MDH denies public health agreement

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WORTHINGTON — The road toward separating a two-county public health agency at the end of this year continues to be a rocky one.

Nobles-Rock Community Health Services was notified last week that it was denied a delegation agreement for food, beverage and lodging licensing.

As such, the Minnesota Department of Health, which denied the request, is stepping in to take over the service as of Friday.

The change will likely mean higher fees for businesses in both counties, from restaurants and bars to hotels and bed and breakfasts.

In a letter dated Oct. 5, MDH said it would not accept a contract between NRCHS and Southwest Health and Human Services for food, beverage and lodging licensing for the remainder of this year.

The state is also denying Nobles County’s request to continue to contract with SWHHS as of Jan. 1.

The reasons for the denial, the letter stated, are that the single-county agency doesn’t meet the minimum requirements, which include having at least 200 licensed establishments and having a qualified staff person to perform the delegated duties.

Finally, the MDH letter also stated it will not allow a delegation agreement between Rock County and SWHHS.

Those two entities had already signed an agreement for coverage, as Rock County will become part of SWHHS as of Jan. 1. MDH explained in the letter that SWHHS will not be able to establish a delegation agreement with Rock County until 2017.

During its meeting Wednesday afternoon in Worthington, NRCHS board chairwoman Karen Pfeifer said MDH will honor all existing licenses in the two counties, but will send letters to food, beverage and lodging establishments in November regarding 2012 fees.

“The Minnesota Department of Health is not satisfied with the contractual arrangements counties are making,” Pfeifer said. “Even though we have a contract with Southwest Health and Human Services for the rest of this year — and Nobles County was hoping to have a contract with SWHHS moving forward — those are being denied.”

Pfeifer said the action taken by MDH, which includes no further issuance of delegation agreements statewide until 2017 — unless counties have 200 or more establishments and a qualified sanitarian on staff — “was not a result of any one individual or one action.”

However, she was told by an MDH official that the state was frustrated with the awkward transition occurring with Nobles and Rock counties and SWHHS, and expressed a “perceived lack of communication” and “chaos” as the counties move in different directions.

“MDH doesn’t feel satisfaction that the services are being delivered,” Pfeifer added.

Chris Sorensen, director of SWHHS, said he was not going to accept MDH’s refusal. Attending both the NRCHS dissolution meeting Wednesday morning and the regular monthly meeting in the afternoon, Sorensen said he has a Friday afternoon conference call scheduled with MDH.

Sorensen said SWHHS has two registered sanitarians on staff to accommodate food, beverage and lodging licensing for Lincoln, Lyon, Murray, Pipestone, Rock and Nobles counties.

“We have the capacity for 400 establishments today,” he said. “We’re at a capacity higher than we’ve ever been as an organization.”

Sorensen said MDH’s decision to deny the delegation agreements “goes against the grain of the MDH commissioner … to work together with public health agencies.” He added that he is hopeful MDH will reverse its decision — at least pertaining to Rock County’s agreement with SWHHS — after Friday’s conversation.

“We’re absolutely open to a review of the service, but do that in context of allowing the service (to continue),” Sorensen said. “We don’t have any reported deficiencies.”

“We are not done yet,” added Rock County Administrator Kyle Oldre. “We will continue to address the issue through whatever means necessary.”

In a phone call to MDH following Wednesday’s meeting, April Bogard, an environmental health supervisor, explained that food, beverage and lodging license holders will likely not notice any immediate change in regard to licensing.

“If they have questions or need to talk with someone at the health department, they can call (651) 201-4500,” Bogard said. She also referred people to the MDH website at health.state.mn.us/ehs.

Bogard said MDH staff members are already working in the area, as the state provides food, beverage and lodging licensing in both Jackson and Lyon counties.

In other action, the board:

* Learned that three NRCHS employees have submitted resignations. Two public health nurses have accepted other positions — one with SWHHS, and one with Nobles County — and one RN has accepted a position with Nobles County. All changes are effective Nov. 1.

NRCHS will work on agreements with the two agencies to continue to provide staffing, as needed, to help NRCHS through the end of the year.

Pfeifer said more agreements may be needed as both agencies continue to work toward filling positions. In Nobles County, plans are to hire four more full-time public health nurses and two more full-time registered nurses to staff Nobles County Community Services on Jan. 1.

The board granted Pfeifer, as board chairwoman, the authority to enter into contractual arrangements as needed by NRCHS to get through the remainder of this year.

* Learned that there are no direct observational therapy cases for tuberculosis in Nobles and Rock counties, and that there are 27 cases of latent TB that continue to be monitored on a monthly basis.

* Received a positive financial recap for the agency. With 75 percent of the year complete, revenues are at 70 percent and expenditures are at 65 percent of budget. There is a balance of more than $803,000 in the agency.

* Received an update on the WIC (Women, Infants and Children) program. Scheduling is now going into January, and clients are being asked to sign up with either Rock County or Nobles County as that is done.

* Approved interpreter contracts with three individuals at a rate of $20 per hour. The contracts will be in effect until Dec. 31.

* Accepted the 2010 NRCHS audit from Larson Allen. Pfeifer said, overall, it was a good year, and the agency’s net assets increased by 25.91 percent.

* Approved the purchase of insurance through Minnesota Counties Intergovernmental Trust (MCIT) for four years following the dissolution of NRCHS on Dec. 31. The insurance costs approximately $4,200.

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