Hawke’S Bay District Health Board

Environmental and Border Health Exemplar for PHU Annual Plan The Exemplar:  is based on the Ministry of Health’s (Ministry) expectations for your PHU service delivery under Environmental and Border Health.

 is to be used to form the Environmental and Border Health section of your PHU Annual Plan, noting all activities in this exemplar are expected to be delivered by PHUs; however, there is a degree of flexi bility in terms of level or quantum of activities appropriate for your population of coverage and individual PHU situation (eg, if your PHU does not have an international port/airport, this specific part of the exe mplar would not be relevant to your PHU Annual Plan). We acknowledge that with limited resources, some activities may be prioritised over others to ensure resources are used most efficiently and effective ly or in times of emergencies/pandemics when surge capacity is directed to respond to such emergency/pandemic management. Please ensure service delivery is aligned with the strategic priorities of the Government, the Ministry and your DHB(s), and that all regulatory requirements are fulfilled.

 is aligned with the Nationwide Service Framework Library (NSFL) Tier 1 (Public Health), Tier 2 (Health Protection) and Tier 3 (Environmental Health) Service Specifications. The Ministry intends to incorpora te the exemplar into the Tier 3 (Environmental Health) Service Specification.

 is aligned with the five Core Public Health Functions (referred to as Service Components in the Public Health Service Specifications)

 uses an outcomes framework based on Results Based Accountability (RBA), which sets out Performance Measures covering the three RBA dimensions:

o How many (Quantity of effort): # (number)

o How well (Quality of effort): ratio; unit cost; % (percentage)

o Is anyone better off (Quality and Quantity of effect): #/% (number and percentage), there are four ‘better off’ sub-categories:

. SK (change in skills, knowledge)

. AO (change in attitude, opinion)

. BC (behavioural change)

. CC (circumstance change)

Note: S (subjective data); O (objective data).

Use the template to demonstrate your performance accountability, covering these three RBA dimensions.

 Where Performance Measures are set by the Ministry, they are compulsory to report against (noting the ‘flexibility approach’ above). PHUs may set additional performance measures if required by the ir PHU Manager as internally monitored performance measures. Performance measures set by the Ministry will need to be reported on: Summary Progress Report at six months; Whole-of-year Report at 12 months.

Service delivery expectations and linkages  In accordance with the Tier 2 (Health Protection) and Tier 3 (Environmental Health) Service Specifications, please see the Ministry’s expectations below on PHU service delivery in relation to Environmental and Border Health and linkages expected when undertaking the Activities set out in this Exemplar: No. Service delivery expectations 1 Carry out all activities in accordance with the:  Environmental Health Protection Manual  Radiation Incident Responders Handbook

Environmental and Border Health exemplar version 1 November 2016

1  National Health Emergency Plan  Microbial Water Quality Guidelines  International Accreditation New Zealand requirements relating to drinking water  National HAZMAT response plan  Major Response to Fires; guidelines for public health units document (Revised 2014)  Investigation and Surveillance of Agrichemical Spray-drift Incidents: guidelines for public health units document  any other relevant Plans, Guidelines, Manuals (additional), Policy and advice provided by the Ministry of Health. Cognisance should also be taken of any other relevant government agency documents. 2 Carry out all activities in compliance with any legislation and regulatory policy directives issued by the Ministry of Health (including the Office of Radiation Safety) and NSFL Public Health Service Specifications.

3 Ensure adequate and appropriate capacity to carry out services and respond to incidents and emergencies 24 hours per day. 4 Employ and/or contract sufficient numbers of statutory officers and other health protection staff to carry out service delivery, and ensure your staff undertake training and other professional development to maintain their competence. 5 Review and update appropriate PHU fact sheets, information, procedures, manuals, plans and websites, as required. Provide the following written reports to the Environmental and Border Health Protection Team (using the templates provided) by the due date:  31 January and 31 July – Solaria – Six-month and annual reports  31 January – Port and Airport – Annual Return  20 February – Report to the Environmental and Border Health team on border health protection activities using the reporting template provided  30 June – Hazardous Substances – Annual Activities and Intentions report  31 July – Statutory Officer Appointment – Status report  8 August – Drinking Water – ESR data (1 July to 30 June) for microbiological and chemical sampling, water safety risk management plans status and compliance with the Health Act drinking-w ater provisions.

Other more immediate notification report requirements are as follows:

Drinking water:  Suspected or confirmed waterborne disease outbreaks reported to the Environmental and Border Health Protection team within 2 hours  Drinking water incidents to be reported to the Environmental and Border Health Protection team within 24 hours.

Hazardous Substances and New Organisms (HSNO):  Incident report to Environmental Protection Agency (EPA) (copied to Environmental and Border Health Protection team) within 24 hours of HSNO incidents or emergencies attended by public health staff usi 6 ng the form provided by the EPA  Copies of Vertebrate Toxic Agent (VTA) permits to the EPA within three working days of issuing the permission  Notifications of hazardous substances injuries, including agrichemical spray-drift complaints, lead poisoning and poisoning arising from chemical contamination of the environment are reported to Centre for Public Health Research (CPHR) in the format required, including General Practitioner (GP) notifications.

Border Health Protection:  Notify the Environmental and Border Health Protection team within 2 hours of any non-routine control measures applied to any vessel.  Inform the Environmental and Border Health Protection team within two hours of the identification and location of a known or suspected exotic mosquito or mosquitoes of public health significance  Provide mosquito interception response situation reports to the Environmental and Border Health Protection Team using the template in the biosecurity section of the Environmental Health Protection Manual. Ensure specimens are forwarded to the laboratory using appropriate protocols and documentation is completed and entered into relevant databases.

Public Health Emergency Planning and Response:  Reports submitted within 24 hours of occurrence of a public health event or emergency with inter-district, national or potentially international implications to the Environmental and Border Health Protection T eam and Ministry’s Office of Radiation Safety (if suspected or confirmed to involve an ionising radiation source) and copied to the Ministry Portfolio Manager.

Other regulatory duties:  Ensure applications for approvals under the Burial and Cremation Act 1964 are completed in a timely manner  Ensure general complaints are recorded and investigations initiated within three working days. No. Linkages 1 Where appropriate, develop Memoranda of Understanding (or equivalent) with other agencies so that roles and responsibilities of the PHU/agencies are clear.

2 2 Ensure linkages with Enforcement Officers in the appropriate central and local government agencies and in respect of other relevant work activities.

3 Carry out Environmental Health service delivery in collaboration with other relevant agencies, central government, local government, private sector organisations, NGOs, and port companies (including shipping and airline companies).

4 Participate in national, regional and local research survey or response events as appropriate.

Reference Performance Measures number Service Grouping Activities How many How well Is anyone better off (optional) (Quantity of effort) (Quality of effort) (Quantity and Quality of effect)) Health Protection % Drinking-Water Assessors that maintain #/% networked water supplies Maintain accreditation of Drinking-Water Assessors and Drinking Water Assessment Unit. # Drinking Water Assessor Environmental accreditation. (broken down by class ie. FTEs. Health – Drinking Identify and investigate incidents, complaints and notifications of adverse drinking water Numerator: # Drinking-Water Assessors that large, medium, minor, small Water quality (or adequacy) of networked, tankered and temporary drinking water supplies. maintain accreditation. and rural agricultural) # investigations related to Denominator: # Drinking-Water Assessors compliant with sections 69V incidents, complaints and and 69Z of the Health Act notifications. Undertake all duties and functions required by the Health Act 1956, including: % drinking water register entries (network 1956 (BC, O). supplies) verified or updated Numerator: (broken down by  Register drinking-water suppliers and water carriers as required. Numerator: # of network registered water class) # networked water  Routinely go through the drinking water register each year and verify or update details supplies verified or updated supplies compliant; of network supplies. Denominator: # of network registered water Denominator: (broken down by supplies class) total # networked water # water supplies surveyed in the  Promote compliance with the drinking-water requirements of the Health Act 1956 to supplies in area of coverage. annual review. drinking-water suppliers and water carriers. % networked water supplies (by class of water Note: The above measure supply) receiving at least one compliance should be informed by the  Conduct the annual review of drinking-water supplies serving more than 100 people # of water safety plans inspection per annum with findings confirmed previous year’s Annual Survey and report to water suppliers as required by Scope 1. assessed. in writing.  Assess water suppliers’ water safety plans as required and provide a report to the Numerator: # networked supplies (by class) # temporary drinking water water supplier within 20 working days. receiving written findings of visit per annum. supplies assessed and Denominator: # networked supplies (by class)  Assess and process applications as required for the use of temporary drinking water approved. supplies. % water suppliers’ water safety plans reported  Ensure water-suppliers have plans and PHU responds in a timely manner to on within 20 working days. transgressions, water supply contamination or interruptions to the supply, including Numerator: # water safety plans reported on taking appropriate measures to protect and advise the community. within 20 working days. Denominator: # water safety plans

% networked water supplies (by class of water Certify the implementation of water safety plans. # authorisations. supply) where timely response was provided by

PHU to transgressions, contamination or Authorise organisations for the purposes of ensuring compliance with the Act, drinking interruption in accordance with drinking water water standards, and water safety plans. legislation and standards. Numerator: # networked water supplies (by Report serious drinking water incidents to the Ministry of Health within 24 hours. Report class) where timely response provided # investigations related to suspected or confirmed waterborne disease outbreaks to the Ministry of Health within 2 Denominator: # networked water supplies (by enforcement (please specify in hours. class) narrative). Undertake enforcement activities in consultation with, and at the direction of, the Ministry Note: PHU to respond within 24 hours on becoming aware of a P1 transgression, of Health. # assessments related to contamination or interruption and within 3 requirements of the Drinking- Refer issues and concerns with self-supplies to territorial authorities as required. working days on becoming aware of a P2 Water Standards Implement the requirements of the Drinking-Water Standards for New Zealand as required transgression (eg, P2 assignments, catchment risk assessments, secure ground water assessments). % networked water suppliers serving more Ensure activities are integrated with the drinking water technical advice services for than 100 people with approved water safety networked supplies serving up to 5000 people. plans. Provide technical advice and information on public health aspects of drinking water Numerator: # of networked supplies serving supplies, including the implications of the Health Act 1956 and the Drinking Water more than 100 people with an approved water Standards for New Zealand, to water suppliers, councils, the public and organisations on safety plan issues of public health significance in respect to drinking water supplies. Denominator: # of networked supplies serving more than 100 people Environmental and Border Health exemplar version 1 November 2016

3 Reference Performance Measures number Service Grouping Activities How many How well Is anyone better off (optional) (Quantity of effort) (Quality of effort) (Quantity and Quality of effect)) Ensure that the public health effects of drinking water supplies are considered and % of network drinking water supplies with an managed by making timely submissions on: approved WSP that have had an  regional and district plans and policies including giving effect to the National implementation completed in the last 3 years Environmental Standard for drinking water catchments (expected 100%). Numerator: # of network water that have had #/% water supplies serving  territorial authority assessments of drinking water supplies an implementation completed in the last 3 1000 people that are years.  resource consent applications. fluoridated (CC, O). Denominator: # of networked supplies with Numerator: # supplies Provide advice on the benefits of water fluoridation when the issue becomes a significant current approved WSP issue in the community by: fluoridated Denominator: # supplies Narrative report: Why it isn’t 100% (if it isn’t)  supporting health professionals who are promoting the extension or maintenance serving 1000 or more people of fluoridated water supplies  ensuring appropriate education material is available to institutions, health professionals, territorial authorities, community groups and the public Complimentary Narrative Complimentary Narrative Reporting Complimentary Narrative Reporting Reporting  ensuring that messages on fluoridation and oral health are consistent and current, and keep all health providers well informed  making timely submissions on water fluoridation when appropriate. Carry out public health grading of drinking-water supplies at the request of drinking-water suppliers. Health Protection # public health HSNO Narrative reporting: Promotion Use the priority criteria in the Hazardous Substances Action Plan, and injury surveillance Environmental enforcement officers. of the HSDIRT reporting data, to develop hazardous substances programme plans. Health – Hazardous process to GPs, hospitals and Substances Report all notifications of hazardous substances injuries, including agrichemical spray-drift # cases of hazardous % debriefs/audits that show responses have others. complaints, lead poisoning and poisoning arising from chemical contamination of the substances injuries that are been consistent with the Ministry’s advice and environment, to the science provider in the format required, including GP notifications. notified by GPs, hospitals and guidelines, including the National Hazmat others. Response Plan, Major Response to Fires; Promote hazardous substances injury notifications by GPs. guidelines for public health units (Revised Participate in the Hazardous Substances Injury Surveillance System and other notifiable 2014), Investigation and Surveillance of condition surveillance systems, including GP notifications via the HSDIRT system and Agrichemical Spraydrift Incidents: guidelines according to Ministry of Health guidelines and direction. for public health units. Numerator: # debriefs/audits that show that Investigate notifications of lead poisoning, poisoning from chemical contamination of the response was consistent with Plans, Ministry environment, and hazardous substances injuries as required. Guidelines etc Denominator: # of responses

Process applications for Vertebrate Toxic Agent (VTA) operations that require public # applications for Vertebrate % routine applications for VTA permissions #/% audited VTA operations health permissions. Toxic Agent (VTA) permission processed within 20 working days. compliant with permit approval received Numerator: # routine applications processed conditions (BC, O). Ensure that the conditions imposed by the public health HSNO enforcement officer within 20 working days. Numerator: # audited VTA granting permits for the use of controlled vertebrate toxic agents are complied with. Field # applications for VTA Denominator: # routine applications operations compliant; or desktop audits of all permissions are required to ensure compliance, as appropriate. permission issued. Denominator: # audited VTA permissions. # desk top audits of 1080 % of 1080 operations with permissions operations. audited, either by desktop or field audit, for compliance with permission conditions # field audits of 1080 operations. (expected 100%) Numerator: # 1080 operations with # desk top or field audits of non permissions audited 1080 operations. Denominator: # 1080 operations with Audit compliance with, investigate breaches of, and where appropriate, enforce the permissions relevant Acts and Regulations, including: # VTA complaint investigations  attending hazardous substances incidents received and investigated.  monitoring storage and display of hazardous substances and products for retail sale # VTA complaints referred to

4 Reference Performance Measures number Service Grouping Activities How many How well Is anyone better off (optional) (Quantity of effort) (Quality of effort) (Quantity and Quality of effect)) another agency.  surveillance of hazardous substances injuries and reporting via the HSDIRT system. Work with other HSNO enforcement agencies to support their regulatory roles and manage potential public health risk, for example, through assisting with recalls and public warnings as required. Receive annual reports on methyl bromide fumigations. Maintain effective risk management strategies and response plans for hazmat incidents and emergencies, including deliberate chemical contamination and chemical fires, and including at designated points of entry. Responses are required to be consistent with the Ministry’s advice and guidelines including the National Hazmat Response Plan, Major Response to Fires; guidelines for public health units (Revised 2014), Investigation and Surveillance of Agrichemical Spraydrift Incidents: guidelines for public health units. Represent public health interests at meetings of the Area Hazmat Coordination Committee.

# hazmat incidents or Narrative reporting: Outcomes Promote public knowledge on the risks of environmental and non-occupational exposures emergencies attended. of hazmat meetings and to hazardous substances and products, including asbestos in the non-occupational exercises. environment by: # hazmat exercises attended.  providing public health advice and information on hazardous substances and products to the public, health professionals and organisations # response plans reviewed and  advising on the safe management of hazardous substances and products, including revised, if necessary, following their removal and disposal from contaminated areas responses and exercises.  advising on the safe management of asbestos in the non-occupational environment according to the Ministry of Health’s guidelines and direction. # area hazmat coordination committee meetings attended.  advising on the safe management of products containing lead, including lead-based paint and mercury (including its removal and disposal). # investigations/activities undertaken, by type (eg, Advise, encourage and/or assist territorial authorities and Regional Councils to: crayons, face paint, chemical  identify potentially contaminated sites in the region and identify contaminants spills). (including clan labs)  implement health impact assessment systems to ensure contaminated land is remedied, where appropriate, and to minimise adverse effects on human health  determine appropriate land use controls for contaminated sites to minimise the risk to the public  ensure appropriate advice is provided to manage any public health risk from sites and during any remediation processes. Narrative reporting: Outcomes related to whether Local Authorities have been responding appropriately to public health risks from contaminated land.

Complimentary Narrative Complimentary Narrative Reporting Complimentary Narrative Reporting Reporting

Health Protection

5 Reference Performance Measures number Service Grouping Activities How many How well Is anyone better off (optional) (Quantity of effort) (Quality of effort) (Quantity and Quality of effect)) Environmental Health – Border Health Protection

Mosquito surveillance #/% exotic mosquitoes that Undertake surveillance of mosquitoes at appropriate frequency (weekly over summer and # interceptions. % responses initiated within 30 minutes of have crossed the border and warmer part of spring/autumn and fortnightly over winter and colder part of autumn/spring notification established in your region (CC, at international sea and airports or monthly audit of surveillance undertaken by the air or # incursions. Numerator: # responses initiated within 30 O) sea port company. minutes Numerator: # incursions; Denominator: # responses Provide mosquito interception response situation reports to the Environmental and Border Denominator: # interceptions. Health Team using the template in the biosecurity section of the Environmental Health Narrative report on mosquito surveillance and Protection Manual. whether it is occurring at appropriate frequency Respond promptly to interceptions of pests with a human health significance eg. rats, # responses to other organisms. (will depend on weather and indicators such as ticks, poisonous spiders and cases of imported disease. biomass)

#/% international points of Border health # authorized or accredited Narrative report on requirements of a entry that meet requirements Ensure designated points of entry achieve and maintain core capacities as required by the persons under the Biosecurity competent authority met by PHU (report of annual verification International Health Regulations 2005; audit core capacities annually as required by the Act 1993 against the appendix) assessment under Ministry of Health. International Health Regulations 2005 (BC, O). Identify and monitor border health protection risks from biological (including pests and # intersectoral meetings (#airports, # seaports) Numerator: # international diseases), chemical and physical (including ionising radiation) hazards. points of entry that meet Develop/maintain contingency plans to deal with border health risks including surveillance, # responses to border public requirements; ill traveller protocols, and border emergency response plans; work with border health incidents. Denominator: total number of stakeholders to support the inclusion of public health response plans within sea and international points of entry in airport emergency response plans. PHU area of coverage. Respond promptly to requests for pratique, inspections and certification (eg ship # maritime pratiques issued. sanitation). # maritime pratiques issued on #% international points of entry Attend border and other intersectoral meetings with relevant agencies and organisations arrival that have contingency plans to on matters relating to border health protection. deal with ill travellers and other # aircraft met on arrival border health responses that Provide sound technical and professional advice on public health issues that are related to are interoperable with public border health protection objectives in relation to imported risk goods, disease vector # ship sanitation exemption, % current staff members involved in ship health response plans (CC, O). surveillance and control, preparation of contingency plans for emergency response, Numerator: # international preparation of submissions as appropriate on proposed pest management strategies. extension and control sanitation inspections who have completed the certificates issued WHO on-line ship sanitation course (expected points of entry that have Provide public health training to air and sea port staff, as required, on border health 100%). contingency plans protection risks and their management . Numerator: # current staff members involved Denominator: # international points of entry Contribute to or lead (when required) the preparation of health impact assessments in in ship sanitation inspections who have relation to border health protection threats and eradication and control activities. completed the WHO on-line ship sanitation # public health training (eg, course Maintain on-call roster to ensure appropriately trained staff are available at all times for advice, update, event) to air and Denominator: # current staff members involved any border responses. sea port staff. in ship sanitation inspections

Complimentary Narrative Complimentary Narrative Reporting Complimentary Narrative Reporting Reporting

6 Reference Performance Measures number Service Grouping Activities How many How well Is anyone better off (optional) (Quantity of effort) (Quality of effort) (Quantity and Quality of effect)) Health Protection # responses. % public health unit plans include #/% PHU Emergency Planning Carry out all emergency management planning, preparedness and responses in Environmental reduction/readiness/response/recovery/resilien and Response Plan collaboration with other relevant agencies and according to Ministry of Health guidelines, Health – Public ce, and identify resources needed to support interoperable with stakeholder plans and advice Health Emergency and carry out public health action (expected plans (ie. TLAs, DHBs, airport, Planning and Maintain and review Emergency Response Plan(s). There must be plans covering the 100%). seaport (CC, O). Response following minimum areas Numerator: # public health unit plans include Numerator: # interoperable the four ‘rs’ PHU /stakeholder plans; - Border Health Response Denominator: # public health unit plans Denominator: total # % plans and Standard Operating Procedures stakeholder plans. - Communicable Disease – Outbreak/Pandemic updated each year (required 100%). Please report in narrative if pla Numerator: # plans and Standard Operating ns are not interoperable on - Hazardous Substances (including radiation, and Chemical and Biological Counter Procedures updated how you are working towards Terrorism Response) Denominator: plans and Standard Operating making plans interoperable. Procedures - Civil Defence/National Disaster Note: As a minimum the annual update should Definition of interoperable: include a check to ensure that relevant contact The two Plans operate Take appropriate emergency actions, as the need arises. This includes liaison with and phone numbers are still correct. together seamlessly, are taking directions from other agencies involved, including providing services for, be directed aligned and there is no by, and report to civil defence authorities. discontinuity. eg. if the airport Maintain, exercise and regularly review plans for responding effectively to a range of % plans tested, including emergency EOC incident controller role is public health emergencies, including national, regional and local meetings, exercise and communications (required 100%). undertaken by the Police then training opportunities. # exercises. Numerator: # plans tested that is documented in the PHU Denominator: # plans Plan. Maintain civil defence and public health emergency planning and response capacity, and Note: checking that all emergency phone ensure there are appropriate numbers of staff trained in emergency management/CIMS. numbers are still correct as a minimum. Ensure key health messages are available in educational and promotional materials through collaboration with other agencies/orgnanisations involved in emergency planning % exercises and responses that are followed Narrative reporting: Outcomes and response. by a debrief (required 100%) of exercises. Numerator: # exercises and responses followed by a debrief #/% health protection officers Denominator: # exercises and responses and medical officers of health g Note: If the exercise is held by another agency raduated from CIMS 4 or CIMS and there is no debrief the PHU should hold its (Health) training (SK, O) own debrief. Numerator: # health protection officers and Medical officers of % debrief recommendations that are Health graduated incorporated into plans and SOPs Denominator: # health protecti Numerator: # debrief recommendations that on officers and Medical officers are incorporated into plans and SOPs. of Health Denominator: Total # debrief Narrative reporting: If not recommendations 100%, please report on when they would be completing this training. Note: target should be 100% o ver a four- year period. Complimentary Narrative Complimentary Narrative Reporting Complimentary Narrative Reporting Reporting

Health Protection # applications/plans/ Encourage and assist Councils to develop and implement policies through processes, Environmental statements/standards assessed such as the review of district plans, including variations or plan changes or Council Long Health – Stakeholder for public health issues. Term Plans that address the wider determinants of health. Planning, % submissions completed that include a public Narrative reporting: Public Submissions and # submissions made. health risk assessment to ensure submission Health impact (or expected Environmental and Border Health exemplar version 1 November 2016

7 Reference Performance Measures number Service Grouping Activities How many How well Is anyone better off (optional) (Quantity of effort) (Quality of effort) (Quantity and Quality of effect)) Resource is (expected 100%): impact) of submissions and/or Make timely and professional submissions on national (including national policy Management # hearings where evidence  evidence based proactive/upstream work with statements, national environmental standards and or guidelines) and regional plans and presented. stakeholders (ie, key public policy statements, district long term and annual plans and, where appropriate, resource  proportionate to the public health risk health gains). consent applications to ensure that the public health effects are considered and managed  peer reviewed Narrative reporting: Brief of: Numerator: # submissions completed that description of include a public health risk assessment  adverse air quality proactive/upstream work with Denominator: # submissions completed  the disposal of the dead stakeholders (who and what). Note: PHU should keep brief documentation to show that above criteria has been considered  environmental noise and implemented.

 ionising radiation (in consultation with the Office of Radiation Safety)

 non-ionising fields

 recreational waters Complimentary Narrative Complimentary Narrative Reporting Complimentary Narrative Reporting Reporting  gaseous, liquid and solid waste

 urban design/form

 sewage collection, treatment and disposal

 drinking water (cross reference with the separate drinking water section)

 other environmental health issues.

Monitor decisions made under the Resource Management Act 1991 to ensure that the health impacts of environmental hazards have been considered. Follow up with regional councils and territorial authorities where this has not occurred. Make timely and professional submissions on local government assessments of sanitary works to ensure that the public health aspects are considered. Comment, as appropriate, on territorial authority plans for sanitary works infrastructure planning. Liaise and, where appropriate, undertake joint projects with consent authorities and affected communities to ensure that public health aspects of planning and resource management are considered. Provide technical advice and information to regional councils and territorial authorities. Inform other agencies and the public on the public health aspects of matters relating to sustainable resource management.

8 Reference Performance Measures number Service Grouping Activities How many How well Is anyone better off (optional) (Quantity of effort) (Quality of effort) (Quantity and Quality of effect)) Health Protection For the following public health issues: Environmental Health – Other  air quality Regulatory Issues  the disposal of the dead  environmental noise  ionising radiation  non-ionising fields  recreational waters  gaseous, liquid and solid waste  other environmental health issues undertake the following: % activities and advice related to ionising # ionising radiation source radiation undertaken in consultation and with  Provide information and advice to other agencies, organisations and the public on transports overseen. their adverse effects approval of the Ministry’s Office of Radiation # requests for advice or Safety (expected 100%).  Take appropriate action to minimise risks and to protect the public health from information responded to. Numerator: # activities and advice related to environmental exposures to these issues ionising radiation undertaken in consultation # complaints referred to the with the Ministry’s Office of Radiation Safety  Monitor territorial authorities’ actions on these issues to ensure health impacts are appropriate agency for action minimized Denominator: : # activities and advice related (where it is outside PHU’s to ionising radiation undertaken  Respond to public enquiries and investigate and/or redirect public complaints and responsibility). queries on these issues. # complaints investigated  Support local government implementation of national policy statements and (where it is within PHU’s national environmental standards. responsibility) . # sanitary surveys conducted by PHU (if it is within the PHU’s responsibility) . # commercial solaria visited six- Ensure applications for approvals are complete, and include the health protection officer’s monthly. covering report and recommendations before they are forwarded to the Ministry of Health # pre-licensing inspections of for action, including: early childhood centres.  disinterments # of early childhood centre inspections undertaken as a  burials in special places result of complaints.  medical referee appointments Narrative report: Nature of any  other burial and cremation approvals. significant work not reported elsewhere eg. beauty industry Supervise disinterments as required. work such as nail bars. Advise and assist applicants to export cadavers, as required, to ensure public health concerns are addressed. (Note that costs may be recovered for this activity.) % visits to commercial solaria operators six #/% of known commercial Conduct six-monthly visits to commercial solaria to encourage compliance with best monthly solaria operators who report practice guidelines. Numerator: # visits to commercial solaria they are aware of the under-18 Conduct and report on pre-licensing inspections of early childhood centres, including Denominator: # known commercial solaria age ban (SK, S). compliance by the licensee of the premises with the Education (Early Childhood Centres) Numerator: # known Regulations 1998. commercial solaria operators who report they are aware of Investigate/inspect and report on early childhood centres in response to complaints. the under-18 age ban; Denominator: # known commercial solaria operators Survey the availability of high-power laser pointers at retail outlets, provide advice on in PHU area of coverage. compliance and take compliance action as required by the Ministry of Health.

9 Reference Performance Measures number Service Grouping Activities How many How well Is anyone better off (optional) (Quantity of effort) (Quality of effort) (Quantity and Quality of effect)) Encourage local authorities to clearly identify, and publically notify, existing or potential Complimentary Narrative Complimentary Narrative Reporting Complimentary Narrative recreational waters, which do not meet minimum microbiological water quality guidelines Reporting Reporting in the Ministry of Health/Ministry for the Environment Microbiological Water Quality Guidelines for Marine and Freshwater Recreational Areas. Encourage the grading of bathing beaches, as outlined in the Microbiological Water Quality Guidelines for Marine and Fresh Water Recreational Areas. Respond to recreational water incidents and inquiries as required. Investigate cases of suspected or confirmed toxic shellfish poisoning. Provide input into regional and local activities associated with recreational water quality. Provide public and stakeholders with appropriate advice relating to recreational waters (eg, public health fact sheets, media releases, updated website information). Encourage territorial authorities and pool managers (including school pools) to implement the requirements of NZS5826: 2010 Pool Water Quality to avoid or reduce public health risks. Conduct routine evaluation of the performance of controlling authority management of public health aspects of sewage collection and disposal with reference to statute, guidelines, standards, resource consent conditions and accepted public health practice. Investigate and assess the public health need for sewerage systems in areas not adequately serviced. Undertake sanitary and waste surveys as required. Provide a system for monitoring of significant public health risks in waste management. Undertake surveys of representative waste management facilities in the region as resources allow. Liaise with councils to verify that sewage overflows that pose a significant public health risk are adequately responded to, engage with sewage collection and disposal providers to ensure overflows are appropriately managed and reduce overflows to high risk areas. Promote improvements in public sewage collection and disposal systems where this is considered necessary. Investigate clusters and cases of illnesses associated with non-occupational exposure to sewage or other waste. Provide advice to schools and early childhood centres during an outbreak investigation and response. Consider becoming a signatory to the NZ Urban Design Protocol (2005). Where appropriate, advocate the use of health impact assessment. Where appropriate, promote the Healthy Cities/communities concept.