Oak Ridge Reservation: Communications & Outreach Work Group

Communications and Outreach Work Group

January 28, 2004 - Meeting Minutes

Attendance

Members attending:
James Lewis (Chair), Peggy Adkins, Karen Galloway, and David Johnson

ATSDR Staff attending:
Melissa Fish, Marilyn Horton (phone), Lorine Spencer (phone), and Bill Taylor

ERG Contractor:
Liz Bertelsen (phone)

Purpose

James Lewis called the meeting to order. The purpose of the meeting was to: (1) review Pete Malmquist's resolution from the January 20, 2004, Public Health Assessment Work Group (PHAWG) meeting, (2) identify communication and educational strategies for public health assessments (PHAs), and (3) discuss trust, consensus, and communication issues regarding the Oak Ridge Reservation Health Effects Subcommittee's (ORRHES) vote on the Y-12 Uranium Releases PHA.

Resolution From the January 20, 2004, PHAWG Meeting

James Lewis read Pete Malmquist's resolution that was presented to the PHAWG at its January 20, 2004, meeting:

The PHAWG requests that ORRHES recommend to Dr. [Henry] Falk of [the Agency for Toxic Substances and Disease Registry] ATSDR that the appropriate divisions of ATSDR develop an environmental communications plan to explain to the communities what the public health findings of the PHA for White Oak Creek and Uranium Releases from Y-12 means. The environmental communication plan for the White Oak Creek and the Y-12 PHA and their implications should be done as quickly as possible so that the public can understand what was said in the PHA in a timely fashion. The environmental communications plan for all future PHAs should be developed and read at the time of the initial releases of the PHA. A timeframe for implementation of the environmental communication plan should be included in part of the public health assessment.

Discussion

According to James Lewis, Pete Malmquist identified a significant problem in this process. Mr. Lewis explained that there is a lot of frustration because people do not know the communication plans that are in place. People are unsure if these plans focus solely on communication, only on education, or if they have a combined communication and education focus. Mr. Lewis has contacted ATSDR and was told that the plan is to focus on filling gaps in the PHA. Mr. Lewis does not believe that a formal health education plan is in place to deal with the issues that Dr. Malmquist has identified. He asked Lorine Spencer if she has been working on a communication plan. Ms. Spencer replied that she has been working on an "integrated health education/health communication plan." She does not have a draft yet, but the plan will be presented at the February 3, 2004, ORRHES meeting.

James Lewis explained that he is currently drafting a resolution to request a health education/health communication plan. Lorine Spencer stated that ATSDR's plan would incorporate actions related to communication, the media, and setting a format for the health education plan. She said that they would need to evaluate if ATSDR's plan addressed Pete Malmquist's issues.

David Johnson asked Lorine Spencer to define the media that she had mentioned. Ms. Spencer replied that ATSDR is managing various media-related actions, which include putting out media releases (i.e., when the PHAs are available), creating fact sheets, meeting with the media, and conducting radio interviews. James Lewis noted that ATSDR's media techniques need to be effective because he is not sure that the agency's methods are successful. He added that fact sheets and media coverage have not worked very well in the past.

James Lewis asked how the current plan addresses these issues for the Y-12 Uranium Releases PHA. Lorine Spencer responded that ATSDR plans to release the final document around mid-February. ATSDR will mail CDs to all subcommittee members and to over 100 people on the mailing list (e.g., legislators, organizations). All of the CDs will be accompanied with the 2-page summary and the more technical summary. ATSDR will issue a press release to present the findings from the final PHA. Also, ATSDR will do its best to conduct presentations when requested by any community member or organization.

In regards to the White Oak Creek Radionuclide Releases PHA, Lorine Spencer explained that ATSDR has sent out the initial document and flyers have been mailed. ATSDR has communicated with some identified local community members, as well as the Chamber of Commerce. Fact sheets will be available when the public comment version is ready for release. ATSDR will answer questions and collect feedback regarding the PHA and will announce public availability sessions to the local media. For the final release, ATSDR will conduct similar actions.

James Lewis commented that these same approaches have already been tried; one person came to the availability session. He is looking for an effective program that includes someone going into the community and to city council meetings. He wants someone who can "market the product" to the public. Mr. Lewis believes that before the PHA process starts, ATSDR needs to look at the community to assess its needs and act accordingly (i.e., if community does not know key terms, send out a definition fact sheet prior to releasing the PHA). Peggy Adkins agreed with Mr. Lewis that they need someone "on the ground" who can answer questions in the community. She noted that the community is already suspicious and that people will have to be convinced face-to-face by someone who is trustworthy, intelligent, and personable. Mr. Lewis wants to know how ATSDR's management team in Atlanta, Georgia, plans to address these concerns and issues.

Peggy Adkins commented that many people in larger communities (e.g., Dyllis, Crestwood) are frustrated. There is a meeting in Kingston, Tennessee, that she would like to bring people to, but she does not want these people to feel that no one cares about their issues or to worry that there will be no follow up. She is torn because she feels that she is betraying her community and she does not want the community to become more frustrated. Lorine Spencer would appreciate if Ms. Adkins brought community members to the meeting. Ms. Spencer noted that Marilyn Horton would meet with them and record their concerns. This would provide ATSDR with contact names and each person's associated issues, and as a result, ATSDR would be able to conduct follow up with each person.

James Lewis said that people do not have time to make two or three visits to these meetings. He said that if they continue to "lock them out," then no one would ever return. He explained that the meetings are not designed for interaction, which is what most people want to do. As part of the new plan, Mr. Lewis thought they needed to look at the structure of subcommittee meetings to enable more open discussion and interaction. Karen Galloway commented that Dr. Henry Falk had even asked, "Who would want to come to these meetings?" According to Ms. Galloway, Dr. Falk had thought that the meetings were business-like and too long. Ms. Galloway believed that the meeting formats are not the right forum for people who expect to make comments. David Johnson noted that there is a need for sensitivity when bringing individuals to these meetings. His observations indicated that many people have high expectations from the experts who come into their communities. Mr. Johnson said that they needed to be sensitive when talking to individuals, but also to make sure that people are not given a false sense of hope.

James Lewis commented that they are talking about exposure situations when people want to talk about health data, health information, and how these relate to the issues. If they continue in this manner, Mr. Lewis said that they are "never going to connect." He wants the communication and education plan to focus on the needs of the community while also considering the data.

Karen Galloway read the second page of the ORRHES bylaws. "ATSDR is committed to engaging the Oak Ridge community as partners in conceptualizing, planning, and implementing public health activities at the site." She wanted to know how this could be achieved. Lorine Spencer replied that ATSDR is working hard with the work groups and ORRHES to find the best way to reach the communities. She said they needed to evaluate and talk to the community to assess the best methods for reaching the residents. Ms. Spencer noted that ATSDR has put a lot of time into the Oak Ridge community. For the first time in ATSDR history, ATSDR has opened a field office with two full-time employees.

James Lewis said that he contacted the state of Colorado to see how effective ATSDR had been in working with communities. He told the COWG that the information he heard would have shocked the work group. The state indicated that it was not impressed by ATSDR's approaches, the agency left issues unanswered, and ATSDR did not adequately reach people.

Karen Galloway added that she reviewed a document entitled, "Public Distrust and Conflict and Public Participation." The document highlighted various types of trust that are needed for public participation with government agencies. Ms. Galloway had always thought that Oak Ridge was a unique site because the people mistrusted government agencies. However, she learned that Oak Ridge is not unique in this regard and that there are several documents on public participation in work groups run by government agencies. She said that their work groups were "struggling to stay together with diverse backgrounds" and noted that no one was managing the issues very effectively. James Lewis read a section of the document that identified a needs assessment as the primary method to identify issues in surrounding counties. Peggy Adkins added some notes about organizational and community development. She said that they could have open forums in the communities. They could divide residents into work groups, such as illness documenting, illness referrals, feedback to ATSDR, and sampling in high alert areas (i.e., maps where they had dumping, draining, blowing, and flushing). If they conducted these forums, Ms. Adkins thought people would feel involved in the effort and also help ATSDR identify people's needs.

Karen Galloway noted that people might be interested in other issues that are not associated with ATSDR's work (e.g., cancer). People might think that ATSDR deals with these issues. Bill Taylor thought that Ms. Galloway brought up a good point. He added that ATSDR's program is about trying to connect with the community and sharing findings or information with the community. He noted that sometimes people would be disappointed because you cannot answer all of their questions. James Lewis suggested preparing a recommendation to state departments and other agencies to indicate actions they should take on the local level. Dr. Taylor explained that health departments have much more serious issues to handle (e.g., teen pregnancy, drug abuse) and do not have money to address these other issues. David Johnson asked if they might explore these data (e.g., stress, cancer, diet) to address some of the issues and concerns.

Based on this discussion, the COWG made the following resolution, which unanimously passed:

ORRHES recommends that ATSDR develop a comprehensive communications–education plan for disseminating key information, such as videos, fact sheets, briefing papers, and presentations, in accordance with the process flow sheet for producing the public health assessments.

This effort should start at the beginning of the PHA process.

The PHA should address concerns, health data, and environmental exposures.

The tools should be crafted to the needs of the individual communities.

Trust, Consensus, and Communication Issues Regarding the ORRHES Vote on the Y-12 Uranium Releases PHA

James Lewis presented a clip from the December 3, 2003, ORRHES meeting to begin discussing outstanding issues with communication. Mr. Lewis brought up the June 6, 2003, News Sentinel article entitled, "EPA [US Environmental Protection Agency] Plays OR Health Report." He explained that the article was about the EPA's letter to ATSDR concerning the Y-12 Uranium Releases PHA. He noted that this was probably the last piece of information that most of the community remembered. He asked if these issues had been addressed and if the answers satisfied most of the work group members.

James Lewis said that there was an issue because minutes for two prior PHAWG meetings had not been distributed before the December 3, 2003, ORRHES meeting. However, ORRHES held a meeting and issues were presented. Kowetha Davidson wrote a letter to the EPA because of the following two key issues in the article: the screening value of 5,000 millirem (mrem) and uncertainty analysis. Mr. Lewis thought that it was appropriate for ATSDR to withhold the release of the PHA until these issues were resolved.

David Johnson believed that they needed to revisit the issue of "institutional arrogance" and explain the concept at the next ORRHES meeting.

James Lewis presented another part of the December 3, 2003, ORRHES meeting. In the clip, Bob Craig said that he agreed with the "no apparent public health hazard finding" and that EPA also agreed. Mr. Lewis asked if EPA truly agreed with ATSDR's findings. Bill Taylor explained that ATSDR and EPA did not agree. He continued that based on EPA's letter responding to Kowetha Davidson, EPA accepted ATSDR's conclusions for current exposures. However, EPA found the past evaluations either vague, conflicting, or in downright opposition of EPA. Dr. Taylor said that the letter was not clear enough to decipher EPA's exact position on ATSDR's past evaluations. A new letter was received that indicated the EPA does not "totally agree with ATSDR's methodology" and EPA will not indicate if it agrees or disagrees with the past exposure evaluations. Dr. Taylor also referred to Dr. Craig's statement in the video, where he indicated that ORRHES would vote on the conclusions in the document. Dr. Taylor does not agree with this logic.

James Lewis said that they have larger issues than the upcoming ORRHES meeting. He said that they needed to look at management changes because there are problems on both sides. Also, the information that Kowetha Davidson received warrants further discussion by the group. Peggy Adkins noted a problem, which is that they sense EPA's lack of endorsement of the PHA. Karen Galloway added that they are not ready to vote on something of this nature when two major agencies are not in agreement. Mr. Lewis believed that these issues warranted discussion before releasing the final document.

Based on its discussion, the COWG developed the following resolution, which passed unanimously:

Recognizing EPA's reluctance to fully endorse the Y-12 Uranium Releases PHA, and because of the associated issues with the News Sentinel article (June 6, 2003, by Frank Munger), and the widespread circulation of that paper:

ATSDR should withhold release of the Final Y-12 Uranium Releases Public Health Assessment until ORRHES has discussed and evaluated both EPA's and ATSDR's views on the remaining outstanding issues specified in EPA's letter to Kowetha Davidson.

Additional Discussion

James Lewis explained that there are issues concerning how the meetings are facilitated. Some people believed that meetings were being managed correctly, whereas other people felt they were not being heard. Mr. Lewis wanted to have a meeting to discuss the roles of the chairs and the management team. He noted that they were "in crisis." He was going to see if they could have a "special call meeting" to address the operation and management of meetings. Peggy Adkins thought it needed to be before February 3, 2004. Mr. Lewis noted that issues had been raised about arrogance; he wanted the management team to direct this effort. He wanted to ask Dr. Falk about making changes in order to increase productivity. Ms. Adkins added that she has talked to many frustrated people who were looking at the February 3, 2004, in regard to rejoining this effort. Bill Taylor suggested discussing the issues outside of the COWG, by forming an Ad Hoc group.