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HomeMy WebLinkAbout2024/07/23 - Board of Health PacketMason County Public Health 415 N 6th Street, Bldg. 8, Shelton WA 98584, Phone (360) 427-9670 ext. 400 ❖ Fax (360) 427-7787 MASON COUNTY BOARD OF HEALTH July 23, 2024 11:00 AM Commission Chambers 411 North 5th Street Shelton, WA 98584 Meeting ID: 834 8034 3274 Passcode: 721009 DRAFT AGENDA 1.Welcome and Introductions Chair 2.Approval of Agenda – ACTION Board Members 3.Approval of Minutes (May 23, 2024) – ACTION Board Members 4.National Breast-Feeding Month Resolution – ACTION Board Members 5.Health Officer Report Dr. Steve Krager 6.Administration Report Dave Windom a.Fiscal b.Board of Health presentation c.Clinic discussion i.Family planning ii.Mobile outreach 7.Environmental Health Report Ian Tracy a.Sanitation Policy b.On-Site Sewage Advisory Committee application c.Street vending 8.Community Health Report Melissa Casey 9.Other Business and Board Discussion Board Members 10.Public Comments 11.Adjourn If special accommodations are needed, please contact McKenzie Smith at (360) 427-9670 ext.589 or msmith@masoncountywa.gov MASON COUNTY BOARD OF HEALTH PROCEEDINGS 411 North 511 Street,Shelton,WA March 26,2024 Attendance: Randy Neatherlin,County Commissioner;Kevin Shutty,County Commissioner; Sharon Trask, County Commissioner;Dr.Keri Gardner,Health Officer;Darrin Moody,Hospital District No. 1;Peggy VanBuskirk,Hospital District No.2;Miguel Gutierrez,City of Shelton;Keri Davidson, Shelton School Board; Ian Tracy,Environmental Health Manager;McKenzie Smith,Clerk of the Board;Dedrick Allen, MasonWebTV; Sunni Evans,Food Safety;Randy Ocean,Food Safety;Ben Johnson,Brooke Quigly Prevention Abuse Coalition;and Rachel Armas,Health Service Director at Squaxin. 1. Chair Neatherlin called the meeting to order at 3:00 p.m. 2. Approval of Agenda Peggy VanBuskirk/Cmmr. Trask moved and seconded to approve the agenda as presented with the amendment to include the appointment of Rachel Armas as item number six. Motion carried. 3. Approval of Minutes Cmmr. Shutty/Cmmr.Trask moved and seconded to approve the minutes as presented with the correction that there has been RSV in the area. Motion carried. 4. Health Officer Search Dave Windom shared Request for Qualifications for the Health Officer position. One application has been received from Dr. Steven Craiger. Peggy VanBuskirk/Cmmr. Shutty moved and seconded to appoint Dr. Steven Craiger as the Mason County Health Officer. Motion carried. 5. Public Health Week Proclamation Dave discussed the National Public Health Week Proclamation. Cmmr. Shutty/Peggy VanBuskirk moved and seconded to approve the Public Health Week Proclamation. Motion carried. 6. Rachel Armas Dave introduced Rachel Armas,Health Director of Squaxin Island Health Clinic. Cmmr. Shutty/Peggy VanBuskirk to appoint Rachel Armas onto the Board of Health. Motion carried. 7. Health Officer Report Dave discussed bats coming out of hibernation and what to do if an individual has an encounter with a bat. COVID has plateaued and the Centers for Disease Control(CDC)has new guidance for COVID response. RSV is down trending. COVID testing kits are no longer being sent from the State. 8. Administration Report Dave shared the budget amendment from the Washington State Department of Health(DOH). The end of the fiscal year is June 30,2024. There were not many changes from the legislative session and there is no impact on the budget. Some Foundational Public Health Services(FPHS)COVID funds were sent back last year. More opioid settlement funding will be received. Darrin discussed a paramedic program. The Women,Infants,and Children(WIC)clinic is up and running and going well. 9. Environmental Health Report Ian Tracy shared the two On-Site Sewer Advisory Committee(OSAC)applications received from James Medcalf and Arther Whitson. Peggy VanBuskirk/Cmmr. Shutty moved and seconded to extend James Medcalf as designer. Motion carried. Peggy VanBuskirk/Cmmr. Trask moved and seconded to appoint Art Whitson to open citizen position. Motion carried. Ian discussed the Basic Sanitation Policy to provide guidance to staff and ensure consistency when encountering non-permitted living conditions regarding tents,recreational vehicles(RVs),campers, sheds,cars, etc. "Chasing"individuals around the County does not eliminate the threat,changing the location leaves no control over where the next location may be. More discussion and research are needed. Ian shared the request for a new food establishment permit type for street vending. Thurston County offers this type of establishment permit and will be piloting their second year. Street vending is a temporary event with a limited menu that has different parameters than other types of food permits— brick and mortar,mobile units, and temporary events. Ian discussed the closure response plans for Lilliwaup and Tahuya which was required to be submitted to DOH within 180 days. Ian shared,regarding the solid waste abatement fund,the Prosecuting Attorney,Tim Whitehead, recommended that the requirements not be removed and retain the ability to foreclose the property to recoup abatement costs. FPHS funds may,if unspent at the end of the period,be used. 10. Community Health Report Ben Johnson gave a presentation on the Prevention Education Partners Substance Abuse Prevention Coalition. Topics included history and mission,twelve sectors,why retail store engagement,what was learned,packaging,and what the coalition would like to implement. The coalition would like to drop off"lock up your cannabis"signs and bags at local marijuana shops. Dilma Demartino added that packaging for marijuana products is similar to candy and chip products. Ben announced the Mason County Substance Abuse Prevention Summit on Wednesday,May 8,2024 at 3:00 p.m. at the Squaxin Island Community Kitchen. 11. Other Business and Board Discussion Cmmr. Shutty,discussed changing the Board of Health meetings to quarterly at moving the time from 3:00 p.m.to 11:00 a.m. on Tuesdays. Darrin added that meetings can be scheduled at any time in case of emergency. Cmmr. Shutty/Peggy VanBuskirk moved and adopted to change the Board of Health meeting time to 11:00 a.m. Motion carried Cmmr. Shutty/Cmmr.Trask moved and seconded to amend Board of Health meetings to quarterly and as needed called by the Director. Motion carried Next meeting will be Tuesday,July 23,2024 at 11:00 a.m. 1. Public Comments Art Whitson commented on the multiple noticeable,and potentially toxic,algae bloom in Mason Lake that seem to be blue-green algae. Two other algae blooms happened in both Benson Lake and Trails End Lake. The County's Health department has the ability to take samples year-round,but the Department of Ecology lab is not open year-round. 2. Adjourned at 4:34 p.m. ATTEST MASON COUNTY,WASHINGTON BOARD OF HEALTH MASON COUNTY,WASHINGTON McKenzie Smith,Clerk of the Board Darrin Moody,Hospital District#1 Miguel Guiterrez,City Council Kevin Shutty,Commissioner Randy Neatherlin, Commissioner Sharon Trask,Commissioner Peggy Van Buskirk,Hospital District#2 Gary Plews,Fire Commissioner Keri Davidson, Shelton School Board Proclamation National Breastfeeding Month August 2024 WHEREAS, human milk feeding is the biological norm for infant feeding and a proven primary prevention strategy that builds a foundation for lifelong health and wellness; and, WHEREAS, the evidence of the value of breastfeeding to the health of the mother and the child is scientific, and continually reaffirmed by new research; and, WHEREAS, the American Academy of Pediatrics and World Health Organization recommend exclusive breastfeeding for about the first six months of life,with continued breastfeeding while introducing complementary foods for two years or as long as mutually desired by the mother and child; and, WHEREAS, the U.S. Breastfeeding Committee designates August as National Breastfeeding Month designates August 1-7 as World Breastfeeding Week; and, WHEREAS,recognizing and celebrating National Breastfeeding Month helps to build and reinforce the connections between human milk feeding and a broad spectrum of other health topics and initiatives; and, WHEREAS,the Centers for Disease Control and Prevention publishes a biennial Breastfeeding Report Card which has consistently shown suboptimal breastfeeding initiation rates on the national and state levels, as well as substantial declines in continued and exclusive breastfeeding as babies grow; and, WHEREAS, the Healthy People initiative consistently identifies breastfeeding as a national health priority; and, WHEREAS, protecting and supporting human milk feeding is essential to ensuring infant nutrition security and immunologic protection for Mason County's youngest people; and WHEREAS, the consistent and well-documented health, economic, and environmental benefits of human milk feeding show that this is an investment that will continue to produce measurable dividends across the country and many times over for families, employers, and the government. NOW, THEREFORE, BE IT RESOLVED,that the Board of Health hereby proclaims the month of August as National Breastfeeding Month; supports the goals of National Breastfeeding Month, World Breastfeeding Week,National WIC Breastfeeding Week,Indigenous Milk Medicine Week, Asian American Native Hawaiian Pacific Islander Breastfeeding Week, Black Breastfeeding Week; Workplace Lactation Week; Latina/x Breastfeeding Week; and supports policies to ensure that all pregnant and postpartum women and caregivers can access a full range of appropriate support from healthcare institutions, insurers, employers, early care and education providers, researchers, and government entities. Signed this day of July 23', 2024. MASON COUNTY,WASHINGTON BOARD OF HEALTH Darrin Moody,Hospital District#1 Miguel Guiterrez,City Council Kevin Shutty,Commissioner Randy Neatherlin,Commissioner Sharon Trask,Commissioner Peggy Van Buskirk,Hospital District#2 Gary Plews,Fire Commissioner Keri Davidson, Shelton School Board From the Directors Desk 71 - July 2024 The height of summer! The CONCON (consolidated contract)Amendment 19 has been released effective July 15Y. We've received the contract and there are no new funds or programs. Our funding will remain the same as last year with FPHS. Casey and I completed the Foundational Public Health Annual Report,the switch that turns on much of the funding. We have submitted our report as quickly as the county books closed for June to minimize any delay on our end. A lag can develop between the legislative process and the report which requires that the financial books are closed for the state fiscal year. We can't bill backwards which puts us in something of a bind though not nearly as bad as last year when the contract was delayed at DOH for several months. We'll be receiving$1.1 million in FPHS funding for the remainder of this calendar year with the same expected for the first six months of 2025 which will be on a new CONCON. Our next amendment,which is due in August, should show the process for the end of the physical year change to the new contract and any roll-over funding that will carry through to 2025. Financially,we're in good shape. We have started the process of renovating a building on the hospital campus that will allow us to move Community and Family Health to the new location and expand office space for EH at the current location.The new location has more office space, and we'll have two exam rooms to get us ready to provide more direct services.The new location is 2300 Kati Court across from the middle school. We plan to move into the new location by the end of August. Our new website has been published at Mason County Community Services, WA (healthymasoncounty.com).This site is in addition to our regular county website and provides a place to showcase community efforts, data, and projects. Please explore the website and forward any comments you may have to me. We have some upcoming program topics to discuss as a board around clinical programs and our direction going forward. We are looking to upgrade our mobile outreach and expand its capabilities. Family planning is also a program that we are moving forward with as we move into the new building. The goal is to provide more service and more outreach than we have in the past and put public health out into the community. Thanks, Dave Windom, MSHS I� From the Director's Desk Director The population of Mason County, Washington in 2022 was 68,166, 12.2% up from the 60,733 who lived there in 2010. For comparison, the US population grew 7.7% and Washington's population grew 15.5% during that period. LBOH Workshop - Statewide Orientation Efforts Jaime Bodden, MPH MSW Managing Director WSALPHO NALBOH Annual 2023 WE Overview of LBOH and Understand the changes Practice LBOH public health in and responsibilities of orientation tools and Washington State LBOH in WA State case studies mon Acron M".Mw& . i LHJ = local health jurisdiction PH = public health LBOH = local board of health CHA = community health assessment BoCC = Board of County CHIP = community health Commissioners/Council improvement plan DOH = WA State Department of WSALPHO = Washington State Health Association of Local Public Health SBOH = WA State Board of Health Officials FPHS = foundational public health WSAC = Washington State services Association of Counties RCW = revised code of Washington WAC = Washington Administrative Code Washl* ngton'sSystem • WA is a HOME RULE state • Local health jurisdictions are governed by a local board of health • County departments • Districts - single county/multi-county • Authority is given to LBOH and local health officers State L jMW 96� • State Board of Health • Public health rule-making & policy • Health impact reviews • State Department of Health • Led by Secretary of Health (Commissioner in Minnesota) • Funds, administers and directs public health programs Whatcom Skagit Okanogan . Clallam ) Snohomis Jefferson Seattl ' t - Lincoln Grays King Maso ' � Harbor -� ' Grant acorn Kittit Adams Thursto Pierce Whitman /acific Lewis e �S . _ Garfield 'W Columbia a kiakum Cowlitz Walla Asotin Skamania Walla • - -•- - KI i ckitat • - ' Clark Role of L Health o You are part of the governmental public health system (WA state RCW 70.05) v You have local responsibilities to ensure the health =Ys ` and safety of your communities and citizens Help set local public health policies Enhance FPHS through local investment for 4�r AIS Enforce local, state, and federal laws r You are a local policymaker with a valuable perspective Having a responsive and viable public health system in your community (and state) enhances the well-being of your community Changes to LBOH � Passage oii� • Adds non-elected officials to LBOH membership 1 • More community input into LBOH governance A required to expand T-,1. or., composition : • Public health and/or medical experts • Community-based member • Lived experience • Tribal member (appointed ) Statewide LBOH Orientation "N9 F`-� Purpo Content (examples) • Educate new members on roles • Hot topics in public health and responsibilities • LBOH roles vs. agency leadership • Provide training on key PH skills • Tribal health and engagement • Network and community build for . Public health law and risk LBOH communications • Conduct annual orientation and . Opioid crisis response training opportunity H o w w e di 1" t M- 41- Ongoing FPHS funding ; free for a rti ci ants p p All system partners invited and engaged Content locally focused and driven Organized and held by - WSAC/WSALPHO ._ Highlighted local health agency experts and a wide range of issues Orientations ' Impact Better understanding of the PH system and larger responsibilities Neutral and peer-supported space for complex or polarizing issues Support localized onboardin efforts pp g e Sharing of alternative insights and --- �- perspectives Connect to other agencies on implementation and innovation strategies oil 1 19 441�9-bq..4-W OW11V -IV 1% 401, Ulm #00 V- * ♦ 1 Is 1 ■ Ift# hhj F, I own 11011N. ♦ �i�► Op of 1W it N1, so 4f 00 to ,.t• 's Practicing r JO _ cc _ W new" ■ - _ _ _ _ _ _ _ _ _ _ �. _ ■ low 4Z, .r -- �- ♦4W 4SQ �• • ♦ � � ♦ ♦ � ♦ ♦ ` ■r ■ � What does public health mean to you.; Why are you on the local board of health? What issues are most important for you? What are your motivations when making decisions? Case Study It's the Thursday before 4th of July. Your local health jurisdiction has received reports of blue- green algae at your most popular county lake. There have also been reports of dog deaths after swimming at this lake. Water sampling tests reveal high levels of cyanotoxins present. Cyanotoxins may cause several mild to serious health effects. This weekend, there will likely be hundreds of people swimming, boating, and fishing in the lake. What should be done? As a member of the local health board, what is your role? How do you work with the local health jurisdiction and members of the public in addressing this issue? Considerations Do your have statutory authority and 111111 111 respoWill 1 111 IN nsibility to respond? What is the agnitude and threat to the public? How do decisions get made - who orders them? Is there any possible fallout from your Milli Who should be engaged in this process? State? Local? Public? Private? How do you communicate to the public? Is there a larger issue that needs addressing? Case Study Your local health jurisdiction just gave a presentation on your county's community health needs assessment and improvement plan. Data show that the rate of suicide among youth is increasing. Community members and organizations including schools and churches are alarmed. Many have called on the local health jurisdiction to act. K""'ZL What role do you, as a board member have in addressing this issue? Do your have statutory authority and responsibility to respond? Consl* deratl* ons What is the magnitude and threat to the public? How do decisions get made - who orders them? Is there any possible fallout from your decision? Who should be engaged in this process? State? Local? Public? Private? How do you communi III cate to the public? Is there a larger issue that needs addressing? Key Take-sways 01 02 03 04 Public health Local health has LBOH members Statewide efforts means different a wide range of play a critical can complement things to responsibilities role in local and enhance everyone and services health success local orientation and onboarding Questions & Contact Jaime Bodden Managing Director WSALPHO U SRLPHO ibodden@wsac. WASHII16T011 STATE ASSOCIATI00 OF LOCAL PUBLIC HEALTH OFFICIALS Environmental Health Briefing TO: Mason County Board of Health FROM: Ian Tracy, Environmental Health Manager DATE: July 23rd, 2024 ITEM: Basic Sanitation Policy SUMMARY: The purpose of this policy is to provide guidance to staff and ensure consistency when they encounter non-permitted living conditions. Over the past 5-7 years our county has experienced an explosive increase in the number of complaints related to people living in tents, recreational vehicles, campers, sheds, cars etc. Complaints such as multiple RVs, sewage, solid waste and un-permitted structures. Initially our enforcement efforts adhered to Mason County Code and the result was the movement people and their associated sanitation issues from one property to the next all over the county. The root public health problems are basic sanitation issues that expose people and the environment to sewage and unpermitted burning or landfilling of solid waste. By chasing people all over the county we were not eliminating the public health threat, just changing the location with no control over where that new location might be. We also quickly found that we do not have adequate staff to enforce the code for most of these complaints. Planning and Environmental Health jointly began exercising enforcement discretion for these cases. We chose to defer enforcement action for certain portions of the code if there were no public health threats identified. This approach has been effective at mitigating public health threats, aligns with our current funding and is similar to the approach used by neighboring jurisdictions. This item was briefed to the Board in March and at that time the board indicated they needed more time to review. REQUESTED ACTION: Board discussion. ATTACHMENTS: Draft policy MASON COUNTY Public Health & Human Services Enforcement - Basic Sanitation for Non-Permitted Living Conditions The purpose of this policy is to protect public health and uphold the intent of existing regulations by identifying our enforcement discretion in response to the current economic, behavioral, and social challenges. This policy does not address building or planning codes. Problem Statement Mason County Public Health and Human Services (MCPH) is aware that many people are living individually or communally in non-permitted housing (including tents, recreational vehicles, converted out buildings, etc.) with a lack of potable water, sewage disposal, and solid waste disposal. This is most often due to their inability to find or afford appropriate housing and/or personal health challenges. However, living in substandard housing and discharging sewage to ground, unapproved drain fields, cesspools, pit privies, dry wells, etc. represent a public health and environmental risk. Accumulation or improper disposal of solid waste leads to public health and environmental impacts. Applicable Regulations • Mason County Code 6.72 Solid Waste and Biosolids Handling and Facilities Regulations • Mason County Code 6.76 On-site Sewage Regulations • Mason County Code 16.22 Mobile Homes and Trailer Parks • Mason County Public Health On-site Standards • RCW 35.21 .915 Hosting the homeless by religious organizations • Washington Administrative Code 51-50-2900 Plumbing Systems Policy Statement It isthe policy of MCPH and the Mason County Board of Health that staff will work with the property owner, occupant(s), Mason County Code/Law Enforcement staff, or other involved parties to ensure: • Sanitary management of wastewater. • Sanitary management of solid waste. • Prevent public health threats and degradation of shellfish harvesting areas. MASON COUNTY PUBLIC HEALTH, COMMUNITY&ENVIRONMENTAL HEALTH 415 6TH ST., SHELTON,WA 98584 SHELTON: (360)427-9670 X400 BELFAIR: (360)275-4467 X400 Basic Sanitation for Non-Permitted Living Conditions The property owner has the ultimate responsibility to ensure proper disposal of all sewage and solid waste on their property. Our intent is not to criminalize people living in these situations. Rather, our intent is to stabilize people where they are and provide time for them to improve their living conditions. This policy applies to any property within the boundary of Mason County. Policy Summary MCPH staff will follow the guidelines in this policy when they identify non- permitted living conditions via building permits, onsite sewage system (OSS) inspection reports, a complaint, agency referral or sanitary survey, etc. If there is an approved onsite sewage system on the property that has capacity for connection, then it may be used to properly handle sewage generated on the property. If there is no approved on-site sewage system or public sewer system connection then staff may authorize temporary occupancy of the property as prescribed in this policy. See Appendix A for definitions not included in Mason Couty Code (MCC) Titles 6 or 16. This policy does not identify approval criteria for siting Homeless Temporary Encampments. Temporary Encampments encompass several types: Continuous- Stay Shelter, Emergency Shelter Facility, Temporary Shelter Site, Resident Safe Park, Temporary Tent Encampment, Unsupported/Unsanctioned Encampment. Appendix A contains definitions of these terms from https://www.commerce.wa.gov/wp-content/uploads/2020/09/hau-ofah-shelter- guidelines-2020-2023.pdf The MCPH Director may extend compliance dates depending upon progress demonstrated by the property owner not to exceed 12 months. After this extension has expired, the property owner may appeal to the Health Officer and finally the Board of Health for more time. If the property owner is not able to comply after additional granted time, MCPH staff will evaluate the Enforcement and Penalty options specified in Title 15 - Development Code and Title 6 Sanitary Page 2 of 13 Basic Sanitation for Non-Permitted Living Conditions Code. Installation and use of pit toilets for sewage disposal shall not be permitted nor considered an adequate form of sewage disposal in Mason County (MCC 6.76.065(3)). Outdoor plumbing fixtures are discouraged, but this policy does make allowance for them if certain conditions are met (see Attachment A). Unoccupied structures and vehicles that are not connected to water service or discharging wastewater are not subject to this policy. Property owners and/or Sponsor will provide adequate pest-proof garbage containers with frequent disposal at a permitted solid waste facility. This policy does not preclude other county departments or state agencies from taking enforcement action within their jurisdiction. No permit fees apply to the temporary circumstances covered in this policy. A1121ying this Policy Table 1 below describes compliance requirements for waste management when people live primarily in travel trailers, recreational vehicles, park models, tiny homes, or other structures with plumbing fixtures where an on-site sewage system or public sewer connection is currently installed or is practical to install within six to 24 months. Table 2 provides waste management requirements for "Temporary Encampments" located on undeveloped properties with no onsite sewage system or public sewer connection, and it's not practical to provide either in the next six to 24 months. A Temporary Homeless Encampment as described in Table 2 is any sanctioned or unsanctioned homeless camp operated by the City, County, or faith-based and non-governmental organizations with a 501(C)(3) status that is a charitable organization. Table 3 provides waste management requirements for "Temporary Encampments" located on developed properties with an approved onsite sewage system including a system that may require supplemental portable services adequate for a temporary encampment at that location. Page 3 of 13 Basic Sanitation for Non-Permitted Living Conditions Attachment A describes compliance requirements/actions where plumbing fixtures installed without permits are identified. Compliance with this policy will be ensured by completing the following: 1. MCPH staff provide property owner (owner) and occupants with information on: A. RV sewage disposal sites such as parks and other facilities. B. List of certified pumpers. C. Guidance for sanitary connection to OSS or portable holding tank. 2. MCPH staff will refer owner and occupants to Community Family Health to evaluate their eligibility for assistance programs. 3. MCPH staff will serve a written Notice and Order/ Notice of Violation (Order) to the owner/occupants of the property. Owner/occupant is required to submit a plan for management of wastewater and solid waste on the property on the Waste Management Plan (WM P) form provided by the department. 4. Recreational vehicles, park models, tiny homes, yurts, and converted outbuildings etc. being used as a single-family residence are all considered to generate the following volume of sewage based on water source. A. Plumbed water- 60gal/person/day. B. Hauled water supply - 5gal/person/day. 5. If the OSS serving the property has no as-built on file, MCPH staff will recommend the system be evaluated by a state licensed designer to determine its functional status and capacity. 6. Owners/occupants mustdemonstrate adequate sanitation and waste management through consistent compliance with and execution of the approved WMP. 7. Onsite sewage system disposal may be augmented by use of pumpable portable sanitation units such as sinks, showers, chemical toilets and bathrooms. These units must: A. Have adequate capacity for all grey and black water wastes. B. Be pumped out and waste disposed of in an appropriate off-site designated waste disposal treatment location. 8. Staff will inspect the connection to an existing onsite sewage system or to an adequate portable sanitation unit to ensure that it is sanitary and leak free. 9. If at any time the owner/occupant is no longer in compliance with the WMP, MCPH staff will review MCC code and policy to determine appropriate enforcement action. Page 4 of 13 Basic Sanitation for Non-Permitted Living Conditions Mason County Board of Health Randy Neatherlin, Chair Date Page 5 of 13 Basic Sanitation for Non-Permitted Living Conditions Table 1:Travel trailers,Recreational Vehicles,Park Models,Tiny Homes,or other structures with Plumb in fixtures Condition Observed Waste Management Owner Responsibilities Enforcement Timeline MCPH Staff Extension Director Extension Health Officer on the property Plan Extension Scenario#1 On board holding tank For an RV,submit WMP or One month for WMP. Up to six additional Up to 12 additional At Health Officer's No OSS available. for RV with waste contract with certified months for installation of months for installation discretion up to 12 management plan(WMP) pumper,or contract for and 12 months for installation of new OSS. of new OSS. additional months. One or more living or pump contract, place a chemical toilet on new OSS. units on the property. site. Condition:Progress Owner must appeal to OR has been made and Owner must appeal to Board of Health Notify staff of any spills. field inspection reveals Health Officer for (BOH) Contract for chemical that sewage is being additional time. for more time. toilet or temporary Apply for a permit and handled correctly. holding tank to handle complete installation of If final deadline not both grey and black new OSS. met,staff will evaluate water. the enforcement and penalty options AND specified in EH Policy and Code. Provide adequate containers and proper and frequent disposal of solid waste generated on the property Scenario#2 Additional living unit(s) Submit WMP. One month for WMP. If final deadline not met, N/A N/A OSS installed. may be connected if OSS staff will evaluate the is not in failure. Notify staff of any spills. enforcement and Single Family penalty options specified Residence connected. If it is not feasible for OSS in EH Policy and Code. to serve the additional Additional living living unit(s),then refer to unit(s)present. Scenario#1. Provide adequate containers and proper and frequent disposal of solid waste generated on the property. Page 6 of 13 Basic Sanitation for Non-Permitted Living Conditions Table 1 Continued Condition Observed Voluntary Compliance Owner Responsibilities Enforcement Timeline MCPH Staff Extension Director Extension Health Officer on the property Agreement(WMP) Extension Scenario#3 Living unit(s)may be Submit WMP. One month for WMP. If final deadline not met, N/A N/A OSS installed. connected if OSS is not in staff will evaluate the failure. Notify staff of any spills. enforcement and No Single Family penalty options specified Residence connected. If not feasible for OSS to in EH Policy and Code. serve the living unit(s), One or more living then refer to Scenario#1. units. Provide adequate containers and proper and frequent disposal of solid waste generated on the property. Page 7 of 13 Basic Sanitation for Non-Permitted Living Conditions Table 2:Temporary Encampments located on undeveloped property with no access to approved wastewater treatment and disposal.Intentionally placed by owner/sponsor.i.e.City of Shelton Mitigation Site. Condition Observed Waste Management Owner Responsibilities Enforcement Timeline MCPH Staff Extension Director Extension Health Officer on the property Plan Extension Temporary Sufficient chemical toilets Submit and implement a One month to submit and Two additional weeks to One additional week to Camp may remain at encampment. for grey and black water, WMP that includes Contract implement WMP submit and implement submit and implement a documented with handwash station, with a licensed and certified WMP if progress has WMP if progress has location with an No OSS or other company to provide been verified. been verified. implemented WMP at approved wastewater OR adequate port-a-pots and the Health management system. potable water for If final deadline not met Officer's discretion up Portable restroom trailer handwashing and cooking. for submittal of WMP, to 12 months with adequate toilets, staff will evaluate the showers and enforcement and Owner must appeal to handwashing. penalty options Board of Health specified in EH Policy (BOH)for more time. Portable kitchen trailer and Code. for cooking and If final deadline not handwashing or other met,staff will evaluate mechanism/methods the enforcement and approved by EH to penalty options provide safe water and specified in EH Policy wastewater and Code. management. Potable water for handwashing and cooking. AND Camp may have to move to accommodate contractor access for maintenance. Property owners and/or Sponsor are responsible for providing adequate containers and proper and frequent disposal of solid waste generated on the property. Page 8 of 13 Basic Sanitation for Non-Permitted Living Conditions Table 3:Temporary Encampments located on pro erties with OSS. Condition Observed Voluntary Compliance Owner Responsibilities Enforcement Timeline MCPH Staff Extension Director Extension Health Officer on the property Agreement(WMP) Extension Temporary OSS Is determined to Submit and implement a One month to Implement Two additional weeks to One additional week to Camp may remain at encampment. treat 60 gallons per WMP that includes Contract WMP. submit and implement submit and implement a documented person per day. with a licensed and certified WMP if progress has WWMP if progress has location with an Approved OSS company to provide been verified. been verified. implemented WMP at installed and potable If number of persons adequate chemical toilets the Health Officers water available. exceeds OSS capacity: and potable water for If final deadline not met discretion up to 12 Sufficient chemical toilets handwashing and cooking. for submittal of WMP, months. for grey and black water, staff will evaluate the with handwash station. Enforcement and Owner must appeal to Penalty options Board of Health OR specified in EH Policy (BOH)for more time. and Code. Portable restroom trailer If final deadline not with sufficient toilets and met,staff will evaluate handwashing. the Enforcement and Penalty options Portable kitchen trailer specified in EH Policy for cooking and and Code. handwashing or other mechanism/methods approved by EH to provide safe water and wastewater management. AND Camp may have to move to accommodate contractor access for maintenance. Property owners and/or Sponsor will be responsible for providing adequate containers and proper and frequent disposal of solid waste generated on the property. Page 9 of 13 Basic Sanitation for Non-Permitted Living Conditions Requirements for the allowance of or decommissioning of plumbing fixtures A. Outdoorfixtures(sink or shower, etc.whether plumbed to water or not): 1 . Current O&M inspection on file. 2. Plumbing fixture discharge must be plumbed into the septic system or remove fixture. 3. Exceptions: a. Hose bib on property okay. b. Exception: Fin or Shellfish wash sink ok if it is located near shore and served by hose. c. Exception: Raw vegetable wash sink ok if nearvegetable garden and served by hose. B. Plumbing removal in a building not approved for plumbing: 1. Remove all plumbing fixtures such as sinks, showers, tubs, toilets. 2. Cut interior pipes atthe wall orfloor,fill firstfew inches of pipe with expanding foam or cement. 3. Water line must be cut and capped one foot outside the building. 4. Sewer line must be cut outside the building and either removed or filled with cement or expanding foam. 5. Septic tank or cesspool (if present) shall be decommissioned or removed with documentation submitted to MCPH. Hose bibs and hydrants are exempt. Page 10 of 13 Basic Sanitation for Non-Permitted Living Conditions Charitable is used in its generally accepted legal sense and includes relief of the poor,the distressed, orthe underprivileged;advancement of religion; advancement of education or science;erecting or maintaining public buildings, monuments, or works; lessening the burdens of government; lessening neighborhood tensions; eliminating prejudice and discrimination; defending human and civil rights secured by law; and combating community deterioration and juvenile delinquency. Continuous-Stay Emergency Shelters offer sponsored living arrangements where households have a room or bed or temporary portable tiny house shelter assigned to them throughout the duration of their stay in a sanctioned and sponsored location. The targeted stay may range from six months to one year and is renewable by the permitting body. Emergency Shelter Facility is defined as a building locally permitted to provide emergency shelter for people experiencing homelessness. This includes re-use of existing buildings and new buildings. This designation requires a certificate of occupancy issued by the local jurisdiction. Living Unit- Includes tents, RVs, travel trailers, sheds, yurts, or other places where people live, sleep, or recreate. Managing agency means an organization identified as the manager of a temporary encampment that has the capacity and expertise to organize and manage a temporary encampment. A "managing agency" may be the same entity as the sponsor. Owner is the property owner as identified in the County Assessor records. Resident Safe Park is an arena or location where people can live in their RVs or cars without standard hookups, but where there are features such as: security, property management, potable water, bathrooms and showers, garbage collection, electricity and access to social support services. This is essentially a non-profit coordinated, temporary RV park and is movable from one location to another. It doesn't usually have typical hookups as in a campground but may be located in a large parking lot or athletic field or commercial property or the grounds of a church. Sponsor means: 1. A government entity(e.g., city or housing authority); or Page 11 of 13 Basic Sanitation for Non-Permitted Living Conditions 2. A religious organization that is recognized bythe Internal Revenue Service as exempt from federal income taxes as a religious organization, and that expresses its religious mission, in part, by organizing living accommodations for the homeless; or 3. Nonprofit organization. Temporary means not affixed to land permanently and not using underground utilities. Temporary Encampment as used in this context means: "Not affixed to land permanently and not using underground utilities."(WA Dept of Commerce definition) There are several forms of"Temporary Encampments" including, but not limited to: • Unsanctioned temporary homeless tent encampment • Temporary supported emergency shelter • Sponsored temporary portabletiny housevillage • Designated temporary vehicle resident safe park arena • Otherforms of temporary encampments, such as for events orsocial or religious gatherings. Temporary Encampments are generally limited to periods of six months to a year, depending on location, and may be renewable. Temporary Shelter Site is a structure or a location permitted to provide temporary shelter for people experiencing homelessness. Tents, mitigation sites, resident vehicle safe park arenas, or hosted encampments of portable tiny houses are examples of Temporary Shelter Sites. This designation requires use approval, as required by the local jurisdiction. This could be conditional or temporary use permits, or a zoning letter stating approvals required. Temporary shelter structures referred to as portable "tiny shelters" or "tiny homes" or "wooden tents" that do not have interior plumbing or kitchens are allowable facility types, in addition to other models approved by Commerce.This designation requires use approval,as required bythe local jurisdiction.This could beconditional ortemporary use permits, or a zoning letter stating approvals required. Temporary tent encampment means a group of homeless persons temporarily residing in tents or other temporary structures on a site owned or controlled by a sponsor with services supervised by a managing agency. Page 12 of 13 Basic Sanitation for Non-Permitted Living Conditions Unsupported/ Unsanctioned Encampment is an encampment of tents or vehicles consisting of unrelated individuals occupying a location or facility without permitting, sanction or support of non-profit organization or government agency. May be located on private property if sanitation requirements fortemporary encampments are met. Waste Management Plan(WMP) is a written plan submitted bythe owner/occupant or sponsoring entity that includes: • Methods of wastewater management. • Capacity based on the proposed number of occupants. • Source of potable water and method of delivery. • Contract with a certified septic pumper for removal of all grey and black water. • Description of solid waste management and disposal. WAC 51-50-2900 Plumbing systems shall be used as a guide for minimum number of fixtures to be provided. At a minimum the following shall be met to be considered adequate: • One toilet shall be provided at a ratio of 1:15 persons. • Showers at the ratio of 1:8 persons. • If three or more sanitary portable toilets or bathrooms with showers are required, at least one shall be ADA accessible. • All shall be set back at least 40 feet from all property lines. • Hand-washing stations shall be provided in both the toilet area and food preparation area. The "owner", "sponsor" and "managing agency" shall ensure compliance with the WMP, Washington State laws and regulations, the City of Shelton Municipal Code, and Mason County Code concerning, but not limited to, drinking water connections, food handling and storage, solid waste, sewage and electrical systems. The "owner", "sponsor" and "managing agency" shall coordinate with MCPH and arrange for inspections by state and local agencies to ensure such compliance and shall implement all directives that result within the specified time period. Page 13 of 13 Environmental Health Briefing TO: Mason County Board of Health FROM: Ian Tracy, Environmental Health Manager DATE: July 23rd, 2024 ITEM: On-site Sewage Advisory Committee (OSAC) Membership -Application for Renewal SUMMARY: Keith Fuller is a current member of the OSAC holding the Realtor position. He has served on the committee since its reformation in 2019 and has applied to extend his service for another three years. REQUESTED ACTION: Board discussion and call for vote if appropriate. ATTACHMENTS: Application P9oN COpNTA MASON COUNTY COMMISSIONERS 411 NORTH FIFTH STREET SHELTON WA 98584 Fax 360-427-8437; Voice 360-427-9670, Ex[. 419,275-4467 or 482-5269 1854 [AM SEEKING APPOINTMENT TO On-site Advisory Board NAME: Keith Fuller ADDRESS: 200 W Shadow Valley Drive PHONE: 360490-3811 CITY/ZIP: VOTING PRECINCT: WORK PHONE: 96584 (OR AREA IN THE COUNTY YODUVE) E-MAIL: landman@keithfuller.com ----------------------------------------------------------------------------------- COMMUNITY SERVICE EMPLOYMENT:(IF RETIRED PREVIOUS EXPERIENCE) (ACTARTIES OR MEMBERSHIPS) COMPANY: Windermere/Himlie Inc 45 YRS Mason County Acsnciatinn of Realtnm POSITION: Real Estate Sales COMPANY: YRS POSMON: -------------------------------------------------------------------------------------------- In your words,what do you perceive is the role or purpose of the Board, Committee or Council for which you are applying: Assist staff through advisory committee on decisinns regarding nn-cite sewage digpnsal policies What interests, skills do you wish to offer the Board, Committee,or Council? 41 years of rem!estate sales working with -iniMproVerl 1,nd h,,yer/gallerc and hoMg hi 1yersiseliers Work rJARY with pumpers and O&M specialists in Mason County. Also, work with Thurston and Jefferson county pumpers and septic pro ess)ona s. Experience dealing with ) icu situations where on-site septic sys ems are l ing. Please list any financial, professional, or voluntary affiliations which may influence or affect your position on this Board: (i.e.create a potential conflict of interest) None known. Your participation is dependent upon attending certain trainings made available by the County during regular business hours (such as Open Public Meetings Act FN Public Records).The trainings would be at no cost to you.Would you be able to attend such tr ' 'ngs? Ye Realistically, how uc tim can you iv to this position? Quarter) ly Weekly 2 �Y Office Use Only ✓ 2� Z - I Appointment Date Signature Dad {{ Term Expire Date Environmental Health Briefing TO: Mason County Board of Health FROM: Ian Tracy, Environmental Health Manager DATE: July 23rd, 2024 ITEM: Request For New Food Establishment Permit Type - Street Vending SUMMARY: The department has received several requests to permit a new Food Establishment type which is commonly referred to as Street Vending. This type of food establishment has a lower cost of entry for those looking to start a food business, at the expense of limitations to the food menu. Thurston County currently offers this type of establishment permit and they are in their second year of allowing this type of establishment. This item was briefed to the Board in March and at that time the board indicated they needed more time to review. REQUESTED ACTION: Board discussion. ATTACHMENTS: Program Summary • • MASON COUNTY Public Health & Human Services Street Vending Food Establishment Mason County Food Safety Program has been approached by approximately 5 small businesses to practice street vending in Mason County.Thurston County currently has a pilot program running for its 2nd year providing this opportunity. There are multiple reasons why someone wants to street vend. Description: A Food Street Vendor is a Food Establishment that sets up with a pop-up facility and equipment like a Temporary Food Establishment but is not associated with an Event.These vendors use tents as food cover protection and ice chests as cold-holding storage. Cooking equipment and hot-holding equipment vary depending on the menu items, but can be BBQ's, Smokers,fryers, grills, crock pots, roasters, etc. Handwashing is a temporary set up, with no direct connection to running hot water and buckets collect the grey water to be disposed of at an approved location. The difference between a temporary food establishment and a Street Food Vendor Establishment is the vendor is not operating at a coordinated planned community event.They pop-up at various and multiple locations to serve food direct to the consumer. With no fixed location and structure associated with Street Vending this would place them in the category of a Mobile Food Establishment with the following key differences: Street Food Vendor Mobile Food Establishment Cold-Hot hold and cook-serve only Vehicle or cart No on-site food prep L&I approval Tent required for overhead cover Fully equipped self-contained unit Extensive setup needed Service direct from unit Limited Menu Minimal set-up at service site. Commissary required Commissary optional (Menu and vehicle dependent) Temporary hand washing set-up Associated Benefits: ➢ Lower start-up costs for food business. ➢ Establishment can provide services to rural parts of community. MASON COUNTY PUBLIC HEALTH, COMMUNITY& ENVIRONMENTAL HEALTH 415 6TH ST., SHELTON,WA 98584 SHELTON: (360)427-9670 X400* BELFAIR: (360)275-4467 X400*ELMA: (360)482-5269 X400 ➢ No Washington State L&I inspection approval required or extensive wait time for inspection to be completed. ➢ This permit will allow them to street vend and participate in coordinated planned community events just like a Mobile Unit. ➢ Specific businesses will be able to invite them to set up adjacent to their location for additional food service in that area and offer seating in the business. (Wineries or Breweries) ➢ Operation routinely inspected. Associated Risk, Concerns, & Burdens: ➢ All the trust would be on these operators to fulfill all food safety requirements every time they set up. ➢ Food safety during operation includes monitoring all temperatures cold-hold, cooking, and hot- holding, and only operating for a set time. ➢ Conducting cleaning and sanitization throughout the service time on site. Always having sufficient supplies to fulfill these food safety practices. ➢ Weather affecting cooking and hot-holding temperature or cold-holding temperatures. Wind and rain can possibly cause cross-contamination if the facility becomes insufficient. ➢ Other government agencies will have requirements associated with the setup and locations to include Fire, City, and County. ➢ Other Food Industry business operators may find this unacceptable due to them having invested time and money into brick n mortar or Mobile Establishments. Following all the requirements to operate a food establishment. ➢ Street Vendor operators will have more restrictions than a Mobile Food Unit and must follow the strict variances approved. Every time they set up. No changes are allowed to the approved facility set up, food safety processes, or menu items without adequate notification to public health and approval received. Commissary requirements Concerns and Burdens: ➢ Street Vendor Operators will have to conduct all preparation of foods at a commissary every day of operation prior to service on-site. They will also have to get their warm water for the temporary handwashing here. ➢ Returning to a commissary every day of operation to conduct final warewashing and equipment cleaning and sanitizing. Gray water disposal. ➢ Storage of dry goods and cold-holding goods must be done at commissary. (Not all commissaries allow this.) ➢ Storage of Street Vendors facility set-up and equipment. ➢ Availability of commissaries in Mason County is limited. 2 Washington State Retail Food Code (WAC246-215) Definitions&Codes: "MOBILE FOOD UNIT" means a readily movable food establishment. "TEMPORARY FOOD ESTABLISHMENT" means a FOOD ESTABLISHMENT: (a) Operating at a fixed location, with a fixed menu, for not more than 21 consecutive days in conjunction with a single event or celebration, such as a fair or festival: or (b) Operating not more than 3 days a week at a fixed location, with a fixed menu, in conjunction with an APPROVED, recurring, organized event, such as a farmers' market. "VARIANCE" means a written document issued by the REGULATORY AUTHORITY that authorizes a modification or waiver of one or more requirements of this chapter if, in the opinion of the REGULATORY AUTHORITY, a health HAZARD or nuisance will not result from the modification or waiver. TT COMMISSARY" means an APPROVED FOOD ESTABLISHMENT where FOOD is stored, prepared, portioned, or PACKAGED for service elsewhere. 09170 Food and equipment protection--Overhead protection. The PERMIT HOLDER and PERSON IN CHARGE shall ensure overhead protection is provided at the site of operation of the MOBILE FOOD UNIT for all FOOD handling activities. 09175 Food and equipment protection--Food and food service supplies. The PERMIT HOLDER and PERSON IN CHARGE shall ensure that all FOOD, EQUIPMENT, UTENSILS, and other FOOD service supplies are contained on the MOBILE FOOD UNIT, at the APPROVED COMMISSARY, at the APPROVED SERVICING AREA, or as otherwise APPROVED in the plan of operation. 09140 Handwashing--Handwashing facilities. The PERSON IN CHARGE of a MOBILE FOOD UNIT shall ensure that a separate HANDWASHING SINK for EMPLOYEES is accessible at all times of operation; allows convenient use by EMPLOYEES; is located within 25 feet of FOOD preparation, FOOD dispensing, and WAREWASHING areas; is installed as specified under 05210; and includes soap and paper towels. 09126 Commissary usage. (5) Depending on the menu and plan of operation, the MOBILE FOOD UNIT operator must have access at the COMMISSARY to: (g)Adequate space for the sanitary storage of FOOD, EQUIPMENT, UTENSILS, LINENS, and single- service, or single-use articles. 06100 Indoor areas--Surface characteristics(FDA Food Code 6-101.11). (2) In a TEMPORARY FOOD ESTABLISHMENT: 3 (a) If graded to drain,a floor may be concrete, machine laid asphalt,or dirt or gravel if it is covered with mats, removable platforms,duckboards,or other APPROVED methods to effectively control dust and mud. (b)Walls and ceilings must be constructed from a material that protects the interior from the weather and windblown dust and debris. 4 It MASON COUNTY Public Health dt Human Services COMMUNITY HEALTH March - June 2024 --------------------------------------------------- ...................................................................................................... COMMUNICABLE DISEASE & • NOTIFIABLE CONDITIONS* LAW ENFORCEMENT 59 cases of Chlamydia ' ASSISTED DIVERSION • *CD rates are suppressed for all counts<10 LEAD (LEAD) LAW ENFORCEMENT ASSISTED DIVERSION • Partnered with EH/Vector group to create a more workable bat intake form for calls/specimens. • Updated local Veterinarians with rabies information/dog JUIy 1, 2023 - June 30, 2024: bite cards. • Final Pathology report received from UW • Total admitted into LEAD: 250 new cases neuropathology pathologist on Unexplained/ • Number of individuals contacted through LE Unexpected death in September 2023. No clear response vs. community referral: explanation found; likely viral in nature. o Social Referrals: 33 SUBSTANCE USE ty o Community: 217 MOBILE OUTREACH a Number of staff contacts: o 2,665 unduplicated encounters 'C ACCpby+BQ D TT i .a LAW ENFORCEMENT CO- RESPONDER PROGRAM gf9peCT 10hn OVERDOSE PREVENTION EDUCATION AND NALOXONE DISTRIBUTION (OPEND) # New #Caseload Total Quarter Clients Carryover Clients Enrolled Served NARCAN�; NASALSPRAYAm9r 134 38 172 1 Jan-Mar ,:P. ^' Successful Overdose Reversals with Naloxone 2 Apr-Jun 118 31 149 • 931 Naloxone Kits distributed • 154 new people trained on overdose Total YTD 252 69 321 prevention, recognition, and response • Re-engaged with 122 participants to give refills MASON COUNTY Public Health & Human Services COMMUNITY HEALTH March - June 2024 -------------------------------------- ...................................................................................................... fic WOMEN, INFANT AND, CHILDREN (WIC) Current Caseload: 255 (Goal from the WA State WIC Program is 300) After School Snack Program at the YMCA gave out 1,234 snacks to teens in five and a half weeks. We are preparing for the WIC World Breastfeeding event in August by asking local businesses and community organizations for donations of snacks and raffle prizes. WIC and YMCA are working together, and the Shelton Family YMCA is giving a 45% discount (financial assistance) on memberships to Shelton WIC Participants. HEALTH EDUCATION AND OUTREACH In the months of March - June, there was a total of 113 social media posts with an average 3.81% engagement rate. We attended the Early Learning Coalition's Summer Kick-off Event, Skokomish Resource Fair, and the Bike Rodeo. ® VI AlicSQN iqucoUNjy �' - F K man Services ��111 couqV i � stir P,ylic Health MASON COUNTY Public Health & Human Services COMMUNITY HEALTH March - June 2024 -------------------- ---------- •— — •----- ............... ..................................................................................... IMB n- HOUSING AND HOMELESSNESS Funding allocated to EP Rent in Mason Number of HH funded Remaining County July 2023 to June 2025 July 2023 to May 2024 funds $406,590 57 $227,361.77 Month #of unlawful detainer January 2019-December 2019 86 January 2023-December 2023 60 January 2024-April 2024 35 Emergency Shelter/RRH Projects Exit to Permanent Performance Housing July 2023 -June 2024 Actual Measure All Mason County funded rental assistance including CAC HEN, CH,TYC.This group is housed and it is a measure of a 57% 80% program's ability to keep participants housed. All Mason County funded shelters including CH,TYC, 42.8% 50% C LL,TPSA MASON COUNTY Public Health & Human Services COMMUNITY HEALTH March - June 2024 --------------------------------------------------- ...................................................................................................... PREVENTION huunON PARTNERS SUBSTANCE ABUSE PREVENTION COALITION SUBSTANCE ABUSE PREVENTION COALITION We have partnered with the Shelton Movie Theater, KMAS 1030 radio, MasonWebTV, and our regular social media outlet to promote cannabis lock boxes. We also partnered with all Mason County Cannabis retail stores to promote locking bags by placing "Lock it Up" posters at their front counters. Public Health and Human Services and the Coalition provided 150 locking bags for distribution to retail store customers. The Coalition also staffed a prevention booth at the first Shelton Bike Rodeo. We are currently planning our Annual Oysterfest Booth and the First ever Latin-X Substance Abuse Prevention Coalition Summit scheduled for November 2024. MATERNAL AND CHILD HEALTH • CSHCN individual case management was provided for 10 families in March, 15 families in April, 11 families in May, and 12 families in June. • Continuing to update the Mason County Family Resource Guide, which identifies support services, and sharing with families and providers. • Organized and completed the June 15th Care-A-Van (mobile vaccination services) Immunization Event in coordination with an Early Learning Coalition family event at Kneeland Park. This was our 4th Immunization Clinic in the past year.