You guys ready to roll? >> Okay, it's 2 o'clock. We'll call the community health board to order. And we don't need to do roll call. Um, first off, we've got the approval of the agenda. Everybody got the agenda. Are
they any additions, corrections, or anything for the agenda? Otherwise, I'll look for a motion to approve the agenda. >> I'll make that motion, Mr. Chair. >> All right, we have a motion by Commissioner Carlson. We hear a second. >> Second by Commissioner Sumar. All in favor of approving the agenda as
presented, say I. I. Any opposed? Motion carried 40. And we got the approval of the July meeting minutes. And uh I noticed one change in there. the uh on the last page, page three, it says the next
regular meeting of the county board will be October 15, 2025, but it actually should say October 21st. October 15th was the 2024 next meeting dates. So, we u we'll have to change that to October 21st, which is today obviously, and then
uh um we'll reprint those and and that. But if we can get a a motion to approve the amended minutes, if there's any other changes that anybody has. >> Mr. Chair, I move that we approve the uh amended minutes. >> Thank you. Do I hear a second to that?
>> Second. >> Second by Commissioner Winger. Any further discussion? All in favor of approving the amended minutes of the July meeting. Say I. >> I. >> I. Any opposed? Motion carries 4 to zero. Community health board programs
and services update. Amy is on deck. You're on up to the podium. That's kind of a big deal, you know, with the World Series coming up Friday. You're off the >> I know. Well, hopefully I hit a grand slam today for you guys. >> Oh,
>> how's that? >> That was good. >> All right. >> My my second goal is to not mess up any of the names of our programs today. So you you had the magic on opening the door and now that what how are you going to top yourself?
>> Well, I I brought a whole team of important people with me. So >> um so we'll get started with our um where we've been, where we are, and where we're going. And I figured since this was our last community health board meeting of the year, it would be a perfect time for us to reflect on where
we've been over the last couple years and then where we're currently sitting and where we're headed. [Music] Do you want to just do it? Oh, good tip. There we go. So, here's our team, our
baker's dozen plus one. Now, if you can count, there isn't a baker's dozen plus one in here because we have two new additional members since this picture was taken. And so I just want to quickly introduce um during our our storm event in June, we had Megan um join us.
There's Megan. And then uh in September, we had Alexa and we had our new program manager uh Jenna. So I just want to make sure that you've introduced to some new names and faces uh for individuals who have joined our team. Um so we are fully staffed and we are ready to go. That's
where we're headed. Uh so this is just uh to showcase um how we make sure that when we're working hard every day, we also take time to do some um team building um and some connecting and just kind of um refreshing ourselves.
Uh we also spend a lot of time learning and sharing. And so over the course of the the last couple years, we've had some really unique opportunities to spend some time um across the country um sharing the work that we do here locally in Bel Tramy County. And so in the top
leftand corner um that was when you guys sent me out to Philadelphia um for the national uh convention on behavioral health. Um and then the top right corner was at our state capital at public health day on the hill. And the bottom
ones are um with our grant and our partnership that you guys approved with uh HERSA with Samford. Um Becky and I had the opportunity, we got caught in a rainstorm, uh but we had the opportunity to be out in Washington DC and share about the work that we're doing with the
maternal child population um NAS and uh so our needle natal abstinence syndrome and improving the health care of our moms and babies. And then um doing some emergency response training. Um the bottom picture is out in um Cincinnati.
Uh we also uh enjoyed some firsts. So uh some firsts was our first uh um uh re not I won't say retirement but Monica Thu left our department. So that was the first for me having a leader leave and
having to hire on a new leader. um the first ever menstrual uh menration health week. Uh uh one of our very own uh Dena uh Michaels, she uh was a guest speaker and got to uh speak at an event that
took place at BSU. Um and then of course our first cha hip. Um so photograph of uh you fine gentlemen um posing for our group photos as we put our cha hip together. Um just a little fun uh in the the big picture is our leadership team.
So that's health and human services. And while we might be a community health board that's funds our public health program. Without everybody in that picture, we would not be able to accomplish the things we do because that's one thing that makes our public health really unique is that we rely on
social services, rely on economic assistance, and we rely on our financial department to make our programs and our services run efficiently. And without that team, we would not be able to serve our people as well as we do. And then in the bottom corner, it's
hard to see, but um I would be a little sad if I didn't bring a little humor into how much I pick on Steve um Shadrich, but uh that is me and his team um telling Steve that he should make a public health director parking spot outside the garage so I don't have to
get wet when it rains. Um and then uh we're just so grateful um that you guys approved our remodel. And so with the the public health um remodel, our space is not only improved, but our services are just instrumentally
changed. We now have a community space where we can host community educations. We had a VA baby shower held there. We have a a really great space for people who are doing supervisory visits where they can come in and their kids can play. They can they can feed them. We've
had um Easter egg hunts in there with families. And so that space up in the middle corner is just been a blessing to our our team and to our agency as a whole. Our wick program has been able to really um transition their services instead of doing everything in one tight
space. Um if you're familiar with hospitals that have um child life centers, it's those specialty areas where they take the child out of the room and that childlife specialist takes them into an exam room where they have their their pokes and their medications
and then their room is a fun place. That's exactly um the type of space that we were able to create with that remodel um by just knocking down a wall and um shifting where office spaces were held. So now in the middle corner, that's where our exam pieces, our health
screenings are done. And then we have a space for kids to play, moms to nurse, and um just kind of that more private intimate area um right off of where our uh WIC dietitians then do their their visits.
Um wellness and team building, it's been a huge part of things that we've focused on over the last uh couple years. And we don't just do those things with our team, we do those things with our agency. And so we just got a couple photographs to showcase some of the
wellness activities that we've done. Um, none of them um resulted in injuries. Just the bottom uh lefthand corner resulted in a quick text message to our maintenance staff letting them know they didn't need to respond to the fire alarm going off because the public health
director may have burnt the bacon. >> What's that? >> The fire alarm goes off. Yeah. Then the food was done. Yes. Yes. And I haven't been invited to cook again. Um and then the outreach and partnerships and education. Um this is
one of my favorite things about public health is our ability to not just do the work within our agency, but the partnerships, the friendships, and the education that we've been able to expand into our community. And so these pictures just showcase some of the the
new things that we've done um since my tenure began here. So we attended um the pride event. Uh Monica Thu, myself and our emergency manager. Um we we really built education into attending that event. People could um watch our videos
and take our survey and then they would be entered into a drawing to go home if they won. They got to take uh home uh an emergency kit bag. And so it was a backpack that had dehydrated food in it. It had um multiple other items that people should have in their home in the
event of an emergency. Um we've attended different youth events. We've done training um for our our agency that was actually opened up to the community. That's that top metal picture. Uh we expanded our uh foot clinics by um
writing a a partnership with a program called Souls for Souls. And so people not only get foot care and education, but now they can leave with a brand new pair of shoes and socks. And then we were the primary sponsor for the Evergreen Conference last year, which was a very well attended and um a pretty
important um event for our community for individuals that serving the youth population. Um and then our big event for this year was preparing people to um respond um training people to prepare and respond
to um emergencies. And so Chris and I partnered together and brought in the Red Cross and we did uh a two-day training for our shelter event. And so we had one day where it was classroom um lecture and then one day where we simulated um actually setting up a
shelter where we had community volunteers come in and you know we had families, we had people with um disabilities. We tried to meet all of the needs of potential things that we may encounter when we opened up a shelter. And then we also provided um
AED training for the all employee um agency training this year in partnership with Steve Shadreck. >> Yeah, >> that that training was actually pretty timely. What wasn't that right before the storm hit? >> Two months to the day. >> Yeah. >> Yeah. So in April on April 21st, uh
Chris and I walked into the shelter or into the Sanford Center to set up for training and two months to the day um I walked in with uh I can't remember Dave's last name, but he is was our head kind of liaison for the uh Red Cross. He
and I walked in to set up for a real life shelter. >> That was pretty awesome that you guys did that training and and were able to capitalize on it right away. Unfortunately, you know, we didn't want the storm, but at least you had done the training ahead of time. So, great job. >> Yeah, thank you >> to Chris, too. >> Yeah, I couldn't have done it without
Chris. >> Well, and this other team behind me, like >> we if they would have participated, taken the the training serious that day that I called them up and said, "Hey, we really have to set up a shelter." and they showed up and whether it was to show up, you know, here at the building
to keep our services running or if it was to show up at the Sanford Center or if it was I had a staff like I had a flat tire and I couldn't ran manage a a shelter and go get my tire fix. So, it took a team to figure out how to go get my flat tire fixed so I could eventually
even go home, you know. So, it was all those kinds of things. Um, from Bobby Anderson, you know, firing up his grill and running out to uh the porta potty station. So, I could probably spend a whole hour talking about just the thanks and the gratitude and and all the hands-
on deck that it took to make that as su successful as it was. >> Great teamwork. >> Yeah. Um after um in between the storm and all those events, we continued to do community um events and engagement. So, this is just um a couple pictures to
show you of some of the booths and the the things that we have purchased with our funding this year um to raise awareness and education in the community for the services that we provide. And then of course, our favorite question were >> Commissioner Summer. >> Yeah.
>> Um your last slide there. Yes. Yeah, I had a question about about Wick and I don't know if this is a question for for you or an uh because I know that we're going to be getting some updates uh in regards to federal uh funding and
whatnot. Is is WIC going to be part of the update or >> I don't know if Ann is including Wick in your update? >> No. >> Okay. >> So, I can just give you a real brief update on Wick Business as normal. >> Okay. >> Yep. people are still able to use their
um it's a card like an EBD card. Yep. They can still use their benefits. They can still enroll in our program. Um we can take new members right now. And if people have issues with their card, they can just call us and we can upload those benefits. >> Okay. Yeah. because I I had a concern. I
I I I've seen and heard uh um chatter in the community about the potential um loss of of the WIC program or funding, you know, of WIC. And I was kind of curious to to know if if um
if if that's true or or if if it's something, you know, you're thinking about on on >> We are keeping tabs on it and we have weekly meetings with the state um to get updates on where funding is at, where the the program is at. And so right now
our um kind of universal message across the state is business as normal. We and we can continue to enroll new members. Okay, thank you. >> Yeah, good question. >> Thank you. >> Um, so one of our favorite questions as uh people have asked us to talk about
our emergency preparedness um training and our response to the storm is we like to ask the question, we were ready. Are you? And because um it's so important that while we can provide education and training across the community, we need to make sure that people are
individually rep prepared also and we need to know who our partners are. And so this is just a showcase. All the red dots on the map are all the counties that participated in our training back in April. Um, and so that's just to
showcase that that partnership is so important because our team of a baker's dozen, even health and human services of 160 plus employees, we need our community partners when we're responding to emergencies and when we want to do education to prepare people.
And just a couple pictures. Um, I probably could have five or six slides. Um, but I tried to pick out some of my favorites um, and to showcase um, all the hands that it took um, to make uh, our response to the storm a success. And
uh, we even tried to have a little bit of fun with it. So, uh, one of the things that I think is pretty cool is that um, in the left middle picture, that's Steve Shadrach's team. So, we even had help and support in the work
that we did from Steve's team. And so I just think that it it speaks wonders to the county employees and their willingness to step up and it really does show um our willingness as a community to partner together and to support each other. And uh we continued
um to make services uh flow as normally as possible. And that's what those two side pictures on the right are showing. And uh just some more of the storm um and our response, our partnerships, keeping our clinic running, um our post
uh storm resource center and our partnership with Salvation Army and uh as you would hopefully expect, we did recover. Um our three uh family health techs uh are now officially uh
college students at NTC. Um, so we had to do their first day of school. Um, when they graduate in May, they will all three have their community health worker certificate. Um and uh we've met with Kev and uh Commissioner Snar and I we
went up to a health fair in Red Lake and uh we had a party uh called In the Woods uh where we celebrated um our September birthdays and then our Wick team did an outreach project where if you attended and did not miss your August visit, you
got a nice little tote for groceries and uh going to the farmers market. And to finalize, uh, we continue to work with community partners across the state. And so, uh, just a couple weeks ago, I had the opportunity to present at
our state shack meeting. Um, and I've had the great opportunity to be mentored, um, by Carol and D um, to other uh, county commissioners across our state. And so I just wanted to showcase uh the importance of not only
the role that you guys play but um the other commissioners across the state uh they've been instrumental in um advocating for the work that we do here in Belrammy County. And that is it for that piece and I'm going to lead that into um a brief presentation by Megan.
Um, one of the other updates that we wanted to give is sometimes our staff also attend our trainings and uh I want her to talk about one of the trainings that she most recently attended. >> Thank you. Um, so I had the privilege of attending our NICHO which is National
Association of City and County Health Organizations meeting down in St. Paul in September. Um this meeting focused primarily on HIV and STI programming through public health departments. Um 17
rural public health departments were present at this meeting. Um and Belrammy County was the only county present at this meeting that does not currently have programming in place for STI and HIV prevention. Um we do some testing um
in regards to TB syphilis um but we don't do extensive panel testing like the other counties present did. So we felt this was a really good opportunity um to sit and listen to other agencies and what they are doing in their communities that look a lot like our
communities. Um so like I said 17 rural health departments were present at this meeting. um all facing similar barriers to what we face here. Issues with transportation, facility shortages, um the stigma that happens in small
towns when we're facing health disparities, uh the anonymity anonymity, oh my gosh, that's a hard word today. Um of just being in a small town and what it means to access services in a small town. Um and then the social
determinance of health that we face in the rural community as well. with not having access to those things. Um, some primary takeaways from this meeting that we wanted that I wanted to share with you guys are that we tend in our rural communities to think that things that
affect the rest of the world and larger communities aren't affecting us here um in rural Belrammy County. And so bringing all of these other rural departments together really showcased to us that we are all facing the same
issues. And so figuring out how to navigate that appropriately in our communities is still really important. So I got to hear from these other communities that have these programs in place what is working for rural people
um versus what is working in big cities. And that was really cool to hear. Um, and hearing that just because we don't see things every day doesn't mean that they don't exist in our communities, too. So, um, we discussed that, uh, HIV
rates and rates of syphilis are still growing even in rural communities, and that's a concern for a program like ours because we focus really heavily on maternal child health. And we're seeing increases in those diseases um, in
women, heterosexual women, which we might we didn't really see before. And so then we're increasing risks um related to health in our children. Um and we want to do what we can to get ahead of that before we see that um risk
increase any further. Um we're also talked really heavily about being in maternal healthcare deserts. We're really lucky in Belrammy County to have a community partner in Sanford where we do still have a pretty
good OB unit. Um but people we know are traveling into Bumiji every single day to access maternal care and rural hospitals are shutting down all over the state. So we might be lucky here but that is something that should be at the
top of our discussion. Um as we're moving forward and making sure that we're giving care to those who need it. Um the other and one of the most important things discussed was how some of these rural healthc care
programs are giving services that differs from how we get services here. So in Baiji any of our services besides our home visiting program are primarily people coming into our public health office to get the services they need.
And that can be a barrier for people who can't really get into our office. They don't have transportation. They don't have the gas funding. Um again, that stigma of what if somebody sees me going into our public health department? Um it's not always an easy thing to
navigate. And so the largest takeaway from this meeting for me personally was that we just need to we need lower barrier access to health care. And instead of trying to change our patients, we really need to
be changing the system in which we serve them. Um, so out of 17 of the rural departments present, over half of them had mobile clinic units. Um, which was crazy to me. I had never I didn't know
that a mobile public health unit was a thing that existed. And to know that over half of those counties had one was phenomenal. So a mobile unit is a unit that is like a miniature public health department on wheels and they get to go out into their communities and deliver
the same service that we do in office out in the communities. So, um, at community events, going to college campuses, uh, driving, parking in the Lucans parking lot, like, and bringing care to where people are and to where
it's as it is accessible for them. Uh, was really cool to hear that communities are able to do that um, in areas where people just can't access. >> See, Megan, yeah. >> Um, did you find out, you know, did they get grants to do that or how how they got that funded? Like I mean that's very
similar to what our our you know um veterans have had created their mobile unit. They got a grant for it and actually the first one in the state to do that kind of thing for veteran services and can you on that? >> Yeah absolutely. So, the main funding
source that I was made aware of when asking questions of these teams um was that they were using their opioid dollars um to help fund these units. And that's because they were kind of reimagining service delivery as a whole
and partnering with community partners and then um offering complimentary service delivery. So, while they're using their vans to go out and do immunization clinics and wick visits and child teen checkups, they're also using
those units to go out into the community and do that HIV STI testing um to offer education to people. And so, by partnering with other community partners and all services provided, then they
were able to utilize their opioid dollars to do so. Yeah, Mr. >> Thank you, Mr. Chair. So, Megan, my understanding is that after two years of our uh veteran service office having their trailer and truck that at the end of
that two years, we're free to do what we want with that. So, hang on to that thought because they don't use it every day of the week. And I think that there's an opportunity coming up in a short period of time. >> Very cool. >> To be able to do double duty with that. >> Very cool to hear. Yeah.
So, um, would you be able to use third party billing for >> I might have to defer to Amy on that question. Oh, where are you? >> You can do third party billing from >> So, that would be another option or opportunity to
utilize a mobile unit. hearing about the mobile unit, it's pretty exciting, especially for folks in in my um district that, you know, that it's a long ways, you know, to get to Bumiji and and not able to readily access, you
know, the >> uh the fine um unit we have over there. Um so, I I hope you continue to to pursue, you know, the the mobile unit. >> Thank you. Um, that was pretty much all I had. Just a little summary of that
meeting and all the work that's being done and what I feel like could potentially come here. So, thank you. >> Great. Thank you. >> Thanks. >> So, in a presentation, we use Megan as our leadin to where we're headed. Um,
and so >> Yes. Yeah. Megan, were you the one with the bananas? in the picture. >> Yeah. >> Yeah, that was Megan. >> Yeah, we broke her in, right? She literally had been with us for 10 days. >> Oh, wow.
>> Yeah. So, um great addition to the team. Uh so, yeah, I'm very glad to hear that the the sound of a mobile unit, um sounds palatable because, um where we're headed, our cha. So, in your um uh packet, you will find an update. Um the
state has already reviewed our CHIP booklet, and so I've shared that with you. um for the strengths and the opportunities for growth. And if you haven't had a chance to review that yet, I'm pretty excited because the opportunities for growth were made as
recommendations. We have nothing to correct in our our booklet, which is good because I printed 500 copies. So, um >> probably gotten back to the spelling error. Yeah, maybe maybe.
>> Uh so that is um our presentation on the first step. Any questions on where we were, where we are, and where we're headed. >> Okay. All right. Perfect. Well, then I'm gonna give the podium to Jeremy. Uh and
he is going to introduce himself. >> Uh thanks, Amy. Uh it's good to see you all. My name is Jeremy Dreer. I'm the state director of the office of addiction and recovery. Um this is a relatively new position. Uh it was created in 2022 by the governor and the legislature. Uh I'll kind of go through
um what it what it does and what it means and what we're working on here in a second, but just want to show appreciation for you all for the opportunity to present. And also just thank Amy in particular uh for inviting us up. And we had a great round table earlier with some local school uh superintendent uh and principles and
local uh community organizations. um just about youth um addressing you know um substance use disorder and youth prevention, treatment, recovery, all of those things. And it's just really valuable from a state perspective to hear about the great work happening um with our county partners because ultimately we all are working together
to really just improve lives for motans and the work really gets done the boots on the ground happen in local communities like Bel like Biji and Bel Tramy. So really appreciate the opportunity to be up here today. Um as I mentioned um my name is Jeremy Ducker. the director of the office of addiction and recovery. Um, this position was
created in 2022 by the governor and the legislature. It was a bipartisan deal. Um, and it really was the goal was to look at all of the different state agencies that touch substance use disorder in some ways or another. Um, to bring them together in what we call a subc cabinet. Um, so to really get state
agencies to work better together to improve the lives of motans um, experiencing substance use disorder, their families and their communities. Um and we started out with eight state agencies in the subc cabinet. So the departments of human services, health,
corrections, public safety, education, higher education, Minnesota management and budget, and then the Minnesota inter agency council on homelessness. And then this last legislative session um because state government looks a little different now with the break up of DHS and also some new um state entities. We
added um the Department of Children, Youth and Families, Direct Care and Treatment, the Office of Cannabis Management, and then the Department of Commerce just given their role in regulating the private insurance market. Um but really our goal is um to f to promote and to create a um comprehensive
substance use disorder continuum of care from prevention, treatment, uh recovery, um that works for motans no matter where they're at in their recovery journey. Uh, and so really bringing all of those state agencies together to really have conversations about how can we better coordinate and align our efforts to do
this work is a lot of what we do. The Office of Addiction Recovery is not a funer. We don't have um grants that we distribute, but what we do do is we work with our state agency partners that do manage those programs uh and run those programs and talk about, you know, what are better ways that we can make
investments, talk about legislative changes that we might need. Um talk about um uh other budget changes that they might go through. Um and so we my office also plays a pretty significant role um in advising the governor and the governor's office in terms of what legislative proposals move forward
related to substance use disorder. So um we're really kind of a policym um body less of a program running body so to speak. Um give you a sense of um kind of how our how we're structured. Um so in 2022 they they created the subc cabinet
of the state agencies. They created the addiction and recovery director to chair that subc cabinet. Uh and then they also created an external advisory body, the governor's advisory council on opioid substance use and addiction. Uh Jeff Lind serves on that um advisory body. Um
we really love having Jeff on there. He brings just a really powerful county perspective, but also perspective of someone in um not just greater Minnesota, but northwestern Minnesota. uh and he's really become a leader in that um in that space um and really helping make sure that that body is a statewide body that really is bringing
the perspective of all motans uh including greater Minnesota. Um you'll see we have the subc cabinet there too which includes commissioners from all these different agencies and deputy commissioners. Um and then how we a lot of how we get our work done is we bring different state agencies together to
work on a problem. Um and so you know we call those either workg groupoups or action teams. Um but sometimes they'll focus on unsheltered motans. So u motans with substance use disorder who are homeless. Um sometimes it'll focus on justice involved individuals or motans
who are um for formerly incarcerated or currently incarcerated like where how can we improve um outcomes there because those things cross different agencies the department of corrections and um the department of human services. So, we really look for those inter agency opportunities um that we can move uh
kind of move the needle on some of these big um these big topics related to substance use and addiction. um some of the key state initiatives that we're working on um so writ large one of the big things that the governor charged me with and I'll talk a little bit about this um in a couple sli next
slides but is really reducing overdose deaths um and so um that's something that has really been a primary charge of mine um and so a lot of the key state initiatives that we're working on are focused in that area but not all of them they're really focused across you know
prevention treatment and recovery um so you'll see that first one that is very acronym um but it's um the department of human services the contract by which we um operate our treatment programs uh with the federal government uh is through the Medicaid program and it's
through what we call an 115 reform waiver so that sets out what we can build for what are the goals and strategies that we want to get out of our treatment system um so that is just a huge body of work that we're always constantly refining looking at how we can improve the work that we're doing there to ensure that outcomes
um that our services are more person- centered, so they're speaking to the individual no matter where they are, their background, but also that we're getting the outcomes that taxpayers deserve. Uh and that we want to make sure we're getting because when we get good outcomes, people flourish, they do better, and also our costs go down. Um
and so there's a lot of uh incentive to continue refining that work and make sure that and making sure that we're we're getting the most out of that program. Um additionally, um one of the things we're working on is what's called a re-entry waiver. So, this is something that is relatively new. Um, but um the
federal government um has recently, historically speaking, you cannot use um Medicaid dollars. Um so, federal dollars to pay for behavioral health or primary care for individuals who are in jail or in prison. Uh the re-entry waiver was an
opportunity that was created by the federal government that would allow states to provide um uh particularly behavioral health care um and addiction care for individuals up to 90 days pre-release in either prison or jail. Uh and then it would also help with
re-entry in hence the re-entry waiver. Also help them re-enter into society after after they've served their time. Um so that is something that was passed in the 2024 legislative session. my office was really a big champion of that. Um, and so the state is working on
um, developing that um, uh, that waiver. We've submitted that application to the federal government and we've been told that they are interested in continuing to approve these waivers. Um, and that they haven't gotten to our waiver yet, but once they do, um, we look forward to engaging them in conversations to actually start implementing that. Um,
but that takes a lot of work. One of the reasons we did that um was because there's just a tremendous amount of evidence that shows that um individuals who um uh are incarcerated or have gone to prison. Um overdoses are much higher in that um in that population. Also, many of them have a substance use
disorder. And a lot of the studies out there show that when you offer support while they're incarcerated uh and then help them transition successfully back into society, you see tremendous public safety benefits. And so it's one of those things that's a big winwinwin uh for everyone. Um, one of our biggest
champions in that effort was the Minnesota Sheriff's Association. So, we worked really closely with Jim Stewart and some of our county partners as well. Our counties were also big champions of that effort. And so, we were able to get that across the finish line in 2024 and continue to work on that. Um, also we are working on uh the Department of
Health um has what they call the comprehensive overdose and morbidity act. So, that's a series of seven different strategies that are really looked at reducing overdose deaths. And that those projects again cover the gamut from prevention, treatment, and recovery. Really looking at linkages to
care um and making sure that um that every community in Minnesota, no matter where they are, have the different systems in place to help folks not um delay use or not start using substances early. Um and then if they do, they have those linkages to care to get the care
that they need and then achieve and maintain um uh momentum in their recovery going forward. Um, I'm not going to go through each one of these because I know time is somewhat limited and I want to give a chance for you all to ask any questions you might have. Um, but really, um, the when the state legalized, um, adult use cannabis, um, a
few years ago, there there came some additional dollars, um, to make sure that we were doing as much as we could to keep kids from, um, using cannabis early. Prevention is a huge priority for my office and for the governor and for the administration. Uh and so we worked really closely with the department of
health to get those um uh youth education dollars out into communities. Uh local public health received um a chunk of dollars. We've been up um here today and we were at Red Lake yesterday uh and heard a lot about how um individual communities are putting those dollars to really good use um providing
really good connection opportunities for youth uh to really head off substance use down the road. Um additionally, the Department of Education is working on what's called statewide health standards. Um so this was something that passed in a previous legislative session. Um so and part of that was
creating educa what are the educational standards for students to learn about substance use um in schools um to again that prevention sense uh to to prevent um early onset use uh and and delay that use. Um that process is ongoing. So we've been working with the department
of education um on those standards um and they are moving through the rulemaking process. But again, those are standards that then every community would kind of figure out how they want to implement those in the way that makes most sense to them. Um, finally, um, nlloxxone saturation. So, one of the big
things that, um, has really helped reduce the overdose deaths, um, in the last few years, um, is getting nlloxxone, the opioid reversal drug Nlloxxone out there. Um, so we've been doing a lot of work at the state across many different state agencies figuring out how we can make sure that every
community gets Nlloxxone in the quantity that they need um and has the distribution networks they need to make sure that if there's an overdose um individuals um there's Narcan on hand or Nlloxxone on hand to reverse that overdose. But even more than that, really working with our state and
community partners, um, including counties, to think about how can we think about reversing an overdose and the administration of Nlloxxone, not just as a one-time event that prevents a death, but that it can be really be a a point for positive change in an individual's life, so that it can begin
a recovery journey. So, it's not just we've reversed the overdose and now we're just going to walk away and hopefully it doesn't happen again, but maybe it will, but really how can that moment be a moment where you can reach someone and really try to get them to to make some decision some decisions to change their lives for the better. Um,
so that's something that we're working on quite a bit as well. And then finally, I would just mention um one of my favorite projects um that I'm really excited about is recovery friendly workplaces. So, one of the things that the governor charged me with was how do we create more recovery in more places? Uh and one of the ways in which you can
do that is um rec um creating what's called recovery friendly workplaces. So these are where do you find people? Many of us go to work. Uh and so working with businesses to create more recovery friendly environments so they can support employees and their families um
with recovery related issues. So sometimes it's not an an employee that's having an issue but a son or a daughter. how can we make sure that they have the services and supports they need within their employer um so that they can um a keep their mind on their work, be
healthy, um care for their family and all of those different pieces. And so we are in the process uh we've created a steering committee around this um and I'm very happy to say that I had a meeting just yesterday with someone from Wells Technology uh which I believe is a Biji area company um and they're going
to have a representative on that um steering committee um just doing some amazing work in that space. Um, I would also just say with all of these initiatives and with this work in general, one of the things um, I appreciate the most about it and I like the most about it is just how about how
bipartisan it is. Um, everyone on both sides of the aisle really engages uh, in a in a in a really positive way. U, there's a lot of um, there's just a lot of shared values in really trying to make sure um, that we're addressing substance use disorder um, in a way that
touches every community and works for every community. Uh, and so I've had a great relationship with Representative Dave Baker on the opioid epidemic response advisory council uh and with members of both sides of the aisle. Just there's just a lot of commitment to addressing this issue. And so it's been really gratifying. Uh, as much as people
argue about things at the state capital a lot, this is one space where we can really come together and focus. And so that's been um that's been really a delight to work in that way. Um, just maybe run through some data real quick. Um so as I mentioned, one of the things that the governor really charged me with
was was working on reducing opioid involved overdose deaths. Um you'll see that in 2024 um overdose deaths really started to plummet. Um we'll be releasing these numbers officially in the next couple weeks. Um but you'll see that we went from uh over a thousand um opioid
overdose deaths in 2022 uh to under 700 in 2024. Uh and those um that reduction in deaths happened um in every nearly every community in Minnesota across every um uh uh ethnic group or background. Uh it was really an overall
reduction and so that was really interesting to see. Yeah, Commissioner, >> Mr. Okay. Um this include fentanyl. >> This includes fentanyl. Yes. In my experience, I'm seeing a lot more
of those than we ever saw before in the last year plus here. So, >> yeah. Yeah. These are the data comes from uh Minnesota death certificates and so the Department of Health um reviews these every year. Um we have um and we can
share that information with Amy and she can get it out, but we also do a monthly overdose snapshot. Um this is just what the trend that we're seeing. And so there might be some individual communities that are seeing some different things. Um but from a death perspective, this is just what the
statewide picture looks like. Um and I can show um from um from a regional standpoint, um this is what it looks like um from 2022 to 2024 just based on geography. Um and so what we are seeing
is um tremendous reductions um across the Northland. Um, you know, there's one area in there's some areas in um, central Minnesota, south central that are about even, but overall we're seeing um, a pretty large reduction statewide. Um, and this mirrors some of the
national trends that we're seeing as well. Um, be interested to talk to you, commissioner, about what you're seeing from a um, from an on the ground perspective. Um, but these are just these these are the numbers that that we're seeing at the at the state level. >> Yeah. the the lack in reporting somehow
or >> I mean it could be I can check with our folks at the Department of Health. Um these are based on um Minnesota death certificate records that go through the local um coroner um and those death reports and then those get reported up to the state. Um so happy to follow up
and things I was going to mention too is um in terms of the partnership between the state and the county. One of the things that the state can do uh and that we are eager to do is collaborate with um local governments on data. Um and so we can certainly work with Amy and her team uh and Jeff um uh to bring some of
our experts from the Department of Health together that really talks about how we get these numbers. Um but this is um but these are like I said from the Minnesota death certificates. >> Yeah, of course. Um and then I think um I mentioned Nlloxxone earlier. So one of
the big distribution ways that we're trying to get Nlloxxone out there um is um we created what's called a Nlloxxone portal. So this is a um this is a way so one of the things that can somehow stand in sometimes stand in the way of the state getting resources to local
communities quickly is our grant process and our RFP process for a lot of program integrity reasons and other things we go it's it's a lengthy process to get dollars out into community and we knew that was important for when it comes to the overdose reversal drug nlloxxone to get it out as quickly as possible. So
what we did was we created a portal um that um organizations um that serve um people who are either in recovery or come in contact with people who are who use drugs um tribes other community- based organizations um law enforcement um they could just order Nlloxxone
directly from this portal without having to go through a lengthy RFP process and so we could get that Nlloxxone to them much quicker. Um, so this was this is just from um uh September 2023 to July 2024. Um, but nearly 300,000 doses of
Nlloxxone were distributed through this portal to areas across Minnesota. And you'll see on that map, those were the zip codes um that it was delivered to. Um, and so I want to really make sure that um, folks know that that's a resource out there um, particularly for our law enforcement partners uh, and some of our other public health workers
who are out there um, involved in this work uh, and can share the information on how to access that portal after this. But um, it's become a really good tool to make sure that as that when I spoke about that nlloxxone saturation effort earlier really making sure that that's a resource that's available everywhere uh,
and on hand when needed. Um, this is just some data and I see I'm getting close. So, what I might do is just kind of skip through these data pieces. Um, um, and these are in your packet, so feel free to follow up with any additional
questions, but there's some Belrammy specific uh, information in here as well. Um, um, this was one on hospital discharge. I think you'll see um, for the non-fatal overdoses too. Um, and again, we can have a follow-up question about the data. Um but a significant
reduction from 2023 to 2024 in non-fatal overdoses as well in the area. Um which is something that that we've been tracking. Um and then just going to the last slide real quick. Um some of the um some of the opioid epidemic key takeaways that that we've sort of
learned uh and that we've had a lot of conversations with our partners around um is just that you know the opioid epidemic has kind of gone in multiple waves. Um it started as a prescription drug epidemic. um with some of the unsaavory marketing practices that were happening from some of the
pharmaceutical or uh companies that has resulted in the opioid settlement dollars. It then as we kind of got our arms around that and figured out strategies to address that, it morphed into heroin um epidemic. um it's now turned into um and then there was the
synthetic um opioids fentanyl for instance and that's where we saw op over overdose deaths um really shoot up uh in 2018 to 2019 when the when fentanyl is called what tipped the market here where that became the dominant opioid in Minnesota. Um now what we're seeing
we're almost in a fourth wave where what we're seeing is a lot of poly substance. So you're seeing um methamphetamine um uh cocaine um fentanyl um xylazine different components all mixed together. Um and so that's one of the things that
we're tracking quite a bit right now um at the state level is really understanding what's in the substances that are on the street right now that people are consuming. Um because oftentimes people are consuming things they don't know what's in it. Uh they think they're buying one thing and there's really something else in it. Um
the other thing that we're working on quite a bit is um medications for opioid use disorder. We call this for short. Um but these are strategies that have really been proven uh in conjunction with um behavioral health behavioral and cognitive behavioral therapy uh to really improve outcomes for individuals
with opioid use disorder. And so it's a combination. There's three main um medications for opioid use disorder out there. There's methadone, there's bupinorphine, and then there's nrexone. U bupinorphine is the most commonly um prescribed one. Um Nrexone not so much.
But um but those three really making sure that um individuals have that available to them um should they want it and need it um is really one of the things that we're working on quite a bit. Um it's um it's it's widely considered one of the reasons why opioid overdose deaths have declined over the
last um several years, not just in Minnesota, but nationally. Um and so really making sure that that's available. We know that in greater Minnesota in particular, there are what we call these deserts. Um, and so it was really interesting to be up here and hear um folks talk about mobile units.
Uh, that's something we're thinking about at the state is um how we can have some mobile units to fill in gaps so that people don't have to drive as far in order to get the medication they need and they can get that care closer to home. So, those are one of the one of the strategies that we're working on.
And again also thinking about and those medications for opioid use disorder um in conjunction with an overdose response. So working with EMS in particular where if they respond to an overdose um often times someone comes what the Narcan will do or do the Noxin
will do will um take them out of that overdose but it will also can send them into withdrawal which can make them very sick um and that will want and the only way that they know how to not be sick is to get more opioids. So, how can we in conjunction with that um overdose
response get that to them so that it quiets those cravings? Um and so it gives them a chance to clear their mind a little bit and and make some better decisions about their where they might want to go next with their life in a way that's more positive. Um so that's one of the areas that we're increasingly working on right now in the state. Um
and it also it's also proven to uh um um improve retention and care. So people will stay connected to treatment longer if they've got those medications helping quiet those cravings and then they can make the best decision for themselves with their do in conjunction with their doctor as they move forward with their
treatment plan. Um and so that's just some of the things we're working on here. Um I'll just pause and take any questions or comments from you all but really just appreciate the opportunity to introduce myself and my office uh and and to be up here with Amy and her team today and and just hear about all the great things that are happening in
Belrammy. So thank you very much. Any commissioners have any questions for Jeremy? Commissioner Sar, >> I guess maybe not a question, but a comment. Um, I I was going to ask about, you know, what you or your office or the the
subcommittee, the cabinet can do to to help uh folks that, you know, have to travel great distances for for dosing. Um you know I often hear from my colleague Winger here you know talking
about you know the the issue with uh people you know having to travel two three four hours you know uh one way you know a day to to do dosing and and and how that you know is you know can be an
inconvenience especially for somebody that you know is trying to to get back on track and and um how that could hinder an individual from, you know, gaining meaningful employment and things
like that. And and so I'm excited to hear that there are discussions about, you know, a mobile unit, you know, because uh believe it or not, we are kind of in a desert up here. You know, you wouldn't think, but but it is. And and I'm hopeful that uh uh Commissioner
Winger is excited as I am about this uh uh mobile unit that we we often, you know, talk about. So, thank you. >> Yeah, thank you, Commissioner. And, um, I'll make sure that you have my contact information, but if you want to email me after this, too. Um, would have be happy to continue those conversations with you
offline and connect you to the experts at the Department of Human Services and make sure that as we're thinking about how to do that very thing. Um, we're in conversation with you all and your teams on what makes sense for for this county. >> Any other questions? All right. Thank you, Jeremy. Appreciate it.
>> Thank you very much. And brings us to commissioner comments, agenda additions for next meeting. Uh Amy, are we looking at uh January 20th for our next meeting?
>> Yep. >> January 20th, 2026. Is that uh sound good to the board? >> That'd be our our second board meeting in January, >> right? Okay. So, we'll me memorialize
that. And do we need to actually have a motion for that? Not really. Right. So, we'll look at that. Um any I don't know if we if anybody has any suggestions right now for agenda topics for that or if we'll >> I have a feeling that uh
I have a feeling Amy's already got it all fil. >> She probably has some general idea. Yeah. [Laughter] Great. >> Well, Mr. Chair, uh before we adjourn, just want to say thank you to Amy and
your team for everything that you've done uh pro, you know, getting this uh child trip together, all the community events that um that you attend uh on behalf of uh the county. Uh it's good to see uh folks in the community doing the
work that uh that you're doing. Um and and I think uh it's important to recognize, you know, without these folks, I think our jobs would be a lot harder and and a lot busier. So, I just want to, you know, express my appreciation. So, thank you.
>> Thank you, Commissioner Summer. And I think the the whole board feels that way. And we appreciate your whole team uh and as well as Chris and everything that you that you do for our community. We really appreciate it. Anything else for the good of the order for the community health board meeting?
Otherwise, we'll look for a motion to adjurnn. Motion by Commissioner Carlson. I hear a second. Second. >> Second by Commissioner Winger. All in favor of adjourning, say I. I. Any opposed? We're adjourned. Help.