The Jefferson County Board of Health held its regular meeting on March 12th, addressing several agenda items including an upcoming community cancer presentation, environmental health budget concerns, and other topics.
99 Counties Cancer Project
Public Health Administrator Christine Estle presented information about the University of Iowa’s 99 Counties Project, an initiative aimed at bringing cancer awareness presentations to all 99 Iowa counties. The topic carries particular urgency, as Iowa ranks second in the nation for cancer diagnoses, trailing only Kentucky.
The board discussed logistics for hosting a local presentation, expressing a preference for an in-person, evening event to maximize community attendance. Estle noted that University of Iowa representatives indicated they would be willing to travel to Fairfield given the county’s proximity — approximately one hour south of Iowa City.
The board considered several possible venues, including the community center, the courthouse, and the county library, weighing factors such as cost, setup requirements, and capacity. Members also discussed the value of offering a Zoom option alongside an in-person event to broaden access for those unable to attend during work hours, however, it is unclear whether the presenters will allow that. Estle agreed to follow up with the University of Iowa team to confirm dates, times, and format.
“I think if you want people to know about it, you’ve got to open it up for the general public,” one board member said, noting that cancer rates have been a frequent topic in local news and among patients at area clinics.
Communicable Disease Update
Estle provided a communicable disease update, noting that tick-borne illness cases continue to be a concern, with some residents being diagnosed months after their initial tick exposure.
On measles, Chris emphasized that there are currently no confirmed cases among Iowa residents in 2026 and none in Jefferson County. However, she noted the situation warrants close attention. Nationally, 1,281 confirmed measles cases have been reported in the United States so far in 2026, with 93% occurring in unvaccinated individuals. Iowa identified nine cases in 2025.
A few days after the board meeting on March 14th, the Iowa Department of Health and Human Services announced that an Illinois resident with confirmed measles had traveled to Iowa during their infectious period. State officials identified a potential exposure location at the Comfort Inn and Suites in Independence — roughly 90 miles north of Fairfield — on March 4th and 5th.
Given the national trend, Iowa HHS State Medical Director Dr. Robert Kruse has encouraged Iowans to ensure they are current on measles-containing vaccines and to consider an accelerated MMR vaccination schedule for children.
Estle said she proactively scheduled a meeting with local hospital partners to review protocols and ensure aligned procedures should a case arise in Jefferson County. “With our vaccination rates and spring break coming, it’s just a matter of time,” she said, noting the nationwide spread.
Budget Discussion
The board devoted significant time to the environmental health budget for fiscal year 2025–26. Environmental Health Specialist Jerry Leonard presented a budget re-estimate reflecting higher-than-anticipated expenses, including costs related to well abandonment closures that came in late in the fiscal year and an influx of septic disposal permits.
Jefferson County Supervisor Lee Dimmitt offered a detailed overview of how the budget system functions, explaining that expenditures cannot exceed what is budgeted in each individual line item, regardless of corresponding revenue. He noted that Leonard’s current year-to-date expenditures of approximately $81,000 remain under the $88,000 budget, but that the amended request of $95,078 — roughly $7,000 over the original budget — reflects anticipated costs through the end of the fiscal year in June.
Dimmitt expressed a desire to restructure the budget relationship with Leonard, who operates as a vendor through his company rather than as a county employee. He suggested moving toward a flat-fee contract model in which Leonard covers all operating costs out of a single agreed-upon sum, with any grant reimbursements flowing back to public health to help offset the county’s cost.
“We can’t budget that way any longer,” Dimmitt said, referencing broader fiscal pressures including a $127,000 increase in county liability insurance and a $52,000 increase in workers’ compensation costs this year.
The board agreed to hold a special meeting to further review the budget before the March 23rd deadline.
Other Business
The board also noted that a countywide emergency preparedness tabletop exercise is scheduled for April 9th and May 14th at the hospital training center. The two-part exercise will simulate an elopement scenario involving a cognitively impaired individual, with the goal of training secondary and tertiary staff who may need to respond when primary leadership is unavailable.
The May Board of Health meeting was rescheduled from May 14th to May 7th to accommodate a board member’s commitment to Indian Hills Community College graduation ceremonies.
Photo by A.J. Roe.
