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HomeMy WebLinkAbout04 April JEFFERSON COUNTY BOARD OF HEALTH MINUTES April 15, 1999 BOARDMEMBBRS Dan Harpole, Member - County O>>nmissioner District #1 Glen Huntingfimi, Member - County Commissioner District #2 Ri.chard W'!it, Chairman - County Commissioner District #3 Geoffrey MRsci, Member - p()l't Townsend City Council Jill Buhler, Member - Hospital Commissioner Distr#t #2 Sheila Westerman, Member - Citiun at Large (City) RDberta Frissell, Vice-Chairman - Citizen at La'lle (County) STAFF MEMJJBRS David Specter, Health Department Director Jean Baldwin, Nursing Serr>ices Director Larry Fay, Environmental Health Director Thomas Locke, M.D., Health Officer Chairman Wojt called the meeting to order. All Board and staff members were present with the exception of Commissioner Huntingford. APPROVAL OF MINUTES Chairman Wojt noted that a correction needs to made to the minutes of the meeting held last month. He stated that on page 2, paragraph 5, sentence 2 under the discussion titled "APPEAL OF SEPTIC PERMIT DENIAL; VINCENT VENTIMIGLIA", it reads "Chairman Wojt answered that the land density in that area has increased due to the adoption 01 the Comprehensive Plan." It should read "Chairman Wojt answered that the land density in that area has deereased due to the adoption 01 the Comprehensive Plan." Commissioner Harpole moved to approve the minutes of March 18, 1999 as corrected. Member Buhler seconded the motion which carried by a unanimous vote. NEW BUSINESS PRESENTATION OF THE 1998 OUTSTANDING FOOD SERVICE ACHIEVEMENT AWARDS: Environmental Health Director Larry Fay explained that this is the fifth year that the Health Department had issued outstanding achievement awards for maintaining food service sanitation standards. He introduced Environmental Health Specialist Gwen Howard who explained that the State Board of Health inspection codes are used in evaluating public health sanitation in local food service establishments. She stated that the Food Service Advisory Committee, made up of restaurant owners who volunteer their time to assist the Health Department with the food program, helped develop the criteria used to determine which establishments qualifY for the award. Larry Fay introduced Jefferson County's Health Officer Dr. Thomas Locke who talked about the function of the Board of Health. Larry Fay also introduced Susan Porto who will be replacing Environmental Health Specialist Gwen Howard who has announced her retirement. HEALTH BOARD MINUTES - APRIL 15, 1999 Page 2 Dr. Thomas Locke presented awards to the following food service establishments, noting consecutive number of years (The owners/managers which were present accepted their award): Discovery View Del's Deli On Common Grounds Valley Tavern Quilcene Senior Nutrition Program Port Townsend Senior Nutrition Program Waterfront Pizza Upstairs Boeitker's Java Port Fat Smitty's Silverwater Cafe Whistling Oyster Bagel Haven Bayside Grill Bloomers Elks Brinnon School Brinnon Seniors Cheeks Chimacum Cafe Ferrinos Fountain Cafe Hard Rain Cafe Portside Deli Jordinis Lanzas Light House QFC Port Hadlock Salal Spruce Goose Tri-Area Senior Nutrition Program Water Front Pizza (5th Year) (5th Year) (4th Year) (4th Year) (4th Year) (4th Year) (4th Year) PUBLIC COMMENTS Nancy Dorgan ofthe Rite is Wrong group commented on community concerns regarding the news reports of the pharmacy law violations in the States of Washington and Oregon involving Rite-Aid store pharmacies. Member Masci excused himself from the meeting. HEALTH BOARD MINUTES - APRIL 15, 1999 Page 3 Ms. Dorgan continued by stating that in February it was posted that the State Board of Pharmacy charged Rite- Aid ,vith almost 200 violations of pharmacy Jaw in the State of Washington and penalties were assessed in the amount of $50,000. Since that time the State Board of Pharmacy has received an additional 123 complaints about Rite-Aid pharmacies. Prior to this meeting Ms. Dorgan called the State Board of Pharmacy for an update and was told that as part of the original settlement Rite-Aid was given a 90 day grace period to remedy the situation. Any complaints received subsequent to the original charges will not be filed during the remedial grace period unless a complaint is more severe in nature than the ones previously received. The State Board of Pharmacy has been mecting on a regular basis with Rite-Aid who is cooperative. At the end of the 90 days Rite-Aid must submit a written statement of policy changes which will bring them into compliance with Washington State law. Ms. Dorgan stated that her name is on a list of individuals to receive that document when it is available. She will insure the Board of Health gets a copy of it as well if the members are interested. While the State Board of Pharmacy has not revoked any licenses from Rite-Aid pharmacies, the Board made it clear that they are monitoring the situation very closely. Historically, in situations such as these, the State Board of Pharmacy has sanctioned individual pharmacists. However, in this case, even though it is the pharmacists violating the laws, not the store, the State Board of Pharmacy must take a corporate approach due to the volume of the complaints and statements from Rite-Aid employees regarding working conditions and under staffing. Ms. Dorgan read a letter written by an ex-employee from Rite-Aid regarding working conditions. Commissioner Harpole asked if Rite-Aid has an active permit before the City of Port Townsend at this time? Ms. Dorgan answered that Rite-Aid has applied for a consolidated permit. Member Buhler asked if there has been any statistical research conducted to compare the number of violations against Rite-Aid with those of other chain store pharmacies? Ms. Dorgan stated that the Compliance Director of the Oregon State Board of Pharmacy told her personally that in the last two years there have been more complaints about Rite-Aid pharmacy violations than all the other chain stores and independent pharmacies put together. Member Westerman stated she would like to see updates on this issue from the Board of Pharmacy. Commissioner Harpole suggested requesting copies of minutes of the State Board of Pharmacy meetings. The Board directed that Health Department staff or Dr. Locke request copies of minutes of the last State Board of Pharmacy meeting as well as copies of future meeting minutes to be included in the monthly packets for the Health Board members. Vice-Chairman Frissell stated that she feels it would be a good idea to share this information with the State Board of Health as well. Commissioner Harpole stated that Dr. Locke serves on the State Board of Health and can directly delivery their concerns. HEALTH BOARD MINUTES - APRIL 15, 1999 Page 4 Discussion ensued regarding the importance of this issue. Dr. Locke will look into the authority of local Boards of Health regarding this issue and report to the Board members at the next meeting. Member Masci returned after the discussion had concluded. OLD BUSINESS LOCAL BOARDS OF HEALTH LEADERSHIP WORKSHOP: This workshop was attended by Roberta Frissell, Jill Buhler, Dan Harpole, and David Specter. Vice-Chairman Frissell reported that she met the newly appointed Secretary of Health Mary Selecky, who told her that she wants to visit all of the health jurisdictions to familiarize herself with the individuals and community concerns. The following topics were highlighted: .. Presentation by Dr. Thomas Locke on the Powers and Duties of Local Boards of Health and Health Officers .. Local Public Health Financing .. Legislation and Policy Making at the State Level .. Policy Governance Model of Board Leadership She added that Member Buhler, Commissioner Harpole, David Specter and herself met with Representative Lynn Kessler and discussed a number of issues including the tobacco settlement, family planning, and budgct items. They also met with Representative Jim Buck, but were unable to meet with Senator Hargrove. Member Buhler added that the workshop this year was much more dctailed than the one held last year. She felt that much of the information was good, but questioned the information regarding the Board and staff relationship in policy governance models. Overall it was a great conference. Commissioner Harpole discussed elements of the policy governance model of Board leadership and stated that while it does not fit every Board, there are some very good ideas. He also felt the workshop was time well spent. The Board agreed that discussion of a Board leadership policy governance model would be a great topic for a retreat in the future. MEDICAL ACCESS IN JEFFERSON COUNTY: Dr. Locke presented a draft document outlining the medical access issues and goals of Jefferson County prepared by the Hospital Administrator Vie Dirksen. He reported that there is an access work group which has been meeting on a regular basis and has been very involved in looking at a number of issues regarding the availability and affordability of medical care. This group is made up of Jean Baldwin, Dr. Locke, employees of Clallam-Jefferson Community Action Council, employees of the hospital including the administrator Vic Dirksen, Hospital Commissioner Jill Buhler, and several physicians. HEALTH BOARD MINUTES - APRIL 15, 1999 Page 5 The top nine access issues are: 1. Diverting Patients 2. Physician OfficeslPractices Full 3. Physician Offices/Urgent Care Patients Unable to be seen in a timely fashion 4. Specialty Care/OrthopedicslLong waits to get on office schedule 5. Specialty Care/Single SpecialtylNo care available when specialist is out of town 6. UnlUnderinsured Patients unable to find physicians to accept them 7. Insured Patients/Local Provider Network not covered 8. Primary Care Providers Without Admitting Privileges 9. Medication Costs Dr. Locke stated that these issues are being reviewed on a regional level as well. On the State level the situation has gotten worse rather than better over the years. Member Buhler will address the issues on access and goals of Jefferson County from the hospital's perspective at a future meeting. LEGISLATIVE UPDATE: David Specter stated that budgct discussions are taking place. He reported that the youth tobacco access bill did not pass due to pressure put on the legislature by retailers who opposed the bill, which he noted were led by the company Rite-Aid. The Health Department will be holding a tobacco forum locally which is scheduled for Wednesday, May 12, 1999. He encouraged the Board members to attend. COMMUNITY HEALTH REPORT CARD: David Specter reported that the Health Department is continuing to work on the community health report card. Lesa Barnes and Vik Dirksen presented to the hospital commissioners the idea of a report card which seemed to be well received. It is anticipated that the report card will be available for public review by mid-October and completed by January 2000. In the interim, it is suggested that the Board of Health members meet with the hospital commissioners to review and select the indicators for this report card. Chairman Wojt suggested including the Alcohol and Drug Abuse Services Advisory Board. Vice-Chairman Frissell reminded the Board members that the South County Medical Clinic Health Fair is Saturday, April 17, 1999. NEW BUSINESS AMENDMENTS TO MINIMUM LAND AREA POLICY: Larry Fay presented two proposed amendments to the policy which the Health Department has been using to implement minimum land area requirements. He stated that there are two issues with this policy: 1) There needs to be flexibility; and 2) The effective date of the policy with respect to transfers of land and the segregation of large parcels of land which have become in effect non-conforming building sites. HEALTH BOARD MINUTES - APRIL 15, 1999 Page 6 Larry Fay explained that the minimum land area requirements are established in the State Onsite Sewage Code. This matrix deals with types of water systems and soil conditions to determine minimum land area requirements. These regulations apply to new permits, however, the Health Officer may issue permits for sites which do not meet minimum land area requirements, if three (3) conditions are met: I) The parcel must be a legal lot of record; 2) The property is not located in an area of special concern (ie. a critical aquifer recharge area); 3) The property complies with all other regulation requirements (ie. no other waivers). Larry Fay stated that these conditions are somewhat vague as a legal lot of record has not been defined. The Health Department assumed the Planning Department knew the definition of a lot of record and the Planning Department assumed the Health Department knew the definition, however, there has never been a definition established or put in writing by the County or the State. Larry Fay stated that in the past it was common practice to require a minimum of 10,000 sq. ft ofland area, however, that was never formally adopted in the codes. When it was discovered that it was not a lawful requirement, individuals began applying for permits for property with land area that was under that amount. In many cases, if configured right, the property would be fully conforming. Consideration was given to the potential number of permit applications which could be submitted. The Health Department held the position that without a definition of a legal lot of record, they had no basis for considering permits for property which did not meet current minimum land area requirements. Therefore, two years ago the Health Department issued a declaration which stated that the Health Department would not issue permits. This forced applicants to appeal to the legislative authority. As a result, the Board of Health adopted the minimum land area requirements policy to address this issue. Now, other issues have arisen which concern the Board regarding the intent of the policy. Larry Fay reviewed the circumstances they were dealing with when the policy was adopted. Since that time, the Health Department has issued 35 land area waivers: 19 in Irondale; 11 in Cape George; and 5 in other parts of the County. Of the 35, only 3 were for sites less than 10,000 sq. ft. and 12 were for sites which were at 10,000 sq. ft. During the Health Board meeting in March, the Board directed staff to draft policy changes that would capture situations that are unique to the relationship of the densities surrounding property and whether or not there is a water system available, with a distinction between individual wells and public water systems and which one affects the environment the least. Larry Fay discussed the two proposed amendments. The first amendment to section III.C.1. is intended to address the implication that lots within an approved subdivision are presumed to be buildable. Jefferson County first adopted subdivision requirements in 1971. AJllots created after the adoption ofthe subdivision codes went through a review process. This amendment proposes to allow standard waivers for lots created in 1971 or later which do not meet current minimum land area requirements regardless of the ownership pattern. An alternative date to be considered is 1974 when the first state on site sewage regulations were established outlining the first minimum land area requirements. The second amendment modifies the lot averaging provisions contained in section IILC.3. It would standardize the area considered for lot averaging to the immediate surrounding 100 acres. All existing lots and all potential new lots would be counted based on land use densities established in the comprehensive plan. When the average lot size is greater than the lot size established in table VII, a waiver could be considered. HEALTH BOARD MINUTES - APRIL 15, 1999 Page 7 The concern is not with individual smaUlots or a few smaUlots which, when being developed, meet aU other onsite standards and do not pose a significant threat to public health and safety, but it is the cumulative effect of large numbers of systems at high densities that tend to lead to public health problems such as aquifer contamination. Member Westerman asked how it was decided to use 100 acres as the basis for lot averaging? Larry Fay answered that 100 acres is a standard used in the critical areas ordinance and it was thought that it may work in this situation as well. Member Westerman stated that she has concerns about overlapping with this type of rough measurement as well as concerns that this type of lot averaging will not work county-\vide. There must be consistency county- wide if it is adopted for the County. Commissioner Harpole suggested tabling any action until after the designation of the Urban Growth Area (UGA) since that is an important factor with regard to this issue. Dr. Locke stated that this type of analysis is very helpful in reviewing public health protection issues. However, there is another issue which has to do with individuals dividing buildable lots into non-buildable lots. The Health Department is unable to prevent individuals from doing this or prevent the buying and selling of non- buildable lots. The Health Department can only deny the issuance of a permit, so the problem lies with educating the public. Member Masci stated that staff did a great job developing this amendment and he feels it will be useful in dealing with this issue. In regard to Commissioner Harpole's point about UGA's, a phrase can be added which states that this policy excludes UGA designations now and in the future. This way there is an actual equitable form which can be used in defense and can be an be changed in the future as conditions change. This is a county-wide methodology for dealing with this issue. There will always be situations that do not quite fit a policy which can be dealt with on a case by case basis. He suggested the Board approve the policy amendments as recommended by staff. After discussing the problem of individuals buying and selling non-buildable lots; and the feasibility of applying the 100 acre lot averaging methodology to property near UGA designations and shorelines, Member Masci moved to table action on this item and to direct staff to further develop language in the proposed amendment. Commissioner Harpole seconded the motion which carried by a unanimous vote. Larry Fay clarified information for Member Westerman regarding State standards. Vice-Chairman FrisseU asked about doing somcthing to prevent the buying and seUing of non-buildable lots? Member Buhler stated that prevention is not a Board of Health issue. Commissioner Harpole stated that it is a difficult issue to deal with since non-buildable lots are bought and sold for a variety of reasons, not necessarily for building. HEALTH BOARD MINUTES - APRIL 15,1999 Page 8 ONSITE SEWAGE ORDINANCE REVISION PROCESS: Commissioner Harpole moved to accept staffs recommendation for the Board to finish reviewing the second draft during the Board of Health meeting in May and to conduct at least one well advertised Board workshop prior to an adoption hearing. The workshop should be conducted at a time that is convenient for public participation, evenings or weekends. Member Masci seconded the motion for discussion. Member Buhler recommended the Board conduct a high profile advertising campaign for public input and participation. Chairman Wojt called for a vote on the motion which passed unanimously. AGENDA CALENDAR REVIEW: The following items will be discussed during future meetings: ... Meeting with Mary Selecky, State Secretary of Health ... Local Tobacco Advertising ... Needle Exchange Program Update ... The Distinction Between Leading Causes of Death and Real Causes Death ... Hospital Report - (Jill Buhler) Meeting adjourned, The next meeting will be held on Thursday, May 20, 1999 at 2:30 p.m. '\ JrFERSONcc6,tTY~&J'. ..F_~TH . . , \ r!-;,( U . l '"' '~"\~_ &-,~~ Sheila Westerman, Member Richard Wojt, Chairman ~ A1i,4;u~J t'Y , Roberta Frissell, Vice-Chairman (Excused Absence) Gl~Huntingford, Member {)~~~ Dan Harpole, Me er