Arapahoe County Board of Health - Regular Meeting

Statewide initiatives and and putting our money where our mouth is with food insecurity and housing insecurity. I think we have to deal with health care insecurity. We're not calling it out as health care insecurity. Safely foster your kids. It's still insecurity. And I think that once we get out of this dark time, which we will, because we will, then I think we have to start talking about what else.

Very well said.

I have nothing follow.

There is there are no general

Do you hear?

Now I don't. Did they stop talking? Peer

accounts on the WIC core presentation by Heidi and Kathleen.

We'll get started then talking a

little bit about load.

Fairly said. Or yeah. Sorry.

Arapahoe County supports breastfeeding in many different ways, and one of the ways is through our breastfeeding care counselor program. Our program at Arapahoe County supports Arapahoe, Douglas, and Wilder Counties as well. Research has shown over and over that when parents are provided support by peers, especially those with lived experience, they tend to breastfeed. They breastfeed longer, and they have more confidence in their ability to breastfeed. And so these types of programs do help increase breastfeeding initiation and duration rates.

Our peer counselors are pictured here. They're all moms that have breastfeeding experience, and then they've also received specialized training to provide basic breastfeeding information and support in English and Spanish to WIC They provide evidence based information through text messages, telephone calls, and email, and they are available outside normal work hours, which is nice. So they're available on the weekends, in the evenings, on holidays when moms tend to have questions about breastfeeding. They can pair moms with breastfeeding experts if needed and also refer them to additional resources.

Sorry. We're having just an issue with the audio, so I'll have to click back to there

you go.

Oh, do you wanna

go further? Is that good?

Do what?

Is that screen good where you're okay.

Yeah. This is the next slide. These are just our our team really provides support when it matters most. When moms are really feeling vulnerable and needing kind of that cheerleader or someone to help them. These are just a few of the comments from our satisfaction survey, and I'm gonna read my favorite. One of the moms wrote that I'm so grateful in these moments when I needed it most and I didn't know what was happening to me or my baby. That informative message arrived calming my mind and bringing me peace. Thank you so much. Keep up the good work. You're a key support during postpartum.

You helped me and continue to help me immense ly. Sorry. Metrics that we track

Stop.

Alright. We're just having an audio issue. If we don't mind just pausing for one second, I'm gonna move the con this computer as far down as I can because I'm actually just using the mic the

computer mic right now. Here.

Let me see if I

can pull this out, New York.

Is he is he on speaker? Not the place.

Hey. It was working earlier, so I'm not exactly sure what I

oh, that's, like,

Is it it?

Okay. There's some I could click on the

and then you should have.

So this just lists a couple of our challenges. One has been, like, the case loads increasing without an increase in staff. The number of hours that your counselors can work is determined by the budget, so that does limit their capacity somewhat. So to work around this, a couple of things that we've tried to increase productivity and contacts. One is we've implemented a system only approach, and moms that are on system only only receive automatic general information text about breastfeeding, and they're not actively in contact with a peer counselor.

Families are moved to system only if they haven't responded to any text messages during pregnancy or for the first four weeks after delivery, so after that first month. Some moms just want to receive the automatic messages, and then if they have successfully breastfed before, we'll also start them on the system only. And then if they do have questions, they can always text in. They'll be put immediately with the peer counselor and can always be added back to the peer counselor caseload. The other thing that we've done is had peer counselors take over the required monthly follow-up we have for any family that has a WIC pump.

So we do those follow ups through text messages, and this has started conversations, increased contacts. And the other great thing is that that is saving WIC staff time. So they were having to do those before, and now we're able to do those through text messages. The other challenge is that breastfeeding rates are affected by a lot of external factors that are beyond our control. So we don't know the support that mom's going to receive at the hospital, at home, work or school, medical conditions that mom or baby might have, legislation, those types of things.

And so to kind of build a network of support in the community, we do work with community partners. For example, we facilitate hospital lactation staff networking meetings with staff to try to increase continuity of care between their hospital stay and then being connected with WIC. And then we're also active in the Colorado Breastfeeding Coalition, which does a lot of statewide initiatives, including a breastfeeding certification. They have a breastfeeding friendly certification program that medical offices, day care providers, and employers can be

a part of. It's part of

that culture. Text contacts count as one of those 11,000 contacts. So those are the the 11,000 contacts that you had, those are all human to human.

Correct. Those are two way conversations.

Okay.

They're not just sending text. Right. Yeah. They receive automatic text. They just have general breastfeeding information, and a lot of those are worded to elicit a response. You know, text one for more information, you know, those types of things to get a conversation going. But, yeah, those are our contacts of the peer counselor.

No.

Turn off. Sorry. Hey, counseling. We need

to talk a little about Wick.

Yeah. Yeah. Oh,

it went. Hey. Oh, wrong way.

Oh, I thought

it went.

Oh, yeah. It went up. It's

to go forward. Alright. So that's

quick turn.

So Sure. My favorite. So as you all know, we provide it's

really a

full range of resources and help to our families. So one on one personalized nutrition counseling to each and every participant that's on the program, breastfeeding support like Heidi's mentioned, which also includes we have baby cafes, those core groups, we have breastfeeding classes and a few counselors and a lot of so much help with that. Access to free and healthy food, so which is really great and that's what our families are coming to us for. And lastly, referrals to trusted community services. So we really do vet all these places that we're referring our families to that will support them in whatever needs that they may have.

Okay. And the first metric I wanted to share with you is we've got some data here. It's two years worth of data. The blue is 2024. The green is 2025. And you can see in green that our caseload has grown. So our caseload has been growing from year to year. The top yellow line is our target or our goal, which our goal was to maintain caseload, which we've we've we're there, so we're maintaining our caseload. And we do watch this metric for lots of different reasons. First, just to keep an eye on workload and capacity of our staff to support us with funding requests, either current funding or future funding.

And lastly, really to keep an eye on what's going on in the community and how it could be affecting our caseload. It could be policies like SNAP. If SNAP's cut, are we gonna see an increase in WIC? What's gonna happen with that? Economic issues, community things, ICE presence, all of that can really affect our caseload ups and downs. Okay. Good. Next one. This is the very same metric, so it's our annual average of enrolled participants. We refer to this as our caseload for three years of data in a line chart.

So you can see a really steep incline or increase from 23 into 24, it's pretty steep there into 24 and then it slowed down a bit but still increasing into 25. So our caseload, as Heidi mentioned, is just climbing, climbing, climbing. And so our challenge is, just as Heidi mentioned a minute ago, is that our caseload is growing. So our caseload is growing and our funding hasn't. And in fact, we've seen some dips, So we're trying to figure out how do we handle this caseload, and we're unable to hire additional staff to see that increase.

So there's a few things that we've we've done. So first action, of course, is asking for more funding from state and local sources, but there's only so much money. There's only so much money to go around and there's lots of high needs, so we understand that. We always are looking for additional income streams, like, else is there that we could get some money to help support staff capacity. But we need to be very careful with that because sometimes that funding, like a grant or something, might come with additional workload that would layer on top of what we're already doing, and we're already there.

So, you know, we gotta watch that. And then lastly is we looked into this wickhealth.org. So it's an online nutrition education platform that families can take self paced nutrition lessons and skip an appointment with WigStat. So this is where we really dived in, and it's really been a huge success. So I've got some information here.

So wighealth.org has allowed us to divert appointments out of our schedule so that they're handled on the platform and that frees up time for our staff to see the remaining caseload. It's also funded by the state of Colorado, so it doesn't hit our budget, which is great. They're paying for it. Yeah. We can divert our clients into the system, and the clients like it. It's very convenient. They can do it whenever they want, sitting, waiting for their kid at school or whatever, night, weekends. Typically, they do two lessons. They're only required to do one. So we know they like it because we can see they're doing more than

Mhmm.

Is needed. It let's see. So oh, so we did a really big deep dive in 2024 to really look at these numbers of this initiative that we're working on. So in 2024, just under 6,000 appointments were diverted into the system, saving we've got, what, one thousand four hundred eighty one hours. But that those hours could then be used to see the rest of our clients. So it's been really nice leveraging system with a savings of $71,000. And for 2025, we've even diverted more appointments into the system. So we're still going strong with this.

There's a question. Yes. What do we know about the efficacy of the work health? Is it meeting the needs of the the clients? We

It is all participant centered. So depending on a client can choose their own lesson and depending how they answer questions, it guides them through different sources and they're given websites and videos to watch and different resources to meet their needs.

And then it also meets the state need or state requirement that we have for nutrition education contacts per year with them, so that replaces that. So it's meeting clients' need for information that will be helpful to them and their family, but also meeting a state requirement of a nutrition education.

Contact. Yep. And it does fulfill that. Yeah. Great question.

Great question. It's not an income dependent. It's not patient's income that determines eligibility. Anyone could call up. Any referral could

Anyone on WIC.

Oh, anyone so they have to be on WIC

already. Okay. Yeah. Yep. And different states purchase it. So it's a platform that a lot of different states have purchased in tribes, and then their participants can but it's all WIC related. Yeah. So it's totally focused on the WIC population, which is nice. So, you know, the lessons are including information on pregnancy and infants, people picky kids, that's the that's the number one picked lesson that people like is feeding shaky children. Yes. Yeah. Think it's a common

Gotta get data systems on it. Yeah.

Check that one out. Yeah. Yeah. It's recipes, online videos. You know, like, everyone's watching, like, TikTok videos. So they have videos of things you could watch on cooking and, you know, to to try and keep up with what's going on in the real life world.

Okay.

So this is a metric we're using to track our initiative to see how we're doing. This shows the number of accounts that have been created by families. So to participate in wichealth.org, you have to create an account. So starting in 2024, you can see we just have 303 accounts, and at the 2025, over 1,600. So we really pushed hard trying to get families into it. It does only serve clients that speak English and Spanish. It's not in other languages. So we are still, of course, meeting with anyone else who can participate in this. You also have to be somewhat tech savvy. It's it's online, so and if a person isn't able to do that, then we, of course, would meet with them one on one.

But it's it's going well. And then my last slide, so our path forward so we can continue providing our our quality of service to our families is, of course, continuing to lean into wickhealth.org, really trying to get more people onto it who wanna participate in that type of lesson. And we've created an action team within WIC to look at clinic practices, any problems staff have with referring to wichealth.org so we can continue to streamline and save as much time as possible so that we can use that time to see our case load. We also have found a new funding stream, which is great, and it's through Medicaid. So we're billing for IBCLC work that our staff great our one staff person, Grace Perez, is already doing.

So she's already doing that work, and we're able to get some payment for that. And then the last action item, I'm gonna pass it back to Heidi.

And then the last one is just for peer counseling. We're creating a OneNote document with text messages on the most commonly asked questions. So there'll be little blurbs with evidence based links that can just be easily searched, copied, paste to try to make them more efficient. And those will be things that we can share with other programs. So, hopefully, there'll be things that can be used widely.

And those are also in English and in Spanish?

Mhmm. Yep.

That was it. Yeah. So more questions.

Have to give a huge shout out to nursing for help we've never built before, but thanks to their team. They really got us really being

able to really hard. With that and

great partnership partnership with nursing in order to get that going.

Any questions?

Thank you.

Thank you so much. Our

second study session item is an environmental health piece presentation by Kristen.

There it is. I know. It's frightening. Have a good one. Alright. Let's do it. Maybe.

Oh, and down goes. Oh,

and then.

Again, this is in account of mine.

Last October to just talk high level about what the process looks like, have everybody just have a good baseline. The beginning is going to be, largely a recap of that. We're gonna talk about the history of fees at Araville County. We did do some surveys tip of the community to try to get some feedback to make sure that the decisions that we were making when we're recommending some changes align with the priorities of the community. We're gonna go through those results.

We're gonna review the proposed fees for, potential board of health's adoption, talk about next steps, and then, obviously, if there's any questions, we'll address those. And feel free to jump in at any time. It's a lot of information. It's really complex. There's a lot of moving parts, so, feel very comfortable jumping in if there's any questions or anything I can clarify.

So a quick recap for retail food that's out of scope for our group, that is managed elsewhere, and they have recently been increased. They jumped about 25% for 2026, which is pretty healthy. Then 17% is planned for 2027 and twenty percent for 2028. Now this is what we're here to talk about. The fees for body art, childcare, swimming pools, and just general environmental health hour services are determined by the board of health.

We also will be talking about the OWTS, so, wastewater and septic systems. The real difference here is that you have the ability to include indirect costs when you're looking for the fees for WTS. We actually chose not to because that group of fees were larger and some of them had larger increases. We have the ability to, but for our purposes, we chose not to this time. For the history, we did not have any data to understand what things were gonna cost for us as we started as a new health department.

So we made a recommendation to the board of health. Hey. Let's just adopt the same ones that Tri County had. It was the best information that we had. We have not changed any fees since then with the exception of the retail food items. And then just for context, the CPI during that time, the last fees were changed in 2029. So between '20 oh, sorry. 2019 and February 2026, the CPI is about 22.39%, and almost all of our recommendations fall below that. There are a couple that are over, but they're typically over by less than a dollar, $8, $20. There's one that's about 200, one of the septic ones.

But, generally, we're actually under the CPI. Excuse me. Alright. So our approach to fees is the first step is we calculate what do they cost us to render. So we're looking at data from, you know, time that people have been tracking, fees that we're charging.

We then look at what the fees that we're currently charging are, and we're looking for our goal is a 100% cost recovery. It's not feasible in many situations. So we're trying to figure out what's the balance between how do we get as much funding as we can to support our services, but not have very large jumps that are problematic to to people. So when we're looking at these, we are looking at those deltas and trying to find that middle ground. And then if there are recommended fee changes, of which we have many, there are some fees that were not impacted, but it's, like, five out of the vast majority.

So and this is just an example. This is an actual data. So we're, again, by program. So for every individual program, the work that we need to do to render services is different. The amount of time that's required, the resources are required. So by program, we're looking at how much does it actually cost us if we have already charged some fees. So for example, if we have a plan review or other hourly fees, we're taking that out. So obviously, we don't need to recoup those fees. And then we're looking at how many units of whatever that, program were were completed. So we're saying our total costs, per unit,

basically.

And then because there is definitely a lot of variability year to year, we're trying to smooth out those differences. So we're not just saying last year, it cost this much. That's what we're asking for. We're looking at the history of the last three years, and we're averaging it out to try to just make it less volatile. Are there any questions about at least the how do we find out what it costs us piece or anything else, I guess, for them?

Community feedback. So that was one thing that we really wanted to make sure that we were considering is we have information from doing our work about what we feel are the priorities of the broader community. Are we correct? The amount of people that had septic systems that responded to our survey, zero. The respondents that could utilize child child care was only 9%, and the percent of respondents who have school aged children who might utilize schools was only 27%.

So and it was a small response also. It was not a large number of respondents. The importance of the various environments, it was pretty consistent. It was schools, and child cares were always at the top. Special event food kind of bubbled up and down depending on the question that we were asking. And then we asked specifically where is sanitation most important. There was a tie between childcare and schools, and then special event food came in just under that. And then we asked because we do need to subsidize these. Right? We we can't get a 100% cost recovery, so where we're gonna do that?

What what's our best place? Or where do they feel like it's most important? Number one was child cares. Number two was schools. Number three was septic systems, public pools, special event food, and then body art. And when we asked how important do you think it is to subsidize them, we got 20% saying that it was very important, 40% saying that it was somewhat important, neutral was 30%, and 10% were like, I don't care at all. This is not important. Not my problem. So we had more than we had 60% saying there's some value in this. This is something that we potentially wanna use our our funding for.

Question. Yes. Do we have information about how other jurisdictions, other county health departments are charging for these services? And do we compare our do we put that into context?

Absolutely. There's actually a slide later in the deck that will show that it has and it's it's emphasized because the way that fees are structured across counties isn't always the same. So we did the best that we could. So for example, for child cares, we do it by duration of care. Some do it by number of children or complexity of care. So there we did the best that we could, but absolutely, that's that's something that for the.

I think he did a really nice job with the survey. The survey came to me as a resident and took the opportunity to to complete it. I like how he set it up to be able to rank order Yeah. Where the priorities were. So I thought it was a really good good approach to teasing out where respondents were in terms of what was most important to them. And I also like those exercises too because I think it gets people to think about, you know, paying for a service, you know, through fees or whatever it may be in in recognizing how those dollars are used. So kudos on how that survey was set up.

Awesome. Thank you. I did have some open ended feedback, that is there's a couple that are interesting to share. So one said childcare businesses can't afford higher fees. So that was consistent with the data that we saw. I appreciate that the county is involved in keeping schools healthy and clean. And then this to me, I don't think it makes the argument. It hits me differently than I think that they intended it, which is different people have different health standards, and the government should not be imposing some people's standards on others. I feel like that's the argument for it to try to make sure that, you know, obviously So, anyway, it just struck me.

So, like, a vaccination or something like that.

Or he's yeah. Think that can probably embed into the septic systems because a lot of them out there

Yeah.

Are, like, learning regulation.

That's right.

But what what was the candidate in terms of the survey? Let's see. I did mention as well, but I can't hear you through that.

There were sorry. I got a frog. There were 20 respondents, but only 11 had, like, filled it up. Some people just, like, looked at everything and submitted it, but didn't actually didn't actually put any answers in.

Maybe I'm joking about the questions.

Well, it's funny. I have allergies, and my eyes have been watering. And I'm like, I'm very passionate about this, but I like

Do it my best.

Just like from the septic system, it's a little hard to get feedback unless, like, you're purchasing a home, which is most likely when you're likely to review the system. But if it's ongoing, you don't really unless it breaks.

You know? But other than

that, when you purchase. So I think those are just about the only two times that you could get a fee, but it was not related to

I agree. And especially because no respondents Yeah. Were personally impacted by that. Like, it's not surprising that but interesting, though, it wasn't last. Yeah. You know? Body art, you know, was generally last. So I I had the expectation because nobody had it that it would be. That wasn't that wasn't what we saw. Okay. So for the proposed fee changes, there are a couple of things that I wanna call out. We were trying to do several things. One is, for example, for childcare. We share school districts with Adams County, so it'd be very weird for them to have one fee for this school because it's an Adams versus Arapahoe. So we were looking at what other count counties are charging.

Also,

one of

the challenges that we have, and it's a significant challenge for the special event food licenses, is people tend to show up a day or two before the event. They're like, I wanna get licensed. And it's it creates a really tough situation for the operator. It creates a tough situation for our team so that we wanna we have to scramble to try to get everything done very quickly so that they can participate in this one time event. It's it's now or never, basically.

So in order to incent them to be a little bit ahead of the game and try to get them to apply earlier, we've structured the recommendation so that if they submit their application ten or more days before the event, they get a discount. So they'll pay $50 less than if they're coming, you know, in that last minute, you know, everything's hectic type of a situation. We do have some fees that are static over the three years. We have some fees that we're we're trying to step up to make it more more palatable, more more less impactful for people that are impacted by them. And also as we're looking at these fees, we're looking at was, is this a a onetime fee such as septic?

Is this something that operators are gonna have to pay every single year? So we try to be more conservative with the recommendations when it's something that's gonna be return recurring again and again. And then child care here for the four day less than four day inspection, we're only getting 23% cost recovery for child care, and that's intentionally low. It has been historically. But we also did a bunch of research around, okay.

Why are we gonna do, you know, such heavily subsidization for child care where we're not doing it for septic or, you know, body art or whatever the case may be? And one of the things that we really try to consider also was in the context of equity, especially in the context of childcare for situations where there's unaffordable childcare, it disproportionately impacts the mothers generally. So besides having affordable childcare being an economic driver of communities, there was also some statistics about, childcare in Arapahoe County, cost about 18% of annual income, and the federal affordability standard is 7%. So we're more than two x that. So we're trying to not add to the burden of the the child care providers to be able to render services.

And, additionally, it actually costs them more to provide care for an infant than they can charge. So they have to have more older kids to just keep the doors open, and there's zoning challenges. There's just there's a lot of headwinds in in running a child care. So we felt very validated both from the survey results that we got and just sort of understanding the broader impact on the community, what you know, why we're pushing more funding towards child care specifically. Are there any questions or yes. The per inspection, how many inspections does

a child care entity have annually?

Typically, it's one. Just one. Yeah.

What is a healthy building program?

That I'll I'll let Dylan take it. We don't have one. Yeah.

So you you live with traditionally industrial hygienists. And what we've tried to do here at Arapahoe County sort of shift the focus a little bit to a healthy building specialist, sort of connote more of focus on indoor air quality, radon, mold, lead, that type of thing. We tend to get a lot of complaints around that. So your report is still more on that. And we advertise as an industrial hygienist. You you tend to get applicants with a higher price tag. Right? They have a credential behind the name, and it's just a little harder to go in the door there. So this kind of includes more of what we're dealing with on a daily basis. So it's a slight twist on what you may be familiar with when you say doctor. K.

That doesn't mean that after a certain number of years, that building has to get a colonoscopy.

And this is the the slide that has some of those sort of stepped up increases. So you'll see, for example, for pools for recreational water, we're currently at $1.75 when we're trying to take smaller steps instead of having, like, an abrupt adjustment. One of the larger ones here is for the on-site wastewater new permit. That's almost going to be two x if we're able to adopt this over time. But, again, because it is that more significant jump, we're trying to just make it a little bit more gentle as we're easing it up there.

And even so, add that 2320 in 2029, we're still at about 70% cost recovery. So that that still doesn't get us to a 100%. So we're trying to find that balance between how are we not making it, you know, too challenging for people to be able to to support and also being able to have the funding to offer the services to rent other services here.

Those were individual homes? Correct.

Could be a business, but I think we'll stop in their residential. Don't think it's just one one part. It's not an annual fee. So Right. Exactly. And that it's so thank you. That was that was one of the thinking around this is this is a a onetime charge that as you're building a house or, you know, like, a use permit if you're buying a house is going from, like, 85 to $1.00 5. So that's, you know, much And that's, like, how

much it takes?

And they've got tanks and

Correct. That's

correct.

So I can make in the backyard. Yeah.

If it is, they're not gonna pass through. The cost of Yeah. It's a lot of data. Yeah. Thank you for printing that up.

Oh, long way.

Okay. And I did wanna call out that some were not changed at all or were recommending changes for. Some, we just didn't have sufficient data for. We didn't have coding for. Some, If we are able to sort of create some new codes, we can better track, some of that information. So not everything is, being suggested as as a change. There are some things that are just staying flat, and even one did go down. So for septic cleaners and installers, it was only $5, but it went down. You know? Down is always better than up if you're the the person needing to pay that fee. So

That's the meth methamphetamine per case.

Yeah. Thank you.

You may I'll next speak to

that briefly too. I think that's a vestige of trigemptase. Okay. Once upon a time, we actually did an on-site evaluation of amphetamines. We would allow we would actually swab, and we submit the samples for meth. But we're not doing that anymore. Okay. Independent contractor. So think she's at that stage. We left it on there just for Okay. Sake and clarity, but, yeah, we're not doing it. Okay.

And it was also sort of part of the prior process. So Right.

What's that? They're certified company. There's a whole host of them. Yeah. So you can contact anyone up. We'll come in. We'll do it for you They're pretty nutty.

I was gonna say that they don't charge for your No. Stuff. Doctor.

It is very

thorough. Very successful.

I do have a kind question kind of for the for the board as well. That's that last row on that that table around the the penalty. You know, when I think of the penalties, I've been in this space a long time. I think about penalties as a deterrent. You know, I think we've had at least one case in front of the board last year and a half related to this. And is this Krishna, is that a max that could be charged per day on that that penalties are correct?

I understand that it's just a flat fee. So per day, it's that. Is that how it was yeah.

So I do I do wonder, you know, if the if there's opportunities to have, you know, a max penalty, but also discretion to the board to to lower it or to eliminate it, again, as a deterrent or maybe an accelerant for someone to address an issue. So can I put that out for for discussion?

But what we did on the last case was we implemented the fee and said if they do complete it, we could waive the fee or lower it. So I think I like that idea to use it, like you said, as a deterrent. But then if they do comply, we have the ability to lower.

And and, Vicky, I agree with that. Is the my question then is also, is that current fee that that fee per day, the penalty per day, is that sufficient enough for a deterrent? I guess I'd ask kind of the the staff level too what your experience has been, and we haven't seen a lot of them. Yeah. But is that sufficient in your mind as a deterrent?

No. But I think we're locked in here because it's in statute. So if if we were looking to try to to move that, we'd have to get with some some of our friends in the legislature to do that, but there might be other methods that we could pursue in terms of enforcement, just through our board of health action, but through report action too.

Oh, thank you. Thank you, Steve. I didn't realize that that was a statutory limitation. Thank you.

You said it's up to 50. Alright. So we could it could be 20. It could be 20.

And that's what you see. Okay. Thank you. That's important.

You have numbers associated with an over average of these permits per year?

Oh, I have those numbers. They're not top of mind.

No. Just just because Yeah. Absolutely. I would feel the relative value of each of these things in terms of the actual money in general.

Sure. I I I could speak to that. I did do the calculation based on the twenty twenty five counts of everything. And in 2027, it would be about $37,000 of incremental revenue. 2028 would be about 58,000, and then 2029 would be about 78,000.

And there was the question earlier about how does this stack up? And things are really all over the place. So Boulder is typically, you know, significantly higher than everybody else. And others are a little bit of, all over the place. We did reach out to Boulder to try to understand a little bit about why are they so high, and they calculate their, cost of delivering services a little bit differently.

For us, when we're looking at hourly fees, we're looking at environmental health spin specialist too, the midpoint, and we base everything off that. They're actually looking at the actual salaries of people currently employed at the time, and they because of where they live, their compensation tends to be higher. So it's it's just a little bit different, but we've chosen to use the midpoint of that salary to have some continuity, not you know, we don't want it to be variable based on but we've got a bunch of senior people on our team right now, so this this is gonna cost more to the the public or, you know, we got a bunch of junior people. Again, we don't want all that volatility. We're trying to keep it as stable as possible.

Actually, it's all proven. Really

is. Wouldn't some of those, like, with the the septic system, would that be based upon whether or not the areas are more urban versus rural? Because if they're more urban, they're less like I mean, I think rural have to take into consideration those costs because the residents might be complaining a lot more of this. Because it would be interesting to see some of the others. Like, I know Wells has a lot of rural focus in like, El Paso County has some, but mainly it's Colorado Springs. So some of, like, the rural counties, that that is the biggest issue where people are complaining. So I would argue, like, with ours, we're not gonna hear too many residents because just the number, the majority of ours tends to be urban.

Yeah. The the this table is really interesting, and I I had the pleasure of the the preview on this. And and I think we actually maybe, you know, in back in back in March. And and you could spend so much time kinda looking at it and to decipher why different counties do different things. But, you know, I liken it to when I lived in Washington State, and I think it was our the car registration was just astronomical.

Like, that number can't be right. Thought they missed the decimal point, by way, to two places. But, you know, different municipalities and jurisdictions collect fees in different in different ways. And so I think that's probably as Chris was saying, it's reflected too in just different ways that different candidates approach the the fee collection or policy decisions on how much of a program I could subsidize or otherwise. So it's interesting to see, but it's so hard to compare, in my mind, apples to apples because they are so different than how the county's approaching.

Well, you brought up a surf point because that you have a car registration. Colorado does charge a lot if you come from a state with a flat fee. So flat fee might be $85, whereas in Colorado, it's 1,500. So yeah.

Another Mhmm. No. My.

I just wanna Yes. Like, it's something I expected. But I guess I have two questions. For body art, is it the artist, or

is it the entity? It's the studio.

The studio? Right. And then

Sorry about that. Some people do actually assess a artist. Okay. But we just do national studio.

Okay. You we do the studio. And then I assume that this is in your, like, analysis of this. What is the breakeven of, like I mean, it's body art because I'm talking about it, like, the body art studio seeking licensure or not seeking licensure because since, like, doing it under the table because fees are high, and then potentially opening it up for bad public health outcomes.

Sure. And they've they have found several of those. So that's Yeah.

Increase. Most artists agree with the fee because it lends credibility to the industry.

Right.

So while we do some see some underground operations, it's not very common. The ones that we do see, often know what to write about, either by other artists or people in community. Because it's all on social media. Right? So they come only on this long. So we do find out a lot. Yeah. So it's rare. Okay.

Yeah. Thanks.

So there's a lot of body art right on the inside of JETCO. We can't expect that.

Far as the timeline and next steps, so, obviously, we've walked through this today, and we've made our recommendations on what we would love to have adopted. Next month where we have an opportunity to if there's any questions or additional data or things that we want you know, obviously, we can have some back and forth and make sure everybody has any questions or concerns they have addressed. And then we're planning to come back in June to seek approval for those fees. And then the effective date for these, should we be able to adopt them, will be January 1 year.

Sure. So we go through this process, and we do we adopt these fees. And then things get even tighter for health and for whatever reason. Federal dollars comes here. Can we do the same thing and change it? Or once we do this, we're kind of on a tweet as well.

We can do it as often as we like. However, our plan is to do it every three years. We are gonna look every year. And then if we're seeing outliers, if we're seeing challenges, we'll come back. But our our expectation right now is that in three years, we'll look through the process again, barring something love.

I really wanna commend Kristen Kristen and others for the the work over last four, five, six months in here really taking a lot of time and care. I know Dylan, Steve, Michelle, and others have also and probably many of these behind the scenes have really Really?

Yep.

Plugged in, I think, the analysis to to come up with these recommended figures has been been intense and really appreciate, again, some of the comments that that I had. I was looking back in the notes, some of the preview of the slides back in March, and we appreciate the sensitivity in there. I think the one thing that we didn't talk about today is also recognize sort of the workload of staff. I mean, there was a discussion, I think, back in October about, like, a sliding scale, you know, recognizing some some equity in that space, They're balancing that too with what it would take administratively to do to do that. And, again, just really applaud folks for for taking time in that space.

So thank you so much. Yeah. No. It's very supportive of the what's been created here today.

Any other questions? Thank you, Chris. Thank you.

Thank you.

So we're gonna move to our third study session, which is the legislative update by Jennifer.

Okay. Oh, Oh, yeah. They sent or they sent about.

Yesterday. There are three bills that I wanna put this on that we continue to launch and celebrate. The first, which I don't know that we've talked about is we did not take a position, but we've been watching it because we believe it's a good bill for equity and for maternal health, specifically black maternal health with in which maternal health outcomes in black women and babies continues to be the worst. And this bill did pass, which is fantastic. It passed yesterday, and it advances equity in maternal health.

It mandates training, cultural competence, and bias for obstetrics. It focuses on collecting data and feedback with through standardized surveys, which CDPHE already does, but should be doing. I think CRAMS may have taken a break. I cannot. And then requiring facilities to report incidents. So it did I'm just glad to see that it passed yesterday. And then the next one is yes.

Is there a fiscal note attached to it?

There was no fiscal note. It was zero. There it does create a it could create a fund. The the bill, a lot of the language references, if money available, if funding available. So it has that out, and the the fiscal note attached was $0, zero FTE. So that has a lot to do with when surveys get done and when they don't get done. But at least the legislation has passed and hopefully will get signed into law, but it opens the door for that. And I think puts attention to black maternal health, which

I think is what's important.

And then the next one is house bill ten thirty three, expanding cottage food act is still hung up in appropriation, but we do and we do expect that it will pass. There was a carve out. Our understanding and what we hear is there was a carve out for the raw milk bill that was never introduced. That fund, it was, like, a $179,000. Got that's the exact amount in the fiscal note for Cottage Foods. It was a $179,000. So we do believe that that money just moved from one to another. Mhmm. And because it was a carve out, it we anticipated passing. We're just expecting that it will so that we can plan for that.

The good news is that with a lot of the advocacy and the back and forth and testimony, it is limited to one food item up to five varieties, five flavors. We still haven't seen the exact language, but we do believe that it is one item because before it was unlimited. One item, five flavors, so that limits risk. So we keep watching it, but that's what we're expecting.

I have another question about the I'm conscious of setting that back. When is that gonna actually pay for this? There's so little money. It's not like they're gonna pass it out to you, or we're gonna get to have

No. It won't come to us.

No. And And charge a fee? Like, are we gonna

It's earmarked for the state to keep track of the various costs we've been in. Initially, it was bond outbreaks.

Know, due to $150,000.

Which we think is a gross underestimate, but it's something.

So and part of our testimony was the cost at the local level. Right. But And these

are people who get licenses. Right. You know, we don't get to stick them in our other bucket and say it's $35.

No. We do respond to complaints, the outbreaks, so there's certainly a cost.

It's you know, it is hard it is hard to if you become ill, remembering that you bought, you know, from it it's harder to track down, which is part of it. By at least one item makes it better than the limit on the.

What what's the the thought process about, like, one out of five minutes? I'm trying to imagine, like, you know, what what that one item is.

Right. The thinking is is you introduce more food items just increases the risk. Right. So if you're focused exclusively on tamales or burritos or tortas or whatever it is, then there's less going on in that domestic kitchen. Right? And it just flavored slightly differently. So it's a vegetarian, as a pork, as a chicken, and a beef as opposed to pizza, tamales, or all sorts of things. Mhmm. So it it limits the risk to Jennifer's point to a certain degree.

I have a question. You know, when you go to a football game and there's all these people with the coolers, and all the pizzas.

It's essentially many of them are licensed prepackaged mobile vendors. So they do some of them are, but some of them are just you know? Like, you don't know. Okay. You can ask for a license.

You know? Yeah.

Well, I'm just

so so glad I made. That's something.

But those people work. Yeah.

No. No.

Yeah. They're they're. They're.

And

the last one that I want to just celebrate is the senate bill 32, which was promoting immunization access. So thanks to doctor Erbina for testifying on our behalf. It was signed into by the governor on the March 27. So, yeah, that was a huge win for public health. See if we can

so you can then he signed it, and they didn't just let it Yeah. Absolutely. Be calm. Yeah.

No. We we'd be we'd be we'd them

unless they each other, but that says something. That is signed up. Yeah. It's good.

When you get the update on the platform of health, I I I picked up, and you can correct me if I maybe there's something newest about that getting approved, especially in light of, like, governor's meeting was signing that last bill, letting it get immediately go to do it. Thanks. So is there concerns that that bill won't actually go through the effect? It might get vetoed? Or No.

I haven't Okay. Heard that there's concern about that. I'm I it just yesterday passed its third reading or hearing, and so now it moves on. I haven't heard that it won't be signed or that it would be vetoed. I doubt it.

Okay. Because

there's because there's no fiscal note, there's no and it there's already legislation in the state or legislation that approves the state health department to collect data and do surveys. This just expands it to training and penalties and if if it's like, if there's injury, deliver injury. So I can't imagine that it wouldn't get signed.

Great. Thank you. Yeah.

So how does this bill in practice change what we do? That that proverbial we No. No. That's

do. Maybe

what changes for us?

Probably not, like, for public health that we would see, but in, like, practices, OBs, it's there's more focus on training and awareness and understanding biases and how treatment is provided to moms and babies and families. So it's and how that happens is I'm not I'm not sure. Like, who provides the training? Who's tracking that? How are they monitoring and managing, and how are they, you know, looking at outcomes? That I'm not sure how that will all play out.

Yeah. From my understanding, Terrence, I haven't seen any interventions from improving it from the data standpoint or practices. I've only seen, like, improvements from the source, like doulas or other sources tend to have better delivery, outcomes versus because we they've that's been an issue for twenty years trying to find that disparity has been there, but trying to nail it down to a cause. I haven't seen, you know, anything, leaking it, but they have seen a lot of improvements with use and do with some of those things. And so that's why, they're even approved for Medicaid, and so a lot of places have great outcomes with those.

And the bill language does include, having a birthing partner and doulas. There's language in there specifically about doulas and, like, expanding care. So Yeah. It and Brianna's just letting me know. No one has registered in opposition. So So to

to answer your question mark, I I don't think there's much opposition to this bill. There's no registered opposition. So

how it actually gets implemented and what outcomes we see, but at least it it is setting it up to have some teeth. And now who holds it accountable? I'm not sure.

Yeah. And that one even varies by income, so that's one of the only statistics that varies every college socioeconomic status. So that one has has always been puzzling from a health perspective or, yeah, health management perspective.

Yes. It's hard not to look to to bias and delivery of care. I mean, I'm reminded that Institute Medicine study from many years ago that talked about bias and, frankly, just racism in in the space and and what that meant for health outcomes. So, you know, to Jennifer's point about implementation, I think that's gonna be absolutely, you know, critical. So I do think it's a good next step. I think that actually looks like to address bias slash racism in the system. Okay?

Mhmm. Mhmm.

That was it for the legislation.

In how many cases, that's in the session for people in Canada.

Oh gosh.

It's like a month. In the month.

Yeah. Yeah. Yeah. Less than 30,000.

Yep.

More trash. Thank god for a lot.

Yeah. Because we have

one final study session is to hear the director's update,

Excellent.

Thank you. And if you noticed in the packet, Hannah has reformatted the director's report to be hopefully easier to read. For here.

Yeah. Been So

first, our mission moments, talking about things that we do license and that you can trust in eating is our mobile food truck review. But the review process. So this has been a continuous quality improvement process for some time. But with Kristen and the team really looking at and Michael Roy from our food program, really looking at how complex and how challenging and difficult it was for mobile food trucks. And so they've done a lot, but the average timeline improved from two months to three weeks.

Wow. And that was in part of, like, removing jargon. Like, everything was just so legalese and governmentally using plain language, greater accessibility, so doing more in English and Spanish. And then we also have staff available available for English, Spanish, and Russian. They've created checklists, very customer focused.

And then just a a story when applicant recently, they went from application to license in five days. So they were able to get the support that they needed, the online help, and this was a Spanish speaking individual. So the team has really made massive improvements, which, you know, results in people getting out sooner and making money. So it isn't just the time spent, but it's economic vitality.

Along those lines, we Jennifer and

I had a conversation when

the incident happened with another health department as it pertains to the food truck and the employee. And the question came up, what would we do as Arapahoe County? And so just if anybody is interested, my personal recommendation will be, hopefully, nobody representing Arapahoe County would behave like that and that we take a different approach to to residents, irregardless of what they're doing and at the point that don't work. Then we have Steve who's a specialist in working with. Right, Steve?

So we bring him in. But it it not just my perspective. But I, you know, I think we have a duty to treat residents the same way we would treat anybody else and try to do our best to work with them. So that was just my personal recommendation, but I didn't check with the other board, but that had made the news. And so Yeah. I wanted, the staff to understand where we stood on something like that if it did emerge.

Our goal

to be in the.

That's exactly what we're doing. Thanks.

So that that so, yeah, point exposed to a little CPHRAs with CityCain again. That that program may be. Don't know what else public about that vendor, so I'm be cautious in my words here. Yeah. But to say it was not the first time that there were issues.

And, you know, Rami, for example, left out for many hours on end and so forth. I mean, at some point, there's a true public health friend right now. That individual, that inspector, highly respected, very good at her job. I won't put staff on the the spot here, but, you know, at point, you do we do we take steps? And I've seen we recall that this board made some decisions about cease and desist on the septic system. That doesn't feel too different than, in essence, a forced cease and desist on food.

Mhmm.

So I think that the situation was unfortunate, but it it's I think there's some incidents where public health threat is great. And when you when you have the intractable situation, there are our other steps. So I I hear what you're saying there, but, I mean, this board has decision. I think this board has made in this space. We opted for a cease and desist because we saw the public health threat, and I can't speak for the public health investigators in that situation.

But my sense is they too saw a public health threat and took steps that they thought was warranted. And I'm offering those comments not as a city of Denver employee, but as a protector of public health and wondering, you know, at times, steps need to be taken to protect public health. So And

I would argue in response I would agree. So the question be for me became, would that stop somebody from serving food? You just say and I would argue no. And I think, like you said, there is no perfect answer. I do like the way Steve presented his case and and really saying, even when you're working with them, what happens when they don't listen or they're not compliant? In that case, do we turn into the public health bullies? We're basically saying, we're gonna make you even when it's publicized, we're gonna make you shut down. And so to me, I I think government has came into communities and took that approach where we're gonna make you do something. And I would argue it just causes people, especially if you're running business,

to push more

of that.

So not to say that it's right or anything, but that's my personal belief. Meaning, the more you push people, I don't think they're gonna be willing to comply. So I don't think by doing that, I think it would just force them to go down the street and set up again and again, look to see when public health is coming. And so nothing is right or wrong, but I think, like you said, we don't talk about values enough. And so in the case, I wanted the committee, even staff, to be clear on where I stood.

And like you said, if Jennifer had a different perspective, I would support Jennifer as a director even if the my fellow board member said, look here, we would like this. If I'm in a minority, I support the larger board. But I wanted everybody to know because because a lot of people had asked me, you know, publicly, hey. We're I said, this is where I stand personally. Like you said, if I knew them and the staff if I knew the staff person, might have I've taken that into consideration and how they responded. Absolutely. But just optics and then the social media

Oh, yeah.

It is very hard. Because once you put something out there and once you proceed, they already proceed public health in a certain way. So I think we've worked very hard to maintain a positive relationship with the community and repair like a lot of what was done after COVID really tell, you know and so for me, perception is also important in saying we got to be caught similar to law enforcement or safety, really cautious with how the public perceives us. And so that was another thing I can make.

Yeah. No. I I totally agree with all that. I guess the last comment I made too is I think about all the in this case, like, food vendors that are doing the right And the responsibility, I think, that we would have at, say, a local public health agency to ensure a level playing field, you know, that you've got a vendor, for example, who is is taking the time to make sure that their food is at a proper temperature or whatever the issues may may be. And by allowing knowing about multiple times for a vendor to be out of compliance, I mean, it does create that that unequal playing field in this that's also not equitable.

It's not equitable to those who are doing the right thing. And so there's no easy, you know, answer to this. This one was really complicated for for sure. So I I think both perspectives are are accurate and are true, and and I I don't have any anyone who's in a a kind of situation for sure. So, hopefully, the Republic Health is not after encounter something as severe as the Denver case, you know, but it's possible. And then there will be some. Yeah.

We have some challenging cases that we are currently working on, and we've you go through and look and work very closely with Monica and others so to make sure that we're doing it within our values and within what tools we have. And if something were like that were to happen or come in front, like, may not be at the right time of a board meeting, so I would be reaching out to you. So that would be you wouldn't see that on the news or social media, but it moves fast.

But we

we do try to get ahead of that, and we do live our values with really valuing relationships and education first. So not to say that it couldn't happen to us that, you know, it could escalate to that point, but we do lose every other.

Thank you.

Thank you. The second mission moment is about our resource finder. So this is an internal tool that we have created, and it was a huge undertaking. And it is just a a significant impact of our ability to work with our clients and get them the resources they need. So it's called it's a resource finder, and we use Airtable.

And there's eight staff members across four divisions, so the whole department is has collaborated on this. They have vetted information for 482 organizations and over a thousand programs that are available in our community. And it's an like, a online platform that you can go to if you're looking for food resources. Like, all of the options in the community for food, the housing, clothing, car seats. You name it. It's a I think Penny was the one. It's like online shopping.

Like, you

should filter. Like, I need mental health resources for adolescents in this part of town by ZIP code. So it's it is an incredible tool. Can you send us a link to

how do we how do we send it? Oh, it's only internal.

It's internal. Internal. But I was gonna

reach out to Allison.

So yeah.

What's the difference between that and the Aripasource Yeah. Resource under?

It's a little it's very specific to and it's a lot easier to use for us.

Yeah. Okay.

And Aripasource, like, this one, we know the accountability of keeping it vetted and up to date, and we think or had heard Erapisource may go away. I'm not sure. But this was something that, you know, we needed internally to be able to to work on these. And now we have brought on we're we are working with City of Aurora, and we are may pilot with another department of the county community resources. How depending on how that goes, we'll see how, like, how big it can get.

But it was piloting with another. Because it takes training. It takes you have to be committed to it, and we need help with vetting because organizations and information changes constantly. And that's why keeping any kind of tool is hard to keep up with. Yeah. But there are others out there. Two one one and then my friend Ben. I think that's right. There's a. But this one was really specific because it's easy for staff to find out about something, vet it, and put it in. Mhmm. So just wanted to share, like, the collaboration and see it. Yeah. The tool's been really useful for staff to help, like, quickly connect resources.

Will they do a demonstration, like, during Yeah. Like a part of They would

love to. Yeah.

Absolutely. Okay. Let me think.

We could do that. Okay. Sure. We'll look to see when we can schedule that in the tummy, whether it's during the business meeting or during the informal session. Cool. Okay. And then moving into just a few updates within the report, one that I'm super excited to share. Arapahoe County, we were selected as one of 12 Mhmm. Teams nationwide for a competitive public health leadership academy through the National Association of Counties, NACO, that has partnered up with the Beaumont Foundation. And we just learned about it last Wednesday, a week ago.

And so it'll be commissioner Warren Goley and myself as the team. Don't know who else has been selected. I we haven't I have heard we received no other information. It goes from now and through, I think, August, the August. It's online webinars and then a visit to DC. So we have to select a public health issue to work on. We our our application was rebuilding trust or building trust. Mhmm. Accelerating trust in government. So not just public health, but it is a public health issue when and when you're thinking about government and trust in government and trying to fund government.

Mhmm. And so we had heard that it was super competitive. In fact, they were delayed in giving announcing the awardees because they had so many applications. But we'll learn more in, like, I think next Tuesday is the first kickoff. So I'll have more information at the May meeting, but we'll doc or doctor commissioner Warren Bully and I will be headed to DC early June.

So Oh, good

for presentation. Yeah.

Really excited. And working with the Beaumont Foundation is amazing. If you've not worked at the moment, phenomenal. So I'm excited to work with them. And then I wanted to share that we had we received an invite from senator Hickenlooper's office pulling together metro public health departments or agencies to meet with senator Hickenlooper on April 8.

I had a conflict, so Brianna and Heather went on my behalf. And he very specific topics that he wanted to address, immunizations, measles, wanted to talk about the ICE facility in Adams County, so that was very specific to Adams County. But I don't know if there's anything that you would wanna add about conversation. I think his his goal was really to find a better way to tell the story,

and so he was very open to hearing the data points. And so we talked through, like, the measles response and the state had compiled a report on that. And so he took that information. He was taking very, very detailed notes. So I think it was it was refreshing and, helpful to see him looking for a better way to tell the story.

This is the first time that that public health has been convened, especially by from some of the, like, the movers office. So there it seemed like that might be an annual thing or happen again, but so let's see. But Adams was it was Adams, Jeffco, Arapahoe, Denver, Boulder Which was kind of represented. Oh, yeah. And then the state health department and Douglas Counties.

So definitely metro focus. And then the last thing under administration is I wanted to give kudos and props to the team, Penny being one coordinating verbal judo for all of our staff. So we've we've approximately 95% of our staff. So we're a team of about 200 employees. That's a lot of people to coordinate and organize into small training cohorts.

We had two different trainers and one who is a nurse, so very focused on the health care, spoke well to that you know, our our nurses and WIC educators. That was the one that I went to. And then another individual who more regulatory, So our folks were in that one. But I think we still have another training left, but most of it happened last week during public health week. So it's just really if you're not familiar with verbal judo, it's deescalation.

Mhmm. And as you can imagine, all of our staff are handling and and managing people's emotions. Like, when they're coming into us and they're needing food or they're trying to get a license, there's a lot of emotion, and it can escalate quickly. So verbal judo is a a way to deescalate and try to get to resolution, not just calming, but in a way to get to resolution. So it was paid for by emergency preparedness and response funding, so we were really appreciative to be able to bring that up.

Thanks for the coordinating because it was a lot to coordinate. And then moving into just a a few updates in the report, wanted to call out Inglewood is working on an age friendly action plan. Mhmm. So Melissa has been asked to participate in the next phase of that. So meetings will be May and June. So that is exciting to be we've heard that this is coming. They put out an RFP. They're working with a consultant. So we're excited to see where that goes and how we can work with Inglewood to do more around age friendly.

We're not

here too, so I can

Oh, good. Also participate with that.

Excellent. Bring it all back

to the Arapahoe County Public Health. Yeah.

Thanks. That's all we can talk about. Right. Yeah.

That would great. And then we can just open up if you have any questions specific to the report or anything that I may have missed from the team. But I wanted to highlight, we we use Qualtrics. So when we started as a health department, I had gone to a conference and got sold on Qualtrics. I was like, oh, this is really cool. We gotta do this. And the opportunity was as a new health department, like, we need this for something. And but we have used Qualtrics for just about everything. We use it for our employee pulse surveys. We use it for community engagement. We use it for forms and, like, all kinds of things. You are using it. Right.

We're doing contact information updates. We're transitioning to a more user friendly version of the forms so it's easier for people to be more mobile friendly than what we have in our existing tool. So we and we do

a lot of unique things with call trucks too, and there's a there's an annual conference. And Julie Ross from emergency repair well, the HPR division submitted an abstract. It was accepted. And so she gave a presentation at streamlining public service, the digital forms revolution. So that's how we've used a lot of Qualtrics to reform forms.

Mhmm. And it's it was well received, and some of the comments were that it was the most applicable session they participated in. Somebody said it was probably my favorite session just to be able to brainstorm it. And I the first time we sent stuff to Qualtrics, it's very different from other, like, public health government sessions. Like, they had a concert. It's huge. It's very different. Mhmm. And so to be able to present there, to have our abstract accepted for the work that we're doing here in Arapahoe County was pretty significant. Really cool.

Did you see that?

It was in Seattle? Mhmm. Yeah.

Yeah.

Yeah.

But just really proud of the work that we're doing and how we use the tool and how we've been able now it's got this a great AI component that can help us really work with the data because we do get a lot of data from it. So just wanted to share that highlight as a fun accomplishment. Mhmm. That was it. Any questions or anything else that I may have missed?

We have so many candidates for our new CMO position. There's so many. Right?

I can do

I can do

I do. I do. Do. We have

as of yesterday, we have six, and it is closing tomorrow. So I get a few less under the wire, but we, as of yesterday, have six. That is a great lead in because I do believe we were going to ask if somebody from the board wanted to serve and represent the board on

an interview panel. Mhmm. I would

like to do that.

Okay. K?

Okay.

Thank you. Thank

you. You won't even have to volunteer. You won't even have to

Should I wear your new subcommittee?

You're on.

We'll get with you on the on timeline and all the county process.

I'll be here.

Thank you.

I appreciate it. By your minutes.

And then I just have a couple, like Yeah. Other updates that are not part of the agenda Yeah. Just to as preparation. So the May just to lay foundation, our two to three session in May, we are going to use that time. The majority well, I don't know how much of it we'll need, but it is to talk about budget.

Mostly just prepping for the June meeting, which is when we present our budget, but it it's really more of, like, what we know for funding right now, what we don't, how we're planning. So no formal presentation. Obviously, nothing that needs decision, just discussion and to bring you up to speed. And then I don't we'll take as much time as you need for that. And then we'll also we'll figure out when we can do a demo of the resource finder because we may combine that, the two, but we'll see.

In June, we are doing the two to three session is the predictive index training, and that will be the full hour. Leslie Myers from HR is gonna be doing that training. She's lovely. Prior or just before the the May Board of Health meeting, you should be getting a survey link, an email from Leslie Myers with the link for the predictive index assessment tool. And Hannah will send out reminders just so that you remember, and it it doesn't come across as spam.

If you

don't see it, let Hannah know in case it did go to your spam. The link will be live for seven days. So once you get the email, you'll have seven days to complete the survey. We'll send reminders if for some reason you're not able to get to it in seven days. Leslie can send you a new link.

And then she'll have all the results and the analysis, and we'll plot it out as a team. So the team will include the seven of you, Nonika, me, and Hannah so that we can see how we all work together. It's it's an interesting if you've never done predictive index, it's different. It is a behavior assessment, but it really does look at how you work as a team and how where your strengths are as a team. And and then, I mean, for us, when we use it, we use it for new employees and or for new candidates before we even actually make the offer to see, like, what is needed on the team.

And it can also help, like, identify where teams where they're like, if the team is all in one area, then we need to make sure that we're pulling in resources to help in other areas. So it'll that should be fine. So just as a reminder, mid May like, before the May meeting, which is why I'm sharing this with you now, you'll get that link, the survey. And should you remember, her name is Leslie Myers. It won't be coming from either of us, so you may not recognize it. But if you get it, you can trust them.

And

I'll remind you when I send out. Okay.