>> [GAVEL]
>> CHAIR: THIS IS HEALTH AND
HUMAN SERVICES CONTINUE. MDH HAS A SHORT PRESENTATION
ON INFECTIOUS
DISEASE OUTBREAK.. [INAUDIBLE] AS WELL. AND SO WHY
DON'T WE MOVED TO
THE TESTIFIER'S. MR. POLLOCK IS
HERE FROM
THE DEPARTMENT. YOU WANT TO MOVE
YOUR PRESENTATION? >> TESTIFIER: THANK YOU. DON
POLLOCK FOR MBH. LITTLE PIECE
AND ASK CHRIS TO DO
SOME BACKGROUND AND I'LL BE THE CLOSER AS WELL. I WANT TO THANK YOU MR. CHAIRMAN
AND YOUR STAFF ARE WORKING ON THIS ISSUE BUT OBVIOUSLY IT'S LATE IN THE SESSION THERE'S A LOT OF OTHER THINGS HAPPENING AT THE CAPITAL RIGHT NOW BUT MOST OF YOU SEE THE NEWS AND WE ARE CURRENTLY RESPONDING TO THREE SERIOUS DIFFERENT DISEASE OUTBREAKS
THAT REALLY REALISTICALLY REQUIRE SOME ADDITIONAL RESOURCES
TO CONTAIN. SO KRISTIN IS GOING TO GIVE
AN OVERVIEW OF THE CURRENT OUTBREAKS AND I'LL TALK A LITTLE BIT ABOUT CONTINGENCY
ACCOUNT IDEA.
>> CHAIR: WELCOME TO THE COMMITTEE THROUGH PLEASE INTRODUCE YOURSELF AND PROCEED
>> TESTIFIER: MY NAME IS
CHRIS ERISMAN DIRECTO
R OF INFECTIOUS DISEASE FOR MINNESOTA DEPARTMENT OF HEALTH. I MEANT TO GIVE YOU AN OVERVIEW OF WHAT WERE DOING WITH RIGHT NOW. I THINK MEASLES HAS PROBABLY BEEN IN THE NEWS QUITE A BIT
AND CAUGHT YOUR ATTENTION WE CURRENTLY HAVE 64 MEASLES CASES IDENTIFIED IN MINNESOTA.
THIS IS THE LARGEST OUTBREAK WE'VE SEEN IN NEARLY 30 YEARS.
WHAT WE ARE SEEING IS SUSCEPTIBLE
UNVACCINATED INDIVIDUALS. SO OF THOSE 64 CASES; 61
ARE UNVACCINATED.
WHEN YOU THINK ABOUT
64 CASES; IT'S IMPORTANT TO KEEP IN MIND WE ARE NOT JUST DOING WITH THOSE CASES. WERE DOING WITH THE 7000 PEOPLE WHO BEEN EXPOSED AND WE FOLLOW UP ON EACH OF THOSE EXPOSURE SITUATIONS TO ENSURE
THOSE INDIVIDUALS KNOW ABOUT
THEIR STATUS. IF
THERE ON SUSCEPTIBLE IF THERE IS A CHILD NOT VACCINATED; WE RECOMMEND THEY NOT ATTEND CHILDCARE. IF THE
HEALTHCARE SETTING THERE'S A NUMBER OF THINGS THAT NEED TO HAPPEN. AS YOU ARE THINK
ING ABOUT THE WORK AS WE ARE DESCRIBING THE CHALLENGES KEEP IN MIND THAT THE 64 CASES REPRESENT 7000 EXPOSURES.
THIS OUTBREAK HAS BEEN GOING ON SINCE APRIL 11. THE FIRST CASES WERE REPORTED TO US THEN
SO WERE JUST BE GETTING OUR
SIXTH WEEK
. WE'VE HAD STAFF WORKING EVERY SINGLE WEEKEND FOR THE PAST
FIVE WEEKENDS AND WORKING INTO
THE EVENING. THE NEXT OUTBREAK WE ARE DOING WITH HIS
MULTI-DRUG-RESISTANT TUBERCULOSIS.
TYPICALLY; AT THE DEPARTMENT WE SEE 1-2 CASES
OF MULTI-DRUG TV EACH YEAR. AS
YOU MAY BE AWARE; WE SEE
ANYWHERE FROM 150-200 CASES
OF TUBERCULOSIS EVERY YEAR.
MULTIDRUG-RESISTANT DISEASE IS
TB THAT IS
ACTUALLY RESISTANT TO AT LEAST TWO OF THE DRUGS
USED TO TREAT IT. THAT MEANS THE
TREATMENT INVOLVES THIS IS WHAT WE CALL SECOND LINE DRUGS. THEY ARE HARSHER BIT THE ENTIRE
LONGER THERAPY. CERTAINLY WE WANT TO
PREVENT MULTI-DRUG-RESISTANT TB FROM OCCURRING AND WE ALSO WANT TO MAKE SURE WE DON'T SEE A LOT
OF CASES. SO WITH THE CASE WE HAVE SEEN THIS YEAR WE'VE
HAD BETWEEN 2016-20 SOMETHING WE HAD NINE CASES
MULTIDRUG-RESISTANT TB. THEY BEEN IN THE HMONG
COMMUNITY AND MAINLY IN ELDERS IN
THAT COMMUNITY. OUR CONCERN
IS THAT THIS IS A VERY SERIOUS DISEASE AND BECAUSE OF THE CULTURAL
COMMUNAL MULTI GENERATIONAL
LIVING SITUATION WITH THE NEW FAMILIES WE HAVE THE POTENTIAL
TO HAVE A SPREAD TO CHILDREN AS
WELL AS ADULTS IN THEIR
MIDDLE YEARS.
RECOGNIZING HOW SERIOUS THIS WAS; WE DID INVITE CDC
TO COME IN
LATE FEBRUARY EARLY MARCH; TO PROVIDE SOME EXPERT
TECHNICAL ASSISTANCE TO US. AGAIN WE ARE TALKING ABOUT
NINE CASES OF MULTIDRUG
RESISTANT DISEASE. BUT WE ARE
JUST IN THE PROCESS OF SCREENING
250 INDIVIDUALS WHO WERE
POTENTIALLY EXPOSED TO SOME OF THOSE CASES. AGAIN; THE CASES
DON'T REFLECT ALL OF THE WORK
THAT'S REQUIRED TO CONTAIN
THE OUTBREAK. THEN SYPHILIS
IS ANOTHER-THE OTHER CONCERN WERE
DEALING WITH.
SYPHILIS CAN OBVIOUSLY CAUSE A NUMBER OF
SERIOUS
CONSEQUENCES BUT WHAT WE ARE MOST CONCERNED AB
OUT RECENTLY IS THAT POTENTIAL FOR
CONGENITAL SYPHILIS.
WE HAVE SEEN AN INCREASE IN SYPHILIS OVER THE LAST NUMBER OF YEARS
BUT
BETWEEN 2015 AND 2016 WE HAD A 30% INCREASE IN
SYPHILIS CASES. AS
WELL AS TYPICALLY WE DON'T
SEE ANY OR PERHAPS JUST ONE CONGENITAL SYPHILIS CASE.
WE
WENT FROM TWO CONGENITAL SYPHILIS CASES IN 2015 WHICH WE THOUGHT WAS BAD TO
; SIX AND 2016 SO OUR CONCERN
IS THAT WE ARE SEEING AN INCREASE
IN SYPHILIS.
LAST YEAR WE HAD 852 CASES. THIS YEAR WE'VE HAD
264 ALREADY. THOSE CASES ARE OCCURRING MORE FREQUENTLY IN WOMEN.
THE REASON THAT'S A CONCERN IS BECAUSE IF THEIR
CHILDBEARING AGE HAVE
THE POTENTIAL
FOR TRANSMISSION TO THEIR UNBORN BABIE
S. IN ADDITION TO THE GENERAL INCREASE IN SYPHILIS; WE HAVE ALSO SEEN
OUTBREAKS IN AMERICAN INDIANS. SO WE HAVE
AN OUTBREAK
CURRENTLY THAT'S ONGOING WITH 37 CASES IN MILLE
LACS COUNTY
AND SO THAT IS A CONCERN TO US AS
WELL. JUST TO IDENTIFY THAT THIS IS MORE THAN
OUR USUAL
WORKLOAD BECAUSE OBVIOUSLY; IN MY DIVISION WE DO INFECTIOUS DISEASE WORK EVERY SINGLE DAY. WE HAVE O
VER 70 STAFF WHO ARE WORKING ON MEASLES RESPONSE AND AS I MENTIONED A WORK EVENINGS AND WEEKENDS FOR THE LAST FIVE WEEKS.
WE HAVE 22 STAFF WERE DEDICATED TO WORKING ON THE
SYPHILIS RESPONSE. AS PART
OF THAT WE HAD
FOR OUTREACH SESSIONS IN MILLE LACS
AND OFFERED TESTING
FOR SYPHILIS FOR HEPATITIS C. WE DID
PREGNANCY TESTING. WE HAD
SYRINGES AVAILABLE. THAT IS THE KIND OF THING
THAT WE NEED TO CONTINUE IF WERE GOING TO GET
AHEAD OF THESE OUTBREAKS COULD THEN IN TERMS OF THE
TV RESPONSE; WE CURRENTL
Y HAVE 15 STAFF WORKING ON THAT ALTHOUGH WE ANTICIPATE IN THE NEXT WEEK OR SO WERE GONNA HAVE TO RAMP
THAT UP AS WELL. SO THAT
GIVES YOU-I REALIZE WE DON'T WANT TO MAKE YOU BE HER LATE INTO THE EVENING THAT GIVES YOU
A SENSE OF THE TYPE OF
INTENSITY OF WORK THAT'S OCCURRING.
IN ADDITION TO WHAT IS HAPPENING AT THE STATE HEALTH DEPARTMENT; OUR LOCAL PUBLIC HEALTH PARTNERS
ARE ALL ALSO PARTNERING WITH US.
WITH MEASLES; HENNEPIN COUNTY HAS HAD
50 STAFF WORKING
ON MEASLES. FOR THE LAST FIVE WEEKS. CROW
WING COUNTY LESUEUR COUNTY AND RAMSEY COUNTY HAVE BEEN
INVOLVED WITH MEASLES;
AND THEN AS I MENTIONED WITH THE TB
ST. PAUL RAMSEY COUNTY PUBLIC HEALTH IS INVOLVED AND
WITH SYPHILIS IT'S MULTIPLE COUNTIES BUT IT'S ALSO THE MILLE
LACS BAND
OF WHICH ARE WORKING WITH US ON THAT. SO IT'S NOT JUST
THE EFFORTS THAT THE STATE
HEALTH DEPARTMENT
ARE PUTTING IN BUT IT'S ALSO A PARTNERS AND LOCAL
PUBLIC HEALTH. >> TESTIFIER: ALL
CONCLUDE WITH THAT WE APPRECIATE THE
CONTINGENCY FUND..
THE PROPOSAL. OBVIOUSLY WE'VE DONE SOMETHING SIMILAR FOR
NATURAL DISASTERS IN MINNESOTA.
5 MILLION
IS PROBABLY ABOUT THE RIGHT AMOUNT
OF MONEY WHERE WE ARE SITTING TODAY WE THINK WE'VE INCURRED COST
OF ABOUT 2.7 MILLION FOR THE
THREE OUTBREAKS
THUS FAR. THAT ACTUALLY ALREADY EXCEEDS OUR GENERAL FUND APPROPRIATION IN THIS AREA. RIGHT NOW; WE BASICALLY [INAUDIBLE]
FEDERALLY FUNDED ACTIVITY TO
DO RESPONSE. THE
BILL THAT IS IN FRONT OF THE COMMITTEE DOES HAVEN'T
LA VIEW PROCESS AND
FAIRLY DETAILED
NOTIFICATION REQUIREMENTS. THERE WOULD STILL BE FAIRLY EXTENSIVE LEGISLATIVE INVOLVEMENT AND OVERSIGHT IN HOW WE USE EVERY DOLLAR COMING OUT OF
THIS FUN. SO HAPPY TO ANSWER QUESTIONS AND DISCUSS
THE NEED. >> CHAIR:
THANK YOU. I WOULD JUST
DIRECT MEMBERS TO THE FACT WERE NOT GOING TO ACT ON
THE BILL.I WILL
MOVE IT WHERE THE AMENDMENT BUT I WANT TO BRING A FURTHER DISCUSSION IN THE AMENDMENT
IS CLARIFICATION ON A COUPLE OF THINGS.
BUT FIRST; TO FIGURE OUT WHAT AN EMERGENCY IS
AND TO FIND
THAT AND-SO THAT WHEN AN OUTBREAK OCCURS THAT WE CAN KIND OF DEFINE THAT
AND PUT IT INTO ITS OWN CATEGORY.
ALTHOUGH IT DOESN'T SEEM LIKE IT; WE ARE NOT HERE MOST OF
THE TIME AND IF THAT
SHOULD HAPPEN WHEN THE LEGISLATURE IS NOT
IN SESSION;
HOW WE DO THAT; HOW WE DEAL
WITH THAT THE LAC IS A WAY FOR THIS TO
BECOME FUNDED FOR THE MONEY TO GET APPROVED AND MOVED THROUGH WITHOUT
THE LEGISLATURE NEEDING TO BE BACK
IN SESSION.
THE AUTHORIZING ENTITY TO BE ABLE TO DO THAT..
THE
AMENDMENT JUST DOES A LITTLE BIT
OF CLARIFICATION. IT PROVIDES MBH MUST
PROVIDE WRITTEN NOTICE TO
THE CHAIRS AND
MINORITY MEMBERS. THE EVENT REQUIRING PUBLIC HEALTH RESPONSE
THE PUBLIC WHERE THE PUBLIC MAY BE REQUIRED
AN ESTIMATE. HOURS
AND RESOURCES THE COMMISSIONER MAY NEED
TO DIVERT TO PROVIDE FOR
THAT RESPONSE.
SO WHAT WERE TRYING TO DO IS FIGURE OUT
WHERE THE LINE IS FOR AN OUTBREAK IN EMERGENCY RESPONSE BUT WOULD
REQUIRE THIS
AND TO HAVE OVERSIGHT OF THE FUNDS
; APPROVAL OF THE FUNDS; WHETHER OR NOT WE ARE IN SESSION KIND
OF MIMICKING SOMEWHAT
REPRESENTATIVE PELOWSKI'S LOOK
AT THE
-WITH BONDING IN TERMS OF BEING ABLE TO AVOID
A SPECIAL SESSION IN CASE OF
A DISASTER. BECAUSE OF THE
KIND OF EMERGENT NATURE OF THIS;
CAME LATER IN THE SESSION SO APPRECIATE THE
DEPARTMENT HELP IN PUTTING SOME LANGUA
GE TOGETHER IN A WAY THAT I THINK IS KIND OF A COMMONSENSE WAY TO RESPOND
TO THIS.
SO THAT'S KIND OF AN EXPIRATION OF THE BILL AND THE AMENDMENT AND KIND OF HOW WE GOT TO WHERE WE ARE. WE HAVE GOT
THE DEPARTMENT HERE TO ANSWER SPECIFIC QUESTIONS ABOUT THE
LATEST OUTBREAK. AND AS MR. POLLOCK SAID; IT'S NOT JUST
MEASLES THAT WERE LOOKING OUT RIGHT NOW; BUT A COUPLE
OF DIFFERENT
EMERGENCIES GOING ON IN THE STATE.
REPRESENTATIVE LIEBLING >> REPRESENTATIVE LIEBLING: I
THINK THIS IS A REALLY
GREAT IDEA.
I HOPE THAT IT CAN GO FORWARD. I HOPE IT CAN BE FUNDED AND PARTICULARLY AS YOU SAY THESE THINGS CAN ARISE FROM
WHEN WERE NOT
IN SESSION. WE NEED TO BE
ABLE TO MEET THESE NEEDS RATHER
QUICKLY SOMETIMES. BUT THE
REASON I RAISE MY HAND REALLY IS I JUST WANT TO
NOTE THAT IN THE BUDGET BI
LL THAT-WELL I DON'T KNOW WHERE WE ARE RIGHT NOW; BUT
I THINK THIS BUDGET BILL THAT CAME OUT OF
THE LEGISLATURE
ALSO CUT THE DEPARTMENT OF HEALTH AND I JUST
THINK THAT BECAUSE WERE
DOING HERE
THE DEPARTMENT OF HEALTH IS OFTEN DOING WITH
PREVENTION.. PREVENTION
IS NEVER A SEXY TOPIC. THIS IS SOMETHING THAT GOES ON BEHIND
THE SCENES
AND THAT'S KIND OF THE MAJOR WOR
K THE PUBLIC HEALTH IS TO KEEP THESE THINGS FROM HAPPENING IN THE FIRST PLACE.
SO I THINK IT'S REALLY IMPORTANT TO HAVE THIS RESPONSE
WHEN
PREVENTION FAILS. BUT I THINK WE ALSO NEED TO
RECOGNIZE THAT K
EEPING THE FUNDING ADEQUATE FOR OUR REALLY
; I THINK NATIONALLY RENOWNED DEPARTMENT OF HEALTH; IS
IMPORTANT. SO
WE CAN BE LEADING IN THAT AND PREVENT THESE THINGS; EVEN THOUGH NONE OF US GET CREDIT FOR IT WHEN THAT HAPPENS.
WHEN WE ARE JUST DOING THINGS THE WAY
WE SHOULD NOBODY GETS CREDIT FOR DOING THAT.
IT JUST SEEMS TO HAPPEN TO PEOPLE THINK IT'S JUST THE BACKGROUND. IN FACT; IT IS IN. THAT
IS THE EXTENSION OF LIFE SPAN AND THE FACT
THAT WE KIND OF MOST OF US EXPECT TO BE
GENERALLY HEALTHY AND SO ON. WE A PRETTY LONG
LIFE EXPECTANCY IS DUE TO PUBLIC
HEALTH WORK THAT KIND OF GOES ON IN THE BACKGROUND.
SO I JUST WANT TO MAKE THAT COMMENT. I DO HOPE WE CAN MOVE THIS FORWARD AND APPRECIATE YOU BRINGING THIS FORWARD MR. CHAIRMAN >> CHAIR: YES.
>> TESTIFIER: WE THINK PREVENTION IS A SEXY
TOPIC. [LAUGHING]
>> CHAIR: REPRESENTATIVE FISCHER >> REPRESENTATIVE FISCHER. I'D A COUPLE OF QUESTIONS FOR THE DEPARTMENT. I'M NOT SURE WHO DOES THE BEST TO ANSWER. IT SEEMS YOU FOLKS ARE QUITE BUSY WITH
ALL THESE EXPOSURES ETC. AND SOMETHING I KIND OF LIKE TO AND I HAVE AN IDEA
ON IS DIFFERENT DISEASES YOU HAVE DIFFERENT LENGTHS OF TIME
THAT
YOU TRACK PEOPLE FORGET WHAT I LIKE TO GET IS A GOOD IDEA WITH THE DIFFERENT EXPOSURES
IN THE DIFFERENT AREAS HOW LONG YOU HAVE TO TRACK PEOPLE FOR MEASLES VERSUS TUBERCULOSIS AND SYPHILIS ETC.
WHAT ALL GOES INTO THAT TYPE OF SITUATION?
>> TESTIFIER: YOU
ARE RIGHT. THE LENGTH OF TIME THAT WE
TRACK PEOPLE
DOES DIFFER AND IT HAS TO DO WIT
H THE INCUBATION PERIOD THE TIME WINTON SOMEONE IS EXPOSED AND DEVELOP SYMPTOMS. FOR INSTANCE; FOR MEASLES WE USE A 21 DAY WINDOW
AND THAT
IS BECAUSE WE EXPECT TO SEE ALL THE CASE OF MEASLES WERE GOING TO SEE FROM DAY ZERO
-DAY 21. SO THAT'S WHY WE HAD LAST CHILDREN TO STATE
OF CHILDCARE. IT'S FOR 21 DAYS.
WITH TUBERCULOSIS
TUBERCULOSIS ON THE OTHER HAND IT'S A MUCH
DIFFERENT SITUATION. IN FACT;
ST. PAUL RAMSEY COUNTY AND THE HEALTH OF HEAVEN JUST CONDUCTED
SCREENINGS LAST WEEK
WE ACTUALLY HAD TO WAIT A
CERTAIN 6-10 WEEKS A CERTAIN LENGTH OF TIME
AFTER EXPOSURE SO THAT WE KNEW THAT PEOPLE WHO
MIGHT DEVELOP
POSITIVE RESPONSES TO THE TESTING WE WOULD DO
HAD A CHANCE TO HAVE THAT HAPPEN.
THE FOLLOW-UP WE WILL NEED TO PROVIDING FOR THE TB CASES WILL BE UPWARDS OF TWO YEARS. SO THAT'S A VERY
DIFFERENT SITUATION. SO MEASLES
IS EXPLOSIVE.
AND TUBERCULOSIS IS REALLY KIND OF A SLOW
BURN. SYPHILIS;
IS KIND OF IN BETWEEN. I MEAN YOU'RE NOT WAITING-YOU DON'T HAVE
SUCH A LONG TIME BETWEEN
WHEN SOMEONE IS EXPOSED UNTIL THEY DEVELOP SYMPTOMS BUT BOTH BETWEEN THE TUBERCULOSIS IN A MEASLES YOU GET A SENSE OF DAYS TO WEEKS.
AND YEARS.
>>
REPRESENTATIVE FISCHER: YOU ARE
MENTIONING THAT YOU QUITE A FEW PEOPLE
WORKING OVERTIME
AND EXTRA PEOPLE WORKING ON THIS CASE GET
THIS I MEAN ARE CURRENTLY TAKING FROM OTHER FUNCTIONS AT THE DEPARTMENT TO ADDRESS
THESE ISSUES?
>> TESTIFIER:
YES. WHAT WE HAVE HAD TO DO IS HAD TO DIVERT
STAFF FROM WHAT WE WOULD CONSIDER TO BE A ROUTINE INFECTIOUS DISEASE WORK TO FOCUS THEM ON WHAT WE CONSIDER
TO BE SORT OF CRITICAL
IN CRISIS WORKER SO; YES THERE CERTAIN ACTIVITIES THAT ARE NOT HAPPENING.
CERTAIN GRANT REQUIREMENTS WE ARE NOT MEETING AT THIS POINT.
>>
REPRESENTATIVE FISCHER: ONE OF THE QUESTIONS I
HAVE IS AS THIS KIND OF ACCOUNT IS SET UP
FOR FUTURE DOES IT ADDRESS
[INAUDIBLE] SO WE DON'T LOSE
REGULAR DATE WORK THAT
IS OCCURRING OR; DOES THIS TAKE CARE OF LIKE OVERTIME AND THOSE KINDS OF THINGS THAT POP UP
TO EACH INDIVIDUAL SITUATION?
>> TESTIFIER:
MY UNDERSTANDING IS
THIS WOULD-THIS WOULD ALLOW US TO DO IS WE ARE NOT
ABLE TO AD
D FULL-TIME EQUIVALENTS; BUT WHAT IT ALLOWS US TO DO IS DEFINITELY ADDRESS ISSUES OF OVERTIME; BUT ALSO I
T ALLOWS US TO USE STAFF THAT WE CURRENTLY HAVE ON FEDERAL GRANTS
AND THEN BE ABLE TO
CHARGE BACK THERE TIME TO THE STATE FUND SO THE FEDERAL GRANT RESOURCES
ARE THERE AND THEN WE WOULD HAVE THE ABILITY
TO DO EITHER HIGHER OR TEMPORARY STAFF OR ASK
CDC TO EXTEND THE TIME
TO ACCOMPLISH GRANT DUTIES BUT IT WOULD GIVE US SOME OPTIONS IN
TERMS OF
BEING NIMBLE IN OUR RESPONSE AND ENSURING WE MEET
OUR FEDERAL GRANT OBLIGATIONS.
>> CHAIR: REPRESENTATIVE LOEFFLER >> REPRESENTATIVE LOEFFLER:
I WAS LOOKING AT THE LANGUAGE THAT
IS THE DDETERMINATION CRITERIA; AND I WONDERED IF
THE USE OF THE WORD; LARGE IN A COUPLE OF THE PLACES A LARGE NUMBER OF
DEATHS; SERIOUS INJURIES LONG-TERM DISABILITIES; SOME OF THOSE THINGS I'M WONDERING IF
SIGNIFICANT OR SOMETHING LIKE THAT. I'M THINKING OF LIKE
WHAT I'VE READ ABOUT
THE 1990 OUTBREAK
OF MEASLES AND THERE WERE THREE DESPERATE I THINK THREE DEATHS IS A LOT OF DEATHS
OF CHILDREN WHO OTHERWISE HAD PREVIOUSLY WERE HEALTHY.
BUT I DON'T KNOW IF EVERYONE
AGREES THAT TO DESCRIBE LARGE. AS
OPPOSED TO THE
BLACK PLAGUE THAT WIPED OUT 30-40% OF
THE PEOPLE SO I'M JUST WONDERING
IF YOU WOULD TAKE SOME TIME AT
SOME POINT TO JUST KIND OF ONCE AGAIN REVIEW THAT TO MAKE SURE THAT IT WOULD FIT THE
KIND OF CIRCUMSTANCES WE ARE TALKING ABOUT BECAUSE I THINK THAT
-WE DON'T WANT YOUR
HANDS TIED WHEN WE THINK WERE GIVING YOU A TOOL
AND THEN SOMEONE CHALLENGES
THE INTERPRETATION. I KNOW YOU HAVE
AN [INAUDIBLE] BUT NOT ON EVERYTHING SO I WANT TO MAKE
SURE YOU CAREFULLY
REVIEW THAT. THE OTHER THING I
WORRY ABOUT AND IT'S NOT ADDRESSED IN THIS BILL; BUT I REMEMBER WHEN
THE PANDEMIC
INFLUENZA WAS A THREAT AND EVERYBODY WAS MAKING
PROVISIONS ACROSS THE NATION INCLUDING IN OUR STATE LAW TO
QUARANTINE PEOPLE ONE OF THE ISSUES WAS
PEOPLE WHO WOULD LOSE
THEIR HOUSING BECAUSE THEY WOULD NOT GET A PAYCHEX OF ECONOMIC THEIR RENT.
I THINK THERE WAS SOME HARDSHI
PS IN CASES WHERE YOU CAN PROVIDE SOME MONEY TO DO THAT
AND COULD YOU EVER IMAGINE NEEDING
[INAUDIBLE] UNDER SOMETHING LIKE THIS. I MEAN I CAN IMAGINE SOME OF THOSE CHILDREN
WHO ARE FORBIDDEN TO GO TO CHILDCARE FOR 21 DAYS; THEIR PARENTS
MANY OF THEM
MAY WORK IN THEIR SITUATIONS WHERE YOU DON'T GET
SICK LEAVE
YOU DON'T GET PAID LEAVE; SO MOM HAS TO GO TO WORK
IF IT'S A SINGLE HOUSEHOLD.
MAYBE PROVIDING SOME KIND
OF BENEFIT MIGHT MAKE THE DIFFERENCE BETWEEN WHETHER
OR NOT THE
CHILD GOES OUT OF COMPLIANCE AND INFECTS OTHERS
AND
WHETHER THAT THEY BECOME HOMELESS AND END UP IN
OTHER SHOULDER. SO I'M JUST WONDER
ING IF YOU THOUGHT ABOUT THOSE KINDS OF THINGS THAT
MIGHT ARISE EVEN IN THIS TYPE OF
PAIN OUTBREAK?
>> TESTIFIER: JUST WITH
YOUR FIRST QUESTION; WE DID
INTERPRET THE;; OR; AS BEING
MULTIPLE; OR. YOU COULD
BE REASONABLY EXPECTED TO REQUIRE EVACUATION OF THE PROBABILITY
[INAUDIBLE] OR; WIDESPREAD EXPOSURE; OR. IN THAT CASE WE
FELT THAT IT
OFFERED FLEXIBILITY. IT IS TRUE THAT
THE DEFINITION OF OUTBREAK
IN THE DICTIONARY OF EPIDEMIOLOGY
WHICH I'M SURE YOU
DON'T HAVE ON YOUR SHELVES; BUT I DO; BUT
THE DEFINITION OF OUTBREAK IS MORE THAN EXPECTED. BUT I
THINK THIS OFFERS
ENOUGH FLEXIBILITY WITH
THE LANGUAGE I THINK WE ARE COVERED. THEN TO YOUR
QUESTION ABOUT
PROVIDING ASSISTANCE THAT
IS SOMETHING THAT HAS
COME UP IN OUR DISCUSSIONS IN PARTICULAR WITH
HENNEPIN COUNTY
WHERE THE MAJORITY OF THE CASES. I THINK THAT IS SOMETHING THEY WERE
LOOKING AT AND I WOULD THINK THAT IF THAT BECAME
AN EXPENSE I DON'T KNOW IF THAT WOULD BE COVERED UNDER THIS BECAUSE WE CAN
REIMBURSE COUNTY HEALTH BOARDS BUT I'M NOT SURE IF THAT WOULD BE COVERED
OR NOT. >> REPRESENTATIVE LOEFFLER
: I THINK WE NEED TO THINK ABOUT THAT. THESE THINGS TEND
TO UNFORTUNATELY CLUSTER IN VERY LOW INCOME POPULATIONS. I KNOW
DISEASE-RESISTANT TO
BE CASES WHICH HAVE FLORIST IN HOMELESS
POPULATIONS AND WHEN THEY
GO INTO CONGREGATE LIVING
IN SHELTERS; MATS ON THE FLOOR
; IT'S ALTHOUGH ALL OF A SUDDEN WE HAVE SOMETHING BECOME
MUCH BIGGER. JUST BECAUSE OF THE
LACK OF
ADEQUATE HOUSING. IF YOU KNOW SOMEONE
IS AFFECTED THAT'S ONE OF THE THINGS YOU HAVE TO ASK IF YOU HAVE
A HOME. WHO IS EXPOSED IN YOUR HOME AND I'M SURE YOU DO.
BUT FOR SOME OF THE TRANSIENT POPULATION WE
HAVE BEEN ABLE TO MAKE THAT RENT PAYMENT IS CAN MAKE THE
DIFFERENCE WHETHER THEY'RE IN A SHELTER OR WHETHER THEY STAY IN THAT APARTMENT.
>> CHAIR: REPRESENTATIVE PINTO
>> REPRESENTATIVE PINTO: I WANT TO ASK
ABOUT THE MEASLES OUTBREAK IN PARTICULAR.
THERE WAS
THE PROPOSAL A COUPLE WEEKS AGO NOW FOR ME POSITION
GRANTS PROGRAM AND HAS A LOOK AT THIS THAT WAS ON THE FIRST
AND THERE WAS ABOUT 30 MAY BE A FEW MORE THAN 30 CASES AT
THE TIME. NOW WE ARE UP
TO 62. SO IT 64 I GUESS. PART OF ME. BASICALLY DOUBLED IN A COUPLE WEEKS SINCE THAT PROPOSAL. HOW
WOULD THE I GUESS FIRST CAN
YOU PROVIDE HOW AR
E THE RESPONSE GOING IN TERMS OF SUPPORT
THAT THE DEPARTMENT IS RECEIVING AND THE FUNDS AVAILABLE
FOR THAT? CAN YOU COMMENT ON
THE PROPOSAL FOR A GRANT PROGRAM. I DO ONE OF THE OBJECTIONS WAS IT THAT WOULDN'T START UNTIL
I THINK TILL JULY 1. JUST WANTING
TO KNOW HAVE YOU PROVIDED SOME COMMENTS ON THAT PROPOSAL FROM JUST A COUPLE WEEKS AGO
SINCE WE HAVE MORE THAN A DOUBLING
OF CASES.
>> TESTIFIER:
I BELIEVE THE GRANT PROGRAM YOU'RE TALKING ABOUT IS REPRESENTATIVE OMAR'S
BILL $500;000. THE PROPOSAL YOU HAVE IN FRONT OF YOU WOULD NOT
INCLUDE GRANTS TO
COMMUNITY ORGANIZATIONS. THAT'S REALLY A PREVENTION STRATEGY VERSUS THE
RESPONSE ACTIVITIES THAT WE ARE ALREADY ENGAGING IN FOR THE
CURRENT OUTBREAK.
SO THEY ARE REALLY KIND OF TWO
SEPARATE CATEGORIES OF ACTIVITIES FOR
MBH AND THE WAY THIS IS WRITTEN THAT WOULD NOT BE INCLUDED.
>> REPRESENTATIVE PINTO:
MY UNDERSTANDING; THE
PROPOSAL IS WOULD NOT BE AS FOCUSED ON THE RESPONSE TO THIS
CURRENT OUTBREAK
; I GUESS OF THEM UNDERSTAND WHAT YOU'RE
SAYING CORRECTLY? MAYBE A
MISUNDERSTANDING YOU? >> TESTIFIER: THIS
BILL WOULD RESPOND TO THE CURRENT OUTBREAK BUT NOT TO THE PREVENTION EDUCATION ACTIVITIES
THAT WERE IN VISION AND A GRANT PROGRAM; THAT PROPOSAL FOR A NEW GRANT
TO HAVE COMMUNITY HEALTH WORKERS AND COMMITTEE ORGANIZATIONS DOING EDUCATION
IN THE SOMALIAN COMMUNITY
WHICH WAS MINOR SIN OF WHAT THAT PROPOSAL WOULD DO. >>
REPRESENTATIVE PINTO: WOULD THE-SO I GUESS DOES THAT A PERMANENT HAVE A POSITION
WERE CONCERN THEY HAD NOT EXPRESSED A POSITION ON THAT BILL.
DOES OUT DEPARTMENT HAVE A POSITION WHETHER THE PROPOSAL WOULD BE HELPFUL IN RESPONDING TO THIS
CURRENT OUTBREAK THAT'S DOUBLED IN THE LAST COUPLE WEEKS?
>> TESTIFIER: NO. WE DO NOT HAVE A POSITION ON THE BILL AT THE TIME AND HAVE NOT TODAY.
OUR FOCUS RIGHT NOW IS JUS
T GETTING THE COST WE'VE ALREADY INCURRED TO DATE FOR THE
RESPONSE ACTIVITY COVERED WE
ARE CERTAINLY HAPPY TO TALK ABOUT
ADDITIONAL ACTIVITIES THAT COULD B
E FUNDED WITH THESE DOLLARS BUT THE BILL
WOULD HAVE TO BE MODIFIED FURTHER.
>> CHAIR: THANK YOU. OTHER QUESTIONS FOR
THE DEPARTMENT? REPRESENTATIVE FISCHER >> REPRESENTATIVE FISCHER:
ONE OF THE QUESTIONS
THAT REPRESENTATIVE PINTO BROUGHT UP
TRIGGERED MY MIND AN
ADDITIONAL QUESTION.
YOU MENTIONED THAT THIS IS NOT APPLY TO ANYTHING
FOR PREVENTIVE
TYPE WORK. HOW DOES THAT WORK IN THE
SITUATION IF WE HAD A PANDEMIC FLU OUTBREAK THAT OCCURRED IN THE WAS A SPECIAL
VACCINE THEY HAD TO COME OUT WITH
IT DOES THAT MEAN THAT WOULD NOT BE COVERED AND LOOK AT HOW TO ADDRESS THAT SITUATION?
>
> TESTIFIER: I THINK THAT WOULD BE A BIT OF A DIFFERENT SITUATION AND I'M QUITE SURE THAT IF WE HAD
THE NEED-IF WE HAD IDENTIFIED THERE WAS A LACK OF A AVAILABILITY FOR
MMR VACCINE AND PEOPLE ARE
HAVING DIFFICULTY ACCESSING
THE VACCINE; THAT WE WOULD BE ABLE TO USE THESE FUNDS AS PART OF
THAT RESPONSE BUT I THINK THAT
WHAT REPRESENTATIVE PINTO WAS
TALKING ABOUT
AND COMMISSIONER PAULA; IS THE IDEA WITH
--FOR THE OUTREACH WOULD BE
A MUCH SORT OF
DIFFERENT APPROACH.. IT WOULD
NOT BE MASS VACCINATION JUST RESPOND TO MEASLES. WOULD
ACTUALLY INVOLVE
A LOT OF COMMUNITY OUTREACH
WORKING WITH PARTNERS AND THAT TYPE OF THING. IT HAS A LITTLE
DIFFERENT FLAVOR. I WOULD NOT WANT TO GIVE THE IMPRESSION WE DON'T DO SOME LEVEL OF PREVENTION DURING A RESPONSE
BUT THAT HAD A
MUCH MORE LONG-TERM
PERSPECTIVE THAN I THINK WE ARE LOOKING AT
WITH THIS
POTENTIAL LEGISLATION. >>
REPRESENTATIVE FISCHER: THANK YOU FOR THE CLARIFICATION BECAUSE I KNOW THAT WHILE WERE
FOCUSED ON
MEASLES AND THE TUBERCULO
SIS AND SYPHILIS RIGHT NOW; WE ARE ALSO TAKING A LOOK AT OTHER THINGS MAY HAPPEN DOWN THE ROAD AND I WANT TO MAKE SURE
WERE KEEPING THOSE OTHER THINGS IN MIND.
I APPRECIATE HEARING THAT RESPONSE AND
UNDERSTAND THAT WILL BE WAYS TO ADDRESS THAT TYPE OF SITUATION.
THANK YOU FOR THE CLARIFICATION.
>> CHAIR:
ALL RIGHT. REPRESENTATIVE MURPHY >>
REPRESENTATIVE MURPHY: I'M JUST
WONDERING IF THE FOLKS FROM THE PRIMITIVE HEALTH CAN GIVE US ANY SORT OF UPDATE
WITHOUT VIOLATING CONFIDENTIALITY ABOUT THE STATUS OF THE FOLKS
WITH MEASLES?
>> TESTIFIER:
YES. WE'VE HAD 16 OF THE 64 CASES HAVE BEEN
HOSPITALIZED AND USUALLY
THE COMPLICATIONS THEY EXPENSE THAT REQUIRE HOSPITALIZATION INCLUDE
DEHYDRATION AND
AMMONIA. SO SEEN A NUMBER OF CASES
OF PNEUMONIA
SECONDARY AMMONIA. THERE IS
ONE CHILD IS BEEN HOSPITALIZED FOR MORE THAN THREE WEEKS BECAUSE OF
THEIR PNEUMONIA. SO THAT'S WHAT YOU'RE LOOKING FOR TO GIVE YOU
A SENSE OF WHAT WE ARE SEEN SO
WE CAN-WE FEEL THIS IS
A SEVERE DISEASE AND THE WE'VE HAD
28% OF THE
CASES HOSPITALIZED. >> REPRESENTATIVE MURPHY: WHAT
IS THE COURSE OF TREATMENT FOR
CONGENITAL SYPHILIS?
>> TESTIFIER: THERE REALLY ISN'T A TREATMENT. IT WOULD BE
SUPPORTIVE CARE. IF A MOM IS
-IF A WOMAN IS PREGNANT
AND GET SYPHILIS AND THEN IS TREATED
FOR SYPHILIS;
IT DURING HER PREGNANCY; THAT CAN PREVENT
CONGENITAL SYPHILIS. AS A RESULT OF THE
CURRENT OUTBREAK THE DEPARTMENT
OF HEALTH IS MADE THE RECOMMENDATION WOMEN SHOULD BE SCREENED
THREE DIFFERENT TIMES DURING
THEIR PREGNANCIES WHICH IS ONE TIME
MORE THAN THE USUAL RECOMMENDATION BECAUSE OF WHAT WE ARE SEEING.
SO THE GOAL OF THAT
WOULD BE THAT WOMEN WOULD BE IDENTIFIED EARLY
IN GET ON TREATMENT AND THEN WE COULD PREVENT CONGENITAL
SYPHILIS BECAUSE WHEN A CHILD HAS
CONGENITAL SYPHILIS PROVIDE
SUPPORTIVE CARE.
>> CHAIR: REPRESENTATIVE JOHNSON
>> REPRESENTATIVE JOHNSON:
I DON'T HAVE A QUESTION BUT MORE OF A COMMONS.
I'M ACTUALLY HOPING WE CAN GO FORWARD
WITH THIS IDEA
THIS YEAR. BECAUSE I THINK IT'S THAT IMPORTANT.
THIS BILL GIVES THE AGENCY
THE ABILITY TO RESPOND TO
EVENTS THAT COULD OCCUR AT ANY TIME.
AND GIVES THEM THE FLEXIBILITY TO DO THE JOBS THEY NEED
TO DO DURING
THESE OUTBREAKS. SO I'M GLAD YOU BRINGING THIS FOR.
>> CHAIR: REPRESENTATIVE TRENDS ARE LOST. >> REPRESENTATIVE ZERWAS: I AM
JUST WONDERING IF WE CAN TALK A
LITTLE BIT--I SAW THERE WAS A
MEDIA REPORT THAT
TALKED ABOUT SOME OF THE
DAYCARE CENTERS AND THE FACT THAT MBH WAS
HAVING TROUBLE IN ONE OF THE I BELIEVE JUST ONE OF THE
DAYCARE CENTERS BEING NOT COOPERATIVE
AND WORKING WITH THE
DEPARTMENT; AND SOME OF
THE RECOMMENDATIONS
WERE REQUESTS THAT A PERMIT HAD. I WONDER IF
YOU CAN TAKE US THROUGH
WITH THE DAYCARE CENTER
INVOLVEMENT WAS; HOW THE
DEPARTMENT RESPONDS TO A SCENARIO
LIKE THAT; WITH SOME OF
THOSE REQUESTS OR
RECOMMENDATIONS ARE AND THEN
THE INSTANCE WHERE THE DAYCARE CENTER APPARENTLY
OR LEAST
REPORTEDLY WAS EITHER NONRESPONSIVE
OR NON-COOPERATIVE?
>> TESTIFIER: YES; WE'VE HAD
A 11 DAYCARE CENTERS THAT HAVE
HAD
EXPOSURES AND 10 OF THOSE CENTERS HAVE BEEN WONDERFULLY COOPERATIVE. WE DID HAVE ONE CENTER WHERE WE HAD DIFFICULTY
. WE TRY TO WORK WITH THEM FOR
TWO WEEKS TO TRY TO GET THE INFORMATION WE NEEDED
AND WHAT WE NEED FROM CHILDCARE
CENTERS IS; IF WE HAVE
A CASE IN THEIR CENTER WE NEED TO GET A LIST OF ALL THE CHILDREN
THAT ATTEND AS WELL AS THEIR VACCINAT
ION STATUS. THAT WAY; WE CAN LOOK AND SEE WHO
IS SUSCEPTIBLE. WHO IS IN ATTENDANCE; AND WHO IS
POTENTIALLY EXPOSED SO WE CAN LOOK AT WHEN
THE ORIGINAL CASE WAS AT CHILDCARE WHEN
CHILDREN WERE SHARING AIRSPACE WITH
THEM. WHAT WE WERE HAVING DIFFICULTY WITH THIS PARTICULAR CHILDCARE CENTER WAS
GETTING COMPLETE
LIST. SO THEY GIVE US A
PARTIAL ROSTER.. MAYBE 40 KIDS ON IT. THEN WE KNEW IT WAS
INCOMPLETE BECAUSE SOME OF THE KIDS WE
KNEW THAT HAD MEASLES THAT HAD ATTENDED THE CENTER WERE NOT ON THE LIST
. MULTIPLE PHONE
CALLS; VISITS; VISITS WITH OUR SOMALIAN STAFF.
I FELT THAT OUR STAFF HAD REALLY DONE
A GREAT JOB OF REACHING OUT TO
THE CENTER. WHEN WE WERE NOT GETTING THE COOPERATION WE NEEDED AND WE REALLY FEARED THAT WE WERE
GOING TO-THIS WAS GOING TO EXTEND THE
OUTBREAK UNNECESSARILY;
WE HAD BEEN WORKING WITH THE DEPARTMENT OF HUMAN SERVICES ALL ALONG ON
THIS OUTBREAK. SO WE WORKED WITH THEM AND THEY ISSUED A
TEMPORARY SUSPENSION FOR THE CENTER SO THEY TEMPORARILY SUSPENDED
THEIR LICENSE AND THAT LICENSE WAS SUSPENDED LAST
THURSDAY AFTERNOON. THEY
ARE BACK.. THEY ARE BACK IN BUSINESS TODAY. SO REALLY THERE LICENSE WAS SUSPENDED UNTIL WE
HAD TIME TO GET RECORDS
FROM THEM; CHECK THOSE RECORDS; IDENTIFY WAS AT RISK; THAT TYPE
OF THING. SO WE FELT THAT
IT WAS-IT WORKED WELL TO WORK WITH DHS. THEY WERE EXCEPTIONALLY HELPFUL TO US WE FELT THAT IT
WAS THE SORT OF THE BEST
CASE SCENARIO. THERE WERE
CERTAINLY SANCTIONS.
WE FELT THAT BECAUSE THE CENTER WAS
NOT COOPERATIVE
BUT ALL THE OTHERS WERE IT WASN'T FAIR
TO THEM. THAT
DISSENTER WAS NOT DOING THE RIGHT THING.
SO BY SUSPENDING THEIR LICENSE FOR
FIVE DAYS I THINK IT GOT THE MESSAGE ACROSS. WE GOT THE INFORMATION WE NEEDED AND THEY
ARE BACK SERVING THEIR
CLIENTS NOW.
>>
REPRESENTATIVE ZERWAS: YOU FOR THE BACKGROUND INFORMATION.
SO WHEN YOU GET A REPORT THAT;
FIRST A LICENSED
DAYCARE CENTER THERE HAS BEEN A REPORT OF
A CHILD IT'S BEEN THERE THAT
NOW HAS SERIOUS INFECTIOUS DISEASE
LIKE MEASLES;
IS THERE SOMETHING THAT THE DEPARTMENT
OF HEALTH; OR; DEPARTMENT OF
HUMAN SERVICES DOES TO NOTIFY
THE OTHER
OR ATTENDEES? IS THERE A POSTING OR IS THERE
A LETTER THAT
SENT OUT? I GUESS ONE OF MY CONCERNS IS WHILE THE
DAYS INTERVENE WHEN YOU'RE GETTING INCOMPLETE
LISTS OR NOT ALL
THE INFORMATION; ARE THERE FAMILIES THAT
ARE PERHAPS CONTINUING TO BRING THEIR
CHILDREN THERE THAT DON'T KNOW
THAT THERE HAS BEEN REPORTED
ACTIVE CASES OF
THE MEASLES AT THIS
DAYCARE FACILITY? EITHER BECAUSE WE'VE NOT BEEN ABLE TO NOTIFY
THEM;; OR IT IS IN OUR PROTOCOL. JUST TO NOTIFY
ALL THE
FAMILIES OR WHAT DOES THAT PART OF IT LOOK LIKE?
>> TESTIFIER:
YES. WHEN WE GOT THE INCOMPLETE LIST
WE WORKED WITH OUT LIST AND NOTIFY THE PEOPLE THAT WE HAD
BUT THEN WE WENT BACK TO THEM AND ASKED
FOR MORE AND
WE CONTINUE TO TRY TO GET INFORMATION FROM THEM BUT YOU ARE RIGHT. UNTIL WE HAVE COMPLETE INFORMATION
WE ARE UNABLE TO MAKE A
COMPLETE NOTIFICATION AND
THAT'S WHY WE FELT IT WAS NECESSARY TO
WORK WITH OUR PARTNER DEPARTMENT OF
HUMAN SERVICES TO TAKE ACTION.
>> REPRESENTATIVE ZERWAS JUST A FINAL COMMENT I GUESS.
HOPEFULLY; AS
THIS OUTBREAK REACHES ITS PEAK AND THINGS
CALM DOWN AS WE WORK INTO THE SUMMER AND YOU LOOK
BACK DEBRIEF THE SCENARIO;
I THINK THERE'S
AN OPPORTUNITY. IF THERE'S ANY TOOLS
TO FOR FURTHER LEGISLATION THAT WE NEED TO PROVIDE
EITHER THE DEPARTMENT
OF HEALTH OR THE DEPARTMENT OF
HUMAN SERVICES TO GO THROUGH THAT PROCESS IN
A MORE
EXPEDITIOUS FASHION. BECAUSE I REALLY BIG CONCERN OF
THE IDEA OF
UNSUSPECTING PARENTS THAT
ARE CONTINUING TO DROP THEIR CHILD OFF
PER USUAL AND PERHAPS NOT AWARE THAT
NOT ONLY IS THERE BEEN A CASE OF
THE
MEASLES; BUT THERE'S ACTIVE CASES OF THE MEASLES AND THAT
DAYCARE CENTER;
THAT DAY; CONTINUE
TO BE NOT RESPONSIVE OR NOT COOPERATIVE
WITH THE DEPARTMENT
OF HEALTH AND TRYING TO STEM THAT OUTBREAK.
I THINK THE PARENTS
WERE AWARE OF THAT INFORMATION MY
GUESSES THERE CENSUS WOULD'VE DROPPED
PRETTY DRAMATICALLY. SO
I'M WONDERING; AS WE KIND OF
LOOK AT DEBRIEF OF ALL OF THIS; IF THERE'S A WAY TO KIND OF
REPORT BACK WHETHER CHAIRMAN
DEAN OR RANKING
MINORITY MEMBERS AS WELL; JUST IF THERE'S A PROCESS
THAT COULD BE TIGHTENED
THERE FOR FAMILY PROTECTIONS AROUND
PEOPLE THAT
-YOUR BRINGING A CHILD TO A LICENSE
DAYCARE FACILITY. YOU ASSUME
THAT WE ARE DOING EVERYTHING
WE CAN AND IT JUST MAKES
ME NERVOUS WHEN THERE'S GAPS LIKE THAT.
>> CHAIR: REPRESENTATIVE SCHULTZ >>
REPRESENTATIVE SCHULTZ: SO WHAT OUR HOSPITALS ARE DOING
RIGHT NOW TO MAKE SURE
THAT THERE
LIMITING TRANSMISSIONS WITHIN THE HOSPITAL? DOES MDH WORK WITH HOSPITALS ON POLICY?
>> TESTIFIER:
YES. WE ARE WORKING WITH HOSPITALS AND
THERE'S A COUPLE THINGS THAT
ARE HAPPENING
IN THE HOSPITAL AND HEALTHCARE SETTING.
AS YOU MAY HAVE HEARD IN THE NEWS
THERE SEVERAL HEALTH SYSTEMS THAT ARE ACTUALLY RESTRICTED
VISITORS TO
THEIR FACILITIES IN AN ATTEMPT TO
MINIMIZE THE POTENTIAL FOR EXPOSURE TO
AT RISK COMPROMISED PATIENTS.
BUT WHEN WE HAVE AN EXPOSURE IN THE HEALTHCARE SETTING WE WORK WITH
THAT FACILITY TO
KIND OF TALK THEM THROUGH THE STEPS OF HOW THEY NEED TO RESPOND.
THAT INCLUDES IDENTIFYING ALL THE PATIENTS WHO MAY HAVE BEEN EXPOSED AND THAT'S WHY WHEN WE TALK ABOUT THE WORKLOAD; IT'S
QUITE EXTENSIVE. WE GO THROUGH THE EXPOSURE SITUATION WITH THEM; WHO MAY HAVE BEEN EXPOSED WHAT PATIENTS; WHAT WAS THEIR IMMUNIZATION STATUS
. THAT TYPE OF THING. THE HEALTHCARE SETTINGS WILL OFTENTIMES THEN
THEY WILL CONTACT
THESE INDIVIDUALS AND OFFER POST
WHAT'S
CALLED POST EXPOSURE PROPHYLACTICS WHICH MEANS IF THEY CAN GETEITHER VACCINE
OR IT
IMMUNE GLOBULIN DEPENDING ON THE PERSON THE
INDIVIDUAL STATUS; INTO A PERSON THAT CAN
SOMETIMES HELP TO MITIG
ATE MEASLES AND PREVENT IT FROM HAPPENING SO THAT IS SOMETHING THEY ARE WORKING ON. WE ALSO
HA
VE WORKED WITH THEM ON JUST GENERAL PROCEDURES FOR TAKING CARE OF PATIENTS WITH MEASLES. A LOT OF FACILITIES NOW HAVE
GREETERS TH
AT MEET PATIENTS WHEN THEY COME IN THE DOOR. THEY
ESTIMATE IMMEDIATELY; ALL IN THE ATTEMPT TO MINIMIZE THE POTENTIAL FOR EXPOSURE.
BECAUSE MUSES MEASLES
IS TRANSMITTED BY THE
RESPIRATORY ROUTE.. WEAVE A STRUCTURE THAT INCLUDES
THE EPIDEMIOLOGIST AND PEOPLE
WORKING WITH SCHOOL AND
DAYCARE AND WE HAVE A TEAM
THAT WORKS HEALTHCARE FACILITIES. WE HAVE A WEEKLY CALL WITH
THE INFECTION
PREVENTION IS TO GO OVER ANY CONCERNS THEY
MIGHT HAVE WE JUST HAD IT TODAY. WE ARE VERY INVOLVED IN WORKING WITH HEALTHCARE FACILITIES IN
TERMS OF BOTH ONE-ON-ONE WHEN THEY HAVE AN EXPOSURE AND THEN MORE BROADLY TO ADDRESS QUESTIONS THEY MIGHT HAVE RELATED TO MEASLES.
>> REPRESENTATIVE SCHULTZ:
THANK YOU. HOW MANY MEMBERS OF
YOUR ORGANIZATION
MDH ARE WORK
ING ON THIS RIGHT NOW AND HOW MANY OF THEM HAD TO BE PULLED FROM OTHER AREAS TO WORK ON THIS OUTBREAK OF MEASLES?
>> TESTIFIER: WE HAVE ABOUT 70 PEOPLE CURRENTLY WORKING
ON MEASLES AND THAT INCLUDES OUR
LABORATORY STAFF.. OBVIOUSLY WE CAN
SWITCH OUT THOSE STAFF BUT WE DO HAVE STAFF WHO'VE COME FROM OUR HEALTHCARE ASSOCIATED SECTIONS AREA
WE HAVE STAFF THAT OF COME FROM OUR
EMERGING INFECTIONS FROM FOODBORNE. WE REALLY HAVE PULLED STAFF FROM
JUST ABOUT EVERY AREA WITHIN THE DIVISION WITH THE EXCEPTION OF TUBERCULOSIS AND
STDS BECAUSE THEY ARE BUSY
WORKING ON THEIR OWN SITUATION.
>> REPRESENTATIVE SCHULTZ: I AM
CONCERNED THAT THIS NUMBER HAS DOUBLED IN THE LAST FEW WEEKS.
IS THERE A NUMBER WHERE YOU GET
REALLY CONCERNED THAT COULD
TAKE
OFF EXPENSIVELY? IS THERE A THRESHOLD WE BECOME EVEN MORE CONCERNED
AND NEED TO PULL MORE
STAFF IN AN ADDRESS AND IT;; THE OPERATE?
>> TESTIFIER: I WOULD SAY
WE ARE DEFINITELY CONCERNED THAT
64 CASES AS WE'VE
TALKED ABOUT THIS MANY MORE CASES THAN WE'VE SEEN IN THE LAST
27 YEARS. IN 1990 WHEN WE HAD A LARGE OUTBREAK I WAS A GRADUATE STUDENT WORKER AT
THAT APARTMENT. SO THIS IS THE BIGGEST OUTBREAK I'VE SEEN IN MY CAREER SINCE THAT TIME. IN
TERMS OF IS THERE A NUMBER
THAT REALLY CONCERNS US;
I THINK WHAT WE WORRY ABOUT IS THAT WE
DON'T KNOW WHICH CASE
WILL HAVE THE UNDERLYING HEALTH CONDITIONS THAT MAY RESULT IN
A DEATH OR MAY RESULT IN A VERY
SERIOUS SITUATION.
ANY TIME YOU ARE ADDING TO THE NUMBER OF CASES YOU ARE JUST ADDING THE PROBABILITY THAT COULD HAPPEN.
BUT WHAT WE DO HAVE THAT'S
AN ADVANTAGE IS AS YOU GET
YOUR SYSTEM READY
TO GO AND TO RESPOND YOU BECOME MORE EFFICIENT IN RESPONSE
. SO I WOULD SAY AS CASES ARE GOING UP
OUR EFFICIENCY IS INCREASING
AS WELL. SO; YES; I THINK WE ARE
IN A GOOD PLACE RIGHT NOW IN
TERMS OF OUR ABILITY
TO RESPOND BUT I AM CONCERNED THIS IS GOING TO GO ON FOR MANY
MORE WEEKS. THAT DOES CONCERN ME JUST BECAUSE OF PEOPLE JUST
GETTING EXHAUSTED.
>> REPRESENTATIVE SCHULTZ ALSO COMPARED TO 1990 WE MORE PEOPLE THAT ARE NOT VACCINATED?
>> TESTIFIER: WELL ACTUALLY;
NO. WHAT HAPPENED IN 1990; THAT OUTBREAK IS
REALLY CAUSED BY UNVACCINATED PRESCHOOL CHILDREN
BUT THAT OUTBREAK WAS REALLY
DRIVEN BY ISSUES OF ACCESS TO
CARE AND THERE'S A VACCINE FOR CHILDREN PROGRAM THAT WAS INITIATED AT THE FEDERAL LEVEL IN 1993. THAT HAS REALLY ADDRESSED
DISPARITIES IN IMMUNIZATION BASED ON ACCESS
TO CARE. WHAT WE ARE SEEING WITH THIS OUTBREAK IS
REALLY OUTBREAK THAT'S DRIVEN B
Y INDIVIDUALS CHOOSING NOT TO BE VACCINATED AND I THINK IN THE CASE OF THE SOMALIAN COMMUNITY BASED ON MISINFORMATION
. WHEN YOU GET
THOSE POCKETS OF THOSE CLUSTERS OF UNVACCINATED INDIVIDUALS THAT ALLOWS OUTBREAKS TO REALLY TAKE HOLD
AND SPREAD. >> CHAIR: ALL RIGHT. NEXT UP
WE LOVE PUNISHMENT EXECUTIVE DIRECTOR OF LOCAL PUBLIC
HEALTH ASSOCIATION. WELCOME TO TH
E COMMITTEE. PLEASE INTRODUCE YOURSELF WITH A RECORD AND PROCEED.
>> TESTIFIER: THANK YOU
. MY NAME IS
LORNA SCHMIDT I'M THE DIRECTOR OF LOCAL PUBLIC HEALTH ASSOCIATION OF MINNESOTA. H
ERE TODAY ON BEHALF OF LOCAL PUBLIC HEALTH DEPARTMENT ACROSS ALL
87 COUNTIES
AND TRIBAL NATIONS. I'M AWARE I
MAY BE THE LAST THING BETWEEN YOU AND HOME RIGHT NOW SO I WILL BE BRIEF.
WE APPRECIATE THE INCREASED ATTENTION THAT'S BEEN GIVEN TO LOCAL PUBLIC HEALTH FUNDING
LI
KE THE CURRENT MEASLES OUTBREAK THAT WE PUT ADDITIONAL STRESS AND ALREADY STRESSED
THE SUM. LOCAL PUBLIC HEALTH GOVERNMENTS ARE STATUTORILY MANDATED TO PREVENT THE
SPREAD OF INFECTIOUS DISEASE. EVEN
IN COUNTIES MAKE THE CASES HAVEN'T YET BEEN CONFIRMED LOCAL DEPARTMENTS ARE SPENDING
BEGIN TIME
AND RESOURCES WORKING WITH COMMUNITY PARTNERS TO RAISE AWARENESS OF THE IMPORTANCE
OF VACCINES AND BE PREPARED TO RESPOND QUICKLY IF OR WHEN THE
CASE OCCURS.
THESE ADDITIONAL EXPENSES OFTEN FALL ON LOCAL TAX LEVIES. WHICH ALREADY MAKE UP THE SINGLE LARGEST SOURCE OF FUNDING FOR LOCAL PUBLIC HEALTH. THE PROPOSAL BEFORE YOU WOULD PROVIDE CRITICAL
FUNDING TO AUGMENT OUTBREAK RESPONSE EFFORTS IN THE SHORT TERM.
YOU WOULD NOT HOWEVER DIMINISH THE NEED F
OR LONGER-TERM STATEWIDE INVESTMENT IN A PUBLIC
HEALTH SYSTEM. MANY OUTBREAKS LIKE MEASLES ARE PREVENTABLE.
MEASLES ISN'T THE
ONLY PRIORITY DEMANDING A PUBLIC HEALTH RESPONSE RIGHT NOW.
INCREASING SYPHILIS CASES AND OPIOID
A VOICE
EPIDEMIC MORE CHILDREN AFFECTED BEING SUSPECTED OF BEING ABUSED TUBERCULOSIS A BREAK GOING MENTAL HEALTH CRISIS. THE CONCERNS OF DRINKING WATER SAFETY. WHAT WE REALLY ARE SEEN ARE
THE SYMPTOMS OF AN ERODING PUBLIC
HEALTH SYSTEM. WE ARE NOT OPPOSED TO THE CONCEPT OF A
CONTINGENCY ACCOUNT BUT WE
ENCOURAGE
YOU TO INCREASING THE STATE'S INVESTMENT IN THE LOCAL PUBLIC
HEALTH GRANT AS A NECESSARY AND MORE SUSTAINABLE MECHANISM TO PROTECT AND PROMOTE THE PUBLIC HEALTH.
THE LOCAL PUBLIC HEALTH GRANT IS THE STATES MAIN INVESTMENT IN OUR LOCAL PUBLIC HEALTH SYSTEM AND THE CORE FUNCTIONS OF
GOVERNMENT MANDATED A
STATE STATUTE. ITS FLEXIBILITY MEANS THE
LOCAL GOVERNMENTS COULD PUT DOLLARS TOWARDS
EMERGENCY EFFORTS
LIKE THOSE CURRENTLY REQUIRED FOR MEASLES. THEY CAN ALSO PUT IT TOWARDS
OTHER MANDATED AND COMMUNITY NEEDS. INCLUDING BUT NOT LIMITED TO OPIOIDS
TO HEALTH AND MANY OF THE OTHERS ALREADY MENTIONED
THIS EVENING. LOCAL PUBLIC HEALTH GRANT FUNDS GO THROUGH ALL COMMITTED HEALTH BOARDS AND TRIBES. DURING STATEWIDE REACH. THE CURRENT FUNDING
IS INSUFFICIENT AND IS
SIGNIFICANTLY COMPROMISED LOCAL
PUBLIC HEALTH CAPACITY TO EFFECTIVELY CARRY OUT
ORALLY MANDATED SERVICE BY PREVENTING THE SPREAD OF INFECTIOUS DISEASE BEING JUST ONE OF THEM.
PUBLIC HEALTH CONTINGENCY FUND WILL PROVIDE A BOOST TO SOME RESPONSE EFFORTS BUT
WITHOUT GREATER LONG-TERM STATEWIDE INVESTMENT IN THE LOCAL PUBLIC HEALTH GRANT
CAPACITY FOR PREVENTION AND RESPONSE WILL CONTINUE TO LAG
FURTHER BEHIND IN HEALTH AND SAFETY OF OUR COMMUNITIES WILL CONTINUE TO BE PUT AT RISK.
WE APPRECIATE YOUR ATTENTION AND I'LL BE HAPPY TO ANSWER ANY QUESTIONS. >> CHAIR: THANK YOU.
REPRESENTATIVE FRANSON >> REPRESENTATIVE FRANSON: TALK
ABOUT OUTREACH; DOES THAT
ALSO INCLUDE LIKE DIETARY
LIKE VITAMIN A DEFICIENCIES; VITAMIN
B DEFICIENCY?
>> TESTIFIER: I WOULD SAY IN GENERAL; YES THOSE ARE ISSUES THAT PUBLIC HEALTH NURSES AND OTHER HEALTH EDUCATORS WOULD BE
WORKING ON WITH FAMILIES
AND OTHERS
IN NEED. >> CHAIR: THANK YOU.
OTHER QUESTIONS? ALL RIGHT; THANK YOU FOR YOUR TESTIMONY TODAY
AND THANK YOU FOR
COMING BACK. SORRY TO MAKE YOU COME BACK
THIS EVENING. APPRECIATE YOUR TIME AND TESTIMONY.
ANYBODY ELSE WOULD LIKE TO TESTIFY ON
THIS TOPIC; OR THE BILL
OR AMENDMENT? SEEING NONE;
I APPRECIATE EVERYBODY'S
COMING BACK. IF I CAN MAKE ONE REQUEST OF THE DEPARTMENT; SPECIFIC
TO THE SOMALIAN COMMUNITY
FOR OUTREACH IN
VACCINATION AWARENESS
AND INFORMATION. IF YOU COULD JUST MAYBE PROVIDE
THE COMMITTEE A VERY BRIEF
WRAP UP OF WHAT YOU'RE
CURRENTLY DOING. VERY SPECIFIC TO THE
SOMALIAN COMMUNITY AND
OUTREACH
AROUND VACCINATIONS AND ALSO AROUND MEASLES
IN PARTICULAR. BUT WHATEVER WE ARE
DOING SPECIFICALLY FOR
THE DISPARITY IN THE SOMALIAN COMMUNITY BECAUSE OF THE CHOICE TO NOT VACCINATE
WITHIN THE LAST YEAR JUST SO WE CAN KIND OF GET A PICTURE OF HOW
MUCH COMMUNICATION HAS BEEN OUT THERE WITHIN
EXISTING GRANTS AND WHERE WE NEED TO GO
FROM THERE.
REPRESENTATIVE MURPHY >>
REPRESENTATIVE MURPHY: I TALKED TO YESTERDAY BRIEFLY ABOUT THIS SO
WERE JUST A FEW DAYS FROM BEING DONE
IN BIG NEGOTIATION GOING ON; IF THERE
WAS ROOM
FOR THIS IN HEALTH AND HUMAN SERVICES BEFORE THE END OF THE
SESSION; WOULD WE DO AN OFFICIAL HEARING ON IT? WOULD IT GO TO THE RULES COMMITTEE
? GIVE A SENSE OF THE PATH FOR THIS
FOR ACTUALLY GOING TO ACT ON IT THE SESSION?
>> CHAIR: WHAT IT WOULD
LIKELY DO WOULD BE TO APPEAR
IN A-THE MOST LIKELY PATH WOULD BE IN CONFERENCE COMMITTEE REPORT. WITHIN THE
CONFERENCE COMMITTEE.. IF WE HAD
AN OPEN CONFERENCE COMMITTEE THAT WOULD BE THE WAY; THE BEST WAY
TO GET THIS PAID FOR
THIS YEAR. >>
REPRESENTATIVE MURPHY: REPRESENTATIVE LOEFFLER WAS TALKING A LITTLE BIT ABOUT THE
DETERMINATION THE CRITERIA
AND THE
TESTIMONY WAS REALLY ABOUT AN INTERPRETATION OF
THAT LANGUAGE. SO
I GUESS MAYBE WE SHOULD TALK OFF-LINE JUST TO MAKE SURE THAT IT IS CLEAR ON
YOUR PERSPECTIVE SO THAT
WE DON'T SEND SOMETHING
AMBIGUOUS FOUR.
>> CHAIR: YES. IF EVERYBODY COULD TAKE A LOOK AT THE
LANGUAGE COULD OBVIOUSLY WE ONLY HAVE A COUPLE DAYS WILL
ACT ON THIS
REALLY QUICKLY IF OR ABLE TO ACT ON IT BEFORE THE END OF SESSION. I HOPE
WE DO AND BE OUT OF HERE ON TI
ME. SO FOR THAT TO HAPPEN WE OBVIOUSLY NEED THAT YOU REAPPEAR IN
A BILL.
OTHER QUESTIONS? SEEING NONE; THANKS FOR COMING BACK EVERYBODY. SORRY TO DELAY THE DAY BUT I THINK IT WAS AN IMPORTANT DISCUSSION. LOOK FORWARD TO SEEING
YOU TOMORROW. WE ARE ADJOURNED.
>> [GAVEL]
>> [ADJOURNMENT] >> >>
>>
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