HomeMy WebLinkAboutBoard of Health March 31 19981
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WHATCOM COUNTY COUNCIL
Special Council Meeting
(COUNCIL TO MEET AS THE BOARD OF HEALTH)
March 31, 1998
The meeting was called to order at 12:30 p.m. by Council Chair Robert Imhof in the Council
Chambers, 311 Grand Avenue.
Also Present: Absent:
Marlene Dawson None
Tom Brown
Kathy Sutter
Barbara Brenner
Ward Nelson
Connie Hoag
EXECUTIVE SESSION
Nelson moved to go into executive session for no longer than 30 minutes to discuss a
personnel matter.
Motion carried unanimously.
(Clerks Note: The Council resumed at I p.m. Imhof announced direction was given
regarding a personnel matter in executive session)
Other Staff Present:
Chuck Benjamin, Health Department Director
Regina Delahunt, Environmental Health Manager
Kay Guirl, Personal Health Services Manager
INTRODUCTION OF ADVISORY BOARD MEMBERS
Chuck Benjamin, Health Department Director, introduced the Health Advisory Board:
Fielding Formway; Bill Palmer; Joann Linville; and Susan Trimingham, Chair.
PUBLIC HEALTH ADVISORY BOARD (PHAB) COMMENTS
Susan Trimingham, 619 -15th Street, Chair, Health Advisory Board which advises the Health
& Human Services Department and Council members as the Board of Health, stated that the agenda
Board of Health Minutes, 3/31/98, Page 1
I includes a policy for bloodborne infections, which the Board has been working on since June. This
2 policy focuses on assessment, prevention, intervention and education. She thanked Council for the
3 addition of the Environmental Health Specialist specifically for water issues. She was grateful for
4 Benjamin's expertise in developing a work plan. She assumed all Council members were on a
5 mailing list for the Community Health Partnership. This partnership has identified what is important
6 to the community regarding health issues. As the projects are identified by this partnership, they
7 should be discussed at a future Board of Health meeting.
9 Benjamin thanked all the members of the Health Advisory Board.
10
11 BLOODBORNE INFECTION POLICIES
12
13 Kay Guirl, Health Department Personal Health Services Manager, spoke about the proposed
14 three bloodborne infection policies (on file). She then reviewed the essential services. The task for
15 policy #1 includes assessment and monitoring of bloodborne infections, including HIV and
16 Hepatitis B and C. The Health Department is working with physicians in the County to determine
17 the prevalence of HIV. They are also evaluating risk factors and will report to the state all
18 information regarding bloodborne illnesses.
19
20 The County needs to develop policies that support prevention efforts, including conducting
21 prevention capacity building activities not only of the Health Department but other County resources
22 to address the issue of identification, diagnosis, and treatment of bloodborne infections, as well as
23 develop priority policies regarding prevention activities. The Health Department will examine
24 programs to develop policies and plans that support individual and community efforts to address
25 prevention of HIV, AIDS, and other bloodborne infections. A community task force must be
26 established to evaluate the need for support of a comprehensive prevention program. Working with
27 community agencies and providers on disseminating prevention information must be accomplished.
28
29 The next essential service was the enforcement of laws and regulations that protect health
30 and ensure public safety. The Health Officer is required to request mandatory testing following
31 substantial exposure and is responsible to initiate enforcement of unsafe health activities.
32
33 The final essential service is to evaluate the effectiveness, accessibility, and quality of
34 comprehensive service in the County. This is state mandated. Individuals, including HIV and
35 Hepatitis B patients, will be referred to needed services. The Health Department is working on a
36 client satisfaction tool, which will be used for all Health Department services. Also needed are tools
37 to evaluate the educational programs, as well as the training sessions and outreach activities.
38
39 Returning to Policy #2, Guirl stated another essential service is to inform, educate, and
40 empower individuals to make their own personal decisions that lessen their risk for HIV, AIDS, and
41 other bloodborne infections. Education presentations must be directed to populations at greatest
42 risk. The Health Department is conducting a trainer activity to build a capacity of staff working in
Board of Health Minutes, 3/31/98, Page 2
1 drug treatment programs, jails, and other areas to educate. Also being examined is providing
2 consultation and technical assistance on the prevention of bloodborne infections to other community
3 agencies, as well as private providers. Another program is youth outreach.
5 Guirl returned to Policy #2, Essential Item (Task) #3. The Health Department has researched
6 the issue of a needle exchange program; however, more information needs to be collected that would
7 be specific to Whatcom County. There has been some skepticism about whether a needle exchange
8 program would work.
10 A task force was recommended to examine community need and support for a
11 comprehensive system established by the Center for Disease Control (CDC). It was recommended
12 this task force should be made up from two members of the Public Health Advisory Board, two from
13 the Substance Abuse Advisory Board, one from the County Council, Health and Human Services
14 Department staff, Law Enforcement, and someone from the medical community.
15
16 There was discussion regarding a needle exchange program in the County. Guirl stated that
17 there have been problems in Vancouver, B.C., due to the rapid increase in HIV and Hepatitis B.
18 People from Bellingham go to Vancouver to get drugs, as Vancouver has a different drug culture.
19 However, even with the programs, there is still a rapid increase of these diseases in Vancouver.
20
21 Benjamin pointed out that research shows a model exchange program only. Time must be
22 spent up front dealing with community stakeholders in the design of the exchange program. Guirl
23 stated the success of this type of program is based on referral to other health services and treatment
24 programs.
25
26 Nelson stated that in the past needle exchange programs were deemed illegal by the courts
27 because they were providing drug paraphernalia, which was illegal according to state law. The
28 history is that policy of needle exchange is containment policy. That is not a benefit to the
29 community, nor does it ensure that people get fair and equitable treatment to get help. He also
30 pointed out that rural areas are unpopular regarding needle exchange programs.
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32 Nelson asked if an evaluation of dollars was done on the three policies, of which there are
33 nine items requiring funding. Guirl responded that the majority of the activities are already included
34 in the current budget. Benjamin noted that one role and responsibility of the Board of Health is to
35 establish County policy. This is a major role played in setting policy for the department. Benjamin
36 recommended the Board of Health consider approval for all the policies either collectively or
37 individually.
38
39 Hoag asked if the needle exchange program was included in the policy presented. Guirl
40 reiterated the current request is to establish a task force. The task force findings would later come
41 before the Board of Health for approval. Hoag stated that she would like to include more citizens
42 and elected officials in this task force. Benjamin spoke for Dave Moody, Substance Abuse Advisory
Board of Health Minutes, 3/31/98, Page 3
I Board, which did have public forums. Hoag asked about individuals who are endangering the lives
2 of others by knowingly engaging in dangerous behaviors. Frank James, Health Officer, stated that
3 the County has a law stating that this is a criminal action and one can be charged with assault. Also,
4 one can be subject to mandatory testing. There is legal precedence for taking action against these
5 types of people.
6
7 (Clerks Note: At 1: 30 p.m. Imhof left the meeting; Dawson took over as chair.)
8
9 Brown stated that the Substance Abuse Committee held a number of hearings on methadone use
10 and needle exchange.
11
12 Nelson inquired if an intravenous drug task force had been established with Substance Abuse
13 and whether it had met. Benjamin stated he was under the impression that the task force was to be
14 established by Council. Moody replied in the negative. Also, he asked about making the Hepatitis B
15 vaccine available to high -risk groups. Guirl stated that there is state - supplied vaccine.
16
17 Sutter noted that the policy does not specify HIV and Hepatitis B. The policy titles specify
18 only bloodborne infections. Some tasks are specific to HIV and Hepatitis B. Guirl stated this policy
19 is for HIV, Hepatitis B and Hepatitis C. Sutter asked to specify those infections specifically instead
20 of stating generic bloodborne infections. Benjamin stated the rationale for not specifically
21 identifying the infections.
22
23 Nelson stated that under consideration is whether HIV should be considered an official
24 disability and inquired if the Health Department has examined these policies in that light. Benjamin
25 stated that they will have to wait for final legislation, etc. Dr. James commented.
26
27 Nelson moved approval of policies #1, #2, and #3 and read them into the record.
28
29 • The Whatcom County Health and Human Services Department will collect, analyze, and
30 disseminate information about bloodborne infections.
31
32 • The Whatcom County Health and Human Services Department will assure policies
33 related to bloodborne infections are developed, implemented, and evaluated.
34
35 • The Whatcom County Health and Human Services Department will assure access to
36 quality prevention and intervention services for bloodborne infections.
37
38 Motion carried 6130 with Imhof absent.
39
40 OTHER BUSINESS
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Board of Health Minutes, 3/31/98, Page 4
1 GROUNDWATER UPDATE
3 Regina Delahunt, Health & Human Services Environmental Health Services Manager, stated
4 the Board of Health is planning to meet quarterly for updates on County groundwater and water
5 issues. A public community meeting in Lynden was held on March 19; approximately 150 people
6 attended that meeting. Agencies present at that meeting were the Health and Human Services
7 Department, the Department of Ecology (DOE), and the state Department of Health (DOH). Each
8 agency gave overviews of the issues and their roles and plans for addressing the north County
9 groundwater issues. Following the meeting, a summary of key points was discussed. The plan is to
10 send this summary to all north County residents on the mailing list (900 residents) and those who
11 attended the meeting (on file).
12
13 (Clerks Note: Tape 1, Side B)
14
15 Brenner asked if this will be made available via the local papers. Delahunt stated that it is
16 actually being sent to the residents. The summary contains information about the most frequently
17 asked questions at the meeting. Since the meeting, a company will provide well testing at a lower
18 price than had been anticipated. Also, there are some limited resources for those north County
19 residents who cannot afford to test their wells. A questionnaire was distributed at the meeting; 42
20 were returned. Delahunt then listed some things learned, which included: most people on private
21 wells are concerned about the safety of their drinking water. The majority of public supplies were
22 concerned about their drinking water. Three times as many people prefer to receive their
23 notification by direct mail rather than newspaper announcements or public meetings. Most people
24 were willing to participate in groundwater studies. The three major topics that people wanted on-
25 going information about were health risks, groundwater sampling and results, and guidelines for
26 testing private wells.
27
28 A draft project has been received from USGS, which will shortly be brought before Council
29 for approval. The Department is in the process of expanding the water program plan to include tasks
30 for the new Environmental Health Specialist position, which will also be brought before Council for
31 review. Drinking water quality is a public health issue. When problems occur, the Health
32 Department must ensure intervention strategies are in place in order to protect public health. By the
33 end of April, the Department hopes to have all existing data collated and mapped, which will also be
34 brought forward to Council.
35
36 Brenner asked if an Environmental Health Specialist has been hired. Delahunt stated that an
37 Environmental Health Specialist currently employed at the Health Department has been moved into
38 the water programs in order to begin the process of addressing these issues. There was discussion
39 regarding the position classification. Brenner requested the person hired have a background in water
40 quality. Council already approved a position for a Water Quality Specialist. Benjamin stated that the
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Board of Health Minutes, 3/31/98, Page 5
I public health component must be reviewed for this position. Delahunt stated that the issue is
2 drinking water as a public health issue. She listed the qualifications required in order to fill the
3 Water Quality Specialist position. The Health Department currently has the necessary expertise.
5 Brown questioned the water sampling summary regarding testing for different items and the
6 cost of each item. Delahunt explained the testing process. Delahunt noted those facts listed on the
7 summary will go to the laboratory, not the Health Department.
9 Hoag reviewed the County Executive =s memo requesting the Water Quality Specialist. She
10 requested the person hired be titled as a Water Quality Specialist so that person cannot be reassigned
11 to other duties at a later date. The six items this person would be responsible for that were listed in
12 the memo should be included in the job description. Council did not approve another position for
13 the Health Department; they approved a person as a full -time Water Quality Specialist. Benjamin
14 stated that the Health Department budget submitted for 1998 included a detailed description of all
15 the Health Department positions and their assigned duties. Hoag noted her request was for the
16 public =s benefit. Benjamin pointed out the water quality program has its own cost center, which
17 defines the work being done by the individual employees. Dave Wareing, Executive's Office,
18 interrupted to say that Administration will work with Health and Human Resources and the Health
19 Department to re -title the position to Council =s expectations.
20
21 Nelson was concerned that the focus be on the epidemiology study and ensuring the
22 protection of the County residents with quality individuals. The position needs to have a broad
23 background to assess disease control in this County. Wareing pointed out this position is to
24 facilitate the access to other agencies that have the resources and laboratories at their disposal. This
25 person will interface with the public, Council, the Health Department, laboratories, and other
26 organizations. There are only three divisions in the Health Department, one of which is the
27 Environmental Health Services Division, which deals with water quality issues. That person hired is
28 to be a designated water quality specialist. There was further discussion.
29
30 Dr. James requested the Board of Health meet monthly and add other people as voting
31 members who have expertise to augment the Board of Health. The Board of Health is a policy -
32 making board.
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34 Brenner moved Dr. James= suggestions for discussion.
35
36 (Clerk's Note: There was no vote on the motion)
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38 There was discussion about the history of the frequency of the meeting of the Board of
39 Health. Nelson stated that the Health Officer would have to request the Board of Health meet, which
40 can be done during any County Council meeting, which is scheduled every other week. Benjamin
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Board of Health Minutes, 3/31/98, Page 6
I stated if the Board of Health meets more frequently and membership is expanded, Council would
2 need to review the roles of the advisory boards and committees. This item is appropriate, Benjamin
3 noted, for discussion at a future meeting.
5 Dr. James gave background on his formal request to the Board of Health to meet more
6 frequently and add experts to the Board. Hoag stated she would like to talk to legal counsel to
7 Council regarding adding non - elected experts onto the Board of Health. There was further
8 discussion on the issue regarding meetings.
10 Brenner moved the Board of Health meet on a regular monthly basis.
11
12 Nelson stated that it is Dr. James' responsibility to designate when Board of Health meetings
13 are necessary and supply the expertise necessary to give information to the Board. The advisory
14 board's role is for the professionals. Dr. James stated his department needs policy leadership from
15 Council which should not be delegated to other agencies. Dawson inquired of James if there were
16 anything which would prevent him from bringing forward items between the regularly scheduled
17 quarterly meetings; James replied that was at the pleasure of the Board of Health. Nelson pointed
18 out it was his responsibility to convene these meetings, to which James replied he could request it be
19 convened, which he has done. Sutter listed the dates when the Board of Health meets this year. She
20 stated that this issue should be put on a regular meeting agenda or a special meeting can be
21 scheduled to discuss this issue. Benjamin suggested a special meeting to discuss this issue.
22
23 Hoag clarified the current Board of Health quarterly meeting schedule. The Board of Health
24 has the option of scheduling extra meetings if the need arises. Also, there have been several issues
25 dealt with in Natural Resources Committee meetings.
26
27 (Clerks Note: Tape 2, Side B)
28
29 Hoag continued that it is not only a Board of Health issue, but a Council issue as well.
30 Dawson noted that other jurisdictions are involved.
31
32 Nelson stated he is not in favor of scheduling meetings without specific items to schedule on
33 the agenda. If the regular Board of Health meetings are scheduled on a regular Council night, the
34 focus would not be on the Board of Health issues. Brown concurred with Nelson and Hoag--s
35 comments.
36
37 There was discussion on the possible frequency of Board of Health meetings. Dawson
38 suggesting having an open session scheduled. Hoag commented on the ability to deal well with
39 various items at meetings. Further discussion followed.
40
41 Brenner amended her motion to add that at the monthly Board of Health meetings an Open
42 Session be included.
Board of Health Minutes, 3/31/98, Page 7
I Brenner--s motion failed 3 - 2 with Nelson, Sutter and Brown opposed, Hoag abstaining and
2 Imhof absent.
3
4 Hoag moved to have an Open Session scheduled at the beginning of all Board of Health
5 meetings that are scheduled.
6
7 Motion was withdrawn, as it was noted that this can be a part of the agenda.
8
9 OPEN SESSION
10
11 (Clerks Note: A five- minute break was taken)
12
13 The following people spoke at open session:
14
15 Donna Shaw, 8822 Golden Eye Lane, Blaine: She was concerned about the need for
16 stormwater sewers. Stormwater is a major problem in this County. Homeowners are just as guilty
17 of pollution as the farmers. The drainage ditches are all there is for stormwater run -off.
18
19 Dan McShane, 1451 Grant Street: He spoke about stormwater and water quality issues.
20 Other areas have heavy metal contamination from stormwater run -off. The County needs to
21 implement stormwater management controls. Heavy metal levels will increase in Lake Whatcom
22 and the Bay. The Board of Health has been pushing for urban growth in areas that affect the water
23 quality. Water quality protection needs to be in place. He encouraged the Board of Health to follow
24 up on Dr. James= recommendations. He suggested Council have plans in place and effectively
25 working before development in invalidated growth areas are approved.
26
27 Hoag asked McShane to clarify his comments about King County requirements. McShane
28 stated that many contaminates in a ground infiltration system is absorbed by the vegetation, which is
29 then cut and handled at a special treatment plant. This is the general best management practice for
30 areas with surface contaminates.
31
32 Colleen Henehan, 2524 Keesling Street: She expressed her concern that there is not
33 representation on the Board of Health with a public health background. She requested an
34 explanation of the purpose of the advisory boards.
35
36 Benjamin responded by explaining the roles of the various advisory boards and the Health
37 and Human Services Department. He stated the Health Department Advisory Board should have
38 someone with some background experience, especially one with environmental background.
39
40 Brenner stated that if meetings are not regularly scheduled, the involvement of the public is
41 not as strong. She proposed setting up a water quality advisory committee that works for as well as
42
Board of Health Minutes, 3/31/98, Page 8
I advises the Council. Dawson pointed out the Water Resources Council is a citizen group that brings
2 issues to the elected officials. Brenner responded.
3
4 Marion Beddill, 3600 Seeley: She read a mission statement of the Water Resources
5 Management Council (WRMC) and outlined its goals and responsibilities. One of the roles is to
6 advise legislative authorities.
7
8 Ron Spaikowich, 6205 Gadmire Road: He displayed a map of the area in which he lives. He
9 stated that the Board of Health also needs to be concerned about contamination by dairy farms and
10 trailer park waste into the Nooksack River.
11
12 Hoag asked Spaikowich what his property was contaminated with; he responded his
13 contaminates are nitrates.
14
15 (Clerks Note: Tape 1, Side B)
16
17 Nelson asked the depth of the area's wells. Spaikowich responded that some of the wells
18 were only two feet deep.
19
20 Greg Hanbey, 1012 Liberty Street, Lynden: His children are suffering from the
21 consequences of the actions /inactions of the people responsible for system monitoring. The Board
22 of Health must seek out good advice from professionals.
23
24 Tom Hilton, 1716 Kaas Road, Ferndale: He stated the Health Department told him that it
25 cannot do anything to help him with his contaminated well.
26
27 Dawson asked Benjamin about the recourse of a neighbor who contaminates a well.
28 Benjamin stated he and Delahunt would meet with Mr. Hilton. There was discussion of Mr.
29 Hilton =s contaminates. His nitrates do not show above normal, but that figure is in question.
30
31 Jim Johnston, fisheries biologist with the Department of Fish & Wildlife, spoke about
32 chemical concentrations and the flow of heavy metals in certain waterways. The levels of heavy
33 levels in the fish were not enough to harm human beings. The standards set at levels for human
34 consumption are higher than what it would take to kill a fish. He further discussed the health of the
35 fish in Lake Whatcom and its tributaries. Also the AY= road dump does not have a liner and drains
36 directly into Lake Whatcom. Wilder--s waste pit is the other dump.
37
38 Nelson asked what would be considered adequate testing. Johnston stated that a comfort
39 level for testing needs to be set so a law could be enacted that does not say b'may =, but states
4o Asha11=
41 for more enforcement. One solution for water quality problems would be to move the intake for
42 Lake Whatcom for the city water. Monies need to be spent to gather data. Within a year, the federal
Board of Health Minutes, 3/31/98, Page 9
I government will set "shall" restrictions; EPA standards for drinking water will follow.
2 Dawson asked Delahunt when there would be a report on the AY= road dump. She
3 responded that this is a County -owned landfill that was closed many years ago in accordance with
4 regulations at the time. The Health Department has since done periodic visual checks. It is time to
5 do some field sampling in the stream, and Delahunt will be talking to Public Works Committee
6 about that survey. Brenner asked about the Clay Pit Pond as well and stated that she would like all
7 sites checked. The Wilder pit is on the state Department of Ecology (DOE) superfund list.
8
9 Carl Weimer, RESources Director, 1155 North State Street, supported Dr. James' request to
10 examine more water quality issues. He listed all the issues that could be brought forward to the
I1 Board of Health. There are many issues to justify monthly meetings, especially water quality issues.
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Dave Schmalz, 1807 Eldridge, supported Dr. James. He applauded Council =s actions so far;
however, they are reactive, and the Board of Health needs to be more proactive. He pointed out the
Geneva Hills subdivision zoning was invalidated by the state, yet approved by the County. It is
important for regulatory bodies to take the lead, especially the Board of Health, to examine specific
public health issues that are the results of political decisions.
Dawson announced the next meeting of the County Council. Council can then discuss under
"Other Business" the issues of monthly meetings and receive input from legal counsel regarding
other Board members.
ADJOURN
The meeting was adjourned at approximately 3 p.m.
Jill Nixon, Recording Secretary
These minutes were approved by Council on , 1998.
ATTEST: WHATCOM COUNTY COUNCIL
WHATCOM COUNTY, WASHINGTON
Dana Brown - Davis, Council Clerk Robert Imhof, Council Chair
Board of Health Minutes, 3/31/98, Page 10
Marlene Dawson, Acting Council Chair
Board of Health Minutes, 3/31/98, Page 11