Loading...
HomeMy WebLinkAbout2019/09/24 - BOH Packet MASON COUNTY COMMUNITY SERVICES Building,Planning,Environmental Health,Community Health HEALTH is M"TtA41 MASON COUNTY BOARD OF HEALTH REGULAR MEETING September 24, 2019 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 of July 23, 2019—ACTION Board Members 4. Nurse Family Partnership Presentation Thurston Public Health 5. Health Officer Report Dr. Daniel Stein 6. Administration Report Dave Windom 7. Community Health Lydia Buchheit 8. Environmental Health Report Alex Paysee 9. Vaping Ordinance Change Commissioner Shutty 10. 2020 Budget Dave/Casey 11. Other Business and Board Discussion Board Members 12. Public Comments 13. 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`s Street,Shelton,WA July 23,2019 Attendance: Randy Neatherlin,County Commissioner;Kevin Shutty,County Commissioner; Sharon Trask. County Commissioner;Scott Hilburn,Hospital District#1;Peggy VanBuskirk,Hospital District#2; Gary Plews, Fire Commissioner.Absent: Kathy McDowell,City of Shelton Council Member. 1. Chair Scott Hilburn called the meeting to order at 3:01 p.m. 2. Approval of Agenda—Peggy/Gary moved and seconded to approve the agenda as published. Motion carried. 3. Approval of Minutes—Peggy/Cmmr.Trask moved and seconded to approve the May 28,2019 minutes as circulated. Motion carried. 4. Health Officer Daniel Stein was not in attendance. Dave reported that Dr. Stein has a varied work schedule and is familiarizing himself with the job requirements. 5. Administration Report—Dave Windom reviewed his report. Mason County received a little over$42,000 from state funding and once the budget allocation is corrected,Mason County anticipates receiving $100,000. This funding will be used to support water quality work. There was discussion of how to address chronic health issues such as smoking,diabetes and obesity. 6. Environmental Health Report—Manager Alex Paysee was not in attendance. Dave reported Environmental Health is working on water quality issues and Group B water systems. 7. Community Health Report—Manager Lydia Bucheit reviewed her report and spoke about the Comprehensive Opioid Abuse Program(COAP)and the Community Stakeholders meeting that was well attended. 8. Proclamation-request to proclaim August 31,2019 as Overdose Awareness Month and August 31,2019 as Overdose Awareness Day. Peggy/Gary moved and seconded to accept the proclamation for Overdose Awareness Month. Motion carried. 9. Other Business and Board Discussion. Member Scott Hilburn asked if Abe could provide an update to the mobile outreach program. Lydia said she will schedule this at the November Board of Health meeting. Dave reported several staff will attend the WSPHA training. 10. Public Comments—Tom Davis attended to meet Dr. Stein and spoke about programs to prevent smoking. 11. The meeting adjourned at 3:40 p.m. BOARD OF HEALTH PROCEEDINGS July 23,2019-PAGE 2 ATTEST MASON COUNTY,WASHINGTON BOARD OF HEALTH MASON COUNTY,WASHINGTON Melissa Drewry,Clerk of the Board Scott Hilburn,Hospital District#1 Kathy McDowell,City Commissioner Kevin Shutty,Commissioner Randy Neatherlin,Commissioner Sharon Trask,Commissioner Peggy Van Buskirk,Hospital District#2 Gary Plews,Fire Commissioner Thurston County Public Health and Social Services Nurse Family Partnership F Serving Thurston, Lewis and. Mason Counties Gretchen Thaller, RN, MSN & Lori Montoya, RN, BSN Nurse Family Partnership Nurse Family Partnership is . . . . y • An evidence-based, community health program :7 J • Transforming lives of vulnerable first-time mothers living in poverty r .......... • Improving prenatal care, quality of parenting and life prospects for mothers by partnering them with a registered nurse uFx P .. low Program Goals: • Improve Pregnancy Outcomes v _ • Improve Child Health and Development • Improve Economic Self-Sufficiency of the Family The How EXPERT: Specially-trained nurses PROVEN: Extensive and compelling evidence INTENSIVE: Pregnancy through age 2 x 4 - TIMELY: First 1000 days N7 r j } Why Nurse-Family Partnership? Our nurses change the future for the most vulnerable babies born into poverty in the United States, and their mothers. Early The First 1 ,000 Days • Early experiences influence the developing brain • Chronic stress leads to toxic stress • Adversity can lead to lifelong problems • Early intervention can prevent consequencesw- j= • Stable, caring relationships essential for STATE SAVINGS PER CHILD BY CATEGORY FROM NFP AT 18 YEARS AFTER BIRTH :r . o � �-_may_ .•.*- '"�••-. Intimate Partner Violence Youth Arrests Youth Crime $153 $699 $374 Youth Substance Abuse $0.35 Other Maltreatment + 7 J Confirmed Maltreatment TANF Payments $1,238 $4,844 Special Education 5678f � r 1r Child Care,2nd Births poop r Fewer Closely Spaced 2nd Births on Medicaid $4,007 Medicaid Graduation $2,443 Now Reduced Costs if on Medicaid $1,480 �r Nurse- FamilyPartnership Projected Outcomes PIRE Report by Dr. Ted R . Miller Based on 177,517 pregnant women enrolled in NFP from 1996-2013, Miller projects that by 2031 , NFP will prevent an estimated: • 500 infant deaths • 10,000 preterm births • 13,000 dangerous closely-spaced births • 42,000 child maltreatment incidents • 36,000 intimate partner violence incidents • 90,000 violent crimes by youth • 41 ,000 cases of youth substance abuse MASON 1UNTY CLIENTS SERVED IN 2018 ' Provided services for 71 families _ Had 227 contacts via phone, email, text �h, y y 603 Home visits and office visits �' -�'� 52 Infants born 99% of the families were 220% of poverty level or below MASON COUNTY HEALTH ASSESSMENTS Homelessness & Depression, Anxiety,& Residential instability Mental Health Issues 40 40 33 30 29 25 30 26 20 17 20 12 10 10 0 0 i I ■Low ■Moderate ■High ■Low ■Moderate ■High Successes .......... • 2018 Fight Crime Invest in Kids Champion for Children and Youth award in Washington State • Successfully implemented the first tri-county regional NFP site • We worked closely with 375 high risk families to improve their health, address mental health and substance use concerns and secure safe housing • 9 Nurse home visitors successfully earned Infant Mental Health Endorsement from the Washington Association of Infant Mental Health. Goals for 2019 • Expand to meet the community need (intermittent 4 waitlist in all counties) • Increase breastfeeding rates at 6 and 12 months k Decrease preterm birth rates • Decrease childhood injury and ER use • Continue to work with families on securing stable- w housing • Continue to support families in substance use treatment through assessment, referral and intervention support Editorial Board noted that the Federal Commission to Eliminate Child Abuse and Neglect ` ." Fatalities found few examples of evidenced-based solutions to reduce child abuse. " . . . One notable exception is the home-based Nurse- Family Partnership.." AM ICA f " . . .The Center for American Progress estimates expanding Nurse- Family Partnership to Medicaid-eligible first-time mothers nationally would prevent 20,000 deaths and more than 400,000 premature o'' - births over 10 years.. .' From the Director's Desk Sept. 24, 2019 Wow, summer ended fast! Smoke became the hot topic over the summer in terms of how does the state respond to a major smoke event? Last year's big smoke events found us unprepared to make a coordinated response A great deal of effort and discussion went into developing a coordinated response and luckily it was not needed. We now have agreed upon guidelines for making recommendations on closures of public activities due to smoke risk and allocation of logistical support for masks, filtration systems and air quality monitors. It leaves us much more prepared than in the past. Early autumn rains are beginning to clear the air and reduce the risk of fire allowing us to all breathe a little easier. Budgets continue to look stable and we are tracking down grant funding for specific work projects. We will be receiving some funding from Cascade Pacific Action Alliance for opioid work. We're still searching for stable funding for water quality work as some contracts expired in 2019. We'll have to leave 1.5 positions open for the time being. Cody Lund has given his resignation as environmental health food specialist.This makes several EH specialists that we've lost to Thurston County in the last year. Mason County can't compete with the higher wages of our next door neighbor. WSALPHO continues to work through the process of seeking funding and prioritizing the efforts funded. Currently, in partnership with the Department of Health, we'll be seeking a $3.8 million dollar ask to fix the funding that was authorized in 2019 but not fully funded. We're currently receiving$42,000 of foundational funding from the state. Should we receive the fix, Mason County should receive another $52,000 in flexible FPHS funding. If any additional funds come through,the agreement is to prioritize spending on Hep C and vaccination work. I continue to be a little skeptical about receiving any additional funds and think that should they be received; they'll probably be earmarked for more high P#4$04 visibility topics such as homelessness and mental health/substance abuse activities.Those activities certainly deserve our attention in Mason County. LOCAL We're looking at an exciting Autumn. Several of our community PUBLIC HEALTIHA health staff will be presenting at the Washington State Public Health Association Annual Conference. I will be partnering with DOH for a presentation of foundational public health funding. Mason County continues to provide great examples of high-quality public health work and outreach. We truly have people to be proud of. Dave Windom, MSHS a Community- Health I wServices 3i • I = et Repo July-August 2019 Communicable Disease & Notifiable Conditions(3 programs-CD,TB, STD)Staff:Audrey O'Connor, Back up: Elizabeth Custis&Lydia Buchheit July-August,our communicable disease(CD)program nurse received 74 reports requiring data entry into the State database,and/or investigation and follow-up. * Reporting of Chronic Hepatitis cases began to be handled directly by the State Department of Health in 2019. Disease July-August Total to date Campylobacteriosis 9 19 Cryptosporidiosis 0 1 Giardiasis 0 3 Shiga Toxin 2 2 3 Hepatitis B-Chronic 0 0 Hepatitis C-Chronic Hepatitis C-Acute 1 1 Lyme 0 0 Pertussis 0 1 Salmonellosis 2 6 Suspected rabies-PEP 0 1 recommended R/O measles 1 6 R/O mumps 0 5 Coccidiodmycosis 1 1 Influenza related deaths 0 3 Tuberculosis-Active/open cases 0 0 Vibriosis(non-cholera) 0 3 Yersiniosis 0 0 1 Chlamydia 43 161 Gonorrhea 13 39 Syphilis 1 5 Herpes 0 4 HIV 0 0 otals 74 265 Maternal Child Health Staff: Elizabeth Custis Maternal Child Health Program: Beginning services with the Division of Children Youth and Families (previously Children's Administration and Child Protective Services)to provide the Incredible Years evidenced-based parenting program for their clients needing parenting instruction and support. Began new home visiting Incredible Years parenting program with funding that is provided by a Division of Behavioral Health Resources (DBHR)grant for prevention work. ABCD Dental Program: Public Health nurse has been reaching out to community agencies (schools, medical providers, community activities etc.)to provide Medicaid dental benefit information to parents regarding dental visits for children. Contact information is provided to assist families with finding appropriate dental care locally. Breastfeeding Collaborative: Public Health nurse continues to facilitate the group of Mason County providers that are collaborating to provide support for breastfeeding health. The current focus is to create a breastfeeding support group. Early Learning Coalition of Mason County: This group is co-facilitated by a MCH public health nurse. The focus for this group is to collaborate to prioritize and bring opportunities for children to have learning opportunities. Immunization Improvement Grant: Public Health Nurses are working to increase immunization rates in Mason County via DOH approved activities. Staff has been distributing pamphlets to access the Washington Immunization Information System online to track their child's vaccine history and forecast. School Data is being reviewed to aid schools that might benefit from help in improving compliance rates. Children with Special Health Care Needs: Public Health Nurse will be participating in the SMART Team of Mason County(School-Medical Autism Review Team). This will enable children from our county,that appear to be on the Autism Spectrum per the team,to be seen for a specialty evaluation and diagnosis at Children's Hospital to be seen in 1 month vs. 18 months. Benefits will be earlier support and services. 2 Social Service Programs Housing Staff:Todd Parker Legislative: The Board of County Commissioners adopted the ordinance under HB 1406 to retain a portion of the state sales tax to be used for affordable housing. It is estimated that this will be$104,000 annually. Housing: Annual summary of persons experiencing homelessness Coordinated Entry Households accessing the Homeless Crisis Response System 7/1/18 through 6/30/19 Total Households 831 Male Head of House 370 Female Head of House 457 Other Gender 4 Veteran 23 Homeless Prevention 83 Unsheltered Homeless 241 Chronically Homeless 85 Average Income of any source $116/mo HH w/Earned Income 75 SSDI 30 SSI 104 Domestic Violence Survivor/Victim 204 Currently Fleeing Domestic Violence 89 Disabling Condition 463 Physical Disability 184 Developmental Disability 140 Chronic Health Condition 167 Mental Health 267 Substance Abuse 1 81 The chart below shows the percentages and types of Disabling Conditions reported for the 463(56%)of households that contribute to homelessness. 3 DISABLING CONDITION ubstance Abus Problem 9% Physical Disability 22% Mental Health Problem 32% Developmental Disability 17% Chronic Health Condition 20 Rapid Rehousing program: 44 Households were housed with rental assistance and move-in costs through this program. Family shelter: Crossroads assisted 24 unique households throughout the year through their 7-unit family shelter. 9 households were assisted through the 5-units of Transitional Housing(program participants may stay up to 2- years)also operated by Crossroads. Adult Emergency Shelter: 183 unduplicated adults used Community Lifeline's adult shelter during the six months of operation. Turning Pointe Domestic Violence Shelter: 12 units and 54 beds. The shelter received 410 requests to stay in the shelter and they were able to shelter 359 unduplicated households. Behavioral Health--Treatment Sales Tax(TST) Funded 5taff:Todd Parker, Lydia Buchheit Therapeutic Courts(operates on a calendar year): 2018 Expenditures$469,131(includes prosecuting attorney, defense attorney,and guardian ad litem as it relates to Therapeutic Court services and the 4 Therapeutic Courts) • 2017: 18 graduates from 4 programs(felony drug,family recovery, mental health,veteran) • 2018: 18 graduates • 2019(first 6 months):13 graduates The following contracts are 18-month terms and end December 31,2019. The following information is reported for expenses and numbers served from July 1,2018 through June 30,2019. • Northwest Resources($83,142): Funding supports one case manager for care coordination services. A total of 339 unduplicated adult individuals were served during this period on a goal of 250, 148 of which were new enrollments. 19 entered detox,72 entered inpatient SUD treatment,120 enrolled in outpatient SUD treatment, 15 entered MAT treatment,5 entered inpatient Mental Health treatment and 87 were enrolled into outpatient mental health treatment. Out of the 148 new enrollments 89 reported being 4 homeless. 46 program participants were assisted with rental assistance funds through this program into clean and sober housing(oxford,fresh start). As a result of the care coordinator's efforts 48 program participants gained employment and 12 entered college. • Behavioral Health Resources($51,000): A school-based therapist is funded and served 85 unduplicated students(on a goal of 90)throughout 5 schools in the North Mason School District. • Peninsula Community Health Services($51,130): Two community health workers(patient navigators)are funded and served a total of 114 unduplicated individuals on a goal of 500. Peninsula reports an 83% patient retention rate as part of this program and that 69 individuals have accessed MAT treatment (through Peninsula's MAT program). • Conseio Counseling($37,168): This funding allowed Consejo to serve non-Medicaid eligible or undocumented residents of Mason County. A total of 25 individuals received SUD or mental health treatment services on a goal of 24 as a result of this funding. A few clients were assisted with the costs of psychotropic medication that could not have otherwise afforded it. Mason County Opioid Response (3 programs) Staff: Abe Gardner,Christina Miller-Shinn,Audrey O'Connor Prescription Drug Overdose August 31 marks the end of this three-year grant.The PDO grant was the first project aimed to help Mason County begin an Opioid Response plan—all subsequent projects had its start here.The CDC has awarded WA DOH with another overdose prevention grant,called Overdose Data to Action,and once again Mason County has been chosen as a sub-recipient.This will allow us to continue and deepen the work we have started in substance abuse and overdose prevention. In 2019,August was declared Overdose Awareness Month in Mason County,centered around International Overdose Awareness day on August 31.We participated in the 3`d Annual OD Awareness Walk and first ever Substance Abuse Resource Fair in Shelton,and expanded participation in North Mason by holding the same event in Belfair. Both events were well attended and included emotional and inspirational speakers.This year we able to use funds from this grant to promote the event and overdose awareness in general through 96.9 KAYO Country Radio and were able to purchase nice t-shirts and banners for the event.We look forward to next year's event! DEPARTMENT OF HEALTH OVERDOSE PREVENTION PROJECT Year Reported non- Fatal opioid #of individuals #of Naloxone #of community Resource fatal opioid overdoses** trained in OD kits workshops Guides overdoses* response distributed distributed 2017 17 5 143 246 8 2100 2018 24 1 481 535 12(+41 table Approx.1700 events) 2019 29 4 314 492 10+32 table events Approx.2375 *Numbers include only reported non-fatal opioid overdoses.Many overdoses are not reported. "Numbers are not final until State Department of Health releases final numbers. This can take a few years until toxicology reports are completed. 5 Substance Use Mobile Outreach of Mason County In July and August,the Substance Use Mobile Outreach of Mason County participated in the University of Washington's biennial WA State Syringe Exchange Health Survey.This is the first year this information has been collected in Mason County.These surveys allowed an opportunity to further our relationship with our Mobile Outreach participants and delve deeper into the needs of our community. Participation continues to grow and has increased at our Kamilche location since it has moved (it is now in the lot across from the Kamilche Parkway Express gas station, East of HWY 101).The participation in Belfair remains very low,a topic we will be focusing on trouble shooting in the upcoming months. July-Aug 2019 Program Totals(Oct 2018-August 31 2019) Number of interactions 73 213 Number unduplicated participants 53 134 Mean number of individuals each 4.5 4 encounter is serving Number of syringes exchanged 27,900 90,539 COAP(Community partnerships,Systemic change, Program coordination)- We continue to engage with community partners to work on our Opioid and Substance Use Response Plan. We are quickly approaching the end of the second year of this grant and we are pleased with our progress thus far and are incredibly excited for our third and final year. We are currently gathering and compiling our first full year of data,that we have been collecting from our local substance use treatment provider partners and look forward to presenting that data in November. We are continuing to concentrate on identifying gaps and barriers in our current response plan/treatment recovery system and are making it a priority to work with community partners to find innovative and sustainable solutions. Substance Use Prevention staff: Ben Johnson&Alison Smallwood Community Prevention&Wellness Initiative(CPWI)-Ben Johnson The Shelton and North Mason Prevention Education Partners(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 coalitions focus on community norms, policy and data review,and reducing easy access alcohol point of sale placement in stores, reducing theft,stopping promotion and sales to underage youth and to increase Evidence based prevention programming. 6 The Shelton Coalition continues to meet the 2nd Wednesday of each month at 4PM at the Family Education Support Services office at the Shelton Transit Center. North Mason coalition meets the 3`d Thursday of each month at 4PM at the North Mason High School commons. Recent projects included supporting the Opioid Awareness walks in Belfair and Shelton.The Shelton coalition will be having a fund raiser at Oysterfest in October to assist with funding the 2020 Nature Remedies Calendar to mindful ways and ideas for healthy living. Both coalitions are working on community prevention summits in October.A Full day summit will be held in Shelton on October 11th and an evening Summit on October 15th will be held in Belfair. The coalition coordinator has been seeking to complete at least 180 adult substance abuse opinion surveys in each community by mid-December.This is the first year for survey collection for North Mason and will establish baseline data. It is the sixth year of collecting data for the Shelton area and will inform the Shelton strategic plan which is currently being updated. Community Health Education,Assessment and Data Staff:Alison Smallwood, Lydia Buchheit Alison attended a "Train the Trainer"training for a new curriculum called "The Trauma Informed Approach".The Washington Health Care Authority recently created this training as a response to growing demand from organizations to provide information on the approach and how it can be implemented into community organizations.According to the Substance Abuse and Mental Health Services Administration (SAMHSA) "trauma is a widespread, harmful and costly public health problem". The Trauma Informed Approach was created to help organizations like primary health care, education and criminal justice,just to name a few,to help ease an individual's capacity to cope with traumatic experiences.The purpose of the training was to teach the concept of the approach and then train staff how to deliver the curriculum to our community partners. Allison intends to deliver this training to the community in the future months. Beginning first,with our current Public Health staff. Emergency Preparedness—Staff:Lydia Buchheit,Alex Paysee,Sunni Wood In August,Alison attended the "Advanced Public Information Officer"training course offered by the Emergency Management Institute in Emmitsburg, Maryland.The purpose of this weeklong course was to learn how to establish, manage and work within a Joint Information Center(JIC). A JIC serves as a single point of coordination for all public information operations during an emergency and is a required component of The National Incident Management System (NIMS).The course included a multi-day functional exercise that simulated a real emergency,where along with her classmates,Alison established and worked within a JIC to deliver necessary public information to her assigned communities. The motto of the course best summed up the purpose of a Public Information Officer in an emergency: "Get the right information,to the right people,at the right time,so they can make the right decisions". Moving forward as Mason County's Public Information Officer,this is exactly what Alison intends to do,emergency or not. July began our new Department of Health funding to support Public Health emergency preparedness. The focus for the deliverables this year are to exercise communication plans with partners locally and regionally. 7 From the Desk of the Environmental Health Manager July and August 2019 For Board of Health September 24th,2019—by Alex Paysse In July,Wendy Mathews was hired as our replacement EHS for the vacant position created by Wendy Jonas resignation. Wendy M.comes to us from WSU and has experience working in Environmental Health. Welcome aboard Wendy! A news release was issued on July 31 St regarding closure to a Lake Isabella public swimming area. This was in response to a complaint and investigation where staff found a seep near the lake that is believed to have derived from a failing onsite sewage system. No reports of illness received; closure was a precaution to protect public health. Investigations and inspections followed,where three separate failing onsite sewage systems were found. The system owners are working with professionals on permits and repairs. Mason County has been working towards improving their data management system for tracking onsite sewage maintenance reports. This was discussed at the previous two BOH meetings. Staff has been working closely with the onsite sewage advisory committee and unanimously decided to change providers from Carmody Inc to OnlineRME. The transition process is ongoing,and we hope to have all data transferred to the new system within the next couple weeks(end of September). We are excited for reporting changes that will come with this new program and hope to create more effective public health response and a more detailed system history. EH review staff have been successful at reducing review times these past couple months. In June,EH was running at 5-6 weeks in review times for building permits and sewage permits. As of today,we are back in our typical ranges of 2-4 weeks for the busier summer months. We continue to work with building and planning staff on finding ways to be more efficient in our procedures. As of July 1St,water quality funding has been reduced to 1 FTE. Katie is currently working on our south sound project in North Bay. In October,additional funds are expected for Annas Bay(Hood Canal),but not enough for an additional FTE. As funds for these projects decrease its difficult to scale the work. We are working on finding reliable solutions to these funding problems. Despite funding problems,there is good news for water quality. DOH is working on a couple upgrades for commercial shellfish harvesting. 172 Acres in Oakland Bay is expected to be upgraded soon due to satisfactory sampling and ongoing PIC efforts. 31 Acres in McLane Cove is also looking to change classifications from Conditionally Approved to Approved in response to previous county PIC projects.