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HomeMy WebLinkAboutM102016JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, October 20, 2016 Jefferson County Public Health, 615 Sheridan Street, Port Townsend WA 98368 FINAL Board Members Phil Johnson, County Commissioner District #1 David Sullivan, Chair, County Commissioner, District #2 Kathleen Kier, 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 Tammey Newton, Community Health Dir Veronica Shaw, Public Health Deputy Dir Michael Dawson, WQ Manager Jenny Matter, Clerk of the Board Chair David Sullivan called the October 20, 2016 meeting of the Jefferson County Board of Health to order at 2:32 p.m. A quorum was present. Members Present: John Austin, Catharine Robinson, David Sullivan, Jill Buhler, Sheila Westerman, Kathleen Kler Members Excused: Phil Johnson Staff Present: Michael Dawson, Tom Locke, Vicki Kirkpatrick, Tammey Newton, Jenny Matter APPROVAL OF AGENDA Chair Sullivan called for review and approval of the agenda for the 10/20/2016 meeting. Chair Sullivan suggested moving New Business, Item 2: Public Hearing for On-site Sewage System Management Plan Fees to November 3`d Kathleen Kler moved to add New Business, Item 5: Nurse Program for Medically -Assisted Treatment (MAT) - Anders Edgerton, Administrator for Salish Behavioral Health Organization. Chair Sullivan suggested moving the Nurse Program for MAT to item number two (2) in New Business. Chair Sullivan asked for approval of the agenda for the 10/20/2016 meeting. Kathleen Kler motioned to approve the agenda. The motion was seconded by Sheila Westerman. No further discussion. The motion passed unanimously. APPROVAL OF MINUTES Chair Sullivan asked for approval of the minutes of the September 15, 2016 meeting of the Jefferson County Board of Health. John Austin motioned to approve the minutes; the motion was seconded by Sheila Westerman. No further discussion. The motion passed unanimously. PUBLIC COMMENT There was no public comment. OLD BUSINESS AND INFORMATIONAL ITEMS 1. Governor Inslee's Executive Order Addressing the Opioid Public Health Crisis Dr. Tom Locke, Health Officer, updated the Board on the executive order signed by Governor Inslee earlier this month. He stated that the order is consistent with national and regional efforts to respond to the epidemic of opiate use and misuse that is impacting communities across the country. This strategy has three key components: to alter prescribing patterns, increase access to medicated -assisted treatment for those addicted to opiates and expand the availability of antidotes for narcotic overdoses. Dr. Locke informed the Board that Governor Inslee has directed state agencies to make this a top priority and efforts are already well underway in Jefferson, Clallam, and Kitsap counties to implement these strategies. NEW BUSINESS 1. Olympic Community of Health Presentation Elya Moore, Director of Olympic Community of Health (OCH), summarized the development and purpose of the OCH as one of the nine Accountable Communities of Health (ACHs) in the State. The purpose of the OCH is to address major health priorities in Kitsap, Jefferson and Clallam counties. Ms. Moore presented data on health care spending and discussed the intent of the OCH to regionally integrate health care and make it more efficient and cost effective. The OCH Board of Directors includes representatives from 15 sectors and 7 tribes. The OCH is a very new organization and in the process of developing a strategic plan. They currently focus on engagement with community partners, educating and informing policy makers and state agency leaders on local health issues, and preparing to conduct projects with funding from the Medicaid waiver. Their current priorities are access to care, aging in place, behavioral health that is coordinated and integrated, chronic disease prevention and management, and early childhood by supporting families and children. Ms. Moore presented data on opioid use in the State. Board members had questions regarding the demographic displayed (women between 45-64 years), the lack of distinguishing between single K and renewed prescriptions, difference of disease and need for legitimate use, and difference in availability of opioids. Ms. Moore has requested more in depth data from various agencies to conduct a more complete data assessment over the next three months in order to better identify areas to target. Ms. Moore went onto introduce the Medicaid Transformation Waiver. An agreement -in - principal has been reached between the Health Care Authority and CMS for $1.5 billion. Although the budget has been negotiated, the details have not been released. Jill Buhler asked if dental is included. Ms. Moore said it is not included under the waiver. CMS primarily focuses on integrative care and financial reform, some social determinants of health, and adults. Children will not be eligible for services through the waiver. Sheila Westerman expressed concern over children being excluded from the waiver. Ms. Moore explained that, because it could take up to 20 — 30 years to see the return on investment in children, they were not included, whereas investing in someone who is homeless and in and out of jails and hospitals, is a quick return on investment. Ms. Moore stated that she was disappointed as well that children were not included. John Austin asked about the structure of CMS. Ms. Moore explained that CMS is located under Health and Human Services at the federal level and the innovation center is located within CMS. Ms. Moore briefly reviewed the three initiatives of the waiver. Projects will be coordinated by ACH's through service providers. It is unknown if CMS will provide pre-packaged projects with specific requirements or just general strategic guidelines. Members had questions about the process for selecting projects, the role of the finance committee in the OCH, how the Community Health Improvement Plan could be used to identify needs, how to include housing, and the possibility of looking at embryology and nutrient deficiency to help future children. 2. Nurse Program for Medication -Assisted Treatment (MAT) Anders Egdgerton, Administrator for the Salish Behavioral Health Organization (SBHO), informed the Board about the Early Periodic Screening Diagnosis and Treatment benefit under Medicaid for children. He also informed the Board of a $500k housing grant the SBHO recently received for people who are coming out of prison, jail or have received in-patient psychiatric and/or chemical dependency treatment. Mr. Egdgerton presented the Harborview Nurse Case Management project where nurses are paired with physicians who are prescribing buprenorphine as an opiate alternative. The nurses support the physicians by taking care of a lot of the chaos that comes with the opiate addicted population. The SBHO has $300k to implement a model similar to the Harborview Nurse Case Management project with local physicians who are prescribing buprenorphine to patients on Medicaid. The SBHO would fund nurses to do the case management and coordinate with outpatient providers. All of SBHO's providers are willing to work in medicated assisted treatment. Mr. Egdgerton informed the Board of the three medications used to help opiate addicted individuals - methadone, buprenorphine suboxone, and vivitrol. Buprenorphine is what most providers prescribe in the area since there is no methadone clinic and research on vivitrol isn't as extensive as it is with buprenorphine. In Jefferson County two of the physicians who can prescribe buprenorphine do not participate in the Medicaid program. There was discussion about why more physicians are not prescribing buprenorphine, who can prescribe it, and the process of becoming certified to prescribe it. Vicki Kirkpatrick expressed concern over prescribing physicians not accepting Medicaid since the majority of the population seeking MAT is most likely on Medicaid. Kathleen Kler expressed concern over continued funding for the program after this year. Mr. Egdgerton believes there will be continued funding due to the seriousness of the epidemic and the priority given by the State and Federal governments. 3. Public Hearing: On-site Sewage System Management Plan Fees There was a brief discussion as to why the public hearing will be moved to November 3rd Kathleen Kler motioned to move the public hearing to November 3rd at 1pm. The motion was seconded by Jill Buhler. No further discussion. The motion passed unanimously. 4. Jefferson County Community Health Improvement Plan: Updated Plan and Resolution of Support. Vicki Kirkpatrick presented the most recent version of the Community Health Improvement Plan and the joint resolution with the Jefferson County Public Hospital District No. 2. On behalf of the Jefferson County Public Hospital District No. 2, Jill Buhler discussed minor changes made to the plan, which were also non -substantive. Ms. Buhler said the plan was very well received and the joint resolution passed unanimously. Ms. Kirkpatrick informed the Board that once the Community Health Implementation Plan is approved, the steering committee will commence. In January, the steering committee will present recommendations or options to consider for ongoing support for implementation of the Community Health Implementation Plan. Jill Buhler motioned to adopt the joint resolution with the Jefferson County Public Hospital District No. 2 for the Community Health Improvement Plan as presented. The motion was seconded by John Austin. No further discussion. The motion passed unanimously. ACTIVITY UPDATE Michael Dawson reported that he attended the Environmental Health Directors state-wide meeting in Leavenworth earlier this month. He said there were a couple things to report. First, all counties were discussing the potential impacts of the Hirst decision and how it impacts water use from previously exempt wells. Second, the Legislative subcommittee came out with a good outreach video and website (http://publichealthisessential.org). Third, there was a session on climate change held by professionals from the University of Washington. Jefferson County was 11 recognized as being at the forefront for looking at how health may be impacted by climate change and for their participation with the North Olympic Peninsula Resource Conservation and Development Council in development of the publication, "Climate Change Preparedness Plan for the North Olympic Peninsula." Vicki Kirkpatrick announced that Kelly Matlock will receive an Excellence in Prevention award coupledwith a Lifetime Achievement Award from the Division of Behavioral Health and Recovery. The award will be presented to her at the Prevention Summit in November. Jill Buhler reminded the Board that the hospital will have an open house on Sunday at 3pm to view the new wing. AGENDA PLANNING CALENDAR Catharine Robinson will not attend the December 2016 meeting of the Jefferson County Board of Health. NEXT SCHEDULED MEETING The next Board of Health meeting will be held on December 15, 2016 from 2:30 — 4:30 p.m. at Jefferson County Public Health, 615 Sheridan Street, Port Townsend, WA. ADJOURNMENT Chair Sullivan adjourned the October 20, 2016 Jefferson County Board of Health meeting at 4:17 p.m. JEFFERSON COUNTY BOARD OF HEALTH Excused Phil Jo s n, M b Da 1 an, air Catharine Robinson, Vice -Chair J ustin, Member illBuhler, ember Sheila Westerman, Member Kathleen Kler, Member Respectfully submitted Denise Banker 5