dvhhs: aug. 14 packet

Des Moines Valley Health and Human Services

Board Meeting Agenda

Date August 14, 2014 9 a.m. Conference Room – LEC – Windom

I. Call to Order / Establish Quorum

II. Public Hearings (if applicable)

III. Approval of Agenda

________________________________________________________________________________________________

IV. Consent Agenda: All items listed under the Consent Agenda are considered to be routine by the DVHHS Board and will be enacted by one motion and an affirmative vote of a majority of the members present. There will be no separate discussion of these items unless a Board Member so requests, in which event the item(s) will be removed from the Consent Agenda and considered separately by the Board under Other below.

a. Approve Auditor Warrants (summary in packet)

b. Approve July 11, 2014 Board Minutes (in packet)

c. RBA- Approval of FSN Joint Powers Agreement/Contract Amendment

d. Approve New Public Health Policies–(Attachment A) Admission Policy, Admission Process Policy, Bill of Rights Grievance Policy, Clinical Record Review Policy, Consent for Medical Photography Policy, Coordination Policy, Emergency Response Plan Policy, Home Health Aide Supervision Policy, Home Health Aide Services Policy, Medicare Qualifying Criteria Policy, Medication Administration Error Policy, Medication Management Policy, Medication Profile Policy, Non-Coverage Policy, Oasis Policy, Professional Standards Policy, Provision of Availability Policy, PT/INR Professional Testing System Policy, Service Plan Policy, Skilled and Maintenance Policy, Staff Competencies Policies, Supervision of Service Policy

e. RBA- Approve New Policy 369 Wage Disclosure Protection, Approve Updated Policy 724 Leave Benefits Sick

f. Approve Joint Powers Agreement for Group Employee Benefits

g. Approve Records Retention Schedule

_______________________________________________________________________________________________

V. Staff / Programming Report- DVHHS Child Support Unit

VI. Executive Director Agency Report

VII. Human Services

a. Director’s Report

VIII. Fiscal

a. Fiscal Reports

b. Approval of DVHHS 2015 Budget

c. Director’s Report

IX. Operations


X. Human Resources


XI. Public Health

a. RBA- Public Health Quarterly Statistics

b. RBA Recommendation for Rose Schultz as to future PHEP Grant Formula to SCHSAC

c. RBA- Approval of JCC School Health Contract

d. Director’s Report

XII. Other

XIII. Adjourn

DVHHS Audit List

May 2014

Date

Beginning

Warrant Number

Ending

Warrant Number Amount

7/9/2014 2364 2415 $24,855.13

7/10/2014 2416 2455 $21,156.81

7/14/2014 2456 2456 $133.37

7/23/2014 2457 2491 $26,310.80

7/24/2014 2492 2513 $8,223.90

7/28/2014 2514 2552 `

7/1/2014 5441 5479 $12,637.43

7/1/2014 5480 5498 $4,067.88

07/05/20114 5499 5500 void

7/7/2014 5501 5514 $14,804.88

7/8/2014 5515 5564 $41,230.81

7/8/2014 5565 5565 $768.80

7/8/2014 5566 5566 $920.31

7/9/2014 5567 5570 $3,774.43

7/10/2014 5571 5589 $26,485.60

7/10/2014 5580 5601 void

7/10/2014 5602 5620 $16,165.12

7/22/2014 5621 5677 $123,948.00

7/22/2014 5678 5703 $63,672.68

7/28/2014 5704 5720 $345,909.56

7/29/2014 5721 5762 $28,849.48

$763,914.99TOTAL OF WARRANTS

The regular meeting of the Permanent Joint Powers Board of Des Moines Valley Health and Human Services (DVHHS) was called to order Thursday, July 10, 2014 at 9:03 AM at the Law Enforcement Center in Windom, Minnesota.

Presiding over the meeting was Chair Rosemary Schultz. Members present for the meeting were Commissioners, Dave Henkels, Norman Holmen, Kim Hummel, John Oeltjenbruns, Kevin Stevens, Jim Schmidt, Tom White, and Gary Willink. Absent: William Tusa. Also present were Craig Myers, DVHHS Executive Director, Patricia Stewart, Public Health Director, Robert Pankratz, Director of Business Management, Kay Steffen, Director of Agency Operations, Tammy Crowell, Collections/HR. Quorum Established.

Agenda Approval Motion by Schmidt, second by Oeltjenbruns and unanimous vote to approve Agenda.

Organizational Consent Agenda

Claims in the amount of $1,128,041.13. A detailed list of claims paid is available upon request.

June 12, 2014 Board Minutes Approval of Employee Advisory Committee Membership Approval of updated policies: Leave Benefits-Personal, Definitions, Confidentiality and

Data Privacy, Sick Leave for Fitness Form, Phased Retirement Option (PRO) and Agreement

Approval of Avera McKennan (d/b/a Avera Behavioral Health Center) Contract Renewal Motion by Henkels, second by Willink and unanimous vote to approve the Consent Agenda items. Staff/Programming Report Presentation by Diana Madsen on the SHIP program. Video and Power Point presentation given on what the SHIP program is, and the projects that SHIP is involved with in the community. SHIP is designed to take a proactive approach to preventable risk factors.

Executive Director Agency Report Craig gave an update on the Work Effects strategic plan process. Initial meetings and trainings are being scheduled. All Board members were interested in participating in the work session. Work Effects Insights addition Request for Board approval to add the Insights package for the leadership group up to a maximum cost of $4,875. Motion by Schmidt, second by White and unanimous vote to approve the Insights add on to the Work Effects package up to a maximum of $4,875.

Human Services Director’s Report Southwest Mental Health Center Consulting Project Request for Board approval up to $5,000 towards costs for specialized mental health consulting services that are needed for children. DVHHS will pay costs not covered by insurance not to exceed $5000. Motion by White, second by Hummel and unanimous vote to approve payment up to $5000 for the SWMHC consulting pilot program. Update on Southern Prairie Community Care. Update on some challenges with MNChoices around the areas of technology and staffing needs. Information presented about changes to the Home and Community Based Services and the impact on consumers. Update on changes around Case Management for both children and adults around the review process.

Fiscal Budget Report Robert Pankratz, Director of Business Management, presented the budget report and the Out of Home Placement costs report. Director’s Report Information provided regarding the special budget work session that will be held July 31, 2014 at 9:30 am in the basement of the Windom Law Enforcement Center.

Operations Operations Report Kay Steffen, Director of Agency Operations, presented an update on staff changes.

Human Resources Life Insurance for employees on Phased Retirement Option Request for Board approval to offer life insurance to employees who are under the Phased Retirement Option who work a maximum of 1040 hours per year. Motion by White, second by Schmidt and unanimous vote to approve Life Insurance being made available to those covered under the Phased Retirement Option. Phased Retirement Option Benefits- Agreement Request for Board approval of a Phased Retirement Option Benefits- Agreement with Rosalyn Carsten effective January 1, 2015. Motion by Schmidt, second by White and unanimous vote to approve the Phased Retirement Option Benefits-Agreement signed by Rosalyn Carsten.

Public Health

Registered Nurse Position Request for Board approval of the resignation of Charlotte Powers from a full time employee to Roster Nurse, and motion to approve filling the position with a 40 hour a week RN. Position was reduced to 32 hours at the May 8, 2014 meeting. Motion by Stevens, second by Henkels and unanimous vote to approve the Charlotte Powers from full time employment to Roster Nurse effective July 11, 2014 and to re-fill vacated position at 40 hours per week.

Out of State Travel Request for Board approval of out of state travel for Angela Naumann and Luke Ewald to attend the National Tobacco Coordinators training in New Orleans August 13th and 14th. Motion by Schmidt, second by Holmen and unanimous vote to approve the Out of State Travel for Angela Naumann and Luke Ewald. Director’s Report Pat Stewart, Public Health Director updated the Board on staff changes. Brief update on the findings of the 2013 State Audit. The Annual Community Health Conference will be held at Cragun’s Resort in September. Update on Tobacco program and upcoming media support for tobacco free and smoking cessation programs. Pitching with the Commissioner Event Pitching with the Commissioner Event will be held on July 22, 2014 in Worthington. The Commissioner of Health will be doing a presentation and there will be an opportunity to meet with the Commissioner of Health and discuss legislative concerns. Motion by Schmidt, second by Holmen and unanimous vote to approve payment of per diem for commissioners attending the Pitching with the Commissioner Event.

Adjourn Motion by Hummel, second by White, and unanimous vote to adjourn meeting at 11:19 a.m. __________________________ ___________________ Chairman Date _______________________________________ _____________________________ Attest To Date

Complete and email this form to: [email protected]


Request for Board Action

** Requests must be received by the Board Secretary before noon the Thursday PRIOR to the regularly scheduled board meeting. ***

Requested Board Date: 08/14/2014

Agenda Type: Consent Agenda

Agenda Item: FSN Joint Powers Ammendent to Agreement

Presenter: Click here to enter text. Estimated Time: Click here to enter text.

Board Action Required: Approval of Ammendment to FSN Joint Powers Agreement

Attachments: Yes, identify below Attachment Name: Click here to enter text.

Background:

Fiscal Impact: None

Attorney Review: Not Applicable

Board Action: ☐Approved ☐Denied ☐Tabled ☐No Action

Motion: ________________________

Second: _______________________

Roll Call Vote: ☐Henkels ☐Holmen ☐Hummel ☐Oeltjenbruns ☐Schmidt

☐Schultz ☐Stevens ☐Tusa ☐Willink ☐White

Notes:_____________________________________________________________________________________

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Des Moines Valley Health and Human Services Adopted: xx/xx/xxxx Employee Policy Handbook Effective: xx/xx/xxxx This policy repeals all prior policies relating to this subject

Wage Disclosure Protection Policy Number: 369

According to Minnesota Statute § 181.172, an employee has the following rights and protections related to wage disclosure. (a) An employer shall not: (1) Require nondisclosure by an employee of his or her wages as a condition of

employment; (2) Require an employee to sign a waiver or other document which purports to deny an

employee the right to disclose the employee's wages; or (3) Take any adverse employment action against an employee for disclosing the employee's

own wages or discussing another employee's wages which have been disclosed voluntarily.

(b) Nothing in this section shall be construed to: (1) Create an obligation on any employer or employee to disclose wages; (2) Permit an employee, without the written consent of the employer, to disclose proprietary

information, trade secret information, or information that is otherwise subject to a legal privilege or protected by law;

(3) Diminish any existing rights under the National Labor Relations Act under United States Code, title 29; or

(4) Permit the employee to disclose wage information of other employees to a competitor of their employer.

(c) An employer that provides an employee handbook to its employees must include in the

handbook notice of employee rights and remedies under this section. (d) An employer may not retaliate against an employee for asserting rights or remedies under

this section. (e) An employee may bring a civil action against an employer for a violation of paragraph (a) or

(d). If a court finds that an employer has violated paragraph (a) or (d), the court may order reinstatement, back pay, restoration of lost service credit, if appropriate, and the expungement of any related adverse records of an employee who was the subject of the violation.

Des Moines Valley Health and Human Services Adopted: 09/26/2013 Employee Policy Handbook Effective: 01/01/2014 This policy repeals all prior policies relating to this subject Revised: 04/10/2014

Leave Benefits – Sick Policy Number: 724

Des Moines Valley Health and Human Services (DVHHS) provides paid sick leave benefits to regular full-time employees and regular part-time employees for use for temporary absences due to illness, injury or medical appointments for the employee or the employee’s immediate family members as provided for in this policy. For purposes of this section, immediate family member is defined as the employee's spouse, child (including adult child, stepchild, biological, adopted and foster), grandchild, sibling, parent, mother-in-law, father-in-law, grandparent or stepparent. Sick leave shall be earned as follows for those employees averaging twenty-four (24) hours per week or more:

Hours Scheduled per Week

Monthly Sick Leave Earned (hours)

Maximum Sick Leave Accrual (hours)

40 8.0 960 32-39 6.4 768 24-31 4.8 576

Regular part-time employees averaging less than twenty-four (24) hours per week will receive eight (8) hours of sick leave for every 173.33 hours worked. Sick leave may accumulate to one hundred sixty (160) hours. Sick leave over one hundred sixty (160) hours will accrue to the catastrophic sick leave bank, as described in this policy. Employees who are unable to report to work due to illness or injury shall notify their supervisor before the scheduled start of their workday. If such notice is not possible, the employee shall contact their supervisor within one-half hour of the employee’s scheduled start time. The employee shall also notify their supervisor for each additional day of absence. Requests for use of sick leave for medical appointments or other planned absences shall be made in writing to the employee’s supervisor as far in advance as possible. If an employee is absent for three or more consecutive days due to illness or injury, the employee shall, on request of their supervisor, provide the agency with a physician’s statement verifying the reason for the absence and the beginning and expected ending dates of the absence. Employees claiming sick leave when physically fit or when not otherwise eligible for sick leave as set forth within this provision shall be subject to disciplinary action, up to and including termination of employment. An employee shall, if requested by a supervisor, director or Human Resources, provide a return to work certification after being absent from work due to illness or injury before the employee will be allowed to return to work. An employee on an extended leave of absence due to a work-related injury or serious medical condition must apply for all other available compensation and benefits, such as workers’ compensation, PERA and other employer-provided disability benefits. Sick leave benefits shall be used to supplement any payments that an employee is eligible to receive from other sources as set forth above. The combination of any such disability benefits and sick leave benefits shall not exceed the employee’s regular weekly earnings.

2


Sick leave may also be used by an employee in the event of death or serious illness of an employee’s immediate family member through lineage or marriage, or in situations where the illness of an immediate family member requires the presence of the employee. Requests for use of sick leave for these purposes must be made in writing to and approved by the supervisor. Pursuant Minnesota Statutes, sick leave may be used for “safety leave” which is defined as “leave for the purpose of providing or receiving assistance because of sexual assault, domestic abuse, or stalking.” Safety leave can be taken for the employee on his or her own behalf, or to help an immediate family member, as defined above, receive assistance. Employees shall begin earning sick leave and are eligible to use earned sick leave immediately upon assignment to an eligible employment classification. Sick leave is earned at the end of each pay period and cannot be used until the pay period after it is earned. The amount of sick leave earned shall be prorated in the first and last months of employment. Sick leave may be used in increments of no less than one-quarter hour. Accrued sick leave benefits shall be paid to an employee who has worked for the agency for more than five years upon voluntary termination or retirement from agency employment based on the following schedule.

Years of Service Rate of Sick Leave Payout at Termination

6-10 years 20% 11-15 years 25% 16-20 years 30% 21-25 years 35% 26-29 years 40% 30+ years 50%

An employee who is involuntarily terminated for cause from agency employment or who resigns pending charges of misconduct will forfeit all accrued sick leave. In the event an employee dies while employed by DVHHS, the appropriate sick leave payout will be made to the employee’s estate. Payment shall be made at the employee’s hourly rate of pay at the time of termination, retirement or death. Employees who have accrued the maximum amount of sick leave allowable may continue to accrue sick leave that shall be contributed to a special catastrophic sick leave bank for that employee. Use of catastrophic sick leave shall be available only after all accumulated sick leave and vacation leave have been exhausted. Requests for use of such leave must be made in writing to the director and approved by the DVHHS Board. Employees shall not be compensated for any accrued catastrophic sick leave upon termination, whether voluntary or involuntary. Sick Leave Payout Transition When determining Years of Service for sick leave payout for former employees of Jackson County, Cottonwood County and Cottonwood Jackson Community Health, Years of Service with their prior respective agency as of December 31, 2013, will be added to their Years of Service with DVHHS.

3


An employee who on December 31, 2013 is covered under a policy that pays out a higher rate of sick leave at termination or retirement than this policy, will be eligible for a payout of hours at retirement or termination up to the sick leave balance as of December 31, 2013 at the payout rate for which they were eligible under that policy or the payout rate under this policy, whichever is higher.

Example 1: On December 31, 2013, employee Jane Doe is covered under policy that pays 20% at resignation and 100% at retirement. On December 31, 2013, Jane has 400 hours of sick leave. Jane retires on December 31, 2020 after 25 years of service with a balance of 600 hours of sick leave. Her sick leave payout would be 400 hours @ 100% (payout benefit under previous policy) plus 200 hours @ 35% (payout benefit under DVHHS policy), for a total of 470 hours.

Example 2: On December 31, 2013, employee John Doe is also covered under the policy that pays 20% at resignation and 100% at retirement. On December 31, 2013, John has 400 hours of sick leave. John leaves employment on September 1, 2015 for another position after 15 years of service with a balance of 300 hours. John’s sick leave payout would be 300 hours @ 25%, or a total of 75 hours. Note: All sick leave payouts may be subject to Post-Employment Health Care Savings Arrangement - Policy # 762.

Catastrophic Sick Leave Transition Each employee’s Catastrophic Sick Leave Balance existing as of December 31, 2013, will be transferred to their new DVHHS Catastrophic Sick Leave account. Catastrophic Sick Leave Balances cannot be transferred to regular sick leave even if that employee’s maximum accrual balance has increased. References: Definitions – Policy # 110 Leave Benefit – Bereavement – Policy # 730 Post-Employment Health Care Savings Arrangement - Policy # 762 Sick Leave Donation – Policy # 765 Sick Leave for Fitness – Policy # 768 Workers Compensation – Policy # 560





Requested Board Date: August 14, 2014

Agenda Type: Regular

Agenda Item: Quarterly Statistics for Public Health

Presenter: Mary Bezdicek Estimated Time: 20 minutes

Board Action Required: None informational only

Attachments: Attachment Name:

Background:

Fiscal Impact:

Attorney Review:





Requested Board Date: 8/11/14

Agenda Type: Regular Agenda

Agenda Item: Click here to enter text.

Presenter: Pat Stewart Estimated Time: 5 minutes

Board Action Required: Recommendation for Rose Schultz as to future PHEP Grant Formula to SCHSAC

Attachments: Yes, identify below Attachment Name: PHEP Funding Formula, Q&A, Funding Spreadsheet

Background: See PHEP Funding Formula Sheet

Fiscal Impact: Negative impact on overall funding

Attorney Review: Not Applicable

Board Action: ☐Approved ☐Denied ☐Tabled ☐No Action

Motion: ________________________

Second: _______________________

Roll Call Vote: ☐Henkels ☐Holmen ☐Hummel ☐Oeltjenbruns ☐Schmidt

☐Schultz ☐Stevens ☐Tusa ☐Willink ☐White

Notes:_____________________________________________________________________________________

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Scenario #3A -new SVI, benchmark, collaboration Summary

LHD Amount Available $3,723,563 Base Funding 400,000$ 11%Population percentage 62.5% 2,327,227 Funds Based on Population 2,327,227$ 63%Base 8,000$ 400,000 Funds Based on SoVI Index 405,915$ 11%Balance for Funding Criteria 996,336 Funds Based on Benchmark 291,326$ 8%Points 10,260 Funds Based on Collaboratio 299,095$ 8%amount per point 97.11$ 3,723,563$ 100%

2014 - 2015 Local/Tribal Preparedness Awards

Community Health Board

*2012 Population Estimates Base Award

Population Award SoVI Index

Bench- marks

Collaboration

Total Points

Points Award

2013- 2014 New Formula Base Award PHEP only

2013- 2014 Actual Base Award PHEP

only

2012- 2013 PHEP Base

Award


Award

$ Change 2013-2014 Base only

% Change 2013-2014

PHEP Base only

Max 15% decrease

Max 60% cap on increase

2013-2014 Potential

Award with caps

2013-2014 Additional CRI Award

Aitkin-Itasca- Koochiching CHB 74,356 8,000$ 32,169$ 140 60 60 260 25,248$ 65,418$ $64,593 $69,304 $73,157 825 1%Aitkin 15,927 60 $19,000 $20,000 $23,000Itasca 45,221 40 $26,593 $29,304 $27,157

Koochiching 13,208 40 $19,000 $20,000 $23,000Anoka County CHB 336,414 8,000$ 145,546$ 40 60 60 160 15,537$ 169,083$ $197,834 $215,168 $202,030 (28,751) -15% $67,016Becker County CHB 33,000 8,000$ 14,277$ 60 60 60 180 17,480$ 39,757$ $19,000 $21,139 $23,000 20,757 109% (9,357) 30,400 Benton County CHB 38,865 8,000$ 16,815$ 60 60 40 160 15,537$ 40,352$ $22,855 $25,636 $23,340 17,497 77% (3,784) 36,568 Countryside CHB 44,160 8,000$ 19,105$ 170 60 100 330 32,046$ 59,151$ $95,000 $100,000 $115,000 (35,849) -38% 21,599 80,750

Big Stone 5,164 20 $19,000 $20,000 $23,000Chippewa 12,135 60 $19,000 $20,000 $23,000

Lac qui Parle 7,109 20 $19,000 $20,000 $23,000Swift 9,594 30 $19,000 $20,000 $23,000

Yellow Medicine 10,158 40 $19,000 $20,000 $23,000Blue Earth County CHB 65,091 8,000$ 28,161$ 40 60 40 140 13,595$ 49,756$ $38,278 $41,632 $39,090 11,478 30%Brown-Nicollet 58,354 8,000$ 25,246$ 80 60 40 180 17,480$ 50,726$ $38,000 $41,284 $46,000 12,726 33%

Brown 25,425 40 $19,000 $20,000 $23,000Nicollet 32,929 40 $19,000 $21,284 $23,000

Carlton-Cook-Lake-St. Louis CHB 251,670 8,000$ 108,882$ 160 60 60 280 27,190$ 144,073$ $176,588 $193,233 $189,300 (32,515) -18% 6,027 150,100 Carlton 35,348 60 $20,787 $23,014 $23,000

Cook 5,185 20 $19,000 $20,000 $23,000Lake 10,818 20 $19,000 $20,000 $23,000

St. Louis 200,319 60 $117,801 $130,219 $120,300Carver County CHB 93,707 8,000$ 40,541$ 20 60 60 140 13,595$ 62,137$ $55,106 $59,210 $56,275 7,031 13% $18,667Cass County CHB 28,357 8,000$ 12,268$ 40 60 40 140 13,595$ 33,864$ $19,000 $20,000 $23,000 14,864 78% (3,464) 30,400 Chisago County CHB 53,452 8,000$ 23,125$ 30 60 40 130 12,624$ 43,750$ $31,433 $35,046 $32,100 12,316 39% $10,648City of Bloomington CHB** 84,057 8,000$ 36,366$ 40 60 100 200 19,422$ 63,788$ $49,431 $54,088 $50,480 14,357 29% $16,745City of Edina CHB** 48,620 8,000$ 21,035$ 20 60 100 180 17,480$ 46,515$ $28,592 $31,604 $29,198 17,923 63% (768) 45,747 $9,685City of Minneapolis CHB** 387,753 8,000$ 167,757$ 80 60 100 240 23,306$ 199,063$ $228,025 $248,814 $232,862 (28,961) -13% $77,243City of Richfield CHB** 35,724 8,000$ 15,456$ 80 60 100 240 23,306$ 46,762$ $21,008 $22,911 $23,000 25,754 123% (13,149) 33,613 $7,116Clay-Wilkin CHB 66,740 8,000$ 28,874$ 90 60 100 250 24,277$ 61,152$ $54,375 $58,371 $59,126 6,776 12% $11,983

Clay 60,155 60 $35,375 $38,371 $36,126 $11,983Wilkin 6,585 30 $19,000 $20,000 $23,000

Cottonwood-Jackson CHB 21,878 8,000$ 9,465$ 80 60 60 200 19,422$ 36,887$ $38,000 $40,000 $46,000 (1,113) -3%Cottonwood 11,597 60 $19,000 $20,000 $23,000

Jackson 10,281 20 $19,000 $20,000 $23,000Crow Wing County CHB 62,882 8,000$ 27,205$ 40 60 40 140 13,595$ 48,800$ $36,979 $40,648 $37,763 11,822 32%Dakota County CHB 405,088 8,000$ 175,257$ 30 60 60 150 14,566$ 197,823$ $238,219 $259,203 $243,272 (40,395) -17% 4,663 202,486 $80,696Dodge-Steele CHB 56,553 8,000$ 24,467$ 60 60 60 180 17,480$ 49,947$ $40,360 $43,788 $46,000 9,587 24%

Dodge 20,231 20 $19,000 $20,000 $23,000Steele 36,322 40 $21,360 $23,788 $23,000

Faribault-Martin CHB 34,738 8,000$ 15,029$ 70 60 60 190 18,451$ 41,480$ $38,000 $40,000 $46,000 3,480 9%Faribault 14,263 40 $19,000 $20,000 $23,000

Martin 20,475 30 $19,000 $20,000 $23,000Fillmore-Houston CHB 39,671 8,000$ 17,163$ 60 60 60 180 17,480$ 42,643$ $38,000 $40,000 $46,000 4,643 12%

Fillmore 20,834 40 $19,000 $20,000 $23,000Houston 18,837 20 $19,000 $20,000 $23,000

Freeborn County CHB 31,054 8,000$ 13,435$ 60 60 40 160 15,537$ 36,973$ $19,000 $20,327 $23,000 17,973 95% (6,573) 30,400 Goodhue County CHB 46,336 8,000$ 20,047$ 30 60 40 130 12,624$ 40,671$ $27,249 $30,036 $27,827 13,422 49%Hennepin County CHB 628,422 8,000$ 271,880$ 30 60 100 190 18,451$ 298,331$ $369,554 $392,679 $377,393 (71,223) -19% 15,790 314,121 $125,185

Additional needed/available (Base only)




Bench- marks

Collaboration

Total Points

Points Award



only


Award


Award


% Change 2013-2014

PHEP Base only

Max 15% decrease


2013-2014 Potential

Award with caps


Horizon CHB 66,365 8,000$ 28,712$ 140 60 100 300 29,133$ 65,845$ $97,414 $103,419 $115,000 (31,570) -32% 16,958 82,802 Grant 5,944 30 $19,000 $20,000 $23,000

Douglas 36,415 20 $21,414 $23,419 $23,000Stevens 9,663 40 $19,000 $20,000 $23,000

Traverse 3,451 30 $19,000 $20,000 $23,000Pope 10,892 20 $19,000 $20,000 $23,000

Isanti-Mille Lacs CHB 63,988 8,000$ 27,684$ 110 60 60 230 22,335$ 58,019$ $41,492 $45,017 $46,000 16,526 40% $7,619Isanti 38,248 30 $22,492 $25,017 $23,000 $7,619

Mille Lacs 25,740 80 $19,000 $20,000 $23,000Kanabec-Pine CHB 45,223 8,000$ 19,565$ 140 60 60 260 25,248$ 52,814$ $38,000 $40,000 $46,000 14,814 39%

Kanabec 16,005 60 $19,000 $20,000 $23,000Pine 29,218 80 $19,000 $20,000 $23,000

Kandiyohi Renville CHB 57,748 8,000$ 24,984$ 120 60 100 280 27,190$ 60,175$ $43,922 $47,471 $48,450 16,253 37%Kandiyohi 42,379 80 $24,922 $27,471 $25,450Renville 15,369 40 $19,000 $20,000 $23,000

Le Sueur-Waseca CHB 46,914 8,000$ 20,297$ 70 60 60 190 18,451$ 46,748$ $38,000 $40,000 $46,000 8,748 23%Le Sueur 27,677 30 $19,000 $20,000 $23,000

Waseca 19,237 40 $19,000 $20,000 $23,000Meeker-McLeod Sibley CHB 74,237 8,000$ 32,118$ 100 60 60 220 21,364$ 61,482$ $59,202 $63,836 $69,000 2,280 4%

McLeod 36,053 30 $21,202 $23,836 $23,000Meeker 23,061 30 $19,000 $20,000 $23,000

Sibley 15,123 40 $19,000 $20,000 $23,000Morrison-Todd-Wadena CHB 71,328 8,000$ 30,859$ 220 60 60 340 33,017$ 71,876$ $57,000 $61,591 $69,000 14,876 26%

Morrison 33,052 60 $19,000 $21,591 $23,000Todd 24,509 80 $19,000 $20,000 $23,000

Wadena 13,767 80 $19,000 $20,000 $23,000Mower County CHB 39,372 8,000$ 17,034$ 80 60 40 180 17,480$ 42,513$ $23,153 $25,470 $23,644 19,360 84% (5,468) 37,045 Nobles County Community Services 21,487 8,000$ 9,296$ 80 60 60 200 19,422$ 36,718$ $19,000 $20,000 $23,000 17,718 93% (6,318) 30,400 North Country CHB 78,398 8,000$ 33,918$ 210 60 60 330 32,046$ 73,964$ $83,684 $88,903 $96,250 (9,720) -12%

Beltrami 45,375 80 $26,684 $28,903 $27,250Clearwater 8,703 80 $19,000 $20,000 $23,000

Hubbard 20,347 30 $19,000 $20,000 $23,000Lake of the Woods 3,973 20 $19,000 $20,000 $23,000

Olmsted County CHB 147,066 8,000$ 63,627$ 40 60 60 160 15,537$ 87,164$ $86,485 $93,813 $88,319 679 1%Otter Tail County CHB 57,288 8,000$ 24,785$ 60 60 100 220 21,364$ 54,149$ $33,689 $37,268 $34,404 20,460 61% (246) 53,903 Polk Norman-Mahnomen CHB 43,586 8,000$ 18,857$ 220 60 60 340 33,017$ 59,874$ $57,000 $60,000 $69,000 2,874 5%

Polk 31,416 80 $19,000 $20,000 $23,000Norman 6,634 60 $19,000 $20,000 $23,000

Mahnomen 5,536 80 $19,000 $20,000 $23,000Quin CHB 47,579 8,000$ 20,585$ 230 60 60 350 33,988$ 62,573$ $95,000 $100,000 $115,000 (32,427) -34% 18,177 80,750

Kittson 4,493 20 $19,000 $20,000 $23,000Marshall 9,449 30 $19,000 $20,000 $23,000

Pennington 14,074 80 $19,000 $20,000 $23,000Red Lake 4,087 40 $19,000 $20,000 $23,000

Roseau 15,476 60 $19,000 $20,000 $23,000Rice County CHB 64,854 8,000$ 28,058$ 80 60 40 180 17,480$ 53,538$ $38,138 $41,716 $38,947 15,399 40%Scott County CHB 135,152 8,000$ 58,472$ 30 60 60 150 14,566$ 81,038$ $79,478 $84,500 $81,164 1,560 2% $26,923Sherburne County CHB 89,455 8,000$ 38,702$ 30 60 40 130 12,624$ 59,326$ $52,606 $57,556 $53,721 6,720 13% $17,820Southwest CHB 74,683 8,000$ 32,311$ 270 60 60 390 37,872$ 78,183$ $114,000 $120,000 $138,000 (35,817) -31% 18,717 96,900

Lincoln 5,818 20 $19,000 $20,000 $23,000Lyon 25,543 80 $19,000 $20,000 $23,000

Murray 8,577 20 $19,000 $20,000 $23,000Rock 9,553 30 $19,000 $20,000 $23,000

Pipestone 9,345 60 $19,000 $20,000 $23,000Redwood 15,847 60 $19,000 $20,000 $23,000

St.Paul-Ramsey CHB 520,152 8,000$ 225,038$ 80 60 60 200 19,422$ 252,460$ $305,884 $330,800 $312,373 (53,424) -17% 7,542 260,001 $103,617Stearns County CHB 151,606 8,000$ 65,591$ 60 60 40 160 15,537$ 89,128$ $89,154 $97,972 $91,046 (26) 0%Wabasha County CHB 21,476 8,000$ 9,291$ 20 60 40 120 11,653$ 28,944$ $19,000 $20,000 $23,000 9,944 52%Washington County CHB 244,088 8,000$ 105,602$ 20 60 60 140 13,595$ 127,197$ $143,540 $154,875 $146,585 (16,343) -11% $48,624Watonwan County CHB 11,187 8,000$ 4,840$ 80 60 40 180 17,480$ 30,320$ $19,000 $20,000 $23,000 11,320 60%Winona County CHB 51,629 8,000$ 22,337$ 60 60 40 160 15,537$ 45,874$ $30,361 $33,468 $31,005 15,513 51%




Bench- marks

Collaboration

Total Points

Points Award



only


Award


Award


% Change 2013-2014

PHEP Base only

Max 15% decrease


2013-2014 Potential

Award with caps


Wright County CHB 127,336 8,000$ 55,091$ 20 60 40 120 11,653$ 74,744$ $74,882 $81,100 $76,470 (138) 0% $25,366TOTALS 5,379,139 400,000$ 2,327,227 4180 3000 3080 10,260 996,336$ $3,723,563 $3,723,563 $4,012,898 $4,014,591 0 109,472 (49,125) $654,953

60,347 Range Range Range

High 80 4 60 Shared Func 100Medium-High 60 3 45 Service-Rela 60Medium 40 2 30 Informal 40Medium-Low 30 1 15Low 20

Tribal GranteesBois ForteFond du lacGrand PortageLeech LakeLower SiouxMille LacsRed LakeUpper SiouxWhite Earth

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PHEP Funding Formula Proposal FAQ July, 2014

Since 2002, there has been dedicated federal funding for public health emergency preparedness activities. Considerable discussion has occurred between MDH and local health departments about funding distribution and work expectations. Many attempts have been made to develop a process for fair and equitable distribution of the funds. Recent shifts in policy and funding at the national level necessitate looking closely at how Minnesota’s public health system becomes better prepared to respond. At the same time, there are increased accountability demands from Congress that impose an added reporting burden. In light of this, the PHEP Oversight Group has spent considerable time looking at the PHEP funding formula and developing the funding principles of: Inclusivity, Rationality, Scalability, Sustainability, and Accountability. These funding principles were approved by SCHSAC in September 2013. Once approved, the group looked at revising the funding formula to be in alignment with the newly developed principles. The revised formula addresses the following issues:

o Equity—in the current year, the largest award is 19.5 times the size of the smallest; some multi-county CHBs with small populations get many times more money than one county with a larger population

o Effort Available for Grant Work—the 2013-14 base award of $19,000 leaves only about 4 hours per week for

program work after administrative time is subtracted

o Dimension—the current formula is based solely on population; CHBs get either the base or a per capita amount, whichever is larger.

The revised formula addresses these issues through introducing new funding components, and by using a points system. Points are awarded for specific data factors; the total number of points awarded is variable based on where each CHB falls on the scale. The components are:

o Base: Each CHB receives a base award of $8000, plus a dollar amount based on points

o Population: 62.5% of total awards are based on a CHB’s population

o Social Vulnerability Index (SVI): Although CDC assigns counties to quartiles in the interactive map online

(http://svi.cdc.gov), the proposed formula breaks CHBs into quintiles to further differentiate vulnerability

o Benchmarks: Yes/no measures of performance of grant duties; all CHBs should meet BP4 measures if they are performing in accordance with their PHEP award contracts

o Collaboration: Definitions of levels of collaboration with partners based on principles

of cross-border sharing Why is the group proposing this new formula? We looked at fundamental inequities in the current population-only formula, a focus on the good of the state as a whole, and finding a way to try to ensure long-term sustainability of emergency preparedness by providing a higher basic level of support for all agencies. Naturally, everyone looks at how the proposed funding formula change affects his/her own agency, but it’s important to keep in mind that most people have friends and family all over the state, and Minnesotans may work, shop, or play almost anywhere. The goal is to provide greater equity in health readiness statewide to assure the ability to respond anywhere.

http://svi.cdc.gov/

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What other factors were considered? MDH staff and the Oversight Group reviewed a large number of possibilities over many months. We considered including factors such as commuter patterns, recreational/seasonal surges in population, geographic area, homeland security Threat and Hazard Identification and Risk Assessment results, a competitive process, and others. What are the major changes to this proposal since it was presented to SCHSAC in March, 2014?

1. Replacement of the previous Social Vulnerability Index (SVI) from the University of South Carolina with the new index developed by CDC.

2. Calculation and ranking of individual SVI scores for the four city-based CHBs and the portion of Hennepin County that lies outside those cities.

3. Clear, objective definitions and point categories for the Benchmarks and Collaboration factors, and insertion of real numbers into the formula.

4. Caps are in place to moderate the impact on any one CHB. Why are you using the 2013-14 budget as the comparison point? First, that budget year (known as BP2) is more representative of the PHEP award; the current budget year (BP3) was a slight increase, and all indications are there will be a reduction next year. Second, the funding formula process has been ongoing for well over a year, and the BP2 budget is most familiar to the Oversight Group and allows them to have more stable comparisons of the actual changes as modifications are made to formula models. Do we have to do this? We are not required to change the funding formula. If no change is made, the current formula and its inequities will continue to exist. Because of the extensive amount of time and effort involved in working on a new formula, there are no plans to revisit the issue during this 5-year grant cycle if the proposed new formula is not approved. What about this will make my community safer? The goal is to give all local health departments basic resources to have a certain level of support for health readiness, and to give those that have particular challenges additional resources. The changes are also meant to encourage partnerships, resource sharing, and other forms of collaboration to benefit all areas of the state. The main change is to ensure smaller communities will have a few additional hours of staff time to work on making their communities safer. Would you use the same formula if we receive more or less funding from the Feds as time goes on? The formula was based on the principles approved by SCHSAC in September, 2013. The formula is designed to work whether funding availability goes up or down. The weights (points for each factor, range of those points, and rate at which they increase for different levels of that factor [10-20-30 vs. 20-40-80, for example]) can be adjusted to modulate the effects of large swings in funding on CHBs. What is the Social Vulnerability Index (SVI), and why was this particular version chosen? A social vulnerability index was identified as a way to include a large number of factors that Work Group members thought were important to quantify “risk”—the community characteristics that make a specific area more vulnerable, or that make emergency preparedness, response, and recovery more challenging. The CDC version, which was just released publicly in April 2014, was preferred by the Work Group over the University of South Carolina model that has been available for many years and which was used in previous versions of the proposed formula. What criteria are included in calculating the SVI? The CDC version of the SVI includes 86 factors from US Census data that are grouped into four themes—Socioeconomic Status (27 variables including persons below poverty level, unemployment rate, etc.), Household Composition (15 variables such as persons aged>65 and single parent households), Race/Ethnicity/Language (13 variables including non-

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white population and persons who speak English “less than well”), and Housing/Transportation (31 factors such as residence in mobile homes and persons with no vehicle). How did you calculate the SVI ranking for the four cities that are separate CHBs and for the remaining portion of Hennepin County? MDH obtained all the raw census tract data for Minnesota from the CDC, along with a list of the census tracts that are contained within each city. For data fields that were averages, such as per capita income, we calculated a weighted average of the data, weighting by population of the census tracts. For data with raw numbers available, such as proportion of multi-family housing units, we totaled the number of multi-family housing units in the city, totaled the overall number of housing units, and calculated a proportion based on those totals. After calculating all of the data fields for each city, we integrated the city totals into the overall percentile rankings. Hennepin County’s value was then calculated after subtracting the data for the four independent city-based CHBs. What objective data are available to compile the scores?

1. Population is obtained from the US Census; actual numbers are used close to collection dates and official estimates are used thereafter until the next census.

2. The SVI data are produced by CDC based on census data. 3. The Benchmarks are objectively measured by tracking completion of grant duties—submission of work plans and

grant reports, documentation of Health Coalition activities, etc. 4. Collaboration data will be collected through observed and reported discrete activities (such as a joint exercise

After Action Report) and certain documents such as a regional strategic plan with shared responsibilities. Why does the formula use additive rather than averaged SVI scores for multi-county CHBs? If the scores were averaged, (or based on just the highest CHB member’s score), multi-county CHBs would in effect be “punished” for working together. There is a significant level of activity that happens within each county of a multi-county CHB. Each county needs to build and maintain partnerships as well as adapt some planning efforts to meet the needs of each jurisdiction. In previous budget periods, these needs were addressed through the funding formula that provided a base level of funding for each county in a multi-county CHB. One option for addressing this need would be to include the (now lower) base amount for each county. Instead, we have determined that using the SVI score for each county addresses this issue in a way that also acknowledges the level of social vulnerability for each county. In the proposed formula, population data still account for 62.5% of the funding distribution, and SVI is approximately 11%, so using additive rather than averaged scores does not cause a highly significant shift in resources. Rural areas have concerns that available resources and access to them are not addressed in SVI; how could that be included in the ultimate formula? Many items in the SVI are intended to address many of the unique issues related to rural areas such as geography, economic issues, lack of availability of persons with specific skills, among others factors. Additionally, population continues to be a major funding formula component. To date, after considerable research, there is no other specific way to best objectively quantify which resources are the most critical for public health preparedness and how that would then be integrated into a funding formula. The metro area has concerns that they are taking a large monetary cut in order to provide a relatively small increase in hours to many smaller agencies. How is this justified? While the amount of money going to the metro is being reduced, it is a smaller percent reduction for agencies than is occurring in several areas. With 62.5% of the funding based on population, the metro still receives a very large portion of the funding. While it may not seem like a lot of benefit for smaller agencies to get funding to increase work by just a few hours a week, in many cases this will be an increase of approximately 75% in the hours dedicated to program work after administrative time is considered. (MDH calculated that the agencies currently receiving the base amount have only about 4 hours per week for program time after other required tasks are considered.)

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How will this be phased in? The funding proposal includes placing caps on increases (60% per year) and decreases (15% per year), and phasing in the changes related to the formula over the course of the two remaining years of the federal grant project period (July 1, 2015-June 30, 2017). Explain the idea behind the caps. MDH and the Oversight Group wanted to soften the impact of sudden changes to the budget by phasing the adjustments in. Several CHS Administrators provided feedback on what percent cut or increase they could reasonably manage in a given year. The choice of a 15% cap on the cuts was just below the middle of the range indicated by the Administrators. In addition, a cap of 15% per year on budget decreases allows the vast majority of changes to be accomplished in the remaining two years of the 5-year grant cycle. The 60% cap on increases was chosen to provide a substantial bump to those CHBs that are currently most under-funded, without causing a large increase that might result in staffing challenges. The cap on increases will also provide some money to offset the amounts needed to cap the decreases at 15%. How will we make up the shortfall (approximately $60,000) in the total budget that occurs because of the adjustments for the caps? This amount will need to come out of the total pool of funds available for CHB awards. There will need to be small additional decreases for any CHBs not affected by the 15% cap until the amount needed to soften decreases balances the amount saved by holding increases to 60%. Is this the only change that will occur in the funding for Budget Period 4? Probably not. The changes indicated in the funding table only reflect adjustments based on the change in the formula. Any changes in the amount awarded to Minnesota by CDC would also affect funding amounts in BP4. What are Benchmarks, how were they determined, and why are they being included in the funding formula? Benchmarks are specific activities that all awardees should meet in order to fulfill the requirements of their PHEP contracts with MDH. The CDC and Congress have long held all states participating in PHEP to a set of benchmarks, and the scrutiny is now required at the local level. For the first year of the formula, we chose four categories of activities that indicate basic compliance; each of the categories is ‘all or nothing’ for getting the associated points. In future years, benchmarks will be adjusted to include other important accomplishments, and CHBs will know ahead of time what they are. The proposed formula awards every CHB full points for the first year, because all should meet those requirements. What is the Collaboration assessment and why is it being included in the funding formula? Collaboration between public health agencies is critical regardless of available resources. This becomes increasingly so when funding levels decrease. The assessment looks at how well CHBs are working with other CHBs on nine measurable key activities. In addition, multi-county CHBs will have the opportunity to earn a small number of additional points based on how well they are coordinating their efforts as a single CHB (while still addressing county-specific needs). What is the reasoning behind the weighting of the components? MDH ran the formulas with approximately 200 permutations in the components, and brought a small number of proposals to the Oversight Group. Only those formulas that best showed changes in accord with the funding principles, and that didn’t cause changes with large orders of magnitude, were considered. The only component that was specifically weighted was population at 62.5%. This was done to recognize the unique challenges of highly-populated areas and to keep the new formula from being a drastic change from the previous one. The percent of funding for all other components was not pre-set—it is the end result of applying the point values for the components. Amounts cannot be specifically assigned to point values ahead of time, because there is a finite award available to be distributed and it is unknown how each CHB will score in Benchmarks, Collaboration, and SVI. The Work Group agreed that there should continue to be a small base award for all CHBs, and $8000 honors this request.

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Is/will there be an appeals process, if a jurisdiction disagrees with their score? Yes. There are two categories where scores are determined by humans--Benchmarks and Collaboration, so those two areas will be open for appeal. For example, if a PHPC rates Collaboration differently from the CHB self-assessment, the CHB will have the opportunity to provide additional documentation for a higher rating. Similarly, a CHB can provide additional documentation if it disagrees with a Benchmarks rating. If a community were to have some extraordinary change in its composition or a major unanticipated challenge, we would consider a possible adjustment. How will this formula provide more statewide equity? In recent years, the largest award has been 16-20 times as large as the smallest one. With the proposed formula, the largest is just over 10 times as great as the smallest award. This provides smaller areas with enough resources to add several hours a week in planning time. In addition, a multi-county CHB with a fairly low combined population no longer receives several times as much grant funding as a single county with a larger population. What if counties or cities change CHB affiliations in mid-grant cycle? MDH will calculate proportions of funding for any counties or cities affected, re-allocate the pro-rated portion of remaining funding to the new entities, and create new contracts. Do you all have any ideas on how we can do more with less? This is difficult for agencies at any level. Declining resources dictate that agencies focus attention on priority activities to address major gaps; some long-standing tasks may need to cease if they are no longer a high priority as the situation has changed over time. There are also opportunities for some savings through increased collaboration, resource sharing, and use of best practices to maximize the effects of the work. Does this formula also apply to Tribal Health Departments? No. Beginning with BP3, Tribal Health Departments have been offered a new way of choosing what level of participation they want in the PHEP grant, with associated funding levels. In addition, according to the agreement worked out with SCHSAC many years ago, the THD awards come out of MDH’s portion of the PHEP grant, not the portion allocated to LHDs.

Protecting, Maintaining and improving the health of all Minnesotans

PHEP Funding Formula Proposal Fact Sheet July, 2014 The PHEP Oversight Group has been working on a new funding formula to address the fundamental inequities in the current population-only formula. The proposed formula focuses on the good of the state as a whole as well as ensuring long-term sustainability of emergency preparedness by addressing issues related to funding equality.

o Equity—in the current year, the largest award is 19.5 times the size of the smallest; in addition, some multi-county CHBs with small populations get many times more money than one county with a larger population

o Effort Available for Grant Work—the 2013-14 base award of $19,000 leaves only about 4 hours per week for program work

after administrative time is subtracted

o Dimension—the current formula is based solely on population; CHBs get either the base or a per capita amount, whichever is larger.

The revised formula addresses these issues through introducing new funding components, and by using a points system. Points are awarded for specific data factors; the total number of points awarded is variable based on where each CHB falls on the scale. The components are:

o Base: Each CHB receives a base award of $8000 (plus a dollar amount based on points for factors below)

o Population: 62.5% of total awards are based on a CHB’s population

o Social Vulnerability Index (SVI): the proposed formula breaks CHBs into quintiles based on the CDC SVI

o Benchmarks: Yes/no measures of performance of grant duties; all CHBs should meet BP4 measures if they are performing

in accordance with their PHEP award contracts

o Collaboration: Definitions of levels of collaboration with partners based on principles of cross-border sharing How would the formula be phased in? The funding proposal includes placing caps on increases (60% per year) and decreases (15% per year), and phasing in the changes related to the formula over the course of the two remaining years of the federal grant project period (July 1, 2015-June 30, 2017). The 60% cap on increases was chosen to provide a substantial bump to those CHBs that are currently most under-funded, without causing a large increase that might result in staffing challenges. The cap on increases will also provide some money to offset the amounts needed to cap the decreases at 15%. How will this formula provide more statewide equity? With the proposed formula, the largest award is just over 10 times as great as the smallest award. This provides smaller areas with enough resources to add several hours a week in planning time. In addition, multi-county CHBs with relatively low populations still receive adequate funding levels to plan for multiple jurisdictions, while allowing for increased levels of funding for single county CHBs which have been traditionally under resourced. Does this formula also apply to Tribal Health Departments? No. Beginning with BP3, Tribal Health Departments have been offered a new way of choosing what level of participation they want in the PHEP grant, with associated funding levels. Tribes still have the option of participating at the same level as smaller CHBs. In addition, according to the agreement worked out with SCHSAC many years ago, the THD awards come out of MDH’s portion of the PHEP grant, not the portion allocated to LHDs.

dvhhs: aug. 14 packet

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