CR 92-125 Environmental Health Services Agreement
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May 27, 1992
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council Report No. 92-125
ENVIRONMENTAL HEALTH SERVICES AGREEMENT FOR 1992
ProDosed Action.
staff recommends the following motion: Move to approve the
environmental health services aqreement with Hennepin County for
1992.
Approval of this motion will allow the Mayor and city Manager to
execute an agreement with Hennepin County to allow Hopkins to
receive financial support from the County for environmental
health services.
Overview.
The state Health Department grants authority to Hennepin County
to provide for environmental health services in the County.
The County allows cities who wish to provide for there own health
services the authority to do so on a year by year basis. The city
has exercised this right and undertakes the inspection and
licensing of establishments such as restaurants, hotels, swimming
pools, etc.
Execution of the agreement with the County allows Hopkins to
continue to locally license certain establishment and the County
agrees to pay the City $2800.00 for direct support of the
activity.
The agreement is the standard agreement we execute with the
county each year.
Primary Issues to consider.
o Should the city continue to provide its own Health
services.
The cost to the city to provide our own health inspection
program is approximately $13,000 per year. The City receives
revenue through licensing of restaurants, lodging
establishments and swimming pools. This revenue more than
covers the costs of administering the program. Local
administration of the program provides Hopkins residents
personal attention and service. staff feels it is in the
City's best interest to continue to provide its own health
services.
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SUDDortinq Information.
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Thomas Anerson
City Building Official
agreement
City of Hopkins
Contract No. A07492
ENVIRONMENTAL HEALTH SERVICES AGREEMENT
THIS AGREEMENT is made and entered into by and between the COUNTY
OF HENNEPIN, STATE OF MINNESOTA, hereinafter referred to as the
"County", through its Community Health Department, hereinafter
referred to as the "Department", and the City of Hopkins, A
Municipality organized and existing under the Laws of the state of
Minnesota, hereinafter referred to as the "Municipality".
WIT N E SSE T H:
WHEREAS, The Municipality wished to provide Community Health
Services; and
WHEREAS, County funds through the Department are available to
support such services and whereas community Health Services subsidy
funds are available from the Minnesota Department of Health:
.
NOW, THEREFORE, in consideration of the mutual undertakings and
agreements hereinafter set forth, the County through the Department
and the Municipality agree as follow:
1. TERM OF AGREEMENT
The term of this Agreement shall be from January 1, 1992,
through December 31, 1992, subject to cancellation provision
contained herein.
2. CONDITIONS OF COUNTY SUPPORT
A. The County through the Department agrees to make payments
to the Municipality for the provision of local
environmental health services (maintenance) as described
in Exhibit A, such Exhibit attached hereto and made a
part hereof as though fully set forth herein.
B. The total 1992 cash payments shall not exceed $2,800.
C. Payments to the Municipality will be made in two (2)
equal installments in the amount of $1,400 to be paid on
or about July 1, 1992, and January 1, 1993, upon receipt
of completed and signed Exhibits Band C, attached hereto
and made a part hereof as though fully set forth herein.
Payment shall be made within (35 days) from receipt of
HCA Form No. 104, Rev. 4/92
the invoice. If the invoice is incorrect, defective, or
otherwise improper, the County, through the Department,
will notify the Municipality within ten (10) days of
receiving the incorrect invoice. Upon receiving the
corrected invoice from the Municipality, the County,
through the Department, will make payment within (35
days). In the event that the County withholds payment
for failure to provide service or failure to comply with
any of the provisions of this Agreement, then no interest
penal ty shall accrue against the County through the
Department. If claims are made by the Municipality that
the County, through the Department, did not act in good
faith in withholding payments as provided above, then
such claims shall be handled as a dispute by the Contract
Manager (pursuant to clause 13 of this Agreement). If
an audit is required by the County, through the
Department, before payment is to be made, then no
interest penalty shall accrue against the County, through
the Department, until after (35 days) after the audit is
completed by the County.
D. The Municipality agrees to make expenditure of County-
provided payment only for the purpose of providing the
environmental health services as described in Exhibit A
attached hereto.
E. The Municipality agrees to provide semi-annual reports
to the County through the Department within thirty (30)
days of July l, 1992, and January 1, 1993, detailing
revenues and expenditure in accordance with Exhibit B
attached hereto.
F. The Municipality agrees to maintain a Delegation of
Authority Agreement with the Minnesota Department of
Health pursuant to Minnesota statutes 145A.07 to act as
the agent of the Minnesota Department of Health to
provide food protection services, lodging, and boarding
services of children's camp inspections. The
Municipality agrees to regulate public swimming pools
pursuant to Minnesota Rules Chapter 4717 relating to
public swimming pools, including all subsequent
amendments thereto. A copy of the Delegation of
Authori ty agreement is attached hereto and marked and
made a part of Exhibit A.
3. CONDITION OF THE PARTIES' OBLIGATIONS
A. It is understood and agreed that the Agreement between
the parties is conditional upon the County receiving
sufficient funding from the State of Minnesota. If such
funding is not available, this agreement shall be
cancelled immediately upon written notice to the
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Municipality, other prov1s1on for cancellation of this
Agreement notwithstanding. This Agreement may be
renegotiated to reflect any reduced funding.
B. Any material alterations, variations, modifications, or
waivers of provisions of this Agreement shall be valid
only when they have been reduced to writing as an
amendment to this Agreement signed by the parties hereto.
c. Upon cancellation or termination of this Agreement, the
Municipality will reimburse to the County through the
Department any and all unobligated funds as required by
the Minnesota Department of Health. This reimbursement
shall be made within sixty (60) days of the effective
date of such termination.
D. In the event of any policy changes which result in a
reduction of services or major inconsistencies with the
1992-1995 Hennepin County Health Services Subsidy Plan
written pursuant to Minnesota Statutes 1987, 145A.10
Subdivisions 5 and 6, the Municipality will notify and
consult with the County through the Department before
implementing the new policy.
E. The Municipality shall comply with the provisions of the
Communicable Disease Reporting Rules adopted by the
Minnesota Department of Health in accordance with the
provision of Minnesota Rules, Chapter 4605, Parts 7000-
7600.
4. AUDITS. REPORTS. MONITORING PROCEDURES. AND RECORDS
A. The Municipality will:
(1) Maintain a bookkeeping system which sufficiently and
properly reflects all direct and indirect costs of
any nature expended in the performance of this
Agreement.
(2) Provide a semiannual budget/expenditure report
within thirty (30) days of July 1, 1992, and
January 1, 1993, to the County through the
Department detailing all revenues and expenses as
described in Exhibit B attached hereto.
(3) Provide a semiannual program activity report within
thirty (30) days of July 1, 1992, and
January 1, 1993, to the County through the
Department as described in Exhibit C attached
hereto.
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(4) Submit a copy of the list of licensees to the
department which is furnished to the Commissioner
of Health as requested by the delegation of
authority agreement, The list will be subdivided
according to the definitions of risk level specified
in Minnesota statues 157.01-.04.
B. The Municipality agrees that the County, the state
Auditor or legislative authority, or any of their duly
authorized representatives at any time during normal
business hours, and as often as they may deem reasonably
necessary, shall have access to and the right to examine,
audi t, excerpt, and transcribe any books, documents,
papers, records, etc., and accounting procedures and
practices of the Municipality which are relevant to the
Contract. Such material must be retained for five (5)
years by the Municipality.
C. The County through the Department will monitor and
evaluate the performance of the Municipality under this
agreement on an ongoing basis. The municipality will
make complete inspections of licensed establishments at
least at the frequency required by Minnesota Statutes
157.01-.04.
5.
DATA PRIVACY
A. All data collected, created, received, maintained, or
disseminated for any purposes by the activities of the
Municipality in the performance of this contract is
governed by the Minnesota Government Data Practices Act,
Minnesota statutes 1990, the Minnesota Rules implementing
such Act now in force or hereafter adopted, as well as
federal regulations on data privacy.
B. In accordance with Minnesota statues 1990, section 13.46,
Subdivision 10, the Municipality shall appoint a
responsible authority who shall allow the responsible
authorities in the welfare system access to data
classified as restricted when access is necessary for the
administration and management of programs or as
authorized or required by state or Federal law. The
Municipality shall notify the County of the name of the
responsible authority.
6. EQUAL EMPLOYMENT OPPORTUNITY AND CIVIL RIGHTS
A.
During the performance of this Agreement,
Municipality agrees to the following:
the
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In accordance with the Hennepin County Board of
Commissioners; Policies Against Discrimination, no person
shall be excluded from full employment rights, denied
access to or participation in the benefits of any
program, service or activity on the grounds of race,
color, creed, religion, age, sex, disability, marital
status, affectional/sexual preference, public assistance
status, ex-offender status or national origins; and no
person who is protected by applicable Federal or state
laws against discrimination and all regulations
implementing such laws, including but not limited to the
civil Rights Restoration Act of 1987, Public Law No. 100-
259, 102 stat 28-32, 1988 and 20 USC 1681 ET. SEQ., 42
USC 20000 and 29 USC 706 shall be otherwise subjected to
discrimination.
.
(1) The Municipality shall comply with all applicable
statues, regulations, and licensing requirements in
the employment of personnel. To the extent that any
of the provisions of the applicable statutes,
regulations, or licensing requirement are
inconsistent with any of the provisions of this
clause, said statute, regulations, or requirement
shall prevail if it has a reasonable bearing upon
the applicant's fitness to be employed in any phase
of the program.
(2) The Municipality guarantees that no funds received
under this Agreement shall be used to provide
religious training and/or services to any individual
receiving Purchased Services.
(3) No qualified handicapped person, as defined by
united states Department of Health and Human
Services regulations, Title 45 Part 84.3 (J) and
(K) , which implements Section 504 of the
Rehabilitation Act of 1973, 29 U.S.C., 704, under
Executive Order No. 11914 (41 FR 17871, April 28,
1976):
a. Shall be denied access to or opportunity to
participate in or receive benefits from any
service offered by the Municipality under the
terms and provisions of this Agreement, nor
b. Shall any qualified handicapped person be
SUbject to discrimination in employment under
any program or activity related to the services
provided by the Municipality.
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(4) It is the policy of Hennepin County that no
applicant or client shall be subjected tp testing,
removed from normal and customary status, or
deprived of any rights, privileges, or freedoms
because of his or her AIDS status except for clearly
stated, specific, and compelling medical and/or
public health reasons.
(5) If during the term of this Agreement or any
extension thereof, it is discovered that the
Municipality is not in compliance with the
applicable regulations as aforesaid, or if the
Municipality engages in any discriminatory practices
as described above, the County, through the
Department, may cancel said Agreement as provided
by the cancellation clause of this Agreement.
7 . MALTREATMENT OF MINORS REPORTING ACT. VULNERABLE ADULTS
REPORTING ACT
A. The Provider will comply with all of the provisions of:
(1) The Maltreatment of Minors Reporting Act, Minnesota
Statutes 1990, and Minnesota Rules, Chapter 9560,
Parts 0250-0300, as promulgated by the Minnesota
Department of Human Services implementing such Act
now in force or hereafter adopted.
(2) The Vulnerable Adults Reporting Act, Minnesota
Statutes 1990, section 626.557, and all rules
promulgated by the Minnesota Department of Human
Services implementing such Act now in force or
hereafter adopted.
8. FAIR HEARING AND GRIEVANCE PROCEDURE
The Municipality W~ll establish a system through which
recipients of serv1ce may present grievances about the
operation of the service programs, and the Municipality will
advise recipients of service of this right.
9.
INDEMNITY
The Municipality agrees to defend, indemnify, and hold the
County, its officers, and employees harmless from any
liability, claims, damages, costs, judgments, or expenses,
including reasonable attorney's fees, resulting directly or
indirectly from an act or omission of the Municipality, its
agents, employees, or contractors in the performance of the
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services provided by this Agreement and against all loss by
reason of the failure of said Municipality fully to perform,
in any respect, all obligations under this Agreement.
The Municipality warrants that it has sufficient insurance
coverage to meet the Municipality liability requirement of
Minnesota statutes 466.02 and 466.04, and to comply with the
foregoing indemnification provisions.
10.
INDEPENDENT CONTRACTOR
It is agreed that nothing herein contained is intended or
should be construed in any manner as creating or establishing
the relationship of co-partners between the parties hereto or
as constituting the Municipality in any manner whatsoever.
The Municipality is to be and shall remain an independent
contractor with respect to all service performed under this
Agreement. The Municipality represents that it has, or will
secure at its own expense, all personnel required in
performing services under this Agreement. Any and all
personnel of the Municipality or other persons, while engaged
in the performance of any work or services required by the
Municipality under this Agreement shall have no contractual
relationship with the County and shall not be considered
employees of the County, and any and all claims that mayor
might arise under the Unemployment Compensation Act or the
Workers' Compensation Act of the state of Minnesota on behalf
of said personnel arising out of employment or alleged
employment including, without limitation, claims of
discrimination against the Municipality, its officers, agents,
contractors, or employees shall in no way be the
responsibility of the County; and Municipality shall defend,
indemnify, and hold the county its officers, agents, and
employees harmless from any pertinent tribunal, agency, board,
commission, or court. Such personnel or other persons shall
neither require nor be entitled to any compensation, rights,
or benefits, of any kind whatsoever from the County, including
without limitation, tenure rights, medical and hospital care,
sick and vacation leave, Workers' Compensation, Unemployment
Insurance, disability, severance pay and PERA.
MERGER AND MODIFICATION
It is understood and agreed that the entire Agreement between
the parties is contained herein and that this Agreement
supersedes all oral agreements and negotiations between the
parties relating to the subj ect matter hereof. All items
referred to in this Agreement are incorporated or attached and
are deemed to be part of this Agreement.
Any material alterations, variations, modifications or waivers
of provisions of this Agreement shall only be valid when they
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have been reduced to writing as an amendment to this Agreement
signed by the parties hereto.
12. SUBCONTRACTING AND ASSIGNMENTS
The municipality shall not assign, sublet, transfer, or pledge
this Agreement and/or the services to be performed hereunder,
whether in whole or in part, without the prior written
approval of the County.
13. NOTICE OF CANCELLATION
This Agreement may be terminated upon thirty (30) days;
written notice of either party.
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Municipality, having signed this Agreement, and the Hennepin County
Board of Commissioners having duly approved this Agreement on
, 1992, and pursuant to such
approval and the proper County official having signed this
Agreement, the parties hereto agree to be bound by the provisions
herein set forth.
Approved as to legality,
form, and execution.
COUNTY OF HENNEPIN,
STATE OF MINNESOTA
By:
Chairman of Its County Board
~Assistant County Attorney
Date:
~
And:
Associate County Administrator
ATTEST:
Deputy/Clerk of the County Board
Deputy City of ~op.kins
BY:~
Its Mayor
7'
And:
ft~ City Manager
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City organized under:
Plan A
charterL
Plan B
HCA Form No. 104, Rev. 4/92
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EXHIBIT A
Program Title: Municipal Environmental He8lth Services - Maintenance of Existinq
Proqrams
Problems Addressed:
Problems addressed by this program include the prevention of food-borne illness;
maintenance of lodging and boarding care facilities; community sanitation; children's
camp sanitation; swimming pool sanitation and related activities performed by or
under the supervision of full or part-time environmental health specialists, public
health sanitarians or other personnel approved by the Minnesota Department of
Health.
Goals:
1. Prevent food-borne illness, and contamination and decomposition of food
during production, processing, distribution, storage, preparation and service.
2. Promote safe and sanitary environments in lodging and boarding care facilities
to prevent injuries and illnesses associate with such places.
3. Prevent transmission of acute and chronic disease agents by ensuring quality of
on-site drinking water supplies, and safe and sanitary disposal of on-site
wastewater.
4. Prevent irritations, illnesses, injuries and deaths associated with environmental
conditions of swimming pools and the community environment, children's
camps and other recreational facilities.
5. Provide basic environmental health services consistent with the characteristics
of the geographic area and the population.
Objectives:
1. To ensure, in those municipalities with full-time personnel, the provIsion of
environmental health services consisting of routine inspection, complaint
investigation, licensing, plan review and laboratory testing services.
2. To ensure, in those municipalities with part-time personnel, the provision of
basic environmental health services; continue to examine unmet problems and
expanded programming to fill gaps in services or resources.
3. To develop appropriate agreements with the Minnesota Department of Health
for delegation of authority to permit municipal responsibility for certain
licensing and inspectional activities pursuant to Minnesota Statutes 145.55 or
145.918.
4. To continue the development and utilization of a County-wide information
system for environmental health services.
EXHIBIT B
DEFlNlTJONS/EXPL.c\NA TJONS FOR REPOR TING FC'R.\IS
.
REVENUES, GENERAL: Any environmental health activity for which a permit,
license, or similar centrol device is required and for which a fee is paid, should be
indicated. This includes fees from other municipal departments for which an
environmental expenditure i~ claimed; i.e., revenues from water billing for
expenditures claimed for chlorine, fluorine, or housing maintenance fees/permits
for the provision of housing maintenance inspections. Liquor license fees are not to
be included. Any other revenue; i.e., special grant or subsidy, should be reported in
this section.
EXP5'\,'DITURES, GE'''ERAl.= If expenditures are claimed for services/activities
which are not conducted by regular environmental health personnel (including
overhead and other common costs), then those claims must be supported by:
appropriately documented time distribution records;
an approved uniform system for allocating indirect costs which is applied
and used on all city programs; and
other documentation on file and up-to-date in support of all other
allocation basis used to distribute costs to the program under this
agreement.
For example, "An estimate of 10 percent of a staff person's time devoted to a
program", is not an acceptable allocation process.
PERSONNEL Personnel not providing a full-time equivalent work load in
environmental health should have their work allocation listed on a separate page in
addition to the dollar amount listed in the expenditure section. Personnel such as
housing inspectors, nuisance inspector, City Clerk, City Manager, etc., must have
adequate support documentation provided to claim environmental expenditures
(time reports or statistical allocation).
FRINGE BENEFITS Include employer's contribution to P.E.R.A., F.I.C.A.,
hospitalization insurance, liie insurance and workmen's compensation.
OFFICE SUPPLIES Include costs incurred for telephone, duplication services,
postage, printed forms, and miscellaneous expendable office supplies.
PROFESSIONAL SER VJCES Induce expenditures for lc.boratory c.ctivities or
consultative services related to the environmental health program.
OPERATING SUPPLIES Induce field test equipment, chemicals, thermometers,
sampling materials, film and developing and miscellaneous operating supplies.
EQUIPMENT REPAIR Self-explanatory.
MISCELLANEOUS Include epxenditures for attendance of professional meetings,
continuing education, dues and subscriptions, books and publications.
CAPITAL GUTLA Y Include major expenditures for equipment and facilities.
SPACE RENTAL Self-explanatory.
TRANSPOR T A TION Include cost of operating agency vehicle(s) or reimbursement
for the use of personal auto.
OTHER Please specify, in detail, what the expenditures are for.
EXHIBIT B, continued
COMMUNITY HEAL TH SER VICES SUMt\'lAR Y OF REVENUE AND EXPENSES
ENVIRONI\'lENT AL HEAL TH FOR THE PERIOD
through
FOR THE CITY OF
ENVIRON~lENT AL HEAL TH EXPENDITURES
FULL AND PART-TIME ENVIRONi\1ENTAL HEAL TH PROGRAMS*
Personnel Services (Full-time programs only)
Environmental Health**
Clerical Support**
Other**
BUDGETED
Fringe Benefits
Office Supplies
Professional Services (including part-time environmental
health services)
Operating Supplies
Equipment Repair
Miscellaneous
Capital Outlay
?ce Rental
Transport2 tion
Other (specify)
OTHE9. ENVIRON~i\ENT.~L EXPENDITURES
On-sil:e Sewage Disposal Program
On-site W2ter Supply Program
Animal Control
Noxious Weed Control
Housing Hygiene
Air, Water, Noise Pollution Control
Municipal Water Supply Chemicals (Chlorine and Fluoride only)
L2boratory Support Services (well water, food, testing)
Other (specify)
TOTAL
ACTUAL
~e Exhibit C for explanations.
~n a supplementary sheet or on bottom of page, please providE personnel breakdown (i.e., number of
personnel and program area if appropriate).
EXHIBIT B, continued
eVIRONI\IENTAL HEAL TH REVENUES
REVENUES
Food License Fees
Food Vending Machine Fees
Swimming Pool License Fees
Hoteljfviotel Lodging Fees
Permit/License Fees for On-Site Sewage Systems and Water Supplies
Animal Control Fees or Service Charges
Air/Water/Noise Pollution Control Fees/Charges
Service Charges for Water Treatment Chemicals (Chlorine and Fluoride)*
Weed Control Fees or Service Charges
Pest Control Fees or Charges
Garbage and Refuse Haulers License Fees
Housing/Rental Property Inspection Fees
Other Fees, Grants or Sources of Revenue (specify)
(including CHS funds provided by Hennepin County)
BUDGETED
ACTUAL
eal Tax
TOTAL
CER TIFleA TJON
I certify that to the best of my knowledge and belief that the data reported in the above financial exhibit
is correct and that all transactions were made in accordance with the Agreement provisions and applicable
assurances.
Authorized Official
Date
FisC2.l Management Officer
Date
. ~* evenues for chemicals can be claimed to the extent that the municipal water charges offset total water
.artment expenditures. It is assumed to be 100 percent unless otherwise indicated.
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EXHIBIT C
CHS Annual Report
- Face Sheet -
County ICity Name:
Authorized Agent*:
(Signature)
Date Signed:
...
This form must be signed by the Chairperson or Vice-Chairperson of the Community Health
Board, or an appointed agent.
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GENERAL INSTRUCTIONS FOR CHS REPORTING
One original and two copies of the completed forms must be submitted by April 1, 1989, to the
Minnesota Department of Health District Office. For assistance in completing the forms, contact your
District Representative. One set of these documents will be retained in the District Offices. District
Representatives will forward the original report and one copy to MDH.
COUNlY AND CI1Y REPORTING
A separate reporting form must be completed for each county or city participating in the CHS program,
Each report should include data on all reportable activities that are mcluded in the CHS plan and
budget.
Reportable activities include those which were funded by the local agency through the use of CHS
subsidy, local funds, special projects grants, and other state and federal funds. If one CHS agency
contracts for services with another CHS agency, the agency that funds the services should report the
related activities. Additionally, information may also be requested of those agencies participating in a
special project grant.
REPORTING ACfMTIES AND EXPENDITURES BY PROGRAM CATEGORY
The CHS Reporting forms are organized around the CHS program categories:
.
.
Disease Prevention and Control
Emergency Medical Care
Environmental Health
Family Health
Health Promotion
Home Health Care
Not Allocated to Program
.
.
.
This is done to improve the compatability of the CHS plan, budget, activity report and expenditure
report. This compatability is intended to simplify the analysis and interpretation of the data at a
district and state level. For clarification as to which program category subsumes which activities, see
Appendix I of the CHS Planning and Reporting Manual,
VOLUNTARY NARRATIVE REPORTS
Any additional information that CHS agencies would like to provide in the way of narrative reports is
welcome. Such reports might include local annual reports, reports on local evaluation projects, or other
special reports regarding community health services, If provided, these reports should be In addition to
and distinct from the required forms. This is necessary to avoid confusion as to what data should be
keypunched and processed as a part of the routinely reported data.
GEl't'ERAL DEFINITIONS
Disease Prevention and Control: "Disease prevention and control" means activities intended to prevent
or control communicable diseases; these activities include the coordination or provision of disease
surveillance, investigation, reporting, and related counseling, education, screening, immunization, case
management and clinical services. ,
Emergency Medical Care: "Emergency medical care" means activities intended to protect the health of
persons suffering a medical emergency and to ensure rapid and effective emergency medical treatment;
these activities include the coordination or provision of training, cooperation With public safety agencies,
communications, life-support transportation as defined according to section 144,804, public information
and involvement, and ,system management.
Environmental Health: "Environmental health" means activities intended to achieve an environment
conducive to human health, comfort, safety and well-being; these activities include the coordination or
provision of education, regulation, and consultation related to food protection, hazardous substances and
product safety, water supply sanitation, waste disposal, environmental pollution control, occupational
health and safety, public health nuisance control, institutional sanitation, recreational sanitation including
swimming pool sanitation and safety, and housing code enforcement for. health and safety purposes.
Reporting and Evaluation
49
FORM I. CHS STAFFING BY PROGRAM
INSTRUCTIONS:
Enter the number of FULL-TIME EQUIVALENT (FfE) staff persons for each of the occupation titles
by program category. The number of FfE employees who worked directly for the CHS agency,
regardless of source of funding, are entered in the .Positions ruled" column. The number of FfE
positions provided by contractors are entered in the "Positions Contracted" column. Enter any unlisted
occupation in the "Other" categories and specify the position title in the space provided.
The occupation categories listed on this form are intended to represent a staff person's job title. For
example, the full value of a Public Health Nurse's FfE should be reported on line #12, "Public Health
Nurse." This FfE may, however, be allocated to more than one CHS program (i.e., .5 FfE Family
Health and .5 FfE Health Promotion).
FfE Standards
Some counties use different standards for calculating full-time equivalent (FfE) employees, One
general defmition is a 4O-hour week or 2,080 hours/year as 1 FTE; a vanation in some counties is 375
hours/week or 1,950 hours/year. Please state your county's defmition of FfE in hours per week on
the blank provided under the title .CHS Staffing by Program." Then use your county's FfE standard
to calculate the FfE's to be reported in each occupation by program category.
For contracted positions use the actual FfE figures from billings or end-oC-year reports Crom
contractors. Estimate the FfE for flat fee contracted positions such as a medical consultant. Roster
nurses are considered contracted positions.
In-Kind Staff Effort
Several CHS agencies monitor the FI'E of in-kind staff effort and include the value of this effort in
their CHS budget and expenditure report. If your agency monitors in-kind staff effort, report it on line
15.
NOTE: All FfEs should be rounded to the nearest hundredth (x.xx). If any of the FfEs total more
than zero, but less than .01, report as .01.
DEFINmONS:
Administrative Staff: Individuals, such as an . Accountant/Financial Manager, a CHS Administrator,
clerical support staff, as well as program directors and supervisory staff. This occupation category
would also include the following job titles:
Account Clerk
Administrative Assistant
Administrative Manager
Administrator of Nursing
Assistant Biostatistician
Assistant Director Public Health Nursing
Bookkeeper
Business Office Staff
Clinic Director (general)
Clinic Manager (generaf)
Community Health SeTVlces Supervisor
County Health Dept. Administrator
Custodian/Maintenance
Data Processing Officer
Delivery Worker
Director of Planning & Administration
Driver
Graphic Artist
Health Coordinator
Health Planner
Hcalth Prowam Analyst
Hcalth Stal1stician
Janitor
Marketing Coordinator
Media Specialist
Medicare Consultant
Medical Records Practitioner
Nurse Prowam Manager
Nursing Drrector
Nursing Supervisor
Office Manager
Other Administration
Planner
Public Health Nurse Supervisor
Program Administration (general)
Program Development/Evaluation
Specialist
proWam Planners (general)
Pro~ect Assistant
Project Director
Public Information Specialist
Records Specialist
Supervisor Administrative
Services
Supervisor Public Health Services
Supply Manager
Storekeeper
Reporting and Evaluation
51
as a physican for the CHS agency should be recorded here.
Public Health Nurse: A nurse registered in Slale of Minnesota and certified as a Public Health Nurse.
.
Other Nursing Staff: This occupational category includes Registered Nurses and Licensed Practical
Nurses as well as other positions which directly assist nursing activities, and are not certified as Public
Health Nurses, Other job titles for this occupational category would include:
Asst. Coord. Maternal and Child Health
Child Development Coordinator
Child Health Aide
Development Services Specialist
Dial Aides for PSS
EPS Coordinator
EPS Outreach Worker
EPS Technician
Family Plannin~ Personnel
Hospice Coordmator
MCH Consultant
Manager Maternal and Child Health
Nurse Midwife
Nursing Practitioner
Nursing Consultant
PNA
Respite Care Coordinator
School/Community Health Aide
School Health Aide
Youth Intake Worker
Therapist: Any of the following types of professional workers:
Physical Therapist: A professional worker prepared to evaluate clients' neuromuscular and
functional ability and to initiate a treatment plan, in conference with a physician (see 42 CFR
(Code of Federal Regulations) 405.1201 (i) for required credentials).
Occupational Therapist: A professional worker prepared to help clients develop and maintain
tasks essential to daily living (see 42 CFR 405.1212 (g) for required credentials).
.
Speech Theraoist: A professional worker prepared to treat clients who have a communication
problem relating to speech, language, or hearmg (see 42 CPR 405,1202 (u) for required
credentials).
In-Kind: Several agencies monitor the FfE of in-kind staff effort and include the value of this effort
in their CHS Budget/Expenditure report. If your agency monitors in-kind staff effort, report it on line
15.
.
Other: Any occupation title which cannot be included in the categories listed above. Please try to
include everything possible in the listed categories and specify "other" entries.
Reporting and Evaluation
53
or chemical {>Oisonine' For purposes of this report. a single case of reactivated tuberculosis which has
not resulted m additIOnal infections should not be considered an outbreak. Indicate in this column only
those confrrmed outbreaks in which the agency was the lead or principal investigator.
Probable Foodbome/Waterbome Outbreaks: A probable foodborne or waterborne disease outbreak is
defmed as an incident in which: 1) two or more persons experience a similar illness. usually
gastrointestinal, after ingestion of a common food or water product. and 2) data are insuffiCient for
epidemiologic analysis; however. a specific food or water item is suspected.
Non-Related Outbreaks: Nonfood or nonwater ingestion-associated outbreaks are defmed as two or
more cases of illness related by time and ",lace in which an epidemiologic investigation is conducted and
the results are inconclusive or do not implicate food or water as a source of the outbreak.
Reporting and Evaluation
55
FORM V. ENVIRONMENTAL HEALTH ACTIVITIES
INSTRUCTIONS:
This form should be completed only for those activities which are supported by the agency. Enter the
numbers requested by the column headings for each of the types of facilities and activities listed for the
past year. Lines 1, 2, 3, 4, 5, 6, 7, 8, and 9 should be, reported only by agencies with authority to
license and inspect under delegation agreement with MDH,
DEFINITIONS:
1'vDes of Environmental Health Activities
Facilities in Agency's Jurisdiction: Exact count, if known, of the facilities in the Agency's jurisdiction,
including zero if none exist. Lines 1, 2, 3, 4, 6, 7, 8, and 9 should be reported only by agencies with
authority to license, inspect or permit under delegation agreements with MDH. For #1, 2, 3, 4, 6, and
7 use the number of licenses issued. If uncertain, write unknown or give a range, e.g., less than 25.
Inspections covering compliance with the Minnesota Clean Indoor Air Act (MClAA) must be recorded
on line 5. Facilities are in agency's jurisdiction only when a delegation agreement with MDH exists.
"Facilities Inspected by CHS; column 2, should be the same number Or less than "Inspections by CHS;
column 3.
Facilities Inspected: The number of different individual facilities which were inspected, according to the
definition specified below. '
Inspections: For items #1 - #9, inspection means a complete full-scale planned inspection. It does
not mean short follow-up inspections, e.g., to determine whether freezer temperature is now low
enough, or if NO SMOKING signs are properly posted.
For items # 19, #20, and #21 both systematic and scheduled inspections, e.g., appropriate housing
maintenance inspections, well or septic tank construction, and non-routine inspectIOns should be added
together. .
The difference between "new" and "existing" is made as follows: A system or well is new if it has
never been put to significant use; otherwise it is an existing system.
In every case, there should be at least one inspection for each "facility inspected:
Complaints Received: Any communication concerning any of the activities or facilities listed in the left
hand column, "Received" does not distinguish frivolous from sincere, nor does it include resolution,
Complaints Investigated Through an Inspection: The number of complaints which resulted in an on-
site visit, no matter how brief. Do not enter the number of on-site inspections, The number of
complaints investigated through an inspection is unlikely to be larger than the number entered under
"complaints received:
Enforcement Action: Any method (in writing) undertaken after issuance of an inspection report and
correction orders used to insure compliance, including letter of non-compliance, license revocation or
suspension, administrative hearing, fme, violation tag, or court action, It does not include field
investigation where none of the foregoing action is taken. This same criterion would apply to
enforcement actions relative to the MClAA,
Facility Plans Reviewed: Those reviewed pursuant to a state law or rule, or a local ordinance.
Facilities
Facility: Defined by the types of establishments listed, Each of the establishments listed (i.e., lodging
establishment, a swimming pool, etc,) is a facility.
Food-Beverage Establishment: As governed by Minn. Stat. 157 (1986) and Minn,. Rule, parts 4625.2400-
4625.5000 includes a restaurant, a bar, or a restaurant/bar combination.
NOTE: Vending machine inspections are reported below on line #14,
Reporting and Evaluation
59
Private Sewage System: Consider private sewage systems as those systems dermed in Minn. Rule, parts
7080.0010-7080.0240, whether or not the standards have been adopted by reference by the county, and
whether or not the systems meet those standards.
Animal and Fowl-Control: Activities undertaken to eliminate unsafe or disease enhancing conditions
caused by animals and/or fowl and violations of a local animal control ordinance. Examples are animal
bite investigations; improper waste disposal; and keeping of any animal, fowl, or reptile where prohibited
by ordinance of any municipality or county or without a special permit. Do not include animal
impounding activities or pet leashing enforcement.
Waste Hauler (solid): As regulated under Minn, Rule 7035.0800,
Other: Any activity which does not fit into a previouS' category. Specify the type of activity. Please
try to include everything possible in the listed categories and specify "other" entries,
NOTE: A CHS agency may want to describe in a short narrative form any environmental health (CHS
supportable) activity which the agency deems as being worthy of reporting, i.e., it consumes more than
1 % of its resources or approximately three days' worth of work during one year's time, or it is an
activity which is expected to require significantly more of the agency's resources in succeeding years.
Any reporting done under this heading is purely optional.
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FORM VII. PRIVATE WELL WATER QUALITY
INSTRUCTIONS:
Enter:
1.
the number of private well water samples analyzed for coliform bacteria and for nitrate
nitrogen,
the number of samples containing coliform bacteria and the number containing the specified
levels of nitrate nitrogen,
the number of positive samples for coliform bacteria and for the specified levels of nitrate
nitrogen which received follow-up contact.
Wbat to Include
2,
3.
. The number of samples should include original and repeat samples from private domestic or
commercial wells, food processing plants, schools, licensed establishments; etc.
. If a sample contained both coliform and nitrate nitrogen, it should be counted in both
categories.
What to Exclude
Do not include public community water supply samples.
The saml?les reported as containing 10 mg/l or more (>) of nitrate nitrogen should not be
included m the counts for 1 mg/I or more (>) and less than (<) 10 mg/I nitrate nitrogen.
DEFINITIONS:
Samples Containing Coliform Bacteria: A positive sample which contains one or more bacteria,
Samples Containing Nitrate Nitrogen: A positive sample which contains at least one milligram of
nitrate nitrogen per liter of water.
Follow-Up: Action specific to a particular sample result. It does not include routine attachment of a
letter or information brochure to a lab report which helps in interpretation of results or tells how to
disinfect a welL
Addendum for Environmental Healtb Data
Perhaps the best way to explain the proper recording of environmental health information in the CHS
Report is through answers (A) to a number of questions (0) which have arisen or may arise,
1 0: Jf7Jen a person representing an agency has been subpoenaed and appears in court, how is the
activity recorded?
A: Only court appearances that result from enforcement action taken by the health agency should
be reported, Form V, column 6 would be used. Appearances for any other purpose would
not be reported.
2aO: How does one report the time spent making a site visit for purposes of discussing environmental
health matters such as remodeling a licensed facility or building a facility that will be licensed?
A: An account of this type of activity is not requested.
2bO: If a person representing an organization without an appointment came to an environmental health
agency and discussed requirements for remodeling a licensed facility, how would the activity be
recorded?
A: An account of this type of activity is not requested.
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,
7 0: Should countics with delegation agreemcnts for non-community public watcr supplies report their
non-community public water supply activities on line #9 "Non-Community Public Water Supplies"
cmd line #8 "Well Code Enforcement"?
A: Yes, The Well Code Enforcement program includes non-community public water supplies.
Line #9 gives MDH the information it needs that is unique to licensed and non-licensed non-
community public water supplies,
8 0: If a CHS agency docs laboratory water analysis for other counties or other CHS agencies, who
should be responsible for reporting the number of samples analyzed in Fonn VII?
A: Infonnation should be reported by the agency having jurisdiction where the water sample was
collected, irrespective of where the analysis takes place.
9 0: Are inspection scores for limited food and beverage facilities to be recorded in Fonn VI? Are
limited food and beverage facility activities to be recorded in Fonn V.
A: Yes, the information is to be included in both fonns,
lOQ: Fonn V, line 10, refers to swimming pools. The definition of swimming pools is pools regulated
under Minn, Rule, parts 4717.0100-4717.3900, which means 0/1 public pools, Some environmental
health agencies are also involved with private pools. Should this work be recorded in Fonn V?
A: No, on line 10, only record swimming pool activities that involve public pools (those serving
many people, e.g" schoo~ municipa~ apartment building, townhouse, etc.).
110: How are services provided to agribusiness to be recorded?
A: If a routine inspection is made of the hog farm because a feedlot pennit has been issued, and
if time is spent discussing surface and ground water protection options, then the whole activity
should be reported on line 24 of Fonn V under the heading ~Inspections by CHS."
When an investigation is made at the hog farm as a result of a complaint or inquiry
concemin~ possible surface and ground water pollution, then the activity would a~ain be
reported m Form V under the heading ~Complaints Investigated Through InspectIOn." The
activity would be reported on line 24 and the word ~feedlot" would be added if the agency
issues permits. Line 16 would be used if no permits are issued.
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