Needs Assessment Work Group Meeting
July 14, 2003

Attendance

ORRHES Members attending:
James Lewis (Co-chair), David Johnson, Kowetha Davidson, Pete Malmquist, Charles Washington, Barbara Sonnenburg (telephone)

ATSDR Staff attending:
Bill Taylor, Melissa Fish, Lorine Spencer (telephone), Jerry Pereira (telephone), Theresa NeSmith (telephone), Marilyn Palmer (telephone), Terrie Sterling (telephone)

Co-chair Donna Mosby was unable to attend due to a work schedule conflict.

Meeting Minutes

The June 30, 2003 draft NAWG meeting minutes were approved unanimously without modifications.

Written Comments on the DHEP/GWU Needs Assessment Document

James Lewis noted that it was indicated at the June 30th NAWG meeting that all written comments regarding the Needs Assessment document be submitted to Bill Taylor. Bill Taylor would then collate the comments.

Regarding the status of the comments Bill Taylor said that he has received comments from several people but he did not group them as indicated in the previous meeting minutes because the comments are in various formats. Bill Taylor indicated that he did not edit or change the comments; he only collected and copied the comments so that they would be available for review and discussion.

Terrie Sterling asked if the comments from Al Brooks were included in the comments that Bill Taylor had collected. Bill Taylor said that Al Brooks’s comments on OREJC letterhead are included along with comments from David Johnson, James Lewis, Barbara Sonnenburg, and Pete Malmquist.

James Lewis asked Bill if the Needs Assessment comments stay within the boundaries that were established at the last NAWG meeting. Bill Taylor responded that the answer is somewhat subjective. Bill has read through the comments and feels that most, but not all of the comments stay with the confines of the headings that were established at the June 30th NAWG meeting. Bill Taylor told the group that the comments will need to be looked at closely as the work group decides what to do with the comments.

Terrie Sterling requests that a copy of the Needs Assessment comments be sent to herself and Theresa NeSmith. Bill Taylor said that he will provide the comments that he has received.

James Lewis stated that issues and questions have been raised regarding whether or not the comments need to be limited to the Needs Assessment document as presented. James Lewis said that some people have spent time reviewing past presentations and meeting minutes and have found numerous disconnects between the Needs Assessment product and what ORRHES members were previously told. James believes that a disconnect between what ORRHES members heard and what ORRHES members see in the final product is an important issue. James Lewis would like the group to look beyond the goals and objectives as identified in the body of the Needs Assessment. James feels that it is important to compare the past information and sequences that were identified in previous meeting presentations to the actual Needs Assessment document.

Letters from Elizabeth Howze, DHEP to Pete Malmquist and James Lewis

Pete Malmquist told the work group that he did not bring his letter to the meeting but it was basically the same as the letter that James Lewis received. Pete Malmquist explained that he wrote Mrs. Howze and asked her three specific questions which included 1) How much money was paid to GWU for the study? 2) Who was in charge of the study? and 3) What were the contents of the contract? The response that Pete received was a boilerplate letter that does not say anything. Pete Malmquist was told that his comments were appreciated and to bring his comments to the NAWG meeting. Pete did not receive an answer to his three questions which Pete views as wanting information rather than comments. As directed by the letter, Pete Malmquist has brought his three questions to the NAWG and asks that these three questions are forwarded to ORRHES as a request from NAWG.

Pete Malmquist told the group it is difficult to criticize GWU if the group does not know what was in the contract or what GWU was asked to do. If GWU did fulfill their contract, the criticism would belong to ATSDR for writing the contract or improper supervision of the contract.

James Lewis told the group that he also received a letter from Elizabeth Howze in response to a letter that he sent to Dr. Falk. James noted that in his letter he made suggestions and not comments. James Lewis asked that his letter to Dr. Falk be submitted into the record (Attachment 1).

Barbara Sonnenburg believes that the three questions that Pete Malmquist identified regarding the Needs Assessment are good questions and those questions should be endorsed by the work group.

The NAWG voted to endorse the following recommendation:
The NAWG endorses the following three questions and requests that the questions are submitted to ORRHES as a NAWG recommendation.

1. What was the amount of money paid to GWU for this study?
2. Who at ATSDR was in charge of the project?
3. What are the contents of the contract pertaining to the purposes and goals? What was the statement of work?

James Lewis told the group that he was shocked to receive a letter from Elizabeth Howze regarding his comments to Dr. Falk. James said that he was not trying to elicit a response, his intent was to make sure that Dr. Falk was aware of the current situation. However, after receiving the letter and looking at how the letter was structured and the attempts to inform James of how the process works, James decided to take a closer look at the process that he is already very familiar with.

James Lewis said that it is important to not “cherry pick” certain portions of a process that has been and is currently being used in one branch. When looking at the PHA process, a lot of information has been presented at various stages so that ORRHES can develop ideas and make intermediate decisions before getting to the final point when it needs to make a decision about the document. James stated that if the group is going to go through a similar procedure as it relates to the Needs Assessment document, then he has some questions and issues pertaining to the way that the Needs Assessment document will be processed.

James Lewis provided an example of the PHA process and how it involves the ORRHES and community in the process. James said that when he looks at the Needs Assessment program/procedure he is not sure what the group is really doing or what phase the Needs Assessment is in. There needs to be clarification and an explanation regarding the process because if the Needs Assessment process is going to mimic the other process such as the PHA, then the group is subject to be in a similar mode and process with this document. James asked if there were any comments from DHEP.

Kowetha Davidson stated that DHEP did not say that they were going to mimic the other process. James Lewis agreed with Kowetha that DHEP did not say that they were going to mimic the other process, but James feels that it was implied.

Bill Taylor said that Donna expressed a few questions regarding the future DHEP process. How will the community have input? How will the community interact with what comes next?

Direction-Where Do We Go From Here?

James Lewis pointed out that ORRHES has always chartered the work group with doing detailed reviews. In the past, issues and documents have worked through the work group and back to ORRHES so that people can get a full review of what is going on. James said that after he reviewed the ORRHES minutes, numerous questions were raised. James Lewis feels that the NAWG must decide on the best way to review the document and must decide on how to present the comments to ORRHES in an organized and structured fashion. In addition, James feels that if the work group is willing to write questions down, then the group deserves written responses associated with each comment so that the group can take the response under consideration before presenting to ORRHES.

Kowetha Davidson stated that the work group must develop its own comments to submit to ORRHES and not ATSDR. ATSDR should not have anything to do with reviewing the comments that will be submitted to ORRHES because that would be censorship. James Lewis and Bill Taylor agree with Kowetha and that is the reason that Bill Taylor did not do anything with the comments that were submitted to him.

James Lewis stated that he is looking for clarification as it relates to the process. James Lewis does not understand how the Needs Assessment process will work.

Theresa NeSmith said that she believes Kowetha Davidson was correct when she said that the process suggested for the Needs Assessment document is for comments to go through the work group then to ORRHES. Theresa stated that it was previously discussed that once the document is completed and once the comments have been addressed, DHEP will begin to talk about follow-up and DHEP will work with this community, the work group, and the subcommittee to do that. However, DHEP does not have plans to send the Needs Assessment document out for public comment. The next step in the process (based on the process that was laid out quite awhile ago) is that once DHEP has the document finalized or at least once it has discussed the document, DHEP will begin follow-up.

Jerry Pereira asked if the process that Theresa NeSmith described is different than the normal procedures used for any needs assessment. Theresa NeSmith said that this process is the same process that DHEP uses for every Needs Assessment.

Pete Malmquist stated that he is looking at 15 pages of written comments. Pete wants to know if the NAWG is expected to go though each individual comment and either agree or disagree with each and then correlate the comments. If it has been decided that a written report must go to ORRHES, Pete is willing to help with the work which will include going through each written comment and looking at how it relates to the Needs Assessment document. Pete Malmquist said that if this is the process that is required, the work group must get on with the process.

Jerry Pereira offered a point of caution to the NAWG. Jerry said that he does not know how the ORRHES chair wants to accept the Needs Assessment comments. Historically, when ATSDR receives individual comments regarding a non-Needs Assessment issue, each writer is dealt with and reviewed by the agency individually. If the NAWG takes all of the individual documents and makes one big document of concerns and presents it to the ORRHES, then a question that could arise is, Has any of the information been filtered or was anything left out? It is important that the NAWG think about how the comments are actually presented from the NAWG to ORRHES. This could be another issue that is vital in the entire process.

Kowetha Davidson feels that the comments that have been received need to be synthesized. Some individual comments may be the same as other individual comments. ORRHES should receive the comments grouped in a way that is understandable. It is important to read the comments and see which are duplicated and which can be combined. In addition, the group can have a full set of comments as back-up for anyone who wants to see the original comments.

Barbara Sonnenburg asked who is going to synthesize the comments.

James Lewis said that this was his original concept. Some individuals may state one comment in a way that captures three or four comments. The group does not have to lose the original comments. As a group, NAWG should look at individual input, criteria, and statements made in the minutes as a procedure for organizing the comments that will go to ORRHES.

Charles Washington believes that the comments need to be more concise before going to ORRHES. However, the group should not add or contract from any concern or comment that has been submitted. Charles Washington feels that ORRHES can work with the list of concerns if the concerns are divided into categories and subcategories.

Pete Malmquist agrees with Charles Washington. There are several comments that are the same with minor differences in the wording. Some type of group needs to sit down and make the comments concise. After the total list is developed, the comments and concerns must be addressed or ORRHES may reject the Needs Assessment report in total.

James Lewis stated that some comments may disappear after going back and reviewing the minutes of previous meetings where statements were made regarding the Needs Assessment. However, after reviewing the previous meeting minutes and presentations, James feels that there are quite a few disconnects between the previous meetings and the actual Needs Assessment document. James Lewis feels that it is important to review the previous meeting minutes as a refresher in order to figure out what the group should be commenting on.

Kowetha Davidson expressed the importance of dealing with the Needs Assessment document first before dealing with other issues.

While compiling the Needs Assessment comments, James Lewis tried to remain focused on the Needs Assessment document. But after completing his review, James said that he began remembering previous statements that were made regarding the Needs Assessment. James Lewis feels that this changed his view on what he sees in the Needs Assessment document. There is no need to go to DHEP or GWU with comments that may be clarified in the minutes. The group needs to look at the past record of meeting minutes and presentations when developing comments that will be presented to ORRHES.

Kowetha Davidson feels that James is describing more than one process. Kowetha reminded the group that the NAWG asked to review the Needs Assessment document before it becomes finalized. The work group should be reviewing the document and providing comments to ORRHES. Going back and reviewing the entire process of the Needs Assessment is a separate issue and is not what the ORRHES asked the work group to do.

Barbara Sonnenburg referred to two statements regarding the focus groups that were made in the January 18-19, 2001 ORRHES meeting minutes. The first statement that Barbara pointed out is How will you select focus group participants? Various methods; for example, if teachers are desired, their meetings will be attended to invite their participation. The second statement that Barbara pointed out is Mr. Pereira stated that if more than eight focus groups are needed, they will be formed. Barbara Sonnenburg said that these statements back up the questions that Barbara has in her mind.

Kowetha Davidson said that most people know that more than two focus groups were planned and Kowetha does not think that this is really an issue that requires additional review. ORRHES has asked the work group to review the document and not the entire Needs Assessment process. Reviewing the entire Needs Assessment process is a different matter and Kowetha believes that it is going to become confusing as to what is actually being presented to the ORRHES. The work group asked to review the document and to submit comments regarding the document. If the work group goes beyond commenting on the document, then the group is outside of what ORRHES has requested the work group to do. If a group wants to go and perform an entirely different review, Kowetha Davidson suggests that the group go to ORRHES and find out if ORRHES really wants the additional review.

Pete Malmquist feels that the group is talking about doing the same thing in two different ways. Pete said that the comment about the focus groups could be brief. A statement could be made that in the minutes of X time, Rebecca Parkin and GWU said that there would be X number of focus groups. However, the Needs Assessment document only identifies two: Why is that and who is responsible for only using two focus groups? This type of statement would be covering both the minutes and the Needs Assessment document. If the minutes indicate that something would be done and it was not done, then a comment on the Needs Assessment document is that DHEP or GWU did not follow through. However, Pete Malmquist does not feel that the group will need to go back and review all of the past meeting minutes.

James Lewis said that the group can put on blinders and only focus on the Needs Assessment document. However, there is frustration because expectations were established based on comments and presentations provided by DHEP, AOEC, and GWU. There are key items in the minutes that are germane to the Needs Assessment product that the group has received. James feels that if the group wants consistency and cohesiveness in its efforts, then the group must fall back to the minutes to some degree.

Jerry Pereira told the group that regardless of what Phase II is, that portion will come before the ORRHES. The NAWG should take the Needs Assessment at face value and not ignore the past history. Jerry Pereira feels that both processes can be used to develop a concise list of comments.

Kowetha Davidson said that the minutes should not be used as a weapon and should only be used for comments.

James Lewis stated that some people view the Needs Assessment process as secretive. James said that there have been numerous problems trying to extract specific details in a timely manner. After reviewing the minutes, James found a statement that indicated that the Needs Assessment process would be performed in a sequence type manner such as a series of events. James Lewis said that if one item in the sequence is weak, he needs to know what has been done to compensate for that weakness. It is difficult to understand how the Needs Assessment document can be used as a foundation for Phase II. Some people may know how to look at it and know where it is going but the NAWG does not. James said that the NAWG will provide strong advice if the group feels that the Needs Assessment product may hamper the ORRHES’s efforts in other areas or may not support what ORRHES is trying to do.

Kowetha Davidson said that all the group needs to do is go back and look at the purposes and goals to see if they were fulfilled.

Barbara Sonnenburg asked Kowetha how that can be done when the group has not been able to see the contract.

Kowetha Davidson asked Barbara Sonnenburg if she feels that there is something wrong with the purposes and goals stated in the document. Barbara Sonnenburg replied that the group needs to see the contract or a copy of the process.

Kowetha Davidson reminded the group that the purposes and goals were presented at an ORRHES presentation.

James Lewis said that some people need additional clarification to help them understand what they believe the purpose and goals were. James stated that the group has the right to ask for more information and what Barbara Sonnenburg is asking for makes sense.

Kowetha Davidson said that Donna Mosby has presented a copy of the purposes and goals in previous meetings. ATSDR should have said something if they had an issue with the purposes and the goals.

James Lewis wants to know if the product is acceptable to ATSDR and to what extent did GWU meet its goals. One purpose of the Needs Assessment was to provide a sound foundation for Phase II. James Lewis does not understand what Phase II is. James asked that someone please define Phase II.

Barbara Sonnenburg said that four people (Al Brooks, James Lewis, Pete Malmquist, and herself) submitted extensive comments. Barbara would like the four people to get together to create one document. James Lewis told Barbara Sonnenburg that he believes this would be appropriate.

Jerry Pereira said that when looking at page 7 of the Needs Assessment document, it is important to not confuse the purpose and objectives. Jerry feels that James Lewis is combining the two. Jerry said that if the purpose is met, then it is OK to go to the objectives. Jerry Pereira recommends that the work group take the document at face value and examine the purpose and the objectives to evaluate if the objectives were met or not. Jerry told the group to look at the shortfalls and the reasons for the shortfalls. Jerry Pereira feels that this type of approach would be more meaningful to the ORRHES than any other approach.

James Lewis told the group to keep in mind that when he was putting together his comments, he tried to do what Jerry has suggested. But at the same time, the ORRHES has new members and people who have forgot certain things. The Needs Assessment document has so much controversy surrounding it that the group needs to develop a procedure to see where we are going and what we are doing. James Lewis said that all of the Needs Assessment issues cannot be argued tonight and that the group of four should get together and bring its findings back to the table.

Charles Washington said that the NAWG seems to have problems with the nature of the document. When looking at the purpose of the study, if we say the study is reliable this same study should prove reliable everywhere. The study is valid only to the point that it is reliable over and over again. The group enumerated seven counties that were going to be affected by the emissions from the various facilities. What concerns Charles is that the study arbitrarily does not include some of the counties and decreased the number of comments from the statistically minimum amount. Charles Washington worries that the comments from the community are statistically invalid. Charles believes that there are other people in the community who will look at the document and say the same thing. Thus, the Needs Assessment has not provided the community with any new information.

Pete Malmquist referred to the objectives listed on page 15 of the Needs Assessment document and said that GWU probably met all of the listed objectives. Pete believes that most people do not have a problem with the objectives, they have a problem with how the results were obtained. Pete wonders if the methods for obtaining the results were flawed. Pete used the 1/3 telephone exchange as described in the Needs Assessment as an example of flawed methodology. Pete wonders what exchanges did they use? If they eliminated the exchange 376 then they eliminated Bradburry where the radioactive iodine went. Pete said that there are issues like these that cause him as well as others to have a problem with the Needs Assessment report.

Jerry Pereira stated that the concerns that Pete described are legitimate.

Pete Malmquist is also concerned about the choice of newspapers that were used to advertise the focus groups. Pete said that people are upset by how they arrived at the results. If the work was not done correctly, the group should recommend that ORRHES does not accept this report because it would be flawed. Pete Malmquist added that he does not know who was surveyed or where they were surveyed.

Jerry Pereira told Pete Malmquist to bring these types of issues in writing from NAWG to ORRHES and if ORRHES endorses the comments, ATSDR will have to respond to the comments.

Pete Malmquist said that the group will review the Needs Assessment page by page. Pete said that there are technical errors and that there is the possibility that the people performing the surveys did not know if they were in Roane or Anderson County.

Barbara Sonnenburg stated that regarding the telephone survey the following sentence jumps out. Just over 70% of the eligible households declined to participate in the survey. Barbara told the work group that she does not know how many people the surveyors spoke with.

James Lewis provided an example of one of his submitted comments. The low community participation in the focus groups and the key resource interviews failed to meet the quantitative needs of the original interview plans. This is very significant due to the fact that these detail interviews were designed to probe or identify the possible reasons for the ORR area’s health issues or concerns. James feels that the group will find that the people making comments about the document are adhering to what the requirements were.

Pete Malmquist would like the people who issued the written comments to form an Ad Hoc group that can sit down and review the Needs Assessment document. Based on the comments and concerns regarding the Needs Assessment document, the group will develop a presentation that will take place at an ORRHES meeting.

Jerry Pereira would like Pete Malmquist’s specific concerns that were mentioned in a letter to Dr. Falk to be included as part of the larger list of concerns that will come back to the NAWG and then be presented before the ORRHES.

Pete Malmquist and Kowetha Davidson feel that Pete’s three questions are separate from the ad hoc task. Jerry Pereira replied that there was an internal meeting and that Pete’s three questions are not being considered separately. Jerry Pereira asked once again that Pete’s questions please be included in the list of comments.

Pete Malmquist said that he does not consider his three questions as comments, rather he considers them as questions to the agency about the work that was done.

James Lewis said that it is his opinion that there may be another entirely different set of comments regarding the Needs Assessment that are similar to the questions that Pete Malmquist has asked. James said that he does not want to make those questions a direct part of the effort to comment on the actual Needs Assessment document. But questions and issues similar to Pete’s will be submitted through the work group process in the same manner as the list of concerns regarding the Needs Assessment document.

Jerry Pereira said that the group can have separate documents. One document could be limited to process concerns and the other could be limited to content concerns. All Jerry was asking is that Pete Malmquist’s three questions are submitted through the NAWG and then to ORRHES.

Barbara Sonnenburg, Kowetha Davidson, and Pete Malmquist said that the issue Jerry has described has already been voted on.

Finally, it was decided that all work group members and ATSDR staff were on the same page and understood the process that would be used to submit comments regarding the Needs Assessment.

James Lewis stated that after the NAWG meeting, the ad hoc group will make arrangements to meet and that the group will inform Donna of the date and time of the ad hoc meeting.

Proposed DHEP/NAWG Meeting Monday, July 28, 2003

James Lewis told the group that it was originally assumed that all of the comments would be pulled together and that representatives from GWU would address the list of comments and issues. However, the group currently is not in a position to meet with anyone.

Bill Taylor said that this issue goes back to when James Lewis and others asked Terrie Sterling and Theresa NeSmith to come to Oak Ridge and meet with the work group to answer questions. Bill said that the work group is now at a different place in their thinking. Bill Taylor asked if there is a need for DHEP staff to come to Oak Ridge.

Pete Malmquist and James Lewis agreed that there is no reason for DHEP to travel to Oak Ridge for a formal presentation. However, James Lewis stated that he would like to be able to contact DHEP if issues arise that require clarification.

Kowetha Davidson said that the need for clarification regarding the Needs Assessment document should be a part of the list of Needs Assessment comments.

Terrie Sterling told the group that she and Theresa NeSmith are quite willing to drive to Oak Ridge and review anything that the group requested be reviewed during the last meeting. However, Terrie does not want to waste the NAWG’s time. Terrie told the group that a trip to Oak Ridge could be very enlightening for her because she is new and going to Oak Ridge would give her a chance to meet the people and see some of the Oak Ridge area. Terrie Sterling wants to make sure that the group understands that both she and Theresa NeSmith are very willing to travel to Oak Ridge but she understands if the work group is beyond that phase and would rather not meet. The decision is up to the NAWG.

James Lewis told Terrie Sterling that he appreciates their willingness to travel to Oak Ridge but he does not see a need for a presentation right now.

The meeting was adjourned at 7:15 p.m.