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Health Services Fiscal Year 2016 Budget PresentationCity of Dubuque Public Hearings # 1. ITEM TITLE: SUMMARY: SUGGESTED DISPOSITION: Copyright 2014 Health Services Fiscal Year 16 Budget Presentation ATTACHMENTS : Description Type ❑ Health Services FY16 Recommended Budget Supporting Documentation Health Services -8- HEALTH SERVICES DEPARTMENT Budget Highlights Employee Expense Supplies and Services Machinery and Equipment Total Operating Revenue Cable TV Charges State Grant Total Property Tax Support Percent Increase (Decrease) Personnel - Authorized FTE FY 2013/14 Actual 419,938 280,987 16,100 717,025 290,494 29,918 11,802 332,214 384,811 5.58 FY 2014/15 Adopted 437,536 302,323 19,046 758,905 290,750 10, 000 300,750 458,155 5.58 FY 2014/15 Amended 437,062 304,992 19,046 761,100 290,750 10,000 300,750 460,350 5.58 FY 2015/16 Recomm'd 435,012 292,541 874 728,427 298,425 8,000 306,425 % Change from Adopted FY 2014/15 - 0.6% - 3.2% - 95.4% - 4.0% 2.6% 0.0% - 20.0% 1.9% 422,002 -36,153 5.58 - 7.9% Improvement Package Summary 1 of 3 This improvement package would increase the two 30 -hour per week part-time Animal Control Officers to full-time at 40 hours per week. This would improve Animal Control staffing by 33%, providing more morning, evening and weekend coverage and timelier follow-up on current animal control incidents and complaints. The added coverage will reduce the amount of calls the Police will need to 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 improved coverage for when Animal Control takes time off for 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 1,513 hours in a twelve-month period. Also, when Animal Control is not on -duty, i.e., evenings, nights, weekends, holidays, training, etc., Police cover animal emergencies and complaints. In FY12, Police responded to 767 animal calls, in FY13, Police responded to 717 animal calls and in FY14, Police responded to 854 animal calls. This amounts to significant time and expenditure for the Police Department. 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. -9- In addition, the amount of dogs and cat licensed in the city has steadily increased since FY 94. 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. Recent and proposed annexations have also added travel time and coverage ability. FY Animal Licenses Sold FY94 6495 FY95 7050 FY96 6900 FY97 7110 FY98 7333 FY99 7147 FY00 7294 FY01 7792 FY02 8005 FY03 7574 FY04 8036 FY05 6293 FY06 7683 FY07 7990 FY08 8675 FY09 8370 FY10 8190 FY11 9055 FY12 9341 FY13 9437 FY14 9486 This improvement package also includes an increase in fuel (+$703) and vehicle maintenance (+$673). In addition, it is expected that animal impoundment fees would increase (+$3,000), court fines (+$5,000) and cat licenses (+$1,000) and dog licenses (+$2,000) due to enforcement and outreach. Related Cost: $75,170— Tax Funds - Recurring Related Revenue: $11,000— Tax Funds — Recurring Net Cost: $64,170 Property Tax Impact: +$.02841+.26% Activity: Animal Control Recommend - No 2 of 3 This improvement package would provide funds for new office furniture for the Environmental Sanitarian to provide appropriate ergonomic standards and improved office efficiency. Related Cost: $2,600 — Tax Funds —Non -Recurring Property Tax Impact: +5.00121-F.01% Activity: Inspections -10- Recommend - No 3 of 3 This improvement package would provide funds for contractual grant writing services for community- wide health and wellness initiative and/or Smarter Health Project. Assistance will be needed for securing funding through opportunities such as the CMS Innovation grant submitted in August, 2013. The City Council adopted Health and Safety as a twelfth Sustainability Principle. Efforts to implement models for environmental, and policy change, and citizen engagement will ensure residents' access to healthy and safe lifestyle choices. Related Cost: $10,000 — Tax Funds —Non -Recurring Property Tax Impact: +$.0044/+.04% Activity: Community Health Services Significant Line Items at Maintenance Level (Without Recommended Improvement Packages) Employee Expense Recommend - No 1. The City wage plan for non -bargaining unit employees will not increase and bargaining unit employees will receive a 2.25% wage increase in FY 2016. 2. The Iowa Public Employee Retirement System (IPERS) City contribution remains at 8.93% and the employee contribution remains at 6.18% in FY 2016. 3. The City portion of health insurance expense decreased from $1,190 in FY 2015 to $1,040 in FY 2016 per month per contract, resulting is a savings of $6,300. 4. FY 2016 is the fourth year that eligible retirees with at least twenty years of continuous service in a full-time position or retired as a result of a disability and are eligible for pension payments from the pension system can receive payment of their sick leave balance with a maximum payment of one - hundred twenty sick days payable bi-weekly over a five year period. Sick leave payout expense of $1,080 is budgeted in the Health Services (for one employee) in FY 2016. 5. Workers' Compensation decreased from $8,253 in FY 2015 to $7,823 in FY 2016 based on FY 2014 plus 6%. Supplies & Services 6. Postage decreased from $7,238 in FY 2015 to $6,154 in FY 2016 based on FY 2014 actual $5,861 plus 5%. 7. Printing decreased from $3,200 in FY 2015 to $2,029 in FY 2016 based on FY 2014 actual $1,990 plus 2%. 8. Legal Notices and Ads decreased form $500 in FY 2015 to $0 in FY 2016. This includes a reduction of $350 budgeted in FY 2015 for vacant positions and a reduction of $150 for radon ads and service of citations and law enforcement in Food Inspections as law enforcement is no longer used for citations. -11- 9. Conferences increased from $4,675 in FY 2015 to $5,634 in FY 2016 due to an increase of $400 for the Public Health Specialist based on location of conferences and increase of $559 for the Sanitarians' conferences. 10. Education and Training increased from $4,200 in FY 2015 to $5,818 in FY 2016 due to increase of $1,200 for training for Animal Control Officers and an increase of $750 for training of medical case management staff on current trends in childhood lead poisoning and Healthy Homes issues. 11. Motor Vehicle Fuel decreased from $5,594 in FY 2015 to $3,654 in FY 2016 based on FY 2014 actual of $4,349 minus 20%. 12. Internet Services decreased from $1,440 in FY 2015 to $360 in FY 2014 due to data charges for the computer tablets being charged to the telephone line and discontinued use of aircards used for animal control. The remaining budget is for hotspots. 13. Field Operations Supplies decreased from $1,100 in FY 2015 to $581 in FY 2016 based on FY 2014 actual $570. This budget represents the supplies used by the Health Inspectors while out in the field conducting inspections related to food, pool/spa, tanning, and tattoo, septic and other environmental operations. 14. Survey decreased from $1,041 in FY 2015 to $250 in FY 2016 due to the City's Urban Deer Management Program helicopter survey now being conducted every other year with FY 2017 being the next year that it is conducted. 15. Consultant Services decreased from $6,000 in FY 2015 to $3,271 in FY 2016 based on actual usage of after hour veterinary calls ($2,271) and the contract for medical advisor services ($1,000). 16. Bill Collection Services decreased from $43,000 in FY 2015 to $39,978 in FY 2016 based on FY 2014 actual $39,194 plus 2%. This budget is for PetData Services for animal licensing. 17. Payments to Other Agencies increased from $188,809 in FY 2015 to $187,609 in FY 2016. The Humane Society had a new one year contract negotiated in FY 2014, which ends June 30, 2015, with the City of Dubuque to provide animal control services; the May Consumer Price Index was used in the new contract. The FY 2016 Human Society contract budgeted is $136,109. 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 $22,500 budgeted for Crescent Community Health Center operating expenses. There is also $4,000 budgeted for the Visiting Nurse Association to provide medical case management of lead poisoned children and the Green and Healthy Homes Initiative (a decrease of $2,000), which is from the Iowa Department of Public Health grant. Machinery & Equipment 18. Purchase of equipment for FY 2016 includes ($874): • Smartphone (2) for Animal Control $874 -12- Revenue 19. Dog and cat license revenue increased from $148,500 in FY 2015 to $150,500 in FY 2016 based on FY 2014 actual of $149,418. 20. Business license revenue decreased from $98,000 in FY 2015 to $97,600 in FY 2016 based on prior year actual of $97,360. 21. Swimming Pool Inspection Fees increased from $8,700 in FY 2015 to $10,700 in FY 2016 based on FY 2014 actual of $10,693. Miscellaneous 22. The Animal Control activity is 62.7% self-supporting versus the guideline of 62.7% self-supporting. 23. The Inspection of Food Establishments activity is 61.0% self-supporting versus the guideline of 61.0%. -13- 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 i 1 Administration I Community Health Environmental Health Food Inspection Expenditures and Resources by Department and Category Animal Control Budget Highlights % Change FY 2013/14 FY 2014115 FY 2014115 FY 2015116 from Adopted Actual Adopted Amended Recomm'd FY 2014/15 Employee Expense 419,938 437,536 437,062 435,012 -0.6% Supplies and Services 280,987 302,323 304,992 292,541 -3.2% Machinery and Equipment 16,100 19,046 19,046 874 -95.4% Total 717,025 758,905 761,100 728,427 -4.0% Operating Revenue 290,494 290,750 290,750 298,425 2.6% Cable TV Charges 29,918 - - 0.0% State Grant 11,802 10,000 10,000 8,000 -20.0% Total 332,214 300,750 300,750 306,425 1.9% Property Tax Support 384,811 458,155 460,350 422,002 -36,153 Percent Increase (Decrease) -7.9% Personnel - Authorized FTE 5.58 5.58 5.58 5.58 -14- PUBLIC HEALTH SUCCESS IS ABOUT PLANNING, PARTNERSHIPS AND PEOPLE LEADING TO OUTCOMES Green & Healthy Homes Initiative PLANNING • 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 Healthcare Preparedness Coalition is a multi -disciplinary partnership that assesses jurisdictional risks and responds cohesively to public health incidents and emergencies ae - DUBUQUE, IOWA ]Vtcsie- a� tlw ,\/1istiiSsipp PARTNERSHIPS Partnerships allow public health to perform its activities in an effective, efficient and inclusive manner. Partners include: • Crescent Community Health Center • Iowa Department of Public Health • Dubuque County Health Department • East Central Intergovernmental Association • Dubuque County Early Childhood • Dubuque County Emergency Management • Operation New View, Community Foundation of Greater Dubuque • Iowa Department of Natural Resources • Mercy Medical Center • Finley Unity Point Hospital • Northeast Iowa Community College • Iowa State University Extension • Veterinarians • Health Care Providers • Dubuque Regional Humane Society -15- • Grocery/Retail Stores, • Iowa Department of Agricultural & Land Stewardship • Dubuque Visiting Nurse Association • Dubuque Community School District • University of Iowa College of Public Health • Iowa Department of Inspections and Appeals • Dubuque County Sherriffs Department • Dubuque Main Street • PetData, Inc. • Great Dubuque Development Corporation • Community Foundation of Greater Dubuque PUBLIC HEALTH Detail by Activity Activity: Administration Overview The Administration Activity 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. Its prime responsibility is to plan programs and develop policies based on the community health needs assessment and emerging health issues and emergencies as required, respond to health related complaints and requests in a professional manner, and to supervise and direct activities of the Health Services Department. Activities • Enforce laws, regulations and policies • Prepare department budget and utilize resources efficiently and effectively • Participate in the community planning efforts • Execute community based programs, services, systems and policies based on the CHNA-HIP and other emerging public health issues • Supervise and support staff and provide staff development opportunities • Promote team work, cooperation, and collaboration within the department, and with other city departments and community organizations • Staff the Environmental Stewardship Advisory Commission Funding Summary FY 2013/14 Actual FY 2014/15 Adopted FY 2015/16 Recommended Expenditures $149,529 $163,508 $156,020 Resources $30,263 $100 $350 Position Summary FY 2015/16 FTE's Public Health Specialist 0.50 Secretary 1.00 Total FTE's 1.50 -16- PUBLIC HEALTH Supporting City and Community Goals Partnering for a Better Dubuque ■ Participate in public advocacy for resources and input on policies at the local, state, and federal level through professional organizations and personal contact ■ Partner with many organizations, businesses and institutions for health care and wellness Improved Connectivity — Transportation and Telecommunications ■ Promote "complete streets" for health & wellness Environmental Integrity ■ Urban Deer Management Plan Performance Measures (-- Administration — Activity Statement Provide an effective public health service, which protects, maintains and promotes the physical and environmental health and well-being of the citizens of the community. Goals ■ Provide a qualified, adequate, and competent public health workforce. ■ Review and develop public health laws, ordinances, policies and procedures regularly to update current practices. ■ Develop and maintain written contracts and memorandums of understanding (MOU) with entities providing for public health services. ■ Collect and utilize public health data to plan, implement and evaluate public health programs and activities. Objective: Assure employees comply with guidelines, licensure, certification, and continuing education requirements and competencies for providing public health services. Environmental Health: Certified Environmental Health Technician (CHEHT): 1 Registered Environmental Health Specialist/Registered Sanitarian (REHS): 1 -17- PUBLIC HEALTH Registered Sanitiarians (RS): 1 Registered Healthy Homes Specialist: 3 Certified Pool Operator: 2 Animal Control Officers completing National Animal Control Association Certification: 1 Officer completed 3 levels, one officer completed 2 levels Registered Nurse: 1 Objective: Develop system for regularly reviewing/updating ordinances and policies and procedures enforced within the Health Services Department Target Evaluate/Review/Update Ordinances enforced by Health Department every 3 years: Animal Noise Nuisance Sewer Connection Refuse Storage FOG Food Objective: Review, update, and negotiate written agreements, contracts, and MOU's with governmental, business and partnering organizations annually or prior to expiration, and assure proper execution of agreements • Iowa Department of Inspections and Appeals - Agreement updated July 1, 2012. Expires June 30, 2015. • Iowa Department of Public Health- Pool, Tanning, Tattoo Agreement updated July 1, 2013. Expires June 30, 2016. • Iowa Department of Public Health & Dubuque County Board of Health and Dubuque VNA • Childhood Lead Poisoning Agreements, updated annually • Dubuque Regional Humane Society Purchase of Service Agreement expires June 30, 2015. • Crescent Community Health Center Health Services Purchase of Service Agreement updated annually. -18- Health Services Department maintains/oversees 7 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 PUBLIC HEALTH Detail by Activity Activity: 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 the core functions and essential services necessary for an effective public health system. Although the primary responsibility of the Public Health Specialist, all Health Services Department staff contribute to community health activities. Funding Summary FY 2013/14 Actual FY 2014/15 Adopted FY 2015/16 Recommended Expenditures $85,595 $94,291 $91,632 Resources $3,799 $10,000 $8,000 Position Summary FY 2014/15 FTE's Public Health Specialist 0.50 Environmental Intern 0.14 Total FTE's 0.64 Supporting City and Community Goals Partnering for a Better Dubuque • Partner for health and wellness; Wellness Coalition, Smarter Health and Wellness, Dubuque County Healthcare Preparedness Coalition • Complete and update the Community Health Needs Assessment and Health Improvement Process (CHNA-HIP) Social/Cultural Vibrancy ■ A sufficient public health system that focuses on prevention and wellness Environmental Integrity • Co -Manage the Lead and Healthy Homes Programs in conjunction with the Housing & Community Development Department ■ Serve on the Dubuque Air Quality Task Force -19- PUBLIC HEALTH Performance Measures Comm unity Health— Activity Statement Maintain and enhance factors that contribute to the public health and welfare of the citizens of Dubuque. Goals ■ Build and maintain collaborative relationships with community partners that support public health assessment, planning and program implementation. ■ 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. objective: Provide, maintain, and educate on measures to prevent and control the spread of infections, communicable and environmental diseases and threats. • 2 extreme cold events planned for • Influenza information provided via City Channel 8 and local media • Seasonal health and emerging disease information provided to local media upon request Objective: Assure accessibility and quality of primary care and population -based health services • /n Crescent Community HEALTH CENTER Public Health Specialist continues to serve on the board and committees of Crescent Community Health Center and promotes community partnerships to contribute to its success and vitality. FY13 • 5,711 patients served; half of these patients from the 52001 ZIP code which includes all of the Washington and North End neighborhoods • 1,500 were children • 56% have incomes at or below 100% of the federal poverty level • 1/3 have no insurance • Dental Visits: 7,084 • Medical Visits: 7,146 -20- PUBLIC HEALTH Objective: Reduce the incidence of environmental health hazards in residential living environments 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. Hospital Emergency Department Asthma Visits # Visits in Dubuque 500 400 300 200 100 0 2006 2007 2008 2009 2010 2011 2012 2013 CITY OF DUBUQUE eati HEALTHYH0MES Healthy I Healthy Families Children LA_ Year Objective: Participate in preparedness exercises and education Participating in preparedness training and drills 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. • Participate in the Dubuque County Health Care Preparedness Coalition, Executive Committee Member • County Public Health Preparedness exercise being scheduled/planned for 2016 • City table top exercise held April 2014 • Additional MINS required training achieved by staff Objective: 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 -21- PUBLIC HEALTH Did you know? The Dubuque County Public Health Preparedness Coalition meets quarterly to assess and plan for public health emergencies. Recent accomplishments include: review and update of the Preparedness Plan, NIMS and ICS training, completed a hazardous risk assessment and formation of the coalition utilizing IDPH guidance. The STAR objective: Emergency Prevention and Response under the Health and Safety Pillar has been achieved. -22- PUBLIC HEALTH Detail by Activity Activity: 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 citizen weed, 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 Supporting City and Community Goals Planned and Managed Growth ■ Healthy neighborhoods through nuisance enforcement Environmental Integrity • Serve on Air Quality Task Force • Enforcing the Nuisance Ordinance • Fats, oils and grease program (FOG) development and implementation 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. Goals ■ Provide a prompt, coordinated response to environmental health issues and needs resulting from a disaster, public health emergency or nuisance. ■ Provide information and education on environmental health risks. Enforce environmental health rules and regulations. \-.._ —.) Objective: To assure safe and sanitary non-residential swimming pools and spas, tattoo and tanning facilities by providing a minimum of one inspection per -23- PUBLIC HEALTH year within Dubuque Country under a contractual agreement with the Dubuque County Board of Health and the Iowa Department of Public Health (IDPH). All facilities inspected a minimum of once per year per IDPH contract: • Pools/Spas: 44 • Tanning facilities: 16 • Tattoo parlors: 9 • Tanning operator certification exams administered: 3 • Pool/Spas closed for "Unsanitary Conditions": 7 • 100% of tanning operators maintaining/meeting training requirements Since July 2012 to July 2014, conducted 10 onsite inspections for one pool/spa facility while working with Iowa Department of Public Health and State Attorney General's Office who revoked registration of pool/spa facility located in county. A sampling of rooms at each facility are inspected bi-annually in accordance with the state regulations Did You Know? Public swimming pools and spas are inspected for both water quality and safety measures annually. Objective: Assure safe and sanitary hotels, motels and bed & breakfast inns through licensure inspection and enforcement Hotel/Bed & inspections/Enforcement Follow -Ups: 8 Objective: Prevent conditions hazardous to public health at festivals and special events through special event permit review and inspection Special event inspections: 143 139 special event permit applications were reviewed. Staff inspects special events every weekend from May -September. Objective: Alleviate overgrown weeds, improper garbagelrefuse storage and disposal and other public nuisances through code enforcement • Nuisance citations issued: 2 • Nuisance violations corrected by hired contractor: 19 • Nuisance complaints: 237 • Fats/Oils/Grease (FOG) assessments conducted at Food Establishments, in conjunction with FOG plan -24- PUBLIC HEALTH Objective: 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. -25- PUBLIC HEALTH Detail by Activity Activity: Food Inspection Overview Under contract with the Iowa Department of Inspections and Appeals, this activity assures food safety through inspection and licensing of food and food service establishments, temporary food stands and mobile food units. Funding Summary FY 2013/14 Actual FY 2014/15 Adopted FY 2015/16 Recommended Expenditures $207,647 $213,714 $194,949 Resources $121,402 $115,650 $118,975 Position Summary FY 2015/16 FTE's Environmental Sanitarian 1.00 Environmental Sanitarian Assistant 1.00 Total FTE's 2.00 Supporting City and Community Goals Planned and Managed Growth • Have a thriving downtown- Continue strong vibrant 24/7 residential/central business core Improved Connectivity — Transportation and Telecommunications ■ Work with not-for-profit partners: Dubuque Main Street Performance Measures Food Inspection — Activity Statement Provide consistent inspections and application of the 2009 Food and Drug Administration (FDA) Food Code to all food and food service establishment to assure safe food for consumers. Goals Assure safe and wholesome food at food service and retail food establishments, temporary/mobile food stands, schools, and vending outlets. Provide access to education and food safety information for food establishment managers, workers, and community. Assure safe and sanitary food and food service establishment facilities. -26- PUBLIC HEALTH Objective: All school lunch programs, licensed food service establishments, mobile unit/pushcarts, tem porary food service establishment and retail food establishments are inspected in accordance with the 2009 Food Code and 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: 736 • Risk -Based Inspections Required: 701 • Complaint Inspections: 22 • Temporary food stand licenses issued: 168 • Temporary food stand licenses inspected: 143 Objective: To assure safe and sanitary food service establishment and food establishment facilities by: reviewing the construction of all new or remodeled establishments each year and requiring existing facilities to meet current food code requirements upon change -of -ownership. 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. • New establishment/change of ownership licenses issued: 55 -27- 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 PUBLIC HEALTH Objective: To assure all food establishments have a certified Food Protection Manager on staff. Percentage of food establishments with Certified Food Protection Staff: . Retail Food Establishments: 25% . Food Service Establishments: 36% -28- PUBLIC HEALTH Detail by Activity Activity: 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. Funding Summary FY 2013/14 Actual FY 2014/15 Adopted FY 2015/16 Recommended Expenditures $274,254 $287,392 $285,826 Resources $176,750 $175,000 $179,100 Position Summary FY 2015/15 FTE's Animal Control Officer 1.44 Total FTE's 1.44 Supporting City and Community Goals Planned and Managed Growth ■ Animal Control contributes to safe, healthy neighborhoods Financially Responsible City Government and High Performance Organization ■ Diligently enforces animal licensing requirements in the City Code Environmental Integrity ■ Remedies animal waste and nuisance issues -29- 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. Goals ■ Prevent the spread of rabies. ■ Investigate and abate animal nuisances. • Protect the public from dangerous animals and vicious and potentially vicious dogs and cats. Objective: 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 1,077 complaints • Police Department responded to 854 complaints during times Animal Control Officers not on duty • 6 Vicious/Potentially Vicious Declarations • 70 citations Were issued for violations of the Animal Control ordinance. LAWS & RULES n¢crnYa Dus� Masterpiece on tlee Mivic<ippi 563 ,0“ 4I US aramalconuOteolyokkobuwe or, .n.-eu l y orauwwe oe g/ovmi cowe a Objective: 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. -30- PUBLIC HEALTH City of Dubuque Pet Licenses 9500 9000 8500 ;doll I'l'i"1 FY10 FY11 FY12 FY13 FY14 1500- 1000- 500- 0 FY10 120- 100- 80- 60- 40 - 20- 0 20- 100- 80- 60- 40- 20- 0 Animal Bites 61, FY10 FY11 FY12 FY13 FY14 Failure to License Citations Issued FY11 FY12 FY13 FY14 ❑ Dog Bites • Cat Bites o Other Animal Bites Objective: 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, licensure, leash laws, running at large, vicious and nuisance issues. • 17 Animals (that have bitten) surrendered to Animal Control -31- PUBLIC HEALTH Did You Know? • Feral cats have an average of 1.4 litters per year, with an average 3.5 live births in each litter. That equals 4.9 kittens per year, per female feral cat. Indeed, a pair of breeding cats and their offspring can produce 420,000 kittens over a seven-year period. • Of approximately 146 million cats in the United States, about half are feral/un- owned. Objective: 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. Currently4 certified animal trappers do business in the city of Dubuque. • 23 wild animals requests for service. -32- Did you know? The most popular breed of licensed dogs in the City of Dubuque is the Labrador Retriever. Recommended Operating Revenue Budget - Department Total 17 -HEALTH SERVICES Fund Account Account Title FY13 Actual FY14 Actual FY15 Adopted FY16 Recomm'd Revenue Revenue Budget Budget 100 42105 100 42120 100 42125 100 42169 100 42235 100 42325 100 42330 BUSINESS LICENSES DOG LICENSES CAT LICENSES TANNING TATTOO LICENSES REFUSE HAULING PERMITS SWIMMING POOL INSP. FEES ANIMAL IMPOUNDMENT FEES 97,165 105,538 40,301 2,654 625 9,328 8,215 97,360 109,001 40,417 3,843 925 10,693 7,470 98,000 107,000 41,500 2,700 750 8,700 8,500 97,600 110,000 40,500 3,900 925 10,700 8,600 42 - LICENSES AND PERMITS 263,825 269,709 267,150 272,225 100 45701 STATE GRANTS 100 45771 FED PASS THRU STATE GRANT 11,802 1,929 10,000 6,000 11,508 1,524 0 2,000 45 - STATE GRANTS 23,311 3,453 10,000 8,000 I 100 51987 WEED CUTTING CHARGES 4,856 7,802 4,500 5,000 I 51 - CHARGES FOR SERVICES 4,856 7,802 4,500 5,000 I 100 53403 IA DISTRICT COURT FINES 0 19,862 18,000 20,000 100 53605 MISCELLANEOUS REVENUE 3,770 1,125 1,000 0 100 53620 REIMBURSEMENTS -GENERAL 166 346 100 1,200 53- MISCELLANEOUS 3,936 21,333 19,100 21,200 17 - HEALTH SERVICES TOTAL 295,928 302,296 300,750 306,425 -33- Recommended Operating Expenditure Budget - Department Total 17 -HEALTH SERVICES Fund Account Account Title FY13 Actual FY14 Actual FY15 Adopted FY 16 Recomm'd Expense Expense Budget Budget 100 290 100 100 290 100 100 290 100 290 100 100 290 100 290 100 290 100 290 100 290 100 100 61010 61010 61020 61030 61030 61050 61091 61091 61092 61092 61099 61310 61310 61320 61320 61410 61410 61415 61415 61416 61416 61620 61660 FULL-TIME EMPLOYEES FULL-TIME EMPLOYEES PART-TIME EMPLOYEES SEASONAL EMPLOYEES SEASONAL EMPLOYEES OVERTIME PAY SICK LEAVE PAYOFF SICK LEAVE PAYOFF VACATION PAYOFF VACATION PAYOFF WAGE ADJUSTMENT IPERS IPERS SOCIAL SECURITY SOCIAL SECURITY HEALTH INSURANCE HEALTH INSURANCE WORKMENS' COMPENSATION WORKMENS' COMPENSATION LIFE INSURANCE LIFE INSURANCE UNIFORM ALLOWANCE EMPLOYEE PHYSICALS 218,497 19,648 58,808 511 0 1,454 290 290 2,175 2,175 0 24,166 1,701 20,992 1,666 33,123 5,550 6,056 77 210 25 517 1,282 223,452 18,409 65,312 935 400 1,453 502 502 0 0 0 25,928 1,646 21,721 1,479 43,322 7,220 7,288 90 211 28 42 0 244,040 0 68,345 3,169 0 2,072 1,003 0 0 0 6,421 28,365 0 24,376 0 49,980 0 8,253 0 487 0 525 500 251,528 0 71,299 3,228 0 2,072 1,003 0 0 0 0 28,494 0 25,181 0 43,680 0 7,823 0 504 0 0 200 61 - WAGES AND BENEFITS 399,211 419,939 437,536 435,012 100 62010 OFFICE SUPPLIES 975 819 1,063 1,336 100 62011 UNIFORM PURCHASES 683 155 600 501 100 62030 POSTAGE AND SHIPPING 6,709 5,861 7,238 6,154 100 62033 HAND TOOLS/EQUIPMENT 0 165 0 168 100 62061 DP EQUIP. MAINT CONTRACTS 5,523 6,152 6,342 7,343 100 62063 SAFETY RELATED SUPPLIES 71 274 400 379 100 62065 LAB SUPPLIES 191 0 400 100 100 62067 ANIMAL CONTROL SUPPLIES 144 863 620 880 100 62090 PRINTING & BINDING 2,271 1,990 3,200 2,029 100 62110 COPYING/REPRODUCTION 3,175 3,613 2,704 2,565 100 62130 LEGAL NOTICES &ADS 513 0 500 0 100 62170 SUBSCRIPTIONS -BOOKS -MAPS 29 24 275 139 100 62190 DUES & MEMBERSHIPS 853 1,110 1,235 1,200 100 62206 PROPERTY INSURANCE 84 129 149 178 100 62208 GENERAL LIABILITY INSURAN 3,723 3,632 3,842 3,838 290 62208 GENERAL LIABILITY INSURAN 154 145 0 0 100 62230 COURT COSTS & RECORD FEES 116 0 120 425 100 62310 TRAVEL -CONFERENCES 2,493 2,751 4,675 5,634 100 62320 TRAVEL -CITY BUSINESS 36 179 350 287 100 62340 MILEAGE/LOCAL TRANSP 95 0 225 185 -34- Recommended Operating Expenditure Budget - Department Total 17 -HEALTH SERVICES Fund Account Account Title FY13 Actual FY14 Actual FY15 Adopted FY 16 Recomm'd Expense Expense Budget Budget 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 62667 INTERNET 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 100 62731 MISCELLANEOUS SERVICES 100 62732 TEMP HELPCONTRACT SERV. 100 62736 CATERING SERVICES 100 62761 PAY TO OTHER AGENCY 100 62779 SURVEY / PLAT 100 62780 HAULING SERVICES 100 62781 LAWN CARE SERVICES 2,546 4,185 1,464 4,745 3,040 0 493 480 0 80 1,496 4,616 41,433 1,331 2,268 0 0 181,955 447 394 2,527 3,631 5,142 1,464 4,349 3,437 0 517 27 429 58 570 3,226 39,194 1,388 0 0 0 186,752 26 577 2,334 4,200 4,012 1,804 5,594 3,127 100 493 1,440 500 0 1,100 6,000 43,000 1,350 0 2,540 225 188,909 1,041 450 2,500 5,818 3,903 1,804 3,654 3,857 0 526 360 438 0 581 3,271 39,978 1,416 0 2,540 225 187,609 250 589 2,381 62 - SUPPLIES AND SERVICES 281,338 280,987 302,323 292,541 100 71120 PERIPHERALS, COMPUTER 0 0 1,994 0 100 71122 PRINTER 0 457 0 0 100 71211 DESKS/CHAIRS 3,314 1,500 0 0 100 71310 AUTO/JEEP REPLACEMENT 14,143 14,143 16,500 0 100 72418 TELEPHONE RELATED 0 0 552 874 71 - EQUIPMENT 17,457 16,100 19,046 874 17 - HEALTH SERVICES TOTAL 698,006 717,025 758,905 728,427 -35- Recommended Expenditure Budget Report by Activity & Funding Sounce 17 - HEALTH SERVICES HEALTH SERVICES ADMINISTR- 17100 FUNDING SOURCE: GENERAL Account FY13 Actual FY14 Actual FY15 Adopted Expense Expense Budget FY16 Recomm'd Budget EQUIPMENT 3,314 375 462 0 SUPPLIES AND SERVICES 36,067 34,159 41,050 37,867 WAGES AND BENEFITS 84,101 85,076 121,996 118,153 HEALTH SERVICES 123,481 119,611 163,508 156,020 ADMINISTR ANIMAL CONTROL - 17200 FUNDING SOURCE: GENERAL Account FY13 Actual Expense FY14 Actual Expense FY15 Adopted Budget FY16 Recomm'd Budget EQUIPMENT 0 375 1,994 874 SUPPLIES AND SERVICES 191,908 195,915 202,968 199,923 WAGES AND BENEFITS 71,749 77,964 82,430 85,029 ANIMAL CONTROL 263,657 274,254 287,392 285,826 INSP. - FOOD ESTBLMNTS - 17300 FUNDING SOURCE: GENERAL Account FY13 Actual Expense FY14 Actual Expense FY15 Adopted Budget FY16 Recomm'd Budget EQUIPMENT 14,143 15,350 16,590 0 SUPPLIES AND SERVICES 20,891 19,904 22,491 22,620 WAGES AND BENEFITS 159,885 172,393 174,633 172,329 INSP. - FOOD ESTBLMNTS 194,919 207,647 213,714 194,949 COMMUNITY HEALTH SERV. - 17400 FUNDING SOURCE: GENERAL Account FY13 Actual Expense FY14 Actual Expense FY15 Adopted Budget FY16 Recomm'd Budget SUPPLIES AND SERVICES 27,512 27,901 28,814 26,131 WAGES AND BENEFITS 52,344 54,732 58,477 59,501 COMMUNITY HEALTH SERV. 79,856 82,633 87,291 85,632 LEAD PAINT PROGRAM'17500 FUNDING SOURCE: GENERAL Account FY13 Actual Expense FY14 Actual Expense FY15 Adopted Budget FY16 Recomm'd Budget SUPPLIES AND SERVICES 4,807 2,962 7,000 6,000 LEAD PAINT PROGRAM 4,807 2,962 7,000 6,000 HEALTH SERVICES TOTAL $666,720.17 $687,106.85 $758,905.00 $728,427.00 -36- CITY OF DUBUQUE, IOWA DEPARTMENT DETAIL - PERSONNEL COMPLEMENT 17 HEALTH SERVICES DEPARTMENT FD JC WP -GR JOB CLASS 61010 Full Time Employee Expense 100 7700 GE -37 PUBLIC HEALTH SPECIALIST 100 7500 GE -32 ENVIRONMENTAL SANITARIAN 100 7375 GE -27 ENVIRON.SANITARIAN ASST 100 0225 GE -25 SECRETARY 290 0225 GE -25 SECRETARY TOTAL FULL TIME EMPLOYEES 61020 Part Time Employee Expense 100 7400 GE -29 ANIMAL CONTROL OFFICER TOTAL PART TIME EMPLOYEES 61030 Seasonal Employee Expense 100 PUBLIC HEALTH INTERN FY 2014 FY 2015 FY 2016 FTE BUDGET FTE BUDGET FTE BUDGET 1.00 87,404 1.00 1.00 65,554 1.00 1.00 51,653 1.00 0.50 19,476 1.00 0.50 19,476 0.00 88,715 1.00 67,190 1.00 52,428 1.00 39,369 1.00 0 0.00 89,833 67,400 52,599 41,696 4.00 243,563 4.00 1.50 70,824 1.50 70,824 0.14 TOTAL SEASONAL EMPLOYEES 0.14 TOTAL HEALTH SERVICES 247,702 4.00 1.44 69,370 1.44 69,370 3,169 0.14 3,169 0.14 3,217 3,217 251,528 1.44 71,299 1.44 71,299 0.14 3,228 0.14 3,228 5.64 317,556 5.58 320,288 5.58 326,055 -37- CITY OF DUBUQUE, IOWA ACTIVITY PERSONNEL COMPLEMENT SUMMARY Run Date: 01/15/15 FY 2014 FY 2015 FY 2016 ACCT FD JC WP -GR POSITION CLASS FTE BUDGET FTE BUDGET FTE BUDGET Health Services Administration -General Fund 10017100 61010 100 0225 GE -25 SECRETARY 0.50 19,476 0.50 39,369 1.00 41,696 10017100 61010 100 7700 GE -37 PUBLIC HEALTH SPECIALIST 0.50 43,702 1.00 44,353 0.50 44,930 Total 1.00 63,178 1.50 83,722 1.50 86,626 Health Services Administration -Cable TV Fund 29017100 61010 290 0225 GE -25 SECRETARY 0.50 19,476 0.00 0 0.00 Total 0.50 19,476 0.00 0 0.00 0 Community Health Services - FT General Fund 10017400 61010 100 7700 GE -37 PUBLIC HEALTH SPECIALIST Total Community Health Services - Seasonal General Fund 10017400 61020 100 0.50 0.50 43,702 0.50 43,702 0.50 PUBLIC HEALTH INTERN 0.14 3,169 0.14 Total 0.14 3,169 0.14 44,358 44,358 3,217 3,217 0.50 44,903 0.50 44,903 0.14 3,228 0.14 3,228 Inspection of Food Est./Environmental 10017300 61010 100 7500 GE -32 ENVIRONMENTAL SANITARIAN 1.00 65,554 1.00 67,190 1.00 67,400 10017300 61010 100 7375 GE -27 ENVIRON.SANITARIANASST 1.00 51,653 1.00 52,428 1.00 52,599 Total 2.00 117,207 2.00 119,618 2.00 119,999 Animal Control -PT 10017200 61020 100 7400 GE -29 ANIMAL CONTROLOFFICER Total 1.50 1.50 70,824 1.44 70,824 1.44 69,370 69,370 1.44 71,299 1.44 71,299 TOTAL HEALTH SERVICES DEPT. 5.64 317,556 5.58 320,284 5.58 326,055 -38- Health Services Department Fy 201 -16 budget presentatio [A! THOGRAPH NO HEALTH INSURANCE COVERAGE Block Groups which have more than 11.8% of the population does not have Health Insurance coverage. • F Source: Map created using American Community Survey Dolaset 1327010: TYPES Of HEALTH INSURANCE (OVERAGE BY AGE 2009-2013 American Community Suivey 5 -Year Estimates. Map Credit: City of Dubuque Planning Services and City of Dubuque Health Services LEGEND >11.8% of Population Does Not Have Health Insurance Parks and Open Space Municipalities Dubuque (aunty Block Groups 1 Water Roadways ,.... Railways NORTH HOUSEHOLDS WITHOUT VEHICLES Block Groups which hove more than 14.8% of the households that do not have a vehicle. r p Source. Mop created using Americo° Community Survey Daloset 615044 TENURE BY VEHICLES AVAILABLE 10041013 American Community Survey 5-Yeor Estimates. Mop Credit City of Dubuque Planning Services and Gty of Dubuque Health Services LEGEND >I4.8° -B of Households without a Vehicle Parks and Open Space Municipalities Dubuque County Block Groups 11 Woter Roadways Railways NORTH HEALTH RISK INDEX Rankings of Block Groups by the number of indicators that exceeded normal thresholds. • tr Map Credit: City of Dubuque Planning Services and City of Dubuque Health Services i LEGEND Porks and Open Space Municipalities Dubuque County Block Groups ltd Water Roadways Railways NORTH CHNA-HIP 4 Task Forces Timeline Healthy Behaviors ►March- community ► Transitions of Care input Environmental ►April- finalize Health Health Improvement Plan Prevent the Spread ►May- Draft to Board of Disease of Health ► Summer- Publication https://www.surveymon key.co m/r/DubCoCHNA Steering Committee ► City of Dubuque ► Dubuque County ► Mercy Medical Center ► Finley Hospital ► VNA ► Crescent CHC Task Forces ► DCSD/Holy Family ► Medical Associates Clinics ► IDNR ► ISU extension ► United Clinical Lab ► Hillcrest ► Hy -Vee ► UD ► Dubuque Comm Y TAR COMMUNITIES SUSTAINABILITY TOOLS FOR ASSESSING & RATING COMMUNITIE Public Health Preparedness Ebola Measles Chikungunya Influenza Enterovirus D68 /Flaccid paralysis „VII. DUNNNOlA AND ~TINA pm ON wmaUT W .DNC Fp —. NmmadOn Calk 117 Rd hal Food Inspection: New Database Software Includes: ► on line payment option ► Reports ► Inspection scheduling ► On-line retrieval of past inspection records https://food .iowa .gov/foodsafety 4— -" C fi https://food.iowa,gov/FoodSafety/Welcome.aspx Home Program Inspection Reporting Tools Administration Logout Welcome to USA Food Safety *USAFOODSAFEY Food/Dairy IrsFe_ -a. a -J Slate • Food Safety 2.1.0.40 City of Dubuque tlink a5� C® USA Food Safety - — ® PA Food Safety 2 P VA 0) l 02/17/2015 J Environmental Health Inspections ► Swimming Pool ► Tattoo Tanning Nuisance ► Weeds/garbage ► Path Forward Plan ► Community Engagement April 13 • EPA Education grant IBM Smarter Cities Challenge O L 'E0 0 c 1N C � 0 N E ? E .6 2 D 0 Cil) 'C 2 v) 4 a) U i y 0 a) CO a Q 0 D 8675 990 Cat & Dog Licenses 8370 8190 9066 9341 9437 OIlUGItO OSUOO!1 dad Crescent Community HEALTI-► CENTER Mary Rose Corrigan, Board of Directors Chair Patients & Visits 20000 18000 16000 14000 12000 10000 8000 6000 4000 2000 0 • T;\ Crescent Community HEALTH CENTER Crescent Patient Revenue Medicare 5% Medicaid 56% ava- e:.. No Insurance 35% ■ No Insurance ■ Medicaid ■ Medicare Private Insurance C 1-11.ALTH CENTER Health Services Department FY 2016 Budget Thank you