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WHATCOM COUNTY COUNCIL
Board of Health
September 14, 1999
The meeting was called to order at 12:30 p.m. by Council Chair Marlene
Dawson in the Council Chambers, 311 Grand Avenue, Bellingham, Washington.
Also Present:
Kathy Sutter
Connie Hoag
Barbara Brenner
Robert Imhof
INTRODUCTION
Absent:
Tom Brown
L. Ward Nelson
Chuck Benjamin, Health and Human Services Director, introduced members
of the Health and Human Services Department staff and members of the Public
Health Advisory Board.
HEALTH AND HUMAN RESOURCES THREE -YEAR PLAN
Benjamin stated this was the three -year plan for the year 2000. The main
components are program title and cost centers. The goals are the long -term goals
for the Department, the objectives are what they need to accomplish in the three -
years, and the activities are annual. They do not take the time to list out every
activity or program they do. They try to prioritize the activities within the
programs. There are indicators in the plan that illustrate various indicators needed
to accomplish the goal. They also list the personnel linked to each goal and allocate
the cost for each goal. For the first time, they have included the administrative
cost for the particular program. He explained the diagrams in the plan.
Dawson asked if the domestic violence program was funded in full by grants.
Benjamin stated it wasn't. All of the motor vehicle excise tax money is distributed
into administration so it gets distributed proportionally across the programs.
Benjamin stated the items underlined in the document are the changes from
the previous year. They will go through and discuss the underlined items only.
Hoag asked about the Maternal /Infant Program on page 7 and the number of
women under 185% of the federal poverty level (FPL). She questioned whether the
women were mostly younger women.
Board of Health, 9/14/99, Page 1
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Kay Guirl, Personal Health Services Manager, stated this reflects the
population they can collect data on. It includes adolescents as well as married
women who are eligible to receive maternity support services through Medicaid.
They are in the process of determining the risk factors for this group.
Hoag asked about the activities in Objective 1. Benjamin stated that activity
is not new. They were in the plan previously.
Guirl stated that previously the objective was for reducing unintended
pregnancy across the population. It is now focused on the women they work with.
Hoag stated they need to discourage unintended pregnancies with women
who have money as well, not just those that don't have money.
Sutter stated the problem would be that the Health Department doesn't
come into contact as readily with those women who have money. They don't come
into the Health Department.
Guirl stated the Health Department can't be held responsible for those and
can't collect the information to document the changes. The population of women
under 185% of the FPL is a population they have data on and could track changes
fo r.
Hoag stated they may not be able to assess the entire community, but they
should be addressed. Guirl stated they still are addressing the entire community
through other programs. The Health Department participates on a State coalition
trying to address the unintended pregnancy. It is a priority at the local and State
levels. In this three -year plan, they were focusing on specific activities that they
are doing.
Dawson stated the Council is asking the Health Department to bring back
measurable, changed objectives. They can't get measurable information on certain
parts of the population regarding this issue.
Hoag suggested in the future the existing objective also be provided, so they
can compare the changes. She also suggested leaving Objective 1 the way it was,
to reduce unintended pregnancies across the board, and move the new proposed
objective to one of the activities. That way, it doesn't remove the goal of
addressing unintended pregnancies across the board.
Guirl stated the goal stays the same.
Hoag stated Goal 1 just says, "...shall occur under circumstances of lowest
risk." Guirl stated that was the language put in a year ago, and were asked to
remove from the goal.
Board of Health, 9/14/99, Page 2
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Hoag stated that was incorrect. They were asked to remove language about
"choice," which is a different thing.
Benjamin stated the 1999 work plan wording for goal is the same.
Hoag moved that Objective 1 not be changed. The proposed Objective 1
should become an activity.
Sutter stated the problem is they don't know if they reduced the percentage
if they can't measure the results. They don't know if they can measure the result.
Hoag stated then they should leave out the percentage.
Dawson stated they have been looking for measurable objectives.
Brenner suggested adding to the goal, "...to reduce the percentage of
unintended pregnancies." Benjamin stated they don't know what the percentage is,
and they won't know the percentage later.
Brenner stated they would be working on a specific activity or objective to
reduce the ones they do know about. They would be saying that wherever possible
they would reduce the percentage. It does not have to be number - specific.
Dawson stated they have to have measurable goals.
Hoag re- stated the motion that the objective would be to reduce unintended
pregnancies in Whatcom County, and the proposed objective would become an
activity specific to women under 185% of the FPL.
Imhof stated that is not an activity.
Brenner proposed a friendly amendment that Objective 1 be, "To decrease
unintended pregnancies in Whatcom County. By the year 2003, decrease the
percentage of unintended pregnancies of women under 185% of the FPL in
Whatcom County to 60 %."
Hoag accepted the friendly amendment.
Motion failed 2 -5 with Brenner and Hoag in favor.
Hoag moved to have Objective 1 be to reduce unintended pregnancies in
Whatcom County and have the objectives in the packet be Objectives 2 and 3.
Sutter stated they couldn't measure it.
Hoag stated they don't have to.
Board of Health, 9/14/99, Page 3
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Dawson stated they have asked over and over again that the departments
produce measurable objectives.
Motion failed 2 -5 with Hoag and Brenner in favor.
Benjamin stated pages 9 -13 are the program plans for Child Health. Under
Goal 1, Objective 1, Activity 1, there is a change regarding Bright Futures
standards.
Guirl stated this is a widely used standard of care for children. Currently,
several agencies will put together a planning group to implement the program as a
community -based system. They will be able to connect the doctor's office with the
social services agencies.
Hoag asked to be provided with more information on this program.
Sutter asked what "ECAC ". Guirl stated it is Early Childhood Assessment
Clinic.
Benjamin moved to Objective 2, Activities 5,6,and 7. The website referenced
in Activity 5 is available. They are receiving State recognition for the website.
Guirl stated the State is going to use the website as a basis for a statewide
website.
Hoag asked who would publish the child health notes. Guirl stated the
County would publish and distribute the information.
Hoag asked what information would be covered in the child notes. Guirl
stated the primary information is for physicians to become aware of social services
available in the County.
Benjamin moved to Goal 2, Objective 1, Activities 1 through 4.
Hoag asked what the previous objective had read. Guirl stated the previous
objective addressed immunization rates and communicable disease in childcare
centers. Those are issues they continue to address, but there are additions to the
health and safety standards required of childcare centers, especially to services
provided for infants.
Brenner asked about Objective 3 under Goal 2. Guirl stated it is a new
objective. They received new money to identify families that are eligible, but not
receiving services.
Hoag asked about the length of the grant. Guirl stated it was from October
1998 to December 1999. The federal government is going to allow the State to
spend the money through March 31. The intention would be to develop a
community -based system that would continue the activity after funding is gone.
Board of Health, 9/14/99, Page 4
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Dawson asked about page 12, Activity 2. Guirl stated they would like to
have a tool to document the development of parenting skills of their clients.
Sutter asked about the indicators on page 12. She suggested it be a goal to
follow up with the juvenile offenders who don't complete the Hepatitis B vaccine
series. Guirl responded the youth don't stay in juvenile detention long enough to
complete the vaccine.
Sutter asked if there is a mechanism to follow up and give them the rest
once they are out of juvenile detention. Otherwise, they are wasting the vaccine
the juveniles are given, if they don't complete the series. Guirl stated one goal has
been to develop a follow up system and work with the youth when they leave.
Dr. Greg Stern, Whatcom County Health Officer, stated that regarding the
immunization of adolescents, the idea is to complete the series as much as
possible. If they are getting the shot, they are up -to -date as of that point. They
would have partial protection. There is also a community -wide registry project that
would allow a mechanism for following up with the children.
Benjamin stated follow -up would be a problem in terms of staff resources.
Hoag asked about the objective regarding increasing the proportion of
adolescents. The indicators don't show the proportion. She wanted more
information on the numbers in detention and those receiving the vaccination. Also,
she didn't want staff chasing these people down in the community. There is
controversy over Hepatitis B.
Stern stated it was not Hepatitis B, but the thimerasol preservative in the
Hepatitis B vaccine that is to keep the vaccination fresh while in storage, which has
been the center of the controversy. Thimerasol is a mercury compound. The
dosage problem wouldn't apply to the adolescents.
Brenner questioned if it would be better to give the juvenile the information
about getting his or her next shot.
Hoag asked about the changes on page 14 and the different numbers. Guirl
stated they are new numbers. The changes reflect the changes in priority from a
focus on the children instead of the women.
Sutter asked where they came up with the numbers that are used throughout
the plan. Benjamin stated they are estimations from previous years.
Sutter stated that gets into the issue of when they are trying to accurately
measure progress.
Imhof stated the following year they would reflect the new numbers.
Board of Health, 9/14/99, Page 5
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Guirl stated they have an authorized caseload of 2,100 from the State
Women, Infant, and Children (WIC) program. There are priorities of cases. The
Health Department adjusts the caseload as they need to.
Brenner asked if the specific numbers are based on the previous year's
numbers. Guirl stated that was correct.
Sutter asked about page 19, Objective 2. The goal needs to be changed to
reflect the higher indicator rate. Benjamin stated they would increase the objective
to 95%
(Clerk's Note: End of tape one, side A.)
Brenner asked about Objective 3 on page 22. She questioned how they find
"all" children.
Dawson asked if "suspected," meant reported.
Hoag moved to strike "all" and change "suspected" to "reported" in Objective
3 on page 22.
Sutter stated if they remove "all," then they are eliminating the objective
altogether. They do want to deal with every one of the children. That is the goal.
This can be measured.
Hoag stated it could only be measured if they change "suspected" to
"reported."
Stern stated they need to remember that all kids that are suspected of being
victims of sexual assault have to be reported. They could focus the definition, but
the intent is that 100% of suspected abuse be evaluated. Mandatory refers to a
suspicion. If they change the term to "reporting," then it is confirmed there is
abuse.
Hoag amended her motion to say, "reported of being suspected."
Motion failed 3 -2 for lack of a majority of the entire Board of Health, with
Sutter and Imhof opposed.
Sutter stated she would approve language that was less cumbersome.
Brenner questioned the previous language for Goal 1, Objective 1, Activity 1
on page 24. Guirl stated the Activity 1 in last year's plan was to conduct two
healthcare provider education programs about tuberculosis (TB). The other
activities, 2 through 4, are exactly as they were last year.
Board of Health, 9/14/99, Page 6
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Brenner questioned Goal 1, Objective 2, Activity 1 on page 24. She
questioned whether it reflected an increase in visits. Guirl stated the activity last
year is less broad, and didn't include all the visits.
Sutter questioned the indicator for that item, and stated those completing
active treatment with TB is 100 %. The preventive treatment is only 64 %. Guirl
stated that was correct. They are investigating the reasons for that low
percentage.
Sutter questioned page 28, Indicator #3. She asked about the jump from 10
to 150. Guirl stated it reflects a change in the standards of practice. Obstetricians
are now required to investigate.
Hoag asked about whether the programs in Goal 1, Objective 1, Activity 2 on
page 26 include abstinence education. Guirl stated they do.
Sutter asked about the indicator on page 32. Guirl stated malaria was an
indicator disease.
Dawson asked about Activity 3 on page 31 and how many issues have been
published in the past. Guirl stated that last year they published five. This year
they may complete six. The primary recipients are the physicians in the
community. It reminds them about certain diseases that show up at a certain time
of year.
Brenner asked if the County was responsible for reporting all communicable
diseases. Guirl stated there is a list of the diseases they have to report.
Dawson asked if the "Communicable Disease Report" is something the
doctors are requesting. Guirl stated the Department used to publish the report,
then they stopped for a few years because of a lack of funding. There have been
requests for that information from the doctors. They used to publish the report
monthly.
(Clerk's Note: Imhof left the meeting at 1:30 p.m.)
Sutter asked if there is a State requirement for water supplies serving
greater than 100 to have a wellhead protection area.
Regina Delahunt, Environmental Health Services Manager, stated there is.
Sutter asked if there are only 3.5% in the County that have them. Delahunt
stated there are caveats associated with the regulation. It may only be for systems
that are required to have a water system plan and serve over 100 people.
Sutter suggested that activity 4 say, "...of those required to." Delahunt
agreed. However, the County statistic is still very low, compared to the number
that should be required. They can clarify activity 4.
Board of Health, 9/14/99, Page 7
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Sutter asked why only 10% is the goal for that activity. Delahunt stated
they were hoping to get at least 10% of them in the year 2000.
Hoag asked that the two groups, those serving greater than 100 people and
those requiring a water system plan, be separated in both the indicators and in
Activity 4. Delahunt stated they could.
Benjamin stated Activity 4 on page 35 was changed because they developed
the database in 1999, and now they just want to maintain it.
Brenner asked if they just now added fluoride levels to Activity 7 on page 35.
She believed the County was already investigating coliform contamination in
shallow wells. Delahunt stated they want a specific investigation to sample shallow
wells and look at the factors that may be causing the increase in bacterial
contamination.
Hoag stated larger water systems have had to begin using chlorine, even if
they have low coliform counts. Chlorine causes degradation of the water. Delahunt
stated she was unsure of the change in the requirements.
Sutter questioned why it would make people ill. Delahunt stated it is
possible the water system used too much chlorine. They need to look at the
individual system.
Dawson asked about fluoride. Delahunt stated they want to investigate the
areas in the County where it occurs naturally in deep wells, then educate the
dentists about not prescribing fluoride supplements to children in those areas.
Dawson asked how they would investigate. Benjamin stated they have been
able to map the fluoride in the water. Stern is getting that information to the
dentist. The original information has come from the water associations.
Stern stated those areas include Lummi Island, Sumas Mountain, and other
locations.
Sutter asked about what constitutes a pesticide incidence as referenced on
page 44, Indicator #2. Delahunt stated an incident would be an incident reported
to the State incidence tracking system. It would be an exposure to a pesticide.
Hoag asked about increasing the public meetings, as referenced on page 41.
Delahunt stated the increase in workshops was from 8 this year to 16 next year.
Chris Chesson, Environmental Health Supervisor, stated this is in response to
the Operations & Maintenance (O &M) program and an interlocal agreement with the
City of Bellingham. They felt they needed to get out more in the community as a
part of the proactive education campaign.
Board of Health, 9/14/99, Page 8
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Delahunt stated they would talk with neighborhood associations, granges,
and other's who would like to hear a presentation about O &M.
Hoag asked about testing 6,000 food workers, as referenced on page 42.
Delahunt stated that was an increase from 5,100. It reflects an increase in the
number of people working in food service.
Sutter asked about the indicator under Objective 3 on page 48. Delahunt
stated schools are not required to let the Health Department do inspections. They
have to be invited. They are not invited as much as they like. The Health
Department can go in on a complaint. They have been trying to develop a
relationship with the school districts.
Sutter asked about the statistics under Objective 4 on page 53. She asked
about the admissions at Western State Hospital and State hospital admission
averages. Benjamin stated those numbers need to correlate. He would find out
the correct statistics.
Hoag asked about the doubling of the statistic on page 56, the last indicator,
for Whatcom County as projected for 2001. Benjamin stated there are a number of
new systems being put in place throughout the region. There will be a better
tracking system to refer people more effectively. He would confer with John
Hooper, Human Services Manager.
Dawson asked about the new crisis response systems. Benjamin stated
there is a new 800 number people can call. Before that, there were questions
regarding a proper response of crisis calls. That is why they went to a region -wide
contract for crisis services. Also, the State required a single number within a
region. The call goes to a professional counselor.
Hoag asked about Activity 4 on page 57. Benjamin stated they currently
issue transportation passes to those coming in for treatment.
Brenner asked about Activity 6 on page 58. Benjamin stated the Activity 6
intent is to work with a client before it becomes a crisis, through the effective
utilization of case management.
Brenner stated she believed they were missing some major components of
triage. Benjamin stated they would be looking at a Pierce County model as an
option for Whatcom County to handle triage.
Brenner asked if there is already a triage set up in Whatcom County.
Benjamin stated there is for mental health, but not for substance abuse.
Brenner stated the Mental Health Board was told there isn't a triage system
set up that has all the necessary pieces. Benjamin stated they don't have a
multiple diagnosis triage center. They do have a mental health triage through the
crisis services hotline, but it is not multiple diagnosis.
Board of Health, 9/14/99, Page 9
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Hoag asked Benjamin to explain activity 6 and what specifically they are
trying to do. Benjamin stated they are trying to keep inebriates in treatment
through more effective case management.
Hoag stated it sounds like they are trying to get them out of the system.
Sutter suggested, "Reduce need of services by chronic inebriates..."
Benjamin stated they would work on the wording.
Sutter asked, on page 60 -61, if Meridian School District is the only school the
County contracts with to reduce substance abuse risk factors. Benjamin stated
there are negotiations going on with other schools.
Hoag asked about the divorce rate and the problem getting State numbers.
Benjamin stated if they want State numbers, it takes about two years to get them.
Dawson asked about Activity 4 on page 63. Benjamin stated it should be
"maintain" or `continue," not "initiate."
Sutter asked if seatbelt complaints would include State Patrol review.
Benjamin stated the survey would include volunteers on corners who watch people
going by.
Hoag asked if the County addresses the driver's education that students
receive from school. Benjamin stated the County doesn't have that authority.
Hoag asked about the Community Health and Safety Fair, and suggested
running a driver's education crash film at the school Health and Safety Fair.
Benjamin stated they do a mock DUI.
Hoag stated the mock DUI only addresses DUI situations, not bad driving.
Sutter moved to approve the plan, as amended.
Motion carried unanimously.
ON -SITE OPERATIONS AND MAINTENANCE
Chris Chesson, Environmental Health Supervisor, stated regulatory changes
are in response to implementation of the operations and maintenance (O &M) work
plan for on -site sewage (OSS) systems, which was approved by the Health Board in
April. The Public Health Advisory Board (PHAB) reviewed and recommended the
changes. A State Environmental Protection Act (SEPA) Determination of Non -
significance (DNS) was issued. There are two categories of changes. The first is
the O &M program. There is a certification of O &M specialist section. There is an
Board of Health, 9/14/99, Page 10
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aerobic treatment unit component for this section, which requires property owners
to obtain and renew an aerobic treatment unit service contract. If they don't renew
that contract, a notice will be placed on their title. Aerobic treatment service
providers should submit a report of their inspection results to the Health
Department, so they can address any identified failures.
(Clerk's note: End of tape one, side B.)
Chesson continued to discuss the septage pumpers' reports and the Health
Department having access to their records. They've also added additional
regulatory changes to streamline the existing permitting process and also to bring
some existing OSS design standards into compliance with current Washington State
guidelines.
Hoag questioned how a potential purchaser of property that must maintain
an aerobic treatment maintenance system would become aware of that
requirement. Chesson stated they currently don't have a mechanism for notifying a
potential buyer. If the current property owner buys the treatment unit, and then
sells the property, they are not required to notify the buyer about the unit.
However, the O &M person for the specific unit would notify the new owner of the
contract. If the new owner doesn't renew the contract, there would be a notice
placed on the title.
Hoag asked if maintenance of the aerobic treatment units was expensive.
Chesson stated the first two years of maintenance were included in the price of the
unit.
Brenner asked if the septage pumpers and designers were involved in writing
the new regulations. Chesson stated they were involved in the process. The
service people helped come up with the service agreement. He has kept the
pumpers informed.
Sutter stated most of the new buyers will become informed because the
lending institutions will require an inspection of septic systems. Also, the real
estate agents should be aware of the type of sewage disposal system on the house.
They are required to give full disclosure. The only ones that would slip through
would be the cash sales.
Hoag stated the inspection doesn't necessarily mean the buyer will be
informed that all the maintenance is required every year.
Hoag asked if the County typically does the inspections for the bank.
Chesson stated the FHA and VA loans require the local health jurisdiction to provide
the inspections. Other lending institutions allow private contractors to perform the
inspection.
Sutter stated the private contractors in the County should be aware of the
requirement.
Board of Health, 9/14/99, Page 11
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Hoag asked if they should pass that information on to the new homeowner.
Chesson stated they could provide a copy of the permit, which would have the
requirements for continued O &M.
Delahunt stated one way the people will find out about the new system is
through the County database for the new systems that are installed. The Health
Department sends out periodic notifications to people to remind them of the type of
system they have and the required maintenance.
Sutter questioned section 24.05.23, Areas of Special Concern, starting on
page 128. She read from page 129, section (2)(b) and (2)(c). She questioned
whether the permit issuing authority referenced in (2) referred to the Health
Department. Chesson stated Areas of Special Concern is a designation done
through a formal process. Right now in Whatcom County, there are no formally
designated Areas of Special Concern. The Lake Whatcom watershed and shellfish
protection districts are areas of special concern, but not formally designated. These
requirements don't apply to those areas at this time. They are looking at
designating those areas, then bringing forward proposals on how they should be
addressed.
Hoag asked who the permit issuing authority is. Chesson stated the Health
Department is the authority. Regarding the South Cape area, he was assured that
the land area size meets the current State and County sewage control regulations.
That has been the extent of his discussions. If the Department of Ecology or other
agencies want to try and impose more stringent requirements, he would sign off on
something that met the County requirements.
Sutter stated that the Health Department making decisions about whether
someone could develop their property made her uncomfortable. Chesson stated
they would not do that without going through the formal designation process,
including public hearings and bringing it forward to the Board of Health. The Health
Department would be the permit issuing authority, but any additional requirements
for formally designated Areas of Special Concern would be brought to the Board of
Health first.
Sutter stated the language in that section of the Code didn't specify that
requirements would be made by the Board of Health. It said the permitting
authority may impose more stringent requirements. She questioned whether the
Health Department would have to come before the County Council for these things
if they designate an Area of Special Concern. Delahunt stated that was correct,
except the Health Department, when bringing forward the designation of an Area of
Special Concern, would also have specific recommendations for what the more
stringent requirements would be. The language is directly out of the State
regulation.
Sutter asked who could make the designations. Delahunt stated only the
County Council could make the designations.
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Brenner suggested the permitting authority could "...impose or recommend
more stringent..."
Sutter moved to amend language in section 24.05.23(2),
shall recommend more stringent..."
Stern stated the Health Department would issue the permit, but it could be
appealed to the County Council.
Chesson stated there would be a formal process to designate an Area of
Special Concern. The work groups could come up with more stringent
requirements, which the County Council would approve. Once approved, the Health
Department would issue permits.
Benjamin stated this would only apply in Areas of Special Concern. If it is an
Area of Special Concern, then it is staff's responsibility to bring forward special
requirements for this Area of Special Concern. In all other areas, the Health
Department has the right and the responsibility to put conditions on permits, within
specific parameters. They can be appealed. Even if they designate an Area of
Special Concern through the public process, then the Health Department would
follow the established criteria, which could still be appealed to the County Council.
Sutter questioned whether the Health Department could require any extra
regulations that were not specified by the County Council in an Area of Special
Concern. Delahunt stated that was correct. They would also be specific about the
size of the lot and the monitoring required in that particular area. Those would be
the basic requirements in Whatcom County for OSS in that specific area.
Sutter questioned whether those would be requirements for every single
property in that area. Delahunt stated that was correct.
Dawson stated the South Cape property has asked for additional
performance standards and larger land area.
Brenner stated that is the State, not the County. They can't do anything
about the State.
Chesson stated for any subdivision that meets the OSS regulation criteria,
the Health Department would issue Department approval of the subdivision.
However, the approval of the subdivision requires approval from many different
entities besides the Health Department. The Health Department has already
approved the OSS portion for South Cape. If the design doesn't meet the OSS
requirements, then they work with the designers and the property owners.
Hoag moved to change to section 24.05.023(2), "...existing developments
within the parameters of the Areas of Special Concern as designated by the County
Council in aFeas ef speeial eeneeffi, including:" Also, the title "Areas of Special
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Concern" should be capitalized. Delahunt stated staff would work on that language
and bring it forward.
Motion to approve Hoag's motion carried unanimously.
(Clerk's Note: the Board did not vote on Sutter's motion to amend language.)
Brenner moved to amend the title of the section, "24.05.23 Areas of Special
Concern Designation."
The Board concurred.
Hoag moved on page 128, section 24.05.23(1)(a) "The local Health Officer
may designate to the County Council..."
Motion carried unanimously.
Hoag was concerned that language in section 24.05.23(1) refers to areas
that are already formally designated areas, such as areas formally designated as
shellfish protection districts. Benjamin stated those areas are not formally
designated Areas of Special Concern. It is an area designated as a Shellfish
Protection District.
Hoag suggested language, "The local Health Officer may bring to the County
Council an area to be designated as an Area of Special Concern to minimize public
health risk... Areas for consideration could be:"
Delahunt stated they should include language that explains how an Area of
Special Concern becomes designated.
Brenner moved that the definition of "Area of Special Concern" should be
"Formally Designated Area of Special Concern" and language should be added,
"...delineated through public legislative process,..."
Motion carried unanimously.
Hoag moved to amend language on page 128, section 24.05.23(1), "The
local Health Officer may recommend to the
County Council formal designation of an Area of Special Concern to minimize public
health risk On a fermally designated aFea sueh as:. Areas to be considered for this
could include:"
Motion carried unanimously.
Dawson stated that the ordinary high -water mark is different for tidal waters.
Chesson stated this is a State Department of Health (DOH) definition, not a State
Department of Ecology (DOE) definition.
Board of Health, 9/14/99, Page 14
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Dawson stated the ordinary high -water mark is different than the mean
higher high tide, which is where the vegetation line is.
Delahunt stated it is a State definition and they can't make it less restrictive.
Hoag stated that definition deals with septic systems. The point is they don't
want the water to get up into the drain fields and then drawing out the septic
waste.
Chesson stated there is a difference between marine waters and a drain field.
They tried to determine what the highest possible watermark could be, and then go
100 feet higher than that.
Sutter moved to recommend the report as amended to the County Council.
Motion carried unanimously.
LEUKEMIA REPORT
Benjamin stated there weren't any links between the clusters. There may be
links between individual cases. The environmental factors did not play a role in the
cluster. Information has come out since the study was issued. There were more
cases of actual cases than expected cases. If there were an environmental factor,
then they wouldn't have seen the downward trend.
Brenner stated all wells were not tested in that area. She questioned
whether the up -flow was tested and whether they tested every well of the families
involved. Stern stated they tested two out of three wells that served children with
leukemia.
Brenner asked if the Water Association was tested. Stern stated they had
data from that Water Association. There were two to four neighboring wells in
which they had testing data. They received permission to test two of the three
wells that were directly involved.
Hoag asked if there was recent data on EDB and 1,2 DCP for the Public Water
Association. Stern stated it was tested and none was found.
Sutter asked where it was located. Stern stated the initial study found a
higher rate in the zip codes that included Lynden, Sumas, Nooksack, Everson,
Custer, and Ferndale. Looking at the entire County, the rates would have been
considered normal for that population. However, if they focused in on the area that
included those zip codes, then there was a higher than expected rate for the years
1992 - 1994.
Hoag asked about the children on the private wells and whether those wells
were tested for EDB and 1,2 DCP. Stern stated two of the wells were tested using
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the full screen used on municipalities. They did not test the third well because they
did not get permission.
(Clerk's Note: End of tape two, side A.)
Stern stated they created the GIS map after the study was done, and they
could see where the contaminates EDB and 1,2 DCP were concentrated. They
realized most of the wells were not contaminated. Even within the areas, there
were not significant levels in the neighboring wells. There was one well out of a
dozen that had a borderline level of 1,2 DCP. It wasn't above the maximum
contamination level (MCL). The hypothesis was the presence of EDB or 1,2 DCP in
all three wells that affected three of the children would be an abnormality. That
would make an association if children exposed to the chemicals had leukemia, and
the rest of the general population didn't.
Hoag asked if the neighboring wells next to the third well, in which they were
not able to test, had contamination. Stern stated they did not. They had data from
those neighboring wells that included data on EDB and 1,2 DCP, however they did
not go back and test the well again.
Brenner asked about the soil types in the area. If there was sandy soil, it
was possible the areas could have been flushed out at the time they did testing.
Stern stated they couldn't find evidence of exposure. A number of kids moved in
from out of the area. They are not looking at the cause of leukemia in general, but
a likely cause in these instances.
Brenner asked if they could do DNA tracking on the type of leukemia.
Benjamin stated the timeframes of when the families moved in and out of the area,
compared with the potential environmental impact, show it is not just water. There
are a number of factors including when the families moved in and out of the area.
Brenner stated she wanted data on soil composition.
Hoag asked about the three families that were identified but not included in
the study. Benjamin stated they were unable to contact the families or they did not
want to participate in the study.
Stern stated that, of the three who did not participate, two of the cases were
explained to not have been caused by environmental causes in the County.
Hoag asked about a reference to five of the children's shared factor. Stern
stated they identified nine cases in Whatcom County. Because the cluster was in
the zip codes outside of Bellingham, the investigation was limited to the zip codes
that had the bump. They included 98226 because it extends into rural Whatcom
County. One child was excluded from the study because they only lived in the City
of Bellingham and wasn't included in the cluster area.
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Hoag asked about the water sources that supplied water to some of the
children. Benjamin stated that information was on page 13 of the report.
Hoag asked about the reference to the one well that the family reported as
contaminated, but was closed down and not tested. Stern stated this was a private
well, and the family didn't have copies of the test results. The family only said
there was contamination, but did not know the specifics.
Hoag questioned whether they tested the adjacent groundwater. Benjamin
stated the sampling of the private wells took part after the report was released.
The sampling of the private wells was not included in the report. They didn't have
the data available. That data will be submitted as an addendum to the report.
Hoag asked if they could get a report on the private well testing. Stern
stated the summary of that information was on page 26. It indicates there was no
contamination with synthetic or volatile organic compounds, including EDB, 1,2
DCP, and DBCP.
Hoag asked for data on the first well that was closed down. Stern stated
they did look for it. There was no data.
Benjamin stated he would provide any information they have on that well.
PUBLIC SESSION
No one spoke.
OTHER BUSINESS
Hoag moved to send a letter regarding teen driving to the Governor and
State legislators that recommends the teen driving permits be approved in a
graduated manner.
Motion carried unanimously.
Hoag moved to convene as the County Council.
Motion carried unanimously.
Dawson moved to send a letter to the Bellingham Herald regarding the
editorial that reported inaccuracies about actions taken to protect the health and
safety of County residents concerning a stop -work order.
Motion carried unanimously.
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Brenner stated it was not regarding the stop -work order. The County Council
only recommended getting approval of improving a water systems plan that did not
currently meet the needs of the County residents. They did not deal with the stop -
work order.
ADJOURN
The meeting adjourned at 3:10 p.m.
Jill Nixon, Minutes Transcription
These minutes were approved by Council on January 11 , 2000.
ATTEST:
Dana Brown - Davis, Council Clerk
WHATCOM COUNTY COUNCIL
WHATCOM COUNTY, WASHINGTON
Marlene Dawson, Council Chair
Board of Health, 9/14/99, Page 18