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HomeMy WebLinkAbout011504 JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, January 15, 2004 Board Members: Dan Titterness, Chairman - County Commissioner District # 1 Glen Huntingford - County Commissioner District #2 Patrick M. Rodgers - County Commissioner District #3 Geoffrey Masci - Port Townsend City Council Jill Buhler - Hospital Commissioner District #2 Sheila Westerman - Citizen at Large (City) Roberta friIseli, Vice Chairman - Citizen at Large (County) Stat Members: Jean Baldwin, Health & Human Services Director Larry Fay, Environmental Health Director Julia Danskin, Nursing Seroices Director Thomas UJcke, MD, Health Officer Ex-officio David Sullivan, PUD #1 Chairman Masci called the meeting to order at 2:30 p.m. All Board and Staff members were present with the exception of Member Westerman. There was a quorum. APPROVAL OF AGENDA Commissioner Titterness moved to approve the agenda as submitted. Member Buhler seconded the motion, which carried by a unanimous vote. ELECTION OF BOARD OF HEALTH CHAIR AND VICE CHAIR FOR 2004 Chairman Masci called for nominations for the position of Chair. Member Buhler nominated Commissioner Tittemess. There being no further nominations, Member Buhler moved to elect Commissioner Titterness as Chair. Commissioner Huntingford seconded the motion, which carried by a unanimous vote. In response to the call for nominations for Vice Chair, Member Buhler nominated Member Frissell. There being no further nominations, Member Buhler moved to elect Member Frissell as Vice Chair. Commissioner Huntingford seconded the motion, which carried by a unanimous vote. APPROVAL OF MINUTES Member Masci moved to approve the minutes of December 18, 2003 as corrected. On Page 4, a sentence should be added to the last paragraph, as the third sentence, which says "He did note that the influenza vaccine used for young children (6-24 months) is Thimerosol-ffee." Vice Chairman Frissell seconded the motion, which carried by a unanimous vote. PUBLIC COMMENT - None HEALTH BOARD MINUTES - January 15, 2004 OLD BUSINESS AND INFORMATIONAL ITEMS Page: 2 Gvusv Moths in Port Ludlow: Larry Fay reported that in February, the Department of Agriculture would be holding a series of community workshops in Port Ludlow to discuss eradicating tree-eating Gypsy Moths in that area. The State Department of Health is aware of this and could offer technical assistance to the County in the event of public anxiety about the use of the relatively innocuous insecticide being sprayed. Healthv Jefferson: Jean Baldwin reported receiving positive responses to the plans for open houses, the announcements of which were included in the agenda packet. Medical Assistance Administration Strate~ic Plannin~ Ouestionnaire: As directed by the Board at the last meeting, Dr. Tom Locke had filled out the survey on the Board's behalf, on which he then solicited additional Board comment or changes. There were minor suggestions for modification to spell out the acronym MAA (Medical Assistance Administration) and correcting Commissioner Tittemess as Chair as the signatory on the letter. Vice Chairman Frissell moved to direct Staff to finalize the survey response as amended. Member Masci seconded the motion, which carried by a unanimous vote. NEW BUSINESS Draft Ordinance Rel!ardinl! Methamnhetamine Manufacturin~ Site Evaluation and Clean-un: Larry Fay summarized the draft ordinance before the Board addressing clandestine drug labs, including the responsibilities of Public Health to initiate an investigation as to whether the property containing the drug lab has been contaminated. Ifthere is contamination, the law requires the local Health Authority to post a notice at the property, record notice on the property title, notify the State Department of Health so that they could run their inventory, work with the property owner on a decontamination ofthe site, and determine whether decontamination was successful. While the ordinance is modeled after Clallam County's, Jefferson County's version also establishes penalties for the occupation ofthe house, additional measures of which the Sheriffs Department is supportive. The Board was asked to make comment on this draft. The next step would be a legal review and administrative process and scheduling of adoption hearings. In response to a question by Member Buhler, Larry Fay further clarified that this ordinance is focused only on meth labs that come to the County's attention as a result of police action. Dr. Locke agreed that the authority in this ordinance is restricted to illegal drug manufacturing and suggested amending the second sentence in Section II Applicability to say "...property that is contaruinated by illegal drug manufacturing or storage. " Member Buhler noted the absence of a statement in Section VIII Appeals about an order prohibiting use. Mr. Fay noted that such language is contained in the WACs and the RCW and was included by reference. Under Section VII Criminal Penalties, Commissioner Rodgers asked whether we should direct the Court to impose restitution rather than stating, "the court may also impose restitution" in an effort to ensure a means for the County to recapture costs of bringing the structure into compliance? Chairman Tittemess asserted that the Judge has flexibility and power to order restitution. There was HEALTH BOARD MINUTES - January 15, 2004 Page: 3 discussion about how to address this matter in the ordinance and support for the suggestion that Staff look to larger counties for precedence on the Criminal Penalties. Larry Fay noted that Section 5 on page 3 addresses abatement and assessment of costs - how the County could attach a tax lien on the property and force a foreclosure in order to recoup clean-up costs. The Criminal Penalties still provide pressure on the property owner to perform the clean up. Member Masci moved to return the ordinance to Staff to obtain a legal review and comparison with langnage in ordinances of other counties. Commissioner Huntingford seconded the motion, which carried by a unanimous vote. Bovine Snonl!iform Encenhalonathv in Washinl!ton State: Dr. Locke provided an update on the issue of Mad Cow Disease, which appeared in Eastern Washington at the end of2003. The agencies in the forefront are the Federal and State Departments of Agriculture, which regulate the health oflivestock and the rules relating to Bovine Spongiform Encephalopathy (BSE). The role of public health is to inform the public about the risks and to perform surveillance for the human form, which is called variant Creutzfeldt-Jakob Disease (vCJD). Among the information in the packet was the letter about vCJD that was sent to neurologists, neuropathologists, medical examiners, and health officers. While instances of human transmission have been very low, the potential presents a huge economic and agricultural issue. In response to questions, Dr. Locke further explained that while BSE is present in highest concentration in nerve tissue, nervous tissue is also distributed in the muscle. Since the efficiency of transmission is so low, the risk of bits of nerve tissue in meat is an incalculably small number. He talked about regulatory changes to address the origin of the problem, feeding large amounts of bovine neurologic tissue back to the cattle. On-Site Sewal!e Permittinl! Prol!ram Activity -- 2003: Larry Fay provided highlights of some ofthe timing and issues around permitting that he recently presented to the County Commissioners. In looking at the table of 2003 Septic Processing Time by Permit Status, he noted that almost 45% of the permit applications received in 2003 were either delayed or remanded for insufficient information, identification of critical area, or design problems. Staff is strategizing how to improve permit processing by better addressing the system bottlenecks. He reported that one third of all systems permitted would never be installed - i.e., people simply want assurance that they would be able to build in the future. Six designers had submitted eighty-five percent ofthe applications received, so there is a relatively small pool of people to work with. In response to a question from David Sullivan, Staff agreed to look for any correlation between these "clock stoppers" and the designers. Member Masci suggested changing the application flow chart to highlight the desired flow for permit approval rather than problems that hold up approval. He also asked whether Environmental Health has a goal- a product improvement plan. Mr. Fay said he believes 70% permit approval is achievable. Larry Fay then reviewed the outcomes of a December meeting meant to get input from designers and engineers on process improvements regarding pre-design inspections. They recommended Staff commit to having a quarterly open house meeting with designers, eventually expanding to include the installers as an opportunity to exchange information and identify issues before they become problems. They would also like Staff to introduce new policies/procedures following these meetings. A consistent message from the design community is that Environmental Health does a lot by practice rather than policy and that the HEALTH BOARD MINUTES - January 15, 2004 Page: 4 practices change some. They would like a clear manual that documents all the practices and the rule interpretations over the years. He then distributed updated Septic Design and Permitting Guiding Principles, noting that nnmbers 2 and 3 would require the tools and information for designers to actually submit a clean and accurate application. Staff has worked with Information Services to have Critical Areas maps available on-line. Linda Atkins has completed two trainings and has two more scheduled to help designers use web-based tools. The first quarterly meeting is scheduled to occur in February. While performance measures have been used for the last couple of years, a change would be made to conduct an earlier review of the application (within seven rather than 14 days). Applications would hopefully go through more rapidly than the current 21 days and problems, if any, could be detected earlier. Member Buhler expressed concern that a homeowner's whole construction process could be delayed if the person hired to submit the application builds "clock stoppers" into it. Larry Fay agreed that it could take a little longer, but said Staff would be challenged to prioritize those that have a building permit and a septic permit applications over other permits for systems that never get installed. David Sullivan asked if fees relate to the amount of Staff time involved and whether additional Staff would speed processing? Mr. Fay explained that fees are broken down by time and they have a two-tier structure on conventional and alternative systems. They also have the ability to charge for redesign if one is needed. He believes that both staffing levels and fees are appropriate for the application process. 2nd Draft of Policv Concerninl! Evaluation of On-Site Sewal!e Svstems and Buildinl! Permits: As continued from the last meeting, Larry Fay and Linda Atkins reviewed with the Board the revised policy for the On-Site Sewage Disposal Program and solicited additional comments. Member Masci reminded Staff about the suggestion to include in the documents the length of time an EES remains valid. Staff agreed there should be a statement to address this in the ordinance. Vice Chairman Frissell said that according to the chart in the appendix, there is at least one other situation that does not require an EES, which is not reflected on the page under exceptions - a permit on property greater than five acres and more than 200 feet from the shoreline that is not adding plumbing. It should either be listed under Exceptions or the chart Appendix should be referred to under those exceptions. Member Buhler asked what mandates the difference between the operational check and the full assessment? Mr. Fay explained that the adopted code establishes what type of application triggers what kind of review. The operational check would be appropriate if it is a building permit application that is not an expansion. A full assessment would be needed to determine if the system is functioning and has the capacity to meet the expansion ofthe home. The only caveat is that in situations where the expansion is less than 120 sq. ft. an assessment would be needed only ifthere is no permit on file or the system never received a final check to verify that what was permitted was actually installed. Linda Atkins then reviewed the status of other Board-requested changes. Member Westerman had asked that the opening paragraph refer to the 8.15 code, so Staff would also add, "to implement provisions of the Jefferson County Code 8.15." On Page 2, the term "non-building" was replaced with a defmition. Although the Board had asked whether the time of sale inspection could actually be required before the sale, Staff did not make this adjustment since it would require a code change. On the last page, item number 4, there was also interest in requiring that deficiencies be corrected at the time of sale rather than HEALTH BOARD MINUTES - January 15, 2004 Page: 5 by the time of the next regular inspection. Since the Department currently does not have a mechanism to inspect and identify such deficiencies at the time of sale, the Board would need to address it in the Code. She clarified while there is notification of the deficiencies, they are not identified as a violation until the next inspection. Member Masci moved to approve as corrected the Policy Concerning Evaluation of On-Site Sewage Systems and Building Permits. Vice Chairman Frissell seconded the motion, which carried by a unanimous vote. Influenza Undate: Dr. Locke gave the Board an updated Weekly Report on Influenza, which showed a peak in the number of lab-reported positive cases. Compared to previous years, this was a fairly bad year with an early peak in the number of cases. While in recent years there have been single peaks in influenza, there could be another peak between now and March. Therefore, there is still is an argument for getting high-risk populations vaccinated with the small amounts available. The children's vaccine is also available in small amounts. The manufacturer of the new flu mist vaccine is now giving it away. While the live virus vaccine appears to be a good vaccine, it currently cannot be used for the high-risk population and is therefore not able to prevent deaths in this population. He noted that Vietnam is now experiencing an avian flu outbreak with 80% mortality. As long as the strains are spread from animals to human, they are relatively controllable, but if the strains are efficiently spread from person to person, it could result in a global pandemic. Sporadic cases of SARS are surfacing in China and there is a definite link with Civet cats. Recently, the U.S. banned their importation. ACTIVITY UPDATEIOTHER ANNOUNCEMENTS There was Board support for holding a special joint meeting ofthe Board of Health and Hospital Board the second week of March (possibly March II). AGENDA PLANNING/ ADJOURN The meeting adjourned at 3:55 p.m. The next meeting will be held on Thursday, February 19, 2004 at 2:30 p.m. at the Jefferson County Health and Human Services Conference Room. OUNTY BOARD OF HEALTH ~~e~:::- (Excused Absence) Sheila Westerman, Membe . Patrick M. Rodgers, Member HEALTHY JEFFERSON* , - You can make a difference! Join colleagues, friends, and neighbors at these Healthy Jefferson Open Houses. STRENGTHEN SUPPORT FOR FAMILIES WITH CHILDREN Thursday,January 22,2004 3:30-5:30 p.m. Pope Marine Bldg. Hosted by Judi Morris, Catharine Robinson, Beth Wilmart Roberta Frissell, Julia Danskin & Quen Zorrah REDUCE ALCOHOL & DRUG ABUSE IN OUR COMMUNITY Tuesday, January 27,2004 3:00-5:00 p.m. Pope Marine Bldg. Hosted by Barbara Carr, Sherry Kimbrough, Geoff Masci, Bruce Marston Kees Kolff, David Sullivan & Mike Blair INCREASE JOB SKILLS & FAMILY-WAGE JOBS Thursday,January 29, 2004 3:00-5:00 p.rn. Pope Marine Bldg. Hosted by Dan Titterness, Katherine Baril, Deborah Johnson Michelle Sandoval, Quentin Goodrich & Larry Crockett Who Should Come?-Everyone ready & willing to make a difference. What to Bring-Your ideas and enthusiasm. Bring your co-workers, friends, family and neighbors. What We'll Accomplish-Find a place where your action counts. HEALTHY JEFFERSON- Making a Difference for Our Community Recent surveys identified these Jefferson Co. public health risks: . l-in-6 children in Jefferson County lives below the poverty level. . Among households with children- l-in-3 adults are heavy drinkers, l-in-3 adults reported abuse as a child. . I-in-S county 8th graders report heavy drinking. . l-in-2 18-34 year-olds has a high school education, or less. Healthy Jefferson is a community-wide collaboration to reduce these health risks, and to increase the well-being of Jefferson County residents. A Steering Committee of community leaders selected three priority goals to create a healthier Jefferson - I. Strengthen the Safety-Net for Families with Children 2. Increase the Continuum of Care (prevention, interven- tion, treatment) for Substance Abuse for All Ages 3. Enhance Education and Vocational Opportunities that Increase Job Skills and Employment Options COMETOA HEALTHY JEFFERSON OPEN HOUSE. CONTRIBUTEYOURTAlENTSAND SKillS. MAKE A DIFFERENCE! For more information, please contact: Barbara Bowen, Healthy Jefferson Coordinator, 379-4498 <'1 STRENGTHEN SAFETY NET FOR FAMILIES WITH CHILDREN Organization What We Do to Strengthen the Safety Net/How We Make a Difference We Invite You to Join Us in Making a Difference List a range of opportunities here. Some examples might be: . Install new operating system software on our computer (or computer network) and test drive the application software with the new OS. A one-time commitment for 3-5 hours. The djfference it would make--increase the efficiency and cost~effectiveness of all the computer-based work, and free-up staff to serve our clients in an even more effective way. . On-call drivers available to drive (people in drug-rehab, pregnant moms) to treatment or doctors' appointments. Time and frequency: You decide. Some trips would be about 4 hours round trip, some are all-day trips to Seattle. You can specify what you want to do. . Board member with specialty in finance. I 2-hour meeting/mo. + 4-6 hours of non-meeting work/month. . Office organizer to provide 2 hrs.lmonth of time/month to work with executive director on office organization--paper files, computer files, tracking and follow-up system. . Adults with hobbies needed to share their hobbies with young people in 4-H. . Men who fish needed to take teen-age boys fishing-several hours on a weekend every month during the season, or on a weekend-long fishing trip, once-awyear. ~ . Algebra tutors for high school students, and parents returning to school for GED or other. . Cash donations to buy musical instrument kits for young people and families. (Andy Mackie) . Cash donations to buy life vests for children available at area boat launches. . OTHERS YOU CREATE January 7, 2004 Meredith Wagner Jefferson County Library POBox 990 Port Hadlock, WA 98339 Meredith, For many months a group of citizens has reviewed Jefferson County Health Statistic data. We know there are key areas where the social, physical, mental and economic health is lacking. We also know that government alone can't fill the voids. That's where I hope you can help. We have scheduled three open houses focused on critical areas of concern. I am a co-chair of the first event and would especially like to have your involvement in the effort to strengthen support for families with children. Using an open house forum we hope to attract as many private citizens to see what is being done and suggest ways each of us can make a difference in the lives of our neighbors. Please join me Thursday, January 22, 2004 anytime between 3:30 PM and 5:30 PM. Bring friends and neighbors. We want to be a community effort and we want to see improvement in the lives of families in Jefferson County. The attached flier lists all three open houses and may be distributed, as you feel appropriate. See you on the 22nd. Judi Morris . Barbara Bowen Subject: Update on Healthy Jefferson Open Houses -- From: "Beth Wilmart" <bwilmart@co.jefferson.wa.us> Cc: "Barbara Bowen" <bbowen@co.jefferson.wa.us> Sent: Monday, January 05, 2004 3:34 PM Subject: Update on Healthy Jefferson Meetings Birth to Five Coalition & Healthy Youth Coalition: On December 15th I sent you an email to save the date for upcoming Healthy Jefferson Meetings. I now have more complete information, and hope that you have set aside time to attend these important events. Three "0pen House" events for the community will be held at the Pope Marine Building next to the Police Department in Port Townsend. At the first Open House, any organization that interacts with families with children is invited to publicize their program and solicit help in the form of volunteers, etc. Tables will be placed around the perimeter of the room and attendees will be able to meet and talk with you about your program or service. Attendees will be asked to sigo "I Want to Make A Differencell forms that programs can use to follow up with interested parties. Open House #1 - Strengthen Support for Families with Children Thursday Jan. 22, 2004 3:30-s:30pm Open House #2 - Reduce Alcohol and Drug Abuse in our Community Tuesday Jan. 27, 2004 3:00-s:00pm Open House #3 - Increase Job Skills and Family-Wage Jobs Thursday Jan. 29, 2004 3:30-5:30pm Note: my previous email indicated that child care would be available. Since these will be "open house" events, you are welcome to bring your children, but there will not be any special accomodations for them. Older children may find this to be a valuable learning opportunity. Action Requested: *If you are involved in a group/agency/organization that works with families, please let me know if your group will attend the Open House on January 22. *Please talk these events up to your friends/neighbors/associates; it won't work without citizen participation. There will be articles and ads in the newspapers, but one-to-one invitations are most successful. *Call Barbara Bowen at the Health Department (379-4498) to order flyers or for more info. What to bring if you will attend: groups should bring information/photos/brochures about their program, and a stack of one-page handouts that lists what your group does, and *explicity* what type of help you need from the community. Use a different page for each program, so people can really hone in on their area of interest. If you need help with your handout, let me know. And of course, you can always contact me with any questions! Beth Wilmart Jefferson County Community Network Birth to Five Coalition Healthy Youth Coalition 360.379.4495 (Mon/Wed/Thur) bwilmart@co.jefferson.wa.us 1 ~<>><?~ PUBLIC HEALTH I.. ~~\ l"!1 Always Working for a Safer and ~~ --,-y HEALTHIER JEFFERSON 615 Sheridan Street. Port Townsend. Washington 98368 January 15,2004 Doug Porter, Assistant Secretary Department of Social and Health Services Division of Policy and Analysis PO Box 45533 Olympia, W A 98599-5533 Dear Mr. Porter: Thank you for the opportunity to comment on your Strategic Planning for our Clients' Future survey. On behalf of the Jefferson County Board of Health, I offer the following recommendations: I. How can MAA improve the health of Washington residents? Epidemiologic studies since the 1970's have consistently found that the determinates of health are roughly 50% behavioral, 20% environmental, 20% genetic, and 10% related to medical care. MAA programs have traditionally focused on the provision of acute and chronic medical care. A greater focus on evidence-based medicine and quality of care could certainly improve the effectiveness of that care, but the greatest health improvement benefit will come from greater attention to the other 90% of health determinates. Support of clinical prevention services, home visiting nurse programs, health promotion and health education programs are some examples of areas that need much greater public sector support. 2. When dollars are limited, how do we prioritize our health care spending? Highest priority should be given to those least able help themselves - the poor, children, and the disabled. Services also need to be prioritized based on their cost and effectiveness. Low cost services that are highly effective should be at the top of the priority list. High cost services that are lacking in evidence of effectiveness should be at the bottom of the priority list. Mental health and oral health services should be included in the same prioritization listing. 3. How do you think we can improve upon the MAA workforce of the future? First and foremost the workforce should reflect the cultural and ethnic/racial diversity ofthe populations that are served. The MAA workforce of the future should also be distributed throughout the state and play an active role in the communities that are served. Greater use of COMMUNITY HEALTH (360) 385-9400 9400 ENVIRONMENTAL HEALTH (360) 385-9444 DEVELOPMENTAL DISABILITIES (360) 385-9400 SUBSTANCE ABUSE & PREVENTION (360) 385- information technology should allow this decentralized workforce and reduce the administrative burdens that current DSHS programs impose on service providers. 4. How can MAA work with other state agencies and local communities to blend our services so we can improve access and quality health care services? Work with other state agencies should focus on administrative simplification and efficiency. The Basic Health Plus plan is an excellent example of this type of collaboration. At a community level, MAA must be seen as an honest broker - willing to pay the true cost of the services being provided. Payment that falls far below the cost of service delivery (which has become the rule, rather than exception) erodes access and degrades quality. Equitable funding of critical health services is a legislative responsibility. Chronic underfunding ofMAA programs by the legislature has caused a breech of trust with community providers. Improvements in access and quality will be difficult if not impossible until this trust is restored. 5. How can MAA maintain and expand our partnerships with health care providers so there is adequate coverage for all Washington State residents? MAA is often perceived as a bureaucratic agency isolated in Olympia and locked in an adversarial relationship with its providers and clients. We suggest you start with specific initiatives - prescription drugs, administrative simplification, and clinical preventive services- to build trust. Ultimately, there must be a commitment by the Governor and Legislature for adequate health care coverage to be universally available to all state residents. Partnerships cannot be built on unfunded mandates, unstable programs, and indifferent political leadership. 6. Of the suggestions you have given MAA, please list and prioritize the three most important. I. Invest in prevention (well child exams, visiting nurses, faruily planning, maternal child services) 2. Reduce administrative burdens, eliminate unfunded mandates 3. Restore trust through cost-based reimbursement for basic health services Sincerely, GeoffMasci, Chair Jefferson County Board of Health