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Health Services FY20 Budget PresentationCopyrighted February 11, 2019 City of Dubuque Public Hearings # 1. ITEM TITLE: SUMMARY: SUGGESTED DISPOSITION: ATTACHMENTS: Description Health Services FY2020 Budget Outline Health Services FY20 Budget Presentation Type Supporting Documentation Health Services -1- This page intentionally left blank. -2- HEALTH SERVICES DEPARTMENT Budget Highlights FY 2018 FY 2019 FY 2020 From FY 2019 Actual Budget Requested Budget Employee Expense 457,389 475,793 508,010 6.8 % Supplies and Services 297,728 303,494 336,362 10.8 Machinery and Equipment 873 2,935 1,875 (36.1)% Total 755,990 782,222 846,247 8.2 Operating Revenue 314,237 312,656 356,914 14.2 % State Grant 5,759 10,500 12,099 15.2 % Total 319,996 323,156 369,013 14.2 % Property Tax Support 435,994 459,066 477,234 18,168 Percent Increase (Decrease) 4.0 Personnel - Authorized FTE 5.58 5.58 5.86 Improvement Package Summary 1 of 5 This improvement package would increase one part-time Animal Control Officer to full-time (+0.28 FTE or 582 hours annually), increasing Animal Control staffing by 11 hours, providing additional coverage and more timely follow-ups on animal control incidents and complaints. The added coverage could reduce the amount of calls Police respond to, increase the number of impounded animals and their subsequent revenue, and provide more prompt and efficient service to citizens. This increase in staffing would also provide more coverage for when Animal Control staff is in training, City business, or for personal time. Currently, when one of the Animal Control Officers requires time off, coverage hours are decreased, since neither part-time Animal Control Officer can go above 29 hours per week or 1,508 hours per year. Annexations have also added travel time and coverage ability for Animal Control. In addition, now that pets are allowed on trails and in some parks, Animal Control can address enforcement for pets in these areas in conjunction with park patrol. When Animal control is not on -duty (i.e., evenings, nights, weekends, holidays, training, etc.), Police cover animal emergencies and complaints. This amounts to significant time and expenditure for the Police Department, who are not as thoroughly trained in animal control. Police Animal Calls FY13: 717 FY15: 569 FY17: 525 FY 14: 854 FY16: 647 FY 18 : 539 Current staffing levels do not allow any time for community outreach and education on animal control and responsible pet ownership issues. Increasing the Animal Control officers' hours would allow them to meet with and provide education to neighborhood associations, civic organizations, schools, animal organizations, etc. -3- Animal Bites 120 100 80 60 40 20 0 Animal Bites 11 !111 1 11. 1111: k_ FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18 Dog Bites Fiscal Year • Cat Bites Other Animal Bites Note: Average number of bites each calendar year from 2006 - 2016 is 131. The average number of bites for 2017 and 2018 is 178, a 36% increase. In addition, the amount of dogs and cats licensed in the city has steadily increased since FY95 This does not account for unlicensed pets, which the American Veterinarian Medical Association estimates 32% of the households owning 1.69 dogs and 27.3% owning 2.19 cats. For the City of Dubuque's 22,560 households, this translates to 12,200 dogs and 13,488 cats. Recent and proposed annexations have also added travel time and coverage ability. Fiscal Year Animal Licenses Sold Fiscal Year Animal Licenses Sold FY95 7,050 FY07 7,990 FY96 6,900 FY08 8,675 FY97 7,110 FY09 8,370 FY98 7,333 FY 10 8,190 FY99 7,147 FY11 9,055 FY00 7,294 FY12 9,341 FY01 7,792 FY13 9,437 FY02 8,005 FY14 9,486 FY03 7,574 FY15 9,897 FY04 8,036 FY16 10,091 FY05 6,293 FY17 10,086 FY06 7,683 FY18 10,309 This improvement package would support City Council Goal 2: "Vibrant Community: Healthy and Safe" by encouraging a sense of safety in the community through increased enforcement as well as ensuring residents feel they are part of a collaborative solution through increased outreach and pet -ownership training efforts. -4- This improvement package also includes an increase in fuel (+$293) and vehicle maintenance (+$165). In addition, it is expected that animal impoundments fees would increase (+$1,500), court fines (+$2,500) and cat licenses (+$1,000) and dog licenses (+$1,500) due to enforcement and outreach. Related Cost: $ 32,641 Tax Funds Recurring Recommend -Yes Related Revenue: $ 6,500 Animal Fees/Fines Recurring Net Cost: $ 26,141 Property Tax Impact: 7570777 0.10% Activity: Animal Control 2 of 5 This improvement package would increase the second part-time Animal Control Officer to full-time (+0.28 FTE or 582 hours annually), increasing Animal Control staffing by 11 hours, providing additional coverage and more timely follow-ups on animal control incidents and complaints. The added coverage could reduce the amount of calls Police respond to, increase the number of impounded animals and their subsequent revenue, and provide more prompt and efficient service to citizens. This increase in staffing would also provide more coverage for when Animal Control staff is in training, City business, or for personal time. Currently, when one of the Animal Control Officers requires time off, coverage hours are decreased, since neither part-time Animal Control Officer can go above 29 hours per week or 1,508 hours per year. Annexations have also added travel time and coverage ability for Animal Control. In addition, now that pets are allowed on trails and in some parks, Animal Control can address enforcement for pets in these areas in conjunction with park patrol. When Animal control is not on -duty (Le., evenings, nights, weekends, holidays, training, etc.), Police cover animal emergencies and complaints. This amounts to significant time and expenditure for the Police Department, who are not as thoroughly trained in animal control. Police Animal Calls FY13: 717 FY15: 569 FY17: 525 FY14: 854 FY16: 647 FY 18: 539 Current staffing levels do not allow any time for community outreach and education on animal control and responsible pet ownership issues. Increasing the Animal Control officers' hours would allow them to meet with and provide education to neighborhood associations, civic organizations, schools and animal organizations. Animal Bites 120 100 80 60 40 20 Animal Bites 110_ ii lo li 0_ iii. li II FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18 Fiscal Year ►�� Dog Bites ■ Cat Bites Other Animal Bites -5- Note: Average number of bites each calendar year from 2006 - 2016 is 131. The average number of bites for 2017 and 2018 is 178, a 36% increase. In addition, the amount of dogs and cats licensed in the city has steadily increased since FY95 This does not account for unlicensed pets, which the American Veterinarian Medical Association estimates 32% of the households owning 1.69 dogs and 27.3% owning 2.19 cats. For the City of Dubuque's 22,560 households, this translates to 12,200 dogs and 13,488 cats. Recent and proposed annexations have also added travel time and coverage ability. Fiscal Year Animal Licenses Sold Fiscal Year Animal Licenses Sold FY95 7,050 FY07 7,990 FY96 6,900 FY08 8,675 FY97 7,110 FY09 8,370 FY98 7,333 FY10 8,190 FY99 7,147 FY11 9,055 FY00 7,294 FY12 9,341 FY01 7,792 FY13 9,437 FY02 8,005 FY14 9,486 FY03 7,574 FY15 9,897 FY04 8,036 FY16 10,091 FY05 6,293 FY17 10,086 FY06 7,683 FY18 10,309 This improvement package would support City Council Goal 2: "Vibrant Community: Healthy and Safe" by encouraging a sense of safety in the community through increased enforcement as well as ensuring residents feel they are part of a collaborative solution through increased outreach and pet -ownership training efforts. This improvement package also includes an increase in fuel (+$293) and vehicle maintenance (+$165). In addition, it is expected that animal impoundments fees would increase (+$1,500), court fines (+$2,500) and cat licenses (+$1,000) and dog licenses (+$1,500) due to enforcement and outreach. Related Cost: Related Revenue: Net Cost: Property Tax Impact: Activity: Animal Control $ 32,641 Tax Funds $ 6,500 Animal Fees/Fines $ 26,141 $ 0.0103 0.10% Recurring Recurring Recommend - No 3 of 5 This improvement package request is for both Health Department sanitarians to attend the National Environmental Health Association Annual Education Conference in Nashville, TN. Conference dates are July 9-12, 2019. The sanitarians will gain tools, resources, networking opportunities, and knowledge of recent trends and research in the environmental field. This will better equip the sanitarians in their daily operations with the City. The main of objectives of this training are to learn about the latest interpretations and requirements for mandated retail food safety standards and learn about the latest research and studies about food safety interventions which can be implemented in the City of Dubuque Health Department. This training and education for the sanitarians will result in better and more effective service for the citizens of Dubuque to address environmental health issues. Approval of this request contributes to multiple City -6- Council goals and priorities by: (1) creating more livable communities with sharper skills and new tools for code enforcement; (2) improving efficiency in daily operations through the development of creative workflows to contribute to a high-performance organization; and (3) developing a more vibrant community by implementing successful operation strategies discovered through networking opportunities with other organizations from around the nation. Related Cost: $ 4,525 Tax Funds Non -Recurring Recommend - Yes Property Tax Impact: $ 0.0018 0.02% Activity: Health Inspection 4 of 5 This improvement package request is for new dictation equipment for the Health Department Secretary. The current equipment is outdated and cannot be used with current computer software. Dictation equipment allows Health Department staff to make more productive use of time by reducing time spent hand -writing or typing their own correspondence and reports. This request would improve staff health and wellness, attitude, alertness, and ultimately overall service delivery to customers. This request reflects the stated outcomes in City Council Goal 2: "Vibrant Community: Healthy and Safe" by encouraging overall health among City employees which is sought to be promoted among citizens of the community as well. Related Cost: $ 400 Tax Funds Non -Recurring Recommend -Yes Property Tax Impact: $ 0.0002 —% Activity: Animal Control 5 of 5 This improvement package would provide funds for a stand-up, adjustable -height desk unit for the Public Health Specialist's workstation. This improvement package addresses the City Council's goal to maintain a financially responsible, high-performance City organization through providing a ergonomically optimal workspace to promote sustainable, equitable, and effective service delivery for the community. A stand-up, adjustable -height desk will enable the Public Health Specialist to stand while working at the computer. This is especially important for employees who spend a majority of their time in a vehicle traveling on City business and/or sitting at their desk. Related Cost: $ 425 Tax Funds Non -Recurring Recommend - Yes Property Tax Impact: $ 0.0002 —% Activity: Community Health Significant Line Items Employee Expense 1. FY 2020 employee expense reflects a 1.5% wage package increase. 2. The Iowa Public Employee Retirement System (IPERS) City contribution of 9.44% is unchanged from FY 2019 The employee contribution of 6.29% is unchanged from FY 2019. 3. The City portion of health insurance expense decreased from $1,193 in FY 2019 to $921 in FY 2020 per month per contract which results in annual savings of $1,108 or 22.77%. 4. Sick leave payout decreased from $4,097 in FY 2019 to $3,291 in FY 2020. 5. Overtime expense is unchanged from $1,500 in FY 2019 to $1,500 in FY 2020. FY 2018 actual was $1,470. -7- Supplies & Services 6. Court Costs and Record Fees decreased from $23,595 in FY 2019 to $18,653 in FY 2020 based on FY 2018 actual $18,653. Beginning January 1, 2016, the court requires the $85 filing fee for municipal infractions to be paid up front by the City. The Court then enters judgment, and if a defendant if found guilty, the defendant will pay a fine plus $85 in court costs and the Court will distribute the fine portion and reimburse the City for the filing fee that was paid up front by the City. If a defendant is found not guilty, the City will pay for the court costs using the $85 filing fee paid upfront instead of deducting the $85 from the City's judgments, which was the process done by the Court previous to January 1, 2016. Departments that file municipal infractions must budget the upfront filing fee and a portion of the amount is reimbursed to the department going forward. The offsetting revenue is budgeted in Iowa District Court Fines and is $20,849 in FY 2020. Due to time delay of reimbursements, the revenue received is less than the expense. Payments to Other Agencies increased from $158,691 in FY 2019 to $188,691 in FY 2020. The FY 2020 Humane Society contracted budget is $132,891. Most of these contracted services for animal control are expenses that the City would have within its organization regardless of who provides the services. In addition, there is $25,000 budgeted for the Crescent Community Health Center for rent of the wellness center at the renovated Engine House and $25,000 budgeted for Crescent Community Health Center operating expenses. There is also $5,800 budgeted for the Visiting Nurse Association to provide medical case management of lead poisoned children, which is funded by the Iowa Department of Public Health grant. Bill Collection Services unchanged from $46,238 in FY 2019 to $46,238 in FY 2020 based on FY 2018 actual $46,941. This line item represents the amount paid to PetData Services for pet licensing. Education and Training increased from $8,703 in FY 2019 to $9,889 in FY 2020. This line item represents public health and nursing continuing education ($350); National Animal Care & Control Training for Animal Control Officers ($4,600); Iowa Department of Inspections and Appeals Training for Sanitarians ($2,939); and Childhood Lead Poisoning Prevention Training and Lead and Healthy Homes Training ($2,000). Machinery & Equipment 10. Equipment replacement items include ($1,875): Animal Control (2) Smart Phones 700 Inspections (1) Smart Phone $ 350 Recommended Improvement Packages 825 Total $ 1,875 Revenue 11. Dog and cat license revenue increased from $161,023 in FY 2019 to $168,373 in FY 2020 based on FY 2018 actual of $165,873. 12. Business license revenue increased from $97,000 in FY 2019 to $139,950 in FY 2020 due to the fee increase approved by the State of Iowa on January 1, 2019. FY 2018 actual was $107,579. -8- 13. Iowa District Court Fines decreased from $28,192 in FY 2019 to $20,849 in FY 2020. FY 2018 actual was $17,814. This revenue represents the reimbursement of the cost of Court Costs and Record Fees for municipal infractions fee paid up front by the City and then reimbursed to the City by the Court. Due to time delay of reimbursements, the revenue received is less than the expense. A majority of the municipal infractions filed by Health Services are for failure to license a pet. Miscellaneous 14. The Animal Control activity is 56.0% self-supporting in FY 2020 versus 61.4% self-supporting in FY 2019. 15. The Inspection of Food Establishments activity is 70.5% self-supporting in FY 2020 versus 52.6% self- supporting in FY 2019. -9- This page intentionally left blank. -10- PUBLIC HEALTH Public Health provides an effective service to protect, maintain and promote the physical and environmental health and well-being of the citizens of the community. Public Health 1 I i I Environmental Health Administration Community Health Animal Control SUCCESS IS ABOUT PLANNING, PARTNERSHIPS AND PEOPLE LEADING TO OUTCOMES People The Health Services Department strives to respond to conditions that affect the overall health of the community in a timely manner. 1926 Planning - The Dubuque County Community Health Needs Assessment and Health Improvement plan is a community -wide effort to assess the community's health needs and decide how to meet them. - The Dubuque County Health Care Preparedness Coalition is a multi- disciplinary partnership that assesses jurisdictional risk and responds cohesively to public health incidents and emergencies. -+ Green & Healthy Homes Initiative NINACrescent Community HEALTH CENTER VISITING NURSE ASSOC,ATiON Partnerships Partnerships allow public health to perform its activities in an effective, efficient, and inclusive manner. Some partners include the Crescent Community Health Center, Iowa Department of Public Health, Dubuque Community Schools, Dubuque Visiting Nurses Association, Dubuque County Health Department, Mercy Medical Center, Unity Point Health/Finley Hospital, and many others. -11- $600.000 $500,000 $400,000 $300,000 $200,000 $100,000 $0 PUBLIC HEALTH FY 2018 FY 2019 FY 2020 Full -Time Equivalent 5.58 5.58 5.86 Resources and Property Tax Support Operating Revenue FY 2018 State Grant Property Tax Support FY 2019 FY 2020 The Health Department is supported by 5.86 full-time equivalent employees, which accounts for 60.03% of the department expense as seen below. Overall, the departments' expenses are expected to increase by 8.19% in FY 2020 compared to FY 2019. Employee Expense Supplies and Services Expenditures by Category by Fiscal Year $457,389 $475,793 $873 Machinery and Equipment $2,935 $1,875 $297,728 $303,494 $336.362 $0 $100,000 $200,000 $300,000 $400,000 $500,000 FY 2018 FY 2019 El FY 2020 -12- PUBLIC HEALTH Administration/Community Health Overview Community Health provides assessment, assurance, and policy development to address public health problems and issues in the community. The Health Services Department works with the Dubuque County Board of Health to carry out public health core functions and essential services necessary for an effective public health system. Evaluate/Review/Update Ordinances enforced by Health Department: Animal Noise Nuisance Sewer Connection Refuse Storage Food Administration plans, budgets, coordinates and supervises the various activities of the Health Services Department and participates in public health assessment, assurance, and policy development for the community, often working with partner organizations. The prime responsibility is to plan programs and develop policies based on the community health needs assessment, city council priorities, emerging health issues and emergencies as required, and respond to health related complaints and requests in a professional manner. Health AdministrationlCommunity Health Funding Summary FY 2018 Actual FY 2019 Budget FY 2020 Requested Expenditures $252,039 $244,079 $269,468 Resources $6,482 $1Z207 $13,565 Health AdministrationlCommunity Health Position Summary FY 2020 Public Health Specialist 1.00 Public Health Intern 0.14 Secretary 1.00 Total Full -Time Equivalent Employees 2.14 Highlights of the Past Year • Community Health Needs Assessment and Health Improvement Plan (CHNA-HIP) completion (2019-2021 version) • Updated Noise Ordinance • City Employee Wellness Committee -provide guidance, support • Attended HUD/National Environmental Health Association (NEHA) Lead and Healthy Homes Conference • Development agreement between Crescent Community Health Center and Metx for a new clinic -13- 177 }L SESSMENT LTH SERVICES NGS, NOVEMBER 2016 tion United Way PUBLIC HEALTH • Bee Branch Healthy Homes Program- assisted with developing evaluation method and tools and providing oversight for Home Advocates • Opioid advocacy policy development for city council and Dubuque Opioid Response Tea m • Brain Health Community Task Force member • Integrated Pest Management Plan (IPM) development- working group member • Controlled Livestock Grazing ordinance and policy staff work group for successful implementation • Revised nuisance and weed ordinance enforcement policies • c,■ i■ ■. _•:.: .• •i ili!_ f ir_ ■� • I :: 1: :: ■■ it: it ■ ■ .""■ ■ ■ ■ ■ ■ III II ini ii 11 1'1 11 11 1 1' 1!1 : ,1111 1 ■ • '1 1' I I I II II 11` 11.1 11 11'11,11� 1111 . ■1 III II II IIi i' 1■111U>tll1,�O 1�pI' II ■ ■ i ■ .■7111■ ■ III III/ c .. r o COMMUNITY NEEDS A' MENTAL HE • KEY FIND Community fou yGmmn• —14- PUBLIC HEALTH Future Initiatives • Further develop SOCRATA dashboard for Public Health data and outcomes • Community education on lead service line replacement for water • Brain Health -continue working with community based Brain Health Task Force to improve the mental/brain health care system and improved access to care in Dubuque County • Healthy Hometown community health initiative in conjunction with Dubuque County Wellness Coalition • Implementation of revised nuisance enforcement policy • Pet Friendly Community Policy development - staff committee • Build out of new Crescent Community Health Center • Opioid Task Force community education and advocacy • Community Health Needs Assessment and Health Improvement Plan (CHNA HIP) tracking and Implementation • Dubuque Regional Humane Society - new agreement Performance Measures Community Health- Activity Statement Maintain and enhance factors that contribute to the public health and welfare of the citizens of Dubuque. 14r Goal: Financially Responsible, High Performance Organization /' Outcome #1: Provide, maintain, and educate on measures to prevent and control the spread of infections, communicable and environmental diseases and threats. • Prepare for, respond to, and recover from public health emergencies and problems. • Work cooperatively with community health partners to prevent and control the spread of infections, communicable and environmental diseases and conditions. • Build and maintain collaborative relationships with community partners that support public health assessment, planning and program implementation. • Seasonal health and emerging communicable disease information communicated to the public via website, social media, TV and newspaper • Participated in the Integrated Pest Management Program (IPM) Task Force which included drafting an IPM plan for the City. • Coordinate Dubuque County Health Care Preparedness Coalition and participate in exercises Participates in and plans emergency preparedness training and drills to ensure that in the event of a public health emergency all participating partners are familiar with their agencies' role and implementation of the public health preparedness plan is tested. -15- PUBLIC HEALTH • Participate in the Dubuque County Health Care, Executive Committee Member • Planned and executed City Management Team Emergency Operations Center (EOC) exercise. Exercise IDPH vIV Iowa's Health Alert Network luv,:i Department ut Public Health . • • oes �' • L 0 -16- PUBLIC HEALTH Outcome #2: Assure accessibility and quality of primary care and population -based health services 6,437 Patients Served 1.699 Children 409 Age 65 6 Older j '1* 2,448 1.880 204 Women Men Veterans 8 600 al.) 4.3C0 150 0 Patients 111 i 7013 7014 7o15 7010 7017 :071 Crescent Community Health Center secured lease with Metx, LLC to move clinic into new space at 1690 Elm Street, allowing for clinic expansion. • 6,437 patients served in 2017 • 1,699 were children • 50% have incomes at or below 100% of the federal poverty level • 19% had no insurance • Dental Visits: 10,780 (up from 9,723 in FY15) • Medical Visits: 7,984 Outcome #3: Reduce the incidence of environmental health hazards in residential living environments Hospital Emergeny Department Asthma Visits # Visitsts in Dubu 500 400 300 200 100 0 ALI MI 20072008200920102011201220132014201520152016 Year _�— BEE BRANCH HEALTHY HOMES Did You Know? The Public Health Specialist and Healthy Homes staff are providing local health and social agencies and providers with Healthy Homes program information and education. • Partner with the Bee Branch Healthy Homes Program for implementation of the HUD Natural Disaster Resiliency grant, incorporating Lead and Healthy Homes Programs. -17- PUBLIC HEALTH Outcome #4: Mobilize community partnerships to identify and investigate public health problems and emerging issues • Bi -hospital infection control committee member • Dubuque County Wellness Coalition, Co -Chair • Air Quality Task Force • GHHI Resource Group • University of Iowa College of Public Health Board of Advisors, Chair • Dubuque County Health Care Preparedness Coalition • Dubuque Opioid Response Team IT'S BRAIN HEALTH END THE NOT MENTAL ILLNESS ?MA Health Services Department maintains agreements: IDIA- Food Inspections IDPH- Swimming pool, tanning, tattoo inspections IDPH/Dubuque County Board of Health- Childhood Lead Poisoning Prevention Program, Annual Dubuque Regional Humane Society- Annual Dubuque VNA- Childhood Lead Poisoning and Healthy Homes Services Crescent Community Health Center - Health Care Access Did you know? The Dubuque County Health Preparedness Coalition meets regularly to assess and plan for public health emergencies. Recent accomplishments include: completion of IDPH Preparedness capabilities, review and update of the Preparedness Plan. Environmental Health Overview Environmental Health promotes a safe and healthy environment by assuring sanitary conditions and practices in accordance with municipal public health and environmental ordinances, codes and regulations. The Environmental Health Activity: • Responds to resident garbage, and nuisance complaints • Inspects public swimming pools and spas • Provides information on indoor air quality and other environmental issues • Inspects tanning and tattoo facilities • Assures food safety through inspection and licensing of food and food service establishments, temporary food stands and mobile food units. -18- PUBLIC HEALTH Food Inspection/Environmental Health Funding Summary FY 2018 Actual FY 2019 Budget FY 2020 Requested Expenditures $216,213 $220,732 $224,391 Resources $122,682 $116,070 $158,116 Food Inspection/Environmental Health Position Summary FY 2020 Environmental Sanitarian Total Full -Time Equivalent Employees 2.00 2.00 Highlights of the Past Year • FDA modified the National Voluntary Retail Food Protection Standards. All Standards were reviewed, updated, and completed. • Renewed contract with Iowa Department of Inspections and Appeals (DIA). • Nuisance and weed ordinance enforcement policies and procedures revised. • Fully digital on food and swimming pool inspections. Future Initiatives • Re-evaluate FDA Standard 6 to meet compliance. • Meet requirements of FDA Standard 9, a new addition to contract with DIA. • Co fully digital on tattoo and tanning inspections • Implementation of new nuisance enforcement policy. • Continue data collection of bedbug incidence and conduct enforcement for hotels along with targeted education and enforcement. -19- PUBLIC HEALTH Performance Measures Environmental Health - Activity Statement Promote a safe and healthy environment by assuring sanitary conditions and practices in accordance with municipal public health and environmental ordinances, codes and regulations. ') ) Goal: Environmental Integrity Outcome #1: Assure safe and sanitary non-residential swimming pools and spas, tattoo and tanning facilities by providing a minimum of one inspection per year within Dubuque Country under a contractual agreement with the Dubuque County Board of Health and the Iowa Department of Public Health (IDPH). - Enforce environmental health rules and regulations. All facilities inspected a minimum of once per year per IDPH contract: • Pools/Spas: 45 • Tanning facilities: 12 • Tattoo parlors: 23 • Tanning operator certification exams administered: 2 • Pool/Spas closed for "Unsanitary Conditions": 1 • 100% of tanning operators maintaining/meeting training requirements Did You Know? Public swimming pools and spas are inspected for both water quality and safety measures annually. Outcome #2: All school lunch programs, licensed food service establishments, mobile unit/pushcarts, temporary food service establishment, retail food establishments, Hotels, motels and bed & breakfast inns are inspected and licensed through a contract with Iowa Department of Inspections & Appeals. Ongoing, regular and follow-up inspections of food establishments protect the public from food borne illness and outbreaks. Food Inspections Conducted: 703 Outstanding past due inspections: 141 Complaint Inspections: 37 Temporary food stand licenses issued: 172 New establishment/change of ownership licenses issued: 36 -20- PUBLIC HEALTH A total of 403 food establishments are inspected on a risk-based system. Of these, 257 are inspected annually. • Number of active Certified Food Protection Managers: 317 • Hotel Complaints: 16 Working with the Building Services Department, the Environmental Sanitarian requires all food facilities to meet Food Code requirements prior to issuance of alcohol and food licenses. Did You Know? In order to obtain a new food establishment or food service establishment license, a plan review packet must be submitted and approved. • Facility must pass inspection • Policies and procedures along with trained staff must be in place Outcome #3: Alleviate overgrown weeds, improper garbagelrefuse storage and disposal and other public nuisances through code enforcement • Nuisance & CrassNVeed citations issued: 5 • Nuisance & CrassNVeed violations corrected by hired contractor: 40 • Nuisance & CrassNVeed complaints: 321 Outcome #4: Provide information, education, and assistance on environmental health risks and Healthy Homes principles. The Health Services Department provides current information on new and recurring environmental health issues such as radon, bed bugs, mold, rodents, vermin, etc. Did you know? Environmental health staff maintains the most current information available on the Health Services Department website. Bedbug information is the most frequent request for environmental health topics. -21- PUBLIC HEALTH Animal Control Overview Animal Control enforces the City Animal Ordinance which provides for licensing of all cats and dogs, the prohibition of dogs and cats running at -large within the city, inoculation of all dogs and cats against rabies, investigation of animal bites and assurance of proper rabies confinement, prohibition of harboring a vicious or potentially vicious animal or dangerous animal and prohibition of animals causing serious disturbance or nuisance. Animal Control Funding Summary FY 2018 Actual FY 2019 Budget FY 2020 Requested Expenditures $287,513 $317,411 $352,388 Resources $190,832 $194,879 $197,332 Animal Control Position Summary FY 2020 Animal Control Officer 0.72 ANIMAL CONTROL OFFICER 1.00 Total Full -Time Equivalent Employees 0.72 Highlights of the Past Year • Animal Control Officers were trained in chemical immobilization • Added PetData and Animal Control phone number to pet license tags in 2018 • Updated Animal Control brochure Future Initiatives • Continue Animal Control Officer education and training • Police Officers involved in animal abuse and neglect training • Utilize body cameras • Evaluate wild cat trapping procedure and policy -22- PUBLIC HEALTH Performance Measures Animal Control - Activity Statement Protect the public health by abating and investigating animal nuisances, preventing the spread of rabies and providing information regarding animals to citizens. Outcome #1: To respond to and abate the problems and nuisances of dogs and cats within the city limits by impounding stray dogs and cats, investigating complaints regarding barking dogs and animals roaming at large and other animal nuisances, and live -trapping dogs and cats. Enforcement of the Animal Control Ordinance promotes responsible pet ownership and provides city residents with guidance for living with and among pets. • Animal Control officers responded to 942 complaints • Police Department responded to 539 complaints during times Animal Control Officers are not on duty • 44 citations were issued for violations of the Animal Control ordinance. Outcome #2: To control the spread of rabies among animals and between animals and humans By assuring accurate and rapid investigation of animal bite incidents, assuring the rabies observation of animal bite incidents, assuring the rabies observation of biting dogs and cats by a licensed veterinarian, apprehending and ordering the laboratory diagnosis of biting, wild and non -domesticated animals for rabies, enforcing the rabies immunization and licensing of all dogs and cats within the city. • 10,309 Pet Licenses Sold • 1,446 Citations for Failure to License Pet 11,000 10,000 9,000 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 City of Dubuque Pet Licences FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 -23- PUBLIC HEALTH Outcome #3: Assess and evaluate animal bites, injuries and attacks for determining potentially vicious and vicious animal declarations. The City Animal Control Ordinance addresses several aspects of responsible pet ownership such as rabies vaccination, license, leash laws, running at large, vicious and nuisance issues. 140 120 100 80 60 40 20 0 Animal Bites FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18 • 179 animal bites in FY18, a 64% increase from FY17 • 3 Vicious/Potentially Vicious Declarations ■ Dog Bites II Cat Bites Other Animal Bites Did You Know? • Per the Iowa Department of Public Health, there were 10 cases of animal rabies reported in Iowa in 2017 -most commonly found in bats, skunks and cats. • In the United States, over 36% of households own at least one dog. • Among adults, men are more likely than women to be bitten by a dog. Outcome #4: To respond to the problems and nuisances of wild animals within the city by: providing citizens with possible abatement methods and consultants and suggesting ways to discourage animals from habitation; and attempting to capture of wild animals suspecting potential rabies exposure. Wild animal trappers must be certified by the IDNR. A list of certified trappers is maintained by the Health Services Department. Currently 4 certified animal trappers do business in the city of Dubuque. Did you know? In the state of Iowa, rabies was diagnosed in 2 cats in 2017. -24- Recommended Operating Revenue Budget - Department Total 17 - HEALTH SERVICES Fund Account Account Title FY17 Actual Revenue FY18 Actual Revenue FY19 Adopted Budget FY20 Recomm'd Budget 100 42,105 BUSINESS LICENSES 100 42,120 DOG LICENSES 100 42,125 CAT LICENSES 100 42,169 TANNING TATTOO LICENSES 100 42,235 REFUSE HAULING PERMITS 100 42,325 SWIMMING POOL INSP. FEES 100 42,330 ANIMAL IMPOUNDMENT FEES 96,949 117,023 43,477 3,276 650 8,087 6,540 107,579 119,613 46,260 2,640 725 7,436 7,350 97,000 117,023 44,000 4,221 650 8,500 6,600 139,950 121,113 47,260 3,070 725 9,533 8,850 42 LICENSES AND PERMITS - Total 276,002 291,603 277,994 330,501 100 100 45,701 45,771 STATE GRANTS FED PASS THRU STATE GRANT 8,354 4,693 5,759 0 5,807 4,693 11,599 500 45 STATE GRANTS - Total 13,047 5,759 10,500 12,099 100 51,987 WEED CUTTING CHARGES 4,132 3,695 4,017 3,695 51 CHARGES FOR SERVICES - Total 4,132 3,695 4,017 3,695 100 53102 PRIVATE PARTICIPANT 100 53,403 IA DISTRICT COURT FINES 100 53,605 MISCELLANEOUS REVENUE 100 53,610 INSURANCE CLAIMS 100 53,620 REIMBURSEMENTS -GENERAL 100 53,625 REIMBURSEMENTS -TRAINING 3,163 28,202 100 382 4,183 0 0 17,814 0 0 668 457 0 28,192 100 382 1,971 0 0 20,849 300 0 669 900 53 MISCELLANEOUS - Total 36,029 18,940 30,645 22,718 HEALTH SERVICES - Total 329,210 319,996 323,156 369,013 -25- Recommended Operating Expenditure Budget - Department Total 17 - HEALTH SERVICES Fund Account Account Title FY17 Actual Expense FY18 Actual Expense FY19 Adopted Budget FY 20 Recomm'd Budget 100 61010 FULL-TIME EMPLOYEES 100 61020 PART-TIME EMPLOYEES 100 61030 SEASONAL EMPLOYEES 100 61050 OVERTIME PAY 100 61091 SICK LEAVE PAYOFF 290 61091 SICK LEAVE PAYOFF 100 61310 IPERS 100 61320 SOCIAL SECURITY 290 61320 SOCIAL SECURITY 100 61410 HEALTH INSURANCE 100 61415 WORKMENS' COMPENSATION 100 61416 LIFE INSURANCE 100 61660 EMPLOYEE PHYSICALS 245,428 73,039 4,037 1,189 4,599 502 28,890 24,059 39 55,650 7,518 217 128 264,469 65,938 2,569 1,470 4,308 211 29,873 24,860 15 55,650 7,662 239 128 272,938 75,970 3,334 1,500 4,097 0 33,394 27,374 0 50,086 6,772 328 0 342,082 36,910 3,410 1,500 3,291 0 36,241 29,620 0 48,978 5,684 294 0 61 - WAGES AND BENEFITS 445,294 457,389 475,793 508,010 100 62010 OFFICE SUPPLIES 100 62011 UNIFORM PURCHASES 100 62030 POSTAGE AND SHIPPING 100 62061 DP EQUIP. MAINT CONTRACTS 100 62063 SAFETY RELATED SUPPLIES 100 62065 LAB SUPPLIES 100 62067 ANIMAL CONTROL SUPPLIES 100 62090 PRINTING & BINDING 100 62110 COPYING/REPRODUCTION 100 62130 LEGAL NOTICES & ADS 100 62170 SUBSCRIPTIONS -BOOKS -MAPS 100 62190 DUES & MEMBERSHIPS 100 62204 REFUNDS 100 62206 PROPERTY INSURANCE 100 62208 GENERAL LIABILITY INSURAN 100 62230 COURT COSTS & RECORD FEES 100 62310 TRAVEL -CONFERENCES 100 62320 TRAVEL -CITY BUSINESS 100 62340 MILEAGE/LOCAL TRANSP 100 62360 EDUCATION & TRAINING 100 62421 TELEPHONE 100 62436 RENTAL OF SPACE 100 62511 FUEL, MOTOR VEHICLE 100 62521 MOTOR VEHICLE MAINT. 100 62528 MOTOR VEH. MAINT. OUTSOUR 100 62614 EQUIP MAINT CONTRACT 100 62663 SOFTWARE LICENSE EXP 100 62667 DATA SERVICES 100 62668 PROGRAM EQUIP/SUPPLIES 100 62671 MISC. OPERATING SUPPLIES 100 62683 FIELD OPERATIONS SUPPLIES 100 62716 CONSULTANT SERVICES 100 62725 BILL COLLECTION SERVICES 100 62727 FINANCIAL SERVICE FEES 523 514 7,875 7,594 0 0 158 1,614 2,282 698 0 1,245 0 141 3,608 23,595 4,685 1,354 167 6,770 3,686 2,304 2,381 8,092 990 688 154 241 507 2,740 182 5,120 46,238 1,421 -26- 1,146 640 7,882 7,895 (1) 0 67 2,038 799 660 159 790 100 132 3,210 18,653 7,842 51 24 6,541 3,409 2,304 2,142 846 0 750 142 311 509 0 596 2,999 46,941 630 614 1,259 7,249 8,054 100 100 500 2,524 2,282 698 320 1,355 0 0 3,437 23,595 7,700 319 285 8,703 2,964 2,304 2,428 1,629 1,010 688 153 481 507 100 182 5,120 46,238 1,421 1,086 1,284 8,168 8,053 100 50 200 3,419 854 660 334 1,310 0 0 3,625 18,653 14,369 564 300 9,889 3,421 2,304 3,086 3,018 1,030 750 150 600 759 100 200 4,172 46,238 630 Recommended Operating Expenditure Budget - Department Total 17 - HEALTH SERVICES Fund Account Account Title FY17 Actual Expense FY18 Actual Expense FY19 Adopted Budget FY 20 Recomm'd Budget 100 62732 TEMP HELPCONTRACT SERV. 100 62736 CATERING SERVICES 100 62761 PAY TO OTHER AGENCY 100 62780 HAULING SERVICES 100 62781 LAWN CARE SERVICES 0 260 194,214 1,021 3,890 0 0 172,449 589 4,483 4,869 225 158,691 1,500 3,890 2,998 225 188,691 589 4,483 62- SUPPLIES AND SERVICES 336,951 297,728 303,494 336,362 100 71111 DICTATION EQUIPMENT 100 71118 PROJECTOR/CAMERA 100 71122 PRINTER 100 71211 DESKS/CHAIRS 100 71310 AUTO/JEEP REPLACEMENT 100 72418 TELEPHONE RELATED 0 0 0 3,734 8,250 910 0 0 0 0 0 873 0 1,100 600 425 0 810 400 0 0 425 0 1,050 71- EQUIPMENT 12,895 873 2,935 1,875 17 - HEALTH SERVICES TOTAL 795,140 755,990 782,222 846,247 -27- Recommended Expenditure Budget Report by Activity & Funding Source 17 - HEALTH SERVICES FUNDING SOURCE: CABLE TV Account FY18 Actual Expense FY19 Adopted Budget FY20 Recomm'd Budget EQUIPMENT SUPPLIES AND SERVICES WAGES AND BENEFITS HEALTH SERVICES ADMINISTR FUNDING SOURCE: GENERAL Account 33,563 131,528 165,090 ANIMAL CONTROL FY18 Actual Expense 405 14,803 131,126 146,3 825 40,297 127,945 169,0 FY19 Adopted Budget FY20 Recomm'd Budget EQUIPMENT SUPPLIES AND SERVICES WAGES AND BENEFITS 582 208,165 78,766 1,525 225,358 90,528 ANIMAL CONTROL 287,513 INSP. - FOOD ESTBLMNTS - 17300 FUNDING SOURCE: GENERAL Account FY18 Actual Expense FY19 Adopted Budget FY20 Recomm'd Budget 700 225,746 125,942 EQUIPMENT SUPPLIES AND SERVICES WAGES AND BENEFITS INSP. - FOOD ESTBLMNTS FUNDING SOURCE: GENERAL Account 291 1,005 350 27,920 28,699 33,486 188,002 191,028 190,555 111111101r- 216,213 COINITY HEALTH SERV. - 17400 FY18 Actual Expense 220,732 FY19 Adopted Budget FY20 Recomm'd Budget SUPPLIES AND SERVICES WAGES AND BENEFITS 23,451 59,094 COMMUNITY HEALTH SERV. 82,546 LEAD PAINT PROGRAM - 175 FUNDING SOURCE: GENERAL Account FY18 Actual Expense 27,409 63,111 27,593 63,568 FY19 Adopted Budget FY20 Recomm'd Budget SUPPLIES AND SERVICES LEAD PAINT PROGRAM HEALTH SERVICES TOTAL $ 4,628 -28- 7,225 7,225 782,222.00 $ 9,240 CITY OF DUBUQUE, IOWA DEPARTMENT DETAIL - PERSONNEL COMPLEMENT 17 HEALTH SERVICES DEPARTMENT FY 2018 FY 2019 FY 2020 FD JC WP -GR JOB CLASS FTE BUDGET FTE BUDGET FTE BUDGET 61010 Full Time Employee Expense 100 7700 GE -37 PUBLIC HEALTH SPECIALIST 1.00 93,274 1.00 94,676 1.00 96,836 100 7500 GE -32 ENVIRONMENTAL SANITARIAN 2.00 137,554 2.00 129,313 2.00 136,293 100 7400 GE -29 ANIMAL CONTROL OFFICER 0.00 0 0.00 0 1.00 59,967 100 7375 GE -27 ENVIRON.SANITARIANASST 0.00 0 0.00 0 0.00 0 100 225 GE -25 SECRETARY 1.00 46,718 1.00 48,949 1.00 48,986 TOTAL FULL TIME EMPLOYEES 4.00 277,546 4.00 272,938 5.00 342,082 61020 Part Time Employee Expense 100 7400 GE -29 ANIMAL CONTROL OFFICER TOTAL PART TIME EMPLOYEES 1.44 77,723 1.44 75,970 0.72 36,910 1.44 77,723 1.44 75,970 0.72 36,910 61030 Seasonal Employee Expense 100 PUBLIC HEALTH INTERN 0.14 3,285 0.14 3,334 0.14 3,410 TOTAL SEASONAL EMPLOYEES 0.14 3,285 0.14 3,334 0.14 3,410 TOTAL HEALTH SERVICES 5.58 358,554 5.58 352,242 5.86 382,402 -29- CITY OF DUBUQUE, IOWA ACTIVITY PERSONNEL COMPLEMENT SUMMARY ACCT FD JC WP -GR POSITION CLASS FY 2018 FY 2019 FY 2020 FTE BUDGET FTE BUDGET FTE BUDGET Health Services Administration -General Fund 10017100 61010 100 225 GE -25 SECRETARY 1.00 $ 46,718 1.00 $ 48,949 1.00 $ 48,986 10017100 61010 100 7700 GE -37 PUBLIC HEALTH SPECIALIST 0.50 $ 46,637 0.50 $ 47,338 0.50 $ 48,418 Total 1.50 $ 93,355 1.50 $ 96,287 1.50 $ 97,404 Community Health Services - FT General Fund 10017400 61010 100 7700 GE -37 PUBLIC HEALTH SPECIALIST 0.50 $ 46,637 0.50 $ 47,338 0.50 $ 48,418 Total 0.50 $ 46,637 0.50 $ 47,338 0.50 $ 48,418 Community Health Services - Seasonal General Fund 10017400 61030 100 Inspection of Food Flt&6/1 Felftfl 0 10,017,30 61010 0 Animal Control -FT 10017200 61010 Est./Environmental - 100 7500 GE -32 100 7375 GE -27 General Fund 100 7400 GE -29 Animal Control -PT General Fund 10,017,20 61020 100 7400 GE -29 0 PUBLIC HEALTH INTERN Total 0.14 $ 3,285 0.14 $ 3,334 0.14 $ 3,410 0.14 $ 3,285 0.14 $ 3,334 0.14 $ 3,410 ENVIRONMENTAL SANITARIAN 2.00 $ 137,554 2.00 $ 129,313 2.00 $136,293 ENVIRON.SANITAR IAN ASST 0.00 $ - 0.00 $ - 0.00 $ - Total 2.00 $ 137,554 2.00 $ 129,313 2.00 $136,293 ANIMAL CONTROL OFFICER Total 0.00 $ - 0.00 $ - 1.00 $ 59,967 0.00 $ - 0.00 $ - 1.00 $ 59,967 ANIMAL CONTROL OFFICER 1.44 $ 77,723 1.44 $ 75,970 0.72 $ 36,910 Total 1.44 $ 77,723 1.44 $ 75,970 0.72 $ 36,910 TOTAL HEALTH SERVICES DEPT. 5.58 $ 358,554 5.58 $ 352,242 5.86 $382,402 -30- ANIMAL CONTROL ANALYSIS HOURS ANNUAL NET HOURS NET WEEKLY COVERAGE (Accounts for Shift Change Overlap) DAYS/TIMES FY20 SUPPLIES/SERVICES & EQUIPMENT FY20 EMPLOYEE COST FY20 TOTAL COST CURRENT: 2 Part -Time Officers 1 Full -Time Officer & 1 Part -Time Officer 29x2=58 Hours 3,026 55 M 8 AM -5:30 PM Tues -W 8 AM -6 PM F 8 AM -5:30 PM Sat 9 AM -2 PM $226,746 $93,913 $320,659 40 + 29 = 69 Hours M -F 8-7 PM* 3,337 66 Sat 9 AM -2 PM Sun 9 AM -2 PM $227,746 ($1,000 added Fuel/Veh. Maint.) $124,540 $352,286 1 Full -Time & 2 Part -Time Officers 2 Full -Time Officers 40+(29X2)= 98 Hours 4,850 95 M -Sun 8 AM -8 PM* 2"d Officer Coverage: T -F 10 AM -2:30 PM Body Cam $550 iPhone $350 iPad $900 Data $624 Uniform $350 Computer $2,275 Fuel $755 Veh. Main. $810 Ed/Training $3,000 Addt'I Costs Sub. Total $9,734 Truck $50,000** TOTAL $286,480 $175,235 vetrns `f 61,°7) 29 x 3 = 87 Hours M -F 8 AM -7 PM* Sat 9 AM -3 PM 4,539 84 Sun 9 AM -3 PM 2" Officer Coverage: M, W, F 3.5 hours Body Cam $550 iPhone $350 iPad $900 Data $624 Uniform $350 Computer $2,275 Fuel $755 Veh. Main. $810 Ed/Training $3,000 Addt'I Costs Sub. Total $9,734 Truck $50,000** TOTAL $286,480 $134,916 $421,396 40 x 2 = 80 Hours M -Sun 8 AM -7 PM* 3,648 77 2" Officer Coverage: W & F 3.5 hours Days/Times will vary with change of seasons (Winter to Summer hours) *1 -hour lunch break included **Truck cost of $50,000 is non-recurring 2/11/2019 Fuel $700 Veh. Main. $800 Sub. Total $1,500 Total $228,246 $152,287 $380,533 Police Animal Control 180 160 140 120 100 80 60 40 20 0 118 2018 Annual Calls for Service to Police by Day of Week 108 113 132 98 105 154 Sunday Monday Tuesday Wednesday Thursday Friday Saturday Poke An 7 6 5 4 3 2 1 0 ma Controi 2018 Annual Animal Bite Calls to Police by Day of /eek Sunday Monday Tuesday Wednesday Thursday Friday Saturday Dubuque is the only community without at least one full-time employee. Saved in F drive: Animal Control: Comparisons Iowa city's ACO staff numbers 2.1.18 2/11/19 Scott County HS - One ACO is in charge of the shelter and ACO's. ACO do not include shelter staff. Cedar Rapids 131,127 12 FT 40 12 0.15 Mon-Sat: 12 pm-5 pm Closed: Sunday and holidays 'Council Bluffs 62,524 2 FT 3 PT 40 32 4.4 7.04 Monday-Friday: 9:00 am - 12:00 pm, 1:00 pm - 5:00 pm Saturday: 11:00 am - 5:00 pm Closed: Sunday and holidays (712) 328-4656 Polk County - 127,115; excluding Des Moines and West Polk Co 467,711 Des Moines 215,472 -125,124 2 FT 5 PT 40 32 6 Mon - Fri: 6:30 am -11 pm, on call after Sat, Sun: 6:30 am - 3 pm, on call after (515) 286-3333 police can send AC message 109,324; Waterloo Waterloo 67,934 Cedar Falls 41,390 2 FT 3 PT 40 25 3.88 4 4 i ACO's have Contract for services for UNI and Cedar Falls along with City of Waterloo. Mon - Fri: 7/8 am - 9/8 pm Sat, Sun: 8 am - 8 pm, On call after hours 319-883-0797 wa City 74,398 3 FT 40 3 .: 0 , Mon - Fri: 6:30 am -6 pm Sat: 6:30 am- 3 pm Closed: Sunday and holidays Chris (319) 356-5295 Scott County 172,509 Humane Society 4FT 2PT(29) 40+6655 > than 30 6.18 3 55 Only it says Scott County HS Mon, Wed: 10-7 Tue, Thur, Sat: 12-5, Sat:105 Fri, - Contracts with the cities of Davenport, Bettendorf, Le Claire, Scott County, Blue Grass, Buffalo, Donahue, Eldridge, Long Grove, McCausland, Maysville, New Liberty, Panorama Park, Princeton, Riverdale and Walcott. 2/1 LM with 563-388- asking for #'s. sent email to (female) Lt. Schutts West Pet (West 125,124; Des Moines, West Des Moines 64,560 Urbandale, Urbandale 43,018 Clive) Clive 17,546 3 FT 1 PT 40 20-30 3.625 2.9 Mon - Fri: 8 am - 8 pm Sat, Sun: 8 am - 4:30 PM Joe 515-222-3364, contract with HS. Ames 66,191 1 FT PT 40+ 14 1.35 2.o Mon - Fri: 8 am - 8 pm Sat, Sun: 8 am - 5 PM Ron Edwards ACO Supervisor, edwards@cityofames.org 515-239-5530 Des Moines 215,472 5 FT 1 PT 40 20 5.5 2.55 Mon - Sun: 7 am - 10 pm Josh 515-243-4526 58,531 2 PT 29 1.45 2.48 Mon - Fri: 8/9 am - 6/7 pm Sat: 9 am - 2 PM Closed: Sunday and holidays Dubuque is the only community without at least one full-time employee. Saved in F drive: Animal Control: Comparisons Iowa city's ACO staff numbers 2.1.18 2/11/19 Scott County HS - One ACO is in charge of the shelter and ACO's. ACO do not include shelter staff.