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HomeMy WebLinkAboutBoard of Health October 2 20011 2 3 4 5 6 7 8 9 10 it 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 WHATCOM COUNTY COUNCIL Board of Health October 2, 2001 The meeting was called to order at 10:35 a.m. by Council Chair L. Ward Nelson in the Council Chambers, 311 Grand Avenue, Bellingham, Washington. Also Present: Sam Crawford Barbara Brenner Marlene Dawson Dan McShane Connie Hoag Absent: Robert Imhof Regina Delahunt, Interim Health and Human Services Director, thanked everyone for attending. Several staff members would be available for questions. 1. PUBLIC SESSION Kerry Chappell, 1121 Roland Street, read from her letter dated October 2, 2001 (on file) to request that rent money generated from Planned Parenthood be earmarked for implementing current health law requirements and to request that the Bellingham School District contact her, as a parent, regarding any guest speakers that are planned to address the students of the district, specifically on the subject of sex, sexually transmitted diseases, and HIV /AIDS. Dawson asked if Ms. Chappell has received any response from the school district. Chappell stated she has not received any response from the superintendent of the Bellingham School District to her most recent letter. She has been talking with the school district on these issues for the past year and a half. She asked the school district if the Whatcom County Health Department has to go before the district's materials committee that reviews all guest speaker materials. The response was that they were working with the Health Department to work out the details. She wants to know from the school district before these guest speakers come in whether or not the speakers' materials are available to her on the topic. She has not been allowed any access to these materials. Hoag asked if the Health Department presented materials for review, and if the parents are notified. Janet Davis, Community Health Manager, stated she couldn't speak to whether parents are told. That is not part of what the County's activities are. The Health Department provides resources to the school in the form of materials and speakers. She didn't know whether the school district's committee reviews the materials specifically. The Health Department does give its materials to the Board of Health, 10/2/2001, 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 48 schools, and the schools do use the materials. She didn't know why the school district is not responding to Ms. Chappell. Nelson stated the Public Health Advisory Board is discussing the issue of the material. Ms. Chappell has been before the advisory board. The advisory board instructed the staff to bring the materials forward, and will review all the materials to be sure the County is in compliance with the regulations. Hoag stated it is important for parents to know what their children are being told. Crawford stated he received notification from the school district about the information, and he made the decision as a parent about his children getting the information. He was fully informed. Chappell stated this is about guest speakers coming in to access the children. Crawford questioned whether this is about a regular class, without notification of the parents. Chappell stated this is on the topic of sex, STD, and HIV /AIDS in the grade schools. Crawford stated he pulled his children out of the class. Chappell stated Mr. Crawford never received a letter, in the last 30 years, from the Bellingham School District informing him of guest speakers accessing the children and the materials being brought in. Crawford stated that is correct. He received a letter saying that if he, as a parent, wants to know what the kids will be taught, then he would have to attend the meeting. Chappell stated that letter only has to do with HIV /AIDS. Dawson stated that letter is about the written material. It is not about what the speakers will tell the children. The teachers don't often know what the guest speakers will talk about. Chappell stated the school district policy is that any guest speaker must go before the materials committee. Her question to the district is whether the County Health Department has gone through the proper channel, like every other guest speaker in the community, to be approved. Nelson stated the only thing the County Council can do is look at its materials to make sure they are accurate according to the Center for Disease Control (CDC). After that, the County is a public agency. Their materials are open to the public. Whoever wants to access that material can access it. The County can't tell the public how to use the material. Chappell stated the County has a teen clinic going into the school district. Board of Health, 10/2/2001, 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 48 Nelson stated that is upon request by the school district. Chappell stated she wants to see the materials. Nelson stated that is why they are going through this process. Regina Delahunt, Interim Health and Human Services Director, stated there are two issues. One issue is about the material the County provides and if it is appropriate to the community. That is being reviewed. The second issue is the school district policy. That needs to be discussed with the school district. Any information the County has is public information. They will have the information available on the materials at the next advisory board meeting. One issue needs to be taken up with the school board, and the County can address the other issue. Hoag stated there is more that the Council can do than make sure the material is accurate. The Board of Health can request that the teacher's notify parents of any speakers. Nelson stated this is the reason why he argued against the Human Rights Task Force being allowed to go into the schools to advocate diversity and education of homosexuality. It is not the role of County government to interfere with the separate elected body of the school district. Hoag stated she is not talking about advocating a position. She is talking about notifying the parents about the materials. Nelson stated the school district does that. Brenner stated it would not be an imposition for the County to request that the school district notify the parents. The school district would make the decision about whether or not it complies. Hoag stated she would support that suggestion. Delahunt stated they first need to clarify what the school board policy is. Nelson stated school boards have their own boards and budgets. He is not in a position to request or demand that the school boards inform the parents that the material is out there. It is important for the parents to come to the Council to make sure the materials are accurate. Brenner stated the County should not make a demand. The County should make a request of all the school districts. They don't need to research the school board policy. Simply add a sentence to the letter to the school district that is already sent. McShane stated this is a school policy decision for all the school districts in the county. This is an area the Council doesn't know much about. He was notified Board of Health, 10/2/2001, 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 48 several times about programs and materials, and parents were given the choice of removing children from the class. He preferred to know what all the school district polices are. He guessed they are under legal obligation to provide notification. Davis asked that the Board of Health allow the Public Health Advisory Board to continue with their work and make recommendations, then bring the recommendations to the Board of Health. Nelson stated they could do that, and then advertise and hold a public hearing on the materials. Hoag stated it makes sense to review the material through the advisory committee. In terms of parent notification, she did not see the desirability of having to go through an advisory board first. There is no connection. It is a fundamental issue that goes to parenting and public education. They are not demanding or interfering with public education to make this request. The Board of Health should take this position. By not taking the position, they are taking the position that they don't want parents notified. Brenner disagreed that they are saying they don't want parents to be notified. It is a simple request that the school district board can do what it wants with. Brenner moved to add a sentence to the letter that is already sent with the materials from the Health Department to the schools asking that parents be notified. Nelson stated that once they start down this path, even though the cause is good, they will open the door for other causes they don't agree with because they are setting a precedent. He questioned why not take the next step to suggesting or demanding that the Board of Health's point of view be heard. This is what it could lead to. Chappell stated she just came to hold accountability to the school district and the Health Department. The County Health Department should go through the materials committee process. Things are not being done properly by the school district. Hoag stated all they are suggesting is that parents be notified when materials are presented. That doesn't take a stand on an issue one way or another. Davis questioned what topics, if any, would the Board of Health like the note to regard. Brenner stated the note should go on all presentations. Hoag stated they were talking about sexuality issues. Board of Health, 10/2/2001, 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 48 McShane stated that if the Council wants to send out a letter, it should come from the Council, not staff. It is the Council's policy request. Brenner stated her motion would apply to anything that requires the materials committee process at the school district. Mary Rogers, resident, stated the law says the school is responsible to notify the parents of the speakers that come in. Her concern is about what they are approving to give to the schools. She suggested that the councilmembers do their homework about this. There is information that is not being presented truthfully. Abstinence programs are being removed, and curriculum is being presented that is not reliable and safe. Hold the advisory board and Health Department staff accountable for the information being presented that may conflict with information given to students at home. Kids who are taught traditional values should not have to be removed from the class. Brenner restated the motion to include a note in the letter regarding notification of parents for topics that must go to the school district materials committee. Motion failed 2 -4 with Brenner and Hoag in favor. Crawford asked if the Public Health Advisory Board is reviewing the materials. Nelson stated they are. They are also reviewing the most recent information from the Center for Disease Control (CDC). Crawford stated it would be a good thing for the councilmembers to get some of those materials. Nelson stated it would come to the Council. Brenner stated make sure there is a comprehensive approach that includes alternatives. (Clerk's Note: Crawford left the meeting at 11:00 a.m.) 2. 2002 WORK PLAN Regina Delahunt, Interim Health and Human Services Director, stated she would highlight the work plan format so they can walk through it together, then make comments on plan direction for the future, and then talk about one thing they need to add to the plan. The plan is based on the three core functions and ten essential services of public health. Then ten essential services are sorted by core function. Activities Board of Health, 10/2/2001, Page 5 1 performed at the Health Department are listed according to the ten essential 2 services. The plan is arranged by division. Each program description includes a 3 program vision. The vision is what they would like to see in the community, and 4 gives them a reason for the program's existence. There is an indicator table that 5 provides information on the magnitude of the issue in the community. The plan 6 arranges the activities as new, priority, and standard on -going activities. At the 7 end of each division, there is a section on the progress made to the 2001 goals. 8 Also at the end of each division there is a budget page reviewed by the Public 9 Health Advisory Board. 10 11 The annual work plan is a work in progress. She is calling this a 2002 work 12 plan. It is an annual work plan that lets the community, board, and staff get a feel 13 for the focus for 2002. The indicators are not ideal, but they are what they have 14 now. They will continue to work toward measurable outcomes, which are difficult to 15 quantify. It is difficult to know if the actions they've taken are significant to change 16 the health status in an area. In 2002, she would like to expand this plan beyond 17 the work plan concept and look at it in a strategic planning way. Think about long - 18 term public health needs in the community. Prioritize the programs and see what 19 new programs are needed in the future. Look beyond the next couple of years. 20 The County administration would like the County as a whole to look more 21 strategically at all of its programs. In light of the attacks on September 11, they 22 need to add another activity to the work plan. Make sure that public health is 23 ready from a homeland security position. They do have emergency response plans 24 in place, and they have worked with Emergency Services on the communicable 25 disease response. The County needs to follow the things that are happening at the 26 federal and state levels. Make sure local planning is here and ready to go should 27 they ever need to use it. 28 29 Nelson stated the Health Department staff were working within budget 30 guidelines, and developed this budget with no increase. Staff did a wonderful job. 31 There were three meetings with the advisory board. Many changes resulted, such 32 as many of the indicators changed from percentages to hard numbers. 33 34 Brenner asked that the emergency management plan include what St. 35 Joseph's Hospital has done to make sure they are ready for any biological 36 problems. It is important to make sure the hospitals have a plan. Delahunt stated 37 the plan would include what is available in the community. They have been 38 sending information to hospitals and physicians about bio- terrorism and different 39 things to look for. 40 41 Hoag stated one goal in the past was pursuing the affects of air pollution on 42 public health. That is not included in the ten essential services. The Canadians 43 have statistics available about increased heart disease and asthma levels due to air 44 pollution. This is a major public health issue, but it is not included in the plan. 45 Delahunt stated they do not have an air quality program at the local health 46 jurisdiction. 47 Board of Health, 10/2/2001, 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 Hoag stated that the State Department of Health has an air program. The Public Health Advisory Board said it is something they want to look at. She asked how they get air quality into this plan. The Northwest Air Pollution Authority (NWAPA) does not cover it. No one is looking at the health impacts to the community or informing the community. Delahunt stated they just this week hired an assessment person for the department. That person could take a look at Whatcom County statistics in relation to air pollution and diseases. Hoag stated they have to do more in -depth reporting than just looking at the local hospital. The greatest concentration is in areas where there are not hospitals. Delahunt stated the County does not have the capacity to do a study of that depth. The staff could take the initial look. Without the assessment coordinator, they have not been able to look at air quality locally. Brenner stated NWAPA is not very responsive to complaints. She asked who people should call on nights and weekends. The County Health Department needs someone on call for problems that are not being addressed after hours. Delahunt stated they don't have an on -call system. It would be through 911. That is how people get through to the Health Department. Nelson stated the sheriff responds to all laws, but on a priority level. Brenner stated the problem with the mushroom composting and infectious waste has been going on for a month, and its getting worse. NWAPA takes a few days to respond. (Clerk's Note: End of tape one, side A.) Brenner stated she is getting phone calls from people complaining about the smell. The calls come from people on Smith Road and as far north as Portal Way. Nelson suggested that they report the calls and complaints. Show the history of complaints to NWAPA to show there is a problem. An assessment person can do an evaluation. Brenner stated NWAPA has all that information. They are not doing anything. This problem affects peoples' health. Nelson stated the history of the Health Department was to determine the cause and effect of health problems. Delahunt stated that is still a big part of what they do. Nelson stated they should assure the public and make the public aware of cause and effect. Dawson asked if the Recomp autoclave and mushroom composting works on the weekends. Delahunt stated she thought it did work on the weekends, but it Board of Health, 10/2/2001, 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 48 varies depending on the waste that is being processed. She agreed that the problem has been with both facilities. Brenner stated it is not supposed to stink off -site, and the residential area was there first. Delahunt stated the Health Department has no jurisdiction over the mushroom facility. It is an agricultural activity, not a solid waste facility. McShane stated it is a fundamental question of whether they want the Health Department to get involved in air quality issues. He hears some dissatisfaction that NWAPA is not serving the county the way they like. Air quality is a significant program increase that would require personnel and budgeting. It is a matter of policy guidance. Hoag stated this is not NWAPA's function. Their function is regulatory to determine whether people are meeting standards, and to apply those standards to the permits they issue. They do not serve the role of assessing the impact to people's health. Look at whether air contaminants have an affect on people's health. Nelson stated they should determine if there is a significant statistical difference in public health issues regarding asthma, emphysema, and lung disease in Whatcom County, comparable to other counties. He didn't know if that information is available. Delahunt stated that is the type of information they could get with the new personnel. The department doesn't have the capacity to do the more complicated analysis without having a program in place with personnel, or requesting that the state take a look at the issue. Hoag stated that if they look at the county as a whole, they will not uncover the kinds of statistics they need to truly help people. A large part of the county lies along the ocean and gets nice, clean air. The contaminants get carried inland. Delahunt stated that type of study is complex. It would take quite a bit to come up with the answers. Nelson stated they need to move on with the plan review. Delahunt asked if there are questions on the environmental health programs. Brenner asked why the county rates of giardia are higher than the state rates. Delahunt stated there are a number of reasons. People may be more aware of it here, and test for it more often. The other reason is that there is a lot of outdoor activity in this community. The food program shows a high rate of campylobacter in the county because this is an agricultural community. Brenner questioned the information in the living environment program, Council packet page seven, items six through eight regarding injuries and drowning. Drowning seems like the jurisdiction of the Parks Department. Injuries Board of Health, 10/2/2001, 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 48 are not so much a public health issue. There are some other issues that seem more fitting for the Sheriff's Office or Parks Department. Delahunt stated it depends on one's view of health issues. A lot of what they do deals with injury prevention, such as around swimming pools to prevent drowning and to promote safety. Brenner questioned Council packet page 10, item 12. Use newspapers for advertisements. Get the newspapers to do public service announcements. Delahunt stated they plan to do a newspaper insert this year that has been done in other counties. It was very effective. The insert talks about onsite septic systems, wells, and water quality. They also mail out information. The idea is to flood the community with information to keep it in people's minds. That is most effective. Nelson stated mail outs are the most effective. Hoag compared the personnel and budget on page eight, the living environment program, and page 11, the onsite sewage program. The living environment program has a total program cost of $71,000 and a .95 fulltime equivalent (FTE) employee. The onsite sewage (OSS) program has 5.35 FTE's and a budget of $501,434. Air affects all the people in the county. OSS affects only some of the people. It is an appropriate place from where to pull money and staff. Delahunt stated it depends on how many building permits to issue and the number of onsite systems they want to make sure are operating. If they pull people from the OSS problem, it will become an issue. There are many subtopics under the living environment section. They have almost no staff. It is tough to do this program. Hoag stated it wouldn't take more than one person to get good information on what is going on. Delahunt stated it is something the Public Health Advisory Board and County Council can talk about. Hoag stated they need to step back and prioritize. Delahunt agreed. That is part of the strategic planning she wants to do. The department has many programs. They do the programs and do a good job, but it is important to step back and look at the priorities. If they did that, air quality might be a priority that comes up. Hoag stated they did that with the advisory board. The advisory board universally agreed it is an issue. Brenner stated don't cut back on OSS. The living environment program is not a good comparison to OSS. The living environment program is a catchall program. If they are going to work on air quality, they need a separate air quality program. She would like to know how many products are being provided in each program. She would like to see hard numbers. Dawson moved to direct the new Health Department assessment person to work on air quality comparisons and analysis in Whatcom County and the state. Board of Health, 10/2/2001, 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 48 Delahunt stated they would look at air quality and diseases, and recommend further steps. Motion carried unanimously. Brenner questioned Council packet page 12, regarding complaints on solid waste activities. The number of complaints is not accurate. Include NWAPA's number of complaints relating to solid waste facilities. Nelson asked whether the sharps collection issue was resolved. Delahunt stated it will come to the Board of Health. Staff went to the Public Health Advisory Board with a recommendation on how to institute a sharps collection station. The issue is with private, residential sharps versus commercially generated sharps. Staff will put together a memo for the Board of Health regarding the advisory board recommendation and when it will come to the Board of Health. They will talk about it at the December Board of Health meeting. Brenner questioned Council packet page 13. She asked if they are doing anything beyond just making it a law regarding treatment of level three stocks and cultures on site. Labs are still sending untreated level three stocks and cultures. She didn't know if they are coming directly here. She asked what the County is doing to assure that untreated stocks and cultures are going somewhere else. Delahunt stated she presented information at the previous Board of Health meeting about all the people and labs they've contacted outside of Whatcom County, including British Columbia and in Washington State. Brenner asked where she got the list of all the labs in Washington and Canada that are taking their waste to Recomp. Delahunt stated she contacted the Ministry of Health in Ontario about all the laboratories in British Columbia. She called the laboratories to find out about their onsite treatment capacity. She never got a list from Recomp. Brenner asked about Council packet page 16. She questioned how many ranked contaminated sites are awaiting cleanup. McShane stated there is a list of no- further action sites. Brenner asked to see that list. Delahunt stated some sites on the list have been cleaned up. Other sites were evaluated and found not to be contaminated, and were removed from the list. Brenner asked about Council packet page 20, regarding the food protection section. She asked about the number of cases of Ecoli, salmonella, and other food - related illnesses they've investigated. She also questioned how many people are taking advantage of onsite sewage loan program. Under the chemical physical hazards section, she questioned how many people are aware of the program. Get the information out if not many people know. Delahunt stated she would provide Board of Health, 10/2/2001, 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 the answers to Councilmember Brenner's questions. Regarding the chemical physical hazards, they visited most or all of the auto recyclers in the county. Davis presented the Community Health Division programs. Brenner asked about Council packet page 21. There is not a correlation between the rate of late pregnancies and low birth rate in the chart. Davis stated that is correct. Brenner stated there is a higher- than -state average for people not getting prenatal care in late pregnancy. However, there is a lower than average rate of low birth rate. Davis stated the two are not necessarily related. It also has to do with culture and access. This data comes from the birth certificate, which asks women when they first see their physician. Prenatal care is a larger picture than first seeing an obstetrician or family practice physician. There is a good system in this county of maternity support services and maternity case management. Women see care providers before the physician. The data is misleading, but when comparing data across the state, they have to collect the same data that is collected around the state. She could add a definition of "prenatal." Brenner asked what First Steps is. Davis stated it is a maternity support services program funded by Medicaid. The program hooks someone up with medical care. Brenner questioned Council packet page 22, item eight. It should say "collaborate with Bellinghang and ethe,F all county school districts." The current language does not ensure that all school districts are involved. Nelson questioned what the comprehensive service program for pregnant teens is. Davis stated the model is what they use with the Bellingham School District. It is their model. The Health Department provides public health nursing, connection, and case management associated with the First Steps program. They go to where the teens are at school, and make sure they make their appointments and are signed up for the Women, Infant, and Children (WIC) program. They go to the site where the teens are gathered. Brenner questioned Council packet page 27. Hepatitis B is a bloodborne disease, even though it is also a sexually transmitted disease (STD). It should not be listed on the STD page. HIV is not listed on the STD page. There are many ways to catch it. It is not predominantly a STD. Davis stated the separation of STD and HIV is because of the differing funding streams. They can put Hepatitis B in both programs or in one or the other. They are trying to target the people who come in with STD and tell them about Hepatitis B being a STD. Brenner stated that is fine, but, it is not listed under bloodborne pathogens. People should not think the only way to get it is through sexual contact. Board of Health, 10/2/2001, Page 11 1 2 3 4 5 6 7 8 9 10 it 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 Brenner questioned Council packet page 31, item ten. She was not comfortable with the language, and it should be amended, "...n9en having sex With nee persons having unprotected sex." People have unprotected sex is the highest risk group. Davis stated there is an identified funding stream, and they are required to target specific high -risk groups. Men who have sex with men is the highest risk group. The Center for Disease Control (CDC) requires the Health Department to target activities. Perhaps those men are not getting the message and their behaviors are not reflecting that they understand what the risks are. The Health Department staff uses the work plan for multiple purposes. That verbiage is part of the CDC requirement. The correct language should say, "...men who have having sex with men..." Nelson stated unprotected sex does not guarantee that one won't get STD's. Councilmember Brenner's suggested language suggests that protected sex completely protects a person from STD. This is statistically based. McShane stated staff is saying that funding is available for this specific target group. Politics play into that. Davis stated the CDC is looking at the United States as a whole and directing their activities based on those numbers. Perhaps locally the situation is different, but they have to respond to that funding stream. McShane questioned whether the Health Department would have to do something separately if there is a unique population here. Davis stated they would. Brenner questioned Council packet page 38. She would like the County to investigate starting immunization plans in the schools again for smallpox and possibly anthrax, in response to the terrorist activities. It takes awhile before these things work. Communities should investigate whether to begin that program, and then add the anthrax. It should be explored. Hoag stated doing that on a comprehensive basis is huge compared to the risk that is out there. It makes more sense to respond to the individual incidents. The vaccinations are not without their own risks. Nelson stated smallpox has mostly been eradicated. Only a small number of countries have the virus in storage. Brenner stated they should evaluate the issue. Delahunt stated the CDC is looking at bio- terrorism potential and what public health agencies need to have in place. There is no reason for Whatcom County to begin looking at whether there should be anthrax vaccinations in school. Whatcom County will follow the federal lead. Hoag stated there are eight central locations in the United States where anthrax is available. If there is an attack, they rush in the vaccinations. Board of Health, 10/2/2001, Page 12 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 48 Brenner stated there is not enough available. It takes 18 months for anthrax to be prevented. Davis stated she is a captain in the Army reserves. She is confident that the distribution method is in place through the Army. Hoag stated they don't have enough in these places. What was sent to New York was enough to do 10,000 people. If the terrorists had released anthrax, there would have been more people than that affected. However, she didn't think that is the correct response. Davis stated she didn't mean there was enough. She meant that the system would be used. McShane stated there is a drop -off of about 1,000 doses of vaccines administered. Davis stated that is correct. They no longer provide direct clinics to do flu vaccines. Visiting Nurse, pharmacies, and other providers took that over. McShane asked how the Health Department works with Western Washington University in terms of measles, and if they still require immunizations. Davis stated they do. Nelson stated Whatcom Community College also requires immunizations. Davis stated there was a push to get all colleges on board with requiring all immunizations. (Clerk's Note: End of tape one, side 8.) Brenner questioned Council packet page 48. It would be nice to have hard numbers. Get information next time on skin testing, health and safety assessment, and nutritional consultation. Brenner questioned Council packet page 49 and asked what "VOA" is. Andy Byrne, Human Services Manager, stated it stands for Volunteers of America. Dawson asked what the youngest age is for involuntary admission. Byrne stated age 13 is the youngest age for involuntary hospitalization. Parents would hospitalize children who are younger. The parent of a 12 -year old can hospitalize a child with the agreement of a mental health expert, without the child's say. As soon as the child turns 13, the parent does not have anything to say about hospitalization if the child doesn't want to go. If the child 13 years old or older doesn't want to go to the hospital, then the child becomes subject to the involuntary treatment act rules and responsibilities. Someone else has to decide whether the law applies to the 13 -year old. (Clerk's Note: Crawford arrived at I2 :10 p.m.) Brenner asked if face -to -face contacts listed in the plan are repeat contacts or first time contacts. Byrne stated it should say face -to -face crisis contacts. They could be repeat contacts. They could say next time the number of repeat contacts. Board of Health, 10/2/2001, Page 13 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 48 Brenner referenced Council packet page 50, item seven under the ongoing section. She wants to see hard numbers. Brenner questioned Council packet page 53. She questioned whether it is a mistake that the number of people in the developmental disabilities program waiting for the day program is none. Byrne stated the number waiting now is 30. The County- funded day programs begin when someone turns 21 years old. As of December 31, everyone was being served. Since January 1, more people have turned 21 and more referrals have come in. They are working now to get new people off the waiting list. They are serving more people, but there are more people to serve. Brenner asked for the number of people on the waiting list for the other developmental disabilities (DD) programs. She was on the DD board for a long time, and she recalled that the waiting list was long. Byrne stated they used to have that information, but it was misleading. If someone is waiting for a DD program, the information didn't specify what program the DD person is waiting for. Brenner suggested one number that includes all the people on the waiting lists. Byrne stated the numbers are identifiable. Hoag asked if one has to be a citizen of the United States to be in the DD program. Byrne stated that if one is enrolled in a County- funded program, that person has to be already enrolled in the State Division of Developmental Disabilities enrollment program. They do the eligibility determination. He believed one has to be a resident of the state. Brenner questioned Council packet page 54, item nine. Change the wording, "Increase outreach to and inclusion of ethnic n9inei=itOes on all sei=viees pFevided to all in the developmentally disabled community." The program needs to be more inclusive of all, not just ethnic people. Nelson stated item ten already says the same thing. The goal of item nine was to specifically identify minorities who are sometimes difficult to find. There are several reasons they deal with that in the mental health arena. There are cultural and social issues that will sometimes deter them from getting services. There may not be the appropriate outreach programs. They need to help the tribes, for example, to work with their own people. This item identifies how to get the message to the ethnic groups. Brenner stated the term "inclusive" means ensuring that they can participate, not going to look for them. Byrne stated they may need to do some wordsmithing here. Nelson stated item nine is about reaching out to minorities. Brenner stated that is fine. Just include outreach in number ten. Board of Health, 10/2/2001, Page 14 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 Brenner questioned Council packet pages 56 and 57, and the percentage of clients who successfully complete treatment. The percentage has stayed static and low. Item ten talks about improving access to treatment agencies as an ongoing activity. She questioned why the success rate isn't up. Byrne stated that was a good question. A person tries to quit drinking many times, but the last time it sticks is considered successful. Many people come back multiple times. Also, they look at completed treatment, which is defined as completed, rather than as successful. Brenner stated they should see an improvement when they improve access. Byrne stated he has noticed that issue. They need to do more activity in this county on quality assurance and best practices to increase access. Crawford stated they also have to monitor the data from the contractors, which they rely on. Byrne stated statewide data is not reported in the same way, and may not be comparable. The treatment completion rates are not off the national norms. They need to look at what to do with substance abuse treatment to increase efficacy. Brenner questioned Council packet page 61. The percentages don't seem to match the numbers. In Whatcom County, there seem to be a higher number of arrests for alcohol and drug violations, but there are fewer than the state level of kids who are favorably disposed to drugs and alcohol. Nelson stated Whatcom County is on the Interstate 5 corridor. Davis stated arrest data is where the arrest occurs. The people may not be local, but they got arrested here. Byrne stated different counties have different arrest rates. Crawford stated it may mean that Whatcom County has better law enforcement here. Byrne stated it is favorable that the attitudes among the youth are dropping. Crawford stated he invited the president of the local chapter of People First to make a presentation to the Council, possibly in November or December. The presentation from People First is about the current state of developmental disabilities programs in Whatcom County. Brenner moved to recommend approval of the 2002 work plan, with the suggested changes. Motion carried unanimously. Board of Health, 10/2/2001, Page 15 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Delahunt stated the Board of Health members should have gotten information about the local Board of Health leadership workshop on October 25 and 26 at the Radisson Hotel in Sea -Tac. Nelson stated it is an excellent program. ADJOURN The meeting adjourned at 12:25 p.m. Jill Nixon, Minutes Transcription These minutes were approved by Council on October 23 , 2001. ATTEST: Dana Brown - Davis, Council Clerk WHATCOM COUNTY COUNCIL WHATCOM COUNTY, WASHINGTON L. Ward Nelson, Council Chair Board of Health, 10/2/2001, Page 16