PROCEEDINGS OF THE BOARD OF HEALTH. DATE: November 17, 2014

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1 The Board of Health met in regular session held at the County Administrative Office Board Room at 10:30am. Those present: David White, Chairman; Gary Ellis, Commissioner; Teresa Williams, County Attorney; Ken Norris, County Manager; Marie Simons, Deputy Clerk to the Board. A. WELCOME None 1. PLEDGE OF ALLEGIANCE 2. ROLL CALL: Ronald Henderson, District 1 Absent Gary Ellis, District 2 Present David White, District 3 Present 3. PUBLIC COMMENT PERIOD: This was the time for members of the public to present issues of concern or interest to the Board. B. CONSENT AGENDA: NONE C. CORE SERVICES & ADMINISTRATIVE ITEMS: 1. Assessment, Planning and Communication: All agencies are required to use assessment and planning methodologies to identify, evaluate and understand community health problems. NONE 2. Vital Records and Statistics: All agencies are required to record and report vital events (e.g. births and deaths) in compliance with Colorado statutes. NONE 3. Communicable Disease Prevention, Investigation and Control: All agencies are required to track the distribution of disease in the population and prevent and control vaccine-preventable diseases, zoonotic, vector, air-borne, water-borne and food-borne illness and other diseases that are transmitted person-to-person: a. Statewide Ebola Preparedness Data Kristin Pulatie HHS Interim Director Kristin Pulatie reported that the Center for Disease Control (CDC) has comprehensive educational materials and resources regarding the Ebola disease on their website ( HHS receives 47

2 weekly updated protocol, information sheets, and various statutory interpretations for Ebola quarantine from CDPHE (Colorado Department of Public Health & Environment), which HHS utilizes for Montrose County. In the event of any suspected Ebola case, CDPHE would partner with local public health entities which meant that HHS would not be acting alone to mitigate the issue. CDPHE recently requested that Colorado public health entities submit an estimate of the total staff time and funds spent on the Ebola disease. Approximately fifty percent of the public health entities responded, and with that data, CDPHE estimated that Colorado public health entities (including CDPHE) had spent 21,000 personnel hours and $3.6 million on Ebola preparedness. HHS Interim Director Pulatie pointed out the countries where Ebola was most prevalent had no public health infrastructure. HHS Interim Director Pulatie noted that because the United States has an excellent public health infrastructure, an outbreak like the Ebola virus would most likely not be a concern. More people would die this year from influenza and vaccine-preventable diseases than the Ebola disease. As an example of how the HHS Department partners with other public agencies to prepare for an event, HHS Interim Director Pulatie reported that County Emergency Manager Don Angell coordinated a tabletop exercise for Ebola preparation. Twenty agencies participated in the event. At Commissioner White s inquiry, Emergency Manager Don Angell acknowledged that the bio suits were available to Montrose if needed in the event of an Ebola outbreak. A plan was in place for obtaining the suits through the Fire Department, Grand Junction, and the Western Region Health Care Coalition. 4. Prevention and Population Health Promotion: All agencies are required to develop, implement and evaluate strategies to enhance and promote healthy living, quality of life and well-being while reducing the incidence of preventable disease, injuries, disabilities and other poor health outcomes across the life span: (Discussion of this item was postponed.) a. Expansion of services at specialty clinics Terry Balet, NFP (Nurse Family Partnership) HHS Interim Director Pulatie noted that discussion of this item would be postponed due to Terry Balet s illness. 5. Emergency Preparedness and Response (EPR). All agencies are required to prepare and respond to emergencies with a public health or environmental health implication in coordination with local, state, and federal agencies and public and private sector partners. a. POD AAR EPR Coordinator Teri Watkins EPR Coordinator Teri Watkins gave the following report. 48

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5 EPR Coordinator Watkins asserted that the event helped clarify what needed improvement but also revealed how well the different entities worked together. The entities involved in the event were the Sheriff and Police Departments, Fire Department, County Road & Bridge Department, as well as the Public Works Department, which assisted with traffic flow. The exercise officially opened at 11:00am by Montrose County receiving the vaccine from the State; a deputy from the Sheriff s Office was given the vaccine to deliver to the Basin Medical Clinic and the River Medical Clinic in Olathe. The clinic remained open until 5:00pm. Felix s Air Service flew the vaccine to Naturita and arrived at 11:42am, and Sergeant Jackson delivered the vaccine to the Olathe clinic at 11:15am. Over 525 vaccines were delivered to the three clinics within a four-hour period. Montrose radio station 94 KIX was present and broadcasted the live event. Personnel from Walgreens were at the event to administer free flu shots. A private citizen was so impressed with the process, he videotaped the event and made the comment that he was going to send the tape to his friends in Denver so they would know how to improve and organize their vaccine distribution. At Commissioner White s inquiry, EPR Coordinator Watkins reported that each vehicle and individual that received a vaccine was required to complete a form. The names of those who received vaccines were then documented and uploaded to the State s computer system, CIIS (Colorado Immunization Information System). At Commissioner Ellis inquiries, Emergency Manager Angell explained that the schematics for the exercise were developed at several planning meetings, which included HHS, and the Public Works, Police and Sheriff Departments. He also noted that no vaccines were provided to individuals who refused to provide personal information; however, the individuals were not required to provide a drivers license to verify their identity. HHS Interim Director Pulatie added that an internet connection was provided during the exercise, which allowed HHS to check immunization records for the children so that immunizations would not be duplicated. At Commissioner White s inquiry, Emergency Manager Angell explained that tents were set up to provide shelter for the traffic control crew in the event of a storm. Most individuals receiving the vaccine remained in their vehicle while the vaccine was administered. This was done to protect the healthcare worker from exposure to disease. The healthcare workers wore no masks; however, masks were available if needed. Gloves were worn by the healthcare workers, which were removed and replaced after each vaccine was administered to prevent contamination. A tow truck was on site in the event of a vehicle breaking down. 51

6 6. Environmental Health. All agencies are required to participate in the protection and improvement of air, water, land, and food quality by identifying, investigating and responding to community environmental health concerns, reducing current and emerging environmental health risks, preventing communicable disease and sustaining the environment. a. Radon Summary Jim Austin, Environmental Health Director Environmental Health Director Jim Austin reported that in 2014 funding was obtained from the State of Colorado, which was EPA (Environmental Protection Agency) pass-through funding for fiscal year (October 1, 2013 through September 30, 2014). The funding was for education purposes regarding radon health risks for the six counties in Region 10. The State required four deliverables from Region 10 as follows. 1. Conduct 10 education sessions for the public. Educational materials consisted of a 30-minute DVD from CDPHE that outlined the health risks of radon contamination. Those who attended the education session were given a free short-term radon test kit (which were given to HHS at no cost). HHS conducted fifteen educations sessions, which exceeded the 10 sessions that were required. One hundred and forty-four people attended the education sessions and 351 short-term radon test kits were given to County citizens. 2. Conduct outreach to local officials to promote the adoption of January 2014 as Radon Awareness Month. Environmental Health Director Austin contacted the six counties as well as the larger cities and towns in the region. Local officials expressed a great deal of interest in the issue and Montrose County, San Miguel County, Gunnison County, the City of Montrose, and the Towns of Crested Butte and Mount Crested Butte adopted proclamations. 3. Conduct outreach to realtors and homebuilders. The goal to communicate with associations in three counties had been reached. Environmental Health Director Austin noted the most comprehensive information concerning radon was on CDPHE s website at CDPHE created a brochure titled Radon for Realtors, of which most local realtors were aware. Environmental Health Director Austin made a presentation to the Montrose Association of Realtors in January of 2014 and ed the information to the associations in Telluride, Delta, and Gunnison Counties. 4. Disseminate and publicize radon risk information. This was accomplished by distributing information materials at the Montrose County Fair, the Montrose Home and Garden Show; test kits were made available at the public health agencies in the six counties, as well as the CSU (Colorado State University) Extension Office in Montrose and Gunnison. Katie Yergenson, County Media Relations Manager, arranged a radio presentation in January

7 At Commissioner White s inquiry, Environmental Health Director Austin reported that Delta County had applied for radon grant funding for this fiscal year on behalf of the region and he did not know whether Delta County had been awarded the grant. At County Manager Ken Norris inquiry, Environmental Health Director Austin reported that approximately 45 percent of radon tests performed in homes indicated the need for radon mitigation. This rate was consistent with tests in past years; it was also consistent with statewide test results. The State of Colorado was a red zone state, which meant radon levels 1 were high (4 picocuries per liter, or pci/l, or higher). Proper ventilation to ambient air was the recommended mitigation. At County Manager Norris inquiry, Environmental Health Director Austin explained the EPA recommended that radon testing be conducted at the lowest level of the home because radon comes up through the soil formations. Commissioner White inquired whether maps were available that showed the various radon levels in the region. Environmental Health Director Austin indicated that HHS did not provide radon level mapping; however, according to the EPA, radon levels were irregular; homes next to each can have different levels of radon. HHS Interim Director Pulatie explained that while Delta County applied for grant funding, it (Radon Awareness) was also part of Montrose County s larger grant application for Amendment 35 funding for Cancer and Chronic Disease Prevention in Montrose County. Interim HHS Director Pulatie predicted that the County would be informed in December 2014 as to whether it would be awarded the grant. At Commissioner Ellis inquiry, Environmental Health Director Austin acknowledged that radon awareness education would continue if the County did not receive grant funding. Approximately 200 radon test kits were still available to the public as well as educational DVD s from the State, which he planned to utilize in future public education sessions. At Commissioner White s inquiry, Environmental Health Director Austin asserted that radon test kits were stamped with an expiration date. However, moisture renders the kits unusable; therefore, if they have not been exposed to moisture, the kits would still be valid. 7. Administration and Governance: NONE D. UNFINISHED BUSINESS: NONE 1 Radon is a chemical element with symbol Rn and atomic number 86. It is a radioactive, colorless, odorless, tasteless [2] noble gas, occurring naturally as an indirect decay product of uranium or thorium. Its most stableisotope, 222 Rn, has a half-life of 3.8 days. Radon is one of the densest substances that remains a gas under normal conditions. It is also the only gas under normal conditions that only has radioactive isotopes, and is considered a health hazard due to its radioactivity. Intense radioactivity has also hindered chemical studies of radon and only a few compounds are known. 53

8 With no further business coming before the Board, the Board of Health adjourned at 11:02am. ATTEST: Sandra D. Nelson, Chief Deputy Clerk & Recorder By: Marie Simons, Deputy Clerk to the Board David S. White, Chairman Glen Davis, Vice Chairman Ronald D. Henderson, Commissioner 54

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