# WASHOE COUNTY HEALTH DISTRICT AIR QUALITY MANAGEMENT DIVISION

March 13 ,2 013

Ms. Co ll een C ripp s, Ph.D. Adm in istrator Divi s ion of Environmental Prot ec tion 90 I 

### S. Stewart St.
, Suite 4001 Carson C it yNV 89701-5249

Dear Ms. Cripps: 

### Public Health

Prev e nt. PromotE

. Prot " ct.



### Enclosed is a revision to the Washoe Cou nt y portion of Nevada's N itro gen Dioxide (N02) Infrastructure State Implementation Plan (I-SIP). This revision was adopted at a public hearing of the Washoe County District Board of Health (DBOH) on January 24
, 2013. The subm ittal includes:

• Proof of publication for the public hearing;

• NDEP request for parallel processing dated January 18
, 2013;

• DBOH Agenda for the JanuarY 24, 2013 public hearing;

• Staff report for the N02 I -SIP;

• N02 I-SIP ;
• Approved minutes from the January 24, 2013 public hearing; and

• Certificate of Adoption.

Two paper and two electronic copies of the submittal are enclosed. The electronic copies

are exact duplicates of the paper copy subm ittal in searchable pdf format. Please review these documents and determine if this submittal is complete. If 

### so, then please forward one paper and one electronic copy to the U

. S. EPA Region IX office. If you have any questions or comments regarding this submittal
, feel free to contact Mr. Daniel Inouye or
me at (775) 784-7200

.

Kevin Dick Director

Enclosures

cc: Daniel Inouye, Washoe County Health District

- AQMD (w /

o 

### enclosures)

P.O. BOX 11130 Reno, NY 89520-0027· (775) 784-7200· FAX (775) 784-7225 www.washoeconnty.ns/health

Printed on Recycled Paper

## W!\SHOE COUNTY r''''''pTRI'l! ! 

### r:'R**,,~I.}r!** .**"'.J'~l.~l...l** 

## l0l3 JAN 18 AM 9 1 

## 09 

# RENO NEWSPAPERS INC Publishers of Reno Gazette-Journal 955 Kuenzli St • P_O. Box 22,000 • Reno, NV 89520 • 775.788.6200

. Legal Advertising Office 775.788.6394

WASHOE CO PO BOX 11130 RENO NV 89520-0027

STATE OF NEVADA COUNTY OF WASHOE Customer Acct# 349008 PO# SIP JAN 2013 DBOH Ad# 1000792568 Legal Ad Cost $230.00

Being first duly sworn, deposes and says: That as the legal clerk of the Reno Gazette-Journal, 

## a daily newspaper of general circulation published in Reno, Washoe County, State of Nevada, that the notice referenced below has published in each regular and entire issue of said newspaper between the dates: 

### 12/21/2012

- 01/17/2013, for exact publication dates please see last line of Proof of Publication below.

. Subscribed and sworn to before me



### , 

# . " "



### Signed: GINA BRILES Notary Public

- State of Nevada

.



## JAN 1 7 WI]

Proof of Publication

NOTICE OF PUBLIC HEARING WASHOE COUNTY DISTRICT BOARD OF HEALTH The Washoe Cot\nty District Board of Health does hereby declare 

### 1 :00 p.m., January 

### 24, 2013, at the Washoe County Health District South Conference Room (1001 East Ninth Street, Relio) as the time, date, and place to consider the adoption oftwo items: I) An Infrastructure Staie Implementation Plan (I-SIP) for the 2010 Nitrogen Dioxide National Ambient Air Quality Standard for submittal to the U.S. EPA as a revision to the Washoe County portion of the Nevada I-SIP; and 

### 2) A Transportation Conformity State Implementation Plan (SIP) for' submittal to the U.s. EPA as a revision to the Washoe County portion of the Nevada SIP. Interested persons who may be affected or wish to comment on any action being considered on the above date should appear at the public hearing to submit oral testimony or may address comments, data, views, or arguments in written form to the Washoe County District Board of Health, P.O. Box 11130, Reno, NY 89520. Copies of the I-SIP and Transportation Conformity SIP are available the Air Quality Management Division website (www.ourcleanair.com)and offices (1001 East Ninth Street, Suite B171, Reno NV 89512) for inspection by any interested person. A M Smith 

### III, Chairman Washoe County District Board of Health No. 792568 Dec 21, Jan 7,17,2012

Ad Number: 1000792568 Page 1 

### of 1

# STATE OF NEVADA

Department of Conservation & Natural Resources


## DIVISIONOF ENVIRONMENTAL PROTECTION



## Jared Blumenfeld Regional Administrator ORA-I, USEPA Region 9 75 Hawthorne Street San Francisco CA 94105 January 18,2013 Brian Sandoval, Governor

leo M. Drozdolf, P.E .• Director

CoIJeen Cripps. Ph.D., Administrator



### RE: The Nevada State Implementation Plan for the 2010 Nitrogen Dioxide Primary**NAA~~~~mo.:stration** 

### of Adequacy

## Dea~e-fiThId: On behalf of Governor Sandoval, as his appointed designee, the Nevada Division of Environmental Protection (NDEP) certifies that the existing Nevada applicable state implementation plan (SIP) contains provisions addressing all the "infrastructure" requirements of Clean Air Act (CAA) section 110(a)(2) for the 2010 nitrogen dioxide (N02) primary national ambient air quality standard (NAAQS). The NDEP is submitting one hard copy and one exact duplicate of the hard copy in electronic form of this certification letter and the following documents as demonstration of the adequacy of Nevada's existing SIP provisions:



## • The Nevada Division of Environmental Protection Portion of the Nevada State Implementation Planfor the 2010 Nitrogen Dioxide Primary NAAQS: Demonstration of Adequacy (Demonstration of Adequacy) and appendices.

• December 11, 2012 letter from the Clark County Department of Air Quality Management (CCDAQ) transmitting their 2010 N02primary NAAQS infrastructure SIP to the NDEP.



## • State Implementation Plan Revision to Meet the Nitrogen Dioxide Infrastructure SIP Requirements of Clean Air Act Section 110(a)(2) and attachments. Clark County, Nevada.

• December 18, 2012 letter from the Washoe County Health District-Air Quality Management Division (WCHD-AQMD) transmitting their 2010 N02primary NAAQS infrastructure SIP to the NDEP with a parallel processing request.



## • The Washoe County Portion of the Nevada State Implementation Plan to Meet the Nitrogen Dioxide 1nfi'astructure SIP Requirements of Clean Air Act Section 110(a)(2) (draft document) and attachments.

The enclosed demonstrations from each of the three Nevada air agencies are organized in table format and list each CAA section 110(a)(2) element and the existing Nevada SIP provisions that satisfy the requirement in each element. In the absence of US EPA guidance for the 2010 N0 2 infrastructure SIPs, Nevada followed US EPA's October 14,2011 guidance for lead infrastructure SIPs (US EPA, Memorandum to Regional Air Division Directors, 

## Guidance on

### Page 2 January 18,2013


## Infrastructure State Implementation Plan Elements Required Under Sections 110(a)(I) and (2) for the 2008 Lead (Pb) National Ambient Ail' Quality Standards (NAAQS). S. Page, OAQPS). Nevada's N02 infrastructure SIP selects those regulatory and statutory provisions from the Nevada applicable SIP that address N02 specifically. This should not be interpreted as an intent to exclude other more general provisions from the applicable SIP from applying to N02 sources in Nevada. Further, although some of the SIP provisions cited in the NDEP table may not be in state regulation, nonetheless those provisions support the NDEP's authority to implement, maintain and enforce the 2010 N02primary NAAQS because they are incorporated into the NDEP's title V operating permits and are federally enforceable.

We certify that the NDEP and Clark County portions of the infrastructure SIP were properly noticed; evidence of public participation is included with the respective submittals. For the NDEP portion of the SIP, the Administrator of the NDEP has the authority to adopt and submit state implementation plans to US EPA (see Appendix D). For the Washoe County portion of this submittal, the NDEP requests parallel processing in accordance with 40 CFR 51, Appendix V.2.3. The final, public noticed copy of Washoe County's portion of Nevada's 2010 N02 infrastructure SIP will be submitted to US EPA by March 15,2013.

The NDEP requests that the US EPA propose approval of this certification of the adequacy of the existing Nevada applicable SIP to implement, maintain and enforce the 20 I 0 N02 primary NAAQS. The NDEP further requests that generally as provisions in Nevada's applicable SIP are replaced or removed through subsequent approvals by US EPA of SIP revisions submitted by the NDEP, US EPA also replace or remove those provisions in this submittal and all of Nevada's CAA 11O(a)(2) SIPs.

If you should have any questions about this submittal or require additional clarification, you may contact Rob Bamford, Chief, Bureau of Air Quality Planning at (775) 687-9330.
Sincerely,

# a:~i~-h.D-.----'- Administrator

Enclosures

cc 

### wlo enclosures: Cory Hunt, Policy Analyst, Office of the Governor Amy Zimpfer, Associate Director, Air Division, USEPA Region IX (AIR-I) Doris Lo, Acting Chief, Planning Office, USEPA Region IX (AIR-2) 

### '-..J Kevin Dick, Director, Air Quality Management Division, Washoe County Health District Lewis Wallenmeyer, Director, Department of Air Quality & 

### Environmental Management, Clark County

ec 

### wlo enclosures Leo Drozdoff, Director, Nevada Department of Conservation and Natural Resources Michael Elges, Deputy Administrator, NDEP Rob Bamford, Chief, Bureau of Air Quality Planning, NDEP

### Page 1 

# MEETING NOTICE AND AGENDA Washoe County District Board of Health Date and Time of Meeting: Thursday, January 2 4 , 201 3 , 1:00 p.m.
Place of Meeting: Washo e County Health District 1001 East Ninth Street, Building B South Auditorium Reno, Nevada 89520



## District Board of Health Meeting Agenda

All items numbered or lettered below are hereby designated for possible action as if the words “for possible action” were written next to each item (NRS 241.020). An item listed with asterisk (*) next to it is an item for which no action will be taken.

Time Agenda

Item No. Agenda Item Presenter



### 1:00 PM * 1. Call to Order, Pledge of Allegiance Led by Invitation Mr. Smith

* 2. Roll Call Ms. O’Neill

Public Comment * 3. Public Comment ( l imited to three (3) minutes per

person) Mr. Smith

4. Approval/Deletions to Agenda for the January 24, 2013 Meeting Mr. Smith

5. Approval/Additions/Deletions to the Minute s of the December 6, 2012 Strategic Planning Retreat and December 20 , 2012 Regular Me eting Mr. Smith WASHOE COUNTY HEALTH DISTRICT 1001 East Ninth Street / P.O. Box 11130 Reno, Nevada 89520 Telephone 775.328

- 2 400 • Fax 775.328

. 2279 www.washoecounty.us/health GEORGE HESS, MD DENIS HUMPHREYS, OD JULIA RATTI JOSEPH P. ISER, MD, DrPH, MSc District Health O

fficer MATT SMITH, Chairman KITTY JUNG, Vice Chairman GEORGE FURMAN, MD SHARON ZADRA

### Page 2

Time Agenda

Item No. Agenda Item Presenter



### * 6

. Recognitions A. Introduction of new employee (s)

– None. B. Promotions

– None. C. Years of Service

– None. D. Recognitions

– CARES/SART Partner Recognition of the WCHD Sexual Health Program Partnership E. Retirements

– None. Mr. Smith and D r. I ser

7. Election of District Board of Health Chair for 2013

– 2014 Term Mr. Smith

8. Election of District Board of Health Vice Chair for 2013

– 2014 Term Mr. Smith

9

. Consent Agenda : Matters which the District Board of Health may cons ider in one motion. Any exceptions to the Consent Agenda must be stated prior to approval.

A. Air Quality Management Cases :

1. Recommendation to Uphold Unappealed Citations to the Air Pollution Control Hearing Board:

a. Mustang Market

– Case 1105, NOV 5317 1215 5 East I

- 80, Sparks NV 89431

b. 4 Wheel Parts

– Case 1106, NOV 5316 40 Victorian Ave, Sparks NV 89431

c. Quickie Mart #201572

– Case 1107, NOV 5315 890 West 4th 

### Street, Reno 89503

d. Preservation Restoration Services

– Case 110 8 , NOV 53 1 8 10672 Fire Poppy Circle, Reno NV 89521

e. Heavenly Auto Body

– Case 1109, NOV 5319 2530 Sutro Street, Suite 1, Reno NV 89512

### Page 3

Time Agenda

Item No. Agenda Item Presenter



### 2. Recommendation of Cases Appealed to the Air Pollution Control Hearing Board. None.

3. Recommendation for Variance : None

.
B. Sewage, Wastewater & Sanitation Cases : Recommendation to Approve Variance Case(s) Presented to the Sewage, Wastewater & Sanitation Hearing Board. None.

C. Budget Amendments / Interlocal Agreements :

1. Retro

- Actively Accept Notice of Grant awards in the amount of $125,000 for the period of January 15, 2013 to January 14, 2015 in support of the Robert Wood Johnson Foundation (RWJF) Northern Nevada Shared Services Learning Community grant (IO

- TBA); Authorize travel and travel reimbursements for

non

- County employees (John Packham, PhD, Emily Brown, MPH, CPH, and Peggy O’Neill) in the approximate amount of $16,400, supported by the grant award; and, if approved
, authorize the DBOH Chairman to execute the grant documents; and if approved, direct Finance to make the appropriate budget adjustments.

2. Approval of amendments totaling an increase of $62,216 in both revenue and expense to the FY13 Centers for Disease Control and Prevention (CDC) Epidemiology and Laboratory Capacity (ELC) Affordable Care Act Federal Grant Program, IO 10984; and, if approved,

au thorize the Chairman to execute.

D. Washoe County Health District Employee Manual : Review and Acceptance of Washoe County Health District Employee Manual

.

E. Appointment to the Air Pollution Control Hearing Board

– Jim Kenney

.

### Page 4

Time Agenda

Item No. Agenda Item Presenter



### 1 0

. Air Pollution Control Hearing Board Cases appealed to the District Board of Health . None. Ms. Albee

11. Presentation on the Washoe County Health District ’ s Indirect Cost Allocation Plan Methodology Mr. Scott Mayne

* 1 2

. Presentation regarding the Prehospital Medical A dvisory Committee (“ PMAC ”) Joseph L. Ryan, MD, PMAC Chairman 13

. Regional Emergency Medical Services Authority :

A. Review and Acceptance of the Operation s and Financial Report s for November and December
, 2012 ; and

B. Update of REMSA’s Community A ctivities Since November , 201 2 Mr. Gubbels

14. Presentation Regarding 38 Recommendations in the Tri

Data Report; and Presentation, Discussion, and Possible Direction to Staff regarding Emergency Medical Services (“EMS”), Including Recommendations Cont ained in the TriData Report and Various Other EMS Studies 

### Dr. Iser, Mr. Smith, Dr. Todd, and Ms. Akurosawa

15

. PUBLIC HEARING : Proposed approval and adoption of the revisions to “The Washoe County Portion of the Nevada State Implementation Plan to meet the Nitrogen Dioxide Infrastructure SIP requirements of Clean Air Act Section 110(a)(2)”. Mr. Inouye

16

. PUBLIC HEARING : Proposed approval and adoption of the revisions to “The Washoe County Transportation Conformity Plan.” Mr. Inouye

1 7

. Discussion and Possible Appointme nt of a Subcommittee to Meet as Needed to Provide Direction to the DBOH and Staff on the Future of the Health District and Its Financial Stability Mr. Smith and Dr. Iser

18. Presentation, Discussion, and Possible Direction to Staff regarding the 2013 Legislative Session Dr. Iser and Ms. O ’ Neill

### Page 5

Time Agenda

Item No. Agenda Item Presenter



### 19

. Review and Acceptance of the Monthly Public Health Fund Revenue and Expenditure Report for December 2012 Ms. Stickney

20

. Discussion and Possible Direction to Staff Regarding FY14 Health Fund Budget Dr. Iser and Ms

. Stickney

*21

. Staff Reports and Program Updates

A. Director, Epidemiology and Public Health Preparedness

- Communicable Disease; Public Health Preparedness; Emergency Medical Services; and Vital Statistics Dr. Todd

B. Director, Community and Clinical Health Services

– Clinical Programs and Non

Communicable Disease Updates

– Maternal and Child Health (Home Visitation) Program Presentation Mr. Kutz

C. Director, Environmental Health Services Food Program; Land Development; Solid Waste/Special Events; and Vector

- Borne Disease Program Mr. Sack

D. Director, Air Quality Management

– Air Quality; Planning and Monitoring Activity; Permitting Activity; Compliance & Inspection Activity; and Permitting & Enforcement Activity Mr. Dick

E. Administrative Health Services Officer

– AHSO agenda items are included in other agenda items. Ms. Stickney

F. District Health Officer

– 2013 Legislative Session; Budget; Human Resources; Communication; Accreditation; Washoe County and Community Activities; Health District Media Contacts and Outreach; Statewide (and Beyond) Organizational Efforts ; RWJF Shared Services Learning Community Grant Update; and District Board of Health Information and Resources Dr. Iser

### Page 6

Time Agenda

Item No. Agenda Item Presenter

Board Comment 

### *22. Limited to Announcements or Issues for Future

Agendas Mr. Smith

23. Emergency Items Dr. Iser

Public Comment 

### *24

. Public Comment (limited to three (3) minutes per

person). No action may be taken. Mr. Smith

25

. Adjournment Mr. Smith

________________________________________________________________________________________________________ Business Impact Statement: A Business Impact Statement is available at the Washoe County Health District for those items denoted with a “ $ .”

___________

_____________________________________________________________________________________________
Items on the agenda may be taken out of order, combined with other items, withdrawn from the agenda, moved to the agenda of another l ater meeting; moved to or from the Consent section, or they may be voted on in a block. Items with a specific time designation will not be heard prior to the stated time, but may be heard later. Items listed in the Consent section of the a genda are voted on as a block and will not be read or considered separately unless withdrawn from the Consent.

________________________________________________________________________________________________________ The District Board of Health Meetings are accessible to the disabled. Disabled members of the public who require special accommodations or assistance at the meeting are requested to notify Administrative Health Services in writing at the Washoe County Health District, PO Box 1130, Reno, NV 89520

- 0027, or by calling 775.328.2416, 24 hours prior to the meeting.

________________________________________________________________________________________________________ Time Limits : Public comments are welcomed during the Public C omment periods for all matters wh ether listed on the agenda or not . All comments are limited to three (3) minutes per person. Additionally, public comment of three (3) minutes per person may be heard during individual action items on the agenda. Persons are invited to submit comments i n writing on the agenda items and/or attend and make comment on that item at the Board meeting. Persons may not allocate unused time to other speakers.

_______________________________________________________________________________________________________ _ Response to Public Comments : The Board of Health can deliberate or take action only if a matter has been listed on an agenda properly posted prior to the meeting. During the public comment period, speakers may address matters listed or not listed on the published agenda. The Open Meeting Law does not expressly prohibit responses to public comments by the Board of Health. However, responses from the Board members to unlisted public comment topics could become deliberation on a matter without notice to the public. On the advice of legal counsel and to ensure the public has notice of all matters the Board of Health will consider, Board members may choose not to respond to public comments, except to correct factual inaccuracies, ask for Health District S taff action or to ask that a matter be listed on a future agenda. The Board of Health may do this either during the public comment item or during the following item: “Board Comments

– Limited to Announcement or Issues for future Agendas.”

________________________________________________________________________________________________________ Pursuant to NRS 241.020, Notice of this meeting was posted at the following locations :
Washoe County He alth District , 1001 E. 9th St., Reno, NV Reno City Hall, 1 E. 1st St., Reno, NV Sparks City Hall, 431 Prater Way , Sparks, NV Washoe County Administration Bu ilding, 1001 E. 9th St, Reno, NV Washoe County Health District Website www.washoecounty.us/health

___________

_____________________________________________________________________________________________

# WASHOE COUNTY HEALTH DISTRICT
AIR QUALITY MANAGEMENT DIVISION

DATE: January 24,2013

TO: District Board of Health

FROM: Kevin Dick, Division Director 

## PublicHea1th
Prevent. Promote. Protect.



### SUBJECT: Public Hearing: Proposed approval and adoption of the revisions to "The Washoe County Portion of the Nevada State Implementation Plan to Meet the Nitrogen Dioxide Infrastructure SIP Requirements of Clean Air Act Section 110(a)(2)." Agenda Item:



### Staff Recommendation
Approve and adopt revisions to "The Washoe County Portion of the Nevada State Implementation Plan to Meet the Nitrogen Dioxide Infrastructure SIP Requirements of Clean Air Act Section 11 0(a)(2)."


### Background

The U.S. Environmental Protection Agency (EPA) establishes health based national ambient air quality standards (NMQS) for six criteria pollutants including Nitrogen Dioxide (N02). The Clean Air Act (CM) directs states to address basic State Implementation Plan (SIP) requirements to implement, maintain, and enforce the NMQS. Many of the CM Section 110(a)(2) SIP elements relate to the general information and authorities that constitute the "infrastructure" of a state's air quality management program. States are required to submit an Infrastructure SIP (I-SIP) within three years after promulgation of a new or revised standard. In 2010, EPA substantially strengthened the N02 NMQS by promulgating a new health-based 1- hour primary standard of 100 ppb.

This I-SIP is a summary of current air quality management elements in Washoe County's portion of the Nevada N0 2 

### SIP. It includes air quality regulations and programs demonstrating the Health District's ability to meet these CM requirements. To reduce printing resources and expenses, the I-SIP is not included with this staff report. The document is 20 pages and can be accessed from the "News 

## & Events" section of the Air Quality Management Division website, www.ourcleanair.com. A hard copy is available by contacting Mr. Daniel Inouye of AQMD at (775) 784-7214 or dinouye@washoecounty.us.

P.O. BOX 11130 Reno, NV 89520-0027' (775) 784-7200' FAX (775) 784-7225 www.washoecounty.us/health
WASHOE COUNTY ISAN EQUAl, OPPORTVNITY F.1I-IPLOYER IIIRING EMPLOYMENT ELlGWLE,\i'PLlC,\NTS**I'rinl~d** on I{ctycled P3rtr

### January 24, 2013 District Board of Health/N0 2 I-SIP Page 2

If the I-SIP is approved and adopted, it will be submitted to EPA through the Nevada Division of Environmental Protection as a revision to the Washoe County portion of the Nevada N02 SIP. A notice of today's public hearing was published in the Reno Gazette-Journal on December 21,2012, January 7, and January 17, 2013. The I-SIP has been available for public inspection at the AQMD website and office since December 21,2012.

Recommended Motion



### Move to approve and adopt revisions to 'The Washoe County Portion of the Nevada State Implementation Plan to Meet the Nitrogen Dioxide Infrastructure SIP Requirements of Clean Air Act Section 110(a)(2)" and direct Staff to forward it to EPA
as an amendment to the Washoe County portion of the Nevada N02 State Implementation Plan.

Alternatives



### The District Board of Health may:

1. Elect not to adopt the revision to the I-SIP; or

2. Continue this public hearing and direct Staff to research some portion of the 

### 1- SIP and report back to the Board at a future meeting.

Kevin Dick Division Director Air Quality Management

# The Washoe County Portion of the Nevada State Implementation Plan to Meet the Nitrogen Dioxide Infrastructure SIP Requirements of Clean Air Act Section 110(a)(2)

January 24, 2013

Washoe County Health District Air Quality Management Division P.O. Box 11130 Reno, Nevada 89520-0027 (775) 784-7200

www. ourcleanair.com

### i 

# Acronyms and Abbreviations

AQS Air Quality System CAA Clean Air Act CSAPR Cross

- State Air Pollution Rule CFR Code of Federal Regulations COCarbon Monoxide DMVDepartment of Motor Vehicles EPAU.S. Environmental Protection Agency FR Federal Register HA Hydrographic Area I- SIP Infrastructure State Implementation Plan NAAQS National Ambient Air Quality Standard NDEPNevada Division of Environmental Protection NO 2 

### Nitrogen Dioxide NRS Nevada Revised Statute NSR New Source Review O 3 

### Ozone Pb Lead PM 2.5 

### Particulate Matter less than or equal to a nominal 2.5 microns in aerodynamic diameter PM 10 

### Particulate Matter less than or equal to a nominal 10 microns in aerodynamic diameter PSD Prevention of Significant Deterioration SIP State Implementation Plan SLAMS State and Local Air Monitoring Station SO 2

### Sulfur Dioxide USC United States Code WCDBOHWashoe County District Board of Health WCAQMD Washoe County Health Distri ct - Air Quality Management Division

### Washoe County Health District - AQMD January 24, 2013 Nitrogen Dioxide Infrastructure SIP 1 

# Introduction and Background

Sections 110(a)(1) and (2) of the federal Clean Air Act (CAA), 42 USC § 7410(a)(1) and (2) hereafter referred to as the “Infrastructure” State Implementation Plan (I

- SIP) requirements, requires states and delegated local agencies to submit an implementation plan to the U.S. Environmental Protection Agency (EPA) demonstrating their ability and authority to implement, maintain, and enforce each National Ambient Air Quality Standard (NAAQS). Section 110(a)(1) addresses the timing requirement for the submissions of the I-SIP. Washoe County is required to submit an I-SIP to EPA not later than 3 years after promulgation of a new or revised NAAQS regardless of whether or not the local jurisdiction has any nonattainment areas.
Section 110(a)(2) lists the required elements that cover the I- SIP. These elements include: enforceable emission limitations, air quality modeling, enforcement programs, ambient air monitoring programs, and confirmation of adequate personnel, resources and legal authorities. The following elements are addressed in this I- SIP:

**•** Enforceable Emission Limitations and Other Control Measures (110(a)(2)(A))

**•** Air Quality Monitoring, Compilation, Data Analysis, and Reporting (1 10(a)(2)(B))

**•** Enforcement and Stationary Source Permitting (110(a)(2)(C))

**•** Interstate Transport (110(a)(2)(D))

**•** Resources, Conflict of Interest, and Emergency Backstop (110(a)(2)(E))

**•** Stationary Source Emissions Monitoring and Reporting (110(a)(2)(F))

**•** Emergency Powers and Contingency Plans (110(a)(2)(G))

**•** SIP Revision For Revised Air Quality Standards or New Attainment Methods (110(a)(2)(H))

**•** SIP Revisions for New Nonattainment Areas (110(a)(2)(I))

**•** Consultation and Public Notification (110(a)(2)(J))

**•** Air Quality Modeling and Reporting (110(a)(2)(K))

**•** Major Stationary Source Permitting Fees (110(a)(2)(L))

**•** Consultation with Local Entities (110(a)(2)(M))

This I

- SIP addresses Washoe County’s portion of the State of Nevada’s requirements for the 2010 Nitrogen Dioxide (NO 2 

### ) NAAQS.

### Washoe County Health District - AQMD January 24, 2013 Nitrogen Dioxide Infrastructure SIP 2 Table1 Current CAA 110(a)(2) (A)

- (M) Requirements in the Washoe County Portion of the Nevada Infrastructure SIP for the 2010 Nitrogen Dioxide NAAQS , Unless Otherwise Noted

Element (A) Enforceable emission limits and other control measures : Requires SIPs to include enforceable emission limits and other control measures, means, or techniques, and schedules for compliance.

WCDBOH Regulations Governing Air Quality Management (Regulation) Section 020.005 (See 38 FR 12702) authorizes the Control Officer to enforce all SIP measures including the following previously submitted Sections: 030.000; 030.005; 030.010; 030.015; 030.025; 030.030; 030.110; 030.115(1), (5), and Subsection B; 030.1201;030.205; 030.215; 030.245; 030.250 (See 46 FR 21758); 030.300; 030.305; 030.310; 030.3101-3105; 030.3107; 030.3108 (See 46 FR 43141); 030.218, 030.230, and 030.970A (See 77 FR 60915); 040.070; 040.075; 040.080; 040.085; 040.090 (See 46 FR 21758); and 050.001 (See 72 FR 33397).
The following Sections have not been submitted as part of the SIP, but have been adopted by the WCDBOH and further support this element requirement (See Attachment B): 020.0051 (Board of Health - Powers and Duties); and 020.020 (Control Officer - Powers and Duties).

Element (B) Ambient air quality monitoring/data system : Requires SIPs to provide for establishment and operation of ambient air quality monitors, collection and analysis of ambient air quality data, and to make these data available to EPA upon request.

Th e WCAQMD operates an ambient air monitoring network in accordance with 40 CFR 58. The network is reviewed annually pursuant to 40 CFR 58.10 to ensure it meets ambient air monitoring objectives (See Attachment A).

### Washoe County Health District - AQMD January 24, 2013 Nitrogen Dioxide Infrastructure SIP 3 Element (C) Program for enforcement of control measures : Requires SIPs to include a program providing for enforcement of all SIP measures and the regulation of construction of new and modified stationary sources as necessary to assure that the NAAQS are achieved, including a permit program as required in Parts C and D.
WCDBOH Regulation Section 020.005 (See 38 FR 12702) authorizes the Control Officer to enforce all SIP measures including the following previously submitted Sections: 030.000; 030.005; 030.010; 030.015; 030.025; 030.030; 030.110; 030.115(1), (5), and Subsection B; 030.1201;030.205; 030.215; 030.245; 030.250 (See 46 FR 21758); 030.300; 030.305; 030.310; 030.3101-3105; 030.3107; 030.3108 (See 46 FR 43141); 030.218, 030.230, and 030.970A (See 77 FR 60915); 040.070; 040.075; 040.080; 040.085; 040.090 (See 46 FR 21758); and 050.001 (See 72 FR 33397).
The following Sections have not been submitted as part of the SIP, but have been adopted by the WCDBOH and further support this element requirement (See Attachment B): 010.1303 (R egulated Air Pollutant); 020.0051 (Board of Health - Powers and Duties); 020.020 (Control Officer - Powers and Duties); 030.002 (Construction or Modification of Permitted Operations); 030.500 (New Source Review (NSR) Applicability); 030.502 (Review fo r Emission Limitation Compliance); 030.503 (Conditions for Approval); 030.504 (Emission Offset Ratios); 030.505 (Completeness of Application); 030.506 (Requirements for Public Notice); 030.507 (Comments); 030.508 (Final Action); and 030.905 (Source s Requiring Part 70 Permits).
On March 3, 2008, the WCAQMD received full delegation of the federal PSD program (See Washoe County 2006 PM 2.5 

### NAAQS I-SIP, Attachment C, submitted December 4, 2009) and is incorporated into Nevada’s SIP (40 CFR 52.1485).

### Washoe County Health District - AQMD January 24, 2013 Nitrogen Dioxide Infrastructure SIP 4 Element (D) Interstate transport provisions : Requires SIPs to contain adequate provisions prohibiting emissions generated within the state from contributing significantly to nonattainment in, or interfering with maintenance by, any other state with respec t to the NAAQS, or from interfering with measures required to be included in the SIP of any other state to prevent significant deterioration or to protect visibility.
Gina McCarthy, Assistant Administrator of the EPA issued a memo on November 19, 2012 to EPA Air Division Directors, Regions 1-10, regarding states’ and EPA’s obligations with respect to the requirements of (D)(i)(I). Ms. McCarthy notes:
“I would also like to note that the recent CSAPR decision made certain holdings regarding the requirement for states to submit SIPs addressing the provisions of Clean Air Act section 110(a)(2)(D)(i)(I), the good neighbor provision that addresses upwind emissions linked to NAAQS attainment problems in downwind states. The decision states that a SIP cannot b e deemed deficient for failing to meet the good neighbor obligation before the EPA quantifies that obligation. Although we have filed a petition for rehearing of the Court’s decision, including this element of the decision, and although the mandate for that decision has not yet been issued, we intend to act in accordance with the decision during the pendency of the appeal. Therefore, at this time the EPA does not intend to make findings that states failed to submit SIPs to comply with section 110(a)(2)(D) (i)(I). To the extent that states may inquire about their obligations to submit SIPs addressing this provision, we believe it would be appropriate to convey that at this time we do not intend to make such findings with respect to section 110(a)(2)(D)(i)(I).”
Because EPA has not informed Nevada of its contribution to any ozone NAAQS attainment problem in downwind states, the W CAQMD concludes that it is not obligated to address this requirement at this time.

Element (E) Adequate resources : R equires SIPs toprovide necessary assurances for adequate personnel, funding, and authority under state law to carry out its SIP, to contain requirements addressing potential conflicts of interest, and to provide necessary assurances that the state retains responsibility for ensuring adequate implementation of the SIP where the state relies on a local or regional government for implementation of any SIP provision.
NRS 445B.500 authorizes the WCDBOH to implement and administer air quality management programs within the geographic boundaries of Washoe County. These programs are managed through the WCAQMD. For the most recent fiscal year (2011 -12), the WCAQMD consisted of 19 allocated full

- time staff. Primary funding sources are: 1) Operating permit fees; 2) EPA grants; 3) Nevada DMV funds; and 4) the City of Reno, City of Sparks, and County of Washoe via an inter

- local agreement with the Washoe County Health District (See Washoe County 2006 PM 2.5 

### NAAQS I -SIP, Attachment D, submitted December 4, 2009).

### Washoe County Health District - AQMD January 24, 2013 Nitrogen Dioxide Infrastructure SIP 5 Element (F) Stationary source monitoring system : R equires SIPs to establish a system to monitor emissions from stationary sources, to submit periodic emissions reports, to correlate the emissions reports with the corresponding SIP emission limits and standards, and to make emissions reports available to the public.
WCDBOH Regulation Section 020.005 (See 38 FR 12702) authorizes the Control Officer to enforce all SIP measures including the following previously submitted Sections related to authority for stationary source monitoring and reporting: 030.210; 030.250 (See 46 FR 21758); and 030.218, 030.230 ; 030.235, and 030.970A (See 77 FR 60915).
The following Sections have not been submitted as part of the SIP, but have been adopted by the WCDBOH and further support thi s element requirement (See Attachment B): 020.0051 (Board of Health - Powers and Duties); and 020.060 (Sampling and Testing).

Element (G) Emergency episodes : Requires SIPs to provide for authority to address activities causing imminent and substantial endangerment to public health and to provide for adequate contingency plans to implement such authority.
Emergency powers are authorized under WCDBOH Regulation 050.001 (Emergency Episode Plan) (See 72 FR 33397 ). In addition, general emergency powers are provided in Nevada’s SIP in NRS 445B.560.

Element (H) Future SIP revisions : Requires SIPs to provide for SIP revisions in response to changes in the NAAQS, or availability of improved methods for attaining the NAAQS, and in response to an EPA finding that the SIP is substantially inadequate.
WCDBOH Regulation Section 020.005 (See 38 FR 12702) authorizes the Control Officer to enforce Section 020.0051 (Board of Health - Powers and Duties) which provides the WCDBOH the authority to revise a SIP “to achi eve and maintain levels of air quality to protect human health”.

Element (I) SIP revisions for new non

- attainment areas : Requires SIP revisions to meet the applicable Part D requirements relating to

non- attainment areas.

The WCAQMD commits to submit S IP revisions whenever the county, or portions of the county, are newly designated non- attainment for any federal NAAQS.

### Washoe County Health District - AQMD January 24, 2013 Nitrogen Dioxide Infrastructure SIP 6

Element (J) [§121] Consultation with government officials, public notification, PSD and visibility protection : R equires states to provide a process for consultation with local governments and Federal Land Managers carrying out NAAQS implementation requirements; . . .
All SIP elements are adopted by the WCDBOH before being formally submitted as the Washoe County portion of the Nevada SIP. Participation by local political subdivisions is authorized by WCDBOH Regulation Section 020.005 (See 38 FR 12702) and an inter- local agreement between the City of Reno, City of Sparks, and the County of Washoe, Nevada (See Washoe County 2006 PM 2.5 

### NAAQS I-SIP, Attachment D, submitted December 4, 2009). This inter

- local agreement requires that the WCDBOH include one elected official from each of the three political subdivisions in Washoe County. The WCAQMD is committed to include all stakeholders, such as local governments and federal land managers, in the SIP development process.

Element (J) [§127] . . . requires SIPs to notify the public if NAAQS are exceeded in an area and to enhance public awareness of measures that can be taken to prevent exceedances; and . . .
WCDBOH Regulation Section 050.001 (See 72 FR 33397) authorizes the WCAQMD to advise the public on measures that are taken to reduce their exposure during elevated air pollutant concentrations. N ear

- time ambient air monitoring data areposted on the WCAQMD website ( www.washoecounty.us/health/aqm/home.html ). A Trends report, which summarizes monitored ambient air quality in Washoe County, is prepared annually and also posted on the WCAQMD website

.
Element (J) [Part C PSD / Visibility] . . . requires SIPs to meet applicable requirements of Part C related to prevention of significant deterioration and visibility protection.

On July 31, 2007, EPA’s approval of Nevada’s interstate transport SIP (CAA 110(a)(2)(D)(i)) for the 8

- hour O 3 

### and PM 2.5 

### NAAQS promulgated in July 1997 was published in the Federal Register (See 72 FR 41629). Also, Article 13 of Nevada’s SIP, “General Provisions for the Review of New Sources,” requires an environmental evaluation before a registration certificate maybe issued. Finally, on March 3, 2008, the WCAQMD received full delegation of the federal PSD program (See Washoe County 2006 PM 2.5 

### NAAQS I-SIP, Attachment C, submitted December 4, 2009) and is incorporated into Nevada’s SIP (40 CFR 52.1485).

### Washoe County Health District - AQMD January 24, 2013 Nitrogen Dioxide Infrastructure SIP 7 Element (K) Air quality modeling/data : Requires SIPs to provide for the performance of air quality modeling for predicting effects on air quality of emissions of any NAAQS pollutant and the submission of such data to EPA upon request.
WCDBOH Regulation Section 030.235 (Requirements for Source Sampling and Testing) (See 77 FR 60915 ) authorizes the Control Officer to require operators provide source stack testing or other types of testing to determine the quantity and effect of emissions produced by a stationary so urce.
In addition, the following Section has not been submitted as part of the SIP, but have been adopted by the WCDBOH and further support this element requirement (See Attachment B): 030.503 (Conditions for Approval).

Element (L) Permitting fees : R equires SIPs to require each major stationary source to pay permitting fees to cover the cost of reviewing, acting upon, implementing and enforcing a permit until such fee requirement is superseded by EPA approval of a fee program under Title V of the CAA.
Permitting fees are authorized under WCDBOH Regulation Sections 030.210 (See 46 FR 21758) and 030.310 (See 46 FR 43141).

Element (M) Consultation/participation by affected local entities : Requires SIPs to provide for consultation and participation in SIP development by local political subdivisions affected by the SIP.

All SIP elements are adopted in a public hearing by the WCDBOH before being formally submitted as the Washoe County portion of the Nevada SIP. Participation by local political subdivisions is authorized by WCDBOH Regulation Section 020.005 (See 38 FR 12702) and an inter-local agreement between the City of Reno, City of Sparks, and the County of Washoe, Nevada (See Washoe County 2006 PM 2.5 

### NAAQS I

- SIP, Attachment D, submitted December 4, 2009). This inter

- local agreement requires that the WCDBOH include one elected official from each of the three political subdivisions in Washoe County.

### Attachment A
Letter from Matthew Lakin (EPA Region IX) to Kevin Dick (WCAQMD) Regarding the “2011 Annual Monitoring Network Plan” (November 1, 2011)

### UNITED STATES ENVIRONMENTAL PROTECTION AGENCY REGION IX



### Mr. Kevin Dick, Director Air Quality Management Division Washoe County Health District 1001 East Ninth Street, Suite A115 P.O. Box 11130 Reno, NV 89520-0027

Dear Mr. Dick: 75 Hawthorne Street 

### San Francisco, CA 94105 

# NOV 0 1 

# 2011

Thank you for your timely submittal of the 2011 Annual Monitoring Network Plan for the Washoe County Health District Air Quality Management Division (AQMD). EPA has reviewed the submitted document and found that it is complete, informative, very detailed and meets the requirements set forth under 40 CPR Part 58.10. We also appreciate your addressing in full our comments to last year's 2010 Network Plan. This letter serves as an official approval of the annual network plan and all of the proposed modifications except the Sparks site special purpose monitoring proposed for non-submission into the AQS. This issue, along with special purpose monitoring at the Ren03 is further discussed in our enclosed comments. AQMD should continue to work with EPA Region 9 staff to obtain the proper documentation and approvals necessary to establish proper special purpose monitoring at the Sparks and Ren03 sites.

If you have any questions regarding this letter or the enclosed comments, please feel free to contact me at (415) 972-385101' Elfego Felix at (415) 947-4141.

Enclosure Sincerely,

Matthew Lakin, Manager Air Quality Analysis Office Air Division

cc: Craig Petersen, Senior Air Quality Specialist, AQMD Julie Hunter, Air Quality Specialist, AQMD

### Comments on 2011 Network Plan for Washoe County AQMD Please update next year's netlVork plan to reflect thefollowing comments:



## 1. 40 CPR 58.20(b) requires any SPM data collected using an FRM, FEM, or ARM must meet the requirements of §58.11, §58.12, and appendix A or an approved alternative. Furthermore, SPM data collected using an PRM, FEM, or ARM that meets appendix A must also repOtt to AQS. Pertaining
to this, EPA noted that the following corrections will need to be made for the AQMD network:

o For the new FEM particulate instruments that are planned for installation at the Sparks site (pp.8), AQMD will either need to meet the requirements of §58.11, §58.12, appendix A and submit data into AQS, or submit an alternative plan for EPA approval that may allow for non-submittal into AQS.

o It was noted that AQMD also operates PM continuous FEM instruments as SPMs at the Ren03 site and is not currently submitting this data into AQS (pp.3). These Ren03 monitors will also either need to meet the requirements of §58.11, §58.12, appendix A and submit data into AQS, or submit an alternative plan for EPA approval that may allow for non-submittal intoAQS.

.
AQMD should continue to work closely with EPA Regional staff to ensure the appropriate documentation and approvals are in place that allow for particulate monitoring at the Sparks and Ren03 sites using FEM instrumentation that does not report to AQS.

2. The cover letter of AQMD's network plan says that no comments were received during the public inspection period of the plan. Page 1 of the Network Plan however contains the following language: "Public comments received during the public inspection period were submitted along with this plan to EPA Region IX." These two statements disagree. EPA requests that this information be clarified in next year's plan and that a consistent message is delivered in the plan as well as the cover letter.

### Attachment B
Washoe County District Board of Health Regulations Governing Air Quality Management Not Included in the Washoe County Portion of the Nevada Nitrogen DioxideInfrastructure SIP But Further Support CAA 110(a)(2)(A)- (M) Requirements

### 010.1303 "REGULATED AIR POLLUTANT" shall mean the following:

1. Nitrogen oxides or any volatile organic compounds;

2. Any pollutant for which a national ambient air quality standard has been promulgated.

3. Any pollutant that is subject to any standard promulgated under section 111 of the Act.

4. Any class I or II substance subject to a standard promulgated under or established by title VI of the Act.

5. Any pollutant subject to a standard promulgated under section 112 or other requirements established under section 112 of the Act, including the following:

a. Any pollutant subject to requirements under section 112(j) of the Act. If the administrator fails to promulgate a standard pursuant to section 112(e) of the Act, any pollutant for which a subject source would be major shall be considered to be regulated on the date 18 months after the applicable date established pursuant to section 112(e) of the Act; and

b. Any pollutant for which the requirements of section 112(g)(2) of the Act have been met, but only with respect to the individual source subject to section 112(g)(2) requirement. (Adopted 10/20/93)

020.0051 BOARD OF HEALTH - POWERS AND DUTIES
Pursuant to the powers and responsibilities that have inured to the benefit of the Board of Health, said Board shall, without excluding any other powers, responsibilities, and authority conferred on said Board in the Nevada Revised Statutes, have the following powers and/or responsibilities:

A. To adopt and enforce rules and regulations to reduce the release into the atmosphere of any air contaminants originating within the territorial limits of the Washoe County Health District in order to achieve and maintain levels of air quality which will protect human health and safety, prevent injury to plant and animal life, prevent damage to property, and preserve visibility and scenic, aesthetic and historic value within said Health District.

B. To establish ambient air quality standards in accordance with law.

C. To make such determinations and issue such orders as may be necessary to implement the provisions of these regulations and to achieve air quality standards in accordance with law.

D. To institute proceedings to prevent continued violation of any order issued by the Board of Health, Hearing Board, or Control Officer, and to enforce these regulations.

E. To require access to records relating to emissions which cause or contribute to air pollution.

F. To apply or and receive grants or other funds or gifts from public or private agencies.

G. To cooperate and contract with other governmental agencies including the State of Nevada, other states, and the federal government.

### H. To conduct investigations, research and technical studies consistent with the general purposes of the Nevada Revised Statutes.

I. To establish such emission control requirements, as may be necessary to prevent, abate, or control air pollution.

J. To require the registration of air pollution sources together with a description of the processes employed, fuels used, nature of emissions and other information considered necessary to evaluate the pollution potential of a source.

K. To prohibit, regulate or control, as specifically provided in Section 030.000 through 030.260 , the installation, alteration or establishment of any source capable of causing air pollution.

L. To issue or deny all requests or applications for a variance or waiver from any of the requirements of these regulations after due consideration of the recommendations of the Hearing Board and Control Officer.

M. To require the submission of preliminary plans and specifications and other information as the Board deems necessary to process permits required by these regulations.

N. To enter into and inspect, at any reasonable time, any premises containing an air contaminant source or a source under construction for purposes of ascertaining the state of compliance with these regulations.

O. To hold any hearing as authorized in Chapter 445 of the Nevada Revised Statutes.

P. To review recommendations of the Hearing Board and to take such additional evidence as the Board of Health deems necessary or to remand to the Hearing Board for such evidence as the Board of Health may direct on any matters arising under these regulations.

Q. To require elimination of devices or practices which cannot be reasonably allowed without generation of undue amounts of contaminants.

R. To specify the manner in which incinerators may be constructed and operated.

S. To delegate all above powers, except Subsections A, B, F, O, and P, to the Control Officer or his representatives as may be necessary to implement these regulations.

T. To appoint by resolution, or other appropriate action of the Board of Health, a Hearing Board consisting of seven (7) members who are not employees of the State of Nevada or any political subdivision of the State of Nevada, or which one (1) member must be an attorney admitted to practice law in the State of Nevada, or which one (1) member must be a professional engineer registered in the State of Nevada and one (1) member shall be licensed in Nevada as a general engineering contractor or a general building contractor as defined by NRS 624.215. All members of said Hearing Board shall be appointed to the terms as specified in NRS 445.481.

U. To institute, in any court of competent jurisdiction, legal proceedings to compel compliance

### with these regulations and the Nevada Revised Statutes pertaining to the emission of air contaminants into the atmosphere within the territorial limits of the Washoe County Health District.

020.020 CONTROL OFFICER - POWER AND DUTIES
The Control Officer, or his designated agent or representative, shall enforce the provisions of these regul ations in his name, or in the name of the Board of Health, in any one or combination of the following ways:

A. By issuing a written notice of violation, delivered personally or by registered or certified mail, to any person if reasonable cause exists to believe said person is violating these regulations.

B. By issuing a warning to any person suspected of violating these regulations and by giving said person an opportunity to correct the cause of said violation prior to issuing a notice of violation or citation and referring the matter to the Board of Health or proper prosecuting authority in the Washoe County Health District;

C. By requesting the District Attorney of the County of Washoe, or other proper agency, person or prosecuting authority in the Washoe County Health District, to institute appropriate criminal, civil or administrative proceedings against the person or persons responsible for violation of any of these regulations.

D. By requesting the Board of Health to levy an appropriate administrative fine against any person found to have violated any of these regulations.

E. By reviewing each variance to ascertain if the variance holder is meeting all provisions of the variance or dates set forth in the compliance schedule; if they are not met, the Control Officer may notify the variance holder personally or by registered or certified mail to this effect and may suspend or revoke any variances or reject any schedule of compliance involved with said infractions.

F. By requesting the Board of Health to institute all necessary and proper legal proceedings authorized by law to carry out the purposes of these regulations and purposes of Chapter 445 of the Nevada Revised Statutes, including injunctive relief.

020.060 SAMPLING AND TESTING

In addition to any other testing requirements provided for in these regulations, the Control Officer or the Board of Health may require any person to conduct or make arrangements to conduct testing of any source to determine compliance with these regulations. In the event such testing is required, the Control Officer may do any of the following:

A. Witness all tests as required by this Section.

B. Determine whether or not generally recognized methods of measurement have been used to determine the quantity of emissions from the source being tested and if not additional testing may be required.

### C. Determine the point or points at or within the source where testing shall be done, to determine the actual discharge into the atmosphere.

D. Make any modifications or adjustments in the testing requirements so as to be compatible with specific sampling conditions or needs as shown by good practice, judgement and experience.

E. Require the cost of any testing to be paid by the owner or person responsible for a ny source of air contaminants.

F. Require additional tests of any source of air contaminants tested in accordance with this Section, provided such separate or additional tests shall be conducted on behalf of the Board of Health and at said Board's expense.

G. Require in writing the construction or creation of sampling holes, safe scaffolding and related facilities, to be provided at the expense of the owner or person responsible for any source of air contaminants being tested in accordance with this section.

H. Require the owner or person responsible for any source of any air contaminants being tested pursuant to this section to provide a suitable power source to the point of testing, so that sampling instruments can be operated as required.

I. All i nformation gathered during any testing operation conducted pursuant to this Section will be provided to both the Control Officer or the Board of Health and the person or persons who own or control or are responsible for any source of air contaminants that are tested pursuant to this Section. All such information obtained pursuant to any testing required under this Section will be treated as confidential in accordance with the requirements of Section 020.055 of these regulations.

030.002 CONSTRUCTION OR MODIFICATION OF PERMITTED OPERATIONS (Amended 4/89, 10/20/93)
A written Authority to Construct shall be required to construct, erect, alter or replace any equipment which may cause, potentially cause, reduce, control or eliminate the issuance of air cont aminants. A single Authority to Construct may be issued for all components of an integrated system or process. Plans and specifications drawn in accordance with acceptable engineering practices shall be required before issuance of an Authority to Construct. The applicant for any Authority to Construct must notify the Control Officer in the application of any source which is or will become subject to 40 CFR Part 70 upon completion of the proposed construction. An Authority to Construct is not needed for routine operation and maintenance. This includes maintenance prescribed by the manufacturer, replacement of worn or broken components with like equipment, etc.

030.500 NEW SOURCE REVIEW (NSR) APPLICABILITY
A major new source or major modification which would locate in an area designated as nonattainment for a pollutant for which the source or modification would be major shall not be allowed to construct unless the stringent conditions set forth below are met. These conditions are designed to insure that the new source's or modification's emission will be controlled to the greatest degree possible, that more than equivalent offsetting emission reductions ("emission offsets") will be progress toward achievement of the national ambient air quality standar ds. For

### the purposes of this part, a reconstructed source shall be treated as a new stationary source. Since major facility definition and requirements vary upon State and EPA area designations, a map (Figure 1) is included to facilitate the determination of which requirements must be met.

030.502 REVIEW FOR EMISSION LIMITATION COMPLIANCE
Authority to construct any new source or modification shall be denied unless the new source or modification meets all applicable emission requirements in the Nevada S tate Implementation Plan (SIP), all applicable Federal New Source Performance Standards, and all applicable National Emission Standards For Hazardous Air Pollutants.

030.503 CONDITIONS FOR APPROVAL (Amended 7/28/93, Revised 10/25/95)
If a major stationary source or major modification would be constructed in an area designated as nonattainment for a pollutant for which the stationary source or modification is major, an Authority to Construct shall be denied unless the following conditions are met:

Con dition 1 The new source or modification is required to meet an emission limitation which specifies lowest achievable emission rate for such
source.

Condition 2 The applicant must certify that all existing major sources owned or operated by the applicant for any entity controlling, controlled by, or under common control of the applicant in the State of Nevada are in compliance with all applicable emission limitations and standards under the Clean Air Act (or are in compliance with an expeditious schedule which is federally enforceable or contained in a court decree).

Condition 3 Emission reductions ("offsets") from existing sources in the same nonattainment area as the proposed new source or modification (whether or not under the same ownership) are required such that they shall not interfere with or contribute to the interference with the attainment of the applicable National Ambient Air Quality Standards. Only intrapollutant emission offsets will be acceptable (e.g. hydrocarbon increases may not be offset against SO2 

### reductions). All emission reductions for the purpose of offsets shall be enforceable under the Clean Air Act.
The terms of the offset emission reductions shall be specified and federally enforceable prior to permit issuance.

All off set emissions reductions shall be, by the time a new or modified source commences operation, in effect and enforceable and shall assure that the total tonnage of increased emissions of the air pollutant from the new or modified source shall be offset by an equal or greater reduction.

All offset emissions reductions must be obtained from decreases in actual emissions from the same or other sources in the area. No emissions reductions otherwise required by the Clean Air Act or other regulatory action my be credited for the purpose of meeting offset requirements.

### Condition 4 The emission offsets will provide a positive net air quality benefit in the affected area. Atmospheric simulation modeling is not necessary for volatile organic compounds and NOX. Fulfillment of Condition 3 and Section 030.504 of these regulations will be considered adequate to meet this condition.

Condition 5 The applicant must perform an analysis of at least two (2) alternative sites for the facility, production processes, and environmental control techniques. This analysis must demonstrate that the benefits of the proposed source significantly outweigh the environmental and social costs imposed as a result of its location, construction or modification.

Condition 6 The Control Officer shall also require the review of any Major Stationary Source or Major Modification subject to New Source Review under this section that may have an impact on visibility in any mandatory Class I Federal area. Such visibility review will ensure the source's emissions will be consistent with making reasonable progress toward State and National visibility goals.

Condition 7 The Administrator has not made a determination that the applicable implementation plan is not being adequately implemented f or the attainment area in which the proposed source is to be constructed or modified.

Condition 8 The proposed major source or major modification shall not contribute to nonattainment in, or interfere with maintenance by, any other State with respect to any national ambient air quality standard, or interfere with measures required to be included in the applicable implementation plan for any other State with respect to prevention of significant deterioration of air quality or to protect visibility.

All emission limitations shall be assessed in light of the limits of "good engineering practice" on stack heights as specified in Section 030.614

. Any major stationary source or major modification commencing construction without an Authority to Construct shall be subject to an enforcement action. Obtaining an Authority To Construct does not relieve the owner from complying with any applicable local, state or federal regulation.
At such time that a particular source or modification becomes a major stationary source or major modification solely by virtue of a relaxation in any enforcement limitation which was established after August 7, 1980, on the capacity of the source or modification otherwise to emit a pollutant, such as a restriction on hours of operation, then the requirements of regulations approved pursuant to this section shall apply to the source or modification as though construction had not yet commenced on the source or modification. All permits issued by the Control officer shall comply with all applicable terms of the State Implementation Plan for the non

- attainment area in which the source is to be constructed.

030.504 EMISSION OFFSET RATIOS (Amended 7/28/93)
Emission reductions required under Section 030.503 shall be offset at a ratio of 1.2 to 1 when the offset sources are five (5) miles or less from the new source or modification. For offset

### sources that are greater than five (5) miles from the new source or modification, the applicant shall determine an offset ratio based on atmospheric simulation modeling or an equivalent method to ensure a positive net air quality benefit. In no case shall the offset ratio for source located greater than five miles from the proposed project be less than 1.2 to 1. Non

-reactive organic compounds (those which are listed in 40 CFR 51.100(s)) cannot be used for offsets.

030.505 COMPLETENESS OF APPLICATION
Following submittal by the applicant, the Control Officer shall determine whether the application for permit to construct is complete not later than thirty (30) calendar days after receipt of the application, or after such longer time as both the applicant and the Control Officer may agree. Such determination shall be transmitted in writing immediately to the applicant at the address indicated on the application if it is determined to be incomplete, the determination shall specify which parts of the application are incomplete and how they can be made complete. Upon receipt by the Control Officer of any re

- submittal of the application, a new thirty (30) day period in which the Control Officer must determine completeness shall begin. Completeness of an application or resubmitted application shall be evaluated on the basis of the guideline for such, published by the Control Officer. After acceptance of an application as complete, the Control Officer shall not subsequently request of an applicant any new or additional information which was not specified in the Control Officer's list of items to be included within such applications. However, the Control O

fficer may, during the processing of the application, request an applicant to clarify, amplify, correct or otherwise supplement the information required in such list in effect at the time the complete application was received. Making any such request does not waive, extend, or delay the time limits in this section for decision on the completed application, except as the applicant and Control Officer may both agree.

030.506 REQUIREMENTS FOR PUBLIC NOTICE (Amended 7/28/93, Revised 10/25/95)
For those sources subject to Section 030.500, following acceptance of an application as complete, the Control Officer shall:

A. Perform the evaluations required to determine compliance with this section and make a preliminary written decision as to whether an Authority to Construct should be approved, conditionally approved, or disapproved. The decision shall be supported by a succinct written analysis;

B. Within ten (10) calendar days following such decision, publish a notice by prominent advertisement in at least one (1) newspaper of general circulation in the County, stating the preliminary decision of the Control Officer and where the public may inspect the information required to be made available. The notice shall provide thirty (30) days from the date of publication for the publication for the public to submit written comments on the preliminary decision;

C. At the time notice of the preliminary decision is published, make available for public inspection at the District office the information submitted by the applicant, the supporting analysis for the preliminary decision to grant or deny the Authority to Construct, including any proposed permit conditions, and the reasons therefore. The confidentiality of trade secrets shall be considered in accordance with Section 020.055 of these regulations;

D. No later than the date of publication of the notice, a copy of said notice and any appropriate data is to be sent to the Nevada Department of Conservation and Natural

### Resources Division of Environmental Protection, the regional planning authority of Washoe County, local government offices, any Indian governing body whose lands may be affected by facility emissions, any Federal Land Manager whose lands may be affected (including visibility effects) and the Regional Office of the U.S. Environmental Protection Agency; and

E. Applicant to bear cost of all public notices under this section and Section 030.508

.
F. The Control Officer shall contact any Federal Land Manager whose lands may be affected for comments on the proposed project within 30 days after the application has been deemed complete. This shall be for the purpose of obtaining comments on the proposed scope of review for affected lands and species.

030.507 COMMENTS
The Control Officer shall consider all written comments submitted during the thirty (30) day public comment period.

030.508 FINAL ACTION (Amended 7/28/93)
Within 180 days after acceptance of the application as complete and the completion of all required preconstruction monitoring and public notice periods (including those required under the District's Part 70 Permit regulations), the Control Officer shall take final action on the application after considering all written comments. The Control Officer shall provide written notice of the final action to the applicant, the U.S. Environmental Protection Agency, other Affected States and the Nevada Department of Conservation and Natural Resources and shall publish such notice in a newspaper of general circulation. The notice and all supporting documents shall be made available for public inspection during normal business hours.

030.905 SOURCES REQUIRING PART 70 PERMITS (Adopted 10/20/93, Revised 10/25/95)

A. Sources Required to Obtain a Part 70 Permit
The following sources and source categories shall be subject to Part 70 permitting:

1. Any Major Stationary Source;

2. Any source, including area sources, subject to a standard, limitation or other requirement under section 111 (New Source Performance Standards) of the Act;

3. An y source, including an area source, subject to a standard or other requirement under section 112 (Hazardous Air Pollutants) of the Act. However, a source which is subject to regulations or requirements only under section 112(r) of the Act shall not be required to obtain a permit;

4. Any source that includes one or more units subject to Title IV (Acid Rain) of the Act;

5. Any source in a source category designated by the EPA Administrator pursuant to 40 CFR Part 70.

### B. Exemptions
The following sources and source categories shall be exempted from Part 70 permit requirements:

1. Any source subject to this regulation solely because it is subject to 40 CFR Part 60, subpart AAA, Standards of Performance for New Residential Wood Heaters.

2. Any source subject to this regulation solely because it is subject to 40 CFR Part 61, subpart M, National Emission Standards for Hazardous Air Pollutants for Asbestos, Standards for Demolition and Renovation.

3. Insignificant Emission Levels
Sources with the potential to emit less than an annual average of two (2) pounds per day of any criteria pollutant or less than one (1) pound per day of any hazardous air pollutant on a facility wide basis are exempted from all part 70 permitting requirements. Such sources may still be required by the Control Officer to obtain a non

-Part 70 operating permit under District regulations. No source which is itself subject to an applicable requirement may qualify as an insignificant
source.

4. All Dry Cleaning operations with the potential to emit less than ten (10) tons per year of any criteria or hazardous air pollutant shall be exempted for a period of five (5) years from the initial EPA Part 70 program approval date unless required to obtain a permit under Section 030.905(A) (5)

.
5. All sources which would be subject to Part 70 permits under Section 030.905 (A) which are not major sources, affected sources or solid waste incineration units subject to permitting under section 129(e) of the act, are exempt from requirements to obtain a Part 70 permit for a period of 5 years from the date of EPA approval of the Washoe County Part 70 permit program.

6. Sources may seek exempt status by limiting facility emissions to levels below those defined for a major source as provided in Section 010.090, part D (prohibitory status) and part E (Synthetic Minor sources)

.
C. Sources Which Must be Permitted by the State of Nevada
Any facility whose principal business is to generate electricity using steam derived from the burning of fossil fuels must obtain any necessary Part 70 permit(s) from the State of Nevada.

### Washoe County

Health District 

## Washoe County District Board of Health Meeting Minutes January 24 , 2013

PRESENT: Mr. Matt Smith
, Chairman, Councilwoman Ratti
, Dr. George Hess, and Dr. George Furman



### ABSENT : Commissioner Jung; Councilwoman Zadra; Dr

. Denis Humphreys



### STAFF:

1:05 pm 1,2

3.



### 4

. Joseph P

. lser, District Health Officer Eileen Stickney, Administrative Health Serv i ces Off i cer , Administrative Health Services ' Robert Sack, Division Director, Environmental Hea l th Services

Charlene Albee
, Branch Enforcemen t Chief, AQM Lori Cooke
, Fiscal Compliance Officer
, AHS Phil Ulibarri, Public Information Officer
, AHS Stacey Akurosawa, EMS Coordinator
, EPHP Leslie Admirand
, Deputy District Attorney Peggy F

. O'Neill, Recording Secretary Kevin Dick, Division Director
, Air Quality Management Steve Kutz
, Division Directo r , Community and Clinical Health Services Ra n dall Todd
, DrPH, Division Director
, Epidemiology and Public Health Preparedness Daniel Inouye, Air' Quality Supervisor
, AQM Patsy Buxton, Fiscal Compliance Officer, AHS Steve Fisher, Department Computer Application Specialist, AQM Peg Caldwell, Registered Nurse I
, EPHP Laurie Griffey, Administrative Assistant I, AHS



### Meeting Called to Order, Pledge of Allegiance and Roll Call Chairman Smith called t he meeting to order, f ollowed by the Pledge of Allegiance led by Dr. Iser

. Roll call was taken and a quorum noted

.



### Public Comment
ApprovallDe l etions

- Agenda -January 24, 2013 No public comment was presented.

Chairman Smith called for any deletions to t he Agenda of the January 24
, 2013 DBOH Meeting.

Dr. Iser directed the B.aard Members to the new layou t of t he Agenda which models the form of the Board of County Comm i ssioners

. 

### Dr. Hess moved
, seconded by C ouncilwoman Ratti, that the January 24
, 2013 Agenda be approved as submitted

.


### MOTION CARRIED

### 5.



### 6.

7

.

.. 8

.

9. 

### Approval/AdditionslDele t ions to the Minutes of the December 6,2012 Strategic Planning Retreat and December 20, 2012 Regular Meeting

Recognitions

Election of District Board of Health Chair

- 2013/2014 

### Term

Election of District Board of Health Vice Chair

- 20131 

### 2014 Term

Consent Agenda Chairman Smith called for any adqitions or corrections to the minutes of the December 

### 6
, 2012 Strategic Planning Retreat and the December 

### 20,2012 Regular Meeting.

Dr. Furman stated that he should abstain since he was not in

. attendance at the December 

### 20 meeting ; however, Ms. Admirand informed him that his abstention was not required and his vote was needed for the motion to pass.

Dr. Iser and Chairman Smith presented the CAR ES/SART Partner Recognition to the WCHD Sexual Health Program Partnership. Councilwoman Ratti moved, seconded by Dr. Hess, that the minutes of the December 

### 6,2012 Strategic Planning Retreat and the December 

### 20,2012 Regular Meeting be approved as presented

.


### MOTION CARRIED

Chairman Smith called

· · f.or nominations for Chairman for the 2013/20 1 4 

### term

. 

## I Dr. Hess moved, seconded by Councilwoman Ratti, that Mr. Smith be re-elected Chairman for the 

### 2013/2014 term.

Chairman Smith called for nominations for Vice Chair for the 2013/2014 

### term

.

Dr. Humphreys and Chairman Smith requested that Agenda Item Nos

. 8.0 and 8.E., 

### respectively, be pulled from the Consent Agenda for discusston.

A. Air Quality Management Cases:



### 1

. Unappealed Citations to the Air Pollution Control Hearing Board : 

### MOTION CARRIED

Chairman Smith moved, seconded by Councilwoman Ratti
, that Commissioner Jung be re-elected Vice Chair for the 

### 2013/2014 term.



### MOTION CARRIED

Page2

### a. Mustang Market

- Case No. 1105, Unappealed Citation No. 5317

- Staff reported Citation No. 5317, was issued to Mustang Market on November 16, 2012
, fo r failure to conduct the required annual performance testing I accordance with Condition No.4 of Permit to Operate No

. G02-0011, which isa major violation of Section 030.2175 of the Washoe County DBo.H Regulations Governing Air Quality Management. Staff recommends the citation be upheld and a fine in the amount of $1,250.00 be levied as a negotiated fine.

b

. 4 Wheel Parts

- Case No

. 1106, Unappealed Citation No. 5316

- Staff reported Citation No. 5316, was issued to 4 Wheel Parts on November 13, 2012, for failure to have an asbestos survey performed by a qualified person and submitted to Air Quality for the issuance of an Acknowledgement of Asbestos Assessment prior to demolition/renovation of a commercial facility, which is a major violation of Section 030.1 05(b)(1 0) of the Washoe County DBOH Regulations Governing Air Quality Management. Staff recommends the citation be upheld and a fine in the amount of $2,500.00 be levied as a negotiated fine.

c. Quickie Mart

- Case No

. 1107, Unappealed Citation No. 5315 -Staff reported Citation No. 5315, was issued to Quickie Mart
on November 14
, 2012, for failure to conduct the required annual performance testing in accordance with Condition No.4 of Permit to Operate No. G02-0006, which is a major violation of Section 030.2175 of the Washoe County DBOH Regulations Governing Air Quality Management. Staff recommends the citation be upheld and a fine in the amount of $1,250.00 be levied as a negotiated fine.

d. Preservation Restoration Service

- Case No. 1108, Unappealed Citation No

. 5318

- Staff reported Citation No. 5318, was issued to Preservation Restoration Service on November 20,2012, for failure to conduct proper asbestos survey , provide notification to Air Quality
, and using improper Work practices during removal of asbestos containing materials involved in the demolitionlrenovation of a commercial facility, which is a major violation of Sections 030.1 05(B)(1 0) and 020

. 107(A), (B), and (C) of the Washoe County DBOH Requlations Governinq Air Qualitv Manaaement. Staff 

### Page 3recommends the citation be upheld and a fine in the amount of 

### $2,500.00 be levied as a negotiated fine.

e. Heavenly Auto Body

- Case No. 

### 1109, Unappealed Citation No. 

### 5319

- Staff reported Citation No. 

### 5319, was issued to Heavenly Auto Body on November 29,2012
, for operating an auto body repair facility without a permit to operate, which is a major violation of Section 030.000 of the Washoe County DBOH Regulations Governing Air Quality Management. Staff recommends the citation be upheld and a fine in the amount of 

### $2,500.00 be levied as a negotiated fine.

2. Recommendation to Uphold Citation Appealed to the Air Pollution Control Hearing Board: None.

3. Recommendation for Variance: None.

B

. Sewage

- , Wastewater & Sanitation Cases: None

.
C. Budget Amendments Iinteriocal Agreements:

1

. The Board was advised Staff recommends retroactive accept of the Notice of Grant award in the amount of $125

, 000 for the period of January 15, 2013 to January 14, 2015 in support of the Robert Wood Johnson Foundation (RWJF) N0rthern Nevada Shared Services Learning Community grant (IO-T-BA) ; Authorize travel and travel reimbursements for non-County employees (John Packham, Pl1D, 

### ACTION ITEMS: (1) Emily Brown, MPH, CPH ; and Peggy O'Neill) in the approximate Letters to Mustang Market; amount of $16,400

, supported by the grant award; and, if approved, 4 Wheel Parts; Quickie authorize the DBOH Chairman to execute the grant documents; and if approved
, direct Finance to make the appropriate budget Mart ; Preservation adjustments

. Restoration Services; and Heavenly Auto Body
2. The Board was advised Staff recommends approval of amendments regarding fines and due totaling an increase of $62,216 in both revenue and expense to the dates; and (2) Letter to Jim FY13 Centers for Disease Control and Prevention (CDC) Kenney regarding Epidemiology and Laboratory Capacity (ELC) Affordable Care Act appointment to Air Pollution Federal Grant Program, 10 10984 ; and
, if approved
, authorize the Control Hearing Board. Chairman to execute.



### Page 4

### 10.



### 11. Air Pollution Control Hearing Board Cases Appealed to the District Board of Healt h

.
Presentation on the Washoe County Health District's Indirect Cost Allocation Plan Methodology E. Staff recommends appointment of Jim Kenney to the Air Pollution Control Hearing Boa rd.

There were no cases heard this month

.

Mr

. Scott Mayne stated that he assists the Health Dis t rict, Washoe County
, Water Resources
, District Attorney's office, Social Services, t he TMFPD, and others in developing their federally approvable indirect cost rates. Mr. Mayne stated that he began doing th i s type work in 1979 when he worked for Clark County.

Mr

. Mayne stated that not everyone in government uses this practice, and of those who do
, not everyone uses it well. However, in his opinion, Washoe County practices the concept well and has done it weir for many years

.
Mr. Mayne stated that much of the indirect cost rate for the State of Nevada is direct charged out. Washoe County chooses to leave most of the central service cost in a general service agency type

. Indirec t costs a r e those costs that support the actual operating agencies of the County

. For example
, IT
, Human Resources
, and the Distri ct Attorney's office ' help and support all o f the other departments of the County

. Mr

. Mayne and staff go through a three month process of identifying a lot of the costs based on federal definition for what is allocable to the operat i ng departments of the Coun t y , including the Health District.

Mr

. Mayne s t ated that t he State of Nevada allocates approximately $15 M i llion out in thei r state-wide cost allocation plan. Wash Q e Cou n ty is unique i n that it allocates approximate l y $43 Millio n ou t i n its cost allocation plan. Tha t is because there was a personnel assessmen t for HR at the state level that gets c h arged to each operating d i vision. There is a charge for the Attorney GeneraFs office that gets direct charged t o each operatin g divisi o n , and so on. Washoe County has those as a Central Service C o st that they include as an ihdirect cost instead of a di r ect cost. So we are deali n g with 

### Dr. Hess moved, seconded by Councilwoman Ratti
, that · the Consent Agenda be approved as presented in a single motion

.
MOTION CARRIED



### Page 5

### Board C omments outside entities and people see what our indirect cost rate is; the cost of administrative cost to general operating costs. Washoe County's is very high because we do this Central Serv i ce Cost rather than direct charge, and that goes down to the Health District. The Health District's indirect cost rate was built out of this Central Service allocation at the County level, but it also includes the administrative structure of the Health District
, and we are taking i t down to the Division level to give each division an individual indirect cost rate

. Those rates are based upon federal definitions of what is an adminis t rative indirect cost versus a direct cost.

Dr

. Hess asked that Mr

. Mayne define "direct cost" and "indirect cost." Mr. Mayne stated that indirect costs are those activities that benefit multiple operating units or supervises and assists all operating units of the department. We can go down to lower levels than that, but Mr. Mayne is trying to be general in nature. The County Cost Allocation Plan is approximately 150 pages of calculations. The Health District's Indirect Cost Policy i s only about 6 or ?pages, but it is based upon the County ' s COWCAP

. Mr

. Mayne offered to meet with any Board Member who would like a more in depth discussion of the methodology.

Dr

. Hess stated that he is concerned about how high the Health District's I n direct Cost Rates are , because in his experience in working with grants, there is no way that the federal government
, or virtually any grantor
, would reimburse at those rates

.
Mr

. Mayne stated that the Health District staff is very educated and does a very good job of separating allowable and unallowable costs as defined by OMB Circular. A-B?, which is the basis for these calculat i ons

. There is also an associated implementation guide. Based on these federal guidelines, Health District staff identifies who is administratiVe and who is not administrat i ve

. Following the federal methodology takes care of these issues in generating t he rate. Staff and Mr. Mayne follow those rules in developing the Health District's Indirect Cost Rate. The structure of the Health District determines and affects t hat rate. The h i gher than normal rates are a function of the County's accounting system and methodology, which creates an overall higher indirect cost rate

. Clark County and the State of Nevada direct charge
a great deat of their costs
, which creates a lower overall indirect cost rate

. The indirect costs are high because you do no t pay directly for things like utilities, which is a policy decision by the County

. Mr

. Mayne reported that

. Staff has looked at some of these items, such as liab i lity insurance and

leases, are now being direct charged
, but the two big drivers for the Health District are Facilitv Manaqement (this location and utilities); IT ; and the OPEB 

### Page 6contribution. Mr. Mayne stated that in the last feW years , the IRS has required that retiree health benefits be fully funded

. Mr. Mayne further stated that in preparation for this presentation, he went back and looked at the COWCAP allocation for the last few years, and in 2003 the County-wide Cost Allocation for the Health District was $2.5 Million, so the costs of operating have really

. come down across the board for the County

. The OPEB contribution is really driving the COWCAP. Historically
, that transfer had run approximately $4 to $5 Million per year. In 2011, it was $14 Million
, and 2012 it was $20 Million. There was a GASB federal accounting requirement a couple years ago that requires government entities to fully fund these obligations. The County is catching up with that requirement. When we look at the $20 Million for FY 12, that is approximately 40% of the whole indirect cost rate.

Chairman Smith asked why the COWCAP is not based on the General Fund Transfer amount, and Mr. Mayne replied that the methodology is to allocate those costs that benefit multiple operating departments and in allocating those costs to the benefitting agency, you are able to on some grants have an indirect cost rate to access more federal funds.

Councilwoman Ratti stated that she wanted to be clear that Chairman Smith
was talking about the COWCAP, which is separate and distinct from the indirect cost rate

. Mr

. Mayne clarified that the results of the COWCAP are used as the basis
, and he then adds the administrative costs for the Health District on top of the COWCAP to generate the Health District's indirect cost rate

. The theory is to identify the actual coslof running government.

Chairman Smith asked what amount the Cities annually contribute to the Health Fund, and Councilwoman Ratti replied that at present there is no annual transfer by the Cities to directly fund the Health District; however, when the Health District was originally created, there was a shifting of the tax rate
, and when we looked it up last time, the General Fund Transfer from the County is now significantly more than what would be the equivalent of the shift that tax swap

. So the County is ina whole lot more than the Cities, and the Cities acknowledge that.

Ms. Pam Fine
, County Finance, reported that the last time she calculated i t (she did not bring the figures with her today) the County portion of what the obligation was of that -original tax swap was about $3

. 5 Million per year , and obviously the County i s funding the Health District more than double that. Sparks was around $1

. 5 Million and Reno ' s was around $4 Million. Councilwoman Ratti stated this is a re curring question to her
, and she would like Ms. Fine to provide that analvsis for her

. 

### Page 7Dr

. Fumian stated that the cost per capita for the provision of a health department in Washoe County is twice that of Southern Nevada

. Dr. Furman asked Mr. Mayne to comment on that disparity. Mr

. Mayne said he could riot comment on that. He was not aware of that figure

. Dr

. Hess stated that he
was initially struck by that figure also, but when he looked at SNHD's budget ; and then added back in their Air Quality department, the per capita is essentially the same

.
Mr. Mayne stated that he does not work with the Health District in Southern Nevada. Counci

. lwoman Ratti asked if he is an independent contractor, and Mr. Mayne stated that he is a retired state and county employee; he worked for the County for five years, and he worked for the state for 19 years, and he worked for Clark County for six years

.
Dr

. Iser reported that he has worked in many counties in California, and Cost Allocation is something they have worked with for decades. Dr. Iser reported that his main issue with the COWCAP is the rapidi t y of its implementation. The Health District is not being given the opportunity to adjust its income to offset the additional expense

. At some point that will come in to equilibrium. At the other departments where Dr. Iser has worked, there was one indirect cost rate for the department rather than the divisional rates. 

## Or. Iser asked why the analYSis is taken to the divisional level here, and what are the benefits to that? Mr. Mayne stated that the main benefit is that you are able to show what the true cost of running that division or unit is with a divisional rate. Mr. Mayne further stated that there is a Health District Indirect Rate in the analysis he provided
, and the District can use that rate

. Mr. Mayne stated that there was an administrative request apprOXimately five years ago to develop divisional rates
, and since that time he has als

.o prepared that analysis. It is absolutely appropriate to have a Health District Rate, but you have a choice. Mr. Mayne caJculates a**Was~oe** County Indirect Cost Rate. Other departments in t he County chose to use one rate. That is a policy

. decision

.

Dr

. Hess asked Mr. Mayne to explain the difference between the two documents which were provided to him

. Mr. Mayne stated that the one document that is approximately 

### 18 pages is the summary pages of the County-wide Cost Allocation Plan ("COWCAP"), and the other document is the Washoe County Health District Indirect Cost Rate Implementation Plan.

Dr. Iser stated that his concern is that we have some programs that have no allocation for a n indirect rate all the way t o the programs in EPHP a t 78%

. There are administrative personnel in all

. divisions. For example, 

### Page 8Administrative Health Services hasa 0% indirect cost rate

. WIC is a specific prog r am in that div i sion, and they have zero cost allocated to them. He believes the dispa r ity is what is concerning to Dr

. Hess

. Dr

. Iser stated that his preference wo u ld be to have one indirect cost rate spread across all divisions. Mr

. Mayne sta t ed t hat the Health District has the ability to have one administrative indirect cost rate and still meet federal standards. M r. Mayne stated that the drawback to utilizing one indirect cost rate is that you may have a division that provides direct service to the public tha t you may generate rate setting from, and therefore t h e rate would be smaller

. Those that have a small rate may see higher costs associated with having a bloated rate applied to them

. Mr. Mayne restated tha t a single Health District rate would be an appropriate policy if that is the policy decision made.

Councilwoman Ratti stated that clearly the OPES contribution is a significant i m pact, so that makes p erfect sense ; however, her concern is that the administrative rate will actually become inflated because of the reduction in
s t aff and the real possibility that Division Directors are doing work that specialist below them performe d in the past
, but the definition doesn't allow you to split that director into direct and ind i rect. Mr

. Mayne stated that a time study wo u ld need to be completed to facilitate accurate recording o f the percentage of time attributable to direct services versus administra ti ve functions. Councilwoman Ratti stated that this is the first time she has heard that the Health District may have more fle xi bility to do a more in-depth study to determine staffing patterns and improve the indirect rate

. Mr. Mayne stated that this calculation is a tool. If he had a high indirect cost r ate
, he would be questioning why is my admin rate so high? That is a fair question. Is it that I ' ve got t o o many chiefs and not e no ugh Indians, or is it the structure and the type of service being provided?

Councilwoman Ratti stated that there has been such a dramatic red u ction in staffing over a short perio d of time. We refer to it as t h e " Swiss cheese in the org**chart "**  The organ i zation took what it could get to balance the budget, and
we are only just now reaching the p oint where the economy i s leveling 9ut to where we can look at a rest r uct ure for the departmen t because of this r eality.

Mr

. Mayne stated that h e believes the District would see a tremendous reduction in its ' indire ct rate if the GASS ruling requir i ng the OPES funding
were not the r eality

. Forty (4 0 % ) percent of t he cost is associated wi t h OPES, and the cost (COWCAP) in 2013 i s act ually the allocat i on tha t the Health District had in 2003.



### Page 9Councilwoman Ratti questioned Mr. Mayne about how and when the County ' began to delve into direct and indirect cost rates and stated that the DBOH has never looked into the indirect cost rate, and Mr. Mayne replied that it was in 2002 when Child Welfare integration occurred, and he came to Washoe County. It was recognized at that point that the County did not have a cost allocation plan. It was identified by County management at t h at time that the County needed to develop an indirect cost rate so that t hey could pull in tho
, se federal funds for Social Services, etc. It was recognized as a good management tool for calculating the cost of doing business and providing certain services
, even thought the County did not fully implement these charges out to the operating divisions until the discussions last year, Mr. Mayne stated that he can certainly appreciate the impact of such a " charge " to the Realth Fund being implemented rapidly, even though the calculations have been made since 2002.

Councilwoman Ratti stated that she really appreciated Mr

. Mayne's presentation today because**sh~** learned a little something new today

. Councilwoman Ratti has been concerned about jumping into the COWCAP on an expense management side and how to spread that out to be able to absorb the costs, but had not deliberated on how we bring down our ind i rect cost rate by being more proficient at tracking expenses. We have the opportunity to reduce the indirect cost rate being charged by this department by restructuring some of how 

## we account for staffing? Mr. Mayne agreed that is one way to accomplish that goal. Mr.

- Mayne stated you could consolidate a couple operating units and spread out the administrative costs over those two operating units in one, it may reduce the percentage of the indirect cost rate. Councilwoman Ratti questioned whether it would reduce the COWCAP allocation, and Mr. Mayne stated it would not.

Dr. Iser stated that the RWJF CJS Grant has just been implemented, and both Dr

. Iser and Ms. O'Neill will allocate portions of their time to the grant. otherwise, we are administration, but for that program , we will be direct services on the grant. That allocation should reduce our i n ternal cost allocation, and it will save General Fund. Dr

. Iser stated that when he was in NevadaCounty, he

- allocated his time to at least 12 different programs_ Here he did not do that until now.

Dr

. Iser thanked Mr. Mayne for his presentation today

. Dr

. lser stated that from a management perspective
, it is his desire to implement a**District~wide** Indirect Cost Rate. Dr. Iser stated that the District as a whole is looking at efficiencies. We have made the strategic decision to try and keep the Division Directors on General Fund so that they can provide the kind of assistance to 

### Page 10Councilwoman Ratti stated that there is a distinction between General Fund and Restricted and indirect rate and direct rate. They are not synonymous '

. She questioned whether the administrative time to get to a more detailed indirect versus direct allocation of our staff would be of benefit to our constituents, tax payers, or rate payers

. The strategic thing might be to not bring down our indirect rate

. She is not advocating for tha t, but how important is it that we get to better allocation of staffing as to direct or indirect?

Dr. Hess stated that he has concern about the high rates because of the grant funding issue and competitiveness. Dr

. Hess questioned the allowable rate
on the PHP grants, and Dr. Todd stated that they allow 15

- 20%. Dr. Iser stated that we are implementing charging all our grants the highest allowable indirect rate. Councilwoman Ratti stated that is precisely her point. If we can only recover 15%, where is the benefit to getting more sophisticated at dOing this? Dr. Iser stated that the indirect rate is not as big a concern to h im as COWCAP. Dr

. Iser ques ti oned Mr

. Mayne about his statement that the federal government requires that government entities fully fund OPEB

. Dr. Iser stated he does not believe that his true. County Manager Simon advised Dr. Iser that the Board of County Commissioners is considering revising their allocation to OPEB on an annual basis. Possibly Ms

. Fine or Mr. Rosen can confirm that, but that was the conversation we had

. It is Dr. Iser's understanding that the Board of County Commissioners can choose how much to prefund or currently fund.

Mr

. Mayne stated that because this was a change.in policy based on federal guidelines by GASB
, county government entities have been fully funding this cost to the counties or the state historically

. Allowances have been given based on a county's ability to pay

. Over the years we have seen the historical contribution at $4 or $5 Million. Once this decision was made and they had
an actuarial adjustment ; they started moving toward fully funding. Mr. Mayne does not know when that actuarial full funding will ·occur, but he does know that the County has been putting in the monies to meet that requirement sirwe this decision and have increased their reimbursement to meet this requirement. Mr. Mayne stated he does believe it is 

## a requirement.

Dr

. Iser stated that he believes it is a choice of the public entity how much to pre-fund

. Councilwoman Ratti stated that she is not an OPEB finance expert, but they went through this exercise at the City of Sparks
, and her understandina is that vou can "fullv fund " but when vou

. choose to Dut that 

### Page 

## 11money into that "Iockbox," then you cannot get it back if your actuarial inputs change for some reason, such as rates changing, or the entity can choose to pay as you go

. Sparks looks at a yearly impact which gives them more flexibility to not have that money in a "Iockbox." Councilwoman Ratti stated this is a very complex issue for each jurisdiction to decide
, but this is the approach that the City of Sparks is taking. In theory, tha t liability will just grow, and grow, and grow.

Dr. Iser stated that he believes one reason the County has such a high credit rating is that they have chosen to fully fund that liability

. Dr. Iser further stated that his second concern about COWCAP is the charge for Tech Services. Dr

. Iser stated that he believes the Health District is being double charged for Tech Services, because of the amount of support the District receives from its internal DCAS staff. Dr. Iser questioned Mr. Mayne about whether those considerations are made when calculating the COWCAP and whether a credit is possible. Mr. Mayne stated that is a challenge, and it should be a discussion point within the County. Dr. Iser stated that he is beginning to have those discussions with those support departments. Mr. Mayne stated that at this point the policy decision has been to allocate based on the Health District's 250 user 

### 105.

Dr. Furman asked whether it is taken into account the management time and
resources used in the oversight of the EMS transport franchise

. Mr

. Mayne stated that it is not, but it is a valid question and an area for discussion.

Ms. Fine reported to the Board on tax allocations from the Cities of Reno and Sparks and Washoe County. Ms. Fine reported that in 1963
, there was a tax swap

. The Cities both agreed to give up a certain amount of ad valorem tax value to Washoe County to fund the Health**Di~trict.** In 1962/1963, that tax value was $55,951 from the City of Reno; $9,335 from the City of Sparks; and $27,470 from Washoe County

. In FY 12/13, those figures are $2,315,340 from the City of Reno; $573,780 from the City of Sparks; and $3,195,428 from Washoe County. If you include the value of the Central Service Costs for the General Fund, the County funded the Health District in the amount of $8,623,891 in FY13.

Councilwoman Ratti stated that to be clear the County funded the Heatth District at the $8,623,891 level, with the benefit of tax value set aside for the Health District in the amount of $6,084,548.



### Page 12

### Presentation regarding the Prehospital

. Medical Advisory Committee ("PMAC")

Boar Comments Dr. Joseph Ryan, Chairman, presented to the District Board of Health regarding PMAC's role in our community; how PMAC interacts with the EMS providers in our community; and how public policy impacts the practice of medicine in our community.

Dr. Furman questioned Dr. Ryan about the current cost of EMS delivery in our community and what would be the cost if PMAC's vision of EMS delivery is fully implemented. Dr

. Ryan stated that he cannot speak

. to dollars specifically
, but he believes we spend too much in areas where we could do better with less money

. Dr. Ryan stated**h~** does not believe we 

### need to reproduce Emergency Medical Dispatch and multiple functions within the chain from a call to 911. It is not efficient for us to do that. Itis not the best quality

· care. Right now, trained Emergency Medical Dispatch staff is trained in protocols that offer the best outcomes. You can't do that part-time

.
Dr

. Ryan stated that there are four things supported by science that save people's lives; (1) Continuous, uninterrupted CPR (which trained staff will begin instructing the bystander to commence on their loved one); (2) clearing
an obstructed airway when a person can't do it themselves; (3) providing a defibrillator shock; and (4) controlling external hemorrhage

. Those are the four things that make a difference to save someone's life

. A system that works well would provide that set of skills to the most number of people in the community acting in the public's interest who would provide that service as rapidly as possible. Anything beyond that, while more sophisticated, is also associated with a greater risk of dOing it wrong. When someone provides emergency care infrequently, which we all do, because only 7% of people calling 911 have an emergency, and only 3% have a medical emergency, we can't do that well when we don't do it very frequently. Dr. Ryan suggests that
we can do better with less if we focus on what the patient needs

.
Councilwoman Ratti asked Dr. Ryan to introduce "PMAC" and explain to the audience its mission and structure. Dr. Ryan stated that PMAC is a committee that meets on a quarterly basis. PMAC most typically meets at Renown

. The people who are on the committee are apPointed by the organization that they represent. Each hospital has a standing seat on the committee, along with the medical director for each EMS agency and the fire departments. Dr

. Ryan stated that he was appointed byREMSA We have standing membership from Family Medicine in our community who Dr

. Ryan believes is appointed by the Medical SOCiety, and the Urgent Care providers, and for quite a long time there was a representative from the Board of Health
, and " PMAC believes 

### Page 13

### 13. 

## I Regional Emergency Medical Services Authority:



### A. Review and Acceptance of the Operations and Financial Reports for November and

· Oecember, 

### 2012; and Councilwoman Ratti asked Dr

. Ryan if PMAC as an organization has reviewed the TriData recommendations and made any findings,and Dr. Ryan

. reported that several members of PMAC were part of the Task Force and it has been made available, but PMAC has not formally reviewed it as a group and made recommendations

. Councilwoman Ratti asked D r. Ryan if PMAC anticipates doing that
, and Dr

. Ryan stated PMAC would if it would be useful to the community and the decisions that need to be made. Dr. Ryan further stated that because PMAC is cross-organizational and different from other healthcare organizations
, PMAC does not have the ability to provide quality review of the medical care that is provided

. Hospital-basedorgariizations have an umbrella under which those things can be discussed confidentially
, so because of PMAC's organizational structure, that protection does not exist within the law. PMAC's recommendation is that that structure be in place
across the organizations to improve ou r ability to deal with the care provided

.

. , Dr

. Ryan stated that the chairman is elected by the members.

Dr

. Hess stated that the problems he sees between geography, the multiple jurisdictions
, etc., that the TriData report provided a good solution, but it will cost money

. The CAD t o CAD linkage that we ' ve been discussing is a great solution. Dr

. Ryan stated that the majority of 911 calls are for law enforcement. The next largest group of 911 calls is medical. Of those medical calls, 7% are actual emergencies, and only 3% of those calls are Iifethreatening emergencies. Dr. Ryan stated that the modem dispatch centers that work best are dispatch centers in whic h specialists manage the major
areas (i.e

. , law enforcement
, fire, medical)

. The initial call taker should only offer (911

- what is your emergency) and then be able to cognitively route to the proper specialist. It is not possible for a generalist to be great at what law enforcement needs while at the same time understanding and doing well with
a medical problem.

Mr

. Jim Gubbels
, Vice Presideniof REMSA
, reported that the DBOH members have been provided with a copies of the November and December
, 2012 Operations and Financial Reports; overall emergency response times in November for Priority One compliance was at 92%; in the 8-minute zone , it
was 92%; for the15-minute zone, it was 98% ; for the 20

- minute zone it was 

### Page 14

### Board Comments:



### B. Update of REMSA's Community Activities Since October, 

### 2012 Overall emergency response times in December for Priority One compliance
was at 93%; in the 8-minute zone, it was 93% ; for the15-minute zone, it was 100%; for the 20-minute zone it was 96%. For Priority Two compliance it was 96%

.
Mr

. Gubbels advised the overall average bill for air ambulance service to date is $7,639, and overall average bill for ground ambulance services to date is $1,026.

Dr

. Hess s tated that he read a recent article in the newspap er about nonnatural causes of death speaking to accidents and injury. Dr. Hess stated that he was surprised by the percentages of death related to accidents and injury and questioned if REMSA captures data on causes and what the community is doing to impact this public health problem.

Mr. Gubbels discussed the activities of the statewide initiative on Zero Fatalities. D r. Iser reported that last year the Health District applied for a grant through the CDC which provides a Public Health Prevention Specialist. This year, the Health District is applying for two grants for Specialists, one in Chronic Disease and one for Injury Prevention
, and the goal would be to look at in more depth REMSA's data at unintentional injury, suicide, and gunshot wound data.

Mr

. Gubbels reported that the past President, Patrick Smith, has stepped down from the position, and the Board o f Directors of REMSAhas offered the position to Mr. Gubbels

. Mr. Gubbels has accepted t h e position. Mr. Gubbels stated that Patrick Smith has put his heart and soul into REMSA over the last 23 years, and REMSA's accomplishments during that time are i

.ngreat part due to Patrick ' s hard work. REMSA appreciates and respects what Patrick has done for REMSA. The organizational transition has been a part of REMSA's plan for several years and we have been working on this effort

.
Mr. Gubbels reported that the Innovation Grant has accepted REMSA's operational plan
, and it will move forward as of December 

### 31. All the planning
we have done will now be implemented

. REMSA has hired 9 internal paramedics

. They start their training period on Jan uary 8

. I t will be a 16- month training program , and we are Gurrently in the process of working with
our community clinics and partners to look at how they willwo rk within those clinics. We are also now havinQ

. conversations with the hospitals on how the Dr. Hess moved
, seconded by Councilwoman, to accept the REMSA Operations and Financial Reports for November and December, 

### 2012, as presented.



### MOTION CARRIED



### Page 15

### 14

. 

### Presentation Regarding 38 Recommendations in the TriData Report; and Presentation, Discussion, and Possible Direction to Staff regarding Emergency Medical Services ("EMS"), Including Recommendations Contained in the TriData Report and Various Other EMS Studies Chairman Smith asked the Board members if they would like to see that presentation and received consensus

.
Mr. Gubbels reported that the Fitch and Washko Reports are completed
, and they have been delivered to REMSA. The REMSA Board will accept the reports at their next meeting, and then we will deliver them to the Chairman of the District Board of Health.

Councilwoman Ratti asked for clarification on the second report, and Mr. Gubbels stated that it is the Washko Report
, and that is the name of the consultant, and the Washko Report is the one that goes through the 38 recommendations included in the TriData Report.

Dr. Iser presented the EMS timeline since the last meeting of the District Board of Health on November 15.

Related Action in ' January: January 7
, 2013 Managers' Meeting
, which included**Dr ~**  Iser, Dr

. Todd
, and Ms

. Akurosawa, the Fire chiefs, and some deputy city managers and others. What we agreed to do there was to set up 

## a process to look at the 38 .recommendations contained in the TriData Report. Ms. Akurosawa has developed a spreadsheet that sets out the 38 recommendations and the Health District's position on those recommendations, a copy of which is i n your packet.

The next Managers' Meeting was on January 23, 2013. We began going through the individual TriData items to understand all comments from each jurisdiction. In the next month ' s presentation, Dr. Todd and Dr

. Iser will present the Health District's view on those recommendations

.
Mr

. Slaughter was tasked with developing an agenda for the February 11 concurrent meeting. Someone representing Fire will make a presentation on the 38 Recommendations as they relate to REMSA, and the Sheriff will make
a presentation on Dispatch, and Dr'. Iser volunteered and was tasked with drafting a narrative on what the EMS agency/authority would look like.

Dr

. Iser asked that Dr. Todd present on the Health District's comments on the 38 Recommendations. Dr. Iser stated that they have received comments 

### Page 16from each Fire jurisdiction also, but are not yet at liberty to share those comments publicly

.
Councilwoman Ratti asked if Dr. Iser was expecting action on these recommendations today, and Dr. Iser replied only if that is the Boara's desire. Councilwoman Ratti stated that without a more in depth review, she is not ready to take action on this report.

Dr. Todd reported that his goal is to orient the Board to the document and the process that the group with which Dr. Iser is working is taking.

Dr. Hess asked if there is proposed action on the agenda for the February 

### 11th meeting, and Dr. Iser responded that he has not yet seen an agenda, but Mr. Slaughter may discuss with each entity a proposed action to be taken

. Dr

. Iser stated that he does not believe any action should be taken at the February 

### 11th meeting, but he is not sure the position of each group

.
Chief Hernandez reported to the Board that at the Managers' and Stakeholders' meeting the group progressed through only about X of the document
, and it is the intent to fully vet the document and get recommendations from each respective political entity and combine the comments into one and submit that to the Board of Health as well as the councils of each entity for comments, recommendations, suggestions, or action.

Councilwoman Ratti questioned if that would be done by the 

### 11 th

, and Chief Hernandez stated he did not see how that could be accomplished in that time frame. Dr. Iser stated that part of the February 11th meeting is designed to orient the new members of each governing body to the EMS issues
, and Dr

. Cohen will present at the concurrent meeting. Chief Hernandez stated that John Slaughter was directed to draft an agenda iter}1 to address bringing the
new members up to date on the issues
, and Councilwoman Ratti stated that is her understanding as well.

Dr. Randall Todd presented Agenda Item No. 14 to the Board for their review and oriented the Board to the design and layout of the document. Dr. Todd noted that not every recommendation in the TriData Report was targeted at the REMSA Franchise. Dr

. Todd stated that this document was sent out to all of the stakehoiders and asked that they pu t in their comments
, concerns, suggestions, or opinions in different colors so that when we went back to the meeting we could then attempt to form consensus on the issues

. That is what really got started yesterday

. We did not include those comments in this report 

### Page 17

### 15. PUBLIC HEARING : Proposed 

### approval and adoption of the revisions to "The Washoe County Portion · of the Nevada State Implementation Plan to meet the Nitrogen Dioxide InfrClstructure SIP requirements of Clean Air Act Section 11 O{a){2)".

Board Comment for you since they are just initial starting points
, and there is a lot more discussion that needs to take place. Dr. Iser did want to include the Health District's initial starting position for your review so that if you did have
concerns or wish to aim staff in a different direction, you would have the ability to do that.

Mr. Daniel Inouye begin athe presentation on the proposed revisions to the Washoe County Portion of the Nevada State Implementation Plan to meet the Nitrogen Dioxide Infrastructure SIP requirements of the Clean Air Act.

Ms. Admirand stopped the proceedings based on the temporary loss of a quorum. The meeting was recessed at 2:50 pm.

Chairman Smith reconvened the meeting of the District Board otHealth at 2:56 pm.

Mr. Inouye stated that the EPA establishes health based national ambient air quality standards for six criteria pollutants including Nitrogen Dioxide. The Clean Air Act directs states to address basic requirements to implement
, maintain, and enforce these standards. Many of the Clean Air Act elements relate to the general information and authorities that constitute the "infrastructure" of a state's air quality management program. States are required to submit an Infrastructure SIP within three years after promulgation of a new or revised standard.

This I-BIP is a summary ofcurrent air quality management elements in Washoe County's portion of the Nevada Nitrogen Dioxide SIP. It includes air quality regulations and programs demonstrating the Health District's ability to meet these Clean Air Act requirements.

Mr

. Inouye reported that if the I-SIP is approved and adopted, it will be submitted to the EPA through the Nevada Division of Environmental Protection as a revision to the Washoe County portion of the Nevada N0 2 SIP.

Chairman Smith opened the Public Hearing and called for anyone who wished to speak. No one appeared to speak. Chairman Smith closed the public hearing and reopened the meeting of the District Board of Health.

Chairman Smith queried the DBOH for comments or action. Dr. Hess moved
, seconded by Dr

. Furman
, to approve and adopt the revisions to the Washoe County Portion of the Nevada State Implementation Plan to meet the N0 2 1-SIP requirements of the Clean Air Act.



### . MOTION CARRIED 

### Page 18

## 17. Proposed approval and adoption of the revisions to "The Washoe County Transportation Confonnity Plan."

Board Comment

Discussion and Possible Appointment of a Subcommittee to Meet as Needed to Provide Direction to the DBOH and Staff on the Future of the Health District and Its Financial

- Stability Mr. Inouye presented a staff report regarding the approval and adoption of the revisions to the Washoe County Transportation Conformity Plan

. Mr. Inouye reported that the Clean Air Act requires that long and short-range transportation plans prepared by local metropOlitan planning organizations (MPO) c onform to local air quality SIPs. The RTC of Washoe County is the local MPO. Transportation Conformity SIPs are the federally enforceable plans that ensure this evaluation occurs.

The Washoe County Transportation Conformity Plan has been revised to be submitted to the EPA as the Transportation Conformity SIP for Washoe County. The Transportation Conformity Plan details each stakeholder's role and responsibility when transportation conformity analysis is required

. Each stakeholder was involved in the development of the document.

Chairman Smith opened the Public Hearing and called for anyone who wished to speak

. No one appeared to speak. Chairman Smith closed the public hearing and reopened the meeting of the District Boa rd of Health.

Chairman Smith queried the DBOH for comments or action.

Chairman Smith stated that he would like to see a subcommittee fo r med to analyze the long term financial stability of the Health District and options available to it. Chairman Smith stated that Dr. Humphreys has expressed interest in being on such a subcommittee

.
Councilwoman Ratti asked what the scope of the committee would be, and Dr. Iser responded that since his time at the Health District, the Health District has been under huge amounts of stress primarily related to financial instability
, and Dr. Iser would like a subcommittee who would advise the Health District by exploring a variety of options available from grants for funding or reorganization tactics that were referred to in our earlier discussion here today. The subcommittee needs to look at how we can decrease costs
, increase revenues, or find other sources of revenues in the long run

.
Councilwoman Ratti clarified that the subcommittee would not look at any short term budget issues or impede the current budget
, and Dr. Ise r confirmed that would not be within the scope of the subcommittee. Councilwoman Ratti asked if this subcommittee would look a U he organizational structure of the Health District and the authority under which it operates
, and Dr. Iser answered in the affirmative

. Councilwoman Ratti moved, seconded by Dr

. Hess, Smith, to adopt the revisions to the Washoe County Transportation Conformity Plan, as presented.



### MOTION CARRIED

Page 

## 19Councilwoman Ratti stated tha t if the subcommittee would consider something that would change the structure of the Health District
, then we should be thoughtful about the representations from each of the jurisdictions. Should that committee come forward with recommendations that affect the jurisdictions that recommendation would have to be sold to the individual councils since they are delegating their authority to have a health department to this body at t his time, Councilwoman Ratti would suggest having the stakeholders on the c ommittee early on to see it turn i nto something viable rather than an "intellectual exercise."

Councilwoman Ratti stated if we are truly interested in doing something significant to the structure of the Health District which includes the governing structure, it is going to have to be a more robust effort than a subcommittee.

Chairman Smith stated that at this point we are looking for i deas to r eally address some issues facing the Health District that could be brought back to the Board, and then if the Board determines they are worth pursuit, then the effort could be stepped up

.
Councilwoman Ratti asked what the fo r m would be to remain a subcommittee, without a quorum , and Ms

. Admirand stated that any subcommittee would be subject to the Open Meeting Law

. Ms

. Admirclnd stated that even if they are not taking action
, they would be making recommendations to this Board, and it is very clear under the Open Meeting Law that such a committee would be subject to the Open Meeting Law

. Dr. Iser then stated that it would reqUire Ms. O'Neill's and Ms

. Admirand ' s attendance also

.
Dr. Hess stated that for this type exploration that would inhibit discussion, and Councilwoman Ratti stated that it is intended to help keep the public informed

. Councilwoman Ratti stated that she would like to be considered, and Councilwoman Ratti recommended again that the other member be one of the elected appointments to the Board. Dr. Iser questioned whether he coul9 ask Commissioner Jung and Councilwoman Zadra if they would like to be on the

. committee, and Ms. Admirand repl i ed in the affirmative. The action today will

be the appointment of Dr. Humphreys and Councilwoman Ratti to this

.

. committee.

Dr. Iser reported that he has asked each Division within the Health Dist ri ct to appoint someone to support this committee in its exploration

. 

### Chairman Smith moved, seconded by Dr. Hess, t o form a committee to explore the financial stability and structure of the Health District and nominated Dr. Humphreys aFld Councilwoman Ratti as members
, with one

. additional member to be appointed at a subsequent meeting of the DBOH

.


### MOTION CARRIED



### Page 20

## 19.

20. Presentation, Discussion, and Possible Direction to Staff Regarding the 2013 Legislative Session

Review and Acceptance of the Monthly Public Health Fund Revenue and Expenditure Report for December, 2012

Board Comments

Discussion arid Possible Direction to Staff Regarding FY 

### 14 Health Fund Budget



## 21

. 

## I Staff Reports and Program Updates



### A. Director

- Epidemiology and Public Health Preparedness Dr. Iser reported that there is nothing new to add at this point other than to inform the Board that a Legislative Update will be a standing item on future agendas. Dr. Iser further reported that there have been multiple requests from the County to look at bills that might have a potential fiscal impact on the Health District.

Dr

. Iser stated that we will bring a report to the .Board each month on the activities staff is tasked with during this process.

Eileen Stickney
, Administrative Health Services Officer, presented the Monthly Public Health Fund Revenue and Expenditure Report for December 2012, stating that Staffrecommends the Board accept the report.

Ms. Stickney directed the Board to pool revenue and tire dollars revenue and that both of these are simply timing issues. Staff will be finalizing ETCs as we go into the budget preparation season

.
Dr

. Hess questioned if the grants usually run this far behind in reimbursement, and Ms. Stickney stated that most of the grants work on a reimbursement cycle, and all of them will be balanced in Period 13 prior to close out of the budget year. Dr. Hess questioned the Medicaid billing, and Ms. Stickney reported that the initial application was rejected and staff has resubmitted under new guidelines

.

Eileen Stickney, Administrative Health Services Officer, presented t h e budget updates to the Board

. Ms. Stickney reported that the County did approve tbe CIP projectto remove the planters from the Lobby.

Ms. Stickney also reported that the meetings with program staff and the Division Directors to prepare budgets will begin next week

. Staff will present the FY 

### 14 Health Fund Budget to the Board at the Special Budget Meeting on March 7 at 1 : 00 pm

. -

Dr. Randall Todd
, Director, Epidemiology and Public Health Preparedness
, presented his monthly Division Director's Report, a copy of which was placed
on file for the record. Dr. Hess moved, seconded by Councilwoman Ratti, to accept the Health Fund Revenue and Expenditure Report for December, 

### 2012,

as presented.

MOTION CARRIED

Page 

## 21

### B. Director

- Community and Clinical Health Services

Board Comments Dr. Todd reported that the influenza year is rather exceptional across the country. Washoe County has not had such an experience to date ; week three is the first week that Washoe County as exceeded the threshold, and we seem to be on somewhat of an upward trend

. We did not exceed the threshold at all last year.

The G2.4 Syndey strain of Norovirus has been in the news quite a bit. We do not yet know if our outbreak was part of the Sydney strain

. Testing is still underway.

Mr. Steve Kutz, Director, Community and Clinical Health Services,presented his monthly Division Director's Report, 

# a copy of which was placed on file for the record.

Mr.Kutz reported the additional influenza vacCine is on order, but we do have vaccine available even with the increase in activity

. The Sexual Health Program developed an STD ! Outbreak Response Plan. We are at Level II (3
cases in a 3 month period) for active Syphilis cases. We have notified the District Health Officer and the State STD Program, and we will meet with the Epidemiology Program tomorrow afternoon to look at data and put together
an EPI News to alert our health care community

.
Dr

. Iser reported that he met with Ms

. Simon last week, and she asked that the Health District provide influenza vaccine to County employees, and we are working in collaboration to vaccinate the County employees.

Mr. Kutz reported that he just met with HR and was told to prepare for approximately 50 immunizations, and Mr. Kutz believes that is something the program can absorb.

Dr. Hess stated that looking at the MCAH Program Report he is conc

. erned that the budget has been cut s6 much

. He is curious how that has affected home visitations since the peak in 2006

. Dr

. Hess also questioned how the program gets its referrals.

Mr. Kutz asked Ms. Hunter to come forward and make the presentation on the Home Visitation Program
, and Dr

. lser reported that this report is in response to Chairman Smith notifying Dr

. Iser last month that Dr

. Furman would like a report on the Program.



### Page 22

### C. Director

- Environmental Health Services '

D. Director

- Air Quality Management Chairman Smith stated that what he asked for was an agenda item

. Ms. Admirand stated that it is okay to discuss as an update
, but no action can ' be taken on it. If the Chairman would rather have action it can be agendized that way next month or Ms. Hunter can give her presentation today.

Dr. Furman stated that he would like it to be agendized as an action item next month

. Dr

. Furman stated that it is fine with him if Ms

. Hunter makes her presentation today
, but it might be better to have it next month so that the other board members will have the benefit of the presentation prior to the vote.

Dr

. Hess asked Ms. Hunter if the report would address the year-to-year statistics he discussed earlier
, and if those statistics are available to him for a Medical Society meeting.

Ms. Hunter stated that she would be happy to provide for the Board even individual presentations if they would like

.
Councilwoman Ratti stated that she would like to hold the presentation until the action to afford t he other members the benefit of the presentation

.
Dr

. Furman stated that he would like to make some comments

. Ms

. Admirand recommended that Dr

. Furman make all his statements and comments at the time the action will be taken to keep the record complete

. Dr

. Furman stated that when agendized he will propose that this program be abolished and not funded

.
Ms

. Admirand advised Dr. Furman that the proper time to address his
concerns will be under Agenda I t em No. 22

- Issues for Future Agenda Items

.
Mr

. Kutz clarified that the Board has the report, and Ms. Hunter will bring the presentation to the February meeting, and the agenda item will be for possible action

. . .

Mr. Robert Sack
, Director
, Environmental Health Services, presented his monthly Division Director's Report, a copy of which was placed o n f il e for the record ;

Mr. Kevin Dick
, Division Director, Air Quality Management
, presented the monthly Division Director's Report
, a copy of which was placed on file for the record. 

### Page 23

## 22.

23.

24.

25. Administrative Health Services Officer

F. District Health Officer



### Board Comment

- Limited to Announcements or Issues for Future Agendas

Emergency Items

Public Comment

Motion to Adjourn**~G' .**  ;:

.**/s ~**  ,J'-ti>t:>r-j>8**jYi~. .**  .. 7· 4**~**



### JOSEPH 

### P

. ISER
, MD
, DrPH, MSc DIS T RICT HEALTH OFFICER Dr. Iser
, District Health Officer, presented the monthly District Health Officer Report, a copy of which was placed on file for the record

.
Dr

. Iser reported that the RWJF Shared Services Learning Community Grant has now been fu nded. Dr. Iser will conduct the first round of meetings wi t h the counties involved in this grant next week

. Dr

. Iser reported that he will report monthly to the Board on the grant activities.

Dr

. Furman stated that he would like to have the Home Visiting Program as an action item on the next agenda. Dr

. Furman stated that due to the serious shortfalls in the FY 14 Budget
, he believes this program should not be funded further. Dr. Furman stated that this program had been voted on before for elimination and th

. at was not done. Dr

. Furman would like i t to be addressed again.

None

.

No public comment was presented.

There being no further business to come before the Board, the meeting was adjourned, 

### Councilwoman Ratti moved, seconded by Mr. Smith, that the meeting be adjourned.



### MOTION CARRIED The meeting was adjourned at 

### 3:21 p.m

. 

# \j) J 

# OYl _"**~ ~nt**  

# -/,

..**~** PEGGY F

. O'NEILL
, RECORDING SECRETARY

Page 

### 24