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HomeMy WebLinkAbout02 February County Health & Human Services HEALTH BOARD MINUTES February 28, 1995 BOARD MEMBERS: STAFF MEMBERS Robert Hinton, Chairman Richard Wojt, Member Glen Huntingford, Member David Specter, Health Department Director Jean Baldwin, Director of Nursing Services Larry Fay, Director of Environmental Health J. Peter Geerlofs, M,D" Health Officer Chester Prudhomme, Director of Substance Abuse CITY OF PORT TOWNSEND REPRESENTATIVE: Bob Sokol The meeting was called to order by Chairman Robert Hinton. The following Board and staff members were present: Commissioner Glen Huntingford, Commissioner Richard Wojt, Larry Fay, David Specter, Jean Baldwin, Chester Prudhomme, Peter Geerlofs, Gwen Howard and Judi Morris. Bob Sokol was not present. PRESENTATlON/1994 FOOD SERVICE OUTSTANDING ACHIEVEMENT AWARDS: Chairman Hinton introduced Environmental Health Specialist Gwen Howard who explained the reason for this assembly is to present the 1994 awards for outstanding achievement in food service sanitation. She stated that approximately a year ago a Food Service Advisory Committee was formed to review new policies, provide input to the food program and develop methods of positive reinforcement in food service. A newsletter is sent to all restaurants to educate individuals about food service. Those individuals are also encouraged to take the food manager's certification course offered in Bremerton. She added that the Bremerton Sun now publishes inspection scores of restaurants in Jefferson County. There are twenty-three restaurants receiving the outstanding achievement award because they have continued to meet or exceed the criteria established by the Food Service Advisory Committee. Health Officer Peter Geerlofs read aloud the names of each restaurant and the owner and presented them with a certificate, HEALTH DEPARTMENT 206/385-9400 ENVIRONMENTAL HEALTH 206/385-9444 DEVELOPMENTAL DISABILITIES 206/385-9400 ALCOHOl/DRUG ABUSE CENTER 206/385.0650 FAX 206/385-9401 HEALTH BOARD MEETING MINUTES - FEBRUARY 28,1995 Page 2 APPROVAL OF MINUTES: Commissioner Huntingford moved to approve the minutes of January 24, 1995 as presented. Commissioner Wojt seconded the motion which carried by a unanimous vote. PUBLIC COMMENT PERIOD: The food service manager of the Discovery View restaurant inquired about serving on the Food Service Advisory Committee. Environmental Health Director Larry Fay will send her the necessary information. RWJ (Robert Wood Johnson Foundation) PROJECT SITE TEAM INTERVIEW: David Specter reported that Jefferson County is one of 6 sites to be studied and interviewed by a project site team under a grant from the Robert Wood Johnson Foundation. The purpose of this study/interview is to help local health departments identify the factors and issues that need to be considered during the possible transition of clinical health services to other providers as the Health Department takes on new roles under health reform. At the State level many policies regarding health reform have changed but implementation of the Public Health Improvement Plan (PHIP) is moving forward. David Specter stated the project team is here to discuss public health care concerns and issues. The following members introduced themselves: Jack Thompson from the University of Washington Health Policy Analysis Program; John Nelson, formerly with the Center for Disease Control; Vicki Kirkpatrick from the Washington State Association of Local Public Health Officials; and Alice Porter also from the University of Washington Health Policy Analysis Program. Jack Thompson explained that when the State was first awarded funding for this particular project it was working on implementing the portions of the 1993 Health Services Act which is being substantially changed in the legislature and as a result the approach of the study is changing as well. Public health is undergoing a transformation that comes from the continuing development of the private sector and expansion of public benefit programs. With this kind of expansion through medicaid programs and others, local health departments are having to define what their role will be, Questions will be raised as to the extent Health Departments should remain involved in clinical services. The role of public health is to provide services that benefit the entire community. The RWJ team has been meeting with local health departments to get an understanding of the services currently provided and issues they're facing. They are also talking to a variety of other individuals in the communities to get another perspective on the issues. Their goal is not only to assist with information specific to each community but also to assist with information across the State to try to identify the common factors and provide information about the variables associated with those factors. The final stage is preparing a report for the RWJ Foundation. The foundation is very interested in looking at Washington State since it is ahead of most states in looking at health care reform. Mr. Thompson asked the Board what issues they feel the team should be considering during their study? Commissioner Wojt stated that he views public health as long term community based health care. For several years the local health department has filled the gap between the private physicians and the hospital. HEALTH BOARD MEETING MINUTES - FEBRUARY 28,1995 Page 3 City Councilman Julie McCulloch asked if gun violence is being included in this study? Mr. Thompson answered that communities are prioritizing gun violence as a public health issue, however data systems need to be in place to get good information, This study will not focus a great deal on that issue. Peter Geerlofs stated an important issue with health care is determining what portion of services should be provided at local, state and federal levels and how funding will be distributed for providing those services. It is very important that counties participate in this process. Vicki Kirkpatrick stated that there are legislative changes occurring that may possibly affect the distribution of funding for local public health services. In the past, funding received from the state and federal government was strictly designated for specific purposes. Therefore, there was not a need for policy making at the local level. If new legislation is passed funding will be provided through block grants giving local jurisdictions the authority to distribute the funding to programs they feel will meet the needs of the community. This will require a much more active role on the part of local jurisdictions who will have to identify and prioritize those needs. DIRECTOR'S REPORT FINANCIAL REPORT: David Specter reported that 9.1 % of the budget has been expended and 3.5% of budgeted revenues have been collected as of January 31, 1995. Revenue is down because various operating transfers and grant payments have not been received. Expenses are high as a result of preordering supplies and prepayment of rent. PROGRAMS/LEGISLATIVE UPDATE: David Specter stated that the Public Health Advisory Committee will be reconvened for the purpose of reviewing health issues and action plans to see how they compare to the State's Public Health Improvement Plan, The second of a series of four training sessions was recently held on the core public health functions. Jefferson County Health Department staff trained with Health Department staff from Clallam and Kitsap Counties in Everett. This group was linked via satellite with six other sites throughout the State. This particular session was for training on assessment functions. There has been a good response from staff. David Specter reported that Lynn Kessler has been appointed to the House of Representatives Health Care Committee. He views this as an excellent opportunity to build lines of communication and influence policy. David Specter and Vicki Kirkpatrick updated the Board on the motor vehicle excise tax funding for public health. Ms, Kirkpatrick stated that the Washington State Association of Counties (WSAC) and the Association of Washington Cities (A WC) are committed to implementing this funding on the condition that the redistribution is different from what was originally proposed. The funding will come into a central account and be redistributed to county health departments based on the amount of funding they received from the cities in 1995, There is not enough funding to cover all the 1995 contributions so it is hoped that the Office of Financial Management will assist by allowing a portion of the funding to come from county sales tax equalization, If funding is not available it will result in a delay in the implementation date. HEALTH BOARD MEETING MINUTES - FEBRUARY 28,1995 Page 4 David Specter added that Jefferson County's portion of this funding will be based on the amount shown in the County's budget to be received by the City. Not the amount that the City's budget indicates will be given to the County, NURSING DIRECTOR'S REPORT PROGRAMS UPDATE: Jean Baldwin reported that the measles outbreak is under control. Locally there is one school where students may need to be immunized. So far there have not been any outbreaks, however, it is being watched closely, Larry Fay reported that an individual was gored by a pig that was believed to have rabies. Subsequently, the individual shot the pig in the head with a twelve gauge shotgun. In dealing with rabies cases usually the head is sent to Olympia to be examined and tested for rabies. In this case the head was not completely in tact, so remnants were sent to a laboratory in Olympia for testing but they were unable to determine if it was infected with rabies. The individual has been contacted and will have to get treatment. The remnants of the head have been sent to the Center for Disease Control in Atlanta for further testing. Jean Baldwin reported in more detail on the core function training and specific assignments of the staff at the Health Department. Eight months ago an HIV community plan was completed where three priority target groups were identified. Those include, adolescents at risk attending schools, LV. drug users and male homosexuals. In Jefferson County the highest priority target group is adolescents at risk attending schools since LV. drug users are concealed and there is no effective outreach method for male homosexuals. The Health Department is only willing to target adolescents at risk and they recently applied for a grant for $14,000 which was accepted (not yet approved) by the State even though they will not be targeting the other groups. The Health Department is reviewing and analyzing the data gathered by the Public Health Safety Network. SOUTH COUNTY SERVICES: Jean Baldwin invited the Board to attend a meeting with Jefferson General Hospital and Ken Lynn, the Total Quality Management (TQM) Facilitator, to discuss services to south Jefferson County. Jefferson General Hospital has rented a facility for their clinic and they are willing to allow the Health Department to use the facility one day a week to provide various services. The number of Family Planning clients coming from Brinnon and Quilcene has been more than anticipated. There have been several requests that the Well-Child program and more immunizations be offered in that area. ENVIRONMENTAL HEALTH DIRECTOR'S REPORT REVIEW SECOND DRAFT OF JOINT PLAN OF OPERATION: STATE DEPARTMENT OF HEALTH: Larry Fay reported that this is a draft joint plan of operation with the State Department of Health establishing regulations for public water systems in Jefferson County. He outlined the changes made and explained what they mean HEALTH BOARD MEETING MINUTES - FEBRUARY 28,1995 Page 5 for the County. Once the final draft is received from the Department of Health he would prefer to send it to the Prosecutor's Office for legal review and then schedule it on the Board of County Commissioners' agenda for approval rather than waiting a month until the next Board of Health meeting. Larry Fay stated that more testing was conducted on the contaminated wells in Quilcene, The test results came back negative indicating the wells are clean and free of gasoline. Next week they will sample the wells again and use a different lab to confirm those results. ONSITE SEW AGE SYSTEMS AND AOUIFER RECHARGE CRITICAL AREAS NITROGEN IMPACTS: Larry Fay presented information outlining the ssues with regard to nitrogen and onsite sewage systems and how they affect aquifers. The latest draft of the Onsite Sewage Regulations under the Disposal Protection Standards section states that the Board of Health will designate critical aquifer recharge areas as areas of special concern. This authority is granted under WAC 246,272.21.501. Designating areas of special concern allows the Health Department to develop special standards for onsite sewage systems within these areas. The Health Department would be required to establish minimum design criteria for these areas which would apply to all on site sewage permits, not just new lots created by subdivisions and multi-family housing and commercial lots. The Health Department would also be required to develop a list of best available management practices, develop policies and establish an advisory committee to deal with possible aquifer contamination issues with regard to nitrogen. Larry Fay reported on the latest technology for removing nitrogen to avoid contaminating aquifers. There are approved systems that remove approximately 50%-60% of nitrogen and systems are being developed with even better capabilities. Commissioner Huntingford asked about designating specific boundaries? Larry Fay stated that the critical aquifer recharge areas would need to be identified in the Critical Areas Ordinance and those areas would then be designated as areas of special concern. There is already a current map with those areas defined. Larry Fay stated there are several existing lots in these areas that do not meet the area requirements for onsite sewage permits and the Health Department does not have the ability with current technology to reduce the nitrogen concentration to a level that will not result in an aquifer degradation. Commissioner Huntingford stated that as a measure of protection the City of Port Townsend is requesting the Board of Health designate the critical aquifer recharge areas as areas of special concern in the interim prior to the adoption of the Critical Areas Ordinance. He asked Deputy Prosecuting Attorney Paul McIlrath his legal opinion regarding this matter. Paul McIlrath has talked with the City regarding a 60 day extension of the sunset clause for the adoption of the Critical Areas Ordinance, The City is agreeable to the extension on the condition that the Board of Health designate the areas of special concern at this meeting today since the previously extended timeline for adoption of the Critical Areas Ordinance expires tomorrow, March 1, 1995. Paul McIlrath stated the WAC does authorize the Health Board to designate areas of special concern, however, he feels the Board should go through the proper public process to insure that there is a good record or tracking method established. The Critical Areas Ordinance is already prepared in draft form and the County and City have made great progress in working together. There may not be a need to take these measures when the Critical Areas Ordinance will be adopted in a few weeks which will cover these issues. HEALTH BOARD MEETING MINUTES - FEBRUARY 28,1995 Page 6 City Councilman Ted Shoulberg stated there have been many meetings on this issue and he feels the County has gone through the proper public process. All the maps are prepared and ready to be adopted. The City wants something more definitive from the County that indicates more than just a willingness to work with the City regarding these issues, Commissioner Wojt stated this measure would also prevent a mad rush of individuals from applying for building permits during the 60 day extension in order to be vested under the current regulations. Larry Fay stated an alternative to that would be to place a moratorium on building permits until after the Critical Areas Ordinance is adopted. City Councilman Julie McCulloch added that the City, as a water utility purveyor, has been supplying the Tri Area with surface water with a backup source being ground water, however, the City is not able to meet the time requirements of the City Drinking Water Act without significant infrastructure improvements in surface water but they can with ground water, which is all the more reason to protect the aquifer. Chairman Hinton stated that today's meeting was not scheduled or published and he is not prepared to make a decision on this matter. Commissioner Wojt stated that if the Board approves the areas of special concern, than the public still has an option to build. If a moratorium is set than they will not have that option. Commissioner Huntingford stated if the Board approves this as a temporary protective measure it will take staff a great deal of time to work out the details. Ted Shoulberg stated that in previous discussions it was stated that there is available technology that staff is familiar with which could be utilized for the short term. Public Services Director Gary Rowe presented the maps which have been prepared. To minimize environmental impacts he suggested that the Board could place a moratorium specifically on septic system permits unless an individual has a bonafide building permit application to insure that they are serious about building and aren't just trying to vest under current health regulations. The Board could also approve the areas of special concern with an effective date 30 days later than the adoption date in order to vest projects of individuals already in the building process. It takes a great deal of time and work to submit a building application and allowing a window of time for serious builders will not result in an avalanche of applications. After further discussion Commissioner Huntingford stated he likes the concept of the City's request but he does not support it. He feels the County needs to go through the public process, Commissioner Wojt moved to extend this meeting. The motion died. Commissioner Huntingford stated that the Board can schedule a special meeting at a later date to discuss this matter further. City Councilman Julie McCulloch asked if the Board could commit to a definite timeline on how soon the Critical Areas Ordinance can be completed and adopted. Since the Board will not be acting on the areas of special concern, the City would like to see the extension period shortened. HEALTH BOARD MEETING MINUTES - FEBRUARY 28,1995 Page 7 Gary Rowe stated it will take approximately six weeks to complete the Ordinance and conduct a hearing. City Council members Ted Shoulberg and Julie McCulloch will go back to the City Council with this commitment. The next meeting will be held on March 28, 1995 at 1 :30 p,m. MEETING ADJOURNED JEFFERSON COUNTY BOARD OF HEALTH Richard E. Wojt, ember )' .:/ ~';?---/ ') f ..., ~..-" J' ,.,' / /~/~---</ . #'~'7/~v Glen Huntmgford, Me~9" p/'