AGENDA PACKET NO. | A |
Members | Thursday, December 19, 2024 |
Devon Reese, Vice Chair | 1:00 p.m. |
Mariluz Garcia | |
Paul Anderson | |
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 |
Vice Chair, Devon Reese, called the meeting to order at 1:01 p.m. The following members and staff were present:
Members present: Devon Reese
Mariluz Garcia Paul Anderson Michael D. Brown John Klacking, PhD Steve Driscoll
Dr. Reka Danko (arrived at 1:06 p.m.)
Staff present: Dr. Chad Kingsley, District Health Officer
Francisco Vega Rob Fyda
Lisa Lottritz Dr. Nancy Diao
Ms. Clara Andriola led the pledge to the flag.
Vice Chair Reese noted that changes to the agenda include Agenda Item 5, Approval of Agenda, being moved up to Position 3, and current Agenda Item 4 being pulled. In addition, Item 9.B.5. has a correction to the name of one of the entities. Vice Chair Reese asked for a motion to approve the agenda with the mentioned changes.
1001 E. Ninth Street, Building B, Reno, NV 89512
Telephone: 775.328.2415 – Fax: 775.328.3752
Election of District Board of Health Chair for 2025-26. (FOR POSSIBLE ACTION) Vice Chair Reese asked Dr. Kingsley for any comment regarding this item.
Dr. Kingsley shared this is the normal cycle of the elections.
Election of District Board of Health Vice Chair for 2025-26. (FOR POSSIBLE ACTION)
This item was pulled from this agenda and will be moved to the February meeting agenda.
January 13, 2024
Motion was made and agenda approved with changes before Item 3.
Introduction
Chair Reese noted it has been a privilege to work with Kristopher Dahir, with so many great things done with this organization. He also performed service during a difficult time, where the pandemic knitted people more closely together.
Michael Brown thanked Mr. Dahir for his leadership and making sure things moved in a fashion that worked for the community.
Mr. Dahir acknowledged that many people don’t know what public health is and what it means, and he isn’t sure he did when he started, but there was a lot of education in the past 8 years. Staff has been amazing and does a lot of work. This Board is crucial to the work done by the department. His service has been an honor and he hopes to see the great work continue.
Chair Reese thanked John Klacking, PhD, for his service during the difficult and challenging time of COVID.
Michael Brown thanked Dr. Klacking for everything he did on this Board and for sharing his wealth of knowledge.
Dr. Klacking shared that he enjoyed his time on the Board, and he learned much. It was great interacting with the Board members, with many exciting meetings and the COVID controversy. He enjoyed the experience.
Dr. Kingsley noted that, on behalf of NNPH staff and as part of the Board, there is an opportunity for each Board member to be assigned to the different departments and he appreciates the time attention Mr. Dahir and Dr. Klacking spent with and in support of staff.
Chair Reese noted an additional change to the Board, with Clara Andriola taking the place of Mariluz Garcia. He also encouraged the Board to reach out with questions to Mr. Dahir and Dr. Klacking.
New Hires
Benjamin Davis, Air Quality Specialist, AQM, hired 12/02/24
Stacy Dozier, Account Clerk II, AHS, hired 12/16/24 Dr. Kingsley noted the new hires for AQM and AHS.
Jack Zenteno shared that Stacy Dozier is the new Account Clerk II for AHS. She came with 15 years of accounting of experience, most recently with the Sheriff’s office, as well as UNR and Renown.
Years of Service
Jeffrey Jeppson, Sr. Air Quality Specialist, AQM – 15 years 12/07/2009
Victoria Nicolson-Hornblower, Public Health Nurse Supervisor, CCHS – 10 years 12/15/2014
Dr. Kingsley congratulated Jeffrey Jeppson and Victoria Nicolson- Hornblower on their years of service.
Health Heroes
Andrea Esp – EPHP
Dr. Kinglsey recognized Andrea Esp on her Health Heroes award.
Proclamations.
A. Recognize January 2025 as National Radon Action Month in Nevada. Staff Representative: Craig Petersen
Accepted by: Christine Kelly
The representative accepting the proclamation was not present today, so Craig Petersen accepted the National Radon Action Month in Nevada proclamation on her behalf. He read the contents of the proclamation for the record, urging residents to pick up a radon detection kit at over 30 locations statewide.
Chair Reese opened the public comment period.
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. November 21, 2024
Approve the Notice of Subaward from the State of Nevada Department of Health and Human Services, Division of Public Health and Behavioral Health in the total amount of
$462,383 (no cash match) retroactive to August 1, 2024 through July 31, 2026, in support of the Centers for Disease Control and Prevention (CDC) Epidemiology and Laboratory Capacity Program; the funds will be used to maintain data for reported COVID-19 cases as directed by federal and state partners and to conduct investigations for other public health conditions of importance and to authorize the District Health Officer to execute the Subaward and any future amendments. (FOR POSSIBLE ACTION)
Staff Representative: Kellie Watkins and Kristen Palmer
Approve the Notice of Subaward from the State of Nevada Department of Health and Human Services, Division of Public Health and Behavioral Health retroactive to October 1, 2024 through September 30, 2025, with funding contingent upon availability of funds issued through the Federal Continuing Resolution. Allowable expenditures reimbursement is retroactive to October 1, 2024 through September 30, 2025, in support of the Community and Clinical Health Services Division’s Women, Infants and Children (WIC) Program and authorize the District Health Officer to execute the Subaward and any future amendments. (FOR POSSIBLE ACTION)
Staff Representative: Lisa Lottritz and Irene Dominguez
Approve the Grant Agreement from the U.S. Environmental Protection Agency (EPA) in the amount of $662,488 for the period of January 1, 2025, to December 31, 2028, for the Air Quality Management, Multipollutant Monitoring Program, IO# TBD, and authorize the District Health Officer to execute the Grant Award and any future amendments. (FOR POSSIBLE ACTION)
Staff Representative: Francisco Vega and Kristen Palmer
Recommendation for the Board to approve the Interlocal Agreement between Northern Nevada Public Health (NNPH) and Washoe County School District Nutrition Services to provide a tasting component for students participating in NNPH’s school-based program, Power Up Kids. (FOR POSSIBLE ACTION)
Staff Representative: Stephanie Chen
Recommendation for the Board to approve the Interlocal Agreement between Northern Nevada Public Health (NNPH) and The University of Nevada, Reno to allow Northern Nevada Public health to house an Immunization Coordinator employed by the University. (FOR POSSIBLE ACTION)
Staff Representative: Lisa Lottritz
Staff Representative: Francisco Vega
Recommendation for the Board to uphold an uncontested citation issued to Sierra Nevada Construction, Case No. 1531, Notice of Violation No. AQMV24-0027 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 DG Golden Triangle, LLC, Case No. 1535, Notice of Violation No. AQMV24-0028 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 Galleria Car Wash, LLC, Case No. 1536, Notice of Violation No. AQMV24-0029 with a $500 penalty for failing to obtain a Dust Control Permit prior to the commencement of a dust generating activity. (FOR POSSIBLE ACTION)
Recommendation for appointment to the Air Pollution Control Hearing Board as an At-Large Board Member. Staff recommends: The reappointment of Ms. Yvonne Downs to the APCHB as an At-Large Board Member for a three-year term beginning on December 15, 2024, and concluding on December 15, 2027; Applicants include: Dorothy Hudig, Ph.D., Pierra Mousset- Jones, William Grey, William Foster McCoy, Ph.D., Bernadette M. Longo, Edmond LeBlanc, Jay Collins, John Peck, Nicolas Favier, Stephen Birdsall, Lee Squire. (FOR POSSIBLE ACTION)
Staff Representative: Francisco Vega
Recommendation for appointment to the Air Pollution Control Hearing Board as Attorney Committee Member. Staff recommends: The appointment of Ms. Theresa A. Ure Stix as the Attorney Board Member for a three-year term beginning on December 20, 2024, through December 20, 2027; Applicants include: N/A. (FOR POSSIBLE ACTION)
Staff Representative: Francisco Vega
Acknowledge receipt of the Health Fund Financial Review for September, Fiscal Year 2025. (FOR POSSIBLE ACTION)
Staff Representative: Jack Zenteno
Chair Reese noted that 9.B.5. has a technical change but does not need to be pulled for separate voting.
Dr. Kingsley confirmed the change as being a name correction in one of the partners.
Recommendation to uphold the decision of the Food Protection Hearing and Advisory Board to approve Variance Case #2-24FP of the regulations of the District Board of Health Governing Food Establishments for Diamond Peak Ski-Main Lodge BBQ Outdoor Food Establishment (H19- 0053FOOD). (FOR POSSIBLE ACTION)
Staff Representative: Amber English
Robert Fyda gave a brief update on the recommendation from the FPHAB for the issue of the facility not having an ANSII approved portable hand sink. The Board unanimously approved upholding the variance with the support of staff, on the condition that they applicant works with NNPH staff to find a timeline for a more permanent fix.
Presentation and possible acceptance of the FY25 Q1 Strategic Plan Results. (FOR POSSIBLE ACTION)
Staff Representative: Rayona LaVoie
Mike Escobar shared a presentation on the Q1 FY25 Strategic Plan Results. He noted that Clearpoint is the performance management system used to track and report the progress as it relates to the Strategic Plan. The Board was provided two reports, one being a status snapshot, a high lever overview of the progress achieved throughout the organization. The other was an
outcomes report, sharing greater detail regarding the specific activities in Q1. Though this is only one quarter into the fiscal year, more than half of the initiatives are being met or exceeded, with almost 70% of outcomes met or exceeded and good progress toward the remaining portion. About 60% of outcomes and initiatives of the division goals are being met, showing good progress toward the District goals. Mike highlighted Domain 5.2.1, where work is currently being performed on QI projects and 5.1.1.2 which is to increase the mandatory training completion rate and is about ½% from the goal.
Chair Reese thanked Mike for his presentation and stepping in to do this as an alternate. Dr. Kingsley acknowledged all staff in their contribution to these successful statistics.
Chair Reese noted that, with a new year and a new Board, it may take some time to become familiar with the process. He wishes to make sure that the work that this group is doing doesn’t get disconnected from measures that matter. He will be watching for a broad understanding that we can be better as an organization and talking with folks about areas we can improve upon, closely monitoring how we can be better and look toward addressing shortcomings and celebrating successes.
Presentation, discussion, and possible action to affirm the recommendation of the District Health Officer to uphold Fiscal Year 2025 fees for Reno Building Permit – BLD24-0149E. (FOR POSSIBLE ACTION)
Staff Representative: Robert Fyda
Robert Fyda introduced Frank Lepori and Harrison Herrera, then provided a brief summary of the project dates and problems regarding fees. The fee changes went into place on July 1, 2024, with the permit being billed on July 5, just prior to permitting. The practice for NNPH is to have fees due past July 1 to be billed at the new rate. This is for all fees across the board. When plan reviews cross fiscal years, it is difficult to adjust the fee schedule.
Chair Reese asked Counsel if there is an order recommended for this discussion.
Dania Reid, DDA, noted that, based on the agenda, the item is up for approval. Based on this and the request for the client to have his argument heard, this could be taken as public comment, with the Chair providing discretion beyond the normal 3 minutes.
Chair Reese asked Mr. Lepori how much time he would like to present his case.
Mr. Lepori was unsure how much time would be necessary, based on potential questions from the Board. Chair offered to have him begin presenting, and if discussion gets too lengthy, he will be asked to wrap up.
Mr. Lepori thanked Dr. Kingsley for his communication and working with them on this situation and hopes to have additional meetings to work through some of the items that have occurred. He has a list of dates where emails or calls were made to NNPH and feels the 5 days over on the permit acceptance were due to lack of communication.
Mr. Herrera noted it took about a month of reaching out to get a response, which then allowed them to begin addressing the issues. It took another month after resubmission to confirm what was needed, before they were able to work on corrections and resubmit. Some of the difficulties were between City of Reno and NNPH. After issues were resolved with NNPH, the City of Reno was
able to help finalize the permitting. They feel that the 5 days in question could have been resolved several weeks earlier with better communication.
Mr. Lepori opined that the problem lies in the messages being returned in a timely manner, especially with eyes toward deadlines. His frustration lies in the fact that these plans were submitted three times in different formats, as requested, with three fees being paid, and the final one being much more costly. He feels that this process could be worked on, there is a lot of frustration from the community. More communication among cities and counties with regard to plan checks would also be helpful.
Paul Anderson asked about the timeline, where it states July 25, 2023, the plan was submitted to Reno, then took 60 days to resubmit, in November/December, 90 days to resubmit, and in April, 15 days to resubmit. He wishes to understand the delay with the resubmits.
Mr. Lepori responded that this was due to the communication attempts with the plan checker where questions were asked and needed confirmation, before plans were resubmitted. Once the answer was finally received, the correction was resubmitted after about a 2-week turnaround.
Mr. Anderson then asked about how communication from NNPH is done. He also questioned rate changes, asking if they always take place July 1 and how are these changes communicated?
Mr. Fyda indicated that the plans are reviewed as a first in first out, with communication being done via letter in Accela after reviewing the technical comments and consolidating everything. The rate changes historically have been on July 1, with previous fee schedules following a CPI index.
Last year was the rollout of a restructuring of fees, where public workshops and hearings conducted prior to the fee update.
Chair Reese asked about the collection of fees and how many days past the submittal date it was.
Mr. Fyda clarified that, to his knowledge, when the permits are submitted, a plan check fee is paid to the jurisdictional building department. When permits are approved, that partner consolidates all the information, including our fees, and provides the invoice to the client. The date this was approved is June 12, with the invoice issued on July 6. Had it occurred before June 30, it would have been on the prior fee schedule.
Mr. Lepori noted that NNPH doesn’t take a plan check fee but accepts the fee after approval.
Dr. Kingsley shared that the partnership between Mr. Lepori and NNPH has been great, and he appreciates the input and insights and recognizes that work needs to be done with jurisdictional partners. During his review, he noted some items for improvement, which are being addressed. In reviewing this permit, the longest a plan review was held was around 20 days, with the one in question about 13 days. This also fell after two holidays. Based on the Rules and Polices, the DHO doesn’t have the authority to waive this, and no significant fault was found in the revisions and timeline. It was recommended that this be brought to this Board for a final decision.
Chair Reese noted that there is a fine line to walk, with a series of rules to be applied as written. There is no discretionary function written into it. Long term, he feels there should be greater discretion imbued with the Health Officer to make some choices. Administratively, things may be able to be resolved differently. He is inclined to reverse the decision of the DHO in this specific case, due to the proximity between the submittal and the fee change date and does not feel this will create a precedent. There will always be a balancing of equities, considering the law and the facts. It is inequitable to consider that such a multi-faceted approval process among multiple agencies could include a bump in fees with this close timeframe.
Mr. Fyda highlighted that this project included multiple complex items. There are three or more permits, with staff review of each component. Staff has been working with other departments on consolidation into one comprehensive review, rather than putting together multiple reviews.
Chair recognized that Mr. Fyda and staff are receptive to being change makers and trying to find a way to follow rules, but also observe that there could be reasons for exceptions. Staff is doing incredible work, but there is a challenge among interlocal governments.
Chair Reese thanked Dr. Kingsley for his recent work recently where things are not always in public, and where he and staff are doing a good job of working through this.
Mr. Driscoll asked about Rules and Regulations internal to the organization being reviewed and changed.
Mr. Reese shared that anyone could ask for items to come to the Board, and Dr. Kingsley and he will determine the timing of the request, as well as Strategic Planning efforts. These are both good places to have these conversations, along with picking up the phone and contacting Dr. Kingsley for questions.
Recommendation to approve the proposed 2025 District Board of Health meeting calendar. (FOR POSSIBLE ACTION)
Staff Representative: Chad Kingsley
Dr. Kingsley noted that a proposed calendar has been provided for approval.
Chair Reese did not note any omissions on the proposed calendar and asked for thoughts from the Board.
Steve Driscoll noted that he will not be present for the April 24 meeting.
Chair Reese noted that he also did not believe he would be available for that meeting.
Staff Representative: Francisco Vega
Francisco Vega shared some highlights from his report, including the EPA convening the Clean Air Scientific Advisory Committee, to review ozone standards. Typically, this is done once every 5 years and has major impacts on what is done in Air Quality. The ozone panel has been put together and includes Dr. Watson from DRI. In November, there were no exceedances of standards and 100% of plan reviews were completed and processed in a timely manner.
Mariluz Garcia mentioned that Francisco Vega was a graduate of the Future Inspired Leaders program this morning.
Prevention Program, Maternal Child and Adolescent Health, Women Infants and Children, and Community Health Workers
Staff Representative: Lisa Lottritz
Lisa Lottritz shared that the Family Planning Sexual Health Program received a second Binx machine, to use for chlamydia and gonorrhea testing. This assists clients in leaving the clinic with a diagnosis and treatment. The immunization team provided COVID and Flu vaccines to the Cares Campus today and earlier this month was at Our Lady of Guadalupe church, where they provided 206 vaccinations. She congratulated registered dietitian, Kelsey Atkin, for her graduation from the HR Inspired Future Leaders program.
Chair Reese thanked Ms. Lottritz for the TB clinic opening.
Staff Representative: Robert Fyda
Robert Fyda highlighted that the Food Plan Review Staff has been working with Anna’s Taqueria at a new location, which is on a commercial septic and needs an NDEP permit for waste discharge. Staff is working with the City of Reno to streamline mobile food ordination, improving service agreements and making sure agencies have applicable mobile food facility information. The septic team has reached out to some realtors, livestreaming a presentation, which is also available online. The vector program is preparing their report to NDEP for the national pollution discharge, accounting for the chemicals released into the environment, specifically the mosquito larvicide and insecticide.
Staff Representative: Dr. Nancy Diao
Dr. Nancy Diao shared that the 2023 Community Antibiogram has been published and is available online. Flu and RSV have been increasing since mid-November. As of week 50, ILI activity surpassed Nevada baseline, but remains below the region 9 baseline. Similar trends are seen on the state level and nationally. Influenza A is showing as the majority of flu, with H3 sub lineage, then H1N1. COVID cases remain low and stable. They are continuing to see outbreaks, primarily gastrointestinal illness, with more respiratory seen.
Chair Reese asked about a report he read about bird flu going to cows, then humans.
Dr. Diao responded that in the U.S., there has been about 60 human cases, from dairy cattle and poultry. Affected states do not currently include Nevada. H5 has been identified in cattle in Lyon County. There have been severe cases identified in Louisiana and British Columbia, both related to poultry. Previous cases in humans have been very mild. There is still low risk to the public.
Mariluz Garcia noted that pasteurized milk is free from H5.
Dr. Diao confirmed this, with additional tests being conducted, but pasteurized milk being the safest. Chair Reese also asked about mpox tracking and is this happening in our community.
Dr. Diao responded that there has always been clade 2 mpox, with a slight uptick occurring. There was one case of clade 1 mpox, which is the variant seen in the DRC. There is one clade 1 case in a CA resident, but he is recovering and there are no additional cases identified.
Chair Reese noted that, because of his travel, he recently received vaccinations at NNPH, and was very happy with the staff, check in, etc. and thanked the process for being very easy to do, with the education provided very helpful. He appreciates that we are able to do this, as his own physician was unable to provide the vaccination. He has discovered that the only locations locally with access to the vaccine are NNPH, the VA, and CHA.
Dr. Diao gave thanks to the CCHS team for working very closely with the epidemiology team to make sure we are prepared for vaccinations or cases or contacts coming in. They work very well together to make sure they are protecting the community.
Dr. Kingsley noted that, about 4 years ago, there was a thought to test wastewater in the community for diseases. He would like to see this expanded, since it could technically test for most viruses and bacteria to help identify prospective situations. State has been able to continue funding for the State Laboratory and it is hoped that this will become more extensive.
Staff Representative: Dr. Chad Kingsley
Dr. Kingsley noted that two staff members, Jordyn Marchi and Robert Fyda, have attended and presented at recent national conferences. He has been meeting with community members, as well as Southern Nevada Health District and Central Nevada Health District, increasing partnerships in Nevada.
Mariluz Garcia thanked everyone for the opportunity to serve on this Board. She enjoyed getting to know the staff and the important work being done. She announced this is her last meeting on the Board and introduced Clara Andriola as her replacement. She also thanked Dr. Klacking for serving these years, especially during COVID. The BCC has also appointment Dr. Eloy Ituarte to join the BOH. He brings an impressive resume and will be a great asset to this body.
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.