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HomeMy WebLinkAbout2016_01_21_BOH_Packet,I January 1i, 1u1tj J JEFFERSON COUNTY BOARD OF HEALTH January 21, 2016 Jefferson County Public Health 615 Sheridan St. Port Townsend, WA 2:30 — 4:30 PM DRAFT AGENDA I. Approval of Agenda II. Election of 2016 Board of Health Chair and Vice -Chair III. Approval of Minutes of December 17, 2015 Board of Health Meeting IV. Public Comment V. Old Business and Informational Items 1. Letter to Dept. of Ecology Regarding Funding for Lake Algae Monitoring 2. Report on Northeast Jefferson Clean Water Project 3. Designation of Olympic Accountable Community of Health 4. Community Health Director Press Release 5. Medication Disposal Letter VI. New Business 1. Designation of Opiate Overdose (fatal and non -fatal) as a Local Notifiable Condition 2. Community Health Improvement Plan Update — Mental Health/Chemical Dependency, Access to Health Care, Immunizations, Chronic Disease Prevention 3. Public Health Heroes Workgroup 4. Jefferson County Public Health Policy Updates VII. Activity Update VIII. Public Comment IX. Agenda Planning Calendar X. Next Scheduled Meeting: February 18, 2016 2:30 — 4:30 PM Jefferson County Public Health 615 Sheridan St. Port Townsend, WA JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, December 17, 2015 Jefferson County Public Health, 615 Sheridan Street, Port Townsend WA 98368 Boa cl Members Phil Johnson, County Commissioner District #1 David Sullivan, County Commissioner, District#2 Kathleen Kier, Vice -Chair, County Commissioner, District #3 Kris Nelson, Port Townsend City Council Sheila Westerman, Chair, Citizen at large Jill Buhler, Hospital Commissioner, District #2 John Austin, Citizen at large Staff Members Thomas Locke, MD, Health Officer Jean Baldwin, Public Health Dir Julia Danskin, Public Health Manager Jared Keefer, Env. Health Dir Veronica Shaw, Public Health Deputy Dir Michael Dawson, Water Quality Dir Vice -Chair Kler called the December 17, 2015 meeting of the Jefferson County Board of Health to order at 2:30 p.m. A quorum was present. Members Present: Phil Johnson, David Sullivan, Kathleen Kler, Kris Nelson, Jill Buhler, John Austin Staff Present: Jean Baldwin, Jared Keefer, Denise Banker, Karen Obermeyer, Dunia Faulx Members and Staff Absent: Sheila Westerman, Thomas Locke, Julia Danskin, Michael Dawson, Veronica Shaw APPROVAL OF AGENDA Vice -Chair Kler called for approval of the December 17, 2015 Agenda. Member Austin noted a typo in the agenda draft and asked that it be corrected. The word "rapid" was corrected to "rabid" in Section IV, Old Business, item #1, Member Austin also asked that there be an additional section added to the agenda that would function as a "follow-up" report on actions requested of staff by the Board. It was noted a letter the Board had requested staff compose had gone unheeded, Member Sullivan moved to approve the agenda as amended; the motion was seconded by Member Nelson. No further discussion. The motion passed unanimously. APPROVAL OF MINUTES Vice -Chair Kler called for approval of the October 15th minutes. Member Sullivan moved to approve the agenda; the motion was seconded by Member Austin. No further discussion. Vice -Chair Kier reiterated the typo in the agenda be corrected. The motion passed unanimously. PUBLIC COMMENT Members of the public were in attendance to comment on the Food fees for which there was a public hearing scheduled. Members of the public included: Jim Lobato of Sobremesa Tacos; Susan Maxwell of Crust Pies and Market Kitchen; Mike Aarbin of Mo-Chilli BBQ. Members of the Board and Staff introduced themselves. 1 1. Rabid Cat in Jefferson County Jean Baldwin, Director, JCPH reported to the Board on the occurrence of a rabid cat in Jefferson County. Ms. Baldwin noted there is only one strain of the rabies virus among wildlife in this area and that the cat indicated this strain. Bats carry the particular strain of the disease so it was assumed the cat was infected by a bat. Other pets in the household are quarantined for a period of 6 months and are being monitored by Animal Control officials. Four people were treated for possible rabies infection. Baldwin noted an erroneous press release, which linked rabies to a sick coyote that had been euthanized by WA Fish and Wildlife, had been retracted by the Jefferson County .Leader. Overall the rabies incident provided a teachable moment for the County. 2. Department of Health Marijuana Prevention Project Ms. Baldwin reported to the Board on a grant provided by the Department of Health that contributes marijuana tax revenue to fund prevention projects focused around "No Initiation" among youth ages 12-21. Public Health staff is involved in supporting prevention activities, one of which is a presentation by Jerry Blackburn, Chemical Dependency Counseling and Education Consultant, to be held Monday, January 11, 2016, 6-8 pm at the Chimacum High School Library. 3. DBHR Substance Abuse Prevention Events Ms. Baldwin continued to report to the Board on activities, funded by the same grant, geared toward prevention. A science -based training program, Strengthening Families Program, to be held Thursdays, February 4 — March 17, 2016, at the Irondale Church, 681 Irondale Rd, Port Hadlock. Training equips participants with necessary life, communication, and social skills. 4. Port Townsend Paper -Mill Solid Waste Facility Financial Assurances Jared Keefer, Environmental Health Director, JCPH reported to the Board that the Port Townsend Paper Mill had completed its financial assurances requirement. Mr. Keefer told the Board that a Trust had been set up in the name of Jefferson County, the monies from which are to be used in closure and post -closure activities in regards to the Waste Facility clean up. The dollar amount contributed by the Mill as part of the assurances requirement is tied to CPI and will fluctuate accordingly, Board members wondered out loud if the Trust account was interest bearing. Mr. Keefer assured Board members he would find out and report. 0 5. Olympic Accountable Communities of Health (ACH) Plan Submittal Ms, Baldwin reported to the Board about ACH activities, Through diverse multi -sector partnerships the three -county work group had completed its plan and had submitted it to the Health Care Authority with the goal of receiving ACH designation, 6. Community Health Improvement Plan Update Karen Obermeyer, Community Health Educator, JCPH reported to the Board on Community Health Improvement Plan (CHIP) activities. The four work groups that were previously established have completed the norming and forming stages and are in the process of identifying long-term and short-term goals. The CHIP groups are working on four priority areas: Mental Health and Substance Abuse, Access to Healthcare, Immunization education and accessibility, and chronic disease prevention. 1. Public Hearing: Food Safety Program Fees Vice -Chair Kler opened. the Public Hearing at 3:10 and invited Mr. Keefer to speak to the issue of Food Safety Program Fees, Mr. Keefer reminded the Board of the discussions leading up to the public hearing and the rationale for the new fee schedule. It was emphasized that JC fees do not cover all costs involved in maintaining a food safety program and that the roughly 10% increase in costs to restaurateurs .represents an effort to recover more costs associated with the program, Jefferson County general fund subsidizes the cost of the Food Safety Program. Mr. Keefer reiterated ongoing efforts to establish efficiency in the program and emphasized the need to lay a foundation for transition to a risk -based rather than type of operation as a basis for fee setting. Vice -Chair Kler opened the floor to members of the public. Mr. Jim Lobato, Sobremesa Tacos asked when the new fees were to take effect and asked how the fees compared to fees in surrounding counties, Mr. Keefer answered; January 1, 2016; and told Mr. Lobato Jefferson County fees were lower than surrounding counties. Mike Aarbin, Mo-Chilli BBQ asked about strategies for risk -based fee assessments, commented on the expense involved in mobile unit food fees, and wondered if there were a way to make the permit application more efficient. Mr, Aarbin was particularly concerned about individual and redundant costs involved in setting up at various locations; redundant costs involved in having a food -truck kitchen and commissary kitchen, and redundancies in costs associated with menu items. Kris Nelson, Port Townsend City Council, and local restaurateur explained various fees are associated with risk and are based on proximity, in the case of mobile kitchens, to hand -washing facilities, Nelson said in the case of menu items it's wise to put as many menu items on a proposed menu as possible to avoid paying additional fees associated with changing the menu. However, Nelson did express concern over the problem of the complexity of the permit application process. David Sullivan, Commissioner, Jefferson County Board of County Commissioners told the group he was concerned by community responses to the costs associated with single - event permits. It was decided there needs to be a work group formed composed of interested community members, restaurateurs, and food program representatives to look for inefficiencies, tighten categories, and establish evenly distributed fees across risk -based categories with the aim of simplifying the program, cutting overhead costs, and moving the Food Safety Fees to a budget neutral program. Members of the public and Member Nelson recorded their names and contact information on a sheet of paper in the first step toward forming a work group. Mr. Keefer will follow through with assigning staff to the group, invitations to interested parties to join, and establishing a working schedule for the group Vice -Chair Kler closed the public hearing at 3:40 and moved to approve the Fee Schedule. Member Nelson motioned to approve, Member Buhler seconded. No further discussion ensued. The motion passed unanimously. 2. JCPH Draft Policy: Physical Activity in the Workplace Ms. Obermeyer updated the Board on work being done in regards to policy updates. The effort is motivated by making it easier for people in the work envirorbnne,nt to make healthier choices. Steps being taken toward this end include removing barriers to healthy choices, providing encouragement for walking groups, educating employees about insurance benefits that offset the costs associated with gym membership and entrance fees. It was noted that "Sitting is the new tobacco." 3. JCPH Draft Policy: Breast Feeding in the Workplace Ms. Obermeyer told the Board this policy is in keeping with Federal mandates and encouraged the County to adopt a policy as well. Added to the JCPH policy is a Location Support. 4. JCPH Draft Policy: Tobacco Use Ms. Obermeyer informed the Board this policy was updated to include vaping, It was noted that the establishment of "tobacco free campuses" has a positive effect in relation to smoking cessation. 5. JCPH Director Search Ms. Baldwin reported to the Board that a job description had been submitted to the county administrator and that work had been done in deciding how to proceed in a formal Director Search. The search committee will be composed of two members of the Board of Health, the Jefferson County Health Officer, and the County Administrator, Ms. Baldwin asked for volunteers from the Board. Member Austin volunteered as did Vice- Chair Kler, The official search will be announced as soon as decisions have been made in regards to how the search will be conducted. 6. 2016 BOH Calendar The draft calendar for 2016 was presented to the Board. Vice -Chair Kler had concerns about conflicts associated with her schedule. It was decided to further discuss dates at the January meeting of the Jefferson County Board of Health, ACTIVITY UPDATE Mr. Keefer stated Water Quality project presentations were well attended by the public. Mr. Keefer updated the Board on inaccuracies in a recent Peninsula Daily News article regarding the number of county septic systems and sewer access. Mr. Keefer said in January he will update the Board on a site in Jefferson County that is in violation of sewage disposal regulations. all I Y-9 U61 E6113 a 161 "1 There was no public comment. NEXT SCHEDULED MEETING The next Board of Health meeting will be held on'rhursday, January 21, 2016 from 2;30 — 4:30 p.m. at Jefferson County Public Health, 615 Sheridan Street, Port Townsend, WA. ADJOURNMENT Vice -Chair Kler adjourned the December 17, 2015 Jefferson County Board of Health meeting at 4:10 p.m. Phil,fo tSl, 1, ivan, J' I l3L11dLu:,-1 tin lei, 6� L'('se 61 Sheila Westerman, Chair Kris Nels(, Mouillier Kathleen Kler, Vice -Chair Jolli /\ustin, NMember Joanna Sanders City Clerk 250 Madison, Suite 2 Port Townsend, WA 983 360-379-5083 jsanders@cityofpt.us Jefferson County P.O. Box 1220 Port Townsend, WA 98368 Deputy Mayor Catharine Robinson has been appointed to serve on the Jefferson County Board of Health. Outgoing councilmember Kris Nelson was the Council representative, Please mail correspondence and meeting notices to Councilor Robinson at the above i?ddress or e-mail to crobinson@cityofpt.us. W ou need further information. Sincerely, Joapna Sanders City Clerk I w I I III 1 1111 IF 11, A N All 0 N AL, M A f N S TR E,, E T C 0 M M U N I TY WASHIN Cj,rl" ON'S iiis,roR.ic VIC,'FORIAN SEA]POR-r Board of Health V Old Business Item 1 Letter to Dept. of Ecology Regarding Funding Public Healt For Lake Algae Monitoring January 21, 2016 .s 1 Public Health Maia Bellon, Director Washington Department of Ecology PO Box 47600 Olympia, WA 98504-7600 Dear Director Bellon: 615 ShcJrIdan iireei Port 1cawnsend, WA 98368 wwvw. Je fersori(Io...jrityl:'Lal.:)lic I leralth.or January 21, 2016 Freshwater harmful algae blooms in Washington are increasing in frequency and severity. Cyanobacterial toxins are a real threat to public health and impact recreation and drinking water'. All indications are that harmful algae blooms will increase in a warming climate z. Here in Jefferson County we have one of the most toxic lakes in the world based on persistent algae blooms with high levels of the potent nerve toxin anatoxin-a'. The nature of these blooms has attracted researchers from the region' and interest from the media', yet significant puzzles remain about the cause and potential control of such blooms. We, the Board of Health for Jefferson County, are concerned that this important water quality problem in Washington State is not receiving adequate attention. Through the Algae Control Account, as authorized by RCW 43.21A.667, Ecology's Freshwater Algae Control Program began to offer grants with an initial funding level of $170,000 in 20086 These climbed to more than $326,000 in 2012 but have since retracted. Unfortunately, while funding has decreased, harmful algae blooms statewide have increased. In fact, funding in 2016 was the lowest ever, but in 2015 the number of toxin samples exceeding Washington State guidelines was 9 times as high as the number in 2007'. This trend shows no signs of abating. Freshwater Algae Control Grants & WA Cyano-toxin Exceedances �( w 01 t Y`. CX7 CY't K-i a-'-t r'v rnCD •,cP' p-""I �a Y+ N C14 CAA} N C*d N r14 raraofunds offered ------- - toxin exceedanr:c,s We urge you to take action on this critical issue for Washington State. Washington needs to be a leader in research and resolution for citizens, counties, cities and others who are dealing with worsening environmental and public health conditions. If the funding mechanism for the Freshwater Algae Control program can no longer meet the need, another system should be instituted to take its place. Perhaps 1 www.doh.wa.gov/CommunityandEnvironment/Contaminants/BlueGreenAlgae z www.epa.gov/nutrient-policy-data/cyanohabs 'jeffersoncountypublichealth.org/index.php?lake-water-quality ' microbiology.science.oregonstate.edu/content/dr-theo-dreher 5 www.seattletimes.com/pacific-nw-magazine/algae-blooms-that-kill-pose-puzzles/ 6 www.ecy.wa.gov/programs/wq/plants/algae/grants/index.html ' www.nwtoxicalgae.org Comnwniiy Ilee.:alth Enviionmentol Ilealth Developairientcl Di.srabiliiles Water Quality 360 385 9400 360 33.'-9444 360 38,.).9401 (f) Always working for o safer and he llfhielr oomirrnunity (f) 360 379...4487 federal funding through the EPA or NOAA could help augment the state effort? The citizens of Jefferson County have very much appreciated and benefitted from funding partnerships between Ecology and our Water Quality Division in the past and we hope to be able to partner again in the future. In any case, we are sure that this public health risk and environmental hazard is not going away on its own and only with proactive support will we be able to meet the challenges ahead. We thank for your consideration on this important issue. Sheila Westerman, Chair Jefferson County Board of Health 615 Sheridan St Port Townsend, WA 98368 Michael Dawson, Water Quality Manager Jefferson County Public Health 615 Sheridan St Port Townsend, WA 98368 C:ow rnuunaty d V�;�dth E) veNa pra ene aal UsaG:. Riifies 360-385-9400 360 385-9dO] ifi Ilwoy n working for a safer and healthier ooiryurnuinity Env'ilronrinentlar Vrealth Water QuaNy 360.. 8 z-S444 ffb 1360..,379 448 Board of .Health V Old Business Item 2 Report on Northeast Jefferson Aortheast JehersonClean WaterProject JeffersonCounty1 G1200127 January 1, 0December Project Cost: , ,�, «, ', a �r .. Final Ecology 1, A, ,! i 994 r.,.• 7" •.. .... Jefferson County Public Health (JCPH) Water Quality Division addressed water quality for the state of Washington by monitoring 71 miles of shoreline freshwater discharges for bacterial contamination and investigation of areas of elevated E. coli counts to identify sources such as failing on -site sewage systems (OSS). Sanitary surveys were completed on prioritized properties to ensure correction of failing OSS. Correction activities were conducted by JCPH and state and local codes were enforced as needed to address identified problems. Public outreach was conducted through door-to-door surveys, newsletters, public informational meetings and :r��;rr�a�rrar�siP °� �re E. coli mpn/100 mL 0 1.99, Low IN - 320, 0 > 320, High no test Project Area Neighborhood Port Townsend stormwater outfall The Next Step for Continued Success 0 Continued monitoring of Irondale ly�tl.reitz �r,�llnu Creek and Little Goose Creek through the Hood Canal Regional PIC project Sanitary Surveys and OSS corrections in Irondale/Port Haddock, and Oak. .w •."" Bay will continue to be completed through the Hood Canal Regional PIC project 0 Lessons Learned There was large variability in water quality between neighborhoods ■ Comparison between non-residential Indian Island and residential Marrowstone island showed that land use makes a difference in water iX quantity and quality all E. coli geomeans were higher in dry season, although highest hits were typically after the first fall rains Hot spots were associated with Glen Cove concentrations of older OSS and Indian Island areas with low O&M compliance Kale Point Barriers remain for financial Marrowstone Island %W assistance for OSS repairs in low to Middle Point h' - Oak Bay moderate .income areas Port Hedlock Port Townsend C74)yrigh[ ¢02014 El 'i.4rti>f111'P'1, HEIjE Final report available at pna,: P'.uofity e Board of Health v Old Business Item 3 Designation of Olympic Accountable Community Of Health t fizon Public HeallIt January 21, 2016 CREATION OF THE OCH INTERIM LEADERSHIP COUNCIL 9/15 ILC Charter document completed by Governance subcommittee 9/22 Steering Committee approves ILC Charter, directs OCH consultant to convene ILC sector stakeholders identified at the July 22, 2015 Stakeholder meeting. Further directed to continue discussion to secure yet unidentified stakeholder representation, include Tribal, rural health, private/not for profit hospital, chemical dependency. 10/1 ILC meeting scheduled for 10/19. Steering committee to disband 10/19/15 as ILC takes on governance role. OCH INTERIM LEADERSHIP COUNCIL -STAKEHOLDERS CHARGE: Support formation of an Olympic (Accountable) Community of GOVERNANCE SUBCOMMITTEE Health and its future designation, serving in a transitional role October CHARGE: Research/recommend 2015 — February 2016 until a yet more formal Governing Board with evolving governance structure for additional sectors and deeperrepresentation is in place. Provide 1-2 ILC OCH. Research/recommend legal form members each subcommittee to chair and report back to ILC. of OCH to ILC including bylaws. Act on legal form if indicated. • Create a regional pathway to improving patient care, reducing the per -capita cost of health care and improving health of the population. MEETINGS: 10/30/2015 12/07/2015 • Guide a regional vision by bringing the voice of sectors and the stakeholders they represent to the table to work collectively toward. common areas of focus: access to care, population health'"' improvements, access to "Whole Person" Support and promoting COMMUNITY HEALTH data sharing and a, region -wide infrastructure. Collaborate across ASSESSMENT & PLANNING systems to improve our community safety and well being. Adhere to the OCH Guiding Principles. CHARGE: Facilitate service gap analysis, priority setting; CHIP; • Intentionally work now to deepen stakeholder participation 1) within develop approach for Regional Health each sector so that representation on the Governing Board is rich Improvement Plan by 11/15; with the experience and voice and 2) bring additional sectors and performance measures, recommend representation yet to be identified from Community Services System. innovations. Carry out RHIP via collective impact. MEETING: MEETING: 10/21/2015 11/13/2015 15` 10/19/2015 2:30 pm — 5:00 pm Silverdale 12/18/2015 01/11/2015 2n1 11/02/2015 1:00 pm — 4:00 pm Port Gamble 3`d 12/07/2015 3:00 pm — 5:00 pm Port Townsend 4t" January 11 1:00 pm — 4:00 pm Port Gamble I AA0 1 , . 1 1 i SUSTAINABILITY SUBCOMMITTEE CHARGE: Research and recommend OCH sustainability plan and health care payment models. MEETINGS: 10/27/2015 12/21/2015 11/06/2015 Relter Ilealth.Retter Care,lowerCost. OCH STAKEHOLDERS Represent a group of people in Clallam, Jefferson and Kitsap Counties who represent entities from a variety of different sectors with a common interest in improving health. 111�1111011i'll CHARGE: Through diverse multi -sector partnerships, ACHs are an integral part of the Healthier Washington initiative. The Olympic Community of Health will: • Establish collaborative decision -making on a regional basis to improve health and health systems, focusing on social determinants of health, clinical -community linkages, and whole person care. • Bring together all sectors that contribute to health to develop shared priorities and strategies for population health, including improved delivery systems, coordinated initiatives, and value based payment models. • Drive physical and behavioral health care integration by making financing and delivery system adjustments, starting with Medicaid. http://www. olympiccommunityofhealth. org/ j0�'WIOPUI U/Uidf �,,, .. y1'N IIm��Mp,,W''i� .pu'roor''MKKIWIUW01PAdVNm .H COMMU OCH Interim Leadership Council 2016 (01/11/2016) Name and Affiliation County Service Area Sector (s) Doug Washburn Director Kitsap County Human Services Robin O'Grady Executive Director Westsound Treatment Center Katie Eilers Assistant Director, Community Health Kitsap Public Health District Larry Eyer Executive Director Kitsap Community Resources Tom Locke Jennifer Kreidler-Moss Chief Executive Officer Peninsula Community Health Services Michael Anderson Chief Medical Officer Harrison Medical Center Kurt Wiest Executive Director Bremerton Housing Authority Roy Walker Executive Director Olympic Area on Aging Erin Hafer Director, Network Development Community Health Plan of WA Peter Casey Executive Director Peninsula Behavioral Health Justin Sivill Director, Operations Harrison Health Partners Kitsap Clallam Behavioral Health Organization Jefferson Staff, by BHO Executive Kitsap Committee appointment Kitsap Kitsap Chemical Dependency (Medicaid Provider) Kitsap Clallam Chronic Disease Prevention Jefferson Across the Lifespan Kitsap Kitsap Kitsap Community Action Program/ Social Service Agency Clallam Statewide Dental Health (State Rep) Kitsap Kitsap Federally Qualified Health Clinic Kitsap Clallam Private/Not for Profit Hospital Jefferson Kitsap Kitsap Kitsap Housing/Homeless Clallam Clallam Long Term Care/Area Agency on Jefferson Jefferson Aging/ Home Health Statewide Statewide Clallam Clallam Kitsap Clallam Jefferson Kitsap Medicaid Managed Care TBD by MCOs Mental Health (Medicaid Provider) Primary Care OCH Interim Leadership Council 2016 (01/11/2016) (Cont'd) Jean Baldwin Director Jefferson Clallam Public Health Jefferson County Public Health Eric Lewis Clallarn Vallam pulalh 14,04altll Chief Executive Officer Olympic Medical Cnter Hilary Whittington Rural Health Chief Financial Officer Jefferson Healthcare TBD Tribal Re wresentative 's Under discussion, to be determined Board of Health 615 Sheridan Streel Part Townsend, WA 98368 wvwv...JeffersonC:oun[yPubl!cHecalth.org January 13, 2016 FOR IMMEDIATE RELEASE Contact: Jean Baldwin Jefferson County Public Health (360) 379-4408 Ibit!A_rnn Q.(( leff`ersor).WaJis JEFFERSON COUNTY PUBLIC HEALTH WELCOMES COMMUNITY HEALTH DIRECTOR Port Townsend WA —Jefferson County Public Health proudly welcomes Dunia Faulx as its new Community Health Director. Ms. Faulxjoined Jefferson County Public Health in December of 2015 after serving the global health community as a Program Officer for PATH, a global health non-profit based in Seattle, WA. Faulx's role as a public health specialist was focused on supporting development and management of partnerships to develop effective diagnostics for neglected infectious diseases. Ms. Faulx led user needs assessments, clinical evaluations, and supported the implementation of new diagnostic technologies around the world, with the majority of her work taking place in West Africa. Ms. Faulx brings a wealth of knowledge to the Jefferson County Public Health team, and her project skills will be a welcome addition as development of the Accountable Communities of Health progress. Ms. Faulx will be working directly with the ongoing Community Health Improvement Project. "Global health is extremely important to me, but having the opportunity to bring my expertise to the community in which I live is key," Ms. Faulx said. Dunia's career in global public health began in 2008 in Nairobi, Kenya, where she worked with HIV - positive women and children. She earned a Master of Public Health degree from the University of Washington and a Bachelor of Arts degree in anthropology and psychology from the University of Colorado, Boulder. In 2010, Jefferson County Public Health was honored to work with Dunia as an AmeriCorps volunteer. Her role at that time was to support the important work being done at the school -based health clinics at Port Townsend High School and Chimacum High School. "Dunia is a wonderful addition to the community and to Jefferson County Public Health." said Jean Baldwin, JCPH Director. "We are thrilled to have her return." Ms. Faulx is currently a member of the American Society of Tropical Medicine and Hygiene and the UW Population Health Forum. Always working for a safer and healthier community Community Healfh I:nvironrnenbl N.,, ih Developrnenal Di.sabiliiie.s Water Qa.ac:ality 360-385-9400 360 385-9444 360-385 9401 (r) Always working for o safer and healthier community ifV 360-379 4487 Port lownsend, WA 98368 wwvv/,Jeffersoi,�iC:o;j,)fyr�'6j6;. i 1-ealtWi.org January 22, 2016 Dr. Stephen Ostroff, M.D. Acting Commissioner U.S. Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 RE: FDA Recommendations to Flush Certain Medications and Harmonize Federal Agency Messaging on Safe Medicine Disposal Dear Commissioner Ostroff: To protect public health and environmental quality, the signatories to this letter urge the FDA to work with the EPA, the DEA, and the White House Office of National Drug Control Policy to develop clear and consistent guidance to consumers on safe disposal of leftover household medications. We call on the FDA to end its recommendation that certain medications be disposed by flushing, and to clarify that secure medicine take -back programs provide the best disposal method for leftover household medications. We appreciate the FDA's efforts to protect people from leftover medications that can be particularly harmful, even fatal, if abused or mistakenly consurned. However, the time has come for FDA to align its medicine disposal guidance with that of federal, state and local agencies who seek to protect both the public's health and our water quality. Disposal of leftover medications by flushing contributes to pharmaceutical pollution that is harming aquatic ecosystems and entering our food web. Wastewater treatment plants are designed to remove hurnan waste and easily degraded organics, and cannot effectively remove pharmaceuticals and other complex, synthetic chernicals. Because of this, some wastewater agencies have established laws, regulations, or guidance prohibiting flushing as a disposal method for pharmaceuticals. In these areas, FDA's recornmendations infringe on wastewater districts' jurisdictional authority to protect public health. While pharmaceuticals also enter wastewater through excretion, flushing of unwanted medication is a source that we have the ability and technology to control. The amount of leftover and expired medications in American homes is significant — estimated at 30-40% of all medications sold. It is critical to keep these pharmaceuticals from polluting our waterways by recommending secure and environmentally sound disposal through medicine take -back programs. Preventing pollution is always the most effective and least expensive option to protect public health and environmental health. Many communities across the country now have medicine collection programs and the DEA's regulation to implement the Secure & Responsible Drug Disposal Act allows new options for take -back of prescription drugs that are controlled substances. We need clear and harmonized direction to the public and health practitioners on using medicine take -back programs, as well as ongoing efforts to increase access to secure medicine take -back programs in all communities. Messages on medicine disposal are inconsistent between federal agencies and often in conflict with state and local regulations or guidance against flushing or trash disposal of leftover medications. This is confusing and frustrating for the public. Furthermore, the pharmaceutical industry takes advantage of inconsistencies in federal agency messaging to undermine efforts to establish local medicine take -back programs and regulations. C orni-nunilyr IVa;;alN E'nviiror7�rneoA He dth Da velc)EasnentciW DisdbiilokI S Way er C' uallHy 360 385 9�O p 4tl Mw ys working for a safer and heaitlhler oorn unity iQ 360 3/9-4487 Food & Drug Administration RE: FDA Recommendations to Flush Certain Medications and Harmonizing Federal Agency Messaging on Safe Medicine Disposal Page 12 We therefore urge the FDA to end its "flush list" recommendation, and work to create a single disposal guidance that is endorsed by all federal agencies and consistently used on all federal websites and materials. The public should be directed to store medications securely in locked containers or cupboards, to use secure medicine take -back programs where available, never to flush medications, and to dispose of medications in the trash only as a last resort where allowed by local ordinances. We encourage adoption of the following, clear messages on safe medicine disposal: 1. To protect water quality, never flush unwanted medicine down any drain. 2. Use a community medicine take -back program for secure and safe medicine disposal. Check with local household hazardous waste, wastewater, or police departments for locations. Use the medicine manufacturer's mail -back program if available. 3. Take leftover medicines to the Drug Enforcement Administration's twice a year National Prescription Drug Take -back Days. Look for a site in your community at http://www.deadiversion.usdoj.gov/drug_disposal/takeback/ or contact your police department. 4. As a last resort, if there are no medicine take -back options in your community: put medicines in a sealed container in the trash after mixing the medicines with an undesirable substance, such as cat litter or used coffee grounds. Make sure the trash cannot be accessed by children, pets, or others who might be looking in garbage. Check with your local government or garbage service first, because local laws may not allow disposing of any pharmaceuticals in the trash. We look forward to your response to our letter and to your actions to address our concerns. Sincerely, Thomas Locke, MD, MPH Jefferson County Health Officer Cc: Administrator Gina McCarthy, U.S. Environmental Protection Agency Director Dan Ashe, U.S. Fish & Wildlife Service Acting Administrator Chuck Rosenberg, Drug Enforcement Administration Director Michael Botticelli, White House Office of National Drug Control Policy Cuornmuniry f IecAN Deve:Pc:>pnnerfld [)ii,cabRifies 360-385..9401 Cal AWay» working for a safer and l°n alflhi r cornmuirflty Env'ironrne 7 al I de alltht Wdcaher Quality 360...385..9444 (fl 360 379 4487 � Board of Health VI New Business Item 1 Designation of opiate Overdose (fatal and non -fatal) As a Local Notifiable Condition Public Heal January21, 2016 rwl�,�`*iVM Co (IA,. 4 Mailing Address: 223 E 4th Street, Suite 14 • Port Angeles, WA 98362 Physical Address: 111 E 3rd Street, Suite I • Port Angeles, WA 98362 360-417-2274 • FAX: 360-452-4492 "` MUMNN December 17, 2015 Contact: Iva Burks, 360-417-2329 or Dr. Christopher Frank, 360-417-2437 OPIOID OVERDOSE MADE A REPORTABLE CONDITION IN CLALLAM COUNTY On December 15, 2015, the Clallam County Board of Health passed a resolution making fatal and non- fatal opioid overdose a reportable condition in Clallam County. A public hearing was held prior to the board finalizing the resolution. Former Interim Health Officer Dr. Jeanette Stehr-Green started the process as a way of gathering additional data to address the opioid epidemic in Clallam County. WAC246-101-505(3) gives each local health officer the authority to require the notification of additional conditions of public health importance occurring within the jurisdiction of the local health officer. According to Dr. Christopher Frank, Clallam County Health Officer, "This is an important step in the development of an evidence -based opioid management plan for Clallam County." Mandatory reporting will be limited to Olympic Medical Center Emergency Department, Forks Hospital Emergency Department and the County Coroner. All have been supportive of this effort. When a case is reported to Clallam County Department of Health and Human Services, Public Health Section, the following actions will be taken: 1) The person who overdosed will be contacted by a public health nurse and offered a naloxone kit and training on use of the device. 2) An attempt will be made to offer case -management services and to review treatment options. 3) The prescribing health-care provider will be contacted when an overdose is due to a prescription medicine. 4) The information will be used to assess the burden of the problem in our community, to evaluate the impact of the naloxone distribution program, and to establish baseline data to evaluate future intervention programs. The mandated reporting will begin January 1, 2016. Board of Health Commum-ity Health Improvemeft Plan 11MELINE 2M DUA SUIRAWY 2M 2M CHW PLAN FNUUJZM PIUMUTIMM PROCIEW N5 CROUP COMMUN"ACCEM DELEGAT11M OF CHIP HWPLEMEPFrATION COMMUNITY HEALTH PROCESS MAP'S HEALTH PRIORMES WORKGROUPS BEGNd TO ASSESSMENT DEVELOP SIRATEGIES T DRAFT FACT CHIP WORKGROLIPS PRESENT CHIP TO CO&VAUWTY dm=�. ACCEPTS CONVENE Hm- N RR-ORMES a4[P COORDINATION GROUP 4WRITES CHIP PLAN X" S� t I Jan 1 1 1 1 11un1jul I JL I oa JL t I Jan I Ii I I liunljw 3, Jan i i Oct 1 1 Feb Mar Apr May I Aug Sep Nov Dec Feb Mar Apr May Aug Sec Nov Dec Feb r4a Apf May Aug W Nov Der HEALTH PRIORITIES ORKGROUP FORMALIZED I CHIPW CHIP. ROCESS REVIEW BY NNMN3ERSHW WORKGROUP SMARI- GOALS MEETING Of kEY STEERROG CORVAFrTEE COMPLETED STAKEHOLDERS l I rl", la"JAPIJA AMEMCAN PUBUC IHEALTH MWJATPON F-aeJe.. OWMAA. National generation - thanks largely to the work of public health. Still, Public Health people in many other high income countries live longer and Week suffer fewer health issues than we do. MilM1111111� That's why APHA has created Generation Public Health. We are a growing movement of people, communities and organizations, Our goal is to create the healthiest nation in onegeaemlmn-2Lget there we have to ensure conditions that give everyone the opportunity to be healthy. It's not enough to provide access to quality health care, We also need to build safe, healthy communities with a foundation of social justice for all, We must help all Americans achieve at least a high school education, better ensure the opportunity to earn a livable wage and improve access to �wk—rhca ft-Wil. VA--��r our environment at work, school and home affects our health downstream. M� and become part of Generation Public Health! We'll share simple steps to help you improve your health and the health of your community. We'll join together to advance policies that promote health throughout our society. Jefferson Co Personnel Administration Manual (November 2015) Currently no policy Proposed update (January 2016) Insert new section at Chapter 11 General Policies Section, Section 22. Insert new section Breastfeeding policy, to appear right after Health and fitness policy. I recommend that the BF policy appear after health policy, instead of after appropriate attire policy. Breastfeeding support in the workplace In 2010, the Fair Labor Standards Act was amended to include protection for breastfeeding employees. It states that employers shall provide breastfeeding employees with "reasonable break time" and a private, non -bathroom place free from intrusion to express breastmilk during the workday, up until the child's first birthday. Jefferson Co. is committed to being a breastfeeding —friendly workplace by creating an environment that make it comfortable and easy for mothers to continue breastfeeding when they return to work after delivering their baby. Schedule Flexibility: With their managers' approval, female employees, who are exclusively breastfeeding their infants age through 12 months, may be granted the ability to return to work with a schedule that meets the needs of the employer and allows flexibility to continue exclusively breastfeeding. Staff can use scheduled breaks and lunch to pump and breastfeed. Any additional time other than scheduled break time may be approved by supervisor. Private Space: JCPH will provide a room for nursing mothers to breastfeed their infant or express milk. This space is shielded from view and free from intrusion, provides a place to sit and a flat surface, other than the floor, to place breast pump and a sink with running water close by for hand washing and rinsing out breast pump parts. The rooms has a door that can be locked. Staff should be allowed to store breastmilk in the lunch room refrigerator/freezer in clearly marked containers. Lactation Support: If interested employees may schedule an appointment with a knowledgeable and experienced member of the Jefferson Co. Public Health maternal -child health team. This person who has specialized skills in breastfeeding management and care, will work upon employee request to arrange a consult. This consult by phone or set appointment time is to address questions or concerns regarding meeting employee breastfeeding goals. This policy shall not be construed as creating term, conditions, or privilege, and Jefferson Co. retains sole discretion to modify or revoke this policy in whole or in part at any time. According to RCW 49.60.030 and 49.60.215 Breastfeeding mothers are protected under state anti- discrimination law, and can breastfeed their children in public places such as restaurants, pools, theaters, government buildings, museums, libraries, busses, or parks. No one, including business owners or employees can tell a mother to leave, go to the restroom, or cover the child. Jefferson Co Personnel Administration Manual (November 2015) Current Health and fitness policy: Chapter 11 General Policies Section, Section 21 Health and Fitness: Only addresses expectation that employee maintain physical and mental health necessary to effectively perform the essential duties of their positions. Proposed update (January 2016) Chapter 11 General Policies Section, Section 21 Health and Fitness: Insert Section 21.1 Jefferson County recognizes the role of physical activity in the maintenance of good health and wellbeing. Jefferson County will foster a workplace culture where regular physical activity is valued and encouraged. Physical Activity includes any bodily movement that expends energy, including, but not limited to activities such as walking, taking stairs, using public transit and active transportation. The benefits of physical activity include increased energy levels, weight management, stress relief, productivity and social connectedness. Jefferson County will foster a physically active working environment by promoting local physical activity opportunities, encouraging commuting via public transit and active transportation, encouraging the use of stairs, posting announcements of employee health insurance incentive events and gym membership flyers. Managers are encouraged to allow employees to flex schedules to fit physical activities into their work day during regular employee break times. Employees work are encouraged to incorporate physical activity into work day, identify walking paths and promote them with signs and route maps, consider participation in walking meetings, Initiate/ develop social support among colleagues for walking two or three times per week at set times for 30 minutes each, spend less time sitting, change positions, stand for some tasks, walk more. Physical Activity in the work place is supported providing it does not have a negative impact upon public service and does not impede Jefferson County from accomplishing its mission in an efficient and cost effective manner. This policy shall not be construed as creating a term, condition, or privilege of employment, and Jefferson County retains sole discretion to modify or revoke this policy in whole or in part at any time. Jefferson County is not responsible for damage to personally owned clothing or equipment. References • CDC Vital Signs, More People Walk Better Health. National Center for Chronic Disease Prevention and Health Promotion. i„ Hpr�1n,sw c�:cy?� � fi �1 Iwik F,lii9�g • Wattles, M.G. & Harris , C (2003) The Relationship between Fitness Levels and Employee's Perceived Productivity, Job Satisfaction, and Absenteeism. Journal of Exercise Physiology, Vol 6 Number 1. • Bureau of Labor Statistics, American Time Use Study. IJi.., .." +���rr ror i�N°� � 'a� a�,� w.'L��t ts/ • Kitsap health District , Physical Activity in the Workplace Wellness Policy, June 2015 Jefferson Co Personnel Administration Manual (November 2015) Current Chapter 11 General Policies Section 1.5 Work Breaks. States "Breaks for all personnel should be taken in areas so designated by departmental directors and / or departmental directive." Proposed Chapter 11 General Policies Section 1.5 Work Breaks. County employees are entitled to a 15 minute break during each 4 hour shift. Employees working less than the standard workday are entitled to a 30 minute lunch break for every 5 hours of work. Breaks f9T Managers are encouraged to allow employees to flex schedules to fit physical activities into their work day during regular employee break times. Employees work are encouraged to incorporate physical activity into work day. Physical Activity in the work place is supported providing it does not have a negative impact upon public service and does not impede Jefferson County from accomplishing its mission in an efficient and cost effective manner. Jefferson Co Personnel Administration Manual (November 2015) Current Chapter 11 General Policies Section, Section 22.0- Smoking Non-smoking employees of the County shave have the right to work in a smoke -free environment. WAC248-152 and RCW 70.160 provide for non-smoking in open public offices and other public areas. If a conflict arises in the normal work environment of both smokers and non-smokers, the rights of the non-smokers shall prevails. In order to ensure that non-smoking employees of the county have the right to work in a smoke -free environment, smoking is not allowed in county owned vehicles. Designated smoking areas must be used if they are available for employees' use. Proposed update(January 2016) Proposed changing it to Chapter 11 General Policies Section, Section 23.0- Smoking. This would allow the Breastfeeding policy to fit in the most appropriate place. Jefferson County Public endorses a smoke free, tobacco -free workplace, which supports our Jefferson County Health priority of preventing and mitigating the impact of chronic disease. Employers have the responsibility to provide a safe and healthful work environment for their employees and to comply with the Smoking in Public Places (formerly Washing Clean Indoor Air Act) Chapter 70.160 RCW and the Jefferson County Board of Health Ordinance 04-0216-06, Smoking in Public Places). It is the policy of Jefferson County to discourage tobacco use. Definitions Tobacco: Tobacco includes all tobacco products, i.e. chewing tobacco, cigarettes, cigars, hookahs, pipes, snuff, etc. Battery -powered vaporizer: Battery powered vaporizers include e-cigarettes and vapor pens ("vapes" and "mods") that heat liquid nicotine (aka e-liquid, e-juice, or smoke juice) to a temperature that causes the liquid to vaporize; the vapor is than inhaled in the same fashion as tobacco smoke. Tobacco use and battery powered vaporizer (including electronic or e-cigarettes) use will not be allowed inside the Jefferson County workplaces, its vehicles or at its service sites. Smoking is prohibited within 25 feet of Jefferson County site entrances or windows that open. This policy does not preclude the use of tobacco or battery —powered vaporizers during rest or lunch periods in accordance with WAC 296-126. • All Jefferson County buildings, outside areas within 25 feet of Jefferson County building entrances and windows that open, service sites, and Jefferson County owned vehicles are designated tobacco -free and battery powered vaporizer free areas. • All meetings sponsored by Jefferson County are smoke -free, tobacco -free and battery —powered vaporizer free. • Jefferson County may provide employees who wish to stop tobacco use, various incentives and support as approved by Jefferson County. Such support may include: participation is health insurance tobacco cessation programs, free use of Jefferson County space for participation in tobacco cessation classes or support groups, and self-help materials. References: • Washington State Legislature, Chapter 70.160 RCW, Smoking in Public Places (formerly Washington Clean Indoor Air Act) Il1kti / ss,,L .w , reward ; anal p ,ite=70.160 • Center for Disease Control and Prevention, Workplace Health Promotion, Tobacco -use Cessation htt : www.cdc. ov work lacehealth romotion im lementation to ics tobacco use iltnd Jefferson County Public Health December 2015/January 2016 NEWS ARTICL 1. "Survey finds continuing presence of E. coil at Irondale Beach County Park, but Quimper Peninsula water largely high quality," Peninsula Daily News, December 141n 2015. 2. "Port Townsend couple renewed in climate change awareness effort after Paris summit trip," Peninsula Daily News, December 16tn, 2015. 3. "Homeless in Port Townsend — Mentally ill woman has no place to go — yet," Port Townsend Leader, December 16tn, 2015. 4. "New Clallam opioid overdose reporting requirement aims to prevent them," Peninsula Daily News, December 17tn, 2015. 5. "Impact of marijuana on teens to be discussed Jan. 11," Port Townsend Leader, January 6th, 2016. 6. "Open space land applications accepted now through March 7 in Jefferson County," Peninsula Daily News, January 5th, 2016. 7. "County seeks applications for open space projects," Port Townsend Leader, January 6th, 2015. Survey finds continuing presence of E. coli at Irondale Beach County Park, but Quimper Peninsula water largely high quality By Charlie Bermant, Peninsula Daily News, December 14'h, 2015. Michael Dawson, lead environmental health specialist for the Jefferson County Water Quality Program, addresses a Marrowstone Island group about local water quality on Thursday. — Charlie Bermant/Peninsula Daily News NORDLAND — Septic waste is the leading cause of stream pollution by Escherichia coli, or E. coli, in the northern part of the Quimper Peninsula, and the worst area is Irondale Beach County Park, according to a two-year survey. Nevertheless, the study found that much of the area's water is of high quality, Michael Dawson, lead environmental health specialist for the Jefferson County Water Quality Program, told about 20 people at the Nordland Garden Club last Thursday evening. Dawson will speak again about the study from 5:30 p.m. to 6:30 p.m. Wednesday at the Jefferson County Public Health office, 615 Sheridan St., Port Townsend. The test area included Cape George, Port Townsend, Port Hadlock, Marrowstone Island and Oak Bay, with samples taken along 40 miles of shoreline and tested for E. coli bacteria. E. coli lives in the lower intestines of people and animals and is commonly found in feces. The survey included 489 septic sites with 72 percent showing no problem at all and the remainder easily addressed, something he said that property owners were willing and eager to do. "Most of the people contacted were quick to fix the system," he said. The study, which was primarily funded by the state Department of Ecology, included sampling Port Townsend stormwater, and comparing the water quality of Marrowstone Island and Indian Island. The worst pollution was found at Irondale Beach County Park, where Irondale Creek continues to show dangerous E. coli levels and is closed to shellfish harvesting. Dawson said that the cause of the Irondale Creek pollution is undetermined, but that septic waste is the leading cause of stream pollution in the survey area, well ahead of pet waste, wildlife and livestock, which is uncommon. Five other beach areas — North Beach, Oak Bay County Park, Indian Island County Park, Mystery Bay and Fort Flagler — showed high levels of E. coli bacteria during some readings but fell to an acceptable level at other times. E. coli, a naturally occurring bacteria, isn't always toxic. A safe level is estimated as below 100 parts per 100 milliliters. Most of Port Townsend has sewer service, although the town contains about 22 septic systems "that we know of," Dawson said. "We did find some failing systems, but they didn't provide any danger because they were above the pavement level and were far enough away from the surface water," he said. Dawson said that he'd like to expand the survey area but that depends on funding availability. Homeowners with septic systems should pay special attention to their care and maintenance, he said. Dawson suggested eight tips for a long septic life: • Spread laundry activity throughout the week. ■ Fix leaky faucets and running toilets. • Avoid liquid fabric softener. • Dispose of pet waste in the garbage. • Do not use additives. • Do not flush chemicals, medications or toxic material. ■ Don't drive or park on the drain field or transport lines. • Landscape the drain field and mound with shallow -rooted plants. Questions about septic maintenance can be directed to the Jefferson County Public Health Department, 360-385-9444. For more information, go to www, j2qffqr onc��Lrnty E lichealth.cro or call Dawson, 360-385-9444. Jefferson County Editor Charlie Bermant can be reached at 360-385-2335 or Ova a �t,, _rj6 i�,���ul����aely,���w�� �)III. Last modified: December 13. 2015 7:20PM Port Townsend couple renewed in climate change awareness effort after Paris summit trip By Charlie eermant, Peninsula Daily News, December 16, 2015 Laura Tucker, left, and her husband, Hank Walker, shown at the COP21 Conference In Paris last week, are surrounded by ribbons with messages they brought from Port Townsend to the conference. — Charlie Bermant/Peninsula Daily News PORT TOWNSEND — A Port Townsend couple who have worked as climate change activists returned from the United Nations 21 st Conference of the Parties this weekend, renewed in their effort to make people aware of the need to decrease their carbon footprint. "It's the single greatest issue that will ever affect man on a planetary scale," said Hank Walker, 61, who traveled to the conference with his wife, Laura Tucker, 59. "We all breathe the same air, we all drink the same water. No one will escape the effects of climate change if we don't address the carbon issue." Tucker, who said she has been an educator all of her adult life, was one of 10 teachers in the United States who was invited to participate in the international conference by Climate Generation, formally the Will Steger Foundation. Tucker approached the trip from an educational standpoint, striving to connect students with the issue and get them working toward decreasing their carbon footprint. While at the conference, Tucker and Walker set up daily Google Hangouts, which allowed them to connect with local students on four mornings. Tucker spent the days recruiting interviewees from among the conference's younger attendees and sitting them down at 5:20 p.m. Paris time (8:20 a.m. in Port Townsend). They connected online with students in Blue Heron Middle School and Port Townsend High School for interactive questions. The first effort Dec. 7 suffered from a poor Internet connection. The connections improved throughout the week, although the experience wasn't completely positive. "We kept trying to find an Ethernet connection, and there just wasn't one," Tucker said. "There was a lot of bad Wi-Fi, but we got better." During one session, fourth -grader Chloe Lampert, 9, asked Australian climate activist Zoe McClure how students can change their lifestyles to fight climate change. McClure responded that for someone so young, the problem can get overwhelming. "Sometimes you feel like, 'What can I do? I'm just one person,' but it's important to conserve energy and reduce waste," McClure said. "Getting involved with groups that are doing something positive is really important. You can start an environmental group at school, perhaps addressing the waste from the cafeteria and helping reduce energy use for the school as a whole." McClure said she became a vegetarian in order to reduce her own carbon footprint but acknowledged that it's hard as a young person to decide what food is being served at home. "But reducing the amount of meat you eat, even a little bit, can make a big difference," she said. Tucker said her days were "packed" with attending exhibitions, talking to students and exchanging information with other activists, but she had no access to the area where leaders such as President Barack Obama and Washington Gov. Jay Inslee were presenting information. "I came away more hopeful than I was before," she said. "When you get together with people from all over the planet with a common vision and a passion to get the job done, when you see that firsthand, it's huge." The day after their return, Tucker was sworn in as the newest member of the Port Townsend schools' Board of Directors, to which she was elected in November. But when it comes to climate change, Tucker will not attempt to educate those who believe there is no problem to begin with. She said that when a change takes place, people fall into one of four categories: trailblazers who move forward with a small amount of information, pioneers who provide the framework for the change, settlers who are first adapters of the technology and the stay-at-homes "who aren't going to join in, no matter what you do." "If you spend all your energy focusing on them, you abandon your other three groups," she said. "I have decided that trying to convince deniers is not worth my time." Tucker said she returned with more to share with people in the community, adults in particular, to give them hope. "Coming back, we have names, faces and information about where things are shifting that we can share with people here," she said. "We're getting the kids more involved, helping them to have positive, constructive outlets for their energy." Jefferson County Editor Charlie Bermant can be reached at 360-385-2335 or UI d j).yrews. oni. Last modified: December 15. 2015 7:05PM Homeless in Port Townsend Mentally ill woman has no place to go —yet 0 By Allison Arthur of the Port Townsend Leader, December 16, 2015 A woman who was banned from the Wn ate r Slwlter because of her behavior slept at least one night earlier this month on a bench in downtown Port Townsend. Port Townsend police officers know her and have offered her blankets, but she has turned down offers of help. Police say it's best not to approach her because of how she's behaved in the past. Photo by Allison Arthur The shape was unmistakable. There was a person sleeping under a pile of blankets on a bench in downtown Port Townsend on a cold winter day. Was it a man or a woman? I wondered, should I approach the person or respect his/her privacy? And why was this person sleeping on a bench when the Winter Shelter was mere blocks away? Another woman was sitting on a bench on Water Street across from her, smoking a cigarette. And another woman was getting out of a car on Taylor Street and heading to work. Were they oblivious to this person? Why wasn't someone doing something? What should I have been doing? The person under the sleeping bag and blankets wasn't budging. There was a coffee cup under the bench, and black shoes were neatly placed to one side, as if the public bench were home sweet home. When I got back to the warm Leader office that morning, I asked all those questions again and then decided to reach out to the Port Townsend Police Department for answers. OFFICER RESPONSE Officer Patrick Fudally knew who was under the covers, even though her face was not shown in the photo I sent him, the same printed with this story. He'd given her blankets one night. On another night, another officer had offered her items, but she had refused assistance. "We check on her when we can to make sure she is still OK wherever she is sleeping," Fudally wrote in an email. Fudally said he first met her — he knew her name, and I'm not going to reveal it — the first year he was working in Port Townsend, in 2007. He said he learned she had used meth when she was a teen, before he met her, and had continued doing that for some time. "Over the years, this has unfortunately done damage to her mental health, and she suffers from that now. We think she is off the meth, but still consumes alcohol," the officer wrote. So now the picture of her life began to be painted. "Since our records system started in 2012, we have had about 104 calls for service where she was listed as a person related to the call," Fudally wrote. The week that I took that photo, there were eight calls about a 31-year-old transient female, he said. Those were about her. Female. Not woman. Not someone's daughter. Female. That's the system talking, you know. Which is not to say that Fudally doesn't care. It is clear that he does. He wanted to help her, too, and had tried repeatedly. "I do know from personal experience she can be violent and aggressive towards police and has fought against arrest and protective custody detentions before," he wrote. "In fact, she was one of the people who we thought of when we developed the joint protocol with East Jefferson Fire Rescue (EJFR) to respond to subjects in a crisis state." Remember, this officer had delivered blankets to her just recently, even though she'd been violent toward him in the past. You could say it's his job to do that, but I doubt "blanket delivery" is anywhere in his job description. "[The woman] is homeless, but still demonstrates aggressive and violent behavior, along with committing minor crimes such as theft and disorderly conduct," he wrote, adding that out of the need to protect volunteers and people using the Winter Shelter in the basement of the American Legion Hall, the woman has been banned from the shelter. That answers a question or two. "To the best of my knowledge, any attempt at mental health help has been unsuccessful, but I do not have any records or facts to back that up, as that is privileged medical information," Fudally noted. So the officers who deal with this woman regularly are in a bit of a bind as to how to help. They can't take her to the Winter Shelter, which includes a special area for women. She doesn't cause enough of a criminal problem to be arrested —jail would not be of any help, anyway. And she's not cooperative with people in authority. "[The woman] is in the rather large gray area that is our [nationwide] current mental health system and drug rehab problems. For years, it was difficult for JMH [Jefferson Mental Health, now Jefferson Mental Health Services] to work with her, because the methamphetamine meant it was hard to diagnose her. Most drug rehab programs are voluntary," Fudally said, again noting that her records weren't something he could access. "Ultimately, even though we know she suffers from mental illness, in order to `force' her to see someone, we have a very limited set of rules to follow that usually involve immediate threat to self or others or so gravely disabled she cannot eat, live or function without intervention. Despite her behavior, she has not recently met this criteria." That's right, the woman on the bench wasn't hurting herself or anyone else, so her access to help was nonexistent, "Right now, sleeping on the sidewalk is not illegal unless she is purposely blocking the path. We respond to and respect the wishes of private businesses that would like her trespassed from their property," Fudally wrote. A week before the photo was taken, he had been contacted by a store owner who had tried talking to her. She threw coffee on him and then threw the cup at him. Still, that incident was not enough to arrest her, put her in jail or take her to the hospital. "It is unfortunate," Fudally concluded in what I consider a respectful and responsive email, "but her mental health illness does make her someone the public should approach with caution and, based on past incidents, should avoid touching her if at all possible." Oddly, that fit in with the sense I was getting, that the person might not react well to being disturbed. Fudally wasn't the only one I reached out to about the woman in the photo. A GAP IN SERVICES DeForest Walker, who is with Community Outreach Association Shelter Team (COAST) and who helps run the Winter Shelter, said that because of confidentiality policies, she can't discuss incidents involving specific individuals. "However, the incidents in last week's Police Log in the Leader concerning a disruptive transient female in Port Townsend clearly illustrate a serious gap in available services in our East Jefferson County communities," Walker wrote in an email on Monday. "By the time a woman is continually sleeping on the street in 30-degree weather, it is usually safe to assume that existing programs are not able to serve that individual." "In my opinion, a person in that situation presents a true danger to herself. A lone, single female on the street at night is vulnerable to assault and hypothermia," Walker wrote. "One who also suffers from mental illness is even more at risk, given that her judgment is undoubtedly impaired." Walker went on to acknowledge that there are limits to what police can do. "Certainly they have been patient and kind with this particular person." Walker suggested that Jefferson Mental Health Services and Adult Protective Services could work to find alternatives for someone who is in need of treatment, like the woman in the photo. NOT THE ONLY ONE But the woman in the photo wasn't the only homeless woman I've encountered this month. On Dec. 7, the first message on my office phone was from a woman in distress who was living in her car. Her message was upsetting. She identified herself as a 42-year-old woman who is on mental -health disability of some kind. She's gone to Olympic Community Action Programs (OlyCAP), as well as Dove House Advocacy Services for help, She said she was living in her car and the car was almost kaput. "I'm not getting any help. People just stare at me," she said in her message. "My car is done, and I will write my own obit, because the town will find me dead," she said. "It will kill me to give up my dogs." So I wrote down her name and number and emailed Officer Fudally about her, as well. Fudally had never heard of her before, but said that as he was researching her situation, he was contacted by a man who previously had helped this woman. Once the man had realized that she had mental health issues, he'd asked her to leave. He, too, said the woman had made some vague, possibly suicidal statements and so, like me, he had asked for a welfare check. "Apparently she has drifted across the whole country in this fashion," Fudally said of the woman moving from town to town. It wasn't the first time she'd come to the attention of police. They'd had a call about her back in August and had checked on her then. She'd denied she was suicidal, but was upset because she couldn't access help. MULTIPLE PEOPLE Fudally said police had been planning to look for her, to see if they could help her, but they were diverted by a case of driving under the influence, in addition to what he called "multiple aggressive patients" at Jefferson Healthcare hospital. Fudally said the staff at the hospital does a great job with limited resources. What he didn't say was that the hospital does not have any inpatient beds for people like the two women in this story. At least not now. Jefferson Healthcare recently was granted $1.509 million for a seven -bed inpatient psychiatric unit within the hospital. But accepting the grant means finding money to sustain the facility for the long term. Where will that money come from? Hospital CEO Mike Glenn is checking into it this month and is expected to report on that question in January. And if the hospital did accept the money and did find money to maintain it for a decade, it still could take as long as two years to build that inpatient unit. That doesn't help these two women, whose names I know, who need help today. And of course, there are still so many questions left unanswered about both of these women, including how they got to this point, how they would tell their own story. And the question that I don't know whom to ask is simply this: Whose job is it today to help people who can't take care of themselves, like the woman sleeping in her car and the woman sleeping under the blankets on a bench in downtown Port Townsend on a cold winter night? Is it anyone's? New Clallam opioid overdose reporting requirement aims to prevent them By James Casey, Peninsula Daily News, December 17'h, 2015 PORT ANGELES — Overdoses from heroin and other opioid drugs — whether users survive or die will require doctors and responders to notify the Clallam County health officer starting Jan. 1. The county Board of Health took the step Tuesday after a brief public hearing at which one person testified. Kenneth Reandeau of Port Angeles told board members he supported the action, It was adopted unanimously by commissioners Jeanne LaBrecque, Mike Chapman, Bryon Monohon and Bill Peach. Members Jim McEntire and Dr. Jeannette Stehr-Green were absent, while member John Beitzel has retired. The measure will help health officials track — and, they say, treat and prevent — addiction, Dr. Christopher Frank, county health officer, has authority from the state to add to the list of "notifiable conditions," which includes measles, hepatitis and others. First in state Clallam is the first county in Washington to add drug overdoses, although others are watching its experiment, said Iva Burks, director of the county Health and Human Services Department. The new protocol will enable Frank to identify the substance, be it a street drug or a prescription medication like oxycodone. In the latter case, it might help authorities identify who prescribed the drug and to whom, Frank said. "The purpose is going to be to identify the people who have had an overdose and prevent it from recurring," he said. "Without understanding what's happening in the community, it's very hard to understand the interventions." Most of the reporting will fall to emergency room personnel at Forks Community Hospital and Olympic Medical Center, who will have 24 hours to report an overdose. "Almost all of the significant overdoses funnel through the two hospitals," Frank said. High in heroin ODs Clallam County is infamous for its high rate of overdoses. According to Stehr-Green at the board's October meeting, during the reporting period 2012-2014, the state's death rate from opioid overdoses was 8.4 per 100,000 people. Jefferson County's rate was 9.7 per 100,000, while Clallam's was 14.3 in 2013, Stehr-Green said.. Burks debunked reports that heroin use correlates with higher rates of AIDS and other sexually transmitted diseases. In Clallam County, that's largely due to the Syringe Services program, in which addicts can exchange used needles for clean ones, not passing them along, she said. Chlamydia rate Areas with correlative rates of addiction and STDs have no such exchanges, according to Burks. The most common STD in Clallam County, she said, is chlamydia, which is not spread by sharing syringes. "It does work," Frank said about Syringe Services on stopping the spread of diseases, including hepatitis. Burks said the program has a nearly 100 percent rate of return of its new needles, but addicts also can buy them from pharmacies or bring them to Clallam County from other areas. These sources, she said, account for most syringes that are found in public places. Reporter James Casey can be reached at 360-452-2345, ext. 5074, or at ggas,y, � a�-�� �n9 a8 roe �s.com Last modified: December 16. 2015 8:49PM Impact of marijuana on teens to be discussed Jana 11 Port Townsend Leader, January 6, 2016 With the recent legalization of marijuana for adult retail sales, the varying perceptions on medical use has had a signification impact on youth access and consumption, an issue that Chimacum Prevention Coalition is to address at an upcoming presentation. The talk, presented by Jerry Blackburn, faculty member in the Chemical Dependency Counseling Education Program at Bellevue College, is set to take place at 6 p.m. on Monday, Jan. 11 at Chimacum High School library, 91 W. Valley Road. Blackburn is set to talk about the impact marijuana use has on both the cognitive and physiological development of young people, consider signs of concern, and discuss effective strategies for increasing protective factors and reducing those factors that put kids at risk for use. Blackburn has worked in the field of chemical dependency for more than 18 years, tackling this area of health care from every angle, working in roles ranging from an intervention/prevention specialist to clinical director of an adolescent residential treatment facility. A graduate of the University of Washington, Blackburn has been a certified chemical dependency professional since 1999. In 2005, he was honored by the Washington State Department of Social and Health Services' Division of Alcohol and Substance Abuse (now the Division of Behavioral Health and Recovery) with the Richard Rivera Passionate Youth Professional Award. For more information on the Chimacum Prevention Coalition, contact Julia Danskin at 385-9420 orjdanskin@co.jefferson.wa.us; or Kelly Matlock, 379-4476, kmatlock@co.jefferson.wa.us. Danskin and Matlock are Chimacum Prevention Coalition coordinators at Jefferson County Public Health. This event is sponsored by the Division of Behavioral Health and Recovery, Chimacum Prevention Coalition, Chimacum School District and Jefferson County Public Health. Open space land applications accepted now through March 7 in Jefferson County Peninsula Daily News, January 5, 2016 PORT TOWNSEND — Jefferson County is accepting applications to protect open space land through the county's ;onservation Futures Program. The deadline to submit applications is Monday, March 7. In 2015, Jefferson County commissioners approved the use of conservation futures funds toward the completion of four projects. The projects were: • The acquisition by the city of Port Townsend of parcels within the Cappy's Trails area of Port Townsend. e A conservation easement on 264 acres of the Bishop Dairy on Egg and I Road. e A conservation easement on 29 acres of Midori Farm in Quilcene. • The protection of 14 forested acres along the south shore of the Big Quilcene River. 2016 funding cycle In the 2016 funding cycle, about $187,000 is available for new projects, county officials said in a news release. Of this amount, up to $28,050 is available to reimburse operations and maintenance expenses for any property acquired using conservation futures funds, they said. A minimum matching amount of 50 percent of the total project cost is required of the project sponsor. Sources of match must be noncounty funds such as private contributions, state and/or federal grants, and/or the value of ther open space lands linked to the project. Landowners and citizen groups, as well as local government agencies, special purpose districts and nonprofit corporations within Jefferson County can apply for funds in partnership, as applicable, with a sponsoring organization based in Jefferson County. Open space lands provide such functions as protecting wildlife habitat and corridors; conserving cultural resources; maintaining natural flood water control; protecting water quality, water supply and soils; enhancing or protecting scenic views; and providing opportunities for education and passive recreation. The annual conservation futures project application process is overseen by the Conservation Futures Citizen Oversight Committee. Each spring, this committee evaluates project applications for their public benefit and makes recommendations to the Jefferson County Board of Commissioners who, after a public hearing, decide which projects merit funding. Meetings of the committee are open to the public. The Conservation Futures Program was created in 2002. It is financed by a property tax levy. Presentations about the program and past projects are available throughout the year by request to the Environmental Health Department. For an application, contact Tami Pokorny at 360-379-4498 or tpplB q ��y -oJe f rs,� n�rA@ (i . For more information, see atl IItdliou I cpmfjID N cot m avationfutures. ast modified: January 03. 2016 4:45PM County seeks applications for open space projects Port Townsend Leader, January 6, 2016 Jefferson County invites application submissions to protect important open -space lands through the county's Conservation Futures Program. Citizens, landowners and citizen groups, as well as local government agencies, special purpose districts and nonprofit corporations within Jefferson County may apply for funds in partnership, as applicable, with a local sponsoring organization based in Jefferson County. Open -space lands provide a variety of functions, including: protecting wildlife habitat and corridors; conserving cultural resources; maintaining natural floodwater control; protecting water quality, water supply and soils; enhancing or protecting scenic views; providing opportunities for education and passive recreation; and perpetuating the benefits of balanced and productive natural systems. In the 2016 funding cycle, about $187,000 is to be available to new projects. Of this amount, as much as $28,050 is to be available to reimburse operations and maintenance expenses for any property acquired using conservation futures funds. A minimum matching amount of 50 percent of the total project cost is required of the project sponsor. Matching sources must be non -county funds such as private contributions, state and/or federal grants, and/or the value of other open -space lands linked to the project. The deadline to submit applications is Monday, March 7. For an application and more information, contact Tami Pokorny at 379-4498 or tpokorny@co.jefferson.wa.us. The annual conservation futures project application process is overseen by the Conservation Futures Citizen Oversight Committee. Each spring, this committee evaluates project applications for public benefit and makes recommendations to the Jefferson Board of County Commissioners, which, after a public hearing, decides which projects merit funding. Meetings of the committee are open to the public. Last year, the county commissioners approved the use of conservation futures funds toward the completion of four projects: the acquisition of parcels within the Cappy's Trails area of Port Townsend by the city; a conservation easement on 264 acres of the Bishop Dairy on Egg and I Road; a conservation easement on 29 acres of Midori Farm in Quilcene; and the protection of 14 forested acres along the south shore of the Big Quilcene River. The Conservation Futures Fund and Program are governed by Section 3.08 of the Jefferson County Code. The program was created in 2002 to help ensure that the county retains adequate wildlife habitat, working farms and forests, scenic areas, and culturally and historically significant open -space lands here — all for the health, benefit and welfare of citizens. The fund is generated by the county's smallest property tax levy. Presentations about the program and past projects are available throughout the year by request to the Environmental Health Department. Visit the Conservation Futures Program and committee online at co.jefferson.wa.us/commissioners/Conservation/conservation. asp.