9

Committing to Improve Behavioral Health

Issues in Southwest ND

1. Provided CISM (Critical Incident Stress Management) - Chaplain In- tegration to 14 individuals, enhancing the number of trained chap- lains. Training was provided on September 15, 2017.

2. CALM (Counseling on Access to Lethal Means) presentation was pro- vided to the teachers/staff of the Dickinson Public School District on March 22, 2017. A total of 60 staff attended.

3. Resource List was updated and continued to be distributed. A total of 400 were distributed.

4. Depression Screenings (PHQ-2 and PHQ-9) were completed by all clients age 14 and older. A total of 2,150 screenings were completed with a total of 51 requiring a referral. Of those 51, 8 agreed to a re- ferral but 43 refused. The majority of those with elevated scores were between ages 14-45.

5. The Emotional Health Toolkit continues to be distributed. In 2017, a total of 1,384 toolkits were given out. (NOTE: number may be higher as these toolkits are places at the front desk for anyone interested to take).

6. Telemedicine Psychiatric Services began February 14, 2017. Three psychiatrists/nurse practitioners are available for our area. A total of 389 people were seen. A total of 60 were no shows. A total of 107 new patients were seen. Of those 107, a total of 38 were aged 7-17.

7. The Partnership for Success Grant continued to focus on underage drinking in the southwest region. This grant required community as- sessment, capacity building and strategic planning workbooks to be completed. The assessment identified two main areas of concern. The first was Social Availability which showed that most underage youth are getting their alcohol from their parents or other adults. The second was Community Norms which shows that most com- munity events involve alcohol of some kind as well as family gath- erings. Some events have few restrictions or monitoring of alcohol being distributed or sold at these community events. The goal has been to decrease underage drinking by educating adults and youth that you can have fun without the use of alcohol. We have created several memorandums of understanding with schools/groups in the area to have youth create messaging items regarding underage drinking prevention. Youth Surveys have been completed in several schools in southwest North Dakota and data from that has been used to educate communities. Other messaging items have been distributed throughout communities. News articles and radio ads have been utilized as well. ID scanners continue to be made avail- able to any SW region community event/liquor establishemtn to use at no cost. In 2017, ID scanners were used to scan IDs of 7,432 individuals and found 52 expired licesnses, 20 fake IDs and 16 un- derage.

Left: Mike Walton Right: Karen Goyne, Coordinator

10

11

GOAL: Decrease Youth Alcohol Use Objective: To provide evidence based strategies to decrease the number of youth using alcohol in SWDHU counties through December 31, 2020.

STRATEGIES EVALUATION RESPONSIBILITY PROGRESS COMPLETION

DATE

1. Collect data from

schools in southwest

counties on underage

drinking

# of schools surveyed

Alchohol Prevention

Staff

6 Schools

December 2017

2. Provide ID scanners

to region businesses/

events as requested

# of scanners utilized

# of IDs scanned

# of underage/fake IDs

itentified

Behavioral Health

7,432 Scanned

88 Failed

Ongoing

3. Provide/distribute

parent lead informa-

tion (health tracks,

newsletters, health

fairs and other com-

munity events)

# of people reached

through distribution

services

Behavioral Health

Over 10,000

Ongoing

Objective: Increase identification of behavioral health risk factors for early in- tervention by December 31, 2020.

STRATEGIES EVALUATION RESPONSIBILITY PROGRESS COMPLETION

DATE

1. Assess client risk of

depression

# of assessments

All Client Programs

2,150

Ongoing

2. Medication (mental

health) management

# of clients

Nursing Staff

6

Ongoing

3. Provide referrals as

needed

# of referrals

All Staff

51

Ongoing

12

The Department of Environmental Health has begun using a new inspection system that allows inspections of food service establishments to be electronically submitted to the Division of Food & Lodging of the North Dakota Department of Health. In addition, the new FDA Food Code has been formally adopted by the North Dakota Department of Health and consequently has also been adopted by reference by the Southwestern District Health Unit.

Contemporary environmental issues including the cottage food law, blue green algae, updated sewer codes and daycare regulations are just some of the items being addressed by the Department of Environmental Health in the coming year.

ENVIRONMENTAL HEALTH IN 2017:

419 Food Service Inspections

33 Nuisance Complaint Investigations

46 Sewer System Inspections

26 Daycare/Preschool Facility Inspections

11 Institution Inspections

26 Swimming Pool/Hot Tub Inspections

16 Non-Community Water System Inspections

1 Body Art Facility Inspections

3 Tanning Bed Facility Inspections

2 Child/ Adult Neglect Investigations

12 Landfill Inspections

371 Water Sample Collections

1139 Additional Environmental Health Contacts

1672 Water Samples Analyzed

M: 841 Non: 257 P: 101 SWP: 304 SPA: 169 Total: 1672

13

From Left: Danielle Rom-

anyshyn, Ken Musick,

Nancy Lantz, Kevin Pav-

lish, Mike Walton, Sherry

Adams

Objective: Provide and support programs to protect the environment.

STRATEGIES EVALUATION RESPONSIBILITY PROGRESS COMPLETION

DATE

1. Inspections

Decrease # of critical

violations

Environmental Health

Staff

560

Ongoing

2. Enforcement

# of clients

Environmental Health

Staff

33

Ongoing

3. Education and

planning

# of trainings & indi-

viduals trained

Environmental Health

Staff

0

As Requested

4. Purchase & train

staff on Electronic

Food Inspection Forms

# of staff trained

NDDoH

4

December 2017

14

2017 SERVICES

• 72 clients were provided with cessation classes through South- western District Health Unit. 40 individuals were referred to the North Dakota Tobacco Quitline-NDQUITS

• 14 of our 20 school districts remain comprehensive tobacco free.

• Southwestern District Health Unit guided a nursing home/assisted living center resources to become a smoke free facility.

• Provided direction for Human Service Center to become Smoke Free grounds facilities.

• Provided tobacco cessation classes to Human Service Center

• Provided tobacco retailer trainings and compliance checks for Dickinson businesses

• Educational resources and presentations to southwest area busi- nesses.

• Baby & Me Tobacco Free Program started at health unit

• Offered resources and education at several health and wellness booth days.

• Veterans Administration Clinic cessation resources given

• Attended Tobacco Use and Recovery with Mental Illness or Addic- tion Training-Dickinson

• Education to High School Students on Electronic Delivery Devices

15

From Left: Delores Roy,

Jennifer Schaeffer (Coor-

dinator), Danielle Roman-

ysyn

Goal: Decrease tobacco use Objective: To provide evidence based strategies to decrease number of individu- als using tobacco products in SWDHU counties through December 31, 2020

STRATEGIES EVALUATION RESPONSIBILITY PROGRESS COMPLETION DATE

1. Ask, advise, and refer clients that present

for SWDHU

All Staff Seeing Clients

6,562

(Increase 2,406 from

2016)

Ongoing

2. Fax in Quit Line rerferrals for clients

# of assessments

Nursing Staff

40

(Decrease 7 from 2016)

Ongoing

3. Support policy change

a. Tobacco program policy changes

# of policy changes

Director of Tobacco

Prevention

2

Ongoing

b. Policy changes in schools

# of policy changes in

schools

Director of Tobacco

Prevention

14 of 20 Schools

Ongoing

4. Provide Cessation

# of clients

Tobacco prevention

72 (Decrease of 8 from

2016)

Ongoing

16

ABOVE PHOTOS: Pandemic Over the Prairie Exercise

Goal: Develop and implement strategies to respond to emergencies and better protect the public Objective: Develop and support programs that address public health emergency preparedness by December 31, 2020

STRATEGIES EVALUATION RESPONSIBILITY PROGRESS COMPLETION

DATE

1. Expand Fit testing and PPE training for other com-

munity partners

# of community part-

ners that receive fit

testing

EPR Division

1,123

(Decrease 255 since

2016)

Ongoing

2. Sharps drop off points

# of containers

Enviornmental Health

Department

20

(Increase 5 since 2016)

Ongoing

3. Offer incident command training to community

partners

# trained

SWDHU Executive

Officer

154

(Increase 42 since

2016)

Ongoing

4. Coordinate coalitions for emergency response

# of coalitions and

meetings

EPR Division

6 Coalitions, 10 Meet-

ings (Same as 2016)

Ongoing

5. Coordinate Exercises with emergency managers

throughout SW North Dakota

# of exercises

EPR Division

4 Full Scale

(Increase 1 since 2016)

Ongoing

17

Goal: Enhance the ability to respond to emerging health issues

1. SWDHU partners with Upper Missouri District Health Unit (UMDHU) on Emergency

Preparedness, which covers 12 counties in Western ND

2. 1,123 first responders, medical entities were trained in Personal Protective Equip-

ment

3. 154 Responders were trained in Incident Command and 50 in Standard Awareness

4. There were 6 coalitions that met monthly to address various needs. They include:

Influenza/Medical, SW Disaster, Utilities, Behavioral Health, Ethics, and Homeless

5. SWDHU Coordinated four full-scale exercises within the SW region to train in re-

sponse to various disasters. Pandemic Over the Prairie had 307 participants with 17

medical entities and covered 12 counties

6. EPR staff responded to numerous incidents. There were 227 oil spills over Western

ND in 2017.

TOTAL OIL SPILLS - 2017

• Adams County: 0

• Billings County: 55

• Bowman County: 21

• Dunn County: 169

• Golden Valley County: 7

• Hettinger County: 1

• Slope County: 1

• Stark County: 23

• TOTAL: 227

TOP LEFT: Western EPR Staff TOP RIGHT: EPR Staff at Pod in October 2017

BOTTOM: Sherry Adams Assisting with Hurricane Harvey Response Effort in September 2017