Environmental Health Continuous Improvement Board
Meeting Summary
Wednesday, May 13, 2015
9:00 a.m. – 1:30 p.m.
Minnesota Counties Intergovernmental Trust Building
Members Present and Absent:
Name
Dawn Beck (co-chair)
Allie Freidrichs
Bill Groskreutz
Tom Hogan (co-chair)
Daniel Huff
Ben Miller
Carol Schefers
Karen Swenson
Jeff Travis
John Weinand
Organization
Present
Olmsted County
Meeker-McLeod-Sibley Counties
Faribault County Commissioner
Minnesota Department of Health
City of Minneapolis
Minnesota Department of Agriculture
Wright County
Brown-Nicollet Counties
Washington County
City of Minnetonka
X
X
X
X
X
X
X
X
X
X
Absent
Other Meeting Participants:
Debra Anderson (Hennepin County); Kim Carlton, Steven Diaz, Dale Dorschner, Michelle Messer, Blake
Nordin, Wendy Spanier, (Minnesota Department of Health, Environmental Health Division); Kirsten
Knopff, Katherine Simon (Minnesota Department of Agriculture); Lorna Schmidt (Local Public Health
Association)
Facilitators:
Stephanie Lenartz, and Chelsie Huntley (Minnesota Department of Health, Health Partnerships Division)
Welcome and Introductions
The Environmental Health Continuous Improvement Board (EHCIB) co-chair Dawn Beck, Olmsted
County welcomed everyone to the EHCIB’s May meeting. Ms. Beck called attention to the Board’s
completion of some “quick wins” including issuing a “Statement of Support” and initiating a process for
Environmental Health Continuous Improvement Board
Minnesota Department of Health
Health Partnerships Division – Public Health Practice Section
P.O. Box 64975
St. Paul, MN 55164-0975
(651) 201-3880
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EHCIB Meeting Summary – May 13, 2015
FPLS program re-evaluations. Ms. Beck proceeded to review the meeting agenda and objectives.
Meeting participants each introduced themselves. Ms. Beck acknowledged both Board and non-board
members and invited everyone to fully participate in the meeting activities.
Meeting Objectives:
1. Initiate the FPLS Program Evaluation Improvement Initiative by 1) developing a value stream
map of the evaluation cycle and 2) identifying data to be collected on the process.
2. Determine next steps for the “establish a standing manager’s meeting and develop a formal,
collaborative process for policy development and roll-out” goal area.
3. Identify additional ways to distribute the Statement of Support.
Introduction to the Improvement Process
Chelsie Huntley, MDH provided an overview of “Quality Improvement Basics” and described how the
EHCIB could use QI to improve the FPLS program evaluation process (see attached).
Goal: Gather information and feedback to improve the FPLS program
evaluation process
Stephanie Lenartz, MDH led Board members and staff from the Partnership and Workforce
Development Unit (PWDU) of the Food, Pools and Lodging Services (FPLS) section at MDH through the
first step of the improvement process. The group mapped the current process for the FPLS program
evaluation and identified data/forms that needed to be gathered to further understand the current
process. A draft map and the corresponding data/forms will be shared in advance of the next EHCIB
meeting. The next step in the process will be to identify issues/waste in the current process.
Business Items
Participants discussed and made decisions about the following business items.
Approve January Meeting Summary
The May 13, 2015 EHCIB meeting summary was presented for approval. Jeff Travis, Washington
County, made a motion to approve the summary. Dan Huff, City of Minneapolis, seconded the motion.
The motion passed unanimously without discussion.
Status Updates on January 2015 Action Items
 2015 Work Plan: Ms. Huntley reported that progress is being made on the work plan and it has
been posted on the EHCIB’s website: http://www.health.state.mn.us/divs/eh/local/cib/
 Re-Evaluation Process: Steven Diaz, MDH reported that the re-evaluation process adopted by
the EHCIB is being implemented by PWDU. The 1st face-to-face meeting and field component
has been completed for the first program to undergo re-evaluation; PWDU staff are in the
process of analyzing the data and creating the report for that re-evaluation. The other three
Environmental Health Continuous Improvement Board
Minnesota Department of Health
Public Health Practice Section – Health Partnerships Division
P.O. Box 64975
St. Paul, MN 55164-0975
(651) 201-3880
Page | 2
EHCIB Meeting Summary – May 13, 2015
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programs are tentatively scheduled and all field components should be complete by September
2015. The feedback to-date on the re-evaluation process has been positive; communication has
been increased to include a mid-week conversation between PWDU evaluators and program
staff and an exit meeting. In addition the PWDU is looking to reduce the field time from two to
one week. Board members requested that Mr. Diaz provide the Board with a summary of the
feedback received throughout the re-evaluation process. Mr. Diaz agreed. The re-evaluation
process adopted by the Board has been posted on the EHCIB’s website.
o Mr. Diaz also shared that he is in the process of hiring a supervisor for PWDU and is
trying to decentralize their operations in order to meet state and local needs.
o Board members shared with Mr. Diaz that while they have heard many negative
comments about the evaluation process, only positive things have been said about the
PWDU evaluators, Kim Carlton and Michelle Messer. In addition Board members noted
their appreciation of Kim and Michelle’s participation in the FPLS Program Evaluation
Improvement Initiative work earlier in the meeting.
o It was noted that MN Department of Agriculture (MDA) staff were appreciative of the
opportunity to participate in the FPLS Program Evaluation Improvement Initiative work
earlier in the meeting and would like to continue to learn from the process. Members
agreed that MDA participation was beneficial in that it could lead to more similarities
between MDH and MDA processes.
Statement of Support: Members shared that they’ve received positive feedback on the
Statement of Support; it resonates with staff and some local programs are sharing/posting it.
Ms. Beck noted that the Statement was on the website and has been distributed to LPHA and
EH Managers. Members noted that it should also be distributed to the State Community Health
Services Advisory Committee (SCHSAC) and within MDH as appropriate. Ms. Huntley agreed to
distribute via SCHSAC. Tom Hogan, MDH agreed to distribute within MDH.
MDH FPLS discussion with EH Managers: Steven provided an update on his activities to engage
with EH managers and local public health directors. Discussions continue but no decisions have
been made. It was noted that there are numerous communication channels and numerous
reasons to communicate (i.e. policy discussions, FPLS specific discussions, broader EH
discussions, etc.) but no one has a complete picture of the current need. It was noted that while
it is important to engage organizations/leaders from across the state in conversations about
environmental public health there is a current pressing need to communicate around FPLS
issues. It was recommended that a map of current communication channels be developed so
gaps can be identified and filled as needed.
Concurrent Session Proposal for the 2015 Community Health Conference: Karen Swenson,
Brown-Nicollet shared a draft proposal for consideration for a concurrent session and the 2015
Environmental Health Continuous Improvement Board
Minnesota Department of Health
Public Health Practice Section – Health Partnerships Division
P.O. Box 64975
St. Paul, MN 55164-0975
(651) 201-3880
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EHCIB Meeting Summary – May 13, 2015
Community Health Conference. Ms. Swenson provided an overview of the proposal selection
process and noted that she and Bill Groskreutz, Faribault County are on the selection
committee. Members provided Ms. Swenson feedback on the proposal and supported the
proposals submission. If chosen Allie Freidrichs, Meeker-McLeod-Sibley, Ms. Swenson and Mr.
Hogan will present.
Member Updates
 Mr. Hogan provided an update on the legislative session noting that the session is scheduled to
end on Monday and there was a large divided in language and money House and Senate bills
related to health and agriculture. Meeting participants asked if there would be a legislative
summary related to EH at the end of session. Mr. Diaz and Lorna Schmidt (LPHA) agreed to
coordinate so that EH issues were included in the LPHA legislative summary.
 Mr. Huff shared that Minneapolis is offering the state’s first Cert Safe training in Somali.
 Mr. Huff also shared that Minneapolis is in the process of implementing a Styrofoam ban and
offered assistance to others interested in similar policy measures.
 Mr. Huff shared that an Asthma bill for getting MA reimbursement for in-home asthma services
did not get heard during this year’s legislative session. He noted that efforts are underway to
strengthen the coalition in order to advance the issue during the next legislative session.
 Mr. Travis shared that the Washington County Fairgrounds will be hosting a “Wipeout”
competition. The event has been deemed to need a plan review for a temporary pool.
Word on the Street
No concerns were raised.
Constituent Engagement
 Ms. Beck noted that non-metro, local, delegated agencies have expressed that they think the
Board is moving in the right direction and that the themes from the interviews of the programs
to be re-evaluated were “right on.”
 A question was raised about the next step for updating ratings for programs who were rated
“conditionally acceptable.” Mr. Diaz and members expressed an interest in addressing the gap
in the improved process. In the meantime programs can contact Mr. Diaz with questions.
Take-home Points, Action Items, and Adjournment
Meeting participants agreed on the following take-home points and action items.
Take-home points:
 The Environmental Health Continuous Improvement Board and staff from the Partnership and
Workforce Development Unit of the Food, Pools and Lodging Services section at MDH mapped
Environmental Health Continuous Improvement Board
Minnesota Department of Health
Public Health Practice Section – Health Partnerships Division
P.O. Box 64975
St. Paul, MN 55164-0975
(651) 201-3880
Page | 4
EHCIB Meeting Summary – May 13, 2015
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the current process for the Food, Pools, and Lodging Services program evaluation. The Board is
taking a structured quality improvement approach to improve the evaluation process. Creating
a map of the process was an important first step in understanding all of the issues before
jumping to solutions. In order to promote future cross-agency learning/sharing, Minnesota
Department of Agriculture Staff attended the meeting.
At its May meeting, the Environmental Health Continuous Improvement Board identified a
number of themes for improvement in the current Food, Pools, and Lodging Services program
evaluation process
o Interaction;
o Continuous improvement;
o Focus on public health risk;
o Clear, consistent, transparent expectations; and
o Partnering relationships (a full description of the themes is attached).
The Board would like to know if these themes resonate with those who participated in the
evaluation process and will be asking for constituent feedback before their July meeting.
In order to make progress on their goals to clarify and improve environmental health
communication channels; and establish a formal, collaborative process for policy development
and roll-out, the Environmental Health Continuous Improvement Board is creating an inventory
of environmental health related committees, networking groups, forums, etc.
The Environmental Health Continuous Improvement Board has issued a Statement of Support
for Minnesota’s State-Local Environmental Health Partnership. The statement can be found on
the Board’s website. Environmental health practitioners, organizations and partners are
encouraged to share the statement of support broadly.
Action Items
 Partnership and Workforce Development Unit staff will collect data, forms and additional
information to inform the next phase of the Food, Pools, and Lodging Services Program
Evaluation improvement initiative.
 Health Partnerships staff will arrange to have the Statement of Support for Minnesota’s StateLocal Health Partnership shared with State Community Health Services Advisory Committee
(SCHSAC) members at their next meeting.
 When the re-evaluations are complete, Steven Diaz will share a summary of findings from the
process with the Environmental Health Improvement Board. The Board will use the summary to
inform the Food, Pools, and Lodging Services program evaluation improvement efforts.
 Steven Diaz and Tom Hogan (MDH) will coordinate with Lorna Schmidt (LPHA) to ensure
relevant environmental health issues are included in LPHA’s legislative session summary.
Environmental Health Continuous Improvement Board
Minnesota Department of Health
Public Health Practice Section – Health Partnerships Division
P.O. Box 64975
St. Paul, MN 55164-0975
(651) 201-3880
Page | 5
EHCIB Meeting Summary – May 13, 2015
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Karen Swenson will submit a concurrent session proposal for the 2015 Community Health
Conference on behalf of the Board.
MDH EH staff and Health Partnerships Division staff will develop a draft map/inventory of
existing environmental health committees, networking groups, forums, etc. for the Board to
review at a future meeting.
The next EHCIB meeting will be held on Wednesday, July 8, 9am-1:30pm (REVISED Time) at the
Minnesota Counties Intergovernmental Trust Building in St. Paul.
Environmental Health Continuous Improvement Board
Minnesota Department of Health
Public Health Practice Section – Health Partnerships Division
P.O. Box 64975
St. Paul, MN 55164-0975
(651) 201-3880
Page | 6
EHCIB Meeting Summary – May 13, 2015
Quality Improvement Basics
What is QI?
Quality improvement is the use of a deliberate and defined improvement process & the continuous
and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance,
accountability, outcomes, and other indicators of quality that improve the health of the community.
What is the benefit of QI?
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Reduction in waste
Less pain and chaos
Increased pride and gratification
Satisfied customers
Increased clarity and knowledge
Better results
How is the “QI Approach” different?
How can the EHCIB use QI to improve the FPLS Program Evaluation Process?
Phase
Plan
Do
Activity
Determine goal(s) of improvement project
Describe/map the current process
Collect data on the current process
Identify root causes
Identify potential improvements
Develop improvement theory(s)
Develop action plan
Test the improvement(s)
Timeframe/Notes
May and July EHCIB mtg.
May EHCIB mtg.
June – between May and July EHCIB mtgs.
EHCIB mtg. TBD
EHCIB mtg. TBD
EHCIB mtg. TBD
EHCIB mtg. TBD
FPLS staff will pilot the process late 2015
Environmental Health Continuous Improvement Board
Minnesota Department of Health
Public Health Practice Section – Health Partnerships Division
P.O. Box 64975
St. Paul, MN 55164-0975
(651) 201-3880
Page | 7
EHCIB Meeting Summary – May 13, 2015
Study
Act
Collect and analyze data
Review data/analysis and make conclusions
Decide to adopt, adapt or abandon
Once a process is adopted the EHCIB will
review on a regular basis
Environmental Health Continuous Improvement Board
Minnesota Department of Health
Public Health Practice Section – Health Partnerships Division
P.O. Box 64975
St. Paul, MN 55164-0975
(651) 201-3880
Page | 8
EHCIB Meeting Summary – May 13, 2015
FPLS Re-Evaluation Process Development Interview Themes
The following themes were compiled based on interviews and feedback received from four FPLS
programs in February, 2015 to assess the re-evaluation process. The themes identified within this
summary highlight areas of the re-evaluation process that could benefit from additional improvement.
Top Themes
1. Interaction- Program staff would like more interaction with MDH during the review process.
There is very little interaction with the evaluators. Ongoing dialog and communication is
needed. Preferably a face-to-face conversation about what the evaluators are seeing. Program
staff would also like the opportunity to sit down with an evaluator to discuss the issues they’ve
identified for their program.
2. Quality Improvement- MDH should focus on applying a quality improvement approach/lens to
the entire evaluation process. Provide recommendations for improvement so programs can
assess their current standing and take corrective actions to improve their rating. The reevaluation process should serve as a tool for continuous improvement and should reflect a
programs progress and efforts towards making improvements. Make the evaluation about the
program not the people.
3. Clear Expectations- Ensure the messaging from MDH is consistent. Program staff voiced
concern about not knowing what is acceptable to MDH. The programs would like to know what
MDH’s expectations are in terms of how to use the code and rules as a tool to achieve positive
public health outcomes.
4. Acknowledge Improvements- Program staff indicated that receiving acknowledgement for
improvements to processes and procedures identified in the original evaluation is important.
Programs would also like to receive recognition in areas where they have gone above and
beyond to make improvements.
5. Transparency- MDH should provide supporting documentation explaining why a particular
rating was received. MDH should also provide programs with feedback and guidance about the
required elements of the evaluation.
6. Partnering Relationships- Learning to work together by fostering relationships among peers
and having peers participate in each other’s evaluations is important. Partnerships help to
Environmental Health Continuous Improvement Board
Minnesota Department of Health
Public Health Practice Section – Health Partnerships Division
P.O. Box 64975
St. Paul, MN 55164-0975
(651) 201-3880
Page | 9
EHCIB Meeting Summary – May 13, 2015
enhancement improvement. Program staff also expressed interest in build cooperative and
trusting relationships with MDH.
7. Help Programs Meet the Standards- MDH should be more involved in helping programs
develop plans for improvement. Program staff would like help with marking instructions. They
suggested MDH create templates and forms containing acceptable ordinance language.
8. Requirements known in Advance - Requirements for the re-evaluation process should be made
known in advance. MDH should communicate what will be evaluated and how it is going to be
evaluated. Let programs know if a face-to-face site visit is required so that the program can
dedicate time and resources to preparing for the re-evaluation.
9. Consistency and Standards- Program staff stressed the importance of having consistent
processes for all delegated agencies and holding each program to the same standards. MDH
should standardize the evaluation process such that it is more uniform and consistent across
local programs.
Environmental Health Continuous Improvement Board
Minnesota Department of Health
Public Health Practice Section – Health Partnerships Division
P.O. Box 64975
St. Paul, MN 55164-0975
(651) 201-3880
Page | 10