HomeMy WebLinkAboutBoard of Health April 27 20041
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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
April 27, 2004
Council Chair Dan McShane called the meeting to order at 10:30 a.m. in the
Council Chambers, 311 Grand Avenue, Bellingham, Washington.
Present: Absent:
Barbara Brenner L. Ward Nelson
Laurie Caskey- Schreiber
Sam Crawford
Seth Fleetwood
Sharon Roy
1. PUBLIC SESSION
No one spoke.
2. PUBLIC HEALTH ADVISORY BOARD CHAIR REPORT
David Davidson, Public Health Advisory Board Chair, submitted a
memorandum (on file) and stated the board doesn't recommend mandatory rabies
vaccines for dogs and cats. Rabies is not a significant health risk for humans in
Whatcom County. The City of Bellingham has a regulation requiring this, but
doesn't actively enforce it. If an animal shows up at the pound, they check before
it is released to a city resident. The compliance rate is 18 percent. Doing that
action countywide, it isn't clear that they'd get a lot of vaccinations, plus there
would be a regulation on the books they all know is not enforced. They do believe
that vaccination is desirable to interrupt the connection from bat to animal to
human. The board supports promoting vaccination through methods other than
regulation. Vaccination could be a contractual agreement with animal enforcement
agencies in the county. Public education is another idea. They're not sure from a
legal point of view how it would work, but there is an idea to have a contract
condition that makes the animal control providers insure that their animals are
vaccinated. The board doesn't urge the Board of Health to spend a lot of staff time
and resources on this, which is a small public health risk. Spend the money on
issues with more risk.
The board hasn't addressed the issue of smoking in public places.
Regarding the Assessment Coordinator position, there are many instances of
various kinds of data the board would like to see the Health Department collect
routinely. A main State goal is assessment. There used to be an assessment
position in the Health Department. The board recommends thinking about
Board of Health, 4/27/2004, Page 1
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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.
reinstating the assessment coordinator position in the 2005 budget. That staff
person compiles data to indicate the levels of service in the community, instances
of disease, and mines data already collected in Health Department files. Compile
useful meaningful trends and statistics out of the various data, or institute new data
collection programs. He read from the old position description.
Regina Delahunt, Health Department Director, stated a part of the Health
Department is to look at the big picture of what's happening in the community.
That's the job of an assessment coordinator, which the Health Department had until
about two years ago. Many times the advisory board would like additional
information, which exists, but there's no one to go collect that data. From a
community perspective, they need someone to come up with the answers to those
questions.
Davidson stated the request for this position comes from the advisory board
after years of discussion.
Regarding the work plan format, the advisory board has been frustrated over
the years that the work plan format is broken into chunks that tie to mandated
funding streams. Those chunks don't align with the State's public health goals,
which are broader statements. The board would like to see broader goals and what
the Health Department is doing to meet those goals. For instance, the larger goal
of child health services is divided into many different chunks. They don't get a
comprehensive vision of child health services. That's what the advisory board is
working on now.
McShane stated the Council's budget retreat is coming up soon. They'll try to
remember about the assessment coordinator position request, and councilmembers
who make it a priority can bring it up to administration then.
3. PUBLIC HEALTH IN CHILDCARE CENTERS
Regina Delahunt, Health Department Director, stated the management team
came up with this idea. They thought it might be helpful to have a presentation
from a staff member at every Board of Health meeting about something the Health
Department staff does in the community that makes a difference. She introduced
Public Health Nurse Debbie Chudek.
Debbie Renaud - Chudek, Public Health Nurse, stated she's been with the
Health Department for 28 years. She's worked in this program for ten years. It's a
relatively newer program to the State. Other states don't have a program to the
extent that Washington State has. The childcare health consultation program
began in the county 12 to 13 years ago. The State passed a rule that any licensed
childcare center with four or more infants must have nurse or physician
consultations monthly about various issues. This position has emerged and
changed over the years. The nurses on staff have received extra training, and the
Board of Health, 4/27/2004, Page 2
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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.
work is becoming its own specialty. They deal with very unique situations. There
are a lot of rules that a childcare provider must follow.
Whatcom County has agreements with 15 different childcare centers. That
includes about 1,000 children. There are five nurses on the team. At a center, the
nurse will ask about issues that are of concern, and present a different topic each
month. In between times, the nurses are available to the centers. The visits last
about an hour or an hour and a half.
They also work with the other childcare agencies in the county, including the
State Department of Health, the childcare licensors, and a number of social
agencies.
Brenner asked about STARS. Renaud - Chudek stated STARS stands for State
Training and Registry System. Childcare providers are mandated to have
continuing education every year.
Brenner asked if the cost for this program is on a sliding scale. Renaud -
Chudek stated the County originally charged $25 per hour for a visit, then the fee
went up to $35 the next year. The brochure is printed to allow them fee flexibility
for year to year. Everyone is charged the same amount.
Brenner asked if there is a program for those who can't come up with that
kind of money. Renaud - Chudek stated there is not. The Health Department
partnered with Opportunity Council for many years. That program included a
sliding scale and grants, but the money for it went away. It would be wonderful if
that could happen again, especially for home providers. She showed a video
presentation of her program.
One visit from a public health nurse can make a huge impact. Some of the
centers have up to 150 children. That is a huge potential for promoting health and
wellness. Even though they have agreements with 15 licensed childcare agencies,
there are 184 licensed homes and centers, but most are in homes. Currently, there
is close to 4,000 children in licensed care. That many or more are in unlicensed
care. Currently, the program serves about 1,000 of those children.
Crawford asked what triggers the requirement for this program and for a
license. Renaud - Chudek stated all homes and centers that provide out -of -home
care are to be licensed, even for only one child. Groups with four or more infants
need to have a public health nurse make monthly visits. There are 15 out of 25
centers in the county that have an agreement with Whatcom County.
Fleetwood asked about an increase in food allergies in kids. Renaud - Chudek
stated they don't know the reason for that yet. Physicians are gaining more
information about allergies all the time. A lot of people are doing research to try
and figure it out. One theory is that people do too good a job of cleaning.
Board of Health, 4/27/2004, Page 3
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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.
McShane asked about summer camps that occur every year. Renaud -
Chudek stated many are not licensed. The YMCA summer programs are not
licensed.
Delahunt stated they have some oversight over camps in terms of drinking
water and onsite sewage, but not to the extent of child safety.
Roy stated she's impressed at the range of activities in which the nurses
have expertise. In her experience in school districts, they would have had to call in
a specialist. She's impressed with the nurses' broad range of knowledge.
One problem is the turnover rate in childcare staff. It's horrendous.
Requiring training would help with that. It would give people the sense that they
have some expertise and this is a career rather than just a job. Renaud- Chudek
stated a large part of the problem, even with the increased training, is that the pay
for a childcare provider is so low. Most are paid minimum wage. They take on
incredible responsibility. It would be great to support programs that increase the
income for those workers.
McShane stated he liked the idea of having these presentations. This is a
county for everyone, including people in Bellingham.
4. CLANDESTINE DRUG LABS - REGULATIONS AND LOCAL CODES
Don Vesper, Environmental Health Services Manager, stated he would talk
about the abuse and use of illegal drugs, specifically methamphetamines (meth).
(Clerk's Note: End of tape one, side A.)
Vesper stated this is a devastating issue. It has tremendous consequences
on the community, families, parents, and children. When parents are more
concerned about how to get their drugs, the community has a growing problem.
The Health Department response is to develop a toolbox to help with the issues.
Develop local regulations to fill gaps in regulatory response to clean up illegal drug
labs. Now, they get authority from State statutes, which is limited. Their authority
includes posting of property, inspection of property, assessment of contamination,
reporting of contamination, and providing notification of contaminated properties.
The Health Department also determines appropriate cleanup, verify it has occurred,
and record the decontamination. The County has been involved in this for three
years, during which 25 properties were declared contaminated. Seven are still
unaddressed. Two are in process of developing plans. Two are hotel rooms that
have additional oversight from the State. Two have been reoccupied without clean
up. One continues to be cleaned by the owner.
They have two areas with substantial regulatory gaps. They lack the ability
to compel cleanup of contaminated properties. It is up to the property owner to
voluntarily clean up the property, even though there is an order on the property.
Board of Health, 4/27/2004, Page 4
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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.
Second, they do not have good authority to enforce violations if someone does
reenter the property by trespass or for occupation. Consequently, the orders lack a
good enforcement protocol.
There have been concerns by the community about a property left
unattended. It is blight in the neighborhood. There is a community group that has
been working with staff to address these gaps. They have draft regulations from
other counties to review and that won't be a big effort. He asked for Council
direction to work on regulations. The health risk from exposure is low, if someone
is only in the area for a short period of time. If the property is occupied, chronic
exposure leads to a higher level of risk. By strengthening the regulatory
requirement, they will send a message to lab operators about being serious about
this issue.
Jim DeGolier, Straight Talk About Responsibility (STAR) Task Force Executive
Director, stated that STAR is a nonprofit organization that has been working on
substance abuse issues for several years. STAR has been given the opportunity to
convene a meth action team in Whatcom County to look at the problem in the
community. Thorough the team, they have talked with a number of different
agencies that deal with meth. There is a widespread impact on the community.
They are continuing to convene the team through STAR and facilitate those
discussions in the community, so as a community they can respond. Meth is a
growing problem, but they can respond proactively and have a future impact.
Mindy Miller, Environmental Health Specialist I, stated one problem is that a
notice posted on the door of a contaminated location gets ripped off. They don't
have the ability to prevent someone from living in a contaminated property. There
are varying levels of contamination.
Roy stated she supports staff updating and creating regulations. She asked
if they've worked with the Sheriff's Office. The community is giving credit to the
Sheriff's Office for cleaning up the location of a recent drug bust. Miller stated the
Drug Task force is mainly the Sheriff's Office. She works with them. They are
limited in their authority, but are given more respect because of who they are. The
Sheriff's Office is in favor of an ordinance to help them do enforcement. The more
heat a community can put on a property owner, the more likely the owner will clean
up the property.
Brenner asked if they can create regulations with the teeth they need to
force cleanup within a reasonable period of time. Miller stated ordinances in other
jurisdictions have time limits for an owner to clean up before earning civil
infractions, misdemeanors, and other penalties. Some ordinances from other
jurisdictions allow law enforcement or the local health department to do
enforcement.
Brenner asked if there is an indication from the Prosecutor's Office that they
agree with new regulations. Delahunt stated she discussed it with Deputy
Board of Health, 4/27/2004, Page 5
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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.
Prosecutor Randy Watts. If they are going to enforce cleanup, they need to have a
local ordinance, which they don't have. Mr. Watts found that there is a mechanism
for the County to clean up a location and put a lien on the property to recover
expenses. This year, the State legislature passed a regulation that said abatements
of contamination are superior liens, even above a mortgage.
Caskey- Schreiber stated they have to have consequences for these
property owners. Someone has to be responsible. She moved to give direction to
staff to create an ordinance. It will help them reduce the number of reentries of
these properties. She'd like to see the properties condemned and forfeited if they
aren't cleaned up.
McShane stated that if they get to the point where the County is doing liens,
maybe it should consider condemnation, recover the money right away, and
distribute the money to the person who lost the property in the seizure.
Motion carried unanimously.
McShane asked if they have received any funding from the Drug Task force.
Miller stated they have not. They have $10,000 from the State Department of
Ecology.
McShane asked the specific health risks to people who enter these locations.
Miller stated it depends on what was used to manufacture the drugs. There is
contamination from the solvents used. Once the chemicals are removed, they are
not a risk. However, there may be lingering residue that they can't evaluate. The
powder from the drug itself also remains. There is also a fire hazard from the
chemicals. Most of the health risk is from the cooking process and the residue once
the chemicals are removed.
Crawford stated he would mention the upcoming summit at St. Luke's on
June 3 at 8:30 a.m. He thanked Executive Kremen, who is helping to fund
facilitation of the summit. STAR is putting the program together. Undersheriff
James is also on the board of STAR.
S. TACOMA - PIERCE TOBACCO ORDINANCE UPDATE
Regina Delahunt, Health Department Director, stated nothing came out of
the legislature this year that would allow counties to pass local regulations. The
Tacoma - Pierce Board of Health passed an ordinance. Currently, it is in effect.
There is another appeal pending. Tacoma - Pierce Board of Health asked for other
counties to file an amicus brief should their ordinance go before the State Supreme
Court. She is asking to prepare an amicus brief. Legal counsel stated it should not
be an increased expense or liability for the County to do such a thing. She asked
the Board of Health for approval of the amicus brief.
Board of Health, 4/27/2004, Page 6
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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.
Dr. Chris Covert - Bowlds, physician, stated that approval of a local ordinance
here would open up the Piece County ordinance to further legal challenges. Filing
an amicus brief would be better.
McShane asked if the legislation has ever been out of committee at the
legislature.
Covert - Bowlds stated it was not.
Delahunt stated there were last minute amendments to the bill that would
have made it worse than nothing.
Brenner moved to request the executive to authorize legal staff to prepare
an amicus brief in support of the Pierce County tobacco ordinance.
Motion carried 5 -1 with Crawford opposed.
6. MUSHROOM COMPOST RULING
Regina Delahunt, Health Department Director, stated the decision was very
confusing. The Saber Tooth farm in Whatcom County filed against The Health
Department, saying that manure is not a solid waste. The local court found that
manure is a solid waste. That decision was appealed to the State. The State
determined that manure was not a solid waste because several years ago the
legislature specifically removed the word 'manure' from the definition of solid
waste. The court was of the opinion that, because it was removed, the legislature
had some reason in mind. This has very broad implications statewide. The State
solid waste regulations clearly regulate mushroom compost. It has implications
beyond composting. There are other things that were removed from the definition,
including discarded refrigerators.
She provided two options. The zoning ordinance could regulate mushroom
composting. Or, the County can develop a local health ordinance that regulates
mushroom composting, based on the fact that it is generally a public health issue.
Another option is to appeal the ruling. That is complicated. It is a State
Department of Ecology regulation, but the Department of Ecology is not a party to
the appeal because they didn't show up at the appeals hearing. The Department of
Ecology is concerned because of the implications statewide, and the Attorney
General's (AG) office will assist Whatcom County should it appeal this ruling.
Caskey- Schreiber asked if they have 20 days to appeal. Delahunt stated
they have 30 days, until May 5.
Caskey- Schreiber stated she wants to appeal. The court decision is crazy.
Delahunt stated the only other fix would be legislative, to put the word 'manure'
back in the State definition.
Board of Health, 4/27/2004, Page 7
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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.
Brenner stated that it was taken out because it was going to be reclaimed
and reused, and would not be a solid waste. However, it should be a solid waste
until it is reclaimed and reused. Delahunt stated she agreed.
McShane stated the AG's office should be involved. The decision dwarfs the
County's issue about mushroom composting. The decision has broad implications.
This is potentially a complete mess for solid waste rules across the state. If this
goes to the State Supreme Court, it might get the Department of Ecology's
attention. He moved to authorize an appeal.
Crawford stated he supports an appeal also. There are inconsistencies in the
appellant's statements, such as the claim that they are not doing a mushroom
composting operation, yet they tell the court that after three weeks the composted
materials transferred to a mushroom farm where it is used to grow mushrooms.
Also, the appellant claimed to spend over $650,000 in land and construction.
However, the assessor's records indicate that another owner of the property is only
assessed a total of $142,000. He doesn't know that this appellate court
understands the facts surrounding this situation. The court is not making decisions
based on what this farm really is. Someone needs to really review this case and
understand the history and the reality of the operation.
McShane stated they could have an executive session discussion with Mr.
Watts on this issue during the next Committee of the Whole meeting.
Motion carried unanimously.
Brenner asked about proceeding with local regulations. Delahunt stated
she'll talk to the prosecutor about proceeding in light of the appeal.
OTHER BUSINESS
Roy asked about progress on re- looking at how they monitor septic
systems. The Drayton Harbor Shellfish Advisory Committee had a discussion. An
ordinance was approved in 2000 about stricter standards in Drayton Harbor.
However, there should be more enforcement throughout the county. She asked if
they are working on it.
Jeff Hegedus, Environmental Health Supervisor, stated the State will adopt
new onsite septic (OSS) codes early next year. At the same time, the County will
revise the local OSS code. Two major parts of the local revision have to do with
operations and maintenance (O &M) and loan inspection requests. The vision now is
to require an OSS inspection for any real estate transaction that involves septic
systems. They are working on an O &M schedule for different types of systems that
will have different maintenance requirements. Licensed O &M specialists will be able
to test the systems on a schedule. With 26,000 systems in the county, the
Board of Health, 4/27/2004, Page 8
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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.
challenge is how to provide maintenance to the systems. They want to have a
comprehensive program countywide.
Roy stated she was told that Skagit County has recently started a program of
more systematic and aggressive oversight of septic systems. It may be worth
looking at their ordinances. Hegedus stated they are looking at how all regional
counties are approaching this issue.
McShane stated they should allow broader types of systems in the future as
the State updates its rules. Hegedus stated new technologies also require
maintenance.
Vesper stated that since Mr. Hegedus has come on board, they have gotten
very aggressive with failing septic systems. When they are looking at every failure
and getting them corrected as fast as they can, a message is sent to the industry
and to homeowners.
Brenner stated they've received correspondence from Rodney Lund about
the potential closure of the Martin Center. She would like to send a similar
letter from the County Council to the Division of Mental Health requesting that the
center stay open and that the State find the funds to keep it open. She presented
two letters regarding the closing of the center. One letter they've received is from
Chuck Benjamin at the North Sound Regional Support Network ( NSRSN) and the
other is from Betty Scott at the National Institute of Mental Health (NAMI). She
moved that the Council send a letter to the Division of Mental Health similar to the
letters from the NSRSN and NAMI. Andy Byrne could help write the letter. This is a
one -of -a -kind center that deals with the most needy and critically ill children.
Andy Byrne, Human Services Manager, stated the Martin Center is one of five
statewide that provides long -term care for adolescents with severe mental illnesses
and emotional experience. Financially, the issue is that the cost of care has been
increasing beyond the reimbursement level from the State for that care. In the
past seven years or so, the State Division of Mental Health has promised to work on
funding. As a result, the program has been using thousands of dollars of their
financial reserves to cover costs. The State told them it can't increase the
reimbursement rate for another year and a half. The center decided it can't afford
to provide the service anymore. If the center closes, the community will end up
paying even more for the care of these kids.
Caskey- Schreiber asked if Catholic Community Services ran the program, got
funding from the State Department of Social and Health Services (DSHS), and
DSHS decided to not fund the service any longer. Byrne stated the State will
provide funding at the current reimbursement rate, but it is insufficient. Catholic
Community Services is making the decision to no longer subsidize the service.
Caskey- Schreiber asked if the letter would try to talk DSHS into increasing its
reimbursement rate.
Board of Health, 4/27/2004, Page 9
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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.
Brenner stated it would.
Byrne stated one option is to ask for bridge funding until a permanent
solution can be found. Another option is to increase the number of beds allowed at
the center. Many different parties statewide are sending letters to DSHS.
Caskey- Schreiber suggested that the letter be sent to the State legislators.
Brenner stated the State legislators are already involved and have visited the
center. They are doing what they can. The Council can send a copy of the letter to
the legislators.
The Council concurred to send a copy of the letter to the State legislators.
(Clerk's Note: End of tape one, side B.)
McShane stated the Council can vote on the final language of the letter at its
Council meeting.
Motion carried unanimously.
McShane stated Catholic Community Services has been carrying this service
for a long time. Someone else is going to have to help out, including DSHS and the
State legislators, who have failed to deal with this issue. The County may also
have to consider finding funds to bridge the gap. It's something for the Council to
talk about.
ADJOURN
The meeting adjourned at 12:08 p.m.
Jill Nixon, Minutes Transcription
The Council approved these minutes on May 18 , 2004.
ATTEST:
Dana Brown - Davis, Council Clerk
WHATCOM COUNTY COUNCIL
WHATCOM COUNTY, WASHINGTON
Dan McShane, Council Chair
Board of Health, 4/27/2004, Page 10
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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.
Board of Health, 4/27/2004, Page 11