Tri-Town Health Department Fiscal Year 2026 Draft Budget Presentation Highlights

Tri-Town Health Department Lee, Lenox, and Stockbridge Boards of Health Tri-Town Health District BOH Meeting and Fiscal Year 2026 Draft Budget Presentation December 19, 2024 45 Railroad Street - Lee, MA 01238-Tel (413)243-5540-Fax (413)243-5542 Web: www.tritownhealth.org 1

FY26 Budget Proposal 1. Budget Highlights 2. Budget Proposal 3. Revenue 4. FY24-25 Accomplishments 5. SBPHC Updates/Accomplishments 6. Main Priorities for FY26 and beyond 2

Fiscal 26 Year Draft Budget Summary Highlights Incorporates COL staff increases All staff (4.0 fte)now qualified for longevity stipends There is an increase in compensation reserve. Reason no budgeted FY25 COL. Salary readjustment happed last FY. FY26 will incorporate COL so you will see a jump. Compare the increase amount for FY24 and FY26. Possible Changes (TBD) to fringe due to insurance adjustments (know more in February) Draft only- Lee has not given final fringe numbers. Requested amount placeholder only Could change Lab and other lines items up slightly due to costs increase: Internet, Spectrum, lab supplies. Web permitting up due to new contract to scanning all documents to make them on cloud. Annual service cost for license. Rent and Bookkeeping adjustments. Rent in Stockbridge is up slightly due to space, bookkeeping has not increased in many years. 3 Year Rolling Average Financial paradigm is still consistent with service delivery percentages (Lee-33%, Lenox 43%, Stockbridge 24%) Permit fees up 20% effective Jan 2025. Projected increase are $35,000-$40,000 in addition to current revenue collections. 3

Fiscal 26 Year Capital Submit separately to each town TTHD move January 6, 2025 We ve digitized 75% of our records with other grant funds (FY25) Need to budget for rest of the 25% to have scanned and digitized. One time cost May explore Community Compact IT Be safe and work on capital if grant does not work $15,023 cost to digitize and cloud license Lee: $4958.00 Lenox: $6,460.00 Stockbridge: $3,605.00 Remaining Moving Costs Member towns will request appropriation at FY26 TM to reconcile costs (Lee paid them up front at time of move) Movers, Office buildout, IT costs, etc Town Manager will work that out 4

Department: Tri-Town Health Department Expended FY2020 Appropriated FY2023 Appropriated FY2024 Appropriated Fy2024 Requested Fy2025 Requested FY26 Increase $ Increase % Expenditures 5111 Salaries Full Time 5116 Salaries Part Time 5132 Overtime 5171 Fringe Benefits 222,141.99 249,427.84 247,200.00 355,500.00 355,500.00 0.00 0.0% 260,498.00 0.00 0.00 0.00 - 1,202.77 99,615.43 322,960.19 1,658.58 122,083.88 373,170.30 1,000.00 108,000.00 356,200.00 1,000.00 154,373.00 510,873.00 1,000.00 173,397.00 529,897.00 0.0% 12.3% 3.7% 1,000.00 122,870.76 384,368.76 19,024.00 19,024.00 TOTAL PERSONNEL 5270 Rentals 5300 Public Health Nursing 5311 Seminars 5340 Communications 5341 Web Permitting 5344 Postage 5580 Supplies Office 5583 Lab 5710 In-State Travel 5740 Bookkeeping* 5795 Compensation Reserve 7,200.00 0.00 3,470.36 2,428.62 11,215.00 280.00 2,199.83 4,206.05 5,144.09 3,000.00 7,200.00 34,953.51 2,195.00 4,392.07 11,810.00 452.00 3,531.01 3,839.02 4,937.41 3,000.00 7,200.00 39,520.00 3,000.00 3,700.00 12,500.00 750.00 3,000.00 4,000.00 7,500.00 3,000.00 13,297.00 97,467.00 453,667.00 -3,366.00 450,301.00 -304,848.00 145,453.00 7,200.00 30,000.00 3,000.00 4,000.00 13,000.00 750.00 3,000.00 4,000.00 7,500.00 3,000.00 3,300.00 78,750.00 589,623.00 (3,366.00) 586,257.00 -395,047.41 190,460.00 9,824.00 30,000.00 3,000.00 4,500.00 13,400.00 880.00 3,000.00 4,500.00 7,000.00 4,080.00 14,854.10 95,038.10 624,935.10 (1,346.40) 623,588.70 -418,706.52 204,882.18 2,624.00 36.4% 7,200.00 39,520.00 3,000.00 4,000.00 13,000.00 750.00 3,000.00 4,000.00 8,000.00 3,000.00 13,482.00 98,952.00 483,320.76 (3,366.00) 479,954.76 -323,824.91 156,129.85 500.00 400.00 130.00 12.5% 3.1% 17.3% 500.00 12.5% -6.7% 36.0% 350.1% 20.7% 6.0% 1,080.00 11,554.10 16,288.10 35,312.10 0.00 0.00 TOTAL EXPENSES SUBTOTAL *5741 LESS IN KIND SUBTOTAL LESS OTHER TOWNS TOTAL BUDGET 39,143.95 362,104.14 -3,366.00 358,738.14 -247,347.00 111,391.14 76,310.02 449,480.32 -3,366.00 446,114.32 -306,966.01 139,148.31 14,422.18 7.6% 5

Lee 33% Lenox 43% Stockbridge 24% $117,315.00 $152,865.00 $85,320.00 $0.00 $240.00 $41,615.28 $127,175.28 $330.00 $57,221.01 $174,866.01 $430.00 $74,560.71 $227,855.71 TOTAL PERSONNEL $3,241.92 $9,900.00 $990.00 $1,485.00 $4,422.00 $290.40 $990.00 $1,485.00 $2,310.00 $1,346.40 $4,901.85 $31,362.57 $206,228.58 -1346.4 $204,882.18 $191,209.59 $4,224.32 $12,900.00 $1,290.00 $1,935.00 $5,762.00 $378.40 $1,290.00 $1,935.00 $3,010.00 $1,754.40 $6,387.26 $40,866.38 $268,722.09 $2,357.76 $7,200.00 $720.00 $1,080.00 $3,216.00 $211.20 $720.00 $1,080.00 $1,680.00 $979.20 $3,564.98 $22,809.14 $149,984.42 TOTAL EXPENSES less in kind $268,722.09 $253,537.89 $149,984.42 $141,509.52 -2357.76 $147,626.66 $6,117.14 FY25 budgeted Fy26 budgeted Increase $204,882.18 $13,672.59 $268,722.09 $15,184.20 6

FY24 Annual Report Financial Calculations Deposit # Lee Permits Lee Online Lenox Permits Lenox Online Stock Permits $715.00 $1,125.00 $215.00 $415.00 $1,165.00 $600.00 $9,115.00 $825.00 $2,955.00 $1,345.00 $1,740.00 $1,400.00 $0.00 $1,075.00 $1,345.00 $540.00 $13,820.00 $750.00 $4,140.00 $4,360.00 $1,720.00 $675.00 $2,275.00 $990.00 Stock Online $1,425.00 $100.00 $1,125.00 $2,275.00 $1,000.00 $2,030.00 $5,100.00 $2,680.00 $3,530.00 $600.00 $1,510.00 $750.00 Lab SamplesSeptic $5,940.00 $1,250.00 $5,740.00 $1,130.00 $4,820.00 $4,590.00 $4,380.00 $1,480.00 $2,780.00 $1,230.00 Septic Online $1,610.00 $870.00 $560.00 $980.00 $120.00 $2,180.00 $1,110.00 $620.00 $250.00 $370.00 $990.00 $2,100.00 Other 1 2 3 4 5 6 7 8 9 $1,585.00 $1,555.00 $815.00 $7,210.00 $2,165.00 $1,555.00 $9,885.00 $12,830.00 $5,490.00 $2,200.00 $3,345.00 $2,205.00 $2,865.00 $50.00 $0.00 $250.00 $870.00 $215.00 $175.00 $100.00 10 11 12 13 14 15 16 17 Total $12,130.00 $33,910.00 $7,265.00 $46,495.00 $7,750.00 $22,125.00 $28,250.00 $6,210.00 $11,760.00 $0.00 FY24 Lee Lenox Stockbridge Totals Permits Water Testing$9,322.50 $12,147.50 Septic $5,930.10 Late/Surcharge Other FY23 Totals $61,292.60 $73,634.60 $40,967.80 $175,895.00 $46,040.00 $53,760.00 $29,875.00 $129,675.00 $6,780.00 $4,312.80 $0.00 $0.00 $28,250.00 $17,970.00 $7,727.10 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 FY23 Lee Lenox Stockbridge Totals Permits Water Testing$7,604.85 Septic Late/Surcharge Other FY22 Totals $57,359.75 $72,257.25 $39,628.00 $169,245.00 Difference 6.86% 1.91% $43,475.00 $54,165.00 $29,530.00 $127,170.00 $9,909.35 $6,279.90 $8,182.90 $0.00 $0.00 $0.00 $0.00 $5,530.80 $4,567.20 $0.00 $0.00 $23,045.00 $19,030.00 $0.00 $0.00 7 3.38% 3.93%

Tri Town Revenue FY18-FY24 Individual Towns $100,000.00 $90,000.00 $80,000.00 $70,000.00 $60,000.00 $50,000.00 $40,000.00 $30,000.00 $20,000.00 $10,000.00 $0.00 FY18 FY19 FY20 FY21 FY22 FY23 FY24 Lee Lenox Stockbridge 8

Tri Town Revenue FY18-FY24 All Towns $250,000.00 FY19, $210,289.58 FY24, $174,177.25 $200,000.00 FY22, $173,957.00 FY20, $201,777.57 FY21, $165,065.20 $150,000.00 FY23, $169,245.00 FY18, $121,823.20 $100,000.00 $50,000.00 $0.00 FY18 FY19 FY20 FY21 FY22 FY23 FY24 Lee Lenox Stockbridge All Towns 9

Public Health Nursing Program Highlights SBPHC Year 3 ($515,300) grant funding to support SBPHC Shared Services Program (through TTHD) Continue to build on comprehensive PHN programming with a strong emphasis on equity and accessibility for 12 town collaborative Year 3 as a vaccine provider Provided 19 Vaccine Clinics ( a winter one planned) COA, town hall s, schools, Community Centers East Mountain Medical 588 High Flu Doses 830 Regular Flu (includes state supplied) 1,200 COVID 62 homebound vaccines (doubled from last year) Communicable disease investigations Monthly blood pressure clinics Strong partnership with FV, MRC, VIM Researching how to support COA on foot care clinics Became a pediatric certified vaccine program New SBPHC website https://southernberkshirehealth.com/ 10

Public Health Nursing/SBPHC Program Highlights Other SBPHC Highlights: Assisted completion of CART assessment, assessing compliance of BOH requirements for all 12- towns Developed work plan that was approved for an additional $225,000 Increased Shared Services Manager position to full time Need to assess CHW needs in South County (not enough funding for position) Shared Health Agent and Inspector services to 2 additional towns Implemented network of sharps collection bins in 3 additional towns Developed list of resources available to south county residents Continued partnership with local organizations South County Wildfire Public Health Response Air Quality advisory Distribution of masks in South County At the table with E response team Car Seat Program continues 11

Accomplishments of FY24-FY25 Revenue collections starting to stabilize and increase. Lee had a great year. Fee increase effective Jan 25. HHW Collection getting bigger and more participation twice a year collections(another example of a regional coordination) SAPHE 2.0 state law is now official. What does this mean? All public health staffing will need to meet new standards Towns not affiliated with shared services, or a PHE will have to modify job salaries to meet the demand. Salaries will exponentially grow and towns not planning will be left behind and gaps in staff Need to prepare for mandatory credentialling Public health workforce will be a big demand Regional Tobacco Program still going strong FY25 (96,000 FY25) Shared Nurse Program increase of $215,000 (totaling $515,000/year) for SBPHC. 12

Accomplishments (contd) of FY24-FY25 Sharps Kiosk program 3 town co-responder clinician program (partnership with all 3 Police Departments) Need to seek out long term funding. Recently transitioned to Lee Police Department TTHD will still have access to calls, hoarding, housing etc Advocating for a comprehensive foot care program for COA s TTBOH still needs to advocated and review EPA plans on UDF Updated T and D Plan out More rail less trucks Many staff members expanding certification/services and programs TTHD wrote the map (oldest district in state) on shared services, and we are seeing trends of non-public health sharing systems being implemented Becket/Otis shared Police Chief Stockbridge/W. Stock sharing EMS/Fire 4 town building d partement (could be growing) 13

Main Priorities for FY25 and beyond Continued Response to COVID-19 as needed Vaccination % has increased significantly. A good sign no out of pocket cost for customers. Utilize vaccine revenues for purchase. Little cost to taxpayers. Communication/education increases, new website for SBPHC East Mountain Medical-2 Clinics Vaccine Homebound program has doubled Workforce Credentialing Continue to get staff credentialed Cross training Post COVID vaccines not going away Expand/Create comprehensive PHN programming Matter of Balance Tai Chi Fall Risk Assessments Homebound vaccine programming Maximize relationships with agencies as TTBoH is a model for success in public health delivery systems Advocate for UDF Rail with stakeholders Roadmap on how to share services long term Implement Regional prescription Drug take back program Sharps Collection is a regional success TTHD Move to Stockbridge 14