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HomeMy WebLinkAbout03 March =-' County Health & Human Services HEALTH BOARD MINUTES MARCH 22, 1994 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 1. Peter Geerlofs, M.D., Hea I th Offi cer 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 Richard Wojt, Larry Fay, David Specter, Jean Baldwin, and Chester Prudhomme. Commissioner Glen Huntingford arrived shortly after the meeting began. DIRECTOR'S REPORT FINANCIAL REPORT: David Specter reported that 16.8% of the budget was expended and 11.4% of budgeted revenues have been collected as of February 28, 1994. Revenue is down slightly due to taxes which have not been received. Federal and intergovernmental grants are under budget as a result of billing schedules. The State holds the December payments on the Consolidated Contract until they receive a final report from the Health Department. The final report will be submitted sometime this week. Fees are ahead of what was projected. Bob Sokol asked about the $57,000 variance in expenses verses revenue. David Specter stated this variance was not budgeted but $25,000 was anticipated to be over budget as a result of the union settlement for their department. In addition, the contract with city of Port Townsend was $12,000 short. Some adjustments were made with grants totalling $8,000. At the beginning of the year the Health Department had a $58,000 reserve fund balance. If the Health Department was unable to impact the $57,000 during the year it would deplete the reserve fund. David Specter stated they will carefully manage expenses and maximize revenues. 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 - MARCH 22,1994 Page 2 PROGRAM/GRANT UPDATE: The Health Department will be closing their offices and holding a workshop on Thursday, March 24, 1994 to get some input from staff on the Public Health Improvement Plan. The Health Department received the grant from the Federal Center for Disease Control to establish an information network within the State. Their goal is to connect all local Health Departments and the State Health Department electronically with CDC in Atlanta. They met representatives from the Center for Disease Control on Monday, March 21, 1994. Jefferson County's computer administrator Shawn Huey was also present. The representatives were very impressed with the system in place and with the work Shawn has done in setting up the communications system. David Specter reported on three grants that will be put on the Board of County Commissioners agenda for approval at a future meeting. The first is the renewal of the Child Abuse Prevention grant for $10,000 from the Washington Council for the Prevention of Child Abuse and Neglect. The second grant is coming from an imposed tax on tobacco. Jefferson County's share of these taxes is $6,000 which will be used to prevent the use of tobacco by minors. The Solid Waste Enforcement grant is the third one. Larry Fay explained that the enforcement grant funds a part- time employee to deal with solid waste matters such as permitting and inspection of existing facilities, as well as nuisance complaints and unauthorized dumping. NURSING DIRECTOR'S REPORT BLOOD BORNE PATHOGEN TRAINING: Jean Baldwin reported on the Blood Borne Pathogen training mandated by OSHA and WISHA. The initial four hour training took place last year for City and County employees. The cost of this training was shared by both the City and County who each paid $1,000 for someone to come from out of State to conduct it. This year, employees are required to take a two hour refresher course. This refresher course will be given in-house by the Health Department to reduce costs. It will take place on Thursday, April 21, 1994. Jean Baldwin stated she is trying to determine how she is going to bill the City and other County departments for the reimbursement of costs incurred by the Health Department. The Health Department provides a lot of free services for the County such as TB testing at the jail and flu vaccines. These free services have an impact on the Health Department's budget. Chairman Hinton asked what the Health Department's cost are? Jean Baldwin replied she is still working on the printing costs but feels they could take a loss and charge each department $6.00 or $7.00 for every employee they send. She would like some direction from the Board on how to proceed with the billing, whether or not to charge each department, or charge the County in general. Commissioner Wojt stated it would be easier if the County paid for the training in one lump sum rather than trying to bill all the different departments. The Board agreed that would be the best way to handle it. MANDATED WISHA TB TESTING AT COUNTY JAIL: WISHA has now mandated that TB testing be conducted in jail and drug/alcohol treatment facilities. WISHA can only mandate that employees be tested, so the jailers were all tested for free. The Health Department billed the employees insurance companies, however, if payment is denied by the insurance companies they will submit the bills to the Sheriff's office since it is mandated they have this testing. Clients of the Human Services Drug and Alcohol Division are billed on a sliding scale. If it becomes mandated that the jail inmates be tested, they will also be billed on a sliding scale based on their income. Testing would only have to be done on the inmates that are there for a long time not for ovemighters. HEALTH BOARD MINUTES - MARCH 22, 1994 Page 3 PROPOSAL FROM GRACE LUTHERAN CHURCH: The Board reviewed a letter from Grace Lutheran Church that was sent to other medical providers in the community. Jean Baldwin reported that the group had a very successful meeting with Clallam/Jefferson Community Action Council (C.AC.). C.AC. is willing to be the umbrella agency for the clinic, thereby solving some of the issues around malpractice and non-profit set-up. David Specter stated that this is exactly what the Health Department wanted to see get done. Chairman Hinton asked if the use of the emergency room at the hospital was still an option, since the Board would prefer they utilize the Hospital rather than the Health Department facilities? David Specter stated he is not sure if they are pursuing that, but that might be some of the responses they get from other medical providers. It would make a lot sense for them to use the Hospital since they have back- up facilities that the Health Department doesn't have. FAMILY PLANNING/COMMUNITY CONCERNS: Jean Baldwin stated tbat the Health Department contracts with Clallam/Jefferson Family Planning. They receive Federal and State funding to serve Jefferson County women. There have been structural and situational problems in the past and meetings have been held with them to go over the problems. Several letters have been received from a community group that began from Family Planning volunteers and Board members expressing their dissatisfaction and feelings that the services are inadequate and improper. The Health Department has met with Family Planning and the Community Board and agree with the analysis of the community. The troublesome issues have to do with management, systems, comprehensiveness, and quality. The Health Officer Dr. Peter Geerlofs has been advised of the issues and is concerned, although no policy statement or commitment has been made. The Heath Department scheduled a meeting with the State Family Planning Coordinator, ClaIlam/ Jefferson Family Planning, the Community Board and one citizen representative to outline the issues. If improvements are not made then the Health Department will need to look into other alternatives. Family Planning is no longer just reproductive health. It needs to be connected with HIV and STD treatment. Clallam/Jefferson Family Planning is only able to provide reproductive health. The Health Department wants Family Planning to be a successful program and they will work with them in addressing the problems. ENVIRONMENTAL HEALTH DIRECTOR'S REPORT QUILCENE WATER PROBLEM UPDATE: Larry Fay stated there have been reports of gasoline in wells located in Quilcene. Tbe Health Department has conducted random samplings in Quilcene. The preliminary results did not show any contamination and the second sampling of neighboring wells showed no contamination also. At this point it looks as though the contamination is confined to the original defined area. The gasoline source has not yet been found. The Department of Ecology is concerned that the source may never be found since there are many gasoline tanks in Quilcene. It used to be common practice for people to have gasoline tanks on their property to keep fuel for their farm equipment. The lab report of the sample taken from the contaminated area has been forward to the toxicologists at the State Department of Health. They are reviewing the report to determine if the concentrations are high enough to be a potential exposure problem just by breathing the air in the household. They are very concerned since the problem is affecting four households, two of which children reside. The toxicologists will be making some recommendations the beginning of next week. HEALTH BOARD MINUTES - MARCH 22,1994 Page 4 The Health Department, Department of Ecology and the State Department of Health have been discussing short and long term solutions to this problem. One suggestion was that the Health Department look into temporary water line connections from the Presbyterian Church to the four contaminated houses. Any drinking water regulations and requirements would be waived to get these people on good water. For the long term they are looking into potential grant sources for the development of a water supply. Timber Impact funds may be available and the Department of Ecology thinks there may be some funds available from the Model Toxic Act for cleanup. It is unclear how quickly the funds can be received. The well at the school is also being considered for an alternate water source. The Health Department is doing its best to keep the community updated on new information as it is received. There is a community meeting next week to discuss the plan they are working on. At some point there will be a meeting with the community and the State Department of Health to discuss the toxic risks from contamination. An individual who resides in the household with the highest concentration of contaminated water has been having health problems for quite some time. It is not known if his health problems are related to the contamination, however, his physician has asked to meet with the State toxicologist to conduct some testing. NEW STATE ONSITE SEWAGE REGULATIONS/IMPLICATIONS FOR JEFFERSON COUNTY: Last week the State Board of Health adopted the revised onsite sewage regulations. As previously reported, this does not mean a lot of changes for the Health Department. Most of the controversial regulations the Health Department has already been enforcing, therefore they will not have major standard revisions. Larry Fay then reported on the following amendments that were adopted into the regulations by the State Board of Healtb: the Health Department is required to note on the face of permits that an applicant has the right to appeal; the regulations delineate a public process for designating areas of special concern; a notice to title is no longer required for non-conforming repairs; the proposed reduction of the required horizontal setback between a drainfield and rain waters from 100 feet to 50 feet was rejected. The regulations will go back to the State Code reviser who will incorporate these amendments. These regulations will go into effect sometime in May. Larry Fay stated the existing Onsite Sewage Ordinance will have to be amended to reflect these changes. This can be done as an amendment or the entire regulation can be revised and updated. He recommends doing an amendment referencing the revised Onsite Sewage Regulations, taking out language and earlier references that are obsolete and adding the chapter with language on designers, installers and pumpers. NEW BUSINESS: Larry Fay briefly reported on a food borne outbreak at the Inn at Port Ludlow. The Seattle City Council held a retreat there and everyone who attended ended up sick. The Health Department found out about this through the Seattle paper and by that time several days had gone by and there was not much to investigate. The Environmental Health Specialist did observe some problems with temperature control and hand washing. This outbreak raised awareness and resulted in two of the managers enrolling in the certification program through the Kitsap County Health Department. Chester Prudhomme reported that the prevention worker is working on the Community Mobilization Against Substance Abuse grant. This grant requires doing a risk indicator survey of the County to find out the most important factors to target. They have applied for this HEALTH BOARD MINUTES. MARCH 22, 1994 Page 5 grant two years in a row and have not received it. It tends to go to the larger Counties. Last year there was $710,000 that went to the 11 of the largest Counties in the State. So a concerted effort is being made to get some of these funds. According to the surveys that have been received, family management is considered to be the biggest problem. This grant for $14,000 will be used for programs that will help people improve their parenting skills. Part of these funds may go to some people in the West End who never receive any services from the Substance Abuse Department. He then reported on how the funds received from the Tobacco grant will be used. APPROVAL OF MINUTES: Commissioner Wojt moved to approve the minutes of January 25, 1994 as presented. Commissioner Huntingford seconded the motion which carried by a unanimous vote. ELECTION OF CHAIRMAN: Commissioner Wojt moved to nominate Commissioner Hinton to serve as Chairman for another year. Commissioner Huntingford seconded the motion which carried by a unanimous vote. The next meeting will be held on Tuesday, April 26, 1994 at 1:30 p.m. MEETING ADJOURNED Dear Dr. . ({;,;t';tcs: Lv~1'I J1) I Cd~1HUVIV, ,'"/ CZ--fnJ/C .J" '1. - I am writing to you to seek your reactions to a proposed effort to help meet some of the medical needs of people in East Jefferson County. A committee consisting of representatives of local churches as well as other intereSted members of the community has been meeting over recent months to consider this problem. We are now contacting the physicians in Port Townsend to inform them concerning our efforts and to soUcit their suggestions for our program. We understand and appreciate your willingness to care for people in need despite their ability to pay. We are concerned, nonetheless, that there remain members of our community who do not access care for their medical needs. In studying this problem we have given considerable attention to the establishment of a medical service to meet these needs. We anticipate that this service will be open for three hours on Saturday morning of each week. We are investigating the possibility of using some of the facilities of the County Health Department as the location of the service. It is our intention that our service would not provide continuing care. Basically the clinic would provide one time treatment for persons with relatively simple problems and would endeavor to help persons with more serious and/or chronic problems to receive the needed attention within the established medical and community system. We are very interested in hearing your thoughts regarding our proposal for a Saturday morning service. I would like to meet with you briefly to answer any questions you might have and to seek your suggestions and support which will contribute to meeting these unmet medical needs. I have enclosed a copy of our Mission Stateinent for your information. I will phone your office to schedule a meeting at your convenience, or to seek a time when we might speak: on the telephone. Thank you for your continuing work in our community. I look forward to talking with you. Yours truly, Elaine Beckman Clinic Manager cc: Mission Statement @6{Id/ """. -4 ., J.C. MASH* A not for profit board will be established to operate a medical service to meet limited, immediate medical needs of people in East Jefferson County who might not otherwise access medical care. The service will, as appropriate, act as advocate for those individuals and promote integration into established community and medical services. (Jefferson County Medical Advocacy & Service Headquarters) Human Services Ellin Larimer PO Box 54 Nordland WA 98358 (f)ch~ Dear Ellin: I understand that you represent a group of East Jefferson County residents that are interested in improving and expanding family planning services in our community. I also understand from Wendy Foster, that your group has expressed dissatisfaction with Clallam-Jefferson Family Planning Service in meeting the needs for family planning services and teen pregnancy prevention/ education in East Jefferson County. I would like you to know that we appreciate your interest and share your concern about the adequacy of family planning services. As you may know, family planning is one of 11 basic personal health protection services provided by Jefferson County 'Health Department pursuant to State guidelines for public health. We have contracted with Clal1am-Jefferson Family Planning Service to provide this service. We feel that significant progress has been made in recent years, particularly in regard to hours of operation and waiting list reduction. However, there are still improvements that need to be made. We are especially concerned about the rate of teenage pregnancy and have identified this issue as one of the top 15 public health priorities in Jefferson County. Ellin, I would like to suggest a meeting among your core group, our Director of Nursing (Jean Baldwin), our Health Officer (Dr. Geerlofs), Wendy Foster and myself to discuss your concerns and to get your input regarding community needs. We want to provide the best services that we can with the resources we have available. We are interested in the community's perception of the service and any suggestions on ways that it might be improved. I believe we have common goals and share a common concern that we not fragment services nor compromise continuity of care. HEALTH DEPARTMENT 206/385-9400 ENVIRONMENTAL HEALTH 206/385-9444 DEVELOPMENTAL DISABIUTIES 206/385.9400 ALCOHOL/DRUG ABUSE CENTER 206/385-9435 FAX 206/385.9401 Health & Human Services March 4, 1994 Wendy Foster, Executive Director Clallam-Jefferson Family Planning Services 1215 E. First Port Angeles, WA 98362 Dear Wendy: I have received the enclosed letter from Barbara Mason, also copied to you, summarizing the concerns that were discussed in our meeting with the East Jefferson County family planning group last MOnday. For our meeting with you on March 22, I would appreciate it if you would be prepared to discuss questions one, two and three in Barbara's letter. specifically, we are interested in knowing: (1) whether you agree with these issues; (2) what specific actions your agency is prepared to undertake to address the issues; and (3) the timeline for implementing these acti9ns. We would also appreciate your thoughts on the needs of older women, noted in question four of the letter. Do you agree that this is a significant unmet community need? If so, how we might we best serve this population and how would the services be funded? pam Hayes, from the State Department of Health Family planning Office, and Dr. Geerlofs both plan to attend the March 22 meeting. We have also invited Barbara Mason to attend the meeting in her capacity as East Jefferson county's representative on the Clallam- Jefferson Family planning board and as a communication link with the community group. I look forward to seeing you on March 22, at 3:00 p.m. sincerely, specter cc. Jean Baldwin Peter Geerlofs, M.D. Barbara Mason Pam Hayes HEALTH DEPARTMENT 206/385-9400 ENVIRONMENTAL HEALTH 206/385.9444 DEVELOPMENTAL DISABIUTIES 206/385-9400 ALCOHOL/DRUG ABUSE CENTER 206/385.9435 FAX 206/385-9401 r- RECei\icD - , r i - 4 \ i I l'H0E1'T. 24 Wellington Court Port Townsend WA 98368 March 2, 1994 David Specter, Director Jefferson County Health Department 615 Sheridan Port Townsend WA 98368 Dear Davi'd: Our family planning group appreciated the time you and your staff were able to give us for the Monday meeting. I regret I had to leave early. I am recapping a summary of our concerns, as discussed in the meeting: 1) Insufficient nurse practitioner hours to meet the county's family planning needs. 2) Insufficient receptionist hours to make appoint- ments, send out billings, and help the clinic manager with other paperwork. 3) Making appointments through Port Angeles is not working. We need to make appointments through Jefferson County Health Department for file refer- ence, information calls, cancellations, etc. 4) Many older women seen at the clinic have no need for family planning services, thanks to tubal li- gation or spouse's vasectomy. Some need a GYN exam to get an estrogen prescription, and can't afford a doctor visit. Many women prefer a female nurse practitioner. While federal family planning funds are not available for women over 52, we'd like to see this unmet community health need fulfilled through the Health Department. (The Baby Boomers are comi ng! ) 5) While this seems to be resolved, a major frustration in the past was the lack of desks and rooms for re- ceptionists, counsellors, and nurse practitioners. The musical chairs atmosphere looked unprofessional and disorganized to outsiders. We have a group of eastern Jefferson County women interested in family planning and women's health care issues. We'll continue to meet, usually monthly, and would like to have representatives serve as an advisory board to your depart- ment. We'd be prepared to meet with Jean, Carol and you on any scheduled or as-needed basis you suggest. Thanking you again for your time and interest, we will look forward to hearing from you by April 1. Sincerely, '1 ~~..~5-h? Barbara Mason cc: Wendy Foster Roberta Frissell Jan Marts Jean Laskey Robin Rickman Jane Rogers Pat Scott Virginia Wolf ^"'~, . ~/ .J^" .y. \'- f-/ 24 Wellington Court Pt. Townsend, WA 98368 March 13, 1994 Wendy Foster, Executive Director Clallam-Jefferson Counties Family Planning Services 1215 East First Street Port Angeles, WA 98362 Dear Wendy: I am submitting my resignation from the Board effective Apr 11 1, 1994. Over the past year I have felt increasing frustration at- tending board meetings. I realize Clallam County has the greater population, but I felt Jefferson County's problems were not being addressed, by either the board or Jefferson County Health and Human Services. As you know, a group of people here formed to try to look into and resolve some of the problems. We never intended to be threatening to any individual or group. Our sole intention has been to improve family planning and women's health services in Jefferson County. When I was to be out of state last week, Pat Scott volun- teered to make the two hour early morning trip to attend the March 8 board meeting. (I had advised you 1 would be away, and you indicated someone else from our group could attend, without voting rights.) Pat attended in a spirit of cooperation and information sharing. I was shocked to learn of the rudeness and name-calling to which she was subjected. "Bible-thumping fundamentalist" is a solid one hundred and eighty degrees from our position. I feel I have nothing to contribute to the board with the current alienation. I hope we can continue to cooperate through Jefferson County Health and Human Services. 1 wish Clallam County well in family planning efforts. Sincerely , ~ Barbara M son cc: David Specter Judy Tozzer