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HomeMy WebLinkAbout06 June COMMUNICABLE DISEASE CONTROL PUBLIC HEALTH NURSING VITAL STATISTICS ENVIRONMENTAL HEALTH HEALTH EDUCATION -=::P -~ .iJ.L~ - - . JEFFERSON COUNTY HEALTH DEPARTMENT 802 SHERIDAN PORT TOWNSEND, WASH. 98368 (206) 385.0722 HEALTH BOARD Minutes of June 18, 1991 BOARD MEMBERS: STAFF MEMBERS: B. G. Brown, Chairman Larry W. Dennison, Member Richard E. Wojt, Member Larry Fay, Director of Environmental Health David Specter, Health Department Administrator Nancy Gow, Acting Director of Nursing Services J. Peter Geerlofs, M.D., Health Officer CITY OF PORT TOWNSEND REPRESENTATIVE: Sheila Westerman The meeting was called to order by Commissioner Larry W. Dennison. The following Board and staff members were present: Commissioner Richard E. Wojt; David Specter; Larry Fay; Nancy Gow; Cathy Masecar, Receptionist; Jean Baldwin, Public Health Nurse; and Diane Espenson, Clerical Support for Child Development and Dental Health Programs. Chairman B. G. Brown was absent. APPROVAL OF MINUTES: Commissioner Richard Wojt moved to approve the Minutes of May 21, 1991 as presented. Chairman Dennison seconded the motion which carried by unanimous vote. Health Board Minutes - June 18, 1991 Page: 2 ADMINISTRATOR'S REPORT Financial Report: David Specter presented a three page "Budget Status Report" including Expenses, Revenue, and a Summary. * EXPENSES: To date 43.3% of the budget for 1991 has been expended. The Equipment line of the budget is at 83.7% of the year's budget due to the failure of the immunization supply refrigerator. Another refrigerator was purchased. * REVENUE: The revenue is understated as there is a time lag between medicaid billing and reimbursement for nursing services. * SUMMARY: The overall budget is $24,627 in the black at this time. Proaram/Grant Update: David Specter reported that: * Dental Program: The Dental Program grant has been held up by the State Budget. The rental of storage space is being considered for donated dental equipment as the need is immediate. * Child Development Program: This program is expected to receive $7,500 this year. * Consolidated Contract: An audit of the Consolidated Contract will be held beginning on July 18. Items under review include: Administrative and Civil Rights; Fiscal; WIC; and HIV. Funding is not considered contingent on the results of the review as it is intended to help the Health Department with the process. * Interagency Coordinating Council (lAC): The Port Townsend School District has voted to begin their own birth to three program as this will be mandated by the State. Funding hasn't come through, but a half-time educator is being hired by the School District. Coordination with the Health Department is expected. The children involved in the program will meet qualifications specified in the Washington Administrative Code. Health Board Minutes. June 18, 1991 Page: 3 ADMINISTRATOR'S REPORT. Continued: Automated Bllllna System: ELITE: David Specter reported that the Department has been exploring the alternatives for automating medicaid billing; and employees have attended workshops and looked at systems currently in place in other counties. A software program was obtained to cut down time needs. Approval will be sought to purchase a system called ELITE, which is in place in Thurston and Pacific counties at a cost of $3,000 for the program and installation. The ELITE system automates manual operations. A resultant increase in revenue would pay for the program. A computer, currently budgeted, would be dedicated to ELITE if approved. Facilities Update: David Specter explained that the options for temporarily solving the space problem are still being discussed. The issue is critical as it is impacting the staff and public in a negative manner. There is concern regarding temporary transition moves as the Department doesn't feel it is effective to move twice in short time. If permanent space is two years away, then temporary office space would need to be utilized. The Board concurred that the time frame needs to be determined immediately so that plans can be implemented. APEX: Assessment Protocol for Excellence in Public Health: David Specter reported that a management team will attend an APEX workshop in Ellensburg. An organizational assessment team will not be chosen until management is familiar with the process. DIRECTOR OF NURSING'S REPORT Statistics . Monthlv Report: Nancy Gow explained that: * The decline in Child Protective Services clients from 79 last year to 27 this year, is intentional. There is not a decrease in need. The situations appropriate for referral to Child Protective Services have been reconsidered and the number of referrals has been decreased. * The Footcare services have increased in productivity without an increase in time usage. * The number of clients for HIV testing have doubled which increases nursing duties. Every client for HIV testing must have pre-test and post- test counseling, whether or not they test positive for the HIV virus. Health Board Minutes. June 18, 1991 Page: 4 DIRECTOR OF NURSING'S REPORT. Continued: HIV TESTING * Each client represents a half day of work with the counseling, testing, phone calls, and paperwork involved in meeting legal requirements. Three active cases are being managed by the Department which insures that the clients get available services. The Heahh Department does not know if these three cases are in addition to the seven previously identified cases in the County or not. * An increase in Well Child Clinics is due to the addition of the Chimacum and Quilcene Clinics. The schedules are full. Homeless Population: Sanitation & Needs Issue: Nancy Gow reported that the poverty of the homeless population induces a need for services such as: immunizations, Well Child, and WIC. Increases in the incidence of abuse and neglect, requiring further services, are also attributed to the poverty of the vagrant clients. The homeless people are building shelters in remote areas without building permits, septic systems, outhouses, bathing facilities, or health care. The same creeks that supply water are used for bathing. It is difficult to provide public health services to these people as they are not easy to locate and eviction doesn't solve the problem. Nancy Gow explained that a way to be of service without being avoided as part of the legal system, is to spend consistent, frequent time with these indigent people. It was noted that the West End has a severe problem due to the isolation. DIRECTOR OF ENVIRONMENTAL HEALTH'S REPORT Statistics - Monthlv Report: Larry Fay explained that on-site sewage disposal permits have dropped to 205 from 252. As the permitting level is becoming manageable, a staff member may be reallocated to reviewing the need to deliver a Class Four Water System in the County (drinking water). The level of service and the ability to permit in two weeks locally, versus six months with the State, would be researched. Jefferson County is the only County in western Washington that does not handle a Class Four Water System. Section 63 . Water Availability: Larry Fay is working on a policy for alternative water systems, including developing guidelines for rain collection systems. A discussion was held regarding encouraging consolidation of systems; satellite systems; well sites; groundwater data; use of springs with water rights; various rainwater collection systems; and client documentation for the need of an ahernative system. A draft, meeting the Growth Management Act Section 63 guidelines, will be provided at the next Heahh Board meeting. Health Board Minutes. June 18, 1991 Page: 5 DIRECTOR OF ENVIRONMENTAL HEALTH'S REPORT - Continued: Update/Action Recommendations. Contaminated Well: Turpentine related compounds were present in samples collected from a new 50 foot deep well. The source of this contaminant is being sought. Domestic wells around the source well have been tested and the results are expected in about a week. The flow, nature and extent of the 50 foot aquifer, from which the well in question is drawn, are not known. The County Landfill is 1/4 mile from the well. Larry Fay recommended that the Health Department drill two holes, utilizing an hollow stem auger for monitoring, to determine if the aquifer extends to the landfill and if contamination from the landfill is possible. With a total of three wells, the direction of aquifer flow can be determined. Commissioner Wojt moved that the Health Department look at the need for drilling test wells. Chairman Dennison seconded the motion which carried by unanimous vote. Administrator David Specter asked for clarification of the motion. Commissioner Wojt stated that it means that if the Health Department finds that they need to drill, then they drill. Chairman Dennison stated that it means that the Department discuss with Gary Rowe, Public Works Director, about the best way to accomplish the drilling and to make sure that the effort is coordinated. Larry Fay expressed concern about how quickly action could be taken, and stated that the test holes should be done promptly. Commissioner Dennison stated that if Public Works cannot do the drilling, then the Health Department could follow through. Larry Fay will meet with Gary Rowe and explain to him what needs to be done, how the Department thinks it should be done, what tools would be best, and have a cost projected within ten days. If Public Works can't accommodate the job, then the Health Department will do it. The Board concurred. Larry Fay noted that the Department of Ecology is supportive of finding out what the problem and the source is. A general discussion of the monitoring methods of the landfill was held. ******* The next regular meeting will be held Tuesday, July 16, 1991, at 10:00 a.m. in the basement conference room. MEETING ADJOURNED JEFFERSON COUNTY BOARD OF HEALTH ~ B.G. Brown, Chairman dlk061991 ~---. ~,