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HomeMy WebLinkAboutBoard of Health September 8 19982 3 4 5 6 7 8 9 WHATCOM COUNTY COUNCIL 10 11 Special Council Meeting 12 BOARD OF HEALTH 13 14 September 8, 1998 15 16 The meeting was called to order at 12:37 p.m. by Council Chair Robert Imhof in 17 the Council Chambers, 311 Grand Avenue, Bellingham, Washington. 18 19 Also Present: Absent: 20 Marlene Dawson 21 L. Ward Nelson 22 Connie Hoag 23 Tom Brown 24 Barbara Brenner 25 Kathy Sutter 26 27 28 29 Chuck Benjamin, Health and Human Services Director, introduced the members 30 of the Health Department Advisory Board the Health and Human Services Department 31 staff. 32 33 34 WATER PROGRAM UPDATE AND WEB SITE DEMONSTRATION 35 36 Benjamin stated that the major areas of the water program update is health 37 assessment, data management, interagency sampling efforts, public education, water 38 availability issues, public water supply issues, and disease investigations around Giardia. 39 There is a newly created website with a lot of water quality information that the public 40 can access. 41 42 Ann Marie Karlberg, Water Quality Specialist, gave an overview of the new 43 drinking water informational webpage. This will be a great tool for public education. 44 Information has been distributed to the public, who can also e -mail the department with 45 questions, concerns, and requests for information. Staff can refer people to the webpage 46 when appropriate. The drinking water webpage can be accessed through the County's Board of Health, 9/8/98, Page 1 I webpage. The most relevant topics to the citizens of Whatcom County are listed in the 2 contents. There will hopefully be a decrease the amount of paperwork and mailings, 3 since people would be able to download information directly, if they have access to the 4 Internet. 6 The first page outlines reasons why the County needs the well test results from 7 private well owners. Currently the County receives 1 in 4 of the lab results of the County 8 residents that test their well. The situation can only improve and affect a change in the 9 County if there is a substantial amount of information. People will be encouraged to 10 share well test results with the department. 11 12 Brenner stated that people are afraid to register their well test results because it 13 would cost a lot of money to clean up the water when they don't use the well for 14 drinking. She questioned whether the department could pinpoint problems and work with 15 people in a way that would allow them to remain anonymous. Benjamin responded that 16 the department worked with local laboratories to help promote the fact that reporting well 17 test results to the Health Department will not begin investigation and enforcement 18 procedures. They are required to notify what is in the well and the risks of the 19 contamination, but the department will not shut them down. 20 21 Brenner stated that the Health department needs to stress that reporting is for 22 information, not enforcement. Benjamin stated they are doing a mailing to residents in 23 the north County. Those are the people that are not providing information for fear of 24 retaliation and the impact to property if they want to sell. If they know there are 25 contaminants, they would have to disclose that information during the sale process. 26 27 Hoag stated that there needs to be a geographical grid to identify approximate 28 location of contaminated wells. People are concerned that if something is found, they 29 will not be able to choose how to remedy the situation. She questioned whether the 30 County could offer a choice of reporting methods, either a list of the name and address, or 31 section description. Benjamin replied that the department does not have detailed 32 information to put together a prevention program. They are attempting a program to 33 collect information. 34 35 Brenner stated that it would work better to allow people to remain anonymous. 36 37 Nelson stated that, as a public health board, there is a concern for everyone in the 38 County. There are two ways to accomplish gathering data. One method is to go get the 39 samples, and the other method is to encourage people to voluntarily submit the samples. 40 Getting that information to the people is the education portion of the program. He is not 41 aware of the benefit of remaining anonymous. 42 43 Brenner stated that if people are listed and that list is distributed, then people 44 would learn not to test their wells. They would be concerned about the ramifications. 45 The County's biggest concern is location of the contaminated wells. 46 Board of Health, 9/8/98, Page 2 I Karlberg continued the presentation and discussed the portion of the website on 2 private well testing. It attempts to alleviate the public's fears regarding the method and 3 frequency of testing wells. Well owners should test yearly for nitrates and coliform. 4 5 Hoag stated she believed it is recommended to test every three years on nitrates. 6 Karlberg stated that the recommendation is annually, but it is not a requirement. The 7 Health department can't force anyone to do anything with their private well. The 8 webpage also outlines where people can go to have their water tested, the cost for testing, 9 and sampling procedures. The web page includes a list of certified labs and tries it to link 10 to already existing drinking water web pages instead of duplicating efforts. The web 11 page can be updated weekly. 12 13 Hoag questioned how the department would know if a linked page is updated. 14 Karlberg stated that she reviews the links regularly. Benjamin stated that the state 15 Department of Health (DOH) notified the County Health Department anyway. Karlberg 16 stated that if there is not any information on a particular topic, they could create their own 17 information. If someone sees a way to simplify the process, she encouraged the 18 suggestion. 19 20 Certain contaminants have their own page. There are four other links to other 21 information sources, which include the DOH, the Environmental Protection Agency 22 (EPA), Washington State University (WSU) Cooperative Extension, and the National 23 Groundwater Association. 24 25 Hoag questioned whether the latest information from the Agency for Toxic 26 Substance and Disease Registry (ATSDR) has been included. Karlberg stated that it 27 includes the same information. It will be updated for specific precautions. 28 29 Nelson questioned whether any laboratory can be listed on the website, or are all 30 labs already listed. Karlberg stated that all labs in the region have been listed. This list is 31 from the DOH list of approved certified labs. 32 33 Nelson questioned whether filtration systems information is included. Karlberg 34 stated that information had just been completed regarding different treatment systems for 35 fumigants specific to the County. She will be working on one for other contaminants. 36 There is treatment system information on National Groundwater Association web page 37 link. The County cannot list vendor names of people who sell filtration systems. 38 39 Hoag suggested information regarding each contaminate should specify specific 40 treatment that can remove the contaminant. Karlberg stated they are currently working 41 on the listing. 42 43 Hoag also stated that there is a laboratory in the County that has national approval 44 and didn't end up in the listing because it was not State approved. Delahunt stated the 45 web site only lists labs that are approved by DOH. Hoag stated that she was told they are 46 certified by EPA, which allows them to do work in all 50 states. Board of Health, 9/8/98, Page 3 2 Benjamin stated he talked to the folks, who decided they couldn't do it 3 economically. 4 5 Hoag stated that is not the point. All approved labs should be included. 7 Benjamin stated he wasn't aware of a national certification that could avoid state 8 certification. All correspondence includes all state certified labs. 10 11 12 13 WHATCOM COUNTY HEALTH AND HUMAN SERVICES THREE -YEAR 14 PLAN 15 16 Benjamin stated that in the packet there is information on the three -year plan. He 17 is available for questions. He distributed information regarding how the format of the 18 three -year plan is to be presented. It will be confusing because of changing cost centers. 19 Each division will have their own set of cost center numbers. This will make it easier to 20 track costs and create reports by division. The first thing to see on each summary (see 21 handout) is the old cost center, the new cost center, and the program name. Next, the 22 sub - program areas contained within the program cost center, the major goals of each 23 program, then one or more three -year objectives for each goal. There will also be a 24 reference to the year 2000 goal or the Public Health Improvement reference regarding the 25 specific objective. The U.S. Goal Year 2000 number gives reference to how the County 26 compares with the state and the year 2000 goal. Next, the activities are listed and are 27 activities intended for the next budget year. 28 29 Brenner questioned the information given in the indicators section and why the 30 County had more measles cases than state actual number. Benjamin stated that the actual 31 numbers given for the state are for the year 1995. 32 33 Brenner questioned the number of communicable diseases that are required to be 34 reported. Benjamin stated that the list is being updated, and some diseases are being 35 removed and some are being added. He will provide both the proposed list and the 36 current list. The state is slower in reporting their actual numbers, which is why the 1996 37 figures are not available. 38 39 The activities are intended for the 1999 budget year. Also included with each 40 program is personnel classification information, full -time employee (FTE) amounts by 41 classification, personnel costs, and other program costs for a total program costs. The 42 communicable disease program has no designated revenue. Other programs will state 43 their revenue. Information is included on the total program costs minus the revenue 44 received for the program and the level at which the County supports the program. This is 45 the same format that was used last year. 46 Board of Health, 9/8/98, Page 4 I Brenner questioned whether the total FTE's remained the same. Benjamin stated 2 that it didn't go up in communicable disease. These are current FTE's and their 3 distribution. 5 Benjamin stated that cost center 5001, Administration, added a public health 6 educator position. He will highlight any changes. Anything that may be different from 7 the previous year in the summary would be the different distribution of the FTE's. There 8 is no increase in FTE's. 10 Hoag questioned when the packet was distributed. Benjamin stated there were a 11 number of delays, including the update of the performance indicators and the September 12 1 Public Health Advisory Board meeting. The board is very excited about the new web 13 site demonstration. The Department hopes to do more public access information about 14 the web site. Sue Hyndman, Health and Human Services Administrative Assistant, stated 15 that the packet was distributed on Thursday. 16 17 Cost center 5049, Assessment, includes collaborative efforts with the community, 18 and other organizations such as St. Joseph's. Public health indicators are funded through 19 this program. A large portion of the cost is from the state Department of Health (DOH). 20 21 Cost center 5003, Fiscal Office, includes the consolidation of Developmental 22 Disabilities, Substance Abuse, and Mental Health divisions into the Health Department. 23 There is a new position of office administrator, which came from the Human Services 24 division. Is not an increase in FTE's agency wide. Through consolidation, FTE's were 25 decreased by 3.3. 26 27 Cost center 5021, Vital Records, are where the birth and death certificates are 28 managed. The fees are set by the state. The Health Department is bringing in more 29 revenue to offset direct cost. Balance moves to administration to offset administrative 30 costs. 31 32 Nelson asked if the consolidation of the Human Services division includes vital 33 records and administration. 34 35 Cost center 5002, Community Health and Wellness Administration, includes a 36 manager and two clerk - typists. The revenue is from Medicaid administrative match. 37 38 Brenner questioned the responsibilities of the Health and Wellness Administration 39 manager. Benjamin responded that the division has been renamed from personal health 40 services to Community Health and Wellness. It oversees all of the public health nursing 41 aspects of all parts of the Health Department, including maternal /child health, 42 immunizations, communicable disease, tuberculosis, among others. 43 44 Brenner questioned whether a nursing health manager position is standard. 45 Benjamin stated that other counties call that position nursing directors, but are beginning 46 to rename their divisions to community health and wellness. It is more representative of Board of Health, 9/8/98, Page 5 I the work they are doing, working with the community's personal health wellness. Kay 2 Guirl, Personal Health Services Manager, stated that the department used to be staffed 3 only by public health nurses. There is now broader scope of personnel, including 4 dieticians and social workers. This division looks at individual and personal health 5 issues. 7 Benjamin continued by stating that cost center 5005, Maternal /Infant Program 8 used to be called maternal child health, which focused on maternity issues. The division 9 was renamed. Child Health Services was consolidated into cost center 5006 due to 10 function. 11 12 Brenner questioned why the Women/Infants /Children (WIC) program is a 13 different cost center. Benjamin stated that funds are dedicated to WIC. Guirl added that 14 the division will try to focus on nutrition. There are also services in the clinics with 15 special health care needs. There are also referrals from community physicians. The 16 division is moving beyond just WIC services into other services. 17 18 (Clerks Note: End of tape one, side A.) 19 20 Guirl continued to state that the Maternal/Infant program is primarily the public 21 health nursing maternity support services. The public health nurses may make home 22 visits and receive referrals from the state on high -risk pregnant women, such as drug 23 users. There are also separate cost centers for tracking and budget purposes. Benjamin 24 stated the state auditor recommended separate cost centers. This is a method to track 25 funds that are received from numerous sources. 26 27 (Clerks Note: Imhof left the meeting. Dawson took over as Chair.) 28 29 Dawson questioned whether the nutrition services outlined in cost center 5005 are 30 more educational than in cost center 5008. Guirl responded that public health nurses 31 provide the nutrition services outlined in 5005. General nutrition services are located in 32 cost center 5008 and provided by registered dieticians who can establish nutritional plans 33 for women and children. 34 35 Hoag questioned where the language in goal #1 originated. Benjamin responded 36 that it comes from the Public Health Improvement Plan and the year 2000 goals. 37 Objective #1 under goal #1 references the Public Health Improvement Plan and year 38 2000 goals by section. In 1993 the state DOH, governor, and state legislature created the 39 Washington State Public Health Improvement Plan, which has been used as a model 40 nationwide. In the development of that plan, it also discusses the core functions. Within 41 those core functions of assessment, policy development and, administration, the plan also 42 establishes goals and objectives. 43 44 Hoag expressed a concern with the word "choice" in that language. She 45 questioned whether the language was specific or summarized. Guirl stated that is Board of Health, 9/8/98, Page 6 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 language that is used at the state and national levels. Hoag stated that she would like to see copies of the document. Brown asked for the summarized state version. Benjamin stated that the Board of Health can change the language in the summary. The language has gone through the scrutiny of the Public Health Advisory Board. Guirl stated that throughout the document the state actuals are from 1995, not 1996. Brenner questioned whether there would be any dramatic changes in 1996 information. Hoag commented that she didn't receive the information being discussed in a timely manner. Benjamin stated that he would be available for comments at a later time, after the Board of Health has had more chance for review. Hoag questioned what action the Health Department is expecting during the meeting. Benjamin responded that last year, the Board of Health approved the three -year plan. He was hoping that would happen today. He may request a special Board of Health meeting. Nelson stated that this was before Council last year. There have been some changes in administration. Benjamin stated that the only changes are the shift in cost centers. Nelson stated that the difference in the budget is approximately $53,000, or 2.8% increase. Brenner stated that the reorganization is significant. Brown stated that he didn't have a chance to review the document. He still wanted to do some comparisons. Benjamin encouraged the Health Board members use the budget summary sheet when comparing the three -year plan. Nelson questioned whether the proposed funding included factors such as population increases, potential state cuts, and goals and objectives over the three -year period. Benjamin stated that funding is distributed according to work plan by looking at indicators, discussions with staff and management, and the program reviews with the Public Health Advisory Board. Population trends will become more of a concern in the future. They will have to look at programs that are provided and come to Board with concerns. This plan is not based on population growth. The plan being put forward is needed to address the concerns as of today. If trends change, they may have to ask for supplemental budget. Future changes would be based on indicators from the community. Board of Health, 9/8/98, Page 7 I Potential cuts come not only from the State Department of Health (DOH), but also the 2 State Department of Social and Health Services (DSHS) in the areas of substance abuse, 3 developmental disabilities, and mental health. If those cuts come about, they will come 4 back for a supplemental. 5 6 Hoag questioned what EPSDT means. Guirl responded that it means Early 7 Periodic Screening Diagnosis and Treatment for the Medicaid program. 8 9 Dawson stated that the goals use language such as "will" instead of "shall." She 10 suggested Hoag's concern on page 10 could be addressed by using the words "should 11 be." Hoag stated that the word choice is not appropriate when discussing pregnancies. 12 13 Brenner suggested the word "educated." 14 15 Hoag suggested dropping the phrase and saying only "...under circumstances of 16 lowest risk." 17 18 Brenner stated that they are aiming toward unintended pregnancies. That is very 19 important. 20 21 Benjamin stated that he would pull the language from the source document and 22 review it. 23 24 Hoag asked if they are required to adopt the state language as County goals. 25 26 Benjamin stated that if a Board of Health member has a problem with particular 27 language, they can voice that concern. 28 29 Hoag stated that the County Board of Health is not required to adopt the language. 30 Benjamin stated he would discuss it with an attorney to see if required. 31 32 Nelson questioned whether the Public Health Advisory Board reviewed it. 33 Benjamin stated that the review had been done. The Advisory Board adopted the three - 34 year plan and forwarded to the Council for consideration. It includes Mental Health, 35 Substance Abuse, And the Developmental Disability Boards. 36 37 Sutter questioned Activity 1 on the bottom of page 13 and the reason number 10 38 was chosen and why the specific number of individual agencies were not listed. Guirl 39 stated that there was no reason for specific number, they attempted to include a 40 quantifier. They could say, "at least 10." 41 42 Benjamin stated that it also shows a measure of success. 43 44 Nelson asked for actuals from 1996. Sutter stated that they were on page 16. 45 46 Nelson asked about comparison years. Board of Health, 9/8/98, Page 8 2 Benjamin stated that they give the most recent information. They should compare 3 State years with County years, and also show the most recent County information. 4 5 Benjamin stated that the next scheduled meeting is December 15th. He will 6 request a special meeting on November 17th to look at the on -site sewage operation and 7 maintenance and the Board of Health membership issues report and recommendation. 8 9 Nelson questioned whether there was a way they could include up -to -date data. 10 Guirl stated that they have to go six months into the following year to get data from that 11 year. 12 13 Hoag asked about the passport program on page 14, Objective 2. Benjamin stated 14 this is anew program with categorical funding from DSHS. It puts a.55 public health 15 nurse in DSHS to look at medical records of children in foster care and make 16 recommendations. There is also a .25 support person for the public health nurse. It is 17 funded by DSHS. The program is called Passport. 18 19 Guirl stated a that a passport is a document that summarizes all medical 20 information for a child for the foster parents. It goes with the child wherever the child is 21 assigned. Categorical information is specific for this program. If state funding goes 22 away, those positions would go away. Benjamin stated that the amount is $54,816.00 23 24 Guirl stated that Section 5008 is nutrition oriented and contains the Women, 25 Infants, and Children (WIC) program. The FTE and cost is detailed on packet page 20. 26 27 Hoag questioned whether the actual on packet page 16 is a large range. Guirl 28 stated that it is for multiple years, from 1991 to 1996. Information was left off after the 29 last Advisory meeting. 30 31 Brenner questioned the Whatcom County indicators in the WIC program. They 32 seem to be higher than the State indicators. She questioned what could bring down the 33 indicators. Benjamin stated that it requires education. The nutritional classes are 34 required. 35 36 Nelson questioned whether the State actuals reflects children in the WIC program 37 or all babies. Guirl stated that it is WIC program. One issue is that many sites have tried 38 to cut program costs and blood tests done by primary care providers, which does not 39 follow the same timelines as the Federal requirements for the WIC program. The County 40 may be doing a better job because they do the blood tests themselves and more often 41 42 Brenner stated that the numbers are not consistent and they don't mean much. 43 44 Nelson stated that he was more concerned with how Whatcom County is doing 45 progressively. The State Public Health Plan was intended to bring uniformity. The 46 federal effort was to create goals. Numbers are based on different mechanisms. They Board of Health, 9/8/98, Page 9 I don't pay too much attention to comparisons. Guirl stated that when this was done last 2 year, it was a first attempt to compare Whatcom County, Washington State, and national 3 levels. They try to look for data to make comparisons, realizing that the comparisons 4 aren't the greatest. 6 Brenner suggested using comparable actuals for multiple years as Whatcom 7 County actuals. Benjamin stated that they are not sure how far back the statistic goes. 9 Hoag would like to see the State statistics. Benjamin stated it is important to see 10 local hard data and compare with State and national data. 11 12 Brenner suggested looking at this and discussing it again in November. Benjamin 13 hoped to have the three -year plan approved before the budget. 14 15 Nelson requested the Board of Health convene at a regular meeting. 16 17 The Board of Health concurred to schedule this discussion at the last meeting in 18 September. Council members will get questions to Benjamin prior to the meeting. 19 20 21 22 PUBLIC HEALTH ADVISORY BOARD RECOMMENDATIONS TO BOARD OF 23 HEALTH 24 25 Benjamin stated that they received a letter, which is on packet pages 81 -82, from 26 Susan Trimingham, Chair of the Public Health Advisory Board, regarding the manure 27 ordinance. The Advisory Board is in support of the manure ordinance from a public 28 health position of high nitrates being in the groundwater. Shellfish farmers have been 29 restricted from harvesting due to the downgrade of Portage Bay. The Advisory Board 30 recommended the Board of Health support the manure ordinance. There are issues that 31 come to Board of Health who would make a recommendation to the County Council. 32 33 Brenner moved that the Board of Health recommend the manure ordinance to the 34 County Council. 35 36 Brown stated that the State Department of Ecology (DOE) has listed the 37 Nooksack River contamination as due to fecal coliform. There are a number of reasons 38 that the DOE has listed the Nooksack River. Various portions do not have any fecal 39 coliform contamination. They have other contamination and water problems, such as 40 temperature and siltation. It is a misleading statement to say that is the only reason the 41 Nooksack River is listed. Benjamin stated that when DOH did the assessment of the 42 downgrade of Portage Bay, agricultural practices were considered to be the primary 43 cause. 44 45 Brown stated that the 303D listing included several areas of contamination. 46 Board of Health, 9/8/98, Page 10 I Regina Delahunt, Health and Human Services Environmental Services Manager, 2 stated that it was primarily listed for fecal coliform. Brown disagreed. 3 4 Nelson stated that areas with temperature problems also had fecal coliform 5 problems. Brown disagreed. 6 7 Hoag clarified that they are not forwarding the Public Health Advisory Board's 8 comments to the County Council, only the three comments. Benjamin stated that the 9 Board of Health could take action as a public health issue on high nitrates in the north 10 county, fecal coliform in the Nooksack River, and fecal coliform in Portage Bay. They 11 would be public health reasons for supporting the ordinance on manure. 12 13 Hoag questioned the reasoning for specifying the department responsible for 14 enforcement. Delahunt stated that it is up in the air who would enforce the ordinance. 15 The Advisory Board felt that whoever enforces, it should be specified in the ordinance. 16 17 Hoag stated that the ordinance would be held up trying to determine who would 18 enforce it. She would rather leave that open. 19 20 Benjamin stated he would rather support an ordinance that the Council would 21 approve, in the interest of the Board of Health. 22 23 Nelson recommended that the Public Health Advisory Board recommendation be 24 forwarded as an attachment to the ordinance as it comes forward on September 15tH 25 26 Benjamin stated that the Advisory Board is not in a position to make a 27 recommendation to the County Council. The ordinance that established the Advisory 28 Board makes them the body responsible for reporting to the Board of Health. 29 30 Nelson stated that the ordinance is before the County Council, not the Board of 31 Health. The Board of Health can forward it as documentation of concern from the 32 Advisory Board. The proper motion would be to forward the Advisory Board's 33 recommendation to the County Council, via the Board of Health. 34 35 Brenner accepted the friendly amendment. 36 37 (Clerk's Note: End of tape one, side B. Skipped tape 2, side A and recorded on 38 side B.) 39 40 Brown asked how many agencies can enforce pollution activities on any water 41 body in Whatcom County. 42 43 Sutter stated that there is not any agency that actively enforces against the spread 44 of manure on bare ground or corn ground in the winter. There are agencies who, when 45 they can prove a specific entity is responsible for a specific material getting into a 46 specific body of water, can enforce against that. However, they are not enforcing against Board of Health, 9/8/98, Page 11 I land use activities that contribute to contamination of the water. Those agencies include 2 the Environmental Protection Agency (EPA), the State Department of Ecology (DOE), 3 possibly the State Department of Health (DOH), and Fisheries. 4 5 Benjamin stated that the question is not who can enforce, but what can be 6 enforced. There have been numerous presentations to the County Council about the 7 improper application of the manure. Also, DOH has shown how quickly the improper 8 application affects the river. That is where the enforcement difficulty comes into play. 9 That would fall under the jurisdiction of the DOE. Then, the burden of proof is on the 10 fact that they have to do numerous water tests and laboratory confirmation. That is the 11 difficulty with current enforcement. The proposed County ordinance would allow better 12 enforcement without lab confirmation. 13 14 Hoag stated that as the Board of Health, they should take a stand and recommend 15 the ordinance. She asked for clarification on item 3 of the letter regarding application 16 approval of the Whatcom Conservation District Board. Benjamin stated that the Board 17 makes the determination, which clarifies the language as to who makes the actual 18 decisions. It specifies who in the Conservation District would make the determination. 19 Hoag stated it is based on a calculation, not on a decision of the Board. Delahunt 20 suggested asking for a clarification, because Gillies stated that their Board would review 21 their recommendations. Gillies stated the language would be clarified. 22 23 Hoag stated that her understanding was that the Board would approve the sum 24 formula, not each request. 25 26 Trimingham stated that these are items that need further clarification. The 27 question is whether this is something that can be done administratively or whether it 28 needs to be done by the Board. This comment is requesting more clarification. 29 30 Brown stated that he received comments that they want the Board to be involved 31 for a check and balance system. 32 33 Hoag stated that the definition of T Sum 200 and best available science should be 34 clarified. Trimingham stated that those items need further clarification 35 36 Hoag stated that if T Sum 200 didn't work well, they may be able to find 37 something that works better. The current language is meant to be nebulous. Brenner 38 suggesting adding best available science based on the Conservation District. 39 40 Hoag stated that the Board of Health should recommend to Council that the 41 ordinance be adopted. 42 43 Motion to forward the letter to County Council carried unanimously. 44 45 Hoag moved that the Board of Health recommend approval of the ordinance to 46 the County Council because of concerns about the fecal coliforms and nitrates. Board of Health, 9/8/98, Page 12 2 Nelson stated that there are significant issues that are still unanswered. He 3 supported the concept, but cannot support the ordinance because he hasn't seen the final 4 version. 5 6 Hoag clarified that her motion is for the Board of Health to recommend approval 7 of the ordinance as it currently is. 8 9 Brown stated that he would not support it. 10 11 Motion failed 2 -3 with Brenner and Hoag in favor. 12 13 Benjamin encouraged the Board of Health to come up with any issues that are 14 significant and recommend them to the Advisory Board for review. 15 16 17 18 OTHER 19 20 Brenner stated that she had asked Benjamin whether Recomp was in the process 21 of assembling an autoclave. He had responded to her that they have not received any 22 request from Recomp. She received a call from a reporter that Recomp was already 23 assembling the autoclave. Benjamin stated that they are assembling it, but he wasn't 24 aware that they have applied for a change of operation. 25 26 Delahunt stated that they have submitted amendments to plan of operation. The 27 County and State are reviewing those amendments. 28 29 Brenner stated that she wanted to be notified on any action on this issue. Another 30 facility assembled the same autoclave, and it probably caused tuberculosis in its workers. 31 Delahunt stated that Stericycle did not have an autoclave. It was very different. They 32 used a microwave technology, not steam sterilization, which is what Recomp is 33 proposing. 34 35 Hoag questioned the mental health services cuts. Benjamin stated that Sun 36 Community Services had a problem when the State reviewed residential services, due to 37 neglect and abuse in other homes. They stated that Sun Community must be a licensed 38 facility, which is a new requirement. For Sun to meet mandates to license, it would be 39 economically not feasible. The article in the newspaper did not state that those services 40 are not going away, they are being transferred to other organizations in the County by 41 other mental health services providers. Through the efforts of many folks, Whatcom 42 County has always had a concern over the RSN mental health dollars from the Medicaid 43 eligible. Those formulas have been changed many times. The County is now getting 44 their fair share. 45 46 Board of Health, 9/8/98, 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 PUBLIC SESSION No one spoke. ADJOURN Dawson adjourned the meeting at 2:35 p.m. Jill Nixon, Recording Secretary These minutes were approved by Council on Februa . 2ry 3, 1999. ATTEST: Dana Brown - Davis, Council Clerk WHATCOM COUNTY COUNCIL WHATCOM COUNTY, WASHINGTON Robert Imhof, Council Member Board of Health, 9/8/98, Page 14