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HomeMy WebLinkAbout05 May ~ ~ .;iL_ ~ . .mFFiRSON COUNTY HEALTH DEPARTMENT / HEALTH BOARD Minutes: May 15, 1985 BOARD MEMBERS: STAFF MEMBERS: B.G. Brown, Chairman John L. Pitts, Member Larry W. Dennison, Member Glenn Ison, M",mber Randall M. Durant, R.S. Gretchen Gephart, D.O.N. Joseph Fischnaller, MoD, Gael Stuart, Administrator The meeting was called to order by the absence of Commissioner John L. Pitts, members were present. Chairman BoG. Brown, in All other Board and Staff Approval of Minutes: The minutes of the April 17, 1985 meeting were approved by motIon of Commissioner Dennison seconded by Glenn Ison. NURSING DIRECTOR REPORT: Highlight of the month of April were noted as follows by Director of Nursing, Gretchen Gephart. * Breast self examination was taught to the Women's Homemakers Extension group and the women at Grace Lutheran Church. Colo-rectal cancer screening was done on 12 senior citizens and two were referred to physicians with positive indicators. * * The..1985~86 . work plan for the North Olympic Health Planning Council w'i'lL.beurisponsored health care, The Essential Emergency Medical Services monies from the Community Action Council have bE!'en used up for Jefferson County. The Rotary Ramble Fund has been asked for a donation. of $5,000 so hopefully these funds will again be available for those in need. * The toys purchased by the Kiwanis donation for the library have been received. The toys were made by the Western State Hospital patients, so two groups of people were helped by this project. The toys should be available for checkout by children this summer. The Rotarians provided a campership for a 15 year old girl in the Juvenile Court system. * Twelve children have applied for and are being given physicals by the Nurse Practicioners to go to the Salvation Army Summer Camp. The * Page 2: Minutes, Health Board May 15, 1985 transportation to and from the camps still needs to be arranged. Gael Stuart and Glennlson advised that the Kiwanis may be able to provide transportation for the children. * Kai Tai caregivers were given a training session on "Loreliness and the Elderly." * Have become involved with the Children Helper and Associates Group. This is a group of all the caregivers that provide services to children, and teenagers. Trying to correlate these services. * Attended a Crippled Children Services Workshop and training for a new assessment method that is to supercede the Denver Developmental for the Well Child Clinics. Looking at some major changes in screen- ing techniques. * 972 people were served by the Health Department nurses in April while the staff was reduced by one. ENVIRONMENTAL HEALTH DIRECTOR REPORT: The following was reported by Randy Durant tor the month of Apirl: * 823 contacts for the month. * Sewage disposal system repairs were 21 to date in 1985 and 5 during the month of April. * Septic Tank Permits were up by one from the same period last year at 24,and site evaluations went from 17 in April of 1984 to 29 this year. Three final inspections of septic systems were made during the month. * There were a total of five food program inspections during the month, which is reflective of the additional time spent on the on-site sewage inspections. * * Randy and John Eliasson attended a soils workshop sponsored by the Department of Social and Health Services, regarding soils testing and soils evaluations, -k Two plan reviews were completed on two portable school classrooms for the Chimacum School Di9trict. -k Did two private school, joint inspections with DSHS. The Swan School in Port Townsend and the new Seventh Day Adventist School in the Had- lock area were inspected. * A follow up evaluation of the City of Winslow proposed sludge utiliza- tion site off of Highway 104 was done. It is aniticpated that this project will begin in the near future. * Paralytic Shellfish Program: Harbor and Discovery Bay for and Oak Bay including Ludlow Arefficurrently closed are: Killiset butter clams only; Olele Point south, Bay for scallops as well as Protection t Page 3:' Minutes, Health Board May 15, 1985 Island and the Pacific Ocean at the West End is closed for scallops also, The State laboratory test the shellfish samples. There is a bill which the Governor is expected to sign soon which will authorize Counties to create Shellfish Protection Districts to control and prevent pollution. This would fit in with our 205j study grant Com- missioner Dennison noted. ADMINISTRATOR'S REPORT: The insurance coverage for malpractice for Dr. Fischnaller is going to increase about 40% Gael Stuart reported, but the general policy will decrease about 50% so the total insurance costs will be about $2,687. $6,500 was budgeted because the insurance costs have been going up over the past years, and a 20% raise was anticipated. It is Gael's feeling that there have been no claims against the Health Department because Dr. Fischnaller, Randy, Gretchen and Sylia have operated in a conservative manner and are not doing things that could bring about litigation. They are careful to work within the guidelines. A summer food service program agreement was signed and grants have been applied for from various agencies in an effort to reduce the amount of County and City funds that go into the operation of the Health Department. Over 60% of the Health Department's funds do not come from local city county tax money but come from fees and money generated through grant applications. HEALTH OFFICER REPORT: The State is urging the Health De- partment to administer a new vaccine, Haemophilus Influenzae Type B, to prevent serious childhood meningitis and runs about an 8% to 9% mortality rate. The children most at risk are those who have some other illness which may reduce their immune response and alsodUldren of lower socio- economic status, Dr. Fischnaller reported. The State will not supply the vaccine which would cost about $6.00 per child to administer. Since the balk of the children who need the vaccine most would probably not be able to afford the cost, the Health Department probably would not receive much even if a fee were charged for the vac- cinations. Locally there were six cases of meningitis reported last year with one death and 37 deaths reported statewide. One recent case was seen in a Health Department Well Child Clinic. The vaccine would be given to children from 18 months to five years of age. Dr. Fischnaller and Gretchen Gephart both noted that even though this would be a drain on the budget, they would like to see it done if possible. Gretchen Gephart indicated that about 400 children would be in the high risk categories and need the vaccination. Gael Stuart advised that there may be funding available through some of the local service organ- izations such as Kiwanis or Rotary. Gael Stuart suggested that no decision be made on this until further investigation is done into al- ternative funding sources. Gretchen Gephart advised that she would write a proposal for funding. Page 4: Minutes, Health Board May 15, 1985 Dr. Fischnaller concluded his report by noting been released by FDA an oral drug for Herpes. be given to people rEeding this drug. that there has just A prescription will Letters re: Grant applications: Gael Stuart read a letter from the Hearst Foundation advising that they do not have adequate funds to cover all applicatioDSand that the Jefferson County application had been rejected. The request for dental health funds for the County submitted to the Department of Social and, Health Services will be considered during the next funding cycle to begin July 1, 1985. Discussion of 205j Proposal for Quilcene Bay: Gael Stuart reported that the 20~J Grant proposal for the clean up of Quilcene Bay was not accepted as packaged,for funding by the Department of Ecology. It was,howeve~ included for funding under the implementation of the Hood Canal Policy. The amount of funding was reduced from $53,000 to $25,000, for that purpose so that the project can be partially completed. Mason and Kitsap counties each received a like award. The detailsof the pro- ject will be worked out in a consultation with DOE at a later date. When the scope of the project is known a recommendation on whether to proceed with the project or not will be made. Charles Laws re: On-site sewage disposal for Lot 12, Div. 4, Cape George Village: Mr. Charles Laws came before the Board and advised that it was his understanding from the last letter he had received from the Board (see letter dated August 17, 1984) that the Health Department would be contacting the State (DSHS) in regard to his specific situation. He further noted that he had responded to the Board,since that was who he had received the letter from and even though Randy Durant had written to him since that time, he had not referred to any information from the State. Randy Durant reported that the representative from the State Department of Social and Health Services had visitied Mr. Law's site, and Commissioner Pitts had accompanied him, with regard to Mr. Law's first proposal for a mound system. The State evaluated the soils and wrote a letter to Mr. Law's which advised that they felt the site was unacceptable for that proposal. Since that time the Health Department has received an appli- cation for a sand filter system for this site and visited the site on two occasions. Letter were sent by Randy Durant on December 5, 1983 and February 25, 1984 which advised Mr. Laws that there was not sufficient soil depth or an area that didn't have high water to be able to approve a drainfield for a mound, sandfilter or a standard septic system. Randy did contact Clallam County for their experience with sand filter systems (See letter date September 13, 1984) but did not realize that he was ex- pected to send a copy of the actual sand filter plan to DSHS since they had already been to this site. Page 5: Minutes, Health Board May 15, 1985 Mr. Laws then gave the following background from his point of view. The man who wrote the letter to Mr. Laws from DSHS had advised him over the phone that the location proposed for the system was inappro- priate, however if a location CQuld be found where two more holes could be tested and if they yielded equivaJentresults found in the southern most hole, that there would be a pretty good possibility for a site that could be approved. Interestingly enough, the southern hole that he is talking about is the worst of the three holes that are on the site now. Mr. Laws has a list of randomly taken measuremenffi on the two new holes on his site over the last year, after a curtain drain was installed, of the level of water in these holes. One hole has stayed practically dry while the hole next to it fluctuated with a higher water level and the third hole that the State referred to had the worst measurements of the three. The curtain drain has caused some change in the water table, Mr. Laws n~ted. Randy Durant advised that the letter from the State was referring to the soil height and depth, not the level of water in the holes. A mound system is above grade and the mound is the drainfield, while in the case of the sandfilter type system, there is a septic tank and a pump that pumps into the sandfilter and another pump that pumps up .to a fresh water drainfield. The drainfield proposed for Mr. Laws' sandfilter was to be a 12 inch deep trench with a partial fill. This would mean digging into the original grade, putting the drainfield closer to the water table and the tighter impermeable soils. Mr. Laws continued by noting that one of the aspects of the sandfilter system was the evaporative quality of the system versus the soil ab- sorbing the water as in a mound system. He then read a paragraph from the Health Board Minutes of June 16, 1983 in which Commissioner Pitts made a motion to communicate via Dr. Fisohnaller of the Health Department the Board's support of any joint effort by Mr. Laws' engineer and DSHS to find an acceptable system for his property. Mr. Laws advised that he doesn't feel that this has taken place, and asked if it is possible to get further action on the mound or a sandfilter system. There are two different types of sand filter systems, Randy clarified. One is a recirculating sand filter system which is the type that is being discussed with DSHS for possible installation on the Samples prop- erty at Griffith Point. This system is on the list of approved alternative systems put out by the State of Washington. There is the standard intermittant sandfilter, which is what Mr. Laws has proposed using. Oregon has approved this type of sandfilter for use, but has not approved the recirculating intermittant sandfilter. These are two different systems that should not be mixed up. Mr. Laws site, Randy Durant con- tinued, does not have the soils for either of these systems, since there is not 24 inches of undisturbed, natural, unsaturated soil. There is a paragraph in the State sandfilter and mound system guidelines that states that with engineering justification, the Health Officer may reduce that 24 inch requirement if it can be shown that a health hazard will not occur. After further discussion of the requirements and the soils on Mr. Laws' property, the Board directed the Health Department to send a copy of Mr. Laws' sandfilter system proposal to DSHS as was done with his mound system proposal and ask for any suggestions the State may have for how Page 6: Minutes, Health Board May 15, 1985 this property can accept a sewage disposal system. that he would notify Mr. Roth (his Engineer) that so that he will be ready if the State contacts him Mr. this with Laws' advised was being done a question. Request for variance: Flying Potato Company: Gael Stuart read a letter from Renee and Eileen Barron of the Flying Potato Company requesting a variance from the requirement for a temporary food service permit that states that the operation site will be within 200 feet of a public restroom. The Barron's have found a site near the Police Station on Water Street that is 525 feet from the only public restroom in Port Townsend, to place their mobile unit from which they sell baked potatoes. In an effort to help launch the flying potato Barrons, Commissioner Dennison moved and Commissioner Brown seconded the motion to approve the variance as requested by the Flying Potato Company. Fee Schedule: Proposed changes: Gael Stuart reported that the environmental health staff is spending more and more time helping people with their requests for appeals of proposals that have been turned downfor a septic system permit, at a cost of $30.00 a hour, and possibly there should be some kind of time basis charge for this type of request. The Board asked that the Health Department staff make a recommendation regarding a possible charge to help defray the costs involved in the area of variances and appeals. Emergency Services Operations Plan: After meetings with the Emergency Services Plan Coordinator for the purpose of discussing rec- ommendations, Gael Stuart advised that there are problems with the Health Department being the lead agency in a Emergency Services Plan. The Health Officer lives in another County and the staff is limited in its ability to respond. The proper place for the lead agency would be within the medical community, at the hospital. The Health Department, Gael Stuart reported should be listed as support staff. The Board directed that the Health Department make their suggestions and give the data to backup the reasons for those suggestions. Area Agency on Aging re: Suggestions for use of 2nd Floor Space: The Area Agency on Aging has suggested that they occupy the three offices toward the back of the second floor and that the Health Department move its offices to the front of the floor where the Community Action Counci.l is presently. The problem with that, Gael Stuart advised, is that the plumbing for the clinic rooms would have to be moved which would be costly. It is his recommendation that the 03A office be put in the front to minimize the costs that will be associated with the move. Meeting Adjourned Jefferson County Board of Health . Dennison,Member B.G. Brown, Chairman John L, Pitts, Member "iiX'::" CONTRACT FOR PROFESSIONAL SERVICES BETWEEN SCHOOL DISTRICT 11 49 and JEFFERSON COUNTY HEALTH DEPARTMENT THIS AGREEMENT IS MADE AND ENTERED INTO BET\\lEEN CHIMACUM SCHOOL DISTRICT 1149 AND JEFFERSON COUNTY HEALTH DEPARTMENT. THIS AGREEMENT BECOMES EFFECTIVE ON THE FIRST DAY OF SEPTEMBER~ 1985 AND CONTINUES UNTIL JUNE 30, 1986 WITNESSETH WHEREAS, School District 1149 is in need of Public Health Services and, ~~EREAS, Jefferson County Health Department referred to as the CONTRACTOR, is prepared and willing to assume the responsibilities as set forth within this AGREEMENT: IT IS AGREED BETWEEN BOTH PARTIES AND NANED HEREIN AS FOLLOWS: 1. The contractor shall perform the following duties; a. Coordinate student screening, rescreening and referral according to WAC 248.148.010 through .150. b. Perform nursing assessment upon referral. c. Counsel faculty, parents and students in health related areas upon referral or request. d. Participate in health curriculum development on request. e. Provide input for the development of district health related policy ad hoc. f. Provide consultation in the areas of communicable disease pre- vention and control. g. Establish lias on with community social, welfare and social agencies on behalf of child/family in need of services. h. Provide environmental inspection of school facilities to insure a healtful environment. 2. For said services rendered under this Agreement, School District 1149 shall pay to the Contractor herein named a ratp of $2,386.00 for the school year 1985-1986, commencing September, 1985 and terminating in June, 1986, the amount to be paid by December 15, 1985. 3. The Contractor will assure the professional preparation and competence of the nurse and environmental consultants. 4. The Agreement may be amended by written consent of both parties and all amendments shall be attached to this Agreement and made a part therein. 5. The agreement may be terminated by either party upon 60 days written notice. .' I I , , I ( . Contract between School District 849 and Jefferson County Health Department Page 2 SIGNED AND DATED THIS /...~ DAY OF_ -mar , N2~t;; SCHOOL DISTRICT #49 sup~ ~r*.) JEFFERSON COUNTY HEALTH DEPARTMENT );hI ~ vb G el Stuart, Administrator JEFFERSON COUNTY BOARD OF HEALTH B4:~4fr:::) Approved as to form: Jefferson County Prosecuting Attorney ...