Pillars of Governmental Environmental Public Health | A Guide to Scalable Environmental Public Health Programs
Staffing
tural activities, testing samples for coliforms might not be a good indicator as it could be difficult to determine the source of contamination—human or livestock. In these cases, programs can use presence/absence testing for coli- forms or markers from detergents (e.g., optical brighten- ers) to determine areas of interest and then investigate the source of contamination with further bacteriology. Plan review was noted as an important EPH function for most jurisdictions. A metric of program function could be the length of time to perform permit review from submis- sion to determination. Additionally, the number of initial permit reviews performed or completed within a certain number of days could provide insight into program effec- tiveness. A reflection of how well plan review and con - struction permitting activities are functioning could be seen in the number of failing septic systems, which are typically reported by the public to the EPH department. Assuming that complaint calls have a high sensitivity rate due to unmistakable sewage odor, this metric could also be measured by how many complaint calls are received about failing systems. In areas where pumping and main- tenance of septic systems are required by EPH depart- ments, a measure of EPH education to the public could be the percentage of homeowners who are fulfilling the requirement of pumping and maintenance. Septic systems might not be appropriate to install in pop- ulation-dense areas, as they can contaminate groundwa- ter. Therefore, a metric based on population would need to consider codes that require connection to community sewage systems within a certain distance of a service line. Although customer service was identified as a potential characteristic of success, measuring this quality using methods like customer satisfaction surveys can be chal- lenging. Often, customers are satisfied or dissatisfied with the installation process or quality, which is per- formed by third-party private companies not associated with the EPH department. Even if the initial installation was efficient from the EPH department perspective, cus - tomers might not know who to contact for installation failures. Therefore, outcome measures for customer ser- vice might not prove helpful. Given that environmental public health departments generally take complaints of various kinds, customers could be more likely to complain to the department even though the issue is reflective of the department’s part in the process. Therefore, the met- ric of complaints per year is recommended for the pur- pose of ensuring the department has methods to receive complaints related to onsite wastewater issues from the public and can assess possible well water contamination to advise on next steps.
Onsite wastewater programs typically involve permitting, inspection, and complaint follow-up activities, with third- party contractors often responsible for soil evaluation and system installation. Research participants suggested cal- culating staffing rates by the number of systems inspected per person per day, excluding complaints and follow-up monitoring activities. A reasonable inspection rate was noted as two septic sys- tem inspections per person per field day, with each sys - tem requiring 2–4 hours of work. Staffing needs increase significantly if EPH professionals are responsible for soil evaluation and design proposal rather than just field ver - ification. Programs requiring comprehensive technical evaluation should adjust staffing ratios accordingly. If EPH professionals are responsible for permitting and evaluating soil and proposing a design rather than just field checking, then that should be considered when determining staffing rates. As population density grows, staffing rates should consider the number and size of new and proposed subdi- visions in the jurisdiction. Staffing benchmarks vary based on program scope and local conditions. One approach allocates 1 FTE for 120 new and repair systems annually, while another sug- gests a maximum of 350 systems per FTE per year. Pop- ulation-based calculations might use 10,000 population served per FTE, though this number can be adjusted based on population density and development patterns. These metrics could have limited applicability in urban areas with centralized sewer systems or rural areas where septic sys- tems predominate, requiring jurisdictions to adapt bench- marks to their specific infrastructure mix. Regular assessment of whether onsite wastewater duties can be completed with available FTEs is import-
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