HomeMy WebLinkAboutCommunity Health Board - Board Packet 2.16.2024 Supporting Documents - 02/16/2024
Becker County Clay County Otter Tail County Wilkin County
712 Minnesota Ave 715 11th St N #303 560 Fir Avenue West 300 5th St S
Detroit Lakes, MN 56501 Moorhead, MN 56560 Fergus Falls, MN 56537 Breckenridge, MN 56520
218-847-5628 218-299-5220
Co- CHS Administrator:
Kathy McKay
218-998-8320
Co- CHS Administrator:
Jody Lien
218-643-7122
Partnership4Health Community Health Board
2/16/2024
9:00 a.m.-11:30 a.m.
In Person option: Clay County -715 N 11th St. Moorhead (Family Service Center building—room 4 on 1st floor)
Virtual Option: Contact Recording Secretary Melissa Duenow if a Virtual Option is
needed.
Agenda
9:00 Call to Order
Quorum Established
Approve Agenda
Approve Minutes
9:05 Introductions and Welcome
Vote on New Community Member Katie Vasey 9:10 Orientation and overview of the CHB 9:25 CHB Governance Documents
P4H CHB Bylaws
Joint Powers Agreement 9:35 Program Highlights: Environmental Health-FPL delegation agreement
Kent Severson
10:15 Legislative Session Updates
Kathy McKay
10:25 Statewide Community Health Services Advisory Committee (SCHSAC)
Updates (Wayne Johnson, Frank Gross)
10:40 Finance Update, Carmen Barth 11:00 Other General Updates & Discussion 11:30 Adjourn
MEETING MINUTES & SUMMARY
Meeting: Partnership4Health Community Health
Board Meeting
Otter Tail County Government Services Center
Otter Tail Lake Room
Attendees:
Clay County: Frank Gross, Dave Ebinger
Wilkin County: Rick Busko
Otter Tail County: Wayne Johnson
Becker County: David Meyer
Staff: Kathy McKay, Carmen Barth, Becky Tripp, Ashley
Wiertzema, Jody Lien, Kristi Goos, Amanda Kumpula,
Kent Severson, Kim Bredeson
Guests: Kristin Erickson, Lynne Penke Valdes
Absent:
Community Representatives: Kathy Anderson, Cheryl
Walter
Date: 11/17/2023 Recorder: Kristi Goos
Agenda Item
9:00
Call To Order
Quorum Established
Approve Agenda
Approve Minutes
Commissioner Gross, Chair, called the meeting to order at 9:04 am.
Quorum Established. Introductions were made.
Approval of Agenda
Motion by David Meyer, seconded by Rick Busko. The motion carried unanimously.
Approval of Minutes
Motion by Wayne Johnson, seconded by Rick Busko. The motion carried unanimously.
9:05
Finance Updates
2022 Audit Review
Carmen Barth presented a PowerPoint for the 2022 audit as well as the annual risk
assessment as included in the board packet.
2024 Budget; Resolution 2023-1
Motion by Wayne Johnson to approve the 2024 budget as presented, seconded by
Dave Meyer. The motion carried unanimously.
Frank Gross, Chair, to sign resolution 2023-1
9:30 (9:45) Authorized Agents; Resolution 2023-2
Elections and
Appointments
Review of Resolution 2023-2 as included in the board packet to appoint Kathy McKay
(Clay) and Jody Lien (Otter Tail) as P4H co-administrators, Clay County as Fiscal Host
and Wayn Johnson (Otter Tail) for SCHSAC appointment.
Motion by Rick Busko, seconded by David Meyer. The motion carried unanimously.
Election of 2024 Officers
Review of P4H CHB Officers as included in the board packet. Wayne Johnson motioned
to appoint the same officers for 2024 as 2023, seconded by David Meyer. The motion
carried unanimously.
10:00 (9:50)
Statewide Community
Health Services Advisory
Committee (SCHSAC)
Updates
Jody Lien (Otter Tail) provided updates from the SHCSAC retreat in Willmar this fall.
The retreat and meeting were attended by Wayne Johnson and Jody Lien. The retreat
discussion was mainly held around Public Health systems transformation and what
efforts have been occurring, and will be, to assure regardless of a person’s zip code
they have access to strong public health services.
10:15 Legislative Funding Jody Lien (Otter Tail) provided a brief update on two areas of funding that Public Health
received from the 2023 legislature. Funds for Foundational Public Health
Responsibilities as well as Emergency Preparedness and Response were overviewed.
10:30 Food, Pool, &
Lodging Delegation Fees
Review
Carmen Barth, Kent
Severson
2024 Food, Pool & Lodging fees
Proposed fee revisions, Clay and OTC proposals, were discussed as included in the
board packet. Kent Severson and Kim Bredeson joined the meeting for this discussion.
• Current program expenses are over revenues; Clay and OTC counties will need
to cover the difference
• Wayne Johnson proposed more frequent CHB meetings to address finances of
CHB and review programs such as EH/FPL and finances of the CHB. He would
also like to see a survey of operators experience with local control of the FPL
program.
• Kent Severson shared MDH is reviewing their rates and has reached out to
delegated authorities. Kent shared MDH also has charges to all licensed
facilities in addition to the local licensing fees.
Motion by Frank Goss to adopt the Clay County FPL proposal and OTC VHR fee
proposal, seconded by David Meyers. The motion carried unanimously.
10:35 Cross Jurisdictional
Sharing Activities Update
P4H Community Health Needs Assessment
The current community survey is out. Staff asked the board to help promote to gather
more information to inform health priorities.
• Amanda shared Becker County has shared with HS community members,
clients they serve, food pantries, emailing out to stakeholders
• Ashley shared health care partners that have been given this information, social
media releases, QR codes shared etc. to spread widely with
stakeholders/partners.
• Clay county is translating into other languages as needed as well as above
resources.
10:45 Discuss Meeting
Locations, Frequency, and
dates for 2024
Discussion was held regarding need to increase meetings of the CHB for further
information sharing and education. Currently the CHB meets twice a year; which is the
minimum requirement by statute.
Wayne Johnson made a motion to begin meeting every other month, the 3rd Friday of
even months, seconded by Meyers. Further discussion was held. It was suggested
starting in February in 2024 that the board will discuss meeting frequency to determine
if every other month is often enough or too often. Feedback was offered to begin
meeting quarterly and address future meeting frequency.
Wayne Johnson withdrew the first motion and proposed quarterly meetings in place of
every other month. Motion by David Meyers to meet quarterly in each county in the
middle of quarter (Feb, May, August (update fee schedule), November) on the 3rd
Friday, second by Rick Busko. The motion carried unanimously.
February meeting will be in Clay County
11:00 Adjourn Motion to Adjourn at 11:23am
Public Health 101
•Definition of Public Health
•Public Health in relation to other health services/health care
•Public Health in Minnesota
•Governance
•Local Public Health Act
•Organizational Structures
•P4HCHB—4 counties
•Becker
•Clay
•Otter Tail
•Wilkin
Definition of Public Health
“Public health is what we, as a society, do to collectively assure
the conditions in which people can be healthy.”
-Institute of Medicine
Public Health and Health Care:
Complimentary But Not the Same
PUBLIC HEALTH FOCUS
Prevention, promotion and protection
Population health focus
Reduce risk in a target group
Policy, system and environmental change
HEALTH CARE FOCUS
Treatment and Therapy
Individual health focus
Reduce impact on an individual
Levels of Government
Federal:
CDC/DHHS/CMS
State:
Minnesota
Department of Heath
Local:
Community Health Board
& Local Health Department
State Boards of Health (c. 1950)
Prior to 1977, over 2,100 local boards of health existed to
serve Minnesota’s communities.
The 1976 Community Health Services Act (now the Local Public
Health Act, or Minn. Stat. §145A) allowed boards of health to
join together and work as Community Health Boards (CHBs), to
serve a larger population and geographic area.
CHBs are statutorily required and the legally recognized
governing bodies for local public health in Minnesota.
Purpose of CHS System
“’Community health services’ [denotes] 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 community resources, and by extending health services into the community.”
Minn. Stat. §145A.02, subd. 6
(Local Public Health Act)
Community Health Board
GOVERNANCE STRUCTURE
•Single-County
•Multi-County
•Joint powers agreement.
•Minimum population requirement of 30,000.
•County board appoints representatives to the
CHB. Organized under Minn. Stat. §145A.
•City Health Department
•Human Services Board
ORGANIZATIONAL STRUCTURE
•Stand Alone Public Health
Department
•Health and Human Services
Agencies
•Hospital/Health Care Organization
Community
Health Boards
in Minnesota
6 Essential Services in MN 145A
1. Assure an adequate
public health
infrastructure
•Assess health priorities
with community input;
develop community
health improvement
plans to address
identified needs and
monitor progress.
2. Promote healthy
communities and healthy
behaviors
•Track data trends
(leading causes of
death, birth outcomes);
implement health
promotion strategies
based on community
needs and priorities.
3. Prevent the spread of
infectious disease
•Monitor immunization
levels and perform
outreach to high-risk
groups; run
immunization clinics;
investigate outbreaks
and conduct contact
interviews with
individuals exposed.
6 Essential Services in MN 145A
4. Protect against
environmental health
hazards
•Implement Childhood
Blood Lead Case
Management Guidelines;
abate public health
nuisances; monitor food
and water illness data.
5. Prepare for and respond
to disasters, and assist
communities in recovery
•Develop and maintain
response plans to address
needs during disasters and
emergencies (infectious
disease threats like COVID-
19 or TB, natural disasters,
terrorist attacks); enforce
emergency health orders.
6. Assure the quality and
accessibility of health
services.
•Identify barriers to health
care service and gaps in
service; implement
strategies to increase
access to health care.
State Community Health Services
Advisory Committee (SCHSAC)
STATE
COMMUNITY
HEALTH
SERVICES
ADVISORY
COMMITTEE
•Required under the Local Public Health Act
•Advises the Commissioner of Health
•Representatives from each Community Health Board
•Work performed by workgroups
Elected Official’s Public Health
Responsibilities
OversightContinuous
improvement
Partner
engagement
Legal
authorization
Resource
stewardship
Policy
development
P4H CHB Membership
Community Health Boards (CHB) are required to have a Community Health
Services(CHS) Administrator and a medical consultant and may appoint an
advisory committee.
❖Current Co-Administrators: Kathy McKay Clay Co. & Jody Lien Otter Tail Co.
❖Each county has their own medical consultant
Members of the Community Health Board are either elected themselves or
appointed by elected officials.
Present Membership:
◦One County Commissioner and one alternate from each county
◦Two at large community members
Joint Powers Agreement
Multi-county community health boards are
formed through joint powers agreements,
which allow the community health boards to
work across political boundaries.
Community health boards of three or more
counties are possible if the counties are
contiguous; there is no minimum population
requirement for community health boards
with three or more counties.
P4H CHB Bylaws
Article I Name/Purpose
Article II Membership
•Currently 6-member board
Article III Officers/Decision Making
•Chairperson and Vice-Chairperson
•1 vote per CHB member
•Quorum: 3 counties
•Recording Secretary to be furnished
Article IV General/Meetings
•Statutory Minimum 2 per year
•P4H CHB meeting quarterly in 2024
Article V Agents
•CHS Administrator
•SCHSAC appointments
Article VI Administrative & Program Management
•Administration & Legal Consult
•Otter Tail County Attorney used for legal
consult.
•Fiscal
•Assessment & Planning
•Performance Management
Article VII Records, Accounts, and Reports
Article VII Budget and Accounting Services
Article IX Bylaws Review & Amendment
Minnesota Local Public Health Act
SUMMARY OF MINN. STAT. § 145A
This document summarizes the Minnesota Local Public Health Act (Minn. Stat. § 145A). This document is not a
comprehensive summary of all public health mandates or authorities. The statute language can be found on the
online: Minnesota Statutes: Chapter 145A. Community Health Boards. This document is not a substitute for the
advice of your jurisdiction’s legal counsel.
145A.01 Citation
May be cited as the “Local Public Health Act”
145A.02 Definitions
This section provides necessary definitions for terms
included in this statute.
145A.03 Establishment and Organization
▪ County must take on the responsibility of a
community health board (CHB) or join a CHB.
▪ Must include 30,000+ within its jurisdiction or be
composed of three or more counties.
▪ CHB or 402 board may assign the powers and
duties to a human services board. Eligibility for
funding will be maintained if all requirements of
a CHB are met.
▪ A county may establish a joint CHB by
agreement with one or more contiguous
counties, or an existing city CHB may establish a
joint CHB with one or more contiguous existing
city CHBs in the same county in which it is
located.
▪ The CHB must have at least five members and
must elect a chair and vice-chair and must hold
at least two meetings per year.
▪ CHBs meeting these requirements are eligible for
the Local Public Health Grant.
Minnesota Department of Health
Center for Public Health Practice
PO Box 64975 St. Paul, MN 55164-0975
651-201-3880 health.ophp@state.mn.us
www.health.state.mn.us
June 2017
To obtain this information in a different format, call:
651-201-3880.
145A.04 Powers and Duties of CHB
▪ Develop and maintain a system of community
health services.
▪ Enforce laws, regulations, and ordinances
pertaining to its powers and duties within the
jurisdiction.
▪ Must identify local public health priorities and
implement activities to address the priorities and
the areas of public health responsibility, which
include:
▪ assuring an adequate local public health
infrastructure
▪ promoting healthy communities and healthy
behavior
▪ preventing the spread of communicable
disease
▪ protecting against environmental health
hazards
▪ preparing and responding to emergencies
▪ assuring health services
▪ Must complete an assessment of community
health needs and develop a community health
improvement plan, seek community input on
health issues and priorities, establish priorities
based on community needs.
▪ Must implement a performance management
process in order to achieve desired outcomes.
▪ Must annually report to the commissioner on a
set of performance measures and be prepared
to provide documentation of ability to meet the
performance measures.
▪ Must appoint, employ, or contract with a
community health services (CHS) administrator
to act on its behalf. CHS administrator must
meet personnel requirements outlined in rule.
▪ Must appoint, employ, or contract with a
medical consultant.
▪ May employ personnel.
▪ May acquire property, accept gifts and grants or
subsidies, and establish and collect reasonable
S UM M A R Y O F THE MIN NE S O TA L O C A L P UB L I C HE A L TH A C T
fees. Access to services must not be denied due
to inability to pay.
▪ May contract to provide, receive, or ensure
provision of services.
▪ Must make investigations and reports and obey
instructions of the Commissioner of Health to
control communicable diseases.
▪ Must participate in planning for emergency use
of volunteer health professionals through the
Medical Reserve Corps (MRC).
▪ May enter a building for inspection.
▪ Must remove or abate public health nuisances.
▪ May seek an injunction to enjoin the violation of
statute, rule or ordinance.
▪ It is a misdemeanor to hinder CHB, county, or
city from entering building where enforcement is
necessary.
▪ Cannot neglect to enforce.
▪ Does not limit powers outlined in other laws.
▪ May recommend legislation.
▪ Must ensure equal access to services.
▪ Must not deny services because of inability to
pay.
▪ MDH must establish State Community Health
Services Advisory Committee (SCHSAC).
▪ SCHSAC must meet quarterly
▪ CHB may appoint a member to SCHSAC.
145A.05 Local Ordinances
▪ A county board may adopt various ordinances
public health.
▪ Cities and towns may adopt ordinances relating
to public health, but they must not conflict with
or be less restrictive than those adopted by the
county board.
145A.06 Commissioner; Powers and Duties
This section outlines the powers and duties of the
commissioner of health. This is in addition to the
duties outlined in other laws.
145A.61 Criminal Background Studies
This section outlines the commissioner of health’s
authority to conduct criminal background studies on
MRC volunteers.
145A.07 Delegation of Powers and Duties
▪ The commissioner of health may enter into
delegation agreements with the CHB to perform
certain licensing, inspection, reporting, and
enforcement duties.
▪ A CHB may authorize a city or county within in
jurisdiction to carry out the activities of a CHB.
145A.08 Assessment of Costs; Tax Levy Authorized
▪ May assess and recover costs for care to control
disease or enforcement actions.
▪ A city council or county board that has formed or
is a member of a CHB may levy taxes to pay the
cost of performing its duties.
145A.11 Powers and Duties of City and County
A city council or county board that has formed or is a
member of a CHB has the following duties:
▪ Must consider the income and expenditures
required to meet local public health priorities
and statewide outcomes in levying taxes.
▪ May by ordinance adopt and enforce minimum
standards for services provided
145A.131 Local Public Health Grant
▪ Formula based on level of funding from 2003.
▪ Must provide at least a 75 percent match for the
state funds received through the local public
health act grant. Eligible match funds include
local property taxes, third party
reimbursements, fees, other local funds,
donations, and non-federal grants.
▪ Must meet all the requirements and perform all
the duties in subd. 3 and subd. 4.
▪ Must comply with accountability requirements
outlined each year.
▪ If CHB does not accept LPH grant, the
commissioner may retain the funds.
▪ May use their local public health grant funds to
address the areas of public health responsibility
and local priorities developed through the
community health assessment and community
health improvement planning process.
145A.14 Special Grants
This section addresses the requirements of migrant
health grants, Indian health grants, and funding to
tribal governments.
145A.17 Family Home Visiting Programs
This section establishes a program to fund family
home visiting program.
The purpose of the Partnership4Health (Clay, Otter Tail, and Wilkin Counties)
Environmental Health Services is to evaluate, educate and promote safe
environmental practices within the counties and regulated facilities using a consistent,
risk-based collaborative approach ensuring a safe and healthy environment for the
people we serve.
Environmental Health educates food operators,
receives, and responds to community
environmental health complaints.
Environmental Health inspects establishments
to ensure clean and healthy conditions.
licensed staff available to
respond to consumer complaints.
Consumer complaints received by
the EH team.
Three Counties
One Goal
Inspections completed.
plan reviews completed.
Food &
Beverage
Lodging Home Park
& Camping
VHR Pool &
Spa
Educates the public on safe food
handling, safe sleeping accommodations,
vacation home rental guidelines, pool
conditions, and other topics.
Ensures food operator practices
are compliant to reduce the top
five known foodborne illness risk
factors.
Clay Wilkin OTC Totals
Program #5470 5680 5685
Revenue
License Fees 124,578 13,347 230,257 368,182
Other Revenues (grants, reinspection and plan reviews)835 835
Total Revenue 125,413 13,347 230,257 369,017
Expenses
Payroll Expenses 146,969 23,423 322,894 493,285
Program Supplies 17,060 3,594 2,925 23,579
Computer Software 3,109 275 7,371 10,755
Total Expenses 167,138 27,291 333,190 527,620
-41,725 -13,944 -102,933 -158,603
Clay Wilkin OTC Totals
Program #5470 5680 5685
Revenue
License Fees 140,513 13,902 232,875 387,290
Vacation Home Rental 61,293 61,293
Other Revenues (grants, reinspection and plan reviews)1,700 875 2,575
Total Revenue 142,213 13,902 295,043 451,158
Expenses
Payroll Expenses 156,672 21,752 352,615 531,039
Program Supplies 12,404 2,920 845 16,168
Computer Software 2,333 1,163 8,213 11,709
License Refunds 0 0 750 750
Total Expenses 171,409 25,835 362,423 559,666
-29,196 -11,933 -67,380 -108,508
Clay Wilkin OTC Totals
Program #5470 5680 5685
Revenue
License Fees 181,000 8,500 245,850 435,350
Vacation Home Rental 80,500 80,500
Other Revenues (grants, reinspection and plan reviews)1,250 7,100 8,350
Total Revenue 182,250 8,500 333,450 524,200
Expenses
Payroll Expenses 174,143 20,519 403,799 598,461
Program Supplies 3,125 1,650 5,900 10,675
Computer Software 4,126 1,425 7,550 13,101
Total Expenses 181,393 23,594 417,249 622,236
857 -15,094 -83,799 -98,036
FPL License Program - 2022 Year End
FPL License Program - 2023 Year End
FPL License Program - 2024 budget
CHB Environmental Health Financial worksheet - 2022-2024
2024 2023 2022
Program #5470 5680 5685
Revenue
License Fees 181,000 140,513 124,578
Other Revenues (grants, reinspection and plan reviews)1,250 1,700 835
Total Revenue 182,250 142,213 125,413
Expenses
Payroll Expenses 174,143 156,672 146,969
Program Supplies 3,125 12,404 17,060
Computer Software 4,126 2,333 3,109
Total Expenses 181,393 171,409 167,138
857 -29,196 -41,725 2024 CHB Board Presentation
2024 2023 2022
Program #5470 5680 5685
Revenue
License Fees 8,500 13,902 13,347
Other Revenues (grants, reinspection and plan reviews)0 0 0
Total Revenue 8,500 13,902 13,347
Expenses
Payroll Expenses 20,519 21,752 23,423
Program Supplies 1,650 2,920 3,594
Computer Software 1,425 1,163 275
Total Expenses 23,594 25,835 27,291
-15,094 -11,933 -13,944
2024 2023 2022
Program #5470 5680 5685
Revenue
License Fees 245,850 232,875 230,257
Vacation Home Rental 80,500 61,293 0
Other Revenues (grants, reinspection and plan reviews)7,100 875 0
Total Revenue 333,450 295,043 230,257
Expenses
Payroll Expenses 403,799 352,615 493,285
Program Supplies 5,900 845 23,579
Computer Software 7,550 8,213 10,755
Total Expenses 417,249 361,673 527,620
-83,799 -66,630 -297,363
FPL License Program - Clay
FPL License Program - Wilkin
FPL License Program - OTC
CHB Environmental Health Financial worksheet - 2022-2024
P a g e 0 | 10
Prepared by Becky Schmidt
January 2024
REVIEW OF ENVIRONMENTAL
HEALTH SURVEYS FOR FOOD
ESTABLISHMENTS
P a g e 1 | 10
Response Dates: August 2016- March 2018 and May 2018- February 2019 (survey was edited)
Questions from 1st Implementation (Aug 2016-Mar 2018)
1. Did the inspector provide information or discuss employee health and hygiene with employees
or management in the establishment?
2. Did the inspector provide information or discuss food handling with employees or management
in the establishment?
3. Did the inspector provide information or discuss food storage and or date marking with
management in the establishment?
4. Did the inspector provide information or discuss war washing and proper sanitizing with
management in the establishment?
5. Was the inspection process informative and professional?
6. Comments?
7. When did the inspection occur?
8. County?
Questions from 2nd Implementation (May 2018-early 2019):
1. How well did the inspector provide information or discuss employee health and hygiene with
employees or management in the establishment?
2. How well did the inspector provide Information or discuss food handling with employees or
management in the establishment?
3. How well did the inspector provide information or discuss food storage and/or date marking
with management in the establishment?
4. How well did the inspector provide information or discuss ware washing and proper sanitizing
with management in the establishment?
5. How helpful was the inspection process?
6. Comments?
7. When did the inspection occur?
8. County?
Number of Responses:
1st Implementation: 31
2nd Implementation: 7
County of Inspection: Total Number of Responses
Clay 0
Otter Tail 38
Wilkin 0
P a g e 2 | 10
Comments from Operators:
“Very Helpful! Thank you Becky!”
“We are a small resort with no food services so food handling and storage were not relevant. Our
inspector was very helpful with other requirements for the resort. He also pointed out areas for
improving current setup.”
“We appreciate being able to have a professional discussion, non threatening and informative. Every
time Tony or other inspector comes, we gain some useful information, or are reminded of steps we may
have forgotten. Thank you, Pat & Jean Connelly”
“Inspector gave me good information to make things more safe.”
“She was awesome!”
“Very Positive and helpful, easy to work with.”
“Answered all questions that I had about random stuff.”
“Inspector was very helpful and informative. He made suggestions and was easy to talk to without being
intimidating.”
“Tony was very thorough and helpful.”
“She was very friendly and informative. She made the staff feel comfortable during the survey process.”
“Very well done.”
“I appreciated the overall demeanor--it was non-threatening but very helpful. I felt like I could ask
questions without getting myself in trouble.”
“Discussed important and positive improvements in a friendly manner.”
“Helpful reminders RE: safety/employee hygiene & health etc/dates on food.”
“Very nice and Helpful.”
P a g e 3 | 10
Data from 1st Implementation:
P a g e 4 | 10
P a g e 5 | 10
Data from 2nd Implementation:
P a g e 6 | 10
P a g e 7 | 10
P a g e 8 | 10
Key Findings
1st Implementation:
Did the inspector
provide information
or discuss the
following:
Percent of respondents who answered
“yes”
Employee health and
hygiene
87
Food handling 93
Food storage and/or
date marking
87
Ware washing and
proper sanitizing
93
➢ 100% of respondents answered “yes” to the inspection process being informative and
professional.
2nd Implementation:
How well did the inspector provide information
or discuss the following:
% of respondents who answered “very satisfied”
or “very well”
Employee health and hygiene 100
Food handling 100
Food storage and/or date marking 100
Ware washing and proper sanitizing 100
➢ 100% of respondents answered that they were “very satisfied” with how helpful the inspection
process was.
Summary of findings
➢ According to the results of the environmental health surveys, food operators reported that
inspectors provided information or discussed with employees or managers the following (at least
87% of the time): employee health and hygiene, food handling, food storage and/or date
marking, ware washing, and proper sanitizing.
➢ In addition, all operators agreed that they were very satisfied with how well the inspector
provided information or discussed employee health and hygiene, food handling, food storage
and/or date marking, ware washing and proper sanitizing with employees or managers.
P a g e 9 | 10
➢ All operators who took the survey reported that the inspection process was informative and
professional, as well as being “very satisfied” with how helpful the inspection process was for
them.
➢ All open-ended comments provided by operators were positive regarding their experience with
P4H inspectors. The following is a partial list of some of the adjectives used to describe P4H
inspectors: “Helpful, professional, informative, easy to work with, answered all my questions,
easy to talk to without being intimating, thorough, friendly, made the staff feel comfortable, very
nice”.
Recommendations:
➢ Consider including questions that relate to the top 5 highest risks factors contributing to
foodborne illness, so that these responses can line up with data obtained from EH Manager
(employee health, approved source, hygiene/handwashing, protection from contamination,
TCS).
➢ Consider expanding the survey beyond food establishments to include lodging and/or pools to
obtain a more holistic view of EH inspection quality.
o If this approach is taken, you may consider having more broad questions that would apply
to food, pool, and lodging inspections so there isn’t a need to develop 3 different
surveys and avoid confusion from operators that have more than 1 establishment
category.
➢ Ensure the survey is being distributed to operators in all 3 counties, so that data can be obtained
from Clay and Wilkin counties.
➢ If using a Likert scale for questions, consistently use the same word in the response that is asked
in the question.
Example:
Question: How well did the inspector provide information or discuss food handling with
employees or management in the establishment?
Response Choices: Very Dissatisfied, Somewhat Dissatisfied, Neutral, Somewhat Satisfied,
Very Satisfied
Response choices should be: Not well at all, Poorly, Unsure (or neutral), Somewhat well,
Very Well
Alternatively, you could consider re-writing the question to: The inspector provided
valuable information about food storage and/or date marking. The responses could then
be strongly agree, agree, neither agree or disagree, disagree, strongly disagree.
P a g e 10 | 10
➢ Consider adding a response to the Likert questions to include, “the inspector did not provide this
information.” This would be a way to blend the type of data obtained in the 1st implementation (did
the inspector provide___) with the data from the 2nd implementation (how well did the inspector
provide____).
➢ Consider expanding on the “comments” question to “Is there anything else you would like to add or
any other information that may be useful for us to know”?
➢ Consider adding a question that relates to how approachable the inspector was during the
inspection or the ability of the inspector to provide useful education and/or answer questions during
the inspection.
➢ Consider a way to track the number of surveys sent to operators and the period of time they are
sent; having a goal of sending to a determined number of operators could provide valuable data for
quality improvement purposes for the EH program.
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
State Community Health Services
Advisory Committee Meeting Take-Home Notes
Wednesday, December 6, 2023 | 12:00 p.m.- 4:00 p.m.
Hybrid Meeting | In person location: Wilder Center, St. Paul, MN
Action items
Update your local Community Health Board on:
SCHSAC approved 2023 performance measures and 2024 performance-related
accountability reporting requirement. These include:
Community health boards self-report on their ability to meet 24 national measures
from the Public Health Accreditation Board. These will be reported in March 2024 as
part of Local Public Health annual reporting, looking back on calendar year 2023.
Community health boards will demonstrate their ability to meet the following
national measure from the Public Health Accreditation Board: Measure 1.3.3 Use
data to recommend and inform public health actions. Community health boards will
submit a narrative example in March 2025, looking back on calendar year 2024. The
narrative example will be used to assess how well they meet the measure. They will
be asked to discuss and report on internal and external factors impacting the ability
to use data to recommend and inform public health actions.
SCHSAC approved Foundational Public Health Responsibility Funding Workgroup
Recommendations. Among several recommendations is the recommend funding formula:
59.6% to base funding for all CHB ($115,000 per CHB)
24.3% according to the social vulnerability of the CHB
16.2% to CHB serving fewer than 100,000 people
Minnesota Public Health Infrastructure Funds will be available for another round of funding
soon. Watch for details on the application process.
The purpose of these funds is to identify new ways for Minnesota’s public health
system to fulfill foundational public health responsibilities by supporting and
learning from projects that test new delivery models and/or processes that have
the potential to benefit multiple jurisdictions.
Disease Prevention & Control Common Activities Framework is being rewritten and there
will be opportunities for input. SCHSAC will have the opportunity to review and approve the
final version in 2024.
Plan to attend upcoming Meetings:
Optional: Coffee, Conversation & Consideration: Housing and Public Health: January 18,
2024, at 8:00a.m. (tentative). Virtual.
SCHSAC MEETING TAKE-HOME NOTES 12/6/23
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The next SCHSAC meeting is Friday, March 8, 2024, from 10:00 a.m. to 2:30 p.m. This is a
hybrid meeting with the in-person option held at the MDH offices in St. Paul.
Community health boards present
Aitkin-Itasca-Koochiching, Anoka, Benton, City of Bloomington, Brown-Nicollet, Carlton-Cook-Lake-St.
Louis, Carver, Cass, Chisago, Countryside, Dakota, Des Moines Valley, Dodge-Steele, City of Edina,
Faribault and Martin, Fillmore-Houston, Freeborn, Goodhue, Hennepin, Horizon, Isanti, Kanabec,
Kandiyohi-Renville, Le Sueur-Waseca, Meeker McLeod Sibley, Mille Lacs, City of Minneapolis,
Morrison-Todd-Wadena, Mower, Nobles, North Country, Olmsted, Partnership4Health, Pine, Polk-
Norman-Mahnomen, Quin, Rice, City of Richfield, Saint Paul Ramsey, Scott, Sherburne, Southwest,
Stearns, Washington, Watonwan, Winona, Wright.
Approval of consent agenda
Damon Chaplin (City of Minneapolis) moved approval of the consent agenda. Daniel Whitcomb (Mille
Lacs) seconded. Motion carried.
Consent Agenda:
Approval of December 6, 2023, meeting agenda
Appointment of Terry Lovgren (Pine County) to Member Development Workgroup
Legislative session outlook
Lisa Thimjon, Legislative Director, MDH
MDH expects these to be some of the public health hot topics this legislative session:
Bonding and drinking water needs
Cannabis
Workforce challenges
The MDH legislative agenda will focus on:
Protecting community
Protecting drinking water
Strengthening public health
Commissioner’s remarks
Dr. Brooke Cunningham, Commissioner, MDH
Commissioner Cunningham shared that there had been several changes in leadership positions at
MDH. Maria Sarabia joined as Assistant Commissioner of the Health Improvement Bureau. Carol
Backstrom is the new Assistant Commissioner of the Health Systems Bureau and Mel Grescyzk is the
SCHSAC MEETING TAKE-HOME NOTES 12/6/23
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Interim Assistant Commissioner for the Health Operations Bureau. Michelle Larson is serving as the
Interim Deputy Commissioner.
The Commissioner reflected on the historic legislative session, particularly the passage of the child tax
credit, and other important issues that we are facing in public health, including:
Data modernization, using and sharing data
Healthy aging, to support seniors live out their lives with dignity
Mental health
Rural health
Health care systems and workforce – shortage areas, especially hitting rural MN
COVID and other illness
Gun violence and firearm injury, accidental or violence (ex: suicide rates from gun rates are higher
in rural than metro area). Needing to think about trusted local, partners (including law
enforcement and public safety)
Assistant Commissioner Dan Huff joined the Commissioner to give an update:
The Minnesota Center for Environmental Advocacy and 10 other environmental groups petitioned the
U.S. Environmental Protection Agency (EPA) under federal Safe Drinking Water Act to address nitrate
contamination in ground water, related to drinking water in Dodge, Fillmore, Goodhue, Houston and
Mower counties, and Wabasha and Winona cities.
The EPA sent notice to the State of Minnesota to respond to the petition. The state must:
Coordinate and communicate with residents who use private wells.
Immediately provide safe drinking water alternatives for those with impacted wells,
prioritizing vulnerable communities.
Develop a testing plan for all wells.
Work to mitigate wells that are not in compliance.
Identify and reduce sources of nitrate.
Three agencies are working on this: MDH, Department of Agriculture, and Pollution Control Agency
The state must submit a plan to EPA Administrator by 1/15/2024
The state has a partnership with Olmstead County to do outreach about drinking water wells. MDH
will reach out to partners in those areas.
Assistant Commissioner Huff will be leaving MDH to take a position as the Executive Director at the
Metropolitan Mosquito District.
SCHSAC MEETING TAKE-HOME NOTES 12/6/23
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SCHSAC business agenda
Approval of 2023 performance measures and 2024 accountability reporting
requirements
Chera Sevcik (Faribault-Martin) and Ann March, MDH
The full workgroup report was shared in advance of the meeting. Important items include:
Recommendation for 2023 performance measures
Community health boards self-report on their ability to meet 24 national measures from the Public
Health Accreditation Board.
These will be reported in March 2024 as part of Local Public Health annual reporting, looking back
on calendar year 2023.
Recommendation for the 2024 performance-related accountability requirement
Community health boards will demonstrate their ability to meet the following national measure from
the Public Health Accreditation Board:
Measure 1.3.3 Use data to recommend and inform public health actions.
Community health boards will submit a narrative example in March 2025, looking back on calendar
year 2024. The narrative example will be used to assess how well they meet the measure. They will be
asked to discuss and report on internal and external factors impacting the ability to use data to
recommend and inform public health actions.
Motion to approve recommendations of the Workgroup made by Jacquelyn Och (Morrison, Todd,
Wadena). Second by William Groskreutz (Faribault & Martin). Motion carried. Unanimous support.
Approval of Foundational Public Health Responsibility (FPHR) Funding
Workgroup recommendation
De Malterer (LeSueur-Waseca) and Nick Kelley (Bloomington), Workgroup Co-Chairs
The full workgroup report was shared in advance of the meeting. Essential pieces include:
SCHSAC charged this group with developing a formula for distributing these funds to help Minnesota
fulfill foundational public health responsibilities, including a method to address equity and any other
recommendations as needed.
SCHSAC MEETING TAKE-HOME NOTES 12/6/23
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Workgroup’s guiding principles:
Every CHB should get enough to be able to make meaningful progress on FPHRs.
The funding formula should take into account that not everyone has the same opportunity to be
healthy across our state.
The funding formula should help alleviate variation in capacity across our system.
Recommendation for formula
59.6% to base funding for all CHB ($115,000 per CHB)
24.3% according to the social vulnerability of the CHB
16.2% to CHB serving fewer than 100,000 people
Recommendations for implementation
For the purposes of these funds, MDH should use definitions developed for the national
Framework for Foundational Public Health Services
Community health boards should not be allowed to use these funds for community health priorities
until SCHSAC has adopted a set of minimum standards for FPHR implementation.
SCHSAC create a workgroup to establish a set of minimum standards for FPHR implementation and
inform the development of a process by which MDH can determine that foundational public health
responsibilities are fully implemented in any given jurisdiction.
Recommendations for reporting
When developing reporting requirements for these funds, MDH should prioritize information that
helps maintain legislative support for these funds, facilitates connections and ongoing learning
across the state, and demonstrates compliance with statute, with as little reporting burden on
community health boards as possible. See additional detailed recommendations in the final report.
MDH should work with the SCHSAC’s Performance Measure Workgroup to align Local Public Health
Act annual reporting with the Foundational Public Health Responsibilities to monitor improvement
in Minnesota’s ability to implement foundational public health responsibilities.
Several additional recommendations were noted in the workgroup’s full report.
Motion to approve recommendations of the workgroup made by DeAnne Malterer (LeSueur-Waseca).
Second by Nick Kelley (Bloomington). Motion carried. 39 yes, 1 no.
Update on MN Public Health Infrastructure Fund: Round 2
Tarryl Clark (Stearns) and Chelsie Huntley, MDH
During the 2021 Legislative Session – $6 million was awarded annually to build foundational public
health capacity across the state and pilot new organizational models for providing public health.
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Priorities: These funds will support projects within any area or capability in the Foundational Public
Health Responsibility Framework
Length of grant period: for new projects it will be two years, with a two-year option to renew. A
portion of the funding has been set aside to continue projects from the first round that align with
the intended purpose.
Applicants should: collaborate; demonstrate benefit to statewide public health system;
demonstrate buy-in from others on how partner jurisdictions will benefit; describe how proposed
projects will support the vision for a seamless, responsive, publicly supported public health system.
Projects will be selected for funding by a balanced review team of 7-10 people that includes
different types of system partners.
Watch for more information coming out from MDH.
Update on Disease Prevention & Control Common Activities Framework
Erica Keppers (Morrison-Todd-Wadena) Infectious Disease Continuous Improvement Board Co-Chair
The Disease Prevention & Control Common Activities Framework (CAF) is being rewritten to
accomplish three primary goals:
1. More clearly document roles and expectations related to infectious disease work in
Minnesota’s governmental public health system
2. Expand documentation to more fully reflect the infectious disease work being done in
Minnesota’s governmental public health system
3. Align governmental public health’s infectious disease work with FPHR
Current draft is not final. There will be an opportunity for input and feedback soon.
Expect a final version to be brought to SCHSAC for review and approval in 2024.
System transformation outlook for 2024
Tarryl Clark (Stearns), De Malterer (LeSeuer-Waseca)
Shared a high-level overview of what to expect to see happening in system transformation in 2024.
The guiding vision is to have a seamless, responsive, publicly supported public health system that
works closely with the community to ensure health, safe, and vibrant communities.
What’s coming in 2024: how transformation happens
Resources: funding, staffing; and learning from assessment of current state (patchwork)
Power dynamics: shared leadership and decision-making across MDH, LPHA, SCHSAC
Policies and practices: learning about what helps and hinders work; policies, statutes, and
laws; and systems and day-to-day activities
Relationships and ways we communicate: new and innovative ways to do/share work; and
messages that “stick” about role and value of public health
Tribal Public health infrastructure development is happening on a parallel track
SCHSAC MEETING TAKE-HOME NOTES 12/6/23
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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 December 13, 2023
To obtain this information in a different format, call: 651-201-3880.