September 30, 2025 Board of Health Meeting Minutes

Otero County Board of Health Meeting
September 30th, 2025, 11:00 am
Otero County Courthouse, Room 107
La Junta, Colorado

MINUTES

Members Present:

Dr. Paul Yoder, President and Medical Officer
Dr. R.J. Nelson, Vice President
Lindsey Hart
Mark McCuistion

Member(s) Absent:

Dr. David Trujillo

Ex Officio:

Richard (Rick) Ritter, BOH Secretary, OCHD Executive Director

Commissioners:

Vicki Powell, Crowley County

OCHD Staff:

Marie Mora-Menges, Nursing/WIC Program Director
Chris Coffield, RHC
Su Korbitz, Environmental Services Program Director
Dee Leyba, CTC Program Director
Dr. Janell Maier, Disease Prevention & Control/EPR Program Director
John Miller, Business Manager
Donna Starck, STEPP Program Director

Guest:

Amanda Cashwell, BCPH HCA Administrator

Call to Order: A quorum being present, the meeting was called to order by Dr. Yoder.
Public Notice Posting (Pursuant to C.R.S. 25-1-509(2)(f), C.R.S. 24-6-402 (2)(c)(I), & C.R.S. 24-6-402(2)(c)(III)): The 2025 BOH meeting schedule was posted on the BOH website on 1/27/2025, and the agenda was posted in the designated public locations in all OCHD offices and on the BOH website before 11:00am on Monday, 9/29/2025.
Public Comment: There were no public comments for items not on the agenda.
Consent Agenda (ACTION ITEM)
1. Approval of Minutes (previously sent on 5/27/2025 & 9/25/2025)
  1. May 27th, 2025, Regular BOH Meeting
2. Contract Ratification (Pursuant to C.R.S. 25-1-508 (5)(k) & C.R.S. 25-1-511 (3))
  1. 2025-2026 CDPHE ELC 2.3 Purchase Order
    1. Purpose: CDPHE financial support for OCHD’s Epidemiology and Laboratory Capacity (ELC) activities.
    2. Status: Fully Executed
    3. Term: 8/1/2025-4/30/2026
    4. Amount: $189,890.59
  2. 2025-2026 CDPHE WIC Contract
    1. Purpose: CDPHE support for OCHD’s WIC Program.
    2. Status: Partially Executed (Local agency option letter contract modifications will be submitted by COWIC into DocuSign by August 31, 2025, for routing and approval by the CDPHE Purchasing and Contract Unit. These modifications do not require local agency signature.)
    3. Term: 10/1/2025-9/30/2026
    4. Amount: $164,771.00
      1. Decrease of $17,151 over the 2024-2025 contract amount of $181,922.
  3. 2025-2026 CDPHE CTC Contract
    1. Purpose: CDPHE support for OCHD’s CTC Program
    2. Status: Partially executed
    3. Term: 7/1/2025-6/30/2026
    4. Amount: $135,337.00
      1. Decrease of $143,189 over the 2024-2025 contract amount of $278,526
      2. An email from CDPHE CTC dated 5/5/2025 reads, in part, as follows: “This email serves to notify Otero-Crowley Public Health Department of this funding reduction and provides information regarding the next steps to complete contracts for the upcoming fiscal year. All COFP grantees will see a reduction in the amount of funds in the FY 2025-26 contract. However, grantees will receive the full amount of funding equivalent to the personnel requested during February and March 2025 budget negotiations. In your case, that amount is $135,337.”
  4. 2025-2026 OCHD Collaborative Management Program (CMP) Memorandum of Understanding (MOU)
    1. Purpose: Colorado Revised Statutes (C.R.S.) Section 24-1.9-102 authorizes local agencies to enter into memorandums of understanding for the purpose of promoting a collaborative system of local-level interagency oversight groups and individualized service and support teams to coordinate and manage the provision of services to children and families who would benefit from integrated multi-agency services.
    2. Status: Fully executed
    3. Term: 7/1/2025-6/30/2026
  5. 2025-2026 CDPHE STEPP Contract
    1. Purpose: CDPHE support for OCHD’s Regional Tobacco Control Program.
    2. Status: Partially executed
    3. Term: 7/1/2025-6/30/2026
    4. Amount: $720,000.00
      1. Increase of $270,000 over 2024-2025 original contract amount of $450,000.
  6. 2025-2026 CDPHE CFPS/MCH
    1. Purpose: CDPHE support for OCHD’s CFPS and MCH Programs.
    2. Status: Fully executed.
    3. Term: 7/1/2025-6/30/2026
    4. Amount: $21,816.50
      1. CFPS funding: $6,650.00
        Decrease of $600 over the 2024-2025 contract amount of $7,250.
      2. MCH funding: $15,166.50
        Decrease of $15,166.50 over the 2024-2025 contract amount of $30,333.
        These funds were previously a component of the CDPHE OPHP contract. Beginning in FY26, they have been combined with CFPS.
  7. 2025-2027 Community Solutions International, Inc. Housing Navigator
    1. Purpose: Community Solutions International, Inc. support for OCHD’s new Housing Navigator Program Director position.
    2. Status: Fully executed
    3. Term: 2025-2027, the contract states the following: “For purposes of this award letter the “Grant Period” shall commence as of the date of this award letter and shall conclude on the 24 month anniversary of the initial hire date of the position being funded.”
    4. Amount: $241,625.00
  8. 2025-2026 Crowley County/SECOR Professional Services Agreement extension
    1. Purpose: Approved no-cost extension for OCHD’s tri-county (Bent, Crowley, Otero) CTC/CSU-PRC school-based SUD prevention activities.
    2. Status: Approved
    3. Term: Through and including 8/31/2026.
    4. Amount: Unspent funds in the amount of approximately $351,934.86 of the original award total of $588,311.60
  9. 2025-2026 Trailhead Institute’s RHC Master Services Agreement
    1. Purpose: Trailhead Institute’s support for OCHD’s Regional Health Connector (RHC) Program.
    2. Status: Fully Executed
    3. Term: 7/1/2025-6/30/2026
    4. Amount: $56,300.00
    5. Increase of $300 over the previous contract amount.
  10. 2025 Crowley County Public Health Services Contract
    1. Purpose: Crowley County support for OCHD’s public health services in Crowley County. This contract now includes vital records services (see below).
    2. Status: Fully Executed
    3. Term: 1/1/2025-12/31/2025
    4. Amount: $16,197.00
3. Approval of Consent Agenda and Approval/Ratification of Items Therein: Mark McCuistion moved to approve the Consent Agenda and approve/ratify the items therein, Dr. Nelson seconded, motion carried.
Old Business: None
New Business, Rick Ritter presented the following information:
1. Budget (Pursuant to C.R.S. 25-1-508 (5)(k) & C.R.S. 25-1-511 (3))
  1. Financial Summary Report (Based upon Tyler Financial Systems reports dated 9/25/2025)
    1. May 2025
      1. Revenues: $172,300.92
      2. Expenditures: $165,140.07
      3. Surplus: $7,160.85
      4. Fund Balance: $3,565,408.83
    2. June 2025
      1. Revenues: $94,814.23
      2. Expenditures: $207,333.50
      3. Deficit: $112,519.27
      4. Fund Balance: $3,452,889.56
    3. July 2025
      1. Revenues: $197,748.72
      2. Expenditures: $338,355.06
      3. Deficit: $140,606.34
      4. Fund Balance: $3,312,283.22
    4. August 2025
      1. Revenues: $178,112.41
      2. Expenditures: $172,296.29
      3. Surplus: $5,816.12
      4. Fund Balance: $3,318,099.34
  2. Approval of Expenditures (ACTION ITEM): Dr. Nelson moved to approve the May 2025, June 2025, July 2025 and August 2025 expenditures in the amounts of $165,140.07, $207,333.50, $338,355.06, and $172,296.29 respectively, Lindsey Hart seconded, motion carried.
  3. 2024 OCHD Fiscal Performance (based upon Tyler Financial Reports dated 9/10/2025): At the end of 2024, OCHD’s fund balance was $3,875,496.45, which represents an increase of $808,879.27 over the 2023 year-end fund balance of $3,066,617.18. Revenues for 2024 amounted to $2,750,992.83, and 2024 expenditures were $1,942,113.56. OCHD received 139.16% of its budgeted revenues, and expended 98.12% of its budgeted expenditures. The large surplus is primarily the result of the SECOR CTC/CSU-PRC grant deposit in the amount of $588,312. Factoring out the SECOR grant deposit, the surplus would be $220,567 ($808,879-$588,312=$220,567). This large surplus follows a nation-wide trend. In a Pewtrusts.org article dated 5/10/2022 and entitled Budget Surpluses Push States’ Financial Reserves to All-Time Highs (Budget Surpluses Push States’ Financial Reserves to All-Time Highs | The Pew Charitable Trusts (pewtrusts.org)) the following statement appears “During fiscal 2021 alone, states grew their collective rainy day funds by $37.7 billion, or an increase of roughly 50% from a year earlier—driving the total held among all states to a record high of $114.6 billion. Moreover, amid widespread budget surpluses, states reported the largest annual increase in leftover general fund budget dollars (known as ending balances) in at least the past 21 years.”
  4. Fund Balance Importance: The fiscal reserves of the fund balance are critical funds that are used in times of necessity and after use should eventually be replenished to a sufficient level dictated by generally accepted financial/accounting principles. They serve as a protection by covering deficits caused by lost funding, unexpected expense, leadership transition, etc. Fund balances are required by C.R.S. 29-1-103 (2) if an adopted budget shows expenditures exceeding revenues. Regarding reserves in a fund balance, three important questions should be considered:
    1. Liquidity: Does the organization have adequate cash to meet its month-to-month operating needs?
    2. Adaptability: Does the organization have flexible funds that allow for adjustments, growth, and change?
    3. Durability: Does the organization have access to funds to address a variety of future needs to deliver its mission over the long-term?
    4. Regarding its ability to respond to the projected deficits, OCHD is in good financial shape. During the last 24 years OCHD has been deliberately building its fund balance to withstand financial tempests. In July 2000 (the month before R. Ritter was employed as executive director) OCHD reserves amounted to $104,699. The approved budget for that year was $837,237. The reserves at that time amounted to 12.5%. In fact, for one month during these fiscally troublesome times OCHD literally went bankrupt, with an approximate -$6,000 fund balance. At the September 2000 staff meeting, R. Ritter devoted most of the meeting to the budget and the dire necessity for staff to work together to build the fund balance. Subsequent staff meetings always had (and continue to have) a budget component. OCHD staff answered the call, and today the department is very well positioned financially.
    5. “Trigger Point”: From the 3/26/2013 BOH Meeting, “R. Ritter has identified the “trigger point” to consider staff and operational adjustments, and that point is when the fund balance reaches or is approaching 25% of the operating budget at the end of a calendar year without a balanced budget or surplus identified for the subsequent year(s).” Principal factors to consider when contemplating financially-driven operational adjustments: Statutory, regulatory, & contractual requirements.
    6. In a 9/24/2024 Governing article titled “The Coming Policy Backwash from the COVID Revenue Wave” the following statements appeared:
      1. “…states and localities need to plan ahead for more cyclical self-sufficiency and expect more-stringent strings on future federal bailout funds.”
      2. “Recipients of countercyclical aid should be required to demonstrate that they have prudently maintained a federally qualifying rainy-day fund as a condition of receiving that aid.”
      3. “Bluntly, states and municipalities must learn to be rainy-day savers because modern Congresses clearly won’t.”
    7. Pew Trust article dated 3/12/2022, the following statement appeared: “Deposit extraordinary revenue into the rainy day fund”
      Fund Balance Multi-Year Perspective 2001-2024: At the beginning of 2001, the fund balance was $181,723.74. At the end of 2024, the fund balance was $3,875,496.45, which is 21.33 times the beginning amount in 2001.
  5. Fund Balance Recommended Amounts: Good financial principles dictate having between 3 to 6 months (25%-50%) of the operating budget in the fund balance. OCHD’s operating budget for 2025 is $2,530,786.00 (June 2025 Tyler Financial Report dated 9/10/2025). 25% of this amount is $632,696.50, and 50% is $1,265,393. OCHD’s fund balance beginning 1/1/2025 was $3,875,496.45 (12/31/2024 Tyler Balance Sheet report dated 9/10/2025), which is approximately 153.13% (or 18.38 months) of the 2025 operating budget.
  6. Surpluses/Deficits Historical Perspective
  7. 2025/2026 OCHD Budget Version 2
    1. Version 2025.2026.2
      1. Overview
        2025 BUDGET ESTIMATE
        REVENUE ESTIMATE: $1,971,142
        EXPENDITURE ESTIMATE: $2,232,688
        DEFICIT ESTIMATE: $261,546
        DEFICIT OFFSET: OCHD FUND BALANCE
        2026 BUDGET REQUEST
        REVENUE REQUEST: $1,702,747
        EXPENDITURE REQUEST: $2,045,375
        DEFICIT ESTIMATE: $342,628
        DEFICIT OFFSET: OCHD FUND BALANCE
        Notes
        AT THE TIME OF THIS WRITING, THERE IS A VERY HIGH DEGREE OF UNCERTAINTY AND VULNERABILITY OVER FEDERAL AND STATE FUNDING. THE ONLY CERTAINTY IS UNCERTAINTY.
        The 2025 & 2026 projected deficits are partially the result of the SECOR CSU-PRC grant draw-down. The 2025 SECOR expenditure is estimated at $206,558 and for 2026 the same amount of $206,558. When this draw-down is factored out, the 2025 deficit is projected at $54,988 ($261,546-$206,558 = $54,988) and the 2026 deficit is projected at $136,070 ($342,628-$206,558 =$136,070).
        On 9/8/2025, D. Jaramillo informed R. Ritter of her intent to retire, last day 12/31/2025. In order to be fiscally conservative in these extremely uncertain and unstable times, R. Ritter is not planning on filling this position. C. Cortez will transfer to the LJ office, and the RF phone will ring at the LJ office.
        T. Harviston retired, last day 6/30/2025. In order to be fiscally conservative in these extremely uncertain and unstable times, R. Ritter is not filling this position.
        G. Harviston resigned, last day 6/30/2025. In order to be fiscally conservative in these extremely uncertain and unstable times, R. Ritter is not filling this position.
        This budget was sent to the Otero County fiscal staff and BOH on 9/10/2025.
        This budget was presented to OCHD staff on 9/10/2025.
        Otero County Government Information: COLA ($50/month), performance evaluation increases (up to $96/month), health insurance increase (7%).
        Future Deficit Offsets: It is R. Ritter’s intention to use the fund balance to support staff and operations during times of deficit, which will happen, OCHD will have years when expenditures exceed revenues. C.R.S. 29-1-103(2) states “No budget adopted pursuant to this section shall provide for expenditures in excess of available revenues and beginning fund balances.” The foregoing applies to local government budgets, including OCHD’s. Thus, deficits are allowed if there are reserves sufficient to cover them in addition to projected revenues.
        CTC/CSU-PRC grant in the amount of $588,311, which was deposited in 2024, is still being spent down through all of 2025 and part of 2026. A no-cost extension through August 31st, 2026 in the amount of $351,935 was granted by SECOR on 9/8/2025.
        Proposed SECOR Harm Reduction grant in the amount of $172,926 was not budgeted for, as it has not yet been awarded, we may know if it is funded in October 2025.
        Rick Ritter said that there will more than likely be a third version of this budget, to be presented at the November 2025 BOH meeting.
        Approval/Adoption: Mark McCuistion moved to approve and adopt the budget as detailed above, Lindsey Hart seconded, motion carried.
2. Personnel
  1. Base Office Change
    1. Carolina Cortez: Carolina Cortez will be reassigned to the La Junta office for front desk and vital statistics duties, replacing Deb Jaramillo who will be retiring at the end of 2025. Ms. Cortez is currently the front desk staff in the Rocky Ford office. After this reassignment, the Rocky Ford main telephone line will be transferred to the La Junta office, and answered there. In Rocky Ford, there will be no front desk staff. Currently, the Rocky Ford office front door is locked, and a doorbell is used for the public to gain entrance to the office. This will continue, and the remaining Rocky Ford office staff will respond to the doorbell as needed. This is an attrition maneuver to mitigate the impacts of current and future funding cuts (see below). This was shared with OCHD staff at the September 2025 staff meeting.
    2. New Staff
      1. Housing Navigator Program Director, Full-Time: OCHD will be hiring a new full-time Housing Navigator Program Director. This position will be fully-subsidized by a 2-year grant through Community Solutions International, Inc., and made possible by the tremendous efforts of Kristin Carpenter of the Colorado Consortium for Prescription Drug Abuse Prevention and the local organization YEEHAW! Per the Housing Navigator’s job description overview, “This position is grant-funded for two-years with the possibility of continued funding. This position will act as a driving force in reducing housing instability, working very closely and deliberately with the Yielding Effective Entry to Housing & Well-Being (YEEHAW) Taskforce. Additionally, the YEEHAW Housing Navigator will work alongside peer support specialists to ensure comprehensive client support and outreach.” A pre-employment offer has been made and accepted. Rick Ritter will introduce the new Housing Navigator Program Director at the next BOH meeting.
      2. Potential BCPH-OCHD Cooperative Arrangement: Rick Ritter has served as Interim Executive Director for Bent County Public Health (BCPH) since 6/16/2025. During this time, multiple individuals have inquired about the possibility of Rick Ritter continuing on as BCPH Executive Director. Rick would like to explore the possibilities of sharing staff and resources between OCHD and BCPH, and report the findings to the BOH at the November 2025 BOH meeting. In these extreme times of financial uncertainty, it most certainly behooves OCHD to explore any means to save and/or share costs. The BOH voiced no objections to the proposed exploration as detailed above.
      3. Crowley County Vital Records Services: Due to staffing issues, Crowley County has requested that OCHD officially assume the duties of vital statistics registrar for Crowley County, and OCHD has agreed. A coordination meeting between Crowley County, CDPHE, and OCHD occurred on Tuesday, 9/16/2025, and John Miller and Rick Ritter went to Ordway on Wednesday, 9/17/2025 to pick up Crowley County’s vital statistics documents. The 2025 Crowley County PH contract includes a provision for vital statistics services (see above). At any time in the future, if Crowley County desires to resume vital statistic services, they are welcome to do so.
7. Program Reports
1. CTC, Dee Leyba: General information
2. DCEP/EPR, Dr. Janell Maier: General information
3. Environmental Services, Su Korbitz: General information
4. Nursing/WIC, Marie Mora-Menges: General information
5. RHC, Chris Coffield: General information
6. STEPP, Donna Starck: General information
8. Executive Session: R. Ritter requested an executive session with the BOH Members regarding personnel, specifically the BOH’s annual evaluation of the executive director. C.R.S. 24-6-402 (4)(f)(I) was cited as the statute authorizing the executive session. Dr. Nelson moved to convene into executive session, Mark McCuistion seconded, motion carried. The BOH and Rick Ritter then moved into executive session at 12:25 pm. The following Executive Session provisions were made explicit:
9. For discussion of a personnel matter under C.R.S. Section 24-6-402(4)(f) and not involving: any specific employees who have requested discussion of the matter in open session; any member of this body or any elected official; the appointment of any person to fill an office of this body or of an elected official; or personnel policies that do not require the discussion of matters personal to particular employees;
1. Participants are to confine all discussion to the stated purpose of the executive session, and no formal action may occur in the executive session.
2. If at any point in the executive session any participant believes that the discussion is going outside the proper scope of the executive session, they are to interrupt the discussion and make an objection.
3. After reconvening into regular, public session, if any person who participated in the executive session believes that any substantial discussion of any matters not included in the motion to go into the executive session occurred during the executive session, or that any improper action occurred during the executive session in violation of the Open Meetings Law, they will state their concerns for the public record.
4. Discussions that occur in an executive session shall be electronically recorded. The electronic recording shall reflect the actual content of the discussion in executive session. The sole exception to this requirement is that no electronic recording shall be required to be kept of that portion of an executive session that constitutes an attorney-client communication, in the opinion of the attorney in attendance at the executive session.
5. The electronic recording device shall be tested before going into executive session to determine whether it is operating. In the event the electronic recording device is unavailable or not operating, the BOH shall not convene in executive session until an operating recording device is available.
6. Upon completion of the executive session, if a tape recorder is used, the tape shall be labeled with “BOH-Executive Session” and the date, and initialed or signed by the Presiding Officer. If a digital recorder is used, the data file recording of the executive session shall be saved to a secure, confidential storage location and the file shall be labeled with “BOH-Executive Session” and the date.
7. Executive session minutes kept by electronic recording device shall stand approved with no further action. If additional written minutes are taken, they shall be approved at a future executive session.
8. The electronic recording and any written minutes of the executive session shall be maintained for 90 days after the date of the executive session and shall not be disclosed to any person except as required by law.
9. Reconvene: The BOH reconvened into regular session at 12:45pm. The Executive Session was recorded and will be kept on file for 90 days.
10. Executive Director’s Annual Evaluation: Mark McCuistion made a motion that, over the course of the previous year, Rick Ritter’s performance as executive director has exceeded expectations, and that Rick Ritter will be given an increase that accommodates a COLA and anniversary increase to his current base salary, which equates to $10,290, said increase to go into effect August 1st, 2025. Lindsey Hart seconded, motion carried. Rick Ritter expressed appreciation for his continued employment and for the generous compensation increase.
11. Adjournment: With no further business, Dr. Yoder adjourned the meeting.
Respectfully Submitted,
Richard (Rick) Ritter
Secretary, Otero County Board of Health
Executive Director, Otero County Health Department

September 30, 2025 Board of Health Meeting Minutes

MINUTES

Members Present:

Member(s) Absent:

Ex Officio:

Commissioners:

OCHD Staff:

Guest:

Otero County Courthouse

Social Services Annex

Public Works, Land Use, & Building Department