Minutes of the Island County Board of Health

Monday, September 15, 2003

Members Present: Commissioners: Mike Shelton, Mac McDowell and William J. Byrd, Mayor Patty Cohen, Oak Harbor, Barbara Saugen, WGH Commissioner; Roger S. Case, MD, Executive Secretary to the Board

Absent: Captain Susan B. Herrold, NC USN (Naval Hospital Oak Harbor)

Call to Order: Commissioner Mac McDowell called this regular scheduled meeting of the Island County Board of Health to order at 1:21 p.m.

Changes or Additions to the Agenda: Tim McDonald, Health Services Director, purposed that the Hart Appeal be heard prior to the Gordon Appeal. The Board concurred.

Minutes: Mayor Patty Cohen moved that the minutes for the August 18, 2003 meeting be approved as written. Commissioner William Byrd seconded. The motion passed for the Chair to sign on behalf of the Board.

There was no Public Input or Comment.

Continuance of Hart Appeal: Keith Higman, Environmental Health Department, asked the BOH to let Mrs. Hart address the Board. She asked for another continuance to the next BOH meeting in October. She stated the reasons for her request for a continuance. Commissioner Mike Shelton moved that the appeal be continued to October 20, 2003. Commissioner William Byrd seconded. The motion passed.

Continuance of Gordon Appeal: Health Services Director read a section of the minutes from the June 16, 2003 BOH meeting regarding the appeal of site registration number 03-060N. It stated that: “Neither the appellant nor his representative were present. After a brief discussion, Mayor Patty Cohen moved to continue the appeal until the appellant can appear, and stipulated September BOH meeting as the deadline for such to occur.”

• Keith Higman reiterated the Proposal, Findings, Analysis, Conclusions and Recommendations For Appeal. He asked the Board to uphold the Island County Health Department’s decision and deny the appeal. Some discussion ensued regarding the subject of saturated soil and fill; the need to keep the liquid below soil; and that soil saturation would move liquid laterally on the slope. Mr. Higman said that WAC 246-272-11501(2)k(iii) states the “The sidewall below the invert of the distribution pipe is located in original, undisturbed soil.” He also cited ICC 8.07C.130 B.12.d “the sidewall below the invert of the distribution pipe is located in original, undisturbed, unsaturated, permeable soil; except as provided in the Washington State Department of Health Technical Review Committee Guidelines for Mound Systems (1993) and Guidelines for the Use of Sand Filters and as hereinafter Amended;
• Commissioner Shelton stated that the development area under discussion was at one time completely under water, and has always been saturated.
• The appellant’s representative Daryl McNabb asked David Martin to engineer a “solution” because the appellant wished to sell his property. Mr. Martin stipulated that he felt the waiver guidelines could be met.
• Much dialog ensued concerning factors to be considered, how soil maturation occurs, its ability to treat affluent, separation requirement, and there being no native permeable soil on the property.

After the waiver guidelines were read, Commissioner Mike Shelton moved that the appeal be denied. Mayor Patty Cohen seconded and the motion passed unanimously.

CHAB-ICHD Budget Task Force Report: David Macys presented a condensed version of the Budget Task Force Report. Four dedicated members of CHAB reviewed the Health Department Budget, the numbers for the last couple of years, and came up with their recommendations based on previously developed CHAB health priorities.

They were aware of the limited amount of current expense funding available.

CHAB Priorities:

• Early Support for Infants and Parents
• Mental Health Services and Resources
• Preventive Health Screening
• Physical Activity and Chronic Disease

Findings and Considerations – The CHAB Budget Task Force also reviewed the administrative costs and overhead charges for the ICHD. The current rate seems appropriate and reasonable, and no budget recommendations were developed relating to these costs.

Budget Work Sheets: (Budget Recommendations)

• Search for grants that would help increase the ICHD effort in Child Abuse Prevention
• Consider providing increased current expense funding to the ICHD for child abuse prevention programs (as part of the Healthy Child program)
• Maintain funding for Children With Special Health Care Needs at no less than current levels, adjusting for (a) inflation of relevant costs, and (b) imposition of new requirements
• Consider providing an increase in current expense funding to the ICHD for programs for children with special health care needs
• Maintain funding for Physical Fitness programs at no less than current levels, adjusting for (a) inflation of relevant cost, and (b) imposition of new requirements.
• Consider funding chronic disease and illness prevention by providing an increase in discretionary funds and/or searching out grant sources.
• Maintain funding for Communicable Disease Prevention and Treatment at no less than current levels, adjusting for (a) inflation of relevant costs, and (b) imposition of new requirements.
• Ensure that the county contingency fund can address “outbreaks”, i.e. a large number of new TB or Aids cases, or a newly emerging disease
• Determine if additional economies can be achieved within the Department through innovative cross-program coordination and collaboration (within limits of funding regulations).
• Determine whether additional sources of Federal, State or non-governmental grants exist which might help support these programs (Communicable Disease and Treatment) freeing up some of the county funds.
• Maintain funding for the Oral Health program at no less than current levels, adjusting for (a) inflation of relevant costs, and (b) imposition of new requirements).
• Consider funding pediatric dental programs by providing an increase in discretionary funds and/or searching out grant sources.
• Consider reducing subsidization for the school nurse program by current expense funds (i.e. $1.00 per student).
• Consider having other nurse consultation programs completely funded by the agency or state or federal program that which supports them (i.e. jail / government).
• Fees for vital statistic records are set by the State, but it is recognized that these should be fully covered by fees. Recommend communicating with State lawmakers about inadequacy of the current fee schedule.
• Maintain funding for the Passport program at no less than current level, adjusting for (a) inflation of relevant costs, and (b) imposition of new requirements.
• Maintain funding for young families at no less than current levels, adjusting for
  (a) inflation of relevant costs, and (b) imposition of new requirements.
• Strive to operate WIC, WIC Breast Feeding, and family planning programs using less current expense funding and continue to advocate to WA State, USDA, and Congress for increased funding to more fully cover operating costs.
• Search out grant sources for all young family support programs to increase level of effort.
• Consider providing increased current expense funding to the ICHD for the Healthy Family program.
• Continue at least this level of support for Alcohol/Substance Abuse.
• Consider providing increased current expense funding to ICHD to support Mental Health programs for adults, adolescents, and children in Island County.

Sources:

· National-level Sources

· State-level Sources

· Local-level Sources

Commissioner Mike Shelton said that there is a need to convince legislature to let fees stay in the program that collects them.

Contracts:

Health Services Director presented the following contracts for review:

1. CPS/PHN-Child Abuse Prevention-DSHS

Contract No.: 20958(6)

Contract Amount $98,932

Amendment Amount $10,716

2. Health Officer-Roger Case, MD

Contract No.: HD-11-03

Contract Amount: $88,000

3. Consolidated Contract-DOH

Contract No.: C 08679(5)

Contract Amount: $741,074

Amendment Amount: $112,644 (We will continue our Child Death Review program even though not funded by state… having been meeting regularly without funding for the past 6½ years)

4. Passport-DSHS

Contract No.: 20872(8)

Contract Amount: $86,073

Amendment Amount: $4,534

5. MSS/ICM-Behavioral Specialist-Compass Health

Contract No.: HD-12-03

Contract Amount: $12,000

6. Consultation Program-Skagit/Islands Head Start

Contract No.: HD-13-03

Contract Amount: $2,500

Commissioner Mike Shelton moved that the six (6) contracts listed above be approved. Commissioner Barbara Saugen seconded; the motion passed unanimously for the Chair to sign on behalf of the Board.

There was no report from the Health Department.

Adjourn: There being no further business, Commissioner William Byrd adjourned the meeting at 3:12p.m. (Commissioner McDowell had to leave at 2:45p.m for another meeting.) The next regularly scheduled Board of Health will be October 20, 2003 at the usual time and location.

Submitted: Roger S. Case, MD, Executive Secretary to the Board

Minutes approved this 20^th day of October 2003.

ISLAND COUNTY BOARD OF HEALTH

Mac McDowell, Chairman