HomeMy WebLinkAbout1985-03-11_SPECIAL MEETINGSJ c (I- l �1i- 3 I rr�YJ�
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EDINA ADVISORY HEALTH COMMITTEE
PUBLIC HEALTH
I. Overview of Public Health
A. Definition: The discipline and practice of managing the health needs
of the public or the community.
B. Focus: The public good: public, community, aggregate
C. Major Values:
1. Public good: The greatest good for the greatest number at the
least cost.
2. Distributive justice: reallocation of resources to provide the basic
needs for all.
3. Responsibility of the individual: to self, family, community.
4. Responsibility of collective: to protect the many from the unsafe
actions of the few.
D. Major Goals:
1. Prevention: to prevent disease, disability and premature death.
2. Promotion: to promote health, wellness and quality of life.
3. Protection: to protect all from hazards and risks that lead to
disease, disability, loss of independence and premature death.
E. Major Intervention Strategies:
1. Education: teaching, guidance and counseling for individuals,
families, groups, organizations and committees.
2. Engineering: changing, building, adapting, planning structures
and products.
a. Environmental: structuring, modifying, adapting things within
the physical environment.
1. community: floridation of water, sewer system
2. organizations: chmical exhaust system within a'factory
3. family: deadbolt locks on doors, smoke detectors
4. individual: immunizations, wearing seat belt.in car
b. Social: modifying behaviors of individuals, families, groups,
organizations, communities
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c. Management /Organizational:
1. Community: establishing overall health systems plan
2. Organization: administration and management of public
health services, development of programs,
allocation of resources, deployment of personnel
3. Family: assisting family in restructuring roles and activities
. as needed during period or illness or crisis
3. Enforcement: legislation, regulations, law, monitoring and surveillence
activities
EDINA DVISORY HEALTH COMMITTEE AND CITY COUNCIL MEETING
March 11, 1985
Excerpts from the Minnesota Coalition of Health Care
Costs report, The Price of Life: Ethics and Economics.,
December, 1984, are noted here because of their relevance to
our disucssion on Public Health:
The ability to provide technology is exceeding our ability
to pay, therefore rationing of health care resources is
inevitable.
Principles for rationing:
1. No person should be denied potentially beneficial
medical care on the basis of limited health care resources
unless waste and inefficiencies are first eliminated.
2. Society has an obligation to ensure equitable
access to a "basic level of health care" to all people.
There are three actions to reduce inefficiency which
will forestall rationing:
1. Education. Extensive programs by government,
health care.institutions, and other major actors in health
care to educate health care providers, employers, third
party payors, policy makers and the general public about the
reality of the need to deal with limited health care
resources.
2. Program Focus.
A. Details of alternative actions to reallocate
health care resources to slow drift toward rationing.
B. Ethical, social, legal, theological and
exonomic issues associated with allocations and rationing.
3. Prevention. Eliminate the current bias against
prevention and public health programs.
A. Develop new and expand existing prevention
programs offered by employers, health maintenance
organizations, other providers and payers of health care.
B. Increase proportion of health care
expenditures by state and local authorities in Minnesota
devoted to public health, especially in prenatal care and
health education.
C. Employers, health care providers and public
and private third party payers provide financial and other
incentive to consumers to participate. in prevention
programs.
MINUTES OF THE REGULAR MEETING OF THE
ADVISORY HEALTH COMMITTEE HELD WEDNESDAY,
MARCH 5, 1985, AT 7:30 P.M.
EDINA CITY HALL CONFERENCE ROOM
MEMBERS PRESENT:
Chairperson Barbara Reynolds, Holly Branch, Kris Hagen, Jim
Hansen, Sharon Aadalen, June Schmidt, Virginia McCollister,
Walter Wilder
MEMBERS ABSENT:
Effie McKerson, Stephen Sinykin, Margaret Rash
STAFF PRESENT:
David Velde, City Sanitarian
OTHERS PRESENT:
Yvonne Hargens, Bloomington Public Health
I. Approval of the Minutes: January 30, 1985
Mrs. Schmidt moved for approval of the minutes and Mrs.
Aadalen seconded the motion. Mrs. Reynolds recommended
corrections to the minutes. She noted that Mrs. Aadalon was
appointed to the Minnesota State Community Health Services
Committee by the Mayor and City Council. She also noted the
discussion regarding the commendable police referral work
done in Bloomington and Richfield. Bloomington Public
Health Services followed up on cases of domestic violence.
It was decided that Kris Hagen and Sharon Aadalon would
speak with the Edina Police Department and report back to
the Advisory Committee. All were in favor of approval with
the changes added; the minutes were approved.
II. Business:
Mrs. Reynolds expressed a need for an Executive
Committee explaining that there were occasions when it could
be necessary for only for two or three members to consult.
This could consist of the Chair, the Vice and one other
member. Discussion ensued regarding the functions and
possibilities of an executive committee. The main purpose
would be to facilitate communication and this Committee's
ability to keep abreast with what is happening in the
Community and contribute input. Mrs. Aadalon moved that an
executive committee be created consisting of three members
and Mr. Hansen seconded the motion. All were in favor; the
motion carried.
Mrs. Aadalon volunteered to act as the "Commission
Member" or third member on the Executive Committee.
Community Reports.
Senior Task Force Report. Mrs. Reynolds stated that
Joyce Omelianchuk and Clem Peterson presented their report
at the last meeting. She summarized that the needs they
found were elderly people who did not know how to obtain
service.
Mrs. Reynolds added that Edina has the largest suburban
count of elderly. The lifespan has increased and therefore,
we can expect a large growth in this population of 75 years
of age and older. She noted that she had spoken with people
from the South Hennepin Human Services Council who had
published the book *. They are presently conducting a
survey regarding the elderly similar to one they had done
three years ago. The South Hennepin Human Services Council
mentioned that hearing is a major health problem for the
elderly. Perhaps community hearing tests and screenings
could be conducted. The surveys also showed interests in
home health care. Yvonne Hargens, Bloomington Public Health
Nursing Services, addressed this issue. She stated that
financing presented problems for the home health care.
Also, the people are not taught how to care for themselves
once their financial benefits are exhausted. Home health
services were discussed. Many times nursing services are
not need, however, some form of adult day care is.
Mrs. Reynolds suggested a public health nurse be
present at the Edina locations of food distribution in order
to provide counciling for nutrition as well as direction for
other health needs.
There was discussion of the quality of care provided
through the group health programs regarding the elderly.
Youth Task Force. Holly Branch reported that the main
problem uncovered was the lack of coordinated information of
referral and access. She suggested an informative telephone
number. She reported that they reviewed various youth
concerns and offered the following suggestions:
Mental Health: A family or youth counceling center or
service available at the Edina Community Center would be
appropriate—
Chemical Dependency:
* Public transportation to Fairview Detox.
* Encourage the expansion of half -way houses.
* AA related groups conduct meetings at the
a
Edina Community Center.
* Support legislation to increase the drinking age
to 21 years.
Mental Disabilities: Presently only one mental health
facility in Edina. It should be suggested that the Council
encourage other activies or establishments in this
community.
Child Care: Latch -key program is very adequate,
however, there is a need for infant programs and day cares.
Family Violence: Dr. Hagen spoke with the Police
Department and reported that weekends are the trouble times.
Yvonne Hargens agreed that the largest amount of referrals
from the Police Departments are received on Mondays. She
spoke about the referral service. It was noted that the
Edina Police Department did not participate, however, in
this referral service. Ms. Hargens explained that the Edina
Police Department was not interested in participating
because of the possibility that the nursing services
contract could be changed at any time. They hated to start
a program which could possibly be discontinued in a short
period of time. When questioned, the Police Department
noted that few arrests were made in regards to family
violence, because the complainant did not want to press
charges. Ms. Hargens argued that it was the policeman's
responsibility.
Public Health Nursing. Mrs. Reynolds believed that a
yearly renewal contract with nursing services was not
beneficial. Large amounts of staff and committee time are
spent each year evaluating contract renewals. The renewal
period should be extended. Discussion ensued regarding this
contract and how it should be presented to the Council.
Mrs. Aadalon motioned that the Committee include in their
recommendation to the City Council that the Bloomington
Public Health Nursing contract extend for a minimum of two
years that corresponds with the Community Health Service
funding cycle. Dr. Hagen seconded the motion. Mr. Hansen
motioned that this apply to a services whoever they are
contracted with. Dr. Wilder seconded the motion. All were
in favor; the motions carried.
Sharon Aadalon presented to the Committe the following
excerpts from the Minnesota Coalition of Health Care Costs
report The Price of Life: Ethics and Economics.
December, 1984:
The ability to provide technology is exceeding our ability
to pay, therefore rationing of health care resources is
inevitable.
Principles for rationing:
1. No person should be denied potentially beneficial
medical care on the basis of limited health care resources
unless waste and inefficiencies are first eliminated.
2. Society has an obligation to ensure equitable
access to a "basic level of health care" to all people.
There are three actions to reduce inefficiency which
will forestall rationing:
1. Education. Extensive programs by government,
health care institutions, and other major actors in health
care to educate health care providers, employers, third
party payors, policy makers and the general public about the
reality of the need to deal with limited health care
resources.
2. Program Focus.
A. Details of alternative actions to reallocate
health care resources to slow drift toward rationing.
B. Ethical, social, legal, theological and
exonomic issues associated with allocations and rationing.
3. Prevention. Eliminate the current bias against
prevention and public health programs.
A. Develop new and expand existing prevention
programs offered by employers, health maintenance
organizations, other providers and payers of health care.
B. Increase proportion of health care
expenditures by state and local authorities in Minnesota
devoted to public health, especially in prenatal care and
health education.
C. Employers, health care providers and public
and private third party payers provide financial and other
incentive to consumers to participate= in prevention
programs.
1
PUBLIC HEALTH PROBLEMS /CONCERNS IDENTIFIED BY THE EDINA HEALTH ADVISORY COMMITTEE
March 11, 1985
"Public Health is the Discipline and Practice of Managing
the Health Needs of the Community"
OLDER ADULTS
DEMOGRAPHICS:
Edina has the largest suburban count of elderly people of any other suburb. The population between the ages of 75 and 84 will increase by 38 per cent
and those aged 85 and over will increase by 72 percent in the next fifteen years.
PROBLEMS AND CONCERNS
1.1. Seniors will be entering nursing
homes who could, with personal
assistance, be maintained at home.
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1.2 Because of D.R.G., many seniors
will be discharged from hospitals
before they are well and able to manage
for themselves.
1.3 Loss of hearing is a common
problem among elderly causing
problems related to safety, isolation
and inability to communicate.
PUBLIC HEALTH VALUES OR GOALS
1.1 Protect individuals from loss of
independence.
1.2 Protect against disability, protect
against premature death, promote
wellness.
1.3 To prevent disability; to protect
against loss of independence; to promote
the quality of life.
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POSSIBLE ACTION STEPS
1. 1 Provide a consultation
service to seniors and /or their
families regarding services
available in the Community.
(Chore services, meals on wheels,
nursing care)etc. d. h� kw,,-
how to aettif 1{1.ez Stydil"
PROVIDER
ORGANIZATION /INDIVIDUAL
1.1 Public health nurse or
geriatric nurse practitioner
at Bloomington Public Health
Department.
1.2 Assistance in planning for : . 1.2 Public health nurse-is
and coordinating service so that available to assist in planning
services may be provided, if and coordination.
necessary. When third party
insurance for skilled nursing care
runs out.
1.3 a.) Health education regard- 1.3 a.) Health educator at
ing this problem targeted toward Bloomington Health Department
sensitizing seniors and their 11 (Newspaper, talks, etc.)
relatives; b.) hearing screening b.) Public Health Nursing
clinics to identify cases and refer promote screening clinics for
for help. oldsters.
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rio
PROBLEMS AND CONCERNS
1.4 Lack of standards/
licensure for home care agencies:
- quality assurance .
- safe care
- ethical conduct among
providers
1.5 Mental health and chemical
dependency problems among the
elderly. Few resources available
for individual and relatives who
need help for oldsters.
1.6 There seem to be many
services for elderly - meals on
wheels, Bloomington Health
Department, VEAP, Senior Comm-
unity Center; but many elderly
services - or there are elderly
who are semi - reclusive and are
over looked by service providers.
PUBLIC HEALTH VALUES OR GOALS
1.4 It is the responsibility of the
collective to protect the many from
the unsafe actions of the few.
1.5 To prevent disease and
disability; To promote wellness
and quality of life.
1.6 To promote the quality of life.
POSSIBLE ACTION STEPS
1.4 a.) To push for state
licensure of home care agencies.
b.) To provide educational programs
for "buyers" regarding what to
expect, ask for, and cost of home
care, c.) to establish a process for
handling grievances.
1.5 a.) To encourage use of mental
health services by elderly and their
relatives b.) To encourage the invi
tation for expansion of services to
oldsters in this Community. c.) To
encourage churches, community
groups, etc. to provide meaningful
activities for seniors.
PROVIDER
ORGANIZATION /INDIVIDUAL
1.4 a.) Community Health Services
administrator writes our state legislators
to encourage licensure /some kind of
standard setting. b.) Public Health
Nursing Services provides consultation
and /or information for buyers.
c.) Community Health Services admins-
trator determines from State Health
Department, the grievance process.
If there is none, consider ways to handle
these.
1,5 a.) Profit /non - profit psychiatric
and c.d, programs; provide flyers,
radiolT . V . spots b.) Promote insurance
for counseling coverage for the elderly.
1.6 Access and information flow to 1.6 a.) South Hennepin Human Services
elderly to tell them about services. Council keep up -to -date information on
services offered in Edina and act as an
information and referral service to resident
b.) Bloomington Health Dept. could pro-
vide information and referral c.) Edina
Community Center might be used to esta-
b ish information and referral service.
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PROBLEMS OR CONCERNS
2.1 Lack of coordinated infor-
mation, referral and access to
information.
V,
2.2 Diphtheria, Pertussii
tetanus is in short supply. Danger
of pert ussis occurance .
2.3 Mental disabilities among
youth.
PUBLIC HEALTH VALUES OR GOALS POSSIBLE ACTION STEPS
YOUTH
2.1 To promote quality of life responsi- 2.1 To promote an information and
bility of individuals to provide for self referral service regarding youth for
and family. Edina,
2. 2 To prevent disease .
2.3 To prevent disease, disability.
2.2 Determine the extent of problem
and dangers.
2.3 Encourage organizations interested
in starting residential facilities, respite
care or day care activities for mentally
retarded, etc, here in Edina.
PROVIDER
ORGANIZATION /INDIVIDUAL
2.1 Community Center, Edina could
be center for information and refer-
ral; Our own "Jt5t Call for Help ".
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2.2 Community Health Services
Administrator or Public Health Nurse
Administrator pursue this question.
2.3 City Council be open to support-
ing zoning for these purposes.
2.4 Lack of infant and day care 2.4 To promote health. 2.4 Encourage service providers to provide 2.4 ---------------------------------
programs in Edina - (adequacy infant care in Edina.
of latch key programs.)
2.5 School age youth in schools 2.5 To prevent disability to promote 2.5 Provide school nursing services in the 2.5 To develop a demonstration
may not be receiving adequate health. schools,. to do case finding, to work with school where there is a full -time
assessment and referral for families, teachers and the school communi- school nurse /PHN who provides
school related injuries, for ties regarding health problems. assessment, education, counseling,
behavioral and physical problems case finding consultations, infor-
mation and referral sources.
3.1 Lack of knowledge of health
status of those below the poverty
level in Edina. There are
approximately 325 individuals
coming to Food Distribution
Centers monthly. (Approxi-
mately ten new people each
month - mostly elderly and single
parents
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3.1 To prevent disease and disability.
POVERTY
3.1 To interview individuals who apply
for food at food distribution centers to.
determine health status and suggest
referral : resources,
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3.1 To place public health nurses at
each Food Distribution location to
conduct interviews, to do health edu-
cation, counselling, case finding and
referral for health and human concerns.
PROBLEMS OR CONCERNS PUBLIC HEALTH VALUES OR GOALS POSSIBLE ACTION STEPS
4.1 Police are called in for
domestic disturbances which
do not necessarily result in an
arrest and where physical
violence is not the primary
reason for the call. It may be
an argument between spouses,
a suicide attempt, a chemical
user who is behaving in
inappropriate way - many of
these families are well known
by the police because of the
frequency of the calls.
5.1 Lack of knowledge of
services available to Edina
citizens. Inability of
residents to find and use
health and human services,
especially public health.
DOMESTIC DISTURBANCES
4.1 To promote health 4.11 To do follow -up interviews with
family members to determine source
of the problem and appropriate
follow up and' /or referral.
6.1 The Community Health Service
Plan is written for a two -year
period. This plan includes programs
and services which will be provided as
well as budget allocated. Large
amounts of Staff and Committee time
are spent each year evaluating the
public health nursing - contract renewal.
VISIBILITY OF PUBLIC HEALTH SERVICES IN EDINA
5.1 ------------ - - - - -- 5. 1, a.) Provide flyers on occasions to
all residents to describe Public Health
and other services in Edina. b.) To
have a regular column in the Suburban
Sun regarding health and human
resources in Edina. c. To redo the
Edina Suburban Dir cotr for 1986
so that it reflects Pu . Health Nursing
Services on the page giving Edina
services; to indicate in the directory
the Community Health Services
Administrator's role; also, to list
function of Edina Advisory Health
Committee at least every other year.
PROVIDER
ORGAN IZATIONANDI V-1 DUAL
4.1 To develop a referral service
between Edina police and Bloomington
Public Health nurses who are already
working very successfully with the
Bloomington and Richfield Police
Departments.
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5.1 a.) Community Health Services
Administrator jointly with Bloomington
Public Health Adminstrator. b.) City
Council to appoint a small task force
including a member of the Health
Advisory Committee to review the
listings and to make recommendations
for changes to the Sun by November,
1985,
6.1 To develop a two -year contract which
coincides with the two -year Health Services
Plan. This would provide a more reason-
able time frame for contracting arrangements
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