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HomeMy WebLinkAbout11 November ~ d"~~~ Health & Human Services HEALTH BOARD MINUTES November 23, 1993 BOARD MEMBERS: STAFF MEMBERS Robert Hinton, Chairman Richard Wojt, Member Glen HUlltingford, Member Larry Fay, Director of Environmental Health David Specter, Administrator Jean Baldwin, Dire.ctor of Nursing Services 1. Peter Geerlofs, M.D., Health Officer Chester Prudhomme, Director of Substance Abuse CITY OF PORT TOWNSEND REPRESENTATIVE: Norma Owsley 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, Chester Prudhomme and Gwen Howard. ADMINISTRATOR'S REPORT FINANCIAL REPO~T_:. David Specter presented a revised revenue and expense report. He reported that 80.2% of the budget was expended and 79.2% of budgeted revenues have been collected as of October 31, 1993. Revenues are down because there is approximately $49,000 in grant revenues outstanding at this time. APPROV.t.\L O~..MINUTES.: Commissioner Wojt moved to approve the minutes of October 26, 1993. Commissioner Hinton seconded the motion. The motion carried. PROGRAMIGRANT ,j,JPDA-T.!i;. The Developmental Disabilities Dental Grant was awarded for twice what was expected. It is a small grant but one that pays for training. education and screening for the developmentally disabled patients, The Immunization Challenge grant was also awarded to the Health Department recently in the amOlmt of $32,959 to be allocated over the next 18 months, beginning in January 1994. This was not included in the preliminary budget so it will have to be amended to reflect the additional expenditures and revenues. 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 - NOVEMBER 23, 1993 Page 2 PUBLIC HEALTH IMPROVEMENT PLAN/PROGRESS REPORT: The committee met on November 10, 1993 and prepared four additional action plans. One more meeting will be scheduled to finish up the process. Copies of the meeting information are being sent to each Commissioner in the event that Commissioner Hinton cannot attend, then someone can go in his place. There are approximately 15 members on the committee, of which 8 or 10 are active participants. DIRECTOR OF NURSING SERVICES REPORT PROPOSAL FROM GRACE LUTHERAN CHURCH: Jean Baldwin introduced Pastor Howard Fosser to explain more about this proposal. He stated they are proposing to establish a low income health clinic in the community. Dr. James K. Rotchford is a new physician in the community who feels there is a real need for this type of clinic. They want to deal with the population of people that some medical providers do not care to deal with and therefore it will not be competitive with them. In order to do this at a reasonable cost they are requesting the use of the Health Department facilities. The clinic would operate weekly, on Saturday mornings. Dr. Rotchford would serve as Medical Director and the congregation members wonld staff the clinic on a volunteer basis. The church has facilities available, however, it would not appear very professional and may be detrimental to those they are seeking to serve. Another concern is that some people may have a problem with the church and it may be difiicult for those people to even enter the church. There will be no evangelizing or preaching. They will only be dealing with medical needs, so they feel that a neutral facility would be better. Pasior Fosser asked if the Board is interested in moving forward with this proposal? Chairman Hinton asked if David Specter had talked with the Prosecuting Attorney Mark Huth regarding the County's liability? David Specter stated he has not yet discussed the matter with the Prosecutor. Typically in the past what was done with other programs is that the physicians carry their own professional liability insurance and the nursing staff is covered under the County's risk pool insurance. He added that it is a matter that certainly needs to be addressed. Chairman Hinton stated that this proposal is with a sepamte entity. David Specter stated it depends on how the proposal is structured. No matter who is fdcilitating the program, the sign over the door says "Health Department" and it will be conceived by many that it is a Health Department program. The Health Department would have the responsibility to insure that it is done well and done right. Comparable to this program is the Family Planning program and the SAFE program. Both are independent programs, so they entered into professional service contracts to use the Health Department facilities. This way there are certain controls over quality and record standards. Pastor Fosser stated they have those same concerns. Since action is requested on this matter, Chairman Hinton asked if a month would be too long to delay making a decision? Pastor Fosser stated nothing will be siarted until after the first of the year, however, they would like to know as soon as possible if the Board is not interested in considering this. Chairman Hinton stated the Board agrees that a low income medical clinic is needed, however, he feels more time is needed to look into the liability issues. HEALTH BOARD MINUTES - NOVEMBER 23, 1993 Page 3 BASIC HEALTH: Jean Baldwin explained that Basic Health is a statewide insurance program for underinsured and uninsured people. This program allows individuals to buy a KPS policy similar to a KPS medicaid policy, at a very reasonable rate. There is currently a three month waiting list. This is the beginning of health care reform. IMMUNIZATION GRANT: The first allocation of funds will be used to do data entry and research of the program changes done in the past. They need to determine if clinic time needs to be increased in Brinnon, Quilcene, Port Townsend or the West End. The grant will also pay for computer equipment, fax machines and clerical s1Jpplies. They hope to establish a good working relationship with local physicians by being able to fax immunization records to them rather than s'pending hours on the telephone. FOCUS ON YOUTH COMMITTEE: This committee focuses on the prevention of child abuse, teen pregnancy, and drug and alcohol abuse. The third meeting will be held Tuesday, January II, 1994 from 3-5 p.m. in the Tri-area. Jean Baldwin invited all the Commissioners to attend. ENVIRONMENTAL HEALTH DIRECTOR'S REPORT PROPOSED FOOD SERVICE POLICY: Larry Fay presented a draft Food and Beverage Service Worker's Permit and Exam policy. Currently the Health Department administers a test provided by the State. Approximately 900 food handler permits are issued each year. While there are certain procedures which are followed there are not any formal written procedures. Any questions or comments can be directed to Larry Fay or Gwen Howard and they will incorporate any changes. The final draft will be brought before the Board for approval at the next meeting. ONSITE SEWAGE DISPOSAL SYSTEM DESIGNER PROGRAM: Septic system designers, installers and pumpers are all licensed by the Health Department. The Onsite Sewage Ordinance dated 1977 contains some very general provisions for installers and pumpers regarding licensing requirements and penalties for failure to comply. There are not anyprovis'ions for designers. In 1987 an amendment to that Ordinance was adopted which states that all systems must be designed by a certified designer, however, a progrdm was never developed to certify designers. Again, certain procedures are followed but there is nothing in writing. The Prosecuting Attorney advised Larry Fay that it would be appropriate to adopt the procedures as an Ordinance rather than a policy. The Health Department has not actively pursued this because for the last two years there has been a pending lawsnit statewide with the State and local Health Departments. This lawsuit was filed by an engineer challenging the authority of Health Departments to certify individuals to do what he viewed a.~ engineering work. The lawsuit was settled with an agreement that the Counties could not require any certification of engineers to do this kind of work, in exchange, the engineers will not challenge the Counties authority to certify other individuals to do this kind of work, with certain limitations such as the size of the systems that certified designers can work on. At this point it appears there is authority for local Health Departments to institute a designer program. Larry Fay presented a draft program format for the Board to review. A draft ordinance will be prepared for the Board to review at the Health Board meeting in January. GRACE LUTHERAN CHURCH 1120 Walker Street Port Thwnsend, Washington 98368 U.S.A. (206) 385 - 1595 Howard A. Fosser, Pastor May 28, 1993 Dr. Peter Geerlofs, Health Officer Mr. David Specter, Director Jefferson County Health & Human Services 615 Sheridan Port Townsend, W A 98368 Gentlemen: The Church Council of Grace Lutheran Church and Dr. James K. . (Kim) Rotchford have begun conversation regarding the establishment of a low income health clinic in our community. Dr. Rotchford would serve as the Medical Director and various members of our congregation would staff the clinic on a volunteer basis. It is anticipated that the clinic would be operated weekly, on Saturday mornings. We are seeking your support of the establishment of this clinic and seeking to explore the use of your facilities. I am enclosing a propos.aJ. and Dr. Rotchford's Curriculum Vitae. Please advise us of the procedure necessary to secure the use of the Health Department's facility on Saturday mornings, or advise us of the possibility of other facilities that may be available and appropriate for our use. Thank you for your help. Howard A. Fosser Pastor PROPOSAL FOR PORT TOWNSEND LOW INCOME MEDICAL CUNIC December 17, 1992 . Purpose: To provide inexpensive acute medical care to members of the community who have no medical coverage or whose medical coverage through DSHS significantly limits access to medical care. Organization: A board appointed by the Church Council Clinic Director Medical Director Volunteer Staff Clinic: Held weekly Saturday mornings Cost to Client: $20 paid in advance (DSHS would be biHed nom:ally, sliding scale would be available but only after triage by the Community Action Council) Services Provided: . 1. Acute diagnostic and therapeutic medical care by a physician or physician assistant. 2. Preventive medical care on a time available basis 3. Each visit the patient will be considered a "new' patient and require to fill out a medical questionnaire prior to being seen by the clinician. 4. Appointments not available. fIrSt come first serve basis. 5. No telephone care, no telephone prescription refdls. no copying of records without appropriate fees. 6. All supplies and Iabomtory services additional fees. 7. Visits of very short dumtion, on average 5 minutes. Only the most acute and urgent problem will be addressed. Other medical problems will need return visits or appropriate referrals. 8. No controlled substances will be prescribed other than tylenol #3 and those can't be refilled. 9. No insurance billing except DSHS. 10. Patients wiU not have individual records. Notes on visits will be part of a day sheet kept on a computer. Medical Billing: 1. Only DSHS 2. Provided through Ocean Shores Clinic $3.00 per claim or on site volunteers with clinic director supervision. Salaries: Clinic Director 10% of profit Medical Director (Physician) 50% of profit Problems to be resolved: 1. Referrals for appropriate counseling 2. Source and communications with Iabomtory and auxiliary services 3. Management of Abnormal Labs 4. liability issues for the Church? CURRRICULUM VITAE June 1992 James K. Ratchford, M.D., M.P.H. 817 Point Brown Avenue Ocean Shores, WA 98569 Tel. 206289-3378 EDUCATION: 1969 William Winlock Miller High Schoo~ Olympia, WA. 1973 Bachelor of Arts, French Uterature, University of Washington 1976 Completed the frrst two years of french medical school at the University of Nantes; Nantes, france 1980 Doctor of Medicine, University of Washington 1983 Advanced Cardlac Ute Support Certification, Univ. of Washington 1984 Acupuncture for Physicians, 200 hrs of CME sponsored by the UClA School of Medicine, Joseph Hehns, M.D. Instructor 1986 Aviation Medical Examiner, Certificate of Designation,. 1990 Masters of PubRc Health, MPH Extended Degree Program and Preventive Medicine Residency, University of Washington School of PubRc Health 1992 Board Certified in PubRc Health and General Preventive Medicine 1992 Fellow of the American College of Preventive Medicine WORK EXPERIENCE: 1980-81 Mixed Internship, Montreal General Hospital, a McGill University affiliated hospital 1981-82 General Practice, North Beach Health Care Inc., Copalis Beach, WA (A federally subsidized rural health clinic) 1982-85 Health Officer, Grays Harbor County 1983 Medical Director, Innersight Alcohol and Drug RehabiRtation 1983-85 General Practice, Solo 1983-85 Investigator, Puget Sound Medical Investigators; Olympia, WA. Involved in a series of Clinical Trials for hypertensive agents 1984- Host of "Doctor, Doctor" a local Television Program with an emphasis on preventive medicine 1984-85 Physician and Medical Director for the Chehalis Indian Medical Clinic 1985- Physician and Medical Director for Ocean Shores CRnic I \. REQUEST FORM FOR WAIVER FRCM WAC 248-96 This form may be used to request wai~ers from WAC 248-96. P1ease provide the information re- qu~sted and return it to the Local Health Department (instructions on reverse side). INDIVIDUAL REQUESTING WAIVER (1) LOCAL HEALTH DEPARTMENT (2) Name: Mil d red '. O. S i m 050 n Name: J e f fer son Co. He a ] t h 1l eo t . Address: 3420 Las Palma. Ave Address: 615 Sheridan St . Glendale. CA. 91208 Port TOlJosend. WA. 98368 Phone;( 20<3 378-6616 ( Friday Harbor. WA , )Phone:(20~ 385-9444 ------------------------------------------_..----------------------.------.--------------------- Property identification (31: S28. T29n. RI~ Tt"~r ,1 rJl.'. Point Tax Parcel # 977-400-015 **********Y***T****~**.***********~**..***************************..*7***'*****.**~************* Please provide the WAC Number (4) following detail: Requirement (5) Waiver Sought (6) ",-2',g ~, lee !l.46 .~?~ -I<to 100' setback well to Ssas Reduction of setback to approx. 77' Justification (7): Provide technical justification for the waiver request, At~ach additional pages if necessary. Please attach copy of permit, site application, or other explanatory documents if available. A: Enhanced treatment of effluentby sand filter prior to disposal in ssas. B' Well is uphill of system design, APPLICANT'S SIGNATURE TITLE Agent for MraSimpsoBIITE 10/11/93 **........* ****~*******~*.~..~~~*****~,,~*******************************.*..***.~.*.********~. LOCAL HEALTH DEPARTMENT COMPLETES ---..-------.--.--.-----------.-- Local Health Department Action (8): Date Received: ( APPROVED, Submit with justification and copy(s) of application to the DSHS Regional Offi ce. ( DISAPPROVED. Return to applicant. Comments (especially concerning reason for action): v~ TITLE rm,l-f7KJn t;oqrrl. of)/(4U(]TdO .';;,(r19 , - **......+.*********~***********~****T*********~**~*****.9'************+*.'. DSHS COMPLETES OSHS Action (9): ( CONCUR. Return to local Health { 00 ~IOT CONCUR. Return to Local Comments (especially concerning reasons Ca te Rece i ved: Department for 9r~nt~ng of waiver request, Health Department for denial of waiver request. for action); '- 1 r:~Jt. TIle," TlTI r OAH -----------------------------------------------