2007 LPH PPMRS Results
Summary Report of Expenditures, Staffing, Activities, and Performance Measures
Introduction
The following report summarizes the 2007 expenditures, staffing, and activities and performance measures information for
the Community Health Services (CHS) System, submitted by Minnesota’s local health departments to the Minnesota
Department of Health. The local health department’s expenditure, staffing, and activities and performance measures are
organized into six areas of public health responsibility:
•
•
•
•
•
•
Assure an Adequate Local Public Health Infrastructure (page 2)
Promote Healthy Communities and Healthy Behaviors (page 3)
Prevent the Spread of Infectious Disease (page 6)
Assure the Quality and Accessibility of Health Services (page 8)
Protect Against Environmental Health Hazards (page 9)
Prepare for and Respond to Disasters and Assist Communities in Recovery (page 12)
Overview
In 2007, the CHS System expended a total of $302 million dollars. Expenditure amounts presented in the expenditure
sections represent portions of this total amount. The source of these funds includes local tax levy, Medicaid, and the LPH Act
Funds (appendix A contains a complete list of funding sources and definitions). Over 2900 full time employees (FTEs) were
employed by the CHS System. Percentages included in the staffing sections are based on portions of this total number. These
employees represent a variety of job classifications including public health nurses, epidemiologists, and health planners
(appendix B contains a complete list of job classifications and definitions).
Percentages included in the activities and performance measure sections are based on the actual number of local health
entities responding to the question. There were 75 local public health reporting entities (referred to in this report as local
health departments (LHD)) in Minnesota. Minnesota’s local public health system consists of 53 Community Health Boards
(CHBs). CHBs are allowed to decide the jurisdictional level at which they will report their data. For example, a multi-county
CHB could have each county in the CHB report as an individual county or could choose to report collectively as one CHB.
Of the 75 local health departments included in this report: 28 are single-county CHBs, 9 are multi-county CHBs, 34 are
single counties reporting separately within multi-county CHBs, and 4 are city CHBs.
Comprehensive statewide reports on activities and performance measures, financial, and staffing can be found at
www.health.state.mn.us/ppmrs.
2007 LPH PPMRS Summary
Page 1 of 12
Assure an Adequate Local Public Health Infrastructure (infrastructure) describes aspects of the public health
infrastructure that are essential to a well-functioning public health system-including assessment, planning, and policy
development. This summary highlights the CHS System’s expenditures, staffing, and activities includes to assure the
diversity of public health services and prevent the deterioration of the public health system while addressing infrastructure
components required by law for community health boards.
Expenditures
Slightly more than $25 million of total expenditures were in the area of infrastructure, a decrease of $3.3 million or 12
percent from 2006. One LHD decreased infrastructure funding by $3.2 million, accounting for a large portion of the decrease.
Of the $25.2 million expended, most (68 percent) was funded by local tax levy. A majority (83 percent) of LHDs used local
tax levy to fund infrastructure. The remaining funding sources included LPH Act state funds (20 percent) and other local
sources (six percent). Sixty-eight of the 75 LHDs (91 percent) used LPH Act state funds for infrastructure.
Staffing
Local health departments classified 317 FTEs as working in the area of infrastructure, which accounted for 12 percent of all
FTEs. This area had a decrease of seven percent (25 FTEs) from 2006. About one third of FTEs were administrative support.
Health administrators (17 percent) and administrative/business professionals (13 percent) also accounted for a high percent of
FTEs. Two LHDs had no FTEs in the area of infrastructure.
Activities and Performance Measures
Community Health Board Statutory Requirements
All Community Health Boards in Minnesota met statutory requirements for MS 145A including:
• The CHB meets composition requirements
• The CHB met at least twice during the reporting year.
• The CHB has written procedures for business transaction
• The CHB has appointed an agent (typically the CHS Administrator)
• The CHB has a medical consultant
Community Health Assessment, Action Plan, and Local Priorities
The majority of local health departments have either updated or completed a community health assessment between 2003 and
2007. A smaller portion had completed an action plan in that time period. Of those completing an assessment in 2007, most
used existing community groups and advisory committees to solicit community input and engage special populations in the
community.
Data, Communication and Research
Almost 90 percent proactively provided information to the public about local public health data and also responded to
requests from the public for local health data. Nearly all (96 percent) local health departments have trained and designated
staff to provide risk communication to the public about real or perceived public health concerns. Most have between 1 to 3
staff trained.
Two-thirds of local health departments have either conducted their own or been involved with research directed by a
university or other research-type organization (this does not include program evaluation). Some examples of this research
include:
• Emergency preparedness surveys on staff knowledge and willingness to respond
• Community and worksite smoking cessation
• Hypertensive risk behaviors
• Reproductive health
• Access to healthcare
• Pregnancy psychosocial risk
• School-based FluMist administration
• Environmental norms associated with alcohol, tobacco, other drugs and gambling
2007 LPH PPMRS Summary
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Social Conditions and Cultural Competence
Seventy-one percent of local health departments described a collaboration that the local health department and community
organizations served on to improve social conditions that affect health. Some examples of these collaborations and work
include:
• Working with human services serving high-risk families in multiple programs.
• Partnering with other organizations to support healthy pregnancy in Latino families.
• Participating in diversity council/advisory committees focused on improving understanding between diverse populations
within the community.
• Addressing access to dental care in low income families and children.
• Serving on teams to prevent homelessness
• Assisting with the development of a free community clinic for the under and uninsured
• Working to reduce drug/alcohol and tobacco use by children and youth.
• Establishing programs that produce lasting improvements in the health and well being of low income, first time parents
and their children
• Partnering with agencies to address the health needs of migrant workers
• Participating on methamphetamine coalitions/task force
• Working with partners to address mental health issues in children and adults.
Most (80 percent) of administrators, directors and management staff have reviewed the Culturally and Linguistically
Appropriate Services (CLAS) standards. Only a quarter of departments were successful in hiring staff who reflect the cultural
and ethnic communities served by the public health department. Methods used to hire these staff included:
• Using diversity internship program to recruit and hire staff
• Working with community partners to recruit diverse staff
• Providing priority status to bilingual/bicultural applicants
Eighty-nine percent of local health departments indicated that they have built cultural competence in their current staff
through education, training and working with cultural/racial groups to develop working relationships and to gain more
understanding of group. Almost all (93 percent) of local health departments took actions to make their services more
culturally competent. These included translating materials, increasing the use of interpreters, training staff, and providing
support to emergency and community health outreach (ECHO).
Policy Development
Over half (57 percent) local health departments helped develop significant community and/or legislative policies around the
areas of:
• Smoke-free facilities (city/count building, city/county parks, restaurants)
• Alcohol, tobacco and other drug use
• School wellness
• Mental health services
• School emergency and crisis plan
• Tattoo and piercing
• Health reform
• Dental Care
• Heat emergencies
• Exotic animals
• Truancy prevention
Promote Health Communities and Healthy Behaviors (healthy communities) addresses the promotion of positive health
behaviors and the prevention of adverse health behaviors- in all populations across the lifespan. This summary highlights the
CHS System’s expenditures, staffing, and activities that enhance the overall health of communities including 20 broadranging topic areas. For each topic area, public health departments indicated the level of service that best described their
activities to address each topic. A “program”, for reporting purposes, was defined as having objectives and a budget or
dedicated staff hours.
2007 LPH PPMRS Summary
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Expenditures
Over $81 million (27 percent of total expenditures) were expended in the area of healthy communities, almost seven million
more dollars than in 2006. Of that, almost one third ($24.2 million) came from other federal funds. All but one LHD used
other federal funds to support these activities. Healthy communities was funded by a wide range of sources including local
tax levy (23 percent), LPH Act state funds (11 percent), Medicaid (ten percent), other state funds (six percent), and other
local funds (seven percent). Nearly all health departments (95 percent) used some LPH Act state funds to support healthy
communities.
Staffing
Healthy communities was staffed by 945 FTEs, or 32 percent of the CHS workforce, a seven percent (64 FTEs) increase from
2006. Public health nurses accounted for 39 percent of FTEs in this area. Other staff in the area of healthy communities
included administrative support (14 percent), public health nutritionists (ten percent), health educators (eight percent), and
other nurses (eight percent). One LHD had no FTEs in the area of healthy communities.
Activities and Performance Measures
Topic Area
Percent of LHDs
that implemented
programs
Percent of LHDs
that provided
health promotion
and educational
activities
Percent of
LHDs that did
not provide
any services
Examples of
Programs and Activities
•
Healthy Aging
51%
45%
4%
•
•
Alcohol
51%
44%
5%
•
•
Arthritis
3%
34%
63%
•
•
Asthma
8%
51%
41%
•
•
Cancer
13%
60%
27%
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•
Cardiovascular
Disease and
Stroke
24%
58%
18%
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•
Diabetes
20%
59%
21%
•
Physical activity and nutrition program for
seniors.
Blood pressure and medication monitoring
clinics at senior centers.
Worked with law enforcement to conduct
alcohol compliance checks and alcohol
retailer training.
Alcohol and drug abuse education programs
in schools.
Arthritis screening and case management
through diet, exercise and medication.
Implemented community-based efforts to
improve the health status and quality of life
for persons who have arthritis.
Education of parents, staff and students to
reduce incidence of asthma attacks in school
age children, management if attack occurs,
education of physiology and symptoms
associated with asthma and tips to mitigate
the attack.
Research environmental triggers of asthma
and implement effective home prevention
strategies.
Provide radon test kits and telephone support
to reduce exposure to radon
Work with community partners to educate
women about prevention, screening and
early intervention of breast cancer.
Community programs focusing on healthy
lifestyles -physical activity, health nutrition,
and decreased tobacco use and exposure.
Public access defibrillator program –
improve awareness and access to AEDs.
Diabetes education and free blood sugar
checks at local clinics, health fairs and
special events.
Diabetes support group to provide education,
2007 LPH PPMRS Summary
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HIV/AIDS
23%
43%
34%
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•
Infant, Child,
and
Adolescent
Growth and
Development
92%
7%
1%
•
•
Injury
67%
26%
7%
•
•
Mental Health
29%
32%
39%
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•
Nutrition
33%
56%
11%
48%
41%
11%
•
•
Oral/Dental
Health
Other Drug
Use
•
•
39%
40%
21%
•
•
Physical
Activity
51%
40%
9%
•
•
Pregnancy and
Birth
87%
12%
1%
•
•
STDs/STIs
39%
49%
12%
•
sharing of ideas and networking.
HIV counseling, education and testing
services to high school students.
HIV prevention education at outpatient
chemical dependency treatment programs.
Home visits to new parents to provide
information on growth and development,
promote breastfeeding, connect families to
resources, promote maternal and infant
mental health, and promote medical homes.
Follow Along program- to detect
developmental delays and socio-emotional
concerns early in school children.
Car seat safety education and distribution
programs in collaboration with community
partners.
Home safety assessment for seniors and new
parents.
Comprehensive, school program to prevent
bullying, improve the social climate of
classrooms and reduce related antisocial
behaviors such as vandalism and truancy.
Screening of prenatal/postnatal women and
senior citizens for depression.
Support to schools for improved nutrition
and physical activity polices and programs.
Communitywide fitness and wellness
programs, encouraging proper nutrition and
exercise.
Dental screenings and fluoride varnishing in
WIC and MCH programs.
Oral/Dental education in the schools.
Involvement in community
methamphetamine coalitions, use reduction
activities and development of ordinances.
Partner to reduce adolescent substance use
and create conditions that make marijuana
and other drug use less desirable and
accessible.
Support community and worksite physical
activity programs through “walkable”
communities and activity challenges.
Nutrition education and physical activity
support to school age children during the
summer.
Information and support for high risk, low
income, pregnant teens and women for
healthy lifestyle choices, preterm birth
prevention, and connection to necessary
resources.
Childbirth and breastfeeding education
classes for teens and special needs clients.
STD/STI information, testing and initial
treatment given to teens and adults at
counseling centers.
Outreach and education on safe sex to high
2007 LPH PPMRS Summary
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Tobacco Use
59%
38%
3%
•
•
Unintended
Pregnancies
64%
27%
9%
•
•
Violence
33%
45%
22%
•
risk individuals in jail, group homes and
alternative learning programs in mainstream
public schools.
Raise the awareness of the health hazards of
secondhand smoke and to raise the number
of restaurant establishments that are smoke
free.
Participate in tobacco diversion classes for
under age youth found with tobacco.
Work with schools to offer education on
unintended pregnancy, STIs, adoption
option, and young parenting issues.
Information to postpartum clients on
contraception options and access to services.
Public campaign on coaching boys into men
to educate them about how they relate to
women in order to counteract negative
messages they may learn from elsewhere.
Address health needs of women and children
in shelter due to domestic violence.
Prevent the Spread of Infectious Disease (infectious disease) focuses on infectious diseases that are spread person to
person. This does not include diseases that are initially transmitted through the environment, such as food, water, vectors
and/or animals. This summary highlights the CHS System’s expenditures, staffing, and activities to detect acute and
communicable diseases, assure the reporting of communicable diseases, prevent the transmission of diseases (including
immunizations), and implement control measures during communicable disease outbreaks.
Expenditures
Almost $16 million were spent in the area of infectious disease; an increase of 15 percent ($2.1 million) from 2006. This
represents nearly five percent of total the CHS System’s expenditures. Other federal funds supported 35 percent ($6.0
million) of infectious disease spending. Other funding sources included local tax levy (29 percent), LPH Act state funds (12
percent), and client fees (nine percent). It is important to note that one public health department accounted for 38 percent of
infectious disease spending and expended 90 percent of the other federal funds in infectious disease.
Staffing
There was an increase of 8 FTEs from 2006, totaling 134 FTEs (five percent of all FTEs) that reported worked in infectious
disease. Nurses, including registered public health nurses and others accounted for 51percent of the staff in the area of
infectious disease. Other professions included administrative support (18 percent), public health educators (five percent), and
public health program specialist (five percent). It is important to note that two local health departments accounted for 27
percent of FTEs in the area of infectious disease and five LHDs had no FTEs in the area of infectious disease.
Activities and Performance Measures
Infectious Disease Trends and Gaps
A majority (73 percent) of the local health departments monitored and analyzed infectious disease risk identifying trends and
reporting gaps for their communities. This was an increase from 56 percent in 2006. Reasons for not identifying trends and
practice gaps included not having staff capacity, no timely access to data, and activity performed by another entity. The most
commonly identified reporting gaps were 1) under reporting of STDs/STIs by health care clinics; 2) gaps in timely access to
infectious disease data from MDH; and 3) gaps in communication between providers, local health departments and MDH on
disease reporting. Local health departments also identified a number of infectious disease trends including decreases in
Pertusis, Hepatitis A, and Hepatitis B with increases in:
• Chlamydia infection rates especially in the age group of 15-24 years
• Tick-borne diseases including Lyme’s disease and Campylobacter
• Tuberculosis cases (including latent tuberculosis) especially in foreign born individuals.
• Mumps
• West Nile
• Salmonella
2007 LPH PPMRS Summary
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Immunization Trends and Gaps
Overall, 81 percent of the local health departments monitored and analyzed immunization data and practices to identify
trends and practice gaps. The reasons for not performing this activity were another entity performing this activity, not having
staff capacity and not having jurisdiction specific data. Local health departments identified a number of disease trends and
reporting gaps. The following examples are organized by frequency reported:
• Issues with MIIC electronic documentation system leading to inaccurate and incomplete data.
• Issues with training and educating staff on immunization practices
• Increase in the number of missed opportunities for immunizations by providers
• Problems in medical clinics with inappropriate vaccine storage
• Decrease in vaccination rates under the MnVFC coverage program.
• Decrease in immunization rates after two years of age
• Increased efforts to target low immunization rates by sending reminders and making follow-up calls.
• Working to increase timely reporting, assess vaccine shortages, storage and handling concerns and school vaccinations.
All local health departments provided infectious disease and immunization information to local providers and the public and
almost all (97 percent) provided immunizations to children and to adults (95 percent). The primary reason among those that
did not provide this service was that immunizations were offered by another clinic in the jurisdiction.
Correctional Health Services
Six-three percent of the LHDs provided some level of correctional health services. Of those that provided that service, the
most commonly seen infectious disease was common cold. They also reported significant number of cases of Hepatitis C,
tuberculosis (including latent TB) and Chlamydia. There were a substantial number of cases whose diagnosis could not be
established.
Contacting Disease Reporting Entities
Local public health departments had 137 hospitals within their jurisdictions and contacted either in person or by phone 74
percent of the hospitals to provide information on infectious disease reporting. Other methods (newsletters or emails) were
also used to contact 88 percent of hospitals. Of the 117 freestanding urgent care clinics in LHD’s jurisdictions – an increase
of 50 percent from 2006- a third of these urgent care clinics were contacted either in person or by phone with 47 percent
contacted by other methods such as newsletters or e-mails to provide education on infectious disease reporting. Over 800
primary care clinics were in LHD’s jurisdictions and contacted in person/by phone (85 percent) and other methods (91
percent) provide education on infectious disease reporting.
Tuberculosis activities
Fifty-nine percent of local health departments provided directly observed therapy (DOT) for tuberculosis. The most
frequently identified reason for those not performing this service were another entity performed this activity or TB clients or
physicians refused DOT. A majority of local health departments indicated a capacity to identify, locate, evaluate, and monitor
contacts of infectious TB cases based on MDH/CDC standards. The remainder indicated that they had not had infectious
disease cases or this function was performed by another entity. Almost 70 percent local health departments monitored a total
of 3062 clients for latent tuberculosis infection (LTBI).
Innovative programs
Local health departments provided a number of innovative programs to prevent the spread of infectious diseases including:
• “Flu Bug” vaccination promotion designed in collaboration with health care clinics
• Vector borne campaign to increase public awareness via media programs
• Provided free flu shots to all county employees
• Conducted Flu shot clinics targeting elderly, chronically ill and children
• Community wide “Do It In Your Sleeve” presentation
• Work with local medical centers to sponsor flu clinics
• Stop Syphilis Now with online scheduling programs
• County-wide presentations on pandemic/seasonal flu
• Hands - on pandemic flu preparedness activities
• Local radio programs on MRSA and prevention
• STDs/STIs prevention programs to schools
• Hand –washing study in schools
• Established Healthy Habits week in schools to emphasize disease containment measures
2007 LPH PPMRS Summary
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•
•
MMR and Tdap vaccination provided to international students.
“Double Dutch Campaign” –distributing free condoms
“Cover Your Cough” campaigns in schools and health care facilities
Responded to Infectious Diseases
Throughout the year, local health departments provided a number of infectious diseases response activities (excluding those
of vector-borne, food-borne, and/or water borne). This included:
• Conducted Tuberculosis contact investigation in school district
• Conducted Pertussis investigations
• Assisted family members and close-contacts of cases of N. meningitides to receive prophylaxis
• Provided individuals and families information as well as providing community education about West Nile at health fairs,
newspaper articles, and radio
• Provided response & education to the media, medical clinics and the public on rabies, treatment and prevention
Assure the Quality and Accessibility of Health Services (assure health services) involves assessing health care capacity
and access to health care. This summary highlights the CHS System’s expenditures, staffing, and activities to identify and
reduce of barriers to health services, fill health care gaps, and link people to needed services.
Expenditures
Over $126 million were spent in health services, slightly higher than 2006. Assure health services expenditures were
supported by local tax levy (36 percent) and Medicaid (24 percent). Fourteen percent ($17.6 million) of spending was on
home health services. It is important to note that one local health department expended $49 million dollars in assure health
services, accounting for 39 percent of overall expenditures, 74 percent of all local tax levy dollars, and 29 percent of the
Medicaid dollars spent in the area of assure health services.
Staffing
The area of assure health services employed 1,212 FTEs, encompassing 41 percent of all FTEs in the CHS System. Over 380
FTEs worked in home health services, which accounted for 32 percent of all assure health services FTEs and 13 percent of
total FTEs in all areas. Nurses, including public health nurses and others, accounted for 49 percent of FTEs in this area. Other
staff included paraprofessionals (19 percent), public social worker (12 percent), and administrative support (ten percent).
Two-thirds of all other nurses and 44 percent of all public health nurses worked in assure health services. All but one LHD
employed FTEs in this area.
Activities and Performance Measures
Identifying Gaps in Health care Services
Local health departments identified health care service gaps or barriers during their most recent community assessment. The
two most frequently identified gaps or barriers were lack of dental services (92 percent) and transportation (88 percent).
Other gaps or barriers identified by more than 80 percent of public health departments included lack of insurance, lack of
mental health providers, dental providers and primary care providers.
Addressing Gaps in Health care Services
Local health departments undertook efforts to address gaps and barriers in health care. The two most frequently addressed
issues were dental services (81 percent) and lack of insurance (73 percent). Other issues addressed by more than 50 percent of
local health departments included transportation, basic life needs and primary care providers. Local health departments
addressed gaps and barriers many ways including:
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Contracted or partnered with culturally diverse providers
Identified insurance status of incarcerated individuals
Participated in local coalitions to address dental services
Provided Medicaid Part D education
Enhanced telemedicine services
Screened for insurance and medical assistance eligibility
Worked with local partners to provide medical and dental services to the under and uninsured
Implementation of low cost family planning services.
Enhanced access to transportation services
2007 LPH PPMRS Summary
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•
•
•
•
Worked with Human Services to provide mental health services to inmates.
Incorporated new services into existing programs (i.e. WIC and CT&C) to increase access
Expanded home visiting services to homeless pregnant women and families
Worked with local partners to address medical provider shortage issues (including mental health and chemical
dependency providers)
Recruitment of PHN interns
Improving Accessibility of Health Services
Most (89 percent) of local health departments took actions to improve the accessibility of health services including:
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•
•
•
•
•
•
•
•
•
•
•
Expanded and varied clinic hours and locations
Maintained flexible hours for home visiting and other programs
Increased nursing hours in jail
Increased number of nurses available for programs
Expanded public health services available during WIC clinics
Expanded use of telehealth services
Increased care coordination for managed care
Maintained 24/7 on call nurse
Use of bus tokens to improve transportation
Waive cost of immunizations, family planning in the uninsured population
Increased number of staff trained to do dental varnishing
Increased use of bilingual staff
Increased the availability of “walk-in” slots for clinics
Almost all (95 percent) local health departments provide Child and Teen Checkup outreach and screening. Other services
provided by more than 80 percent of local health departments included elderly waiver, early intervention service coordination
for children with special health needs, tuberculosis case management, WIC clinics, immunization clinics, family home
visiting, Follow Along Program, long term care consultations, and personal care assistance assessments. Of those that
provided the above mentioned services, most of them indicated that their health department staff routinely assessed clients for
health insurance status. Over all, only a small number of local health departments indicated that they were able to report
health insurance status data on their clients.
Protect Against Environmental Health Hazards (environmental health) addresses aspects of the environment that pose
risks to human health (broadly defined as any risk emerging from the environment), but does not include injuries. This
summary highlights the CHS System’s expenditures, staffing, and activities that identify and mitigate environmental risks,
including food-borne, waterborne, and vector-borne diseases and public health nuisances. This area of responsibility includes
31 broad-ranging topic areas within the following categories: Air Quality, Built Environment/Housing, Selected Public
Health Nuisances, Food Protection, Solid and Hazardous Waste Management, Recreational Water, Drinking Water and
Other. For each topic public health departments indicated if there were ordinances or written policies and trained staff and
what services provided.
Expenditures
There was a six percent increase in Environmental Health spending, from $40.0 million in 2006 to $42.5 million in 2007.
Other fees supported 54 percent ($23 million) of the environmental health expenditures. Other funding sources included local
tax levy (27 percent), other local funds (eight percent), and other state funds (four percent). It is important to note that one
LHD represented 50 percent of spending in this area, accounting for 77 percent of the other fees expended. Another LHD
represented 20 percent of spending, accounting for over 50 percent of local tax levy expended. Nine LHDs had no spending
in the area of environmental health.
Staffing
Environmental health was staffed by 210 FTEs, or seven percent of the CHS workforce. Over half (52 percent) of those FTEs
were environmental scientists and specialists. The remaining occupations represented included
licensure/inspection/regulatory specialists (six percent) and health educators (seven percent). It is important to note that two
local health departments accounted for 35 percent of all FTEs in environmental health. Ten LHDs had no FTEs in this area.
2007 LPH PPMRS Summary
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Activities and Performance Measures
Ordinances and Policies
For 9 of the 30 topic areas (excluding “Other”), over 50 percent of the local public health departments indicated that they did
have written policies and/or ordinances to address the topic. These topics included:
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•
•
•
•
Environmental Tobacco Smoke
Manufactured Home parks
Clandestine Drug Labs
Garbage/Junk House
Animal/Pest/Vectors
Household Hazardous Waste
Solid Waste
Individual Sewage Treatment
For 18 of the 30 topic areas (excluding “Other”), over 50 percent of local public health departments indicated that they did
not have written policies and/or ordinances to address the topic. These topics included:
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•
•
•
•
•
•
•
•
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•
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•
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Outdoor Air
Indoor Air
Radon
Asbestos
Lead
Licensed Lodging Facilities
Mold
Rental Property Inspection
Recreational Camps and Youth Camps
Food Service
Grocery and Convenience Stores
Daycare Establishments
Public Pools and Spas
Lakes and Swimming beaches
Water Well Construction and Sealing
Private Well Testing
Non-Community Water Supplies
Source Water Protection
Consumer Food Safety
Body Art
Tanning Beds
Trained Staff
For 9 of the 30 topic areas (excluding “Other”), over 50 percent of local public health departments indicated that they did
have staff trained to address the topic. These topics included:
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•
•
•
Radon
Environmental Tobacco Smoke
Lead
Mold
Animal/Pest/Vectors
•
•
•
•
Clandestine Drug Labs
Garbage/Junk House
Private Well Testing
Consumer Food Safety
For 19 of the 30 topic areas (excluding “Other”), over 50 percent of local public health departments indicated that they did
not have staff trained to address that topic. These areas include:
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•
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•
•
•
•
•
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Outdoor Air
Indoor Air
Asbestos
Licensed Lodging Facilities
Manufactured Home parks
Rental Property Inspection
Recreational Camps and Youth Camps
Grocery and Convenience Stores
Daycare Establishments
Household Hazardous Waste
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Solid Waste
Individual Sewage Treatment
Non Household Hazardous Waste
Public Pools and Spas
Lakes and Swimming beaches
Water Well Construction and Sealing
Non-Community Water Supplies
Source Water Protection
Body Art
Tanning Beds
2007 LPH PPMRS Summary
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Services Provided
In all but one topic area (Manufactured Home Parks) local public health departments indicated that the that the service they
provided most frequently was education. In 22 of the 30 topic areas (excluding “Other”) the next most frequently identified
service was consultation/technical assistance. In half of the topic areas the “Referral to another county/city department” or
“No activities /services provided by the city/county” was the most frequently selected response. These topic areas included:
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•
•
•
•
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Outdoor Air
Asbestos
Manufactured Home Parks
Rental Property Inspection
Recreational Camps and Youth Camps
Grocery and Convenience Stores
Household Hazardous Waste
Non Household Hazardous Waste
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•
•
•
•
•
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Solid Waste
Individual Sewage Treatment
Lakes and Swimming Beaches
Water Well Construction and Sealing
Source Water Protection
Tanning Beds
Body Art
When specifying a department within the county/city department to which the local public health department referred these
services, the most frequently identified city/county department was the Environmental Health or Environmental Services
Department. When indicating that the city/county did not provide these services, the most frequently identified responsible
entity was the Minnesota Department of Health or the Minnesota Pollution Control Agency.
Emerging Environmental Health Issues
The emerging environmental health issues most frequently identified in 2007 in order of frequency:
• Mold
• Declining and Substandard Rental Property
• Garbage/Junk Houses
• Lead
• Source Water Contamination
• Body Art
Public Health Nuisances
Most (75 percent) of local public health departments have written policies and procedures for implementing the removal and
abatement of public health nuisances specified in Minn. Stat. 145A.04 Subd. 8 and 145A.03 Subd. 17. Local public
departments reported a total of 1166 public health nuisance inspections in 2007, of these 85 percent were public health
nuisances confirmed in 2007. The top three most frequently reported public health nuisances complaints were 1)
Garbage/Junk Houses; 2) Mold; and 3) Accumulation of rubbish or junk.
Drinking Water
To assess the quality of drinking water in their communities, 20 percent of local health departments reviewed test results on
public non-community water supplies. The primary reason for those not performing this function was that another entity
provided these activities.
Food-borne Illness
Local health departments were asked if they were able to collect data on the average number of food-borne illness risk factors
per establishment for its jurisdiction, and if they were able to report on that data. Three quarters (75 percent) do not do food,
beverage and lodging licensing so were not able to report data. Of those able to report the data, the top two risk factors
identified included improper holding temperatures and poor personal hygiene. They indicated an average of 4.45 risk factors
per inspection.
Environmental Health Innovation
Local health departments provided examples of an innovative or effective program in environmental health including:
• Updated public health nuisance ordinances
• Mandatory training of new food workers.
• Radon activities, including education, screening, and tracking
• Environmental tobacco smoke ordinances and advocacy
• Septic system inspection and education programs
• Junk yard abatement
• Water quality on public beaches
• Food safety education
• Clandestine drug lab ordinances
2007 LPH PPMRS Summary
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Environmental Health Response Activities
Local public health departments provided examples of vector-borne, food-borne, and/or water borne disease response
activities including:
• E-coli and Salmonella outbreak investigation
• Norovirus outbreak investigation
• Investigation and mitigation of rat infested home
• Unsafe community water system
• Tick-borne illness investigation
Prepare for and Respond to Disasters and Assist Communities in Recovery (emergency preparedness) addresses
activities that prepare public health to respond to disasters and assist communities in responding to and recovering from
disasters. This summary highlights the CHS System’s expenditures, staffing, and activities to plan and prepare for and
respond to disasters.
Expenditures
Emergency preparedness expenditures were a little over $11 million or four percent of total expenditures. Emergency
preparedness had a three percent decrease in expenditures from 2006 to 2007. Almost 79 percent ($9.0 million) of the 2007
emergency preparedness funding was from other federal funds. Federal preparedness and pandemic flu planning dollars
comprise the majority of other federal funds. The remaining funding came from other local tax levy (15 percent) and LPH
Act state general funds (three percent).
Staffing
There was a two percent decrease in emergency preparedness FTEs from 2006, for a total of 105 FTEs in 2007. A quarter of
emergency preparedness FTEs were public health nurses with health planners accounting for 14 percent, administrative
support (11 percent), and public health educators (11 percent). Three LHDs had no FTEs in the area of emergency
preparedness.
Activities and Performance Measures
Contact Information
All local public health departments kept their primary contact information updated with MDH and in the local jurisdiction’s
Emergency Operations Plan (EOP).
Planning
Almost all (96 percent) local health departments reviewed or updated their department’s emergency response plan. Ninetyfive percent reviewed the health and medical annex of the local jurisdictions’ EOP with the emergency manager.
Workforce
All local health departments indicated that they have trained appropriate staff in the National Incident Management System
(NIMS) and have a system to notify and deploy those staff during an emergency. Ninety-six percent have tested the system.
Communication
Most (97 percent) local health departments tested their Health Alert Network system at least once during the year. All local
health departments have an emergency response plan that includes how the public health department will communicate with
the media and public.
Response
Over half (52 percent) public health departments indicated that they participated in a real public health response to a potential
or actual emergency including:
• Response to Hepatitis A outbreak
• Family assistance to 35W bridge collapse incident
• Implementation of clinic plan in response to pediatric flu death
• Response to industrial fire
• Response to train derailment
• Response to floods ( assuring food, water, heat, medications, and transportation to shelter)
• E-coli contamination of community water supply
• Strep A Meningitis
2007 LPH PPMRS Summary
Page 12 of 12