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HomeMy WebLinkAbout021705 JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, February 17, 2005 Board Members: Phil Johnson - County Commissioner District #1 David Sullivan, Vice Chairman - County Commissioner District #2 Patrick M. Rodgers - County Commissioner District #3 Geoffrey Masci, Chairman - Port Townsend City Council Jill Buhler - Hospital Commissioner District #2 Sheila Westerman - Citizen at Large (City) Roberta Frissell- Citizen at Large (County) Staff Members: Jean Baldwin, Health & Human Services Director Julia Danskin, Nursing Services Director Thomas Locke, MD, Health Officer Chairman Masci called the meeting to order at 2:35 p.m. in the Health Department Conference Room. All Board and Staff members were present with the exception of Conrmissioner Rodgers, Member Buhler, and Member Westerman. There was a quorum. APPROVAL OF AGENDA Commissioner Johnson moved to approve the Agenda as written. Vice Chairman Sullivan seconded the motion, which carried by a unanimous vote. APPROVAL OF MINUTES Member Frissell moved to approve the minutes of January 20,2005, as written. Vice Chairman Sullivan seconded the motion, which carried by a unanimous vote. PUBLIC COMMENT - None OLD BUSINESS AND INFORMATIONAL ITEMS Influenza Update Vaccine Redistribution. Influenza Activity. Policv Implications: Dr. Tom Locke announced that Influenza A activity is now widespread in Washington State, with school absenteeism near 30% on the peninsula. The CDC has also put out a new health alert on the Avian flu, which is widespread in Asian poultry and periodically jumps to humans, with a fatality rate as high as 80%. An anti-influenza drug does have effect on this virus when administered early. Asia is working on an experimental vaccine. The pandemic scenario would involve the coupling of this virus with the human version and acquires human-to-human transmission. Respiratory surficial virus is also circulating and can also cause pneumonia. There is not a lot of benefit to doing specific diagnosis except in response to outbreaks in institutions, such as in a nursing home. Noting that HEALTH BOARD MINUTES - February 17,2005 Page: 2 drugs taken after the onset only reduce the duration by about a day, it is only cost-effective to administer the drug before contact. Washimrton State Board of Health 2004 Annnal Renort: A copy ofthe report was distributed. Dr. Locke explained the report's purpose was to review work done on the four to six main priorities the State Board had set for itself. In May, the State would be visiting to review with Staff its measurement against Public Health Performance Standards and at next month's Board retreat, Staff would plan to present the updated Standards for Public Health in Washington State. The Board received advance copies of the updated booklet. Governor Grel!oire Reannoints Secretarv of Health: Dr. Locke noted the packet included an announcement of Gregoire's reappointment of Mary Selecky. There was interest in having her visit Jefferson County again. NEW BUSINESS Isolation and Qnarantine Conference Follow-up - Role of Local Board of Health: Dr. Locke discussed an article that found that past isolation and quarantine exercises have not been effectively contained. Because isolation and quarantine can only work if99% of the diseased population is contained, he stressed the importance of the Board of Health's role in public communication. He showed a book, Crisis and Emergency Risk Communication by Leaders for Leaders, and suggested the Board discuss it at a future meeting. Jean Baldwin noted that in-house risk communication training is a requirement of all Staff. Dr. Locke said Staff would request copies for each member of the Board. Ms. Baldwin noted the whole issue of incident management involves a good deal of cross-county communication. Vice Chairman Sullivan thought the exercise was helpful. Jean Baldwin offered to share job description packets for everyone she is preparing for the three-day training March 29-31. It would also help to look at the County and Health Department emergency plans. Chairman Masci, in describing the critical communication challenges presented by emergency situations such as 911, said a higher, military-like degree of discipline and organization is needed. Jean Baldwin agreed that we are facing great tests and said the exercises are designed to give staff the confidence that comes from knowing their role within the entire response picture, adding that every agency in the chain must do this. When asked by Chairman Masci if funding is the reason the tabletop exercises could not be expanded to accomplish this with all agencies simultaneously, Jean Baldwin agreed that the County is limited by its bioterrorism planning budget of $25K. 2005 Lel!islative Session Kev Public Health Issues: Dr. Locke noted the packet contained a number of pertinent documents. HB 1415 is a cruise-ship bill that seeks to expand the State's jurisdiction over inland waterways but concluded that to fully realize the bill's intent, the federal government would have to transfer those rights as they did with the corresponding Alaskan waterways. HB 1516 is a health-care access bill, focusing on the "Kids Get Care" program to prioritize children in service delivery. The goal ofSB 5597 is to make fresh, farmers' market produce more accessible to those with WIC vouchers or Food Stamps. A tracking sheet shows that HEALTH BOARD MINUTES - February 17,2005 Page: 3 hundreds of bills in committee, have health-related implications. While most will soon perish, some elements may find life as part of some other legislation. He called attention to three bills that address public health funding - seeking a stable funding source in a State budget where there is estimated to be a $2.2 billion shortfall. SB 5700 - Establishes a $20M Statewide Emergency Communicable Disease Response Fund. Proposes to add .20 cents per $1,000 of assessed value to the (property) taxing authority of public health hospital districts and divides it three ways - hospitals get the same amount and the remainder is split for public health funding and funding for uncompensated care. Approximately $93 million is involved. Getting public health system up to the level where it should be would take an additional $400 million a year. This bill establishes a joint public health financing committee or study group of stakeholders to take this issue on and pick the best alternatives for further consideration. HB 1818 - HB 1737- Member Frissell moved that the Board of Health draft a letter to the 24th District legislative delegation supporting HB1818, SB5700, and HB1737, with a copy to other legislators. Vice Chairman Sullivan seconded the motion, which carried by a unanimous vote. Dr. Locke agreed to draft such a letter and suggested the effective use of e-mail to transmit the letter. Jean Baldwin reminded that the Department had committed to speak as one with Washington State Association of Counties on issues affecting the group. Chairman Masci asked about Bill 1458, which addresses on-site sewage in marine areas. He said Council members had been getting information about this bill from the Association of Washington Cities that might be different from the Board's. He also expressed concern that local testimony might be called on before Staff has been adequately briefed on the bill. Jean Baldwin noted that the Washington State Association of Local Public Health Officials is opposed to the bill as currently written because it increases regulation without addressing maintenance and education. Linda Atkins and Dave Christensen submitted comment in opposition when the bill was being drafted. Dr. Locke explained that the bill had been drawn up by the Puget Sound Action Council to force a solution - an operating permit mandate - on an issue they had been waiting for local health departments to solve for ten years. He added that board members could take a stand on pros and cons as citizens as long as it is in public session. Boards discuss principles and priorities, but then they give their Chairman the authority to testify. Discussion revealed that the City and County are in agreement in their lack of support for this bill. Dr. Locke predicted that the legislature would pass the mental health parity bill, which would provide the same coverage as medical and surgical. There was discussion about mental health bills by Jim Hargrove and Eileen Cody and a suggestion to supply a letter to support Hargrove. Vice Chairman Sullivan moved to send a letter in support HEALTH BOARD MINUTES - February 17, 2005 Page: 4 of Senator Hargrove's omnibus bill. Member Frissell seconded the motion, which carried by a unanimous vote. Vice Chairman Sullivan moved to send a letter of support on HB1154 and SB5450 mental health parity bill. Commissioner Johnson seconded the motion, which carried by unanimous vote. Chairman Masci asked the Commissioners to make the Board of Health aware of bills on which they plan to testify during this session. Jean Baldwin also agreed to send the Board drafts on bills. Jefferson County Food Code: Dr. Locke noted that Dana Fickeisen previously reviewed with the Board the changes to the State code that take effect May 2, which does not conflict with the County's practices. If it was decided to synchronize the two, Staff could present a draft code to the Board next month, with a soft deadline for passage in April. Dr. Locke said Staffs proposal is to streamline the local code by adopting the very comprehensive state code by reference - with the exception of the appeals process (i.e., suspensions/revocation of their license, closures of their restaurants, fees). The current County code provides for a one-stage appeal process, which is the Board of Health. He would suggest instead replicating the Methamphetamine Open Record/Closed Record approach, which would begin with an open record, administrative hearing, or conference, before the Health Officer (or Hearing Examiner in the case of a revocation). Chairman Masci expressed favor for the more manageable, single-stage, closed-record hearing. Dr. Locke noted that hearings are rare, because most issues are resolved in administrative conferences. It is unlikely the administrative or Board of Health appeal would be used in the reahn of food service licenses. There being no Board objection, he noted that next month the Board would consider a document with a lot of strike outs of most of the current language and adopting the state code by reference and focusing on the appeals process. Member Frissell asked about the possibility of invoking a public - A,B,C - grading systemlpostings in establishments as in Califomia. Dr. Locke did offer support for making publicly available PassIFail scores for restaurants, which Jean Baldwin noted is available on the Countywebsite. Washin~ton State Vaccine Prol!ram - Local Policv Issues: Jean Baldwin offered this information to help the Board understand the level of commitment to this contract, even though it had not come before the County Commissioners. Referring to a two-page document, she explained how the immunization program is run, how we store and handle the vaccine internally but also the monitoring of storage temperatures and logs in physicians offices throughout the county. Chairman Masci congratulated the Department on its efficient use of resources to carry out this complicated and costly federal mandate. Prevention Monev: Jean Baldwin reminded the Board of their discussion last month of substance abuse prevention. She offered the Board a written explanation of the family violence and substance abuse prevention-programs the Department administers. All are best practices, all three based on prevention, all use local dollars to match out-of county money, and each targets a different population (matemal child health, school-aged youth, and Big BrotherlBig Sister). Veronica Morris- Nakano's graphing and narrative of each of the programs and their funding contributions were discussed. HEALTH BOARD MINUTES - February 17, 2005 Page: 5 Chairman Masci noted that the 14.24% as shown on the Nurse Family Partnership graph is assumed to be disappearing. Jean Baldwin noted that a set percent of the liquor excise tax, 2% of the total City and County contribution, must go to substance abuse and was forwarded to Beacon of Hope Safe Harbor Treatment Facility. Staff noted that they would get this handout to Commissioner Rodgers, since he sits on the Substance Abuse Advisory Board. Veronica Morris-Nakano agreed to do a brief workshop on the same with Chairman Masci and City Council Member Frank Benskin, who would now be attending Substance Abuse Advisory Board meetings. Access! Ability! Toward a Livable Community: Jean Baldwin noted the packet contained an announcement of this March 23 event/presentation by nationally-known speaker Dan Burden. Chairman Masci has committed to attend, representing the Board. ACTIVITY UPDATE/OTHER ANNOUNCEMENTS Environmental Health Director: The position has been closed. Based on phone interviews, candidates would be invited to come and submit an example of their technical writing skills. Vice Chairman Sullivan, Chairman Masci, Dr. Locke and Jean Baldwin were identified as the interviewing team. There was some discussion of possible interview dates, roughly in the second week of March. Ms. Baldwin agreed to send them resumes and a copy of the questions asked. AGENDAPL~NG/ADJOURN Future al!enda topics: Food Code (March), two-year Family Planning report, Board Retreat (April 21 "- retreat in morning, meeting in the aftemoon). It was also agreed that a review of the future funding/partnership needs for Best Beginnings and Behavioral Risk Factor Surveillance Survey (BRFSS) should occur before June. The meeting was adjourned at 4:10 p.m. The next meeting will be on March 17,2005 at 2:30 p.m. in the Conference Room of the Jefferson County Health Department. (Excused Absence) Jill BuWer, Member (Excused Absence) Sheila Westerman, Member Ckf-kt.-4.<;t.uf!Z Roberta Frissell, Member (Excused Absence) Patrick M. Rodgers, Member