HomeMy WebLinkAboutBoard of Health November 2 20101
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WHATCOM COUNTY COUNCIL
Board of Health
November 2, 2010
CALL TO ORDER
Council Chair Sam Crawford called the meeting to order at 10:37 a.m. in the Council
Chambers, 311 Grand Avenue, Bellingham, Washington.
ROLL CALL (10:37:35 AM)
Present: Barbara Brenner, Sam Crawford, Kathy Kershner, Bill Knutzen, Ken
Mann, L. Ward Nelson and Carl Weimer
Absent: None
1. PUBLIC SESSION
Betsy Pernotto, resident, stated she is a Health Department Women, Infant, and
Children (WIC) Program staff person, submitted a proposal (on file), and stated the
employees work with and respect the administration. The WIC Program is an important
program that a belongs in the Health Department. She read through the proposal. Many
people in the community are losing their jobs and homes due to the economy. WIC is a
well -used program in the community. There is a strong perception in the community that
services to low- income families are being cut to preserve administrative positions, and this
perception angers people and creates mistrust and a loss of confidence in government.
Allison Williams, resident, stated she is a County employee working in the WIC
Program. WIC Programs should remain in the Health Department to bring a distinct public
health perspective to their work. They have a dedicated, trained staff who provide award -
winning service. They work with organizations outside the Health Department to expand
their services. She described different collaborations.
Erica Lamson, resident, stated she is a dietician in the WIC Program. They are
excited about the new focus at the Health Department. Clients are often impacted by
nutrition and physical activity environments that are not conducive to making healthy
choices. These families have limited access to fresh fruit and vegetables, due to cost and
availability. The kids have limited opportunities for physical activity because there are no
sidewalks in the neighborhood or a safe way to walk to school. They talk to this community
daily, and know their challenges. (10:53:49 AM). Addressing the fundamental issues at the
systems level is effective to making the healthy choice an easy choice for families.
However, they differ in the role WIC can play in this new direction. WIC is important
to create a community that protects and promotes public health. The work does more than
the WIC directive through collaborations with other agencies. The information the WIC staff
have can enhance the systems -level change in the Health Department. They work with
other organizations for changes and improvements in the community. WIC dollars have
contributed to the systems -level change. By being creative and innovative, WIC can
enhance systems- and policy -level work.
Board of Health, 11/2/2010, Page 1
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Nelson asked why the WIC service would be diminished if provided by another
agency. Other agencies will have the ability to do Medicaid billing to recovery costs. He
asked the advantage of keeping the WIC program with the County. Lamson stated WIC can
help to address larger public health issues if in the County Health Department. Staff can
gather information from WIC clients for public health assessments that are a County
priority. The County staff were able to get more surveys from its WIC clients than their
partners were able to get. Having the program in -house makes it easier to gather data. It
takes more staff time and energy to create those relationships and partner outside the
Health Department.
The ability to bill Medicaid depends on the agency. WIC is operated out of various
agencies. Some of those agencies bill, and some don't, based on whether or not they have
the infrastructure to do that.
Purnotto stated she has knowledge of WIC agencies around the state. Some private
agencies run WIC. Many nonprofits are run with limited funds. Often, wages are low and
there is a high staff turnover. The quality of the service suffers, because people don't have
experience. Whatcom County has staff stability and experience. They can do the job more
efficiently. Some WIC agencies do very perfunctory nutrition education because of their
limited funding. That can be a problem, particularly with pregnancies. They want to start
nutrition education early in the pregnancy. Once WIC leaves the Health Department,
there's no public control of program quality other than at the State level. That's a concern.
It's important to connect with other programs. The Health Department, including WIC, has
a broad view of community partnerships. Other agencies don't necessarily partner. Other
agencies have fewer staff, so less nutrition education is provided and there is a much higher
staff turnover. The quality of the education isn't as good.
The following people answered questions:
• Regina Delahunt, Health Department Director
• Dr. Greg Stern, Health Department Health Officer
Discussion included an option of reducing, but not eliminating, WIC services; any
current grants received for WIC that other agencies would not qualify for; the efficiency of
the program under the Health Department versus a nonprofit agency; whether the proposal
submitted is practical; indirect costs of the program; moving around offices and rearranging
spaces; quality control of the WIC Program at another agency; different functions of the
WIC Program; the lease term and cost of the State Street facility; changes in the program if
moved to another agency or clinical provider; whether the change could allow multiple
county locations for the WIC Program; the importance of the nutrition services in addition to
receiving vouchers, and; the potential of transferring existing WIC staff to a new agency.
3. CURRENT OPERATIONS AND MAINTENANCE PROGRAM UPDATE (11;33:06
AM)
John Wolpers, Health Department, stated there was an ordinance change in
regulations in March 2010. They want to explain the effects of those changes.
Kyle Dodd, Health Department, submitted and read from a presentation (on file).
They have received positive feedback from classroom training participants. Reports of
system status (ROSS) percentage results are different depending on whether the system is
inspected by a licensed inspector or the homeowner, which could be due to homeowners not
completely understanding and being able to interpret what they're looking at. It may also
Board of Health, 11/2/2010, Page 2
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be due to some maintenance and failures that are knowingly unreported, as they've found
in a couple of instances.
Knutzen stated that those professionals inspecting the systems are also the ones
who install them.
(11:51:29 AM)
Brenner stated the Board of Health recommended that there still be hands -on
classes. Wolpers stated they will have some targeted training. They won't completely
eliminate it. They are trying to move forward with homeowner education online. Other
counties are also developing online training.
Kershner asked if the County is in compliance with the State regarding onsite sewage
(OSS) regulations.
Regina Delahunt, Health Department Director, stated the County is compliant. The
Health Department wants to make sure they interpreted the Board's direction from the last
ordinance. Given all the budget cuts they're experiencing, it makes sense to review and
prioritize everything, including enforcement of operations and maintenance. That's why
they chose this direction. Staff will encourage people to continue doing evaluations.
Knutzen asked if the next class has any openings. Wolpers stated the next class is
November 4. He can't say whether it's a gravity or pressure class.
Dodd stated all classes through the end of the year are booked, due to the postcards
the County mailed and the demand.
Mann asked if there is no enforcement after the third letter, except in the Drayton
Harbor and Lake Whatcom watersheds. Dodd stated that from now on, they won't send
multiple notifications.
Wolpers stated there will be no second letter.
Mann asked if it's up to the owner whether or not to comply. Delahunt stated the
County is just letting the homeowner know they are legally required by State law to do it.
If the County has a complaint or reason to believe someone's system is failing, the staff
would request a visit.
Brenner stated this Council went from one extreme of doing absolutely nothing to
the other extreme of being overbearing. This is a good compromise for right now. She
asked if someone with a gravity system, who has taken the pressure class, also has to take
the gravity class. The pressure class is much more complicated. Dodd stated staff would
like to work with those individuals, who can schedule a time to talk with staff. The checklist
is different. The methods for evaluating the systems are different.
Wolpers stated homeowner data shows the number of quality assurance visits to
self- inspected systems and their results. The staff performed 17 quality assurance visits,
which included visiting the sites and verifying results. Staff found that four were correctly
reported. Eleven systems were changed to maintenance - needed status. Staff explained the
reason to the homeowners. One system reported as satisfactory was actually a failing
system, as determined by a flow test and finding dye coming out of a seawall. He and
Councilmember Brenner had talked about enforcement to individuals who would not tell the
Board of Health, 11/2/2010, Page 3
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truth after taking the class. The staff found one of those systems. They visited the site.
When they checked the checklist, the staff found that the person filled out the form and
talked all about the septic tank, when in fact the system had never been dug up. In talking
with that owner, staff explained the issues and why it was important to follow up. Staff
intends to no longer allow those owners to submit their evaluations in the future, as it says
in the ordinance. He described how the 11 systems had to be corrected.
Kershner asked if future buyers of the property owned by the person whose report
was not truthful would be able to self- inspect. Wolpers stated future owners would be able
to self- inspect. The staff will not allow evaluations from specific persons.
2. ON -SITE SEWAGE (OSS) LOAN PROGRAM UPDATE (12:02:10 PM)
John Wolpers, Health Department, stated they have been awarded $1.5 million in
loan and grant funds. Staff will request that the Council sign a contract to obtain those
monies. They had hoped to use a third -party contractor to administer the program. Now
they are exploring another option of using only the grant funds.
Regina Delahunt, Health Department Director, stated they would use only the grant
funds as a loan loss reserve and buy down interest rates from a lending institution, who
would use their capital to fund the loans. A bank in town is doing a similar program for
energy assistance.
Discussion included making sure they take care of people who are really in a financial
bind; the structure of a loan program; the possibility of recouping the loan costs when a
house is sold; creating a request for proposals (RFP) with all the criteria for the program,
and; allowing the bank contractor to inherent the issue of putting liens on properties.
ADJOURN
The meeting adjourned at 12:08 p.m.
Please contact the Council Office to obtain an
official, signed copy:
360- 676 -6690 or council &o.w hatcom .wa.us
Dana Brown - Davis, Council Clerk
Sam Crawford, Council Chair
Board of Health, 11/2/2010, Page 4