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HomeMy WebLinkAbout02 February JEFFERSON couNTY' BOARD OF HEALTH MINUTES February 18, 1999 BOARD MEMBERS DaI1 Harpole, Member - county Commissww District I Glen H1Infill(lford, Member - county Commissiona District 2 Richard wojt, cHairman - county Commissioner District 3 Gtoffrey Masci, Member - Port Townsend City cOjincil Jill Buhh, Membrr - fWspital District #2 commissioner sheila wesltrmal1, Member - Citizen at Large (City) Roberlll FrisselI, vice-chairmal1- citizen at Large (county! STAFF MEMBERS David syuter, Htalth Dtyartment Dimwr JeilJ1 Baldwin, Director of Nursing servius Larry FI1)', Director of Envimnmenllll Htalth Thomas Locke, M.D., Htalth officer Chairman Wojt called the meeting to order. All Board and staff members were present with the exception of Member Westerman. The representative for the Port Townsend City Council was also unable to attend (see later in minutes). APPROVAL OF MINUTES Commissioner Huntingford moved to approve the minutes of January 21,1999. Member Buhler seconded the motion. Commissioner Harpole noted a correction which needs to be made to page 1, the second item which was discussed prior to the beginning ofthe meeting: "Notice olLocal Boards olHealth meeting on April 24 & 25 in Olympia". The correct date is March 24 & 25. Commissioner Huntingford amended his motion to approve the minutes as corrected. Member Buhler seconded the motion which carried by a unanimous vote. PUBLIC COMMENTS No public comments. Vice-Chairman Frissell stated she would like to add to the agenda a discussion regarding the South County Medical Clinic Health Fair. Chairman Wojt asked Member Buhler for an update on staffing problems at the hospital. Member Buhler explained that in the past the hospital has had problems with staff shortages resulting in the need to divert patients to other health care facilities. The staffing shortage is partly due to union regulations. According to the union contract, medical staff which is "on-call" is not required to respond. In many cases, staff shortages result from "on-call" medical staff that are ill or out of town and unable to work a shift. The hospital is in the process of hiring additional staff to prevent the diverting of patients. The problem is not that the hospital beds are full, as much as it is that there is not enough staff to cover the patients if they were to be admitted. Member Buhler will provide a more detailed update to the Board of Health at the next meeting. HEALTH BOARD MINUTES - FEBRUARY 18, 1999 OLD BUSINESS Page 2 LINDA SEXTON UPDATE: Larry Fay stated that he met with Prosecuting Attorney Juelie Dalzell to discuss the background on this issue. The Prosecutor indicated that she is satisfied with the information provided and is ready to move forward. While he does not know the specifics on how the Prosecutor will proceed, he is aware that she has hired a Civil Deputy Prosecutor who will presumably be given the assignment of dealing with Ms. Sexton. He noted that the Prosecutor may be considering criminal prosecution since the County ordinance identifies the illegal operation of a solid waste facility as a criminal offense, while the RCW's identifY the offense as civil. DRAFT SOLID WASTE ENFORCEMENT PROCEDURES: Larry Fay stated that he has been editing the draft Solid Waste Ordinance based on the concerns of the Board members discussed at the last meeting. A revised draft will be given to the Board for review in March. To address a specific concern of Member Westerman regarding procedures and policies on enforcement of the ordinance, Mr. Fay prepared draft solid waste enforcement procedures and presented them to the Board for review. These procedures which were modeled after Bremerton-Kitsap Health District's rules and regulations are very detailed. 1999 BUDGET UPDATE: David Specter reported that the forecasted $85,000 shortfall in the Health Department's budget did not occur. This is partly due to the fact that the 1999 budget was prepared 7 months ago and there was more grant funding carried over from 1998 than what had been originally estimated. In addition, the Health Department staff and management team did a great job managing the budget last year. LOCAL BOARDS OF HEALTH LEADERSIDP WORKSHOP: David Specter stated this workshop is scheduled for March 24 and 25, 1999 in Olympia. He reviewed the topics which will be discussed during the workshop and encouraged the Board of Health members to attend. LEGISLATIVE UPDATE: David Specter stated that the Health Department will be updating the Board on legislation which impacts local health, based on the following criteria: Mandates, Functions, and Funding. This will allow the Board to provide input and take a stand on various issues, although, it may be difficult due to timing restraints. The Board only meets once a month, while legislation changes daily. The timing is perfect for taking a position on legislation relating to funding for public health emergencies. More specifically, SB 5778, which creates an emergency response fund for outbreaks of communicable disease and tuberculosis detention. This fund would help local health jurisdictions pay for the costs involved in major communicable disease outbreaks, including the costs of detaining individuals, which can be very significant in small health jurisdictions where there are no facilities for detention. David Specter presented a fact sheet about the legislation, a matrix on the history of outbreaks in Washington Counties, a copy of SB 5778, and a draft letter prepared by Health Department staff in support of SB 5778 for the Chairman's signature. David Specter stated that the Senate Health & Long Term Care Committee will hear this legislation on Monday (February 22) afternoon. He stated the Board of Health has the option of taking a position on this legislation by sending the letter of support. Chairman Wojt stated he will be in Olympia on Monday and could hand deliver the letter if the Board is in support of the legislation and approved him doing so. Commissioner Harpole suggested that if the letter is approved, copies be sent to Representatives Lynn Kessler and Jim Buck as well. Commissioner Harpole moved to support the Chairman signing the letter regarding the establishment of an emergency response fund and delivering it in person to Olympia next Monday. Vice-Chairman Frissell seconded the motion which carried by a unanimous vote. HEALTH BOARD MINUTES - FEBRUARY 18, 1999 Page 3 PORT TOWNSEND CITY COUNCIL APPOINTMENT TO BOARD OF HEALTH: City Councilman Geoffrey Masci was elected to replace Ted Shoulberg on the Port Townsend City Council and is the City's new representative on the Board of Health. Member Masci was unable to attend the meeting today due to a previous commitment. David Specter stated that he is meeting with Dr. Masci on Monday to review some Health Department and Board of Health materials. NEW BUSINESS HEALTH FAIR: Vice-Chairman Frissell reported that she received a letter from the South County Medical Clinic regarding the second annual South County Medical Clinic Health Fair to be held on Saturday, April 17, 1999, in Quilcene. There wilI be approximately 60 booths and several individuals are coming from Seattle to make presentations on various topics. In the letter it was stated that they would like to have a booth for the Board of Health members. Vice-Chairman Frissell stated that the Health Department is going to have a booth and she and Member Buhler are planning to attend. The Board members concurred that they do not need a booth of their own at the fair. Vice-Chairman Frissell will contact the South County Medical Clinic to inform them that the Board of Health members who are available, will participate, but, they do not need their own booth at the fair. UNIVERSITY OF W ASHINGTONlDR. DAVID OLDS PROJECT OPPORTUNITY: Jean Baldwin stated that originally, the University of Washington was going to use Seattle-King County and Snohomish County Health Districts to participate in the UW/Olds project because they wanted to replicate this study only in urban centers. As it got more complicated, they considered looking at rural communities. Jean Baldwin had been lobbying for Jefferson County as a pilot site, because of the very well educated and very consistent maternity support staff of the Health Department. Dr. Bernard of the University of Washington made an exception and decided to experiment with Jefferson County due to the fact that the Health Department nurses see a very large percent of the current births through the maternity support program, and they are very well established in the community. The grant to fund this project was submitted by the University of Washington to the Robert Woods Johnson Fund and Jefferson County was included as a pilot site. Jean Baldwin stated that now they are waiting to hear if the University will be approved to receive the funding. Once approved, each county involved will be signed up for a 3 year pilot study, and a representative from the Robert Woods Johnson Fund and Dr. Olds or one of his representatives will visit each pilot site. Jean Baldwin introduced Carol Hardy who is the Maternity Support Coordinator and a mental health specialist with the Health Department. Ms. Hardy prepared the grant application for submission. Jean Baldwin noted that this is being presented to the Board for review and for authorization to proceed if the grant is approved. To help the Board members understand the project, Carol Hardy read the following description: "The Olds nurse visit model focuses on five domains: 1) Maternal Health, 2) Parental Role, 3) Parental Family Course, 4) Family and Friends, and 5) Linkage with Services. A structured visit promotes attention to individual needs and prevention objectives to promote effective and responsible care of children with anticipatory values at different developmental stages. A management information system supports the program. This series begins with weekly visits at the time a pregnancy is first identified. Bi-monthly visits follow until delivery, then weekly with a newborn for the first six weeks of life, bi-monthly until 21 months old, and then rnonthly until the age of two. For a total of 50 or more visits over a 2 1/2 year period oftime." Ms. Hardy has worked in maternity support for almost 1 0 years and she believes this a wonderful program. It provides a structure and protocol for the nurses to follow. The Health Department currently conducts a similar HEALTH BOARD MINUTES - FEBRUARY 18, 1999 Page 4 program, however, this project will double the numbers of visits currently being conducted and increase the structure of the visits. This program is aimed at high-risk pregnant women and their families. Jean Baldwin reported on funding for this program. [n answer to a question from Commissioner Huntingford, she replied that the case load in the Health Department's current program is approximately 190 clients. If they are approved for participation in the Old's project, they will enroll approximately 25 first time mothers into that project. If it does well, they will open it up to 35 first time mothers. Carol Hardy added that the Health Department enrolls approximately 120 new pregnant women each year. Jean Baldwin stated that the project will not be offered to all their clients, since it is more intensive than some clients want or need. Commissioner Harpole stated that he feels this will be a very successful project and asked if there is an opportunity to receive additional funding after the third year, or will the County be obligated to take it on? Jean Baldwin answered, no, the County will not be obligated to take it on. There is action taking place at the State level to extend home visits through maternity support. She explained how the Health Department bills for services and can carryover funding from one year to the next, as long as they are continually enrolling clients. David Specter stated that the Health Department can bill for the first two years, but, not the third year. However, the billing for the first two years will more than cover the costs of the third year. He added that if they lost funding completely, the Health Department could divert funding from a lower priority program, or discontinue the additional visits. The Health Department would still provide their current services, it just wouldn't be at the same level as with this project. Commissioner Harpole asked when the Health Department expects to hear an answer as to whether or not they will receive the grant funding? Jean Baldwin answered that they hope to hear something within a couple of weeks. The training for this project is in April and it is anticipated that the project will begin around that time. She reported that the Counties which were accepted as pilot sites are: Jefferson, Snohomish, and Chelan, Commissioner Harpole stated that the Chelan County Commissioners will be attending the Board of Health Leadership Workshop next month, and he suggested that there be a round table discussion with them regarding this project. Commissioner Harpole moved to proceed with the project upon the approval of the grant. Member Buhler seconded the motion which carried by a unanimous vote. 1999 COMMUNITY HEALTH REPORT: Lesa Barnes reported that the 1996 Community Health Report will be updated this year. The data assessment workgroup and the executive advisory board decided to prepare a system that tracks health status better than a data book or health report. They want to stimulate community discussion to help identify and prioritize health concerns. Ms. Barnes stated that several other communities in Washington State have developed "community health report cards", and Jefferson County is considering the same format. She presented copies of report cards from Southwest Washington Health District (Clark County), Cowlitz County, and Spokane County for the Board to review. Each county tracks features which are unique to their county. These examples all have very broad categories with indicators being tracked within each category. Ms. Barnes stated that they are presenting this to the Board members for input. The goal ofthe report card is to better identify and prioritize community issues and concerns which may change over time. HEALTH BOARD MINUTES - FEBRUARY 18, 1999 Page 5 David Specter added that this project is also being undertaken by other agencies in the Community Health Partnership. He asked if the Board members feel this would be useful and how involved they want to be? Vice-Chairman Frissell stated that the examples only identity the specific County's statistics. She would be interested in seeing how counties compare to State statistics. Commissioner Harpole stated that he feels this type of tracking system would be very useful and he is in support of it, however, he feels there needs to be quite a bit of discussion with the hospital commission and other agencies to identity a group of indicators that everyone can agree on to track for the next several years. David Specter stated that the Board will need to determine how narrow or broad a focus there will be on health. He asked the Board members if there were particular topics that they would be interested in seeing on the report? Commissioner Harpole stated that for discussion purposes, he would like to see a draft model be prepared for Jefferson County with benchmarks and indicators. All Board members agreed. David Specter summarized what was discussed and stated that while there is not a time frame scheduled for when this will be completed, they will update the Board members during future meetings. AGENDA CALENDAR The following items are scheduled to be discussed at the next meeting: * Y2K Press Release * Environmental Health Ordinances: - Solid Waste Ordinance - Onsite Sewage Ordinance * HIV Workshop * Update on Hospital Diversion (Jill Buhler) The next meeting will be held on Thursday, March 18, 1999 at 2:30 p.m. Ri (Excused Absence) ey Masci, Member Jij (Excused Absence) Sheila Westerman, Member