Six people who received dental treatment at the Texas City Coastal Health & Wellness Clinic in the past three years were diagnosed with hepatitis C after visiting the clinic, county health officials confirmed Monday.
Two of the people did not contract the disease at the clinic, which suspended dental appointments in February after an accreditation review identified multiple problems with the way the clinic sanitized instruments used in invasive procedures.
The county health district is still investigating how the other four people were infected, said Dr. Phllip Keiser, the Galveston County health authority.
It’s possible the people contracted the disease before, during or after visiting the dental clinic, Keiser said.
Uncertainty about how the people were infected and the proximity in time of the diagnoses and clinic visits were critical factors in the health district’s Friday announcement that as many as 9,500 people were potentially exposed to hepatitis B, hepatitis C and HIV at the dental clinic.
The district urged people who had dental procedures at the clinic between March 1, 2015, and Feb. 13 to be tested for infections.
The health district set up a hotline Monday to answer questions about the possible exposure and to help set up free screening tests.
The district had already tested about 200 people by Monday afternoon, Keiser said.
The free screening tests will be available through April 13, he said.
No one from Coastal Health & Wellness attended a news conference or responded to questions about the clinic’s practices Friday when the health district announced its concerns.
Mary McClure, the clinic’s executive director, and Milton Howard, chairman of the Coastal Health & Wellness Board of Governors, held a news conference Monday to announce the organization was fully cooperating with the health district’s investigation.
Howard, a dentist, said none of the hepatitis C cases identified so far had been connected with the clinic’s sanitation practices.
“We see patients with hep C, hep B and HIV and we take the proper precautions when we see each and every patient,” he said. “Seeing them or any patient, we take the same precautions.”
McClure, who was named executive director of Coastal Health & Wellness in November 2017 after serving 11 months as its interim director, said there had been a delay between closing the clinic on Feb. 12 and notifying the public so officials could make initial findings and consult with state and local authorities.
Appointments at the dental clinic had been canceled during that 38-day delay and patients had not been told why, McClure said.
“We told them that when we were canceling their appointments that we were doing some redesign internally,” McClure said.
The dental clinic is not yet reopened.
Hepatitis C is a liver infection carried through the blood. It can cause fatigue, nausea, loss of appetite and the yellowing of skin and eyes. It can lie dormant for long periods of time, but it can also cause organ damage and death.
Hepatitis C can be cured through medication, Keiser said.
“The good news about this is that we have no evidence of hepatitis B or HIV infections,” Keiser said. Those viruses have no cure.
Galveston County Health District officials did not disclose that dental clinic patients had been diagnosed with hepatitis C when initially announcing their concerns last week. Keiser said the health district was trying to walk a “fine line” between informing the public and sparking a public health panic.
So far, no illnesses have been connected directly to work done at the clinic, Keiser said.
McClure at the news conference Monday would not confirm whether anyone had been fired since the sterilization issue was first raised. She cited the ongoing investigation.
In the past month, the clinic had hired a consultant to bring the clinic up to standard, and instituted an infection control policy, she said.
The clinic’s staff had been trained about sterilizing equipment, and the clinic can now document that the staff members have been trained, she said.
In an interview after Monday’s commissioners court meeting, Galveston County Judge Mark Henry said he had been informed about the situation about two weeks ago and was told about the positive diagnoses Thursday.
Henry said that he did not know what, if any, role the county would have in holding the clinic and the health district responsible for the sanitation lapses.
“We don’t know what the fallout is yet,” Henry said. “The short answer is, we don’t know, and I’m not sure what we can and cannot do.”
After months of local infighting among maritime players over fog delays and rules governing the board charged with overseeing pilots who guide ships into ports, the issue came before state legislators for the first time Monday.
While many of the lines of argument and examples remained the same, members of the Texas House Select Committee pressed the two sides to explain their positions on issues that have divided the groups in Galveston County.
“It is appropriate to have this hearing to understand how the state can help the growth potential in Galveston,” said Rep. Joe Deshotel, a Democrat from Port Arthur who chairs the committee.
The chairman of the Galveston Wharves Board of Trustees, which governs the Port of Galveston, for months has led calls for more representation and control of the five-member Board of Pilot Commissioners for Galveston County, which oversees the Galveston-Texas City Pilots Association. Although vessels have captains, they’re required to have pilots on board to guide them to and from the harbors. Ship pilots charge for that service.
Galveston Mayor Jim Yarbrough, who also sits on the wharves board, Monday testified about the need to reconsider how area pilots are governed.
“I’ve been in public policy for 30 years and I’ve discovered that public policy, both good and bad, is workable as long as it is equitable,” Yarbrough said. “Right now, Galveston is unique in how it is set up, and we are just seeking to be treated the same as all the rest.”
Port of Galveston officials for months have contended the port doesn’t have the same level of representation on the board of pilot commissioners as other Texas ports.
Each of the state’s pilot commissioner boards are slightly different, governed by different sections of the Texas Transportation Code, but this assertion is technically true, according to maritime experts.
A representative from the Board of Pilot Commissioners for Galveston County was slated to testify Monday, but didn’t attend.
Yarbrough said Monday he hoped legislators would consider a change that would give the port the power to approve or veto proposed rate increases from the Galveston-Texas City Pilots Association, similar to the situation in Jefferson County.
“We aren’t asking to take away the power to appoint from the governor, just the ability to approve what the pilot commissioners do,” Yarbrough said.
Deshotel followed Yarbrough’s testimony by asking whether the port could be put in a situation in which it reached a contract agreement with a cruise line, only to see it fall through because of a rate increase.
“There’s a history of evidence on why the current situation isn’t working,” Deshotel said. “We need to come up with an idea that allows the port to make a plan for the future.”
Cruise lines, the biggest revenue generators at the Port of Galveston, have accused ship pilots of using fog as an excuse to delay vessels coming in and out of the island’s harbor.
Cruise line operators said an unusually high number of fog delays was in retaliation for their complaints about a sharp increase in rates pilots charge.
Representatives of the Galveston-Texas City Pilots Association followed Yarbrough, testifying that the proposed change to give the port of Galveston veto power over rate increases wasn’t a good idea.
“A lot of logistics for the safe operations of pilotage and the rates support that,” said Paxton Crew, the association’s attorney. “Commercial interests shouldn’t take top priority, but safety — avoiding a catastrophe.”
If the port was given veto power over any rate increases, it would through attrition make it unfeasible to maintain pilots’ supplies, Crew said.
But Deshotel pushed Crew, telling him the issue wasn’t safety or not appreciating what the pilots do, but purely about rate increases.
“The issue is about the port’s ability to plan for growth, which they can’t have in this scenario,” Deshotel said.
Before that point in the hearing, neither side had directly mentioned fog delays, but Crew said he worried the port would use the veto power to retaliate against the pilots for not bringing ships in in the fog.
“My opinion is that the current situation works just fine,” Crew said. “The pilot board is unbiased and capable of making decisions. But the underlying issue is that the cruise ships want to move in fog and aren’t willing to take no for an answer. It would imperil the entire port system.”
Rep. Tracy King then asked whether Galveston-Texas City Pilots Association’s rates were comparable to surrounding ports, and Crew said that they were.
Later, Christos Sotirelis, the presiding officer of the association, testified the pilots were working with cruise lines directly to address some of its concerns.
“We’re looking at putting an extra set of eyes on each ship and purchasing better equipment,” Sotirelis said. “But, ultimately, the individual pilot has ultimate discretion.”
The pilots already give cruise ships priority after a fog delay and earlier waived a tariff requirement for a second pilot on each cruise ship to accommodate the cruise lines, Sotirelis said.
A representative from the Port of Texas City also testified, saying that they were comfortable with the pilot situation as it was, but that if a change were made to the pilot board, that port would also want a voice.
Deshotel said that he hadn’t yet drawn any conclusions, but that meetings were needed to understand the issues.
“There may be some underlying issues pushing this,” Deshotel said. “We’re trying to figure this out.”
Architects designing the Stewart Beach Pavilion will unveil a new design for the building.
The city’s land use rules for development are overreaching and overly complicated for entrepreneurs trying to start businesses on the island, a Galveston Regional Chamber of Commerce subcommittee said in a recent letter to the city.
In a letter to the city’s planning commission and staff, John “Rocky” Sullivan recommended some edits to the land use document and the zoning map. Sullivan is an island businessman leading the chamber’s subcommittee reviewing the land use restrictions.
The chamber’s primary complaint is existing land use regulations are so detailed and specific that they overly complicate the development process, he wrote.
The comments stem from challenges raised about the document as a whole and not necessarily the recent proposals up for consideration by the city council next month.
“As a general commentary, it seems that the level of detail attempted in the LDR is where many of the mistakes are found and due to the fact that there is an infinite number of circumstantial scenarios it is almost impossible to accurately and effectively regulate,” Sullivan said.
The zoning map has many inaccuracies with properties listed under the wrong zone, Sullivan wrote.
“This begs the question: why do we need to have such a voluminous and inherently complicated document for development regulation?” Sullivan said.
The Galveston City Council is slated to vote next month on revisions to the land use document. The city in March 2015 approved the Galveston Land Development Regulations, a complete overhaul of a 1991 zoning and land use document.
In the time since the 2015 approval, city planning staff has been working on revisions and proposed amendments to the document primarily to address administrative-type issues that have come up, Mayor Jim Yarbrough said.
Those revisions went before the planning commission last year and to city council in October 2017. The city held public meetings on the changes through December 2017.
The council had planned to vote on those changes, but pushed back the vote after a request from the chamber’s subcommittee for more time to review the changes. Meanwhile, city staff has been meeting weekly with the chamber’s committee on land development regulations.
But the recent proposals put a renewed spotlight on the overall document and zoning map, with some parties revisiting the debate about that document. Conversations about the land use document as a whole will be a topic for discussion over the next nine to 12 months, Yarbrough said.
“In the process of looking at those administrative changes, Rocky in particular, and to a lesser-degree the chamber subcommittee, decided the base LDR approved in 2015 have some problems, at least from their perspective,” Yarbrough said.
“If they want to review it, that’s fine but that’s not going to be done by a chamber subcommittee; it’s a city process,” Yarbrough said.
The city council will vote on the proposals where there’s consensus next month and revisit the issues about the document as a whole after that vote, he said. Those issues will go through the process of public hearings, he said.
The proposed revisions to be voted on next month include things such as redefining retaining walls, defining additional terms and fixing typos, according to planning documents.
The other revisions vary in scope. One revision is a neighborhood services district, which would serve as a buffer zone between residential and commercial zones. The regulations require setbacks between businesses and residential properties.
Another policy change is the addition of density standards for the West End. Excavation would also be regulated if the revised land use document is approved. Anyone excavating on the island would need a specific use permit, and would have to provide the city with detailed information about the project, including a full site plan, sand quality and cost analysis.
Boat repair facilities have new limited-use standards, such as required screening enclosing outdoor boats visible from public rights of way. Boat sale or rental locations wouldn’t be able to place outdoor displays or storage within 25 feet of a residential district boundary, according to the revisions.
Recreational vehicle parks also would be regulated. Those would have to be placed 300 feet back from a residential property line.
This week, the city council heard the staff’s timeline for taking up the revisions. The planning department is reviewing the chamber’s recommendations, said Tim Tietjens, director of the planning department.
The planning commission will next discuss the proposals on April 3 and April 17 before the document goes for a final review before the city council April 26, according to the city.
During the April 3 meeting, the planning commission will vet the chamber concerns and compile a list of what staff and the chamber agree on and what they disagree on, Tietjens said.
The items they can agree on will be before the council for a vote in April, he said. The areas where they disagree will be the next phase of review, Tietjens said. Those issues will likely be part of upcoming public meetings, he said.
“The things we can’t work out and the things that weren’t part of the original scope will be the next phase,” Tietjens said.
A separate issue tangentially related to the land development regulations came up during the city council meeting last week with a Broadway business owner seeking permission from the city to build a gas station within 200 feet of homes, which would be a violation of the city’s land development regulations.
It highlights some of the friction, even among council members, about the land use regulations document and their application.
Trong Van Ha, owner of the Shop-N-Drive on 54th Street and Broadway, requested a planned unit development, basically a permit to allow for construction of a gas station that deviates from the existing land use regulation, according to city documents.
Van Ha recently renovated his Shop-N-Drive convenience store on Broadway and planned to add six gas pumps to turn the property into a full-function service station.
In a 4-3 vote, the city council denied the planned unit development permit for the gas station, with the deciding members arguing it violated the current land use regulations and went against the direction for Broadway development an ad hoc committee is studying.
“I believe strongly in the original LDR that said 200 feet from residences,” Councilman Mike Doherty said. “I wouldn’t want to live 200 feet across from a gas station.”
The city has hired consultants to create a vision for Broadway and should not create exceptions going against that vision, he said.
“All of a sudden, it becomes meaningless to have these ordinances,” Doherty said.
But Mayor pro tem Terrilyn Tarlton-Shannon, one of three members who supported granting the permit for the service station, said Broadway is a commercial zone and the business owner had taken expensive steps to improve the look of the building. He also had permission from neighbors for the gas station, she said.
“We have very few commercial corridors and just because some people don’t want gas stations on Broadway should not dictate what happens citywide,” Tarlton-Shannon said.
The council has passed different planned unit developments and made exceptions for properties before, she said.
“This is not a chain, this is one of our own people trying to have a dream,” she said. “We’re going through the LDR changes right now and making revisions to them because of the errors we’ve made.”
The vote followed the current land use regulation guidelines, Yarbrough said.
“If you start making exceptions, where do you stop?” Yarbrough said. “Public policy needs to be consistent, equitable and fair.”
If the city decides the 200-foot setback policy is not the right policy for the city, then those changes could be considered for the document, but through ordinance and not through making exceptions, Yarbrough said.
“If that’s bad public policy, then let’s change the public policy,” Yarbrough said. “But that needs to be balanced by the public good.”
A hurricane recovery program managed by Galveston County could elevate as many as 200 homes across the county in coming years in an effort to get them above flood levels, according to a preliminary estimate commissioners received Monday.
Commissioners heard details of the plan from Grantsworks, consultants hired to oversee disaster recovery planning.
Commissioners could take the first step in creating the program, notifying the Texas Department of Emergency Management of county interest in the funds, by their next meeting in April, Galveston County Judge Mark Henry said.
The emergency management department plans to release $500 million in hazard mitigation funds across Texas, officials said.
Galveston County anticipates getting a large portion of those funds to raise houses flooded by Hurricane Harvey.
The exact number of houses that could be raised through the county program and how much money would be available for the work is undetermined, but officials believe the county could get enough money for up to 200.
Thousands of homes in the county flooded during the late-August hurricane, but the program would target those that had flooded more than once, officials said.
“This is to elevate home that have flooded multiple times,” Galveston County Judge Mark Henry said.
About 900 homes across the county met repetitive flooding guidelines, Henry said, adding that he didn’t expect owners of all of them would seek help raising their properties.
“There is a pool in both incorporated and unincorporated areas,” Henry said. “Of that number, not everybody is going to want to participate, not everybody is going to meet the guidelines, not everybody is going to get their paperwork in, so we’re going to get a pretty steep fall-off rate.”
The county’s program likely would require homeowners to pay a percentage of the cost of the project, Henry said.
Some of that cost to residents could be borne by Community Development Block Grants expected to be awarded to the county by the U.S. Department of Housing and Urban Development in the future, officials said. The county won’t know how much it will receive through those grants for perhaps another year, however.
Commissioners have been getting questions about a home-raising program for months, Galveston County Precinct 4 commissioner Ken Clark said.
“We’re going to do our best to craft it to where it’s cost-effective to the taxpayer and timely for the homeowner,” Clark said. “This program and other programs are critical to bring to them to try to relieve the issues of flooding long-term for homeowners.