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HomeMy WebLinkAbout09 September County Health & Human Services HEALTH BOARD MINUTES SEPTEMBER 25, 1996 CITY OF PORT TOWNSEND REPRESENTA TIVE: Ted Shoulberg, City Council Member STAFF MEMBERS: David Specter, Health Department Director Jean Baldwin, Director of Nursing Services Lany Fay, Director of Environmental Health Chester Prudhomme, Director of Substance Abuse Thomas Locke, M.D., Health Officer BOARD MEMBERS: 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, Judi Morris, Linda Atkins and Health Officer Thomas Locke, M.D. The City Council's representative Ted Shoulberg, Commissioner Richard Wojt and Lany Fay were not present. Chester Prudhomme arrived shortly after the meeting began. APPROVAL OF MINUTES: Commissioner Huntingford moved to approve the minutes of August 27, 1996 as presented. Chairman Hinton seconded the motion which carried. PUBLIC COMMENT PERIOD: No public comments. ENVIRONMENTAL HEALTH DIRECTOR'S REPORT APPEAL OF DENIAL OF EXISTING ONSITE SEWAGE SYSTEM APPROVAL; BOB HUELSDONK: Linda Atkins gave the Board an overview of this appeal. Bob Huelsdonk applied for a permit to operate a 7 bedroom Bed and Breakfast at the Hoh Humm Ranch. In July of 1995 Mr. Huelsdonk received approval for a home business subject to conditions from Jefferson County Development and Review. A letter was sent to the applicants from Gwen Howard, in August 1995, indicating that they would need a water system approved for the proposal and that the onsite sewage system would need to be evaluated. Linda looked at the existing sewage system on June 26, 1996. During the evaluation, Mr. Huelsdonk indicated that the drainfield had been HEALTH ENVIRONMENTAL DEVELOPMENTAL ALCOHOL/DRUG DEPARTMENT HEALTH DISABILITIES ABUSE CENTER FAX 360/385-9400 360/385-9444 360/385-9400 360/385-9435 360/385-9401 HEALTH BOARD MINUTES - SEPTEMBER 25, 1996 Page: 2 installed in 1985 to repair an existing drainfield which was not functioning properly. He uncovered a portion of the drainfield which showed 3 lines, 2 feet wide totaling 165 linear feet and the soil consisted of sandy loam over coarse sand and gravel. Linda determined that the system was designed to handle 396 gallons per day. This will not meet the standards for a 7 bedroom structure. Mr. Huelsdonk's options are: 1) Amend the proposed remodel to reduce the total number of bedrooms; and 2) Expand the existing system to meet current code for a 7 bedroom house. Linda stated that had Mr. Huelsdonk applied for a repair permit in 1985, he would have met the standards for a 7 bedroom structure. Chairman Hinton asked what is required to bring the drainfield up to standards? She reviewed several options. Bob Huelsdonk said that the food service application was for seating for 14 but 8 of those seats are for the owners use. They have 4 children which will be visiting periodically and he would like space to be available for them. The Bed and Breakfast would be using 6 seats, 4 people plus the owners. He indicated that the water system is complete and certified. Commissioner Huntingford asked Mr. Huelsdonk if this was a Class A or B system? Mr. Huelsdonk replied that it is a Class B. He also indicated that he would be willing to reduce the number of bedrooms to 6. One bedroom isn't really a bedroom because it doesn't have a closet. Mr. Huelsdonk then stated that he was unaware that he had to apply for a permit to move to an alternate site on his own property. He indicated he felt that the soil was not excessively coarse gravel. Linda said there are two ways to test the soil. 1) "The Quick and Dirty" method. This is where a #10 screen is used, which is the break between excessively coarse gravel and sands; and 2) Send the soil to a certified lab. Mr. Huelsdonk stated that there are only 3-4 months that the rooms will be occupied. That is well below 50% of the usage if you average that out over the whole year. Linda said that unfortunately it is based on the peak season when the drainfield gets the most use not just 3-4 months of the year. Commissioner Huntingford asked if an additional link could be added to the drainfield to handle the overflow? Linda responded that the tank capacity is low. The applicant would need an additional 500 gallon tank as the second compartment to protect it from the solids. The Washington State Code requires that if you have more than 4 bedrooms you need a 2 compartment tank to allow for the settling of solids. She also said that the Health Department is not requiring replacement of the existing tank, just an additional 500 gallon tank placed in the same area. Commissioner Huntingford asked if Mr. Huelsdonk currently has a permit? Linda said that he does not. The Health Department doesn't actually issue a permit after the fact, they only record what currently exists for future knowledge. Mr. Huelsdonk asked if he could appeal to the State? Dr. Locke said that the local Government would be the place to appeal. Commissioner Huntingford moved to deny the appeal and instructed Health Department Staff to work with the applicant to resolve this issue. Chairman Hinton seconded the motion which carried. HEALTH BOARD MINUTES - SEPTEMBER 25, 1996 Page: 3 REQUEST FOR EXTENSION OF WAIVER FROM TOILET FACILITY STANDARDS; HOOD CANAL SEAFOOD; KURT LAKENES: In May the Lakenes' received a waiver allowing temporary use of a portable toilet to meet public facility requirements. This waiver expires September 30, 1996. The applicants are requesting a three (3) week extension. At the time the Lakenes' requested an extension, the system was functioning properly and has since failed. The Lakenes' are working with Tillman Engineering and the State Health Department to get the water system upgraded from Class B to a Class A system. Commissioner Huntingford moved to approve the three (3) week extension and to give authority to Health Department Staff to work with the Lakenes' for an additional three (3) week period, if necessary. Chairman Hinton seconded the motion which carried. Commissioner Huntingford asked ifLany Fay could give an update in the next couple of weeks, at the Board of Commissioner's meeting, regarding BMPs for septic and Marrowstone Island seawater intrusion issues? David Specter said that Environmental Health is planning on giving a report sometime in November, but Lany will keep the Board informed. DIRECTOR'S REPORT FINANCIAL REPORT: David Specter reported that revenue is right on target at 60.9%. Federal and State grants are down but are expected to catch up. Expenses are tracking low. Professional services are expected to bring that up to what was budgeted. COMMUNITY HEALTH ASSESSMENT: David Specter introduced Chris Hale who gave the Board an update on the Community Assessment Survey Project. The issues that have surfaced in Jefferson County are: "'Mental Health "'Alcohol related deaths (all of which is assumed to be preventable) "'Suicide (Majority are white males over 50) "'Teen pregnancy. Clallam, Jefferson and Kitsap Counties combined have a higher rate than the whole State for suicides. There may be multi county funding available for data collection. Commissioner Huntingford asked if this is going to be a problem for budgets. Chris said that funds can be allocated to where the numbers show there is a problem. For example, if the data shows the County is below the rate for teen pregnancy, but is high in breast cancer, funds will go to breast cancer prevention. COMMUNITY MOBILIZATION PROJECT: David Specter reported on the Community Mobilization Project. Jean Baldwin said that this is a process that takes time. The Health Department is setting up a meeting that will be held in November for all the parties involved. The Board will be briefed on the issues prior to the meeting. HEALTH BOARD MINUTES - SEPTEMBER 25, 1996 Page: 4 NURSING DIRECTOR'S REPORT PROGRAM UPDATE: Jean Baldwin reported that they have been busy with flu clinics and school immunizations. ALCOHOL AND DRUG ABUSE SERVICES DIRECTOR'S REPORT PROGRAM UPDATE: None. HEALTH OFFICER'S REPORT Dr. Locke talked about the "Public Health System Financing Principles" report in the Board's packet. There are 3 essential areas: 1) Public health funding is a shared responsibility; 2) Stable long term funding; and 3) Building up capacities. Dr. Locke asked the Board to review this document and if there are any comments to let him know. He then reviewed the "Local Health Jurisdiction Fee Principles" report. He said that a policy or ordinance that deals with how fees are set, will be done locally within the next year. It will be likely that the State codes (WAC) that deal with Public Health Financing will also be changed. Hearing no new business, the meeting was adjourned. The next meeting will be held Tuesday, October 22, 19 .m. N COUNTY BOARD OF HEALTH (Excused Absence) Richard E. Wojt, Member Public Health System Financing Principles "The history of public health financing in Washington state reflects a series of historical responses to specific situations in local communities and across the state, rather than systematic development according to any established ptinciples". This is a finding from a recent report completed by the University of Washington's Health Policy Analysis Program. The Finance and Governance Technical Advisory Committee has developed financing principles intended to serve long-term guidelines for state and local government to use in making decisions about how public health activities are financed. The finance principles are designed to be general statements which can be implemented through specific, short-term strategies. They cover issues of public benefit, incentives for building system efficiency, stability of financing, and equity of opportunity for basic public health protections. Three assumptions have served as philosophical underpinnings in the development of the principles: 1) State and local government have a shared responsibility along with the individual and the community, in the protection and promotion of the public's health, 2) A well functioning public health system requires an adequate base of support from state and local government, and 3) a fundamental level of capacity is needed throughout the state for carrying out the core public health functions. In order to make best use of the resources available for strengthening the system, these principles should become the framework for guiding public health financing policy. To best understand the their impact in guiding policy decisions, the financing principles should be considered as an interactive package of components, rather than as separate, isolated rules. Financing Principles 1. Public health activities vary along a continuum of benefit, from primarily benefiting individuals (e.g. reproductive health examinations. travel immunizations) to primarily benefiting communities (e.g. communicable disease investigation. health education campaigns). In some cases, public health activities have a population-based benefit while being directed at an individual or family (e.g. child abuse or domestic violence intervention. prenatal case management). The degree of benefit to the individual and the community, as well as whether the activity is conducive to fee collection. should all be considered in determining the financing of a public health activity. (reference the Fee Principles for Local Health Jurisdictions) a) When an activity has primary benefit to an individual or an organization or protects the public from individual choices (e.g. on-site sewage permits, food handler's certification) a greater share of the cost should be passed on, through a fee or permit, to the individual or organization. There are circumstances where an individual can not pay, and the fee should be subsidized. finprin7.doc 8/22/96 .' b) When an activity has primary benefit to the community (e.g. early childhood immunizations, monitoring on-site system failure) a greater share of the cost should be publicly subsidized. c) In the event that charging a fee jeopardizes community health status (e.g. HIV counseling/testing, on-site repair permit), the local health jurisdiction should have an established policy for fee waiver or adjustment. This in turn, may require public subsidy of the activity. 2. When a public health activity has benefits to the population beyond the boundaries of the public health jurisdiction (e.g. response to a public health emergency, groundwater monitoring, INPHO), a regional financing scheme (e.g. funds, staff, resources, mutual aid agreements) involving state, local and tribal governments should be developed. 3. The recipients of state public health financing should be accountable through performance based contracts for: a) establishing the capacity to perform core public health functions. b) contributing to the improvement of community health status by impacting health risk and protective factors. 4. The state should provide start-up financial incentives to initiate the formation of long -term partnerships between local health jurisdictions, tribal governments, community based organizations, and other organizations, which will increase regional capacity and improve the overall efficiency and effectiveness of the public health system (reference the Public Health Partnership Principles). 5. The state will intercede when a local health jurisdiction has not independently attained the capacity required to perform the core public health functions and has not entered into a partnership as a means to improve perfonnance. The state will charge back to local government a share of the costs of carrying out the core public health functions in that community (reference RCW 43.70.130 and 70.05.130). 6. Both stability and flexibility are necessary for state and local government public health financing. a) Stable financing at an adequate level, which is both predictable and responsive to changes in the population, is required for carrying out the core public health functions. b) Flexible financing, responsive to health assessment information including the degree and extent of public health threat, the effectiveness of prevention activities, and the community's priorities and values is required for public health activities which reflect policy choices of a community (e.g. anti-smoking education for youth, fluoridation of water supplies). 2 finprin7.doc 8/22/96 Local Health Jurisdiction Fee Principles The cost of protecting the public's health is supported by federal, state and local government, as well as direct charges to the consumer in the form of fees for services and permits. The revenue generated by fees is a legitimate and necessary component of the overall mix of public health financing. However, not all public heath activities are conducive to fee collection. Some activities directly benefit an individual. while other activities have a combination of individual and community benefit. Local government has authority for decisions about which services are supported by fee revenue and the level of that support. The Finance and Governance Technical Advisory Commillee, as part of its study of public health system financing. recommends that local health jurisdictions have fee policies and practices which are consistent with the Fee Principles (listed below). These principles are intended to be a guide for public health administrators and board members in the process of determining fees for the activities of the local health jurisdiction. Each local health jurisdiction should have a written fee policy that: . complies with RCW 70.05.060 (see attached) . describes a process of fee schedule development and frequency of review . describes a method for service cost calculation . describes a philosophy of service cost recovery . addresses the use of sliding fee scales . addresses fee collection practices Prior to setting a fee, the service should be clearly defined, using standard definitions of practice when they exist. The actual cost of the service, including indirect cost, should be calculated using sound and consistent methodology. Fee schedules should be routinely reviewed and revised. Hourly rates should be established to cover services not specified by the fee schedule. Cost recovery from fees can vary by service and should be consistent with the local health jurisdiction's philosophy of service cost recovery. The following factors should be considered in setting a service fee. . If a service primarily benefits an individual or business, the cost recovery rate should be greater (e.g. on-site sewage permit, food handler's certification). . If a service primarily benefits the population by protecting them from health problems or hazards. the cost recovery rate should be lower (e.g. childhood immunizations, on-site repair permit). . It should be taken into account that a high rate of cost recovery, for some services, may significantly influence practices and behaviors which put the public at risk of health problems(e.g. temporary food service permit, HIV counseling /testing). Local government should have the primary responsibility for subsidizing services which have less than 100% cost recovery from fees, except when grant funding is specified to support a service. 8/20/96 feeprin6.doc . Issue: Revision of WAC 246.05 Background: The current WAC 246.05 (section 020), which was enacted over 20 years ago, provides guidelines for local health jurisdictions (LHJ) regarding the set of required and optional services that should be supported by local government. This section of the WAC also sets out funding formulas for the cities and counties to use in deciding their shares of support. Local public health administrators have indicated that this section continues to be used to influence the policy of local boards of health. The State Board of Health (SBOH) has statutory authority for promulgating any changes of this section. Rationale of Action: The public health system should have implementation rules which match the current and future direction of system development. The guidelines for LHJ responsibilities and duties should be consistent with the core function approach described in the 1994 PHIP report and the 1995 legislation. The responsibilities and duties of the State Department of Health (DOH) need description to assist in coordinated system development. Recommendation: The PHIP Steering Committee recommends that DOH and the SBOH should involve local government in development of the revision language of WAC 246.05: . to include a description of state and local health jurisdiction responsibilities . to include a description of the public health approach . to include a description of the core public health duties . to include financing principles for state and local government policy . to delete parts of WAC 246.05.020 which no longer apply june5a.doc 8/20/96 NOTICE CHANGE IN HEALTH BOARD MEETING TIME The Jefferson County ,B08rdof Health will be meeting on Wedl'lesday, September 25, 1996 at 1 :30 p.m. at the Courthouse in the lower level conference mom, 182,0 Jefferson Street, Port Townsend, WA 98368 Next month the regular schedule for this meeting wiHbe-resuml!d"which is t!)e fourth Tuesday ole"ch monthat 1:30 p.m. Robert Hinton, Chairman Jeff'1rson County Board of Health 43129-18 Affidavit of Publication STATE OF WASHINGTON) SS COUNTY OF JEFFERSON) SCOTT WilSON, being sworn, says he is the publisher of the Port Townsend Jefferson County Leader, a weekly newspaper which has been established. published in the English language and circulated continuously as a weekly newspaper in the town of Port Townsend in said County and State, and for general circulation in said county for more than six (6) months prior to the date of the first publication of the Notice hereto attached and that the said Port Townsend Jefferson County Leader was on the 27th day of June 1941 approved as a legal newspaper by the Superior Court of said Jefferson County and that annexed is a true copy of the Notice - Change in Health Board Meeting Time as it appeared in the regular and entire issue of said paper itself not in a supplement thereof for a period of ~ consecutive weeks, beginning on the 18 day of September ,19~, & ending on the ~ day of September , 19~, and that said newspaper was regularly distributed to its subscribers during all of this period. That the full amount of $ 18. 45 has been paid in full, at the rate of $8.65 ($6.20 for legal notices received electronically, sertion. Publisher Subscribed and sworn to before me this----.UL day of Sept. 19.2..6. '" .; " 'C'tJ d for the State of Washington, I residing at Port Hadlock Please Publish: One (1) time, September 18, 1996 Bill: Jefferson Counly Commissioners P.O. Box 1220 Port Townsend, W A 98368 NOTICE CHANGE IN REALTII BOARD MEETING TIME The Jefferson Counly Board of Health will be meeting on Wednesday, September 25, 1996 at 1:30 p.m. at the Courthouse in the Lower Level Conference Room, 1820 Jefferson Street, Port Townsend, W A 98368. Next month the regular schedule for this meeting will be resumed, which is the Tuesday of each month at I :30 p.m. ~ Hinton, Chairman Jefferson Counly Board of Health