WASHOE COUNTY HEALTH DISTRICT 

AIR QUALITY MANAGEMENT DIVISION 

March 13,2013 

Ms. Co ll een Cripps, Ph.D. 

Adm in istrator 

Division of Environmental Protection 

90 I S. Stewart St., Suite 4001 

Carson CityNV 89701-5249 

Dear Ms. Cripps: 

Public Health Preve nt. PromotE . Prot"ct. 

Enclosed is a revision to the Washoe County portion of Nevada's Nitrogen 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 

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

l0l3 JAN 18 AM 91 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 N02 

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 24, 2013, 1:00 p.m.

Place of Meeting: Washoe 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 (limited 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 Minutes of the 

December 6, 2012 Strategic Planning Retreat and 

December 20, 2012 Regular Meeting

Mr. Smith

WASHOE COUNTY HEALTH DISTRICT

1001 East Ninth Street / P.O. Box 11130

Reno, Nevada 89520

Telephone 775.328-2400 • Fax 775.328.2279

www.washoecounty.us/health

GEORGE HESS, MD

DENIS HUMPHREYS, OD

JULIA RATTI

JOSEPH P. ISER, MD, DrPH, MSc

District Health Officer

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

Dr. Iser

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 consider 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

12155 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 

1108, NOV 5318

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, 

authorize 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

10. 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

*12. Presentation regarding the Prehospital Medical 

Advisory Committee (“PMAC”)

Joseph L. Ryan, 

MD, PMAC 

Chairman

13. Regional Emergency Medical Services Authority:

 

A. Review and Acceptance of the Operations and 

Financial Reports for November and December, 

2012; and

B. Update of REMSA’s Community Activities Since 

November, 2012

Mr. Gubbels

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

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

17. 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. 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 NonCommunicable 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 later 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 agenda 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 Comment periods for all matters whether 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 in 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 Staff 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 Health 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 Building, 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 N02 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/N02 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

CO Carbon Monoxide 

DMV Department of Motor Vehicles 

EPA U.S. Environmental Protection Agency 

FR Federal Register

HA Hydrographic Area

I-SIP Infrastructure State Implementation Plan

NAAQS National Ambient Air Quality Standard

NDEP Nevada Division of Environmental Protection 

NO2 Nitrogen Dioxide

NRS Nevada Revised Statute

NSR New Source Review

O3 Ozone 

Pb Lead

PM2.5 Particulate Matter less than or equal to a nominal 2.5 microns 

in aerodynamic diameter

PM10 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

SO2 Sulfur Dioxide 

USC United States Code 

WCDBOH Washoe County District Board of Health 

WCAQMD Washoe County Health District - 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 (110(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 (NO2) NAAQS. 
Washoe County Health District - AQMD January 24, 2013 

Nitrogen Dioxide Infrastructure SIP 2 

Table 1 

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.

The 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 (Regulated 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 for 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 (Sources Requiring Part 70 Permits).

On March 3, 2008, the WCAQMD received full delegation of the federal PSD program (See 

Washoe County 2006 PM2.5 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 respect 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 be 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 WCAQMD concludes that it is not obligated to address this 

requirement at this time. 

Element

(E)

Adequate resources:

Requires SIPs to provide 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 PM2.5 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:

Requires 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 this 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 achieve 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 SIP 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: 

Requires 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 PM2.5 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. Near-time ambient air monitoring data are posted 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 O3 and PM2.5 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 

may be issued. Finally, on March 3, 2008, the WCAQMD received full delegation of the 

federal PSD program (See Washoe County 2006 PM2.5 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 source. 

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:

Requires 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 PM2.5 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 the following 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 Dioxide Infrastructure 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 

regulations 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 any 

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 information 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 contaminants. 

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 standards. 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 State 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:

Condition 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 offset 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 for 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 

Officer 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. Any 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 Services Officer, Administrative 

Health Services ' 

Robert Sack, Division Director, Environmental Health Services 

Charlene Albee, Branch Enforcement 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 Director, Community and Clinical Health 

Services 

Randall 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 the meeting to order, followed by the Pledge of 

Allegiance led by Dr. Iser. Roll call was taken and a quorum noted. 

Public Comment 

ApprovallDeletions - Agenda 

-January 24, 2013 

No public comment was presented. 

Chairman Smith called for any deletions to the Agenda of the January 24, 

2013 DBOH Meeting. 

Dr. Iser directed the B.aard Members to the new layout of the Agenda which 

models the form of the Board of County Commissioners. 

Dr. Hess moved, seconded 

by Councilwoman Ratti, that 

the January 24, 2013 

Agenda be approved as 

submitted. 

MOTION CARRIED 
5. 

6. 

7. 

.. 8. 

9. 

Approval/AdditionslDeletions 

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 2013/2014 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, for 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. 1 07(A), (B), and (C) of the Washoe County DBOH 

Requlations Governinq Air Qualitv Manaaement. Staff 

Page 3 
recommends 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 Health. 

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 Board. 

There were no cases heard this month. 

Mr. Scott Mayne stated that he assists the Health District, Washoe County, 

Water Resources, District Attorney's office, Social Services, the TMFPD, and 

others in developing their federally approvable indirect cost rates. Mr. Mayne 

stated that he began doing this 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. Indirect costs are those costs 

that support the actual operating agencies of the County. For example, IT, 

Human Resources, and the District Attorney's office'help and support all of 

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 operating departments of the County, including the 

Health District. 

Mr. Mayne stated that the State of Nevada allocates approximately $15 

Million out in their state-wide cost allocation plan. WashQe County is unique 

in that it allocates approximately $43 Million out in its cost allocation plan. 

That is because there was a personnel assessment for HR at the state level 

that gets charged to each operating division. There is a charge for the 

Attorney GeneraFs office that gets direct charged to each operating division, 

and so on. Washoe County has those as a Central Service Cost that they 

include as an ihdirect cost instead of a direct cost. So we are dealing 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 

Comments 

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

ice 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 it 

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

trative 

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 is 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 Indirect 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 calculations. There is also an 

associated implementation guide. Based on these federal guidelines, Health 

District staff identifies who is administratiVe and who is not administrative. 

Following the federal methodology takes care of these issues in generating the 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 that rate. The higher 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 not 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

ility 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 6 
contribution. 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 it 

(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 is 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 recurring question to her, and she would 

like Ms. Fine to provide that analvsis for her. 

Page 7 
Dr. 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 rapidity 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 the 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 an indirect rate all the way to the programs in EPHP at 78%. 

There are administrative personnel in all. divisions. For example, 

Page 8 
Administrative Health Services hasa 0% indirect cost rate. WIC is a specific 

program in that division, and they have zero cost allocated to them. He 

believes the disparity is what is concerning to Dr. Hess. Dr. Iser stated that 

his preference would be to have one indirect cost rate spread across all 

divisions. Mr. Mayne stated that the Health District has the ability to have one 

administrative indirect cost rate and still meet federal standards. Mr. 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 that you may 

generate rate setting from, and therefore the 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 that 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 

impact, so that makes perfect sense; however, her concern is that the 

administrative rate will actually become inflated because of the reduction in 

staff and the real possibility that Division Directors are doing work that 

specialist below them performed in the past, but the definition doesn't allow 

you to split that director into direct and indirect. Mr. Mayne stated that a time 

study would need to be completed to facilitate accurate recording of the 

percentage of time attributable to direct services versus administrative 

functions. Councilwoman Ratti stated that this is the first time she has heard 

that the Health District may have more flexibility 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 rate, he would be 

questioning why is my admin rate so high? That is a fair question. Is it that 

I've got too many chiefs and not enough Indians, or is it the structure and the 

type of service being provided? 

Councilwoman Ratti stated that there has been such a dramatic reduction in 

staffing over a short period of time. We refer to it as the "Swiss cheese in the 

org chart " The organization took what it could get to balance the budget, and 

we are only just now reaching the point where the economy is leveling 9ut to 

where we can look at a restructure for the department because of this reality. 

Mr. Mayne stated that he believes the District would see a tremendous 

reduction in its' indirect rate if the GASS ruling requiring the OPES funding 

were not the reality. Forty (40%) percent of the cost is associated with OPES, 

and the cost (COWCAP) in 2013 is actually the allocation that the Health 

District had in 2003. 

Page 9 
Councilwoman 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 that time that the 

County needed to develop an indirect cost rate so that they 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 indirect 

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 internal 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 10 
Councilwoman 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 that, 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 him as 

COWCAP. Dr. Iser questioned 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 11 
money 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, that 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 Dr. 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 our 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 to 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 which 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 stated that he read a recent article in the newspaper 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. Dr. 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 of Directors of REMSAhas offered the 

position to Mr. Gubbels. Mr. Gubbels has accepted the 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 January 8. It 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 willwork 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 in 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 16 
from 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 11th, 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 put 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 N02 

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 N02 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) conform 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 Board of Health. 

Chairman Smith queried the DBOH for comments or action. 

Chairman Smith stated that he would like to see a subcommittee formed 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. Iser confirmed 

that would not be within the scope of the subcommittee. Councilwoman Ratti 

asked if this subcommittee would look aU 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 19 
Councilwoman Ratti stated that 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 this time, Councilwoman Ratti would suggest having the 

stakeholders on the committee early on to see it turn into 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 ideas to really 

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 form 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 replied 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 District to 

appoint someone to support this committee in its exploration. 

Chairman Smith moved, 

seconded by Dr. Hess, to 

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 the 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 the 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 Item 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 on file 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 7· 4 jYi~. ~ 

JOSEPH P. ISER, MD, DrPH, MSc 

DISTRICT 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 funded. Dr. Iser will conduct the first round of meetings with 

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 it 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) ~nt J

-/, .. 

OYl~ 

_" ~ 

PEGGY F. O'NEILL, 

RECORDING SECRETARY 

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