Beyond general fund: environmental health revenues in a down economy.Editor's note Editor's Note (foaled in 1993 in Kentucky) is an American thoroughbred Stallion racehorse. He was sired by 1992 U.S. Champion 2 YO Colt Forty Niner, who in turn was a son of Champion sire Mr. Prospector and out of the mare, Beware Of The Cat.
Trained by D. : NEHA NEHA National Environmental Health Association
NEHA National Executive Housekeepers Association
NEHA Northern Estates Homeowners Association (Indianapolis, Indiana) is committed to providing its members with information specific to the profession of environmental health. The Journal of Environmental Health has taken a major new step in this direction by employing a staff reporter. Rebecca Berg, who has long copy edited the Journal, will be writing in-depth reports on trends and events in the field. Her reports will provide Journal readers with important insights into the profession. They will also be designed to encourage discussion of controversies, challenges, and big-picture issues facing the profession. Readers are invited to participate in these discussions through letters to the editor: Please send your responses, opinions, or comments to Joanne Scigliano, Journal Coordinator, email@example.com.
This month we bring you Part 2 of a two-part series about the impact economic hard times have been having on the profession.
As the Journal of Environmental Health (JEH JEH Journal of Economic History ) reported in this space last month, demands for environmental health services health services Managed care The benefits covered under a health contract are up while traditional sources of revenue are stagnant or declining. How are health departments coping with the situation? Many are looking to fee-for-service arrangements and grant funding to support revenue-starved programs. In some cases, these strategies offer health departments a measure of independence from the politically driven budget decisions made in statehouses. They also, however, bring with them a new set of challenges and controversies for the profession.
Fee for Service--The Future of Environmental Health?
In Napa County, California “Napa Valley” redirects here. For the wine country, see Napa Valley (Wine).
Napa County is a county located north of the San Francisco Bay Area in the U.S. state of California. It is part of the Napa, California Metropolitan Statistical Area. , the environmental health program traditionally has been funded partly by general-fund revenues (primarily from property taxes) and partly by fees charged to consumers. That is changing. "We are one of the last counties in California The U.S. state of California is divided into fifty-eight counties. Counties are responsible for all elections, property-tax collection, maintenance of public records such as deeds, and local-level courts within their borders, as well as providing law enforcement (through the county that has huge subsidies from property taxes," says Jill Pahl, assistant director of the Napa County Department of Environmental Management. The subsidies are being reduced, and the program is being "re-oriented" with the goal of recouping most, if not all, of its costs through fees.
"That's really the future," Ms. Pahl says. "That's how you assure care." Fee-based financing also will protect the program against cuts in personnel because county decision makers will know that if they reduce the program, they'll lose revenues from the associated fees.
Tom Hart of Linn County, Iowa Linn County is a county located in the U.S. state of Iowa. As of 2000, the population was 191,701. The 2006 estimate is 201,853. It is named in honor of Senator Lewis Linn of Missouri. , agrees. Fees will help insulate in·su·late
tr.v. in·su·lat·ed, in·su·lat·ing, in·su·lates
1. To cause to be in a detached or isolated position. See Synonyms at isolate.
2. environmental health programs from political whim whim
1. A sudden or capricious idea; a fancy.
2. Arbitrary thought or impulse: governed by whim.
3. A vertical horse-powered drum used as a hoist in a mine. , he says. Mr. Hart envisions developing "salable sal·a·ble also sale·a·ble
Offered or suitable for sale; marketable.
sala·bil products" that industries like building and construction will buy because it will be to their commercial advantage to say that their product has been certified. He cites mold as an issue that has been "hyped" by the media and for which no national standards exist. Environmental health programs could step in, he suggests, and charge a reasonable personnel and processing fee to handle the issue for the real estate community. Environmental health practitioners could find other such issues "that have a legitimate scientific basis," he says, and with which a recognized hazard is associated. It may even be a question of developing recognition of a hazard--of "seeding the program with some awareness." Once that has been done, environmental health practitioners call start generating revenue based on public demand for the service."
Michael Kirsch kirsch
A colorless brandy made from the fermented juice of cherries.
[French, short for German Kirschwasser; see kirschwasser. of Zanesville-Muskingum County, Ohio, says that the majority of his environmental health programs are funded through fees. Indeed, he puts leftover environmental health money into a pot that helps fund other health department programs. Food service inspection rates in his jurisdiction range from $130 to $599.
Many jurisdictions have instituted or raised fees for noncompliance noncompliance
failure of the owner to follow instructions, particularly in administering medication as prescribed; a cause of a less than expected response to treatment.
noncompliance or late renewal of permits. "We charge $75 per visit to a food establishment when we have to visit for a second time because of noncompliance," Brian Collins This article or section is written like an .
Please help [ rewrite this article] from a neutral point of view.
Mark blatant advertising for , using . says. Even when such fees do not cover the cost of the program, he believes, they help reduce the number of inspections the department needs to do by encouraging compliance.
The use of fees can be complicated, however. In some jurisdictions, any fees the health department collects just go back into the general fund. In North Carolina North Carolina, state in the SE United States. It is bordered by the Atlantic Ocean (E), South Carolina and Georgia (S), Tennessee (W), and Virginia (N). Facts and Figures
Area, 52,586 sq mi (136,198 sq km). Pop. , according to according to
1. As stated or indicated by; on the authority of: according to historians.
2. In keeping with: according to instructions.
3. Tom Ward, the money goes to the state, and then some of it comes back, depending on how many facilities a county has and what percentage of inspectors it has. The fees are very low. "Out of the $25 food service inspection fee," Mr. Ward says, "$16 comes back to me." In Colorado, the state legislature A state legislature may refer to a legislative branch or body of a political subdivision in a federal system.
The following legislatures exist in the following political subdivisions:
According to Howard Roitman of Colorado, certain kinds of fees are not stable if they are not spread across a broad-enough base. Roitman, who stresses that he is expressing a personal opinion here, and not the official position of his agency, gives the example of a hazardous waste Hazardous waste
Any solid, liquid, or gaseous waste materials that, if improperly managed or disposed of, may pose substantial hazards to human health and the environment. Every industrial country in the world has had problems with managing hazardous wastes. program that relies on fees in Colorado. Until about five years ago, the bulk of the funding came from fees assessed for large volumes of waste disposed at a commercial hazardous waste facility. "Well," he says, "that market changed." A fee that used to generate several hundred thousand dollars suddenly yielded less than a hundred. The result was a fiscal crisis for that program, which then had to change its fee structure. Now more people have to pay fees, but they pay smaller fees.
Roitman, again expressing a personal opinion rather than official agency position, thinks the best approach might be some kind of general environmental fee. "Right now," he says, "we regulate entities that may pay a dozen different fees, which is somewhat inefficient for us and for them." Under this model, one overall fee, covering items such as stormwater, wastewater, and air, would be assessed per facility. Roitman thinks that kind of fee structure would not only be more efficient, but also would provide a more secure funding base for environmental health programs.
How are consumers and regulated industries reacting to increases in fees? Pat Maloney of Brookline, Massachusetts Brookline is a town in Norfolk County, Massachusetts, which borders on the cities of Boston and Newton. As of the 2000 census, the population of the town was 57,107. Etymology
Brookline was known as the hamlet of Muddy River , thinks that with the publicity in the media about state budget crises, most people aren't surprised. The Boston Globe, he says, has reported that all state fees are just about tripling, in his jurisdiction, the base fee for a tobacco permit has risen from $60 to $250. In addition there are steep surcharges if there has been a violation of the law. Some facilities have had to pay a couple thousand dollars to renew tobacco licenses. "I received very few calls on that," Maloney says.
Brian Collins of Piano, Texas, however, is leery of raising fees in a slow economy. "It's tantamount tan·ta·mount
Equivalent in effect or value: a request tantamount to a demand.
[From obsolete tantamount, an equivalent, from Anglo-Norman to squeezing water from a rock," he says, since many of the regulated businesses have been hard hit by the downturn.
"The feedback we got from food service establishments was, 'We're barely making it. Why would you think we could pay extra fees?'" There has been resistance to increases in fees in Colorado, as well, and some controversy about who should determine the amount. For more on that story, see the companion article starting below.
"The interesting thing," says Jill Pahl of Napa County, California, is that when her department implements new fees and raises existing ones, "we'll be charging significantly more for the same service that clients have had in the past." That can be uncomfortable, she acknowledges. But Napa County is looking for Looking for
In the context of general equities, this describing a buy interest in which a dealer is asked to offer stock, often involving a capital commitment. Antithesis of in touch with. ways to be more efficient so as to provide even better service.
Peter Schade of Cuyahoga County, Ohio, agrees. In a down economy, he says, it's hard for a food service establishment to get a bill that's risen, for example, from $400 to $428. "But you know what?" he says. "We've got to turn it around and say, 'Look what you're not taking advantage of from the health department. We'll train your new employees. We're here at your beck and call."
Reliance on fees has had other repercussions repercussions npl → répercussions fpl
repercussions npl → Auswirkungen pl , however. "We're becoming more focused on financial issues," Maloney says. "I feel like a collection agent at limes limes
In ancient Rome, a strip of open land along which troops advanced into unfriendly territory. It came to mean a Roman military road, fortified with watchtowers and forts. ." Sometimes when surcharges and penalties are involved, he finds himself on the phone "dickering over cost." He has also found himself in the position of giving notice or closing facilities down simply for nonpayment of fees. "It's not what environmental health people are traditionally trained to do," he adds, and environmental health education will have to adjust.
Maloney adds that the new fees "don't come close to" covering the cost of the environmental health programs. Policy makers and financial people sometimes look at the budget, he says, and wonder why the public health division can't earn its keep. "I don't know Don't know (DK, DKed)
"Don't know the trade." A Street expression used whenever one party lacks knowledge of a trade or receives conflicting instructions from the other party. of anyone who can do that. People don't ask that of the fire department." Maloney believes that the public protection element of environmental health is part of what people pay for with their taxes. "We try to soften the burden by adopting some of these innovative financial approaches," he says, "but we'll never break even."
Breaking even partly depends on where the lines between departments are drawn. Steve Roy of St. Paul St. Paul
as a missionary he fearlessly confronts the “perils of waters, of robbers, in the city, in the wilderness.” [N.T.: II Cor. 11:26]
See : Bravery , Minnesota, says that his environmental health programs are entirely supported by a fee-based special fund. In his jurisdiction, however, the environmental health department includes the building department, which generally takes in more than it would cost to issue permits for new construction. The money from building fees goes into a general environmental health fund.
Inversely, particular environmental health programs may be sheltered from funding difficulties if their fees are kept entirely separate from other parts of the environmental health program. An example of a sheltered program of this type is the hazardous waste division of Seattle-King County, Oregon (see the companion article starting on page 50).
However a department is organized, though, there will always be a need for programs for which fees aren't or can't be charged. "We continue to struggle with that," says Jill Pahl, because "sometimes the things that you can do to achieve a higher public health status are not things that are fee generating."
In Napa County, the animal shelter "Dog Pound" redirects here. For the rap group, see Tha Dogg Pound.
An animal shelter is a facility that houses homeless, lost or abandoned animals; primarily a large variety of dogs and cats. falls under the environmental health division because of the disease risk to the public. And the department can't charge the animals for the cost of their board and care. County leaders are going to have to make "some really interesting and tough decisions," Pahl says.
In Massachusetts, says Pat Maloney, health departments are mandated to respond with housing inspections to citizen complaints of inadequate living environments--inadequate heat, for example, or lack of screens in windows. The department does not charge citizens for such calls.
In Michigan, according to Ron Grimes Grimes is a surname, that is believed to be of a Scandinavian decent and may refer to
1. Impermeable by air.
2. Having no weak points; sound: an airtight excuse.
1. . Meanwhile, demand for other services is rising, department resources are stretched, and, because fee-generating services cannot be neglected, IAQ IAQ Indoor Air Quality
IAQ Investment Administration Qualification
IAQ Infrequently Asked Questions
IAQ Internal Air Quality
IAQ Inuit Art Quarterly
IAQ Illinois Air Quality complaints don't always get prompt attention.
In Foxborough, Massachusetts Foxborough (or Foxboro) is a town in Norfolk County, Massachusetts, approximately 30 miles (48 km) southwest of Boston and 20 miles (32 km) northeast of Providence, Rhode Island. The population was 16,246 at the 2000 census. , the environmental health program is supported entirely by general-fund revenues. Would George Young George Young may refer to:
invincible scourge of crime. [Comics: Horn, 642–643]
See : Crime Fighting
superhero under guise of Clark Kent, mild-mannered reporter. Cape" in the November 2003 issue of the Journal.) But he is wary of lees lees
Sediment settling during fermentation, especially in wine; dregs.
[Middle English lies, pl. . "l could imagine that a community could just get greedy and set outrageous fees--to have a whole fleet of inspectors." That sentiment is echoed by Peter Meersman of the Colorado Restaurant Association. For more on industry worries about abuses of fee-for-service systems, see the companion article starting on page 47.
Peter Thornton For the MacGyver character, see .
Peter Kai Thornton CBE (April 8, 1925 – February 8, 2007) was a museum curator and writer. He was keeper of furniture and woodwork at the Victoria and Albert Museum in London between 1966 to 1984, and curator to Sir John Soane's of Volusia County, Florida “Volusia” redirects here. For the unincorporated community, see Volusia, Florida.
Volusia County is a county located in the state of Florida. The U.S. Census Bureau 2005 estimate for the county is 496,575 . , sees the need for non-revenue-generating programs as just one more reason to look to fees for as much revenue as possible. He has been holding a series of meetings with policy makers and industry representatives in an effort to raise fees on a number of services. He reports success. Onsite sewage contractors, he says, "no longer want to hear about the possibility of environmental health general-revenue reductions; they want the program completely funded by their fees." Precisely because environmental health programs also have to provide unfunded or poorly traded services related to emerging pathogens emerging pathogen Public health Any pathogen that ↑ incidence of an epidemic outbreak Examples Cryptosporidium, E coli O157:H7, Hantavirus, multidrug resistant pneumococci, vancomycin-resistant enterococci. See Emergent disease. , re-emerging pathogens, and the threat of terrorism, routine programs should be "as self-supporting as possible."
Grants and Bioterrorism Funding--How Much Help Are They?
Despite the down economy, Tom Hart of Linn County, Iowa, reports that he's actually looking at hiring planners and educators, on the basis of grants he expects to receive from the Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center. (CDC See Control Data, century date change and Back Orifice.
CDC - Control Data Corporation ). The grants, which support bioterrorism response and education, should run through 2005.
Other revenue sources are down, and Mr. Hart acknowledges that there has been a shift from the traditional environmental health focus to counterterrorism coun·ter·ter·ror
Intended to prevent or counteract terrorism: counterterror measures; counterterror weapons.
Action or strategy intended to counteract or suppress terrorism. . But, he says, "The aspect of that I appreciate is that we're encouraged to think about dual-use capabilities with these resources that are coming through bioterrorism." The grants are helping him build the public health infrastructure with high-speed Internet See broadband. access, laboratory capabilities, and communication capabilities and experience that will facilitate interactions with other health providers.
"That," he thinks, "is in the nature of environmental health: trying to spend money in ways that meet the definition of bioterrorism preparation. It's one of the benefits, but one of the hardships, of having money staring you in the face."
There are limits, he admits. Finding a way to make this kind of money cover West Nile virus West Nile virus, microorganism and the infection resulting from it, which typically produces no symptoms or a flulike condition. The virus is a flavivirus and is related to a number of viruses that cause encephalitis. prevention efforts would take a lot more "creativity" than he has, he says. "The trouble with bioterrorism money," says Brian Collins of Piano. Texas, is that while it is good for the counties, it is not "filtering down expeditiously ex·pe·di·tious
Acting or done with speed and efficiency. See Synonyms at fast1.
ex " to the city level. He thinks it will be two to three years before his department sees any of the money.
Ron Grimes of Jackson County, Michigan Jackson County is a county in the U.S. state of Michigan. In 2000, its population was 158,422. In 2006, the population was estimated to have reached 163,851. This county makes up Jackson's Metropolitan Statistical Area. The county seat is Jackson6. It is named for U.S. , agrees. The amount of funding that has filtered down to the local level has probably not been adequate to cover the additional demands the need for terrorism readiness has placed on departments. Financial support has not increased in tandem Adv. 1. in tandem - one behind the other; "ride tandem on a bicycle built for two"; "riding horses down the path in tandem"
tandem with increases in expectations. In other words Adv. 1. in other words - otherwise stated; "in other words, we are broke"
put differently , the threat of bioterrorism is not a windfall for local environmental health programs. "The funding that we receive here," Mr. Grimes says, "really is only one position."
In Zanesville-Muskingum County, Ohio, Environmental Health Director Michael Kitsch kitsch [Ger.,=trash], term most frequently applied since the early 20th cent. to works considered pretentious and tasteless. Exploitative commercial objects such as Mona Lisa scarves and abominable plaster reproductions of sculptural masterpieces are described as used to be very involved in local disaster preparation. He still attends meetings, but he has reduced staff time devoted to preparedness.
Bioterrorism preparedness too?
"Yes, because I don't get any money for it," he says.
Tom Ward of Union County, North Carolina Union County is a county located in the U.S. state of North Carolina. As of 2000, the population was 123,677. Its county seat is Monroe6. History
The county was formed in 1842 from parts of Anson County and Mecklenburg County. , however, believes that the bioterrorism issue has had some positive effects on his program, regardless of the level of direct funding associated with it. "There's a realization that some of those preventive things we've been doing all along are important," he says. He believes the principle of prevention is catching on in public consciousness, even beyond the issue of terrorism, influencing apparently distant areas of public health like food safety.
What about other kinds of grants?
Ron Grimes of Jackson County, Michigan, and Peter Tabbot of West Caldwell West Caldwell, borough (1990 pop. 10,422), Essex co., NE N.J., a residential suburb of Newark and New York City; inc. 1904. It has some light manufacturing. , New Jersey, warn that grants are not a panacea Some antidote or remedy that completely solves a problem. Most so-called panaceas in this industry, if they survive at all, wind up sitting alongside and working with the products they were supposed to replace. for the budget woes of environmental health programs. Federal, state, and local grants are drying up, says Grimes, and competition for funds has increased among agencies.
To help environmental health programs claim more of the shrinking grant pool, Peter Schade is proposing to establish a grant clearinghouse through NEHA. He acknowledges that a resource of that sort might increase competition for grants still further. But, he says, it might also help departments from different jurisdictions work together. He envisions collaborative grant applications in which, for instance, several health departments would propose a pilot food-sampling program across the boundaries of three to four jurisdictions.
Conclusion: Changes Ahead
Economies have ups and downs ups and downs
Alternating periods of good and bad fortune or spirits.
ups and downs
alternating periods of good and bad luck or high and low spirits . The current down is just one of many--perhaps a bit more severe than usual--that environmental programs have survived over decades. Still, this economic "moment" promises to leave a more lasting imprint than most because it has prompted an extensive restructuring of funding mechanisms. Perhaps the conjunction of economic downturn with political events that have raised new public concerns--bioterrorism, for instance--also has contributed to the effect. At any rate, if changes in funding entail changes in environmental health priorities, the implications may continue to unfold for years.
TABLE 1 Interviewees Jurisdiction or Name Title Organization Ken Armstrong Administrator Local Hazardous Waste Management Program, Seattle--King County, Washington Brian Collins Director of Plano, Texas Environmental Health Ron Grimes Health Officer/Director Jackson County, Michigan Tom Hart Environmental Linn County, Iowa Supervisor Michael Kirsch Environmental Health Zanesville-Muskingum Director County, Ohio Adrienne LeBailly Director Larimer County Department of Health and Environment Pat Maloney Director of Brookline, Environmental Health Massachusetts Peter Meersman CEO Colorado Restaurant Association Jill Pahl Assistant Director of Napa County, California Environmental Management Howard Roitman Director of Colorado Environmental Programs Steve Roy Environmental Health St. Paul, Minnesota Specialist 3 Peter Schade Deputy Director of Cuyahoga County, Ohio Environmental Health Ed Schemm Assistant Director of Larimer County, Environmental Health Colorado Peter Tabbot Health Officer West Caldwell, New Jersey Peter Thornton Director of Volusia County, Florida Environmental Health Thomas Ward Environmental Health Union County, Director North Carolina George Young Health Agent Foxborough, Massachusetts Name Type Population Ken Armstrong Urban, suburban 1,737,034 Brian Collins Urban 236,539 Ron Grimes Rural, suburban 158,422 Tom Hart Rural, urban 191,701 Michael Kirsch Rural, urban 84,900 Adrienne LeBailly Rural, urban, 251,226 national park Pat Maloney Suburban 57,101 Peter Meersman Industry group -- Jill Pahl Rural, urban 128,145 Howard Roitman Statewide 4,506,542 Steve Roy Urban 287,151 Peter Schade Rural townships, 1,380,421 inner-ring suburbs Ed Schemm Rural, urban, 259,472 national park Peter Tabbot Town 11,233 Peter Thornton Rural, urban 443,343 Thomas Ward Suburban 123,677 George Young Suburban town 16,246
Food Safety and Fees in Larimer County, Colorado Larimer County is the seventh most populous and the ninth most extensive of the 64 counties of the State of Colorado of the United States. The county is located at the northern end of the Front Range, at the edge of the Colorado Eastern Plains along the border with Wyoming. : Impasse
In Colorado, the state legislature traditionally has helped fund county health department programs, distributing money according to a per capita [Latin, By the heads or polls.] A term used in the Descent and Distribution of the estate of one who dies without a will. It means to share and share alike according to the number of individuals. formula. In other words, the state paid counties a dollar and some cents per resident. In Larimer County, the per capita money amounted to about $350,000--until last year, when the governor used his line item veto item veto
See line-item veto. to cut funding for local health departments from the state budget.
Located in north central Colorado Central Colorado is a region of the U.S. state of Colorado. It can be roughly defined by Jackson County in the northwest, Weld County in the northeast, Pueblo County in the southeast, and Chaffee County in the southwest. , Larimer County covers 2,640 square miles A square mil is a unit of area, equal to the area of a square with sides of length one mil. A mil is one thousandth of an international inch. This unit of area is usually used in specifying the area of the cross section of a wire or cable. and has a population of 251,226. It includes the cities of Fort Collins and Loveland, the towns of Estes Park and Berthoud, and in Rocky Mountain National Park Rocky Mountain National Park
National park, north-central Colorado, U.S. Established in 1915 and enclosing part of the Front Range of the Rocky Mountains, the park has an area of 262,191 acres (106,105 hectares). .
The loss of $350,000 brought to head a budget crisis that had been brewing for some time. In fact, according to Adrienne LeBailly, M.D., director of the Larimer County Department of Health and Environment Mission Statement:
"To create, promote and enhance health and vitality through innovation, collaboration and celebration."
The 10 Essential Public Health Services
(excerpted from "The Essential Services of Public Health" by James A. , the department is facing a shortfall of twice that amount. Over the years, she says, there has been a "slow erosion" of support for public health services that made Larimer County vulnerable going into the latest economic downturn.
"It's not that county contributions have gone down," she observes. "It's just that county Contributions haven't kept up with increases in costs, particularly salary and benefits costs."
Over the past 15 years, the Years, The
the seven decades of Eleanor Pargiter’s life. [Br. Lit.: Benét, 1109]
See : Time department has had to eliminate a number of services, including an encephalitis encephalitis (ĕnsĕf'əlī`təs), general term used to describe a diffuse inflammation of the brain and spinal cord, usually of viral origin, often transmitted by mosquitoes, in contrast to a bacterial infection of the meninges surveillance program, pollution prevention, and a hazardous waste program. With the latest blow--the loss of state per capita funding--even the county food safety program is in jeopardy.
The county commissioners gave the health department stopgap money from county property tax funds to keep the program going from January through June of 2003; the hope was that after that the health department could obtain increases in licensing fees. They doled out Adj. 1. doled out - given out in portions
apportioned, dealt out, meted out, parceled out
distributed - spread out or scattered about or divided up a little more for the following six months when it became clear that, for reasons examined below, fee increases would not be sufficient.
What happens when the current six-month funding period ends--this month? We're at risk," says Ed Schemm, assistant director of environmental health. "We're in limbo limbo
In Roman Catholicism, a region between heaven and hell, the dwelling place of souls not condemned to punishment but deprived of the joy of existence with God in heaven. The concept probably developed in the Middle Ages. six months at a time." Which is why the department has been losing staff and, to the extent that it is replacing those who leave, has been replacing them with temps.
The Larimer County Department of Health and Environment used to hold food safety classes for restaurant managers and staff--no more: Inspections of low-risk establishments have been cut, with establishments in the lowest risk category not being inspected at all. Another loss has been to inspections of special-event activities--the festivals and weekend events that are so numerous in the area;
"We still have really good people," says Ms LeBailly. "But we had a super food program." Indeed, in 2001. Larimer County placed in the top three for the Crumbine Award.
"But of course we aren't applying for that award now," LeBailly adds. The department has been searching for new sources of revenue. In November 2002, it got a proposal on the ballot asking the public to approve a mill levy that would fund public health programs. The proposal had a lot of support, not only from the county commissioners, but also from the restaurant industry.
"Local restaurants--and even the Colorado Restaurant Association--contributed to that campaign," LeBailly says.
Still, the mill levy didn't pass. LeBailly thinks the Latimer county public health programs have been victims of their own success, so effectively preventing disease that people can't see the risks being averted. It might require losing the programs, she says ominously, "to help people understand what they provide."
LeBailly would like to increase restaurant licensing fees so that they cover two-thirds to 80 percent of inspection costs, at least. But in Colorado, food service license fees are set by state law. And the Colorado legislature, LeBailly says, "has repeatedly failed to" increase fees to amounts that would support the food program.
As of the latest survey, taken in 2001, the average licensing fee for Colorado establishments was $366 per establishment, says LeBailly. The median cost was $377, with a range of $157 to $598. The average cost in Larimer County was $366.
Recently, the legislature did raise fees Charged to the food service industry by about 40 percent overall with the increases varying according to the size and type of establishment, For each establishment licensed, the county has to send $25 back to the state (up from $20 prior to the recent fee increase). LeBailly says that a typical restaurant seating fewer than 100 people now pays $154 per year, of which the county gets to keep $129. The fees cover about 35 percent of the inspection costs.
Why won't the legislature allow higher fees--or allow counties to set their own fee structures?
"The Colorado Restaurant Association is really powerful in the legislature," LeBailly says, "and they have fought increases that would have been able to fund the program fully."
Peter Meersman, CEO (1) (Chief Executive Officer) The highest individual in command of an organization. Typically the president of the company, the CEO reports to the Chairman of the Board. of the Colorado Restaurant Association (CRA See Community Reinvestment Act. ), bristles at the implication of obstructionism ob·struc·tion·ist
One who systematically blocks or interrupts a process, especially one who attempts to impede passage of legislation by the use of delaying tactics, such as a filibuster. . "It's difficult to get the legislature to raise those fees. Every time they have been raised, they have been raised with our support." He points out that CRA supported the most recent increase.
"However, as a matter of policy," he says, "we do not support paying the entire amount that it costs local health departments to inspect the restaurants." He acknowledges that CRA does have influence with the legislature: "There's no question that they're responding to lobbying on our part." He sees nothing objectionable in that. The legislators are elected officials, and they respond to lobbying from the other side, toe, he says.
Meersman also wants it on record that his organization supported the Latimer County mill levy proposal put before the voters in November 2002.
Adrienne LeBailly is cynical about that support. "That would have been a tax, and they [the Colorado Restaurant Association] support taxes paying for food safety inspections."
If the state won't provide per capita funds, voters won't approve a mill levy, and fees can't be raised to cover the shortfall, how should restaurant inspections be paid for? Meersman believes the funding arrangements should continue as they are now, with the local jurisdiction paying part of the costs and the licensees paying part of the costs. The problem, he says, is that health departments have to struggle to get county commissioners to increase their budgets.
When JEH asks if that means raising local taxes, Meersman laughs. "I'm not suggesting that anybody raise taxes, especially in a down economy." He says the county commissioners should simply determine what their priorities are given the money they have.
Meersman also does not believe counties should be allowed to set their own fee schedules, as happens in other states and, in Colorado, in the city of Denver
Any discussion of changing the Colorado law would need to address the following issues, he adds:
* What limits might there be on fees?
* What would the programs look like?
* How often would inspections be conducted?
Would CRA consider a change in the law if those issues were addressed?
"Right now our official position is that we will share in paying fees; we will not pay the entire amount," Meersman says.
It sounds as if the health department is at loggerheads log·ger·head
1. A loggerhead turtle.
2. An iron tool consisting of a long handle with a bulbous end, used when heated to melt tar or warm liquids.
3. with the industry in Latimer County, but LeBailly disagrees. She says that many local restaurants appreciate the educational work the department used to do and would support greater fee increases. CRA represents only some of the restaurants in the state, she points out. She puts the number at about one-third. Meersman's estimate is 40 percent--about 4,000 restaurants statewide.
At any rate, Ed Schemm says, without some new source of revenue, the department may have to give its food safety program up entirely. If that happens, the state agency--the Colorado Department Of Public Health and Environment--would have to pick up the program, because restaurant inspections are mandated by state law. There is an irony here: The state, which precipitated the crisis by cutting per capita funding, would have to shoulder the entire cost of the inspections.
It's not yet clear how significant that burden would be and how the level of service would be affected.
"As I understand it, we'd be able to get the fees that would be otherwise paid to Latimer," says Howard Roitman, director of environmental programs with the state agency. "But what we could do for that amount of money, we haven't looked at yet."
Hazardous Waste Fees in King County, Washington “King County” redirects here. For other uses, see King County (disambiguation).
King County is located in the U.S. state of Washington. The population in the 2000 census was 1,737,034 and in 2006 was an estimated 1,835,300. : Stability
Does the fee-for-service trend inevitably work to the detriment of education and prevention activities? Perhaps. Broad-based programs that serve general public rather than specific private interests do not seem likely to thrive on fee-based funding. It is hard to imagine having an effective West Nile virus prevention program or an effective bioterrorism preparedness program without some sense that public health is a collective responsibility. Nevertheless, under certain circumstances, the imaginative use of fee-based funding can support education and prevention programs.
Readers may recall an article that was featured in last month's issue of the Journal, "Helping the Auto Repair Industry Manage Hazardous Wastes: An Education Project in King County, Washington." Written by environmental health specialists from the Seattle-King County Local Hazardous Waste Management Program, the article described visits environmental health staff made to auto repair shops to analyze waste streams and discuss proper handling of materials such as waste oil, oil filters, used shop towels, antifreeze antifreeze, substance added to a solvent to lower its freezing point. The solution formed is called an antifreeze mixture. Antifreeze is typically added to water in the cooling system of an internal-combustion engine so that it may be cooled below the freezing point , sludge from parts washers, and batteries.
It can take months to put together a scholarly report like the one on the King County project--and still more time for the report to proceed through the submission, revision, and approval process of a peer-reviewed journal peer-reviewed journal Refereed journal Academia A professional journal that only publishes articles subjected to a rigorous peer validity review process. Cf Throwaway journal. . So it occurred to JEH that if the educational program described in the article was funded with general revenues, it might be a thing of the past. Or, if the program was still flourishing in the current climate of budget cuts, perhaps it had some source of funding that was sheltered from the storm, so to speak.
The auto repair shops did not pay for the visits, which had no licensing or enforcement component. Nor did they pay penalties if violations were found. The project was purely educational.
So how was it funded? JEH called to ask.
"We have a dedicated fund," said Ken Armstrong Kenneth Armstrong (3 June 1924 – 13 June 1984) was an English footballer.
Born in Bradford, and serving in the RAF during the Second World War, Armstrong was a versatile, tough-tackling and energetic midfielder who played mainly for Chelsea. , administrator of the Local Hazardous Waste Management Program for Seattle--King County. A hazardous waste fee is collected from every residential and nonresidential account in a region that covers the city of Seattle and the surrounding King County. The fees are not high: $0.66 per month for residential accounts and $6.77 per month fur nonresidential accounts. Wastewater treatment plants Wastewater treatment plant also called wastewater treatment works
"Revenues are fairly stable," Armstrong said.
The program has been in existence since 1991, when the Washington State Hazardous Waste Management Act mandated the creation of local plans. The county board of health sets the fees, which do not pay for any specific service but go into the dedicated fund that supports all of the hazardous waste programs.
It is this funding structure that allows Seattle--King County to maintain its educational projects for hazardous wastes. Indeed, in the 12 years since its inception, the program has shifted its emphasis from waste management to prevention.
Recent projects include educational visits to autobody repair shops (a variant of the auto repair shop project described in last month's article) and educational outreach centered on a geographic area of Seattle that has long been contributing pollution to regional waters through storm drains storm drain
1. A storm sewer.
2. A catch basin. .
Another undertaking was a chemical-safety project that addressed conditions in school laboratories.
"We found highly toxic highly toxic Occupational medicine adjective Referring to a chemical that 1. Has a median lethal dose–LD50 of ≤ 50 mg/kg when administered orally to 200-300 g albino rats 2. chemicals that were Stored in incompatible ways," Armstrong said. "In the case of an earthquake, you Could imagine a worst-case scenario worst-case scenario n → Schlimmstfallszenario nt in schools."
The program also has addressed mercury. The Seattle-King County Hazardous Waste Management Program was able to get the board of health to ban the sale of mercury thermometers. Its advocacy also played a part in a statewide ban later passed by the legislature.
Still, the picture isn't entirely rosy. While revenues have been stable, real costs have been rising. Personnel costs, particularly the costs of benefits, have been "skyrocketing," according to Armstrong. "Government agencies everywhere are having to look critically at what they're doing, and we're no different," he said, "This has provided the opportunity to really refocus Verb 1. refocus - focus once again; The physicist refocused the light beam"
focus - cause to converge on or toward a central point; "Focus the light on this image"
2. what we're doing."
Although the focus now is on the highest priorities, that does not mean the program has been forced to abandon its educational activities.
"Education is one of the highest priorities," Armstrong said.