96-583S v.bst; }�..�e.. - � �3 � 9 ¢
�
Aw�c.�� or•� - 'T /3 � `i G
RESOLUTIOIV
CITY
Presented by „( �io,,
Referred To
Date
substantially in the form
RESOLVED, that the proper City offi ials aze hereby authorized and directed to execute a joint powers agreement
with the County of Rasnsey provid' for the consolidation and transfer of various public health programs and
functions as more particulazly set fo ' said agreement which is incorporated herein by reference, a copy of which
is to be kept on file and of record in the Department of Finance and Management Services.
5 Subject to the following modifications to the Joint Powers Agreement:
�
: :
Until a mereer is accomplished and while the Joint Powers Aereement (JPAI is in effect. the Saint Paul City
Council will have the final authorit�n what health services aze provided through the JPA within the Cit�
Until a mer�er is accomplished and while the Joint Powers Agreement is in effect the Saint Paul Citv
Council will set priorities for health services provided throu�h the JPA within the Cit�
10 C. The lan�ua�e regarding conve�p the Public Health building to the State of Minnesota is removed (naee
11 7, para aphs beginnin� "The State of Minnesota..." through pa¢e 7 paragraph ending with "...to the CitX
12 property taacpavers throu�h a propertv taac lew reduction." and replaced with the followin� lan�uaee: "The
13 convekance of the Public Hea]
14 the Saint Paul Citv Council."
MINNESOTA
'.S�
Council File # �� S $3
Green Sheet # � 03
or non public health-use
f�1
15 D. Personnel issues will be resolved prior to the Joint Powers A�reement takin e� ffect•
16 E. The Council Secretarv is directed to transmit a copv of this Resolution and the Joint Powers A�reement
17 fJPAI to the Ramsev Countv Board of Commissioners and the Ramsev Coun Manager and res e�ctfally
18 requests that the Board of Commissioners approve the JPA in time for the JPA to be implemented January
19 L 1997.
F�
9�- S83
1 F
5 G. The Mavor's administrazion has agreed to facilitate a closed session meeting with the City Councii to discuss
6 labor issues and the union's concerns as it �ertains to the Health Department Joint Powers Agreement The
7 time and place will be detennined bv the CiTy Council �n
8 H.
9
l0
11
12
13
14 I. . . . "
,...
15 anake�a��+e �� ••�•�'«.,.._..L1:..L..../aL ....._.:,.�L_�,.�._�_,....,�_i._..__.,1_�
1 !_ ,.a LCC l�.�A__ +L,� L._.1 �..�,, W_�...._ _r L,.,,l� a_ A�!U ,.f b_. - T„__t a s
V
17 J. IIL Governance A. City's Agent. In the third sentence, substitute "' ��, ° A' �"` for
18 "community health board." The new sentence now reads "The CITY transfers its public health activities
19 but retains its b�eai�k � ,,�� as the City Council ��R� ��� ��_,.
20 ` �` :. _ `?�
Requested by Department of:
�
Form Approved by City Attomey
By:
Adopted by Council: Date
Adoption Certified by Council Secre Approved by Mayor for Submission to Council
By: �� a.++—� , ��t�J�A�—wA_...—.—BY:
� �
Approved by Mayor: Date �`If � �( p
BY� _ �-k e���S
t.��v: (:o�ii�=ac�i�(:aun "Boar� prior to the expiration of the Joint Powers Agzeement
'R��1�111�I����t L�I�I���l�l�t ���1���1L���
q `- 58'3
oE C A ity N Council NC'L D S/23/96 GREEN SHEE N_ 35703
CANTACT PEfl50N 8 PHONE INRIAL/DATE INITiqIJDpTE
O �EPARTMENi OIPECTO(i � CRY CqUNCIL
Councilmember Dino Guerin ^��N � cmarroANer � cmc�aK
MUST BE ON CqUNCIL AGENDA BY (DATE� ���� Q BUDGEf OIRECfOR O FIN. & MGT. SFAVICES Dlq.
June 5, 1996 — Discussion ° Q�Y���RA$$ISTAMn 0
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATUR�
ACTION REWESTED:
Authorizing and directing the proper City officials to execute a joint powers agreement
with the County of Ramsey providing for consolidation and transfer of various public health
programs and functions.
RECOMMENDA710NS: Apprave (A) a Rejeet (H) PERSONAL SERViCE CONTRACTS MUST ANSWER TNE FOLLOWING QUESTIONS:
_ PLANNING CAMMISSION _ CIVIL SERVICE CAMMISSION �� Has this personttirm ever worked under a contred for this department? -
__GBCOMMITiEE YES NO
— 2. Has this person/tirm ever been a city employee?
_ SiAFF — YES NO
_ DISTRIC7COUR7 _ 3. Does this personRirtn possess a skill not normall
y possessetl by any curteM city employee?
SUPPORTS WHICH COUNCIL O6IECTIVE4 VES NO
Ezplain all yes answers on separate sheet and ettaeh to green aheet
INITIATING PflOBLEM, ISSUE, OPPORTUNIN (WFw. What, When, Where. Why):
ADVANTAGESIFAPPROVED:
DI3ADVANTAGES IFAPPROVED:
DISADVANTAGES IF NOT APPqOVED:
TOTAL AMOUNT OF TRANSACTION S COST/REVENUE BUDGETED (CIHCLE ONE) YES NO
FUNDIibG SOURCE ACTIVITY tiUMBER
FINANCIAL INFORMATION: (EXPIAIN)
..
6/10/96
• JOINT POAERS BGRF��►�'�'
BET47EEN
THE CITY OF SBINT PBDL
�iD
2'HS COIINTY OF R�ISEY
FOR
PIIBI,IC �LTH SERVICES
qc. —5�3
THSS JOINT POAERS ��REEMENT (Agreement) is made and entered
into by and between the City of Saint Paul, a duly chartered city
of the first class, and the County of Ramsey, a duly chartered
political subdivision, both of the State of Minnesota.
ARF.RF.AS� in October 1995, the Ramsey County Board and Saint
Paul City Council adopted the Saint Paul-Ramsey County Community
Health Services Plan for 1996 to 1999; and
AHERSAS, the Saint Paul-Ramsey County Community Health
Services Plan for 1996 to 1999 is a joint effort between the
Community Aealth Boards of the City of Saint Paul and the County
of Ramsey; and
WF�REAS, City and County staff have prepared a report which
recommends that the services of the City Public Health Department
and the Ramsey County Public Health Department be combined
through use of a purchase of services agreement; and
AHEREBS, the purpose of this Agreement is to streamline the
implementation of the joint community health services plan, to
provide high quality, efficient and cost-effective public health
services to the citizens of the City and the County;
WHERFBS, the staff report identifies several implementation
issues which will be addressed during the term of this Agreement;
, the parties agree as follows:
I. DEFINITIONS
Unless otherwise provided in this Agreement, all services
listed below sha11 have the meanings ascribed to them in the 1996
City of Saint Pau1 and County of Ramsey budgets; the Saint Paul-
Ramsey County Community Health Services Plan for 1996 to 1999,
any future amenc4ments thereto and successor documents; and the
Ramsey County Solid Waste Master Plan in effect as of the date of
this Agreement.
II. PIIBLIC HEAI,TH SERVICBS
The public health services described in the S�int Paul-Ramsey
County Communit,y Health Services Plan for 1996 to 1499, any
future amendments thereto, and successor documents (PLAN); the
1996 City of Saint Paul and County of Ramsey budgets; and the
Ramsey County Solid Waste Master Plan shall be jointly provided
by the City of Saint Paul {CITY) and the County of Ramsey
(COUNTY) as described herein.
A. City Duties
1. The CITY shall retain responsibility for the following
services within the CITY limits:
a. Housing Enforcement Services
i.
ii.
iii.
iv.
v .
vi.
vii.
Housing - Complaints
Vacant Buildings
Summary Abatement
Lead Paint Hazard Control
Lead Hazard Reductian
Truth in Sale of Housing
Nuisance Abatement
b. Animal Control
c. Food Inspection Services
d. Solid Waste Activities: Solid waste activities
performed by the City as of the date of execution of
this Agreement will continue to be performed by the
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(Bold, underlined italics reflect 6 10 36 modifications.)
qG-s�3
City. The City recycling program is addressed in an
existing joint powers agreement between the CITY and
COUNTY, dated September 28, 1943, which sha11
continue according to its terms.
2. Effective January 1, 1997, the CITY shall begin providing
the following services on behalf of the COUNTY within the
areas of the COIJNTY outside the CITY limits:
a. Dangerous Dog Registration
b. Lead Paint Hazard Control
c. Lead Hazard Reduction
The CODNTY shall pa� the CITY for these services on a
reimbursement basis.
3. Effective January 1, 1997, all remaining Saint Paul
public health board activities that are not transferred
to the COUNTY pursuant to this Agreement will be
transferred to other CITY departments and the City will
no longer use the name "Saint Paul Public Health."
B. County Duties
1. The COUNTY shall continue to maintain responsibility for
the following services:
a. Community Clinics/Living-at-Home-Block Nurse Program
b. Public Health Administration
c. Disease Prevention and Control
d. Family Health
e. Preadmission screenings�waivers
f. Adult Health management
g. Child and Teen Checkups
h. Solid Waste Activities, including
i. Solid Waste Regulation
ii. Aousehold Hazardous Waste
iii. Yard Waste Management
iv. Residential Recycling
v. Recycling Processing
vi. Business Waste Assistance Program
vii. Solid Waste Public Education
viii. Solid Waste Administration
ix. Resource Recovery
i. Correctional Health
j. Community HealthfViolence Prevention/Employee Health
Promotion
-3-
(Bold, underlined italics reflect 6 10 96 modifications.}
k. Adolescent xealth
1. Hazardous Waste Program
m. Community Sanitation Program
n. Nutrition
o. Nursing Administration
p. Personal Care Attendant Assessments
2. Effective January 1, 1997, the COUNTY shall begin
providing the following services on behalf of the CITY
within the CITY limits:
a. Epidemiology/Disease Investigation and Control
b. Tuberculosis
c. Administration, including Nursing Administration
d. Families in Crisis
e. Community Clinics/Living-at-Home-Block Nurse Program
f. Family Planning
g. Immunizations, including Travel and Hepatitis B
h. Nutrition
i. Dental
j . Women' s Fiealth
k. Colposcopy
1. Sexually Transmitted Diseases
m. HIV�AIDS
n. Preventive Medicine/Refugee Screening
o. wIC
p. Childhood Lead Prevention
q. We12 Child/Children's Initiative
r. Health Education
s. Chronic Disease
t. Child Health Initiative (Maternal Child Health Grant)
u. Native American Health
v. Immunization Registry
w. Family Ties
x. Immunization Action Plan
y. Health Records
z. Data Services
aa. Laboratory
bb. Birth and Death Records
cc. Building Iiai.ntenance
3. The Ramsey County Department of Public Health will be
renamed the "Saint Paul - Ramsey County Department of
Public Health" effective on January 1, 1997.
C. Level of Services
Services described in the PLAN which have been performed by
either the CITY or the COUNTY up to the effective date of this
-4-
(Bold, underlined itaZics refZect 6 10 96 modifications.)
9�-sr3
Agreement shall not be eliminated or reduced as a direct result
of this Agreement, except:
1. after compliance with the statutory process £or amendment
of the PLAN, or
2. through budgeting processes. Both the County and City
budgets are subject to the budget review and comment
procedures described in Paragraph VI.E., below.
The parties acknowledge that provision of services at current
levels will depend upon the continued availability of state and
federal funding, and continuing authority under applicable state
and/or federal law. If funding or authority changes during the
term of this Agreement, the parties agree to incorporate such
changes as are necessary into the PLAN or their resgective
budgets, as applicable.
III. GOVERNANCE
A. City's agent
The COUNTY is hereby designated the agent for the CITY with
respect to the delivery of services set forth in Paragraph
II.B.2., above. The Ramsey County Board of Commissioners shall
have all governing and decision-making authority with respect to
the delivery of services set forth in Paragraph II.B.1 and 2.,
above. The CITY transfers its gublic health activities from its
communit� health board to the City Council. The Cl2'Y egpressly
reserves its authority to review and aporove amendments to the
gLAN and future community health plans and any amendments
thereto.
B. County's agent
The CITY is hereby designated the agent for the COUNTY with
respect to the delivery of services set forth in Paragraph
II.A.2, above. The Saint Paul City Council shall have all
-5-
(Bo1d, underlined italics reflect 6 10 96 modifications.)
governing and decision-making authority with respect to the
delivery of services set forth in Paragraph II.A.1 and 2., above.
C. Community Health Services Advisorv Committee
The Joint City-County Community Health Services Advisory
Committee shall continue in effect in accordance with the process
in effect at the time of this Agreement unless otherwise agreed
to, in writing, by the parties.
IV. FINBNCE�BIIDGET ISSDES
A. Grants
On or before January 1, 1997, the CITY will assign to the
COUNTY its interests and obligations under each individual grant
relating to duties transferred to the COUNTY under this
Agreement. The CITY is responsible for obtaining all necessary
approvals from the respective grantors. All funds from such
grants wiil be transferred to the COUNTY. In the event that a
grant(s) cannot be assigned to the COUNTY, the CITY will contract
with the COUNTY to provide the services on the CITY's behalf and
pay the COUNTY for the services within thirty-five (35) days of
invoice.
B. Transfer of assets
As and for partial consideration of the duties and
responsibilities undertaken by the COUNTY, the CITY shall quit
claim the real and personal property located at its public health
building at 555 Cedar Street to the COUNTY. The CITY will
provide an inventory of the personal property to be transferred
within sixty (60) days of execution of this Agreement. The CITY
will obtain� at its cost and ezpense a Phase I, Phase II and
Phase III if necessarv Eavironmental Revort of the buildinv and
the site, , including, but
-6-
(Bold, underlined italics reflect 6 10 96 modifications.)
GI ` -S �'._.3
not limited to, identification and location of
asbestos,
underground storage tanks and other hazardous materials
management. Notwithstanding anp other termiaation provision
hereia to the coatrarp. the CITY shall have the right to
tezmiaate this Agreement n�on thirtp (30) daps rvritten aotice if
the Phase III Re�ort indicates the CITY•s cleanup costs rvou3d
eaceed S100.000.
The COUNTY intends to continue to use the building for public
health sezvices. In the event the services are relocated, the
COUNTY shall fully consider customer needs and accessibility
before selecting an alternative site. Reuse of the current site
shall be consistent with the CITY's dmvntorvn @evelopment goals
and�riorities �Ian adopted bp CITF resolation. r�hich sha22
include any aZternative governmental use bp the COUNTY.
The State of Minnesota has recently expressed interest in
considering the site at 555 Cedar for state government use. The
CITY and COUNTY agree that it is in their mutua2 best interest to
eacourage this economic development opportunit�. In this event,
the COUNTY agrees to enter into good faith negotiation of the
sale of the nroperty n*ith the State. If the COIINTY conveps the
site to the State on or before December 31, 200I. the CITY wi2Z
pav oae haZf of the costs for relocating the public heaZth
services within the CITY, not to eaceed S3.000.000. Re2ocation
costs sha11 include site acquisition costs, construction costs.
incZudiag furniture, fistures and equipmeat (FPE). professionaZ
desiQn services te2ephone�ata eapenses and customarp moving
eapenses.
The CITY shaZl nav for its share of re2ocation costs bv
raising no more than 5600.000 per year. through its prop�rty tag
-7-
(Bold, underlined italics reflect 6 IO 96 modifications.)
Ie duria each of the five ears after ezecntion of this
Agreement The fuads raised for this nurnose sha1Z be alaced
into continaencv until aeeded if the site is not conveved�
the COUNTY oa or before December 31 2001 the continaencv funds
sha1l be returned to the CITY propertv ta%navers throuah a
propert� tag 2e� reduction.
In the event of termination or nonrenewal of this �greement
as provided in Paragraphs VI.A. or C, the COUNTY will quit claim
the real and personal property to the CITY. If the COUNTY makes
any capital improvements to the building or site and the building
and site are subsequently returned to the CITY, the CITY will
reimburse the COIINTY for the cost of the improvements, less the
accumulated depreciation. In the event that a reimbursement
amount cannot be aareed to bp the varties an indenendent
�,praiser seZected and agreed upon bv both narties shall be hired
to determine the value of the improvements and the anUraiser's
value of the imarovements shaZZ be bindino uvon both narties.
The appraiser's fee shalZ be even2p divided bet�een the narties.
C. Assianment of contracts
On or before January l, 1997, the CITY will, if requested by
the COUNTY, assign to the COUNTY its interests in and obligations
under each individual contract relating to duties transferred to
the COUNTY under this Agreement. The CITY is responsible for
obtaining all necessary approvals from the respective
contractors. All funds encumbered by or receivables owed to the
CITY for expenses associated with the contracts will be
transferred to the COUNTY. In the event that a contract(s)
- cannot be assigned to the COUNTY the CITY will continue to comply
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(BoZd, underlined italics reflect 6 10 96 modifications.)
�IC -S�3
with the terms of the contract(s) until its expiration or
termination.
D. Propertv tax financina
The parties acknowledge their concurrent jurisdiction for
levy of the costs for services provided under this Agreement.
Beginning with the 1447 ta�t levy, if allowed by statute, the
parties agree that the COIINTY will increase its levy to collect
funds necessary to pay the expenses assumed for services to be
provided pursuant to Paragraph II.B.2., above. Subject to the
provisions of Paravraph ID.B._ above. t�Phe CITY will reduce its
1997 levy by the same amount to reflect its reduction in costs
for services transferxed to the COUNTY under this Agreement.
E. Pavment to City
The COUNTY will pay the CITY for the services of CZTY's
employees providinq services to the COUNTY pursuant to this
Agreement. The amount to be paid will be the CITY's actual cost.
The COUNTY will pay fifty percent (50$) of the CITY's budgeted
total on or before May 31st of each year and forty percent (40�)
of the CITY's budgeted total on or before October 31st of each
year. The COUNTY will pay the balance after the CITY certifies
its actual cost each year and invoices the COUNTY for the
balance due. The COUNTY will pay the final balance within
thirty-five days of receipt of the CITY's invoice.
V. MBNAGEMENT
The Saint Paul - Ramsey County Department of Public Health
will be managed by a single director who shall be appointed by
the COUNTY. The director will establish a management team to
facilitate transition of services between the CITY and the
COUNTY.
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(BoZd, underlined italics reflect 6 10 96 modifications.)
vz . psxsoxi��
This Agreement is a purchase of services agreement. The
COUNTY agrees to accept certain duties and responsibilities from
the CITY and is purchasing the services of CITY employees from
the CITY until such time as the COUNTY, is able to staff services
with COUNTY employees. Such staffing shall be accomplished by
transferring CITY positions which become vacant through attrition
to the COUNTY. eny new positions which may be created due to
service needs shall be COUNTY positions.
Within ninety (90) days of the eaecution of this Agreement,
the CITY shall meet with the CITY employees' representatives and
the COUNTY shall meet with the COUNTY employees' representatives
to begin identification and discussion of the effects of this
agreement upon employees.
VII. GSNERAL CONDITIONS
A. Term
The initial term of this Agreement shall be from the date of
execution through December 31, 1999. Subject to earZv
termination as �nrovided herein� tsPhis Agreement will
automatically renew for additional term(s) to coincide with the
timeframes of future Saint Paul-Ramsey County community health
services plans unless written notice of intent not to renew is
submitted by either party to the other at least one hundred
eighty (180) days prior to the end of the term then in effect.
B. Insurance
It is acknowledged that both parties rely pri.marily on self-
insurance programs for liability coverages, including statutory
workers' compensation coverage. Each party agrees to maintain
its self insurance program or to obtain insurance policies for
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(Bo1d, underZined italics reflect 6 10 96 modifications.)
�IL-583
tort, automobile, professional liability and workers'
compensation coverage. Such tort, automobile or professional
1iat�ility insurance golicies, if any, shall have minimum limits
of those liability limits established by Minnesota Statutes
Chapter 466 (1994) and as amended, which are currently $200,000
per person and $600,000 per occurrence or, in the case of
workers' compensation coverage, shall have minimum .limits as
established by state statute.
The parties agree to work cooperatively with respect to
workers' compensation return-to-work programs for employees.
C. Termination
Either party may terminate this Agreement with or without
cause upon written notice to the other. The parties specifically
agsee that the notice must be received no late= than May 31 to be
effective at midnight December 31st of the same yeaz. Any notice
received after May 31st will be effective no earlier than
midnight December 31st of the following year.
D. Disbursement of funds and distribution of prope�ty
In the event of termination of this Agreement, funds
encumbered for a particular purpose shall be used for that
purpose. Any unencumbered funds and any property acquired as a
result of this Agreement will be returned to the parties in
proportion to their contribution. In addition to the
reconveyance of the property located at 555 Cedar Street, as
described in Paragraph IV.B, if this Agreement is terminated or
not renewed, the CITY shall accept return of the obligation to
levy for the costs of services, as described in Paragraph IV.D.,
and the personnel positions transferred to the COUNTY via
attrition, as described in Paragraph VI., above.
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(Bo2d, underlined italics reflect 6 10 96 modifications.)
E. Budget review and comment
Each party will notify the other in writing when its proposed
public health budget is ready for review which shall be no later
than June 15 of the year preceding the term of the budget year.
Each party may review the other party's public health budget and
may submit comments within thirty (30) days of the notice. �
F. Nonassianability
Neither party shall assign any interest in this Agreement and
shall not transfer any interest in the same, whether by
subcontract, assignment or novation, without the prior written
consent of the other party.
G. Independent contractor
It is agreed that nothing contained in this Agreement is
intended or should be construed as constituting either party as
the employee of the other party for any purpose or in any manner
whatsoever. Each party is an independent contractor and neither
it, its employees, agents nor representatives are employees of
the other party. Payment of federal income tax, FICA payments
and state income tax are the responsibility of each party for
their own employees, agents or representatives, as required by
law.
H. Data practices
All data collected, created, received, maintained or
disseminatec3 £or any pnrpose in the course of the parties'
performance of this Agreement is governed by the Minnesota
Government Data Practices Act, Minnesota Statutes Chapter 13, and
any other applicable state and/or federal statutes, rules or
regul.ations on data privacy.
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(Bo1d, underlined italics reflect 6 10 96 modifications.)
CTTY OF SAINT PAUL
Norm Coleman. Mayor
7une 14, 1996
Council President Dave Thune
And City Councilmembers
310 City Hall
15 West Kellogg Boulevard
St. Paul, MN 55102
Dear Council President and Councilmembers:
OFFICE OF HUMAN RESOURCES p
lohn Hamilton, Director q�"� 0�
400 Ciry Ha11 Arzn¢s Telephone: 612-266-6500
25 West Fourth Sneet TDD/7TY: 6I2-266-6501
Saint Paul, MN 55102-I631 Jabline: 612-266-6502
Facsimile: 612-292-7656
The City and County Health department Merger Final Report, dated June 5, 1996, noted (page
10) that the State is seeking a new location for its Depaztment of Revenue and that downtown
sites, including the City's Public Health building, would be considered. This development could
bring an important infusion of jobs into the downtown.
PED staff has begun meeting with the State to pursue the development and with the Merger
Group to craft language that woutd address this contingency. As promised in the Final Report
(page 10), the new language is ready.
Attached is a revised vetsion of the 7oint Powers Agreement, regarding the merger of City and
County Public Health Depattments. This version supersedes any earlier versions and is noted by
the footer "(bolc� underlined italics reflect ¢/10/96 modifrcations)."
The 7une l Oth changes primarily address the Public Health building issues expected to arise in the
event that the State selects the Public Health site for a new Department of Revenue building.
These changes are found in section IV. FinanceBudget Issues, B. Transfer of Assets:
Page 6.
Page 7
Page 7
Requires that an environmentat sudit of the building be performed and that
the City will pay for the sudit. This is customary language.
In the event that site and building conditions require clean-up/remediation,
with costs in eaccess of $100,000, the City may terminate the agreement.
Requires that any reuse of the site will be consistent with the City's
downtown development goais and priorities.
�
`� (� - S��
Page ?. If the �te is selected by the State for the new Revemie building, the County
agrees to negotiate with the State for the sale of the property. If the site is
com�eyed to the State, the City and the Counry will each pay one-half of
the cost for relocating public health seivices within the City. The City's
share is capped at S3,000,000.
Page 7. The City will pay for its share of the relocation costs by raising no more
than $600,000 per year for five years. Under this plan, 60% of the City-to-
County tax levy shifr will be put into a contingency account and 40% o£
the savings will be passed on to City taxpayers. If the funds are not used
by December 31, 2001, the funds will be retumed to the taxpayers.
Page 8. If the JPA is terminated or not renewed, the building will be retumed to the
City. The new language provides a method by which any improvements
that the County makes to the building can be valued.
Page 9. D. Propg�'a�c Financine: T'he new language makes this section
consistent with the provisions of section IV. B. Transfer of Assets.
If you have any questions about this new language, please contact me at 266-8799.
Very truly yours,
o..� ���
Peter Hames
Innovations Director
Attachment
c: Mayor Coleman
Neal Holtan
Mary Keamey
Jane Norbin
Mark Shields
Kris Wendorff
AFSCME
PEA
Rob Fulton
Diane Holmgren
Paul McCloskey
Jce Reid
Ivfichele Timmons
Pam Wheelock
Loca170
SPSO
f:�usersslhame.s�innovlhealth�rc.wjpa06.13
_.��A �
: ;
GERF2Y STRATHMAN
Direc[or
July 19, 1996
CITY OF SAINT PAUL
COUNCIL INVESTIGATION AND RESEARCH CENTER
Office of the Boazd of Ramsey County Commissioners
Commissioner John T. Finley
Commissioner Susan Haigh
Commissioner Hal Norgard
Commissioner Rafael Ortega
Commissioner Rich O'Connor
Commissioner Brenda Thomas
Commissioner Dick Wedell
Ramsey County
220 Court House
St. Paul, Minnesota 55102
Dear Commissioners:
��,s�3
The attached resolution, Council File #96-583 (Authorizing and directing the proper Ciry
officials to execute a joint powers agreement with the County of Ramsey providing for the
consolidation and transfer of various public health programs and functions), was adopted by the
Saint Paul City Council on July 3, 1996, and approved by Mayor Coleman on July 11, 1996.
It is requested that you place this item on your agenda to consider and approve the Joint Powers
Agreement in time for the Joint Powers Agreement to be implemented by January 1, 1997.
Sincerely,
� ���
Assistant Council Secretary
NA
Attachments
cc: Terry Schutten, County Manager
Bonnie 7ackelen, Cluef Clerk to the Boazd
CITY HALL SUTTE 310 SAINT PAUL, MINNESOTA 55102
s�as
Pdn4d on Rec9cled Pnper
612/266-8560
i
��
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� � �
� ,�5
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3une 19, 1996 City Council Meeting
Amendments to Resolution #96-583:
Subject to the following modifications to the Joint Powers Agreement:
Until a merger is accomplished and while the Joint Powers Agreement (JPA) is in
effect, the Saint Paul City Council will have the final authority on what health
services are provided through the JPA within the city.
2. Until a merger is accomplished and while the Joint Powers Agreement is in effect,
the Saint Paul City Council will set priorities for health services provided through
� the JPA within the city.
3. The language regarding conveying the Public Health Building to the State of
Minnesota is removed (page 7, paragraphs beginning "The State of Minnesota..."
through page 7 paragraph ending with "... to the ciry properiy taxpayers through a
properly tax levy reduction: ') and replaced with the foliowing language: "The
conveyance of the Public Health Building to other ownership requires a separate
action by resolution hefore the Saint Paul City Council:'
4. Personnel issues will be resolved prior to the Joint Powers Agreement taking
effect.
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r�MEN�EO # 9�-sg3
r ,,, �,.� � �' 19 � � � Council File
s' 6 .�' � �` o- �� ,� t"t
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� Green Sheet # 35��
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA f Z
Presented By
Referred To
The following amendments were made to Resolution
Subject to the following modification� to the Jo
1
2
3
4
5
6
RESOLVED, that the proper City officials aze hereby authorized directed to
execute a joint powers agreement with the County of Ramsey providing r the consolidation
and transfer of various public health programs and functions as more iculazly set forth in
said agreement which is incorporated herein by reference, a copy of 'ch is to be kept on
file and of record in the Department of Finance and Management rvices.
1. Until a
effect,
sexvices
2. ilntil a
the Saint Paul City Council
the SPA within the City.
3. The
Min
thr
�
con
act
4. Per
Committee :
er is accomplished and while
Saint Paul Citv Council will
the
ri
e oz tne ruoiic
resolution bef
on June 19, 1996:
�t rowers egreement:
�
Joint Powers Agreeme
the final authority
the City.
Joint Powers Agreeme
set 'riorities for health
e Public Health Buildin
graphs beginning "The Sta
ith " ..to the City proper
and replaced with the foll
uilding to other ownership
aint Paul City Council."
�rior to the Joint Powers
is in
is in effect
to the State of
e of Minnesota..."
y taxpayers throug
wing language: "T
requires a separat
Agreement taking
Requested by Department of:
By:
Adopted by
Adoption �
By:
By:
. Date
by Council Secretary
by Mayor: Date
Form A ved by Ci.ty A torney
B `��uk,/��%' '� fJ4sw� ^ 2 5� c/
y � — /
!
Approved by Mayor for Submission to
Council
B�� 1�_.-��t�
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City and County Health Department Merger
Finai Reporf
Prepared by the City and County Health Merger Group
City of Saint Paul
Office of The Mayor
390 CityHall-Courthouse
County of Ramsey
Office of The County Manager
220 City Hail-Courthouse
June 5, 1996
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Table of Contents
I. Executive Summary
II. Introduction
III. Merger Issues
IV. Inclusion in the Report Review Process
V. Summary
Appendil� A: Section II of Proposed 7oint Powers Agreement
Append'uf B: City and County Health Merger Implementation Issues
Appendix C: Bstimated Tax Isnpact Upon Selected Value Homes of a Ramsey
County and City of Sairn Paul Public Health Departmern Merger
Appendix D: Proposed Joint Powers Agreement
Appendix E: Saint Paul-Ramsey County Health Department Proposed IvTission
Statement
Appendix F: Written Comments and Replies
Appendix G: Questions and Concems &om Four Community Meetings
Append'vc H: Letter to the Joint Community Health Services Advisory Comsnittee
(with attachmerns)
3
6
7
12
13
14
17
14
20
37
41
71
8Q
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L Egecutive Summary
In the fall of 1995, a gronp of City and County staffwas formed to review whether and
how the City and County Health Departments shoutd be combined. Merging the two
agencies shouid:
► resuit in coordinated management and service delivery;
► save approximately $100,000;
► continue current services at the same service level;
► appropriately use the County's larger tax base to fund public health as a
human service;
► posirion the agency to handle e�cpected Federal and State changes in heatth
caze;
► provide a measure of tax relief to the Saint Paul property tazipayers who
currently pag twice for health services.
In order to merge the two agencies, a 7oint Powers Agreement (JPA) is recommended.
The highlights of the 7PA are:
Services. The City will sell its services to the County. Current service
levels will be mainYained.
Levet of Future Services. If future service levets need to be changed,
because of changes in federal or state funding or authorization, City input
will be maintained. Either an amendment to the approved 1996-1999 Saint
Paul Ramsey County Community Health Services Plan or the annual
budget process will be used to propose needed changes.
Governance. The City Council wili continue to act as the Health Boazd for
those services (i.e., animal control, housing code enforcement, lead control
and reduction) that the City will retain. In light of the County assuming the
responsibility for managing a11 public health services and levying a single,
countywide property tax, the County Board will be the Health Board for
public heaith services. The Joint Community Health Services Advisory
Committee will be retained.
Budget and Finance. The majority of public health funding comes from
outside sowces (e.g., federal funds). The property tax provides 20% of the
total City budget and 16% of the total County budget. Under the JPA,
Saint Paut property tu�es will slightty decrease and Ramsey County taa�es
will slightiy increase. In light of the County assuming additional
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management and fiscat respons�bility, ownership of the City's public health
building will be conveyed to the County.
Management. The County Board will appoint the director of the merged
agency. Slhe will create a blended management team to oversee the
merger implementation.
Personnel. i3nder the 3PA, City and Courny employees wifl retain their
separate status. The long-term strategy, however, is a"merger through
attrition," where vacant City positions will be transferred to and filled by
the County. If the Mayor, Ciry Council and County Board approve the
JPA, then discussions and negotiations with employee unions, over the
effects of the decision upon employees, will commence.
•, General Conditions. The term of the 7PA coincides with the Community
Health Services Plan, in place until December 31, 1999. Either party may
terminate the 7PA with six months notice. If not terminated, the JPA will
automatically be renewed. The parties will e�cchange their proposed annual
budgets by June 15 and send comments to the other within thirty days.
A special effort was made to include various stakehoiders in the review of tlus report. Some
1,500 notices were mailed to commumty members and organizations, inviting them to comment
upon the report and JPA. In addition, they were invited to four community meetings, held to
present the report and JPA, and to hear questions and concerns. Written comments and replies
are contained in Appendix F and reports from the community meetings are contained in Appendix
G.
a�.� _ ���
II. InUroduetion
Previously, the �esota Legisiature passed laws declaring that the State wouId assume
responsibility for the provisian of human services (e.g., health, courts, wetfare). The
counties, as agents of the State, would be the local authorities responsible for providing
humaa services. The legislative intent was to ensure that there would be no gaps in the
provision of human services. And, as policy, it was determined that cournies had the
appropriate local tax base for funding human service delivery. Thus, county government
has the historical, as well as the legistative pernrission to provide human, including health,
services to its citizens.
In 1976, the Legislature adopted the Community Health Services Act that identified the
county as the provider of pubfic heakh services. One purpose of the act was to streamline
the number of public health agencies in the State.
The Act, however, ailowed cities that operated a health department to be grandfathered
into the new stnzcture. To do so, they had to form their own commnnity health services
agencies, establish local health boards, prepaze a communiry health services plan
consistent with the county's plan, establish an advisory committee, and get the approval of
the Minnesota Commissioner of Healt6. Five cities, inciuding Saint Paui and lvrnneapolis,
elected to maintain their own public heaith services.
Although Saint Paul chose not to merge its Health Department with Ramsey County's, a
1978 City Councit resotution, adopted and approved by the Mayor, stated that it would be
City golicy to merge, at some point in the future, its Health Department with Ramsey
County's. During the past 20 years, merger studies were conducted but, for a variety of
reasons, the two agencies never merged.
In 1988, the City Council authorized a major effort to merge the two agencies. City and
County staff identified a host of issues and set up teams to resolve them. The bulk of
work, done on personnel-related issues, involved reseazch into the respective job
classifications, wages, and bene$t packages. In addition, City and County bargainuig
representatives were appoinfed to and met with the Personnel Committee to address their
concems and demands. Since all their demands coutd not be satisfied, Mayor Latimer
stopped the negatiations and the merger attempt.
In 1991, the State Legislature established the Ramsey County Local Government Seavices
Study Commission to find ways to streactiline City and County services. The Commission
considered proposals to combine public safety communication centers, libraries, toads,
attorneys and public health. Again, an extensive amount of research was conducted.
The Commission voted on a resalurion to not mer$e the two Heaith Departments and it
passed on a vote of fourteen in favor and seven opposed. Dissatisfied with the
Commission's final positions, a group of Commission members filed a minority report
recommending that City and County health department services, along with seven other
services, be regulariy put out for bid.
q� �
In 1995, the Mayor's staff, with cooperation &om the County Manager's sta$ icutiated a
new set of discussions regarding the merger of the two heaith ageacies. It is the efforts of
the City and Coucriy Heaith Merger Group that are contained in this regort.
The following is a list of reasons why City and County officials initiated the current
merger discussions:
Improved Customer Service:
Merging the two agencies will result in improved administration,
glanning and coordination of public heakh setvices.
The merged agency w�l continue to provide the same level of
services that are cunently provided to city and county residents.
2. Prepare for the Uncertainties of Future Federal and State I-Iealth Actions:
A common City and County concern is that the federal government
will reduce the funding of health programs. It is believed that a
combined pubtic health agency will be better able to handle these
cuts and m;n;m;�e the impact upon services.
Actions at the federat level are likeiy to affect the heaith care
industry and a merged agenoy w�l be better posirioned to respond
to those expected changes.
3. Improved Financial Stability and Equity
A vacancy in the City Public Health Departmem's top management
position provides an opportunity to annually save approximately
$100,000 by having one director manage the combined agency.
The County's properry taac base, consistent with State statute, is the
more appropriate funding source for public health seivices.
Currendy, City residerns pay twice for public health service: once,
via the City's properry ta�c levy, for the Saint Paul Heatth
Department; and once, via the County's praperty t� levy for the
Ramsey County I3eaith Depamncynt. The levying of a single tax, hy
the County, for a merged department would be more equitable.
The impact upon County property owners will be relatively minor.
III. Merger Issues
The City and County Health Merget Staff Group (the Group) began its wark by
idenrifying the following major issues: services; governance; finance and budget;
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management; personnat; and implementation. The group focused upon a Joint Pawers
Ageement (JPA)* as the most appropriate vehicle for the merger.
(?ther altematives were considered:
Maintain the status quo, making no change in services or locai levy responsibility;
Merge the City inta the County operarions; and,
Provide services using City staffunder contract with Yhe County, shifting
governance and levy authority to the County.
Minnesata Statutes § 471.59 Joint Exercise of Powers. 1. Agreement. Two or more
governmental units, by agreement entered into through action of their govemin$ bodies,
may jointly or cooperatively exercise any power common to the contracting parties or any
similar power, including those which are the same eaccept for the territorial limits within
which they may be exercised. The agreement may provide for the exercise of such powers
by one or more of the participating governmental uniis on behalf af the other participating
units. The term "governmental unit" as used in this section includes every ciry, county,
town, school district, other politicat subdivision of this or another state, another state, and
any agency of the state of Ivrnnesota or the United States, and includes any instrumentality
of a governmental unit. For ihe purpose of this section, an instrumentatity of a
govemmental unit means an instnzmentatity having independent palicy making and
appropriating authority.
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The TPA is the chosen aitemative and the following sections review the issues as they are
defined in the IPA
A Services
In reviewing the services provided by the two agencies, the Group had common
goals. First, the Group wanted to assure the continuation of current service 3evels.
This goal is reflected in the IPA (See Apgendix A, Section II. Public Health
Services, C. I,evel of Services), and provides that no services wiil be eliminated or
reduced as a result of the merger.
The Groug sought to identify which agency couid better deliver particular services.
In making these recommendadons, factors considered were customer service, staff
expertise, and appropriate level of govemment. Decisions were made to retain
some seivices in the City; have the City grovide some services for the County�, and
have the County provide most services for the City. Appendix A contains a list of
the division ofservices.
A third goal was to assure that City officials continue their involvemetrt in public
heaith. This wili be accomplished through their review of the annuat hudgets and
changss to the Community Health Services Plcm. A plan of annuat budget reviews
for the comhined services was established, the existing Joint Community Heatth
Secvices Advisory Committee was retained, and the Community Health Services
Plan's amendment process was recognized as fhe method for making future
service changes.
B. I,evel of Future Services
The Group believes that combining services shouid not directty result in the
elimination or reduction of the current service leveis. Other factors (e.g,
reductions in state or federal funding, changes of authority for seivice provision, or
changes in communiry needs), however, could have an impact upon levels of
services in the future. Tlws, the JPA holds that the parties, using the Plan
amendment and budget review processes, would incorporate these needed
changes.
C. Gvvernance
The governance recommendations follow the service distribution decisions. Since
the County assumes primary responsibility far services currently provided by the
City and assumes the locai levy for these services, governance of the combined
services will be at the Counry level.
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The Governance recommendations inciude:
Naming the new entity ihe "Saint Paui-Ramsey County Department
of Public Health." This name recognizes the historicai developmenY
of public heatth, first wiYhin Saint Paui in the 1850s, followed by
services under Ramsey County, beginning in the early 1900s. It
also reflects that services will be focused upon both city and county
residents and follows the pattern set by city-county mergers in other
parts of the country.
2. Retaining the 21 member 7oint Community Health Services
Advisory Committee. The Committee has nine members appointed
by the Mayor and City Cauncil; four members appainted by
Ramsey County Commissioners with districts representing the City;
and, eight at-large members appointed by the County Boazd.
3. Recognizing the 1996-1999 Saint Paul-Ramsey County Community
Health Services Plan as the major defining document for public
health assessment, priority of needs, and pragramming of services.
4. The City Council will continue to act as the Heatth Boazd for those
services (i.e., animal control; housing code enforcement; lead
connrot and reduction) that the City will retain.
D. Budget and Finance
Both agencies are financed through a combination of praperty tax tevies, gants
and fees. The 1996 Saint Paul Pubiic Aealth budget for those services being
aliocated to the County is $9,3�1,174 with $1,893,764 (20%) coming from the
property ta}c levy. The 1996 Ramsey Counry Department of Public Health budget
is $17,496,690 with $2,873,114 (16%) caming &om the countywide property taac
levy.
The Group identified 7anuary 1, 199? as the best and earliest possibie date to shift
the change in properry tax levy from the City to the County. This requires policy
action by August, in time for the change to be made in the Truth in T�ation
Notices.
Since the City wi11 contract with the County for the services provided by its staff
and the County wilt levy for these services across the full County property taac
base, there wil16e a small net reduction in properiy t�es for city residents and,
subsequent3y, small increases to those properties outside of the aty.
Appendix C presents an analysis of the levy shift and its impact upon taaies paid �
selected valued homes in Saint Paul and in suburban communities. The Ievy shi�
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would cause Saint Paul residents to see sn estimated decrease of 0.51% in their
total property tax. For a 5aint Paul home valued at $I15,000, the ta�c decrease
would be $12.41
The levy shift would cause suburban communides to see an estimated increase of
0.41% to 0.52% in the'u total gragerty tax. For a suburban home valued at
$115,000, the tax increase would be $9.88. This reallocation af property taztes is
consistent with the current system of providing and funding other human services.
Both enrities receive e�ensive grants from the state and federal govemments. Tn
order to cambine services, the City has agreed to assign, where feasi'bie, its
imerests and obligadons under these contracts to the County. Most of the City
grants are from the Mmnesota Departmem of Health. Those grants require the
consent of the Minnesota Department of Heatth before the gam may be assigned
to another party. See Appendix H, Attachment II for a listing of cunent City
grants.
The final budget and finance issue is the ownership of the City's puhlic health
assets. Since the County wil] be accountable for funding, managin8 and delivering
the services, the JPA provides that the City Public Health land, building and
coments be conveyed to the County. If the 7PA is terminated or not renewed,
those assets would be returned to the Ciry.
Since this report was prepared, the Merger Group has learned that the State is
looking for alternative sites for relocatiug its Departmern ofRevenue. Specificatly,
the State staffmust consider downtown Saint Paul sites as they evaluate
alternarive locadons. The Public �Iealth building is expected ta be included in the
evaluation. From the City and County perspective, the site wouid be a good o�,
since ii would bring additional economic activity to down town. The challenge, if
the site were taken, would be to find a repiacement that has the same accessibility
features as 555 Cedar.
The Merger Group has not agreemern on JPA language that would adequately
address this contingency. Thus, this section of the JPA is not yet finat {Appendix
D, Proposed 3oint Powers Agreement, B. Transfer of Assets}. The Group
continues to work on the issues and e�ects to have them resolv� within two
weeks.
E. Management
The County, having the major service, governance, and taY levy funding
respons�"bility shontd have the authority to appoint the director of the Saint Paul-
Ramsey County Department of Public Health. Slhe will assw'e that there is a City-
County blended management team to cany out a detailed merger implementatiott
plan to fully combine public heaith services.
T�l
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The merger implementation plan is a separate document from the JPA and is
contained in Appendi�c B. The elements inciude mission af the merged agency,
vision, values, organization, employee relations, facilities, stafftransitions, and
informarion services. A copy of the proposed mission and related value statements
is contained in Appendix E.
F. Personnel
The long-term strategy for the JPA is to attain a fully merged agency through
attrition. That is, City empioyees, under the 7PA, will remain Gity employees until
they leave their positions. When a City position becomes vacant, the County will
fill it. Over time, all City positions will be eliminated through attrition.
An unportant mecger issue is that of employee righis. The City and County staff
have met with emptoyees and their bargaining agents to keep them informed of the
progress of the Group's work. Instead of attempting to first resolve employees'
concerns, the Group choose to first focns apon resoiving the ssrvice-related issues.
The focus upon service delivery and maintaining levels of service is simply putting
first things first. Similariy, resotving budget and &nance issues, inciuding grants
and contracts, is alsa important. If those issues couid not be resolved, there wouid
be no sense in proceeding.
Iia�ing said that, it is known that some unions want a say in whether or not a
merger should take place. The Group, on the other hand, in several meetings with
staff and their agents, has made ctear that the approach will be to negotiate the
effects af the decision and not the decision itself. Framing the merger issues is
managemenYs responsibility, This approach was shazed with staff and their agents
during the numerous sessions heid to update staff on the progress of the project,
answer their questions and to hear their concerns.
In order to imptement the JPA, the Mayor and City Council and the County Board
must first approve the TAA. Then discussions with the unions, over the effects of
the decision upon employees, wilt commence. In anticipation of JPA approval,
City and County representatives have agreed ta a number of items, regarding
personnel issues, in an effort to reduce employee and union concerns and make the
JPA implementation phase less problemaric. Discussion of these items with the
employees' agents has already begun.
G. General Condirions
The Group addressed the issues of the ierm of the 7PA, inswance and liability, �
budget review.
The term of the JPA coincides with the 1996-1999 Community Health Service
{CHS) Plrnz, which is in place with the State until December 31, 1999. Either
party may give notice, at least 180 days in advance of the date they do not wi
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continue the 7PA; othenvise, the IFA will automatically 6e renewed. Further,
either party can give ternunation nodce by May 31 of any year, effective December
31. By October 31, 1999, the County must submit a revised CHS Plan to the
State. This revised CHSPIrm wit[ reflect and include the continuing relationship of
the TPA.
Both parties will continue their respective teveis af self insurance and additional
insurance to cover tort, automobile, worker's compensation, and professionat
liabitities policies.
Both the City and the County agree to notify each other, in writing, when the
proposed budgets for the combined public heatth services are ready for review.
This must occur no later than 7une 15 of the year prior to the budget year.
Both parties then hava 30 days to comment on the proposed budget.
1V. 7nciusiaa in the Report Review Process
A Staff.
On several occasions, health depaRment staff were briefed on these issues. These
sessions were atso an opportunity to hear their concerns and answer their
questions. In addition, the staff created, via focus goups, the master list of inerger
questions that guided the Group's discussions.
A draft of this repon and the 7PA were presented to them for review and comment
in Apn7. Severat staffattended the community meetings and their quesrion and
concerns are reported in Appendix G. Their feedback was used in the preparation
of the final report.
B. Community.
The 7oint Community Health Advisory Committee was inirially briefed in 7anuary.
Another presentation was made on April 10 and drafts of this report and the JPA
were preserned to them for review and comment. A letter addressing their
questions and concerns is contained in Append'vL H. Their f�edback was used in
the prepazation of the final report.
Notices were sern to 1,500 community stakeholders inviting them to comment
upon the report and the 7PA. Recipients were alsa invited to attend the four
community meetings to give feedback. Written comments are wntained in
Appendiac F and reports &om the four community meetings are contained in
Appendix G. This input, too, was used in the preparatian of the finai report.
1z
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c. u�ong.
Union representatives were briefed on severai occasions. This was an opportunity
ta listen to their concems and answer their questions. Copies of this report and the
7PA were presented to all affected City and County unions. The comments of
those who reglied are contained in Appendix F. Their feedback was used in the
preparation of the final report.
VL Summary
This review was undertaken to determine whether the City and Gounty Heatth
Depaztments should be merged. The answer we have found is yes. The JPA approach to
accomplish the merger is creative and will cause the least amount of disruption. t�'hile
there wiil be some cost savings, this is a change that maimains service levels, more
equitably distributes the funding responsibility, and improves management and delivery of
pubtic health services.
In the past, the League of Women Voters, the Joint I�ealth Services Advisory Committee,
the County Board and the City Council have recommended ihat the two agencies be
merged. The primary obstacles that stopped past merger attempts, we believe, have been
m;nimi�ed. Councii and Board approvai is the first step to create an agency that is well-
positioned to provide quatity health services to all residents of Ramsey Counry now and in
the future.
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Section II of the Proposed Joint Powers Agreemern Regarding Ciry and County Public Aealth Services
(Note: This Appendix is rakea directly from the draft 7oint Powers Agreement)
II. Public Health Services
T6e public heaith services described in the "Saim Paut-Ramsey Counry Commimity Health
Services Flan for 1996 to 1999," any future amendtnents titereto, and successor documents
(PLAN); the 1996 City of Saint Pavi and Cwmy of Ramsey budgets; and the Ramsey County
SoHd Waste mastar Pian shall be joindy provided by the City of Saint Paut (CITY) and the County
of Ramsey (COUN'TI') as descri6ed herein.
A. City Duties
1. The City s6a11 retain respoasibility for the following services within t�e City
limits:
a. Housing Enforcement Services
i. Aousing - Complaints
ii. Vacant Bm'Idings
iri. Summary Abatement
iv. Lead Paint Hazard Control
v. Lead Hazard Reduetion
vi, Tntth in Sale of Aousiag
vi;. xuisance abareme�,c
b. Animat Control
c. Food Inspecfion Setvices
d. Solid Wzste Activities: Solid waste activifies performed by the City as of
the date of execution of this Agreement wiii continue to be performed by
the City. The City recycling program is addressed in aa existing joint
powers agreement between the City and Caunty, dated September 28,
1993, which shall conrinue according to its terms.
2. Effecflve 7anuary i, 1997, the City shall begin providiag the following services on
beLatf of the County addun tfie areas of the County ouL�ide the City limits:
a. Dangerous Dog Registrafion
b. Lead Paint Hazard Cornrol
c. Lead Hazard Retiucfion
3. Effecfive January 1, 1997, all remaining Saint Paul public health board activities
tbat are not transferred to the Caunty pursuant to d�is Agreemem wi11 be
travsferred to other City deparGnems and the City wiU � longer use the name
"Saint Paui Public Heaith."
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B. County Duties
i. The County shall continue to maintain responsibility for the following services:
a. Community ClinicslLiving-at-Home-Block Nurse Program
b. Public Health Administration
c. Disease Prevention and Control
d. Family Health
e. Preadmission screenings/waivers
f.
S•
h.
i.
.1•
k.
1.
m.
n.
o.
P•
Adult Aeaith management
Child and Teen Checkups
Solid Waste Acdvities, including
i. Solid Waste Regulation
n. Household Hazardous Waste
iri. Yazd Waste Management
iv. Residential Recycling
v. Recycling Processing
vi. Business Waste Assistance Program
vri. Solid Waste Public Fducation
via. Solid Waste Adminisffation
ix. Resource Recovery
Correctional Health
Community Health/Violence Preven6on/Employee Health Promotion
Adolescent Health
Hazardous Waste Program
Community Sanitation Program
Nutrifion
Nursing Administration
Personal Care Attendant Assessments
2. Effective January 1, 1997, the County shall begin providing the following services
on behalf of the City within the City ]imits:
a. Epidemiology/Disease Investigation and Control
b. Tuberculosis
c. Adcninistration, including Nursing Adnilnistrafion
d. Families in Crisis
e. Community Clinics/ Living-at-Home-Block Nurse Program
£ Family Planning
g. Immunizations, including Tnvel and Hepafifis B
h. Nutrition
i. Dental
j. Women's Health
k. Colposcopy
1. Seavally Transmitted Diseases
m. HIV/AIDS
n. Preventive MedicinelRefugee Screening
o. WIC
p. Childhood Lead Prevention
q. Well Cluld/Children's Iniflarive
r. Aealth Educa6on
15
����5�
s. chronic D3sease
t Child I�ealth Initiative (Maternal Child Health Grant)
u. Native American Heaith
v. Immunization Registry
w. Family Ties
z. Immunization Action Flan
y. Health Records
z. Data Services
aa. Iaboratory
bb. Birth and Death Records
cc. Building Maintenance
3. The Ramsey County Department of Public Health will be remdmed the "Saint
Paul-Ramsey Counry DepaRment of Public Health" effective on January 1, 1997.
C. Leve1 of Services
Services described in the PLAN which I�ave been performed by either ihe City or the
County up to the effecfive date of dus Agreement sLall not be eliminated or reduced as a
direct resutt of ihis Agreement, ezcep�
1. After compliance with the statutory process for amendment of the PI.AN, or
2. Thrwgh the budgeting process. Both the County aad City budgets are subject to
the budget review and comment procedures described in Paragaph VI. E.,
below.
The parfies acl�wledge that provision of services at current levels will depend upon the
continued avai]ability of state and federal funding, and continuing authority uraier
applicable state and/or federai law. If funding or authority changes during the term
of dris Agreement, the parties agree W incorporate such cLanges as aze necessary into the
PLAN or their respective budgets, as applicable.
16
n� �
��,��
'�1 .J t� ,�
APPENDIX B
City County Health Merger Implementation Issues
The following is a list of issues that were identified by the Group. It is not intended to be an
exciusive list and may be expanded as additional study is done. The Group opted not to
resolve these issues until after the City and County elected officiais have made their policy
decision regarding a merger. Most of these issues should be addressed, by January 1, 1997,
using the input and feedback of the staff from the two agencies.
Mission of Merged Agency: Both agencies have similar missions that have been approved by
their respective elected bodies. A new mission statement combining both current missions
should be developed.
Long Term Vision of Merged Agency: A vision statement on Community Health Services in
the year 2004 was created by Phase I of the County's Strategic Plan. This vision statement
should be used in preparing a visioning process for a merged agency. The supervisory staff of
both agencies met in January to look at azeas of common efforts and this work product can
also be used in this visioning process.
Values of Merged Agency: Both agencies have established a list of values that drives their
mission. These two lists should be reviewed and combined into one document. There aze
both similarities and differences that need to be reconciled.
Methods of Providing Public Health Services: The City and the County have traditionally
used different methods in the provision of public health services. A balanced approach to
these differences will need to be determined.
Organization of Merged Agency: The organiza6onal structure of the merged agency must be
developed. For a short period of time, it can operate in its cunent organiza6onal style. Study
needs to be carried out to determine what division, sec6ons, units, and program groupings
would best provide leadership, management, and supervision to staff and services to clients. It
is anticipated that some supervision of Counry staff by City staff and vice versa could occur.
Culture of Merged Agency: There is a wide variety of culturai elements within the agencies
that need to be defined and blended. They include resource allocation, professionalism, cost
recovery, planning, labor-management, evaluation, quality assurance, total quality
improvement, staff development, information services, service delivery, confidentiality, policy
and practices, empioyee empowerment, community relationships, intergovernmental
relationships, and provider relationships.
�nployee Relations: A merged agency will need to develop consistent methods of handling a
variety of personnel issues (e.g., performance appraisals, discipiine, grievance procedures,
productivity, worldng condidons) that will also allow for flexibility to opetate under two
separate personnel systems and numerous union contracts.
n
�� ���
Facilities of Merged Agency: The facilities of the merged agency should be reviewed and
best used to serve public health nceds and clients. These inciude the two major sites at 555
Cedar and Govemment Center West, as well as other locations at 1954 University, Selby-
Dale, Eastside and Suburban PH Nursing co-locations, and Maplewood Ia'brary Lower Level.
Planning Process of Merged Agency: The two agencies have completed a joint Community
Health Services Assessment and Program Planning process. Monitoring and updating of the
CAS plan needs to be joinfly developed and carried out.
Staff TY�ansitions: Opportunities nced to be developed for staff to participate in the transition
process. It will be important to buiid a positive staff environment through employee
empowerment, communication and team building.
Information Systems: The two agencies operate on different information systems. Issues for
consideration include technicat support staff, future development, funding, data, billing, and
connection between the two systems.
Relationship of Merged Agency with the City: The relationship that the merged agency, its
director and staff, will have with the City will need to be determined. This needs to include
relationships to City offices/departmenu, Citywide planning, Mayor's Office, City Council,
etc.
is
�l�
APPENDIR C
Fstimated Tax Impact on Selected Value Homes of a Ramsey Caunty and City of Saint Paul
Public Health Deparmient Merger
Affect on Suburban Taxpayers
Home Taxable btarket Value: 550,000 �72,000 ;115 �150,000 $250,000
Currenc Mechod
1996 County Ta� 5218.93
Pr000sed loin� Po�ers
1996 County Ta� 222.06
Change in Cour,�� Ta� 53.13
Perccntage Change in Counry Tax:
Pertentage Change in Total Ta� on Property:
(Depends on nhich suburban cit��, school district
ancVor warershed the properry is located inJ
--------------------
Affect on City of St. Paul Taxpayers
E315.z5 � f691.80 � 599830 � E1,874.00
319.75
E4.50
701.G8 1,012.j5
E9.88 S141i
+1.43%
+0.41%to +0.52%
HomeTaiableDlarkctValue: 550,000 572,000 $115 $150,000
Current Method
1996 St. Paul Heal:h 7aa E 7.06
1996 County Ta� 0.11
Total a207.17
P�000sed loint Pon�ers
1996 St. Paul Health Tax (E7.06)
1996 Counry 7a� $210.i0
Total 3203.24
Changein TaY (E3.93)
Percentage Change in Ta�
Permntage Change in 7ota1 Tax on Property:
1,9oD7j
b26.75
$250,000
510.16 E22.29 b32.i7 E6039
2$$�¢ 2?j 12.0 12.4
29832 $654.64 $944.67 $1,77333
(f I0.16)
2. 2
Sz92.66
{E 5.66)
(E2229) (E32.1�
4. ? $955.92
5642•23 5929•75
(E12.41) (517.92)
-1.90%
-0.51%
ASStlmption5: Ta�impactsarecakularedusingPaya61e199Glevies,valuesandtaxcal�ulations.
Previous Health properry tax levies: Ramsey Counry • E2,973,912
CityafSt.Paul • 51,893,7G4
NewCounryHealthpmpettytaclevy: E4,791,420
(has been reduced by St. Paul Heal[h Direttors salary)
PrepareC Bv Ramse�� Coumv, Dept. of Propeny RecorAs & Revenue, Loca� Go��emment, Pol¢y fi Resarch (GS)4/i/9G
(560 39)
1 8
$1,734-G9
(E33.64)
19
��
Appendia D
Proposed Joint Powers Agreement
Note: Changes have been made to this Joint Powers Agreemetrt since it was originally
distnbuted in April. Additions aze marked by under]ining and deletions are marked by
overstrike.
�
JOINT POAERS �GRSEMENT
BETFiEEN
TBS CITY OF SBINT P�DL
8ND
THE COIINTY OF R8M5EY
FOR
PDSLIC HSALTH SERVICES
7`HIS JOINT POAERS BGRE&MENT (Agreement) is
into by and between the City of Saint Paul, a
of the first class, and the County of
political subdivision, both of the State
�RF.AS� in October 1995, the
Paul City Council adopted the Saint
Health Services Plan for 1996 to 199
AHEREAS, the Saint Paul
�� -��.�
and entered
chartered city
; a duly chartered
County Board and Saint
and
County Community
County Community Health
Services Plan for 1996 to 199�'is a joint effort between the
Community Health Boards of
of Ramsey; and
�REAS, City and
recommends that the
City of Saint Paul and the County
staff have prepared a report which
of the City Public Health Department
and the Ramsey Cou Public Aealth Department be combined
through use of a p�€`rchase of services agreement; and
AHEREAS, th purpose of this Agreement is to streamline the
implementatio of the joint community health services plan, to
provide hig quality, efficient and cost-effective public health
services the citizens of the City and the County;
, the staff report identifies several implementation
issues/which will be addressed during the term of this Agreement;
, the parties agree as follows:
ai
�� - ��3
�.
Unless otherwise provided in this Agreement, all services
listed below shall have the meanings ascribed to them in the 1�6
City of Saint Paul and County of Ramsey budgets; the
any future amendments thereto and successor documents
�tamsev County Solid Waste Master Plan in effect as
this Agreement. ,;�
II. PIISLIC HEBLTH SERVICES
The public health services described in
and the
date of
Saint Paul-Rams�
any
future amendments thereto, and
1996 City of Saint Paul and County
Ramsey County Solid waste Master �'1,
�
by the City of Saint Paul (�ITY)
�
a
(COUNTY) as described herein.r�
A. City Duties
documents (PLAN); the
�f Ramsey budgets; and the
shall be jointly provided
and the County of Ramsey
1. The CITY shall �etain responsibility for the following
F'
services within;�the CITY liunits:
a. Housinq
�
Services
i. ��using - Complaints
ii. �7acant Buildings
iii. Summary Abatement
iv. Lead Paint Hazard Control
v. Lead Hazard Reduction
v'. Truth in Sale of Housing
i. Nuisance Abatement
Animal Control
Food Inspection Services
d. Solid Waste Activities: Solid waste activities
performed by the City as of the date of execution of
this Agreement will continue to be performed by the
a�
�/,�-y��
City. The City recycling program is addressed in an
2
existing joint powers agreement between the CITY and
COUNTY, dated September 28, 1993, which s� all
continue according to its terms.
Effective January 1, 1997, the CITY shall begin
the following services on behalf of the
areas of the COUNTY outside the CITY limits
a. Dangerous Dog Registration
b. Lead Paint Hazard Control
c. Lead Hazard Reduction
rei.mbursement basis.
3. Effective January 1, 1997, all
public health board activities
to the COUNTY pursuant to
transferred to other CITY
no longer use the name "
B. County Duties
1. The COUNTY Shall
the following
a.
b.
a.
e .
f.
8•
h.
k.
Community Cli.
Public Health
Disease Prev
Familv Heal�
s
thin the
ng Saint Paul
t are not transferred
s Agreement will be
and the City will
Paul Public Health."
to maintain responsibility for
ving-at-Home-Block Nurse Program
and Control
Preadmissi ' screenings/waivers
Adult Hea h management
Child an Teen Checkups
Solid W te Activities, including
i. So d waste Regulation
ii. usehold Hazardous waste
iii. Yard Waste Management
iv. Residential Recycling
v. Recycling Processing
v'. Business Waste Assistance Program
'i. Solid Waste Public Education
iii. Solid Waste Administration
ix. Resource Recovery
Correctional Health
Community Health/Violence Prevention/Employee Health
Promotion
Adolescent Health
.�.
2�
�� ` ���
1. Hazardous Waste Program
m. Community Sanitation Program
n. Nutrition
o. Nursing Administration
p. Personal Care Attendant Assessments
2. Effective January 1, 1997, the COUNTY shall
providing the foilowing services on behalf of
within the CITY li.mits:
b.
a.
e.
f.
3•
h.
k.
n.
4•
r .
t.
u.
v .
w.
x.
Y•
z .
aa.
bb.
3. The
CITY
Epidemiology/Disease Investigation and Co�;trol
Tuberculosis
Administration, including Nursing Admix�stration
Families in Crisis 4�
Community Clinics/I,iving-at-HOme-Bl�ek Nurse Program
Family Planning ,�
Immunizations, including Travel a,�d Hepatitis B
Nutrition ��
Dental
Women's Health
Colpoecopy ,,�
Sexually Transmitted Disea s
HIV�ATDS
Preventive Medicine�Refu ee Screening
WIC
Childhood I,ead Preven��''i n
Well Child/Children�,s Initiative
Health Education �;
Chronic Disease ��
Child Health Init``iative {Maternal Child Health Grant)
Native American�,�iiealth
Immunization Registry
Family Ties '�
Immunizatio��Action Plan
Health Rec�'rds
Data Servi>Ces
Birth aLicl Death Records
County Department of Public Health will be
the "Saint Paul - Ramsey County Department of
Health" effective on January 1, 1497.
C.
s described in the PLAN which have been performed by
the CITY or the COUNTY up to the effective date of this
of
shall not be eliminated or reduced as a direct result
Agreement, except:
_`�
ay
�"l�'.�a��
1. after compliance with the statutory process for amendment
of the PLAN, or
2. through budgeting processes. Both the County and C
budgets are subject to the budget review and co
pxocedures descxibed in Paragraph VI.E., below.
The parties acknowledge that provision of services at rs
levels will depend upon the continued availability of �tate
federal funding, and continuing authority under
and/or federal law. If funding or authority d
term of this Agreement, the parties agree to
changes as are necessary into the PLAN o�
?
budgets, as applicable. f t
III. GOVERNANCE
A. City's agent
The COUNTY is hereby designated
respect to the delivery of serv
II.B.2., above. The Ramsey County
have all governing and decision- }
the delivery of services set �rtk
above. The CITY transfers itc�p�.b]
ent
and
able state
s during the
such
respective
agent for the CITY with
set forth in Paragraph
of Commissioners shall
Zg authority with respect to
in Paragraph II.B.1 and 2.,
thereto.
B. County's agent
The CITY is ereby designated the agent for the COUNTY with
respect to t delivery of services set forth in Paragraph
II.A.2, abo . The Saint Paul City Council shall have all
governzng and decision-making authority with respect to the
delive of services set forth in Paraqraph II.A.1 and 2., above.
..i-..
as
a� -��3
C. Community Health Services Advisory Committee
The Joint City-County Community Health Services Advisory
Committee shall continue in effect in accordance with the pr ess
in effect at the time of this Agreement unless otherwise greed
to, in writing, by the parties.
IV. FINBNCS�BIIDGET ISSIIES ��
A. Grants
On or before January 1, 1997, the CITY wil assign to the
�
COUNTY its interests and obligations under ea� individual grant
relating to duties transferred to the �COUNTY under this
Agreement. The CITY is responsible for �btaining aIl necessary
<
�
approvals from the respective granto�s. All funds from such
�
rz
grants will be transferred to the G�bUNTY. In the event that a
�
k`
grant(s) cannot be assigned to th� COUNTY, the CITY will contract
�°
with the COUNTY to provide the,�ervices on the CITY's behalf and
.��
pay the COUNTY for the services within thirty-five (35) days of
4
invoice . ��
,,;
�;
B. Transfer of assets ,
,>
F*
As and for par�```ial consideratioa of the duties and
�'
responsibilities unc bp the COIINTY, the CITY shall quit
claim the real anc�vpersonal property located at its public health
building at 55�Cedar Street to the COUNTY. The CITY will
provide an in�entory of the personal property to be transferred
within sixt (60) days of execution of this Agreement. The CITY
will obta' an environmental audit of the property, including,
but no limited to, identification and location of asbestos,
under round storage tanks and other hazardous materials
6
.� 4
��"���
The COUNTY intends to continue to use the building £or public
health services. In the event the services are relocated the
C�UNTY shall fully consider customer needs and access' ility
before selecting an alternative site. In the ent of
termination or nonrenewal of this Agreement as ovided in
Paragraphs VI.A. or C, the COUNTY will quit claim�'the real and
�
personal property to the CITY. If the COUNTY m�es any capital
improvements to the building or site and the�ilding and site
/
are subsequently returned to the CITY, the�ITY will reimburse
/
the COUNTY for the cost of the improvements� less the accumulated
�
depreciation. ��
C. Assianment of contracts �`
On or before Ja
the COUNTY, assign
under each individu
the COUNTY under t
obtaining all n�
contractors. All f
CITY for expense
transferred to thE
cannot be assigned
with the terms oi
termination.
0
ary 1, 1997, t�1/CITY will, if requested by
the COUNTY it in and obligations
contract r�%�ating to duties transferred to
s Agreem��. The CITY is responsible for
essary , from the respective
r
ids en ered by or receivables owed to the
ass„ciated with the contracts wi11 be
CO TY. In the event that a contract(s)
� he COUNTY the CITY will continue to comply
the contract(s) until its expiration or
The part " s acknowledge their concurrent jurisdiction for
levy of th costs for services provided under this Agreement.
Beginning with the 1997 tax levy, if allowed by statute, the
partie agree that the COUNTY will increase its levy to collect
funds necessary to pay the expenses assumed for services to be
.Z
�7
�� -��3
provided purs¢ant to Paragraph II.B.2., above.
The CITY will
reduce its 1997 levy by the same amount to reflect its reduction
in costs for services transferred to the COUNTY unc]�r this
Agreement.
E. Pa�[nent to City �
The COUNTY will pay the CITY for the serv' es of CITY's
employees providing services to the COUNTY suant to this
r
�greement. The amount to be paid will be the�CITY's actual cost.
a
The COUNTY will pay fifty percent (50�) a� the CITY's budgeted
total on or before May 31st of each ye�and forty percent (40�)
of the CITY's budgeted total on or� y b'efore October 315t of each
year. The COUNTY will pay the ba�ance after the CITY certifies
its actual cost each year aad invoices the COUNTY for the
balance due. The COUNTY w�:�.l pay the final balance within
;%
thirty-five days of receipt�'of the CITY's invoice.
. 14ANBGEMENT
The Saint Paul -
County Department of Public Health
will be managed by
the COUNTY. The
facilitate
COUNTY.
This A
COUNTY acTr�'f
the
the
single director who shall be appointed by
tor will establish a management team to
tion of services between the CITY and the
VI. PERSONNBL
is a purchase of services agreement. The
to accept certain duties and responsibilities from
and is purchasing the services of CITY employees from
until such time as the COUNR'Y, is able to staff services
COUNR`Y employees. Such staffing shall be accomplished by
transferring CITY positions which become vacant through attrition
8
a`�
��-���
to the COUNTY. Any new positions which may be created due to
service needs shall be COUNTY positions.
Within ninety (90) days of the execution of this Agreement,
the CITY shall meet with the CITY employees' representatives d
the COUNTY shall meet with the COUNTY employees' representa ves
to begin identification and discussion of the effects this
Agreement upon employees. ;'
VII. GF.x�RAT. CONDITIO2zS u�
A. Term
,,
i
The initial term of this Agreement shall be � the date of
r
execution through December 31, 1999. Th' Agreement will
automatically renew for additional term(s)��o coincide with the
timeframes of future Saint Paul-Ramsey �ounty community health
t
services plans unless written notice o� intent not to renew is
submitted by either party to the o�her at least one hundred
eiqhty (180) days prior to the end of the term then in effect.
!'
B. Insurance
�
It i5 acknowledged that ��h parties rely primarily on self-
insurance programs for lia lity coverages, including statutory
workers' compensation cov rage. Each party agrees to maintain
its self insurance pro am or to obtain insurance policies for
tart, automohile, professional liability and workess'
compensation cove ge. Such tort, automobile or professional
liability insura e policies, if any, shall have minimum limits
of those lia lity limits established by Minnesota Statutes
Chapter 466 1994) and as amended, which are currently $200,000
per perso and $600,000 per occurrence or, in the case of
_ workers' compensation coverage, shall have minimum limits as
estab shed by state statute.
4
�
�� -���
The parties agree to work cooperatively with respect to
workers' compensation return-to-work programs for employees.
C. Termination
Either party may terminate this Agreement with o without
cause upon written notice to the other. The parties s cifically
agree that the notice must be received no later than ay 31 to be
r
effective at midnight December 31st of the same ye,`�. Any notice
received after May 31st will be effective
midnight December 31st of the following year
D.
In the event of termination of
encumbered for a particular
purpose. Any unencumbered funds
result of this Agreement will
proportion to their contr
reconveyance of the
earlier than
his Agreement, funds
sha11 be used for that
any property acquired as a
returned to the parties in
tion. In addition to the
located at 555 Cedar Street, as
described in Paragraph IV �, if this Agreement is terminated or
,
not renewed, the CITY sks�all accept return of the obligation to
levy for the costs of
and the personnel��
attrition, as desc�ibE
E . BudcLet _revie and
, as described in Paragraph IV.D.,
sitions transferred to the COUNTY via
in Paragraph VI., above.
Each party,�,*ill notify the other in writing when its proposed
public healt budget is ready for review which shall be no later
than June ��of the year preceding the term of the budget year.
Each
may
may review the other party's public health budget and
t comments within thirty (30) days of the notice.
10
3a
���-f���
F. Nonassignability
Neither party shall assign any interest in this Agreement a d
shall not transfer any interest in the same, whethe by
subcontract, assignment or novation, without the prior itten
consent of the other party.
G. Independent contractor
It is agreed that nothing contained in this greement is
intended or should be construed as constituting ither party as
the employee of the other party for any purpose r in any manner
whatsoever. Each party is an independent con actor and neither
it, its employees, agents nor representativ s are employees of
the other party. Payment of federal inc e tax, FICA payments
and state income tax are the responsib'�.ity of each party for
their own employees, agents or repre� ntatives, as required by
law. �/
��
H. Data practices ,'
All data collected, cre f ed, received, maintained or
disseminated for any purpo� in the course of the parties'
t"
performance of this Agr ,`ment is governed by the Minnesota
r
Government Data Practice Act, Minnesota Statutes Chapter 13, and
any other applicable state and/or federal statutes, rules or
regulations on data rivacy.
I. Access to doc ents
Until exp' ation of three years after the furnishing of
services pu= ant to this Agreement, each party, upon written
request o the other party, shall make available to the
requesti party, the State Auditor or the requesting party's
ultima funding sources, a copy of this Agreement and the books,
11
.��
31
q� � ��3
documents, records and accounting procedures and practices
relating to this Agreement.
J. Indemnification
Each party shall indemnify, hold harmless an defend the
other party, its employees and officials agains, any and all
liability, 1oss, costs, damages, expenses, cla,'�"ms or actions,
<-
including attorneys' fees, which has been or,�'may hereafter be
incurred by the second party as a result of�acts or omissions by
.<.
�
the first party, including any and all liability, loss, costs,
damages, expenses, claims or actions, iricluding attorneys' fees,
which may hereafter be incuxred, aris`ing out of or hy reason of
any act or omission in the execution, performance, oz failure to
.;
adequately perform its obligatiqiis pursuant to this Agreement.
Nothing herein shall constitute a waiver by either party of the
limitations on exceptions tA liability available at Minnesota
Statutes Chapter 466 or
K. Alteration
Any alteration, v�
r
provisions of this Agi
:i
been reduced to writi�q
L. Compliance
Each party
laws or ordin�
standards esta
e
which are no�1�
applicable law.
tion, modification, or waiver of the
�nt shall be valid only after it has
and duly signed by both parties.
to comply with all federal, state and local
, and all applicable rules, regulations, and
by any agency of such governmental units,
or hereafter promulgated insofar as they relate to
the parties perfortttance of the provisions of this Agreement. It
shall be e obligation of each party to apply for, pay for and
obtain_a 1 permits and/or licenses required by any governmental
12
3�
��-���
agency for the party's provision of the services contemp:
herein.
M. Workforce diversitv
The parties shall make good faith ef£orts
of this Agreement, any extensions thereof, to
the term
persons of
color for all classi£ications of work under this greement, and
shall, when requested by the other party, submit-a written report
to the other party regarding the efforts a results of such
efforts, including employment by job classif " ation.
N. Waste reduction
in
a recycling program for at least
materials and shall favor the pi
its procurement processes
broad types of recyclable
of recycled products in
reports, publications and
documents produced as a result �c� this Agreement shall be printed
on both sides of the paper,��here commonly accepted publishing
practices allow, on recycle�and recyclable paper using soy-based
inks, and sha11 be bound
O.
Each party agrees
laws, resolutions,
including the
a manner that does not use glue.
comply with all federal, state and local
snces �including Cha�ter 183 of the Saint
rules, regulations and executive orders,
with Disabilities Act, pertaining to
unlawful dis rimination on account of race, color, creed,
religion, n ional origin, gender, marital status, status with
regard to
age. W
party a:
assistance, sexual preference, disability, or
required by law or requested by the other party, each
furnish a written affirmative action plan.
13
3'3
���5��
P. Prevailing wage
All contractors and subcontractors shall conform to the labor
laws of the State of Minnesota, and all other laws, ordinances,
and legal requirements affectinq the work in Ramsey (County and
the State of Minnesota.
..,:....__.:..-,:��:._�:._.-�:. - - - - _
Q. �-�
Each party shall make all
the party's employees,
efforts to ensure that
and subcontractors abide by such
,:..�::..�_,:.- -
R.
This
shall constitute the entire Agreement between
the parties and shaZl supersede all prior oral or written
negotiations.
24
�
��r "��J
S. Severability
The provisions of this Agreement shall be deemed severable.
If any part of this AgYeement is rendered void, invalid or
unenforceable, such rendering shall not affect the valid' y and
enforceability of the remainder of this Aqreement unless he part
or parts which are void, invalid or otherwise unenforc able shall
substantially impair the value of the entire A eement with
respect to either party.
T. Notice �
�
Any notice required to be given by thi��¢Agreement shall be
made by United States mail to:
COUNTY CITY �
County Manager Mayor �
250 Courthouse-City Hall 390 C urthouse-City Hall
15 West Rellogg Boulevard 15 We'st Rellogg Boulevard
Saint Paul, MN 55102 Saiptt Paul, MN 55102
15
�
a� � ���
IN AITNESS THEREOF, the undersigned governmental units, by
action of their qoverning bodies, have caused this Agreement to
be executed in accordance with the authority of Minnesota
Statutes Section 471.59.
COIINTY OF RAMSBY
By
Hal Norgard, Chair
Board of Commissioners
By
Bonnie C. Jackelen
Chief Clerk
Approved as to form:
CITY OF S�INT
By
By
as to form:
Assistant County Attorney�" Assistant City Attorney
Insurance approved:
Risk Manaqer
Funds are avail e:
Budcret and A ountir.
County Department
blic Health
Funds are available:
Director of Finance and
Management Services
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Append'u E
Saint Paul-Ramsey Courny Heatth Departmern Proposed 2vfission Statement
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MISStON STATEMENT OF
ST. PAUL-RAMSEY COUNTY DEPARTMENT OF PUBIIC HEALTH
The missioa of the Departmeat of Public Health is to wark with
conanuaity partners aad to protect and promote the health of Lhe
St. Panl-Ramsey County Community.
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The Mission of the
Saint Paul Division of Public Heatth
The Missian of Saint Paul Diva.sion of Public Health is to
protect aad promote the health of our community. We mill ensure
or provide quality services tlaat address public health needs.
Ia this leadership role, we mi13 promote a healthier cosmnunity
which is responsive to neighborhood needs. oPe will work in
partnership with individuals and agencies to promote improved
heath and a safer anvironment.
Values
In order to achieva our missioa, we eavision an agency that:
Participates in strong outreach efforts to high risk populations, minorities and special populations;
Responds to the needs of the community;
Provides collaboration, technical assistance and service to the community in an effort to make
individuals and other organizations operate efFicientiy and on an independent basis;
Protects the health of the pubiic through the enforcement of State law and Gity ordinances;
Educates those individuals with whom we have contaci in both regulation programs and
medicaUclinical programs to ensure that there is an increased understanding leading to improved
health of the community;
Operates with visionary leadership and welt qualified, motivated staff where there are adequate
facilities, equipment, and sufficient funding io provided needed community services;
Supports research and program development so that community needs are understood and that
programs and services are flexible to be responsive to these needs;
Faces economic realities which prevent access to heatlhcare and improved environmental conditions
while aggressivefy advocating for a change in #unding prior?ties at the Federat, State, County and City
levels; and
Values the ideas and contributions of community volunieers,, elected officiafs, clients and staff in the
planning, design, implementation and evaluation of public heafth services.
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t'IRY-23-1996 13�24 FROM RAMSEY CO PUBLIC HEFlLTH TO 929Z7656 P.05iO4
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The Mission of the
Ramsey County Department of Public Healih
The Mission of the bepartment o� Public 8ealth is to
work tagether to create a healthy future for Ramsey Couaty.
Yalues
Tbe Missioa is base@ oa shareH va2ues that
motivate and guide our eurreat aad futuze actions.
Sound Pubiic Health Principles
The Department carries out its Mission using sound pubiic heatth principles, and recognizing the core
pubiic heaith functions of assessment, poiicy development and assurance of services.
Excelience in Heaith
The Department values promotion ot optimum healih for a!! individuals. This includes the prevention
of environmental, community and personal health problems.
Quality
Providing the highest quality services using the resources available is fundamenta! to the
DepartmenYs way of conducting business,
Community Partnerships
Working with the communiry is a criticai part of public heatth work. The Department values its work
to develop, coordinate and participate in community partnerships, based on mutual respect, involving
citizens, professionals, businesses, community organizations and local regiona( and state
govemment.
Fisrat Responsibiiity
Fiscal responsibility is a comerstone of the De{�aRmenYs operations. The appropriate use of revenue
and other public funds is esseniiai to the confidence of the community toward the support of
Department programs.
Environmental Responsibility .
The Departmeni wilt use +ts resources in ways which protect and improve the environment.
Access by All
The Department affirms access to services to a!I persons based on need, and no one shall be denied
access based on race, color, gender, age, national origin, religion, sexua! orientation, potitical
persuasion, physicat or mental ability or place of residence.
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Appeud'u F
Written Comments and Replies
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Mr. Peter tiames
Director of Innovations
400 City Hall Rnnex
St. Paul, MN 55102
Dear Mr. Hames:
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2550 Universdy Avenue West Suite 460-S • St PauL MN 55114
May 8, 1996
The community clinics in St. Paul have worked closely with both
the St. Pau2 Division of Public Hea2th and�the Ramsey County Pubiic
Health Department for over fifteen years. We offer the following
comments in regard to the proposed merger.
The seven community clinics (American indian, Family Tree, Face
to Face, Healthstart, Model Cities� North End and West Side3 provide
frcnt line atcess to primary health care services for people of all
ages, including teens, women and the homeless. Clinic patients are
low-income, underserved, and many have special needs because of
2anauage, culture or persona2 circumstances. They are individuals and
families who have little or no access to the traditional health care
system. O�er the years, the number of peopie seeking care at
community clinics has grown tremendously. The scope of care we offer
has expanded in response to the needs of community, the emphasis on
preventive services and the shift of providing care from an
acute/hospital setting to the out patient/community setting.
Maintaining and improving the system and'availability of care to
poer peop:e in St. Paul and Ramsey County is critical to the health of
the community. We hope the merger will result in the health
department continuing to be the watch dog for low-income, underserved
people. Steps should be taken to ensure there is not a diminished
interest or concentratinn of service to City residents. We are
confident that the County will continue to be responsive to the health
needs nf special populations. It will be important for the County to
have a committment in the long-term to continue the operations of the
community cl:nics who are key providers ofi health care in the public
health system.
Merging two large and important government departments is not
easy task. We appreciate the efforts made by the Merger 6roup and
process they used in developing a workable plan. The community
clinics are very wiiling tq participate in discussions or
imp2ementation strategies of the "merged system", and look forward
helping to strengthen public health services in the community.
Sincerely,
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(Vat�cy Briggs
Chair� East Metro
a re
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to
Fmencz.^. Inoi2n Health C6nic • CommonHealth Climc • Face ro Face Health and Counseline • Fa^:���� � ree Crnic
Hezl;h Sta� Inc • He ping H2nd Health Center • Model Cities Aorxms Climc • Mooel Crties Hzatth Cevter • Nertn cnc Meac2� Ce^?er
Ramsey Counry Pu6hc Health • Samt Paul Healih • VJest Sitle Commun:ry H_al;h Center
7R
OFFICE OF HUMAN RESOURCES
CTTY OF SAINT PAUL
Narm Co[eman, Mayor
John Hamilton, Director
400 Ciry Hall Annex
25 West Fourth Street
Saint Paul, MN 55102-1631
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Telephone: 612-266-6500
TDD/77Y: 612-266-6501
Jobline: 672-266-6502
Pacsimile: 612-292-7656
May 31, 1996
Ms. Nancy Briggs, Chair
East Metro Community Health Network
2550 University Avenue West, Suite 460-S
St. Paul, MN 55114
Dear Ms. Briggs:
Thank you for sending your comments on the draft report and proposed Joint Powers Agreement,
merging the City and County Health Departments. Your letter will be published in the final
report.
You may be confident that the merged department will continue to "be the watch dog for low-
income, underserved people." We wrote the 3PA to ensure that there will be no reduction in
services as a result of the merger. We also expect that funding to the community clinics will
continue in the future. Finally, we have no expectation that the staff s commitment to their
customers will be diminished by the merger.
The Resolution approving the 7oint Powers Agreement has been placed on the June 5 City
Council Agenda. The Couneil meeting begins at 3:30 p.m. and wi(l be held in the City Council
Chambers (15 W. Kellogg Boulevard, St. Paul). �
Again, thank you for your comments and participation in the community review process.
Very truly yours,
C�zr.� ��
Peter Fiames
City of Saint Paul
Innovations Director
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SAINT PAUL PUBLIC HEAL7H
Neal Ho17an, MD., MP.H., Direcfor
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C1TY OF SAWT PAUL sss ce�. so�eer 6�zavz-»>1
Norm Coleman, Maya> Sairu Pau� MN 55101-2260
May 8, 1996
Peter Hames
Duector of Innovation
City of Saint Paul
City Hall Annex
25 West Fourth Street
Saint PaLI, MN �5412
Deaz Mr. Hames:
This coaespondence is a follow-up to my letter to Mayor Coleman dated January 23,
1996 relating to the current draft of the Joint Powers Agreement merger between the
City of Saint Paul and Ramsey County Health Services. I appreciated the recent
opporfuniry I had to speak at tfie Community Advisory Boazd meeting and tius tetter is
a follow-up summarizing my concerns.
As I delineated at the Community Health Services Committee meeting on Wednesday,
April lOth, the public health needs of the City of Saint Paul and suburban Raiusey
County aze overlapping but have distinct features focused on the issue that the City of
SainT Paul is much pooxer and has a much more ethnicly diverse population than
suburban Ramsey County. Those demographic features aze linked to high risk for many
issues including Tuberculosis, Sexually Transmitted Diseases, HIV/AIDS, lack of
immunizations, and lack of access to medicat services due to no or inadequate health
insurance. As an example, at the City of Saint Paul STD Clinic a recent survey found
that 46% of our patients were non-white and that only 30% had private insurance with
approximately 50% havine no insurance what-so-ever. Numerous studies have
convincingly demonstrated that low cost accessible STD and TB services aze vital to
minimize the impact of those communicable diseases on a community. A sunilaz
contrast can be seen when one looks at the number of HIVlAIDS cases reported from
the one Ramsey suburban hospital (St. John's Northeast) and just Saint Paul Ramsey
alone. To date Saint Paul Ramsey has reported almost 975 cases of HIV/AIDS to the
Minn esota Department of Health vs. 12 total for St. John's Northeast.
I don't believe that the current draft of the merger agreement goes faz enough in
prioritizing the key services that should be protected no matter what the funding
situation is over the ne� decade. I think it highly likely that financial support for public
health services from the federal governmenY and the staYe will eiYl�er bazely keep pace
with inflation or actually decrease. I am concerned that the suburban Ramsey County
residents may, in a time of si�cant taxpayer cost accounting, not be willing to continue
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Page 2/Merger Concerns
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funding services that aze principally located in the City of Saint Paul. Although the
merger plan has considerable merit, I believe that two issues need to be specifically
addressed.
1. HIV, STD, TB, Inununization, and Fanuly Plauning Services need to be
placed at highest prioriTy within the azray of services provided by the
joint public health department should a merger conc��mmate.
2. The wording on page 5 of the draft needs to be changed as it relates to
the issue that as funding changes during this agreement, the employees
agree to incorporate such changes that are necessary and their respected
budgets, as applicable. That pazagraph clearly states that if there is less
money from state and federal funding there will have to be either cuts in
services provided or fiu�ther increases in t�es to pay for those services.
In the absence of any prioritization of services, I am concerned that this
may impair the ability of the key �ublic health services listed above to
maintain a minimal level of infrastructure. These services should be
guazanteed in a merger agreement, and it should be available at a location
that is already accessible to persons that use public transportation or
don't have funds to even cover pazking fees.
I will be happy to discuss my concerns with you or anybody on the merger planning
committee at any time. Please consider these issues during further deliberations about
the future structure of the City Health Department.
Sincerely,
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Keith Henry, MD
Director, Room 1 1 STD and HIV Clinic, Saint. Paul Department of Health
Director, AIDS/HIV Programs, Saint. Paul Ramsey Medical Center and
University of Minnesota A.IDS Clinical Trail Unit
Saint Paul Ramsey Medical Center
640 Jackson, Suite 125 orth, Saint Paul, MN 55101
phone @ Saint Paul Health Deparhnent (292-7752); at SPRMC (221-1280)
internet henry02@karlof£fstrf.org
cc: Neal Holtan, MD, MPH Medical Director Saint Paul Department of Health
Mary Sonnen, PHN Program Director Family Plamiing Services
Kristine MacDonald, MD, MPH Minnesota Department of Health
Michael Osterholm, PhD, MPH Minnesota Department of Health
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OFFICE OF HUMAN RESOURCES
CITY OF SAINT PAUL
Norm Coleman, Mayor
�•�+■May 31, 1996
John Hamilton, Direcror
400 Ciry Hal! Annes
25 A'est Fourrh Streei
Saint Paul, MN 55102-1631
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Telephorte: 612-266fi500
TODITTY: 6I2-266-650!
Joblirse: 612-266-6502
Facsimile: 6I2-292-7656
Keith Henry, MD
Saint Paui Public Aealth
555 Cedar Street, Room l ll
Saint Paul, MN 55101-2260
Dear Dr. Henry:
Thank you for sending your comments on the draft report and proposed 7oint Powers Agreement,
merging the Ciry and County Health Departrnents. Your letter will be published in the final
report.
The priority ranking of services, based upon a community assessmern, is contained in the 1996-
1999 Saint Paul-Ramsey Couniy Community Health Services Plmz FiIV, STD, TB,
Immunization and Family Planning Services are highly ranked within the CHS Plan.
The purpose of the merger is not to identify a guazanteed list of priority services. The merger
group went as far as it felt it could go in guazanteeing that the JPA would not result in a reduction
of seivice levels. We do not know whai the heakh services landscape will look like a year from
now, much less five years from now. It is elected officials who are accountable for making
decisions regarding the priority of services.
Finally, we agree that services should continue to be available at a site which is access�'ble to the
public. We believe that is addressed in the JPA
The Resolution approving the Joirn Powers Agreement has been placed on the 7une 5 City
Council Agenda. The Council meeting begins at 3:30 p.m. and will be held in the City Council
Chambers (IS W. Kellogg Boulevard, St. Paul).
Again, thank you for your comments and participation in the community review process.
Very truly yours,
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Peter Hames
Innovations Director
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CITY OF SAINT PAUL & INDEPENDENT SCHOOL DISTRICT NO. 625
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Professional
372 St. Peter St., Suite 301 St. Paul, MN 55102
May 8, 1996
Mr. Peter Hames
Director of Innovations
400 City Hall Annex
25 W. 4th Street
Saint Paul, MN 55102
Dear Mr. Hames:
Association, Inc.
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In response to the proposed Joint Powers Agreement and the Final Report, the
Professional Employees' Association has identified the following concerns. Although the issues
we raise are often inseparable from one another, we have attempted to break down our concerns
into four general areas. These areas of concern represent the issues that need further development
and specific answers. Without more certainty and clarity, we oppose the merger as proposed by
the city and county authors of the Joint Powers Agreement and the Final Report.
GOVERNANCE
One of the most critical aspects of the city's proposed Joint Powers Agreement
(hereinafter JPA) is the abdication of authority over the city's public health care. Despite the
dual-agency approach, the proposed JPA clearly states that "[t]he Ramsey County Board of
Commissioners shall have all governing and decision-making authority with respect to the delivery
of services set forth in II.B.1 and 2, ...." 7PA Draft, III.A. p. 5.
Those services that will become the sole responsibility of the county inciude, but are not
lunited to, the following:
- Epidemiology/Disease Investigation and Control
- Childhood lead prevention program
- Preventive Medicine/Refugee Screening
- HIV/AIDS Services
- Seaually Transmitted Disease Control
- Tuberculosis
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- Immunizations
- Communiry Clinics
- Women's Health
- Dental services
- Nutrition counseling and services
- Families in Crisis/House Calls
The city is willing to relinquish its control over these services and abandon its commitment to
these eatremely successfui programs. In turn, the city leaders haue agreed to allow the public �
health needs of our citizens to be addressed 6y a larger govemmental agency with less proven
experience in these programs. The proposal hands over nearly 150 yeazs of public health service
e�erience to the county. It approaches the merger implementation in hopes of passing ta�c levy
burdens to a more remote county agency. The proposal is also offered as a tenuous measure to
better survive anticipated federal cats in the future. Such a measure is made at the expense of the
city's citizens' documented and unique health needs.
The city leaders provide doubtful assurances that the same level of services will be
provided after the merger. Although this might be true for the near future, a more realistic
statement would admit that the service would remain the same untiI the county department of
health perceives changes in the larger community's needs. The county would then be at liberiy to
reduce or alter the services during every budget review. Thereby leaving some of the city's most
valuable and critical services at the disposal of the county's budget perspective.
Another concern with the proposed 7PA is the transference of these basic human needs to
another, higher level of govemment. At a time when big governments are pointed out as
burdensome and bureaucratic, this proposal attempts to further remove the solutions from the
probiems. It cannot be disputed that the counry will have more constituents to answer to and
more public health needs than ever before. But it wi21 also be lacking the experience and history
that has successfully met these needs by St. Paul's public health department.
The governance proposals also fail to address the myriad of personnel problems that will
result in such a drastic and broad merger. The conflicts will undoubtedly range from simple chain
of authority issues to the more complex issues of promotional rights, seniority issaes and
professional employee autonomy.
Personnel issues have been conveniently absent from much ofthe discussion regazding the
merger. The city has proceeded on the theory that the merger itself should be solidified before the
personnel issues are resolved. Yet it is health care providers, trained professionals and dedicated
employees who make up this agency. It is the personnel who can idenrify the specific problems,
create viable options and maintain the effectiveness of our city's public health department.
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SERVTCES
The JPA has not established a joint mission statement that is critical to any public health
department. Nor has it set forth a long-term vision or priority of services statement. Perhaps
even more important is a specific values statement. Leaders in the public health department have
stated that a clear determination of values drives the programs and specifies the broader mission.
These are imperative for decision making on budget issues.
W e are cognizant of the fact that all budgets, city and county, are at risk of suffering cuts.
Yet, no efforts have been made to delineate some services as high priority with a dedicated long-
term commitmern af maintenance. This alone is a threat to the health needs of the city which has
the majority ofneeds for disease prevention and control.
Also questionable is the fragmentation of public health services that aze already well
integrated with other proarams. Saint Paul Public Health has the ability to meet many needs of
clients at one location. Removing certain prob ams from the health department dangerously
unpedes this ability. For example dividing the lead program into two locations is taking a step
backwards and is contrary to the JPA's intention to streamline services.
Furthermore, there are extreme demographic differences between the city and the county.
These differences require acknowledgment and further development to the unique and separate
approaches to each of the municipalities' needs. Obviously the city has been aggressive about
obtaining grants to meet challenges as evidenced by the HUD �rants, AIDS programs, Hepatitis
B, TB outreach, women's health, house calls and immunization action plan just to name a few.
We are concerned that the grants previously dedicated to the urban core, with its concentrated
poverty, may be jeopardized by the JPA.
Another major concern related to the grants is the dilution of resources to finance
programs. The hands-on service providers believe the elimination of services will result when
resources and programs aze dispersed by the county. The intent and integrity of the programs will
be at risk when they are compared and prioritized against the greater needs of the County.
FINANCE AND BUDGET
Tf budget cuts are likely to occur in the future, the city, not the county, should be the
political entity malang the budget decisions. Since the city's citizens will suffer the greatest
impact by cuts, the city's elected officials are best suited to establish such priorities and satisfy
such obligations.
Additionally, the city has agreed to transfer the buildin�, land and equipment at 555 Cedar
Street to the county without any cost or obligation to Ramsey County. These assets aze extremely
valuable and have been bought and paid for by St. Paul's residents. We have been told that such a
transference is an incentive to get the county to accept the additional responsibility. The
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responsibility, however, will be met at the sole discretion ofthe county. We propose that in
consideration for such valuabie property and real assets, the county could at least guarantee that
high priority services (i.e. lead program, Immunization, STD clinics and disease control) ue
immune from eliminaTion.
There should atso be more discussion about the compatibility of the two agencies'
computer systems. Will the thousands of dollars invested in software and programm;ng be
merged to form a unified system of computer networks and databases? If they are to remain
separate because of logistics, it further highlights the need to maintain two separate public health
agencies. If the systems are to be inteb ated, then we must discuss the costs involved and the
interim risk to the clients who are cunently being served.
The JPA also provides that the city has ajreed to assign its interest and obligations for
grants to the county. There is some uncertainty, however, whether all grants are assignable. The
JPA states that when a grant cannot be assignec3 to the county, then the city will contract with the
county to provide the services. If the grants or funding are delayed or interrupted, the county
would have a contractuai right to suspend those contracted services untess there is a express
agreement stating otherwise. The JPA does not offer such a provision. Also, there needs to be
clear understanding as to whether these a ants are provided on the condition that the grantee be
the direct provider of the services in question. If such a condition e�sts, the subsequent
contracting out could be viewed as an attempt to circumvent the conditions of the �rant, thereby
jeopazdizing the grant alto�ether. These are questions that warrant answers before the proposed
JPA is implemented.
Another concern about the future funding is the effect of consolidating the agencies and
creating one single grant recipient. While the 7PA authors have stated that there might be an
increased likelihood of receiving grants, no evidence or data supporting this contention have been
offered. It seems equally logical that a reduction in the number of grant applicants, from two to
one, will reduce the total grant dollazs. This would reduce the previous effectiveness of each
entity in receiving the necessary grant dollars.
UNRESOLVED IMPLEMENTATION ISSUES
For over 140 years St. Paul has been a leader in providing services to its citizens by
funding the St. Paul Heaith Department The St. Paul Health Department has received regional
and national recognition for its programs and staff Xet as merger talks continue, no one has
identified existing problems with the services offered, the proposed departmenYs mission, the
future program's goals or the commitment and dedication of the staff. The TPA's authors
disregard the idea that "if its not broken, don't fix it," stating further that proactive management
and statutory authorization support the idea of a merger.
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The authors of the proposed merger have failed to recognize the probable lon� term risks
associated with the merger. Consolidation of resources into the county is combined with a great
increase in the services needed. These increased needs will be addressed with limited resources
that will be facing eventual cuts. Those resources will be administered by the coz�nty accordinn to
the public health needs of the entire county. The unique and critical needs of the city will have to
vie against the broader and much different needs of the county for necessary resources. The only
questions remaining are which of the essential services will be ellminated and when.
wth these serious concerns looming, the 7PA authors have identified eleven (11)
unplementation issues that they propose will be dealt with after the merger decision is made.
These unresolved issues, such as creation of a mission statement, long-term vision, values, culture
and employee relations, need to be resolved before any new plan can be implemented. These are
the factors that define an agency. The city of St. Paul and Ramsey County citizens do not share
identical needs, therefore, this merger can only create serious uncertainties and potential
problems. All of these unresolved issues detrlct from the services St. Paul already provides.
CONCLUSION
The Professional Employees' Association welcomes a written reply to our response and
we urge the city officials to openly discuss these concerns in all future public discussions. These
concerns stem from the unansweted questions of our members and the apparent risks associated
with the planned merger. It is our desire to have all of these issues discussed and resolved before
such a proposed plan proceeds any further.
Respectfully submitted by
THE PROFESSIONAL EMPLOYEES' ASSOCIATION
on behalf of its members and the citizens of St. Paul
cc:
City Council member 7erry Blakey
City Council President David Thune
City Council member Michael Harris
City Council member Roberta Megard
City Council member Janice Rettman
City Council member Dan Bostrom
City Council member Dino Guerin
PEA Executive Board
County Board member John T. Finley
County Board member Susan I3aigh
County Board member Hal Norgard
County Board member Rafael Oertega
County Board member Rich O'Connor
County Board member Brenda Thomas
County Board member Dick Wendell
$/
OFFICE OF HUMAN RESOURCES
CIT'Y OF SAINT PAUL
Narm Catemars, Mayor
John Harrsilton, Director
400 Ciry HaU Amne.r
25 A'est Fourth Street
Saint Paul, MN 55102-1631
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Telephone: 612-266-6500
TDD/7TY: 612 -266-6501
labline: 6I2-266-6502
Facsimite: 612-292-7656
May 3I, 1996
Ms. I,aura Mylan
Mr. lvTike Wilde
PEA
372 St. Peter Street, Suite 301
St. Paul, MN 55102
Deat Ms. Mylan:
Thank you for sending your comments on the dra8 report and groposed Joint Powers Agreement,
merging the City and County Health Departments. Your letter will be published in the Snal
report.
In response to your Ietter, I offer the following:
Governance
The City will relinquish its authority over the provision of certain public heahh services.
The County Board will be accountable for public heaith policy and the County Public
Health Department will be accountable for the provision of public health services. The
same City employees who provide public health services now will provide those services
after the Joint Powers Agreement (JPA) is signed.
The terms of the 7PA require that services will not be reduced by virtue of the 7PA
Recognizing our timited abitity to la►ow what the future will bring, the 7PA says that
cuirent services will continue unless the Sairn Paul-Ramsey Community Heaith Services
Plan is amended or changes in funding or suthority necessitate a change in the budget. It
is also understood that a change in community aeeds could result in a change in the level
of services provided, but would not result in an arbitrary reduction of service Ievels. The
City will, as the JPA requires, have significant input irno these decisions.
Your letter implies that the JPA's purpose is to `Yeduce or alter the services during every
budget review. Thereby leaving some of the City's most valuable and critical services at
the disposal of the County's budget perspective." No facYs, however, are offered to
support your assertion.
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PEA
Page 2
May 31, 1996
Furthermore, there is a positive lustory of the City turning over services to the County
(e.g., welfare, corrections, courts). Those tcansfers form a basis for believing the merger
of the two Public Health Depaztments will be successful. Courny Board members, like
their City Council colleagues, are elected to represent their constituern's i�erests. Saint
Paul residents already elect four County Commissioners.
At the outset of the merger process, Public Health staff were informed of the process and
how it would function. Similarly, their bargaining representatives were informed that a
policy proposal would be prepared and submitted to elected officials. The effects of that
poficy decision upon employees, they were told, would be discussed and, if appropriate,
negotiated after the policy decision was made. Periodic updates were given to the staff
and their representarives. Finally, staff from both agencies observed the work of the
merger team.
This does not imply that personnel issues are not important. Staff from the City and the
County have been working on personnel issues and have begun meeting with the
employees' representatives. Resolution of personnel issues is not a pre-condition for
moving forwazd on the policy proposal.
Services
A draft mission statement has been developed by the City and County managers. In
addition, there is agreement that the County supports the City's value statement. The
draft mission statement will be distributed to staff for their input with a finai version by
the end of May. It will be published in the Final Report.
The statement of priorities for services exists in the 1996-1999 Saint Paul Ramsey County
Community Health Services Plan. The listing of services in the JPA is linked to that plan.
If there is a shift in need, which affects the service priorities, the 3PA provides a
mechanism for amending the plan. Services are and will be based upon community needs.
We do not expect the JPA to resuit in fragmentation of services. For the immediate
future, having the Housing Code Enforcement Inspectors remain at Public Health will
alleviate concems of the Lead Program being split.
We do not have data which suggests that grant resources will be diluted. We do not
expect that resources and programs will be dispersed by the County; nor do we e�cpect
that City programs will suffer when they are compared and ranked with the needs of the
County.
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May 31, 1996
Finance and Budget
Four County Commissioners are elected by City residents. That makes them, lust like City
Councflmembers, accournable to the City dectorate. If service cuts are nceded in the
future, the County Commissioners will be just as able to make those decisions as City
Councilmembers. (We are unaware of the data which support the assertion: "Since the
City's citizens will suffer the greatest impact by cuts...")
The transfer of ownership of the City's Public Iieslth building makes sense as Part of the
merger package (i.e., services will be provided at the Public Health bu�ding, the County
will be respons�'ble for managing setvice delivery, the County will assume the conntywide
tax ievy for funding City public health services, tt►e County will assuma the respons►'bility
as the Board of Health). The estimated market value of the site is 52.5 million. The
estimated repiacement vatue of the site, building and contents is $4.8 million.
By wnveying the ownership, the City's balance sheet assets will decl'u►e and the CountY's
balance sheet assets will increase. The County will realize no direct financ►al benefit unless
the site is sold. In thaz case, the cost to relocate and replace the services (land, building
and contents) would still be greater than the market value. From another perspective, if
the annual levy is transferred to the Courty, City taxpayers will save $1.0 million per year.
ARer three years, taxpayers would have saved $3.0 million, more than the market value of
the site.
Computer systems issues are implementation details. In the short term, the two systems
will stay separate. In the long term, changes will be made based upon the work of the two
staffs. It is expected that equipment enhancement will take place according to the
County's replacement schedule.
At tivs writing, all grants, received from the lv�innesota Department of Health, are
assignable as long as the M�nnesota Department of Heatth agrees. The County's
budgeting practice is to reciuire that a cash flow treserve e�osts for all activities. In the case
of an interrupted grant cash 9ow, the reserve should handle the problem. ln most cases,
there is no overlap or duplication in grants received by the two agencies. Where there is
duplication, those grants are based upon population. Combining the two agencies would
not change that fact and there should be no decrease in Srant fundin8 based upon the
merger.
Unresolvad Implementation Issues
The purpose of the merger is not to fix something that is broken or to Sx a problem. The
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May 31, 1996
purpose of the merger is to: provide for better coordination and flexi'bility in meeting
public health needs; create an agency which builds upon the strengths of the talented,
dedicated personnel in both departments; more equitably distnbute the cost of providing
public health services to the residents of Saint Paul and Ramsey County, and, better
positions the agency to respond to threatened budget cuts and program changes.
No data sowce is given for the assertion that "consolidation of resources irno the County
is combined with a great increase in the services needed." If the City does have "un'sque
and criticai needs," then, uniess the County has similar unique and critical needs, there
should be no reductions. Merging the two agencies should better position them to provide
health services in the face of reduced resources.
The Resolution approving the Joint Powers Agreement has been placed on the 7une 5 City
Council Agenda. The Council meeting begins at 3:30 p.m. and will be held in the City Council
Chambers (15 W. Kellogg Boulevard, St. Paul).
Again, thank you for your comments and participation in the community review process.
Very truly yours,
C �_,L� ���i2�G�
Peter Hames
City of Saint Paul
Innovations Director
SS
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1V�INNESOTA AFSC1Vj,E CDUNCIL N0.14
'��� �:�:_�::,
� 30o Hn�n�.aN AveNOe Sijo�i'`• Stn're 2 '
SOU77i SAINT PaUi. MINNES07'a �5075-2469
�[�elw C.It1e.r
�EHO�lLlf1lM �IYFA
Peter Hames
Director of Innovations
400 City Hall Annex
25 West Fourth Street
St. Paul, MN 55102
Dear Mr. Hames:
(612) 455-0773 �Rdf (6{�?,`;}SS�F�il ' ,_ �..
May 4, 1996
On behalf AFSCME I,ocaLs 1842 and 2508, We woutd like to inform you of employees conceras
and reservations about the proposed "mergei" of City and Courny Health Departments. After
cazefulIy reviewing the proposai, employees find it seriously flawed in its failwe to protect very
important services to Ciry residents.
We have attempted to identify below as many of the design defects as possffile.
1. The proposal is a Joint Powers Agreement in name only. The proposal enables the
City to shift responsibiliTy, while avoiding future accountability, to Ramsey County.
Joint Governance will consist of City "input", while the County makes decisions on
taxes, types of services and the level of services to be provided. The most under-
served, under-represerned, most vulnerable poputations of the City would see their
services put in jeopardy. The heatth condition of St. Paul residents will be threatened.
2. The plan is incomplete. Appendiaf B of the REPORT identifies integral
unresolved issues. It would seem impossible to make an informed decision to
support the proposal unless these issues aze resolved before rather than after
policy makers are askec3 to vote on the proposal. Appendix B states "The
Group opted not to resolve these issues umil after the City and County elected
oflicia(s have made their policy decisioa regarding merger." It appears because
City and County managers are either unwilling or unable to resolve these issues
it will be 1eft for Coumy officials to decide once they have obtained controt.
The "issues" that have not been agreed to are very substantive. Some of them
are concems such as:
• Ivfission ofMerged Agency
• I,ong Term �sion of Merged Agency
• Values of Merged Agencies
• Methods of Providing Public Health Services
• Relationship of Merged Agency with the City
It can only be concluded that City and County Management have been unable
to agree to priorities and goaLs for a merged agency. If the two management
groups have been unabte to resolve such "boiler plate" issues in advance of the
County's acceptance of "all governing and decision maldng authority with
Sfo
s�
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respect to the delivery of services...", then Counry managers will decide
afterwards.
3. Commitment to maintain services are not supported by the Agreement.
The 7oint Powers Agreement states:
Seivices ... shall not be eliminated or reduced as a direct result of this
Agreement, except:
i. After compliance with the statutory process for
amendment of the plan, or
2. Through budgeting processes.
These two exceptions leave huge loopholes enabling the Counry to make almost
any decision it wishes regarding services with only "inpuY' from the City of St.
Paul.
4. A tax increase for suburban Ramsey County Taapayers to support
Services restricted to the City limits ignores political realities. Even if the
County Board were to support the initial 1.9 Million dollar tax increase, would
Board members be abie to support future increases to maintain those services?
It appears that in the four weeks since the proposal was released suburban
County Commissioners are much more concemed about tax liabilities than
responsibility to maintain services.
Inequities between City of S� Paul services and those available to the
remainder of the County will threaten the maintenance of ezisting
services. County Commissioners will be pressured to either eatpand City
services to the rest of the County, which will likely be unaffordable, or reduce
services in the City. Diluting current services by dispersing them throughout
the County will reduce the level currently provided to City residents, unless
tases are raised to adequately fund eapanded setvices.
6. The proposal establishes no system of accountability. When decisions are
made affecting funding, level of services, who is to receive those services and
even which services to offer; who will be responsible?
It has been claimed that "single point accountability" is a significant advantage
derived from a merger, while it is also asserted that the City maintains control
over services it yields to the County. It can't be both ways.
Where is final authority to decide which services to provide? What level of
services to provide? What the tax rate will be for providing health seivices?
• Ifthere are complaints, who responds?
57
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• If an unforeseen health need arises within the City, how will a timely and
appropriate response be decided?
• Would the Courny play a role in negotiating Collective Bargaining Agreements
for City employees who perform services for residents outside the City limits?
• Would a County manager have suthority to adjust a grievance of a City
employee? If so, what is the nature of that sixthority?
7. Some programs may have to be pnt out for bids eliminating continuity of
service and causing the layoff of ezisting employees. The City-operated
Women Infants and Children's Nutrition program and perhaps others cannot
legally be simply transferred to Ramsey County. Replacemern of the City as a
Vendor requires that other potential providers be permitted to offer competing
bids. It would seem to be counterproductive to put the curreni lrighly utilized
and very effective program at risk of a takeover by an outside organization.
8. Grants currently funding 80% of St Paul's Pablic Health services may be
jeopardized by this merger proposal. When questioned, managers who
drafted the JPA and Merger Report, have been unable to offer assurances
regazdin$ the transferability and/or eligt�ility requirements if the County
became the grants administrator. Aithough employees idernified ttris concem
for grants 6 months ago, little research has been done or specific information
provided. Will the County with limited experience in these azeas be able to
maintain the City's momentum?
9. The City of St Paulloses leadership of a Public Health professionaL It is
the Director that has developed St. Paul Public health as a nationally
recognized model for many programs. It is tlus historic leadership that has
assured the City will be able to protect the health of its residems and that many
valuable progams aze funded by State and Federal garns reducing the impact
on local property tax payers.
10. Giving away a 2.5 m�lion dollar building located on prime rea!-estate
with little assurance of continued use slso seems shortsighted. The County
gains the building, contents and real estate while aiso receiving authority to
discontinue services and/or relocate services.
11. It is ezpected that there will be 2,000 or more South East Asian refugees
arriving in S� Paal this snmmer (199�. The City is most experienced and
best equipped to address their nceds. How much does continued examination
and debate of the merger issue detract from the need to be prepared to serve
and meet Yhe needs of these �pected new residents?
12. The "Merger Report" provides no iadication of increased
from a merger. Tt seems likely that there would be some
either the City or County would have to assume these costs.
will be a need for:
costs resulting
additional costs;
It is likely there
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a. a lughly paid manager to direct adopted City services
b. purchase of a compah'ble Computer system
c. stafftime for,
• developing proposals
• selling the plan to the public and politicians
+ resolution of u�esolved issues from Appendix B
• implementarion
• resolving disputes
• lost time traveling beLween Department Offices
• relocation costs to move housing code and other relocation in the
future
13 Programs that are currentlp coordinated and located at Public Health will
be fragmented and dispersed. Housing Code now coordinates with lead,
Homeless and Aouse Call programs. Plans are being made to relocate Housing
Code enforcement in the event of a merger of other services. In addition
House calls will become a County function with new reporting relationships.
Coordination between Housing Code and Health programs for the Homeless
will also be disrupted. Lab services may be less accessible to programs that
remain with the City, but moved to other locations. Years of planning with the
St. Paul Public Schools toward collaborative efforts were realized with a
successful mantow� screening program during school year 92-93. From that
effort developed an effective, on going, coordinated immunization and
mantoux program for students new to the District. The District and City
cooperate on other programs such as dental screening as well. What steps have
been taken to maintain the St. Paul School District's relationship to Public
Health Services while considering the County's jurisdiction which includes
several school districts?
14. The County traditionally refers clients in need of inedical care to private
health clinics and has avoided most direct medical care. In the past
Ramsey County has denied reimbursement for clinical services provided by the
City for suburban Counry residents, and since 1990 has refused to arrange for
payment. This proposed merger is the only evidence that the County may haue
shifted from that philosophy. How can one accept that the County has
suddenly made a sincere commitment at this time? This uaditional lack of
County support for direct care is another factor that makes this mamage seem
one of convenience. The bride provides a valuable dowry and the goom
promises future support with no real obligation.
I5. Employee personnel issues identified during summer 1995 in focus groups
and on a list provided to management by the Unions have still not been
addressed. Deciding to merge before these issues are resolved through good
_ faith wllective bargaining leaves employee's future rights, opportunities,
benefits and wages in doubt.
16. With sll of the above weaknesses in the plan there xre no proposed
service improvements that would result. As William Rouse, Of AFSCME's
s9
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Deparnnent of Research and Collective Bazgaining Services, in Washington,
D.C. has said:
If the merger does not result in service improvements or
reduced costs, one has to wonder why the consolidation is being
considered. Clearly, there must be "unofficial" plans to art
services and/or costs, or the findings of the final report, and the
wording of the JPA, would have been more speciSc.
The cost sa�ings appear to be either negligible or nonexistec►t when
increased costs ideatified in No. 12 are also considered. There appears to
be no service improvemerns.
Employees have been esttemely frustrated by theer exclasion from the pianning process.
Employees who have committed their careers to maldng St. Paul Public I3ealth effective
for the benefit of the City's residents have been left to a roIe of reacting and fioping some
one will pay attention. This reactionary role becomes even more fiustrating when
reviewing the proposat and while watching its developers try to sell it. Employees know
that had they been included, adequate considerarion could have been given to the needs of
individual programs, recognizing their reliance on grant funding, their urterdependence
and future political impacts.
The sales pitches observed at Community meetings and before the St. Paul Ramsey
Community Heaith Services Advisory Committee have been scary. wth �o supporting
evidence, we are to believe Ramsey County is now committed to programs it has not
supported iu the past; in fact support services it refuse@ to pay for when asked. Are we
to believe that suburban interests and the popuIation (political power) shift to the suburbs
will have no impact on the County's ability to financiaily support necessary City health
services or commitment to maintain services? There has been no recognition that some
City services will either be reduced by dilution to meet Couniy wide demand or as a result
of inadequate fivancial support. We are also eapected to believe the County will suddenly
become eacperts in providing services they've never provided before.
The management planners and promoters haue finally acknowledged a possible risk to
grant funded programs, but cavalierly dismiss the danger by saying if a grant program is
jeopardized Yhe City couid keep it. There has beea no research and reporting done to
show immediate consequences or long term impacts of a merged agency on any of the
grants. This response igaores the intertwined relationstrip of programs at public health. If
eighty percent of the cost of the City's Public Health services are funded by grants, why
have grants been treated as an afterthought? It would seem that the ability to maintain
grants would be a precondition for any merger.
The Ciry and County managemern advocates of the proposal also suggest that if things
don't work as planned the parties could easily revert back to a City Heaith Departmern.
They have even suggested that a monitoring system might be in ptace to evaluate whether
goals were being met. It needs to be recognized that it will be ne�ct to impossible to return
these programs to the City. The human and physical infrashvcture will be gone, the tax
savings will need to be politically defen@ed and those who ate hurt will be voiceless,
disenfranchised residents, especially the City's children.
b0
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lC� J��
We do believe there is value in greater cooperation and collaboration between the two Health
Departments. We also believe that the talents, skill and knowledge of City employees and other
stakeholders should be utilized in developing opportunities for enhanced cooperation. Therefore
it is our recommendation that a new planning group made up of stakeholders be established to
develop a plan for improving the health of Ciry and Coumy residents through improved delivery
of health services. Unlike the management proposal, a new plan could be designed to improve
health caze and other services.
S' erely,
�������
Robin Madseq President
AFSCME Local 1842
��,� � ,
Cheryl O'Regan, Presiden
AFSCME Loca12508
cc St. Paul City Council
Ramsey County Board
CHS Advisory Committee
Mike Wild
�r
OFFiCE OF HUMAN RESOURCES
CITY OF SAII�iT' PAUL
Norm Coleman, Mayor
John Hamiltors, Director
400 Ciry Hall Annu
25 West Fourth Street
Saint Paul. MN SSIO2-I63I
�� ����
Telephone:612-266-6500
TDD/TTY: 612-266-6501
Jobline: 672-266-6502
Facsimile: 612-292-7656
May 31, 1996
Robin Madsen, President
AFSCME Local 1842
Cheryl O'Regan, President
AFSCME Locai 2508
300 Hardman Avenue South, Suite 2
Soath St. Panl, MN 55075-2469
Dear Ms. Madsen:
Thank you for sending your comments on the draft report and groposed Joint Powers Agreement,
merging the City and County Health Departments. Your letter will be published in the final
report.
In response to your tetter, I offer the following:
1. There is a shift in accountability to the County. Saint Paul residents are the
constituents oF County Commissioners and can hold them accountabte just as they
hold the Mayor and City Councilmembers accountable. Further, we expect that
Saint PauI's eIected officiais will, if necessary, be advocates to the County
Commissioners.
2. At the outset, the plan was to frame a policy issue for the Mayor, City Councii and
Counry Board. That approach has been widely communicated. The maziagement
issues are signiScant, but they should not drive or impede a policy decisioa A
mission and value siatemem has been drafted and is being given to staff in the two
agencies for their input. It should be completed by the end of May. It will be
published in the final report.
Merger implementation teams will be established within the two agencies to
address the issues contained in Appendix B. The strategy, which is being pursued,
is done in recognition of past processes; moving forward, in a timely manner, is
one of the merger group's goals.
The JPA is a contract between the City and the Cowrty. In order to respond to
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AFSCME
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May 31, 1996
those who were concerned that the merger would result in a reduction of services,
language was written tbat services would not be eliminated or reduced as a result
of the agreement. If the terms of the contract are not followed, the County will be
in breach of the wntract. The exceptions listefl in the JPA reflect the realities of
govemmental financing in the 1940s. If the merger does not take place, there is no
guarantee that services will not be cut. Lintdng any future changes to
amendments to the Community Health Services Plan, insures that County
decisions should be based upon community needs. Finally, we expect that Saint
Paul o$icials will continue to be advocates on behalf of their constituents.
4. T'he tax increase for suburban property owners, depending upon location and home
valuation, will range from less than two cents a day to seven cents per day. These
annualized costs range from $3.13 to $26.75. This t� increase is both
understandable and justifiable: it will result in all County residents paying one tax
for public health services. The rationale for paying for services for the neediest
people at the level of government with a broader tax base has been in place for
many yeazs. It is reflected in the moving of welfare, healthcare, and conections
services from the City to Ramsey County. This focusing of public heatth services
at the County level also exists with the development of hazardous waste generating
licensing services and solid waste planning and management within the County
Department of Public Health.
5. There is no evidence to support the opinion that the demand for public health
services will increase because of the merger. Currently, non-Saint Paul residents
are served by the City's Public Health Division. Even residents who live outside of
Ramsey County are served. Changing the funding base for these services should
not tesult in an increase in service demand.
6. The JPA makes it clear that the County, through the JPA, will be accountable for
the provision of public health services. Under the JPA, the scrvices to be provided
are identified and the currern service level, according to the JPA, is to be
continued. An estimate of the property tax rate, for providing services under the
7PA, is provided in the report. Based upon current circumstances, the City will
terminate its levy for $1.8 million (the property taaces which support the general
fund) and the County will raise, on a countywide basis, the same $1.8 million.
The current avenues for responding to complaints will also exist under the TPA.
For e�cample, residents can call the Saint Paul Public Health Department or the
Citizens Service Office. Those avenues will remain open under the 7PA The
difference is that ultimate management accountabi(ity will rest with the County
Director of Public Health. If an unforeseen health need arises within the City, the
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AFSCME
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May 31, 1996
same decision-maldng process as exists today should exist under the JPA The
only difference, again, is that ultnnate management accountability will rest with the
County Director of Public HealW.
Under the JPA, City �►ployees wilt remain City employees and will be govemed
by City-negotiated bargaining agreeme�s. We expect tbat the Couaty would play
a role in the negotiation of firture agreemems. With respect to a Coumy manager
adjusting the grievance of a City employee, no such authority arists undec the
current bargaining agreements. We expect this type of issue w�l be negotiated
with the bargaining representatives after the policy decision is made to merge the
agencies.
7. It is our understanding that ihis coacem, regardiag WIC, is not an issue for the
Ciry and the County. The circumstances in Mmneapolis and Iiennepin County are
different from those in Saint Pau1 and Ramsey County.
8. Both City and County staffs have been aggressive in seeldng and receiving grants
to provide public health services. We expect that aggressive grac►t-seeidng
behavior to continue under the merger. Our research indicates that all grants
received through the Ivfinnesota Departme� of Health may be assigned to the
County upon written approval by the State. We have no reason to expect that
written approwal wouid be denied. Our grants research, on assignability, will be
concluded before the City Council acts upon the JPA
9. We expect that the City and County sta� under the merged agency, will continue
the positive leadership that has been set by past Public Health directors.
10. The County wi11 assume accountability for the provision of public heahh services
on a countywide basis, will use 555 Cedar to deliver services and will assume the
property talc levy ($1.8 million) to fund public health services. It makes sense that
the Covnry have ownership of the building to carry out those responsibilities. 1'he
market value of the bu�ding is estimated at 52.5 million and the replacement value
of the building and contents is estimated at $4.8 mitlion. If one performs a break-
even analysis, using the annual savings to City property taxpayers, the market
value of the building will be recov�ed in fewer than three years and the
replacement value will be recovered in fewer tLan five years. Thereafter the
property tax savings will be unencumbered.
The State oflVlnnesota is currently searching for altemative sites for its
Department of Reveirue: 555 Cedar is a site under consideration. Relocating the
Department of Revenue to that site would have positive benefits for the downtown
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May 31, 1996
economy. If the site were chosen by the State, then the public heatth services
would tiave to be relocated. The eiureat draft of the IPA covers this corningency.
Conveying owners}rip of the building to the Courny is also consiste� with past
precedents when the County took over the services and facilities connected with
the merger of Welfare, Cornctions, Saint Paul-Ramsey Hospital and the City Hall
and Courthouse building.
11. We are looking to a speedy decision on the merger issue and are confident that ffie
staff, as they have in the past, will serve the needs of any new clients.
12. There is no expectation that any new positions will be created as a result of the
merger. Specifically, the City's Division Directot position will be left vacant. T'he
acquisition of equipment (e.g., computer system) will occur according to the
County's replacement program. At least in the short term, the Housing Code
Enforcement function will remain at 555 Cedaz. There will be costs incurred for
staff to participate in resoiving impiementation issues, developing proposals, etc.
These are "sunk costs," however, and wouid not be new e�cpenditures.
Consultants to facilitate the implementation of the merger may be new costs paid
for within the existing budgets.
13. For now, Housing Code Enforcement will remain at 555 Cedar. We expect that
the inter-program coordination that has developed will continue in the future.
That coordination should not be jeopardized by the organizational location of
some functions.
There have been contacts with the Saint Paul School District, as result of the 7oint
Property Tax Advisory Conunittee. As merger implementation issues are resolved,
more contacts with the School District will take place. In 1997, establishing a
relationship between the merged Health Department and the School District will be
explored.
14. It is no secret that the County Public Fiealth Department was designed to
complement, not duplicate, the Saint Paut Public Health Department. Tt►e County
does provide direct services which do not duplicate the City's direct services. The
City's success in getting other units of government to pay for the services provided
to their residents is mixed. At least in Ramsey County, that issue will go away
with the merger.
15. The focus of the merger team's work has been whether or not to merge the two
public health agencies. That focus was communicated widely to employees and
their bargaining representatives. The approach has been to first resolve the policy
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AFSCME
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May 31, 1996
issue and then discuss and negotiate the effects of that decision with employee
representafives. Discussions with those representatives have already been initiated.
Aad, the JPA cails for City emgloyees to remain City �ployees. As they ]eave
their public heaith positions, the posirions will be filled by the Courny.
16. The Srst item on the agenda is to make the policy decision to merge the agencies.
The second item is to discuss and negotiate the effects of the decision with the
employee npresentatives. The third item is a smooth implementation of the
merger. During that time, a 5100,000 savings wHl occur. That savings is an
ongoing savings. To the extent that costs ide�ified in No, i2 are real, those costs
will tikety be one-time txpenses versus the ongoing savings achieved by leaving the
City's I}ivision Manager position vacant. As the merged agency becomes fully
functional, we would expect to see service improvements.
As stated at the outset, the purpose of the merger is to achieve three goals:
�nproved Customer Service. There w�71 be no confiision among customers as to
who is responsible for the delivery of public health seivices. tn addition, the
merger will not result in reduced services. Over time, as fhe two agencies become
better integraied, we will expect service improvemerrts.
2. Financial Equity. By shifting the City property tax to a Countywide property ta�c
Ievy, City taxpayers w�l no longer pay twice for public health seivices. In
addition, leaving the Ciiy's Division Manager positioa vacant cviil save $100,000.
Similar mergers have taken place in the courts, wrrections, welfare, hospital and
City Hall and Courthouse building.
Responsiveness to CLanges in the Funding Environmert. The Joim Property Tax
Advisory Committee, charged with finding new ways for the City, County and
School District to increase the impact of tax dollars, has the merger as one of its
projects. The merger is also a response to the expected changes in Federal and
State policy and funding decisions affecting public health secvices.
The proposed merger docs not fit the typicat reasons for ini6ating change. At the moment, there
is no funding crisis, there is no scandal, there is no breakdown. The comeational wisdom would
conclude that "If it sin't broke, don't Sx it."
WhaYs needed, however, is less comentional wisdom. Recendy, taxpayers have sent a message
to their elected officials: do a better job in reducing ta�ces, streaniline govemmex►t bureaucracy and
improve customer service. Across the country, govemment agencies are responding to t6at
mandate. This merger proposal, the first of many to be undertaken by the Joint Property Tax
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May 31, 1996
Advisory Committee, is focused upon merging the two Health agencies. After the policy decision
is made, we will call upon our stalceholders to assist us in implementing the merger plan and
creating a Public Health agency wlnch is stronger than the two separate agencies.
The Resolution approving the Joint Powers Agreement has been placed on the June 5 City
Councii Agenda. The Council meeting begins at 3:30 p.m. and will be held in the City Council
Chambers (15 W. Kellogg Boulevazd, St. Paul).
Again, thank you for your comments and participation in the community review process.
Very Uuly yours,
�� �/ ,�► / �.
.
Peter Hames
City of Saint Paul
Innovations Director
67
6, 2,22¢9445
s�t ��
Building and Construction Trades
q�
Covncil
LABOR CENTRE, 411 MAIN STREET, ROOM 2Q6
SAINT PAUL, MINNESOTA 55102
��
May 16, 1996
Mr. Peter Hames
Director of Innovations
400 City Hall Annex
25 W. 4th Street
St. Paul, MN 55102
Re: Building Trades Response to Proposed Health Dept. Merger
Dear Peter:
In reviewing the "Draft" Joint Powers Agreement, I have one
concern, some comments and a suggestion.
The concern, on behalf of building trades members working for the
County, is that the draft indicates the County will do the
maintenance on buildings in the City. Currently, building trades
members do the maintenance in the Courthouse and Operating
Engineers Local 70 performs maintenance in the existing City-owned
Health Department building. I would like a clarification on this
to provide assurances to both unions that there will be no
conflicts or loss of employment to our members.
Aaving been at initial meetings regarding this issue, it was
understood that the City would do a determination study as to the
viability of any mergers and then discuss any proposals with the
unions to consider their positions and hear any concerns. It is
my hope that the approvals of the City Council and the County Board
would be "preliminary" and contingent upon resolving concerns of
the collective bargaining units. I do understand that some
meetings have been scheduled. I look forward to scheduling a
meeting on building trades' concerns.
I suggest that, prior to the City Council and County Board voting
on any "final" proposal, a joint meeting be held with the affected
collective bargaining units, representatives of the City Council,
County Board and the Mayor's office. This would be a great
opportunity for all parties to hear first hand information upon
which to base further action.
(08`
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May 16, 1996
Peter Hames
Page 2
Thank you for this opportunity to voice my comments.
S' er 1y,
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Dick Anfang
Executive Secretary
DA/df
afl-cic
opeiu#12
�04
OFFICE OF HUMAN RESOURCES
CTTY OF SA1NT PAUL
Norm Coleman. Mayar
May 31, 1996
John Hamilton, Director
400 Ciry Ha[! Annex
25 West Fourth Sneet
Saint Paul. MN SSIO2-1631
V�
Teleplwne: 612-266-6500
TOD/7TY: 612-266-6501
Joblirse: 612-266-6502
Facsimile: 6I2-292-7656
Mr. Dick Anfang, Executive Secretary
St. Paul Building and Construction Trades Council
Labor Center
411 Main 3treet Room 206
St. Paul, MN 55102
Dear Dick
Thank you for your May 161etter regarding the Building Trades response to the proposed Health
Department merger. It, along with other responses will be published in the final report. It is my
understanding that Mary Keamey has contacted you and the Operating Engineers Local No. 70
regarding your concem about maintenance of the City's Public Heaith building. In addition, she is
meeting with the other bargaining units (i.e., AFSCME, PEA, SPSO) that would be affected by
the policy decision to merge the two departments.
As you know, a number of ineetings with union representatives, community members and staff
have already been held. I suspect that there will be more meetings before any vote is taken. Your
idea for an additional meeting is an interesting one; however, I cannot promise that one will be
structured in the way you suggest.
The Resolution approving the Joint Powers Agreement has been placed on the 7une 5 City
Council Agenda. The Council meeting begins at 3:30 p.m. and will be held in the City Council
Chaznbers (15 W. Kellogg Boulevard, St. Paul).
Again, thank you for sharing your concems and suggestions.
Very truly yours,
� /
Peter Hames
Ciry of Saint Paul
Innovations Director
cc: Mary Keamey
Mark Shields
7�
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Append'u G "�� r � � �
Quesrions and Concerns from Four Community Meetings
7/
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CONCERNS AND QUESTIONS
COMMLTNITY MEETING
Apri125, 1996
How were the decisions made as to which services go to the County and w}nch stay with
the City? Speci&cally, why is the Lead program being split betareen housiag and medical?
Employee believes it is important to have the two together.
There is concem about housing code enforcement moving out of the Health building
because this employee works (as a social workerj closety with the housing code
enforcement staff. Concem with the County Boazd making final decisions. The County
has not shown an inclinaYion to provide funding support for City programs. For esampie,
employee works with the FORCE unit. The County said "no" to funding a social worker
to wor[c with the FORCE unit. Believes a social worker needs to be present after a
FORCE raid to take care of kids. Concerned about losing transportation. City staff
provides transportation to some of its clierns. The County does not and its nurses often
ca11 the City Health Department to arrange transportation.
2. Individual is concerned about services being reduced. He doesn't believe that the new
director will be comrnitted to public health services. Rob Fulton's background is in
hospital administration.
The Counry does not demonstrate a commitment to public heaith services. Room 121 was
turned down for funding by the County. Other attempts to have the County pay for some
services (e.g., TB, family planning) have failed. On the other hand, other Counties do pay
their biIIs.
What happens to services in the future if grant funding goes away? City residents have
speciai needs and she does not believe the County will respond to them.
4. Person doesn't believe that County customers (with special needs) are treated with
wmpassion by County staff.
5. Do we have information on how grants will be affected? It appears that no State grants
will be affected by the merger, but a deia7ed im�entory needs to take place. We should
establish a tracldng/monitoring system to insure that there's no adverse effect upon City
grants.
6. Stated he understands that the WIC progam had to be put out for bids when Mmneapolis
turned over its program to Hennepin County. (Unclear if this will be an issue here but it
does appear to be a State requirement.)
7oZ
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7. What happens if the County breaches the wrnract? Is there any language which calls for
some resolution of disputed issues (e.g., mediation)?
8. Concem that City services will be diluted when they are made available Countywide. Also
a concern that the County will be more concemed about keeping taxes down rather than
responding to public health needs.
9. A concern that City employees will be treated as second class employees under the
merger. Since there is no proposal for seniority, promotion, etc., it appears that City
employees will suffer.
Concemed about how confusing it will be having City employees supervising County staff
and/or vice versa.
l0. Individual stated that it is her experience that when people pay for a service they expect to
get that service. In the case of public health, some people do not make contributions
when they aze asked to help pay for services. Expanding City services to the County will
e�cacerbate that problem.
What system will be installed to insure that service levels are not reduced?
11. Why is it that the services being transferred to the County are all services for poor peopie
and the services being retained by the City (housing code enforcement, animal control,
etc.) are middle class services? This issue will come up over and over. Past practices
suggest that the County board has little concern for services to the poor while services to
the middle class are kept at the City level.
F:4IACAMMON�AAtdES�CONCERNS.425
2
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CONCERNS AND QUESTIONS
Community Mceting
Wilder Recreation Center
Apri129, 1996
1. Person stated concern that personnel issues were not included in the document and that
staff was not involved in the preparation of the report and the 7oint Powers Agreement.
They should have been involved from the stact and personnel appears to be an issue
which will be done after the fact.
She is concemed that union representatives were at the mcetings but were not active
participants. Again, these matters are being dealt with after the fact. It is important to
involve people who aze responsible for delivering services and they should have bcen
involved in the beginning.
2. The concerns raised in #1 have been a huge disappointment w the City Aealth staff.
Since they were not invoived in the process, they are afiaid to respond to management.
They are, however, preparing a detailed reply on the service issues.
Grants (80% of the City budget and 84% of the County budget) are significant funding
sources. Are you sure that there will be no problem in icansferring the grants to the
County?
4. Employee is aiso concemed about the ability of grant funds to be transferred from the
City to the County. She has read the federal conhact and does not see any language
there about "assignability".
5. Individual is concemed about solid waste as well. In the JPA it says "other solid waste
responsibilities" will be continued by the City. What does that mean? ThaYs in
addition to the City continuing its recycling prograzn under a separate contract.
6. Person is concemed that the passage of the Joint Powers Agreem�t could put political
pressure on Public Health to open more WIC clinics in suburban locations in an effort
to have "parity" in the number of City and County WIC clinics. (There aze currenfly
nine WIC clinics located within the City limits, and two in the suburbs. Tfris reflects
the fact that there are many more low-income women and clrildren within the City
limits.)
Since the WIC program already serves the entire County, passage of the 7PA should
not increase the number of suburban WIC participants and, therefore, should not
increase the need for suburban WIC clinic sites. The WiC budget is limited. In order
for WIC to provide effective, efficient service to the gre�atest number of paficipants,
the number of clinic sites must be limite�i to a reasonable number. Staff time, should
74I
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be used to provide direct client service (e.g., taking height and weight, drawing blood
samples, assessing the diet, providing nutrition education, maldng referrals to medical
programs, etc.) as much as possible. If there are too many small WIC clinic sites,
WIC staff will spend too much time loading suppfies into cars, driving w ciinic sites,
unpacldng supplies, setting up clinic, taldng down clinic, etc.
7. Since the WIC program already serves the entire County, why would there be more
customers? What do other counties (e.g., Washington, Dakota) do with their WIC
customers?
8. What happens to the City Nutritionist I when a City Nutritionist II retires? Will the
City person enjoy the same promotion rights, under the JPA, as they do now?
The City Council is concerned with public health services and wants to see them
continued.
9. If the personnel issues aze treated as "implementation issues" and there was agreement
that City staff could transfer to become County employees, would that be inconsistent
with the JPA which says that vacant City positions will become County positions?
10. One of the reasflns staff is concerned is because a colleetive bazgaining agreement can
only last three years. Even if agreement is reached on personnel issues, they still could
go away with the termination of the collective bargaining agreement. Tt�at azgues for
having a resolution or ordinance but staff is skeptical about how they would be treated
in an ordinance or resolution. They're also skeptical that a Joint Powers AgreEment
could be changed at the whim of the City Council and County Board.
A:�AACOMMONULIMES\CONCFRN5.429
7S
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DRAFT
CONCERNS AND QUESTIONS
COMMUNTTY MEETING
COMO LAT�SIDE PAVII.ION
MAY 6, 1996
1. Why would the County do this? It seems that there is no benefit in it for them and County
residents will have to pay for services for St. Paut residents.
2. Grants. The grants are not listed and have not been investigated. What happens if the
federat government, as it has recently, refuses to make grant payments2 What happens if
the benefit is for the City as a grant applicant and the County does not qualify for the same
grant?
In the ]PA where it says the City services will be provided for people inside the City, does
that mean that people outside of the City can't use them? Tf thaYs true, isn't this just a
chazade?
3. What about the people who are disenfranchised (i.e., poor people, immigrants, etc.)?
They don't know about this proposal and they don't vote in elections. How are their
concems going to be communicated to the County Board?
4. Isn't the County Board going to be insensitive to the needs of St. Paul residents versus the
desires of suburban residents? Tfiat is, won't Shoreview residents object to paying more
in order to have St. Paul residents receive public health services? Isn't this like the
suburban residents voting down a referendum to increase taxes to pay for schools?
5. What about the difference in philosophies between the two health departmerns? What
matces yo¢ think that the Counry has any interst in providing the ldnd of services that St.
Paul provides nov�? Won't this, over the long term, result in City services being cut
because the County Board will be responsive to subruban taxpayers?
6. Can't you negotiate a better deal for the public health building? It doesn't make sense to
give ii to the Counry and get nothing in return. You should make the County buy Yhe
public health building.
7. The JPA language does not guarantee that current services will be provided in the fut�ue.
The County has different priorities than the City and those priority differences will be
reflected in the Health budget (i.e., reductions in public health services).
8. Why is Yhere provision for the JPA to be terminated with six month's noYice? What
percentage of the City's budget is this $100,000 savings? Is there any history of a JPA
being terminated?
76
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9. Who initiated this process? Is there any interest on the part of the City Council and
Counry Board?
10. FTistorically, the City has tried to keep general fund dollars low and that has resulted in the
experience in gaining grants. Why don't you lmow whether or not the grants will continue
into the future? Why don't you know whether public heal;th will lose grant funds if the
County is the applicant?
11. If the WIC grant is transferred to the County, doesn't that mean that the renewal of the
grant will be put out for bids and anyone can appl� Will the grants issue be resolved
before the JPA is �ecuted?
12. Peopie perceive that you are giving away the Health building. You should be a better
negotiator and have the County pay for it. People don't understand this "break even
analysis" where City ta�cpayers will save an amount equal to or greater than the value of
the Heaith building over a three year period.
13. It doesn't make sense to compare Ramsey County-St. Paul with puhlic health agencies in
non-metropolitan counties.
14. How will service accessibility be insured if the public health services are moved from 555
Cedaz?
15. Who decided which services wili go to the County and which will stay with the City?
Why, for example, is food inspections staying in the City when the County already
provides food insprectors? There is a case where there is reai duplication. What about
the housing code enforcement inspectors? Aren't they all men? Isn't this a sexist move
that is going to hurt the pay of females?
16. Why are you splitting the Lead Control and Abatement progam in half? Shouldn't it be
kept together? It doesn't make sense.
17. Will you send us a notice of when tlris goes to the City Council and County Board?
Answer: Yes, I will.
18. Why are you going to all this trouble if the savings for City taxpayers is so small?
19. The only reason this is being done is because it's the Mayor's campaign promise and
because he's against AFSCME.
F:IAACOMMONUtAMES�CpNCERNS.056
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COMAZUNITY MEETII3G
C013CERNS ArID QUESTIONS
MAY 9, 1996
EL RIO VISTA RECREATION CENTER
1. It is misleading to say that there will be a$100,000 sa�ings achiev�
attempt has been made to identify start-up costs (e.g., computezs,
2. How much money has been sPent studying merger proposals in the past? Tt►e cost of
preparing this proposal should be documented.
3. What happens if those involved in the 7PA change? How do we know that the services
will continue to be the same under a renewed JPA?
4. The personnel issues should be resolved before the JPA is approved and e7cecuted.
5. City Public Health nurses can transport parients to their appointments. County Public
Health nurses can't. Will this change under the 7PA?
G. If the City and County both receive funds under the same grant program wil1 the3' be able
to do so in the future? If they can't, where will the lost revenue be made up2 Will it be
ethical for the City and the County under the merger, to both apply for the same grant
funding?
7. The County's different philosophy will cause problems for the merged agencies. The
County has not financially supported, for example, the STD Clinic. This shows that the
County is insensitive to the special needs of Ciry residems.
8. County ta�cpayers are also insensitive to special needs of City clients. The County Board
will respond to those taxpayers and will reduce services under the merger. City residents
will suffer.
9. Employees are wncerned that they will be treated unfairiy because they have voiced their
concerns and raised questions regarding the proposed merger.
10. Why is the Lead Program being split off from Public Health? The housing inspection and
medical lead programs need to stay together.
11. Why is the City retaining the housing code enforcement, animal control and lead
7 8'
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inspection programs instead of giving them to the Counry?
12. People who live in St. Paul understand the need to share the costs of providing public
heatth services to people with special needs. People who live outside St. Paul do not
understand those needs and are unwilling to pay for them
F:IAACOMMON�HAMES�CONCERNSA59
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79
OFFICE OF HUMAN RESOURCES
CTTY OF SAINT PAUL
No�m Coleman, Mayor
lohn Hami[ton, Direcror
400 Ciry Hall Annex
25 West Fourth Street
Saint Paut, MN 55102-1631
�C� �`��3
Telephone: 612-266•6500
TDDl7T3': 612-266•6501
Jobline: 612-266-6502
Facsimit e: 612-292-7656
May 30, I996
Ms. Zora Radosevich
275 Cecelia Place
Saint Paul, 2�nnesota 55105
Deaz Zora:
At the Cammunity Health Services Advisory Comtnittee's May 1 meeting, a number of
issues and concems were raised by Committee members. I thought it would be useful to
respond to those issues and concerns before the Committee's June 5 meeting. I hope the
following will facilitate your discussion:
1. Long-term Vision. The genesis of the current merger proposal can be
traced to the 1991 creation of the Ramsey County Local Govemment
Services Study Committee. The Committee was established by the
legislature and among the subjects they reviewed was the merger of the
Health Departments. Although the Committee voted not to merge the
departments, a minority report was filed. This report urged that, among
other things, City and County Iieaith Services be put out for bid on a
regular cycle.
In 1993, the legislature created the 7oint Property Tax Advisory Committee.
The Committee is made up of three representatives each from the City of
Saint Paul, Ramsey County, the Saint Paui 5chool Boazd (ISD No. 625)
and an ex officio member representing the Ramsey County League of Local
Govemments. One of the purposes of the Committee is to foster new
service delivery relationships. The criteria for selecting joint projects aze
attached (Attaciunent n.
The merger of Health Departments has been an agenda item for the
Cowmittee since its inception. The merger group began working last fall in
response to the Commiitee's directive.
The Public Health merger and the work of the Ioint Property T� Advisory
Committee need to be piaced in context. At the federai level, the voters
sent a message to Congress that fundamental changes had to take piace.
While people may disagree with the results that have been achieved so far,
C;�
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Ms. Zora Radosevich
May 30, 1996
Page 2
there is no doubt ihat changes bave taken place and that more are to come.
The national agenda has tiuly shifted. And, one item on the agenda is
cbange in the health caze industry.
Ai the State level, sim�ar demands for change are being made. The Weber-
Brandl Report, in response to a forecasted State revenue shortfall, has
recommended major changes in State government. At the same time, there
is littte doubt that the State's property tax system must undergo change and
change will probably be uutiated during the ne� legislative session.
The ct�ange in the property taafation system may also complement the
demands for changes in ihe State's system of aid to local govemments. To
illustrate the potential impact for the City of Saint Paul, consider that state
aids ($63 million) aze a lazger generai fund revenue source than property
tases ($44 million).
As strategic planners, we have leamed to look at our external environment
for threats and opportunities and at our organization for strength and
weaknesses. Eactemally, the threats are cleaz: outside revenues may very
well be decreased and taxpayers want changes in the way that government
pays for and delivers setvices. The proposed Heatth merger is an
appropriate zesponse to ihe demands foz change being eacpressed in ow
extemal em�ironment.
We experience difficulty, however, in creating opportunities. Too often our
attitude is "if it ain't broke, don't fix it" This attitude complements our
problem-solving approach to public policy. Only recenfly have we begun to
ask ourselves to create opportunities by finding better ways to do things.
And, since noYhing is perfect, there will always be ways to make
improvements.
Tfie City and County Public Health Depaztments are not broken. And,
merging the two agencies creates an opportunity to do a better job of
providing health services. Merging the two agencies wi11:
Provide for better coordination and flexibility in meeting health
care needs, with a single point of entry for public health services.
Create an agency which baiids upon the strengths of the talented
and committed personnel in both departments_
g1
Ms. Zora Radosevich
May 30, 1996
Page 3
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More equitablq distn'bute the cost of providing public heaith
services to the residents of Saint Paul and Ramsey County.
Position the agency to better respond to the changing climate in
health care delivery.
2. Grants. Both the City and County EIeahh Departments have a successful
record of aggressively pursuing grants as a way to fund the delivery of
public health services. The success of these grant-seeking efforts is
reflected by the fact that the property tax, as a funding source, makes up
oniy 20 percent of the City's Health budget and 16 percent of the County's
Health budget. There is no question that grants will be aggressively pursued
under the merger.
Last fall, the merger group did a brief review of the grants that the City and
County Fieaith Departments received. Now we are undertaking a detailed
review to detennine if grants received by the City can be assigned to the
County under the 7oint Powers Agreement. The City receives a total of 2S
grants (Attachment I�. Of that number, we have reviewed 19 of them.
Grants with the Ivfinnesota Department of Heakh have a provision that they
may be assigned to another entity as long as the written consent of the State
of 2vfinnesota is obtained.
3. Nfission Statement. A draft mission statement, consolidating the mission
and statements of the City and County Health Departments, has been
prepared and taken to the staff of the two agencies for their input. A copy
is attached (Attachment III).
4. Costs to Impiement the Merger. In the short term, additional costs to
implement the merger shouid be minor. These would include, for example,
use of consuhants to facilitate merger implementation. Over the long term,
costs could be incurred for new personal computers, staff development and
training, phone system, etc. Equipment will be replaced based upon the
County's replacement schedule.
5. Service Measurement. A service measurement system already exists. Those
measures are annually reported to the Committee, the Mayor and the City
Council. These include the CHS Pian monitoring, the annual budget's
measures and the annual CHS report to the state. In addition, the Citizens
Service Office has been 3sked for a four-year history of Health Departtnent
%�
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Ms. Zora Radosevich
May 30, 1996
Page 4
complaints.
A potential measurement device would be to ask customers to evaluate
services now and after the merger takes piace. Your Committee may have
additionat thoughts attd/or advice on the necessity of establishing such a
system and how it could be done.
6. Outcome Tracldng. The assessment for public health services was
completed as part of the Saint Paul-Ramsey Couniy Community Health
Services Ptan. The Plan and iu implementation are part of ongoing efforts
to monitor public health status.
Tf you have any additional concerns or questions, please let me know of them. My
telephone number is 266-8799.
Very tnily yours,
Cil���
Peter Hames
Attachments
cc: Community Health Services Advisory Committee Members
Rob Fulton
Diane Holmgren
Neal HoItan
7ane Norbin
Mark Shields
Ivfichele Timmons
E�uas�Lames\muoa�Sealth\CHSAC3
D'1
Qt�- 5�3
Attachment I
Joint Property Tax Advisory Committee
Joint Efforts Suhcommittee
Joint Efforts Recommendations
I. Recommendations
The Joint Efforts subcommittee of the Joint Property T� Advisory Committee submits its
recommendations to the Committee for the joint efforts initiatives that will be endorsed by the
Committee for implementation. Although the Committee's original resolution specified ten
initiatives, the subcommittee has actually identified fourteen recommendations, which are listed
below.
New Initiatives:
Dayton's BluffRecreation Center and School Facility: Combined Usage
2. Joint Management of Fleet/Equipment
3. 7oint maintenance of facilities and grounds
4. 7oint purchasing of fleet/equipment
5. Altematives to Incazceration
Initiafives In Progress:
6. Tmancy center
7. Health department merger
8. Libraries (consolidation of administrative functions}
9. Worl�'orce development
10. Communications center/emergency dispatch and records management
11. 800 megahertz project
12. Economic development
BS
13. 7oint use of recreation centers �� � ��� �
�.e
14. Joint design and detivery of after-school progams
II. Principles
The Joint Efforts subcommittee developed the following principles to gt2ide their selection of
opportunities for the City, County and School District to merge, consolidate or cooperate in
delivering services. Each principle is important. Aowever, the subcommittee felt that each
collaboration/consolidation opportunity did not have �o reflect all of the principles £or the
initiative to be recommended to the Committee. For example, some of the iniqatives primarity
reduce costs, while others primarily allow a greater number of constituents or clients to be served
with the same amount of resources.
- Improved Outcomes. The joint effort should improve the outcomes of the service or function.
That is, there should be a programmatic benefit resulting from the joint effort. The improved
outcomes shouId be cIient-focused, with significant input from the clients being served. (These
improvements may not be immediately quantified or measured in dollars.)
- Reduced Costs. The joint effort should reduce the cost of service delivery. There should be
dollar savings achieved through merger, consolidation and cooperation.
Appropriate Governance. The joint effort should enswe that the ability to decide the level of
service and how it is to be provided is appropriately matched to the service and to who is paying
for it. (This is not intended to include the determination of what service is to be provided; that
decision is beyond the scope ofthese recommendations.)
- Innovations. The joint effort should reflect innovation in service delivery, including innovation
through the identification and fulfillment of new or changing constituent needs, and/or through the
use of new technology.
- Responsive to Federal mrd State Actions. The joint effort should be responsive to impending
cuts in Pederal and State financing and programs. The joint effort should permit local
jvrisdictions to address whether they should assume responsibility for @elivezy of services formerly
provided at the State or Federat level, or identify altematives for meeting the underlying needs.
- Impact on Staff. The joint effort should consider what the impact on the affected staff will be.
The joint effort must address the IeveI of resources and commitment that must be present to
accomplish the implementatioq recognizing that staffmust be primarily responsible.
- Organized Labor. The joint effort shouid include discussions with organized labor as early as
feasble in the analysis and implementarion process, recognizing that the level of support and
participation by the unions will strongly influence the successfiil implementation of the initiative.
The joint effort should consider, where appropriate, privatization as an atternative for more
effective and less-costly service delivery.
-Spirit of Compromise and Cooperation. The entiries participating in the joint effort must be
2
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committed to viewing the service and delivery altematives with creativity and flexili�ty, e�xpect
some difficulty in overcoming barriers to implementatioq and be willing to give up some degree
of their previous autonomy in order to make the jairn effort successful.
-�'imetable. The joint effort should address how fast can the initiatives be implemented, and
define the timetable.
- Feasibility and Cost Effectiveness. The joint effort should address how easily the initiatives can
be implemented and consider major barriers or obstacles to implementation. The joint effort
should weigh the ease of implementation and staff/constituent acceptance against the payback for
investing this effort.
F:\USERS1fL4MES�INNOW 3EALTHVt'EFFORT
47
Attachment II
SAINT PAUL PUBLIC HEALTH
CURRENT GRANTS
DRAFT
NII1�7�'ESOTA DEPARTMENT OF HEALTH:
Contracts with the Minnesota Department of Health contain a standard clause:
a%�5�3
DRAFT
"ASSIGI�TA�NT. GRANTEE shall neither assign nor transfer any rigfits or obligations
under this grant contract without the prior written consent of the STATE."
Contacts verbaily indicated interest/condition that funding be used as curtenfly assigned
to designated services/service area, with qualified staff.
Breast & Cervical Cancer Screening $ 87,400 exp 9/30/96
• Funding is competitive, with reapplicauon process
• This funding is for the actual screemng
Breast & Cervicai Cancer Outreach $10,000 exp 9l30/46
• Funding is competitive, with reapplication process
� Funding going to St. Paul currendy also includes activity for Ramsey County
• Funding for outreach and recruitment of women for screening
Chronic Disease Coalition
g,000 exp 12/31/96
• Funding is competitive, with only CHS aaencies eligible to apply
� Renewal funding available for 1497
• Ramsey County also received funding (expired 9/95, worldng on extension unti19/96)
• With limited funds ($80,000 total for state) spread to numerous Community Health
Boards, question if as a combined entity we would be able to obtain the same level of
funding as separately; although 2 proposals were submitted for the Carlton, Cook, Lake
CHS and two were funded - required creative thinking, demonstration of need,
collaborarion and pooling resources.
Fanuly Planning Spec Proj $ 97,768 eacp 12/31197
• Funding is competitive with a$ maximum per agency
• Saint Paui and Ramsey County could be applying as two agencies currently and obtain
up to the maximum funding for each agency; whereas if there is one CIiS agency, only
one aliocation could be applied for.
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Hep B Perinatal Prev & High Risk � 87,555 exp 12/31/97
• Funding provided only to Saint Paul and Hennepin County
• Funding also includes Hep B for Room 111 if federal dollars are allocated
AIV/Room Ill - Ryan «'hite $ I1,000 exp 6/30l96
• Funding is based on competitive application with CHS agencies and nonprofits eligible
to apply
• Intend to do a competitive RFP this summer
HIV Testing & Counseling $131,275 exp 12131/96
• Funding is provided to "confidential/anonymous clinics" only - Saint Paul and
Hennepin County for lab services and counseling, and Bloomington for lab services
only
� Funding is based on performance and number of persons served.
Immunization Action Pian: �151,115 exp 12/31/96
• Funding based on population allocation - all CHS agencies receive
• Funding also contingent on quality of grant applications, staff who write them, and
data to support needs
Immunization Registry $ 65,000 exp 12/31/96
� Funding given to those agencies with specific expertise to deve]op a registry (funding
provided to Saint Paul, Hennepin County and Olmsted County)
� Would want written assurance that the project could continue to be carried out and the
work stay centered in Saint Paul
• Question if there would be an extra overhead/indirect charge
I.ead Safe Housing $ 25,000 exp 9/30/96
• Competitive grant available to Comm Health Boards
• Funding based on application and demonstration of need
Lead Safety Video $ 20,000 exp 6/30/96
• Joint project with EPA and City PED funding
• Not expected to receive recurring funds
Maternal and Child Health $1,641,056 exp 12J31/97
• Funding is provided to Community Heal[h Boards only.
• Funding level for Saint Paul and Minneapolis is specified in State Statute
• Statute change may be necessary to move funding from Saint Paul
• The large majority of this funding is currently subcontracted to community clinics to
- improve pregnancy outcomes and for adolescent health through school based clinics.
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Native American Health $ 87,000 exp 12/31/97
• Funding is competitive, to Community Health Boards only.
• Funding is received to provide services to Native Americans in Saint Paul and
suburban Ramsey County
• Enrire allocation of these funds is subcontracted to a community clinic
Refugee Health Tracking $ 20,000 exp 10131/97
• Funding provided to CHS Agencies based on a resettlement formula of at least 500
persons in last fiscal year - Saint Paul and Hennepin County have been receiving
funding
• Additional $20,000 is possible for 1997.
STD: Family of Surveys - CDC $ 8,000 exp 12/31/96
� Funding given to Saint Paul and Hennepin County - the only two clinics with su�cient
volume to participate in the study, have receiveti funding since 1988.
• Currently operate under a purchase agreement rather than a contract
TB Control Outreach $ 40,000 exp 12l31/96
• Funding provided to the two public TB clinics in MN - Saint Paul and Hennepin Co.
�i'IC $1,600,000+ exp 9/3Q/97
• Funding is awarded based on competitive grant, with preference to CHS agencies
• Program currenily covers Saint Paui and Ramsey County
Community Aeaith Services $ 940,190
• Annual funding available to CAS Agencies/ Community Health Boards
• Funding comes to Saint Paul through Ramsey County, based on population allocation
Core Public Heaith Functions
• New funding appropriated by the legislature
• Discussions underway as to how the funding will be allocated (statewide to those
CHS agencies currently operating under PMAP, or wiil have plans by 7/1/96 to
implement in FY 1997)
• Saint Paul could potentially be allocated up to $86,000 -$130,000 for funding to carry
out core public health functions (only one year of funding appropriated at this time)
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DEPARTMENT OF HEALTH A1VD HUb4AN SERVICFS - PUBLIC HEALTH SERVICE
Title X- Family Planning $252,000 exp 12/31/96
• Fundina based on competitive application with gov't entities and nonprofits eligible to
apply
• IvIN has two grants. SPPH, the oldest grantee in the region, receives a categorical
grant with specific requirements.
• 1946 is the first year of a three qear grant cycle, need to reapply for continuation
funding for following year(s).
• Funding Ievel is based on history and target area
• Concern to maintain cunent focus and services
• Requested copies of JPA and report for review.
Family Ties - CISS Grant $35,056 10/1/96-9/30/97 exp 9/30/97
• Fiscal agent for grant for home visiting services to pregnant women and
infants/children under age 5.
• Four year grant with reduced funding each successive year
• Funding is allocated to West Side, Health Start, Model Cities, North End, Face To
Face and the American Indian Health Clinic, Saint Paul Public Health and the
Neighborhood Health Care Network
OTHERS:
Saint Paul Foundation
1. Immunization Project $ 37,500 exp 6/30/96
• Immunization education and outreach
� • Joint project with Children Health Care - St. Paul and Ramsey County Public
Health
• Will request project extension
Cowles A4edia/Edwards Trust
1. Healthy WeighUHealthy Kids
$2,000
nonexpiring
Children's Aealth Care - St. Paul
1. Anemia Study
$36,000
exp 12/31/96
St. Paul SchooLs Community Erl
1. Youth Deve]opment Grant $ 2 exp 9/1/96
• Recreationai opportunities for youth from Frogtown I.oaves and Fishes
Partnership with Main Street Health
l. House Calls
5/29/96
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Attachment III � �� , �$�
MISSION STATEMENT OF
ST. PAUL-RAMSEY COUNTY DEPARTMENT OF PUBLIC HEALTH
The missioa of the Department of Public Health is to work mith
coaanuaity partners and to protect and promote the health of the
St. Paul-Ramsey County Community.
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The Mission of the
Saint Pau! Division of Public Health
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The Z+tissioa of Saint Paul Dinision of Public Health is to
grotect and promote the 2�ealth of our community. �Pe will ensure
or provifle guality services that address publia health needs.
Ia this leadership role, we will promote a healthier coamrunity
which is responsive to neighborhood needs. We will work in
partaesship with individuals and agencies to promote iaKpxoved
heath and a safer enviroxmaent.
Values
In order to achzeva aur mission, we eavision an agency that:
Participates in strong outreach efforts to high risk populations, minorities and special populations;
Responds to the needs of ihe community;
Provides coilaboration, technical assistance and service to the community in an e4fiort to make
individuals and other organizations operate efticiently and on an independent basis;
Protects the health of the public through the enforcement ot Stafe law and Ciry ordinances;
Educates those individuals with whom we have contact in both regulation programs and
medicaUclinical programs to ensure tF�at there is an increased understanding leading to improved
health of the community;
Operates with visionary leadership and well qualified, motivated statf where there are adequate
faciiities, equipment, and sufficient funding to provided needed community services;
Supports research and program development so that community needs ara understood and that
programs and services are flexible to be responsive to these needs;
Faces economic reatities which prevent access to heatlhcare and improved environmental conditions
while aggressively advocating tor a change in funding priorities at the Federat, State, County and City
ieve(s; and
1/alues the ideas and contributions of community volunteers,.elected officials, clients and staff in the
planning, design, implementation and evaluation of public heaRh services.
93
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The Mission of the
Ramsey County Department of Pubiic Heaith
The Missioa of the Degartmeat o� Public Health is to
work together to create a 2�ealt2�y future for Rsmsey County.
Values
The Missioa is basad on sharefl na2ues that
motivate and guids our current aad #uture actions.
Sound Publec Health Principles
The Department carries out its Mission using sound pubtic health principles, and recognizing the core
public health functions of assessment, policy development and assurance of services.
Excellence in Health
The Department values promotion of optimum health for all individuats. This incfudes the prevention
of environmental, community and personal health probiems.
Quality
Providing the highest quafity senrices using the resourc�s availabie is fundamental to the
DepartmenYs way of conducting business.
Community Partnerships
Working with the communiry is a critical part ofi public health work. The Department values its work
to develop, Coordinate and participate in community partnerships, based on mutual respect, involving
citi2ens, profiessionals, businesses, commanity organizations and local regionaf and state
govemment.
Fscal Responsibility
Fiscal responsibility is a comerstone of the DepartmenYs operations. The appropriate use ot revenue
and other public funds is essentiaV to the conf'idence of the community toward the support of
Department programs.
Environmental Responsibility ,
7he Depariment wifl use its resources in ways which protect and improve the environment.
Access by AII
The Department affirms access to services to all persans based on need, and no one shall be denied
access based on race, cotor, gender, age, nationat origirt, religion, sexual orientation, potitical
persuasion, physicaf or mental ability or place of residence.
{ � Tll+n� D iaC