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HomeMy WebLinkAboutM041510V .. JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, April 15, 2010 2:30 PM — 4:30 PM Mountain View Commons, Conference Room, 1925 Blaine Street, Port Townsend, WA 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, County Commissioner, District #3 Julia Danskin, Nursing Services Director Kristen Nelson, Vice Chair, Port Townsend City Council Sheila Westerman, Chair, Citizen at large (City) Chuck Russell, Chair, Hospital Commissioner, District #2 Roberta Frissell, Citizen at large (County) Chair Chuck Russell called the meeting of the Jefferson County Board of Health to order at 2:37 PM. A quorum was present. Members Present: John Austin, Phil Johnson, Kristen Nelson, Chuck Russell, David Sullivan, Sheila Westerman Members Excused: Roberta Frissell Staff Present: Dr. Thomas Locke, Jean Baldwin, Julia Danskin, Veronica Shaw APPROVAL OF AGENDA Member Nelson moved and Member Westerman seconded for approval of the agenda. The agenda was approved unanimously, as written. APPROVAL OF MINUTES Member Austin moved for approval of the March 18, 21010 BOH meeting minutes; Member Nelson seconded. The minutes of March 18, 2010 were approved unanimously. PUBLIC COMMENTS (None) NEW BUSINESS 2010 Public Health Heroes Awards Jean Baldwin introduced Julia Danskin and Lisa McKenzie, and provided a brief history and background information on the Public Health Heroes Awards. The awards recognize community members whose efforts positively impact the health of the community. She noted that in keeping with the 2009 annual theme of the national American Public Health Association, "One Community at a Time", the Jefferson County BOH had decided to recognize those involved in H1NI planning and prevention, which was of significance to the whole community. She provided a brief overview of the BOH, their role and responsibility within the community and explained where the Health Department and other providers/agencies fit into the overall health care system. BOH members and Dr. Locke introduced themselves and their individual roles on the BOH. Member Westerman noted that Roberta Frissell, who could not attend, represents the citizens of Jefferson County. Ms. Baldwin noted that the HINT preparation and response required the support of the entire community, and that a great deal had been learned in that process. She expressed her appreciation that, despite the complexity and compressed time frame, the overall outcome had been so successful. Julia Danskin described the H 1N l education/awareness efforts that had been made beginning in the spring of 2009. She said she and other staff had visited tens of community sites, schools and organizations to discuss H1N1 preparation, prevention and protocols, as information evolved, as well as having provided training to providers and other health care professionals. Jean Baldwin noted that she and Dr. Locke had also worked with school superintendents and principals regarding tracking/reporting of absenteeism and virus transmission prevention. Lisa McKenzie discussed surveillance and epidemiology. She noted that at least 10 different guidance updates from national and state centers had to be shared with providers and agencies over the period of the pandemic. This related to who, when and how suspected cases should be tested. The Jefferson Health Care lab was extremely busy with rapid flu testing, and with weekly reporting on positive tests for types A and B. For example, in October there were 178 of these lab tests. Schools reported whenever the absentee rate exceeded 10%. There were 5 different updates to guidelines for hospitalization case reporting, which mainly affected Jefferson Health Care. In addition, Ms. McKenzie noted that the anti-viral treatment guidelines had changed many times and had been disseminated rapidly to providers. Ms. McKenzie also reviewed the federal vaccine requirements for contracts and reporting. Jefferson County coordinated signing of 13 different contracts among providers, pharmacies, the hospital and Kah Tai Care Center. She described how vaccination plans had to be periodically adjusted because of delays and shifts in the types and amounts of vaccine received. Clinics had to stay abreast of shifting target groups and vaccine target groups, as well as communicate with concerned patients about those changes. She said that considering the lack of control over many factors, the response worked out very well. By February, over 6000 doses had been administered throughout the County. Jean Baldwin then asked those representatives present to receive awards to introduce themselves and their organization. Dr. Locke noted that planning for an influenza pandemic had been underway for over 5 years, beginning with the first warnings that H5N1 Avianflu had the potential to become the first pandemic of the 21" century. Unexpectedly, H 1 N 1 suddenly came into the picture in April of 2009. He noted that, fortunately, the elderly were not as susceptible as the general population; that there was not panic among the population; and that that there was time for planning and vaccine production. Although illness from HIN1 was relatively mild for most people, there were at least 12,000 deaths and over 200,000 hospitalizations nationally. He said that this is not likely to be the only pandemic of the 21St century, and that there is no guarantee that the next occurrence will be as mild. It is necessary to pay close attention and improve upon any aspects of prevention/response that did not work well. Jean Baldwin expressed her appreciation to all those involved. She mentioned surveys that had been sent out to providers etc. to collect feedback and suggestions for improvement. She said the responses affirmed that there had been good teamwork and communication, despite challenges and constrained resources. BOH member Westerman said she was thankful that this pandemic did not necessitate quarantine; she acknowledged that much more work would be needed to prepare adequately for such a situation. Member Austin added that Jefferson is a relatively small, isolated county, which increases the need for the community to work together in these types of emergencies. He expressed his thanks for all that everyone had accomplished. Chair Russell said he was particularly proud of how well everyone had responded to rapidly changing demands and circumstances and expressed his appreciation to all. Member Nelson said she was impressed with the number of individuals and agencies involved and with the breadth and depth of participation in this community wide issue. Member Sullivan noted the ever increasing challenges to each of our systems and the demonstration of our ability to meet these challenges by working together. Member Johnson said that, in addition to all that had been said, he simply wished to thank all the Health Heroes. Julia Danskin then acknowledged each of the particular individual contributions and presented each representative with a Health Heroes certificate. BOH member Sullivan presented Jefferson County Public Health with their certificate. Group photographs were taken following the awards. "Our Kids, Our Business" JCPH roles Kelly Matlock presented information on the Our Kids, Our Business program. Written packets containing the history of the program, participants, highlights for the preceding years, event announcements, call to action and pledge statement were distributed. This is the third year for the Our Kids, Our Business Campaign. April is national Child Abuse Prevention and Sexual Assault Awareness month. The Health Department partners with the Jefferson County Community Network to develop this program. The campaign has several integral parts. Each year, the BOCC and Port Townsend City Council proclaim April as Child Abuse Prevention Month. There is a call to action to community members to take at least one intentional action within the year to make Jefferson County a safer and more nurturing place and to sign a pledge. There are trainings and educational events around related to child abuse and its prevention, and celebrations of existing services and agencies in this regard. Ms. Matlock briefly described the role of businesses, organizations, schools and the media in this campaign. She pointed out two events in particular. The PTHS Student Task Force is putting on a Town Hall meeting about alcohol/substance abuse, which is made possible by a small grant from SAMHSA (Substance Abuse and Mental Health Services Administration). A Food Coop event celebrates the resources and services that are available for kids. BOH members were invited to sign pledge statements and to attend both events. Jean Baldwin mentioned that the Health Department has recently placed a food collection bin in the department; all are invited to participate in making food donations to local food banks. Chair Russell added that Valley Tavern has donated more than 1.5 tons of food in the past year. Member Nelson offered to bring copies of documents and Our Kids Our Business promotional items to the next City Council meeting. Public Records Requests Veronica Shaw reported to the BOH on the process and activity of Public Records requests. She and Cathy Avery have recently attended two training sessions related to this function. Veronica said there been enhancements made to the County's records system over time. Although one of the training sessions addressed electronic records systems, she said that the County is not yet ready to implement a fully electronic records system. Veronica referred to the packet document entitled "What are Public Records?" She wrote this policy document to assist staff in understanding the definition of public record and what constitutes a public record. The document is based on input from David Alvarez and the State's Public Records Act. It is part of the Procedures Manual and the orientation materials for all new employees. Jean Baldwin noted that Health Department policies and procedures are accessible only to departmental personnel, are less formal than County personnel procedures and are frequently updated. She affirmed that this policy has been checked for consistency with the County's "Record Access Policy". The second document, prepared for the BOH, is a summary of the procedure followed for processing a request for Public Records. The third document is the actual procedure from the Procedures Manual. There was a brief discussion about the need for employees to recognize and follow through on all requests, even those received orally and/or outside the office. Veronica Shaw noted that the departmental process is very effective, but expensive in terms of staff time. To date in 2010, more than 200 hours have been spent on Health Department public record requests; program codes are used to track the time. She noted that a multi- step process is usually needed to first list the range of possible documents that the requestor desires and then to work with them to identify the small subset actually needed. For example, a recent request was successfully narrowed down to 2 documents from an initial possible list of over 600 e-mails. Jean Baldwin noted that when individuals wish to debate/question County policy or decisions in connection with a records request, she invites them to make public comment during a BOH or BOCC meeting. Mystery Bay Shellfish Growing Area Now Approved Neil Harrington provided an update on the Mystery Bay shellfish growing area. He reported on the recent reclassification by the State Department of Health of the Mystery Bay shellfish growing area from Conditionally Approved back to Approved, as it was classified prior to August 2009. A letter from the State Department of Health outlining this action dated March 25, 2010 is included in the packet. Mr. Harrington also distributed copies of maps and the Executive Summary from the newly developed Management Plan. In the spring of 2009, the Department of Health closed the outer portion of Mystery Bay to shellfish harvesting. The primary issue was that the number of boats moored there caused it to be considered a marina, where shellfish harvesting is prohibited by the National Shellfish Sanitation standards. This led to a conditional closing; it was not based on water quality testing. In response, a large ad-hoc group of stakeholders including local Tribes, shellfish growers, DNR, Jefferson County DCD and Health Department, Marine Resources Committee, Army Corps of Engineers, Marrowstone residents, and the National Northwest Fisheries Commission was brought together under the Governor's Office of Regulatory Assistance (ORA) as facilitator. Mr. Harrington explained that the ORA assists businesses in navigating the regulatory environment of Washington State. One outcome was the development of a management plan. Under that plan, DCD has adjusted its permitting process; implementation of the updated SMP ordinance will also help to limit the number of mooring permits. Illegally moored boats and buoys are being removed by DNR and Jefferson County. Mooring buoys require permission from the Army Corps of Engineers, a DFW hydraulic permit to work in the aquatic environment, a building (shoreline) permit from DCD and permission from DNR to anchor into the bedlands of the Bay. The State Department of Health is allowing certain mooring buoys and boats located along owners' shoreline properties (approximately 20) to be exempt from the boat counts in the Bay and marina, provided that owners sign an affidavit regarding proper waste discharge. This is the first instance of such an arrangement in this State. Member Sullivan noted that there is a great deal of monitoring and scrutiny at this time, with property owners participating in that. Mr. Harrington showed an aerial view diagram/inventory of all the objects (boats, buoys, etc.) in the Bay and pointed out the marina, State Park and outer bay areas. Along with this plan, there will be a voluntary no -anchor zone established, based on the Port Townsend eel grass zone model, with transitory boats directed to the State Park area. This will be implemented by the Marine Resources Committee via a grant from the Northwest Straits Commission for marker buoys, signage and education/outreach. There is potential for this multi-party collaborative endeavor and process to become the model for other areas in Puget Sound. The next step will be a memo of understanding stating that the Health Department has participated in this process and will exercise regulatory authority to further this plan. However, there is no new ordinance or regulatory change. Mr. Harrington noted that the State Department of Health will monitor the situation carefully and is likely to initiate further remedies if this solution does not continue to work as planned. Mr. Harrington announced that he will be leaving his position with the Jefferson County Health Department on April 17, but will be assisting with transitional matters beyond that date. BOH members thanked him for his years of service and wished him well in his future endeavors. Data Steering Committee Workgroup Report from Healthcare Access Group Jean Baldwin reviewed the composition and purpose of this workgroup. Participants include Vic Dirksen and Paula Dowdle from Jefferson HealthCare, Dr. Locke, Jean Baldwin, Julia Danskin, Sam Markowitz from Mental Health, and representatives from Olympic Area Agency on Aging, OlyCap, and Domestic Violence. The group meets informally to discuss mutual challenges and concerns, such as budget constraint impacts on programs and services. She mentioned that a new working group is being formed to address emergency mental health issues and access to mental health services. In the past, the Data Steering Committee had developed a series of priorities through a vetting process based on shared data. The Committee had then met with a group of about 30 community leaders to prioritize that list. She said that the Committee believes it is time to re-examine the data in order to understand what has shifted or changed in the community. Is there a homeless problem? Do the aged have sufficient resources and health care access, including mental health? Is there a hunger problem and how serious is it? Ms. Baldwin recommended a workgroup be formed to gather information and present reports under the authority of the BOH for prioritization and action. She said that the Hospital, the Health Department and other agencies have all expressed interest; an epidemiologist will also be involved. Ms. Baldwin said she plans to begin a gradual, long term process of updating the demographics and analyzing health risks. BOH members viewed preliminary statistical reports that are examples of the type of information to be examined in depth by the steering committee. In response to a question about cost, Ms. Baldwin said that, for the Health Department, the cost would be covered by the current budget. She said that she would shift focus from evaluating internal programs to better understanding community characteristics and needs. She invited BOH members or representatives from City Council or City staff to participate, or asked for suggestions on potential representatives from the community or other agencies. BOH members expressed their support for going forward with this workgroup. Legislative Update/Wrap Up The Special Legislative Session ended on Monday, April 12. Maternity Support appears to have survived expected cuts. Child care oversight services have been transferred from DSHS to the Department of Early Learning; details are not yet known. Jean Baldwin said that currently there is a nurse assigned to licensed child care centers for inspections and support of the staff of child care centers. It is also unclear what will happen with the child abuse prevention part of this program. The impacts of the DSHS reorganization are not yet known. A number of proposed Environmental Health related programs did not pass. Member Austin noted that in the future the State Board of Health will not pay for travel for Board members. As a consequence, most meetings will be held via teleconferencing. NEW BUSINESS Green Business Award: Wandering Wardrobe Wandering Wardrobe, 936 Washington Street, Port Townsend has earned Green Business certification. A copy of the notification letter from Lori Clark is included in the packet. Letter to Senator Hargrove re: Immunizations Waiver A letter to Senator Hargrove from Dr. Locke regarding the immunizations waiver bill, approved by the BOH at the March meeting, was sent; a copy is included in the packet. Dr. Locke said that there has been no response as yet, and that he would check on the outcome of this bill before the next meeting. Newsletter: Hood Canal update on projects A copy of the Spring 2010 Jefferson County Water Quality Newsletter was included in the packet. ACTVITY UPDATE The Health Department is in the process of interviewing candidates for the Environmental Health Director position. AGENDA PLANNING CALENDAR The next BOH meeting is scheduled for May 20, 2010 in the Health Department Conference Room. There was a brief discussion about the June meeting, which had been previously rescheduled to June 10, 2010. Jean Baldwin will verify that the change of date has been property publicized. ADJOURNMENT Chair Russell adjourned the meeting at 4:30 PM. JEFF SON COU auc'kssell, Chair BOARD OF HEALTH W�k Kristen QNeson, Vice -Chair Excused Roberta Frissell, Member Sheila Westerman, Member f Phil Jo son, Member as Jo Austin, Member David Sull van, Member