Members | Thursday, July 24, 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 |
Chair Reese called the meeting to order at 1:01 p.m. Members present: Devon Reese, Chair
Clara Andriola, Vice Chair Paul Anderson
Michael Brown Steve Driscoll Dr. Eloy Ituarte Dr. Reka Danko
Dr. Ituarte led the pledge to the flag.
Years of Service
Jennifer Howell - Public Health Supervisor - CCHS - 25 years 7/3/2000
Ana Richeson - Public Health Investigator II - CCHS - 10 years 7/27/2015
Kelsey Zaski - Office Specialist - PHD - 5 years 7/20/2020
Scott Oxarart announced the years of service and thanked staff for their dedication.
Health Heroes
Joe Dibble - CCHS - Adaptability, Collaboration, Compassion, Trustworthiness
Stephanie Chen - CCHS – Collaboration
Scott Oxarart shared congratulations on the Health Heroes for their hard work and receipt of the recognition.
Possible approval of June 26, 2025, Draft Minutes.
Retroactively approve the State Public Health Funds Interlocal Agreement for the period of upon execution by the Nevada Board of Examiners through June 30, 2027, in the total amount of 2,364,160 ($1,182,080 per fiscal year), in support of core functions of public health, and if approved, authorize the District Health Officer to execute any future amendments.
Recommendation for the Board to uphold an uncontested violation issued to STC Ventures, LLC, Case No. 1548, Notice of Violation No. AQMV25-0011 with a reduced Administrative Penalty of $9,000.00 for failing to control fugitive dust from construction activities.
Recommendation for the Board to uphold an uncontested violation issued to Pyramid Materials, Inc., Case No. 1558, Notice of Violation No. AQMV25-0010 with a
$500.00 Administrative Penalty for failing to control fugitive dust from an aggregate facility.
Recommendation for the Board to uphold an uncontested violation issued to Alston Construction Company, Inc., Case No. 1569, Notice of Violation No. AQMV25-0012 with a $500.00 Administrative Penalty for failing to obtain a Dust Control Permit prior to the commencement of a dust generating activity.
E. Acknowledge receipt of the Health Fund Financial Review for June, Fiscal Year 2025.
Recommendation to accept the REMSA Health Monthly Franchise Report for June 2025 which includes REMSA Health Accounts Receivables Summary, Compliance by Zones, Average Response Times, Incident Details Reporting, Summary Penalty Fund Reconciliation, Ground Ambulance Operations Report, Patient Experience Report and Comments, Education Report, and Public Relations Report, and provide possible Board direction.
Barry Duplantis noted that REMSA Health met or exceeded franchise response compliance for all priority 1 calls for the month of June and the fiscal year to date. To follow up on a question by Mr. Driscoll at the last meeting, Mr. Duplantis shared that they are working to prepare a detailed response and have a meeting scheduled for August 25 to review the data and best answer the question. During June 2025, REMSA responded to nearly 8,400 priority 1 calls, transporting 5,348 patients to area hospitals. The customer survey noted a score of 94.32%.
Chair Reese thanked REMSA for their response to an outside question regarding a new development in his jurisdiction and the prospective response of emergency vehicles to this area. The REMSA team put together data and provided input to the City of Reno planning department to help make a judgment about the primary response obligation to that area.
Mr. Duplantis shared that one of the items structured in the EMS services information from many years ago was that population moves, so the system design of REMSA is designed to follow people. They use predictive analytics to stay ahead of the curve.
Presentation of the Inter-Hospital Coordinating Council FY25 Accomplishments.
A presentation was shared about the accomplishments of the Interhospital Coordinating Council for FY25.
Zeb Nomura, IHCC Chair, Truckee Meadows Fire, shared that this is a great group of healthcare entities. He invited Board Members to attend meetings to see the collaboration, discussions, and ideas, which are then put into motion via NNPH staff.
Leslie Allfree, IHCC Vice Chair, from the Washoe County School District, thanked the Board and NNPH staff for their support. The community is better prepared for a response with this cooperative work.
Julie Fry, IHCC Member at Large, Saint Mary’s Regional Medical Center, shared that it is great to have so many members from the community coming together to resolve the challenges that they share.
Dr. Kingsley thanked IHCC for their work together. In the past, they have been recognized as
a national model, with many entities viewing them as an example and a leader. The amount of cooperation and collaboration done for the region is to be recognized.
Discussion and Possible Appointment of Dr. Nicholas Von Foerster, Emergency Room Physician Representative to the Regional Emergency Medical Services Advisory Board for a three-year term effective July 24, 2025.
Andrea Esp shared that the Emergency Medical Services Advisory Board (EMSAB) bylaws required an ER physician on the Board. The position was posted, and the recommendation is for Dr. Nicholas Von Foerster to be the nominee.
Dr. Nicholas Von Foerster shared that he is an emergency physician for Northern Nevada Health System, serves as their EMS Medical Director, and is the Medical Director for the Reno Fire Department. He has worked at every level from non-emergency wheelchair transport to BLS transport, through pre-hospital physician and critical care flight, and is now double boarded in emergency medicine and EMS. He would like to be on the Board to be an advocate at the patient and community levels and believes he offers perspectives in the various roles he has served in rural agencies, suburban agencies, and urban agencies. He also offers a breadth of perspectives at an advisory level, to allow forward thinking on system oversight, design, and protocols.
Chair Reese thanked him for being here to address the Board, providing the opportunity to meet him.
Presentation, discussion, and possible approval of the 2025 Legislative Summary Report for the 83rd Nevada State Legislative Session.
Joelle Gutman Dodson shared some of the highlights of the 83rd Legislative Session. The main priorities were maintaining sustainable funding and avoiding unfunded mandates, which were both accomplished. She feels this was a successful session, with other wins including AB360, efforts around preventing congenital syphilis, and AB451, helping to improve suicide prevention efforts. AB352 is effective in 2027, for a limited type of food prepared in home kitchens to be moved back to state oversight. AB102 authorizes health districts in counties with populations between 100,000 and 700,000 to regulate emergency medical services, but it will remain at the state level until NNPH elects to assume it. She thanked everyone in NNPH who helped her during the session and recognized partnerships, including SNHD, NaCo, City of Reno, Washoe County, NPHA, and UNR School of Public Health. This session, 1210 bills were introduced, 243 signed into law, and 87 vetoed, in 120 days. Out of the 243 bills signed into law, NNPH was involved in 40 that took a substantial amount of time. Public Health is in every committee and several departments at the State,
representing local and state government issues. A lot of education is necessary to explain to legislators all that public health encompasses.
Ms. Andriola thanked Ms. Gutman Dodson for the difficult work done, which was a collective opportunity in coming to a consensus. She also thanked her for what she does throughout the year, looking into the next session.
Mr. Driscoll also thanked Ms. Gutman Dodson for what she did and noted she underplayed the effort and time spent working with advisory committees, providing precise and concise information and updates, and for her ability to hit the most important parts, along with the relationships built and the work they’ve done to help this part of the county.
Chair Reese noted that Ms. Gutman Dodson did a great job. With the pace of the session and difficulty in communicating the needs during the session, he feels she did a great job of keeping the Board apprised. While there may be moments of despair, she fought a good fight.
Ms. Gutman Dodson noted that there is an expectation that a special session will be held this fall to deal with budgetary items.
Presentation and possible approval of revisions to the FY24-FY26 Strategic Plan.
Rayona LaVoie presented a proposal to revise the strategic plan, in accordance with the commitment to organizational excellence.
Review, discussion, and direction to staff regarding the provisions of the Interlocal Agreement (ILA) entered into by the Cities of Reno and Sparks and Washoe County for the creation of the Health District. Take action to accept the ILA in its current form or direct staff to forward any additional recommendations for possible amendments to Reno, Sparks and Washoe County.
Dania Reid noted that this matter was continued from the last meeting to include a more robust Board presence. Once per year, the Board is offered an opportunity to review the ILA to determine whether or not their jurisdictions may like to see changes to the agreement. Any revision amendments drafted are taken to the city councils and county commission for approval before becoming effective. In the event this Board has any changes to pursue, it would need to be completed before October 1, to be effective 90 days before January 1.
Ms. Andriola does not have any items she would like to change within the ILA at this time. Mr. Driscoll enquired of Ms. Reid, currently, Reno, Sparks, and Washoe County are directed
by legislation to review EMS and fire services and if this allows this Board to enter into the conversation or be excluded because it is its own entity as a subset of the county.
Ms. Reid shared that, if they are speaking of ambulance service, both the cities and the county have delegated authority to provide exclusive franchising for ambulance service to this Board. It may be a valid conversation, regarding fire service with EMS being delegated to the DBOH, but it is not believed this Board has any role in fire services outside of EMS. This Board may have a voice due to the existing franchise, which is valid through 2030.
Air Quality Management - EPA Announces Sunset of the Advance Program After 13 Years, EPA Issues FY2026 Proposed Budget Justification, June 2025 EPA Small Business Newsletter, Divisional Update, Program Reports, Monitoring and Planning, Permitting and Compliance.
Craig Petersen shared that information received from the National Association of Clean Air Agencies changed what is written in the report as a 54% agency-wide reduction in the EPA’s overall budget to a 23% proposed reduction. There was one exceedance of the 8- hour ozone standard in June with a concentration of 74 ppb, which is a rare overnight exceedance, likely from stratospheric ozone intrusions or ozone transport from other areas. The NWS suggested it was likely the latter from Sacramento or the foothills. The permitting team completed all plans received for June 100% in a timely manner.
Community and Clinical Health Services - 2025 Client Satisfaction Survey Results; Data & Metrics; Sexual Health (Outreach and Disease Investigation), Immunizations, Tuberculosis Prevention and Control Program, Reproductive and Sexual Health Services, Chronic Disease Injury Prevention Program, Maternal Child and Adolescent Health, Women Infants and Children, and Community Health Workers.
Christina Sheppard shared that the annual client satisfaction survey results were overwhelmingly positive, with an improvement in satisfaction with appointment scheduling, and commended staff for the education and care they provide. The WIC Program also had a biennial program review from the State WIC office, and staff were commended for their exceptional customer service along with a clean and welcoming environment.
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 highlighted that the first special processes fair, designed to elevate the food handling skills of restaurateurs, was completed. The Food Plan Review Team is now holding office hours for those interested in plan reviews or having questions for staff. It has been a busy season for temp food staff. More home-based tattoo shops have been identified, and staff are responding to complaints. The septic team has been proactively working to find new sand for sand filters, with the existing pit projected to close. A few options have been identified and are being explored.
Mr. Anderson thanked everyone for all the different things they do and are working on to help the community, which people don’t think about
Population Health - Epidemiology, Statistics and Informatics, Public Health Preparedness, Emergency Medical Services, Vital Statistics, Sexual Health Investigations and Outreach, Chronic Disease and Injury Prevention.
Dr. Nancy Diao shared that the Population Health Division was officially launched on July 1. All of the programs are progressing nicely. A few highlights from her report include Public Health Preparedness creating a radiation exercise that occurred this month, aimed to test emergency response capabilities during a radiological incident, with various community partners participating. The outbreak numbers have been low, with a majority being gastrointestinal and hand-foot-mouth disease. The quarterly communicable disease reporting and statistics report was published, and compared the reported morbidity of selected communicable diseases for the most recent quarter to historical morbidity from the past 5 years. Increases were seen in this quarter from RSV and animal bites.
Nationally, other states have seen an increase in COVID, but Nevada’s numbers remain low.
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 and Outreach.
Dr. Kingsley noted that he recently attended the NACCHO360 annual conference and will give a full report next month. Information learned at the conference allowed a quicker local response when shared with the state regarding the tobacco award. The connections from the conference showed that other states are having similar challenges. As part of workforce development, funded by a grant, all-staff training occurred, to empower and support staff. The CHA and CHIP are continuing and will lead to the development of the Community Health Improvement Plan.
Ms. Andriola asked if there has been any additional feedback or concerns about the mosquito abatement measures approved by this body.
Dr. Kingsley shared that he recently spoke with program coordinators and, when the temperatures do not go below 80 at night, we will see an uptick in mosquito populations.
The complaints have been low, but with the warmer weather this month, there may be additional populations.
Ms. Andriola asked for an update to help with transparency.
Dr. Kingsley will have a report prepared on this for the August meeting.
Molly Rose Lewis from Senator Jacky Rosen’s office shared that she appreciates everyone and the work being done. Their office is keeping tabs on cuts and potential cuts and finds it interesting to hear about the items that affect NNPH. Please share with them if there are specific programs that would be cut due to federal budget changes, so they can advocate for funding for these programs. If applying for federal grants, they also work with Senator Amodei’s and Senator Cortez Masto’s offices and can provide letters of support.
Chair Reese asked Dr. Kingsley to meet with Molly Rose Lewis’ office in the next 30 days to identify any areas of concern.
Mr. Driscoll shared some of his experience with the recent NACCHO 360 conference he attended. There were education tracks on public health topics and worldwide topics, many of which were relevant to things done locally. He found many nuggets of information in each session attended. Through several of the courses, even with minimal knowledge, he understands that NNPH is doing things well.