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HomeMy WebLinkAbout092007JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday September, 20, 2007 Board Members: Phil Johnson- County Commissioner District # 9 David Sullivan — County Commissioner District #2 John Austin, Vice Chairman — County Commissioner District #3 Jill Buhler — Hospital Commissioner District #2 Geoff Masci — Por-t Townsend City Council Sheila Westerman — Citi .Zen at Large (City) Roberta Frissell, Chair— Citi .Zen at Large (County) Sta Members: Thomas Locke, MD, Health Ofcer Jean Baldwin, Public Health Services Director Julia Danskin, Nursing Programs Director Mike McNickle, Environmental Health WaterQuality Director Meeting was called to order at 2:30 pm on September 20, 2007 by Chair Frissell in the conference room of Jefferson County Public Health. All members were presents with the exception of Member Buhler. A quorum was present. APPROVAL OF AGENDA Board Member Sullivan moved to approve the agenda with the addition of two New Business Agenda Items: 2007 Shoreline Survey and Clean Water District. Member Johnson seconded the motion, which carried by a unanimous vote. APPROVAL OF MINUTES Board Member Westerman moved to approve the minutes of August 16, 2007 as written. Board Member Austin seconded the motion, which carried by a unanimous vote. None PUBLIC COMMENTS OLD BUSINESS National Health Service Corps Provider Recruitment Member Buhler testified at the Rural Health Conference in Washington, D.C. Dr. Locke spoke to the Board about recruiting National Health Service Corps health care providers stating that it is a competitive process and that there are more requests than there are providers. Dr. Locke spoke of the success of the National Health Service Corp and the role it's played in covering the rural communities and said this may be a viable option for recruiting a position for South County. Jefferson County Board of Health, September 20, 2007 Page 1 of 7 Jefferson County Public Health in NACCHO (National Association of City and County Health Officials) News Jean Baldwin commented on the article in the NAACHO Issue Brief publication. Jefferson County Public Health was featured in the August 2007 article on Women's Mental Health: Local Health Department Strategies in Addressing Depression Among Pregnant and Parenting Women. NACCHO initiated a survey on the integration of mental health services in maternal health programs and followed up with an interview. Jefferson County was one of three counties featured. Jean reminded the Board about the continued work with our Kitsap County partners, focusing on mental health and substance abuse assessment data to determine community needs. JCPH is pursuing an electronic database with the capabilities of compiling maternal depression screening data to profile and produce a report for the Methamphetamine Action Team. This information will focus on methamphetamine use in the family and its community impact. Board Correspondence Dr. Locke complimented Mike McNickle and his staff on the hard work that was done on the On -site sewage Management Plan and On -site code revision. Both have passed review by the Washington State Department of Health. Mike McNickle commented briefly on the funding from the Department of Ecology which will help pay for the archaeological study and some construction costs at Beckett Point. Member Sullivan said he spoke with Jim Parker from PUD and said the project is on schedule and due to be finished in November. NEW BUSINESS Policy Issues Related to Formation of JCPH District: Progress Report Dr. Locke introduced this agenda item as a follow up to a prior discussion with the Board. The Board instructed JCPH to gather additional information about formation of a Health District. Mike McNickle invited proposals from outside agencies to conduct a feasibility study and received two bids. Member Masci, Member Austin, Dr. Locke and Jean Baldwin conducted the interviews this morning. Jean Baldwin pointed out that there are a number of problems that formation of a health district may or may not be a viable solution to. Workforce recruitment and retention issues remain a big part of the problem and complicates JCPHs ability to recruit public health nurses and other specialty positions as well as environmental health positions. We are in a market where qualified people can make a much better income working for a hospital or working in the private sector, making it difficult to recruit and retain staff. Jefferson County Board of Health, September 20, 2007 Page 2 of 7 Dr. Locke noted that with each passing year we find ourselves with more responsibilities and there is no reason to believe these trends are going to reverse. Current revenue streams are unable to keep up with the pace of rising service demands. This is something a health district could potentially address by broadening the base of funding for local public health. Performing services that fulfill our core mission to protect and improve community health is increasingly a multi jurisdictional problem. The health district feasibility study will look at a variety of different issues and provide an opportunity to discuss what the future of public health should look like in Jefferson County. Ultimately, formation of a county health district is a decision of the county legislative authority, i.e. the Board of County Commissioners. Member Sullivan spoke to the issue of funding, stating the funding and budget comes through the commissioners. Dr. Locke referred to the statutes and pointed out that each county has a governmental responsibility to fund mandatory public health services. Member Westerman expressed her view on city inclusion and feels there is a perception that city residents do not feel included, even though they come to the health department and access all of the services available. A Health District it is not a county or the city entity, it's about public health services and everybody that lives in the district. Member Masci noted that we should not approach this as out - sourcing another governmental function for the convenience of the budget, but rather because it's the right thing to do for residents and it's the right thing to do for public health of the entire county. We need to be clear about why we are doing this. We need to be prepared with facts and the reality that this is for everybody and that everybody will be served equally. Member Masci moved to move forward with the feasibility study of becoming a health district. Member Johnson seconded the motion, which carried by unanimous vote. Jean Baldwin asked for volunteers to work on the next step. Members Westerman, Masci, Sullivan and Frissell volunteered. Public Health Emergency Preparedness Funding Cuts Federal funding received by local health departments for emergency preparedness fell 20% last year and will decrease again next year by another 20 %. We have argued that to improve and sustain emergency preparedness capacity would take a long term investment. The political reality is that as the years have passed, funding for this has become less of a priority and it now appears that we have passed the peak of funding. With federal funding came a broad and detailed list of deliverables that were not fully covered by federal funding. In most cases existing staff were used to complete deliverables and most of the staff came from communicable disease control. Dr. Locke referred to the NAACHO Executive Summary findings showing that only 19% of LHDs feel that they are now highly prepared for an emergency with 77% feeling that although they have made improvements, more improvement is needed. Dr. Locke says that with Jefferson County Board of Health, September 20, 2007 Page 3 of 7 regional funding of $25,000 we were not going to purchase a lot of real emergency capacity. We have put almost all of it into building linkages and increasing staff training in preparedness and communications technology. Jean Baldwin feels that we have made strides in preparedness but notes there is room for growth and that building partnerships has been one of the best investments. 2008 Jefferson County Public Health Budget: Impact on Programs and Staffing Veronica Morris - Nakano, Chief Operations Director, gave an overview of the proposed 2008 Budget for JCPH. Veronica commented that the 2008 Budget reflects the addition of a new Public Health Nurse and an Environmental Health Specialist. She stated that there are unutilized grant dollars because of the level of staffing which also impacts our administration. There have been changes since the draft was produced. John Fischbach and Allen Sartin made some changes in the amount requested from the general fund. They have removed some funding for the public health nurses and the drinking water program. Jean Baldwin reminded the board about the performance measures stating that they are clearly tied to the budget. They are also tied to deliverables. Veronica explained one problem with the current funding formula. JCPH currently receives Substance Abuse Prevention contributions from the County and the City. The County's contribution has remained flat at $28,000 - $33,000 over the last 10 -15 years. JCPH has proposed that the county contribute to Substance Abuse Prevention using the same formula as the city, which would provide an increase ofl$ 15,000 - $16,000. 6e_+we_e-" Dr. Locke stated that the budget is a County Commissioner responsibility but the impact of the budget ultimately reflects what we can or can't do as a health jurisdiction and that impacts the responsibilities of the Board of Health Another principle concern discussed was the increase in facilities cost. Member Masci raised the question of the disproportionate square footage rate between DCD, Public Works and JCPH and asked if the county used a base square footage charge levied across all departments. Veronica Morris - Nakano responded stating that the explanation she received was that the rate is not based on square footage. It is based on actual cost. At the end of the year totals are run to see how much time IT and maintenance staff spend in each facility. The totals are based on a cost analysis in 2005 for the 2007 budget. Veronica questioned whether it was reasonable for Public Works, who is as large a department as JCPH, to incur a charge of $10,893 when JCPH is being charged $80,943. Member Masci stated that it seemed that JCPH was being penalized for finding other sources of revenue, which alleviates the burden from the county. Member Masci suggested a more viable formula to determine facilities cost and would reward departments for bringing in outside revenue and allocate an overhead charge into those dollar amounts and defray facility costs. Jefferson County Board of Health, September 20, 2007 Page 4 of 7 West Nile Virus Update: State Emergency Funding and Local GIS Data Dr. Locke talked briefly about West Nile Virus noting that we have not seen any positive human cases or mosquito pools that have tested positive for WNV. There have been 7 horses confirmed with WNV in the Yakima area. There are some isolated cases of infected birds. The new additions to the WNV plans this year is commitment of state funding if certain conditions are met: • Declaration of an emergency • Local capacity to contract with a company to conduct effective mosquito control • Demonstrated presence of the disease and serious threat to human populations • DOH evaluation that the proposed emergency mosquito control is deemed appropriate in ensuring public safety Also noted was the mapping and location of mosquito trapping in Jefferson County. Pipiens and Tarsalis mosquitoes, both potential WNV vectors, were identified but no samples tested positive for the virus. 2007 Shoreline Survey Member Sullivan shared the Department of Health 2007 Shoreline Survey with the Board. During August 2007, DOH conducted an evaluation of the shoreline and upland conditions along 9 marine miles in the Port Townsend Bay shell fish growing area. The evaluation was completed as part of a routine re- evaluation of the commercial shellfish growing area. The report stated that there were numerous potential sources of pollution identified along the shoreline of approved growing area and within unclassified portions that may be classified for commercial /recreational harvest. With the exception of the area near the northern -most tip of Indian Island and the eastern shoreline of Marrowstone Island, the public beach around Fort Flagler State Park can be approved for commercial /recreational shellfish harvest. Clean Water District Update Member Sullivan informed the Board that the public hearing for the formation of a Clean Water District, scheduled for September 26th, will have to be rescheduled due conflicting appointments. The public meeting will open but there will be a request for a continuance. There were specific concerns discussed regarding different funding sources, including contract match dollars, property tax or a new parcel tax. Mike McNickle reminded the Board that we were under a deadline from a state requirement to form a Shellfish Protection District. Mike stated that he talked to DOH about Mats Mats Bay and explained that the reason that it's conditionally approved for shellfish is because of the boating population in the summer months and the concern about marine waste. Mike reminded the Board that the results from the data were samples collected in the winter months. Sampling is not done in the summer months when ambient water quality improves due to reduced surface runoff. The next round of sampling will include six samples taken over the next year. Mike also noted that Dosewallip tidelands are not only affected by the elk heard but also by a failing septic system in the park that has yet to be repaired. Jefferson County Board of Health, September 20, 2007 Page 5 of 7 Member Austin discussed the parcel tax and the difficulty in communicating its rationale to the public. Mike replied that the original draft of the Clean Water District was written with options for multiple parcel discounts and senior discounts making it more equitable. Due to cost analysis, this was not feasible. None ACTIVITY UPDATE AGENDA PLANNING November 15th BOH meeting schedule conflict. Will discuss at October 18th meeting. John Barth - Substance Abuse discussion Member Westerman moved to adjourn the meeting. Member Sullivan seconded the motion, which carried by unanimous vote. Meeting was adjourned at 4:35 p.m. Next Board of Health meeting is October 18, 2007 Jefferson County Board of Health, September 20, 2007 Page 6 of 7 JEFFERSON COUNTY BOARD OF HEALTH Roberta Frissell, Chair John stin, Vice Chair David Sullivan, Member a n, Member Sheila Westerman, Member Unavailable for signature Geoff Masci, Member Excused Jill Buhler, Member Jefferson County Board of Health, September 20, 2007 Page 7 of 7