The Board of Health convened a budget ad hoc committee that has met a total of five times from September to October. Members of the committee are Vice-Chair Anji Jorstad, County Councilmember Nate Nehring, City of Arlington Councilmember Heather Logan, City of Mill Creek Mayor Pro Temp Stephanie Vignal, and Public Health Advisory Council Chair-Elect Jean Doerge.

The committee reviewed proposed revenues and expenditures and gave instruction to staff regarding budget parameters and direction. A public hearing for December 13, 2022, has been noticed (Exhibit A).

The proposed budget (Exhibit B) highlights a list of the many accomplishments made during 2022, despite the transitioning work related to the pandemic and the pending integration with Snohomish County.

The proposed budget includes the following assumptions:

• 2% salary increases have been added for all staff per collective bargaining agreements; non-represented staff typically follow the bargaining agreements. Collective bargaining has not begun for represented employees.
• Estimated $1327.89 monthly per employee for medical. The cost is the same regardless of coverage.
• Estimated $105.47 monthly per employee for dental. This is the mid-range cost across County plans.
• Estimated $9.02 monthly per employee for vision. The cost is the same regardless of coverage.
• The indirect rate will fall from 11% to approximately 10.5% for 2023. This is due to the reallocation of many indirect staff to COVID-19 response duties. The indirect rate is a carry-forward calculation and 2023 is based on 2021 actuals with a 2019 carryforward.

Staffing updates included in the proposed budget:

• Filled vacant positions have been updated with incumbents and terminated staff have been removed
• Public Records – ARPA funding
  • Additional 1.0 FTE – $65,000
• Communications team
  • Extends 3.0 FTE beyond June 2023
  • Removal of Policy Analyst position
  • Net savings of $75,000 between extending the 3.0 FTE and removing Policy Analyst position
• Call Center
  • Additional 2.0 FTE – $165,000
  • Software – $20,000
• EHS III Land Use
  • Additional 1.0 FTE – $101,000
• EHS III Safe Environments
  • Additional 1.0 FTE – $101,000
• Reclassify Technical Writer position to an EHS III and make permanent
• Hire previously approved contract temp position as a permanent PAII staff member
• Increase all fees by 2% to cover 2022 COLA
• Analytics and Informatics program
  • 4 additional FTE – $416,752
• Vaccine Clinic
  • 3 additional FTE – $394,626
• STD Clinic
  • 0.5 additional FTE – $129,629
• Refugee Health
  • 1 additional FTE – $112,273
• COVID/MPV – ARPA funding
  • 5.75 FTE – $400,000

Additional proposed changes since the November 8 briefing and public hearing include:

• COVID vaccine services reduction in revenues to match expenditures – ($214,556)
• Reduction in south county building expenditures – ($106,522)
• Reduction in unspecified capital outlays for Rucker Building – ($72,912)
• Countywide septic system inventory – $400,000
• Maternal & Child Health program
  • Increase one FTE from .5 to 1.0 – $64,231
• STD/HIV program
  •  1 additional FTE – $101,471

Projected revenues are sufficient to cover projected expenditure increases. Effective July 2021, the State Legislature approved an increase of Foundational Public Health Funding with projected increases through the end of June 2025. While 2023 through 2025 are projected to increase in both state fiscal years 2024 and 2025, due to unknown future legislation securing new and sustainable funding sources is critical to the department’s long-term financial stability.

The 2023 Proposed Budget reflects a combination of ongoing COVID-19 funding and increased Foundational Public Health Funding.Most of the COVID funding is currently set to expire in 2023 and 2024.

The Board has held one public hearing regarding the 2023 budget and will hold a second at the December Board meeting, with final adoption of the 2023 budget expected at the December 13 Board meeting.

Consistent with Resolution 19-20 and the revised Division of Responsibilities (10/8/19), the Board of Health has authority over the  Health  District  budget.

MOVE TO adopt Res. 22-33 approving the 2023 Health District budget.