[in person] Board of Health

Today we’re meeting in person at 333 S State St.

The presentation slide reads “Immunization Program Update” https://t.co/6dF0S77wJJ

We’re getting started, Dr. Carolyn Lopez is running the meeting and we’re first approving the minutes from the March 2022 meeting.

The first page of today’s agenda:

So far, in person meetings rock compared to online — I love an up-to-date agenda! https://t.co/tYVgkBhwzu

There were no substantial corrections — Just a typo on page 5. No objection to accepting the minutes, moving to commissioners update.

Megan Cunningham — Managing Deputy Commissioner — is here speaking on behalf of Arwady https://t.co/iKvErcWCDY

She’s offering to circulate a letter that CDPH co-signed to support vaccinations in the global south.

They recently submitted names to the mayors office for vetting, if approved they’ll be discussed by city council at the next meeting. If the committee advances them, they’ll be finally approved again by city council in May.

“CDPH continues to be keenly focused on how do we improve trauma-informed care,” Cunningham said. “We’ve seen tremendous success.”

“We’re scaling that project city wide to cover all 77 community areas to ensure all people who need it have access to trauma-informed care,” she said.

“Fortunately, as you see because we’re all gathered here together, Chicagos community risk level remains low,” Cunningham said.

“We have been laser focused on how to increase vaccination rates,” she said. Black Chicagoan’s have led in vaccine rates recently, she said, thanks in part to the call center that shares resources and helps book appointments.

“We’ve been seeing the results of that effort,” she said

They’re launching a program called “Dr Taylor’s Table,” that will be a live series intended to provide a direct means of communication with Black Chicagoan’s.

Cunningham wraps up her presentation

“I hope we begin to look for minorities to communicate with minorities,” said Dr Horace E Smith.

“You’re not going to reach that population if the people don’t trust you,” said Smith

“Those are critically important points and they’re top of mind for us,” Cunningham said. “Creating either new communication channels or figuring out what are those trusted communication channels and how we’re connected to them in a meaningful way” she said is their focus.

“That’s really the eye toward the future: how is this not just reactive toward COVID,” she said.

“What is our legal authority at this point?” Steven Rothschild asked about the CDPH ability to keep mask mandates on the CTA.

“I am actually not sure to what extent we are able to make some of those decisions,” Cunningham said. There will not be enforcement on any public transportation at this point, she said, but they’ll continue to encourage it. “That is going to be our message,” she said.

“That was a dodge but we’re going to keep looking into it,” Cunningham said.

“Politics and political people make these decisions — I think we start out wrong,” Smith said. “He’s the governor, but is he the source of what we should be doing?”

Smith blames the political influence of messaging on the lack of trust from people.

“Regardless of where that information is coming from, our job as CDPH is to figure out how we’re going to navigate that information,” Dr. Janet Lin said. “How do we balance safety with practicality in many ways.”

“At the time of a lot of swirling sources, people turn to their neighbors and people whose judgement they trust,” Matthew Davis said.

“It’s super important to try to bring voices of the public into those conversations,” he said.

“We want to make sure as a board that we hear what are CDPH’s own internal expectations about turn around and processing time,” he said.

CDPH Rep Response: Our expectation is that when the month is closed, the delegate agency will submit the voucher the next month for payment.

“That’s a timeline that applies to the program to do the work that’s necessary with the agency to make the work so smoother,” Cunningham said after seeing eyebrows raise at the month-long projection.

“This is an opportune time to actually look at the processes and make sure that at each step, people can at least explain why it’s there and not with an answer that’s ‘well this is how we’ve always done it’,” Lopez said.

Moving onto President Lopez’s presentation.

“As we begin to look at transitions, one of the transitions involves a really important group that exists within the DPH,” Lopez said, referencing the Partnership for Health in Chicago. Sheri Cohen is presenting.

The group has been around for over 20 years. “As you may know, through the partnership the CDPH does the community health assessment and the community health improvement program,” she said.

She’s hoping a board of health member will join the partnership, currently there are about 42 member organizations involved in the group. “We’re looking to invite more hyper-local organizations into the group,” she said.

“I’m not asking for a volunteer at this moment,” Lopez said. “I am asking people to really think hard about the possibility of participating.”

“Having attended some of these sessions, you would be amazed some of the things you learn because you’re actually looking at raw data that we end up getting [after it’s] filtered,” Lopez said. “It can be both enlightening and alarming.”

The next meeting is April 29th at 9am — “I’m very interested,” said Rosa E Martínez Colón.

That wraps up Lopez’s presentation.

“It’s fascinating that this is our presentation for today,” Lopez said.

Jacqueline Tiema-Massie, DrPHs, MPH, Immunization Program Director, is presenting. https://t.co/Ft4CSNaDDd

She’s giving a “broad overview of the immunization program that’s expanded since COVID,” she said.

“We’re partnering with Ever Thrive to build a speakers bureau,” she said, the bureau will include community members.

Goals/objectives/activities of Vaccines for Children (VFC) https://t.co/H9siXbl6VE

“One of the things I was very surprised about coming on board is how underfunded immunization is,” Tiema-Massie said.

“We will be advocating for more funding and it’s on the federal radar too,” she said. They’re trying to fill some staff vacancies: project coordinators, admin, nurses.

“I didn’t realize how hard it would be to recruit nurses,” she said.

“The VFC program seeks to provide free vaccines to parents and guardians who may not be able to afford them,” she said. Child must be under 18 y/o, and one of the following: medicaid eligible, uninsured, underinsured or American Indian or Alaska Native

They also provide direct services through “fast-track” services, Tiema-Massie said. They’re currently at Uptown WIC clinic and Greater Lawn WIC. https://t.co/qclBRpYhA5

“We did award EverThrive and ICAAP $1M” each, she said. https://t.co/3O92XLeBGp

From Sep-Dec 21, they held 86 flu/covid clinics, 7,748 flu vaccines and 4,126 covid vaccines. https://t.co/FTZwDfN2zY

Graph representing reported vaccine preventable diseases in Chicago from 2017-2022; https://t.co/OWWoXRbDhG

“Growing by leaps and bounds,” she said of the funding. https://t.co/Es1bvXuGS5

“Sometimes these fall to the background but they are occurring,” Tiema-Massie said of these program initiatives https://t.co/hGwerq5Pcr

“We’ve exceeded the CDC target” for site-visits, Tiema-Massie said.

CVQI initiative: To date, they’ve distributed over 2k report cards to provider systems. Second photo is a blurry example of a report card :) https://t.co/ibZXPsjnVd

“This project just kicked off and is underway,” she said. The program follows the Healthy Chicago regional model. https://t.co/xnRe23pQxv

Beginning Jan 2021, the VOC transition began https://t.co/29uzZiriiX

The Protect Chicago At Home Program has been “Very successful in the Far South and South regions,” she said. https://t.co/NdvYAIen5J

“We’re looking at other ways we can continue to use the at-home providers,” she said. The program has administered over 37k COVID vaccine doses.

Healthy Chicago Equity Zones https://t.co/jPiOBwxWlf

“When we look at the preliminary data we’re seeing where there are gaps,” she said.

“We’re going to use the data to have an open conversation about that,” Tiema-Massie said.

They’ve met with NYC, Houston, and DC on how to spread a similar program to their cities.

Vaccine incentive program: They’ve distributed over 61,000 gift cards and spent $3.7 Million in incentives. https://t.co/L2ejstADL6

The highlighted zip codes are those that they’re now intending to focus on for incentives. They’re also looking into a mail-in version of the incentive distribution rather than the face-to-face distribution that had safety concerns.

Immunization weeks in April: Next week (4/24-4/30) is World Health Immunization Week and National Infant Immunization Week https://t.co/cXivbWJN7I

And with that we’ve reached the end of the presentation — Lopez opens the floor to any questions.

Debra Wesley asks if there’s a way to work with DFSS to work on a combined messaging/outreach for youth

“I did some quick math from some of what you’ve shared,” said Matthew M Davis said. It’s costing about $1,000 for every vaccine, he said.

They’re working on building COVID into the usual CDC schedule of vaccination, so providers will have to administer the vaccine. “That is the goal” a rep said. “We’ve been under-funded for many, many years.” “That is the goal, for COVID-19 to become a regular, routine vaccine.”

Davis asks about hiring non-nurse individuals and training them to fill some of the vacancies — “CDC offered to support immunization programs nationwide to hire surge staffing,” Tiema-Massie said. “That was a team you didn’t see [on the chart] but that’s how we’re surviving.”

Joel Johnson said the board needs to focus on what role they have in “nudging the dialogue” on “how to build a bench to be prepared to serve” come the next pandemic.

“We’re talking about a program that really gets the families where parents can’t take time off, lower health literacy or they don’t have the health care provider in their community — so I always worry about when we try to quantify it,” Rothschild said.

“Do we have what percent of kids get the required vaccines by age 2 in each hyper-local area?” Rothschild said.

They do have it, a rep said (pictured), just haven’t had an opportunity to look at it during COVID. https://t.co/CMlqDC33qV

50% of the people they serve through the at home program are Black, she said. “There are still community areas at 60% vaccinated she said, and they’re hoping to provide the community with necessary information to say yes.”

“Is there legislative opportunities to start thinking about how do we demonstrate this?” Janet Lin said. She’s concerned about sustainability when a lot of the funding is available because of COVID.

“We’ve been meeting with congressional delegation over the past few weeks,” a Arwady rep said, they’re looking for funding that is flexible — not limited specifically to COVID or other specific uses.

Lopez asked if there are any other questions — seeing none, she’s answering a question about the board’s responsibility.

There is no public comment registered for today, but the board just received notice that their recommendations to the Mayor’s office were approved. Now those names will be put forward to council and they’ll be up for final approval in May.

There is no new business, so they’re moving onto old business. Lopez is addressing the AIDS Foundation Letter — “The thing I want to emphasize is: [whats] better than saying what we’re doing to do, is to do it,” Lopez said.

The meeting adjourns at 10:30am!

**DCFS