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2017-03-07 Update with Health BOCC Update Minutes March 7, 2017 Start Time: 9:42 am End Time: 10:35 am Present: Commissioner Fund Danette York Commissioner Jackson Bill Teitzel Recorder: Sandi Andrus ISSUES FROM PREVIOUS MEETINGS: • Coal Creek Update – Danette Discussion: There is a public meeting scheduled for tonight at 6:00 at the Kresky building. Bill informed every homeowner about the meeting and anticipates it will be well attended. The engineer will be on site with a presentation. The project will go to bid on March 20. The new City management has been very positive about this project. • Update on Remodel – Danette Discussion: The lights that were on backorder have arrived and are currently being installed. The panels will be installed after the lights. Once the 2nd floor is completed, all staff on the 3rd floor except for the water lab will be moved temporarily to the 2nd floor while they remodel that floor. We will close the immunization clinic while everyone is housed on the 2nd floor. Testing found asbestos in the joint compound of some walls so Facilities staff are having a second test done and we will receive the results soon. Matt is meeting with an abatement company today just in case it is needed. • Update on Reorganization – Danette Discussion: The process is going slower than anticipated. Danette received the contract with McDonald Consulting today and we will begin the process for approval soon. Jane, our TB nurse, is investigating another TB case. This is a difficult case and the client has miliary TB. He is not able to cough up sputums so they may have to do an invasive procedure to get those. We need to go ahead and treat him and follow up on contacts. There are several children under age five who are close contacts so we are consulting with an infectious disease pediatrician; the closest one is in Portland. NEW ISSUES: • Updated List of Code Enforcement Cases (handout) – Bill Teitzel Discussion: The following items were discussed: o #1 – Thomas, Dilwyn, Punches, Nancy – 513 River Rd., Chehalis – Reporting party is a concerned neighbor. This is in the Shoreline jurisdiction and they have cleared out logs, debris, dead snags and brush. Much of the debris is from 2007 flood. The Planning Department sent them a letter that they cannot cut down trees on the shoreline. o #2 – Mayberry, Betty – 112 Lacy Ln., Toledo – Mrs. Mayberry had German Shepherd dogs she could not take care of. Her son took eight or nine dogs to the Animal Shelter for adoption. o #3 – Lewis County Property – 1303 W. Reynolds, Centralia – The cars along the right of way are being scrapped at the junk yard and should be completed this week. Bill explained the criteria used to scrap those vehicles. Bill has generated a project description for bidders for the vehicles. The next step is to ask how we will pay for the rest of the cleanup/abatement for the property. We can possibly use Public Works staff if they have the capacity and it would lower the cost. We may be able to recycle or we could get containers and load them up for a low cost. The BOCC will need to give direction to move on that before we do anything. It may cost upwards of $200,000 and may be a biddable job. Danette would like to meet with Bill, Eric Martin and Eric Eisenburg to discuss a plan and how we might be able to abate the property for the lowest cost to the county. Decision: Bill will get the information on the junk yard and attend the City Council with Commissioner Fund on March 14. o #4 – Andrews, Kimberlee – 109 Elma Dr., Centralia – The only violation is the junk vehicle on the property. Bill spoke to Kimberlee and informed her he will send a Notice of Violation. If the vehicle is gone, this is done. If she wants a new building, she needs to get a permit from the permit center. Bill couldn’t confirm anyone was running any commercial businesses. o #5 – Lewis County Property – 1700 Block of Airport Rd. – Bill talked to Lee Napier about this. Commissioner Jackson asked about the facilities. There is only one building there which is a giant blue concrete building with graffiti on it. We have it posted for trespassing. If we have bidders going out there, we let the Sheriff’s Office know ahead of time so they won’t be charged with trespassing. o #6 – WSDOT – MP 63.8 Interstate-Five, Winlock – A fuel spill was reported a few weeks ago that occurred on January first. Both tanks of a semi that ran into the median were ruptured and the fuel flowed into the gravel around the median. This is on DOT property on I-5. Bill looked at it and has concerns. There are streams that cross approximately 800 feet down. Bill feels the fuel may resurface and get into the creek which goes to Clackamas Creek. Bill sent a report to DOE and they should send us water resources. The driver and hauling company of the spill cannot be located. • Nurse Family Partnership (NFP) Update – Danette o Archie Smith arrived at approximately 10:00 and informed the Commissioners about doing a “market analysis” for the Public Health Nurse positions. Last June a job description was created for the Public Health Nurse III position which scored 23 on the Salary Scale. We recruited for the position but only 4 people applied. We are not getting much interest in this position and it has been advertised and posted on our website and several other locations. Archie proposed doing a market analysis to see if it should be scored higher, possibly a two-grade increase which could mean about a 10% salary increase. We have some flexibility in the PHN I and II. We have both PHN II and III advertised currently. This is the hardest position to fill at this time. Danette looked at Pacific County’s results from a 2015 salary comparison and Lewis County is below every comparable county they compared. An increase to the salary would make us more competitive with comparable counties. Commissioner Fund stated that someone from Senator Braun’s office heard that someone here thought her salary was double what she actually received so Commissioner Fund sent the job information to Senator Braun’s office. Commissioner Jackson made a motion that Archie look into doing a market analysis for Public Health Nurses. Commissioner Fund seconded. Motion passed 2-0. Decision: Archie will look into doing a market analysis for Public Health Nurses and bring his findings back to the Commissioners. o Thurston County contract for Supervision – Danette Discussion: Danette informed the Commissioners that we have an interview scheduled today for the PHN I or II position. She gave a background on the mandated Communicable Disease (CD) program. Donna Muller was our CD nurse and also worked in CSHCN and Work First. When we started the NFP program we decreased Donna’s .5 in CD and assigned it to the NFP Supervisor. Part of the reason the NFP Supervisor left was because CD overwhelmed her. We are in the process of contracting with Thurston County for supervision because we have to have it by the NFP national base model. Donna is currently doing backup CD until we get the vacant positions filled. We held an interview last month for the NFP Supervisor position and Danette met with the applicant last week but she really did not fit what we are looking for in a supervisor. Fortunately, she is interested in the home visiting position. Today we have another interview and are hopeful we will be able to hire one for the Home Visitor position. Danette would like to talk to Thurston County about the possibility of making this supervision contract more long term. Danette will meet with their NFP Supervisor and the State Coordinator next Tuesday to discuss whether they have the capacity or would want work together for the NFP program. Now that our program is going, we could just contract the supervision piece with them and our two NFP nurses would be employed by Lewis County and go to Thurston County for supervision only. The other option is for Lewis County and Thurston County to have a joint NFP program. Several counties in the State currently work with that model where the larger county employs all of the NFP staff but some of them are dedicated to doing home visits in the smaller county. Cowlitz and Clark just entered into such a contract. Decision: The Board approved contracting with Thurston County to provide long-term NFP supervision if that is acceptable to both parties • Communicable Disease position – Danette Discussion: If the market analysis comes back increasing the salary for the nurses’ positions, we may be able to keep the two NFP nurses and hire for a CD position. Danette would need to open the CD position (includes Work first and CSHCN) at a .8 FTE. There should be funds in the budget to cover this position. CD and CSHCN programs do not need a nurse; we could use a social worker, epidemiologist, or health educator with clinical expertise. Decision: The Board approved Danette pursuing adding an employee to handle CD based on what is finalized for the NFP program. • Animal Shelter Bequests – Danette Discussion: The resolution is in packetwriter and will go before the Board next week. BOH ISSUES: Review Board of Health agenda for March 13, 2017 meeting at 1:30 Consent Item: o H. Res #031317.1 Approve Amendment #11 to the Consolidated Contract #C17116 between Lewis County and Washington State Department of Health. This increases amount by $3,446 for maximum consideration of $2,532,042 Commissioner Jackson made a motion to move Resolution #031317.1 to the regular agenda of the monthly Board of Health meeting; Commissioner Fund seconded. Motion approved 2-0. OTHER ISSUES of Concern to the BOCC: • GRBHO – Danette Discussion: Danette shared the minutes from the last GRBHO meeting stating they are getting a Mental Health provider license to do the FACT program. GRBHO said the State would take the funding back if not used so they decided to take the program and the funding from the agency initially awarded the funding, which is in Cowlitz County. Danette and Commissioner Fund have received calls from providers who have serious concerns with GRBHO paying staff over 30% of what providers typically can pay and calling selected people to apply. They need to discuss the fact that there are millions of dollars available for mid-adopters at the next GRBHO governing meeting. Commissioner Fund should inquire why they do not want to go mid-adopter even though it could do away with GRBHO. Danette will attend the next meeting with Commissioner Fund. The GRBHO Advisory Board meeting is today. Decision: Commissioner Fund will ask the GRBHO Governing Board about the mid-adopter.