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From YouTube: Recording of April 10 Meeting
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C
All
right
well
I'll,
go
ahead
and
at
least
kick
it
off
or
oh
wait.
So,
there's
Brooke,
okay,
all
right!
Well
welcome
to
the
Monday
April
10th
2023,
regular
Board
of
Health
meeting
the
time
is
now
5
31.
and
our
first
item
is
public
comments.
So,
as
a
reminder,
the
Board
of
Health
provides
opportunity
for
the
public
to
share
their
viewpoints
and
opinion
on
public
health
matters.
C
The
not
at
the
practice
of
the
board
or
agency
staff
to
review
vet
for
accuracy
or
grounding
and
scientific
evidence
or
provide
responses
to
public
comments
and
is
expressed
by
the
public
should
not
necessarily
interpreted
as
accurate
if
staff
or
the
board
does
not
challenge
the
perspective.
So
I
believe
we
have
two
public
comments
tonight.
Is
that
correct.
A
So
we
had
one
written
comment
that
was
submitted
to
the
board
and
then
we
had
a
request
to
speak.
That
was
Brian
Scott,
but
I
do
not
see
him
online,
so
I'll
leave
it
to
the
subject
of
the
board.
If,
when
he
does
log
on
oh.
C
C
C
Okay,
all
right
well
we'll
go
back
Ryan
welcome!
You
have
three
minutes
to
make
comment.
F
Thanks
for
circling
black
I
appreciate
it
just
just
curious
I,
maybe
missed
the
comment,
but
certainly
advocating
for
you
all,
allowing
the
public
to
attend
your
meeting
in
person.
I.
Think
video
chat
doesn't
do
it.
You
guys
have
been
trying
to
do
that
since
September.
So
all
I
can
say
with
encouragement
is
make
it
happen.
Boulder
City,
Council,
Arts,
commission,
County,
Commissioners,
every
other
groups
made
it
happen,
except
for
you
guys.
F
So
if
you
could,
that
would
be
appreciated
back
to
kovid
I
think
we
see
the
Public
Health
Emergency
winding
down
arbitrarily
at
a
future
date,
which
I
think
is
comical
in
itself.
So
you
know.
I
I
certainly
hope
that
there's
been
a
little
bit
more
expansion
on
your
thoughts
on
that
thread
over
time.
F
I
I
find
it
appalling
that
they're
still
being
recommended,
but
you
can
see
other
countries
are,
are
rolling
back
their
recommendations,
Switzerland
being
one
of
them
so
good
on
them.
They
do
not
recommend
the
covid
vaccine
anymore.
We've
seen
the
coveted
shot
looks
like
a
nuclear
bomb
in
someone's
system,
immune
suppression,
increased
cancer
rates
reactivation,
no
latent
viruses,
now
35
000
deaths
and
bars
over
1.5
million
adverse
of
Adverse
Events.
F
Again,
no
one
in
your
group
has
ever
acknowledged
this
and
you
thrust
your
position
on
the
community,
which
is
why
I
continue
to
show
up
here.
You
made
my
life
immeasurably
harder
for
no
reason:
the
community
transmission
levels,
boy
I,
wish
we
had
those
back
in
2021
earlier
2020
are
another
arbitrary
threshold,
so
again,
I
think
there's
a
lot
of
anger
in
the
community.
I
think
it's
unfortunate!
You
hide
from
the
community.
You
disable
all
your
comments
everywhere.
Public
can't
attend
it's
only
this
short
comment
period.
F
I
define
this
to
be
really
relatively
ineffective
rather
than
chatting
with
you.
So
to
that
extent,
don't
vilify
your
opponents
and
you
won't
get
so
much
pressure
back
revisit
that
February
meeting
of
last
year
to
know
community
does
show
up
when
they
are
needed.
Glad
this
covet
emergency
is
beyond
us,
never
was
an
emergency
and
don't
don't
ever
again
use
mandates
or
any
lockdowns
or
or
Force
otherwise,
for
any
future
health
emergency
tell
people
to
get
outside
stay
healthy
and
that's
it,
and
that
would
be
greatly
appreciated.
F
Thanks
for
listening,
I
encourage
you
get
in
person
great
make
it
happen.
You
say
the
same
Spiel
every
day.
September,
please
make
it
happen.
Let
the
community
show
up
there's
only
a
few
of
us
anyway,
30
seconds
I
think
anyone
else
Tunes
in
yeah
it
would
be
impactful
and
I,
think
your
ability
or
inability
to
actually
reason
and
talk
with
us
through
these
issues
that
makes
movement
forward,
not
disparaging
your
opponent,
not
just
allowing
a
comment
period
with
a
notice
on
the
front
of
it.
F
F
C
That's
the
item
three
on
the
agenda.
2021
audit
results.
G
Director
of
Boulder
County,
Public,
Health
and
interim
executive
director,
our
first
item
on
the
agenda
tonight
we
have
Sam
felwig
principal
at
Clifton,
Larson,
Allen
LLP.
To
present
our
2021
audit
findings.
Welcome
Sam.
H
H
H
Perfect
I
just
want
to
start
by
saying
yep.
We
completed
the
2021
Financial
audit.
We
know
this
is
as
of
December
31st,
2021,
so
2022
for
those
who
are
considered
wondering
the
December
31st
2022
audit
is
expected
to
start
either
in
May
or
June
of
this
year,
so
we're
getting
back
on
track.
H
We
know
things
were
extremely
hectic
and
busy
over
the
last
couple
years,
so
we're
expected
and
excited
to
get
back
on
track
with
an
audit
schedule
this
coming
year,
so
with
that
I
just
wanted
to
briefly
present
on
the
audit
going
back
to
December
31st
of
2021.
So
the
pages
that
we
have
here
include
the
Auditors
independent
Auditors
report.
This
is
on
the
first
couple
of
pages
of
the
annual
financial
statements.
You'll
note
that
this
does
reflect
the
governmental
activities
and
the
major
fund
being
the
general
fund
of
Boulder
County
Public
Health.
H
These
are
comparative
financial
statements
for
2021
as
well
as
2020..
So
every
statement
that
you
see
will
have
two
statements
for
both
of
those
years,
comparatively
so
new
this
year.
Com,
if
you
were
to
compare
and
go
back
to
last
year's
I,
should
say
2020's
financial
statements
and
our
audit
opinion.
There
was
a
slight
change
in
the
terminology
and
just
the
the
ordering
really
of
of
this
audit
report.
H
Basically,
what
happened
was
it
moved
the
pitch
the
opinion
from
page
two
or
three
all
the
way
up
to
the
front,
so
I
got
to
the
good
news
first,
so
we're
happy
to
report
that
in
our
our
opinion,
the
financial
statements
referred
to,
above
meaning
the
governmental
activities
and
the
major
fund
for
those
two
fiscal
years
are
presented
fairly
in
all
material
specs.
So
that's
the
great
news.
It's
a
clean
audit
opinion.
H
It's
it's
what
everyone's
excited
for,
so
as
you
scroll
down
just
a
little
bit
the
paragraph
just
below
it
is
our
basis
for
opinion,
and
so
this
is
the
standards
that
we
measure
our
audit
work
against
in
the
financial
statements
themselves.
This
was
unchanged
it's
in
accordance
with
generally
accepted
United,
States
or
sorry.
Auditing
standards
generally
accepted
the
United
States
of
America,
as
well
as
Government
auditing
standards.
H
So
the
report
at
the
very
back
will
actually
refer
to
the
government
auditing
standards
report,
which
is
over
internal
control
and
compliance
I'll,
get
to
that
in
just
a
moment,
so
responsibilities
for
management,
there's
auditor
responsibilities
on
the
next
page,
but
the
management
responsibilities
are
what
I
also
wanted
to
touch
on,
and
that's
where
management
is
responsible
for
the
preparation
and
fair
presentation
of
these
financial
statements
in
accordance
with
those
accounting
principles
that
I
just
previously
mentioned.
This
includes
the
design,
implementation
and
maintenance
of
internal
control
relative
to
preparing
those
financial
statements.
H
One
other
thing
that
was
added
as
a
real
in
the
last
year
was
related
to
going
concern.
This
is
typically
not
an
issue
for
governments,
but
it
is
something
that
is
now
called
out
in
audited
audit
opinions,
so
that
last
paragraph
on
this
first
page
discusses
that
there,
if
there
was
an
issue
related
to
going
concern
for
a
period
of
12
months
after
a
report
date,
we
would
have
to
call
that
out
and
subsequently
add
that
to
our
footnotes.
So
there
was
no
issue
in
that
regard.
H
This
also
was
expanded
upon
in
the
new
audit
opinion
format.
It
basically
goes
into
more
Auditors
responsibilities
and
calls
out
what
we
what
we
do
as
part
of
the
audit.
So,
although
our
standards
and
our
exact
efforts
during
the
audit
procedures
didn't
change,
this
is
just
a
more
detail
about
what
we
actually
went
through
as
part
of
the
audit
process.
So
in
that
terms
of
that
first
bullet,
we
exercise
professional
judgment.
We
maintain
professional
skepticism
throughout
the
audit.
H
We
we
assess
the
risk
of
material
misstatement
over
the
financial
statements,
whether
due
to
fraud
or
air.
We
obtain
an
understanding
of
those
internal
controls
set
up
by
management
and
we
design
tests
related
to
that
internal
control
and
key
balances,
and
at
the
very
bottom
there
we
go
into
the
appropriateness
of
accounting
policies
and
the
reasonableness
of
significant
accounting
estimates.
So
I'll
go
into
a
little
more
detail
about
significant
estimates
in
the
governance
communication.
H
This
audit
opinion
does
call
out
required
supplementary
information
as
well.
This
is
the
as
it
spells
out
the
Management's
discussion
and
Analysis
the
schedule
of
net
pension
liability.
The
opeb
schedules,
those
sorts
of
things
those
are
called
out
in
the
table
of
contents,
as
well
as
our
audit
opinion,
because
those
are
not
part
of
the
basic
financial
statements.
H
Okay,
so
anything
related
to
the
basic
financial
statements
includes
includes
the
basic
financial
statements,
the
the
balance
sheet,
the
income
statement,
the
statement
of
net
position
and
the
statement
of
activities
and
the
related
notes
to
those
financial
statements.
That's
what
we
issue
our
opinion
over.
This
requires
supplementary
information.
We
do
perform
regular
audit
tests
to
tie
it
into
the
rest
of
our
audit
work,
but
we
do
not
express
an
opinion
over
that.
Those
statements.
H
H
So
with
that
I
think
the
next
several
Pages
this
is.
Our
entire
audit
report
includes
the
audited
financial
statements
for
2021
and
2020.,
so
between
Pages
6
through
64
I
believe
is
where
you
get
the
various
schedules
you
get
the
basic
financial
statements
I'm
not
going
to
go
into
too
much
detail
with
these
other
than
to
highlight
on
page
six
is
where
the
Management's
discussion
and
Analysis
starts,
and
if
you
wanted
to
go
back
and
look
at
2021,
2020
high
level,
the
management
discussion
analysis
provides
really
good
depth
about
what
happened
in
those
comparative
years.
H
H
There
we
go
there,
we
go
so
this
report
is
in
accordance
with
government
auditing
standards,
and
this
is
associated
with
it
really
just
comes
up
with
Federal
the
receipt
and
expense
of
federal
dollars.
So
with
these,
we
we
do
have
to
perform
audit
procedures
in
accordance
with
gas
is
what
it's
called.
So
what
this
report
goes
into
is
that
it's
our
evaluation
of
internal
control
over
financial
reporting
and
on
compliance
and
other
matters
with
with
gas.
H
So
when
we're
talking
about
this,
we're
not
issuing
an
opinion
over
internal
control,
but
we're
evaluating
and
the
internal
control
environment
for
any
non-compliance
related
to
these
auditing
standards,
so
at
the
very
bottom
scroll
through
it
goes
into
that
it
references
our
audit
report
that
we
had
ever
mentioned,
but
the
beginning
here
at
the
very
bottom
goes
into
that
there
was
no
significant
issues
identified.
D
Well,
I
think
this
is
great
news
because
we
have
had
a
lot
of
turnover
in
this
department,
so
it's
great
that
this
came
through.
I
did
have
a
question
about
in
the
in
the
past,
because
this
is
an
issue
of
Statewide
in
Colorado
I,
remember
this
came
up
years
ago,
but
just
about
pension
liabilities.
I
D
H
That
would
be
the
same
position
and
you
scroll
down
to
the
liabilities,
and
this
is
where
the
net
pension
liability,
as
well
as
opeb
other
post-employment
benefits.
This
is
where
it
did
become
part
in
several
years
ago,
when
Gatsby
67
was
adopted
for
every
every
government,
the
pension
and
opeb
liabilities
were
previously
not
reported
on
government
financial
statements,
and
then
the
portion
that
was
related
to
each
government
was
reported.
H
So
when
you
scroll
down
just
a
little
bit
more
to
the
bottom
of
net
position,
everybody's
net
position
got
skewed
and
kind
of
thrown
throwing
awry
because
of
those
liabilities
going
on
to
each
financial
statement.
So
that's
why
there's
a
a
big
negative
or
deficit
net
position
on
just
about
every
government
because
of
that
pension
and
opeb
liability.
The
messaging,
though,
is
the
same
where
every
year
it
just
becomes
part
of
the
contributions
that
that
may
or
may
not
change
those
percentages
that
go
through
payroll
in
terms
of
the
overall
liabilities
themselves.
H
It's
really
not
of
a
risk
or
concern
of
those
becoming
immediately
due
and
payable.
There
would
be
no
risk
from
that
standpoint.
It's
just
a
this
is
a
number
that
you
see
once
a
year
in
audited
financial
statements
and
and
so
I
wanted.
I
wanted
to
address
that
on
these,
what
you
would
call
government-wide
financial
statements,
but
if
you
were
to
go
down
two
or
three
pages
to
the
balance
sheet,
let's
go
one
more
yep
here
we
go
so
this
would
be.
H
If
you
wanted
to
look
at
the
general
fund,
it
excludes
those
long-term
liabilities,
and
this
gives
you,
if
you
scroll
down
just
a
little
bit
to
the
overall
fund
balance.
This
reflects
more
healthy
fund
balance,
more
accurate
representation,
if
you
will
of
what
resources
are
available
for
the
for
Boulder,
County,
Public,
Health
and
every
in
any
given
moment.
D
H
That's
a
great
question
at
the
very
back
one
of
the
or
a
couple
of
the
required
supplementary
schedules
it
might
be
in
the
60s
starting
in
the
60s.
H
H
But
again
this
is
a
historical
perspective.
It
doesn't
look
out
into
the
future.
It's
it's
really
just
something
that's
assessed
every
year
and
the
Actuarial
reports
that
are
really
relied
on
those
those
come
in
typically
one
one
year
in
arrears,
with
with
roll
forward
work,
procedures
done
but
I
know,
that's
all
the
results
it's
tough
with,
especially
over
2022
you're,
looking
at
a
higher
interest
rate
environment.
Obviously
a
lot
of
things
have
changed
there.
Contributions
change
in
accordance
with
those
Actuarial
estimates.
J
E
H
So
this
is
the
final
part
of
the
audit
report,
so
we
issue
our
audit
opinion,
but
we
also
have
final
governance
Communications
with
with
you
the
board
over
over
the
results
of
the
audit.
So
this
really
summarizes
the
key
aspects
of
of
any
audit
documentation.
You'll
notice,
it's
pretty
similar
to
the
one
that
was
issued
each
year.
There
were
too
many
substantive
changes
with
this
document.
So
if
you
scroll
down
just
a
little
bit,
the
first
section
goes
into
aspects
of
accounting
policies
and
practices.
H
If
there
was
any
new
accounting
policies
put
into
place,
let's
say
management
changed
a
certain
aspect
of
how
things
were
measured.
Then
we
would
call
that
out
here
and
express
how
we
ended
up
going
about
the
audit
in
that
way.
So
for
2022,
a
common
one
that
we're
seeing
for
other
audits
that
have
been
completed
was
gas
b87
or
leases.
That's
something
that
we're
going
to
be
going
into
in
the
future.
With
the
2022
financial
statement,
audit
is
consideration
of
leases
and
both
on
the
less
east
side
and
less
source
side.
H
So
that's
something
I'll
be
working
with
Desiree
and
her
team
on
in
the
coming
future,
but
that's
just
an
example
for,
for
reference,
sure
accounting
estimates
just
down
below
is
what
we
just
talked
about
regarding
the
pension
and
oped
liabilities.
So
that's
the
most
significant
accounting
estimates
there,
but
in
all
actuality,
there's
not
too
many
changes
there
regarding
Management's
estimate
in
that
regard,
a
lot
of
that
is
Actuarial,
actuarially
driven
and
go
to
the
next
page.
H
This
goes
into
any
significant
issues
or
or
other
conversations
that
management
might
have
had.
We
might
have
had
with
management.
So
there
was
no
significant
unusual
transactions.
There
was
no
difficulties
encountered
in
performing
the
audit
other
than
the
delay
in
time,
which
is
not
unusual
and
again
we're
working
to
get
back
on
on
track.
From
that
perspective,
the
next
two
bullets
were
uncorrected
in
the
statements
and
corrected
so
with
uncorrected
misstatements.
This
is
something
and
I
apologize.
H
That
final
should
have
been
16
800,
not
16
and
80
cents,
but
this
is
something
that
was
deemed
immaterial
to
the
overall
financial
statements
and
was
passed
on
recording
by
management.
So
this
is
something
that
we
noted
should
have
not
been
recorded
twice,
but
it
was,
and
it
was
not
corrected
in
fiscal
22..
So
it's
gonna
it's
one
of
those
that
gets
correct
and
going
forward
and
right.
H
Be
correct,
misstatements
if
it
was
deemed
material
or
significant
to
the
financial
statements,
we
would
be
forced
to
call
that
out
and
there
were
no
such
corrected
misstatements
so
again,
just
reiterating
with
the
turnover
we
understand.
The
process
was
long
for
closing
the
books
in
a
long
audit
process,
but
overall,
very
clean
results
from
those
two
sections.
H
The
only
other
two
pieces
that
I
wanted
to
call
out
was
just
below
it
with
disagreements
with
management
there.
There
were
none
if
there,
if
there
were
any,
we
would
be
calling
them
out
here
and
management
representations
those
go
into
Pages
four
through
the
the
last
10.
So
those
would
be
the
bullet
points.
If
you
wanted
to
review
those
what
management
has
represented
as
part
of
the
audit
going
over
things
such
as
assets,
liabilities,
Equity,
any
anything
of
those
representations,
that's
what
management
has
asserted
in
the
last
few
pages
of
that
document,.
A
C
H
C
He's
great
thanks
and
thanks
to
the
everybody
on
the
bcph
team,
I
know
a
lot
of
you
know,
grant
funding
was
happening
during
this
time:
the
change
in
systems,
and
so
that
required
extra
diligence
on
your
part
and
there's
too
many
people
to
thank
but
great
job.
Everyone.
C
G
We
moved
to
the
next
agenda
item
I,
believe
Desiree
and
Catherine
have
a
little
follow-up.
Oh.
C
B
Yeah
I'm
misery,
Castle,
rosian,
finance
manager
and
I
just
wanted
to
give
you
a
quick
update
where
we
are
with
the
county
on
this
year's
audit.
So
last
year
the
audit
wasn't
issued
to
the
end
of
the
year
so
this
year
the
goal
is
to
issue
the
audit
in
July,
so
bcph
doesn't
create
our
own
financials.
We
hire
Clifton
Larson
Allen
to
do
that
for
us,
so
the
county
is
aiming
to
get
their
trial,
balance
ready
by
May
1st.
We
were
probably
in
for
some
time
in
May.
B
We
don't
have
the
same.
We
don't
have
the
same
prep
after
we
get
the
trial
balance
that
they
do
so
we
are
working
on
getting
our
engagement
letter
because
that
hasn't
been
received
yet
from
Clifton
Larson
Allen.
So
I
discussed
that
with
Sam
on
Friday.
So
we're
looking
to
get
that,
so
we
can
actually
get
the
audit
started
under
our
contract.
B
We
use
them,
obviously
because
the
county
uses
them.
So
we
piggyback
off
of
that
same
contract.
The
news
for
us
is
this
year
we
have
a
new
senior
accountant,
so
we
used
to
have
Susan
Hyatt.
So
now
we
have
Jessica
fullinger
and
she
started
a
month
ago
and
she
is
already
into
audit
reconciliations.
B
We
are
having
a
weekly
meeting
with
the
ofm
Alan
Smith
and
aligning
ourselves
to
the
county
timelines.
Is
there
anything
else
I
can
provide
for
you.
G
Right
and
I
I
just
want
to
extend
the
appreciation
to
the
staff,
so
when
this
audit
was
conducted,
that
was
in
the
middle
of
an
enormous
amount
of
turnover
in
the
NF
team
and
just
kudos
to
the
team
for
being
able
to
make
sure
that
those
puzzle
pieces
were
all
fitting
together
and
the
Auditors
got
just
what
they
needed
to
provide
us
with
that
feedback.
So
thank
you
so
much
of
course,.
C
G
So
in
January
we
said
that
the
providance
update
in
April
to
the
Board
of
Health
on
progress
on
our
Public
Health
Improvement
plan,
which
is
focused
on
mental
and
Behavioral
Health,
which
we
are
developing
as
part
of
a
broader
strategic
plan
and
coordination
with
other
County
departments,
as
well
as
provide
an
update
on
our
broader
strategic
planning
process.
G
We
are
still
aiming
to
have
the
public
health
Improvement
plan
or
the
fifth
largely
built
out
in
terms
of
strategies
and
priorities
by
early
summer
and
our
strategic
plan
by
the
end
of
the
year.
This
evening
we
have
Elise
Wong
our
help,
planning
and
evaluation
manager
and
Rachel
mental,
our
health
planning
and
evaluation
Health
planner
to
provide
updates
on
both
planning
processes
and
I
believe
Kelly
hinch.
Our
director
of
strategic
initiatives
will
start
us
off.
I
Lexi
so
Kelly
hinch
to
your
pronouns,
because
she
take
initiatives
director
yeah
before
we
turn
it
over
to
Elise
and
Rachel
I
just
wanted
to
reiterate
what
Lexi
said
that
this
is
a
a
complex
process
of
building
our
Public
Health
Improvement
plan
in
our
broader
strategic
plan
and
we're
building
in
a
way
that
we've
never
done
it
before.
I
As
an
agency
and
I
think
it's
a
really
unique
and
interesting
ways
are
going
to
really
move
us
forward
or
move
the
needle
forward
in
ways
we
haven't
been
able
to
do
so
in
the
past,
and
so
again,
Rachel
and
Elise
will
give
an
update,
but
I
do
want
to
send
out
Kudos
I
think
we
have
a
really
Dynamite
team,
with
both
Rachel
and
Elise,
and
also
Dave
larocca,
who
is
our
mental
Behavior
Health
coordinator
also
on
the
Sim
team.
I
He
is
joining
us
remotely
and
also
to
Lexi
who
meets
with
us
every
week
and
brings
her
skill
set
significant
skill
set.
I
must
say
to
this
discussion
as
well.
So
we
really
appreciate
that.
So
at
least
let
you
jump
in
sounds.
K
Good
nice
to
be
back
and
see
you
all
again
again.
My
name
is
Elise
Wong
health
planning
and
evaluation
program
manager.
She
her
hers,
pronouns
and,
as
you
also
have
heard,
Rachel
mental,
our
wonderful
Health
planner,
who
also
uses
she
her
hers,
pronouns.
We
are
going
to
tag
team,
our
presentation
tonight
and
give
you
kind
of
an
update
on
a
lot
of
the
information
that
we
shared
with
you
back
in
I
think
it
was
February.
K
So
yeah
you've
kind
of
gone
already
a
sneak
preview
of
what
our
purpose
is
here
today,
just
to
provide
you
on
updates
on
both
our
Public
Health
Improvement
planning
process
and
our
strategic
planning
process,
we're
going
to
try
to
spend
the
first
20
to
25
minutes
or
so
providing
you.
Those
updates
and
they'll
meet
you
about
five
to
ten
minutes
at
the
end
for
questions
go
ahead,
we'll
just
go
ahead
and
Dive
Right
on
in
onto
our
Public
Health
Improvement
plan.
You
can
go
ahead
and
click
ahead.
K
The
what
I
want
to
start
off
with
was
just
a
really
quick
refresher
on
some
of
the
information
we
provided
last
time.
So
as
a
reminder,
our
previous
Public
Health
Improvement
plan
was
wrapped
up
in
December
of
2022
and
we
are
in
the
process
of
developing
our
2023
to
2027
Public,
Health
Improvement
plan
and,
as
Lexie
already
mentioned,
hoping
to
have
that
finalized
by
June
of
this
year.
Again,
this
is
a
mandated
activity
for
all
local
public
health
departments.
K
Here
in
Colorado
to
develop
our
community
health
assessment
and
our
Public
Health
Improvement
plan
required
to
do
so
at
a
minimum
of
every
five
years.
Although
some
health
departments
do
choose
to
have
a
more
a
quicker
cycle,
and
here
at
bcph
we
utilize
the
Colorado
Health
assessment
and
planning
system
to
kind
of
dictate.
What
our
process
looks
like
that
is
the
chaps
process
outlined
by
cdphe
go
ahead.
K
Another
friendly
reminder,
our
upcoming
Public
Health
Improvement
plan
will
be
mental
and
Behavioral
Health
and
focus,
and
when
we
talk
about
the
area
of
work
that
we
hope
to
accomplish
or
kind
of
the
Wheelhouse
of
Public
Health
in
this
mental
Behavioral
Health
space.
We're
talking
really
about
focusing
our
efforts
in
promotion
prevention
and
then
this
small
segment
of
treatment,
namely
identification
and
referral
for
clients,
go
ahead
and
Skip
forward.
K
K
So
I
we're
going
to
talk
about
this
framework
a
little
bit
more
in
just
a
second,
but
I
really
want
to
highlight
that
this
is
a
wonderful
resource
that
our
colleagues
with
expertise
developed
and
is
turning
into
kind
of
a
central
tool
that
we're
using
in
planning
for
fit
and
ensuring
that
we
are
focusing
our
efforts
in
the
right
places
and
aligning
our
work
with
really
what
is
within
public
Health's
wheelhouse.
So
you
can
go
ahead.
K
Jordan,
quick
recap
on
what
we've
accomplished
over
February
and
March,
our
hpe
staff
presented
on
our
chocolate
process
at
the
behavioral
health
roadmap
community
meeting.
So
as
a
reminder,
our
colleagues
in
NPC
services
are
spearheading
and
coordinating
this
county-wide
effort
to
develop
a
behavioral
health
strategic
plan
for
the
county,
and
so
we
had
the
honor
of
presenting
on
our
process
there
and
speaking
to
the
alignment
that
we're
working
towards
between
our
Public
Health
Improvement
plan
and
the
behavioral
health
roadmap.
K
Omni
institutes
are
our
Consultants
that
we
are
paying
to
facilitate
our
chocolate
process
and
working
closely
with
our
hpe
team.
They
and
our
cha
FIP
work
group
have
worked
diligently
over
the
past
several
months
to
continue
Outreach
and
engagement
efforts
in
order
to
bring
together
all
the
quantitative
and
qualitative
data
that
we
are
pulling
together
for
our
community
health
assessment,
the
quantitative
and
qualitative
data.
K
The
kind
of
specific
piece
within
our
chat
is
that's
all
pulled
together
in
our
community
health
profile
and
in
addition
to
that,
we've
been
working
with
Omni
to
develop
these
data
snapshots,
which
I'll
talk
about
more
in
just
a
second,
and
so
those
were
developed
for
inclusion
in
our
child,
as
well
as
to
help
these
pH
staff
partners
and
community
members
identify
strategies
for
our
Public,
Health,
Improvement
plan
and
last,
but
certainly
not
least,
just
want
to
reiterate
again
and
again
and
again
and
again
that
we
are
working
on
spending
a
lot
of
time
working
to
coordinate
with
our
colleagues
over
at
community
services
to
ensure
that
whatever
comes
out
of
our
Public
Health
Improvement
plan
is,
is
highlighted
and
is
represented
in
some
way
shape
or
form
in
that
behavioral.
K
Health
roadmap
for
the
county
go
ahead,
Jordan
buzzing
I'm,
not
sure
if
that's
mine,
looking
ahead
to
activities,
we're
looking
forward
to
accomplishing
in
April
May
and
June
Jordan
dumaine
clicking
it
just
one
more
time
for
some
reason:
I'm,
not
sure
why
that
one
was
off
on
a
different
timer.
Apologies,
so
yeah,
looking
ahead
to
April,
May
and
June.
K
So
again
data
snapshots
strategy,
crosswalk
capacity
assessment
and
start
that
initial
dive
into
question
bless.
You
start
that
initial
dive
into
again
the
strategies
goals,
objectives
activities
for
our
Public
Health
Improvement
plan.
Looking
ahead
to
may
we
are,
we
have
selected
a
tentative
date
for
a
community
Gathering,
where
we
are
looking
forward
to
Bringing
together,
BCP
staff,
Community,
Partners
and
community
members
to
again
review
the
data
that
has
been
collected
so
far
and
drill
down
even
further
into
the
go
goals:
objectives
activities
for
a
public
health
Improvement
plan.
K
We
are
looking
forward
to
hosting
that
meeting
in
collaboration
with
our
colleagues
over
our
community
services,
who
are
responsible
for
the
behavioral
health
roadmap.
So
that
again
you
can
continue
to
work
towards
that
alignment
between
what
is
outlined
in
our
FIP
and
the
prevention
and
early
intervention
and
harm
reduction,
work
kind
of
outlined
in
the
behavioral
health
roadmap
and
last,
but
certainly,
not
least,
like
I,
said
in
late
June
we're
looking
forward
to
the
formalization
finalization
of
the
cha
FIP
documents,
including
the
development
of
our
year,
one
action
plan.
K
So
what
does
our
agency
hope
to
accomplish
in
the
first
year
of
implementing
our
FIP
and
then
the
next
step
that
I
haven't
included
up
there,
but
is
obviously
once
those
documents
are
all
are
all
finalized?
We
would,
we
would
obviously
be
sharing
those
with
cdphe
and
that's
it
go
ahead,
I'm
not
going
to
spend
2
along
on
the
slide.
Lexi
asked
me
to
include
this
because
we
had
shared
this
earlier
as
kind
of
a
high
level
overview
of
everything.
That's
coming
up
in
the
next
couple
of
months
with
the
main
takeaway
here
really.
K
Is
that
we're
working
in
close
partnership
again
with
our
colleagues
over
at
Community
Services,
who
are
facilitating
the
development
of
the
behavioral
health
roadmap?
And
we've
just
got
a
tight
schedule
over
the
next
few
months
in
terms
of
trying
to
stay
in
lockstep
with
their
process,
ensuring
that
we
are
on
time
on
scope
with
our
contract
with
Omni
yeah,
so
we're
working
very
closely
in
Tandem
and
also
working
to
ensure
that
all
these
pieces
fall
into
place.
So
we've
got
a
lot
of
work
scheduled,
but
we're
really
looking
forward
to
this.
K
The
color
coding
is
really
just
to
highlight
all
the
activities
that
are
kind
of
planned
for
the
behavioral
health
roadmap
process
that
one
orange
one
is
the
kind
of
only
in-house.
Only
bcph
focused
Gathering
that
we
are
facilitating.
That's
the
meeting
that's
happening
later
this
week,
but
all
the
purple
activities
that
you
see
up
there
are
again
where
we
are
working
very
closely
with
our
Behavioral
Health
Partners.
Sorry,
our
community
service
Partners,
to
ensure
that
alignment
again
between
these
two
plans.
K
A
K
J
Sorry
Jordan
I
dialed
in
okay,
I'm
gonna,
hang
out
hang
up.
Oh,
is
that
better?
Can
you
guys
hear
me
yeah?
We
have
no
trouble
hearing
you
Lindy
yeah,
there's
some
weird
feedback.
If
you're
on
the
phone
I
think
that
was
me
anyway,
can
you
go
back
to
that
timeline
really.
J
K
It's
not
outlined
explicitly
in
this
process,
but
in
the
timeline
right
here.
But
yes,
that
is
a
part
of
our
process
before
sending
it
off
to
cdphe.
We
developed
this
one
in
in
meeting
with
our
colleagues
at
Community
Services,
to
mainly
mainly
stay
sure
that
we
were
on
top
of
what
their
key
dates
were
and
what
some
of
our
key
internal
dates
were,
especially
when
working
with
Omni
as
part
of
their
contract,
but
I
admit
that
this
doesn't
include
every
single,
explicit
step
in
our
process.
K
But,
yes,
you're,
you're,
correct
Lindy,
sharing
our
final
documentation
with
the
Board
of
Health
is
certainly
part
of
our
process.
K
You
will
have
an
opportunity
so
in
just
a
second
I'll
share
that
may
community
meeting
we.
We
will
certainly
be
inviting
the
Board
of
Health
to
that
may
community
meeting
to
view
the
data
and
have
an
opportunity
to
weigh
in
in
on
it
in
that
setting,
and
you
will
be
able
to
review
the
final
documentation
before
we
share
it
with
cdphe
and
technically.
If
there
was
anything
at
that
time
that
the
board
found
issue
with
or
was
not
satisfied
with,
we
would
need
to
rectify
that
before
setting
it
off
to
the
state.
J
J
K
K
Their
plan
is
going
before
the
County
Commissioners,
and
so
that
was
kind
of
one
of
the
important
pieces
that
we
wanted
to
ensure
that
our
fit
could
be
finalized
and
elements
from
our
FIP
incorporated
into
the
behavioral
health
roadmap
before
it
goes
before
the
board
of
County
Commissioners,
but
our
our
FIP
explicitly
is
not
going
before
the
board
of
County
Commissioners
apologies.
If
there
was
confusion
on
that
I.
K
Apologies,
we
have
two
plans,
our
our
fifth
and
then
the
behavioral
health
roadmap
that
sounds
very
similar
and
do
have
slightly
different
processes.
So
apologies
for
that
Lindy.
We
could
have
made
that
more
explicitly
clear
again
when
we
originally
pulled
this
together.
It
was
mainly
for
our
team
to
kind
of
get
a
hand
hold
on
the
numerous
meetings
coming
up
in
the
next
several
months
between
ourselves
and
our
community
services.
Colleagues,
but
does
that
answer
your
question
Lindy
or
was
there?
Was
there
anything
else
that
felt
yeah.
J
E
Yeah,
it
doesn't
look
like
looking
at
this
versus
what
we
were
provided
in
the
appendix
the
dates.
It
seems,
like
things,
are
either
missing
or.
K
It's
not
clear
or
they've
been
updated,
since
we
sent
that
as
a
perfect
thought
is
a
perfectly
a
possibility
as
well.
So
this
has
been
a
shifting
process,
as
I
think
Lexi
and
Kelly
can
speak
to
you
on
of
trying
to
stay
as
closely
aligned
with
our
community
services
Partners
when
dates
have
changed
and
availability
of
Partners
has
changed,
and
so,
if
there
are
discrepancies
that
could
be
in
part,
that
could
be
an
in
part,
and
it's
also
possible
for
human
error
on
our
part.
K
I
can
acknowledge
that
the
timeline
I
think
what
you
have
probably
in
your
timeline
is
a
more
accurate
reflection
of
dates.
K
Some
of
these
again
are
pieces
that
this
was
in
meeting
with
our
community
service
colleagues,
and
since
then,
some
of
these
dates
have
changed
on
their
end
as
well.
I
think
they're,
another
April
26
meeting
has
been
updated
yeah.
Some
of
these
just
aren't
in
our
timeline
again,
because
some
of
these
are
internal
yeah.
Some
of
these
are
specific.
The
timelines
are
specific
to
our
process.
What
we
have
here
is
outlining
of
both
of
these
processes:
okay,
internal
and
external,
yes,
yeah,
yeah,
and
so
again.
K
There's
just
been,
you
know
a
a
present
and
an
ongoing
desire
to
see
that
our
work
be
represented
in
there
as
that
moves
forward
and
does
get
presented
to
the
board
of
County
Commissioners
and,
as
we
do
look
at
future.
Resourcing
of
that
plan
and
ultimately
our
Public
Health
Improvement
plan.
Does
that
feel
like
a
fair
statement
to
say,
Lexi.
K
D
L
K
K
You
and
there's
also
feed
into
this
Behavioral
Health
roadmap
right,
okay,
so
we're
just
trying
to
make
it
extra
complicated
for
sure.
No.
Thank
you
for
outlining
that
that
way,
thanks
Jordan
all
right,
diving
back
into
these
key
data
products,
I'll
try
to
walk
through
these
quickly
and
if
there
are
more
questions
afterwards
on
these
happy
to
provide
more
information.
I
want
to
preface
this
by
saying
for
both
of
these
documents
that
we
are
sharing
or
these
resources
we're
sharing.
These
are
very
much
in
draft
form.
K
We
are
in
the
process
of
working
with
Omni
as
well
as
well
as
our
chocolate
work
group
and
internal
colleagues
and
even
some
external
colleagues
to
finalize
these
documents,
but
you
can
go
ahead.
Jordan,
the
first
one,
we'll
chat
about
are
these
data
snapshots,
so
what
these
are
are
they're
intended
to
be
one
to
two
page
documents:
summarizing
the
quantitative
and
qualitative
data.
K
That's
been
gathered
as
part
of
our
community
health
assessment
process
for
those
priority
populations
that
were
identified
as
part
of
our
community
health
assessment
process,
and
the
purpose
of
these
snapshots
is
really
to
capture
high
level
mental
and
Behavioral
Health
Data
on
strengths
and
challenges
for
our
priority
populations
and
kind
of
an
initial
synthesis
of
some
of
the
strategies
and
recommendations
that
have
emerged
from
all
of
the
Community
engagement
efforts
that
have
been
ongoing.
You
can
go
ahead,
Jordan
as
a
quick
reminder.
K
These
are
the
priority
populations
that
were
identified
as
part
of
our
community
health
assessment
process.
Again,
looking
ahead
to
our
Public
Health
Improvement
plan,
it
is
anticipated
that
our
Public
Health
Improvement
plan
will
work
to
focus
on
a
subset
of
these
priority
populations,
but
not
necessarily
work
to
address
work
to
incorporate
efforts
that
Target
all
of
these
priority
populations.
But
again
this
was
we
identified
our
priority
populations
based
on
where
we
saw
discernible
descriptions.
K
I'm,
sorry,
not
discrepancies,
disparities
in
the
data
and
also
where
there
was
a
lack
of
sufficient
data,
and
we
wanted
to
explore
more.
So
these
are
the
populations
we
will
be
developing
data
snapshots
for
go
ahead,
Jordan
and
on
this
next
slide.
I
want
to
share
with
you
just
a
draft
and
I
want
to
reiterate
that
this
is
a
draft.
This
is
something
that
has
been
shared
with
internal
colleagues
as
well
as
some
external
colleagues
to
proofread
for
readability.
Are
we
using
the
correct
language
in
some
of
these
cases?
K
Should
we
tweak
that
language
at
all
visually?
Is
it
easy
to
decipher?
This
is
something
that
Omni
has
really
taken
on,
and
this
the
example
that
you
see
here
is
our
snapshot
for
maternal
health,
and
so
one
side
is
focused
on
High
level.
Indicators
for
mental
health
and
the
other
side
has
high
level
indicators
for
Behavioral
Health
and
there,
as
you'll
see
for
each
of
those
is
a
little
description
to
help
make
it
easier
to
decipher.
What
are
we
looking
at?
K
What
is
the
time
frame
we're
looking
at
Jordan
if
you
want
to
skip
to
the
next
one?
This
is
obviously
a
little
longer
than
the
two-pager
that
we
just
described.
This
one
is
ending
up
being
a
four
pager.
It
looks
like,
or
at
least
in
draft
form,
and
so
what
you're
seeing
on
these
two
slides
here
is
the
the
initial
synthesis
or
the
trying
to
tackle
synthesizing
all
that
qualitative
feedback
that
has
been
brought
together.
K
So
this
looks
like
my
understanding,
is
that
this
is
looking
at
qualitative
data
that
was
gathered
from
focus
groups
with
our
nurse
Family
Partnership
program,
WIC
Genesis,
as
well
as
data
that
has
been
captured
as
part
of
the
behavioral
health
roadmap
process,
so
really
trying
to
pull
out
tease
out
some
of
the
themes
and
the
recurring
needs
that
have
been
identified,
recommendations
that
are
emerging
from
this
data
and
again
we
have
our
colleagues
reviewing
this
to
ensure
that
this
is
legible,
understandable
that
it
is
presented
in
a
format
that
they
feel
that
folks
will
find
digestible
and
able
to
review
in
order
to
make
some
of
those
decisions
around
fit
priorities.
K
A
K
Yeah,
so
when
Omni
was
reviewing
the
data
for
this,
there
were
several.
There
were
several
topic
areas
that
they
felt
were
so
broadly,
encompassing
that
they
were
trying
to
put,
rather
than
creating
its
own
separate
data
snapshot,
trying
to
incorporate
some
of
that
data
within
the
general
broader
County
snapshot.
So
we
don't
have
a
subset
of
the
population
per
se.
It's
more
trying
to
look
at
indicators
broadly
around
climate
change
impact
within
Boulder
County,
rather
than
a
specific
subset
impacted
by
by
climate
change.
K
K
To
find
those
indicators
that
the
crosswalk
between
climate
change
and
mental
Behavioral
Health
Data,
so
it
is
a
smaller
subset
rather
than
just
climate
change
broadly,
but
looking
at
what
I
think
some
of
the
I
think
some
of
the
indicators
they
do
have
for
that.
One
are
broad
impacts
of
climate
change,
but
trying
to
do
that
crosswalk,
where,
where
we
can,
where
the
data
is
available
of
the
mental
Behavioral,
Health
impacts
of
climate
change,
if
that
makes
sense,
okay,
I.
G
K
And
I
also
thank
you
for
bringing
that
up,
because
I
do
want
to
bring
up
the
caveat
that
you
know.
Omni
is
pulling
together
these
data
snapshots
with
data
where
available.
So
we
acknowledge
that,
for
some
of
these
priority
populations,
we
have
quite
a
bit
of
both
quantitative
and
qualitative
data
to
pull
from,
and
for
some
of
these
frankly,
we
have
mostly
qualitative
data
to
pull
from
either
because
the
data
is
lacking,
or
it's
not
updated
in
a
timely
enough
manner
to
really
be
relevant
to
this
chocolate
process.
K
So
to
Lexi's
point,
we
acknowledge
that
there
are
for
some
of
these
populations.
I'll
bring
up
the
example
of
homelessness.
We
don't
have
great
quantitative
on
the
ground
data
at
times
for
the
homeless
population,
however,
we
have
been
able
to
gather
some
qualitative
data
to
build
out
that
snapshot.
K
If
that
makes
sense,
so
we
we
want
to
be
transparent
and
Omni
wants
us
to
be
transparent
in
that
is
that
we've
tried
to
pull
together
kind
of
the
existing
data,
acknowledging
that
in
some
of
these
spaces
we
it
doesn't
always
exist
to
the
standard
that
we
would
like
it
to
thanks.
Jordan
apologies
you're
skipping
all
over
the
place.
K
Thank
you
so
really
quickly.
Our
MBH
strategies
crosswalk.
So
I'll
summarize
this
very
quickly
to
say
this
is
a
tool
we're
hoping
or
not
we're
hoping.
This
is
a
tool
that
we're
actively
pulling
together
where
we
are
working
to
visualize
mental
and
behavioral
health
strategies
and
recommendations
that
again
are
emerging
from
the
qualitative
data
that
we've
collected
and
from
the
community
engagement.
K
So
Jordan,
if
you
don't
mind
skipping
ahead
to
the
next
slide,
I'm,
not
going
to
share
the
actual
tool
itself
and
the
reason
we're
not
going
to
share
it.
Is
because
we
were
worried
about
anything
being
misconstrued
of
that
we've
already
selected
these
priorities,
that
these
are
the
things
that
we've
selected
and
these
are
going
to
be
finally
informally
incorporated
into
our
FIP.
It
is
very
much
a
living
document.
K
It
is
continuing
to
be
flushed
out
with
more
of
that
qualitative
data
as
it
has,
as
we've
been
Gathering
it
from
partners
and
from
our
own
processes,
so
rather
than
walking
through
kind
of
all
that's
emerged.
I
was
going
to
give
you
kind
of
a
sneak
preview
of
some
of
the
strategies
that
have
emerged
in
some
of
these
spaces,
but
again,
I
really
just
want
to
reiterate
there.
These
have
not
been
finalized.
K
These
have
not
been
selected
for
our
FIP,
it's
more
just
to
give
you
a
sense
of
some
of
the
things
that
are
emerging
in
some
of
these
spaces,
so
working
from
left
to
right
in
that
Foster,
Community,
Connection
belonging.
One
of
the
themes
that
has
emerged
is
Spanish
language
access
across
all
efforts,
so
it
can
be
engagement.
The
services
we
provide
Workforce
cultural
competency,
things
like
that,
moving
over
to
increased
Community
capacity
and
for
mental
health,
health
and
resilience.
One
of
the
themes
that
has
emerged
there
is
provider,
training
and
curriculum
in
key
areas.
K
So
we
just
mentioned
cultural
responsiveness,
but
also
things
such
as
Suicide
Prevention,
trauma-informed
practices,
positive
Youth,
Development,
person-centered
care
things
such
as
that
moving
over
to
address
Community
conditions
and
policy.
One
of
the
things
that
has
emerged
there
is
advocating
for
insurance
reform,
so
universal
health,
health
care
coverage,
more
Medicaid,
covered
providers
and
services,
provider,
reimbursement
treatment
coverage,
all
of
those
sorts
of
things.
K
Moving
over
to
increased
Community
engagement,
one
of
the
themes
that
has
emerged
there
is
paying
peers
and
people
with
lived
experience
to
participate
in
our
planning
program,
development,
evaluation
efforts,
recognizing
them
as
experts
with
lived
experience.
Moving
over
to
Foster
Prosperity,
just
one
of
the
themes
that
has
emerged
there
was
safe
and
accessible
transportation
to
Community,
Services,
supports
work
and
then
moving
over
to
early
intervention
efforts.
Just
one
of
the
themes
that
has
emerged
is
community-based:
mental
and
Behavioral
Health
screenings
and
evaluations.
So
that
could
begin
home
settings.
K
K
That's
a
great
question:
I,
don't
know
if
I
actually
have
an
answer
for
that
we're
again.
This
is
intended
to
be
reviewed.
The
information
being
captured
in
here
and
this
tool
that
we're
developing
is
expect
to
be
reviewed
alongside
that
capacity,
assessment
and
I
feel
like
that's,
where
a
lot
of
those
pieces
are
fleshed
out
of
like
in
what
of
these
areas,
because
we
also
use
this
framework
as
kind
of
the
filter
for
synthesizing
information
from
our
capacity
assessment
and
so
I
think
what
that
will
help.
K
At
least
what
that
should
help
highlight
in
some
sense
is:
where
do
we
have
a
lot
of
capacity
along
the
Spectrum,
and
where
do
we
see
a
gap
but
to
your
question
of
which
one
which
of
these
are
more
staff?
Sorry
staff,
bcph,
driven
versus
Community,
Driven
I?
Don't
know
that
right
off
the
bat
but
I
think
it's
a
great
consideration
for
sure.
G
Yeah
and
I'll
just
add
that,
in
addition
to
the
process
of
kind
of
identifying
with
the
themes
that
are
emerging
are
and
kind
of,
where
is
our
opportunity
to
either
double
down
in
capacity
that
we
have
or
to
develop
capacity?
If
something's
really
important
part
of
the
value
of
aligning
with
the
behavioral
health
roadmap,
the
broader
plan
and
all
of
the
community
engagement
processes
that
we're
using
is
that
we
can
identify
where
other
folks
are
filling
some
of
those
roles
so
that
we're
not
doing
duplication.
G
So,
for
instance,
there's
you
know
a
bill
right
now
with
the
legislature
that
would
provide
screenings
to
students.
G
Obviously,
we
wouldn't
want
to
advocate
for
that
bill
if
it
goes
through,
but
there
may
be
those
kind
of
attention
to
where
other
community
processes
are
happening
and
what's
our
role
in
supporting
those
processes.
Even
if
we're
not
leading
it.
K
And
I
will
say
that,
as
one
of
so
some
of
the
criteria
that
our
BCB
staff
will
be
looking
at
in
terms
of
prioritization,
one
of
those
is
around
capacity,
and
it's
one
of
the
ways
we've
looked
at
it
is:
do
we
have
capacity
in-house,
but
I
think
there
is
an
opportunity
here
to
maybe
say
user
capacity
in-house,
or
is
there
opportunities
to
support
this
work
elsewhere?
I
think
we
do
want
to
be
very
mindful
of
capacity
because
oftentimes,
you
all
are
probably
aware.
K
Sometimes
these
plans
can
end
up
becoming
wish
lists
more
than
actionable
plans,
and
so
I
think.
That
is
why
we
do
have
capacity
top
of
mind
is
where
do
we
have
existing
capacity
or
where
are
there
opportunities
to
acquire
the
capacity,
whether
it
be
resources
or
Manpower
or
whatever?
You
know,
whatever
the
needed
resource
is
so
but
I
think
it's
a
fair
point
of
having
that
in
the
back
of
our
mind
when
we
think
about
capacity,
yeah.
D
No
I
think
it's
great
to
think
about
capacity.
I
think.
My
question
is
more
coming
from
a
place
of
just
trying
to
understand
the
origins
of
some
of
the
things
that
are
being
identified
under
each
category.
Is
it
the
community
Through
omni's,
Community
engagement
or
through
Community
engagement
meetings
that
these
recommendations
are
coming
forward,
or
is
it
staff
bringing
these
recommendations
forward?
It's
not
their
own
experience
within
the
community.
K
D
We're
trying
to
understand
the
balance
of
where
those
are
coming
from
and
then
of
course,
I
want.
We
all
be
thinking
about
capacity,
that's
really
important
so
and
who
else
might
be
doing
it,
but
just
trying
to
understand
where
the
origins
of
those.
K
There
have
been
things
that
have
emerged
in
some
of
these
Community
engagement
spaces
where
we're
like.
That's
not
that's,
not
really
something
that
we
are
equipped
to
provide
or
that
maybe
we
have
partners
that
are
much
better
suited
for
providing
that,
and
so
essentially
this
has
been
kind
of
again.
Another
way
to
ensure
that
we're
grounded
in
whatever
we
do
want
to
consider
for
prioritization
is
within
our
wheelhouse.
K
So
I
guess
to
answer
your
question:
we've
we've
tried
to
strike
a
balance
with
both
of
community
identified
solution,
as
well
as
Community,
Partners
and
Community.
Sorry,
Community,
Partners
and
staff
that
have
been
engaged
in
the
process
as
well.
Could
answer
your.
D
I
mean
I,
think
I
have
additional
questions,
but
I'm
not
sure
that
you
can
answer
them.
So
it's
okay,
I,
just
I,
think
that
I
guess
I'm.
It's
it's
so
important,
I
think
to
engage
the
community
in
the
process.
So
it
sounds
like
there
are
opportunities
for
the
community
to
engage
in
the
process
and
for
us
to
be
capturing
care
input.
I
Yeah,
just
really
quick
I
just
want
to
say
where
we'd
be
happy.
You
know
to
connect
with
you
even
outside
the
meeting
and
walk
you
through
spaces
and
also
understand
that
we're
seeing
this
as
Community
engagement,
that's
ongoing.
It's
not
just
between
engagement
to
get
to
here
to
plan
it's
that,
and
this
plan
is
a
living
document.
So
Community
engagement
also
to
tweak
and
to
you
know,
maybe
we
move.
We
start
off
down
a
path
and
decide
to
come
back
because
there's
somebody
else
already
on
the
path
or
whatever
so.
K
Thanks
for
sure,
go
ahead,
Jordan
I'm
trying
to
wrap
it
up,
so
I
can
get
to
poor
poor
Rachel's
portion
of
the
presentation
really
high
level
summarizing
again
both
of
the
data
snapshots,
as
well
as
the
strategies
crosswalk
in
combination
with
that
capacity
assessment.
All
that
information
is
being
brought
together
by
Omni
2
facilitate
some
of
these
prioritization
conversations
So.
K
The
plan
is
for
initially
later
this
week
for
our
staff
to
start
engaging
in
that
process,
but
then
again,
looking
ahead
to
May
we're
looking
forward
to
staff
partners
and
community
members
to
be
involved
in
the
finalization
formalization
of
those
goals,
objectives
and
activities,
but
Jordan
I'll
wrap
things
up
by
again,
very
high
level.
Next
steps
for
these
tools,
which
is
kind
of
a
repeat
in
some
ways
of
you,
know
the
next
steps
for
our
chocolate
process
generally,
but
tomorrow,
I
keep
forgetting
that
today
is
the
10th.
K
Now,
tomorrow
is
when
those
data
snapshots
are
going
to
be
finalized.
K
Again,
Omni
has
been
working
with
our
chocolate
work
group
as
well
as
some
external
Partners
to
finalize
that
language
Insurance
appropriate
approachable
later
this
week,
again
we're
going
to
be
using
those
day
snapshots
the
capacity
assessment
strategy
crosswalk
to
start
the
process
of
identifying
priorities
and
high
level
goals
were
fit
again,
looking
ahead
to
maze
when
we're
looking
forward
to
using
all
these
resources
again
but
again,
diving
even
deeper
into
goals,
objectives
and
activities
for
the
fifth
with
Community
Partners,
our
bch
staff,
and
certainly
community
members
and
again
would
love
to
extend
an
invitation
to
you
all
to
join
that
meeting
again.
K
This
is
still
a
slightly
tentative
date,
but
I
think
we
are
very
close
to
having
it
be
finalized.
We
were
just
waiting
for
some
final
feedback
from
our
chocolate
board
group
to
make
sure
we
weren't
missing
some
large
community
in
event
that
we
wanted
to
not
overlap
with,
but
again
would
really
encourage
the
Board
of
Health
once
that's
finalized,
we'll
certainly
for
the
invitation
to
that
through
the
Board
of
Health.
I
would
love
to
have
you
attend
if
you're
interested
and
then
again
in
terms
of
next
steps?
M
All
right,
that's
my
turn:
hi
everyone
again
I'm
Rachel,
the
health
planner
nice
to
meet
you
all.
This
is
my
first
time
being
here
with
you
all
at
the
Board
of
Health
meeting.
M
So
I
only
have
a
few
slides
to
present
done
I
lucked
out
and
got
the
shorter
part
of
the
presentation,
so
I'm
just
going
to
provide
a
little
bit
of
an
update
on
our
strategic
plan.
One
of
the
many
planning
components
that
we
were
we
are
working
on.
You
can
go
next
time.
Thank
you.
M
So
a
quick
reminder
that
we
are
in
the
process
of
developing
our
strategic
plan
that
will
operate
from
2024
through
2028
and
our
goal
is
to
have
this
document
finalized
in
December
of
2023
at
the
end
of
this
year.
While
this
is
not
mandated
like
the
child,
fit
process
is
still
a
core
Public
Health
capability
and
best
practice
for
local
public
health
departments
to
have
a
strategic
plan.
M
I
guess
one
positive
to
it
not
being
mandated
is
that
we
are
not
on
the
strict
timeline
that
it
has
to
be
completed
this
year
like
our
fifth.
So
we
do
have
a
little
bit
of
flexibility,
we're
still
aiming
for
that
December
timeline,
but
we
have
that
flexibility
slide.
B
M
All
right,
so
this
is
a
graphic
that
might
kind
of
help
illustrate
Morgan
your
the
many
pieces
coming
together.
L
M
So
if
you
look
in
the
upper
right
hand
corner
that
mental
Behavioral
Health
as
Elise
just
outlined
is
our
FIP
topic,
our
fit
Focus
area,
which
also
aligns
with
the
County's
Behavioral
Health
roadmaps,
that's
kind
of
how
they
all
fit
in
together
the
other
strategic
priorities
that
we
have
in
our
strategic
plan
going
counterclockwise.
M
We
have
climate
action
or
climate
Justice
health
and
racial
Equity,
sustainability,
transparency
and
stewardship,
and
then
the
yellow
circle,
the
additional
priorities,
Community
engagement
policy
and
emergency
preparedness
and
response
and
I'll
give
you
an
update
kind
of
on
the
next
slide
as
to
where
we're
at
with
those
additional
priorities.
But
again,
these
are
just
our
strategic
priorities
and
how
they
kind
of
align
with
our
fifth
process,
as
well
as
the
behavioral
health
to
the
next
slide.
M
Please
all
right
so
some
activities
that
we've
completed
in
the
last
couple
of
months
since
Elise
last
presented
to
you
all
the
management
team
and
the
respective
division
leadership
teams
have
had
a
chance
to
review
our
project.
Charter,
the
hpe
team
created
a
roles
and
responsibilities
document,
so
this
really
just
outlined
the
scope
of
work
that
the
work
groups
are
going
to
be
completing
around
each
strategic
priority.
M
We
also
completed
a
really
high
level
assessment
on
where
things
are
at
with
each
of
our
strategic
priorities
to
kind
of
help
us
make
some
decisions.
Moving
forward
kind
of
asking
questions
of.
Is
there
already
a
worker
board
committee
around
the
Strategic
priority?
How
many
people
are
working
on
it?
Are
there
any
goals,
objectives
or
strategic
plans
already
in
the
process?
M
So
again
that
kind
of
helped
create
some
awareness,
so
we
could
make
decisions
moving
forward
and
will
help
us
as
we
stand
up
these
workers
and
then,
just
last
week
the
management
team
determined
our
next
steps
for
the
agency
priorities.
So
those
three
priorities
in
the
yellow
circle-
Community
engagement
and
emergency
preparedness
and
response-
are
going
to
be
incorporated
into
our
strategic
plan,
so
they
will
join
the
other
four
priorities.
Strategic
priorities
policy
is
kind
of
tabled.
M
M
Okay,
so
what
we're
working
on
in
the
next
couple
of
months?
Really
the
focus
is
on
establishing
these
work
groups
and
getting
going
with
that
tomorrow.
April
11th
we're
anticipating
that
our
project
Charter
will
be
finalized
by
the
management
team,
as
well
as
we'll
have
kind
of
a
roster
of
participants
for
the
work
groups.
M
So
the
participants
are
all
bcph
staff
subject
matter,
experts
staff
that
are
already
working
in
each
strategic
priority
area
or
will
be
doing
the
work
moving
forward
in
that
area.
Kind
of
a
subset
of
those
groups
help
us
create
the
goals,
objectives
and
the
first
year
detailed
implementation
plan.
So
these
will
not
be
completed
by
April
30th,
but
the
work
groups
will
be
started
by
April
30th.
So
this
is
a
process.
M
That's
going
to
take
a
few
months
to
kind
of
look
at
the
data
and
then,
as
a
group,
develop
these
rules
objectives
in
the
action
plan
and
also
by
the
end
of
this
month,
we
are
hoping
to
have
our
staff
and
Community
input
process
outlined
kind
of
one
we're
going
to
start
asking
for
staff
and
Community
input
and
what
that's
going
to
look
like.
M
M
Again,
a
lot
of
strategic
plans
going
to
be
focusing
on
getting
those
work
groups
up
and
going,
and
we
would
like
to
invite
ourselves
back,
if
possible
in
June,
to
give
you
guys
an
update,
just
like
we
did
tonight
on
where
we're
at
with
the
public
health
Improvement
plan,
which
should
be
pretty
close
to
being
done
and
finalized.
I
Yeah,
thank
you.
Rachel
I
just
want
to
add
also
that,
as
part
of
this
process,
it's
not
only
the
working
groups
around
around
those
priorities,
but
we're
also
looking
at
building
and
sustainability
piece
of
that
plan.
The
monitoring
evaluation
piece
of
that
plan,
the
programmatic
strategic
budget,
piece
of
that.
So
there's
lots
of
moving
parts
and
pieces
we'll
be
looking
at
over
the
next
several
months.
That
may
not
necessarily
have
a
work
group
but
maybe
have
a
smaller.
You
know,
team
working
in
the
space
as
well,
everyone's
gonna,
be
on
all
those
but
surprise.
K
Yeah
and
thank
you
for
I,
we
I
apologize
I
definitely
took
up
the
majority
of
our
time
here
today.
I
know:
we've
kind
of
extended
our
time
our
allotted
time.
So
if
there
are
any
further
questions,
please
don't
hesitate
to
reach
out
again.
We
are
happy
to
connect
one-on-one
via
email.
Whatever
format
makes
the
most
sense
for
answering
more
questions.
K
I
know
that
there's
a
lot
going
on
in
these
processes,
we
tried
to
be
succinct
in
presenting
where
we
are
at
in
next
steps,
but
always
recognize
that,
as
Kelly
has
said
numerous
times,
these
are
complex
processes
and
want
to
make
sure
that
you
all
feel
that
you
have
the
information
you
need
to
feel
comfortable
and
how
we're
moving
forward,
but
with
that
I
think
that's
it
from
US.
Unless
there
are
already
final
questions
or
I'm
sure
we
probably
have
gone
over
time.
Yes,
you've
had
me
feel.
C
C
G
It
away
so,
finally,
this
evening
we
have
a
program
Spotlight
on
the
community
policies
and
emergency
management
team
following
our
presentation
last
month,
related
to
some
of
the
other
impacts
related
to
the
end
of
the
public
health
emergency,
which
is
slated
to
end
in
May.
The
communicable
disease
team
will
provide
an
update
tonight
on
the
covid-19
transition
plan
and
where
Public
Health
expects
to
continue
to
have
expects
to
have
continued
response.
G
Additionally,
we'll
have
excuse
me:
I'll,
have
a
quick
update
from
the
emergency
management
team
on
why
we
will
be
digging
deep
this
year
on
an
updated
Emergency,
Management
response
and
Recovery
plan
is
one
of
our
strategic
priorities
and
how
we'll
be
approaching
it
so
to
get
us
started.
Steffi
Goodman,
Collinson,
Claire,
Stacy
farm
and
Carol
head
Helwig
and
Keith
Rawls
will
present
on
the
covid
transition
plan.
On
behalf
of
that
team
and
Chris
Campbell
will
present
on
behalf
of
our
emergency
management
team,
so
happy
to
turn
it
over
to
you
all
fantastic.
N
Thank
you
Lexi
good
evening
to
the
Board
of
Health
I
know
you
have
had
a
long
day
today.
So
thanks
again
for
your
time
tonight,
my
name
is
Colleen
Sinclair
I'm,
an
emergency
management
planner
with
communicable
diseases
and
Emergency
Management
Division,
and
help
to
facilitate
this.
Our
third
iteration
of
pandemic
planning
efforts,
like
Lexi,
said
we'll
be
joined
tonight
by
several
of
the
Sedum
subject
matter:
experts
in
our
presentation,
you
can
go
ahead
and
go
to
the
next
slide.
Jordan.
N
Thank
you.
Thank
you.
Actually,
one
more,
please
thanks
thanks.
So
after
after
three
years
of
continuous
response
operations,
including
three
catastrophic
fires
of
mass
casualty
event
and
layered,
emergent
pathogenic
threats
such
as
empocs,
we're
really
humbled
to
reach
this
Milestone,
where
we
begin
to
transition
out
of
expanded
operations
and
embark
on
the
process
of
stabilizing
our
core
programming.
This
transition
is
part
of
a
multi-year
commitment
to
pivoting
strategies
planning
for
the
future
and
evaluating
our
current
efforts
to
make
process
improvements.
N
So
this
journey
of
transition
and
stabilization
for
Boulder
County
Public
Health
is
aligned
with
the
sun
setting
of
the
state
and
federal
Public
Health
emergencies
on
May
11th,
while
the
World
Health
Organization
still
defines
covet
as
a
global
pandemic.
This
timing
represents
us
entering
into
a
period
of
pandemic
recovery,
one
that
will
impact
the
community
and
Public
Health,
so
public
health
strategies
and
goals
recognize
changes
associated
with
impacts
such
as
fiscal
cliffs,
the
first
of
which
we'll
initiate
this
summer,
and
it
also
recognizes
changes
in
strategy
as
free
vaccines.
N
So
well,
while
we
I
know,
you
all
have
heard
a
lot
of
detail
from
Lexi
last
month
on
the
impacts
of
the
end
of
the
public
health,
emergency
declarations,
and
while
we
can
identify
specific
impacts
at
the
end
of
the
PHD
week,
we
also
acknowledge
that
questions
remain
so
it'll
be
necessary
for
us
to
be
nimble,
continue
to
monitor
those
changes
in
the
coming
months
and
how
they'll
affect
our
community.
We
recognize,
like
I,
said
that
the
pandemic
has
not
ended.
Our
agencies
now
has
the
opportunity
to
transition
into
some
of
our
core
functions.
N
You'll
have
here,
we
say
this
a
lot
throughout
the
presentation,
but
a
large
component
of
this
plan
will
be
communicating
these
changes
to
our
partners
in
the
public
to
ensure
continued
access
to
testing
and
Therapeutics
and
immunizations,
especially
to
those
priority
populations
and
priority
settings.
N
N
You
can
go
ahead
to
the
next
slide,
please
so.
Throughout
the
pandemic,
Public
Health
Emergency,
Management
team
has
been
committed
to
ensuring
we
regularly
assessed
our
current
challenges
and
pivoted
according
to
changing
needs.
So
those
planning
efforts
often
took
months
to
lead
and
was
aligned
with
the
agency's
commitment
to
participatory
leadership
in
which
all
programmatic
staff
contributed
to
strategy
formation.
So
we
can
talk
to
three
plans.
N
N
In
2022,
we
engaged
in
a
series
of
action
planning
sessions
that
helped
to
rely
on
all
epidemiology,
Emergency,
Management
and
immunization
work
with
shifts
and
state
guidance
and
the
Governor's
roadmap
in
2023,
we're
now
in
a
position
to
roll
out
the
transition
and
stabilization
plan
that
recognizes
changes
in
funding
and
a
move
towards
working
with
limited
priority
populations
and
specific
priority
settings.
N
In
addition
to
these
plans,
Chris
Campbell
and
the
emergency
management
team
conducted
many
many
after
Action
reviews,
which
are
continuous
quality
improvement
activities,
and
these
reviews
helped
us
as
an
agency
to
evaluate
the
work
with
our
Community
Partners
and
make
shifts
and
pivots
to
ensure
strong
Community
response
and
with
that
I
am
going
to
pass
it
on
to
Steffy
to
talk
about
Community
impacts.
Thank
you.
O
Thank
you,
Colleen.
All
the
leaders
of
the
Board
of
Health
I
am
Steffi
Goodman
pronouns.
She
hers
data
surveillance,
epidemiologist
at
bcph
and
I'm,
going
to
present
a
brief
recap
of
community
impacts
and
public
health
responses
associated
with
the
end
of
the
public
health
declaration.
Next
slide,
please.
O
N
O
O
I'll
turn
off
my
camera,
just
so
that
it
might
help.
But
a
few
important
points
to
clarify
would
be
that,
as
Colleen
mentioned,
the
public
health
emergency
declaration
is
ending,
but
the
covet
pandemic
is
not
and
remains
a
public
health
priority,
although
we
are
certainly
in
a
much
better
place
than
we
were
in
2020.
O
Many
of
those
directives
dictated
by
the
state
or
the
US
government
for
public
health
action
have
ended
and
are
transitioning
back
into
Health,
Care,
Systems
and
Commercial
markets,
and,
as
Colleen
noted,
while
we
can
identify
specific
impacts
resulting
from
the
end
of
the
public
health
emergency
declaration.
We
also
acknowledge
that
the
road
map
ahead
may
leave
us
with
many
questions,
and
so
we
will
continue
to
monitor
for
impacts
to
our
community
in
the
coming
months
and
be
ready
to
Pivot
as
necessary.
Next
slide.
Please,
at
the
as
the
time
draws,
oh.
O
O
Please,
and
as
Colleen
mentioned
moving
forward,
we
are
going
to
be
seeing
a
shift
from
Priority
population
focused
to
Priority
settings.
What
we
mean
by
that
is
that,
throughout
the
pandemic,
we
basically
structured
our
response
to
support
those
who
were
at
greatest
risk
for
Cova
transmission,
hospitalization
and
death
from
covid,
as
well
as
populations
who
may
have
reason
to
mistrust
Health
Care
interventions.
Our
Focus
has
been
to
use
a
public
health
and
Health
Equity
lens,
as
we
focused
on
people
living
and
working
in
congregate.
O
Settings
referred
to
as
our
priority
settings,
along
with
people
who
were
at
highest
risk
for
Contracting
the
disease
and
having
the
worst
Health
outcomes
such
as
hospitalization
and
death,
and
these
were
referred
to
as
priority
populations
and
as
we
enter
into
this
transition
phase.
There
is
a
lot
of
discussion
about
the
shift
away
from
a
priority
population
focus
into
priority
settings
focus
and
so
I
just
wanted
to
take
a
moment
to
clarify
by
what
we
mean
with
respect
to
our
plans.
O
Moving
forward
next
slide,
please
Jordan
and
with
increasing
scarcity
of
resources
within
the
agency
will
narrow
down
the
priority
populations
list
that
you
can
see
on
the
right
side
of
this
chart
and
focus
on
actually
the
left
side.
Sorry
and
we'll
focus
on
things
like
access
to
free
vaccines
to
these
populations
and
ongoing
Communications
and
on
the
right
side
of
the
chart.
O
We
Define
priority
settings
such
as
jails,
shelters,
long-term
care
facilities
and
other
congregate
living
settings
which
have
a
substantial
which
have
substantial
impacts
on
public
health,
and
we
will
continue
to
investigate
outbreaks
in
and
provide
support
to
people
living
and
working
in
priority
settings,
as
mandated
by
the
state.
We
are
currently
awaiting
guidance
on
vaccine
availability
and
accessibility
for
these
settings
from
the
state
next
slide.
Please
just
wanted
to
share
a
couple
of
illustrations
that
helped
us
decide
where
to
focus
our
interventions
on
certain
populations.
O
The
graph
on
the
left,
the
Orange
Line,
shows
the
vaccine
uptake
in
Hispanic.
Populations
lagged
behind
other
populations
in
Boulder
County,
whereas
the
map
on
the
right
shows
how
we
created
maps
of
vaccine
rates
by
ZIP
code,
age
and
social
vulnerability
index
in
order
to
Target
interventions
among
certain
populations,
and
then
the
next
slide.
O
Please-
and
this
slide
illustrates
the
reason
why
focusing
on
priority
settings
is
so
crucial,
noting
that
the
outbreaks
in
these
settings
increase
rapidly
during
the
pandemic,
leaving
those
fulfilled
facilities
and
dire
need
of
help
and
support,
particularly
within
like
long-term
care
facilities,
correctional
centers
shelters
and
early
care
and
education.
School
settings
Healthcare
settings
and
our
Focus
will
be
on
these
priority
settings
as
we
moved
into
these
net
this
next
transition
period
and
thank
you
and
with
that
I
will
pass
it
back
to
you.
Colleen.
N
Awesome.
Thank
you
Steffy
thanks
for
that
background,
with,
with
this
background
in
mind,
we'd
like
to
go
over
agency
strategies
developed
by
individual
teams
during
this
planning
process
to
adjust
to
the
changes
we'll
see
as
a
result
of
the
federal
and
state
declarations
ending
in
May
next
slide.
Please.
N
First
I'll
I'll
be
covering
the
the
community
impacts
and
agency
response
and
changes
in
access
to
testing
and
Therapeutics
so
and
I
do
want
to
just
give
a
quick
pat
on
the
back
to
Boulder
County
Public
Health.
Well,
over
500
000
PCI
PCR
tests
were
accessed
at
multiple
sites
over
the
course
of
the
pandemic,
which
I
think
is
something
to
be
really
proud
of.
N
The
ending
of
the
public
health
emergency
declaration
will
impact
community
members
access
to
testing
with
respect
to
their
payer
source,
so
Medicare
will
cover
provider
ordered
tests.
Only
Medicaid
will
continue
covering
testing
through
the
end
of
September
2024,
and
then
private
insurance
companies
will
determine
the
cost
to
beneficiaries.
N
So,
as
far
as
our
response
goes,
we
will
be
connecting
with
our
Community
Partners
to
make
sure
they're,
taking
advantage
of
the
remaining
supplies
of
Rapid
energy
tests
from
the
state
we'll
do
more
research
into
what's
called
icat
or
increased
Community
Access
to
testing
opportunities.
Those
are
through
two
organizations:
color
health
and
LTS,
who
are
agencies
contracted
through
the
CDC
for
the
cicap
program
and
then
linking
them
with
partner
organizations.
N
Since
funding
for
these
programs
will
not
be
affected
by
the
end
of
the
public
health
emergency
declaration,
you'll
hear
me
continue
to
talk
about
Communications,
but
we'll
want
to
make
sure
we
communicate
with
the
public
on
how
to
access
tests
and
also
to
encourage
personal
responsibility
for
testing,
so
people
can
self-isolate
and
then
prevent
further
disease
spread.
N
Public
health
will
also
continue
to
monitor
reporting
requirements
for
tests
which
are
ending
at
the
federal
level,
but
will
remain
in
the
state
of
Colorado
on
a
slightly
different
Cadence,
and
that
will
be
reevaluated
sometime
this
summer
and
next
slide.
Please
Jordan.
N
So,
although
the
the
end
of
the
public
health
emergency
won't
directly
impact
Therapeutics
looking
forward,
there
will
be
some
changes
coming
right
now.
The
federal
government
has
a
large
stockpile
of
oral
antivirals
and
is
working
with
stakeholders
to
ensure
Equitable
access
to
Therapeutics
they'll
remain
free
until
those
stockpiles
are
depleted
or
commercialization
of
these
medications
occurs.
The
emergency
youth
author
use
authorization-
excuse
me
for
medications-
are
not
ending
on
May
11th,
the
commercialization
of
Therapeutics
is
anticipated
to
end
at
the
end
of
2023,
at
which
time
pharmaceutical
companies
will
determine
pricing.
N
Private
insurance
companies
will
determine
the
cost
sharing
for
their
beneficiaries.
Medicare
recipients
will
likely
have
to
pay
a
portion
of
their
Therapeutics,
and
then
Medicaid
will
reimburse
for
treatments
only
approved
by
with
full
FDA
approval.
So
right
now
that's
baclery
or
REM
deserveer,
and
then
the
states
will
determine,
if
medications
covered
under
the
emergency
youth
use
authorization
I,
don't
know
why
I'm
stumbling
there
will
be
covered,
that's
Pax,
lovid
and
legacrio.
N
So
right
now,
most
community
members
are
accessing
Therapeutics
through
their
providers,
Telehealth
visits
or
the
test
to
treat
sites
that
are
in
nearby
counties.
These
are
likely
ending,
but
we
just
do
not
have
a
definitive
timeline.
N
P
P
The
immunization
program
is
in
a
season
of
transition
from
covid
response
to
a
routine
vaccination
Cadence.
The
immunization
team
met
to
reestablish
goals
for
this
transition.
P
These
goals
include
the
following:
one:
reignite:
the
immunization
Coalition
and
connect
with
Partners
to
connect
to
offer
vaccines
for
low-income
children
on
Medicaid,
three
integrate,
coveted
vaccinations,
appointments
into
our
vaccines
for
children,
clinics,
four:
execute
a
fall
strategy;
five
develop
a
Communications
campaign
next
slide.
Please.
P
P
We
are
now
in
a
stable
environment
for
Staffing
to
respond
to
a
seasonal
approach
to
respiratory
season
in
lieu
of
the
public
health
declaration.
Ending
we
will
likely
have
challenges
with
getting
free
vaccine
for
the
broader
community
and
will
need
to
shift
strategy
to
prioritize
specific
settings
and
populations.
P
I'll
know
more
over
the
summer,
as
Stephie
alluded
to
as
cdphe
is
waiting
to
hear
from
the
CDC
about
additional
vaccine
stockpiles.
The
immunization
team
success
successfully
pivoted
from
evening
clinics
at
the
Hub
to
incorporate
coveted
vaccine
appointments
into
VOC
clinics
on
Mondays
and
Wednesdays.
At
this
time,
we
do
not
plan
to
run
any
additional,
coveted
vaccination
clinics.
This
fall
at
the
Hub.
Instead,
we
will
focus
our
Limited
stock
power,
vaccine
and
Community
settings.
P
L
Good
evening,
everyone
I'm
Stacy
farman
I'm,
an
epidemiologist
with
communicable
disease,
focusing
on
congregate
settings
and
we're
going
to
talk
a
little
bit
about
the
epidemiology
infection
prevention,
surveillance,
resource
navigation
in
the
call
center.
Next.
L
So
our
Epi
approach
has
shifted
over
time
from
a
draconium
hammer
to
protect
the
Health
Care
system
when
we
were
all
susceptible
to
severe
illness
and
death
to
over
time,
increased
vaccination
uptake
in
more
widespread
access
to
Therapeutics
led
to
improvements
in
the
population
susceptibility
to
to
covid,
which,
in
turn
led
to
reduced
severity
of
impacts
of
Health,
Care,
Systems
disease
and
death,
leading
to
shifts
in
our
Epi
response.
The
shifts
in
the
trajectory
have
required
an
Adaptive
approach,
leadership,
style
and
mindset.
L
It
probably
or
it
has
been
our
relationships
with
our
key
partners
and
priority
sectors
that
have
helped
us
to
be
successful
in
adapting
to
these
changes
next
slide.
L
L
This
reflects
an
increase
over
the
pre-pandemic
five-year
average
of
19.2
per
year
by
just
under
2
000
percent,
while
outbreaks
caused
by
covet
accounted
for
80
percent
of
reported
outbreaks.
There
was
awesome
uptick
in
non-coveted
respiratory
outbreaks
and
enteric
outbreaks
in
2022
compared
to
previous
years
next
slide.
L
We
will
continue
to
respond
to
outbreaks
and
priority
settings
and
need
to
continue
fostering
our
relationship
with
key
partners
that
became
stronger
during
the
pandemic.
Our
community
benefited
from
the
strong
collaboration
with
various
Partners,
such
as
cider,
which
engages
our
Healthcare
infection,
preventionists
and
ID
docs,
our
long-term
care
facilities
and
other
congregate
settings
such
as
the
jail.
L
L
D
Lot
of
questions.
Sorry,
no!
That's
good!
So
I'm
curious
about
the
increase
in
in
outbreak
reporting
outside
of
covid
and
I
know
that,
because
I
have
young
children,
I
mean
I
know
there
was
increases
in
respiratory
viruses
and
whether
or
not
that's
related
to
sort
of
our
lockdown
years
and
all
of
that.
L
Yeah
I
I
agree
with
you,
I
think
when,
before
the
pandemic,
we
had
relationships,
but
they
weren't
as
strong
with
our
Community
Partners
and
then,
but
once
we
can't,
you
know
had
this
close,
intense
relationship
with
these
Community
Partners.
They
really
saw
the
value
in
looping
Us
in
to
other
outbreaks.
So
now
we
have,
you
know
our
eces
and
our
long-term
cares
who
are
reporting
things
that
they
probably
didn't
report
in
the
past
and
I
do
think.
G
And
buy
more
common
too,
in
addition
to
just
awareness
about
the
reporting
of
outbreaks,
we
know
that
you
know
if
we
can
get
to
Chris's
presentation
tonight.
We
know
that
climate
change,
for
instance,
yes,
yeah,
significantly
impacts
outbreaks,
yeah.
D
No
I'm,
just
thinking
about,
like
our
ECE
setting
for
my
kids,
that
just
you
know,
I
think
that
the
relationship
that
they
now
have
with
bcph
because
of
covid
means
that
they
are
now
monitoring
and
Reporting
back
on
a
lot
of
other
related
or
non-coveted
outbreaks
that
are
happening.
So,
thank
you.
That's
just
I
think
it's
interesting.
N
Right,
thank
you
Stacy.
So
thanks
again
for
your
time
tonight,
everyone
we'll
wrap
up
with
just
a
brief
statement
about
the
communication
strategies
next
slide
Jordan.
N
N
M
N
It
will
require
incredible
adjustments
on
behalf
of
the
agency,
the
community
itself,
as
well
as
our
Health
Care
Partners,
and
as
we
initiate
transitional
operations,
the
communicable
disease
and
emergency
management
team
will
be
taking
time
to
celebrate
staff
and
their
families
for
all
of
the
sacrifice
and
dedication
will
honor
the
resiliency
of
these
staff.
Many
who
maintained
these
continuous
response
operations
over
three
years
through
Relentless
ups
and
downs,
monkey,
wrenches
curve
balls
and
entire
leadership
changes.
We
really
want
to
thank
the
board
for
your
support
in
recognizing
our
staff
and
for
your
time
today.
G
E
Q
Okay,
okay,
well
good
evening
and
I
I
really
appreciate
the
the
opportunity
it's
great
to
see
the
board
members
this
evening
and
and
what
also
it's
great
to
good
evening
to
community
members
that
are
sticking
with
us.
I'll
jump
right
into
it.
Excuse
me,
my
name
is
Chris
Campbell
I'm,
the
emergency
manager
with
Boulder
County,
Public,
Health
I.
He
him
his
also
joining
this
evening
is
Carrie
Middleton
the
Emergency
Management
planner,
with
Boulder
County
Public
Health.
Q
We
really
appreciate
the
opportunity
this
evening
to
present
an
overview
of
our
emergency
preparedness
response
and
Recovery
strategic
plan.
You've
seen
kind
of
the
setting
of
building
up
to
this
plan.
So
this
evening
we're
going
to
be
providing
just
a
real
quick
overview
for
for
the
board.
Kerry
is
going
to
provide
just
a
quick
overview
of
the
plan.
I'm
just
going
to
quickly
provide
a
broader
context
that
has
brought
us
to
this
five-year
strategic
plan.
Q
Next
next
slide.
Please
thank
you.
So
just
just
some
just
to
frame
our
conversation
this
evening.
We
just
want
to
highlight
that,
as
the
pandemic
continues
to
evolve,
we're
really
rebuilding
we're
rebuilding
in
the
context
of
a
new
landscape
that
that
is
really
framed
by
climate
impacts
and
multiple
long-term
recoveries.
Where
you've
heard
the
board
is
definitely
following
the
of
course,
the
Marshall
fire
recovery.
Q
This
really
is
going
to
be
a
print,
an
unprecedented
recovery
from
this
pandemic
response,
and
a
lot
of
things
you
hear
tonight
are
are
initiatives
and
approaches
that
that
we're
working
on
as
we
roll
into
recovery,
that
is
that
is
the
context
we're
in
right
now.
We
know
this
work
in
this
new
landscape
is
resource
intensive,
not
only
for
agency,
but
for
our
Community
Partners
in
the
Greater
Community
as
well.
Q
So,
broadly,
we
need
to
plan,
we
need
to
plan
for
climate
adaptation.
We
know
that
climate
change
impacts
a
wide
range
of
Health
outcomes,
and
this
graphic
really
illustrates
the
significant
most
significant
climate
change
impacts:
Rising
temperatures,
more
extreme
weather,
rising
sea
levels,
increasing
and
increasing
carbon
dioxide
levels.
It
also
shows
this
the
effects
of
exposures
to
to
community
members
and
the
subsequent
Health
outcomes
that
can
result
from
these
changes
so
to
really
bring
that
down
then
to
to
our
community.
We
know
that
disaster
is
an
incidents
in
Boulder.
Q
So
from
a
public
health
perspective
and
and
again
the
board
is,
is
very
aware
of
this:
we've
supported
the
2013
flood
outwood,
Four
Mile
and
car
muscle,
fires
to
ricin
poisonings,
a
widespread
hepatitis,
A
outbreak,
meningococcal
disease
outbreak,
the
impox
outbreak,
The,
Table,
Mesa,
mass
shooting
and
RSV
pediatric,
Surge
and,
of
course,
the
covid-19
pandemic.
Q
That
is
a
lot
for
our
community
in
the
last
decade.
We
know
that
climate
change
is
not
only
led
to
increased
extreme
weather,
but
it's
also
worsening
infectious
disease
patterns
and
is
increasing
the
risk
for
future
natural
and
man-made
disasters
in
Boulder
County.
The
next
slide,
please
just
as
a
reminder.
Our
role
as
Public,
Health
and
emergency
and
disasters
is
is
framed
or
is
is
an
all
hazards
approach.
Q
More
specifically,
these
hazards
include
mitigating
the
impacts
on
environmental
health,
supporting
the
Health
Care
System,
including
hospitals
and
Long-Term
Care
Homes
impacted
by
an
emergency,
providing
medical
countermeasures
such
as
mass
prophylaxis
and
supporting
community
members
with
access
and
functional
needs,
such
as
Mobility
challenges.
We
are
really
seen
as
leaders
and
in
in
Boulder
County.
We
play
a
role
in
Cena's
leaders
for
the
overall
response
and
many
of
these
disasters
and
incidents.
We're
also
seen
as
leaders
in
the
region
and
as
Statewide
responses
as
well.
Q
So
we
just
we're
getting
into
the
plan
details
here
and
we
just
wanted
to
frame
how
how
the
plan
is
came
together
and
then
and
kind
of
the
landscape
we're
looking
at,
but
ultimately
the
the
goal
of
our
strategic
plan
for
emergency
preparedness,
preparedness
response
and
Recovery
is
to
truly
improve
and
create
systemic
changes
in
our
community.
Q
We
know
that
we
know
that
these
systemic
changes
will
really
reach
and
and
create
the
best
possible
outcomes
for
everyone.
So
we
also
know
that
there's
some
negative
outcomes
should
we
not
invest
in
these
systemic
changes.
Q
I
think
many
of
the
board
has
heard
in
the
community
about
staff
burnout
over
throughout
a
sustained
and
long-term
emergency
response,
repeated
immersive
responses.
You
hear
the
list,
as
you
all
know
well,
over
the
last
decade
and
we've
also
had
which
does
equal
and
can
lead
to
a
loss
of
institutional
knowledge.
Q
This
is
really
challenging
for
an
agency,
not
not
investing
in
these
systems,
changes,
impacts,
relationships
with
key
Community
Partners
we
have
seen,
and
we
have
seen
difficulty
in
operationalizing
our
Equity
values
and
may
seem
missed
opportunities
due
to
delays
and
inefficiencies
and
we're
proud
of
how
we've
we're
proud
of
how
we've
really
come
to
the
the
priorities
in
this
plan.
So
it
has
been
mentioned.
We
we
emphasize-
and
the
board
has
definitely
heard
about
our
after
Action
reviews
and
our
process
really
emphasize
a
an
approach
of
continuous
quality
improvement.
Q
Q
R
Yeah
good
evening
everybody,
my
name
is
Carrie
Middleton
and,
as
Chris
mentioned
I'm
an
emergency
management
planner.
She
her
hers
and
I
know
it's
been
a
long
evening
and
it's
coming
on
quarter
after
seven.
So
we
appreciate
your
your
continued
time
Jordan
if
you
could
move
to
the
next
slide,
please
so,
as
Chris
mentioned
in
the
interest
of
time,
we're
not
going
to
go
into
high
levels
of
detail
about
these
priorities,
but
we
did
want
to
hit
some
of
the
highlights.
R
So
if
one
component
of
our
rebuilding
and
Recovery
is
updating
our
various
emergency
plans
and
related
agreements
with
Partners,
so
as
you
would
expect,
we
have
various
emergency
plans
and
agreements,
and
many
of
them
have
not
been
updated
for
a
long
time
and
just
to
illustrate
that
our
Public
Health
Emergency
Operations
plan,
which
is
the
foundation
of
emergency
response,
was
last
updated
in
2016..
R
R
A
second
recommended
priority
focuses
on
our
own
internal,
at
bcph,
administrative
and
fiscal
systems.
So
clearly
these
systems
impact
emergency
and
Recovery
operations.
So
a
quick
example
of
that
is,
we
have
seen
sometimes
a
need
to
rapidly
hire
staff,
and
so
we
saw
this
during
the
covid-19
pandemic
when
we
quickly
had
to
hire
contact,
tracers
and
immunization
nurses.
R
We've
also
seen
this
need
for
Rapid
hiring
during
the
Marshall
fire
recovery
and
unfortunately,
our
systems
are
not
necessarily
set
up
for
quickly
getting
quickly
hiring
and
getting
people
on
board
in
the
context
of
a
disaster
or
an
emergency.
So
that's
just
illustrative
in
general.
We're
recommending
improvements
in
these
systems
that
will
result
in
Greater
efficiencies
and
ultimately
improved
a
response
and
Recovery
outcomes.
R
I
won't
spend
a
lot
of
time
on
our
third
priority,
as
Chris
mentioned
in
this
changed
landscape
due
to
climate
change,
it's
resource,
intensive
emergency
preparedness
response
and
recovery,
and
so
we're
recommending
that
we
identify
what
resource
needs.
We
have
to
be
sure
that
we
are
adequately
resourced
to
meet
Community
needs
during
emergencies
and
disasters
Jordan.
If
you
would
go
to
the
next
slide.
R
Our
fourth
priority,
strengthening
community
of
Partnerships,
so
I
I-
think
we're
all
very
well
aware
that
bcph
we
don't
excuse
me,
we
don't
repair
for
we
don't
respond
to
and
we
don't
recover
all
by
ourselves
from
emergencies
and
disasters.
And
so
we
recommend
that
we
really
just
look
to
continue
to
strengthen
those
Community
Partnerships
during
our
empox
response,
formerly
known
as
monkey
pox
as
an
example
we're
very
closely
with
Community
Partners
and
ambassadors,
and
it
was
their
work
that
especially
allowed
us
to
reach
and
support
priority
populations.
R
And
that
response
was
an
instance
of
us
operationalizing
equity.
And
we
know
that
in
general
that
we
do
need
Community,
Partners
and
Community
ambassadors
support
to
operationalize
that
Equity
value.
So
so
we
definitely
want
to
want
to
emphasize
that
and
then
finally,
we
also
see
a
need
to
develop
a
staffing
and
resiliency
plan,
one
that
allows
not
just
for
the
short-term
responses,
but
also
long-term
responses
and
recoveries
that
we've
seen
during
the
pandemic.
R
That
we've
seen
during
Marshall
plans
that
are
sustainable
to
support
those
kinds
of
responses
and
recoveries
or
put
another
way,
plans
that
avoid
that
significant
burnout
and
staff
turnover
that
Chris
alluded
to
briefly
before
and
that
we've
seen
again,
especially
with
the
covid-19
pandemic
and
the
Marshall
fire
response
and
Recovery
Jordan.
If
you
could
go
to
the
next
slide.
R
Thank
you.
So
next
steps
I
know
Elise
mentioned
this
earlier.
All
of
this
work
is
integrated
into
the
whole
agency
strategic
planning
process,
and
it
will
continue
to
be
so
integrated
and
align
with
those
overall
planning
processes
for
the
agency.
We
also
recognize
that
these
are.
This
is
a
lot
of
work.
These
these
priorities
represent
a
lot
and
so
we're
anticipating
that
at
the
Timeline,
probably
in
the
vicinity
of
three
to
five
years
for
completion,
so
that
that
mostly
sums
it
up
again
I.
We
want
to
thank
you
for
your
time.
R
We
wanted
you
to
be
aware
of
the
rebuilding
work
that
we're
doing
and,
and
also
ask
for
your
support
as
we
rebuild
and
continue
that
repairedness
response
and
my
recovery
work
to
meet
Community
needs
in
is
changed
landscape
of.
Unfortunately,
increasing
numbers
of
disasters
and
emergencies.
Thank
you
very
much.
G
Been
a
while,
yeah
and
and
I
think
I
think
something
that's
really
important
to
recognize
is
that
the
process
of
developing
this
plan
is
going
to
touch
on
a
lot
of
our
other
strategic
priorities.
So
it's
going
to
you
know
health
and
racial
Equity.
Connect
with
this
work
are
sustainability,
transparency
and
stewardship.
Priority
connects
to
this
piece
of
work.
G
The
climate
action
will
connect
to
this
piece
of
work,
so
we're
starting
to
really
suss
out
and
see
kind
of,
not
just
where
you
know
where
we
have
strategic
priorities,
but
how
they
reinforce
each
other
and
support
each
other
to
create
something.
That's
really
holistic
across
the
agency.
D
Yeah
I
I
want
to
say,
I
appreciate
the
overview
both
from
Emergency
Management
and
also
from
the
Sedum
crew,
and
thanks
for
all
the
work
that
has
gone
into
the
last
couple
years,
I
I
do
think
this
is
so
important
for
the
board
to
continue
to
follow
and
visit,
because
we
are
going
to
have
a
lot
more
emergency
response
and
in
particular
just
how
do
we
staff?
How
do
we
Finance
it?
That
is
really
important
for
the
board
to
continue
to
engage
in
that
conversation,
so
not
tonight,
but
ongoing
I
think
is
really
important.
D
C
C
To
say
thank
you
to
everybody
involved
throughout
the
agency.
I
mean
I,
know,
cdem
had
a
big
lift
here,
but
I
also
know
most
folks
were
redeployed
at
various
points
along
the
last
three
years
and
it
was
incredibly
stressful,
often
rewarding
occasionally
hair
pulling,
but
we
we
made
it
and
I
look
forward
to
this.
Evolution
I'll,
probably
be
mostly
a
spectator
for
for
that.
But
I
wish
you
luck
and
success,
and
just
again
my
sincere
thank
you.
C
All
right:
okay,
we
have
item
six,
the
director's
report.
The
comments
are
questions.
C
I
think
it's
been
a
long
day,
so
I'm
sure
it's
just
I'll
just
say
like
the
perfect
director's
report.
I
have
no
questions
beautiful.