HomeMy WebLinkAboutM101713JEFFERSON COUNTY BOARD OF HEALTH
MINUTES
Thursday, October 17, 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 Dir
Jared Keefer, Env. Health Services Dir
Veronica Shaw, Public Health Deputy Dir
Chair Buhler called the October 17, 2013 meeting of the Jefferson County Board of Health to
order at 2:35 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, Julia Danskin, Veronica Shaw
Members Excused: None
APPROVAL OF AGENDA
Chair Buhler called for review and approval of agenda.
Member Westerman moved to approve the agenda as presented; the motion was seconded
by Member Frissell. No further discussion. The motion passed unanimously.
APPROVAL OF MINUTES
Chair Buhler called for review and approval of the minutes.
Member Frissell moved to approve the minutes as presented; the motion was seconded by
Member Austin. No further discussion. The motion passed unanimously.
PUBLIC COMMENT
No public comment.
BOH Minutes — October 17, 2013
OLD BUSINESS AND INFORMATIONAL ITEMS
Affordable Care Act Update: Health Exchange Enrollment
Julia Danskin reports that there are complications with implementation of the Affordable Care
Act (ACA) and the Health Exchange enrollments, however staff is working through them. One
complication is the newly qualified, who would qualify for Medicaid under the expansion, are no
longer being processed through DSHS, and are instead being directed by DSHS CSO to JCPH
and Jefferson Healthcare. There are programmatic overlaps with Breast and Cervical Health
program and with the Take Charge program where there are gaps in income eligibility between
program limits and ACA limits. There are glitches in the website signup, which is taking
anywhere from 15 minutes to 3 weeks, and the call center lines are at capacity, with very long
wait times.
Girls Night Out: Breast Cancer Prevention
Julia Danskin reported that Girls Night Out 2013 was a very successful evening. Main Street
Project puts together gift bags to be sold, and each bag included information about healthcare
reform, and breast health. Almost $6,000 was raised through sale of the bags, and funds (after
expenses) will partially benefit the Jefferson County Breast and Cervical Health Program,
Jefferson County Public Health WIC Newsletter
Julia Danskin reviewed the WIC client newsletter included in the Board's agenda packet. WIC is
no longer in danger of being cut now that Federal government shutdown has ended. WIC is
becoming a services coordination hub, serving 830 individuals a year in Jefferson County. Other
programs highlighted for WIC clients (which are also inclusive of other populations) are Smile -
Mobile, Farmers Market produce purchase, and the Breastfeeding Tea.
JHC Meeting with JCPH
Dr. Locke discussed the second in a series of meetings between Jefferson Health Care and
Jefferson County Public Health, focused on Community Health Needs Assessments (CHNA), a
survey of the major health needs of the community. This process addresses services provided
and needs, where the gaps are, and how to mobilize improvements. JCPH currently has
assessment data that can be updated. There was a consensus that CHNA planning is important
and will be implemented locally. Mental health inclusion issue was discussed — identifying a
solution for treatment, and prevention and maintenance.
NEW BUSINESS
Environmental Health Fee Schedule: Proposed Adoption Schedule
Jean Baldwin reviewed discussion from the September meeting of the Board of Health, which
included addressing water recreation fees. Subsequent to that meeting, staff found that there are
changes in the temporary food fees, and in solid waste fees. With the inclusion of all fee needs,
it's suggested that the December discussion be postponed until an all-inclusive fee schedule
change discussion can occur in January or February.
2 BOH Minutes — October 17, 2013
Member Robinson moved to postpone the hearing on fees which was to occur during the
regular December Board of Health meeting. Member Austin seconded the motion. No
further discussion. The motion passed unanimously.
Environmental Health Proposal for Enforcement Cost Recovery
Linda Atkins presented information on the possible placement of notice to title and charging a
fee for rescission of the notice for certain violations. She included review of how it would
intersect with our current compliance efforts and how other jurisdictions utilize this tool. It is a
way to alert future owners of existing violations and recoup costs associated with the noticing
process. It is also an incentive for the owner to correct the issue, and is a way for interested
parties to be aware of important and lasting land issues, although currently the tool is used
infrequently because of the cost.
Three jurisdictions that use this tool are Okanogan, Seattle -King, Tacoma/Pierce counties. JC
Civil Deputy Prosecuting Attorney David Alvarez has reviewed those programs. The
jurisdictions utilizing a cost recovery fee are finding that with the fee, many violations see a
response before filing the Notice to Title.
Costs which might be included in a Notice to Title fee include: recording fees, administrative
costs, time spent creating the site specific notice and rescission, and communicating with current
and future interested parties about the notice, or rescission. This issue will be presented to the
Board again with subsequent all-inclusive fee schedule change discussions. Member Westerman
suggests adding a per -hour fee description and an additional per hour fee (for overage) included
with this fee structure in order to adjust for outliers, and recoup all costs.
Temporary Food Program Permit Activity Report
Susan Porto recognizes Food Program staff member Mina Kwanza's diligence in tracking
information on the day to day activities associated with implementing the food safety program.
The information tracked allowed us to represent accurately the time spent in the temporary food
permit process, which is becoming a year-round program. The hand-out in the Board's agenda
packet includes time studies, take-away's related to the time studies, and comparisons with past
data. Member Westerman recommended the addition of a per -hour fee description and an
additional per hour fee (for overage) included in the fee structure.
2014 Jefferson County Public Health Budget
Jean Baldwin reviewed impacts to the Jefferson County Public Health Budget. JCPH budgeting
has included a budget carryover yearly through the recession, this is diminishing. JCPH
programs will be changing, and Federal and State programs are making changes that may or may
not be affecting JCPH programs. JCPH has asked for budget appropriations, and is budgeting on
a three month basis to adjust quickly and appropriately. The annual County budget process was
completed in July but did an October budget review and November all appear similar. Budget
reviews will be completed in January, and again in April. JCPH may have to use program cuts,
policy shifts, staff adjustments, and layoffs in order to meet any further budget shortfalls. There
have been programmatic and policy adjustments and one layoff since October of 2013. This
budget shortfall will be continuing through the coming year.
BOH Minutes — October 17, 2013
JCPH has been notified that CPS will no longer be contracting with us for court observations,
and low risk families. The Affordable Care Act (ACA) enrollment stops in March, but how the
ACA will financially impact the department is unknown. Our electronic medical records (EMR)
system has problems, and contracts are changing — this will have financial implications for
JCPH.
Ms. Baldwin will be coming to the Board for guidance about shortfalls, programmatic and policy
adjustments as the need arises. A Board retreat may be advisable to address these issues.
Federal Government Shutdown: Public Health Program Impacts
Dr. Locke reported that the Federal government shutdown has ended. In the long run, the cost to
the American public in terms of loss in Gross National Product will likely be in the billions.
JCPH was prepared to respond to the program cuts with furlough notices, and the first victims of
this reduction would have been children — Head Start, TANF and WIC. The issue may arise
again in January 2014.
ACTIVITY UPDATE
Ms. Joswick noted that a national drug take -back day event will take place a week from Saturday
10-2 at Safeway, under the auspices of the Port Townsend Police Department. Volunteers are
needed, and Ms. Joswick encourages members to spread the word.
No public comment.
PUBLIC COMMENT
AGENDA PLANNING CALENDAR
The November Jefferson County Board of Health meeting will be canceled due to the WASAC
meeting and other scheduling conflicts. Notice of the cancellation will be given according to
public meeting procedures.
NEXT SCHEDULED MEETING
The next Board of Health meeting will be held on Thursday, December 19, 2013 from 2:30 —
4:30 p.m. at Jefferson County Public Health, 615 Sheridan Street, Port Townsend WA 98368
ADJOURNMENT
Chair Buhler adjourned the September 19, 2013 Jefferson County Board of Health meeting
at 4:20 PM.
4 BOH Minutes — October 17, 2013
JEFFERSON COUNTY BOARD OF HEALTH
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Phil Johnson, Me r n... ill Buhler, Chair
Roberta Frissell, Member Davi u 1 ice air
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Catharine Robinson, Member Jo Austin, Member
Sheila Westerman, Member
Respectfully Submitted:
Cara Leckenby
5 BOH Minutes — October 17, 2013