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HomeMy WebLinkAbout1996/04/04 - Board of HealthMASON COUNTY BOARD OF HEALTH April 4, 1996 The Board of Health was called to order at 10:00 a.m. by Chairperson William O. Hunter with Board Members Cady and Faughender in attendance. ATTENDANCE: William O. Hunter, Chairperson Mary Jo Cady, Board Member Mary L. Faughender, Board Member Brad Banner, Health Services Director Steve Kutz, Director of Personal Health Dr. Mark E. Trucksess, Health Officer Mark Tompkins, Water Quality Program Manager Brent Long, Clerk of the Board Sean Hanlon, Journal Kathy Giest, City of Shelton CORRESPONDENCE Letter received from the State of Washington, Puget Sound Water Quality Authority, in support of implementation of the On -Site Sewage Operation and Maintenance Program. APPROVAL OF MINUTES Adoption of March 7th, 1996, meeting minutes delayed until next Board of Health meeting. HEALTH OFFICER'S REPORT Dr. Mark E. Trucksess, Health Officer, reported that the county's Hepatitis A epidemic may be over. Since the end of January when the first case was identified and the middle of March when the last case was identified, there have been sixteen cases of Hepatitis A. Of those sixteen, thirteen were also infected with Hepatitis C and six were also infected with Hepatitis B. The cases have primarily been in patients who were IV drug users. That was not to say that Hepatitis A was transmitted through IV drug use alone, but is was known that it can be transmitted that way. However, the primary transmission for Hepatitis A was still by the fecal or oral route. Many of the people involved in the epidemic became infected in clusters and were related through friendship or family relationships. Chances were that this epidemic was still being transmitted by the fecal/oral route and it was due to the close association of these people in what were probably unsanitary conditions which promoted the epidemic. Because they were IV drug users, they were also seeing Hepatitis B and C which were transmitted primarily through IV drug use but may also be transmitted through sexual contact. During the month of March, 49 people were given Hepatitis immune globulin. Dr. Trucksess stated he would like to correct a few inaccuracies which have appeared in a couple of previous Journal articles. He had received a letter from a person who had claimed to have MASON COUNTY BOARD OF HEALTH April 4, 1996 - Page 2 of 7 Hepatitis C who was very distressed by the first article which had implied that all cases of Hepatitis C were acquired through IV drug use. This was not the case. However, most of the recent cases that have been diagnosed have been current or former IV drug users. Many cases have been acquired in the past by blood transfusions before Hepatitis C was identified and was referred to as non -A, non-B. Now, Hepatitis C can be tested and the instances of transmissions through blood transfusions has dropped considerably, and risk was extremely low. The second article published stated that Hepatitis A was being transmitted by drug use. The major way Hepatitis A was transmitted was by the fecal/oral route. The fact that recent epidemics have occurred in IV drug users was probably related to close personal contact and unsanitary conditions and practices. With Hepatitis A, B, and C, there was a percentage thought to be sexually transmitted and there was always a percentage of cases in which the mode of transmission was unknown. There was a . possibility that there may be an unusual mode of transmission. There were no other instances of communicable diseases reported in the month of March. Mason County 1995 statistics demonstrate that 192 patients were tested for HIV. In those, 1 was confirmed positive and 175 received post-test counseling. Statewide, there were 44,359 patients tested and, of those, 416 were confirmed positive. Post-test counseling had been received by 28,321. This indicated that Mason County has done better than the state-wide average in terms of post-test counseling. A new law requiring that gun shot wounds be reported to the Health Department by emergency rooms, other medical facilities, and police and sheriffs department personnel has been instituted. Steve Kutz, Director of Personal Health, noted that it was about one week since the Health Department's last case of Hepatitis. There were some failures in people who were immunized with immune globulin during the initial contact with clusters of people who were infected. That happens. They cannot feel totally safe yet because the incubation period has not expired. In other counties where this occurred, it went on for quite some time. They believe it halted because all the people at risk were infected. It was not just the IV drug users that were part of this risk, it was also those in close personal contact with them. The IV drug users bring it into their circle of acquaintances and friends, which spreads out the outbreak. DEPARTMENTAL MISSION STATEMENT Brad Banner, Director of Health Services, stated that, with the encouragement of Dr. Trucksess, the Health Department has prepared a mission statement. In January, 1995, the entire department met in order to become acquainted. Over the next year, Dr. Trucksess, Mr. Kutz, Mark Tompkins, Wayne Clifford, and he began meeting periodically at the hospital to develop a departmental mission. This process was facilitated by Bob Appel, the Mason General Hospital Administrator. When the draft was prepared, another staff meeting was held at which time the mission statement was reviewed. Input was received, discussed, and minor changes were made. The statement was now ready for consideration by the Board of Health. MASON COUNTY BOARD OF HEALTH April 4, 1996 - Page 3 of 7 Mr. Kutz read aloud the statement: "We are an organization dedicated to protecting and improving the health status of our community through effective, professional, collaborative leadership in health promotion, disease and injury prevention, and elimination of environmental hazards." Mr. Banner commented that mission statements from other counties were reviewed, and they believed Mason County's to be very effective. The glossary of terms used in the statement was reviewed aloud. Board Member Cady asked how the Environmental Health Department planned on reducing the incidence of exposure to violence in the community. Dr. Trucksess responded that statement was a mandate from the State Health Department and the legislature. It has become more of a priority of health departments. Mr. Kutz stated that, as a Health Department, maybe not specifically Environmental Health, they were addressing this by cooperating with the community networks regarding reducing violence in our children. The issues they were looking at relate directly to this by direction of the legislature also. Many of the Health Department's programs were in cooperation with committees. Mr. Banner stated that they may not be the primary provider, but they were involved in an advisory capacity or participating in other ways. Board Member Cady commented that the scope of "elimination" of environmental hazards was very broad. The items listed were very good, but it may go beyond what Mason County Health Department would be able to do. She noted that environmental hazards could be all sorts of things. Mr. Kutz answered that there were a lot of environmental hazards out there and some of them were not under their purview, necessarily. Some were under the purview of state agencies, but where their scope of responsibilities lie, they wanted to address the elimination of those hazards. Board Member Cady asked if this was why the wording, "including but not limited to," was used. Mr. Kutz concurred they had used those words to further define the matter. Mr. Banner commented that Board Member Cady was bringing up the idea that there were reasonable limits to how far they could isolate people from hazards. She stated that the word elimination was harsh and very broad. "Effective control" of environmental hazards may be better than "elimination" of environmental hazards. For instance, they were unable to stop everyone from smoking; however, they could try to effectively control this. Guiding principles of the statement were reviewed. Mr. Banner noted that the principles were discussed quite extensively at staff meetings. Principles included: who the department serves; customer service; team work; professionalism; individual and group participation; and continuous quality improvement. Mr. Kutz commented that collaboration, cooperation and support were necessary within programmatic areas. There were many areas were there were cross -over responsibilities interdepartmentally as well where cooperation was also necessary. It was agreed that the initiative and responsibility would be accepted for investing personal time and resources where appropriate in maintaining and enhancing professional skills. Board Member Cady commented that in some agencies there were incentives given to personnel to help them with training which would promote their academic standing. This statement indicates that would not be considered. Mr. Banner responded that in the past, staff has been given time to take tests, but the work to pursue this was on the employee's own time. Chairperson Hunter noted that many positions require that a certain degree of training be accomplished prior to hire. Mr. Banner noted that the statement infers that staff would take the initiative to increase their skills without MASON COUNTY BOARD OF HEALTH April 4, 1996 - Page 4 of 7 the financial assistance of the county, for the purpose of personal improvement. Chairperson Hunter asked for questions. Board Members Faughender/Cady moved/seconded that the Board approve the Mason County Department of Health Services Mission Statement, Glossary and Guiding Principles (Exhibit A) as written. Chairperson Hunter asked for discussion pertaining to the motion. Board Member Faughender applauded the department for the great deal of work they completed in preparing the document. He appreciated the fact that the Mission Statement was brief and to the point, and that the amplification was in the Glossary and Guiding Principles. He wanted to adopt this document as written because it was their document, they wrote it, and it was their department's guiding principles. Board Member Cady and Chairperson Hunter concurred, noting the cooperative effort and the job well done. Motion carried unanimously. OLSEN APPEAL DECISION Mark Tompkins, Water Quality Program Manager, presented the Findings and Order in the appeal hearing of William and Kimmerlee Olsen which the Board had prepared. Board Members Faughender/Cady moved/seconded that the Board publish and sign the Board of Health's Findings and Order in regards to the appeal of William and Kimmerlee Olsen. Board Member Faughender read aloud No. 4 of the Order, "All system repairs and corrections' must be completed within 30 working days of the date of this order. If the requirements of this order are not fulfilled, action will be taken to vacate the premise as a public health hazard and the matter will be referred to the county prosecutor for enforcement action as a health hazard, violation of state and local regulations, and a public nuisance." (Exhibit B). Chairperson Hunter asked for comments on the motion. Board Member Cady remarked she still had the feeling that Ms. Olsen did not thoroughly understand what an appeal to this Board meant. Ms. Olsen came before them very unprepared, and did not really understand the gravity of what this was. Ms. Olsen has also continued to fax data to her quite often which has been placed in a folder unread because she did not want any more input until this decision was made publicly. She would not be surprised if Ms. Olsen took this case beyond the Board of Health because she was very determined. She would hope that when she takes it beyond here that she was better prepared to present her case. It was very unfortunate that she did not come with more preparation and an understanding of what was necessary. She was on the right track when she started out with her attorney, but the attorney was dismissed before the case was presented, and that could have been a mistake because she would have had a better representative if someone was present handling it for her. Board Member Faughender stated he agreed with Board Member Cady's comments. Their job was to review the information given to them the day of hearing. In reviewing that, they found very little, if anything, that was new or that would support her position. Therefore, it was a decision they have to make based on the information that was given to them during the hearing which was all that could be considered. Chairperson Hunter concurred with the Board Members' statements, adding their thanks to the staff for the professional presentation they made to the Board at the time of the hearing. During the hearing, it was brought out that there was another house connected to the same system. He noted that this MASON COUNTY BOARD OF HEALTH April 4, 1996 - Page 5 of 7 property owner should be aware of the Findings and Order, and a copy should be mailed to them. Mr. Tompkins replied he would see this was done. Motion carried unanimously. POLICY - SEWAGE DISPOSAL ON PROPERTY FOR RECREATIONAL USE Mr. Banner informed that Environmental Health has policies pertaining to people residing on property without a permanent dwelling or permanent on -site sewage disposal system. Many times, these people are in the process of building and living temporarily on -site in a travel trailer. In working with these people, they have to address health risks and other concerns expressed by neighbors. The current policy has been reviewed and amendments proposed in order to improve the wording. Disposal of portable systems and shoreline setbacks for these temporary dwellings were discussed. Board Member Faughender informed that he receives many complaints pertaining to families living in recreational vehicles for periods of times. Mr. Banner noted there were time restrictions on this; however, people leave and return and the time period starts over. Another concern was that commercial properties were not addressed in this policy. Even though the policy does not answer all the questions, it does give staff guidance. Board Member Faughender noted that guidelines which were too general allow people to get away with things. Chairperson Hunter commented that investigations should not only be started due to a complaint, but should also be initiated because of notification or staff becoming aware of them in other ways. Board Member Cady stated that health hazards need to be addressed. Mr. Banner stated that the policy amendments also make it less costly. Board Member Cady suggested that staff continue to review the policy, incorporating the suggestions made by the Board. Board Members Faughender/Cady moved/seconded that the recreational use of property policy be referred back to the Environmental Health Department for review at the next Board of Health meeting in May. Chairperson Hunter asked for further discussion; none heard. Motion passed unanimously. ON -SITE SEWAGE OPERATION AND MAINTENANCE PROGRAM Mr. Banner presented the Mason County On -Site Sewage Operation and Maintenance Program draft and an Alternative Phasing Method as updated on April 2, 1996. RECESS Board recessed from 11:10 a.m. to 11:15 a.m., to review the Mason County On -Site Sewage Operation and Maintenance Program draft and an Alternative Phasing Method as updated on April 2, 1996. ON -SITE SEWAGE OPERATION AND MAINTENANCE PROGRAM Chairperson Hunter questioned Item 3 pertaining to mandatory participation in Phase One of the implementation process of the Operation and Maintenance Program to take place in 1997. Mr. Banner responded that the Board of Health would review Phase One and they could not go on to Phase Two without the determination of the Board to proceed. Chairperson Hunter commented that Case Inlet voted down the Clean Water District overwhelmingly, and this would be coming in the back door, which he has a hard time doing. This would be the same, except it would be more expensive for the participants. Mr. Banner informed that the homeowners would be given MASON COUNTY BOARD OF HEALTH April 4, 1996 - Page 6 of 7 the opportunity to check gravity systems and submit the paper work, or they could have a professional do it. Chairperson Hunter asked what would be done if the resident refused to have it done. Mr. Banner replied that if a person was on the program mandatorily and the person would not even inspect the system themselves and turn in the form, the action would be to record a Notification of Non -Compliance on the property deed. Board Member Cady asked for the WAC number which requires this program to be initiated by the year 2000. Mr. Banner stated he was unsure of the number, but he did know that the reference was very general and did not outline the program requirements. The state did prepare a guidance document which listed options. Board Member Faughender commented that additional policies would be forthcoming. Board Member Cady moved that the Board approve the On -Site Sewage Operation and Maintenance Program with the Alternative Phasing Method with the following changes: In Phase Two move Chehalis Watershed to Phase 4; in Phase Three move West Hood Canal Watershed to Phase 4; and in Phase One move Case Inlet into Phase Three; this approval pending upon this matter being placed before the voters on the September ballot; if approved by the voters it shall be brought back before the Board of Health for adoption. Board Member Faughender asked for clarification on the motion. He asked if Board Member Cady's intention was to place it on the primary ballot. Board Member Cady replied it would be the September primary ballot. She has discussed the matter with the Auditor and there would be no extra cost in placing an item like this on the ballot. Her intention for doing so was in dealing with the consent order she did not believe all areas have been treated equitably. She believed the Department of Ecology was trying to get them to cure a problem that the state and federal government refused to identify which was the mammals which were also swimming around in Lower Hood Canal. Chairperson Hunter seconded the motion calling for discussion. Board Member Cady stated that people in the county need the opportunity to vote on this since it was impacting them financially. Board Member Faughender moved to table this motion until such time as the Board of Health has the opportunity to discuss the proposal to place the issue on the ballot with the Department of Ecology, who was the other signer to the consent order. Board Member Cady seconded the motion for discussion. Board Member Cady commented that the Department of Ecology has concern with an April 15th deadline which she believes pertains to a letter they received from the shellfish growers which indicated if this was not adopted by April 15th, that they would be taken to court. At this time, they have not received confirmation from the Department of Ecology as to why this date was the one which had to be met. She was assuming it related to the letter from the shellfish growers because she had not seen it anywhere else. She believed they had been driven to do things too hastily with growth management, and she was not in favor of imposing things upon the citizens that they have not had a chance to look at especially when it involves monetary expense. Chairperson Hunter called for a vote on the motion to table the motion until discussions were held with the Department of Ecology. Motion carried unanimously. Chairperson Hunter noted the public would have had the opportunity to express their input on this matter, if they would have been present. MASON COUNTY BOARD OF HEALTH April 4, 1996 - Page 7 of 7 MEETING CONTINUED Board Members Faughender/Cady moved/seconded that the Board of Health meeting be continued to Monday, April 15, 1996, at 10:45 a.m., in the Commissioners' Chambers. Motion carried unanimously. MASON COUNTY BOARD OF HEALTH 701;14 William O. Hunter, Chairperson `-7c/ )�4V Mary C 4, Board,/ Iember k 0 Thn ,O 0 CI Q> M. L. Faughender, B" rd Member Respectfully submitted, Lorraine Coots