AGENDA PACKET NO. | A |
Members | Thursday, March 6, 2025 |
Devon Reese, Chair | 3:00 p.m. |
Clara Andriola, Vice Chair | |
Paul Anderson | |
Michael D. Brown | Virtual Meeting ONLY |
Dr. Eloy Ituarte | |
Steve Driscoll | |
Dr. Reka Danko |
Chair, Devon Reese, called the meeting to order at 3:00 p.m. The following members and staff were present:
Members present: Devon Reese
Clara Andriola Paul Anderson Michael D. Brown Dr. Eloy Ituarte
Steve Driscoll (joined at 3:17 p.m.)
Dr. Reka Danko (present as attendee until 3:34 p.m.)
Chair Reese asked for all to mute and make a personal Pledge of Allegiance and observe a moment of silence.
Chair Reese opened the public comment period.
Recommendation to approve the overfill of the Community and Clinical Health Division Director position not to exceed 11 weeks, at an approximate range of $44,000 to $58,000.
1001 E. Ninth Street, Building B, Reno, NV 89512
Telephone: 775.328.2415 – Fax: 775.328.3752
Temporarily allowing both the retiring and new Director appointment to occupy position 70002281 for up to 11 weeks to accommodate cross training and allow the retiring Director to provide support to the new Director as needed while utilizing accrued leave time. (FOR POSSIBLE ACTION)
Staff Representative: Erin Dixon
Update, discussion, and possible direction regarding the FY26 Northern Nevada Public Health Budget, including revenues, expenditures, and projections. (FOR POSSIBLE ACTION)
Staff Representative: Chad Kingsley
Dr. Kingsley noted that this discussion is for the budget period FY26. The overall mission is to improve and protect our community’s quality of life and increase equitable opportunities for better health, protecting the health of Reno, Sparks, and Washoe County. A Syphilis Community Taskforce has recently been convened, which includes healthcare providers, and NNPH has recently begun implementing rapid testing for syphilis, which allows for treatment to begin during that same visit. The hope is that the community partners will be influenced by this success and begin implementing it as well. Another recent success is the Food Business Resource Fair, where local food entrepreneurs are offered comprehensive resources in their specific area. Preparation for another fair is in the works. The Safe Drinking Water Program is another example of the work being done here, where we have been working toward identifying lead and copper pipes with lead soldering.
Chair Reese asked if there were any questions so far and reminded everyone to use the raise hand feature if they have questions during the presentation.
Jack Zenteno shared that for FY25, there are currently 201.74 NNPH FTE positions, with
196.58 of those filled with full-time, part-time, or intermittent hourly staff. The flexibility of the intermittent hourly staff allows us the ability to deal with emergencies as needed. The $1M above base request from the County will help address the salary benefit needs, along with a few other items. Mr. Zenteno shared the personnel numbers, revenue generated and expenditures for each division and touched on the overhead costs associated with services provided by the County, such as technology services, the DA’s office and Human Resources.
Ms. Andriola asked for a clarification on the open staff positions.
Mr. Zenteno noted that there are about 4 vacant positions currently. These differ from the frozen positions, which aren’t reflected in the budget and include positions eliminated during COVID.
Ms. Andriola asked if the $1M request was for the four positions to be fully funded. Mr. Zenteno noted he has further information about this later in the presentation.
Ms. Andriola will hold her remaining questions for later.
Mr. Zenteno continued with FY24 starting with a fund balance of nearly $19M, which included money banked during COVID, with staff billing COVID projects. That year ended with a net change in fund balance of roughly $2.8M, due to a number of the COVID awards ending, and FY25 opening with a balance of roughly $16M. This leaves the projection for closing FY25 is about $2.483M in deficit. FY26 is showing some ARPA funding related to the TB Clinic, with grant revenue being around $7M and expenditures $41M. Divisions have been asked to look for opportunities to rein in spending, create efficiencies and be as streamlined as possible, knowing Federal, State, County, and City levels are all dealing with financial issues. These projections are based on worst-case scenario.
Salaries and wages, benefits, and overhead cover 80-90% of the expenditures within the department. Projections for the next three fiscal years are based on flat federal and state funding, with 1/3-1/2 of funding coming from those awards. As NNPH moves into the next fiscal year, decisions will be made as additional information is available.
This meeting is the start of the next steps, then a meeting with the county leadership and city managers to discuss the interlocal agreements and the activities currently occurring. Questions or concerns from that meeting will come back to this Board at the next regular meeting with the NNPH budget then rolled into the County budget, which is presented in April and finalized in May. The full County budget goes to the Department of Taxation by June 1.
Chair Reese appreciates the hard work that has gone into getting to this point. The information carries a lot of uncertainty as it evolves from the County, State, and Feds. He expressed concern over how quickly we are dipping into the negative in the ending fund balance and feels this body and board will be addressing it in the next couple of years. There have been productive conversations for the past nine months and the needle is ultimately moving towards a more sustainable baseline model. He thanked Dr. Kingsley for his leadership and effectively articulating the vision for the Board through the budget. Elected officials are going through various similar budget processes now, but this one is very specific and narrowly focused on public health.
Ms. Andriola asked for clarification that the expenses outpacing revenue and dipping into reserves is expected within the next two years.
Mr. Zenteno confirmed that is the current trajectory. NNPH is waiting and spending now, while looking for places to reduce, but staffing is the most challenging piece, so positions are becoming vacant are being reviewed to see if they can remain open.
Ms. Andriola asked how many positions are frozen.
Mr. Zenteno noted he doesn’t currently have that information available but will provide it to the Board.
Chair Reese commented that cities, counties, and larger organizations often freeze positions to accrue salary benefits, but these positions are critical, with no way to change the budget through vacancy savings. In the past, this has been navigable by federal and state funding, many of which are being reviewed in the current Legislature. Many of the grant and federal funds are passed through State, then County, then NNPH, and have not made our budget larger, except for Federal COVID dollars, which caused growth in the district in an unanticipated way. Work is being done with the County to find a sustainable path regarding funding transfers, which have not increased since before 2019.
Ms. Andriola noted she is aware that cutting or freezing positions won’t help balance the budget, especially with the nature of the specialty and variety of responsibilities the organization has. Even with the $1M the County has added to the budget, the fact that it hasn’t changed in many years while the population has increased over time, and having only two years to resolve the issue is not sustainable. Do we see that there is any indication the County will increase further?
Chair Reese noted that there is a path to sustainability, and it will require all of us to engage in the process of helping to identify the successes and needs of public health in our community. It’s been very good working with the County and the County Manager’s and finance teams, and we have perhaps gotten a smaller amount than desired, but it is a starting point. The Nevada Legislature and the Federal Government will impact future conversations.
Mr. Driscoll shared a concern with 82% of the budget in salaries and benefits increasing with inflation and ongoing COLAs, there is less money for the other expenses. Without a large influx of revenue or a huge decrease in expenditures, balancing will be difficult. He noted for the record that they will need to be careful because this has the potential to become exponential.
Chair Reese noted that with Mr. Driscoll’s vast experience in Government, his addition to the Board will be welcome in this area. The elected officials have a different view on how and why budgets work and how they are built, so there’ll be other perspectives. Because we have previously had such a large ending fund balance, we have been able to operate without asking for help, then with COVID funds, the financial resources into the district increased, thus the need for these conversations was delayed.
Mr. Anderson asked for clarification as to the 82% mentioned by Mr. Driscoll, where he was seeing it at 71%.
Mr. Driscoll responded that the numbers do indicate 71% for salaries and benefits, but adding in the one-time expenditures with the TB Clinic, the number is driven up to 82%.
Chair Reese noted the next steps again and clarified that this budget to the County and City Managers will occur after this meeting.
Dr. Kingsley confirmed that the meeting is scheduled for next week, with any requested changes coming back to the Board at the regular March DBOH meeting.
Board Comment.
Chair Reese thanked Sparks City Councilmember Paul Anderson for sharing in the privilege of shaving for Northern Nevada Children’s Cancer Foundation. As an extension of public health, there is another head-shaving event tomorrow night at the downtown Reno ballroom at 6:00 p.m.
Special Accommodations: The District Board of Health Meetings are accessible to the disabled. Disabled members of the public who require special accommodations or assistance at the meeting are requested to notify Administrative Health Services in writing at Northern Nevada Public Health, 1001 E. 9th Street, Building B, Reno, NV 89512, or by calling 775.328.2416, 24 hours prior to the meeting.
Public Comment: Members of the public may make public comment by submitting an email comment to jlawson@nnph.org before the scheduled meeting, which includes the name of the commenter and the agenda item number for which the comment is submitted. Reasonable efforts will be made to hear all public comment during the meeting. During the “Public Comment” items, emails may be submitted pertaining to any matter either on or off the agenda, to include items to be heard on consent. For the remainder of the agenda, public comment emails will only be heard during items that are not marked FOR POSSIBLE ACTION. All public comment should be addressed to the Board of Health and not an individual member. The Board asks that your comments are expressed in a courteous manner. All public comment is limited to three minutes per person. Unused time may not be reserved by the speaker nor allocated to another speaker.
Response to Public Comment: The Board of Health can deliberate or take action only if a matter has been listed on an agenda properly posted prior to the meeting. During the public comment period, speakers may address matters listed or not listed on the published agenda. The Open Meeting Law does not expressly prohibit responses to public comments by the Board of Health. However, responses from the Board members to unlisted public comment topics could become deliberation on a matter without notice to the public. On the advice of legal counsel and to ensure the public has notice of all matters the Board of Health will consider, Board members may choose not to respond to public comments, except to correct factual inaccuracies, ask for Health District staff action or to ask that a matter be listed on a future agenda. The Board of Health may do this either during the public comment item or during the following item: “Board Comments – District Board of Health Member’s announcements, reports and updates, request for information or topics for future agendas. (No discussion among Board Members will take place on the item)”
Pursuant to NRS 241.020, Notice of this meeting was posted electronically at the following locations: Northern Nevada Public Health, 1001 E. 9th St., Reno, NV
Reno City Hall, 1 E. 1st St., Reno, NV
Sparks City Hall, 431 Prater Way, Sparks, NV
Washoe County Administration Building, 1001 E. 9th St, Reno, NV Downtown Reno Library, 301 S. Center St., Reno, NV
Northern Nevada Public Health Website https://www.NNPH.org State of Nevada Website: https://notice.nv.gov
How to Get Copies of Agenda and Support Materials: Supporting materials are available to the public at Northern Nevada Public Health located at 1001 E. 9th Street, in Reno, Nevada. Ms. Jackie Lawson, Recording Secretary to the District Board of Health is the person designated by the District Board of Health to respond to requests for supporting materials. Ms. Lawson is located at Northern Nevada Public Health and may be reached by telephone at (775) 328-2415 or by email at jlawson@nnph.org. Supporting materials are also available at the Northern Nevada Public Health Website https://www.nnph.org pursuant to the requirements of NRS 241.020.