Elbert County public-health director reviews staffing, clinic and septic-permit proposals amid new state OWTS rules

Elbert County Public Health Director Sarah McIntosh briefed the Board of County Commissioners during the work-study session on first-quarter staffing, clinic activity and proposed fee adjustments tied to forthcoming state on-site wastewater treatment system (OWTS) rule changes.

McIntosh said the department has completed several staffing changes: her office now contracts a medical officer, Dr. Marvin Couch (Fort Collins), and has two nurse practitioners on-site for clinic coverage. The department has also shifted its finance-and-grants manager to a contracted role and plans to use funds freed by that change to pay for a medical-billing or coding contractor to improve clinic revenue capture.

Clinic services reported include pediatric, adolescent, adult and senior care visits, well-care and sick visits, lab draws through LabCorp and Quest, respiratory fit testing for local businesses and drug tests primarily for county needs. McIntosh showed quarterly visit trends the department said are increasing as the clinic matured since opening in late 2022.

Environmental health specialist Marissa Ginger briefed commissioners on proposed changes tied to the state’s Regulation 43 OWTS update. She said the state will roll out Regulation 43 changes on June 15, 2025, and counties will have up to one year to enforce new rules. Some Regulation 43 items are mandatory statewide; others are optional at county discretion. Ginger said many contractor-facing rules will change and that counties can opt into some provisions; she said staff will provide details at the next Board of Health meeting.

To help cover cost increases and to provide a public-facing septic-map lookup service, Ginger proposed modest increases to four of six septic/permitting fees that have not been raised since 2013. Proposed changes include raising the new-system permit to $1,000 (from $973), increasing a replacement tank-and-field permit to $600, raising the field permit to $400 (a $150 increase to better reflect county design time when soils are poor), and increasing the tank permit to $300. Ginger said the county will remove the prior reinspection charge and keep alteration-permit fees unchanged.

Ginger proposed the public-facing map lookup to reduce daily phone and email requests; the department currently fields 15–20 map requests per day. Commissioners asked staff to provide an estimate of additional revenue generated by the fee increases; Ginger said she would return with modeled numbers.

Public-health educator Lisa Helseth summarized outreach and vital-record activity, reporting 59 vital-record issuances and $1,089 in revenue for the quarter. Helseth also reviewed mental-health collaborative work with Colorado State University Extension (Northeast Region 5) on suicide-prevention outreach and reminded the public about quarterly blood drives (next scheduled for July 9, 10 a.m.–2 p.m. at the Ag Building).

During Q&A Commissioner Schroeder asked whether the proposed septic fee adjustments should be sized to track inflation; Ginger said she intentionally proposed modest increases and would bring comparative county fees and additional modeling back to the board. No formal Board of Health vote was required in the work-study session; the department will bring Regulation 43 options and fee modeling to the next Board of Health meeting for formal consideration.

"The changes will be rolled out 06/15/2025 and then we will have a year to begin enforcing them," Ginger said of Regulation 43, adding that some provisions are mandatory and others are optional for counties. "We have not increased our fees since 2013. ... The new system ... is currently $973. I would like to increase it to a thousand dollars, flat, just $27 increase."