HomeMy WebLinkAbout2018/11/27 - BOH Packet 1 MASON COUNTY
COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
ICEMASON COUNTY BOARD OF HEALTH
REGULAR MEETING
November 27, 2018
3:00 PM
Commission Chambers
411 North Fifth Street
Shelton, WA 98584
DRAFT AGENDA
1. Welcome and Introductions Scott Hilburn Chair
2. Approval of Agenda-ACTION Board Members
3. Approval of Minutes September 25,2018-ACTION Board Members
4. Health Officer Report Dr.Diana Yu
a. Opioid Discussion
b. Other
5. Administration Report Dave Windom
6. Legislative Report Dave Windom
7. Environmental Health Report Alex Paysse
8. Community Health Report Lydia Buchheit
9. Other Business and Board Discussion Board Members
10. Public Comments
11. Adjourn
If special accommodations are needed,please contact Melissa Drewry,427-9670,Ext.589. From the Belfair area,please dial
275-4467,Ext.589;from the Elma area please dial 482-5269,Ext.589.
Mason County Public Health
415 N 6th Street,Bldg,8,Shelton WA 98584,
Shelton:(360)427-9670 ext.400 ❖ Belfair:(360)275-4467 ext.400 ❖ Elma: (360)482-5269 ext.400
FAX(360)427-7787
MASON COUNTY BOARD OF HEALTH PROCEEDINGS
411 North 5`h Street,Shelton,WA
September 25,2018
Attendance: Randy Neatherlin,County Commissioner;Kevin Shutty,County Commissioner;Terri Drexler.
County Commissioner;Peggy VanBuskirk,Hospital District#2; Gary Plews,Fire Commissioner; Kathy
McDowell,City of Shelton Council Member.
1. Chair Scott Hilburn called the meeting to order at 3:03 p.m.
2. Approval of Agenda—Peggy/Cmmr.Shutty moved and seconded to approve the agenda as presented.All
in favor.
3. Approval of Minutes—Peggy/Gary moved to approve the July 24,2018 minutes as written.All in favor.
4. Health Officer Report—Dr.Yu reminded everyone to get their flu shot before flu season hits. Scott
reminded the group that in 2017 discussion was had about getting flu shots to homeless/low income
individuals.Lydia noted that the cost is the issue but it is something they are still looking into.Talks were
had about possible options to cover the costs.Because vaccines need to be ordered in March for the
upcoming season,Scott suggested placing an agenda item on the March 2019 meeting for further
consideration.
5. Administration Report—Dave passed out a revenue spreadsheet for Public Health and addressed County
Contributions statewide.He noted that spending and revenue are both currently on track.Dave talked about
fee for service contracts and how that affects the department.He talked about WSALPHO and a bill
moving forward which would allow input on how funds are spent.He spoke about attending the
Washington State Association of Counties(WSAC)conference and the encouraging discussions he heard.
Gary and Dave had a conversation about Public Health working with Fire Districts during time of
emergency including smoke issues and evacuations.
6. Environmental Health Report—Alex Paysee reported that onsite permits are up 20%then talked about
the new permitting software which is going live in October and how it will assist with staff time.
Cmmr.Drexler questioned if the onsite increase is due to new construction.Alex said much of it is new but
did not have exact numbers to compare.
7. Community Health Report—Lydia passed around a handout and announced a stakeholders meeting being
held at Alderbrook Resort.
Abe Gardner spoke about an upcoming forum at the Mason Transit Center.He talked about the speakers
and resources that will be available.
Dr.Yu noted that the overdose report on the handout is only verified overdoses to date and there is a
possibility the number is higher and will change as death certificates are reviewed.
Abe then talked about a program being implemented by the Tacoma Fire Department which allows
naloxone kits to be left with patients who refuse to be transported to the hospital for an overdose.Mason
County is trying to create a similar program and is currently in the beginning stages.
Mobile outreach program-Lydia announced that a$60,000 grant was won through the Cascade Pacific
Action Alliance(CPAA)for this program,along with$7500 from the Washington Department of Health
and$5,000 from the Squaxin Island Tribe. She did explain that after being in operation,they may qualify
for some larger dollar amounts. The program will begin October 1st.Lydia then handed out information
about the funding sources,locations,and vehicles.She gave more insight as to their next steps and goals for
the program.
BOARD OF HEALTH PROCEEDINGS
September 25,2018-PAGE 2
Gary questioned how many people will be on the road. Lydia explained that there will always be at least
two at a time,possibly more.
8. Other Business and Board Discussion-None
9. Public Comments-None
10. Adjourn-Meeting was adjourned at 3:56 p.m.
ATTEST MASON COUNTY,WASHINGTON
BOARD OF HEALTH
MASON COUNTY,WASHINGTON
Melissa Drewry,Clerk of the Board
Scott Hilburn,Hospital District#I
Kathy McDowell,City Commissioner
Kevin Shutty,Commissioner
Randy Neatherlin,Commissioner
Terri Drexler,Commissioner
Peggy Van Buskirk,Hospital District#2
Gary Plews,Fire Commissioner
From the Director's Desk
November 27, 2018
i
Happy Thanksgiving!
Fall seems to be the time of meetings and conferences. I participated in a panel discussion at the
Washington State Public Health Association in October where we discussed the role of Accountable
Communities of Health and the relationships to public health. A vast majority of the ACH work now
centers around the Medicaid Demonstration Project work. We have talked about this funding in past
meetings and it is a great deal of money coming into local systems but it's aimed primarily at new
deliver systems for Medicaid services.As public health, we're starting to push to get the ACHs, in our
case the Cascade Pacific Action Alliance, to really start looking at the entire population and what it takes
to keep people healthy and out of the health care system in the first place. Prevention is the key to
driving down health care costs. In January, I'd like to set a time for a BOH workshop on prevention and
goal setting for 2019.You'll be seeing some information coming your way in December.
Our new software, Smart Gov isn't quite ready for prime time but it's very close.The vendor has been
excellent to work with but the sheer volume of data to bring over from the old system is just about
overwhelming. It's looks like the first of the year will now be our go-live date.
Public Health is Essential! This will be our slogan as we move forward into the next legislative session.
For the first time we have Foundational Public Health Services (FPHS) as a key
priority for WSALPHO, Department of Health and the Washington Association ��P0�
of Counties. We have a substantial monetary ask that we've submitted to be
included in the Governor's budget as well as a companion policy bill that
defines local public health officials as the key partner in spending decision
concurrence. In business for this month we have a resolution that shows our LOCAL
support for FPHS and in December and January I'll be sending talking points PUBLIC HEALTH!
out to board members to take to their legislative contacts. While this is a OL
statewide ask,we're also getting the message out that public health is local
and it's imperative to support the activities and build stronger local public health agencies.
Construction activities continue all around our building making it difficult at times for the public to
access our building.The staff continues to be flexible as changes seem to occur daily. Our motto is
"Semper Gumbi....Always Flexible." It will be great when it's all finished sometime next spring or early
summer.
Get your flu shot!
Our FTE's stand at 19.65, stable from last report
Dave Windom, MSHS
From the Desk of the Environmental Health Manager
October 2018 and November 2018
For Board of Health November 27th—by Alex Paysse
October Activities:
October 21. Board of County Commissioners approved the Annas Bay SPD Closure Response Plan. Katie Otanez
had been working on this plan with community and state stakeholders for the past several months. Now that we have
an approved plan,work can begin. A copy of the plan is available on the Environmental Health Water Quality
webpage. Our current water quality work in Hood Canal is part of a regional effort,administrated by the Hood Canal
Coordinating Council.
October 61 and 7'h. All Environmental Health staff worked the weekend of Oysterfest,performing temp food
inspections and hosting our onsite sewage maintenance booth. 39 temp food inspections were conducted,and no
illnesses have been reported. Our onsite sewage maintenance booth provided septic system information and educated
the public on the importance of proper maintenance and the link to commercial shellfish growing areas.
October 121. EH staff participated in the Bi-annual CSD all-staff workshop. Katie Otanez was recognized for her
work within Annas Bay and provided a certificate of appreciation.
October 161. Katie Otanez,Luke Cencula,and Linsey Fields attended the South Sound Science Symposium hosted by
the Squaxin Tribe. This is a collection of presentations and posters on current environmental projects and studies by
various groups and organizations.
October 181. Cody Lund and I attended the annual Food Workshop hosted by DOH. DOH did a great job of bringing
interesting topics to the table and updating regulators on code revisions,common problems,and more.
October 231. Luke Cencula attended a Local Health Jurisdiction workshop for Solid Waste,hosted by Department of
Ecology. This workshop went over updates to the related Solid Waste regulations,WAC173-350.
October 241. In September we were asked to attend a State Shellfish Coordination Group meeting in October to
present and explain barriers related to PIC work in Mason County. This was a great opportunity to present and discuss
on-going WQ efforts and the needs and barriers for healthy Mason County waters.
October 301. Dave'Windom provided a presentation at the Hoodsport Board of Commissioners meeting for shoreline
On-site Sewage Systems.
November Activities:
November I'. Wendy Jonas and I attended the West-side Coordinators meeting for onsite sewage regulators hosted by
DOH in Kent. DOH provided updates on the rule revision process for WAC246-272A. These bi-annual meetings
bring together sewage system regulators to discuss industry issues,successes,technologies,and more.
November 5th. Mason County co-hosted a workshop for the Mason County Onsite Sewage System(OSS)contractors.
This workshop was brought together by Nathan Ek(Nuwater)and Dave Lowe(Loweridge),where they presented on
how to properly install and maintain their treatment products. Local OSS contractors always appreciate when we can
bring training opportunities to them. Mason County certified contractors are required to maintain professional
development hours for their annual certification. Jeff Wilmoth and Wendy Jonas attended this training as well.
November 13th. In coordination with Public Works and the Ells Hill Transfer Station,we were successful in moving
an unused shipping container from Public Works to the transfer station for the Opioid Mobile Outreach project. This
will provide a secure structure to house used needles generated from the program. Bart Stepp(Utilities Manager)and
the transfer station staff will work with us on proper disposal when ready.
November 131. Sean McGuire has announced he will be resigning from Mason County on November 271. Sean has
been with us for just over two years. He is currently working on the Hammersley Inlet WQ project,beach program,
and biotoxin monitoring. We appreciate all his hard work and will miss his positive attitude.
November 291. Annas Bay SPD advisory meeting. Letters are being mailed out to residents within the Annas Bay
SPD inviting them to this stakeholder meeting to discuss the work and implementation of the recently approved
response plan. This will provide the public an opportunity to be a part of the upcoming work and learn more on what
they can do to assist the water quality improvement efforts.
Quick Stats:
Onsite Sewage Permits 2017 2018 %Change
September 36 35 -2.8%
October 29 34 +14.7%
Well Construction Permits 2017 2018 %Change
31 Qtr Report 23 41 +43.9%
As of November 151, 143 rebates(or$29,550.68)have been provided to Mason County residents towards
maintenance of their Onsite Sewage Systems in 2018. These rebates remain a critical component towards water
quality efforts and assisting homeowners with costs of maintaining their systems.
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Commuhity- HeIlt I
I I • er R� • •
September-October 2018
Communicable Disease & Notifiable Conditions(3 programs-CD,TB,STD)
September-October,our communicable disease(CD)program nurse received 89 reports requiring data entry into
the State database,and/or investigation and follow-up. * Hepatitis cases being directly entered into new WDRS
database.
Disease Sept-Oct Total to date
Campylobacteriosis 4 37
ryptosporidiosis 0 2
Giardiasis 2 5
Shiga Toxin 2 1 1
Hepatitis B-Chronic 0 2
Hepatitis C-Chronic * 82*
Hepatitis C-Acute 1 1
Lyme 0 1
Pertussis 1 2
Salmonellosis 0 2
occidiodmycosis 0 1
Anthrax—Ruled out 1 2
Hepatitis A—Ruled out 0 1
Meningitis-Ruled out 1 1
Vibrio-Ruled out 1 1
Tuberculosis-Ruled out 3 11
Tuberculosis-Latent 2 3
1
Tuberculosis-Active/open cases 0 1
Vibriosis(non-cholera) 0 3
Yersiniosis 0 1
hlamydia 58 230
Gonorrhea 7 51
Syphilis 2 5
Herpes 3 10
HIV 2 3
otals 89 459
Housing Programs: (Consolidated Homeless Grant and Local Document Recording Fees)
Results are from FY19 Q3(July—September)unless otherwise noted
Crossroads Housing:
1. Housing Crisis Support Center(Coordinated Entry):
a. 102 households(252 individuals including 115 children and 13 veterans)requested housing
assistance
i. 82 households were literally homeless
ii. 20 households were for prevention service to maintain current housing.
2. 7-unit Family Emergency Shelter: 100%capacity;35 referrals were made
a. At this referral rate,in one year 140 families will need shelter and we only have 7 units available
3. Transitional Housing: 5 units are at 100%capacity
4. Rapid Rehousing(Rental Assistance):
a. 82 Households literally homeless and 10 households housed=12%conversion
b. 20 households qualified for prevent and 4 received prevention assistance=20%conversion
c. 11 households assisted into recovery housing(Treatment Sales Tax)=100%of requests were
housed
Community Lifeline:
• Case Management(year-round): 27 adults are currently receiving housing case management services
• Adult Seasonal Emergency Shelter: Open November 1 through April 30
o Average nightly stay(November 1—6)=17 adults
Community Action Council: Housing and Essential Needs Program$129,613 paid out for rent and housing costs as
follows:
• Rapid Re-housing: 60 households receiving rental assistance
• Prevention: 49 households receiving rental assistance
Turning Pointe: (Local Recording Fees fund one Advocate position)
1. Domestic Violence Shelter: From July 1,2017—June 30,2018
a. Total number of requests to stay in the shelter: 701
b. Total number of unduplicated households that stayed in the shelter: 287
c. Total number of children that stayed in the shelter: 211
2. Advocate: 15 households currently receiving case management services
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North Mason Resources:
1. Coordinated Entry: 21 households requested services(34 individuals,11 children and 4 veterans)
a. 5 households qualified for prevention
b. 16 households literally homeless
c. Outcome: 0 have been funded with the Rapid Rehousing funds
2. Case Management: 14 households are receiving case management services
Treatment Sales Tax: Mental Health and Substance Use Disorder Treatment Services
For July and August unless otherwise noted
Therapeutic Courts(January—June 2018)
Court Program Active Participants Dropped Out Graduated
Felony Drug 15 6 6
Family Recovery 11 5 5
Veteran 4 0 1
Mental Health 9 4 1
Total 39 15 13
Northwest Resources II: Care Coordination Services
1. New enrollments into care coordination: 48
2. Total Served: 77
3. Number entered in Detox: 4
4. Number entered in Inpatient SUD Treatment: 32
5. Number enrolled into MAT treatment: 7
6. Number enrolled into Mental Health Treatment: 49
7. Assisted with rental assistance into recovery housing: 11
Behavioral Health Resources: North Mason School District School-based Therapist
School Enrolled Students Gender
Belfair Elementary School 11 3 female/8 male
Sand Hill Elementary School 19 5 female/14 male
Hawkins Middle School 14 10 female/4 male
James A.Taylor High School 7 4 female/3 male
North Mason High School 7 4 female/3 male
Consejo Counseling: Mental Health and Client Services for up to 10 individuals that do not have medical coverage
or gaps in coverage. Medication assistance program to provide mental health medication for those that cannot
afford it.
• 13 households currently enrolled(10 adult only,1 family and 1 youth<24)
Peninsula Community Health Services: 2 Peer Navigators are funded
• 7 households are currently enrolled and assisted(3 MH/SUD treatment,2 case management, 1 medical
insurance,2 coordinated entry,2 transportation needs)
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Mason County Opioid Response
Prescription Drug Overdose Program(PDO)Funded by Department of Health Grant through 08/30/19
These statistics are only what is reported to Public Health.
PDO-Opioid Statistics Sep-Oct YTD
Naloxone Kits Distributed 73 495
Resource Guides Distributed 110 1760
Opioid Overdoses 3 16
Opioid Overdose Fatalities 0 0
In October, PDO funds were increased to allow staff, Christina Muller-Shinn to be re-classified as full time.We
continue to engage the community addressing opioid overdose prevention through public workshops at
Community Lifeline once a month,the weekly Transit Center table on Wednesday's from 2-5 PM,street
"backpack"outreach in conjunction with the peer-pathfinder program STIR,as well as a monthly inmate training at
the county jail. Private agency trainings were given to Telecare's Crisis Mobile Outreach team,as well as Squaxin
Island Tribe's Family Support Services employees. Between September and October we trained 47 new individuals
on overdose recognition and response.
PDO staff received additional training at both a Mental Health First Aid class as well as a Stimulants and Harm
Reduction workshop to better serve our community's needs during outreach.We attended the 2"d Annual Olympic
Community of Health's Regional Opioid Summit to stay abreast of the work our neighboring counties are doing
around the opioid epidemic and network with other providers,as well as participated in a state-wide syringe
services program call to learn about other programs and opportunities.
Comprehensive Opioid Abuse Program (COAP)Funded by Bureau of Justice Assistance through(BJA)10/30/20
Mason County's COAP project continues to grow and strengthen with each passing day. The amount of
collaboration and partnership within Mason County is absolutely inspiring. There are conversations that
Public Health is having with existing and potential partners and there are conversations that continue to
happen between partners as well. There are now 26 formal partners that have entered into MOU's or
have signed letters of support/participation. The data collection process continues to solidify,and we
are beginning to see what gaps are present in our current system and how we may be able to leverage
partnerships to find solution. Partners meet every two months around the county as part of the
Stakeholders group.
MOU's-(20) Letters of Support/Participation-(6)
Capital Recovery Center(STR program) Thurston-Mason Behavioral Health Organization
Central Mason Fire&EMS Squaxin Island Tribe
Consejo Counseling and Referral Service Shelton School District
Gethsemane Ministries North Mason School District
Mason County Jail City of Shelton
Mason County Fire District#4,#6,#16,#18 (4 MOU's) Washington Corrections Center
Mason County Sheriff's Office
Mason County Therapeutic Courts
Mason General Hospital
Mason Transit Authority
North Mason Regional Fire Authority
Northwest Resources II
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Peninsula Community Health Services
Shelton Police Department
Skokomish Indian Tribe
Social Treatment Opportunity Program(STOP)
Telecare
Substance Use Mobil Outreach Funded by Cascade Pacific Action Alliance(CPAA)&Medicaid Transformation
Project through 6/30/22
Mason County's Substance Abuse Mobile Outreach,nick named MOBI,launched on November 6,2019. It operates
two days a week and has four different locations. Business cards with the contact number 360-427-9670 ext 128,
are being shared at surrounding county syringe exchanges.The MOBI extension has a recorded message with
times and location and cell numbers of the staff for further information.
Substance Use Prevention
Shelton Prevention Education Partners(PEP)Goals:
The Shelton coalition meets monthly on the second Wednesday of each month at Oakland Bay Jr high.The
coalition works on community policy and prevention event projects throughout the year.
Coalition topics and goals include:
The Shelton PEP is a partnership of community sectors county,city state, parents,law enforcement, mental health,
key community leaders,substance abuse counselors and school prevention staff.Our highest priority is to reduce
underage drinking and drug use among 8th and 10th grade students.
The coalition focuses on community norms, policy and data review.Reducing easy access alcohol point of sale
placement in stores, reducing theft,stopping promotion and sales to underaged youth.Increase Evidence based
prevention programming
Ongoing and New evidence-based prevention programs include:
• Good behavior Games: School Based Evidence Based,ESD 113 (Partner)Ongoing-Implemented in 2017-Current.
• Guiding Good Choices:Community Project, Evidence Based,Family Education Support Services(Partner)
Winter-Spring 2018.
• Strengthening Families:Community Project,Evidence Based,Family Education Support Services(Partner)
Capacity Building-Training staff.
• Incredible Years:Parenting Project,Evidence Based,(Mason County Public Health Nurse)Training staff.
• Media Awareness:Jr,High,Middle school,and High School Project,Promising Practice, SADD Club(Partner).
• Monitor current prescription drug take back boxes and increase take back box capacity.
North Mason Prevention Coalition
The coalition meets monthly. Meetings are scheduled for the third Wednesday of each month at 5:30 PM at North
Mason High School.
Public Health applied and was awarded a Substance Abuse prevention grant for North Mason School District.We
will provide a 0.5 FTE position to ensure grant deliverables.The project will begin in mid-November 2018.Funding
will enable evidence based and best practice prevention programming in the North Mason School District and
5
surrounding area.We will be partnering with ESD 114 who will be providing an Intervention Specialist at North
Mason High School to work on policy,and prevention and be member of the newly developed North Mason
Substance Abuse Prevention Coalition.
Tobacco/Vaping Regional Strategic Planning workgroup topics and goals include:
Collaboration with chronic disease and other programs
Strategic planning
PSE focused activities trends in region-using the Health Youth Survey
County challenges encountered and needed assistance from DOH
Geographic/Racial Disparities
What activities can we provide that fits within our communities
Disparities and Data
Marijuana Regional Strategic planning workgroup topics and goals include:
The purpose of the Regional Strategic planning group is to prevent initiation and use of marijuana by youth ages
12-20 throughout Washington State.The Regional group will focus on the following:
• Decrease percentage of 10th grade students(statewide)who have used marijuana on at least one day in the
past 30 days.
• Decrease percentage of 10th grade students who have used marijuana on at least one day in the past 30 days
in African American,Latino/Hispanic,Asian/Pacific Islander,American Indian/Alaska Native,and LGBQT
population.
• Decrease the percentage of 10th grade students who first used marijuana before they were 14 years old.
• Attended the CHOICE 3-day cultural diversity training in June 2018
• Attended High in Plain Sight workshop July
• Attended the State-wide prevention Summit November 2018
Community Health Assessment and Data
As mentioned in the previous report, public health completed a community health assessment(CHA)at the end of
August 2018.This report will be available on the county website.In addition,the report information will be
available for the community on a new webpage platform called LiveStories.This platform will allow community
members to view report details such as graphs and tables in more detail;while also allowing them to interact with
the report through images,videos,and connecting them to other websites through links. Mason County's
LiveStories site will also include pages on two of our areas of focus:Opioid Response and Housing&Homelessness.
In October,Public Health joined with other community health partners in the newly formed Mason County Health
Coalition. Partners included Mason General Hospital, Public Hospital District's 1 and 2,and Peninsula Community
Health Services. Discussions occurred around current Accountable Communities of Health work, reviewing MGH's
Community Health Needs Assessment and Public Health's Community Assessment and the new LiveStories
platform as a potential source of sharing and tracking community work to improve health outcomes.
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November 14, 2018
Dear Members of the Board of Health and County Commissioners;
With mixed feelings I am writing to let you know that I have decided to fully retire from my Public Health
career by the end of May, 2019. 1 can negotiate a different end date depending on your finding a
suitable replacement for my position. It has been a full 32 +years in the field with successes, plenty of
learning opportunities, a lot of collaboration, some failures, fond memories and many stories to share.
My heart and mind will always be focused on public health and I am sure I will continue to dabble in it
intermittently. My plan is to keep on "walking my talk" and continue my pursuit of active aging and
community wellness in my full retirement years,
In February 2005, I remember very clearly being asked to take over the Health officer duties for Mason
County, in addition to Thurston and Lewis. I really had no prior experience with Mason County but
within two years time, I chose to give up my duties in Lewis County to focus on Mason and Thurston.
When I decided to retire from my full time work 5 years ago, I chose to remain as the Health Officer for
Mason County.
Clearly, I have a special affinity and affection for Mason County. The more I interacted with the
leadership and the community, the more enamored I became. Mason County IS the LITTLE COUNTY
THAT CANM Time and again, we have proven that this community is special and has the tenacity and
determination to succeed and care for our residents, The biggest transformation was watching Mason
County realize the need for and focus on a response to the Opioid crisis we are facing. I know that you
will continue to succeed in this initiative because the community is so committed to acting together.
I started my medical career by training for Public Health at the University of North Carolina in Chapel
Hill. By the time I began Medical School at the University of Washington, I already had a public Health
mindset. After my internship in Family Practice and residency training in Pediatrics, I began my career as
a Pediatrician in the public health clinics in Seattle King County, WA. Once I moved to Olympia in 1990 1
transitioned to focus solely on public health.
In over 32 years I have experienced hundreds of outbreaks, started many initiatives, championed many
causes, represented local public health on the State Board of Health, affected a lot of change and
hopefully made a difference in the lives of the residents and all the communities that I have served.
It has been an honor and pleasure to work with the excellent staff of Mason County public health and I
wish them continued success in improving the health of the community. Thank you for the opportunity
to serve this wonderful community. I remain eternally grateful.
Sincerely and Respectfully,
Diana T,Yu,!MD, M H
Mason County Health Officer(Short-timer)