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Car Seats Maternal Child Health 701.845.8518 City-County Health District can help with car seats! We offer: Car seat checkup events Car seat installation by appointment Free car seats for families who qualify What to Expect: Our trained and certified child passenger safety technician will show you how to correctly use your child’s car seat or seat belt. Did you know? Five of six car seats are used incorrectly in North Dakota. During the checkup, we make sure your car seat: Has not been recalled. Meets federal safety standards. Is installed correctly Fits your child’s age, weight and height. Secures your child properly. Car seats for those who qualify. Your family may qualify for a free car seat if you are enrolled in programs like WIC, TANF, or Medicaid. We follow guidelines from the ND Department of Health and the ND Department of Transportation. For more information or to schedule an appointment, call 845-8518. Resources Child passenger safety best practices ND child passenger safety laws Previous Item Next Item

Nursing Services 701.845.8518 Nursing Services The City-County Health District Public Health Nursing Team provides nursing services Monday - Friday. Walk-ins are welcome. Some services are available by appointment only. To schedule an appointment, call 845.8518. Blood Pressure Check: CCHD nurses can check your blood pressure. Cost: $5 Availability: Walk-ins welcome. Blood Sugar Check: CCHD nurses can check your blood sugar (glucose). Cost: $6 Availability: Walk-ins welcome. Cholesterol Screening: CCHD nurses can check your cholesterol levels with a fingerprick test. Results will be available before you are done with the appointment. Cost: $40 Availability: By appointment. Footcare: CCHD offers low-cost foot care services to help prevent foot problems for people who are unable to care for their own feet. Cost: $40 Availability: By appointment. Immunizations: CCHD offers immunizations for children and adults. Vaccines prevent disease in people who receive them and protect those who come in contact with unvaccinated people. Cost: Vaccinations can be billed though our partnering insurance companies. Children who are 18 and under, may qualify for free vaccine through the Vaccine for Children (VFC) program. They must meet one of the following criteria: No health insurance Medicaid eligible Native American or Alaskan Native Underinsured *Some adult vaccines are available through the 317 vaccine to adults uninsured or underinsured. Please call to find out which vaccines are available and eligibility requirements. Please call 701.845.8518 if you have any questions. Availability: Walk-ins welcome. By scheduling an appointment, we can help you be seen in a timely manner. Injections: CCHD nurses can administer injections, based on provider prescription. Cost: $20 Availability: Appointment required. For same day, please call ahead to coordinate. Medication Management: CCHD nurses can setup medication boxes to help you manage your medications. Cost: Billable to Medicaid. Self-pay is available. Availability: By appointment. Previous Item Next Item

Home Care Adult Health, Aging Services 701.845.8518 Certified Home Care Care for All. Infancy through Aging. Your Choice. Your Home. Since 1982, City-County Health has been providing high quality care to clients in the comfort of their own home. Services are available to residents of Barnes County under the care and direction of their medical provider. Our home care team includes Registered Nurses, Home Health Aides and a Physical Therapist. We coordinate services and care with Doctors, Pharmacists, equipment providers and other resources. City-County Health District is a Medicare certified, licensed member of the North Dakota Association of Home Care. Who needs home care? Individuals who: have a difficult time leaving the house, typically with a taxing effort are in need of skilled nursing care on an intermittent basis are returning home after a nursing home or swing bed stay are recovering from surgery or other ailments Who pays for home care? Medicare Medical Assistance Veterans Administration Private Insurance Services: Skilled Nursing Home Care Aides Physical Therapy Other Service Coordination Assessment and Education How do I get home care? Request from your physician or hospital discharge planning team that you be visited by City-County Health District’s Home Care Team. When you choose our Home Care team, you’re helping to ensure that Public Health can continue to provide essential services for the community and those who need us most. Resource: VA Community Care – Eligibility Public Health Home Care Previous Item Next Item

WIC Maternal Child Health 701.845.8518 WIC (Women, Infants and Children) Not sure if you are eligible? The WIC PreScreening Tool can help you determine if you may be eligible. About The WIC Program aims to safeguard the health of low-income women, infants, and children up to age 5 who are at nutrition risk by providing nutritious foods to supplement diets, information on healthy eating, and referrals to health care. Clients receive an individualized food package and nutrition education. Families must meet income guidelines and be screened for a nutritional risk. Appointments are necessary, please call (701) 845-8518 . Eligibility You must be a: pregnant woman ; breastfeeding woman (up to one year after giving birth) new mother (up to six months after giving birth) parent, guardian or caretaker who has an infant or child younger than 5 years of age AND You must have a nutritional health risk . The WIC Staff will be able to find a risk by checking your height, weight and iron level and having you answer some health and diet questions. AND Your annual household income must be within WIC Income Eligibility Guidelines which are based on gross income unless you are self-employed. Note: You may have a job and still meet these guidelines. OR If you receive Medical Assistance (Medicaid), TANF, SNAP, or Healthy Steps , you are income eligible for WIC even if your income is above these guidelines. [Note: If you are pregnant, you can add one more person to the size of your household.] Did you know WIC offers the following? 1. Healthy Food + Nutrition Tips WIC helps you feed your family healthy meals by providing: Monthly food benefits on an eWIC card to use at your local grocery store Recipes and ideas on how to use the WIC foods Tips for picky eating 2. A Community of Support WIC offers a network of experts for information and guidance: Nutritionists provide personalized nutrition counseling Breastfeeding specialists to help you breastfeed successfully Individual assessment of growth and health 3. Referrals WIC offers information about other helpful services including: Health care professionals such as doctors, dentists, and lactation consultants Immunization services Local social service programs including Medical Assistance, SNAP, and housing assistance. Resources WIC Food List WIC Program Previous Item Next Item

Breastfeeding Maternal Child Health 701.845.8518 Breastfeeding Support For Moms Benefits of Breastfeeding: Protects baby and mom from getting sick. Saves time and money on formula, bottles, and medicine. Helps with mom-baby bonding. For Employers ND Law states you must provide space and breaks for nursing employees. Read more about the law here: Becoming an Infant Friendly Workplace: Why should you become infant friendly? Benefits Include: Less Sick Leave- Breastfed babies stay healthier, so parents can work more. Less Staff Turnover- Companies with breastfeeding programs keep skilled workers longer. More Funds- Nursing babies visit the doctor less, lowering insurance costs. Higher Performance- Support for nursing parents increases success! How can we become infant friendly? Three Easy Steps: Make Space: Workplaces need a clean, private space. Need help creating a space? Grants Available for Infant Friendly Workplace Program! Craft Policy: Policies cover rules for space, breaks, and storage. Sample Policy Apply! Once approved, an Infant Friendly Designation offers many benefits like joining the Infant Friendly Workplaces in North Dakota! Apply now! Application for Infant Friendly Workplace Designation Online Breastfeeding Resources ND Breastfeeding La Leche League International Kelly Mom WIC Breastfeeding Support Previous Item Next Item

Substance Use Prevention Adult Health, Behavioral Health 701.845.8518 Prevention is a proactive approach; creating an environment that promotes the health and well-being of individuals and communities, which prevent problems before they occur. Our substance use prevention programs implement evidence-based strategies in the community to prevent use of all substances. What We Do: Advocate for the use of best practices in preventing substance misuse focused on Alcohol , Opioids , and Tobacco . Parents, community members, and professionals can learn more about prevention and behavioral health for children and adults at: Parents Lead  and the North Dakota Department of Health and Human Services . Alcohol Binge drinking among adults in North Dakota is a top public health concern. SPEAKS VOLUMES is a campaign aimed at raising awareness among North Dakota adults on standard drink sizes to help them make better decisions about their alcohol intake. Valley City has a long history of proactive prevention and support for the safety of our community. Social access is our most persistent issue when it comes to underage drinking in North Dakota. Whether it’s from home, from a friend, or another adult over age 21, alcohol is often far too easy to get. Not in my House is a campaign focused on reducing social access to alcohol by raising awareness about social host liability and related misperceptions surrounding underage drinking. Opioids Our goals are to: Reduce misuse of opioid medications Increase drug take-back locations and utilization in the community Increase access to overdose prevention education and Narcan Narcan Naloxone (Narcan) is an antidote to overdose of heroin or other opioid drugs. It works by blocking the effects of opioids in a person’s system, helping to restore breathing. Training for Narcan use (in person and virtual) is available through City-County Health.  A free box with 2 doses of Narcan is provided to participants upon completion of training.   If you are interested in being trained or need Narcan replacement , please call 701-845-8518. Medication Disposal Take Back Locations: Unused meds can be deposited in a Take Back container located at these participating locations: Barnes County Sheriff’s Office, 575 10th Street SW #4 Valley City Police Department, 216 2nd Avenue NE Thrifty White, 239 2nd Avenue NW NuCara Pharmacy, 234 Central Avenue N Central Avenue Health Mart Pharmacy, 323 Central Avenue N #101 Deterra Pouches: In addition to local drug take-back locations, CCHD offers Deterra bags to the public at no cost. Deterra Pouches are proven to destroy unwanted or expired medications safely and permanently, making them unavailable for misuse, abuse, and accidental ingestion. Call our office to request: 845-8518. Screening for Potential Opioid Misuse We screen all home care and public health clients for potential opioid misuse through the ONE (Opioid and Naloxone Education) Program. ONE provides North Dakota organizations to screen patients prescribed an opioid medication and provide education, resources, and support to ensure safe medication use. Tobacco Prevention and Control Our Tobacco Prevention and Control program follows The Centers for Disease Control’s (CDC) Best Practices for comprehensive tobacco control programs. Our focus is to: Provide education and information to state and local policy makers and the public regarding current issues in tobacco control. Assist tobacco users seeking cessation. Work with local policymakers, businesses and organizations, and schools to develop and adopt tobacco-free policies in the workplace and the community. Prevent youth initiation to tobacco. Resources: ND Quits Breathe ND Previous Item Next Item

Women's Way Women's Health 701.252.8130 City-County Health District contracts with Central Valley Health District (CVHD) for Women's Way services. Women’s Way is a program that pays for breast and cervical screening services for women who meet certain age and income qualifications. Women can have insurance, but that insurance may not cover preventive screening services or they may have a high deductible. The program serves Barnes, Foster, LaMoure, Logan, McIntosh and Stutsman counties. Eligibility Requirements: Is a resident of North Dakota. Is age 40 through 64. Meets income guidelines. Has insurance that doesn’t cover Pap tests and/or mammograms or can’t afford to pay her deductible or co-payments or doesn’t have insurance. Is not enrolled in or eligible for Medicaid or Medicare Part B. Is 65 or older and is not eligible for Medicare or cannot afford Medicare Part B. Is age 21 through 39, has breast symptoms (lump) or is due for a Pap test or needs breast or cervical diagnostic procedures. To enroll, call 1.800.44.WOMEN or 701.252.8130 and ask for Tonya. The process is easy and can be done over the phone. Previous Item Next Item

Sheyenne Valley Memory Cafe 701.845.8518 Sheyenne Valley Memory Cafe was created in 2023 as a way to connect people with early-onset dementia or Alzheimer's, and their caregivers/family members. Sheyenne Valley Memory Cafe provides access to resources. Sheyenne Valley Memory Cafe meets monthly from September through May. Meetings are held at Faith Lutheran Church, 309 4th Street NE, Valley City, ND 58072. For more information, follow @sheyennevalleymemorycafe on Facebook or call City-County Health District at 845.8518. Previous Item Next Item

Emergency Preparedness 701.252.8130 City-County Health District works with the North Dakota Department of Health and Human Services (NDHHS), public safety agencies, and other community groups to plan and prepare for disasters or emergency situations. This is in conjunction with local all hazards emergency planning, preparedness, and response. City-County Health District is part of an eight-county region established by NDHHS for emergency preparedness and response planning. Counties included in our region are: Barnes , Dickey , Foster , LaMoure , Logan , McIntosh , Stutsman , and Wells. An emergency preparedness/response coordinator and a public information officer serve the eight counties within the Southeast Central Region. Their work is funded in part by federal grants and is focused on public health emergencies. This is done through public education and planning which involves partnerships for enhanced regional response plans and capabilities. For more information, contact Central Valley Health District – Emergency Preparedness. Emergency Notifications Barnes County offer services to inform residents of emergency situations or critical community alerts. Alerts are issued for a variety of situations, including natural disasters, terrorism threats, gas leaks, water contamination, chemical spills, missing child alerts, severe weather such as tornadoes and flash flooding, and for general community notifications. Signup for Barnes County alerts . Previous Item Next Item

Family Planning Women's Health, Men's Health, Family Planning 701.252.8130 Family Planning is offered at City-County Health District 2nd Tuesday of every month from 9:00 AM to 12:00 PM Available Services Central Valley Health District offers a range of family health services, including Birth control & family planning. Find the method that's right for you, from oral contraceptives to IUDs. STI testing & treatment. Get screened and treated for sexually transmitted infections to protect your health and that of your partners. Pregnancy testing and counseling. Accurate, confidential pregnancy testing and counseling services are available. HPV vaccinations. Protect yourself with the HPV vaccine, reducing the risk of certain cancers and genital warts. Annual wellness exams. Comprehensive check-ups to assess reproductive health, including pap test, pelvic exams, and more. As a collaborating partner, City-County Health District provides limited services on a daily basis. Call (701) 845-8518 to schedule an appointment for: Pregnancy Testing Emergency Contraceptive Pills (ECP, also known as the morning after pill) About CVHD Services Central Valley Health District offers family planning in collaboration with City-County Health District. We guarantee our services are always Confidential & judgement free. Your privacy is our priority. All services are strictly confidential. Inclusive support. We welcome people of all backgrounds and identities, ensuring a safe space for everyone. Affordable care. All services are provided on a sliding fee scale and based on income and household size. Your appointment may be filed through your medical insurance, if you choose. Schedule An Appointment Call Central Valley Health at 701.252.8130 *Evening hours are available in Jamestown on the first and third Wednesday of each month for those who can't visit during the day. At-Home STI & HIV Testing Need sexually transmitted infection (STI) or HIV testing? Order a FREE home test collection kit to your door today. Benefits of at-home testing Anytime, Anywhere testing Private Free! Order a at-home test kit today. For more information, Central Valley Health Di strict Reproductive Health Services . Previous Item Next Item

Measles Status: Current North Dakota measles case counts are available at NDHHS Measles , as is information on possible exposure locations. North Dakotans who are vaccinated against measles are well protected and at low risk. Updated May 21, 2025 Report Suspected Measles Cases IMMEDIATELY! Call the HHS Immunization Unit at 701.328.2378 and fax report to City-County Health District at 701.845.8542. What is Measles? Measles is a highly contagious virus that spreads through the air when an infected person coughs or sneezes. Symptoms typically appear 7-14 days after exposure and can include: High fever Cough Runny nose Red, watery eyes A rash that starts on the face and spreads to the rest of the body One out of every five children who get measles in the United States will be hospitalized. One or two out of every 1,000 children in the United States who get measles will die from the disease, even with the best care. Measles can cause serious health problems, such as: Pneumonia, an infection of the lungs. Brain damage caused by swelling. Deafness. A vaccine can prevent measles You can protect yourself and the people around you from measles. The best protection against measles is a measles, mumps, and rubella (MMR or MMRV) vaccine. Two doses of the measles vaccine are about 98% effective at preventing measles. Anyone unsure of their vaccination status should contact City-County Health District or their healthcare provider. Resources for schools, childcare, employers Measles Fact Sheet Measles - Fact Sheet Exclusion Guidance Exclusion Guidance (see page 2) Immunization Rates Immunization rates are available by grade and/or county. The rate of measles immunization is included in the MMR vaccine count. Measles: Total Cases in ND Measles cases are reported to North Dakota Department of Health and Human Services (NDHHS). Frequently Asked Questions What are the risks? One out of every five children who get measles in the United States will be hospitalized. One or two out of every 1,000 children in the United States who get measles will die from the disease, even with the best care. Measles can cause serious health problems, such as: Pneumonia, an infection of the lungs. Brain damage caused by swelling. Deafness. Am I up-to-date for measles immunization? You are considered immunized against measles if you have written documentation (records) showing at least one of the following: You received two doses of measles-containing vaccine, and you are a(n) — school-aged child (grades K-12) adult who will be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, health care personnel, and international travelers. You received one dose of measles-containing vaccine, and you are a(n) — preschool-aged child (12 months to 4 years) adult (born in 1957 or later) who will not be in a high-risk setting for measles transmission. Laboratory confirmed that you had measles at some point in your life. Laboratory confirmed that you are immune to measles. You were born before 1957. What about my infant who can't be vaccinated yet? Infants who are too young for routine vaccination and people with medical conditions where they can't receive a measles vaccine depend on high MMR vaccination coverage among those around them. In the event of a local outbreak or international travel, infants as young as 6 months can be given a dose of MMR vaccine in addition to the regular MMR 2-dose series. What are the isolation/quarantine requirements? If you have been exposed to measles, you need to quarantine (stay home): If you have NOT had any doses of measles vaccine. If you are NOT immune to measles through prior infection You do NOT need to quarantine (stay at home): If you have had one or more doses of measles vaccine. If you are immune to measles from prior infection. If you were born before 1957. If you have received a measles vaccine within 72 hours of your first exposure. Questions? Don't be afraid to ask your healthcare provider or call City-County Health District at 845.8518. How can I get my immunization record? North Dakota residents can get their immunization record by calling City-County Health District at 701.845.8518 following the steps on the North Dakota Health & Human Services Immunization Record Request If you were born outside of North Dakota and need to locate your immunization records, here are a few helpful tips: Contact the local public health unit where you resided Contact your previous clinic or healthcare provider If you need additional help locating records, please give us a call. Once you locate your records, you can bring a copy to City-County Health District and we will create a North Dakota immunization record for you. What is the current situation with measles, mumps, and rubella in the United States? North Dakota and many other states are at risk of measles outbreaks due to declining measles immunization rates and increases in measles cases worldwide. Measles, Mumps, and Rubella (MMR) vaccination rates in young children ages 19-35 months are about 81%, and kindergarten MMR vaccination rates are about 90%. Rates are below 95% threshold needed for community protection (herd immunity). How serious are measles, mumps, and rubella? Measles can lead to serious complications and death, even with modern medical care. The 1989–1991 measles outbreak in the U.S. resulted in more than 55,000 cases and more than 100 deaths. In the United States, from 1987 to 2000, the most commonly reported complications associated with measles infection were pneumonia (6%), otitis media (7%), and diarrhea (8%). For every 1,000 reported measles cases in the United States, approximately one case of encephalitis and two to three deaths resulted. The risk for death from measles or its complications is greater for infants, young children, and adults than for older children and adolescents. Mumps most commonly causes fever and parotitis. Up to 25% of persons with mumps have few or no symptoms. Complications of mumps include orchitis (inflammation of the testicle) and oophoritis (inflammation of the ovary). Other complications of mumps include pancreatitis, deafness, aseptic meningitis, and encephalitis. Mumps illness is typically milder, with fewer complications, in fully vaccinated case patients. Rubella is generally a mild illness with low-grade fever, lymphadenopathy, and malaise. Up to 50% of rubella virus infections are subclinical. Complications can include thrombocytopenic purpura and encephalitis. Rubella virus is teratogenic and infection in a pregnant woman, especially during the first trimester can result in miscarriage, stillbirth, and birth defects including cataracts, hearing loss, mental retardation, and congenital heart defects. What are the signs and symptoms healthcare providers should look for in diagnosing measles? Healthcare providers should suspect measles in patients with a febrile rash illness and the clinically compatible symptoms of cough, coryza (runny nose), and/or conjunctivitis (red, watery eyes). The illness begins with a prodrome of fever and malaise before rash onset. A clinical case of measles is defined as an illness characterized by a generalized rash lasting 3 or more days, and a temperature of 101°F or higher (38.3°C or higher), and cough, coryza, and/or conjunctivitis. Koplik spots, a rash present on mucous membranes, are considered pathognomonic for measles. Koplik spots occur from 1 to 2 days before the measles rash appears to 1 to 2 days afterward. They appear as punctate blue-white spots on the bright red background of the buccal mucosa. Pictures of measles rash and Koplik spots can be found at www.immunize.org/clinical/image-library/measles/ . Providers should be especially aware of the possibility of measles in people with fever and rash who have recently traveled abroad or to an area with an ongoing outbreak in the United States, or those who have had contact with people from an outbreak area or international travelers. Providers should immediately isolate and report suspected measles cases to their local health department and obtain a nasopharyngeal, throat, and/or urine specimen for diagnosis confirmation and virus genotyping. Providers should also collect blood for serologic testing during the first clinical encounter with a person who has suspected or probable measles. How long does it take to show signs of measles, mumps, and rubella after being exposed? For measles, there is an average of 10 to 12 days from exposure to the appearance of the first symptom, which is usually fever. The measles rash doesn’t usually appear until approximately 14 days after exposure (range: 7 to 21 days), and the rash typically begins 2 to 4 days after the fever begins. The incubation period of mumps averages 16 to 18 days (range: 12 to 25 days) from exposure to onset of parotitis. The incubation period of rubella is 14 days (range: 12 to 23 days). However, up to half of rubella virus infections cause no symptoms. If there is an outbreak in my area, can we vaccinate children younger than 12 months? MMR can be given to children as young as 6 months of age who are at high risk of exposure such as during international travel or a community outbreak. However, doses given BEFORE 12 months of age cannot be counted toward the 2-dose series for MMR. Is there anything that can be done for unvaccinated people who have already been exposed to measles, mumps, or rubella? Measles vaccine, given as MMR, may be effective if given within the first 3 days (72 hours) after exposure to measles. Immune globulin may be effective for as long as 6 days after exposure. Postexposure prophylaxis with MMR vaccine does not prevent or alter the clinical severity of mumps or rubella. However, if the exposed person does not have evidence of mumps or rubella immunity they should be vaccinated since not all exposures result in infection. Rubella was declared eliminated (the absence of endemic transmission for 12 months or more) from the United States in 2004. Fewer than 10 cases (primarily import-related) have been reported annually in the United States since elimination was declared. Rubella incidence in the United States has decreased by more than 99% from the pre-vaccine era. A provisional total of 3 cases of rubella, and no cases of congenital rubella syndrome, were reported in 2022. Can unvaccinated kids spread measles to vaccinated people during an outbreak? Can the vaccinated still get it? You are correct that vaccinated people can still be infected with viruses or bacteria against which they are vaccinated. No vaccine is 100% effective. Vaccine effectiveness varies from greater than 95% (for diseases such as measles, rubella, and hepatitis B) to much lower (60% for influenza in years with a good match of circulating and vaccine viruses, and 70% for acellular pertussis vaccines in the 3-5 years after vaccination). More information is available for each vaccine and disease at www.cdc.gov/vaccines/by-disease/ and www.immunize.org/vaccines .

About City-County Health District (CCHD) is a local public health unit serving Barnes County since 1978. The public health office is located in Valley City, North Dakota. CCHD is committed to building healthy communities. Public health is based on the idea that everyone should have the chance to be as healthy and safe as possible. Public health workers include many people with different skills, all working together to protect people from getting sick or hurt. At City-County Health District, we provide a variety of services to help our community stay healthy, including: Nursing services to help community members care for their health. Prevention work to help build healthy communities in Barnes County. Restaurant inspections through a contract with Central Valley Health District. While our District primarily serves Barnes County, some of our programs reach our regional partners in south central North Dakota. Through this collaborative effort, we are able to serve our communities. Leadership Team Katie Beyer, CHES Administrator "Public health is where science meets compassion! Working in local public health gives me a front-row seat to community resilence!" Kerry Due, RN Director of Nursing "Public health allows me to work with people of all ages, whether I’m providing homecare or administering immunizations."