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Home My WebLink About08 August -==-- ~~~~ County Health & Human Services HEALTH BOARD MINUTES AUGUST 24, 1993 BOARD MEMBERS: STAFF MEMBERS 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 Chester Prudhomme, Director of Substance Abuse 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 Richard Wojt, Commissioner Glen Huntingford, Larry Fay, David Specter, Jean Baldwin, Chester Prudhomme and the representative for the City of Port Townsend, Norma Owsley. APPROVAL OF MINUTES: Commissioner Wojt moved to approve the minutes of July 27, 1993. Commissioner Huntingford seconded the motion which carried by unanimous vote. ADMINISTRATOR'S REPORT FINANCIAL REPORT: David Specter reported that he would answer any questions the Board may have on the financial reports through the end of July. (See attached) He explained that expenditures and revenues are tracking as expected. Commissioner Huntingford asked if he knew of any large expenditures in the near future? David Specter stated that he was not aware of any. HEALTH DEPARTMENT 206/385-9400 ENVIRONMENTAL HEALTH 206/385-9444 DEVELOPMENTAL DISABILITIES 206/385-9400 ALCOHOLJDRUG ABUSE CENTER 206/385-0650 FAX 206/385-9401 Health Board Minutes - August 24, 1993 Page: 2 ADMINISTRATOR'S REPORT - Continued PROGRAM/GRANT UPDATE: David Specter presented a list of fifty Health and Human Services contracts and agreements that they are req~ired to track, manage and update. His goal is to draft perpetual agreements that will not have to be renewed each year, except for a dollar amount. He reported that the State Consolidated Contract application that deals with nursing must be submitted in September. The school contracts are also being renegotiated at this time. Commissioner Huntingford asked what services the schools received? Jean Baldwin stated that they provide school nursing and some health education needs, but their basic purpose is to meet the school's mandated contract needs. The school contracts are for nine months and total about $18,000. David Specter listed several other contracts that will be coming up within the next few months, which include substance abuse treatment in the West End, the Skookum grant, a water quality grant and a solid waste enforcement grant. Commissioner Huntingford asked about the water quality grant. Larry Fay explained that the Discovery Bay Water Quality Grant will be coordinated by Cooperative Extension, but there will be an !Environmental Health component dealing with failing septic systems. Commissioner Huntingford also inquired about the Water Recreation MOD. Larry Fay explained the Health Department has an agreement with the State to do licensing and safety inspection of public swimming pools and spa facilities in the County. HEALTH IMPROVEMENT PLAN UPDATE: David Specter presented a standardized form that will be used to identify problems and help with ideas that will lead to solutions in the public health improvement planning process. To test the form, they chose one of the problems, communicable diseases, and filled out the form and attached graph. There are 14 other problems that will be addressed in this way. PUBLIC HEALTH SERVICE ACCOUNTS: David Specter reported on the process the State requires to receive Public Health Service Account grant money. There was a discussion about the three areas identified that require urgent attention. Food Services Personnel Education: The present program is a reactive, regulatory program and is funded out of restaurant fees. Gwen Howard, the Environmental Health Specialist that works in this area is a part time employee. Larry Fay explained that the extra funds would be used to make this a full time position. This would allow more time to work on promotion and training. Their plans include: Health Board Minutes - August 24, 1993 Page: 3 . a newsletter that will be sent to licensed establishments in the County . establishing a "Food Service Advisory Group" that would consist of industry representatives who would meet regularly to identify areas where the Department may be weak, find ways to improve sanitary standards in facilities and help identify and work on policy needs when it is necessary . working with other Puget Sound counties to develop a certification program for Food Service Managers . develop a database computer program to track food service establishment compliance Larry Fay added that the funding from the Urgent Needs Program would pay for the extra hours. If funding is eliminated, the position would return to part time. Dav Care and Child Care Facilities Personnel Health Education: Jean Baldwin explained that this would fund a nurse to visit day care and child care facilities to advise licensed owners on preventative health care such as cleanliness, hygiene and diaper disposal. Tuberculosis and HIV/AIDS Case Identification: Jean Baldwin stated that Clallam County has reported a tuberculosis outbreak in the West End. Most of the affected people are members of families of the prison population and migrant workers. The added funding would allow a nurse to visit the West End to do testing for TB and AIDS. At that point, they will be able to work on a solution. David Specter stated that this grant from the Public Health Service Account Fund does not require matching funds from the County. The full amount of the grant is $44,000 over a 22 month period, from 1993-1995. He does not foresee any additional administrative costs or overhead expenses and supply costs should be minimal. He assured the Board that these are short term projects that may not need to be looked at again for five or ten years. Commissioner Huntingford moved to approve the proposed work statements and budgets for the Public Health Service Account Fund and forward the information to the State Department of Health. Commissioner Wojt seconded the motion which carried by unanimous vote. DIRECfOR OF NURSING SERVICES REPORT APPROVAL OF INCREASE IN WIC PROGRAM CASELOAD: David Specter reported that the Federal government has requested that the Department add 60 people to the WIC caseload. Currently, they are serving 40-50% of the potentially eligible clients in the area. They have 450 clients. Their caseload was increased earlier this year and support staff was added. If 60 clients are added at this time, the revenue will increase adding more staff. Jean Baldwin explained how the program works. They have a list of clients they see until their babies are born. If these mothers are bottle feeding, the mothers go off the program, but the babies still receive formula. These women are below poverty level with high nutritional needs after their babies are born. If they are added to the program, they will receive coupons for supplemental food, cheese and milk for an extra six months. Commissioner Wojt moved to approve the increase in the original WIC caseload. Commissioner Huntingford seconded the motion which carried by unanimous vote. FUNDING FROM PORT TOWNSEND: Norma Owsley reported that the Finance Committee had recommended approval of $10,000 to the County for regional services. Health Board Minutes - August 24, 1993 Page: 4 WOMEN'S STD PROGRAM PROGRESS REpORT: Jean Baldwin reported the figures in this report are for the women's clinic only and in past reports she has included the men's clinic figures also. They are averaging one case a week in the women's Clinic, rather than three cases as initially projected. They have made a beginning effort to advertise the clinic, but acknowledge that they need to continue to promote the service. Jerome Parnes, a constituent with an interest in this clinic, asked how many advertisements had run in the newspaper? Jean Baldwin said that three ads had been placed in The Leader. with ads in Clallam and Kitsap County newspapers also. David Specter added that a private citizen had run ads in The Leader. as well. They have also made an effort to have articles written on the service. Jerome Parnes suggested that they obtain a free weekly listing in the Community Calendar section of The Leader. He also suggested mailings to local women's organizations and sending a representative to speak on the subject at meetings in the area. He added that he feels this service should be available to all taxpayers and not just the impoverished. The next meeting will be held on September 28, 1993 at 1:00 p.m. MEETING ADJOURNED Jefferson County Health Department BUDGET STATUS REPORT: REVENUE August 1, 1993 I , ~I ~... ... ..... I ...YTD I r-- / .1993 .. BUDGET · IYTD BUDGET ~% . I. ACTUAL I II GRANTS 1.Federal* 2.State* 3.lntergovemmental Total Grants $100,341 111,866 97,907 $310,114 $58,395 65,102 56,979 $180,476 $59,000 54,517 69,427 58.8% 48.7% 70.9% $182,944 59.0% FEES 4.Nursing Fees $248,628 $144,693 $141,243 56.8% 5.Environmental Health Fees 162,350 94,482 93,444 57.6% 6.Vital Records Fees 1,948 1,133 1,999 102.6% 7.Donations 500 291 0 0.0% 8.Miscellaneous Fees 560 326 12,351 2205.5% Total Fees $413,986 $240,926 $249,036 60.2% 59.7%\ TOTAL REVENUE r$724,099. L$421 ,402 i U431,9811 I "* Including Vaccine A."\9307BSRR.WK1 19-Aug-93 Jefferson County Health Department BUDGET REPORT: EXPENSES August 1, 1993 A B C D 1993 i i YTD I IEx~ed I I Operating Budget , YTD% Budget (58% X A) I i Expended I (1 ) Salaries & Bene1its $842,268 $492,474 $466,568 55.39% (2)professional Services 58,541 $34,~29 31,614 54.00% (3)Office Supplies 3,360 $1,965 4,232 125.96% (4)Operating Supplies. 67,076 $39,220 33,873 50.50% (5)Equipment 14,120 $8,256 15,437 109.33% (6)postage 5,000 $2,923 2,666 53.32% (7)Telephone 20,060 $11,729 10,317 51.43% (8)Travel 10,400 $6,081 8,633 83.01% (9)AdvertisinglPrinting 3,000 $1,754 792 26.39% (10)Training 6,400 $3,742 2,222 34.73% (11)Leases & Maintenance 140,856 $82,358 84,558 60.03% $1,171,08211 $684,7311 r $660,913 56.4%1 * Including Vaccine A:I9JOlBSRE. "Xl 08119/93 JCH&HS CONTRACTS & AGREEMENTS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 NURSING EFFECIlVIl EXPIRES Consolidaled Contract JAN 93 DEC93 P'ISD School Health SEP 92 AUG93 Chimicum School District School Health SEP 92 AUG 93 BrinnoR School District School Health SEP 92 AUG93 Queets/OeatWater School District School Health SEP92 AUG 93 WCPCAN JUL 93 JUN 94 CPS Case Manaslement Stale JUL93 JUN 94 CPS Case Manuement Loca1 JUL 93 JUN 94 Chaoter [ AUG93 JUL 94 P'ISD - Birth to Three SEP 92 JUN 93 Relrional AIDSNET JUL 93 DEC 93 HIV/AIDS Case ManaRcment JAN 92 ONGOING Familv Plannina JAN 93 ONGOING SAFE ainic Dr. Schneidman AUG 92 ONGOING Medicaid Case Man3.2ement JAN91 Communitv Counselimz Birth to Three JAN91 Department of Corrections APR 92 ONGOING Mark Saran PENDING Carole Gautschi AUG91 ONGOING T.B. MAR 86 ONGOING Jamestown S'Klallam MOU PENDING SUBSTANCE ABUSE EFFECIlVIl IRES 22 DASA County Community Service Contract JUL 93 i JUN 95 23 DASA TItle 19 Assessment JUL 93 JUN95 24 DASA TItle 19 Out alient JUL 93 JUN 95 25 West End Outreach JUL91 JUN 93 26 Good Be ionin Otild Care JUN 92 DEC 93 27 ESD 114 - Student Assistance ram 0Cf91 JUN 93 28 CMASA - Crisis Res nseP m JUL 93 JUN 94 DEVELOPMENTAL DISABILITIES EFFECIlVIl EXPIRES 29 DDD County Omtract JUL93 JUN 95 30 DVR JUL93 JUN 95 31 Skookum Educational P s JUN 93 DEC 93 32 DD TItle 19 JUL 93 JUN 95 ENVIRONMENTAL HEALTII EFFECIlVIl EXPIRES 33 Solid Waste MAR 92 DEC93 34 Water Quali Grant PENDING 35 Water Recreation MOU DEC92 SEP 97 36 Recreational Shellfish DEC92 JUN 93 ADMINISTRATlVE/OTIIER EFFECIlVIl EXPIRES 37 HCA - Primary Dental JUL 93 DEC 93 38 HCA - DD Dental JUL 92 JUN 93 39 KPS Provider cement PENDING 40 Ci of Port Townsend JAN 90 DEC 94 41 DSHS Fund Advance JUL 93 JUN 95 42 Dr. Geerlofs DEC 89 ONGOING 43 Birth to Six - ICC AUG92 SEP93 44 PRC Grant ocr 92 SEP93 45 Bill Neesmith DEC 89 ONGOING 46 Dr. Juel JUL 93 JUN 94 47 Sheila Pickett JUL93 JUN 94 48 Cat Do JUL 93 JUN 94 49 Kim Wheeler DEC 92 AUG93 50 DSHS Basic reement JUN 87 ONGOING !;i[!1 ~ I i,~ -ll ~ ~iS :>:1:1! "I ~ '"'/.!! c: " . ," ..ll e: ~I~ I ~ JEFFERSON COUNTY PUBLIC HEALTH IMPROVEMENT PLAN , DESCRIPTION OF THE HEALTH PROBLEM RISK FACTORS AND CONTRIBUTING FACTORS HEALTH PROBLEM: Communicable Diseases This problem ranges from incomplete childhood immunizations, to sexually transmitted diseases, HIV/AlDS, hepatitis, giardiasis, tuberculoSis, infulenza, diseases brought back by travelers and others. Some communicable and contagious diseases are presently under control due to public health measures, while others such as HIV/AlDS, are not. Still others such as TB and measles, which were once under control are reemerging. Risk Factors: Immunization levels; Unsafe behaviors Contributing Factors: Access; beliefs & attitudes; lack of education; poor personal hygiene; unsafe sex; and environmental factors. CORRECTIVE ACTIONS TO REDUCE THE LEVEL OF THE CONTRIBUTING FACTORS A. Immunization Levels 1. Evaluate barriers to immunizations (cost, hours, location, etc.) 2. Publicize outbreaks of communicable and contagious diseases. 3. Community education (proactive; newspaper articles; speakers) 4. School health education 5. Identify those at risk, i.e. elderly, newborns, and children. 6. Provide immunizations and vaccines. B. Unsafe Behaviors 1. Education to target and at-risk populations, I.e. food handlers, day care workers, schools, adolescents, correction facilities, substance abusers. 2. Condom distribution. 3. Peer helper programs. 4. Traveler education and immunization. S. Drinking water program. PROPOSED COMMUNITY ORGANIZATIONS AND PROGRAMS TO PROVIDE AND COORDINATE ACTIVITIIES 1. Jefferson County Health & Human Services (immunizations, school health, education, disease tracking tracking and follow-UP, food program, water program.) 2. Schools (enforcement of immunization standards, WACs.) 3. Local physicians and providers (report and treat communicable diseases; education.) 4. Jefferson General (Emergency department.) 5. 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