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HomeMy WebLinkAbout10 October JEFFKRSON COUNTY BOARD OF HEALTH MINUTES OCTOBER 16, 1997 BOARD MEMBERS Glm HUllti'l'iford, CMimlall - county CommisswIler District 2 Richard wojt, M<mber - COI!/1ty commissioner District 3 Dall HaryoIe, M<mber - COUIlty Commissioller District I Ted shoulbcrg, M<mber - port Townsend City CouIlcil JiU Buhler, Member - Jeffersoll COWlty HOspiinl District #2 commissioner Sheik WestemlM, M<mber - Citizen at Lalge (City) RobertJ! Frissell, Member - Citizell at Large (COUllty) STAFF MEMBERS David specter, Health Department Director J eall Baldwin, Director of Nursing services Lany Fay, Director of EIlvirollmellinl Henlth duster prudhomme, Director of substallce Abuse Thomas locke, M.D., Health officer Mary MMdel, Admi'listrative SUYfort In the absence of Chairman Glen Huntingford the meeting was called to order by Vice-Chairman Dan Harpole. All other Board and staff members were present. APPROVAL OF MINUTES Commissioner W ojt moved to approve the minutes of September 18, 1997 as presented. Member Buhler seconded the motion which carried by a unanimous vote. PUBLIC COMMENT PERIOD No public comments. OLD BUSINESS UPDATE - SOLID WASTE ENFORCEMENT: LINDA SEXTON: Larry Fay stated that this case has been forwarded to the Prosecuting Attorney's office and is pending prosecution. He presented an article from the Seattle Post Intelligencer titled 'Trash Talking" which illustrates that Jefferson County is not the only public agency dealing with neighborhood nuisances. UPDATE - SEPTIC WASTE DUMPING ENFORCEMENTILICENSE SUSPENSION: ECOTEC: Larry Fay presented a copy of a letter from Milton Foss, owner of Ecotec which states that he has withdrawn his license and is no longer operating as a septage pumper. An ex-employee of Ecotec recently applied for a septage pumping license which the Health Department is currently processing. An inspection was scheduled this week to review the equipment and identify the disposal site. The license will not be issued until the applicant provides documentation that the septage will be taken to a licensed disposal facility. To insure against illegal dumping, the Health Department will most likely issue a probationary license, and in the short term, require weekly reporting and review of the applicant's records. Failure to report may result in the loss of the license. HEALTH BOARD MINUTES - OCTOBER 16, 1997 Page 2 UPDATE - BOARD OF HEAL TH BYLAWS DEVELOPMENT: David Specter reported that the subcommittee assigned to work on the bylaws met last Thursday, October 9, 1997. David Specter, Dr. Locke and the subcommittee developed a draft set of bylaws using sample bylaws from other Health Departments/Jurisdictions within the State. The bylaws will be submitted to the Prosecuting Attorney for review and then to the Board of Health for adoption at the next meeting. NEW BUSINESS BOARD OF HEALTH ORIENTATION: Items 3, 4 and 6 of the "Essential Responsibilities of Public Health" were discussed as follows: Enforce laws and regulations that protect health and ensure safety. Dr. Locke stated that this is a major statutory obligation of the Board of Health. Failure to enforce State codes may result in the dismissal of the Health Officer and the Board of Health members being charged with a misdemeanor criminal offense punishable by a fine. Most of the statutory obligation falls under environmental health, although communicable disease control falls under public health. Environmental Health Specialist Gwen Howard reported on the food program. She stated that providing education on the laws and regulations is the key to protecting public health and safety. Copies of the laws and regulations are given to the public to make them aware of the requirements they must follow. Enforcement may be necessary in some situations, but it is a long process. If the public is not educated on why the regulations exist, then enforcement does not do much good. She reported that the Health Department has issued approximately 300 food service permits. The E-Coli outbreak in 1993 showed the general public why it is necessary that Health Department's enforce public health safety regulations. The Health Department is required to inspect food service establishments at least once a year, however, some food service establishments are inspected 8 to 10 times a year, as they are in violation of food services regulations and need more education than others. If there is no improvement after several inspections, the food service establishment must pay a fee for reinspection. She noted that money and education work well to bring about compliance. Ms. Howard stated that food service establishments are not always the cause of foodborne illnesses. She reported on an incident which occurred this past summer where several individuals had reportedly eaten raw oysters in Jefferson County and became sick with diahrea and severe stomach cramping. While the Health Department does not recommend eating raw oysters, it was never believed that it needed to be advertised. This was the first year that the Health Department had experienced this type of outbreak and after talking with Dave Christensen who manages the shellfish program, it was agreed that the Health Department should publish a press release on the matter. There were only a few more calls received after the press release. Gwen Howard believes that the public educated themselves by word-of-mouth and reading literature. Member Buhler asked if there is some type of communication mechanism between agencies to share this type of information? Gwen Howard replied that she contacted the State in order to share the information and was told that the individual in charge of press releases was out of town. Larry Fay added that a large number of these types of cases are reported to the State every year. According to State standards, the number of reported incidents may not have been alarming, however, the majority of the cases reported originated in Jefferson County. This concerned the Health Department since Jefferson County has the highest recreational shellfish activity in the State. HEALTH BOARD MINUTES - OCTOBER 16,1997 Page 3 Member Shoulberg asked if signs are posted on all the beaches in Jefferson County advising of the shellfish problem? Larry Fay stated that the County did not post signs, however, late in the summer the Department of Ecology closed all the recreational beaches in Jefferson County to shellfish harvesting. Signs are posted when the beaches are closed, however, no general signs are posted. Larry Fay noted that the Health Department has applied for additional grant funding for 1998 to expand the outreach and education on the risks of shellfish harvesting. The Board members were provided with the following information which Ms. Howard briefly discussed: . Food Service Newsletter . Foodborne Disease Chart . Foodborne Illness Outbreaks - Washington State by Contributing Factors 1990-1994 . 1997 Food Service Fees . Food Service Establishment Inspection Report A food handling course is offered by the Health Department to managers of local food service establishments. This five-week course provides managers with the skills to train and educate their employees on safe and proper food handling as well as monitor their procedures. The Health Department uses positive reinforcement by giving safe food handling awards to establishments which meet certain criteria. Gwen Howard welcomed any of the Board members to accompany her on a food service inspection. Inform, educate, and empower people about health issues. David Specter stated that the Health Department provides information and education on all of their services. A good example is health education which the Health Department contracts with the schools to provide for students. Hillary Metzger is the staff person which provides the education on behalf of the Health Department. She presented a handout titled "Jefferson County Health & Human Services School Health Program", which illustrates the specific topics she teaches and services she provides. Her area of expertise is in Comprehensive Sexuality EducationlHealth Education. She reported on a grant program, which is outside of school activities, called S.H.A.R.E. or Start Helping Adolescents Reach Each other. It is a program where high school students are mentors for middle school students. This program is being evaluated by the Washington Institute of the University of Washington to see if it makes a difference in the formation of attitudes about health decisions. Hillary Metzger conducted a demonstration which she uses in teaching students about the different influences family members, teachers, and friends have on their lives. Students are influenced by many relationships and some influences are more positive than others. She stated that the evaluation of the S.H.A.R.E. program only includes the middle school students. It is her belief that the high school students also gain a great deal by this program because they get the satisfaction of helping others. She asked the Washington Institute if she could design a method to evaluate and get feed back from the high school graduates who had participated in this program. Evaluation forms were sent to several individuals and the responses and comments she received were very positive. While it may be difficult to evaluate what students get out of these types of programs, the Health Department attempts to make it a pleasant learning experience. Hillary Metzger also discussed her efforts over the past three years in getting a sexuality education course provided for students in the Quilcene School District. While she does not know at this point if she will be teaching a sexuality education course for the Quilcene School District this year, she will be teaching a course on H.I.V./A.I.D.S. education which is mandated by the State. She added that the students in Quilcene are very interested, respectful, responsive and healthy. HEALTH BOARD MINUTES - OCTOBER 16,1997 Page 4 Jean Baldwin stated that this orientation is only highlighting certain areas that the Health Department deals with. She feels it is important to mention some other programs that the Health Department offers: A child abuse/neglect prevention and education program which deals with schools and parents; a parenting education program which includes providing information and education at high schools for parents of teenagers, at the Health Department for the breast feeding tea group, at the Baptist Church for non-breast feeding mothers; a tobacco use prevention and cessation program which deals with the schools; a Women, Infant and Children (W.I.C.) nutrition program which provides free food packages along with nutrition education; an H.I.V./S.T.D. prevention program; a substance abuse prevention program which deals with at-risk youths; and family planning programs which will be discussed in more detail at a future meeting. Link people to needed health services and assure access to health services. Dennis Langlois stated that in preparing for this meeting he felt that two important areas to discuss are case management for Child AbuseINeglect and H.I.V./A.I.D.S. The Health Department provides case management for many families in various types of situations and then connects the families to resources which can meet their needs and provide support. He presented a handout which is focused on the H.I.V./ A.I.D.S. program and discussed the services the Health Department provides. Member Shoulberg asked what is the biggest issue that the health community is facing in regard to case management. Jean Baldwin replied that the largest case management program, as far as population, is maternity support for pregnant and parenting families. The most complicated case management program is the H.I.V./A.I.D.S. program. Vice-Chairman Harpole asked how many H.I.V. positive individuals live in Jefferson County? Dennis Langlois replied that being H.I.V. positive is not reportable at this time, although being diagnosed with A.I.D.S. is reportable. The State has kept track of the number of affected individuals by County since 1982. The current number ofresidents in Jefferson County diagnosed with A.I.D.S. is 18, however, that number is deceptively low since that does not include the number of people who have moved to this area that are H.I.V. positive or were diagnosed with A.I.D.S. somewhere else. Vice-Chairman Harpole asked ifthe Health Department has an idea of how many residents are H.I.V. positive? Dennis Langlois stated that the Health Department is working with approximately 7 individuals and families, however, he knows there are more individuals out there that are H.l.V. positive that manage their care independently. In addition, the Health Department tries to reach, test and treat the higher risk groups which may be H.I.V. positive and are unknowingly putting other individuals at risk. Member Shoulberg asked how the case management topics are prioritized? Dr. Locke stated that the topics have been prioritized according to the needs of the community. He believes that it is the role ofthe Board of Health to prioritize these issues. After a brief discussion regarding long term H.I.V./A.I.D.S. care and facilities, Dennis Langlois talked about Health Department services provided for child abuse and neglect. In response to a question posed from Member Shoulberg regarding the health status of the community, Dr. Locke stated that the overall health ofthe community is better than it has been in the past. Jean Baldwin stated that there are a wide array of health issues and some are more difficult to monitor than others. Each issue has a different status, some are better, some are worse. Overall the health status of the community is doing well. INTERAGENCY AGREEMENT REGARDING OCCUPATIONAL EXPOSURE TO HIV and OTHER COMMUNICABLE DISEASES: Dr. Locke explained that this agreement was produced in response to a legislative mandate which states that health jurisdictions and jails will share very specific information on communicable diseases. This originated due to the concern of correctional workers about the exposure of infectious diseases. The legislation began as a bill that required local Health Departments to HEALTH BOARD MINUTES - OCTOBER 16, 1997 Page 5 check all jail inmates for all communicable diseases. The costs involved in such a requirement is difficult to estimate, but would definitely be over $10,000,000 per year, and subsequently the bill was changed. In its present form it only requires the sharing of information available and codifies what is already being done in terms of occupational exposures. Dr. Locke stated that the Sheriff has reviewed and approved the agreement. Member Buhler moved to approve the agreement as presented. Member Westerman seconded the motion which carried by a unanimous vote. ENVIRONMENTAL HEAL TH/G.M.A.: Member Shoulberg asked about the issues dealing with "lots of record". More specifically, can the Board of Health change minimum lot size requirements or does the Board need to follow State standards? Larry Fay replied that from a public health stand point, the Board of Health addressed that issue by adopting policy #97-02. There are other planning decisions that still need to be made and Larry Fay is continuing to participate in order to track the decisions to insure compliance. Member Shoulberg stated that ifbuildout is based on densities outlined in the Health Department policy, then the policy will not be able to stand on its own. Larry Fay replied that he is uncomfortable with the lot size in the onsite sewage standards. This raises questions as to how many waivers will be requested, and in dealing with the mitigations in the waiver process, will they reach some critical threshold. Member Shoulberg stated that the overall concern from a health standpoint, is the weakness in G.MA. in allowing all of this to occur with no accumulative analysis on where this is going. The examination of sewage systems is pre-empted by stating that the health concerns are addressed in this policy. This is not true except on a lot by lot basis. The whole concept of policy making is to find the aggregate. Larry Fay stated that is presumable in the planning arena. Member Shouldberg added that it is a health concern also. Larry Fay stated that there are different thresholds which the Health Department must work with. Discussion ensued regarding the method of evaluating the contamination risk to aquifers and the responsibilities of the Health Department in this regard. After a brief discussion of the status of the Best Management Practices (B.M.P. 's) the meeting was adjourned. The Washington State Association of Local Public Health Officials and Washington State Association of Counties have scheduled a local Board of Health leadership workshop for Wednesday and Thursday, January 21 & 22, 1998 in Olympia. David Specter stated that all the Board members are welcome to attend. The next meeting will be held on Thursday, November 20,1997 at 2:30 p.m. JEFFERSON COUNTY BOARD OF HEALTH (Excused Absence) Glef Huntin ford, Chairman E. Wojt, /', { ~. 01 ~; ,-,/./;'l,,-, ~ Buhler, ~~wber W ~W~ ~ Sheila Westerman, Member mUJfL<!dL,:f;eee Roberta Frissell, Member / (~ Ted Shoulberg, Mem er County Health & Human Services Interagency Agreement The following interagency agreement between the Jefferson County Dept. of Health and Human Services (JCHHS) and the Jefferson County Jail is for the purpose of assuring compliance with ESHB 1605, laws of 1997, and with WAC 246-136-020. I. The sexually transmitted disease (STD) status of a person detained in a jail who has had a mandatory test conducted pursuant to RCW 70.24.340(1),70.24.360, or 70.24.370 shall be made available by the JCHHS communicable disease public health nurse to the Jefferson County Jail health care administrator 2. STD status information is confidential and the release of such information is governed by RCW 70.24.105. Staff responsible for the disclosure or receipt of STD information under the provisions of this interagency agreement will be informed of applicable statutes. In particular, subsection (5) ofRCW 70.24.105 requires that disclosures be accompanied by a statement in writing which includes the following or substantially similar language: "This information has been disclosed to you from records whose confidentiality is protected by state law. State law prohibits you from making any further disclosure of it without the specific written consent of the person to whom it pertains, or as otherwise permitted by state law. A general authorization for the release of medical or other information is NOT sufficient for this purpose." 3. Whenever any member of a jail staff or department of corrections stafi'has been substantially exposed to the bodily fluids of a detained person, the results of any tests conducted pursuant to RCW 70.24.340(1),70.24.360, or 70.24.370, and other information required under RCW 70.24.105( 4)(d)(e) and (t) shall be disclosed to the staff person in accordance with the Washington Administrative Code rules goveming employees' occupation exposure to bloodborne pathogens. Disclosure must be accompanied by appropriate counseling for the staff member Disclosure and counseling will be conducted by the JCHHS communicable disease public health nurse. 4. When a member of the jail staff who has potentially experienced a substantial exposure to a detainee's bodily fluids, the following timelines will be followed: (a) The Jefferson County Jail health care administrator will report the incident of possible substantial exposure to the JCHHS communicable disease public health nurse within one (1) working day of the reported exposure. HEALTH DEPARTMENT 360/385-9400 ENVIRONMENTAL HEALTH 360/385-9444 DEVELOPMENTAL DISABILITIES 360/385-9400 ALCOHOL/DRUG ABUSE CENTER 360/385-9435 FAX 360/385-9401 (b) The local health officer will make a deternIination as to if the reported exposure qualifies as substantial, and if appropriate, order the detained person to be tested for HIV with two (2) working days of receipt of the report in (4)(a). (c) The detained person's previous mandated or other known HIV test results or other communicable disease information will be disclosed within two working days to the exposed jail staff person as permitted by law. (d) The results of a new HIV test done as a result of the exposure will be disclosed to the exposed jail staff person as permitted by law within one(l) working day of receipt of test results. (5) Denis Langlois, PHN is responsible for submitting to the Department of Health (pO Box 47840, Olympia, WA 98504-7840) by December I, 1997 a report to include: (a) The number of negative, positive, and other HIV test results disclosed to the Department of Corrections health staff or local jail health staff as required by RCW 70.24.105 (4)(a) and (b); (b) A listing, without jail staff or detainee identifYing information, of the requests for determination of substantial exposure, the circumstances of the exposure, the deternIination made, the information disclosed to the exposed jail staff person from existing records, and information disclosed to the exposed jail staff person from new testing for HIV or other STDs. Completed copies of the attached "Substantial Exposure Tracking Form For Jail Staff' submitted to the Department of Health will be sufficient for this listing. / , - < d" . 0,/ .' ". ..-. . ./ )/ /t..., .... ._ / . - .//'''~~., -< . '.:../- , . "f:.. Glen Huntingford ;' / Chair, Jefferson Cofutty Board of Health . /7. Vi Date ~. .. . y~ Pete Piccini Sheriff, Jefferson County It). lO- 97 Date ~-~~~ 'O('IP{Cf7 Date Thomas Locke, MD, MPH Jefferson County Health Officer