It is an honor to reflect upon my first year as Director of Grand Forks Public Health (GFPH).
Staff at GFPH experienced a lot of change this year. From new leadership to ending emergency operations of the COVID-19 pandemic response, their resilience shone through on multiple occasions.
Two activities I’d like to highlight from 2023, in addition to those throughout this report, include the final submission for Public Health Advisory Board (PHAB) accreditation and strategic planning.
PHAB accreditation is a demonstration of best practice at a national level. Submission for accreditation is no small task. Delayed by the pandemic, this work had been occurring within the department since 2018, making the submission a major accomplishment.
We advanced strategic planning with consideration for workplace culture and department infrastructure such as data reporting, communication cadences, and program expectations. With set intentions for the future, we have a united drive to advance our mission.
Woven into each of our activities is our vision to empower healthy people, support healthy environments, and build healthy communities. This vision to enhance public health does not exist in a vacuum. We are grateful for the many community and regional partners that contribute to positive health outcomes for all residents that we serve.
In gratitude,
Tess Wall
Supporting independence of older adults
The Adult Home Visiting Program provides affordable health maintenance nurse visits to adults living within Grand Forks County. More than 260 client encounters were provided in 2023, focusing on medication management, health monitoring, and connecting individuals with local resources that help maintain safety and independence. Along with empowering the clients to live more independently and comfortably in their own homes, these services help mitigate the risk of unnecessary hospitalizations or moves into long-term care facilities – promoting efficient resource allocation within the greater healthcare system.
As a member of Service Providers for Seniors, GFPH collaborates monthly with local community providers to promote the health and wellbeing of older adults through education and networking.
Protecting lives through screening and early detection
GFPH’s Women’s Way, a breast and cervical cancer screening and prevention program that serves the northeast region of North Dakota, had
490 women enrolled
105 new clients
Among the 659 breast and cervical exams completed through Women’s Way, 2 women with invasive breast cancer and 4 women with cervical dysplasia, 1 with invasive cervical cancer, were diagnosed. Early detection and timely treatment are key to promoting positive health outcomes for patients with breast or cervical cancer.
Correctional center nursing by the numbers
A team of three nurses continually provided quality care at the Grand Forks County Correctional Center. The team oversees all medical intakes and responds to a wide variety of medical concerns including mental health, pain management, skin and dental issues, STI screening and treatment, sleep concerns, and more.
4,056 medical concerns addressed
3,472 intake records reviewed
742 health assessments including tuberculosis screening completed
195 HIV rapid-screening tests administered
150 hepatitis C rapid screening tests administered
Supporting positive health outcomes
The North Dakota Ryan White Program Part B provides access to HIV-related medical care and treatment, case management, and reimbursement for core and support services. GFPH’s Ryan White coordinator helps local clients access and navigate HIV care and needed support services to overcome barriers to maintain positive health outcomes.
95% of clients at the beginning of 2023 chose to re-enroll
105% increase in client enrollment by end of 2023
100% of clients who responded to a client satisfaction survey reported being satisfied or highly satisfied with the program (n=21)
With more accessible transportation services, many clients successfully retained medical care services - vital to preserve overall health. As the program expands, so do the case management approaches and measures taken to ensure clients enrolled feel confident navigating perpetually shifting support systems.
Syringe Service Program by the numbers
The Syringe Service Program (SSP) aims to:
1. Reduce the spread of Hepatitis C and HIV due to injection substance use
2. Establish relationships with clients and facilitate client-driven positive change for individuals who may be in active substance use
3. Reduce the incidence of opioid overdose and opioid overdose death in the community
Testing/Prevention
96 overdose reversals reported
44 HIV rapid screening tests administered
37 hepatitis C rapid screening tests administered
Discussions/Referrals
83: substance use disorder treatment
73: health care
67: behavioral health
Safety supplies
1,103 sharps containers provided for safe needle collection/disposal
1,024 naloxone (medication to treat narcotic overdose in emergency situations) doses provided
Providing care while meeting rising service needs
Throughout 2023, the Withdrawal Management Center (WMC) observed an increase in the demand for services with 321 total admissions. While meeting clients’ immediate need for a safe, monitored place for withdrawal management, the program’s primary goal is to engage clients in recovery support and connect them with essential community services. This goal recognizes many clients face intersecting social stressors acting as barriers to recovery. For example, 54% of clients surveyed in 2023 were also managing homelessness.
Human cases of West Nile virus prevented in Grand Forks County
To reduce the risk of mosquito-borne diseases and the nuisance level of mosquitoes while maintaining the integrity of our ecosystem, mosquito control staff:
performed more than 3,000 field inspections
treated around 54,000 acres
conducted 2 city-wide ground sprays and 5 high-traffic sprays which focus on parks, golf courses, bike trails, the Greenway, high risk West Nile virus (WNV) habitat, special event sites, etc.
While the 2023 season was drier than normal, the risk of WNV, a virus spread by mosquitoes, was somewhat elevated. The first identification of WNV activity in ND was reported from a pool of mosquitoes collected in Grand Forks on June 20. Throughout the season, the surveillance division collected and tested 105 pools (groups of 1-50) of mosquitoes and 6 birds, in which 12 pools of mosquitoes and 2 birds tested positive for WNV. Despite 58 human cases of WNV being reported in ND during the season, there were no human cases reported in Grand Forks County.
Behind the scenes of a vibrant community
The Environmental Health team continuously inspects, tests, and educates in order to keep our favorite eateries and activities safe to be enjoyed. From summer pools to food truck festivals, the team supports vibrant communities year-round.
595 routine food establishment inspections
436 nuisances investigated
34 temporary food event inspections
30 mobile food truck inspections
96 pool inspections
COVID-19 response transitions focus to recovery and mitigation
The COVID-19 testing site located at University of North Dakota’s Fritz Pollard Athletic Center closed on March 10, 2023. This testing site, managed by GFPH’s Emergency Preparedness and Response (EPR), administered a total of 120,089 tests throughout its lifespan.
EPR supported COVID-19 testing in the community by providing updates to community partners regarding COVID-19 guidance and coordinating local distribution of state resources. Masks, at-home testing kits, and guidance were provided to the public throughout the year.
Laying foundations for healthy youth
Through support and funding from the Grand Forks County Commission, GFPH filled 2 school nurse positions that directly served 4 rural Grand Forks County school districts through June 2023. After which, rural school support transitioned to provide targeted curriculum, immunization information, and connections to health information and resources.
GFPH school nurses facilitated 103 classroom presentations in 2023. Topics included:
Activity and nutrition
Head lice
Personal, hand and dental hygiene
Puberty
Summer and winter safety
Vaping
Elementary students biking towards healthy habits
GFPH hosted a Bike, Walk or Roll to School two-week challenge for fourth and fifth graders in Grand Forks elementary schools. This physical activity challenge ended with 16 classrooms participating. There were 322 students who took on the challenge, making a total of 775 trips (biked/walked/rolled) to school.
Boosting health equity through community connections
More than 50 community outreach events and/or presentations to special populations attended by GFPH staff
25 health equity collaborations with nonprofits and religious organizations on community outreach events and practices
4 languages used for outreach materials: Arabic, Nepali, Somali and Spanish
6,390 community members received outreach and educational services related to health programs and COVID-19 in collaboration with Spectra Health
City of Grand Forks becomes a Blue Zones Project Approved Worksite
Thanks to the Wellness Program led by GFPH dietitians, the City of Grand Forks met all qualifications to become the second Blue Zones Project Approved Worksite in Grand Forks. Cooking demonstrations, accessible farmer’s markets, story speeches, walking moais and a healthy vending machine in City Hall are some of the ways the City of Grand Forks is promoting healthy, connected lifestyles for city employees.
Supporting UND nursing education
UND nursing students teamed up with GFPH as part of their program planning, implementation and evaluation (PPIE) project. The students offered education about the meningitis B vaccine on campus and about the RSV vaccine at GFPH.
Farmer’s market creates access to fresh, local produce
The 4th Street Farmer’s Market, organized by the Wellness Program and open to the public, offers an accessible location and time for city and county employees to buy fresh produce from local growers and connect with each other and the community. With more than 500 visits, this market is located behind the county office building and runs every Thursday for five consecutive weeks in July and August. Taste testing was available each week, and two of the markets featured cooking demonstrations.
Planting the seed for a healthier Grand Forks
Twenty (20) community members were assigned plots at the Grand Forks Community Garden, managed by GFPH. Two of the 2023 plots made a big community impact. One plot, cared for by the National Resources Conservation Service, donated more than 170 pounds of produce to local food pantries. The other, cared for by Northlands Rescue Mission, used the produce to supplement the meals served to their clients. We are blooming with joy over these acts of community kindness!
Preventing the spread of tuberculosis
GFPH Tuberculosis (TB) program works closely with the North Dakota Department of Health and Human Services (NDHHS) to prevent the spread of TB in Grand Forks County. In 2023, the TB program worked with a total of 49 unique individuals to determine tuberculosis exposure, refer, evaluate, and treat TB disease and latent tuberculosis infection (LTBI).
The treatment for TB and LTBI is highly robust, typically involving a combination of antibiotics taken over several months. Case management plays a crucial role in ensuring treatment adherence, monitoring for side effects, and providing support to patients, which is essential for successful TB treatment outcomes. Among the 49 clients who received TB program services, there were 565 treatment encounters in 2023, accounting for 62% of TB client services at GFPH. 10 clients successfully completed their treatment in 2023, and 17 clients are on track to complete treatment in 2024.
2023 Public Health Champion Awards
As part of National Public Health Week, four community members and one team were recognized for their commitment and dedication to the advancement of public health in Grand Forks County. Doris Haynes Lebby with Love in Action, Jen Berger with UND, Mandy Iverson with Mental Health Matters, Rosy Dub with GFPH, and the team of social detox advocates with GFPH were honored with Public Health Champion Awards at Grand Forks City Council.
Pictured left to right: Tess Wall, GFPH director; Mandy Iverson; Rosy Dub; Jen Berger; Megan Anderson Weisgram and Amira Ragab, Detox Advocates; Ciara Ballard, Social Detox Coordinator
Providing skills to support breastfeeding families
Ninety-five (95) UND nursing, medical, and nutrition and dietetic students received breastfeeding skills training across three sessions hosted by GFPH. The Breastfeeding Skills Training course engages students in six focus areas of breastfeeding education and teaches practical approaches to supporting breastfeeding parents.
"The staff from GFPH make a huge contribution to the UND Nursing student's understanding of breastfeeding. Every semester they share focused information as well as advice about how best to support breastfeeding mothers. This partnership enriches the community by strengthening the availability of breastfeeding resources." - Dr. Tracy Enger, UND clinical associate professor of nursing
Employee milestones & awards
Social detox advocates and Rosy Dub, public health nurse, received 2023 Public Health Champion Awards presented by GFPH