HomeMy WebLinkAboutCommunity Health Board - CHB Board Packet 5.17.2024 Supporting Documents - 05/17/2024Below is the 2023 Actual and the 2024 Budget for OTC in Clay’s budget.
**Please note that in 2024, Clay expenses to OTC will only include staff time related to OTC FPL
program, OTC postage costs, related travel expenses, and % of cardstock for licenses.
Previously: 20% of OTC revenues were withheld for program expenses supported by Clay and OTC
was “made whole” if expenses were less.
Effective 2024: 100% of revenues will be directly sent to OTC with Clay program expenses
invoiced quarterly.
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Grant Name Grant Period Budget Actual Variance Budget
to Actual
Blue Plus Dental 1/1/2023 - 12/31/2023 96,000 81,121 -14,879
MN Public Health Infrastructure 4/1/2022 - 3/31/2024 165,716 181,921 16,206
Child and Teen Checkups - C&TC 1/1/2023 - 12/31/2023 317,867 391,538 73,671
Children and Youth with Special Needs - CYSHN
Birth Defects (fee for service)7/1/2022 - 12/31/2023 0 12,200 12,200
City Readiness 7/1/2022 - 6/30/2023 16,500 12,689 -3,811
COVID-19 Implementation 1/1/2023-12/31/2023 826,326 201,216 -625,110
COVID-19 Workforce Development Grant 1/1/21 to 6/30/24 82,209 82,209
Environmental Health (AFDO) 0 0 0
Strong Foundations (replaces MIECHV and EBHV)7/01/2021 - 6/30/2022 966,000 966,000 0
Family Planning Special Projects (Mahube-Otwa) 7/1/2021 - 6/30/2022 7,555 4,500 -3,055
Follow Along Program - FAP 10/1/2021 - 9/30/2022 8,400 8,400 0
West Central Initiative 18,228 0 -18,228
Local Public Health Act - LPHA (estimated award)01/01/2023 - 12/31/2023 970,702 970,702 0
Maternal Childhood Health -MCH 10/1/2021 - 9/30/2022 190,674 191,852 1,178
PEAR / Perinatal Hep B (fee for service)7/1/2021 - 6/30/2022 0 8,100 8,100
Public Health Emergency Preparedness - PHEP 7/1/2022 - 6/30/2023 118,970 115,814 -3,156
Refugee Health 7/1/2022 - 6/30/2023 2,749 2,749 0
Regional Health Equity Network 1/27/2023 - 5/31/2023 0 111,869 111,869
Statewide Health Improvement Project - SHIP 11/1/2022 - 10/31/2023 393,531 463,880 70,349
Temporary Assistance for Needy Families - TANF 7/1/2022 - 6/30/2023 220,443 261,172 40,729
Women, Infants, and Children - WIC 10/1/2021 - 9/30/2022 747,519 963,580 216,061
TOTALS 5,067,180 5,031,512 -35,668
Partnership4Health CHB
UNAUDITED Financial Recap
2023
C:\Users\maduenow\Documents\Copy of P4H CHB Financial Recap
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Grant Name Funding Source Purpose/Uses Funding Formula/Amount Grant Cycle P4H Award Amount
Foundational Public Health Responsibility
Grant
State funds The purpose of this funding is to support the
implementation of Foundational Public Health
Responsibilities by community health boards
(grantees). The Foundational Public Health
Responsibilities are the unique responsibilities
of governmental public health that define a
minimum package of public health
capabilities and programs that must be
available in every community.
Total available to CHBs: $9,844,000
Funding is based on a SCHSAC funding
formula of base funding, SVI funding and a
capacity bonus for some CHBs.
Calendar year grant for five
years with annual award
letter.
$204,632
Becker: $51,185.43
Clay: $51,756.25
OTC: $50,000
Wilkin: $51,690.32
Response Sustainability Grant State funds In the 2023 legislative session, CHBs and
Tribes received state funding for Emergency
Preparedness and Response (EPR). The
funding acknowledges a previous lack of state
funding specific to EPR and assure that all
CHBs and Tribes are able to increase their
individual EPR responsibilities. This funding
has a funding formula, developed in
partnership with SCHSAC that is unique to
these state funds. The activities must align
with the CDC PHEP capabilities, strengthen
capacity across the state (each CHB should
have a .5 FTE dedicated to EPR), and multi-
county CHBs should ensure that all counties
have access to staff dedicated to EPR.
Total available to CHBs and tribes: $8,400,000
Funding formula approved by MDH
Commissioner based on recommendation
from the State Community Health Services
Advisory Committee (SCHSAC).
Four year grant agreement
with funding July 1st
through June 30th.
$199,939
Becker: $42,465.60
Clay: $58,089.26
OTC: $41,726.33
Wilkin: $57,657.80
State Cannabis Funding State funds Grants to local health departments and Tribal
health departments to create and disseminate
educational materials on cannabis flower,
cannabis products, lower-potency hemp
edibles, and hemp-derived consumer
products and to provide safe use and
prevention training, education, technical
assistance, and community engagement
regarding cannabis flower, cannabis products,
lower-potency hemp edibles, and hemp-
derived consumer products.
Funding available for CHBs and tribes:
$10,000,000
To be determined: Funding starts in SFY 2025
(July 1, 2024)
To be determined To be determined
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2024 Legislative
Action Priorities
Supporting Minnesota’s Local Public Health System
LPHA supports continued investment to support local public health foundational responsibilities.
Foundational public health responsibilities need to be available in health departments across the state so the public
health system can work as a whole. All Minnesotans should have access to good quality public health services,
regardless of where they live. Foundational responsibilities must be in place in every health department, so they are
always ready to serve their community and achieve equitable health outcomes. Local health departments should
have a baseline of organizational competencies such as assessment and surveillance of health threats, data analysis,
infectious disease prevention and control, communications, and development of community partnerships. Investing in
prevention and a strong local public health infrastructure pays off by saving health care and other public program
costs, such as those from corrections and child protection. LPHA is grateful for increased investment in local public
health during the last legislative session and look forward to continued efforts to strengthen our public health system.
Responding to Public Health Workforce Shortages
LPHA supports policy changes that enable local health departments to fill open positions and retain current employees.
Since 2008, local health departments across the United States have lost more than 20% of their workforce, more than
50,000 jobs. A significant investment in the public health workforce, focused on retention of the current workforce and
bringing in new skilled workers, is needed to ensure there is a robust workforce to provide crucial public health services
into the future. In Minnesota, local health departments report difficulties in hiring crucial positions such as public health
nurses, health educators, and more. Further, many local health departments are struggling to fill the statutorily mandated
Medical Consultant role with a physician, particularly in areas where there are shortages of medical providers. LPHA
supports policy change that would expand medical consultants to other prescribing providers such as nurse practitioners
or physician’s assistants. Programs such as loan forgiveness and investment in training and recruitment of public health
workers will also remain key in recruiting and retaining a robust public health workforce in the future.
Strengthening Technical Assistance for Local Public Health Departments in Adult-Use Cannabis
LPHA supports investment in technical assistance and coordination support for local and tribal public health departments
around adult-use cannabis through the Minnesota Department of Health.
Local public health departments are grateful for the investment of $10 million per year, beginning in FY 2025, focused on
creating and disseminating educational materials, providing safe use and prevention training, technical assistance, and
community engagement around adult-use cannabis. Local public health departments are already receiving and
responding to cannabis related educational and technical assistance requests from their communities. LPHA supports
reallocation of up to 10 percent of the previously dedicated funds to the Minnesota Department of Health to build staff
capacity and legal technical assistance in MDH. This reallocation would support local and tribal public health
departments through statewide coordination to ensure sharing of resources and reduced duplication across the state.
LPHA also supports efforts to maintain local authority and public health protections such as the MN Clean Indoor Air Act.
Addressing Community Health Needs
LPHA supports policy and funding to address post-COVID-19 community health needs and ongoing stable, statewide
funding for the Statewide Health Improvement Partnership to help Minnesotans live healthier, longer lives.
Local public health plays an important role in addressing social determinants of health that have a direct link to poor
health outcomes. COVID-19 has deeply impacted people in our state, further exacerbating existing health inequities.
Local public health will continue to serve a leading role in addressing ongoing community needs such as housing
challenges, food insecurity and healthy eating, violence, higher rates of addiction, and mental health challenges.
About the Local Public Health Association of Minnesota
LPHA is a voluntary, non-profit organization that works to achieve a strong local public health system through leadership and
collective advocacy on behalf of Minnesota’s county, city and tribal local public health departments. The Association represents
more than 245 public health directors, supervisors and community health services administrators throughout the state. LPHA is an
affiliate of the Association of Minnesota Counties.
125 Charles Avenue, St. Paul, MN 55103-2108 | 651-789-4354 | www.lpha-mn.org
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Meeting Notes: State Community Health Services Advisory Committee (SCHSAC)
March 8, 2024 | 10:00 a.m. to 2:30 p.m.
Hybrid | Wilder Center, St. Paul & Webex
Action items
•Watch for email requesting approval of Foundational Public Health Responsibilities (FPHR)
Definitions Workgroup in April. If you have questions or comments, please reach out to your
Executive Committee representative as directed in the email.
•Sign up to subscribe to the Joint Leadership Team newsleter, visit: Subscribe: Updates from the
Joint Leadership Team.
•Plan to attend upcoming Meetings:
o Optional: Coffee, Conversation & Consideration: Transportation and Public Health: April
11, 2024, at 8:00 a.m. Virtual.
o The next SCHSAC Meeting is Thursday, June 13, 2024, from 10:00 a.m. to 2:30 p.m. This
is a hybrid meeting with the in-person portion held at the MDH offices in St. Paul.
Community health boards present
Aitkin-Itasca-Koochiching; Anoka; Beltrami; Brown-Nicollet; Carver; Cass; Countryside; Dakota; Des
Moines Valley; Dodge-Steele; Edina; Faribault-Martin; Fillmore-Houston; Freeborn; Goodhue;
Hennepin; Horizon; Isanti; Kanabec; Kandiyohi-Renville; Le Sueur-Waseca; Meeker-McLeod-Sibley;
Mille Lacs; Minneapolis; Morrison-Todd-Wadena; Mower; Nobles; North Country; Olmsted; Pine; Polk-
Norman-Mahnomen; Quin; Rice; Richfield; Saint Paul-Ramsey; Scott; Sherburne; Southwest Health and
Human Services; Stearns; Wabasha; Watonwan; Winona; Wright.
Approval of consent agenda
Consent agenda:
Approval of March 8, 2024, meeting agenda
Approval of December 6, 2023, meeting notes
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Motion to approve by Steve Gardner (Kandiyohi-Renville), seconded by Bill Groskreutz (Faribault-
Martin). Motion carried.
Chair’s remarks
Tarryl Clark, SCHSAC Chair
Chair Clark thanked the members of the SCHSAC Retreat Planning Committee: Lisa Fobbe, Sheila
Kiscaden, Michelle Clasen, Lisa Brodsky, Denise Daniels and Amy Bowles who have volunteered to
serve with Vice Chair De Malterer and herself. If anyone is interested in joining the Committee, they
can contact Chair Clark or MDH staff Deanna White. The schedule of meetings has been truncated to
make it more accessible for those who serve. The Retreat will continue to be focused on system
transformation.
Commissioner’s remarks
Dr. Brooke Cunningham, MDH Commissioner
•Introduced new leadership at MDH: Deputy Commissioner Wendy Underwood, Assistant
Commissioner for Health Systems Carol Backstrom, and Interim Commissioner for Health
Protection Myra Kunas.
•The Commissioner and others recently attended National Association of County and City Health
Officials (NACCHO) meetings in Washington, D.C. where they had the opportunity to visit
Congressional offices to advocate for continued funding for public health on the Federal level.
About 60% of MDH’s budget comes from Federal Funds. (About 40% of those funds are passed
through to local public health.) She asks that elected officials at all levels are reach out to their
Congressional delegation about the importance of public health funding.
On the Senate side, they have proposed steady funding of $350M. On the House side, they
have proposed $100M. Without more pressure on the House to increase funding, we will face
consequential cuts.
•Addressing topics that were identified by members during registration:
o Infectious Disease Updates
Respiratory viral activity
•Our COVID numbers are decreasing. ER visits and hospitalization numbers
are decreasing. CDC is recommending 65+ get their next booster.
•RSV activity also a threat for our elders and babies. This is also
decreasing/stable.
•Looking at moving towards a pan-respiratory approach. CDC recently
changed isolation guidance. We are looking at MDH to align our
recommendation to what CDC has put out.
Congenital syphilis
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•In January, MDH released new guidance about testing pregnant women
with congenital syphilis to test each trimester. We also need to think
about how when people are tested that they get follow-up. A lot of
people get positive results but no follow-up.
•Why are we seeing more cases? There was a lot of effect from the
pandemic and use of resources therein. We have gone from zero cases in
2013-14 to about 29 cases now. This is significant because this is a
treatable condition, preventable, and impactful for the infant and
pregnancy.
o Cannabis
This session we are going to the Legislature for additional funding for
administrative support and clarification to allow MDH to process grants and
provide technical assistance to coordinate with external partners and
organizations.
Goals are to conduct a statewide youth education program that focuses on
giving money to youth-focused organizations to conduct the work and to
conduct an educational media campaign targeting pregnant and breastfeeding
women.
We will want to collect information about the impact of aforementioned
programs. Part of the data collection that we need to do is around trends that
we might see in hospitalizations related to cannabis-related poisoning or toxicity.
We plan to modify our current health surveys to collect that information.
o Water
EPA directed MN to address nitrate contaminants in water in eight southeast MN
counties. We submitted a workplan with three phases:
1. Outreach and education and providing alternate water
2. Mitigation
3. Long-term strategy about reducing nitrate concentrations
More information can be found online here: MDH Response to Southeast
Minnesota EPA Requests - MN Dept. of Health (state.mn.us)
•We have a website for grants that we encourage you to keep an eye on and share with
partners: Grants and Loans: Open Grant Opportunities - MN Dept. of Health (state.mn.us)
Legislative outlook
Lisa Thimjon, Legislative Director, MDH
•MDH supporting two policy bills this session:
o Vital records mini omnibus (to be introduced)
Ensure timely birth registration for “safe place” infants
Clarifying corrected, amended or replaced vital records definitions
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Eliminating “subsequent marriage”
Allow men who have registered to request an MFAR search without needing a
court order
o MDH policy Bill – SF4573 (Wiklund), waiting number in the House
Several provision but most interesting to SCHSAC
•International medical graduate program expansion to include temporary
refugees.
•Nursing home informal appeal revision for federal conformity
•Chair Clark shared that it is very valuable when local commissioners and staff are talking to
legislators about what it looks like on the ground in local communities. She encouraged
members to share if they are talking with their legislators about public health issues.
Updates from the Joint Leadership Team
Tarryl Clark (Stearns), Chair, DeAnne Malterer (LeSueur-Waseca), Vice Chair
Chair Clark and Vice Chair Malterer shared an overview of the makeup and the work of the Joint
Leadership Team including:
•Using the cost and capacity analysis to develop a baseline and develop funding formulas
to support Foundational Public Health Responsibilities
•Upcoming systems assessment results that will help inform conversation about the
structure of our system
•The new round of innovation projects that will inform future work
•Plans for communications and outreach to bring everyone into the conversation around
public health system transformation
•The parallel process that Tribal public health is undergoing
They announced that the Joint Leadership Team for system transformation is starting a monthly
newsletter in March for local public health leaders and staff, SCHSAC members, and MDH staff, to
share more information about our shared vision for an updated and transformed public health system
in Minnesota. The format will vary between a shorter and longer version every other month, and will
include notes from Joint Leadership Team members, activity updates, and answers to frequently asked
questions.
To subscribe to this newsletter, visit: Subscribe: Updates from the Joint Leadership Team.
Understanding the Foundational Public Health Responsibilities – what you need to know
Kim Milbrath, MDH & Linda Kopecky, MDH
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This presentation was about deepening SCHSAC’s understanding of the Foundational Public Health
Responsibilities, focusing on what local leaders need to know to make informed decisions about public
health.
How we got here: The Center for Public Health Practice began the learning phase of how to make
Minnesota’s public health system work better by conducting the cost and capacity assessment. This
was a huge lift for local public health, but it gave us a baseline to look at our system. Between 2017
and 2021, nothing had really changed much.
Now, we are starting to see some investments in our system. Specifically:
1.Infrastructure Fund Innovation Projects: First round of funding started in 2022. PHP is accepting
applications for the second round of funding now.
2.Foundational Public Health Responsibilities Grant: Dedicated annual funding from the
Minnesota legislature to carry out foundational public health responsibilities.
A dive into foundational public health responsibilities: The Joint Leadership Team chose the
Foundational Public Health Responsibilities Framework as a way to organize and talk about the way we
do public health work.
These foundational public health responsibilities are made up of five foundational areas and eight
foundational capabilities:
•Foundational areas: “traditional,” or what we typically think of when we communicate and
fund public health.
•Foundational capabilities: Cross cutting skills that would be happen across all departments,
areas, and programs.
Importantly, the framework does not cover roles and responsibilities. That is our (SCHSAC, local public
health, and MDH) job to figure out. It also does not tell us how much or to what extent does it mean to
‘be fulfilled.’ Questions and comments from the audience (summarized):
•Foundational Public Health “Responsibilities,” not “services”: Why do we call them
foundational public health “responsibilities” when the Public Health Accreditation Board (PHAB)
framework calls them “services”? This is to move away from the idea that this work means
giving direct services to individuals versus at the population level.
•Equity: Several members shared valuable perspectives on equity, including the need to lift
equity in a specific way, that equity is unique because it needs to be both part of the process
and an outcome, and that achieving health equity means different things for different
communities (e.g., rural and BIPOC populations). Presenters emphasized that CHBs have the
autonomy and authority to decide how best to approach equity in their communities.
•Leadership and accountability: The FPHR framework does not outline who does what. Who is
leading the charge and how will we hold others accountable for their part in strengthening the
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system? It will be a continuous conversation among community health boards, directors, MDH
staff, and SCHSAC to figure out how roles and responsibilities pan out now and what is the best
way for them to move forward in the future. We have a lot of homework to do.
• Reporting and funding: Will this work eventually turn into a sort of report card about each CHB
that will eventually lead to funding? No. It gives us a baseline of our system on how it is
operating.
Panel: Stories of foundational public health responsibilities work around Minnesota
Host: Maria Sarabia, Assistant Commissioner, MDH
Panel Members: Sarah Grosshuesch (Wright), Sarah Reese (Polk), Maggie Rothstein (Aitkin-Itasca-
Koochiching), Ann Stehn (Horizon)
This panel highlighted on some community health boards of different sizes, regions, and makeup are
planning to use their Foundational Public Health Responsibilities Grant funding. The goal of the panel
was to share and inspire ideas for its use across the state:
• Sarah Grosshuesch (Wright): Wright County is creating a water lab to promote and expand
access to clean water. The accredited water lab would be available for free to people who need
them, e.g., foster care-licensed homes, adult and childcare facilities that are on private wells,
and family home visiting clients.
• Maggie Rothstein (Aitkin-Itasca-Koochiching): Their CHB see data (assessment and
surveillance) and communications as top needs and gaps. The CHB plans to hire one position to
cover both skillsets.
• Ann Stehn (Horizon): Horizon does not have final decisions yet about exactly what they are
doing with the funds but shared insight into how they are assessing their needs and gaps within
the agency’s organizational structure. They are potentially looking into growing their
communications capacity and hiring planners or strategists.
• Sarah Reese (Polk): Sarah spoke about how her CHB is building a foundation for success. Right
now, that has been spending time finding what expertise they have locally (what subject matter
expertise do they have within FPHR) because she believes their workforce is the most
important tool they have. They are also examining how to build skillsets internally, e.g., within
their communications team. She emphasized that they don’t necessarily need subject matter
experts/expertise right in Polk County, but just access to them. With additional funding, they
plan to increase FTE of one or both of their communications staff or add staff. They are in the
process of examining how to use social media software and data analytics to see how their
efforts are translating to action, e.g., around STI and Radon testing.
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Three Simple Rules of the State-Local Public Health Partnership
I. Seek First to Understand
II. Make Expectations Explicit
III. Think About the Part and the Whole
Minnesota Department of Health
State Community Health Services Advisory Committee (SCHSAC)
651-201-3880 * health.schsac@state.mn.us * www.health.state.mn.us/schsac
Updated March 20, 2024
To obtain this information in a different format, call: 651-201-3880.
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Foundational Public Health
Responsibilities
Partnership4Health CHB Presentation
May 17, 2024
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Foundational Public Health Responsibilities Framework
•Minnesota has adapted the Public Health Accreditation Board (PHAB) National Framework.
•The framework outlines:
•the unique responsibilities of governmental public health and
•defines a minimum set of capabilities and areas that must be available in every community.
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Foundational Capabilities
•Cross-cutting skills and
capacities needed to
support basic public
health protections,programs,
and activities.
•Key to ensuring community
health and well-being
and achieving
equitable outcomes.
17
Foundational Areas
•The basic public health,
topic-specific programs, and services aimed at improving the health of the community.
•Reflect the minimum level of service that should be available in all communities
18
Foundational Capabilities
19
Assessment and Surveillance
•Collect and analyze health and community data across CHB
•Detect and monitor health trends
Example: Reviewing immunization data to see % of children with
all required vaccinations in each county.
20
Community Partnership Development
•Build and maintain community relationships
•Engage community members in health improvement process
Example: Build relationships with local food banks to address food insecurity and increase availability of healthy food options.
21
Equity
•Address social and structural determinants of health
•Work together towards a shared understanding of equity
Example: Provide COVID-19 messages in multiple languages.
22
Organizational Competencies
•Strong, effective leadership to help team meet goals and objectives
•Uses technology to support work
•Workforce capacity building
Example: Hire new staff and ensure that necessary training is
completed.
23
Policy Development and Support
•Serve as subject matter expert in health policies
•Advocate for health compliance and regulation
•Build equity into all policies
Example: Pass or recommend an ordinance limiting the sale of
flavored tobacco products.24
Accountability and Performance Management
•Use evidence-based or promising practices with programs
•Use quality improvement tools and methods
•Performance management
Example: Summarize grant accomplishments for annual reports.
25
Emergency Preparedness and Response
•Maintain and able to exercise preparedness and response strategies/plans
•Activate emergency response staff and communications systems
•Respond to events 24/7 if needed
Example: Maintain and execute a continuity of operations plan (COOP) during
events.
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Communication
•Maintain relationship with the media,write press releases,and participate in press conferences
•Use social media to directly communicate with the communities
•Recognize and tailor messages to various audiences
Example: Post on Facebook about upcoming vaccination opportunities.27
Foundational Areas
28
Communicable Disease Control
•Conduct disease investigations
•Provide the community with timely disease information
•Performance management
Example: Contact tracing during the COVID-19 pandemic.
29
Environmental Public Health
•Conduct environmental health inspections
•Identify public health hazards
Example: Food, pool and lodging inspections.
30
Chronic Disease & Injury Prevention
•Increase rates of healthy eating and active living through outreach
and education
•Reduce commercial tobacco rates in the community
Example: Community education on risks of vaping in youth or
supporting car seat check events.31
Maternal, Child, & Family Health
•Promote evidence-based interventions for prenatal and early childhood
period
•Assure that newborn screenings are being done
Example: Collaborate with local agencies to provide safe sleep education
and cribs/beds.32
Access to & Linkage to Care
•Collaboratively work with healthcare partners to ensure access and
linkage to local care
•Provide accurate data on access and usage of local healthcare
Example: Connect the public to medical services.
33
Baseline Capacity Assessment
34
2022 Cost & Capacity
Assessment: Purpose and
Scope
University of Minnesota Center for Public Health Systems surveyed all Minnesota local health departments and the Minnesota Department of Health, to answer the following questions:
•How are the local health departments currently fulfilling the national framework of foundational public health responsibilities?
•How much time are we spending right now on this work (FTE)?
•What needs to be done to complete this work?
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The self-assessment scores were assessed across the entire framework.
The ‘icicle chart’ displays scores for all Foundational Capabilities & Areas in one image; this is done in a top-down format from
each Foundational Area or
Capability to its associated
responsibilities.
36
Level of Implementation Definitions
37
Becker
County FPHR
38
Clay County
FPHR
39
Otter Tail
County
40
Wilkin
County
41
Capacity Building
42
Innovation Projects
(Infrastructure Fund)
The Minnesota Legislature provides $6 million in annual funding for local and tribal health
departments to strengthen the public health system and create a system for the 21st century.
Funded projects provided insight into the most efficient and effective ways to ensure Minnesota's statewide public health system has the expertise, skills, and capabilities it needs to meet new and emerging public health challenges.
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First Round
Awarded
Projects
44
Foundational Public Health Responsibilities Grant
Disease Prevention
and Control
Organizational
Competency
Communications Community
Partnership
This is ongoing funding to
strengthen local and tribal
public health in Minnesota
and is for foundational public
health responsibilities.
P4H CHB received $204,632
and will work to build
capacity in:
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Sources
•https://www.health.state.mn.us/communities/practice/systemtransformation/docs/headlinesactivities.pdf
•https://www.health.state.mn.us/communities/practice/systemtransformation/foundationalfunding.html
•https://www.health.state.mn.us/communities/practice/systemtransformation/infrastructurefund.html#partnership4health
•https://www.health.state.mn.us/communities/practice/systemtransformation/foundationalresponsibilities.html
•https://www.health.state.mn.us/communities/practice/systemtransformation/docs/202310costcapacity-memoreport-reduced.pdf
•https://tableau.umn.edu/t/cphs/views/MinnesotaCCAIndividualHDs/Home?%3Aembed=y&%3AisGuestRedirectFromVizportal=y
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The Partnership4Health Community Health Board (P4HCHB) data team is a collaboration of Becker,
Clay, Otter Tail, and Wilkin County Public Health Department staff working to build data
infrastructure across the CHB. The Minnesota Legislature provides annual funding for local health departments to strengthen the public health system and create a system for the 21st century. P4HCHB applied for and was awarded funding for a data & epidemiology project.
Partnership4Health Data & Epidemiology Infrastructure Project
June 2022- June 2024
The Project
The goal of this project was to increase capacity in data and
epidemiology across jurisdictions while building data-sharing and disease reporting relationships across state borders.
Team Members
Rebecca Schmidt, Clay County – Project Manager
Leah Jesser, Otter Tail County
Ashley Wiertzema, Wilkin County
Mike Hayes, AmeriCorps Member
Amber Davidson, AmeriCorps Member
Project Outcomes
6.Created an internal data request process andsubmission form to assist with CHB datarelated needs.
7.Developed a collaborative partner and CHBprocess for the Community HealthAssessment (CHA).
8.Obtained access to the CDC ESSENCESyndromic Surveillance platform.
9.Developed a process and report fordistributing healthcare syndromicsurveillance data to internal staff.
Examples of our Work
1.Collaborated with North Dakota partnersto share immunization records.
2.Compiled data and created reports forPH program areas.
3.Surveyed and educated PH staff on datatopics, efforts, and use.
4.Developed a Shared Services Charter fordata analytics and the CHA.
5.Created a shared staffing model acrossthe CHB to build capacity in data andepidemiology.
•Internal data request form
•EH program report
•STI one pager
•Public Health staff survey results
•Data Analytics Charter Addendum
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Apple Tree Dental plans to expand their current Becker County
hub in Hawley, MN by opening a new outreach clinic site in Detroit
Lakes.
With the help of Sen. Amy Klobuchar, Apple Tree is the recipient of
$3.7M in Federal Funding to help expand current space and renovate
new. Together with Essentia Health, a co-located space is expected to
be finalized in Detroit Lakes around July 1st.
Additional funding support for this Becker County flexible staffing
outreach clinic has been provided by:
108 mobile dental services
dates were hosted in 20
community sites throughout
P4H.
Oral Health Education was
delivered to 4,671 students,
across 22 schools, with support
from BCBS funding.
Additional ongoing progress was made during 2023 supporting the
expansion of dental services for people enrolled in Minnesota Healthcare
Program Insurances across the Partnership4Health counties.
•Blue Cross/ Blue Shield
•Local Donations
•West Central Initiative/ Frank
W.Venden Trust
•MDH Grant
•Essentia Grant
•Becker County Children’s
Initiative
•Becker County Health Public
health funds
48
As 2024 began, health department leaders of the Partnership4Health Community Health Board (P4H
CHB) recognized the importance of reassessing organizational structure and workflow. Motivated by
changes happening in the national and Minnesota public health systems, as well as increasing
demands of financial management and workforce capacity, they organized a strategic planning
session with the assistance of the Minnesota Department of Health.
Partnership4Health
Director’s Strategic Planning Session
April 4, 2024
Scope
The scope of the strategic planning session was to review the
strengths, weaknesses, opportunities, and challenges regarding
the Community Health Services (CHS) Administrator role and
the impacts to the four-county region.
Health Department Leaders
Amanda Kumpula, Becker County
Kathy McKay, Clay County
Jody Lien, Otter Tail County
Kristi Goos, Otter Tail County
Becky Tripp, Wilkin County
Ashley Wiertzema, Wilkin County
Strengths Identified
•Cross Jurisdictional Sharing (staff)
•Resource sharing (e.g. funds, expertise)
•Ability to meet statutory (Chapter 145A)
requirements
•Positioned well for grant applications
Next Steps Opportunities
➢Review & update the Joint Powers
Agreement and By-Laws as related to
decision making.
➢Advance Cross Jurisdictional Shared
Services Charters.
➢Review CHS Administrator models in other
multi-county CHB’s.
➢Enhance financial and grant reporting.
•Decision-making process
•Shared services/Charter
Agreements
•P4H CHS Co- Administrator role
•Finance and Grant reporting
transparency
49
Jody Lien Otter Tail County Public Health Dir
Abby Laubenstein
Clay County Sanitarian Andrea Demmer
Otter Tail County Sanitarian
Clay County Board
Otter Tail County Wilkin County
Frank Gross Wayne Johnson, etc. Add comm…
Kevin Campbell
David Ebinger
Becky Tripp
Wilkin County Health &
Human Service Director
Kathy McKay Clay County Public Health Adim.
Tony Georgeson
Otter Tail County Sanitarian
Monique Erickson
Otter Tail County Sanitarian
Partnership4Health CHB
Frank Gross, Wayne Johnson, Rick Busko, David Meyer, Kathy Anderson, Katie Vasey
Provides CHS Administration,
EH Program administration &
Supervision of Clay County Staff
Agreement for FPL
program
P4H FPL Program Manager,
provides Field Supervision, P4H
Plan Review Oversight,
Coordination of Variance &
Enforcement for P4H
Agreement for shared FPL
Supervision, Financial, &
Licensing Service
Coordinates with
Program Manager for
Otter Tail County Staff and program needs
Chris LeClair
Land, Environment and
Resource Dir/ Sanitarian
Kent Severson
Environmental Health Manager
Provides CHS
Administration, contracts for
partial FTE for Supervision
of Otter Tail County staff
Wilkin County Board
Jon Braton Sr.
Eric Klindt Dennis Larson
Rick Busko
Jon Green
Otter Tail County Board
Dan Bucholz Lee Rogness Wayne Johnson Robert Lahman Kurt Mortenson
Clay County Board
David Ebinger
Frank Gross
Kevin Campbell Jenny Mongeau Paul Krabbenhoft
50
1
Original version adopted 2014
Revised: 2020, 2022
BYLAWS
OF
Partnership4Health Community Health Board
Article I
Name/Purpose
Section 1: The name of the Community Health Board shall be Partnership4Health Community
Health Board (P4HCHB), as established in the Joint Powers Agreement between the Counties of
Becker, Clay, Otter Tail, and Wilkin to establish a joint entity Community Health Board.
Section 2: Partnership4Health is organized for the purpose of providing public health services
pursuant to Minnesota Statute 145A, and the foundation for a strong local public health system to
meet the challenges of the future. As outlined in the National Association of Local Boards of
Health, the six functions of public health governance are:
1. Policy Development: to lead and contribute to the development of policies that
protect, promote, and improve public health while ensuring that the CHB and its joint
participants remain consistent with the laws and rules to which it is subject.
2. Resource Stewardship: to assure the availability of adequate legal, financial,
human, technological, and material resources to perform essential public health services.
3. Legal Authority: to exercise legal authority as applicable by law and understand
the roles, responsibilities, obligations, and functions of the governing body, health officer, and
contracted agents/staff
4. Partner Engagement: to build and strengthen community partnerships through
education and engagement to ensure the collaboration of all relevant stakeholders in promoting
and protecting the community’s health.
5. Continuous Improvement: to routinely evaluate, monitor, and set measurable
outcomes for improving community health status and the public health departments/governing
body’s own ability to meet its responsibilities.
6. Oversight: to assume ultimate responsibility for public health performance in the
community by providing necessary leadership and guidance in order to support the public health
departments in achieving measurable outcomes.
Section 3: The CHB parties agree to abide by the terms and conditions of the Joint Powers
Agreement, bylaws, policies, delegation agreements, and procedures adopted by the CHB.
Article II
Membership
Section 1: The CHB shall be governed by a six-member board made up of the following:
51
2
Original version adopted 2014
Revised: 2020, 2022
1. One County Commissioner and one alternate shall be appointed from each of the
four represented counties.
2. Two At Large community members may be recommended by the respective
Public Health Director(s) and be appointed by the respective county boards of the
Joint Participants. At large community members must be from two separate
representative counties.
Section 2: The appointment of all members to the CHB shall be by the respective appointing
authority and shall be made by January 31st of each year.
Section 3: Terms for the County Commissioners on the CHB shall be for one year with no term
limits. Term for At Large community members shall be a three-year term and rotated among the
4 counties. Alternate terms for the two at large community members will allow for consistent
guidance and leadership.
Section 4: County Commissioner Board members shall receive per diem allowance and travel
allowance through their respective appointing entity. At large community member shall receive
per diem allowance and travel allowance as the Community Health Board may determine and
which is consistent with Minnesota law.
Article III
Officers/Decision-making
Section 1: There shall be a chairperson and a vice-chairperson each of whom shall be elected
annually at the last meeting of the calendar year.
Section 2: The chairperson shall preside at all Community Health Board meetings. The chair
shall be responsible for representing official positions and statements formulated by the CHB.
The chair shall also perform all duties common to the office of chairperson and as the CHB may
designate.
Section 3: The Vice Chair shall assume the powers and duties of the chairperson during periods
of his/her absence and shall perform such additional duties and functions as the CHB may direct.
Section 4: The recording secretary shall be furnished appointed by the P4H directors. The
recording secretary shall keep the minutes of the CHB meetings and shall attend to the delivery
of notices and agenda for CHB meetings and perform such additional duties as the CHB may
direct.
52
3
Original version adopted 2014
Revised: 2020, 2022
Section 5: Each Community Health Board member shall be entitled one (1) vote on the CHB.
Votes shall be cast in person by the member or an alternate. Voting shall be by voice vote. A
quorum shall consist of members representing three (3) counties. All CHB actions shall be
determined by a simple majority of the votes cast at a meeting of the CHB.
Section 6: Vacancies, due to resignation or other reasons, shall be filled by appointment of the
county boards. Officer vacancies will be filled by election at the next scheduled meeting.
Article IV
General/Special/Annual Meetings
Section 1: All meetings of the CHB shall be conducted in a manner consistent with the
Minnesota Open Meeting Law Chapter 13 D. There shall be a minimum of two meetings per
year on such dates and at such times and places as the CHB shall determine. The last meeting of
the year will be the annual meeting with elections and appointments. Special meetings or
emergency meetings under Chapter 13 D may be called by the chairperson or upon request of
two (2) or more counties. Notice of regular meetings shall be provided to each CHB member at
least seven (7) calendar days prior to the date of the meeting and posted in accordance with the
open meeting law. Notices shall include an agenda. All proceedings of the CHB shall be open to
the public unless appropriately closed pursuant to law. All votes taken of members of the CHB
shall be recorded and shall become matters of public record.
Section 2: The CHB shall assure public input on public health matters relating to the
development, maintenance, funding and evaluation of community health services via community
member representation on the CHB and staff participation on community coalitions and
workgroups.
Article V
Agents
Section 1: The CHB may appoint and authorize agents to act on the CHB’s behalf and bind the
CHB for the following purposes:
A. To serve as the CHB’s agents according to Minnesota Statutes 145A in
communicating with the Commissioner of Health between Community Health
Board meetings, including receiving information from the Commissioner and
disseminating information to the Commissioner on the CHB’s behalf.
B. To sign and submit to the Commissioner the established local public health
priorities and the mechanism to address the priorities and achieve statewide
53
4
Original version adopted 2014
Revised: 2020, 2022
outcomes within the limits of available funding according to Minnesota Statutes.
145A.
C. To sign and submit to the Commissioner the CHB’s annual budget, revisions to
the budget, and expenditure reports submitted according to Minnesota Statutes.
145A.
D. To sign and execute, on behalf of the CHB, contracts for funding under Grants
Contracts administered by the Commissioner of Health or other entities as
deemed appropriate by the CHB.
E. To appoint one representative and one alternate to serve on the State Community
Health Services Advisory Committee (SCHSAC).
Article VI
Administrative and Program Management
Section 1: Administration and Legal Consultant: Prior to December 31st of each year, the
Community Health Board shall appoint one of the Joint Participants to serve as the CHS
Administration and Legal Consultant agency for the Community Health Board for the next
calendar year. The duties and responsibilities of the Administration and Legal Consultant
Agency, and the relevant county officials shall be set forth in a separate document between the
Community Health Board and the Governing Board of the appointed agency.
Section 2: Finance: Prior to December 31st of each year the Community Health Board shall
appoint one of the Joint Participants to serve as the Fiscal Agent for the Community Health
Board, in cooperation with its Auditor for the next calendar year. The duties and responsibilities
of the Fiscal Agent, and the relevant county officials shall be set forth in a separate document
between the Community Health Board and the Governing Board of the appointed agency.
Section 3: Assessment and Planning: Prior to December 31st of each year, the Community
Health Board shall appoint one of the Joint Participants to serve as the CHS Assessment and
Planning Agency for the next calendar year. The duties and responsibilities of the CHS
Assessment and Planning Agency shall be set forth in a separate document between the
Community Health Board and the Governing Board of the appointed agency.
Section 4: Performance Management: Prior to December 31st of each year the Community
Health Board shall appoint one of the Joint Participants to serve as the CHS Performance
Management Agency for the Community Health Board for the next calendar year. The duties and
responsibilities of the CHS Performance Manager Agency shall be set forth in a separate
54
5
Original version adopted 2014
Revised: 2020, 2022
document between the Community Health Board and the Governing Board of the appointed
agency.
Article VII
Records, Accounts, and Reports
Section 1: The books and records, including minutes and the originally executed Agreements, of
the CHB shall be subject to the provisions of Minn. Stat. Ch.13. They shall be maintained by the
Administrative/Legal and the Fiscal Agents for the CHB.
Section 2: The CHB will ensure strict accountability for all funds of the organization and will
require reports on all receipts and disbursements made to, or on behalf of the CHB. All funds
shall be accounted for according to generally accepted accounting principles and shall be subject
to an annual audit by the State Auditor or auditor of choice.
Section 3: An audit for the CHB will be completed in accordance with auditing procedures for
the joint participant acting as the Fiscal Agent for the Board.
Article VIII
Budget and Accounting Services
Section 1: Each public health department shall prepare and obtain approval of their respective
budget and submit to the CHB Fiscal Agent. The budget preparation shall account for funding
required as match for grants and projects; shared costs incurred for operation of the CHB or joint
projects, and for the unique programs provided by the respective public health department.
Section 2: In recognition of direct and indirect support services provided by each county for the
cross-jurisdictional functions including administrative, accounting, auditing, legal services,
community assessment, planning and performance management and administrative fee will be
determined annually during the budget process.
Section 3: The CHB shall obtain and maintain liability insurance and may obtain such other
insurance it deems necessary.
Section 4: The CHB will develop an annual budget, dependent upon budget reserves and/or
anticipated continued grants, project funding, fees, contracts, and tax allocations. The budget
may be modified as needed to meet the actual grant or funding amounts and requirements.
Article IX
55
6
Original version adopted 2014
Revised: 2020, 2022
Bylaws Review & Amendment
Section 1: These Bylaws will be reviewed yearly at the Annual meeting.
Section 2: These Bylaws may be amended by a vote of the majority of the members of the CHB
at any meeting of the CHB, provided that notice of such proposed amendments shall have been
given in writing at least ten (10) days in advance to all members. The CHB shall forthwith notify
the members of any and all amendments adopted.
56
JOINT POWERS AGREEMENT BETWEEN THE COUNTIES OF
Becker, Clay, Otter Tail, AND Wilkin
TO ESTABLISH A JOINT ENTITY COMMUNITY HEALTH BOARD
THIS AGREEMENT is entered into by and among Becker County, Clay County, Otter Tail
County and Wilkin County, all municipal corporations organized under the laws ofthe State of
Minnesota, hereinafter referred to as "Joint Participants," tbr an indefinite duration, subiect to
termination in accordance with Section 4, below. For the purposes of adopting Operating
Procedures, appointing key administrative roles, developing Delegation Agreements with Local
Boards of Health, and the completion of other organizational duties necessary for the transition
of services and actual implementation of the powers and duties of the ofthe Partnership4Health
Community Health Board, this agreement shall be effective July 1,2014.
From the date of adoption until June 30, 2014, staff will develop documents required for
implementation of this agreement including the identification of shared services and related
financial responsibilities as well as organize and conduct the community health assessment,
develop the community health improvement plan and CHB strategic plan. The actual duties of
the Partnership4Health Community Health Board, as stated herein, shall commence on January
l, 2015. Up until that date, each of the Joint Participants shall continue to operate and serve their
respective populations under their current Community Health Board Structures.
WHEREAS, the joint participants desire to enter into an agreement to form an entity functioning
as the Partnership4Health Community Health Board (hereinafter "CHB"), pursuant to Minnesota
Statutes Chapter 145.4, and pusu:mt to Minnesota Statute $ 471,.59, for the purpose of
establishing and maintaining a cooperative system of community health services under local
administration to secue more efficient public health services for the mutual benefit of each of
the Joint Participants and the communities they serve.
WHEREAS, it is desirable to set forth the Joint Participants' agreement in writing,
THEREFORE, the Joint Participants, in their joint and mutual exercise of their powers, hereto
agree as follows:
SECTION l - Definitions
All terms used in this Agreement are defined in Minnesota Statutes Chapter 145A. AII other
terms shall have their plain and ordinary meaning.
SECTION Il - Puroose
It is the intention of the Joint Participants that the formulation of a CHB and the delegation of
certain duties to Local Boards of Health, as prescribed herein, will allow the citizens of each
57
county to enjoy even more efficient local public health services and provide the foundation for a
strong local public health system to meet the challenges ofthe future.
The CHB's purpose is to engage in activities designed to protect and promote the health of the
general population within a community health service area by emphasizing the prevention of
disease, injury, disability, and preventable death through the promotion of effective coordination
and use of commrmity resources, and by extending health services into the community. The areas
of responsibility shall include:
l. assuring an adequate local public health infrastructure;
2. promoting healthy communities and healthy behaviors;
3. preventing the spread ofinfectious disease;
4. protecting against environmental health hazards;
5. preparing for and responding to emergencies; and
6. mobilizing community resources to address gaps in health services.
SECTION III - Name
The name of the CHB comprised of the Joint Participants shall be known as the Partnership4
Health Community Health Board (P4HCHB).
SECTION IV - Governins Board Composition. Annointment of Terms
A. The CHB shall be govemed by a five member board, with the members of that board
appointed as follows:
1. One county commissioner and one altemate shall be appointed from each of the four
represented counties, those being Becker, Clay, Otter Tail, and Wilkin Counties.
2. One At Large community member from one county who may be recommended by the
respective Public Health Director and will be-appointed by the county board.
Appointment of all members to the CHB shall be by the respective appointing authority, and
shall be made by July l, 2014 and by January 3 I " of each year thereafter.
C. Terms:
Terms for county commissioners on the Community Health Board shall be one year with no term
limit.
Term for At Large community member, shall be a three year term and this will be rotated between
the 4 counties. The tkee year rotation schedule witl be in the following order: Wilkin, Otter Tail,
Clay and Becker.
2
58
B.
SECTION V - Authori8 and Duties of the Combined Communitv Health Board:
Powers and Duties - The CHB shall possess all of the powers and duties now assigned by
the law, pursuant to Minnesota Statutes Chapter t45A, as now enacted or hereinafter
amended. Local Boards of Health shall possess all other powers and duties assigned by law
to such Local Boards of Health, pursuant to Minnesota Staotes Chapter 145A, as now
enacted or hereinafter amended, and as more specifically delegated to it in the Delegation
Agreement attached hereto and incorporated herein in compliance with Minnesota Statutes
Chapter 145A.
Emplovees - The CHB will not employ staff. The CHB will purchase services through
contracting with the joint participanB, community organizations or independent contactors
or agents as necessary to carry out the provisions of this Agreement and the requirements of
Minnesota Starutes Chapter 145A, as now enacted or hereinafter amended.
Acquisition of Prot)€rty: Acceptance ofFunds. Collection ofFees - The CHB by any lawful
means, including gifts, purchase, lease or transfer of custodial control, may acquire and hold
in the name of the CHB, the lands, buildings and equipment necessary and incident to the
accomplishment of the purposes of Minnesota Statutes Chapter 145A, as now enacted or
hereinafter amended, and may accept gifts, grants and subsidies from any lawful source.
The CHB may also apply for and accept state and federal funds, may request and accept
local tax funds, and may establish and collect reasonable fees for community health services.
Fundins- The CHB shall coordinate local, state, and federal services and funding for public
health services. The CHB shall expend funds in accordance with the 4ru1rrql 4pp16yscl
budget and local priorities.
Disbursement of Funds - The CHB shall develop criteria for distribution of resources to the
Public Health Departments of the joint parricipants. The CHB shall develop guidelines to
select the service delivery model for programs for which the CHB is fiscally responsible.
The CHB may provide lor disbursements from public funds to carry out the purposes ofthis
Agreement. The method of disbursement shall agree, as far as practicable, with the method
provided by law for the disbursement of funds by the Joint Participants. The CHB shall be
strictly accountable for maintaining records of all funds and reports of all receipts and
disbursements.
Contracts for Services - The CHB may contract for services from private firms, non-protit
corporations, primary and secondary schools, state and local government agencies, or other
community agencies to avoid unnecessary duplication of services and to realize cost
advantages. Contracts shall be awarded on the basis of benefiVcost comparisons and the
ability to provide the services.
Coordination of Services - The CHB shall coordinate public health services designed to
protect and promote the health of the general population of the CHB by emphasizing the
prevention of disease. injury, disability, and preventable dearh through the promotion ol
effective coordination and use of community resources or by extending health services into
the community; it shall ensure responsible medical consultation and direction from a
C.
D.
F.
G.
59
H.
licensed physician; and it shall coordinate public health service related to environmental
health and regulatory services in the community.
Establishine Local Priorities and Evaluation of Health Services -As a condition of
qualifying for the Local Public Health Grant Funding, the CHB shall:
l. Establish local priorities based on an assessment of community health needs and
assets.
2. Determine mechanisms to address the priorities and achieve statewide outcomes within
the limits of available funding, as required by Minnesota Statutes.
3. The CHB also shall evaluate the effectiveness and efficiency of community health
services systems and programs.
Equal Access to Services , The CHB shall identifu community health needs and set
priorities among the needs for the broad range of commrmily health services, including but
not limited to the health needs of residents, minorities, non-residents, tourists, and migrants.
The CHB shall ensure that services are accessible to all persons on the basis of need, so that
no one is denied services because of race, color, sex, age, language, religion, nationality,
economic status, political persuasion or place of residence, as provided by Minnesota
Statutes.
Reports - The CHB shall submit such reports on its expenditures and activities as is
necessary for monitoring public health services and as required by Minnesota law.
Operatine Procedures - The CHB shall conduct business according to its approved operating
procedures, which will be reviewed annually.
SECTION VI - Indemnification and Hold Harmless
Aoplicability. The CHB shall be considered a separate and distinct public entity to which the
Parties have transferred all responsibility and control for actions taken pusuimt to this
Agreement. The CHB shall comply with all laws and rules that govem a public entity in the
State of Minnesota and shall be entitled to the protections of M.S. 466.
Indemnification and Hold Harmless. The CHB shall fully defend, indemnily, and hold
harmless the Parties against all claims, losses, liabitity, suits, judgments, costs and expenses
by reason ofthe action or inaction ofthe Board and/or employees and,/or agents ofthe CHB.
This Agreement to indemnifu and hotd harmless does not constitute a waiver by any
participant of limitations on liability provided under Minnesota Statutes, Section 466.04.
To the full extent permitted by law, actions by the Parties pursuant to this Agreement are
intended to be and shall be construed as a "cooperative acriviry" and it is rhe intent ofthe
Parties that they shall be deemed a "single governmental unit: for the purpose ofliability, as
sel forth in Minnesota Statutes, Section 471.59, subd. la(a); provided funher that for
purposes of that statute, each Party to this Agreement expressly declines responsibility for
the acts or omissions ofthe other pafty.
J.
K.
A.
B.
4
60
B.
C.
The Palties ofthis Agreement are not liable tbr the acts or omissions ofother participants to
this Agreement except to the extent to which they have agreed in writing to be responsible
for acts or omissions ofthe other parties.
SECTION VII - Term ofAereement
Term - This Agreement shall be continued from year to year until terminated as provided
herein-
Termination - This Agreement may be terminated by withdrawal Ilom the CHB of any
member county board of any ofthe Joint Participants.
Withdrawal - The counties that are members of the CHB may withdraw from this
Agreement by serving a copy ofa resolution of withdrawal, duly passed by its goveming
body, upon the chairperson of the county boards and the auditor of the other counties
participating in this Agreement. The withdrawing county also shall serve a copy of the
resolution of withdrawal upon the Commissioner of Health for the State of Minnesota.
Provided, however, a member county may not withdraw from the CHB during the first
five (5) calendar years following the county's initial adoption of this joint powers
Agreement, pusrxmt to Minn. Stat. g 145A.09, Subd. 7(b). The withdrawing county
shall serve the resolution of withdrawal at least one (l) year before the beginning of the
calendar year in which the withdrawal is intended to take place, in accordance with
Minnesota Statutes Chapter 145A, as now enacted or hereinafter amended. Service ofthe
resolution of withdrawal shall be made in writing and delivered electronically with a
retum receipt or-by first class mail and the date of service shall be one week after the date
ofthe notice.
Termination Pavment of Expenses - Upon termination of this Agreement the payment of
expenses ofthe CHB shall be governed as follows:
I . No distribution of any share of uncommitted surplus fi.rnds shall be made rurtil all
operating expenses (excluding pal,roll expenses) incurred during the operation of the
CHB have been fuUy paid and satisfied.
2. Upon the termination date of this Agreement, alt fiurds may be transferred to the fiscal
host until all operating expenses (excluding employee expenses) have been paid.
3. The authority of the fiscal host to continue to disburse funds of the CHB after the
termination date of this Agreement shall continue for a period ofnot more than six (6)
months.
4. If the authority of the fiscal host to expend firnds or sign docwnents on behalf of the
CHB is needed for more than six (6) months, a resolution ofeach member county board
shall be sufhcient authority to continue to handle the funds until terminated as set forth
by the Resolution adopted by the county boards.
D.
5
61
E. Termination Transition Oversieht - If there are .rny expenses incurred in connection with
the termination of the CHB after the termination date of this Agreement, the member
counties agree to pay their share ofthe said expenses based on crurent year Community
Health Board budget.
F. Termination Grant Closeout - Any grant moneys received during the operation ofthe CHB
which have not been earned by the time of the effective date of the termination of this
Agreement shall first be distributed according to the grant agreement with the granting
agency (i.e. MDH, DHS) and if not otherwise specifred in the grant proposal or agreement,
said monies shall be distributed in the following order:
l. Rerumed to the agency supplying the grant frurds or distributed as instructed by said
agency or as provided in the Grant.
2. Disnibuted to the county which will continue to provide the services by said grant.
G. Termination Distribution of Propertv - Upon the terrnination of this Agreemen! any
property and/or funds urder the control ofthe CHB as dehned herein shall be retumed to
each Joint Participant in proportion to its relative financial contributions to the CHB.
SECTION VIII - Modification of Asreement
Any modifications, amendments, or alterations to the provisions of this Agreement shall only be
valid ifthey are reduced to writing and approved and signed by all by respective County Boards.
SECTION IX- Execution - Entire Aereement
This Agreement shall be executed pursuant to resolution adopted by the participating County
Boards.
This Agreement shall constitute the entire Agreement of the parties and shall supersede and
amend any previous written agreement and any previous contemporaneous oral agreement ofthe
parties.
This Agreement may be executed in several corinterparts, each of which shall be an original, and
all of which shall constitute one and the same instrument.
Original: Adopted November 2013
Amended: February 2014
Signatures on separate pages-
6
62
Adoptcd by the Cleyot nbl,b.t/].
County Board of Commbsloners on this lfday
Chairperson,of Commissioners
8
63
Atloptcd by the Otter Tail County Board of Commissioncrs on this 59day
,rthrq t/ts*tsy'
Public Health Direcror, Otter Tail County
Approved as to .fornz a
64
Adopted bl the Clay Countl Board of Commissioners on this _ day
of ,20
Clav olCommissioners
County Administrator. CIay
65
County Board of Commissioners on ttric /day
Wilkin County Board of Commissioners
10
1,)
,lpprovad us to /brm (nd 4lntcnl
Wi lkin ('()unty Arrorney
66
by the Becker Counry Board of Comnrissioncrs on this ?5dav
-204
A11ttol,,rl os to for.,,t atkl conl(ut/httUqu l lx(,y,t",^,llcckertkrunrl' anor,,[- -
l--
ru*'r"aiZn
Coyify Admirrisn-a1or Becker Counr)' ,rtt,,/ /ft112 /l-_-
Conrnrunill' I leakh Supervisor. Becker Countv
67
Section 6.
Scction 7
Scction il.
Scction 9.
IN \,\1I1NE5S
Adoptcd br tbe
a\of
\ !-/l /'
During the coursc ofthe Agreemcnt. thc Comrnunity Health Board shall
not perform any ofthc delegared duries specified herein. cxcept audits
nccessar),to monitor compliance $ ith this Agreentent, unless the panics
othcnvise agrce in writing that the Community l{ealth Board may periorm
certain spccifi ed duties.
The Comnrunity Health Board shall consult with, advise, assisr or direct
the Local Board olllealth as needed, or as requested by the Local Board
of Health, in the performancc of rhe duties of the Local Board of Health
under this Agreentent.
'lhis Agrecment does not ahe r rhc rcsponsibilit) olfte Community Hcalth
Board for the perlbrmance of dutics rvhich it tnust undertake and mainhin
by law.
'flre Conrmunitl- Health tloard shall distribute l_ocal public l{ealrh (;ranr
funds to the Public Health Depanrnent established by the Local Board of
I lealth in accordance rvirh rhe responsibilitics dclegared to the Local
lloard of I lealth. 'l'he Local Board of Hcalrh agrces its public t lealth
Dcpartmcnt rvill bc accountablc for appropriate cxpenditurc olthe grant
l'unds.
('ounn Board of ('ommissioncrs on rhis, "-, Lhal
- _ Count)' Board of Commissioners
(lounty Board olComrrissioneru
\ l/?\-}:y /l'{! "*: (
'Chairperson.
Counl) Administrator,
68