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HomeMy WebLinkAboutM050279 • • .n.NIw �NN� • COMMUNICABLE PUBLIC HEALTH HOME • VITAL ENVIRONMENTAL HEALTH DIC-EASE CONTROL NURSING • - NURSING STATISTICS HEALTH EDUCATION lt el ,,,,.l,I•tfi Pl -,40,4r ----P i tit, -.�"_--�`-\`— . • r ---- r JEFFERSON COUNTY HEALTH DEPARTMENT 7 4 an SHERIDAN PORT TOWNSEND•WASH-9E36i (206)36S0T22 a �� C i BOARD OF HEALTH MEETING HEALTH DEPARTMENT CONFERENCE ROOM - BOARD MEMBERS: STAFF MEMBERS: B. G. Brown,lNember Randall M. Durant, R.S. A. M. O'Meara, Chairman Phyllis Bee, P.H.N. Carroll M. Mercer, +iember Joseph Fischnaller, M.D. Gael Stuart,' Administrator MINUTES • May 2, 1979 - 9:30 a.m.. Meeting called to order by Commissioner O'Meara with all members present. MINUTES: The minutes of April 4, 1979 were approved by motion of Commissioner Mercer, seconded by Commissioner Brown. Unanimous. 4 CORRESPONDENCE: None OLD BUSINESS: 1) Discussion of and report on pending cases in Environmental Health. Randy Durant reported that the Kirst case is still under advisement by Judge Holloway on a motion to dismiss. Durant added that the other cases discussed in last month's meeting are still being held until the Kirst case is settled. Mr. Durant reported the follow-up of the Strick- land property on the Coyle. There is sewage surfacing and needs to be tested. Commissioner O'Meara suggests writing a letter to the Strickland's explaining the situation and request to enter the house and run tests. 2) Sewage disposal system - Quilcene & Hadlock areas. Mr. Stuart reported that the Farm Homes Administration has money for financing sewer systems and David Goldsmith, Director of Planning, is writing up the general application,. Before an application can be submitted a sewer disctrict must be formed for the desired area. Indian Island has a sewage disposal system but prefers the County not pump to theirs. They would rather participate in the cost of construct- ing one-for the County if they could pump their sewage to it. NEW BUSINESS: • • 1) Report on Home Health Care through the month of March. (attachment #1) Actual visits under the program are averaging 170 per month, each visit requiring dictation and write ups for the chart and billing forms. Mr. Stuart reported that the program is not only paying for itself but is actually providing reimbursement for 67% of the previous Home Health Program. Receipts to date are $9,268.26. Because of this increase Mr. Stuart recommends Kathy Tayer be employed full time to help keep Medicare billings correct. Commissioner Mercer moved, in view of Mr. Stuart's recommendation, to hire Kathy Tayer full time. Commissioner Brown seconded the motion. Unanimous. Mr. Stuart will request a budget extension. - 2) Proposed policy for continuing education for nursing staff. (attachment #2) Nurses will be expected to participate in continuing education to renew their licenses. Some of the grants such as M.C.H. require that a policy be adopted to provide continuing education for nurses. Ilimummommiik Aimusimimeift .01111111M11111•111\ , . . . ' I Board of Health Meeting Mak. 2, 1979. Page 2 , NEW BUSINESS: can't - 3) Conference and Evaluation for Charleta Handley, PHN, Staff Nurse. (attachment #3) Ms. Handley has completed the 6 month probation period ' .. ,,,, and by reommendation of Phyllis Bee, be put on permanent status with a $50.00 per month salary increase. Linda Nutsford also has completed the 6 month probation period and is due for a $50.00 per month increase and permanent status. Mr. Stuart recommends they both be moved to permanent status with raise. Commissioner Brown moved to approve, Commissioner Mercer seconded the motion. Unanimous. • _ . 4) Job Disctiptions. Mr. Stuart feels it is essential to have a job - • • • ' • discription on every position. He has instructed the supervisors to write up these discriptions. . . . REPORTS: . . 1) Public Health Nurse; Phyllis Bee(Mrs. Bee was absent, Dr. Fischnaller read to the Board the Activities Report. a) Report of Nursing Services (attachment #4) 1 Tests in schools for scoliosis, grades 5 through 8,. have brought the School Health number up. i b) Dr. Fischnaller reported that there are 2 reported cases of the measles in Neah Bay. 2) Environmental Health; Randy Durant . . a)Activities Report (attachment #5) Inspections of restaurants are done and they are doing the follow-ups. b) Randy submitted time sheet on time spent on material lists for Thousand Trails suit. (attachment #6) Randy reported that he must go , 1 back to the Thousand Trails property and reevaluate the whole drain . . 4 I i field because they removed sand in the area. He will keep the Board , informed of findings. 4 c) The first series of.tests have been submitted on the Donald's jet , . tank sewage system. No tests results as of yet. d) Randy will be attending a meeting May 29, 1979 with the Department of Ecology and the State Health Department in Olympia on the current " •expertise of full fill and partial fill drain fields. . _ e) American Campground, Gardiner. The new caretaker said that a con- struction crew will be out in the next month. What is to be done is not known at this time. f) DrainFbaldFlexpipe. Problems with the pipe moving and causing pOssible premature drain field failure. Randy reported that the pipe has been approved by the State. The Board felt that the pipe shouldn't be prohibited but the public should be educated on how to use it. g) Guidelines for Deep Trench Drain Fields. (attachment #7) Randy said that he will follow the procedures and policies recommended by- the State. Randy referred to an older sewer system located in Seaview Estates that is currently failing for the second time. It is draining out into the bluff and down Upon the beach. He plans not to approve anymore deep trench drain fields in this area until it is determined whether or not the failure is due to the deep trench. The . existing system will have to be dug up. Bill White, site evaluation applicant for a lot in the area, commented on Randy's decision. Mr. White feels it is the system that is failing and not the land because it is the only failure. He asks Randy not to condemn the entire area .:, until a sewer line runs out that far. Randy replied that they are not • being condemned but before approval they will have to have approved engineering justification. White feels it unfair and unjustified to require property owners to spend the extra money for engineering just -because one system has failed. Commissioner Brown said that he agrees with Bill White and feels the County should proceed as they have been . in the past. - .' h) Randy reported that he inspected a 5 acre parcel on the Chicken Coop ._ , Road in Gardiner. The site evaluation was previously approved in 1976 . by Olympic Health District, Port Angeles. The report read that it had 6 inches of top soil to hard pan. The property owner came to the Jeff- erson County Health Department for a septic tank permit. After reading ,•; the report Randy had the property owner dig holes for testing. Because :. the first set of holes did not past the tests the owner was advised to -. Board of Health Meeting May,2, 1979 Page 3 dig deeper holes. When Randy arrived the second time to test the new holes there were approximately-20 people waiting with the owner. Randy ; . was ill treated. The first two holes were unacceptable but the third hole was approved. 3) Public Health Officer; Dr. Fischnaller a) Dr. Fischnalier reported that the state of Idaho has an outbreak of rubella and the County will take preventative measures by increasing" , .their immunization program. 41 Administrator; Gael Stuart .;' a) Gael reported that Phyllis Bee has located funds from March of Dimes to purchase a 16 mm sound projector and a 35 mm automatic slide projector. If they donate the machines they will not need a budget extension but if they give money the budget extension will be necessary. b) Gael Stuart will review the insurance coverage to see what the County $; is carrying and what is actually needed. He will eliminate any unnecessay insurance. �f . Meeting adjourned Ne t meeting, June 6, 1979 F�r t y r5 e � X y 11111.11.111.11.1 LY +4 M.. attach #1 JEFFERSO G.'E£'; X E f ¢3 �c'T. CORRECTED FIGURES 802 Sner'can ,i: . Port Townsend,Writ+. Wudt. I $i Home Health Service (Medicare) Oct., Nov. Dec. 187 visits @ $27.34 = $5113 (Medicare of H ) 4b36 Total expense39% including allHS overhvisitsead $ 477 Profit Jan. Feb. Mar. 517 visits @ $27.34 = $14,135 (Medicare 67% of all EMS visits) 13,276 Total expense including overhead $ $59 Received so far - $4,921.20 Above expenses do not include capital outlay (Lanier equipment or IBM typewriter) March expenses do include Kathy Tayer's pay plus 3/5 of Linda's pay (Linda will not be doing NHS unless Kathy gets behind again. f. • t# A4111110010111111111WAMMEMMWOIMMW _ e$ a� < • attminemt #2 POLICY FOR CONTINUING EDUCATION - Philosophy The Nursing Department of Jefferson County Health Department is committed to providing preventative health care services to the people of Jefferson County. The Department shares a concern for the promotion and advancement of health care and the improvement of nursing practice. This is a joint responsibility of Jefferson County Health Department and each member of the nursing staff. Goals • ContinuingEducation consisting ng of planned learning experiences will be pro- ' vided to promote the developing of knowledge, skills, and attitudes for the enhancement of nursing practice, thus improving the health care of the public. Objectives 1. To insure that the nursing staff of Jefferson County Health Department will receive continuing education each year to improve their ability to give optimal services to the citizens of Jefferson County. 2. To facilitate the travel and participation of members of the nursing staff in continuing education programs outside of our county when possible. Methods Recognizing that continuing education is a joint responsibility of both the Health Department and the practicing professional nurse the following guide- lines will be used to administer the program in Jefferson County Health Depart- ment. 1. When the agency requests a staff person to attend a continuing education_ , offering as a means to improving the service of a program, the Health Department will be responsible for: a. Payment of tuition or fees b. Payment for travel c. Payment of the regular salary for the days the nurse is involved in continuing education , d. Payment for meals and lodging e. Staff person will be given compensatory time for time spent in F travel. q.r 2. Continuing education offerings made available by Jefferson County Health Department to staff members, but not specifically required will be paid as follows: a. Travel expenses for one car with mileage from Jefferson County Health Department and return, to include ferry tolls for passenger, will be reimbursed by Jefferson County Health Department. b. Tuition, fees, etc. will be decided on a case by case basis as funding permits. c. Staff members salary will be paid for the day or days involved. d. Staff members shared responsibility will be any extra time in- Volved over regularly scheduled hours. Therefore, no compensatory y.. p # , a f � a h z r Policy for Continuing Education (continued) Page time will be allowed. - s 3. Staff persons wanting to attend a continuing education offering that has not been approved by Jefferson County Health Department may submit a request to the Director of Nursing Service for consideration. In some cases €undt g may be available, but this will be decided on a case by case basis weighing the usefulness and application of such education to health department programs. All staff nurses will be expected to attend Inservice offerings arranged by Jefferson County Health Department during working hours. 5. 'Requests to attend continuing education programs must be submitted to the Director of Nursing Services a week prior to the event to k. facilitate staffing coverage. 4/79 r _ t2�8 ;J FERSON COUNTY HEALTH DEPARTMENT 802 Sheridan Street 'Fort Townsend, WA 98368 EDUCATION PHILOSOPHY The nature of public health is constantly changing. In order to have a staff that can respond respond rapidly and.appropriately to public health problems and situations, an ongoing educational program is essential. Education starts with the orientation program and continues with regular x inservice programs and attendance at workshops pertaining to public health and/or nursing or their administrative aspects. Personal Health staff are members of the total Health District team. At times, problems or programs may require overall Health District staff inservice. Expected result of joint inservice would be a team approach to problem solving in selected program areas, i.e., CD. ' • ' � r fi ♦t AMMIMMOOMMMML attachment #3 COMMUNICABLE PUBLIC HEALTH HOME VITAL ENVIRONMENTAL HEALTH OCESECONTROE - NURSING NURSING STATISTICS HEALTH EDUCATION JEFFERSON COUNTY HEALTH DEPARTMENT . %" a 862 SHERIDAN PORT TOWNSEND,WASH.983I (206)385-0722 • April 23, 1979 CONFERENCE AND EVALUATION at the end of six months probation period for CHARLETA HAADLEY, PHN, Staff Nurse, Jefferson County Health Department, by Phyllis Bee, Director of Nursing. Charleta's performance of her duties has been satisfactory at all levels. She was evaluated January 1, 1979 (see attached report). She has continued to add to her skills and is a valued member of our nursing staff. I have requested the Board of Health through our Administrator, Gael Stuart, that Charleta be given a raise in pay in accordance with Section 4.4 of the Jeff- erson County Personnel Policies and that she be assigned to a permanent status. The amount of the salary increase is $50.00 per month (approximately 5%). This request will be acted upon at the next Board of Health meeting on May 2, 1979. Phyllis Bee, PHN Director of Nursing • i t COMMUNICABLE PUBLIC HEALTH HOME ' �' #3-A h. - '✓ 0 Nt NURSING VITAL ENVIRONMENTAL-NURSING STATISTICS HEALTH . r EDUCATION JEFFERSON COUNTY HEALTH DEPARTMENT 44. I ;�; $ t02-SHERIDAN PORT TOWNSEN©,WASH.Iu261 (206)MISOT22 EVALUATION CONFERENCE 2-2-79 Charleta Handly Charleta and I reviewed her goals written when she began working part time to in August, 1978. On October 1, 1978 she became a full time employee of Jefferson County Health Department. Due to a misunderstanding she did not have her objectives clearly defined, but had written them as goals. However, her goals were very good and she has come a long way toward achieving them. She has written her goals for 1979 and has also clearly spelled out her ob- jectives and I think that these are quite acceptable. I am pleased with Charleta's achievements in the months she has been here. She has been working mainly in Maternal Child Health but has had some Home Health patients and also has done school nursing. Charleta has a good ability for organization of her time and of materials_ Since public health nursing is a new area of practice for Charleta she has had many things to learn. She has been an enthusiastic learner, and quickly is able to perform new procedures. She is interested in learning more about the different areas of public health nursing and will be broadening her duties to include pregnancy testing, abortion counselling, VD, so that she can fill in in these areas as needed. Charleta is well liked and her professional skills well regarded by her peers. Her appearance and demeanor is befitting a person of her profession. I am well satisfied with Charleta's adjustment to her staff position and am very happy to have her as part of the nursing staff of Jefferson County Health Department. et,� Phyllis Bee, Director" of Nursingt tom` Charleta Handiy, P.a N. - c P REPORT op NURSING SERVICE 1 - May 1, 1979.'., d April March April 1978 1979 197 ',,,ft.,.! H(}ME VISITS 374 11111111111115111 OFFICE VISITS 11/11 111.1 NEWBORN0 iiiiii 11111 A UNDER 1-YEAR50 G 2 _ 51 60 45ME MI ,J E - 2I 30 S 21 - 60 50 30 t- 111111 6C+ 302 302 1 34 ACC M.C.H. 145 56 2 G C.S. ADULT HEALTH 11-!/11111111111111111111 p ACUTE COODJMICAHLE DISEASE Imo. Im . Imm, H CONTROL 140 115 122 0 Cz V.B. 3 0 R A' T.B. M * Scoliosi Scoliesi S 696 158 , SCHOOL HEALTH 119 0.534 immmili78 4 1 mil DIAL 0 0 0 1 116 HOME HEALTH (AIDE) 179 178 155 133 121 HOME HEALTH (P.H.N. @ FOOT CARE 27 28 0 i * Scoliosis screening done in all J. County schools gra.i 5,F,7 & 8. ......fit t " -11 c #, '•• JEFFERSON COUNTY HEALTH DEPARTMENT MINT c r +1:, p a *2SHEPIDAN PORT TOWNSEND,W45,49$35S (2C5)385-0T22 To: Jefferson County Board of Health From: Randall M. Durant, R.S. t Director of Environmental Health s Date: May 1, 1979 • Subject: Activities - Environmental Health Section - April 1979 I Field Work: (High Points) Decrease in sewage disposal permits and site # . • evaluations over same period last year. Food program continues quite active with 39 full inspections and 22 followup. Increased ntimber of final inspections made of septic tank and drainfields and followups of existing systems. Continue increase in office and correspondence activity as it relates to questions of the public �. regarding septic tank permits, site evaluations, and platting. Training of new staff proceeding. Other Field Work: Food Complaints Water Other Finals Foll wup Total 4_ 61 7 5 I9 10 55 157 Contacts: Office calls, telephone calls, plan review y y Sanitarians: 399 Secretaries: 246 telephone 185 office contacts 431 for secretaries 830 total for secretaries and sanitarian Total contacts for year to date: 2,755 (does not include field contacts or foodhandler's tests) "- Food Handler permits: April - 83 Year to date -189 f �M w a ' �#5A v O O C O • ,..,T'S C. .1.-i '(Da C> O O o o o 0 0 O O o 1 Q r. O .c, f art.n,c) Lr"^ a r O f f O .fl „., ,•„ •n ran en n. v {'� CI �.. O a 0 `0 .-f.. .--t oa.o OOC,o aoa oo}Cl >t .i 82 as o d Oda O • ,,, 00{a t) I d 0 w„O•n •, .,1'In a r_ .D.D{ -el Y'. i 1st r-i- D` 0 '...C. ''''t 0 n<•m e7.D e--.ems, ,..0, a 1'' fa Si. a 0.. 4 .-1 r, N rc-n,ri c•l.--[ r (^l ` fn 1' Sw ..` i - gi f6 W IC 62 > }a v v-v N 0 0 0/O Q'0 0 O O 0 O O(}0 y 0.1 C)00000O . 0 .0 .. rt GY O O O - c) ( ,n O O ,n O .n v, u l I} 1. a O o Q O C.CC`L en ,n'0 O0-.1,ea _ ,..{v 1:"m. 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CU.0r 4 0� - • • r'w a4$ J f • .. x _ +fee - 4r 4 e gnvxrouaeatal Health Totals - Ist 4 months Septic tank and drain€field S3,9Q8.SC} C148) 3,683.QET C124) site evaluations 2r375.00 (189) . 2,325.00 (l9Q)' • 342.0E (1 song 471.00 (3 Tong Platting 10 short) 9 short) 38.75 ::4::st.) • 843.5E_ C29rest.) 1 Food Establshzaents ll©_EJ@ Clagroe.,meat m )28fl.00 334.Q0 (I6I) Food FEazuiler permits $7,76 56.4 $6,444.25 € ' t , E P. i. { 1 t "ff�w�lr *t. y w IIIIIIIIIMIIIIIIIINIIik _ f t t6 PIIFi.TCz.,2„. C u ' April 27, 179. Time spent on material lists for THOUSAND TRAILS suit f Randy 4 hrs PtSylvia 3_ hrs Phyllis H. l� hrs Linda 34' hrs ` 4/I8 21_1 hrs 4/20 4 hrs 4�t23 5 hrs " •� 4/24 7'� hrs 4/25 71 hrs 4/26 7 hrs 4/27 1 hr. r x TOTAL HRS. 43 hrs. Total Xerox copies:made I;934 copies r e k• • k • t i m • a" fit El'g'( 1 .: Directors of Environmental•Pealth Date: April 18, 1979 ` Ftnm, Gary, Flews, R.S. nneth J. Merry, P.E. . - Subject:: DOE APPROVAL OF DEEP SEEPAGE PITS AN0 WAC 248-46-110(5)(b) } Attached is a recent letter from Secr etary Gerald Thompson to Director Hallauer on the above subject. The Department of Ecologyhad previously indicated by letter that they were no longer going to become involved in approving deep ' 1 seepage pits for individual on-site sewage disposal. Director Hallauer conveyed his intent to Secretary Thompson. Secretary Thompson responded by indicating we 3 would try to assist local health departments with deep seepage pit approval within our resources. The history on this specific issue is long and complicated. However, until the on-site rules are revised, the following procedure and policy is recommended: 1. All seepage pits, especially those exceeding 10 feet, are to be discouraged. 2. If an application is received for a deep pit, it should only be approved after engineering justification is provided. 3. DSHS District Engineers will p-ovide technical support and recommendations on the applications within the resources available. GDP:KJM:par Attachment. cc: Health Officers DSHS District Engineers 174-4-53 •Try �t -Y�'"r � • [ b fr "„ STATE OF DEPARTMENT OF SOCIAL AND HEALTH SERVICES _E 4 t. WASH:NGTO 4 {`�� Let.Pau Go e,w April 6, 1979 Mr. Wilbur G. Hanauer Director Department of Ecology Mail Stop PV-11 - Olympia, Washington 93504 Dear Mrt Hanauer: R Thank you for your March 19, 1979 letter concerning an apparent conflict - between our respective sewage disposal regulations. I can also understand your staff's concern about undertaking the review of sewage systems having design flows of less than 14,500 gallons per day, especially when your own regulations do not generally govern smaller systems. As I understand the issue, Chapter 248-110-(5)(b) of our regulations requires Department of Ecology approvals of seepage pits below 10 feet in depth. However, there is nothing in the Department of Ecology's regulations that requires approval of seepage pits. This is an apparent conflict and will be corrected at the next revision to our regulations. In the interim, I will instruct the Water Supply and Waste Section of your desire not to be involved in the review process for seepage pits. The Department will continue to provide technical assistance to local health departments within our resources on all issues, including seepage pits. In providing this assistance, we will attempt to convey your concerns for seepage pits and will discourage their use. I appreciate your bringing this matter to my attention. Sincerely, @ `` • GERALD J. THOM SO;v' ' Secretary • t s • S «e r "` -, -r . ,'_s..:.. x_.,max.,✓ ,. ' COMMUNICABLE. PUBLIC HEALTH HOME VITAL I x DISEASECON'TROt NURSING NURSING STATISTICS ENVIHE HEALTH e HEALTH EDUCATION • ' JEFFERSON COUNTYHEALTH DEPARTMENT t 'r **et 602 SHERIDAN PORT TOWNSEND,WASH.ygg6Q RON 385,II72 Board of Health Meeting t 2 Agenda . Nay 2, 1979 9:30 A.M. 1,0 Approval of minutes of Previous Meeting 17 Correspondence Old Business: A. Discussion of and report on pending cases in Environmental Health. 1 1 B. Other Old Business New Business: A. Attached is a report on Home Health Care through the month of March, Actual visits under the program are averaging over 170 per month and each visit requires dictation and writeups for the chart and billing forms. It is recommended that Kathy Taylor be employed full time to help keep Medicare billings correct. As you can see the program is not only paying for itself but is actually providing reimbursement for 67% of our previous Home Health Program. Receipts to date are $9,268.26. B. Attached is a proposed policy for continuing education for nursing staff. Nurses will be expected to participate in continuing education to renew * their licenses. In addition, some of our grants (MLC.H.) require that a policy be adopted to provide continuing education for nurses. C. Attached is a report Conference and Evaluation on Charleta Handley, P.B.N. In conformance with policy she should be assigned to perm- anent status and awarded a $50.00 a month raise." s B. In order to be certain that each employee is aware of assigned duties. Supervisors will be asked to update job descriptions for each employee's file. E. Other New Business Reports: A. Public Health Nurse (Mrs. Bee will be absent) B. Environmental Health C. Public Health Officers D. Administration