Board:

• (Present)

Rod Woodbury, Chair – Councilmember, Boulder City (Present)
Bob Beers – Councilmember, City of Las Vegas
Susan Crowley – At-Large Member, Environmental Specialist
Chris Giunchigliani – Commissioner, Clark County Commissioner (arrived at 8:35 a.m.)
Timothy Jones – At-Large Member, Regulated Business/Industry
Allan Litman – Councilmember, City of Mesquite
John Marz – Councilmember, City of Henderson
Marietta Nelson – At-Large Member, Physician
Frank Nemec, At-Large Member, Physician
Bill Noonan – At-Large Member, Gaming
Lois Tarkanian – Councilmember, City of Las Vegas
Wade Wagner – Councilmember, City of North Las Vegas (arrived at 8:41 a.m.)
Lori Winchell – At-Large Member, Registered Nurse (arrived at 8:59 a.m.)

• (Absent)

Mary Beth Scow – Commissioner, Clark County

Also Present:

• (In Audience)

Kathleen Peterson – At-Large Alternate, Environmental Specialist (In Audience)
Douglas Dobyne – At-Large Alternate, Regulated Business/Industry

• Legal Counsel:

Annette Bradley, Esq.

• Executive Secretary:

Joseph Iser, MD, DrPH, MSc, Chief Health Officer

• Staff: Heather Anderson-Fintak, Mary Ellen Britt, Richard Cichy, Darris Cole, Marcia Gershin, Andy Glass, Victoria Harding, John Hammond, Forrest Hasselbauer, Cassius Lockett, Brian Northam, Shirley Oakley, Jacqueline Reszetar, Bonnie Sorenson, Leo Vega, Jacqueline Wells, Dr. Christian Young.
• Public Attendance:
  

• Recognitions: Dr. Iser informed that Valery Klaric, Executive Assistant, decided to take voluntary layoff and has eased into retirement. Marcia Gershin is working in her place today.Dr. Iser and the Board congratulated Member Litman on his new post as Mayor of the City of Mesquite.Dr. Iser advised that Item IV.4.1, Memorandum #02-14: Consider/Adopt Amendments to SNHD Emergency Medical Services Regulations will be moved to the June 26, 2014 BOH Agenda.The Chair reminded Board members to submit their Nomination of Officers form if they have not done so already.

I. Public Comment: A period devoted to comments by the general public about those items appearing on the agenda. Comments will be limited to five (5) minutes per speaker. Please step up to the speaker’s podium, clearly state your name and address, and spell your last name for the record. If any member of the Board wishes to extend the length of a presentation, this may be done by the Chairman or the Board by majority vote.

Seeing none, this portion of the meeting was closed.

II. Adoption of the May 22, 2014 Agenda (for possible action)
A motion was made by Member Litman seconded by Member Giunchigliani and unanimously carried to adopt the May 22, 2014 Agenda as modified.

III. Consent Agenda: Items for action to be considered by the Southern Nevada District Board of Health which may be enacted by one motion. Any item may be discussed separately per Board Member request before action. Any exceptions to the Consent Agenda must be stated prior to approval.

1. 1. 1. Approve Minutes / Board of Health Meetings: April 28, 2014 PDF 839KB (for possible action)
      2. Petition #03-14: PDF 962KB Approval of Interlocal Agreement for Distribution of Transit Bus Passes from the Regional Transportation Commission of Southern Nevada (RTC) to provide to SNHD Patients and as Incentives at Outreach Events; direct staff accordingly or take other action as deemed necessary (for possible action)
      3. Petition #10-14: PDF 951KB Approval of Amendment to Interlocal Contract Between the City of Henderson and SNHD Lead Testing of Children; direct staff accordingly or take other action as deemed necessary (for possible action)
      4. Petition #06-14: PDF 627KB New Classification Specification for Legal Secretary; direct staff accordingly or take other action as deemed necessary (for possible action)
      5. Petition #11-14: PDF 526KB New Classification Specification for Accreditation Coordinator; direct staff accordingly or take other action as deemed necessary (for possible action)
      6. Petition #12-14: PDF 344KB Ratification of the Supplementary Memorandum of Agreement Dated April 16, 2014 by and between the Southern Nevada Health District and the Service Employees International Union, Local 1107, Revising the Health Records Supervisor Classification Specification from Non-Exempt to Exempt Status; direct staff accordingly or take other action as deemed necessary (for possible action)

In regard to Petition #03-14, Member Giunchigliani asked if the bus passes were tracked and was told by Bonnie Sorenson, Director of Clinics and Nursing Services that they were logged and treated as money. The passes are used in the TB and STD clinics to ensure that patients return for treatment.

A motion was made by Member Giunchigliani seconded by Member Jones and unanimously carried to adopt the Consent Agenda as presented.

IV. Public Hearing/Action: Members of the public are allowed to speak on Public Hearing / Action items after the Board’s discussion and prior to their vote. Each speaker will be given five (5) minutes to address the Board on the pending topic. No person may yield his or her time to another person. In those situations where large groups of people desire to address the Board on the same matter, the Chair may request that those groups select only one or two speakers from the group to address the Board on behalf of the group. Once the public hearing is closed, no additional public comment will be accepted.

1. 1. 1. Memorandum #02-14: PDF 5.2MB Consider/Adopt Amendments to SNHD Emergency Medical Services Regulations: direct staff accordingly or take other action as deemed necessary (for possible action)

This item was moved to the June 26, 2014 BOH Agenda.

1. 1. 2. Memorandum #03-14: PDF 3.1MB Consider/Adopt Proposed Fee Schedule for EMS and Trauma; direct staff accordingly or take other action as deemed necessary (for possible action)

Mary Ellen Britt, Manager, Emergency Medical Services & Trauma System (EMS&TS) and Dr. Christian Young, Medical Director, EMS &TS presented the proposed fee schedule. Ms. Britt stated that a cost analysis of business activities performed by staff demonstrated there is a gap between current fees and the cost involved in actually providing services. Further, new services have been added that are not addressed in the current fee schedule. In general, the Office of EMS&TS has not increased its fees in more than ten years. The proposed fee schedule is based on time and effort analysis performed and increases the fees incrementally over a three year period. To reduce the impact over existing permitting agencies, fees were not increased in FY15 for certification and licensure of EMS personnel which would have very high multipliers or the renewal of instructors or critical care endorsements. Three public workshops were held for all interested persons to comment on the proposed fee scheduling and it was presented to the Medical Advisory Board on May 7, 2014 where it was unanimously endorsed and recommended to be sent to the Board for consideration and adoption.

In response to Member Giunchigliani, Ms. Britt stated that a new service, for example, would be fees charged to authorized training centers.

Member Crowley asked if the increase in fees will bring the District in line with the cost of services and make EMS&TS self sufficient. Ms. Britt replied that the current revenues only cover about 11% of the activities that are done by EMS&TS and will increase to 30% by FY17. It is unlikely that based on fees alone, EMS&TS will be self-sufficient; however the Trauma System Advocacy Committee is working to try to explore other dedicated and sustainable funding sources for EMS&TS.

Member Jones asked Ms. Britt if the EMS&TS revenues and expenses were in line with the budget to which Ms. Britt replied currently EMS&TS is under-spent as she has not filled a vacancy and has been thoughtful about how funds are spent.

Member Weekly arrived at 8:42 a.m.

Sam Scheller of Guardian Elite Medical Services stated that the proposed increases and costs will negatively impact their operational budget. Member Winchell asked if services provided were billable to which Mr. Scheller replied his is a special permitted purpose agency, providing EMTs, paramedics and ambulances to special events and does not bill patients directly, the promoter or event organizer is billed a flat rate.

Member Beers arrived at 8:51 a.m.

Member Giunchigliani clarified that the fee increases will be effective July 1, 2014.

A motion was made by Member Jones seconded by Member Tarkanian and unanimously carried to adopt the Proposed Fee Schedule for EMS and Trauma as presented

V. Report/Discussion/Action

1. 1. 1. Review/Discuss: Three Year Budget Projection; direct staff accordingly or take other action as deemed necessary (for possible action)

Dr. Iser stated he has been trying to analyze the budget with the changes that the Board made last month and get a better handle on what the costs will be over the next three years. The projections are using a 2.5% increase in employee wages over the next three years and originally a 4% increment for the tax transfer was used, however, it has been recommended that only 3% be used. Given the increase to the Maternal Child Health program in the amount of $600,000 and the other unknowns, particularly the SNPHL, and working through a plan to increase revenues there, the budget looks good and he wants to take a careful look at everything before presenting to the Board. Dr. Iser believes that the intent of the Board’s decision to give $600,000 to the MCH program did not take into consideration the indirect costs related to the program which adds another $125,000 to $150,000 that is not included in the $600,000 directed to the program.

VI. Board Reports: The Southern Nevada District Board of Health members may identify emerging issues to be addressed by staff or by the Board at future meetings, and direct staff accordingly. Comments made by individual Board members during this portion of the agenda will not be acted upon by the Southern Nevada District Board of Health unless that subject is on the agenda and scheduled for action.

Member Jones thanked Jackie Reszetar, Director, Environmental Health, for meeting with food industry. The next meeting is in August and it will include the chefs.

VII. Health Officer & Staff Reports

• • • CHO Comments

Building Update – Dr. Iser stated after approval was granted to move forward, an offer was submitted on the 278 S. Decatur property and is still pending, possibly because the District may be considered an “obnoxious tenant” because of the clinical facilities. Additional offers are still coming in so it may be up to two weeks before a decision is made. Backup plans are in the works and the hope is to consummate a deal within the next two weeks.

Fire at Recycling Facility – Brian Northam, Acting Supervisor, Solid Waste and Disposal Permanent Disposal Facilities Program, was notified on May 19 at approximately 7:30 p.m. by Todd Widows, Area Engineer for Republic Services, of a fire at their facility. District staff reported to the facility at approximately 6:00 a.m. on May 20 and reported significant damage to the commodities and loss of equipment. The operator has been notified to submit an incident report as required by permit to the District and has not yet been received.

Member Wagner arrived at 9:03 a.m.

Legislative Issues – Dr. Iser reported he recently attended the Southern Nevada Governance Forum where they discussed several BDRs related to the District, which may be submitted to the legislature in this coming session:

• • Whether there should be an Administrator or a physician in charge of the District.
  • Composition of the board, as there is a recommendation to do away with the appointed representatives.
  • Disbandment of alternate Board members.
  • Interest in taking Environmental Health out of the District and putting it elsewhere.

Member Giunchigliani asked about the increase in completed EH inspections. Jackie Reszetar, Director, Environmental Health, noted that there was an error in the documentation and it will be corrected by the end of day. Ms. Reszetar added the mandate is once per year and she is working with the restaurant association and the inspectors to become more business friendly. It was announced at the restaurant association meeting that if there are any complaints to call immediately so the issues can be worked out. Dr. Iser receives notice of all closures as they pose imminent health hazards.

Member Noonan attended the restaurant association workshop and has heard many positive comments. He encouraged Ms. Reszetar to schedule these meetings regularly and was advised that the next meeting is August 21 at Maggiano’s. All Board members are invited and encouraged to attend.

Dr. Iser stated in regard to the comments he heard at the Governance Subcommittee, they are not hearing positive comments, they are hearing complaints and he would appreciate it if the Board members would take positive information related to Environmental Health and the District back to their constituents.

Member Nelson asked if there is objection regarding the bill proposed to remove the alternates from the Board. Dr. Iser stated that at times it is difficult to keep twenty-eight members informed, and some of those discussing at the subcommittee felt that the alternates may not be informed or prepared to represent.

VIII. Informational Items

1. 1. Chief Health Officer and Administration
      1. Monthly Activity Report – April 2014 PDF 1.28MB
   2. Community Health
      1. Monthly Activity Report – April 2014 PDF 2.21MB
   3. Environmental Health
      1. Monthly Activity Report – April 2014 PDF 3.15MB
   4. Clinics and Nursing
      1. Monthly Activity Report – April 2014 PDF 944KB

IX. Public Comment: A period devoted to comments by the general public, if any, and discussion of those comments, about matters relevant to the Board’s jurisdiction will be held. No action may be taken upon a matter raised under this item of this Agenda until the matter itself has been specifically included on an agenda as an item upon which action may be taken pursuant to NRS 241.020. Comments will be limited to five (5) minutes per speaker. Please step up to the speaker’s podium, clearly state your name and address, and spell your last name for the record. If any member of the Board wishes to extend the length of a presentation, this may be done by the Chairman or the Board by majority vote.

Seeing no one, the Chair closed this portion of the meeting.

X. Adjournment

The Chair adjourned the meeting at 9:16 a.m.

Joseph P. Iser, MD, DrPH, MSc
Chief Health Officer/Executive Secretary

Note: Disabled members of the public who require special accommodations or assistance at the meeting are requested to notify Jacqueline Wells in Administration at the Southern Nevada Health District by calling (702) 759-1201.

This agenda has been posted in the main lobby of the following locations:

Clark County Government Center, 500 S. Grand Central Pkwy., Las Vegas, NV
Las Vegas City Hall, 495 S. Main St., Las Vegas, NV
North Las Vegas City Hall, 2250 Las Vegas Blvd. North, North Las Vegas, NV Henderson City Hall, 200 Water St., Henderson, NV
Boulder City, City Hall, 401 California Ave., Boulder City, NV
Mesquite City Hall, 10 E. Mesquite Blvd., Mesquite, NV
Southern Nevada Health District, 330 S. Valley View Blvd., Las Vegas, NV