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HomeMy WebLinkAboutM022278 • ` COMMUNICABLE PUBLIC HEALTH HOME VITAL ENVIRONMENTAL HEALTH''ASE CONTROL NURSING NURSING STATISTICS HEALTH EDUCATION • ......0.....A 1:---- ... .--,' . • p, . , .I.4r, 1 ' 0.0 . 'I JEFFERSON COUNTY HEALTH DEPARTMENT RTMENTa , . '1 II t 1} I�((( `. 602.SHERIDAN PORT TOWNSEND,WASH.98368 (206)385-0)� ic,.... . 1 A qJefferson County Health Department • Board of Health Meeting m 9930 a.m. February 22, 1978 Health Department Conference Room Election of Officers Approval of minutes of the January 18, 1978 meeting. Correspondence t 1. The contracts for the following services will be presented for discussion and your signatures. , a. Laboratory service for G.C. Smears with Jefferson General Hospital. b. Pediatric nursing service with Jeanne HiSberd. c. Cervical Cancer Screening Contract with Debbie Stokke. 2. The-position of C.E.T.A. home health aide has been approved. Do you want to be involved in the interviewing for this position? .3. Environmental Health. Randy Durant a. Minimum lot size requirements for unrecorded and recorded subdivisions without public water supplies. b. Minimum lot size requirements (under ideal soil conditions) of unrecorded and recorded subdivision with public water supplies. c. Reports and inspection data. 4 fr ,I 4. Public Health Nursing. Phyllis Bee a. Monthly report of activities. i 5. Health Officer. Joseph Fischnaller, M.D. 0. Report. b. Proposed activities and. problems. 1 —1 • • • f j snsf • • Page 2 - Agenda - Health Department (cont'd) 6. Administrator a. Reports - Fiscal - Contractors b. Clallam County division and relationships. 7. Other items 8. Adjournment: t • T. • { 4 F • • • • C • ININNI an 1111 W WNW • • COMMUNICABLE PUBLIC HEALTH HOME VITAL ENVIRONMENTAL HEALTH DISEASE CONTROL NURSING NURSING STATISTICS HEALTH. EDUCATION Jam•~t ,� „ram j' �� '��i Q ' JEFFERSON COUNTY HEALTH DEPARTMENT ' x�, 602 SHERIDAN PORT TOWNSEND,WASH.98368 (206)314.0722 •' ‘141444 Jefferson County Health Department Board of Health Meeting 9130 a.m. February 22, 1978 Health Department Conference Room MINUTES Present were: Board of Health Members - B. G. Brown, A. M. O'Meara and Carroll Mercer. Staff Members - Randy Durant, Phyllis Bee, Joseph Fischnaller M.D., Gael Stuart, and Herbert Kuzniczi, who is in charge of dissolution of the Olympic Health District. Election of Officer B. G. Brown moved, A. M. O'Meara seconded that the Board of Health officers be the same as the Board of County Commissioners, the motion carried and Carroll Mercer was named Chairman of the Board of Health. Minutes The minutes were approved as presented. r Corresoondence s A letter from John A. Beare M.D., Director of the Washington State Health Services Division was read. The letter invited the Public Health Officer and the Administrator to meet with the Health Services Division in Olympia and pledged coopera- tion with the Jefferson County Health Department. (Attached #1) Herbert Kuzniczi Mr. Kuzniczi reported on progress on the dissolution of the Olympic Health District. t 1. The roof repair on the Health District Building has not been completed, but the authorizied money will be set aside out of the unspent funds of the District. ,6 y • • ,era • • 2. Dr. Willa Fisher is entitled to about $530.00 for annual leave from District funds. 3. Vacation time and sick leave was discussed. It was'agreed that each Department would receive a pay off for its employees for unused annual leave and sick leave as of December 31, 1978.' Each Department will negotiate with its own.employees the terms of transfer of benefits. The Board of Health will contact the prosecuting attorney to determine their legal position in this matter. 4. The chest x-ray machine that is housed in the District office in Port Angeles was purchased for $25,000.00. The present value, according to Mr. Kuzniczi's contacts with Mr. Arthur Gore, is $1.000.00. 5. There is $30,000.00 to $40,000.00 to be distributed between the two county Departments after the obligations of the District are paid. Funds received by the County Treasurers for district operation will not be transmitted until negotiations are com- pleted. 6. Compensatory time policies will be consulted before a decision is made on the disposition of this matter. Mr. Kuzniczi was provided with a record of employees accumulated compensatory time, sick leave and annual leave. (Attached #2) Old Business 1. B. G. Brown moved, A.M. O'Meara seconded to discontinue the Cervical Cancer Screening Program on March 31, 1978 unless state or federal funds are received to pay for the service. An estimate of the cost of the program is attached. (Attached #3) Motion carried. 2. B. G. Brown moved, A. M. O'Meara seconded to approve and sign a contract with Jefferson General Hospital for laboratory service to interpret G. C. smears. Motion carried. (Attached #4) 3. B. G. Brown moved, A. M. C'Meara seconded to approve and sign a contract with Jeanne Hibberd to provide pediatric nursing services for Maternal child'Health and Early Periodic Screening Diagnosis and Treatment. Motion carried. (Attached #5) 4. The position of Home Health Aide has been awarded by C.E.T.A. Phyllis Bee will set up interviews with applicants and the Home Health Aide will be hired. The Board of Health will be notified as soon as the aide has been hired and will be furnished back- ground information on the employees. Report% grwironmental Health- Randy Durant 1. A letter to Mr. Cunningham from Randy Durant making suggestions' for revisions in the Jefferson County Subdivision Ordinance was presented. (Attached #i) Mlioommummun mimmummmoms eammommum • , - - , • -., • • 2. A letter to John D. Littler of D.S.H.S. Water Supplies and Waste Section regarding Class IV Water System package was presented (Attached #7) 3. (a) A discussion was held on the minimum lot size requirements for unrecorded and recroded subdivisions with- Out water supplies. Randy Durant recommended to continue to enforce the old regulations on recorded plots and to recommend a minimum of one acre on unrecorded plats. (b) In the case of a public water supply on unrecorded or recorded plats with ideal soil conditions, there are some plats with lots of only 5,000 square feet. Randy Durant recommended that there be a two lot minimum.and asked if there was a need to differentiate between mobile homes and permanent structures. The Board of Health felt that there should not be regulations preventing the construction of housing unless there - was an indication of an immediate health problem. Permits , I would be based upon a first come first served basis. Problems of density of construction could result in the use of more efficient or central disposed systems and in more and better public water supplies. In any case, the property owner should be warned in writing of the possible dangers of construction on too small a lot and the problems that would exist as the population density increased. 4. A copy of the letter to Mr. Charles Allert from Randy Durant was discussed. A copy of the letter is in the Environmental Health Department files. Reference to the 100% replacement area requirement will not be mentioned in future site evaluations. (Attached #8) S. A survey of Aerobic Sewage Systems dated January 31, 1976 was presented. (Attached #9) Randy Durant will continue to monitor local systems and to attempt to get complete information on alternate systems on sewage disposal. 6. A repoit of the activities of the Environmental Health Department for the month-of January was presented. January 1978 showed an increase of 50% in site evaluations over January 1977. There were 506 contacts made. (Attached #10) , f Public Health Nursing - Phyllis Bee I. In addition to the attached report (Attached #11) numerous Community organization have been contacted. 2. Marla Weed the new public health nurse will work in the QMilcene, Chimacum, and Brinnon areas. She will establish a working office in either the Quilcene Community Center or the Quilcene School. Gael Stuart will talk to the Quilcene Community Center Board to get their approVal. 3. The State of Washington will provide x-ray viewers free of charge to the Health Department so that Dr. Fischnaller can read and interpret chest x-rays. This will be an increase in service to our clients and will be a savings in money. ; . t • . • F 4. The Well Child Clinic is getting good response. There will be four clinics in Jefferson County each month. The first and third Thursday in Port Townsend, the second Thursday in Chimacum and the fourth Thursday in Quilcene. S. The problems posed by home deliveries is growing. There were 15 last year. 6. The V.D. Clinic was discussed. These will be under the > ,t supervision of Dr. Fischnaller. The Health Department provides penicillin to the local doctors free of charge. We do not administer penicillen at the Health Department. Health Officer - Joseph Fischnaller ' 1. Dr. Fischnaller reported on the staff time study that will be kept to assist us in preparing the quarterly report. Jack Minckler of the state health office will come to Port Townsend to help with the preparation of the report. 2. A contact with Dr. Bassett of the Maternal Child Health section indicates that sufficient funds (approximately $12,000.00) will be available for Well Child Clinics. A grant application will be developed to cover our costs. 3. The professional liability policy has come. The premium-is S1421.00 annually. After copies are made for Dr. Fischnaller and . the Department the policy will be given to Fran Hanson of the auditors office to be paid Out of the Jefferson County Insurance Fund,. If Dr. Fischnaller takes other employment, the County will be reimbursed proportionally. d Health Department Administrator - Gael Stuart 1. A letter to Ms. Norma J. Evans stating the Jefferson Health Departments' intention to enter into a formal agreement with the Clallam Health Department to jointly sponsor Home Health Services, was presented. B. G. Brown moved, A. M. O'Meara seconded that the letter be sent. Motion carried. (Attached #12) 2. A copy of the insurance policy for the Olympic Health District with an endorsement covering the Clallam County Health Department and the Jefferson County Health Department has been received. A copy of the letter from Gellor Insurance is attached. (Attached#13) The copy of the policy and the endorsment will be given to the County Auditor, Policy term ends May 1, 1978. . 3. The city of Port Townsend has been contacted to be sure that they take the necessary legal steps for Jefferson County Health Department coverage. The mayor has been asked to send a represen- tative to the regular Jefferson County Health Department meetings. ( 4 • 1.111.111.11111.1.1.1 ..1.01161111. r 4. Agreements with Ciallam County, to provide service to the West End of Jefferson County will be developed when they have hired a Health Officer and Administrator. In the meanwhile, service is being maintained. 5. The administrator reported that there may be a necessity for budget amendments for equipment and contracted services because of increased activity. A filing cabinet for the WIC program was purchased through our budget but reimbursed by the state and the M.C.H. contract will be increased. The increased -A ,receipts will exceed the increased expenditures. 6. The need for additional secretarial time, because of increased activity may require an additional full time employee. As soon as the work load stabilizes, a recommendation will be made. " 7. The storage room in the basement will be remodeled as soon as the maintenance man comes to work. Miourrment Meeting adjourned at 12:15 p.m. p� • • • ii...r..ima ....moor. .11111411•11/11M Attachment #1 a STATE OF DEPARTMENT OF SOCIAL AND HEALTH SERVICES t V I WASHINGTON Olympia,Washington 98504 n � DucGotrry Lee Ray x Harlan P.McNutt,MD,MPH,Secretary February 10, 1978 Mr. Gael R. Stuart Administrator I s Clallam-Jefferson County Community Action Council, Inc. P. 0. Box 553 Port Townsend, Washington 98368 Dear Mr. Stuart: • Reference: CA-213 I This is in reply to your letter of February 6, 1978, in which I note with pleasure the naming of Dr. Joseph Fischnaller as Health Officer for the newly formed Jefferson County Health Department. fly sincere congratulations on your appointment as business adminis- trator for the department. Dr. Fischnaller was correct in indicating our willingness to provide you with information and guidance. Perhaps the best approach would be for you to visit the division at a time mutually convenient when we might discuss public health in general and offer suggestions as appropriate. If such a visit appears warranted from your perspective, please feel free to call (206) 753-5871 for an appointment. I am familiar with the dissolution of the Olympic Health District and the reasons leading to this action. The department is looking forward to having a close working relationship with the Jefferson County Health Department. Sincerely, -441.4 ohn A. Beare, MO, MPH Director OB-44J Health Services Division JAB:ep ■sr �assas, .a111111M.wsNININIM9 Attachment #2 .-_ - Jefferson County Hrtlth Deaartricnt Time accumulated through December 31, 1977 Annual Sick Comp fltiyllii:flee 63.5 hrs. 50 hrs 17k hrs. Joy Guptill 35.0 hrs. 65 hrs. 16 hrs. Randall t7."Durant 30 days 77 days 100 hrs. . Larry Anderson 5 days 3 days V Nikki Schuler 35 3/4 hrs. 30 hrs. Sylvia R. Adams 24 days 461/2 hrs. 107 days 9=i hrs. • { } mmwommon Timmummm Ammommommorm • } • y,,a 1 i tZAci,•, tali " j .s ,„„ ��� TO: Dr. Fischnaller � FROM: Phyllis Bee DATE: February 21, 1978 ' SUBJECT: Cervical Cancer Screening 4 Costs in.•..January, 1978 Debbie Stokke (7.43/hr) $222.90 `'• ' Mileage c> 2. 8 • Billed to State GCS Program $203.10, Collected 3n January . $2 Total patients in January 20 Total patients (part pay) 5 paid $56.50 ,' Lab still to bill us $2.25/Pap Smear for 5 that paid on a sliding fee scale $56.50 � ` Less 11.2 Real Income $45.25 . . These will only be paid for through March 31, then Jefferson County H.D. will be responsible. . CERVICAL CANCER SCREENING CLINICS AFTER MARCH 31, 197E Proposed action -- To continue or discontinue clinics Cash Outflow: 20-25 clients per month Salary -- Woman's H.C. Specialist ` ' Clinics at-Port Townsend 2x Chimacum lx Quilcene lx ' 4 clinics per month 4 10 hrs. each (including travel time) e 7.43 per hour $297.20 1 Travel Mileage (450 miles x .15) 1 w cost of Pap test (2.25 x 25) $ .20 (cost may go up) 20.9 per month Clerical Times (4 - 6 hrs/mo x $5) ' 0.00 O. Equipment needed (paper supplies) __5y 00 Total monthly cost $455 90 Total monthly income (patient fees estimated) . . 0.00 Deficit - $4 y.gp Effect on clients -- program will possibly be picked up by Council on Aging Effect on H.D. -- Cost up to $450 to $500 per month (it is not budgeted). • } • .! • _ . • flacA JEFFERSON COUNTY HEALTH DEPARTMENT CONTRACT FOR PROFESSIONAL SERVICES Agreement Between • THIS AGREEMENT is made and entered into between the Jefferson County Health Department and the Jefferson General Hospital. • THIS AGREEMENT became effective on the first of January 1978, and was set • into writing on. the 3rd of February 1978. WHEREAS, the Jefferson County Health Department is in need of laboratory service for the interpretation of G. C. Smears, and .WHEREAS, laboratory services for interpretation of G. C. Smears are avail- able at the Jefferson General Hospital, and WHEREAS, the Jefferson General Hospital is willing to provide this service to the Jefferson County Health Department. IT IS AGREED BETWEEN BOTH PARTIES HEREIN AS FOLLOWS: 1. Jefferson General Hospital will process and interpret G. C. smears for the Jefferson County Health Department. 2. The Jefferson County Health Department will send all G. C. smears to the Jefferson General Hospital Laboratory for interpretation. 3. The Jefferson County Health Department will pay the sun of $5.00 for the interpretation of each G. C. smear upon receipt of a billing from the Jefferson General Hospital. 4. The Jefferson General Hospital in the performance of services under th-4 contract, when applicable, will provide its own malpractice insurance. 5. The Jefferson General Hospital shall not discriminate against any person presenting himself/herself for service because of race, religion, color, sex, age or national origin. The hospital shall take affirmative action to ensure that persons receive services without regard to race, religion, color, sex, age or national origin. 6. This agreement shall continue and be binding upon both parties herein un- less terminated by giving thirty (30) days notice by either party. • Y • ,,.: , • • • n r • Jefferson County Health Department Agreement --2-- 7. This agreement may be amended by written consent of both parties and all amendments shall be attached to this agreement and made a part thereof. • Signed /Dated: Jefferson General Hospital • Signed 4/171 �// 4/,-C (� . )Dated: � - 7 d • Chairman, Jefferson County Commissioners , Signed /Dated: �—2� 76 Health Department Administrator 6 • • } • • • Attachment #5 JEFFERSON COUNTY HEALTH DEPARTMENT CONTRACT FOR PROFESSIONAL SERVICES AGREEMENT BETWEEN This agreement is made and entered into between the Jefferson County Health Department and Jeanne Hibbard. This agreement became effective on the first of January 1978, and was set into writing on the 16th of January 1978, and voids the contract of the 26th of October 1977 between Jeanne Hibbard and the dissolved Olym>dic Health District. WHEREAS, the Jefferson County Health Department is in need of a Pediatric Nurse Practitioner and, WHEREAS, at the present time„ the Jefferson County Health Department hereafter referred tows the Department, is unable to provide these services from a full-time member ofrits staff, and, WHEREAS, Jeanne Hibbard, hereinafter referred to as the Contractor, is prepared and willing to assume the responsibilities as set forth within this agreement. IT TS AGREED BETWEEN BOTH PARTIES HEREIN AS FOLLOWS: ti 1. The Contractor shall act as•a Pediatric Nurse Practitioner, and shall provide from two (2) to four (4) clinics per month in Jefferson County, and will provide the services as outlined in the IEeternai Child Health contract with the State of Washington. (The M.C.H. contract is attached to this agreement). The Contractor will also provide the services relating to the Early Periodic Screening Diagnosis and Treatment Program. (Attached copy of Department of Social & Health Services Contract.) 2. For said services rendered under this agreement, the Department shall pay to the Contractor herein named a rate of $7.00/hr. and' mileage at the rate established by Jefferson County. 3. Payment shall be made on or before the twentieth (20) day of the month, following one full month of service, aid it shill be understood that the Contractor shall be responsible for report- ing the :weber of hours worked each month and the mileage travelled on Department business. 4. As an independent Contractor, it is understood that the Depart- ! sent is not responsible for payroll deductions such as Income { Tax, Social Security, etc., and the Contractor must make arrangments, according to Internal Revenue Service directives, for the payment of such tax as may apply. 5. The Contractor, in the performance of services under this agreement, shall be an independent contractor and shall not be considered an eawigoyee of the Department, and when applicable, shall provide malpractice insurance at the Contractor's expense. +Cfw4x.a.f4_ . t -MillIMMMOMUMM _______ rr..MINIIII • y '• r * .:. it 6. The Contractor shall not discriminate againstany person present- ing himself herself for service because of race, religion, color, sex, age or national origin. The Department shall take 'affirma- tive action to ensure that persons receive services without regard to race, religion, color, sex, age or national origin. 7. This agreement shall continue and be binding:upon both parties herein unless terminated by giving sixty (60) days written notice by either party. % S. This agreement may be amended by written consent of both parties and all amendments shall be attached to this agreement and made a part thereof. Signed: 1L.Elc'.t .c--J_ - te/tG� a.-,.,oL /�r Dated: /, Vi.e_, .2, /9 CONTRACTOR -^fir 4 ..'// Signed: . at- y�/I/r..//� .Z Dated: - 2- 1-. 3AIRMAN, Viil ERSON COUNTY CC NISSIONERS Signed: h._Cd`-- -! (1-a`1 Dated: .2-.2-7t HEALTH LEPARIMENT ALMINISTRATOR my as to foJ i .... G . IL,A. Dated: e..A+ tr l ?6 SEC 'ING ATTORNEY - JEFFERSON COUNTY k ( i i i I • �.___. -- - — ._____.__...___.___ _ ....k IMINIMIIIIMIK • IP t 9 os `,. AGREEMENT • • • EARLY AND PERIODIC SCREENING, DIAGNOSIS AND TREATMENT • • . OF ELIGIBLE INDIVIDUALS UNDER 21 (EPSDT) • :,``.•. of• • • This agreement between the'Officeof Medical Assistance of the_ Health Services Division representing the Department of Social and Health Services (Title XIX Agency) and Jefferson County Hc•a1th Department , provider of screening services, defines respective responsibilities, services and basis for reimbursement as required by the Social Security Act. ,�,, • 1. The local office of the department will issue medical ID coupons to eligible persons,-inform them of the EPSDT program and make referrals - to-the screening provider. . • • 2. Itiitial-screening services-should include: • a._ medical history b. assessment of physical growth - C. developmental assessment (physical and mental) £ f • d. inspection of obvious physical defects e. . inspection of ears, nose, mouth, teeth and throat • f. visual screening; auditory testing g. screening for cardiac abnormalities h. screening for anemia ' I.. ..acreening for sickle cell trait for children at risk if not '- `` previously- tested j. urine screening-- k.:_-bIood pressure (children 12 years of age or older) 1. assessment of imzunization status and updating immunizations al. tuberculosis screening if indicated 3. Reimbursement for screening services will be as specified in attachments.. • 4. Recipients in- need of definitive diagnostic study and/or treatment should be referred to a participating medical or dental specialist. The freedom i of the eligible person of choice of providers must be r.bserved,.. i S. Reporting requirements are specified in attachments. 6. Patient records maintained by the provider' of screening services shall be confidential, • • t Y i • • • • • • • V This ,agrcement shall become effective an4 shall remain in full force and effect subject to the right of either party to cancel at the expiration of any calendar month during the life of this agreement upon giving thirty days written notice of such cancellation to the other party. 1 Dated this day of 197 • HEALTH SERVICES DIVISION OFFICE OF MEDICAL ASSISTANCE PROVIDER OP SCREENING SERVICES Robert P.`Hall; H.D.-; Chief J€FFERSUFf.Cou:4TY HEALTH DEPT: _. Address o - , CO2 .y�. �fuan Ave. - Port Townsend;Wash. 98368 • • Phone - 206-385-0722 • • • • • • • • .:• • • ..1.• • ••• • •t: • w, . • • • f••• wY.1 61111841111814484410 7 , ,, . , . ,, , . . , . „ „ . ,. , • ..„ ,? ., COMMUNICABLE, ,. . . .......... , . . . .. . . .. . , , . ........... PUBLIC HEALTH HOMEAttachment #6 .,, STATISTICS DISEASE CONTROL NURSING NURSINGV1TAL ENVIRONMENTAL HEALTH HEALTH EDUCATION ,Aialpikjt, '"*A".. ....:(nk...;......efee"....-•-• % '1."° . . tor -9. : - r .1EFFERSON COUNTY HEALTH DEPARTMENT ,wa '7 802 SHERIDAN PORT TOWNSEND,WASH.90396 .t veit • ♦ Y N.. February 21, 1978 David Cunningham, Director Planning Department Jefferson County Courthouse i Port Townsend, Washington 98368 f Dear Mr. Cunningham: Re:. Revisions to Jefferson County Subdivision Ordinance The following are comments and requests which I feel should be included in the revision as they relate to public health. Sec. 2.40 - Definitions 420 The words."Local Health Department or Health Department" means "Jefferson County Health'Department". This needs to be done throughout the ordinance. An easy way would be to strike out Olympic Health District and replace with iocal Health Department or Jefferson County Health Department. Specific • Sections'which require the words "Jefferson County Health Department" would be the fee sections, 5.103 and 6.103. Include fee schedule for Mobile Home Parks. Sec.:5.103 -A fee of $25.00 shall be paid to the Jefferson County Health Department. Sec. 6.103 A fee of $40.00 plus $1.00 per lot shall be paid to the Jefferson County Health Department. Include fee section in Section 7 - Mobile Home Parks. A fee of $40.00 plus $1.00 per lot shall be paid to the Jefferson County Health Department. I also recommend, if not in this form but some other, another paragraph under- Sections 5.309, 6.309, and 7.309 - Surveys stating " A final survey is not necessary until after preliminary plat approval. However, approximate lot corners shall be staked during preliminary plat review." I • Some subdivisions, specifically short plats, are coming in already surveyed. Many times, however, lot size and configuration must be changed due to con- tours, soil conditions and other factors. This, I feel, creates an unnecessary financial and time consuming hardship on the owner. Please consider this and let's discuss this. I alto feel in sections such as 5.106 (1) Health Department - after Jefferson ti * !. David Cunningham February 21, 1978 Re: Subdivision Ordinance Page 2 County HeaitR bepartment which are WAG 248-96 - Rules and Regulations of the State Board of Health for on-site sewage disposal systems and Jefferson County Ordinance 2-77. This type of statement should also be included in Section 6 - Long Subdivisions. Section 7 Mobile Parks WAC 248.76 also applies, so it should be included in this section in some form. For interpretation we could specify whichever requirement is more demanding. I hope to discuss the revisions at greater length with you. I also plan to discuss this with the County Commissioners. Thank you for the opportunity to review the proposed revision. (Si 1y, { Randall M. Durant, R.S. Dir. Env. Health RMD/sa CC: Board of County Commissioners 1 • Dr. Fischnaller, District Health Officer i • • • s IY.IMIN111... ....ter. IMIIIIIIIMMINIII __1111/1111.1 COMMUNICABLE Attachment #7 DISEASE CONTROLICABLEPUBLIC HEALTH HOME VITAL NURSING NURSING ENVIRONMENTAL TAL HEALTHSTATISTICS- HEALTH �EDUCATION J HEALTH DEPARTMENT 'P ", .,�... 802 SHERIDA# PORT TOWNSEND,WASH.98368 A '' - t (208�9tly0F22 144, . N February 21, 1978 John D. Littler, P.E. DSHS Water Supplies and Waste Section t Hail Stop ED-11 Olympia, Washington 98504 Dear John: , .Re: Class IV Water Systems committee meeting The draft of the Class IV system y package is a good beginning for what locals need if they are to handle plan review and approval of new systems and to make similar decisions as they apply to existing Class IV systems which have never been previously approved. The major request is to "keep it simple". Also, I feel submittal of a design by a certified engineer should be a major requirement with a certified "as- built" plan submitted. This would keep things from becoming confusing for the owner and save the time of the owner and sanitarian. . The narrative should include as many examples of designs as possible with reference to particular pages of the system package. This is so calculations can be compared to particular situations and lead the reader through the review process. A check list is also necessary. . There should be two separate (or in some other form) design system packages, one for new systems, and one for old unapproved systems. In both, expecially for the existing system, the narrative should include major and minor require- ments noting which ones can be waived and under what conditions. Having two packages would save us and the purveyors time. Also discussed in the narrative should be the "two or three" tap family systems, basic requirements, etc. A pump test should be required for new systems and required if new taps are proposed on old unapproved systems. Springs should be presented in such a way to discourage their use. Specify specific examples of problems with springs and requirements for possible approval. John, I hope these comments are helpful to you in development the system package. I concurred with most of the comments made at the meeting. I dis- cussed with you WAC 248-54-575, Paragraph 2. Could I get an interpretation 61111111•110.1. .111• ..ram_ .M....I. • m Y• ' John D. Littler, P.E. Re: Class IV water systems committee • February 21, 1978 Page 2 of'this"5ecirion'and the definition of and/or examples of "surveillance program". As you know, others and myself feel "shall" should not have been included. "May" would have been a better word. • Being a small department, our involvement beyond providing water bottles, well site inspection, and inspection of private supplies will be very limited. A decision will be made at a later date regarding the agreement with your department. If you have any questions or comments please contact me at this office. Sincerely, Randall M. Durant, R.S. Dir. of Env. Health RMD/sa • • { fi «..,...:,.a...m».«.«.. MiMss.ass:r.. rs/rr11•1assa ems, • • Attachment #8 crd- February 14, 1978 . Mr. Charles Allert P. O. Box 393 Hadlock, Washington 98339 • Dear Mr. Allert: + 's Re: Lot 1, Block D, Paradise Bay - on-site sewage disposal ' 4 The original preliminary approval was conditional. It was approved for a travel trailer or a small mobile home. I noted there was a very limited area for drainfield. It was donditional that prior to approval of a sewage disposal permit the site be staked and a proposed plan submitted for review. The reason for this type of evaluation was due to the small and irregular lot size, high water table and was a way to allow some type of usage on the lot. No specific trailer size was noted so there would be some leeway in reviewing for any future proposal. I anticipate a narrow trailer (10 ft. or less) and a length of 40 to 55 ft. might be 'acceptable. • I have administratkvely decided since the lot was evaluated in 1975 and the 100-14 replacement area was not noted on the report to forgo this requirement. • Please submit a detailed plot plan and design of the on-site sewage dis- posal system noting 100 lineal feet of drainfield, driveway, parking, set- backs and size of trailer unit. Stake the site and I will evaluate it. If after this evaluation a variance on setback is required from the Building Department you would then need to pursue the variance. Should the site be approved by this office (with no replacement area) and the system fails the site would need to be vacated unless there is some other alternative system available. I If 100 ft. of drainfield does not fit there a second choice of review would 'be to consider usage of a destroilet or compost toilet which would cut the drainfield size by 40%. Enclosed is a copy of the actual lot size computed. The lot is even more limited in size than indicated by the previous owner. If you have any questions or comments please contact this office. Sincerely, Randall M. Durant, R.S. , Dir. of Env. Health Encl.Blind cony to co nissioners +cony of site evaluation ot e, .. $ -t t 9 'mot r_ 1 'T/ G Q d 'Pie w C rir " #41 8y'r,'jfd- • ___ /fie, • ‹: • Jii► A • C s .4 "A-re = ie:• S..•; C• ,ca C Z '? 3T.3SCY x.G.‘725'!x.74'¢7?? Z32e•3Z = ZZ?_> 32. /9 'e44•P aPoJ �sY<s*,/- AMEMMUMMOW himemmewarmma asommmeem0. . , • r MVO C HEALTH DISTRICT' • •SITE EVALUATION RECORD • Sec. Tvn. R. Legal Description .A TO: *.•.t 1. 1Td- •r..;?_^., ty -11,A N. -. • • • • %AC)a Site Size S,01D 51. ft. Seller payer A sit. evaluation of the above property has been made by this department and your request for lbr14 ,torcv • has been (approved) llapproved) ((rennin. Comments: :.c-it of n-1.: a 10• h:,1•:_..; on 1-1--75 -t t of r the lot. i --it 45 t-.) v._ry I ar.1.71 is Jb:s. rot r. 1.y. r raj . 7. f.or tr---,tc.1 1-i o.r::er trza- rly :.• trz...11er t rt , ths- lot to the a laveA a.: t.le eight. o.f.t dr f : Th, i1ditr. Very truly yours, • I Sanitarian 1,41.7.••11 V.. : -ant • --"; Date: 1-7 fitt:llow to maintain a 2 ft. SProrigtion lletwe..:en the batto.n of the tr-nch ane the water table. Prtor to a-prove' of a newa•Je 4tsoal el-it the. site rant ste,lci-Jd and a prot-osed pl)t elan submitted ler review. tne.11 Copy tor buyer ?di • -1 - ) 4-- I, C.' C..e OHD:11/73 • • • * OLY PIC HEALTH DISTRICT. SITE EVALUATION RECORD See. Twn. R. Legal Description .t • TO: R Fowler 3a1L, net 1, A?se! Dt 'rad.isa Any CeE6 i;t A-.=. N. SettLie, :'A 98117 Sits Size hrr=.n.. 7.4000 �1. ft. Seller Buyer A site evaluation of the above property has been made by this department and your request for--Aprerr 1 f rr ei..CIC SG.*.ly mobile hors. has been ($ c ) (denied). Comments nit) 'rrZe-tip^ ^4' 3 '1,-"kh -n;' ,Q, ,- i,.6 a 1^ 9:71 +,:-oar table at approx. 3' in all holes. Fire hydrant was inetalled at lower corner of lot on Magnolia— County road is not carrying any water. Only recorin-nd-ition would be to perhaps deepen .. - might not help. Very truly yours, 1 Sanitarian Randall }. Lurant, R. S. Date: 1. 7fi pp 3 o :llj73 moo.. ...a..... .�� y r , • • Attachment #9 STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES OFFICE OF ENVIRONMENTAL HEALTH PROGRAMS SURVEY OF AEROBIC SEWAGE SYSTEMS January 31 , 1976 • PU'R Pb SE ••• The reason for the survey was to obtain information on aerated sewage systems that have been in operation for an extended period of time. The majority of the units inspected were installed prior to 1970. Almost all of the units were found in Skagit County, either on Fidalgo or Guemes Island. A number of units were inspected.in Island County. • �a ! GENERAL It was determined that in many instances the aeration unit was selected as the method of treatment due to the belief that conditions were such that a standard septic tank system would be likely to fail. In some cases, the property owners stated that health authorities required the aerated units in the belief that the units would provide a higher degree of treatment. Some property owners expressed resentment that they were 'forced' into pur- chasing a relatively expensive treatment system. Another complaint voiced by several owners was that they had been pressured to sign contracts for regular inspection and maintenance although few actually signed such contracts. Of those who signed contracts. a number had cancelled thinking that they could make the inspections themselves and call the installer when maintenance is required. • Number Approx. %- Number of Visits Made . • . , . . . _ 61 0 Information Obtained dr Survey Forms Completed 53 0 Number With No Apparent Problems • 22 40 Apparent Failure of Aeration Unit Only . . 5 10 Apparent Failure of Drainfield Only 16 30 Apparent Failure of Both Aeration Unit & Drainfield . • 5 10 Questionable (D.F. Close To Bank or Heavy Vegetation), • 5 10 As indicated above, more than half the systems surveyed exhibited failure of the aeration unit, 'drainfield or both. The highest percentage of failures were due to + high water table, drainfield flooding or impervious soil conditions. In addition, • nearly one-fifth of the aeration units were not in operating condition. • As mentioned previously, few owners had maintenance contracts on their units, and a sizeable number were obviously in.a state of neglect. Some of the problem "•was obviously due to ignorance on the part of the owners. Some had purchased their homes after the units were installed and were not instructed in the need for proper care and maintenance. Page l of 1 001.11111110.111.11. • • t Survey of Aerobic Sewage Systems Page 2. • • • Several owners who had obvious drainfield failures indicated they had been advised ' • that the effluent was harmless. One owner said she was told the'effluent was pure enough to drink but said she did not believe that to be true. EVALUATION 1 ., It was obvious that the majority of the aerated units were installed in the belief that a higher quality effluent would be produced which was meant to compensate for adverse conditions such as poor soil or a high water table. In a number of instances, however, no method of on-site sewage disposal would have been suc- cessful the year around due to a high winter water table, insufficient permeable soil depth or lack of available area for drainfields. A few units surveyed had replaced failing septic tank systems. Some of these systems were apparently working and others had obviously failed. Of all units surveyed no odors were noticed although one owner said he would be happy when sewers were available so he could "get rid of the smelly thing." Ordinarily odors, if any, would be more noticeable in the summer months. It should also be mentioned that only two systems, where a nearly direct discharge: could be observed, produced a discolored effluent. This may have been due in part to the fact that there was some filtration through the soil in most cases and also that the effluent was highly diluted by ground water or run off from higher areas. In one case the drainfield was located in shallow fill underlain by shale. It was not possible to determine whether the effluent exited at the lower end of the shale due to extremely steep terrain. • CONCLUSIONS The installation of aerated units is not recommended when it is obvious that sub .•surface disposal of effluent is impossible or even questionable. A number of property owners seemed to hold the false assumption that the effluent discharged - - from such units was essentially harmless. No effort was made by owners to prevent children or family pets from walking through effluent that had surfaced on Iawns or which ran across driveways or.walkways. It is true that these units were inspected during the wettest part of the year and some of the seepage from drainfield areas can be attributed to high ground water but it is also true that where such conditions exist, sub surface disposal of effluent cannot be successful. 1Should aeration units be allowed in the future, the minimum soil requirements should be met in all cases. Additionally, adequate maintenance of the aeration units must be assured on the basis of regular inspections by qualified individuals. It appears that this can best be accomplished through the use of maintenance ••..agreements or contracts. :s • • • • • • • • • 4 ROUTING SLIP - 11E210 o OLYMPIC HEALTH DISTRICT Port Townsend Wash. 98368 *+ • TO: SUBJECT: e Board of Health Activities-Environmental Health January 1978 sv FROM: DATE: Randall M. Durant, R.S. 2-22-78 Director of Environmental Health MESSAGE: Field Work - Sewage Disposal Permit and Site Evaluation attached. 30 septic tank permits. 31 Site evaluations. 50% increase over last January. Field Work (Other) €` Food Complaints Water Other Finals Follow-up Total 21 8 6 11 4 21 70 Contacts - Office Calls, Telephone Calls, Plan Review Sanitarian - 281 Secretaries - 125 Total. 506 4/75 For: Inf. Action Approval Comment Reply �Mf • • • • • • :IC: ON40 40 0 D N v N •N e w•s! 1 sT es i0 et st'v ... `A OO000000OOOOO OOO0000pO • rs • • R pp•0p..(1 ON UV'• LO, r 4 Ci O 01 h N m N CO 01 N e•1 Men ua .. N NNNNr-1m01 ens- en C 0 0 0 0 0 0 0 O 0 0 0 O o VD 0 0 o 0 0 0 0 o p o 0 0 .W -R in in 0 0 in o 0 in 0 V l ul u• t O Ct u1 sf N ICOO N Ln 00)in cr. O e-e •-1 N r•1 N r1 .-f N ri r4 > 0 40 00000 - Ea t 000.000 1 I rNl N C) 17 im 1. O • el 1 —, t a• • V l'w CV � V 1 t- Q1 40Ri010RW Csel F MW V 14 N e•i en 10 en tel N sfv v v...L 0 0 0 o • pp 0 o 0 0 O O p pp Q or R S O O O o 0 0 Q 0 •0 0 OOOO O 00 Q 000 J.i e` R st'r-e Ct FO OOp v1 Ul - .u-1 R • ♦ • • • • • rl te1 N e+1 •"1 r1 el II tT N N N e4 m iV N N VI R Rt0ht0 hlA to hs! 0' tCFN .-1 at @F in en riNO r-Ih O r1 Nsr in to inc00 pg tD e`Om ae.i p• pppp b 1. 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W lgae a L i•i E 0).0�E e' i Cc 4 TC0�,pi aL >� • z 7L V•.• N S17 GI-.O0 gi �+ q Y 10 C �0 7 9 U V O y Z C d L L. !1 C r- 0%es.1-, > e.) tiG.. f < ,=r'f ►, < vl0 Z0 AeyroC.ro777 N UOC1 r7 11...3E41Cf7"7601020 0 ,........,- 7 .r..��► ....ter... ,.. .. . - • 3 r:-Y^`T Crii=i -- L L ,_1-_t 1 ,r..iTC -_i_2H __P. t G .i Y_: '-1 L� T Attachment #I1 ' 2 urse3 t'•fir'7Y , 10 7n - This Last Year t Tine of S rvice I;onth'meth Date. 1. public Health "ursine (nn-y{ visits} A•hilt . -Eo 2. Pub1i c Health ;'ursinC (ro;,e visits-) 1 nn T tzc 1 3. Public Health 17ur.ing (1 om visits) wtorn • !, Public }'oalth ITursing (office visits - Adult 5, Fubl4 Healt (ursine_ (office visits) - Fediatric_ 6. Public:icalth Torsi g office visits) - Vewborn 7. Public -:ealth ?lumina (TC in l'Ln-1u_0(' visit) e 8. Blood Pressure (for hyrertension,_etc.) -- Mill g.Urine 'sis for }KU, sugar, albu-in, etc.) e 10. Blood Tests :it'll_ 11. ursring (auhio'roes} -- 12. Vision Tests Snellea_ 111k1M11111111111 13, Pregnancy Tests (0001 __ 'U. Smear/Culture (for Gonorrhea or FBU etc LEll 15. Serolov__(VC tes. ror S chills 1i. Visits to VD C1 ni 17. Communicable diseases invest] ated/rerQi ems_ 1• r 18_Medication reviewand counselling _ 80 7.9.:lTutrition Counselling 70 =, 20. Diabetes 10 21. Referral and/or consultation wit p ysician 22. Referral and/or consultation with other agencies 8 23. Pei+-3Sl V chooisits-lan-&-service) 0 24. PM School Vis is (vision screening) 69 25. MI School Visits (vision referrals- - 64 ,M . PIll SchoolVisits hearing-screening) 4 27. FM School Visits (amilogra is/ie erra.Ls) 3 ` 28, PHD School Visits (teacher/nurse conference 15 29. Pu? School Visits (pupil/nurse conference")-�^ 11 30. Pal School Visits (parent/nurse conference) 31. School Vrs is 1confe`rence Frith school-person �l) 10 '` 32. PM School Visits(dental-healt1ii) 0 ;, 3r,P111?School Visits (health education) 0 _31r. Variants Health. Care Srecialist (pelvic and/or rig cancer chess) 15 35. :Grants" I:ealth Care racialist (breast e_.a^rina-tion for cancer) 15 36. Pediatric rurse i`ractioner1 ysTcal exa-ination) 0 37. PAdiatric hiurse Fractioner (develop untal assess-_ont) 0 , 3.4,4. pediatric Nurse Practioner (counselling) 0 39. Chil-lren seen in Jell-Child Clinics 0 40. WIC Prozraa (uo-yen on program- 19 41. E:16 trogrars uoren seen this *en a 42.111C grogram (chileren on program)" 42 111111 43. WICoE.ram children seen �111s can 11 - 44. WIG Program (infants on program) 5 45. WIG Program (infants seen is rent. _ 46. HomeHealth-kide (name vizit-) ° i G ufi Co:anty greetings attended I _ 48. hedical (yublie 1raltn crVsician� _ 49.' Nutritionist Ivisits affd�r connaultation) NEM - 50. I-r n d-in1e izations anc ions- Q I -517 Birth Certificates . ` '� (Home Deliveries Reris,.ered�3ric 52. Death Certificates _ � L_53.VCortifiod aopies`(birth and-d-aitTi)-`_- -5��7....-� Internationai Travel ttampa `.�� ,..zJ.,L'+trin£ Ennrnmt"rr_�.. _nrl,ii4-intl 4Q8hoYe_ ------- *i'_ 56. l'_ursinz Te iiiongeal s in addit on_ to above MIIIII� 57. Conference by '-?.C.7. in Seattle 2 days .' - '_eeting in Fort Angeles on ;EH MATT. . • • 5 I co 'ge j PSG, IPPrV -A .o PpD 0 X-ray j y 4 III -. ti 1'` :tt1e 111111 rqi 0 C to Patient .. b- I ..,},. Report S year ( W ... �� {�:Recrort Culture r. eaetion c' °action m I t I 1.-,' ±'IFA?•PIN m � ) I eaetion +10 I II I I I��' I TF{AiB1JrOL I I "eaetion 1 I ► 'RDOXiIJE i 0 ether o' ,claclo N a c I 1� -nelien m !m m m m •. ! ka olor g 9 .' ao I • her rt a�a o # o �-:� im_ `i 1-4 1`°ported to ID ;gmg " 1 .. eferred $�.o a 03 I or school certification'�a ',al Certification (other) '0.4 sO tee► i m { c+ . I rrrr11116111111M Almommiom 3...miamommit. ` . ) :< • • Attachment #12 COMMUNICABLE PUBLIC HEALTH HOME VITAL ENVIRONMENTAL HEALTH DISEASE CONTROL NURSING NURSING STATISTICS HEALTH , EDUCATION. • kir, , . ,, i , .., .C=11. 'el 1 :.,'7#P.: : 4 '/;.,..N4iL..,-' 4 441146.44-4 (•4‘itig.fli... ;` . ,: JEFFERSON COUNTY HEAL H T DEPARTMENT ,1' Jj;. ^ :4 802 SHERIDAN PORT TOWNSEND,WASH.98361 (206)3654722 1 ;!44 • 22 February 1978 Ms. Norma J. Evans, RPC Public Health Service Region X Arcade Plaza Building 1321 Second Avenue • Seattle, WA 98101 Re: 10-H-520011 Dear Ms. Evans: Your letter of February 13, 1978 requests in item 2, evidence of a formal agreement between Clallam and Jefferson County Health Departments to jointly sponsor the Home Health • Services in the two counties. • The Jefferson County Health Department will enter into a formal agreement with Clallam County to jointly sponsor Home Health Services as soon as a meeting between the two departments can be arranged. It is hoped that this agreement can be made before March 1, 1978, but this letter is written to convey our intents. The Jefferson County Health Department endorses the application for Home Health Services. If you have any questions regarding this matter, please feel free to contact Gael Stuart at the Jefferson County Health Department. Sincerely yours, Carroll Mercer Chairman CM/jc _ • AMEMIRIMMINM , b • • r • b you /Attachment #113 GELLOR INSURANCE, INC. 214 EAST FIRST STREET • PORT ANGELES,WASHINGTON 98362 • TELEPHONE: (206)452-2166 February 16,_1978 Jefferson County Health Dept. 1430 1411`1314 C/O Gael Stuart A1N1/00 -(der Port Townsend Medical Clinic 1136 Water street 9E,Z Z 833 Port Townsend, .Washington 98368 vv 03M333a Re: Health Dept. Dear Gael, The company agreed to name both Dept on same policy for remainder of policy term of May 1, 1978. If we rewrote now we would both get a minimum premium. We are still trying to get the coverage up to at least 300,000 or better. Attached is copy of the policy for your records. _ __.. Would you please send me your estimated payroll for 78-79 plus the number of nurses and sanitation personal and outpatients. Presume you have Dr. Fischnaller's Professional coverage by now. Thank you again. Sincerely yours, ie„.„„zi W. 8. Ge r Gellor Insurance, Inc. wbg/bjr FORKS OFFICE. SEOttIM OFFICE FORT TOWNSEND OFFICE 535 Forks Avenue South 250 West Wbshin*toe 1036 Laurette.Street Forks,Nash. 98331 Sequim,Wash. 98382 Port Tossrsend,Wash. 98366 (206)374.5038 (206)683.3352 (206)385-1925 M11160sr