Loading...
HomeMy WebLinkAbout031606 JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, March 16,2006 Board Members: David Sullivan, Chairman - County Commissioner District #2 Pat,,'ck M. Rodgm, Vice Chairman ~ County Commissioner District #3 PM Johnson- County Commissioner District #1 Jill Buhler- Hospital CommiSJ'ioner DiJtrict #2 GeoJ! MaJ,i ~ Port Townsend City Council Sheila Westerman - Citizen at Large (City) Roberta Ftimll- Citizen at Large (County) StafMembers: Jean Baldwin, Pubh'c Health Seroices Director Julia Danskin} j\Tursing Services Direttor Thomas Locke, MD, Health Officer Alike McNickle, Environmental Health & Natural Resources Director Meeting was called to order at 2:30 pm on March 16, 2006 by Chair Sullivan, in the conference room of Jefferson County Public Health. All Board members were present with the exception of Commissioner Johnson. All Staff members were present with the exception of Julia Danskin. There was a quorum. APPROVAL OF AGENDA Commissioner Rodgers moved to approve the Agenda with one change. New Business was changed to reflect Tobacco-Next Steps being presented before the scheduled Methamphetamine Abuse agenda item. Member Buhler seconded the motion, which carried by a unanimous vote. APPROVAL OF MINUTES Member Masci moved to approve the Minutes as written. Commissioner Rodgers seconded the motion, which carried by a unanimous vote. PUBLIC COMMENTS Chair Sullivan called on the public for comments. Beth Wilmart, Jefferson County Community Network Program Manager, introduced Holly Carlson, the Community Network Board, Chair. Holley Carlson read and submitted a letter to the BOCC written by the Community Network Board. The letter was written requesting JCPH to release the 2004 Healthy Youth Survey data, as well as the Community Readiness Survey conducted by JCPH in the summer of2005. John Chiles, from the Jefferson County Substance Abuse Advisory Board, requested the release of data from the 2004 Healthy Youth Survey and the 2005 Community Readiness Survey in order to prepare for community presentations. Chair Sullivan stated that the time it takes to analyze and release community health reports is a funding issue. Jean commented that past studies have been funded by a City, Hospital District, and County partnership. An effort is being made to renew this funding partnership. Jean stated that Kellie was in the final stage of analysis of Healthy Youth data comparison of Jefferson County and the state using other program dollars. OLD BUSINESS Solid Waste/Junk Cars Public Meetine Report Mike McNickle reported on the public meeting held February 23rd. He stated that approximately 70 people were present. A 20-minute presentation was given at the meeting followed by questions. There were many questions and comments from interested parties and Mike felt there was productive dialogue. There is going to be ongoing work to clarify language in the solid waste ordinance and implementing policies. Application has been made to Department of Ecology for $30,000 towards moving junk cars out of the county. This should move 800 cars. Negotiations with community tow truck drivers have begun. Projected sites are in Quilcene and Brinnon. EH continues to work to help those on a limited income who want to remove a car but can't tow it from their house to the site. An event is tentatively scheduled for the end of summer at the county gravel pit. Member Westerman questioned whether substantive changes in the ordinance need to take place and expressed concern as to whether or not the $30,000 would cover the entire junk car cleanup effort. She expressed the desire not to have the event be too heavily subsidized to aid people who are violating ordinances. Immunization Proeram Site Visit Report Jean pointed out that these reports are not generally made a part of the Board of Health packet but wanted to share this information because the report provided a through review of the program and highlighted the excellent work being done by program staff. Member Westerman complimented the staff on ajob well done. Reeion 2 Public Health Newsletter - Winter 2006 Dr. Locke shared the Quarterly Newletter that is put out by our three county emergency preparedness region. The target group for this newsletter is healthcare providers. He pointed out that changes in the Communicable Disease Surveillance data were prompted by a request from the Jefferson County Board of Health to facilitate comparisons between counties. Swamp Nurse Jean Baldwin talked about the Nurse Family Partnership aka the Timber Nurse program. She pointed out that the article came from the New Yorker Magazine that addressed the personal side, not the science side of the program. Jean reported that one of JCPH's Timber Nurse staff was at University of Washington making a film on ways to do 'depression screening' for other nurses through UW and for the Maternal Child Health program for the state. 2005 Community Health Performance Measures Jean Baldwin reviewed the four components of Community Health Performance Measures. The report for each program includes the mission, goals and objectives for 2005 and performance indicators for which the county gives JCPH the funds to provide these services. She pointed out that these numbers are used for preparation of the budget. Member Masci asked for clarification on what percentage of the population was being reached by these programs and if there is a way to publicize this information. He suggested a press release, so the public would have a better understanding of the amount of money JCPH has to work with to perform these services. Commissioner Rodgers reminded us that there is a story in each one of those numbers. Kellie Ragan clarified the Family Planning report stating the comparison showed that about two-thirds of the I5-24-age population would have seen some sort of service. Jean Baldwin introduced Jefferson County Public Health's new Prevention Specialist, Kelly Matlock. Kelly will be working with the prevention team to work on strategic planning and community forums. NEW BUSINESS Tobacco - Next Steps Kellie Ragan reviewed the Tobacco Workplan Rationale. The data presented on the work plan is from state funds. The state does an oversampling of a minimum of 200 people per county to determine smoking prevalence rates. In November oflast year, voters amended the Clean Indoor Air Act. The Jefferson County Board of Health passed its Clean Indoor Air Ordinance in February. As a consequence, indoor smoking was addressed on this report. The next step will include supporting employers to promote cessation among their employees. With tobacco funds, JCPH sent Brenda Plouse, pharmacist from Jefferson Healthcare, to a tobacco specialist training. Brenda Plouse summarized the training of national researchers and explained changes in the prescription of nicotine replacement therapy. She touched briefly on nicotine gum, the inhaler, the patch, nasal spray and Zyban as therapy replacement. Brenda stated that providers are generally under-dosing their patients with nicotine replacement and usually use only one form of therapy. Research has found that you can use several different replacement therapies together, even with some smoking, because you don't really reach the level of nicotine that a 1 pack-a-day smoker is getting. The plan focuses on counseling combined with nicotine replacement therapy and providing enough nicotine therapy so patients don't have to go through cravings. Brenda said the next step to come after I-901 is helping employers help their employees. This information was presented to clinical staff at the hospital. Brenda drafted an order sheet for nicotine replacement therapy to be used by the doctors as a checklist, which gives them choices of therapies and dosages that they can check off and give to the patient. Brenda talked about starting a support group in Port Townsend and will be talking to the press. Dr. Rotchford remarked that some studies show that some people who have not quit smoking will live longer if you give them the nicotine replacement and are less likely to have a stroke or heart attack. Commissioner Rodgers remarked that Hadlock Building Supply gave monetary incentives to employee who quit smoking, knowing it was good business. Methamphetamine Abuse - A Public Health Approach Dr. Rotchford, who is the liaison appointed by the Substance Abuse Advisory Board to the Board of Health, gave a power point presentation and spoke on the county wide epidemic of methamphetamine and effect that meth has on the brain. Methamphetamine use causes brain cell death. It affects judgment. Dr. Rotchford explained that every medication is different and needs a unique approach. Methamphetamine is a chemical dependency disease and a nervous system disease. Dr. Rotchford explained the difference in terms between using and abusing meth. Dr. Rotchford discussed depression associated with meth use and the persistence of depression weeks or months after stopping the drug. When asked by Member Buhler whether depression was a result of drug use or the reason why they took the drug, Dr. Rotchford explained that drugs like methamphetamine can have initial anti-depressant effects but the cumulative toxic effect eventually becomes a cause of further depression. Dr. Rotchford stated, "It is a disease that needs treatment and chronic relapse prevention." Treatment can improve health, reduce recidivism and reduce criminal activity by abusers. He stated that this is a public health crisis and asked that the Board of Health intervene, treating it as an epidemic and using well established epidemic control measures. He recommended that the tools of epidemiology be used to combat the meth epidemic and that is was not a problem that could be effectively dealt with only by law enforcement and treatment providers. Member Westerman expressed concern over the statement relating to the meth epidemic could be like a flu epidemic stating that with methamphetamine abuse we have people out in the community that are choosing a behavior. Strategies like isolation we use for a communicable disease epidemic would not be useful in responding to a drug abuse epidemic. She asked how will we fund it and would we give up some other important priority. Member Westerman feels there needs to be more clarification about the public health role before the Board of Health can act. Jean Baldwin addressed concerns by saying, that we are uniquely positioned to deal with this disease using community based approaches. Increased screening in doctor's offices and clinics and talking about the health effects of drug use is occurring. There are many norms that are being set by behavior around meth, so as community norms change, individual behaviors change. Community mobilization and prevention programs have a chance to change community norms around meth use. Chairman Sullivan brought up Senator Hargrove's bill, 6239, that passed, which will give $100,000 a year for years 2008, 2009 and 2010 to counties for methamphetamine treatment. Funding will be given to the counties that have passed the Mental and Substance Abuse Disorders sales tax, which Jefferson County has done. We start collecting that tax on April 1 st and part of that money will go to treatment. Dr. Locke asked the board to look at three essential questions. One - Is this really in your mission and within your responsibilities? The authority of a local board of health in the state of Washington is very broad and virtually all diseases are covered. A more specific question would be, is this one ofthe diseases you would want to tackle? We have been battling drug epidemics for a long time and the methamphetamine epidemic is particularly hazardous. Two - Does Public Health have a distinctive capability that we can bring to this task? The most powerful tool we have is the science of epidemiology, which is the study of human disease and how it affects population. Three - What options are available? New resources and initiatives are going to be started up and need to be focused on the area with the greatest impact. Epidemiology is one of the tools you can use to target those efforts. This would be one way to look at treatment outcomes; the dollars saved on criminal justice systems, and other community impacts. Member Masci spoke about the need for more tools and resources and believes that this issue should be continually brought before Jefferson BOCC and Port Townsend City Council to request funding. The constant struggle as a board is trying to find every possible funding source just to be able to afford to provide the services that are already in place. Joint Board Assessment Project Proposal Dr. Locke reported that he and Vic Dirksen spoke on this issue this week. Jean Baldwin and Dr. Locke drew up a draft project proposal to present to Jefferson Healthcare Board of Commissioners suggesting project activities, a timeline and the funding necessary to get this project started. At a minimum the two Boards would look at and analyze the new community health data and use it for joint and individual organizational decision-making. Member Masci reminded the board of the timeliness of pitching this project to the City Council because the City has already accelerated its budget process. The project needs to be presented to the City council between March and June, as the City will start to work on their budget in July/August. Member Masci asked for a show of support for consensus on the format of the project proposal as it was written so it can be presented to Jefferson Healthcare Commissioners. There was a majority in agreement. It will be presented as an agenda item to the hospital commiSSIOners. Leeislative Session Summarv Dr. Locke reported that new funding for Pandemic Influenza planning will be available for local health departments. Over two million dollars was appropriated for the 35 local health jurisdictions. There is also a small amount of federal funding for this effort that must be spent in the next several months. Discussions were held at a Regional Public Health Emergency meeting about the most effective way to spend one-time only dollars by combining education efforts for the region. Substance Abuse Advisorv Board Reappointments Member Masci made a motion to reappoint Laurie Strong to the Substance Abuse Advisory Board. Member Buhler seconded the motion, which was carried by unanimous vote. She will be appointed to a three-year term. Activity Update / Aeenda Plan nine Member Westerman requested that the changes to bylaws be discussed at the board meeting in April. She would like to see every member on the board having equal voting authority. Jean would like to include discussion about the Strategic Planning Process as an FYI. Kellie Ragan will have the Healthy Youth Data ready to be released to the Board of Health and the schools. Chair Sullivan adjourned the meeting at 4:34 p.m. Next Board of Health meeting is April 20, 2006. JEFF.lJ.E, SON. COUNTY BOARD OF HEALTH ,~ // /14- av~~~ fl. 1'1/.~ J, ".--i#~ ill Buhler, Member ~~W~tJ~ eila Westerman, Member tnc . 0 gers, Vice Chalr .~~ Robe~rissell, Member Excused Phil Johnson, Member sci, Member JEffERSON HENTAL HEALTH SERf/eES CommUffity Supported Outpatient Care for East Jefferson County Children, Adolescents, Adufts and Older Adults-24 Hour CriSis March 6, 2006 Jefferson County Board of Health 615 Sheridan Port Townsend, WA 98368 Dear Board, Thank you for reminding me that my three year term on the Substance Abuse Advisory Board ended on January 28, 2006.....how time flies! I would like to extend this appointment. At this time the 5MB is developing an exciting community education program-for which I am literally in the midst of applying for funding-that I would like to see through to conclusion. I have really enjoyed my work with the Board. Thank you for your kind consideration. Si~elY, . ~~ Laurie Strong Board of Directors President Z. Jack Randall Vice President Quentin Goodrich ~ w.e. Henry ~ Doris Hardyman Rex Whipple Mike Beers Sandra Stewart Dee Dee Spann Cheryl Bozarth Executive Director Laurie Strong, MSW, LCSW PO Box 565 f 884 W. Park Port Townsend. WA 98368 Phone: 360.385.0321 Fax: 380-379-5534 800-659..Q321 Email: general@jrnhs.info wwwJmhs.info