9/5-9/9/2005 Meetings for the week of September 5th- September 9th Page 1 of 1
The City of Saint Paul
Alt
Meetings for the Week of
September 5th, thru September 9th, 2005
MONDAY - September 5th
No Meetings Scheduled
TUESDAY - September 6th
*Ramsey County Board 9:00 AM Council Chambers, City Hall/Court
House
Legislative Hearing 10:00 AM Room 330, City Hall
Legislative Hearing 1:30 PM Room 330, City Hall
WEDNESDAY - September 7th
*Budget Meeting 9:00 AM Council Chambers, City Hall
Library Agency Board Meeting 2:00 PM Council Chambers, City Hall
*City Council--- see Agenda 3:30 PM Council Chambers, City Hall
*City Council Public Hearing 5:30 PM Council Chambers, City Hall
THURSDAY - September 8th
Heritage Preservation Commission 5:00 PM 4th Floor, Central Library
FRIDAY - September 9th
Planning Commission 8:30 AM Room 40, City Hall
* Cablecast live and repeated on Saint Paul Channel 18.
Interpreter service for the hearing impaired will be provided at public meetings upon request.Request can be made by
calling(651)266-8509(Voice and TDD)Monday thru Friday, 8.00 A.M. to 4.30 P.M A minimum of two days notice is
required.
For more information on any of these meetings,you can send Email to:
citizen.service@ci.stpaul.mn us, or call the Saint Paul Citizen Service Office at 651-266-8989
http://www.ci.stpaul.mn.us/depts/meetings.html 9/6/2005
SAINT rST PAUL CITY COUNCIL CITY OF SAINT PAUL
PAUL � !+^L Dept.of Planning and
�� 1 Economic Development
A A A A �u o f`}` Phone:(651)266-6589
�~__ Fax: (651)228-3220
iic Hearing Notice
C\-0 FILE#05-136-773
PURPOSE: Appeal of the Planning Commission's decision to deny Conditional
Use Permit for Auto Detailing(Zoning File#05-117-785) PROPERTY
ADDRESS: 1229 Payne Ave.,SW corner at Hawthorne
FILE NAME: Rase Automotive,Inc.
HEARING DATE: Wednesday,September 7,2005,at 5:30 p.m.
All public hearings are held in City Council Chambers, 3"'Floor City Hall -Court House.
15 W. Kellogg Boulevard.You may send written comments to the Zoning office at the
address listed on the reverse side of this card. Please call (651) 266-6591, or e-mail
emily.ulmer@ci.stpaul.mn.com,or call your District Council representative at
(651)774-5234 if you have any questions.
Mailed: August 27,2005
Christine Haas - Fwd: Library Board Agenda Page 1
From: Shari Moore
To: Haas, Christine
Date: 9/1/2005 2:29:19 PM
Subject: Fwd: Library Board Agenda
>>> Mary Rubio 9/1/2005 2:20:53 PM >>>
Attached to this email is the agenda for the Saint Paul Public Library Agency's Board Meeting.
The Library Agency Board Meeting has been rescheduled for Wednesday, September 7, 2005 in the City
Council Chambers Office from 2:00 to 3:00 p.m.
The regular Library Agency Board meeting scheduled for September 21 has been canceled.
If you have any questions please call me at(651)266-7073.
Thank you,
Mary Rubio
St. Paul Public Library/Administration Office
90 West Fourth Street
Saint Paul, MN 55102
(651)266-7073 Fax: (651)266-7060
A 1 N SAINT PAUL - RAMSEY COUNTY -
A L
410,‘ COMMUNITY HEALTH SERVICES milk
A A A A ADVISORY COMMITTEE TO THE SAINT PAUL CITY COUNCIL AND THE RAMSEY COUNTY BOARD OF COMMISSIONERS
555 Cedar Street
r Saint Paul,Minnesota 55101-2260 - RAMSEY COUNTY
651-266-1200
MEETING NOTICE
WEDNESDAY, SEPTEMBER 7, 2005
SAINT PAUL - RAMSEY COUNTY DEPARTMENT OF PUBLIC HEALTH
Ramsey County Government Center West (RCGC-West)
50 West Kellogg Boulevard, Suite 930 - STAR Room
Saint Paul
Enter on the river side/back of the building.
Map and Directions are Enclosed. RECEIVED
AUG 3 0 2005
AGENDA CITY CLERK
1. Call to Order
2. Update on the STEPS to a Healthier St. Paul Grant
3. Introduction Exercise
4. Updates Since Last Meeting
5. Overview of Department and CHSAC
6. Discussion on New Program Year
7. Adjourn
CHSAC Public Meeting will begin at 5:30 p.m.
NEXT MEETING OCTOBER 5, 2005
PACKET ENCLOSURES
1. July 2005 Section Updates
2. August 2005 Section Updates
3. Map and Directions to RCGC-West
** Attention CHS Advisory Committee Members **
Please contact Jan Pierson if you will not be attending the meeting:
Phone: 651-266-2408
E-Mail: jan.piersonaco.ramsey.mn.us
S.a(
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MI** 11110
IWm:eyGouMy
Saint Paul- Ramsey County Department of Public Health
Section ' UpcCates - JuCy 2005
MEDICAL DIRECTOR
During July and August,I will be hosting a physician from the occupational medicine residency
at Regions Hospital, Dr. Kenton Dodd. He will be observing and participating in activities here
at Saint Paul - Ramsey County Department of Public Health,the Minnesota Institute of Public
Health, and the Environmental Resource Council. Born in Nashville TN, he was educated at
Tennessee State University and Meharry Medical College,both in Nashville. After two years of
an internal medicine residency, he started the Occupational Medicine residency at Regions
Hospital and will finish in June 2006. Dr. Dodd is interested in public health prevention
programs for underserved populations, having seen the many preventable problems afflicting his
underserved patients while working as an internal medicine resident.
I continue to serve on the Maternal/Child Health Advisory Task Force for the Minnesota
Department of Health.
The tuberculosis clinic continues to be very busy with many new cases of the disease to assess
and treat. Rob Carlson, the Regions physician assistant who has been seeing patients in the TB
clinic here has just returned from six months of service with the American Refugee Committee
in the Darfur region of the Sudan. We are happy to have him back.
HEALTHY FAMILIES SECTION
C&TC Update:
Carver, Dakota, Hennepin, and Ramsey County Child and Teen Checkups Programs have
teamed up with ECHO to promote Child and Teen Checkups and Back-To—School Health on
their show schedule. ECHO can be seen on TPT/channel 17.
The segment will air July 24th at the following times:
8:00PM—Spanish, 8:20PM-Hmong, Somali-8: 40PM
The segment will air again on July31 at the following times:
8:00PM-Vietnamese, 8:20PM Lao, 8:40PM Cambodian
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The show will replay on August 20th, at 11:00PM and on September 3rd, at 11:00PM.
The information will also be available on the web through streaming video after the show airs on
TPT/channel 17. For further information about ECHO and additional web links about C&TC go
to www.echominnesota.org.
HEALTHY COMMUNITIES SECTION
Injury Prevention:
The Injury Prevention Program Coordinator is teaching safety classes at the East Side YMCA
Summer Camp this year. Bike Safety and Poison Prevention were the topics for June and July
and Home Safety will be covered in August. Classes are taught to about 40 children in two age
groups, 5 up to 8 and 8 to 11. This is the third year that Public Health and the YMCA have
worked together on this summer camp program.
The Risk Watch School Based Injury Prevention Program gives children and their families the
skills and knowledge they need to create safer homes and communities. The program has trained
a total of 447 teachers so far this year with more requests coming in for late summer. These
teachers come from 85 St. Paul schools including 8 preschools and all of Head Start. Teacher
evaluations continue to come in with positive responses. Orders for supplies for the '05— '06
school year have come in showing a strong commitment to the Program as well. Health Partners
just recently gave a grant of$1,000 to Risk Watch. The St. Paul Fire and Safety Services
Department continues to coordinate with the Ramsey County Sheriff's Department, Saint Paul
School District, and Saint Paul -Ramsey County Department of Public Health as active partners
on the Team.
PREVENTIVE HEALTH SERVICES SECTION
Robert Carlson is a Physician Assistant at the Center for International Health and Infectious
Disease Clinic at Regions Hospital. He also works in the Refugee/Immigrant Health and TB
Clinics at Ramsey County Public Health. He has recently returned from a 6 month leave of
absence working with the American Refugee Committee (ARC) in Sudan, Africa. ARC works
for the survival, health and well being of refugees, displaced persons and those at risk in order to
rebuild productive lives while respecting the values of those served.
Sudan has been plagued with civil war,which has resulted in famine and widespread health
crises. Rob worked with local staff providing Primary Care and Reproductive Health Services in
South Darfur. In collaboration with UNICEF and other United Nations partners, he participated
in National Immunization Campaigns to vaccinate children against Polio. Over 25,000 oral
vaccine doses where administered to children in remote villages.
We welcome Rob back with appreciation for his contribution to the ARC working during
political unrest in high risk security areas.
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Immunization Program:
The Immunization program has seen a shift in service needs over the last couple of years with
the same trend continuing in 2005.
In 2003 the immunization clinics had 2,589 visits with 31%being travel related and the
remaining 69%being regular,routine immunization visits (none of these visits include flu clinic
visits). In 2004 the immunization program had 2,992 visits (an increase of 16% over 2003) with
51%being travel related and 49%regular, routine immunization visits (again, none of these
visits were flu visits).
The decreasing number of visits for regular, routine immunizations is being felt in most counties
since the focus of all county immunization programs is to serve those clients that are uninsured
or underinsured. This is a positive decrease as long as those who are fully insured are going to
their own clinic for shots and well child exams/physicals. The immunization program believes
strongly in getting clients in for C&TC, well child visits and other preventive services.
Countless referrals to St. Mary's Health Clinics, Portico Healthnet, C&TC, dental and WIC
services etc. are made by the nurses during immunization visits. The staff in the immunization
program are doing a wonderful job of changing to meet the needs of the many clients we serve!
WIC SECTION
Not all of our seven clinics have been able to call in their monthly counts for June yet,but based
on the counts we have in hand, it looks like our caseload for June 2005 could be the highest we
have ever had. It will certainly be over 17,000.
We had three Farmers'Market vendors at our East Side WIC clinic last Thursday to launch the
first ever Farmers' Market located right at one of our WIC clinics. Participants and staff are very
happy to have the market right at East Side. This market will continue into late September on
Thursday afternoons from 2-6 pm.
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Ramsey County
Saint Paul- Ramsey County Department of PubCic Health
Section Updates - ,August 2005
MEDICAL DIRECTOR
I've been asked to serve as chair of the Minnesota Heart Disease& Stroke Prevention Committee. This
advisory committee will have its first meeting near the end of September. The purpose is to advise the
Minnesota Department of Health on its 2004-2010 State Strategic Plan for Heart Disease and Stroke.
That plan is available on the MDH website at www.health.state.mn.us/cvh.
There are three post-graduate medical trainees spending time at St. Paul - Ramsey County Department of
Public Health during August. Dr. Kenton Dodd from the Regions Hospital occupational medicine
residency is spending July and August with us. During August he will be joined by two other physicians,
Dr. Adam Ailabouni from the University-St. John's family medicine residency in Maplewood and Dr.
Akira Fujiyoshi, a fellow at the Mayo Clinic preventive medicine program. Each of the three physicians
has provided me with a bit of information about himself. Kenton Dodd grew up in Nashville TN and was
educated at Tennessee State University and Meharry Medical College in Nashville. He completed two
years of internal medicine training before joining the occupational medicine training program at Regions
Hospital in St. Paul. He is interested in public health prevention programs for underserved populations.
Akira Fujiyoshi graduated from a med school in Japan in 1991, worked as an endoscopist/internist for
several years in Japan, and then changed his career focus to health promotion, disease prevention, and
nutrition/lifestyle modification. Akira completed a medical residency at the University of Hawaii in 2005
and is currently a fellow in Preventive Medicine at Mayo Clinic. He is interested in nutritional
epidemiology and lifestyle related diseases, especially now that obesity is becoming universal in Japan as
well as the US. Adam Ailabouni is a second year resident in the family medicine program at St. John's
Hospital in Maplewood. He grew up in Farmington, MN, graduated from Iowa State University with an
aerospace engineering degree,then changed career paths and attended medical school at the University of
Minnesota - Duluth and then the University of Minnesota Twin Cities. He plans to practice family
medicine in the Twin Cities area after completing his training program.
ADMINISTRATION SECTION
Juenemann Building
It is anticipated that this fall the parking lot, sidewalks and ramp to the garage will undergo
improvements. Ramsey County Capital Improvement funds have been approved for these projects. The
dates, timeline, or impact on our operations is not yet known,but as plans are finalized staff at the
Juenemann building will be informed.
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_ I
VITAL RECORDS
Obtaining a Vital Record will cost more this Fall. In July, the fee for a marriage license increased to $100.
By receiving 12 hours of special premarital marriage counseling, you may have that fee reduced to $30.
Birth and death certificate fees also increased in August. The cost of a certified birth certificate is now
$16 and death certificate $13.
Passport changes are soon coming in three stages:
• December 31, 2005—passports are required for all travel to or from the Caribbean, Bermuda,
Central & South America
• December 31, 2006—passports required for all air and sea travel to or from Mexico & Canada
• December 31, 2007—passports required for all border crossings.
For some land border crossings other documents may be accepted in lieu of a passport,these include
Sentri for Mexico and Nexus for Canada. The cost for a passport is $97 for 16+years old.
ENVIRONMENTAL HEALTH SECTION
ADMINISTRATION
Energy Task Force. Ramsey County recently joined the Metro Counties Energy Task Force, which
includes Anoka, Dakota, Hennepin, Ramsey, Scott, Stearns and Washington Counties. Ramsey County is
represented by Commissioners Ortega and Carter, and Zack Hansen and Dan Donkers from the
Environmental Health Section are participating in staff-level work of the Task Force. The Task Force is
involved in energy policy supporting reliable, affordable energy supply, efforts to support renewable
energy such as wind and waste-to-energy, and programs promoting energy efficiency in county facilities
and other local government facilities. Membership for 2005 is on a trial basis; Ramsey County will
decide whether to continue involvement when it considers the department's budget for 2006-07.
COMMUNITY INVOLVEMENT
Radon Outreach Funding. We recently received short-term Federal funding through MDH to increase
radon outreach education in Spanish, Hmong and Somali. Activities to be funded included translation of
materials,placement of radon awareness ads in community papers and creation of recorded radon
"hotlines" in Spanish, Hmong and Somali.
Earth Action Challenge. A team of EH Section employees has been busy planning for the return debut of
the Earth Action Challenge on September 15th. The Challenge will spiritedly promote the values and
principles of the Ramsey County Environmental Mission over the upcoming year. The Challenge will
assist employees in their roles as environmental stewards of Ramsey County's resources by providing
tools and resources along with timely,useful information. The EH Section has already planned many
activities to promote the issues that the Challenge addresses, including monthly articles,pledges, quizzes,
mini-trainings, a purchasing fair, and environmentally friendly incentives to increase participation.
However, the team working on the Challenge is eager to hear what issues you would like to learn about,
and is willing to adjust the plan to accommodate most requests. Watch for the Ramsey News on
September 15th to learn more about the Challenge and how you can make a difference!
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COMPLIANCE PROGRAM: SOLID AND HAZARDOUS WASTE
Refuse Hauler Licensing. The Solid and Hazardous Waste Compliance Program has issued regional solid
waste hauler licenses for the current 2005-06 license year to 86 waste haulers,with applications from an
additional 10 - 15 haulers expected. The 6" x 6" orange decals are required to be displayed on the cab
side of the garbage truck. Look for the decal the next time your garbage is picked up and call us if you
don't see one! Michael Reed, 651-773-4443. Eight solid waste transfer stations and one infectious waste
treatment facility have been licensed for 2005-06 as well. These facilities are inspected at varying
frequencies depending on facility size and types of waste managed. Inspection frequencies range from
once quarterly to monthly.
RESOURCE RECOVERY
Two important policy actions were taken in recent weeks:
Tipping Fee Reduced from $39 per ton to $34 per ton. At their respective meetings on August 9, the
Ramsey and Washington County Boards reduced the tipping fee for haulers that have contracted to
deliver all of their Ramsey and Washington County waste to the Resource Recovery Facility in Newport.
It is hoped that the tipping fee reduction will increase and stabilize deliveries to the Newport Facility.
Both Ramsey and Washington County Boards have policies that support processing of waste and support
a transition to a merchant facility after their contract with NRG Energy for the Newport Facility expires in
July 2007. Declining deliveries at the Newport Facility are partially the result of competitive pricing at
landfills. The waste stream has not decreased,but the deliveries to places other than the Newport Facility
have increased. The County Environmental Charge (charged as a portion of refuse hauler bills) indirectly
affected deliveries to the Newport Facility due to redefining portions of the industrial waste stream.
Waste currently being handled as industrial waste was formerly handled as Municipal Solid Waste, which
was delivered to the Newport Facility. Industrial waste can be delivered to landfill. The reduction in the
tipping fee will somewhat offset the loss of the State Processing payment,which was rebated to haulers
who delivered to the Newport Facility. This payment ended in June 2005 and was not funded by the State
for future years.
Resource Recovery Project Budget Approved. On August 9, 2005, Ramsey and Washington County
Boards of Commissioners approved a two-year Resource Recovery Project Budget for 2006 and 2007.
The 2007 budget is actually for seven months of 2007 because the contract between the Counties and
NRG Energy will expire in July 2007. The budget is based on the reduction in the tipping fee from $39
per ton for haulers who deliver all waste to the Resource Recovery Facility to $34 per ton. Specific
Tonnage haulers (haulers that have agreed to deliver a specific amount of waste)will continue to deliver
at $41 per ton and can receive a rebate to the $34 per ton level if they meet their contractual obligation by
delivering the designated tonnage throughout the year.
POLICY, PLANNING, EVALUATION
Amendment of Contract for Providing Recycling Consulting Assistance to Municipalities. The
Department has contracted since 2003 with the national solid waste consulting firm of R.W. Beck, along
with the local firm of Dan Krivit and Associates, to provide technical assistance to municipalities on
recycling program issues. At its August 9 meeting, the Ramsey County Board increased the contract
amount by an additional $20,000 because of the continued demand for services by municipalities. During
the remainder of the contract this year, the consultants will continue to provide assistance to the City of
Maplewood, to help them procure a new curbside recycling contract and increase recycling in apartment
buildings, to the City of North Oaks, to help them with a curbside recycling contract and a pilot recycling
program with collection of additional recyclable materials,to the City of Roseville, to complete a pilot
recycling study report, and to one or two other communities, as the need arises.
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HEALTHY COMMUNITIES SECTION
WAKANHEZA UPDATE .
The Wakanheza Project continues to grow throughout Ramsey County and continues to get State and
National attention.
In September, Donald Gault has been invited to spend a day and a half at Helena,Montana for"The
Montana Coalition Against Domestic& Sexual Abuse (MCADSV) Annual"Leading the Way"
Conference. Donald will be sharing the lessons and perspectives of the Initiative for Violence Free
Families and Communities in Ramsey County and highlighting workplace and community violence
prevention tools. Wakanheza will be shared as an example of the processes and products that participants
can take back to their communities in crafting their own violence prevention initiative.
In October, Darleen Simmons has been invited to Richmond,Virginia's "Action Alliance" Conference
to showcase and facilitate a five-hour presentation/discussion of The Initiative for Violence Free Families
and Communities in Ramsey County's practices,philosophies and work in violence prevention. Joe
Olson, Senior Director of Visitor Services&Volunteers at the Minnesota Children's Museum will be
joining Darleen in this presentation to highlight how the MN Children's Museum has imbedded the
principals and practices of Wakanheza into their organization.
The Wakanheza Project is also expanding to schools statewide. Through a unique partnership with the
Minnesota Department of Education,Minnesota Children's Museum, Twin Cities Public Television,
Minnesota Parent Teachers Association, Minnesota Elementary School Principals Association and Saint
Paul-Ramsey County Department of Public Health,Wakanheza is being implemented to enhance school
environments and assure that all families,children,youth and staff in schools feel comfortable and
welcome.
HEALTHY FAMILIES SECTION
In mid-August,the newly named Bienestar Latino ("well-being of Latin people")work group (formerly
known as the Beta Spanish Work Group)visited the new CLUES and Mexican Consul building on Payne
Avenue to meet with representatives from the Latino Community and HealthEast to discuss collaborative
outreach in the community. CLUES Director Jesse Bethke Gomez reported that, in partnership with
HealthEast Care System,their organization will be opening an on-site clinic this September that will work
towards developing a public health model of care to provide services to all Saint Paul and Ramsey County
residents. Additionally he is looking to pilot a health plan with HealthEast clinics,with the goal of having
it replicated nationally to cover all uninsured Americans. Other areas that CLUES plans to work with are
mental and chemical health, case management services, and tobacco cessation initiatives. Jesse also plans
to invite the Ramsey County Board of Commissioners to the new CLUES location so they can see first-
hand the positive and exciting things that are happening in the Latino community.
Nathan Wolf Lustbader, Mexican Consul for the four-state area including Minnesota, described the role of
the consulate, including promoting Latino businesses,providing protection with immigration concerns,
issuing ID and matricular cards,and serving as a bridge to better understand Latino/Mexican and
American communities. Nathan summarized the contribution of Mexican workers to the U.S. economy at
$160 billion dollars per year. He also shared that through collaboration with groups such as DPH's
Bienestar Latino, the Consulate could be influential in creating changes that will benefit the Latino
community.
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Len Kaiser, Administrator of HealthEast clinics, described the creation of a health clinic at CLUES called
La Clinica HealthEast Salud Integral, following the vision of HealthEast Care Systems, CLUES and St.
Joseph's Hospital. Originally designed for Latinos,the clinic will serve all community members through
a medical model of practice, with two medical doctors and a certified nurse-midwife. Staff will be
bilingual and bicultural, supporting the language/cultural model mentioned previously. It is expected to
open in September. As a non-profit but not federally-subsidized clinic, it is working on ways to service
uninsured clients, possibly through a health care plan for Latinos with Portico insurance or a charity care
policy and referral system; it does not plan to offer a sliding fee scale. As it develops, the clinic is
dedicated to advance and expand services from a public health perspective.
Representatives from Public Health's Bienestar Latino, CLUES, the Mexican Consulate, and HealthEast
will continue to work together, and input from the greater community is always welcome. Current
members of Bienestar Latino include Deb Schumacher and Michelle Lessard, co-coordinators, Martha
Alicia, Elaine Borsheim, Kristi Brennan,Norma Cheesebrow, Marisol Chiclana-Ayala, Rosana Connell,
Tara Swaby, Sherrie Dougherty, Amy Edelstein, Rob Fulton, Donald Gault, Beverly Gerdes, Deb
Hendricks, Paula Henry, Diane Holmgren, Ann Hueller, Jillayn Lindahl, Cathi Lyman-Onkka, Sharon
Lynch, Barb Nelson, Mary Peick, Karla Schmieg, Patty Seflow, Mary Sonnen, and Denise Wolff.
PREVENTIVE HEALTH SERVICES SECTION
Family Planning Program
Family Planning Staff received the following letter from a patient for whom we provided services:
"Hello,
My name is . When I was in school in the early 1990's, I would visit the St. Paul-Ramsey
County Public Health offices for check-ups and medications,but didn't always have the money to cover
the full cost of services. Thanks to the sliding payment scale where I could pay according to my income, I
was able to continue receiving medical attention as needed.
I was always grateful for that,but even more grateful for the kind, non judgmental, and generous care I
received from those working there. I told myself that once I was out on my own and more financially
stable,that I'd send a donation of some kind to the center. Please accept this donation to Family Planning
in order to repay a small portion of what I used, and maybe help pay a little towards someone who needs
it. Use it however you see fit.
Thanks again for all of your help in the past. You've been a part of my success."
The Refugee Health and TB Control Programs have been very busy the past month managing the
influx of Hmong refugees from Wat Tham Krabok Camp in Thailand. According to the Minnesota
Department of Health(MDH), there were an estimated 5,180 Hmong refugees remaining in Wat Camp as
of the end of May, 2005. It is estimated that approximately 4,600 will be coming to the US by the end of
September, 2005. Approximately 1/3 or 1,500 of those refugees will come to Minnesota with @ 1,050
arriving in Ramsey County. The Refugee Health Program has been at full screening capacity since
March, 2005, and has been working closely with MDH and private clinics in Ramsey County to assure
that the recent influx of refugees are screened in a timely fashion.
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From the information received from MDH, as well as what we have seen thus far, a significant percentage
of the newly arriving Hmong refugees from the Wat Camp are designated as Class B TB. These
individuals need to be seen on a priority basis in the TB clinic, as they are either TB cases who have
completed treatment or persons with an abnormal CXR who need to be evaluated for active TB disease.
In addition,there are many children who are contacts of cases of TB disease in the camp and have been
placed on latent TB infection treatment.
This influx of Hmong refugees with TB-related concerns comes at a time when the TB Clinic is already
providing services to record numbers of patients. As of July 30th of this year,the TB Control Program is
providing services to 21 "counted" TB cases and 16 TB suspects. This compares with 11 "counted" cases
and 9 suspects at the same time last year. The total number of"counted" TB cases was 27 in 2004 and 29
in 2003.
The number of patients who are being treated for latent TB infection, that is,those persons with a positive
TB skin test and normal CXR who are advised to take medicine for 9 months to prevent TB disease from
developing in the future, has risen 47% over 2004 and 65%over 2003. The majority of these patients
have been identified through our Refugee Health Program. Thus, as refugee numbers increase, referrals
for latent TB infection treatment also increase. We follow these patients for up to a year as they complete
their medication regime. Thus, the recent influx of refugees will continue to impact the TB Control
Program in the coming months.
The TB Control Program and Health Records are continuing their participation in two CDC-sponsored
studies. One study is examining the factors associated with acceptance of and adherence to treatment for
latent TB infection. This involves a retrospective chart review,which is being conducted by Chris Bogut,
Supervisor of Health Records. The purpose of the second study is to describe the epidemiology of TB
among foreign-born persons in the U.S. and Canada in order to identify barriers to care and missed
opportunities for prevention. This involves interviewing a random sample of TB cases seen in the TB
Clinic. The interview is conducted by CDC-supported staff housed at MDH. These studies will provide
valuable information in our continuing efforts to improve TB-related services to foreign-born persons.
SCREENING &CASE MANAGEMENT SECTION
PCA Program
The Personal Care Assistant(PCA)program continues to see an increasing demand for services from an
increasingly diverse population. Since 1996, there has been a state mandate that county Public Health
Nurses perform these assessments on behalf of the State. The staff who work in this program provide
assessments to persons who are on straight MA to recommend eligibility for benefit under the Minnesota
Department of Human Services PCA program. Approximately 45%of the client assessments in Ramsey
County require the use of an interpreter. Data for this program demonstrates the increasing number of
assessments over the past several years:
PCA 2000 2001 2002 2003 2004
Assessments 1,094 1,173 1;396 1,503 1,959
Case Management Services
In 2003 the Minnesota Legislature adopted a service model, Minnesota Senior Care, intended to integrate
acute care and continuing care service by transferring the administration of the Elderly Waiver(EW)
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program from counties to health plans. The four health plans in Ramsey County are Blue Cross, Health
Partners, Medica and UCare. This model is to be effective 7/1/06.
By 1/1/06 all four health plans will offer the Minnesota Senior Health Options (MSHO)product which
will combine Medicare(parts A, B, and D) and Medical Assistance dollars for the "dually eligible". Case
management for consumers selecting the MSHO product will be provided by the health plans.
We have had numerous internal discussions and external discussions with colleagues from metro counties
at the Association of Minnesota Counties (AMC) Elderly Services Subcommittee meetings regarding how
these changes will affect our clients, the potential gains and losses, and the staffing and financial
implications for us.
WIC SECTION
The WIC participation count for July is in: WIC served an all time high number of participants: 17,251.
The WIC dietitians who counsel WIC participants with more serious health problems (eg stunted growth,
very low hemoglobins, failure to gain weight in pregnancy, etc)report that they are delighted with the
gains in growth and the resolution of low hemoglobin problems they are seeing in Hmong refugee
children who are coming back to WIC for follow up visits. They are doing very well! This should make
all of us in Public Health who have worked with these families very proud. It is due to the work of many
Sections that these children are thriving.
WIC Breastfeeding Initiation Rates for July, 2005:
West Side 82.32%
New Brighton 71.80%
Midway 68.81%
White Bear Lake 65.95%
555 Cedar 60.54%
East Side 50.08%
McDonough 47.93%
Consolidated 61.02%
55%- 79%of the women who initiated breastfeeding are still breastfeeding at 3 months. These duration
rates, along with the initiation rates, continue to rise. WIC staff have been working hard to provide
outstanding breastfeeding education and support, and it's great to see these efforts pay off in higher rates
of initiation and duration.
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Directions to the Government Center West Building
on the River Side Entrance
Public Health, 50 W. Kellogg Blvd., Suite 930, Saint Paul, Minnesota
From I94 going east or west, take the Marion Street/Kellogg Blvd. exit and
proceed down Kellogg Blvd (towards downtown) to West Seventh Street. Turn
right on 7th street and go one block to Chestnut Street. At Chestnut turn left from
West 7`h. Proceed down Chestnut to the 2nd stop light (Science Museum will be in
front of you) and take a right and proceed down to Shepard Road. After you cross
the railroad tracks, go left on Shepard Road. Proceed east on Shepard Rd. to the
next stop light and take a left. You will go back across the railroad tracks. As
soon as you cross the tracks go right. You will see the District Energy plant on
your left and then the Government Center WEST building (on your left). Park
anywhere behind the GC WEST building and enter the building under the brown
awning.
Security will open the door. Present your ID (drivers license or other picture ID).
Come up to the 9th floor. When you get off the elevator turn left and proceed to the
STAR room.
THE P Bldg. a LEGEND
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