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HomeMy WebLinkAbout2025_11_20_BOH_Packet�e{{ehson Public H Board of Health Meeting November 20, 2025 Jefferson County Board of Health Agenda Minutes Public H November 20, 2025 Regular Meeting Agenda Jefferson County Board of Health Thursday, November 20, 2025 @ 2:30 PM Jefferson County Courthouse — Commissioners' Chambers 1820 Jefferson Street, Port Townsend, WA To view agenda items and meeting materials, click here: www.co�efferson.wa.us — Services — Laserfiche Web Portal (username and password is: public) — Health — Agendas —Minutes —Packets — Board of Health Documents (then search by date: yyyy_mm_dd) To view public comments received, www.co jefferson.wa.us — Services — Laserfiche Web Portal (username and password is: public) — Health — BOH Public Comments (search for folder of comments by date, year first) This is a hybrid meeting: Virtual and In -Person Attendance You can join this meeting by using these methods: • Zoom Meeting: https:llus06web.zoom.us/*/82378389363 This option will allow you to join the meeting live. You will need to enter an email address. If you wish to provide public comment, click on the hand icon at the bottom of the screen to "raise your hand." Participation will be up to the Chair and/or Clerk of the meeting. Audio -only: Dial: 1-253-215-8782 and use Webinar ID: 823 7838 9363# This option will allow you to listen to the meeting live. If you wish to provide public comment, press *9 to "raise your hand." Participation will be up to the Chair and/or Clerk of the m • In -Person: You are welcome to join the meeting in -person. In the event of technical difficulties, at least one of the methods above will be accessible to the public. Please try all methods first before calling 360-385-9100 to report any issues. Public comment will be accepted and can be emailed to: BOH@co.jefferson.wa.us until 5:00 PM the evening prior to the start of the meeting. AGENDA CALL TO ORDER — Chair Grace I. Public Comment (10 mins.) Public Comment Periods are dedicated to listening to the public. Each person may address the Board one time during these periods. To ensure equal opportunity for the public to comment, all comments shall be limited to 2 or 3 minutes per person, depending on the volume of public in attendance. AT A REGULAR MEETING, THE MEMBERS MAY ADD AGENDA ITEMS AND TAKE ACTION ON OTHER ITEMS NOT LISTED ON THIS AGENDA. Americans with Disabilities Act (ADA) Accommodations Provided Upon Request II. Approval of Agenda III. Approval of Minutes of October 16, 2025 Board of Health Meeting IV. Old Business and Information Reports 1. Jefferson County Public Health (JCPH) Report (Apple Martine) (5 mins.) 2. Jefferson Healthcare Report (Dr. Kees Kolff) (10 mins.) 3. Infectious Diseases Update (Dr. Allison Berry) (10 mins.) V. New Business 1. Policy Regarding Establishing Public Health Clinical Fees (Apple Martine) (5 mins.) 2. Alternate Board Member Representing the Board on the Behavioral Health Consortium (Apple Martine) (10 mins.) 3. Board of Health Member Updates (Dr. Berry) (10 mins.) 4. Encampment Update/Board Discussion: Mission, Policy, and Service Delivery (Apple Martine, Dr. Berry) (30 mins.) VI. Future Potential Agenda Topics: The County Strategic Plan Salish Behavioral Health Administrative Services Organization Opioid Settlement spending Olympic Connect, the Community Care Hub model Board of Health 101 Homelessness Public Health Impacts resulting from Federal Initiatives Rural Reproductive Health Emergency Fund for Public Health The Child Development Center Sewer projects / wastewater VII. Announcements ADJOURNMENT BY: 4:30 p.m. Next Scheduled Meeting: December 18, 2025 2:30 — 4:30 PM Jefferson County Public Health Hybrid Meeting AT A REGULAR MEETING, THE MEMBERS MAY ADD AGENDA ITEMS AND TAKE ACTION ON OTHER ITEMS NOT LISTED ON THIS AGENDA. Americans with Disabilities Act (ADA) Accommodations Provided Upon Request 4PUIrlice HeaA REGULAR MEETING MINUTES Jefferson County Board of Health Thursday, October 16, 2025 @ 2:30 p.m. Jefferson County Courthouse — Commissioners' Chambers 1820 Jefferson Street, Port Townsend, WA Hybrid Meeting Board Members Greg Brotherton, County Commissioner, District #3 Heather Dudley-Nollette, County Commissioner, District #1 Celeste Dybeck, Tribal Representative Heidi Eisenhour, County Commissioner, District #2 Amanda Grace, Chair, Community Stakeholder Dr. Kees Kolff, Public Hospital District #2 Commissioner Monica MickHager, Vice -Chair, Port Townsend City Council Gabrielle Vanwert, Consumer of Public Health Staff Members Denise Banker, Community Health Director Dr. Allison Berry, Health Officer Lara Cittadini, CHIP Manager Michael Dawson, Water Quality Manager Carter Erickson, Environmental Health Manager Apple Martine, Public Health Director Pinky Mingo, Environmental Public Health Director Jenn Mitchell, Finance Manager Veronica Shaw, Public Health Deputy Director Chair Grace called the October 16, 2025 meeting of the Jefferson County Board of Health to order at 2:30 p.m. Members Present: Chair Amanda Grace, Members Greg Brotherton, Heather Dudley-Nollette, Celeste Dybeck, Heidi Eisenhour, Monica MickHager and Gabrielle Vanwert. Staff Present: Staff Members Denise Banker, Dr. Allison Berry, Michael Dawson, Carter Erickson, Apple Martine, Pinky Mingo, Jenn Mitchell and Veronica Shaw. APPROVAL OF AGENDA Chair Grace called for a motion to accept the agenda for October 16, 2025. Chair Grace noted that, in the absence of Member Kolff, Chair Grace would read a brief statement from Dr. Kolff in place of his Jefferson Healthcare Report. MOTION: Member Eisenhour moved to approve the agenda as revised. Member Dybeck seconded the motion, which carried by a unanimous vote. Respectfully submitted Page 1 of 4 G. Gilbert NEW BUSINESS 1. [POTENTIAL ACTION] PUBLIC HEARING in the Matter of Amending Jefferson County Ordinance No. 02- 0220-25, Section 8.15.055(7) Local Management Plan for On -Site Sewage of the Jefferson County Code (JCC), Addressing the Exemption from the Annual Operations & Maintenance Fee (Carter Erickson, Ariel Speser) Staff Presentation Staff member Erickson presented a slideshow concerning the changes to exemption criteria for the recently adopted On -site Sewage Code, providing the reasoning for the original language and the reasons for amending the language. Public Testimony There was none. Board of Health Deliberation and Possible Vote on Adopting Code As the amendment was discussed at the September meeting, the Board moved to vote. MOTION: Member Brotherton moved to approve an ordinance amending Jefferson County Ordinance No. 02-0220-25, Section 8.15.055(7) Local Management Plan for On -Site Sewage of the Jefferson County Code, Addressing the Exemption from the Annual Operations & Maintenance Fee as presented today. Member Dybeck seconded the motion, which carried by a unanimous vote. APPROVAL OF MINUTES Chair Grace requested a motion to approve the minutes of the August 21, 2025 meeting. MOTION: Member Dudley-Nollette moved to approve the minutes of the September 19, 2025 Board of Health meeting. Member Eisenhour seconded the motion, which carried by a unanimous vote. PUBLIC COMMENT Chair Grace called for public comment. Commenter brought to the attention of the Board that, overnight, the current administration fired every single person at the Title 10 office, with no intention of reinstating Title 10 funding (which is now gone.) OLD BUSINESS AND INFORMATIONAL ITEMS 1. Jefferson County Public Health (JCPH) Report Staff member Martine stated that COVID vaccines are currently available to everyone (in Washington) six months and older, and discussed multi -state alliances being formed to provide science -led guidance to the public to counter federal confusion and misinformation. The Women, Infants & Children (WIC) program, highly impacted by federal cuts, is currently funded through the end of the month; other temporary resources are being sought. JCPH is the regional winner of the Great Diaper Drive. 2. Jefferson Healthcare Report Member Kolfi's statement, read by Chair Grace, concerned the reduction of wait times for appointments for new or transferring patients, and also mentioned new services in the new wing of the hospital and also funding reductions and potential losses of coverage by many local patients. 3. Infectious Diseases Update Concerning WIC, Dr. Berry mentioned that the State Board of Health laid off staff in order to keep funding available for WIC. Respectfully submitted Page 2 of 4 G. Gilbert Locally, COVID still circulates but hospitalizations are down. Adult vaccines are available, but child vaccine for COVID is still scarce and distribution is spotty. RSV and flu are, so far, rare and vaccines for both are available. RSV vaccine has proved to be very effective and is recommended for young children up until 8 months of age, up to 19 months of age with certain high risk conditions. Measles continues to spread in the United States, but so far not significantly in Washington. A current danger is "community transmission," where the source of the infection is unknown (still not found in WA). Community transmission signals that there are many other undetected cases in that community. Thankfully that has not yet been the case in Washington, where public health agencies have continued to be able to control sporadic cases. The best protection against measles spread is to stay up to date on measles vaccination. Dr. Berry acknowledged the Governors' Health Alliance, but shared her concern about its being named the "Governors'..." which suggests a political element and could erode trust in communities that do not agree with the governor. NEW BUSINESS (continued) 2. JCPH Clinic Fees — Board Discussion (Apple Martine; Dr. Berry) With a brief introduction by Dr. Berry, the subject was opened up for discussion by the board. Member Dudley- Nollette quoted WSALPHO materials affirming that guiding laws state that local boards of health approve the budget and set fees (unlike in Jefferson County). Staff member Shaw stated that, some years ago, the Board declined to be responsible for setting clinic fees (established by county resolution). It is recommended that the resolution be reexamined for compliance with state law. Concern was expressed that publication of sharply increased fees (without accompanying publication of sliding scales) may discourage potential patients from seeking treatment. Further discussion ensued. 3. Successes of Public Health Tobacco/Cannabis Prevention Program (Laura Tucker, Mike Reynolds) Brinnon School Board member Mike Reynolds described the origin of the Brinnon Run Club and its expansion into the Brinnon Youth Club, which is funded, in part, by Public Health mini -grants for the Youth Cannabis and Commercial Tobacco Prevention Program (YCCTPP). Several students provided testimony concerning the benefits of the program activities in regard to socialization and physical and mental/emotional development. JCPH staff member Tucker provided a slideshow describing other activities supported by YCCTPP mini -grants 4. Award of Certificate of Completion for JCPH Summer Intern (Veronica Shaw) Staff member Shaw introduced JCPH summer intern Thailer Houck -Ball and presented him with a Certificate of Completion. ANNOUNCEMENTS Member Dudley-Nollette noted that October is National Disability Employment Month, which was commemorated by a Board of Commissioners Proclamation. FUTURE POTENTIAL AGENDA TOPICS Staff member Martine reminded the board that board members are welcome to suggest topics for regularly scheduled meetings by filling out and submitting a Call to Agenda form. Respectfully submitted Page 3 of 4 G. Gilbert AGENDA PLANNING CALENDAR The Agenda Planning Meeting for the next regular meeting of the Board will be held on November 13, 2025 at 10:30 a.m. The next regular Board of Health meeting will be held as a hybrid meeting on Thursday, November 20, 2025 from 2:30 p.m. — 4:30 p.m. ADJOURNMENT Chair Grace adjourned the October 16, 2025 Jefferson County Board of Health meeting at 4:23 p.m. until the next Regular Meeting or Special Meeting as properly noticed. JEFFERSON COUNTY BOARD OF HEALTH Amanda Grace, Chair Glenn Gilbert, Public Health Assistant Respectfully submitted Page 4 of 4 G. Gilbert Jefferson County Board of Health Am Old Business and Information Reports Item 1 Jefferson County Public Health Report Mn hanrj-OUfl V Public Healt November 20, 2025 Jefferson County Board of Health IV. Old Business and Information Reports Item 2 Jefferson Healthcare Report rAin h"1d-Out] ;ffnson Public H November 20, 2025 Jefferson County Board of Health IV. Old Business and Information Reports Item 3 Infectious Diseases Update rn�� h�nd'-out] Public H November 20, 2025 It Jefferson County Board of Health V. New Business Item 1 Policy Regarding Establishing Public Health Clinical Fees Public H November 20, 2025 JEFFERS ON COUNTY BOARD OF HEALTH Community Health Fees All of the services/fees listed for Jefferson County Public Health and Community Health are set as follows: A cost analysis will be completed every year to set reimbursement rates for family planning services and immunization programs. Fees for medications, antibiotics and treatment methods will be based on cost of acquisition unless acquired by an outside vendor at no cost to Jefferson County Public Health. No handling fee to cover staff time on inventory and ordering will be assessed. All fees for vaccines not subsidized by the Vaccine for Children or Washington Vaccine Association will be based on the cost of the vaccine, shipping and handling, and allowable market reimbursement rates. Laboratory Services are based on the actual fees of laboratory contractors, price lists are available upon request. Office visit fees are calculated and reviewed annually, and are based on cost analysis. In the event the cost analysis exceeds the contracted private insurance provider rates or market rates, the lower of the rates will apply. The Clinical Services Financial and Operations Guidelines policy is in place, reviewed and updated annually, which includes the Federal Poverty Guidelines used to establish the sliding fee schedule. A copy of the sliding fee schedule will be available upon request. The sliding fee schedule will not be offered for privately purchased vaccines administered for international travel or outside laboratory cost. Certain service fees may be waived, including but not limited to communicable disease prevention services, medications, laboratory services or vaccines to prevent outbreaks of communicable disease. Services for vaccines subsidized by the Vaccines for Children or WA Vaccine Association and Family Planning Services will not be denied due to a client's inability to pay. Board Members Phil Johnson (Chair), County Commissioner District #I, Jill Buhler (ice -Chair), Hospital Commissioner David Sullivan, County Commissioner, District #1, John Austin, County Commissioner, District #3, Catharine Robinson, Port Townsend City Council, Sheila Westerman, Citizen (City), Roberta Frissefl, Citizen (County) 615 Sheridan . Castle Hill Center * Port Townsend ■ WA • 98368 (360) 385-9400 Jefferson County Public Health will automatically implement future modifications to fees for vaccines, medications, and medical supplies when any of the following changes occur: 1. There is a change in the actual cost of the service provided by an outside vendor, the supply, medication, vaccine, laboratory charges, or shipping and handling costs. 2. The Federal Poverty Level Guidelines change. 3. The maximum allowable Medicaid reimbursement rate changes and is more than market rate. Chair, Jefferson County Board of Health Jefferson County Health Officer (IW(Z— Date cl f I Date Board Members Phil Johnson (Chair), County Commissioner District #1, Jill Buhler (ice -Chair), Hospital Commissioner David Sullivan, County Commissioner, District #2, John Austin, County Commissioner, District #3, Catharine Robinson, Port Townsend City Council, Sheila Westerman, Citizen (City), Roberta Frissell, Citizen (County) 615 Sheridan • Castle Hill Center • Port Townsend e WA • 98368 (360) 385-9400 Jefferson County Board of Health V. New Business Item 2 Alternate Board Member Representing the Board on the Behavioral Health, Consortium [No hand-out],,,, ��l�SOf2 Public Healt November 20, 2025 Jefferson County Board of Health V. New Business Item 3 Board of Health Member Updates r Public H November 20, 2025 WASHINGTON STATE BOARDoFHEALTH Information Sheet Engroasod 5wbsjltwh_House Bill (ESHB) 1g46 passed during the 2025 legislative session. It amends local board of health (LBOH) composition requirements. It clarifies appointment of Tribal representation to LBOHs. The Washington State Board of Health (Board) has the authority, for adopting rules for appointing non -elected members, Including Tribal representatives, to LBOHs. Updated rulemaking will establish deadlines for LBOHs to update their membership when a Tribe or Urban Indian Organization appoints a representative to the local board of health. Under ESHB 1946, federally recognized Tribes holding reservation or trust lands within a county and Urban Indian organizations recognized by the Indian Health Service and registered as a 501(c)(3) and providing services within a county, will choose their own Tribal representative to serve on LBOHs. The legislation changes the appointment authority from the American Indian Health Commission (AIHC) to Tribes and Urban Indian organizations. This respects and affirms Tribal sovereignty and self-determination. The Tribe or Urban Indian Organization will notify the LBOH of the appointment. Local Boards of Health are required to: Add the Tribal representative to Its membership. Notify AIHC of the appointment. • Modify their membership within 60 days to balance elected and non -elected members. This law was effective July 27, 2025. The Board has 12 months from the effective date to complete rulemaking, which may change the 60-day requirement for LBOHs to modify membership. To learn more about this legislation and the Board's rulemaking, visit the SHUH rulemaking-pAg or scan the QR code. You can also contact Ashley Bell, Tribal Liaison, at any time via email at ashley,b.QLaLsboh.wa.ggy Washington State Board of Health BYLAWS OF THE JEFFERSON COUNTY BOARD OF HEALTH ARTICLE 1. NAME The name of this organization shall be the Jefferson County Board of Health. ARTICLE 11. PURPOSE The purpose of the Jefferson County Board of Health is to supervise all matters pertaining to the preservation of the life and health of the people of Jefferson County and to comply fully with the requirements of all applicable chapters of Title 70, Revised Code of Washington. The Board of Health shall: • Collect, analyze and disseminate to the community, through Jefferson County Public Health, information about community health conditions, risks and resources, and the availability of resources to address identified problems. ■ Enact such rules, regulations and policies as are necessary to preserve, promote and improve the health status of Jefferson County residents, and guide the allocation of appropriate and necessary public health resources. • Assure that necessary, high quality, effective public health services are available for the protection of the people of Jefferson County, including the control and prevention of any dangerous, contagious or infectious disease within the county. ■ Provide for the prevention, control and abatement of nuisances detrimental to public health. • Enforce, through the Health Officer, the public health statutes of the state and county. ■ Establish fee schedules for issuing and renewing licenses and permits or for such other services as are authorized by the law and rules of the State Board of Health. Jefferson County Board of Health Bylaws (rev.04/2022) Page 1 ARTICLE IIl. REPRESENTATION Membcrshi : Membership of the Board of Health shall be established consistent with applicable state law, including RCW 43.20.300, and promulgated regulations. The appointment of Members to the Board shall proceed as follows: Elected Officials: The Board shall include all Jefferson County Commissioners, as well as one member of the Port Townsend City Council, selected by the Council, and who shall then be appointed by the Board of County Commissioners. Non -Elected Officials: The Board of County Commissioners shall appoint non- elected officials to the Board of Health to ensure, to the extent practicable, that the Board includes a balanced representation of elected officials and non -elected people with a diversity of expertise and lived experience. (1) Number: The number of non -elected members, including tribal representatives, must equal the number of elected officials on the Board. Elected members of the local board of health may not constitute a majority. (2) Tribal Representation: As to any federally recognized Indian tribe that holds reservation, trust lands, or has usual and accustomed areas within the County, the Board must include at least one of the non -elected members as a tribal representative selected by the American Indian Health Commission, according to the selection process prescribed by the Commission. (3) Residency Requirements: Except for a tribal representative, to be appointed, an applicant must be able to demonstrate residency in Jefferson County. (4) Appointment -Categories: Contingent upon there being at least three non- elected members, one shall be selected from each of the categories below. A fourth non -elected member may be appointed from any of the categories, unless a tribal representative, in which case being from one of the categories is optional. a. Public health, health care facilities, and providers; b. Consumers of public health; and C. Other community stakeholders. (5) Additional Required Considerations for Appointment as a Non -elected member: The Board of County Commissioners shall assess the following when selecting an applicant for appointment as a Non -elected member: a. Whether the applicant's background meets the qualifications of the applicant's selected category or categories, as defined below, or as otherwise defined by a subsequent change in state law; b. Potential conflict of interest; C. The applicant's demonstrated commitment to public health; d. Recommendation from current Board of Health members; e. Whether the applicant represents a diversity of expertise and lived experience; Jefferson County Board of Health Bylaws Page 2 f. Whether the applicant represents the geographic diversity of the community; and g. Whether the applicant identifies with a historically underrepresented community when being considered as a non -elected member representing consumers of public health. (6) Categories for Non -Elected Officials Defined: Consistent with WAC 246- 90-010, or as subsequently amended or replaced, the categories from which Non -elected members must be selected are defined as follows: a. "Consumers of public health" means the category of persons consisting of county or health district residents who have self - identified as having faced significant health inequities or as having lived experiences with public health -related programs. b. "Other community stakeholders" means the category of persons representing the following types of organizations located in the county or health district: i. Community -based organizations or nonprofits that work with populations experiencing health inequities in the county; ii. Active, reserve, or retired armed services members; iii. The business community; or iv. The environmental public health regulated community. C. "Public health, health care facilities, and providers" means the category of persons practicing or employed in the county or health district who are: i. Medical ethicists; ii. Epidemiologists; iii. Experienced in environmental public health; iv. Community health -workers; V. Holders of master's degrees or higher in public health or another field with an emphasis or concentration in health care, public health, or health policy; vi. Employees of the public hospital districts located in the county; or vii. Any of the following providers holding an active or retired license in good standing under Title 18 RCW: Physicians or osteopathic physicians; advanced registered nurse practitioners; physician assistants or osteopathic physician assistants; registered nurses; dentists; naturopaths; or pharmacists. viii. In filling this position, preference will be given to appointing an individual who meets the above criteria and is recommended by the Public Hospital District No. 2. Jefferson County Board of Health Bylaws Page 3 (7) Recruitment and Application Processes: The processes for the recruitment and application for appointment as a Non -elected member of the Board shall, in all respects, comply with applicable state law. Additionally: Applicants for non.�elected membership on the Board shall be recruited in a manner intended to solicit a broad pool of applicants that represent a diversity of expertise and lived experience by, among other things — a. Providing reasonable advance notice for applicants to apply for vacancies; b. Posting of vacancy -announcements in public places, including the newspaper with the most readership, if any, in the county; C. Posting of vacancy -announcements in the most common languages spoken in the county; d. Posting of vacancy -announcements in all geographic regions represented by the Board; e. Working with local community organizations to distribute vacancy notices; and f. Complying with applicable provisions of the Americans with Disabilities Act, Public Law Number 10 1-33 6 and chapter 49.60 RCW. (8) The Board shall develop an application form or process that is consistent with all applicable law, except that such application or process shall not require an applicant to provide their political affiliation or voting history. In addition, the application or process may require an applicant to designate the category or categories they are applying for as identified and defined above. The Board may consider applicants for any position for which they are qualified. (9) All applicants for non -elected positions shall be interviewed in a panel format by the Board subject to the following: a. All applicants shall be asked the same questions; and b. In the event of a substantial number of applicants, the local board of health may elect to interview a smaller number of applicants as long as the applicants interviewed include a diversity of expertise and lived experience. C. The recruitment process must be consistent with applicable provisions of chapter 42.30 RCW. Terms: Appointed members shall serve for three-year terms. Board of Health members may serve more than one term, including consecutive terms. Vacancies: In the event that a vacancy occurs for an appointed representative, the Board of County Commissioners shall appoint another representative within thirty (30) days, or as soon as practical, from the date of vacancy. In the event that a vacancy occurs from the Port Townsend City Council or Jefferson Healthcare District Jefferson County Board of Health Bylaws Page 4 #2 member, the City or District shall nominate another representative from their membership within thirty (30) days. Absences: Board members shall notify the Chairperson in advance if unable to attend any regular meeting of the Board of Health. Appointed Board members may be removed from Board membership by action of the County Commissioners for lack of attendance. Three or more unexcused absences from regular Board of Health meetings in one calendar year will be considered cause for removal. Non -Voting Members: The Board, by majority vote, may appoint non -voting members to the Board for a three-year term. ARTICLE IV. OFFICERS Chairperson: The presiding officer of the Board of Health shall be the Chairperson, who shall serve for a term of one (1) year. The Chairperson shall be selected by a majority vote of the Board members present at the first regular meeting of each year. Vice -Chairperson: At the same meeting, a Vice -Chairperson shall also be selected for a term of one (1) year, who shall preside over all proceedings of the Board in the absence of the Chairperson. Vacancies: In the event of a vacancy in the office of Chairperson, the Vice - Chairperson shall immediately assume the duties of the Chairperson for the remainder of the year. Another representative shall be selected to serve as Vice -Chairperson at the next regular or special meeting of the Board. Consecutive Terms: Board members shall not serve consecutive terms as Chairperson or Vice Chairperson. ARTICLE V. RULES OF BUSINESS Business shall be conducted in accordance with the most current edition of Robert's Rules of Order, so long as they are consistent with these Bylaws or amendments thereto. ARTICLE VI. COMMITTEES The Chairperson shall appoint subcommittees from the Board of Health or members of the community from time to time as the Chairperson shall deem necessary. The Chairperson shall be an ex-officio member of all committees. ARTICLE VII. ADMINISTRATIVE OFFICER The Board of Health may appoint an Administrative Officer who shall fulfill the responsibilities specified by RCW 70.05.045, including administering the operations of the Health Department. The Administrative Officer shall serve at the will and approval of the Board. Jefferson County Board of Health Bylaws Page 5 ARTICLE VIII. HEALTH OFFICER The Board of Health shall appoint a County Health Officer, who shall be a qualified physician trained and experienced in public health, who shall exercise the powers, and perform the duties prescribed in RCW 70.05.070. The Health Officer shall serve at the will and approval of the Board. ARTICLE IX. OPERATING RULES Section 1. Meetings Re ular Meetin : Regular meetings of the Board of Health shall be held on the third Thursday of each month. If the third Thursday is a legal holiday, an alternate day may be selected by the Chair. Any regular meeting of the Board of Health may be cancelled with the concurrence of a majority of the Board. The location of the meetings shall be within Jefferson County. Special Nleetin : The Chair or two-thirds of the voting members of the Board may call a special meeting of the Board consistent with RCW 42.30.080. Executive Session: The Board may hold executive sessions from which the public may be excluded for the purposes set forth in RCW 42.30.110. Quorum: A majority of all voting Board members, including at least two Jefferson County Commissioners, shall constitute a quorum for Board meetings. Tana Recordin s: The proceedings of all Board meetings shall be recorded electronically. Any person may request a copy of electronic recording media of any meeting of the Board by payment of reasonable cost per policy. Minutes: Written minutes of each Board meeting shall be prepared and approved by the Board at the subsequent regular meeting. Minutes shall be signed by the attending Members at the time of their approval by the Board. Meetings Open to Ptibi is .- All regular and special meetings of the Board and Board committees shall be open to the public, in accordance with RCW 42.30. Materials to Board Members: Except in cases of emergency, the agenda and materials related to action items shall be sent to Board members in advance of the meeting at which the items will be considered. Section 2. Voting Actions Rewiring a Vote: Each regular member of the Board shall be entitled to one vote on all actions of the Board that require a vote. An affirmative vote of a majority of voting Board members shall be required to pass an action of the Board, provided that a quorum of the Board is present. Voting on Fees: Any decision by the Board related to the setting or modification of permit, licensing, and application fees may only be determined by the votes of the city and county elected officials on the Board. Voting By Proxy: There will be no voting by proxy on any question before the Board. Jefferson County Board of Health Bylaws Page 6 Tied Votes: Any vote that results in an equal number of votes cast for and against shall be resolved as follows: First, after further discussion, the Board shall vote a second time on the matter, with a second tie -vote causing the matter to be not passed. In the alternative, by a majority vote of the entire Board upon motion, the matter can be tabled before taking a second vote and brought back for reconsideration at the next regularly scheduled meeting, either in the same or revised form. Section 3. Ethics Conflict of Interest: Members of the Board of Health having personal or professional interest on an action item that may be deemed conflicting or infringe upon the appearance of fairness shall declare the conflict. If the member or the Board, by majority vote, determines the conflict of interest to be significant, the member shall refrain from discussing or voting on the matter. Section 4. Public Testimony General Public Comments: At each meeting, according to the usual order of business, the Chair shall call for general comments. Persons wishing to comment shall give their name and address. The Chair may establish time limits for individuals who wish to speak. Comments on Action Items: Prior to voting on any item requiring action by the Board, the Chair may call for comments by persons interested in or affected by the matter under consideration before the Board. Persons wishing to comment on action items shall give their name and address. The Chair may establish time limits for individuals who wish to speak. Section S. Public Hearing The Board shall conduct public hearings prior to adoption of fees, ordinances, rules, or other exercises of its quasi -legislative powers. All members of the public in attendance at a public hearing will be allowed to speak if they so desire. Persons wishing to provide testimony shall give their name. Time limits may be placed on individual comments at the discretion of the Board Chair and the public should be advised that comments must relate to the matter at hand. Order and decorum should be maintained at all times. Rules for the conduct of the hearing should be stated by the Board Chair at the beginning of the hearing. Following public testimony, the Board Chair shall close the public hearing and the Board may deliberate and take action on the matter at hand. Call for Public Hearin: A public hearing may be called for by an affirmative vote by a majority of the Board. Public notice will be given at least 10 days prior to a public hearing of the Jefferson County Board of Health. Section 6. Appeals Hearing Board of Health appeal hearings shall be open to the public and presided over by the chair of the Board of Health. Such hearings shall be recorded. Board of Health hearings shall be opened with a recording of the time, date, and place of the hearing; and a statement of the cause for the hearing. The hearing shall be limited to argument of the parties submitted in writing prior to the meeting and no additional evidence Jefferson County Board of Health Bylaws Page 7 shall be taken unless, in the judgment of the chair, such evidence could not have reasonably been obtained and submitted prior to the hearing. Additional appeal hearing procedures may be required by the specific public health code (e.g. On -site Sewage, Solid Waste, or Food Safety) that governs the matter under appeal. ARTICLE X. MISCELLANEOUS Reimbursement of Ex eases: Board of Health members may receive reimbursement for approved expenses related to completion of their responsibilities. ARTICLE XI. AMENDMENTS TO BYLAWS These Bylaws can be amended at any regular meeting of the Board by two-thirds (2/3) vote of total members, provided the amendment has been submitted in writing to the Board of Health at least ten (10) days prior to said meeting. AD OP ,D the 19te day of April, 2022 � o It A 7LN'l -, Greg Brotherton, Chairperson Jefferson County Board of Health Jefferson County Board of Health Bylaws Page 8 Jefferson County Board of Health V. New Business Item 4 Encampment Update/Board Discussion: Mission, Policy, and Service Delivery V [No hand-out] . Iffason Public H November 20, 2025 it Jefferson County Board of Health VI. Agenda Planning ziffvcson Public H November 20, 2025 Jefferson County Board of Health VI I . Announcements Public H November 20, 2025 FWA)TWM Public H