Environmental Health Continuous Improvement Board
Meeting Summary
Wednesday, March 9, 2016
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
Jeff Brown
John Weidner
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
City of Edina
Lake County
City of Minnetonka
X
X
X
X
X
X
X
X
X
Absent
X
Other Meeting Participants:
Paul Allwood, Assistant Commissioner MDH; Debra Anderson, Hennepin County; Mageen Caines, City of
Minneapolis; Kim Carlton, Steven Diaz, Caleb Johnson, Michelle Messer, Denise Schumacher, Minnesota
Department of Health, Environmental Health Division; Jeff Luedeman, Minnesota Department of
Agriculture; Jason Newby, City of Brooklyn Park; Lorna Schmidt, Local Public Health Association; Jeff
Travis, Washington County
Facilitators:
Megan Drake-Pereyra 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 January meeting. Ms. Beck officially welcomed the EHCIB’s
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 – March 9, 2016
new members: Jeff Brown, City of Edina, and John Weidner, Lake County. On behalf of the EHCIB, she
also thanked Karen Swenson, Brown-Nicollet Counties, and Jeff Travis, Washington County for all their
contributions as EHCIB members over the past two years. Ms. Beck proceeded to review the meeting
agenda and objectives. Meeting participants each introduced themselves. Ms. Beck acknowledged
both EHCIB members and other meeting participants and invited everyone to fully participate in the
meeting activities.
Meeting Objectives:
1. Finalize new FPLS evaluation model workgroup charter.
2. Prioritize the top performance measures for FPLS programs.
3. Reflect on the EHCIB’s 2015 workplan.
Goal: Finalize Workgroup Charter
Ms. Beck shared a draft Food, Pools, and Lodging Services (FPLS) Evaluation Process workgroup charter
that she, Jeff Travis, Steven Diaz, Kim Carlton, and Denise Schumacher revised as directed by the EHCIB
at its January 2016 meeting. Meeting participants identified that additional clarity was needed. The
discussion resulted in the following changes:
 Additions to Deliverables of Workgroup:
o Addition of the word “process.” The workgroup will not only develop the criteria,
metrics, and tools, but also the process used for self-assessment and evaluation of each
Standard.
o Minimum criteria. The group confirmed that the overall intent of the evaluation process
was continuous improvement. They also recognized that there may be times when a
program is not ready for continuous improvement because they don’t meet the most
basic or foundational program criteria. The workgroup will identify the minimum criteria
that a program must meet in order to proceed in a continuous improvement track. If
minimum criteria are not met, the program will move into a corrective action track.
o Corrective action. The workgroup will also identify a process to be used for corrective
action. Meeting participants felt that expectations of programs and the corrective
process used if programs are not meeting the minimum expectations needed to be
transparent and clear and that it fits within the scope of the workgroup to develop this.
o Best practices. The workgroup will make recommendations on how to disseminate best
practices in order to promote improvement.
o Current evaluation tools. It was clarified that there has not been a decision about the
quality of the current evaluation tools such as the self-assessment. The workgroup will
use the existing tools as a starting point for their conversation.
 Addition to Purpose of Workgroup: Meeting participants felt it was important to specify that
the workgroup must not only look at and review the FDA standards but also the delegation
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 – March 9, 2016


agreement throughout the entire process. Meeting participants acknowledged that the
recommendations and products of the workgroup may impact and lead to
changes/improvements of the current delegation agreements. The current rating system was
provided as an example. As the workgroup finds issues with the delegation agreement they
should bring those issues to the EHCIB for discussion and potential action.
Membership:
o Advisory group. Meeting participants liked that an advisory group was added to the
membership. The advisory group will provide the workgroup guidance and help them
reach consensus, when needed. It will include the MDH FPLS Program Manager, Steven
Diaz; the MDA retail food program manager, Jeff Luedeman; and a delegated agency
manager who is/was a member of the EHCIB, still to be determined at this time.
o Additional workgroup member. The charter included 4 MDH staff, 1 MDA staff, 4
delegated program staff (1 metro, 1 MDH-MDA dual, and 2 non-metro), and 1 ad-hoc
member. Some meeting participants from the metro area felt that one more metro
representative was needed to equally represent the different needs and challenges of
metro and non-metro delegated programs. Also, since city and county programs are not
captured in the membership, adding another metro member to the workgroup could
help capture that as well. Meeting participants had mixed reactions about this. Many
felt that the MDH-MDA dual member will, most likely, be from the metro since most
MDA delegated programs are metro programs; therefore, another metro representative
was not necessary. Others felt that since there was no guarantee the MDH-MDA dual
member would be from the metro, another metro representative was important to
have. MDH staff shared how they hear that the FPLS program is too metro-focused.
Others felt that the workgroup needs as many people who are willing to work be a part
of it and that it is not a voting group but a group that will make recommendations to the
EHCIB and its constituents for final approval. After some discussion, meeting
participants decided to add another metro representative. Meeting participants also
agreed to review the membership after the first group of standards is completed by the
workgroup.
o Emphasis on reaching out to constituents. Meeting participants want it to be very clear
to workgroup members that part of their role is to seek constituent input on workgroup
recommendations.
Addition to Operations of workgroup: Meeting participants thought there should be more
clarification in the charter about how others outside of the workgroup membership can provide
input. The charter will be edited to include language about this and specify that the workgroup
meetings are open meetings.
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 – March 9, 2016
The small group working on the charter will update it based on this discussion and share it with the
EHCIB members via email for final approval. Once finalized, members are to share the final charter
with their constituents and begin recruitment efforts. These efforts involve seeking volunteers or
nominations and having programs select their workgroup representative. If there is no agreement,
then the EHCIB can make the decision. At the May 2016 meeting, the EHCIB will review and approve
workgroup members and discuss who should be its co-chair.
Meeting participants also discussed the facilitation and project management resources needed for the
workgroup to succeed. Chelsie Huntley noted that MDH’s Health Partnerships Division does not have
the capacity to support both the EHCIB and this workgroup. She noted they could serve as coaches to
the workgroup chairs while continuing to facilitate the EHCIB. Meeting participants underscored the
importance of a neutral facilitator for the success of the EHCIB. In lieu of resources for additional staff,
meeting participants discussed specific actions MDH staff and workgroup members could take to
ensure the workgroup functions as a partnership. Ideas included involving a local workgroup member
in planning of workgroup meetings, having materials sent in advance of meetings, and members
prepared to participate. Meeting participants also expressed the need for strong project management
so progress is made and the work is not stalled. Kim Carlton, Supervisor of the Partnership and
Workforce Development unit of MDH’s FPLS section noted that the development and implementation
of the program evaluation is in their work plan. Mr. Hogan suggested having a local and state person
co-chair the workgroup. Meeting participants liked this idea and felt it could possibly replace the need
for a facilitator if the project was managed and workgroup members and staff tended to the
“partnership.” The charter will be updated to include a state and local co-chair, MDH Health
Partnerships coaching, MDH EH staff as project managers, no facilitator, and members’ responsibility
to have completed their work ahead of time.
Goal: Prioritize FPLS Performance Measures
One of the EHCIB’s 2015 workplan goals is to “establish a common understanding of a quality FPLS
program and develop corresponding metrics.” Meeting participants made progress on this goal. They
reviewed the brainstormed list of potential FPLS program performance measures (Appendix A) and
shared constituent feedback on that list and other measures already being collected locally. Also,
Mageen Caines, City of Minneapolis, shared the performance measure work she has been doing. She
has been reviewing the data that tells them the “percent of Minneapolis restaurants with CDC top 5
risk factors for foodborne illness observed” (Appendix B). She explained that it took some work but was
not too difficult to analyze this information and it is data that programs already collect. Meeting
participants liked this analysis because it is a nice way of tying their work to the ultimate outcome of
keeping people safe. Based on all this information, meeting participants discussed the possibility of a
set of performance measures that would be collected by every FPLS program so that we could say how
well FPLS in MN is working and target improvement areas as needed. They identified the following four
potential areas for performance measurement and will be seeking feedback to further refine the areas
and define specific performance measures.
 Inspection staff training/competencies – Are staff equipped to conduct a “good” inspection?
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 – March 9, 2016



Timeliness of inspections – Are establishments being inspected when they should be?
“Customer”/establishment feedback – Do establishments have what they need from the FPLS
program to keep their customers safe from foodborne illness and make changes if necessary?
Frequency of risk factors observed in establishments – How often are we seeing the things that
are likely to cause foodborne illnesses?
Goal: Reflect on the EHCIB’s 2015 Work Plan
The EHCIB has been in existence for two years and completed or is in the process of completing much
of its first 2014-2015 work plan goals. The timing is right to determine what the EHCIB’s next focus is
and develop a new work plan. To start the process, meeting participants participated in a reflection
activity where they discussed the following: accomplishments the EHCIB has had, challenges (what gets
in the way?), what is left undone, what do they want to see in the future. The results of this discussion
are listed in Appendix C. As homework, EHCIB members will get feedback from their constituents about
what they want to see from the EHCIB in the future.
Business Items
Participants discussed and made decisions about the following business items.
Member Updates
Paul Allwood, Assistant Commissioner, MDH, thanked everyone for their commitment to the EHCIB
and shared that the executive office at MDH is very interested in its work. This is the first meeting he
has been able to attend, but he senses that progress is happening and is impressed that despite the
difficulty everyone is still smiling. He asks that people do not hesitate to communicate with him if they
have ideas to share.
Mr. Hogan shared the following updates:
 MDH Drinking Water staff have developed a presentation in response to the national news and
state interest in water quality “Flint, could it happen here?”. They will be presenting it to the
State Community Health Services Advisory Committee (SCHSAC) at their April video-conference
meeting.
 Environmental Protection Agency (EPA) sent letters to the Governors of every state requesting
a review of their drinking water programs in relation to the Lead and Copper rule. This activity
is taking place within MDH.
 Water Summit occurred the last Saturday in February. Mr. Hogan attended and helped with a
breakout session. 800 individuals attended. The Governor will compile all the comments and
notes from it – expect a summary after the legislative session is complete. There was a lot of
good discussion.
 Legislative session:
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 – March 9, 2016

o Began on Tuesday, March 8 – it is a very short and tight session this year, the first
deadline is April 1st.
o Governor has proposed a water infrastructure bonding and there will be some
supporting bills regarding this.
o Governor supplemental budget will come up mid-March
o MDH is continuing to work on the following policy bills:
 Lowering the lead action level for children so it aligns with the commissioner’s
designation
 Ability of MDH to use scientific reports outside of EPA to set risk limits for
groundwater contamination
 Remove mobile food decal in order to reduce redundancy and prevent error in
use.
 Modify the definition of special events so that it is good for 10 days.
o MDH is watching for the following bill introductions:
 Radon licensing bill that would eliminate what was passed last year
 Expansion of the flame retardants bill for furniture and bedding
 Bonding for vulnerable source water protection
 Various assisted living and lodging issues and Airbnb
 Rustic camping exemption: special event camping (e.g. historical reenactments)
MDH recognizes that there are a number of local programs interested in expanding their
operations. It is a process that takes a lot of resources. MDH is working with a few local
programs now.
MDH and MDA continue their discussions about alignment. Some progress has been made on the
following:
 Food code alignment – the two agencies are looking at a way to present the food code revisions
to their agency leadership jointly and expect a notice of adoption sometime in the fall;
 Alignment of position classifications – this work continues; and
 Discussions about updating the existing memorandum of understanding (MOU) about licensing
between the two agencies.
o MDA used their recent workshop with delegated agencies as an opportunity to
introduce the draft flow chart developed by MDH and MDA staff and run through
examples with it. The draft flow chart helps clarify who is responsible for what. There
was good discussion and feedback and recognition that it is a work in progress.
o Daniel Huff, City of Minneapolis, and Debra Anderson, Hennepin County, were in
attendance at the MDA workshop. They agreed that it is a start to helping simplify
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 – March 9, 2016
things, but it brought up many questions and will impact everyone, whether or not they
have a MDA delegation agreement.
o MDH and MDA anticipation some shift because the goal is to make things simpler and
reduce the number of establishments in the gray area. For example, temporary food
establishments may change from MDA to MDH.
o Next steps are for MDH and MDA to continue to work together at the agency level to
update the draft flow chart and then get feedback from local partners.
Word on the Street
Meeting participants shared an update about the draft report from the Bush Grant Advisory
Committee (BGAC). The report has undergone significant changes and no longer focuses on the
merging of the food programs within MDH and MDA. To view the BGAC draft report or for more
information about BGAC please contact Jane Jewett, Minnesota Institute for Sustainable Agriculture, at
218-845-2832 or [email protected] or Jan Joannides, Renewing the Countryside, at 612-251-7304 or
[email protected].
Community Health Conference
EHCIB members will email any ideas they have for a session at this year’s Community Health
Conference to Mr. Hogan and Ms. Beck.
Re-evaluation feedback
Due to lack of time, the EHCIB will review the feedback and share any thoughts about it at the next
meeting in May.
Approve November Meeting Summary
The January 27, 2016 EHCIB meeting summary was presented for approval. Daniel Huff, City of
Minneapolis, made a motion to approve the summary. Jeff Brown, City of Edina, seconded the motion.
The motion passed unanimously without discussion.
Constituent Engagement
For the May meeting, EHCIB members will recruit workgroup members from among their constituents
and get input from them on the following: the identified performance measures and how to best
define them, and the next focus area for the EHCIB.
Take-home Points, Action Items, and Adjournment
Meeting participants agreed on the following take-home points and action items.
Take-home points:
 Volunteers needed: The Environmental Health Continuous Improvement Board (EHCIB) needs
volunteers to serve on its Food, Pools, and Lodging Services (FPLS) Program Evaluation
Workgroup. Being involved in this workgroup will allow you to shape the entire FPLS program
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 – March 9, 2016
evaluation process. If there is something you did not like about the FPLS program evaluation
process in the past, now is your chance to change it for the better. Membership will include
representatives from local delegated programs, MDH, and MDA. A local delegated program
member and MDH member will co-chair the workgroup. There will be regular meetings
beginning in May 2016 and assignments between meetings. For more information, please
contact your EHCIB representative.

The Environmental Health Continuous Improvement Board (EHCIB) made progress on its goal to
“establish a common understanding of a quality food, pools, and lodging services (FPLS)
program and develop corresponding metrics.” The EHCIB discussed the possibility of a set of
performance measures that would be collected by every FPLS program so that we could say
how well FPLS in MN is working and target improvement areas as needed. Meeting participants
identified the following four potential areas for performance measurement and are seeking
feedback to further refine the areas and define specific performance measures.
o Inspection staff training/competencies – Are staff equipped to conduct a “good”
inspection?
o Timeliness of inspections – Are establishments being inspected when they should be?
o “Customer”/establishment feedback – Do establishments have what they need from the
FPLS program to keep their customers safe from foodborne illness and make changes if
necessary?
o Frequency of risk factors observed in establishments – How often are we seeing the
things that are likely to cause foodborne illnesses?

The Environmental Health Continuous Improvement Board (EHCIB) spent time at its March
meeting reflecting on its work over the past two years. Accomplishments include:
o Completion of a Food, Pools, and Lodging Services Program Re-Evaluation Process based
on local program input.
o A statement of support for Minnesota’s state-local environmental health partnership.
o Identification of areas for improvement in the Food, Pools, and Lodging Services
Program Evaluation process, recommendations to transform the evaluation process,
and initiation of a work group to develop the new evaluation process.
o Increased communication and partnership between MDH Environmental Health and
local entities.
o Initiated a process to develop performance measures for food, pools, and lodging
services in Minnesota.
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 – March 9, 2016

The Environmental Health Continuous Improvement Board (EHCIB) spent its first two years
focusing on food, pools, and lodging services (FPLS) challenges. Meeting participants took time
brainstorming what the next area of focus could be. Ideas included:
o Identification of non-delegated environmental health issues and improvement of service
delivery in those areas
o Water
o Public Health Nuisances
o Environmental health performance measures
o Better partnerships for non-FPLS environmental health issues

The Environmental Health Continuous Improvement Board (EHCIB) would like to recognize and
thank its out-going members, Karen Swenson (Brown-Nicollet Counties) and Jeff Travis
(Washington County). They have voluntarily served on the EHCIB since its inception two years
ago and have been integral to its success. Thank you, Karen and Jeff!

The Environmental Health Continuous Improvement Board (EHCIB) would like to welcome its
two new members: Jeff Brown, City of Edina, and John Weidner, Lake County. They began their
two year terms in March 2016. The EHCIB looks forward to their contributions.
Action Items
 MDH EH staff and EHCIB members will finalize the new FPLS program evaluation workgroup
charter and complete recruitment for the workgroup by the next EHCIB meeting in May 2016.
 EHCIB members will ask constituents for input on what they want the EHCIB to focus on in the
future.
 EHCIB members will get constituent suggestions and feedback on the identified performance
measures and how to best define them.
 Health Partnerships Division staff will reschedule the May 2016 meeting due to MEHA
happening on the same day.
The next EHCIB meeting will be held in May 2016; the date and location are TBD due to the MEHA
conference.
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
Appendix A: EHCIB FPLS Performance Measure Brainstorm Results
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 | 10
EHCIB Meeting Summary – March 9, 2016
Appendix B: City of Minneapolis FPLS Performance Measures
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 | 11
EHCIB Meeting Summary – March 9, 2016
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 | 12
EHCIB Meeting Summary – March 9, 2016
Appendix C: Reflection on the 2015 EHCIB Workplan
What are some accomplishments the EHCIB has had over the past two years?
 Workgroup charter – ID new process
 Successful transitions
 Group “gel” (trust, harmony)
 Performance measures
 Reevaluation of programs
 EHCIB understanding of the process
 Community health conference presentation
 Good/solid communication
 Groundwork for defining a quality FPLS program has been laid
 Group/Board (new/old members)
 Common acceptance of Program Standards as a foundation – (less angst about this)
 Collected feedback
 Statement of support
 Value process mapping of old evaluation system
 RBA performance measure exercise
 Optimism
What is still left undone?









Formalized, centralized, collaborative forum/manager meeting for policy development &
rollout
Common understanding of a quality FPLS program
Defining a program (results oriented)
Path for new delegated programs
Shifting model to non-FOOD!!!! e.g. public nuisances and water
Path must go both ways, Local → State and State → Local
EH as an important part of PH (public health accreditation process can help here?)
How to harmonize larger system?
Communication plan
What are the EHCIB’s challenges? What gets in our way?
 Building trust level with locals (initially focused internally)
o How to do this?
o Negative perspectives with loud voices
 Political – local, state legislature, FSMA
 Resources – build on improved infrastructure
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 | 13
EHCIB Meeting Summary – March 9, 2016







Letting go of the past… when do we stop talking about what happened and move on to making
things better?
“on boarding” new staff, leadership, and changing political landscape actors/players
Engaging partners as members of the system
Change management
Communication – keep the focus, feedback loops
Time/personnel – developing and implementing new process
“Quality” = subjective definitions
What do we want to see in the future from the EHCIB? Looking ahead…
 Even stronger partnership
 Local capacity to address other EH challenges
 Continued progress on alignment
 Increasing and diversifying # of connections
 Building on EHCIB “model” to create systems change within state and local organizations
 Community EH issues without delegation, for better service delivery
 Water is an ongoing challenge (going forward)
 Public Health nuisances are an ongoing challenge
 Defining the new evaluation/self-assessment model, with associated metrics, tools, process,
etc. – consistent between MDH and MDA → and holding MDH/MDA to same standard
 Common set of performance measures
 Better partnerships for non-FPLS, EH issues
 Finding a way to establish consistency while honoring uniqueness
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 | 14