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.
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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.
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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
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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.
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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.
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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
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