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Home My WebLink About121604 JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, December 16, 2004 Board Members: Dan TiftemeJs, Chairman - County Commissioner Distnd # 1 Glen Huntintford - County Commissioner District #2 Patrick M, Rodgers - County Commissioner Distnd #3 GerJ/frey Masci - Port Townsend City Council Jill Buhler - Hospital Commissioner Distnd #2 Sheila Westerman - Citizen at La1J:e (City) Roberta Frisse/!, Vice Chairman - Citizen at La1J:e (County) Stat! Members: Jean Baldwin, Health & Human Services Director Julia Damkin, Nursing Services Director Thomas Licke, MD, Health Officer Ex-ojjicio David Sullivan, PUD # 1 Chairman Titterness called the meeting to order at 2:40 p,m, in the Health Department Conference Room, All Board and Staff members were present with the exception of Commissioner Huntingford and Member Buhler. There was a quorum, APPROVAL OF AGENDA Member Masci moved to approve the Agenda as written. The motion was seconded, which carried by a unanimous vote. APPROVAL OF MINUTES Commissioner Rodgers moved to approve the minutes of November 18, 2004, as corrected to reflect Commissioner Huntingford's absence. Member Masci seconded the motion, which carried by a unanimous vote. PUBLIC COMMENT - None OLD BUSINESS AND INFORMATIONAL ITEMS Nurse Familv Partnershin: Julia Danskin reviewed that Secretary of the Department of Social and Health Services (DSHS), Dennis Braddock had provided $25,000 to enable the County to supplement and extend expiring City and County services through June 2005 - half of the amount requested, Chairman Titterness was recognized for his special effort on this matter. He commented that while it is important to maintain the integrity of the Commissioner's office, it is certainly okay to step outside the protocol. Member Masci said that from talking with the City Council Monday he believes it might be possible to get the additional $26K to assist for the remainder of2005, adding his hope that the County could also contribute, Julia Danskin indicated that they do not anticipate HEALTH BOARD MINUTES - December 16, 2004 Page: 2 financial support from DSHS into the next biennium, but she agreed to follow up with Sheila McNamara ofDSHS, Henatitis C Surveillance Svstem: Dr. Locke noted the agenda packet contained a communication to primary care providers reminding that Hepatitis C is a notifiable condition and requesting their assistance as the Department tries to determine the prevalence of the disease in this county, He provided a brief history of Hepatitis C testing, which began in 1992, Noting that the number of cases among N drug users is growing, the burden is expected to be mostly that of old infections, which is thought to have peaked in the D,S, in the late 1980s, Because of the cost and drawbacks ofthe available treatments and cures, prevention (diagnosis and needle exchange programs) would be extremely important in the next 10-20 years, Dr. Locke then described the differences between Hepatitis A, B, and C. Jean Baldwin mentioned the Department provides the vaccine for Hepatitis B, which is preventable but not curable, There is also a combination Hepatitis NB vaccination, Having signed up for the electronic surveillance system this month, by next month Lisa McKenzie should be able to run electronic reports on communicable diseases, NEW BUSINESS Influenza Un date - Vaccine Redistribution. Influenza Activitv. Policv Imnlications: Dr. Tom Locke talked about recent press coverage of production difficulties, Fortunately, Jefferson County received its 12-13,000 doses and was able to share its surplus to help cover regional shortages in Clallam and Kitsap Counties, Aventis' distribution of extra supplies to the critical shortage areas, while coming relatively late in the flu season, will be of substantial benefit. Although there remains a surplus of pediatric vaccine, several jurisdictions are going to broaden their priority list as soon as next week, Last year, 87 million people were vaccinated; this year 60 million - at best - would be vaccinated, There continues to be a scramble to redistribute vaccine, but the real issue is how to address shortages and production problems, There is some feeling that the vaccine should be more widely used and possibly a requirement for school-age kids, More manufacturers would make vaccine if they knew they would be able to sell it. Even if the government decided to nationalize the production of the vaccine, it would take a decade to ramp up to the private sector. Some discussion of vaccination rates among the at-risk (high priority) populations ensued, Dr. Locke noted that those most likely to be vaccinated are those 65 and over, In contrast, the rate among healthcare workers is 34% and it is even lower among children, He stressed that as a communicable disease prevention tool, a vaccine must reach 80-90% ofthe population, Ofthe approximately 10 known cases in the state, there have been no known associated deaths, The vaccination rate among the county is currently unknown, Jean Baldwin said the pediatric flu vaccination has only recently been available for kids and it has only been suggested recently as disease prevention, When asked if a question about vaccination could be added to BRFSS survey, Dr. Locke suggested focusing efforts on correcting misinformation and changing the public's attitudes about vaccines, Providing information about the risks and benefits is an area Public Health could influence, Jean reported having been approached by the Rotary about partnering to change perceptions about vaccines, and solicited member input on such a potential project. Jean Baldwin agreed to follow up with the Rotary and report back to the Board, HEALTH BOARD MINUTES - December 16,2004 Page: 3 Member Westerman acknowledged that exemptions in Port Townsend are historically high, but added that the concerns center on the dangerous components of past vaccines. People tend to make this decision solely on the basis oftheir individual risk and might not realize the risk they are presenting to those compromised members of the public when they do not immunize their children, While vaccines are not perfect, in the bigger picture they represent the more responsible path, There was Board support for a comprehensive education program, The peninsula's Parent Teacher Associations were thought to present an opportunity for vaccination lectures by Dr. Locke, The goal would be to target 2005 fall registration, Public Health Emerl!encv Preparedness and Response (aka Bioterrorism) Workplan 2005: Jean Baldwin reviewed the contract and deliverables associated with the $25K Public Health Bio- terrorism work plan, The County is now testing its plan - there will be a discussion between the top Staff of both the Health Department and Jefferson HealthCare on January 20; in March there would be a two-day public health "incident." There would also be a training at Fort Worden on February 3rd to explain the legal issues and implications of isolation and quarantine, It will be an explanation of the legal issues and responsibilities of quarantine and will be attended by Commissioners and other elected officials from Jefferson, Clallam and Kitsap Counties, as well as the upper level personnel of their various law enforcement, fire, and health agencies, Dr, Locke noted that the need for this comprehensive approach is driven by the SARS outbreak, The issue is not only finding a place for containment but how you feed and monitor them and getting law enforcement to recognize the statutory responsibility, Jean Baldwin noted that many programs are funded, but not fully funded, which is the case with this program, Side benefits are collaboration with other counties, Lisa McKenzie and the regional organizers are doing most ofthe work to send invitations, Member Westerman suggested a memorandum of understanding document the effort in time and training, There was agreement to the need to outline/document the existing authorities, Since he could not attend, Commissioner Rodgers asked to get information from this training, ACTIVITY UPDATE/OTHER ANNOUNCEMENTS Environmental Health Director: Jean Baldwin reported the Department is completing a new job description and would soon be re-advertising for this position, Given the staffing shortages in Environmental Health, she is still considering how to cover the gap in the meantime, She would also be seeking some outside assistance for contract review and analysis, Board of Health assistance would be sought for reviewing applications and interviewing candidates, There was a brief discussion about whether the County's internal standards and policies might be exceeding State standards, although they were thought to have had positive impacts to the County, Bil! Brother and Bil! Sister: This program is funded from a grant the Health Department wrote in conjunction with the Office of Juvenile Justice, It funds a school mental health person, the Big Brother and Big Sister program and a little of the work with the Community Network Prevention Plan, Community members are being sought to serve on the Board, HEALTH BOARD MINUTES - December 16, 2004 Page: 4 AGENDA PLANNINGI ADJOURN The meeting was adjourned at 3:40 p,m, The next meeting will be on January 20, 2005 at 2:30 p,m, in the Conference Room of the Jefferson County Health Department, JEFFERSON COUNTY BOARD OF HEALTH Dan Tittemess, Chairman // ' /L:lltef,U ,.::luu<lt Roberta Frissell, Vice Chairman (Excused Absence) ~ill Buhler, Member , i '\ ',.. :iVC\' ,,-,,,', \ ". ""_ I,' \'-'""1.----- ,~ ~J, \)"J Sheila Westerman, Member (Excused Absence) Glen Huntingford, Member y PUBLIC HEALTH . . , Always Working for a Safer and ,% o*/HEALTHIERJEFFERSON ,,l''!ll''O~ 615 Sheridan Street, Port Townsend, Washington 98368 Date: June 7, 2004 To: Primary Care Providers From: Tom Locke, M,D" M,P,H" Jefferson County Health Officer Re: Reporting System for Chronic Hepatitis C Acute and chronic hepatitis C became notifiable conditions in Washington in 2001. Prior to introduction of a specific diagnostic test in 1992 hepatitis C was classified as nonA, nonB hepatitis, About 1.8% ofthe V,S, population has chronic hepatitis C, which is the most common indication for liver transplantation among adults in this country, Washington State data on chronic hepatitis C will become available for the first time in the 2003 Annual Communicable Disease Report. We have very incomplete prevalence information for chronic hepatitis C in Jefferson County, Jefferson County Health and Human Services (JCHHS) would like to ensure that we have a good understanding of the prevalence and epidemiology of hepatitis C in Jefferson County, The Washington State Chronic Hepatitis B/Chronic Hepatitis C Confidential Case Report form includes details that will help characterize the pattern of hepatitis C infection in Washington and in Jefferson County, This will provide a better understanding of the proportion of disease that is due to blood products received before 1992, injection drug use, occupational exposure, etc, This information will help us to better target education and prevention activities, The enclosed Request for Reporting letter will be sent to your clinic when JCHHS receives a copy of a positive lab result for hepatitis C for a patient who has not been reported previously, Please complete as much information on the report form as possible, Please ask the patient the risk information questions at the visit while discussing lab results with them, The report may be sent back to JCHHS through the JOH mail courier. If you suspect that a patient has acute hepatitis please call JCHHS at 385-9400 and ask for the Communicable Disease Nurse, We would like to assess possible sources of exposure and recent contacts, There is a different reporting form for acute hepatitis, Also enclosed is the full list of Notifiable conditions for Washington State, Reports may be made to JCHHS at 385-9400 during office hours, For urgent reports or questions after hours call my pager number, (360) 582-8353, If you are unable to reach me please call Jean Baldwin at (360) 531-1736, The CDC's Hepatitis C Fact Sheet is enclosed in case you would like to use it for a patient education handout. If you would like additional patient education materials, or if you have questions about reporting, please call Lisa McKenzie at 385-9422, Thank you for helping with this effort, COMMUNITY HEALTH (360) 385-9400 ENVIRONMENTAL HEALTH (360) 385-9444 DEVELOPMENTAL DISABILITIES (360) 385-9400 SUBSTANCE ABUSE & PREVENTION (360) 385-9400 v PUBLIC HEALTH Always Working for a Safer and HEALTHIER JEFFERSON 615 Sheridan Street,. Port Townsend. Washington 98368 Request for Reportable Conditions Information for Chronic Hepatitis B or C Date: To: From: Re: Chronic hepatitis C and B are conditions for which we have incomplete prevalence information in Jefferson County, Jefferson County Health and Human Services (JCHHS) would like to ensure that we have a good understanding of the prevalence and epidemiology of these conditions in Jefferson County, This is needed in order to target prevention activities, Please see the attached lab result for your patient and the report form, Please complete as much information on the report form as possible, Please ask the patient the risk information questions at the visit while discussing lab results with them, I realize that you may not have all requested information in your records for this patient. If you suspect that this patient has acute hepatitis please call JCHHS at 385-9400, We would like to assess possible sources of exposure and recent contacts, There is a different reporting form for acute hepatitis, Thank you in advance for your timely attention to this report. Please send the report back to JCHHS as soon as possible, through the JGH mail courier, COMMUNITY HEALTH (360) 385-9400 ENVIRONMENTAL HEALTH (360) 385-9444 DEVELOPMENTAL DISABILITIES (360) 385-9400 SUBSTANCE ABUSE & PREVENTION (360) 385-9400 , Patient Data: Last Name CONFIDENTIAL CHRONIC HEPATITIS B/CHRONIC HEPATITIS C CASE REPORT First Name Address City Stale Init Zip Code County Date of Diagnosis Race" -Check all that apply Dale of acute IUness (if known): ~_ Test Date mol Positive N / Not tive Unk Done IgM hepatitis A antibody (lgM anll-HAY) gepa a gan c Inttiel hepatitis B surface antigen (HBsAg) Most recent hepatitis B surface antigen (HBsAg) HBV DNA: Qualitative (circle one) Quantitative epa s screening an an - Anti-HCV supplementary antibody lest (e,g" RIBA) Viral RNA: Qualitative (cirde one) Quantitative ver u es : con rmve a or em AL T (SGPT) AST (SGOT) BiUrubin 0 0 0 0 ~- 0 0 0 0 ~- 0 0 0 0 0 0 0 0 copies or EqImI 0 0 0 0 ~- 0 0 0 0 0 0 0 0 copies or EqlmI on > Imes nonna ~- Value: ~- Value: / Value: Comments: Submitted by (provider) City Yes No Unk 000 000 000 000 o 0 0 000 000 000 000 000 000 Person completing report Sex Dale of Birth Mo Da U-Unknown Yr Risk information check all that a 1): Injection drug use ever Blood products or solid organ transplant before July 1992 Factor concentrates before 1987 Chronic hemodialysis History of occupational needle stick or blood splash Sex partner HBV+/HCV+ (circle one) Infant of HBV+/HCV+ mother(circle one) Other risk (specify) If female, is currently pregnant: Due Date Interviewed by the provider Interviewed by the LHJ Provider telephone State Person Completing report telephone