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HomeMy WebLinkAbout2025/07/22 - BOH PacketMason County Public Health 415 N 6th Street, Bldg. 8, Shelton WA 98584, Phone: (360) 427-9670 ext. 869  Fax: (360) 427-7787 If special accommodations are needed, please contact the Commissioners Office at (360) 427-9670 ext. 419 MASON COUNTY BOARD OF HEALTH July 22, 2025 11:00 A.M. Commission Chambers 411 North 5th Street Shelton, WA 98584 DRAFT AGENDA 1. Welcome and Introductions Chair 2. Approval of Agenda – ACTION Board Members 3. Approval of Minutes (May 27, 2025) – ACTION Board Members 4. Health Officer Report Dr. Steve Krager 5. Administration Report Dave Windom a. Fiscal 6. Environmental Health Report Ian Tracy a. Two-Party Wells b. OSS Code Enforcement Challenges 7. Community Health Report Melissa Casey a. Kratom Store Survey Results Update 8. Other Business and Board Discussion Board Members a. Small Lot Size Waivers b. Methadone Mobile Clinic c. Board of Health Membership Opening(s) 9. Public Comments 10. Adjourn MASON COUNTY BOARD OF HEALTH PROCEEDINGS 411 North 5th Street, Shelton, WA May 27, 2025 Attendance: Randy Neatherlin, County Commissioner; Pat Tarzwell, County Commissioner; Sharon Trask, County Commissioner; Dr. Steven Krager, Health Officer; Darrin Moody, Hospital District No. 1; Peggy VanBuskirk, Hospital District No. 2; Eric Onisko, City of Shelton Mayor; Rachel Armas, Tribe; David Windom, Director of Public Health; Ian Tracy, Environmental Health Manager; Melissa Casey, Community Health Manager; Christina Muller-Shin, Public Health; McKenzie Smith, Clerk of the Board; and Dedrick Allen, MasonWebTV 1. The Chair called the meeting to order at 11:04 a.m. 2. Approval of Agenda Cmmr. Trask/Eric moved and seconded to approve the agenda as presented. Motion carried. 3. Approval of Minutes Cmmr. Tarzwell/Peggy moved and seconded to approve the March 25, 2025, minutes as presented. Motion carried. 4. Health Officer Report Dr. Krager shared the Vector Borne Diseases Eastern Washington PowerPoint presentation. Topics included mosquito-borne viruses, tick-borne diseases, and prevention. 5. Administration Report David discussed Foundational Public Health Services (FPHS) funding and potential budget cuts. At this time there could be a $12 million cut, which would equal out to about $149k cut for Mason County. David suggested cutting funding for most recent programs. Mayor Onisko shared concerns around what may be important for one County may not be important for another. Cmmr. Trask/Peggy moved and seconded to approve David drafting letter of support for local control around FPHS funding. Motion carried. 6. Community Health Report Melissa highlighted the Home Service Program expansion. The 2024 proposal brought forward syndemic clinic services and syringe services. Currently there are delays in the ability to implement as planned. An Advanced Registered Nurse Practitioner (ARNP) or a Physician Assistant – Certified (PA-C) are still needed for the program. However, due to the funding climate, purchasing a mobile clinic vehicle and posting for positions is paused. Christina is working with the Mobile Integrated Health Program to start a weekly infectious disease and wound care clinic. The intake paperwork would also allow individuals to pursue primary care with Peninsula Services. 7. Environmental Health Report Ian discussed appointing David Killoran to the On-Site Sewage Advisory Committee (OSAC). Peggy/Cmmr. Trask moved and seconded to appoint David Killoran to the OSAC. Motion carried. 8. Olympic Region Clean Air Agency (ORCAA) Presentation Jeff Johnston, Odelle Hadley, Mike Shults, and Dan Nelson presented the Focus on Mason County Air Quality PowerPoint presentation. Key topics included who ORCAA is, County demographics, story of air monitoring in Shelton/Mason County, Mason County Saturation Study for May 2019-April 2020, 24 years of Mason County daily Air Quality Index (AQI), smoke issues, outdoor burning, asbestos and demolition programs in Mason County, working with businesses, and inspection visit of pacific coast fiber fuels. 9. Other Business and Board Discussion Ian shared that Happy Garden is still working through challenges; however, it is not consistent with the required path forward. 10. Public Comments No public comment. 11. Adjourned at 12:21 p.m. ATTEST _______________________________ McKenzie Smith, Clerk of the Board MASON COUNTY, WASHINGTON BOARD OF HEALTH MASON COUNTY, WASHINGTON _______________________________ Darrin Moody, Hospital District #1 _______________________________ Eric Onisko, City Council _______________________________ Pat Tarzwell, Commissioner _______________________________ Randy Neatherlin, Commissioner _______________________________ Sharon Trask, Commissioner _______________________________ Peggy Van Buskirk, Hospital District #2 _______________________________ Gary Plews, Fire Commissioner _______________________________ Keri Davidson, Shelton School Board From the Director’s Desk July 2025 Happy Summertime The latest legislative session concluded with a 7% reduction in Foundational Public Health Services (FPHS) funding compared to last year. The statewide FPHS budget, previously set at $324 million, was reduced by $24 million over the coming biennium. For this current budget year, beginning in July, both the Department of Health and the broader public health system will each see a $4 million cut. Local Impact and Budget Allocation WSALPHO oversaw the distribution of these reductions, prioritizing cuts in counties that consistently underspend their allocations—many of which are smaller jurisdictions. These areas often face persistent recruitment challenges, creating what might be considered chronic under- recruitment. Here in our department, the impact is significant: a reduction of $392,000, amounting to a 19.8% cut in our FPHS budget. For comparison, King County saw a 2.33% reduction, while Adams County experienced a 29.44% cut. Program Reductions and Future Planning These financial constraints forced difficult decisions. We’ve eliminated our Hepatitis C program and Emergency Response Planning under FPHS. Our Life Course work—focusing on chronic disease prevention—has also been significantly scaled back. Thankfully, we were able to preserve staffing levels, but these cuts halt our ability to expand into anticipated programs that were in development. Although the changes were implemented on July 1st, final contract language is expected later this month. Upcoming Legislative Visit On July 29th, Mason County will host a joint delegation from the House and Senate. This group is visiting select health departments statewide to understand how budget reductions are affecting local communities. We welcome the opportunity to share our experience. A New Chapter in Public Health Leadership Washington’s new Secretary of Health is Dennis Worsham—a long-time colleague of mine. Dennis brings a wealth of experience from both DOH and his prior leadership roles in Seattle/King and Snohomish Public Health. I’ll be meeting with him on July 24th in Olympia to discuss shared priorities and chart our course for the next two years. Warm regards, David Windom, MSHS Environmental Health Briefing TO: Mason County Board of Health FROM: Ian Tracy, Environmental Health Manager DATE: July 22nd, 2025 ITEM: 2-Party Water System - Minimum Lot Size SUMMARY: 2-Party water systems are private wells with two connections. The two connections can be from structures on the same or separate parcels. Mason County regulates these systems under the authority of WAC 246-291 and has codified the requirements under MCC 6.64 – Group B Water System Regulations. MCC 6.64 adopts as code the Mason County Design and Construction Standards for Group B Water Systems(Standards). The Standards require that the lot or lots served by a 2-Party water system are each a minimum of one-acre. This requirement was put in place to maintain consistency with the minimum lot size requirements for septic systems found in WAC 246-272A-0320 Table XI. However, the lot size requirements found within the septic regulations are more nuanced than our flat one-acre requirement found within the Standards. We are encountering an increasing number of permit proposals where the On-site Septic regulations will let the project proceed, but the applicant cannot develop a water source due to the 2-party water system restrictions. REQUESTED ACTION: Discussion. ATTACHMENTS: 2-Party Presentation. 2 -Party Water Systems Conflict between OSS regulations and drinking water regulations Development Development Projects comprise two primary Environmental Health components: •Potable Drinking Water Source •Sewage Management and Disposal Regulatory Framework Drinking Water: •Washington Administrative Code(WAC) 246 -291 Group B Public Water Systems •Mason County Code (MCC) 6.64 – Group B Water System Regulations •Mason County Design and Construction Standards for Group B Water Systems On-site Sewage Systems(OSS): •WAC 246 -272A On-site Sewage Systems •MCC 6.76 –On-site Sewage Regulations •Various policies OSS & Minimum Lot Size OSS & Minimum Lot Size OSS & Minimum Lot Size Exemption –Lots that do not meet the minimum lot size may install an OSS if no waivers are required to meet the minimum setbacks •Griffin v. Thurston •Codified in 2025 WAC update 2 -Party Water System Minimum Lot Size Mason County Design and Construction Standards for Group B Water Systems: “Mason County Department of Health Services may authorize such private two-party water system provided that the water system serves two lots in which each lot is at least an acre or larger in size and the water source is a drilled well.” No requirements in WAC 246-291 Unintended Consequences The 2-Party minimum lot size was created to maintain consistency with the OSS Regulations. The result is a requirement that, in some cases, creates situations where the applicant installs a septic system but can not obtain water when a 2-Party water system is the only option. Options •Drop the minimum lot size requirement. •Require the overall project meet the requirementsoftheOSSregulations. Exempt projects on sewer or LOSS. •Maintain the current standard. Environmental Health Briefing TO: Mason County Board of Health FROM: Ian Tracy, Environmental Health Manager DATE: July 22nd, 2025 ITEM: Challenging OSS Code Enforcement Cases SUMMARY: We are accumulating a growing number of code enforcement cases involving properties where the owners are unable to install a septic system. In some cases, it is for financial reasons, and in others it is due to the code restricting minimum land area, or both. Example #1: An RV occupied seven months out of the year by a couple on a fixed income. Their sewage is accumulated in a 250-gallon accessory holding tank, which is pumped regularly. This tank is unpermitted. They have no solid waste issues. Their parcel does not meet the base minimum land area requirements, which makes them ineligible to install a permitted holding tank (the least expensive option). Craft3 denied them a loan because Craft3 does not fund new systems or systems that serve RVs. Example #2: A couple on a fixed income purchased a home with a new septic system. The new septic system failed after 1 year of use. The couple applied to Craft3 and were denied due to inadequate credit. We wrote an appeal to Craft3, which was again denied. REQUESTED ACTION: Discussion. ATTACHMENTS: None 1 Environmental Health 2025 Statistics 2025 1st Quarter Data 2025 2nd Quarter Data Water Recreation Pools 16 16 Seasonal Pools 13 11 Spas 4 4 Seasonal Spas 1 1 Total Inspections 1 10 Drinking Water Group A Sanitary Survey 13 13 Special Purpose Investigation 0 0 Group B Approval 1 2 Well Construction Inspections 32 23 2 Party Well inspections 17 11 Well Decommission Inspections 1 1 Food Annual Food Establishment 261 247 Mobile Food Establishments 28 29 Street Vending Establishments 1 3 Temporary Event Establishments 27 78 Temporary Event Inspections 3 49 Number of inspections conducted 76 197 Number of Reinspections conducted 4 2 Pre-Operational inspections 3 16 Complaint Inspections Conducted 1 1 New Food Worker Cards 786 852 Replacement Food Worker Cards Issued 67 8 Vector Rabies calls 8 3 Rabies specimen tested 0 0 Rabies specimen tested positive 0 0 Solid Waste Complaints Received 36 19 Complaints Closed 29 28 Civil Infractions Issued 8 3 Facility Inspections 0 4 Facilities permitted 21 1 Funding source (+current expense) Permit fees come in first of the year Paid as fee for service by DOH & ECY Annual and mobile permits come in first of the year Temp permits as scheduled LSWFA, FPHS Tipping Fees and Facility Permits All County contribution come in throughout year 2 Environmental Health 2025 Statistics 2025 1st Quarter Data 2025 2nd Quarter Data Professional Certification Pumpers Certified 28 1 Installers Certified 96 6 O&M Specialists Certified 45 2 Onsite Sewage Systems New System Applications submitted 109 149 New System Permits Issued 94 113 Tank Only Permits 15 23 Repair/Replace Permits 14 21 Finals Conducted 33 16 Preapplication Conferences 8 17 Environmental Health Reviews 2 1 Short Plats 0 0 Large Lot Subdivisions 0 0 Boundary Line Adjustments 6 2 Complaints Closed 34 40 Complaints Received 37 53 Number of Civil infractions 15 15 Homeowner workshops 0 1 Blitz Mailings 0 37,609 Deficient OSS 1108 1012 Overdue Maintenance 18,932 17,851 OSS records on file 28,274 28,313 Water Quality Water Samples analyzed 170 238 Water Quality Surveys Closed 56 10 Water Quality Surveys 12 10 Mailings 0 0 Miles of shoreline sampled 0 4.26 Public Meeting/education 1 3 Shellfish Bi-weekly Jarrell's Cove 5 5 Oysterfest Booth 0 0 CWD parcel fee; various grants Consolidated Contract: DOH Fees come in at the first of the year Funding source (+current expense) Permit fees at time of service DOH local Mgt. plan funds Community Health Report MAY - JUNE 2025 COMMUNICABLE DISEASE AND NOTIFIABLE CONDITIONS Chlamydia – 31 cases Other STI (Gonorrhea, Herpes, Syphilis, HIV) totals less than 10 Tuberculosis Cases Our office continues to “rule out” possible TB cases. Currently, we are doing Direct Observation Therapy and Video Direct Observation Therapy with one active TB case. We are screening close household contacts for active or latent TB. Animal Bites – Post-Exposure Prophylaxis (PEP) Our office receives 6-10 calls a month from people who have been bitten by dogs. We have provided “Dog Bite Cards” to the Sheriff's Department for the deputies to have readily available in their patrol cars. This has streamlined our office's information regarding dog/cat bites and referrals to services as needed. We also get multiple calls regarding bats. We work with the Department of Health and the Environmental Health team to determine if there has been a bite or possible exposure, and to coordinate animal testing for rabies as needed. OVERDOSE PREVENTION EDUCATION AND NALOXONE DISTRIBUTION (OPEND) SUBSTANCE USE MOBILE OUTREACH Unduplicated Participants 119 1,020 YTD Syringes Exchanged 11,790 474 Naloxone Kits distributed 27 new people trained on overdose prevention, recognition, and response Re-engaged with 66 participants to give refills 176 Successful Overdose Reversals with Naloxone Community Health Report MAY - JUNE 2025 SYNDEMIC CLINICAL SERVICES The syndemic clinical program, in partnership with NMRFA’s Mobile Integrated Health Program, was disrupted significantly in June due to the City of Shelton’s ordinance to enforce the camping ban. The clinic had been operating in the Community Lifeline building and largely served unhoused individuals staying in the adjacent area. Once the ordinance was enforced, many patient participants relocated, and the clinic has been unable to re- engage with many for their follow-ups and prescription check-ins. Several participants or prospective patients are showing visible mental health decompensation or cognitive degression; it appears that medical services may not be a priority for many during this time of destabilization. # Total Infectious Disease Tests* # Wound Care Sessions # People Treated for STI # Started on HCV Treatment # Inducted on MOUD Other Services Provided # Unique Individuals Served # Total Clinical Engagements 9 7 3 2 0 Antibiotic prescriptions, overdose response, CBC, CMP, bacterial and metabolic urine panel, medication re- initiation, psych evaluation, SUD treatment referrals 23 32 Community Health Report MAY - JUNE 2025 HOMELESS RESPONSE SYSTEM The Public Health and Human Services Department received a notice dated May 12, 2025, that Community Lifeline has closed its overnight shelter services effective April 20, 2025. The FY26-27 Homeless Response System NOFO was open from April 15 through May 16. Eight organizations applied for funding to operate five different project intervention types. The Housing & Behavioral Health Advisory Board evaluated and scored applications to select the service providers and make funding recommendations to the Board of County Commissioners. Contracts are currently being developed for BoCC approval in July. Over 24 and Family Households Active within the following projects during May – June 2025: Street Outreach: 85 Coordinated Entry: 177 Housing and Essential Needs Program: Rental Assistance - Rapid Rehousing: 59 Homeless Prevention: 41 Off-site Family Shelters: 15 On-site Family Shelter: 9 Domestic Violence Shelter: 25 Transitional Housing: 8 Eviction Prevention: 31 Rental Assistance – Rapid Rehousing: 25 Shelton Veteran Village: 29 Under 24 (single and Family Households) Active within the following projects during May-June 2025: Street Outreach: 27 Coordinated Entry: 23 Eviction Prevention: 16 Rental Assistance - Rapid Rehousing: 13 Emergency Shelter: 2 Community Health Report MAY - JUNE 2025 LAW ENFORCEMENT CO-RESPONDER PROGRAM Quarter # New Clients Enrolled # Caseload Carryover Total Clients Served 1 Jan-Mar 144 31 175 2 Apr-May 135 31 166 Total YTD 279 62 341 LAW ENFORCEMENT ASSISTED DIVERSION (LEAD) May - June 2025: Total admitted into LEAD: 19 new cases Number of individuals contacted through LE response vs. community referral: Arrest Diversion: 0 Social Referrals: 6 Community: 13 Number of staff contacts: 860 unduplicated encounters The co-responder team responded to a referral involving a client expressing suicidal ideation while experiencing severe alcohol intoxication. Upon contact, the client demonstrated an inability to engage in safety planning or utilize voluntary supports. The co-responders consulted with a clinical supervisor, resulting in a custody authorization being issued to law enforcement in accordance with crisis intervention protocols. In coordination with law enforcement and emergency medical services, The team facilitated the safe transport of the client to the nearest emergency department for further evaluation by a Designated Crisis Responder (DCR). This coordinated response ensured the client received timely access to emergency behavioral health care in a safe and supportive manner. Success Story A significant ongoing challenge is the lack of an emergency shelter for individuals experiencing homelessness. This gap in local resources severely limits the options available for individuals in crisis, particularly those with behavioral health or substance use concerns who require safe, stable environments to begin recovery and stabilization. Without access to shelter, many individuals remain in unsafe or unstable conditions, which increases their risk of repeated crisis episodes and complicates efforts to connect them with ongoing services. The absence of a shelter also places additional strain on first responders and crisis teams, who often have no safe placement options during outreach efforts. Community Health Report MAY - JUNE 2025 IMMUNIZATION IMPROVEMENT CASELOAD 815 WOMEN INFANT AND CHILDREN (WIC) Continued monthly Community Breastfeeding Class and Breastfeeding Support Group in both English and Spanish 1,857 snacks given out in the After-School Snack Program MATERNAL CHILD HEALTH Care coordination for an average of 19 families per month Investigated 5 cases of children with elevated capillary lead levels Leading a monthly 0-3 year Immunization Improvement meeting with DOH and area providers to discuss barriers and supports needed for increasing vaccination rates in this age group Two more vaccine clinics are scheduled on May 2 and June 6 nd th VACCINES 366 HEALTH EDUCATION AND OUTREACH In the months of March and April, there were a total of 41 social media posts, with an average engagement rate of 6.98% We hosted our 2 annual Bike Rodeo and Safety Day, with over 50 participantsnd We also attended the North Mason Safety Days at Belfair and Sandhill Elementary. We provided dental and substance use prevention education to over 1,000 students Community Health Report MAY - JUNE 2025 As of July 7, 2025, kratom is legal in Mason County for purchase, possession, sale, and use with no statewide restrictions or age limits. This means that there is currently no legal minimum age to purchase or use kratom in Mason County or in Washington State. Washington has no government oversight of kratom product safety, purity, or labeling. A proposed bill that would have established a "Washington Kratom Consumer Protection Act" was introduced but did not pass. This bill, if passed, would have restricted the sale of kratom products to individuals over 21 years of age. A proposal to classify kratom as a Schedule I substance is currently under review. If this proposal is enacted, it could significantly restrict or ban kratom in Washington. Therefore, while there is no current legal age restriction, it is advisable to consider potential future regulations and exercise caution when purchasing and using kratom products in Washington due to the lack of oversight. Potential for addiction and dependence: Kratom's active compounds, mitragynine and 7-hydroxymitragynine, interact with opioid receptors in the brain, raising concerns about potential for abuse, addiction, and withdrawal symptoms similar to those experienced with opioids. Health risks associated with kratom use: Organ damage: High doses of kratom have been linked to liver toxicity, kidney failure, and respiratory depression. Fatal overdoses: The CDC reported kratom-related deaths, often involving polydrug use, highlighting the potential for serious adverse outcomes. Contamination risks: In an unregulated market, there's a higher risk of kratom products being contaminated with harmful substances like heavy metals or bacteria, posing further health dangers. SUBSTANCE USE PREVENTION COALITION Next Page: Sample Voluntary Agreement on Responsible Kratom Sales Voluntary Agreement on Responsible Kratom Sales Between the Mason County Board of Health and Local Kratom Vendors This voluntary agreement is intended to promote safe, responsible kratom sales in Mason County, Washington. While there are currently no statewide restrictions on kratom sales or minimum age requirements, the County and participating businesses recognize the importance of protecting public health and preparing for possible future regulations. Participating businesses agree to: Age Responsibility Voluntarily restrict sales to customers 21 and older. Product Safety and Transparency Purchase Kratom from reputable vendors who offer third-party lab results for their products. Store Kratom behind the counter, in a case or a cabinet. Remove all Kratom promotions from your store. i.e., widow, sidewalk, and street ads. Stay informed about legislative changes.