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HomeMy WebLinkAbout08 August JEFFERSON COUNTY BOARD OF HEALTH MINUTES August 19, 1999 BOARD MEMBERS Dan Harpole, Member - County Cummissioner District #1 Glen Huntingford, Member - County Cummissioner District #2 Richard Wojt, Chairman - County Cummissioner District #3 Geoffrey Mnsci, Member - Port Townsend City Council Jill Buhler, Member - Hospital Cummisswner DistrUt #2 Sheila Westerman, Member - Citizen at Lm;ge (City) Roberta Frissell, Vice-Chairman - Citizen at Large (County) STAFF MEMBERS Jean Baldwin, Nursing Services Director Larry Fay, Environmental Health Director Thomas Locke, M.D., Health Officer Chairman Wojt called the meeting to order at 2:00 p.m. All Board and staff members were present with the exception of Commissioner Huntingford, Member Masci, Member Westerman and Dr. Tom Locke. APPROVAL OF MINUTES Member Buhler moved to approve the minutes of the July 15, 1999, as read. Vice Chairman Frissell seconded the motion which carried by a unanimous vote. ( NEW BUSINESS APPEAL OF SEPTIC PERMIT DENIAL -- SEP98 - 0264: Larry Fay reviewed the parcel description and action taken to date on the application for an onsite sewage system and distributed an aerial photograph of the area. He indicated the system design for the site was based on the use of an intermittent sand filter and a reduced size drain field. He stated that the system would comply with the code with the exception of the land area requirements as outlined in the Minimum Land Area Policy Statement 97-02. Staff is not authorized to approve waivers for sites less than 50 percent of the required land area. Regarding existing lots, the Policy allows some waivers to the land area requirements if there are mitigations in place, such as reduced flows and higher level of treatment. Larry Fay suggested the Board of Health revisit the policy and determine whether a treatment- or technology-based standard needs to be applied or whether the basis would be land area. He does not feel this individual system would be a health risk if properly constructed, operated, and maintained. The regulations have established 12,500 sq. feet as being critical in areas of new development and do not require issuing permits for lots smaller than 12,500. The homes are getting larger and squeezing the space available for the septic and drain fields. Mr. Fay expressed HEALTH BOARD MINUTES - August 19, 1999 Page: 2 a desire to investigate moving the sewage offthe spit and identifying available upland areas. However, rerouting effluent upland is a multi-year process and the relative cost has to be analyzed. Property owner Jim Mackay commented that it is not feasible or affordable to acquire additional properties upland to take effluent. Project Engineer David Jensen said the property, including halfthe width of the roadway in front of the property, would bring the total square footage to between7,000 and 7,500. Mr. Jensen described the system's design and its response to power outages. He indicated the 1,000 gal. pump chamber could be increased to provide a larger surge capacity. The dose for the system is 60 gals. per dose and there would be approximately 700 gals. of extra storage in the tank, an amount which could be increased. He feels that the minimum land requirement policies recently implemented impose unnecessary hardship on owners who wish to develop their property. Chairman Wojt questioned whether the interpretation of the land area to include the roadway would compromise the Policy. Larry Fay responded that it may not be inconsistent with the intent of the policy because of land area averaging. If you have a small lot and some large acreage adjacent to it, you could work out an arrangement to move your drain field through an easement. In this particular case, due to the water and the small lots sizes, you do not have that mitigation available. Commissioner Harpole said he supports reviewing the policy. The challenge of small lots in our communities are making them buildable while not degrading the environment. Commissioner Harpole moved to uphold the staff action and authorize a site specific waiver for this project based upon a finding that the development proposal and design are consistent with the intent of the regulations and that there would be no potential public health threat resulting from the action. Final approval is contingent upon a Health inspection performed at the applicant's expense. Member Buhler seconded the motion for discussion. The findings of fact will show: 1. that the County has factored in to the land area calculations to the centerline of the road to a total of 7,000 square feet; 2. the land area is coupled with the treatment standard that would be meeting with the intermittent sand filter; 3. an operational inspection by Health Department staff, for which they will charge an appropriate fee, to assure there is no public health threat associated; and 4. approval is site specific. HEALTH BOARD MINUTES - August 19, 1999 Page: 3 Vice Chairman Frissell commented it is important to find out what kinds of conditions are in place at Bridgehaven spit, Beckett Point, and other similar sites. The Chairman called for a vote on the motion which carried by unanimous vote. RECLASSIFICA nON OF OUlLCENE BAY: Harriet Beale from the Puget Sound Water Quality Action Team is the local liaison for Jefferson, Kitsap and Clallam Counties. Ms. Beale reviewed the request to change the shellfish area classification at the head of Quilcene Bay from Restricted to Inactive. Despite the improvement of water quality, due to the efforts of Environmental Health Department and local citizens, the water remains muddy and unsuitable for growing shellfish. Because this site has never been suitable for growing shellfish, its Restricted designation appearing on many recreational maps harms the image of commercial and recreational shellfish. Myrl Winjum, representing area shellfish growers, supports the change in designation because of the positive impact the change could have on recreational shellfish harvesting. Member Buhler moved that the Jefferson County Board of Health support the State Department of Health in its proposal to reclassify upper Quilcene Bay from Restricted to Inactive. Commissioner Harpole seconded the motion which carried by unanimous vote. A letter/press release will be drafted for the Chairman's signature. LICENSING PROCEDURES: The Board agreed to table this topic until the next regular meeting. KPS INSURANCE UPDATE: Jean Baldwin referred to the various press releases related to KPS' receivership situation. The problem, she said, is not with current subscribers not having insurance coverage, but that contract providers are not being paid. She distributed additional information used to notify new applicants that KPS is no longer available as a health plan choice and that, in Jefferson County, there is no health plan available for new Basic Health members. Commissioner Harpole said the immediate issue is that Basic Health is closed in the County. Commissioner Harpole moved that the staff draft a letter to Senators and Representatives, with a copy to Governor Locke, regarding the critical nature ofthis issue. Member Buhler seconded the motion which was approved by unanimous vote. Jean Baldwin said KPS has been a tremendous community service link. The County will miss this liaison as well as the local medical community tracking and monitoring. Commissioner Harpole excused himself from the rest of meeting. HEALTH BOARD MINUTES - August 19, 1999 Page: 4 INITIATIVE 695/ ENVIRONMENTAL HEALTH FEES: Chairman Wojt asked whether a recommendation from the Board of Health to the County Commissioners is needed on applying the fees. Larry Fay reviewed the issue as outlined in the agenda packet. He asked for guidance from the Health Board on fee principles and stated that his goal is to get the year 2000 fees in place before the law change. He asked if there is a base percentage fee that should be the goal. Vice Chairman Frissell proposed the development of two different fee schedules depending on the outcome ofInitiative 695. She feels it is irresponsible not to plan for the possibility of the initiative passing. Larry Fay said compared to fees in other counties, Jefferson County is low. He reviewed areas such as solid waste, food program and pool permitting where fees could be adjusted. Jean Baldwin reviewed nursing services and fees. She said the issue isn't with raising and lowering fees but recovering the fees. Member Buhler suggested providing discounts for cash payment at the time of service. Member Buhler supported getting information out to voters on how this initiative will affect the public. People need to know how this is going to affect them. Larry Fay said he can't charge more than it costs to do the service. Jean Baldwin agreed to provide a recommended fee schedule in September. Larry Fay said he would provide a cost plus analysis on those programs that have the potential to generate fees. Environmental Health fees will be listed as an action item on the October agenda. OLDS PROJECT UPDATE: Jean Baldwin reported she now has three videos on early child development, provided by the State Department of Health. Nursing staff have completed the OLDS training, are making visits, and are excited about the work. Chairman Wojt said he and Ms. Baldwin attended the presentation on early intervention and if the evidence is as good as was presented, he supports having a presentation to the Board of Health. Ms. Baldwin would like to set a date for a one-day summit with providers and policy makers to talk about services from early pregnancy through age three. The evidence indicates that home visits and early intervention make a difference. Chairman Wojt said this is a policy decision the Board of Health needs to make regarding its long-term planning. Ms. Baldwin said she is carefully monitoring this program for cost. BOARD MEMBER REAPPOINTMENT: The County Commissioners reappointed Geoffrey Masci and Sheila Westerman to serve another term on the Board of Health. HEALTH BOARD MINUTES - August 19, 1999 Page: 5 AGENDA CALENDAR I ADJOURN SEPTEMBER 16 -- SPECIAL MEETING: Health Board and Hospital Board 12:00 - 5:00 p.m. @ Courthouse Lower Level Conference Room. ENVIRONMENTAL HEALTH FEES - October Action Item. MEETING WITH LEGISLATORS - (Dr. Tom Locke) LICENSING PROCEDURES - Rescheduled to October or November. Meeting adjourned at 4:30 p.m. The next meeting will be held on Thursday, October 21, 2:30 p.m. JEF;~~~ :'~! . h ,./C:J3ti?d . h' Ric ar WOJt, C a (Excused Absence) G~f~eZ:;;ber fifBuhler, Member J (Excused Absence) . Sheila Westerman, Member (Excused Absence) J1:tii~rd' Me~ Dan Harpole, ~ Human Services September 16, 1999 The Honorable Gary Locke Office of the Governor PO Box 40002 Olympia, W A 98504-0002 Dear Governor Locke: As Jefferson County's Board of Health, we are writing to express our concern over the lack of affordable health insurance in our County. This problem has worsened considerably in the past month with the financial collapse of Jefferson County's last remaining Basic Health Plan (BHP) and individual insurance provider - Kitsap Physician Service. The origins of this problem are complex but the effects are brutally simple- more and more Jefferson County residents are uninsured, underinsured, or on the verge of becoming one or the other. There is a growing consensus that the introduction of competitive state purchasing strategies in rural Washington State communities has been an unqualified failure. Rather than bringing price stability, improved efficiency, and greater choice, the effect of these health system changes have been just the opposite. Insurance premium rates are skyrocketing, rural health care providers are unable to sustain their practices, and some health care consumers are forced to change doctors and insurance plans on an annual basis. Ultimately, it is the health of rural communities that suffer most from the growing instability of the health care system. As a Board of Health, protecting and improving the health of our community is our highest priority. Only 6 years ago, Washington State residents were confidently looking forward to universal access to health insurance by the end of the decade. As the year 2000 approaches, access to affordable health insurance is deteriorating rather than improving. Not only are publicly supported programs like Medicaid and the BHP floundering in rural areas, the private market for individual insurance has virtually collapsed. For the self- employed, health insurance is only available through the State's high-risk pool, an unaffordable option for most people. HEALTH DEPARTMENT 360/385-9400 ENVIRONMENTAL HEALTH 360/385-9444 DEVELOPMENTAL DISABILITIES 360/385-9400 ALCOHOL/DRUG ABUSE 360/385-9400 FAX 360/385-940t Effectively addressing this growing health care access crisis will require strong and decisive leadership on your part. The fundamental assumptions that have created our worsening health insurance predicament will need to be reexamined. Above all, the notion that urban-based models of competitive bidding, selective contracting, and volwne discounts are appropriate in rural communities must be challenged. They have not succeeded in controlling costs or expanding access. They have had the effect of disrupting longstanding doctor-patient relationships, increasing administrative costs, and creating serious problems in the recruitment and retention of rural health care providers. The message we hear from our citizens is loud and clear - they want affordable, predictable health insurance that protects them from the catastrophic costs of a major illness. They do not want health insurance plans choosing their doctors for them, forcing them to switch plans and providers every year, or turning major health care decisions into an adversarial process of authorization and appeals. Ultimately, rural consumer choice is better served by a limited number of plans offering comprehensive local networks than by multiple plans with limited local providers. We appeal to you to provide the needed leadership in this crisis and return Washington State to its original goal of universal health care access for all citizens. We ask that you put your highest priority on assuring that the Basic Health Plan remain available to Jefferson County residents. And we seek your support in our struggle to protect our fragile rural health care system as health insurance plans leave rural areas to focus on more lucrative urban markets. .chard Wojt Jefferson County Board of Commissioners Chair, Jefferson County Board of Health cc: Representative Lynn Kessler Representative Jim Buck Senator Jim Hargrove Deborah Senn, Washington State Insurance Commissioner