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HomeMy WebLinkAbout2026_01_15_BOH_Packet_Amended�e{{ehson Public H Board of Health Meeting January 15, 2026 Jefferson County Board of Health Agenda Minutes e, ��LSCMI Public Health January 15, 2026 Regular Meeting Agenda Jefferson County Board of Health Thursday, January 15, 2026 @ 2:30 PM Jefferson County Courthouse — Commissioners' Chambers 1820 Jefferson Street, Port Townsend, WA To view agenda items and meeting materials, click here: www.co. jefferson.wa.us — Services — Laserfiche Web Portal (username and password is: public) — Health — Agendas —Minutes —Packets — Board of Health Documents (then search by date: yyyy_mm—dd) To view public comments received, www.co.jefferson.wa.us — Services — Laserfiche Web Portal (username and password is: public) — Health — BOH Public Comments (search for folder of comments by date, year first) This is a hybrid meeting: Virtual and In -Person Attendance You can join this meeting by using these methods: • Zoom Meeting: https://us06web.zoom.us/i/82378389363 This option will allow you to join the meeting live. You will need to enter an email address. If you wish to provide public comment, click on the hand icon at the bottom of the screen to "raise your hand." Participation will be up to the Chair and/or Clerk of the meeting. • Audio -only: Dial: 1-253-215-8782 and use Webinar ID: 823 7838 9363# This option will allow you to listen to the meeting live. If you wish to provide public comment, press *9 to "raise your hand." Participation will be up to the Chair and/or Clerk of the meeting. • In -Person: You are welcome to join the meeting in -person. In the event of technical difficulties, at least one of the methods above will be accessible to the public. Please try all methods first before calling 360-385-9100 to report any issues. Public comment will be accepted and can be emailed to: BOH@co.iefferson.wa.us until 5:00 PM the evening prior to the start of the meeting. AGENDA CALL TO ORDER — Chair Grace I. Public Comment (10 mins.) Public Comment Periods are dedicated to listening to the public. Each person may address the Board one time during these periods. To ensure equal opportunityfor the public to comment, all comments shall be limited to 2 or 3 minutes per person, depending on the volume of public in attendance. AT A REGULAR MEETING, THE MEMBERS MAY ADD AGENDA ITEMS AND TAKE ACTION ON OTHER ITEMS NOT LISTED ON THIS AGENDA. Americans with Disabilities Act (ADA) Accommodations Provided Upon Request II. Approval of Agenda III. Approval of Minutes of November 20, 2025 Board of Health Meeting IV. Old Business and Information Reports 1. Jefferson County Public Health (JCPH) Report (Apple Martine) (10 mins.) 2. Jefferson Healthcare Report (Dr. Kees Kolff) (5 mins.) 3. Infectious Diseases Update (Dr. Allison Berry) (15 mins.) V. New Business 1. Legal Aspects Regarding Setting of Public Health Clinical Fees (Apple Martine, Allison Berry) (5 mins) 2. Public Health Budget Update; Potential Services Cuts (Apple Martine, Veronica Shaw) (30 mins) 3. Update on BHAC's progress with 1/1Oth of 1% Funding and Opioid Settlement Funding (Apple Martine) (15 mins) 4. Lakes Program Update (Michael Dawson, Tim Weissman) (20 mins.) 5. Selection of New Board of Health Chair and Vice -Chair (5 mins.) VI. Future Potential Agenda Topics: The County Strategic Plan Salish Behavioral Health Administrative Services Organization Opioid Settlement spending Olympic Connect, the Community Care Hub model Board of Health 101 Homelessness Public Health Impacts resulting from Federal Initiatives Rural Reproductive Health Emergency Fund for Public Health The Child Development Center Sewer projects / wastewater VII. Announcements ADJOURNMENT BY: 4:30 p.m. AT A REGULAR MEETING, THE MEMBERS MAY ADD AGENDA ITEMS AND TAKE ACTION ON OTHER ITEMS NOT LISTED ON THIS AGENDA. Americans with Disabilities Act (ADA) Accommodations Provided Upon Request Next Scheduled Meeting: February 19, 2026 2:30 — 4:30 PM Jefferson County Public Health Hybrid Meeting AT A REGULAR MEETING, THE MEMBERS MAY ADD AGENDA ITEMS OTHER ITEMS NOT LISTED ON THIS AGENDA. AND TAKE ACTION ON Americans with Disabilities Act (ADA) Accommodations Provided Upon Request Public Health REGULAR MEETING MINUTES Jefferson County Board of Health Thursday, November 20, 2025 @ 2:30 p.m. Jefferson County Courthouse — Commissioners' Chambers 1820 Jefferson Street, Port Townsend, WA Hybrid Meeting Board Members Greg Brotherton, County Commissioner, District #3 Heather Dudley-Nollette, County Commissioner, District #1 Celeste Dybeck, Tribal Representative Heidi Eisenhour, County Commissioner, District #2 Amanda Grace, Chair, Community Stakeholder Dr. Kees Kolff, Public Hospital District #2 Commissioner Monica MickHager, Vice -Chair, Port Townsend City Council Gabrielle Vanwert, Consumer of Public Health Staff Members Denise Banker, Community Health Director Dr. Allison Berry, Health Officer Lara Cittadini, CHIP Manager Michael Dawson, Water Quality Manager Carter Erickson, Environmental Health Manager Apple Martine, Public Health Director Pinky Mingo, Environmental Public Health Director Jenn Mitchell, Finance Manager Veronica Shaw, Public Health Deputy Director Vice -Chair MickHager called the November 20, 2025 meeting of the Jefferson County Board of Health to order at 2:30 p.m. Members Present: Vice -Chair Monica MickHager, Members Greg Brotherton, Heather Dudley-Nollette, Celeste Dybeck, Heidi Eisenhour (departed early), Kees Kolff (departed at 3:10 p.m.) and Gabrielle Vanwert. Staff Present: Staff Members Denise Banker, Dr. Allison Berry, Michael Dawson, Apple Martine, Jenn Mitchell and Veronica Shaw. PUBLIC COMMENT Vice -Chair MickHager called for public comment. There was none. APPROVAL OF AGENDA Vice -Chair MickHager called for a motion to accept the agenda for November 20, 2025. Staff Member Martine requested a change to the agenda, correcting the title of Section V.2 to read "Behavioral Health Advisory Committee" in place of"Behavioral Health Consortium." MOTION: Member Kolff moved to approve the agenda as revised. Member Dybeck seconded the motion, which carried by a unanimous vote. Respectfully submitted Page 1 of 3 G. Gilbert APPROVAL OF MINUTES Vice -Chair MickHager requested a motion to approve the minutes of the October 16, 2025 meeting. MOTION: Member Dudley-Nollette moved to approve the minutes. Member Brotherton seconded the motion, which carried by a unanimous vote. OLD BUSINESS AND INFORMATIONAL ITEMS 1. Jefferson County Public Health (JCPH) Report Staff member Martine addressed Public Health annual budget issues, including various factors negatively impacting public health budgets and consideration of reducing services. Staff member Shaw elaborated on the potential need to discontinue some JCPH programs due to lack of funding. 2. Jefferson Healthcare Report Member Kolff reported that Jefferson Healthcare is also facing budget cuts similar to JCPH which could result in reduction of critical services. The recent expansion of the hospital included introduction of new "specialty services" which may save the hospital financially. A linear accelerator recently treated its first patient, and delivery of a new mobile "health and dental van" is expected. 3. Infectious Diseases Update Dr. Berry reported that the number of COVID cases is declining. There has been one death from COVID-19 reported this season in Jefferson County. Staying up to date on vaccinations is important to reduce the risk of severe disease, especially for those at high risk. There is a rapid rise in flu cases locally and current flu appears to be more severe than in recent years; vaccination and masking in public gatherings is recommended. RSV is expected later in the season. Avian influenza is a risk during this migratory bird season; avoid contact with wild birds (personal flocks should be kept separate from wild birds). Flock owners are recommended to wear N95 mask, gloves, and eye protection if caring for sick birds or cleaning their coops. The CDC recently claimed that a connection between vaccines and autism "cannot be discounted," contradicting years of research. Dr. Berry shared that there has been extensive research into this possible connection and it has been repeatedly disproven. The primary driver of increasing rates of autism is better detection and the broadening of diagnostic criteria, with a small contribution of increased parental age. With the reopening of the federal government, funding for SNAP and WIC has resumed, although funding has been reduced. Dr. Berry recommended supporting local food banks. Discussion ensued. NEW BUSINESS 1. Policy Regarding Establishing Public Health Clinical Fees Staff member Martine spoke in response to a question (from the October meeting) requesting consideration of how the Board can be more involved in the setting of fees. The County Prosecuting Attorney's office is reviewing the 2012 Board of Health policy which set rules for clinical fee setting; recommendations for revision of the policy are expected by the 5 h of December and may be considered at the December Board of Health meeting. Discussion ensued. 2. Alternate Board Member Representing the Board on the Behavioral Health Advisory Committee Staff member Martine led a discussion of the need for an alternate representative to the BHAC, and its responsibilities. Member Vanwert volunteered to serve as alternate representative. MOTION: Member Brotherton nominated Gabrielle Vanwert as the alternate for the Board of Health representation on the BHAC. Member Dybeck seconded the motion, which carried by a unanimous vote. Respectfully submitted Page 2 of 3 G. Gilbert 3. Board of Health Member Updates Dr. Berry addressed an update to board membership rules at the state level. Engrossed Substitute House Bill 1946, passed during the 2025 legislative session, amends local board of health composition requirements regarding appointment of Tribal representatives. Multiple seats on the board must be made available if there are multiple local tribes who wish for representation on the board. Additional tribal members will necessitate rebalancing of elected and non -elected members on the board. Discussion ensued. 4. Encampment Update/Board Discussion: Mission, Policy, and Service Delivery Staff member Martine introduced an update and discussion concerning happenings concerning the sweep of the encampment adjacent to the DSHS building, and planning for support of those affected by the sweep. Wide-ranging discussion included the role of JCPH in providing harm reduction services in support of the unhoused, guidance provided by National Association of County and City Health Officials, the county policy governing how homeless issues should be addressed going forward, and the critical lack of available housing. Viola Ware, Director of Housing and Community Development at OlyCAP, described partnering with JCPH harm reduction staff to provide funding for support services. FUTURE POTENTIAL AGENDA TOPICS It was recommended that homelessness be added as a recurring topic on the BoH Agenda at least quarterly. Staff Member Martine will reach out to Jolene Kron, Executive Director at Salish Behavioral Health Administrative Services Organization, to present an update about behavioral health programs and services available in Jefferson County through SBHASO, in addition to an update on the Opioid Settlement funding process. Member Dudley-Nollette requested an update on the status of Senate Bill 5803, the Vapor Tax. There were none. ANNOUNCEMENTS AGENDA PLANNING CALENDAR The Agenda Planning Meeting for the next regular meeting of the Board will be held on December 11, 2025 at 10:30 a.m. The next regular Board of Health meeting will be held as a hybrid meeting on Thursday, December 18, 2025 from 2:30 p.m. — 4:30 p.m. ADJOURNMENT Vice -Chair MickHager adjourned the November 20, 2025 Jefferson County Board of Health meeting at 4:32 p.m. until the next Regular Meeting or Special Meeting as properly noticed. JE ERSON CO71Vtice- YPair; EALTH [,onica MickHagerGlenn Gilbert, Public Health Assistant Respectfully submitted Page 3 of 3 G. Gilbert Jefferson County Board of Health w Old Business and Information Reports Item 1 Jefferson County Public Health Report [No hand-out] ..r Public Health January 15, 2026 Jefferson County Board of Health IV. Old Business and Information Reports Item 2 Jefferson Healthcare Report i�Q�"P�iSOYI (:ounhPublic Healt January 15, 2026 2026 State Legislative Agenda The Washington State Hospital Association (WSHA) strives to ensure that all our state's diverse communities and patients have access to high -quality and equitable health care. Hospitals provide the only lifesaving care to patients regardless of their ability to pay — 24 hours a day, 7 days a week. Hospitals provide both inpatient and outpatient care, everything from primary to specialty care. Patient demand exceeds workforce capabilities and complex patients remain in hospitals long after they are ready for discharge, absorbing what the community cannot sustain. In 2023, Washington's hospitals employed more than 117,000 people. Hospitals statewide provided more than $464 million in charity care — an increase of more than $100 million annually since 2021. Hospitals are the only providers mandated by the state to provide charity care. In some communities, hospitals are often the only providers seeing patients on Medicaid and Medicare and often at unsustainable payment rates. Nonprofit hospital systems are the only providers mandated to provide community benefits. While nonprofit hospital systems do have property tax relief, this is more than offset by charity care and Medicare and Medicaid costs that hospitals subsidize. Hospitals are also subject to business and occupation taxes. Ninety percent of all community hospitals in our state are non-profit or public hospital districts. WSHA's 2026 legislative priorities are grounded in the following key principles: • Ensure patients have health coverage and access throughout the care continuum before, during and after hospitalization. ® Ensure hospitals are financially stable institutions serving their communities, long into the future. • Maintain flexibility for hospital operations while mitigating new regulations that often add costs and complexity to the care hospitals deliver. Budget Issues for 2025-2027 Sunset the B&O tax surcharge enacted in 2025 for hospitals Hospitals are one of the only groups in the state that took both cuts and taxes in the 2025 budget. Annually, these new cuts and taxes total $240 million starting in 2027. Urban and system hospitals took the brunt of these cuts and new taxes, including the B&O tax surcharge, which will have a $60 million impact beginning in 2026. Other consumer price sensitive products and services, such as gas and groceries, were exempted from the B&O tax surcharge. WSHA strongly supports sunsetting the B&O surcharge on hospitals from HB 2081 on June 30, 2027 at the end of the 2025-2027 biennium and before the largest cuts contained in H.R. 1 take effect. Combined, state and federal cuts will be devastating to patients seeking hospital services. Sunset the PEBB/SEBB cuts by 2028 Hospitals took significant cuts to payments through SB 5083 PEBB/SEBB bill last year. The law sets a payment rate cap in statute, which reduces hospital payments by $100 million annually. Hospitals are unable to absorb this level of cut without impacting services. Again, WSHA will advocate to sunset these cuts prior to the most significant impacts of H.R.1 becoming effective. WSHA was pleased most rural hospitals were exempted from this cut. • No new cuts or taxes that target hospitals Hospitals support coverage and access to care for patients in Washington State. While we recognize the state's budget may be facing challenges, hospital finances are as well. Washington's hospitals have faced unprecedented operating losses from serving patients. WSHA is opposed to cutting payments to or imposing new taxes that target hospitals because hospitals are unable to absorb these kinds of cuts without impacts to access to services. Hospitals provide ongoing funding to the state's general fund of $452 million a biennium from the hospital safety net assessment. Policy Issues WSHA strongly supports the following Policy proposals: • Enact Improvements to Prior Authorization Transparency and Accountability (WSHA proposal) WSHA supports legislation to provide greater transparency and accountability for how state -regulated health carriers operationalize the prior authorization requirement. Components include ensuring a qualified carrier clinician reviews any denials of a prior authorization request and provides information regarding their credentials, creating standards for use of Al tools, and revising OIC data collections. We also support requirements regarding posting and notification of new prior authorization requirements. • Enact Stricter Carrier Timely Payment Requirements (WSHA proposal) Hospitals continue to face delays and inconsistent payment timeliness from health insurance carriers for services delivered to patients. It can often take months for carriers to pay, which delays determination of patient responsibility, and is confusing and frustrating for patients. WSHA supports legislation to provide clearer, measurable, and enforceable timelines for payment. Components include a uniform and measurable timeline of when a clean claim needs to be paid and how much time a carrier has to resolve the claim if more information is needed. We also support requirements that require carriers to track receipt of claims and documentation, respond to provider inquiries, pay interest and an administrative penalty under the new standard, and avoid repeated requests for additional information on the same claim. • Limit Significant Payer Contract Modifications (WSHA proposal) Without mutual agreement or sufficient notice, health insurance carriers often make significant changes to their administrative policies that reduce payments or increase costs for hospitals without sufficient notice or mutual agreement. This is one factor in premature contract terminations, disrupting care for patients. WSHA supports the prevention of significant contract changes by requiring insurers to give providers 90 days' written notice for certain types of policy changes. It also allows the hospital to review and accept or reject the policy without impacting their existing contract before the change is applied. The changes covered in the proposal include changes to payment, new payment rules or methodologies, and restrictions on locations where care can be provided to patients. The notice by the carrier must be sent to the provider organization's contracting contact, identify the affected contract, explain the impact, and allow providers to accept or reject the change. This would not apply to other policy changes, such as those required by law or needed for new treatments. This legislation will provide transparency and greater protection for all providers in contract negotiations. • Create Medicaid Network Adequacy Standards for Post -Acute Care (WSHA proposal) Medicaid -managed care plan networks for skilled nursing facilities and inpatient rehabilitation hospitals are woefully inadequate. WSHA supports legislation directing the state Health Care Authority to establish 2of4 network adequacy standards and ensure Medicaid patients have more equitable access to post -acute care (PAC) options in a timely manner. Patients need to be discharged from acute care hospitals to the next level of care and receive the support they need when they are medically ready. Without predictable and timely access to certain facilities and services, patients are not getting the rehabilitative and restorative care they need at the right time or in the appropriate setting. This results in patients being less able to care for themselves after strokes, surgeries, and major accidents, creating long-term health inequity. The lack of timely access to PAC also impacts patient quality of life and can result in hospital readmissions. • Provide Staffing Flexibility for EMS Providers Completing Inter -Facility Transports in Rural Washington (WSHA proposal) Hospitals across rural Washington rely on their emergency medical services (EMS) partners to transfer patients to other facilities when the patient's complexity warrants it. Paramedics or a registered nurse with an EMT certification are required for many inter -facility transports when provided by ground ambulance. In many communities, EMS agencies are not able to retain paramedics on staff full-time. This results in communities having to heavily rely on air ambulance for transport, yet during parts of the year air ambulance is not able to safely fly. WSHA supports creating narrow exemptions to ensure patient safety while allowing rural hospitals to transfer patients via ground ambulance to help maintain access to appropriate care. Protect 340E Program Access for Patients and Communities (WSHA working within a coalition) The 340E program was created by Congress to enable qualifying health care entities that treat high numbers of underserved patients to stretch scarce federal resources through price discounts from drug manufacturers. Drug manufacturers are increasingly circumventing the program by either refusing to contract or contracting on unfavorable terms with 340E entities and the pharmacies they work with. This threatens the financial viability of safety net providers and access to needed drugs and services in their communities. WSHA supports legislation that would prohibit such behavior by drug manufacturers. Provide More Flexible Supervision Requirements for IV Contrast Administration WSHA supports expanding state law to allow physicians to provide virtual direct supervision and for Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs) to provide direct in -person supervision of IV contrast. This change for IV contrast will help ensure patients receive timely, and sometimes lifesaving, treatment for imaging of trauma, stroke, sepsis, and other time -sensitive emergencies. State law, however, is more restrictive than the Centers of Medicare and Medicaid Services (CMS) and requires physicians to provide direct supervision of IV contrast administration, which must be in -person. This results in a disruption or diversion of services in places where physicians cannot be on site 24/7, often due to staffing shortages or financial limits. CMS allows physicians and other types of practitioners, including APRNs and PAs to provide direct supervision. CMS also permits virtual direct supervision. WSHA opposes the following policyproposals: Oppose Rate Setting and Contracting Requirements in the Public Option (Cascade Care Select) Currently, hospitals must contract with at least one Cascade Care Select carrier if they offer, and there is an overall aggregate spending cap of 160% of Medicare for all covered services. The Washington Health Benefit Exchange (WAHBE) continues to discuss legislation to mandate hospitals to contract with all Cascade Care Select carriers that offer to contract and to create a separate price cap for hospital services. 3 of 4 WSHA opposes this policy, which could lead to further cuts to reimbursement at a time when hospitals are already financially fragile. Oppose changes to the Corporate Practice of Medicine Doctrine that could Create Barriers to Team - Based Care in Hospitals WSHA supports the general goal of prohibiting the corporate practice of medicine; we agree that licensed providers should be responsible for clinical decision making. WSHA opposes legislation that would hamstring hospital's ability to use non -licensed personnel in a team -based context for roles that advise on clinical pathways, decisions on the services should be offered at the hospitals, discharge planning work for patients, and compliance with billing requirements. Preserve Access to Hospital Services in Health Care Transactions Oversight WSHA supports protecting access to care for certain health care services. WSHA opposes legislation that would place expensive, burdensome state oversight on health care transactions. Health care transactions in Washington State have maintained access to health care and hospital services for patients in local communities across the state that would otherwise have been lost. WSHA supports maintaining access to services in the event of a health care transaction. Maintain Outpatient Access: Oppose Restrictions on Facility Billing and Payment for Off -Campus Clinics Hospitals provide access through off -campus hospital -based clinic sites for many services that are not otherwise available in their communities at freestanding clinics. These locations expand geographic access to patients for services such as infusion centers for cancer chemotherapy and other medications, dialysis, blood thinner regulation for heart patients and wound care/diabetes care. Hospital -based clinics serve high proportions of Medicaid and other vulnerable patients - patients who may not have local alternatives for care and may otherwise seek care through the emergency department. Because they provide specialized services and serve large proportions of Medicare and Medicaid patients, they need sustainable payment for the costs of buildings, staffing, and equipment. WSHA opposes any prohibitions or cuts to facility payment without a full understanding of the costs of providing services and the potential impact of cuts on access, particularly for vulnerable populations. • Ensure New Barriers are Not Put in Place to Access Behavioral Health Care WSHA supports efforts to increase access to behavioral health care including increased inpatient capacity for high acuity or complex patients. However, new behavioral health legislation should improve access to care. Imposing burdensome regulations on hospitals and providers would create care inefficiencies, restrict patients' civil rights, and ultimately reduce patient access. While some recent proposals have good intentions, implementing laws such as requiring immediate referrals to a system without capacity, requiring counseling for opioid use disorders on all or some units in the hospitals, and creating penalties for failure to summon a designated crisis responder to evaluate intoxicated patients under the involuntary treatment act are punitive and challenging. Chelene Whiteaker, SVP, Government Affairs December 3, 2025 4 of 4 Jefferson County Board of Health IV. Old Business and Information Reports Item 3 Infectious Diseases Update �eff-5�on otrnti Public Health January 15, 2026 Infectious Disease Update Viruses, vaccines, and data Allison Berry, MD MPH Health Officer Clallam County Emergency Department visits ■ COVID-19 0 1n UMM i RSV VP� ACYteR•Wnnolyllfnoss (AM) Statewide ARI Threshold =14% ..........y..Y...................................................................................................... /.... 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ILI Activity Lev Very High High Moderate ] Law Minimal — Insufficient Influenza Positive Tests Reported to CDC by Public Health Laboratories, National Summary, 2025-26 Season, week ending Jan 10, 2026 O pW AI DiAM1) O-: AI�+L�cb SWl�ya) ONABgI O A(H1NWp O A(S, ,PrVWPwla� Q (♦ B (Lvwpr U­fed) D i NY O B (- LY ) O W B (Y� W Lo") 12 0 A (H51 National Measles Activity Childhood Immunizations IMMUNIZATIONS RECOMMENDED FOR All CHILDREN Vaccine and other immunizing agents Birth 1 mo 2 mos Diphtheria, tetanus, acellular pertussis (DTaP < 7 yrs) 1st dose Tetanus, diphtheria, acellular pertussis (Tdap? 7 yrs) Haemophilus influenzae type b (Hib) 1st dose Pneumococcal conjugate (PCV15, PCV20) 1st dose Inactivated poliovirus (IPV < 18 yrs) 1st dose Measles, mumps, rubella (MMR) Varicella (VAR) Human papillomavirus(HPV) IMMUNIZATIONS RECOMMENDED FOR CERTAIN HIGH -RISK GROUPS Vaccine and other immunizing agents Birth 1 mo 1 2 mos 4 mos 6 mos CDC Recommendation Changes Respiratory syncytial virus (RSV-mAb)' ••omAb)' Respiratrysyncytialvirus(RSV- Hepatitis B (HepB)3 1 dose ldose 1st dose 2nddose Dengue' MeningococcalACWYs Meningococcal B6 Hepatitis A (HepA)7 Childhood Immunizations Childhood Immunizations Jefferson County Board of Health U New Business Item 1 Legal Aspects Regarding Setting of Public Health --Clinical Fees and -out] ` fount; Public Health January 15, 2026 Jefferson County Board of Health V. New Business Item 2 Public Health Budget Update; Potential Services Cuts it �.cnrrif Public Healtl January 15, 2026 • $75,000 Epidemiology - Requesting support for salaries and benefits for 2026 only. To replace loss of funding. • $90,000 Dept Admin - In 2026, General Liability insurance will have increased over 110% since 2022. • $15,000 Dept Admin - Dept Admin has no means to recover the increase in interfund rents & leases without assistance. • $35,000 Footcare - This program supports seniors and vulnerable populations. Fees are unable to cover the costs. $173,000 Communicable Disease - This mandated program, which provides provider consultation, disease surveillance, investigation and reporting, along with education, screening and treatment of exposed persons. $15,000 Sexually Transmitted Infection - Mandated program provides testing, diagnosis, treatment, partner notification, prevention education, referrals and Pre -Exposure Prophylaxis. • $11,000 Tuberculosis - Mandated program provides screening and case management. Active cases take months of consistent staff monitoring and interaction. • $145,000 School Based Health Centers - Provides essential services in schools, removing barriers to access to care. This programs always requires general fund support to remain sustainable and recently lost other funding support. Jefferson County Board of Health 0 New Business Item 3 Update on BHAC's progress with 1 /10th of 1 Funding and Opioid Settlement, Funding Lotirtf Public Healtk January 15, 2026 August - September July 2025 March - April 2026 July 20 i����EnjZJ..u:.:,y::20:2:71 July 2027 2024 Request for Proposals for 2025-2026 Vendor Contracts begin for vendors on 2025 calendar cycle year (1/1/25 - 12/31/25) Vendor Contracts Begin for vendors on state fiscal year cycle SFY 2026 (7/1/25 - 6/30/26) Request for Proposals for 2027-2028 Opiold Settlement Funds - Phormaclers, ulactur" (Fund 132) August 2023 2024 February - June July 7, 2025 2025AL Vendor Contracts Begin for vendors on state fiscal year cycle SFY 2027 (7/1/26 - 6/30/27) Vendor Contracts Begin for vendors on 2027 calendar cycle year (1/1/27 - 12/31/27) Vendor Contracts Begin for vendors on state fiscal year cycle (SFY 2028 7/1/27 - 6/30/28) October - January 2026 February 2026 Marc llm26 July 2026 ] Decem 025 10 I Board of County BHAC: BHAC & BHC BOCC BHC considering Proposed RFP Opioid RFP RFP review and Start of Commissioners (BOCC) Facilitates Opioid collaborated to Workshop restructuring for contracts In Settlement applications funding contracts for Workshop Requested: Funding Retreat to develop a to consider Distributor Funds 2026/2027. Funds RFP due determinations. fiscal year • Behavioral Health determine targeted Memorandum of newly reaffirmed for BHAC published Proposed 2027. Advisory Committee uses of Pharmacy funds Understanding arriving BHC subcommittee results to BOCC (BHAC) distributed to distribute equitably Manufactures work on Pharmacies' funds to community partners Funds developing RFP • Behavioral Health via the Request for for Pharmacies Consortium (BHC) Proposals (RFP) process & Manufactures received Distributor • Pharmacies' funds funding funds arrived over many • BHAC & BHC: months throughout Memorandum of the year Understanding Jefferson County Board of Health 0 New Business Item 4 Lakes Program Update CottrittPublic Health January 15, 2026 JCPH Lakes Program 2026 Update Michael Dawson, Water Quality Manager e dated �dersT C Ita�weabcl: an �_.a at�er tw° s die dogs ti JEFFERSON COUNTY PUBLIC HEALTH 615 gMdtlan gbeal • Pod T—ad • Wshbpon • 96365 —..1.01armcoum..1,11chsaalwm Health Care Provider Alert June g, 20M To: lafr— Cmmty Health Caro Provider Prom Tom Lack., MD, MPH, Jeff—, Caumy lislth OIRea High eoocmhadooa or Cya..iuc i hn bundelerredle Andea.ovlake Telawereperika—d eger 2 deg. iugesdng lake water died and •third wad ado a ooma Prdimionry lau have dunvv ryaoubaaeridcoum.ofl S million collueel Tm WwWlleWl O,pdmdoahude ,,ioedtlata 'modems prab.bdky af.dws heskh. fsm" .—with au.0 over 200,000 cdW ml ad . Ngb risk eaiew when bw id arum, ere present in balhiog area Aderaoo Lake his been dad nod advisories have bean ported rgardil g,aradmd wvimmu,g, fishing, and rishoonmmplioa Teri, of bxi. levels present th AodersmLke ue pending Othe, public lakes in leRersan County Its. been sampled Cyanobaeeria see in a largo family vfphotoryduke bacteria upable ofprducing mukiplermda They vnnd iaear ly (a'ely) ref d to s "biuegram alpc" Both Ararhaena ad Mbocym s ryan ,,ishave been detected i. Anderson We,I-b—. species av produw a eeurolarw that muacle er_W,, mitchu,g pazaly.L% cardiac a req—fury failure, and death in aeimds Mrsruyxix tpcwes esn ,,do" a beltdola,ln that tan cause meuq vomiting, ad acute lives falure Roth main. ace hest stabled arc vet itch-ed by boiling or men onion. IaMobgies 111—of lordc cy—bactaris ocour K uwediclable imervala to warm weeher l. Homs. illoea associated with cy—baneria is rare. Cotat-i ed water tumully his a viublc won layer td is fool tasting U.S. sal li—ock sue especially suseaplible to Otal ingesioa ofrovamiaaed —ter lh,mut cap—msi often ocaue through din comr{ inhalmion of —.pinks, of iageadoo ofconu,ni-d water. Tbe,iak ofcyaeubuierid Orin apmreatt—gh aaumpda offish is cootrovasid. The loam esn bo proem is We inw d organs (apedelly dm liver) offish or oo the fah .kin.d um ionn un m adeaed m the rah or rut m hesvdy aomawaded water.. )e@rnn County Public Health his received sm*W repots of self-limaed diarheal illnm fdbwing mptin,offi,h recently esughtfrom Adenmlehe. Nospecifrcttmfaryamtosin espoevei. vdlablead diagnoan is 1y eacluaioo Tmuocnt is rupponi a Palieae with Lake AM— fi,h umpdm histories and presenting with ganrointatiod symptom should be e„latd f athet esum ofilleas, Po,lb— wslh peraiaRml rymploo*e Aalian ofh—Pottier is advisd rot Po utor inrorinatim go to IdiplTy'.47S�.A .'pllrp_aY tCtlfr'lilSxl ��� •� olorvan l-s..rviri n:.rrtds. PUBLIC HEALTH a m as r�AVN3evi HFALI3LIEAC41k5641kfry e�il,r�� pO'so nous al ae lOses StatE' 9, Dogs stricken p ark after visiting �Thaiula,C °� Anders+ r� T lfrp $lvrpr0ep clg.q pcaa 50_n Laj,i l.. >�4, IRt1en friltln a h t 1"8uf4 Blue -yam �tl� 971, trravlfn nor r6`)= L4e hluo- *'etoer off r oa fEyy 7�At+1we hi�YJ-F1;" mzmcoY. fall dR eh. 1f°n' �fn m� the hleha whlrh nmrid realm O r k Finelth t°°ipks or (! n1'u rack !! r #h°nnn Cvs+ri17 Ivkeo in Nnrsday to 4. rancl�,� j wour ma„um me afp� CLhi,1 Ixlru h, C7d. W wickii,[ inLuedr„7, in Tacntr,4 �, eared hddllekjr is stl°hAkd .p HtlicI read dajG { inaplheW0116L iadett �ui f)}OJ s'aari ropps},te �hde ljWnttk Avt try mitre lye r'f 61dR;!1y aLbn h4,orne )C adt Cau,�p�, '0} J.ffe, �� f�hj Aljh! }n'f Try w'�rsWrtrq. ntrp.hta ilk. nl....._aki amep��O a.id the N '_�'la� W Al by t be,, lsae ab nd>d to the llrkrn'1 fo dribk ��"' mnro wI! +•aenr, mid McNleklellfrts, atardtn�g algae BYmpfoma s�'Fhr :y+uplams nr LIuM Pain, �dPr'a"uro can ✓>e 1qyTom are ,aura aeaarngvr.ni[ AundHae vp Srhrrday l.� a1»der>e od, fleiyY N wn rlPa'd up fy lrafsr ira":i vuiadn>t ew ILn:*vlfgd, p0a aa� Mnndhy; 7LTraf Ta Iwk'r�Re V. Sri Aw .\� anobacter*ia "blue-green algae" Most are harmless, but some can produce toxins Algae Blooms • Appearance • Scum • Toxicity? CO2H 1 0 HN 0 N NH l� 0CH3 O O NH H H HN O Nl�,� N� NH2 O CO2 � HN-I�l N H H ni O f Lab testing mtuil Repor! Washington State Recreational Guidance for Microcystins (Provisional) and Anatoxin-a (Interim/Provisional) July 2008 W� Health WA Dept. of Health 2008 Provisional Guidance WA Ecology Freshwater Algae Control Program FRESFlWATPR ALCA6CUA"IROLPRIN:kAhf (:11AiYTAGREp1TF1yT SPATE 6P WA51!lNs:7'U p 'MDKfOFECUL4GY l _ 11:FFJ'JttiON COUNTY PORLlC FFVA1.Tlt {1i14 rs EN1jw�1r lrlTuwa Cuuruslsic vl'1t'uhirp,tnn DepvinmKlHticalpyr t3EPAR yuaementis hr,hra[iJe fwukwthe }� PuWic Npltlr (RECFP1CNFy, 7irr p+rp[kcnfthlt �ynrrneq. CIWkii1 !o °�7 [tH 1lr Iknirllltl dcrtrh'{+ed yl 1)J� �J. t: �`'RALINPU u■Tr •• Pm)ect 1 rtk. L+kt Ararcrrrrt eed Teale Gyarwberlerie Moalinrtiog Preiert Gant Number, GOS00611 RECIPMMT Nrme■od Adder Itlkrwo Cocaty l'ablit lledth SJS ShtrlJarl Sr. f'un'rU0-"ad. WA 99W REc1PI[T1T Carrtact 7'rlrphpctittrnber: Nrllll Pac Mrtrrlbcr; I?dl} 3&R.C"1cY.111 E-mail Address: (M)379.4.418�17�., Y�rN�'-T.+J�teaYa.IrLY i RECIPID17 8ilfir� Conran 'fe3ePtlro>c Number: Sane Parka Fnx tiumbrr (360)3S W7 S_H Address. (360) 3d�9401 +Par'ke(y'eelerRnoo.wa.n RECIPIENT Federal JD Number. 9l-60Ull_I DF.PAR77AENT Addre 3: Waft .r Vudle9 Pen&ram W-Amgtta Blau llepalYmrar nr F.totoRy P.0, lies 47600 10".Dia, WA 9SSU4.7600 DEPARTtf1:�T i4ujor: /lmalrr rrle'pklnx!lumher Joon Clark (360)407{S70 &N IAd 6-]Nail Address: (360)407.7151 jeie461@Jeq.en,Rev a- JCPH Accomplishments • Weekly monitoring April - October • Bloom investigations at 15 lakes & ponds • >670 water samples tested • 14 lakes w/toxic species present- • 4 public lakes with high toxins • Outreach/public presence www.ieffersoncountvpubIicheaIth.org/723/Lake-Water- itv JCPH Accomplishments, cont. • 2008-20 20 4 Ecology grants • Lake bloom characteristics • Anderson Lake nutrient budget/sediment history i Anderson Lake fishing season 2021-present E. coli monitoring * 2024-present Remote sensing pilot go DEPARTMENT OF ECOLOGY State of Washington gRo>i oe',�r 6 Collaboration DOH lQ KhV Ccwty Ecology King County WA State Parks Jefferson County Parks and Recreation WA Department of Fish and Wildlife 8 40 USGS Oregon State University '■ ... OregonState University i U S G S science for a changing world _' � � r x � -,r.. �_ z r ^`.� • End weekly observations • Respond only to reported blooms • Staff time? • Shipping costs? • Restrict follow-up sampling to periods of likely bloom dissipation (October) • Forward web traffic to nwtoxicalgae.org • End E. coli monitoring • End research collaboration • Notify lake managers/agencies of these changes Thank you'. jeffersoncountypublichealth.org main desk: 360-385-9444 like us on facebook facebook.com/jeffersoncountypublichealth @jeffcop ublichealth_wa Jefferson County Board of Health V. New Business Item 5 Selection of New Board of Health Chair and Vice -Chair rw i - L- end -out] Public Health January 15, 2026 Jefferson County Board of Health VI. Agenda Planning R_ l t 1I o SriIt Public Healtk January 15, 2026 Jefferson County Board of Health Announcements C Publ*lc eaItth January 15, 2026 F I - AOA)I'OIM Public H