Water Our Precious, Critical Resource

R2

All County municipalities evaluate means to increase the capacity, and enhance the survivability, of municipal reservoirs and water storage facilities.

R3

Calistoga, St. Helena, and Yountville prepare their own detailed plans that supplement and complement the County’s ERP.

R1

Municipalities within the County develop, expand, and formalize agreements to provide water allocations to address a catastrophic loss of water.

R4

Each County municipality prepare a plan to ensure rapid repair of the water delivery system and include procedures for emergency water delivery to facilities responsible for providing immediate health and safety aid to the community’s population, especially local hospitals, shelters, and emergency centers.

R5

Cities of American Canyon and Napa are encouraged to complete their updated UWMP plans on schedule and train appropriate city and County officials to carry out their specific responsibilities. St. Helena is encouraged to update their UWMP plan on a periodic basis.

R5

Cities of American Canyon and Napa are encouraged to complete their updated UWMP plans on schedule and train appropriate city and County officials to carry out their specific responsibilities. St. Helena is encouraged to update their UWMP plan on a periodic basis.

R6

NCFCWCD conduct a countywide hydro-geologic groundwater survey and develop a management plan as a County priority.

R7

BOS develop regulations to ensure adequate groundwater supply for future needs.

R9

The County and all municipalities continue development and expansion of recycled water projects to alleviate future water shortages.

R11

St. Helena accelerate its planning process and implementation of distribution and use recycled water.

R8

The City of Napa and NSD identify a process for, and develop an implementation plan to, integrate NSD and PWD into a single department.

R10

The County, all municipalities, and NSD investigate the process and economics for the formation of a countywide utility district to benefit the County residents and holistically manage the availability, distribution, and economics of potable and recycled water.

R12

NSD proactively and aggressively identify funding sources to accelerate expansion of recycled water service in Napa.

R13-20

474 112.6 14.0 21and 1,575 409.2 50.9 older Total 3,613 804.7 100 It is likely much of these monies were spent to repair tooth decay. Perhaps if access to fluoridated water was available, using a 49 percent decline in cavities in baby teeth and 60 percent in permanent teeth from fluoridated water, in 2004 the County would have saved more than $150,000. Given the increase in the numbers treated and costs of dental care since 2004, today these savings would be greater. The potential health benefits of fluoridated water to County residents have been studied. In a November 2007 Napa County Community Health Needs Assessment Fact Sheet, dental services were identified as a recommended priority. At that time, based on projections from statewide statistics, a conservative estimate of about 6,680 Napa County residents, newborn to nineteen years of age, have decay requiring treatment, corresponding to about 5 percent of Napa County’s population. Epidemiological evidence suggests that this number would be markedly lower if there was access to fluoridated water. Napa County is significantly behind the curve with respect to fluoridation of its PWS. In 2006, 69 percent of the US population received fluoridated water from municipal water systems. In 2008, 60 percent of California residents received fluoridated water from municipal water systems. One goal of the US Department of Health and Human Services (HHS) “Healthy People 2010” initiative (www.healthypeople.gov) is to increase the percentage of the population receiving optimally fluoridated water to 75 percent from the current level of 69 percent by 2010. In 2006 the Council of State Governments adopted a resolution encouraging states to “support and adopt community water fluoridation standards.” The State of California has encouraged its counties to invest in fluoridation of its public water systems in various ways including initiatives through CDPH. In 1995 the California legislature passed AB 733, titled “Fluoridation Act,” which was signed into law by Governor Wilson. This bill was sponsored by the CDA. AB 733 mandates fluoridation of public water systems having 10,000 or more connections. Prior to passage of AB 733, California ranked close to the bottom, forty-eight out of fifty states plus the District of Columbia, in the percentage of its population receiving community fluoridated water. AB 733 was subsequently clarified in 2004 by Senate Bill (SB) 96, also sponsored by the CDA. Both AB 733 and SB 96 are unfunded mandates and stipulate exemptions and requirements for its implementation. CDPH is responsible for identifying funds to purchase and install fluoridation equipment for PWS. What Would be the Benefit of Fluoridation to Napa County’s Residents? One estimate suggests that across the state, California taxpayers could have saved about $385 million in dental care costs five years after introduction of fluoridation in community water systems. Aside from the capital costs to build the capability of adding fluoride to its municipal water systems, the cost of providing fluoridated water in community water systems is estimated to be about $0.68 to $0.72 per resident annually depending on the size of the community. With Napa County’s 2008 population estimated by the United States Census Bureau to be 133,400, this translates to a cost of operating a fluoridated water supply countywide at approximately $100,000 annually. This is less than the amount Denti-Cal is estimated to have spent on tooth decay treatment in 2004. Based on this information, the Grand Jury believes water fluoridation is the most economical and cost effective approach to implementing a major oral health preventive measure for the County’s residents. Further, using the above CDA estimate that each $1.00 invested in fluoridated water translates into $140 savings in bills for dental services, this $100,000 annual investment would yield some twelve or more million dollars in savings. Implementing Water Fluoridation in Napa County In 1998 the CDA, Dental Health Foundation, and CDPH formed a partnership to administer a multimillion dollar California Endowment grant for water fluoridation projects. CDPH has responsibility to identify monies for such purchases. It does not appear that any Napa County municipality has sought funding to provide this demonstrated public health benefit. Since the City of Napa has more than 10,000 water connections, it is mandated by AB733 to fluoridate its water. In a March 2, 2003, Napa Valley Register article Phil Brun, general manager for the Napa Water Department, was quoted “…Napa County ranks 17 out of 166 districts on the state’s priority list…” prepared by Department of Health Services. Despite this high ranking, the City of Napa has not applied for funds. This article was the last of a flurry of articles and letters, both for and against fluoridation, in the Napa Valley Register appearing during 2002 and 2003. The City of Napa PWD has estimated the capital costs to implement fluoridation at its three treatment plants to be $1.1 million. Even if the capital costs for the other treatment plants throughout the County were estimated at the highest of those for the City of Napa plants, the total cost for the County’s municipal water systems would be less than $3.5 million. FINDINGS The 2009-2010 Grand Jury finds: 1. Water quality testing in all municipalities in Napa meets current California Department of Public Health and EPA Clean Drinking Water Act requirements. Water Quality Reports are available annually from all Napa County municipalities. 2. In the event of supply disruption from the NBA, the County and its municipalities will depend on water from municipal reservoirs and water storage facilities. 3. The current County Emergency Response Plan (ERP) provides a general framework for a regional response to all emergencies. The Cities of American Canyon and Napa have their own ERPs; other municipalities do not. 4. A major earthquake would likely cause a significant disruption to water delivery infrastructure throughout the County. 5. State law requires the City of Napa and American Canyon to have UWMPs in place and to update them every five years. At present, these are current and are being updated to comply with current law and regulations. 6. Although not required, St. Helena voluntarily prepared a UWMP. 7. Napa County has not completed a detailed hydro-geological study of its groundwater resources since 1973. 8. Recycled water is a non-potable supply option to alleviate demands on potable water programs. 9. In Yountville, eighty-five percent of wastewater is recycled. 10. Calistoga uses 100 to 200 acre-feet per year of its wastewater and distributes it to about twenty locations. 11. St. Helena is not currently using recycled water but is “looking into it.” 12. As more City of Napa water customers convert to using recycled water the revenues for Napa City Water Department decline since recycled water is delivered to customers at a lower rate than potable water. 13. Napa Sanitation District and the City of Napa have agreements to manage transition from using potable to recycled water for new users. 14. None of Napa County’s public water systems fluoridate their water supplies. 15. Fluoridated water has a documented significant oral health benefit and fluoridating water in Napa County was recommended as a component for community dental health improvement. 16. AB 733 mandates fluoridation of public water systems having 10,000 or more connections. 17. Annual savings in oral healthcare to County residents is projected to exceed the estimated costs of operating water fluoridation systems at the County public water systems. 18. No County municipalities have applied for funding to fluoridate their public water systems. RECOMMENDATIONS The 2009-2010 Grand Jury recommends: 1. Municipalities within the County develop, expand, and formalize agreements to provide water allocations to address a catastrophic loss of water. 2. All County municipalities evaluate means to increase the capacity, and enhance the survivability, of municipal reservoirs and water storage facilities. 3. Calistoga, St. Helena, and Yountville prepare their own detailed plans that supplement and complement the County’s ERP. 4. Each County municipality prepare a plan to ensure rapid repair of the water delivery system and include procedures for emergency water delivery to facilities responsible for providing immediate health and safety aid to the community’s population, especially local hospitals, shelters, and emergency centers. 5. Cities of American Canyon and Napa are encouraged to complete their updated UWMP plans on schedule and train appropriate city and County officials to carry out their specific responsibilities. St. Helena is encouraged to update their UWMP plan on a periodic basis. 6. NCFCWCD conduct a countywide hydro-geologic groundwater survey and develop a management plan as a County priority. 7. BOS develop regulations to ensure adequate groundwater supply for future needs. 8. The City of Napa and NSD identify a process for, and develop an implementation plan to, integrate NSD and PWD into a single department. 9. The County and all municipalities continue development and expansion of recycled water projects to alleviate future water shortages. 10. The County, all municipalities, and NSD investigate the process and economics for the formation of a countywide utility district to benefit the County residents and holistically manage the availability, distribution, and economics of potable and recycled water. 11. St. Helena accelerate its planning process and implementation of distribution and use recycled water. 12. NSD proactively and aggressively identify funding sources to accelerate expansion of recycled water service in Napa. 13. That the City of Napa apply for funding sources for capital improvements to fluoridate water supplies for its three treatment plants in compliance with AB 733. 14. That American Canyon, Calistoga, St. Helena, and Yountville prepare capital cost proposals for fluoridation of their water supplies. COMMENDATIONS The 2009-2010 Grand Jury commends: • American Canyon for its plan to use recycled water to irrigate fields at its new high school and for building recycled water storage capability for other beneficial uses within the City. • Calistoga for its current uses of recycled water and showing forward thinking in seeking to expand recycled water distribution and use. • The Town of Yountville for being the first municipality in the County to recycle a large percentage of its wastewater. • The members of the Flood Control and Water Conservation District and all municipal Public Works departments who have assisted the Grand Jury with reports, maps, and other information sources. The personnel were helpful, efficient, and expert in their contributions. REQUEST FOR RESPONSES The 2009-2010 Grand Jury requests responses to recommendations from: • BOS Recommendations 1,6,7,8,9,10,12 • NCFCWCD Recommendations 1,6 • Napa Sanitation District Recommendations 8,9,0,12 • Public Works Department of American Canyon Recommendations 1,2,4,5,8,9,10,13 • Public Works Department of Calistoga Recommendations 1,2,4,9,10,14 • City of Napa Public Works Department, Water Division Recommendations 1,2,4,5,8,9,10,13 • City of St. Helena Public Works Department Recommendations 1,2,4,9,11,14 • Town of Yountville Public Works Department Recommendations 1,2,4,9,14 • Mayor, American Canyon Recommendations 3,5,9,10,14 • City Council, Calistoga Recommendation 14 • Mayor, St. Helena Recommendations 5,8,9,10,13 • City Council, St. Helena Recommendations 3,5,9,11,14 • Mayor, Yountville Recommendation 14 DEFINITION, GLOSSARY, RESOURCES REVIEWED,

R13

That the City of Napa apply for funding sources for capital improvements to fluoridate water supplies for its three treatment plants in compliance with AB 733.

R14

That American Canyon, Calistoga, St. Helena, and Yountville prepare capital cost proposals for fluoridation of their water supplies.

R13-20

474 112.6 14.0 21and 1,575 409.2 50.9 older Total 3,613 804.7 100 It is likely much of these monies were spent to repair tooth decay. Perhaps if access to fluoridated water was available, using a 49 percent decline in cavities in baby teeth and 60 percent in permanent teeth from fluoridated water, in 2004 the County would have saved more than $150,000. Given the increase in the numbers treated and costs of dental care since 2004, today these savings would be greater. The potential health benefits of fluoridated water to County residents have been studied. In a November 2007 Napa County Community Health Needs Assessment Fact Sheet, dental services were identified as a recommended priority. At that time, based on projections from statewide statistics, a conservative estimate of about 6,680 Napa County residents, newborn to nineteen years of age, have decay requiring treatment, corresponding to about 5 percent of Napa County’s population. Epidemiological evidence suggests that this number would be markedly lower if there was access to fluoridated water. Napa County is significantly behind the curve with respect to fluoridation of its PWS. In 2006, 69 percent of the US population received fluoridated water from municipal water systems. In 2008, 60 percent of California residents received fluoridated water from municipal water systems. One goal of the US Department of Health and Human Services (HHS) “Healthy People 2010” initiative (www.healthypeople.gov) is to increase the percentage of the population receiving optimally fluoridated water to 75 percent from the current level of 69 percent by 2010. In 2006 the Council of State Governments adopted a resolution encouraging states to “support and adopt community water fluoridation standards.” The State of California has encouraged its counties to invest in fluoridation of its public water systems in various ways including initiatives through CDPH. In 1995 the California legislature passed AB 733, titled “Fluoridation Act,” which was signed into law by Governor Wilson. This bill was sponsored by the CDA. AB 733 mandates fluoridation of public water systems having 10,000 or more connections. Prior to passage of AB 733, California ranked close to the bottom, forty-eight out of fifty states plus the District of Columbia, in the percentage of its population receiving community fluoridated water. AB 733 was subsequently clarified in 2004 by Senate Bill (SB) 96, also sponsored by the CDA. Both AB 733 and SB 96 are unfunded mandates and stipulate exemptions and requirements for its implementation. CDPH is responsible for identifying funds to purchase and install fluoridation equipment for PWS. What Would be the Benefit of Fluoridation to Napa County’s Residents? One estimate suggests that across the state, California taxpayers could have saved about $385 million in dental care costs five years after introduction of fluoridation in community water systems. Aside from the capital costs to build the capability of adding fluoride to its municipal water systems, the cost of providing fluoridated water in community water systems is estimated to be about $0.68 to $0.72 per resident annually depending on the size of the community. With Napa County’s 2008 population estimated by the United States Census Bureau to be 133,400, this translates to a cost of operating a fluoridated water supply countywide at approximately $100,000 annually. This is less than the amount Denti-Cal is estimated to have spent on tooth decay treatment in 2004. Based on this information, the Grand Jury believes water fluoridation is the most economical and cost effective approach to implementing a major oral health preventive measure for the County’s residents. Further, using the above CDA estimate that each $1.00 invested in fluoridated water translates into $140 savings in bills for dental services, this $100,000 annual investment would yield some twelve or more million dollars in savings. Implementing Water Fluoridation in Napa County In 1998 the CDA, Dental Health Foundation, and CDPH formed a partnership to administer a multimillion dollar California Endowment grant for water fluoridation projects. CDPH has responsibility to identify monies for such purchases. It does not appear that any Napa County municipality has sought funding to provide this demonstrated public health benefit. Since the City of Napa has more than 10,000 water connections, it is mandated by AB733 to fluoridate its water. In a March 2, 2003, Napa Valley Register article Phil Brun, general manager for the Napa Water Department, was quoted “…Napa County ranks 17 out of 166 districts on the state’s priority list…” prepared by Department of Health Services. Despite this high ranking, the City of Napa has not applied for funds. This article was the last of a flurry of articles and letters, both for and against fluoridation, in the Napa Valley Register appearing during 2002 and 2003. The City of Napa PWD has estimated the capital costs to implement fluoridation at its three treatment plants to be $1.1 million. Even if the capital costs for the other treatment plants throughout the County were estimated at the highest of those for the City of Napa plants, the total cost for the County’s municipal water systems would be less than $3.5 million. FINDINGS The 2009-2010 Grand Jury finds: 1. Water quality testing in all municipalities in Napa meets current California Department of Public Health and EPA Clean Drinking Water Act requirements. Water Quality Reports are available annually from all Napa County municipalities. 2. In the event of supply disruption from the NBA, the County and its municipalities will depend on water from municipal reservoirs and water storage facilities. 3. The current County Emergency Response Plan (ERP) provides a general framework for a regional response to all emergencies. The Cities of American Canyon and Napa have their own ERPs; other municipalities do not. 4. A major earthquake would likely cause a significant disruption to water delivery infrastructure throughout the County. 5. State law requires the City of Napa and American Canyon to have UWMPs in place and to update them every five years. At present, these are current and are being updated to comply with current law and regulations. 6. Although not required, St. Helena voluntarily prepared a UWMP. 7. Napa County has not completed a detailed hydro-geological study of its groundwater resources since 1973. 8. Recycled water is a non-potable supply option to alleviate demands on potable water programs. 9. In Yountville, eighty-five percent of wastewater is recycled. 10. Calistoga uses 100 to 200 acre-feet per year of its wastewater and distributes it to about twenty locations. 11. St. Helena is not currently using recycled water but is “looking into it.” 12. As more City of Napa water customers convert to using recycled water the revenues for Napa City Water Department decline since recycled water is delivered to customers at a lower rate than potable water. 13. Napa Sanitation District and the City of Napa have agreements to manage transition from using potable to recycled water for new users. 14. None of Napa County’s public water systems fluoridate their water supplies. 15. Fluoridated water has a documented significant oral health benefit and fluoridating water in Napa County was recommended as a component for community dental health improvement. 16. AB 733 mandates fluoridation of public water systems having 10,000 or more connections. 17. Annual savings in oral healthcare to County residents is projected to exceed the estimated costs of operating water fluoridation systems at the County public water systems. 18. No County municipalities have applied for funding to fluoridate their public water systems. RECOMMENDATIONS The 2009-2010 Grand Jury recommends: 1. Municipalities within the County develop, expand, and formalize agreements to provide water allocations to address a catastrophic loss of water. 2. All County municipalities evaluate means to increase the capacity, and enhance the survivability, of municipal reservoirs and water storage facilities. 3. Calistoga, St. Helena, and Yountville prepare their own detailed plans that supplement and complement the County’s ERP. 4. Each County municipality prepare a plan to ensure rapid repair of the water delivery system and include procedures for emergency water delivery to facilities responsible for providing immediate health and safety aid to the community’s population, especially local hospitals, shelters, and emergency centers. 5. Cities of American Canyon and Napa are encouraged to complete their updated UWMP plans on schedule and train appropriate city and County officials to carry out their specific responsibilities. St. Helena is encouraged to update their UWMP plan on a periodic basis. 6. NCFCWCD conduct a countywide hydro-geologic groundwater survey and develop a management plan as a County priority. 7. BOS develop regulations to ensure adequate groundwater supply for future needs. 8. The City of Napa and NSD identify a process for, and develop an implementation plan to, integrate NSD and PWD into a single department. 9. The County and all municipalities continue development and expansion of recycled water projects to alleviate future water shortages. 10. The County, all municipalities, and NSD investigate the process and economics for the formation of a countywide utility district to benefit the County residents and holistically manage the availability, distribution, and economics of potable and recycled water. 11. St. Helena accelerate its planning process and implementation of distribution and use recycled water. 12. NSD proactively and aggressively identify funding sources to accelerate expansion of recycled water service in Napa. 13. That the City of Napa apply for funding sources for capital improvements to fluoridate water supplies for its three treatment plants in compliance with AB 733. 14. That American Canyon, Calistoga, St. Helena, and Yountville prepare capital cost proposals for fluoridation of their water supplies. COMMENDATIONS The 2009-2010 Grand Jury commends: • American Canyon for its plan to use recycled water to irrigate fields at its new high school and for building recycled water storage capability for other beneficial uses within the City. • Calistoga for its current uses of recycled water and showing forward thinking in seeking to expand recycled water distribution and use. • The Town of Yountville for being the first municipality in the County to recycle a large percentage of its wastewater. • The members of the Flood Control and Water Conservation District and all municipal Public Works departments who have assisted the Grand Jury with reports, maps, and other information sources. The personnel were helpful, efficient, and expert in their contributions. REQUEST FOR RESPONSES The 2009-2010 Grand Jury requests responses to recommendations from: • BOS Recommendations 1,6,7,8,9,10,12 • NCFCWCD Recommendations 1,6 • Napa Sanitation District Recommendations 8,9,0,12 • Public Works Department of American Canyon Recommendations 1,2,4,5,8,9,10,13 • Public Works Department of Calistoga Recommendations 1,2,4,9,10,14 • City of Napa Public Works Department, Water Division Recommendations 1,2,4,5,8,9,10,13 • City of St. Helena Public Works Department Recommendations 1,2,4,9,11,14 • Town of Yountville Public Works Department Recommendations 1,2,4,9,14 • Mayor, American Canyon Recommendations 3,5,9,10,14 • City Council, Calistoga Recommendation 14 • Mayor, St. Helena Recommendations 5,8,9,10,13 • City Council, St. Helena Recommendations 3,5,9,11,14 • Mayor, Yountville Recommendation 14 DEFINITION, GLOSSARY, RESOURCES REVIEWED,

R13

That the City of Napa apply for funding sources for capital improvements to fluoridate water supplies for its three treatment plants in compliance with AB 733.

R14

That American Canyon, Calistoga, St. Helena, and Yountville prepare capital cost proposals for fluoridation of their water supplies.