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HomeMy WebLinkAboutM091808JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, Sept 18, 2008 2:30 PM — 4:30 PM Court House, First Floor Conference Room, Port Townsend Board Members Staff Members Phil Johnson, County Commissioner District #1 Thomas Locke, MD, Health Officer David Sullivan, County Commissioner, District #2 Jean Baldwin, Public Health Services Director John Austin, Chair, County Commissioner, District #3 Andrew Shogren, Environmental Health Director Chuck Russell, Hospital Commissioner, District #2 Julia Danskin, Nursing Services Director Michelle Sandoval, Port Townsend City Council Sheila Westerman, vice Chair, Citizen at large (City) Roberta Frissell, Citizen at large (County) Chair John Austin called the meeting of the Jefferson County Board of Health to order at 2:30 PM in the First Floor Conference Room of the Jefferson County Court House, Port Townsend, WA. Members Present: John Austin, Roberta Frissell, Phil Johnson, Chuck Russell, David Sullivan, Sheila Westerman Members Absent: Michelle Sandoval Guests Present: Frances Joswick, Substance Abuse Advisory Board Staff Present: Jean Baldwin, Dr. Thomas Locke, Andrew Shogren, A quorum was present. APPROVAL OF AGENDA Roberta Frissell moved to approve the agenda and Chuck Russell seconded. The agenda was unanimously approved, as written. APPROVAL OF MINUTES Dr. Locke said that approval of the June 12 minutes had been deferred until information could be obtained from Mr. Andy Brastad. He read the updated information aloud: "Mr. Brastad stated that Clallam County spent approximately $50,000 the first year on facilitation and stakeholder group in development of the O & M Plan. The $50,000 was part of an approximately $100,000 grant from the Department of Ecology." Sheila Westerman moved to approve the June 12, 2008 minutes, as amended. The motion was seconded by Roberta Frissell, and approved by unanimous vote. Page] of 8 September 18, 2008 Sheila Westerman moved to approve the minutes of August 21, 2008, as submitted. The motion was seconded by Phil Johnson, and approved by unanimous vote. There were no public comments. PUBLIC COMMENTS OLD BUSINESS Quilcene Bay Oyster Harvest Closed Due to Vibriosis Risk Dr. Locke stated that Vibriosis risk is becoming an annual occurrence in Hood Canal and other areas of Puget Sound. The Vibrio organism tends to proliferate in warm weather, particularly in shallow tidal areas. Ingestion of infected oysters can cause serious human illness including diarrhea, intestinal cramps, vomiting, and fever. Skin rashes and skin infection can also occur from wading or swimming in water where Vibrio is present. Dr. Locke said that the State of Washington has enhanced its monitoring, testing and shellfish closure procedures in recent years. Dr. Locke said he knew of at least one case of intestinal infection and one skin infection have occurred in Jefferson County this season. DOE water samples/cultures are showing increased Vibrio levels, as well. Case counts are compiled at the end of the season. West Nile Virus Activity in Washington State Dr. Locke reported that there have been almost 50 positive mosquito pools, 14 horses, and numerous birds carrying the virus found in Eastern Washington. One human case was discovered in a blood donor. Jean Baldwin said that earlier in the day there was also one reported case from Seattle and one from Yakima. The Seattle individual had traveled extensively in Eastern Washington. Dr. Locke said there appears to be increasing activity in Eastern Washington, and the season typically lasts through the end of October, i.e. until the first hard freeze. He noted that there are many variables, but thus far Washington State has had some of the lowest West Nile activity in the continental US. Chair Austin asked if blood centers typically test for West Nile virus. Dr. Locke said that they do. About 80% of carriers do not know they have the virus; potential blood donors can pass it on without knowing they have it. He said there had been at least a dozen cases of West Nile inadvertently passed on to others through blood transfusions before screening was employed. Implementation of E -Onsite in Jefferson County and Homeowner Inspections in Clallam County — Follow Up Report Andrew Shogren, Environmental Health Director, introduced Angela Pieratt, Environmental Health Specialist. He said that this presentation would include a follow up to the presentation by Andrew Brastad's June report on Clallam County Homeowner Inspections. Ms. Pieratt stepped through a slide presentation on Clallam County's code revisions, their homeowner pilot project, O & M implementation and training. Page 2 of 8 September 18, 2008 Clallam adopted the revised code on August 19, 2008. She pointed out highlights of their code: new Homeowner Program; new Professional O & M program; Inspection at time of sale; and new Inspection for Land Use/Building Permit. Homeowner Pilot Project — Before the code was adopted, homeowner trainings and classes were held. The 8.5 hour one day class was free to participants; 120 spaces were available. Funding was provided by a grant from the Washington State Department of Health. The total cost, which included administration, staffing and provider fees, is estimated at about $200 per participant. Training was for conventional, permitted, gravity systems only. The provider is WOSSA, Washington Onsite Sewer Association. WOSSA supplied the original estimate for Jefferson County homeowner classes. Staff members who attended the class in Clallam County said the class was very well done, which was also reflected in high ratings based on evaluation forms. Ms. Pieratt noted, however, that thus far relatively few inspection reports have been received from participants. Member Westerman questioned whether there was information indicating that such as class could be done at a lesser cost. Staff indicated that it may be possible to shorten the class to 5 hours. Much of the time was devoted to safety and very basic information about septic systems. Clallam future plans for the class are uncertain at this point. O & M Implementation — Clallam County does not plan to implement enforcement until the entire program is up and running. Although the Homeowner program is limited to systems under a certain size, the number of inspections per person is not limited. Electronic submittal of inspection reports (E -Onsite) is available. A fee structure has yet to be determined. Future Homeowner Trainings — Education and training will be required. Training and testing must be approved by the Health Officer, and will be offered if grant funding is available. There was mention of a special program that will be offered in December for septic systems of special concern that is separately grant funded. They are presently focusing on conventional and pressure system types, and will issue an RFP for training and materials. In the case of systems in Marine Recovery Areas or unpermitted systems, initial inspection must be done by a professional. Building/land use activities require inspection by a licensed designer. Member Westerman asked for clarification on the process and expectations regarding submission of the reports by the participants in the pilot. Dr. Locke said that participants had signed an agreement to submit reports electronically, and that input was essential to the evaluation of the training and program. There was a brief discussion about State deadlines. Jean Baldwin stated that the effective date for the new state O & M mandates was July of 207. Ms. Pieratt then described the work that had been done on the Jefferson County database and website application enhancements via recent grant funding. Permits dating back to 1974 - 2004 have been scanned and made accessible in a database. More recent permits, as well as those from 1970 - 1974 will also be entered. Tidemark is the permit database that is used by the Health Department and Public Works. eOnsite.net is an internet driven database system that has been designed and developed to support local health jurisdictions. She walked through a series of screens and functions that are used by staff for reference, for permit processing, as well as for Page 3 of 8 September 18, 2008 professionals (and possibly homeowners) to submit inspection reports online. The public can access parcel and permit information, etc. Eventually, there will be convenient linkage among the three websites employed: www.co.jefferson.wa.us ; www.jeffersoncountypublichealth.org; and eonsite.net. The number of cases in the database is about 8,000 out of about 11,000 known septic systems in the County. Breast and Cervical Health Program "Girls Night Out" Fundraiser Julia Danskin described this fundraiser scheduled for October 2 that is sponsored by Jefferson Healthcare Home Health and Hospice, the Port Townsend Wedding Guild and Wedding Show and other Main Street Project participating merchants. Proceeds go to the Jefferson County Health Breast and Cervical Health program. In 2007, over $3,300 was raised. The program offers health exams, pap smears and mammograms to low income women ages 40 to 64 with limited or no health insurance. Approximately 100 - 110 women are served by this program per year. Ms. Danskin said that funding is also received from King County and the State. This additional funding is used to ensure that there is no waiting list. For those who may not be eligible for free services, referrals to other providers are given. The coverage includes those with incomes up to 150% of the federal poverty level. Anyone diagnosed with either cervical or breast cancer through this program can get on full medical assistance through Washington State. This year the mobile mammogram from Swedish Hospital will be brought to Quilcene. Several BOH members affirmed that this is a great program and enjoyable community event. NEW BUSINESS National Alcohol Abuse And Recovery Month Kelly Matlock, Health Educator, said that the Substance Abuse Advisory Board, Jefferson Community Networks, and Jefferson County Public Health had partnered this year to promote September as National Alcohol Abuse and Recovery Month. A series of awareness articles were written and published by the Leader. The Substance Abuse Advisory Board (SAAB) has also placed a referral information ad in the Leader. Ms. Matlock also presented written information on methamphetamine treatment services, including copies of a brochure and special cards listing resources and telephone numbers, which are being distributed throughout the County. The intention of the cards is to urge people to call for support, for themselves or someone else. In addition, the methamphetamine white paper has been published, and is now available on the web site. Hard copies are also available. Jean Baldwin noted that the two year methamphetamine treatment funds are from the Office of Financial Management, provided to counties who adopted the one tenth of one percent provision. Frances Joswick added that the SAAB has approved implementation of a relapse prevention program for the County Jail. It is expected to begin on October 1. The recidivism rate for Page 4 of 8 September 18, 2008 Jefferson County is about 70%, one of the highest in the State. The SAAB has decided to initiate different types of intervention, and this program was considered to be the easiest, as well as doable without special grant funding. The jail has hired Patricia Wiggins, a nurse with considerable relevant experience, for 20 hours per week. Many inmates, having experienced relapses several times, had requested such a program. There will be two educational gender specific classes per week, provided by Safe Harbor at no cost. A third session will be a 12 -step meeting to help participants get involved with the 12 step community, which is well established and has many experienced members. Lack of a structured program is considered to be a major factor for those who relapse. The goal is to reduce the recidivism rate, possibly to 60-62% by October 2009. There was a brief discussion about the need to track the budget process to ensure that monies for programs do not fall away. Commissioner Sullivan requested that the BOCC should be kept apprised of funding status so that they can provide support as needed. Ms. Joswick noted that it is important to spread community awareness of the startling statistics about drug and alcohol abuse locally. To that end, Ann Winegar is developing a PowerPoint presentation. The SAAB welcomes help in reaching various community groups about this serious problem. Members Sullivan and Johnson moved and seconded that staff should send a letter to legislators regarding the need for continued funding. The motion was unanimously approved. Shell Fish and Discovery Bay Water Quality Update Andrew Shogren said that a letter from the State Department of Health had proposed the upgrade of Discovery Bay from Restricted to Approved. Neil Harrington, Water Quality Manager, walked through a slide presentation explaining the background, reasons for the upgrade and discussed related issues, including shellfish economics and safety. The portion of Discovery Bay that was downgraded early in 2007 has recently been proposed for upgrade to Approved; that order should become final on October 14. Mr. Harrington pointed out the 50 acre area on the map and explained the two conditions for upgrading. The area needs to meet water quality standards for growing commercial shellfish, and pollution sources need to be sought out and, if found, corrected. He showed where Snow Creek and Salmon Creek flow near the station. He explained the two part standard and sampling requirements. The area (Station 48) had failed the standard estimated at the 90" percentile in late 2006. For the last 18 months, however, the FC (Fecal Coliform) level has been sufficiently low to again meet the standard. Mr. Harrington retraced the history including the convening of a closure response group (DOH, Conservation District and JCPH as lead agency) and the development of a Closure Response Plan. Actions taken included: water quality monitoring of the Salmon and Snow Creek watersheds; implementation of agricultural best management practices; shoreline surveys; and door to door sanitary surveys to talk to residents about their septic systems. Page 5 of 8 September 18, 2008 He said they found no major sources in terms of re -samples from shorelines and small streams. There were several corrections and repairs for septic systems where problems, potential problems or failure to meet code were identified. Certain stations on Salmon and Snow Creeks still do not meet the freshwater standards. Continuing work is to show where best management practices could make a difference. Also continuing are shoreline surveys to sample small drainages to catch any seepages that may occur. Other areas of concern - Mr. Harrington said that a Centennial Grant was recently received to address threatened Mats Mats Bay water quality, where either septics, boats or possibly wildlife are suspected. Mr. Harrington also noted high readings in the area of Hood Canal #3 in the Duckabush delta, which is a shellfish growing area. Mystery Bay is also on the threatened list due to boat moorage. The standards do not allow shellfish to be grown in a marina. In this case, there is a question as to whether or not this should be classified as a marina; the number of actual "live aboards" is not known. However, samples continue to be clean. He pointed out that the water quality sampling method is intended to detect chronic pollution problems, not episodic events. Paralytic Shellfish Poisoning — Mr. Harrington said that the Health Department, with the help of seven volunteers, submits shellfish samples to the DOH every two weeks during the growing season. Results are known in 24 hours, and signs posted immediately if appropriate. He said the process has been very effective and there has only been one case of illness in the last few years, which was caused by eating butter clams from a beach in Kitsap. Regarding closures, there was a very fast bloom in Kilisut Harbor, which led to recall of commercial shellfish product. There have also been blooms in Mystery Bay, Port Ludlow, Discovery Bay, and Port Townsend Bay, and these areas have been closed. There have also been closures for Vibriosis in Quilcene Bay due to several confirmed cases in commercial product. He noted the need for education and tight procedures, i.e. cold temperatures, all the way from harvest site to consumption. Economic Impact — Statistics for Jefferson County (2006) were reviewed: 15 million pounds of shellfish harvested each year; . Estimated $22 million in gross sales/year (including hatcheries); . 17-20% of production for Washington State; . Third most productive county in Washington; . Two largest shellfish hatcheries in North America; . Impact of V. tubiasi; affects larvae development; . Possible implications of low dissolved oxygen and increased acidity; . Tribal harvest is estimated at about 283,000 pound of clams and geoducks and 2.9 million oysters; . 77 jobs generated in the County. Recreational harvest is estimated at 74,000 pounds of clams, 111,000 pounds of oysters; 30, 324 harvester -days. Page 6 of 8 September 18, 2008 Mr. Harrington displayed a map showing the numerous locations throughout the county that are approved for shellfish harvesting in Jefferson County, and which must be monitored to control health threats. Public Health Funding Resolutions — Washington State Medical Association and Draft Jefferson County Board of Health Dr. Locke reviewed the background to the funding resolutions, which address the issue of providing adequate, stable and dedicated long term funding for local public health statewide. He said that at the urging of Public Health leaders statewide the legislature had created the Joint Select Committee on Public Health Funding and had made recommendations last year, which were not acted upon. During recent years, a number of large health departments have been spending down reserves in anticipation of enhanced statewide funding. Since the easy budget reductions had already been made, important core public health programs are now being eliminated. An attempt is now being made to return to the legislature, with support from existing partners such as the State Medical Association and local Boards of Health. Dr. Locke said that the outcome is not at all certain. In some counties, lay offs may occur before the legislature is in session to consider the requests. Jean Baldwin added that in some cases, such as King County, the notion of taxing districts is also now on the table for discussion. She mentioned the types of cut backs that are occurring in several large counties. Member Westerman said she was discouraged by the lack of new ideas for addressing this problem statewide. She mentioned past experience with the motor vehicle excise tax, and suggested that something similar, targeted only for public health, is needed again. Dr. Locke said that there has been much discussion about specific taxes and junior taxing districts, which all have problems. He said that the favorite proposal seems to be a "sin tax" on alcohol and tobacco, but the legislature had not placed sufficient priority on this whole issue. There was a brief discussion about strategies and possible eventual outcomes. Jean Baldwin noted the lack of a statewide solution, and the chances of survival and transition to taxing districts by the larger counties. Sheila Westerman moved that the BOH sign and send the draft BOH Resolution. The motion was seconded by Roberta Frissell, and approved unanimously. ACTIVITY UPDATE Jean Baldwin reported that staff is working on the idea from the previous meeting regarding acquisition of birth certificate copies for low income families. This item will be on a future agenda. A Substance Abuse Advisory Board presentation will be scheduled for the October meeting. Homeowner septic systems discussion will be scheduled for November. Page 7 of 8 September 18, 2008 Jean Baldwin is continuing to seek information on the Pierce County Preventative Therapeutic Court model. ADJOURNMENT Phil Johnson moved to adjourn and Chuck Russell seconded. Chair Austin adjourned the meeting at 4:40 PM. JEFFERSON COUNTY BOARD OF HEALTH Jo ustin, Ch it Roberta Frissell, Member Phil Johnson, Member Absent Michelle Sandoval, Member Sheila este an Vice Chair Chuck Russell, Member David Sullivan, Member Page 8 of 8 September 18, 2008