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HomeMy WebLinkAbout09 September County Health & Human Services HEALTH BOARD MINUTES SEPTEMBER 26, 1995 BOARD MEMBERS: Robert Hinton, Chairman Richard Wojt, Member Glen Huntingford, Member STAFF MEMBERS David Specter, Health Department Director Jean Baldwin, Director of Nursing Services Larry Fay, Director of Environmental Health Chester Prudhomme, Director of Substance Abuse 1. Peter Geerlofs, M.D., Health Officer 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 Richard Wojt, Lany Fay, David Specter, Chester Prudhomme, Jean Baldwin, Judi Morris, and Bob Sokol. Commissioner Huntingford arrived shortly after the meeting began. APPROVAL OF MINUTES: Commissioner Wojt moved to approve the minutes of August 22, 1995 as presented. Chairman Hinton seconded the motion in the temporary absence of Commissioner Huntingford. The motion passed. PUBLIC COMMENT PERIOD: No public comments. DIRECTOR'S REPORT FINANCIAL REPORT: David Specter presented the revenue and expense summaries. He reported that 66.5% of the budget has been expended and 61.6% of budgeted revenues have been collected as of August 31, 1995. Environmental Health and Substance Abuse fees are tracking low while expenses are in line with budget projections. PROGRAM/GRANT UPDATE: David Specter reported that the Health Department is falling behind with grant reporting due to the workload this time of year with budget deadlines, etc. They will be working on grant reports all next week in order to catch up. 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 MINUTES - SEPTEMBER 26, 1995 Page: 2 He also stated that the Health Department is considering partnering with Jefferson General Hospital to hire a Community Health analyst to study health needs and trends in the community. A meeting was held last month with a group called the Jefferson Community Assessment Partnership made up of representatives from the Hospital, Clallam-Jefferson Community Action, Olympic Area Agency on Aging, Mental Health, and Kah Thai Care Center. Funding for hiring the analyst will come from the Hospital and the Health Department. The other agencies participating will be asked to assist financially at some point in the future. Additional funding is available from the State Department of Health which they are using as incentives to encourage partnerships. The Health Department has applied for $15,000 of this funding. David Specter stated that they have also been working with Clallam and Kitsap counties to do a regional project which is similar in nature. However, this project is to jointly hire a more advanced public health demographer to conduct more sophisticated analyses, train Health Department staff, and work with the Board and the community. They have applied for a grant to fund this project as well. If funding is received for the regional project, then the local project may not be needed. In regard to funding, David Specter stated he would like to meet with the City of Port Townsend to request that they participate in the community assessment and other priority public health needs by providing funding. Beginning in January 1996, public health will be funded by the Motor Vehicle Excise Tax (MYET) and the City of Port Townsend will be required to provide approximately $20,000 less funding than they had previously by contract. The Health Department feels that the City should still allocate the $20,000 to support public health services. Especially, with the imbalance that currently exists between County and City contributions versus the services provided. The City's contribution is not proportionate to the services they receive. In past discussions with the City, the negotiating team either did not address this aspect or did not prevail. Therefore, he would like to pursue the issue again during the budget process. FEE WAIVER POLICY: David Specter stated that the fee waiver policy has a significant impact on the Health Department since many fees are waived for various agencies. Larry Fay explained that most of the waivers approved are for food program fees. Currently there are no written procedures which outline conditions of eligibility. Granting fee waivers is something that just happened over time. Initially, fee waivers were granted for non-profit organizations. In 1988 it was decided that since some projects take a great deal of Health Department staff time, and in the absence of a policy, fees waivers would no longer be granted. On August 28, 1995 the Jefferson County Board of Commissioners passed resolution #74-95 adopting a policy for consideration of fee waiver requests associated with County ordinances. After discussion of the interpretation of this policy, Larry Fay stated another policy may need to be developed which outlines what services will not be charged a fee and under what circumstances. Commissioner Hinton suggested Larry Fay talk with the Prosecuting Attorney regarding the interpretation of the current policy before a more detailed policy is developed. Larry Fay will review it with the Prosecuting Attorney and report back at the next meeting. Chester Prudhomme stated the fee waiver policy affects his department as well. Fees of individuals who are indigent can be funded several different ways including contracts with State. However, there are some individuals that do not meet any of the financial requirements of the Department of Social and Health Services (DSHS) to receive these grants and do not have the money to pay the fees. The State has HEALTH BOARD MINUTES - SEPTEMBER 26, 1995 Page: 3 allowed the Health Department to waive fees for individuals who request a waiver in writing and can provide documented evidence that proves they are unable to pay the fees themselves. If the fees are lowered to such a degree that all individuals could afford treatment, the Substance Abuse department would be unable to bill the State for the full cost of services provided, since State regulations say that they can only be billed for actual fees. They cannot be billed more than the public is charged, unless the services are provided for free. Jean Baldwin stated the State Department of Health and Federal Family Planning recently conducted an internal audit of the Health Department. She explained the sliding scale used by the Health Department to determine fees charged to individuals based on their income. Commissioner W ojt stated that he thought the fee waiver policy resolution dealt with fees charged by the County for services other than those of medical nature. Larry Fay stated the resolution deals with fees that are adopted by County ordinance and all the Health Department fees are adopted by County ordinance. David Specter added that no individual will be denied services due to inability to pay. The amount recovered is greater than in Clallam, Kitsap and Snohomish Counties. The Health Department needs to balance public health objectives with income objectives to insure against a disease outbreak that could end up costing much more than a small fee. But at the same time they need to apply the policies in a clear and consistent manner. ALCOHOL AND DRUG ABUSE SERVICES DIRECTOR'S REPORT INDIGENT ASSESSMENTS & TREATMENT: Chester Prudhomme reported that their cases are beginning to pick up after months of cases being stuck in the Court system. The District Court Probation Officer advised him that in 1996 they will begin referring individuals to an alternative program at Lakeside Counseling Center located in Silverdale, to get DWI and chemical dependency assessments. In the past, the Health Department has held a contract with District Court to conduct these assessments, which are paid for by the court, if the individual is adjudged by District Court. The Health Department receives $75.00 for each assessment. Lakeside Counseling Center performs free assessments. In order to compete with this other program, the Health Department may want to look at offering free assessments as well. Commissioner Hinton asked how the other program is funded. Chester Prudhomme replied that it is a private agency and their funding is insurance based. Since most of their clients have insurance, they collect almost 100% of their fee schedule. The Health Department can do the same thing, but they are unable to bill insurance for court ordered assessments. The other program gives free assessments and then bills the insurance for the full cost of the program. The concern is that more and more individuals will go the alternative program and Jefferson County will lose business. Chester Prudhomme feels it needs to be determined if the program is worth continuing. HEALTH BOARD MINUTES - SEPTEMBER 26,1995 Page: 4 NEW BUSINESS Larry Fay reported on reviewing subdivision applications. The time frame for reviewing complete applications is outlined in the subdivision ordinance. After that time, the Permit Center is required to make their preliminary approval or denial of the application. The Permit Center sends notice to the Health Department requesting their comments on the soils information and layout of the application within 7 to 10 days. Since there is a legislative deadline for the review of applications, Health Department staff must drop everything they're working on to review them. This means that the review of septic permits may be delayed due to the increasing volume of subdivision applications being received. With the variety of applications the Health Department works with, they have always reviewed them as they come in rather than giving certain projects priority over others. The Board suggested the Health Department track the subdivision applications and if difficulties arise they will be addressed at a future date. Jean Baldwin reported that the Jefferson County agencies that deal with youth will be meeting on Friday, October 13, 1995. She presented an outline of the meeting to the Board and welcomed any input. Jean Baldwin also reported that Lisa McKenzie, an immunization nurse with the Health Department, received the Washington State Public Health Annual Award and was presented with a plaque at the Washington State Public Health Association annual meeting in Yakima, for her efforts in discovering the measles epidemic which originated in Whatcom County. Only three individuals received awards; the State Secretary ofHealtb, Island County Commissioner, Mike Shelton and Lisa McKenzie, so it was an honor to be among the individuals recognized. She also received the Shoe Leather Epidemiology Award from Whatcom County. This unique award displays a leather shoe, once worn by the State Secretary of Epidemiology. He still owns its match. Additionally, the Health Department presented her with an award made by the Port Townsend Foundry. Commissioner Huntingford stated that the Home Builders Association is concerned about the Health Department's review of septic systems. Larry Fay stated they are still working on eliminating the duplication of efforts and speeding up the process. Meeting adjourned. The next meeting will be held on Tuesday, October 24, 1995 at 1:30 p.m.