Board of Health - Regular Meeting

Right. So we're going to call the meeting of the Board of Health to order. Let's all stand and do the Pledge of Allegiance. I pledge allegiance to the flag of The United States Of America and to the Republic for which it stands, one nation under God, indivisible, with liberty and justice for all. All right.

Let the record show that mayor Woodford is excused. Doctor. Vogel is expected. And all other members are present, so we do have a quorum. 25, eleven fifty, approve the minutes of the September 10 Board of Health meeting. Can I have a motion to approve? Move to approve. Alderperson Jones, is there a second? Second. Any comments, questions, changes? Okay. I see Nate wants to go in. Do I need to press something up here?

Sorry, I was just seconding it.

Oh, well. Too late.

No way.

Alright. She beat you. Thanks, Nate. That was older person, Wolf. So and he is joining us by Zoom. Any comments, questions, changes? All in favor, say aye. Aye. Opposed? Abstentions? Passes unanimously. We have no public hearings on our action items twenty five eleven fifty six, twenty twenty six health department budget. Doctor. Siepers, if you'd like to point out your highs for us, and then we'll entertain any questions. Thought I had you on already. Thank you.

So if we turn to page three eighty three, I'll just kind of cover the highlights. And then I'll pick out a few things from both the general budget and the special funds budget. So you can see a little bit here on the program revenues for 2026. We do see a little bit of a decrease. This is entirely due to an overestimation of the number of tourist rooming house licenses that would be issued in 2025.

So that projected 2025 number, we don't expect to reach that. So that has been tailored for the 2026 budget year. And if we categorically, we look program expenses increase by 4.7%, those are that's largely due to staffing. About 3.4% or so is due to year over year compensation increases there. And then so if we look at the other line items for expenses, those are just small increases.

Training and travel, there was a weights and measures training and travel increase there, which has a zero budget impact as it's funded through program revenue there. The increase in purchase services, this is due to the new Granicus contract as of 2024. This is a new expense that is in the budget as it relates to the annual software for that license. I will say just to and I'll circle back to this a little bit. But I do want to highlight that one of the most important things to think about, too, with the loss of projected program revenue due to the tourist rooming house license.

On the other side of that, we have a compliance piece that we've had 50 tourist rooming house unlicensed tourist rooming houses that we're operating that have now been brought into compliance without licensure. So think of this as they've either sold that property, they're renting it long term, most cases, but that translates into 50 housing units that have been put back into the local housing market. So success is good. Failure is good because we also have more housing in that case. So going through section by section, nothing significant to point out for Unit 12510, administration.

So we'll kind of skip through that. The nursing budget and I'll just note, I want to highlight the, amended budget for 2025 does not highlight the change that had happened in early twenty twenty five. And that is the part time wages. You see that set at $24,266 That should have been about what that looked like in 2025, the amended budget. So basically what we did, as we increased staff in that nursing support section what we did was we moved funds from that part time line item into the full time line item.

So other than that, no significant changes. We see a little bit of an increase in service costs. And that's the increase of our annual software licenses for our patient medical record. And next business unit 12/2030. Again, biggest change here is the revenue.

So in order to close that gap, we did increase fees in our schedule fee schedule. So we're a little bit below our statutory allowed limit, and that is we serve as the agent for the state agent for both DATcap and DSPS. And so there is a ceiling of revenue that can be generated from those programs. So the expenses will never sort of match what that revenue is. But we're about $30,000 $40,000 below that ceiling to be budget neutral for the programs in which we can be reimbursed.

What doesn't get reimbursed are the more traditional environmental health things, so mold complaints, rabies investigations, all of that work. Then there's a number of city licenses, taverns, beekeeping, and what have you.

Those things that don't pay for themselves.

Those things that don't pay for themselves. And we can take a look at the fee schedule here a little budgets. And then weights and measures, we were able to reach budget neutrality on the weights and measures program last year. And the plan moving forward is to alternate between an increase in fee schedules and the opposite, the next year, we would increase the daily fee schedule for what we received through our consortium partners. So that gives two years of there's a two year a one year gap.

But every two years, we would see a slight increase to keep up with the increased costs. That's working really well. Added a few days, so that increases that revenue and makes those fee schedule changes a lot smaller. Just going through, if we look at page three ninety two, just sort of a roll up of everything, nothing really to note there. But if we look at the overall 1.544 versus 1.617 and again, that's largely due to just the increase in operating expenses due to costs and that sort of thing, natural cost compensation increases, things of that sort.

And then after the general fund budget, you can see this is the pages it's eighteen and nineteen of your packet. You can see the 2025 fees on the left hand column and the proposed 2026 fees on the right hand column. This does include a number of council set fees. Normally, we don't we don't touch those, but it's been, I believe, five years since those have been moved at all. Those so if we look at on page 19, the second to last chunk there that the beekeeping, chicken keeping, and so on, those are the council set fees.

So those are those are what we are proposing to council to increase as well that we don't have more operational control over. I would like to highlight that even the fee increase on those items do not cover the cost to implement those programs. Any questions on the chair, would you like me to continue with the special I might

to do the questions if anybody has them now on this area. And since we're going to start questioning, I'm going to seek a motion to approve the health budget to the council? Oh, it's information. Oh, we don't have to Okay. That's good to know. I'm sorry. Other times in the past, I thought we had. Okay. So any questions from any older person, Jones.

Looking at page 18, the increased health fees, you had said that they had not been updated in about five years. Are these new ones comparable with other surrounding municipalities?

Sorry. So everything on page 18 are license fee schedules for the DACAP and DSPS programs. We have been increasing fees each year. In 2023, we did a very large increase in fees to get closer to the actual cost to service those licenses. And since then, we've been doing incremental increases each year. So this is on top of our annual I should say, this is in line with our annual fee schedule increase.

And then on page 16 of the packet, you have your list of your weights and measures consortium members. I just kind of noticed that each daily rate is different. How is that calculated?

Yep. That's a great question. This is a change that we made for 2025 that has worked really well. So in the past, we had a single daily rate. And so every consortium partner from Kimberly to Nina or I should say the other end of the spectrum is Ashwaubenon.

So if we can compare those two communities and maybe look at Greenville, where the layout is much different, there's a significant amount of time difference in the servicing of those smaller communities as it is for those larger communities. And because of that, it was challenging to balance that that equity on the on the fee schedule side, and and still reach some sort of parity. Right? So, what we did was we moved to a, a tiered system. So there's a one a tier one, a tier two, and a tier three.

And so with that and so so Kimberly is the only tier one. Every other community except for Neenah and Ashwaubenon are the Tier two. And then Neenah and Ashwaubenon are that Tier three. And so more businesses, more gas stations, that kind of thing. Like, gas station is a that's a one day, right?

That just takes one day because a quick trip will have for each gas pump, you've got six actual pumps, right? So you've got to so you have to measure each side. So you multiply that by four islands times two units, right? It just adds up. Of the distribution of the retail business type, that tier system works really well. Is

that it? Any other questions? Oh, Aldergperson Wolf.

Thank you, Chair. So my question is on the fee schedules, specifically the hotel motel rates increase. Typically, people who are staying at a motel might be people who are struggling to find permanent housing, right? Or what happens there at least? Now that there are people in our city who are experiencing homelessness and will try to rent a cheap motel to do that.

Do you think raising the rates on motels are going to increase prices for those motels for people to stay at in the short term and long term?

No, I don't believe so. I should say, I don't believe that if if we look at a a particular license, which most most of our licenses fall within the 31 to 99 or the 100 to one ninety nine, I don't know if a large chain lodging facility like a I won't name any particular ones. But if we're thinking about a large chain, part of one of the ones that we all typically stay in when we travel, I don't know if moving from $590 to $679 is going to have much of an impact on a large corporate chain like a Wyndham or a Hilton or something like that. I don't think we can break that $100 down and pass it on to people. Now, rising costs overall for all businesses tend to get passed on to consumers.

That's a fair statement. But I don't think that for the for hotels, motels, and the lodging in general, I don't believe that these changes are will cause a significant impact on the the end user in this case.

Okay. Any other questions? Alderperson Wolf?

That takes care of it. Thank you.

Okay. And I'd just like to point out that by inspecting those places where people who may be homeless are seeking shelter, we're ensuring that they're in a safe place with running water, working electricity, things like that that will make sure that what they are paying for is legitimate. So it's a good thing to make sure that they're going to be in a place that's safe.

And I would just add yeah, thank you. I really do thank you for that question. I think it's good to talk about that. I will also add that the fee schedule increases do reflect the amount of cost that it takes to implement the inspections and maintain those licensures. Things have certainly gotten a lot more complicated on the environmental health side.

In the last three years, we've been changing software. We're changing software again, moving from a desktop base to a cloud based system, state programs, and that kind of thing. So it's complicated and it takes a lot of time, a lot of administration time to be able to do this the right way.

Okay. Any other questions? I have a couple. First off, are we prepared if the grants that we're having listed as revenue don't come through from the federal government? Do we have a contingency plan in place?

We do not have contingency plan for 2026, but all of our $20.26 dollars have been secured. One of the last ones to hear about, we were expecting the bioterrorism grant to be funded at 75%. We received word this week that that grant will be funded full. So there's a couple other grants that came in this week that we expected to get, but we had confirmed. So every dollar that we had expected in federal dollars for 2026, with the exception of Vaccines for Adults program.

We are the amount of vaccine that we are able to get from the state, which we normally did not have to pay for and we don't have to pay for now, But there is a dollar allocation assigned for each vaccine. And so that's the only limitation. But in terms of the monies that we receive, none of that has changed. And we're past that federal fiscal October to where all the monies that would have affected 2026, we have gotten or have been confirmed that we will get.

Okay. And then I just have a couple of questions questions on overall on the training and conferences. I noticed that between each of the units, there's kind of a discrepancy base of one is $6,000 for travel and conferences, one was $1,900 and other is 5,200. And so I'm just kind of concerned because for a group that needs to go to conferences and learn new things and to learn to work or be able to reach out to other similar experts in their field. I do think that your conference overall budget is pretty low.

Is this something that there's been talk of to increase?

Yeah. Thank you for that question, Chair. We have slowly been increasing where possible travel and training budget line items. We have gotten very good at finding value in many of the opportunities that we see around us. Our nurses, for example, do attend a great number of conferences within the state.

Many are free. And now that we have fleet vehicles and that sort of thing, there are typically no costs in terms of traveling, in that case. That becomes different in the other sections where, overnight, travel is necessary. We did increase our environmental health section last year to allow the supervisor to attend one national conference per year, as it turns out. And again, trying to use our dollars as smart as we can.

The national conference did not compare to the state conference. So we sent three people to the state conference with the same amount of money it would have taken someone to go. So those are the decision points that we make at each point. And we have been slowly increasing travel and training because we do recognize that need. And it is important. But we're not going to go beyond get over our skis, as wise folks might say, in this regard. So we're confident that these funding levels will meet our travel and training needs for 2026.

Okay. So we'll move on. I think we have where did you end off?

I didn't talk about the weights and measures fee schedule.

That's what I thought. Okay.

But the only fee increase let's see. I want to be correct here. The only fee increase is the gas pumps, I believe. So petroleum pump went from $30 so fee 14, that went from $30 to $40 And the nice increase or the nice thing about the consortium is we make the rounds early summer and have all of these meetings. And we're able to get the buy in to have every consortium partner adopt the same fee schedule.

So 11 communities, 12 with the city of Appleton all have the same fee schedule. And that's really nice for the value of those operators.

Any questions on that? I just have one. How do we compare to the state rate that we're being competitive with?

So I don't have the state breakdown. But I do know that for the daily fee schedule or the sorry. The daily rate for for contracts is about $900 $850 $900 I would point out that those are the state offers a five hour workday. We offer a six point five hour workday. So because we're much closer, we're able to utilize more of the workday. So it's a good value for consortium partners in that case.

And are we at the maximum amount of consortium based on our I know about the gas meter and the reader and that type of thing. And maybe if you want to explain that to me since we have time this morning. I don't know if everybody's aware.

Yeah, that's a good question. No, we have a little bit of a capacity to expand. And that is something that we're actively trying to do. We are promoting our services. Last year, when we brought in the tech to handle the tourist rooming house project.

That person actually splits their time between weights and measures and And there's plenty to do in both. But we do have the capacity to be able to take on more contracts without any FTE increase. So that is something that we're actively looking at.

And from a capital standpoint, is there anything in the future that you anticipate you're going to have to replace?

Yes. So we are slated to have our large fuel trailer would be replaced in 2027, I do believe. We are CEA. So that comes out of our CEA costs. So we do budget for that every year.

One thing that we're looking at, and it looks very favorable, the fuel trailer that we do have is in very great shape. It's outlived its life many times over, but it's in fantastic shape. And because of this, we have requested that we get the new trailer on schedule but retain this other trailer as a backup. It's extremely expensive cost, but there's no sense in selling functioning assets that could help expand our current capacity or to help us if there's some sort of failure if it goes down or something like that. So that looks favorable and we do expect that to be able to happen.

But all of our major capital costs are coming out of our CEA funds now. Great

question. Any other questions before we move on to the health department grants? Okay. Health department grants.

The roll up isn't as helpful on the grants because you'll see big swings. And the revenue will always match the expenses on those because we can't spend more money than what we have. So we can just go through page by page by grant. No change in the maternal child health, page 26. So same cost there.

I will highlight that in 2024, we began assessing an agency indirect cost. And so that transfer out, that $21.38 that's what that is. And that helps pay for HR, finance, IT, etcetera. So we assess that on most external funds not all, but most. Okay, page 28.

That's our BOTS grant. That is for the purchasing of child passenger safety seats. And so just in time, the October 1 date, we're able to purchase new seats. And we do expend that $4,000 every year. And that goes to families in need that do require that child past your safety seat. So great program. Started in 2023. It's been going really well in partnership with FIRE. Page 30. This is our prevention grant.

So we use these funds for funding well, in the past, we've used to fund staff. Moving forward, these are funds that we are using for our buy in into the cost sharing of the Tri County Community health improvement process. And so that's what those funds are. It changed slightly, but it was a recalculation. So largely the same unchanged.

Moving on to page 32, this is our CD grant. No changes there. Funding steady, there's no changes whatsoever. Next, I believe, is lead. This is our public health infrastructure grant.

These funds are used to pay for the community health supervisor. And so this is a five year grant that goes through the 2027 and we will fully expend the grant by the 2027 we won't let's see We will have about $15,000 $20,000 remaining in that grant when we head into 2027. So we'll be looking at other funding mechanisms. And we've written a few grants and whatnot. That role is built into our table of organizations.

So we will keep it funded. Health grants, CDC led grant, no changes there. And then the bioterrorism, this is one that program is next. That did increase slightly. So that is good there.

But again, that increased, but the amount of vaccine we can actually get decreased. So that that will be some interesting math at the state level. And then the last is our let's see. So no COVID dollars. So we'll just go ahead and skip 40.

All the COVID dollars have been spent, and that time has gone by. And then you'll just focus on page 42. You'll see the decrease from $20.25 in the first revenue line item, $4.02 $2.05 $0.00. So that, that did decrease, here. But we did receive word this week that, it it's actually fully funded.

So it'll go back to that fifty eight two zero two. We were, so the $18,000 that is income generated through our FEP consortium work. And then the other reimbursements, that is a deferred revenue line that over the years that $18,000 has filled many times over. And so that's where we've been drawing from to fully fund that position. So with the FEP funding going back to 100%, what we'll see it just happened this week, so it's too late to do anything about it here.

But a budget amendment will end up being that increase will go will be in that line item. So we'll go back to 58,202 and then that'll come back off of the other reimbursements and go into the shared revenue pot if you will. And those are the highlights there. So as you can see, no major changes and largely going into 2026 unscathed from any funding cuts.

Any questions? Kathleen Folkes. The bioterrorism

grant, could you describe what the person or people do that carry out that grant? Yeah,

sure. And so it's known as the Bioterrorism Grant. It's known as the FEP Grant. It's public health emergency preparedness and a response. So it is the preparation for public health related events.

Think of a global pandemic, if that were to ever happen. But it's the planning and the operations around, being prepared for such, events or the health component of other major events. Think of flooding. Think of power outages. All of those things as they affect people's health.

Where do we gather? Where do we put survivors in a building collapse, right? It's all of those things, making sure that those MOUs are in place. It's helping to ensure all of those logistical pieces are in place before a disaster that would affect human health would actually occur. And we're really lucky in the staff that we have.

This position is actually shared with a secondary role. So the FEP coordinator is also the city emergency manager. So Cassidy Walsh serves both roles. Typically, are different. One is the planning. The other is sort of the execution of said plans. We've got a good resource and asset with our staff and the fact that they serve both roles. Great, great question.

It sounds like this involves a lot of coordination with local partners and that's what this area usually shines in. So that sounds good.

And she does a fantastic job.

And I think all the counties work together to do their scenarios. So there's mutual aid agreements so that they will come and help each other. So they have usually one thing a year where they're besides the tabletops where they actually do it for real. And sometimes I know it was at the airport one year. And it was it's fascinating to watch how it all works.

Yeah. We did our functional exercise yesterday in partnership with I can't talk today with Ottoghamy County EM staff. So yep, we work very closely together. It takes a lot coordination with a lot of partners.

Any other questions? Okay, thank you so much. And let's see. We're on to should have wrote this off. Twenty five-ten-thirty one, Respiratory Virus Surveillance and Wastewater Report.

Not a whole lot of time to spend on that. Just to remind folks, we are in respiratory virus season. You can kind so with that, it's time to start looking at COVID wastewater numbers again, seeing a high category for see broken out on page 47. This is a snapshot of the overall ILI influenza like illness data. So we're seeing it trending up, as it will every time this year.

Okay. Any questions? All right. 251148, new noise variances. Numbers are doing good.

We are starting you can tell that the temperature is starting to get a little more tepid. So noise variances are going down. But overall, it was a good year for the variance fee. I would say we came in right about where we thought we would, between $600 and $800 Some growing pains in terms of getting folks to understand that they need to submit all of their dates to get invoice to be able to get their noise variance for that. But we're working through that very well.

Any questions? Twenty five-eleven forty nine, Health Department Newsletter. Another beautiful newsletter. Thanks to Megan.

Yeah, nothing to really highlight here. I'm proud of all the newsletters that we put out. It's just an opportunity for us to share some of the things that we're working on, other partners, and so on. So it's just a nice opportunity to highlight that. In this one, we just talk about the access to services in some of the newer programs in terms of sending out birth postcards, something we did in the past that we kind of got away from with COVID.

So now sort of circling the wagons and what are the gaps and what can we fill in. And so when we can do those kinds of things, that's what we would like to do. And then meet Alison. Alison is the zero point five FTE admin support specialist that we brought in earlier this year. She's been an awesome member of our team. Really thankful that Allison is here.

Excellent. Any questions? I'm seeking a motion to adjourn. So moved. Second. Ruth Jones, is there any comments, questions? All in favor, aye. Aye. We are adjourned.