Meeting Summary Delegation Agreement Advisory Council February 22, 2012 Snelling Office Park, St. Paul 10:00 a.m. – 1:00 p.m. Environmental Health Division Environmental Health Services Section Attendees • • • • • • • • • • • • • • • • • • • • • • Pauline Amundson, Pine County Debra Anderson, Hennepin County Liz Auch, LPHA and Countryside Dawn Beck, Olmsted County David Benson, Nobles County Sarah Berry, Waseca County Sue Blaisdell, Winona County April Bogard, MDH, EH, EHS, PWDU Jeff Brown, City of Edina Linda Bruemmer, MDH, EH Division Director Jill Bruns, Redwood-Renville Counties Debra Burns, MDH, Office of Performance Improvement Manny Camilon, City of St. Louis Park Mark Clary, Ramsey County Maggie Edwards, MDH, EH, EHS, PWDU Sherry Engelman, City of Edina Matt Finkenbiner, Le Sueur County Chris Forslund, City of St. Cloud Allie Freidrichs, Meeker-McLeodSibley County Pete Giesen, Olmsted County Cris Gilb, Southwest Health and Human Services Diana Graning, Benton County 1|P ag e • • • • • • • • • • • • • • • • • • • • • • Bill Gunther, City of St. Paul Lisa Gyswyt, City of Wayzata Zack Hansen, Ramsey County Brian Hoffman, City of St. Louis Park Tom Hogan, MDH, EH Assistant Division Director Janet Howard, Nobles County Duane Hudson, Hennepin County Dan Huff, City of Minneapolis Tim Jenkins, City of Minneapolis Jill Johnson, Winona County Keith Jullie, City of Brooklyn Park Larry Kittelson, Pope County Jason Kloss, Southwest Health and Human Services Nicole Koktavy, MDH, EH, EHS, PWDU Tim Langer, Faribault-Martin Counties Kris Lee, Countryside Public Health Aggie Leitheiser, MDH, Assistant Commissioner, Health Protection Bureau Cheri Lewer, Waseca County Gwen Lewis, Waseca County Jeff Luedeman, City of Bloomington Becky Malone, City of Wayzata Lynne Markus, MDH, EH, EHS, PWDU • • • • • • • • • • • • Tim Martin, Benton County Dan McElroy, Hospitality Minnesota Michelle Messer, MDH, EH, EHS, PWDU Jason Newby, City of Brooklyn Park Mike Nordos, MDH, EH, EHS, PWDU Susan Palchick, Hennepin County Bonnie Paulsen, Morrison County Colleen Paulus, MDH, EH, EHS Manager Spencer Pierce, Anoka County Linda Prail, MDH, EH, EHS, Regulatory Operations Julie Ring, Association of Minnesota Counties Hank Schreifels, Stearns County • • • • • • • • • • Barbara Skoglund, MDH, EH, EHS, PWDU Pam Steinbach, MDH, EH, EHS, Regulatory Operations Amanda Strommer, Washington County Karen Swenson, Brown-Nicollet Counties Sandy Tubbs, Horizon Community Health Board Bev Wangerin, McLeod County John Weinand, City of Minnetonka Chris Wenisch, Kandiyohi County Susie West, Wabasha County Julie Wischnack, City of Minnetonka Note: all of the handouts mentioned in the meeting summary may be found at: www.health.state.mn.us/divs/eh/food/pwdu/delegationagreement.html Under “Handouts from the February 22, 2012 meeting.” Introduction and Purpose • • • Linda Bruemmer, MDH Environmental Health Division Director, welcomed and thanked everyone for taking the time to attend. Linda also thanked original Delegation Agreement Advisory Committee (DAAC) members for their previous hard work. All attendees introduced themselves. Linda gave a brief overview of the original committee’s work. The DAAC met throughout 2008 to develop the new delegation agreement. The new agreement was implemented in 2009 and 2010. Legislative Update Review • SF 0743/HF1442 deals with recycled water. There is swimming pond language included in the bill that would require natural swimming ponds to comply with public pool regulations when possible and directs the MDH commissioner to develop specific rules for natural swimming ponds. 2|P ag e • • • • SF 1701/HF1755 as amended by the Senate Health and Human Services Committee on 2/23/12, includes language relating to local fees. It also divides the $60 private sewer or water fee into a $30 fee for private sewer and/or $30 for private water. The bills contain various other provisions related to the restaurant industry. It has been forwarded to the Senate Jobs and Economic Growth Committee. SF 1190/HF1523 defines vacation home rentals. This issue repeatedly comes up in the legislature. HF 2302/SF1637 requires background checks and fingerprinting for all lodging facility staff and prohibits those previously convicted of some crimes from working in lodging establishments. There have been two recent cases involving the conduct of lodging employees. HF 1417/SF 1176 concerns special event camping fees in MDH jurisdiction. It reduces fees for events with more than 2000 camp sites. What have MDH & Delegated Agencies been doing since Summer 2009? Self-assessments and program evaluations April Bogard, MDH/EH/EHS Partnership and Workforce Development Unit Supervisor, reviewed the Program Evaluation Schedule (Handout 1). Program evaluations were conducted first with delegated agencies that volunteered and then the rest of the schedule was determined by a random drawing. Copies of the completed evaluations were available for review at the meeting. All of the Delegation Agreement Materials may be found on our website at: http://www.health.state.mn.us/divs/eh/food/pwdu/delegationagreement.html Q: What do the terms acceptable, conditionally acceptable, unacceptable mean? How does an agency ask for a reconsideration of its rating? A: The terms were determined by the original 1987 agreement. Those agencies that do not meet minimum standards must develop an action plan to address issues uncovered during the evaluation. The MDH evaluators who conduct the evaluations work with the delegated agencies to continuously improve environmental health programs. Delegated programs should contact the Partnership and Workforce Development staff to request a reevaluation when they have improvements that they want reviewed. Scheduling of a reevaluation would be based on the nature of the program improvements needed, the prioritization of reevaluations and first time evaluations, MDH staffing availability and other issues. MDH will convene a group to develop a process for re-evaluation. Trends and lessons learned from program evaluations 3|P ag e Michelle Messer R.S., one of the program evaluators from PWDU, reviewed the Trends and Lessons Learned from Program Evaluations: Opportunities for Continuous Improvement (Handout 2). Michelle encouraged agencies to elaborate on their program and toot their own horns during the self-assessment process. The evaluators are only there a short time so give them all the information you can. Each program evaluation begins with a self-assessment. Delegated agencies submit the selfassessment 30 days before the scheduled evaluation visit. There was discussion about the current evaluations, program ratings, what those terms mean, how they are changed and what process the agency goes through to get reevaluated. Q: Have you found the self-assessment process helpful? Can MDH be more specific about what they are looking for during the evaluation? MDH was asked to inform delegated agencies regarding any changes to the evaluation criteria. Can MDH update delegated agencies on trends and lessons from the evaluation process more frequently? What were some positive findings? A: Yes, both MDH and various program representatives commented on the value of the selfassessment process. The self-assessment is available for any agency to complete at any time. There are five evaluation survey tools (food, lodging, MHPs/RCAs, pools and youth camps) available online at http://www.health.state.mn.us/divs/eh/food/pwdu/delegationagreement.html. Programs do not have to wait for their formal evaluation to conduct a self-evaluation. MDH recommends agencies conduct a complete self-assessment, including scoring each item and calculating a final score. Comments on the self-assessment should include more than “yes/no” answers. There is an annual meeting to specifically review the assessment process. It is scheduled for April 25, 2012. MDH indicated there have been no changes to the evaluation process or criteria after the first pilot evaluations. Programs are evaluated against the minimum program standards in Minnesota statutes, rules and the delegation agreement. The structure of the evaluation is based upon the FDA Voluntary National Retail Food Regulatory Program Standards. The evaluation tools are available online at http://www.health.state.mn.us/divs/eh/food/pwdu/delegationagreement.html. The tools to complete the self-evaluation are the same tools used by the MDH evaluators. MDH publish any new tips and trends updates in the PWDU newsletter, http://www.health.state.mn.us/divs/eh/food/pwdu/pwdunewsletter/index.html. The PWDU newsletter is sent to all delegated agencies and interested parties, posted online and included in the CHS mailbag which goes to community health board commissioners. The new PWDU 4|P ag e communications staff member, Barbara Skoglund, will also develop additional information on trends as part of the EHS website revisions. Copies of Characteristics of Successful Environmental Health Programs (Handout 3) were available next to the completed program evaluation materials. Trainings, newsletter, FSP/FSP+ Colleen Paulus, EHS section manager, reviewed MDH/EHS Training, Newsletters, Workshops, 2008-2012 (Handout 4). She encouraged delegated agencies to read the newsletter and participate in as many training events as possible. She pointed out that all FSP and FSP+ are available via video conferencing and web streaming. (See http://www.health.state.mn.us/divs/eh/food/pwdu/fsp/index.html.) Community Health Boards and Delegated Agency Changes Deb Burns, MDH Office of Performance Improvement director presented information on community health boards (CHB). There are currently 52 community health boards across the state. Two thirds are multi-county boards. Deb has worked with community health boards for 10 years and during the first eight there was only one change in their configuration. During the last two years there have been many changes as local government has undergone rapid changes. Over a quarter of Minnesota counties are considering new community health board arrangements. The Minnesota Community Health Boards (Handout 5) map was distributed. Because many of the environmental health delegation agreements are with community health boards, these rapid changes impact the delegation of food, beverage, lodging, MHP/RCA, pools and youth camp licensing, inspection and enforcement. It takes up to a year to dissolve a community health board. Some of the proposed new community health boards want to ensure they will have a delegation agreement prior to changing the make-up of their CHB. This is causing a conflict because MDH cannot approve delegation agreements to boards that don’t exist. The systems that exist to form and approve delegation agreements were not set up for these types of rapid changes and the situation is raising a lot of issues at the local and state level. The County Delegation Map of Food, Beverage and Lodging and Mobile Home Park/Recreational Camping Area Jurisdiction map (Handout 6) was distributed. Managing Delegation Agreements Colleen Paulus, EHS section manager, reviewed a document illustrating the different environmental health programs (Handout 7, “Eat, Sleep, Swim” Document). The EHS delegation 5|P ag e agreement covers where people eat, sleep and swim. The ultimate authority and responsibility for maintaining these statewide programs (food, lodging, MHPs/RCAs, pools and youth camps) comprised of state and local programs, lies with the Commissioner of MDH. There are two other EH programs for which there are delegations: Well Management and NonCommunity Water Supply. In addition, there are numerous additional environmental health programs administered by MDH. (See http://www.health.state.mn.us/divs/eh/.) They are not part of the delegation agreement from EHS. The handout also identifies other programs and services that fall under the generic environmental health term; which are administered by other state agencies and/or local government. Several participants commented positively about the handout and explanations of the wide variety of environmental health programs/services. Discussion of Issues around Environmental Health and Environmental Health Services Delegation Colleen Paulus praised state and local environmental health professionals and agencies for their ability to shine and work well together during crisis situations. She stressed the need for us to work more collaboratively in the day to day work of protecting public health and sought ideas for developing models to help us work together more. How can we have a consistent statewide public health protection program for Food, Beverage, and Lodging (FBL) services? Before the discussion of the regional team concept, some general comments were offered. There was concern that there was no agreement on the big picture or the vision and that there should be a higher level policy discussion. The suggestion was offered that a SCHSAC committee be assigned to address environmental health. Some members offered that SCHSAC had already written reports on Environmental Health in 1980, 1993 and 2002. They did not want to repeat something that had already been done but not implemented. The question was also raised about whether we should involve industry. Some felt that industry should not be involved in policy setting, but it’s good to involve them in implementation. A specific question was asked why MDH denied a request to contract with another organization for licensing, inspection, and enforcement services. MDH knew the contract question was not handled very well. The issue for MDH is if the delegation agreement work is under contract with another governmental unit, there appears to be a lack of direct accountability. If there is an issue in the county, is it an appropriate response to direct MDH to contact the adjoining 6|P ag e contracted county to deal with it? There have been gaps and no one has been available at times in a delegated agency and MDH had to fill in. Some counties have a 24/7 coverage agreement to help each other. With the discussion of the evaluations, someone asked when MDH will be evaluated. MDH and Anoka County participated in the pilot. They are scheduled for full evaluation at the end of the cycle. As part of the proposal for a Regional Team, MDH offered that EH leadership visits regional offices annually; perhaps there should be an open house to meet with local government and delegated agencies at the district offices. This would also increase the visibility of district offices. Small Group Dialogue Each table was asked to respond to some questions regarding the idea of creating regional teams. a. What are the “pros” of the Regional Team concept? b. What are the “cons” of the Regional Team concept? c. What are your ideas for modifying the Regional Team Concept to make it better and more workable? d. Are there any alternative(s) to the Regional Team Concept that would result in the same outcomes? e. What are your recommendations for next steps? Each table shared the highlights of their discussion. TABLE 1 Pros: • • • • • Implementation LPHA Region/SCHSAC (increase participation of commissioners) Relationship building Enhance SCHSAC system Consistency Cons: • • Delegated/non-delegated involvement Time/travel – another meeting 7|P ag e Other: • • • Higher level policy group (SCHSAC Directors), regional to follow Revolving responsibility for calling/facilitating meetings Increase participation at all levels – continuity of staff TABLE 2 • • • • • • • Why not use regions already designated (SCHSAC, LPHA) – there are too many regions already What is the problem? What are we trying to solve? Who is attending (i.e., directors? Staff?) Consistent answers across the state Counties have different issues Don’t/can’t get rid of grey area, broader goal/code interpretation Where on the Program Evaluation list are the Counties the State inspects? TABLE 3 Pros: • • Will help make delegated programs more uniform o Similar policies o Trainings/code interpretation Sounding board for inspectors Cons: • • • Who will lead group? Impact of this reaching front line of PH Will efforts meet the needs of a diverse community? Other: • • • • • What’s up with contracting? Identify expectations Expanding delegation agreements per CHB MDH organize into regions 1st meeting; then change as needed with EH local changes and see how things work Trainings-Regional o Hot topics pertaining to that region o Recognition of differing issues o Consistent training throughout all regions TABLE 4 Pros: 8|P ag e • • • • • • • • MDH liaison to local EH No consistent training for local inspectors/sanitarians Develop best practices What does MDH require specifically? Where is the EH handbook? Isolated EH entities would like the support of health in regional meetings Need consistency between MDH/Regions/Locals Regional leadership needs to take charge of agenda, issues of meetings Cons: • • • • Regions should be consistent with 8 MDH regions? Too large a region for Metro agencies – need manageable size group meetings Unless specific measureable goals, this is a waste of time Why not invite industry even though to compelling reason – promotes transparency Other: • • • FSP model has worked; don’t reinvent; use this to coordinate activities Web/audio/video conference Expand existing mutual aid agreements to Regional TABLE 5 Pros: • • • • • • Leads to more consistency and understanding of “ripple” effect between agencies Identify regional trends that could lead to statewide impacts Have EH consultant assigned to each region – like the PH Nurse consultants. One per region More possible to have face-to-face to discuss issues/create policies An advocate for local programs/liaison for state/local issues Regional consultant would know and understand local variances and programs – quality improvement and policy Cons: • • • • • Admin are more used to LPHA regions Some partners are dissimilar How do different regions talk to each other? Look at where counties have the most synergy/partnerships already State needs more resources for consultation - SHF Other notes: • Technology – integrated and accessible for entire state 9|P ag e • • Emergency notification system – more use by locals Notifications – who belongs on which list? Operational vs. policy TABLE 6 • • • • • Real questions Need to share a common goal (SCHSAC workgroup) o We were there at end of DA process; not there now Locals and state need to be nimble and innovative o Contracts o MOUs o Timeliness Regional teams would work for operational issues; not shared vision/administrative Solution for a different question TABLE 7 • • • • • • • • • • • • • • Better communication Prepare for evaluation Idea sharing Need mechanism for inter-regional information sharing Based on regional needs Facilitates sharing of resources Who decides on boundaries for resources? Boundaries don’t match between delegated programs and new regional team Why were the boundaries chosen? Population? Good brainstorming but might not be efficient Everyone – county/city/MDH is unique with enforcement etc.-PH is 1st priority Will regions promote stability? Current agreement crosses boundaries Will sharing be effective according to group size? TABLE 8 • • • • • • • • Other issues need to be worked out Clear expectations Better and consistent communication between MDH and locals Forum for policy development Recognize the need for flexibility Stronger ties to CH system Greater efficiency Use technology TABLE 9 10 | P a g e Pros: • • • Existing relationships Forum for sharing best practices and challenges Rural areas have limited resources and need to share resources Cons: • • Proposed regions do not align with the broader regions of LPHA May not be of value if regions lack a clear charge Other: • • • • • Regional team needs way to connect to bigger picture Need forum for regional and MDH communication and training Emphasis on MDH-Local TEAM ATMOSPHERE Potential for region to be advisory to MDH Proceed with regions and clear charges Parking Lot issues for further discussion included: • • • • • • • • • • Meeting Frequency/Newsletter Procedures for re-evaluation • Look at existing models • Move more swiftly to re-evaluate • Prioritization: new evaluations vs. re-evaluations Self-assessment timing Healthcare/hospital inspections Contracting 200 establishments in jurisdiction Multi-county – consistency gaps Staff capacity 24/7 coverage Business/industry input Aggie Leitheiser and Linda Bruemmer appreciated everyone’s attention and effort and thanked them for coming. Next Steps and Update (3/9/2012) It appears that there are two tracks of discussion that have emerged. The first is about all of environmental health, not just the environmental health services delegation. Two of the three 11 | P a g e SCHSAC reports of past on Environmental Health have been located. The only one that is on the internet is the following: February 2002, “Strengthening Environmental Health in Minnesota – Final Report and Recommendations of the State Community Health Services Advisory Committee Environmental Health Work Group.” www.health.state.mn.us/divs/cfh/ophp/resources/docs/ehfinal2002.pdf January 1993. “Environmental Health in Minnesota – Strengthening Public Health Leadership in Environmental Health.” MDH, State Community Health Services Advisory Committee Environmental Health Work Group. Hard copy is available in MDH files. March, 1980. “Final Report of the Environmental Health Policy Study Advisory Committee. A Joint Project of the Minnesota Department of Health and the Association of Minnesota Counties.” Not in MDH files. At the SCHSAC meeting on February 24, an addition to the SCHSAC annual work plan for an environmental health committee of some form was accepted. A charter will be written for inclusion in the annual work plan. For follow-up to the concerns about the EHS delegation agreement, the annual meeting to specifically review the assessment process is scheduled for April 25, 2012. Other information will be distributed as it becomes available. For more information contact Linda Bruemmer, MDH Environmental Health Division Director, at [email protected] or 651-201-4739. 12 | P a g e
© Copyright 2026 Paperzz