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Cole County health department recommends fee increases, highlights nurse-practitioner clinic
Summary
Health department staff proposed doubling food-inspection fees and increasing fees for on-site sewage permits and lodging inspections; they also described growth at the county clinic run by a nurse practitioner and argued the clinic can reduce urgent-care expenses for county employees.
Health department staff told commissioners Dec. 2 they will return with fee proposals to help the department cover the cost of environmental and clinic services and to reduce reliance on state grant supplements.
Speaker 2 presented data showing the department spent nearly 300 staff-hours on food inspections during Sept.–Nov. and currently collects only a modest fee (high-risk inspections at $150). "We're spending a lot more money doing food inspections than we're collecting," Speaker 2 said, and recommended increasing food-inspection fees (proposed levels compared with neighboring counties) and raising on-site sewage permit and lodging-inspection charges. Commissioners asked staff to compile comparative county fee data and a proposed fee schedule for possible implementation Jan. 1, 2026.
Speaker 2 also reviewed the county clinic’s nurse-practitioner services, which started in July 2024. The clinic bills a modest per-visit fee (example cited: $45) and staff cited examples where urgent care or ER visits cost employees hundreds of dollars on the front end. "One of our staff went to urgent care and paid $630; Michelle (the nurse practitioner) would have cost $45," Speaker 2 said, arguing that increased employee use of the on-site clinic could reduce the county’s overall health-insurance exposure.
Commissioners requested comparative revenue and utilization figures to quantify expected fee revenue and clinic-related savings, and asked the health department to return with proposed ordinance language and estimates of the public reaction to fee increases.
Next steps: Health staff will prepare proposed fee tables, comparative county benchmarks and a summary of clinic utilization and cost-savings scenarios for the commission’s review next week.
