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HomeMy WebLinkAbout2019/11/26 - BOH Packet 04. • OJ-- G P C Al 7„----- t MASON COUNTY I COMMUNITY SERVICES 9�, ``" Building,Planning,Environmental Health,Community Health kb•FIl.•l�N� 4:4 PUBLIC ,& HEALTH I is C L�' ►, lC� MASON COUNTY BOARD OF HEALTH REGULAR MEETING November 26, 2019 10:00 AM 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 September 24, 2019—ACTION Board Members 4. Health Officer Report Dr. Daniel Stein 5. Administration Report Dave Windom 6. Community Health Lydia Buchheit 7. Environmental Health Report Alex Paysee 8. Vaping Ordinance Update 9. 2020 Budget Dave/Casey 10. Other Business and Board Discussion Board Members 11. Public Comments 12. 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 5th Street,Shelton,WA September 24,2019 Attendance: Kevin Shutty,County Commissioner;Sharon Trask.County Commissioner;Peggy VanBuskirk, Hospital District#2;Gary Plews,Fire Commissioner;Kathy McDowell,City of Shelton Council Member. Absent: Cmmr.Randy Neatherlin;Scott Hilburn,Hospital District#1;Keri Davidson, Shelton School Board 1. Vice Chair Peggy VanBuskirk called the meeting to order at 3:02 p.m. 2. Approval of Agenda—Cmmr.Shutty and Gary motioned and Seconded to approve the agenda.All in favor.Motion Carried. 3. Approval of Minutes—Gary/Cmmr.Trask moved and seconded to approve the July 23,2019 minutes as presented.All in favor.Motion Carried. 4. Nurse Family Partnership Presentation-Representatives from Thurston County Public Health showed a PowerPoint presentation regarding a Nurse-Family Partnership.A discussion was then had regarding infants and the importance of healthcare. 5. Health Officer Report—Dr.Stein discussed some projects he has been working on such as a grant for opioid recovery assistance to assist with the epidemic,and partnering with local community organizations to create a system of community partners to improve the health of Mason County.He then discussed a plan to develop a program to address Hepatitis C and explained that there is a goal to eradicate Hepatitis C within Washington State by 2030. Dr. Stein addressed the recent vaping ban and said he would like to see vaping banned on public lands and would like to have a ban on flavored nicotine products in Mason County. 6. Administration Report—Dave Windom briefly recapped his report and announced that there is still work to be done with Legislation in regards to the budget. He then passed out a 2018 annual report and hit key points within the report.Dave asked the board to read through the report and ask questions if they arise.He announced the report will be on the website soon. 7. Community Health Report—Lydia did not go through her report and received no questions from the Board or present public. Lydia then presented a proclamation regarding vaccinations and asked if it could be approved and signed today. Cmmr.Shutty/Gary moved and seconded to approve the proclamation as read.All in favor,motion carried. 8. Environmental Health Report—Dave presented in place of Alex Paysee.An application for a new Onsite Sewage Advisory member was handed out.There was a question regarding her county of residence,so it was moved to hold off nomination until the bylaws were reviewed. Cmmr.Shutty/Gary moved and seconded to wait until the November Board of Health meeting for approval.All in favor,motion carried. Dave talked about a sewage pipe issue at the Fir Lane nursing home.Because of this location being a nursing home,the case will need to be turned over to DSHS. 9. Vaping Ordinance Change-Cmmr. Shutty said he wanted to start a conversation about the possibility of changing Mason County Code in regards to vaping. Dr. Stein said that according to statistics,vaping has grown over 85%in the last two years and the negative effects are now starting to show.He said he would like to see flavored vaping products banned within the BOARD OF HEALTH PROCEEDINGS September 24,2019-PAGE 2 County to prevent teens from using.Kathy McDowell suggested that more education is needed for the kids to realize the harm possible from vaping.Cmmr. Shutty suggested continuing this topic at the November meeting to gain more information about possible bans at the State level. Gary/Cmmr.Trask moved and seconded to support the prohibition of vaping on county property. All in favor,motion carried. 10. 2020 Budget-Dave said he needs to go in front of the Commissioners to ask for a county contribution increase.He discussed how there is a need for more staff in the Health Department,and explained how state funding for staff has dwindled over the years.Dave said he would have more information regarding the budget at the November meeting. 11. Other Business and Board Discussion Cmmr.Shutty discussed the work being done by the Housing Advisory Board.He said that he,Cmmr. Trask and Cmmr.Neatherlin were able to tour the properties owned by the Housing Advisory Board and they have since adopted an ordinance to implement legislation under HB 1406.This allows a portion of the state sales tax to be used for affordable housing projects.Cmmr. Shutty said he was also able to meet with Crossroads Housing to talk about a housing trust fund project. 12. Public Comments-Tom Davis spoke in favor of the vaping motion just made.He said he was impressed at how quickly the Board acted.He then welcomed Dr. Stein,praising his ambitious goals for the County. Tom talked about a recent trip to Oregon,where he saw the Eugene Public Health Department put on a flash mob to gain interest.He suggested Mason County do something along the same lines,or put on a 5k to raise awareness. 13. Adjourn-The meeting adjourned at 4:24 p.m BOARD OF HEALTH PROCEEDINGS September 24,2019-PAGE 3 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 Keri Davidson,Shelton School Board Reminder, get your flu shot! From the Director's Desk November 27, 2018 Happy Thanksgiving! Fall seems to be the time of meetings and conferences.As I write this, I'm about to head to the County Leaders Conference.This year will include County Commissioners, WSALPHO, Planning Directors, Solid Waste Directors and Human Services Directors. Our department touches all these areas so it should be a very valuable conference. Other members of our team participated in a panel discussion at the Washington State Public Health Association in October where we discussed the role of local public health in relation to the opioid epidemic, demonstrating where Mason County is leading opioid intervention. Another panel addressed the future of funding for Foundational Public Health Services. In partnership with the Cascade Pacific Action Alliance, we held an event at Alderbrook to introduce the community to the idea of a health forum.We're looking at the entire population and what it takes to keep people healthy and out of the health care system in the first place.The focus is Prevention;the key to driving down health care costs.The event was very well attended, and we've gotten some great feedback from the community. Now it's time to "close the deal" and get commitments to support this work through time, efforts, or dollars. I want to thank our team members from Community Health who put on the event and made it such a success! Dr. Stein will be leading the charge for our local health coalition. Public Health is Essential! For the first time we have Foundational Public Health Services (FPHS) as a key priority in RCW and now we have the launchpad to move forward. 22 million dollars was allocated in 2019 for FPHS in legislation but only 18.3 million was PO actually delivered. Part of the issue comes from attaching FPHS dollars to 404 vaping taxes which came in at levels less than anticipated. In the DOH budget for this next legislative session, we're asking for a "technical fix" which would complete the funding to the legislative authorization. With the current LOCAL restrictions on vaping and further restrictions anticipated coming from the PUBLIC HEALTH! next legislative session,we may have difficulty in achieving the fix. I'm not forecasting much in the way of public health legislative issues beyond vaping in the upcoming session. I'd like to take this opportunity to commend the public health team we have. Our environmental health folks have had some turnover, but Alex is building a great EH team. Our community health folks continue to lead the way at the local level.The Administrative folks keep things humming along and in many ways are the public face of public health. As I walked through Oyster Fest, I saw our people working as well as donating their time to a variety of community organizations. We truly have a sharp, involved, and energetic team. Reminder, get your flu shot! Our FTE's stand at 19, stable from last report Dave Windom, MSHS 4.0*, 41.4 , 4 6 S Community' Health & Human Services- Manager Report: f September-October 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 60 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 Sept-Oct Total to date Campylobacteriosis 9 28 Cryptosporidiosis 1 2 Giardiasis 1 4 Shiga Toxin 2 0 3 Hepatitis A-Acute 1 1 Hepatitis B-Chronic 0 0 Hepatitis C-Chronic * * Hepatitis C-Acute 0 1 Lyme 0 0 Pertussis 0 1 Salmonellosis 0 6 Suspected rabies-PEP 0 1 recommended R/0 measles 0 6 R/O mumps 0 5 Coccidiodmycosis 0 1 Lead Exposure 1 1 Influenza related deaths 0 3 Vaping Associated Lung Injury 1 1 1 Tuberculosis-Active/open cases 0 0 Vibriosis(non-cholera) 0 3 Yersiniosis 0 0 Chlamydia 39 200 Gonorrhea 6 45 Syphilis 0 5 Trichomoniasis 0 1 Herpes 1 5 HIV 0 0 Totals 60 323 Maternal Child Health Staff: Elizabeth Custis Maternal Child Health Program: As part of the DBHR prevention grant, Elizabeth Custis is providing the Incredible Years evidenced-based parenting home visiting program to families across Mason County. Education in a classroom setting is planned to start in January. ABCD Dental Program: RN collaborated with the new Early Childhood Education and Assistance Program(ECEAP)to provide Medicaid dental information as part of their parent open house for new students. Previously Shelton Headstart,the ECEAP is a pre-kindergarten program serving at-risk children and their families, providing preschool education, health services, intensive family support, and parent involvement and training. Medicaid dental information was also provided to the Skokomish Headstart and Childcare,Squaxin Headstart and Childcare, and South Puget Intertribal Planning Agency(SPIPA). Outreach materials were also provided to Grapeview Elementary, N. Mason High School,and Hawkins Middle School. Breastfeeding Coalition of Mason County: Staff continues to facilitate the group of Mason County providers that are collaborating to provide support for breastfeeding health. This group is a collaboration of medical providers, MGH Birth Center RNs, home visitors,clinic staff, lactation consultants,WIC,and Mason County Maternal Child Health (MCH)staff. The group is organizing a new breastfeeding support group with the goal that infants will be supported to breastfeed longer and improve the health of mother and babies in our county. Early Learning Coalition of Mason County: Elizabeth continues to co-facilitate this group made up of agencies serving Mason County. The mission of the coalition is to support parents,caregivers, and the community in developing the skills children need to be successful in school and life. The coalition coordinated an Early Learning Family Fun Fair in October for families to have access to free early learning activities and agency resources. Immunization Improvement Grant: Public Health Nurses are working to increase immunization rates in Mason County via DOH grant approved activities.Staff has been distributing pamphlets to access the Washington Immunization 2 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: RN is participating in the SMART Team of Mason County(School-Medical Autism Review Team). This enables children from our county that appear to be on the Autism Spectrum per the team,to be prioritized 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. Elizabeth Custis, RN-Mason County, Dr. Rose Rayos, MD-Oakland Bay Pediatrics, and Cheryl Woods, PT Director of Mason General Hospital Rehabilitation were recognized at the Department of Health CYSHCN Communication Network Meeting for work instrumental in creating the SMART team in Mason County. They are working with Kate Orville,the UW Director of Medical Home Partnerships and received grant funding to bring the Autism Diagnostic Observation Schedule(ADOS) curriculum to our county.This curriculum will be utilized by the MGH therapists to evaluate children in Mason County. Social Service Programs Housing Staff:Todd Parker Crossroads Housing held a Landlord Appreciation and Recruitment Event on September 26,2019.The event included a special emphasis on landlords that are willing to rent to veterans. Community Lifeline opened October 1,2019! Community Lifeline was granted an extension on their special use permit from the City of Shelton and received grant funding to be open every night for 7 months(October 1—April 30). The City of Shelton is requiring building code upgrades before they will be eligible to be open year-round or expand bed capacity. Behavioral Health--Treatment Sales Tax(TST) Funded Staff:Todd Parker,Lydia Buchheit Discussions have been occurring to develop Medication Assisted Treatment(MAT)and wrap-around re- entry services for those in and exiting the Mason County Jail. The Housing and Behavioral Health Board have been reviewing changes to Behavioral Health Services for Medicaid covered and uninsured individuals in Mason County in 2020 and how the TST funding might support gaps in services. Mason County Opioid Response (3 programs) Staff:Abe Gardner,Christina Miller-Shinn,Audrey O'Connor Overdose Data to Action(OD2A) Mason County's Prescription Drug Overdose program (the program prior to OD2A)was asked by the Washington State Department of Health to present at the Washington State Public Health Association Conference in October.Together with DOH and Snohomish Public Health,we specifically presented on the challenges and successes of reaching survivors after a reported overdose event.We also discussed what we have done creatively in our community to connect with high risk individuals to educate them about overdose risks and link them to recovery support services. Overdose Data to Action,or OD2A, is the next iteration of the Prescription Drug Overdose(PDO) program which ended August 31, 2019.This grant has a similar end-goal as PDO--to reduce morbidity and mortality due to opioid use--and expands upon the work done in the previous grant. Short-term outcomes include increased awareness and coordination of linkages to care, improved coordination of public health and safety efforts, use of shared data to inform collaborative public health and safety prevention,and increased awareness of the risks of prescription and illicit opioids. 3 Intermediate outcomes include improved utilization of evidence-based approaches to prevention, intervention,and referral to treatment by increasing referrals to and engagement in evidence-based treatment, and increased fidelity to opioid prescription/medication protocol. These outcomes will be accomplished through four major tasks: participating in care coordination meetings and improving referral processes, conducting data collection and analysis, conducting continuous community education and outreach, and facilitating academic detailing to providers on safe opioid prescribing, overdose prevention,and buprenorphine-based Medication Assisted Treatment (MAT). Substance Use Mobile Outreach of Mason County Attendance for the Mobile Outreach continued to grow during September and October,with the largest increase in unduplicated participants to date (64 unique individuals seen in these two months).The end of October also marks the end of the first year of program operations,as it debuted the first week of November 2019.The following is a collection of data from November 12018-October 31, 2019. Program Data Syringes Exchanged 117,029 Unduplicated Participants 173 Total Individuals Served(#people being exchanging 585 for) Total Number of Visits 298 Percent of Visits Where Naloxone Was Given 56% Demographic Information Age:18-25 7% Age:26-35 40% Age:36-45 21% Age:46-55 24% Age:56-65 6% Age:66-75 2% Age 76+ 0% Gender: Female 54% Gender: Male 46% Race:White 71% Race:American Indian/Alaskan Native 24% Race: Hispanic/Latino 3% Housing Status: Housed 82% Housing Status:Un-housed 18% Drug History Information Drug of Choice: Heroin 64% Drug of Choice: Meth 23% Drug of Choice: Heroin/Meth Combo 6% Drug of Choice: Marijuana 6% Ever Overdosed 38% Never Overdosed 59% Referrals Given Treatment(inpatient,outpatient,detox) 26 Medicated Assisted Therapy(MAT) 18 Mental Health 2 Medical(primary,urgent,specialist) 5 4 COAP(Community partnerships,Systemic change, Program coordination)-Abe Gardner Abe Gardener was nominated by peers and chosen by the Behavior Health Resources Foundation to receive the Phoenix Award.The award celebrates perseverance and strength in rising from past challenges and celebrating individual achievements to become a model for others in the community. We are very proud of Abe and all he has contributed to Mason County's Opioid and Substance Use Disorder Response. Public Health's COAP program continues to facilitate and coordinate county-wide efforts to accomplish a no-wrong door approach for individuals accessing the local treatment and recovery support system. There have been recent efforts to help coordinate with community criminal justice partners in bringing a Law Enforcement Assisted Diversion (LEAD) program to Mason County. There will be an RFP process that should be released sometime in November that would provide the necessary funding to start a program in Mason County. There has also been a concerted and continuous effort to improve coordination between the local substance use treatment partners and local recovery support agencies(transportation, housing, mental health etc.) With monthly meetings, network surveys and real-time feedback, Public Health is hoping that the current gap between treatment and recovery support continues to lessen,as nationwide data shows that sustained engagement and overall success to treatment is directly tied to holistic and comprehensive care coordination. As a part of the COAP cohort,there was also an opportunity in joining a workgroup at the Bureau of Justice office in Washington D.C. back in October. This workgroup was tasked with providing feedback and insight into what data and research would be useful to local jurisdictions to better support opioid and substance use responses. There will be a paper published and data collections efforts started as a result of this and several other similar workgroups. Abe Gardner was able to attend this important national meeting and felt it was an honor to be a part of such a diverse and knowledgeable workgroup and a privilege to represent Mason County amongst so many other communities across the United States. Substance Use Prevention Staff: Ben Johnson&Alison Smallwood Community Prevention&Wellness Initiative(CPWI)-Ben Johnson The Shelton Coalitions 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 3rd Thursday of each month at 4PM at the North Mason High School commons. Both coalitions assisted with supporting the Opioid Awareness walks in Belfair and Shelton in Late summer. The Shelton coalition served ice cream at Oysterfest in October to assist with funding the 2020 nature remedies calendar.The calendar was completed and over 5000 have been distributed throughout Mason County, Health Clinics,Treatment Centers, Hospitals, Libraries. County Buildings and more. The Shelton Substance Abuse Full Day Prevention Summit was conducted at the Squaxin Island Tribes community kitchen Oct 11' The North Mason Prevention Summit series are scheduled for January, February and March. Dates and times TBA. Topics for both summits include: Current Science on Cannabis&Alcohol-Implications for Prevention--Dr.Jason Kilmer, University of Washington Associate Professor in Psychiatry&Behavioral Sciences Do Dad's Make a Difference?--Keoki Kanuanoe, Director of Father Engagement, FESS Current Science on Vaping-- Kateri Wimsett,Thurston County Public Health &Social Services. Social Norms--Scott Walker,Washington State Traffic Commission 5 The coalition coordinator has conducted more than 215 Department of Behavioral Health community surveys in North Mason.This the first year for North Mason (Baseline).Over 275 surveys were collected for the sixth year for Shelton. The Shelton Strategic plan was also updated and reflects all current Health Youth Survey and community data. Community Health Education,Assessment and Data Staff:Alison Smallwood, Lydia Buchheit The first week in October Alison attended the annual Washington State Public Health Association Conference along with several other Community and Family Health team members as well as Community Services Director, David Windom. One of our team,Christina,was a conference presenter with the State Department of Health on Mason County's Overdose Prevention program. In addition staff attend in order to learn more about what is going on in Washington State in their areas of focus.This year's conference focus was "Building Bridges to an Equitable Future-Strength and Resilience in Public Health". Lastly, it is always important to network with folks from neighboring counties and the state department of health to share ideas, challenges and successes. In 2020 our division will send another group of staff to contribute and benefit from this annual conference. Also in October,the Mason County Health Coalition hosted a Summit at the Alderbrook Resort&Spa. This event was paid for using grant monies received from a Cascade Pacific Action Alliance grant that required the coalition to host an event of this nature.The purpose of this event was twofold: (1) We wanted to share important information about the current health of Mason County and (2)We hoped to engage the community in the process of improving the health and wellness in Mason County, by asking them to provide input on the areas in which the coalition should focus its work.The evening was successful,we ended up having 85 individuals in attendance and we received contact information cards from 41 of those attendees. We are planning a follow-up event that will establish work groups in the four priority areas that were selected on the contact cards returned by attendees during the Summit. The most popular areas emerged as: 1. Access to Behavioral Health (Mental Health&Substance Abuse) 2. Healthy Living(Healthy weight, physical activity smoking&tobacco use) 3. Access to Affordable& Healthy Housing 4. Access to Healthcare Services This follow-up workshop meeting will be held on December 4',2019 from 3-5 PM at the Public Works building.We are hopeful we will have a good turn out and we can begin to establish projects to work in the areas above. Next Board of Health we will report back to the board on how the workshop event and the status of the workgroups. We continue to work to improve Mason County's smoking policy to include vaping on all county property including parks and fairgrounds. We must hold a hearing for public comment prior to the change.The paperwork for this has been summited to the clerk of the commission and is scheduled for December 10th.We are hopeful we will be able to establish this change in early 2020,and will provide an update on our progress at the next Board of Health meeting. 6 From the Desk of the Environmental Health Manager September and October 2019 For Board of Health November 26th,2019—by Alex Paysse On September 3ra,Mason County completed the contract with OnlineRME for use of their online data management services for Onsite Septic System maintenance tracking. Around September 21 St all the historic reports were successfully transferred from the previous service provider. The past two months staff has worked closely with providers,the public,and OnlineRME staff to cleanup historic errors and fine tune Mason County reporting. Staff is currently working with OnlineRME on report building so we can continue our mailings and homeowner notification work listed within the county Local Management Plan(LMP). In September we received resignation notices from both Cody Lund and Katie Otanez. Cody had accepted a new position with Thurston Co.and Katie had decided to move to Yakima. While the turnover in EH has put strain on staff and management,I believe we have thrived in minimizing impacts to the programs serving Mason County. One of the items I have pressed staff on this past year is documenting policies and procedures for the many services we perform. By doing this we reduce impacts of staff changeovers and increase job performance for new staff. I am very proud of our staff in EH for all their hard work and dedication to Mason County. On September 16th,Kayla Hamme joined the EH team. Kayla has a bachelor's degree and recently completed an internship with Environmental Health at Spokane Health District. Kayla will be working our food program as the replacement food inspector for Cody Lunds resignation. Kayla is scheduled to attend the state Food Inspector training course on November 19th-21 St,although the past couple months have already provided many learning opportunities. She is doing a great job so far and I am excited to see what she can do for the program. Oysterfest 2019 was held on October 5th and 6th. Mason County EH staff again hosted a water quality/septic system education booth. Staff educates system owners on the importance of OSS maintenance and Au.sEp•ile _ possible impacts to water quality and public health. In addition,EH REQUIRE , ;- staff inspected 34 temporary food establishments throughout the """'°"" _ weekend. Between the booth and food inspections,Oysterfest is 5 always a busy weekend for EH. it • LL SEPTIC SYSTEMS 1 QUIRE MAINTENANC October 15th,Kayla attended the annual food program workshop hosted by DOH.Much of this workshop was spent discussing the Or WAC revision status and proposed changes. 2019MCPHOysterfestbooth October 16th through the 18th,I attended the annual Environmental Health Directors meeting. This 3-day meeting brings together EH leaders across the state of Washington for updates and collaboration towards statewide environmental health concerns. During this meeting,the WAC updates to Food Rule and Onsite Rule were discussed. I included a couple handouts received for further information. As you will see these are two significant rules that are looking at implementation dates within a year of each other. These WAC updates will require additional training with staff and increased coordination with program stakeholders. October 22nd EH staff participated in our All Staff training event for Community Services. Most of this event was spent discussing the building permit process and how to resolve process issues and obtain online submittals in the new program SmartGov. In 2018,there were around 1500 building permits. Most these permits require EH staff to review for sewage and/or water adequacy and setback issues. October 28th through the 31st,Luke attended an out-of-state 3-day FDA training in Florida for Temporary Food Events. While Kayla will handle most of our food inspections for temporary events,Luke has been training as a backup food inspector. This training was funded by an FDA grant awarded to our department. While most of our EH programs are only funded for 1 or less FTE,we take advantage of cross-training opportunities like this one to provide depth to our EH services. DOH is working on possible upgrades to the Big Bend Shellfish Protection District within Hood Canal#6,replacing the conditional harvest area with full approval and removing many individual parcel closures. The past 2 years staff has been working this area investigating non-point pollution sources and correcting OSS failures. This work was funded with our regional NEP project with the Hood Canal Coordinating Council,referred to as Hood Canal Regional PIC. See attached flyer that highlights some of the Phase 3 outcomes. Phase 4 will include work in the downgraded area of Minas Bay,per the closure response plan that was approved in 2018. Phase 4 is awaiting additional funding. �yp•166 T- E Haller Ave E Sprague Ave k i 6 E eaanon Ave ¢ Hood Canal><6 ;Noon Cans#6 Robin Hood Yfy 3P Hood Canal 66 E YID DOH Commercial Shellfish Map 11.18.19 Retail Food Service Chapter 246-215 WAC ',%I Health Rule Revision Draft Changes Update October 2019 Retail Food Rule: Top 10 Potential Changes Progress Timeline *The following provisions are being reviewed and are not final.* Current timeline has lengthened by three months. 1. Certified Food Protection Manager(CFPM) At least one employee must be a CFPM with ANSI certification from one of • July 2018 Stakeholder comment on 2017 five national tests.The CFPM does not need to be on premises, but must FDA Model Food Code ensure all PICs are properly trained and able to ensure Active Managerial Control.There is a 1 year extension to meet CFPM requirement. • September 2018 Food Safety Advisory Council 2. Employee Health rule review meetings begin Establishments must notify employees about reporting illness to the PIC and be able to verify they provided the notification. • May 2019 First draft of revised WAC 246- 3. Clean up of Vomiting and Diarrheal Events 215 shared with stakeholders Establishments must have a written plan to clean up vomit and diarrheal events. Department of Heath will share sample plans/items to include for • July 2019 use in food establishments,such as temporary events, mobile food units, Draft rule presented at five schools,and facilities serving highly susceptible populations. statewide locations and online 4. Bare Hand Contact with Ready-to-Eat Foods • October 23, 2019 Establishments wanting to prepare food with bare hands must demonstrate Final Food Safety Advisory unique active managerial control requirements related to employee health Council review of draft rule in order to be approved. Department of Health is working on a sample • Late 2019 application with guidance materials for local health. Submission of CR-102 5. Date Marking for 7-Day Shelf-Life • January 2020 Select ready-to-eat, refrigerated, perishable foods prepared in-house or in State board of health meeting opened packages will need to be marked and used within 7 days. Able to reheat or otherwise remediate products that can be safely reconditioned. • September 2020 Potential implementation date 6. Refilling Reusable Consumer-Owned Containers of revised WAC 246-215 Establishments have the option to allow customers to bring in a clean container to fill, refill,or reuse. Education Materials 7. Dogs in Outdoor Areas Upcoming education materials. Dogs may be allowed in outdoor areas if an operator follows set procedures with an approved plan and signage notifying customers. • Mobile Food Unit Guides Plan review guidance materials 8. Mobile Food Units to be complete by March 2020 Several changes were made for mobile food units based on recent state law • Public Health Rationale changes and comments received. A written explanation of all 9. Donated Foods Washington modifications to the Several sections were changed to clarify food source and reduce limitations FDA Model Food Code to help safely rescue food. Additional changes to notification are expected. • Training Materials 10. Food-Specific Changes New Food Worker Card and • Ground meats will need to be cooked to 158°F instantaneous Person in Charge materials by • Fish must be kept separate to prevent allergen cross-contact July 2020 For more information about the Food Service rule review, visit www.doh.wa.gov/foodrules>Retail Food Code Revision or contact Susan Shelton at 509-212-1206 or susan.shelton(Jdoh.wa.00v. dWashington State Department of 6Health OFFICE OF ENVIRONMENTAL HEALTH AND SAFETY On-site Septic Chapter 246-272A WAC October 2019 ANTICIPATED' ' Purpose oisitioCOMPLETION DATE DATE The purpose of this rule revision is to J �... COMPLETED update chapter 246-272A WAC, On-site Review On-Site Rule, December 2017 December 2017 sewage systems. Updates to the rule will Chapter 246-272A WAC State Board of Health reflect septic design, installation, operation (SBOH)directs DOH to January 2018 January 2018 and maintenance, and management. begin rulemaking File CR101 March 2018 March 2018 Recent Issues and Activities Form On-site Rule The On Site Rule Review Committee (ORRC), Revision Committee May 2018 May 2018 (ORRC) comprised of industry experts, local health ORRC kickoff meeting#1 June 2018 June 2018 and other stakeholders, has been ORRC Meeting#2 September 2018 September 2018 established and will meet throughout 2018 ORRC Meeting#3 November 2018 November 2018 ORRC Meeting#4 December 2018 December 2018 and into 2019 to discuss revisions to chapter SBOH update January 2019 March 2019 246-272A WAC.The ORRC will provide ORRC Meeting#5 April 2019 April 2019 options and recommendations regarding ORRC Meeting#6 June 2019 August 2019 rule revision for the State Board of Health to Draft revised rules August 2019 August 2019 consider. Hold statewide workshops Sept-Oct 2019 October 3,2019 Informal draft comment Aug-Oct 2019 October 8,2019 period-Pre CR102 SBOH update November 2019 November 18,2019 Next Steps Revise draft rules based November 2019 Stay informed of this rule revision process on stakeholder comments by signing up for GovDelivery rule-making ORRC Final Meeting to December 2019 review final draft rule notices Wastewater Rules and Regulations Prepare rules and June 2020 Email Updates. required analyses for filing SBOH briefing June 2020 File CR 102—formal rule 2020 proposal July Last day to submit written August 2020 comments Public Hearing September 2020 1----- Respond to stakeholder October 2020 comments File CR 103—adopted November 2020 rule Train Stakeholders on 2020-21 new rule Rule Effective November 2021 For detailed information about the On-Site rule revision process,please see the Department of Health website at https://www.dohma.gov/CommunityandEnvironment/Waste waterManagement/RulesandRegulations/OnsiteRu IeRevision or contact Jeremy Simmons,On-Site Program,at 360-236-3346 or email leremy.5immonsr?a doh.wa.gov c°°RDIA,,,r t oc., HOOD CANAL REGIONAL POLLUTION IDENTIFICATION AND CORRECTION (PIC) PROGRAM .,1 ...e 2017-2019 ACCOMMPLISHVE\TS & HIGHLIGHTS 45. • The Hood Canal Regional PIC program is a The PIC team collects water samples along drainages cooperative effort to identify, investigate, and to Hood Canal shorelines, looking for fecal pollution proactively correct fecal pollution sources that drain - that puts Hood Canal at risk.When they find to the Hood Canal shoreline. We work directly with __, pollution,they track it back to the source,and community members to protect clean water and r work with neighbors to fix the issue. beaches and keep our community healthy. ;.F: Why is the PIC program important? '` Clean water is the key to preserving Hood Canal's human , J. . ' ,- !`•I~ r_ -;, health, robust tourism, recreational appeal, and rich _ � " natural resources—including shellfish and finfish,whichi. r ..x•. . , offer important economic, cultural, and subsistence value i;- , ▪ r to residents and tribes statewide. The PIC program is -• - f y = focused on protecting our clean water by proactively ;5"; ` �. 7;'' identifying, investigating, and addressing threats to :} Y prevent further harm. `,. 1t i fLt . SK O/f �. In addition, because our regional approach consolidates r "" �` �` grant applications,contracts, quality assurance plans, • -� t. �,,1 +t . - • expertise, labor hours, and reporting, individual program �`` ' ' p p g !_ ,'. „tot, partners experience the full benefits of the program at a - • , .6.- fraction of the cost. In turn, each partner brings a broad �,':�i "^*`,,� A. range of resources and knowledge to help us address "'. challenging pollution problems. - - A robust local PIC program N SEPTIC SLEUTHING keeps Hood Canal and the Between 2017 and 2019,the regional team walked 66.6 peoplwho live here miles of priority Hood Canal shorelines and sampled all e fresh waters draining to the beach.We focused on places healthy. . where people swim,fish,and harvest shellfish,because sf,- , li A that's where human health is most at risk. We identified multiple"hotspots"with high fecal pollution and visited 380 properties in those drainage areas to look for fecal pollution sources. During each visit,we provided site-specific tips on how to get the - most life possible from septic systems. - — The team worked closely with 28 property owners to ti - complete needed on-site septic system(OSS)repairs, '. providing free technical assistance to support these ` ° community members in correcting their pollution sources voluntarily.�� / (' • ACOI M1rfMason llr r'r' skuorq .,x'•yryf nJ-Sl ay'ani ,illii- a _. `11 KITSAP PUBLIC Ir"Tl�(���' Consar canon e.....MAW.... SKOKOMISH I�HEALTH DISTRICT tIC�Heaith I ,-;-� `� DlsMet GOORUUI(4is yo HOOD CANAL REGIONAL POLLUTION IDENTIFICATION AND CORRECTION (PIC) PROGRAM ail °yj•) 2017-2019 ACCOVPLISHVENTS & HIGHLIGHTS EST.1985 • jl• .. 1. •t� �.fi, - RESULTS THROUGH COLLABORATION: 2017-2019 Highlights �;Y.r� . i' ` Agency Overall g Y Outcomes Outcomes ' .r , . ' -. JEFFERSON COUNTY is ��`t' y-isti"F y i-9 59.5 shoreline miles Y 001Q 11 ' r ' D 190 site visits a 41 OSS failures 5`21 OSS repairs 66 380 SHORELINE MILES INSPECTED SITE VISITS CONDUCTED The regional PIC team provides a coordinated I. c 7 a.lCf•{ approach and works KITSAPCOUNTY collaboratively with the MASON COUNTY -re 0.8 shoreline miles e fi.3 shoreline miles IDa 88 site visits community to protect p�102 site visits S OSS failures 28 clean water on Hood = 9 OSS failures -V4 OSS repairs 55 Canal beaches. 5`3 OSS repairs OSSFAILURESIDENTIFIED OSS REPAIRS COMPLETED Hoodsport is a vibrant and historic community with miles of shoreline,rich shellfish resources,and aging septic systems.Area shorelines have been closed to shellfish K !� harvesting for decades due to septic system pollution.The Hood Canal PIC partners—led by �I the Skokomish Tribe,Mason County,and Washington State Department of Health(DOH)— ,R ,, have been working diligently to prevent and correct pollution sources to open the shellfish ,,r ;L beds to harvest.We have seen water quality improvements as a result of this work and it ., will allow DOH to evaluate reopening shellfish harvest in Hoodsport. CA COLLABORATIVE ACCOMPLISHMENTS W ► Skokomish Tribe alerted the team to rich shellfish resources in Hoodsport and assisted /� with Hoodsport water quality monitoring CJ ► Mason County conducted Hoodsport shoreline investigations and identified seven failing septic systems—two are repaired,and five are in the correction process �* 0- Water quality has improved at six of the nine shoreline pollution hotspots due to PIC . Co) activities in the drainage,as we await additional OSS corrections in progress We Need Your Support Clean water is crucial to the health of the Hood Canal community. It is also essential to safe recreation and its economic benefits. The Hood Canal Coordinating Council developed the PIC program to protect Hood Canal,and continuation of our work will require a stable funding source.Grant funding is becoming harder to secure,but the challenges that the PIC program addresses are urgent and ongoing.A robust PIC program requires a sustainable funding source to meet the needs of our communities today and prepare for the challenges of tomorrow. This project has been funded wholly or in part by the United States Environmental Protection Agency under assistance agreement PC-01J18001 to the Washington State Department of Health.The contents of this document do not necessarily reflect the views and policies of the Environmental Protection Agency,nor does mention of trade names or commercial products constitute endorsement or recommendation for use.