Cole County considers DHSS participation agreement to inspect more childcare facilities, citing per-inspection pay

Cole County health staff briefed the commission on Sept. 9 about a Missouri Department of Health and Senior Services (DHSS) participation agreement that would extend county-conducted sanitation inspections to child care facilities located within the Jefferson city limits.

Under the described agreement, Cole County would inspect roughly 45 childcare facilities annually in the county and the city (up from about 11 previously), and DHSS would reimburse the county on a per-inspection basis: $130 for each inspection and approximately $75 for reinspections, with separate fees for certain special inspections. “So for the next year, we will be taking on a larger load, but we will be inspecting all of the facilities in Cole County, including the city Jefferson, and that's under, DHSS's authority,” the health department staff member said.

Staff told commissioners DHSS is consolidating contracts and seeks to delegate inspections to the local public-health agency rather than contract directly with municipalities. The presenter said the county would track hours and costs because some larger childcare sites require multiple staff for an inspection and reimbursement may not fully cover labor for every facility.

Commissioners asked whether city restaurant/food inspections could also shift to the county if the city stopped permitting those services; the health staff said county implementation would be possible under state delegation but would likely require a memorandum of understanding and additional staffing if the city relinquished its program. The staff distinguished inspection fees, saying city permit fees can be substantially higher (the staff said city fees were in the roughly $500 range versus county fees in the $200s for certain permits).

A commissioner moved to approve the scope-of-work section of the DHSS child-care sanitation inspections participation agreement and another commissioner seconded the motion during the meeting. The transcript excerpt does not record the final roll-call vote on that motion.

Why it matters: If implemented, the agreement would transfer responsibility for city child-care inspections to county inspectors under state authority and increase inspection workload and reimbursement-based revenue. County staff said they would monitor labor hours to determine whether reimbursements cover true costs and would raise staffing issues if more work is added.