HomeMy WebLinkAboutBoard of Health February 5 20021
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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
February 5, 2002
The meeting was called to order at 10:30 a.m. by Council Chair L. Ward
Nelson in the Council Chambers, 311 Grand Avenue, Bellingham, Washington.
Present: Absent:
Barbara Brenner None
Laurie Caskey- Schreiber
Sam Crawford
Seth Fleetwood
Dan McShane
Sharon Roy
1. PUBLIC SESSION
Tim Paxton, Clean Water Alliance board member, 2120 Ellis Street,
Bellingham, stated there was a four -day sewage discharge in the watershed in
December. He estimates that Y2 million to 1 million gallons of sewage spilled into
the reservoir. Many government agencies fell down on their responsibilities,
including the County. Water District 10 opened a valve when their detention tank
overflowed the system. They decided to dump the sewage into the reservoir and
let it flow across the golf course and into the lake. It began on a Thursday night
and lasted through Monday.
He called the State Department of Ecology (DOE), who told the Fisheries
Department that it was under control. He showed a video demonstration of the
path the sewage took. Kids were walking to school through the sewage. They tried
to get someone to shut it off. This has been an ongoing occurrence over the last
ten years.
There was no visit from the Health Department. The County has
responsibility for the first spill response for any spill in the county. The Fisheries
biologist made a 911 call on Sunday. The 911 operator didn't know what to do.
He is also concerned because no testing was done to see whether or not the
contaminated sewage had chemicals. They don't know what the levels if giardia or
cryptosporidium were in the sewage. There was no notice to the school district.
Area residents were not notified that this was happening.
There is liability to the County. The Board of Health has oversight of the
systems. He requested a public presentation to get more public input on this
situation. More people should be aware. Also, DOE wasn't planning on getting out
there at all. No one from the City of Bellingham came out.
Board of Health, 2/5/2002, 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.
Brenner stated the Public Works Committee deals with water quality issues.
She asked to put this issue into the Public Works Committee. She would like to
schedule a special committee meeting to deal with this. She would invite DOE and
the Health Department to come. She spoke to Dr. Stern right after this happened.
Dr. Stern said he would make a written or oral presentation to the Council about
this.
Caskey- Schreiber stated she and Councilmember McShane attended the
January 18 public meeting. It was very informative and well done. Health and
Human Services Interim Director Regina Delahunt admitted that the County made a
mistake, and talked about ways that the County would correct the problem for the
future. She questioned what the Clean Water Alliance is trying to accomplish by
going over it again and again.
Alex Cummings, resident, stated all the councilmembers need to hear about
it. Some of the solutions that were presented are not good enough. That needs to
be addressed. Public notification is a huge issue with any kind of health
emergency. 911 was activated that weekend, and nothing happened. Other
solutions that were offered included a phone notification system. Federal
recommendations don't recommend that, because it is not a good way to get in
touch with people and make sure people are properly notified.
Caskey- Schreiber asked the goal of all this, and whether it is to establish a
system that everyone feels good about. Cummings stated this should not have
happened.
Nelson stated his concern is whether the County alone is responsible. Spill
response is a collective responsibility with the City of Bellingham and Water District
10. There is a problem with response to spills. He suggested that they address
this through the Joint Lake Whatcom Management Committee process to solve the
problem in a unified manner.
Caskey- Schreiber agreed.
Brenner stated she didn't care how it's done, but she wanted all the agencies
and players involved. She is concerned that there seems to be more focus on spill
response rather than prevention. Have a system in place that does a better job of
prevention.
McShane stated it's a good idea to have a presentation done in committee.
He was out there. The presentation will be informative. The Council should think
about how they are going to be satisfied with what the Health Department
recommends. He is proud of Health Department for saying that they need to do
better. The Council must help the Health Department do better. More than
Whatcom County government is involved. Bring it up as discussion item at the
Joint Lake Whatcom Management Committee.
Board of Health, 2/5/2002, 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.
Nelson stated he would look into getting it onto the schedule for the Joint
Lake Whatcom Management Committee, and Councilmember Brenner can schedule
it in the Public Works Committee.
The Council agreed.
Lynn Weeks, 1277 Erin Drive, Lynden, and Linda Sweeney, 406 E. Wiser
Lake Road, Lynden, introduced themselves.
Weeks stated they would present to the Board of Health the information
they've been using in the Whatcom County area. They go into the public school
systems to present information on fetal development to students in health classes.
New information has come to light in the past five to ten years. They can present
the new information to the students and the public. She showed the first few
minutes of a video that uses fiberoptics.
Sweeney showed three - dimensional ultrasound photos of a 31- week -old
baby. There is also a photo of an 18 -week old fetus that underwent surgery. The
photo shows the child grasping the surgeon's glove as it is replaced in the womb
after being repaired for spinabifida. The technology has become more advanced.
Weeks stated the fiberoptics presentation shows the development of the
fetus from the moment of conception to the first trimester.
Roy asked the grade levels that see their presentation. Weeks stated they
talk to students in the middle school through to high school.
Weeks stated they expand on what has been presented in the video with the
models. They discuss with the students the health factors for the mother and baby,
and the importance of healthy lifestyles. They've had a good response with the
students and hope to expand the presentation in the community.
Sweeney stated she sees the value of teaching good health care for girls,
about things that occur with drug and alcohol use, and the effects of unhealthy
lifestyles on a baby. It is important for Whatcom County to be aware of what is
going on and the ways to enhance the education to the students. Students respond
to this presentation. She asked the Council to consider using part of this as the
curriculum in the future from the Health Department.
Brenner asked for a copy of the video.
Nelson asked if the Health Department has a copy of the tape. Weeks stated
it does not.
Nelson asked if the County uses these educational assets for teen pregnancy
classes.
Board of Health, 2/5/2002, 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.
Janet Davis, Community Health and Wellness Services Manager, stated the
Grads program for pregnant and parenting teens is the one place that the Health
Department does education. It is usually one -on -one case management with the
teens. The Health Department doesn't do a classroom presentation, but this
program would be wonderful for the teens in the program.
Weeks stated they would like to present it to all students and the community
at -large so they are more aware of fetus development. Then, young people can
make informed decisions.
Brenner asked if they go to all the schools. Weeks stated they send
information in August to the health teachers in all the schools in the county. It is
up to the teachers to schedule a presentation. The Ferndale school system has not
presented this information.
Sweeney stated they've had speakers at the Bellingham schools last year.
Weeks stated this video has not been approved in Bellingham, but it's been
used in all of the other school districts. She hopes they will approve this video.
Caskey- Schreiber stated she saw the video at a psychology class in child
development at Western Washington University.
2. RESIDENTIAL SHARPS COLLECTION PROGRAM PROPOSAL
Regina Delahunt, Interim Health and Human Services Department Director,
stated this issue was before the Board of Health at its previous meeting. There
were concerns relating to whether or not people should bring sharps into
pharmacies in grocery stores for disposal. Staff was directed to take the issue to
the Solid Waste Advisory Committee (SWAC) for comments and advice. She would
like direction from the Board of Health on what the next step will be.
Chris Chesson, Environmental Health Supervisor, stated local solid waste
rules prohibit disposal of residential sharps if there has been a sharps collection
station in the county. They've been researching different options for collection
stations in the county.
The SWAC generally supports the program. It recommended an alternative
technology for adequate encapsulation prior to direct disposal into the solid waste
stream. They originally proposed a public /private partnership for cost sharing. The
haulers who were present were not supportive of that option. They recommended
that the County provide its own funding. An additional concern was that
commercial generators should be allowed to dispose of sharps at a sharps
collections station if the program is privately funded. There would be additional
requirements due to the increased quantity of waste that would be accepted at the
sharps collections stations. The preferred alternative is a County- funded sharps
collection station program. Investigate other locations with less public exposure,
Board of Health, 2/5/2002, 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.
such as fire stations or medical clinics, in six locations countywide. Use the solid
waste excise tax to pay for the program.
Brenner stated she had other concerns she raised at that meeting. They
aren't listed. She spoke to two SWAC members after the meeting who said her
concerns were not discussed. One concern was about people not doing it if it isn't
convenient. The County can spend all the money it wants to, but if people don't do
it, the program won't work. She was told at the meeting that her concerns would
be shared with the SWAC, and they weren't according to the two SWAC members
who she talked to. She received information from Wayne Turnberg about a study
that was done in 1994 that talks clearly about very little compliance to any program
other than a program where people do it in their own homes. There are options
available that she hadn't heard about, such as the needle clipper. There is a type
of plastic bottle, a soda bottle, that has been tested to see if it would break during
compaction. It was the one container that didn't break. Containers specifically for
needles did break. The amount of people and exposure is low, but it could be
dangerous. She is amazed that there are products that are cost - efficient. People
can do it in their homes. The study shows that efficiency and compliance is
reduced if people have to take the sharps somewhere.
Nelson stated the Board of Health established biomedical regulations that
prohibit disposal of residential sharps in the solid waste stream. Delahunt stated
that is correct once a sharps collection station is established. That was at the
direction of the Medical Waste Task Force, who believed that residential sharps
should not go into the general waste stream.
Nelson stated the question is whether the Board of Health wants to continue
with the policy. Delahunt stated that if they don't want to implement a sharps
collection station, the Health Department can go in the direction that
Councilmember Brenner suggests.
Nelson stated there are other mechanisms out there to address the issue of
medical waste in residential treatment. Blood contaminant comes from the needle.
The clipper takes the needle off of the syringe. That would have a low effect on the
waste stream because the needle is very small. The bottle is the polyethylene
terephthalate (PET) plastic resin 2 liter pop bottle. Delahunt stated that is what the
Health Department currently recommends that people use. The Health Department
gives out biohazard labels for the bottle.
Nelson stated they used to provide the community stickers to label the
bottles. If people purchase their syringes, the pharmacy could give them a sticker
to apply to the bottle, which would notify the waste haulers about the needles and
syringes.
Crawford questioned whether the waste handlers were not interested in
handling a separate collection system. Chesson stated the waste handlers were not
interested in a curbside collection system.
Board of Health, 2/5/2002, 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.
Chesson questioned whether the handlers expressed any concern about the
needles being introduced into the normal solid waste stream. Delahunt stated
that's where people dispose of their needles now.
Crawford asked if waste haulers are concerned about that. Chesson stated
they are, but not extraordinarily. They are not going through the garbage and
handling the waste. The exposure potential is minimumal.
Delahunt stated there is exposure potential if the sharps are not properly
contained. They have expressed a concern about that.
Crawford stated the law prevents home users from disposing of their home
generated syringes into public or privately operated recycling containers or
recycling sites. The law also prohibits the syringes from being disposed of in the
general waste stream only in communities that have a home syringe collection
service. As soon as the County starts the home syringe collection service, a home
user can no longer use the PET bottle with the label. The user has to take the
syringe to the collection center. The County can go one way or the other, but not
both. Delahunt stated that is correct. That is also what the local ordinance states.
Crawford asked how they started talking about a collection system. It
sounds like there is already something in place that works. Delahunt stated it was
a recommendation from the Medical Waste Task Force. Initially, the proposal was
to not allow residential sharps to be put in the waste stream. Then they discussed
setting up a residential sharps collection system.
Crawford questioned whether the Medical Waste Task Force realized that it is
an either /or situation when they discussed this. Delahunt stated they understood
that.
Brenner stated she is a member of the Medical Waste Task Force. They
never saw the information she presented. There was another recommendation
from the Medical Waste Task Force that all stocks and cultures be treated on site.
That didn't happen. The Center for Disease Control (CDC) is doing a study of this
to see if anything has changed, and the results should be ready in the near future.
She recalled that Mr. Turnberg didn't expect to see people's habits change a lot.
Don't make it so onerous that people end up dumping the sharps in the trash. The
only way to do that is to make the process convenient. Before this, she hadn't
known whether there was anything that people can put the sharps in that is crush
resistant, but there is. The Board of Health members needs to digest this before
making another step in this direction.
Caskey- Schreiber stated the direction to move is to find some kind of safe
container to keep disposing the sharps through the home waste system. People will
be most compliant with what they've been doing. People don't have time to seek
out drop off points. She would like to identify the ultimate safety containers and
distribute them through pharmacies and doctors' offices.
Board of Health, 2/5/2002, 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.
McShane asked if there is a container that they are allowed to use for home
disposal in Washington State if there is a collection center. Delahunt stated there
isn't. If the County creates a collection system, someone can't dispose of their
sharps in the trash.
Fleetwood stated this is going to create lots of people who are violators.
(Clerk's Note: End of tape one, side A.)
Fleetwood asked what the enforcement policy would be. Delahunt stated it
would be on a complaint basis. The haulers would see the improper packaging or
the syringes in the trash. The Health Department would do education first. If there
were a repeat complaint, the County would go through the civil enforcement
process.
Fleetwood stated information refers to a statistic that there was only one
instance of infectious disease transmission nationwide. Delahunt stated that
statistic is very accurate. The number of instances is very low. The correlation
between needle sticks related to waste handling and disease transmission is very
low.
Nelson stated syringes with needles come with a cap. People always put the
cap back on. Therefore, there is already a secondary protection method if the
syringe user doesn't do clip the needle.
McShane read a statement from the SWAC recommendation regarding
alternative technology providing adequate encapsulation prior to direct disposal.
He questioned whether that was for a sharps collection center or home use.
Chesson stated the recommendation was for a commercial generator. The Board of
Health previously discussed the issue of plaster encapsulation prior to disposal into
the solid waste stream. The SWAC brought up the point of whether or not
retractable needles are adequate to prevent a stick. The SWAC was supportive of
the program overall.
McShane asked if the haulers have concerns. Chesson stated the haulers
were supportive of the process. The haulers felt that the County needs to do
something more than what it is doing right now.
Brenner stated they can say there is SWAC support, but the SWAC members
didn't have the information that the Board of Health members are getting now. The
Medical Waste Task Force didn't have a big discussion about pros and cons.
There is going to be a cost to enforcement. Anyone who accepts them has to
create plans and go through an approval process. Stay with what the County is
doing now, emphasize using the PET bottle, labels, and clipper, and wait for the
new CDC study. Use the PET bottle and clipper alternatives combined with a lot of
education.
Board of Health, 2/5/2002, 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.
Dr. Greg Stern, Health Officer, stated the reason this came up at the Medical
Waste Task Force was to have consistency. The whole reason for not allowing
sharps from the commercial generators at the doctors' offices to go into the waste
stream was because of the risk of them breaking open during compaction. Then
they would have needles on the tipping floor and in the waste stream where people
could get stuck. It is consistent to have restrictions on residential generators,
because they would have the same result of containers that get opened up if they
were being compacted.
Fleetwood stated it sounds like there is practically no risk, and questioned
whether that was true. He questioned why they have to do more, if that's the case.
Stern stated they developed the local medical waste regulations based on the
principal of minimizing risk, and there is a potential risk there. The other issue is
that if it is possible to have a container that won't break open during compaction,
then it's safe.
Nelson stated he hears that the Council is not quite ready to adopt these
restrictions on home waste disposal. He would like to give direction to staff on
what the Board of Health wants. He moved to recommend that staff develop a
program to provide better access for the public to get the proper materials, such as
the PET bottles, clippers, and stickers.
Delahunt asked if the motion is the second option in the staff
recommendation.
Nelson stated his motion is to develop policies along those lines to help the
community.
Brenner stated she didn't want to downplay the risk. It's difficult to track
disease back to medical waste. Encourage people to dispose of sharps as safely as
possible to get the most safety bang for their buck, rather than change the
regulations so much that people end up dumping the sharps.
Nelson restated the motion to adopt option two recommended by staff,
expanded as discussed by the Board of Health.
Motion carried 6 -0 with Caskey- Schreiber out of the room.
Delahunt stated there are two recommendations for revisions to the
biomedical waste rules. One of the recommendations still applies. The staff needs
direction from the Board of Health. There are some commercial generators, such
as doctors' offices, that treat onsite. The regulations are currently written so that
treated needles cannot go into the solid waste stream. They have to be picked up
by a biomedical waste hauler and taken to Stericycle. The staff recommendation is
to allow treatment onsite as long as they plaster - encapsulate the sharps, and put
them into the solid waste stream.
Board of Health, 2/5/2002, 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.
Brenner moved to approve the staff recommendation to provide the option
for commercial generators to plaster encapsulate sharps after onsite treatment, and
then dispose of the containers in the solid waste stream. When they talked about
this before, staff said this was doable for the larger generators, but not for people
in their homes. That is why she supports the motion.
Motion carried unanimously.
3. SEX EDUCATION/ DISEASE PREVENTION POLICY
Janet Davis, Community Health and Wellness Services Manager, stated the
direction from the last Board of Health meeting was not very clear to her. Her
experience as a nurse is that the topic of sex - related issues brings forward a strong
emotional response in people, with definite opinions that are not always shared.
She hoped to come up with a common approach to all of this.
Her division has all of the health care workers in it. They are the ones who
deal with these individual medical health issues. There is a myriad of ways of doing
this. It is very difficult for her to describe all of those ways. The basic principle
they use when they deal with this topic is harm or risk reduction. The Health
Department uses this principle in other arenas besides sex - related issues. Most of
the people they deal with are already pregnant or already have a sexually
transmitted disease (STD). Most of the time they are not talking about primary
prevention, but are talking to people who are in the midst of the situation. Nurses
assess what the clients are doing and the diseases they are at risk for, and look at
what behaviors can change. Women are more vulnerable. The nurses teach the
women what the harm is and how to reduce the harm.
The concept of the five stages of change has been well researched by social
scientists. She adapted it to this situation. Nurses will identify what stage a person
is in, then apply what should be done. Abstinence is a good principle, but when
they are talking about changing behavior, they have to be very specific.
Nelson questioned whether the County would go out into the community,
send out material, or offer classes for prevention to the general public if there were
a Hepatitis B outbreak. Davis stated the County would not, because they don't
have the capacity. The County deals with each case to get the individual to identify
who they've had contact with. It's called a contact investigation. Then the Health
Department would contact those individuals to protect them.
Nelson asked why they do that. Davis stated they do the contact
investigation to help prevent disease transmission further out into the community.
Nelson stated education is great, but his concern about public health risk is
not the actual sexual activity, but the ramifications of sexual activity as a
mechanism of spreading diseases. Davis stated that goes back to harm reduction.
Board of Health, 2/5/2002, 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.
Nelson asked how the County is doing harm reduction. Davis stated the
County is doing harm reduction on an individual basis.
Nelson asked what the effective tools are to protect the public health from
the consequences of a disease, such as cancer and other risks for death.
Davis stated that when she talks about risk reduction, it's on an individual
counseling basis with each client, and is based on the diseases and behaviors the
client exhibits. The State Department of Health now requires the County to use the
prevention messages suggested by Center for Disease Control (CDC). In the
future, the State mandates that these messages from the CDC be added to the
County's written materials. That is a specific intervention the County will use.
Nelson read the CDC statements. If this is the message, the County would
be telling people that latex condoms can reduce the risk of transmission of genital
herpes and other diseases. That is a conflicting message. Davis stated this is what
the CDC has mandated that the County does, because the County receives funding
from the federal government. The County can add more language to address the
conflict in language.
Nelson stated perhaps the message is only the minimum, but the County is
not being active enough to let people know the ultimate consequences. If this is
the message that the County delivers, then it is doing a disservice to men and
women in the community. Davis stated that if the Council drafts language, it could
be added to the CDC language.
Brenner stated there is nothing in the requirement that prevents the County
from saying that people should abstain from sex and that nothing is 100 percent
effective. That message would be the most effective. Davis stated the County
can't change the CDC language, but they can add to it.
Caskey- Schreiber stated she doesn't interpret the language as saying that
condoms will absolutely protect, but they are better than nothing. People need to
be reminded that they can take some action that might prevent some of these
things from happening.
Nelson stated there is a disease factor in the community. The Board of
Health is responsible to educate the public.
Crawford stated he agreed with Councilmember Nelson. It would be
appropriate for Whatcom County to expand on the CDC statements. It is
important, but the statements need to be followed up with another statement to
clarify the County's message. The inference could be that condoms are going to
provide a level of protection that is universally acceptable. That is not necessarily
the case. People need to understand the risk involved, and the CDC statements
don't say that.
Board of Health, 2/5/2002, Page 10
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Stern stated the CDC statements were mandated by the federal law that said
the CDC needed to develop evidence -based statements on the effectiveness, based
on medical evidence. The CDC did a literature review, determined the degree of
evidence for the effectiveness for condoms to prevent specific diseases, and came
out with statements that there is conclusive evidence that they reduce the risk of
HIV transmission, and there is not conclusive evidence that it is effective for other
things. There is a more detailed report of their studies. They used the terms "can
prevent" or "may prevent" based on the fact that it is not conclusive, but there are
theoretical reasons that it is partially effective. In the context of preventing
sexually transmitted disease, the County always uses abstinence plus risk reduction
model. That is part of the message the County gives during individual counseling
and in health education materials. If the County tries to change the messages for
these very focused statements to meet the general requirement of the abstinence
plus risk reduction, then the County will lose track of how these statements are
being used. He is afraid that the Council will try to change the specific messages
that are based on how effective condoms are for protecting against specific
diseases. These messages will be given in the context of a larger discussion about
risk reduction. A lot of the Council's concerns would be addressed in that larger
discussion.
Nelson asked how it overall protects the general health of the community
when they just deal with the individual. Davis stated the Health Department
doesn't have the capacity to do public education at this time. They deal with the
individuals.
Nelson stated they are talking about the information that the Health
Department hands out. He doesn't feel that there is a problem in educating the
public about public health risks.
Brenner stated she is more reassured that the County is discussing
abstinence. Teenagers see and hear things differently than adults. Adults can't say
often enough to kids that abstinence will absolutely protect them. Anything the
County can do to give that message is good. Davis stated the statements are in
the context of all the other things that the Health Department talks about.
Roy stated that teens listen more to what people tell them than what they
read. She questioned how many people would see these statements. Davis stated
they don't pass out the pamphlets community -wide.
Stern stated these messages would be included in the State Department of
Health materials that the County uses.
Roy stated many of the messages go to people who already have a problem
or are perceived as heading for a problem. Davis stated that is correct.
Roy stated that is a different audience than the general public. Another issue
is about treatment. She asked if treatment is also mentioned to people who are
being counseled. Davis stated it is.
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Caskey- Schreiber questioned what they are debating. Davis stated the
Board of Health requested a staff report on her activities.
Caskey- Schreiber stated it sounds like part of the discussion is focused on
abstinence and how materials are perceived. The reality is that people come to Ms.
Davis because they have a problem. The County has to talk about prevention to
prevent future problems. Abstinence is one measure, but since the people are
already active, it is not likely that the people are going to choose that route. The
reality is that these people have chosen a different method. The County has to
reach that audience to prevent them from harm and engage in risk reduction in the
future.
Nelson asked if the County materials go to the schools. Davis stated they do
if invited. They typically do six to ten presentations to the schools. The Health
Department provides a lesson plan to the schools to review before the presentation.
Nelson stated the Health Department is talking to people other than those
who have the diseases. Davis stated they haven't done any school presentations
this last year.
Nelson stated he hoped the Council does not view abstinence as the only
mechanism in dealing with people who are sexually active. As the Board of Health
and the Health Department, the County has information that is allowed into the
general community to discuss sexually transmitted diseases. They are trying to
figure out what the message is and how to get it across.
Brenner stated she wants a combined message of abstinence and prevention
methods. Information on abstinence has changed a very small percentage of
people. Abstinence or monogamous relationships are preferable. Just because
abstinence will not generally happen, it is still a great focus. Kids are influenced by
the things that adults say to them. It is a viable alternative.
Nelson read into the record a portion of the State law regarding labeling
condoms accurately. The Board of Health wants to be proactive in preventing the
disease from spreading in the community.
Davis stated her recommendation is to put a label on all the materials that
the Health Department uses related to this topic to summarize a policy statement
from the Council.
(Clerk's Note: End of tape one, side B.)
Davis stated adding the label would be a way to address the message that
needs to continually be said over and over again. The label could be in addition to
what they have to say regarding condoms.
Board of Health, 2/5/2002, Page 12
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Nelson stated he is interested in addressing the consequences of wrong
behavior. He asked if individuals are fully informed on the consequences. Ms.
Davis says that they are through the statements. Davis stated she is not saying
that people are informed of the consequences through the CDC statements. The
statements are required.
Nelson stated he is not sure the County is fully informing people. Davis
stated the statements are required, but the department does much more. The staff
certainly does more than just give the statements when it has conversations and
gives instruction. The CDC statements are not the end -all and be -all of what is
being done.
Nelson stated he preferred to develop a mechanism to get better information
to the public.
Brenner stated she would like abstinence included. Davis stated they do that
on an individual basis and during the presentations. She questioned whether this is
the policy statement that the Council would like to have on all of their written
statements.
Brenner asked if there is a concern that condoms are not effective with the
human papillomavirus (HPV). Davis stated the warts occur in areas that condoms
don't cover. There can be skin -to -skin contact in other areas.
McShane stated the County policy should be to reduce sexually transmitted
diseases (STD). That is being carried out. He is not sure the Council should direct
staff on how to carry out that task. The message on a client -by- client basis and for
the community will have to be changed, depending on how effective the charts and
data are. The Council should give some latitude there. There are times when
abstinence may be the best term to use. Other times, other things may be more
effective. The policy should not be abstinence, it should be preventing STD's.
Nelson stated he is interested in the ramification of disease transmission
itself.
McShane stated the policy is clearly to reduce STD. The Board of Health
should get out of the way of the people who are trying to make that happen, unless
the they see that there is a problem that is out of the ordinary with sexually
transmitted diseases.
Nelson stated he can bring in the reports from the cancer center about
women who have developed cervical cancer.
McShane stated he is talking about locally, not on a national level.
Nelson stated he is talking about locally. Davis stated HPV is associated with
cervical cancer. There are other communicable STD's that the Health Department
deals with.
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Brenner stated if they are going to have information about condoms, then
they should include information about abstinence.
Crawford suggested that they take the CDC statements and follow them up
with another paragraph stating that the use of condoms does not negate any risk
whatever, and having no sexual contact ensures that there is no risk of
transmission.
Nelson moved to send this back to the Public Health Advisory Board for
recommendations. This is a complicated issue that needs a fuller discussion in light
of the recommendations from the CDC and the loaded abstinence message.
Motion carried 4 -3 with Caskey- Schreiber, McShane, and Roy opposed.
Davis asked for clarification on what the Public Health Advisory Board should
discuss.
Nelson stated the Public Health Advisory Board should discuss the County's
message on the STD issue. They have the requirement regarding condoms.
Davis questioned whether the Board of Health wants the Public Health
Advisory Committee to focus on the condom message.
Nelson stated that is correct.
Crawford stated that in addition to the new laws, this came up based on
information from the public that condoms were not protecting what they might be
inferred to protect. That's why he is focused on having additional language that
says the CDC required statements on condom use should not be taken as iron -clad
information.
ADJOURN
The meeting adjourned at 12:19 p.m.
Jill Nixon, Minutes Transcription
These minutes were approved by Council on March 12 , 2002.
ATTEST: WHATCOM COUNTY COUNCIL
WHATCOM COUNTY, WASHINGTON
Board of Health, 2/5/2002, Page 14
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DISCLAIMER: This document contains the Whatcom County Council or Committee
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Dana Brown - Davis, Council Clerk L. Ward Nelson, Council Chair
Board of Health, 2/5/2002, Page 15