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HomeMy WebLinkAbout2004/09/02 - Board of HealthMASON COUNTY BOARD OF HEALTH PROCEEDINGS September 2, 2004 Chairperson Jayni Kamin called the meeting to order at 10:02 a.m. Attendance: Dist. 1, Herb Baze; Dist. 2, Wes Johnson; Dist. 3, Jayni Kamin. ATTENDANCE Steve Kutz, Department of Health Director Dr. Trucksess, Health Officer CORRESPONDENCE None APPROVAL OF MINUTES Cmmr. Johnson/Baze moved and seconded to approve the Board of Health meeting minutes for August 5, 2004 with the deletion of the October 7, 2004 meeting announcement. Motion carried unanimously. B-aye; J-aye; K-aye. PERSONAL HEALTH ISSUES Steve Kutz, Public Health Services Director, introduced Lydia Buchheit, Clinic Services Coordinator. Staff Presentation: Nurse Family Partnership Ms. Buchheit presented a PowerPoint presentation on the Nurse Family Partnership (NFP) program. Ms. Buchheit introduced the nursing staff she works with. Ms. Leslie Dolan, Nurse, has worked with the program for three years and Ms. Elizabeth Custis; Nurse has recently joined the nursing staff. Ms. Dolan was previously a mid -wife here in the county so her expertise is a great addition to the family partnership and maternity services offered at the health department. Ms. Buchheit began her presentation by talking about the research Vincent Felitti, a doctor in San Diego, California, did on adverse childhood experiences and how it impacts adult health. She talked about the research and how it reflects on the NFP program offered through the Health Department. The NFP program is designed to reduce child neglect and abuse. The program started in 1989 to serve high risk pregnant women by providing them services and education on healthy pregnancies and raising healthy children. The vision was expanded in 2001 to include child abuse prevention, drug and alcohol abuse and reduce school drop out rates. Mason County is one of six counties in the State of Washington that has a NFP program. The nurses provide intensive home visitations during the pregnancy and the first two years of the child's life. There are short and long term results and at all times the nurse focuses on the success that has been accomplished. Focusing on the success that has been achieved empowers the client to make changes in their life. The client receives one nurse that will work with them continually through out their program. This has proven to be very successful in building a trusting relationship. The program is for first time parents. Ms. Buchheit's complete PowerPoint presentation is available in the Personal Health Department. Ms. Dolan shared a case history of one of the first families to graduate from the program. When the family agreed to be used as a client example it became even more apparent that history does repeat itself. The great grandmother joined in to give information about how she grew up in poverty, family violence, extraordinary life long mental illness, and continual drug and alcohol abuse, which created MASON COUNTY BOARD OF HEALTH PROCEEDINGS September 2, 2004 Page 2 problems for the grandmother of the baby in the case study. The grandmother grew up in an extremely poverty stricken neglectful home. She was removed from her mother's care as a toddler and was never returned to her mother. She didn't have a relationship with her mother until she was an older teen. The grandmother of the baby experienced extreme mental abuse and neglect and she herself had numerous teen pregnancies. She had four children by the time she was twenty-one years of age. As an adult now she has an anxiety disorder, depression and at times still lives in poverty. When the teen aged mother of the case study enrolled in the NFP program she was living in poverty, a smoker, a high school drop out and had unstable living conditions. She also had other risk factors that were involved and was fairly resistant to the program and change. At the time she enrolled she lived in denial of the problems that surrounded her life. When these conditions exist in a person's life it is very scary for them to make the difficult changes without guidance. It takes having a relationship and trust to be able to make changes for a positive future. Over the course of the program the mother quit smoking, she had a healthy full term baby, she has secured stable housing, she got her drivers license and has reliable transportation. She is determined to get her GED and is enrolled in college classes to accomplish it. She is determined to get a job for herself and be a role model for her child. She did use Temporary Assistance for Needy Families (TANF) for a short time until she was approved for Social Security due to her severe learning disability. Ms. Dolan said the mother is a loving mom and has taken the assistance the program had to offer and used it to create a stable, loving and positive environment for herself and her baby. Often times when the family knew the nurse was coming the whole family would come because they were all learning new ways to be successful and they all had needs. Ms. Dolan stated that the client she presented is the type of clients that the nurses work with regularly and that it is very rewarding when the client succeeds in changing their families future to a positive loving environment for the their children. Cmmr. Kamin asked how often the nurses meet with their clients. Ms. Dolan, replied, the nurses meet with them weekly for the first month then biweekly until delivery. After the baby is born they meet weekly again for the first month then biweekly until the child is twenty- one months of age. From twenty-two to twenty-four months the program is tapered off to once a month for the last three months. Some parents want frequent visits if they are in crisis, so there may be periods that the nurse comes weekly instead of the routine biweekly appointment. There are also some parents that go to work shortly after having their baby and because of their schedule the appointments are made every three to four weeks when the infant gets older. The nurses work very closely with the families during the first few months of the baby's life. Most parents find that infants are really easy compared to toddlers because it is really easy to misinterpret a toddler's behavior. The nurses provide the parents with many tools to help with the toddler years. By teaching the parents about the difficult years of childhood there is lower risk of child abuse. Cmmr. Baze asked Ms. Dolan how many families she works with currently. Ms. Dolan stated she has thirty women on her caseload and actively sees twenty-five of them. She stated that not all of the families on her caseload are NFP cases. But she does use the NFP techniques with all of her families. The techniques that are used in the program are based on promoting strength within to be successful rather than using the problem solving techniques. Cmmr. Baze commented on when Mr. Kutz began working with the Board on this program in 2001. He had the Board of Health come to a meeting in Olympia to promote the NFP program. The Board that attended was absolutely sold on the program and agreed it would be a very positive addition of services to the nursing program. MASON COUNTY BOARD OF HEALTH PROCEEDINGS September 2, 2004 Page 3 Ms. Dolan stated that she had run the First Steps program for three years prior to the implementation of the NFP program. The First Steps program focused on problem solving techniques and the NFP program focuses on strength based techniques. Ms. Dolan has found that people respond better with the strength -based techniques rather than the problem solving techniques Cmmr. Johnson asked what the success ratio is of her cases. Ms. Dolan stated that many of her clients are success cases. She will not have an actual percentage of success clients until next year because the program runs in three-year cycles and until next year the first cycle will not be completed. Cmmr. Baze asked if the families actually graduate the program. Ms. Dolan replied yes, they go have pizza and reflect on all of the wonderful changes that have been made and they are given a framed certificate and a second birthday gift to the baby. Ms. Buchheit commented that as the program moves forward that they are considering having some of the graduates be mentors for the other clients by sharing their success stories and being role models. The Commissioners thank Ms. Buchheit for her presentation. AIDS Walk Proclamation Mr. Ben Johnson presented a proclamation for the Mason County Walks Against AIDS on September 25, 2004. The walk will begin at Wal-Mart. The walk is to raise awareness and a fundraiser to help local individuals with various services. There are approximately ninety-two people in Mason County living with AIDS and about half of those are registered at the Washington Correction Center. Mr. Johnson stated that the Mason County AIDS Advisory Group started a golf tournament to raise money for people living with AIDS in the community. The funding has been used for eyeglasses, emergency housing and other expenses. There have been two golf tournaments and both have been very successful. Cmmr. Johnson encouraged emphasis in preventive actions to reduce the transmission of HIV and the spread of AIDS. Mr. Johnson commented that one of the new programs he provides is the prevention for positive program. Anyone that comes in as a new client for case management is required to attend a three-hour education class with him. The goal is to provide the person with all the information they need to prevent the transmission of HIV and the spread of AIDS, even to their own family. Cmmr. Johnson asked Mr. Johnson if his preventative action procedures come from the Advisory Board. Mr. Johnson replied the Advisory Board is very active in looking at policies and protocols. Cmmr. Kamin asked if Mr. Johnson oversees the Advisory Board. Mr. Johnson stated no that he is a member of the Board. MASON COUNTY BOARD OF HEALTH PROCEEDINGS September 2, 2004 Page 4 Cmmr. Johnson asked whom the Advisory Board Advises. Mr. Johnson replied the Board does advise him on case management and education services. Mr. Kutz stated the Mason County Advisory Council is a community based organization that organized themselves to provide input to the County on AIDS prevention and delivery of services. They provide advice solicited or unsolicited. They are an independent advisory council and anyone can volunteer to be on it. Cmmr. Baze/3ohnson moved and seconded to adopt a Proclamation to declare September 25, 2004 as Mason County Walks Against AIDS day. Motion carried unanimously. B-aye; J- aye; K-aye. ADMINISTRATIVE ISSUES Mr. Kutz updated the Board on the influenza shot delay that may be coming forth in all of Washington State. The manufacturer the County uses for their vaccines has had a recall on all of their influenza products already shipped and their stock on hand. The CDC is predicting that this years influenza supply will still be greater than any previous years. Washington State has ordered the children's influenza vaccine from another company so it shouldn't be affected. Mr. Kutz announced that as part of the influenza program the Pneumonia and Tetanus Diptheria would also be offered to adults at the Health Department. The Tetanus Diptheria vaccine is good for ten years. Health Officer's Report: Dr. Trucksess, Health Officer, reported for the month of August on communicable diseases: Rabies Prev. Treatment — 2 cases; Chronic Hep B with lab — 1 case; Chronic Hep C with Lab — 3 case; Positive PPD Tuberculosis — 1 case; STD Report from January 1, 2004 through August 31, 2004 indicates: Chlamydia - 71 cases; Gonorrhea - 2 cases; Herpes Simplex — 2 cases; Herpes Genital Simplex — 6 cases; Secondary Syphilis — 1 case; Latent Syphilis — 1 case; and HIV — 2 cases. Dr. Trucksess discussed a report he had received regarding the significant impact West Nile Virus (WNV) has had on health care resources in various places of the United States. During the peak outbreak in 2003 many hospitals in Montana reported their emergency rooms were evaluating twenty to twenty-five patients a day that had symptoms consistent with WNV. Currently there are no cases reported in Washington State. There were three horses reported with WNV in Oregon. Regional Support Network (RSN) Ms. Donna M. Bosworth, Thurston/Mason County Chemical Dependency Program Manager, introduced Mr. Erik Landaas, Chemical Dependency Program Specialist. Ms. Bosworth presented the background about RCW 7096 A. It is the statue that sets up the Chemical Dependency Treatment and Prevention System in the State of Washington. The Division of Alcohol and Substance Abuse administers the residential part of the chemical dependency program and sub -contracts with the counties to deliver the out patient services. Thurston and Mason County services have been administered by Thurston County since the mid -seventy's. At the time the health districts split the Mason and Thurston County MASON COUNTY BOARD OF HEALTH PROCEEDINGS September 2, 2004 Page 5 Commissioners agreed Thurston County would administer the social services. The types of services that are provided include community based out patient treatment, alcohol and drug addicted prevention and education programs. Ms. Bosworth gave a PowerPoint presentation, which covered the current revenues, chemical dependency services provided, funding allocations, 2003 treatment service summaries and advisory board members. There were 584 Mason County residents that received chemical dependency treatment services during 2003. There is a waiting list for services offered. The highest priority clients are served first. A priority list has been established. The priority list is: Pregnant/parenting women, youth, injection drug users, homeless, child protective services clients (CPS), and persons living with HIV/AIDS and clients returning form inpatient treatment. Currently Ms. Bosworth and her staff are working on a needs assessment report for the 2005-2007 biennium. In the past years a resource assessment report had been done for funding agencies. Ms. Bosworth has decided to do a true needs assessment, to provide accurate details to secure better funding in the future. The assessment will be presented to the Board upon completion. Ms. Bosworth informed the Board, in August 2004 there have been five heroin overdose deaths in Thurston County. This prompted the network groups to notify the Health Departments across the state that there is some bad heroin on the streets. These network groups notify each other when there is an increase of drug -related deaths or illnesses. The person that runs the needle exchange program talked with some of the people that use the program and they provided useful information that would help identify where the bad drugs were coming from. Ms. Bosworth stated heroin is becoming more of an issue in Lewis, Mason, Grays Harbor and Pacific County. They use the methadone clinic users as a way to track the heroin users by county. Currently there are thirty-one people from Mason County that come to the methadone clinic everyday except Sunday to get their medication and attend group sessions. The other tracking method is by the needle exchange program. The size of syringe the person requests identifies whether they are using methamphetamine or heroin. For a number of years there were more methamphetamine users but recently there have been more heroin users using the needle exchange program. At the Thurston County needle exchange one out of three needles that are exchanged are to out of county people. Grays Harbor is in the process of opening a needle exchange program but it is not open yet. There has been an increase in youth using the needle exchange program. Cmmr. Johnson asked if the demand for services are increasing or declining. He also inquired if one in five clients who need treatment receive services how is the decision made as to which one of the clients would be selected to receive the services. Ms. Bosworth replied it is based on the priority table shown in the Powerpoint presentation. She gave an example of a pregnant lady, who is injecting heroin versus a homeless man, who is injecting heroin the pregnant lady would receive the services, as she would be the priority. She also said the demand for services are increasing around the state not just in Thurston and Mason County. Cmmr. Johnson asked if the demand for services have increased in Mason County. Ms. Bosworth replied yes. Cmmr. Kamin commented that the drug use is a cultural community awareness type issue. Not only is education important but to change the community values to understand the enormity of the problem to be able to reduce it instead of standing by watching helplessly. MASON COUNTY BOARD OF HEALTH PROCEEDINGS September 2, 2004 Page 6 The Board thanked Ms. Bosworth for her educational presentation and acknowledged the program she manages has also been a great asset in the drug court program. Mr. Kutz announced there was one Mason County open position on the Regional Support Network (RSN) Board, and if anyone was interested they could contact Ms. Bosworth for an application. ENVIROMENTAL HEALTH ISSUES Staff Presentation: None Environmental Health Waivers/Variances: Provided for informational only. Submitted to the Board by Health Director, Steve Kutz OTHER PUBLIC COMMENT None ADJOURNED The meeting was adjourned at 11:57 a.m. due to no further business. HEALTH OFFICER Dr. Mark Trucksess, Health Officer BOARD OF HEALTH MASON COUNTY, WASHINGTON Jayni Kamirr, Chairperson 44/F Wesley E. Johnson, Board Member Herb Baze, Board Member