Oak Ridge Reservation: Health Needs Assessment Work Group

Health Needs Assessment Work Group

June 30, 2003 - Meeting Minutes

Needs Assessment Work Group Meeting (Continued)

Kowetha Davidson reminded the group that the PHAWG reviews the Public Health Assessments. Kowetha thinks the process that has been used with the Uranium PHA works well because the process was smooth and there was a very short turn around time. There is no reason to believe that the process used for the PHA’s would not work for this document as well. Kowetha Davidson suggested that the NAWG use the PHAWG process rather than an Ad Hoc process. Kowetha Davidson also stressed the importance of the group remaining focused.

Donna Mosby told the group to look around the table and answer the question of who will be in the Ad Hoc committee. Donna said that the group is already too small and she wonders if the group is going to Ad Hoc the Ad Hoc. Donna does not believe that there is a need for a group smaller than the group that already exists. Donna Mosby added that nobody will be at the same level as James Lewis and everyone needs to accept that. The group needs to provide Bill Taylor with comments and move forward.

Barbara Sonnenburg asked if the NAWG knows exactly what ATSDR asked GWU to do as far as the Needs Assessment is concerned. Barbara stated that perhaps ATSDR asked GWU to do A, B, and C and perhaps they did, and maybe some ORRHES members and community members do not see the value in A, B, and C. Barbara stated that she has never understood what GWU was charged to do.

Donna Mosby responded by saying that the NAWG feedback could be what was A, B, and C. However, the answer to the question of what GWU was charged to do still does not alter the group’s task of providing feedback on the Needs Assessment.

James Lewis does not know if what ATSDR asked for meets the real needs of the Oak Ridge Reservation community.

James Lewis reminded the group that Kowetha Davidson had previously explained the PHA process. James contrasted the PHA documents with the Needs Assessment document. James stated that with the PHA process there is a flow diagram with time limits on producing a product. But with the Needs Assessment there is no process and nothing is laid out. James Lewis asked when the last time a summary or overview had been presented to ORRHES or the NAWG with the purpose of helping the group understand where the process is and to learn how the Needs Assessment will be used in Phase II. James Lewis wants to know if A, B, and C and up to D, which involves moving forward. Many action items that belong in D are already going on. For example, some physician education has already taken place in the Oak Ridge Reservation community. DHEP has not been involved and thus does not know the processes that have taken place. What is Phase II? James Lewis stated that he questions Phase II and so do other people.

Kowetha Davidson responded that Phase II includes developing an actual Health Education and Promotion plan and carrying that plan out.

James Lewis told the group that the ORRHES mission statement discusses contaminants of concern and releases while DHEP’s objective and goals as stated in the minutes of a previous meeting, indicated that they would focus on issues similar to the mission statement. But when James looks at the Needs Assessment, he sees a large generic document that did not want to bias anything such as the focus groups or interviews by identifying contaminants of concern. ORRHES is focused on one specific issue while the Needs Assessment document is focused on another very general approach. There is a huge disconnect between ORRHES’s mission and the content of the Needs Assessment.

Kowetha Davidson said she did not agree with James. Kowetha Davidson said that from the beginning, she had the understanding that the Needs Assessment was for the entire community and not just this site. Kowetha feels that the Needs Assessment helps put the contaminants of concern and general health concerns into perspective. According to the Needs Assessment, when it all boils down, site issues are not the primary concerns in the minds of community members.

James Lewis is still concerned about the focus group portion of the Needs Assessment. Kowetha Davidson responded by telling James that it is the past and he should not go into that because the past cannot be changed.

Donna Mosby said that ORRHES sabotaged the process by sending out extensive emails that were negative toward the focus group advertisements. Donna Mosby said that Susan launched a campaign against the ad and the entire focus group process.

Barbara Sonnenburg said she does not understand how ORRHES sabotaged the focus group process. Also, Barbara believes that the focus group issue is important although it occurred in the past.

Kowetha Davidson and Donna Mosby asked Barbara what can be changed from discussing the poor participation in the focus groups.

Barbara Sonnenburg said that the Needs Assessment will not change anything that ORRHES is already doing. ORRHES did not ask that GWU perform the Needs Assessment; in fact, ORRHES might not have approved the GWU process if it had not been previously arranged.

A question that the entire group agreed on is Where do we go from here?

Donna Mosby stated that the NAWG must make the Needs Assessment useable. Barbara Sonnenburg wants to know why the group should make the Needs Assessment useable when the ORRHES did not vote for the document in the first place. Donna Mosby replied that a lot of money has been spent.

Kowetha Davidson told Barbara Sonnenburg that the Needs Assessment has been completed and that the group cannot change anything from the past.

Bill Taylor said that the group may not want to go forward if the task has not been useful or is not worthwhile. Kowetha Davidson responded by saying that when a contractor has been awarded money to perform a project, the money cannot be retrieved so you continue with the process and the project.

Donna Mosby reminded the group of the three approaches that have been suggested, which include the ORISE review, Ad Hoc committee, and compiling individual comments.

Barbara Sonnenburg feels that the Needs Assessment can be reviewed by the work group together without forming an Ad Hoc.

James Lewis stated that he had suggested an Ad Hoc committee so that there would be a formalized group with a specific process. James told the group that specific criteria for collecting comments regarding the Needs Assessment must be written down and discussed.

Donna Mosby said that the group needs to establish criteria for developing feedback.

Kowetha Davidson provided a list of three criteria that are based on the larger question of Are conclusions supported by results? The list included:

• Regarding stated purpose and goals of the Needs Assessment
  • Did the Needs Assessment meet the purpose and goals of the project?
• Regarding the Action plan and Recommendations
  • Are the components of the recommendations and action plan supported by the focus groups, key resource interviews, telephone survey, and literature review?
• Regarding the Literature Review
  • Did the literature review provide adequate information regarding the sources that they used? How was the information from the literature review used?
    James Lewis applauded GWU for acknowledging the faults of the Needs Assessment document. James Lewis wants to know if ATSDR feels that the Needs Assessment is useable with all of the faults.

Kowetha Davidson said that the group does not want to know if ATSDR feels the document is useable because the Needs Assessment is still not in its final form. James Lewis responded by saying that nothing else will be added to the Needs Assessment and that they will not get any additional information.

Kowetha Davidson responded to James Lewis by saying that GWU could change the action plan. Both James and Kowetha agree that there are problems associated with the Needs Assessment action plan.

James Lewis would like the group to provide individual comments to Bill Taylor to compile. Then, the group can look at the totality of the comments and evaluate them based upon the three objectives set by the group.

Barbara Sonnenburg requested that a notice be sent out to all work group members stating exactly what the group is expecting. Bill Taylor told Barbara that a notice can be sent out.

Bill Taylor told the NAWG that he will not summarize or edit the comments that he receives; instead he will collate the comments and bring the comments back to the work group for review.

Barbara Sonnenburg stated that she hopes that each person in the work group takes part in the process of providing comments.

Kowetha Davidson said that the final work group comments need to be completed two weeks prior to the ORRHES meeting so that they can be sent out in the pre-meeting mailing.

James Lewis has asked that someone from DHEP come to Oak Ridge and explain the process that will be used regarding the Needs Assessment and health education. After the work group understands the process, then the work group members will be able to compile their comments. James feels that a DHEP presentation would help bring the members “up to speed” on the new philosophy as well as whatever the old philosophy was. James Lewis would like to interface with ATSDR staff by spending an afternoon listening to them explain how the Needs Assessment will be used. After listening to the presentation, members would be able to develop criteria for feedback.

Donna Mosby is afraid that if a presenter comes to Oak Ridge, the work group will run that person out of town.

James Lewis asked that DHEP come share their concepts with the work group and that Donna Mosby trust work group members to ask questions. James stated that the group may ask tough questions but it is from those questions that the group members will be able to formulate their position.

Kowetha Davidson reminded the group that the group must move forward. James Lewis responded by saying that he has laid out an approach to move forward and that approach is to bring someone from DHEP to Oak Ridge. After a DHEP presentation, the group can generate a list of criteria that is needed in order to generate feedback about the Needs Assessment. Individual feedback will be sent to Bill Taylor and then Bill will compile a large list of feedback based on individual comments.

Donna Mosby asked Theresa NeSmith and Terrie Sterling for a meeting to discuss the DHEP process. Theresa NeSmith responded by saying that they need an opportunity to talk and look at their schedule.

Donna Mosby told Theresa NeSmith that she would like a commitment that DHEP will consider giving a presentation. Theresa NeSmith responded by saying that she will definitely consider giving a presentation and that she will let the work group know what is decided.

Terrie Sterling added that she believes that the NAWG comment process should move forward while the group is waiting for information regarding DHEP scheduling. James Lewis responded by saying that he does not believe it would be beneficial to begin generating comments about a document if people do not understand the process that resulted in the document or the process that the document will be used for in the next Phase.

Donna Mosby expanded on the topic of the DHEP presentation. Donna said that she believes that the reason for the presentation is the concern with what will happen in Phase II. The idea of a DHEP presentation is all based on wanting knowledge about the foundation for Phase II. There is uncertainty about Phase II.

Barbara Sonnenburg stated that she was unaware that there would be a Phase II.

Theresa NeSmith asked that someone read Kowetha Davidson’s criteria again aloud. The three criteria were then read aloud.

Donna Mosby reminded Theresa NeSmith that Barbara Sonnenburg had brought up an issue about the GWU contract. Barbara had wanted the scope and/or contract of the overall project identified. Theresa NeSmith responded that the goals outlined in the Needs Assessment were consistent with the scope of the project identified in the contract.

James Lewis pointed out that some items in the Needs Assessment are so vague that people do not know what they are dealing with and do not know how to respond. James went on to say that the Action plan is so generic that after reading it, anyone could do anything that they want to do. Kowetha Davidson added that she also has problems with the Action plan.

James Lewis would like to make sure that feedback is not labeled as trash just because it is critical of the Needs Assessment. Donna Mosby and Kowetha Davidson responded by pointing out that a statement saying something is a piece of trash is not a constructive comment. The group can not work with the single statement that something is a piece of trash. It is important that there are reasons documented as to why it is a piece of trash.

The group decided that comments regarding the Needs Assessment are due to Bill Taylor by the close of the business day on July 10th. The next NAWG meeting will be held on July 14, 2003 from 6:00 p.m. to 7:30 p.m. The July 7th NAWG meeting with Rebecca Parkin is cancelled.

Donna Mosby told the group that no new business will be introduced during the July 14th meeting. Recommendations may come from the discussion of the comments but nothing new, such as a new document will be accepted. The goal of the July 14th meeting is to bring closure to this process and to have a recommendation leave the NAWG and go to the ORRHES.

Theresa NeSmith told the group that she will look at July 14th as a possible day to present to the NAWG.

James Lewis is concerned that Theresa NeSmith waited until Donna Mosby said that no discussion would be allowed at the July 14th meeting before she announced that DHEP would perhaps come during that meeting. James does not like the idea of DHEP giving a presentation at the end of the process and when the agenda will be limited. James Lewis told Donna Mosby that if DHEP arrives after the comments are turned in and if discussion is not allowed, there will be a fight.

Donna Mosby expressed concern about the appropriateness of Bill Taylor collecting the comments because he is ATSDR staff. Bill Taylor said that he will not editorialize or summarize the comments, he will just cut and paste the comments under the appropriate headings.

Donna Mosby wanted to provide clarification based on James Lewis’s concern. Donna said that her intent of the July 14th meeting is to work from the collective comments rather than introducing new comments. Donna would like everyone to have turned in their comments so that they can be discussed on July 14th.

Action Items

• Donna Mosby will call Peggy to get clarification about her email status.
  
• Donna told the group that she will contact Mike Knapp to verify that he wants to be included on the NAWG email distribution.
  
• July 7th NAWG meeting is cancelled.
  
• Needs Assessment comments due to Bill Taylor by the end of the business day on July 10th.
  
• The next NAWG meeting will be on July 14th from 6:00 p.m. to 7:30 p.m.
  
• Theresa NeSmith and Terrie Sterling will check the DHEP schedule for a date when they could give a presentation to the NAWG.
  
• A notice will be sent out informing the rest of the NAWG members about the Needs Assessment comment due date and next meeting date.

The meeting was adjourned at 8:00 p.m.