Supervisors approve first reading of Private Burial Ordinance, discuss funding considerations with VMH for mental health services in county

by Joe Moses

The Allamakee County Board of Supervisors met in regular session Monday, September 27 to address an agenda that included the Public Hearing for Private Burial Ordinance LX, consideration of signing 28E agreements with non-profits and discussion of an American Rescue Plan related funding request by Veterans Memorial Hospital.

The Public Hearing for Private Burial Ordinance LX was opened with Allamakee County Zoning Administrator Stephanie Runkle providing an overview of the matter. Runkle discussed feedback received from Director/General Manager Craig Lensing of Martin-Grau Funeral Home, with Lensing recommending that a concrete liner would be best to preserve property surrounding a private burial site.

Runkle also discussed feedback from Assistant County Attorney Jill Kistler relating to cremated remains also being included under Iowa State Code 5231. Kistler, also in attendance at the meeting, discussed the importance of knowing where burial sites are at within the county as property ownership changes and land is developed in the decades ahead. Kistler discussed the need for having regulations in place for private burials and that without an ordinance in place, maintenance of these private burial sites would fall upon the County.

Kistler discussed the sale of Amish-owned land containing burial sites and that the County’s Private Burial Ordinance would need to be communicated to this community. Kistler said that the County is not being inundated with requests for private burials but that the ordinance is recommended to ensure that maintenance and planning is taking place.

Supervisor Dan Byrnes discussed Section 4, Part D of the Private Burial Ordinance which establishes that Allamakee County shall not now or in the future be held responsible for preservation or protection of private burial sites. Byrnes advised that periodic review of the ordinance take place. The Public Hearing was closed with the First Reading of Private Burial Ordinance LX being approved by Schellhammer, Byrnes and Supervisor Mark Reiser. The Supervisors set the Second Reading of the Private Burial Ordinance as Monday, October 4 with the Third Reading scheduled for Monday, October 11.

The Supervisors moved into plat requests for Joseph T. and Joshua P. Teff (Lot 3), Joseph T. and Joshua P. Teff (Lot 4) and Myron Valley Property, LLC with each being individually reviewed and approved.

Allamakee County Engineer Brian Ridenour addressed the next matter relating to the consideration of bids for a sealcoat project. Ridenour noted that this project relates to Iowa River Drive/County Road A26 and plans for double sealcoating, beginning at State Highway 76 and continuing easterly to County Road X20/Lycurgus Road, a distance just over seven miles. Ridenour advised that the project has been advertised with a notice published in the newspaper and plans being sent to eight contractors. Byrnes opened and read aloud the single bid received for the project from Fahrner Asphalt Sealers LLC of Kaukauna, WI at $384,194.40.

Ridenour advised that the bid received is over the engineer’s estimate and that he is surprised that only one bid has been received with the project being scheduled for next summer, a timeframe allowing for competitive bidding. Schellhammer said that Ridenour will review the bid and provide a recommendation at a later date.

Ridenour discussed the next matter relating to the consideration of hiring a full-time employee for the Secondary Roads Department. He provided a recommendation to hire Cory Huinker of Waukon as Maintenance Person II at a starting wage at the Union rate of $21.04 per hour with a start date of October 18. The Supervisors approved the recommendation.

Allamakee County Attorney Tony Gericke provided a recommendation to appoint Connie Schneden of Waukon to fill a vacancy on the Civil Service Commission with the Supervisors approving that recommendation.

The Supervisors moved into the consideration of signing 28E agreements with non-profits including Northeast Iowa Area Agency on Aging (NEI3A), Northeast Iowa Resource Conservation and Development (RC&D), Retired Senior and Volunteer Program (RSVP), Riverview Center, Helping Services and Allamakee Soil & Water Conservation District. Per changes in guidance from the State of Iowa, the Supervisors have established 28E agreements with organizations receiving County funding to define expectations in providing services and to cooperate in other ways of mutual advantage. Gericke advised that additional agencies and their associated 28e agreements may be added at a future time. The Supervisors approved to sign 28E agreements with the organizations listed.

Chief Executive Officer (CEO) Michael Coyle of Veterans Memorial Hospital (VMH) addressed the next matter relating to VMH’s American Rescue Plan funding request. Coyle began the discussion by providing mental health statistics indicating that one in five adults will be impacted, nearly half of all Americans will develop one of these related conditions, and that more than 50 percent of counties do not have providers.

Coyle advised mental health has become an overwhelming matter at the national level and that at the state level, over 470,000 Iowans have a mental health condition. He noted that more than half of Iowans have reported that the COVID-19 pandemic has negatively affected their mental health. Coyle further continued that over 130,000 adults in Iowa have a serious mental health issue with more than half of those with a mental health condition not receiving treatment in the last year.

Coyle discussed tracking information relating to Medicare participants living in Allamakee County that have chosen to seek behavioral and substance abuse treatment outside of the county. He also discussed trends relating to acute care and emergency room visits which have incrementally increased for behavioral health and substance abuse. Coyle advised that over 45 percent of VMH Waukon Clinic patients, general population, have a behavioral or substance abuse diagnosis. He further discussed barriers in place for Allamakee County residents in seeking treatment including the desire to receive treatment, stigma associated with mental health treatment, lack of anonymity, shortages of mental health professionals, affordability, accessibility and transportation to care.

Coyle discussed cost savings to patients that are able to seek behavioral health treatment in a clinic environment rather than through family practitioners or a hospital environment. Integrated Telehealth Partners (ITP) and their behavioral health services were discussed by Coyle, including their associated costs.

Coyle then transitioned into discussion of a proposal included in an information packet presented to the Supervisors at the beginning of the meeting. He noted that there is a storage area in the new VMH Waukon Medical Clinic that was formerly used by the Mayo Clinic for its Radiology Department and Lab Department, approximately 1,250 square feet of space. Coyle said that this portion of the building is currently not Americans with Disabilities Act (ADA) accessible, including the entrance, but with some remodeling and ADA compliant parking could provide space for an outpatient behavioral health program.

Coyle noted that a psychiatric mental health nurse practitioner has been hired and is scheduled to start August 2022 with another psychiatric mental health nurse practitioner currently being recruited to start in 2023 along with a licensed social worker to be recruited within that same timeframe. He indicated that the VMH Waukon Clinic model would be unique for Allamakee County in treating physical medical problems in addition to behavioral health with a separate entrance, reception and parking areas to preserve anonymity.

Coyle discussed the American Rescue Plan funding request of $380,000 for this project to cover renovation, equipment and start-up costs, with VMH to take on further costs associated including tele-behavioral health, therapists and support staff to include, in total, three therapists, two psychiatric mental health nurse practitioners, one clinical social worker and a receptionist. Coyle further discussed the need to make this treatment more readily available with 45 percent of patients having a behavioral health diagnosis, an increasing suicide rate and an increase in Emergency Room transports associated with behavioral health all being factors.

Schellhammer offered his support of the proposal with the American Rescue Plan funding presenting an opportunity to provide a greater level of service to residents of Allamakee County. Byrnes said that he agreed with Schellhammer about behavioral health being a valid concern and his thoughts relating to the project but also indicated that American Rescue Plan funding would need to be reviewed and prioritized prior to providing a commitment. Reiser was in agreement with Byrnes relating to the project and prioritizing the use of American Rescue Plan funding prior to committing an amount.

Allamakee County Auditor Beyer discussed loss of revenue calculations used by the County for American Rescue Plan funding. Schellhammer said that an answer relating to funding would likely to be provided by the end of October.

Under Department Head Updates, Allamakee County Emergency Management Coordinator Corey Snitker discussed recent data relating to COVID-19 with 47 positive cases reported for Allamakee County over the last seven days, an average of 11 percent based upon the number tested, which is slightly above the state average of 9.6 percent. Snitker discussed that personal protective equipment (PPE) and handsoap will be distributed to several area agencies.

Snitker also provided an update relating to scheduled meetings including the courthouse security meeting and a safety meeting. He noted that a courthouse fire drill has been scheduled for Tuesday, October 5 and a Commission meeting is scheduled for Monday, October 4. Snitker also advised that an election-related tabletop exercise is scheduled for later in the week and provided an overview of several upcoming public events within the county. He lastly noted that he will be attending the State Emergency Management Conference October 13-15.

Ridenour discussed the Monday, September 27 DOT meeting relating to the Black Hawk Bridge in Lansing. He noted that the Secondary Roads Department maintenance crew will be returning to a five-day work schedule and that pavement crack sealing is taking place in locations throughout the county with weather this week likely allowing that project to continue.

Prior to adjournment, Beyer discussed proof reading ballots for City/School elections and that calculations relating to loss of revenue, information to be submitted for American Rescue Plan funding, has been completed. Beyer and the Supervisors discussed setting a time to follow the next Supervisors meeting to meet with Executive Director Paul Berland of Northeast Iowa RC&D.