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HomeMy WebLinkAbout03 March County Health & Human Services HEALTH BOARD MINUTES March 28, 1995 BOARD MEMBERS: STAFF MEMBERS CITY OF PORT TOWNSEND REPRESENTATIVE: Bob Sokol 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 Robert Hinton, Chairman Richard Wojt, Member Glen Huntingford, Member The meeting was called to order by Chairman Robert Hinton. The following Board and staff members were present: Commissioner Glen Huntingford, David Specter, Jean Baldwin, Larry Fay, Judi Morris, Gwen Howard, Lisa McKenzie and Chester Prudhomme. APPROVAL OF l\fiNUTES: Commissioner Huntingford moved to approve the minutes of February 28, 1995 as presented. Chairman Hinton seconded the motion. The motion carried. PUBLIC COMMENT PERIOD: There were no public comments. DIRECTOR'S REPORT FINANCIAL REPORT: David Specter reported that revenue was below the expected level. For the last three (3) years the Health Department has not increased its operating and supply budget and it will be difficult to stay within the budget for this year. He also reported on the proposed funding from Washington State Association of Counties that would take the place of the City of Port Townsend's contribution. Funding would start in 1995 at $76,065,00 which is close to the amount budgeted to be received from the City. The level of funding would carry forward into 1996 with no increase, It would increase in 1997 to $83,191.00 and then $107,294.00 in 2001. This proposal will begin January 1, 1996, if approved, PROGRAMS/GRANTS UPDATE: The Health Department has received a grant for an additional $6,000.00 to develop a plan for a breast and cervical cancer program by 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 - MARCH 28, 1995 PAGE: 2 the end of May. This program would be geared toward seniors and preventative care for women. A $1,000.00 grant for children with disabilities has been approved for Jefferson County. David Specter stated we also received $600.00 from the Department of Health for the training of public health officials and a portion of that will go to Cooperative Extension for the use of their new office space. Jean Baldwin reported that the Department of Social and Health Services received a grant for family planning and are negotiating a contract with the Health Department to work together in providing family planning to people on welfare. David Specter stated that they just found out that they received a grant for $7,000.00 from the March of Dimes. Larry Fay stated that the paperwork is being prepared for a grant from the Puget Sound Water Quality Authority. S.A.F.E. CLINIC FOR CHILDREN: David Specter submitted a report and told the Board that this program was established in 1992 to gather medical documentation to use in prosecution, not to provide medical care or emergency exams. Between 1992 and 1994 there has been a considerable decline in these kinds of cases with no explanation. Backlog was suspected but was not the case. The Sheriffs Office treats these cases as high priority. The Health Department will continue to monitor this program and report back to the Board. David Specter indicated that the State is trying to adopt a voucher system that would eliminate all County funding and the Health Departments role. He will keep the Board updated. NURSING DIRECTOR'S REPORT Jean Baldwin said that Ken Lynn gave some training on Total Quality Management (TQM). The TQM process has helped with getting programs started in South Jefferson County such as maternity support, immunization, some well child check ups and food handler tests. Lisa McKenzie submitted and discussed the Immunization Challenge Grant Progress Report, This report compared the number of two year old children who were up to date on their immunizations in 1990 to those in 1993. The report showed that there was a dramatic increase of immunizations in 1993. Chairman Hinton asked about the recent rabies incident? Lisa McKenzie answered in that case the women was bitten by a pot belly pig. The State's test was inconclusive as to whether the pig actually had rabies, so the woman was given the choice to have the vaccine. ENVIRONMENTAL HEALTH DIRECTOR'S REPORT REQUEST FOR WAIVER WAC 246-272-0950(1); TO REDUCE SETBACK BETWEEN DRAINFIELD AND MARINE WATERS FROM 100' TO 85': BRIDGEHAVEN DIV. 7, LOT 29: APPLICANT, JOHN DEAN: Larry Fay recommended that the Board approve this request. Commissioner Huntingford asked if this has to go the State? Larry Fay responded that both of these requests have to go to the State because they were received in 1994 under the old rules. These are some of the last ones under the old rules. Commissioner Huntingford moved to approve staffs recommendation to reduce the setback between the drainfield and marine waters from 100 feet to 85 feet. Chairman Hinton seconded the motion. The motion passed, HEALTH BOARD MEETING MINUTES - MARCH 28, 1995 PAGE: 3 REQUEST FOR WAIVER WAC 246-272-0950(1); TO REDUCE SETBACK BETWEEN DRAINAGE DITCH AND DRAlNFIELD FROM 30' TO 10': CAPE GEORGE COLONY, DIV. 2, LOT 10: APPLICANT, HARRY DOST: Larry Fay reported that D.R. Strong Consultants prepared the application for Harry Dost. Mr. Dost is applying for a permit for a three (3) bedroom house on a small lot. The proposed system is a sand filter pressure system. Larry Fay said that the culvert in the drainage ditch has a permanent stream running through it. We have some concerns about placing the drainfield near the culvert. One, is that some overflow might run into Discovery Bay. Larry Fay recommended to deny the waiver as it was proposed. He expressed his concerns to Mr. Dost and David Jensen, a consultant with D,R, Strong. Mr. Dost suggested that he build a smaller house (two bedroom) and that would cut the size of the drainfield down. Mr, Jensen is checking to see if he can fit that proposal on the property with the normal setbacks. Larry Fay suggested that the applicant go with the gravel system but set aside the whole area for a drainfield in case a whole system is needed. Commissioner Huntingford moved to deny the request to reduce the setback between the drainage ditch and the drainfield from 30 feet to 10 feet. Chairman Hinton seconded the motion. The motion carried. Commissioner Huntingford moved to authorize Larry Fay, Environmental Health Director to approve reducing the drainfield from 25'-30'. Chairman Hinton seconded the motion. The motion carried, Larry Fay also reported that the agreement between Jefferson County and the Department of Ecology will be ready for approval in a couple of weeks. DRUG AND ALCOHOL ABUSE DIRECTOR'S REPORT Chester Prudhomme stated that the figures are down from the first of the year and he is not sure. More advertising will be done to try and get the word out to people who need this program. Everyone will be happy to know that the rat that has been eating everything from paper to food has been destroyed. The next meeting will be held on April 25, 1995 at 1:30 p.m. MEETING ADJOURNED (J? Health & Human Services March 9, 1995 FROM: Board of County Commissioners (Board of Health) David A. Specter pAt Pediatric Sexual Assault Case Backlog: Attached Letter from Sydney Schneidman, M.D. TO: SUBJECT: We have received the attached letter from Dr. Schneidman requesting that the Board make an inquiry into a possible backlog of pediatric sexual assault cases within the Jefferson County Sheriff's Office. As you know, the Health Department operates a program (the SAFE Clinic for Children) which provides non-urgent, medical forensic examinations for children who are victims of sexual assault. We have a contract with Dr. Schneidman to be Medical Director of the Clinic and conduct the medical exams. Potential cases of child sexual assault identified by law enforcement agencies, families or medical practitioners are referred to DSHS Child Protective Services, which in tnrn refers cases needing medical exams to the SAFE Clinic. When we started this program in 1992, we had discussions with the Sheriff's office and CPS about the need for services. We were informed at that time that the Sheriff's office was receiving approximately 12 reports of sexual assault on children per month, with an additional four cases per month reported directly to CPS. Based on this analysis, we estimated that four to six cases per month would be referred to the SAFE Clinic for medical exams. Our actnal experience was two to three examinations per month. As Dr. Schneidman indicates in his letter, referrals to the SAFE Clinic dropped off to almost zero in mid- 1994. Since we have no information that would suggest that the rate of child sexual assault has changed in the community, it is possible that there are other factors in the referral system that account for this decline. I spoke with SheriffPiccini. He indicated that he is aware of Dr. Schneidman's concern, has assessed the statns of pending cases and did not fmd a problem within the Sheriff's office. I have not yet connected with the CPS office to determine whether there are problems within that referral system that account for the drop in cases. Health Department staff will continue to investigate this sitnation and will report on our fmdings at the next Board of Health meeting. In the meantime, if you have any questions or would like any additional information, please call me or Jean Baldwin. cc. Pete Piccini, Jefferson County Sheriff Peter Geerlofs, M.D., Health Officer Sydney Schneidman, M.D., SAFE Clinic Medical Director Jean Baldwin, Nursing Director, Jefferson County Health Department Jack Gray, DSHS Children and Family Services HEALTH DEPARTMENT 206/385-9400 ENVIRONMENTAL HEALTH 206/385-9444 DEVELOPMENTAL DISABILITIES 206/385-9400 ALCOHOl/DRUG ABUSE CENTER 206/385-9435 FAX 206/385-9401 SAFE Clinic for Children (Sexual Assault and Forensic Examination) Sydney W. Schneidman, MD, FACEP Medical Director ,...-.--.--..-- -. , r-..',...,. ..." --, i f'-;C - ~~_., ] i I . : , ----. -~......I ,: JEF~ :~.~: i"l . :<.:":,,:,,,~-,. c:.:;.-;: I - March 5, 1995 David Spector Jefferson County Board of Health Jefferson County Health Department Port Townsend, W A 98368 Gentlemen, As you are aware, I have been running the SAFE Clinic for Children at the Health Department for the past two years. For the first year and a half, I was reasonably busy, seeing an average of2.5 cases a month. Last summer my case load dropped off to almost zero. I was perplexed as to why this was happening, so I took it up with Mr Spector, the staff at CPS and JCSO, When I asked if there was some dissatisfaction with my work or reports, I was told this was not so. When I recently discussed the situation again with representatives of JCSO, I was told there are many accumulated cases that need to be evaluated, I mentioned my concern about this apparent backlog to Mr. Picini on two occasions. Both times he promised an investigation, but I have yet to hear anything from him. I am concerned that there are cases of pediatric sexual assault continuing in this county that are not getting proper and complete medical evaluations, so necessary to bring the perpetrators to justice, or support their claim of innocence. Because I have made no progress with informal meetings, I am requesting that the Jefferson County Board of Health, as it sees fit, make formal inquiries as to why cases of alleged pediatric sexual assault are not being brought for medical evaluation or prosecution, Thank you for your assistance in this matter. Syd -- . Jefferson County Health Department. 615 Sheridan' Castle Hill Center' Port Townsend' WA . 98368 ' . 206/385-9400 ' FAX 206/385-9401 ' JEFFERSON COUNTY SHERIFF'S OFFICE - See March 16 memorandum. - Reviewed child abuse case records and finds no apparent backlog of cases needing medical forensic exams. - Policy is to treat child abuse allegations with top priority. - Will continue to assign an investigator with primary responsibility for child abuse cases and limit other duty functions of that officer. CHILDREN AND FAMILY SERVICES / CPS - Doesn't have a way of extracting statistics on sex abuse cases. - Only investigates in-family cases. If perpetrator is outside the home, determines if the child is safe and refers to law enforcement for crime investigation. - Have relied on law enforcement agencies to refer directly for medical exam. - Haven't had many non-urgent cases lately; will continue to make referrals as needed. SAFE Clinic Referrals: Conclusions 1 There does not appear to be a current backlog of child sex abuse cases within the Jefferson County Sheriff's office or CPS. 2 It does not appear that children in need of medical exams are being denied service referral. 3 Existing data are not adequate to explain the decline in cases seen by the SAFE clinic and referred to the Jefferson County Prosecutor's office. 4 There are issues regarding referral criteria and SAFE Clinic program that need to be discussed. RECOMMENDATIONS: 1 Jefferson County Health Department should continue to monitor case and trend data. .2 Health Department management should convene and facilitate an interagency / provider meeting to: a) Develop referral criteria for child sexual assault cases; and b) Discuss issues regarding service needs, including: SAFE Clinic program scope; emergent vs. non-urgent exam needs; other area/out of area resources; caseload volumes required to assure service quality; issues regarding legal prosecution. 3 Suggested participants: Jefferson County Sheriff's Office Children and Family Services I CPS Jefferson County Prosecutor's Office Port Townsend Police Department SAFE Clinic Health Officer Jefferson General Hospital Physicians p~etz PETE PICCINI JEFFERSON COUNTY SHERIFF 81 Elkins Road' Port HadlocK, Wa~hil1gton 90339 . (360) 385-3831 .1-ROO.552-0750 TO~ ~oard ur County Commissioners from: Pete piccini, Jefferson County Sheriff Dat.e, Morch 16, 1995 Subj: pediatric Sexual Assault Case Backlog; Attached Letter from David A. Specter Attached Letter from sydney schneidman Attached list of JCSO cases This correspondence is in reply to letters received by the BOCC concerning an inexplicable drop in referrals to the Jafferson ~ounty H~Alth Departments "safe Clinic", a facility under the direction 0:1: lJr. syulley Schn<.:idl1\an whn..... task is to provide fU4ensic medical ex~minations in caseS of alleged sexual child abuse, Dr. Schneidmans' letter infers that the Jefferson county Sheriff's Office is remiss in its duty to investigate and bring to justice, perpetrators of this most insidious type crime. A thorough review was made of all caseS involving child abuse that was lnveb~i~ated by thi~ ~0p.ncY in 1994 and included all cases of physical as well as sexual child abuse, It was determined that this agency investigated 105 such caseS. Of these 105 cases, only 47 cases were pending at the time of Dr. Schneidmans inquiry concerning sexual child abuse cases and these were being or already had been investigated. The breakdown was as follows: Z2 Sexual assault allegations 16 physical assault allegations 9 Other m~scel!aneUUb ~~i~c~ of the 22 sexual assault cases listed above, only one case, 94-1383, would benefit from forensic medical examination. This case involves a 2-1/2 yr old victim whose paren~ is reluctant to set UP the examination. The rest of the cases are either closed,' inactive or have been sent to the prosecutor. KEN SUKERT UNDERSHERiFf DON WOODWARD CHIEf CIVIL DEPUTY CARLA SCHUCK SUPT. Of CORRECTIONS ., I~ h~~ Always been the policy of the Jefferson County Sheriff's office to treat chl1U d~U&C ~11Q9~.lon. wi~h top priority. This is borne up by the fact that these are the only type caseS that have been assigned an investigator with primary responsibility to investigate all reported caSes of child abuse. Additionally, every effort is made to limit other duty functions assigned to the child abuse investigator. In example, of assigned patrol duties, only 7 werA night shifts. This agency will continue to view child abuse cases with utmost concern tll1U prio:t'ity. If theJ'"p. is a reason for the drop in SAFE Clinic referrals, it does not lie within the Jefferson County Sheriff's Office. P.04 -..T'fie rema;..n;1.ng c.a.~l-io <:U.G ........----... 94-1383 (V) 2 1/2 yr old fem. reports touching of genital area to grandmother. Child non-communicative wit.h investigator, Recoromended that child participate in therapy in hopes that she will disclose to ther~pist. 94-2240 (V) 2 yr. old male reported that 13 yr, old cousin licked his penis. child told investigator "He touched me here" and pointed to crotch, he refused to talk further or answer questions. 94-2822 (V) reports only touching of crotch on top of clothing by great uncle. 94-2840 (V)'S report touching only by 13 yr, old boy. 94-1651 (V) reports that 5 yrs ago when he was 15 yoa he was fondled on his penis by a camp counselor. 94-0986 (V) reported being "looked at naked" by a teen age boy, Child in therapy in hopes of more disclosure. 94-0607 (V) reports father of her friend fondled her breasts during the night, She refuses to testify. 93-2567 (V) reports brother licked her private. She lives in Kitsap county. Forensic done there. 94-1418 report of a 15 yr. old Jane Doe possiblY living with an adult male, not the father. 94-2529 (V)'S living in California unknown location of occurrence, (possibly Queets Indian Res.) report sent to JCSO for info . 94-1138 School reported after a counselling session. This was a previou~ly report casQ (4 y~nrs ago), 94-1648 (W) reported (V) touched on breasts while being picked up, and helped off of trampoline . 94-1998 father reports that (V) was molested by ex-wife's boyfriend. (V) did not disclose to investigator or hospital p~L~onnel, ~urin9 tim~ nf exam. 94-2881 (V) reports that step-father fondled her breasts when he was "as leep" . 94-0763 (V) reports that 16 yr old male touched her crotch on top of clothing only. 93-1334 (V) reported that his grandfather touched his penis over clothing. 94-0819 (V) 4 yoa male, reports father touched his penis ~Iith hands. 95-0018 RP believes (V) is being molested by father. (V) interviewed by school and CPS. She has not disclosed to them, interview by investigator pending. 95-0094 (V) reported that she was touched by ex- boyfriend of mom 7 yrs ago, 95-0230 Mother reporte that dau9ht~r oAin9 molested oy ex-husband. Daughter did not disclose to Mary Bridge, at time of exam, or theropi5t. Therapist believes this is in the mind of the mother only, 95-0314 20 yr. old female gave birth to child conceived wich a 15 yr. old male. Male refuses to give statement. Charges pending against female anyway. 95-0354 (V) reports physical abuse, with touching involved, Interview by investigator pending. ~All other sexual abuse cases listed on the memo of 1-16 have been investigated closed. p.as The only case which may have benefitted from aD immediate forensic exam is 94-1383. 3