Sessions

Jesse Powell, PA-C & Chelsea Shaw, PA-C; Hennepin Healthcare

Hepatitis C infection (HCV) is the most common chronic viral illness in the USA and is increasing despite highly effective and safe treatments. Many of the people with HCV struggle to access healthcare through traditional modalities for a variety of reasons, including competing priorities to meet basic needs and disparities in SDOH. Many have been disenfranchised by past experiences and the stigma they encountered at state-wide health institutions. These current barriers reflect previous findings we experienced with assessing HCV treatment readiness amongst persons residing in homeless shelters. In response to these findings, we have initiated measures to help mitigate these barriers. The Community Collaboration Viral Hepatitis ECHO (Extension for Community Healthcare Outcomes) is a virtual teaching platform that brings both providers and non-clinical community workers together around the goal of HCV elimination. The ECHO serves to develop a network for the treatment of HCV and empower those working in the community to improve identification, linkage to care, and treatment of those living with HCV. We also developed partnerships with syringe service providers (SSPs), treatment centers and other community groups to provide on-site HCV testing and education.

Caitlin Orgon, BS; Minnesota Department of Health

Labor trafficking is a pervasive and often overlooked issue facing many BIPOC individuals across the globe and right here in Minnesota. This presentation will shed light on the prevalence and impact of labor trafficking in our state and highlight key trends and risk factors, challenges, and strategies for prevention and intervention. Drawing on recent research and case studies, we will explore the various industries and contexts in which labor trafficking occurs, as well as the vulnerabilities and risk factors that contribute to its persistence. Attendees will learn about the resources and support services available to survivors of labor trafficking in Minnesota, and how they can get involved in the fight against labor trafficking. Attendees will also learn about recent legislative changes regarding labor trafficking and the child welfare response.

Alyssa Palmer; Southside Community Health Services

Burnout has been the buzzword for quite some time. As healthcare providers, it is our responsibility to deliver excellent, high-quality care to all individuals. But this is a challenge to succeed at this when we are ignoring our own mental and physical health needs. Operation re-design and employee wellness programs do not need to be complicated or costly. Here we can see how one clinic has begun investing in the people who do the work through employee health inquiries, building a multi-disciplinary wellness team, implementing new policies that support healthy lifestyles, and encouraging employees to use the very same advice we provide our patients.

Ryan Van Wyk, PsyD, LP; Trauma Focused Consulting

Our healthcare systems are in a state of crisis, evidenced by system closures, funding challenges, provider and team member departures, and increasing rates of burnout. It is clear that significant change is needed. Adopting a trauma-informed approach within the healthcare space recenters the policies and work dynamics around fostering safety and well-being for both team members and the individuals and communities they serve. A trauma-informed approach considers the ways in which trauma affects everyone and moves the ecosystem of care towards increased acknowledgment, improved support, and an environment that is welcoming and person-centered. This presentation will provide an understanding of the human nervous system and outline how to incorporate trauma-informed principles into healthcare settings, creating work cultures based on safety and predictability, increasing the effectiveness of care delivery, and cultivating greater resilience for everyone involved.

Micah Wilkins, MPH & Ali Ruprecht, MPH, RN; Minnesota Department of Health

Fetal Alcohol Spectrum Disorder (FASD) impacts up to 1 in 20 children in the United States, but confirming prenatal alcohol exposure, identifying symptoms and diagnosing FASD can be a challenge, especially because many, including clinicians, are unaware of FASD. Due to this lack of awareness and the lack of resources and supports around FASD, families are falling through the cracks. To better understand the supports and services needed for families impacted by FASD, dozens of parents and caregivers, clinicians, and care coordinators were interviewed, and the transcripts were thematically analyzed. Join us as we share findings from our qualitative research and discuss the next steps for this project to further engage community organizations like Proof Alliance and other key groups to use these findings to inform policy recommendations.

Robert Hest, MPP; State Health Access Data Assistance Center (SHADAC), UMN School of Public Health

The Minnesota Community and Uninsured Profile was created by SHADAC with essential guidance from the advisory board of MNsure navigators and policymakers and support from the Blue Cross Blue Shield of Minnesota Foundation to foster or bolster targeted outreach and enrollment activities of health insurance navigators and provide information about the uninsured to Minnesota policymakers as they develop strategies to reach the remaining uninsured in Minnesota. Since launching in 2019, the Profile has been downloaded more than three thousand times and has been used by navigators across Minnesota to support their work, identify regional uninsurance hotspots, and effectively target outreach to Minnesota’s remaining uninsured. The presentation will demonstrate the Profile and show how it has been and can be used by navigators and other community-level organizations to reach uninsured and underserved Minnesotans and support other community-level equity-focused work.

Stephanie Devitt, MPP; SDK Consulting

Digital technology is a new area of intervention that can improve health and reduce disparities. A study found that broadband access is the single social driver of health that is most correlated with surviving COVID during the pandemic. Since the pandemic, SDK has led community-informed research on both digital equity for Ramsey County and Saint Paul, as well extensive qualitative interviews on telehealth experiences with community-based healthcare providers like FQHCs and patients. This presentation will share lessons about the opportunities and barriers of connectivity to advancing the social drivers of health and health equity.

Vonyee Howard, CHW; Minnesota Community Health Worker Alliance & Zaira Rebollar; Ready, Set, Smile

Minnesota (MN) is one of the healthiest states in the nation, however, Black Indigenous and People Of Color (BIPOC) communities and/or communities with limited English proficiency (LEP) are consistently subject to health disparities. Many communities most affected by health disparities experience barriers to accessing healthcare in traditional settings. Community Health Workers (CHWs) play a vital role in advancing health equity, by bridging gaps between healthcare providers and underserved communities. MN has the framework for a strong and vibrant CHW workforce that reaches communities that experience disproportionately poorer health outcomes; however, barriers exist for the CHWs workforce to serving its full potential including limited access to CHW Certificate Training due to financial barriers, and lack of CHW awareness of agencies that could benefit from CHW services and thus lack of job opportunities. The Minnesota CHW Training Program (CHWTP), a collaborative effort between the MN Department of Health, Minnesota Community Health Worker Alliance, MN Department of Labor and Industry, and accredited institutions, aims to strengthen, diversify and expand the CHW workforce to address workforce barriers and ultimately impact health disparities in MN.

Laura Melnick, JD; Southern Minnesota Regional Legal Services, Inc. (SMRLS)

Government benefits are complicated, with arcane rules for who qualifies for what benefit. Providers and CHWs are in a unique position to connect noncitizen patients to these benefits, but it is key to understand their eligibility requirements. This session will provide an overview of benefits like cash assistance, food support, and health care and the requirements for eligibility for noncitizens.

Dr. Eileen Crespo, MD; Delta Dental of Minnesota & Sarah Wovcha, MPH; Children's Dental Services

In 2022, the Minnesota Department of Education found that nearly 44% of students in grades 8, 9, and 11 expressed that they experienced mental distress with approximately 20% of Minnesota youth (ages 0-17) being diagnosed with a mental or behavioral health condition. Mental health intersects with all areas of life, and if left unaddressed may have severe consequences for one’s overall health and well-being that can continue into adulthood. This session will address how common mental health conditions such as depression, as well as specific issues, like dental anxiety and eating disorders, impact one’s oral health. These conditions and issues can lead to unhealthy coping behaviors such as smoking/vaping, binge eating, induced vomiting, and physical habits like teeth grinding that can affect oral health (Delta Dental). This presentation seeks to raise awareness about the interrelationship between oral and mental health in children and youth, provide relevant resources to providers and stakeholders, and serve as a catalyst for additional public health work that will identify ways to strengthen ties between the disciplines of oral and mental health.

Amy Koch & Brian McDaniel; Wrong About Everything Podcast

Get a look at the legislative horizon and dive into the upcoming election and the impact it will have on community health in Minnesota.

Dr. Alice Lehman, MD; University of Minnesota

Syphilis rates in Minnesota have been increasing over the past decade. The epidemiology is changing with increasing rates among females of childbearing age and men who have sex with women. As with other health inequities, syphilis in females and infants disproportionately impacts AI/AN populations due to structural determinants of health, socioeconomic factors, and material circumstances. Public health measures have included efforts to increase healthcare system and provider awareness and endorsement of increased screening. The epidemiology of congenital syphilis in Minnesota and across the nation demonstrates a lack of timely testing and treatment in the majority of cases. Responses therefore need to both address barriers to access from both the healthcare system and community actions. During this presentation, we will describe lessons learned from time working in the AI/AN community with community members, community organizations, and health organizations in Minnesota.

Jennifer Strickland, RN, BAN, CPHQ; Minnesota Department of Health & Kayla Witzman; St. Luke's

The Health Care Homes (HCH) model is an approach to primary care in which primary care teams, patients and families, ancillary providers, and community partners work together to improve health outcomes for individuals with complex health conditions. This patient-centered medical home (PCMH) model shifts the focus from a purely medical model of care delivery to linking primary care with wellness, prevention, self-management, and community resources to benefit patients and community members. This unique model is showing improvements in cost and utilization, being outlined in literature, industry reports, and state and federal evaluation, and impacts each element of the quadruple aim.

Katelyn Laue; National Kidney Foundation & Dr. Ann Zukoski, DrPH; Minnesota Department of Health

Improving CKD recognition and management is urgently needed to improve healthcare quality, improve patient outcomes, close inequities in chronic disease outcomes, and improve financial performance. To address this underrecognized public health burden, the National Kidney Foundation (NKF) partnered with the Minnesota Department of Health and other key leaders to build a collective impact (CI) strategy to work across disparate sectors to address rising rates of CKD, low awareness, and late diagnosis. The Ending Disparities in CKD Leadership Summit (EDLS) utilized a series of Learning and Action Work Groups to engage over 50 key stakeholders and identify a series of recommendations to drive improvement in CKD, with an emphasis on closing disparities in care. This session will review the recommendations developed through the EDLS convening, describe alignment with existing efforts like MDH’s 2035 plan, and highlight opportunities for safety net providers to utilize the recommendations in their practice to improve quality of care and equity in chronic disease management.

Joanne Flores, LDA, REF, Lucia Humphrey, LDA, REF, Maria Spanier, Crystal Robledo; Community-University Health Care Center (CUHCC)

After the pandemic, many community health centers (CHCs) have struggled to recruit and retain dental assistants. Since oral healthcare is so crucial to patients' health,this created an opportunity to adapt to meet the needs of their patients. Community-University Health Care Center (CUHCC) faced similar challenges and had to learn to be resourceful by participating in the Minnesota Association of Community Health Centers' (MNACHC's) Dental Assisting Apprenticeship Program. This presentation will share the strengths and benefits of participating in this program, as well as the challenges.

Yesica Gonzalez de Evans, BS & Jose Salinas-Valdivia, MA; NorthPoint Health & Wellness Center

Across the nation, there have been challenges faced by vulnerable populations accessing quality services in health and social care. Those challenges are more significant in the case of newly arrived immigrants whose primary language is not English. This presentation will explore demographic, institutional, language, and culture-based challenges in providing health and social services to newly arrived immigrants in Minnesota. Observations from interpreters and translators working at NorthPoint Health & Wellness Center will be shared.

Dr. Adrienne Richardson, MD; Minnesota Perinatal Quality Collaborative

Perinatal quality collaboratives, like the one at MNPQC, give an opportunity to participating hospitals, clinics, and community organizations to work together on a specific topic or initiative that will improve patient outcomes. MNPQC has ongoing initiatives within their quality collaborative to address substance use in pregnancy. These initiatives include a combined initiative that will focus on substance use and mental health in pregnancy, along with short, focused efforts on naloxone education and community mapping. These quality improvement programs allow for dissemination of accurate evidence-based data and allow organizations a structured way to improve their quality of care. Participants develop their own plan, do, study, act cycles for various quality improvements of their choosing and then discuss with the collaborators. This presentation will share the findings from participants in this quality collaborative.

Christine Rangen, DNP, APRN, CNM, SANE; People's Center Clinics and Services

Safety net providers are in the most excellent position to provide compassionate, comprehensive trauma-informed care that is both culturally responsive and competent while being patient and whole-person-centered. People’s Center is on the frontline as a critical access safety net clinic providing first-time care to many new arrivals to the state of Minnesota. New arrivals often are faced with challenges brought by female circumcision requiring not only medical expertise but also cultural and patient-focused care to meet the numerous needs of the patient. This presentation aims to provide tools and interventions to lay the groundwork for patients to be empowered in their care, through being understood and respected, for them to actively take charge in managing chronic health conditions and prevent others.

Sheyanga Beecher, MSN, MPH; Hennepin Healthcare Mobile Health, Maggie Eckerstorfer; University of Minnesota Mobile Health Initiative, Reysel Castillo; Neighborhood HealthSource

Minnesota has seen a surge in newcomer families from Central and South America over the past year. They are often reluctant or unable to access traditional healthcare due to a lack of health insurance or fear of deportation. Mobile clinics are a uniquely adaptable model of healthcare that can meet newcomers where they are rather than waiting until they present to emergency departments. The Hennepin Healthcare Pediatric Mobile Clinic, Neighborhood Health Source, and the University of Minnesota Mobile Health Initiative have collaborated to provide care for newcomers at emergency shelters, schools, and community-based organizations. This panel discussion will describe the current migrant crisis, identify specific and unique migration health risks, and propose solutions based on best-practice evidence.

Emily Petran, MPH; Midwest AIDS Training & Education Center (MATEC) ; Jean Larson, MS, APRN, PMHNP-BC; Minnesota Department of Health; George Froehle, PA-C, AAHIVS; Hennepin County Medical Center/Aliveness Project

Surveillance data in Minnesota shows that many people are being missed in receiving HIV testing and in turn are diagnosed late for HIV/AIDS. HIV is now considered a manageable chronic condition, with life expectancy very similar to the general US population when taking HIV meds. Individuals living with HIV deserve access to treatment where they feel comfortable and safe, and those at risk for HIV deserve appropriate interventions, including HIV testing and PrEP. This presentation will describe how important CHCs, FQHCs, and community-based organizations are in ending the HIV epidemic, and what resources are available to them to support their involvement in ending the epidemic.

Dr. Katherine Montag Schafer, PharmD, BCACP, CDCES, Dr. Kathryn Brown, Dr. Cassie Silveira, PhD, MPH, RD; University of Minnesota

Diabetes prevalence rates have been reported to be as high as 11.3% in Hmong-American populations. The Hmong community experiences disparities in diabetes outcomes in Minnesota. Local data from state registries identifies that Hmong-speaking patients in Minnesota have the lowest rate of optimal diabetes care as defined by community standards. The current disparities demonstrate that the standard of care and available tools are not meeting the needs of Hmong patients with diabetes and culturally relevant resources for this community are greatly needed. This presentation will share information about the creation of culturally informed materials to support the management of diabetes for patients in the Hmong community.

Karmen Dippmann, MPH; Minnesota Department of Health, Rachel Engh; ACET Inc., Sheyanga Beecher, CNP, MSN, MPH; Hennepin Healthcare

The goal of this presentation is to showcase the IMPLICIT (Interventions to Minimize Preterm and Low birthweight Infants using Continuous Improvement Techniques) program in Minnesota. This is a family medicine, maternal-child health learning collaborative where the Minnesota Department of Health (MDH), and technical assistance providers at ACET, Inc., and National IMPLICIT Network, support clinics to improve healthcare for women, infants, and families. The MN IMPLICIT network focuses on the ICC (interconception care) model. The network developed the IMPLICIT Interconception Care Toolkit to incorporate maternal risk assessment between pregnancies for smoking, depression, family planning, and multivitamin/folic acid intake into well-child visits to improve birth outcomes.

Dr. Gretchen A. Moen, DNP, APRN, CNP & Kelly Kenley, MPP; Dakota Child and Family Clinic/Open Door Health Center

Results of the 2022 MN student survey indicate 44% of student responders in grades 8-11 are battling mental health issues which is a 10% increase over the previous survey in 2016. Pediatric and adolescent mental health providers are unable to meet the growing need for mental health services. The model for integrating behavioral health and primary care services improves access to urgently needed services for children and families, particularly for members of safety net clinics. Participants will learn how to provide culturally appropriate and clinically sound support to families who have children with mental health or neurobehavioral conditions while utilizing our position as a trusted provider to reduce the stigma of mental health conditions.

Dr. Jonathan Neufeld, PhD; Great Plains Telehealth Resource & Assistance Center (gpTRAC) & Kate Surbaugh, BSN, RN; Sawtooth Mountain Clinic

Telehealth use among health centers has settled at about 5%-10% of primary care and 30%-45% of behavioral health care. The policies that allow health centers to bill for telehealth services are still temporary, despite recent extensions. It is important for health centers to understand the current state of telehealth policies, recognize potential policy changes on the horizon, and understand relevant service examples that they can emulate and modify for their own use. This presentation will review the current status of telehealth regulations and reimbursement for Minnesota health centers, and will also provide an in-depth review of a recent funded project conducted at health centers in the Breakwater Health Network.