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HomeMy WebLinkAboutM011818 BOHJEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, January 18, 201�i Jefferson County Public Health, 615 Sheridan Street, Port Townsend WA 98368 Board Members Kate Dean, County Commissioner District #1 David Sullivan, County Commissioner, District #2 Kathleen Kier, County Commissioner, District #3 Ariel Speser, Vice -Chair, Port Townsend City Council Sheila Westerman, Citizen at large Jill Buhler, Hospital Commissioner, District #2 John Austin, Chair, Citizen at large Staff Members Thomas Locke, Health Officer Vicki Kirkpatrick, Public Health Dir Stuart Whitford, Env. Health Dir Veronica Shaw, Public Health Deputy Dir Michael Dawson, WQ Manager Jenny Matter, Clerk of the Board Vice -Chair John Austin called the January 18, 2018 meeting of the Jefferson County Board of Health to order at 2:32 p.m. A quorum was present. Members Present: Sheila Westerman, David Sullivan, Jill Buhler, Kathleen Kler, Kate Dean, John Austin, Ariel Speser Staff Present: Vicki Kirkpatrick, Veronica Shaw, Thomas Locke, Michael Dawson, Jenny Matter APPROVAL OF AGENDA Vice -Chair Austin asked for approval of the Agenda of the January 19, 2018. Member Kathleen Kler motioned to approve the agenda. The motion was seconded by Member Jill Buhler. No further discussion. The motion passed unanimously. ELECTION OF OFFICERS Vice -Chair Austin called for nominations of officers for 2018. Sheila Westerman nominated John Austin for position of Chair. The nomination was seconded by Jill Buhler. No further discussion. The motion passed unanimously. Kathleen Kler nominated Ariel Speser for the position of Vice -Chair. Sheila Westerman seconded the nomination. No further discussion. The motion passed unanimously. APPROVAL OF MINUTES Chair Austin asked for approval of the minutes of the December 21, 2017 meeting of the Jefferson County Board of Health. Page 1 of 6 Member Jill Buhler motioned to approve the minutes. The motion was seconded by Member Sheila Westerman. No further discussion. The motion passed unanimously. PUBLIC COMMENTS Al Bergstein spoke in support of compostable toilets and women's health issues. Angela Gyurko spoke in support of women's healthcare and concern over future funding for school based health clinics in the high schools. Linda Martin spoke in support of funding for family planning and had questions about the new women's clinic at Jefferson Healthcare. Rachelle Merril spoke in favor of composting toilets and year around grey water systems. She provided information on nutrient leakage from conventional and composting septic systems. Paul Ruben spoke in favor of composting toilet systems and stated he would like to document results of composting toilet systems in a quantitative and scientific way and provide the report annually to homeowners and the County. Tony Goldenberg spoke in favor of permitting grey water systems and composting toilets as a way to make housing more affordable. Karen Wyeth spoke in favor of composting toilets and presented a study conducted in Australia. Carol McCreary spoke in favor of ecological toilet systems as a disaster risk reduction measure. David Steele spoke in favor of the grant proposal by the Conservation District and the effects of failing septic systems on shellfish beds. Chuck Gibilisco spoke in favor composting toilets and gave information on other states and counties that allow composting toilets. JoAnn (no last name given) spoke in support of composting toilets as a sustainable and earth conscious choice and, as she builds her home, hopes to work with the County instead of evading it. Eric Jorgensen spoke in favor of alternative waste water systems and finding a way for private citizens and businesses to partner with the County to move toward more sustainable options. Maj -Britt Peacock spoke in support of composting toilets as water saving systems and gave examples from Sweden. Page 2 of 6 OLD BUSINESS AND INFORMATIONAL ITEMS 1. Jefferson Healthcare (JHC) Update Jill Buhler reported that the hospital commissioners will be in Olympia on January 26th to speak with Senator Van De Wege, Representative Tharinger, and Representative Chapman about various topics, including Medicaid expansion, individual insurance options, health system partnerships, and pharmacy standards. 2. Letters re: Composting Toilets and Greywater Systems Sheila Westerman noted that all the letters received were in favor of composting toilets. Ms. Westerman said Jefferson County has worked hard to work with people to meet state regulations, help those who have financial concerns about septic systems, and protect the water and soils of the County. She explained that, although local health jurisdictions can adopt public health rules that are more stringent than those of the state, they cannot issue rules that are less stringent than the state standard. Ms. Westerman suggested that staff research what other counties have done that meet the state code and see if Jefferson County can replicate what has been done elsewhere. Kathleen Kler added that she has also received letters in support of composting toilets where supporting research has been included, and noted the research as very useful while they move forward to better understand the issue. 3. Influenza Season Update Dr. Tom Locke, Health Officer, said we have entered the peak of flu season. The predominant flu strain is H3N2 and is associated with higher death and hospitalization rates. In addition, the vaccine is only about 30% percent effective for the predominant strain. Influenza activity is expected to peak over the next several weeks and then begin to decline. NEW BUSINESS 1. Regulation of Composting Toilets and Greywater Systems in Washington State Dr. Tom Locke said composting toilets and grey water systems have been legal in Washington State for some time. He reviewed types of composting toilets and ways to dispose of septage and biosolids in the county. He noted there are a variety of proprietary commercial composting toilets that have been approved by the state. Dr. Locke explained that technical standards for greywater systems are based on the volume of water, soil types, and intensity of the waste stream. Specifications are set by the state and intended to keep infectious pathogens away from food and drinking water. Linda Atkins, Environmental Health Specialist, added that, like conventional septic systems, greywater systems must meet vertical and horizontal separation standards. The type of system (conventional or greywater) permitted also depends on the soil type, total area, and the water table. Although waivers are allowed, they are viewed as alternatives to meet the intent of the law, not an exemption from it. Dr. Locke challenged the notion that composting toilets and grey water systems were low cost alternatives to repair failing septic systems. Generally, these systems are most cost effective if Page 3 of 6 installed when a house is first built because the cost of refitting plumbing to accommodate a composting toilet and greywater system can be more expensive than repairing an existing conventional system. Moreover, in climates such as Western Washington with heavy winter rains and a limited growing season, greywater systems may be unable to handle wastewater year round. This requires property owners to have a backup OSS to deal with wastewater when surface soils are saturated with rain. Michael Dawson, Water Quality Manager, stated he distributes information on programs (Craft 3 or USDA) that help ease the financial burden of replacing a failing septic system to those he encounters in the field. Mr. Dawson agreed that an easily reproduced, affordable, public domain designed system that uses less water would be beneficial, but is not aware of any systems that meet these requirements and the state code. Dr. Locke added that if the state standards need to be modified to allow more economical methods to dispose of grey and black water, the forum to discuss these changes is at the state level. Linda Atkins informed the Board that the state has just started the review process to open up the rule again and will be taking comments from the public. Vicki Kirkpatrick, Public Health Director, said, based on the emails she received, the issue is not as much about understanding the regulations, but wanting to amend the regulations so a land owner designed and installed system can be permitted without going through a certified designer. This is not allowed under current state codes, and changes to that code would have to come from the State Board of Health. A discussion ensued regarding the difference between greywater and conventional septic systems, the permitting process (including hiring a licensed designer), how to better educate the public about the state standards and viable alternatives to conventional septic systems, the severity of water borne illness, and the possibility of Public Health designing systems and policy implications. 2. County -level Drug Take Back Programs Dr. Tom Locke briefed the Board about pharmaceutical stewardship ordinances enacted in King, Kitsap, and Clallam Counties. These ordinances require pharmaceutical manufacturers to take back the unused drugs they manufacture. Pharmaceuticals can be dropped off at kiosks in pharmacies or mailed -in, as the trend increases towards using mail order pharmacies. The Board had questions about additional costs, physical disposal of pharmaceuticals, applicability to homeopathic remedies or over-the-counter medications, and legislative interest and actions. Kathleen Kler added that Walmart is distributing gel packets that will de -activate unused opioids so they can be disposed of in the garbage. Dr. Locke said that the Board of Health has the authority to adopt an ordinance like King, Kitsap, or Clallam County. The Board agreed to move forward by conducting an in-depth review of similar ordinances. 3. Legislative Update Dr. Tom Locke said that a short legislative session is in progress and the initial focus is on passing a capital budget. Page 4 of 6 4. Three County Coordinated Opiate Response Project (3CCORP) update Dr. Tom Locke said he recently gave a 90 minute talk on Medication Assisted Treatment (MAT) and the opioid epidemic to the Jefferson Healthcare medical staff. He said the opioid crisis has true characteristics of an epidemic and MAT has the highest success rate (60-80%) of available treatments. At the meeting he shared his experience treating individuals with MAT and is hopeful that other clinicians will start treating Medicaid eligible patients. Vicki Kirkpatrick shared a story of a public health client who wanted to stop using heroin and was buying MAT pharmaceuticals from her drug dealer because it wasn't available to her. The Board had questions about regional treatment options and availability. PUBLIC COMMENT Paul Ruben gave examples of different ways to store or dispose of waste (i.e., vault, bucket systems) and said it was unclear under what circumstances it is permissible to compost bio - solids. He also said a water barrier can be placed under compost so it does not leach into groundwater. Carolyn McCreary noted that half of the world's population are urban dwellers and work is being done to create systems to manage human waste. She encouraged the Board to look at the work being done by Soil Haiti, the Rich Earth Institute in Vermont, and the Gates Foundation. ACTIVITY UPDATE Dr. Locke said that he, along with the Health Officers for Clallam and Kitsap counties, has been invited to meet with Senator Cantwell's and Senator Murray's staff to discuss the opioid epidemic. Kate Dean informed the Board that the Senate Majority Leader said they are very close to passing a Hirst bill and the capital budget is expected to roll out by the end of the week. She also said that both the Senate Majority Leader and the Director of the Office of Financial Management independently commented on how counties need to do a better job on mental health and opioid response. Vicki Kirkpatrick provided a brief update on the possibility of establishing a school based clinic in Quilcene and said Mike Glenn, on behalf of Jefferson Healthcare, has pledged $20k. Linda Atkins reported that they have narrowed down the search to two vendors for the on-site permitting data base and will be visiting other jurisdictions to see how they work. AGENDA PLANNING CALENDAR There were no agenda planning updates. Page 5 of 6 NEXT SCHEDULED MEETING The next Board of Health meeting will be held on Thursday, February 15, 201 W from 2:30 — 4:30 p.m. at Jefferson County Public Health, 615 Sheridan Street, Port Townsend, WA. ADJOURNMENT Chair Austin adjourned the January 18, 2018 Jefferson County Board of Health meeting at 4:31 p.m. JEFFERSON COUNTY BOARD OF HEALTH n J n Austin, Chair J 11 Buhler, Member Kathleen Kler, Mem e Sheila Westerman, Member Ariel Speser, Vice -Chair KatD ah_Mle=r�, Davi Sullivan, ember Respectfully submitted J. Matter Page 6 of 6