Loading...
HomeMy WebLinkAbout2002- January File Copy • Jefferson County Board of Health Agenda Minutes January 17, 2002 r • JEFFERSON COUNTY BOARD OF HEALTH Thursday,January 17, 2002 2:30—4:30 PM Main Conference Room Jefferson Health and Human Services AGENDA I. Approval of Agenda II. Election of Board of Health Chair/Vice-Chair for 2002 III. Approval of Minutes of Meetings of December 20, 2001 IV. Public Comments V. Old Business and Informational Items 1. Letter of Commendation, Environmental Health Staff • 2. Document Signatures VI. New Business 1. Public Health Funding—State and Local Policy Issues • A Brief History of Public Health Funding Tom (10 min) • Public Health Funding in WA State Jean (15 min) • Jefferson County Budget Directives Charles (10 min) • Jefferson County Fee Study Group Sheila/Larry (15 min) • State FY 2002 (7/02-6/03) Budget Cut Impacts 2. Jefferson Access Project—Next Steps Kris Locke (30 min) 3. Congressional Bioterrorism Funding Update Tom (5 min) 4. Bioterrorism Preparedness Tabletop Exercise Tom (5 min) January 30, 2002 VII. Agenda Planning VIII. Next Meeting: February 20, 2002 + Joint Board Meeting (?) i � 1 • JEFFERSON COUNTY BOARD OF HEALTH DRAT"t' MINUTES R D Thursday, December 20, 2001 AFT Board Members: Staff-Members: Dan Titterness.Member-County Commissioner District#1 Jean Baldwin,Nursing Services Director Glen Hunting%ord,Member- County Commissioner District#2 Larry Fay,Environmental Health Director Richard Wojt.Member- County Commissioner District#3 Thomas Locke,MD,Jlealth, Officer Geofrey Masci,Member-Port Townsend City Council Jill Buhler, Chairman-Hospital Commissioner District#2 Sheila Westerman, I-'ice Chairman-Citizen at Large(City) Roberta Frissell-Citizen at Large(County) Vice Chairman Westerman called the meeting to order at 2:40 p.m. All Board and Staff members were present with the exception of Chairman Buhler and Commissioner Huntingford. Member Masci moved to approve the agenda. Commissioner Wojt seconded the motion, which carried by a unanimous vote. • APPROVAL OF MINUTES Member Masci moved to approve the minutes of October 17, 2001 with one correction, noted by Dr. Tom Locke on Page 3, paragraph 4 under Bioterrorism Preparedness: In the last sentence, the words "There is no way to" should be replaced with "We can." The date of the minutes should also be corrected from October 17 to October 18, 2001 Commissioner Wojt seconded the motion, which carried by a unanimous vote. PUBLIC COMMENT New resident, Fernando Caneo said he is happy to be here, but has no other comment. David Sullivan said he is concerned about how the 0% increase in the County budget will affect healthcare and is curious how the Board will respond to the changes. OLD BUSINESS Comparing Sewage Systems Article: Larry Fay complimented Linda Atkins,David Christensen and Staff for putting together this project, funded by a grant from the State Department of Health to reduce nitrogen, which resulted in getting the article published. Member Masci moved to direct Staff to write a letter of commendation to both Linda Atkins and Dave Christensen on behalf of the Board for getting the article published. Commissioner Wojt seconded the motion, which carried by a unanimous vote. r + HEALTH BOARD MINUTES - December 20, 2001 Page: 2 • Local Board of Health Workshop Report: Member Frissell discussed the highlights of the workshop she attended in October. • Keynote speaker Tom Milne, Executive Director of the National Association of County and City Health Officials [NACCHO] reported the Centers for Disease Control (CDC) is creating a new resource center to aid environmental health, looking at bio-terrorism, infectious diseases and smoking. Mr. Milne characterized public health preparedness and awareness in Washington State as far better than in other States. Nationally, there has been a significant switch in outlook and approach to public health issues as a result of the events of September 11, 2001, moving public health to the forefront for the first time and creating an opportunity to build public health infrastructure. Mr. Milne's handouts were given to Jean Baldwin. ✓ Washington State Secretary of Health Mary Selecky's presentation, coming in the midst of the anthrax scare, made the point that law enforcement must determine whether something is a credible threat. ✓ Scott Lindquist, Kitsap County Health Officer stressed the importance of communication among Health Departments, emergency management personnel as well as the need for ongoing training for emergency room staff to recognize these diseases. In considering whether county-wide forums could be held to provide information to the media, he said his Department used a full- • page ad in the newspaper to educate the public and also prepared a video for in-house training. He recommended that 9-1-1 operators be given a list of questions to aid screening of credible threats, and suggested Health Departments learn new terminology in order to better communicate with police (e.g., credible threat = probable cause). ✓ Methamphetamine labs were discussed at the workshop and Member Frissell was struck by the range of services needed when meth labs are destroyed. For example, contamination is limited to the lab area only but there is economic impact on other renters and landlords when their properties are used for labs. While the meth-making technique has changed (chemicals no longer need permeate and ruin a structure for further habitation), there is still the potential for explosion, fire as well as great health risks and serious issues related to child abuse and neglect. Member Frissell strongly believes that mental health services for individuals are essential to changing behavior. One suggestion was that local Boards of Health address coordination between agencies by becoming a convener and determining what is happening in this County so we can reach these kids before they make decisions about substance abuse. Describing the workshop as time very well spent, Member Frissell recommended as many Board members as possible try to attend in the future. Vice Chairman Westerman asked whether other Boards have expanded to include citizen participation? Member Frissell said that while a few have, she believes our Board's constitution is unique in that regard. Dr. Locke said to his knowledge only Kittitas County has taken a similar step,but added that he believes there is strong support in Clallam where the Board is examining the issue. Member Frissell said4111 she has communicated that having non-commissioner members can help de-politicize some of the issues. • • HEALTH BOARD MINU FES - December 20, 2001 Page: 3 Hearing Examiner Decision re: Port Ludlow Sewers: Larry Fay said this item is mostly for information and relates to the Board's discussion a few months ago about sewer extensions in Port Ludlow and consideration as to whether the current on-site sewage regulation and policy work are for, against or neutral in promoting sewer extensions. He said this case is a little different in that ORM (Olympic Resources Management, now Ludlow Development)has applied to the County for a short plat of the property and proposed developing this property with septic systems. While there was no argument from Environmental Health that lots and the soil requirements are suitable for a septic systems, the ordinance gives preference to sewers when they are available. In this case, the question is not one of availability but cost. The Hearing Examiner's recommendation to the Community Development Department,on approval of the plat, was to require that they extend sewers to the lots they are creating.The Hearing Examiner was clear that they were correct in making sewer extension a requirement of the plat. As of the final date of the appeal period, Ludlow Development had not asked for a review of this issue. Mr. Fay believes this decision will set the stage for what local development can expect in the future. In response to a question about the attitude of the people attending the hearing, Mr. Fay said it was the first one at which there was a showing of public support. • NEW BUSINESS Bio-terrorism Preparedness Update: Jean Baldwin reported that the Department is on the waiting list for a table-top exercise. Having completed several Emergency Management Plan exercises with JPREP, the sheriff, and law enforcement, they have come up with some resolutions about how to respond to anthrax. Locally there were five suspicious packages or letters that went to the State lab to be investigated, a number considered high for a small county. And although they all tested negative, the two and a half months of handling this matter cost the County $4,500. She said this expense raises the question, what would happen if the County was to increase its surveillance and awareness, and continue to meet twice a month with the hospital? She noted that Jefferson County Safety Officer Mark Bowes did several training sessions about how to handle the mail and the Nurse Communicable Disease Coordinator also attended to provide information on the diseases and risks.With this being the first opportunity to put the plan into action, it revealed some difficulty with interpretation. Dr. Locke said the local concern has been on suspicious mail and the anthrax threat, which in the scheme of bio-terrorist incidents is probably the easiest to manage because it is treatable and is relatively straightforward to diagnose, and there is no person-to-person transmission. Given this, however, there remains an incredible expense to respond to the events. Much of what was thought to be known about anthrax—that it required large doses to contract and that cross contamination through mail was a virtual impossibility—has been proven wrong. He believes the lesson we have learned from anthrax, in terms of bio-terrorism, is that weaponized infections are enormously more dangerous than the naturally occurring forms of the infections. He believes this has put pressure to find out about small pox and plague and other biological weapons. It has also applied pressure to improve coordination among response agencies • for an all-hazards approach and made this a front-burner issue in terms of working with the hospital on infectious disease threats more generally. In addition to bio-terrorism, there are also concerns about HEALTH BOARD MINUTES - December 20, 2001 Page: 4 • antibiotic resistant infections and new emerging diseases. He noted we would almost certainly have occasion to use any system we develop for the naturally occurring infections. Dr. Locke reviewed the many things occurring at the state level since the Board of Health last met. The SBOH held a hearing in October and information from this session was incorporated in a report adopted in mid-November, the executive summary of which was included in the Board's agenda packet. He called to the Board's attention the report's recommendations because he believes the whole point of a preparedness assessment is to ask the question "Are you ready to deal with this problem?"If the answer is no, then"What is it that we need to do and what are the priority tasks to be accomplished?"The SBOH's answer was No—there is not adequate protection. Referring to the State Board of Health Resolution No. 01-001, Vice Chairman Westerman, said the measure seems to support funding levels that provide for adequate state and public health. She asked what is to be done with the resolution? Dr. Locke said he would prefer to answer the question by reviewing some of the recommendations listed on page 6 of the Final Report titled"Response Capacity During a Health Emergency" because they are more specific. • Number 2 asked the Governor and State agencies to advocate for the federal funding,which has now been decided. • • Number 3 refers to what the State will do with federal funding—expanding response capacity not using it to offset cuts in State contributions to existing programs. • Number 4 also addresses the budget issue in that the capacity for bio-terrorism or biological emergency response at a local level essentially involves mobilizing people to do the kinds of intensive surveillance, investigation, vaccine and medicine distribution, and quarantine activities that really only public health can accomplish. It comes down to how many appropriately trained staff we have. He noted the ways Washington public health departments have maintained themselves by cobbling together different kinds of programs and contracts from different state and federal agencies. This pays for the public health nurses and the epidemiologic capabilities and the environmental health specialists, items very much threatened in the state budget. The most noticeable element to begin with is the misnamed "I-695 backfill."This funding gap was created when the legislature repealed the motor vehicle excise tax and displaced a source of money that used to come primarily from cities, but that had been a stable part of public health since the 1970s. Without this, we are at pre-1970s funding levels and are probably worse off now than ever. Rather than continuing that funding through the biennium, the Governor's budget proposes to stop it all together six months short of the end of the biennium. • Number 5 deals with the issue of flexible versus categorical funding. Much of the funding received from state and federal agencies has a lot of strings attached to it. Since this makes mobilizing that capacity for communicable disease efforts much harder, we need flexibility. • • HEALTH BOARD MINUTES - December 20. 2001 Page: 5 Recommendation 6 focuses on the Medicare system. Medicare has lost its excess capacity and • virtually an hospitals are "lean and mean"in staffing and bed support. At any given time there is only an excess of 40-50 intensive care beds in the entire Seattle area system—so there is little, if any, surge capacity. Even a small release of Botulinum toxin would require at least 10,000 respirators and a huge intensive care capacity to keep people alive until the effects of the toxin wore off. While we would not propose to have 10,000 ICU beds, currently the ICU surge capacity is zero. This would also be a real problem in the event of an influenza pandemic. • Item 7 deals with a need to identify and set priorities. • Item 8 is mostly a federal issue but one we are becoming more and more aware of, related not just to bio-terrorism but all communicable diseases. The vaccine production system is breaking down and we are seeing the effects in public health. Vaccine production is not attractive to the pharmaceutical companies in an environment where the worldwide market for vaccines is about $3 billion and the market for Viagra is $5 billion. • The final recommendation, Number 9, asks if the Board is looking at its own statutory authority, but it very much overlaps with the statutory authority of local Boards of Health. We have seen that our current system for notifiable conditions is really not adequate to deal with the urgency of reporting bio-terrorism outbreaks. • Dr. Locke said these are the priorities that emerged after a fairly detailed review by the State Board of Health. He urged the Board to review the whole report, stressing that there are certain issues that can only be dealt with on the community level. When asked what an individual can do to protect him or herself(against anthrax, smallpox or botulinum) he tells people the only way to be safe and secure is to have a functional public health system at the community level. Member Frissell asked what steps can be taken to give the public the kind of information they would need? Dr. Locke said although he could not attend, he heard the Clallam hospital's bio-terrorism forum was well received. Efforts have been geared toward the medical staff and continuing education presentations. Jean Baldwin talked about the significant amount of work that needs to be done with the hospital in dealing with infectious disease, quarantine, moving vaccine, and all the players involved. Another step being taken locally is a Memorandum of Agreement(MOAs) between Jefferson, Kitsap and Clallam Counties. Dr. Locke provided a draft resolution, which is an opportunity for the Board of Health to formally support any or all of the recommendations. Member Masci moved to adopt the resolution dated December 20,2001. Commissioner Wojt seconded the motion. During discussion of the motion, Dr. Locke clarified that resolutions will be • grouped and forwarded to the Governor, the legislature, and the State Board of Health.The motion carried by a unanimous vote. HEALTH BOARD MINUTES - December 20, 2001 Page: 6 • Vice Chairman Westerman said because of the challenges in the County budget and inadequate resources to support current levels of service, she asked whether this Board, as a local action,would like to discuss making specific recommendations for the County to come up with additional funding for the Health Department? Commissioner Titterness asked how to address the funding issues given that the issues are bigger than just the Board of Health? Vice Chairman Westerman would like to see the Board of Health come out publicly in support of trying to find a stable funding mechanism for the Health Department. She believes part of the reason the Board was expanded was to support that process. While there is huge pressure not to raise taxes, she feels the Board of Health should do more than to pass general resolutions which sound good,but do not really produce the needed results. Commissioner Titterness said he believes the general attitude is that there can be support if you identify a specific goal for which you can generate public support, but you have to have the authority to target that goal. He pointed out that the Board of Health doesn't have that authority. Dr. Locke said he believes it is already a priority on a state and local level to find a stable, dedicated source of public health funding. The proposed solution is connected to a public utilities tax. If people want public health security, this would be the way to vote it in. • Commissioner Wojt commented that he believes the other aspect to which Member Westerman was referring was that people have to realize that you don't gear up after the disease threat. It is our responsibility to educate people on what they are getting for their dollar and that the cycle of funding does not necessarily correspond to the cycle of disease. Member Masci responded that when the legislators appeared at a law and justice council meeting, they were proposing a utility tax for law and justice issues. He noted even within the County there are competing interests for the elusive utility tax and its assignment for specific needs. 2002 Data Steering Committee Fact Sheet: Member Frissell and Member Masci recognized Kellie Regan and Dr. Chris Hale's efforts in compiling the information. Member Masci then reviewed data which was broken into three areas: Birth/Material Child Health Indicators, Socio-Economic Indicators, and Population Indicators. Member Masci noted that our rapid growth in the 65+ and 85+ age ranges is atypical in Washington, and identifies us as a special needs population. He also noted a big spike in the over 45-55 range. He believes we are fortunate to have all of this valuable data, noting that more will be available in about three months. Jean Baldwin said Kellie Regan and Dr. Chris Hale are also developing an environmental health satisfaction survey which is expected to be available in January and that will quantify many of the Environmental Health measurements. Larry Fay said the goal of the survey is to better gauge what is and • is not working. • HEALTH BOARD MINUTES - December 20, 2001 Page: 7 Update of 2002 Strategic Plan with Budget Shortfall Impacts: Due to insufficient time remaining, the Board agreed to spend a significant portion of the next meeting on this topic. Commissioner Tittemess said it appears, based on revenue projections, that the County will have to severely cut expenses or find additional revenues. Letter to the Editor: Vice Chairman Westerman requested the Board's permission to identify herself as a Board of Health member in writing a letter to the editor regarding her support of an affordable housing project. She believes the Board of Health should discuss whether they can come up with guidelines or a policy about whether members can speak out on behalf of an issue. Given the data the Board is receiving and the tremendous pressure that elected officials come under, she feels that there will be an increasing desire to speak out on some of these issues and that public officials need support. While the Board expressed no concern about an individual member making statements on their own behalf, there were several comments and concerns about referring to the Board of Health. One suggestion was that a member could state"this is not necessarily a position of the Board,"however it was thought that even this use of the Board's name implies advocacy and might lead people to think that there is a Board position favoring one project or another. Member Frissell said the organizations in which she has been involved ask that members not use their name • unless they are referring to stated and agreed-upon policies. HEALTH BOARD MINUTES - December 20,2001 Page: 8 • AGENDA CALENDAR/ ADJOURN Update of 2002 Strategic Plan with Budget Shortfall Impacts and Report on Access Project. 2002 AGENDA ITEMS ./ CONTINUED STABLE FUNDING TO REPLACE MVET • ACCESS HEALTH CARE ./ PROGRAM MEASURES (Genetic Research and Public Health Implications) ▪ METHAMPHETAMINE SUMMIT • PERFORMANCE STANDARDS & COMMUNITY ASSESSMENT ▪ TOBACCO PREVENTION AND COALITION / FLUORIDE / TRANSIT AND PUBLIC HOUSING • BIOTERRORISM READINESS & PLAN / AGING POPULATION / WATER / MATERNAL CHILD PREVENTION GOALS (0-3) Meeting adjourned at : 425 p.m. The next meeting will be held on Thursday, January 17, 2002 at 2:30 • p.m. at the Jefferson County Health and Human Services Conference Room. JEFFERSON COUNTY BOARD OF HEALTH (Excused) Jill Buhler, Chairman Geoffrey Masci, Member Sheila Westerman, Vice-Chairman Richard Wojt, Member (Excused) Glen Huntingford, Member Roberta Frissell, Member Dan Titterness, Member • • Board of Health New Business Agenda Item # VI. , 1 • Public Health Funding - State and Local Policy Issues January 17, 2002 • . r • RCW 70.05.060 Powers and duties of local board of health. Each local board of health shall have supervision over all matters pertaining to the preservation of the life and health of the people within its jurisdiction and shall: (1) Enforce through the local health officer or the administrative officer appointed under RCW 70.05.040, if any, the public health statutes of the state and rules promulgated by the state board of health and the secretary of health; (2) Supervise the maintenance of all health and sanitary measures for the protection of the public health within its jurisdiction; (3) Enact such local rules and regulations as are necessary in order to preserve, promote and improve the public health and provide for the enforcement thereof; (4) Provide for the control and prevention of any dangerous, contagious or infectious disease within the jurisdiction of the local health department; (5) Provide for the prevention, control and abatement of nuisances detrimental to the public health; (6) Make such reports to the state board of health through the local health officer or the administrative officer as the state board of health may require; and • (7) Establish fee schedules for issuing or renewing licenses or permits or for such other services as are authorized by the law and the rules of the state board of health: PROVIDED, That such fees for services shall not exceed the actual cost of providing any such services. [1991 c 3 § 308; 1984 c 25 § 6; 1979 c 141 § 79; 1967 ex.s. c 51 § 10.] RCW 70.05.120 Violations -- Remedies -- Penalties. Any local health officer or administrative officer appointed under RCW 70.05.040, if any, who shall refuse or neglect to obey or enforce the provisions of chapters 70.05, 70.24, and 70.46 RCW or the rules, regulations or orders of the state board of health or who shall refuse or neglect to make prompt and accurate reports to the state board of health, may be removed as local health officer or administrative officer by the state board of health and shall not again be reappointed except with the consent of the state board of health. Any person may complain to the state board of health concerning the failure of the local health officer or administrative officer to carry out the laws or the rules and regulations concerning public health, and the state board of health shall, if a preliminary investigation so warrants, call a hearing to determine whether the local health officer or administrative officer is guilty of the alleged acts. Such hearings shall be held pursuant to • the provisions of chapter 34.05 RCW, and the rules and regulations of the state board of health adopted thereunder. • Any member of a local board of health who shall violate any of the provisions of chapters 70.05, 70.24, and 70.46 RCW or refuse or neglect to obey or enforce any of the rules, regulations or orders of the state board of health made for the prevention, suppression or control of any dangerous contagious or infectious disease or for the protection of the health of the people of this state, shall be guilty of a misdemeanor, and upon conviction shall be fined not less than ten dollars nor more than two hundred dollars. Any physician who shall refuse or neglect to report to the proper health officer or administrative officer within twelve hours after first attending any case of contagious or infectious disease or any diseases required by the state board of health to be reported or any case suspicious of being one of such diseases, shall be guilty of a misdemeanor, and upon conviction shall be fined not less than ten dollars nor more than two hundred dollars for each case that is not reported. Any person violating any of the provisions of chapters 70.05, 70.24, and 70.46 RCW or violating or refusing or neglecting to obey any of the rules, regulations or orders made for the prevention, suppression and control of dangerous contagious and infectious diseases by the local board of health or local health officer or administrative officer or state board of health, or who shall leave any isolation hospital or quarantined house or place without the consent of the proper health officer or who evades or breaks quarantine or conceals a case of contagious or infectious disease or assists in evading or breaking any quarantine or concealing any case of contagious or infectious disease, shall be guilty of a misdemeanor, and upon conviction thereof shall be subject to a fine of not less than • twenty-five dollars nor more than one hundred dollars or to imprisonment in the county jail not to exceed ninety days or to both fine and imprisonment. [1999 c 391 § 6; 1993 c 492 § 241; 1984 c 25 § 8; 1967 ex.s. c 51 § 17.] • • Agenda Fee Review Advisory Board to the Jefferson County Board of County Commissioners 1. Call to Order by the Chair( Shiela Westerman, Vice Chair, Board of Health) 2. Committee's Charge from the Commission Commission policy is that development fees cover the cost of the program or service and 75%of the division/department administrative cost. Review the recommended fee schedules in view of the division/department's cost estimate for the program or service. Benchmark our cost/fees to other jurisdictions. • Recommend appropriate fees for the services if different from those recommended by staff. The Committee has the expressed authority to question staff as to how fees were determined, request relevant supportive data, make recommendations regarding staff procedures that might produce efficiencies or cost savings and report on any additional information they gather. A final report from the Committee is due to the Board of County Commissioners no later than January 24, 2002. 3. Introduction 1. Committee 2. Staff 4. Staff Reports 1. Legislative Background 2. Administrative Directive 3. Departmental Response 1. Environmental Health's Approach to Fees (With handouts) 2. Community Development's Approach to Fees (With handouts) 4. Summary 5. Questions about staff presentations �P �ODL - 4 —.pod 5. Next Meeting (suggest TuesdayJanuary8, 2002 at 7 p.m.1 • 6. Announcements tkic c J 1 • 1.1t: '4. .i , . ' Jeffersonerson CountyHealth r Hu man Services 'p" J I_, t NA, 615 SHERIDAN • PORT TOWNSEND,WA 98368 • FAX 360-385-9401 1 Date: January 7, 2002 To: Fee Committee From: Larry Fay t -) / 1 Re: Fee Adjustment Rational Under the administrator's directive to cover 75% of divisional administrative costs, Environmental Health must collect an additional $84,000 in fees. Since there are a number of reasons, as discussed last week, for not including solid waste programs in this analysis, all the additional fees must come from the four remaining programs. A greater percentage fee increase has been proposed in the food program for two main reasons. These are: • • Permit costs can be passed on to the consumers who benefit from the program • Part of the fee is picked up by non-residents who may visit local establishments. The distribution of fee increases as proposed covers the $84,000 revenue increase needed. An alternative approach would distribute the $84,000 revenue proportionally among the four programs based on the current revenue projections. The result would be larger increases in septic permits and smaller increases in food permits. • COMMUNITY ENVIRONMENTAL NATURAL DEVELOPMENTAL SUBSTANCE ABUSE HEALTH HEALTH RESOURCES DISABILITIES &PREVENTION 360/385-9400 360/385-9444 360/385-9444 360/385-9400 360/385-9400 • cco o- 0-, 6' v H o n1 (D UI - In (0 I y ON o N i 0 = ao • o- � o1 3 0 - . O ? -n = o g �. 5 'C -r7 Ni O (N11 O Z U1 W ©O W Z W 0.. 0 v C7 co O co O C7 O ET 5 co n• ED (D o " o 0 n 0 C ED cm fl1 0 • 0 CC Q 3 - CD C m = cr m CD c1 ._. Ni Ni -a _. _a Ni Ni --,. W --, CO C (D I O W 01 O 01 .A A O 0) O O CD N O O O 01 O O O O W O 0 O = C n N Lj CD T1 0 N o i n 0 CO Uj D o o o N a) = a) = 77.: W 01 A 0) Ni CO -A W U1 WA A A CO 01 O (D A A O (D . = CSD CD U7 O 01 01 O O O - O A O C o ID a O m O Q i co (D.; D o D 0 0 5• C C U1 Sv a 0 Z a A o w Ni Ni co Ni 4' '*: 0 v CD A > V) 01 OO 0 0 O o 0 O A O O Ni O c p o 0 (D -co m Ni NiNiN -, A - Ni _, fl) I NiN � C7 Ni co C), O A -t 01 CO O A O O • � A O O O O A O O 1! O --4 O sG O 0 II co O 0 rRECEIVED AikPlease publish 1 time: December 12, 2001 ill: Jefferson County Commissioners Office !DEC 1 3 2001 PO Box 1220 1820 Jefferson Street defersccrin Port Townsend, WA 98368 �oI ] a�F iii NOTICE OF PUBLIC HEARING NOTICE IS HEREBY GIVEN that a public hearing is scheduled by the Jefferson County Board of Commissioner to take comments on a proposed Ordinance amending the fees for the Environmental Health Division and Animal Services Division of the Health & Human Services Department and the Building Division of the Department of Community Development. The hearing is scheduled for December 24, 2001 at 10:05 a.m. in the County Commissioners Chambers, Lower Level, Jefferson County Courthouse, 1820 Jefferson Street, Port Townsend, WA 98368. JEFFERSON COUNTY BOARD OF COMMISSIONERS ClAfiri 27.1 }fa, . n untirig .r., -airman • • Page 1 STATE of WASHINGTON • COUNTY of JEFFERSON In the matter of an Ordinance } Amending Specific Fee Schedules } Contained in Ordinances 12-1209-96, } ORDINANCE NO. 11-1115-99, and 10-1108-99 } for the Health & Human Services, } Environmental Health Department, } Animal Services, and the Department } Community Development } SECTION 1 - PURPOSE AND SCOPE: The purpose of this ordinance is to amend or repeal and replace fee schedules for the following Jefferson County Departments and/or Divisions of Department: Health & Human Services - Environmental Health Division; - Animal Services Department of Community Development (formerly Permit Center) - Building Division SECTION 2 - FEE SCHEDULES: The following fee schedules are to be amended as follows. Only new and changed items are listed. Fees that remained the same are not listed — previous ordinance for these fees. • HEALTH & HUMAN SERVICES DEPARTMENT- ENVIRONMENTAL HEALTH DIVISION ON-SITE SEWAGE FEE 2001 Proposed Additional Fee and/or 2002 Fee Other Information SEWAGE DISPOSAL PERMITS New Conventional 250.00 340.00 Valid for 3 years New Alternative 300.00 410.00 Valid for 3 years New Septic tank and/or pump chamber 110.00 150.00 Issued in conjunction with an existing sewage disposal system or community system New Community or >1000 G.P.D. (Base fee) 250.00 340.00 Plus$57 per connection Valid for 3 years New Commercial > 1000 G.P.D. Conventional 300.00 410.00 Valid for 3 years • Page 2 &Ordinance No. re: Fees for Various County Services PROGRAM/SERVICE ' FEE 2001 I Proposed Additional Fee and/or 2002 Fee I Other intormation Alternative 325.00 440.00 Valid for 3 years Repair/upgrade 55.00 80.00 Applies to existing installed sewage disposal system Expansion 200.00 270.00 Redesign 55.00 80.00 Applies to pending or active but not installed. Reinspection 70.00 100.00 Renewal 60.00 90.00 EVALUATION OF EXISTING SYSTEM Filing Fee 20.00 To record EES done by •rivate inspector iiiSeptic System only 100.00 175.00 Septic System plus water sample 125.00 208.00 Retest/Re-inspection 50.00 70.00 OTHER Waiver/Variance Application 85.00 120.00 I Waiver/Variance Hearing 200.00 Technical Assistance - Minimum 50.00 58.00 Technical Assistance - Per Hour 50.00 58.00 Wet Season Evaluation 200.00 270.00 LICENSES Installer, Pumper, Operator (maintenance person) 200.00 270.00 Retest 80.00 110.00 Renewal 140.00 190.00 Renewal after January 31 200.00 270.00 ON SITE SEWAGE On Site SPAAD 200.00 • Page 3 Ordinance No. re: Fees for Various County Services • PROGRAM/SERVICE ' FEE 2001 Proposed Additional Fee and/or 2002 Fee j Other Information T Septic Permit with SPAAD (Conventional) 150.00 Septic Permit with SPAAD (Alternative) 225.00 FOOD SERVICE ESTABLISHMENT FEES (Annual Permit) Immediate Consumption Limited 70.00 110.00 Non-Complex 90.00 140.00 Complex 0-50 seats 160.00 250.00 51-100 seats 190.00 300.00 101-150 seats 215.00 340.00 Alcohol served in multiple areas 70.00 110.00 • Not for immediate Consumption Limited 70.00 110.00 Non-Complex 90.00 140.00 Complex 215.00 340.00 Annual Permit Issued After September 1 50%of fee same Late Fees 50%of fee same Additional Temporary Permit Non-Complex 55.00 C90.09) Limited 30.00 50.00 Other Food Fees Plan Review Minimum 50.00 58.00 Per Hour 50.00 58.00 Page 4 • •rdinance No. re: Fees for Various County Services PROGRAM/SERVICE FEE 2001 Proposed Y Additional Fee and/or 2002 Fee Other Intormation IReinspection First inspection 40.00 70.00 Second inspection 75.00 120.00 Administrative Hearing 110.00 170.00 Food Handler Card 8.00 8.00 Reissue Unexpired Food Handler Card 2.00 2.00 Manager's Course 110.00 170.00 SOLID WASTE Landfills requiring environmental monitoring 400.00 410.00 Inert Landfills 250.00 260.00 Bio-solid Utilization 350.00 360.00 Other Solid Waste Facility Permits 250.00 260.00 Drop Boxes 110.00 120.00 New Facility Application 320.00 330.00 Plan Review 50.00 58.00 Per Hour WATER Drinking Water (notice of intent) 80.00 120.00 Notification of Availability 30.00 50.00 Well Site Inspection 160.00 240.00 Water Sample Bottles Cost Plus $2 Cost Plus $3.00 LIVING ENVIRONMENTS Pools 160.00 220.00 Spa 160.00 220.00 Pool/spa combined 220.00 300.00 • Page 5 Ordinance No. re: Fees for Various County Services • PROGRAM/SERVICE FEE 2001 i Proposed Additional Fee and/or 2002 Fee Other Information Subdivision Review Base Fee 200.00 300.00 Plus $15.00 Per Lot I { Plan Review 58.00 Per Hour ANIMAL SERVICES Only new and changed items are listed. Fees that remained the same are not listed — see previous ordinance for these fees. FEE 2001 Proposed Additional Fee and/or 2002 Fee Other Information DELETE Senior Discount on License Fees 50% DELETE Replacement of Lost Tag 2.00 4.00 IMPOUND Surrender Fee (to owner) 20.00 REDEMPTION - Fertile Dogs and Cats • First Offense 30.00 45.00 Fee may be refunded if dog or cat is spayed or neutered. Second Offense 32.00 48.00 Education required Third Offense 45.00 67.00 Plus spay/neuter fee REDEMPTION - Sterile Dogs and Cats First Offense 16.00 24.00 May be refunded Second Offense 32.00 48.00 Education Required Third Offense 45.00 67.00 Board for Dogs and Cats 8.00 16.00 After first 24 hours - per each subsequent 24 hour period. LIVESTOCK Impound Fee 21.00 42.00 After first 24 hours- per each subsequent 24 hour period. Board 8.00 20.00 After first 24 hours. • Page 6 Ordinance No. re: Fees for Various County Services PROGRAM/SERVICE FEE 2001 , Proposed Additional Fee and/or 2002 Fee Other Information . Transportation 2100 42.00 The greater of$42.00 or actual cost. EUTHANASIA AND CREMATION SERVICES Euthanasia 21.00 32.00 Cremation Services PRIVATE: 0 pounds to10 pounds 20.00 30.00 Over 10 pounds to 40 pounds 40.00 60.00 Over 40 pounds to 75 pounds 60.00 90.00 Over 75 pounds to 110 pounds 60.00 110.00 Over 110 pounds 110.00 130.00 COMMUNAL: 4110 0 pounds to10 pounds 10.00 15.00 Over 10 pounds to 40 pounds 15.00 25.00 Over 40 pounds to 75 pounds 20.00 30.00 Over 75 pounds to 110 pounds 25.00 40.00 Over 110 pounds 30.00 45.00 • Remote Pick up by Animal Services Employee 10.00 20.00 KENNELS AND DANGEROUS DOGS Kennel License Fee 31.00 75.00 Commercial -- If paid after February 28 add$10.00 Dangerous Dog Registration Fee 181.00 250.00 ADOPTION FEE Dogs 55.00 60.00 ' ncludes Licenl= Spay or ^" ion,and Veterinary Exam. • Page 7 Ordinance No. re: Fees for Various County Services 410 PROGRAM/SERVICE FEE 2001 Proposed j Additional Fee and/or 2002 Fee i Other Int'ormation 1 Cats 55.00 60.00 ,�cludes License, pay or I Neuter,Vaccination and IVeterinary Exam. DEPARTMENT OF COMMUNITY DEVELOPMENT (formerly Permit Center) BUILDING DIVISION, DEVELOPMENT REVIEW AND LONG RANGE PLANNING a) Applies to new construction only, otherwise, number 6 applies. b) The fee is determined by a schedule established in the Uniform Building Code, and is based on the value of the structure. c) The fee that is charted by the Auditor's Office for filing. d) Applies to commercial, industrial, multi-family construction and is calculated as a percentage of the base fee. e) The fee is based on Building Valuation Data established by ICBO, Buidling Standards, modified for Western U.S. Washington State. • BUILDING, MANUFACTURED HOME, AND FEE 2001 Proposed Additional Fee and/or OTHER PERMIT APPLICATIONS 2002 Fee ; Other Information 1) Main Floor b b Base Fee 30% 65% Plan Check Fee a, e a, e Valuation 2) Additional Floors, Finished Basement b b Base Fee 30% 65% Plan Check Fee a, e a, e Valuation 3) Unfinished basement b b Base Fee 30% 65% Plan Check Fee a, e a, e Valuation 4) Carports, Garages, Pole Buildings, b b Base Fee Decks 30% 65% Plan Check Fee $10.00 per square a, e Valuation foot • Page 8 eirdinance No. re: Fees for Various County Services PROGRAM/SERVICE FEE 2001 Proposed Additional Fee and/or 2002 Fee Other Information ' 5) Modular Home foundations and b b Base Fee foundations for relocated structure 30% 65% ! Plan Check Fee $26.00/sq.foot $26.00/sq. Valuation foot 6) COMMERCIAL structures, construction Cost or Fair Market Cost or Fair or improvement Value Market Value UBC Fee UBC Fee 65% 65% Plan Check Fee 7) Manufactured Homes (one or two 141.00 151.00 sections) 8) Additional manufactured home sections 29.00 31.00 9) Wood stoves, inserts, propane tanks and 48.00 47.00 pellet stoves (in existing structures) j 10) Inspection; reinspection 48.00 47.00 •11) Change of Use or Occupancy 120.00 129.00 12) Title Notice Removal c c 13) Renewal 56.00 94.00 14) DELETE Variance 159.00 DELETE 14) Fire Marshall Services 47.00 per hour 15) Notification of Water Availability 32.00 In addition to Health Department Fee for same thing. RIGHT OF WAY, UTILITY & ADDRESS APPLICATIONS 16) Road Approach 39.00 141 .00 Type I Permit 17) Application for 911 Number/Address 29.00 141.00 18) Application for 911 Replacement 5.00 5.00 Number 19) Road Approach & Address 51 .00 141 .00 Combined • Page 9 Ordinance No. re: Fees for Various County Services111 PROGRAM/SERVICE 1 FEE 200] Proposed Additional Fee and/or 2002 Fee Other Information 20) Utility Installation of General Permit 39.00 141.00 LAND USE APPROVAL APPLICATIONS (Unified Development Code) 21) Pre-application Conference 80.00 188.00 Not applied to permit 22) Appeals of Type II and Type Ill Base 400.00 470.00 Decisions, Code Interpretations, State Pub. Hear Notice 113.00 121 .00 Environmental Policy Act Notice Boards 15.00 8.00 Determinations, and Notice and Order 121.00 Notice of Application (Abatement) 23) Revisions to Land Use Applications 111 .00 94.00 Base Requiring a Second Public Hearing 121 .00 Public Hearing Notice Notice 24) Site Visit (first site visit is included in 39.00 per hour 94.00 • application base fee) 25) Code Interpretation Base 120.00 282.00 Notice of Application) 11 .00 26) Notice Board 15.00 for two 8.00 Each 27) Hourly Rate 39.00 47.00 TYPE I PERMITS 30) Allowed "Yes" Use Consistency 39.00 Base 47.00 1 hour charge 47.00 minimum. Per Hour prorated for additional time. 31) Stormwater Management Permit 188.00 Stand Alone Only 32) Boundary Line Adjustment 169.00 188.00 33) Minor Plan Modification (Preliminary Base 169.00 188.00 approval only) App. Not. 111 .00 Hearing Not. 113.00 Page 10 • Page • Ordinance No. re: Fees for Various County Services PROGRAM/SERVICE j FEE 2001 i Proposed Additional Fee and/or 2002 Fee Other Information 34) Site Plan Approval Advance 39.00/hour 188.00 Determination (SPAAD) 35) Shoreline Master Program Base 167.00 282.00 Exemption App. Notice 111.00 36) Shoreline Master Program Permit Notice 113.00 94.00 Revision 37) Last Will & Testamentary Division 169.00 282.00 38) Home Business 113.00 Base 47.00 1 hour charge 47.00 minimum. Per Hour prorated for additional time. 39) Temporary Use 56.00 Base 47.00 1 hour charge 47.00 minimum. Per Hour prorated for additional time. •40) Sign Permit 29.00 Base 47.00 1 hour charge 47.00 minimum. Per Hour prorated for additional time. 41) Minor PRRD (Planned Rural Residential 39.00/hour Base 47.00 1 hour charge Development) Amendments 47.00 minimum. Per Hour prorated for additional time. 42) Additional fee for State 225.00 423.00 Base Environmental Policy Act (SEPA) Minimum 121 .00 Notice of Review (including SEPA base fee, Pend Not. 56.00 8.00 Application Notice of Application, and Notice Board) Notice 113.00 Notice Board TYPE H PERMITS (Require Notice of Application and Notice Board 43) Discretionary "D" or Unnamed Use 120.00 188.00 Base Classification 111 .00 121 .00 Notice of 15.00 8.00 Application Notice Board • Page 11 Ordinance No. re: Fees for Various County Services • PROGRAM/SERVICE 1 FEE 2001 Proposed 1 Additional Fee and/or Ir 2002 Fee Other Information i 44) Short Plat (including Planned Rural 563.00 Residential Development Application Plus $21 per lot 1,269.00 ' Base 111 .00 121 .00 Notice of Application 15.00 8.00 Notice Board 45) Conditional (Administrative) "C(a)" 281 .00 470.00 Base Use 111 .00 121 .00 Notice of Application 15.00 8.00 Notice Board 46) Conditional (Discretionary) "C(d)" 281 .00 470.00 Base Use 111 .00 121 .00 Notice of Application 15.00 8.00 Notice Board I 47) Cottage Industry 281 .00 ' 470.00 Base 111 .00 121 .00 Notice of Application 15.00 8.00 Notice Board 48) Wireless Telecommunication 228.00 470.00 Base 111 .00 121 .00 Notice of Application • 15.00 8.00 Notice Board 49) Temporary Use 56.00 Hourly Review Fee 111 .00 121 .00 Notice of Application 15.00 8.00 Notice Board 50) Variance, Minor 169.00 470.00 Base 111 .00 121 .00 Notice of Application 113.00 Hearing Notice 15.00 8.00 Notice Board 51) Shoreline Substantial Development 281 .00 705.00 Base (Primary Use) 111 .00 121 .00 Notice of App. 113.00 Hearing Notice 15.00 8.00 Notice Board 52) Forest Practices Act/Release of Six 169.00 282.00 Base Year Moratorium 111 .00 121 .00 Notice of App. 15.00 Notice Board • Page 12 • Ordinance No. re: Fees for Various County Services PROGRAM/SERVICE FEE 2001 Proposed Additional Fee and/or 2002 Fee Other information 53) Conversion Option Harvest Plans 169.00 282.00 Base 111 .00 121 .00 Notice of App. 15.00 8.00 Notice Board 54) Binding Site Plans (including 3,995.00 Base Planned Rural Residential Development 121 .00 Notice of App. application) 8.00 Notice Board 55) Additional fee for State Minimum 225.00 423.00 Environmental Policy Act (SEPA) Pend. Not. 56.00 Review Notice 113.00 Notice Boards 15.00 TYPE III PERMITS (Require Notice of Application, Public Hearing Notice and Notice Board) 56) Conditional "C" Use 281.00 1,034.00 Base ID 111.00 121.00 Notice of App. 113.00 , 121 .00 Public Hearing Not 8.00 8.00 Notice Boards 57) Wireless Communication 228.00 1,034.00 Base 111 .00 121.00 Notice of App. 113.00 121 .00 Public Hearing Not 15.00 8.00 Notice Boards 58) Long Plat, Preliminary (including 563.00 Planned Rural Residential Development Plus $21 per lot 3,995.00 Base application.) 111 .00 121 .00 Notice of App. 113.00 121 .00 Pub. Hrg. Notice 15.00 8.00 Notice Board 59) Variance, Major 169.00 940.00 Base 111 .00 121 .00 Notice of App. 113.00 121 .00 Pub.Hrg. Notice 15.00 8.00 Notice Board • Page 13 • Ordinance No. re: Fees for Various County Services PROGRAM/SERVICE FEE 2001 I Proposed ' Additional Fee and/or I 2002 Fee Other Information I 60) Reasonable Economic Use Variance 169.00 940.00 Base 111 .00 1 121 .00 Notice of App. 113.00 121.00 Public Hrg. Not. 15.00 8.00 Notice Board 61) Shoreline Substantial Development 338.00 1 ,128.00 Base (Secondary Use) 111 .00 121 .00 Notice of App. 113.00 121 .00 Pub. Hrg. Notice 8.00 ; 8.00 Notice Board 62) Shoreline Conditional Use 394.00 1 ,128.00 Base 111 .00 121 .00 Notice of App. 113.00 121 .00 Pub.Hrg. Notice 15.00 8.00 Notice Board 63) Shoreline Variance 169.00 940.00 Base 111 .00 121.00 Notice of App. • 113.00 121 .00 Pub.Hrg. Notice 15.00 8.00 Notice Board 64) Additional Fee for State Minimum 225.00 423.00 Environmental Policy Act (SEPA) Pend Not. 56.00 Review Notice 113.00 Notice Boards 15.00 TYPE IV PERMITS 65) Short Plat, Long Plat, Binding Site 141 .00 Plans; Final (including Planned Rural Residential Development application) TYPE V PERMITS 66) Special Use (Essential Public 281 .00 1 ,034.00 Base Facilities) 111 .00 121.00 Notice of App. 113.00 121 .00 Pub. Hrg. Notice 15.00 8.00 Notice Boards 67) Jefferson County Comprehensive No Fee Plan/UDC Amendment Suggested) • Page 14 •Ordinance No. re: Fees for Various County Services PROGRAM/SERVICE FEE 2001 I Proposed Additional Fee and/or 2002 Fee Other Information 68) J.C. Comprehensive Plan/UDC 250.00 2,250.00 Amendment (Site Specific) includes SEPA 69) J.C. Shoreline Master Program 2,250.00 CURRENT USE TAX ASSESSMENT APPLICATION 70) Open Space/Open Space & Open 281 .00 1,034.00 Base Space Timber Applications 111 .00 121 .00 Notice of App. 113.00 121 .00 Pub. Hrg. Notice 15.00 8.00 Notice Board 71) Open Space Agriculture Applications 113.00 121.00 Base 111.00 121 .00 Notice of App. 113.00 121 .00 Pub. Hrg. Notice 15.00 8.00 Notice Board • 72) Application to Transfer Forest Land 111.00 121 .00 Base (RCW 84.33) to Timber Land (RCW 113.00 121 .00 Pub. Hrg. Notice 84.34) 15.00 8.00 Notice Board 73) Copy or Duplicating Fee 11 " x17" Page $.30 Color or Oversized Documents At cost Cassette Tapes 5.00 Land Use Maps $10.00 Publications At Cost SECTION 7 - REPEALER This Ordinance repeals and replaces the Permit Center-Building Division Section of Ordinance No. 12-1209-96 and the Permit Center-Building Division Section of Ordinance No.13-1213-99 and Ordinance No. 10-1108-99. It also repeals the Environmental Health Division Fees of the Health & • Page 15 • Ordinance No. re: Fees for Various County Services • PROGRAM/SERVICE FEE 2001 Proposed Additional Fee and/or 2002 Fee Other Information Human Services Department Section of Ordinance No. 11-1115-99 SECTION 8 - SEVERABILITY If any section, subsection, or sentence, clause, phrase, or figure of this Ordinance or its application to any person or circumstance is held invalid, the remainder of the ordinance or the application to other persons or circumstances shall not be affected. SECTION 9 - EFFECTIVE DATE This Ordinance shall become effective January 1 , 2002. APPROVED AND ADOPTED this day of , 2001 . JEFFERSON COUNTY BOARD OF COMMISSIONERS • SEAL: Glen Huntingford, Chairman ATTEST: Dan Titterness, Member Lorna Delaney, CMC Richard Wojt, Member Clerk of the Board • Page 16 s t ---',_:1,. ..--.;-.:,'-c.-,,', v � .; �� / rte t i t y 1 • ! t ,tom a.� � --::i.--.-•;,:_-..,-,•,, C. v, A ,7-.v,;:-:,-,,',11:,-,N-4:2.: :` -s''. '' .>T `-- r� t ,,y ,' .� x j , aa{ .i'b a� T -:',,,i!',';--.-1-, :-.7t: .� a. s:- r.t {'rd lie ` '. L w -' i ., ,., • a� y "' k:r �'{ #✓ : M+b 71.--`f."%"' ` }„F ? ` `,�1'a C 15.E ', �i S 1 ' At 1'i i s, :- .:,,..,,,:.-,.,,4:::!.,,;,:.:. �_...q.:.,.,,:-::: .o t .� �� '�� � /C ;- '� � t♦� ,.�"! �t�� '� '' < 'tx' {-'tt� <l� ,yra�•r. Y�y�'� � � ��.Z. .'t<� x F � .'�,�,,, -kt�a'x;`�„ i S' tz r t yZ2:: +�.. F !y. 4., +f /✓1 ( x •}. ' . ( �} %, -Sj:}, r} \ f jlf f ,�y.1, y{ H {,t„1 4 r.,1 „� _' 4 j y ; 1�`! �r '�'\ r fik . �4;,r..: C-k 'A !!�, K.-L > R,et V ,'\ . h.;'%,to L. S 0 'z.. "4 "\.t Y f 4 Z4 y s } ,4 - '`v;-�^��. ),r .'s 5 >h �^4 f a 't{ c . sX r�1 _1 p x .I� {✓ J'/ ) - Y �` xC }� k Fr y.i l 1 a3? .•T N! i5 J. s}+('Yl � ` ( f _i..y.M C .if t.{ i': r.-. :- �e 3 �X [ - }, -r{3{'/ j r•r: .7. d •!:.;-/;:7-:- j I fs'` 'S-t`b ••r` { x ..,? '^-,`C� .,�-,.r„+' t'p .;z, ti-.l f ' _' ` ( r, a.4' -, ::-- --.-i; p ,.;0'' t ,�-^�C...`F-F rte '}( r{ j1r?'Yrs'_.-..a * 'p . , .:',..-j.%._;� , - 'S ,,,- ,Y t�l.� r .t r,d-' tx# _ r• wf a F l , � t\t 4;' Y4 X r;St-i'S{♦�`"-r S y ,. ° F � f I, / F 1 Y fl ." �vj 4" =1w iy, Fi S y hy� ` J ,f,. X / Y' v_�� � S3 Y �`- i�' � 4- �n. ( t\ -� 'l.�-+ K �:�1� S ? ll'F��Jr mss", � / � tt � ATwiä • _ }4y .. 10. �:l h''l. i -. yr t :qty s T5d ¢. _ ';Y� � kt1h•<i"+-r y r 1,. ? \t Sy ill ...� :r.•:-.,.q.' r; ' rr µ ' + 1 .,., ti Mr. ' ( .Cie '. �� ,:�' ♦flfn - � ■ t . �/-�S� �x k S.r� 1 i 1 ..-'T', -s s .`t''''!...k...;:..: r ' 3 : rp, . a • 3 b dlX r y } `4 / 1 . a ,yam �i f. �_� 2 t i �. \ ,� f ��t�4w�•�'t^�is�` -'k J-,��a,J '��13�'Y`i�i' '-i:::::4;',...171- 1-- `k �F.' f1.. � �: � -'.. ,:., n\ .t .. ti�a � �..-. � ''.::.:7.:!:'.;4,,, 3 1���j`.":r. ?k.--� ',:�-: }k 1 „,,,a4_-,,.., T ..:-..I•` s.:' .r ''S ; ., ''ri fy-1 y. Flt`i :t ,-; .,'- f./- •,,,t...-:,--:,. ..-'-:,--,7,... ...,.:(,-.),,.:.,..,-,,,,N... ,.,,.. ,3'''''.....; ,.-::::-:NT:".:.$.'it17...jr:....":-'7);',';'i r 1� .„.. :.. ,,a, ,..e,,,,„_,,,,...,,,,„,,,:c.:A• : i. F;,.,.,.:...=,......,,,•,....5,......„...„... ....,..1,74,d-:'1.s.,5:1f,-,::',...-",---, . • r'. ♦ i y l �y,e�. -'m �- 1 < � ,''.'• +' - `r � `e 'F+ C �.` kf Tr 4.� 4:1';'7)'''s''''''''-'- =1 i' >. '..,:1-"L-i.:4?,_- ':,''..-'..:::'2...:.-'-;--..1'...:4Y:. -'. rF� aT .• ) ,L , 't` ie kli._ 14i) i',..4-'s,',:".'-'- I 1 J..a /f\ r Y ",i---:0-:::.. {J. ._`r ''"',.v.'.- ,s'!-.a A.Ip. „f ,'Ni„-..-.',..1.,',5....:::-,, :. _ t ,'+� y i 1'r� : tJ :! i'..',:•••):.:.: ,/ f•\ 16:.1..-.•,,k,-,.---;'-''''*-?:', s74 ” 417 v . -`L *3.. l.. J r' -,,, f r•:> ,� " c ? .-'4;.':',..>:: ',,y 1Y-rT• ,'� �' ,.,•.: ::-%,'4,.;,;--• f '' 4- + : f ' Lr/ _ I I- 7 1- A �'. C 'f Clear 'f�.,C i 1 • ..',i'!:';'?;.:::'--r,'., #)„,.`-- - f-j..,1,: ( z }tom-:-' x;c 3 : 4 t z ! t � ht If' r j ;' rjt . r ht ` tr �'f'„b. \i .f .s '� - �� 'vt c �. • ,.. � J , , t y' "Y +S, ' L . ^rti s x a i,` i ;ti / y ,� i jvs ;t: t`, l �ry � `f it;j ' e .:./'.: ,r r4`, 1 q,t._ 'c! z ', /- f e _ a .f. F s ii E t ,Kt ' 7 ! r�"- !•s , , i cafe i * J._,' , ) acy.; t'7 Ott - r,�4` :L. ::%. ' "�x � �,a,.s�� � �, .f T �,. t1 i..s :Yt �� f „t �, J x �,:, �h� h,( >. '`�� �r � ,jtY''f` ,.�'sp}. (ti `Y r- -Z;�. !r �t J r (( 7. t r+{ d. a ak ti i t�.r x ft- f. A { .l-• •� t"l � ; , 1. '{ri .:r{ S - 's, ,� 2'1 *Y +t. S.Y -Y rt it ( 4 ' } �'`t ��y. f ♦ 2"� �„ '�: y> �is�p;��. � I •t ��� !.t�J d.•'� ¢� `p -�<• . , ' "Y . •'s. n, " .. t - fi -)z'.i .h } =� !` S : ..:-J' r +s :tk ., .r,,: ,} `,�,,x r3'- '�1 s T "'-%:i if " '� -J;t S i -F' !. k S : ' r. `yt ^r if'. t . ry �`4',f # y .C.1`A -ate^ - 1 �Y,...,".1„:„,,,..,„.,_.,,,..:,!:;„1,t , fist? +' \� - x �� k f `S 9 �,� ,- N 4. ,1, .. t , - ,r-a �+ .; '�j t x ffvvy j. � r• _0,•i, - �' '� \ ,;� �,,3��e� '�.�' �£y. ,va vy y}�i•'g�{,t 4( >1y �� ' 1.�r'^'.;-:,,,..„,,L,..„,4„.,...„...,r - d : ti.,.:„:1..,-,:,;:,...;:.,.„..:+4.. ,-;,„,!.. , 1 'f :4:.::-.,2'.:,,-;-,:r-,-.-7.,::. -.r r y( *( ^ .. ��-.v T' V 3, 45,.. i �" s ;1t.,4. -- gX` n''tc to .�}•��'�^, ,fi,�7".sr`„..:::,...:—:.„4„,.....:::,_ + a .t! om- f cy -- ➢'§A - ,y�, t�, ^l'.' f` }' >'1' :-4s �` t ¢} ,+.��j. ;,,>•” a r; a,::„.-...,,,,.::::•:,,,,,,,s - ve.., ✓ 1 ash� ... 7 ✓ a 4/ c..+ . :,,,-,..,,-1.4-„,---„. T n 4 4-�" ?�g�y's-i' r�h., `� '�� y`� � �l'- � ��".'�,~ �� �'�(! i< - t�t..is„,.lc����� �rvF'`t��b�{{� >'�,tt S. � �„�� y y��y�fi.�",,�. _.. ..,'•-,i;4•': ti. i �� � �" fi p ' i,y Y #S w C'-, y�•� x -' .t.Y_� _ �{..-,' �. x.e :' t../ r � m��: t� ., .. 'f'/ .. ��f Z. .0 i . .x } Y.ly Y. 1'y }y.,,,,,,.,.,,,r,:e,s f"L+ �'-0 }y .*:.. �'aa 'r ')•"t r''�'°t . s �' ... N }' gam-�,t?f 9',{Cr-..ss lr. • y .: s }- 1 ''G' ..Fy 4` �r f'r p .F. t \ ' ! I'r'Y:r .' - 4 y .y�ykJt, '',�'t y+-. f � �;Sts�.�� -'r:..� ` '},� '� � ,�1� °i .,J^„e g- t r e 3'�,x,,,y4jf � L:�'/ 1�'+� <-�Jr�Y� '!� ar lQ t� i (� /I: �-' i. c.� _ry \.4 ', .n+. ; -`v.x. wT,, f. t .� 3_ fi i .,{r E I' ✓' 'Y"4 is Y .. .,,,•;;,..,, f` ,y 7(Lt ��"i ,/�``,. M��,++ 'k%r�r�` i !!` '� . ' t. y,r \ - t �� Wfj -� ' r�. "r. } 1. w 3_.+`e ,. �.�.. p y ,- `'S'sc :�.. `4.� �h ,X. 3 zt` ',�. -�rt� }�-' .-5 •'�-. �r--,..:.-'••T+ .St x'w ,it�,.- k' ��,.•3 -•r,- ct 4} :fr..„,-,,;,7,..;-A-. { �l ,',.�xt�.° . , r ,. s .k - � ,z✓/ .$14, w r --.1",,,i",7. ' a t9' ° 'Y l f£F .r•.� Y . i k A fF k7 :r �„r�i 4 \..t��'y �.i!?.-...,*.;,,,w:,,-4 3 ' r}"c--i:, �r�•� -� W ,fi: T? e�+l try , - y •iJy . ' '`�(�+�' ; S'�` L. �� *�y � t s,1. � k� �s ,y v� 9 : (, F Y ^t •��t \.. 3,� 1.sy���x �.� ���Fy� �` v' '�•�r 1-)A-L,4:,6.:4-.A.. 'tet ,'4e t� ". r .:'' 'L- ' . { d ..C'' Bt ` +`e^" y tG'j'' -_ q.a { \� h. .y� �,• �r'i /'. 'T �y4_' -s : 'y Y: �,,(��V� te� -�,Tt�t a y ��';�•y' {Y xt"qq• // -#'�'�,..+ Yrr��a i.-:A..;.:;;... .;.4 4 �r+.f� T .L ��ii. �j-w -:,.1'.. .,4.-,--1.,.. 7:, -.` ..,t `r� ,.j' �h ,'"'f+� "``f�Jr� aJn.• .� .� d�.:rfc �� t.\.sJ�y'sr � �,� ;S-t�,x,:' , "r_ t'x11 c� 1 y. .*, ti? L>:,;.'' .JN�� V � -_1 , `� t �_. a -:, '`_.,-:.:,-.,."--.....,. ..,:4-.1.3.,, �/�.'I1{"` , t f.i k-_. "# Y'. .'• t e •. / ' 1 K -1-7.-";17..,'± _ it x s s < .,�,1� ::-1 �,�.. trttinr <:� t ; <x. tirig SSR Strategr� !earnri Res©t� € t` F_ r _yarj 4•'-if.- .'7::-.7:..- t 1 - .Z �- - :'-f-'%' ` _ r.. • Executive Summary • This report lays a foundation for improving the financing Washington State. The principles and recommendations contai ed in this report eport were developed by a state-local Public Health Financing Committee which worked to understand funding for public health; to inform the Department of Health's 2001 Public Health Improvement Plan (PHIP); and to identify the policy questions and implications of current and future funding methodologies. Problem Definition Three broad system financing problems exist. First is a lack of underlying philosophy for this highly interdependent system. The lack of a systematic approach has led to revenue insufficiency across the system, wide variations in the level of public health investment, and great variation in the level of service and size of health jurisdictions. Disagreements exist about the benefits and costs of regional approaches, accompanied b strong concerns about potential loss of local control and attention to local priorities. y The second system shortcoming is the mechanism for allocating funds in the system. Categorical funding — "strings" on expenditures by state and federal agencies — constrains responsiveness to community priorities and the cost-effective use of funds. Local Health Jurisdictions (LHJs) lack trust in funding distribution formulas because they are complex, not updated regularly, and the role of the State in the public health system is unclear. • The third system problem is poor linkage between system funding and standards and outcomes. LHJs and the State are working together toward public health performance standards, but lack a defined set of core or basic services that should be available statewide. Thus, there is no way currently to demonstrate the return on public investment in the public health system, and financial data systems do not support good decision making or understanding of the financing system. Approach. After defining these problems, the Public Health Financing Committee used several resources to inform its work, including a recommendation framework to parse policy questions into four manageable issue areas: underlying philosophy, expenditures, and outcomes/standards. Other resources included revenue andexpenditure data and a 1997 survey of funding formulas; prior principles and recommendations; the input of WSALPHO members; and a look into leami gs from other states dealing with public health financing issues. Using this broad information, the Committee laid out the following system principles and recommendations to guide the financing of public health in Washington. Financing System Principles and Recommendations Education and Communicating System Needs. Education about the essential role of public health is needed at all levels of federal, state, and local government and with the public. To implement this principle, the Committee recommends designing specific financing strategies that mesh with the work of the • Standards Committee; estimating state and local costs to meet the performance standards; Public Health Financing Committee Report—December 2000 Page i identifying a core set of public health services that must be provided and the cost to 411 provide them; and developing a communications plan to explain the principles to system partners, why public health is important, and how it should be funded. Shared State and Local Responsibilities. Public health funding is a shared responsibility of federal, state and local government Responsibilities for funding shares among state and local partners need to be defined to implement this principle, using Standards Committee outcomes, core services definitions and funding flexibility principles (see below) as a foundation. How regional and statewide financing arrangements may change also needs clarification. State Role and Responsibility in Public Health. The role of the State is to develop and administer the public health system and the state and federal revenues that support it. This includes; ► Ensuring a core set of defined public health services are provided across the State, and interceding where they are not available, ► Developing policies and regulations, ensuring regulatory compliance, providing technical assistance and some regional services ► Evaluating and measuring system performance;and ► Acting in a coordinating role among other system partners, including community providers, local health jurisdictions and the state and federal government, The Committee recommended defining a basic set of public health services that must be • available in all communities; and determining the process of intervention and funding implications if the State and LHJs do not meet the public health standards. Finally, -the Committee will work to ensure the separate, strategic planning efforts of LHJ's and DOH work in concert, to develop joint system goals. Local Role and Responsibility in Public Health. The role of local health jurisdictions is to provide and/or assure provision of core public health services in their community as well as community-specific services. This includes; ► Locally determining strategies to meet public health performance standards. ► Working with partners to identify community health needs, community capacity, and strategies to promote and protect community health, ► Providing the most cost-effective/lowest-cost services, ► Developing local policies and regulations. This means that a definition of"most cost-effective" needs to be developed, and the cost of service and service delivery options should be explored further. Flexible Funding. Federal, state and local funds can be used most effectively when restrictions are few, while still maintaining accountability for public health outcomes The Committee's recommended strategies to de-categorize funding include: ► LHJs examine local budgets to maximize resources and the State examines its allocations and use of its funds. ► Identify least flexible sources and issue areas. ► Identify categorical sources that can be blended or distributed differently. • ► Develop a timeline to address categorical funding issues with state or federal agencies. Public Health Financing Committee Report—December 2000 Page ii • Who Pays for Public Health? A 1996 principle states that "the degree of benefit to the individual and the community, as well as whether the activity is conducive to fee collection, are two of the factors,.in determining the financing of a public health activity,.," The Committee supports this principle and recommends an update and review of the 1996 Fee Toolbox, and technical assistance at the state level to help LHJs maximize revenue capacity. Funding for Core Services. Sufficient, stable sources of funding should be directed to core services and to meet minimum performance standards. In addition, funding should be directed to local community priorities and needs To support this principle, the Committee must define sufficient funding — including costs for system partners to meet the standards; the capacity of state and local governments to raise funds (assessing existing and potential revenue sources). Then identify which tax base funds/should support which services (as noted in the who pays section). Equitable Allocations. State and federal sources should be allocated based on regularly updated, well-defined/documented/communicated, measurable characteristics To further study and clarify this principle, the Committee suggests that specific grants be prioritized and analyzed that have oldest formulas and are least flexible. Then model differently weighted allocations and test additional factors to distribute funds (may include local willingness and ability to pay, local population characteristics, service delivery cost factors, nature and extent of community health risk, and allocation of a "base" amount to all LHJs). Finally, develop weights for these factors based on system priorities. • Financial Incentives for Cost-Effectiveness. Financial encourage partnerships that result in less costly and most cost-effective public health services. The Committee recommends that these incentives should be developed and included in revised funding formulas (see recommendations for equitable allocations). Need for Standards. Accountability tools such as system standards, performance measurement, and consistent reporting are essential to improving the public health system and demonstrating the need for funding. The Committee supports the development of a performance-based contracting system to implement this principle. Link Standards to Funding. Public funding should be linked to the provision of a core set of public health services and meeting the performance standards. To improve these links, the Committee recommends revising BARS coding to align with performance standards and core services to support management-level decisionmaking. Also, funding structures and algorithms should be made more explicit (as noted in the equitable allocations section). The specific activities to link standards and funding need to be defined, and policies and protocols for evaluating performance, confirming provision of services, assuring contract compliance, and reporting activities and outcomes should be developed. 411 Public Health Financing Committee Report— December 2000 Page ill Next Steps • This report sets the 2001 workplan for the Public Health Financing Committee. All recommendations need further development and study, and are linked to the actions of the PHIP Standards Committee and future Communications Plan. Recommended actions include: ► Develop a list of public health services that should be available in every community. ► Identify the financial incentives to support adequate state and local investment in public health, and make the Committee's vision of public health system financing a reality. ► Carry out analyses of funding flexibility and allocations needed to support the principles. ► Support the performance standards process through further evaluation of ways to link funding flows to the standards. • • • Public Health Financing Committee Report—December 2000 Page iv CD CD CD CD CD ` En N CO N Da N CO N N 1�) N 70Aj Na N N CO 7Oj N N N N N N CO N N CD CO N N N OOo 0 CD CO A C.) (077 4+ N N N lj O o�•. (0 CD V Q) C71 A W N c0 0 A W A 70 (71 A W N CND CoNV CN) (N71 A )-.ON 0 0 0 0 0 b 0 0 0 0 m 3 Y D C- c, m y . Q nm m Q (0 5-52 '1Si �CTD c? g) n g S< oo oo - C -1 ro °< m 0 n CrTDm m 3 °nm m m o h - ma3. 3v tn $ oCoo m3 ° ? o ' .3 m Coo= O. am7mOjO y " y HC M y Z m mS0 N3 ] Gmmn vnmo -' odp' 3 3mm — _ � y� OowT Na o n J7 ' Nm o �. , Co J• a^ D 3 <6<N n }+- C3NO `Ga o 3. CCm3 �y ? Av Ae . Se0 a I X. oo a tr aoocn 3 o Co in co SOmopv � NdQ ? .S�( Oj e o d O< o $ Er d 8 8 o N N320z p,� -- 5 X N a2 () $ a m m m 0 m .qOm . mX = coa — O o go \ \m • N O 4,W N - C) CJ CCla A CO A NS� ((((.��.TL7((N,�7 to pOp)CT SD 1. CyaD V O V N CT U1 (C..�7 .N.. E. A N COD OD 4, W cO O T V CO A CO cD W O OD O A O)NW t ap V OOppD w Cy)N CO�s (��a SD -a -co to(.��•((7OD1 C(O�7 CA CO 0D VA W Cpp7�1 V A LO -• _ (2 p4+ O V W N A CWT COVCCA ANO V V CD V CO0N c0 V O A A O) A C0 N7 V (NJ 0) N CD N 10 W co OVD A A 07O O -a OA. CO j V CAOOAa coTI 0 W O N (31 03 Cn C7� 1.7 y, C,,) V A0) CO71) Ja A V A A (Np �(,.7�� N f.71 O 'QAj N pN7 C71 U1 C71 O W CO N 91 1� A CO Ct.07 co V O co Zig A N A m O O1 QNB (D co N O Of (,W7 V�D y�, co _ A 0 -.°) •-4c° -.4. v N CC.N�77 -.4 (00 CD A V c(App U ...,G) OJ CO ppp�(O� CC7D(-) ....(p co W(0IQ _-.1qj i v OCA° W V V $2 p7 < Zn V W CD 0 A CO 0 O A C) V V > O OD A a W A 01 O O O N O g N Cf(8 C8 V A CA A O rn V T N W T C) (n V-' A ' D ao000V � r- -1-1 prn So = O) C.O7 -(p p N tOp .' UI ua CO CD O N 5 V V CO 0_cr A T rn ONJ (0 O 0C D-NND A. A. CCODp O UD NN_A O C7 A17I1 O N C.�� ,�,, (7� II N W O O A O O O (D C�71 A tD CO W co m+O(.j (:i A w m ('� rn CA V SO 00.104 0071 CO N(VD V N CAD ^4 A W W 0(ND N W W ( 11111 1,x-(1COp0) C) OD 01- (0 O) NClW �CN1 (u i Z CVT Oo CD CO A A W A 0 NJ 0071 CON CO CO N CO0 CD O O D) W • W 0 N Z CI 0 O V W W ON) CO O cC7,71� o C co co (0 C' O O!J CN71 N W SoS.)W Cu -V+ A Na Na N CD C a r (O 1) o74p (Cil,� OCp Ca CO V co CO CO (NO O N C) co CO C71 O OW (A71 V A V 7VJ V b) • G 0 V CO V W 0 A p D N 0 .Ni r A. it 0 N CO CO spp� Ka co S -8-2 O V A W N W W N W OD N Cl A Cv N W O N A p7 y M OD CC..77 O N D(w7 zit W pC� O pppp V V Q)0) V 0DD N(40(p CCVS7 A ?W O 0D ppOH� (II W d D W O N CO W N V CO A C) OC A CD V O V co 00 A coyo CO co V A A A 0 CT CA (D W CD CO CO NJ CO 0 CO d Q C- Na W CC.�77 _ _ C So W p h) V A co 0(T V A. 0 0 -COCD (D (p V — (VT CO CO O -0 (71 CJ COOC��7II Cb V N W.ccoo 0D 0 V W g O (D il y AN (OT CO0CWD OCAD CO N W N V '' C071O700 CN) mtoo COT � T CD CT ('� CO C) 0 0 co W co V 0 m "'i 0 21 X = 0 A j N $X .!1:1 O) A j'O N Op O)(D CO O t(CCCD CO C.7 0 _ CO in pp �p Qo 00 :255 O A N C.Oi A 7 O7 N 3.. O AW V NOV CO) 2NOCOT (0 (O0)V A N V b N Y raa CO O W CO (0 CO O V V CO O Co C0) CO j iO CA71 O cD N - a v 0 N —8 N _ _ O COACD V C(T71 A Zn C.-4,7 O A ..V W N N A A V 0 0 A 8ch17 N W N W O. CO N CT 0 0 CO 0 A V CO co A CA 7.07 CO A co CO tp�p V V W CA 0 A A O 0) W A CO Vt 0) NJ A N W A(W� (b (tT0 NOW CD Oo O) n A. OD V U1 j NN77�� V (D V 0 V CA V CD CO c0 0 0 V (WD 0071 O C07) 0 0 O Ja.(,7 Cp O(.7 O(Ap W W . r OV C) CO V W O Co CA A N CD W 0 0 (D 0 CO A In.7 W co O Q/O) W W .+ W -'70�W 0 CA N N 0 OD ^C V W O OD 0 CO V CO N O 74 W 0 W N SO CT I r (AD A Co Co V _0 8 r f' 0 fJ A CO O A V 3 y N N COTY C N A V N N 0) W y m y o V V 0 _V OO 8 C. SCO O 76 mo a ill cw nA NJ In b .7 .7 3 c O W _. V N C07 m CO -+ W O) 0 m V CO NaN V CD COO N O (.� SWC V CD 07 ((ATTcn uo C.71 Cpp (D A Opp 00 O)CT((071 v (D O V N H a 8 o Z2 CO N) Co CO "4 (O 0n (VO co ca COOOD 00 �C07 -.4 V CbNa A O 0 t8p Cb 0 8 p A -CO N W W 0 W.... m O(D A CDCACCA ND p (O -, A A _ N_ cri -2 O O) 'NG) N O"'co N 0 0 m V co 0 co-' co"O A W cccc0000 0071,CO) @ O O N "` m CN71 (ND N CD N A W COT COT CAT -.CVO V A V m Co O A A 00 A V CO77 C)) N 4, W n N 00) 0) 888 ) 0)' 860)0) ) m N N N N N N N N N N a 70 V COO CO V V V V V ..c0 A- s.. m c0 o co to m W N -+O m D .. w 8. 0, s N m <n CD ? CDm -oc) rcmg c o °� > C O c H w a m m a. 0 8 , m 3. y m m m O � ) S. z 8 o 8 � d w 3 a m as < a c mz 0 C ,... >a �F ca ag vo -0 o = ?$ 3 > Q mw �� 3 w _ co m � oa m x mo DfAy m 31 o? o m m m rc° roa m sr8 o D E.O. w o 10 \\ hi ., �\ w VM N x A W N W _0) t0 N V C71 �,, 01 IN) = O�C.�. A 0 A p N N N W o O V tT C-7J�. 0 8 8 W N N 1(0p CO Of -V+ N-CO t Oo O a — N N 07 3 A CO CT W O C) 6p) -. V t0 (V� NV Aa W C a°eo co 0 AOVi 0 CO -4 O) A CO CO O V Uf -q-` C O W N N N A D k $ N o o WN r O _ O a m N V 0N NNW 0m(p , DN - WjOf0VOm X a V N coV Wi RI go -4N N Cm00 � m- A 0. CAj AON � — co 11 m NO CD N V co01 N ...� Q1zi C.71 g ()f A W at V CT t01 Vco N cT W cD m C C) W iYf IQ A O -4 O 0 co t0 - Oto CD 02 C) ornmm m A N CTrm m V co N 2n CD N N � n C CDA ((77�� 8 Cry S O O V (� O) O O O) 01 N 0 = Z • o o e +„ A CD 01 O N Co CA A V _0 N Co tD (V) -,01 Co O N Z V O CO n 02 co p 0 V T m o r '� V -` (C jN NN W0 N 0 r V CT A W Of A N a 6 m 0 CO COo W C0)1 W CO n D r i N P = A 61 N N Op O CO W g > OT ODOR ca CrN07m r 4 A W j 0 A CO CT A X CD CD N 01 CCD O CO C'1 ` a x Et M to iii� � y 00 QCT O N O O Z r_X Z AN co co Vi x CO W V $ "°� j CON (n7 A j W O Sz -I A en' CC� V W r 9 N6 1 Ao _ co alN V k3 (a (p (p W W 8 N CAn A W N *1 O itO $ A A W O tp O A N 8 O I r r i co m WF N T w �3s o 8 Ili . fr I"co CD T p$i C07C V N V Co W COVm 0 o. P Cp w 0 00 dj „~,,tNN� N V IV j w s 0 0 O W o V A N V Uf CO CD g �0�a Co Co m w A al W CT CO A Co W W m o O) CTOm V A V N '• M 7_ N A Co O 2 O V W CO W 61 -V` W O N o O o• _{ O C O o O 3 92.ie; 8 m 0 m 0 Ft 0 13 C_ Pt; m O N Q n '. CA 7 C Oo 0- ao C O r 7 41 v O m A m c o T C Itr, P0D co N s)CD ppopm A-co V1 O . 'te -0C Ca - A r y r � 4 �3m 2 Im m A'R � .r CA oA m r to a _ 4 C) ;q 0) m n � '�I z • c 11.::‘:''''' ' N Z o G) p i -< 0 ro m C' ) �m a T I= m D r X C 73 CO is a e§� n j 5 m o v ;�a , e li Cl) T T S Cq O a Y '1: 7$y O 0 2 i2 01 cn CO 01 CO CA 00)) W Off) CO CO 0) 00)) Off) 0) 0)00) C)) 00) 0) 0)00) 00)) Off) CO 00) CO C)) 00) 00) 00) Cr) C) C)) Off) 0) 0)0) 00) 00) Off) CT U1 01 01 Cl N) ° CD ` p CO O V Oil:i in 61 in in in A W N A 4 A A 4 W W N N N N N N N N N N N N N co 0) A W ( N) W p �p co �p N A W coCT W W N N N N N N N N •N -+ O •O •O O O O N V O O W m o A W NOOo vrncn ANO OOOOOOOOOO • mrom < 003oQ < -100o CI < < 70 R � o =. o m m O2c � � O � T0n03 — , 0) m m R° sx Z m o A D m C� 3 3 n = n 3 sz— 3 y o ai Qo < m ea 6 m m o Lti w O (n o m 9 Z m m m ;�vo -0 v c� 3QD anm n3 w_ 3 mm — mm 3 $ >• (nmga 0o st 5 7 0iiT m m C w 7 c 7 -=. 7 m ? O D m Zl O g)..2 y 7 O m 3 `� m m 3 c m S c m m v n ? m to to O1 w 41- mw [J3 ToA � m a) a cm2w ). c3n0 m z m p m m c -0 o > x v a Z m m m — a, 2 w 0 y , Z m 0 — Q, 9 a, < co ? o f Z m . t 7 m m a m D m m I X -_I D 2 v — co to w w (7 Q w 2 - a o » c w w c CD 0— cn 0 a m —tO , m X SO 3 Chm CT cs w C A N CO N A r CO CO A N W W O V N' r V OCA 0 A COCT 0) CO 0 N) co O r CA V W A V CAT p "co "'' pW� O A A VI co p Ap A tq p� C S CO NA0 A0) 0 ; A CO V 00) CMCOOA CNO N co m CO20 r - r A 01 W N A _ _ Of � No _ - .. O CD pNor A ' V GA O0) OACC _CGO OT-CO0220Oo 0 N 1,11 < m ��aa p OD —(W OA.A01pAp A W C) ,� 00 CO NA0 A0 0 -O+ A CO V W CA A A CO Co)OC _G CD n m 0l CT A N W t III rn rn co bI C co Z Al Z ca A N N 01 OA ' co �lQ'� p CO co 0 00 A O C.) W A Q) O G "C W CT = r I N 0 n co c v r °° a0 m m c — D N 1 CO "r� CVO t0 U N0)C� Co . _ CO 0 A CO CO 0 0) m • Cc ..m Z 7 CI) CT N ) o T 0 -co 0 -co) �• m n O O N m N n O _T Z _CO R 2A ^IK m 0) II g,3 0 m n $ g3mXa — A A co COV9 O) fA ACU CO Al:.S AN co.47 WW� fO .A.. V CO'co NIII� C. r 00 V 0) CO A N A 0 V N) CO A CD V A V CO < O N) A N -. CO N -� co CT A W i C m C� CQrJ 111111 1:1 m CD ? g V) Cl) ro sro w `.. C 25A co _co t0 A N W N O) CO CO 010.C°'T CSD 00) CNA00 U A A A m O w �7 I. 00 K C g W s3 Z-t N 0 ... co 0 Q.:Ell a m fA N Co W N co 0 1.4 > 0 V CO cD Er T7 Co) CO O j Cjcc m0. � .. No ' =oaO <mo rnrnrnrnrnrn 01 C) rn CD o CoN N N N N N N N N N a OOW V V V V V O mz A O O O O Co CO N -+ O = My0m smg� � m <-- 0aco $ y CD momm � av3mm 0 C INO7nq� m m T y mv Q. y • c a °' 3 O m °' D S y m -0 m m m s 3 3n m m CD 0 0 n . Z. m m to 3 coa p D m e a D 0 m y = co y 8 2 = D o c o o Q c r o _a o m m - m 1 ~, m o 7 y mo m a . CDI1[ .W V x -4 a Er f •A . ONoA w mS V � - � e \ W 0, CO O O O NN) c �W t0 mTO m cnV mD D co r c, `c o my sg ES - = a C ID m m V W OD w r g rn 7 co m k: CO N 0 co C N OD N 0 Cn co m n o V OO i A G7 N I; C) W y 1 pppp A Di N ER A ., W VO ID m III N tD t N 5 0. r ., cn TND Co O C V coN _N m COQ a e e e , O N ...+ m S r C r N -n m r r m 13 g 0 8 a so Fr 'i * m lm m C FIT A VJ V mco "'I �Sm A m m Z o. Aga=I @ CO o eq V ��e� -. A CJ N < Q g cco V -co".n.. -A -IC - Oo• Hf 3 m,-3-=> N Q I xi,g` Co y 0 3 com m _ m 7 T V m c O. I • Board of Health New Business Agenda Item # VI., 2 • Jefferson Access Pro ject - Next Steps January 17, 2002 • Next Steps • Jefferson Access Project Draft by Kris Locke December 15, 2001 The Jefferson Health Access Summit produced a variety of ideas for ways to improve access to health care in East Jefferson County. Since then, the economy has taken a serious downturn. The 2002 state legislative session will be dealing with an estimated $1.2 billion deficit. Most state agencies have been directed by the governor to propose budgets with 15% reductions. This translates into severe cuts to the Medicaid and other state health programs. These cuts, coupled with Medicare reductions and increasing costs for health insurance, will result in worsening local access problems and more financial instability for health care providers. A new Washington Health Foundation mini-grant has been received by Jefferson General Hospital to continue access work in Jefferson County. The goals of this grant are to: • Identify next steps for the project — short and long term • Clarify the roles of each board as well as joint areas of focus relative to access projects • Prepare a concept paper for staffing the Jefferson Access project • Prepare a comprehensive grant proposal to fund activities over a 1-2 year period • • Convene a gathering to inform the community of activities. Next Steps Product. I think there are three separate but related work activities: 1. A project exploring alternative insurance arrangements using high deductible plan coupled with a community basic health component. (Jefferson Passport Project) 2. A project to discuss and seek consensus on what constitutes critical or essential health services. (Civic Engagement in Health Project) 3. Establishment of a community based-access project coordination function. (Jefferson Access Project) Process. The decision-making process to affirm or modify these ideas and then implement them needs to be planned and agreed to. I'd like to propose the following: • Draft a more detailed paper describing next steps. • Meet separately with Commissioners and Board of Health to propose plan and potential organizational roles. • Modify products or process based on discussions with boards. • Bring proposal to Joint Boards and discuss roles of each organization. • Initiate work (detail depending on discussion). This is the phase where I think we could use the expertise of the Work Group to refine ideas and give reality check on practicality and acceptability. • • Plan Spring Summit. lb Board of Health New Business Agenda Item # VI. , 3 • Congressional Bioterrorism Funding Update January 17, 2002 • • NACCHO NATIONAL , OUNCY SSOCIAyT`ON&CITOYF NEWS FROM WASHINGTON HEALTH OFFICIALS A NACCHO MEMBERSHIP MONTHLY Supplement January 2002 Even as Congress abandoned efforts to pass highly visible and partisan economic stimulus legislation before the end of 2001, it acted the week before Christmas to pass generous funding bills for the Department of Health and Human Services and for homeland security and bioterrorism preparedness. Federal funding for public health is now on a steep upward trajectory. On Dec. 20, the last day of the session, the Senate also passed a bill establishing new mechanisms for funding bioterrorism preparedness. The House had passed its version earlier in the month,but time ran out before the bills could be reconciled. Congress Funds Public Health Preparedness at New High Level On Dec. 20, Congress appropriated $865 million in supplemental spending to upgrade state and local public health capacities. These funds are in addition to the regular FY2002 appropriations • for the Department of Health and Human Services (DHHS). The supplemental spending is part of the $40 billion that Congress voted to spend on disaster recovery and counterterrorism shortly after September 11. The total to be spent on public health and bioterrorism activities is $2.5 billion, of which $865 million is earmarked for state and local capacity. The conference report (the final statement of House and Senate conferees who reconciled the House and Senate versions of the bill) specifies how these funds are to be used: 'The conferees believe that a portion of this funding($865 million)should be available immediately to meet the needs of state and local health departments as a result of the September 11, 2001 attacks and other subsequent events related to terrorism. The conferees also believe that a portion of this funding should be granted under the authority of the Public Health Threats and Emergencies Act, which calls for assessments of public health needs,provides grants to State and local public health agencies to address core public health capacity needs, and provides assistance to State and local health agencies to enable them to respond effectively to bioterrorist attacks. " The next step is for the Department of Health and Human Services to determine more precisely how to administer these funds and apportion them between bioterrorism preparedness activities and core public health capacity-building (among which there are many overlaps). NACCHO leaders have met with CDC and DHHS officials and have been assured that Secretary Thompson intends to get the money get out quickly and assure that local public health infrastructure benefits directly. NACCHO's pre-September 11 objectives for public health capacity funding were $40 million for the Health Alert Network program (for which support will be included in the $865 million supplemental funding) and $100 million for implementation of the Public Health Threats and • Emergencies Act in FY2002. Clearly these objectives are been greatly exceeded as fears and threats of bioterrorism have brought public attention to the years of insufficient support for the governmental public health system. CDC, HRSA Programs Receive Increases for FY2002 Congress also completed its routine annual appropriations work,passing the FY2002 funding bill for the Department of Health and Human Services two and one-half months after the fiscal year began. The final result was worth waiting for. CDC received an overall increase of 11 percent to achieve a total of$4.3 billion. The total increase for the Health Resources and Services Administration was 10 percent, for total agency funding of$6.1 billion. The National Institutes of Health received the largest percentage increase, 15 percent, and its budget now totals $23.38 billion. The single greatest percentage increase at CDC was for public health improvement(34%), a line item that, at $149 million, also is the smallest at that agency. It includes prevention research, some activities in information technology, and new funding of$17 million to initiate an environmental health tracking network and capacity development in environmental health at state and local health departments. Congress continued CDC's bioterrorism funding at $189 million, including $34 million for the Health Alert Network(HAN). This compares to $32 million for HAN and a similar amount for other bioterrorism activities last year. These are the • numbers that Congress did not increase in the regular FY2002 appropriations bill because of its intent to fund public health and bioterrorism preparedness through the special supplemental funding discussed above. The FY2002 funds are modest by comparison,but they will be available in addition to the $865 million supplemental appropriation. Other programs at CDC receiving increases include immunization(14 percent), environmental health(12 percent) and infectious disease control, HIV/AIDS, STDs and tuberculosis, all increased by nine percent. The preventive health and health services block grant to states received level funding. Programs at HRSA receiving increases include community health centers (up 15 percent to $1.34 billion), the National Health Service Corps (19 percent) and Healthy Start (10 percent). Ryan White AIDS programs were increased by six percent, while the maternal and child health block grant was held to a three percent increase. The Community Access Program,which the Administration had proposed to abolish,was decreased from $125 million to $105 million. House and Senate Pass Differing New Bioterrorism Measures Congress also addressed bioterrorism by acting on new authorizing legislation, although work was not completed by the Dec. 20 adjournment. News reports about Congressional action can be misleading because they often fail to distinguish between legislation which authorizes federal spending and sets the terms and condition for that spending, and appropriations, which is legislation that actually provides money. Senators Ted Kennedy(D-MA) and Bill Frist (R-TN), • 4111 whose pioneering work led to passage of last year's Public Health Threats and Emergencies Act (aka"Frist-Kennedy"), also led the way this year in devising more approaches to bioterrorism preparedness. They introduced"The Bioterrorism Preparedness Act of 2001"on Nov. 15. These are both authorizing bills that do not actually provide funds. The proposed new Bioterrorism Preparedness Act would leave intact the program established by last year's Frist-Kennedy bill for assessing and building core public health capacities and would add to it a block grant program for bioterrorism preparedness. States would receive grant funds, apportioned among states on a population basis, and would be required to use the funds to produce and implement a bioterrorism preparedness plan. This bill passed the Senate unanimously on the last day of the Congressional session. The House of Representatives also passed its own, different version of bioterrorism legislation the previous week. The House bill, by contrast, does not establish a new funding mechanism for public health preparedness, relying instead on the existing authority of Frist-Kennedy. Passage of new legislation was not necessary to provide new funding for bioterrorism preparedness, because it is the appropriators who actually propose funding levels and who may impose terms and conditions of their own. This year, the failure of new authorizing legislation for bioterrorism programs did not hinder Congress from appropriating the ample new funds described above and prescribing in broad terms how they should be spent. NACCHO's position has been that the Public Health Threats and Emergencies Act provides ample authority and an effective scheme for improving state and local public health capacities and public health preparedness, and that no new authorizing legislation is needed. This year, the House of Representatives agreed. It is • likely that the House and Senate will reach a compromise between their two bioterrorism bills and pass a new one next year, which may then play a role in the complex "dance of legislation" that will precede FY2003 appropriations. CHECK OUR SPECIAL WEB PAGE FOR LATEST NEWS, INFORMATION AND ACTION ALERTS "NACCHO Responds to Bioterrorism"available at www.naccho.org This month,please write to your Members of Congress to say"thank you"for their support of the new funding for public health preparedness and to ask that it continue. See the Legislative Action Center on our Web site for quick and easy ways to convey this important message. For more information, contact Donna Brown, Government Affairs Counsel, by phone at(202) 783-5550 or by e-mail at dbrown@naccho.org. NACCHO NATIONAL I'+11i E COUASSOCIATION OF NTY&CITY HEALTH OFFICIALS a'. • • Board of Health New Business Agenda Item VI., 4 • Bioterrorism Preparedness Tabletop Exercise January 17, 2002 • • V.10 ' ' Jefferson County Health &Human Services tel' i I 1 615 SHERIDAN • PORT TOWNSEND,WA 98368 • FAX 360-385-9401 January 8, 2002 Dear, You are invited to attend a Jefferson County Bioterrorism Preparedness Tabletop Exercise sponsored and facilitated by the Washington State Department of Health, coordinated by Jefferson County Health and Human Services and Jefferson General Hospital. The other counties around the state that have participated in this exercise have been giving it very good reviews. January 30, 2002, 12:30 — 4:30 PM, Jefferson General Hospital auditorium Please RSVP to Colleen at 385-9413 This Tabletop Learning Activity is designed as an opportunity for public health personnel and other members of the local health system to prepare for and respond to a large-scale communicable disease or bioterrorism event. Participants address a hypothetical incident in the form of an infectious disease outbreak to acquire this learning. The exercise enables participants to identify the communication, resources, data, coordination, and organizational elements associated with an emergency response. The exercise is aimed at identifying the policy and procedural questions that • need to be considered in responding to a Bioterrorism event. Exercise Objectives: • Understand measures that can be performed at the local level to prepare for a large-scale communicable disease or bioterrorism incident • Promote interagency collaboration/coordination regarding emergency preparation and responsiveness • Recognize the roles of a variety of public officials and agencies in a large-scale communicable disease or bioterrorism incident • Recognize need for intense teamwork and communication to prepare for a large scale communicable disease or bioterrorism incident • Identify gaps in local preparedness and begin coordination discussions • Identify additional related training/learning needs (an "assessment tool") To ensure that there is a broad range of participants in this exercise, emergency and health related personnel from the following areas are being invited. Public Health EOC Coordinator Law enforcement Officials EMS Coordinator Fire Department Officials School District Officials Hospital Mental Health We look forward to seeing you. If you have questions please contact Lisa McKenzie at 385-9422 or Julia Danskin at 385-9420. Sincerely, Tom Locke, MD, MPH Health Officer COMMUNITY ENVIRONMENTAL NATURAL DEVELOPMENTAL SUBSTANCE ABUSE HEALTH HEALTH RESOURCES DISABILITIES &PREVENTION 360/385-9400 360/385-9444 360/385-9444 360/385-9400 360/385-9400 • Board of Health Media Report • January 17, 2002 • Jefferson County Health and Human Services DECEMBER 2001— JANUARY 2002 NEWS ARTICLES These issues and more are brought to you every month as a collection of news stories regarding Jefferson County Health and Human Services and its program for the public: 1. "County fees increase Dec. 24", P.T. LEADER, December 12, 2001 2. "Bioterror attack could strain state", Peninsula Daily News, December 16, 2001 3. "Meth lab uncovered by deputies", Peninsula Daily News, December 18, 2001 4. "Poverty rates vary: Jefferson in decline, Clallam numbers rise", Peninsula Daily News, December 20, 2001 5. "County budget plan increases health fees", P.T. LEADER, December 24, 2001 • 6. "Jefferson taps fund reserves", Peninsula Daily News, December 28, 2001 7. "County fee increases frozen", P.T. LEADER, December 31, 2001 8. "County balances budget by cutting staff", P.T. LEADER, December 31, 2001 9. "Taxing districts not levying$1.1 million for 2002", P.T. LEADER, December 31, 2001 10. "Propane tanks dislodge: Duckabush homes evacuated as river overflows its banks", Peninsula Daily News, January 9, 2002 11. "County health clinic in Hadlock closes", P.T. LEADER, January 9, 2002 • County. • fees Increase Dec. 24 Fee increases are a key component to balancing the Jefferson County budget for 2002. Fees charged for services offered by the county's envi- ronmental health department and building and permit cen- ter are due to increase in 2002, some dramatically.As County Administrator Charles Saddler explained, "We are trying to change the focus of our pro- grams associated with devel- opment to be fee-driven" rather than funded through property taxes. "It's a major change in policy,"he said. These fees, for services such as septic permits and building permits,were last re- vised in 1999.Saddler said the proposed changes bring the county into the"middle of the pack" for other counties that charge the same fees, Before, Jefferson County had been at the lower end of the cost spec- trum. ` Both the environmental health division and the depart- ment of community develop- ment are being challenged to fund 75 percent of their ad- ministrative costs from fees rather than the general fund. Fees charged by the county's animal services pro- gram are also slated to in- crease, and the 50 percent senior citizen discount on li- cense fees is proposed to be rescinded. A public hearing to take comment on the amended fee scihedule,is,.set,for 10:05 a.m.• Monday„Dec. 24 in the com- missioners' chambers at the Jefferson County Courthouse. The lengthy legal notice be- ginning on page C8 of this is- • sue lists all the proposed fee changes by category. After taking action on theT _ fee schedule Dec.24,the com- L (`T bC missioners are expected to / adopt the 2002 budget,which /. — / _d calls for general fund expen- ditures of$12.3 million. Z • Bioterror attack - could strain state THE ASSOCIATED PRESS patient load, and laboratories real needs." OLYMPIA — Washing-ton in the state might not have the Even as Washington and III Training for health offi- hospitals and laboratories resources to perform proper the West Coast have so far ncials and providers in recog- would have trouble handling testing. avoided the problems on the ng and responding to the strain if the state were to other side of the country, potential bioterrorism disease come under a sustained bioter- II tested agents. 80 Davies said, the heavy news rorism attack, a Health Since anthrax was first dis- coverage has stirred up con- ■ Implementation of a sys- Department official has told a covered in mail on the East cerns here, already placing a tern of rapid electronic report legislative committee. Coast,the state Department of burden on the state Health ingo and communications that The attacks would have to Health has tested nearly 80 Department even in the would allow the Health be of a wider scale than the suspicious envelopes and pack- absence of actual attacks. Department to quickly coordi recent anthrax threat on the ages, turning up no actual We often don't have nate its response with public enough people to answer our health and law enforcement East Coast, Assistant Health threats so far. Secretary Jac Davies said. "We've handled the work- phones," Davies said. "There officials statewide. But if such an attack were load," Davies said at a hearing are a lot of public concerns out II Development of a system to occur, whether from of the House State Govern- there." anthrax or some other chemi- ment Committee earlier this that would seek out patterns cal or biological threat, Davies month. Health Department needs of symptoms and diagnosed ses. said hospitals would have diffi- "But if we had a real event Davies outlined these needs III dis Expansion of the emer- culty keeping up with the — that would expose some that the Health Department is gency capacity capabilities of requesting to improve bioter- local and state health agen- • rorism detection and response: cies, labs and hospitals. ?bk /oz-i6 -0 I 0 3 III Meth lab Lab: Two arrests tS uncovered CONTINUED FROM Al der or marijuana. by deputies District Court Judge Mark Post and Sgt. Rick Smith Huth ordered the husband then'secured a search warrant BY PHILIP L. WATNESS held on a cash bail while he from Huth, leading to the dis- PENINSULA DAILY NEWS allowed a bond or cash for the covery of several propane wife during their initial tanks apparently filled with PORT TOWNSEND—A appearance Monday. anhydrous ammonia and other Sheriff's deputies discov- ingredients used in making domestic violence complaint ered nearly one ounce of what methamphetamine. led to the discovery of a appeared to be meth, along The Washington State methamphetamine lab on the with chemicals used to manu- Patrol's Statewide Incident Coyle Peninsula,Jefferson facture the illegal drug,during Response Team was at the County sheriff's deputies reported Monday. their investigation of a domes- house Monday, removing the Investigators said Phillip tic violence complaint, a toxic chemicals while Detec- Maki Jr, 40, and his wife, report said. tive Dave Miller continued the 39, were being held Chief Criminal Deputy Bob Sheriff's, Office's investiga- Rosanne,eu 39, w 0 befor pod- Anderson said Deputy Brian tion. in lieu with ,000 bailo dirt rib- Post responded to a complaint "We think there's more Saturday afternoon by Phillip methamphetamine out there ute the potent drug. Maki Sr. that Rosanne Maki somewhere," Anderson said. TURN TO LAB/A2 had threatened him with a „ handgun. It looked to be a significant Maki Jr. claimed that his lab, especially because of the • wife had pointed a gun-shaped amount of precursor chemi- cigarette lighter at her father- in-law, according to an inci calx."We won't know until later dent report. But when he went just how big this operation to get the lighter against was." Post's instructions, Post fol- Anderson said the lab was b k i _t e-o l lowed him into the house at 37 inactive at the time of the Sea Home Road. arrest Saturday. Surveillance cameras The deputy said he noticed surveillance cameras aimed at the driveway. Maki Jr. allegedly thrust his hands quickly into his pocket, alarm- ing Post,who grabbed him and searched him. • That search discovered a residue-stained cocaine or methamphetamine pipe. Maki Jr. led Post into another room where the deputy found addi- tional pipes for smoking pow- . V • THURSDAY, DECEMBER 20. 2001 A5 Povertyrates v Jefferson in decline, Clallam At a glance . . . numbers lbers rise THE ASSOCIATED PRESS Jefferson County:3,071,-9% Poverty rates declined in King County: 126,999,-5%° PENINSULA DAILY NEWS most Washington counties Kittitas 3,998,County:2924% AND THE ASSOCIATED PRESS from 1989 to 1998, accord- Klickitat County:2,934,0% ing to Census estimates. Lewis County:9,658, -9% New Census 2000 figures County name, followed Lincoln County: 1,216, 18% show that the poverty rate has by number of people living Okanoason aCn County:nty: ty:7,543,-8% increased in Clallam County, in poverty, followed byper- Pacific Okanogan my 3,y: -1 -12% and decreased in Jefferson cent change in poverty rate Pend Oreille Coun�ty:2,111,-12% County, since 1989. from 1989 to 1998: Pierce County:69,907,-13% The figures show 7,832 res- Adams County:2,464,3% • San Juan County: 1,018,-6% Asotin County:3,2tD,-14% Skagit County: 11,065,-13% idents live in poverty in Clad- Benton County:13,547, -6% Skamania County:968, -17% lam County. That's 6 percent Chelan County:8,330,-13% Snohomish County:39,479,.10% more than in 1989. Clallam County:7,832,6% Spokane County:49,591,-11% I Clark County:29,703,-8% Stevens County:6,133, -11% A family of four is said to be Columbia County:546, -11% III livingin Cowlitz County: 11,755, 1% Thurston County: 18,405,0% poverty by Census Douglas County:3,421,-35%° Walla Walla County:408,-14% standards if its annual income --Ferry County: 1,385,9% Walla Walla County:6,829,-17% is $17,650 or less. Franklin County:8,145,-18% Washington:569,830,-10% Clallam County is one of 10 Garfield County:245,7% Whatcom County: 17,460, -13% Grant County: 10,810,-9% Whitman County:4,749, -13% counties in Washington state Grays Harbor County: 10,819, - Yakima County:39,617, -23% where poverty rates have 1% Island Courtly:5,510, 1% Source:U.S.Census Bureau remained flat or continued to climb during the last decade. The other nine are Thurston, Klickitat, Cowlitz, looked at poverty rates from lallam County is one 1989 to 1998, the most recent Kitsap, Island, Adams, Garfield, Ferry and Lincoln. of 10 counties in figures available. In neighboring Jefferson Washington state In 1998 there were 569,830 County, poverty is on the where poverty rates have people living in poverty in decline. Washington state, 10 percent Census figures show 3 071 remained flat or continued of the population. residents — 9 percent fewer to climb during the last Child poverty rates fell 18 than in 1989 — are living in decade. percent from 1989 to 1998 in poverty in Jefferson County. Washington. Child poverty decreased in Statewide poverty biggest declines. all but four counties: Lincoln, But statewide poverty fig- Island, King and Whitman. Statewide,poverty rates fell ures could be changing — Statewide in 1998, there by 10 percent during the since January, 38,000 jobs were 206,558 children living in 1990s,according to the Census have been lost. figures, which were released poverty, 14 percentof the pop- Most counties made strides ulation under 188. Wednesday. in reducing poverty rates dur- The federal poverty level in Douglas, Kittitas and ing good economic times. Yakima counties saw the The Associated Press o1998 four Now it's $1f7o,650.amily III s • A 2•Monday,December 24,2001 County increases health fees No one at the Jefferson fee revenues - at 10:45 a.m. opportunity to voice their opin- County Courthouse was thrilled Both the fee increases and the ions on this policy change. about the idea of conducting budget could be adopted before The $38 million proposed important government business noon, which is when the court- county budget, of which $12 on Christmas Eve,but the pace house is scheduled to close for million is housed in the general of the county's drawn-out bud- the Christmas holidays. fund, was balanced in part by get process left the elected offi- The fees charged by the en- program and staffing.cuts and cials with no choice, vironmental health division of reductions in Health and Human So on Monday morning, Health and Human Services,the Services.Programs for maternal • Dec. 24, the Board of County Department of Community De- child health, family planning Commissioners meets in its velopment, and Animal Ser- and,inoculations are on the regular chambers at 10:05 a.m. vices are proposed to increase chopping block. to hold a public hearing on in- by as much as 50 percent in an If decisions about adoption of creasing certain fees for county effort to wean these departments either the fees or the budget can- services.The board is scheduled from relying-on general fund not be reached Monday,the top- to discuss the 2002 budget - revenues. The public hearing ics could be held over until the which is predicated upon those will give county residents an next Monday-New Year's Eve. • G '�- �� Co December 28-29, 2001 ">pco•�.� —, H o • covO ° v) -1-) ° ' d " >' "� 0 Jefferson En o� aa) � a, G) ...0 ro ,� ° W > 3Q-o � a cog2 , L0w° oa= � � f5 .22., .co : No � 2tos fund >, 3 i 2r90g CDw o '- 5 'bv o �i (0 ow'i° a>i � � aai ° ro ° erves ›,c.):=.. L °' °) a•' 2 a) -, a ate,' '" m res W " a) 4p p ro w >, $+ a) t, N 1. cu^o o 2 BY PHILIP L. WATNESS °.� H o ro [[o al o 0 Co - �+�' PENINSULA DAILY NEWS p 4 as y C�-p•. a) �, r•„,a; PORT TOWN U " a) a) 3 °•3 0 SEND—TheJeffer- AE,SO• (^ b Co aro " ' t'a) av „ o 0 II Juvenile +J a o a).� c.o cd �'°) ro >''. ° c'.. .e son County Sheriff's (� ) ro.� c� o N au C .ro,, E on- tCo Office will have one services U a) ^-d. .6 ° o ; > less patrol deputy expects hard (� 2 c" ° a ° °A ° o o cd next year followingdeputbudget r '`+�, o °v 'v.� v•C o °oD ti " ti the hits/A8 �.4 �; 3 a ro a) g a c)•� " c° g c' ;) 3 approval Thurs- v) 3 ro?, ° E c: ° day of the Jefferson County budget. �...) E. o 15. 0 ro > U o c `,•5 a•°F 0 R. g Jefferson County commissioners •-).° E o ° 0 4°•V co Co Co co 0 carved away here and there to make up for an estimated $300,000 deficit o " a) " .. .�5 ° •5aa) ai ao° CO >1 aoE in the$38 million fiscal 2002 budget. �i/ $ o s� o ti 2 " o 2 &'.� ^ o They decided to draw $171,870 a E"6 ti. S -� o a) ° ro a) o ° o - °: from the fund balance — a county ai " a a) a) o d 0 >' n a " a= a) reserve fund — to make up most of °' ao ro �' ro ° o a °) the deficit. '•- A p ° av-[ n '° a)-2 a a) o > E" ° 3 tIIIiBut they also cut the patrol posi- tion > ° ° 3 eq `� °' `" Co3 on as well as several other count 0 o ▪ E E a> 'E a> •o.°°' 0 ,x " 0 o jobs to make up for expected revenue •4 7 o •'n n° 8 -O ulw y > 2 2 4) o "o�,k E .o w shortfalls. n �° c � C � c � o " c; X 3 ,- �� Q a). The Juvenile Services and Health �...L,� 0 o w °'"•° ° ° 3 " a`� ° '" and Human Services departments U o• U Co' ° ° ° o " o ° 0, " E (� ) • a) a) 'v o x a) ° c - " y a)'77 a7 a each lost one position — in addition CD~ " 4 a t'f'd Co w up . ° n. a ,, cn ro 3 E to a two-person cutback previously T'��{ included in the budget. v L' y °' °' °' n aa) > roLc '� cci c� 3 � � $.4 v �) 4 al Workloads affected l(-4 E cc H ro ° ° a 3 > a c ��. o -[ ba• o ..00C $. Sheriff Pete Piccini and Juvenile cro �.E a� a� a o Services Director Barb Johnson each �", `'-" ••� "' ck .3 a' d ° • o ° O o cv a said the cuts will have an effect on ^i x — a� 3 F. ° " ro -- a their departments' workloads, but -E Oa C a E `" o -° 'E 'n -c a a."8"' ° ° not enough to cause concern. v ``" >_. 0 C ro -2 "I fully expected that to happen," - O �, V C cuO o " Coro 2 al ~ ro v C 8 ro a) z iU >, E o a) -o 0 Piccini said. "We worked hard to try a. 0 L a� x C , o w a) — a co o' ,) to keep that person, but I feel good 0 0 •- c L' E• 0 c .2 3 F oro L " .� we lost one instead of two. ^ " `' • E .° E a oc2 .° ° .° "The biggest impact it will have is -- -, 4: a) we won't be able to man a south • • Q ° ° ro ° °�°' " °' °' county annex as we wanted to do." a ,o o crl o cam°, 3 ° o ` E E o o -.>4 3 Z Johnson said the support staff4w E ro ° .c a ro o x position she lost hadn't been filled w a ro c " "x -°.c ro¢-o 0 since September, so it was az a)1 o " -d a o�° �' �� y " 3 c able cut. palat- VieF -°� � ^° ° 1 b.Ego o °a > Ec 0 Illm ° E •TURN TO BUDGET/A2MCI U ▪ 0 )-• a) E o i ho 0 0 d w n Co = . ..a C a dna-0 aa) ux) O� _ .4 c2a Q c' m c3 '0 a co 113 u, a) 3.a "E-, a) N a) al a , -o " a co .-�-aa) 3 °Co .CC� Li. .E 'a-aa a>Baa° �.5 cr 7 County ifee increases frozen Fee review advisory board appointed, meets Jan. 3 S By e Y an The committee appointed to Leader Staff Writer from$1,722 to$2,299.This is review the proposed fee sched- "The an increase of one-half of I ule is bound to honor this new percent in the total cost of the Perhaps Chris King of county policy of the proponent development home. Chimacum put it best when he paying the full costs of devel- Gene Seton complained, complained to the county corn- opment and environmental re- industry is the "The development industry is missioners that increased county view. The committee's task isthe only thing raising taxes in fees could negatively affect his not to question the underlying only thing raising this county,"so why would you quality of life as a resident and philosophy behind these fees, eliminate public tax subsidies business owner in Jefferson but to study the methodology taxes in this for it? County:"Every time you upsize, that county staff used to recom- county," so why Commissioner Huntingford we downsize," he said. "That's mend the higher fees and to not my picture of government, report on the impact these in- 'saidorted by with the policy p would you supported by Tittemess and Wojt, and I hope it's not yours." creased fees may have on thewhich is to have fees cover the Mark Grant of Middlepoint users. eliminate public entire cost of the service."If we likened the "IIth hour" fee in- The following committee charge for fees and collect taxes. creases to the commissioners' members were appointed by the tax subsidies rush to adopt the Unified Devel- board last Thursday, foregoing what ngam I rd agetting for He latermy taxeold opment Code at the end of 2000. advertisement of the volunteer for lt. the Leader,erIatole "Don't ram an ill-advised fee in- positions. Each commissioner the n "I'll supportm . fee crease on Christmas Eve,"added appointed three Gene Seton increase,but not that much." pPo people from his developer Some speakers expressed Allen Frank, an outgoing Port own district,with Dan Titterness concern that higher fees will re- Townsend city councilor. (District 1) appointing Ann suit in lower compliance with the It was stiff resistance from at- Avary, Aldryth O'Hara and tendees such as these at a public Sheila Westerman. Glen county'so regulations. "It'spjust hearing the morning of Dec. 24 Huntingford (District 2) named Spoken comments ranged bud-frop t going e force more people not g suggestions to balance the to get permits;'said Bill Marlow. that prompted the Jefferson Phil Flynn,Mark Grant and Judi get by paying'county employ- "And you'll defeat the very pur- County commissioners to delay Morris.The District 3 represen- ees minimum wage, to pose you're trying to accom- the adoption of fee increases that tatives appointed by Richard "destroying"the Port Townsend plish,"added Pat Rodgers. were expected to generate Wojt are Bill Leavitt, Susan city charter so that one of the two In the end,the board voted 2- $240,000 in revenue in 2002. Miller and David Sullivan. governments serving the 1 to delay adoption of the fee • The resultant hole in the The committee includes the county's small population could schedule,with Wojt opposed. county budget has been filled director of the Economic Devel- be eliminated, to levying a"$5 If the county eventually by cutting unfilled staff posi- opment Council of Jefferson access fee" for the privilege of adopts fees similar to those in the tions (see related story, this County, a certified-public ac- voting in an election. original proposal, as Titterness page)and spending excess cash. countant,ageneral.contractor,.an. One attendee opined that:the., predicts it;will,Jefferson County from reserves. excavating contractor, a nurse- county's "budget woes" would. will move from "the bottom of And in an unprecedented and the elected county treasurer. be solved if Wal-Mart and Costco the middle of the pack"to the top move,an ad hoc committee has were"allowed"to open stores in of the middle in relation to what been appointed to review the pro- Christmas Eve complaints the county. ("For the record," similar jurisdictions charge for posed fee increases. The nine- About 15 people attended the CommissionerTitterness assured similar fees. member committee is first Dec.24 hearing,as did 15 staff. the speaker,"We're working very "For the most part I believe scheduled to meet Jan.3,is slated Eighteen written comments from hard to make that possible.") that the committee will generally to make a recommendation to the the public were received as well, To put the proposed in- concur that staff has done a good commissioners by the end of the many chastising the commission- creases in perspective,County job,"said Tittemess. He added, month, and then is expected to ers for scheduling a public hear- Administrator Charles Saddler "If they come to the same con- disband.The elected officials are ing on Christmas Eve- said the development fees paid elusion we did,which I think for expected to adopt some form of The commissioners didn't to the county by the builder of the most part they will, we can fee increases within a 30-day receive much specific feedback a$100,000 single-family home move forward with most of this window dating from Dec.27. on the proposed fee increases. would increase by one-third, fee schedule as drafted." New committee Fees for services provided by the county departments of Com- munity Development, Environ- mental Health, and Animal Services—such as building per- mits, onsite septic inspections and dog licenses—were proposed /.Z- 3/- 0 to increase to the point where each fee covered 100 percent of the costs of providing the service and 75 percent of the adminis- trative costs associated with the • service. In the past,fees have covered about 50 percent of the service costs and none of the associated administrative costs. The heads of these departments were di- rected by the board to suggest appropnate fee increases. ali 4' 11 A o `p s c h v a • u " ._ ., o L) •3 °• . Is 7 ° N4-' " ° .5 � E � � v ti � c c � o ° 0 3 _ cci y r a V A p k•ZN U N Y U p cc ,4O 4-' N M cC CCQC = O8 .01 2 Sw ° > C " 3 12 qv ° o � o - .. ° : v .s o a . w ° E ° a v 3 .bN o ° ° c ' O JOUU ° >,4 C O p > > c_1c_1..? J G • E..,`F., 3E E .2 7 , .g - y .b o O o ac ,, :5 Fu o= - ocs p5U > `n-dt .au .D 0 O O N0O 'R a "N' -5 wEaN ° E la °E .E D " c C 3 ` o a v ow Xo . � � UP EF) O $ y � � va0 > '. ° . .2 „, . ......... „ „, ,, -.-oc 5 k O N ° u '^ % cp w '>4.1 c , Oc . c .S c 0 i 0. ° y ° C 0 C 'O ° AO ° V. = 4) ,,a 1... ..., g , ..0 tL) . .5 3 3 . o ° S ti ,E y�`aj ' O v w v � _ V - ., .c h ° a E 1a -o S 40 ° LI ° E `"a .° E .5 > o 0, .a 3 -0 > 3 �� ai .5 CD O ° c ° N ° • °- U ° p 5/i 'D - a C ° •p it:4) H ° -= .0 ° ° ° O a. O • c E 3 6 ° "' 17i t) b4 as A 0 3 o ° F- o ' `ted' h p n a ° ° 3 c v p E Ed L- ° • n ? a, oc .° b r o o pp c - S E O c > p p O -O Oa 'o ° ° O U ° T; ,5,' v hn E 0 C 0 r . ' °: o ou ctaoc o 42 `/1 �� V _U v N E N � -, c � 'c o ° c > .. c ct . ° c - L c `d `u t x > y w t c `-) °) ° U ° a E ° `a `° a ° -c o ,S 44) d Q c c c w -° E 3 Q' :9-' -a $ F E a.'� - ° o Cu) 4 N A k p c - ro 0 c w ° .c o. E ,o cci 3 ..8 ° c o ° FC y ° '° `a 0 o u u n y ° °c o ro E u 3 S L ° N a � c °° a t,1 0 S L c Ct . 00 0 • w E `a ,-. N T M w 5 0 .D ° c T ° riC `-. a — � � a' E roN NO 0.w 0.:d O 'u ., 5 a1 (C , c0 4 ti O w L1 E h e .a .c .o o ? c E ° t E ° ° t° a E _c O ° E o o ° 4. E .c S. h w ti c o w ES � - E ° x 3 > a 0. o �c • O p O N ° O ? .�rnG y v, 0 8 ° `a ° N ° C ° urn i E v v-, `.° ° V c •m E • E E c • v o c •c u ° > ro u, v Q ° O .c T'° -c v V c > .c p ° `a O .E p O .O ° `a 9, Q v 1 %I c o O L 1 ti F T � _ �. �a Fc v, L ` L - `a �I .., U r• N K v ° 0c co 3 T �� c V tom' - a `° .S x _ 5 1.3 - N c ° v r T ° Qo 'J ti Q a-. camii) - ,)_.) m v - .,7, ,L) v - - .2_.-- a c .E 5 E E.. E. o° aE, . Local taxes not being levied • 2002 2002 2002 Maximum Amount Amount Levied Per Amount of Savings To Taxing District Which Could Be Levied Budgets/Resolutions Taxpayers axpayers(Banked Capacity) County General Levy $5,313,650 $4,815,050 $498,600 County Roads $2,952,150 $2,725,150 $227,000 Conservation Futures $158,150 $153,000 $5,150 County(sub)Total $8,423,950 $7,693,200 $730,750 Port of Port Townsend $649,000 $635,150 $13,850 Public Utility District $434,500 $380,650 - $53,850 City of Port Townsend $1,546,075 ' $1,366,975 - $179,100 JCRLD(Library District) $926,250 $806,250 $120,000 Grand Total $11,979,775 $10,882,225 $1,097,550 Source:Jefferson County assessor Taxing districts not levying S1 . 1 million for 2002 When all the taxing districts that Tim Eyman's statewide ini- in Jefferson County had submit- << tiatives are the main reason local III ted their 2002 property tax levy That dike a amounts, county Assessor Jack pre-February taxing districts have limited theirtax levy amounts. Westerman III did some simple "Even though up until now math. He discovered that the Christmas they [the initiatives] have all various elected officials had left „ been unconstitutional,as elected untouched more than one million present. officials they feel there's a mes- dollars which they could have sage that the people are giving levied on their taxpayers: Jack Westerman III Them: 'We'd really like you to $1,097,581, to be exact. Jefferson County assessor control property taxes,'" "That's not $1,097,581 in ' Westerman related. value,"Westerman emphasized. Now Initiative 747, which "It's $1,097,581 in taxes. That's That represents a $110"say- passed convincingly statewide a substantial amount in a county ings" for each of the estimated and in Jefferson County, has so- our size." 10,000 property owners in the lidified that stand. It limits tax- The $1.1 million figure rep- county. ing resents the"banked capacity"of "That's like sort of a pre-Feb- inccreases or the rate of inflstricts to 1 percent at on, . Jefferson County,the City of Port ruary Christmas present," said whichever is less, without hav- Townsend, the Port of Port Westerman,noting that tax state- ing to seek voter approval. The Townsend,Public Utility District ments go out Feb. 14. initiative does not te the No. 1, and the Jefferson County In his position as county as- use of banked capacity from pre- Rural Library District. sessor, Westerman has gathered vious years. • /2 -31-al 1 }.11 ; H . ; " -0 -a .. x „ x January 9,2002 ` f 3 g--.' ,) 1-5 41 b.0 w city / , o ° aF;vvdfsex3.og0t .90� aS §c5d.?8ri ..°� g � w -u yQ Propane> ° wowwgY3 ,u.t' g° H"rvcg � °I , ,i„ o $cSx 8.0� 3 3 w y ° 81 r '� i,', ! sA.'.r,t g E i ;hp ;t °�,� � a� � ° p ,- tanks e. ° 8 �'^ .B ".a a 64EY ,,; ,,ra _ .s •$t o `' & Y a o°c°•O 1,7- ,.;.1'.1. 94! err? om a., o s m3¢r��°x" °�� v$" "� a • �� r t 3 a w cw U 5. a ji t: ,�l\ t.„...,...;, 641. ,..,: ,I »A w m ti a' 5 g iu " w•� *g"2,0<._...0 " " ` " islodge 12 ! C Y w 3 was w e d a 1Iti �frs � p > ❑ _, E� �_: dn3c cc , > m 1 = fY t,,,. +, , �, , a: . g a ? 2 > ° 2.r. i Y g Duckabush homes �: tvloot� ', aw &�a � ao 3 " " oaf • 1w "� ®, r ,lot ,tik f.4 f 2-s .Ji:i ,. ' w YL' ' evacuated as river • ~ >i9a � 'ao x �� � .m.Q o y a 2 >o a�Y overflows co its banks ' so �ti. • t ' .. u m 3 c F o aU a U iz' c $A BY STUART ELLtarr < � l�p $.� C $ m O • y, Y PENINSULA DAILY NEWS .. i✓ ,lr ,,„, ,{ t. 43 , y D 3 c 0 `tl o • a: g g' E"a u > 0,9 >•;•- -t ' lot., ;1 ( .t g, O 2 .0 > E oo.s ti...,'t~ 0x • The cumulative effect of warm rain an t' , �:wtv0 „ ▪ • ,o a > x c c Jc-a gE b., melted snow led'to evacuations and road c1P t” {> " q y a.Y ., 2 E 1 U q y> [ " sures in south Jefferson County on Tuesday. 0 * nr? t �. ' a 8)E-.1.t1D'1 i .B '° ar °'U 2 d 3•e - U.S.Highway 101 near Lilliwaup remains =•, •-....; a v o m etl ; ' a ,•ill ,•) E:10.,.rd v c >,-^°3,5g d closed for a second day following a slide c .- •' t'.',yt C'II r. `�- w a g-' g > d ` 50•» w 3 w Monday. tCr P gg •N J�' o ~ >,' ° a p E yy•O QO_O.O �' :.; ) S V, y 9 `a C .'�..,U y CJ 8 a w Y-Sv °..p a �. tl FF t 3. co , ,y [ E Y° a Transportation officials are now saying \� '° 0 9 ^ 3•E ` °c?. �° °' v hi hwa could be closed for up to a week. 1� } � aooYod �O' laE dUC ° �ig yt E zF 00 > ii a •� Theproblems were partly the result of se -• " $v - " 8 .21›.56.13 Cg y ‘;°1-71 eral days of warm weather and an abundan� a c wof rain, which caused snow and ice to melt - a0 >b. '� ow 3G d " ac v x " m 4 o • ; • 0 E o .1.g.70-.° . y 'Doi .c >>:2 0-'E A 0 �i.4-o E ycc awl_m c N the mountains and send water down triby w °' `9 °>'' d °''o,a �'n �' 3 .� '".a.d 3 5 w �-.+ taxies. o • i. a d �' >` Y0 al ~ o Y > U wc w c w x a South of Brinnon,a half-dozen homes ne, a rn c w Y •-•9 ° " > = d 5 $ the Duckabush River were evacuated Tuesd, x E > °N•� m� ° m 'd m d q ? � -0-.-0-0' .4.° a morning after the river overflowed ar al r'-.'z �v.w > o � Y a � me �° O ,a °cy�w c a. ,0ov " > 3•� g propane-'X 0 CO_o m .0^ o knocked loose five ro ane tanks. 0 w O•r-sc-. $ .c t ° 0 8 m I o 8 3 3-0w >�Q..0 . x n°�"'" 0 ° � �' a 1:11 °(g ;—3 bowl'. " 8 c r aw � C^ �' a w TURN TO FLOOD/E ;° > -51-',1 - $ 3 � a,2-, 2, os ng h''',,c > o a Z'" owl'4 .c ° 7 d 6-0 ..9.t~'a •" a a "=� 3 m0 0 cYYE 8 y >>s °'",Y. E t47 ppS ° op rig , -08 ' Z oC > EE >N °1 W—,2. 7 E.- a W Y >a"a,'5� >" Y " "d 'D O c ° " m F U "-cr mbmm = B ie. Ewowag oc0-'110-S uO a. �'> a �- ° ie. a.O .8E .z8 .�ti.,w 8.CE- E c .11 y. L' ° .'-'2 Y 2 a...11O !m� 8 ,,yyy ,j, G1}•� kyr-g y ya 15 n � /irt > �y 4... O >,m •wT.L�j l� (�,N ry ir° ° i]-got it u 7 Q, G) Y Q) 8. a3 - 0 4�-T a" " Mg& �. ,, ° 8ti $ •X008 x 'o = r oyq° gEc o wCOro> .4....) go O o d o "> E _Y 5sE � m $ `�[`' �' � awl�'� 0-5E 00 �'2 $ d;° .'R.G° ° S JL, 8 o y a r>� m>E a, 3 ., a Gq .ty v v. •o 3 ��mmyy 5 PJ o Y "¢� r �j -tt' 0E" •O y fJ y q' i Y,•., a',.g 1•,' U 0 y -C., i a r°r{^ p ,d'-' O g O p,a g�' >, 2 5 N'a '1' F...>,x 18 .0 A .. T`., U gy u,22� le �wa > .„„ ad . oSm z�' 8 �:-z.$ d.' x ..0 .a n.,0_, Em , g� ww & ,y ° oy o Y b m £ � t� � c v >' aci . 1 x.c w w o v ° . 2"0-"'—`-'84' L ,,,s ,„0 E ' z 8 m • O ,y�; .2• 4'.0 „ •-' ' y . -20. .c d m o " , v Y'� v a � 5 0 c 5 c cl�Y d.$ 8 g.;; d., z a° dc� ` 3 � ty 3 � 8 E� � & -. ".4• �.11 E 2., d �m „, ¢ c .g. a°.o . 0 " " go ag 8avi,5aw 7&ic'1E" 1 W-` 0 �.3 � „„ , ,..N�..c. Ypp•. E > g W -. 3 j� o ” $oYH C 3�� ,•, �., s [ ” °'� E'W 8 ro .� c � t°.O.g.� o Y 3:�'.�,.9 •c C�, E-s0 :, °��.c > 2=''' W m Q o o.E 0 E'. 13.'a E "Y ,. rat 2 3 - ° " o. x 8 >ti foo i ` y,° �' o m x �u1 3 � ° o . : $ t a •rB E••, „ "....• ,b.>•..c y.- 8 Sc 0 R-.1.7-8.4 o a. ,S m'� o. ■ ■ w a0~ ° -ox� °Bo _& 0 .., vt' oo.dy. a . .g-,9,. 2 w > .4 Tow � O �" � , °" n a ° •o �� ate- °w 0 0 E� x a x . 0 0 x 0 , � E a,.�' .,,Y_ ova c3 a 0 °.c c" " � g Y �0 ; 2vo sc " d,0w • .ca3 ,5 d - .E . ' m . " a' E0a 28 " > O x S ;v a W " a G n0 a, 8Y a 3 c c $ 3 da a F b o 00 C 3Y $ E,, 8 cA , a :ti tit ; d EY _ a v_.tia .., $ 'a° E > Z " E- od3v 0' >,> E '' 0 c _a 2 -.8 acig a .. ,,, ., . c ,� Ec n,'°'S g. Q . om > > 3 � E "-a o v v tl) a o v d o 8 e0 a+ m " v w83 E i '' r -3- - - > a� cgJJ. 1 ' hJIi awia 't,wInn > ,o.a ��'ua 0 ,532 a O F a� G. E8-0 ,,,°)..5•3° s��bq a 3 �= 3� •5 Qa a u A.0.-,* 800 ° E i " � Z o 3 c° A c° 0. 8 y - '-s,A � two � o 8�00E" m •- '�>,x a. sF�s - co 1 E 4 >, w n xvti .i.5 xF,5 8A3 .2g 2 " ...:- .'g _ F0 County clinic in Hadlock closes Due to Jefferson County Jefferson County Health and Health Services thank indi- budget reductions, Jefferson Human Services (JCHHS) in viduals and organizations that County Health and Human Ser- Port Townsend, next to QFC. have supported the Port vices is cutting back some ser- The Family Planning clinic in Hadlock clinic for the last five vices, effective January 2002. Quilcene will continue every years.It also thanks the Leader Flu clinics in local commu- Wednesday, 12:30-4:30 p.m. for the donated clinic space in nities will be eliminated, the on Roger Street, next to the Kivley Center; the Oak Bay Port Hadlock Family Planning South County Clinic. Emer- Clinic'for loaning equipment; Clinic is closing, and Family gency contraception is available the physicians of Olympic Pri- Planning hours in Port at both the Port Townsend and mary Care, who shared their Townsend will be reduced. Im- Quilcene clinics. You may also office space at Kivley Center munization hours in Port call the Port Townsend Clinic at when JCHHS first had a satel- Townsend will be Tuesday and 385-9400 or 1-800-831-2678 lite office; the Tri-Area Cham- Thursday afternoons only, and Monday-Friday, 9 a.m.-4:30 ber of Commerce, which WIC will be offered one less p.m., to obtain emergency con- graciously shared its space;and day a week. traception information. the Tri-Area residents who em- • Family Planning Services JCHHS and the Washington braced this clinic and made it will continue to be offered at State Department of Social and their own. LEA DE 1- - 0 2- •