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HomeMy WebLinkAboutM091610JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, September 16, 2010 2:30 PM — 4:30 PM Public Health Conference Room, 615 Sheridan Street, 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, County Commissioner, District #3 Julia Danskin, Nursing Services Director Kristen Nelson, Vice Chair, Port Townsend City Council Stuart Whitford, Environmental Services Director Sheila Westerman, 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 2:32 PM. A quorum was present. Members Present: John Austin, Roberta Frissell, Kristen Nelson, Chuck Russell, David Sullivan, Sheila Westerman Members Excused: Phil Johnson Staff Present: Dr. Thomas Locke, Jean Baldwin, Julia Danskin, Stuart Whitford Guests: Frances Joswick, SAAB APPROVAL OF AGENDA Member Westerman moved and Member Sullivan seconded for approval of the agenda. The agenda was approved unanimously, as written. APPROVAL OF MINUTES Member Sullivan moved for approval of the July 15, 2010 BOH meeting minutes, as written; Member Westerman seconded. The minutes of July 15, 2010 were approved unanimously, as written. PUBLIC COMMENTS Jean Baldwin introduced Americorps student, Dunia Faulx, a graduate student in Public Health, who will be working in the school based clinics for the next year. Page 1 of 9 OLD BUSINESS and INFORMATIONAL ITEMS Initiatives 1100 and 1105 — Public Health Impacts Julia Danskin referred to informational materials from the Voter's Guide for the two ballot initiatives concerning liquor sales. Liquor will be more available at various types of retail outlets in the community from 6:00 AM to 2:00 AM. The State will lose its current revenue from liquor sales, which now funds Drug and Alcohol prevention programs. Potential sales tax revenue is uncertain and may not fully replace the current revenue. Most of the current liquor excise tax proceeds for Jefferson County and the City of Port Townsend are used to fund prevention programs. The sales revenue generated goes to other services. It is unclear whether a portion of the revenue under the proposed plans would be allocated to the County/City. Jean Baldwin noted that enforcement under the new arrangement would become much more expensive. It is possible that any revenue generated would be needed to for enforcement to replace what is now derived from liquor store sales. Presently, the Health Department receives a bit less than $100,000 from the liquor excise tax, which is applied to Nurse Family Partnership and the school programs, i.e. community based substance abuse education. The critical issues for the BOH/Health Department are the potential loss of dependable revenue streams and the likelihood of an increased enforcement costs. Washington State Revenue Forecasts and Proposed Budget Cuts Jean Baldwin reported on a recent statement from the OFM (Office of Financial Management) which indicated that the economic status is still in decline and uncertain. She said that the Governor was expected to make a more definitive statement about further across the board budget cuts the following day; if/when there is clear information regarding impact to the Health Department and local programs, it will be e-mailed to the BOH. Virtually all applications of funds are constrained by federal mandates. Ms. Baldwin noted that numerous advocacy groups are mobilizing in anticipation of these possible budget adjustments. She mentioned that Take Charge, the funding stream for family planning, and maternity support funds may be in line for cuts as early as January, in addition to wider cuts effective in July 2011. State furloughs are also taking place. September 27 Tire Recycling Event Stuart Whitford provided information on the planned Tire Recycling Event at the Quilcene Transfer Station, which was organized by Margie Boyd. Volunteers are being sought to assist; the Sheriff's Department will be on site for traffic control. October Presentation — Port Townsend City Council Meeting Jean Baldwin noted that the next presentation, on October 18, will focus on Environmental Health's local source control program, which works with entities that generate toxic waste to Page 2 of 9 voluntarily adopt more effective models of recycling and reuse. She said that thus far there has been significant participation of businesses at the Port/Boat Haven. The presentation will also cover Nurse Family Partnership, particularly with regard to a national award and a national challenge to expand its work. Member Westerman noted that demographic information about the number of City and County residents benefiting from the program would be included. Clean Water District and Environmental Health Projects Stuart Whitford, Environmental Health Director, reviewed the presentation that had been made to the BOCC regarding the $1,000,000 EPA Clean Water District grant. Partners include, Jefferson County, Clallam County Environmental Health Services, Jefferson County Conservation District, Clallam Conservation District, and Puget Sound Partnership. In addition to water quality improvements, it will allow the County to implement a homeowner O & M training program. Another aspect of the program will be online electronic data availability for inspection records, permits, etc. Another project beginning later this year under a Centennial Clean Water grant provides for shoreline surveys higher in the watershed. Septic failures and animal waste problems will be identified and corrected. The contract for this project must be negotiated and completed this year. Mr. Whitford also mentioned existing projects in Mats Mats Bay, Discovery Bay and working with the Conservation District in Chimacum Basin, as well as supporting the WRIA 17 planning unit. In response to a question from Member Austin, Mr. Whitford indicated that the team would be able to make use of Clallam County's experience with the education/training components of O &M. There was a brief discussion about new 2011 requirements for small business drain fields. Chair Russell said that he believes the emphasis should be placed on correcting failed systems. Mr. Whitford noted that most property owners appreciate the value of regular monitoring and maintenance so as to avoid septic failures that are extremely expensive to resolve. BOH members also discussed the need to consider pending sewer system plans in certain locations. Member Sullivan briefly discussed WRIA -17 noting that that phase IV funding runs out in December. Mr. Whitford mentioned some planned shifts in staff assignments. Dana Fickeisen will return to Water Quality work and be replaced by a new hire in Food Services. Alison Petty will move from Water Quality to Solid Waste project work. He also reported that he has determined that two of three contracts with the Conservation District need to be updated/amended, including the amount of match required of the Conservation District; these contracts will need to be approved by the BOCC. Page 3 of 9 NEW BUSINESS Protocol for Response to Tobacco Complaints Karen Obermeyer of the Tobacco Prevention Program presented theXrocedure for tobacco complaints received by JCPH. She noted that Washington has the 3` lowest smoking rate (14.8%) in the USA; the combined rate for adults in Jefferson County over the last three years is 17.7%. Subsets of the population including pregnant women and lower education levels have higher smoking rates. The County ordinance and procedures are based on the State law prohibiting smoking in public places. The benefits are that employees have smoke-free workplaces and non-smokers are no longer exposed to indoor second hand smoke. Ms. Obermeyer cited a study showing that indoor pollution decreased by 88% in restaurants and bars since this initiative was implemented. It has also motivated people to quit smoking; smoking rates have been decreasing since the initiative was implemented. And, there has been no decrease in taxable revenue from restaurants and bars in this State since implementation of Initiative 901. There is a high compliance rate with the smoke free rules; there were only 18 complaints in Jefferson County during the last 12 months. Definitions: a "public place' is any portion of a building or vehicle used by or open to the public, regardless of ownership — this applies to all permitted places in Jefferson County as well as facilities such as the Library, and places of employment. The procedure, as outlined in the packet, is intended to be enforced with the people in charge of each business, location, or building, not the individuals who are smoking. Individuals who do not comply with requests from the businesses are to be dealt with by the police. A new regulation now covers bus stops. With this procedure, there are three main responsibilities. The person in charge must prohibit smoking indoors and within 25 feet of entrances, exits or opening windows/air vents; and they must post signs. Ms. Obermeyer said that she has not received complaints about indoor smoking; outdoor enforcement is the most challenging. Ms. Obermeyer walked through the steps of the "Jefferson County Clean Air Regulation Procedure", noting the flow of staff activities and information/education to be provided in response to complaints. There are a series of escalating consequences if complaints and violations continue after staff provides education and makes a site visit to seek a Voluntary Correction Agreement with the offending business or location. Actions/penalties range from assessed fee to notice of civil violation (NOCV) to suspension and then revocation of food establishment permit (upon the 5th violation). Jean Baldwin noted that the Ordinance was designed to be complaint based. Staff site visits are made only if triggered by complaints. There is limited funding for the Tobacco program that expires in July 2011. It was noted that potential expansion of no smoking regulations to apartment or other multi -unit housing situations would be burdensome to enforce without additional resources. Ms. Obermeyer Page 4 of 9 said that it is preferable to work with housing management to develop its own internal policies and procedures. She also informed the BOH that although Washington State expects to receive $700 million in 2011 from tobacco taxes and Master Settlement Agreements, but none of that revenue is directed toward the Tobacco Prevention program. As of July 2011, the Tobacco Prevention account will be zeroed out; there will be some funding from cigarette licensing for monitoring of sales and from the CDC for education. She also described several new tobacco products designed to appeal to children. In response to a question, Ms. Obermeyer estimated that the 18 complaints last year involved about 15 different sites; the number of repeat complaints is down significantly from the previous year. Member Westerman said that, in her experience, the public has become more supportive of no smoking regulations over time. Olympic Regional Tribal -Public Health Mutual Assistance Agreement — Mutual Aid Authority Resolution Dr. Locke recalled that he and David Alvarez had briefed the BOH about this project in July. The plan and project was finalized during a phone conference of all parties on September 14. In addition, there were a few minor language changes by the attorneys to the Mutual Aid Authority Resolution. He noted that the BOH resolution is needed because state and local public health laws do not apply on tribal lands or reservations. In the event where assistance would be needed, the Tribal governments would need to grant public health officials authority to help enforce existing public health laws in their jurisdictions. The agreement gives Health Officers and their designees the ability to make emergency decisions until the Board of Health can be convened to affirm or not affirm those decisions. Member Frissell pointed out one error in the document where the term Health District was used instead of Health Department; Dr. Locke said he would ensure that is corrected. Dr. Locke pointed out certain provisions of the agreement (under the third Whereas on page 1 and under item 4 on page 2) which, by not specifying arbitrary deadlines, allows for a reasonable timeline and reasonable notice. There was a follow up discussion about the flexibility permitted regarding status reports to the Board and there was some concern that the language in item 3 was unclear. Dr. Locke noted that attorneys for all parties had approved this language. He said that if he, the Health Officer, was unable to make a report every thirty days, he would bring that issue to the Board. He said that this document should be considered the starting point, with the ability of the BOH to make changes in any particular emergency. He said it was of primary importance to the attorneys that there be an official document that establishes the fact that the grant of authority is in effect between the Tribal Health jurisdiction and the Board of Health. Member Austin moved that the BOH authorize the Chair to sign Resolution 35-10. He accepted as a friendly amendment from Member Frissell the addition of "with the change of Health District to Health Department". The motion was seconded by Member Frissell and approved unanimously, as amended. Page 5 of 9 Jefferson County Budget Review Jean Baldwin referred to a series of bar charts in the packet and provided highlights of a few. She corrected one statement from the county budget meeting that had been made to the effect that the General Fund (GF) pays for all departments rent and IT (Information Technology). She pointed out that, the Health Department uses General Fund monies to pay the County for rent and IT. She said that the actual amounts are greater in 2011 than in 2010. Ms. Baldwin briefly mentioned other statistics: Of 7.9 people/FTEs in Administration, 1.98 FTEs are paid out of the General Fund. Of 8.44 FTEs in Environmental Health, only 1.4 is paid from the General Fund. Of 16.91 FTEs in Community Health, 2.5 are paid from the General Fund. For Developmental Disabilities, less than 1% is from the General Fund. Ms. Baldwin stressed that since Public Health differs from other departments in its revenue sources, and must be allowed to optimally maintain/reallocate its non -GF revenue streams. A Health Department budget has been submitted. Jean Baldwin said there was only one add for 2011 $5,000 for maintaining the lakes program. Statistics of web site use show that this is a priority interest for the public. Stuart Whitford briefly discussed the health hazards of blue green algae. He noted a case in California where Microcystin toxin from inland lakes found its way into shellfish and eventually harmed sea otters. This type of toxin bio -accumulation is not adequately monitored and tested by the State. Jean Baldwin noted the need for and expense of constant monitoring/posting of warning signs for Vibrio and other shellfish problems. In response to a question, Dr. Locke explained that for Anderson Lake, the primary concern is anatoxin, a potent neurotoxin. Microcystin is a hepatic toxin, which can cause liver failure in high doses; there is concern about the possible impact of chronic low- dose exposure as a risk factor for hepatic cirrhosis and liver cancer. Ms. Baldwin also mentioned deletions from the budget associated with Proposition 1. She said that Environmental Health is barely breaking even. However, with the help of a stimulus package grant for training other health departments to do billing, the Health Department has been able to submit a balanced budget that falls within the parameters specified. The final picture will depend on other federal, State, County and City budget adjustments. She said that the County and City will negotiate on substance abuse funding. She said that since there is no November BOH meeting, this topic will next be discussed at the December meeting. Summary of September 9, 2010 Data Steering Committee Jean Baldwin discussed the participation in and results of this meeting. In addition to staff, there was excellent attendance with 29 participants including the Port Townsend School Board, Hospital, Chamber of Commerce, Library, Mental Health, SAAB, many other agencies, and Roberta Frissell for the BOH. The meeting included an update of demographics and good discussion. The BOH packet materials include September 9 Page 6 of 9 meeting materials showing Committee goal, project activities, timeline and the demographic summaries. The next meeting will focus on Substance Abuse and Mental Health; it is scheduled for October 28, 3-5 PM in the Health Department Conference Room. Resources will include the Jail Survey, youth surveys, and other statistical summaries. Topics of future meetings include: Access to health care and community health (November); Death, birth, quality of life (February 2011); and Summary and prioritization (March 2011). Ms. Baldwin said she had received very positive feedback from those who attended the September 9 meeting, particularly regarding its usefulness for prioritizing resources and services. She said that the entire data packet will be mailed electronically after each meeting, and is also available on the web and in printed form. In response to a question, she clarified that the data is derived from a combination of cited sources — it is not only US Census data. She also noted that the BOH is the sponsoring body, and will be called upon for any decisions that need to be made. Member Frissell said she believed the four meeting format is an improvement over previous one -day events. Member Westerman requested that a list of attendees be provided to the BOH for each of the Data Steering Committee meetings. 2011-12 Fee Revision Timetable Jean Baldwin said that there would be revisions this year on food, immunizations, and family planning fees. She will bring a proposed draft to the BOH October meeting, with the expectation of obtaining the final BOH approval at the December meeting. Member Nelson recalled from an earlier presentation that the Food Program did not pay for itself, and expressed concern about that. Jean Baldwin explained that for a period of time the staffing/scheduling arrangement had been overly expensive, but that the situation had been corrected. She also mentioned a one-time software upgrade that contributed to the high cost in 2010. Member Westerman noted that in the past, the County General Fund had been heavily subsidizing many departments and services. She explained that several years ago, after a lengthy public process, the BOH and the Department of Public Health had begun a gradual process of aligning fees with costs; that process is now very nearly complete. Member Frissell affirmed that the BOH policy is to establish fees that fully cover the cost of delivering environmental health services. Substance Abuse Board Nominations Member Austin said he wished to nominate two persons to the SAAB, Chase Glenn and HarGopal. He and Frances Joswick explained that both individuals are interested in substance abuse/mental health issues and had attended SAAB meetings in an effort to learn about the work of the Board. The SAAB is recommending them for SAAB positions. Member Westerman asked for clarification on the composition of the SAAB and the Page 7 of 9 maximum number of members. Ms. Joswick indicated that the maximum is 14. With two additional nominations expected in October, the total would be 13, assuming these two nominees are approved. There was further clarification that the SAAB composition must include only three elected officials and that at least 25% of the SAAB members must be in recovery. Member Austin moved that Chase Glenn and HarGopal be approved for appointment to the SAAB; Member Westerman seconded. The motion was approved unanimously. Fran Joswick also announced that a Drug Return event, hosted by the SAAB, Port Townsend Police Department, and Community Network, would be held at the Safeway on September 25. Any class of drugs will be accepted except those in liquid form. ACTIVITY UPDATE Stuart Whitford reported that Environmental Health had received several public records requests regarding their role in permitting the proposed biomass generator at Port Townsend Paper. He said that JCPH only permits and monitors the mill's inert landfill, which is for the inert non-toxic boiler ash. Jean Baldwin said she had received telephone calls requesting information, most of which have been referred to DOE or the paper mill in accordance with pre -established protocols. Contact information for both entities is posted on the JCPH website, with a brief description of the project. There was further discussion about the fact that JCPH has no regulatory authority with regard to this project. Dr. Locke said that their role is to assess the impact on community health; he recalled JCPH's involvement in a Dept. of Health report on industrial air pollution impacts done in 2008. However, he said that industrial air pollution falls under federal regulations administered by the States; local health jurisdictions have no authority over air pollution. Others who had attended local public meetings expressed concern that DOE representatives had not been able to satisfactorily address questions and concerns about possible health hazards of the proposed biomass facility. Member Nelson noted that the DOE claims there are very few extant regulations that apply to this relatively new technology. In addition, the time frame for research and public response to this proposed project is quite limited. Dr. Locke noted that obtaining good air quality data and actual exposure rates is very difficult. He said that, at this time, there is only limited data, i.e. opacity of the stack smoke from the mill. The particle sizes/counts and chemical composition are not known. With biomass facilities, the output air/smoke will depend on many factors such as fuel type, combustion temperature, and the pollution control technology used. There are many variables and many unknowns. Member Russell noted that this process has been purported to reduce air pollution overall because it replaces on-site burning of forest debris. Member Sullivan added that the project was presented as being ecologically better than the status quo of burning coal or oil, as not using toxic fuel sources such as construction debris, and that it would be compliant with evolving regulations and standards. Presumably, whatever specific permit is issued will Page 8 of 9 place conditions on the types of fuel that may be burned, along with other parameters and constraints. AGENDA PLANNING CALENDAR During the October 21 BOH meeting, staff will present Nurse Family Partnership Reports, with new local data that has been developed during the last year. This is a profile of those in the program and of risk factors for pregnant women in the community. The Washington State Adverse Childhood Experiences Report and Foundation of Lifelong Health Essential Findings Report will also be presented. Any budget updates will also be discussed. ADJOURNMENT Members Austin and Nelson moved for adjournment. Chair Russell adjourned the meeting at 4:20 PM. JEFF SON COU TY BOARD OF HEALTH 14 Chuck Russell, air Kristen Nelson, Vice -Chair r Roberta Frissell, Member � k� L4, W -&7 �4 "-- Sheila Westerman Page 9 of 9 Excused Phil Johnson, Member J Austin, Member David Sullivan, Member