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HomeMy WebLinkAbout1997/06/05 - Board of Health (2)MASON COUNTY BOARD OF HEALTH June 5, 1997 The Board of Health was called to order at 10:12 a.m. by Chairperson Cady with Board Member Bolender in attendance. ATTENDANCE: Mary Jo Cady, Chairperson John Bolender, Board Member Dr. Mark E. Trucksess, Health Officer Brad Banner, Director of Health Services Steve Kutz, Personal Health Director Mark Tompkins, Environmental Health Director Mike Rutter, Central Services Director Carla Huyck, Health Educator Diane Crabtree, R.N., P.H.N. Nancy Plews, Board of Health Clerk CORRESPONDENCE Announcement of the Second Annual Minority Health Summit to be held June 19, 1997, in Sea Tac was received from DSHS/Tacoma Urban League, Inc. An article relating to the importance of minimizing human and domestic animal contact with bats was received. APPROVAL OF MINUTES Board Member Bolender/Chairperson Cady moved/seconded that the minutes of the May 1, 1997, meeting be approved as corrected. Motion carried. Vote: C:yes; B:yes; O:absent. HEALTH OFFICER'S REPORT Dr. Mark E. Trucksess, Health Officer, presented the communicable disease report for the month of May, 1997. There was an outbreak of giardia in a daycare center resulting in five cases being identified and three more under investigation. There have been two cases of camplabactor, one case of Hepatitis C, one Hepatitis B, and one Hepatitis A. The Morbidity and Mortality Weekly Report issued by the Centers of Disease Control on May 9, 1997, had a report pertaining to human rabies in the United States. Since 1980, there have been a total of 32 cases of human rabies nation-wide. Of those 32 cases, over half were bat related. A definite bite history in the bat related cases could be documented in only one. In eight instances there was contact with a bat reported by a patient, family member or friends. In none of those cases was there a bite evident or a wound recognized. These findings suggest that limited or seemingly insignificant physical contact with rabid bats may result in transmission of the virus even without a definite history of animal bites. Therefore, the rabies post -exposure prophylaxis should now be considered in all situations in which there is a reasonable probability that contact with a bat may have occurred, unless prompt laboratory testing of the bat has ruled out rabies. Examples of potential contacts include a sleeping person who wakes to find a bat in MASON COUNTY BOARD OF HEALTH June 5, 1997 - Page 2 of 5 the room, when an adult finds a bat in the room with a previously unattended child, or a bat is detected in the presence of an unattended child or mentally disabled or intoxicated person. Adherence to these recommendations and guidelines from the Advisory Committee for Immunization Practice should maximize and help the provider's ability to respond to situations. There have been two recent bat exposures. One includes a woman who was walking when a bat flew down, bit her, and flew off. She is now getting post -exposure prophylaxis. In the other case, a couple woke with a bat in the bedroom. The bat was captured and brought to the health department in a coffee can. The bat was subdued by health department personnel who are now receiving bat prophylaxis because the bat was rabid.. The couple has been advised to receive the prophylaxis also. Chairperson Cady asked Dr. Trucksess to comment on a case mentioned at an earlier meeting in which an individual had no known exposure, but had still contracted rabies. Dr. Trucksess responded that one text book stated that there was one known case in which the rabies incubation period appeared within 7 years, but there were no other details. He noted that the usual incubation period was approximately 4 to 6 weeks. Chairperson Cady asked Dr. Trucksess to comment on the fact that rabies infection has also been transmitted through the air. Dr. Trucksess replied there was suspicion of transmission via the air occurring in a spelunking cave located in Texas. The Texas Health Department placed a cat and a dog in a fine meshed cage so they could not be bitten, lowered the cage into the cave, and both animals died of rabies. This documents the fact that transmission through the air can occur. This case was a special circumstance, however, because the cave was very heavily infested with bats. Chairperson Cady commented on a house located in the Cloquallum area that had been infested with thousands of bats at one time. The roof was taken off the house, replaced, and the bats are no longer there. She worried that the workers who replaced the roof may have been exposed, as well as the owners of the house, their pets, and visitors who had come in close contact with the bats. Dr. Trucksess noted that long incubation periods can occur. Before doing work around areas where bats have lived, mucus membranes should be protected as well as any flesh which might come 'in contact with bats, or bat excrement. Chairperson Cady suggested that another public service warning be released regarding bat exposure. Dr. Trucksess agreed that another announcement was in order, but there was still quite a bit unknown about rabies. He advised the Board that the Health Officer of Lewis County wrote a recent article about being attacked by the health plans, especially the managed -care plans, for recommending rabies prophylaxis more widely than ever in the past. The health plans are trying to suggest that the health department should pay for the prophylaxis. It should be clear that just because a health department makes a recommendation, it does not mean that the health department has an obligation to pay for it, and will not be paying for rabies prophylaxis. Payment would be a matter between the patient and their doctor and the health insurance they have. Chairperson Cady stated she would like to read a copy of the Lewis County article. MASON COUNTY BOARD OF HEALTH June 5, 1997 - Page 3 of 5 Mr. Kutz commented that since there is still unanswered questions about rabies, when statements are made more questions are raised that there are answers for. Chairperson Cady stated that a general warning should be issued because many children will be playing in the woods this summer. Board Member Bolender agreed, noting that because there is so much unknown is cause for people to take even greater caution than they normally would because they don't know as much as they need to know. People need to be on notice that they need to be more cautious than they may have been in the past. The Board requested that a generic announcement be prepared giving basic facts pertaining to safety precautions concerning bats. POLICY UPDATES Brad Banner, Health Services Director, presented proposed amendments to the time accounting policy. He indicated that the policy amendments would define how and when time sheets should be turned in, and how the sheets are reviewed to ensure that data entry mistakes are corrected prior to the sheets being submitted to the accountant to be used for the basis of the department's billing. Since this policy is included in the department's policy manual, amendments are required to be officially adopted by the Board. Chairperson Cady wondered what brought the need to amend the policy to his attention. Mr. Banner replied that he and the fiscal clerk were trying to streamline the process to get reports out more readily. They troubleshooted the process to see where things were slow and where things could be done smoother. Chairperson Cady circled one typing error in the amendment. Board Member Bolender/Chairperson Cady moved/seconded that the Board accept the proposed change for the time accounting provision of the Policy Manual for the Department of Health. Motion carried. Vote: C:yes; B:yes; O:absent. Mr. Banner reported that the Mason County Department of Health Services' Accident Prevention Program has been amended to apply to the entire Health Services Department personnel pursuant to a recommendation from the Department of Labor and Industries. Mr. Banner read aloud the amended and new sections pertaining to prevention during rabies investigations. Chairperson Cady asked what safety meetings were being held currently. Mr. Banner replied that Environmental Health holds weekly staff meetings and each meeting has a safety component. Will Satak is the Safety Coordinator who is the person staff can go to if they are not comfortable with going directly to management about safety issues. Mr. Satak takes minutes of the meetings which are kept on file. Mike Rutter commented that this document represents a supporting safety program for the staff in Mr. Banner's department, and the document should be included in the county's safety program. Board Member Bolender asked if this program was going to be a policy amendment for the county's umbrella safety committee to act on. Mr. Rutter replied that it would be. Board Member Bolender/Chairperson Cady moved/seconded that the Board incorporate the Accident Prevention Policy into the Department of Health Services' Policy Manual. Motion carried. Vote: C:yes; B:yes; O:absent. CHILDREN WITH SPECIAL HEALTH CARE NEEDS PROGRAM Diane Crabtree, R.N., P.H.N., informed the Board that the Program for Children with Special Health Care Needs ensures that children with special health care needs receive the services they need. In collaboration with the Mary Bridge Neurodevelopmental Outreach Clinic in Tacoma MASON COUNTY BOARD OF HEALTH June 5, 1997 - Page 4 of 5 and Mason General Hospital, Dr. Tripp, a Neurodevelopmental Pediatrician, has agreed to travel to Shelton every other month to see children who have developmental or behavior issues. Dr. Tripp sees children aged birth to age ten. He follows up on cases and sees new clients. This is very helpful to this community because it eliminates the need for families to travel to Tacoma to see the doctor. The first clinic was held on April 19, and it went very well. Five children were seen. Ms. Crabtree noted that her job was to coordinate the referrals with the Mary Bridge Clinic so charts can be opened and billings arranged. She also weighs and measures the children and completes local follow-up, if needed. The next clinic is June 20th. There are 8 slots which have already been filled. Three will be follow-up cases, and five new patients will be seen. She noted that local school teachers have been actively referring children to the program. If the high need continues, Dr. Tripp may increase his visits. These services are provided pursuant to a letter of agreement between the Health Department, Mason General Hospital and Mary Bridge. TOBACCO PREVENTION GRANT Carla Huyck, Health Educator, presented a letter supporting a youth tobacco prevention grant application for Board review. Ms. Huyck read the letter aloud, and explained that there were eight grant projects available, and they would be applying for seven. CMASA will be the fiscal and legal lead agency. Board Member Bolender/Chairperson Cady moved/seconded that the Board sign the letter of support for the CMASA grant for tobacco prevention. Motion carried. Vote: C:yes; B:yes; O:absent. ENVIRONMENTAL HEALTH ISSUES Mr. Banner requested that the remaining environmental health issues on today's agenda be tabled. Board Member Bolender/Chairperson Cady moved/seconded that the Board table action on the Environmental Health Policy Manual update, and the revised Environmental Health job descriptions until the July Board of Health meeting. Motion carried. Vote: C:yes; B:yes; O:absent. OTHER BUSINESS/PUBLIC COMMENT Chairperson Cady called for other business or public comment. None heard. MEETING ADJOURNED Chairperson Cady adjourned the Board of Health meeting at 10:48 a.m. MASON COUNTY BOARD OF HEALTH l Mary Jo C»dy�,Chairper MASON COUNTY BOARD OF HEALTH June 5, 1997 - Page 5 of 5 ofin Bolender, Board Member (absent) Cindy Olsen, Board Member Respectfully submitted, th1.1.A-kie Lorraine Coots