Environmental Health Continuous Improvement Board
Meeting Summary
Wednesday, September 9, 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:
Kim Carlton, Steven Diaz, Michelle Messer, Blake Nordin, Denise Schumacher, Wendy Spanier,
(Minnesota Department of Health, Environmental Health Division); Valerie Gamble, Kirsten Knopff, Jeff
Luedeman (Minnesota Department of Agriculture); Lorna Schmidt (Local Public Health Association);
Cindy Weckwerth (City of Minneapolis)
Facilitators:
Stephanie Lenartz, Chelsie Huntley, and Megan Drake-Pereyra (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 September meeting. Ms. Beck proceeded to review the
meeting agenda and objectives. Meeting participants each introduced themselves. Ms. Beck
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
Page | 1
EHCIB Meeting Summary – September 9, 2015
acknowledged both Board and non-board members and invited everyone to fully participate in the
meeting activities.
Meeting Objectives:
1. Make progress on the FPLS Program Evaluation Improvement Initiative by brainstorming,
prioritizing, and selecting potential process improvements.
2. Discuss constituent feedback and other relevant member updates.
Goal: Gather information and feedback to improve the FPLS program
evaluation process
Stephanie Lenartz, MDH, led Board members, staff from the Partnership and Workforce Development
Unit (PWDU) of the Food, Pools and Lodging Services (FPLS) section at MDH, and other meeting
participants through the next step of the improvement process: identifying and prioritizing potential
solutions. The group reviewed the prioritized issues/waste in the current process, including constituent
feedback on them. Overall, constituents felt the issues identified were accurate and complete.
Constituents did ask about the FPLS best practices guide and how it works with the program
evaluation. Specifically the question was raised, is the FPLS best practices guide meant to tell you how
you should do your job or how you could do your job? This lead to discussion about the need to define
what excellence looks like.
Meeting participants then brainstormed potential solutions for improving the current FPLS program
evaluation process (see Appendix A). The brainstorm also resulted in an idea to transform the FPLS
program evaluation model. Some solutions were discussed in-depth by the group:
Field Evaluations: Many felt the field evaluation portion needed to remain a part of the FPLS
evaluation process because it demonstrates the application of what programs have on paper (policies,
ordinances, etc.). However, there was agreement that the field evaluation needs to be improved; some
questioned whether the current field evaluation process was measuring the right thing and others
wondered whether the field evaluation process was efficient.
New Model: An idea for transforming the FPLS program evaluation model was raised and discussed.
Instead of evaluating each program, in its entirety, one at a time, over the course of five years, the
Board considered evaluating one standard for all programs at the same time. In this standard by
standard model each program would be evaluated over the course of five years rather than once in
five years. The benefits of this model could include increased learning across programs; the ability to
identify and implement continuous improvements; greater consistency in evaluation findings and
resulting actions; and a more even, manageable workload for MDH’s Partnership and Workforce
Development unit. It could also reduce the wait time and allow field evaluations to be completed in the
warmer months. FPLS programs in attendance liked this idea and determined that several actions need
to take place between now and the November EHCIB meeting before the Board can officially decide to
pursue and pilot this idea:
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 – September 9, 2015



Board members will share the idea for a new FPLS program evaluation model with constituents
for review and feedback
MDH EH staff will develop a draft of a possible new Food, Pools, and Lodging Services (FPLS)
program evaluation model, including how program status (acceptable, conditional, etc.) will be
determined
EHCIB members, MDH EH staff, and Health Partnerships Division staff will develop a plan for
pilot-testing the possible new FPLS program evaluation model
Performance Metrics: Meeting participants agreed that another step to improving this process is to
develop FPLS program performance metrics. The current process has everyone being evaluated on
something that is not well-defined and this could improve that.
Refine evaluation scoring: Meeting participants agreed that they like the self-assessment tool but feel
the evaluation and scoring should align with it.
Meeting participants also agreed that continuous improvement needs to be built into the FPLS
program evaluation process so that it is easier to adapt, change, and improve as needed and that all
chosen solutions will need to be tested first.
At its November meeting, the Board will review plans for piloting and implementing the potential
solutions.
Business Items
Participants discussed and made decisions about the following business items.
Progress on Action Items
All previous action items have been completed or are in-progress for completion.
Approve July Meeting Summary
The July 8, 2015 EHCIB meeting summary was presented for approval. Jeff Travis, Washington County,
made a motion to approve the summary. Daniel Huff, City of Minneapolis, seconded the motion. The
motion passed unanimously without discussion.
2015 Community Health Conference
Karen Swenson, Brown-Nicollet Counties, shared the draft presentation and handouts that she, Allie
Friedrichs, Meeker-McLeod-Sibley Counties, Tom Hogan, and Steven Diaz, MDH, developed for a 2015
Community Health Conference concurrent session. Meeting participants provided input into the
language, handouts, interaction portion, and examples that will be used at the conference session.
Copies of the presentation and handout will be available on the conference webpage.
Local Public Health Association Report Out
Due to limited time, this was not discussed.
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 | 3
EHCIB Meeting Summary – September 9, 2015
2016 EHCIB Meetings
The Board decided to conduct an email poll of members to determine the 2016 EHCIB meeting
schedule.
Member Updates
Mr. Hogan provided MDH updates:
 MDH/MDA Alignment – The Minnesota Department of Agriculture (MDA) is in the midst of a
reorganization and is in the process of hiring new staff, which has resulted in limited
conversations between MDH and MDA to discuss alignment. However, both agencies recognize
the need to continue conversations and plan to do so in the near future.
 MDH is in the process of developing legislative proposals for the upcoming session.
 The Center for Disease Control and Prevention (CDC) may be reducing funding to some program
areas. The funding for lead surveillance has already been reduced significantly. CDC also funds
climate change, environmental tracking, health impact assessment, and other MDH
environmental health program areas. The Association for State and Territorial Health Officials
(ASTHO) is in conversation with CDC about the impact of these funding reductions.
 A Public Health Lab sample analysis issue was recently in the news. Information about it can be
found on the MDH website.
Ben Miller provide MDA updates:
 Jeff Luedeman is the new supervisor for the Food and Feed Safety program at MDA. He will be
working closely with Mr. Diaz.
Word on the Street
No concerns were raised.
Constituent Engagement
No updates were shared.
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 (Board) and staff from the
Partnership and Workforce Development Unit of the Food, Pools and Lodging Services (FPLS)
section at MDH continued to follow a structured quality improvement approach to improve the
FPLS program evaluation process. The Board identified a number of possible solutions to help
improve the process (a full list of these solutions is attached in Appendix A). Some of the
changes identified can be implemented quickly to improve the current FPLS program evaluation
process.
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 – September 9, 2015

In addition to identifying changes to the existing FPLS program evaluation process, the
Environmental Health Continuous Improvement Board (Board) identified and discussed
changing the evaluation model in a way that is more transformational.
o Instead of evaluating each program, in its entirety, one at a time, over the course of five
years, the Board considered evaluating one standard for all programs at the same time.
In this standard by standard model each program would be evaluated over the course of
five years rather than once in five years. The benefits of this model could include
increased learning across programs; the ability to identify and implement continuous
improvements; greater consistency in evaluation findings and resulting actions; and a
more even, manageable workload for MDH’s Partnership and Workforce Development
unit.
o The Board would like to know if a change in the evaluation model from program-byprogram to standard-by-standard resonates with constituents. Board members will be
asking for feedback in preparation for their November meeting.

The Environmental Health Continuous Improvement Board (Board) will be presenting a
concurrent session at the 2015 Community Health Conference. The session will be interactive
and focus on the role of environmental public health and the history of the Board and its work
to date. The Board would also like to use this time to hear about items they should consider for
their 2016 work plan.

The Environmental health Continuous Improvement Board (Board) is looking ahead to next
year. To date the Board has focused on Food, Pools, and Lodging Services (FPLS) and has
completed, or is in the process of completing, a number of its 2015 goals including: 1)
determining a FPLS program re-evaluation process, 2) improving the FPLS program evaluation
process, and 3) issuing a statement of support for Minnesota’s State-local environmental health
partnership. In 2016, the Board plans to continue its work on FPLS and begin to focus on
environmental public health in a broader context.
Action Items
 MDH EH staff will develop a draft of a possible new Food, Pools, and Lodging Services (FPLS)
program evaluation model, including how program status (acceptable, conditional, etc.) will be
determined, by the next EHCIB meeting in November.
 EHCIB members will share a summary of the idea for a new FPLS program evaluation model
with constituents and gather feedback.
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 – September 9, 2015





EHCIB members, MDH EH staff, and Health Partnerships Division staff will develop a plan for
pilot-testing the possible new FPLS program evaluation model.
EHCIB members, MDH EH staff, and MDA staff will develop an action plan for implementing
some possible solutions to improve the current FPLS program evaluation process and for how
to develop program evaluation standards and measures.
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.
Health Partnerships Division staff will update the EHCIB’s workplan online.
Health Partnerships Division staff will connect with the Local Public Health Association about
the recruitment of new EHCIB members.
The next EHCIB meeting will be held on Monday, November 16, 2015 9am-1:30pm 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
Appendix A: Potential solutions identified in the current FPLS Program Evaluation Process by step number
Step 1:
Notification & Request
for Information
Step 2:
Review of
Submitted
Information
- Self-assessment
should be done (and
submitted?) on a
regular basis
(annually?), not just
report as part of an
“official” evaluation
- Before selfassessment, have an
initial conversation (in
person mtg) to answer
questions regarding
submittal of self-eval
and resources
available
- Have clear
communications at
beginning of process
by MDH about
expectations and
process
- Schedule a sit-down
informational meeting
for review of selfassessment
- Develop/discuss eval
criteria and how to
assess them – Do selfassessment &
evaluation yield
similar results?
- Common instructions
for self-assessment
Step 3:
Onsite
Meeting with
Program
- Select
firms for
evaluations
that
represent
inventory
Step 4:
Field Evaluation
Step 5:
Records Review
Step 6:
Reporting
Examine and refine field
evaluation.
Make this step valuable
and efficient:
- Share a summary of
data (de-identified?)
from evaluations with
all programs (eval
results)
- Field evaluation should
include time spent with
agency inspection staff
- Have some preliminary
information on field
eval after it is done
- Audit field staff using
methodology of
standard 4 of VNRFRPS
critical
- Define what is valuable
(needed) to accurately
assess programs in this
step (what exactly is
needed – define
criteria)
- Include field staff for
field portion of eval
- A standardized
inspector does not need
further evaluation
during the process
- Compare what is
happening in the field
- Limit report review to Streamline reporting:
last routine &
- Audit/eval should end
subsequent followwith verbal close out &
ups
written report within 30
- More focus on PH
days
risk, less focus on
- Have clear scoring metrics
choosing the correct
- Have improved consistent
code citation
standardized metrics,
- Focus of audit:
include input from
public health and
stakeholders. Develop
food safety (review
standardized metric. Have
and update
peer review.
procedure for
- Simplify scoring process
weighting and
to allow for quicker
scoring)
summaries
- Supply all programs
- Eliminate long narrative
with tic sheets for use
reporting format
- Refine tic sheet to
- Standardize the eval
make more useful
report so it can be written
- Formalize tic sheet
sooner
into evaluator
- Define reporting schedule
checklist
and timeframes at the
beginning
- Develop and discuss
expectations in a meeting
prior to submittal of
report to MDH
- Have dialog/conversation
in addition to program
response to draft the
report so we know
concerns are heard
Step 7:
If not Acceptable
- If program is
found conditional
or unacceptable,
hold on-site
meeting to
discuss
improvement
process
- Comment from
MDH
improvement
plan, including
possible upgrade
in rating
Overall
- Evaluation of all program elements that are
essential and not essential
- Make evaluation a continuous improvement
process that promotes quality and health
outcomes
- Adopt a process for improving the evaluation
process
- Create a true improvement process. Don’t have an
eval process with unsatisfactory and subject to
termination. Only have areas of improvement. If a
program is so bad, have another process.
- Have a separate process for those needing
improvement
- Develop cohorts of similar programs & use team
approach to eval. Eval team consists of reps from
each jurisdiction (i.e. metro area) w/PWDU doing
majority of paperwork.
- Increase PWDU staff capacity – hire more staff –
change frequency of eval
- Conduct evaluations of field staff doing
inspections
- Reduce # of program elements evaluated (steps
1,2,4,5,6)
- Have feedback process for local programs through
each step of the eval process. Use feedback for
annual review & to improve process
- Allow for more opportunities to provide
information or clarification during the process
- MDH & MDA should strive to use the same or very
similar eval process & conduct evals concurrently
- Put all eval survey tools in eval protocol
- Develop performance measures to help
w/assessment
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
Page | 7
EHCIB Meeting Summary – September 9, 2015
Step 1:
Notification & Request
for Information
Step 2:
Review of
Submitted
Information
and evaluation
program elements
- Develop agreed upon
guidance documents
for components of
eval and
distribute/use them
before eval
(i.e..marking
instructions for
consistency of reports)
Step 3:
Onsite
Meeting with
Program
Step 4:
Field Evaluation
eval protocol and what
is actually happening in
the field
- Discontinue field
evaluation
Step 5:
Records Review
Step 6:
Reporting
- Shorten MDH report
approval process by
instituting a meeting of
staff/managers
Define terms to be used up
front (i.e..lack of enforce,
compliance period, too long)
Step 7:
If not Acceptable
Overall
- Written SOP for eval process with timeframes and
scoring
- Standardization process for evaluators
- Assure local role program mgr/dir is
knowledgeable in FPLS program
- Program managers be more actively involved-take
ownership of their program and be actively
involved In eval process vs waiting to be told what
to do
- Develop job action sheets (for delegated and nondelegated)
- A formal appeal and re-evaluation process is
needed
- Evaluate individual program elements for multiple
agencies at once
- Break eval process into continuous process
instead of entire program at once
- Program termination may still be an outcome if
performance presents risk to public health
- Use eval to identify and highlight areas of success
and tools to share
- Utilize accreditation model instead of a pass/fail
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