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HomeMy WebLinkAboutBoard of Health November 29 20051 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. WHATCOM COUNTY COUNCIL Board of Health November 29, 2005 Council Chair Laurie Caskey- Schreiber called the meeting to order at 10:30 a.m. in the Council Chambers, 311 Grand Avenue, Bellingham, Washington. 1. 2. Present: Barbara Brenner Dan McShane Sam Crawford Seth Fleetwood Sharon Roy L. Ward Nelson PUBLIC SESSION No one spoke. Absent: None PUBLIC HEALTH AND CHILD PROTECTIVE SERVICES Regina Delahunt, Health Department Director, introduced Public Health Nurse Michelle Jerome. Michelle Jerome, Public Health Nurse, stated the project is called the Early Intervention Project. The State Division of Children and Family Services (DCFS) funds the County to work with certain families that are eligible. The family has to be referred to the County by Child Protective Services (CPS), and the County has to accept the referral. The families are generally quite high risk. The case may or may not be an open Child Protective Services case. They do a lot of parenting assessment and coaching. The project can be quite long term. They can work with the family until the youngest child is three. One case example is a referral of a woman who denied she knew she was pregnant or used drugs. CPS had many requirements of her. She worked with the client to achieve the CPS requirements. She seldom has trouble getting in the door of the client. Her presence gets the CPS worker off the client's back. She started working with the client when the baby was born. The baby was in the grandmother's custody, and the grandmother had to supervise any time the client spent with the baby. The client followed through with all the requirements. She started working with this client a little over a year ago. It only took six or seven months for client to start admitting her problems. CPS closed the case a while ago. The client now maintains her drug treatment and continues with her parenting Board of Health, 11/29/2005, Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. program. This client even wrote a thank you to the CPS case worker, which was a first. Another case has been with a client for many years. Three of this client's four children have been taken away or given up. The client started when she was 16, and is now 25. Now, the client is with a stable partner. Progress has been slower with this client. She's known the client through all the four pregnancies. Because of the CPS early intervention project, she was allowed to attend the client weekly. Now, the client has been in the same home for six months, which is a record. The client is not planning to have more children. The client is just now starting to be involved in parenting the child. Had CPS not worked with her on this case, she would not have been able to have intense contact with the client. For moms having trouble parenting, having someone help them consistently is important. This project is wonderful because she can keep servicing the client long- term, as needed. She has leeway to do what needs to be done in the home. It's very rewarding work. Brenner asked how the first client was referred. Jerome stated the first client was tested at the hospital when she gave birth. The baby has not shown any signs of being affected by drug use, which is amazing. Roy asked if schools or others can make referrals. Jerome stated the referral must come from CPS. People will call the Health Department, and she tells them to call CPS. Caskey- Schreiber thanked Ms. Jerome for her work on the program. She asked the amount of funding they get for the program. Terry Hinz, Assistant Director, stated the funding amount is about $25,000 per year. 3. I -901 IMPLEMENTATION - REVISED CLEAN INDOOR AIR ACT Regina Delahunt, Health Department Director, introduced their new Environmental Health Manager, John Wolpers. They hired him away from Kittitas County. The main changes to the Clean Indoor Air Act is that it names the local health department as the enforcement entity of no smoking in public places. That is a great thing for public health, but no funding for enforcement is associated with the act. The Clean Indoor Air Act adds bars and restaurants to the list of public places where smoking is not allowed. It applies to all businesses that have employees within the county. The Health Department must enforce against owners and operators of businesses. The Sheriff must enforce against individuals who smoke in restricted areas. Board of Health, 11/29/2005, Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. The rule calls for a 25 -foot perimeter around doors and windows, within which people are not allowed to smoke. That may be problematic for enforcement. Brenner asked if the Health Department can do something to allow an exception to the 25 feet. Delahunt stated there is a provision for the Health Department to issue a variance if the owner can demonstrate that the smoke won't enter the building if closer than 25 foot. That is also problematic if many businesses decide to apply for a variance. The Health Department will have to use criteria to come up with a variance. One idea is requiring an engineer to certify the ventilation or positioning of the windows. Caskey- Schreiber stated it sounds costly. Delahunt stated it does, but she doesn't know how else to do it. Brenner stated that instead, the County could say a variance will apply if certain circumstances are met, rather than issuing variances individually. Delahunt stated she doesn't know if there is a way generally for smoke to not enter a building. Fleetwood stated the law is silent on the question of whether or not a variance applicant can appeal the determination of the director. Delahunt stated there is always an appeals process. She will be meeting with legal counsel to decide if they can adopt a local ordinance, which allows the regular administrative process for appeals and civil penalties. Without that, all appeals may go right to Superior Court. Fleetwood stated people are saying they won't be able to walk down the middle of a public street under this rule. Delahunt stated there are a lot of questions about the rule. Roy stated California has gone through this very successfully. Restaurant bar business increased once the ban was established. She assumed they would look at similar procedures. She asked if they are looking at those procedures. Delahunt stated they are looking at those cases. A lot of education needs to be done. Initially, there may be some folks who don't comply. If the rule is enforced and people receive the proper information, it will work. What's different is the 25- foot rule. There aren't any other states that have the 25 -foot rule. Crawford stated this is the most restrictive smoking law in the United States. Because this is the public's will, a business owner should have the burden of proof to do engineering, even though it will be expensive. One section of the law addresses the issue of smoking while walking down the street. Most business owners will have to accept the new social norm. Nelson asked how to fund enforcement of the 25 -foot rule. It will probably be complaint driven. They may have to have 24 -hour callouts. He asked if there is Board of Health, 11/29/2005, Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. a funding mechanism. He asked if there can be a local tax for cigarettes or permit fees to somehow collect funding for this effort. Delahunt stated the Public Health Advisory Board had an initial discussion on this. They propose to initially focus on educating specifically the businesses that are currently smoking establishments. There are only about 70 in Whatcom County currently. The Health Department will let them know this will be enforced. The Health Department will also respond on a complaint basis and do some compliance checks, possibly using environmental health food inspectors as they check restaurants. They weren't planning to gear up a large program. During the first six months, they will see if the ban becomes the social norm and whether people will comply with the law. If it does become a huge burden, she will come to the Council to talk about resources. Tobacco program staff can use State tobacco dollars for education. Dr. Greg Stern, Health Officer, stated one issue with Initiative 901 is making sure there is consistency statewide. They don't want to have 34 different solutions to the problems. A lot of the issues will be addressed in other jurisdictions. Delahunt stated the initiative goes into effect December 8. There is very little lead -time to get out the information. Statewide, all the health jurisdictions have been having weekly conference calls to hammer out inconsistencies and interpretations of the law. Brenner stated the complaints are going to be about establishments themselves. She doesn't anticipate people walking out 25 feet to see if someone is in violation. Delahunt stated she agrees. There may be complaints about the 25- foot rule if the establishment allows people to congregate right outside the door. Caskey- Schreiber asked if they will rev up the anti - smoking campaign. Delahunt stated they will do more education about available resources for people who want to quit smoking. 4. ONSITE SEPTIC SYSTEM (OSS) COMMITTEE UPDATE AND RECOMMENDATIONS Regina Delahunt, Health Department Director, stated a Public Health Advisory Board subcommittee discussed the new State requirements for onsite sewage. David Davidson chaired the subcommittee since it began in the spring. It was a very active, participatory committee. A broad spectrum of people with different interests participated. The committee met every other week to discuss a lot of the issues associated with operations and maintenance. The committee's charge is described in the Council's packet. She read the list of the subcommittee tasks. The recommendations are general in nature. The committee came up with general guidelines, after which the department can come up with specifics. Nelson stated he liked the format of the information. He asked if there was subcommittee discussion on protection around the Nooksack River. Many small cities draw from the Nooksack River. Board of Health, 11/29/2005, Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. David Davidson, Public Health Advisory Board member, stated the language of their recommendation is included. It includes any surface water that is a source of drinking water. Delahunt stated that the Nooksack River is part of Portage Bay shellfish protection district area. It would be protected as a special area under that designation. Fleetwood asked what a gravity mound system is. Delahunt explained a gravity mound system. Mounds are required to be pressurized in most areas of the state. In Whatcom County, mounds can be fed by gravity only. Many years ago, the County proposed that the gravity systems worked as well as pressure mound systems. Based on that study and information, the State approved the gravity mound system in Whatcom County. Brenner stated the State Department of Ecology said all groundwater is considered surface water, and vice versa. She would like to see surface water include all kinds of tributaries that are all over the county. Even if people have wells, any shallow wells are called surface water. Make sure that the onsite septic systems near wells or any water body are dealt with as a more sensitive area. Delahunt stated the State regulation charges them with looking at specific areas posing increased public health risk that are listed in the regulation. They use that list as a basis of prioritizing where to start with operations and maintenance (O &M) and for placing emphasis in certain other areas in terms of enforcement. This is a list of where to start, not a list of exclusive areas they will only work in. Brenner stated plenty of private companies do septic system maintenance. There is a financial interest in them doing this. Nothing talks about them being the ones to keep track of all the systems and making sure they are maintained on schedule. See that this is applied countywide right away, with those companies that do this work. Do a mailing to everyone, with the names of the businesses who do this work. Davidson stated that was a topic of discussion at the Public Health Advisory Board. There are O &M regulations on the books today. They don't work. Owners are supposed to be contacting private businesses to have the work done, but it's not being done. In higher risk areas, and then the entire county, the goal is to get it done. The Health department is where the records live and where the proof of maintenance exists. One recommendation is for maintenance and inspections to be done by private industry. They want the Health Department to collect records, but it's the private party to do the maintenance with a private pumper. Brenner stated have the private companies do the paperwork, and they would be the ones to get the records to the Health Department. The County would pay the contractor to do that. She agreed that the County should hold the record. Give the contractors a financial incentive to submit the paperwork. The County has Board of Health, 11/29/2005, Page 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. not said to the private companies that the companies have this authority. Delahunt stated the pumpers submit pumping records to the Health Department currently. An O &M private specialist will submit the inspection records to the Health Department. Brenner stated the companies don't have the authority to go out to one area within their jurisdiction or company area, where they can contact the owners and start the ball rolling. Nelson stated the citizens have to be aware that it's time for getting their septic pumped. The private companies should be able to do the inspection and maintenance. They would have to have some kind of clearance with the Health Department. Delahunt stated the Health Department would have to set up a program to certify O &M specialists. Nelson stated the Health Department could take the role of notifying people that it's time to do their septic O &M and then recommend companies. The companies need to be able to notify the property owners with the reminder. He asked if there is a reason they can't do that. Davidson stated that Councilmember Brenner's suggestion almost sounds like a franchise with an established area. Absent the notion having a piece of turf, all businesses have to work countywide and decide if it's worth their effort to send mailers to people countywide who might work with another business or who might not to choose to pump at all because there is inadequate enforcement. Nelson stated the Health Department would serve notice on individuals that they must service their systems. The individuals would contact the business owners and ask to be put on a notification list. Davidson stated they envision that the Health Department would continue to tell people it's time to get their systems serviced. If the idea is for the businesses to take it upon themselves to make that notification, a franchise would be some kind of incentive. The subcommittee didn't discuss the idea of awarding someone a particular area. Nelson asked who on the committee did this work, and if the committee included any pumpers. Delahunt stated there were pumpers on the committee. Notification would be a good business practice for the businesses. (Clerk's Note: End of tape one, side A.) Caskey- Schreiber stated they've talked about sending out reminder letters before. Crawford stated they do need to keep it competitive to keep the price down for the homeowners. Regarding the funding options, he asked if the County has legislative authority to levy a fee attached to O &M costs to pay to administrate this program. Davidson stated a tipping fee gets at that somewhat. Board of Health, 11/29/2005, Page 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. Delahunt stated there is a small tipping fee currently. Crawford stated consider a flat fee per pump to administrate the system, if the County is legally allowed to do that. Delahunt stated a homeowner will not always be required to pump. Operations and maintenance is required, but the homeowners may only need an inspection. There is a potential for a filing fee to the pumper that the homeowner would pay. These are ideas that must continue to be explored. Crawford stated the committee is suggesting that every three years, the property owner must report on the O &M for the gravity mound system, including old style drain fields and septic tanks. Davidson stated the recommendation is parroting back the State regulation here. It may be that only an inspection is necessary. The maintenance may simply be a visit by the pumper. There are a fair number of older, simpler systems in the county. There was discussion about whether they should make an option for the homeowner to be responsible for the simplest systems. For everyone else, they need to have a certified professional. Crawford stated that if they are looking for a transfer of property to trigger some assurance to the public that the systems are being transferred in an operating manner, then they should also include land use actions. An example is when any land use activity occurs that is going to make the existing parcel with a system smaller, such as a boundary line adjustment. In addition to just sales, any land use action that makes a property smaller would trigger an inspection. The Health Department would work with the Planning Department. Davidson stated the committee didn't think of that possibility. He believes the committee would say that's a great idea. Crawford stated the current zoning requirement doesn't require an inspection of a current system. If they are saying the point of a property sale merits review, then a land use activity also merits a check. Shrinking a lot is a compelling land use activity because it can impact the neighbors. Roy stated do whatever they can to remind many people as frequently as possible about their O &M schedule. Encourage the private businesses to play a role in that. It's another way of reminding people. Brenner stated she likes the idea of a land use action or property sale triggering a review of a system. Do whatever they can to make sure the O &M gets done. Inspire the private companies to be more involved in notification. Davidson stated that if they are moving to better County enforcement, which is what this recommendation involves, there will be an incentive for the homeowners to stay on their schedules. If the demand is stronger and there is more enforcement, the private businesses will make an effort to solicit that business. Board of Health, 11/29/2005, Page 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. Delahunt stated enforcement is a significant factor of the recommendations. Education hasn't really worked. The committee recommends that the department have resources to enforce the regulation to make sure people who don't pump or have their systems inspected on a regular basis receive notice of violation and enforcement. Caskey- Schreiber stated a letter of notice of violations is important. Enforcement will be a serious reality check for people. Delahunt stated she envisions phasing the enforcement areas, starting with areas of risk, then expanding countywide. Brenner stated some systems don't need to be pumped every three years. She asked if a homeowner would pay for an inspection only, and the inspector would say the system is okay for now. Delahunt stated that is correct. Nelson stated consider a requirement of three years on every system. They may find that some of the simpler systems should not be there or should not be simple systems. If they have that consistency of every three years, the land use activity check wouldn't matter. There are already setback requirements. A land use trigger would be redundant. Delahunt stated that if the County has O &M records showing homeowners have done O &M regularly, inspections wouldn't be required. Nelson stated that would be the enforcement element. Homeowners would find out from the Health Department which private businesses provide the notification service. Davidson stated the Public Health Advisory subcommittee. One recommendation is that the regulations be done away with and that existing protective of health in watersheds. There isn't a Lake Whatcom watersheds. The issue is O &M and special design rules, just O &M enforcement. Board decided to continue the existing Lake Whatcom- specific design methods out there are need for that specifically in the enforcement. They don't need Delahunt stated the special requirements for Lake Whatcom have been in place since 1970, when there was not a lot of basis in science. The subcommittee discussed it over several meetings. Everyone achieved consensus that the existing requirements are sufficient, regardless of location in the county. Fleetwood moved to approve the continued work of that subcommittee to resolve the main issues. Caskey- Schreiber asked if the subcommittee would suggest enforcement options. Davidson stated staff is beginning to draw up implementation options. Delahunt stated the Public Health Advisory Board asks the Board of Health to allow the subcommittee to continue working on the four items listed in the Council's Board of Health, 11/29/2005, Page 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. packet. The subcommittee would also like to follow up on some technical issues that have come up. Fleetwood amended his motion to include continued subcommittee work on the four items on page eight plus technical issues. Motion carried unanimously. Geoff Menzies, Public Health Advisory Board, stated the outline of the subcommittee stakeholder list includes participation from the Department of Ecology, Whatcom County Water Resources, and Whatcom County Planning and Development Services, but they did not participate. The purpose was to develop a local O &M for sensitive areas, and the subcommittee has moved in that direction. Those agencies may have participated outside the regular process. Delahunt stated those agencies did participate periodically. Menzies stated they talked a lot about funding. It was not an enlightened discussion about funding sources. One option is using the shellfish protection district authority for developing an O &M program. The Henderson Inlets approach is one funding mechanism. They envisioned that a property tax would go to an O &M program and the County would contract with O &M specialists. Then they would know that all the systems have to be inspected each year. The concept is to have a mechanism to make sure that work gets done. It's not left entirely up to the landowners. The homeowners would have to pay for repairing a system, but the tax or assessment would be used to support the program. The cost of the inspection is based on the type of system and frequency of inspection. There aren't any certified O &M specialists, but they didn't like having the fees being locked based on a particular system type. The Health Department would have a very good system for tracking what needs to be done. The subcommittee discussed this model. Brenner asked if every property in the district would have that assessment and if they know if every property in the district has a septic system. Menzies stated that the Henderson Inlet case looked at the entire watershed area. Certain areas that didn't have an impact were not taxed. The tax would be on people within the district outside city boundaries. There are many different non -point sources they are trying to address in the watershed. Don't limit the use of the tax to an O &M program exclusively. As they get into this, they are going to have to discuss all the funding options. His highest priority is to develop a budget, plan, and timeline. For five years, the Drayton Harbor Shellfish Protection District Advisory Committee has recommended that there be requirement of proof of O &M records and proof of a functioning system at the point of property transfer. He's very glad to see that recommendation. Move forward with an ordinance to that effect right away. Board of Health, 11/29/2005, Page 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. Roy stated the shellfish protection district tax would be used for other activities that deal with non -point sources. Menzies stated he recommends a fifth subcommittee activity to identify the process for more precise determination of sensitive areas, where they will be on the ground, who will make the determination, and when. If they can define the areas, the local plan should say that's where they will do an inventory. If there are no records, do a site inspection to see what's out there. Add an activity to the list, °Identify that process for more precise determination for these sensitive areas, develop a timeframe for completion of inventories and follow up in these sensitive areas." If they don't identify a timeframe, it will be another two or three years before they get to doing this kind of work. Drayton Harbor Shellfish Protection District Advisory Committee and the Community Oyster Farm would really like to see this going. Establish a timeframe. McShane asked for more information on the Henderson Inlet Shellfish Protection District overlay, its funding mechanism, budget, and the activities funded. Delahunt stated the committee looked at that information. The subcommittee must look at specific, different possibilities. Caskey- Schreiber stated they need a backup plan for residences in violation with owners who can't afford to do the O &M. Delahunt stated there could be some kind of assistance program through the Opportunity Council. Roy stated she's afraid this will be another two or three years down the road. Put a timeline on this. Create an ordinance about real estate transactions not served by municipal sewers must provide proof. That would be a start. The Board of Health meets infrequently and there are many issues. She's afraid this will take a long time. Delahunt stated they can amend the existing ordinance to include that one piece. Roy moved to request the Health Department work up an ordinance related to the buyers providing O &M records status on real estate transactions, as defined in the committee's recommendation. Crawford stated the committee has further refining to do. He asked if the committee would have it's final recommendations by the time that comes forward. Caskey- Schreiber stated it would. Motion carried unanimously. Crawford stated he has empathy for those who are financially challenged to comply. However, they are publicly responsible to pay their own fair share. People in cities must pay their monthly sewer system bill. People will need to pay, just like they pay their property taxes, a reasonable and minimal share. If the County has a database and enforcement or some accountability, and there are compelling Board of Health, 11/29/2005, Page 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. reasons for these people to get their inspections done, they ought to consider adding a fee to the pumping cost. It would be a source to fund the system. S. PANDEMIC INFLUENZA PLANNING UPDATE Regina Delahunt, Health Department Director, introduced Buffi LaDue. Buffi LaDue, Disease Response and Control Manager, stated a summary of the department's work is in the packet. They met with Executive Kremen, who gave direction to have a series of meetings with community leaders to plan for pandemic influenza and disaster planning countywide. There are specifics in a general plan for things such as specific disasters and diseases. They all met two weeks ago at the first meeting. The participants were given an influenza overview and a presentation of the work the Health Department has done so far. They are also working with the Division of Emergency Management (DEM). The Division of Emergency Management and others is hosting a drill tomorrow on avian influenza. The next step is to identify individuals from this group at the meeting and others who can help pull together people for task forces to look at different issues, which are listed in the packet. In late January, they will have a meeting with all these people to get them started on the task of writing a plan and thinking about what businesses, schools, churches, and other organizations will need during a pandemic. The community will not have outside help during a pandemic. If the scenarios are correct, one -third of the workforce would be out sick and another one -third would be home to take care of those who are sick. One issue for Whatcom County is maintaining services. Delahunt stated they are hoping to have a product to the Board of Health and Executive at the end of June. Nelson stated the last pandemic was in the 1960's. He asked what makes this different. Dr. Greg Stern, Health Officer, stated the focus on this is because of the avian flu that is circulating. The big pandemic was in 1918, a direct avian flu virus that became transmissible person -to- person. Other pandemics were in 1957 and 1968. They were combinations of avian flu genes with human flu genes, which had less of an impact than full avian flu. This current avian flu has the potential for being more like the 1918 pandemic. Nelson asked if this has a more a genetic match to the 1918 pandemic. Stern stated the characteristics are more similar. (Clerk's Note: End of tape one, side B.) Stern continued to state that they need to be prepared for the potential. The preparations they make may be valuable whether or not it hits. Many plans have Board of Health, 11/29/2005, Page 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. been based on localized, short -term crises. This emergency could be more prolonged. Everyone will be impacted. They can't depend on mutual aid agreements to get help from people on the outside. Nelson asked how they coordinate care or make sure they get a vaccine. Stern stated they can count on not getting an effective vaccine for pandemic flu for six to eight months. Regarding Tamiflu, there is the issue of stockpiling. Those jurisdictions that stockpile still won't have enough for everyone. They need to plan responses that consider there won't be enough for everyone. One question is how to expand capacity and what to do when the situation goes beyond their capacity to expand. Define the criteria for making decisions on using limited resources. Nelson asked if he would start planning for the worst -case scenario. Stern stated he would start planning from both directions. The issue for the Pandemic Flu Planning Task Force is deciding what to do to expand capacity and how to plan for when that capacity is exceeded. Caskey- Schreiber asked when this flu is likely to hit, if it does. Stern stated they don't know when, but they know they need to have plans in place. They don't know if this strain will be the one to hit. He hopes there is enough time to get the plans in place. Now, there is a confluence of interest. Pandemic flu is stepping out of the public health arena and there is a larger community response. Develop the planning relationships within the community. McShane stated they could borrow the plans from other communities who are planning. Whatcom County is unique because of it's location on the border. He asked if that is being talked about much. Stern stated it is. There is a lot of planning going on worldwide. The key is going outside the arena of public health. Keep working on it. Brenner stated people are working on getting vaccines out sooner than six months. There are many things in the works. The big thing is to get the drug companies on board to be more altruistic. Stern stated the issue of vaccine is not a local issue. They need to develop plans to purchase what they need when they can and also plan on not having it available. They are developing cell culture techniques that bypass the use of eggs, but it still takes time to make a vaccine for a specific strain of influenza. It will still be months and there will still be production issues. They can hope for the best, that a vaccine will be available quickly, but they must plan for the worst. ADJOURN The meeting adjourned at 12:13 p.m. Board of Health, 11/29/2005, Page 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 DISCLAIMER: This document contains the Whatcom County Council or Committee minutes, as approved. However, unless an attested signature page is attached, they are not the final approved minutes. Jill Nixon, Minutes Transcription The Council approved these minutes on January 17 , 2006. ATTEST: Dana Brown - Davis, Council Clerk WHATCOM COUNTY COUNCIL WHATCOM COUNTY, WASHINGTON Laurie Caskey- Schreiber, Council Chair Board of Health, 11/29/2005, Page 13