Hennepin County officials convened a special meeting Thursday to wrestle with Minneapolis' decision to end its contract with the county's epidemiology team for disease tracking and containment.
The city signaled to the county late last year that, come April, it will perform its own disease services rather than pay the county $200,000 annually for the work.
Minneapolis Health Commissioner Gretchen Musicant said the decision to end the 35-year arrangement grew from a desire to streamline epidemiology work and do it better. "There really wasn't a problem to solve," she said.
County commissioners and administrators, however, seemed puzzled both by the decision and how the services can be neatly disentangled. While the city's $200,000 payment was not significant in the massive county budget, they said the disruption was.
"This is not a money issue by any means; it's about the health and safety of our population," said Jennifer DeCubellis, the county's deputy administrator for health and human services, after the hourlong public study session with the County Board and staffers.
Hennepin County runs the largest local health department in the state. Bloomington performs similar services for Richfield and Edina, but Minneapolis has a uniquely vulnerable population with more poor and homeless residents.
County leaders talked about how they are better positioned to avert and tame public health problems because of their broad social services mission. The county runs most homeless shelters and provides health care for the indigent.
Commissioner Jan Callison said the split with Minneapolis "flies in the face of the trend toward consolidation" of government services. She asked at the meeting what would happen when a Minneapolis resident walks into a county public health clinic with tuberculosis.
"We would still provide service," County Public Health Director Susan Palchick said.
The county now conducts disease investigations for the city and tracks the treatment of those who might have been exposed. Under the new arrangement, the city will be responsible for the investigation and follow-up.
Hennepin County's epidemiology unit treats and prevents environmental health issues. It tracks food-borne illnesses, lead contamination and indoor air complaints. The unit also inspects and investigates lodging, swimming pools, children's camps and indoor air complaints.
Musicant said the severance, proposed by her office, grew from "changes in staff capacity," a desire to streamline the services, and the "marginal additional flexibility" that would come by not paying the county $200,000. She said city officials believe the change will be "cost neutral" and that residents' health "will be attended to as well or better than it has up to this point."
County leaders, however, said Minneapolis was getting much more than $200,000 worth of services. They raised concerns about the city expecting the county to continue to do some work for free, and questioned how the separation made sense in terms of administrative costs.
Most of Hennepin County's epidemiology work occurs in Minneapolis. According to the county, Minneapolis accounts for at least half of its public health cases even though only a third of the county's population lives in the city.
From 2017 through 2019, Hennepin County saw 67 measles cases, 73% of them in Minneapolis. Over that same period, the county saw 174 tuberculosis cases, with 47% in the city, and 50 cases of hepatitis A, with 70% in the city.
County epidemiology manager Dave Johnson said the county spent $395,000 in 2017 to fight a significant measles outbreak concentrated in Minneapolis' Somali community.
The handoff to Minneapolis is expected to occur at the end of March. County Board Chairwoman Marion Greene said she plans to meet with Mayor Jacob Frey about the decision.
