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HomeMy WebLinkAbout2002- February File Copy • Jefferson County Board of Health Agenda * & Minutes February 21 , 2002 • • JEFFERSON COUNTY BOARD OF HEALTH Thursday, February 21, 2002 2:30—4:30 PM Main Conference Room Jefferson Health and Human Services AGENDA I. Approval of Agenda III. Approval of Minutes of Meetings of January 17, 2002 IV. Public Comments V. Old Business and Informational Items 1. Letter to Board of County Commissioners and Port Townsend City Council re: Gambling Tax Receipts and Public Health Funding • 2. Chronology of Gaikowski Complaint VI. New Business 1. Report of Fee Committee Larry/Sheila 2. Public Health Funding Crisis Tom 3. Community Health Partnerships and Regional Jean Public Health Service Coordination 4. Bioterrorism Preparedness Tabletop Exercise-- Tom Follow-up Report 5. Environmental Health Customer Survey Larry VII. Agenda Planning 1. March Meeting— Chris Hale BRFSS Presentation VIII. Next Meeting: March 21, 2002: 2:30 PM—4:30 PM • JEFFERSON COUNTY BOARD OF HEALTH • MINUTES DR P4451 Thursday, January 17, 2002 DRAFT Board Members: StaMembers: Dan Titterness.Member-County Commissioner District#1 Jean Baldwin, Nursing Services Director Glen Huntingford,Member- County Commissioner District#2 Lara Fay,Environmental Health Director Richard Vojt.Member-County Commissioner District#3 Thomas Locke,MD, Health Officer Geoffrey Meisel, Vice Chairman-Port TownsendCity Council Jill Buhler,Member-Hospital Commissioner District#2 Sheila Westerman, Chairman- Citir en at Large (City) Roberta Fri ssell,Member- Cititien at Large(Count) Chairman Buhler called the meeting to order at 2:32 p.m. All Board and Staff members were present, with the exception of Commissioner Huntingford. PUBLIC COMMENT • Charles Chase, a 17-year resident of Jefferson County, expressed concern about health issues in his neighborhood on Egg and I Road in Chimacum. He described a neighboring one-acre parcel, which now has about five travel trailers and a mobile home, no septic or water, an incorrect fire sign and is known for drug activity. He has received no response to his calls to the Sheriff and the Health Department. He and his neighbor are concerned about health and safety issues associated with the syringes and beer cans that he has found in his own driveway. They are also concerned about the safety of their shared well. He wants to know how compliance will be addressed? Dr. Tom Locke explained that the Board has the authority to address illegal dumping of sewage and potential impacts on the drinking water. Larry Fay said he is aware of the long-term issues of this case,which Linda Atkins has been pursuing. He was unaware of the status of the violations, but agreed to investigate and report back to both the Board and Mr. Chase. He added that the situation Mr. Chase describes is common in the County— trailers, accumulation of trash, no water, no sewer. Although some issues can be dealt with through sewage permitting, that does not address the underlying problem. Unless the County begins to deal with this type of housing situation directly, it will continue to be a problem. Jean Baldwin said this issue occurs in the Data Steering Committee's discussions of affordable housing. We are different from surrounding counties in that it is easier to "squat"here. • Vice Chairman Westerman noted that the lack of an enforcement officer makes the problem difficult to track. She asked Staff to provide the Board with a status report in the future. HEALTH BOARD MINUTES - January 17, 2002 Page: 2 • APPROVAL OF AGENDA Member Masci moved to approve the Agenda, with the addition of New Business Item 5. EnviroStars, as proposed by Larry Fay. Member Westerman seconded the motion, which carried by a unanimous vote. ELECTION OF BOARD OF HEALTH CHAIR/VICE-CHAIR FOR 2002 Out-going Chairman Buhler thanked the Board for the opportunity to serve over the last year. She called for nominations for the position of Chair. Member Frissell nominated Sheila Westerman. There being no further nominations, Chairman Buhler then called for nominations for the position of Vice-Chairman. Commissioner Titterness nominated Geoff Masci. There being no further nominations, Commissioner Wojt moved to elect Sheila Westerman as Chairman and Geoff Masci as Vice-Chairman. Member Frissell seconded the motion, which carried by a unanimous vote. APPROVAL OF MINUTES Vice-Chairman Masci moved to approve the minutes of December 20, 2001. Commissioner Wojt • seconded the motion, which carried by a unanimous vote. OLD BUSINESS Jean Baldwin circulated two articles: 1) West Nile Virus from the Washington State Department of Health and 2) news release on Streptococcus Infection in British Columbia. Letter of Commendation: Chairman Westerman suggested a minor change to the Board's letter commending Linda Atkins and Dave Christensen for getting an article published. Instead of your high professional standards far exceeded our expectations, she recommended your success at obtaining this grant confirmed our expectations. Larry Fay noted that while he expected that we would get the grant, the work done to win it was far superior to other health departments in the state. Chairman Westerman moved to approve the letter as revised. Member Frissell seconded the motion, which carried by a unanimous vote. NEW BUSINESS PUBLIC HEALTH FUNDING—STATE AND LOCAL POLICY ISSUES A Brief History of Public Health Funding: Dr. Locke said he believes it is important, when trying to 1111 address today's problems, to consider the context of public health funding. He noted that the sizeable HEALTH BOARD MINUTES - January 17, 2002 Page: 3 • public health infrastructure of 100 years ago gradually declined as the medical sector began to benefit from the technologies emerging to control epidemics. Around 1977, the dedicated millage, which counties had been collecting for public health funding, no longer had to go to public health. The priorities of the era and an economic recession brought on a decade of incremental dismantling at a rate of 3-5% per year. In 1988, a national report entitled The Future of Public Health detailed the severity of the problem and triggered the creation of the State Department of Health. The public health community was empowered to come up with a public health improvement plan, which they did in 1993. In 1995, the legislature stepped up to provide the down payment which pays for the County Health Officer. Dr. Locke said that in 1996, the State, in an effort to prevent City—County battles over public health funding, transferred MVET funding to Counties and relieved the Cities of any obligation to pay for public health funding. The MVET funds then disappeared and the legislature replaced 90% with backfill funding. Now the governor is proposing to stop that funding. When testifying recently on bio-terrorism funding, Dr. Locke said a representative remarked that we have not used that backfill money very well to prepare for bio-terrorism. Dr. Locke reminded him that this funding was in the base funding allocation (municipal contribution) that persisted over the better part of the last century and did not exactly represent new dollars to deal with the new threat. Public Health Funding in Washington State (Where It Comes From And Where It Goes): Referring to the pie charts in the Analysis and Recommendations for Financing Public Health in Washington State, Jean Baldwin noted where local departments across the State get their money versus • where Jefferson County gets its money: Funds Received by Washington Counties Funds Received by Jefferson County 42% Local Government/MVET 44% Local Government/MVET Local Sources 9% Medicaid/Federal Fee for Services 1% Medicaid Title XIX/Other Fed.Fee for Service 8% Federal from Other Sources 2% Federal 7% State from Other Sources 6% State, Other State/Federal 2% Local Capacity Fund 2% Local Capacity Fund(Health Officer Funding) 9% Federal Pass Through Money From DOH 10% Federal Pass Through Money from DOH 7% State Department of Health 4% State Department Of Health 2% Misc./Fund Balance/Other 2% Misc./Fund Balance/Other 7% Fees 29% Fees 7% Licenses/Permit 0% Licenses/Permit She noted that fees cover 29% of Jefferson County's public health expenses, reflecting our aggressive billing of insurance companies and Medicaid. She explained that for every $5 of funding, $1 comes from Jefferson County General Fund and $4 dollars comes from somewhere else (client fees, insurance, Medicaid, federal or state grants). The funding structure is delicate and each program is comprised differently. Adjusting staff schedules to make FTE cuts is extremely complex and difficult to explain to the public. • She reported that the Finance Committee began working on allocations and funding distribution formulas as part of the Public Health Improvement Plan. In the second year, they realized they were dealing with a legislative issue. A central issue the committee looked at was determining what parts of HEALTH BOARD MINUTES - January 17, 2002 Page: 4 public health should be paid for by what parts of the population. Because charging a fee jeopardizes the • community's health by creating a barrier, local health jurisdictions should have a policy regarding fee waivers. The Department needs to come to some agreement on these kinds of issues. In light of the changing fiscal picture, we need to make sure policy is not driven exclusively by the budget. The Board will need to reach agreement on whether it is a greater good issue, an individual issue, or for the protection of all. The second piece to look at is unfunded needs and whether these are needs of the community or discretionary services. Jefferson County Budget Directives: County Administrator Charles Saddler pointed out that the differences in distribution between the State and Jefferson County are due in large part to demographics and how they are reported. Loss of funding that might be critical to some jurisdictions is catastrophic to counties like ours. We are expecting a $200,000-$250,000 loss from the legislature in State and Federal pass-through funds in July 2002, which will result in the loss of five employees. He said the Department needs guidance on these priorities. The County Commissioners has also instructed all departments to determine how to get revenues in line with expenditures. We now know the County is likely to lose an additional 5%: $300,000 in MVET and backfill funds, $100,000 in Juvenile Detention Services, and $200,000 in Health, totaling a loss of about $600,000 from a current expense budget of$12 Million. To address the shortfall, a series of subcommittees, working through a budget and management team, will concentrate on: (1) developing a financial business plan for the organization, (2) reviewing different programs—identifying what is mandatory or discretionary (i.e., 1111 not required by statute or contractual requirement), and (3) determining level of service. He asked the Board of Health to work collectively with Staff to identify level of service issues by July 1, 2002. Jean Baldwin said a second budget would begin to be developed in April and the timing of its completion will depend on how the Board wants to do the prioritization. She noted that the Board set priorities as a part of the County Strategic Plan and chose to use the State Department of Health's standards. She asked whether these standards should be revisited in order to address the level of service within them. Chairman Westerman commented that because you cannot provide everything, you have to make decisions about who you are going to serve and what you will provide. In some cases, it would be worse to cut back the level of service than to stop programs altogether. She suggested a workshop to prioritize programs, noting that there was some discussion of this at the access summit. Member Buhler also spoke in favor of holding a workshop and collaborating with other organizations such as the hospital. Jean Baldwin added the need to collaborate with other departments, too. Charles Saddler then introduced a proposal for the Board's consideration. For background, he reminded that in 1977 a state statute established a dedicated millage and identified the level of funding to be provided by municipalities within the county for public health purposes. Last year, the City agreed to fund basic public health services and health and human service activities as part of the analysis of the Behavioral Risk Factor Surveillance System (BRFSS). At that time, the City made it clear that it would • not be able to provide a continuing level of service to the County. He asked the Board to recommend to the County Commissioners and City Council that they investigate imposing a tax on profits of gaming, • HEALTH BOARD MINUTES - January 17, 2002 Page: 5 • dedicating a sum equivalent to this revenue to public health in Jefferson County. The Washington State Gaming Commission would collect and remit this "sin tax" in Jefferson County and the City of Port Townsend. He has been told that this would be a stable financial resource for the department— generating $66,000 a year in Jefferson County alone—and would make up for the loss of MVET money. While we will probably lose far more than the tax could generate, if we do not have the types of cuts expected, these funds could appreciably reduce current public health expenses. Chairman Westerman asked about the potential losses in state or federal funding if we reduced the current expense contribution? Mr. Saddler said it depends, but wherever the County mandates cuts within the Department it would be done so as to not affect other funding. He noted that the County Commissioners reviewed a list of mandated versus discretionary programs and the percentage of County current expenses contributed. Few expenses went into contract services they have with the Washington State Department of Social and Health Services and other state and federal agencies and more went into the mandatory core public health programs. He noted that when assuming responsibility for contract administration with state agencies, the County charges 12-17% to keep administrative costs as low as possible. If the County loses the grants, it will have repercussions on administrative overhead. He asked whether the Board was supportive of the County continuing to gather information in pursuit of a tax on so-called "pull tabs?" Chairman Westerman expressed concern over not having the "bigger picture." She would not want to • gain $66,000 at the risk of losing other state or federal funds. Mr. Saddler explained that the $66,000 would go into the General Fund and then the County would allocate an equal amount. Chairman Westerman moved that the Board express to the City and the County Commissioners its recommendation to investigate a gaming tax for the purpose of augmenting the Health Department's budget. Vice-Chairman Masci seconded the motion. During discussion, Member Frissell said with Law and Justice and Transit each getting some of the sales tax, $66,000 sounds paltry. Mr. Saddler explained that its value is an ongoing stream of funds that would not require administration. He said it is a lawful capacity to levy a tax that is not being utilized. Chairman Westerman mentioned she likes the fact that this is a stable funding source replacing the one being lost. The motion carried by a unanimous vote. Commissioner Wojt moved that the Board write a letter to the County Commissioners and City Council suggesting that they further investigate the gaming tax. The letter would be signed by the Chairman and Vice-Chairman. Vice-Chairman Masci seconded the motion, which carried by a unanimous vote. Jefferson County Fee Study Group: Larry Fay explained that Environmental Health has been almost entirely funded by a mixture of fees and the General Fund. As part of this year's budget strategy, the County is working under a policy statement that people who benefit from the services being provided should be paying for the cost of delivering those services. Accordingly, Department managers developed a fee schedule to cover 100% of direct costs of delivering the program and 75% of the associated administrative costs. During the December 24, 2001 County Commissioners budget meeting an ad hoc Fee Advisory Board was formed to review the proposed fee schedule, of which he is a member and Sheila Westerman is chair. The committee's charge, at least with regard to Building and Community HEALTH BOARD MINUTES - January 17, 2002 Page: 6 Development, Environmental Health and Animal Services, is to recover 75% of the administrative costs • plus the direct costs of programs out of fees. Chairman Westerman talked about the group's process. In light of the large amount of information being reviewed, they engaged in a discussion with staff from Community Development and Environmental Health about whether the approach taken to satisfy the policy was sensible, rational and comprehensible. She believes it has been a worthwhile process, with thoughtful questions and good discussion. In her opinion, the County is far behind in charging adequate fees and has been subsidizing programs through the General Fund for a long time. It will be a difficult transition for the County because of the public's skepticism about the use of funds in County government. Larry Fay said the policy statement means that for Environmental Health the amount to be recovered in fees is $84,000. Even with fee increases, the County in many cases would still be in the lower half in the state, with the exception of the food program which would be in the upper one third. It was noted that the new fees would still put the County lower than the City by about 20%. There was a perception that because permits were down, the County needed to increase fees to keep people employed. However, the purpose of the increase is that we are shifting $84,000 of Environmental Health costs from current expense to fees. They based their fees on an assumption of a stable permitting activity. Member Frissell said the public does not fully understand what it is getting for its taxes and recommended finding a way to educate the public about how funds are used. Mr. Saddler said public . education and outreach will be a component of working on the financial/business management plan. - ,Tefferson Access Project—Next Steps: Kris Locke announced that the hospital received a $15,000 grant from the Washington Health Foundation to continue its work to refine and develop three work products: Jefferson Passport Project, Civic Engagement in Health Project, and Jefferson Access Project. After distributing additional information on the products, Ms. Locke reviewed the next steps which include designating an "access point person,"preparing a comprehensive grant proposal, having a joint meeting with the Board and the Hospital Commissioners to propose a plan for moving forward, utilizing the expertise of the Work Group to help refine ideas, and planning a Spring Summit to inform the community of the Project's activities. Ms. Locke then described alternatives other communities are considering, some of which are variations of the same projects. Referring to the Jefferson Passport Project, she talked about the resources that such a project would require. She believes there are many entities that would be interested in this project and there may be funding and support through the Insurance Commissioner or Governor's office to do more research. She described the Civic Engagement in Health Project as an opportunity for the Board of Health to engage the community in a dialogue about healthcare issues, including costs, and to elicit from the community its healthcare priorities. She recommended the Board consider taking on the Civic Engagement Project as a good step in thinking about the public health issue and what might be attempted in this community. She noted that a group called Human Links has put together a training • program on how to engage people in a discussion of these issues. She believes the Passport Project would fit with the hospital and that an access coordinator could help bring the projects together and HEALTH BOARD MINUTES - January 17, 2002 Page: 7 • coordinate the work. There was some Board support for working on the Civic Engagement Project for the purposes of educating people and helping the County Commissioners prioritize how we will spend our dollars. Referring to the high cost of health insurance plans, Vice-Chairman Masci spoke of the mis-perception that small business owners and their employees can afford coverage. Even the insurance provided by major employers such as the County is perceived as being affordable. When Commissioner Titterness and other Board members expressed interest in what would happen if everyone stopped carrying health insurance, Dr. Locke said that discussion is a focus of the Civic Engagement project. There is a need for public discussion of alternative ways that money could be distributed. Jean Baldwin asked what the difference was between this proposal and the previously discussed healthcare authority? She questioned whether healthcare access is the problem or is it the funding for the care that the hospital is providing? Kris Locke said that fewer and fewer small employers can keep up with the increasing cost of healthcare. One of the reasons it costs so much is that there are so many mandated benefits. • Kris Locke added how you support them is also critical in terms of what services residents should have and who pays for it. How they pay is a different question. She said it is not just health services, but public health as well. One of the things that the Access to Critical Health Services points out is that they are both important. The Board responded affirmatively to continuing its commitment to access and to scheduling a joint meeting with the hospital. Dr. Locke said Staff will follow up with the Board about scheduling a two- hour joint Board meeting sometime during the middle two weeks of March. Congressional Bio-terrorism Funding Update: Dr. Locke said the bill would provide $16 million in Washington State for public health preparedness. Eligibility for and apportionment of these funds have not yet been determined. He said there has been a growing consensus that an effective bio-terrorism response has to occur at the local level. Jean Baldwin announced that the Bio-terrorism Tabletop Exercise is scheduled for Wednesday, January 30, 2002 from Noon-4:30 p.m. The Board is invited to attend this exercise with the Hospital, EMS, and the community system, though their presence is not required. EnviroStars: Larry Fay distributed a memorandum explaining the EnviroStars Program, a hazardous waste and pollution assistance and incentive program. Circle and Square Auto in Port Hadlock has applied to be the first to receive an award. Because this is a Health Department function, he asked if the Chairman and/or Vice-Chairman would attend the presentation of the award. • HEALTH BOARD MINUTES - January 17, 2002 Page: 8 AGENDA CALENDAR / ADJOURN • Update of 2002 Strategic Plan with Budget Shortfall Impacts and Report on Access Project. 2001 AGENDA ITEMS 1. CONTINUED STABLE FUNDING TO REPLACE MVET 2. ACCESS HEALTH CARE 3. PROGRAM MEASURES (Genetic Research and Public Health Implications) 4. METHAMPHETAMINE SUMMIT 5. PERFORMANCE STANDARDS & COMMUNITY ASSESSMENT 6. TOBACCO PREVENTION AND COALITION 7. FLUORIDE 8. TRANSIT AND PUBLIC HOUSING 9. BIOTERRORISM READINESS & PLAN 10. AGING POPULATION 11. WATER 12. MATERNAL CHILD PREVENTION GOALS (0-3) • at 4:32p.m. The next meetingwill be held on Thursday, February21, 2002 at The meeting adjourned Y� 2:30 p.m. at the Jefferson County Health and Human Services Conference Room. JEFFERSON COUNTY BOARD OF HEALTH Sheila Westerman, Chairman Jill Buhler, Member Geoffrey Masci, Vice-Chairman Richard Wojt, Member (Excused) Glen Huntingford, Member Roberta Frissell, Member Dan Titterness, Member • • Board of Health Old Business Agenda Item V. , 1 • Letter to Board of County Commissioners and Port Townsend Council February 21 , 2002 • • DRAFT Jefferson County Board of County Commissioners Courthouse—P.O. Box 1220 Port Townsend, WA 98368 Port Townsend City Council Port Townsend, WA 98368 Re: Dedicated Public Health Funding Sources Dear Commissioners/Council Members: As the duly constituted Board of Health for Jefferson County, we are writing to express our growing concern over the unstable funding of essential public health services and to recommend a specific, short-term action to address this issue. Provision of essential public health services is a fundamental duty of all governments from the municipal to federal level. Prior to 1996, this obligation was met by a combination of city, county, • state, and federal funding sources. In 1996, the Washington State Legislature transferred the municipal obligation for public health to a statewide pool funded by the Motor Vehicle Exise Tax. In 2000, following passage of Initiative 695, the State Legislature repealed this tax, eliminating a important source of public health funding. Beginning with the 2001-2003 State Biennial budget, the legislature restored 90% of this funding as "I-695 Backfill". At the urging of Governor Locke, the legislature is now considering eliminating this funding beginning in 2003. Public health funding is heavily tied to federal and state categorical funding programs. Only about 23% of the average local health budget is available to meet essential public health needs like communicable disease control,bioterrorist response preparation, and community health surveillance activities. Loss of state"backfill" funding, will eliminate almost half of these local resources, crippling the ability of our health department to respond to urgent local public health needs. "Belt tightening"will not solve this crisis. Core public health programs must be eliminated to close a budget gap of this magnitude. The Legislature's repeal of appropriated funds for local public health is occurring in the context of Washington State's worst recession in 20 years. Existing local revenue sources are unable to fill the gap created by the state's unilateral decision to cut local public health funding. A long-term solution to this impending crisis will require Legislative action and a probable vote of Washington's citizens. Until that occurs, local governments must be innovative in their search for potential revenue sources. One such area of unused taxing authority is contained in RCW 9.46.110, allowing taxes on various • gambling activities, including punch boards and pull tabs. Such a tax would need to be enacted by both the county and the city of Port Townsend to cover the entire county. • Revenue from such a tax must be dedicated to law enforcement activities. We are proposing that this tax be enacted and general fund "saving" for law and justice activities be dedicated to local public health funding to replace lost MVET funds. The Jefferson County Board of Health is responsible for carrying out the duties outlined in RCW 70.05.060. We understand that the good health and long life that most Jefferson County residents enjoy is possible only because of the foundation of local public health services that has existed since the l9th century. This foundation is now in jeopardy. We respectfully ask for your support in utilizing your taxing authority on gambling activities to maintain support for Jefferson County's public health system during this period of crisis. Sincerely, Sheila Westerman Chairman, Jefferson County Board of Health Geoffrey Masci Vice Chairman, Jefferson County Board of Health • II u5L t RCW 9 . 46. 110 Taxation of gambling activities -- Limitations -- Restrictions on • punch boards and pull-tabs -- Lien. (1) The legislative authority of any county, city-county, city, of town, by local law and ordinance, and in accordance with the provisions of this chapter and rules adopted under this chapter, may provide for the taxing of any gambling activity authorized by this chapter within its jurisdiction, the tax receipts to go to the county, city-county, city, or town so taxing the activity. Any such tax imposed by a county alone shall not apply to any gambling activity within a city or town located in the county but the tax rate established by a county, if any, shall constitute the tax rate throughout the unincorporated areas of such county. (2) The operation of punch boards and pull-tabs are subject to the following conditions: (a) Chances may only be sold to adults; (b) The price of a single chance may not exceed one dollar; (c) No punch board or pull-tab license may award as a prize upon a winning number or symbol being drawn the opportunity of taking a • chance upon any other punch board or pull-tab; (d) All prizes available to be won must be described on an information flare. All merchandise prizes must be on display within the immediate area of the premises in which any such punch board or pull-tab is located. Upon a winning number or symbol being drawn, a merchandise prize must be immediately removed from the display and awarded to the winner. All references to cash or merchandise prizes, with a value over twenty dollars, must be removed immediately from the information flare when won, or such omission shall be deemed a fraud for the purposes of this chapter; and (e) When any person wins money or merchandise from any punch board or pull-tab over an amount determined by the commission, every licensee shall keep a public record of the award for at least ninety days containing such information as the commission shall deem necessary. (3) (a) Taxation of bingo and raffles shall never be in an amount greater than five percent of the gross receipts from a bingo game or raffle less the amount awarded as cash or merchandise prizes . (b) Taxation of amusement games shall only be in an amount sufficient to pay the actual costs of enforcement of the provisions 0 of this chapter by the county, city or town law enforcement agency and in no event shall such taxation exceed two percent of the gross receipts from the amusement game less the amount awarded as prizes . http://search.../ViewHtml.asp?Action=Html&Item=29&X=1231134047&p=1&X=123113414 12/31/01 Page 2 of 2 (c) No tax shall be imposed under the authority of this chapter on • bingo or amusement games when such activities or any combination thereof are conducted by any bona fide charitable or nonprofit organization as defined in this chapter, which organization has no paid operating or management personnel and has gross receipts from• bingo or amusement games, or a combination thereof, not exceeding five thousand dollars per year, less the amount awarded as cash or merchandise prizes . (d) No tax shall be imposed on the first ten thousand dollars of gross receipts less the amount awarded as cash or merchandise prizes from raffles conducted by any bona fide charitable or nonprofit organization as defined in this chapter. (e) Taxation of punch boards and pull-tabs for bona fide charitable or nonprofit organizations is based on gross receipts from the operation of the games less the amount awarded as cash or merchandise prizes, and shall not exceed a rate of ten percent. At the option of the county, city-county, city, or town, the taxation of punch boards and pull-tabs for commercial stimulant operators may be based on gross receipts from the operation of the games, and may not exceed a rate of five percent, or may be based on gross receipts from the operation of the games less the amount awarded as cash or merchandise prizes, and may not exceed a rate of ten • percent. (f) Taxation of social card games may not exceed twenty percent of the gross revenue from such games . (4 ) Taxes imposed under this chapter become a lien upon personal and real property used in the gambling activity in the same manner as provided for under RCW 84 . 60 . 010. The lien shall attach on the date the tax becomes due and shall relate back and have priority against real and personal property to the same extent as ad valorem taxes . [1999 c 221 § 1; 1997 c 394 § 4; 1994 c 301 § 2; 1991 c 161 § 1; 1987 c 4 § 39. Prior: 1985 c 468 § 2; 1985 c 172 § 1; 1981 c 139 § 8; 1977 ex. s. c 198 § 1; 1974 ex.s. c 155 § 8; 1974 ex.s. c 135 § 8; 1973 1st ex.s. c 218 § 11. ] NOTES: Effective date -- 1999 c 221 : "This act takes effect January 1, 2000. " [1999 c 221 § 2 . ) Severability -- 1981 c 139: See note following RCW 9 . 46. 070 . Severability -- 1974 ex. s . c 155 : See note following RCW 9. 46. 010 . • http://search.../ViewHtml.asp?Action=Html&Item=29&X=1231134047&p=1&X=123113414 12/31/01 Page 1ofl • RCW 9 . 46 . 113 Taxation of gambling activities -- Disbursement. Any county, city or town which collects a tax on gambling activities authorized pursuant to RCW 9. 46 . 110 shall use the revenue from such tax primarily for the purpose of enforcement of the provisions of this chapter by the county, city or town law enforcement agency. [1975 1st ex.s. c 166 § 11.] NOTES : Severability -- 1975 1st ex. s . c 166 : See note following RCW 9. 46. 090 . III • file:////LEGINFOB-2/RCW$/RCW 9 TITLE/RCW 9 . 46 CHAP.../RCW 9 . 46 .113.ht 12/31/01 DRAFT Jefferson County Board of County Commissioners Courthouse—P.O. Box 1220 Port Townsend, WA 98368 Port Townsend City Council Port Townsend, WA 98368 Re: Dedicated Public Health Funding Sources Dear Commissioners/Council Members: As the duly constituted Board of Health for Jefferson County, we are writing to express our growing concern over the unstable funding of essential public health services and to recommend a specific, short-term action to address this issue. Provision of essential public health services is a fundamental duty of all governments from the municipal to federal level. Prior to 1996, this obligation was met by a combination of city, county, • state, and federal funding sources. In 1996, the Washington State Legislature transferred the municipal obligation for public health to a statewide pool funded by the Motor Vehicle Exise Tax. In 2000, following passage of Initiative 695, the State Legislature repealed this tax, eliminating a important source of public health funding. Beginning with the 2001-2003 State Biennial budget, the legislature restored 90% of this funding as "I-695 Backfill". At the urging of Governor Locke, the legislature is now considering eliminating this funding beginning in 2003. Public health funding is heavily tied to federal and state categorical funding programs. Only about 23% of the average local health budget is available to meet essential public health needs like communicable disease control, bioterrorist response preparation, and community health surveillance activities. Loss of state"backfill" funding,will eliminate almost half of these local resources, crippling the ability of our health department to respond to urgent local public health needs. "Belt tightening"will not solve this crisis. Core public health programs must be eliminated to close a budget gap of this magnitude. The Legislature's repeal of appropriated funds for local public health is occurring in the context of Washington State's worst recession in 20 years. Existing local revenue sources are unable to fill the gap created by the state's unilateral decision to cut local public health funding. A long-term solution to this impending crisis will require Legislative action and a probable vote of Washington's citizens. Until that occurs, local governments must be innovative in their search for potential revenue sources. One such area of unused taxing authority is contained in RCW 9.46.110, allowing taxes on various • gambling activities, including punch boards and pull tabs. Such a tax would need to be enacted by both the county and the city of Port Townsend to cover the entire county. • Revenue from such a tax must be dedicated to law enforcement activities. We are proposing that this tax be enacted and general fund"saving" for law and justice activities be dedicated to local public health funding to replace lost MVET funds. The Jefferson County Board of Health is responsible for carrying out the duties outlined in RCW 70.05.060. We understand that the good health and long life that most Jefferson County residents enjoy is possible only because of the foundation of local public health services that has existed since the 19th century. This foundation is now in jeopardy. We respectfully ask for your support in utilizing your taxing authority on gambling activities to maintain support for Jefferson County's public health system during this period of crisis. Sincerely, Sheila Westerman Chairman, Jefferson County Board of Health Geoffrey Masci Vice Chairman, Jefferson County Board of Health • • • Board of Health Old Business Agenda Item # V. , 2 • Chronology of Gaikowski Complaint February 21, 2002 • . ‘ �T.• " ' ' .' Jefferson County Health 6'Human Services tel' J I 615 SHERIDAN • PORT TOWNSEND,WA 98368 • FAX 360-385-9401 Date: February 14, 2002 To: Jefferson County Board of Health From: Larry Fay, Environmental Health Director Re: Follow up to the January Board of Health Meeting—Charles Chase Attached is a chronology of activities related to the concern expressed by Mr. Chase regarding possible health violations on his neighbor's property. • At this time, we have not been able to actually gain access to the property to verify the complaints. From the road, travel trailers have been observed and we have presumed a violation exists. To date the property owner has not picked up the mailed notices. If the most recent notice is not picked up, arrangements will be made to post the notice in cooperation with the sheriff's office. • 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 • TIMELINE OF ACTIVITY FOR GAIKOWSKI COMPLAINT- EGG AND I RD- 2-13-02 Prior to 9-26-00 calls were made regarding this site and site visits were made but only one travel trailer was on the site and no signs of occupancy. 9-26-00 Action request received from Permit Center. Cc to this office for action on occupancy without septic system portion of complaint. Site visit completed— several travel trailers now onsite, no one present at time of visit but does appear that site may be occupied, will make another visit. No trespassing signs and security signs on site. Further site visits made and saw smoke coming from chimney and more sign of activity and cars 9-17-2001-Notice of violation sent certified requiring owner to contact designer and apply for permit or vacate site. Cc notice to Building Official. Notice was picked up. Did not receive any response to the letter. 10-10-2001- site visit made—nothing removed from site, no one on site at time of visit but the site does appear to be occupied. 19-26-2001- 2nd Notice of violation sent certified. Stated that case may be referred to Pros. Attorney if not informed of status on site. Cc notice to Building Official. Notice not picked up. • 11-19-2001- Received another complaint on the site regarding many issues including suspicion of drug production and sales on site along with abandoned cars and the lack of septic system. 1-24-2002- Complaint referred by DOE to this office. Caller reported that a pipe had been attached to a trailer and occupants of the site were draining their gray water directly to the ditch that is upgradient from the callers well. 1-25-2002 —another site visit was made and photos taken. There is a black plastic pipe going into the roadside ditch but no sign of suds or algae indicating wastewater. A trench has been dug from a travel trailer out to the road and there was a piece of white 1"-1 r/2" pvc pipe in it. It appears to be possibly for phone or power. Out of state RV pulled up on lot as I was leaving. I reported to Sheriffs office my observations based on concerns of adjacent property owners that an RV has been on site and they are concerned about drug activity when it is there. 1-29-2002- 3rd notice of violation sent and cc to Pros. Attorney with cc to Building Official. Have not received notice back as of 2-13-02.No response from property owner. Have had several phone conversations with concerned citizens over this site during the entire time period. S • Board of Health New Business Agenda Item # VI. , 2 • Public Health Funding Crisis February 21 , 2002 1 Washington State Association 1 �� ofLocal Public Health • b 1C Officials AN AFFILIATE OF WASHINGTON STATE ASSOCIATION OF COUNTIES FOR IMMEDIATE RELEASE January 30,2002 CONTACTS: Rick Mockler 425.238.4610 rmockler@shd.snohomish.wa.gov M. Ward Hinds 425.356.8907 whinds@shd.snohomish.wa.gov Vicki Kirkpatrick 360.753.1886 vkirkpatrick@wacounties.org Local public health in critical condition Health officers testify Feb. 8; poor funding & political games risk lives OLYMPIA—The leaders of Washington state's 34 local health jurisdictions will go on the record Feb. 8, warning the House Health Care Committee that budget cuts to public health could cost lives. The health officers hope to preserve all current funding in the state budget that is designated for local public health. "Insufficient public health funding carries a human price tag—irresponsible decisions now will cost lives later," said Pat Libbey, President of the National Association of City and County Health Officials. "If we learn any one lesson,from the nation's recent tragedies, it must be that our public health infrastructure is decayed and has to be rebuilt in order to protect the nation. This could be our only chance to change that," he said. Libbey, who also serves as Health Director for Thurston County, is among the speakers slated to testify the afternoon of Feb. 8. "In my home state of Washington, where not one anthrax spore was found in 2001, our public health capacity was stretched to its limits trying to respond to `credible threat' samples," said Libbey. "Imagine the panic if we had found the real thing." In addition to the national perspective,the House Committee will get the statewide picture from State Board of Health member, Tom Locke, MD, MPH, Health Officer for Clallam and Jefferson counties. "Washington state's local public health agencies are chronically underfunded, understaffed and unrecognized for the enormous responsibility of protecting the public's health," Dr. Locke said. "Every year new threats to public health emerge—international epidemics, antibiotic-resistant infections, and now bioterrorist attacks—and every year our capacity to respond falls farther behind. The health security of Washington's citizens is at stake,"he continued. "Cutting funds for essential local public health protection cripples an already weakened system and is a dangerous move in the wrong direction." In recent years funding streams for public health have dried up. Originally cities and counties funded local health,but the state legislature changed that in 1996 by redirecting a percentage of the motor vehicle excise tax (MVET) to public health. Four years later the legislature eliminated the MVET and committed to"backfill"the lost public health dollars. The 2002 proposed budget reneges the promised • ...MORE... 206 TENTH AVENUE SE, OLYMPIA, WA 98501 TELEPHONE: (360) 753-1886 (360) 753-2842 PUBLIC HEALTH OFFICERS, Page 2 January 30, 2002 • backfill and fails to provide new funding to meet resource needs for disease surveillance. Snohomish County's health officer and chair of the Washington State Association of Local Public Health Officials, M. Ward Hinds, MD, MPH, will address the House Committee on the need for disease surveillance at the local level. "We `locals' carry the burden for detecting disease outbreaks,"said Dr. Hinds. "We need to watch for the earliest sign of something going wrong and be able to mobilize. If we lose our current state funding during this legislative session, our surveillance systems will be greatly weakened and the limited surge capacity we now have at the local level will be lost,"he said. "We have many professionals who know what we need to do to prepare, but we simply do not have the resources to do it at the needed level,"Dr. Hinds said. "For example, if a significant outbreak of smallpox were to occur in Everett, we quickly would be overwhelmed—the 600,000 lives in my county and three million lives along the I-5 corridor would be in jeopardy." The Washington State Association of Local Public Health Officials is a non-profit organization that brings together the leadership of local health departments. The Association creates a constructive and collegial environment needed to advance the broad interests of public health. The Mission of public health is to improve health status through the promotion of health and the prevention of and the protection from injury and disease. To support this mission, the purpose of WSALPHO is to encourage improvement in the quality, capacity • and leadership of health departments/districts in order to provide a more effective, efficient and consistent public health infrastructure throughout Washington state. For more information about WSALPHO, contact Vicki Kirkpatrick, 360.753.1886. ###END### NOTE: Media Q&A opportunity with Health Officers, Feb. 8, 11:30 am-12:15 pm, Ramada Inn Governor House, 621 S. Capitol Way, Olympia WA. Health Officers' testimony before House Health Committee scheduled to begin at 1:30 p.m., John L. O'Brien Bldg, Hearing Room C. Washington State Association - of Local Public Health Officials AN AFFILIATE OF WASHINGTON STATE ASSOCIATION OF COUNTIES WSALPHO health officials testifying before the Washington State Legislature House Health Care Committee,February 8, 2002: M. Ward Hinds, MD, MPH, Health Officer—Snohomish Health District whinds@shd.snohomish.wa.gov 425.339.5210; 425.356.8907 pager Ward Hinds, MD, MPH, has led Snohomish Health District since 1986, serving a county of 606,000 people north of Seattle. A graduate of Vanderbilt University Medical School and the University of Washington School of Public Health and Community Medicine, he is board-certified in Public Health. He served in the U.S. Army as a Prevention Medicine Officer during the Vietnam Conflict. Dr. Hinds has worked at the Washington State Division of Health, the Cancer Center of Hawaii, and the Kentucky State Health Department, where he was the state epidemiologist. He currently chairs the Washington State Association of Local Public Health Officials, and is a past member and chair of the Washington State Board of Health. Dr. Hinds is a Clinical Professor in the University of Washington School of Public Health and Community Medicine. • Patrick M. Libbey, Health Director—Thurston County libbeyp@co.thurston.wa.0 360.786.5581, ext. 7204 Pat Libbey directs the Thurston County Public Health and Social Services Department, serving a suburban and rural population of 210,000 near the state's capital. He is president of the National Association of County and City Health Officials and past president of the Washington State Association of Local Public Health Officials. In recent years he also has served as president, Washington State Association of County Human Services; chair, NACCHO County Forum; member, Washington State Core Government Public Health Functions Task Force; member, Public Health Improvement Plan Steering Committee; and chair, Performance Measures Technical Advisory Committee. In 1993 Mr. Libbey received the Award for Excellence in Environmental Health from the National Association of County Health Officials. Thomas Locke,MD,MPH, Health Officer—Clallam and Jefferson counties tlocke@co.clallam.wa.us 360.417.2437 Tom Locke, MD, MPH, lives on the Olympic Peninsula where he works as the Health Officer for Clallam and Jefferson counties and serves as the Medical Director of the Port Gamble S'Klallam Tribal health program. He is a graduate of the University of Kansas School of Medicine and the University of Washington's Preventive Medicine residency. He is board-certified in General Preventive Medicine and Public Health. Dr. Locke is a member of the Washington State Board of Health and Washington State Medical Association's Inter-Specialty Council, representing local public health officials. He is a past • president of the Clallam County Medical Society and 20-year member of the Olympic Medical Center's medical staff in Port Angeles. 206 TENTH AVENUE SE, OLYMPIA, WA 98501 TELEPHONE: (360) 753-1886 (360) 753-2842 Washington State Legislature • House Health Care Committee February 8, 2002 Testimony of M. Ward Hinds,MD, MPH Health Officer, Snohomish Health District Madame Chair and members of the Committee, as the chair of the Washington State Association of Local Public Health Officials, I can assure you that local public health officers and directors know that we are very underprepared to deal with large communicable disease outbreaks or bioterrorism in our State. And, it is important to note that any such event will happen locally first. We must be better prepared locally if we are to be able to detect such events as quickly as possible and respond in a highly effective way. • Our current disease surveillance systems are adequate for monitoring of many diseases, but they often cannot quickly spot many small outbreaks of disease that now occur naturally. It is commonly several days after illnesses begin to occur before we identify an outbreak. We need to enhance these systems — we need to make them more active and less passive - to make them more sensitive and more responsive to unusual disease occurrences. Loss of I-695 backfill funding would instead drastically weaken these systems. Our surge capacity is not substantial at this time. We have a very limited number of nurses and environmental health staff that we can shift from their regular responsibilities to respond to an unusual event of any size. This became very clear last October and November as we struggled to deal with the thousands of phone calls and visits from the • worried public during the anthrax exposure events. And that was without a single case of anthrax in our state. Loss of I-695 backfill funding, as proposed by Governor Locke, would markedly reduce the number of public health staff at the local level and cripple our surge capacity. This State would become very vulnerable to any large outbreak of disease, whether from a bioterrorism event, a meningitis outbreak or an event such as the E. coli outbreak of 1993. Local public health's ability to respond would be weakened to a dangerous level if we lose this funding. We live in a time of emerging new infectious disease threats, such as West Nile Virus, antibiotic-resistant tuberculosis and Ebola Virus. We face the new threat of old diseases such as smallpox, plague and anthrax spread by bioterrorists. The world has become very small and diseases from another continent are now only hours away by jet plane. There is new federal funding for bioterrorism preparedness apparently on the way. However the total amount coming to Washington State is less than the amount of I-695 backfill funding that Governor Locke proposes cutting. Only a part of the new federal funds will come to local public health. Even with the new bioterrorism funding, public health will fall further behind in preparedness if I-695 backfill for local public health is cut. This is a time to strengthen our local public health system, not to weaken it as would happen with the Governor's budget. Lives will be endangered if our public health system is weakened. We hope you will agree and will preserve I695 backfill for local public health. • • Testimony before the House Health Care Committee Thomas Locke, MD, MPH Health Officer, Clallam and Jefferson Counties Member, Washington State Board of Health In October of 2001, in the midst of growing national alarm over the threat posed by bioterrorism, the Washington State Board of Health examined the level of preparedness of the state's public health system to respond to a biological emergency. The Board heard testimony from local, state, and national public health experts and reviewed extensive national research on the subject. On November 14, 2001,the Board published its findings and recommendations. The verdict—Washington's public health system is underfunded, understaffed, and underprepared to deal with the extraordinary threat posed by a bioterrorist attack. In the best of economic times, adequate preparation for a public health threat of this magnitude would be a monumental challenge. Instead, Washington State finds itself in the midst of a recession and a major budget crisis. Legislators are being forced to make painful choices between competing priorities. A major share of local public health funding, in the form of"backfill" MVET appropriations, is on the chopping block. Bioterrorism experts are in agreement that a strong local public health surveillance and response capability is the only effective defense against a biological attack. If the biological • agent is communicable (like smallpox, plague, or Ebola) and primary containment fails, the resulting epidemic will go national or international in a matter of days. This is the brutal reality of bioterrorism defense—your first chance may be your only chance. Washington State has a bare bones local public health workforce that has weathered over two decades of relentless cuts in public health funding. This workforce is maintained by an unstable collection of categorical programs, user fees, grants, and contracts. Loss of MVET backfill funding will cause this house of cards to collapse in many parts of the state. In terms of bioterrorism defense capability, Washington will move from being seriously underprepared to dangerously vulnerable. The threat of bioterrorism is very real. The amount of time we have to prepare is uncertain. An attack anywhere in the country will have major repercussions on Washington, as was well demonstrated with the East Coast's anthrax exposures. An attack on our state will have consequences unimaginable to most of its citizens. They will, however, know whom to hold responsible if we fail to adequately prepare for such an attack. The health officers of this state recognize the severity of the current budget crisis. But we must issue an urgent warning: Local public health is our frontline defense against biological disasters, including bioterrorism. Loss of core local health funding will result in large gaps in this frontline defense. The public health consequences could be nothing short of catastrophic. • ti washI'nton State ►� ate Association CO • f e o ,ocal Public I Iealth Officials AN AFFILIATE OF V/ " WASHINGTON STATE ASSOCIATION OF COUNTIES Memorandum February 7, 2002 To: The Honorable Members of the Washington State Legislature From: The Washington State Association of Local Public Health Officials Subject: Local Public Health Preparedness The undersigned local public health officials agree that local public health agencies in Washington State are suffering from chronic underfunding. Loss of I-695 backfill funding will make this problem much worse. We are experiencing increasing difficulties, especially in smaller jurisdictions, in carrying out our communicable disease prevention and control responsibilities. We arc underprepared to respond to a significant bioterrorism event. Our disease surveillance systems are not adequate to quickly identify outbreaks of illness that might signify a bioterrorism event or other public health emergency. Our capacity is very limited for shifting staff resources to respond to a significant bioterrorism event or a communicable disease outbreak. IILoss of the critical I-695 Backfill funding will further weaken a system that is essential for protection of public health at the local level. Now is the time to strengthen the local public health system, not to weaken it. Local public health needs a stable funding source for our basic communicable disease control responsibilities. Name Local Health Department/District 774._..)C2 itit,,&A.,.A___,_ /1 1) i/ d# 7:4, L ill, 10C1j- C%-41 114-41- 'Yle5)Lx:,vN;'SI 4e-eJ 771c- i-- -t- 1,1 1 2C-Pri-av-4 � � M P7`� qL� � W - � ' '/t,/'G✓ � --,,?. L.„, , ,/:-' I,�� , ,' i'1' i��r( 5-,,,,,,,i,,, ,,.:t- �/( r r`''�".-,_k�fi,-, /--�''..�41) -(_u,-f (' �tS V 1 i. . )-L,e.t, AAA)i �1 p N C o L,.: t i i-t Coin i--�� �ft,. t<v t .. I ,.,,,a..,. Su -. <,-t- / l,. I .-.., 1, . i u, 1,C� 1 1,,�� N �AV.�K1Luw. Cou�� 1-\c a.a,. Vklkrvlah SJt_•_, c`} • ` (LL' i._ 1 tll D IVei ill kci 1-6(00$i-c1 I11- i?Si 67-' 206 TENTH AVENUE SE, OLYMPIA, WA 98501 TELEPHONE: (360) 753-1886 (360) 753-2842 T-- illi.----- 41-*4-----, ti 9 mes4 if,A-4.,_ leC174i,-••--4--R fliCo‘he( 17Apkt • Ae-i -1--/t--7-sir, A/y/3 /-mr--,-// A / Zbal ; b . >-'gyilia #0eaezi AMAdt_ 6)714-1 "."--- '/Ate/s/oek, 6 X6,6//c: X/e.oez - 177d, V 4 / (' .. (1 1 le l �1y1PH- W I ' / /1 0-, 4 ((c. 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I--H--- ,may i • //`" `{--K. 4c-c-:t lam, E/ -2) HK i (o...ct/ 4'"( Le , .-7/'-'-.-,.(7_ i\i\ck,1/4,k_ \_,_ ,Z._A - ..___ . 9 </:, 7(4.1,-� ,,-/AeG.>i --/;:,-, Ca,--,/ yrs, ///, �i 57/i( r -P01416 -.- m d<zi/bey u(5 Ith RwNJI ►G 14-ect.. • Public Health Dollar$ in Critical Condition Historically Counties & cities Legislature directs cities & counties to fund local public health 1996 Counties & cXs Legislature eliminates cities' mandate to fund local public health MVET Legislature redirects MVET to fund public health 2000 AT Legislature eliminates MVET Backfill Legislature commits to backfill of lost MVET dollars • 2001 Bioterrorism hits the nation, P uts new demands on public health; resources overwhelmed by emergent needs 2002 Bill Governor's proposed budget eliminates backfill for basic public health; no money to prepare Cuts to public health funding put the public at risk: inadequate disease surveillance, insufficient response capacity, no resources for timely disease investigation. We appreciate your ongoing support of local public health! CI Washington State Association III i_- of Local Public I Iealth Officials U ._. - AN AFFILIATE OF V/ WASHINGTON STATE ASSOCIATION OF COUNTIES i`) FEDERAL BIOTERRORISM FUNDING WON'T REPLACE 695 BACKFILL FOR PUBLIC HEALTH Federal Bioterrorism Funding • $2.5 million goes to hospitals, not public health. • Bioterrorism funds are very categorical, not flexible —with specific outcome requirements. • Much of the $17.9 million for public health will be used for improving state-level capacity, such as the state lab. • The guidelines calls for regional plans, not funding for every county and district. Every local health jurisdiction will not receive federal bioterrorism funding. • Federal funds intended to achieve a higher level of preparedness. Backfill funding for Public Health • • $24.5 million loss annually to Local Health Jurisdictions • Represents 30% - 50% of the unrestricted funding in local health jurisdictions. • Much of the backfill supports communicable disease control — the foundation of public health protection. • This funding used to come from cities — the Legislature changed that funding stream to MVET. Reality • Loss of backfill funding ensures our public health system will be less prepared despite new federal funding. • Counties will not be able to provide additional funding for public health. • Taking away the backfill funding will severely damage the foundation of local public health. Building a new floor, such as we must do for bioterrorism preparedness, cannot be done without a strong foundation. S 206 TENTH AVENUE SE, OLYMPIA, WA 98501 TELEPHONE: (360) 753-1886 (360) 753-2842 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.] S • Board of Health New Business Agenda Item # VI. , 3 • Community Health Partnerships And Regional Public Health Service Coordination February 21 , 2002 • J , • Jefferson County Health th'Human Services 7, . 615 SHERIDAN • PORTTOWNSEND,WA 98368 • FAX 360-385-9401 February 13, 2002 Scott Lindquist, MD Bremerton Kitsap Management Team 109 Austin Drive Bremerton, Washington 98312 Dear Dr. Lindquist and Bremerton/Kitsap Health Management Team: Thank you for coming to Jefferson County to discuss possible regional Public Health services last week. It is refreshing in these horrendous fiscal times to talk about providing Public Health with • strength and vision that each of our departments can share. We look forward to further talks. In summary our initial focus will be: • Strengthening our Bioterrorism Regional Response through doing regional medical staff, hospital training and active surveillance. • Viewing our current infrastructures and systems such as program evaluation, billing, tracking as we all try to improve Public Health standards. • New partnerships are necessary for Public Health survival in the state of Washington. Partnership will be strength-based on adequate local fiscal support and trained staff. • New and current programs can be reviewed regionally before contracts are negotiated with DOH, DSHS, etc. We look forward to meeting with you and Clallam County Health and Human Services next week for an in depth review of regional services. With kind regards, Jean Baldwin Larry Fay Community Health Director Environmental Health Director 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 New Business Agenda Item # VI., 4 • Bioterrorism Preparedness Tabletop Exercise - Follow-up Report February 21, 2002 • tittacn. v • Hands-On Training for Introduction: Public Health This learning activity is an Emergencies opportunity to gain skills in how to prepare for an emerging disease Fr-Vi &� outbreak or bioterrorism event through the recognition of related policy needs & issues. You will learn about preparing for such an Washington State Department of Health emergency and about the related Northwest Center for Public Health Practice information/communication needs. Purpose of Exercise Purpose of Exercise • Understand policies needed for a • Recognize the roles of various public large scale Communicable Disease officials in a large CD outbreak or BT (CD) outbreak or bioterrorism (BT) event • event • Identify gaps in local preparedness & • Promote interagency collaboration coordination regarding emergency preparedness • Identify related training/learning needs Instructions to Remember Instructions to Remember • Respond as a group to information • Meeting notes will be kept by a as it emerges note-taker • Maintain your community role • Individual notes should be kept on • Focus on policy issues over specific the lower half of the pages provided procedures • Do not look ahead in the exercise • Use any materials you have • This activity will be followed by a available debriefing • 1 • Storyboard 1--the Setting Storyboard 1--the Setting Cedar County Dogwood County • 150,000 residents • Just north of Cedar County • 1 major city of 40,000 • 35,000 residents • Site of upcoming trade conference • Water recreation and resort area • 2 hospitals • Multiple small water systems • 1 public water supply • Local health department of 25 staff • Local health department of 70 staff Storyboard 1--the Setting Day 1--Friday Gastrointestinal illness strikes: Pine County • Presenting via nurse hotlines, • 15,000 residents private providers, & ER's on • Many Pine County residents work Fl iday .~4-,<W,*" • in Cedar County • Presenting patients tend to be • On the Cedar County water supply middle-aged adults, with about • Local health department of 14 staff 10% > than age 65 • 30 people seen in hospital ER's by late Friday Day 1--Friday Day 1--Friday • Increase in persons presenting with the following symptoms: • Stool samples taken on 6 of cases . Severe diarrhea • Vomiting • 3 people hospitalized for . Fever dehydration or other • Abdominal pain gastrointestinal complications . Chills . Bloody stools . Headache . Nausea • 2 • Day 2--Saturday AM Day 2--Saturday Noon • Patients still being seen in the ER's •The known patient count is up to and urgent care centers 60 •At 10 AM the number of patients • Local health officer decides to exhibiting symptoms is up to 45 convene a meeting around next • Decision made to notify the health steps department • Local pharmacist calls the hospital, •Concerns regarding the capacity of asking what is happening, since her the clinics to handle number of store is almost out of anti-diarrheal patients needing treatment medicine due to heavy demand Day 2--Saturday PM Day 2--Saturday PM • Dogwood and Pine County providers The Cedar Co. Health report many patients complaining of Department begins severe gastrointestinal (GI) problems • .w _. >. rii ery w 9 ase r • At 5 00,PQM 1:19A9 l„pgtier►t c,,o at_,, from all 3 counties is 75 • 16 stool specimens have been taken • 6 people have now been hospitalized Day 2--Saturday PM Day 2--Saturday PM Hospital personnel have confirmed • 5:00 PM--a tour group operator to the news media that a large reports to the health department number of people are being seen that 35 out of 50 group members with some type of"intestinal illness," have become ill with severe but they refer media calls to the diarrhea, vomiting, and nausea health department. • None have sought medical attention • 3 • • Storyboard 2 Day 2--Saturday PM Investigation Results • All tour group members ate at Food service establishments are local restaurants in the area during indicated: the past week • Many restaurants are being •These tourists are non-English identified but no one restaurant is speaking visitors from Southeast standing out (12 in Cedar County, 1 Asia in Dogwood County) • Some cases have not eaten in restaurants in the week prior to their illness Storyboard 2 Storyboard 2 Investigation Results Investigation Results The restaurants & grocery stores: The restaurants & grocery stores: •National chains to upscale dining and •3 restaurants with food handling shopping violations histories • .PtiN"anti bM'lfness a e s & - 4festaurants's eff iil 6 - government officials (Mexican, Asian) •Some are popular with tourists Day 3--Sunday AM Day 3--Sunday AM • Health department personnel Interviews find commonly named continue interviewing cases food items consumed include: • Lab results on patients will be •Fresh salsa available Monday (Day 4) •Pesto • Many ill patients have not eaten at •Pizza a restaurant in the past week •Asian soups *Gourmet salads • 4 • Day 3--Sunday AM Day 3--Sunday PM • Emergency rooms and clinics are •Patient count is up to 250 after a becoming overwhelmed news report on the disease • Medical care facilities are short outbreak staffed because of personnel ill •Report states that the source is not with "gastrointestinal upset" yet determined, but food is • Medical staff are concerned about suspected--particularly fresh herbs potential spread of the illness •Most cases are middle-aged adults within the hospital and urgent care (Age range of cases is 5 to 82 years) clinics Day 3--Sunday PM Day 3--Sunday PM • Extremist group sends message to Early results of diagnostic tests mayor of large city in Cedar indicate that Shigella sonnei is the County ;, ', •.Message=takesFreditffl :� caysat�Ve i��nt. `�-� '. "contaminating the food supply with a bacterial agent" Day 3--Sunday PM Day 3--Sunday PM • Message also threatens to continue contamination unless the Someone from the extremist upcoming economic trade group calls the local conference is canceled newspaper and says she •The Mayor shares the message represents a group who with the County Commissioners, wishes to take credit for Heath Department Director & "making people sick with food Chief of Police contaminated with botulism." • 5 • Day 3--Sunday PM Day 4--Monday AM The Health Officer declares a Health Department phone Public Health Emergency. lines are jammed with concerned callers. Day 4--Monday AM Day 4--Monday AM • Reported patient count is over 400 • 30 cases are restaurant workers • 80% of cases are from Cedar • Affected cases range from age 4 to 87- yews,., twataweeet : • Remainder of cases come from Pine • 30 cases are hospitalized--5 are in and Dogwood counties serious condition Day 4--Monday AM Day 4--Monday AM • State University microbiology laboratory (located in Maple Co.) • Campus security contacts Maple reports to Campus police that County Sheriff several vials of Shigella sonnei are • Maple Co. Sheriff contacts local missing health department (Maple County • Vials were last seen 7 days ago Health) •A few vials from the original batch are still available 11111 6 • Storyboard 3 Storyboard 3 The Terrorist Action The Terrorist Action •A terrorist group stole bacterial •Broth was sprayed onto produce at vials from the State University in a food distribution warehouse in Maple County Cedar County over a 2 day period •An infectious broth was produced •Contaminated produce was used in with the stolen vials of Shigella restaurants & bought directly in sonnei grocery stores Day 4--Monday PM Day 4--Monday PM Business at area food News media from other states • establishments has decreasedare calling various county ,significantlyvtax officials:for rnterview or information. Day 4--Monday PM Day 4--Monday PM Cedar County Health An elderly woman (86 years old) Department is re-interviewing dies from complications resulting cases and working closely from Shigellosis. Her family with restaurants to identify threatens a lawsuit against the common ingredients. "responsible agency." Indications are cilantro and basil as the most likely contaminated products. • 7 • Day 14, Friday-- Day 14, Friday-- Recovery period Recovery period • Nothing more is heard from extremists • People still call about food safety • No other new cases attributed to and are concerned by cases the identified food source in the continuing to occur past 7 days • The trade conference is • Secondary cases continue to scheduled to be held 1 week occur including 3 daycare from today outbreaks Discussion Discussion •Strategies to prevent/control • Evaluation of incident response system for management of a CD or outbreaks or bioterrorism BT event threats (4104e.red.a ta concts • to ra'supuIcre e . Strengths &challenges of response •Interactions between affected .Gaps in policy or training agencies .Gaps in communication planning .Gaps in information management systems For More Information •Julie Wicklund, Bioterrorism Surveillance Coordinator- Washington State Department of Health (206)361-2881; iulie.wicklund@doh.wa.00v •Greg Smith, WEDSS Development Director- Washington State Department of Health (206)361-2924; areg.smith©doh.wa.gov • 8 • Board of Health Media Report • February 21, 2002 • i 1 r`. Jefferson County Assessment Highlights Fact Sheet 0 February, 2002 Birth/Maternal Child Health Indicators Jefferson WA State • Births to Unmarried Mothers, 2000 42% 28% • Medicaid paid delivery, 2000 62.3% 33.5% • Medicaid paid delivery, 1999 54.5% 32.5% • AFDC/TANF Participants, 2000 1.4% 3.2% • Low Birthweight rate (1996-2000) 5.1% 5.8% • Non-Smoking Mothers, 2000 73.2% 86.5% E" • First Trimester Prenatal care, 2000 77.3% 82.6% • First Trimester Prenatal care, 1998 87.1% 83.0% Comments: W.1 • In 2000, births to unmarried mothers accounted for 42% (87) of all births • In 2000, 62.3% (127) of all Jefferson County births were funded through Medicaid. This is a 7.8% (12) increase from the 1999 total of 54.5% W • Jefferson County Medicaid paid deliveries has been greater than 45% during all years 1992-2000 • Jefferson County participation in AFDC/TANF programs has continued to drop from the 1992 14.2% (33) to the 2000 total of 1.4% (3) • Mothers who smoked during pregnancy gave birth to low birthweight babies at a rate greater than twice that of non-smoking mothers; 8.6% and 3.6% respectively for 1996-2000 CA • In 2000, 73.2% (153) of mothers reported not smoking during pregnancy • In 2000, 77.3% (160) of mothers reported beginning prenatal care in the first trimester; in 1998, 87.1% (171) of mothers reported beginning prenatal care in the first trimester Hospital of Delivery Indicators 2000-211 Total Births/127 Medicaid Paid deliveries % all births % Medicaid • Jefferson General Hospital, 2000 63.6% 62.2% • Home/Midwife-attended births, 2000 11.8% 12.6% CIIII) • Harrison Memorial Hospital, 2000 7.6% 7.9% • Olympic Memorial Hospital, 2000 6.6% 4.7% • King County Hospitals, 2000 5.7% 6.3% 1999-220 Total Births/115 Medicaid Paid deliveries • Jefferson General Hospital, 1999 66% 72.2% • Home/Midwife-attended births, 1999 5.5% 4.3% PIT* • Harrison Memorial Hospital, 1999 12.3% 12.2% • Olympic Memorial Hospital, 1999 4.5% 3.5% • King County Hospitals, 1999 6.8% 4.3% Comments • In 1999 and 2000, Jefferson General Hospital delivered over half of the births born to resident IImothers; greater than 50% of these births were paid for through Medicaid. • Home/Midwife-attended deliveries increased significantly from 1999 to 2000. s • • • Socio-Economic Indicators Jefferson WA State • • Estimated Median Household Income, 2001 $38, 826 $50,182 • Estimated Median Household Income, 2000 $34,662 $50,152 • Estimated Median Household Income, 1999 $33,446 $48,289 • Median House Sales Prices, 2001 (third quarter/not year-end) $174,400 $183,200 • Median House Sales Prices, 2000 $174,700 $176,900 • Housing Affordability, 2001 (third quarter/not year-end) 90.8 123.2 • Housing Affordability, 2000 78.1 108.4 • First-time Home-buyer Affordability index, 2001 53.6 74.7 Comments: • $38,826 was the 2001 (third quarter/not year-end) Jefferson County median household income compared to $50,182 in Washington State • Jefferson County households earned an estimated 23% less than Washington State households, but housing costs were roughly the same. $174,400 was the median house sale price in Jefferson County at the end of September 2001, nearly equal to the Washington State average $183,200 • Housing Affordability indices point to economic disparities often encountered by first time home buyers, most often young families, who are unable to afford to purchase homes in the county. IPPopulation Indicators Jefferson WA State • Growth Rate, 1999-2001 1.7% 2.5% • Population Age 65+ 2001 20.9% 11.2% • Population Age 85+ 2001 2.2% 1.5% • Median Age, 2001 47.3 35.6 • Median Age, 2000 47.1 35.4 Comments: • The county's growth rate seems to have slowed and is now below that of the state • Jefferson County population age 65+ is nearly twice that of the state • Jefferson County population age 85+ is one and one-half times that of the state _PA 0 J 4y'/ • Provider Newsletter Jefferson County Health & Human Services 615 Sheridan Street , Port Townsend , Washington 98368 Phone : 360 - 385 - 9400 Fax : 360 - 385 - 9401 February 2002 Money, Money, Money. . . I Inside this issue: We all thought we were going into Health Care professions to increase healthy outcomes for individuals and communities. We thought we were going to make a Data Steering 2 Committee difference in the lives of individuals. Increasingly, all of us in Health Care are spending more and more time watching the bottom line and the accelerating changes Jefferson County 2 of community needs. Unfortunately, recent changes in the Health Department will works on Bioterrorism have an impact on some of your practices. The repeated passage of initiatives has Preparedness taken a large toll from the Health Department, as a publicly funded government Behavioral Risk 3 agency. Factor Survey Yes, we are still here and yes, we will continue to strive for improvement in our System proficiency of communicable disease and communicable disease reporting. Some of Hear and Say 3 the changes will include bioterrorism training with the hospital and the Emergency Reading Method Management Teams will continue throughout this year. With the University of Washington School of Nursing we will continue Mental Pregnancy Risk 4 Health Screening, the Dr. David Olds Home Visits, and Childcare Center Assessment Assessment that identifies children with mental health issues. The Jefferson County Commissioners' budget for 2002 could no longer support I some of our services due to a declining county revenues. The changes you will see will include: • We will no longer be doing community flu clinics in the fall. We currently see approximately 1,400 people and have a large web of volunteers. Some people will be choose to go to Costco, QFC, pharmacies, Safeway, others will appear at your practices,requesting this important vaccine. • We will be decreasing our walk-in Immunization Clinic to two days a week — Tuesday and Thursday afternoons • That will only allow us to do PPD 113 testing on Tuesday. 1'13 testing is required for people going into drug and alcohol treatment, childcare workers, and others. We have also finished our 1'13 protocols, and are willing to share those with any of you who are interested • We will no longer be providing HIV counseling and testing in the jail. • Family Planning Clinic has continued to grow and expand in client demand. • JCHHS will continue to have Family Planning Clinic in Quilcene one day a week and four days a week in Port Townsend. • Monday will no longer be open for Port Townsend Family Planning clinic services • Port Hadlock Clinic has closed. • Emergency Contraception will be available five days a week during business hours. Hopefully you and • local pharmacies also can provide Emergency Contraception. • JCHHS will no longer be able to see walk-ins complaining of communicable diseases. Continued on Page 3 a Page 2 Data Steering Committee ,,, • The purpose of the Behavioral Risk Factor issues, substance abuse Data Steering Survey System (BRFSS), and family violence. Committee is to identify Prenatal Risk Assess- Jefferson County also health outcomes and ment (PRAMS), arrest is home to a significant problems. Committee records and ER data proportion of 65+ membership includes from Jefferson General residents. Many of representation from city and Harrison Hospital. these issues that have ' * ,' i and county government, In General Jefferson multiple spectrum `��g w citizens, O l y m p i c County is a healthy impact will become ": Community Action county with few more clear as we final- 1 z: Program and JGH, individual health ire our work with WSU and courts. Under outcomes that are BRFSS, census and the guidance of Dr. problems. PRAMS. Chris Hale, the Preliminary health Please contact Jean Bald- committee is looking at outcomes that appear to win at 385-9408 ifyou are county and regional data, cross all age spectrums interested in more information vital statistics, Census, include: mental health and if you would like to be more actively involved, or watch www.coJefferson.wa.us Jefferson County Works on Bioterrorism Preparedness • On January 30th a Bioterrorism Fire Districts, Red Cross, OIyCAP, responders to better coordinate Preparedness Tabletop Exercise, P.T. School District, Port Town- services and determine sponsored and facilitated by the send Paper,Navy Fire District. additional training needs. Washington State Department The goal of the exercise was to The participants are now of Health, was held at Jefferson help participants to identify the being asked to help prioritize General Hospital. The exercise communication, resources, data, the preparedness gaps that were was well attended by staff from coordination, and organizational identified and discuss possible many agencies including: JGH, elements associated with a solutions. Next steps will JCHHS, EMS, City and County biological emergency response. include medical and EMS Law Enforcement, County Identifying gaps in local training. Emergency Operations Center, preparedness, allows community Behavioral Risk Factor Survey System The BRFSS was concluded in December 2001. 600 quality. The BRFSS analysis will be available in Jefferson County adults voluntarily responded to all March 2002. Dr. Chris Hale, epidemiologist and or part of the following modules: health status, demographer, will be working with our staff to health care coverage, health care access, blood pres- interpret the results. The information will first be sure, diabetes, tobacco use, alcohol use, firearms and shared with the Data Steering Committee. safety, demographics, impairments, cancer screening, domestic violence/sexual assault history, For more information, or to be included in the mailings, • environmental health concerns—air and water please contact Jean Baldwin at 385-9408. • Page 3 Hear & Say Reading Method University of Washington cohorts receive one of three methods for teaching researcher, Dr. Colleen Hear and Say reading: ' P=1 Huebner, with the support of • Through small group instruction, the Jefferson County Health • Through a videotape and phone support, or & Human Services,is bringing • Through videotape alone a reading program to all The study will measure which methods were parents of two-year-olds in most effective in delivering the parent-child Jefferson County. Parents reading instruction and enhancing children's who learn the Hear and Say expressive language development. All families will Reading Method can expect enhanced language receive a video and Children's Book. The literature acquisition for their child, and children who participate shows this is an exciting way to impact school in this reading program typically start school ready to success. learn to read. Classes are at Jefferson County Library, PT Dr. Huebner brings the program to all eligible Library, Child Care Centers. county participants without cost. Her research projects will attempt to determine the best way to For additional information on the project, or to participate, deliver the program to parents. Three different parent contact the project at 360-379-4471. • Money, Money, Money Continued from Page 1 This includes spider bites, rashes, wounds, a provider. If others are interested in this • scabies and head lice. JCHHS will be an federal program, please contact Julia Danskin informational source for things such as head at 385-9420. Women between 40-60 are lice and scabies, and maintain handouts for not appropriate in Family Planning Clinic home treatment. We will also continue to because often times they have other primary work with school volunteers at the begin- care needs. ning of every school year and screen all Other decreases in services that you may notice will be a significant drop in our caseload of families classrooms. The success of doing all the head lice checks for buildings has decreased involved with Child Protective Services. We intensity of outbreaks and the problem of currently serve families with problems which have school closures. become issues of abuse and neglect. We are also decreasing the number of women Maternity Support and Home visiting is in its third • we see for Breast and Cervical Cancer screen- year of the Dr. David Olds study with the University of Washington and the University of Colorado. We g will continue to serve 40 clients a month and we • JCHHS has seen 58 women a year. The anticipate having the same outcomes as Dr. Olds payments have increased in this program and so has the ability to do referrals and over the last 20 years. • obtain payment for positive cancer findings. Ellen Phillips, a private provider in Port Hadlock,is seeing BCHP. Marilee Mount is (Call for research articlesif interested). Pregnancy Risk Assessment Initiative Page 4 I In maternity support programs, client issues, such as adverse effects of tobacco and III anecdotes reveal rich and complex histories of alcohol;benefits of folic acid;and risks of HIV domestic violence, substance abuse and families The Jefferson County Pregnancy Assessment will living in poverty. Research tells us that without be modeled after the Centers for Disease Control intervention, these problems follow families, PRAMS (Prenatal Risk Assessment Monitoring impacting community, school, and law and justice Survey). JCHHS is fortunate to have a partnership systems. with the Washington State Department of Health Jefferson County Health & Human Services is PRAMS Unit. undertaking a Pregnancy Risk Assessment Thirty-two states partner with the CDC to conduct Initiative. The purpose of this initiative is to PRAMS. Since 1987,PRAMS data has been utilized to survey all Jefferson County mothers who give identify pregnancy risk and community outcomes. birth in 2002. Topical areas covered in this President Clinton utilized PRAMS to identify the need assessment will include: for longer postpartum hospitalization. PRAMS data • Attitudes and feelings about the most recent has also been used to identify problems with substance pregnancy abuse and health care access. • Content and source of prenatal care The Data Steering Committee recommended that • Maternal alcohol and tobacco consumption JCHHS explore use of a PRAMS-like survey. As a • Physical abuse before and during pregnancyresult of the recommendation, JCHHS has obtained • Pregnancy related morbidity permission from the CDC and Washington State Department of Health to conduct a PRAMS-like • Infant health care initiative that will survey all 2002 birth mothers in • Maternal living conditions Jefferson County. Detailed information will be • Mother's knowledge of pregnancy-related health available in the near future. 410 Jefferson County Health & Human Services 615 Sheridan Street Port Townsend, Washington 98368 1 I 1 I i 1 1 I i i 1 Ill i 1 i I Depression Screening • The incidence of major depression screens positive we talk about self-care, reviewed with the clinician during in pregnancy and in the first year after discuss medication as a possible the visit. Items 4, 8, 12, and 16 are birth is 10-20%. Factors such as option, refer her to her primary scored in reverse. A total score of inadequate support, previous provider, and also to Jefferson Mental 16 indicates the probability of depression, low income, and Health. We offer to send a copy of the major depression. Item 11 needs to unresolved loss/trauma increase the completed CES-D to her provider but be clarified with pregnant and risk of a major depressive episode. some women do not want us to do mothering women. If a woman's Women often do not look or act this. If a woman appears in acute crisis sleep is restless because of her baby depressed, as they may feel ashamed or is suicidal we use Jefferson Mental or pregnancy discomforts it is not or afraid to admit to how badly they Health's crisis line and the emergency scored positive. are feeling. Research has shown that room if needed to access immediate An excellent resource for the baby's behavior and development care. Some women are ready to treat women who like to read is the book are affected when women experienc- their depression but even the women "Women's Moods" by Deborah ing major depression are not treated. who are not ready benefit from the Sichel, MD.. and Jeanne Watson We use the Center for Epidemiol- education. The women who qualify for Driscoll, MS.. R.N. This book is ogical Studies Depression (CES-D) Maternity Case Management will be very readable and explains the screening tool to screen all pregnant followed until their baby is 1 year old. complex interplay between genetic and postpartum women who are part As trust builds within this longer influences, life events, hormones, of our Maternity Support Services and relationship the woman might feel brain chemistry, and women's Maternity Case Management. The more able to accept her depression and moods. It explores the options of CES-D's accuracy in recognizing seek treatment. This also allows us to counseling, self-care, a n d major depression in the general adult be alert for later onset post-partum medication. It is available locally. population is well supported by depression. Some women are more For any further questions please research. This tool has been simple to receptive to medication and/or coun- call Quen Zorrah 385-9424 or Carol use and score. Our clients have seling after a repeat screen. Hardy 385-9419. • responded well to being educated and This tool can be given to the screened for depression. If a woman woman in the waiting room and CES — D Center for Epidemiologic Studies Depression Instructions for Questions: Below is a list of the ways you might have felt or behaved. Please tell me how often you have felt this way during the past week: rarely or none of the time (less than one day);some or a little of the time(1 —2 days); occasionally or a moderate amount of time (3—4 days);most or all of the time (5—7 days). During the Past Week: 1. I was bothered by things that don't bother me. 0 1 2 3 2. I did not feel like eating;my appetite was poor. 0 1 2 3 3. I felt that I could not shake off the blues,even with help 0 1 2 3 from my family and friends. 4. I felt that I was just as good as other people. 0 1 2 3 5. I had trouble keeping my mind on what I was doing. 0 1 2 3 6. I felt depressed. 0 1 2 3 7. I felt that everything I did was an effort. 0 1 2 3 8. I felt hopeful about the future. 0 1 2 3 9. I thought my life had been a failure. 0 1 2 3 10. I felt fearful. 0 1 2 3 11. My sleep was restless. 0 1 2 3 12. I was happy. 0 1 2 3 13. I talked less than usual. 0 1 3 14. I felt lonely. 0 1 2 3 15. People were unfriendly. 0 1 2 3 16. I enjoyed life. 0 1 2 3 • 17. I had crying spells. 0 1 2 3 18. I felt sad. 0 1 2 3 19. I felt that people dislike me. 0 1 2 3 20. I could not get"going". 0 1 2 3 . • a , ° Breastfeeding Tea Party 0. The breastfeeding tea party The group is ongoing and has unpredictable how many folks occurs every Wednesday from moms of varying ages (17 to 40s) might be there. There have been 1:30 to 3:00 pm at the Health and frequently has babies of vary- as few as two and as many as 44 Department. All new ing ages also. Becoming a mom is moms and babies with an breastfeeding mothers and their the thread that ties these moms of occasionalgrandmother and or babies are welcome. This is a differing ages, backgrounds and toddler sibling. lightly structured, supportive group experiences together. Often Written resources for moms to for moms to talk about the joys moms begin coming to the group read and take home are on safety, and lack of joys involved in when their infant is less than a child development, depression, breastfeeding their new child. The month old and frequently continue feeding, birth control, parenting most frequent topics that come up regular attendance until the baby is tips, violence prevention, anger in the group include: sleep, (usually somewhere between 6 months and and different aspects of breast- the lack of), stooling patterns, 12 months of age. As the infant feeding. We respond to different feeding styles, becomes more active and interests that might surface within i i n fan t c u e s, explorative and the mother the group. j postpartum becomes more adjusted to life with Our latest group arranged for .b ' , changes, feelings baby, often the frequency with Linda Pfaffman, the car seat safety ty' about the birth which the mom attends the group person, to come show moms how ' e x p e r i e n c e , decreases. Usually by the time the to safely put their car seat in and '' , postpartum blues, infant is a year old the mom and she also checked individual car seat p o s t p a r t u m baby have stopped attending the placements . depression, issues with partner, Breastfeeding Tea Party although The tea party has been ongoing • issues with relatives, going back to they will often stop by once every at the Health Department for over work, what to eat and drink while couple of months until the baby 7 years and is facilitated by breastfeeding, sore nipples, ductal reaches around 18 months or 2 Carol Hardy,MA,LM,IBCLC. yeast, mastitis, birth control and years just to check in. the general process of life with The group is free and is on a If you have any questions send e-mail baby. drop in basis therefore it is quite to: chardy@cojfferson.iva.us 40$4 "Monday Movies for Moms at the Rose" rig 'k', The new group of Breastfeeding Tea Moms has .-">° , c_ instigated a timefor mothers to bring their babies and some- t �. g a ( " one to help with the baby) to watch a movie. There is an • t "' `` e-mail list by which they share the movie information weekly �.. -. . ! t versk ,�' �. x r 7. ` /. �.. #a 4 with the folks who are on the list. For those moms who do -stow:�� •.-- � � ` ;,,, not have e-mail there is also a telephone list. '.. , �f �`��'`,. —' • Any mom and baby are welcome to attend the movies. $' '+il`ii�` `�„ II . '"" There is a minimum number of attendees in order for Rockie f �, to show the film so moms who want to participate need to call Sylvia Platt at 385-9645 or e-mail Caroline Proffer at ioprofers@olympus.net. • Jefferson County Health and Human Services JANUARY — FEBRUARY 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 programs for the public: 1. "Food worker classes change in February", P.T. LEADER, January 16, 2002 2. "Jefferson: Old, damaged child car seats cashed in", Peninsula Daily News, January 22. 2002. 3. "Local Governments brace for knockout budget punches", Peninsula Daily News, January 20, 2002 4. "Jefferson appeals well-monitoring ruling", Peninsula Daily News, January 23, 2002 5. "County budgets for capital facilities", P.T. LEADER, January 23, 2002 6. "Trimmed county budget means service cuts", P.T. LEADER, January 30, 2002 7. "Seawater intrusion input sought by county",P.T. LEADER, January 30, 2002 8. "County faces water well action plan",Peninsula Daily News, February 5, 2002 9. "Seawater intrusion issue seeps from island to county", P.T. LEADER, February 6, 2002 10. "Budget shortfall may harm state bio-terrorism defense", Peninsula Daily News, February 11, 2002 11. "County `exempts' terrorism emergency management plans",P.T. LEADER, February 13, 2002 • I • ,. ,.(y.:.‘.. ik 4itr .. rii ,• G nMJ a� y a r , " at"a , ct,,z4414:,,i7:_,,,!,:::,.'-.. .%gr,:._....,-.4^,y,,."!,:_- ,:l.,-,-1-.4-..,,"1--,2:vP-1/4.-apol,L,•,;;;,z..e.,„,,.,,41:0;ricay.,,--,:.;:-'44if- f'li,-4,-','',4,'J. 3 c ,e[14 3'� `4 .-- L�p 4 ill 4 '.}' ,4 0 i ,O -_ sus ' ,-.)1,;4i?,,,!..,::!-*u ' • .} - -101,4,V"".... t ak.,4,,, '•s.. s a•a poi' ,,'�X, i y 6 v n ..go o ua + }+' 9 x ka 3?....-11-4-: of o.�/,t AS'- +s a•.114.:,... ." ` § ' r y` + 4'r P✓„e .:e� Elft . ,. a :9�* : i�, , ,`I 3 ,i{r� di e'�!83 . T 5?0 F' B-"'F,a., 2 , 7 f inti r i:;::, a t a3 a'. ''`''''is -s' t � ,K*.,. �• t41 x pl_ a4d Human Acle to let iF C�ases 4!� _ 1Px° a � r 4o t i+ s' }lliMitit, as 1,. ..._•,_ :..„ ,„ :„.,,''; a '1.11'' 1...;;Ii ai 1 e t`a 1 ails iaf .0 a €® •k .� R 3 St# l a hi • -'4.,"--4-W:•;.,.,; -',1..: ^s + , t rill of h IticiiiO4. t`�d.,y 7i vojef7.R4 • �3tm $t T ,*0,00.0 0lies „..P1.,,-0.0,4::::: ( i 385944.4az o 1is3t s�. 5 r r: + man ®t'� 1: i } e .=:'I''''''''''''4''' (rtti !-',',:::.:fl.lai s sew• 7�, r t tha1Oi ( y 4 a :h+:, } �A red a• - A ';0:6;:',9: n ; 1 ` iYA# e ai` y3,a x 01f' :40ft' -i itl Polit$4 v^ i r y, 3.” ` / OE e_ 1- t -O 2-- . 0 Qu�ckReadY Jefferson: Old, damaged child car seats cashed in The AAA is offering a $5 reward to those who turn in old, used and damaged chil- dren's car seats and booster seats. Seats can be dropped off at the'Jefferson County Sheriff's Office, 81 Elkins Road, Port Hadlock, or at the Washington State Patrol office, 62 Old Olympic Highway, Port Angeles. A seat is considered no longer safe if it has already protected a child in a car crash, if it is more than six years old, if it is miss- ing parts and pieces that cannot be replrbced by the manufacturer, or if it is listed on the recall/defect list. The reward program continues through Jan. 31. PENINSULA DAILY NEWS '- )-0--b d^ I • Localgovernments brace for knockout budget punches . BY PAUL QUEARY ernments adjust to a major THE ASSOCIATED PRESS tax revenue change,"said OLYMPIA—With six Ed Penhale,a spokesman deputies to help him patrol for Locke's Office of Man 800 square miles,Garfield agement and Budget. "It's tough on these local govern County Sheriff Larry Bowles says he already runs ments,but it's not some a lean operation. thing that was ever Dispatchers double as intended as a permanent. matrons in the rural We're dealing with a$1.25 county's six-person jail,and billion budget problem. sometimes at night there's Something had to go." nobody patrolling the Senate Ways and Means' county's lonely roads,just a Chairwoman Lisa Brown deputy on call. doesn't hold out much hope But soon his skinny for its restoration as law operation could become a makers alter Locke's pro- skeleton,victim of a pro- posal. ' posal to eliminate millions "We can't share revenue in state aid for local govern- if we don't have it,"said ments. Brown,D-Spokane,who "It could be really devas- hopes to preserve some • tating to us,and it could be money for the smallest gov- devastating to the people of ernments. "That's just the our county,"Bowles said. way it is." Before Initiative 695 passed in 1999,some of the No room to adjust motor vehicle excise tax it abolished was kicked back Many of the smallest to local governments— local governments don't especially those with tax have room to adjust. bases too small to support But counties may have themselves.Although I-695 an even tougher time cop- was tossed out by the ing with decreased state courts,lawmakers bowed to support,said Bill Vogler, the voters'will and repealed executive director of the the hated car-tab tax. Washington State Associa- But with the economy tion of Counties. booming and state coffers Counties lost 47 percent fat,the Legislature didn't of their state support when leave local governments to lawmakers repealed the car- suffer the full conse- tab tax.Now they stand to quences.Instead,they lose the rest. approved a new subsidy "The combined cost to known as"695 backfill," the counties is nearly$50 restoring some of the loss. In Garfield County,that million a year,in the two money makes up about 40 that we are charged percent of the total budget. by state law to provide— Now fast-forward to public safety and public today.The state budget is in health for the citizens," . the tank along with the Vogler said. broader economy. Gov. Gary Counties were already Locke and the budget-writ- hurting from the same ers in the Legislature are economy-related dip in tax 410looking for ways to erase revenues that's causing the more than$1 billion in red state's problems.And they ink.And the$84.6 million expect to lose an additional in backfill money for fiscal $20 million in potential rev- 2003 is gone in Locke's pro- enue to the property tax posed budget. limit imposed when voters "The 695 funding was approved Initiative 747 last intended to help local gov- year,Vogler said. 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UaU id U 5O al O >,• _,QQ ., a) c y+,d 4'*'> E 0 � ,OC) -~ 0 o,-, �" N O „., 0 q Cl) 75 0 70 �/ in V] Q 6 —o gym'0 Z-DGn'” -� c, E • w V] m o E q o a a. 0cr-o o � roa) a) Et o_i '' 0 4E >)-. .,. 1 " O 2 g ro w c. cn acn z a0-roro - 0 v •� on w a 50 �� 0 •� 00 p. c-, o c, a >, C7 W v U 44 4111 • Coun bud ets for capltal facilities• By Shelly Testerman panic cell, and $36,000 for expanding evi- the county's monthly payments will not Leader Staff Writer dence storage. change substantially with the purchase, but Plans for a $13 million law and justice annual payments of$180,000 will be going Jefferson County government's $38.2 center housing courts,prosecutors and clerks toward eventual ownership,not rent.i' rJ2, million 2002 budget, adopted last Dec. 27, have been placed on hold, with no money $265,000 is budgeted for remodeling the fa- aims to move key capital projects forward. budgeted in 2002 for further design or con- cilities, which currently house the depart- The single biggest item in the county's$2.1 struction. "This project is of the scale that ments of Community Development and million capital facilities budget is $1.5 mil- can only be funded through a voter-approved Health and Human Services. lion for relocation and expansion of the levy,"County Administrator Charles Saddler One county department will be relocat- Jefferson County Sheriff's Office adminis- wrote in a Nov.21 budget memo. ing due to budget constraints.District Court's tration, E-911 dispatch and the emergency Improvements to the courthouse facility adult probation department —currently co- operations center. total $178,000, with $143,000 for seismic housed with Superior's Court's corrections According to Sheriff Pete Piccini, the retrofitting and $14,000 for resurfacing the department in Port Hadlock—will be mov- space currently occupied by the sheriff's parking areas. No money was specifically ing to the county courthouse in March.The administration will likely be used by dis- earmarked for clocktower renovations, but department will save a total of$53,000 in • patch, which is now housed within the jail. Saddler said if a$2.5 million state grant is 2002 by eliminating rent payments and one Dispatch's vacated space can then be filled awarded; the county will have to come up unfilled administrative position. Rowe has by emergency operations, and the sheriff's with a $1 million match that has not been recommended relocating the department to administration, including Piccini's office, budgeted. the new sheriff's administrative facility, but will be moved to a new building. The county is currently negotiating for the until it is constructed,housing probation staff Other major projects at the sheriff'/cor- purchase of the facilities it has leased for the in the space currently occupied by the rections facility in Port Hadlock include last decade at Castle Hill,adjacent to the Port assessor's mapping department. $25,000 for replacement of 10 toilets in the Townsend Quality Foods Center.According Next week: Changes in county services county jail, $35,500 for padding the jail's to Deputy CountyAdministrator Gary Rowe, due to 2002 budget cuts. LEADER, t- -3 -b 2 • • a -o v w o .g 0 a) ,) F, b u> ti T" v y ark ars .RI 1,,i#,' E,-.,; R* .• s 3z N 0aP VV) >, Nw G .0ct ' c cV... d , G N O .N C : . NCO „ r) 'b c70 CO > aE U E g o ) ' „limei. • O `" C ca O '� � C .� NO U. E " 4. C E al m ° 0 .T O °� en r + a' = 0 v � > W r �" ay F .176: vT o :4: F° > dUC " vF ° aai . a wQ00b ° br , 'a 0 o . „ c4 . .c liii ° a4ffl : Idilh1I C a;a .' c 11UiiI. 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N 0 cd o. a.... dN . ,d .0 7 • Seawater intrusion input soughty cOunty By Barney Burke on his own initiative and had not means that Jefferson County has Leader Staff Writer been directed to do so by the jurisdiction beyond its bound- Board of Commissioners. aries if an aquifer extends to The Jefferson County Board Alvarez said that while the those locations. of Commissioners has scheduled county would like the decision The motion also questions a hearing for 2 p.m. Monday, overturned,he didn't see that as whether the county can limit the Feb.4,to solicit input on options a likely outcome of the motion. number of wells allowed when for complying with a state deci- Rather,he explained,the county state law requires that building sion regarding seawater intrusion feels that the decision raises permit applicants must have a and the county's Unified Devel- questions that need to be an- source of potable water.Outside opment Code(UDC). swered before amending the of the city's service area, water Jan. 10, the Western Wash- UDC to comply with the deci- is usually supplied by wells,in- ington Growth Management sion. eluding individual wells, wells Hearings Board upheld an ap- If the county decides to appeal serving several properties in a de- • peal from the Olympic Envi- the decision,it would have to file velopment, and larger well sys- ronmental Council and the a separate motion in Superior tems operated by Public Utility Shine Community Action Court. District No. 1. Council. The county had ar- Alvarez's motion for recon- Christiansen stressed that the gued that it had no authority to sideration says that the growth primary goal of the motion to regulate wells,but the hearings board's decision contains items reconsider is to seek clarification. board disagreed. that are either "misinterpreta- "We do intend to comply" with Now,the county has 180 days tions"of the law or"clerical mis- the order,Christiansen said. to either appeal the decision or takes." Only the Department of Colette Kostelec,the engineer comply,and David Christiansen, Ecology(DOE),not the county, who represented the appellants, the county's manager of natural has the authority to regulate the could not be reached for corn- resources,says three options for consumption of well water, his ment Monday. Last week, she complying with the order have motion states. said she was preparing a response been developed. Among other things,the mo- to the county's motion to recon- Christiansen said one option tion asks whether the decision sider. is to comply using the staff and resources already available to deal with the issue. A second option would be to either cut an- other county program to free up resources or develop a new rev- enue such as a water manage- ment district. The county could also look beyond the issue of wells and include the taking of . _ surface water;that would involve - Le-MD _ significantly more time and • money,he said. c f_ 3d_ U 2 Meanwhile, Chief Civil 1 Deputy Prosecuting Attorney 1 David Alvarez has filed a motion for reconsideration of the order. 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C . 0 d [ cd> y a cd . da s . oowa .da o > P., . o � 0)-° I)411) 0 � OO • pn o � Co�" O Od vkt cn > w a> Oa ,,y 0aO '' • mo c2 = 4.0 10 0 0 CZ (1.1) Q.) •,--i s-, 4as Uaiy � a> 0otiadio `d CM) CZ 4--) s... o• a Cr) ma. -253. c. aa.zi . U> c, 3 intrusion q Seawater issue seeps• from to county By Philip L.Watness Management Hearings Board. "And,given the political climate Leader Staff Writer Christensen offered three op- "These oin. Jefferson County, these op- tions to comply with the board's options tions will also anger groundwa- Jefferson County could spend January order that Jefferson will also anger ter activists and the growth as much as$300,000 per year to County establish a monitoring management board — because comply with a state board's rul- program to ensure that ground- groundwater they are likely to fail." ing to monitor seawater intrusion water near shorelines isn't con- Kepner encouraged the com- in private wells. taminated by saltwater. activists qnd the missioners to first admit that the That's a rough estimate pre- The first option — and least g rowth county has a problem with sented Monday to the county costly—places the burden on the groundwater quality; educate commissioners by county water property owner to prove that his management themselves, staff and residents resources specialist David well isn't susceptible to seawa- concerning the complexity of the Christensen in what some resi- ter intrusion or will not affect board— because issues;then utilize volunteers to dents have called a"draconian" adjacent wells. The Jeffersonscreen wells but turn to profes- response to the recent ruling of County Public Utility District they are likely to sionals in hot spots indicated by the Western Washington Growth would monitor wells within fahigh levels of chloride in wells. Critical Seawater Intrusion Ar- fail." Colette Kostelec of Port eas, defined as wells reaching Townsend represented the sue- below sea level within one-quar- Rita Kepner cessful effort of the Olympic ter mile of shorelines. resident Environmental Council and "No development would be al- Marrowstone Island Shine Community Action Com- lowed that increased seawater in-, - rnittee to convince the state hear- trusion or had•the'potential to - ings board-that the county had cause increased seawater intrusion use to Jefferson County. The failed to provide adequate safe- for adjacent wells,"Christensen county would impose mandatory guards for drinking water. She wrote in his briefing paper. water conservation measures in said the three options represented The second option would re- Critical Seawater Intrusion Zones. a good-faith effort to comply quire property owners to install Christensen estimated that with the board's order, but she • flow meters on wells located in ar- Option 2 would cost the county hadn't had time to review them eas highly vulnerable to seawater $100,000 per year in staffing and in detail, having received- intrusion—Critical Seawater In- monitoring costs. Christensen's briefing paper at trusion Zones—defined as those In the third,most costly op- Monday's workshop. areas with high chloride readings tion, Jefferson County would "The burden is on the county within one-quarter mile of shore- manage water resources with a to comply with the hearings lines, and to provide annual re- protection strategy concerning board, and we'll certainly look ports regarding water quality and seawater intrusion as well as over the options,"Kostelec said. other potential impacts on water "We'll argue that they're in corn- quality. Option 3 would essen- pliance or not[before the board]. tially mean that the county would We'd like to be optimistic that take over the responsibility for compliance can be achieved and water use and rights from Wash- we can move forward" ington state agencies such as Christensen and county long- Department of Health and De- range planner Josh Peters will partment of Ecology. meet this afternoon in Olympia The county would regulate and with representatives of the state monitor all water utilization—both departments of Health and Ecol- withdrawals and uses.This could ogy to discuss the ramifications mean establishing minimum lot of the hearings board order. sizes based on the rate an aquifer "We need to clarify conflicting would be recharged.Restrictions statements of who has the legal on water use could be imposed in authority over water rights," any area where water use could Christensen said. The hearings impact water quality, including board decision"is causing a lot of seawater intrusion, in-stream discussion.We hope to get agree- flows, fish habitat and surface ment from Health and Ecology water quality. where the lines of authority are" The county commissioners County Commissioner Rich- discussed Christensen's three ard Wojt offered a fourth option: options Monday but didn't settle a mediated discussion among the on a preference. They did hear litigants,other affected residents from half a dozen residents,sev- and the county. eral of whom encouraged them Kostelec said that could have • to use volunteers in addressing been achieved before the Olym- the state board's order. pic Environmental Council and (Pr LEAD Rita Kepner of Marrowstone Shine Community Action Com- Island�T!/ Island said she favored none of mittee went to the hearings ��JJ f b the three options. board, but the county decided t7C' =0 2- The options "will result in against further negotiations when angering fearful people who op- she proposed having a mediator pose regulation," Kepner said. at the table. I0 • Budget shortfall may harm state bio-terrorism defense Health officials say $20 million,and some will go to Locke spokesman Pearse <' local health districts and hospi- Edwards said."The 695 backfill there's no money tals. money was temporary' and t0 deal with threats But it won't replace all they never intended as a long-term stand to lose. solution." THE ASSOCIATED PRESS Patrick Libbey, president of "I think the committee is the National Association of well aware of the problem," OLYMPIA — Public-health County and City Health Offi- Committee Chairwoman Eileen officials say Washington state's cials, said he expects the state Cody,D-Seattle, told the health budget shortfall could threaten to lose as much as half its dis- officials. its first line of defense against a ease-response capability "But as you know, we also bioterrorism attack or outbreak because of the cuts. are well aware of the budget, of disease. Funding for public-health and so we hope that we can Directors from across the departments came from the reach some amicable solution." state told lawmakers last week state's motor vehicle excise tax She said if the Legislature that cuts in Gov. Gary Locke's until the Legislature repealed could not find adequate funding proposed budget would leave the levy in 1999,prodded by the for public health,then law-mak- them unable to effectively pro- passage of Initiative 695. ers could at least provide coun- tect against threats ranging For the past two years, the ties with authority to raise the from anthrax to undercooked state has helped cover the loss, funds themselves. meat. but funding was eliminated this A bill to do that has found "Cutting these funds will year. little support outside King place our cities at greater risk "We had to make some very County, said House Appropria- from• an infectious disease out- difficult decisions this year to tions Committee Chairwoman break,"Snohomish Health Dis- trict Director Ward Hinds told fill the$1.2 billion budget gap," Helen Sommers, D-Seattle. . the House Health Care Com- mittee on Friday. "Now is the time to strengthen our public health system, not weaken it." Hinds, who heads the state Association of Local Public Health Officials, said lives will be endangered if the state does- n't help out. "We are currently underpre- pared to deal with any sizable disease outbreak in our state, P V whether it be from natural causes or bio-terrorism," Hinds said. "This became very clear last October and November as we struggled to try to deal with . . concerns about contami- nated letters and powders. And that was without a single case of anthrax in our state." The proposed $25 million cut would force local depart- ments to reduce staff and ser- vices, King County Health Director Alonzo Plough said, resulting in fewer available vac- cines — and fewer nurses to administer them. In January, President Bush • pledged more than $1 billion to defend the nation against bio- logical attack. Washington's share of those funds is about G / it pCountyexempts terrorism • emergencymane ement lans By Patrick J.Sullivan exempt from disclosure as a pub- Leader Staff Writer "This is for lic record.Once the document is "Our evacuation complete,Saddler said it will be Jefferson County government criminal actions, reviewed to determine which plans are public. has already announced its inten- portions will be open as public tion to invoke a Public Disclo- not natural record and which are exempt.He The school board sure Act exemption on a disasters and not anticipates something being reviews the plans "terrorist response"plan not yet ready before month's end. written. " "This is new to us,too,but we The county has an emergency accidents. are trying to do the best we can at a public management plan that attempts based on our understanding of meeting and we to coordinate response to a van Charles Saddler the plan," Saddler said. "This ety of incidents—from floods to administrator type of document, if it became practice them Jefferson County earthquakes, fires to hazardous public knowledge, to most 1 O waste spills. New to this plan is people it wouldn't mean any- openly. a proposed "annex" of how the thing, but to those who want to county would coordinate a"ter- general accidents or emergency use it for illegal or terrorist pur- Carol Andreasen rorism response," said County incidents,Saddler noted. poses,it might give them certain Port Townsend School Administrator Charles Saddler. For example, Saddler indi- information that would allow District Superintendent The terrorist attacks of last cated that the annex includes re- them to take advantage of weak- Sept. 11 have changed many sponse to biological threats, nesses." things, Saddler noted,including which would not be open for Saddler would not say if the public plan on disaster or crisis how Jefferson County gears itself public review.But if a biological county has already implemented response, reported Chimacum to face such emergency issues. threat came as a hazardous waste any terrorism response plans. School District Superintendent • The proposed terrorism response accident—such as a semi-trailer Dr. Mary Lynne Derrington. A annex would include how to of ammonia overturned on a lo- School plans summary was sent to parents,and handle threats of suspicious pow- cal highway—that is already coy- Public school districts have teachers received full details.The der uncovered in the mail. Four ered under a different emergency their own contingency plans for plan includes response to meet such incidents — all non-threat- response chapter that remains evacuation drills,some more de- the situation, such as bomb ening — happened locally last public information. tailed than others.The county's threat,earthquake or fire. year. "This is for criminal actions, intention,Saddler said,would be "In some situations, you "The rest of the[county emer- not natural disasters and not ac- to not make public any specific would keep the kids inside and gency response]plan is public," cidents,"Saddler said. school evacuation plan dealing protected,and in other cases,get he said."This is an annex to the specifically with a terrorist re- them outside and as far from the plan, and in regard to terrorism Public disclosure sponse. budding as possible,"Derrington response,it will be kept private." Last year,the state Legislature Port Townsend School Dis- said. The U.S.Postal Service is not crafted new rules regarding ter- trict Superintendent Carol The information not publicly hiding the precautions being rorism, including an exemption Andreasen, who works with the circulated is exactly where off- taken inside post offices to screen to the state public records law Port Townsend Police Depart- campus students might be taken mail for possible contaminants, that keeps "terrorism response" ment and not the county,said the during an emergency. In such a nor how a public building—es- plans out of the public's hands. district's school evacuation plans case, a person posted at the pecially one containing other The Revised Code of Wash- are and will be public. school gate would inform incom- public offices—would be evacu- ington 42.17.310(1)(22)allows "Our evacuation plans are ing parents where to retrieve their ated. However,the actual inves- a public records exemption for: public," Andreasen said. "The children. tigation of the source of any 'Those portions of records con- school board reviews the plans at As to what records the county such mail is kept private by mining specific and unique vul- a public meeting and we practice might decide to keep private in postal inspectors. nerability assessments or specific them openly." regard to "terrorism" response, Some of the county's pro- and unique response plans,either Specific plans that the police Derrington said that's different posed "terrorism" categories of which is intended to prevent or sheriff have in response to a from a school plan. would be"policies, weapons of or mitigate criminal terrorist acts bomb threat or other terrorist act "Our relationship with the mass destruction,directions and as defined in RCW 70.74.285, may be kept private, but county in disaster crisis plan- control, sequencing, initial re- the public disclosure of which Andreasen said she would al- ping has been outstanding," sponse,reporting,roles and route would have a substantial likeli- ways want parents to know how Derrington said. "I have confi- illresponsibilities,agencies respon- hood of threatening public the public school district is car- dence in them." sible, and federal agencies."All safety." ing for their children. (Leader reporter Shelly are intended to specifically The county document is still Two years ago the Chimacum Testerman contributed to this apply to acts of terrorism, not in draft form and therefore is School District finished its story.)