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