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9-25-89 agenda CITY OF RICHFIELD, MINNESOTA Study Session Letter No. 224 September 25, 1989 F 0 proposed Resolution. Issue Statement: Discussion of the Runway Use System for MSP Airport, and a Resolution in the alternative. Background: For the first time since 1970 when the Preferential Runway System (PRS) went into effect, the matter of a runway use system at MSP Airport is being considered. The PRS, which sought to direct as much traffic as possible to the S.E. and S.W., worked very well until the early 1980's, from the point of view of Minneapolis and St. Paul. For example, in July 1979, 85% of takeoffs were to the S.E. or S.W., and 70% of landings were to the S.E. or S.W. There are three runways to the S.E. and S.W. and three to the N.E. (St. Paul) and N.W. (Minneapolis). Because the PRS gave more protection to St. Paul than Minneapolis, it became clear in 1986 and 1987 that Minneapolis, who by that time was receiving a large amount of traffic, could get some relief if traffic were shifted to St. Paul. A test was conducted from July 1988 to January 1989 of a revised plan called the Runway Use System (RUS). The test tried to reduce traffic over South Minneapolis and North Richfield, and sent more traffic over St. Paul. The test showed that a small, but measurable, amount of traffic could be shifted to St. Paul. Another alternative would be to suggest a different plan which would provide for more equity in noise distribution. The attached Resolution does just that. The Resolution would not allow unlimited flights in certain areas, nor would it allow total exemptions for other similar areas. Flightsl,would have to be first contained in designated corridors, then balanced on all remaining runways. MASAC will hold hearings on September 26, 1989 and October 3, 1989 on whether to recommend to MAC that the RUS or some other system, such as that described in the Resolution, be put into place. MAC will consider the MASAC recommendation later in the fall and presumably reach a decision by year end. Unless MAC takes the unlikely action of staying with the present PRS, there will be strong legal challenges from St. Paul. Any new system, whether the RUS or other type, will require considerable environmental evaluation. Recommended Motion: It is the recommendation of staff that the council adopt the Basis of Recommendation: • Although the RUS has some desirable features, such as giving St. Paul more traffic, it has some undesirable aspects as well. 1. It calls for sending all possible traffic to the S.E. first, and secondly placing as much traffic as possible on the crosswind runway (4/22) in a balanced manner, with South Minneapolis receiving last priority for traffic. There is no limit to the amount of traffic the Eagan/Mendota Heights area could receive, and likewise the South Richfield/Bloomington and St. Paul areas. It is unlikely, but under lower traffic levels, flights over South Minneapolis could be almost totally eliminated under the RUS. 2. If 4/22 is extended, it will be far easier to put traffic on the Richfield/Bloomington end, and thus we would get an overwhelming share, despite the fact that the RUS would call for traffic in a balanced manner. The RUS, as the PRS before it, will be described as a system to promote equity in the distribution of overflights. However, without the traffic objective in the system calling for equal treatment of similar residential areas, it will simply be the means of giving one area almost total protection at the expense of other similar areas when operation levels allow. • 3. The alternative runway use pattern, as described in the Resolution, provides more equity in aircraft noise distribution. The Resolution first limits the amount of traffic in the Eagan/Mendota Heights area to that which can be contained in the industrial corridor. Secondly, it seeks to balance traffic on all four other runways, since those flights all go over similar residential areas. Alternative Recommendation: The Council can choose not to adopt the Resolution. An alternative to the Runway Use System would not then be offered to MASAC. Discussion/Decision Mode: This matter will be discussed at the September 25, 1989 Council Meeting, and any action should be taken before the MASAC meeting on September 26, 1989. Resp t ully submitted, Jam D. Prosser Cit. Manager 0 JDP/mba • Resolution Regarding a Runway Use System at Minneapolis/St. Paul International Airport WHEREAS: Any runway use system at Minneapolis/St. Paul International Airport (MSP Airport) must recognize that all areas surrounding MSP Airport benefit from its proximity and all areas must share in the overflights, - and - WHEREAS: Any change from the present system will require extensive environmental review and thus must be clearly fair to all involved, - and - • WHEREAS: The proposed Runway Use System (RUS) does not correct the fundamental problem of the present Preferential Runway System since it still provides for unlimited overflights over some nearby residential areas and total exemptions for other similar areas when traffic levels, wind conditions and runway conditions permit. NOW, THEREFORE BE IT RESOLVED, that the City of Richfield requests that MASAC recommend and the MAC approve a runway use system that within the limits of the safe, efficient operation of the airport would first direct as much air traffic;Southeast of the airport (arrive on Runways 29 Left and Right; depart on Runways 11 Left and Right) as could be contained in the corridors the affected communities have zoned for overflights, and secondly place the remaining traffic as equally as possible on the other four runways, all of which overfly similar nearby residential areas. 174 0?? CITY OF RICHFIELD Council Letter No. 223 Agenda September 25, 1989 Issue Statement: Cancellation of the November 27, 1989 Regular City Council Meeting. Background: During a recent Study Session, three, and possibly four, City Council Members indicated they would be traveling to the National League of Cities Conference in 1989. The Conference runs from November 25 through November 29. If at least three City Council Members are planning to attend the conference, there will not be a quorum available for the November 27 City Council Meeting. Thus, if this is the case, the City Council may want to take action to cancel the City Council Meeting and/or find a replacement meeting to cover any City business that may need to be handled during the second part of November. Recommended Motion: City Council cancellation of the November 27,`1989 City Council Meeting if a quorum will not be available. Basis of Recommendation: 1. In order for a City Council Meeting to legally occur, a quorum must be available for the meeting. 2. If at least three City Council Members are planning to • travel to the National League of Cities Conference, a quorum will be impossible for November 27. 3. If the meeting is to be canceled, appropriate notice to the public should be given. This would be done in the form of a posted and published notice. Alternative Recommendation: 1. If at least three Council Members plan on attending the November 27 City Council Meeting, this potential cancellation should be disregarded. • 2. If the meeting is to be cancelled and there are Council Members who feel a meeting is necessary in the later part of November, an alternative meeting could be scheduled. Discussion/Decision Mode: Action to cancel or change the November 27 Regular City Council Meeting should be taken at the September 25 City Council Meeting in order to provide adequate notice for any such change. JDP:ff Re t ully submitted, Ja D. Prosser Ci' Manager CITY OF RICHFIELD, MINNESOTA • Council Letter No. 222 Agenda September 25, 1989 Issue Statement: Approval of the•1989 Labor Contract with the International Association of Firefighters Local 1215. Background: City staff have completed negotiations on a labor agreement, subject to City Council approval, with the International Association of Firefighters Local 1215 to cover the period of January 1, 1989 through December 31, 1989. The International Association of Firefighters Local 1215 represents the positions of Fire Captain, Fire Lieutenant and Firefighter. There are presently twenty-four employees represented within the unit. The 1989 contract is a one year agreement. 1. An adjustment of 4% over 1988 wage rates for all classifications, bringing the annual top firefighter wage to $35,419.97, Fire Lieutenant, $38,962.21 and Fire Captain to $40,733.06. • 2. A $10.00 increase in the maximum monthly health insurance premium. This increases the payment from $173.50 per employee per month in 1988 to $183.50 per employee per month in 1989. 3. A $.50 per month increase in employee dental insurance, from $14.50 per employee per month in 1988 to $15.00 per employee per month in 1989. Recommended Motion: Approve the labor agreement with the International Association of Firefighters Local 1215. Basis for Recommendation: 1. Firefighter wage settlements in other communities with a full-time dominated Fire Division range from 3.0% to 4%. For the past years, Richfield has maintained a salary position as the top Firefighter base wage rate. The proposed wage increase maintains that position. 2. The City insurance contribution increase maintains the internal comparison between both union employees and non- union employees. 3. The Firefighters have voted to accept the terms of the 1989 • agreement. • Alternative Recommendation: 1. Do not approve the labor agreement, requiring further negotiations and/or arbitration. Discussion/Decision Mode: In order to allow the City's accounting personnel to modify payroll records in a timely manner for January 1, 1989, it is recommended that the City Council act on September 25, 1989 to adopt the attached resolution providing for contract changes, effective January 1, 1989. Respec u y submitted, osser James fager City JDP:ff • 0 RESOLUTION NO. _ RESOLUTION APPROVING LABOR AGREEMENT BETWEEN THE CITY OF RICHFIELD AND THE INTERNATIONAL ASSOCIATION OF FIREFIGHTERS LOCAL 1215 BARGAINING UNIT FOR THE YEAR 1989 WHEREAS, the City Manager and the International Association of Firefighters Local 1215 bargaining unit have reached a complete understanding concerning rates of pay, hours and other conditions of employment for the year 1989; and WHEREAS, the Personnel ordinance requires that contracts between the City and the exclusive representative of the employees in an appropriate bargaining unit shall be implemented by Council resolution. NOW, THEREFORE, BE IT RESOLVED hereby approve the labor agreement and the International Association Bargaining Unit for the year 1989 labor agreement to be implemented that the City Council does between the City of Richfield of Firefighters Local 1215 and order the provisions of the effective January 1, 1989. Passed by the City Council of the City of Richfield, this 25th day of September, 1989. C? Steven J. Quam Mayor ATTEST: Thomas P. Ferber City Clerk CITY OF RICHFIELD, MINNESOTA Council Letter No. 221 Agenda, September 25, 1989 • Issue Statement: Request for division of property; 66th Street and First Avenue South. Background: In 1983 the Lincoln Companies redeveloped the strip shopping center lying north of 66th Street and between Nicollet and First Avenue. As part of the redevelopment, Lincoln acquired all of the properties in the block, except the land on which the Dairy Queen restaurant is located, and which is owned by David and Kathy Doll. Lincoln did, however, purchase from the Dolls a tract of land lying immediately west of the Dairy Queen. Recently, the Dolls discovered that, because the conveyance to Lincoln had the effect of splitting their property, they would be unable to sell the Dairy Queen site without City approval. It was also discovered that the tax statement for the Dairy Queen site has been sent to and paid by Lincoln since 1984. Following these discoveries, the Dolls and representatives of Lincoln have resolved the question of the previously paid taxes and both the Dolls and Lincoln are now requesting that the City take action to approve the lot split. Recommended Motion: • Approve the requested lot split by adopting the attached resolution. Basis of Recommendation: 1. Approving the lot split will acknowledge the ownership patterns which exist on the property. 2. Approval will permit each owner to be responsible for its own property taxes and will permit the owners, should they choose to do so, to sell and encumber their properties. Alternative Recommendation: The Council could deny the requested lot split; however, such action is not recommended. Discussion/Decision Mode: This matter is scheduled for Council consideration at the September 25, 1989, City Council Meeting. The proposed resolution is attached. Respectfully submitted, James . Prosser City pager 0 JDP:ff RESOLUTION NO. RESOLUTION AUTHORIZING PROPERTY SPLIT WHEREAS, prior to October 26, 1983, David Duane Doll and • Kathy Ann Doll ("Dolls"), were the owners of the tracts and parcels of land lying within the City of Richfield and legally described in the attached Exhibit A; and E WHEREAS, on October 26, 1983, the Dolls conveyed to Lincoln Development Services Corporation ("Lincoln"), by warranty deed and tracts and parcels of land lying within the City of Richfield and legally described in the attached Exhibit B; and WHEREAS, such conveyance has been recorded among the land records of Hennepin County and is memorialized upon Certificate of Title No. 641122; and WHEREAS, following such conveyance, the Dolls continue to be the owners of the tract and parcel of land lying within the City of Richfield and legally described in the attached Exhibit C; and WHEREAS, the Dolls and Lincoln have requested that the City approve of the split shown in Exhibits B and C so that separate real estate tax statements can be generated and so that the parcel described in Exhibit C can be separately conveyed; and WHEREAS, the City has reviewed such request and the provisions of the subdivision regulations of the Richfield City Code. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Richfield as follows: 1. The Council finds and determines that an unnecessary hardship would be created if the Dolls and Lincoln were required to resubdivide the parcels of land described in Exhibits B and C; and that a waiver to such requirements should be and is hereby granted. 2. The division of the parcels described in Exhibit A into the parcels described in Exhibits B and C is hereby approved. 3. The City Manager is hereby directed to take such actions and do such things as are reasonably required to effectuate this resolution. Passed and adopted by the City Council of the City of Richfield, Minnesota, this 25th day of September, 1989. Steven Quam ATTEST: • Mayor Thomas P. Ferber City Clerk EXHIBIT A PROPERTY DESCRIPTION • The East 16.06 feet of Lot 8, except the North 49 feet thereof, all of Lot 9, except the North 49 feet thereof, Block 9, "Town's Edge" Village of Richfield, Hennepin County, Minnesota. • • EXHIBIT B PROPERTY DESCRIPTION That part of the East 16.06 feet of Lot 8, Block 9, "Town's Edge" Village of Richfield, Hennepin County, Minnesota lying South of the North 49 feet thereof; and that part of the West 38 feet of Lot 9, Block 9, "Town's Edge" Village of Richfield, Hennepin County, Minnesota lying South of the North 49 feet thereof. 0 EXHIBIT C PROPERTY DESCRIPTION That part of Lot 9, Block 9, "Town's Edge" Village of Richfield, Hennepin County, Minnesota lying South of the North 49 feet and East of the West 38 feet of said Lot. 0 0 • City Of Richfield, Minnesota Council Letter No. 220 Agenda, September 25, 1989 Issue Statement: First reading consideration of an ordinance to rezone the property located at 2232-2236 East 66th Street from "R", single family residential district to 11C-2" general commercial district. Background: Richfield Credit Union has requested the rezoning of 2232-2236 East 66th Street from "R", single family residence district to "C-2" general commercial district, in order to allow the construction of a financial institution. Currently, the eastern two parcels are vacant and a small single family home is located on the western parcel. Petitions in favor of the rezoning have been submitted; however, a number of property owners have also expressed opposition to the rezoning. The Planning Commission unanimously recommended approval of the Credit Union request on July 25, 1989. Recommended Motion: Approve first reading of an ordinance to rezone the property at • 2232-2236 East 66th Street from "R", single family residence, to "C-2", general commercial district, and schedule the public hearing and second reading for the October 9, 1989 City Council meeting. Basis of Recommendation: 1. The Planning Commission voted 7-0 to recommend approval. 2. Two of the three lots have been vacant for some period of time as residentially zoned property. 3. The 66th Street corridor has been planned as a medium density buffer across the entire city. Changes that have occurred on 66th Street in the past several years have all increased density or intensity of use. Some of these changes west of Cedar include the chiropractic office and the doll museum west of 18th Avenue and the apartment building at the Mount Calvary Church. The CDP building and the City liquor store also influence the change. 4. The site is located immediately west of MAC property. To the south are athletic fields and southwest is the golf course of the City. To the west of the site are two fourplexes and to the north is a single family home owned or optioned by the Credit Union. The Richfield Evangelical • Free Church is located just west of TH77 on 66th Street. In the next block, there are two commercial buildings that housed NECO and North Star Bumper Exchange. At least part of this is now for lease. Mike's Frame Service was • approved at 1916 E. 66th Street in 1985 but does not appear to be in business at this time. The next several blocks on 66th include apartment buildings and two single family residences. The remainder of NFT is generally single family. A proposal to permit a heating/air conditioning business as a home occupation at 20th Avenue and 65th Street was rejected in 1989. 5. On 66th Street east of TH77, there are several different zoning designations. The westerly two blocks are zoned commercial and the remainder is MR, MR-2 and single family residential. The two lots west of the subject site are zoned MR-2. 6. Several plans and developments impact this area. The mega mall will substantially increase traffic on TH77 and the state has a plan in progress looking at needed changes to accommodate such. The Transportation Guidelines for the City show 66th Street and Standish Avenue as a minor arterial. This is less than a half block from the subject site. The various airport studies have no short term effect on this property. Such proposals as the N-S runway and the Met Council chairman's statement that the whole City could be taken for the airport are totally rejected by the City as unfounded. The TH77/New Ford Town Study Area plan suggests non residential use for NFT but has • not been officially adopted by the City Council. 7. A special survey form has gone out to all residents of NFT and the results should be available in the next several weeks. Expressed sentiment at the public meetings and by phone and letter to planning staff has been directed in large part against aircraft noise and its impact on the living environment. 8. Current noise exposure maps indicate that the subject site is in the 70-74 Ldn category. (Ldn means the day-night average level, or the 24-hour equivalent continuous sound level from midnight to midnight, obtained after the addition of 10 dBA to sound levels measured from 10 p.m. to 7 a.m.). Single family, multiplex with individual entrances and mobile homes are considered to be incompatible uses in such noise zones. Office, commercial and retail is considered consistent provided noise reduction is built in during construction. 9. Buffering and screening is provided on the north and west sides of the property including an 8 foot privacy fence. There are numerous mature trees on the site in variable condition. Applicant proposes to maintain as many trees as possible and adding considerable plantings and shrubs • on all sides of the property. Staff has approved the landscaping plan. 10. Objectors have noted that there will be increased traffic at the end of 66th Street and immediately adjacent to the apartment building. At this time, the only use of this deadend road are the ball fields and archery range which are heavily used only in the summer. Applicant has indicated that most of their business is carried on through the mails and that people who transact business in person will probably continue, in large part, to utilize the facility at Central School because of its convenience to school personnel. The Central School site will stay open. The parking lot will be located to the east along the MAC side and the only traffic along the apartment building will be to the drive-up windows which are located at the southwest corner of the building. An 8 foot fence and other landscaping is provided as a buffer but cannot totally screen all noise. A tenant with a young child living in the apartment building suggested that a safety hazard may be created because her child plays in the south yard of the apartment building in the absence of any playground on the property. Consideration should be given to using an open weave type fence near the sidewalk in place of the proposed solid four feet high fence at this location even though there is ten feet between the fence and the curb cut. Alternative Recommendation: • Do not give first reading consideration to the proposed rezoning ordinance. The denial would be based on the fact that most of the properties on the block are single family residential uses. Therefore, the proposal would be incompatible with the neighborhood. Discussion/Decision Mode: First reading is scheduled for September 25, 1989. Notice was published although not required. The public hearing and second reading is scheduled for October 9, 1989 and will be published and notices mailed to the adjoining property owners per requirements. JDP:sae s fu ly submitted, J D. Prosser i Manager REQUEST FOR REZONING FROM MR-2 TO c-2 FOR PURPOSE OF ZONTNG CHANGE Street Address: 2232_2236 66th StrPPt FRaRt Legal Description: Lots 12, 13 and 14, Block 7, New Ford'Town, together with the South 1/2 of the vacated alley accruing thereto. We, the undersigned, being owners of land within 300 feet of the land described above, do hereby concur in this rezoning request. Signature of Owners* Address 0 S`?.? 2 2 /VD v- *For purposes of determining if petition contains the proper number of signatures to intitate the rezoning process, signatures may not be removed once a petition is signed and returned to the Planning Division. • C1 REQUEST FOR REZONING FROM MR-2 TO C-2 FOR PURPOSE OF 7oNTNG CHAN Street Address: 232-2916 66th Stmt Fact- Legal Description: Lots 12, 13 and 14, Block 7, New Ford`Town, together with the South 1/2 of the vacated alley accruing thereto. We, the undersigned, being owners of land within 300 feet of the land described above, do hereby concur in this rezoning request. Signature of Owners* Address Co 5i *For purposes of determining if petition contains the proper number of signatures to intitate the rezoning process, signatures may not be removed once a petition is signed and returned to the Planning Division. 1-1 N co UW ON J M N N L N N N G Y P, £z NSIONVIS ?. z z N 12 VIOz .1 61 MO11319N01 3AV tlv030 41 91 41L1 41 91 N019NIn0016 41 sl VI?1 41 £I 4421 VI II 41 01 101113 oarplNp snennioo )Itlrd ON/1xv0 3AV ONV11MOd 419 YI ? NO1N110 N£ 31z SN3A lot N N N 113051r1B MlaOM1N3M Atlnesllld 1NVSV31d ONV:O 131aaN 0131,4u va 3AV 31VONA1 M31tloly 1NVAae xv310a 1NOdna NOSa3w3 LNOMAU awwwo 10loennw aZ Z 0 ? ? Y - f LLI O > U ~ = 2 Va. . W z= 2 M0113lON01 3AV NT030 41 61 41 41 4 1 91 P4010 NI MOMS 41 11 VI VI VI £I 41 21 VI II 41 01 10,113 OOVOIMO snewnl05 xtlvd ONV INVO 3AV ONVIlaOd V! S V/f Npl Nllp 01£ 042 S N3A31S is l 3AV 1311031N 113051v1e M1tlOM1N3M AaneSllld LNVSV31d ONVtl9 131aaVN 01313aVO 3AV 31VONA1 NOIa01V x V! 100 1NOdn0 NOSVIn3 11YOn3tld aartllo laloennw S3nvv xONx Nv001 NVOVOn NO1M3N tl3AIlO 3AV NN3d N33nO 113SSn11 NvaiV3NS svnowl Noldn 1N3JNIA NaneNSvM 3AV S3xa3x ,-.- „_ __ _.__, _ -- , _ _ _._ , 3AV 53xa3x Z N N N N N N N N N n ? N i ./ N JI N N N N N p O O Q 2232 E. 66th ST. COMPREHENSIVE DEVELOPMENT PLAN E` INSTITUTIONAL ® MIXED LAND USE • E3 MEDIUM DENSITY/BUFFER E{ PARKS SINGLE FAMILY RESIDENCE N 4T 63RD ST. E. 66TH ST. T N W Q Q Q O W U • V 4 W > N N N N W 1 i > - m N c%d Z z Q I I 1 I 1 E3 COMMERCIAL VACANT ® QUASI-PUBLIC 2232 E. 66th ST. LAND USE ED APARTMENTS co PARKS EIDUPLEX SINGLE FAMILY RESIDENCE ST. 4 `O { I I I { { I E. 66TK ST. T N W > a a O W U ^ _?_ Two` ?^ .1• __-_-_' N W a 3 O J J W W 0 2 O J -- N N N N N W W W -- W W --- --- ? Q Q a - a a - _ G N N Z N 4F 2232 E. 66th ST. ZONING ED C-2 GENERAL COMMERCIAL ® I INDUSTRIAL L-1 R RESIDENCE E3 MR MULTIPLE DWELLING MR-1 2 FAMILY RESIDENCES El MR-2 3-16 UNIT RESIDENCES E. 63RD ST. I 2 64TH ST. • • E. 5TH ST. vi W a Q a O W U ;jll'0,7 4 N ui Q N N N N N LLI a .. . o :r? a a a a N N Z 2 E. 66TK ST. • • CITY OF RICHFIELD, MINNESOTA Council Letter No. 219 September 25, 1989 - Agenda Issue Statement: Commemorating the Drafting of the Constitution of the United States of America. Background: The President of the United States of America has declared September 17 - 23, 1989 as Constitution Week. The proclamation, as found in Public Law No. 915, commemorates the signing of the Constitution and encourages citizens to study the Constitution. Recommended Motion: Adopt the attached Resolution which proclaims September 17 - 23, 1989 as Constitution Week. Basis of Recommendation: 1. A city resident has requested that the City Council officially recognize September 17 - 23, 1989 as Constitution Week. By making the proclamation, the Constitution is recognized as the superb body of laws. 2. Citizens who study the Constitution become better informed and more responsible citizens. Alternative Recommendation: Do not proclaim September 17 - 23, 1989 as Constitution Week, since it has already occurred. Discussion/Decision Mode: This matter is presented to the council for action. Respectfully submitted, James Prosser City M alter JDP/mba 0 -E1 RESOLUTION NO. THE AMERICAN CITIZENS COMMEMORATING THE DRAFTING OF THE CONSTITUTION OF THE UNITED STATES OF AMERICA WHEREAS, it is the privilege and duty of the American people to commemorate the two hundred second anniversary of the drafting of the Constitution of the United States of America with appropriate ceremonies and activities; and WHEREAS, Public Law No. 915 guarantees the issuance of a proclamation by the President of the United States of America, designating September 17 through 23 of each year as Constitution Week. NOW, THEREFORE, BE IT RESOLVED that the Mayor and City Council do hereby proclaim the week of September 17 through 23, 1989, as Constitution Week and urge all citizens to study the Constitution, to express gratitude for the privilege of American citizenship in our Republic functioning under the superb body of laws - the • Constitution of the United States of America. IN WITNESS WHEREOF, I have hereunto set my hand and caused the Seal of the City to be affixed this day of the year of our Lord one thousand nine hundred and eighty- nine, and of the year of the Independence of the United States of America, the two hundred thirteenth. Steven J. Quam, Mayor (SEAL) ATTEST: Thomas P. Ferber, City Clerk L' CITY OF RICHFIELD, MINNESOTA Council Letter No. 218 Agenda September 25, 1989 Issue Statement: Approval for the Administrative Services Department to enter into a custody agreement with Norwest Bank Minnesota to provide custody services for the City of Richfield's investment portfolio. Background: The newly adopted Statement #3 by the Government Accounting Standard Board (GASB) places municipalities in the position of disclosing levels related to the custodial status of securities. Statement #3 discloses the level of risk in the following categories: Category 1 includes investments that are insured or registered, or for which the securities are held by the municipality or its agent in the municipality's name. Category 2 includes uninsured and unregistered investments for which the securities are held by the broker or dealer or its trust department or agent in the municipality's name. Category 3 includes uninsured and unregistered investments for • which the securities are held by the broker or dealer or its trust department or agent, but not in the municipality's name. The City's cash and temporary cash investments as of December 31, 1988 were $32,615,834. Of that total, $17,850,279 was listed under credit risk category #3, which represented 55% of the total investments. Legality, safety, liquidity and yield are the prime factors used when investing City's funds. Diversification of the investment portfolio as to maturity, investment and financial Institution is a prime concern as well. Various banks within the metropolitan provide custody services for a fee based on the type of services performed., Services provided include: 1. Safekeeping of securities 2. Collection of all income 3. Remittance of principal and income as directed 4. Settlement of security purchases and sales 5. Use of short-term investment vehicle (cash sweep) 6. Monthly statement of assets, with market values' 7. Option for performance measurement system 8. Monthly transactions statement • Norwest's Custody Services Division, a part of the Norwest Capital Resources group, is responsible for the administration of over 400 institutional custody accounts. The assigned custody administrator will be responsible for the day-to-day control of the City's investment portfolio through the close working relationship of the Finance Manager. As necessary, the Administrative Services Director may perform the Finance Manager's duties in the Finance Manager's absence. Attached to this letter is Norwest Bank Minnesota's custodial fee schedule for the City of Richfield. An estimated yearly charge paid quarterly for custodial services will range from $4,000 to $7,000 depending on the amount of security transactions and the size of the investment portfolio. The fee schedule is subject to an annual review and adjustment. The Custody Agreement may be amended by written agreement of the parties at any time. This agreement may also be terminated by either party upon 30 days written notice to the other party. Recommended Motion: It is recommended that the City Council authorize the City Manager to execute a Custody Agreement with Norwest Bank Minnesota for the City of Richfield's investment portfolio. Basis of Recommendation: 1. It has been recommended by the City Council and the City's Auditors that custodial services be used to provide proper • safekeeping of City investments through a third-party agent. 2. Proposals from three providers were solicited. Norwest has provided a proposal which is most acceptable to City staff. Alternative Recommendation: 1. The City Council could decide not to approve the Custody Agreement. That would not address the level of risk resulting by not holding securities in the hands of a third- party custodian bank or depository trust. 2. The City Council could direct staff to negotiate an agreement with another financial institution. Discussion/Decision Mode: It is suggested that this item be considered at the September 25, 1989 City Council meeting so that the conversion process can be completed by the 1989 year-end financial reporting period. Within sixty days after conversion an extensive review of all records must be completed to ensure that all items were properly transferred. Re ec f lly submitted, Jame . Prosser Cit anager JDP: jm cc: Steven Devich, Administrative Services Director . Jean Mitchell, Finance Manager NORWEST BANK MINNESOTA, N.A. Custodial Fee Schedule for CITY OF RICHFIELD August 1989 Transaction Charges $25.00 per each commercial paper transaction including purchases, sales and maturities. $15.00 per each securities transaction, including Treasuries, FNMA's and FHLMC buys, sells, and principal and interest payments $8.50 per each outgoing money movement such as checks, wires and internal account transfers. $8.50 per each incoming cash deposit other than the initial deposits necessary to establish the account. Account Charges $500 per account per year Extraordinary Services For any service other than those covered above, a special charge may be made commensurate with the service provided, time required and responsibility involved. Such services include but are not limited to unusual reports, certifications, audits, etc. Additional Charges Reimbursement for out-of-pocket expenses such as postage, insurance, shipping, telephone, supplies, etc. Fee schedule is subject to annual review and adjustment. Assumptions The City of Richfield's investment philosophy involves investing in Treasuries, FNMA's, FHLMC and commercial paper. Special School District #1's investment philosophy. The above schedule may be changed if the investment philosophy 40 changes to include other types of investments and holding strategies. • CITY OF RICHFIELD, MINNESOTA Council Letter No. 217 September 25, 1989, Agenda Issue Statement: Master Purchase •Order for Salt To Be Used in Ice Control During the 1989/90 Winter Season. Background: The city council policy resolution on purchasing provides that when the purchase of merchandise, materials, equipment or construction exceeds the amount of $5,000, authority to purchase shall be submitted to the city council for consideration. Each year, the city purchases rock salt, which is usually mixed with sand, to control ice on road surfaces during the winter season. A recent history of prices for this product is: Year Unit Price Delivery Total 83/84 16.69/ton 2.00/ton 18.69/ton 84/85 21.41/ton 3.15/ton 24.56/ton 85/86 23.47/ton Included 23.47/ton 86/87 20.05/ton 1.95/ton 22.00/ton 87/88 18.96/ton 1.80/ton 20.76/ton 88/89 24.96/ton 1.43/ton 26.39/ton • Funding for this purchase is included in the 1989 and 1990 operating budgets for street maintenance. Recommended Motion: It is recommended that the city council approve the purchase of an estimated 1,000 ton rock salt for the 1989/90 Winter season from International Salt Company, Clarks Summit, Pennsylvania at a unit price of $26.48/ton plus $1.85/ton delivery for a total estimated purchase price of $28,330.00. Basis of Recommendation: 1. The city participates in a joint purchasing agreement with Hennepin County. 2. Hennepin County solicited bids for all the participants in the joint purchase agreement. 3. Under this particular joint purchase agreement, the City of Richfield has an obligation to purchase from the low bidder. 4. International Salt Company was the lowest responsible bidder for rock salt. Alternative Recommendation: None Discussion/Decision Mode: The Hennepin County contract information for this salt arrived • after the last council meeting (September 13, 1989). In order to take advantage of a $2.00/ton discount offered if orders are placed by October 15, 1989 and delivery accepted by December 1, 1989, staff is asking approval at this time. With the amount of • covered storage available at the city garage site, approximately one-fourth of the estimated tonnage will be received at the discount rate. Respectfu.112 submitted, James aD. Prosser City ge r JDP/eja • n U CITY OF RICHFIELD, MINNESOTA Council Letter No. 216 Agenda September 25, 1989 Issue Statement: Payment to the League of Minnesota Cities Insurance Trust Administrator in excess of $5,000. Background: The City purchases general liability insurance from the League of Minnesota Cities Insurance Trust with GAB Business Services as Administrator. The City's insurance policy has a $50,000 deductible for liability claims. In 1986, the City significantly reduced its premium by having a large deductible. The premium savings and additional monies have been used to create a Self- Insurance Fund to cover payments made which are under the deductible as claims arise. On May 26, 1987, Richfield police officer assisted the Minneapolis Police Department in an arrest at 77th and Cedar. The subject of that arrest subsequently alleged an injury caused by Richfield police officers and a denial of constitutional rights as a result of the arrest. After a thorough review of the legal issues involved, the City's • insurance carrier and legal representation made a demand that each Richfield defendant be dismissed from the law suit. On May 26, 1989, the stipulation for dismissal was filed by both parties and accepted by the court. Thus, Richfield is no longer a part of the law suit. While Richfield has been dismissed from this suit, a significant cost was incurred to defend the City. The cost for the defense of this claim is $31,612.36. Since it falls within our deductible limit, the City is directly responsible for this payment. Recommended Motion: Approve the payment to GAB Business Services in the amount of $31,612.36. Basis of Recommendation: 1. The City's insurance policy provides that the insurance carrier shall, at its discretion, investigate, settle, or defend any claim or suit against the City. The insurance carrier and its attorneys have settled this claim. 2. Funding is provided for defense or payment of 'claims costing less than the $50,000 deductible. Alternative Recommendation: 40 None. • Discussion/Decision Mode: This item is on the September 25, 1989 regular City Council meeting consent calendar. Respectfully submitted, Jame Prosser City naaer JDP:ff • • 0 RECEIVED SEP 0 7 )989 GAB Business Services Inc 9531 West 78th Street Suite 220 Eden Prairie, Minnesota 55344 Telephone 612-942-9818 Branch Office Sep ember 6, 1989 Howard Rowland City of Richfield 6700 Portland Ave. Richfield, Mn. 55423 Re: Waryge vs. City of Richfield GAB file no.: 56527-11449 OVER A CENTURY Of SERVICE Dear Howard; Please find enclo -sed copies of all bills and payments made concerning this file totaling $31,612.30. Per your contract with the League of Minnesc=t- Cities and in particular po:iicy MF824038R-7 as issued to the City on 7-1-86 through 7-1-87, ME030 Endorsement applies. • "-is endorsement states that there is a50.0OO.O0 deductible each _Iccuri-•erce for general liability, auto liability, uninsured motorist, under insured motorist. personal injury protection and Public Officials Personal Liabil.it,,°. This portion would apple to this particu Lar incident. It also states that the dam,_-,ges include any legal' defense costs, loss adjustment expense and claims cost. Could you please review the enclosed material and'then if it is in order please see that a draft is issued to GAB Business Cervices in the amount of V31,612.3c. Your cooperation is appreciate. Sincerely, Thomas M. Fe1.cy y n Adjuster TMF/nh ' , Encl. 7k, CITY OF RICHFIELD, MINNESOTA Council Letter No. 215 Agenda September 25, 1989 • Issue Statement: Approval of an updated 1990-1991 Community Health Services Plan. Background: In 1976, the State Legislature passed the Community Health Services Act. The purpose of the act is to develop and maintain a system of community health services under local administration. Community health services are those services provided to protect and improve people's health by preventing illness, disease and disease disability. Through this Act, Richfield receives community health services subsidy funds from the State to support the provision of services such as home health, disease prevention and control, health promotion, family health, environmental health and emergency medical services. Since 1977, Richfield has contracted with the City of Bloomington for the provision of personal public health services. The community health services provided in Richfield meet the requirements of the State Community Health Services Act, and have continually qualified for a subsidy. The Community Health Services Act requires an Advisory Board of • Health to advise, consult with, or make recommendations to the Board of Health on matters relating to the development, maintenance, funding, and evaluation of community health services. The Advisory Board of Health met on September 18, 1989 and evaluated the Community Health Services updated plan for 1990-1991. The Advisory Board of Health approved the plan at that time. Recommended Motion: It is recommended that the Richfield City Council approve the updated 1990-1991 Community Health Services Plan. Basis of Recommendation: 1. By approving this plan, the City will meet the requirements necessary in order to receive a State subsidy for the years 1990-1991. Alternative Recommendation: 1. The council could decide not to approve the updated 1990- 1991 Community Health Services Plan. This would mean that the City of Richfield would not meet the requirements necessary to receive a State subsidy for 1990-1991. • • Discussion/Decision Mode: The updated 1990-1991 Community Health Services Plan is being presented for City Council approval at this time. Respectfully submitted, James Prosser City nager JDP:sae r] . PROPOSED 1990-91 CHS PLAN CHANGES HOME HEALTH Addition: ISSUE 7: With the growth of the population over age 65, along with the trend to support an individual's ability to live as independently as possible, a variety of issues arise related to group living options. Many group community living alternatives are developing outside of the regulatory system. The role of public health in "ensuring conditions in which people can be healthy" requires guiding the evolution of community group living options which promote personal independence, prevent abuse and neglect of vulnerable adults, provide adequate care, and deal effectively with city planning concerns. Method Define and monitor health concerns in unregulated senior group homes. Method 2. Develop community guidelines for dealing with health issues in the variety of community group residential arrangements. 0 Evaluation 1. Summary of identified health issues related to unregulated croup living situations for seniors. 2. Presence of developed guidelines. DISEASE PREVENTION AND CONTROL Addition to issue 2, Objective 2: Method 8. Provide support for the initiatives of the Tri-City HIV Infection Coalition. HEALTH PROMOTION Revision of Issue 2, Objectives, Methods and Evaluation: Cardiovascular disease and cancer are the leading killers of American adults. Heart disease is the leading cause of death in Bloomington, Edina and Richfield. In 1986, 700 residents died from cardiovascular causes. Cancer was the second leading cause of death, killing 248 residents. Many of these deaths can be prevented. Life style choices are believed to contribute to more than 50 percent of the premature deaths from heart disease. According to the National • Cancer Institute, nearly 60 percent of deaths from cancer are related to life style choices. Life style changes, especially diet, can significantly impact the health of our cities' residents. . Elevated cholesterol levels is one of the major causes of cardiovascular disease that can be modified with a.change in life style. The blood cholesterol level of most Americans is undesirably high, in large part because of our high intake of calories, saturated fat and cholesterol. Appropriate changes in diet will reduce blood cholesterol and thereby reduce the number of deaths. It has been recommended by the NHLBI National Cholesterol Education Program that every adult American should know his/her cholesterol level and make efforts to monitor and control it. The NCEP has released guidelines for evaluating cholesterol levels which has led to numerous cholesterol screenings in the community. Concern has been voiced that the quality of these screenings is questionable. The results are not reliable and/or there is little or no education or follow-up. The following recommendations have been made by NCEP: - To ensure reliable test results, strict quality control measures and extensive staff training are necessary. - To ensure that the screening experience is useful, high quality education must be provided. - To ensure medical treatment, appropriate recommendations should be given to participant and a system of follow-up should be initiated. • Another concern is reaching potentially high-risk groups. Certain groups tend to attend screenings: elderly women who are well- educated with a higher income, white adults and previously screened individuals; while men, younger and middle age adults and low socioeconomic groups attend screenings less often even though these groups tend to be at higher risk. Objective Z. To increase awareness of cholesterol leve',,ls by providing high a'uality public cholesterol screenings; to lower elevated cholesterol levels by incorporating education and follow-up activities into screenings and providing additional support services for people seeking to control cholesterol levels; and to promote appropriate life style choices to reduce the incidence of heart disease and cancer. Method 1. Offer rapid cholesterol screening and education to the Bloomington, Edina and Richfield residents on a regular basis at the Bloomington HealthlDepartment. Method Z. Promote cholesterol awareness through public education. Method 3. Target high-risk groups by promoting programs to work sites that employ predominately young male workers and/or lower socioeconomic residents. • Method a. Offer cholesterol education to all participants in public cholesterol screenings. 2 • Method 5. Follow-up on all high-risk individuals by mail or phone encouraging them to seek medical attention. Method 6. Provide individual or small group education to all participants in cholesterol screening. Method' 7. Or'fer additional nutrition education to participants in screening and to all residents through regularly scheduled nutrition workshops. Method 8. Offer the Health Risk Assessment Program to individuals seeking more complete blood analysis, screening and education. Method 9. Provide environmental support for healthy dietary choices by providing the Shop Smart Program to local grocers. Method 10. Offer health risk assessment and education to individuals through the Bloomington Health Department. Method 11. Offer health promotion talks focused on nutrition and chronic diseases to the community. • Method 12. Provide nutrition counseling on an individual or grouo basis. Method 13. Collaborate with the Bloomington Heart and Health Program on a community smoking cessation campaign. Method 14. Work with the Bloomington Heart and Health, Program in providing work site smoking consultation.'- 1. Number of participants in cholesterol screening and education program. 2. Number of community nutrition workshops conducted and number of participants attending sessions. 3. Number of work sites requesting screening services and number of employees screened. 4. Percent of high-risk individuals utilizing services. 5. Number of high-risk individuals receiving follow-up. 6. Number of individuals receiving complete lipid analysis and • education through the Health Risk Assessment Center. Number of grocers utilizing the Shop Smart Program. • 8. Number of Health Risk Assessment Center programs offered and number of participants attending. 9. Number of health promotion talks presented and number of participants attending. 10. Percent of high-risk participants utilizing service. Addition: ISSUE 8: Effecting desired healthy behavior choices in school-aged children requires the mobilization of many community groups to work cooperatively both inter-organizational and inter-disciplinary. We know from experience that well-conceived, community-based health promotion programs can enable the community to encourage and support healthy behaviors and can have an important impact on life styles and risk factors in the population; and when programs are sustained, that it 1S pOSSIble to maintain the behavior changes over time. Objective 8. Demonstrate collaboration with the schools and other community constituents in supporting the model learner outcomes (behaviors) for health education. • Method 1. Participate as a program leader in the Minnesota Department of Education's Health and Wellness Education Program Planning Project. Method 2. Develop and implement School-based Cholesterol ProJject. "' Fva iilarTnn 1. Application of the project. 2. Identification of learner outcomes. EMERGENCY MEDICAL SERVICES Replacement: PR08LEM STATEMENT Sudden illness and injury can occur at any time. Timely intervention of emergency medical services is needed to provide a rapid means for recovery. STATEMENT OF NEED Individuals who experience emergency medical needs require immediate • intervention of trained EMS and support personnel. Response requirements may involve one victim of illness, or a very large group of trauma victims followine a disaster. These needs must be met on a 1 24-hour basis. The police department responds to medical calls, 24 hours a day, with First Responder trained individuals on every call and EMT trained individuals on many. The fire department provides 24-hour-a-day assistance if needed in the areas of: fire suppression, auto extraction; hazardous materials, and large scale search and rescue (2k-hour ambulance service is provided by a private company). The rescue squad supports the police and fire departments when available with additional EMT personnel and EMS equipment. Each of the response groups are managed by their Department Head. Coordination of the public safety emergency services is the responsibility of the Emergency `tanager. Needs exist to: 1. Continue personnel training. 2. Ucdate and develop inter-department planning. 3. Upgrade and maintain EMS communications equipment. 4. Develop public awareness of EMS resources and how to access • them. 5. Continue overall system management. COAL I: To increase the abilities of EMS response through training, planning, communications, public awareness, and system management. Objective 1 Respond to medical emergencies 24 hours a day. Method 1. Ensure availability of trained personnel,to meet medical emergency needs around the clock. C-I..ter;- 1. Training to First Responder level or higher. 2. Number and tyres of response. 3. Average response time. Objective Z. Develop and update inter-department training. Method 1. Prepare city-wide emergency plan including the integration of-all medical services including EMS response. • evaluation :Distribution or plan. • 2. Test and exercise plan during training. Objective 3. Upgrade and maintain EMS communications. Method 1. Develop inter-agency communications for both field and Emergency Operations Center to enhance EMS abilities. 1. Obtain and use radio equipment. Objective 4. Develop public awareness of EMS resources. Method 1. Meet with community leaders and groups to train in the use of 911 System to activate EMS. 1. Number of meetings. Objective System Management. Method 1. Use the Office of Emergency Management to plan and coordinate EMS activities. • Evaluation 1. Participate in planning activities with Board of Wealth. 2. Monitor EMS response activities. DELEGATION AGREEMENTS: None REQUESTED MINNESOTA DEPARTMENT OF HEALTH ASSISTANCE: None M TABLE OF CONTENTS Page Home Health ................................ 2 Family Health ............................... 6 Family Health Resource Bibliography......... 14 Disease Prevention and Control, Health Promotion Resource Bibliography............ 31 Envir^,r.*nen Health Serv4Ces ............... SeT_"7=Ces.. ... . . U C. A, HOME HEALTH 0 PROBLEM STATF?tFVT Proliferation of home health services and products with minimal measures of quality and ineffective coordination creates the potential for misuse of personal and public funding as well as unnecessary health problems. Limitation of home health for the low income or chronically ill can cause personal hardship and inappropriate use of nursing home. GDAr,. To ensure that persons whose illnesses or disabilities require health care but do not necessitate institutional services will gain access to care that will improve or maintain the maximum health status for their conditions. STAT yr `rT nF N777- mu^ QVEF?7TFT+7 T" ag-ag current- dr_ve towards ccr_ta_._.;,e--, hac ant _mpacr or_ acme health care. - a - -?z t -?--: _- by ` a t- - Research 7-r-ccra -_on, hcme health ==e pad t- -=5- of l.nat consumers say t.hev need. _ e-c?ca_?_ng this fu pure mare-, most health care + organizations are "getting to home care. In Hennepin County alone there are now at least 29 Medicare-certified home care agencies. Increasing need requires increased services, but with increasing services--many of which are publicly financed--comes the need to create standards of quality and community coordination to protect the population in need. Recognizing the potential for confusion among residents about home health services as well as documented events 'of residents being "sold" services and products that fail to meet their health needs, public health has an important role in providing residents with useful information on home health options. This information should be targeted towards population segments likely to be faced with home health decisions. The population of 21,592 individuals over age 65 in Bloomington, Edina, and Richfield, and their children, will be faced with the majority of home 'health care decisions. Outreach to this group organizing cost-effective home health care. QhI Pn-H VP 1 Tnn-r=Agp awarpnacc of and arrnnQPmeI is fnr a,anrnnriat'P hnmP e-ArP GPrVi rec Amen= targpt g-rn ing Method 1. Active personalized marketing of public health home care services to specific groups of consumers and providers. • PAGE 2 } 0 Method 2. Provide information and referral services to residents via intake system. Method 3. Provide home health assessment and consultation for residents in organizing care. Evaluation 1. Number of outreach encounters. 2. Target group surveys of service awareness. 3. Source of referrals. ISSUE 2: Public health has a chang4ng role in home health care, from an emphasis on short-term therapeutic care to loncer term chronic conet_ors. ?_. adds ?. _ _e='S is c=Ow _ y.ng r=74 - Oi c a en s _ ? care. 73-cause cff _nVerJe r e,a ionsn_^ "bet We=:' - 21'_:rne and cost, i is important ro ac-i re-V keel t:le TIC-S ume C= care as high as cossiiule. or .. - reaSCn marketing continues tC be important- Objective 2. Provide intermittent arofessional health care in t1afthome setting regardless of inability of oav to those who n health intervention or sunnort. Method 1. Public health nursing services will be provided based on an integrated plan of care and utilizing nursing outcome criteria. Method 2. Home health aides /homemakers will provide intermittent personal care and supportive homemaking as needed or through supplemental fee- for-service. Method 3. Physical, occupational, and speech therapy will be diracted towards specific patient problems. Method 4. Psychiatric nursing services will be utilized to enhance/ extend nursing service. Method 5. Medical social services through an agreement with Lutheran Social Services. Evaluation 1. Number of patients and visits by discipline. 02. Quarterly record reviews. Page 3 I A_ 3. Patient evaluation of quality/satisfaction of services. 4. Medicare certification. ISSUE 3• During the past 30 years, public health agencies have developed a cost-effective home care service that would be valuable as adjuncts to HMO or employer health packages. In order to be considered, public health agencies need to have a standardized system. Through the Public Health Nursing Cooperative, Transcare can serve as such a vehicle. Objective 3. Provide a metropolitan public health home care model as an option ?o :MOs and em-plovers. Method 1. For .al Public v?ethod 2. ??a=ke `^e -, cd 3. E'v alua J_on ize the operational structure of the Health Cooperative Transcare project. '_anscare services to providers. .„y arscare services to group purchasers • 1. Case-based cos- measurement 2. Patient outcomes. TQCTT7 d• Because of the curr_nt trend of horizontal and vertical integration, service alignments need to be established in order to be a part of coordinated service delivery. Objective 4. Establish collaborative relationships which are in the best interests of the community. Method 1. Participate with Presbyterian Homes and H.O.M.E. in providing coordinated Home Services of South Hennepin. Method 2. Participated with the Hennepin CountvCommunity Health Department as a provider in the PAS/ACG program. Evaluation 1. Compile utilization statistics. 2. Assess patient satisfaction and perceived benefit of continuity of care. ISSUE 5: Page 4 4 ile there is a need for multiple services and providers in both te public and private sector to meet the growing need in the home health care field, organizations which have entered the market for primarily profit motives have demonstrated instances of misusing private and public funds. To protect individuals from being sold misdirected "goods" and to protect the taxpayer from misuse of their tax dollars, the public policy which guides the development of a system of cost-effective home health care. Uojeczive o. Promote public health olicv which (1) addresses accountability for use public funds in home health services, (2) promotes cost-effective services, and (3) minimizes fragmentation of care. Method 1. Document home health system problems. Method 2. Document cost-effectiveness of the public health model for home care. Continuity of care. Me Cnod 3. Pa_ ___^a ?e _ developmenz or S,, - in 1andar s of a? -ssurance for home heal. care agenc4es. -vaIuan 1. Development- of oublic policy which protects consumers • and maximizes effective and efficient use of public funds. TS.7TTF F The future of public health is partially reliant on the extent to which students have an opportunity to gain an understanding of the role of public health in the health care delivery sys4em. While they can acquire experiences in community health in'. multiple settings, the public health setting offers a more comprehensive overview of the role of the public health professional. Objective 6. Facilitate the devel nursing knowledge and sk411s among within the community nursinq set ti a select number o health students Method 1. Provide home visit experiences to students with clients who have a variety of needs. Method 2. Provide involvement with community health services such as screening clinics and special programs. Evaluation 1. Input to clinical instructor from coordinators and primary nurses regarding each student's follow-through with assignments. nt of ccmmuni Page 5 A.- • FAMILY HEALTH PROBLEM STATEMENT Timely, affordable health care is needed to promote family well- being and ensure hea'_t::y child growth and development. GOAL: To enhance t^e opportunity for optimum health among parents and children by promoting access to and utilization of _nd health promo-_or_ ser-' _,.=s . F Vim- - W vtaP.v yaC7OrS ^paC =..^_e =am4'v's abilit,7 t0 successfully + nurture the,r cr.,_dran a:.c the__+child to develop op__mum potential. • ISSUE 1. Prenatal care reduces prematurity, low bit;-.h ortali+v. The _ ns-= - •,?=e of ,,,T _ ei?ht, and infant :n Medicine, part o--,: t• the National Academy of Science, reccrts that each "$1 spent on prenatal care saves 53.38 in the batv's first year alone." Health education, including proper nutriticn, steps to prevent problems,-and emotional /psvchosccial support have been shown to decrease pre- term labor and improve birth outcomes. The earlier prenatal care is initiated, the likelihood of a birth of a healthy b'.abv will be increased. A total of 11.5% of all Bloomington, Edina'„ and Richfield births started prenatal care in the second or third trimester or received no care at all. Individual services directed at prcmoting early and continuous prenatal care and connecting with, providers of prenatal care to improve access to them can imprcve birth outcomes to Bloomington, Edina,', and Richfield residents. Objective 1. To promote positive birth outcomes through increasing access to utilization of timely, continuous comprehensive, quality prenatal care as measured - by an increase in the percent of women who receive early and continuous prenatal education and care; increase in the percentage of babies weighing 5.5 or more • pounds at birth. Method I. Extend nursing care to target populations: Page 6 W.E.C. clinic clients • Family Plaftni=ig-STD clinic clients Hennepin County Community Health Department prenatal clinic C.E.C. program High risk referrals Method 2. Connect clients with appropriate clinical services. Develop collaborative relationships with local service providers. Support the Hennepin County Community Health Department South Suburban Prenatal Clinic. Method 3. Provide prenatal/postpartum nutritional guidance and support. Maintain W.I.C. clinic services. Extend individualized nutritional guidance for defined needs. 1. Number of Bloomington, Edina, and Richfield residents receiving prenatal care in the first trimester. • 2. Percentage of babies weighing 5.5 pounds or more. 3. Percentage of W.I.C. caseload of pregnant women. 4. Number of clients accepting services. 5. Number of visits. Routine and periodic screening services can identify deviations from normal growth and development before they become severe and more costly to treat. Early identification of these deviations can prevent long-term costs to the family, schools, and community as a whole. Data from the South Hennepin Human Services Survey indicate that health care services are very important to the residents of South Hennepin. - "73.2% of the clients using the energy assistance program said low cost health care was a very important',service." - "255 of the low income respondents had serious health problems." 0 Page 7 A comparison of income to insurance status and type reveals that after excluding women receiving Medical Assistance, 41% of persons with incomes below $5,000 have no health insurance, and 2196 of those with incomes over $15,000 have no insurance. In . addition, 38,000 Minnesota children living in families with income below the poverty level have no health coverage. An additional 62,000 above the poverty level do not have health insurance. Many of Minnesota's children and women of childbearing age are either uninsured or underinsured. The working poor are the most vulnerable because they do not qualify for Medical Assistance. The Children's Defense Fund reports that when the family income is limited, routine well child care is often discontinued. It is viewed as a financial burden, but, when compared to what the costs would be to let a potential problem that can be dealt with in early intervention may turn into one that needs expensive medical and educational intervention, the savings are not there.' As an example, ear infections are a common childhood experience. If left untreated, hearing loss and speech changes can occur. Treating an ear infection is relatively cheap compared to costs of hearing and speech therapy and special education. Well child services are being provided by the Bloomington Health Division currently. But, due to the increasing numbers of the uninsured, establishment of more comprehensive clinical services will need to be explored. In addition to screening services, nutritional services are also a necessary component in the promotion of health children. • "Infants with inadequate food are more likely to be mentally retarded, learning disabled ...or have more behavior problems than other infants. Poor nutrition is one of the major causes of mental retardation. Women, Infants, and Children, or W.I.C., is a food supplement program for low income children to age 5 and pregnant or breast-feeding women. Studies have shown that W.I.C. participants have diets that are higher in iron andl,key vitamins than non-participants, and children on the W.I.C. program are low income and, therefore, are uninsured or underinsured and are at risk to not use routine health care. Children enrolled in the W.I.C. program are more likely to have a reqular source of health care and were better immunized. The individualized promotion of healthy and constructive parenting can impact the growth and development of the child. These home visits provide individualized health education, emotional support, and positive parenting practices. Public health nursing services can effectively impart health knowledge to high risk mothers and can effect positive changes in maternal attitudes and parenting practices. These changes may be associated with positive changes in health and development for infants." 0 Page 8 Y • Method 1. Provide low cost, comprehensive Child and Youth Clinic screening services. Method 2. Explore the establishment of a south suburban satellite clinic for comprehensive, low cost children's clinical services. Method 3. Provide preschool screening services according to defined contracts. Method 4. Provide W.I.C. services according to contract. Method 5. Promote healthy, constructive parenting through individualized guidance targeted towards: "family support" referrals C.E.C. teen mothers Parents reques-4-g guidance :? . . C. mot ers care parents tar - acenc,7 r-erra s :"i4 and out.. C14n1C parents ?am-4_v Center participants. • Evaluation 1. Number of 2. Number of 3. Follow-up outcome. 4. Outcome o: ISSUE 3: individuals served by nature of service. visits by nature of service. on clinic referrals to determine referral parenting support services. Fifty percent (50°s) of teens in Bloomington, Edina, and Richfield indicate having engaged in sexual relations by age 18. The most recent available statistics indicate an annual total of 314 pregnancies to Bloomington, Edina, and Richfield teen-age girls in 1982. With two-thirds of these teen pregnancies ending in abortion, the extent of the problem remains largely hidden. While much community energy has been directed towards stopping abortion, little has been directed towards preventing the need for abortion. The 1987 South Suburban Coalition for the Prevention of Teen Pregnancy spring conference, "Insights and Intervention," corroborated the importance of public health leadership in developing broad-based community support 'for parents and youth. Five thousand (5,000) Minnesota have chi .each year. Babies born to Minnesota teens are almost twice asren likely to be born under 5.5 pounds or to die in their first year. Four out of five Minnesota teens who give birth at 17 or younger Page 9 1 never finish high school. Teen moms are likely to be . undernourished and to suffer from complications. a total of 3.2% of Bloomington, Edina, and Richfield births are-to individuals 19 and younger. Ten percent (10%) of all teen births received prenatal care in the second or third trimester or no care at all in Bloomington, Edina, and Richfield. Community education to promote delayed sexual activity among teens and awareness of responsible sexuality is vital. Parents are held responsible for sexual education but lack the support and the "how-to". Imparting human sexuality information needs a full focus approach. The community, schools, and most of all, the family need the technical assistance of how to relay values, responsibility, and how to improve communications with teens. Affordable family planning services will be provided for those choosing to be sexually active. Method 1. To provide community education which promotes delayed sexual activity among teens and awareness of responsibility for family planning methods for the sexually active. Method 2. Continue to provide family planning and basic • gynecological clinical services with a sliding fee scale. Method 3. To extend supportive services in the community through leadership in the South Suburban Teen Pregnancy Prevention Coalition. Eval up-H on 1. Number of clinic patients. 2. Number of clinic visits. 3. Evaluation of clinic participants. 4. Number of community education sessions. 5. Number of education participants. 6. Evaluation of learner outcomes. 7. Accomplishments of the "Coalition" TSSiT is Child care services are increasing in south Hennepin County. This is in response to the need for child care. It is estimated Page 10 that 60$ of all mothers work outside the home. There has been an increase of 26 child day care facilities over the past year in South Hennepin. Children in day care are at an increased risk for communicable diseases. Public Health consultation is one way to reduce spread of communicable diseases as well as promote healthy child care provider/child relationship. The school age population is among the healthiest of all age groups. It is also a population where targeted health interventions can yield the greatest benefits. Students are a captive population for developmental screening as well as promoting patterns of healthful living. School health programs need to be directed towards the common needs of age groups as well as targeting special problems. Children in other group settings are a population that could benefit from developmental screening. These children may have routine health care but may be at risk for a developmental delay. Group development screening is a cost-efficie.^.t wav to identi-Fv these ch_4 7 _dr-an _.. _ -ck. - New _ za..e and _ece_ a1 - I eC- J-C _on Gs mCrC. _ -..-d 1 :......? ?? !? - mande--e- that 'he school d-; S ?..r.4 c s as T -vi -?lCar en icn needs of 3-year-o7 cs.- ?ec_slaV^-orV?s pending .,_rth-to 2.) Mu't;- disci_ lirar-,T _ -70lvement _s also mandated. ?,,.:-14c Health hasl_u ? takenUa leadership role in designing this system and ensuring • that it will be family-focused and in the best interest of the child. A formal system will be in place by September, 1987, for 3-year-olds. Objective 4. _omota we " ^ess among children in croup settings. Method 1. Provide consultation visits to day care/nursery sch ools for health promotion. and disease prevention and control. Method 2. Provide guidance to family day dare providers. Method 3. Provide school health services to parochial schools on contract with the school district. Method 4. Extend development screening to children in group settings: a. day care b. battered women's shelters c. schools. Method 5. Build in a public health nursing component to the • schools' Interagency Learning Program Evaluation Page 11 i 0 1. Number of visits. 2. Number of children screened. 3. Outcomes of screenings. 4. Number of group sessions. 5. Number of group participants. 6. Learner outcomes. ISSUE 5: Family dysfunction can have many causes. Providing services to children and their families when an injury, disease or disability exists is necessar:T. Reducing the long-term effects of the S cc Lens.-a , -and -preventing . ... er -.-+- _S- cas_c public health. 'SS Y?• Cris_ .: ,ir lCSs are al. riSK ?.r e dove=^c^en- cfd_sease, manual ore'ku child and nee-' ec- J??, ?v ?p or abuse 7? ?• .,__ Health nursing intervention -oc ses on assessment and short-term counseling for matching the family with . an appropriate resource. When families are stressed, they are often not- ot able to access helping agencies without support. Public Health intervention is also offered to families following a police call. Services are extended to these families as a means to increase functional communication and decrease repeat rPolice calls. Officer safety is jenrnardi'-ed SJi1'.'^, each repeat call. Children in homes where domestic violence'; exists are at risk for child abuse and neglect. The Public Health Division received 236 referrals in 1986; 60% of the families accepted the help offered. Suicide is also a symptom of family dysfunction. It accounts for 25% of the deaths in the 15- to 24-year age bracket. The suicide rate for teen.-ace mothers is ten times that of the general population. A community-wide venture will be initiated to explore the problem and possible solutions. Objective 5. Provide Public Health services to children and parents experiencing disease, disability or crisis Method 1. Nursing services will be made available to assist parents in providing appropriate health care for children affected by injury, disease or disability and/or for health promotion and • disease prevention and control. Method 2. Public Health nurses will extend counseling to families experiencing a health-related crisis or loss. Page 12 • Method 3. Families at risk for domestic violence will receive serviceq through the family support team. Method 4. Collaborative community ventures for suicide prevention will be initiated. Evaluation 1. Number of clients by nature of the problem. 2. Number of nursing visits. 3. Outcomes of interventions as indicated in periodic chart reviews. 4. Community-specific suicide data will be collected. CJ t 0 Page 13 A c 0 FAMILY HEALTH RESOURCE BIBLIOGRAPHY 1Preventing Low Birth Weight, Institute of Medicine, National Academy of Sciences 2Minnesota Department of Health, Center for Health Statistics. 3Human Service Needs in South Hennepin, 1987. 4Analysis of Health Insurance Coverage and Health care Utilization and Expenditures in Minnesota for 1985. 5Health of Minnesota's C:^_? r=_n, Investing in the Future, League or Women Voters. F, "Chi_ .r e_^.'s Lef=nse . -::? - .._^nescta _ Project, 1986 7Pub1_c Heal,... Currer._s Jo-l. 46, No. 4 1986 8Agectiveness s-Orme, Terri, Janet Reis and Lydia Dantes Ward, of Home Visits by Public Health Nurses in Maternal and Child Health, "Public Health Reports, Sept.-Oct. 1985, Vol 100, No. 5, p-. 490-49.9. 9'I'een Perspectives on Sexuality, Bloomington Public Health Division, 1985. Domestic Abuse Project, Minneapolis. 1Levering, Carol Swanton, "Teen-age Pregnancy and Parenthood", Childhood Education, Vol. 59, No. 5, 1983. 0 Page 14 • PROBLEM STATEMENT Failure to identify, prevent, and control communicable disease endangers the well-being of individuals and the community. GOAL: To diminish the incidence of and problems related to communicable diseases where cost-effective prevention and control measures are available. ISSUE 1: Communicable diseases have a significant impact on the population including days of restricted activity for persons of all ages, decreased work ^rcduct?<r?-v loss of income, increased heal car e ccs mss, an= Increased th JC'Cial COS "s . _7cidemiolcc_c ___v__es ccns-strnc primari communic -e c-sense surve_-_ance and ?nves iga-z_-n are i and assent_._- elsimen,s c_ in-fec`ious disease *""° t.7cn` ? tioer. and control. • Communicable diseases occur when bacteria, viruses, parasites and other pathogenic organisms gain entry and cause damage to the bcdv. They are transmitted through a variety of mediums including air, water, food, animals or contact with an infected person. -cod-borne diseases, crimarily of a gastrointestinal nature and often caused by enteric bacteria (e.g., salmonella, shigella, or staphylococcus), viruses (e.g., hepatitis A. Norealk), result from infected food handlers and/or improper --cod handling techniques, and generate hundreds of citizen complaints each year. i When water-borne diseases occur in this area they are caused by individual water supply problems as opposed to municipal water contamination. Currently, more than half of mothers with young children are working outside of the home with their children cared for in day care settings. A variety of infections have been documented in children being cared for in these settings, sometimes with spread to caregivers and to others at home. The most common infections found are those of the respiratory or gastrointestinal tracts. There are several factors that place children attending day care at increased risk of infection, including close physical contact for extended periods of time; poor hygiene habits; and immature immune systems. In addition, when there are young children in diapers, diarrheal disease may occur and be spread when handwashing and environmental sanitation practices are Page 15 inL"equate. For these reasons, surveillance of communicable di ase is especially important in day care settings to-decrease the risk of transmission and the severity of outcomes. In 1986, there were 184 investigations and reports completed of confirmed (laboratory confirmed and/or ipi-linked) cases of reportable disease, excluding sexually transmitted diseases and tuberculosis, in Bloomington, Edina, and Richfield. This number does not reflect, however, an almost equal number of investigations conducted where confirmation was not possible or the disease was not a reportable disease (e.g., head lice), but where education disease was not a reportable disease (e.g., head lice), but where education was provided and prevention and control recommendations were made. Objective 1. To assume or-ncical resconsibility for communicable disease surveillance, ;.nves-_cat_,;on, consultation, inror_nation, and training within our g=ven Jurisdiction. Method 1. Too A ^ass?.ve ?._sease sur-re-__a^ce systam slanca? "u in-forma;-on an all _?cr ,.??__ .._s?ases ?r?m ?::ose re^u=red ?o reocr ,.. `? Method 2. To investigate all reportable diseases (except • gonorrhea, syphilis, chlamydia, and tuberculosis) . 1. Conduct interviews related to the investigation and complete State/Centers,for Disease Control surveillance form. 2. Obtain specimens and samples for laboratory analysis when appropriate. 3. Make prevention recommendations and implement control measures. Method 3. To investigate cases of reportable and non- reportable illness in excess of what is normally expected and may be derived from a common source (outbreak investigation). 1. Conduct interviews related to the investigation and complete State/Centers for Disease Control surveillance form. ,2. Obtain specimens and samples for laboratory analysis when appropriate. 0 3. Make prevention recommendations and implement control measures. Page 16 • 4. Collect, analyze, and interpret outbreak data. 5. Prepare and disseminate summary report. Method 4. To provide consultation, information, and training concerning infectious diseases. 1. Provide technical assistance and consultation to staff and other health professionals by telephone and in person. 2. Provide training seminars and inservices for staff and other health professionals. • 3. Provide information (research findings and educational materials) upon request. 4. Develop and provide audiovisual Rva l tiat- i nn instructional/educational pieces. 1. Number and kind of disease-specific reports by city. 2. Number and kinds of disease investigations by city. 3. Disease investigation outcomes. 4. Number and kind of professional education provided by city. 5. Number and kind of public education provided by city. 6. Number and kind of educational materials requested and provide d. Lyme Disease is a newly recognized disease caused by bacteria and passed to humans by the bite of a very small tick called Ixodes dammini. This tick lives in wooded, grassy areas and is most active and feeding from April through October. Although Lyme Disease is not life-threatening, later symptoms of the untreated disease can include complications of the heart, nervous system or joints. Most patients, particularly if treated with an antibiotic early in their infection, do not develop these symptoms. AIDS is a major public health and human service problem and was accordingly named the number one priority of the United States • Page 17 Public Health Service. The consequences of this disease are devastating, not only physically, but also emotionally, socially, and economically. The only way to stop this disease now, is to prevent infection in the first place. This requires a long-term prevention strategy of health education and behavior intervention. AIDS-related illness is a very serious and widespread problem pandemically, nationally, and here in Minnesota and our communities. As of May 18, 1987, Minnesota had 201 cases of AIDS. Thirty-eight (38) of these 201 cases had as their residence at onset the seven-county metropolitan area (excluding Minneapolis and St. Paul); 5 of the cases resided in Bloomington, Edina, and R4chfield at onset. The Centers for Disease Control estimate that for each case of AIDS there are 50-100 persons infected with the virus. Most of these individuals are gay and bisexual men, and probably only 1,500 of the 20,000 know that they are infected. Nationally , the estimate is 1.5 million infected. In ?'=-•= e=cc?, ve ro'ec_ ?60 new cases cf A,_nS in 1990 of which 43-=5 ca =-1 be the result c= heterosexual sex. The eco cmic predict-ions for AIDS are also staggering. The Minnesota Depar-ment of Health predicts "From 1986 through 1990 • the estimated impact of AIDS on Minnesota in terms of combined direct health care costs and estimated disability costs will range from S78- to $155 million. With the inclusion of indirect mortality costs as a measure of the value of life lost to the disease, the complete economic impact of AIDS for the interval 1986 through 1990 may range from $430- to $840 million." (Minnesota Department of Health, 1986: 82-83) It is appropriate for public health to assume a leadership role in the development of a coordinated community effort to minimize the impact of the AIDS epidemic. Objective 2. To focus on special communicable disease concerns such as Lvme Disease and AIDS prevention. Method 1. Inform the community through printed material and telephone contact about the emergence Lyme Disease. Method 2. Provide education on AIDS risk reduction practices through clinical services, schools, community organizations, and businesses. Method 3. Provide epidemiologic teaching, inservice education and consultation for health • professionals concerning AIDS medical research, epi trends, infection control, HIV antibody testing, and counseling. Page 18 Method 4. Provide consultation/technical assistance to schools and businesses developing HIV infection policies, Method 5. Provide accurate AIDS information to the public. Method 6. Make referrals to knowledgeable and concerned providers of medical and psychosocial professional services. Method 7. Provide space and support for an alternate test site as an adjunct to family planning/sexually transmitted disease services. Evaluation 1. Results of knowledge, behavior and attitude surveys. 2. Number and kind of educational services provided to sc^cols, ccmmuni?-T organizations, businesses, and 3. Number and k_nd of epidemiologic inservices provided to healt professionals. • 4. Kind of technical assistance/consultation requested and provided to schools and businesses. 5. Number of public requests for AIDS information. 6. Number of referrals made. ISSUE 3: Reproductive health includes any factor affecting males and females-of reproductive age that may influence their ability to produce children and to affect the health of their offspring. Untreated sexually transmitted disease can lead to such problems of infertility. One problem is those with no symptoms. With gonorrhea, for example, up to 80 96 of females and 20 $ of males may experience infection without symptoms. Without symptoms, the infection is likely to spread and result in permanent sterility. In 1984, there were 113 reported cases of gonorrhea among Bloomington, Edina, and Richfield residents. "Although not reportable, the incidence of chlamydia is estimated to be two to four times that of gonorrhea." According to the American Social Health Association (ASHA) more than four million people are infected with chlamydia each year and the disease is four times as frequent as gonorrhea. It is estimated, said the ASHA, that about 30$ to 50$ of the one million women who have pelvic inflammatory disease annually are Page 19 • infected with chlamydia. The disease may cause 100,000 women per year to become infertile and may be responsible for 20,000 ectopic pregnancies each,year. As there are no other low cost, confidential screening, diagnosis and treatment services for sexually transmitted diseases in southern Hennepin County, the Bloomington Public Health Clinic plays a significant role in increasing accessibility to services. Timely outreach and education to high risk groups is essential in preventing sexually transmitted disease as fear and ignorance are two major enemies in preventing them. Seventy percent (70%) of respondents in the Hennepin County Public Opinion Poll saw sexually transmitted disease amchg teen-agers and young adults as a significant problem that needs more attention. Once diagnosis is make, it is essential to work towards preventing further spread through education and epidemiologic follow-up. Objective 3 trarsm_ ..-Sa `^e -ncd , . To _ rovi de communes lr educa-,cn on preventing the acguisiticr_ and spread of ST--s. Method 2. To provide low fee, confidential, biweekly • clinical services for prevention, diagnosis, and treatment of STDs. Method 3. Report cases of gonorrhea, syphilis, chlamydia, ar_d AIDS/HIV infection to the state with sex partner(s) locating information when possible. Evaluaticn 1. Monitor the frequency of reportable STDs. 2. Number of individuals receiving clinical services. 3. Number of visits. 4. Frequency of diseases diagnosed. 5. Number of education sessions. 6. Number of participants in education sessions. 7. Education participant evaluation. ISSUE 4: The seven major vaccine preventabel diseases (diphtheria, tetanus, pertussis, polio, measles, mumps, rubella) can all cause permanent disability or death. With mandatory immunization currently in place for school children in Bloomington, Edina, and TO prevent and control the spread of sexuall -- S CCSe ( ST... , . Page 20 Richfield, children have documented full immunization histories upon entering school. The major problem area with these seven vaccines is that of rubella outbreaks among college age and young adults who were inadequately immunized. Active efforts need to be made to identify and immunize this population while maintaining the high immunization level among preschoolers. As the base cost for the entire series of childhood immunizations has risen from $4.88 to $19.54, access to low cost immunization needs to be maintained. "The federal government estimates the benefit-cost ratio for the mumps, measles, and rubella immunization program as approximately 14:1. The Centers for Disease Control indicated that the $1.3 billion in medical and long-term care by reducing hearing impairment, retardation, and other problems." The Bloomington Public Health Center offers the only low fee immunization clinic in southern Hennepin County. For elderly and the chronically ill, influenze and the consequent potential for pneumonia can be life threatening. Research indicates that vaccination of this population with the appropriate vaccine in advance of the influenza season results in a 70% to 90% lower chance of contracting influenza. However, only about 20% of persons at high risk receive the vaccine. Method 1. Educate targeted population groups on the need • for immunization and access points. Method 2. Hold monthly low cost immunization clinics at the Public Health Center. Offer vaccines for seven vaccine-preventable diseases (diphtheria, tetanus, pertussis, polio, measles, mumps, and rubella.) Method 3. Offer flu immunizations at senior centers in Bloomington, Eding, and Richfield) Method 4. Adult initiatives:- rubella, measles, tetanus, diphtheria, influenza, pneumococcal disease, and hepatitis B. Method 5. Provide epidemiological surveillance, investigation, and counselijng of reported cases. 0 Page 21 • Evaluation 1. Number of immunizatign given by type. 2. Number of reportable diseases. 3. Investigation summaries. • Page 22 • • r? LJ HEALTH PROMOTION PROBLEM STATEMENT Inadequate health-related knowledge, attitudes, and behaviors contribute to a diminished level of well-being and/or the presence of preventable disease or disability. GOAL: To promote life style choices which decrease risk for injury,disease or disability. ISSUE 1° Minnesotans have the second longest life expectancy in the nation, surpassed only by Hawaiians. At age 65, Minnesotans can expect to 1_4ve an add:ticnal 17 years. This population over age 65 is grow_^c a? a s_47nif_cant rate. In Blccmingtcn, Edina, and Richfield e is - ^ro;ectad increase of 4,730 yndividuals over ace 66 betNeenv_98C and 1086. Charge in ?cpulaticn Over 65 - 1980-1986 BLOOMINGTON EDINA RICHFIELD TOTAL 1980 4,589 6,691 3,966 15,246 1986 6,422 8,441 5,113 19,976 Increase 1,833 1,750 1,147 4,730 With the shift towards keeping the elderly in the community comes the challenge of promoting systems and personal choices that support maximum independence. That support includes increasing awareness of some of the primary contributors to accidents among ° the elderly. Objective 1. Promote the ability of residents over age 65 to retain their independence through adoption of behaviors incorporated in the educational program, "A Healthy Old Age." Method 1. Market the program to groups of seniors in Bloomington, Edina, and Richfield. Page 23 Method 2. Tailor the sessions on fitness, nutrition, and • health care to participant needs. Method 3. Adapt the Health Risk Assessment program to senior groups. Evaluation 1. Participant descriptors. 2. Session objectives. TCCTTT7 '? Cardiovascular disease, Primarily heart attack and stroke, is the number one killer of American adults between the ages of 24 65. Together, hear- attacks and strokes kill more Americans than all other causes of death combined, including accidents and cancer. Hear-_ disease _-ad=n cause of dea t . _.^. B 1 T, and- 7 _ g cau Com?ngton, a, a .. 1986, 70C (324 B_cc,,ingtor. 186 Edina, and 19C resider--;Cs died from CarA_cvascular causes Mest heart at-!:acXS and strokes could be prevented. According to the National c..^1C1e5terQl EA ucation Program ever half of the adult population should be concerned about their cholesterol level because of an elevation (greater than 200). Life style choices are believed to contribute 54s to premature deaths from heart disease. The kev risk factors of cigarette smoking hvpertersicn, and elevated blood cholesterol cani,be significantly decreased by changes in behavior. Risk factors measured among Bloomington adults by the University of Minnesota Division of _ Epidemiology in 1982 showed that: - - 12.63 of men and 10.5% of women had a serum cholesterol greater than 250 mg; 35.13 of men and 28.4% of women were currently smokers; - 1496 of men and 10% of women were hypertensive and on no treatment; and - 4% of men and 43 of women were being treated for hypertension but were not controlled. Education in personal risk factors, along with nutrition, weight control, fitness, and smoking cessation, have been shown to relate to behavior changes which decrease the risk for heart disease. Evaluation of several worksite programs indicates that participants do change eating habits and reduce risk factors (i.e., weight and blood cholesterol levels) during the program. Inclusion of nutrition counseling in the program is useful in maintaining long-term adherence to changes in life style. Page 24 • Objective 2. To stimulate reduction of health risks, contributing particularly to heart disease, through blood chemistrv screenings linked with health education Method 1. Offer health risk assessment and education to individuals through the Public Health Center. Method 2. Adapt the Health Risk Assessment program to the interest of community groups including worksites and churches. Method 3. Work with the Bloomington Heart Health Program on a community cholesterol reduction initiative. Method 4. To provide nutritional counseling on an individual or group basis. Evaluation 1. Number cf part-icican_s in the Health Risk Assessment prccram from churches, wcrksites, other organizations, anc caneral public. 2. Number of eating patterns weight management, fitness, smck=ng cessation classes conducted. • 3. Number and kind of educational sessions conducted and number of participants in each. 4. Survey public awareness of the Health Risk Assessment program. - 5. Survey works ite/church awareness of the Health Risk Assessment program. 6. Results of Bloomington Health Health Program/Bloomington Public Health Division cholesterol campaign. 7. Number of Bloomington organizations (worksites and schools) assisted with smoke-free policy development. S. Number of clients receiving nutrition counseling. ISSUE 3: An individual's occupation or place of employment can serve as a potential source of disease or disability. While: no complete, accurate data collection system on occupational illness and injury is available at the local level, application of available data indicates the occurrence of a substantial incidence of potentially preventable disease or disability at the worksite. • Page 25 Barriers to effective injury and illness prevention activities include: • 1) inadequate surveillance systems which are!`_linked to employer fears of related costs in the possible identification of work-related problems; 2) limited availability of non-regulatory consultation through legislated programs; 3) marginal supportive attention to small and mid-sized worksites. Through its group norms, worksites can also serve as a primary contributor to an individual's choice in personal behaviors related to health which recent studies have identified as contributing to 75.' of one's health status. While it is clear that the worksite is an important environment for stimulating positive choices in health and life style, there are multiple barriers to the inclusion. of health promotion ir_terventions at the work site. These 'tarriers include: 1) the politic, that it is not "the business to be meddling in emplovee life style choices; 2) inadequate cost benefit analyses; • 3) availability of designated program resources.' Because of the geographically fluid nature of residency and place of employment with the county, it is valuable to aooroach occupational health initiatives with a county-wide perspective. Objective 3. To enhance the health of employees through cost- effective occupational health initiatives provided on a fee-for- service basis. Method 1. To work with Hennepin County Community Health Department and Minneapolis Health Department in the development and utilization of a tool to use in assisting management in determining areas of health risk or cost. Method 2. To work with Hennepin County Community Health Department and Minneapolis Health Department in establishing a resource directory of worksite health programs available to Hennepin County emplovers. Method 3. Provide employers with cost-effective worksite health programs including: • 1) Back Injury Prevention Page 26 2) 3) • 5) 6) Evaluation Hearing Conservation Blood Pressure Control Health Risk Assessment Nonsmoking Initiative Employees Assistance Program. 1. Outcome of employer consultation provided. 2. Number of worksites and employees served. 3. Evaluation of worksite health programs provided. • ISSUE 4• In its 1982 survey of Bloomington residents, the University of Minnesota Division of Epidemiology found that 1496 of men and 1016 of women were on treatment but uncontrolled. One of the greatest challenges o hvpertensicn control lies in supporting the individual i- adhering to what may be unpleasant or costly t_ ea tment raq_4 mess when - e byy per-eansign i?ger doesnr t make them feel sick. ?_.ause of the freguercv at whic. ^. hypertension itself r doesn't make :em feel sick. Because of the freauencv at which hypertensive '_ndividuals may have no svmptoms and, therefore, seek no medical care, it is par"4cularly important to uncover hidden cases and assist individuals in accurately monitoring and effectively controlling their blood pressure. Objective 4. Prevent essential hypertension Method 1. Offer standardized blood pressure screening, education, counseling, and follow-up through: 1) free community sessions 2) fee-for-service individualized assessment and counseling 3) routine clinical services 4) worksites. Method 2. Build collaborative relationships with other individuals and organizations in 'the community capable of enhancing blood pressure control: Evaluation 1. Number screened: 2. • over age 65 and 65 and under Of those screened with elevated blood pressures: Page 27 a. number previously diagnosed with high blood pressure; • b. number previously unaware of high blood pressure; c. Follow-up calls on outcome of screening among those with elevated blood pressures. ISSUE 5 Accidents are the fourth leading cause of death in the metropolitan area. From age 1 through 40, accidents are the leading cause of death and disability. Motor vehicle accidents account for 61°s of all accidental deaths in individuals under age 65. In suburban Hennepin County, car crashes increased 5.4 $ between 1980 and 1983. However, injuries decreased 1.6%s and deaths 34.5°x. The overall decrease in deaths and injuries (with the exception of Richfield where injuries increased by 5.2$) may be attributable in part to increased use of automobile restraints. There is, however, significant improvement yet to be made as 67. :iennepin County residents Surveyed continue to use seat begs _.._reauently or never. Yours people are the drivers in a i=spr-ccrtionate percent of fa-z:a_ accidents. Nearly %°s cr motor ve:cle fatali,.=_ es in Minnesota in 1983 were males between the ages of 15 and 24. Alcohol is frequently related to these events. A total of 6.6$ of the population sampled in Hennepin County report that they have driven having had too much to drink one or more times in the past month. • Age is an important variable in approaching causes. The greatest hazard to the chvsical health of children and youth are accidents and injuries which move beyond automobiles to include fall, fire, poisonings, and drownings. While the world cannot be childproofed, there are simple precautions which can eliminate immeasurable pain. Sports injuries have recently been acknowledged as a significant source of injur-s. Dr. Paul Gunderson, Minnesota Department of Health Center, for health Statistics, noted that 100$ of hockey players sustain an injury requiring medical treatment each season. Also, he noted that all-terrain vehicles are an increasing source of injury. For the older population, sensorideprivation creates needs for making adjustments in one's living environment to avoid accidents due to falls, burns, and medication misuse. Objective 5. Heighten awareness among target populations of actions that can be taken to reduce frequency of accidents. Seniors - falls, burns, medications Adults - auto accidents, recreational injuries Youth - sports injuries, recreational injuries, auto accidents Children - auto accidents, household accidents, water accidents, fire, poisonings Page 28 Method 1. To incorporate timely, population-specific accident prevention messages throughout agency programs. Evaluation 1. Surveys of client knowledge, attitudes, behaviors. 2. Accident morbidity/mortality reports. ISSUE 6: The success of public health initiatives is dependent on the i? extent they are able to reach the target populations with timely, meaningful messages and connect individuals with the appropriate services or behavior choices. Marketing plans need to be designed through which the most cost-effective means can be utilized to reach defined populations. Objective 6. Enhance oublfc awareness of health issues and connection w_- Public Health services. Met cd Mortzly cable television specials, "Healthy Living." Method 2. Special "Health Edition" brochures. • Method 3. Timely media communications. Method 4. Intake nurse availability during office hours. Method 5. Personalized "Community Caseload" system. Evaluation 1. Telephone surveys. 2. Focus group sessions. 3. Program participant surveys. ISSUE 7• ."Approximately one out of ten women will develop breast cancer at some time during her life." In addition, "an estimated 48,000 new cases of uterine cancer were diagnosed" in the United States in 1986. Many of these cases can be effectively treated through early diagnosis and treatment. For low income women, cost of preventive screening may be a significant barrier. Objective 7. Reduce the incidence of morbidity and mortality from cervical and breast cancer. Page 29 Method 1. Provide low cost clinical services for well-women • screening and education. Method 2. Provide community education on cancer risks and warning signs. Evaluation 1. Number of pap tests. 2. Number of abnormalities. 3. Number of education sessions. 0 2 0 Page 30 DISEASE PREVENTION AND CONTROL, HEALTH PROMOTION RESOURCE BIBLIOGRAPHY 1Maternal Child Health Plan, 1985. 2The Nation's Health, May-June 1987. 3Bloomington Public Health Division 1986 Annual Report. 4Hennepin County Public Opinion Poll, 1984. SBloomington, Edina and Richfield Demographic and Statistical invent-cry, _987. ?P escri rions for Health.: Promoting Heap: and Preventing Disease _r. t::e Twin Cities Metropolitan Area, Metropolitan Area, Metropolitan Council, 1985. 70pportunities for Success: Cost-Effective Programs for • Children, U.S. Government, 1985. 81986 Minnesota Health Profiles, Minnesota Center for Health Statistics. 9T L en eading Causes of Death, Center for Disease Control, 1978. 10National Institute of Health, Lowering Blood Cholesterol, 1984 11S ummary Report on the Study of the Hennepin County Community Health Department's Role in Occupational Health, 1984. 12C ancer Facts and Figures - 1987, American Cancer Society. 13 S " umner, Sheron, et al., A Weight Control and Nutrition Education Program for the Insurance company Employees", Journal of Nutritional Education, 18:560, 1986. I 14Journal of Chronic Diseases, 1978, 31:201, Pooling Project Research Group. 15Motor Vehicle Facts, Minnesota 1983 s Page 31 0 ENVIRONMENTAL HEALTH SERVICES HOUSING MAINTENANCE Problem Statement Diminished health resulting from conditions or illnesses associated with substandard housing. Statement of Need Although the total impact of substandard housing on health cannot be fully determined, certain parameters of unsound housing have a definite ralatj.orship 'Co an individual's health status. Many researchers believe that the irritations, frustrations, and f invasions o; pr_vacv tha. occur in some residential environments are leading or contributing factors of mental illness. Respirator, infections, such as cold, bronchitis, and influenza, are related to inadequate heating or ventilation and inadequate and crowded sleeping arrangements. Digestive-tract diseases are usually related to crowding, inadequate water and sewage facilities. Other potential problems include carbon monoxide poisoning due to faulty home heating devices, rodent and insect infestation, accidents due to crowding, unsafe electrical connections, unsafe lighting, and structural problems. Goal: To minimize the public health problems associated with substandard housing. Objective. By systematic inspection and education ensure that housing code violations are documented and corrected. Method 1. A minimum of one survey will be,conducted for each multiple dwelling within the city. Follow-up inspections will be made to ensure compliance with the building, fire and housing maintenance codes. Method 2. All complaints regarding rental housing will be investigated and abated when necessary. Method 3. A Code Compliance Officer will investigate substandard housing conditions noted during - routine patrol. Page 32 Method 4. Referred requests from Hennepin County Welfare and/or the Minnesota State-Welfare Department will be promptly investigated and reported to the responsible agency. Evaluation The housing inspection program is evaluated on the basis of how well each housing unit complies with code requirements. Inspections are recorded and violations are noted for correction. Follow-up information is recorded to ensure compliance with each violation. Those housing units that require repairs are given more emphasis by means of increased inspections. C Page 33 • ENVIRONMENTAL POLLUTION CONTROL Problem Statement Diminished health resulting from exposure to polluted air, water, or noise. Statement of Need Air pollution is ailments such as the common cold. disease and abno irritation. reported to be a major factor in respiratory lung cancer, emphysema, chronic bronchitis, and Data indicates it may be a factor in heart anal human behavior. It also causes eye Noise pollution can affect human health. The effects fall into two overlapping categories, consciously perceived and insidious effects. Consciously perceived effects are those recognized by the recipient or person. They usually have a subjectively irritating cr a nuisance character, but they are nevertheless imncrtant _?^.C-ionailV, producing such effects as interference with thong rocesses, communication disruption, performance impairment, sleep disturbance, and general mental stress. Excess noise can also result in permanent hearj.ng loss. Water has many uses; the potential threat of contaminated is drinking water and polluted recreational waters is increasing. Such facilities include public and semi-public water supplies, private wells, swimming pools, on-site sewage disposal units, storimwater discharge, cross-connections and unprotected backflow. Goal: To minimize the health effects attributable to air, water, and noise pollution. Method 1. All air, water, and noise complaints will be promptly investigated and abated when valid. Method 2. A continuing effort will be made, in cooperation with the PCA, to continue air monitoring within the city. • Page 34 Method 3. A minimum of one inspection per year will be conducted on industries with a valid "Operating Permit" to ensure that pollution equipment is operating as designed. Method 4. Permits will be issued and inspections conducted on all new, repaired or abandoned wells, public or private, within the city. Method 5. Permits will be issued and inspections conducted on all new or remodeled individual sewage systems. Method 6. Routine sampling will be conducted in all underground garages and arenas for CO concentrations. Method 7. All complaints involving formaldehyde gas will be _nvesticated and air samples will be taken. Method S. All commur._t-y noise complain -s will be _nvesti?ated and measurements taken to determine :f violations exist. Method 9. Plars will be reviewed on all new or remodeled buildings to determine if air, water, or noise • pollutions will be a potential problem. Method 10. Noise measurements will be taken (weather permitting) on city streets to tag motor vehicles not in compliance with the Noise Code. A Compliance Test Center will be operated to- test all violators for compliance. Method 11. Routine water sampling will be conducted for individuals with private wells on request. The city water distribution systems will be sampled and analyzed as required by the State Health Department. All newly extended water mains will be sampled to insure potability prior to placement into service. Evaluation The environmental pollution activity will be evaluated mainly on the basis of output as a result of maintaining detailed statistics as to number of inspections and compliance results. Air pollution activities will be evaluated on the basis of air • Page 35 sampling and effectiveness of pollution control equipment. Noise • control enforcement activity will be evaluated by review of daily statistics, effects from applying abatement%?procedures such as li barriers, on-street enforcement, and educational efforts. Water pollutants will be evaluated through routine inspection coupled with laboratory analysis procedures. • I U Page 36 . FOOD PROTECTION Problem Statement Diminished health resulting from food-borne illness caused by the consumption of food contaminated with chemical substances or micro-organisms. Statement of Need Contamination of foods may occur from unsanitary conditions or improper handling during food manufacture, processing, delivery, or service. In addition, problems associated with contamination, food spoilage and loss or nutrients may result from improper storage or excessive shelf-life. Some of the more common underlying causes of food-borne disease outbreaks are inadequate refrigeration, poor personal hygiene, failure to hold readilv perishable foods at legal refrigerated temperature, failure to hold hot foods at legal holding temperatures, and inadequate cooking. At the Prase::,. Lme, there are 15z0 food establishments in Richfield. As the population increases or is redistributed, the number of food establishments will increase correspondingly. The National Restaurant Association reports that the restaurant is business in M4nreapolis-St. Paul metropolitan. statistical area has a sales volume of $484,355,000 in 1975. The U.S. Public Health Service has suggested that a rough estimate for utilization of food service establishments is about 250 persons per establis:.ment per day. Assuming this figure is applicable, it is estimated that approximately 37,500 persons are served daily by Richfield food establishments. During the school year,- the Richfield School System food service provides meals for 4,350. When proper food handling procedures are followed, most food-, borne illnesses can be prevented. Food protection programs are intended to prevent illnesses attributed to the consumption of foods. This program includes inspection of all food establishments, sampling and analysis of selected food and environmental samples, and education of food service personnel in the safe and proper food-handling techniques. Goal: To achieve, through education and enforcement, compliance with the various laws, ordinances, and policies which will ensure all citizens of Richfield a healthful and aesthetically pleasing food consumption experience. • Page 37 4 . Objective. By systematic inspection and education, ensure that all food, while being transported, stored, prepared, displayed, served, or sold to the public is protected from all forms of contamination or adulteration consistent with the Richfield ordinances to ensure safe consumption and minimize the possibility of food-borne disease episodes. Objective. To ensure, through the plan review process, that each building or parts thereof, that are intended for food production or storage, is constructed according to compliance with the provisions of the Richfield ordinances to ensure that the structure and equipment is designed to provide a durable, easily cleanable, and aesthetically appealing environment in which to store, display, or serve food to the consuming public. Method 1. A minimum of two comprehensive surveys will be conducted for each facility along with the necessary follow-ups to ensure compliance with written orders. Method 2. A minimum of one inspection per year will be conducted on all licensed, readily perishable food vehicles. Method 3. Prompt attention will be given to all citizen complaints involving food. Method 4. Prompt attention will be given to all investigation and reporting of all food-borne episodes. Method 5. Routine sampling and analysis of food samples- will be accomplished to compliment our inspection efforts. Method 6. A continuing effort will be made to ensure that all food management personnel receive Quality Assurance Training. Method 7. Each new or remodeled food facility will receive a comprehensive plan review along with the necessary field follow-ups to ensure compliance. Evaluation The inspection process will be evaluated using several methods. The environmental health specialists will have access to policy statements which will aid them on the uniform interpretation of the ordinances. This is coupled with routine staff meetings to clarify those items of the ordinances in question'. Another evaluation method will be to maintain detailed statistics whereby Page 38 all work activity is recorded on a daily basis and analyzed so that administrative support personnel can keep the environmental health specialist informed of his or her progress. Periodic field visits will be made by supervisory personnel to determine levels of compliance and uniform application of the code. In addition, Richfield supervisory personnel will meet with the Bloomington supervisory personnel to provide routine feedback for the environmental specialists. The overall evaluation will be based in terms of "output." The evaluation of the plan review process will be evaluated through review of daily records, field inspection follow-up, an periodic review of the plan reviewers' work. Correspondence and meetings with builders and owners will be reviewed and supervised to determine uniformity of effort. 0 Page 39 0 COMMUNITY SANITATION Problem Statement Diminished health resulting from exposure to environmental contaminants, hazards, or conditions in the physical environment of the community. Statement of Need Community sanitation covers a variety of environmental problems which provide a link in the transmission of disease to man. Included are problems related to rodent, insect, weed control, improper refuse storage, animal control, and a variety of public health nuisances. Many sanitation problems are interrelated so that a practical approach to control involves looking at the total community sanitation picture rather than each component separately. In addition to being public health nuisances, communitv san_ ?a ?? cr. problems are offen evescres which lessen the aesthetic app y - e c_tv and ccntr_buts tc, decline in p= opert-v Val--:eS. Goal: Either by citizen complaint or observation in the community, =den-i_y and abate all nuisance consistent with state • laws and local ordinances. Objective. Respond to all complaints to determine validity and write specific orders for each, specifying a compliance date. All complaints will be followed up to determine compliance. Method 1. Complaints received from the public or environmental health specialists! are recorded, assigned a number, and assigned to specific individuals for investigation. The environmental health specialist determines at the time of his or her initial visit if the C7 Page 40 complaint is valid. If the complaint does • constitute a violation of state or local ordinancq, an order is written specifying a timetable of compliance. A follow-up inspection is made on the compliance date to verify compliance, grant an extension, if warranted, or issue a violation tag when appropriate. Evaluation The evaluation of this activity is mainly achieved by performance output. Statistics are complied on each complaint regarding all inspections and completion of a report for each complaint including a follow-up phone call to each complaint and to determine the degree of public satisfaction. • U Page 41 c ,f • EMERGENCY MEDICAL SERVICES PROBLEM STATEMENT Failure to provide timely intervention for emergency medical needs results in unnecessary morbidity and mortality. STATEMENT OF NEED Individuals who experience emergency medical trauma require immediate intervention by individuals competent in emergency medical intervention service. The community fire squad does not respond to medical calls. The police department has their responsibil--r divided between care for the injured, safety of others, anG in,.7 estigaticn of an accident or crime. The ambulance service cove=s a wide geocraphical area and, therefore, has an extended emergency response time. Therefore, the need exists for a community-'ased emergency service which can provide expert first response intervention as support to the police department. The 280 program, begun in 1977, provides this support by • furnishing trained EMTs from the Rescue Squad in?a fully equipped basic life support unit 65 hours a week. The needs for this service as a supplement to police response are: 1. one of the two police officers normally assigned to EMS calls is able to pursue more conventional police activity; - 2. sophisticated EMS equipment not practically transported routinely by a police officer; 3. a vehicle capable of transporting victims in the case of difficulties with ambulance coverage; and 4. in the case of a community disaster, rescue squad members would provide the bulk of emergency medical services as well as victim transportation. Timely intervention can be provided by individuals who are present at the time of the trauma, if they have been adequately trained in the provision of services. The need exists for training of community residents in emergency medical response. Goai: To decrease the incidence of morbidity and mortality resulting from medical emergencies in select situations. i Objective 1. Maintain the average of 3.0 minutes aver response time to medical emergencies in the community. Page 42 W . Method. Utilize the current response system. Evaluation 1. Average response time. 2. Number and kinds of responses. Objective 2. Provide ambulance service in select situations Method. Utilize protocols in screening for ambulance services. Evaluation 1. Service is within existing protocols. 2. Number of runs. Objective 3. ?rcvide "first aid coverage for selected city ecJ en l.s . Method i. Maintain guidelines for selecting events for coverage. • Method 2. Provide staff. Evaluation 1. Number of events. 2. Number of staff. Objective 4. Provide support for fire and rescue services through the utilization of the 280 program Method. Maintain current guidelines and staffing. Evaluation 1. Number of responses. 2. Number of staff involved. Objective 5. Provide training in first aid and cardio ulmonas-Y resuscitation. Method. Field and respond to requests according to available staff. • Evaluation 1. Number of sessions. Page 43 ,o v,4 A 2. Kind of sessions. 3. Number of participants. 0 • Page 44 0 RESOLUTION NO. A RESOLUTION AUTHORIZING SUBMISSION OF A PLAN IN APPLICATION FOR A COMMUNITY HEALTH SERVICES ACT SUBSIDY FOR 1990-1991 WHEREAS, the City Council official governing body of the the official Board of Health o WHEREAS, the City Council and maintain the health of the level; and of the City of Richfield is the City of Richfield and functions as f the City of Richfield; and is committed to promote, support, entire community at the highest WHEREAS, the Community Health Services Act provides for subsidies in support of public health services on the local level throughout the State of Minnesta; and WHEREAS, the Advisory Board of Health of the City of Richfield has reviewed and approved the plan for the provision of public health services in the City of Richfield, and recommends that the City Council authorize its submission in application for a grant; and WHEREAS, the City Council finds this plan consistent with the needs and priorities of the community as determined by the Advisory Board of Health and as expressed by the citizens of Richfield; NOW, THEREFORE BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF RICHFIELD, that the 1990-91 Community Health'Services Plan for the City of Richfield is approved and authorization is hereby given to submit said plan in application for a Community Health Services Act subsidy for 1990-91. Passed and adopted this 25th day of September, 1989. Steven J. Quam Mayor ATTEST: Tom Ferber City Clerk