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2002- March
File Copy • Jefferson County Board of Health Agenda Minutes March 21, 2002 • JEFFERSON COUNTY BOARD OF HEALTH Thursday, March 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 February 20, 2002 IV. Public Comments V. Old Business and Informational Items VI. New Business • 1. 2002 Legislative Session Report—Bills, Backfill, Tom Bonds, and BioT 2. Jefferson County Behavioral Risk Factor Surveillance System (BRFSS) Report - Introduction: Data Steering Committee Reps Geoff/Roberta -Survey Report Chris Hale -Action Items: Subcommittees and Next Steps 3. Prenatal Risk Assessment Monitoring (PRAMS) Jean/Chris VII. Agenda Planning 1. Joint Board Meeting VIII. Next Meeting: April 18, 2002 2:30 PM—4:30 PM • k JEFFERSON COUNTY BOARD OF HE TH °RAVI MINUTES Thursday, February 21, 2002 Board Members: SteMembers: Dan Titterness,Member- County Commissioner District#1 Jean Baldwin,Nursing Services Director Glen Huntingford,Member- County Commissioner District#2 Larry Fay,Environmental Health Director Richard Wojt,Member- Couny Commissioner District#3 Thomas Locke,MD, Health Officer Geoffrey Masci, Vice Chairman-Port Townsend Ciy Council Jill Buhler,Member-Hospital Commissioner District#2 Sheila Westerman, Chairman- Citizen at Large (Ci ) Roberta Frissell,Member- Citizen at Large (Couny) Chairman Buhler called the meeting to order at 2:30 p.m. All Board and Staff members were present, with the exception of Commissioner Huntingford. APPROVAL OF AGENDA • Vice Chairman Masci moved to approve the Agenda. Commissioner Wojt seconded the motion, which carried by a unanimous vote. APPROVAL OF MINUTES Member Buhler moved to approve the minutes of January 17, 2002. Member Frissell seconded the motion, which carried by a unanimous vote. PUBLIC COMMENT Charles Chase asked for an update regarding health issues on property located on the Egg and I Road, which he brought to the Board's attention at the January meeting. (See later in minutes: Chronology of Gaikowski Complaint) OLD BUSINESS Letters to Board of County Commissioners and Port Townsend City Council Re: Gambling Tax Receipts and Public Health Funding: Chairman Westerman asked if there were any comments on the • draft letter to the County Commissioners concerning the proposed gambling tax receipts and public health funding? HEALTH BOARD MINUTES - February 21, 2002 Page: 2 Commissioner Titterness referred to the language in RCW 9.46.113, "...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." This language appears to be inconsistent with the Board's original request. Dr. Tom Locke and County Administrator Charles Saddler explained that the courts have used a broad interpretation of this language and ruled that general support of law enforcement has a chilling effect on illegal gambling, thus meeting the requirements of the statute. Because the tax has to be used for law enforcement rather than public health, the letter asks to use these funds to offset other general fund dollars for public health. Member Buhler pointed out that the last paragraph stating "maintain support for Jefferson County Public Health systems during this period of crisis"does not sound like a request for ongoing support. Dr. Locke explained that Public Health sees this as a symptom of a larger problem. If a dedicated source of funding were found to replace lost municipal and county dollars and stabilize the public health system, it is likely that the governing bodies might choose to reallocate this funding. The Board suggested revising the letter to say, "during this period of uncertain public health funding" rather than "during this period of crisis." Vice Chairman Masci expressed fear that these funds could easily become diverted to another use over . time. He suggested a memorandum of understanding be approved between the City and County clarifying that the gambling tax would be used for law enforcement so that other funding can go towards public health. County Administrator Saddler suggested the Board might want to relay this fear to both governing bodies, asking that this intent be specified in an interlocal agreement with the level of funding calculated on a formula basis. Chairman Westerman agreed with the concern that funds could easily be reallocated over time and recommended staff consider alternatives to ensure that the funds are specifically used for public health. Commissioner Wojt moved that staff send the letter as amended. Vice Chairman Masci seconded the motion, which carried by a unanimous vote. Chronology of Gaikowski Complaint: At the January 17, 2002 Health Board Meeting, Charles Chase asked that something be done regrading the condition of his neighbors property on Egg & I Road in Chimacum. Chairman Westerman acknowledged that the Board received a timeline of activities on this matter and noted an incorrect date. She expressed concern about the time that elapsed between the first site visit and first notice. She asked for Board comments about the timeline. 11) Member Buhler asked whether there is documentation of further site visits? • HEALTH BOARD MINUTES - February 21, 2002 Page: 3 • Larry Fay assumed staff has never been on the property. Because there was no response to the notice of violation sent last September nor was the situation corrected, he believes staff would recommend this as an opportunity to test the new civil infraction procedure from the On-site Sewage Code. County Administrator Saddler said he believes this matter might develop into a criminal infraction. Larry Fay said it would initially be a civil infraction to be ruled on by a judge, however if there is a lack of compliance, the party may be held in contempt of court. Vice Chairman Masci said if the goal is to remove the health danger from one piece of property, fines may not solve the problem. He is curious about the possibility of cleaning up the property and billing the owner. It was suggested that staff investigate how Clallam County is handling such matters. There was discussion of the County's enforcement authority. Dr. Locke indicated the Board of Health has legislative authority to pass ordinances and resolutions for the abatement of nuisances. Larry Fay said the law offers a broad definition of a nuisance but nothing specifying how to abate one. In response to questions about the effectiveness of ticketing to solve the problem, he used as an example how Animal Services issues tickets—if a fine is paid but the problem is not remedied, another ticket is written. • Vice Chairman Masci asked if there is support for drafting an enforcement ordinance for the Board of Health? Member Buhler asked if the Board is required to prove that the nuisance is a health hazard? Dr. Locke said he believes it has to be health-related. In other words, a nuisance detrimental to public health. There was Board support for a suggestion by Dr. Locke that staff first research what other Boards of Health and Counties have done. Chairman Westerman was supportive of the Board of Health, rather than the County Commissioners, pursuing a fast track enforcement solution. Expressing interest in citizen complaints being addressed promptly, she requested stipulating a response timeline in the policy. Larry Fay responded that while there may be a need for a mechanism, he would discourage a specific timeline. Each situation is different and a clear violation might not be able to be determined in 60 days. Commissioner Wojt suggested writing the code so that indigence cannot be used as a defense. County Administrator Saddler said the availability of a grant program could be part of the County's record,which would be in the documentation submitted to the Court. Larry Fay explained the County would soon finalize its standardized complaint response procedure, establishing tracking, investigation, and enforcement measures as well as providing staff with investigator certification training. HEALTH BOARD MINUTES - February 21, 2002 Page: 4 NEW BUSINESS • Fee Committee Report re: Proposed Fee Increase: Chairman Westerman reviewed her experiences as Chair of the Ad Hoc Fee Advisory Board under direction of the County Commissioners. After considering their underlying charge that the fees should cover 100% of the delivery cost and 75% of the administrative cost, some members forcefully disagreed with this approach. In later meetings, a number of issues arose that seriously damaged the process. Several members had been led by a Commissioner to believe that they did not have to honor the process as outlined. Some members proposed staff not be allowed to participate. Members also violated the ground rule that they would not review each fee individually by, at one point, taking control of the meeting to do just that. Chairman Westerman went on to report that even with two additional meetings, there was not enough time allotted to complete the task. It would also have been helpful had the meetings been recorded. She does not feel good about many of the specific recommendations produced by the committee because they were made outside of the underlying direction. Some members did not support the group process or the ultimate recommendations. A member agreed to circulate a draft report for Committee input before delivering a final version to the County Commissioners. Chairman Westerman believes the County Commissioners were brave to try to address the situation and hope they have the courage to move forward. David Sullivan commented that the experience was worthwhile. He and others learned a lot about the fee • structure. Some members felt if the County could cut costs, maybe fees would not need to be raised. Others were concerned about affordable housing and the lack of control over rising costs in general. Still others were concerned about employment. There was no agreement on where to cut the budget. While members were aware of possible competition for funding, they did not want to raise the cost of a building permit plan review or fill the empty planner position. The group had difficulty understanding the connection between paying fees and maintaining the expected level of service. Each person wanted an opportunity to express their individual view and submit their own report, so it will be hard to produce a report summarizing the different opinions. Chairman Westerman said members wanted vote tallies on each of the recommendations because there were many close votes. It is her understanding that the Board of Health can set Environmental Health fees. For the purpose of discussion, Vice Chairman Masci moved to submit to the County Commissioners a recommendation that the Board of Health review and set the Environmental Health fees. Commissioner Wojt seconded the motion. Staff noted that there are roughly 75 individual fees covering solid waste, onsite sewage and food. The same rationale could be presented to the Board of Health that was presented to the Fee Committee, which is that the County Commissioners would like the fees imposed by the Building and Community Development Department and the Health Department to pay for the delivery of the service and 75% of the administrative costs. Commissioners and Mr. Saddler commented that because loss in revenue are already being felt, it may be most efficient this year to run the fees through the County Commissioners rather than the Board of110 Health. It was noted that the report by the Fee Advisory Committee is nearly 30 days overdue, but there was Commissioner interest in postponing a decision until after examining that report. HEALTH BOARD MINUTES - February 21, 2002 Page: 5 • Vice Chairman Masci amended his motion to reflect that this review would take place beginning next year. Commissioner Wojt seconded the motion as amended. There was further discussion about the charge of the Fee Committee,which was to confirm that staff correctly interpreted the task given to them by the County Commissioners, making fees cover the cost of the services provided. It was recognized that the process was not as successful as it could have been because members of the Fee Committee either did not agree with the philosophy or were unhappy with the specific results. County Administrator Saddler pointed out that there will likely be a major mid-year revision of the Health Department budget. The County may even need to revisit fees this year. The motion carried by a unanimous vote. Public Health Funding Crisis: Dr. Locke said that the press packet from the February Conference in Olympia contained many warnings from the Association of Local Public Health Officials and Health Officers, often referring to public health in the state with this particular backfill funding as "the bottom of a house of cards."It appears inevitable that the State legislature will fail to supply the needed money, leaving the public at risk in certain areas of the State, especially regarding the communicable disease programs. Dr. Locke talked about the severe budget loss in some Counties. New revenue forecasts reflect a shortfall in the current biennium of up to $1.5 billion, which pales in comparison to what is expected in the next biennium. • Jean Baldwin reported that some legislators mistakenly believe that federal anti-terrorism funding will replace the $26 million in lost MVET funds. Although there may be some funding for staff exercises and training, because the federal bio-terrorism funds are categorical, it is unlikely any of the bio-terrorism money will show up in the budget. Community Health Partnerships and Regional Public Health Service Coordination: Jean Baldwin reviewed that at the last meeting, the Board was interested in having further discussions on fiscal matters. There was also a desire not to have policy driven explicitly by the budget. With the potential for laying off staff and closing programs, the Board also suggested investigating regional partnerships. Staff met with Bremerton/ Kitsap Health District and Clallam County and agreed to work on: 1) budget shortfalls and maintaining a minimum amount of safety in public health for the communities; 2) efficiency studies for clinical services; 3) regional bio-terrorism response; 4) training for hospitals and medical staff by Drs. Locke and Lindquist; 5)program evaluations, billing, tracking and infrastructure; 6) reviewing new or current programs before negotiating with State Departments of Health, Ecology, and Social and Health Services; 7) developing ten shared indicators to track long-range community health; 8) fee structures; and 9) exploring a three-county arrangement to share resources on drug labs and drinking water issues. Commissioner Wojt asked if the State legislature has been told that counties need a free hand to utilize funds to provide minimum staff? Staff responded that the only non-categorical money counties are receiving are the funds that are going away. The rest is categorical federal pass-through funding. • Jean Baldwin reported having a series of meetings with the hospital about the impacts of the Department's closure of programs and cutback of services. They also discussed areas of future HEALTH BOARD MINU I'LS - February 21, 2002 Page: 6 collaboration. The hospital expressed interest in certain findings from the Data Steering Committee and • the prenatal risk survey. She commented that it is staggering to think that if local public Health Departments do not provide services, the State Department of Health, by statute, would be responsible for providing them. She just received notice that about $60,000 in cuts, that were not expected until later, are coming now. County Administrator Saddler noted that the hits to operational capabilities will be more significant than the reports have indicated—a 30-35% reduction. With the local Board of Health and Health Department having liability, at what point will we say we can not do it and ask the State to take it over? Jean Baldwin, as incoming chair for WSALPHO, said they will define public health core issues that must be funded. While they could close family planning, maternal child health, foot care, and other unmandated programs, they will have to close out basic programs and hold the state accountable. Some counties have said they will only do TB prevention. Dr. Locke reviewed RCW 70.05.060—Powers and Duties of Local Board of Health which he believes is an important reference. Staff agreed to continue to provide budget updates. The Department may be in a budget shortfall by June and a long-range planning session may be needed. Community Delinquency Prevention Grant: Jean Baldwin distributed a draft letter of support from the • Board for a juvenile justice grant which will enable the continuation of the OLDS/Best Beginning Project. Commissioner Wojt moved that the Board approve the letter of support. Vice Chairman Masci seconded the motion, which carried by a unanimous vote. Bioterrorism Preparedness Tabletop Exercise Follow-up Report: Dr. Locke noted that the agenda packet included a copy of the January training exercise. The exercise was a good opportunity to appraise how the Department worked in action, the biggest benefit being that it allowed other agencies to see how dependant they would be on the local Health Department in a biologic emergency. At the end of the exercise, they identified areas to work on: surge capacity, clear agency roles, and more collaboration between the Health Department and the Hospital. It also underscored the importance of quick communication to the media. A summary of the discussions and recommendations will be mailed to the group. Once a local plan is complete, regional response planning will begin,which is where federal funding is targeted. Several officials are frightened that it is not a matter of if, but when an biologic emergency will occur. Based on this exercise, he believes there is a lot of talent with which to confront an emergency. Customer Survey: Larry Fay suggested this item be tabled until the next meeting. A telephone survey instrument is being designed to regularly evaluate the on-site sewage program. The Board was asked to submit questions it might want to ask Environmental Health clients. • HEALTH BOARD MINUTES - February 21, 2002 Page: 7 • AGENDA CALENDAR/ADJOURN Budget Shortfall Impacts and Update from Dr. Chris Hale on BRFSS. The meeting adjourned at 4:35 p.m. The next meeting will be held on Thursday, March 21, 2002 at 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 New Business Agenda Item # 2 • Jefferson County Behavioral Risk Factor Surveillance System (BRF55) Report March 21 , 2002 • Staff Report BOH on Jefferson County Data Steering Committee 2001-02 March 21, 2002 Ongoing Process of Designing community indicators. * Data are used to guide knowledge-based decisions about public policy. Strategic Planning is based on fiscally responsible budgets. * Jefferson County Data Steering Committee has been asked to review very detailed information, interpret the data, and discuss strategies for sharing with the community&policy makers. * Committee represents a several community agencies, government officials, and citizens. * Completed evaluating vital statistics data through 2000 (birth, death, morbidity, mortality) * Completed evaluating data from the short form of the 2000 Census(long form,which has detailed socioeconomic data is due to begin public distribution in June 2002 Next Projects for the Data Steering committee * Additional data needed -prenatal risk assessment survey of all county residents giving birth in 2002 o Jail survey and search through DWI, DV records o Four Jefferson County school districts health and substance abuse survey 4-02 Next Projects or reports to Board of Health * JCHHS program evaluation/customer satisfaction (are current programs meeting community needs identified in data) o Survey of all EH customers and community realtors/designers to begin in 4/02 o Maternal Child Health -MDS, clients-6/02 • o Abstracting of Family Planning Clinic records-7/02 * Work Groups— o Family violence, Law&Justice o Health care access, hospital, JCHHS, MDS o Substance Abuse, Substance Abuse Board o Seniors, OAAA, MDS, hospital * Reports to the community o Press-staff will submit short interpretation of data to the 2 papers. They may choose to do feature articles o Substance Abuse Committee 4/30/02 Community Methamphetamine training with the community numbers o Law&Justice meeting (5/02) o Focused presentations to School administrators and teachers, hospital commissioners, physicians... * Policy implications/schedule 1. Complete tasks of work groups utilizing the data steering committee and other community members' information forums 2. What are ongoing measurements of community success, or indications of need that should be used by the County Strategic Plan? 3. Program review/Health Department services, community human services and others? Measure program outcomes over time. Evaluate effectiveness. These programs were chosen to because of documented community needs, and • their responsiveness to those needs should be measured. 4. Community education around ways to become healthier. • 3/21/2002 JEFFERSON COUNTY 2001 BEHAVIORAL RISK FACTOR SURVEY 1. What is it? The Behavioral Risk Factor Surveillance System (BRFSS) questionnaires consist of modules or small groups of questions developed by the US Center for Disease Control and Prevention (CDC) beginning about 1985. These questions all have validity and reliability sufficient to meet the standard of scientific acceptability. The focus of modules was originally on health care access and chronic disease risk factors, but in more recent years it has been expanded to include modules on firearms, family violence, and environmental health. The Jefferson County BRFSS questionnaire was administered to a random sample of 603 county residents between April 1 and December 31, 2001. Although the sample size might seem small, in fact it gives a statistically accurate portrait of the county's adult population and allows us to calculate rates that are valid within a range of+4%. The method used is the same used by political parties and other large organizations that routinely do public polling. Jefferson County's BRFSS questionnaire contained the following modules: • Self-reported health status Health insurance coverage and access to a provider Additional access questions getting at actual use of health care services, delay, or lack of available care High blood pressure knowledge and prevention behaviors Cigarette and other tobacco use Alcohol consumption Firearms Physical activity Colorectal screening Oral health Environmental health Family violence The Jefferson County demographic questions, like those used by BRFSS generally, had information that could be used to determine whether or not a person was overweight based on body mass index (BMI). The county questionnaire also added questions identical to those on the census about where respondents had lived five years earlier, where they worked, and their one-way commuting time from home. 2. How is the data analysis organized? • We first calculated the prevalence rate of each risk factor or characteristic. That is, what percent of the population had each factor or characteristic. 411, 3/21/2002 We next looked for statistical differences between these rates by five demographic characteristics: age (18-34 years old, 35-64 years old, 65+ years old) education (used as a measure of socioeconomic well-being and defined as high school or less, some post-secondary, 4+ years of college) residence (ZIP code 98368 or other) recent arrival in the county (lived here five years ago or lived elsewhere five years ago). Finally, we looked for statistically significant differences in rates between measures in the BRFSS survey. For example, in assessing routine medical care and use of preventive services, we compared those with a regular health care provider with those not having a regular provider. We also compared the major health risk behaviors— being overweight, physically inactive, currently smoking, heavy drinking —with each other and with the major risk factors or other conditions. 3. How will the results be made public? • There will be two meetings of the Data Steering Committee to review these findings, March 8 and 20. A report will be made in the March 21 Board of Health meeting. Other dissemination efforts will occur after those three meetings. 3/21/2002 • Jefferson County 2001 BRFSS Adult Health Adults in Jefferson County generally enjoy better health than the state average. • Life expectancy in Jefferson County has been higher than life expectancy in Washington State for the past 20 years (Figure 1). For 1995-99, life expectancy here was almost 79 years, compared with just over 77 years for the state. The theoretical maximum life expectancy, given the current state of medicine and technology, is considered to be 81-83 years. • Self-reported health status is a powerful predictor of a person's overall health. 22% of Jefferson County residents said their health was excellent, 35% said it was very good, 27% said it was good, and 16% said it was fair or poor (Figure 2). These levels of self-reported health status are essentially the same as the state percentages, except for the last one which is significantly higher (worse) than the 12% of Washington State's adult population who rated their health fair or poor. • • Adults were asked how many days in the past 30 their physical health was not good. Sixty-three percent of county residents said "none", compared with 61% of the state; 11% of county residents said one or two compared with 14% of the state, and 26% of county residents said three or more compared with 25% of the state (Figure 3). None of these differences is statistically significant. • Adults were asked how many days in the past 30 their mental health was not good. Sixty-six percent of county residents said "none", significantly higher (better) than the 60% of the state who said "none" (Figure 4). Ten percent of county residents said one or two, compared with 13% of state residents, and 24% of county residents said three or more compared with 27% of state residents. The state and county rates are not significantly different for the last two. • Respondents were asked how many days in the past 30 they had been limited in their usual activities by either poor physical or poor mental health. Seventy-eight percent of county adults said "none", 14% said seven or fewer, and 8% said more than seven (Figure 5). These rates are not significantly different from the state rates. • • Figure 1. Life Expectancy at Birth, Jefferson County and Washington State, 1980-84 through 1995-99 Period Jefferson County Washington State 1980-84 76.8 75.1 1981-85 77.9 75.3 1982-86 77.6 75.5 1983-87 77.9 75.6 1984-88 77.7 75.6 1985-89 77.0 75.8 1986-90 76.7 75.9 1987-91 77.1 76.2 1988-92 77.6 76.4 1989-93 78.1 76.5 1990-94 78.4 76.6 1991-95 78.7 76.8 1992-96 78.2 76.8 1993-97 78.3 76.9 1994-98 78.3 77.1 1995-99 78.8 77.3 Figure 1. Life Expectancy, Jefferson County and Washington State, • 1980-84 through 1995-99 Source: Deaths: Vital Statistics database,Jefferson County Health Department. Population 1980 and 1990,US Census; 1981-89,Office of Financial Management intercensal estimates; 1991-1999,OFM intercensal projections. 1980-1990 figures are final;1991-99 figures are provisional. 81.0 - 79.0 - Jefferson County f 77.0 75 0 Washington State 73.0 - J 71.0 - 0 69.0 - a m 67.0 - 65.0 I f I I I I I I I I I I I I I d' u) (D t of W O T N M !t La CD - 03 C) 00 00 00 00 00 00 C) C) C) C) Q) C) C) T C) C) O T N r 4') CD N- 03 Ci 0 T N M 4 V) 03 03 03 03 03 03 03 00 CO CO C) C) C) a) C) C) C) C) C) C) C) C) C) C) C) C) C) C) C) C) C) C) T T T T T T T T T r- 3/21/02 3/21/02 • Figure 2. (Q1X1)Would you say that in general your health status is... Jefferson County 2001 BRFSS and Washington State 2000 BRFSS Jefferson County Washington State Excellent 22% 22% Very good 35% 38% Good 27% 28% Fair/Poor* 16% 12% Figure 2. Self-reported health status, Jefferson County 2001 BRFSS and Washington State 2000 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;Washington State,CDC website 100% - 90% - 80% - • 70% H 60% ■Jefferson County ElWashington State 50% - I 40% -I 38% 35% ° 30% - 27% 28°/0 22% 22% 20% 16% 12% 10% Excellent Very good Good Fair/Poor* *County rate is significantly higher(worse)than state rate. • 3/21/02 • Figure 3. (Q1X2) For how many days during the past 30 days was your physical health not good? Jefferson County 2001 BRFSS and Washington State 2000 BRFSS Jefferson County Washington State None 63% 61% One or two 11% 14% Three or more 26% 25% Figure 3. For how many days during the past 30 days was your physical health not good? Jefferson County 2001 BRFSS and Washington State 2000 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;Washington State,CDC website 100% - 90% ■Jefferson County ❑Washington State • 80% 70% - 63% 61 60% 50% - 40% - 30% 26% 25% 20% - 14% 11% 10% - 0% -,-- None One or two Three or more 3/21/02 • Figure 4. (Q1X3) Now thinking about your mental health,which includes stress... Jefferson County 2001 BRFSS and Washington State 2000 BRFSS Jefferson County Washington State None* 66% 60% One or two 10% 13% Three or more 24% 27% Figure 4. For how many days during the past 30 days was your mental health not good? Jefferson County 2001 BRFSS and Washington State 2000 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;Washington State,CDC website 100% - I IN Jefferson County 0 Washington State 90% - • 80% - 70% - 66% � 60% - 50% - 40% - 30% - 27% 24% 20% - 13% 10% 10% - 0% -I 60% - None* One or two Three or more *County rate is significantly higher(better)than state rate. 410 3/21/02 • Figure 5. (Q1X4) During the past 30 days for about how many days did poor physical or mental health keep you from doing your usual activities? Jefferson County 2001 BRFSS and Washington State 2000 BRFSS Jefferson County Washington State None 78% 77% Seven or fewer 14% 16% More than seven 8% 7% Figure 5. How many days during the past 30 days were you limited in your usual activities? Jefferson County 2001 BRFSS and Washington State 2000 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 100% BRFSS;Washington State,CDC website III Jefferson County El Washington State 90% - 78 • 80% ° 77% 70% - 60% 50% - 40% 30% 20% 16% 14% 10% 8% 7% 0% -- None Seven or fewer More than seven 3/21/02 ,0 3/21/2002 Jefferson County 2001 BRFSS • Health Care Access Adults in Jefferson County generally have as good access to health care as the state average, or they have better access. • Health insurance is needed to access most health care services. Ninety percent of people in Jefferson County have some form of health insurance, the same as the state rate (Figure 1). • Having one doctor or health care provider is important in accessing health care services. Eighty-five percent of county adults have one doctor or health care provider, about the same as the state average, 83% (Figure 2). • Having one particular place to go when you need health care is also important. Eighty- eight percent of county residents have such a place (Figure 3). Comparable rates for the state will be available early in the summer. • An annual, routine physical is an important protective aspect of health care. Seventy-five percent of county adults had a routine physical within the previous 12 months, significantly higher (better) than the state rate, 68% (Figure 4). Thirteen percent of county residents had a routine physical within the past two years, about the same as the state rate, 15%. Only 13% of county residents had a routine physical more than two years ago, significantly lower (better) than the state rate, 17%. • Eighty-six percent of adults said they or another adult in their household had not experienced difficulty or delay in getting health care, and 14% said they had (Figure 5). Comparable rates for the state will be available early in the summer. • Twenty-nine percent of county adults have been told they have high blood pressure, significantly higher (worse) than the state rate, 22% (Figure 6). Other data, not presented here, indicate that this apparent excess occurs because the county population is older than the state, and a diagnosis of high blood pressure becomes more common as a population ages. Age-specific rates of blood pressure diagnosis among county residents are not significantly different from those of the state. • An important health care recommendation to detect colorectal cancer early, when more than 90% can be treated without recurrence, is that people age 50 and older use a home blood stool test kit (under a doctor or health care professional's direction). Sixty-seven percent of adult respondents in Jefferson County age 50 and older had used such a kit, significantly higher (better) than the state rate, 41% (Figure 7). • • An annual dental visit is recommended for oral health. Seventy-two percent of county adults had made a dental visit within the past year, a rate significantly higher (better) than the state rate, 67% (Figure 8). • Figure 1. (Q2X1) Do you have any kind of healthcare coverage? Jefferson County and Washington State 2001 BRFSS Jefferson County Washington State Yes 90% 90% No 10% 10% Figure 1. Do you have any kind of health care coverage? Jefferson County 2001 BRFSS and Washington State 2000 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS; Washington data from CDC website 100% - 90% 90% 90% - 80% - 70% ■Jefferson County ❑Washington State 60% - 50% 40% - 30% - 20% - 10% 10% 10% - 0% f 111111711_,— Yes No • 3/21/02 • Figure 2. (Q2x6) Is there one doctor or health provider who you usually go when you need routine medical care? Jefferson County 2001 BRFSS &Washington State 1996 Jefferson County, 2001 Washington State, 1996 Yes 85% 83% No 15% 17% Figure 2. Is there one doctor or health care provider you usually go to when you need routine medical care? Jefferson County 2001 and Washington State 1996 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS; Washington data from CDC website 100% - 90% - 85% 83% ■Jefferson County,2001 80% ❑Washington State, 1996 • 70% 60% 50% - 40% - 30% - 20% 17% 15% 10% - 0% Yes No • 3/21/02 • Figure 3. (Q19x1) Is there one particular clinic, health center, doctor's office, or other place that you usually go if you are sick or need advice about your health? Jefferson County 2001 BRFSS Jefferson County, 2001 Washington State, 2001 Yes 88% No 12% Figure 3. Have one particular place you go to for care. Jefferson County 2001 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS 100% - 90% - 88% 80% • 70% 60% - 50% - 40% - 30% - 20% - 12% 10% - 0% Yes No • 3/21/02 • Figure 4. (Q19x5) How long has it been since you last visited a doctor for a routine checkup? Jefferson County 2001 BRFSS and Washington State 2000 BRFSS Jefferson County Washington State Within the past year* 75% 68% Between one and two years 13% 15% More than two years ago* 13% 17% Figure 4. How long has it been since you last visited a doctor for a routine checkup? Jefferson County 2001 BRFSS and Washington State 2000 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS; Washington data from CDC website 100% - ■Jefferson County ❑Washington State 90% - 80% - • 75% 70% 68% 60% 50% - 40% 30% - 20% - 15% 17% iiii13% 13% 10% -' 0% Within the past year* Between one and two years More than two years ago* *County residents significantly more likely to have checkup within past year and significantly less likely to have had one 2+years ago. • 3/21/02 • Figure 5. (Q20x2) In the last 12 months did you or any adult in your household? experience difficulty or delay in obtaining health care? 2001 BRFSS Jefferson County,2001 Washington State, 2001 Yes 14% N/A No 86% N/A Figure 5. Did you or any adult in your household experience difficulty or delay in obtaining health care? Jefferson County and Washington State 2001 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS 100% - 90% o 86/0 80% - • 70% - 60% - 50% - 40% - 30% - 20% - 14% 10% - 0% Yes No 410 3/21/02 • Figure 6. (Q4X1) Have you ever been told by a doctor, nurse or other health care professional that you have high blood pressure? Jefferson County 2001 BRFSS and Washington State 2000 BRFSS Jefferson County Washington State Yes* 29% 22% No 71% 78% Figure 6. Have you ever been told by a doctor, nurse or other health care professional that you have high blood pressure? Jefferson County BRFSS, 2001 and Washington State BRFSS, 1999 Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;Washington State 1999 BRFSS,CDC website 100% - 90% - ■Jefferson County ❑Washington State 80% 78% • 71% 70% - 60% - 50% - 40% - 30% 29% 22% 20% - 10% - 0% i Yes* No *Significantly more adults in county than in the state were told they had high blood pressure • 3/21/02 • Figure 7. (Q17x1) Have you ever used a home blood stool test kit? Jefferson County 2001 BRFSS and Washington State 2000 BRFSS (respondents age 50+only) Jefferson County Washington State Yes* 67% 41% No 33% 59% Figure 7. (Q17x1) Have you ever used a home blood stool test kit? Jefferson County 2001 BRFSS and Washington State 1999 BRFSS respondents age 50+ only Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;Washington State data from CDC website 100% - ■Jefferson County ❑Washington State 90% - 80% - • 70% - 67% 60% 59% 50% - 41% 40% - 33% 30% - 20% - 10% 0% Yes* No *County rate is significantly higher(better)than the state rate. • — - --- 3/21/02 • Figure 8. (Q21x1) How long has it been since you last visited a dentist or a dental clinic for any reason? Jefferson County 2001 BRFSS and Washington State 1999 BRFSS Dental visit for any reason within the past year Jefferson County Washington State Yes* 72% 67% No* 28% 33% Figure 8. Dental visit for any reason within the last year*,Jefferson County 2001 BRFSS and Washington State 1999 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS; Washington data from CDC website 100% - 90% - •Jefferson County 0Washington State 80%S 1 72% 70% - 67% 60% - 50% - 40% - 33% 30% - 28% 20% - 10% - 0% Yes* No* *County rate is significantly higher(better)than the state rate. • 3/21/02 • 3/21/2002 • Jefferson County 2001 BRFSS Risk and Predictive Behaviors In general among county adults, rates of behaviors that predict good health are higher, and rates of behaviors that predict poor health are lower. • Cigarette smoking is among the very worst risk-taking behaviors, because it is associated with so many diseases. Only 16% of Jefferson County adults smoked cigarettes in 2001, significantly lower (better) than the rates seen in either Kitsap County (23%) or the state (21%, Figure 1). • Being overweight puts people at risk for a number of conditions that can cause poor health. Only 29% of county adults were overweight when body mass index (the relationship of height and weight) was computed, a rate significantly lower (better) than the state rate, 36% (Figure 2). • Being physically inactive (neither engaging in physically demanding work nor having any leisure time activity or being active fewer than three times a week for at least 20 minutes/time) is associated with conditions that can cause poor health. Only 13% of county adults were physically inactive, a rate significantly • lower (better) than the state rate, 27% (Figure 3). • Alcohol consumption can be protective: adults who drink an average of 1-2 drinks on most days, moderate drinkers, have lower death rates than those who abstain. But the highest death rates are among heavy drinkers, those who consumed five or more drinks at one time in the past 30 days. Seventeen percent of county adults were heavy drinkers by that standard, a significantly lower (better) rate than that for the state, 23% (Figure 4). • The presence of any one risk behavior is associated with threats to good health. Multiple risks represent even greater threat. We evaluated all possible combinations of the risks cited above and found o Among those who currently smoke, 34% reported heavy drinking within the previous 30 days (Figure 5). This is twice the average prevalence. o Among those who are overweight, 27% reported heavy drinking within the previous 30 days (Figure 6). This is almost 60% above the average prevalence of heavy drinking among all county adults. o Among people who are overweight, 18% were physically inactive • (Figure 7). This is almost 40% above the county's average inactivity level among adults. Figure 1. (Q10x2) Do you smoke everyday, some days, or not at all? • Jefferson County BRFSS, 2001; Kitsap County BRFSS, 1998 and Washington State BRFSS, 2000 Jefferson County* Kitsap County Washington State Current Smoker 16% 23% 21% Figure 1. (Q10x2) Currently Smoke, Jefferson County BRFSS, 2001, Kitsap County BRFSS, 1998, and Washington State BRFSS, 1998 Source: Jefferson County Department of Health&Human Services,2001 BRFSS; Washington data from CDC website;Kitsap data from Bremerton-Kitsap County Health District,Office of Assessment. 100% - 90% - • 80% - 70% - 60% - 50% - 40% - 30% - 23% 21% 20% - 16% 10% - 0% Jefferson County* Kitsap County Washington State County rate is significantly lower(better)than Kitsap and state rates. • 3/21/02 • Figure 2. At risk for health problems related to being overweight? (NHANES definition,BMI >=27.8 for males, >=27.3 for females) Jefferson County and Washington State 2001 BRFSS Jefferson County* 29% Washington State 36% Figure 2. At risk for health problems related to being overweight? Jefferson County and Washington State 2001 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS;Washington State data from the CDC website. 100% - 90% - 80% - • 70% - 60% - 50% - 40% - 36% 30% - 29% 20% - 10% - 0% , Jefferson County* Washington State County rate is significantly lower(better)than the state rate. • 3/21/02 . Figure 3. At risk for health problems related to physical inactivity? (No physical activity or<3 times/week, 20 minutes day) Jefferson County and Washington State 2001 BRFSS Jefferson County* 13% Washington State 27% Figure 3. At risk for health problems related to physical inactivity? Jefferson County 2001 and Washington State 2000 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS;Washington State data from the CDC website. 100% - 90% - 80% - • 70% - 60% - 50% - 40% - 30% - 27% 20% - 13% 10% - 0% , Jefferson County* Washington State County rate is significantly lower(better)than the state rate. • 3/21/02 • Figure 4. (Q11x3) Consumed 5+drinks of alcohol at least once in past 30 days Jefferson County 2001 BRFSS and Washington State 1999 BRFSS Jefferson County* 17% Washington State 23% Figure 4. Consumed 5+ drinks of alcohol at least once in past 30 days, Jefferson County 2001 BRFSS* and Washington State 1999 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS;Washington State data from the CDC website. 100% - 90% - 80% - • 70% - 60% - 50% - 40% - 30% - 23% 20% - 17% 10% - 0% , Jefferson County* Washington State County rate is significantly lower(better)than the state rate. • 3/21/02 • Figure 5. Heavy drinking (5+/time)* among current smokers. Jefferson County BRFSS, 2001. Heavy Drinker(5+/time) Heavy Drinking No Heavy Drinking Current Smoker 34% 66% Non-Smoker 15% 85% Figure 5. Heavy drinking (5+/time) and smoking*, Jefferson County BRFSS, 2001 Source: Jefferson County Department of Health&Human Services BRFSS,2001 100% - 90% - 85% IN Current Smoker 0 Non-Smoker 80% - • 70% - 66% 60% - 50% - 40% - 34% 30% - 20% - 15% 10% - 0% Heavy Drinking No Heavy Drinking *Difference is statistically significant,p<.01 • 3/21/02 • Figure 6. Heavy drinking (5+/time)*and overweight. Jefferson County BRFSS, 2001. Heavy Drinker(5+/time) Heavy Drinking No Heavy Drinking Overweight by BMI 27% 73% Not overweight 15% 86% Figure 6. Heavy drinking (5+/time) and overweight by BMI*, Jefferson County BRFSS, 2001 Source: Jefferson County Department of Health&Human Services BRFSS,2001 100% - 90% - 86% • 80% - 73% 70% - 60% - 50% - 40% - 30% - 27% 20% - 15% 10% - 0% Heavy Drinking No Heavy Drinking *Difference is statistically significant,p<.01 • 3/21/02 A y 411 Figure 7. Physical inactivity among overweight respondents. Jefferson County BRFSS, 2001. Physically Inactive Physically Active Overweight by BMI 42% 27% Not overweight 58% 73% Figure 7. Physical inactivity among people overweight by BMI*, Jefferson County BRFSS, 2001 Source: Jefferson County Department of Health&Human Services BRFSS,2001 100% - ■Overweight by BMI ❑Not overweight 90% - • 80% - 73% 70% - 60% 58% 50% - 42% 40% - 30% - 27% 20% - 10% - 0% Physically Inactive Physically Active *Difference is statistically significant, p<.05 • 3/21/02 3/21/2002 • Jefferson County 2001 BRFSS Alcohol Consumption Jefferson County's drinking patterns are different from those of the state. • The health effects of alcohol are complex. Those who abstain from alcohol have higher mortality rates than those who drink in moderation (1-2 drinks at one time). However, some people are unable to drink in moderation. Heavy drinking (defined as consuming five or more drinks at one time in a 30 days period) is a risk factor for poor health. • Sixty-eight percent of the county's adult residents consumed at least one drink of alcohol in the 30 days before the survey (Figure 1). This is significantly higher than the state rate, 61%. • Within the county, 73% of men drank alcohol in the past 30 days compared with 63% of women; the difference is statistically significant (Figure 2). Alcohol consumption rates within gender are also significantly higher among county residents than the state averages. • Within the county, alcohol consumption rates within the past 30 days increase with education. Sixty percent of those with a high school education or less consumed alcohol in the previous 30 days compared with 65% of those with some post- secondary education, and 77% of those who had four years or more of college (Figure 3). All of these differences are statistically significant. Alcohol consumption rates at all education levels are also significantly higher in the county than in the state. • County residents drink on more days in a 30-day period than the state average. Forty-nine percent of those who drink do so on 1-5 days of the past 30 compared to 60% for the state (Figure 4); the difference is statistically significant. Twelve percent drank on six to 10 days compared with 14% in the state, and 15% drank on 11-20 days compared with 17% in the state; neither difference is statistically significant. Twenty-four percent of county residents drank on 20+ days compared with 8% in the state; this difference is also statistically significant. Most people in this category drank every day in the past 30 days. • On average, county residents drank on about 12 in the past 30 days (Figure 5). Men drank on more days (14.4) than women (9.1); the difference is statistically significant. • On average, county residents consumed 1.7 drinks on days when they drank (Figure 6). Men drank an average of 2.0 drinks, and women drank 1.5 drinks. The difference is statistically significant, and the levels of drinking reported are at the recommended gender-specific protective rates. • Heavy alcohol consumption, drinking five or more drinks at one time in the past 30 days, is considered a risk factor for poor health. Seventeen percent of county adults were heavy drinkers by that standard, a significantly lower (better) rate than that for • the state, 23% (Figure 7). • Figure 1. (Q11x1) Consumed alcohol in past 30 days Jefferson County 2001 BRFSS and Washington State 1999 BRFSS Jefferson County 68% Washington State 61% Figure 1. Alcohol consumption in past 30 days, Jefferson County 2001 BRFSS* and Washington State 1999 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS;Washington State data from the CDC website. 100% - 90% - 80% - IP 70% - 68% 61% 60% - 50% - 40% - 30% - 20% - 10% - 0% Jefferson County Washington State County rate is significantly higher than the state rate. • 3/21/02 Figure 2. (Q11x1)Alcohol consumption by gender Jefferson County 2001 BRFSS and Washington State 1999 BRFSS . Jefferson County Washington State Male 73% 67% Female 63% 55% Figure 2. Alcohol consumption by gender, Jefferson County 2001 BRFSS* and Washington State 1999 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS;Washington State data from the CDC website. 100% — 90% — ■Jefferson County ❑Washington State 80% — 73% 70% — 67% 63% 11) 60% — 55% 50% — 40% — 30% — 20% — 10% — 0% I I Male Female SGender difference is statistically signficant,p=.05;state/county differences significant for both genders 3/21/02 • Figure 3. (Q11x1) Alcohol consumption by education Jefferson County 2001 BRFSS and Washington State 1999 BRFSS Jefferson County Washington State High school or less 60% 53% Some post-secondary 65% 61% 4+years of colleae 77% 70% Figure 3. Alcohol consumption by education*, Jefferson County 2001 BRFSS and Washington State 1999 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS;Washington State data from the CDC website. 100% - 90% - Jefferson County ❑Washington State 80% - 77% 11, 70% - 65% 70% 60% 61% 60% - 53% 50% - 40% - 30% - 20% - 10% - 0% I I High school or less Some post-secondary 4+ years of college *Difference between levels in county is statistically significant,p<.001;state/county rates significantly different at all levels • 3/21/02 Figure 4. (Q11x1) Number of days in past 30 days when alcohol was consumed Jefferson County 2001 BRFSS and Washington State 1999 BRFSS Jefferson County Washington State 1-5 days 49% 60% 6-10 days 12% 14% 11-20 days 15% 17% 20+days 24% 8% Figure 4. Number of days in past 30 when alcohol was consumed*, Jefferson County 2001 BRFSS and Washington State 1999 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS;Washington State data from the CDC website. 100% - 90% - ■Jefferson County ❑Washington State 80% - • 70% - 60% 60% - 50% 49% 40% - 30% - 24% 20% - 17% 14% 15% 12% 10% 8% 0% 1-5 days 6-10 days 11-20 days 20+ days *At 1-5 days,county rate is significantly lower than state rate;at 20+days,county rate is significantly higher than state rate. O 3/21/02 • i • Figure 5. (Q11x1) Mean number of days in past 30 days when alcohol was consumed by gender, Jefferson County 2001 BRFSS (range=1-30 days) Jefferson County All respondents who drank 11.8 Males 14.4 Females 9.1 Figure 5. Mean number of days in past 30 when alcohol was consumed by gender*, Jefferson County 2001 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS 15.0 - 14.4 13.0 - 11.8 • 11.0 - 9.1 9.0 - 7.0 - 5.0 - 3.0 - 1.0 - -1.0 - All respondents Males Females who drank *Males and females significantly different,p<.001. • 3/21/02 Figure 6. (Q11x2) Mean number of drinks on days when alcohol was consumed 1111 by gender,Jefferson County 2001 BRFSS (range=l-12) Jefferson County All respondents who drank 1.7 Males 2.0 Females 1.5 Figure 6. Mean number of drinks on days when alcohol was consumed* by gender, Jefferson County 2001 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS 3.0 - 2.5 - • 2.0 2.0 - 1.7 1.5 1.5 - 1.0 - 0.5 - 0.0 , All respondents Males Females who drank *Males and females significantly different, p<.001. 3/21/02 DRAFT Figure 7. (Q11x3) Consumed 5+drinks of alcohol at least once in past 30 days Jefferson County 2001 BRFSS and Washington State 1999 BRFSS Jefferson County* 17% Washington State 23% Figure 7. Consumed 5+ drinks of alcohol at least once in past 30 days, Jefferson County 2001 BRFSS* and Washington State 1999 BRFSS Source: Jefferson County Department of Health&Human Services,2001 BRFSS;Washington State data from the CDC website. 100% - 90% - 80% - • 70% - 60% - 50% - 40% - 30% - 23% 20% - 17% 10% - 0% Jefferson County* Washington State County rate is significantly lower(better) than the state rate. 3/21/02 3/21/2002 • Jefferson County 2001 BRFSS History of Childhood Abuse County residents report higher rates of being abused in childhood than the state average, and this abuse affects their adult functioning. . Nine percent of adult residents said as children (before the age of 18), they had been punched, kicked, choked, or received a more serious physical punishment from a parent or other adult guardian (Figure 1). This is about the same as the state level, 7%. . Twelve percent of county residents said someone had touched them in a sexual place or made them touch someone when they did not want to compared with 9% of state residents (Figure 2). . Eleven percent of county residents said they had seen or heard one of their parents or guardians being hit, slapped, punched, shoved, kicked, or otherwise physically hurt by their spouses or partners (Figure 3). Comparable state data will be available early in the summer. • . An abuse index to assess any childhood experience of abuse. Overall, 25% of county residents reported at least one abuse experience in childhood (Figure 4). This is significantly higher (worse) than the state rate, 20%. . Rates of reporting a childhood history of abuse were significantly lower (better) among the oldest respondents. Twenty-six percent of county respondents age 18-34 and 29% of those age 35-64 reported a childhood history of abuse compared with only 15% of those age 65+ (Figure 5). • Respondents with four or more years of college reported significantly lower (better) rates of physical abuse in childhood (6%) than those with a high school education or less (13%) and those with some post-secondary education (11%, Figure 6). • In both the state and county, women had significantly higher (worse) rates of reporting a childhood history of sexual abuse than men. Five percent of men in both samples reported a childhood history of sexual abuse compared with 18% of women in the county and 14% of women in the state (Figure 7). The county rate for women is significantly higher (worse) than the state rate. • People with childhood histories of any abuse reported, on average, significantly more days of poor health in the previous 30 days than people without such histories (Figure 8). • 3/21/2002 o All respondents averaged 4.3 days of poor physical health, but people who also reported childhood histories of any abuse averaged 5.7 days while those without such histories averaged 3.8 days. o All respondents averaged 2.9 days of poor mental health, but people who also reported childhood histories of any abuse averaged 4.7 days while those without such histories averaged 2.3 days. o All respondents averaged 2.2 days of impaired functioning, but people who also reported childhood histories of any abuse averaged 3.3 days of impaired functioning while those without such histories averaged 1.8 days. . People with childhood histories of sexual abuse reported, on average, significantly more days of poor mental health or poor functioning in the previous 30 days than people without such histories (Figure 9). o All respondents averaged 2.9 days of poor mental health, but people who also reported childhood histories of sexual abuse averaged 6.2 days while those without such histories averaged 2.5 days. o All respondents averaged 2.2 days of impaired functioning, but people • who also reported childhood histories of sexual abuse averaged 3.9 days of impaired functioning while those without such histories averaged 1.9 days. • People with childhood histories of seeing a parent or guardian physically abused reported, on average, significantly more days of poor mental health. All respondents averaged 2.9 days of poor mental health, but people who reported seeing a parent or guardian physically abused averaged 5.0 days of poor mental health but those without such histories reported 2.0 days (Figure 10). • • Figure 1. (Q27X1) Before you were 18 was there any time when you were punched, kicked, choked or received a more serious physical punishment from a parent or other adult guardian? Jefferson County 2001 and Washington State 1997 BRFSS Jefferson County Washington State, 1997 Yes 9% 7% No 91% 93% Figure 1. Punished violently before age 18, Jefferson County 2001 and Washington State 1997 Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;Washington data from WA State Department of Health 100% - 93% 91% 90% - 80% _ •Jefferson County ❑Washington State, 1997 • 70% - 60% - 50% - 40% - 30% - 20% - 10% - 9% 7% 0% Yes No a 3/21/02 Figure 2. (Q27X4) Before you were 18 did anyone ever touch you in a sexual place or • make you touch them when you did not want to? Jefferson County 2001 and Washington State 1997 BRFSS Jefferson County Washington State Yes 12% 9% No 88% 91% Figure 2. Sexually abused before age 18, Jefferson County 2001 and Washington State 1997 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;Washington data from WA State Department of Health 100% - 91% 90% - 88% 80% - ■Jefferson County ❑Washington State . 70% - 60% - 50% - 40% - 30% - 20% - 12% 10% 9% 0% Yes No 3/21/02 • Figure 3. (Q27X7)As a child did you ever see or hear one of your parents or guardians being hit, slapped, punched, shoved, kicked, or otherwise physically hurt by their spouse or partner? Jefferson County and Washington State 2001 BRFSS Jefferson County Washington State Yes 11% coming No 89% coming Figure 3. As a child, saw parent or guardian physically hurt, Jefferson County 2001 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 100% - 90% 89% 80% - ■Jefferson County ❑Washington State • 70% - 60% - 50% - 40% - 30% - 20% - 11% 10% - 0% 0% 0% i Yes No 3/21/02 Figure 4. (Q27X1, 27x4, 27x7) As a child did saw or experienced physical or sexual abuse 410 Jefferson County 2001 and Washington State 1997 BRFSS Jefferson County Washington State Yes 25% 20% No 75% 80% Figure 4. As a child, saw or experienced physical or sexual abuse, Jefferson County 2001* and Washington State 1997 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;Washington 100% - data from WA State Department of Health 90% - 80% 80% - ■Jefferson County ❑Washington State 75% • 70% - 60% - 50% - 40% - 30% - 25% 20% 20% - 10% - 0% i Yes No County rate is significantly higher(worse) than the state rate. O 3/21/02 • Figure 5. (Q27x1, 27x4, 27x7) History of abuse by age Jefferson County 2001 BRFSS Reported any kind of abuse as child 18-34 years old 26% 35-64 years old 29% 65+years old* 15% Figure 5. Any reported abuse in childhood, by age*, Jefferson County 2001 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 100% - 90% - 80% - • 70% - 60% - 50% - 40% - 0 30% - 26% 9/o 20% - 15% 10% - 0% 18-34 years old 35-64 years old 65+ years old* *People age 65+reported significantly less abuse than those in other ages,p<.01 • 3/21/02 • Figure 6. (Q27X1) History of physical abuse as a child by education Jefferson County 2001 BRFSS Reported physical abuse as child High school or less 13% Some post-secondary 11% 4+years of college* 6% Figure 6. Reported history of physical abuse as a child, by education*, Jefferson County 2001 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 100% - 90% - 80% - 70% - 60% - 50% - ' 40% - 30% - 20% - 13% 11% 10% - 6% 0% High school or less Some post-secondary 4+ years of college* People with 4+years of college reported significantly lower rate p<.01 • 3/21/02 • Figure 7. (Q27X4) Reported sexual abuse before age 18, by gender Jefferson County 2001 BRFSS and Washington 1997 BRFSS Jefferson County Washington State Males 5% 5% Females 18% 14% Figure 7. Reported history of sexual abuse as a child, by gender*, Jefferson County 2001 and Washington State 1997 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS; Washington data,WA Department of Health 100% - 90% - 80% - 1111 70% - 60% - •Jefferson County ❑Washington State 50% - 40% - 30% - • 20% - 18% ° 14% 10% 5% 5% 0% Males Females *Difference by genderwithin state and county is statistically significant,p<.05;state-county difference is significant for females only. • 3/21/02 • Figure 8. (Q1X2-1X4)Average (mean) days of limitation, by history of child abuse, Jefferson County 2001 BRFSS Average days in past 30 of... All Any abuse as child No abuse as child Significance Poor physical health* 4.28 5.72 3.83 p<.05 Poor mental health* 2.88 4.73 2.33 p<.001 Impaired functioning* 2.15 3.25 1.83 p<.05 Figure 8. Average days of poor health in past 30 days, by history of abuse as a child, Jefferson County 2001 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 7.00 - MAD ❑Any abuse as child ®No abuse as child 6.00 - 5.72 • 5.00 - 4.73 4.28 4.00 - 3.83 `' $ 3.25 3.00 .':..:_.... 2.88 ? 2.33 ....... 2.15 ::;::»:> 1.83 2.00 - �>:::<:::::::>::>::: 1.00 k::: tir 4..� 0.00 ;wc<::c: •: w x5,w::... .'.cx Poor physical health* Poor mental health* Impaired functioning* *statistically significant difference,see table • 3/21/02 • Figure 9. (Q1X2-1X4)Average (mean) days of limitation, by history of child sexual abuse, Jefferson County 2001 BRFSS Average days in past 30 of... All Sexual abuse as child No abuse as child Significance Poor physical health 4.28 5.60 4.14 n.s. Poor mental health* 2.88 6.23 2.52 p<.001 Impaired functioning* 2.15 3.90 1.94 p<.05 Figure 9. Average days of poor health in past 30 days, by history of sexual abuse as a child, Jefferson County 2001 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 7.00 - ■AII ❑Sexual abuse as child ®No abuse as child 6.23 6.00 - 5.60 • 5.00 - 4.28 4.14 4.00 .`>"�: 3.90 <::::::::: 2.88 3.00 - "'� ' 2.52 idiiii 2.15 E:i?4i:[•i:•i: 2 1.94 .00 r::ff.>ff<: 1.00 •,;,: >„ ,.;.:..,_w,r; s :.<. i:: 'fir.:,,:: ii:?}}i;{Y•: ...............• •.. {:::::: ..:. :•44i:•?}}}:: ...............•:i 4 x k ilii:+iiii::. ...:-- 0.00 :.:>.;:iii}iii: ::::::.::::::.. I Poor physical health Poor mental health* Impaired functioning* *statistically significant difference,see table • 3/21/02 III Figure 10. (Q1X2-1X4)Average (mean) days of limitation, by history of seeing abuse as a child, Jefferson County 2001 BRFSS Average days in past 30 of... All Saw parent abused Did not see parent abused Significance Poor physical health 4.28 5.29 4.23 n.s. Poor mental health* 2.88 5.01 2.66 p<.05 Impaired functioning 2.15 3.32 2.03 n.s. Figure 10. Average days of poor health in past 30 days, by history of seeing parent abused, Jefferson County 2001 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 7.00 - ■AII ❑Saw parent abused ®Did not see parent abused 6.00 - 5.29 • 5.00 - 5.01 4.28 4.23 4.00 4 3.32A 3.00 2.88 2.66 ilii '} {:;, :> ,iii\\C:: '::>' 2.15 2.03 f:::: C\ .; ;. .:,.,.ti,,y 2.00 : 4 !,:a••:.,:.••::•.-!.-!::',.:,.:::',.:,:.•'.•'.••:.•%.•%.•'!:.•%.,.-%.•'.•'.•%.•*:.:x1.00 - : to I Poor physical health Poor mental health* Impaired functioning *statistically significant difference,p<.05 • 3/21/02 0 • • 3 3/21/2002 • Jefferson County 2001 BRFSS Households with Children Younger than 18 Jefferson County households with children younger than 18 have unusually dense concentrations of adults who reported health care access problems and who smoke, drink heavily, and themselves have childhood histories of abuse. • Respondents were asked how many children younger than 18 lived in their homes. 595 people answered that question; 417 (70%) had no children younger than 18 living in their homes, and 178 (30%) had at least one. • Overall, 74% of Jefferson County adults had had a routine checkup within the past year, but only 65% of adults living in households with children younger than 18 had (Figure 1). • Seventy-one percent of county adults had their teeth cleaned in the past year, but only 65% of households which included children younger than 18 had (Figure 1). • Forty-two percent of all adults said cost was a barrier to seeing the dentist, but that figure rose to 68% of adults whose household included children younger than 18 (Figure 1). • Sixteen percent of all adults currently smoke cigarettes, but 24% of adults whose households include children younger than 18 smoke (Figure 2). • Seventeen percent of all adults are heavy drinkers (that is, consumed five or more drinks of alcohol at one time in the past 30 days), but 28% of adults whose households include children younger than 18 are heavy drinkers (Figure 2). • Twenty-five percent of adults reported experiencing some type of abuse in their childhood. Among households currently including children younger than 18, that rate rose to 33% (Figure 3). • Nine percent of adults reported experiencing physical abuse in their childhoods. Among households currently including children younger than 18, that rate rose to 15%. • Eleven percent of adults reported seeing a parent or guardian physically abused during their (the respondents') childhood. Among households currently including children younger than 18, the rate was 16%. • • Figure 1. (Q13x6) Selected health care access measures and presence of children <18 in household,Jefferson County 2001 BRFSS All households Children <18 No Children <18 Adult had routine physical in 12 months* 74% 65% 78% Adult had teeth cleaned in last year* 71% 65% 74% Cost was barrier to seeing dentist* 42% 68% 26% Figure 1. Selected health care access measures and presence of children <18 in household, Jefferson County 2001 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 100% - MAD households ❑Children <18 0 N Children <18 90% - 0 80% - ° 74% 74% • 71% 70% 65% 65/0 o 68% 60% o _ 50% - 42% 40% - 30% - 26% o - 20/o 10% o _ 0% Adult had routine physical Adult had teeth cleaned in Cost was barrier to seeing in 12 months* last year* dentist* *All differences are statistically significant. 3/21/02 • Figure 2. (Q13x6) Selected adult risk factors and presence of children <18 in household,Jefferson County 2001 BRFSS All households Children <18 No Children <18 Current smoker* 16% 24% 13% Heavy drinker* 17% 28% 13% Figure 2. Adult risk factors and presence of children <18 in household, Jefferson County 2001 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 100% - 90% - ■All households ❑Children <18 0No Children <18 80% - ill70% - 60% - 50% - 40% - 30% - 28% 24% 20% - 16% 17% 13% 13% e7 je/i 10% 0% C".f:/// , /7/ 1 Current smoker* Heavy drinker* *All differences are statistically significant. • 3/21/02 DRAFT • Figure 3. (Q13x6)Adults reporting childhood abuse histories and presence of children <18 in current household,Jefferson County 2001 BRFSS All households Children <18 No Children <18 Any reported abuse as a child* 25% 33% 21% Physical abuse* 9% 15% 7% Saw parent abused* 11% 16% 9% Figure 3. Adults reporting childhood abuse histories and presence of children <18 in current household, Jefferson County 2001 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 100% - 90% - 80% - •All households ❑Children <18 ElNo Children <18 • 70% - 60% - 50% - 40% - 33% 30% - 25% 21% 20% - 16% 15% 9/° ° 11% 9% 10% - 7% o Any reported abuse Physical abuse* Saw parent abused* as a child* *All differences are statistically significant. • 3/21/02 • Board of Health Media Report • March 21, 2002 • PATTY MURRAY COMMITTEES: WASHINGTON APPROPRIATIONS BUDGET HEALTH,EDUCATION,LABOR United *tate& *111at1AND PENSIONS VETERANS'AFFAIRS WASHINGTON,DC 20510-4704 February 8, 2002 Jean Baldwin Community Health Director RECEIVED Jefferson County MAR 01 2002 Health and Human Services 615 Sheridan Jefferson countY im- Port Townsend, Washington 98368-2439 ' ttNSery Dear Jean: Thank you for contacting me with your concerns about our Nation's readiness for detection and treatment of bioterrorism. It was good to hear from you. As you know, with the recent terrorist use of the United States mail system to spread Anthrax, our national public health infrastructure has been put to the test and shown its flaws. We are now realizing that increased investment in the system is needed and will be the only way to prepare for and detect outbreaks of infectious diseases and bioterrorism. • I am proud to be a cosponsor of the Bioterrorism Preparedness Act of 2001 which includes _ money for drugs and vaccines and would give $1.1 billion to states, including $670 million in grants for bioterrorism preparedness. The bill also would provide $500 million to protect food supplies and crops and $120 million for the CDC to improve its medical response system and laboratories and create a national laboratory network. Its goals would be to enable the Federal Government to provide health care assistance to States and localities in the event of a biological threat or attack, improve public health, hospital, laboratory, communications, and emergency response personnel preparedness and responsiveness at the State and local levels, rapidly develop and manufacture needed therapies, vaccines, and medical supplies, and enhance the protection of the nation's food supply and protecting agriculture against biological threats or attacks. An essential part of combating these threats is early detection. I realize that our weakest link in the detection process is the over 45 million Americans who do not have any health care coverage and many more are underinsured. Without health insurance, access to health care services for many American families is almost impossible, making early detection of diseases much more difficult. I strongly support legislative efforts to increase access to health care services. In 1994, Congress considered establishing a universal health care coverage system, but it was overwhelmingly rejected. It seems that a majority of Americans are not ready for wholesale health care reform. However, I have always been a strong supporter of the State Children's Health Insurance Program(CHIP). This important program provides funding for health care coverage for low-income children. . 2930 WETMORE AVENUE 2988 JACKSON FEDERAL BUILDING 601 WEST MAIN 140 FEDERAL BUILDING 402 E.YAKIMA AVENUE SUITE 903 915 2ND AVENUE SUITE 1213 500 W.12TH STREET SUITE 390 EVERETT,WA 98201-4107 SEATTLE,WA 98174-1003 SPOKANE,WA 99201-0613 VANCOUVER,WA 98660-2871 YAKIMA,WA 98901-2760 (425)259-6515 (206)553-5545 (509)624-9515 (360)696-7797 (509)453-7462 PRINTED ON RECYCLED PAPER Internet:senator murray@murray senategoy worldwide web:http://wwwsenate.gov/—murray/ You may also be interested to know that I am a cosponsor of the Protecting America's Children • Against Terrorism Act, S.1539. Currently, our health system is inadequately prepared for biological and chemical terrorism against children and our health providers have very little information or training on the symptoms and treatments of illness resulting from children's exposure to chemical and biological agents. This bill would ensure that our country's health system take into account the health needs of children and youth through researching appropriate doses of vaccines, training physicians and health care personnel on how to deal with these specific needs of children, providing community information and outreach to ensure that parents and families have the necessary information to protect their children and attend to their immediate health needs shouki an attack occur, and ensuring that schools have a plan in place to safely evacuate all students and school personnel and notify parents of their children's whereabouts. I have concerns about the safety of providing widespread vaccines when the effects of which have not been tested on women and children. As a member of the Senate Health, Education, Labor and Pensions Committee I have worked to increase funding for CDC to improve the stock pile of the vaccines. I have also worked to improve funding to support enhanced communication between public health authorities and CDC to respond to any biological weapons threat. Rapid communication and response from CDC would be critical to saving thousands of lives. Rest assured, the nation's preparedness for the threat of bioterrorism is one of my greatest concerns and I will continue to work to improve our health care infrastructure to combat these threats. Again, thank you for contacting me regarding this important issue. Please keep in touch. • rely, eep Patty rray United States Senator l ke PM\jmh • • Jefferson County Health and Human Services FEBRUARY— MARCH 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. "Running out of time: Deaths outpace births in Jefferson, Clallam counties", 2 pages, Peninsula Daily News, February 24, 2002. 2. "Marrowstone residents hot, cold for PUD", P.T. LEADER, February 27, 2002. 3. "Commissioners reaffirm their support for county administrator",P.T. LEADER, February 27, 2002. 4. "County well drilling could be restricted", P.T. LEADER, March 6, 2002. 5. "Quilcene spruces self up", Peninsula Daily News, March 10, 2002 • 6. "Quilcene coordinates cleanup", P.T. LEADER, March 13, 2002 7. "Everyone shares the air: keep it clean", P.T. LEADER, March 13, 2002 8. "County plans drastic steps to fix budget", Peninsula Daily News, March 12, 2002. 9. "County budget$1 million short: Commissioners OK hiring freeze", P.T. LEADER, March 13, 2002. 10. "County launches `EnviroStars' program", P.T. LEADER, March 13, 2002. 11. "County, environmentalists settle", P.T. LEADER, March 13, 2002. 12. "Elected officials seek input on county administrator evaluation",P.T. LEADER, March 13, 2002 13. "Top county executive terminated", Peninsula Daily News, March 14, 2002. 14. "Jefferson to review crisis response plans", Peninsula Daily News, March 14, 2002 • 1 • ; fig '' up 3 s14ICs) ^ — Z -•t4.-s‘i, N, N >8) 0, :=," tMk ,� t-' ` Z 7�E aif4tr �� co _ Z �, r v _o m 66, 6• 6, a . _ 9 � 6; i N Nj _ S� 5n �:4 6' /N Nr xw 0.1 61 let (13 'sem O — A' UCYAN ^M.^tom N N v6), �I ,5 13 On ,C1/ . w,..,:•: - 61 N L9 r ' Li I I I I I I I I i'- I 0 00 CD moi' N O co co ':r N O" M N N N N N i— — r .- 1 0 o 00 0 ' ":3 0.) • , �-, o^ poi 400 w ZS) &)',-.. 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O -Om 'D .1.) o a, Z . °OgNATC ^ wib „.5 Nu c L.'") u _ 40 ayw 7 . ° .a > D uT!T i 0 O VS b y 5 L g3 O. W — c -O _ u 4 y = c g y1° v c?, c,) '0 d LL q ouY o -„ o =oto .., 06 .- u o Cr� m-' " n. o ._ E . u E u 2O >O , EOUp' d >..E gupO QLL .- .sg `aW u y (9 g u to u U u ,, o O u o a L D� t _ g 3ab C ~ r = m pCau0 O 3 ° x 'ca ` v E E 3 ° o °H5 -J3 3 c w - s 3 110 Wednesday,February 27,2002 •A 4 Commissioners r their support for county administrator By Philip L.Watness employees' hours rather than the budget matter,"Saddler said. among elected officials and de- Leader Staff Writer cutting positions. "We have an$800,000 deficit in partment directors wasn't unex- "He apparently said he was in an$11 million budget.It's going pected, especially given the Jefferson CountyAdministra- charge and he was laying down to have to be people." daunting economic conditions tor Charles Saddler has the back- the law,"Huntingford said."If we Saddler said his office won't that indicate Jefferson County ing of at least two of his bosses stay on the same route,we'll get be immune to personnel cut- will have an $800,000 hole in following a discussion Monday. very little cooperation on budget backs.He said he plans to reduce its budget if cuts aren't made Commissioner Richard Wojt issues." the number of deputy adminis- and/or user fees and taxes in- broached the subject of Commissioner Dan Titterness trators from two to one this year. creased. Saddler's job security because said Saddler has his support, That can be accomplished if "It was inevitable because he said he'd been hearing ru- though he is concerned the Deputy County Administrator this is the first time the county mors that the commissioners administrator's office has too David Goldsmith decides to re- has gone to the administrative were unhappy with the many deputies. tire following 26 years with the form of government," Saddler administrator's performance. "I support Charles Saddler county. Goldsmith said he will said."They went willingly,but 4110 "I'm hearing questions of and the work he's doing, and I decide in June whether to retire. it was a change in government whether we can afford a county understand some people are not Saddler said that might save without unanimity." administrator and whether we are comfortable with what he has some money, but Goldsmith's Huntingford said the county getting an advantage from hav- said,"Tittemesssaid."We'refac- duties as risk manager and hu- commissioners and admin- ing a county administrator,"Wojt ing difficult budget problems, man resources director will have istrator's office will also bear told his fellow commissioners. and he's stuck in the middle as to be covered by someone, so some of the pain of cutbacks. "The advantage is that we get the administrator,but I don't see cost savings aren't guaranteed. "The county really has to focused direction to the staff,so any immediate changes coming." "The county administrator's take a hard look at itself bud- the strategies the board decides Saddler took exception to office is set up so the office is get-wise, and we also need to on. we have somebody to bring Huntingford's characterization of pretty top-heavy—there is some look at ourselves,"Huntingford the ideas together." his comments to another elected concern there," Titterness said. said."We're asking everyone to Commissioner Glen Hunting- official, but when the commis- "We've asked that to be looked look at what's mandated and ford said he was initially opposed sioner began speaking specifics, at, and I'm fairly confident that what's not.We aren't mandated to the idea of hiring a county ad- Wojt said he thought the discus- will be addressed." to have an administrative posi- ministrator when consultant Ken sion should take place in execu- Wojt said his motivation in tion." Lynn of Bainbridge Island rec- tive session. On Tuesday, the raising the subject was to send a Saddler said he has saved ommended the new position ap- commissioners discussed clear signal to department direc- the county more money than proximately three years ago.That Saddler's performance evalua- tors, including elected officials, his $82,400 annual salary. He led to the hiring of Saddler,who tion, which is due on his second that the commissioners have no discovered the county had been is approaching two years in the anniversary March 1. plans to scrub the county admin- under-billing Port Townsend job this March. Saddler said the county istrator position. for jail services by $125,000 Huntingford declined to com- government has to make dra- "We are going to have to say per year. Combined with other ment on Saddler's performance matic changes in operations, to all the elected officials and the "found" money, Saddler said Tuesday,but Monday he said one and much of it will fall on staff that the administrator posi- he recouped $131,500 in his of the other elected county offi- employees because salaries tion is solid,"he said. "We need first year as administrator. cials had complained that Sad- and benefits consume 80 per- to send that message out loud and "There's no reason to be- dler had dismissed a suggestion cent of the budget. clear so we can get on with insti- lieve we'd have discovered it •that budget savings could be "If you just reduce people's tuting policies." without someone like me in accomplished by reducing hours, that doesn't take care of Saddler said the dissension this position," he said. • Countywell drilling could be restricted Jefferson County Water Re- within 1,000 feet of marine source Specialist David coastlines as Critical Seawater Christensen outlined a plan for Intrusion Zones.Wells would be addressing potential seawater in- prohibited from within 100 feet trusion of wells for the county of the zones, or 1,100 feet from commissioners Monday. the shoreline. The plan is a response to an The county commissioners order by the Western Washing- plan to appoint a citizens task tort Growth Management Hear- force to review and refine the ings Board that the county proposal. The new regulations identify areas susceptible to sea- would then go through the usual water intrusion and develop a public hearing process for adop- plan to limit the threat. tion into the county's Unified • The plan designates any land Development Code. 3- 6 -d 2_, • 6. March 10. 2002 • rQuilcene spruces self up Townsfolk razing derelict buildings Quilcene: Clean BY STUART ELLIOTT CONTINUED FROM Al gets chronic garbage dumping PENINSULA DAILY NEWS that takes place in residential QUILCENE — Property owners and corn- "They weren't aware of the areas'e munity volunteers have set to work tearingcondition of the property," County code specifies that Siemion said. "When they were down several derelict buildings along U.S. approached by the county and garbage must be kept in con- Highway 101 as a means of sprucing up down- tamers,she said. town community members, they But the county has histori- Quilcene. were active and cooperative Armed with handtools,crowbars and elbow about helping to clean it up." �lY had little power in terms grease to remove a collapsed three-car garage of enforcing that policy,Pearson at the southern end of town, a group of more Start of a community trend? said.than 20 people started working last week. "We basically just send out a In the coming weeks,a burned-down house Molly Pearson, environmen- letter,"she said. will be demolished, junked cars towed away tal educator at the Environ- Environmental health offi- • and other garbage removed from the quarter- mental Health Department, cials are currently developing acre site that contains two rental properties hopes the clean-up effort is the an ordinance that would give abandoned for the last four years. beginning of a trend. the county the ability to issue "As you enter town, its the first thing you "One of the things I'm tickets and fines to chronic see," said Kit Siemion, a licensed massage always looking for is whenever trash offenders and eventually practitioner who has a business next door. "It we can get government, indus- dragthem into Jefferson was an eyesore." try and community together County District Court. Volunteer effort like this,"she said. "If we find out there is a pol- Pearson spends much of her icy violation," she said. "This Siemion,who led the effort to clean up the job investigating illegal dump- would give us some clout." area, got together volunteers from the Cross- ing area,she said. The ordinance is currently roads Recovery Center and others in the corn- It's common to find illegal being reviewed by county munity last Saturday to help tear down the 'dumps in remote areas:on state administrators and the prose- structure and remove trash like stoves,bikes, Department ,.of Natural outing attorney's office. • wires, old roofing and bags of garbage that Resources land or land owned It is expected to come before had gathered in the area over the years. by Olympic Resource Manage- Jefferson County commission- The community was very supportive," ment. ers for consideration during the Siemion said. But her department also tar- next month,Pearson said. The first clean up effort — Siemion said she will target other areas but won't say where yet — came about after the property passed from the previous owner to Partner Mortgage Corp. of Mercer Island. "The man who had owned it previously had been approached, and would not help at all," Siemion said. Annie Ricker,who owns property adjoining the site, said the area had become a de facto dumping ground over the years. "At one point, I had a Dumpster there,but after it was gone,people continued dumping," she said. "It was just habit." ' Trash bin costs Siemion had filed complaints with the Jef- • ferson County Environmental Health Depart- ment over the property, and the department contacted the mortgage company about clean- ing up the site once the property changed hands. The Mercer Island company has already paid for trash bin costs and plans to pay for asbestos removal and costs to take down one of the buildings at some point over the next several weeks,Siemion said. 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E ° a. .a 8. oA >, ooa 0 wuiU1Duu1 iUi >, u74 Eb ° OD° b (rC 6. ,° U c E • v > •. ao•� o 3 � c 4 Y0 ° 4 0 � � g0 [[ 0 co0er oU >, ° F.. >,M c � �055oou aA 7xa ° 8vw o a .oa h otw •5� wA 0), ,..0 E , y 8 .e ° d 0 ° LID q on o ° ' °� ° ° v '°) > Go a .ga a ap3 aami v atp P. E . 5 I, .5 •C .am, ° -/ / C3 b = ° yE g ad, E •J - •. a- - aoc''° to .a ^4 , wu ° 5 � ° " g)8 y E UU g v . C = . op C o o ; u0 •a o .$ •v oa -5b `• a Nsv u E o 5ppAvcvvC at-9," ° ° s". U OUA.'6. y " g 2 N , y O, U H ° N ° o8 3 > 0 7 .. oLd - ° '" 3 o .P > ooo :2v 000 ab b o '� � 3 - HWW E ' wsaya ° . 5 � au ° w° O '' ° 'C w .') ° ° ❑ S 'S o `" > m0- p,2. ADog E OiEP - 0 'ZJ" .s " o oa .. Q v ° ° O 0. La .0.co •a o . > v3 .n 8 Edition March 12, 2002 •County ans drasticstepsF, o7? po. y c , 2 - 2.- mi m p a� o o , m • �`t, N O0 UO a)0 y Q-O cn to fix budget W ani m ° o' o, cu cL) a a ,.., 0 o rc2,cr, -E a 2 id-; co 0 cn 1) a ° °m con ° Pay cuts hiring from the state. E z ,,,,--.:,,,) t-o b-1;97:' a o'ti Qb l 0 Revenue predictions show the o'7 o,� a E~ ,., ani�' Q ° 2 ` E' " than toriginalygprojected$400,000thiless E~ ro a No > -o 3),E~ -' o 0 \.- .b freeze amongcow`''a2. .a. 2, °. 8oJ'D N 2 sales tax, private harvest tax, and likely actions interest earned on money it cur- rently has in reserve. di a a [ aE °A vi c y 3 a ai o 5' m a).-. a o ._ Commissioners will consider a > 8 3 °o. , 0'E 0 3 c 0 PErrssui DAILYEEws fersonresolution Countytoday Cou Courthouse se to freeze •S c a E.m. at the Jef- z a-V6.2 2.° o-[ 0 �' 0 o cu new employment positions and 'o Q o a °'•" 3 '9 U 52 ` E o Jefferson County commissioners require review by county commis- c°�a 0 o ro 0 - °'E c a a. > are weighing midyear budget cuts sinners before any vacant posts are o o E" c° o g - , ,' co > end a hiring freeze as the county's filled. `� o a 3 ° y, •' ° o o end position worsens amid a The proposed salarycd . o o '- o In 3 U 72, a =01 T slowingstate economyp p reductions, 17...0 Q o ao m••� ° n-o a 0 o-0 totaling $219,000, would include '4'� 2 p p ,F"Ts xcz L — 1) - Two months after the county's reducing management salaries by 4 3 U an a o o ° c of o> 2002 budget was adopted, a county percent, reducing the number of H 2 :-o. 'a a.0 a. °: 2 aii < n. budget committee recommended hours for contract employees and r Q Q x 3 ro E° Monday that more than $400,000 in clerk hirings by 4 percent, and `/ additional cuts be made this year to reducing overtime by 25 percent, a .,;:11,-,:._> a -5 > g a 5 °a' o > the $12.1 million general fund bud- among other measures, accordingto ■ ■ wo ° �' °x a ti° v o a ° 0 >, ma, aa..a ci 2� � a get. the report. x . "It appears that our budget Q a = deficit will be considerably worse Situation review w . -, o a a o a g to �. 0 ro than projected," Jefferson Countyz co •Q.0 a, 8 2 O aa' .N.0 a i;0.°�' cu'' Central Services Director Gary Elected and appointed officials H v o 3 o a s Rowe told commissioners. are scheduled to meet April 17 totiw o ° v�° �, a'o "We're talking about a significant review the budget situation and U a N E S.4 o•� c'a a a 5 shortfall." make recommendations on balanc- a °�,' = �; ° ° [ y ingthe budget over the next several a o as a 2 k E " G x Commissioners could take action g u, d o a .� o ° as soon as this afternoon to shore u years, during which there is M U t•.. tj E• c•9 o pq a x z ° the budget. p expected to be similar shortfalls. W ,� E ° ° °a ro E o s o a Projected revenue for 2003 is 3 3 n " .� °°� " ° ° Recommended eat include a hir- expected to be around $11.1 million, ing freeze, snlery and benefit reduc- nearly $1 million less than this tions for county employees, and a year's $12.1 million total budget. midyear belt tightening that would The situation is also compounded include anywhere from 5 percent to by the elimination of so-called 25 percent cuts in such areas as "backfill" money that the state gave training, equipment supplies and cities and counties to make up for - professional services. losses from Initiative 695, which Slumping revenues reduced car tab fees. Elimination of the funds in 2003 The projected shortfall is a result ��ill mean a loss of$239,000 for the of a slowing economy that means county, the report said. •ess tax revenues and less money TURN TO BUDGET/A2 • 9 A 10•Wednesday,March 13, 2002 County budget Budget: • 1 million short Continued from Page A 1 county recreation programs All that combined would re- (junior soccer, junior hoop, aCommissioners OK hiring freeze extpendita ure9,254 reduction in s. Jefferson son Countyer camps,etc.)t the new YMCA, By Philip L.Watness "The reduction in expendi- though the entire amount likely Leader Staff Writer Costly administration tures is for a full year, but to wouldn't be realized because Elected officials meet,see page A 10 accomplish a 4 percent cut,you the YMCA has asked for county Dire financial forecasts have forced have only six or seven months financial support during its for- the Jefferson County commissioners to to do that;' Rowe said. "To do mative years.The commission- look for cuts in all departments and re- Another$239,914 will likely not be that,you'd have to double these ers haven't indicated whether think property tax increases. forthcoming from state coffers due to the numbers." they support the idea. At this The first move came Tuesday after- state's budget shortfall.That gmpilnt had noon with a unaminous decision for a been provided this year to make up for Rowe also presented the point, it is just one of many hiring freeze on all county jobs,effec- revenue lost to the motor vehicle excise commissioners with a grocery options Rowe proposed they live immediately. Any job openings tax rollback caused by voter approval of list of places to tighten the bud- consider. deemed"mission critical,"such as an E- Initiative 695.The vehicle tab fee roll- get belt, including reducing With all that,the county cof- 91 1 radio dispatcher,could still be filled, back was ruled unconstitutional by the supplies,professional services, fers would still be$200,000 shy Deputy County Administrator Gary Washington Supreme Court,but the state Rove told the commissioners Monday Legislature decided not to keep the old travel and training, and sub- of matching expenditures with he expects 2002 revenues earmarked for higher fees. scriptions and memberships to lower revenues. the general fund to be $1 million less Rowe provided a list of potential cut- outside organizations.The belt than anticipated last fall. The current backs that included a 3 percent salary would also be pulled tight on Property tax hike? budget expected$12,178,360,but Rowe reduction for all elected officials effec- Public Works, E-911 dispatch The commissioners will estimated the revised revenues will be live in 2003 (the three commissioners services and Health and Human consider placing a hiring freeze S 11,375,873. cannot reduce their salaries this year),a The county will earn$200,000 less 4percent salaryServices,with 5 percent reduc- on all departments and have reduction for all em- tions in general fund transfers. begun w in interest earnings,receive$136,500 ployees,a 25 percent reduction in over- g discussing Nether to 411, ess in timber tax revenue and get time hours and a$15,208 reduction in All that would save another increase property tax revenues 80A00 less in sales taxes, Rowe es- benefits. $193,869, leaving a gaping up to the full 13 percent allowed timated. See BUDGET,Page 10 $519,281 hole in the current by state law(1 percent per year budget. for this year and beyond, but 6 Rowe proposed removing a percent for each of the past two $171,620 general fund transfer years when the commissioners to the Central Services Depart- decided against collecting the ment for construction and reno- maximum allowed by law). vation; a $40,000 transfer to "That gives you the scope, Public Works'special projects; or scale,of the budget we need a $51,893 transfer to Commu- to consider,"Rowe said. nity Services; and another County Administrator $34,583 transfer for flood and Charles Saddler said the com- stormwater management by missioners shouldn't expect Public Works. In addition, the departments to be able to come county could eliminate$25,000 in under budget as they have in in support of the after-school past years because they have program popular in Quilcene, already factored in 2 percent and another $25,000 for non- reductions in personnel and departmental expenses. non-personnel costs. That would save another The department heads $383,721 — still far from the have also been looking at needed$1 million. their programs to determine The county could realize which are mandated by state another $177,404 through a law.The commissioners have $64,000 contribution by the scheduled a full-day retreat City of Port Townsend to sup- April 17 at the WSU Commu- • port the WSU Cooperative Ex- nity Learning Center, 201 W. tension set-vices and a$117,404 Patison, Port Hadlock, to re- reduction by spinning off view their findings. /0 • w .i:) oo N � �o ° 'Sb � � .Y o a 7 g C ❑ � pp p `n U SU . }r N Ng � 0G '' .V c> Gga vC O , aH W Octo p 'd „ ~ p pp . 0yy �' y w T .D G vi rC 5 ,i C x 0. ` 0.7:5 ) . 2, 4.) 80 E C E c S ° o,v • n 80oagU ^Cy by O > • trs) • o . 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O ° po r � y � 0 W .0 ii ,3i 9 < 9 /•••'•"4 _ p U p E U v) 0 > y 3 a n. 3 0 O C y E p .)U O g •-4 cca O 41.'1 v, 5, p 'ti > 'b O • U ..,' 0 0 vi y : u ° C CN v av ou o ' • a "C U .L D Tp p � M• ~ T 7 y A Y U . O C 'fl b p N2 •g • g 74 0 O int'ua o pi v; . .u0 U 0 y a C• p a' a .0 •-• ,...- L.) p ° C ^ o 0 Q p ' •[ r-] w C N1 ') aOa : > C a tl 00cn . 0 a) w Ga E y o • • County - environmentalists settle Jefferson County has agreed government officials engaged turbed by new development. It public health, pubcnd to address several environmental in constructive dialogue can will develop a process or classi the property damages restulting issues in the coming year under produce creative solutions that fying and protecting state prior- from development in areas prone a negotiated settlement with the protect the environment and ity and locally important species to flooding hazards." Washington Environmental address the concerns of local and'their habitat, using.a land- Gorsline said the environmen- Council (WEC). government." scape-based approach where tel The council had appealed nu- County Civil Deputy Pros- possible. coonciln ou dispute with nty focused n merous provisions of the ecuting Attorney David Alvarez Beginning with Chimacum methods to achieve the county's county's Unified Development agreed:"I think it's a good corn- Creek,the county will initiate a stated goals to protect and en- Code pertaining to floodplains, promise.lt:alIgws,us tq pr©ceed -collaboratiYe,stakeholder.effort ;hance yvretlands,,fish and wildlife wildlife and wetlands. with what we wanted to do any- to develop a systematic, volun- habitat. The agreement, finalized way.It stops the legal process so tary watershed-based program to "We have a lot of work to do March 5,settles a lawsuit which we can focus on science and data address the impacts of agricul- to implement this agreement," had been brought by WEC alleg- gathering." ture on salmon habitat. If the said Dave Christensen, county ing that the county had failed to The agreement calls for voluntary approach is not imple- natural resources division man- follow provisions of•the law Jefferson County to initiate a mented within two years, the ager. "We're looking forward to which require the county to pro- project to identify and map flood county will adopt new regula- working with WEC to put this on tect salmon habitat and other hazard areas and river meander tions to address the impacts of the ground. We actually began critical areas from the harmful patterns of the major eastern agriculture on fish and wildlife down this pathway last year,when impacts of development and county rivers, followed by an habitat. Oher activities. we obtained state funding to iden- of its regulationsto bet- "This settlement will benefit tify the best remaining salmon "This agreement is a real win ter protect fish and wildlife in the all residents of the county,"said habitat in eastern Jefferson for both the environment and the floodplain.The county will also County Administrator Charles County. Our next projects will county," said Jerry Gorsline, follow a policy developed by the Saddler. "Not only will it im- include wildlife habitat mapping WEC policy associate."It shows state Department of Ecology for prove fish and wildlife habitat, and improving knowledge of flood that environmentalists and local replacing wetlands that are dis- but it also will reduce risks to hazard areas." LEIcPhi -(3 -02 111 / 1 Port Townsend&Jefferson County Leader • • see officials Elected k input on county evaluation By Philip L.Watness vey any concerns we had had over the budgeting process, as they administrator's office is top- Leader Staff Writer the last two or three years, and have been accustomed to doing heavy,and that's no secret." there were a lot of them," said in previous years. Walters said the potential $1 The Jefferson County corn- County Clerk Marianne Walters. "The Jefferson County elected million budget deficit demands missioners met Tuesday in an The two-hour meeting in- officials have always worked well that the commissioners cut their extraordinary executive session cluded all the elected officials: together," Eldridge said. "We own expenditures as well as with all of the other elected offi- judges,sheriff,prosecuting attor- wanted to have some input on those of other departments. cials to discuss the pending an- ney, treasurer, auditor, assessor Charles' performance evaluation "The county is at a real piv- nual job evaluation of County and clerk of court. as county administrator." otal point right now," she said. Administrator Charles Saddler. Treasurer Judi Morris said the Titterness said the officials "They've got to make some lead- "' "At least one elected official officials expressed their desire to provided useful information that ership decisions. They will ask ' aid if he was a commissioner, have input on Saddler's evaluation. would be considered as the coin- us to make tough decisions,and he would eliminate the county "I think it's appropriate for us missioners draft Saddler's evalu- they need to look in their own administrator position," County to share with the commissioners ation, which could be complete camp first." Commissioner Dan Titterness our perceptions of Charles'per- by the end of the week. An ex- Assessor Jack Westerman III said Tuesday. formance," she said."Some ap- ecutive session to review said the elected officials pre- Several elected officials re- preciate his role and some think Saddler's job performance was sented both the pros and cons of frained from stating that to a re- some things could be done in a scheduled for Wednesday. Saddler's performance. porter, but they did say they different manner." "Some are dissatisfied with "This was not a beat-up ses- expressed criticism of Saddler's Auditor Donna Eldridge said things and others were compli- sion," he said. "We knew that performance over the past year, the meeting was an opportunity mentary," he said. "Some had we're going through a process— particularly regarding budget for elected officials to impress comments on the current county the budget scenario has just been matters. upon the commissioners their administrator,but they also gave finished—and we felt the board "We definitely wanted to con- desire to be involved throughout the clear message that the county could use our input." 3 -t3 -07-- • N O 5 O a 0 0 .°-y co m M O 4 b ("D m 0 m ,Y w 0 „N m a Can p- b,, ( J Cl) ` m -wG < N a.m "mm < m ° O pm ' .< m ma. om m VJ ' 0 10.,.3 0 10 t7 0•m `4 CI) S52� p,?'=+�C-1 cn CA 7,1 ° m G m Z � '._ �- ' £ m �� °o�°' es� CL. 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' )•••••LQ ..b . ( D ti D ,..I ... • ' mNo ° G mLo ~ _ 0N ° "O'o '''•<-1- .um "E.0-` m cm' N� o' m m r 0 0 m a p "m00 , p ° mpu w m "° ° r. o0wa m 0 oym 0 G oom0mK"'10 £ 0 Obop o ,1-1„, -..,:a oy Gn0°mo`< �.. N`< m o10'"� Cn c. -o — m m � o • � m Cro° 0m oo mm 5 •w baG m <<c 5mobo• mm mE0 a " ma '-'r. w ' '-s m 0 n o 5 Z•p 0 " � = °• co comm _ ° coma'< _ ' oa co cn 1 13 • Jefferson to crisis responseplans BY JOSH BELZMAN the outward, geometric migra- PENINSULA DAILY NEWS "Jefferson County has a tion of a problem," he said. Is Jefferson County a target pretty low probability of "The psychological aspect of for international terrorists? being a terrorist tar , but some kind of terrorist event will et Those responsible for devel- � gbe worse than the event itself. oping the county's emergency that's not to say we Coordinating a local be prepared." response are busy updating shouldn't response to natural and man- LIN made emergencies is the charge their plans to contend with BOB HAM new, manmade threats and Jefferson Countyofo mithemergencyi planning repre- applying for homeland-security Office of Emergency Management committee,from local vefunds from the federal govern- ment, police, fire and medical Some of those efforts will be of developing a terrorism agencies.The group's meetings, outlined f thus when the Jef- addendum to its emergency held every other month, are - management plan. open to the public. ferson-Peninsula Regional "Jefferson County has a The federal Emergency • Emergency Planning Commit- pretty low probability of being a Planning and Community Commit- tee meets at 10 a.m. at the Chi- me Fire Department, 9193 terrorist target, but that's not Right-to-Know Act requires the Rhody Drive. to say we shouldn't be pre- committee to make public its The focus of the public meet- pared, Hamlin said. hazardous materials response ing will be a federally required plans and records about the Fallout from Puget Sound transportation, manufacture, annual review of the county's hazardous materials response Hamlin, who has led emer- storage and use of dangerous plan — one which has under- gency planning efforts in the Tnaterealin the area. gone few substantive changes region for more than 30 years, The act also requires an in the past year. said the greatest threat to Jef- annual review of for the plans and But bioterrorism and other ferson County comes not from a an opportunity public corn- But post-Sept. 11 topics also will be conventional or biological discussed, said Bob Hamlin, attack, but from urban popula-gThet. community has shown an increased interest in emer- Jefferson County Office of tions that might descend upon gency response matters since Emergency Management coor- it following a terrorist strike in the terrorist attacks, said Mark dinator. the Puget Sound area. Bowes,Jefferson County safety The county is in the process "I'm most concerned about programs coordinator. III