ORRHES Meeting Minutes
November 16-17,
2000
November 17, 2000
The meeting resumed on the following morning at 8:30 a.m.,
with introductions of those present and a summary of the
previous day by the Chair.
Presentation of ATSDR Needs
Assessment
Ms. Theresa NeSmith, of ATSDR's Division of Health Education
and Promotion, outlined her agency's process of conducting
a community needs assessment. Based on the science of community
health, the process assesses the concerns, strengths, and
resources in a community. By identifying those, it also
can serve as an empowerment tool (e.g., that information
can be used to address traffic patterns, apply for grants,
etc.).
A needs assessment involves several steps, to: assess
community needs and resources, define problems and/or identify
resources. A program is designed in response, which is
pretested (e.g. to a focus group in the community) to ensure
its appropriateness, and then a follow-up is done based
on the pretest results. When final, the program is implemented,
monitored, and evaluated. Part of the process is the definition
of what the "community" is, by the persons in the area.
Information is collected through interviews with community
members or leaders, literature and computer searches, focus
groups, telephone surveys, attendance at formal and informal
community meetings, from census data, and school and occupational
records. Part of the information collected is used to indicate
routes of communication back to the community (e.g., company
picnics, sending information in children's school take-home
folders).
Ms. NeSmith outlined the areas of investigation: 1) knowledge
(about subjects related to the site, such as about science
or disease), 2) attitudes (that influence message delivery:
trusting, suspicious, or overwhelmed by the situation),
and 3) behaviors (that contribute to healthy or unhealthy
lifestyles, such as children eating dirt). Also explored
are the community, social, and local political structures,
accessibility and adequacy to health care, opinions of
the local media, local social services available, and identification
of key community leaders (to get information out and facilitate
community access).
The data from all these areas are very important in developing
health information about a community. This provides a snapshot
of the community; helps to target health education efforts
by indicating what information needs to be delivered and
how; and helps to uncover what else has occurred/is occurring
in the community (e.g., people feeling they've been overly
studied already). It enables the agency and community to
determine the priorities for health education; issues other
than environmental ones may need to be addressed first.
Importantly, the needs assessment helps to develop relationships,
prevents mistakes being made based on assumptions, promotes
successful educational strategies, and serves as a decision-making
tool.
As an example, she presented a community in which ATSDR
is working in Colorado. The community, which is Hispanic
and African-American, is concerned about arsenic contamination
in the soil, in particular about children's ingestion.
The source of the contamination is unclear. ATSDR is planning
a health assessment and study, and EPA is doing soil sampling.
The needs assessment there indicated mistrust of government;
strong family, religious and community ties, and cultural
practices around soil ingestion (e.g., grandparents making
mud pies with kids; pottery brought in from Mexico). Many
of the families are long-time residents, and gardening
is very popular. English is a second language; there are
few healthcare facilities or schools in the area.
ATSDR plans to: 1) address community concerns about government
by working with community representatives to develop/implement
health education, and have them review all communications
to be sent to the community residents; 2) inform family
daycare providers about the issues of soil ingestion; 3)
discuss dirt ingestion with the community (e.g., explaining
why that is being explored first) and provide alternatives
(e.g., get soil from elsewhere as opposed to their own
yards); 4) focus on homes with preschool children and grandparents;
5) provide information about safe gardening (soil amendment
and washing vegetables that do not take up arsenic through
their roots, etc.); 6) work closely with religious and
community leaders (send information to them, hold meetings
at churches, etc.); 7) provide information in Spanish and
English through newsletters; and 8) work with area health
care providers and schools to educate about the health
issues of concern.
The steps in the process at Oak Ridge site involve a cooperative
agreement with the AOEC. They identified George Washington
University (GWU) to conduct the needs assessment, which
is now in the early stages. The GWU researchers will come
to Oak Ridge to discuss their assessment plans with this
Subcommittee. The needs assessment plan will be revised
as necessary, and the process will begin with data collection.
GWU will continually validate the process over the course
of its work. Once the report is developed, it will be presented
to the community and Subcommittee members.
Discussion.The
Subcommittee's discussion with Ms. NeSmith included the
following points:
- How will ATSDR begin to reach everyone in this diverse
community? The process involves referrals, with community
members identifying others to be interviewed. Mr. Pereira
added that a Subcommittee Community Outreach Work Group
could help as well.
- If it turns out that the arsenic came from a company,
what would the agency/Subcommittee's response be? ATSDR
would refer this to the EPA as the regulatory authority.
Mr. Hanley added that ATSDR can identify an exposure
and source, inform the community, and educate on how
can the exposure can be minimized. Given certain criteria,
an analytical epidemiology health study can be done,
to define and measure exposure, determine health outcomes
and measure them, and using statistics to investigate
any association between exposure and outcomes). The needs
and exposure assessments identify the contaminant and
source; the health study is a possible next recommendation.
Mr. Akin noted that EPA Does most of the work of finding
the source in their exposure investigations' air, soil,
and water sampling.
- If done well, the health assessment will be valuable,
but if not, it won't help. How long will it take? ATSDR
is also doing an assessment around the Savannah River
Site (SRS), which is more similar in complexity to Oak
Ridge. The planning up to the present point of going
out into the Oak Ridge community to interview has taken
about 8 months.
- ATSDR was asked to provide a completed needs assessment
as an example and to ensure that the surveys are statistically
valid and that the sampling method and survey reflects
the needs of the community. The concept of a pre-test
was well received, and doing this in various community
neighborhoods was advised, to ensure the survey will
meet needs. Finally, the need was cited for a way to
validate that a person claiming to be a "community leader" actually
is, even if they head up an organization (e.g., ATSDR
should examine the meeting rosters to see if only three
people actually come).
- Who is conducting the SRS needs assessment? The Association
of Environmental Health Nurses (AAOHN) and the Oak Ridge
Institutes of Science and Research (ORISE).
- Why isn't ORISE doing the Oak Ridge work? They would
probably have a shorter learning curve than GWU will
need? When this work was funded last year, ATSDR requested
and received proposals to work at SRS and Oak Ridge.
The cooperative agreement signed with the AOEC included
their identification of their partners, partly to avoid
appearance of too much government interference in the
selection process. They chose GWU, which will be able
to explain fully the work already done at Oak Ridge when
they come to meet with the committee. But they also will
be looking to the committee for information, as would
any contractor. This will be a two-way process. Dr. Brooks
found GWU to be an excellent choice, and even expected
that they may know more about the work in the trenches
at Oak Ridge than ORISE.
- Will the needs assessment address of the community's
perceptions and fears (e.g., an unreasonable fear of
radiation)? Yes, a component of the "knowledge" assessment
is determining if the present community information
is accurate about exposure or diseases, explores fear
of government/agencies, etc. Experts who are also good
risk communicators can help to allay some fears.
- Mr. Washington reported that gold mining is again underway
in the Denver area, which may affect a number of deep
wells. He also commented that a study is valid if it
measures what it is supposed to; and is reliable if it
consistently Does so. He advised using the same community
as the SSAB (the five counties closest to the ORNL, plus
two more since lakes/streams win 100 miles have been
contaminated). He also observed that many local groups
that have done work lack credibility as well. While he
did not believe that DoE deliberately tells people to
stack the deck, some (not just scientists, but workers)
believe that they want it done; do it; and have been
rewarded for it. That is one reason why people don't
believe the data. There are also members of the general
public who refuse to believe that a threshold of danger
has been passed for a contaminant. He expected that the
public would continue being divided.
ORRHES Guidance Document Presentation/Discussion
After a short break, Ms. Jan Connery, of the Environmental
Research Group (ERG) engaged in a thorough review with
the Subcommittee of a draft operational guidance document
developed by Dr. Davidson, ERG, and ATSDR staff. She suggested
forming a Procedures work group to incorporate the comments
received so far into another draft to be returned to the
Subcommittee. This is a living document of five sections;
Sections 1-3 provide the purpose and history of the Subcommittee
(the latter is charted on Attachment #2); Section 4 addresses
its organizational structure and roles (charted on Attachment
#3), and Section 5 provides process guidelines. Sections
4 and 5 are appended to these minutes as Attachment #4,
rather than reported here for the reader's review, since
much of the information in the guidance replicates that
already provided in this meeting and reported in this document.
Discussion: ORRHES
members provided input in writing prior to this meeting
(which was discussed) and during the review itself, as
follows:
Organization
- Why is DoE not on the organizational chart? This was
a conscious decision, since the MOU requires DoE to provide
ATSDR/CDC with any information needed, and many communities
want to avoid any DoE influence on the agency's or Subcommittee's
activities. Including them on the chart might infer that
DoE has some influence over the recommendations or studies,
which they do not.
- Won't DoE provide the data and fund the work? Mr. Bert
Cooper of ATSDR confirmed that most of the data used
will be DoE's, but ATSDR will also look for other sources
(e.g., EPA data) to validate it. ATSDR's sampling capacity
is very limited. And, although DoE Does fund the work,
the MOU specifies ATSDR's independent execution of DoE-funded
studies. The intent was to correct the lack of credibility
of DoE's self-conducted studies.
- Dr. Frome suggested placing community groups and unions
on the chart as well.
Work Groups
- How does conflict of interest relate to work group
members? How are community members selected to participate
in a work group, and can they be co-chaired? Mr. Hanley
reported that conflict of interest is not applicable
to community members, only to Subcommittee members, because
they will deliberate and recommend to ATSDR. Community
members are not paid for their work. Mr. Hanley will
check with CDC's Office of General Counsel for the formal
regulations relating to work groups (e.g., whether non-Subcommittee
members can vote in the work group, which the Subcommittee
members thought should be all right). Mr. Pereira stated
that the Subcommittee can invite members of the public
to participate in a sanctioned ORRHES work group. He
agreed to check on the co-Chair, but suspected this should
be a Subcommittee member, since a citizen has no responsibility
to either the work group or the Subcommittee. Ms. Kuykendahl,
of CDC's Committee Management Office, agreed to check
and report back on the work groups. Since they are not
subject to FACA, their requirements could differ.
- The Subcommittee members felt the member of the public
should be able to vote on work group questions to check
for consensus. Dr. Brooks stressed the need for open
work groups, and of acknowledging those who consistently
participate as a work group member. Ms. Sandy Isaacs
appreciated that advice and requested more on what works
best at Oak Ridge. While only the Subcommittee can vote
and provide consensus recommendations to the agencies,
the work groups can help this group explore and settle
issues. The only legal limitation on the work group is
that there must be a DHHS staffer present.
- Ms. Connery summarized that flexibility and openness
are to be desired on the work groups, and that perhaps
semantics are related to the work group's "consensus".
Process Guidelines
- Mr. Pereira noted that, in order to not violate FACA,
the Agenda Work Group can form and disband at the will
of the Chair, rotating members.
- Dr. Brooks moved that the Procedures Work Group, when
appointed by the Chair, consider the Draft Operational
Guidelines and the comments received, and recommend on
them to the full Subcommittee. The motion was seconded
and, with 12 in favor and one opposed, the motion passed.
- With note that a simple majority is a long way from
consensus, the Subcommittee discussed whether to require
a super majority (i.e., two-thirds) to pass a vote on
a motion (the process is charted in Attachment #5). Alternatively,
Dr. Davidson suggested referring the question to a work
group for further discussion and then returned to the
Subcommittee. Straw votes could be taken during Subcommittee
discussion to assess where the members stand, which would
also help to ensure all sides are represented in any
work group created. It was agreed to add a box to show
referral to the work group for further discussion.
- Dr. Brooks noted that Robert's Rules considers calling
for an end to discussion an infringement on members'
rights, and requires the super majority to pass a motion.
Ms. Connery noted that the guidelines borrowed from Roberts
Rules in some respects, this being one, and that consensus
is not always possible.
Public Comment
Mr. Peele suggested a procedure that, if work groups come
to any kind of agreement, this be put in the public record;
and 2) if the group has approved a recommendation, that
should be reportable in any media interview of a member.
He stressed the importance of handling work groups sensitively,
something not done early in the SSAB's work, leading to "disastrous" results.
People working on a work group must be recognized. They
resolved this by letting anyone who wished to sit at the
table and participate; the work group produced letters
to the agencies and those present signed them. Finally,
he suggested a dotted line on the organizational chart
to show DoE's relationship. Since individual DoE scientists
might have high credibility, hearing about their work from
that individual who did it might be helpful.
Mr. John Steward posed several pointed questions. He began
by noting that Dr. David Michaels, Assistant Deputy Secretary
to DoE Secretary Richardson, had observed that DoE spent
$27 million in the last year studying workers. He observed
that this committee seems ready to do so again, with the
needs assessment. He asked when the local people get the
benefit of this committee? Will this be more production
of papers to be placed in the Reading Room? He called for
a start in defining the destination of all this work, to
indicate why the public should contribute. He stated that
the union's help in previous work had been provided before,
but would not be this time. They want some results; they
want to know why people are dying.
Ms. Janice Stokes said that she had considered, but could
not, participate on this committee due to her disability.
It looked to her like a well-oiled machine. While she respect
the knowledge present, she felt it to be heavily weighted
to the DoE perspective. She asked where the common citizens
were on this board, suspecting that they were absent partly
by choice and partly by protest. Not only workers but also
off-site residents had been damaged by documented contamination,
carried by wind, water, and soil. She and citizen's groups
had asked ATSDR, CDC, and DOE for 9 years to provide Oak
Ridge with something tangible to hold on to about the work
and making a living, and to address unusual cancers and
other diseases in concert with the health department. Many
people see the Subcommittee as a way to keep Oak Ridge
economically viable. Unless the members can help the people,
they will not have credibility, and will have wasted the
taxpayers' money. The citizens must be able to provide
input and impact to the work group meetings. While she
had little hope for gains from this board, she challenged
it to get something positive done to give the community
a product useful to help the public's health.
Mr. J.W. Fowlkes stated that the assessments and studies
had already been done, and the community can say by whom,
of what, and where. He wished this committee would move
to validate what is already known, because the community
does not need 9 more years of people from GWU to tell them
what they already know.
Dr. Frome asked Ms. Stokes if she was one of those in
the community who would not trust this Subcommittee's findings.
She responded that while she had learned not to trust much
after 9 years of ATSDR's condescension, the ORRHES could
earn her trust if it does a good job (e.g,. establishes
a clinic to screen people for toxic exposures, inviting
public involvement in the meetings). The experience of
the past 9 years has made doubters of her and the community
that anything but inconclusive studies will be done.
Dr. Frome responded that he is an ORNL employee, but both
he and his wife also have medical problems and the members
represent themselves and the community. He was involved
in the worker studies and had never seen any hint of DoE
interference. Ms. Stokes believed him, and recognized independent
representation on this board. It they can do anything solid,
it will be appreciated. Mr. Pardue stated that public participation
in the ORRHES' activities is of concern to the members,
and asked her to attend.
Mr. Steward knew that several committee members are independent
members of this committee (e.g., Mr. Washington and Ms.
Kaplan), and found that to be a big step forward in Oak
Ridge's process. Ms. Sonnenburg asked that the speakers
from the public to leave their phone numbers so the committee
members could talk to them further.
Ms. Kaplan wondered if Ms. Stokes was not on the committee
because she would lose her disability benefits if she is
paid to participate. She confirmed that. Ms. Kaplan stated
that a person to represent those who are ill is needed
on this committee and suggested a waiver be procured for
her. She also asked if GWU could act as an impartial observer
for a local outfit to do the work to ensure the data aren't
corrupted, rather than wasting 3-6 months getting set up.
She commented further that $500,000 had already been paid
to a group in Washington who issued a report the community
found to be not worth it.
Continuation of Process Guideline
Discussion
- Ms. Sonnenburg suggested that the Work Group on Organizational
Structure consider setting a time in advance of the next
meeting by which the work group would submits its recommendations.
- Ms. Sonnenburg moved that the Subcommittee recommend
to ATSDR that they consider getting a waiver for Ms.
Stokes to serve on this Subcommittee. Frome seconded.
However, Mr. Pereira reported that ATSDR had explored
this with the Social Security Administration, and providing
such a waiver is not within the jurisdiction of DHHS.
However, such a person could serve on the committee without
pay. Mr. Hanley added that one nominee's attorney advised
her not to participate, and there is an outstanding invitation
to participate to someone who self identified as a "sick
worker." In addition, some members are here because the
ORHASP findings indicate them to be at high risk.
Mr. Hill stated, as the union health and safety representative and one who
works on compensation issues (SSI, worker's compensation, disability), that
any disabled person would risk all their benefits if they accepted payment
for participating on this committee. They really do need to listen to their
attorneys. Ms. Sonnenburg: withdrew her motion. However, Ms. Kaplan still
wanted to take this question to the upper agency levels, finding it logical
that the SSA office to which ATSDR refers such questions will tell them that
they cannot participate. With that, the committee adjourned for lunch.
Discussion of Work Groups
Mr. Pereira presented an overview of the work groups formed
by the other Subcommittees and outlined what they address.
The Hanford Subcommittee (HHES) has four work groups,
addressing: 1) Public Health Activities (focuses on issues
affecting the public health and is developing an exposure
registry and medical monitoring program with ATSDR); 2)
Health Studies (focuses on related health effects research,
considers the development of new health research proposals,
and advises ATSDR and CDC); 3) Public Health Assessment
(focuses on ATSDR's Hanford site assessment); and 4) Outreach
(develops procedures to keep the public informed of the
HHES' communication activities).
The INEELHES has five work groups: 1) Agenda (develops
meeting agendas in cooperation between the members, the
DFO, and CDC; 2) Education; 3) Membership, (recommends
the criteria to use in seeking a replacement for a vacancy
or additional membership position); 4) Procedures (develops
definitions, action guides, and rules to facilitate the
deliberations and decisions of the Subcommittee. These
can be modified as necessary by consensus and acceptance
by the INEELHES and CDC for the Subcommittee's operation);
and 5) Public Communications (develops and monitors public
involvement activities and proposes a public communication
plan for INEELHES consideration/approval, to outline the
role of public participation in the Subcommittee's work).
Mr. Robinson added that these can be flexible; some of
them have been combined.
The ORRHES had already considered three work groups to
address the Agenda (developing and prioritizing agenda
items/issues to present to the Subcommittee); Procedures
(finalizing the guidelines document), and Education (recommending
to the Subcommittee requests from members/work groups to
invite interested individuals, community members, or technical
experts to participate directly in a discussion or to make
a presentation).
Mr. Pereira asked that no one be invited to join the work
groups until those related questions are resolved (which
he committed to do within 30 days). Further discussion
of the Subcommittee included the following points:
- The Agenda and Education work group seem to overlap
in procuring assigned speakers, and should be combined.
Education also overlaps with Outreach.
- Forming work groups to seek out the information the
needs assessment would require was suggested, but Dr.
Davidson advised patience until GWU can present their
plans for the Subcommittee's input. The CDC and ATSDR
staff agreed. Mr. Robinson thought that the information
needs would become apparent over time, and advised against
forcing a framework based on ATSDR's. Mr. Pereira also
noted that much of the institutional knowledge was available
through this committee's members.
Dr. Brooks moved that standing work groups be appointed
by the Chair: 1) a Guidelines and Procedures Work Group;
2) a Program of Work and Agenda work group; and 3) a Communications
and Outreach Work Group; and that 4) other ad hoc work
groups be appointed as needed. Dr. Malmquist seconded the
motion. Dr. Brooks explained that the first would be limited
in scope, only occasionally needing to meet for work; the
second would plan out what would be done, when, and receive
suggestions from members, and work with the Chair to assemble
program of work and agenda; the third would communicate
to the Subcommittee members, and carry out outreach to
the public, and the last would allow others to address
specific issues.
In discussion, two opinions were expressed: 1) that the
members needed to get more guidance from ATSDR about what
is expected of them, so forming work groups was premature;
and 2) that most of the information dissemination on the
agenda was complete, and it was preferred to move forward.
Since the first two issues (agenda and guidelines) are
critical to the agenda for the next meeting, it was agreed
to vote on all the work groups as moved. Dr. Davidson called
for a vote on the motion. With 16 in favor and one opposed,
the motion carried.
Volunteers signed up for the work groups as follows:
- Guidelines and Procedures Work Group: Davidson (who
suggested sending the draft to Ms. Connery for incorporation
of comments and distribution), Pardue, Johnson, Manley,
Brooks.
- Program of Work and Agenda Work Group: Hill, Eklund,
Creasia, Sonnenburg, Malmquist, Brooks.
- Communications and Outreach Work Group to develop methods
for internal and external communication: Kaplan, McNally,
Lewis, Creasia, Mosby, Brooks, Frome, Washington.
Public Comment
Mr. Robinson referred to a comment by Mr. Lewis which
suggested that close contact with the University of Tennessee
might be negative. He related that CDC had contracted with
them to conduct a door-to-door survey in Scarboro, which
was done by students from the UT College of Social Work.
He stated that they did a creditable job and turned in
the data, which CDC tabulated and analyzed. He added that
this also was a good opportunity to involve the community.
Mr. Lewis did not debate that, clarifying that his quarrel
was with the approach taken. Each agency focuses on their
own particular sphere of interest, but communities frequently
have issues that will not be addressed in an all-inclusive
survey. In his opinion, the overall impact of that method
did not satisfy the needs of the community, and made subsequent
work more difficult.
Committee Planning Discussion
Mr. Pereira announced that by January 1, 2001, ATSDR will
have a permanent storefront office. It will be open for
normal hours of operation, five days a week, in Oak Ridge
at Tulane and Wilson, across from the Bank of America.
Meeting Site. He then asked the members
their opinion of the YMCA as an ORRHES meeting site. While
the location was found to be fine in general, it is long
distance for some of the members to call home, and there
is only one phone; and it is difficult to make a left out
of the parking lot in the evening. Alternate sites suggested
were the mall, which also has multiple eating places, or
the Hazmat facility at the old Aubrey Springs shopping center.
Action Items. Mr. Pereira: summarized
this meeting's action items for ATSDR to do:
- ATSDR will provide a copy of the ORHASP studies' summaries.
- CDC and ATSDR will provide a listing of the recommendations
made over time by the other Subcommittee s/cs, and what
happened in response.
- ATSDR will provide an example of a completed needs
assessment to the Subcommittee.
- CDC/ATSDR Committee Management and the Office of General
Counsel will explore the regulations and procedures of
what Subcommittee work groups can and cannot do. Mr.
Pereira will advise the members within 30 days of any
formal procedures found.
- The Procedures Work Group will consider the draft operational
guidelines and the comments received earlier and at this
meeting (including the revision of Figure #2), and recommend
on them to the full Subcommittee. A new draft will be
provided with the initial member changes and the Work
Group's changes redlined.
- ATSDR will try to provide copies of the independent
East Tennessee Technical Park investigation study report
provided by Norman Mulvenon (two bound volumes).
- A PCB toxicological profile for will be provided to
Dr. Eklund and Mr. Akin.
- Dr. Brooks will meet with Ms. Bush on a compendium
of Oak Ridge-related data.
Mr. Robinson advised that these action items always be
clear at the end of the meeting so that ATSDR can address
them. He noted in particular that action items are created
by consensus; everything else is an individual request.
He also suggested that at least an outline of the next
agenda be created before disbanding.
Next Agenda. Dr. Davidson summarized
the next meeting's potential agenda items: 1) a NIOSH report
by Mr. Larry Elliott; 2) provision of more detail from
ATSDR on the public health assessment; 3) GWU presentation/discussion
of the needs assessment; and 4) reports of the Standing
Committees. In addition, it was reported that Dr. Henry
Falk, ATSDR's Administrator, may attend; as well as Dr.
Paul Seligman, Deputy Assistant Secretary for Environmental
Safety and Health and Director of the Office of Health
Studies. Mr. Tim Joseph added that Dr. Leah Dever, the
DoE/Oak Ridge Operations Manager, is also interested in
attending to welcome the committee.
Mr. Brooks suggested that the Chair appoint the Work Group
Chairs, and she agreed.
Future Meetings. The members
tentatively agreed to meet on January 18-19, 2001, when
almost all can attend. Dr. Eklund cannot meet on Tuesdays,
nor Ms. Kaplan on Wednesdays. Ms. Sonnenburg will be abroad
at the end of January. Mr. Lewis suggested attention to
the timing of presentations related to public participation
(e.g., have Drs. Falk and Seligman present when the public
could participate). Mr. Cooper also suggested the Agenda
Work Group's consideration of the other Subcommittees'
schedule, which may involve a full day plus an evening
session, and then ending at noon on the second day.
Mr. Hill asked how soon the work groups could begin meeting,
and Dr. Davidson said any time. An ATSDR staff member must
attend, but could do so by conference call which ATSDR
can set up with a toll-free dial-in. Dr. Brooks asked what
the full time staff person in the Oak Ridge office would
do. Mr. Pereira listed meeting attendance in the area (other
local groups, work groups, and the Subcommittee), staffing
the office, providing publications and computer access,
providing drop-in consultations, etc. The office also will
have a small conference room that could host work group
meetings.
Mr. Pardue said that the Guidelines and Procedures Work
Group would probably will have to meet the first week in
December, in order to provide the draft guidelines to Subcommittee
before the January meeting. Dr. Davidson committed to appoint
the Work Group Chairs by the next Friday. Mr. Pereira suggested
that those Chairs then contact him or Ms. Bush and they
will begin to set up the meeting times and places. Ms.
Sonnenburg suggested an ATSDR staffer be in Oak Ridge for
2 days in December, and scheduling all the work group meetings
on those days.
Ms. Kaplan asked how the Subcommittee could address enlisting
a sick worker as a member, to surmount the difficulties
to date. Mr. Pereira responded that the first order of
action would be to identify such a person. Since there
is one such invitation pending, Dr. Davidson suggested
holding on that action item until the next meeting to give
that person an opportunity to respond to the formal invitation.
Mr. Lewis suggested the Subcommittee write a letter to
request that person's participation. Since ATSDR cannot
reveal his/her name, it could be sent through the agency.
Dr. Eklund proposed also pursuing Ms. Stokes or someone
else in parallel with checking on that pending invitation;
if 2 rather than 1 new members result, that would be fine
too. He also suggested seeking support from a congressman
to overcome the disability payment/Subcommittee service
problem. But before the Subcommittee does anything like
that, Mr. Pereira reiterated his suggestion that her interest
in being a member be ascertained first. Mr. Hanley added
that, if the invitee declines, member nominations would
be re-opened.
Dr. Brooks strongly felt that sick workers should be represented,
and recommended ascertaining as soon as possible (e.g.,
within 10 days) if the outstanding offer will be accepted.
If not, another person not so constrained should be found.
Mr. Akin wanted to ensure that "sick worker" is not an
offensive term. Ms. McNally agreed; the label of "sick
worker" also worried her. Since health exists in a continuum,
and unless that term was volunteered by a group of individuals,
she would not agree with it. She also wondered if the disabilities-benefits
problem could be resolved by enlisting community members
who were adversely affected just by living in the Oak Ridge
area.
Mr. Pereira reported a suggestion voiced at the break
that the Subcommittee invite representatives of SSI, Workers
Compensation, etc. to discuss what is allowed or not. Mr.
Hill's suggestion of parallel solicitations also could
be done, with the same formal nomination process to ensue.
Dr. Davidson referred this to the Agenda Work Group.
However, Mr. Hill was loathe to address SSI, workers compensation,
long- and short-term disability, and litigation issues,
because they do not pertain to the ORRHES charter. Dr.
Davidson noted that people can self-nominate; the Subcommittee
does not have to notify ATSDR of a nomination to fit a
category. But the Outreach Work Group could ask community
members about their interest in being on the Subcommittee.
Closing Comments
Dr. Davidson requested a one-sentence meeting assessment
from the members, most of whom responded in one word: interesting
(Dr. Kuhaida); still learning (Dr. Lands and Mr. Lewis);
great day (Mr. Manley); eye-opening (Ms. McNally); the
Subcommittee has its work cut out for it, but hoped they
could all be friends (Ms. Kaplan); the tasks are challenging,
but he hoped something positive could be accomplished (Mr.
Pardue); challenging (Ms. Sonnenburg); fantastic (Mr. Washington);
invigorating (Mr. Johnson);
"Did I mention I'm a grandfather?" and his rising interest (Mr. Hill); good job
(Mr. Nwangwa); good meeting (Dr. Frome); worthwhile (Dr. Eklund); still ambivalent
(Dr. Creasia); still learning and interested (Ms. Vowell); very good (Mr. Akin);
predicted a storm at the next meeting (Dr. Brooks).
Mr. Lewis was impressed with the comments offered by Mr.
Farmer on the previous day. He stressed the critical importance
of how such issues are addressed, particularly to people
who can only come once or twice. Their issues, telephone
numbers, and names need to be recorded. As Mr. Pereira
had done, the Subcommittee needs to make a commitment to
the public. If it is to be a go-between or liaison, a process
must be in place to ensure that feedback occurs.
Dr. Davidson reported having spoken with Mr. Farmer outside
of the meeting and reiterated the invitation that he return
when Mr. Elliott attends the January meeting. She suggested
that follow-up with the public be discussed by the in the
Communications/Outreach Work Group.
Mr. Henley noted that all the material sent to the Subcommittee
members also was sent to the mailing list (100+ people),
with a form to fill out if they want to continue to receive
this material. Mr. Pereira appreciated what had emerged
as a passion and interest in doing a good job. He applauded
the good groundwork done at this meeting.
Dr. Davidson thanked the Subcommittee members for the
past two days' work. She had learned a lot, expected to
continue to do so, and hoped to continue to improve as
Chair. She thanked the members of the community for their
comments, which will be taken under advisement. Finally,
she noted that Ms. Bush's address is on the committee list
for those who wanted to communicate with her. With no further
comment, the meeting adjourned at 4:00 p.m.
I hereby certify that, to the best of my knowledge, the
foregoing Minutes are accurate and complete.
Kowetha A. Davidson, Ph.D., Chair
Attachments
Attachment #1
Motions and Action Items, 11/2000 Meeting
Motions passed during the November 2000 ORRHES meeting:
- The Procedures Work Group, when appointed by the Chair,
consider the Draft Operational Guidelines and the comments
received, and recommend on them to the full Subcommittee.
- Standing work groups will be appointed by the Chair:
1) a Guidelines and Procedures Work Group; 2) a Program
of Work and Agenda work group; and 3) a Communications
and Outreach Work Group; and that 4) other ad hoc work
groups be appointed as needed.
Action Items Created at the November, 2000 ORRHES Meeting:
- ATSDR will provide a copy of the summary of the Oak
Ridge Health Assessment Study Panel.
- CDC and ATSDR will provide a listing of the recommendations
made over time by the other Subcommittees, and what happened
in response.
- ATSDR will provide a completed needs assessment to
the committee as an example.
- Committee Management and CDC's Office of General Counsel
will explore the regulations and procedures of what Subcommittee
work groups can and cannot do. Mr. Pereira will advise
the Subcommittee within 30 days of the formal procedures
found, if any.
- ATSDR will try to provide copies of the independent
investigation of the East Tennessee Technology Park study
report provided by Norman Mulvenon (two bound volumes).
- A PCB toxicological profile will be provided for Dr.
Eklund and Mr. Akin.
- Dr. Brooks will meeting with Ms. Bush on a compendium
of Oak Ridge-related data.
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