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HomeMy WebLinkAbout1991/11/04 - Board of Health MASON COUNTY BOARD OF HEALTH NOVEMBER 4, 1991 The Board of Health was called to order at 3:40 p.m. by Chairperson Laura E. Porter. ATTENDANCE: Laura Porter, Chairperson William O. Hunter, Board Member Michael D. Gibson, Board Member J. Joanne Hoover, M.D., Health Officer Brad Banner, Health Services Director Sharon Bisser, Health Services/Personal Health Director APPROVAL OF MINUTES: Chairperson Porter noted that the following minutes 2/4/91; 3/4/91; 4/1/91; 5/20/91; 6/3/91; 6/17/91 and 10/7/91 have not received official approval of the Board. The Board held the minutes until the next meeting. ADMINISTRATION ,Brad Banner, Health Services Director, stated that he had no administrative issues to bring before the Board. PERSONAL HEALTH VACCINES Sharon Bisser, Health Services/Personal Health Director, advised the Board that the Personal Health Department has gone through 1100 doses of flu vaccine and are looking for more vaccines. If possible, they will order 400 additional doses. Chairperson Porter asked if individuals pay for the vaccination. Ms. Bisser noted that the fee is $6 for the flu vaccine. She noted that she has also ordered another 100 doses of pneumococcal vaccine. The charge is $15 for this. Board Member Gibson asked how the fee relates to the actual cost of the vaccine. Ms. Bisser stated that the $6 does not cover the cost of administration. It covers the cost of the vaccine and a little bit more. The vaccines are still being subsidized. The Personal Health Department is still arguing with the provider who contracts with the State so the County could buy off of the State contract. The company that provides the vaccine for the State says there has to be a DEA number, which Dr. Hoover has; however it lists Dr. Hoover's home address. They feel this is not good enough and that it has to have the County's address. The Department feels that the DEA number is not necessary, because it is only used for controlled substance and a vaccine is not a controlled substance. MASON COUNTY BOARD OF HEALTH NOVEMBER 4, 1991 - PAGE 2 If this is straightened out the County could cut the costs on the vaccines. Dr. Hoover, Health Officer, stated that she has called the Federal Narcotics Board representative and advised that this is what is being required on the contract. It was suggested that the County go to the State Board of Pharmacy. Dr. Hoover felt that this was restraint of trade. There is also a provision in the contract that states the physician must live in the County in which the business is done. Board Member Gibson asked if it would be beneficial for the Board of Health to send a letter. Dr. Hoover responded that they will see what the State has already tried to do. Ms. Bisser interjected that the State will be visiting local Health Departments regarding the contract and Mason County is included on that schedule by our request. HEALTH OFFICER'S REPORT Dr.Hoover stated she would bring up the subject of the vaccine purchase off the State contract at the next Health Officials meeting. JANUARY - OCTOBER ACTIVITY REPORT Brad Banner, Health Services Director, noted that Board Member Gibson asked for a report from the three divisions of Health Services: Personal Health,Water Quality and Environmental Health. Sharon Bisser, Personal Health Director, noted that she has provided a written report for the period of January - September, 1991. She asked the Board if they would like a report on a quarterly basis. Board Member Gibson felt that it is beneficial for the update. Chairperson Porter referred to the section noting that the HIV case management services have grown to eight people. She asked what the previous case management was. Ms. Bisser responded they had one case previously. Chairperson Porter concurred that quarterly reports would be good to track the various activities of the departments. 1992 CONSOLIDATED CONTRACT The Board was presented with the 1992 Consolidated Contract. Sharon Bisser,Personal Health Director, noted that it needs to be signed by the Board. There are three contracts that need signature. Board Member Gibson/Porter moved and seconded to recommend the Board of County Commissioners sign the Consolidated Contract for 1992 as recommended by staff. Motion carried unanimously. G-aye; H-absent; P-aye. Board Member Gibson asked if there is any significant change from the 1991 contract. MASON COUNTY BOARD OF HEALTH NOVEMBER 4, 1991 - PAGE 3 WIC CASELOAD Sharon Bisser, Personal Health Director, stated that the WIC program requires that the County stay within 95 - 100% of the case load. Currently, the case load is way over 90%. The County has taken steps to increase the authorized case load, with State's concurrence, to 550. The County is also in the process of dropping back on cases to stay within the number. The County can accept children up through two years of age. Prior to this, the County was accepting children up through five years of age. Board Member Gibson stated that he understood there is a reimbursement with the case load. Ms. Bisser concurred that there is a reimbursement for each case. It is approximately $92 for each pregnant/breast-feeding mother and a little less than that for children, per year. The County's total allotment has gone from $44,000 - $51,000. The County is paid on the numbers authorized to serve. Next year the State will watch to see if the County is serving more than 100% (550) as it is an additional cost to the State for the food packages that go with those people. The program is not entirely supported by the funds that the State (Federal) government pays for administrative fees. Board Member Gibson asked if the County is realizing a reduction in State funds. Ms. Bisser responded, no. It will probably come closer to paying for itself next year. Chairperson Porter asked how the ceiling of the 550 is set. Ms.Bisser replied that the County could apply or the State can set it. The State has a consultant that works with the County. For years the County has been at 250. The State WIC program coordinator came and asked that the County serve up to 42% of the possible eligible population in the County. The 550 level does not put Mason County at 42%, but it would be closer. Dr. Hoover interjected that it is true of all departments across the State that they do not pay for themselves. Chairperson Porter stated that she would be interested in seeing what percentage of subsidy it is. It would be useful for the Board to see about the investment. Board Member Gibson reiterated that on programs where there is a direct reimbursement for case load it would be beneficial for the Board to have the figures to track it through. Chairperson Porter commented that it is a contract; however, it almost ends up being like a grant because monies are matched by the State. Brad Banner, Health Services Director, interjected that Mike McCarty, City of Shelton, has no problem with the assessment on the nursing programs. He would like to look at the Environmental Health and Water Quality fees closer. 1992 STATE HEALTH REPORT Brad Banner, Health Services Director, noted that the 1992 State Health Report must be done by January 15, 1992. This is the report provided by a group of community leaders. MASON COUNTY BOARD OF HEALTH NOVEMBER 4, 1991 - PAGE 4 Chairperson Porter acknowledged receipt of a letter from the State Board of Health indicating they were upgrading their goals and objectives and were interested in having Mason County make a plan on how we would be involved in their process. She noted that she took that request to the Rural Health Committee. The Board of Health wanted a group of key community members that were involved in the health arena. The Committee found that looking at the planning agenda there is a planning and goal setting session in February. Chairperson Porter noted she would respond back to the Board of Health in February. The State was welcomed to results of that planning session. WATER QUALITY BOAT SEWAGE DISPOSAL Mr. Banner briefed the Board on a boat sewage disposal situation in the County. There was a person living in a boat,at Union,and pumping it out in the water. A resident living in the area filed a complaint about it. The Health Services Department was very slow in responding to it as it was unclear as to whose jurisdiction it fell under. Mr. Banner stated he thought it would be a Coast Guard responsibility and spoke to them. He was advised there was a State law and they felt the locals should do enforcement. He also talked with the Sheriff's Department and by the time it was all done the boat was moved. The citizen who had filed the complaint called in and came in for a meeting. Wayne Krause sat in on the meeting to represent the boaters perspective. They finally agreed to a short and long term plan. The short term plan is if they get a complaint the Health Services Department will refer it to the Sheriff's Department, because they can write a ticket. The complainant wanted the Health Services Department to formulate this in a written policy so the Sheriff would follow up in a timely manner. The long term plan is to look at putting together a local boating ordinance. Not only regulating it (enhancing ordinance) but come up with alternatives for boaters to have disposal facilities. Board Member Hunter interjected that the County has a boating ordinance already. Mr. Banner and Wayne Clifford would carry the proposal to the Commissioners from the committee. He commented that there are a number of boaters that are interested. It is another advisory committee; however, it might be the best way to go. Chairperson Porter felt that it is appropriate to have an advisory board to look at this. Board Member Hunter suggested that Mr.Banner ask the Sheriff's Citizens Advisory Committee to look at this instead of a creating a new committee. Board Member Gibson noted there is statewide movement through the State Parks Department for additional pump out stations. He suggested that the Health Services find out about the funding available. There are at least two approved pump out stations in Mason County. MASON COUNTY BOARD OF HEALTH NOVEMBER 4, 1991 - PAGE 5 Chairperson Porter asked that Mr. Banner write a 1-2 page analysis on where the County is right now so the Board can have something to talk with the Sheriff about. Board Member Hunter arrived at 4:09 p.m. ENVIRONMENTAL HEALTH VARIANCE REPORTS 1. Frank Arnold - Variance was approved. 2. Edgar Higbee - Variance was approved. 3. Betty K. Anderson - Health Officer upheld the Health Department decision. Dr. Hoover briefed the Board that Ms. Anderson appealed a refusal by the Health Department to provide her with the name of the complainant who reported that her family put dog manure onto the beach. John Dennison went out to look into the situation and he didn't find any evidence that this was happening. Ms. Anderson was assured that the complaint did not appear to be valid. Some time later she talked with Environmental Health and asked for the name of the complainant. It went to Brad Banner and staff and they informed her that it is their policy not to reveal the name of the complainant. She wanted to appeal that decision. In the meantime, Dr.Hoover, Will Satak &Diane Crabtree attended a conference on Infectious Disease. One of the items on the agenda was a panel regarding confidentiality issues in the Health Department. The panel consisted of an Assistant Attorney General from State;Attorney retained by Yakima Health District, State Health Officer, Editor of the Yakima paper and another Health Officer. Dr. Hoover spoke with the Yakima Health District Attorney and discussed the instance the County is dealing with. He suggested talking to their Attorney. He concurred denial of the request. He felt that the RCW used in the memo was quite appropriate one to use. The panel agreed in similar circumstances to not reveal the name of the complainant. Some of the reasons of concern for Ms. Anderson is that she had undergone a very distressing series of events in having complained about something that turned out to be a drug dealer. She was told that she was going to be treated confidentiality and was not. Mr. Banner felt that there was no element of harassment in the person complaining. She was informed she could appeal it to the Board of Health. Board Member Hunter noted that Ms. Anderson spoke to him. Board Member Gibson stated that an appeal to the Board of Health would be proper under the normal procedures. He added there is a timetable for the appeal process. Chairperson Porter suggested that the Board wait for a reasonable period of time before making policy on this. MASON COUNTY BOARD OF HEALTH NOVEMBER 4, 1991 - PAGE 6 4. Jo Anne Brown &Daniel Elsworth - Item tabled pending arrangement of a consultation with Washington State Department of Health. EXECUTIVE SESSION Board Member Gibson/Hunter moved and seconded to go into an executive session regarding possible legal action. Motion carried unanimously. G-aye; H-aye; P-aye. The Board came back into regular open session immediately following the executive session. WATER ADEQUACY ORDINANCE Mr. Banner stated that they were planning to brief the Board on the draft ordinance. Several months ago the Board was presented with a draft version of the ordinance for a public hearing. Erik Fairchild, Planning Coordinator, reviewed it and wanted time to comment before a hearing was set. Robin Munro-Tyner, Growth Management Planner, revised the ordinance and now it is before the Board to set a public hearing for consideration of adoption. Board Member Gibson asked if the information would be more appropriate as a briefing instead of at a formal meeting. Mr. Banner stated that they would like to set a public hearing. Chairperson Porter asked if the ordinance is in a form that the Board could advertise for a public hearing to adopt it. Mr. Banner responded, yes, provided that Mr. Fairchild review the final draft. Ms. Munro-Tyner stated that they would like to have a hearing set in December. Board Member Gibson/Hunter moved and seconded to set a public hearing on December 2, 1991 at 3:30 p.m. to consider adoption of the Water Adequacy Ordinance. Motion carried unanimously. G-aye; H-aye; P-aye. NEEDLE EXCHANGE Chairperson Porter acknowledged receipt of a letter from the Attorney representing all of the amicus curiae regarding our support for the County's right to decide what kinds of programs should be put in place. The specific example was needle exchange. The report is that the Supreme Court Commissioner issued a ruling in our favor. The Commissioner order the Attorney General to permit the Governor, State Boards of Pharmacy and Health, State Patrol, Department of Health and Region I AIDS Service Network to decide for themselves whether each wishes to support or overturn the trial judge's decision that needle exchange programs are legal. MASON COUNTY BOARD OF HEALTH NOVEMBER 4, 1991 - PAGE 7 ADJOURNED Board Member Gibson/Hunter moved and seconded to adjourn at 4:55 p.m. Respectfully Submitted, Rebecca S. Rogers Clerk of the Board MASON COUNTY HEALTH BOARD L ura E. Porter, C airpersoi Michael D. Gibson, Board Me er 76 , / William O. Hunter, f3oard Member