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HomeMy WebLinkAbout1991/04/01 - Board of Health MASON COUNTY BOARD OF HEALTH APRIL 1, 1991 The Board of Health was called to order at 1:37 p.m. by Chairperson Laura E. Porter. ATTENDANCE: Laura Porter, Chairperson Michael D. Gibson, Board Member J. Joanne Hoover, M.D., Health Officer Sharon Bisser, Nursing Supervisor ENVIRONMENTAL HEALTH ARTICLE VII Erik Fairchild,Planning Coordinator,presented the proposed amendments to Article VII of the Board of Health Regulations. He noted that the proposed amendments are minor in nature. It expands the Code to also include a review procedure for large lot subdivisions. The amendments are consistent with the Comprehensive Plan,North Mason Sub Area Water Quality Protection Plan, Oakland Bay Watershed Protection Plan, Totten/Little Skookum Watershed Action Plan, Hood Canal Regional Planning Policy and the yet to be adopted draft Southeast Mason County Sub Area Plan. The amendments, if adopted,would also fit nicely with the end of the moratorium which ends April 2. The amendments are necessary to ensure that large lot subdivision applications are reviewed for sewage disposal, water supply and other health related issues that the Planning Department relies very heavily on the Environmental Health Department for. He noted that John Denison,Environmental Health,has found the amendments to be adequate. The Planning Commission reviewed these and they were made available to the public at those meetings as well. The Planning Department is recommending adoption of the proposed amendments to Article VII which expands the article to regulate large lot subdivision. The other primary changes are to change the Administrator from General Services Director to the new Health Services Director. The fees will be considered before the Board of County Commissioners at 2:00 p.m. next Tuesday. He stated that he would make a further request later to schedule another hearing before the Board of Health to consider the Environmental Health fees. John Getty, Environmental Health, recommends adoption of the rules. Board Member Gibson/Porter moved and seconded to adopt the amendments to Article VII. Motion carried unanimously. G-aye; H-absent; P-aye. HEARING ESTABLISHED - LARGE LOT SUBDIVISION FEES Mr. Fairchild requested a hearing before the Board of Health to consider the fees for Environmental Health for the review of large lot subdivisions. Chairperson Porter noted that it would be the first monday in May. MASON COUNTY BOARD OF HEALTH APRIL 1, 1991 - PAGE 2 Board Member Gibson/Porter moved and seconded to concur with the Board of County Commissioners public hearing time for taking public comment on the Environmental Health fees which is one week from tomorrow at 2:00 p.m. Motion carried unanimously. G-aye; H- absent; P-aye. NURSING DIVISION TRAVEL REQUEST Sharon Bisser requested approval to send Carolyn Auseth to the Washington State Dietician Association Meeting April 25 & 26 in Tacoma. The registration fee is $90.00. This includes meals. Board Member Gibson/Porter moved and seconded that there are no objections to the travel request for Carolyn Auseth. Motion carried unanimously. G-aye; H-absent; P-aye. CITY/COUNTY ACTIVITY REPORT Sharon Bisser, Nursing Supervisor, presented the Board with the 1990 City/County Activity Report. She itemized the last three years statistics for all the phases of the nursing division from well child to sports physical. She noted that as requested last year she has divided the number of pap smears and sports physical. She noted that she included an "Other" category for those that came from outside the County (vacationers). She noted that she would be making the report to the City as well. CONTRACT - SQUAXIN TRIBE The Board was advised that Tiff Barrett, Squaxin Tribe, was one of those called off to serve at Operation Desert Storm. Mr. Barrett has handled the well child/immunization services for the Squaxin Tribe. They have asked if they could enter into a contract with the County for providing one well child clinic a month and one immunization clinic a month. Ms. Bisser noted that she has had the Prosecutor review the contract. Basically the Squaxin Tribe will provide the appointment scheduling and work area. The County will provide a Physician's Assistant/Public Health Nurse. Board Member Gibson questioned if the Tribe has been operating their own separate program. Ms. Bisser stated, yes; however, they would like to try this to see how it would work. It would free Mr. Barret up to do the follow up that he needs to do with referrals to private physicians. Board Member Gibson stated that Ms. Bisser previously has expressed that additional staff is needed for immunizations. He stated that he questioned how the Health Department could provide the immunization service for the Tribe without additional staff. Ms. Bisser stated that a nurse can do the immunizations, a Physician's Assistant is not needed. The Well Child Clinic requires that a PA be on staff. MASON COUNTY BOARD OF HEALTH APRIL 1, 1991 - PAGE 3 Bill Crowell who is the current PA is willing to do this; however, if his job changes and he is no longer available the Nursing Department would not be able to provide this service. Ms. Bisser noted that because of the increase in Whooping Cough and other communicable diseases she felt it is important to provide this service. Chairperson Porter questioned what the $143/month covers. Ms. Bisser replied that it covers the PA's salary, travel, benefits and three hours for Well Child Clinic time. The contract is the same as with the Skokomish Indian Tribe. The County will agree to stay for one hour. If there is more need for the service the PA will stay longer. Chairperson Porter asked if the $143/month is provided in the budget. Ms. Bisser responded, no. It is not part of the revenues at the time of the budget. Board Member Gibson noted that this will require a budget extension. Ms. Bisser concurred that eventually they will need to extend the budget. Board Member Gibson/Porter moved and seconded to authorize Dr.Hoover to sign the contract with Squaxin Tribe as recommended in the amount of $143.00/month. Motion carried unanimously. G-aye; H-absent; P-aye. Board Member Gibson asked if it is an ongoing contract. Ms. Bisser noted that it ends on September 30, 1991 which is the end of their federal funding. COMMUNICABLE DISEASE UPDATE PERTUSSIS Dr. Hoover, Health Officer, stated she is writing an update letter to the physicians in the community as to where the County stands with regards to pertussis. It is serious right now and on the verge of being big time. As of Friday afternoon, there are 9 confirmed cases and 6 suspicious cases. This afternoon those will be confirmed. The individuals with pertussis range in age from 7 months of age to 29 years of age. Last Friday, one of the people who had turned out to be positive had been in the jail the preceding weekend. He had been in the protective cell rather than out in the general population. The degree of contact should be very self-contained. The individual was definitely positive and he was already discharged from the jail. There had been ten other individuals in the cell and three were discharged. They are being tracked down. All those that were in that cell are being given prophylactive medication, as well as jailers who had the closest contact with him. There is a state law that says that pertussis cases need to be reported to the local Health Department within one working day. The local physicians have not been cooperative in spite of letters to them and pointing out the state law. MASON COUNTY BOARD OF HEALTH APRIL 1, 1991 - PAGE 4 GIARDIA Dr. Hoover stated that there has been a total of 19 Giardia cases. Eighteen of them are in Day Care or Head Start settings. The Birth - three program up at Mt. View and the 3 - 5 year old program up at Mt. View has cases. Dr. Hoover pointed out that the schools don't want the kids tested unless they have loose stools. Many children don't have symptoms, but still harbor the organism. SHIGELLA There have been four Shigella cases. It can make people quite sick and is extremely communicable. There are Day Care settings and Head Start programs that bring concern. It is more communicable than Giardia. The Nursing Staff did perform rectal swabs on about 50 people. So far there have only been four cases within one family. LEGIONALLA There is a suspect Legionella disease which probably won't be confirmed. However, the Nursing Division is following up on it. Chairperson Porter asked what the origination is on the Shigella and Giardia. Dr. Hoover concurred that they could be food borne. Shigella could be food borne but then passed person to person fecal/oral route. One of the worst problems is when unsupervised kids go to the toilet and don't wash their hands well. Giardia is transmitted in the same manner. They are usually introduced into the home from someone who has been out camping. The staff has been working weekends and evenings trying to track down people who have had contact with pertussis. The individuals with pertussis are supposed to stay home for five days after receiving medication. People don't have respect for the seriousness of this. It was noted that the Journal did an excellent job in passing the message about the seriousness of these diseases. IMMUNIZATIONS LAW Sharon Bisser, Nursing Supervisor, stated that the State immunization law will change before this legislative session is over. It will be required for children entering sixth grade to have a second dose of measles vaccine (MMR). The HIV vaccine will be required for children in preschool/day care settings. This vaccine is only given to children up to age five. This will be an ongoing thing. Every year the County will have to look at fifth graders for the MMR. It is now available to give along with DPT when they are infants at 2, 4 and 6 months of age. Most will already have it as a matter of routine. A special clinic has been scheduled in North Mason School at the request of the nurses up there. The Nursing Staff feels the parents are responsible for the immunization record. The clinics are scheduled for April 17; 3 - 7 p.m.; May 6; 3 - 6 p.m. and August 21; 3 - 8 p.m. They have also scheduled some special clinics in the Shelton area to meet the same need on April 23, May 21, June 11 and August 27. They will run from 3 - 5 p.m. and 6 - 8 p.m. for parents who are working. The regular clinics will continue in the Belfair area. MASON COUNTY BOARD OF HEALTH APRIL 1, 1991 - PAGE 5 HEPATITIS B VACCINE The Board was advised that the Hepatitis B vaccine impact is being felt. The State Patrol Academy has called. Each time they have a new class coming in they ask the County to come out. The Nursing Department has also had contacts with several of the fire districts. Some have gone through there own volunteers. The jail and the County deputies are about half way through on their vaccines. RURAL HEALTH GRANT Ms. Bisser stated that the Rural Health Grant just came in. This is a contract for pass through money for a consultant. The contract period is for April 1 through June 30, 1991. The Board instructed to leave it with the Clerk and it would be brought up to the Board of County Commissioners. JAIL CONTRACT Dr. Hoover commented that it appears that the jail contract is just about complete. SUDAFED RECALL Dr. Hoover noted that at the last Board of Health she was instructed to write a letter to the State regarding notification on the Sudafed recall. She commented that she received a phone call asking whether the County needed something in writing or whether the phone conversation was sufficient. She advised them that the phone call was sufficient. The State was interested in the County's interpretation of what had happened. The individual said the phone tree had been activated late on Saturday. They were appreciative to be apprised that the phone tree had not worked as well as they had hoped. HEALTH SERVICES DIRECTOR Chairperson Porter announced that Friday at 4 p.m. there will be a staff meeting regarding the Health Services Director position. BOARD OF HEALTH Board Member Gibson/Hunter moved and seconded to change the Board of Health from 1:30 p.m. to 3:30 p.m. for the first Monday of each month. Motion carried unanimously. G-aye; H- absent; P-aye. ADJOURNED The meeting adjourned at 2:35 p.m. Respectfully Submitted, Rebecca S. Rogers Clerk of the Board MASON COUNTY HEALTH BOARD Laura E. Porter, Chairperson MASON COUNTY BOARD OF HEALTH APRIL 1, 1991 - PAGE 6 r Michael D. Gibson, Board Member William O. Hunter, Board Member