HomeMy WebLinkAboutM031716JEFFERSON COUNTY BOARD OF HEALTH
MINUTES
Thursday, March 17, 2016
Jefferson County Public Health, 615 Sheridan Street, Port Townsend WA 98368
DRAFT
Board Members
Phil Johnson, County Commissioner District #1
David Sullivan, Chair, County Commissioner, District #2
Kathleen Kler, County Commissioner, District #3
Catharine Robinson, Vice -Chair, Port Townsend City Council
Sheila Westerman, Citizen at Large
Jill Buhler, Hospital Commissioner, District #2
John Austin, Citizen at Large
Staff Members
Thomas Locke, Health Officer
Vicki Kirkpatrick, Public Health Dir
Julia Danskin, Public Health Manager
Jared Keefer, Env. Health Dir
Veronica Shaw, Public Health Deputy Dir
Michael Dawson, WQ Manager
Dunia Faulx, Community Health Dir
Denise Banker, Clerk of the Board
Chair David Sullivan called the March, 2016 meeting of the Jefferson County Board of Health to
order at 2:35 p.m. A quorum was present.
Members Present: John Austin, Phil Johnson, Kathleen Kler, Catharine Robinson, David
Sullivan, Sheila Westerman
Staff Present: Denise Banker, Michael Dawson, Dunia Faulx, Jared Keefer, Vicki Kirkpatrick,
Tom Locke, Philip Morley, Veronica Shaw
APPROVAL OF AGENDA
David Sullivan, Board Chair, added an item to the agenda: Formal welcome to Vicki
Kirkpatrick, Public Health Director.
Philip Morley introduced Vicki Kirkpatrick and formally welcomed her to Jefferson County
Public service. The board members introduced themselves. Ms. Kirkpatrick thanked everyone
present and shared her joy at being so warmly and sincerely welcomed.
Chair Sullivan approved the Agenda of the March 17, 2016.
The formal approval process was inadvertently overlooked and the Chair moved for the
approval of the minutes of the February 18th, 2016 Board of Health meeting.
APPROVAL OF MINUTES
Chair Sullivan asked for approval of the minutes of the February 18, 2016 meeting of the
Jefferson County Board of Health.
Member John Austin asked that the Clerk of the Board be named as a staff member in the
minutes' letterhead.
Chair Sullivan asked for approval of the minutes of the February 18th, 2016 meeting of the
Jefferson County Board of Health as amended.
Member Austin motioned to approve the minutes as amended; the motion was seconded by
Member Robinson. No further discussion. The motion passed unanimously.
PUBLIC COMMENT
There was no public Comment
OLD BUSINESS AND INFORMATIONAL ITEMS
1. Lead Detected in Bainbridge Island School District Water
Dr. Thomas Locke, Health Officer, discussed an advisory issued by the Kitsap Public Health
District concerning tests that revealed elevated levels of lead in a Bainbridge Island Elementary
School's water. Dr. Locke told the Board that slightly elevated levels were detected from water
fixtures at Ordway Elementary School and explained how lead in the water is related to the
water's "corrosivity", a measure of how aggressively water corrodes plumbing fixtures. Often
the problem is not high lead levels in the source of the drinking water; the problem is that water
with high corrosivity can dissolve lead in pipes and fixtures resulting in increased levels in
drinking water. This is, Dr. Locke said, what happened in Flint, Michigan. Highly corrosive
water undermined the city's lead -pipe infrastructure. Dr. Locke reported that there is increased
attention to lead in drinking water as a result of the well-publicized contamination of Flint's
drinking water and that reports of low level contamination of public water supplies will become
more common as monitoring intensfies.
2. National Public Health Week, April 4-10, 2016: Healthiest Nation 2030
Dr. Locke announced National Public Health week's Healthiest Nation 2030 theme and
explained that each year the American Public Health Association (APHA) chooses a different
theme for this annual event. Jefferson County Public Health, in keeping with National Public
Health Week, will celebrate by awarding six Public Health Hero awards at its April meeting.
There are daily celebrations and events listed at the APHA website: http://www.pphw.or /
NEW BUSINESS
1. Targeted Clinical Services Program Performance Measures Report
Dunia Faulx, Community Health Director, began her report by celebrating the fact that among
the 34 counties in Washington State, Jefferson County ranked sixth for overall Health Outcomes
in a national community health assessment report. This number is up from last year's fifteenth
ranking. Faulx explained successes and areas of focus for further examination in the report.
With respect to utilization of health care services at JCPH, she reported that some clinic numbers
were down and, as a result, focus surveys were performed. These surveys revealed the need for
evening hours and targeted outreach, particularly at the Quilcene clinic. One highlight of the
report is our overall approval rate among clients and their subsequent loyalty to our clinicians.
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Clients who established relationships with our clinicians through the School-based Health
Centers generally continue to seek routine reproductive health care at Jefferson County Public
Health, regardless of income and insurance status. Additionally, due to the Affordable Health
Care Act, the clinic sees fewer clients in need of a sliding scale and is more often able to bill
insurance for services rendered.
Member Sheila Westerman, Citizen at Large, suggested in going forward, if the objective of
Goal 3: to improve access to health care for high school students in Jefferson County is going to
be expressed as a percentage, then the actual and planned findings need to be expressed as a
percentage as well.
2. Family Health Services Program Performance Measures Report:
Ms. Faulx continued to apprise the Board of the successes and observable trends revealed by the
performance measures data. JCPH providers are actively engaged in continuing education by
attending multiple and various trainings throughout the year, which provides secure foundations
for evidence -based practices and programing. Faulx also emphasized the need to review data
trends over the long-term; the performance measures have been set for 20 years.
It was noted there is a nation-wide downward trend in Family Health Services, particularly with
regards to WIC programs. In Jefferson County, clients are concerned by the inability to use WIC
dollars to buy organic milk. As well, the stigma associated with using a WIC check at the
grocery check-out counter continues to be a barrier.
Jefferson County has a high success rate with its breastfeeding outreach and education; its
successful and long-standing Breastfeeding Tea is of paramount importance in maintaining this
success and building community for new mothers.
The Nurse Family Partnership, a maternal and early childhood health program that links at -risk,
first-time parents to specially trained maternal and child health nurses, has targeted client
outreach and attrition as a focus of their efforts. The NFP home -visiting program is a very
specific and intensive program for the highest -risk families based on proven models for
favorably impacting crime rates, drug and alcohol abuse, nutritional status, violence in the home,
and other consequences of poverty. It is, by necessity, restrictive in its targeted populations.
In conclusion it was noted by member Westerman that Early Family Support Services (EFSS)
and Early Intervention Program (EIP) numbers were alarmingly low when compared to three
years ago. This, it was explained, is due to various factors including cuts in Child Protective
Services (CPS) funding—JCPH has only the EIP contract remaining; the loss of clients when
Quen Zora, a former JCPH employee, moved to a state position; the problem of a very specific
referral form originating in the CPS office, as well as CPS office turnover, which exacerbates the
aforementioned problems. JCPH has talked about filling out the forms for understaffed CPS
offices. Ms. Kirkpatrick said numbers were down across the state and suggested questioning the
state's funding priorities. Catharine Robinson, Vice -chair, wondered if CPS's Family
Intervention Support (FIS) program might have a negative impact on JCPH funding. Veronica
Shaw, Deputy Director, assured the group that these programs, EFSS and EIP, are unrelated to
the FIS contracts held by other agencies, and that JCPH is the only agency providing this service.
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Ms. Shaw re-emphasized that referral forms have been a great barrier. Staff are willing, if
necessary, to fill out the referral forms.
3. Syringe Exchange Program 2015 Report
Lisa McKenzie, Public Health Nurse III, updated the Board on the successes in the Syringe
Exchange Program (SEP), which is now distributing the opiate overdose antidote Naloxone to
willing participants. The overall goal of the SEP is education and outreach in the prevention of
disease. Ms. McKenzie reviewed numbers related to type of drug used, decreases in the number
of female clients, increases in the number of unincorporated Jefferson County clients; and she
discussed the program's mobile population. It was noted, as well, that the number of older clients
has increased. Program hours have been reduced in 2016 to three days per week, which is in
keeping with regional trends. Staffing, due to an upcoming retirement, is a concern; and funding
presents problems due to the upcoming loss of County General Funds, which leaves only the
Substance Abuse Special Use Tax as the SEP's funding source. Member Austin suggested Waste
Site Disposal Fees might be used as a source of funding. The program's goals for 2016 include
continuing this effective program, with its 20 -year history in Jefferson County, with a focus on
client harm reduction education, offering naloxone overdose prevention, informing clients at
each visit of resources available to them, ensuring clients are insured, and exploring new
approaches to HIV and Hepatitis C testing.
4. Syringe Exchange Programs in Washington State Report
Ms. McKenzie continued to update the Board with information on the SEP by comparing
Jefferson County's program to a statewide overview that included eighteen syringe exchange
programs from seventeen counties across the state. Jefferson County's program was visited when
this data was compiled and its numbers are included in the report. David Sullivan, Chair, said
syringe exchange programs and naloxone distribution are on the legislature's radar. Senator
Murray visited this subject at a recent meeting. Sullivan hoped this would lead to the
Legislature's setting aside funding for syringe exchange programs.
5. Public Health Heroes
The nominations for Public Health Heroes were presented to the Board. It was decided that every
nominee would receive an award.
Chair Sullivan asked for approval of the Public Health Heroes nominees.
Member Austin motioned to approve; the motion was seconded by Member Kler. There
was no further discussion. The motion passed unanimously.
6. Influenza and Zika Virus Update
Dr. Locke reported to the Board that influenza is on the wane in the Jefferson County region. He
expects this year's flu season to end by mid-April. Influenza B, a less serious strain that does not
cause pandemics, has been the predominate strain detected this year.
Dr. Locke continued his report with a discussion of the Zika virus. The CDC currently has a very
liberal surveillance protocol. Anyone who is pregnant and has traveled to Mexico or other
outbreak countries is eligible for testing; additionally, because there have been proven cases of
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sexually transmitted Zika virus infection, men who has traveled in outbreak areas, have a
pregnant partner, are eligible to be tested. About 80% of the people with Zika infection are
asymptomatic; therefore, travelers returning from outbreak areas need to be conscientious about
avoiding mosquitos and their bites for at least three weeks after their return because the virus is a
blood-borne pathogen transferred person-to-person via mosquitos. The mosquito, Aedes aegypti,
that transmits the virus is found in the Southern US, but is not in Washington State. Returning
travelers bitten by this type of mosquito can transmit their infection to others who are bitten by
the same mosquito. The virus infection causes mild illness in most cases. Similar to West Nile
Virus, most infected people do not become ill. About 20% do have fever, often with rash, joint
pain and conjunctivitis. About 1% have severe illness. There are serious concerns that infection
in pregnancy can cause microcephaly, an often fatal birth defect, although it has not been
conclusively proven to be a result of Zika virus infection. This and other potential pregnancy -
related complications of Zika infection are the subject of intensive international study.
7. Legislative Update
Kathleen Kler, Commissioner, reported to the Board that the Regional Support Networks, which
will become known as Behavioral Health Organizations began to distribute their reserves in
response to the Legislature's interest in the funds. Jared Keefer, Environmental Health Director,
reported on legislative actions. The governor promised to arbitrarily veto bills if the Legislature
prolonged its recent session and followed through on this threat when the legislature failed to
pass a budget by the end of the regular session. Several of the vetoed bills directly impact health
departments. The Legislature has the option of passing these bills again in the special session.
ACTIVITY UPDATE
There was no update.
PUBLIC COMMENT
There was no public comment.
AGENDA PLANNING CALENDAR
Public Health Heroes will be honored at the April meeting of the Jefferson County Board of
Health.
NEXT SCHEDULED MEETING
The next Board of Health meeting will be held on Thursday, April 21, 2016 from 2:30 — 4:30
p.m. at Jefferson County Public Health, 615 Sheridan Street, Port Townsend, WA.
ADJOURNMENT
Chair Sullivan adjourned the March 1711, 2016 Jefferson County Board of Health meeting
at 4:30 p.m.
JEFFERSON COUNTY BOARD OF HEALTH
Phil Jo so ,, ember
David Sull' , C it
Catharine Ro son, Vice -Chair
John Austin, Member
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Sheila Westerman, Member
Kathleen Kler, Member
respectfully submitted
Denise Banker