The Island County Board of Health convened in Regular Session on November 9, 1998 at 11:15 a.m., Island County Courthouse Annex, Coupeville, Wa. Board of Health members present included: Wm. L. McDowell, Chairman; Tom Shaughnessy, Member; and Mike Shelton, Member. Others Present: Tim McDonald, Health Services Director; Dr. Roger Case, Health Officer; Keith Higman, Environmental Health Director; Jan Dahl, Assessment Coordinator; Marshal Bronson, Community Health Advisory Board [CHAB]; Kathy McLaughlin and Peggy Tennant representing the Island County/Stanwood Community Public Health & Safety Network,.

The Board, by unanimous motion, appointed Toni Kotschwar, Oak Harbor, to Position #2 on CHAB for a term to March 8, 1999.

Mr. Bronson reported that CHAB at their last meeting formed three task forces: (1) Com-munication Task Force; (2) Vision Task Force; and (3) Study Group to look at an expanded Board of Health. Looking at an expanded Board of Health is included in the CHAB’s recommendation, and CHAB will be looking at Jefferson and Kittitas counties where they have expanded the Board of Health aspect.

Jan Dahl followed-up on an article Mr. McDonald sent the Board last week about long-term effects of nurse home visitation on children’s criminal and anti-social behavior. This was a research study beginning in 1978 and just completed the 15-year follow-up looking at the 15 year olds who were the babies born to women enrolled in the study in 1978 and 1980. There were 400 women in the study, most white, 62% unmarried, 48% teenagers, and 59% low socio-economic status. Close to 40% were middle class who were not poor and who were married.

The families received about 9 home visits during the pre-natal period and about 22 during the first two years of the child’s life, and then 15 years’ later a follow-up to see how the kids were doing. The results showed that those children who were born to women who received the nurse home visits who were unmarried and from households of low socio-economic status had:

• fewer incidents of running away
• fewer arrests
• fewer convictions and violations
• fewer lifetime sex partners
• fewer cigarettes smoked per day
• fewer days of having consumed alcohol in the last 6 months.

Parents reported fewer behavioral problems related to the use of alcohol and drugs and fewer of the mothers were on welfare 15 years later. When intervening in pregnancy the brain structure can actually be changed of the child so they do not have learning deficits, and the nervous system functions so they can fit in with society. Nurse home visits can impact the pre-natal period. She encouraged that the Board of Health support Healthy Families Whidbey as the grant process continues.

Kathy McLaughlin, Coordinator, Island County/Stanwood Community Public Health & Safety Network, advised that a summit of 53 networks was held this weekend at SeaTac. The Island County/Stanwood Community Public Health & Safety Network, put on a Communication workshop and a workshop on Child Abuse and Neglect. They presented a report on Healthy Families Whidbey about investigating the possibility of 0 – 3 programming in Island County. Mona Lee Locke was very interested in that effort at the State level, and Island County representatives were invited to tell her what was happening in Island County, where the County was headed and what kind of work was being done. She shared with the Island County group where she is with the Children and Families Commission for the State which she chairs with Mrs. Gates. She applauded Island County for taking such a step forward at the local level.

In order to communicate better within the network one of the additions created was a list-serve to share problems and successes, and proved to unite the group better. The Island County network, San Juan, Skagit, Whatcom and Snohomish networks got together with local DSHS representatives and formed a safe collaboration feeling. The Northwest region has led in that effort and set the example for other networks. Island County is one of the most vocal counties reminding the State that this work has been done locally. The Department of Health has been on the leading edge in setting an example l for other agencies.

Peggy Tennant, Chairman, Island County/Stanwood Community Public Health & Safety Network, pointed out that not only did the list-serve flood the Governor’s Office with messages and the regional model inspire cooperation, but there now are regular meetings with the Governor’s Office on a quarterly basis with representatives of the network.

Mr. McDonald presented for Board approval a propose for the renaming of existing fees

effective December 1, 1998 in response to land use changes. The Health Department will continue to do the same work but change the fee under a renamed fee category.

The Board, on unanimous motion, adopted Resolution #C-148-98 [HD-10R-98] as presented.

Next, Mr. McDonald presented a proposal for new fee categories; some of the new categories will include a charge for services not previously charged for; some are for new services, and some actually reduction of what the fee is for services, with the change to be effective January 1, 1999. As indicated at the last staff session with the Board, and in a memo provided, Mr. McDonald reiterated that the other fees by other departments are for a different service and go to a different department. These fees would be to compensate the Health Department for the work it does. The Board has asked that the Health Department pay for services in the envir-onmental health section through fees; those fees are adjusted each year to address the cost of providing the services. Budget impact wise, the whole package turns out to be budget neutral.

Note: correction needed -- exhibits attached all reflect Exhibit A, when in fact each needs to reflect Exhibit A, B, C and D.

The food program is a service being provided at no charge in the past. Contract food service is a new category, developed in this community just recently. For Institutional kitchens the Department proposes issuing the permit effective 1/1/99, with permit fee not required until July 1, 1999 pro-rated for the year [for the first year the fee will only be half the amount shown on the exhibit, then 1/1/2000 on an annual basis]. For the fee, the Health Department will provide periodic inspections similar to restaurant – the number of inspections dependent upon the situation, but at minimum, two thorough inspections per year and responses to other issues.

As far as Water, it is a new category for services, a sanitary survey performed by the Health Department, required by the State under the Clean Water Act. Mr. McDonald provided a copy of the Washington State Department of Health Small Water System Sanitary Survey Checklist [copy on file]. Liquid Waste fees, as shown, is a proposed reduction from $273 to $134.

The Board generally agreed not to adopt Exhibit B, Food Program new fee category, charging fees where none before had been charged from seniors, schools and jail, etc. It was pointed out by Commissioner Shelton too that when looking at Institutional Kitchens one that would be adversely affected would be the senior program meals on wheels. The County already supports those programs in terms of current expense dollars so ultimately if fees were charged would provide the Health Department with some additional funds, but taking it away from another current expense supported system, which would be true of the jail as well. The primary source of revenue would come from the school districts, and while that may be a way to transfer some revenue from the school districts to the County, he preferred not to do that. He did not see any inconsistency in terms of what is proposed. From a community standpoint the fact that the County would continue to inspect school cafeterias to make sure from a health standpoint food meets appropriate health criteria.

The Chairman commented that the proposed action is not performing the service, rather the issue of charging a fee or not, and his thought was that if one user is charged a fee, others should also be charged.

Commissioner Shelton disagreed for those reasons he stated.

Commissioner Shelton moved that the Board adopt Resolution #C-149-98 [HD-11R-98] in the matter of revision of the environmental health service fee schedule of the Island County Health Department, deleting what is now Exhibit B proposed fees for the Food program, and adopting Exhibits now marked: Exhibit A, Land Use; Exhibit B, Water; Exhibit C, Liquor Waste. Motion, seconded by Commissioner Shaughnessy, carried by majority vote; Chairman voted in opposition.

Commissioner Shelton clarified intent of the Board was to not adopt the fee proposed for the Food Program permit, but that the County would continue issuing permits and doing the inspections.

NEW FEE CATEGORY

Water

The meeting adjourned at 12:05 p.m. The next Regular Board of Health meeting is scheduled on December 14, 1998 at 11:15 a.m.

BOARD OF HEALTH

ISLAND COUNTY, WASHINGTON

Wm. L. McDowell, Chairman

Tom Shaughnessy, Member

Mike Shelton, Member