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HomeMy WebLinkAbout06 June COMMUNICABLE DISEASE CONTROL PUBLIC HEALTH NURSING VITAL ST A TI STlCS ENVIRONMENTAL HEALTH HEALTH EDUCATION -=:. .;,iL-~4f(, 802 SHERIDAN PORT TOWNSEND, WASH. 98368 (206) 385,0722 HEALTH BOARD MINUTES JUNE 23, 1992 BOARD MEMBERS: STAFF ~EMBERS: B.G. Brown, Chairman Larry W. Dennison, Member Richard E. Wojt, Member Larry Fay, Director of Environmental Health David Specter, Administrator Nancy Gow, Director of Nursing Services J, Peter Geerlofs, M.D" Health Officer CITY OF PORT TOWNSEND REPRESENT A TIVE: Sheila Westerman The meeting was called to order by Chairman B.G. Brown, The following Board and Staff members were present: Commissioner Larry W, Dennison, Commissioner Richard E. Wojt, Larry Fay, David Specter, Nancy Gow, and Dr, Geerlofs. APPROVAL OF MINUTES: Commissioner Dennison moved to approve the minutes of May 19, 1992 as corrected. Commissioner Wojt seconded the motion which carried by a unanimous vote. ENVIRONMENTAL HEALTH DIRECTOR'S REPORT DETERMINATION OF DWElUNG STATUS: Rav Wilson: Mr. Wilson was present when Larry Fay presented correspondence between the Health Department and the Wilson's, he reported that the Wilson's own property on Lake Leland which they have been using for week-ends for several years, a recreational vehicle (5th wheel trailer). Currently there is no septic system installed so they use a Sanican serviced by Goodman Sanitation. Due to the need for more space Mr. Wilson replaced the 5th wheel trailer with a larger trailer. Larry Fay stated the Issue now is whether the larger trailer Is considered a recreational vehicle or a mobile home. It Is registered as a travel trailer. The use class was changed to travel trailer since it is on Jack stands and used as a park trailer, However, when Mr. Wilson contacted Puget Power to get electricity hooked up they informed him that the trailer was considered a mobile home and that it needed a final Inspection release from the State Department of Labor & Industries. Mr. Wilson contacted the County Building Inspector, Mike Ajax to discuss the situation, Mr, Ajax stated he will not require a building permit since It is not on a foundation and he has no objection as long as the Health Department approves the continued use of the sanican. The decision needs to be made whether the trailer fails under the existing policy relating to recreational vehicles or whether a septic permit is required for the site, Larry Fay added that the lot Is so small and narrow that Mr. Wilson would probably not be able to get a septic permit. HEALTH BOARD MINUTES - JUNE 23, 1992 Page 2 Mr, Wilson then presented photographs of the trailer on the lot. He stated it is a construction type trailer that can be moved and hooked up to septic systems in parks. The trailer is used 3O-S0 days a year, Commissioner Wolt asked If there is a well on the lot? Mr, Wilson stated there is no water system at all, Commissioner Dennison stated his concern is that there Is no control over what happens In the future. He added that the trailer could be considered exempt from a septic permit as long as inspections could be done periodically. He suggested that Mr. Wilson get an agreement with Goodman Sanitation to advise the County when the sanlcan has been pumped In order to monitor its maintenance. The Board discussed holding tanks and gray water. Commissioner Brown agreed that a septic system permit would not have to be required as long as the Health Department did not have arr; health or safety concerns. Larry Fay suggested that a notice be placed on the title explaining the reasons the permit was not required. Mr. Wilson then presented and read from a page of Corpus Juris Secundum-39A (AttaChment A), referencing health and environment and its eflect on personal and property rights. After further discussion the 80ard found that the trailer is registered as a travel trailer, placed on Jack stands and stili on its tires and wheels, not equipped with running water, relatively easy to be moved, placed on property with a 'Sanican' and arrangements have been made With a licensed pumper to service the toilet, not required by the Jefferson County Building Department to have a building permit, Commissioner Wolt moved that Mr. Wilson's trailer be considered exempt from an on onslte septic permit. Commissioner Dennison seconded the motion with the addition that in the future this type of request be decided on a case by case basis, on its own merits. and that this decision does not constitute policy. Chairman B.G. Brown cailed for a vote on the amended motlon. The motion carried by a unanimous vote. ADMINISTRATOR'S REPORT FINANCIAL REPORT: David Specter reported that 40.9% of the budget has been expended to date. Cilnical suppIles are high due to purchasing vaccines in advance, TeieJ)hone expenses are low, however. projections indicate that the budget category will be approximately $6,000 short at year end. Responsible factors include long distance phone bills doubling aiter going olf the scan system and additional lease expense for the new phone system. There has been 39% of budgeted revenue collected. Grants are In good shape while fees are down, environmental health Is down $12.000. Nursing Is down $21,000 partially related to doing immunizations and flu clinics later in the year. PROGRAM/GRANTS UPDATE: David Specter reponed that he could not get a schedule of Grants that will be cycling within the next year, or what the associated costs to the County are. The Interagency Coodinatlng Council (Ice) grant is being renewed this year In the amount of $2.800 effective July/August The County Is the lead agency on this program and very little costs are Incurred. The money received wilt go towards a salary, Child Find and Education. Ice is also applying for state funds under SB6428 which was passed In early 1992, setting up a Family Policy Council which Is a consortium of state agencies. this consortium Is to use funds to provide support and/or services for existing categorical services or community programs needed to implement a family or child case plan. this program requires a 25% local match and local doctors will be targeted, Nothing is expected from the County except that they be the lead agency. HEALTH BOARD MINUTES - JUNE 23, 1992 Page 3 The Dental program grant has been received for 1992-1993, in the amount of $21,134 which Is a 13% reduction from last year. Funds go towards approximately 20 dental and hygene clinics costing about $900 each. The state agency that administers this program is trying to encourage providing dental services to medicaid clientele. David Specter suggested waiting to see where that fits in with the Community Health Plan. In regard to the Safe Program, Prosecuting Attorney Mark Huth reviewed the contract with Dr. Schneldman and suggested that the County be named as an additional insured on Or. Schneiclman's profession liability policy. Or, Schneidman contacted his insurance company and discovered that the County cannot be named as an additional inSUred on his polICy. The County is not liable for professional services the Doctor provides, but the County Is liable In a general sense and Is covered by a general liability policy which the County has with the Risk Pool. Chairman B.G, Brown stated that the Risk Pool covers everything except medical malpractice for physicians. David Specter stated he will give this information to the Prosecuting Attorney. MEETINGS: The State Secretary of Health, Kristine Gebble will be visiting on July 7, 1992 from 9:00 A.M. to 12:00 P.M. David Specter will put together an agenda for the meeting, DIRECTOR OF NURSING'S REPOAT STATISTICS/MONTHLY REPOAT: Nancy Gow reported on the HIV walk-in clinic. The majority of the people being tested are low risk and nobody is being turned away. There are two aids: cases and six HIV positive cases who are County residents. 1992 FLU CLINICS: There has been an increasing demand for Flu vaccines causing some staffing concerns. Nancy Gow suggested capping the number of vaccines available due to the fact that the fee charged only covers the cost of the vaccine not the stafflng time involved. WEST END ACTIVITIES UPDATE: Nancy Gow reported she has recently been out to the West End admlnisterlng Hepatitus B vaccines, assessing needs and networking with the tribes and neighboring counties. By September she would like to have somebody go to the West End for two days every two weeks but she still needs to determine if the costs can be covered with the money that would be paid to ClaHam County. Commissioner Dennison suggested contracting with the Hoh tribe to provide services to the West End. OSHA/HEPATITUS B MANDATES: Nancy Gow reported that $5,000 In Hepatitus B vaccines has been spent on the Olympic Corrections Center. Those costs wlll be recovered from the Corrections Center. She stated that a single series of Hepatltus B V8CCine costs $121.00 per person. WISHA standards went Into effect May 26, 1992 setting Hepatitua B mandates. The end of August Is the deadline to meet all the standards. There must be an ExPOsure Control Plan in effect and she explained the standards as follows: 1, Identify all employees who are considered to be at risk, There are two categories of employees considered to be at risk. 1) Employees whose job requires them to come Into contact with blood or other bodily fluids (ie, nurses) 2) Employees who per10rm some tasks within their job description that puts them Into contact with blood or other bodily fluids (Ie. employees who administer first aid). 2. Engineer job settings In a way to decrease the risk of those employees Identified as being at risk (ie. implementing masks goggles, sell-sheathing needles. gloves. etc.). HEALTH BOARD MINUTES - JUNE 23, 1992 Page .. 3. There must be an Education Plan for all employees as risk, Each employee must have an in-service training session recommended to be 3 hours in length. this education must be documented and kept in the employees personnel file for 3 years, Each employee must be re-educated annually, Every new employee that falls Into one of the risk categories must be trained within 10 days of employment. Videos may be used for the education as long as there Is opportunity for and questions and answers. 4, After the employee has their education they must be offered the opportunity to receive the Hepatitus B series. The employee may decline it. If an employee wants to receive the series then the employer is responsible for paying for it and must document it in the employee's personnel file. Nancy Gow Slated the hospital is greatly Impacted by this and suggested contracting with them to provide the training and education, Each series will cost approximately $154.00 per person, including some administration costs, which will have huge Impact on the County's budget. The Health Department is working with PUblic Works, the fire districts, parks, and the Sheriff's office on getting some employees immunized. Regular billing forms are filled out for each employee noting at the top which department they work for. The bills are then sent to the specified department for payment. She added that these costs are covered on the employees Insurance. Each employee is asked to bill their health insurance and return the money back to the department. DaVid Specter asked how many County employees were estimated to be at risk? Nancy Gow reported almost everyone in the Sheriff's Department, and park employees. Most of the Health Department staff have already received the series. She stated that counseling, blood work or anythin,g done medically must be documented but cannot be kept in the employees personnel records because it is considered a confidential medical record. This Information must be kept in a separate file and retained for 30 years following termination of employement. The Health Department Is currently the depository for those files. She then reported on the Post Exposure Plan for those who have an incident that puts them at risk. This plan needs to Include medical visits for the employee and a source investigation. These plans are taking time and also impacting the Health Department's budget. Nancy Gow stated she would like to attend a Department Head meeting to go over the plans with some guidelines on how to identify employees at risk. ENVIRONMENTAl HEALTH DIRECTOR'S REPORT GROUP B "",,'Q:R SYSTEMS/MOU UPDATE: Larry Fay reported on the draft Memorandum of Understanding (MaU) between the State Health Department, County Health Department, and the PUD for small water systems technical assistance, He stated it allows the County to take on fuil responsibility if the PUD cannot take on the lask, and establishes the fee proceedures and what systems are affected. One change he made was in the handling of the fees, The Draft MOO now states that the County will only handle group B system fees. He reported he has been working on II new form that will break down the fees. The PUO wanted a clause in the agreement stating the agreement will be reviewed in two years and the fees reviewed after one year. Any party may backout of the agreement at any time thrOUgh written notification. The draft MOU will be sent to the State Health Department, the PUO, and the Prosecuting Attorney for comments. Larry Fay stated he met with Jerry Smith regarding the SubdiVision Ordinance. There are some water system requirements that need policy clarification. The Intent of the ordinance Is to state that each well must have an easement or protective zone of approximately a 1 00 foot radius. To avoid confusion the Health Department will establish this as the Health Department policy. Lots smaller than two acres will have to have wells drilled in order to establish that there Is water, for lots larger than two acres It must be indicated on the plat where the well site will be before the well site is approved, to Insure there will HEALTH BOARD MINUTES - JUNE 23, 1992 Page 5 be a protective zone around the well, This is being required before drilling has begun or water has been located. The Board directed Larry Fay to work with the Planning Department on making sure everyone is aware of this. Larry Fay stated he will work with the Prosecuting Attorney on thIs policy, He then presented, for the chairman's signature, the Bedroom Policy which was approved on April 21, 1992, The next meeting will be held July 21, 1992. MEETING ADJOURNED JEFFERSON COUNTY BOARD OF HEALTH S(EXCv..$ ED Ii 8svJc i) B. . Brown, Chainnan -~,-~.- HEALTH & ENVIRONMENT ~~ 5-6 I.. Valldlly of Statutes and Regulations in , General '. GeDerany 'peaklna. the appropriateness of health legis. la . question tor the Jeablature, but Its power In this respect must be reuoaably ~lsecI. ADd c1a"Weatlon or the subjects rezulated must have . reasonable object. Research Note Power of courts to order medJcal or surgical treat- ment of children is considered in C.J.S, Infants I 11. Inspection of private premises for viol!ltions of health or safety laws without consent or warrant as unreason- able search is considered In C.J.S. Searches and Seizures 166, Library References Health and Environment ~2. 20, 21. While the legislature of a state has the power, generally, to detennine what laws are necessary to preserve public health and safety," and health regulations. in a general way, are not affected by constitutional provisions,69 the power to estab- lish them must be exercised reasonably,70 The mere assertion that a subject relates to the public health does not render an enactment on the sub- ject valid;" rather, a regulation which purports to be enacted for the promotion or preservation of the public health may properly be scrutinized to ascertain its essential characteristics and what its results will be in actual practice,72 The act must have a direct relation as a means to an end, and the end itself must be appropriate and legitimate,73 The criterion is whether the pub- lic health in general will be promoted" and not whether it is required to promote the public health in isolated cases," Thus, in order that a health regulation may be valid, there must be a reasonable necessity to regulate the activity which is the subject of the regulation.76 More- over. the means adopted must be appropriate to the objective; 77 and there must be a real rela- tionship between the actual provisions of the regulation and its ostensible purpose.78 Pre- ventive measures to protect the public health or safety may be valid, however, even though there is no immediate necessity or menace to health or safety.i!i In enacting measures to promote public health and safety. such reasonable classifications may be made as are deemed necessary to accomplish the object sought." The legislature may pro- ceed a step at a time, addressing itself to the phase of the problem which seems most acute", I so that legislation is not inv~Ud when it ratioD-;>' ally chooses to regulate a limited class of heaJtb;: related activities. even though the class of ac:: tivities embraced might properly have ~ broader," However, the principle of proteclloll, of non-confonning uses does not apply to h : regulation,82 So, a use of property which Nt, antedated the enactment of a health regulaliol',' may be prohibited or regulated by the new Jni:, for the future.ri3 Similarly, a new enactmellt~ may validly include in its field of regulation " future acts of persons who have been engap! in the regulated activities before the law becaml' effective.&~ or pre-existing institutions or stna6f; tures.85 Unreasonable discrimination, how~, renders a health statute invalid.86 ~ Effect on personal ond property rights. : ' state has a compelling interest in safegu the health, safety, and lives of its citizens, : " that regulations to that end may be valid ~ though they interfere to some extent with coa- stitutionally protected rights of citizens.87 'I1wri' when the object of the enactment is to pro~: ';. " ATTACHMENT A " pubUc Iiealth, there may be no constitutiona.r-- . ion, even if the enforcement of the law in- eres to some extent with Uberty or property." ,'faldividual citizens may be required by health ~ations to expend funds in the interest of Uc health,8' as, for example, by improving private property so as to remedy unsani- iJpy or unhealthful conditions." However. the er to regulate matters of public health can- be exercised so as to deprive citizens of the ise or enjoyment of their lawful rights in a er not injurious or dangerous to others,Sl lh regulations must not be overbroad so they limit the exercise of fundamental per- rights more than is necessary to achieve a te objective which promotes a specific in- t of the state in preserving health or safe- ;It Although it has been held that the state's ' st in sustaining life will justify compulsory !ment of an adult against his will in order 'prevent death or grave injury," other authori- maintain that the interest of the state in 'ng the life and health of its citizens does " extend so far." .