Board of Health Meeting Minutes December 3, 2018

Board President, Dr. John Harris, called the meeting to order at 5:35p.m., at the offices of the Sarpy/Cass Health Department, located at 701 Olson Drive, Ste. 101, Papillion, NE 68046.

Roll Call: Erin Ponec, Acting Recorder

Roll call States as follows: Demetria Geralds – absent; Dr. Brandon Grimm –; Dr. John Harris – present; Janet McCartney – present; Gary Mixan – present; Dr. Matt Neumann – not present (arrived at 5:40 pm); John Sheehan – present; John Warsing – excused.

Staff Present: Sarah Schram, Director; Jenny Steventon, Assistant Director; Erin Ponec, Acting Recorder.

Guests Present: Dean Lif, CPA, Lengemann & Associates, PC (Audit Firm)

Approval of Agenda: Per the Open Meetings Act the agenda may not be altered after 24 hours prior to the meeting, unless an emergency arises.

Sheehan moved, seconded by McCartney to approve agenda as submitted. Roll call states as follows: Geralds –absent; Dr. Grimm – aye ; Dr. Harris – aye; McCartney – aye; Mixan – aye; Dr. Neumann – not present ; Sheehan – aye; Warsing – excused.

Approval of Meeting Minutes:

Dr. Grimm moved, seconded by Sheehan to approve the September 24, 2018 meeting minutes as submitted. Roll call states as follows: Geralds –absent; Dr. Grimm – aye ; Dr. Harris – aye; McCartney – aye; Mixan – aye; Dr. Neumann – not present ; Sheehan – aye; Warsing – excused.

Audit Review - Fiscal Year Ending June 30, 2018, Dean Liff, CPA, Lengemann & Associates, PC:Dr. Grimm moved, seconded by Sheehan to accept the audit for Fiscal Year Ending June 30, 2018, as submitted. Roll call states as follows: Geralds –absent; Dr. Grimm – aye ; Dr. Harris – aye; McCartney – aye; Mixan – aye; Dr. Neumann – aye ; Sheehan – aye; Warsing – excused.

Presentation: Regional Health Council Update - Sarah Sjolie, Executive Director, Live Well Omaha

Treasurer’s Report:Nothing to report in lieu of the Audit Review

Director’s Report (Full Report is Included):See Attached

Other Business: Nothing to report

Standing Committee Reports: Nomination Committee: Dr. Arman Pajnigar, Internal Medicine, CHI Health, was nominated to serve as both a Sarpy County citizen and as the Medical Director. Sheehan moved, seconded by Dr. Grimm to accept the nomination of Dr. Pajnigar to serve in a dual capacity as a Sarpy County citizen and as the Medical Director. Geralds –absent; Dr. Grimm – aye ; Dr. Harris – aye; McCartney – aye; Mixan – aye; Dr. Neumann – aye ; Sheehan – aye; Warsing – excused. Finance Committee: Nothing to reportPolicy Committee: Nothing to report.Personnel Committee: See Executive SessionProgram Committee: Nothing to reportMedical Director’s Report: Nothing to report

Public Input: None

Information: Announcements: Demetria Geralds has submitted her resignation from the BOH, effective immediately. Sarpy County Commissioner Gary Mixan, has been given a new Board assignment by the Sarpy County Board; this is Mixan’s last BOH meeting. Commissioner David Klug will be the new County Board representative. His first meeting will be January 22, 2019.

Correspondence: None Next Meeting: January 28, 2019

Executive Session: Dr. Grimm moved, seconded by Sheehan to enter into Executive Session at 6:25 p.m. to discuss the annual evaluation for Sarah Schram, Director.

Dr. Harris moved, seconded by Sheehan to adjourn out of Executive Session at 6:30 p.m. Roll call states as follows: Geralds –absent; Dr. Grimm – aye ; Dr. Harris – aye; McCartney – aye; Mixan – aye; Dr. Neumann – aye ; Sheehan – aye; Warsing – excused.

McCartney moved, seconded by Dr. Harris to approve a 3% salary increase for Schram based off of her annual evaluation. Roll call states as follows: Geralds –absent; Dr. Grimm – aye ; Dr. Harris – aye; McCartney – aye; Mixan – aye; Dr. Neumann – aye ; Sheehan – aye; Warsing – excused.

Adjournment: Sheehan moved, seconded by Dr. Grimm to adjourn the meeting at 6:35. Roll call states as follows: Geralds –

absent; Dr. Grimm – aye ; Dr. Harris – aye; McCartney – aye; Mixan – aye; Dr. Neumann – aye ; Sheehan – aye; Warsing – excused.

ATTEST:

Dr. John Harris, PresidentSarpy/Cass Board of Health

John Sheehan, SecretarySarpy/Cass Board of Health

BOH Director’s ReportDecember 3, 2018

Administrative/Personnel Updates: Community Health Needs Assessment Outcome Report

o http://douglascountymetro.healthforecast.net/index.html Change Makers Summit – November 5, 2018

2018 CHNA Data was released The 3 regional LHD presented 2016 CHIP priorities and outcomes at Summit Initial prioritization occurred and identified the following priorities;

Adults: Mental health, Nutrition/Diabetes/Physical Activity, Access to health care services, Substance abuse, Injury/violence

Child/Adolescent: Mental health, Nutrition/Diabetes/Physical Activity, Access to health care services, Sexual health, Tobacco/Alcohol and Drugs

Community Health Improvement Plan (CHIP)o Partnering with Live Well to complete a number of community conversations and

surveys of residents to prioritize the list of five down to two or three. Nebraska DHHS Staffing Update

o Deputy Director Judy Martin retiring on January 23rd

Unless an interim is named all senior leadership positions at DHHS will be vacant.

Nebraska Statute 71-1628.05--Annual Report Submitted via NALHD on September 27 th. Sarpy/Cass Health Department WIC Office

o Starting in March services will be provided at the Health Department. WIC Breastfeeding Peer Counselor Update

o Goal is to hire 5 Breastfeeding Peer Counselors ($12/hour) and one Lead PC ($13/hour) QPR Statewide Advisory Board – BHECN (Behavioral Health Education Center of Nebraska)

o Creation of a state wide advisory board for the dissemination of QPR education via LHDs across the state over the next three years.

o Health Director will sit on board representing LHDs. Creighton University Master of Public Health External Advisory Board

o Five external member board helping to frame the public health experience for students. Grants Submitted:

o 2018 Strategic Prevention Framework-Partnership for Success – 5 year grant through Region 6. Budgeted amount of $99,300/year. This funding is focused towards prevention strategies for alcohol and marijuana use in youth. If awarded the Department would hire a full time Community Health Planner. Supports 7.5% of existing staff.

o Lead Poisoning Surveillance and Prevention – DHHS - $9,500 – community education and awareness of childhood lead poisoning.

o Radon Awareness and Risk Reduction – DHHS - $3,000 – community education and testing for radon.

2 Vacant Positionso Part-time Health Educator – open since November 2017o Full-time Health Educator – open since September 2018

Grants Awarded: Making Connections Year 3 - $3,800 – Funding from NALHD from Prevention Institute

o Goal 1: Promote upstream drivers of mental health and wellbeing for Veterans and Veteran families by connecting communities around Veteran issues and providing immediate and long-term outreach to families and their Veterans.

o Goal 2: Establish a culture of “Vets in all policies" at the local and state level. o Goal 3: Leverage and further-develop Local Health Departments’ (LHDs’) capacity to

enhance community-level infrastructure to support the specific mental health and wellbeing needs of Veterans and Veteran families.

Section/Program Highlights:

Disease Surveillanceo Acute Flaccid Myelitis (AFM)

First confirmed case in Nebraska One suspect case still pending review at CDC

See Public Health Report attached

Public Health Activity Report2018

New Cases of Reportable Diseases

Disease J F M A M J J A S O N DAcute Flaccid Myelitis 1 1Animal bite exposure 5 2 7 4 7 18 3 6Aseptic meningitis 4 1 1 2 2Campylobacteriosis 1 2 1 2 5 3 6Cryptosporidiosis 1 2 2 1 1 2 2Cyclosporiasis 1Enteropathic e. Coli 3 1 1 1 8 9 9 8 4Giardiasis 1 1 1 3 1 2Group A Strep 2 2 1 2 1 1Group B Strep 3 3 2 2 1 1 2Haemophilus influenza 1 1 1 1Hepatitis A, acute 1Hepatitis B virus infection 2 3 4 1 1 1 3 1 4Hepatitis B, acute 1Hepatitis C virus infection 5 6 11 7 11 5 3 12 9 13Hepatitis C, acute 1 1Histoplasmosis 3 3 1 1 2HUS 1Kawasaki Disease 1Lead poisoning 2 3 1 7 4 2 8 7 4Legionellosis 2 1 1Lyme Disease 1 1 1 2Pertussis 1 1 1 1 7Salmonellosis 1 4 5 3 2 4 3 5Shiga Toxin Producing E.coli 2 2 1 1 2 2 2

Shigellosis 1 1 1Spotted Fever Rickettsiosis 3 2Streptococcus pneumoniae 1 1 1Toxoplasmosis 1Tuberculosis 2

Disease J F M A M J J A S O N DTularemia 1Vibrio paraheemolyticus 1

Vibrio, non-cholera 1West Nile Encephalitis/ Meningitis 10 10 2

West Nile Fever 7 12 1Western Equine Encephalitis 1

Yersiniosis 1

School Surveillance

Date Total Absent Total Absent Rate

Flu Symptom

Rash/Fever

GI Illness Strep Asthma

9-5-18 543 1.67% 92 77 104 14 59-12-18 440 1.33% 67 82 86 9 29-19-18 430 1.32% 53 77 81 14 59-26-18 535 1.64% 58 82 90 14 310-3-18 572 1.76% 72 81 91 18 4

10-10-18 632 1.94% 87 83 101 22 410-17-18 636 1.95% 96 82 74 17 510-24-18 571 1.75% 73 75 101 21 210-31-18 462 1.42% 76 78 74 10 511-7-18 636 1.95% 99 103 103 13 2

11-14-18 719 2.21% 139 118 128 21 4

Based on a total enrollment of 32,554

Home Visits

MonthMaternal Child Health Active Aging

Cass Sarpy Cass Sarpy

January 2 7 4 10February 4 7 5 7March 2 7 4 5April 1 7 8 6May 3 4 4 9June 0 5 4 5July 0 2 6 9August 4 4 6 10September 0 5 7 6October 8 1 11 6

Child Passenger Safety Seat Installations

MonthNumber of Installations Number of Free Seats

Cass Sarpy Other Cass Sarpy OtherJanuary 0 2 4 0 1 0February 0 0 0 0 0 0March 2 14 4 1 2 0April 0 12 0 0 1 0May 2 6 2 2 0 2June 0 5 1 0 2 0July 0 8 1 0 0 0August 0 7 4 0 0 0September 0 8 1 0 1 0October 0 7 0 0 4 0

Active Aging Wellness Clinics

MonthNumber of Clinics Number of Clients Served

Cass Sarpy Other Cass Sarpy OtherJanuary 1 6 2 6 47 6February 3 5 2 24 33 11March 2 7 3 15 45 27April 3 7 3 26 52 24May 2 7 5 11 46 32June 3 7 4 28 48 32July 2 7 4 9 49 31August 3 7 4 26 53 30September 2 8 3 14 48 23October 3 7 3 18 50 21

Presentations

Program Number of Presentations

Number of Participants Topic

Health Hub 5 151 Breast Cancer Screening

Health Hub 1 35 Every Woman Matters Program Enrollment

Maternal Child Health 1 1 Breastfeeding, newborn, and postpartum care

Maternal Child Health 4 25 Adolescent girls’ healthMaternal Child Health 1 2 Breastfeeding 101Preparedness 1 3 Closed POD’s

Safe Kids 1 5 Transportation safety for childcare providers

Safe Kids 9 185 HandwashingSafe Kids 4 61 Child passenger safetySafe Kids 3 54 Bike and helmet safetySafe Kids 2 33 Sports and coach safetySafe Kids 2 64 Sun safetySafe Kids 1 248 Home safetySafe Kids 6 120 Pedestrian safetyGeneral 1 66 QPR suicide prevention

Program Highlights

January Oversight continued for the medication resistant tuberculosis patient. Health coaching calls were provided to 37 women engaged in modifiable health

programs through the Health Hub program. 289 educational letters were mailed to patients with blood lead levels under 5 µg/L. Preparations continued for the March assessment of the Department’s mass

dispensing and vaccination plans. The first sessions of the “Becoming a Mom” series began in Papillion.

Meetings attended: Lift Up Sarpy, the Nebraska Radon Task Force, CRI, ECC Working Group, T.E.A.M., Community of Practice, Safe Kids Douglas County, LiveWise, NALHD, OMMRS Healthcare Coalition, United Way Together Inc., Planning Region 23, Longterm Residential Care, Bellevue Early Childhood Care, and Cass County LEPC.

Trainings attended: United Way of the Midlands Grant Reviewer training and the No Wrong Door training.

February Oversight continued for the medication resistant tuberculosis patient. Coordination

occurred with DCHD on an interjurisdictional TB patient. Sputums were collected on a third TB patient.

Health coaching calls were provided to 31 women engaged in modifiable health programs through the Health Hub program.

241 educational letters were mailed to patients with blood lead levels under 5 µg/L. Preparations continued for the March assessment of the Department’s mass

dispensing and vaccination plans. “Becoming a Mom” series continued. Through a partnership with Milkworks, one

enrollee received a free breast pump.

Meetings attended: Cass County Inter-Agency, Sarpy County Head Start Health Services Advisory Committee, Nebraska Breastfeeding Coalition, CRI, T.E.A.M., the Nebraska Radon Task Force, State and Local Surveillance conference call, OMMRS Healthcare Coalition, Long-Term Residential Care, Sarpy County LEPC, South East Nebraska Healthcare Coalition.

Trainings attended: Elevated Blood Lead Level training, Multi-Agency Resource Center

March Oversight continued for the medication resistant tuberculosis patient. DOT began

this month on two additional patients with tuberculosis. Skin testing of close and

in-home contacts of both individuals were collected. Health coaching calls were provided to 42 women engaged in modifiable health

programs through the Health Hub program. Ten FOBT kits were distributed to the public. 328 educational letters were mailed to patients with blood lead levels under 5 µg/L. Department staff presented sports and hydration safety information to over 300

participants attending the Chandler View Elementary School Wellness Night. Department staff provided a variety of health education and information at the

Plattsmouth High School Health Fair on March 8. Department staff provided emergency preparedness information to students

attending the College of Public Health’s Opportunity Fair on March 29. Emergency Preparedness Coordinator conducting annual fit testing of N-95

respirators of all staff. The Department partnered with DHHS to provide one Swimming Pool Operator

training clinic at Midlands Hospital. Safe Kids Coordinator’s “Subaru Love Story”, which was written regarding the

program’s partnership with Beardmore to offer child passenger safety seat installations, was selected by the President of Subaru to be featured in their national publication of Drive Magazine.

Meetings attended: Cities Readiness Initiative, Tri-County Citizen Corp, Offutt full-scale exercise planning, Papillion-La Vista Community Schools Early Childhood Coalition, Sarpy County Head Start Health Services Advisory Committee, Nebraska Breastfeeding Coalition, Bellevue Early Childhood, T.E.A.M., the Nebraska Radon Task Force, State and Local Surveillance conference call, OMMRS Healthcare Coalition, OMMRS Pharmacy Committee, OMMRS Alternative Facilities, Foodbank for the Heartland, Cass County Head Start, Project Extra Mile, Nebraska Veteran and Family Task Force, Community of Practice, and United Way of the Midlands Grant Review meeting.

Trainings attended: NESIIS inventory management training, Transformative Leadership and Health Equity in Local Health Departments, Mining Demographics training, and OSHA Compliance.

April Information was provided across the Department’s social media outlets regarding

National Public Health Week, April 2-7. Staff represented the Department at a variety of community events throughout the week.

Oversight continued for the three patients with tuberculosis. DOPT (direct observation pediatric therapy) window treatment began on three children with

close contact of one of the active tuberculosis patients. DOT began this month on a fourth patient with extra-pulmonary tuberculosis. Skin testing of close and in-home contacts were collected.

Health coaching calls were provided to 15 women engaged in modifiable health programs through the Health Hub program.

Three FOBT kits were distributed to the public. 210 educational letters were mailed to patients with blood lead levels under 5 µg/L. MCH nurses are developing an educational brochure on perinatal mood and

anxiety disorders. One MCH nurse attended the Lactation Management preparation course in

anticipation of taking the board exam for the IBCLC in the fall. The Department partnered with DHHS to provide three Swimming Pool Operator

training clinics at Midlands Hospital. Safe Kids Sarpy/Cass received a $1,000 grant from the Walmart Community

Giving Grant to purchase additional child passenger safety seats. Also received a donation of 200 bottles of sunscreen and 200 bottles of hand sanitizer from a local Walgreens to distribute at Safe Kids summer safety events

Meetings attended: Health Hub, Immunization Task Force Steering Committee, Nebraska Breast and Cervical Cancer Control Program Advisory Committee, Sarpy County Head Start strategic planning, Douglas County Breastfeeding Advisory Meeting, MRC Steering Committee, Tri-County Citizen Corps, Federally Qualified Health Center meeting, TEAM, Citizen’s Committee to Provide a Safe and Healthy Community for the Youth of Gretna, and South East Nebraska Healthcare Coalition.

Trainings attended: QPR training, Minority Health Conference, Current Practices in Maternal Behavioral Health Conference, National Preparedness Summit, FMLA Compliance, Child Passenger Safety Technician update.

May Oversight continued for the seven patients with tuberculosis. Staff partnered with TEAM (Tobacco Education and Advocacy of the Midlands) in

a “Bag the Butts” event on May 31 in recognition of World No Tobacco Day. Staff picked up litter and cigarette butts in two parks in Gretna.

A new session of the “Becoming a Mom” series began in Papillion. MCH nurses began preparing a grant application through the Nebraska

Breastfeeding Coalition to provide breastfeeding support in Cass County. MCH nurses created an educational brochure about postpartum mood and anxiety

disorders. Safe Kids participated in the Sarpy County Head Start annual spring family event

and provided information and activities to over 200 attendees. The Emergency Preparedness Coordinator conducted partner planning meetings

with the Salvation Army, American Red Cross, and Region 6 Behavioral Health; created a variety of summer-related preparedness brochures; conducted outreach to restaurants regarding the use of placemats with emergency preparedness activities for children.

Health coaching calls were provided to 2 women engaged in modifiable health programs through the Health Hub program.

585 educational letters were mailed to patients with blood lead levels under 5 µg/L and three were mailed to those with levels over 5 µg/L.

Meetings attended: Meeting with Region 6 regarding collaborating on QPR training, Sarpy County Head Start Health Advisory Committee, Papillion-La Vista Schools Early Childhood Planning Region, Cass County Inter-Agency Meeting, Bellevue ECC, Cass County Head Start Health Advisory meeting, Nebraska Veteran and Family Task Force Meeting, OMMRS Emergency Coordination Center, MRC Steering Committee meeting, Tri-County PET Working Group, OMMRS Exercise Design Team, Offutt MARE full scale exercise planning meeting, Immunization Task Force Steering Committee, Susan G. Komen Breakfast meeting, and NALHD Health Hub quarterly meeting

Trainings attended: Nebraska Immunization Conference, Center for Preparedness Education’s Preparedness Symposium, Communications Planning, QPR training, Nebraska Public Health Lab/HEROS on High Consequence Pathogen training, and Nebraska Cancer Summit

June Oversight continued for the seven patients with tuberculosis. Coordination efforts

began in order to allow one active patient to travel abroad. Staff partnered with Sarpy County Head Start to provide a Head Start screening

day held in the Department’s office. MCH nurses began distributing breastfeeding materials to medical clinics as part of

a partnership with the Nebraska Breastfeeding Coalition. The Department received $25 per distributed packet.

VetSET Coordinator coordinated with Region 6 to host a Youth Mental Health First Aid training.

Health coaching calls were provided to 20 women engaged in modifiable health programs through the Health Hub program.

373 educational letters were mailed to patients with blood lead levels under 5 µg/L

and one was mailed to those with levels over 5 µg/L. The Environmental Health Specialist completed 39 swimming pool inspections. Under the Department’s West Nile Virus/Arbovirus Surveillance program, the

Environmental Health Specialist distributed over 1,500 packs of insect repellent and completed two rounds of mosquito trapping on June 4 and 18.

Department staff partnered with T.E.A.M. (Tobacco Education and Advocacy of the Midlands) to clean up cigarette litter in two parks in Gretna in recognition of National Kick Butts Day.

Staff applied for a $13,000 Accreditation Readiness grant through the Nebraska Office of Community Health and Performance Management.

Meetings attended: Offutt STD meeting, OMMRS Mass Fatality, OMMRS HCC, Sarpy PET, T.E.A.M., meeting with Seldin Management regarding hanging smoke alarms in the Chandler View apartment complex

Trainings attended: Developing Emotional Intelligence, Nebraska state-wide tabletop exercise, Youth Mental Health First Aid, Breastfeeding Support in the Community Setting, CityMatch webinar, Maternal Mental Health webinar, Mental Health Means a Stronger You webinar, Water Safety – Reaching At-Risk Children webinar

July Oversight continued for the seven patients with tuberculosis. Coordination efforts

began in order to allow one active patient to travel abroad. 69 health coaching calls were provided to women engaged in modifiable health

programs through the Health Hub program. 416 educational letters were mailed to patients with blood lead levels under 5 µg/L

and 7 were mailed to those with levels over 5 µg/L. Staff began completing nutrition assessments of Sarpy and Cass County grocery

and convenience stores as part of a partnership with CHI Midlands Hospital. The Department received a $2,000 grant from the Nebraska Breastfeeding

Coalition to promote and advance breastfeeding efforts in Cass County. The Environmental Health Specialist completed six swimming pool inspections and

set/collected 18 mosquito traps. Staff distributed information at a variety of community events, including the

Papillion Farmer’s Market, the Bellevue Schools/New Beginnings shopping event,

and No Wrong Door training. Safe Kids Sarpy/Cass Coordinator provided car seat installation demonstrations.

And distributed information at both the Ponca Tribe of Nebraska Baby Shower event and the Offutt Airman and Family Readiness Operation Backpack event. She provided and fitted 42 bike helmets at the Kids Crusin’ Kitchen lunch series in Bellevue.

Meetings attended: T.E.A.M. meetings, Billing Work Group meeting, HCOAD meeting, Child Passenger Safety Coalition meeting, and Sarpy PET.

Trainings attended: National Institute of Child Health and Human Development training, Healthcare Coalition Response Leadership training, and Behavioral Health Conference and tabletop exercise.

August Oversight continued for the seven patients with tuberculosis. Public health nurses collaborated with DHHS to investigate a cluster of Salmonella

Oranienburg. Public health nurses investigated 17 cases of West Nile Virus-related diseases. 453 educational letters were mailed to patients with blood lead levels under 5 µg/L

and 7 were mailed to those with levels over 5 µg/L. Enrollment began in the Cass County text messaging breastfeeding support

initiative. The Environmental Health Specialist set/collected 11 mosquito traps. The Emergency Preparedness Coordinator collaborated with Cass County EMA to

create and distribute vulnerable population forms to towns and villages. Safe Kids Sarpy/Cass Coordinator applied for the Safe Kids Buckle Up grant.

Meetings attended: OMHCC core planning group meeting, Sarpy County LEPC meeting, SENHCC meeting, HCOAD meeting, Tri-County Citizen Corps meeting, Nebraska Breastfeeding Coalition meeting, Community Breastfeeding Initiative grant recipients meeting, TEAM meetings, WNV mid-season conference call, Living Well conference call, and Citizen’s Committee to Provide a Safe and Healthy Community for the Youth of Gretna.

Trainings attended: Talking with Parents about Vaccines for Infants webinar, Improving Adult Immunizations webinar, Institute for Healthcare Improvement Virtual Expedition – the Psychology of Change trainings, Chronic Disease Self-Management – Living Well training.

September Oversight continued for the four patients with tuberculosis.

Influenza vaccine clinics were offered at Elmwood Murdock Schools and with the Sarpy County Head Start; a total of 18 vaccines were provided.

Public health nurses investigated 22 cases of West Nile Virus-related diseases. 386 educational letters were mailed to patients with blood lead levels under 5 µg/L

and 9 were mailed to those with levels over 5 µg/L. The Environmental Health Specialist set/collected 12 mosquito traps. Staff represented the Department at the St. Columbkille health fair. Michelle Leahy presented QPR suicide prevention training to Department staff.

Meetings attended: Planning Region 23 meeting, Cass County Inter-Agency meeting, maternal mental health webinar, Rural-Urban Differences in Delivery Systems in Population Health webinar, Safe Kids Nebraska Coalition meeting

October Oversight continued for the four patients with tuberculosis. An Influenza vaccine clinic was held at the Plattsmouth Early Childhood center for

center staff. The Cass County Breastfeeding Initiative continues with four pregnant women

receiving weekly text messages about pregnancy and breastfeeding. 137 educational letters were mailed to patients with blood lead levels under 5 µg/L

and 4 were mailed to those with levels over 5 µg/L. Safe Kids Coordinator taught a transportation course (DHHS requirement of

daycare facility that transports children) for a daycare center in La Vista. Safe Kids Coordinator presented home safety to 85 families attending the Sarpy

County Head Start’s Annual Fall Festival. Preparedness staff collaborated with the Douglas County Health Department and

Three Rives Health Department to offer a POD volunteer training for the UNMC Student Emergency Response Team.

Meetings attended: Sarpy County Head Start Health Services Advisory Committee, Bellevue University Nursing Advisory Board meeting, MRC Steering Committee, OMHCC meeting, Southeast Nebraska Regional Jurisdictional Risk Assessment meeting, Tri-County TEPW, American Red Cross planning meeting, Emergency Response Coordinator conference call, HCOAD meeting, CRI meeting

Trainings attended: Influenza webinar, Closed POD exercise, Depression During Pregnancy and Postpartum training, POD Planning and Response training