, director of Community Health and Well-being and the Tobacco Initiative, Covid testing appointments have significantly decline the county, possibly attributable to the increased discussion on vaccinations. It remains critically important that anyone with symptoms seek a test. Those in need of a test also can register online, at in.gov. The state’s 211 hotline also will help set up testing appointments.

The next 525 Foundation takeback day will be from 10 a.m. to 2 p.m. April 24. Sarah Albert welcomes contacts from anyone who would like to establish a location. During the six-county takeback day in October, 13,000 pounds of pills were collected. This is in addition to the 9,210 pounds collected at Martins drop boxes. The foundation is expected to expand its educational reach with a new partnership it’s establishing with Purdue University School of Pharmacy and the American Pharmacist Association chapter. 

Beginning Feb. 1, the YMCA is introducing a free online health and physical fitness challenge. Learn more and register at www.ymcagm.org/reset. The program will last six weeks.

The Partnership for a Drug Free St. Joseph County is sponsoring a youth prevention video contest for grades sixth through 12. Winner will be made into an ad with WNDU.  Contact Janet Whitfield at  Pepsadfc@gmail.com

The next general meeting will be March 18, 2001, via Zoom, 10:00 am

November 12, 2020 Minutes

Location: Remote/Zoom

Find slides from this meeting’s presentations, several COVID-19 resources, a list of members, upcoming events, and past minutes at www.healthalliancesjc.org

Jim Baxter welcomed members to the Zoom meeting. Alliance membership now numbers 400.

1. Laura Jensen, CEO of United Way and representative of the county Covid 19 task force, gave an overview of calls for assistance logged by the 211 help line, which has merged with the Family and Social Services Administration. A uniform input form now collects a wide variety of information about a caller, and establishes a case record. Before Covid, 211 experienced fewer than 10 calls a week for assistance in such areas as food, housing, medical care and utilities. Those numbers immediately shot up in April as the impact of Covid hit families. The county registered between 170 and 180 calls for assistance for both food and utilities, and 120 for help in health care. The 211 data base has allowed the county Covid task force to identify unmet needs and to respond. These needs continue to be for housing, food and utility assistance and health care. (Slides provided.) 

Unemployment spiked to around 20 percent at the height of Covid and is now below 8 percent. But needs persist, because federal financial assistance and rent moratoria have ended.

Alliance members can tap into data from the 211 website, either by using the site directly (https://in211.communityos.org/) or by requesting a data pull. 

Jensen asked that members promote 211 among their service populations.

• Robin Vida of the St. Joseph County Department of Health noted that Gov. Holcomb has issued new restrictions that the health dept. will soon be disseminating. Those with the strongest restrictions are in a red zone, which Elkhart County has achieved and St. Joseph is close to reaching. She asked members to emphasize the importance of masking up, keeping social distance, practicing hand hygiene and staying home in the face of symptoms. Those who need tests should start with their primary care provider.

Holiday travel is not advised, and those who plan to do so should quarantine first for 14 days, beginning immediately. Health Department chief health officer Bob Einterz strongly emphasized that the county is facing a “potential catastrophe” and warns against indoor events greater than 10 people. (Gov. Holcomb’s recommendation for gatherings of up to 25 is not advised.)

1. Speaking on a coalition that addresses emergency food needs, Jim Conklin of Cultivate Culinary, noted that weekly phone calls allow participants to share resources, make sure pantries are stocked with basics and ensure that services are not being duplicated. Between the South Bend Schools and Cultivate alone, almost 1 million meals have been prepared and distributed since Covid struck. Food insecurity is expected to be an issue for two and a half years. Conklin also said on Dec. 3, Barnaby’s pizza will donate a portion of their sales to Cultivate.

Jennifer Henecke and Sara Maloney described the foray the St. Joseph County Public Library has made into helping patrons sign up for federal health insurance during the open enrollment period. The library received a grant to join other local agencies in providing this service, and has trained several librarians as navigators. Patrons can make appointments to meet face-to-face with a librarian-specialist, have a meeting by Zoom or a meeting by telephone (574-288-4646.) Spanish-speaking assistance is available. Appointments for these services may be made on the library’s website (sjcpl.org/health-insurance). Librarians already are practiced at helping people get email addresses and manage documents and thus bring a full-service approach to offering assistance.

1. Jessica Brookshire, an executive board member with the Alliance, described a new University of Notre Dame initiative called the Office of Clinical Partnership, which she directs. The office was formed in response to faculty interest to engage on community issues related to the social determinants of health. This new office plans a forum Dec. 4, Covid 19-What Comes Next? This forum will be delivered by Zoom between 9 a.m. and 1:30 p.m. Sessions will cover women’s health, infrastructure, learning, and social underpinnings. Register for all or just some of the sessions at https://notredame.zoom.us/meeting/register/tJ0kdeusrjIuHdKNBmjOrrRAKs3yZY5T7q6X

• Becky Savage, president of the 525 Foundation, describe the success of October’s Substance Abuse Prevention Month activities, which engaged some 200 volunteers offering 15 live educational events across Zoom and Facebook. Some 14,500 individuals were reached by these activities. Two particularly successful events were a seven-county pill drop-off which yielded 8,000 pounds of pills turned in for destruction. An event “Say Boo to Drugs” involved pairing information on drug safety with Halloween candy distribution. Events also focused on training individuals on the use of Narcan in the face of drug overdoses, and making Narcan widely available.     
• The next session is Thursday, Jan. 21

September 17, 2020 Minutes

Location: Remote/Zoom

Find slides from this meeting’s presentations, several COVID-19 resources, a list of members, upcoming events, and past minutes at www.healthalliancesjc.org.

1. 1. Jim Baxter welcomes the group to a session whose focus is on issues that touch many Alliance members: Homelessness, racism and education and workforce development.
   2. Lani Vivitiro, chief policy and resource officer of the Center for the Homeless, provides an overview of Homelessness in St. Joseph County.
      1. Our most current county homeless census, taken in January, indicates we are neither at peak homelessness, nor a low, but “average.” The county shows 21 people literally have no shelter; 537 were homeless (430 households) but sheltered; 90 were described as chronically homeless, a slight increase from previous years. Mental illness and trauma count heavily among the reasons this group is facing homelessness.
      2. Vivitiro used the analogy of medical services to describe how to meet the varied needs of the homeless. A small population of chronically homeless will need permanent care similar to long-term care; another segment of the population needs a period of concentrated support similar to physical therapy, but can then reenter the world of work and maintain a home. Crisis services, similar to a hospital’s Emergency Department, serves the highly traumatized. Ultimately, prevention and diversion are the most effective approach. St. Joseph County has resources in each of these categories, although the federal government has reduced support to transitional services. The challenge is to coordinate these services to assure appropriate assistance for each client.
   3. Robert Einterz, Health Officer of the St. Joseph County Health Department, addressed the department’s recent decision to recognize racial inequity as a public health issue.
      1. 1. The health consequences of structural racism are obvious in such measures as access to medical care; the disproportionate rates of chronic disease such as diabetes and heart disease; exposure to health risks such as lead paint, and disproportionate exposure to Covid in the workplace.
         2. The cost of racial inequity is clear in black infant mortality rates (3 times greater mortality than whites); life expectancy (five years less than whites); number of children in poverty; disproportionate representation in 21 and under deaths, and bias in health care diagnosis and treatment.
         3. The Health Dept.’s action plan, in addition to staff training, includes:

            1) developing a health equity and epidemiology data unit, conducting and an equity focus survey and identifying factors contributing to health disparity in partnership with Alliance members and other groups.

            2) Recruiting community health workers of color to strengthen relationships between the health dept and the community.

            3) In partnership with law enforcement, initiate a pilot program of crisis intervention that mobilizes health department staff for non-criminal problems.

   4. Kate Lee, executive director of education and workforce at the Chamber of Commerce, described resources being made available by the state, and locally, to connect the unemployed with jobs and prepare them for new opportunities. The resources are robust, but there is need for all to pitch in to connect our unemployed to some of these new outlets. (Slides provide a broad list of these resources.)

   5. The state has initiated Project Rapid Recovery for a Better Future in order to drive people into education and training and connect them with jobs that exist but might require new skills. Nextleveljobs.org and YourNextStep.in.org are state resources for identifying these jobs. A cadre of counselors from organizations ranging from Work One to Ivy Tech are providing career counseling. Tuition free training and on-the-job training are options.

      Lee is part of movement to engage local educational, faith-based and institutional leaders to engage those seeking jobs, particularly those whose jobs will have disappeared during Covid, to consider new options. Although many workforce development programs had been restricted to high school graduates, the service population has been expanded to those who have obtained college associate or bachelor’s degrees who are having trouble finding work.

   6.  

      Crossing our fingers for Emily Rupchock of United Way, who is submitting a comprehensive grant proposal for a new neighborhood center on the Southeast Side of South Bend. Application due to the Robert Wood Johnson Foundation in early October. The center’s work would address gaps in health equity in the neighborhood. 

   7. Bill Agnew of Saint Joseph Health System asked that everyone fill out the system’s health needs assessment survey, at: https://www.surveymonkey.com/r/2020_SJHS_needs_assessment                                      https://www.surveymonkey.com/r/2020_la-evaluacion-de-las-necesidades
   8. Suzie Krill, South Bend Fire Department Community Paramedic. introduced a new associate, Dawn Jones.

July 16, 2020 Minutes

Location: Remote/Zoom

Find slides from this meeting’s presentations, several COVID-19 resources, a list of members, upcoming events, and past minutes at www.healthalliancesjc.org.

• Jim Baxter, Alliance coordinator, welcomed members and introduced Dr. Jennifer Sullivan, secretary of the Indiana Family and Social Services Administration.
• In her 30-minute presentation, Dr. Sullivan made several notes about FSSA’S work against COVID-19, which she described as “flying the plane while building it.”
  1. One of the first decisions, to ramp of Telehealth to improve access to health care, proved fortuitous, particularly for those suffering mental health or substance abuse issues. Attendance to telehealth conferences for this population improved the treatment of many. Telehealth likely will continue to be important in mental health treatment in the future. FSSA continues to iron out problems in HIPPA, access to broadband and payments.
  2. Work groups assembled to address the social determinants of health and vulnerable populations helped narrow service gaps. One such achievement was identifying housing for people who live in group homes (homeless shelters, homes for the disabled) who needed somewhere to recover from COVID. The quantity of rooms needed has decreased.
  3. FSSA took several administrative actions to ensure that access to services would continue to be available, to the extent that rules and criteria were suspended.
  4. Stepping up a merger between 211 and FSSA proved extremely helpful, especially including the real time trend data they are able to access (the St. Joseph County Health Dept. and the Covid-response team overseen by United Way also have been able to access this data and plan responses based on this useful and up to date data.)
  5. FSSA became the sixth state in the U.S. to begin delivering SNAP orders, particularly helpful to rural areas. Deliveries will continue after the COVID crisis passes.
  6. In cooperation with the Indiana Dept of Ed, some 600,000 Electronic Benefit Transfer (EBT) cards have been distributed to families, in lieu of meals students would have received in schools, had face-to-face classes been in session during the last three months of the school year.
  7. Indiana has very advanced data partnerships with CTSI and WISE, an academic library consortium. Both have made highly effective contributions to provide data that informs the state’s decisions.
  8. She favors statewide wearing of face masks
  9. In a weekly newsletter she publishes, “Broken Pieces,” Dr. Sullivan examined the philosophy of devising solutions not to help the majority, but to solve the problems of the small number that fall through the cracks. Through that method, the majority also will be helped.
• Laura Jensen of United Way presented slides reviewing the efforts of the Covid-19 task force. Before COVID, about 37 percent of the county’s population had been struggling to make ends meet, is stretched to the limit, or lives in poverty. With unemployment spiking at 20 percent, this population has become more vulnerable and is the focus of the task force’s work. The task force has transition from emergency response to what they call “early recovery,” and is planning through June 2021 for a restoration phase and a community development phase that considers the possibility of future events. (See slides for further detail and budget information.)
• Robin Vida of the St. Joseph County Department of Health noted that cases are on the upswing again. IN addition:
  1. Regarding school openings, the health department has worked very closely with all school districts on safe approaches. While preparing for schools to open, the department also is monitoring the increase in cases and will recommended course corrections based on the presence of the virus.
  2. The department and the department’s board are working on expanded emphasis on facemasks, this time targeting employers with a message to keep their employees safe.
  3. The board has declared racism a public health issue.
  4. The department’s website now links to a map of local food banks with info such as location and hours.
  5. The department is working in conjunction with upcoming Mask Up Michiana events.
  6. Robin noted that the department will establish an online form for residents to use to comment on or complain about poor adherence to mask mandate.
• Jim Conklin of Cultivate Culinary encouraged those who might know of food sources for donation to join a Cultivate email chain. Contact Jim by email to join.

April 23, 2020 Minutes

Location: Remote/Zoom

Find slides from this meeting’s presentations, several COVID-19 resources, a list of members, upcoming events, and past minutes at www.healthalliancesjc.org.

• Jim Baxter, Alliance coordinator, welcomed members. He has helped facilitate a number of COVID-related partnerships, many noted below. He expects the next meeting, May 21, to occur remotely.
• Laura Jensen, United Way, reported that the agency raised more than $1 million in less that 2 weeks in support of COVID-19 initiatives, both immediate and long term. $344,000 has been distributed to 29 non-profit agencies focusing on food stability, utilities and rent and helping the staffs of agencies who work with the most disadvantaged. The next focus is to protect the county’s safety net with infrastructure grants. United Way is the recent recipient of a $1.6 million grant from the Lilly Endowment. The agency is preparing for a future that includes a cycle of: response, disease peak, downturn, resurgence, response.  Also from Jensen, the Indiana 211 hotline is effectively managing COVID-19 responses. The hold time has reduced to 2 minutes; the service spends an average of 8 minutes with each client. It has become an effective source of information on problems and problem areas.

• Becky Zakowski, H.R. Jung and Allie Sobieski of the St. Joe County Cares Consortium (addressing youth mental health) discussed the findings of a needs assessment survey requested by the Indiana Department of Mental Health regarding access and availability to a full array of mental and emotional health services. Slides attached, but some findings:
  1. Most accessible resources were early childhood, educational, parental cafes and faith-based services. Less accessible were child advocacy or restorative justice. Formal mental health services were least available.
  2. Parents most worry about their children’s anxiety and moodiness followed by hyperactivity and suicide. Two thirds surveyed said they sought help and 2/3rds who did found resources. They start with family doctors; 1/3 ask help from their schools.
  3. Youth were surveyed through small focus groups, and their positive responses to the conversation mirrored their report that they just want someone to listen to them. They rely most on peers, less on schools and parents. These conversations were so successful, St. Joe Cares wants to continue to hold them.
  4. The organization now approaches the challenge of how to move forward using remote tools.

• Robin Vida of the St. Joseph County Health Department indicates their professionals don’t believe Covid-19 will go away without adequate testing and a vaccine (more than 6,000 tests administered locally thus far.) Physical distancing and frequent hand washing may become a way of life, which will greatly cut down on disease transmission. Vida asked alliance members to seek information from the county or state health departments and their social media outlets, and to share that information widely as a means of negating inaccurate information, a particular problem in minority communities.
• Beacon’s Kimberly Green Reeves described testing sites opening in neighborhoods where health disparities are most persistent, including Harrison Elementary School and Goodwill on Western Ave. These sites provide assessment, testing and education. Michelle Peters adds that St. Joseph Health Center also is reaching out into neighborhoods in need, providing testing at Sister Maura Brannick and other sites. Map of St. Joseph Health System testing sites
• Jim Conlin described Cultivate Culinary’s success in stockpiling frozen meals to address food insecurity that likely will extend beyond the stay-at-home mandate. Assisted by volunteers including 24 employees of the Parks Dept., South Bend Schools, the Northern Indiana Food Bank, they have prepared 35,000 meals and may eventually reach 60,000. They have been able to tap into food sources from the USDA and have financial support from United Way. They expect to deliver 15,000 meals a week, 10,000 through South Bend Schools and 5,000 from agencies helping other populations including the elderly, for at least six weeks.