HomeMy WebLinkAboutM071813JEFFERSON COUNTY BOARD OF HEALTH
MINUTES
Thursday, July 18 2013
Jefferson County Public Health, 615 Sheridan Street, Port Townsend, WA 98368
Board Members
Phil Johnson, County Commissioner District #1
David Sullivan, Vice Chair, County Commissioner, District #2
John Austin, County Commissioner, District #3
Roberta Frissell, citizen at large (County)
Catharine Robinson, Port Townsend City Council
Sheila Westerman, Citizen at large (City)
Jill Buhler, Chair, Hospital Commissioner, District #2
Staff Members
Thomas Locke, MD, MPH Health Officer
Jean Baldwin, Public Health Services Dir
Julia Danskin, Nursing Services Director
Jared Keefer, Env. Health Services Dir
Veronica Shaw, Deputy Director
Chair Buhler called the meeting of the Jefferson County Board of Health to order at 2:30 PM. A
quorum was present.
Members Present: Jill Buhler, Sheila Westerman, Roberta Frissell, Catharine Robinson, David
Sullivan, Phil Johnson, John Austin
Staff Present: Dr. Thomas Locke, Jean Baldwin, Jared Keefer, Julia Danskin
Members Excused: None
APPROVAL OF AGENDA & MINUTES
Chair Buhler called for approval of agenda and minutes.
Member Austin requested to amend the agenda to add a report on Baby friendly hospital
celebration and gala # 7 under new business and activity update on Pacific Coast Salmon
Activity.
Member Frissell requested a correction of the June 20, 2013 minutes on page 4, 4th paragraph
from the bottom; change from "chairman Frissell" to "member Frissell"
Member Robinson requested a correction on page 5, under Legislative Update, sentence
beginning "A large amount of the gap..." change $230,000 to $230,000,000.
Member Robinson requested a correction on page 5, under Activity update: Reword first
sentence "...to present the hospital with a "baby friendly hospital" award. Reword 2"d sentence
to: "Jefferson Healthcare is one of five hospitals in the state being honored."
Member Robinson moved to approve the agenda and minutes as amended; the motion was
seconded by member Frissell. No discussion. The motion passed unanimously.
BOH Minutes — July 18, 2013
PUBLIC COMMENT
Helen Lauritzen speaking as a co-chair of bio -mass committee and a member of the North
Olympic Group of the Sierra Club thanked Dr. Locke for his strong commitment to the Port
Townsend Paper Company landfill issues. She outlined her concerns regarding the process for
permitting the PTPC landfill, and urged the County, and Department of Ecology (DOE) to hold
firm in requiring the company to obtain a limited purpose permit for their landfill.
Kees Kolff concurred with Ms. Lauritzen. Dr. Kolff thanked the board for their service and
thanked Dr. Locke for the decision that he made regarding The Port Townsend Paper Co.
Dr. Kolff hoped for continued open participatory process regarding the issue.
Dave McWethy also concurred with Ms. Lauritzen and Dr. Kolff. He noted that in the course of
interaction with JCPH, he has appreciated officers and staff and supports positions of the County
regarding the PTPC.
Member Johnson responded to public comments, noting that ORCA and University of
Washington have secured a $516,000 grant to install nano -particle monitors in Jefferson and
Clallam Counties, which will allow a base -line measurement (studied by the University of
Washington).
OLD BUSINESS AND INFORMATIONAL ITEMS
Senator Patty Murray Press Release:
Member Austin reviewed a press release from Senator Patty Murray's office, noting that she has
secured 65 million dollars in federal funding for the Pacific Coast Salmon Recovery Fund. This
is a significant increase over both President Obama's proposed FYI budget and the
corresponding House budget, and will likely benefit JCPH water resources budgets.
Member Austin moved to direct Chair Buhler to send a letter of appreciation to Patty
Murray's office. Member Westerman seconded the motion. No further discussion. The
motion passed unanimously.
Healthy/HAPPENINGS — JCPH WIC Newsletter
Julia Danskin — Annual breastfeeding picnic will be August 7th to celebrate World Breastfeeding
week. Several partnerships should be noted: partnership with Jefferson Healthcare, helping to
support baby -friendly care; partnership through outreach with the YMCA summer program,
providing free meals for kids; partnership with the Jefferson County Farmers market, providing
WIC vouchers for fresh -from -the -farm food; partnership with the Smile Mobile, which is
currently visiting, providing dental care to children and mothers/pregnant women. Member
Frissell commented that she was happy to see Chef Arran Stark giving cooking classes to
families and children, using fresh farmer's market produce. Member Johnson — asked for
clarification regarding the numbers noted in the WIC newsletter specific to Apple Health
BOH Minutes — July 18, 2013
monthly income limits. Ms. Danskin clarified that levels are for Apple Health free health
coverage for kids, which is 200% of the Federal poverty level. There are further income limits
for subsidized health care coverage.
Got Birth Control?
Julia Danskin drew attention to the fliers included in the Board's packet regarding family
planning services. A large number of people in the community utilize these services.
Affordable health Coverage: 2014 Information
Julia Danskin reviewed a flier included in the board's packet, prepared by the CHOICE Regional
Health Network about upcoming healthcare and insurance changes, subsequent to the Affordable
Care Act. Jefferson Healthcare, JCPH and Olympic Area Agency on Aging will have small
contracts with CHOICE to train staff and volunteers to help the public enroll in health insurance
options. Starting October 1St, the health care recruitment sign-up will begin, and insurance will
kick in on January 1, 2014. The public can learn more at www.wahealthplanfinder.org. JCPH
will have rooms with internet access and staff available to function as a drop-in center for
enrollment. There will also be at home online registration option.
Member Austin questioned whether Safe Harbor and Jefferson Mental Health are aware of all
this? Ms. Baldwin noted that these agencies and others will be included in outreach. Member
Robinson asked if there is outreach to Dove House and Jumping Mouse. Ms. Danskin responded
that Jefferson County Public Health will be preparing for outreach as the time approaches and
CHOICE will also be doing outreach.
West End Natural Resources News
Jared Keefer prefaced this presentation; the coastal Marine Resource Committee (MRC) and
Conservation Futures programs are housed under Jefferson County Environmental Health and
these programs complement the clean water programs. Tammy Pokorny, Environmental Health
Specialist, noted that the Washington State Department of Fish and Wildlife manages the coastal
MRC's. The North Pacific Coast (NPC) MRC incorporates East and West Jefferson Counties.
The organizations bring together tribes and agencies at the local, State and Federal level to create
and implement projects related to coastal marine environments. The NPC MRC received
funding for its programs, including publishing a newsletter regarding the range of projects which
the MRC's address. The June issue of the West End Natural Resources News (included in Board
packet), highlights projects, including the Marine Spatial Planning — zoning coastal waters, and
prepare for alternative energy projects and other area issues. MRC member enthusiasm exposes
under -appreciated and under -covered issues in the coastal areas — highlighted in the newsletter.
Member Austin noted that the publication is well put together.
Syringe Exchange Program
Julia Danskin reviewed the Syringe Exchange Program (SEP) 2012 end of year report — JCPH
has continued the SEP. A public health nurse is available to see drop -ins in addition to
scheduled clinics offered. In 2012, the number of syringes dispensed was 17,405, with 150
BOH Minutes — July 18, 2013
visits. In light of recent heroin deaths in Clallam Co. and the use among younger people, there's
an increased effort for education and referral during client visits to SEP.
Legislative Wrap-up
Dr. Locke reported that State government shutdown was avoided, with the most significant
change from local public health standpoint being that the 3 funding streams are intact, but their
distribution has changed to a "block grant" through the Treasurer's office (rather than through
the Department of Health). Stable, predictable funding for foundational public health services
has been a priority, and those funds are intact. Member Westerman wondered whether the result
was a product of effective lobbying effort. Dr. Locke responded that a strong coalition of
Counties, Cities, local health departments and allies in the hospital association and state medical
association, all supportive, lead to the positive outcome. The message that gets to the legislature
is that these core services are a high priority for many different groups and core services have a
high impact on the community. Additionally, in a very tough budget year, there was a push for
restoring oral health-care funding in the Medicaid program for adults, which has been restored
for about 45,000 adults in the state, plus those who will become eligible through healthcare
reform (taking effect in the beginning of January 2014). Getting coverage is one issue, but an
additional barrier is finding dentists who will accept that coverage. Overall, the legislature
should be complimented for their foresight in funding of these programs.
NEW BUSINESS
A Conversation with John Wiesman, DrPH, MPH, Washington State Secretary of Health
Chair Buhler introduced and welcomed Dr. Wiesman, Dr.PH, MPH, the Washington State
Secretary of Health. Dr. Wiesman extended his thanks for a warm welcome, and outlined some
of his background and goals. A priority for Dr. Wiesman, having come from local health
department background, is the opportunity to visit all local health jurisdictions in the state.
Four goals for Dr. Wiesman and the Department of Health (DOH): Healthcare reform, Working
on obesity epidemic, Public health impacts of climate change, and funding of public health
system.
• Healthcare reform: Opportunities to care for public health: working with healthcare
authority, health benefit exchange, and DSHS at a systems level. Thinking about better
engagement and increased healthcare for the public.
• Continuing to work on obesity epidemic. The epidemic is likely to result in chronic
disease cost increases and lower life spans if not addressed.
• Public Health impacts of climate change. Paying attention to air quality, animal -pest
ecological changes, and changes in extreme heat conditions. Focusing on what the
Department of Health role is in mitigation of these issues and where the opportunities are
to partner across systems.
• Funding of public health system. The State and local systems are struggling with
funding. As Secretary of Health, Dr. Wiesman will focus on providing leadership to find
4 BOH Minutes — July 18, 2013
stable funding. One area of focus is adding to the stakeholders at the table. Believes in
bringing more partners in the discussion, including BOH members and commissioners.
Finally, the state/local relationship is important. Dr. Wiesman shared what's going on in
Jefferson County through DOH: 1094 Shellfish biotoxin tests, 800 marine water testing, and one
white powder sample; data accumulation and interviews regarding the health of Jefferson
County; 102 newborns tested for genetic and other diseases; 22 commercial shellfish growers
licensed, 17 large onsite sewage systems, 67 Group A systems serving 24,000 people; 83
different professions and managing disciplines licensed; 1700 healthcare credentials in Jefferson
County, and one hospital, from those, 19 complaints investigated.
Dr. Wiesman welcomed input and feedback as he moves forward with these goals.
Member Sullivan noted that different counties, although diverse, tend to come together on
flexible funding, meeting needs on an individual county basis. He also noted that he would like
a coordinated message from the State across agencies.
Member Johnson conveyed that Jefferson Co. works at meeting and agreeing across jurisdiction
for a coordinated approach to state DOH, and noted major differences and diversity between the
counties.
Member Westerman noted that despite extensive outreach and calls for public involvement,
there's disparity between public understandings about what public health does in the community.
She indicated that the challenge is to educate public about the importance of funding public
health.
Dr. Wiesman responded that creativity — thinking outside the box — may be the key for engaging
and solving these funding issues. The solutions may not be what have worked in the past, but
he's confident that with collaboration, new solutions can be found.
Ms. Baldwin noted that there's a possibility of restructuring and systemizing some of the work,
sharing expertise across jurisdictional boundaries and ensuring that training and expertise still
exists even in funding crises. Dr. Wiesman agreed and noted the successes (example: sharing
epidemiology with Kitsap) in sharing across jurisdiction, including some cost savings.
School-based Clinic End of Year Report
Ms. Baldwin distributed a draft of School-based Clinic End of Year Report. The draft doesn't
include mental health funding. The final report will follow later in the summer. The clinic
continues to see the same amount of students; there are more chronic issues: eating disorder
spectrum, asthma, diabetes, etc. There aren't many with diabetic or asthma out of control, but
health monitoring is continuing. The Nurse Practitioners in the schools are well accepted and
students continue to reach out. Member Austin mentioned the reported teen pregnancy rate
decrease, and noted that it says a lot about public health involvement in that decrease.
BOH Minutes — July 18, 2013
Nurse Family Partnership Yearly Partnership
Yuko Umeda, Public Health Nurse, presented the NFP annual plan. NFP focuses on decreased
pre -term births, and increased attrition in the program. The program has been in place in
Jefferson County since 1999. JCPH NFP team works to change smoking habits, child abuse and
neglect rates locally, increase school readiness, help mom's space births and decrease use of
substances. In the past year, Jefferson County NFP formed a regional partnership with Kitsap
and Port Gamble S'Klallam Tribe. With this new partnership there's opportunity for forming a
new community advisory board with members of Jefferson, Kitsap, and the Tribe. Ms. Baldwin
conveyed that JCPH met with the Elwha Tribe about NFP partnership and they're considering
options.
Dr. Wiesman, having visited Kitsap County Health District, conveyed how appreciative Kitsap
staff was of the NFP partnership and leadership coordination.
Big Quilcene River Fishing Season Sanitation
Mr. Keefer spoke about the Big Quilcene River. Historically when fishing season opens, people
have dumped trash, defecated and left messes, this all affecting water quality, as a result DOH
closed downstream shellfish beds. JCPH and Public Works did fund one year of portable toilets
and dumpsters which did improve the 2012 season.
Michael Dawson noted that progress has been made with funding of the vault toilet in Riverfront
Park, but the hindrance is ensuring long-term maintenance of the toilet. Community groups and
interested parties (including tribes), came together and discussed maintenance. Help in public
education and outreach is needed as well. Mr. Keefer added that the State Department of Fish
and Wildlife is interested, since Commissioner Sullivan contacted and requested some help. At
this point, DOH, DOE, and the County have put in significant time, money and resources.
Water Quality Division update
Michael Dawson outlined current issues regarding water quality in Jefferson County. Starting
with water quality overall —There's a great deal of algae bloom. Jefferson County has been
working closely with the state on testing. Compared with last year, biotoxins haven't been as big
of an issue until this week. Anderson Lake closed and Gibbs Lake has been recommended to
restriction and closed for swimming. There have been some areas of concern in the Irondale Park
restoration area in a small stream contributor. Water quality staff is looking at septic systems in
the area. In the Hood Canal, Water Quality staff has found areas that need attention. These
areas are extremely rural and spread out, making it difficult to locate sources. Other issues are
Best Management Practices regarding livestock and agriculture practices.
Baby -friendly Hospital Report
Note — meeting time constraints prohibited review.
6 BOH Minutes — July 18, 2013
ACTIVITY UPDATE
None
AGENDA PLANNING CALENDAR
Member Robinson asked that review of the King County drug take -back program be added to
agenda before October.
NEXT SCHEDULED MEETING
Next Board of Health meeting will be held on August 15, 2013 from 2:30 — 4:30 p.m. at an
alternate location: The Jefferson County Library, 620 Cedar Ave, Port Hadlock, WA 98339
ADJOURNMENT
Chair Buhler adjourned the BOH meeting at 4:35 PM.
JEFFERSON COUNTY BOARD OF HEALTH
Phil Johnson, tember VJ"il1l1'eB u h I e k C h a i r
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Roberta Frissell, Member
Catharine Robinson, Member
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Sheila Westerman, Member
Respectfully Submitted:
Cara Leckenby
David Sullivan,.Vice Chair
John Austin, Member
BOH Minutes — July 18, 2013