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HomeMy WebLinkAbout091505 JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, September 15,2005 Board Members: Geoffrey Masci. Chairman - Port Townsend City Council David S ulJivan, Vice Chairman - County Commissioner District #2 Phil Johnson- County Commissioner Dir/net #1 Patrick M. Rodgcr.r - County Commissioner District #3 ]ill Buh/er- Hospital Commissioner District #2 Sheila Westerman - Ciu'(!n at Large (City) &iberta Fri",l!- Citl,?!" at La",e (County) rt'fffMembers: Jean Baldwin, Health & Human Services Director julia Danslein, Nursing Semas Director Thomas Locke. MD. Heatth Officer Mike McNickle, Envirrmmental Health Director Vice Chairman Sullivan called the meeting to order at 2:37 p.m. in the Health Department Conference Room. All Board and Staff members were present with the exception of Chairman Masci and Member Buhler. Visitors in attendance included Dana Fickeisen, Mark Sperrazza and Laurie Strong. There was a quorum. APPROVAL OF AGENDA Jean Baldwin requested one addition to the agenda under New Business to give an informational report on school services. Member Westerman moved to approve the Agenda as amended. Member Johnson seconded the motion, which carried by a unanimous vote. APPROVAL OF MINUTES Vice Chairman Sullivan moved to approve the Minutes from July 21, 2005, as written. Member Westerman seconded the motion, which carried by a unanimous vote. PUBLIC COMMENT Laurie Strong, Jefferson Mental Health Executive Director, drew attention to the upcoming Jefferson County Board of Commissioners public hearing, October 3, 2005 regarding the creation of a tax for mental health and chemical dependency services. She explained that the expanded services that this funding would provide could offer a unique opportunity for the County to bring those services to people with the kind of disorders that are very expensive to the system. She asked the Board of Health to support the implementation of the proposed one-tenth of I percent sales and excise tax. Ms. Strong answered questions and Member Westerman suggested that this item be added to the agenda so that the Board might discuss it more in-depth in advance of the public hearing. It was noted that the hearing is only about instituting the tax, decisions on how monies would be spent from year to year would be an ongoing budget decision and the BOH would have input on those decisions. Jean Baldwin noted that staff recommendations had previously been requested by the BOH and she had them available upon request. She also noted that the Law and Justice group and the Substance Abuse Committee were asked to give opinions and to weigh-in, and will most likely be at the formal hearing. The Board agreed to return to this topic and added this as item #6 under New Business. HEALTH BOARD MINUTES - September 15,2005 Page: 2 OLD BUSINESS AND INFORMATIONAL ITEMS West Nile Virus Detection in E. Washinl!ton: Dr. Tom Locke gave an update on the status of WNV in the state. He noted that the virus now has been officially detected in Washington in mosquito samples. Given the fact that we're not seeing birds or animal cases yet at this time of year, it is very unlikely that Washington is going to have any significant human activity this year. The virus has made it to the State and ifthe right combinations of weather and bird migration occur, we may start to see human cases next year. Health Department Director, Jean Baldwin noted that JCPH plans to issue press releases about the mosquito sampling that has been going on within the county. The purpose of this sampling is to determine species. Certain types of mosquitos are much more likely to carry West Nile than others. Correspondence - Jefferson Health Care: Jean Baldwin reviewed a letter sent (over the signatures of Dr. Locke and herself) to Vic Dirksen of Jefferson Healthcare. The letter formally requested that Jefferson Healthcare contribute $25,000 for calendar year 2006 to maintain and expand community health assessment capacity in Jefferson County. Dr. Locke noted that, after receipt of the letter, the hospital has set up a meeting in October for follow-up. Jean would also like to send a similar letter to the City of Port Townsend and asked for direction as to whether it should be sent from herself, Dr. Locke or the BOH. She explained that the City doesn't provide dedicated funding for public health services provided to City residents nor does the hospital have a funding mechanism to support public health services that benefit Jefferson Healthcare clients.. There was discussion about what the County contributes by way of providing infrastructure. Member Westerman suggested that a more positive response might come from the City ifthe letter ofrequest gives details demonstrating that the County is offering an equal commitment of resources. It should also note the hospital's commitment. Jean will draft a letter reflecting those suggestions. Correspondence - Department of Health & Human Services: Jean Baldwin reviewed a letter that was sent (over the signature of David Sullivan) to DSHS and their response in regard to an appeal for prevention funding for the Nurse Family Partnership. This turned out to be unsuccessful in securing ongoing funding. Rel!ion 2 PHEPR Newsletter: Dr. Locke noted that the newsletter is coming out quarterly and goes to all health care providers in the 3 county region. He pointed out that they are now publishing selected notifiable condition reports covering a 3 month period. Member Westerman suggested that it would be helpful to show the differing county populations on the chart. Dr. Locke said that they will add something that reflects the relative size of the counties. The newsletter will be included in BOH packets every 3 months. He noted that there is also a quarterly regional meeting where they come up with themes for the next newsletter. The next issue will reinforce respiratory etiquette issues because we will be heading into flu season and also push for flu vaccination, especially among health care workers. It appears that there will be an adequate supply of influenza vaccine available. American Public Health Association - In Defense of Science: Dr. Locke explained the American Public Health Association's Resolution 2004-11, adopted November, 2004 "In Defense of Science". He commented on the organization's concems that science as a basis of policy-making is increasingly being challenged. This is an issue for those that believe that public health policy should be evidence based. HEALTH BOARD MINUTES - September 15, 2005 Page: 3 "Bracinl! for the Inevitable" Global Pandemic Flu Planninl!: Jean Baldwin and Dr. Locke reviewed and commented on an article from the Washington Post discussing the grave possibility of pandemic flu. In terms of likely communicable disease outbreaks of global significance, this is now #1. As it spreads from country to country, this strain of "bird flu" in Asia is becoming more and more dangerous. Dr. Locke noted that if it becomes less lethal and more contagious it will pose a serious global threat. In contrast, a virus that has a high fatality rate is not very successful at spreading broadly. Regional, state, national and intemational public health agencies are very serious about preparing for this. He noted that the challenge would be to have sufficient personnel capacity to deal with something of this scale. It is also possible that this particular virus may never mutate and trigger a global pandemic. NEW BUSINESS Draft Jefferson County Solid Waste Ordinance and Enforcement Procedures: Mike McNickle, Environmental Health Director, gave a detailed presentation on JCPH SolidIHazardous Waste Regulations. His presentation covered the history of county solid waste regulations; main goals of the proposed regulations; specific changes from existing regulations; enforcement procedures; and the specifics of "notice of civil infraction" (ticketing). His Power Point presentation also included photos showing examples of solid waste problems in Jefferson County. Mike requested that the Board move forward in the adoption process of the solid waste regulations and give permission to move forward with adopting the enforcement procedures as policy. The Board asked questions and discussed specific issues. Recommendations were made for needed changes to the printed regulations. They discussed the process to move ahead, which is: 1) to call for a public hearing, 2) publish the regulations for public distribution (generally a minimum of 2 weeks, and sometimes longer), 3) make it available on our web site and make copies available upon request, 4) receive feedback from the public by conducting one or more public informational meetings, and 5) present feedback to the BOH at the hearing which will occur at their next regularly scheduled meeting on October 20th. The public will have the opportunity to testify at the meeting. Mike recommended that Environment Health host two open houses (North County and South County) as an education piece, in advance of the public hearing. This would provide opportunities for one-on-one interaction to address any public concems. The Board agreed to hold the hearing at the BoCC chambers. Member Frissell moved to have a public hearing at the October 20, 2005 Board of Health meeting in the Commissioners Chambers. Member Johnson seconded the motion, which carried by a unanimous vote. Public Health Service Fee Settinl! Authoritv: Dr. Locke explained this issue ofBOH authority as relates to adopting fees. He noted that County Commissioners have a general fee setting authority, depending on how broadly you construe their licensing authority under RCW 36.32. For public health services, Boards of Health have a very specific statutory authority to set fees. This authority is very broad and is delegated by the legislature in order to provide the local board of health with the funding necessary to carry out their responsibilities. As a practical matter, the majority of fees are for environmental health services. There are some non-environmental health services (like adult immunizations) that are also within Board of Health fee setting authority. Staff is not proposing a specific set of fees today. This issue before the Board today is whether to take on the task of setting fees. Dr. Locke strongly recommended that the Board take on this responsibility. HEALTH BOARD MINUTES - September 15, 2005 Page: 4 The Board would need to adopt a new fee schedule before we would want to approach the BOCC and seek a repeal ofthe existing one. Jean Baldwin explained that in the past there was a whole different cycle of how our fees were set as a department, and that it was done differently than other departments. She further explained that fees are reviewed every 2 years based on a comparison to other counties and a cost analysis of each service. She noted that updates are needed in the EH fees and some Community Health fees. The process is scheduled to begin in the Fall and, in the past, the BOH has been invited to participate in the workgroup. She expressed her hope that some of the Board would want to participate as we start the process. Member Westerman stated that she welcomed this responsibility and felt it appropriate. Her preference would be that staff brought the Board specific information and recommendations in preparation to voting. Member Frissell volunteered to help in any way that staff would see fit. Jean agreed to bring back recommendations to the Board at the October 20th meeting for discussion. A public hearing could be scheduled in November. Ideally, food service fees need to be adopted to go into effect January 1, 2006 because payments are due at the first of the month. The billing goes out at the end of December.) Draft Food Service Inspection FreQuencv Policv: Dana Fickeisen presented a revised draft policy statement for the Food Safety program. She introduced Mark Sperrazza from Port Townsend School District who sits on her advisory committee. She informed the Board that the food code that was adopted and implemented in May allows for local health jurisdictions to decide on the frequency of inspections with a risk based plan. She explained routine inspection frequency, re- inspections and pre-opening inspections. She noted that the main goal is to make sure we're doing inspections frequently enough and that we comply with the W A State code. The goal of the policy is to standardize inspection frequency throughout the county. Joint Meetinl! - Jefferson. Kisap. Mason County BOH - November 8. 2005 - Re: On-site Sewal!e Svstems and Hood Canal Water Ouality: Jean Baldwin noted that Mason County could not come to the other tentative date that had been set so it has been rescheduled to 11/8/05. This joint meeting will focus on the on-site sewage systems and Hood Canal water quality. There will be some discussion about current projects, and an update on the work the University of Washington and others are doing in monitoring water quality. The agenda is still being worked on for this discussion. All 3 counties are involved with Hood Canal water quality and the Boards of Health are specifically charged with developing plans for marine water quality protection.. The meeting will be held from 11:00 am -1:00 pm at Kitsap Health District in the Norm Dicks building in downtown Bremerton. It will be facilitated by Hood Canal Coordinating Council's Dave Christiansen. A van pool will be arranged. Clallam County BOH members have also been invited to attend. Call Mike or Jean with any specific items you would like to have on the agenda. Jefferson County Board of Commissioners Public Hearinl! October 3. 2005: Discussion resumed from earlier in the meeting about the full BOH officially supporting the BoCC in regard to implementation of the proposed tax increase for mental health funding. The question was raised to the three County Commissioners present by Member Westerman as to whether it would be helpful to have a letter of support or gesture from the BOH. Some individual views were expressed about the need for the tax. Member Westerman stated that support from the full Board would be a stronger statement than individual support. Member Frissell expressed disappointment that this source of funding would not be coming through the BOH. Member Rodgers noted that since the Substance Abuse Board is now under the purview of the HEALTH BOARD MINUTES - September 15, 2005 Page: 5 BOH, in that sense there are funds coming for that piece, and it addresses public health problems because the Commissioners recognize mental health as a public health problem, not as a separate problem. Vice-Chair Sullivan believes that it would lessen competition for money at the local and state level. Dr. Locke noted that although it is certainly appropriate for the Board to take positions on issues of this type, the critical health issue conceming this new legislation is how the money would be spent. He encouraged the Board to look at its role in deciding what would be done with the funding. Jean Baldwin expressed concems and made comments about assessment issues. Commissioners Sullivan and Rodgers both expressed some awkwardness at a full Board vote of support since they serve in dual roles as BOH members and BOCC members. Dr. Locke suggested the most effective approach would be to testify individually as a BOH member before the BOCC in support of this. The date ofthe hearing is Monday, October 3, 2005 at 9:00 am. Katie Carlson School Services Report: Jean Baldwin pointed out the project Take Time evaluation summary and invited anyone who would like the in-depth report to contact her. She noted that the summary looks at services being provided in the schools under this outside contract. She has concerns about this project (as well as Big Brothers I Big Sisters) because the money is being held "very dear". If this topic is something of interest to the Board she will arrange a short overview from Katie Carlson. It's a program that is doing a fair amount of prevention in the community. Interest was expressed in having a further presentation at a later time. AGENDA PLANNING/ADJOURN Member Frissell recently returned from a cruise where there was a staff environmental officer on the ship that was responsible for monitoring their systems, and also, the cruise line showed a DVD about their systems and how they protect the environment. She offered to obtain the 20 minute DVD for the Board to view if they were interested. She also has information on new regulations on dumping. Some interest was expressed. The meeting was adjourned at 4:20 p.m. The next meeting will be on October 20, 2005 to be held at the Jefferson County Courthouse Commissioner chambers. JEFFERSON COUNTY BOARD OF HEALTH ~~LLW~~~ ~" E' st rman, Member " '4 ;" '.~.' " . ..- -.."........ .....-..~-- P il Jo son, Member C07l:~i!J:iltice Chairman Patrick M. Rodgers, b~ /1 . 1. /1/7 .,fr'f !'ckft,r;J/td<<flt.. Roberta Frissell, Member Excused GeoffMasci, Chairman V:!,~m~ JEFFERSON COUNTY BOARD OF HEALTH July 29, 2005 Secretary Robin Arn.old-Williams Department of Social and Health Services P.O. Box 45010 Olympia, WA 98368 Re: Nurse Family Partnership (NFP) Dear Secretary Arn.old-Williams, This letter is an appeal for prevention funding. As County Commissioners have regularly faced budget crises and battles between mandated and essential services, we recognize that DSHS is also in crisis and the solution could be within reach if early intervention and prevention programs were in place. Jefferson County Board of Health six years ago directed Jefferson County Public Health to begin the Best Practice of Nurse Family Partnership (NFP) with Public Health nurses and local fami1ies. Dennis Braddock provided needed funding for the first six months of the year to continue this program in 2005. In 2006 the local Public Health department continues to be squeezed by all DSHS contracts providing family support programs. As prevention and early intervention services continue to decrease with long-term consequences to the local community, this will increase demand for DSHS services (DASA, MH & MAA). Nurse Family Partnership is based on work by Dr. David aIds. It is rated in the July 6,2004 Washington State Institute for Public Policy as a sound investment of public prevention money. NFP provides home visits by registered nurses to first-time mothers, beginning in early pregnancy and continuing until the child's 2nd birthday. National research highlights the following outcomes related to the NFP model. Low- income, first time mothers and their children who receive NFP had: 79% fewer verified reports of child abuse or neglect 31 % fewer subsequent births 30 months less receipt of Aid to Fami1ies with Dependent Children (TANF in Washington State) 44% fewer matemal behavioral problems due to alcohol and drug abuse 69% fewer matemal arrests 60% fewer instances of running away on the part of 15-year-old children 56% fewer arrests on the part of 15-year-old children 56% fewer days of alcohol consumption on the part of 15-year-old children 615 Sheridan. Castle Hill Center. Port Townsend. W A (360) 385-9400 NFP has a positive impact on children and their families. These aforementioned outcomes offer strength and hope to local families. As of 2004 local CPS referrals for young children have decreased up to 50% since NFP services were started in the co=unity in 1999. Additionally, none of the families served through NFP have been referred to CPS or seen in the ER. By decreasing MSS rates and not providing any other funding stream, Best Practices will disappear from the co=unities who have tried to focus on the issues. We ask you to join in the funding of NFP to maintain services at a level that addresses the needs of our population. We need an additional $50,000 a year in our 2006 revenue to maintain trained Public Health Nurse staffing to provide Nurse Family Partnership services to at-risk population in this rural co=unity. This staff sees 25 families a year from six months prenatal to the child's 2nd birthday. This investment would in turn save thousands of dollars in welfare utilization, law and justice, child abuse and neglect, hospitalization/ER, mental health and alcohol/drug treatment costs. First time mothers in the midst of pregnancy are in a teachable moment in their life stage of development. NFP serves as a catalyst for positive change in generational problems. Thank you for your consideration of our request. Please contact us at your earliest convenience to further disCuss this important issue. 7~a-, David Sullivan Vice Chairman, Jefferson County Board of Health Jefferson County Commissioner District #2 Jefferson County Board of Health 615 Sheridan. Castle Hill Center. Port Townsend . W A STA TE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES P.O. Box 45010, Olympia, Washington 98504-5010 August 10, 2005 15) ff: fL") i:;, n \\/7 [E: r "~'l In;,! /1:;,1 J11,I..,[1 \\.',1 I', ".f I)' U- -,,, --, , .'/ U ~ . "" l . .-:::J AUG 1 .2 2005 David Sullivan, Vice Chairman Jefferson County Board of Health Jefferson County Commissioner District #2 615 Sheridan, Castle Hill Center Port Townsend, Washington 98368 JEFFEHSON COUN I 'i BOARD OF COMMISSIONERS Dear Mr. Sullivan: I have received your letter dated July 29, 2005 requesting additional funding for the Nurse Family Partnership (NFP) that has been operating in your county for several years. I applaud your efforts to provide the NFP for Jefferson County. When the Nurse Family Partnership was introduced into Washington State several years ago, the Medical Assistance Administration allowed the NFP agency providers to use First Steps reimbursements for the provision of NFP services. First Steps' scope of service is not as large as NFP's. Therefore, the total cost of the program cannot be reimbursed through First Steps. The Jefferson County Health Department was reimbursed $94,411 for First Steps during the one year period, October 2003 through September 2004 (for all clients receiving First Steps services). This has helped pay for some of the NFP services. During these difficult budget times, we are all keenly aware of the many needs and shrinking dollars. DSHS will, of course, continue to support your program by reimbursing NFP for all First Step covered services. Unfortunately, DSHS does not at this time have any additional funds to give you for services beyond those covered within First Steps. I share your concern about the negative impact of scarce resources on prevention efforts across all program areas and bope that additional resources may be available in the future. Thank you for your continuing support of the families of Washington State. Sincerely, Robin Arnold-Williams Secretary -~ cc: Blake Chard