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272846 WNITE - CITV CLERK P 1 N'!( - F I N A N C E C�VnL•ll 8 �/-�'�' ,'� B�.�R� -�vtO.N R ME"T , GITY OF SAINT PAUL � , ��._-�� File N 0. � i Council Resolution Presented I Referred To - Committee: Date Out of Committee By; Date 2 . FURTHER R�SOLVED, that the City accepts as its Advisory Committee the �1-member Ramsey County Advisory Committee , con- sisting of pro�aortional representation between the City of Saint Paul and� other communities within the County, as its Community Health Services Advisory Committee; and, be it FURTHER RESOLVED, that the Mayor is strongly urged to appoint as many members of the old advisory committee to the new joint city-county advisory committee as may be possible and lawful ; an�l, be it FURTHER RESOLVED, that the Council of the City of Saint Paul shall continue to assume the responsibilities of the Board of Health for the City of Saint Paul pursuant to Minnesota Statutes , Sectaon 145 . 913 . COUNCILMEN Requested by Department of: Yeas Nays � Butler [n Favor �� Hunt ! l Levine v __ Against BY Maddox Showalte Te o APR 2 6 �gTg Form Approved by City Attorney Adopt y Council: Date tified Pas- by Counc.� et�ry BY i tlpp by 17avor: Dat � � �.� �� Appr ve by Mayor for Su io to�Council By BY �PI18liSt�NEO MAY 5 1979 N�HITE - CITV CLERK �I � �j����� PINK - FINANCE G I TY OF SA I NT PAIT L Council r CANF42V -�7F,.�ARTMENT . BL�JE - MAV�OR File NO. � Council Resolution Presented By Referred To ' Committee: Date Out of Committee By' Date WHEREAS, the Council of the City of Saint Paul, pursuant to Minnesota Statutes, Section 145.913, assumed the responsibilities of the Board of�� Health under Minnesota Statutes, Sections 145.911 to 145.922; and WHEREAS, i�. compliance with Minnesota Statutes, Section 145.913, Subd. 3, the City Council has established a Community Health Services Advisory Committee; and WHEREAS, tl�e City of Saint Paul' s Community Health Services plan is transmitted to the State Commissioner of Health as part of the plan for th� County of Ramsey; and �, WHEREAS, it is the adopted policy of the City of Saint Paul that the County� assume at some point in the future responsibility for all community health services within the County of Ra.msey; and WHEREAS, i� is the desire of the City Council and the Ramsey County Board to abolish their Advisory Committees and substitute in place thereo� a single County-wide Community Health Services Advisory Commit�ee to advise both the Saint Paul City Council and � the Ramsey Co�.n.ity Board; and WHEREAS, t�{�.e Assistant Commissioner� Office of Community Health Services, Minne�ota Department of Health, has advised the City that a single Countyrtwide Advisory Committee would be acceptable compli- ance for the Citty of Saint Paul with the requirements of Minnesota Statutes, Section 145.913, Subd. 3; now, therefore, be it RESOLVED, by the Council of the City of Saint Paul, that the Community Healtl� Services Advisory Committee of the City of Saint Paul is hereby �.bolished; and� ,be it COUNCILMEN Requested by Department of: • Yeas Nays Butler In Favor Hozza Hunt Levine ; _ __ Against BY Maddox Showalter Tedesco Form Appr by City t rne Adopted by Council: Date Certified Passed by Council Secretary BY By ` �.lpproved by 1�lavor: Date — Appr d by Mayor for Submi io to Council By _ By . . ;:�� , ; .: , . , � � . �, � , . _. . . 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' 'r4solut ett��`ing � 't.� reeolm�end�L�od af 'fi�iNe �3t�► Pau�. . _ ` � �i Aieir�;��.h 3er�►,it�a /�darisa�y'Co�me�.4�t�e rege�rditt� t��,. :� � � ' • ea'liitb3! � o� s��a#.n� Ci.�y-G+c��us�y I�1t1� `+a+�itt.i�. ;'� :�, � Go�ii x�w�at�ed t�t �t �t�ola�tvri ;bf for�rrded' #,c� - . t� �Legi� �t#no t�p�tt#� a!'t.er pre�ei�►t�:o�. , � ; - ' ' _ , . . . ,' Yer�r tarr�],1r�yout��i t , , ,. . , - " � . , ' Rc►so M�t , : , , , L 1 ' . , �� �� � . , ; l . . � AB4sLt , ' ,� ' ,. ' ` _ , - . , ,_ , , . , . �,, . , . j . . , . . . � . . . . . : . . , . , . . . .. . . . . . . ,�.. . � • � . �. . . . . . . . . . . :( . . . . � � ' . ' .. , . . ' . . . . . . . . , . � : . . .. V , - � � .� ' � - .. , � � . • . � . . .. •. . �� ' � ' . ' � . . . 1�, • � .. . , . . . .. , , � / . ' � � . � � ... ' . � � � . . : . i. ' . '� . ' ' - . . � , . . . , . - _. . . . �.. . . . . . . . . . , . . . � .. - . . , i � . � /( ' . . . � ' , • . . . ' . . , . :� ' ' ' / - . .. . '� • . ' ' . .. . . . � �- . . ' .. . C. � � . . �` �. .' .. -\. � � . ' . ,1 I . • ' ' ' ' � .. . .. ' • \\ . � �� � . . . . . . . � . ' . , . .. \ . � . � - . ' ' . , . l ' . . ' .. • . . ` . . . • .. . ' ... ' . . , ' . . � ' . j , � . . .Y . • . . ... � , � DEPARTMENT OF COMMUNITY SERVICES DIVISION OF PUBLIC HEALTH CIYY OF SAINT PAUL INTER-0FF�CE COMMUNICATION March 22 , 1979 T0: A1 Olson, Recorder of Council Proceedings FROM: Betty Tedesco � SUBJECT: Agenda Item Please place the St. Paul Community Health Services Advisory Committee on the City Council agenda for Tuesday, March 27 , 1979 . BT :cb Com�aunity Health Services Advisory Committee Public Health Center � 555 Cedar Street 7 : 30 p.m. March 22 , 1979 _ MINUTES . Members pres�nt : Arlene Atehison Richard Gunderson Marjana Callery Bruce �arkkula R•iargaret Dor�n Fred Mayer Peggy Foster Francis Tompkins Maria Girsch Members absent: Mary Pat Arri,ngton Jean Donaldson (excused) John Catlin Lawrence Suess Paul Dickinsan Vernon taeckworth (excused) Staff present,• Edward R. EbeThardt Betty Tedesco Joan Foreman ( � Others--'presen�t: - � Ray Cink, director, Ramsey County Community Health Services The special meeting was called to order at 7 : 30 p.m. by Chairperson Marjana Ca11e�y. The city attoxney had been asked for an opinion on several questions concerning Community Health Services and how the statutes would apply to the City of Saint Pau1 if the city and county advisory boards were merged. Copi�s of the opinion were distributed and members present were given time to assimilate the information therein. After discuss�on about the joint recommendations of the city/county staffs , repre�entation on a merged committee, population of the city and county, et�c. , the committee tovk the following actions . ADOPTED: Motion to recommend to the City Council (acting as the oar o ea t at t e aint au visory ommittee issolve t emse ves to aci itate t e eve opment o a sing e a visory com- mittee w ic wou e an appointe -mem er commltfiee o w ic _ mem ers wi e o icia re resentatives , provi er representatives , an consume � representatives as recommen e y t e city county ealt sta s ,jand presented to t�ie�aint Pau3, and amsey ounty CHS ' advisory comm�;ttees. � � ADOPTED: Motion that the makeup of the new advisory committee ( also be pxoportionate to t�e population of the city and county. ADOPTED: Motion to adjourn at 8 :40 p.m. Respectfully submitted, � Kay Bricher Recorder � , , r r. t ..ol':.v.v,r-:.;. � _�6���TY �� ._ CITY OF SAINT PAUL =�� s . . '^ ' ` OFFICE OF THE CITY ATTORNEY �O � 2'. �_.i IIIIIT"iNll. 9�` . ::, ''-"-'1'`1" == SUZANNE E. FLINSCH, CITY ATTORNEY ,. � �'':�;� �s�. ..-' 647 City Hall,Saint Paul,Minnesota 55102 ,�:t•:;,..,�;:���� 612-298-5121 GEORGE LATIMER MAYOR Mr. Edward Eberhardt Assistant Director Saint Paul Health Department 555 Cedar Str�et Saint Paul, Minnesota 55101 Re: Opinion F�equest of March l, 1979 � Dear Mr. Eberhardt: Your opinion �equest concerning Community Health Services has been approved by the office of the Mayor and was assigned to the under- signed on Mar�h 12, 1979, for response. You ask a variety of questions con�erning the merger of the City' s CHS Advisory Commit- tee and the County' s CH5 Advisory Committee, the subsidy to the City under th� CHS Act, and the po,ssible incorporation by the County 'of Cit� Health Department responsibilities. - With reference to the CHS Advisory Committees, the facts are briefly: 1. The Legis�.ature in 1976 enacted the Community Health Services Act, 1976, Laws of Minnesota, Chapter 9, which provides, inter al.ia; ' (a) for a County Baard of Health and a City Board of Health; (b) subsidy payments based on established criteria; and (c) in counties such as Ramsey, the City of Saint Paul may �reate its own Health Board or it may elect to consent to a County-wide Health Board. 2. In June o�' 1976 the Council by resolution (C. F. 267420) assumed t�e responsibility as the local Board of Health and noted that it is a palicy af the City to continue to wark with the �County for the transfer of responsibility for . i ,�g,�, p,,,�. '`�v Edward Eberhardt Page Two health from the City to the County. (No such transfer has yet been made. ) 3. The City subsequently appointed a CHS Advisory Committee. The provision for Advisory Committees is found in 5ubd. 3 of Minnesota Statutes s� 145. 913. The size of the Advisory Committee cannot be less than nine persons nor more than 21 persons. The issue of inerger of� the City of Saint Paul ' s CHS Advisory Committee with the County' s CHS Advisory Committee has been discussed with Robert Hiller, Assistant Commissioner of Health, and he indicates that a merger of the City and County CHS Advisory Committees would be acceptable compliance with Minnesota Statutes � 145.913, Subd. 3, from the State Department of Health.' s view. The merger of the two Advisary Commi�tees does not alter the City Council ' s responsibilities as the Board of Health for the City of Saint Paul and the merger of the two Advisory Committees does not alter the relationship between the Council as the Board of Health for the City of Saint Paul and the Ramsey County Board c�f Commis- sioners as the Board of Health for other parts of Ramsey County. The powers of the County with respect to Community Health Services will not change until such time as the Council of the Ci.ty of Saint Paul takes action to allow the County to preempt the powers and duties of the City. The City of Saint Paul is eligible for a CHS subsidy under Minnesota Statutes s� 145.917, Subd. 2. The actual subsidy is made to the County based on a formula outlined in Minnesota Statutes � 145.921, Subd. 2. The City' s proportionate share of the subsidy "shall be determined by calculating the proportion of local expenditures for Community Health Services within the County that were expended by the City. " Minn. Stat. � 145.917, Subd. 2. It is our understand- ing that the County has allocated a larger percentage of the sub- sidy to the City than the mandated minimum share to the City following the Minnesota Statutes � 145. 917, Subd. 2, distribution. •� Edward Eberhardt Page Three As long as the City retains its status as a local Board of Health and meets the other requirements of Minnesota Statutes � 145.917, Subd. 2, it is eligible for a proportionate share of the County' s CHS subsidy. Therefore, the merger of the City and County Advisory Committees, with the concurrence of the State Department ot Health, will not � affect the powers of the City Council as the Board of Health, and it will not lessen or increase the City' s proportionate share of the County' s CHS subsidy. Those parts of your request concerning the statutory authorization for an assumption of City Health responsibilities by the County is quite complex. You ask what presents the most advantageous organ- ization for a County-wide Health Department fro;n the City' s view. Without further input from those charged to set policy, we do not know what the City' s view on this issue may be. Respectfully submitted, / ! � TERRENCE J. GARVEY Assistant City Attor:�ey • � TJG:er F , CITY-COUNTY HEALTH STAFF JOINT RECOMMENDATIONS FOR PROGRAM INTEGRATION The St. Paul Community Health Service Advisory Committee at its January 11, 1979 meeting requested City and County Health Staff to jointly prepare a plan for the inte- gration of the two health agencies. The two staffs have met and submit the following plan for consideration. I. Develop a single Community Health Service Advisory Committee 1. abolish the County Community Health Advisory Committee 2. abolish the City Community Health Service Advisory Committee 3. appoint a 21 member Community Health Service Advisory Committee a. 11 offici�l represen�atives to include at least one City Councilman, one Countp Commissioner, and one St. Pau1 School Board member � b. 5 provider representatives c. 5 consume� representatives 4. Establish sub-committees on: Community Nursing; Environmental Health; Health Education; and, Emergency Medical Services. 5. Establisn by-laws based upon the County recommended model, existing City Community Hea�.th Service Advisory Comr�ittee by-laws and requirements for Title � XVI�I ;e;ertifi��ation. . Note: Mr. Eberhardt has submitted a modified suggestion for the establishr.!ent of a 15 member Advisory Committee (see enclasure). • II. Determine the statutory basis for integration of certairi City pro�ams with the County. This issue arises because three Statutes currently address the situation of a County assum3,ng certain health responsibilities. Two Statutes MSA 145.4?-145.54 (1949) and Laws 1971 Chapter 579 provide enabling authority for creation of a County Health Department. There are, however, differences between these laws and thus it becom�s important under which Law we proceed. The issue becomes' even more complex given the presence of the CHS Act, (MSA i45.911- 145.922 (1976)�, itself and the enabling provisions it con�ains. Staff suggests that we obtain clarification of the statutory basis and limitations of integrating Ci�ty and County health functions. Such clarification could be obtained from the County Attorney's office by routing our request. through the Executive Director's Office. III. Staff have identi�ied each City and County Program indicating local tax, CHS subsidy, other State or Federal funds, and revenues earned. We then discussed each City Program and identified thpse programs which would be appropria�e for integration, which sho;�d remain with the C'�ity, and which should more appropriately be attached to some other County Department',. � This has been prepared for your discussion and suggestions. It will also be discus5ed at the County CHS Advisory Commifitee on February 7, 1979, and a copy has been forwarded to Mr. Larry Brow�, Ramsey County Executive Director, for review. 1-31-79