A move to accept a grant to conduct a Health Impact Assessment (HIA) as part of the Winona County Comprehensive Plan lacked momentum as it headed into Tuesday night's County Board meeting. In a 9-2 vote on Monday night, the Comprehensive Plan Committee recommended that the board turn down a grant to conduct a study of the impact of policy decisions on public health as part the Comprehensive Plan update. The recommendation is, of course, not binding, but the HIA had already received criticism from a couple County Board members at a previous meeting, at which point it was referred to the Comprehensive Plan Committee. The County Board met to discuss the HIA proposal and the committee's recommendation after the Post went to press on Tuesday night.
A $30,000 grant from the Minnesota Department of Health (MDH), and matching staff time from Winona County, was proposed to support the collection of public input and identify policy issues that are important to public health in the county. A citizen subcommittee made up of healthcare professionals, professors, and others "with an interest in health" would help shape policy recommendations coming out of that public input. The HIA would be "a stand-alone document that informs: if these are the policies we're going to have in the comprehensive plan, are they going to have any effects on health and, if so, are there any mitigations that we can do if necessary?" explained Winona County Environmental Services Director Jill Johnson. "It's not coming from the state down; it's really driven from stakeholders up," she added.
A majority of the committee members recommended that the study not be included with the comprehensive plan update for fear that including an HIA would delay the comprehensive plan update. Critiques of the grant contract and the substance of the study were expressed, as well, while one committee member defended the study's potential value.
After examining the proposal, committee member Don Evanson called the healthy study contract "backloaded" with costs that the county might be stuck with if bureaucrats in St. Paul did not approve of the county's decision-making. "I could see that it would come down to [a situation where] the County Board might not approve what the HIA comes up with and the researcher in St. Paul might not write the check," he said. "We know the Department of Health is not happy with everything our county is doing, so I don't know if we want to drag them into our comp plan."
According to the contract presented to the board, the county could be denied reimbursement if the MDH determined the county did not satisfactorily fulfill its duties under the contract.
Evanson also raised concerns about the agenda behind the HIA. A description of the study's potential focus in Winona County reads: "Winona County is facing unparalleled changes in land use patterns having impact on public health. Local officials can no longer ignore these land use policy impacts as costs for public health increase and create long-term imbalances in funding local service needs." The description lists the following land use trends with impacts on public health: "the disappearance of small dairy farms" and growth of large-scale row cropping, access to services for the poor and elderly, mineral resource demands, and water quality. "That's wide open to all kinds of issues that I don't think we want to get into," Evanson said.
Committee member Leon Bowman responded, "I think what I'm reading in this [proposal] is to gather information. That's one thing we're going to need a lot of." With this grant, "we can get information and some of that would be taken care of [financed by the state]." He countered Evanson's contractual concerns saying that County Planning and Environmental Service Director Jason Gilman would not mismanage the grant. "I think he's very capable. I don't think he's going to allow mistakes to jeopardize this grant money."
Ultimately, concerns that the HIA would slow down the comprehensive plan update persuaded a majority of committee members to oppose the proposal. According to the contract, the HIA would be completed by December of 2014. That would coincide with the earliest hopes for finishing the comprehensive plan update. If the HIA proposal is approved, it is unclear at this point whether the Comprehensive Plan Committee would review the HIA and revise it or further revise the updated comprehensive plan to bring the two into accord before submitting both to the County Board. Doing so would likely require months of meetings after the HIA was completed.
Bowman and committee member Nick Koverman voted against the motion to recommend denial of the proposal. In an interview with the Winona Post following the meeting, Bowman said that he opposed the motion because he believed that including the HIA in the comprehensive plan process was a fundamental aspect of the state's grant offer. The recommendation made by the committee suggests that the two documents might be kept totally separate. The MDH selected Winona County for the grant because of the comprehensive plan update, according to county staff. Whether the MDH would be agreeable to funding an HIA separate from the comprehensive plan is unclear.