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HomeMy WebLinkAboutM031711JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, March 17, 2011 - 2:30 PM — 4:30 PM Public Health Conference Room, 615 Sheridan Street, Port Townsend Board Members Staff Members Phil Johnson, Vice Chair, County Commissioner District #1 Thomas Locke, MD, MPH, 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 Roberta Frissell, Citizen at large (County) Stuart Whitford, Environmental Health Services Director Kristen Nelson, Chair, Port Townsend City Council Sheila Westerman, Citizen at large (City) Jill Buhler, Hospital Commissioner, District #2 Chair Kristen Nelson called the meeting of the Jefferson County Board of Health to order at 2:30PM. A quorum was present. Members Present: David Sullivan, John Austin, Roberta Frissell, Kristen Nelson, Sheila Westerman, Jill Buhler Members Excused: Phil Johnson Staff Present: Dr. Thomas Locke, Jean Baldwin, Julia Danskin, Veronica Shaw APPROVAL OF AGENDA Jean Baldwin asked to add two items to the end of the agenda as New Business; Item 6, An update on the environmental situation in Japan and Item 7, Discussion on the Data Steering Committee. Member Austin moved to approve the agenda as amended; Member Frissell seconded. The agenda was approved unanimously, as amended. APPROVAL OF MINUTES Member Austin moved to approve the February 17, 2010 BOH meeting minutes. The motion was seconded and approved unanimously. PUBLIC COMMENTS Mr. Thomas Brotherton, a resident of Quilcene, expressed his concern that JCPH is not doing enough to reduce tobacco use in Jefferson County. Mr.Brotherton handed out information showing the health risks of tobacco use, stating Jefferson County has a higher tobacco use rate than any other county in the State, copies of Jefferson and Clallam counties website for comparison and a comparison of the amount spent on public health in Jefferson vs. Clallam counties. Page 1 of 8 BOH Minutes March 17, 2011 Chair Nelson responded to Mr. Brotherton by stating that tobacco use along with alcohol and drug use, especially among the youth is a topic that is continually discussed and will be addressed in the future. Mike Whitaker, a resident of Quilcene, stated that he understands that all septic systems in the County must be on an inspection schedule by 2012 and that the County will be educating homeowners to inspect their own septic systems. Mr. Whitaker asked why the class will cost so much. Mr. Whitford offered to speak to Mr. Whitaker outside of the meeting and get him the requested information. OLD BUSINESS and INFORMATIONAL ITEMS Prevention Team Report Julia Danskin announced that JCPH will be doing the Our Kids Our Business campaign in April for National Child Abuse Prevention and Sexual Awareness Assault month. Part of the campaign involves an annual call to action to fill out a form stating you are committed to kids in Jefferson County. Ms. Danskin asked the Board to fill out the form stating they are committed to kids in Jefferson County. Ms. Danskin reported that JCPH is partnering with the City Library on a teen read event. The book being read is "13 Reasons". JCPH has updated the `help cards', which includes the signs of depression and important contact phone numbers to get help for teens with experiencing depression. The help cards will be inserted in all of the books that are being distributed to all Port Townsend High School students. Letter to Washington State Federal Delegation Dr. Locke addressed the letter that was included in the BOH packet. The letter is from Governor Gregoire and the presidents of the Washington Association of Cities and Counties. It points out the magnitude of the state impacts from the federal budget cuts enacted by the House of Representatives' HR 1 bill. Several of the proposed cutbacks are items that have very significant public health impacts. NEW BUSINESS 2010 Public Health Performance Measures Report Ms. Baldwin announced that staff members will be presenting some of the 2010 Public Health Performance Measures Report. Page 2 of 8 BOH Minutes March 17, 2011 Ms. Danskin reminded everyone that the performance measures were originally written in the summer of 2009, 18 months ago, in preparation for the 2010 budget. The reports have been updated with 2010 data and analysis. Ms. Danskin encouraged everyone to review the Study/Analysis section of the reports, which was written by staff as they reviewed the Actual 2010 Performance Indicators. Lisa McKenzie, Communicable Disease program coordinator, reported on the Communicable Disease 2010 Performance Measures Report. Ms. McKenzie pointed out that one of the major changes in the budget in 2010 was the funding from the Department of Health to improve disease tracking and reporting timelines, increasing uptake on childhood immunizations and working with the schools on immunization compliance was decreased by $20.000 following de -funding of Washington State's universal distribution system for childhood vaccines, a system that was established in 2010 to allow clinics to continue to keep one supply of State supplied vaccine. The clinics then report which children had which insurance programs and those insurance programs reimburse the State. Next Ms. McKenzie reported that the number of publicly funded pediatric vaccine doses has decreased, although between 2006 and 2009 the numbers had increased each year. The increase had been due to new vaccines being added to the schedule in 2007 and 2008. By 2010 the new vaccines had been caught up so the number of doses decreased. Ms. McKenzie pointed out that the section of Human Papilloma Virus Vaccine (HPV) is a new section in report for 2010. The HPV vaccine is available to all adolescents age 11 through 18 and recommended for women through the age of 26. State supplied vaccine is only available to adolescents ages 11 through 18. Privately purchased HPV vaccine is very expensive, so JCPH has worked with Merck vaccine company's Patient Assistance Program so that low income uninsured woman can receive the vaccine for free. Ms. McKenzie briefly explained that the County is working on increasing the number of Chlamydia screenings to go with the State and Federal guidelines. Ms. Baldwin pointed out that the Chlamydia screening is typically done at the same time as the PAP test. Many women are not having their routine PAP annually any more and are being told that a PAP test is only needed every 3 years. For young women PAP testing is being delayed until they have been sexually active for several years. Both of these trends make it harder to achieve the public health goal of screening for sexually transmitted infections on an annual basis for certain age groups. Next Ms. McKenzie addressed the syringe exchange program. The number of syringes being exchanged decreased from 2009 to 2010. Ms. McKenzie believes this is due to clients that used to exchange large amount of syringes are not clients any longer. They are finding that the new clients are exchanging a fewer number of syringes. In talking to clients they are finding that some clients are reusing their syringes several times, so JCPH is taking this as an opportunity to educate the clients on safe practices and offering referrals. JCPH will be submitting a competitive application to DOH to continue funding for the Syringe Exchange Program (SEP) around July 2011. Page 3 of 8 BOH Minutes March 17, 2011 Member Frissell asked if it is in the funding for adolescent boys to receive the HPV vaccine since they can be carriers of the disease. Ms. McKenzie stated that the State has approved the vaccine to be given to adolescent boys as well as girls. Member Nelson commented that she was surprised at a statistic she recently heard about, which stated that under 50% of the children entering kindergarten are properly immunized. Ms. McKenzie responded by stating that Jefferson County has a higher percentage than the rest of the state of parents who sign exemptions. This may also be due to children not being caught upon their immunizations at the time of school entry. Ms. McKenzie also stated that JCPH has been working with the school secretaries to help them get complete records. Ms. Baldwin reported on the Family Health 2010 Performance Measures report. In looking at the performance indicators it shows that the numbers significantly dropped. In the Study/Analysis section it shows a 30% cut in funding and JCPH has had to figure out a way to see fewer people. Instead of dropping people from services, they dropped people from universal services. Ms. Baldwin touched on the number of families served through the CPS/DSHS contract. The contract with DSHS is likely to end in July and JCPH may not be able to renew the contract. Ms. Baldwin explained how DSHS is changing their relationship with local health departments and they will be making one large vendor responsible for over one-third of the state. Most counties are not in favor of this change because the liability shifts from the State for a CPS case to the individual counties. She does not recommend continuing this relationship. This all comes at a time when public health nurses are seeing some of the most complicated families. Member Nelson asked for clarification on what type of access women in their 1St trimester of pregnancy are being denied. Is it access because the women do not know what they need to do to qualify for Medicaid, access to Medicaid because it takes time to get through the system and get care, or access to the clinics? Ms. Baldwin responded that a group has been formed to get the answers to these questions. They are also looking at why one area of the county is showing lower levels of first trimester prenatal care than others. The group will be looking at data and taking it to the OB providers to ask their opinions as well. They also want to know why it is only women on Medicaid and women in South County that are not seeking medical care in their first trimester of pregnancy. Ms. Baldwin addressed the Targeted Clinical Health Services 2010 Performance Measures. JCPH is seeing more clients under the age of 19. The numbers on the performance measures all remain fairly stable. Ms. Baldwin stated that in the Healthy Youth Survey it showed that people in school felt they had access to services that they needed and they knew who to ask for help. These numbers were higher in Jefferson County than in the rest of the State. Ms. Baldwin reported that the teen pregnancy rate is very low in Jefferson County and has continued to drop. Ms. Danskin summarized the findings of the Population & Prevention 2010 Performance Measures. She stated that the tobacco prevention funds ended December 31, 2010, so that half time position has been eliminated, however Washington State will continue their Quit Line. Ms. Page 4 of 8 BOH Minutes March 17, 2011 Danskin reported that funding also ended December 31, 2010 for the Child Care Consultation and State Oral Health Funds. Member Buhler asked why the number of school health classes was 243 when it was only planned to be 225. Ms. Danskin replied that classes were added because of funds received from Developmental Disabilities to do special classes for the developmental disability population at school. Member Nelson asked why JCPH is having so much success in decreasing the number of teen pregnancies and they are not having the same kind of success in tobacco use prevention. Ms. Danskin replied that she feels part of the reason for this is that JCPH has been in the schools doing human growth and development classes for over 20 years, there are school based clinics and family planning services and the girls know where to go for services. She also feels that teen pregnancies are not a community norm while tobacco and alcohol use are. Mr. Whitford reported on the Onsite Sewage and Operation and Monitoring Programs as well as the Water Quality Program. He pointed out that on the performance measures of the Onsite Sewage and Operation and Monitoring it shows that new system permitting is down, as it is across the state, and that repair applications are slightly higher. Because permitting is down, the staff has also been trained to do sanitary surveys under the water quality grants. Mr. Whitford pointed out that on the Water Quality Performance Measures Performance Indicators the goal was not met for the number of property surveys that were planned for 2010. He stated that even though permitting is down there continues to be grant monies available to do water quality projects. Mr. Whitford also reported on the Food Safety Program, by stating that in 2010 their goal was not met, but the right infrastructure is in place to accomplish their goal for 2011. Ms. Baldwin urged the Board to look at the Solid & Hazardous Waste performance measures. Member Westerman asked for an explanation of Local Source Control. Mr. Whitford explained that Local Source Control is a Department of Ecology program to look at different sectors of business that typically generate hazardous waste and use hazardous substances. The point of the program is to prevent the waste from ending up in storm water and impacting the public and environmental health. JCPH is in the process of applying for additional funds to run their own program next year. Ms. Shaw presented the Administration Performance Measures of 2010. She stated that Administration supports the other divisions within Public Health, maintains other relationships outside the departments, and handles contracts and reports. Ms. Shaw also reported that JCPH and three other counties are writing a resource guide to help all local health jurisdictions bill private insurance companies for immunization services. Ms. Shaw also stated that since JCPH does not generate a profit so funding received from the ARRA grant allows the Department to bill their local partners less for internal services. Page 5 of 8 BOH Minutes March 17, 2011 2011 Public Health Heroes Award Nominations Ms. Danskin announced that the first week of April is National Public Health Week and time to nominate Public Health Heroes. Member Frissell volunteered to serve on the subcommittee with Ms. Danskin and will review all the nominations. The Nominees will be announced next month. Influenza Update and Notifiable Conditions Reports Dr. Locke reported that as a service to the health care providers, JCPH issues a Notifiable Conditions Report for the past year. A copy of the 2010 report was included in the agenda packet. He stated that influenza has shown a very slow increase in the number of cases week by week since late February. The schools have not shown absenteeism over 10%. Mandatory Healthcare Worker Immunization Dr. Locke announced that beginning February 21, 2011 influenza was circulating in the community to a point that he determined that all un -immunized healthcare workers in the three North Olympic Peninsula hospital districts must wear a masks when involved in direct patient care. This requirement is expected to continue at least through the end of March and possibly into April. Legislative Update Ms. Baldwin informed the Board that there are legislative hearings happening to maintain the programs of home visits which would fund Nurse Family Partnership. She will be watching this very carefully to see if it goes from a hearing to an actual action item. Ms. Baldwin asked the Board that if this moves to an action item The Board write a letter of support. Member Austin moved that the Board authorize the Director of JCPH to draft a letter asking for legislative support to be signed by the Chair. Member Sullivan seconded and the motion passed unanimously. Update on Environmental Situation in Japan Dr. Locke reported that due to the amount of phone calls JCPH was receiving in connection with the nuclear power plant disaster in Japan an advisory was sent to local health care providers and pharmacists that urged them not to recommend people take over the counter medications, such as Potassium Iodide, Kelp and other medications with Iodine in them because they are unnecessary at this time and can have serious health risks. Dr. Locke also announced that JCPH put out a detailed press release, which gave a considerable amount of background information about radiation hazards and specific advice regarding the crisis in Japan. He stated that one positive outcome from this tragedy is that people are reviewing their emergency preparedness and disaster kits in preparation for a disaster here. Page 6 of 8 BOH Minutes March 17, 2011 Data Steering Committee Ms. Baldwin announced that that Data Steering Committee is coming to an end. Their next meeting, which is a summary meeting, will be held April 28, 2011. Ms. Baldwin feels that the committee is at a point where she will be able to bring the information before the Board to determine what additional actions should be taken. Member Frissell announced that an attendee at the Data Steering Committee meeting today reported that a $50,000.00 grant for the library was obtained using the data that is coming out. She feels that other agencies need to be made aware of these possibilities. Ms. Baldwin asked whether this is a big enough issue to pull together a few community leaders. Member Buhler suggested that they take the approach of it being a workshop with an outcome rather than a meeting. Member Westerman suggested that Ms. Baldwin go to different groups in the community with a presentation that is tailored to that specific group and their interests. ACTIVITY UPDATE Ms. Baldwin announced that Dr. Locke and Lori Clark will be attending the City Council meeting to speak about Local Source Control and other local public health issues. Ms. Baldwin also stated that Public Health Heroes will be in the April meeting. AGENDA PLANNING CALENDAR The next scheduled BOH meeting will be held Thursday, April 21, 2011 from 2:30-4:30 PM at the Health Department, 615 Sheridan Street, Port Townsend, WA. ADJOURNMENT Chair Nelson adjourned the BOH meeting at 4:38 PM. Page 7 of 8 BOH Minutes March 17, 2011 JEFFERSON COUP 'i2�Ak Kristen Nelson, Chair J' 1 Buhler, Member HEALTH Excused Phil Johnson, Vice -Chair Jo Austi , Member Roberta Frissell, Member David llivan e be S� Sheila Westerman, Member Page 8 of 8 BOH Minutes March 17, 2011