HomeMy WebLinkAboutCommunity Health Board - 2025.2.21 Supporting Documents Board Packet Supporting Documents - 02/21/2025
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Partnership4Health Community Health Board
2/21/2025
9:00 a.m.-11:30 a.m.
In Person option: Clay County Public Health 715 11th St N Ste 303 Moorhead MN, 565560
Virtual Option: Microsoft Teams
Microsoft Teams Need help? Join the meeting now Meeting ID: 241 217 291 165 Passcode: gy3Dq2J3
Agenda
9:00 Call to Order
♦ Introductions & Establish Quorum
Approval of Agenda– February 21, 2025 (action)
Approval of Consent Agenda (action)
♦ November 22, 2024, Partnership4Health CHB meeting minutes
♦ December 16, 2024, Partnership4Health CHB special meeting minutes 9:05 Financial Update, Brandon Nelson
♦ CHB Budget Resolution {2025.1 amended} (action)
♦ Finance “retreat” March 6th
RSG training workplan & budget discussion
9:20 Community Member per diem & travel allowances, Kathy McKay (action)
9:25 Review of Statutory Authority and Responsibility under MN 145A, Amanda Kumpula 9:30 Local Public Health Association 2025 Legislative Platform and legislative updates, Kathy McKay
9:45 SCHSAC Report, Commissioner Wayne Johnson and Jody Lien
♦ February 6th, 2025 meeting
9:50 Program Highlights & Reports ♦ Statewide Health Improvement Partnership (SHIP) updates, Jason Bergstrand Strategies: Healthy Foods & Active Living
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♦ MDH Response Sustainability Grant (RSG) Report, Kristi Goos ♦ Public Health System Development in Minnesota Report, Maggie Wiertzema 10:40 P4HCHB Governance Changes, Jody Lien 11:00 Other General or County Updates 11:15 Adjourn Next Meeting Date: 5/16/2025 Location: Wilkin County
P4HCHB webpage: https://ottertailcounty.gov/board/community-health-board/
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Partnership4Health Community Health Board
11/22/2024
9:00 a.m.-11:30 a.m.
In Person option: Otter Tail County Government Services Center Otter Tail Lake Room 500 W Fir Ave Fergus Falls, MN 56537
Virtual Option: Microsoft Teams
Attendees:
Board Members Present Local Public Health Staff
☒ Commissioner David Meyer (Becker County) ☒ Amanda Kumpula
☒ Commissioner Frank Gross (Clay County) ☒ Kathy McKay
☒ Commissioner Wayne Johnson (Otter Tail County) ☒ Jody Lien
☒ Commissioner Rick Busko (Wilkin County) ☒ Kristi Goos
☒ Community Member Katie Vasey (Becker County) ☒ Becky Tripp
☒ Community Member Kathy Anderson (Clay County) ☒ Maggie Wiertzema
Alternate Board Member Present ☒ Ashley Wiertzema
☒ David Ebinger (Clay County) ☒ Melissa Duenow
☒ Dan Bucholz (Otter Tail County) ☒ Brandon Nelson
☒ Guests: Lynne Penke Valdes, Jane Neubauer, Kristin Erickson, Erica Keppers, Allie Wells-
Shepard
Minutes
Call to Order
• Establish Quorum
• Approval of Agenda– November 22, 2024 (action)
• Roll Call Vote- Motion to approve made by Commissioner David Meyer, seconded by Commissioner Rick Busko. The motion carried.
• Katie Vasey Community Member recognized with being virtual.
Approval of Consent Agenda (action)
• August 16, 2024, Partnership4Health CHB Meeting Minutes- Motion to approve consent agenda made by Commissioner Wayne Johnson, seconded by Commissioner David Meyer. The motion carried.
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Regional Dental Access Updates, Jane Neubauer, Dental Outreach Coordinator
• Funding: Original grant of $~100,000 from Blue Cross Blue Shield back in 2021. The funds have been renewable and were to expire in 2024, however, with the results we were able to show BCBS has committed to another year of funding through 2025. P4HCHB can spend down funds from prior years of grant funding which will get us into the early parts of 2026.
• Increased access opportunities is more than double in 2024 compared to 2020.
• Becker County Dental Access Project- multiple organizations meeting weekly and as of September 5th, 2024, Appletree Dental added a permanent outreach clinic in Becker County.
• Added mobile sites at multiple school districts
o Added nine new school sites- nearly all of our school districts are being served. o Collaboration with our nonprofit school providers and our schools and counties
• Education in Schools o 5,273 students throughout 17 different school districts with multiple dental providers
o Added dental to school workplans of 17 school districts and 5 have added dental to their wellness policies
Financial Update, Brandon Nelson
• CHB Risk Assessment
o Reviewed the financial risks and mitigations o Managerial risks
o Overall Risks
• CHB Audit o Audit was commenced in May 2024 and the report was made available on September 20, 2024 o The Audit report found that our financials needed to me unmodified.
This means the auditors don’t need to make any adjustments to our balance sheets or incomes statements. o They didn’t identify any Internal material weaknesses or significant deficiencies. All of our financial statements were compliant. o The Federal Program that was audited was the WIC program and that audit was unmodified as well.
o Financial statements findings: there were no matters to be reported o Federal Award findings: there were no matters to be reported
• 2024 Grant Funding Details o 2024 Budget with Expenses through September 2024. o New Grants
Cannabis Substance Use Prevention Grant
• Started November 1, 2024-October 31, 2025
CDC Public Health Infrastructure Grant
• Monies available now until end of 2027
FPHR and Response and Sustainability grant Approve the Financial Report- Motion to approve financial report as presented by Brandon by Commissioner David Meyer, seconded by Commissioner Rick Busko. The motion carried.
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Approve the CHB Budge Resolution {2025.1} (action)- Motion to Approve by Commissioner Rick
Busko, seconded by Commissioner David Meyer. The motion carried.
Community Health Assessment Update, Ashley Wiertzema
• Focus Group Results at total of 35 participants o Conducted 5 focus groups
Becker (Hawley)
Clay (Moorhead)
Wilkin (Breckenridge)
Otter Tail (Pelican Rapids and Parkers Prairie)
o Top 4 Questions asked with the Main Themes of- 1. What brought you here and/or what has motivated you to stay?
o Family, quality of life (cost of living, safety and rural environment) and job. 2. What health related issues are you seeing or experiencing in your community? 3. Out of the issues we discussed above, what do you believe are the 2-3 most important
ones that must be addressed to improve health in your community? o (2 &3) Healthcare access and affordability (dental, physical, mental), transportation, and community engagement/supports. 4. What ideas do you have that could help your community move forward with addressing these health priorities? o Expand public transportation options and hours, increase access to care (physical and mental/behavioral), and provide more community education on services/resources in plain language.
SCHSAC October 9-10, 2024, Retreat Report, Wayne Johnson/Jody Lien
• SCHSAC Updates
• Commissioner Wayne Johnson shared his observations from a presentation by Dr. Brian Castrucci from the de Beaumont Foundation. Some highlights from Dr. Castrucci's talk
included: - The importance of partnerships between elected officials and public health
organizations. - Effective public health messaging and communication. - Building trust and partnerships within communities.
He emphasized that trust in public health is developed by consistently engaging with communities and building relationships during times of stability, not just during crises.
Otter Tail County CHB Assessment Update, Wayne Johnson/Jody Lien
• Otter Tail County held work sessions to assess the Community Health Board o Jody Lien went over a PowerPoint that presented the Information around the work sessions
• Session 1- Invited members of MDH o Roles of a Community Health Board
o Orientation for Commissioners/Board
• Session 2
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o History of P4H o Review of governance documents and bylaws
• Session 3 o Public Health Framework o P4H Directors SWOT
o Impacts of staffing, founding, workflow
• Session 4 o Reviewed governance board structure options o Opportunities/efficiencies of proposed structures o Determined next steps
Jody Lien explained that the Otter Tail County Board of Commissioners was seeking commitment to change from P4H CHB rooted in the directors' SWOT analysis from April with implementation of these changes in 2025. Key focus areas include improving decision-making processes, enhancing shared services and charter agreements, reviewing the Co-CHS Administrator role, and increasing transparency in finance and grant reporting. At the director level, it was previously discussed the need to review and update the Joint Powers Agreement and bylaws, advance cross-jurisdiction shared services charters, explore CHS Administrator models in other Community Health Boards, and enhance financial and grant reporting.
Otter Tail County recommended improving clarity around decision-making authority and processes at both the director and Joint Powers Board levels. This includes establishing clear
action steps for meetings, defining the role of the CHS Administrator, determining the frequency of financial reports, and ensuring greater transparency regarding finances.
Wayne Johnson explained that assessments have been conducted in Otter Tail across five different departments and operations within the County. This systematic process allows Otter Tail County to ensure it operates as efficiently as possible while being responsible with taxpayer dollars. The Otter Tail County Board feels that the Co-Administrator role is not functioning effectively. It has become difficult to determine the hierarchy and responsibilities among the staff. The by-laws need to be reviewed and updated to provide clarity on everyone's duties. Financial reporting has been a significant frustration. The Otter Tail County Board is currently discussing whether the current CHB partnership is the right fit. If no changes are made and no one is willing to commit to these necessary adjustments, then Otter Tail County will have a decision to make.
Commissioner Rick Busko commented that when he first joined the board, he noticed that the budget report needed to be more detailed to better understand how funds are being spent.
A discussion was held regarding the budget presentations to the Community Health Board (CHB).
Commissioner David Ebinger inquired about the Co-Administrator roles, asking what the concerns are and if they could be resolved. Lynne Penke-Valdes, Deputy Administrator from Otter Tail County, asked Kristin Erickson from the Minnesota Department of Health (MDH), where this board fits among others and what the best practices are.
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Kristen Erickson noted that this is the only CHB in the state with Co-Administrator roles. It was suggested the current bylaws do not indicate the presence of two administrators and should be
reviewed. Further discussion took place regarding the Co-CHS Administrators. No action was taken and no recommendation made.
Appointment of Authorized Agents, Kathy McKay (action)
• Authorized Agents Resolution {2025.2}
o CHS- Administrator
Jody Lien
o Fiscal Agent
Kathy McKay o SCHSAC
Representative: Wayne Johnson
Alternate David Meyer Motion to approve authorized agents by Commissioner David Meyer, seconded by
Commissioner Wayne Johnsson. The motion carried.
2025 At Large Community Member, Becky Tripp (action)
• Wilkin County presented Dave Sailor- retired Social Services Director in Wilkin County for 38 years. Motion to approve community representative by Commissioner Rick Busko, seconded by Commissioner Wayne Johnson. The motion carried.
2025 Officers, Administrative & Program Management, Jody Lien (action) Officers
• Chair Wayne Johnson motioned for Commissioner Dave Ebinger to serve as Board Chair, seconded by Commissioner Frank Gross. The motion carried.
• Co-Chair Rick Busko motioned for Commissioner Wayne Johnson to serve as Board Vice Chair,
seconded by Commissioner Frank Gross. The motion carried.
• Executive Secretary
Executive Secretary roll will continue to be staffed by Otter Tail County Public Health.
Annual By-Laws Review, Jody Lien
• Article II o Section 2 " made by January 31 of each year" to o “the first meeting of each year.”
• Article III o Section 1 From "at the last meeting of the calendar year" to “at the annual
meeting.”
• Article VI
o Section 1,2,3,4 From "prior to December 31st“ to "at the annual meeting” From
"set forth in a separate document" to “set forth in appendix A”
• Article VIII o Section 2 Review CHB determination "administrative fee"
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2025 P4H CHB meeting dates, Kathy McKay
• Feb 21, 2025, Clay
• May 16, 2025, Wilkin
• August 15, 2025, Becker
• November 21, 2025, Otter Tail
Other General Updates & Discussion
• Updated P4HCHB webpage to house all documents P4HCHB webpage
Adjourn Meeting Adjourned at 11:35 by Chair Frank Gross Next Meeting Date: 2/21/2025 Location: Clay County
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Partnership4Health Community Health Board
12/16/2024
2:00 p.m.-3:00 p.m.
Dead Lake Room Otter Tail County Government Services Center
Minutes
2:00 Call to Order by Commissioner Frank Gross at 2:01 pm
♦ Establish Quorum
♦ Board Present by Roll Call Vote
o Commissioner David Meyer (Becker County)
o Community Member Katie Vassey (Becker County) o Commissioner Frank
Gross (Clay County) o Community Member Kathy Anderson (Clay County)
o Commissioner Wayne Johnson (Otter Tail County) o Commissioner Rick Busko (Wilkin County)
♦ Alternate Board Member Present
o Commissioner David Ebinger (Clay County) o Commissioner Dan Bucholz (Otter Tail County)
♦ County Leadership
o Amanda Kumpula
o Kathy McKay
o Jody Lien o Kristi Goos o Becky Tripp
o Maggie Wiertzema o Melissa Duenow (Board Secretary)
o Brandon Nelson (Financial)
♦ Guests o Erica Keppers (MDH) o Kristen Erickson (MDH)
o Deeann Finley (MDH) o Lynne Penke Valdes
o Denise Warren (Becker County) o Lori Larson (Clay County)
o Kent Severson (Clay County)
♦ Approval of Agenda
o Motion to Approve the Agenda as Presented by Commissioner David Meyer, seconded by Commissioner Wayne Johnson. The motion carried.
Membership of Partnership4Health Community Health Board Commissioner Wayne Johnson announced that the Otter Tail County Board of Commissioners has decided to send a letter of withdrawal from the Partnership4Health Community Health Board to the Minnesota Department of Health (MDH) and to Partnership4Health. The primary reasons for this decision are based on an assessment conducted by Otter Tail County, which identified both strengths and challenges. This assessment included four work sessions.
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Chair Frank Gross raised the question of whether the Otter Tail County Board has approved this withdrawal. Commissioner Wayne Johnson confirmed that there is a resolution on the agenda for the Board of Commissioners Meeting scheduled for December 17, 2024, and it is expected to be passed by
all board members. Commissioner Johnson further explained that this notification initiates a one-year transition period, allowing the county a year to unwind from their ongoing collaborative work. The Otter Tail County board believes that this is the right decision for moving forward to effectively deliver services to county residents. Commissioner Wayne Johnson opened to questions. Deeann Finely from MDH clarified that any county choosing to withdraw from a Community Health Board must notify the Commissioner one calendar year before the start of a new Community Health Board. If Otter Tail County submits notification by the end of this calendar year, they will work collaboratively with both parties—Otter Tail County and others—on the transition. The new Community Health Boards would commence on January 1, 2026. Throughout the upcoming year, three processes
will take place: a new Community Health Board will be formed, the remaining Community Health Board will address necessary actions, and the current Community Health Board will operate as usual in 2025. A significant aspect of this transition relates to grants and financial allocation.
Chair Frank Gross then inquired if a specific reason is required for withdrawal. Deeann Finely answered that no reason is needed unless stipulated in the bylaws. Jody Lien from Otter Tail discussed the Joint Powers Agreement, which includes a withdrawal clause stating that no withdrawal can occur until five years after joining, a threshold they have now surpassed after ten years as a Community Health Board. Notification must also be provided to each county, including each County Chair and Auditor, as well as the Partnership4Health Community Health Board (P4HCHB). Otter Tail County will prepare the necessary documentation for this process. Chair Frank Gross opened the floor for any final questions or comments.
Commissioner David Meyer discussed the financial contribution from Clay County to the Community Health Board, emphasizing the need for an increase as the current funding of 0.33 FTE is not feasible.
Kathy McKay, Clay County Public Health Director, mentioned that Brandon is on board with this plan and can increase his time commitment to the Community Health Board. Commissioner Meyer is seeking a resolution on this issue by the February meeting.
The meeting was adjourned at 2:15 by Chair Frank Gross. Next Meeting Date: 2/21/2025 Location: Clay County
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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 complete statute
language can be found 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.
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 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.
SUMMARY OF THE MINNESOTA LOCAL PUBILC HEALTH ACT
2
▪ May acquire property, accept gifts and grants or subsidies, and establish and collect reasonable
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
SUMMARY OF THE MINNESOTA LOCAL PUBILC HEALTH ACT
3
145A.131 Local Public Health Grant
▪ Funding formula based on level of funding from 2003.
▪ Funding for foundational public health responsibilities must be distributed though a formula
determined by the commissioner in consultation with SCHSAC.
▪ Must provide at least a 75 percent match for the state funds received through the local public
health act grant and the foundational public health responsibilities funds. 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 145A.03 and 145A.04
▪ Must comply with accountability requirements outlined each year.
▪ If CHB does not accept LPH grant, the commissioner may retain the funds.
▪ May use their base of 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.
▪ Must use funding for foundational public health responsibilities to fulfill foundational public health
responsibilities. If a community health board can demonstrate foundational public health
responsibilities are fulfilled, they may use funds for local priorities.
145A.135 Local and Tribal Public Health Emergency Preparedness and Response Grant
Program
This section establishes a local and Tribal public health emergency preparedness and response grant
program.
▪ Funds must be distributed to CHBs and Tribal public health departments.
▪ Grant activities must align with CDC Public Health Emergency Preparedness and Response
Capabilities.
▪ Grantees must report to MDH on how the funds were spent.
▪ MDH must submit a report to the legislature on how the funds were spent.
145A.14 Special Grants
This section addresses the requirements of migrant health grants, Indian health grants, and funding to
tribal governments.
145a.145 Nurse-Family Partnership Programs
This section establishes expansion grants to community health boards and tribal nations to expand
existing nurse-family partnership programs.
145A.17 Family Home Visiting Programs
This section establishes a program to fund family home visiting program.
Minnesota Department of Health
Community Health Division
651-201-3880
health.ophp@state.mn.us
www.health.state.mn.us
8/24
To obtain this information in a different format, call: 651-201-3880.
2025 Legislative
Action Priorities
Supporting Minnesota’s Local Public Health System
LPHA supports continued investment to support local and Tribal public health foundational responsibilities.
Foundational public health responsibilities need to be available in local and Tribal health departments across the state
so the public health system can work as a whole. A recent assessment of Minnesota’s state and local public health
system revealed that the capacity of our system varies widely across the state and significant additional investment is
needed to ensure that all Minnesotans have access to good quality public health services, regardless of where they
live. Local health departments should have a foundation of organizational competencies such as assessment and
surveillance of health threats, data analysis, infectious disease prevention and control, communications, and
development of community partnerships. Currently, Minnesota’s local health departments are experiencing significant
challenges related to addressing increasing infectious disease outbreaks. Minnesota statute charges the state and
local health departments with responsibility for controlling and preventing the spread of communicable diseases.
Limited funding resources coupled with continually emerging novel outbreaks and ongoing response to tuberculosis,
measles, HIV, syphilis, and MPox strain the ability of local health departments to maintain community protection.
Further, the share of community health boards reporting mental health as a priority health issue in their Community
Health Improvement Plans increased from 2015 (77%) to 2020 (96%). Addressing mental health challenges will continue
to be a priority and local health departments need capacity to work with their community to address these challenges.
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 previous investment in local
public health and supports further investment of $21 million per year to continue to strengthen our public health system.
Restoring Funding for Local Public Health Departments Cannabis Education and Prevention
LPHA supports restoration of $3.6 million in cannabis and substance use prevention funds that were reallocated to other
programs during the last legislative session.
In the 2023 legislative session, local and Tribal health departments were allocated $10 million per year to focus on
cannabis education and youth prevention. During the 2024 session, $3.6 million of those funds allocated for local public
health were reallocated to other programs. Local public health departments are already receiving and responding to
cannabis and other substance misuse related educational and technical assistance requests from their communities and
will play a key role in education and outreach as adult-use cannabis legalization continues to move forward. Investing in
prevention through public health ensures that education is provided on safe use of substances and helps prevent young
people from ever beginning use.
Responding to Public Health Workforce Shortages
LPHA supports policy changes that enable local health departments to fill open positions and retain current employees.
The 2021 Public Health Workforce Interests and Needs Survey revealed that nearly one-third of state and local public
health employees said they are considering leaving their organization in the next year and 44% said they are considering
leaving within the next five years. A recent UMN study revealed that nearly half of all employees in state and local
governmental public health agencies across the U.S. left their jobs between 2017 and 2021. 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. Further, LPHA
supports policy and funding changes to expand the role of Community Health Workers and Community Paramedics.
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.
LPHA is a voluntary, non-profit organization that works to achieve a strong 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
250 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
2025 Federal
Action Priorities
Investing in and Strengthening Minnesota’s Local Public Health System
A significant increase in funding for Minnesota’s local public health foundational responsibilities is crucial for responding
to current and emerging health threats. Investing in prevention and local public health pays off by saving health care
and other public program costs, such as those from corrections and child protection.
Responding to Public Health Workforce Shortages
Initiatives are needed to recruit and retain a robust public health workforce. A significant investment in the public health
workforce, focused on retention of the current workforce and bringing in new skilled workers, is necessary to provide
crucial public health services into the future. LPHA is grateful for the inclusion of the Public Health Workforce Loan
Repayment Program in the Consolidated Appropriations Act of 2023 and supports funding to begin implementation.
Supporting Timely and Secure Data Sharing
Local public health faces challenges in accessing timely data. Infrastructure must be created to enable sharing of data
between systems, health care providers, and within different levels of government. Increasing secure access to data
builds in efficiencies and helps identify health threats early to best use limited resources.
Improving Maternal, Child and Family Health Outcomes
LPHA supports legislation that authorizes the use of televisits for clients in Women, Infant and Child (WIC) programming.
During COVID-19, waivers were put in place to allow visits to happen via phone or video, which enabled local public
health to reach more clients in need, increase efficiency and reduce barriers for clients. LPHA also supports direct funding
to local health departments to expand family health programs and enhance home visiting to improve health and
development outcomes for at-risk children in Minnesota.
Strengthening Public Health Emergency Preparedness (PHEP) and Response Capacity
Responding to disasters and emergencies is a core responsibility of Minnesota’s local public health departments. Past
proposals to redistribute PHEP funds and a series of funding cuts compromised local public health’s ability to respond to
emergency events. Adequate, sustained funding is necessary to build emergency preparedness and recovery capacity.
Addressing Social Determinants of Health
Local public health plays an important role in addressing social determinants of health that have a direct link to poor
health outcomes. LPHA supports policy and funding to ensure all Minnesotans have access to health. Local public health
will continue to serve a leading role in addressing community needs such as higher rates of addiction, housing
challenges, food insecurity, violence, and mental health.
Mitigating Impacts of Extreme Weather Events
LPHA supports policy, funding, data collection, risk identification, and planning activities related to extreme weather
events and changing climate patterns in partnership with local health departments, including shifting vectors, impacts to
water systems, extreme precipitation and heat events, and food production and security.
Acting on Increased Rates of Infectious Disease
Limited funding resources coupled with continually emerging novel outbreaks and ongoing response to tuberculosis,
measles, HIV, syphilis, and MPox strain the ability of local health departments to maintain community protection.
According to the Minnesota Department of Health, in 2019, 69.2% of Minnesota’s 2-year-old children were up to date on
their immunizations, but by 2023, that rate had decreased to 63% not up to date. As a result of decreased immunization
rates, we are experiencing increased outbreaks including Measles and Pertussis.
Ensuring Access to Healthcare for Incarcerated Individuals
Incarcerated individuals have diverse and significant health needs, such as chemical use disorders and mental health
diagnoses. LPHA supports current legislative efforts to restore Medicaid and other federal benefits for incarcerated
individuals during periods of pre-trial incarceration and 30-days prior to release from prison or jail.
Meeting Notes: State Community Health Services Advisory Committee (SCHSAC)
February 6, 2025 | 10:00 a.m. to 2:30 p.m. | Hybrid
Action items
• Share the “Public Health System Development in Minnesota” report. The full report can be
found online here: Public Health System Development in Minnesota: A Report to the Minnesota
Legislature from the Joint Leadership Team for Public Health System Transformation
o Use the Report Summary provided to help develop your story and talking points to
share with community members, elected officials and others.
• Sign up for the Mentorship Program is open until Feb. 20. The program will begin in April. The
application can be found here: https://forms.office.com/g/zXtavM23Nn
• Upcoming meetings and events:
o The next SCHSAC Meeting will be June 12, 2025. 10 a.m. to 2:30 p.m. Hybrid. In person
location will be at the Wilder Foundation in St. Paul.
o New Member Orientation will be April 2 at 9 a.m. This is designed for new members and
alternates, but it is open to anyone involved with SCHSAC who might like a refresher.
RSVP by March 30 ( https://forms.office.com/g/YRD9WMpeVZ )
o Upcoming optional CCC: Coffee Conversation & Consideration events! These are
optional learning events open to the SCHSAC network.
Feb. 20, 2025. 8 a.m. Topic: What is the Social Vulnerability Index?
April 10, 2025. 8 a.m. Topic: Drinking water and public health.
Community health boards in attendance:
Aitkin-Itasca-Koochiching, Anoka, Beltrami, Benton, Bloomington, Blue Earth, Brown, Carlton-Cook-
Lake-St. Louis, 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,
Nicollet, Nobles, North Country, Olmsted, Partnership4Health, Pine, Polk-Norman-Mahnomen, Quin,
SCHSAC MEETING NOTES FEBRUARY 6, 2025
2
Rice, Richfield ,Saint Paul-Ramsey, Scott, Sherburne, Southwest Health and Human Services, Stearns,
Wabasha, Washington, Watonwan, Winona, Wright.
Welcome, call to order, approval of consent agenda
DeAnne Malterer (LeSueur-Waseca), SCHSAC Chair, called the meeting to order. The Tribal-State
Relations Acknowledgement was read. Marcia Ward (Winona) moved approval of the Consent Agenda.
Steven Heinen (Benton) seconded. The motion passed.
Consent agenda:
▪ Approval of Feb. 6, 2025, amended meeting agenda
▪ Approval of Dec. 12, 2024, amended meeting notes (SCHSAC Meeting Notes Dec. 12, 2024)
Chair’s Remarks
DeAnne Malterer, SCHSAC Chair welcomed everyone and acknowledged the many partnerships that
exist in the room. She encouraged everyone to remember where they were five years ago in February
2020 and how many challenges had been overcome and how many lessons have been learned,
including the lesson that we are stronger together.
Commissioner’s remarks and MDH update
Dr. Brooke Cunningham, Commissioner, Minnesota Department of Health (MDH) thanked everyone for
their interest, engagement and energy. Some of the key points from her remarks:
• 50% of MDH is federally funded and 36% of local public health departments on average are
federally funded. We know that there are many questions and concerns about the potential
impacts that federal government actions will have on funding. MDH is with you in sharing those
questions and concerns.
• Unfortunately, we don’t have additional information to what has been publicly reported. We
feel it is very important we share with you only what is certain and true and to not add to the
swirl by communicating without clear information.
• We will continue to work collaboratively with you as our partners to understand how these
actions may impact programs and services in Minnesota. For now, the best thing we can do is
to keep working and not be deterred.
• The Commissioner addressed questions related to water quality, diversity, equity, and inclusion
(DEI) efforts, and H5N1.
Legislative session update
SCHSAC MEETING NOTES FEBRUARY 6, 2025
3
Autumn Baum, Assistant Legislative Director, MDH, shared a brief update of the current status of the
legislative session. The Minnesota Senate and House are both currently undergoing shifts in leadership
and working through power-sharing agreements due to closely tied partisan numbers.
Key points from her presentation include:
• The Governor’s budget proposal does not include any cuts to the MDH budget.
• 2025 MDH budget proposals
o $1.3 million per year for MDH to sustain current infectious disease prevention and
control activities. The proposed activities have been largely federally funded in the past,
those funds have been reduced to the point that the programs cannot be sustained
without additional state investment. There is increased need for the work as Minnesota
is experiencing a significant increase in cases of disease and a significant demographic
transformation.
o Operations adjustment for MDH to help cover expected growth in employee
compensation and insurance and other operating costs.
o Fee proposals that would generate revenue to address cost pressures that impact
services being delivered to Minnesotans. Many are fees that have not been changed in
more than a decade. Areas included are:
Food, pools, and lodging; radioactive materials; X-ray; asbestos; public water
supply; and well management fees
Assisted living and health care facilities licensure fees
Health maintenance organization (HMO) fees
o Restoring funding to local public health for the cannabis and substance misuse
prevention grants ($2.5 million per year).
o Clean Water Fund proposals that would protect, enhance and restore water quality in
lakes, rivers, and streams and protect groundwater from degradation.
Public health system legislative report overview
DeAnne Malterer, SCHSAC Chair; Amy Westbrook, Local Public Health Association (LPHA) Chair; and
Chelsie Huntley, Division Director MDH, presented an overview of the “Public Health System
Development in Minnesota” report. The full report can be found online here: Public Health System
Development in Minnesota: A Report to the Minnesota Legislature from the Joint Leadership Team for
Public Health System Transformation
Key points from the presentation:
SCHSAC MEETING NOTES FEBRUARY 6, 2025
4
• There is nothing public health can’t positively impact. For entire populations, public health
diagnoses, cooperates, and prevents.
• Minnesota’s governmental public health system is outdated; a lot has changed in 50 years.
• We need to keep investing in a new approach to public health to achieve our vision of a public
health system that…
o is seamless, responsive, and publicly-supported;
o works closely with the community;
o ensures healthy, safe, and vibrant communities; and
o helps Minnesotans be healthy no matter where they live.
• Our transformation work is grounded in shared leadership between local health directors
(LPHA), state health officials (MDH), and locally-elected community health board officials
(SCHSAC).
• Our public health system has strengths and challenges:
o Minnesota’s public health system is locally driven, but also fragmented
o Our partnership is timeless, but our approach is outdated
o Governmental public health is small but mighty – and needs more capacity for
foundational work
o Deep, broad expertise and experience cannot overcome chronic underfunding
• A new path forward (visit pp. 23-29 of the full report) is necessary.
o Recent investments in public health from the legislature have been a much needed
down payment, but a long term investment is needed
o We need 21st century public health tools
o This is a 21st century public health practice
o We must invest in local innovation
o Continue to partner and cooperate as a jointly-led, cross-jurisdictional team
• Consult the report or the document “Summary: Public Health System Development in
Minnesota” for full explanation and talking points
Regional caucuses
Regional caucuses were held for each region. Each region selected a Member and Alternate to
represent them on the Executive Committee for the 2025-26 term. Those selected were:
Region Member and Community Health
Board
Alternate and Community Health
Board
Northwest Joan Lee, Polk-Norman-Mahnomen Bonnie Engen, North Country
SCHSAC MEETING NOTES FEBRUARY 6, 2025
5
Northeast Lester Kachinske, Aitkin-Itasca-
Koochiching
Shelley Fredrickson, Carlton-Cook-Lake-
St. Louis
West Central Gordon (Gordy) Wagner, Horizon David Meyer, Partnership4Health
Central Steve Heinen, Benton Jeanne Holland, Wright
Metro Mandy Meisner, Anoka Michelle Clasen, Washington
Southwest Steve Gardner, Kandiyohi-Renville Phil Nasby, Des Moines Valley HHS
South Central William Groskreutz, Faribault-Martin Beth Oberg, Meeker-McLeod-Sibley
Southeast Mitchell Lentz, Fillmore-Houston Cindy Wright, Fillmore-Houston
Report back from the regions
DeAnne Malterer, SCHSAC Chair lead the Regions through a brief report back on their discussions
about how Foundational Public Health Responsibility (FPHR) funding is being used in their region.
South Central: Bill Groskreutz (Faribault-Martin) reported that CHBs were working on reaccreditation,
developing communication programs and improving performance management. One CHB is making
changes in an advisory team to be more inclusive of other areas of the community including health
care, retired people and youth, another is expanding partnerships.
Southwest: Sarah Benson (Renville) reported that Commissioners have supported public health to hire
staff. All CHBs have been able to use their FPHR funds to expand capacity to hire more staff in
communications, strategy planning, and data.
Central: Steve Heinen (Benton) reported that there was a lot of work happening around
communications and data. Almost every CHB in the region was able to add new staff. There is work
going on with strategic planning and emergency management and preparedness.
Southeast: Mitch Lentz (Fillmore-Houston) reported that funding is being used overwhelmingly for
data and foundational competencies.
Metro: Lisa Brodsky (Scott) reported that there had been an increase in mandated services that led to
questions about what services were acceptable uses of funds. Communities are completing Community
Health Assessments and need resources to address the challenges identified by the community.
SCHSAC MEETING NOTES FEBRUARY 6, 2025
6
Northwest: Joan Lee (Polk-Norman-Mahnomen) reported that there was work going on around
communications and strategic planning. There were some adjustments being made where funds had to
be used to fill unexpected gaps rather than big new plans. The funding has helped with collaboration
and allowed for new hiring, but there are some constraints due to lack of workforce.
West Central: Wayne Johnson (Partnership4Health) reported that funds had been used to fund
additional positions. This allowed more staff support on grant reporting and disease prevention and
control. There is also work going on around planning.
Northeast: Amy Westbrook (St. Louis) reported that staff capacity through added positions and
contract positions allowed more work to happen in assessment planning, communications, and data
analytics. The funding has allowed CHBs to increase collaboration and has been helpful in allowing
them to do really in-depth legwork needed for things like strategic planning, workforce development,
communication campaigns, and more.
Several regions mentioned the importance of ongoing work with tribal public health partners.
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 February 11, 2025
To obtain this information in a different format, call: 651-201-3880.
2024 In Review: West Central Food Council
Milestones & Accomplishments
Meeting Attendance
Summary Statistics:
n = 12
range = 10 - 16
mean = 13
median = 13
mode = 11
13 13 15 16 14 11 12 11 16 10 11 14JANFEB MARAPRMAYJUNJULAUGSEPOCT NOVDECBY MONTH
Relationship Building/Networking
• Lakewood Presentation/Meeting
• Detroit Lakes Boys and Girls Hydroponics
Tour, March 15, 2024
• April 18 Food Bank Meeting (Great Plains,
Second Harvest)
• Food Security Subcommittee Survey
• Farm Buds Relationship Established
• In-person council meeting at Thousand Lakes
Brewing, August 16th
Community Engagement/Outreach
• Parkers Prairie Farmers Market (including February 21 Community Meeting)
• Deep Roots Festival community table, Saturday September 14
• Subcommittee One-Pagers
• Caliton’s Farm Tour
• Food Forest Event, MB Johnson Park in Moorhead, September 9 (featuring
Caliton’s lecture/demonstration and free samples of his famous East African
Eggplant)
In The Queue
• Urban Agriculture Subcommittee Educational
Events in Process for March 2025
• Food Insecurity Food Guide in Process (99%
Done)
• Food Council Website
Guest Speakers & Topics at Council Meetings
• January 2024: Amy Wiese, Lakewood Health Care - Food Security
• March 2024 (Marketing Subcommittee): Ryan Pesch, U of M Extension
- Marketing
• April 2024: April Rog, Cedar Walters – WCI Climate Action Plan
• April 2024: (Food Security Subcommittee) Great Plains, Second Har-
vest – Food Banks
• June 2024 (Marketing Subcommittee): Ariel Pressman, Whole Farm
Strategies - Marketing
• July 2024: Ariel Kagan, MinneAg – Intro to MinneAg
• September 2024: Matt Barthelemy, Farm Buds – Farm Tour and Volun-
teer Program
• October 2024: Theresa McCormick, The Good Acre – Twin Cities
Area Food Hub; Marketing Subcommittee: Arlene Jones, Sprout –
Food Hub
• November 2024: Mike Zastoupil, MDA – State and Federal Funding
Opportunities
What We Applaud & Want To See
More Of
• Parkers Prairie Community Garden
• Parkers Prairie City Hall Compost
• Health and Hunger Summit, Fargo
• Support from 2 interns
Grant Received: $71,330
• Earth Rising ($11,000)
• MPCA Local Climate Action ($35,330)
• Joy & Healing ($25,000)
Newsletter Subscribers: 230
Council Members1:
• Cecilia Tenant Amadou
• Laurie Drewlow
• Ed Gehrke
• Meghan Jahnke
• Anna Johnson
• Caliton Ntahompagaze
• Luybov Slashcheva
• Harold Stanislawski
• Ron Roller
• Julie Rosenberg
• Scott Roser
Advisory Team Members:
• Jason Bergstrand
• Patrick Hollister
• Emily Reno
• Luke Preusller
• Kate Mudge
1 Listed in alphabetical order
T he Minnesota Department of Health’s
Statewide Health Improvement Partnership
(SHIP) and PartnerSHIP 4 Health are helping
to make Becker, Clay, Otter Tail, and Wilkin
Counties more bicycle and pedestrian friendly.
The Statewide Health Improvement Partnership
(SHIP) supports community-driven solutions to expand
opportunities for active living, healthy eating, and
commercial tobacco-free living.
PartnerSHIP 4 Health is a collaboration of community
and public health partners in Becker, Clay, Otter Tail
and Wilkin counties working to prevent chronic disease
through sustainable changes that increase physical
activity and healthy eating and reduce tobacco use and
exposure.
Since 2010, PartnerSHIP 4 Health has been involved in
numerous bicycle, pedestrian, and/or trail studies that
have resulted in great infrastructure projects that make
our communities better places to bike and walk.
BIKE & PEDESTRIAN PROJECTS
BARNESVILLE
PartnerSHIP 4 Health approached the City of Barnesville
in 2018 about MnDOT’s scheduled reconstruction of
Highway 9 through town. PartnerSHIP 4 Health hired a
consultant to work with the city to create a concept plan
for improved sidewalks, safer crossings, and a multi-use
path along the east side of Highway 9. Construction took
place in 2023.
“Minnesota State Highway reconstruction projects can
be overwhelming for small communities. Because these
projects only occur every 50 years it’s almost a once-in-a-
lifetime chance to do things right. The City of Barnesville
was very fortunate to have the guidance and assistance of
PartnerSHIP 4 Health as we planned the project amenities.
Their past knowledge of working with other communities was
invaluable. Today, Barnesville residents and visitors enjoy the
beautiful multi-purpose path which was constructed as part
of the project. It is used year-round for walking dogs, biking,
running, pushing strollers and more. We are both proud
and pleased with the final project.” ~Karen Lauer, Executive
Director, Barnesville EDA
BATTLE LAKE
MnDOT was originally planning a mere resurfacing
of Highway 78 in Battle Lake in 2013, but in 2011, at
the request of an area resident, PartnerSHIP 4 Health
encouraged MnDOT to upgrade the resurfacing into a
full reconstruction and Complete Streets project that has
transformed Battle Lake. The new downtown has wider
sidewalks and traffic calming features to make Highway 78
safer and easier to cross.
BRECKENRIDGE
The City of Breckenridge had long wanted a trail along
Highway 75 from downtown to Saint Francis Healthcare.
PartnerSHIP 4 Health provided funding to the city in
2011 to hire a consultant to work with the city to create
a concept plan for the trail. Breckenridge then used the
study as a basis for a successful Transportation Alternatives
grant application. The Breckenridge Active Living
Committee then underwent an impressive grassroots
funding campaign to meet the local match requirement
for the grant.
Clay
Becker
Wilkin Otter Tail
Detroit Lakes
Barnsville
Breckenridge
Perham
Pelican Rapids
Battle Lake
Parkers Prairie
Frazee
“PartnerSHIP 4 Health was instrumental in getting our multi
use trail project implemented. That trail is now a foundation
that our community is hoping to build and expand upon. The
Breckenridge community couldn’t be more pleased with the
relationship we have built with PartnerSHIP 4 Health staff,
and we look forward to continuing to foster that relationship
into the future.” ~Neil Crocker, Director of Public Services,
Breckenridge
DETROIT LAKES
Becker County approached PartnerSHIP 4 Health in 2021
about their scheduled reconstruction of West Lake Drive
which was intended for an extension of the Heartland Trail.
PartnerSHIP 4 Health provided funding to Becker County
to hire a consultant to work with the County and the City
to create a concept plan for a multi-use path.
Becker County approached PartnerSHIP 4 Health in 2018
for help in fulfilling the requirements of a grant they had
received from the DNR. PartnerSHIP 4 Health provided
funding to Becker County to hire a consultant to do the
engineering design for a short but critical segment of
the Heartland Trail from County Road 54 to a box culvert
under Highway 10.
FRAZEE
PartnerSHIP 4 Health approached the City of Frazee
in 2016 about MnDOT’s scheduled reconstruction of
Highway 87 through town. PartnerSHIP 4 Health provided
funding for Frazee to hire a consultant to work with the
city to create a concept plan for a bike and pedestrian trail
along the west side of Highway 87. Construction took
place in 2022. PartnerSHIP 4 Health is now helping Frazee
redesign their Main Avenue for improved pedestrian safety
and accessibility.
“The shared use path is a great amenity for our City, allowing
residents and visitors of all abilities to safely access key point
around town, including our businesses, school, parks, and
public beach. We greatly appreciate the efforts of PartnerSHIP
4 Health to help make this project a reality.” ~Mike Sharp,
Mayor, Frazee
PARKERS PRAIRIE
PartnerSHIP 4 Health approached the City of Parkers
Prairie in 2013 about MnDOT’s scheduled reconstruction
of Highway 29 through downtown. PartnerSHIP 4 Health
hired consultants to work with the city to create a concept
plan for improved sidewalks and safer crossings. Later
PartnerSHIP 4 Health participated in the streetscape
design process to integrate an aesthetic pattern into the
new sidewalks along with surface-level planters.
PELICAN RAPIDS
PartnerSHIP 4 Health approached the City of Pelican
Rapids in 2019 about MnDOT’s scheduled reconstruction
of Highways 59 and 108 through downtown. PartnerSHIP
4 Health hired a consultant to work with the city to create
a concept plan for improved sidewalks and safer crossings.
Later PartnerSHIP 4 Health participated in the streetscape
design process to integrate street trees and other
amenities. Construction started in 2024 and will conclude
in 2025.
PERHAM
Otter Tail County approached PartnerSHIP 4 Health in
2014 about contributing financially and participating in
a corridor study for a trail from Perham to Pelican Rapids.
PartnerSHIP 4 Health contributed funding along with the
County and the two cities to hire a consultant to create
a concept plan for trail connection between Perham and
Pelican Rapids. This trail is now known as the Heart of the
Lakes Trail and includes Maplewood State Park.
“The Heart of the Lakes Trail has become an invaluable
asset for our community. It offers residents an exceptional
outdoor recreational experience while also attracting visitors
seeking safe routes to bike, walk, or run. This amenity not only
enhances our quality of life but also supports local economic
growth.” ~Jonathan Smith, City Manager, Perham
RESPONSE SUSTAINABILITY ANNUAL REPORT
PUBLIC HEALTH EMERGENCY PREPAREDNESS AND RESPONSE
12/20/2024
Response Sustainability Annual Report
Minnesota Department of Health
Division of Emergency Preparedness and Response
PO Box 64975
St. Paul, MN 55155-2538
651-201-5700
health.epr@state.mn.us
www.health.state.mn.us
As requested by Minnesota Statute 3.197: This report cost approximately $4,738 to prepare, including staff time, printing,
and mailing expenses.
Upon request, this material will be made available in an alternative format such as large print, Braille, or audio recording.
Printed on recycled paper.
Table of Contents
Executive Summary ....................................................................................................................................................4
Introduction ................................................................................................................................................................5
Purpose and Overview ...........................................................................................................................................5
Funding Distribution ...............................................................................................................................................5
Tribal Nation Funding .............................................................................................................................................6
Grantee Expenditures .............................................................................................................................................7
Accomplishments and Impacts ...................................................................................................................................7
Tribal Health Departments Accomplishments .......................................................................................................7
CHBs Accomplishments ..........................................................................................................................................8
Focused Activities ................................................................................................................................................ 12
Additional Impact Stories .................................................................................................................................... 21
Response Sustainability Annual Report 4
Response Sustainability Annual Report
Executive Summary
For FY24 and FY25, the state invested in public health emergency preparedness (Sec. 145A.135 MN Statutes),
Statutory language: Line 239.27-240.12, Appropriation language: Line 810.26) to support emergency response
capabilities at the state, local, and tribal levels. They also invested in the sustainment of a health care strategic
stockpile, the transition and demobilization of COVID-19 response activities to existing programs within MDH,
archiving of COVID-19 response documents, and integration of lessons learned into response and recovery plans
and annexes. Significant progress has been made across the state to develop and maintain a response ready
workforce, revise and improve plans, engage communities in preparedness planning, and strengthen
partnerships across agencies. The COVID-19 response has been demobilized and COVID-19 documents have
been archived. Warehouse operations have been scaled back with attention now focused on sustaining a
strategic critical care supply resource for health care operations during emergency responses.
MDH revised and modernized their response structure using a cadre approach to building a stronger response
workforce with more depth that will include an improved training and exercise program. The Emergency
Preparedness and Response (EPR) Division has established a Data Work Group, which will create a Data
Management Plan and standardized processes and procedures to use as a foundation for data needed during
emergency responses. MDH EPR continues to support Community Health Boards (CHBs) and Tribal Health
Departments (THDs) through guidance, material development, training, and technical assistance.
MDH EPR partnered with the Local Public Health Association (LPHA), providing funding for additional support to
CHBs in becoming response ready. They held a statewide conference in collaboration with MDH, offered three
leadership-specific trainings, fostered information and resource sharing across CHBs, and provided learning
opportunities to develop skills. This included presentations at LPHA meetings on communications and message
framing. They are developing a toolkit to fill resource gaps in CHBs preparedness work. This toolkit will contain
factsheets, communications resources, tools to onboard new staff, and regional best practices.
Grants ($8,400,000 annually) were distributed to CHBs and THDs and this report shows that this funding has
contributed significantly to the governmental public health’s system readiness to respond. Progress was made
across all activities including staffing, reaching out to communities and across agencies, and building internal
readiness through plan and agreements updates. CHBs and THDs have been building their workforce through a
number of approaches such as hiring, increasing current staff time spent on emergency preparedness, response,
and recovery, and contracting. Recognizing the critical roles of internal and external partners, CHBs have
intensified efforts to strengthen and build new relationships. All CHBs are working on updating key plans and
examining the status of disaster response agreements.
These dedicated funds for public health emergency preparedness are making a difference in supporting wider
engagement with communities and partners. CHBs were able to train more staff on critical response and
recovery topics and skills, increasing workforce capacity. Plans addressing multiple components of public health
emergency response and recovery have been updated. Several foundational aspects of response and recovery
have also been addressed, including maintenance of contact lists, and methods to improve communications.
These actions have resulted in significant progress toward a response ready public health system in Minnesota.
Response Sustainability Annual Report
Response Sustainability Annual Report 5
Introduction
Purpose and Overview
The Public Health Emergency Preparedness and Response Grant (Sec. 145A.135 MN Statutes), provided state,
local, and tribal public health with funding intended to build capacity and infrastructure to support a response
ready workforce, critical care resources, and updated and improved plans. Strengthening and developing new
relationships is another key component of being response ready. Incorporating lessons learned from the COVID-
19 response addressed identified gaps and more efficient actions to better protect and maintain the health of all
Minnesotans. This funding aided MDH in moving to a post-COVID-19 sustainable model for future responses.
MDH focused on basic but critically important actions. These funds supported the demobilization of the COVID-
19 response. Response work was archived, ready to serve as a reference in future responses. Lessons learned
and corrective actions were identified and incorporated into plans, training, and response structures to improve
response activities. The MDH Strategic Stockpile continues, to maintain a cache of supplies identified as most
critical for health care operations during emergencies.
The MDH Emergency Preparedness and Response (EPR) Division has initiated several new projects. The first, a
new approach to a response structure, has been developed and implementation is underway. This consists of
creating teams of the primary Incident Command Structure (ICS) positions, with more depth built into each
position and additional training and practice opportunities. A Data Lead has convened an EPR Work Group to
assess current data, identify future data needs, create an EPR Data Management Plan that includes
standardization policies and procedures and training recommendations. This will help build a stronger base for
data surge needs and increase staff capacity to manage and analyze data that inform decision making and
response actions.
Finally, MDH continued to collaborate with the Local Public Health Association (LPHA). Begun under the CDC
COVID-19 Crisis Workforce Cooperative Agreement, MDH and LPHA have worked together to provide learning
opportunities and leadership development support to local public health and Tribal Health Departments. Several
initiatives have been continued and expanded with these state funds, including a joint conference, Minnesota
Partners in Public Health: Transforming systems together for a healthy Minnesota. Another hallmark of this
partnership has been leadership cohorts intended to support the large number of new public health directors.
This has proven particularly popular, resulting in LPHA offering three cohorts of twenty public health directors.
LPHA and MDH are coordinating development of public health emergency preparedness training materials,
which will allow for creation of a larger number of resources.
Funding Distribution
MDH Emergency Preparedness and Response (EPR) Division worked with the Public Health Emergency
Preparedness (PHEP) Oversight Work Group to adopt principles specific to the response sustainability funding,
which included agreement on a funding formula. The PHEP Oversight Work Group is a standing committee of
the State Community Health Services Advisory Committee (SCHSAC) and serves in an advisory capacity, making
recommendations to SCHSAC who in turn, provide recommendations to the Commissioner of Health. The
principles MDH and the Work Group agreed upon included:
Response Sustainability Annual Report
Response Sustainability Annual Report 6
• Each CHB needed to have a minimum of .5 FTE dedicated to public health emergency preparedness and
response (EPR) in order to strengthen capacity.
• Grant duties were to be aligned with national standards and public health EPR.
• Multi-county CHBs should ensure that all counties have access to staff dedicated to EPR.
o The formula includes a multi-county component to assure each local public health (LPH) director
has a relationship with their local Emergency Manager.
Health equity was an integral part of the funding discussion. While the CDC Public Health Emergency
Preparedness (PHEP) Grant funding to CHBs has long included a Social Vulnerability Index (SVI) component, its
application varied across MDH programs. MDH EPR and Public Health Practice (PHP) agreed to both adopt SVI as
a metric and ensured consistency in the way SVI is calculated and applied, particularly as it relates to city and
multi-county CHBs. SCHSAC approved the PHEP Oversight Work Group’s recommended funding formula and
forwarded it to the Commissioner of Health (see Table 1):
• $75,000 base + population + multi-county + Social Vulnerability Index (SVI)
Table 1: Response Sustainability Funding CHB Distribution Formula
Tribal Nation Funding
A collaborative approach was used to determine the funding distribution for the Tribal Nations. The MDH EPR
division and MDH Office of American Indian Health discussed different options that would provide the Tribal
Health Departments with sufficient funding to make investments in public health emergency preparedness. A
review of the historic tribal grant spending amounts was also completed. Based on these conversations and the
spending review, the Tribal Nations were allocated $75,000 each, as shown in Table 2.
Table 2: Tribal Nation Funding
Funding Component Amount Total
Base for 51 CHBs $75,000 $3,825,000
Funding Component Amount
(after base) Total
Population 77% $2,887,500
Multi-County Addition 13% $487,500
SVI (highest per CHB) 10% $375,000
Funding Component Amount Total
Base for 11 Tribal Nations $75,000 $825,000
Response Sustainability Annual Report
Response Sustainability Annual Report 7
Grantee Expenditures
Grantees utilized grant funds in a variety of ways at the local level, with majority of the funds being allocated to
personnel expenses (Table 3). As shown in Figure 1, 83% of the expended funds were allocated to personnel
costs, covering salaries and fringe benefits. This substantial investment in staffing is crucial for ensuring the
sustainability of response efforts. The remaining funds were expended in supplies, equipment, technology,
travel, contractual, indirect, and other direct costs that support the overall grant initiatives.
Table 3: Total CHB/THD expenditures Figure 1: Percent of CHB/THD expenditures by
by budget category budget category
Accomplishments and Impacts
CHBs and THDs made significant progress in several areas to increase their readiness to respond. Their
accomplishments are captured in the remainder of this report. A final section shares the impacts these funds
have made to the work CHBs are doing, in the CHBs own words.
Tribal Health Departments Accomplishments
Tribal Health Departments are working on tribal specific strategies to increase their capacity for emergency
preparedness, response, and recovery. They are participating in regular meetings with MDH EPR staff that allows
for information exchange between MDH and the THDs and provides a platform for the THDs to share ideas,
resources, and troubleshoot challenges together. In addition, MDH EPR has reconfigured a position to provide
dedicated support to the THDs. This position will be 50% tribal-focused.
Strategies of tribal health departments for strengthening their ability to prepare, respond and recover from
public health incidents include:
Budget Category Expenditures
Personnel (salaries/fringe) $2,449,469.02
Supplies $92,953.85
Equipment $17,133.13
Technology $18,470.78
Travel $50,684.25
Contractual $37,919.52
Other Direct Costs $94,461.05
Indirect $189,532.35
Total $2,950,623.95
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• Increased workforce capacity by hiring a health educator, a nurse, and a planner. In addition, one tribal
nation worked with their emergency manager to assign time to public health preparedness.
• Working across internal programs such as communicable diseases, tribal health services, elder focused
services and programs, maternal, child, and family health, Statewide Health Improvement Program, chronic
disease and injury prevention, and communication. The types of activities performed with these programs
promoted emergency preparedness through providing training, establishing regular communication, giving
presentations, and distributing flyers.
• Training staff on topics such as the Incident Command System, Psychological First Aid, emPOWER,
Shelters/Family Assistance Centers, and Crisis & Emergency Risk Communication.
• Collaborating with other Tribal Nations to share ideas, resources, promising practices, and planning
strategies during monthly Tribal meetings, trainings, and conferences.
• Creating or updating contact list policies or procedures.
• Revising, updating, or developing plans.
• Addressing technology gaps.
• Developing and expanding partnerships with tribal governments, public safety and emergency management,
social services, community leaders, education and childcare settings, health care, and mental health
providers. Activities with partners included providing training, giving presentations on preparedness,
clarifying roles and responsibilities, and helping partners understand tribal sovereignty and tribal public
health authorities.
• Engaging with their communities through Tribal health fairs, celebrations, increased communications,
Powwows, community healing event, enrollee days, listening sessions, individual meetings, and workshops.
• Assessing plans, processes, and procedures for health equity.
• Strengthening risk communication by developing plans and fostering trusted messenger development.
The Tribal Health Departments shared how the Response Sustainability funding has helped them become
response ready. These stories can be found under the Impact Stories section.
CHBs Accomplishments
Workforce Capacity
All 51 Community Health Boards (CHBs) built their workforce capacity, using the funding to expand and maintain
positions, add key positions to better engage communities, improve communication, and increase efforts to
create more equitable response and recovery plans. Table 4 provides an overview of how LPH is building a
strong foundation to respond and recover more rapidly. Although the majority of CHBs have successfully added
staff or increased FTEs, a few CHBs experienced difficulties increasing their staffing. These difficulties included
low salaries, no qualified applicants, local elected officials not allowing hiring, and human resource management
delays.
Universally, CHBs expressed their gratitude for these funds that allowed them to dedicate additional staff and
time to public health emergency preparedness work.
The Response Sustainability Grant has taken [the CHB] from having 0.25 FTE in emergency
preparedness work to 0.745 FTE in emergency preparedness work. With this drastic increase, we
have been able to integrate departmental preparedness programming. We have had the opportunity
to make preparedness a priority for this department, which was not possible before receiving RSG
funding.
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Health Promotions Coordinator went from being funded only .3 FTE (under PHEP and REP) to fully
funded and dedicated to preparedness activities - RSG was able to fund remaining .7 FTE; resulting in
the creation of a job description for an official "Public Health Emergency Preparedness Coordinator".
Table 4: Public Health Emergency Preparedness FTEs
Position
FTE
Baseline
01/01/2024
FTE
As of
09/30/24
Emergency Preparedness Coordinator 28.8 33.4
Agency leadership 10.3 15.8
Planners 13.5 14.8
Nurses 5.3 13.1
Health educator/Health promotion 2.7 7.9
Community health worker 0.5 3.7
Communication specialists 0.7 3.0
Administrative office support 1.9 2.5
Case Aid 0.4 1.4
Information technology and data system staff 0.1 1.1
Epidemiologist 0.8 1.0
Behavioral health staff 0.5 0.5
Environmental Health 0.5 0.3
Finance 0.2 0.2
Total 66.2 98.7
Disaster response agreements
MOUs, MOAs, and/or Mutual Aid Agreements
During disaster response, it is critical to know where assistance and resources can be rapidly accessed. One way
to ensure this happens is to develop agreements with other agencies or governmental jurisdictions. These
agreements can be memoranda of understanding (MOUs), memoranda of agreement (MOAs), or mutual aid
agreements. During the past nine months, CHBs have focused on updating current agreements and developing
new ones based on the lessons learned from recent responses. See Table 5 and Figure 2.
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Table 5: Number of agreements Figure 2: Entities CHBs worked with on agreements
CHBs described how the RSG funding has made a difference in their abilities to ensure they have agreements in
place for future responses.
The CHB successfully created a Memorandum of Agreement with the County Public Information
Officer and the County Emergency Management. The purpose of this agreement is to align our work
which has improved efficiency in grant duties and in preparing our communities in the County for
potential disasters, emergencies, and public health events.
RSG funds have facilitated the development of stronger relationships with community partners. The
CHB has increased engagement with stakeholders leading to MOU updates and development.
Contact lists
Communication during a disaster is a key to effective, coordinated response. Yet the most common gap
identified in after-action reports is an outdated contact list resulting in communication gaps and lack of
situational awareness. To address this issue, CHBs have developed or updated processes they can use to ensure
their lists are maintained and ready for the next disaster response. See Figures 3 and 4.
Status N
09/30/2024
Developed 20
Revised 37
Reviewed 70
Total 127
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Figures 3: Do you have a process? Figure 4: Process development status
Baseline: January 1, 2024 Progress: September 30, 2024
Health equity in disaster response
Factors that impact daily living and create inequities are exacerbated during disasters. To better protect the
health of all Minnesotans, public health needs to plan response actions that recognize these factors and the
populations who are disproportionately affected. A first step in improving public health responses is to review
plans, policies, and procedures using a health equity perspective. A second important step is to engage
communities in conversations about their strengths, challenges, and needs and jointly create equity-centered
response plans. CHBs have taken these first two steps and have made considerable progress in identifying gaps
and strengths, as can be seen in Figure 5.
Figure 5: Documents and Processes assessed for health equity
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CHBs have implemented strategies that improve relationships and readiness with many different groups within
their jurisdictions that include adding community health workers, bilingual/multi-lingual staff, and culturally
specific message development, among many other activities. A CHB shared some of the innovative work they
have been able to do because of the RSG funds.
To recruit diverse volunteers from our community to join our MRC unit, we launched the medical
interpreter program, offering potential bilingual volunteers the opportunity to become certified
medical interpreters in exchange for volunteering 40 hours over two years with our MRC unit. We
partnered with trusted messengers from Spanish, Hmong, and Somali communities, promoted the
program through Facebook, Facebook groups, WhatsApp, and existing public health-community
partnerships, to ensure that our recruitment efforts reached a diverse range of individuals. As a
result of these efforts, we received 22 applications, conducted 16 interviews, and ultimately selected
10 candidates who were bilingual in Spanish and Somali with strong backgrounds in health care,
education, nursing, volunteering, and public health. These candidates have strong ties to their
cultural communities. The candidates are in the process of enrolling in our MRC unit and the medical
interpreter program led by the Academy of Interpretation.
Focused Activities
While all 51 CHBs addressed preparedness and response actions described above, those with greater capacity
and funding were able to take on additional work, focused on specific areas of public health emergency
preparedness, response, and recovery work. These areas help build CHBs capacity to respond more effectively
and efficiently. The next few pages describe the work they accomplished.
Working across public health agencies
Thirty-four CHBs focused on working across their agency’s public health programs to increase overall agency
capacity. Table 6 provides a snapshot of the major public health program areas that participated in
presentations, trainings, or exercises about public health emergency preparedness, response, and recovery.
Building internal capacity and understanding of public health’s role in emergency response and recovery
provides a larger base of workforce to draw upon as well as increasing staff capabilities. Communicable disease
control and communications programs were the most frequently identified by the CHBs. Figure 6 describes the
types of activities employed to help increase staff awareness and capacity. The CHBs almost evenly split their
efforts between establishing regular communication, and providing training, education, and presentations.
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Table 6: Public Health programs engaged Figure 6: Activities increasing staff engagement
The 34 CHBs working on this activity recognized the benefits of being able to broaden their public
health emergency preparedness work within their agency.
RSG funds have allowed us to expand our preparedness efforts by including more staff, integrating
the work across units, and creating more of a department function rather than a PHEP silo. We
invited Public Health employees to join an internal EP workgroup and were thrilled to onboard 17
staff who are now actively participating in annex reviews, safety improvements and departmental
trainings. This workgroup has allowed for more collaboration opportunities for preparedness and
increased bench depth and strength for future responses. This new funding is opening the doors to
flexibility, creativity, and collaboration - and it's undoubtedly making an impact.
Emergency Preparedness training
Thirty-four CHBs focused on providing emergency preparedness training in order to achieve a response ready
workforce. Staff turnover and lessons learned during recent responses highlighted the need for incident
command system (ICS) training, topic specific courses, sharing of best practices, and basic public health practice
knowledge. The Response Sustainability funds supported the professional development of CHB’s public health
professionals, with the vast majority of training focused on Incident Command System (ICS) training, followed by
Communications, Mental and Behavioral Health, and Equity training. These were the most commonly identified
gaps from recent responses. The RSG funds provided the funding for the CHBs to beginning addressing these
gaps. Table 7 provides an overview of the 221 trainings attended.
Program Sept. 30, 2024
Communicable disease control 26
Communications 21
Maternal, Child, and Family Health 13
SHIP 9
Family Home Visiting 13
Community Partnership Development 14
Chronic disease and injury prevention 8
Equity 9
Environmental Public Health 8
School Health 7
Total 132
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Table 7: Emergency Preparedness trainings CHBs completed
Training N 09/30/2024
Incident Command System (ICS) Trainings 103
Communications 34
Mental and Behavioral Health 25
Equity 22
Shelter trainings/FAC 11
Community Engagement and Emergency Preparedness, Response, and Recovery 8
Emergency Preparedness Conferences 6
Point of Dispensing (POD) training 4
Other 8*
Total 221
*Other: HAZMAT trainings (2), Emergency plan development (2), Engaging Policy Makers to Improve Health, University of Minnesota:
Crafting a compelling data story, Enhancing response and recovery in rural communities, Outbreak at Water’s Edge (Epidemiological
Investigation)
The 34 CHBs selecting this activity shared how they have been able to improve their readiness to respond by
training staff, and in some cases, key partners on plans, incident command system, and other critical emergency
preparedness topics.
[The CHB] been able to train staff on a more regular basis pertaining to emergency preparedness
plans. Staff have been trained on the recently completed All Hazards Response Plan and the
Notification and Activation Annex. Without RSG funding, we would have a hard time being able to
justify training needed staff utilizing non-preparedness funds.
All staff job descriptions require specific training on incident command from FEMA and localized
training. Thanks to RSG funding. All existing and new staff have completed FEMA 100, 200, 700, and
800. [The CHB] is waiting to send an additional lead staff to IS-300 and IS-400 pending course
availability. Six staff also completed Behavioral Health training using the Question, Persuade, Refer
Model.
Public Health Emergency Preparedness plans and annexes
CHBs made considerable progress in updating their public health emergency preparedness policies, plans, and
procedures. The 25 CHBs working on this activity incorporated results from after action reports to address
identified gaps, reduce inefficiencies, and enhance actions that worked well. Using the results of their health
equity assessments, many were able to strengthen their efforts aimed at ensuring equitable response activities.
Figure 7 provides a snapshot of the ongoing work to improve CHB response plans, policies, and procedures.
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Figure 7: Developing, reviewing, and updating policies, plans, and procedures
*Other: Family Assistance Center Plan, Immigrant Influx Response, Access and Functional Needs, Extreme Heat Event Plan, Human Services Strike Teams
The 25 CHBs who worked on their plans described the progress they made on developing and revising their
response plans.
Worked with our county EM to review and update the PHEP Annex in our County EOP [emergency
operations plan]. Reviewed outdated documents and plan to update them or incorporate them into
existing documents such as our regional ones or the EOP.
We hired an additional full-time Public Health Emergency Preparedness Coordinator. This additional
position has enabled [the CHB] to update emergency preparedness plans and connect with
community partners to help support those updated plans.
[The CHB] has been able to revise and streamline emergency plans, making them more accessible
and user-friendly. These changes include clearer protocols, simplified checklists, and more practical
guidance.
Technology for Public Health Emergency Preparedness
Software and platforms can aid response work and can also hinder it. Twenty-two CHBs recognized a need to
examine their current software and platforms due to challenges they encountered during responses that
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prevented them from efficiently doing work, quickly obtaining information, or rapidly being able to share
information. Using the Response Sustainability Grant, several CHBs have begun identifying options that can
address these technology gaps, including assuring staff know how to use software and platforms. Figure 8
provides a status overview on the progress CHBs have made.
Figure 8: Addressing technology gaps
One multi-county, multi-agency CHB described the importance of having the RSG funding to implement
advanced technology to improve their ability to work across their counties efficiently.
The implementation of Microsoft Teams is still a work in progress. Teams has the potential to
streamline internal communication and document collaboration by allowing real-time editing and
easier information sharing across the organization. However, not all counties within our CHB
currently use Teams, which has posed a challenge in achieving full-scale implementation. Securing a
Microsoft license for all counties is ongoing, and this will be critical to ensuring consistent use of the
platform across the board. In the meantime, we are continuing to explore alternative solutions to
maintain collaboration until Teams can be fully adopted. In the Region, SharePoint has been adopted
as a centralized platform for collaboration and document management. This tool has enhanced
coordination by allowing all participating counties to access, update, and share preparedness plans,
training materials, and response protocols in one location.
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Partnership development
It is a well-known fact that disaster response requires collaboration across many organizations and community
groups. It is also well known that this requires well-established relationships and that these require dedicated
time to develop. Twenty-seven CHBs elected to use Response Sustainability funding to concentrate efforts on
developing or expanding an astonishing 110 relationships with community partners. On average, each CHB
averaged over four new or expanded partnerships. Health care, public safety and emergency management, and
cultural/faith-based groups were the most frequently identified sectors for engagement activities, as can be
seen in Table 8. A few CHBs also engaged libraries (2), public utilities (1), and correctional facilities (1). The type
of activities used to engage partners can be seen in Figure 9 and included developing new partnerships,
presentations about emergency preparedness, providing training, identifying roles, and when partners should be
engaged.
Figure 9: Activities conducted to engage community partner sectors
*Other: Created a preparedness survey for community members, Re-organized and coordinated the PHEP Advisory committee meeting
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Table 8: CHB relationships with community partners / organizations
Sectors Sept. 30, 2024
Health care (Hospitals/clinics) 23
Public Safety and Emergency Management 20
Cultural and Faith-based groups 19
Education and childcare settings 16
Local government 16
Social services 13
Community leadership 11
LTC, Assisted Living, other senior services 10
Voluntary Organizations Active in Disasters and Non-profits 8
Housing and sheltering 6
Mental/Behavioral health 5
Media 5
Business/Worksites/Agri-business 4
Coroner, Medical Examiner, and Funeral Homes 4
The 27 CHBs working on this activity described the benefits they experienced in partnering with others in their
communities to prepare and respond to incidents.
We were able to coordinate and provide trainings to external partners to increase capacity and be
better prepared for a response to infectious disease, such as measles. We developed new or
expanded partnerships with MDH, area schools, area clinics/hospitals, Emergency
Management/Sheriff's Departments. Additionally, we were excited to establish a relationship with
external community partners in the agriculture communities during this reporting period.
Was able to engage 7 County Senior Federation, and Central MN Council on Aging; both
organizations were identified as partners of interest in years previous and because of an increase in
staff capacity were finally able to engage with them and get those organizations involved at the
Emergency Preparedness Advisory Committee. Their involvement and perspective are critical to
support the AFN [access and functional needs] population and promote a health equity lens to
response planning efforts.
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Community Engagement
To work authentically with community groups and organizations, it is important to develop and sustain
relationships. This work is just as important as developing partners. The 20 CHBs working on this activity had
varied approaches, based on the types of communities in their jurisdictions. Many emphasized the critical
component of communications and one-on-one meetings, knowing these underpin all other activities in building
relationships. Figure 10 illustrates the strategies used by CHBs ranging from listening sessions and focus groups
to training, leadership development, and individual meetings.
Figure 10: Community engagement activities
The 20 CHBs working on this activity felt strongly that building relationships is a critical component to their
response readiness. They shared how they were able to strengthen this component of their preparedness work.
Due to increased funding, the EP coordinator spends 100% of their time doing Emergency
Preparedness and has been able to do more outreach and engagement with different populations
including youth.
We [Public Health, PIO, EM] have attended community events together, we have collaborated on
communication, education, meetings, and trainings. We have participated and networked with Leech
Lake, Red Lake, and White Earth tribes.
Communication
Communication can be challenging at any time and is often identified as a major stumbling block during
emergencies. During disasters, effective and timely communication can be the key to a well-coordinated,
efficiently run response. Nineteen CHBs recognized these challenges, with several electing to work on plans,
message development, training, and several aspects related to health equity communication. Many of these
CHBs noted they were able to send several staff to the Crisis & Emergency Risk Communication (CERC) training
offered by MDH throughout the state. Figure 11 provides a summary of the CHBs communication progress.
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Figure 11: Improving disaster communications
The 19 CHBs selecting Communications as an additional area of activity recognized the progress they were able
to make in improving readiness, pre-incident message development, and emphasizing health equity in
messaging.
The formation of the new Communications and Emergency Preparedness team has been
instrumental in enhancing the department's communication capabilities. By bringing together
dedicated communications specialists and implementing streamlined workflows, we have been able
to significantly improve the efficiency and effectiveness of our communication efforts, particularly in
how we collaborate with trusted messengers.
[The CHB] sent staff to the Crisis and Emergency Risk Communication (CERC) training hosted by
MDH. Utilizing lessons learned from this training, [the CHB] was able to create messaging templates
that have already been used to communicate with both the public and the media. Creating these
materials has always been a priority for our department, but with limited FTE in preparedness work,
it was difficult to complete when other work takes precedence.
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Additional Impact Stories
The Response Sustainability Grant funding importance to the CHBs and THDs cannot be underscored. The work
they have been able to undertake and accomplish in less than a year of funding is remarkable. With continued
funding, Minnesota’s public health system will be ready to respond to disasters affecting our citizens anywhere
in the state.
Tribal Nations’ Tribal Health Department Impact Stories
This [funding] has allowed us to travel to Upper Sioux to observe their shelter training to see if it was
a good fit to offer at Bois Forte.
This funding has allowed our agency to have staff dedicate more time to reviewing and updating our
emergency plans as well as collaborate with internal and external partners on a regular basis.
RSG Funding has allowed Leech Lake Band Tribal Health to add a 1.0 FTE Position that will be
responsible for emergency preparedness planning and response for the tribe. If not for this funding,
they would not have the funding to add any positions to work on ep [emergency preparedness].
Traveling to the MMIR [Missing and Murdered Indigenous Relatives] Training was possible due to the
[RSG] funding. The training was fantastic and taught me some of the reasons the native community
is suffering. I have a better understanding of why generations did not teach the next language.
RSG funds have provided an opportunity to collaborate with external partners during a recent school
vaccination clinic. USIC worked with county public health and a local charter school to provide a
service to children who are part of an at-risk population in our service area.
White Earth Tribal Health is able to partner with White Earth Tribal EM and emergency management
planner to align tribal health and tribal emergency management plans and activities. This would not
have been possible without RSG Funding.
Community Health Boards’ Impact Stories
Workforce capacity
Another grant was expiring, and we are going to be losing our community health worker.
Fortunately, the timing of this grant was perfect, and we were able to support her work and
transition her to this extremely important work where she can be in our communities, providing
education to families pertaining to being ready for emergencies similar to the one we recently
experienced, in order to prevent this situation from occurring again. An added bonus is that the
Community Health Worker is bilingual and therefore she has the ability to educate not only in
English, but in Spanish as well.
[The CHB] collaborated with The National Weather Service…on an Amish/Plain Community
Integrated Warning Team event…this multidisciplinary event involved a series of presenters from MN
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and WI providing information about the Plain Community. [The CHB] provided information for
Minnesota. Discussion also took place about best practices and next steps to address weather
emergencies with the Amish community.
Our Emergency Preparedness Coordinator…heard feedback that written Somali wasn't as accessible
as an audio option. For National Preparedness Month, they drafted a version of a preparedness
handout with Somali translation as a QR code option on both English and Spanish handouts. A
Somali county staff then read the content in Somali in a voice over. They were then able to go to the
council with feedback.
We have been able to use RSG funds to do outreach to our Karen community. We have provided
educational materials such as a picture list of items to include in a kit along with the information in
the Karen language.
The hiring of a 1.0 FTE [staff person] and expanding the time for PHEP for [another staff person] EP
in [another county] has allowed [the CHB] to work on PHEP items that in the past were not
completed or done hastily. This hire would not have been possible without [the RSG] funding.
Disaster response agreements
Our LPH continues to build upon existing relationships with the new capacity that we have because
of RSG. We have identified beneficial MOU partners and will have the capacity to work on updating
existing agreements and drafting new agreements.
Working on MOUs. County Attorney reviewed in 2023-2024 and contract person is now renewing
older MOUs. Added new POD locations and updated those to Plans and Updated Contact lists for all
MOUs and partner collaboration and Advisory Committee. Working with Emergency Manager on
Updating the County Emergency Operations Plan (EOP) update and Jurisdictional Risk Assessment
(JRA).
Health equity
[The CHB] has been able to expand our use of PHDoc to chart access and functional needs that
clients may have during an emergency. We have utilized the CMIST model to capture which
categories of CMIST the client falls into. During an emergency, we can pull reports to identify which
of our clients would need assistance if the emergency would or has impacted folk with those needs.
We have also implemented the ability to chart whether folk have supports or not. Clients with little
to no supports would be the ones we want to reach out to first in the event of an emergency to check
on and see if they need assistance.
Working on health equity incorporation in policies, procedures, and resources. For example, included
an access, functional need, and cultural resource section to the [CHB] community resource guide
which is available for the public and staff to use non-emergency and emergency purposes. This
document also references disease prevention and control, emergency services, sheltering, and
resources that can be used in case of isolation and quarantine.
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[CHB is] strengthening resources and understanding of risks, vulnerabilities and needs across our
community and increasing health equity in PHEP plans.
MDH health equity team [attending] monthly meetings to better prepare LPH for increased
understanding and abilities to incorporate equity into preparedness planning.
[CHB is] conducting monthly plan review meetings and following the MDH health equity spreadsheet
to make updates [to] the plans.
Working across Public Health agency programs
At each of our All-staff meetings, which occurs every other month, there is time dedicated for EP
education. We have started with basic EP 101, PHEP Capabilities review, and the role of LPH in
emergencies. We then build off of that to review ICS/NIMS and how it would be used within our
agency. We are in the process of planning for COOP education at our next all-staff meeting. After this
education, each program will review their program priorities at upcoming work plan meetings to
then allow us to update our overall agency COOP plan. The intent of this process is to continue to
build on EP related trainings for all staff so they have a general idea of EP in the event a response
was required of all our staff.
Emergency Preparedness training
The ability to increase the staff time, trainings, and opportunities from the state's funding has been
instrumental in increasing our capacity for emergency preparedness work. We have been able to
attend more trainings related to communication, risk assessments, health equity, and so much more
to better serve our communities and ensure that all individuals have their needs met accordingly.
Each of the PHEP Coordinators within our CHB as well are the LPH Directors and other public health
staff have been able to increase our focus on Emergency Preparedness. This would not have been
possible without the state funding. Thank you.
Able to use funding to contract with trainer on providing COOP training and exercise for county-wide
supervisors and department heads. All public health staff also participating in COOP training.
[The CHB] completed a training needs assessment in the spring for human services and public health
staff. The results are being used to create a workforce development program. In addition, over 500
staff indicated an interest in participating in further training and exercises.
Public Health Emergency Preparedness plans and annexes
[THE CHB] was able to meet with the Safety Coordinator and the EM to go over emergency plans for
county buildings that were very outdated.
Previously we did not have the FTE to support a deep dive into our plans to update them post-COVID.
We have been able to begin this work with the additional funding.
Partnership development
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[CHB] recognized National Preparedness Month in a much different way this year. Because we have
more preparedness funding thanks to the Response Sustainability Grant, we were about to spend
more time preparing better tailored communications about the month's goal of bringing awareness
to the importance of preparedness. We created new partnerships with grocery and hardware stores
to tag preparedness items around the stores. This brought awareness to the items that should be
included in an emergency supply kit. These new partners were excited about the preparedness
campaign as it was little effort on their part but had potential to really capture the interest of the
folk in their stores.
In response to the increasing risk of a measles outbreak due to declining MMR vaccination rates, [the
CHB] partnered with [another CHB] to host a lunch and learn event for local health care providers in
April. The session featured a subject matter expert who shared valuable insights on health care
preparedness in the event of a measles outbreak. The discussion centered around key considerations,
including the roles and responsibilities of health care professionals in preventing and managing
potential cases. Our goal was to equip providers with the knowledge and strategies necessary to
ensure their facilities are prepared to respond effectively to this growing public health threat.
Previously, PHEP funds only covered a small amount of staff time. RSG funds afforded us the time to
pull together these stakeholders for an important conversation.
This additional position has enabled [the CHB] to update emergency preparedness plans and connect
with community partners to help support those updated plans.
[The CHB] has historically reported having difficulty coordinating with the EM. We have made
progress towards LPH and EM partnering for a staffed emergency shelter plan.
…reconnecting with partners from COVID-19 response and creating new partnerships that will help in
future responses. For example, we built on an existing relationship with our local library system to
set up a heating/cooling shelter at their [city] location. We were able to leverage an existing
relationship to share responsibilities and plan for future community needs.
[The CHB] has been able to partner with [the city] Emergency Management Director and host a
learning series on various emergency management series of focus with a public health lens. The first
meeting was a presentation on Family Assistance Centers and the Incident Command System.
Community engagement
[The CHB’s] biggest highlight was adding an additional EP Specialist to our team! This position will
focus on Emergency Preparedness Community Engagement, review/updating Closed POD Plan and
partnerships. Overall, this position will allow our EP team to increase external/internal partnerships.
One highlight was our team was able to provide emergency preparedness education and emergency
kit development education to families in the counties we serve as part of their WIC appointments.
Specifically, we held this education at our off-site locations where many of our non-English speaking,
culturally diverse community members attend. This outreach provided education to a population
who may not have received this type of education otherwise.
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With the additional funds, our team has achieved significant success in optimizing our operations
and expanding our impact. [The CHB] was able to create a brand-new position, hiring a dedicated
individual to focus on emergency preparedness, response, and health education. This marks a major
milestone for the county, as it's the first time they've been able to strengthen their presence in the
community, fostering lasting relationships with local residents.
We have been able to increase our involvement in school activities and with all of our educational
partners to focus on emergency preparedness at a child's level. We have been able to join events
such as "Back to School Night", "Be the Voice" events, and increase our involvement with local
groups focusing on mental health and disaster recovery.
Communication
Community Health Educators have been able to integrate emergency preparedness into their
communications and outreach efforts.
We have increased our social media presence and are working on website updates.
…developing a monthly newsletter that will tie together various public health grants and programs
with an ongoing focus on emergency preparedness. The newsletter will be distributed to both staff
and community members, ensuring that preparedness remains a consistent topic of conversation.
The goal is to keep both internal staff and the broader public informed about updates in emergency
preparedness, share success stories, and provide actionable steps for improving individual and
community preparedness. This will not only foster greater awareness but also align public health
efforts across multiple programs under a unified communication strategy.
National Preparedness Month provided a successful venue to pilot some new ideas around
communication and translation. We increased social media presence, tried audio recording for
Somali translation, and were able to advertise the events to community partners as a way to
increase engagement.
Our communications specialist transitioned from a grant funded position to a full-time agency
position. She attends many of our program specific meetings, including emergency preparedness
team meetings as needed. She's also included in work plan meetings and assists with our EP social
media, newspaper, radio spot and newsletter/yearly report development.
…our agency has committed and supported funding for a full-time Communications Specialist for our
agency. It is a huge advancement to have someone skilled in communication to have time committed
in our EP [emergency preparedness] program to truly help highlight and share our EP work and
available resources to everyone across our multi-county CHB.
…had an intern over the summer months assist us in gathering social media material and organize it
in a way that we can easily pull it in the event of a response. This will help cut down on the amount
of time it takes staff to find the materials and will allow us to be more efficient in getting important
messaging out to our communities.
Response Sustainability Annual Report
Response Sustainability Annual Report 26
The new Communications and Emergency Preparedness team has made significant strides in
enhancing the department's capacity for emergency preparedness. As demonstrated by our recent
measles awareness campaign, the team is effectively leveraging various communication channels to
raise awareness, encourage vaccination, and promote public health. These efforts are laying the
groundwork for improved emergency response and recovery efforts.
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Public Health System Development in Minnesota
SUMMARY OF THE REPORT TO THE LEGISLATURE, JAN. 2025
This biennial, statutorily required report describes how Minnesota’s public health leaders, elected officials, and
community members work together to help our communities thrive by doing the foundational work of public
health in innovative and collaborative ways, partnering across sectors and geographies, and working together to
meet today’s health needs while anticipating tomorrow’s.
Read the full report: Public Health System Development in Minnesota (PDF)
(https://www.health.state.mn.us/communities/practice/systemtransformation/docs/202501-systemdevelopment.pdf)
State of the public health system: Strengths and challenges
Minnesota’s public health system is ready to transform itself to meet the needs of Minnesotans more effectively,
but a number of challenges stand in its way.
Minnesota’s public health system is locally driven, but also fragmented
Strength: Minnesota’s governmental public health system has a collective responsibility to Minnesotans, and its
agencies and workforce are bound together in practice, partnership, and often in statute. This state-local system
was built to be responsive to local need and driven by local priorities, and it excels at doing so.
Challenge: However, these varied approaches and structures limit public health departments’ ability to
collaborate across jurisdictions, which then undermines public health’s ability to work across sectors and leads to
a patchwork of capacity statewide. The factors that shape health cross geographies and sectors—public health
must be able to span those boundaries, too.
Our partnership is timeless, but our approach is outdated
Strength: When it was created in 1976, Minnesota’s public health system was seen as forward thinking and as a
model for other states to follow.
Challenge: Now, 50 years later, Minnesota’s public health system struggles to meet today’s problems or
anticipate tomorrow’s without a significant and transformative shift, given substantial changes in data and
technology, how we take in news and information, and the public’s expectation for engagement and precision.
Our outdated approach also undermines public health’s ability to work together with community to enact proven,
effective interventions that address the root cause of health issues while reflecting local needs and priorities.
Governmental public health is small but mighty—and needs more capacity for foundational work
Strength: Minnesota’s public health workforce has deep and broad experience and is committed to working with
its communities on effective, innovative ways to build community health.
Challenge: Experience, expertise, and commitment aren’t enough to make up for the fact that Minnesota’s public
health system does not have enough capacity to do the fundamental, foundational public health work that helps
make communities thrive. Public health’s resources, people, and delivery models are out of alignment with each
other and with the work of prevention and population health.
SUMMARY: PUBLIC HEALTH SYSTEM DEVELOPMENT (REPORT TO THE LEGISLATURE, JAN. 2025)
2
Deep, broad expertise and experience cannot overcome chronic underfunding
Strength: Public health workers have a wealth of experience and expertise. They cooperate across sectors to diagnose
health issues happening broadly across the community and work to prevent health problems before they start.
Challenge: However, Minnesota’s public health system is funded in large part by a series of categorical,
prescriptive, time-limited grants that don’t allow for flexibility depending on jurisdictions’ needs or assets or cover
individual service delivery instead of population-level prevention work. This funding structure also limits public
health from scaling up when it’s most needed during emergencies, subjecting public health to an ongoing funding
roller-coaster of panic booms and neglect busts.
A new path forward
While our system continues to face challenges, over the last several years Minnesota has taken many steps to
strengthen and improve the public health system. For examples in each area below, visit pp. 23-29 of the report.
▪ 21st century tools: Ensuring that all public health partners have access to functional, modern tools and
technologies is critical to strengthening our public health system. Modern data systems can support data
driven decision making, allowing public health officials to deploy human and financial resources where they
can make the greatest impact. Minnesota is implementing strategies to improve the quality and availability of
data and technology at the state and local level.
▪ 21st century practice: State and local departments must work to address the upstream causes of health
inequities, by centering collaboration, community voice, and equity.
▪ Sustained investment: Insufficient public health investment has compromised the ability of public health
departments at all levels to address emergent public health threats and community priorities. In addition to
increased, sustainable funding, the system needs innovative and flexible funding models to break down silos
and support core public health infrastructure building that is aligned with community need.
▪ Local innovation: Innovation that challenges the status quo helps develop novel, creative approaches to improving
the public health system. Local communities are often best positioned to implement these novel approaches
because they are on the front lines, identifying the gaps and problems in the current system. They are also able to
adapt, iterate, and scale innovative approaches quickly for maximum impact. Several projects are piloting new
service delivery innovations to improve the public health system through the Minnesota Infrastructure Fund.
On the horizon: Recommendations and next steps
▪ LPHA, SCHSAC, and MDH should continue to partner and cooperate through the Joint Leadership Team. They
should also work with the MDH Office of American Indian Health to consult with Tribal partners, and should
incorporate community perspective on how to create a truly coordinated public health system.
▪ While recent state investments are a helpful down payment to build the capacity of the public health system,
Minnesota needs more ongoing and sustainable federal and state funding, especially in prevention programs
and policies, to make sure every health department has access to the human and technical resources to fulfill
foundational public health responsibilities.
▪ Local public health and MDH should keep using data to understand current system gaps, use available
resources to build foundational public health capacity statewide, and test and scale new service models.
Joint Leadership Team for Public Health System Transformation in Minnesota:
Local Public Health Association of Minnesota, Minnesota Department of Health, State Community Health Services Advisory Committee
651-201-3880 | health.ophp@state.mn.us | www.health.state.mn.us/systemtransformation
January 2025. To obtain this information in a different format, call 651-201-3880.
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CHB Governance Change Timeline
JANUARY 2024
This table provides only a high-level summary of each step in the process. MDH Community Health
Division staff will work with the CHB to navigate this process with CHBs and their leadership. More
details can be found in the CHB Governance Change Handbook.
CHB Withdraw/Dissolution
Topic Local Action Timeline
County withdrawal from a CHB Withdrawing county sends written notice and applicable board resolution to Commissioner of Health 1+ calendar year
CHB Dissolutions CHB sends written notice and applicable resolution to Commissioner of Health 1+ calendar year
Document grant funding Complete form to identify list of grants currently received from MDH. This should include grants to individual counties within the CHB.
April/May or earlier
Determine grant funding distribution As necessary, work with or notify MDH grant programs regarding the distribution of grant funds between the counties
June/July or earlier
Notify MDH of grant funding distribution CHB sends written notification of their preference for dividing the required MDH grants July/August or earlier
Cancel Existing MGC None for CHB. The current MGC is valid until December 31, 2024 N/A
Cancel Existing Grant Project Agreements Respond promptly to MDH grant program staff requests. By December 31
CHB Formation Timeline
Topic Local Action Timeline
Submission of legal documentation required for formation
New CHB(s) send written notification and applicable resolutions regarding the formation of the CHB to Commissioner of Health
June/July or earlier
New CHB Grant Funds If necessary, new CHBs meet with MDH grant programs to discuss funding. July or earlier
Submission of administrative documentation required for formation
New CHBs submit the following administrative
information to the MDH:
▪ Full legal name of the new CHB
▪ CHS Administrator
▪ CHB chairperson
▪ Agent(s) of the board
▪ Fiscal agent
▪ Fiscal host
▪ Copies of legal documentation (e.g., applicable
board resolutions, signing authority)
July or earlier
CHB GOVERNACE CHANGE TIMELINE
2
Topic Local Action Timeline
Submission of grant documentation required for formation
Obtain and submit (on MDH form) the following:
▪ MN tax ID#
▪ Federal tax ID#
▪ SWIFT Vendor ID and location code
▪ UEI# (federal grants)
▪ List of any EH delegation agreements
August 1
Assign New Master Grant Contract# and draft new MGC None. MDH will assign new number and share with MDH grant program staff August
Process New MGC None. MDH will draft the new MGC and send to new CHBs for signature. August
Execute New MGC New CHBs obtains needed signatures August-September
Meeting between MDH and new CHB(s) Participate in state-local meeting. September
Establish New Program Grants Respond promptly to MDH grant program staff requests. September-October
Execute All Program Grants New CHBs obtains needed signatures Early December
Other Considerations
The regional Public Health System Consultant and other MDH Community Health Division staff are
available to help talk your organization through these and other considerations.
▪ Withdrawal/Dissolution: grant closeouts
a. Study the timeline for grant closures. What needs to get done when and by whom?
b. Discuss the dissolving CHB’s staffing needs regarding completing grant closures.
▪ Withdrawal/Dissolution: business operation closeouts
a. Finish up CHB business to complete dissolution (i.e., schedule remaining meetings to meet
statute requirement, pass necessary resolutions, etc.)
b. Arrange for future access to statistical and financial records (especially for CHB
withdrawals). Which party retains this data?
c. Arrange for future access to grant and program records (in case of audits). Which party
retains this data?
d. What are the implications for records retention of (old) CHB records? Where will the
records be kept? For how long? Who will manage them?
e. Some old grants may not be closed out before the governance change is official (i.e., start of
new calendar year). How will the fiscal agent and/or billing agent changes be handled?
f. Annual reporting in REDCap has a one year lag (e.g., in the first quarter of the new year,
CHBs report on their activities of the previous year). What arrangements will be made to
complete joint reporting after the dissolution is final? (Only applicable in the case of a
multicounty split or withdrawal).