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JEFFERSON COUNTY HEALTH DEPARTMENT
802 SHERIDAN PORT TOWNSEND, WASH. 99366
(2061 365.(1722
HEALT BOARD
Board Members:
Minutes: June 20, 1984
Staff t1embers:
B.G. Brown, Chairman
A.Ii[. O'rlleara, t1ember
John L. Pitts, Member
Brent S. Shirley, Member
Randall ~1. Durant, R.S.
Gretchen Ge~~ayt, D.O.N.
Jose~h Fischnaller, M.D.
Gael Stuart, Administrator
Commissioner John L. Pitts was the only member not in
attendance when Chairman B.G. Brown called t'-J.e meeting to order at
the aODointed tj,me.
Approval of Minutes: Commissioner Brown seconded Commissioner
O'Meara's motion to approve the minutes of May 16, 1984.
DIRECTOR OF NURSING REPORT: Gretc'-J.en Gephart, D.O.N. reported
on the nursing service activities for the month of May:
* 54 cases of head lice were reported and counselled on treatment.
at Grant Street School. The cases were all within the Little
League team members and were nrobably spread by use of '-J.elmets.
The helmets 'viII nmv be sprayed bet'"een uses by team members.
* Blood pressure screenings were conducted on 122 neonle between
the ages of 20 and 50 at the local Safeway store, wit'-J. 13 neople
being referred to a doctor.
* Educational sessions: Hepatitis B for Bayshore Industries and
for the local Group Homes. Vaccinations
will be given when the State provides the
vaccine.
Poison Control: An educational session
was held at Wanda's Pre-school for Darents.
Kiddie Health Fair: Held at QuHcene
School. Presented film on brushing teeth.
Staff training: Kah Tai Care Center
statt traininl', on "Physiolol',y of Ageing".
Community dental hygenists on sealant
program.
Minutes, June 20, 1984
Page 2:
* Gael Stuart advised that as soon as requests are received
the Health Department is planning to set UP influenza
vaccination sessions and blood pressure screening sessions
at the Court House and the City Hall.
ENVIRONMENTAL HEALTH DIRECTOR REPORT: Randy Durant out-
lined the tollowing changes in the new State regulations for On-site
Sewage Disposal Systems, which will be effective July 1, 1984. He
reported that these regulations were developed by a 17 member committee
composed of builders, realtors, planners, local healt~ officials and
one county commissioner, during the course of six mep.tings. The first
draft went public in June 1982 and after four statewide public ':1earings
they were adopted in May of 1983, by t':1e State Board of Health.
Section 248-96-025 Local Regulation: This section regarding the local
rules and regulations tor on site sewage disposal statffithat t':1ey must
be'tonsistent with, and at least as stringent as, the State Board of
Health regulations," and will be reviewed and approved by the State.
Randy explained that the current Ordinance 2-77 will need to be revised
and cover a minimum of five areas: 1) installer requirements 2) pumper
requirements,3)fees charged, 4) local penalties and 5) the appeal process.
A designer section should be included during this revision, which
should be done and approved by t':1e State before the end of the year
so it can be effective January 1985.
Section 248-96-040 Applicability: This section delineates how the
new regulations will be applied to areas addressed previously:
* Paragraph 1) The old regulations will apply to permits already ~ued
at the time the new regulations are adopted (July
1, 1984), and when they are renewed only sections
of the new regulations that are less stringent than
the old, will apply. '
* Paragraph 2) Repairs of failed systems will be done to the new
regulations, to the best ability allowed by the site.
* Paragraph 3) New regulation to be consistent with the State
Platting law (RCW 58.17). The old regulations will
apply to subdivisions that were recorded or had
received preliminary plat approval between
7/1/79 and 5/30/84 (five years). Those plaG prior
to July 1, 1979 as well as those after July 1, 1984
will be governed by the new reg\llations.
The new regulations will be applied to the plats
'grandfathered" five years from the date of recording.
Section 248-96-046 Alternative systems: Paragraph 4 was added which
requires monitoring and pertormance reports on any alternative system
installed. The monitoring can be done by an entity designated by the
local health department. The Health Department can also charge for
monitoring and/or the reporting required.
Minutes, June 20, 1984
Page 3:
Section 248-96-047 Experimental systems: This new section allows, in
two situations, the use ot an experimental system. An experimental
system is one that has not been approved by the State as an alternative
system. The two instances are: 1) Where attempting to correct a failing
system and there is no other way to do it and 2) Where there is also area
available to put a conventional drainfield should the experiment fail.
This also requires monitoring of the system.
Section 248-96-060 Connectimto public sewer system: The old regula-
tion stated that where an existing dwelling is on a failing on-site sewage
disposal system that is within 200 feet of a public sewer system, a hook
up shall be required. The new regulations provides that this requirement
may be waived by the Health Officer if it is determined that adequate
site conditions will allow the installation of a replacement on-site
sewage system.
Section 248-9'6-075 larger on-site sewage systems: This section is
essentially the same with DSHS being responsible for plan review and
approval on systems with a daily flow of 3,500 gallons to 14,500 gallons.
The local health department can by mutual agreement with the State do
plan.. review and approval for these systems. The State Department
of Ecology is responsible for systems with a daily flow of 14,500 gallons
or more.
Section 248-96-080 Permit: Will have to add a reminder of the applicant's
right ot appeal to our permit application, as well as some of the infor-
mation in item 2 of this section.
Section 248-96-090 Minimum land area requirement: Basically for new sub-
divisions ot land, multi-tamily housing developments and commercial estab-
lishments. This section does not apply to subdivisions done between
July 1, 1979 and June 6, 1984 and any plat or parcel of land that was
put together prior to July 1, 1979. Two methods of determining lot size
for new subdivisions are allowed with Method II being the one that will
be used in the final determination.
Section 248-96-094 Determination of site characteristics: This section
adopts a new design criteria "On-site Wastewater Treatment and Disposal
Systems", United States EPA Report. The determination of site character-
istics relates back to minimum lot size and is always dependent on the
specific proposal of the individual for such items as house size, number
of bedrooms, driveway location, and well location as well as other
factors.
There is no minimum lot size in this regulation for lots that were
done prior to 1979. These lots will have to meet the design requirements
as set forth in the newly adopted design criteria.
Section 248-96-095 Subdivision and individual site review: Individual
sites will require one soil log at the site ot each disposal area as
a minimum. This will mean a soil log will be required for the initial
system and the reserve system, where the 100% replacement requirement
is applicable. .
Minutes, June 20, 1984 Health Board
Page 4:
Section 248-06-096 Larger Tract requirements: The requirements of WAC
248-06-094 (3),-100 (2), and 100 (2) may be altered by the Health Officer
but if this is done a restrictive covenant against further subdivision
of the property shall be recorded on the building site.
Section 248-96-100 Location: This section concerns horizontal separation
with the major change being in the aistance required between the property
lines and the drainfield. Currently 10 feet is required, and these new
regulations will reduce this to 5 feet.
A section has been added on the distance required from cuts or banks
for a (SSAS) subsurface soil absorption system, as well as a new section
on required soil depths for slopes. The setback from surface waters
shall be measured from the ordinary high watermark. This term is defined
and clarified on page 3(WAC 248-06-020) Definitions (13)), as it has
always been interpreted in the past.
Paragraph 4: The Health Officer can authorize less than 100% of the
normally needed area for the purpose of system replacement. This requirement
will have an affect on whether some of the older, smaller lots in Jeffer-
son County are buildable. Variance to this requirement will have to
be handled by the appeal process.
Section 248-96-110 Design: This regulation requires more drainfield
than currently required tor soil types 3, 4 and 5 (tighter soils).
Section 248-96-130 Designer Program: Unless the County has a designer
program and that designer pertorms the final inspection, the local
health department is to make a final inspection on every job. This re-
quirement will require additional staff and cause increased costs to
the installer and property owners, but would provide for an improved in-
spection program as currently only three out of 10 systems ar~ inspected.
A designer program will be considered in our local ordinance.
Commissioner Brown seconded Commissioner O'Meara's motion that as per
WAC 248-96-025 Jefferson County will begin to enforce the July 1983 edition
of that WAC entitled "Rules and Regulations of the State Board of Health
On-Site Sewage Disposal Systems, on July 1, 1984 along with those portions
of existing Jefferson County Ordinance 2-77 which are not in conflict with
this WAC, and until such time as Ordinance 2-77 is revised, which is expected
to be by the end of 1984.
Randy advised that letters will be sent out notifing the installers, realtors,
etc. that this new regulation will be going into effect on July 1.
Health Department Closure: Gael Stuart invited the County
Commissioners and the Mayor to attend the seminar on July 23, 1984 on
communications, and a potluck dinner following the meeting.
Space requirement for the Health Department: Gael Stuart
reported that there is general agreement on the areas to be used by the
Heal th Department in the basement of the Couxthuse after the Sheriff's
Office moves out to their new facility in Hadlock. Approximately
Minutes, June 20, 1984 Health Board
Page 5:
2,800 to 3,000 square feet of the old jail and three adjacent rooms
would need to be developed. The Health Department staff will be asked
to determine how they could best use this space. Cost estimates will be
developed by Brian Shelton, Director of Public Works.
Bed and Breakfast Guidelines: These guidelines are currently
under review and DSHS expects to senOithem out to the industry by June
30, 1984, with the expectation that they will be put into effect September
1, 1984.
Update on Clearwater Store: Since the letter was sent allowing
the Clearwater Store to reopen on a temporary basis and under outlined
conditions, Randy reported that he has had no other communication with
the owner.
CONTRACT re: Public Health Nurse: Commissioner O'Meara moved
to approve and sign the contract with Nancy Smith for her services as a
part-time public health nurse. Commissioner Brown seconded the motion.
AGREEMENT re: Early intervention services: Commissioner Brown
seconded Commissioner O'Meara's motion to approve and sj~n the agreement
between Jefferson County Community Services and the Jefferson County
Health Department Children's Program for the provision of early inter-
vention services to children ages 0-3.
Update on sludge utilization site, City of Winslow: Randy
Durant reported that he, representatives ot the FUDIrc Works Department,
the Mayor of the City of Winslow, the consultant for the City of Winslow
and representatives from the State Department of Ecology as well as
representatives from Pope and Talbot met at the proposed site on June 8,
1984.
Soil logs will be done next week and a final proposal has yet to be
submitted. The proposal is to utilize a 35 acre area for a five year
period, to spread nine tons of sludge per acre, by use of a water cannon
on the back of a truck. This would be less than a half an inch of
sludge, spread over the acre. If this long term (20 to 40 years) project
is approved by the Board of Commissioners for the County there will be an
annual permit fee and a plan review fee required.
In response to Randy's attempt to determine the Board's feelings on this
proposed, long-term project, Commissioner Brown expressed concern about
the contents of the sludge, since there isoome industry in the Winslow
area. Tests will be conducted on the sludge to determine if there is
anything harmful, such as heavy metals contained in it.
ADMINISTRATOR'S REPORT: The budget is in good shape and will
require some amendment due to the receipt of additional grant funds.
The next meeting of the Board of Health will be July 18, 1984.
MEETING ADJOURNED
.
Agreement # 84-10-07
AGREEMENT
'Ihis agreerrent is made and entered into the 1st day of July 19 84.
by and between Jefferson County Ccmnunity Services and Jefferson COlmty Health
Deparbrent Children' s Program for the provision of early intervention services
to children ages 0-3.
GENERAL PROVISIONS:
The Term of this agreement shall be for the period beginning July l, 1984
and ending June 30, 1985
2. This agreement may be terminated by either party with 30 days written notice.
3. This agreerrent may be rrodified at any ti1re by Irnltual written agreerrent.
4. Corrrmmity Services reserves the right to terminate this agreerrent in whole
or in part, without prior written notice in the event exr;ected or actual
funding fran the state is withdrawn, reduced, or limited in any way after
the effective date of this agreerrent.
5. Work to be perfo:rned is as outlined in the attached staterrent of W:lI::k.
6. Jefferson County Health Departrrent-Early Intervention Program will abide
by Special Terms and Conditicns as attached.
ALLCCATION FOR THIS PERIOD:
$ 3,309
$ 2,862
$ 5.901
State Funds
County Funds
'IDl'AL
FOR THE SERVICE ProVIDER:
Jw (2 h::J
Signature
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Date
--------------------------------------------------------------------------------,
FOR JEFFERSON CXXJNTY:
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Signature
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Date
FOR CCl'MJNITY SERVICES DEPARIMENT:
'17> Jfi,
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Signature
t--cJ,() - fI L/
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Date
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EXHIBIT A
SPECIAL TERMS AND COODITIONS
DEVEWPMENTAL DISABJLITIES
/
BILLTh'G
The provider shall voucher -and provide data for services provided under this .
=ntract ac=rding to instructions issued by Jefferson County Corrmunity
Services.
ELIGIBIT.,ITY AND PIACEMENT
The state pursuant to WAC 275-27-030, 040, 050, 230, shall detemdne the
follqwing for individuals: (1) eligibility for the direct service areas listed
in WAC 275-25-520 - child developren.t, employment, camnmity integraticn, and
residential; (2) which services, if any, are necessary; and (3) program place-
nent. Name of individuals referred for county servioes will be provided by
the state.
CONTRACT RE(JJlREMENI'S
I. The following State Guidelines regarding payrrent for. services t.o the
County will apply to the provider:
A. The reimbursement for the four direct service areas listed in WAC
275-25-520 - child developrent, employrrent, ccm:nunity integration,
and residential shall be based upon one or TIOre of the three
following COilllty subexmtracting. reimburserrent options.
1. Fee for Service Contracting
Reimburserrent shall be based upon the funds established in the
StateI!ETIt of ~rk (Exhibit B) and shall be ITBdecnly following
the delivery of a unit of service at the unit rate identified
in the staterrent of work. The unit of service shall be defined
in the staterrent of work. .
2. Bl=k Funding Contracting
Reimbursement shall be based upon the funds established in the
Staterrent of Work (Exhibit B) for each specific service. 'Ihe
county's service unit levels shall be established in the State-
ITEnt of ~rk in two six-rronth periods - January through June
and July throogh December. 'Ihe follCMing review procedure may
be applied to each of the six rrmth pericds.
Notwithstanding any other provision of this contract, if the
county's particular service unit level declines by the end of
the six-m:mth pericd under review by nore than 10 percent, the
deparbrent may unilaterally reduce the funds available to the
.'
"
.
=unty for 1:h= respective six-rronth pedo:1 in which the decline
occurs. Any such reduction shall be made following the review
of all vouchers within said six-rronth perio:1 and prior to payrrent
for the last IlOllth of 1:h= six-rronth period under review. Any
reduction shall be applied to the prorated share of funds for
the perio:1 under review and shall be effective ufxm written
notice and shall be limited to the percentage decline in the
=ntracted specific service unit level exceeding 10 percent.
/
3. Grant Contracting
This contracting optic:n is available only for services that
have identified outcare results.
Rellnbursement shall be based up:ln the following i terns established
in the Staterrent of Work: The funds for each service, and the
numi:.er of people to be served. The number of people to be
served shall be established in the Staterrent of Work in two
Six-lIOIlth pericrl. Notwithstanding any other provision of
this =ntract, if the number of people to be served declines
by the end of the six-rronth pericrl under review by rrore than
10 percent, the depart:rrent nay unilaterally reduce the funds
available to te =unty for the respective six-nnnth perio:1
in which the decline occurs. Any such reduction shall be made
following the review of all vouchers within said six-rrcnth
pedro and prior to payrrent for the last nonth of the six-
nonth perio:1 under review. Any reduction shall be applied
to the prorated share of funds for the pericrl tmder review and
shall be effective up:ln written notice and shall be limited
to the percentage decline in the contracted service level
exceeding 10 pe=ent.
When using the grant contracting option, a county shall
establish within the county/vendor con'aact pericdic reviews
(at least one quarter of the contract pericd or three rronths
whichever is greater) to detennine the degree of COITpliance
with identified outcare results and language indicating actions
to be taken if contractor does not reach specified outccmes.
Infonration pertaining to the periodic reviews and any sub-
sequent action taken is to be reported to the divisic:n.
Upon assessment of the COilllty quarterly report and other data
relating to Olltcare results, the depart:rren.t nay elect, at its
sole dis=etion, to begin contract negotiations relating to
canpensation and/or outcarres.
B.
Programs receiving reimbursement on a fee per client unit of
service basis nay be reimbursed, at the dis=etion of the county
governing bOO.y or its designee, for any closure or substantial
non-attendance necessitated by natural causes, disatsters, state
offered training such as the Ellensburg series, or rrecha:nioal.
failures above and beyond the control of the service provider.
The County Governing Board has exercised proper discretion in
continuing payrrent to the subcontractor despite the closure or
substantial non-attendance, if said discretion is based on:
,
1. Weather cmditions or other natural causes necessitated the /
closure of the public schools in the service pruvider's
cat:clment area.
2. other conditions prevail not affecting the public schools
or their poFUlation in the sane manner as the service
providers or their clients are affected, and the county
governing body or its designee has obtained concu=ence frem
the regional program administrator or his designee that
the closure is necessary.
/"
3. Reirnburserrent shall be based on t..he average daily nnits of
service for the three IlDnths preceding the rranth of closure.
Report in the billing packet the clients and untis of service
thuS clabred separate frem the clients and nni ts of service
claimed for "open" days.
MJNTIORING
1. Work Staterrent outa:lITes for this pruvider will be IIDnitored at the
end of each six-rronth period and before payment for the last IlDnth
of the period. If the service nnit level declines by rrore than
10 percent, the county may nnilaterally reduce the funds available
to the pruvider for the respective six-IlDnth period in which the
decline occurs. A written report on work staterrent outccmas is
~red fran the provider at the end of each six-m:mth period,
to be presented to the Corrmunity Services Board and the Division.
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CONTRACT FOR PROFESSIONAL SERVICES
This Contract is between the JEFFERSON COUNTY HEALTH DEPARTMENT (DEPARTMENT)
and NANCY SMITH (CONTRACTOR). The contract is to be effective
June I, 1984 and will continue until terminated.
WHEREAS, the Department is in need of the part-time services of
a Public Health Nurse; and
\~EREAS, at the present time the Department is unable to provide
the services from personnel within its employment; and
WHEREAS, the Contractor states that she is qualified to perform
the duties of a Public Health Nurse as set forth in the body of this contract;
NOW THEREFORE,
IT IS AGREED:
(1) The Contractor shall act as a Public Health Nurse assisting the
Pediatric Nurse Practitioner in conducting Well Child Clinics. She will serve
under the direction of the Director of Nurses in conducting home visits,
school programs and general nursing duties.
(2) The services to be performed by the Contractor will be in
~
accordance with the standards of the profession, the State of Washtngton
and the Jefferson County Health Department.
(3) The Department shall pay the Contractor the amount of Eleven
dollars and fifty eight cents ($11.58) per hour for professional services
rendered and shall reimburse her for mileage driven in her personal vehicle
at the rate established by Jefferson County.
(4) The Contractor shall provide the Department with a detailed
accounting of the work performed and the mileage driven at the conclusion of
each month of this contract. The Department shall make payment for the work
performed on or before the 20th day of the month following the month in which
the work was performed.
,
,
,;c
(5) The Contractor is employed by the Department to substitute fOr
Department personnel during leaves and vacations. It is understood that she
acts as an independent contractor and that she will receive no employee
benefits from the Department of Jefferson County. It is further understood
that neither the Department nor Jefferson County will withhold F.l.C.A. taxes
or other obligations for which the Contractor may be responsible.
(6) The Contractor shall be considered an agent of the Department
and will be covered by the terms of the Department's insurance policy.
(7) The Contractor shall not discriminate against any person
presenting themselves for service based upon race, religion, color, sex,
age or national origin. The Department shall take affirmative action to
insure that persons receive services without regard to race, color, sex, age
or national origin.
(8) This contract may be terminated by either party by written
notice of thirty (30) days.
Contract for Professional Services (Smith) dated this
3/~
day of
-fit aa
, 1984.
JEFFERSON COUNTY BOARD OF HEALTH
~
By
~L~Av
B. G. Brown, Chairman
JEFFERSON COUNTY HEALTH DEPARTMENT
k /; j.J1 I
By V( C~
Gael R. Stuart, Administrator
By
~ ~7RN
Na cy S th, R.N.
,