Community Concerns and Communications Work Group

Community Concerns and Communications Work Group

December 21, 2004 - Meeting Minutes

Attendance

ORRHES Members attending:
George Gartseff (Chair), Karen Galloway, Jeff Hill, David Johnson, and James Lewis

ATSDR Staff attending:
Loretta Bush (phone), Marilyn Palmer (phone), and Bill Taylor

DOE Staff attending:
Tim Joseph

TA Consulting, Inc. (contractor):
Amy Adkins

ERG Contractor:
Liz Bertelsen (phone)

Purpose

George Gartseff called the meeting to order shortly after 5:30 p.m. The purpose of the meeting was to discuss CCCWG issues raised at the November 30, 2004, ORRHES meeting and for work group members to talk about other existing issues.

Discussion of CCCWG Issues

Facilitator: George Gartseff, Chair

George Gartseff was aware that some work group members were concerned that past recommendations have not been acted upon. He wanted to discuss the issues that arose during the November 30, 2004, ORRHES meeting, and also for the work group to think about ways to best address the community’s concerns within the time remaining.

George Gartseff questioned how they were viewing the “community.” He said that they always use this term in a general manner, but that people may have differing views of the specific populations within a geographic area.

Bill Taylor suggested that the work group consider the approach that ATSDR is using to identify concerns. Dr. Taylor explained that they have spoken about this subject in different ways and by using different terms, but that a certain approach will give ATSDR “a particular set of information.”

George Gartseff viewed these as separate, but related issues. He stated that Loretta Bush (ATSDR) was working on a process/communication plan for the Cancer Incidence Assessment. He noted that they have past recommendations for packaging public health assessments (PHAs) and conducting various outreach activities. He added that they have a past needs assessment, which was “not well received.” Mr. Gartseff pointed out that these are all efforts for ATSDR to reach the community, but asked if they were targeting the right community. He also asked which community needs the work group wanted to focus on, and said that they should address ATSDR’s means for reaching these groups.

Jeff Hill thought that the ORRHES represented the surrounding communities. He added that when the ORRHES made a decision, he had confidence that the subcommittee maintained a “good representation” of the community. Mr. Hill said that this might be different than talking about outreach efforts to the community. David Johnson agreed with Mr. Hill about addressing the concerns of the community at large, and that they needed to ask, “What to do?” and “How do we do it?”

In reference to conducting outreach, David Johnson stated that Loretta Bush was working on a process to address concerns. Ms. Bush asked if Mr. Johnson was referring to her development of a communications plan for the Cancer Incidence Assessment and other PHAs; Mr. Johnson said that Ms. Bush was correct. Mr. Johnson said that he was making a “blanket statement,” but that when they mention cancer, it becomes “personal” for people. He added that people want to know how cancer impacts them in regard to the environment and what encompasses the environment (e.g., the food that they eat).

George Gartseff explained that the work group’s charter is to deal with community concerns and communication issues. However, there are opinions that “failures in communication” have occurred. He said that many people felt that there was too much of an emphasis on Scarboro in the Y-12 Uranium PHA, whereas some people might have felt that this was appropriate. Based on listening to arguments over the past years, Mr. Gartseff did not get the “strong sense” that ATSDR is in sync with the community that it is trying to reach nor aware of how to best reach the community. He questioned if this was possibly because they had several different communities and that they needed to reach each one separately.

Karen Galloway thought that the ORRHES is a “pretty good” representation of the community. She believed that the original expectations to outreach to the community and gather people’s concerns “fell through.” George Gartseff asked if Ms. Galloway was referring to the work group, to ATSDR, or to ORRHES. Ms. Galloway said that she was referring to the “whole organization,” including ORRHES and the work group. She explained that Libby Howze (ATSDR) had come and tried to help them after the needs assessment “fell through.” She said that Dr. Howze tried to “resurrect some of the most pertinent things that were outstanding.” Ms. Galloway said that one issue was to conduct outreach to individual communities. She said that the work group heard plans to do this, but “then they were gone.” She said this was “an expectation that fell to the ground.”

Marilyn Palmer thought that Karen Galloway made a “great point” about ATSDR’s Division of Health Education and Promotion (DHEP) making recommendations on how to fill gaps of the needs assessment. Ms. Palmer said that there were several parts to the recommendation, which included performing a literature review, holding focus groups, conducting physician education training sessions, and other items as well. Ms. Palmer explained that, as mentioned during the November 20, 2004, ORRHES meeting, ATSDR is planning to conduct physician education training. Maria Teran-MacIver (ATSDR) will lead this effort. According to Ms. Palmer, during the first week of January 2005, ATSDR staff will go through each DHEP recommendation “word-for-word.” ATSDR will determine those that can be carried out, and will report back to the CCCWG.

James Lewis stated that there was no continuity when moving from the former work group to this new work group, or from going from DHEP to the Community Involvement Branch (CIB). When they met with Bill Cibulas, Mr. Lewis added that no continuity existed with what Dr. Cibulas knew had occurred in the past. Mr. Lewis questioned that ATSDR was saying that after many years, the agency was going to look through these recommendations in January 2005 and “figure out where they are.” He thought that this was “amazing” as they were already into the “program almost 4 years.” He added that he “hates to be so harsh.” He explained that when Kowetha Davidson made the transition, this was never discussed with them as a group or with him. He was unsure “what DHEP was approached with, but a whole lot went on and some things were laid out.” He asked, “Where is the continuity?” and “What are we doing?”

George Gartseff said that no one disagrees with James Lewis that continuity has been nonexistent. He added, “We are where we are at this point.” Mr. Gartseff wanted to discuss what people could remember from the November 30, 2004, meeting with Barry Lawson because “a lot of community concerns ended up on poster boards” and there are “a lot of issues out there.” He asked how the CCCWG could be effective advisors. He wondered if there were specific agenda items that they could recommend for ATSDR to pursue or if past disappointments and outstanding issues needed to be revitalized and brought back to ATSDR. Mr. Gartseff hoped to send out a 2005 agenda by January 2005, which will state the work group’s priorities and the ways in which the CCCWG will represent the community. He believed that the first step was to identify the community that the group represented. He also asked if there were other areas or activities that the work group needed to handle instead of ATSDR and asked if there were agency-specific items on which the work group needed to provide guidance.

Jeff Hill asked if ATSDR was going to start outreach efforts with physicians in February 2005. Marilyn Palmer replied that ATSDR was considering holding the next ORRHES meeting in February 2005, but that she believed the physician education would possibly occur in April 2005 with Dr. Robert Brent, a physician recommended by Herman Cember. Mr. Hill asked how they would outreach to local physicians prior to completing the information gathering process. He believed that ATSDR was “putting the cart before the horse.”

James Lewis agreed with Jeff Hill. Mr. Lewis said that they had a plan, the plan was broken down, ORRHES voted on the steps of the plan, and the recommendation was submitted. Mr. Lewis thought that they needed to see the recommendation. He added that one of the key points of the recommendation dealt with “moving from Phase I to Phase II.” He questioned the physician education plan under Phase II, and which parts of Phase I indicated to ATSDR that physician education was needed. According to Mr. Lewis, based on a review of the needs assessment, the former Needs Assessment Work Group (NAWG) said that there was no basis to move to this step. Mr. Lewis added that the work group wrote out the gaps and presented them in detail in a recommendation. He said that they were now hearing that ATSDR is going in a “different direction than voted on.”

Karen Galloway asked who would decide the parts of the recommendation that ATSDR can follow through with at this point. Marilyn Palmer explained that she and Bill Cibulas discussed several items when they were in town for the November 30, 2004, meeting. She said that they talked about events that have been occurring and many of the projects, including the needs assessment. Ms. Palmer had showed Dr. Cibulas some of the recommendations that had been formed, and the information that Libby Howze’s group had presented on the steps to fill gaps in the needs assessment, which ORRHES voted on and recommended in (she believed) February 2004. She continued that DHEP was taken off the project in July 2004, and Maria Teran-MacIver was brought on to help with health education. Ms. Palmer said that ATSDR’s Division of Health Assessment and Consultation (DHAC) “did drop the ball in trying to do everything that another division was doing.” However, she stated that the DHAC team was going to revisit these recommendations and decide those that were feasible to address.

James Lewis said that they wrote a recommendation that “ATSDR appeared to accept.” He added that the division director had also accepted this recommendation. He had a problem with this because “they laid this out” and it “seemed feasible by ATSDR at the time presented.” He said, “No one in ATSDR felt that this was a problem, but no actions were taken place on the items laid out.” He said that ATSDR gave this to George Washington University (GWU), then brought it in-house, and did not “do anything.” He continued that the agency was “telling him after all the effort and the work they have put forth” that ATSDR was “going to see what is feasible” because the agency is in the “11th hour.” Mr. Lewis added that Bill Cibulas did not know what the recommendations were and had apologized for not being more familiar with them.

Marilyn Palmer replied that ORRHES makes recommendations to the agency, and ATSDR has to respond to whether it accepts them. She explained that DHEP is a different division than DHAC, and that DHAC is now in charge of the entire project.

James Lewis heard what Marilyn Palmer was saying. However, DHEP had accepted these recommendations and indicated that they were reasonable. Mr. Lewis questioned why they had not received a written response to all of the recommendations. He said that ORRHES members had “done their job” as they had laid out the recommendations and they were accepted, but no actions were taken. Mr. Lewis stated that now he was hearing, “ATSDR has decided to proceed with the physician education piece, which was one of the key components.” He questioned ATSDR’s “justification for doing physician education in an area that doesn’t seem to be a major need.” He noted that there was no consultation with him or the other work group members who worked on the recommendations.

Marilyn Palmer explained that Marin Teran-MacIver would bring this information to the CCCWG. If the work group finds that this is not warranted, then the group can make a recommendation to ORRHES that ATSDR not conduct physician education. George Gartseff confirmed that Ms. Teran-MacIver should bring with her the agency’s responses to the ORRHES recommendations. Ms. Palmer stated that Ms. Teran-MacIver would present “information on this particular piece.”

George Gartseff shared James Lewis’s frustration with the time that this was taking and “how long this is dragging out.” Mr. Gartseff believed that the work group’s main responsibility was to make use of the time that remains. He did not believe that it was a “bad idea” to engage community physicians because of the potential health issues that exist within the community. He noted that ORRHES created a new work group to deal with health outcome data. He said that if they begin to obtain health outcome information, then it would be useful to have physicians to communicate any findings. Mr. Gartseff was “puzzled” because they were about to begin their fifth year, and yet they were still discussing the process to develop communications within the community. He stated that Mr. Lewis and past work group members “worked hard” to prepare the recommendations, but no actions have resulted from them. He questioned if there would be further action if they prepared and voted on another recommendation.

James Lewis said that they should ask Henry Falk (ATSDR) to respond to the formal recommendation and written request that was sent to DHEP in a step-by-step manner:

1. Why actions were not taken on those items?
2. What actions ATSDR planned to take on those items?
3. How ATSDR plans to recover from this?

James Lewis said that if Henry Falk indicates that ATSDR has a new philosophy about this, then the agency needed to write to them and explain its rationale. He was not saying that physician education was a bad idea; instead, he was saying that if they were going to conduct a health outcome data evaluation associated with this, then they would have had physicians get involved. He noted that there had been “logic and a plan here.” However, Mr. Lewis believed that ATSDR was going to be “proceeding on with a cookie cutter approach.”

James Lewis thought that the most logical approach was to bring DHEP back in an “orderly transition.” He believed that DHEP had a good communication strategy in place by starting to meet with people, gathering issues, and reviewing previous work. He was “still stunned” by ATSDR’s “failure to sit down and communicate so they could make an orderly transition.”

Karen Galloway expressed her frustrations. She said that a PHA is a technical document, and that ATSDR could have prepared the PHA in Atlanta and had community members review the document. She said that this, as well as an exposure evaluation, “could have been done already.” She believed that ATSDR should have had a plan for conducting community outreach efforts and gathering concerns in a “realistic way.”

George Gartseff asked what they could do as a work group with the time remaining. James Lewis believed that they should “resurrect” what was already done in the past, review and evaluate this work, and identify any weaknesses or problems. Mr. Lewis thought that they needed to speak to ATSDR and added that he personally did not think that they had “to listen to whether or not they’ve got resources to complete” the work. He noted that if ATSDR “squandered” its resources, then the agency should acknowledge this and say that they cannot complete certain efforts. He said, “If you’re broke, say so.”

George Gartseff explained that they needed to determine what they could do with the remaining time and the available resources. James Lewis replied that they needed to determine the effectiveness of the efforts. Mr. Gartseff asked Mr. Lewis for clarification. Mr. Lewis said that if ATSDR cannot meet the recommendations that were voted on, and ATSDR proposes other actions, then Mr. Lewis thought that they should evaluate if these suggestions will effectively meet what they believe to be their needs or the community’s needs. Based on this evaluation, the work group can give a recommendation on whether or not to support ATSDR’s proposed actions. However, Mr. Lewis thought that they should not be asked to endorse an action (e.g., physician education) when “they haven’t shown a need exists for the effort.”

George Gartseff believed that the sentiment was coming across that they were not pleased with what has taken place to date and that the group wanted a response to the past recommendation.

Karen Galloway suggested that the work group evaluate the written recommendation. If ATSDR is not going to follow through with the recommendation, then the CCCWG could make another recommendation and see if ATSDR will agree. However, Ms. Galloway did not “have full confidence that anything would be done.” She said that ATSDR needed “to be frank at this point with what is possible.”

George Gartseff was concerned that ATSDR might spend “a lot of time evaluating things and not doing things.” James Lewis believed that they needed to assess the available resources, and determine the most needed efforts and those that would provide the most benefit to the community.

James Lewis explained that they had two physicians “on board” in the beginning of the process. He said that they needed to determine whether or not physicians see a need to become involved and to also determine a “better way” to communicate the issues. Mr. Lewis wanted to ensure that they knew the community’s concerns and to determine the best method to convey the results of their efforts (e.g., town meetings, physician presentations).

James Lewis did not believe that “evaluation data points” were taken to the community to find out the best way to support the public. George Gartseff asked Mr. Lewis about whom he was referencing. Mr. Lewis said that he was talking about the ATSDR representatives who received their recommendation. They had given a presentation on what ATSDR was going to do, which “raised expectations.” Mr. Lewis added that Henry Falk had endorsed the concept. However, according to Mr. Lewis, “everyone involved disappeared.” He said that they were now hearing a new plan, but yet the last time they had met, “most people” did not think that it was a “great idea to educate physicians.” Mr. Lewis believed that town meetings with physician panels would be more effective to explain the data and efforts to the community. Mr. Lewis said that they had also identified areas for ATSDR to focus their efforts and that most people were interested in health outcome data.

George Gartseff asked if the group wanted to form a recommendation. James Lewis thought that they should pull the recommendation that was already sent and have ATSDR explain the reasons why the recommendation was not implemented. Mr. Gartseff asked if they should talk to Jack Hanley, Bill Cibulas, or Henry Falk. Mr. Lewis explained that the first recommendation asked to have the three division directors “brought to the table,” and he believed that all of these directors should be involved.

George Gartseff asked if a recommendation would be meaningful given the present time frame or if a discussion with Maria Teran-MacIver would be more productive. James Lewis asked why they could not do both. He added that it would have been helpful if the Chair of ORRHES had endorsed the recommendation. He said that Kowetha Davidson and ATSDR did not think that some of the items were needed, which leaves the group “on hold.”

George Gartseff explained that they would have an opportunity for two more CCCWG meetings before the next ORRHES meeting. He suggested that the work group conduct a critical review of the recommendation at its next meeting to identify the most important parts and rephrase the recommendation as appropriate to yield a response.

James Lewis said that he understood George Gartseff’s “position as chair,” but that they had already “watered down” the first recommendation. Mr. Lewis did not want to “rush into another” recommendation until the other recommendation was addressed by ATSDR and the agency explained why it was invalid or infeasible.

George Gartseff explained that he was “not watering down anything;” instead, he was looking at the work group’s priorities. He noted that they could make a recommendation at the February 8, 2005, ORRHES meeting, but then they might not receive a response until March or April. He suggested that they might want to rephrase the recommendation after speaking with Maria Teran-MacIver into something that is more appropriate with the “context of where they are now.” He said that they “want to keep the recommendation alive” and not wait several months for a response from ATSDR because, before they know it, the PHAs will be released before anyone talked with the community.

James Lewis said that they have had an issue “all along” because ATSDR could complete a PHA without talking to the community. Karen Galloway said that this is “where they are now.” Mr. Lewis asked how ATSDR handles specific components of the PHA, such as a health outcome data evaluation and issues on concerns. He wanted to know the agency’s policy that was associated with dealing with these specific issues. He was unsure whether it would be beneficial to resubmit the recommendation if ATSDR has changed its philosophy or policy. Mr. Lewis wanted to have Libby Howze and Bill Cibulas on the next work group call. He believed that they needed “to come together and say what is going on” and “explain where we are.”

George Gartseff made an action item to have copies of the existing recommendations sent to everyone before the January 11, 2005, CCCWG meeting.

Marilyn Palmer stated that she would be in the office on December 22, 2004, but that she was on leave until January 5, 2005. However, she would try to send the recommendations to everyone before she left. Mr. Gartseff asked if the next meeting would be on the second Tuesday in January 2005. Ms. Palmer said that he was correct; the next meeting would be on January 11, 2005. Mr. Gartseff also requested that Ms. Palmer share any history on this matter when she sends the existing recommendations.

Marilyn Palmer confirmed that this was the recommendation presented by NAWG, and that DHEP then made a presentation on how the agency would follow through with the recommendation. James Lewis said that two formal recommendations were put forth. One recommendation was made by NAWG and addressed GWU’s efforts. He explained that the second recommendation dealt with Libby Howze’s presentation where she laid out the commitments made by ATSDR. Mr. Lewis said that Dr. Howze went to a work group meeting prior to going to ORRHES, and based her presentation at ORRHES on the work group meeting minutes.

Marilyn Palmer knew that Libby Howze made presentations on what DHEP was going to do and she had the two separate presentations. She also stated that Bill Cibulas planned to come to the next ORRHES meeting and several more in the future. Ms. Palmer stated that she has been setting up bi-weekly meetings with Dr. Cibulas so that he can become more involved.

James Lewis said that they discussed problems with Barry Lawson at the last ORRHES meeting. He said that there was one remaining item that they did not delve into, which is the problem that exists with interactions between ATSDR and ORRHES. He added that if they had held this discussion during the meeting, then they could have dealt with the issue and identified steps to address the problem.

Marilyn Palmer said that she e-mailed Barry Lawson’s report shortly before the meeting. She said that his report captured some of the concerns, and added that ATSDR made a commitment to respond to specific comments/issues that were made in writing. James Lewis said that at the beginning of the meeting, Mr. Lawson made a statement to indicate what they would be dealing with during the meeting, some of which “bled into that area.” Mr. Lewis said, “Don’t take two or three little tidbits of information and make the assumption that we had a detailed discussion on that.” He asked if this was “intentional avoidance.” Mr. Lewis had wanted to handle this issue first and told Mr. Lawson; David Johnson remembered this taking place at the meeting.

Marilyn Palmer read the information presented on page 16 of Barry Lawson’s report, under the heading “ORRHES–ATSDR Relationship Issues,” which identified the five principal issues as:

1. How to identify and resolve hurdles between subcommittee and agency
2. How to get ATSDR to indicate what it wants from ORRHES
3. How to avoid possible manipulation of ORRHES by ATSDR
4. How to get the job done
5. How to best answer the questions: a) Has any harm been done to individuals by ORR operations? and b) Is the community safe to live in now (and will it be in the future)?

James Lewis said that Barry Lawson might have identified these items during a brainstorming part of the meeting, but that they did not address these issues during the meeting. Marilyn Palmer said that the report was sent to everyone on ORRHES. Mr. Lewis said that they were supposed to deal with internal ORRHES issues.

George Gartseff made two points. First, no one had yet received the report and everyone needed to read the complete report. Second, this was not the topic for tonight’s work group meeting. Mr. Gartseff said that if anything was brought up that dealt with the community during the ORRHES meeting, then this was “fair game” and they could deal with these issues within the work group. He said that if the work group members identify specific community issues within the report that need to be addressed, then the CCCWG will try to address them at the next meeting. Mr. Gartseff said that they would also discuss the recommendations (where they stand now and what they may recommend to ATSDR), and speak with Maria Teran-MacIver about physician education. Marilyn Palmer will confirm that Ms. Teran-MacIver will be speaking with the work group at its next meeting.

George Gartseff noted that they had a limited amount of time left and that they needed to use this time to best advise the agency and to be effective. He hoped that they could “avoid future frustrations.”

Jeff Hill asked Marilyn Palmer about the time frame. He did not have any problems with physician education being conducted in April 2005, but he wanted the CCCWG to know the information before it is presented to the physicians. George Gartseff thought it seemed to be revolving around the Cancer Incidence Assessment, which considers health outcome issues. Mr. Gartseff stated that the work group’s main goal is to work with the PHAs and to ensure that they are communicated correctly to the community. James Lewis explained that the recommendation was “advice” that was formally written, submitted, and discussed with ATSDR. He said that if there was something wrong with this “advice,” then the agency needs to tell them. Mr. Lewis believed that the recommendation was “sound, logical, and fair.” George Gartseff said that there were no disagreements among the group.

Tim Joseph suggested that they give a time frame for when they expect a response as part of their recommendations. James Lewis thought that this would have been included within the project plan.

George Gartseff said that they might be making a recommendation to Henry Falk to respond to the state of previous recommendations, but that this would not be formulated until the next CCCWG meeting. It would then be brought to ORRHES in February 2005. He noted that this has been a “long and frustrating process that takes iteration after iteration.”

James Lewis shared a discussion that he had with Bill Cibulas during the September 2004 meeting. Mr. Lewis said that Dr. Cibulas apologized because he had not reviewed the prior recommendations and that he intended to review them and become familiar with them. Marilyn Palmer said that it had been her responsibility to prepare Dr. Cibulas for the meeting and that the needs assessment was one of the documents that she had not provided to him before the meeting. She had spoken with him about it and he has now read the information. Ms. Palmer added that ATSDR has not been very responsive to ORRHES recommendations in the past. She noted that Dr. Cibulas does not believe that the tracking sheet ATSDR uses is “responsive enough for this group,” and therefore, ATSDR will now respond in writing to formal recommendations received from ORRHES in addition to using the tracking sheet.

James Lewis believed that it weakens the position when the ORRHES Chair does not support a recommendation that is passed by the subcommittee. He thought that this resulted in many recommendations not being “aggressively pushed.” He believed that the Chair did not like that they had attacked the original needs assessment prepared by GWU. He stated that this assessment contained nothing that could be used for the basis of decisions, and he recalled that the group had voted that this was true following the presentation. He explained that they developed a “recovery plan” to handle the situation, but his opinion was that Kowetha Davidson was “still upset about other things and didn’t push it, and ATSDR did not address it.” As a result, he said this “fell into a crack.”

James Lewis believed that there were better concerns data in the work that the University of Tennessee (UT) conducted for the U.S. Department of Energy (DOE) than what was obtained from GWU. He believed that UT had performed a “good job of going out and canvassing people” and “stayed focused on the issues.” Mr. Lewis questioned why ATSDR could not use the concerns collected by DOE to assist in guiding its efforts as ATSDR used technical data from sampling efforts conducted by other agencies (e.g., DOE, TDOH). He said that if these are older data, then so are the data contained in the Oak Ridge Dose Reconstruction that are being used in the PHAs.

James Lewis continued that there is “no consistency” in ATSDR’s logic pattern. He said that using DOE’s concerns data would have allowed ATSDR “to see the area of concerns,” which were “not followed up on.” He said that they are here for the reason of addressing community concerns. He added that people cannot “always come out to little focus groups,” and that this report indicated that some town meetings could be held. Mr. Lewis wanted to obtain the issues and ensure that they are addressed within the reports. He noted that this was outlined for ATSDR and that a copy of the report was provided to the agency, as well as telling the agency where to find concerns within newspapers. He said that they had “worked hard to lay out recommendations.” Mr. Lewis believed that there was fear “in ATSDR to step up to the plate and say this is what the public is thinking and here are the issues.” He stated that ATSDR should “step up and try to address it.”

David Johnson said that they needed to use a non-traditional approach and “get the word out to barber shops and beauty parlors.”

James Lewis said that he would “never forget” what Tom Sinks told him regarding health outcome data issues on cancer. According to Mr. Lewis, Dr. Sinks was unsure if ATSDR had the necessary “skill sets to present and that CDC [Centers for Disease Control and Prevention] was better suited to do it.” However, Mr. Lewis said that he has “yet to see anyone from the group he was talking about.” Mr. Lewis said that he might call Dr. Sinks to see if he remembers their conversation and that maybe Dr. Sinks “can help them.” Mr. Lewis explained that it “sometimes seems he talks too much, but he worked very hard to do the job.” He said that this was outlined for ATSDR, but the agency “failed to address those issues more than once.” He does not want to hear “don’t know,” “can’t do it,” or we are “out of money.” He stated that they have a “customer,” but that the job has not been done.

Karen Galloway was unsure how much they could accomplish until they received the recommendations for the next meeting.

Action Item

George Gartseff made an action item to have copies of the existing recommendations sent to everyone before the January 11, 2005, CCCWG meeting.

Additional Comments

George Gartseff asked Marilyn Palmer about the schedule for the next ORRHES meeting. Ms. Palmer said that she was still confirming the date, but that it would probably be held on February 8, 2005. She added that she was going to ask Maria Teran-MacIver to be on the next CCCWG meeting’s agenda to discuss some of the recommendations that DHEP brought forth.

Since George Gartseff had to leave the meeting at 6:30 pm, Karen Galloway adjourned the meeting at 6:41 pm.