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Home My WebLink About061404 ~. ~ ~ ]EFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, June 17, 2004 Board M""hers: Da1I Tillenuss, Chaimta1l- COII11fy Commissioner District #1 GIm HNntinlfford - COlmty Commissioner District #2 Patric" M. &dgers - COIInty Commissioner District #3 GtIlfJirJ Masci - Port T IJIPIlStItd City CONncil JiQ Bnhler - Hospital Commissioner District #2 Sheila We.rtmnan - Citi"!" at Ln-gt (City) &bma FriSSl/~ Via Chairma1l - Citi'(!ll at Ln-gt (CoNntyJ StqJf Members: Jean 13aItJMn, Health & Hl/lJla1I S enoi"s Dirtctor David Christensen, Interim Environmental Health Dimtor Jnlia Danslein, Ntming S enoi", Di,,_ Thomas Locke, MD, Health OF Ex-<dJicio: David SnIIi_, PUD #1 Chair Tittemess called the meeting to order at 2:30 p.m. in the Health Department Conference Room. All Board and Staff members were present with the exception of Commissioner Rodgers and Member Westerman. APPROVAL OF AGENDA Member Masci moved to approve the Agenda as written. Vice Chair FrisseU seconded the motion which carried by a unanimous vote. APPROVAL OF MINUTES Member Masci moved to approve the minutes of May 20, 2004. Vice Chair FrisseU seconded the motion which carried by a unanimous vote. PUBLIC COMMENT - None OLD BUSINESS AND INFORMATIONAL ITEMS Child Frome Landmark: Dr. Tom Locke presented an update on CHILD Profile Health Promotion. Washington families of children birth to six years receive 17 different age-specific mailings, which provide information and resources on growth, health, development, safety, nutrition, school readiness and other parenting issues. In addition, reminders of well -child checkups and immunizations are sent to parents of children turning six years old. The latest survey has indicated that 30 percent of parents felt the information has helped change thoughts and behaviors. to . HEALTH BOARD MINUTES - June 17, 2004 Page: 2 Washinl!ton State Board of Health 2003 Report: Dr. Locke presented the Washington State Board of Health 2003 Annual Report. NEW BUSINESS Draft Solid Waste Ordinance - Public Hearinl! Notice Julv 15. 2004: David Christensen reported that as directed by the Board during their meeting last month, he retnrned the draft solid waste regulations to Deputy Prosecutor David Alvarez for review of the changes. Mr. Christensen requested the Board set a hearing next month for public comment. Member Masci moved to set a public hearing for Jnly 15, 2004 for review of solid waste regulations. Member Buhler seconded the motion which carried by a unanimous vote. Adverse Childhood Events Study: Julia Danskin, Nursing Services Director, presented the Board with a condensed version of research on adverse childhood events and how it relates to our local data and the services at the local Health Department. A major research project, the Adverse Childhood Experiences (ACE) Study revealed a powerful relationship between emotional experiences in childhood and physical and mental health in adulthood. From a survey of 17-thousand middle-aged, middle-income participants, the study numerically scored adverse childhood experiences, such as physical, sexual, emotional abuse, witness to domestic violence, substance abuse, mental illness, parental loss and having a faruily member in prison. The results showed that more adverse childhood experiences increased the risk for health problems throughout the life cycle. Fewer adverse experiences appeared to promote effective coping mechanisms. With regard to residents of Jefferson County, based on data from the Behavioral Risk Factor Surveillance System (BRFSS) sampling of2000-2001, it was determined that 25 percent experienced abuse prior to age 18 (compared with the State average of20 percent). Additionally, adults with adverse childhood experiences appeared to experience more days (in the pas! 30) of poor physical and mental health and impaired function, particularly those having the experience of sexual abuse and domestic violence. In response to the high infant mortaIity rate in our country, the Federal Government in 1989 enacted the "Maternity Care Access Act," which provided health insurance and support programs to pregnant women. Washington State began the First Steps Program (prenatal care) and the Maternity Support Services Program, in which Jefferson County began participating in 1989, paying for monthly visits from Public Health nurses, social workers and nutritionists. After learning of 1990's research on violent crime that pointed to a higher incidence of adverse childhood events in those imprisoned for violent crimes, Jefferson County Health Department investigated research-based prevention programs and founded Nurse-Family Partnership (NFP) in 1999, a best-practice program, using Public Health nurses to provide intensive home visiting services during the first two years of a child's life. Ms. Danskin provided the Board with impressive statistics on and examples of success. In 2002, the Health Department received a three-year Federal grant expanding the NFP. Changes at the Federal level discontinued the grant a year early, leaving our program out of Federal funding next month. The State and Federal .-" HEALTH BOARD MINUTES - June 17, 2004 Page: 3 Maternity Support Services program is experiencing loss of funds, while County costs have nsen. The Health Department will re-prioritize clients, trying to serve the highest risk and those with whom the Department may be most effective. Services will be lost; however, WIC program and monthly maternity support services will remain funded. It is likely that the intensive best-practice NFP program will be cut in half. Mr. Sullivan posed a question regarding the feasibility of group, rather than individual focus. Member Masci asked about the "Olds" and the "Y" models and suggested that it might be time for Jefferson County and the City of Port Townsend to address these issues in a joint meeting. Commissioner Huntingford recommended forming a long-term vision in addition to any immediate solution. Member Masci agreed and insisted that this Board begin looking at prioritization of programs. Jean Baldwin, Health & Human Services Director, has addressed staff about prioritizing community health funding. Staff's general response about the agency's most important task: prevention, primary prevention and preparation for the next generation. Commissioner Huntingford noted that priorities established here have to also fit the County budget. Member Buhler stressed that the Hospital District wants to stay in contact with the Health Department regarding programs and funding. Mr. Sullivan reminded of the need to get the public involved in this community-wide issue. 2004 Washinl!toD State Health Renort: Dr. Locke advised the Board that the bi-annual Washington State Health Report is mandated to collect information from the public and state agencies and components of health-related programs within the state, and then arrive at a series of priorities for the Legislature, state agencies and others. The current report was generated by the Governor's Subcabinet on Health in collaboration with the State Board of Health, coming up with the following series of values to guide policy. · Maintain and improve the public health system · Insure fair access to critical health services · Improve health outcomes and increase value · Explore ways to reduce health disparities · Improve nutrition and increase physical activity · Reduce tobacco use · Safeguard healthy air and healthy water HEALTH BOARD MINUTES - June 17, 2004 . Page: 4 Although many of the recommendations focus on state policy, a significant number have local ramifications in areas that we want to examine, especially areas of nutrition and increased physical activity. It acknowledges the effectiveness of several programs. Its very solid data appears to have influenced both the governor's budget and that of the legislature. Various agencies and legislative leaders also agree with the priorities. 2003 WIC (Special SUDDlemental Nutrition Prol!ram for Women. Infants and Children) Annual ReDort: Ms. Danskin reviewed the 2003 WIC Annual Report and cited Jefferson County's uniqueness in administering WIC and other programs from one facility, particularly identifying each Public Health nurse's ability to work with several programs. She pointed out that WIC brings over $300,000 of Federal food dollars to Jefferson County. The Board members were given flyers announcing the free women's mammogram and health exam (sponsored in part by the Jefferson County Health and Human Services), to be held at Hadlock Days on July 10, and reminded of the success of this program at the Quilcene Fair. Public Hearinl! Priority Settinl! - Mandated Local Health Services: Dr. Locke referenced his June 10, 2004 memorandum to the Board concerning mandated local public health services. Essentially, local public health services are categorized as either mandated by statute, required by contract, or identified discretionary local programs. Despite the worsening budgetary conditions, programs provided by public health service that are considered "hard" mandates, (i.e. communicable disease control, conduct endangering public health, food, on-site sewage systems and public water systems) have specific standards, are primarily funded by county dollars, and failure to enforce is easily identifiable and carries strict penalties. "Soft" mandates, other broad duties provided by local health boards and officers, are less specific and are regarded as a level of service to which the public is entitled and may initiate legal action ifharm befalls as the result of absence of a service. Contractual obligations are legal mandates for the duration of a contract. Elective, discretionary local programs, even those with huge impact on the health of the community, have no law requiring them. In the priority setting, we initially determine statutory mandate. In response to Chair Tittemess' query about listing and categorizing programs and procedures of Board recommendations, Ms. Baldwin requested there be, at the July meeting, discussion about how to frame the process of prioritizing the programs and assessing the damage to current level of service. Regarding the matching of funding in the County General Fund, Ms. Baldwin explained that funding might be matched with other sources, but not with federal funding. Discussion ensued between Staff and Chair Titterness, Member Masci, and Mr. Sullivan regarding additional funding sources, particularly private. Dr. Locke also identified the Public Health Pool, authorizing the use of funds from sources such as foundations and charitable organizations. Member Masci and Chair Titterness volunteered to work with Ms. Baldwin to review alternatives prior to the July meeting. ACTIVITY UPDATE/OTHER ANNOUNCEMENTS - None HEALTH BOARD MINUTES - June 17, 2004 Page: 5 AGENDA PLANNING/ADJOURN The meeting was adjourned at4:10 p.m. The next meeting will be on July 15,2004 at 2:30p.m. in the Conference Room of the Jefferson County Health Department with an agenda including the public hearing, programmatic update and priority setting, fee setting, ordinance, as well as a brief presentation on breast-feeding work in the community and coordination with Jefferson General Hospital. JEFFERSON COUNTY BOARD OF HEALTH ~~ 9.f{~ 1 {t..f:ea:i-.. d1~'ee (Absent) Sheila Westerman, Member Roberta Frissell, Vice Chairman g~ --- ./ Geo~y Masci, Member ~-- 1 Gien Hunting or (Absent) Patrick M. Rodgers, Member , " s: " '" 0;' ~ Q ;j 3' ~f "'" 5' .. "'" .. " Q, ~ ~ " '" ~f 3 ~ ---I )>l " " " ::'. ~ ~ ~ " OJ q 3 .. :>- " ;;; .. " ." ~ "- "- s. ::'. " !!!. !1. 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