Service Specification Template Headings Explanation

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Service Specification Template Headings Explanation Powered By Docstoc
					                                                                                 on behalf of all DHBs


            PUBLIC HEALTH SERVICES
     REGULATORY SERVICES AND REPORTING –
    PHYSICAL ENVIRONMENTAL HEALTH SERVICES
                 TIER LEVEL TWO
              SERVICE SPECIFICATION

Status:
Approved for recommended nationwide                                 RECOMMENDED 
use for the non-mandatory description of
services funded by DHBs.
Status:                                                             MANDATORY 
Approved for mandatory nationwide use
for the description of services to be
funded by the Ministry of Health.
Review History                                                      Date

Endorsed by Nationwide Service
Framework Coordinating Group (NCG)

Published on NSFL

Review: of Public Health Handbook (2003):
Amendments: inserted into service specification format, added
support services ,service linkages table, quality requirements,     April 2010
Purchase Unit Code table, reporting requirements, links to Public
Health Services tier one service specification .

Consideration for next Service Specification
                                                                    Within three years
Review

Note: Contact the Service Specification Programme Manager, National Health Board
Business Unit, Ministry of Health to discuss the process and guidance available in
developing new or updating and revising existing service specifications. Web site address
of the Nationwide Service Framework Library: http://www.nsfl.health.govt.nz/.
     PUBLIC HEALTH SERVICES -REGULATORY SERVICES AND REPORTING –
               PHYSICAL ENVIRONMENTAL HEALTH SERVICES
                            TIER LEVEL TWO
                         SERVICE SPECIFICATION
This tier two service specification for Public Health Services Regulatory Services and
Reporting – Physical Environmental Health Services (the Service) must be used in
conjunction with the overarching tier one Public Health Specification and is linked to the
tier two Social Environments and Health Promoting Schools service specification.
Refer to the Public Health tier one service specification under the following headings for
generic details on:
     Service Objectives
     Service Users
     Access
     Service Components
     Service Linkages
     Exclusions
     Quality Requirements
The above heading sections are applicable to all the Service delivery.
Background

When considering the role of the physical and social environments on the health of
populations, the concepts of sustainable development and supportive environments must
be included. Ecological public health involves creating physical and social environments
conducive to health, to make healthy choices easier choices. It requires a comprehensive
approach to public health including developing linkages between existing areas of public
health activity.
Creating sustainable healthy environments contributes to key public health outcomes such
as healthy eating healthy action, for example through urban design contributing to healthy
action or health promoting schools providing a vehicle for nutrition policies in the education
sector.

1.     Service Definition
Enforcement is the investigation and action in response to alleged non-compliance, and
requires specialist experience and skilled practitioners. While there is a distinction between
compliance and enforcement, it is not always easy to practicably separate the two.
The enforcement of public health legislation is undertaken by District Health Board (DHBs)
Public Health Units, which are responsible for planning and delivering compliance and
enforcement functions as part of comprehensive public health programmes. In addition,
the Director-General of Health directly employs or contracts enforcement officers to
undertake the enforcement of more complex, or precedent setting, or specialised
legislation.
The Services must provided in accordance with the tier one Public Health Services service
specification Appendix One Regulatory Services and Reporting Requirements and the
Ministry of Health Environmental Health Protection Manual.
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The following legislation is required to be enforced by DHB’s Public Health Units under this
service specification:
     Biosecurity Act 1993
     Burial and Cremation Act 1964
     Civil Defence and Emergency Management Act 2002
     Epidemic Preparedness Act 2006
     Hazardous Substances and New Organisms Act 1996
     Health Act 1956
     Misuse of Drugs Act 1975
     New Zealand Public Health and Disability Act 2000
     Prostitution Reform Act 2003
     Radiation Protection Act 1965
     Sale of Liquor Act 1989
     Smoke-Free Environments Act 1990.
Officers within Public Health Units are designated (or appointed) under the Health Act
1956, Smoke-free Environments Act 1990, Hazardous Substances Act 1996, and the
Biosecurity Act 1993. Public health managers may also use the Ministry of Health’s (the
Ministry’s) specialised enforcement officers for compliance and enforcement activities to
support and enhance the public health unit’s staff.
The Director of Public Health, and other appropriately experienced public health medicine
specialists within the Ministry, have been appointed as national medical officers of health,
although these national medical officers of health would largely exercise their powers
during public health emergencies, rather than for more routine compliance and
enforcement functions.
2.     Service Objectives
2.1    General
The overarching health goal is that public health and whanau health are improved through
the protection and promotion of healthy communities and healthy environments including
the global environment.
The key outcomes, to be achieved in 10 to 20 years, are the reduction in the incidence and
impact of:
     environmental hazards
     environmental inequalities across sectors
     settings-based environmental health issues
See Appendix One Figure 1 for Outcomes Focused Framework for Environmental Health
and Social Environments.
Individual contract service specifications each have a goal, which is focused on that
particular aspect of the environment.



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2.2    Māori Health
Refer to the tier one Public Health service specification.
3.     Service Users
The New Zealand general public.
4.     Access
The services under this service specification are accessed though the DHB’s Public Health
Units.

5.     Service Components and Linkages
5.1    General

 Service Categories      Subcategories Included


 Environmental              Air quality (indoor and outdoor)
 Health                     Border health protection
                            Burial and cremation
                            Contaminated land
                            Drinking water quality
                            Environmental noise management
                            Hazardous substances
                            Ionising/non-ionising radiation
                            Public Health emergency planning and response
                            Recreational water
                            Resource management
                            Sewage treatment and disposal
                            Waste management (liquid and solid waste)
                            Other regulatory activities.
5.2    Environmental Health
5.2.1 Air Quality (Indoor and Outdoor)

 Health Goal            To reduce the incidence and impact of environmental hazards by
                        developing strategies to prevent or control the adverse impacts of air
                        quality (indoor and outdoor) on public health.


 Rationale and Key          Air pollution from industrial, domestic and mobile sources can give rise
                             to serious health problems, particularly in urban areas where the
 Issues
                             majority of the New Zealand population (over 80%) reside and work.
                             Air pollution can also occur from natural sources, such as geothermal
                             areas.
                            Risks to public health exist both outdoors and indoors (including non-
                             occupational environments) where exposure to short-term high, or
                             long-term low, concentrations of air pollutants can give rise to acute
                             and chronic conditions and, in extreme cases, death.

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 Objectives                 To have strategies to prevent or minimise the health risks and diseases
                             associated with air pollution.
                            To promote a physical environment both outdoors and indoors, which
                              has clean air.

 Key Linkages            Department of Building and Housing
                         Emergency Services
                         Ministry for the Environment
                         Department of Labour
                         Regional Councils and territorial authorities
                          Agricultural Compounds and Veterinary Medicines Act 1997
 Relevant
 Legislation                Building Act 2004
                            Building Regulations 1992 (under review)
                            Hazardous Substances and New Organisms Act 1996
                            Health Act 1956
                            Housing Improvement Regulations 1947
                            Health and Safety in Employment Act 1992
                            Land Transport Management Amendment Act 2008
                            Land Transport Act 1998
                            Land Transport Rules (a form of delegated legislation similar to
                             regulations made under the Land Transport Act 1998)
                            Local Government Act 2002
                            New Zealand Public Health and Disability Act 2000
                            Resource Management Act 1991
                            Resource Management (National Environmental Standards Relating to
                             Certain Air Pollutants, Dioxins and Other Toxics) Regulations 2004
                            Traffic Regulations 1976 (only requirements relating to vehicle noise,
                             brakes, steering and couplings remain in these regulations)

 Components of           Service Descriptions/Activities
 Service

 Promote public          Provide information and advice to other agencies and the public on adverse
                         effects of adverse air quality.
 health knowledge


 Provide advice and         Make timely and professional submissions on national (including
                             national policy statements, national environmental standards and or
 input into the
                             guidelines) and regional plans and policy statements, district plans,
 activities of linkage       and where appropriate, resource consent applications to ensure that
 agencies                    the public health effects of adverse air quality are considered and
                             managed.
                            Seek to develop a Memorandum of Understanding (or equivalent) with
                             regional councils that describe roles and responsibilities in this area.




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5.2.2 Border Health Protection

 Health Goal            To reduce the incidence and impact of settings-based environmental health issues
                        through the management of public health risks entering or leaving New Zealand
                        and through the surveillance, exclusion, eradication, and effective management of
                        pests of public health significance from the environment.


 Rationale and Key      New Zealand has remained free from many imported human, animal and plant
 Issues                 diseases and their vectors.

                        Effective border health protection procedures are needed to prevent the entry and
                        establishment of new diseases or disease vectors, and other public health risks.


 Objectives             To prevent potential health risks caused by the arrival of travellers, goods, aircraft
                        and vessels from overseas, and the introduction of pests and unwanted diseases.

                        To prevent the international spread of disease and other public health risks by
                        facilitating New Zealand’s international reporting obligations and compliance with
                        international obligations.


 Key Linkages           Department of Labour
                        Department of Conservation
                        Ministry for the Environment
                        Ministry of Agriculture and Forestry
                        Ministry of Fisheries
                        NZ Customs Service
                        Port and airport companies
                        Territorial authorities and regional Councils
                        Travel industry

 Relevant                   Biosecurity Act 1993
 Legislation                Health Act 1956
                            Anthrax Prevention Regulations 1987
                            Health (Quarantine Regulations) 1983
                            New Zealand Public Health and Disability Act 2000
                            International Health Regulations 2005

 Components of          Service Descriptions/Activities
 Service


 Public health           All border health protection programmes will be carried out in collaboration with
                         other relevant agencies.
 regulatory services


 Border health          Border health protection programmes should:
 protection services        ensure adequate capacity to carry out services and respond to incident and
                             emergent issues
                            undertake surveillance of container-breeding mosquitoes at international sea
                             and airports

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                            identify and monitor border health protection risks (including surveillance) and
                             develop/maintain contingency plans to deal with them
                            respond promptly to interceptions of pests, and cases of imported disease
                            respond promptly to requests for pratique, inspections and certification (eg
                             ship sanitation, fumigation, anthrax control).
                            assess the effectiveness of implementation of public health aspects of border
                             health protection, in conjunction with other agencies (eg, quarantine facilities
                             and practices, vector surveillance and control, radio pratique, potable water,
                             waste disposal)
                            provide sound technical and professional advice on public health issues that
                             are related to border health protection objectives in relation to imported risk
                             goods, disease vector surveillance and control, preparation of contingency
                             plans for emergency response, preparation of submissions as appropriate on
                             proposed pest management strategies
                            contribute (when required) to the preparation of health impact assessments in
                             relation to border health protection threats and eradication and control
                             activities; participate in national, regional and local research survey or
                             response programmes as appropriate; participate in national, regional or local
                             emergency responses as required.

 Information and        All dates apply annually.
 Reporting              In February each year, provide the Ministry of Health with:
 Requirements
                            a summary for the previous calendar year of activities undertaken including
                             issuing pratique, undertaking sanitation inspections, ensuring points of entry
                             are maintained in a sanitary condition and free from sources of infection and
                             contamination including vectors and reservoirs; supervision of any deratting,
                             disinfection, disinsection, or decontamination as appropriate; application of
                             control measures to any conveyance; interception responses; and
                             maintenance of effective contingency arrangements;
                            a report on designated airports’ and ports’ ability to meet core capacities as
                             outlined in Annex 1B of the International Health Regulations 2005;
                            forecast of your border health protection surveillance programme for the
                             forthcoming financial year.
                            provide situation reports on activities undertaken during interception responses
                             as required by the Senior Advisor (Border Health Protection), using the format
                             in the biosecurity section of the Environmental Health Protection Manual.
                        Providers are required to advice the Senior Advisor (Border Health Protection)
                        within two hours of the identification and location of an exotic mosquito or
                        mosquitoes of public health significance.
                        Immediately notify the Senior Advisor (Border Health Protection) of any control
                        measures applied to any conveyance that are other than routine, and copy the
                        Office of the Director of Public Health.
                        Immediately, or within 24 hours of occurrence of a public health event or
                        emergency with inter-district, national or potentially international implications,
                        submit a report to the Environmental & Border Health Protection Team and a copy
                        to your Public Health Group, Portfolio Manager, Health and Disability National
                        Service Directorate, Ministry of Health.




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5.2.3 Burial and Cremation

 Health Goal             To reduce the incidence and impact of environmental hazards by ensuring the
                         lawful, hygienic and dignified disposal of the dead.

 Rationale and Key       The sanitary disposal of the dead is essential to protect the public health.
 Issues                  The public expect burial and cremation activities to be conducted with dignity,
                         sensitivity and with respect for the deceased and their families.

 Objectives              To ensure the correct procedures are used for disposal of the dead and any
                         subsequent movement of remains.

 Key Linkages           Funeral directors
                        Territorial authorities and regional councils
                        Burial Ground/Crematorium Management Trustees.

 Relevant                    Burial and Cremation Act 1964
 Legislation                 Cremation Regulations 1973
                             Burial and Cremation (Removal of Monuments and Tablets) Regulations
                              1967
                             Local and Private Acts of Parliament
                             Health Act 1956
                             Health (Burial) Regulations 1946
                             New Zealand Public Health and Disability Act 2000
                             Resource Management Act 1991

 Components of          Service Descriptions/Activities
 Service


 Ensure compliance      Supervise disinterments.
 with Burial and        Investigate and follow up incidents and complaints.
 Cremation Act 1964     Advice and assist applicants to export cadavers to ensure public health concerns
 and regulations        are addressed.


 Information and        All dates apply annually.
 Reporting              Provide reports to the Ministry of Health as required for:
 Requirements
                            disinterment licence applications
                            burials in special places
                            medical referee nominations
                            other burial and cremation issues.




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5.2.4 Contaminated Land

 Health Goal            To reduce the incidence and impact of environmental hazards by preventing or
                        controlling the adverse impacts of corrosive, explosive, flammable, oxidising and
                        toxic hazardous substances.

 Rationale and Key      Human activities in parts of New Zealand have resulted in the contamination of
                        land with substances hazardous to human health. Human exposure may occur
 Issues
                        through contact with contaminated soil, dust, food and water. This exposure may
                        be hazardous to health and, therefore, needs to be quantified and minimised.

 Objectives             To minimise the impact of contaminated land sites on human health using a risk
                        management and health impact assessment approach.
                        To work with regional councils and territorial authorities in the assessment and
                            management of contaminated land sites in order to minimise any potential or
                            actual effects on human health.

 Key Linkages           Ministry for the Environment (The Ministry has developed a series of 5 guidelines
                        cover the following areas: reporting, application of environmental guideline
                        values, risk screening, classification and information management and
                        investigation and analysis. Their main purpose is to introduce consistency in
                        contaminated land assessment and management throughout the country.)
                        Department of Labour
                        Regional Councils
                        Territorial authorities
                            Hazardous Substances and New Organisms Act 1996
 Relevant
 Legislation                Health Act 1956
                            Health and Safety in Employment Act 1992
                            Local Government Act 2002
                            New Zealand Public Health and Disability Act 2000
                            Resource Management Act 1991

 Components of          Service Descriptions/Activities
 Service

                        All contaminated land programmes will be carried out in collaboration with other
 Public health
                        relevant agencies.
 regulatory services

                        1.   Advise, encourage and/or assist territorial authorities and Regional Councils
 Work with
                             to:
 territorial
 authorities                    locate contaminated land sites and identify contaminants
                                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 health.
                        2.   Seek to develop a Memorandum of Understanding (or equivalent) with
                             Regional Councils that describes roles and responsibilities in this area.
                        All reporting dates apply annually.
 Information and
 Reporting


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 Requirements


5.2.5 Drinking Water

 Health Goal            To reduce the incidence and impact of environmental hazards by promoting
                        the availability of adequate supplies of safe drinking water to all
                        communities.

 Rationale and Key      Safe drinking water is essential to protect the public health from diseases or
                        harmful contaminants in New Zealand.             Water intended for human
 Issues
                        consumption or for activities such as food preparation should be of such
                        quality that good health is not compromised or threatened.
                        In 2007, the Health Act 1956 was amended to include a regulatory
                        framework to promote safe drinking water supplies. The amended Act
                        defines the competencies, functions and powers of drinking-water
                        assessors and designated officers.
                        The Act also specifies the regulatory duties applying to drinking-water
                        suppliers including the requirement for water suppliers to:
                           be on the Register of Community Drinking Water Supplies in New
                            Zealand; and
                           take all practicable steps to comply with the Drinking Water Standards
                            for New Zealand and, if they are larger than a neighbourhood supply, to
                            provide an adequate supply of safe drinking-water and to prepare and
                            implement a public health risk management plan for their supply.
                        The Resource Management (National Environmental Standards for
                        Sources of Human Drinking Water) Regulations 2007 administered by the
                        Ministry for the Environment came into effect on 20 June 2008. The
                        regulations aim to reduce risks to the quality of water bodies from which the
                        source water for drinking-water supplies is taken. It will do this by
                        preventing discharge and water permits being granted, and preventing the
                        inclusion of permitted activity rules in regional plans, if they will cause
                        drinking water to become unsafe to drink after the existing treatment
                        processes. To implement the national environmental standard, regional
                        councils and consent applicants will need to understand the:
                           likely contaminants that might be associated with a particular activity
                           ability of the various treatment processes used in New Zealand to
                            remove contaminants from the water.
                        The Drinking Water Standards for New Zealand 2005 sets out the quality of
                        water that water suppliers are expected to deliver for public consumption.
                        The publication of the Register of Community Drinking Water Supplies in
                        New Zealand identifies from where communities receive their water, the
                        Priority 2 determinants present, and the public health grading of the supply.
                        The publication of an annual report on the chemical and microbiological
                        quality of drinking water supplies in New Zealand means that the public is
                        made aware of the quality of their water.
                        There are a large number of small community drinking water supplies that
                        do not reach the required standards. This can be due to the poor quality of
                        the water or because they are not monitored and so do no demonstrate
                        whether or not they meet the desirable standard. Suppliers should b
                        encouraged to register their supplies and demonstrate compliance with the
                        desired standards.
                        The drinking water assistance programme (DWAP) has two parts, a
                        Technical Assistance Programme (TAP) and the Capital Assistance
                        Programme (CAP). The TAP provides technical assistance to small water
                        supplies serving less than 5000 people. The TAP assist with preparation of
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                        public health risk management plans, optimisation of small water supplies,
                        options for upgrading or improving supplies and preparation of capital
                        assistance programme applications. The capital assistance programme
                        provides funding to upgrade small water supplies.

 Objectives             To optimise the safety and quality of all drinking water available for public
                        consumption in New Zealand.
                        To prevent the spread of disease to the public through the public water
                        supply.
                        Department of Building and Housing
 Key Linkages
                        Department of Internal Affairs
                        Drinking Water Suppliers
                        Local Government New Zealand
                        Ministry for the Environment
                        New Zealand Food Safety Authority
                        Territorial authorities and regional councils

                           Building Act 2004
 Relevant
 Legislation               Food Act 1981
                           Health Act 1956
                           Local Government Act 2002
                           New Zealand Public Health and Disability Act 2000
                           Resource Management Act 1991

 Components of          Service Descriptions/Activities
 Service
                        NB priorities for action are shown in bold type e.g. (P1) is priority 1.

 Public health          1. Drinking water assessor units are to have access to the services of a
                           sufficient number of appointed Drinking Water Assessors to carry out
 regulatory services
                           the programme within the public health unit’s region. (P1)
                        2. Items (except (a)) are to be performed by, or certified by, a drinking-
                           water assessor. (see individual priority ranking)
                        3. Undertake such duties as are required by the Health Act 1956, as
                           amended by the Health (Drinking Water) Amendment Act 2007:
                           Identify all drinking-water suppliers in the Health District, including
                            specified drinking-water suppliers and specified self-suppliers and enter
                            them on the Register [section 69B, 69J, 69K,L,M,N] (P1);
                           All applications for the registration and de-registration of water
                            suppliers and registration, renewal of registration and de-registration of
                            water carriers to be processed within 20 working days [DWA Tech
                            Manual] (P1);
                           Assess water supplier (including water carrier) compliance with the
                            Drinking Water Standards for New Zealand 2005.           Report on
                            compliance / non-compliance with duties under the Act to the water
                            supplier within 20 working days [section 69V]. (P1);
                           Provide reports to the Ministry of Health on water suppliers’ compliance
                            with the Health (Act 1956, compliance with Drinking Water Standards
                            for New Zealand 2005 and implementation of their public health risk
                            management Plan (P1);
                           Verify adequacy of water suppliers’ public health risk management
                            plans and provide report to the water supplier within 20 working days
                            [section 69Z] (P1);
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                           Certify implementation of a water supplier’s public health risk
                            management plan at no greater than a three yearly interval and report
                            to the water supplier within 20 working days [section 69Z] (P1);
                           Assess the competence of and, where appropriate, authorise persons
                            to perform drinking water analyses and calibration of water treatment
                            and testing equipment, report to the water supplier within 20 working
                            days [section 69ZL(1) (e)&(f)] (P2);
                           Assess water suppliers’ complaint management procedures and report
                            to the water supplier within 20 working days detailing whether
                            legislative requirements are met [69ZE]. (P2);
                           Assess and process applications for the use of temporary drinking
                            water supplies (P1).
                        4. Undertake enforcement activities, where appropriate using powers
                           under the Health (Drinking Water) Amendment Act 2007. (P1).

 Participation in       1. Carry out public health grading of community drinking water supplies in
                           accordance with the national programme and synchronised with the
 grading of water
                           phasing in of the Drinking Water legislation.
 supplies
                        2. Grading of all drinking water supplies with population >500 to be
                           completed by 30 April 2009 and thereafter every two years. Grading
                           reports to be sent to the water supplier within 20 working days of
                           assessment. (P1)

 Maintain               1. Carry out the surveillance of drinking water monitoring by suppliers and
                           maintain the Water Information New Zealand (WINZ) database entries
 monitoring and
                           for all community drinking water supplies (P2).
 surveillance
 systems                2. Collate microbiological and chemical drinking water quality data and
                           information on public health risk management from all drinking water
                           suppliers listed in the current edition of the Register and transmit the
                           data for the previous calendar year to the Ministry of Health’s science
                           provider before 31 August (P1).
                        3. Collect and supply water samples and water source data for the Priority
                           2 determinands identification programme to the Ministry of Health’s
                           science service provider according to their planning schedule and
                           timelines (within 10 days of scheduled sampling date) (P2).
                        4. Transmit the information of Priority 2 assignation to water suppliers.
                           Advise water suppliers of new Priority 2 assignations(P2).
                        5. Audit the quality of drinking water supplier’s water quality monitoring
                           records (P1).

 Advice and             1. Provide technical advice and information on public health aspects of
                           drinking water supplies and the public health grading of water supplies
 information on the
                           to water suppliers, including the implications of the Health Act 1956 and
 quality of drinking       the Drinking Water Standards for New Zealand 2005 for their operations
 water supplies            (P2).
                        2. Provide advice and information to the public and organisations on
                           issues of public health significance in respect to drinking water supplies
                           (P2).
                        3. Take measures to protect and advise the community of appropriate
                           action in the case of contamination of their drinking water supply (P1).
                        4. Promote the importance of clean, potable drinking water as a high
                           priority for supply authorities (P2).
                        5. Make timely and professional submissions on national and regional
                           plans and policies, district plans and policies, and local government
                           assessments of drinking water supplies and, where appropriate,

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                            resource consent applications to ensure that the public health effects of
                            drinking water supplies are considered and managed (P2).
                        6. Work with small drinking water supplies to assist them to prepare public
                           health risk management plans, optimise their supplies and identify
                           options for upgrading to provide safe drinking water supplies (P1).
                        7. Assist small drinking water supplies to make applications for capital
                           assistance programme funding using Ministry of Health criteria (P1).
                        8. Comment as appropriate on territorial authority plans for sanitary works
                           infrastructure planning (P2).

 Investigate public     1. Identify, investigate and follow up as appropriate incidents, complaints
                           and notifications threatening drinking water quality (including tankered
 health problems
                           and temporary drinking water supplies) using sanitary survey,
 arising from              epidemiological techniques or other relevant methods. Ensure all such
 drinking water            events are entered into WINZ database and serious incidents are
                           reported to the Ministry of Health within 24 hours (see 7.5) (P1 for
                           ‘incidents’ as defined by DWA Technical Manual, otherwise P2)
                        2. Maintain calibrated drinking water testing equipment to enable the
                           public health unit to undertake surveillance (and incident investigation
                           response) testing of Free Available Chlorine, Turbidity and pH (P1)

 Promote public         1. Provide advice on the benefits of water fluoridation when the issue
                           becomes a significant issue in the community (P1) by:
 health knowledge
                           supporting health professionals who are promoting the extension or
                            maintenance of fluoridated water supplies
                           ensuring appropriate education material is available to educational
                            institutions, health professionals, territorial authorities, community
                            groups and the public
                           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.
                        2. Assist and work with Māori and other ethnic groups and communities
                           as appropriate to provide advice around the benefits of water
                           fluoridation (P2).
                        See also the Well Child specification.

 Information and        All reporting dates apply annually.
 Reporting              1. Report within one month of the end of each quarter on the DWAU
 Requirements              activities, according to the agreed work plan for that quarter, using the
                           format specified by the MoH (P1).
                        2. Before 31 March each year, advise the Ministry of Health of any
                           objections made by drinking water suppliers in respect of Priority 2
                           determinand assignments specified in December of the previous year
                           (in a form specified by the Ministry of Health) (P2).
                        3. Before 30 April each year (at a date and in a form specified by the
                           Ministry of Health) provide to the Ministry of Health (P2):
                               A list of water supplies for which data collection has been
                                completed under the Priority 2 determinands identification
                                programme specified for the current financial yea
                               A list of water supplies for which data collection is uncompleted.
                        4. By 31 August each year, provide to the science service provider (in a
                           form specified by the Ministry of Health) data on microbiological and
                           chemical sampling and the status of public health risk management of
                           drinking water supplies for the calendar year for incorporation in the

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                               Annual Report on the Chemical and Microbiological Quality of
                               Community Drinking- water Supplies (P1).
                           4. Provide the science service provider with the assessment report on
                              water suppliers’ public health risk management programmes and
                              compliance with the Drinking-Water Standards for New Zealand 2005
                              [see 1.4] within two calendar months of completion of the assessment
                              (P1).
                           5. Report serious drinking water incidents (see 5.1) to the Ministry of
                              Health within 24 hours (P1).

Notes to above table

(P1)    Priority One tasks: Where drinking water resources within a public health unit do not allow the
completion of all tasks within this specification, tasks in this category must be prioritised for completion in
preference to other tasks.

(P2)    Priority Two tasks: Where drinking water resources within a public health unit do not allow the
completion of all tasks within this specification, tasks in this category should not be completed at the
expense of completion of Priority one tasks (with the exception being if they can be completed in conjunction
with a Priority One task e.g a drinking water supplier’s complaint procedures may be assessed at the same
time as a Public Health Grading assessment).

5.2.6 Environmental Noise

  Health Goal              To reduce the incidence and impact of environmental hazards by reducing the
                           adverse health effects of environmental noise on people and communities.


  Rationale and Key        Noise is unwanted or undesirable sound and can materially affect an individual or a
                           community’s health, well-being and enjoyment of their surroundings.                As
  Issues
                           communities grow and urban environments become more densely populated and
                           industrialised, and as traffic increases, the level of background and intrusive noise
                           generally increases. Noise can affect people physically, psychologically and
                           socially. Prolonged exposure to high levels of noise can damage hearing, interfere
                           with communication, be annoying, cause mental and physical fatigue, stress-
                           induced hypertension and ischaemic heart disease, and reduce efficiency. Adverse
                           effects include: interference with speech communication, disturbance of rest and
                           sleep, psycho-physiological, mental health and performance effects, effects on
                           residential behaviour and annoyance, and interference with intended activities.
                           To ensure that the health effects of environmental and non-occupational noise are
  Objectives
                           considered by territorial authorities in the course of their duties.

                           Ministry for the Environment
  Key Linkages
                           Department of Labour
                           Environmental Noise Analysis and Advice Service
                           Territorial authorities and regional councils

                               New Zealand Public Health and Disability Act 2000
  Relevant
  Legislation                  Resource Management Act 1991
                               Health Act 1956
                               Health and Safety in Employment Act 1992
                               Local Government Act 2002
                               New Zealand Public Health and Disability Act 2000
                               Civil Aviation Act 1990


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  Components of          Service Descriptions/Activities
  Service

  Public health         All environmental noise programmes will be carried out in collaboration with other
                        relevant agencies.
  regulatory services


  Liaison with           1. Liaise with territorial authorities on the establishment of goals, objectives, plans
                            and priorities for environmental noise control.
  territorial
  authorities            2. Monitor territorial authorities’ actions on environmental and non-occupational
                            noise issues to ensure that health impacts of such noise are minimised.

  Resource               1. Make timely and professional submissions on national (including national policy
                            statement, national environmental standards and guidelines) and regional plans
  Management Act
                            and policy statements, district plans and, where appropriate, resource consent
  1991 activities           applications to ensure that the public health effects of adverse environmental
                            noise are considered and managed.
                         2. Monitor decisions made under the Resource Management Act 1991 to ensure
                            that the health impacts of environmental and non-occupational noise have been
                            considered. Follow up with territorial authorities where this has not occurred.

  Information and        All reporting dates apply annually.
  Reporting
  Requirements


5.2.7 Hazardous Substances

  Health Goal            To reduce the incidence and impact of environmental hazards by reducing the
                         adverse health effects of hazardous substances on people and communities.

  Rationale and Key      Proper management of hazardous substances throughout their life cycle is
                         necessary to avoid adverse health effects either from direct or indirect exposure to
  Issues
                         hazardous substances or from environmental contamination.
                         At all stages, except where the hazard is in an occupational health setting,
                         responsibility for protecting the public health lie with the Director-General of Health,
                         in association with a number of other agencies.

  Objectives             To protect the public health by minimising the harm from hazardous substances.
                         To maintain good interagency networks to prevent harm to the public health from
                         hazardous substances.

  Key Linkages           Customs, Police and Transport
                         Emergency Services
                         Hazardous Substances and Technical Liaison Committee
                         Ministry for the Environment
                         Environmental Risk Management Authority
                         Ministry of Agriculture and Forestry
                         NZ Fire Service
                         Department of Labour
                         Territorial authorities and regional councils

  Relevant                  Agricultural Compounds and Veterinary Medicines Act 1997
  Legislation               Building Act 2004


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                             Hazardous Substances and New Organisms Act 1996
                             Health Act 1956
                             Health and Safety in Employment Act 1992

                             Local Government Act 2002
                             New Zealand Public Health and Disability Act 2000
                             Resource Management Act 1992
  Components of          Service Descriptions/Activities
  Service

  Public health          All hazardous substances programmes will be carried out in collaboration with other
                         relevant agencies.
  regulatory services


  Liaison with           1. Liaise with territorial authorities on the establishment of goals, objectives, plans
                            and priorities for hazardous substances control.
  territorial
  authorities            2. Seek to develop a Memorandum of Understanding (or equivalent) with territorial
                            authorities that describes roles and responsibilities in this area.

  Audit compliance       1. Audit compliance with, investigate breaches of, and where appropriate, enforce
                            the relevant Acts and Regulations, including:
  with relevant Acts
  and Regulations                Polychlorinated biphenyl (PCB) storage and surveillance checks
                                 supervision and inspection of imported hazardous substances
                                 attending hazardous substances incidents
                                 consider and review permissions for applications of vertebrate toxic agent
                                 monitoring storage and display of hazardous substances for retail sale.
                         2. Ensure that the conditions imposed by the HSNO designated officer granting
                            permits for the use of controlled vertebrate toxic agents are complied with.
                            Audits should be conducted to ensure compliance, as appropriate.

  Maintain an            Maintain effective risk management strategies and action plans for emergency
                         situations involving hazardous substances, including deliberate chemical
  emergency
                         contamination.
  response capacity


  Maintain               1. Inspect and report on premises in which PCBs (are used and/or stored).
                            Report on non-compliance with conditions of exemption, and lapsed
  inspection,
                            exemptions.
  monitoring and
  surveillance           2. Prepare and update a database of locations for ownership of PCBs.
  systems                3. Implement the recommendations on the Investigation and Surveillance of
                            Agrichemical Spraydrift Incidents: guidelines for public health services including
                            providing annual returns from Driftnet to the science provider as requested.
                         4. Participate in the Chemical Injury and other notifiable condition surveillance
                            systems, including exposures to asbestos in a non-occupational environment.

  Interagency            1.   Represent public health interests at meetings of the Hazardous Substances
                              Technical Liaison Committee (or equivalent body).
  networking and
  administrative         2.   Provide input into territorial authorities’ hazard and risk assessment and
  procedures                  management systems so that risks to public health from hazardous substances
                              are addressed.
                         3.   Maintain networks with PCB holders, the electrical industry and disposal
                              agents to ensure that the storage, transportation and disposal requirements

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                              are environmentally sound.
                         4.   Seek to develop a Memorandum of Understanding (or equivalent) with other
                              agencies that describes roles and responsibilities in this area (consistent with
                              relevant national MoUs).

  Promote public         1.   Promote public knowledge on the risks of non-occupational exposures to
                              hazardous substances by:
  knowledge
                             providing public health advice and information on hazardous substances to the
                              public, health professionals and organisations.
                             Advising on the safe management of hazardous substances such as lead-
                              based paint including their removal and disposal from contaminated areas.

  Information and        All reporting dates apply annually.
  Reporting              1. By 30 June each year provide:
  Requirements
                                summaries for the past year (to 30 June) and estimates for the coming year
                                 (1 July to 30 June) of the nature and level of inspection and enforcement
                                 services under HSNO Act s98(2), such matters as:
                                 -     the planned and actual levels of inspection/investigation
                                 -     emergency responses
                                 -     compliance orders and infringement notices and warnings issued
                                 -     a list of the premises or situations inspected
                                 -     investigations and actions proposed and undertaken
                                 -     prosecutions.
                                summaries for the past year (1 July to 30 June) of the notifications of
                                 hazardous substances hospital admissions injuries and GP notifications
                                 reported to the Medical Officer of Health under the HSNO Act s143 including:
                                 -     the hazardous substances injury classification (eg. toxic or corrosive)
                                 -     the site/location (workplace, school, home etc)
                                 -     where available, ethnic breakdown, gender, and age.
                         Note:       furnishing information to the Ministry of Health will be sufficient for Medical
                                     Officers of Health to meet their statutory requirement to supply the
                                     information, in an anonymised form, to the Minister of Health.
                         2. Provide annual returns to the science provider on the incidence of agrichemical
                            spray drift complaints using the DriftNet surveillance system.
                         3. Provide copies of VTA permits to ERMANZ every time they are issued.
                         4. Report to the Ministry of Health as required on:
                                PCB use and storage exemptions
                                HSNO incident or emergency situations
                         5. Immediately, or within 24 hours of occurrence of a public health event or
                            emergency with inter-district, national or potentially international implications,
                            submit a report to the Environmental and Border Health Protection Team and a
                            copy to your Public Health Operations portfolio manager.
                         Formats for the reports will be outlined in the Hazardous Substances section of the
                         Environmental Health Protection Manual.




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5.2.8 Ionising Radiation/Non-Ionising Fields

  Health Goal            To reduce the incidence and impact of environmental hazards by
                         developing strategies to prevent or control the adverse impacts of ionising
                         and non-ionising radiation.

  Rationale and Key      Exposure to radiation can pose a significant threat to the public health.
  Issues


  Objectives             To work with the National Radiation Laboratory to minimise risk to health
                         from ionising/non-ionising radiation.

  Key Linkages           Hazardous Substances Technical Liaison Committees
                         Ministry for the Environment
                         National Radiation Laboratory
                         Port authorities
                         Transport industry

  Relevant                  Health Act 1956
  Legislation               Microwave Ovens Regulations 1982
                            Land Transport Act 1988
                            Local Government Act 2002
                            Marine Pollution Act 1974
                            Relevant National Environmental Standards and Policy Statements
                            New Zealand Public Health and Disability Act 2000
                            Ozone Protection Act 1981
                            General Harbour (Ship, Cargo and Dock Safety) Regulations 1968
                            Radiation Protection Act 1965
                            Radiation Protection Regulations 1982
                            Resource Management Act 1991
                            Ministry for the Environment/Ministry of Health National Guidelines for
                             Managing the Effects of Radio-frequency Transmitters.

  Components of          Service Descriptions/Activities
  Service

  Public health          Provide services in accordance with the National Radiation Laboratory
                         Radiation Incident Response Plan.
  regulatory services


  Work co-               Activities will include:
  operatively with the      ensuring that appropriate action is taken to minimise risks and to
  National Radiation         protect the public health
  Laboratory                conducting surveillance and evaluation of the management of radiation
                             with reference to statute, guidelines and best practice
                            assessing the health risks associated with exposure to radiation as
                             part of any population health status review
                            identifying and investigating public health risk associated with radiation
                             including epidemiological field investigation where appropriate

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                                developing contingency plans and response capability to deal with
                                 radiation contamination/hazard incidents, including counter-terrorism,
                                 in accordance with the National Radiation Laboratory Radiation
                                 Incidence Response Plan

  Promote public         Provide public health advice on the health effects of ionising and non-
                         ionising radiation to organisations and the public.
  health knowledge


  Purchase Units,        All reporting dates apply annually.
  Information and        Immediately, or within 24 hours of occurrence of a public health event or
  Reporting              emergency with inter-district, national or potentially international
  Requirements           implications, submit a report to the Environmental and Border Health
                         Protection Team and a copy to your Public Health Operations portfolio
                         manager.

5.2.9 Public Health Emergency Planning and Response

  Health Goal            To reduce the incidence and impact of environmental hazards on
                         communities and individuals in the event of a public health or other
                         emergency.

  Rationale and Key      The impact of public health emergencies, including civil defence
                         emergencies, can be mitigated if providers have prepared contingency
  Issues
                         plans. Examples include communicable disease outbreaks, exotic
                         mosquito interceptions and incursions, terrorism threats, and the chemical
                         incidents, as well as flooding or earthquakes.
                         Pre-disaster public health planning and interagency liaison can also
                         improve preparedness for the response and recovery phases, and reduce
                         the overall impacts on the public health, of a disaster.
                         Part six of the National Civil Defence Plan sets out the functions, roles and
                         responsibilities and the Civil Defence Act 1983 sets out the obligations of
                         health sector agencies in relation to civil defence. Section 70 of the Health
                         Act 1956 describes the special powers of the Medical Officer of Health in
                         relation to infectious and notifiable diseases when a national or regional
                         disaster has been declared under the Civil Defence Act, or in the event of
                         special authorities.

  Objectives             To be well prepared for any civil defence emergency or other emergency
                         where there is a risk to public health, including counter-terrorism.
                         To act, in association with other agencies, to protect the public health in
                         the event of such an emergency
                                 Ambulance Services, Defence Forces, Order of St John, Red Cross
  Key Linkages
                                 Civil Defence Organisation
                                 Hazardous Substances Technical Liaison Committee
                                 Territorial authorities and regional councils

                                 Civil Defence Emergency Management Act 2002
  Relevant
  Legislation                    National Civil Defence Plan
                                 Hazardous Substances and New Organisms Act 1991
                                 Health Act 1956
                                 Local Government Act 2002
                                 New Zealand Public Health and Disability Act 2000



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  Components of          Service Descriptions/Activities
  Service

  Public health          All emergency management planning and programmes will be carried out
                         in collaboration with other relevant agencies.
  regulatory services


  Act in emergency       Take appropriate emergency actions, as the need arises. This includes
                         liaison with and taking directions from other agencies involved.
  situations


  Maintain civil         1. Participate in the development, review and revision of regional and
                            local civil defence contingency planning and ensure they adequately
  defence and public
                            address planning for the provision of:
  health emergency
  planning and               basic sanitary services including basic safe water supplies to
  response capacity           communities
                             basic safe shelter
                             safe food to communities
                             basic facilities for the maintenance of personal hygiene
                             removal and hygienic disposal of the dead
                             removal and disposal of hazardous substances
                             prevention and control of communicable disease outbreak
                         2. Communication with the Ministry of Health.
                         3. Identify resources needed to support and carry out public health action
                            and maintain an inventory of current resources, including vehicles,
                            communication systems, protective clothing, identification cards and
                            equipment.
                         4. Maintain, test and regularly review contingency plans for responding
                            effectively to a range of public health emergencies, such as natural
                            disasters, chemical spills, emergent diseases, communicable disease
                            outbreaks, food-borne illnesses or food contamination incidents.

  Assess risk of            Identify predominant natural and human activity hazards (including
                             deliberate contamination) in the region that are likely to give rise to
  emergency
                             emergency situations affecting public health.
                            2. Carry out risk assessment of these events and check that
                             emergency planning and response capacity is sufficient to deal with
                             those risks. The plan will include preparedness, mitigation, response
                             and recovery.

  Interagency               Participate in national, regional and local meetings, exercises and
                             training opportunities.
  collaboration
                            Provide services for, be directed by, and report to civil defence
                             authorities in the event of an emergency.
                            3. Seek to develop a Memorandum of Understanding (or equivalent)
                             with Regional Councils which describes roles and responsibilities in
                             this area.

  Promote public         Ensure appropriate educational and promotional material is provided to
                         institutions, health professionals, territorial authorities and community
  health knowledge
                         groups on the public health aspects of planning for, and responding to,
  of emergency           emergency situations.
  planning and


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  response


  Information and        All reporting dates apply annually.
  Reporting              Immediately, or within 24 hours of occurrence of a public health event or
  Requirements           emergency with inter-district, national or potentially international
                         implications, submit a report to the Environmental and Border Health
                         Protection Team and a copy to your Public Health Operations portfolio
                         manager.

5.2.10 Recreational Waters

  Health Goal            To reduce the incidence and impact of environmental hazards associated
                         with recreational waters. Note: Recreational water includes swimming, spa
                         and thermal pools, and natural water for water contact activity.

  Rationale and Key      Hazards posed by recreational water include unsatisfactory water quality
                         and associated disease risks.
  Issues


  Objectives             To protect the public health by preventing the risk of disease associated
                         with the public use of recreational waters.
                         To protect the public health by minimising the risk associated with the use
                         of recreational waters.

  Key Linkages           Ministry for the Environment
                         Ministry of Fisheries
                         New Zealand Food Safety Authority
                         Territorial authorities and regional councils

  Relevant                  Fencing of Swimming Pools Act 1987
  Legislation               Health Act 1956
                            Territorial Authority Bylaws

                            Local Government Act 2002
                            Resource Management Act 1991
                            New Zealand Public Health and Disability Act 2000
                            NZS 5826: 2000 Pool Water Quality
                            Ministry of Health/Ministry for the Environment Microbiological Water
                             Quality Guidelines for Marine and Freshwater Recreational Areas.

  Components of          Service Descriptions/Activities
  Service

  Public health          All border health protection programmes will be carried out in collaboration
                         with other relevant agencies.
  regulatory services


  Work                   1. Make timely and professional submissions on national and regional
                            plans and policies, district plans and policies and, where appropriate,
  collaboratively with
                            resource consent applications to ensure that the public health effects of
  Regional Councils         adverse recreational water quality are considered and managed.
  and Territorial

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  Authorities
                         2. Encourage Regional Councils to clearly identify existing or potential
                            recreational waters, which do not meet minimum microbiological water
                            quality guidelines in the Ministry of Health/Ministry for the Environment
                            Microbiological Water Quality Guidelines for Marine and Freshwater
                            Recreational Areas.
                         3. Encourage the grading of bathing beaches as outlined in the
                            Microbiological Water Quality Guidelines for Marine and Fresh Water
                            Recreational Areas.
                         4. Provide advice to territorial authorities on the need for warning signs to
                            be placed around areas of high public health risk.
                         5. Advise Regional Councils to ensure that waters classified as CR
                            (suitable for contact recreational purposes) meet at least the minimum
                            requirements for the protection of health.
                         6. Seek to develop a Memorandum of Understanding (or equivalent) with
                            Regional Councils, which describes roles and responsibilities in this
                            area.

  Increase and           1. Encourage territorial authorities to monitor compliance with the Fencing
                            of Swimming Pools Act 1987.
  maintain
  compliance with        See also the tier two Injury Prevention Services service specification.
  legal obligations


  Promote public         1. Participate in school safety education initiatives for recreational water.
  health knowledge       2. Encourage territorial authorities and pool managers (including school
                            pools) to implement the requirements of NZS5826: 2000 Pool Water to
                            avoid or reduce public health risks.
                         3. Promote good supervision of preschool children in the vicinity of pools
                            and other recreational waters including promoting guidelines for
                            parents of infants/toddlers (using ‘Before You Take to the Water’ health
                            education resource).

  Information and        All reporting dates apply annually.
  Reporting
  Requirements


5.2.11 Resource Management

  Health Goal            To reduce the incidence and impact of environmental inequalities across
                         sectors by ensuring public health issues are identified and addressed in
                         decisions made on the sustainable management of natural and physical
                         resources and social environments.

  Rationale and Key      Land, air and water are the basic elements of the environment necessary
                         to support human life. These elements must be sustainably managed in a
  Issues
                         way or at a rate that enables people and communities to provide for their
                         social, economical and cultural well-being and for their health and safety.

  Objectives             To ensure that resource management decisions do not impact negatively
                         on the public health
                         To develop strong networks with agencies involved in sustainable resource
                         management.




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  Key Linkages               Ministry for the Environment
                             Other service providers
                             Regional Councils
                             Territorial authorities.

  Relevant                   Building Act 2004
  Legislation                Health Act 1956
                             Resource Management Act 1991
                             Local Government Act 2002
                             New Zealand Public Health and Disability Act 2000.

  Components of           Service Descriptions/Activities
  Service

  Provide advice and      1. Make timely and professional submissions on local government
                             assessments of sanitary works, national policy, standards or guidelines,
  input into activities
                             regional plans and policy statements, and district plans, where
  of linkage agencies        appropriate, and resource consent applications to ensure that the
                             public health aspects are considered.
                          2. 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.
                          3. Provide technical advice and information to regional and local
                             government.
                          4. Review and advise on territorial authority annual plans.
                          5. Seek to develop a Memorandum of Understanding (or equivalent) with
                             Regional Councils that describes roles and responsibilities in this area.
                          6. Comment as appropriate on territorial authority plans for sanitary works
                             infrastructure planning.

  Health promotion        Inform other agencies and the public on the public health aspects of
                          matters relating to sustainable resource management.
  activities


  Information and         All reporting dates apply annually.
  Reporting
  Requirements


5.2.12 Sewage Treatment and Disposal

  Health Goal             To reduce the incidence and impact of environmental hazards from liquid
                          and solid waste management.

  Rationale and Key       Sewage contains a large number of potential pathogens. Unsatisfactorily
                          managed sewage collection, treatment and disposal can pose a significant
  Issues
                          threat to public health.

  Objectives              To reduce or prevent any potential health risks from sewage treatment or
                          disposal.

  Key Linkages            Department of Building and Housing
                         Department of Conservation
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                          Ministry for the Environment
                          Public Health Engineering Consultants
                          Territorial authorities and regional councils
                              Building Act 2004
  Relevant
  Legislation                 Building Regulations 1992 (under review)
                              Health Act 1956
                              Local Acts of Parliament
                              Local Government Act 2002
                              Marine Pollution Act 1972
                              New Zealand Public Health and Disability Act 2000
                              Resource Management Act 1991

  Components of           Service Descriptions/Activities
  Service

  Public health           All sewage treatment and disposal programmes will be carried out in
                          collaboration with other relevant agencies.
  regulatory services


  Maintain                1.   Make timely and professional submissions on national and regional
                               plans and policies, district plans and policies, local government
  monitoring        and
                               assessments of sanitary works and, where appropriate, resource
  surveillance                 consent applications to ensure that the public health effects of
  systems                      sewage treatment and disposal are considered and managed.
                          2.   Conduct routine surveillance and evaluation of the performance of
                               controlling authority management of public health aspects of the
                               service area with reference to statute, guidelines, standards, resource
                               consent conditions and accepted public health practice, in respect of
                               sewage collection and disposal and the microbiological quality of the
                               receiving water.
                          3.   Investigate and assess the public health need for sewerage systems
                               in areas not adequately serviced.
                          4.   Undertake sanitary surveys as required.
                          5.   Report and make recommendations using Ministry of Health criteria,
                               including prioritising in their region, applications for sanitary works
                               subsidies.
                          6.   Comment as appropriate on territorial authority plans for sanitary
                               works infrastructure planning.

  Promote    public       1.   Promote knowledge of local public sewerage systems and sewage
                               disposal, and advocate for improvement where this is considered
  health knowledge
                               necessary.
  and advocate for
  public     health       2.   Seek to develop a Memorandum of Understanding (or equivalent)
  action                       with Regional Councils that describes roles and responsibilities in this
                               area.

  Information and         All reporting dates apply annually.
  Reporting
  Requirements




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5.2.13 Sewage Waste Management

  Health Goal            To reduce the incidence and impact of environmental hazards from
                         gaseous, liquid and solid waste management.

  Rationale and Key      Liquid and solid wastes may contain hazardous materials and can provide
                         a medium to support pathogens and disease vectors. Unsatisfactory
  Issues
                         operated liquid and solid waste collection, treatment and disposal systems
                         can pose a threat to the public health.

  Objectives             To reduce or eliminate any potential harmful effects of waste management
                         on the public health.
                         To ensure public health issues are identified and addressed in decisions
                         made on the sustainable management of natural physical resources.

  Key Linkages           Department of Conservation
                         Environmental Risk Management Authority (ERMANZ)
                         Ministry for the Environment
                         Territorial authorities and regional councils
                            Hazardous Substances and New Organisms Act 1996
  Relevant
  Legislation               Health Act 1956
                            Litter Act 1979
                            Local Government Act 2002
                            Marine Pollution Act 1972
                            New Zealand Public Health and Disability Act 2000
                            Resource Management Act 1991

  Components of          Service Descriptions/Activities
  Service

  Public health         All waste management programmes will be carried out in collaboration with
                        other relevant agencies.
  regulatory services


  Maintain               1. Make timely and professional submissions on national and regional
                            plans and policies, district plans and policies, and local government
  monitoring and
                            assessments of sanitary works and, where appropriate, resource
  surveillance              consent applications to ensure that the public health effects of waste
  systems                   management are considered and managed.
                         2. Provide a system for routine and regular surveillance and monitoring of
                            significant public health risks in waste management.
                         3. Undertake waste surveys with other agencies as appropriate.
                         4. Seek to develop a Memorandum of Understanding (or equivalent) with
                            Regional Councils and Territorial Authorities that describes roles and
                            responsibilities in this area.

  Information and        All reporting dates apply annually.
  Reporting
  Requirements




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5.2.14 Other Regulatory Activities

  Health Goal            To reduce the incidence and impact of environmental hazards by developing
                         strategies to prevent or control the adverse impacts of environmental health
                         issues.
                         To reduce the incidence and impact of environmental inequalities across sectors.
                         To reduce the incidence and impact of settings-based environmental health
                         issues.

  Rationale and Key      There are many regulatory and health protection activities that are too infrequent,
                         small, or localised to a particular area and, therefore, do not require a separate
  Issues
                         service specification in their own right to protect the public health. The
                         specification groups these activities together so they are covered and can be
                         included in health protection activities.

  Objectives             To allow for all aspects of regulatory and health protection work to be included in
                         service provision.

  Key Linkages           Territorial authorities and regional councils.


                                Health Act 1956
  Relevant
  Legislation                   New Zealand Public Health and Disability Act 2000
                                Resource Management Act 1991.

  Components of          Service Descriptions/Activities
  Service

  Public health              All border health protection programmes will be carried out in collaboration with
                             other relevant agencies.
  regulatory services


  To maintain            1. To perform activities and services at a local level where these are considered
                            necessary and are not included elsewhere in the Physical Environment
  comprehensive
                            specifications.
  health protection
  and regulatory         2. Make timely and professional submissions on national and regional plans and
  services                  policies, district plans and policies and, where appropriate, resource consent
                            applications to ensure that the public health effects of activities are considered
                            and managed.

  Information and        1. All reporting dates apply annually.
  Reporting              2. As soon as practicable and not later than 14 days after the occurrence of any
  Requirements              emergent issue, unusual event or public health investigation which has
                            potential inter-district, national or international implications, submit a report to
                            the Environmental & Border Health Protection Team and a copy to your Public
                            Health Operations portfolio manager.
                         3. Reports Verifying Ongoing Competence of Statutory Officers
                                 By 31 July each year, each public health manager will provide a written report
                                 to the Environmental & Border Health Protection Team which identifies all
                                 statutory officers in the public health unit and provides the following information
                                 for each officer:
                                 Full name
                                 Position (title)
                                 Statutory appointments
                                 Training attended during the year

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                             Verification that attendance at training relevant for each statutory
                              appointment has been undertaken within the previous 5 years
                             Verification that the personal and practical skills and competencies have
                              been retained
                             Verification that the manager is confident that the officer is competent to
                              exercise the statutory powers, including in emergencies.
                         Note: for medical officers of health, evidence of competence will be provided by
                         their ongoing registration as public health medicine practitioners and their
                         attendance at four out of six medical officer of health training sessions over a two
                         year period.
                         4.      Enforcement
                         Public health units shall furnish quarterly compliance and enforcement returns to
                         the Ministry (in a format to be specified by the Ministry) to enable the Ministry to
                         monitor the level, nature and range of enforcement activity being undertaken.
                         Social Environments - Early Childhood Centres

  Health Goal            To reduce the incidence and impact of settings-based environmental health issues
                         across early childhood education settings.

  Ministry of Health     The Ministry of Health expects that the service specification will be delivered
                         through the mandate that staff have, in undertaking visits: that the potential
  Expectations
                         licensee has requested a pre-licensing health report and/or the public health unit
                         been invited to undertake visits by the licensee or Ministry of Education officials to
                         address a health concern they may have.
                         The undertaking of visits and provision of environmental health advice to early
                         childhood centres should be part of the more general role in improving, promoting
                         and protecting public health through the early childhood setting. However it needs
                         to be recognised that these do not have a statutory mandate under the Education
                         (Early Childhood Services) Regulations 2008 and that staff are providing advice
                         and seeking cooperation, not exercising statutory powers. Should a centre refuse
                         entry to an officer to undertake these environmental health visits, there is no
                         power of entry or inspection. However, in this instance, it would be appropriate to
                         discuss the centre’s response with the Ministry of Education.

  Rationale and Key      Early childhood centres play an important role in the education, health and life of
                         preschool children and provide excellent avenues for health promotion. Early
  Issues
                         childhood centres may present a large number of potential risks to children’s
                         health and safety, particularly disease transmission. These risks also have
                         implications for the health and well-being of the wider community, particularly
                         friends, teachers, parents, caregivers and other family members of the children
                         attending the centres. The identification, assessment and management of health
                         and safety risks in the centres is a priority.
                         The Secretary of Education relies on advice from designated officers as to the
                         adequacy and suitability of the health and safety provisions for children attending
                         early childhood centres, particularly in the granting of licences by the Ministry of
                         Education. Prior to using licences for new early childhood education and care
                         centres (ie centre-based services), all prospective service providers are required
                         to obtain health report from the local public health service unit. This is in
                         accordance with Regulation 9(2) in the Education (Early Childhood Services)
                         Regulations 2008. Note that this requirement only applies to new centred-based
                         services only. It does not apply to new or existing home-based or hospital-based
                         services, or existing centred-based services. Section 310(2)(i) of the Education
                         Act 1989 makes this clear in relation to home-based and hospital-based services.
                         In relation to existing centre-based, home-based and hospital-based services,
                         however, health reports are discretionary.



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  Objectives             To promote the health and well being of children attending early childhood centres
                         through population-based initiatives.
                         To work intersectorally to promote the health and well-being of children attending
                         early childhood centres.

  Key Linkages           Early Childhood Centre Group, National Office, Ministry of Education, , Ministry of
                         Education Regional Offices
                         Occupational Safety and Health Division (OSH), Department of Labour
                         Department of Building and Housing
                         National and regional Early Childhood Centres Associations
                         Other service providers
                         Territorial authorities.

  Relevant                  Building Act 2004
  Legislation               Building Regulations 1992 (under review)
                            Education Act 1989
                            Education Amendment Act 2006
                            Education (Early Childhood Services) Regulations 2008
                            Education (Home-based Centre) Order 1992 (valid until 2014)
                            Fencing of Swimming Pools Act 1987
                            Food Act 1981
                            Food Regulations 1984
                            Hazardous Substances and New Organisms Act 1996
                            Health Act 1956
                            Health (Infectious and Notifiable Diseases) Regulations 1966
                            Health (Immunisation) Regulations 1995
                            Food Hygiene Regulations 1974
                            Health and Safety in Employment Act 1992
                            New Zealand Public Health and Disability Act 2000
                            Smokefree Environments Act 1990
  Components of          Service Descriptions/Activities
  Service

  Public health          All early childhood setting programmes will be carried out in collaboration with
                         other relevant agencies.
  regulatory services


  Increase and           1. Carry out inspections of early childhood centres, in response to requests.
  maintain               2. Carry out statutory obligations for licensing of early childhood centres including
  compliance with           assessing health and safety risks to ensure compliance with relevant
  statutory public          legislation, standards and guidelines.
  health                 3. Conduct routine surveillance including compliance by the licensee of the
  requirements              premises with regulatory responsibilities, including Education (Early Childhood
                            Centres) Regulations 1998.

  Advice and             1. Advise early childhood centres on population-based health strategies to
                            improve, promote and protect the health of the children attending.
  information for

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    early childhood
                         2. Advise on health promotion strategies that will improve the health and well-
    centres                 being of children and their family/whānau.
                         3. Advise early childhood centre staff and parents on health and safety risks to
                            protect the health of children attending.
                         4. Advise on health and safety requirements for new and proposed centres prior
                            to licensing.
                         5. Undertake education initiatives where appropriate to improve and protect the
                            health of children attending centres.

    Communication        1. Establish and maintain working relationships with the Ministry of Education, the
                            Occupational Safety and Health Division of the Department of Labour, and the
    and liaison
                            licensee to promote good public health practices and standards in early
                            childhood centres.
                         2. Maintain working relationships that respect the cultures, organisational
                            requirements and philosophies of the various early childhood centre
                            organisations.
                         3. Make submissions and provide input and feedback where appropriate to
                            relevant documents and legislative changes.

    Information and      All reporting dates apply annually.
    Reporting
    Requirements


                         Social Environments -Healthy Urban Design/Form

    Rationale and Key    New Zealand is a relatively urbanised country with more than 85% of its
                         population living in urban/suburban environments. A range of health problems are
    Issues
                         emerging that are associated with modern urban life. Increased reliance on cars
                         for example, can lead to physical inactivity and increasing levels of obesity.
                         Reliance on private vehicles, congestion and greater travelling distances also
                         cause air pollution. A lack of access to affordable transport can restrict access to
                         basic goods and services.
                         The Healthy Cities/Communities (HCC) project is a World Health Organisation
                         programme that was first started in New Zealand in 1988. There are currently
                         nine HCC in operation. The project strives to improve environmental health and
                         better living conditions in urban areas. Healthy Cities are a recognition that a
                         person’s health is affected by their environment e.g. urban design/form as well as
                         the quality of health care.       Local authorities have a key role with the
                         implementation of HCC and there are significant opportunities for HCC
                         programmes to involve Maori.
                         Many local authorities in New Zealand are doing work to improve urban planning
                         and design. This includes work to design areas that are well serviced by public
                         transport, are user-friendly for walking and cycling, and have ready access to
                         services and facilities (including hospitals, schools, leisure facilities and
                         supermarkets). It can also include projects to ensure or encourage new building
                         developments to consider things like parking, noise and amenity, access to
                         outdoor space, insulation and sustainable building principles and features. Safe
                         Community accreditation also involves extensive urban planning.
                         The Urban Design Protocol (2005) administered by the Ministry for the
                         Environment is a voluntary commitment by central and local government and other
                         stakeholders, including property developers and investors, to undertake specific
                         urban design initiatives. The protocol therefore affects formal district plans made
                         under the RMA. The New Zealand Urban Design Protocol has a vision of making
                         New Zealand towns and cities more successful through quality urban design.1 It

1
 http://www.mfe.govt.nz/publications/urban/design-protocol-mar05/html/index.html
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                          has a wide range of signatories, including central and local government,
                          businesses, sector groups and others. Related to the Protocol are programmes
                          involving Crime Prevention Through Environmental Design (CPTED) (see section
                          on ‘crime prevention’ below) and more recently the Te Aranga Māori Cultural
                          Landscapes Strategy.
                          Initiatives such as Healthy Cities are based on principles identified in the Ottawa
                          Character for Health Promotion (1996). Access to adequate housing is one of the
                          important factors for public health acknowledged in the Ottawa Charter. There is
                          strong evidence that improving urban planning and design including sustainable
                          building principles is an effective way of reducing inequalities in health and
                          improving well being.
                          The potential impact of urban form on public health relates to sense of community
                          and mental health. WHO estimate that by 2020, mental ill health will be the third
                          leading cause of disability life-adjusted years globally.
                          There is strong evidence that the built environment affects the transport-mode
                          choices of both adults and children. A growing body of evidence confirms that
                          neighbourhoods characterized by low density, poorly connected street networks
                          and poor access to shops and services are associated with low levels of walking.
                          Urban sprawl or low walkability appears to be associated with obesity.
                          Traffic exposure decreases walking in children because of parental concerns
                          about safety.
                          Reduced local walking, affects opportunities for causal interactions between
                          neighbourhoods.

     Objectives           To work collaboratively with the local government sector as they develop urban
                          planning related policy, rules etc initiatives which relate to urban design/form.
                          Where appropriate advocate the use of health impact assessment for proposals
                          that include urban design/form.

     Key Linkages         Ministry for the Environment
                          Department of Internal Affairs
                          Department of Building and Housing
                          Ministry of Health’s Health Impact Assessment Support Unit

     Relevant                Building Act 2004
     Legislation             Resource Management Act 1991
                             Local Government Act 2002
     Components of        Service Descriptions/Activities
     Service
     Work co-             Encourage and assist Council to develop and implement polices through
     operatively with     processes such as the review of district plans including variations or plan changes
     local government     or Long Term Council Community Plans that address the wider determinants of
     in the development   health.
     of urban             Consider becoming a signatory to the NZ Urban Design Protocol (2005)
     design/form          Where appropriate advocate the use of health impact assessment for proposals
     policies that        that include urban design/form.
     promote health and   Where appropriate promote the Healthy Cities/communities concept
     wellbeing of
     communities
     Purchase Units,      Purchase units are as for the tier two Public Health Services service specifications
     Information and      for Social Environment.
     Reporting            All reporting dates apply annually.
     Requirements

7.      Exclusions
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This service specification excludes services described in the tier two Social Environments -
Health Promoting Schools service specification that covers policy-level health impact
assessment activities; see Social Environments Health promoting Schools tier two service
specification.
This Physical Environment Public Health service specification relates more directly to
project-level health impact assessment methods and approaches used in resource
management processes.
8.     Quality Requirements

The Service must comply with the Provider Quality Standards described in the Operational
Policy Framework or, as applicable, Crown Funding Agreement Variations, contracts or
service level agreements.
Providers of environmental health services should comply with all relevant manuals, standards
and guidelines promulgated by the Ministry – this includes in particular the Environmental
Health Protection Manual and any other guidance material cited in the relevant tier two (and
tier three) service specifications.
9.     Purchase Units and Reporting Requirements

Purchase Units are defined in the joint DHB and Ministry’s Nationwide Service Framework
Data Dictionary. The following Purchase Unit applies to this Service.

PU Code    PU              PU Definition                   PU Unit of    Unit of Measure     National
           Description                                     Measure       Definition          Collections or
                                                                                             payment
                                                                                             systems


RM00108    Physical        Air quality (indoor and         Service       Service             National Non-
           Environment     outdoor)                                      purchased in a      admitted
                           Biosecurity and quarantine                    block               Patient
                           Burial and cremation                          arrangement         Collection
                           Contaminated land                             uniquely agreed     NNPAC
                           Drinking water quality                        at a local level.   (Optional)
                           Early childhood centres
                           Environmental noise
                           management
                           Hazardous substances
                           Ionising/non-ionising
                           radiation
                           Public Health emergency
                           planning and response
                           Recreational water
                           Resource management
                           Sewage treatment and
                           disposal
                           Shellfish and shellfish water
                           Waste management (liquid
                           and solid waste)
                           Other regulatory activities.
The Service must comply with the requirements of national data collections (if applicable).

9.1    Additional Reporting Requirements

All reporting requirements are detailed in the individual contracts.

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                                Figure 1: Outcomes-focused Framework for the Environmental Health and Social Environments



                               Public health and whanau health are improved through the protection and promotion of healthy communities and healthy
   Societal                                                        environments including the global environment

    Level




                                                                                                                                                                         Environment
                                                                                                                                                                         Reporting of
  Outcomes




                                                                                                                                                                         Monitoring,
                                                                                                                                                                                                                                               Measuring,
                                                                                                                                                                          Indicators
                                                                                                                                                                           al Health
  Vital Few                    Reduction in the incidence and impact           Reduction in the incidence and impact           Reduction in the incidence and impact




                                                                                                                                                                              and
  Outcomes                          of environmental hazards                     of environmental inequalities across          of settings-based environmental health
                                                                                              sectors                                          issues
10 to 20 years

                                            Climate change
 Examples of                                                                  Housing: quality, affordability, accessibility        Pacific and global communities




                                                                                                                                                                                                                       Measuring, Monitoring, and Reporting of
                                                                                                                                                                                     Environmental Health Indicators
Medium Term                                                                                      Energy                            Education incl schools and ECCs
                                  Water incl drinking and recreational
 Outcomes
                                   Sanitation, Sewage, Waste mgmt                    Urban Planning and Design                          Exposed populations
 5 to 10 years
                                                                                                                                         Industry/Workplaces
                                    Indoor and Outdoor Air Quality                Social developments incl migration             Border health protection (incl trade)

                               Natural disasters and emergency management       Sustainable development incl tourism                    Industry/Workplaces


                               Hazardous substances incl contaminated sites               Local Government


                                 Mass gatherings incl World Cup 2011
                                                                                                                                               EH Programmes

                                                                                                                                                 and Projects




                                                                                                                                                                             Monitoring and
                                                                                                                                                                              Reporting to

                                                                                                                                                                              Measuring,
                                                                                                                                                                                Service
                                                                                                                                                                                Funder
 Short Term
Outcomes and                               EH Programmes                                    EH Programmes
   Outputs
                                             and Projects                                     and Projects
  1 to 3 years
   Supporting Legislation and Policy (eg Health Act 1956, Resource Management Act 1991, Local Government Act 2002, Achieving Health for All People, Public Health Legislation Review,
standards including global standards), Intersectoral Service Planning and Delivery, Leadership incl advocacy and champions, Research and Information, Effective Action (including guidelines,
         best practice, advice and information), Monitoring and Evaluation, New Technologies, Health Impact Assessment (including precautionary approaches, risk perception and risk
                                                                                       communication)
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