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Home My WebLink About07 July r---..// r -..-~ ,.' .~( 4 "'1'~4. :~~ ,: . :~'~ /04"I;n.- if. k~'" - "ft:1 C ~~. ~:,' , ~I .. It: l~~! ~ ' ~ _11~~~~t!~~. k-..{)~ ""t~- ~_:;...~_ __-e. JEFFERSON COUNTY COURTHOUSE NATIONAL HISTORIC SITE PORT TOWNSEND, WASHINGTON Jefferson County Board of County Commissioners P.O. Box 1220 Port Townsend, Washington 98368 Phone (206) 385-9100 . 1-800-831-2878 ROBERT H. HINTON, DISTRICT 1 GLEN HUNrlNGFORD, DlsrRICT 2 RICHARD E. wOJr, DISTRICT 3 HEALTH BOARD MINUTES JULY 27, 1993 BOARD MEMBERS: STAFF MEMBER..C;; CITY OF PORT TOWNSEND REPRESENTATIVE: Norma Owsley Larry Fay, Director of Environmental Health David Specter, Administrator Jean Baldwin, Director of Nursing Services J. Peter Geerlofs, M.D., Health Officer Chesier Prudhomme, Director of Substance Abuse Robert Hinton, Chairman Richard WO.it, Member Glen Huntingford, Member The meeting was called to order by Chairman Rohert Hinton. The following Board and Staff members were present: Commissioner Richard W~it, Commissioner Glen Huntingford, Larry Fay, David Specter, Jean Baldwin, Chester Prudhomme and the representative for Port Town~end Norma Owsley. APPROV AL..~F.JIUNUTES: Commissioner Huntingford moved to approve the Minutes of June 22, 1993. Chairman Hinton seconded the motion. The motion carried. PUBLIC COMMENTS: Jerome Pames, ARNP, complimented the Health Department on the job they do in writing grants to bring money into the community for health care. He stated he wants the Commis.~ioners to be aware that this is a real asset and very positive. He also commented on the proposal from Grace Lutheran Church and Dr. James K. Rotchford. He stated he is not against a low income medical clinic and feels Jefferson County is in need of one, however, he has the following concerns: The County's liability; .. \..1 100% Recycled Paper HEALTH BOARD MEETING MINUTES - JULY 27, 1993 Page 2 quality of care for short visits averaging 5 minutes; separation of church and state (religious philosophies entering into issues of sexually transmitted diseases and abortion counseling); will a certain percentage of the profits go to the Health Department for the use of the facilities or will the County be subsidizing the clinic; protection for the Health Department if supplies or equipment are damaged; the fact that the clinic will not have a telephone; and the fact that the clinic will not keep files on patients which is very important in order to insure continuity of care and track medical histories. ADMINISTRATOR'S REPORT FINANCIAL REPORT: David Specter reported that he would answer any questions the Board may have on the financial reports. (See attached) PROGRAM/GRANT UPDATE~. On September 1, 1993 the Health Department will submit the annual grant application to the State Department of Health. This is the major grant that funds the public health activities throughout the State. It is an intensive process that includes work statements and projections. He feels it is a good exercise to go through as they put together their budget for submission to the Board. 1993 GOALS/STATUS REPORT~ David Specter presented a list of the Health Department's goals and reported on each item. Health & Human Services Consolidation/Integration: Earlier this month the Human Services Department moved into the space at the Health Department. The move went smoothly but has been difficult emotionally for some. Storage is now a bit of a problem with boxes stacked as high as possible and a desk having to be left out~ide. Complete APEX Planning Process/Adopt Community Health Plan: APEX is now called PHIP (Public Health Improvement Plan). Commissioner Wojt and Commissioner Huntingford are now being sent the materials for each meeting. Everyone participating has done good work but this process has been slow. There are concerns about getting everything accomplished by the next meeting. Commissioner Hinton suggested having a follow-up meeting after this next one. The participation of the schools has not been what was hoped for and there has not been any participation from law enforcement. Implement One-Stop Permit Center: There are some procedural issues that need to be worked out at the Permit Center. Staff will be holding a meeting tomorrow regarding changes to the records keeping process. Customers seem to be generally pleased with the Permit Center. It has brought short term planning, the Health Department and Building Department together as far as understanding what department regulates what and has provided everyone with a better perspective of the "big picture". The goal is to become less departmentalized and be able to answer a broader array of questions. HEALTH BOARD MEETING MINUTES - JULY 27, 1993 Page 3 Implement Women's STD Program: This program has been operating since February. There is a potential revenue problem since $10,000 has not been received from the City of Port Townsend. If funding is not forthcoming from the City, a decision will need to be made whether or not to continue this program. Norma Owsley reported that the Health Department initially requested the funding for the continuation of exisiing programs not to fund new ones. Since the City did not hear back from the Health Department they put the earmarked funds back into the general fund account at budget time. David Specter stated when he put the budget together last fall it was the Health Department's understanding that $10,000 was to come from the City to go toward regional program~. Commissioner Hinton stated it doesn't matter if the $10,000 from the City was going to be used for current regional programs or for the STD program, because all the regional program funding goes in the satne pot. Norma Owsley siated the City knew nothing about this and the money wa~ put back in the general fund. Commissioner Huntingford stated the Commissioners had lunch with Mayor Clise earlier this year and he said during the discussion of regional service.~, that the City was holding the $10,000 until the County decided how the program funding was going to be used. Norma Owsley stated she will talk to Mayor Clise at their meeting tomorrow. She went on to ask if the number of individuals that are treated make.~ the program worthwhile? Jean Baldwin reported that 11 different individuals are seen each month, some negative, some positive. They feel that is quite a few people for a small county and that it is an important public health issue. Even one case would be significant in terms of the potential for spreading. Norma Owsley stated that some sort of number needs to be applied to fit the amount of funding. Information on the number of positive ca~s will be put together for next month's meeting. Policy Development/Revisions: The Environmental Health policies are almost complete. One area that needs to be worked on is the Designernnsialler licensing program. The Ordinance states that a person must be a licensed designer or licensed installer in order to do septic systems, however, there are no procedures on how people will be tested and evaluated and what penalties there will be. The Health Department didn't want to develop any policies until there was a ruling on the Engineer's lawsuit against the State Department of Health, since the policies could be pulled by the Courts. The Judge ruled that the State Department of Health and local Health Departments do not have authority to require licensing of engineers, or the authority to license people to do engineering practices. However, the Judge did not rule on whether designing septic systems was a practice of engineering. With this ruling the Health Department will continue licen~ing and will use models of other Counties to put together some procedures. Another area that needs to be looked at is the procedure for issuing building permits for remodels or additions where there are older unpermitted septic systems. Discussion ensued regarding well drilling policies. HEALTH BOARD MEETING MINUTES - JULY 27, 1993 Page 4 Computer/Information Systems Enhancement and Integmtion: Four computers are now linked with the Courthouse system. They are continuing to work on the billing information system and once they are up to speed on the capabilities of the system, extracting the statistics from the data will be relatively easy. Support Staff Cross-Training: The cross-training of support staff is going well. The goal is to have all the support staff cross-trained to work in any position in order to move people around to suit the needs of the Health Department. Now that Human Services is moved in they will cross-train in their programs as well and hopefully even the Permit Center in order to form a network of support for each other. County Health Benefits Strategy: This is moving along and they will be coming up with some recommendations. Discussion continued regarding the Health Department providing medical care for County employees in order to cut health care costs. URGENT PUBLIC HEALTH NEEDS: David Specter reported that the State allocated ten million dollars statewide for urgent public health needs over the next two years. Jefferson County's share will be approximately $44,000 which started July 1, 1993. He sat on a committee, at the State level, which is developing procedures for receiving and spending the funding. The c01L~olidated contract with the State Department of Health will be the mechanism for receiving the funding. The Health Department will receive $11,000 for the remainder of 1993. He presented to the Board the list of priorities identified by the State committee which will form the basis for the guidelines on how to spend the funding. He noted that this may seem similar to the Public Health Improvement Plan process, however, this is completely separate and both will be funded separately. The Health Department identified communicable diseases as the urgent need locally and recommends using the money in three specific areas: 1) developing a regional certification progrd1tl for restaurant managers, 2) increasing the hours of the food service employee and 3) increasing the hours of the communicable disease nurse. This can be done within the funding available with some funding left over. Larry Fay provided some background information on the recommendations made and welcomed any suggestions from the Board. Discussion e1L~ued regarding communicable diseases in Jefferson County. DIRECTOR OF NURSING'S REPORT IMMUNIZATION UPDATE: Jean Baldwin presented an outline of information on immunizations and the immunization program. She reported they are supposed to be targeting children 2 years of age since they are the most likely to have an outbreak of measles or pertussis. Jefferson County has one of the lowest percentage ratings of immunized individuals in the State so a great deal of effort is going into this program. rate HEALTH BOARD MEETING MINUTES - JULY 27, 1993 Page 5 PROPOSAL FROM GRACE LUTHERAN CHURCH~ Jean Baldwin has talked extensively with the Reverend of the Grace Lutheran Church regarding their proposal. He wants to resubmit a plan based more on community clinics. There are community clinics that exist throughout the State, and using their model for charting, safety, malpractice, staffing, etc., he will resubmit the plan to the provider to see if he would still be interested. She stated the Health Department has a lot of the same concerns that Jerome Parnes (see public comments) mentioned and she feels this would make the proposal more clear. ENVIRONMENTAL HEALTH DIRECTOR'S REPORT Larry Fay stated he already presented his report along with the Administrator's report. Commissioner Huntingford asked about the solid waste complaint in Chimacum. Larry Fay reported there have been several complaints and the Health Department has sent notices of violation and done ins'peCtions. He clarified that these arc piles of junk, not garbage. There is not a problem in terms of odor or flies, but there is a problem in terms of general unsightliness and probably a situation of harboring rodent~. This problem is not clearly defined in law as a public health nuisance but Larry Fay will talk to the Prosecutor to see what type of action can be taken. The next meeting will be held on August 24, 1993 at 1:00 p.m. MEETING ADJOURNED JEFFERSON COUNTY BOARD OF HEALTH ( '-. Jefferson County Health Department BUDGET REPORT: EXPENSES July 1,1993 ABC ,---------l ~--~ ,-------, I 1993 YTD, I I Operating J Budget : Expended I i Budget , (50% X A) . .~.!D D YTD% Expended (1 )Salaries & Benefits $842,268 $416,532 $401,011 47.61% (2)Professional Services 58,541 $28,951 28,932 49.42% (3)Office Supplies 3,360 $1,662 11,011 327.70% (4)Operating Supplies~ 67,076 $33,172 27,595 41.14% (5)Equipment 6,120 $3,027 7,630 124.67% (6)postage 5,000 $2,473 2,629 52.57% (7)Telephone 20,060 $9,920 1,180 5.88% (8)Travel 10,400 $5,143 7,579 72.87% (9)Advertising/Printing 3,000 $1,484 498 16.60% (10)Training 6,400 $3,165 2,124 33.19% (11)Leases & Maintenance 140,856 $69,658 90,036 63.92% $1,163,082' I $575,1851 Lts~22~ I 49.9%1 * IncJuding Vacdne A:19305BSRE. WKI 07(2t/93 .' Jefferson County Health Department BUDGET STATUS REPORT: REVENUE July 1, 1993 I B~~ET.--- ~:I ~ 50% AC~~ ~ I i i 1993 ! BUDGET GRANTS 1. Federal* 2.State* 3.1ntergovernmental $100,341 111,866 97,907 $49,896 55,627 48,686 $154,210 $51,136 49,683 53,409 $154,208 51.0% 44.4% 54.6% Total Grants $310,114 49.7% FEES 4.Nursing Fees $248 ,628 $123,635 $125,586 50.5% 5.Environmental Health Fees 162,350 80,731 82,921 51.1% 6.Vital Records Fees 1,948 968 1,967 101.0% 7.Donations 500 249 0 0.0% 8.Miscellaneous Fees 560 278 3,878 692.5% Total Fees $413,986 $205,862 $214,351 51.8% TOTAL REVENUE $368,560 I I 50.9%1 $724,099 i ~60,O?.1J I * Including Vaccine A.:\9306BSR.R.WK.l 21-1u.1-93