AGENDA PACKET NO. | A |
Members | Thursday, October 24, 2024 |
Kristopher Dahir, Chair | 1:00 p.m. |
Devon Reese, Vice Chair | |
Mariluz Garcia | |
Dr. Reka Danko | Washoe County Administration Complex |
Michael D. Brown | Commission Chambers, Building A |
John Klacking, PhD | 1001 East Ninth Street |
Steve Driscoll | Reno, NV |
Chair, Kristopher Dahir called the meeting to order at 1:03 p.m. The following members and staff were present:
Members present: Kristopher Dahir
Devon Reese Michael D. Brown
Mariluz Garcia (via Zoom)
Dr. Reka Danko (via Zoom at 1:17 p.m.) Steve Driscoll
Members Absent: John Klacking
Staff present: Dr. Chad Kingsley, District Health Officer
Francisco Vega Erin Dixon
Jim English Lisa Lottritz Dr. Nancy Diao Andrea Esp
Mr. Steve Driscoll led the pledge to the flag.
October 24, 2024
1001 E. Ninth Street, Building B, Reno, NV 89512
Telephone: 775.328.2415 – Fax: 775.328.3752
Introduction
Chair Dahir welcomed Steve Driscoll, as the non-elected appointee for the City of Sparks. He shared that Mr. Driscoll brings a lot of knowledge to the Board, having served positions for the City of Sparks for many years.
Mr. Driscoll noted that he has had some experience with this Board and is looking forward to working on some of the issues and serving the County of Washoe. Mr. Driscoll will serve a 2-year term ending December 31, 2026.
Years of Service
Danika Williams, Epidemiologist, 5 years, hired 10/14/19 – EPHP
Jessie Latchaw, Environmental Health Specialist, 5 years, hired 10/28/19 – EHS
Francisco Vega, AQM Division Director, 5 years, hired 10/28/19 - AQM
Dr. Kingsley recognized the years of service for Danika Williams, Jessie Latchaw and Francisco Vega.
New Hires
Milagros Carreno Olivera (Millie), Senior Office Specialist, hired 10/21/24 - EHS
Mr. Jim English introduced and welcomed Ms. Olivera.
Resignations
Sara Smith, Emergency Medical Services Coordinator – effective 10/11/24 - EPHP
Dr. Kingsley announced the resignations of Sara Smith.
Health Heroes
i. Maria Magana – CCHS ii. Yeraldin Deavila – ODHO
Irene Dominguez - AHS iv. Liliana Wilbert – EPHP
v. Jordyn Marchi – EPHP vi. Jim English - EHS
Dr. Kingsley thanked the Health Heroes being honored this month for their work.
Staff Representative: Andrea Esp
Mr. Brown announced the proclamation for Crash Responder Safety Week
Andrea Esp accepted the proclamation to present to the Traffic Incident Management Coalition, which several audience members are part of.
Katherine Yriarte, introduced herself as the owner and operator with her husband Dan, of Team Yriarte Horsemanship. They are a state licensed business and have been in operation in Rancho Haven since 2016. Their Special Use Permit was approved unanimously by the Board of Adjustments in December 2023, and their Washoe County Business License Application has been in progress since. The SUP invokes commercial codes for permanent bathroom facilities and septic systems to be installed on private property. She opined that it is outrageous for a small home-based business with limited traffic and little public usage. They do not meet the threshold to qualify as a public water system, but are still required to install a permanent restroom with commercial septic on private property in order to comply with codes. They currently provide an ADA accessible restroom that is serviced weekly. They are currently designated and taxed as a home-based business, but cannot obtain a business license, which is a testament to the flaws that need to be addressed. She would welcome the opportunity to meet to discuss alternative solutions to allow small equine based businesses to operate and allow them to continue to provide educational services in a safe and natural environment to the equine community.
Vice Chair Reese asked Ms.Yriarte to meet with his staff present at this meeting to schedule a time to meet.
Matters which the District Board of Health may consider in one motion. Any exceptions to the Consent Agenda must be stated prior to approval.
Approval of Draft Minutes. September 26, 2024
Approve the Notice of Subaward from the State of Nevada Department of Health and Human Services, Division of Public Health and Behavioral Health for the period retroactive to August 1, 2024 through May 31, 2025 in the total amount of $313,988 (no match required) in support of the Northern Nevada Public Health HIV Prevention Program and authorize the District Health Officer to execute the Subaward and any future amendments. (FOR POSSIBLE ACTION)
Staff Representative: Lisa Lottritz & Anne Stoll-Truelock
Approve the Professional Services Agreement with Make the Road Nevada in the amount of $100,000 from December 1, 2024, through December 31, 2025 to support Northern Nevada Public Health (NNPH) in carrying out its goal to enhance street food vendor operations and promote public health in our community; and authorize the District Health Officer to execute the agreement and any future amendments. (FOR POSSIBLE ACTION)
Staff Representative: Robert Fyda
Approve a Grant Award and Agreement from the Nevada Clinical Services, Inc. retroactive to July 1, 2024 through June 30, 2025 in the total amount of $188,800.00 (no required match) in support of the Community and Clinical Health Services Division (CCHS) Tobacco Prevention Control Program and authorize the District Health Officer to execute the Grant Award and any future amendments. (FOR POSSIBLE ACTION) Staff Representative: Irene Dominguez & Lisa Lottritz
Acknowledge receipt of the Health Fund Financial Review for September, Fiscal Year 2025. (FOR POSSIBLE ACTION)
Staff Representative: Jack Zenteno
Staff Representative: Francisco Vega
Recommendation for the Board to uphold an uncontested citation issued to Lennar Reno, LLC, Case No. 1521, Notice of Violation No. AQMV24-00023 with a $500.00 penalty for failing to control fugitive dust from construction activities. (FOR POSSIBLE ACTION)
Recommendation for the Board to uphold an uncontested citation issued to Toll North Reno, LLC, Case No. 1523, Notice of Violation No. AQMV24-00024 with a $500.00 penalty for failing to control fugitive dust from construction activities. (FOR POSSIBLE ACTION)
Staff Representative: Kristen Palmer/Craig Petersen
Presented by: Cody Shadle, City of Reno Director of Public Safety Dispatch
Cody Shadle shared the background for this project as having begun in 2019, with the need to replace the current Computer Aided Dispatch and Law Enforcement Records Systems. An external consultant was brought in, and decisions were confirmed in 2023. During that time, a regionalization project began, to identify emergency medical service, fire service and dispatch service opportunities for improvement. Recommendations were made to expand and include other entities not involved at the beginning of the project, for a final number of 17 user agencies represented.
Three public boards: Manager’s Board providing oversight, an Executive Board to provide operational guidelines and a Change Advisory Board for new integrations were created for transparency and a voice across the agencies.
The system unanimously selected was Hexagon, with implementation beginning in January 2024. Hardware and software have been installed, the initial system build has begun and is still in progress. The third-party integrations have also begun.
Being a regional product allows better business practice changes, improved workflow, establishment of integrated responses, and automation, with one call.
Public and responder safety across the system with real time information, available to all dispatchers and responders at the same time.
This phase is expected to be in process until January 2025, then the shift will move to testing, with substantial testing conducted for about 3 months, then training will begin and take about 2 months. The go-live date is still scheduled for September 9, 2025. The project is on schedule and on budget.
Chair Dahir shared that this is crucially important and should reduce the duplication of necessary information.
Presented by: Barry Duplantis
Barry Duplantis shared that, for September and the fiscal year to date, REMSA Health has exceeded Franchise compliance responses for all priority 1 calls in all zones, with 91% in zone A, 95% in B, C and D. During September, there were 8,192 priority 1 calls, with 5,180 transports to area hospitals. The Customer Service survey scored 90.89 for September. They are currently in the process of their annual audit and will provide the results in December.
Mr. Duplantis opened the item for questions.
Michael Brown asked about the 86 exemptions showing on the report under declared emergency. He enquired as to whether this was during the Davis Fire and if this was 86 calls for exemptions because fire departments were tied up or if there were that many ambulances committed.
Mr. Duplantis responded in the positive and that it was due to a number of things related to the fire, with some units dedicated to the fire and a number of other things happening all at once. He also shared that, at the beginning of the fire, when there were a number of patients needing to be removed from a rehabilitation center, many agencies collaborated to move patients possibly at risk. This was done without taking any EMS resources out of the system. This was profound for the community, in the ability to take care of these patients without impacting the 911 response.
Dr. Kingsley added that Andrea Esp and Jordyn Marchi, are staff who were part of the incident command system to help coordinate that response.
Vice Chair Reese mentioned that he is encouraged by the depth and transparency of the data provided. He has said that he doesn’t necessarily want to see the reporting as a
presentation but does read it. The public continues to receive incredible value from the service REMSA Health provides, and when he meets members of the public who had encounters with REMSA for any reason, they are talking about how the employees have gone out of their way to help, being gracious ambassadors of the care provided.
Mr. Reese recently had the opportunity to sit with the REMSA Board, learning more about the unique role REMSA plays in the community. He learned about air transport services and the skill and enthusiasm the Board exhibits. He commended Mr. Duplantis on his leadership and the Board on working through all the issues that face REMSA. Mr. Reese shared that he had some specific and direct comments about his thoughts about REMSA and the future of medical transport, and they were answered.
Chair Dahir asked if situations like the 86 exemptions will be explained better when the Hexagon application is in place.
Mr. Duplantis replied that there is an expectation that there will be better visibility of data in relation to calls and how resources are deployed and what resources are available.
Chair Dahir noted that the meaning of this is not just helping to understand what is happening and make sure the Franchise is fulfilled, but also to protect.
Staff Representative: Andrea Esp
Andrea Esp noted that the report outlines the operational review of compliance by REMSA Health since the inception of the 2014 Franchise. This report was developed in January 2015 after a compliance report was presented to the Board to finish the old Franchise. The Program was asked to provide an auditable checklist for the Franchise and compliance of REMSA Health. A checklist was then presented to and approved by the Board. The Program brings a report to the Board outlining the compliance each year.
During this 10th year, the Program recommends that the Board approve this operational review for REMSA Health.
Chair Dahir asked for clarification as to this review being for only this year, not all 10 years, compiling all the monthly data over the last year.
Ms. Esp responded that during the 10th year, there is to be a review of data back to the beginning of the Amended and Restated Franchise, giving an overview of the annual compliance of REMSA Health since the beginning of the Amended and Restated Franchise, not just the last year.
Chair Dahir clarified that this is then a compilation of the audits of the last 10 years.
Staff Representative: David Kelly
Staff Representative: Francisco Vega
Mr. Vega mentioned that there will be three positions open on the Air Pollution Control Hearing Board at the end of the year. A press release will go out to solicit applications. Any assistance from this Board for applications would be helpful.
Chair Dahir asked for these press releases to be shared with the local entities for them to share.
Mr. Vega noted that he will forward when the press releases go out.
Staff Representative: Lisa Lottritz
Ms. Lottritz added that they are in the middle of the flu/COVID vaccine events. A flu/COVID POD was held October 19, and earlier this week, they were at the Mobile Harvest Event. She thanked Dr. Kingsley for helping with translation. There are additional events coming up in November and early December.
Staff Representative: Jim English
Mr. English thanked the Board for the support of the nationally recognized Food Safety Program to be a mentor to Saipan. He also thanked the Board for allowing them to tweak their staffing and positions. Their new staff member’s position was a reclassification from Administrative Assistant to an Office Specialist, which went through the budget process and was approved by the Board. This is expected to provide the best customer service possible.
Mr. English welcomed Mr. Driscoll to the Board, and stated they look forward to working with him.
Vice Chair Reese asked for clarification about the staffing and reclassification leading to better customer service. He had the privilege of working with Environmental Health Services as a Board member for the last couple of years, which was very enlightening. This is a very complicated area, covering a lot with so many moving parts. He questioned the general concern about us not being very customer service oriented as an agency. He feels this is possibly mainly through the commercial plan review side and asked if the staffing model mentioned was designed to address this or if this was bigger than the scope of what can be discussed today.
Mr. English feels that what is being asked is bigger than what can be addressed today. The position reclassified was a clerical position, parts of which do touch the review process, providing the initial customer to internal and external customers at the front desk.
Mr. Reese followed up with a question regarding an important meeting from last week, where he was not present. It was a gathering of folks not happy with the plans and permitting process. He was thinking that this might be a good time to invest some time and energy into figuring out what is being done right and what could be worked on. He opined that if the staffing model is preventing success, the Board needs to know about it, as they would then need to be more proactive to identify what isn’t being done well and what can be done better. This is the commitment that the public expects of the Board.
Chair Dahir mentioned that these conversations are being held, and he wants the Board to know Dr. Kingsley will keep the Board updated and continue communicating.
Mr. Reese wishes to make sure that information collection is being done and that work will be done to the satisfactory resolution of all. He wants the community to know that when they interact with this agency, their concern is seen as valid and will be addressed. The goal is to figure out how to make sure the community is supported from a public health standpoint, business and industry, and home-based businesses.
Chair Dahir agreed with this statement and said that staff was part of the recent conversations. He wanted to make it clear that this will not be a delayed fix, but is to be addressed immediately, with appropriate staff involvement. He also added appreciation for their work during the events season.
Mr. English indicated he would share that sentiment with the group. He has also heard that Reno and Sparks are working to put more events on the calendar for upcoming years.
Staff Representative: Dr. Nancy Diao
Dr. Nancy Diao highlighted that the PHP Team worked with CCHS for a successful flu/COVID POD on October 19. On October 22, they partnered with Nevada Department of Public Health and various partners for a cross border virtual tabletop and functional Chempack exercise. The aim was to enhance preparedness and coordination among regional response teams in addressing hazmat incidents requiring a deployment of Chempack resources across state lines.
The third quarter communicable disease reporting and statistics report was published, covering tables and figures comparing morbidity for selected communicable diseases in the last quarter with the last five years.
Flu season began with MMWR week 40 on September 29. This began the publication of the Respiratory Virus Surveillance Report, covering influenza, RSV and COVID. ILI activities currently remain below baselines.
The reports have been published on the respiratory virus surveillance program page on the NNPH website, as well as being send out to the Listserv. To be included, reach out to Dr. Diao to be added.
Chair Dahir introduced Dr. Diao to Mr. Driscoll, who will be the Board member working with EPHP.
Vice Chair Reese asked to be added to the Listserv. He read about possible changes in the age for people to receive the pneumococcal pneumonia vaccine. He wondered if the reports tracked this and if the age to receive it had been changed. Also, he asked about the best understanding for the COVID and flu season.
Dr. Diao noted pneumococcal pneumonia is not on the reports, but she can have the information provided to him. She believes the vaccine change is still in the discussion stage. Flu has settled into a regular pattern, always during the wintertime, with COVID still showing a winter and a summer surge.
Dr. Kingsley commented that the data review is showing what is not there. Where the numbers are not low, it is due to the prevention assisted by the teams at NNPH.
Staff Representative: Dr. Chad Kingsley
Dr. Kingsley recognized staff and the service they’ve been providing. He authorized two items, a committee that put together updates to the appearance policy and a change to a fee schedule change for CCHS. The PHAB information has been submitted and we are waiting for a site visit.
Chair Dahir asked about the accreditation process contacting members of the Board. None have had any contact regarding this.
Dr. Kingsley indicated that this is part of the process and believes that the Board will be involved in the site visit portion.
Chair Dahir noted that there has been talk of having numbers on permitting and how long it is taking and if there is something behind. He would like the Board to be able to see this, possibly a presentation, to understand the data behind permitting.
Having no further comments from the Board, Chair Dahir closed this item.
Special Accommodations: The District Board of Health Meetings are accessible to the disabled. Disabled members of the public who require special accommodations or assistance at the meeting are requested to notify Administrative Health Services in writing at Northern Nevada Public Health, 1001 E. 9th Street, Building B, Reno, NV 89512, or by calling 775.328.2416, 24 hours prior to the meeting.
Public Comment: Members of the public may make public comment by submitting an email comment to jlawson@nnph.org before the scheduled meeting, which includes the name of the commenter and the agenda item number for which the comment is submitted. Reasonable efforts will be made to hear all public comment during the meeting. During the “Public Comment” items, emails may be submitted pertaining to any matter either on or off the agenda, to include items to be heard on consent. For the remainder of the agenda, public comment emails will only be heard during items that are not marked FOR POSSIBLE ACTION. All public comment should be addressed to the Board of Health and not an individual member. The Board asks that your comments are expressed in a courteous manner. All public comment is limited to three minutes per person. Unused time may not be reserved by the speaker nor allocated to another speaker.
Response to Public Comment: The Board of Health can deliberate or take action only if a matter has been listed on an agenda properly posted prior to the meeting. During the public comment period, speakers may address matters listed or not listed on the published agenda. The Open Meeting Law does not expressly prohibit responses to public comments by the Board of Health. However, responses from the Board members to unlisted public comment topics could become deliberation on a matter without notice to the public. On the advice of legal counsel and to ensure the public has notice of all matters the Board of Health will consider, Board members may choose not to respond to public comments, except to correct factual inaccuracies, ask for Health District staff action or to ask that a matter be listed on a future agenda. The Board of Health may do this either during the public comment item or during the following item: “Board Comments – District Board of Health Member’s announcements, reports and updates, request for information or topics for future agendas. (No discussion among Board Members will take place on the item)”
Pursuant to NRS 241.020, Notice of this meeting was posted electronically at the following locations: Northern Nevada Public Health, 1001 E. 9th St., Reno, NV
Reno City Hall, 1 E. 1st St., Reno, NV
Sparks City Hall, 431 Prater Way, Sparks, NV
Washoe County Administration Building, 1001 E. 9th St, Reno, NV Downtown Reno Library, 301 S. Center St., Reno, NV
Northern Nevada Public Health Website https://www.NNPH.org State of Nevada Website: https://notice.nv.gov
How to Get Copies of Agenda and Support Materials: Supporting materials are available to the public at Northern Nevada Public Health located at 1001 E. 9th Street, in Reno, Nevada. Ms. Jackie Lawson, Recording Secretary to the District Board of Health is the person designated by the District Board of Health to respond to requests for supporting materials. Ms. Lawson is located at Northern Nevada Public Health and may be reached by telephone at (775) 328-2415 or by email at jlawson@nnph.org. Supporting materials are also available at the Northern Nevada Public Health Website https://www.nnph.org pursuant to the requirements of NRS 241.020.