Local Public Health Association General Membership Meeting August 16, 2012 Meeting Notes Welcome and Introductions Members were welcomed and all introduced themselves. Chair and Director s Remarks Liz Auch and Britta Orr The minutes from the June meeting were approved with no changes. Executive Committee Update o The NACCHO Conference was great thanks to members for continuing to support this travel for the LPHA Chair and Chair Elect. Seeing other states in action was very valuable. Unintentional injury due to distracted driving is a growing issue. o Jill Briggs has retired and has left the association she couldn t be with us today, but we hope to have her back before the end of the year for acknowledgements. o Please tell Britta if you are interested in the role of Chair Elect or Treasurer for 2013. o Please send speaker ideas for the LPHA Annual Meeting to Britta or Liz via email. o The recent MDH Executive Office meeting went well. MDH is putting a lot of time into reviewing changes to the genetic privacy law following the Bearder decision. They want to know how it could impact local public health. The Commissioner was very positive about sustainable, statewide funding for SHIP. LPHA members continue to be part of conversations around Minn. Stat. 145A (the Local Public Health Act). Britta has communicated a strong interest in remaining at the table as language is drafted. o Strategic planning and budgeting are both ongoing. Job shadowing will be deemphasized to accommodate this work. o A Master s capstone pilot opportunity is available through Tricia Todd at the School of Public Health. It would involve hosting a team of students around a specific project. Director Update o Regional visits have been going well. o Britta has a number of meetings coming up with MDH staff (Jeanne Ayers, Linda Bruemmer, and Lee Ho included). o Sen. Hall called a tobacco tax hearing last week and Britta testified along with many members of the Raise it for Health Coalition. o Survive & Thrive fellow applications are now available. o The AMC Conference will include a session by LPHA highlighting our key public health messages and building off the theme of an elevator speech. 1
LPHA Committee Updates Legislative Committee Bonnie Brueshoff. o Teams are being formed to fine tune the platform. We will use the same format as in the past. o Patty Bowler introduced a letter directed to the Commissioner of Health urging MDH to request that the Governor seek sustained funding for MDH s lead surveillance system. The Executive Committee approved signing on to this letter as an association. o The Public Health Law Conference for the Northern Region was attended by a few LPHA folks. The Public Health Law Network (PHLN) is ready to provide technical assistance to locals. Sign up to get PHLN resources on your radar (www.networkforphl.org). o Testimony training will take place on October 18. Julie Myhre shared that her experience was very positive in this training last year. The skills learned are translatable into many other venues (with local legislators, county commissioners, and so on). Policy and Practice Committee Britta Orr. o The committee recently collected elevator speech ideas that others have used and worked through some taglines that could move forward for LPHA. The main focus was on key products (vehicles) for this messaging that might be useful to LPHA members. Informatics Subcommittee Wendy Bauman. o Basics of the Omaha System training will take place around the state in September. The cost is $135 for 5.5 contact hours. o Normandale Community College is accepting students for their totally online mid career professional program in health IT. Scholarships are available. See www.mnhealthit.com. o At a high level, there will be a meeting with Ellen Benavides and Marty LaVenture tomorrow to talk about the state and locals moving forward in HIT and what needs to make that happen. We will advocate leveraging funding for someone within OHIT to work more closely with LPHA. o At a practical level, the SCHSAC HIT work group will talk about home visiting and specific data elements involved in the new federal expansion benchmarks as a concrete project to better align our informatics/exchange infrastructure. MDH Updates Deb Burns, Office of Performance Improvement There is an opportunity to apply for a Pew Grant on Health Impact Assessment. Fracking is one area under consideration. If anyone is interested in this, contact Jim Kelly at MDH (james.kelly@state.mn.us; 651 201 4910). A brief proposal is due in September. The collection, storage, use, and dissemination of genetic information have potential farreaching implications after the Bearder decision and MDH is reviewing the extent of impact on programs outside of newborn screening. o MDH has an inventory of program areas regarding what genetic material is collected. They are looking for input from LPHA volunteers since CHBs/LHDs fit the definition of government entities. Next week we ll sift through priorities at the second 145A working session. Information will go back to a SCHSAC work group regarding the statute. 2
o There was mention of a more formal orientation for new MDH staff/department leaders to go out and see local public health in action. Gretchen Musicant suggested talking to the Executive Committee to identify a range of opportunities depending on scope/curiosities. MDH is applying for the shared services grant on behalf of all those interested both level one and level two CHBs. o Level one is actively in the process of sharing services. o Level two is interested in learning opportunities that would trickle down from level one. If we aren t funded, we should talk about other ways we could do something along these lines. Candy Kragthorpe and Laurel Briske talked with members about the MIECHV expansion. o Candy clarified certain parameters of the grant. It is very much federally prescribed based on nationwide home visiting efforts and is being evaluated that way. The agreement is to do one of the two evidence based programs, either Healthy Families America (HFA) or Nurse Family Partnership (NFP). o Candy cannot post the awards until MDH has been approved to expend the funds, which will not happen any sooner than October due to the role of the Legislative Advisory Commission (LAC). o Right now they are contacting those who are considered high risk. As you re contacted by nurse consultants, please develop a very specific budget telling them what you d need to do this program. Awards will be based on risk scores. Capacity for success will also be considered. o Awards include funding for training. The training offered by MDH is an extra resource. If you enter into this agreement, you will also have money to contract with national developments if MDH can t provide training in a timely manner. o It is not certain yet whether the evaluation by the University of Minnesota is separate from the 35 benchmark items. It is specific to reflective practice and motivational interviewing and they will probably do site visits. The U of M cannot be started as a contractor until the money is available to be spent, but one requirement of the original proposal was to include an evaluation with an outside evaluator. A suggestion was made to integrate these evaluations if it is at all possible. o If you haven t heard from MDH, that doesn t necessarily mean you don t have the risk factors to qualify for MIECHV expansion funds. MDH is not done following up yet and expects to speak to everyone who submitted the survey. The LAC will meet the second week of October. o What is MDH spending money on? A little over $6 million will go out for local agreements ( subcontracts ). They will hire two new nurse consultants to be out in the field to help develop programs. Contracting with the IT department to improve PPMRS for home visiting reporting. o The funds are not intended to be geographically diverse. On the website risk scores are adjusted for population. o They will not fund any site to serve less than 25 families. This was not in the survey, but is a requirement according to models by HFA/NFP. 3
Healthy Minnesota 2020 Partnership and Framework LPHA members were encouraged to join the Healthy Minnesota 2020 Partnership subscriber list. All should go back and see where they fit into this framework and these strategies at the local level. LPHA can use regional meetings to do this. Questions asked by LPHA members included whether the framework has natural links to CHIP, community health assessments, and/or accreditation. One person commented that this framework, along with the HM2020 Statewide Health Assessment, can be useful in arguing for health as the basis for human services. Another comment suggested that some people will see this framework as transferring department duties and staff to other areas (SNAP, housing, job development, and so on). o We would appreciate MDH helping to offer specific insights on the unique role of public health within this framework. The full PowerPoint shared by Dorothy Bliss is available through the password protected portion of the LPHA website. Networking Lunch DHS Reform 2020: Long Term Care Reform in Minnesota A number of individuals from the Continuing Care Administration at DHS visited the LPHA meeting: Lisa Rotegard in Aging/Adult Services as well as Pam Erkel and Lori Lippert in Disability Services. Lori offered a primary presentation around Medicaid reform, long term supports, and human services reforms. o She shared that a strong system of home and community based services in Minnesota has been 30 years in the making. This is a watershed moment for a number of reasons including changing demographics and economic pressures. Are we getting out of the case management business and into the assessment business? o Case management is something that over the last 15 years advocates/stakeholders have been asking to review. Some people have access to many, some have access to none, and there have been three reports with recommendations in the past decade. A case management workgroup began as required by legislation. MNChoices is separating the administrative side of case management from the services side. The case manager is more of an advocate role while the administrative/gatekeeping role is more about access to public funding. 2007 and 2011 reports both recommended a need for choice of case managers. The work group will begin again in September and consider provider standards for case management and how we will pay for it. Right now counties can case manage/assess, but there is a shift toward counties being less involved in case management. Criteria will need to be set to ensure that those doing assessment do not have a conflict of interest with those who advocate for specific services. What is the payment model for MNChoices? o Random moment time studies will be used. o Assessments will now be done looking at a client s needs, what services would be appropriate, and how we can resource them. 4
Can you speak more about CFSS replacing PCA? How soon will this happen? Will organizations just flip over? o PCA was initially designed around older adults (18 64) with physical disabilities; it was about doing things for people. Since we ve added to who can get PCA services (children and the mentally ill, for example), it has made the program almost untenable. CFSS is meant to be a self directed program that allows a direct care worker to do more in terms of skill acquisition/enhancement things that currently require waivers. There will be an implementation council for this service that will begin before the feds approve the waiver application. It will take about 1.5 years to decide how this will look. The goal for implementation of CFSS is January 1, 2014. There was discussion about assessment involving the right professional, for the right purpose, at right time, and in the right way. Social workers do not necessarily have the same skill as public health nurses to do in home health assessments. o DHS feels there is a place for both and that is why a multidisciplinary team will be used. MNChoices is currently in the beta testing phase, which means the tool is pretty much done. Dakota County is working with DHS to do reassessment using the new MNChoices assessment through the beginning of September. o Beta 2 testing will take place at the end of October and beginning of November. o First implementer lead agencies 14 counties, 2 tribes, and 3 health plans have been involved for the last few years. They will again test rules and also offline capability (since it was built so web access is not necessary). o Before Beta 2, first implementers will do training (a broad overview of MNChoices, programs, and other information) all online. After they ve gone through general training, they will engage in application training, and then they ll conduct assessments. In March of 2013 first implementers will begin real use. o Training for non first implementers is still under discussion, but may be happening reasonably soon. o By the end of 2013 everyone will be using statewide. The full PowerPoint shared by the group is available through the password protected portion of the LPHA website. Announcements and Other Business A letter was received in a number of counties from the VA related to HIPAA privacy and communicable disease. A question was forwarded to Kris Ehresmann at MDH who will talk to her legal department and respond to Renee Frauendienst with thoughts. Britta will be asked to disseminate more information once it is available. Adjourned at 2:30 p.m. 5
In attendance Liz Auch, Countryside Public Health Susan Brace Adkins, Goodhue County Merrilee Brown, Scott County Lisa Brodsky, City of Bloomington Bonnie Brueshoff, Dakota County Jennifer Deschaine, Scott County Peggy Espey, Dodge County Renee Frauendienst, Stearns County Sue Hedlund, Washington County Mary Hildebrandt, Nicollet County Laurel Hoff, Anoka County Janet Howard, Nobles County Lowell Johnson, Washington County Karen Jorgensen Royce, Wright County Kathy Landwehr, Sherburne County Cheri Lewer, Waseca County Gwen Lewis, Pine County Marina McManus, St. Paul Ramsey County Todd Monson, Hennepin County Karen Moritz, Brown County Gretchen Musicant, City of Minneapolis Julie Myhre, Carlton Cook Lake St Louis CHB Bonnie Paulson, Morrison County Laura Reid, Sibley County Carol Schefers, Wright County Janelle Schroeder, Mille Lacs County Cindy Shaughnessy, Le Sueur County Marcee Shaughnessy, Carver County Karen Swenson, Brown Nicollet Counties Sue Yost, Freeborn County Karen Zeleznak, City of Bloomington ITV attendance Clearwater County site: Bonnie Engen, Clearwater County Cook County site: Joni Kristenson, Cook County Crow Wing County site: Diana Graning, Benton Cheryl Schneider, Todd County Koochiching County site: Susan Congrave, Koochiching County MDH Fergus Falls: Sharon Braaten, Pope County Debra Jacobs, Wilkin County Kathy McKay, Clay County Ronda Stock, Becker County Diane Thorson, Otter Tail County NCROC site: Sue Erzar, Itasca County Polk site: Jamie Hennen, Norman Mahnomen Counties Sara Reese, Kittson County Renville County site: Jill Bruns, Renville County Kathy Nowak, McLeod County Genie Simon, Redwood County Winona County site: Merrily Hazelton, Winona County Rachel Nice, Winona County Deb Rock, Houston County Lantha Steven, Fillmore County 6