Pulling Together Section One -- Roles
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SECTION ONE: Roles and Responsibilities As with many current environmental and public health issues, the challenges of effectively addressing public health and environmental protection at hazardous waste sites are greater than one agency or discipline can manage. A significant factor that hinders effective communication and collaboration is poorly defined roles and responsibilities. "No one person or group always has the lead on any site. The lead shifts as a need arises. The shift is smooth because everyone works well together. They realize they all have the same goal. There are fewer overlaps in function—more of a collaborative effort." — LCP site, Georgia, ATSDR Regional Representative The web of regulations and agencies assigned to overseeing environmental and public health issues related to hazardous substances is as complex as the environmental health issues related to the hazardous substances themselves. Thus far, the "solution" to the complexity of these technical issues has been to bring together the knowledge, expertise, and resources of agencies working across multiple disciplines. However, with this solution comes the fragmentation of authority and a new challenge: effectively working together across multiple agency boundaries, mandates, authorities, jurisdictions, and cultural differences. Though federal, state, tribal, and local environmental health agencies have a common goal of improved public health and environmental protection, the means to achieve this goal depend upon the resources, focus, and perspectives of the various agencies as well as the diverse professional training and perspectives of agency staff. These differences are intended to be complementary, but can lead to real or perceived conflict and confusion among involved agencies and the community. The challenge is to seamlessly leverage these differences to provide the team of individuals working together with more information, expertise, and resources—bringing the best that each agency has to offer to bear on the problem to improve public health and environmental protection. Improvements in science and technology offer one part of the solution, but effective management of hazardous waste sites, and the communities affected by them, requires improvements in interagency collaboration. Overlapping Roles and Shared Responsibilities Given the web of responsibilities and authorities created by federal and state regulation, it is often difficult to delineate where one agency's responsibilities end and another agency's begin. For example, two major federal agencies—U.S. Environmental Protection Agency (EPA) and the Agency for Toxic Substances and Disease Registry (ATSDR)–are both mandated to protect public health. EPA is the lead agency for site remediation (clean-up) and ATSDR for public health investigation and intervention. Both agencies collect and use health data for different purposes. While EPA collects site samples and health data to determine long-term remediation, ATSDR conducts human health assessments and consultations to determine existing human health exposure and consequences. "At the beginning of meetings and conference calls, participants introduced themselves, giving their name, the agency they work for, and their or their agency's roles, interest, and mission. This helped to keep the various participants informed of roles and responsibilities, and also to keep the meetings focused".— Lowell Lufkin, Director of Environmental Health (OH) Understanding the distinct and overlapping roles and responsibilities of each agency involved is a critical first step to building effective working relationships and garnering the benefits of interagency collaboration. To help you define the roles and responsibilities of various agencies, a brief description of many key agencies is provided below. Click here for the Roles and Responsibilities Chart, which notes the core roles and responsibilities at hazardous waste sites, and illustrates where the roles and responsibilities overlap among the five key agencies—EPA, ATSDR, the state health agency, the state environmental agency, and local public health agencies (LPHAs). For more detailed descriptions of each agency's role and responsibility, click on the agency title below.
"Getting Your Ducks in a Row" and the Perception of Secrecy A tension often exists between the desire to begin interagency collaboration without public participation in order to "get your ducks a row" and the desire to gain the trust, acceptance, and cooperation of the community. Caution should be exercised when choosing to hold meetings that exclude community members. This action can create a perception of secrecy and decision-making behind closed doors. A closed door inevitably leads to the assumption that there is something to hide. Why Collaborate The overlap of roles and responsibilities by multiple agencies may seem confusing, duplicative, and even contradictory, especially to the newcomer and members of the affected community. In fact, much of the conflict at sites between agencies and community members may arise from the perceived lack of coordination or the presence of conflict among agencies. Therefore, effective interagency collaboration is an essential ingredient for effective agency-community interaction. This brief overview of the multiple roles and responsibilities at hazardous waste sites highlights the need for interagency communication and collaboration, not only to accomplish the complex task of site clean up, but also to address the range of community concerns related to the hazardous substances and agency actions at the site. Interagency teams should discuss and define these roles at specific sites early in the collaborative process to ensure understanding of one another's responsibilities and commitments. Roles and responsibilities should be re-evaluated throughout the multiyear process of site remediation to improve collaboration and communication among all parties. The worksheets listed below should help you get started. The next section, A Framework for Agencies Working Together, will help you build from this understanding of differing roles to developing shared purpose and joint action. Opportunities and Need for Collaboration
Worksheets
ATSDR ATSDR is the public health agency mandated to address human health concerns at hazardous waste sites. ATSDR is funded through Superfund money and sits within the Centers for Disease Control and Prevention. Its mission is to "prevent further exposure and adverse human health effects, and diminished quality of life associated with exposure to hazardous substances from waste sites, unplanned releases, and other sources of pollution present in the environment." ATSDR employs a multidisciplinary staff including epidemiologists, physicians, toxicologists, engineers, public health educators, and support staff. ATSDR has an advisory role only; for example, ATSDR can advise medical treatment, but does not provide it. Also, ATSDR advises EPA on health measures, such as providing an alternative water supply for a community or restricting access to a site, but it cannot require EPA to follow these recommendations. For more information see the ATSDR Web site www.atsdr.cdc.gov/faq. Here, you will find information on how EPA and ATSDR differ, what ATSDR cannot do under legal mandate, and other useful information.
Primary roles and responsibilities: Scientific/data
Community
Interagency
Health Consultations Health consultations provide assessment and service on a specific health issue related to possible human exposure. ATSDR can provide assistance about the potential health impact of exposures, supply information about ways to reduce exposures, or determine appropriate public health measures. ATSDR can be petitioned to conduct a health consultation on non-NPL sites. Health consultations are generally completed within several months. Public Health Assessments ATSDR uses environmental, health outcome, toxicological, and community concerns data to undertake a thorough evaluation of the public health impact of a site. If a site poses a public health hazard, ATSDR identifies public health actions that may prevent or reduce exposure, or lessen the impact of that exposure. If a site may pose a public health hazard, ATSDR identifies what information needs to be obtained about the site or the substance in order to determine whether the site poses a public health hazard. Public health assessments are conducted at all NPL sites and may be petitioned at non-NPL sites. They may take up to two years to complete. EPA EPA was created in 1970 as the federal regulatory agency responsible for "protecting human health and safeguarding the natural environment—air, water, land—upon which life depends," as stated on the EPA Web site. EPA's broad powers include regulation and enforcement. It primarily uses scientists, engineers, lawyers, and analysts to carry out its responsibilities. EPA oversees the remediation (clean-up) process at all Superfund sites and most hazardous waste sites except for military sites. EPA may formally delegate authority to a state agency for oversight of clean-up for non-military sites. For more information, see the EPA Web site at www.epa.gov/superfund.
Primary roles and responsibilities Authoritative
Scientific/data
Community
Interagency
Note: If the state, tribe, or, in rare cases, local agencies have the lead in remediation, they would adopt some of the responsibilities listed above. Local Public Health Agencies (LPHAs) "The role of the LPHA in the relationship changes as needs arise. LPHAs have conducted blood sampling, surveys, and lead/paint testing where they are able." – Director of Environmental Health, Marion County Health Department (OH) LPHAs provide a variety of public health services to protect and ensure the health of the people living in their jurisdictions. Some of these services are inspections, maternal health programs, communicable disease control, health education and promotion programs, lead screening and abatement, family planning, and solid waste management. There are approximately 3,000 LPHAs nationwide. About two-thirds of them serve populations of 50,000 or smaller. The average-sized health department has a staff of 20, with staff sizes ranging from 1 to 21,700. On average, 46 percent of total funds come from state and federal sources; local sources provide 34 percent; and Medicaid, Medicare, and other sources account for the rest. For more information about LPHAs, visit the NACCHO Web site at www.naccho.org. Local public health agencies (LPHAs) have no statutory authority at hazardous waste sites, and cannot enter intercooperative agreements with ATSDR or be delegated authority by EPA. However, they still play an essential role at hazardous waste sites. In fact, this lack of statutory authority and associated mandates, may enable LPHAs to ensure that site issues are not dealt with in isolation of other public health issues of concern in the community. Local public health officials work to address the individual and community impacts of a site or hazardous substance in the context of the multiple public health as well as socioeconomic factors in the community. As the local governmental presence, local health agencies serve as an immediate point of contact for communities and agencies. Therefore, LPHAs must be informed and capable of addressing community concerns and questions. Additionally, LHPAs can serve in a leadership capacity or assist others with communication and coordination of public health issues among all interested and affected parties. Local public health agencies often take a role in collaborating with community residents due to their close proximity to the site; access to health records; and close connection to community members, local physicians, and media. "Local health officials have critical roles in identifying community health concerns and populations-at-risk, developing local responses to prevent or minimize exposure to hazardous substances, and ensuring that the responsibilities and commitments of other agencies and parties are carried out" (Don't Hazard A Guess, pg. 18). Primary roles and responsibilities: Local Public Health Authority
Scientific/data
Community Involvement
Interagency
State Department of Health State health agencies often have cooperative agreements with ATSDR to perform health assessments and other health-related work. States with cooperative agreements must follow technical guidance developed by ATSDR and are held to the same federal standards. For more information about state health agencies, see the Association of State and Territorial Health Officials' (ASTHO's) Web site www.astho.org. Primary roles and responsibilities of the State Department of Health: Scientific
Community
Interagency
State Environmental Agency State environmental agencies may take responsibility for aspects of site remediation if authority has been officially delegated by EPA. Generally, state agencies have the primary role at a hazardous waste site during the pre-remedial (conducting Preliminary Assessment and Site Inspection) and post-remedial (long-term operation and maintenance) phases. The state must meet the minimal federal remediation requirements. Thus, they can enforce stricter standards, but cannot weaken the federal standards. For more information, see the Environmental Council of the States Web site at www.sso.org/ecos. Primary roles and responsibilities of State Environmental Agency: Authoritative/technical
Scientific/data
Community/interagency
Community Organizations and Concerned Residents Members of the community are the individuals affected by the site and therefore have a right to participate in the decision-making related to the site. These rights are recognized in federal and state statutes that require that the health assessment and remedial processes be a matter of public record and both EPA and ATSDR employ community involvement coordinators to address community concerns and provide information on site activities. Additionally, public comment and review are actively solicited at particular points in the process to ensure that the selected remedy is "acceptable" to the community. Although these formal requirements are important, broader community engagement is essential to fully capture the essential knowledge and information that only community members will have regarding site history and unrecorded uses, health concerns, and changes overtime. Community collaboration includes the participation of community members in the designing and implementing of programs and policies. The degree of community collaboration is determined by the degree of partnership between the community and the LPHA, the frequency of regular communication, the equity of decision making, community access to LPHA information, and the skills and resources of the community members. Most critically, community collaboration is a dynamic, ongoing process of working together through which the community is engaged as a partner in public health action. Effective community collaboration builds and strengthens the relationship between the LPHA and the community. It also enhances the agency's work. The community has critical skills and knowledge which, when incorporated into departmental program planning, development, implementation, and evaluation, will increase the likelihood of success in achieving the goals of programs and projects. NACCHO continually provides LPHAs and their communities with assessment and planning tools. Assessment and planning are important functions of public health and can help communities to identify and address issues that will improve community health. To assist with these processes, NACCHO has developed other tools, including the following: Protocol for Assessing Community Excellence in Environmental Health (PACE-EH) A guidance tool designed to assist local health officials in the planning and implementation of a community-based environmental health assessment. The PACE EH methodology consists of 13 interrelated tasks, including project planning, assessment team recruitment, environmental health issue identification, indicator development, and action plan development, that together describe a flexible and collaborative assessment process. Mobilizing for Action Through Planning and Partnerships (MAPP) A Web-based, community-wide strategic planning tool for improving community health. Facilitated by public health leadership, this tool helps communities prioritize public health issues and identify resources for addressing them. Community ownership is the fundamental component of MAPP. Because the community's strengths, needs, and desires drive the process, MAPP provides the framework for creating a truly community-driven initiative. Assessment to Action: A Tool for Improving the Health of Communities Affected by Hazardous Waste A tool that facilitates collaboration between local public health agencies and communities in decision making throughout a community environmental health education needs assessment process. It provides steps and methods to assess community needs and concerns related to hazardous waste sites, and formulate action steps for addressing environmental health concerns. |