Members | Thursday, November 20, 2025 |
Devon Reese, Chair | 1:00 p.m. |
Clara Andriola, Vice Chair | |
Paul Anderson | |
Michael Brown | Washoe County Administration Complex |
Dr. Eloy Ituarte | Commission Chambers, Building A |
Steve Driscoll | 1001 East Ninth Street |
Dr. Reka Danko | Reno, NV |
Vice Chair, Clara Andriola, called the meeting to order at 1:00 p.m. Members present: Clara Andriola, Vice Chair
Michael Brown Dr. Eloy Ituarte Steve Driscoll Paul Anderson
Dr. Reka Danko, joined virtually at 1:32 p.m.
Board Member Brown led the pledge to the flag.
With no requests for public comment, the item was closed.
Special recognition of Dr. Danika Williams as the DeBeaumont Foundation’s Class of 2025 list of 40 Under 40 in Public Health.
Erin Dixon congratulated Dr. Williams on her commendation.
Years of Service
Heather Holmstadt – Public Health Investigator (PHD) – 15 years 11/08/2010
Andrea Esp – Preparedness and EMS Program Manager (PHD) – 10 years 11/12/2010
Kara Roseburrough – Clinic Office Supervisor (CCHS) – 10 years 11/16/2015
Kaleigh Behrendt – Senior Public Health Nurse (CCHS) – 5 years 11/9/2020 Ms. Dixon thanked staff for their years of service to the community.
Health Heroes
Milissa Schaeffer – PHD – Collaboration
Andrea Esp – PHD – Compassion, Trustworthiness
Julieta Gallardo – CCHS – Adaptability, Compassion
Marisol Martinez-Avila – CCHS – Collaboration, Compassion, Inclusivity Frenchie Rubio shared congratulations to the Health Heroes for their awards.
Possible approval of October 23, 2025, Draft Minutes.
Recommendation for the Board to uphold an uncontested violation issued to JC Golden Mesa, LLC, Case No. 1579, Notice of Violation No. AQMV25-0017 with a
$500.00 Administrative Penalty for failing to obtain a Dust Control Permit prior to the commencement of a dust generating activity.
Recommendation for the Board to uphold an uncontested citation issued to Smith’s Food & Drug Centers, Inc., Case No. 1585, Notice of Violation No. AQMV25-0018 with a $500.00 Administrative Penalty for failing to comply with vapor recovery testing requirements in Permit to Operate No. AAIR16-0800.
Approve the Subgrant Agreement between the State of Nevada, Department of Conservation and Natural Resources, Nevada Division of Environmental Protection (NDEP), Bureau of Safe Drinking Water and Northern Nevada Public Health, effective upon NDEP Administrator’s approval through September 30, 2029 in the total amount of $262,000.00 (no match required), in support of the Environmental Health Services Division (EHS) Safe Drinking Water Act (SDWA) and Residential Wells programs; and if approved, authorize the District Health Officer to execute the Agreement and any future amendments.
Recommendation for the Board to approve the Interlocal Agreement between Northern Nevada Public Health (NNPH) and Washoe County School District Nutrition Services to provide a tasting component for students participating in NNPH’s school-based program, Power Up Kids, agreement not to exceed $5,000.00.
Recommendation to approve FY26 purchases in the approximate amount not to exceed a total of $215,000 from Merck & Company Inc. for vaccines in support of
clinic operations on behalf of the Community and Clinical Services Division.
Acknowledge receipt of the Health Fund Financial Review for October, Fiscal Year 2026.
End of Consent Items.
Barry Duplantis shared that REMSA Health met and exceeded franchise response compliance for priority 1 calls for all zones for October and the year to date. During October, there were 8,500 P1 calls, with 5,542 transported to local facilities. The customer survey report showed a score of 93.73, with the highest scores as cleanliness of the ambulances and the person driving.
Mr. Duplantis recognized Bryant Hines and David Biggs for displaying decisive initiative on the scene of a behavioral health call. After responding to the scene, they acted quickly and transported the patient for additional care. Their actions transcended the call of duty and showcased a level of skill, calm, and compassion that exemplifies true heroism. They were provided with a commendation medal for their remarkable service.
Wes Rubio noted that this presentation is the result of a request from the Board for a summary of the 2025 season. The Mosquito Abatement Program includes several core functions: responding to service requests from the community, conducting surveys and treatments, performing adult mosquito surveillance, and providing public education, along with limited support for other vector concerns such as rodents and rabies-related services for Animal Services. Service requests include inspections, mosquito abatements, and deliveries of mosquito-eating fish. Survey and treatment activities encompass field inspections, larvicide applications, catch-basin treatments, and documentation of all activities through GIS mapping. Adult mosquito surveillance involves setting traps, retrieving them, identifying and counting mosquitoes, and submitting samples for laboratory testing for mosquito-borne diseases.
In 2023, the program received 99 total service requests, of which 65 were mosquito-related. Staff completed 52 mosquito abatements before the aerial application conducted on July 18, and 17 mosquito-fish deliveries. In 2024, which the program designates as a baseline or “normal” operational year, there were 63 total service requests, including 31 mosquito abatements, mosquito-fish deliveries, and 19 other surveillance and treatment activities. In 2025, the program responded to 96 total service requests, including 57 mosquito abatements, additional mosquito-fish deliveries, and several other vector-related requests.
Larvicide and field-treatment efforts included 650 site visits and 478 mosquito-control treatments across the county. Staff also completed 17 mosquito-fish deliveries and treated approximately 4,000 storm drains. All sites were documented using GIS tools to ensure accurate tracking and to support operational planning. Mosquito surveillance in 2025 included 570 trap collections. Surveillance focused on established trap locations to maintain consistent long-term data, with additional traps placed in areas where mosquito activity was anticipated. Nearly 20,000 adult mosquitoes were tested for disease, and all results were negative.
Seasonal trends varied over the three years. In 2023, mosquito numbers were elevated during the first half of the season due to delays in aerial treatment following the retirement of the helicopter pilot, which prevented flights from resuming until July. In contrast, 2024 represented a typical year, with aerial treatments conducted throughout the season and mosquito populations remaining at low to moderate levels consistent with program objectives. In 2025, mosquito activity remained generally mild for most of the season because of cooler temperatures and intermittent rainfall, which reduced breeding opportunities. A noticeable increase in mosquito activity occurred late in the season, during August and September, when temperatures rose, and rainfall decreased. Expanded trapping capacity in 2025 also provided more comprehensive surveillance data.
Overall, mosquito activity between 2023 and 2025 was influenced by weather conditions and the availability of aerial treatment services. The year 2024 most accurately reflects normal operations, while 2025 showed generally mild activity with a late-season rise. Throughout this period, no mosquito-borne diseases were detected in any of the samples collected.
Mr. Anderson asked about what the colors indicate on the first map regarding the ground larvicide treatments.
Will Lumpkin noted that the red is small sources, from 10 sq ft to a couple of acres, with the green showing surveys where no treatment was made, and the orange showing where chemical or mosquito fish treatment occurred.
Vice Chair Andriola asked about the pause due to budget constraints and if there was an increase in calls directly related to the aerial program.
Mr. Rubio noted that there was a significant increase in people calling to voice an opinion, but there was also a level of confusion between what NNPH was doing and what was being
done in Carson City. In addition, NNPH responded to as many complaints as quickly as possible, which was a challenge due to the size of the county and the number of vector staff. Many calls ended up being education-based.
Vice Chair Andriola noted that early in the process, there was significant confusion, extensive public attention, and numerous inquiries related to the issue. She acknowledged that staff made a concerted effort to share accurate information and clarify the situation. She asked if the volume of calls and concerns tapered off as the public became more familiar with the facts and as ongoing efforts and services continued without interruption.
Mr. Rubio confirmed that, in the beginning, there were many concerns, but as the season progressed with a lack of mosquito activity, there were fewer calls. When the number of mosquitoes increased, more calls were received.
Vice Chair Andriola thanked staff for their presentation and for managing approximately 4,000 storm drains, in addition to other ongoing responsibilities. She mentioned that, if the budget continues to limit or pause certain activities, it may be useful in 2026 to compare data to the 2024 baseline to assess changes over time, noting that such comparisons can be affected by variables like weather and other uncontrollable factors, but emphasized that the calls received may have provided many educational opportunities.
Rayona LaVoie presented the Q1 Strategic Plan results, noting that this update reflects NNPH’s commitment to measuring impact and strengthening organizational accountability. The presentation highlighted areas of momentum, challenges, and alignment with long-term goals, and included an overview of the agency’s scoring system used to track performance, identify trends, and monitor progress across quarters. Strong performance was reported in many divisions, including increased community reach through media campaigns on secondhand smoke, expanded STD/HIV outreach in the county jail, and broad participation in the community health assessment survey. Improvements were also noted in data collection and use. Challenges remain due to staffing limitations and uncertainty surrounding federal funding, which has required additional planning and discussions about future operations.
Staff emphasized that proactive planning helps the organization prepare for potential changes and continue moving forward.
Mr. Anderson asked where the biggest gap in staffing is right now.
Erin Dixon noted that many of the current gaps are occurring within CCHS. She explained that there is now a committee to review whether or not a newly vacated position should be refilled. This review includes an assessment of relevant data, alignment with the strategic plan, performance metrics, financial considerations, and the potential public health impact if the position remains unfilled.
Ms. LaVoie also added that there is a significant gap in PHD, and they are trying to work
through some challenges with unfunded mandates.
Mr. Driscoll shared that, despite staff shortages and delays or pauses in certain initiatives, staff have continued to invest time and effort into producing the strategic plan reports. He noted that this work allows the monitoring of overall performance and examination of specific areas affected by budget constraints and external factors such as federal and state funding levels. He commended staff and leadership for maintaining focus on this work rather than deprioritizing it due to limited capacity and emphasized that this continuity will support a smoother transition forward once resource challenges are resolved.
Air Quality Management -Scientists Unveil Better Way to Predict Heat Deaths, Proposed Electric Vehicle (EV) Tax, September 2025 EPA Small Business Newsletter, Divisional Update, Program Reports, Monitoring and Planning, Permitting and Compliance.
Francisco Vega reported updates on several topics, including new advancements in forecasting heat-related deaths, which are increasingly important as the region is among the fastest-warming areas in the country. Information was also provided on road maintenance and public transportation funding as it relates to electric vehicles and potential impacts on air quality. He clarified that the intention was not to propose definitive solutions but to acknowledge existing funding gaps and share data showing that electric vehicles alone are unlikely to resolve them, while also outlining related public health considerations. It was noted that there were no exceedances of ozone, PM10, or PM2.5 air quality standards in October. Staff also reported a 99% plan review rate for October, with 59 reviews received and 57 completed on time, and they remain at 99% for the calendar year.
Mr. Driscoll commented on the discussion of vehicle-miles-traveled on the EV tax, noting that related mandates in various states have shifted over the past several years. He expressed that the issue is likely to become a federal political conversation before states are able to take significant action and observed that relying on this for meaningful progress may be more complex than anticipated.
Mr. Anderson asked about the science behind predicting heat deaths and the potential for predicting and what could potentially be done about preventing them.
Mr. Vega noted he recently participated in a panel that highlighted a gap in public messaging related to forecasting extreme heat days. He clarified that the current communications focus primarily on air-quality conditions and do not yet include information on extreme heat. They will continue monitoring new forecasting
advancements and evaluate how extreme heat information might be incorporated into future public messaging alongside air-quality updates.
Community and Clinical Health Services – Impact of the Federal Shutdown; Data & Metrics; Immunizations, Tuberculosis Prevention and Control Program, Reproductive and Sexual Health Services, Maternal Child and Adolescent Health, Women Infants and Children, and Community Health Workers.
Christina Sheppard reported that the recent federal government shutdown affected two programs but noted that the continuing resolution passed by Congress includes funding for WIC through September 30, 2026, ensuring program stability even if another shutdown occurs. She shared appreciation of county partners in Human Resources, Human Services, and the Library, for assisting with contingency planning, as well as to WIC staff for their dedication during this period. Additionally, a collaborative flu POD clinic with PHP that administered 115 flu vaccines and served as an emergency preparedness exercise, as well as a Harvest of Health event on November 4 that provided food to 93 families, along with various health screenings and insurance enrollment assistance. She also shared how quick action by WIC personnel helped identify and respond to a medical emergency involving an infant, reinforcing WIC’s importance as a connection to essential health and social services.
Vice Chair Andriola noted that, with proper permission and without compromising privacy, the story could be shared for valuable community communication. Many people may know of WIC without fully understanding its impact. This was a compelling illustration of how a family doing its best still faced a critical situation, and how WIC staff intervention may have prevented a tragic outcome. She encouraged consideration of sharing such stories because they resonate with the community.
Mr. Driscoll asked if SNAP was funded by the federal government through the end of the fiscal year, along with the WIC funding.
Ms. Sheppard noted that SNAP was also funded through the federal fiscal year.
Environmental Health Services Program – Consumer Protection (Food Safety Plan Review & Operations, Commercial Plan Review, Foodborne Illness, Special Events, Permitted Facilities); Environmental Protection (Land Development, Safe Drinking Water, Vector-borne Disease Surveillance, Waste Management / Underground Storage Tanks).
Rob Fyda shared that the food program hosted representatives from Walla Walla County, Washington, to observe the local food safety program and held an “inspection boot camp” using real inspection photos to help facilities identify and correct potential violations.
Staff are collaborating with Washoe County School District to support expansion of school culinary programs, potentially including mobile food truck operations for entrepreneurship classes. We are assisting with permitting and kitchen infrastructure. The
Land Development team is working on updated septic regulations, having engaged over 100 attendees and accepted more than 50 calls; a business impact statement will be presented next month, with regulation adoption anticipated in January. Additionally, a grant was received from NDEP to investigate PFAS in domestic wells, which are unregulated water sources, and will be developing community outreach and sampling plans.
Mr. Driscoll asked about the food truck program and the potential for commercial kitchen installation at Reed and Smith for the culinary program, and if NNPH is participating in that curriculum for purposes of teaching all things needed for inspection. Have they asked for input for that curriculum?
Mr. Fyda believed there is no NNPH education at the high school level, though there is some done through UNR.
Vice Chair Andriola asked if there was anything seen, being worked through, or challenged with, regarding the upcoming ordinance changes.
Mr. Fyda shared that much of the feedback has been related to septic density. Some are wishing to increase the density for more affordable ADUs, and others are interested in decreasing, so there are fewer septic systems per land area, to protect groundwater.
Epidemiology and Public Health Preparedness – Epidemiology, Statistics and Informatics, Public Health Preparedness, Emergency Medical Services, Vital Statistics, Sexual Health Investigations and Outreach, Chronic Disease and Injury Prevention.
Nancy Diao provided an update on respiratory virus activity, including influenza, COVID-19, and pertussis. Overall activity remains low, though flu activity is beginning to increase. ILI levels are below state and regional baselines but rising, and nationally, flu activity is increasing primarily among children. COVID-19 cases and hospitalizations remain low, with three reported COVID-associated hospitalizations this season in individuals over age 65, and no influenza-associated deaths reported locally. The H3N2 influenza subtype, which has mutated compared to the current seasonal vaccine, is circulating globally, but H1N1 remains the dominant strain in Washoe County. Pertussis cases are over four times higher than in the previous two years, mostly among unvaccinated or under-vaccinated individuals, though no outbreaks have been identified. November outbreaks remain steady compared to October, with a seasonal shift to respiratory and gastrointestinal illnesses. She also reported that the epidemiology team completed a comprehensive update to the disease manual, which is 67 chapters covering
90 reportable conditions, to ensure consistent investigations and rapid responses; chapters have also been shared with state and local partners.
Office of the District Health Officer Report – Northern Nevada Public Health Communications Update, Accreditation, Quality Improvement, Workforce Development, Community Health Improvement Program, Equity Projects / Collaborations, Community
Events, and Public Communications Outreach.
Ms. Dixon thanked staff for their efforts at the final Family Health Festival of the season, held on October 8, and showed the event’s strong community partnerships and staff dedication. She provided updates on the recently concluded special session, which included a bill related to immunizations that primarily affects pharmacists and is not expected to impact current departmental processes. She also reported that the new TB clinic building is progressing, and staff have been able to tour the facility.
Vice Chair Andriola asked about the timeline for moving into the new building.
Ms. Dixon shared that the expectation for moving in is no later than April 1, 2026, but hoping for late February or early March.
Having no requests for public comment, the public comment period was closed.
There were no requests for Board Comment, so the item was closed.