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HomeMy WebLinkAbout2002- July File Copy Jefferson County Board of Health Agenda i & Minutes ii "gt July 18 , 2002 11,f1 11 • JEFFERSON COUNTY BOARD OF HEALTH Thursday, July 18, 2002 2:30—4:30 PM Main Conference Room Jefferson Health and Human Services AGENDA I. Approval of Agenda II. Approval of Minutes of Meetings of June 13, 2002 III. Public Comments IV. Old Business and Informational Items 1. Civil Penalties Ordinance—First Draft Larry • 2. Complaint Investigation Enforcement Manual Larry V. New Business 1. 2002 Washington State Health Report Tom 2. Jefferson County Tobacco Prevention and Control Report Kellie 3. The Health of Jefferson County and Port Townsend— July 8, 2002 Report to the Port Townsend City Council Jean 4. Jefferson Access Project/Joint Board Project Update Tom Jean VI. Agenda Planning VII. Next Meeting: August 15, 2002, 2:30-4:30 PM Main Conference Room,JHHS a JEFFERSON COUNTY BOARD OF HEALTH iDR AFT MINUTES Thursday,June 13, 2002 DR A Aipt Board Members: Stair Nlembers: Dan Titterness,Member- County Commissioner District#1 Jean Baldwin, Nursing Services Director Glen Huntingford,Member- County Commissioner District#2 Larg Fay,Environmental Health Director Richard IY'ojt,Member-County Commissioner District#3 Thomas Locke,MD, 1-lealth Officer Geoffrey Masd, Tice Chairman-Port TownsendCity Council Jill Buhler,,Member-Hospital Commissioner District#2 Sheila Westerman, Chairman- Citizen at Large (City) Roberta Fussell,Member- Cititien at Large (County) Vice Chairman Masci called the meeting to order at 2:00 p.m. All Board and Staff members were present, with the exception of Chairman Westerman. APPROVAL OF AGENDA Member Frissell moved to approve the Agenda. Commissioner Wojt seconded the motion,which carried Al a unanimous vote. APPROVAL OF MINUTES Commissioner Wojt moved to approve the minutes of Thursday, May 16, 2002. Member Buhler seconded the motion, which carried by a unanimous vote. PUBLIC COMMENT -None OLD BUSINESS AND INFORMATIONAL ITEMS Abatement of Public Health Nuisances—Policy Options: Referring to his memorandum to the Board regarding abatement issues and authorities, David Alvarez summarized two available tools: Civil Infraction and Abatement. Civil infraction is similar to writing a speeding ticket. Recipients go to District Court and pay a fine. The disadvantage or deficiency is that if the individual is unable or disinclined to pay, the problem (cars, garbage, or septic system) may go unabated. It does not work on individuals who refuse to comply and may not be a way to proceed with someone who defies the system. likatement leads to Superior Court where the case gets lined up behind expedited cases. An abatement case requires both proof of the nuisance and pre-trial discovery, which is a multi-layered and extremely HEALTH BOARD MINUTES - June 13, 2002 Page: 3 oting that today's action would have no effect until the codes are changed, Commissioner Wojt asked about getting these conditions codified so that they can be enforced. Larry Fay agreed that more work is needed on a procedures ordinance similar to those in Kitsap and Pacific counties, which says, "violations of health codes... is, among other things, a civil infraction."All of our codes would be combined into one compliance code so that infractions for any violations—solid waste, on-site sewage, drinking water, etc. —could be addressed. The Board of County Commissioners could then adopt a parallel ordinance to create a standardized procedure for civil infraction for building and zoning violations. The first step is the normal notice of violation, followed by work toward resolving the problem, then issuance of a civil infraction and then abatement. Ideally, there would be a need for a compliance officer who knows the system and could "birddog" all the cases. Initially, however, we could move along effectively by creating those authorities, providing training, and getting some consistency about how we approach these problems interdepartmentally. Motion carried by a unanimous vote. Commissioner Wojt moved to direct staff to prepare the necessary process and framework for the designated Notice of Civil Infraction (NOCI) Enforcement Officer. Commissioner Titterness seconded the motion, which carried by a unanimous vote. The Board thanked Mr. Alvarez for his memorandum, after which Mr. Alvarez then left the meeting. •Larry Fay then referred to the solid waste report of violations over the last year, which was included in the agenda packet. There has been a resolution to most of the situations. BOH Policy 96-02 Consideration —Required Connection: Larry Fay noted based on discussions at the last meeting, he made modifications to Policy 96-02 to require connections to public water when there is a compelling public health concern. However, due to some of the recent work on the seawater intrusion policy regarding requiring such connections and alternative water systems, he believes it would make more sense to create a unified Board of Health water code addressing public health issues. While the Board could choose to move forward with the policy as amended, he would like to pursue the development of a water code linking the Department's requirements regarding water development and water improvement to the outcome of the Critical Areas Ordinance. Member Frissell noted that a compelling public health interest would include saltwater intrusion. Commissioner Huntingford questioned whether the Board's approval of the modifications makes any difference since these requirements already exist as part of the Coordinated Water System Plan?When requiring proof of potable water, the first thing the Building Department does is look for a water service area. The individual is required to hook up to this service unless the purveyor states in writing that they do not have the capacity, in which case the property owner can drill an exempt well. Or. Fay agreed that this does happen as part of a Health Department Well Construction Utility Service Review, but modifications to the policy actually reduce the connection requirement. Currently the policy • , HEALTH BOARD MINUTES -June 13, 2002 Page: 5 •ealth felt it had no choice but to create an expansion of an existing category titled Conditional Entry. meaning that entry is conditional upon the completion of the required vaccine series at appropriate intervals. This will now allow kids who cannot get vaccinated because of shortages to be admitted rather than to force families into exemption. In response to a question by Member Buhler about there being only one supplier, Dr. Locke explained that principal among several factors, is low profitability. The other factors are that the regulations are tighter for vaccines and that there are natural delays in creating vaccines. To the question whether we should be gearing up for a potential outbreak, Dr. Locke said that while the risk varies among vaccines, the only concern in the DtaP is the whopping cough component. Tetanus is not transmittable person-to-person and the last case of Diphtheria was in 1985. On the other hand, there were Pertussis outbreaks even when there were adequate vaccine supplies. Staff will be in a heightened surveillance mode for Pertussis in schools, for which there are antibiotics. However, since the vaccine is the only tool against the viral infections like Measles the shortage is much more serious. Because the vaccine wears off when you reach adolescence there is concern about adults reinfecting kids, especially those unimmunized. Currently, all kids are vaccinated for their primary series for DtaP, which provides immunity for 95-97%. The 4`h and 5th doses, to be deferred, are booster doses. While most children will remain immune through their initial school years based upon their primary series, the immunity of 10- 15% of these will wane if they have not had a booster. He noted that we are at an all-time high in vaccine levels in the County and at an all-time low of vaccine preventable diseases. So we are not seeing oany increase of outbreaks during the shortage, but we are coasting on benefit of a vaccinated population. Vice Chairman Masci asked if there is a plan to address the fact that many kids are vulnerable because their parents lack knowledge. Dr. Locke noted that three years ago, Jefferson County peaked at an 8.9% exemption rate for vaccinations, as compared to the State average of 3%. It now appears that after an aggressive effort, this exemption rate may have dropped to 5%. Member Frissell suggested Dr. Locke consider publishing his article about the importance of vaccinations in The Leader again. Commissioner Wojt asked about the State's plans for identifying a protocol for notification in the event of an outbreak. Dr. Locke said a single case of measles constitutes an outbreak. In any such disease where there is a person-to-person risk, all non-immunized kids can be pulled from school. Dr. Locke mentioned that Health Officers from throughout the State wrote to the congressional delegation in order to bring the vaccine issue to the federal level. He asked the Board of its interest in taking similar action to express concern about the shortage and provided a draft letter for review. Commissioner Wojt moved that Staff send the draft letter as presented to both Representatives and Senators. Member Buhler seconded the motion. Member Masci proposed a friendly amendment to the motion to include that the entire Washington State Delegation receive a copy of iiie letter. The motion as amended carried by a unanimous vote. 4 # HEALTH BOARD MINUTES - June 13. 2002 Page: •ata into manageable modules for taking action and what type of framework will work best for looking at performance indicators. Jean Baldwin announced that the Health Depai tment received an $80K prevention grant from the Governor's Commission on Juvenile Justice, the first non-juvenile justice group to do so. AGENDA CALENDAR/ADJOURN The meeting adjourned at 3:30 p.m. The next meeting will be held on Thursday, July 18, 2002 at 2:30 p.m. at the Jefferson County Health and Human Services Conference Room. JEFFERSON COUNTY BOARD OF HEALTH (Excused) Sheila Westerman, Chairman Jill Buhler, Member Geoffrey Masci, Vice-Chairman Richard Wojt, Member Glen Huntingford, Member Roberta Frissell, Member Dan Titterness, Member • Board of Health Old Business Agenda Item # IV., 1 & 2 • Civil Penalties Ordinance & Complaint Investigation Enforcement Manual July 18, 2002 • . `' , . Jefferson CountyHealth ea'Human Services / 1 � 615 SHERIDAN • PORT TOWNSEND,WA 98368 • FAX 360-385-940-1 Memorandum To: Jefferson County Board of Health From: Larry Fay Date: July 10, 2002 Re: Draft Civil Penalties Ordinance and Complaint Response Policy • • Attached for your review are the above referenced documents. These have been prepared at the direction of the BOH in the June Board meeting. The draft civil penalties ordinance was developed using the Bremerton Kitsap Health District, Pacific County and Klickitat County civil penalties ordinances as models. It has been reviewed and edited by David Alvarez, Deputy Prosecutor. The Board is being asked to review and comment. If acceptable, we can initiate appropriate legal advertising and schedule for hearing in August. The second document, "Complaint Response and Investigation Procedures", was originally prepared at the request of Charles Saddler as a framework for a standardized county enforcement methodology. To date no action has been taken at a county level. However, it would be a relatively straightforward matter to edit the procedure so that it is specific to Health and Human Services and adopt it as a standard operating policy at the same time that the Board moves forward with the civil penalties ordinance (inf it chooses to do so). Staff recommends moving forward with both documents and having the board schedule a public hearing at our next regular meeting, August 15th COMMUNITY ENVIRONMENTAL NATURAL DEVELOPMENTAL SUBSTANCE ABUSE HEALTH HEALTH RESOURCES DISABILITIES &PREVENTION 360/385-9400 360/385-9444 360/385-9444 360/385-9400 360/385-9400 I JEFFERSON COUNTY BOARD OF HEALTH • ORDINANCE ENVIRONMENTAL HEALTH CIVIL ENFORCEMENT WHEREAS, the Jefferson County Board of Health wishes to establish civil penalties for violations of public health laws, regulations and/or ordinances adopted by the Washington State Legislature, Washington State Board of Health, Washington Department of Health or the Jefferson County Board of Health; WHEREAS, all conditions which are determined by the Health Officer to be in violation of any public health law, regulation and/or ordinance shall be subject to the provisions of this ordinance because they are detrimental to the public's health, safety and welfare; WHEREAS, all violations of public health laws, regulations and/or ordinances are detrimental to the public health, safety and welfare and are hereby declared to be public nuisances pursuant to Ch. 7.48 RCW; WHEREAS, a civil infraction process, established pursuant to Ch. 7.80 RCW, can . protect the public from the harmful effects of violations, will aid in enforcement, and will help reimburse the County for expenses of enforcement; WHEREAS, enactment of this Ordinance promotes the health, welfare and safety of the citizens of Jefferson County; and WHEREAS, the Jefferson County Board of Health enact this Ordinance pursuant to the authority granted them by various state statutes, including, but not limited to, those codified at Ch. 7.48 RCW, Ch. 7.80 RCW and Ch. 70.95 RCW. NOW, THEREFORE, be it ORDAINED by the Jefferson County Board of Health as follows: Section I Purpose: It is the express purpose of this ordinance to provide for and promote the health of the general public and not to create or otherwise establish or designate a particular class or group of people who will or should be especially protected by the terms of this ordinance. It is the specific purpose of this ordinance to place the obligation of complying with its requirements upon persons, businesses or companies required to meet provisions of the health regulations. No provision of or term used in this ordinance is intended to impose any duty upon the Jefferson County Health and Human Services Department nor any of its officers or employees for whom the implementation or enforcement of this ordinance • shall be discretionary and not mandatory. • \\Healthserver\home\env health\larry\My Documents\BOH Agenda\Nuisances&abatement\Civil Enforcement Ordinance 2nd draft 070502.doc 0 7 Section II Authority This ordinance is promulgated under the police power granted to the Jefferson County Board of Health, including, but not limited to, authority granted to them by Ch. 7.48 RCW, Ch. 7.80 RCW and Ch. 70.05 RCW to protect the public health, safety, and welfare of the people in Jefferson County, including those County residents residing within the City of Port Townsend. Section III Applicability Provisions of this ordinance apply to violations of the following statutes, regulations and/or ordinances as they now exist or as they may hereafter be amended: Chapter 70-90 RCW Water Recreation Facilities Chapter 70-95 RCW Solid Waste Management Chapter 246-203 WAC General Sanitation Chapter 246-215 WAC Food Service Chapter 246-260 WAC Water Recreation Facilities Chapter 246-261 WAC Recreational Water Contact Facilities Chapter 246-272 WAC Onsite sewage systems Chapter 246-290 WAC Public Water Supplies Chapter 266-291 WAC Group B Public Water Systems Chapter 173-304 WAC Minimum Functional Standards for Solid Waste Chapter 173-308 WAC Biosolids Management Chapter 8.05 JCC Food Service Sanitation • Chapter 8.10 JCC Solid Waste Ordinance# 08-0921-00 Onsite Sewage Section IV. Designation of Civil Infractions Any violation of the laws, regulations and ordinances specified above in section III (including any future amendments to those statutes, regulations and ordinances) shall constitute a civil infraction. Each (twenty-four) 24-hour period when a violation is found to exist shall constitute a separate and distinct violation. The owner or Lessor of any real property shall be and is jointly and severally liable with any tenant, occupier or user of real property for any violation alleged against that • property or alleged to have occurred on the owner's property. The legality or illegality of the use or occupancy of the land by a person or entity shall not be a defense available to the owner of said property if it is alleged a violation of this Ordinance occurred on that property. A first offense shall be a Class 3 civil infraction as established in Chapter 7.80 RCW. A second offense shall be a class 2 civil infraction as established in Chapter 7.80 RCW. A third offense shall be a class 1 civil infraction as established in Chapter 7.80 RCW. I \\Healthserver\home\env health\larry\My Documents\BOH Agenda\Nuisances&abatement\Civil Enforcement Ordinance 2nd draft 070502.doc 0 • Section V. Processing and Adjudicating Civil Infractions: Such infractions shall be adjudicated and any related fines determined in accordance with the procedures established in Chapter 7.80 RCW, the Jefferson County District Court rules for Infractions and the Washington State Rules for Courts of Limited Jurisdiction. Upon a determination that the County has met its burden of proof regarding any infraction alleged against a person or entity pursuant to this Ordinance or upon the decision of the alleged violator to not contest the infraction, the County may seek to obtain attorney's fees against the violating party or entity pursuant to RCW 7.80.140. Utilization of the procedures and penalties laid out in this Ordinance and the underlying state statutes shall not prohibit this County from utilizing any other lawful means or seeking any other lawful remedies against the person or entity that has allegedly violated the terms of this Ordinance. Nothing in this Ordinance shall prevent the Judge hearing these civil infraction matters from reducing or mitigating the monetary fines that would otherwise be imposed. Section VI Enforcement Officers The Board of Health, or its designated Health Officer, may authorize one or more persons to serve as an "enforcement officer," duly authorized to enforce this Ordinance. Section VII. Severability Should any section, paragraph, phrase, sentence or clause of this ordinance be declared invalid or unconstitutional for any reason, the remainder of this ordinance shall not be affected. Section VIII. Effective Date The effective date of this ordinance shall be \\Healthserver\home\env health\larry\My Documents\BOH Agenda\Nuisances&abatement\Civil Enforcement Ordinance 2nd draft 070502.doc • Draft 6/2002 Jefferson County Uniforrigt . Complaint Response • Enforcement Procedures Manual Draft 6/2002 • I. Introduction ® This document seeks to provide general guidelines for use by all Jefferson County Departments dealing with responses to citizens' complaints, and basic enforcement procedures for civil infraction ticketing. Certain Departments may have specific compliance codes to follow. This document does not override or replace those codes. Jefferson County must occasionally seek damages from an individual or other entity, if a clear and present violation of applicable codes exists. Jefferson County wishes to seek all possible recourse BEFORE issuing a ticket for a civil infraction. Jefferson County commits to the following guidelines when approaching a potential violation: • The County will always strive to respect the rights of private property owners when conducting an investigation. • The County will keep a database of "No Trespassing" notices,for ease of contacting individuals who may wish to conduct the interview at a neutral site. • The County will review each case before beginning a full-scale field investigation. Its field inspectors will, to the greatest degree possible, use the telephone and mail in lieu of site visits Jefferson County is committed to a friendly and helpful approach using good common sense reasoning. . This document details the procedures to be followed when responding to complaints and enforcing provisions of Jefferson County Regulations as these regulationsapply to all persons. IMPORTANT: Before conducting any enforcement,it is very important that inspectors understand the contents of all sections of this document to determine which enforcement approach is applicable. Any questions about these procedures should be directed to the appropriate program supervisor or manager. II. Standard Complaint Enforcement Procedures A. COMPLAINT RECEIPT Most suspected violations are reported to the Departments via telephone calls and letters. The inspector or person receiving the complaint should determine if it falls under the Department's jurisdiction. If not, the caller should be forwarded to the appropriate Department or agency. If the complaint is within the Department's jurisdiction, the complaint must be recorded onto a sequentially numbered Jefferson County Complaint Form. A sample complaint form is located in Appendix A. Be advised that emergency complaints require special consideration and handling. • C:Molly/MyDocuments/FinalEnforcement302 1 5/16/02 Record the following information on the standard complaint form as completely and accurately as possible as described below: • • Record the date and time the complaint is received • Check the box indicating the complaint type. Complaint type determination is explained in more detail further on in this document • Record the name, address, zip code, and phone number of the complainant r IMPORTANT: Jefferson County does not investigate anonymous complaints. The name of the complainant person must be revealed to the County employee, although the complainant's name can remain confidential, i.e.,known only to County employees. If the complainant indicates that they wish to remain confidential, and/or indicates that disclosure of their name may endanger their life, physical safety, or property, check the "YES" box following the question "DO YOU WANT TO REMAIN CONFIDENTIAL?" on the complaint form. After staff have received a complaint and completed the complaint form, the completed form must be forwarded to the staff member responsible for logging complaints into the complaint database and assigning complaints to the appropriate inspector. • If known, record the name, address, zip code, and phone number of the alleged • violator. • If known, check the appropriate box to indicate if the alleged violator is the owner of the property. • Write a description and record the address of the alleged violation. r IMPORTANT: Public requests for copies of complaint files must be forwarded to a supervisor or program manager. Consider every request for a copy of a complaint file, whether the request is oral or in writing, to be a request for public records pursuant to the state law known as the Public Disclosure Act, codified at RCW 42.17.250. A.1 Law firm or ACLU requests handling: Any request for a complaint file,which comes from a law firm or the ACLU, shall be immediately referred to the Risk Manager or the Civil Deputy Prosecuting Attorney. A.2 Request for Public Records: When complying with a request for public records the County employee should redact on a copy (cross out with magic marker) the name of any complaining person who asked that his or her name remain confidential. 2 C:Molly/MyDocuments/FinalEnforcement3 02 5/16/02 IMPORTANT: County employees are strongly encouraged to contact the Civil Deputy Prosecuting Attorney if they have any questions or concerns about what is the proper • response to a citizen's request for public records or public documents because failure to comply with the Public Disclosure Act can have negative financial and public relations consequences for the County. B. COMPLAINT TYPE DETERMINATION The Department's supervisor or designated program lead will first review all complaints to determine whether the complaint is an emergency or non-emergency. If the complaint is determined to be an emergency, the supervisor will handle it. If the complaint is determined by the supervisor or program lead to be a non-emergency, it will be assigned to the appropriate staff member for follow-up. 1. Emergency complaints Emergency complaints include any report of an incident where significant environmental damage, severe injury or death has occurred or is imminent is the situation is not corrected immediately. Staff members receiving complaints of an emergency nature must: a.) Log the complainant's name and phone number, complaint description, and directions to the incident, b.) Immediately forward this information to 9-1-1, and c.) Immediately forward all documented information to the program • supervisor or manager. 2. Other complaints Program staff can directly respond only to reported or suspected violations within the program area and within its Department's jurisdiction. Certain complaints will need to be referred to other agencies or County Departments with primary responsibility for that type of complaint. Appendix "B" includes complaint referral and contact information for related federal, state and local agencies. tar IMPORTANT: To help protect the safety of staff in other agencies or programs, be sure you advise them of any known or potentially hazardous situation regarding the complaint. If the complaint involves a situation handled by another jurisdiction, • The complainant should be told to whom we are forwarding the complaint, and be given a contact person and telephone number. • Record information given to complainant from first bullet on the complaint form. • Staff must advise the contact at the other jurisdiction of any known or potentially hazardous situation regarding the complaint. • The complaint should then be logged-off the complaint database as "forwarded". 11, 3 C:Molly/MyDocuments/FinalEnforcement302 5/16/02 3. Complaint coordination . Many complaints received by Jefferson County will involve multiple issues and require coordination with another agency. Inspectors should use their judgment in determining if it is necessary to contact another agency or Department in advance of conducting a site inspection. Conducting joint site inspections can be a useful tool to help facilitate interagency or interdepartmental coordination. If a joint inspection will be conducted, it is recommended that a pre-inspection meeting be held so that all inspectors can agree on what will be covered during the site visit. A list of other contacts is listed in Appendix B. C. DECISION MATRIX 1 � . 3 For instance,If"yes",go here, if "no"go there.) D. INSPECTION PREPARATION Pre-inspection preparation is an important part of the complaint response process. The amount of preparation will vary significantly by the type and alleged severity of the complaint. Pre-inspection preparation includes: • Completion of required training. . • Possession of knowledge of applicable ordinances, policies and procedures, • Confirmation and collection of additional complaint information, and • Gathering necessary supplies, equipment, and protective clothing. 1. Training In addition to general training and orientation of new staff, training specific to complaint response and investigation techniques is a requirement for all staff having responsibility for compliance. Training such as the NCIT offered by the "Council on Licensure, Enforcement and Regulation" or equivalent is desirable. The EPA Basic Inspector Training Course is recommended, and may be REQUIRED, for inspectors. Other field staff training will be periodically provided. Although it is management's responsibility to provide required staff training, staff is encouraged to recommend any other training opportunities or needs that would improve the function of the program or further improve field safety. 2. Applicable Policies and Procedures In addition to this procedure outline,field staff conducting complaint inspections must be familiar with the appropriate Jefferson County Ordinances, Departmental Policies, and all 4 • C:Molly/MyDocuments/FinalEnforcement3 02 5/16/02 • other adopted County policies and procedures. See the program supervisor or manager about questions on any of these policies or procedures. • 3. Complaint Information After receiving a new complaint, the inspector (if he/she did not receive the complaint) should call the complainant to verify the nature and location of the problem and other information not normally collected at the time the complaint was filed. This procedure is recommended as a guideline and may not be necessary in all cases. Make sure that you can answer"yes" to all of the questions listed below before performing an on-site inspection: • Do you clearly understand the complainant's concern? • Is the nature of the complaint within the Department's regulatory jurisdiction? If there is overlapping jurisdiction, a joint inspection with another agency or Department may be appropriate. • Has the complainant been asked to offer any and all additional information that was not initially recorded on the complaint, such as: i. Date/time the problem occurred or was first noticed ii. License plate numbers, knowledge of previous problems/violations, and/or iii. The alleged violator's name, address, telephone number, and place of work, etc. • • Have you checked the complaint database to see if previous violations for this person (or property) have been logged? • If applicable, have you or your Department conducted a more detailed review of historic cases if previous violations are identified? la-IMPORTANT: It is critical to record all information pertinent to the complaint on the complaint form,including information collected while preparing for the site visit. Feel free to use additional pages if needed. 4. Supplies and Equipment: The supplies and equipment listed below are required (or optional, as indicated) for all enforcement fieldwork. All required and most optional items are provided to staff at the Department's expense. Optional items not provided by the Department may or may not be approved for purchase. Pre-approval on any business expense not listed is required. Check with the program supervisory or manager for clarification of reimbursement and purchasing procedures. a. Required supplies and equipment • Jefferson County picture ID (worn in plain sight) 5 C:Molly/MyDocuments/FinalEnforcement3 02 5/16/02 • Jefferson County business cards • Appropriate educational materials . • Completed complaint forms for the day's inspections • Field notebook and/or laptop computer • Pepper spray and holder (carried at all times in the field when conducting enforcement) • Noise making device, such as a whistle or a canned air horn • Camera and extra film or a digital camera • Cellular telephone and emergency contact telephone numbers • Appropriate personal protective equipment (PPE) for the employee. Depending upon the type of complaint, hard hats and heavy duty gloves may be appropriate • Evidence collection supplies • Sharps container • Violation notices as appropriate • Order to Correct Violation Compliance Agreements b. Optional supplies and equipment • Dog biscuits • Other supplies specific to the Division and/or type of complaint 4. Field Clothing and Personal Protective Equipment: Appropriate attire for conducting field activities is required. In some cases,basic personal • protective equipment is necessary. In general, dress appropriately for the type of weather you may be facing when you go out in the field. Boots or other hard-soled shoes are required at all time (steel toe recommended). Gloves are required for any circumstances where the inspector will touch the materials, such as when collecting evidence. If you have a question about appropriate clothing or PPE, talk with a program supervisor or manager. w IMPORTANT: Jefferson County picture ID must be worn AT ALL TIMES when employee is in the field. The ID should be visible to the citizenry or shown to them if such a request is made. E. SITE INSPECTION The purpose of the site inspection is to document facts related to the complaint. This includes, but may not be limited to: • Field notes • Witnesses and/or alleged violators interviews • Photo documentation, and • Collecting physical evidence 6 • C:Molly/MyDocuments/FinalEnforcement3 02 5/16/02 This information is used to build a case and determine if a violation has been committed. Unless otherwise approved by a program supervisor or manager, all inspections must occur Sduring the investigating Department's normal business hours, or a time mutually agreed upon with the Department and the appropriate property owner or property custodian. r IMPORTANT: Jefferson County staff, as a matter of courtesy, should always attempt to contact the property owner or custodian by phone before conducting a site visit,unless the violation is a clear and compelling risk to public health and/or safety a. Site Entry and searches While conducting inspections or surveys, Department inspectors must often enter private property. Because the state and federal constitutions prohibit unreasonable searches, inspectors must decide whether to enter a particular property to conduct an inspection. As explained in this section, each situation is different. There are no blanket rules regarding allowable searches. In all cases, an inspection can occur only after obtaining consent from a responsible party (owner or tenant), or by making observations from a location where the inspector may legally be without consent or from a place he/she has consent to be, or with a search warrant. To assist you in determining whether you may enter a property, discussed below are some basic constitutional doctrines: Please review RCW 10.79.040 regarding the rights of a private property owner. Note well that unlawful entry onto private property without a search warrant amounts to a gross misdemeanor according to RCW 10.79.045. Reasonable Expectation of Privacy: There are two components to a reasonable expectation of privacy. The first is a subjective component: Does the person have a subjective expectation of privacy in a particular object or location? The second is an objective component: is this expectation one that society recognizes as reasonable? Generally, a person has a reasonable expectation of privacy in his/her home, in the area immediately adjacent to the home, and in areas where he/she has taken steps to exclude the public and shield the area from the public's view. r. Important: PRIOR NOTICE GIVEN From time to time,there will be individuals who notify the county by written or oral means that county personnel are not allowed on their property without prior written or documented permission. When an inspector learns that such notice has been provided to the County,the inspector will not enter upon that owner's property unless the inspector has received permission from the owner or the owner's authorized representative (e.g.: Legal counsel) or has obtained a valid search warrant. This restriction to access supercedes the normal principles as discussed under curtilage. 7 C:Molly/MyDocuments/FinalEnforcement302 5/16/02 Residence: A person always has a reasonable expectation of privacy in his/her home. You may NOT enter a person's home or outbuilding, except with the resident's consent or with a valid search warrant issued by a court of competent jurisdiction. Curtilage: Curtilage is the land immediately surrounding and associated with the home, i.e., that area associated with the intimate activity of a home and the privacies of life. Curtilage receives the highest level of protection under both the federal and state constitutions. You may not enter the curtilage without a resident's consent, except as explained below. To help determine if an area is within the curtilage, answer these questions: Q. How close is the area you want to inspect to the house? A. The closer the area you want to inspect is to the house, the more likely it will be considered within the curtilage. Q. Is there a fence or other enclosure that surrounds the house and the area you want to inspect? A. A fence that surrounds the house suggests the limits of the curtilage. Accordingly, where a house is situated on a standard lot and the lot is fenced, that is the limit of the curtilage. On a larger piece of property there may be a fence around the • perimeter of the property, and an inner fence enclosing the house. In that case, the interior fence would indicate the limits of the curtilage. A clearing or maintained area has the same effect. Thus, on a larger piece of property that is forested, the cleared area surrounding the house would indicate the limits of the curtilage. Q. What is the area you want to inspect used for? A. The concept of the curtilage is to protect those activities normally associated with the home and the privacies of life. Thus, if an area near the house is used for family or personal activities (e.g., play area, patio, garage), then it is probably within the curtilage. However, if the area is used for activities not associated with home life, especially illegal activities, then it probably will not be considered within the curtilage. You may use evidence you observe from the road or a neighbor's property... if you have permission to be there... or information a neighbor gives you, to determine if an area is being used for an activity associated with the home or some other activity. Q. Has the resident taken any steps to protect the area you want to inspect from observations of passersby? 8 • C:Molly/MyDocuments/FinalEnforc ement3 02 5/16/02 A. If a fence--especially a sight-obstructing fence--or hedge shields the view of the house from the street and neighboring properties, then the area within the fence or • hedge will probably be considered within the curtilage. Q. Can an inspector ever enter the curtilage? A. Yes. You may enter the curtilage to contact the resident. In doing so, however, you may use only a recognizable access route, such as a driveway, walkway, or path. Approach the house as any reasonably respectful citizen would. Normally, you should not enter a side or back yard. You may, however, call out or try to get someone's attention if you see or hear something that leads you to believe the resident is in a side or back yard. Other factors to consider when conducting an inspection of private property: No Trespassing Signs: A "No Trespassing" sign or "No Solicitors" sign does not prohibit you from approaching a residence using a recognized access route for the purpose of contacting the resident. A recognized access route would generally be the same route a UPS truck driver would walk in order to deliver a package. BUT this sign clearly and strongly indicates a notice of expectation of privacy. Consider adjusting your approach appropriately. You may want to try and contact the party by phone first, and set up an appointment. Open Fields: Areas that are outside the curtilage are considered "open fields" and do not • always receive the same high level of constitutional protection that the curtilage does. In an urban area, you will likely not find any open fields. In outlying areas, however, you are likely to encounter them. An open field doesn't need to be either "open" or a "field". It could be a thickly wooded area or a beach. Generally, an open field is any unoccupied or undeveloped area outside the curtilage. In many instances, you will be able to enter open fields without the permission of the owner. However,you need to consider whether the owner has manifested an "expectation of privacy" in the area you want to enter. Some manifestations of an "expectation of privacy" are: 1. A long driveway 2. "No Trespassing" or "No Solicitors" signs 3. Fences, especially sight-obstructing fences, or maintained hedges 4. A locked gate, or 5. The area cannot be seen from a road or neighboring property. Each situation is different, so it is not possible to provide a blanket rule for entering open fields. Open View: If you are in a place you may legally be, such as a • 9 C:Molly/MyDocum ents/FinalEnforc ement3 02 5/16/02 • Roadway • Public property • A neighboring property that you have permission to be on, or • • You are approaching the residence via a recognized access route, and then you can base an enforcement action on anything you can see from that vantage point. • Accordingly, if a person allows you in his/her backyard, and you can see a clear violation, you can write a notice and order to correct the violation or a notice of civil infraction, based on what you can see from the neighbor's property. As long as you remain on the property you have permission to be on you can take photographs of the alleged violation. • Do not go to extraordinary measures, such as using ladders and/or binoculars to document an alleged violation. Although these actions are legal, they clearly are in conflict with the individual's "reasonable expectation of privacy. Plain View: The plain view doctrine applies when you have entered a property with the resident's consent. The plain view doctrine allows you to use anything that you see inadvertently as you walk through the area. The object must be in plain view; you may not move anything. For example, you may not remove a garbage container lid to look inside. Plain view works the same way when the resident has given you permission to look around. If you want to see inside or under something, ask the resident's permission. Implied Consent: An inspector obtains valid consent to inspect when he or she asks the resident for permission to conduct an inspection and receives an affirmative VERBAL • response. An inspector need not inform a person of his/her right to refuse an inspection but, if the person asks whether he/she may refuse, the inspector must tell the person that yes, he/she may refuse. Statements such as "I'm going to look around" or "I have to inspect the property" MUST be avoided. A person who submits to an inspection after such a statement has not given his/ her consent to the inspection and a court could suppress anything that is found during the inspection, and may subject the Department and/or the employee to civil liability. Always phrase as a question, e.g. "May I have your permission to look around?" IMPORTANT: In situations where the field worker is uneasy or unclear about how to proceed, it may be best to consult with a supervisor and/or seek legal guidance from the Prosecuting Attorney's office before entering. F. Conducting the Inspection Conduct the inspection within the bounds of your job. You are conducting the inspection to determine the "who, why what, where,when, and how" as they relate to the complaint. When doing the inspection keep in mind what evidence,facts or items you might someday need to assert and prove in court in order to obtain a judgment on a civil infraction. What 10 • C:Molly/MyDocuments/FinalEnforcement3 02 5/16/02 information would you need to collect in order to prove in court that the owner has failed to do what the Ordinance obligates him/her to do? What evidence would you need in order to • prove in court that the owner has done what the Ordinance prohibits? Avoid discussing violations or making any enforcement promises until after investigation and evidence collection as been completed and you have thoroughly formed your enforcement approach. While you are conducting the inspection, take thorough notes in a field notebook. Do NOT use the complaint form for field notes except for the simplest complaints. In most cases, the complaint form is your formal statement related to the case. You should thoughtfully prepare it when you have returned to the office and had a chance to review your notes and other evidence. More complex cases may require preparation of a more formal inspection report. Photos are useful tools the inspector can use to document suspected violations. If you take photos, record information about each photo in your field notebook. At a minimum, this information should include: 1. Subject of the photo (what are you trying to show?) It is useful to include an everyday object, for scale. Be sure and note the placement of such an object. 2. Where you were standing when you took the photo 3. The direction in which the photo was taken • 4. After the photos have been developed, you should complete a "photo log" (Appendix "C"), and 5. Attach the photos to the log. Witness and suspect interviews are very important investigation tools. Conduct interview in a non-emotional, objective, and non-accusatory manner. Be certain to record the: a.) Name b.) Address and c.) Telephone number of all people you interview in case you need to follow-up and get more information later. This information is also necessary to validate the information collected in the interview. IMPORTANT: Always request to see photo ID of witnesses and suspects. If they refuse, provide a detailed written description of the people involved. Occasionally, inspectors will encounter a case that is fairly "straight forward" and be able to formulate an enforcement approach before the inspection is completed. In these cases,it may be possible to complete a written compliance agreement before leaving the site. Verbal orders to correct a violation may be used in conjunction with a written order,but should not • 11 C:Molly/MyDocuments/FinalEnforcement302 5/16/02 be used alone. If a verbal order is issued, refrain from doing so until after the inspection is completed. Premature discussion of any violation may cause the inspection to be cut short before you've had the chance to collect all available evidence. Take clear notes of any verbal • order, agreement, or promise made while at the site. A business card and/or "door hanger" should be left if no contact is made during a residential or business inspection and violations are found. The door hanger lists the general violation noted, and requests that the occupant contact the inspector. A sample copy of the door hanger is included in Appendix "D". IMPORTANT: If the violator threatens an inspector during an inspection, either directly or indirectly,the inspector shall immediately leave the site. The inspector shall: i. Immediately report the incident to his/her supervisor ii. Fill out an incident report iii. Determine whether a warrant is appropriate before returning to the site. iv. If the inspector DOES return to the site, do so only with law enforcement backup. Backup shall be provided by the appropriate jurisdictional law enforcement agency. Threatening a public servant is a class B felony in the State of Washington under RCW 9A.76.180 G. General Field Employee Safety . This section briefly discusses employee safety while in the field. Because a field site visit cannot be a controlled situation, the responsibility for personal safety rests with the employee who is conducting the visit. These are merely guidelines; the most critical of which is to USE YOUR GUT FEELINGS. Some suggestions to increase safety include the following: 1. Plan ahead: If the referral you've taken is in a location unfamiliar to you, try to find another worker who may be more familiar with the area to brief you to any known risks or hazards 2. Pre-site contact: As a matter of courtesy and to respect the individual's right to an expectation of privacy, it is Jefferson County's policy to contact the potential violator ahead of time by phone or letter. This is also helpful in ensuring that the employee will not take anyone by surprise. 3. Stay in contact with the office while in the field: Leave an itinerary at the office. Keep your address file updated. Call in to the office at scheduled times. If working in pairs, stay together. 12 • C:Molly/MyDocuments/FinalEnforcement302 5/16/02 • 4. Carry nothing unnecessary: Lock or conceal your purse in the trunk of the car before leaving the office. Take only the • items necessary to do your job. Select forms, brochures, etc. that you will need each day and arrange them in a briefcase or other carrying device. 5. Noise making device: Carry a noise-making device...a whistle or canned air horn. 6. Extra keys: Carry two sets of car keys. One set to use and one set to have in reserve and concealed in your notebook or bag. 7. Think about where you park: It's always better to park on the street than in a driveway. That way, there is no danger of being blocked in when you want to leave. This also ensures that the employee is not parked on private property. 8. Approaching the dwelling: Pause at the door before knocking and listen. If you hear loud quarreling, sounds of fighting, or some other disturbance, leave immediately. 9. Potential Meth lab danger: Be careful when walking in yards with discarded glassware and containers. If these are Meth lab residues, any contact with the contents can contaminate you. Typical containers found at a Meth lab • look like common household glassware. The "sludge" residue of the cooking process closely resembles used crank case oil. Do not touch anything or lift any container lids. H. POST-INSPECTION DOCUMENTATION 1. Research Always record all information obtained in the Complaint Database after your inspection before the end of the workday, IF FEASIBLE. Often the inspector will need to do some research to locate the violator,property owner, or gather other necessary information. There are a variety of resources available to help gain this information including County Assessor's (taxpayer) records. 2. Inspection report The inspection report is probably the most important piece of evidence in a complaint investigation. After the inspection is complete, you should: a. Review your notes from the field and other sources and, 13 C:Molly/MyDocuments/FinalEnforc ement3 02 5/16/02 b. Prepare an inspection report. The report should be limited to the facts you collected about the case and your • observations during the site inspection. It should be professionally written, thorough, and objective. DO NOT INCLUDE OPINIONS IN AN INSPECTION REPORT! Include only facts and observations. In most cases, the inspection report should not initially be written on the back of the complaint form. The complaint form, along with the inspection report, should be completed after the investigation. In more complex cases, a more formally prepared inspection report may be warranted. The program supervisor or manager can assist you with determining which report format is appropriate. c. The inspection report should include each and every piece of information, evidence, observation or item that you might someday take to court in order to prove that the violator did in fact violate a state law, regulation or local Ordinance. For this reason always err on the side of being overly inclusive and detailed rather than being brief or omitting items. d. The report should, in most routine cases, be filed by the . end of the workday during which the site visit occurred. I. ENFORCEMENT OPTIONS: The general approach to compliance is as follows unless there are different procedures specifically addressed in the applicable ordinance. 1. Warning letter: A warning letter is appropriate in some situations. Examples of these situations are: a. No clear evidence of a violation, b. The violation warrants education rather than enforcement; or, c. The offense is the first for the violator and does not constitute a public threat. A sample-warning letter is contained in Appendix "E". 2. Compliance agreement (Violator present and/or tenant agreement; violator is a non- mail receiver) 14 • C:Molly/MyDocuments/FinalEnforcement302 5/1 6/02 As stated previously, sometimes you will be able to form an enforcement approach while conducting an inspection. In this case if the violator is present during the inspection, the inspector can fill out a Compliance Agreement at the end of the inspection. The Compliance Agreement fulfills all the requirements of a Notice and Order to Correct Violation (NOCV). After the inspector completes the form, the violator signs the bottom of the agreement and receives the bottom copy. An example Compliance Agreement is provided in Appendix "F". If a rental property is involved, as explained below, the renter and the property owner must jointly receive a separate written NOCV prior to the issuance of a civil infraction notice. Therefore,when a Compliance Agreement is used with a tenant, a copy must be mailed to the owner of the property. Compliance Agreements can also be useful if there is some indication that the violator does not (or may not) receive mail. tar IMPORTANT: Process servers may be used in cases where it is doubtful the violator receives or is picking up the mail, or at other times, as deemed appropriate by the supervisor. 3. Notice and Order to Correct Violation (NOCV) If the violator is not present, or cannot immediately be identified, the inspector should issue a written Notice and Order to Correct Violation (NOCV). The content of the written notice must conform to the requirements of the regulations. An example NOCV • letter is provided in Appendix "G." Letters that include non-standard language must be supervisor approved prior to being sent. The NOCV must be served on the person to whom it is directed by mailing a copy of the order via certified and regular mail to such person at his/her last known address, or via a process server. The process server may attach the NOCV to the door of the residence. • After receipt of the NOCV, the person receiving the notice may request an extension of the compliance date. The inspector must require this request to be in writing, either by letter or electronic mail (email). • Upon receiving the return certified mail receipt, attach it to the file copy of the NOCV. If there is reason to believe that the certified mail copy will not be delivered or accepted, then a Declaration of Mailing should be completed for the copy sent by regular mail. A copy of the Declaration of Mailing is contained in Appendix "H". • A process server may be used to deliver the notice. 4110 15 C:Molly/MyDocuments/FinalEnforcement3 02 5/16/02 Violation Compliance Deadline: In most cases, the deadline recommended for the correction of any violation is seven to • thirty (7-30) days following receipt of the written notice. Compliance deadlines should generally not exceed more than thirty days. Deadlines can be shortened or extended depending on the severity of the violation, or as otherwise determined by the inspector using best professional judgment. As a courtesy when appropriate, if the violation occurs within the City limits or on an Indian reservation, the inspector should send a copy of the Compliance Agreement of NOCV letter to the appropriate staff within that jurisdiction. See Appendix "B" for a list of contacts. Rental Property Violations: For rental premises' violations, the inspector must write the NOCV to the renter and the property owner. Each party's name should be included in the address block of the NOCV, and each party should be sent a copy. If the violation continues past the compliance deadline, each party will be written, separately, a civil infraction notice as explained below. Past Deadline Violation Status: After the deadline specified in the written notice has been reached, the status of the violation must be determined. This can be accomplished either through: • A phone call to the complainant, with an appropriate follow-up site visit. • If site inspection is conducted, document the inspection just as thoroughly as the • initial inspection. • If a violation still exists at follow-up, other enforcement options as described in this section may be appropriate. Under normal circumstances,failure to comply with a NOCV is followed by a Notice of Civil Infraction (NOCI). Violation Corrected process: If the violation has been corrected, this must be: • Noted on the complaint form (with the date of the inspection and the inspector's name), • The complaint is then abated,logged-off the database, and filed. Violation partially corrected: If the violation is partially corrected, the inspector should use professional judgment to continue enforcement activities. This may include: i. Issuing a ticket or ii. Agreeing to a revised compliance date with the violator, if authorized. 16 • C:Molly/MyDocuments/FinalEnforcement302 5/16/02 • There are exceptions to the use of the NOCV. The NOCV is not required in cases of illegal dumping and in other instances. In these cases, a ticket can be written without a proceeding • NOCV. 4. Letter from the Prosecuting Attorney's Office: The Civil Deputy Prosecuting Attorney may, upon written request, and if his or her schedule and workload permits, write a letter to the person or entity that is allegedly in violation which will outline the consequences of not coming into compliance. The Civil Deputy Prosecuting Attorney will only write this letter based upon receipt from the County Department of a written file describing with specificity the: 1) property and persons involved, 2) alleged violation and 3) steps previously undertaken by the County Department. A. Precondition: The County Department must have written at least one letter or memo to the party that is allegedly in violation of a state law, state regulation or County Ordinance and shall send a copy of its letter to the Civil Deputy Prosecuting Attorney as a precondition to the Civil Deputy Prosecuting Attorney writing such a letter. This letter from the Civil Deputy Prosecuting Attorney can be sent only before a Notice to Correct Violation has been issued. • 5. Notice of Civil Infraction (Ticket) Notices of Civil Infraction procedures are also known as "ticket writing" procedures. Example of a completed ticket is provided in Appendix "I." In most cases, tickets are issued following failure to comply with the NOCV. However, a NOCV is NOT required prior to issuing a ticket. A ticket can be issued to a defendant during the initial site inspection or any other time the inspector has reasonable cause to believe that the person has violated the regulations. Before writing a ticket, the inspector should conclude for himself or herself that he or she has a reasonable level of confidence that he or she could provide to a Judge information, observations, evidence and items which would lead that Judge to convict the alleged violator. A reasonable level of confidence is not the same as "complete confidence", in the legal sense. Each time an inspector writes a ticket he or she should do so with the expectation that it will end up in court. It may not lead to a court case, but preparation is the key to succeeding in court. • 17 C:Molly/MyDocuments/FinalEnforcement302 5/16/02 la, IMPORTANT: A notice of civil infraction can only be written in cases where the inspector has made a direct observation of the infraction being cited. • Prior to writing the ticket, if within the City or another jurisdiction, the inspector must contact the appropriate code enforcement officer where the infraction is occurring to ensure that duplicate tickets for the same infraction are not being written. The inspector must write only one infraction on the ticket even though several infractions may exist. The inspector should generally choose the infraction that is easiest to prove but must also consider which infraction or violation is most harmful to the public welfare and safety regardless of how difficult it might be to prove in a court of law that such a violation occurred. In other words, the inspector should not be hesitant to write an infraction that is both serious and yet also hard to prove because public policy supports the idea that the County should have a "zero tolerance' attitude about the most severe and egregious violations. Public Good does come from attempting but failing to convict the most severe violators. If this approach is followed, the inspector may choose to inform the judge in court that several other offenses were committed but not cited. For infractions on properties with more than one property owner, the inspector should write separate tickets, one for each of the property owners. District Court should be notified of this fact when the ticket is forwarded to the court. The judge is the final arbiter of who committed the infraction. It is up to the defendant to decide how to respond to the ticket. If both property owners contest the infraction, a motion (through the Prosecuting Attorney) • can be made to consolidate the cases and ask the court to hear both at the same time. Each defendant has the right to counter the motion and ask that his/her individual case be heard on its own. If this occurs, it is up to the judge to decide how to hear the cases. When tickets are written for premises infractions caused by renters on rental properties, the renter and property owner shall each receive, separately, a civil infraction notice. The procedures are the same here as they are for multiple property owners. If the owner of a property is a corporation, the ticket should be written to the corporation itself and the ticket served on the president or the registered agent of the corporation. This information can be found be contacting the Washington State Secretary of State's office. The following details must be completed on all tickets • Check the following boxes on the top portion of the ticket: "INFRACTION", "NON- TRAFFIC", and COUNTY OF JEFFERSON COUNTY DEPARTMENT. • In the spaces provided, complete as much information about the defendant as possible: 18 • C:Molly/MyD ocuments/FinalEnforcement3 02 5/16/02 1. The defendant's name and address are required, at a minimum • 2. If the defendant is present while you are writing the ticket, request to see his/her driver's license or state identification card. Confirm that the information is current and copy this information to the ticket. 3. The residential phone number is needed to notify the defendant of a change in the court date or time. • Indicate the infraction date in the space provided below the personal information. The time of all infractions should be noted in military time (1-24 hours). • On the next line, indicate the location of the infraction. This could be an address or tax accounts number. When written in this space, the term "situs" indicates that the infraction occurred at the defendant's address as listed on the top of the ticket. • Do NOT complete any of the information in the large white box (motor vehicle section) in the center of the ticket. • In the next section, describe the specific section(s) of the regulations violated and provide a brief narrative describing the infraction. • • Indicate the potential penalty amount in the "PENALTY/BAIL" box. The penalty for one infraction will be identified in the authorizing ordinance. tar IMPORTANT: When subsequent tickets for the same infraction are necessary,they should not be written until after a judgment has been reached on the first ticket. If a violation remains after a judgment has been reach on a second ticket, consult with a program manager or supervisor. • Indicate the date the infraction was observed in the "DATE NOTICE ISSUED" box. The ticket should be written as soon as possible after the infraction has been observed (and/or as necessary after an infraction has not been corrected as required). • Sign your name in the "OFFICER" box and put your employee number in the "NUMBER" box. Print your name in the box below the "OFFICER" box. • On the next line, indicate the date the ticket is written, and write "Jefferson County" after the word "PLACE". • If the defendant is present when the ticket is written, show him/her the ticket and explain what the ticket is being issued for and then do the following: 41) 19 C:Mo lly/MyDocuments/FinalEnforc em ent3 02 5/16/02 1. Have the defendant sign in the "DEFENDANT'S SIGNATURE" box (failure to . sign a ticket is a misdemeanor). 2. Advise the defendant that by signing the ticket, he/she is not admitting guilt, only promising to respond to the court within 15 days. 3. After he/she has signed, detach the green copy and give it to the defendant. 4. The response instructions are explained on the back of the defendant's (green) copy. 5. Review verbally each of these options with the defendant. 6. If the defendant refuses to sign, or is not present when the ticket is written, write the word "INVESTIGATION" in the signature box. • Do not complete the "ABSTRACT OF JUDGMENT" section of the ticket. • Provide a narrative of case events on the reverse side of the yellow copy, and then sign it on the bottom. This narrative is the only testimony the court will see from the inspector if he/she is not present for a hearing. Therefore, a general guideline for completing this section is to be thorough enough to describe and • prove your case in the event you are absent from court. Include a description of all infractions in your narrative, even though you may have written the ticket for only one or two. When completed, the copy of the ticket with the narrative will be forwarded to the court, so the inspector should make a photocopy of the narrative for his/her records. If the ticket is completed at the site,the narrative may be completed after returning to the office. • A pre-printed label with the Jefferson County District Court address must be affixed to the bottom of the green copy of the ticket. The inspector should affix these labels to all the tickets in a ticket book as soon as it is received. • The defendant should be told that the inspector could dismiss the ticket if the infraction is corrected prior to the court date (when one has been requested). To dismiss a case: 1. Complete and sign a "Motion,Certification, and Order to Dismiss" form 2. Forward the "Dismissal Order" to the Prosecuting Attorney's office, Civil Division, to be signed. 20 • C:Molly/MyDocuments/FinalEnforcement302 5/16/02 3. The inspector or Deputy Prosecuting Attorney must then forward the signed Dismissal Order to the court for the judge to sign. • 4. A copy of the Dismissal Order must also be sent to the defendant after all appropriate signatures are obtained. An example Dismissal Order is provided in Appendix "I." r0-IMPORTANT: This process must be started a minimum of one week before a hearing date and the inspector may also verbally request dismissal during a hearing. IMPORTANT: The inspector should dismiss any ticket pending against a first time violator if the violator complies with the Department's NOCV prior to the court date. '0-IMPORTANT: The inspector must never give legal advice to the defendant or attempt to predict what the District Court judge will do when the case goes to court. Copies of the completed ticket must be routed as follows: • Green Copy: Defendant (if present) • White and Yellow Copies: (Green also, if defendant not present) District Court • Gold Copy: Inspector • Blue Copy: Supervisor The court's copies must be filed in District Court within 48 hours of writing the ticket, excluding Saturdays,Sundays, and holidays. The inspector should attach a business card and note the court's copies requesting notification of the court date and location(if one is scheduled). Court copies can be delivered through interoffice mail to District Court. Mailed copies should be sent to Jefferson County District Court. When a ticket is issued, the defendant has 15 days to respond to the court. Instructions for this response are on the back of the defendant's (green) copy. Possible responses include: • Request for a hearing (contested or mitigated), or • Payment of the monetary penalty. 1. The court will notify the inspector of the court date and type of hearing if the defendant requests one. 2. The inspector, or a qualified substitute, must represent the Department at all hearings on their tickets. 3. If the defendant fails to respond within 15 days, the court enters a default judgment against the person named on the ticket and the full fine amount is levied. Additional questions about filling out the ticket should be directed to an experienced staff member or the program supervisor or manager. C:Molly/MyDocuments/FinalEnforcement302 21 5/16/02 5. Other Enforcement Options Some cases may require other enforcement options in addition to those previously • mentioned. Certain Departments have the ability to issue abatement orders, stop-work orders, and/or to request the Prosecutor's Office to pursue a court order or civil lawsuit for abatement. Each of these options is used only in the most extreme cases. If you believe a case warrants one of these approaches, see the program supervisor or manager for assistance. J. COURT 1. Preparation The inspector writing the ticket (or a qualified substitute) must represent the Department in court. The inspector should dress in a professional manner at all court appearances. The inspector may request to have a substitute appear in his/her place only if the substitute has personal knowledge of the case to the extent that the substitute has made a documented site visit. The inspector must always be extremely well prepared when going to District Court. The inspector bears the complete burden of proving through the evidence that he or she presents that the violator's actions (or failure to act) rise to the level of a violation of a state law, state regulation or local Ordinance. This is called the"burden of proof" and cannot be shifted to anyone else. The inspector must be objective, honest, and credible • when testifying or answering questions in court. The inspector should never attempt to answer any question in court if he/she doesn't know the answer. In these situations,the inspector should simply state that he/she does not know the answer. The County's Deputy Prosecuting Attorney assigned to the Department may be notified of upcoming court appearances by Jefferson County employees. The Prosecuting Attorney will not be present in court during the hearing. r IMPORTANT: Any requests by Department staff for legal opinions or other services from the Jefferson County Prosecuting Attorney's Office should be made in writing through the Department Director. A subpoena should be issued to any witness who needs to be present in court to support the Department's case. • A subpoena should be issued whether or not the witness is appearing voluntarily. A subpoena form is included in Appendix "J". • Before completing the form, contact the Deputy Prosecuting Attorney assigned to the Department and brief him/her on the case and the reason why the subpoena is needed. 22 • C:Molly/MyDocuments/FinalEnforcement302 5/16/02 With the approval of the Prosecuting Attorney, in issuing a subpoena the inspector would: • Complete the subpoena form and return it to them for processing. • • Contact the witness and notify them that a subpoena is being issued to them and that it is not a reflection of their willingness to appear. The site of the violation should be revisited just prior to the date and time of the hearing. or IMPORTANT: Previous to this step,follow "Entering Private Property" procedures before continuing. Dated photographs or Polaroids should be taken to document the status of the violation. These photographs need to be developed quickly so they can be presented in court. Dated digital images are admissible in court. All available evidence must be taken into court by the inspector. This includes,but is not limited to: • Jefferson County Assessor's records providing a legal description of the property and the name(s) of the property owner(s), • An Assessor's map showing the exact location of the violation (the violation should be marked on the map), • A copy of all complaints, correspondence, inspection reports, and signed certified letter receipts (green slips), and • A copy of any applicable regulations. • 2. Hearing • Testimony: When your case is called, stand up in front of the clerk's desk and when prompted, 1. Give the court a summary of the case. 2. This is your opportunity to present all the evidence,facts, items, observations etc that you possess in order to prove to the Judge that the actions (or the failure to act) of the alleged violator constitute a violation of a state law, state regulation or a local Ordinance. Be both concise and complete in your presentation to the Judge. 3. Pass any pictures of the violation to the judge (via the clerk) to review while you are giving your testimony. • Give a full history of the complaint including how many complaints were received. • The date(s) the complaint(s) were filed. • When inspections were performed, and what was observed. 411 23 C:Molly/MyDocuments/FinalEnforcement3 02 5/16/02 • Describe the enforcement measures taken by the Department including how these measures were successful or unsuccessful in gaining compliance. • Include any agreements (verbal or otherwise) between the Department and the defendant and how these agreements were successful or unsuccessful. • Always address the judge as "Your Honor". 4. If the judge requests the identity of the complainant, the inspector should: • Explain that all of the evidence collected in the case was done so by the inspector and that the complainant's name does not affect the status of the violation. • If the complainant requested that their name be held confidential, the inspector should explain this request to the judge. The inspector should advise the judge that the Department asks complainants if they would like to remain confidential to encourage the reporting of problems in Jefferson County. • If the judge still request the name of the complainant, the inspector should make a motion to view the complaint "in camera" (privately with the judge). • If the judge cannot agree to view it privately, the complainant's name should be provided. orIMPORTANT: An inspector may make a penalty recommendation to the court, however, do not do so until after the judge has issued a "committed" judgment. Penalty recommendations are discussed in more detail in the following paragraph. 5. Judgment: Should the judge find that a violation was "committed" and he/she offers the defendant time to correct the violation, the inspector should always request the judge to set a second hearing to determine compliance. The inspector should appear on that date, prepared to show that the violation either has or has not been corrected. If the violation has NOT been corrected at the time of the compliance hearing, the inspector should be prepared to recommend a penalty to the court. This could include all or part of the original penalty or community service. 4. Court follow-up If a violation is not corrected when the court has finished hearing a case, the inspector can issue an additional civil infraction notice. • No more than two tickets should be written for the same violation • If a violation remains after a judgment has been issued on a second ticket, consult with a program supervisor or manager on how to proceed with the case. 24 • C:Molly/MyDocuments/FinalEnforcement302 5/16/02 The final outcome of all the tickets written must be documented for program planning and reporting purposes. The following information must be documented on the bottom of the blue file copy of each ticket: 1. Did the infraction go to court or was it dismissed before going to court? 2. Was the infraction undeliverable? 3. Did the defendant pay the penalty in lieu of a hearing? Record this information only after the case is completely played out in court. If the judge continues the hearing, wait until the judge makes a final determination before recording the results. If a hearing is held on a ticket, you will receive a written copy of the judgment including the amount of the penalty. A copy of the judgment should be attached to the complaint and the blue copy of the ticket. a IMPORTANT: If a property is inside the City limits of Port Townsend and remains in violation following the application of all legal remedies,the inspector must forward all complaint information to the City. The City should be notified that a violation exists on the property. A recommendation should also be made that the property be handled according to City procedures. 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O -J < CD c C) 0' N Cl- 01CC) 2w 0' F CD 0 O w -1 — W HS GJ CNC a) 6.) 5?'' 0) 01 (n G.) 0) N 0 ° 3 x• • ,• o T Q v CZ a) a) Q ( N N 3 CD Cp 01`.< a) C.)1 C 2 al 7 op cn o C71 G S) U)co CD Q. a) (n rf 'A 2 -0 o Co CS O a) Cn r CD CA ° CD �J 0 o C.)1 cD S) _, 0 _, CD Q o co O co N• , o WO n o (D A) CD 1Cn (-. � � ", N (-D O -,i -6: 1 (-s X -ice ° CD 2) M Ci) CD coo w N� c o3 ® -. � OD ° co -, a) wu)� oo = m 4 (D0 rnF 0 ® m o 6 0 3 ® co c 0` o 0 m a) 5. o S) 0 73 • Jefferson County 2001 BRFSS Tobacco Analysis S 1 DRAFT July 10, 2002 Tobacco Jefferson County 2001 BRFSS Tobacco use is the leading single cause of preventable death in our society— one in five of all deaths can be attributed to tobacco use. More than 20% of Washington adults continue to use tobacco despite increasing knowledge about its harm. Adult tobacco use in Jefferson County is generally lower (better) than the state. • Regular tobacco use is defined as having smoked at least 100 cigarettes (5 packs) in a person's lifetime, according to the CDC definition. Fifty-five percent of Jefferson County respondents report having smoked at least 100 cigarettes in their lifetime; this rate is significantly higher (worse) than the 51% of state respondents (Figure 1). • Current smokers, by CDC standards, are people who smoked on some or every day during the last 30. Sixteen percent of Jefferson County adults are current smokers; this rate is significantly lower (better) than the state rate, 21% (Figure 2). • Of the current adult smokers, 15% are males; this rate is significantly lower (better) than the state, 22% (Figure 3). There were no significant differences between male and female county residents or between county and state rates for females. • Twenty-eight percent of residents age 18-34 are current smokers; this rate is significantly higher (worse) than the state rate, 24% (Figure 4). Within the county, the current smoking rate among 18-34 year olds is significantly higher (worse) than 4110 residents age 35-64 and 65+ (19% and 5% respectively). • Significantly more residents who are current smokers (28%) have a high school education or less as compared to 15% with some post-secondary and 8% with four or more years of college (Figure 5). Rates among current smokers with some post- secondary education (15%) are significantly better than the state, 21%. • Among households within ZIP code 98368, the current smoking rate is 11% and is significantly lower (better) than the 21% among households in all other ZIP codes (Figure 6). • Among current smokers, 22% report fair/poor general health status; this rate is significantly higher (worse) than the 14% of all respondents who report fair/poor general health status (Figure 7). The label on this figure is crossing the column. • Among the 16% of adults who currently smoke, 34% reported heaving drinking (5+ drinks at one setting) within the previous 30 days (Figure 8). The presence of smoking is associated with heavy drinking. • 1 of 1 • Within reported age of first use and age of regular use, there are significant differences among residents • Among the 18-34 year olds, the median age of reported first use was 13.5 years as compared to 16.7 years for 35-64 year olds; this difference is significant. • Among the 18-35 year olds, the median age of reported regular use was 18 years as compared to 20.3 years for 35-64 year olds; this difference is significant. • Among those with high school education or less, the median age of reported first use was 14.7 years as compared to 17.9 years among those with some post-secondary education and 16.4 years among those with 4+ years of college; these differences are significant. . Among those with high school education or less, the median age of reported regular use was 18.8 years as compared to 21.3 years for those with some post-secondary education; this difference is significant. . Among household with children less than 18 years old, the median age of reported regular use was 17.9 years as compared to 21.7 years among households with no children less than 18 years old. Jefferson County residents are motivated to quit. . Seventy-six percent of everyday smokers tried to quit smoking for one or more days during the past 12 months; this quit rate is significantly higher (better) than the state rate, 49% (Figure 9). . Twenty-eight percent of everyday smokers age 18-34 tried to quit; this is significantly lower (worse) than the state rate, 55% (Figure 10). However, 72% of currently smoking residents age 35 and older tried to quit; this rate is significantly higher (better) than the state, 42%. . Fifty-nine percent of everyday smokers with high school or less education quit for one or more days; this rate is significantly higher (better) than the state rate of 42% (Figure 11). However, only 41% of currently smoking county respondents with any college tried to quit; this rate is significantly lower (worse) than the state rate of 50%. . Seventy-six percent of everyday smokers in households with other than ZIP code 98368 tried to quit; this rate is significantly higher (better) than the 24% of everyday smokers who tried to quit in ZIP code 98368 (Figure 12). . The median age of those who quit smoking ten years ago or longer is 62.1 years as compared to 47.2 years for those who quit smoking within the past ten years. • Jefferson County households generally have clear rules about smoking in the home. . Seventy-nine percent of all respondents reported that they do not allow smoking inside their homes (Figure 13). . However, 17% of respondents age 65+ reported no rules about smoking inside the home, compared to 10% of the 18-34 and 12% of the 35-64 age groups; the difference between younger ages (both groups) and those 65+ is significant. (Figure 13). . Respondents with some post-secondary or four or more years of college are significantly more likely to prohibit smoking inside their home (79% and 86% respectively), while only 71% of respondents with high school or less education reported that they prohibit smoking inside the home (Figure 14). . Forty-three percent of currently smoking adults prohibit smoking inside their home; this is significantly lower (worse) than the 86% on non-smoking adults who prohibit smoking inside their home (Figure 15). • Eighty-four percent of the respondents who reported that their general health status was excellent/very good/good also reported that they prohibit smoking in the home; this rate is significantly higher (better) than the 33% of respondents who reported fair/poor health status and who either allowed smoking in some places / at some 111/ times or had no rules about smoking inside their home (Figure 16). Children's Exposure to Adult Risk Factors for Poor Health . Sixteen percent of all adults reported currently smoking cigarettes, but 24% of adults whose households include children younger than 18 smoked (Figure 17). • Although 24% of households with children younger than 18 include currently smoking adults, 87% of these households prohibit smoking inside the home (Figure 18). S DRAFT 7/11/02 Figure 1. (Q10x1) Have you smoked at least 100 cigarettes in your entire life? Jefferson County 2001 and Washington State 2000 BRFSS Jefferson County* Washington State Smoked at least 100 cigarettes in lifetime 55% 51% Figure 1 . Have you smoked at least 100 cigarettes in your entire life? Jefferson County 2001 and Washington State 2000 BFRSS Source: Jefferson County Department of Health&Human Services BRFSS,2001; 100% - State-CDC BRFSS website 90% - Jefferson County* ❑Washington State 80% - 70% 4111 60% - 55% 51% 50% - 40% - 30% - 20% - 10% - 0% Smoked at least 100 cigarettes in lifetime *County is significantly higher(worse)than the state • • DRAFT Figure 2. (10x1 X 10x2) Currently smoking among those who ever smoked ioJefferson County 2001 and Washington State 2000 BRFSS Jefferson County* Washington State Current Smoker 16% 21% Former Smoker (not currently smoking) 39% Never Smoked 45% Figure 2. Current Smoker, Jefferson County 2001 and Washington State 2000 BRFSS Source: Jefferson County Department of Health&Human Services BRFSS,2001; State-CDC BRFSS website loo°i° ■Jefferson County* ❑Washington State 90% - 80% - • 70% - 60% - 50% - 45% 40% 39% 30% - 21% 20% - 16% 10% - o% I Current Smoker Former Smoker(not Never Smoked currently smoking) *County is significantly lower(better)than Kitsap County and the state • 7/11/02 DRAFT Figure 3. (Q10x2) Do you smoke everyday, some days, or not at all, by gender. • Jefferson County 2001 and Washington State 2000 BRFSS Current Smoker Jefferson County Washington State All 16% 21% Male* 15% 22% Female 17% 20% Figure 3. Current smoker, by gender. Jefferson County 2001 and Washington State 2000 BRFSS. Source: Jefferson County Department of Health&Human Services 2001; State-CDC BRFSS website ■Jefferson County ❑Washington State 100%- • 90%- 80%- 70%- 600/0- 50%- 40%- 30%- 21% 22% 20% 20%- 16% . 17% 15/. 10%- 0% i All Male* Female *County male respondents are significantly lower(better)the state,p<.01. 7/11/02 DRAFT Figure 4. (Q10x2) Do you smoke everyday, some days, or not at all, by age. • Jefferson County 2001 and Washington State 2000 BRFSS ....current smoker Jefferson County** Washington State* All 16% 21% 18-34 year olds 28% 24% 35-64 year olds 19% 22% 65+year olds 5% 10% Figure 4. Current smoker, by age. Jefferson County 2001 and Washington 2000 BRFSS. 100% - Source: Jefferson County- Department of Health&Human Services,2001 BRFSS; State-CDC BRFSS website 90% ■Jefferson County** ❑Washington State* 80% -I • 70% - 60% - 50% - 40% - 30% - 28% 24% 21% 22% 19% 20% � 111 10% 10% 5% I I All 18-34 year 35-64 year 65+year olds olds olds *The rate among county 18-34 year olds is significantly higher(worse)than the state rate. • **Rates among county residents age 18-34 year is significanity higher(worse)than in other age groups. 7/11/02 DRAFT Figure 5. (Q10x2) Do you smoke everyday, some days, or not at all, by education. Jefferson County 2001 BRFSS and Washington State 2000 BRFSS ..current smoker Jefferson County Washington State All 16% 21% High school or less** 28% 30% Some post-secondary* 15% 21% 4+years of college 8% 11% Figure 5. Current smoker, by education. Jefferson County 2001 and Washington 2000 BRFSS 100% - Source: Jefferson County- Department of Health&Human Services,2001 BRFSS; State-CDC BRFSS website 90% - 80% - • 70% - 60% - ■Jefferson County ❑Washington State 50% - 40% - 30% 28% 30% 21% 21% 20% - 16% 111 15% 11% 10% - Ain 0% All High school or Some post- 4+years of less** secondary* college *County rates are significantly lower(better)than state rates among respondents with some post secondary education. • **County rates among respondents with some post secondary and 4+years of college are signifcantly lower(better)than 7/11/02 . Figure 6. (Q10x2) Do you smoke everyday, some days, or not at all, by ZIP Code. Jefferson County 2001 BRFSS Jefferson County ZIP Code 98368 All other ZIP Codes Current Smoker 16% 11% 21% Figure 6. Current smoker, by ZIP Code. Jefferson County BRFSS, 2001 Source: Jefferson County Department of Health&Human Services,2001 BRFSS 100% - ■Jefferson County ®ZIP Code 98368 EAU other ZIP Codes 90% - 80°i° - • 70% - 60% - 50% - 40% - 30% - 21% 20% - 16% 11% 10% - 0% o Current Smoker *The smoking rate in ZIP Code 98368 is significantly lower(better)than All Other ZIP Codes,p<.05 • 7/11/02 DRAFT Figure 7. Current smoker, by general health status al Jefferson County 2001(n=595. ....general health status Excellent/Very Good/Good* Fair/Poor* All 79% 21% Current Smoker 78% 22% Non-Smoker 86% 14% Figure 7. Current smokers, by general health status. Jefferson County 2001 BRFSS Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 100% - ®Current Smoker 0 Non-Smoker 90% - 86% 80% - 78% rtx•::rttir!�x: • 70% - 600/ . • ..- :■: ! r•r ■-'r.-5 40/0 0 '-':-'R :::-:.-l: ...-......-. -! .U..-.-. 30% .-r. •.;�;•.;�R yR 20/0 ` . .!:l... ::! : . . :-': 0% ! r ;.S:S...'•j Excellent/ery Good/Good* Fair/Poor* 1110 7/11/02 Figure 8. Heavy drinking (5+/time) among current smokers. (n=400) • Jefferson County BRFSS, 2001. Heavy Drinker(5+/time) Heavy Drinking No Heavy Drinking All 17% 83% Current Smoker* 34% 66% Non-Smoker 15% 85% Figure 8. Heavy drinking (5+/time) among current smokers, Jefferson County BRFSS, 2001 Source: Jefferson County Department of Health&Human Services BRFSS,2001 100% 1 ® Heavy Drinking ❑No Heavy Drinking 90% - 85% 83% 80% - 70% 66% 60% - 50% - 40% - 34% 30% - 20% - 17% ■.•-! 15% !y. efir .. ` . U.RK ■-:■ ..Y 0% xr-... �. !,. :■-' . All Current Smoker* Non-Smoker . *Current smoking among respondents who report heavy drinking within the past 30 days is significantly higher(worse) than respondents who report no heavy drinking within the past 30 days;p<.001 7/11/02 DRAFT 7/11/02 • Figure 9. (Q10x3) During the past 12 months, have you quit smoking for 1 day or longer (people who smoke everyday)? Jefferson County 2001 and Washington State 2000 BRFSS. (Jefferson County n=74) Jefferson County Washington State Tried to quit smoking for 1 or more days 76% 49% Figure 9. Tried to quit smoking during the past 12 months, Jefferson County 2001 and Washington State 2000 BRFSS. Source: Jefferson County Department of Health&Human Services BRFSS,2001; State-CDC BRFSS website ■Jefferson County ❑Washington State 100% - • 90% - 80% - 76% 70% - 60% - 50% 49% 40% - 30% - 20% - 10% - 0% Tried to quit smoking for 1 or more days • County is significantly higher(better)than the state DRAFT • Figure 10. (Q10x3) During the past 12 months have you quit smoking for 1 day or longer, by age. Jefferson County 2001 and Washington State 2000 BRFSS. (Jefferson County n=74) Quit for 1 day or longer Jefferson County Washington State 18-34 years old* 28% 55% 35 years and older** 72% 42% Figure 10. Tried to quit smoking during the past 12 months, by age, Jefferson County 2001 and Washington State 2000 BRFSS. Source: Jefferson County Department of Health&Human Services BRFSS,2001; State-CDC BRFSS website ■Jefferson County ❑Washington State 100% - . 90% - 80% - 72% 70% - 60% - 55% 50% - 42% 40% - 30% 28% 20% - 10% - 0% - 18-34 years old* 35 years and older** *Rates for county respondents age 18-34 are significantly lower(worse)the state. • **Rates for county respondents age 35 and older are significantly higher(better)the state. — 7/11/02 DRAFT . Figure 11. (Q10x3) During the past 12 months have you quit smoking for 1 day or longer, by education Jefferson County 2001 and Washington State 2000 BRFSS. (Jefferson County n=74) Quit for 1 day or longer Jefferson County Washington State High school or less** 59% 42% Any college* 41% 50% Figure 11 . Tried to quit smoking during the past 12 months, Jefferson County 2001 and Washington State 2000 BRFSS. Source: Jefferson County Department of Health&Human Services BRFSS,2001; State-CDC BRFSS website ■Jefferson County ❑Washington State 100% - • 90% - 80% - 70% - 59% 60% - 50% 50% - 42% 41% 40% - 30% - 20% - 10% - 0% — High school or less** Any college* *Rates for county respondents with any college are significantly lower(worse)the state. ill **Rates for county respondents with high school education or less significantly higher(better)the state. 7/11/02 DRAFT • Figure 12. (Q10x3) During the past 12 months have you quit smoking for 1 day or longer, by ZIP Code. Jefferson County 2001. (Jefferson County n=74) Quit for 1 day or longer Jefferson County ZIP Code 98368 All Other ZIP Codes 76% 24% 76% Figure 12. Tried to quit smoking during the past 12 months, by ZIP Code, Jefferson County 2001. Source: Jefferson County Department of Health&Human Services BRFSS,2001 ■Jefferson County Z ZIP Code 98368 m All Other ZIP Codes 100%- • 90%- 80°i. 76% 76% 70%- 60%- 50°/.- 40%- 30%- 24% 20%- 10% /7/4424 Quit for 1 day or longer *Rates for county respondents with any college are significantly lower(worse)the state. "Rates for county respondents with high school education or less significantly higher(better)the state. 7/11/02 DRAFT Figure 13. (24x6) Which statement describes the rules about smoking inside your home, by age 41) Jefferson County 2001 BRFSS. (n=599) Rules about Smoking in the home Not allowed Some places/some times No rules All respondents 79% 8% 13% 18-34 years old 76% 14% 10% 35-64 years old 79% 9% 12% 65+years old* 79% 4% 17% Figure 13. Smoking rules inside your home, by age, Jefferson County 2001 BRFSS (all respondents). Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 100% 90% -I ❑Not allowed Some places / some times ©No rules 79% 79% 79% • 80% - 76% 70% - I 60% 50% - 40% -. 30% - I ' 20% - 17% 13% 4%0% ° 12% 0 0 10% - 8/0 % •• 4% 0% All 18-34 years old 35-64 years old 65+years old* respondents 7/11/02 • DRAFT Figure 14. (24x6)Which statement describes the rules about smoking inside your home, by education Jefferson County 2001 BRFSS. (n=600) Rules about smoking in the home Not allowed Some places/some times No rules All respondents 79% 8% 13% High School or less 71% 12% 17% Some Post-secondary* 79% 10% 11% 4+years of college* 86% 4% 10% Figure 14. Smoking rules inside your home, by education, Jefferson County 2001 BRFSS, (all respondents, n=600) Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 100% - ❑Not allowed Some places / some times ©No rules 90% - 86% • 80% - 79% 79% 71% 70% - i 60% - 50% - 40% - 30% - i 20% - 17% 0 13% o, 2 0%11% 10% trt 10% H ° . _ W 4% 0% _ All respondents High School or Some Post- 4+years of less secondary* college* *Respondents with some post-secondary or 4+years of college are significantlly more likely to prohibit smoking in the 7/11/02 DRAFT Figure 15. (24x6)Which statement describes the rules about smoking inside your home. 0 Jefferson County 2001 BRFSS. (n=599) Rules about Smoking in the home Not allowed Some places/some times/no rules All respondents 79% 21% Current Smoker 43% 57% Never smoked/former smoker 86% 14% Figure 15. Smoking rules inside your home, by current smoker, (n=599). Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 100% ❑All respondents ®Current Smoker D Never smoked/former smoker 90% - 86% • 80% 79% --- -_--- - 70% - - - - 60% - --- ----__- _ 57% 50% - --- - _ - 43% __- • DRAFT • Figure 16. (24x6)Which statement describes the rules about smoking inside your home, by health status.Jefferson County 2001 BRFSS (n=598) Rules about Smoking in the home ...general health status Not allowed Some places/some times No rules All respondents 80% 9% 11% ExcellentNery Good/Good* 81% 6% 13% Fair/Poor 67% 19% 14% Figure 16. Smoking rules inside your home, by general health status. Jefferson County 2001 BRFSS, (n=598). Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 0 Not allowed Some places / some times 100% ©No rules 90% 1 -, 80% 81% 80% 70% 67% 60% - 50% - 40% 30% 20% 19% 0 11% 13% '•'•''14% 9% 10% 6% ,++ 7F•''L5 ,'i+ All respondents ExcellentNery Fair/Poor Good/Good* *Respondents who report excellent/very good/good health are significantly more likely to prohibit smoking in the home; 7/11/02 DRAFT Figure 17. (Q13x6 & Q21x3) Current smokers and the presence of children < 18 in the household. Jefferson County 2001 BRFSS All households Children < 18* No children < 18 Current smokers 16% 24% 13% Figure 17. Current smokers, and the presence of children < 18 in the current household, Jefferson County 2001 BRFSS. Source: Jefferson County- Department of Health&Human Services,2001 BRFSS 100% - 90% - 80% - • 70% ■All households ❑Children < 18* D No children < 18 60% 50% - 40% - 30% - 24% 20% - 16% 13% 10% - 0% - - - Current smokers "Current smoking among adult respondents in households with children less than 18 years old is significantly higher(worse) than households without children less than 18 years old;p<0.01 • 7/11/02 • DRAFT Figure 18. (24x6)Which statement describes the rules about smoking inside your home, 1pby the presence of children < 18 in the household. Jefferson County 2001 BRFSS, (n=602) Rules about Smoking in the home Not allowed Some places/some times No rules All households 79% 8% 13% Children <18* 87% 7% 6% No children <18 76% 9% 15% Figure 18. Smoking rules inside the home, and the presence of children < 18 in the current household, Jefferson County 2001 BRFSS. Source: Jefferson County- Department of Health&Human Services,2001 BRFSS l00% D Not allowed LL Some places / some times ©No rules 90% - 87% 110 79% 80% 76% 70% - 60% - 50% - 40% 30% 20% 13% 15% 10% 8% 7% 6% 9% 0% �— All households Children <18* No children <18 *Households with children less than 18 years old are significantly more likely to prohibit smoking in the home;p<.01. • 7/11/02 • Jefferson County Tobacco Prevention & Control Program Supplemental Materials • Smokefree Guide • Drinking, Dining, &Desserting Establishment Letter- June, 2002 • • Retailer Letter- June, 2002 • BRFSS Fact Sheet (included in Retailer and Establishment packets) • Tobacco Use and Exposure Chapter from The Health of Washington State, Washington State Department of Health -July, 2002 • ' County, � Jefferson Health &Human Servi• ces •l' 11.✓ > 615 SHERIDAN • PORT TOWNSEND,WA 98368 • FAX 360-385-9401 June 26 �. Dear East Jefferson County Drinking, Dining, & Desserting Establishments, Congratulations!!! Your establishment has been included in the Smokefree Drinking, Dining, &Desserting in East Jefferson County 2002 update. Welcome to the newly smokefree Harbormaster Restaurant and Lounge and Flagship Grill and Spirits (formerly The Old Alcohol Plant). Your decision to provide smokefree environments increases public health and safety. Sixty-four percent of Washington State respondents think that breathing secondhand smoke is very harmful.' Eighty-three percent of Washington State respondents think that all children should be protected from secondhand smoke.' Seventy-nine percent of Jefferson County residents report that smoking is not allowed inside their homes.' Secondhand smoke (SHS) is a Group A carcinogen (the deadliest of all), known to cause cancer in humans, and is linked to lung cancer and heart disease in nonsmokers. SHS also causes serious respiratory problems in kids, increases the risk for Sudden Infant Death Syndrome(SIDS)and middle ear infections in children. SHS toxins cannot be removed by ventilation systems. Although your establishment provides a smokefree interior, there are other things you can do to promote a smokefree environment. Perhaps your customers complain about walking through a smoke cloud to enter your establishment. You can discourage smoking near the entrances by: • posting reminders that request that as a courtesy to customers, people not smoke within 50 feet of an entrance • removing ashtrays • reminding employees of the dangers of SHS and customer concerns You can also provide incentives to staff who may be motivated to quit tobacco. Incentives can be as simple as a healthy supply of chewing gum, hard candy, toothpicks, straws or bottles of bubbles, even notes of encouragement. You can post the Washington State Tobacco Quitline phone number in employee break rooms or include Quitline inserts in paychecks. Most smokers want to quit and it takes an average of seven attempts for a tobacco user to quit and stay quit. Please take a few moments to review the enclosed materials. These are available at no cost through the Jefferson County Tobacco Prevention and Control program. If you want additional materials, please contact me at 360-385-9446 or kragan©co.jefferson.wa.us. On behalf of the citizens and visitors of Jefferson County, your efforts to reduce SHS exposure are greatly appreciated. Sincere , Kellie Ragan, M.A. Jefferson County Tobacco Prevention and Control Program ,2001 Washington State Department of Health,Tobacco Prevention&Control Program Adult Telephone Survey,Olympia,WA Fall 2000 • Jefferson County 2001 Behavioral Risk Factor Survellience Survey,Jefferson County Health&Human Services COMMUNITY ENVIRONMENTAL NATURAL DEVELOPMENTAL SUBSTANCE ABUSE HEALTH HEALTH RESOURCES DISABILITIES &PREVENTION 360/385-9400 360/385-9444 360/385-9444 360/385-9400 360/385-9400 j , l.' Jefferson County Health 6-Human Services T J! iiikk 615 SHERIDAN • PORTTOWNSEND,WA 98368 • FAX 360-385-9401 June 2002 Dear East Jefferson County Tobacco Retailers, Congratulations!!!'In a recent series of tobacco compliance checks conducted by the Jefferson County Tobacco Prevention & Control Program, 23 out of 25 retailers we checked were in compliance with Tobacco Youth Access Laws. In other words, most clerks refused to sell tobacco products to minors who tried to buy tobacco. This recent round of compliance checks continues our high overall compliance rate. We know that minors can access tobacco products through many methods—including friends and parents. However, tobacco retailers can face fines and possible license revocation for multiple tobacco youth access violations. As you may know, smoking is one of the leading causes of preventable death in the United States today and many current smokers began smoking as teenagers. Current youth access laws are making it tougher for youth to access tobacco products. Efforts are also at work in our schools and communities to provide education about marketing techniques of tobacco industry, immediate and long-term health consequences of tobacco use, and cessation classes and support. . You can provide incentives to staff who may be trying to quit tobacco. Incentives can be as simple as a healthy supply of chewing gum, hard candy, toothpicks, straws or bottles of bubbles, even notes of encouragement. You can post the Washington State Tobacco Quitline phone number in employee break rooms or include Quitline inserts in paychecks. Most smokers want to quit and it takes an average of seven attempts for a tobacco user to quit and stay quit. Perhaps your customers complain about walking through a smoke cloud to enter your establishment. You can discourage smoking near the entrances by: • posting reminders that request that as a courtesy to customers, people not smoke within 50 feet of an entrance • removing ashtrays • reminding employees of the dangers of secondhand smoke and customer concerns Please take a few moments to review the enclosed materials. These are available at no cost through the Jefferson County Tobacco Prevention and Control program. If you want additional materials, please contact me at 360-385-9446 or kragan@co.jefferson.wa.us. Thank you for your efforts to reduce youth access to tobacco products. Sincer ly, Kellie Ragan, M.A. Jefferson County Tobacco Prevention and Control Program COMMUNITY ENVIRONMENTAL NATURAL DEVELOPMENTAL SUBSTANCE ABUSE HEALTH HEALTH RESOURCES DISABILITIES &PREVENTION 360/385-9400 360/385-9444 360/385-9444 360/385-9400 360/385-9400 • - TOBACCO FINDINGS FROM THE 2001 JEFFERSON COUNTY BEHAVIORAL RISK FACTOR SURVELLIENCE SURVEY* Suit tobacco use in Jefferson County is generally lower (better) than the state. Figure 1. Current Smokers, by age ■Jefferson County** Sixteen percent of Jefferson County adults are 100% ❑Washington State* current smokers**; this rate is better than the state 80% rate of 21% (Figure 1). 60% Twenty-eight percent of county respondents age 40% 28% 21% 24/ 22% 18-34 are current smokers (nearly 3 in 10); this 20% 16' '9' 10% rate is worse than the state rate of 24% (Figure 1). 0% u—i Currently smoking county rates among 18-34 year All 18-34 year 35-64 year 65+year olds is worse than people age 35-64 and 65+ (19% olds olds olds and 5% respectively). Current smokers in Jefferson County are motivated Figure 2.Quit for 1 day or longer in past 12 to quit. months,by age ■Jefferson County ❑Washington State Seventy-six percent of currently smoking county adults 100% - tried to quit smoking for one or more days during the 80% 76%- 72/° past 12 months; this quit rate better than the state rate ° 55% 60% 49/0 of 49% (Figure 2). 42% Ask% - 28% Twenty-eight percent of currently smoking county adults age 18-34 tried to quit; this rate is worse than the state 0% of 55% among18-34 year olds (Figure All 18-34 years old* 35 years and 2). older** However, 72% of county adults age 35 and older tried to quit and is better than the state rate of 42%. Jefferson County households generally have clear Figure 3.Rules about Smoking in the home rules about smoking in the home. ❑Not allowed •Some places/some times ElNo rules Seventy-nine percent of all respondents report that they do not allow smoking inside their homes (Figure 100% 79% 87% 76% 3). 80% 60% 87% of the households with children younger than 18 40% prohibit smoking inside the home, even though 24% of 20% 8%13% I7%6% I915 those households include currently smoking adults 0% All households Household with Households (Figure 3). children<18* without children<18 *The Behavioral Risk Factor Surveillance System (BRFSS)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. Jefferson County BRFSS questionnaire was administered to a random sample of 603 county residents between April 1 and ember 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. **Current smokers, by CDC standards,are people who smoke on some days or everyday. • Tobacco Use Definition:Tobacco use and exposure includes the intake of tobacco smoke from cigarettes,cigars,and pipes,either by the individual smoking or via exposure to environmental tobacco smoke,and the oral absorption of nicotine and related toxins and Exposure through smokeless tobacco(snuff,dip,chew).An adult who has smoked at least 100 cigarettes in his or her lifetime and currently smokes every day or some days is defined as a current smoker.A current youth smoker is an adolescent who has tried cigarettes and has smoked on at least one of the past 30 days. Summary smoking.National trends are similar, and 23.2%of US adults reported current smoking in 2000. Tobacco use is the leading single cause of Data from the Pregnancy Risk Assessment Monitoring preventable death in our society—one in five System(PRAMS)indicates that smoking during the third of all deaths can be attributed to tobacco use./ trimester of pregnancy has remained essentially constant More than 20% of Washington adults from 1996 to 1999. In 1999, 11.7%(±2.5%)of continue to use tobacco despite increasing Washington resident mothers reported smoking during the knowledge about its harm.The Washington third trimester of pregnancy. State Department of Health has launched a The Washington State Survey of Adolescent Health comprehensive Tobacco Prevention and Behaviors(WSSAHB)indicates that,among youth, Control Program to prevent tobacco use cigarette smoking within the past 30 days increased initiation,increase quitting, and reduce during the early 1990s, and has remained constant since III exposure to secondhand smoke. This program then. In 2000, 19.8%(± 1.4%)of 10th graders and 27.6% includes interventions that have proven (±2.0%)of 12th graders reported current use of successful in other states, such as a paid cigarettes.z media campaign and telephone quit line. Year 2000 and 2010 Goals Time Trends Healthy People 2000 and 2010 Goals. Washington did Data from the Behavioral Risk Factor Surveillance not meet the Healthy People 2000 goal of reducing the System(BRFSS)indicates that the use of cigarettes prevalence of adult smoking to 15%. Birth certificate data among Washington adults remained essentially from 1998—2000 combined(see technical note)indicated constant from the late 1980s to 2000. In 2000,20.7% that almost 14%of women smoked during pregnancy and (± 1.3%)of Washington adults reported current so Washington did not meet the goal of reducing smoking among pregnant women to 10%.Washington data are not available to measure the Healthy People 2000 goals for Adults Reporting youth. Current Cigarette Smoking WA State BRFSS The national Healthy People 2010 goals for tobacco use 30 include reducing current smoking among adults to an age- 20adjusted prevalence of 12%or less.Washington's age- 1- prevalence of smoking in 2000 was about 20%. Additional Healthy People 2010 goals include increasing I 2 X smoking cessation among pregnant women to 30%,and a- 10 reducing current smoking among high school youth (grades 9— 12)to less than 16%. In 1999, approximately 28%(±2%)of high school youth in Washington reported 0 IIIIIIIIIIIIITIIIIIII3 o Lc) cD ino smoking. rn co rn rn o " Washington State Goals. State goals include reducing the III L WA x HP 2000 Goal proportion of adult current smokers by 3%per year through 2010(so that the 2010 BRFSS finds a prevalence The Health of Washington State 1 Tobacco Use and Exposure Washington State Department of Health updated:07/02/2002 of 16.5%or less);reducing the proportion of mothers small town and isolated rural areas reported smoking • who smoke during pregnancy by 4%per year through during pregnancy than women in other areas.For women 2010(so that the 2010 PRAMS fmds a prevalence of under age 25,slightly fewer living in large towns report 8.0%or less);and reducing the proportions of youth smoking during pregnancy than did women in other areas. in 10th and 12th grade who are current smokers by 2% per year through 2010(so that a school-based survey Smoking During Pregnancy in 2010 finds prevalences of 16.2%and 22.6%or Urban and Rural less,respectively).These goals are more conservative WA State Birth Certificates, 1998-2000 than the Healthy People 2010 goals and are based on V 9.4 the observed success of tobacco control programs in Urban other states. H 20.3 9.9 Suburban I-I 20.9 Geographic Variation 10.2 Large Town County data on current smoking reported in the 1---117.1 BRFSS and WSSAHB are not generallyavailable Small 73.8 because of the small number of respondents from �' 'A P Town/Rural � H 20.0 many counties. Similarly,PRAMS cannot be used to measure county variation in smoking during 0 10 20 30 pregnancy.However,smoking during pregnancy Percent reported on the birth certificate,represented below, a Women 25+years varied among counties from 5%to nearly 30%.(See 0 Women<25 years technical note.) Age and Gender SELF REPORTED SMOKING DURING PREGNANCY Based on the Fall 2000 WSSAHB4 and combined BRFSS WA Birth Certificates 1998 2000• 111111111111data from 1998-2000,the prevalence of current smoking increased from 6th through 12th grades,and then generally � �� decreased with age after age 24.The prevalence of current smoking among 8th, 10th, and 12th grade girls was significantly higher than among boys. illr--‘ :, irlim'ie,--51 jii ill Current Cigarette Smoking Age and Gender WA State BRFSS 1998-2000,WSSAHB 2000 65+ - ....._`_ _ 15.3 1i31 Percent 45-641 - 249 0 2.56 to 10.17A. 2a4 10.41 to 13.73 35 44 25.6 15.45 to 18.62 State Rate: 13.73 24.6 18.74 to 27.47 ?ctlucea by OIR?AGIS 25-34 .v. -n 27 1-7f-217 18-24 29.3 Urban and Rural 12th grade 26.1 29.6 Washington BRFSS data for 1998-2000 combined grade 293 10th r �1= 17.5 did not show differences in current smokingamong218 8th grade �.3 residents of urban,suburban,large town, and small y-I 14.5 town/isolated rural areas.Washington PRAMS and 6th grade 4.1 WSSAHB data are not available to describe urban 39 and rural variations in tobacco use.However,birth 0 10 20 30 40 certificate data(see technical note)from 1998-2000 Percent •combined indicated that among women giving birth Io Female ®Male at age 25 years and older,more women living in Tobacco Use and Exposure 2 The Health of Washington State updated:07/02/2002 Washington State Department of Health • • Combined PRAMS data from 1997- 1999 indicated WSSAHB data indicated that the prevalence of youth that prevalence of smoking during the third trimester smoking for all grades was highest among Native of pregnancy was highest among young mothers. American youth,followed by blacks,Hispanics,and Among mothers younger than 20, 19.2%(±4.7%) whites,and was lowest among Asian/Pacific Islanders. had smoked during pregnancy,and among mothers For example,among 10th graders the smoking prevalence age 20-24, 18.8%(±3.3%)had smoked during was 40.5%(± 1.0%)for Native American youth,22.8% pregnancy.In contrast,only about half as many (±.8%)for blacks,20.9%(± 1.0%)for Hispanics, 19.2% mothers in older age groups had smoked during (±.8%)for whites,and 14.8%(±.7%)among pregnancy. Asian/Pacific Islander youth. Race and Ethnicity Income and Education BRFSS data indicated that Native Americans have Increasing levels of education and annual household the highest prevalence of cigarette smoking,followed income are associated with decreases in prevalence of by blacks,whites,and Asian/Pacific Islanders.The current cigarette smoking. prevalence of smoking among Hispanics was not PRAMS data from 1997- 1999 indicated that the significantly different from non-Hispanics. prevalence of smoking among Medicaid recipients(low- Current Cigarette Smoking income mothers)was 20.7%(±2.7%),nearly three times Race and Ethnicity greater than among non-Medicaid mothers. WA BRFSS 1998-2000 Washington data to describe the socioeconomic status of Am Indian/ 1 1 youth who smoke are not currently available. 34. Alaska Native AsianPacfic 15.8 a Current Cigarette Smoking Islander -, m Income and Education Black 23.4 °C WA State BRFSS 1998-2000 III White 213 425,000*ear 312 a Hispanic I I 227 $2550,000year 229 0 1 1 .g 2 Non-Hispanic H 215 W $50,000+year : �, 16.8 -- 1 1 I 0 10 20 30 40 50 d-IS Graduate I 139.2 Percent - 0 HS Grad,GED H 286 - I The comparatively low prevalence of current Some College+ H �.3 W smoking among Asian/Pacific Islanders can be 1 I deceptive.There are significant cultural differences 0 10 20 30 40 50 around tobacco among subpopulations within this Percent group,and there are significant gender differences in tobacco use within these communities as well.The low overall group prevalence probably masks high Other Measures of Burden use rates among males within specific subgroups. One study conducted in King County found that the Smokeless Tobacco prevalence of smoking among Korean and Vietnamese men was about 30%,while smoking In the 2000 BRFSS,3.1%(±0.7%)of Washington adults among women in these same populations was about reported using smokeless tobacco in the past month. 4%.5 Among adult men,the prevalence of smokeless tobacco use was 6.3%(± 1.5%),while among women the PRAMS data from 1997- 1999 indicated that the prevalence of smokeless tobacco use was less than 0.1%. prevalence of smoking during pregnancy was highesto (± Among12th grade boys the rate was 16.3% .2%).For among Native Americans(24.9%±2.7%),followed 1998 2000,use of smokeless tobacco waslowest among by whites(14.3%±2.0%)and blacks(12.4%± those living in urban core areas(1.9%±.5%),increased 2.2%),and lowest among Asian/Pacific Islanders among residents of suburban and large town areas(2.5% ill (6.7%± 1.6%)and Hispanics(3.4%± 1.2%). ± 1.5%,and 4.1%,±2.1% respectively),p y),and was highest The Health of Washington State 3 Tobacco Use and Exposure Washington State Department of Health updated:07/02/2002 • among residents of small town and isolated rural Youth are put at increased risk for initiation of tobacco 4111 areas(6.1%±2.9%). use by complex social,environmental,and personal factors. Social and environmental factors include Cigars availability of tobacco products,tobacco industry 0 promotion practices,the price of tobacco products, In the 2000 BRFSS,4.2/o(±0.6%)of Washington perceptions that tobacco use is normal,peers' and adults reported smoking cigars in the past month.For siblings'use and approval,and lack of parental 1998—2000 combined,cigar smoking was highest involvement.Personal risk factors include low self-image among those living in urban areas(4.6%,±0.8%)and and low self-esteem,the belief that tobacco use provides decreased to 1.7%(± 1.4%)in the small town and some benefit,and a lack of skills to refuse offers of isolated rural areas. tobacco.8 Health Effects High Risk Groups Cigarette smoking causes heart disease,several kinds Lower income and education levels are important risk of cancer(lung,larynx,esophagus,pharynx,mouth, factors for tobacco use. In addition,Native Americans and and bladder),and chronic lung disease. Smoking also some groups within the Asian community are at increased contributes to cancers of the pancreas,kidney,and risk of tobacco use.Youth are a high-risk group for future cervix.As a direct result of tobacco use,more than tobacco use.Among adults who currently smoke in 430,000 people die annually in the US and more than Washington,the average age of smoking initiation was 8,300 die in Washington.6 Other tobacco products, about 15,and approximately three-fourths began smoking such as smokeless tobacco,cigars,pipe tobacco,and while younger than 18.11 novel tobacco products,such as clove cigarettes (kreteks)and bidis,also pose serious health risks and Compounding these risk factors are the promotional are not safe alternatives to cigarettes. efforts of the tobacco industry.National marketing expenditures by the tobacco industry increased 22.3%to Smoking during pregnancy is associated with $8.24 billion from 1998 to 1999.12 • spontaneous abortions,premature births,low birthweight,and sudden infant death syndrome.The 1998—2000 birth certificate data indicated that about Intervention Strategies 11,000 infants are born in Washington each year to mothers who report smoking during pregnancy. In 1999,Washington received the first of a series of payments from the national Master Settlement Immediate health consequences for youth who use Agreement.This settlement between the tobacco industry tobacco include impaired lung growth and function, and a group of state Attorneys General, led by increased respiratory illnesses,and poorer overall Washington Attorney General Christine Gregoire,is health.Early initiation of smoking has also been expected to generate$4.5 billion in payments to associated with increased risk of subsequent drug use Washington over 25 years.With this funding,DOH and might be a marker for underlying mental health launched a statewide comprehensive tobacco prevention problems,such as depression.8 and controlrogram in 2000,based on best practices from Nationally,exposure to environmental tobacco other states and with the advice of a statewide tobacco smoke(ETS)contributes to the deaths of an council.A recent review of evaluated interventions for estimated 3,000 nonsmokers from lung cancer each tobacco prevention and control supports the program's year.ETS makes thousands more ill and contributes design.The review found that mass media campaigns and to their deaths from other conditions.Nationally,ETS telephone cessation support systems,in particular, are causes up to 300,000 children to suffer from lower highly effective interventions.14 respiratory tract infections each year.9 Cessation Programs.A multicomponent telephone counseling service has been shown to be effective in Barriers and Motivation helping adult tobacco users to quit.Health care provider training to promote effective clients interventions and In the 1998—2000 combined BRFSS,about half of establish provider reminder systems are also effective current smokers reported making a serious attempt to population-based strategies to reduce smoking.14 quit during the past year,and nearly 80%of all Public Education&Awareness. Media campaigns illcurrent smokers indicated that they wanted to quit targeted toward high-risk youth have been shown to smoking.Pregnant women can be especially reduce smoking initiation among youth. Successful motivated to quit. Tobacco Use and Exposure 4 The Health of Washington State updated:07/02/2002 Washington State Department of Health campaigns contain carefully developed themes that Technical Notes • resonate with the target audience.Mass media strategies that market telephone quit lines to adults Smoking During Pregnancy.Currently,delivering mothers in and targeted education and awareness campaigns Washington are asked whether they smoked during their using print and other media are also effective in pregnancy(not during a specific time,such as third trimester), reducing tobacco use.14 and responses are included on the birth certificate.A mother is classified as a smoker if she reports that she has smoked at Community-Based Programs. The Centers for some time during the pregnancy. Research has indicated Disease Control and Prevention(CDC)recommends significant under-reporting of this measure(up to 30%); community-based programs as an important element however, if under-reporting is constant,differences in smoking of comprehensive state tobacco prevention and rates are valid. control programs.13 Implementing smoking bans and restrictions and working with health care providers to Endnotes give smokers strong messages to quit and referral to other services(such as a quit line)are two community-based interventions that have been 1 McGinnis JM,Foege WH,1993.Actual Causes of Death in the United successful in reducing tobacco use.14 States.JAMA,270:2207-12. 2 OSPI 2001. Washington State Survey of Adolescent Health Behaviors School-Based Programs. A recently released long- 2000:Analytic Report.Office of the Superintendent of Public term study of a curriculum-based tobacco prevention Instruction,Safe and Drug-Free Schools Program.Olympia,WA. program found that education alone is unlikely to 3 Bensley L,VanEenwyk J,Schoder J,Tollefesen P.(2000). reduce tobacco use among youth. Rather, Washington State Youth Risk Behavior Survey:1999. Olympia, comprehensive school-based tobacco prevention Washington:Washington State Department of Health and Office of the programs that include curriculum,policy, staff Superintendent of Public Instruction. training, linkage with communities, intervention 4 Adult prevalence was measured using BRFSS,and youth prevalence services for youth,and parent involvement have been measured using WSSAHB. successful in reducing rates of smoking among 5 Smyser M,Krieger J,Solet D.1998. The King County Ethnicity and youth. Health Survey. Public Health—Seattle and King County.Seattle,WA. • 6 DOH 2000. Tobacco and Health in Washington State:County Profiles See related chapters on Indoor Air of Tobacco Use.Washington State Department of Health,Office of Community Wellness&Prevention.Olympia,WA.DOH Pub.345-150 Quality, Coronary Heart Disease and 'DiFranza JR,Lew RA. 1995.Effect of maternal cigarette smoking on Lunq Cancer. pregnancy complications and sudden infant death syndrome.Journal of Family Practice.40(4):385-394. Data Sources(For additional detail, see Appendix B) 8 US DHHS 1994.Preventing Tobacco Use Among Young People:A Report of the Surgeon General.Atlanta,GA.US Department of Health Behavioral Risk Factor Surveillance System, 1987—2000. and Human Services,Public Health Service,Centers for Disease Washington State Birth Certificate Data, 1980-2000 CD- Control and Prevention. ROM issued November 2001. 9 NCI 1999.Health Effects of Exposure to Environmental Tobacco Smoke:The Report of the California Environmental Protection Agency. The Pregnancy Risk Assessment Monitoring System Smoking and Tobacco Control Monograph no.10.Bethesda,MD.US (PRAMS), 1998—2000. Department of Health and Human Services,National Institutes of Washington State Survey of Adolescent Health Behaviors, Health.NIH Pub.No.99-4645. 2000.Analysis completed by Assessment and Evaluation t0 US DHHS 2001. Women and Smoking:A report of the Surgeon General.Atlanta,GA.US Department of Health and Human Services, Unit of Tobacco Prevention&Control Program, DOH. Public Health Service,Centers for Disease Control and Prevention. For More Information " DOH Tobacco Program"Adult Telephone Survey"2000-01. t2 FTC 1999.Cigarette Report for 1999.Washington,D.C.US Federal Washington State Department of Health,Tobacco Trade Commission. Prevention and Control Program, (360)236-3665 13 US DHHS 1999.Best Practices for Comprehensive Tobacco Control Centers for Disease Control and Prevention, Office on Programs.Atlanta,GA.US Department of Health and Human Services, Smoking and Health Public Health Service,Centers for Disease Control and Prevention. The Guide to Community Preventive Services:a 14 Hopkins DP,Fielding JE.2001. The Guide to Community Preventive Comprehensive review of published community-based Services:Tobacco Use Prevention and Control.Am J Prey Med. 20(2s). interventions to reduce tobacco use 15 Peterson AV,Kealey KA,Mann SL,Marek PM,Saranson IG 2000. • Centers for Disease Control and Prevention, State Hutchinson Smoking Prevention Project:Long Term Randomized Trial Tobacco Activities Tracking and Evaluation System The Health of Washington State 5 Tobacco Use and Exposure Washington State Department of Health updated:07/02/2002 • in School-Based Tobacco Use Prevention—Results on Smoking. J Natl Cancer Inst 92:1979-91. 16 MMWR 2001."Effectiveness of School-based Programs as a Component of a Statewide Tobacco Control Initiative—Oregon, 1999-2000"August 10,2001.50(31);663-6. • • Tobacco Use and Exposure 6 The Health of Washington State updated:07/02/2002 Washington State Department of Health • Board of Health New Business Agenda Item # V., 3 Health of Jefferson County & • Port Townsend, July 8 , 2002 Report to Port Towsend City Council July 18, 2002 • • Summary: After presentation to Port Townsend City Council , on July 8, 2002 Establish Community Visions • Prioritize Issues (problems and assets). . . ie: Education, Fitness, Disparity • Who are Partners. . . ie: City, County, Hospital, EDC, Citizens, Schools • Policy Implications and Vision Funding decisions Benchmarking Accountability Actions: Set Goals • Data Steering Committee • Community Input & Work Focus Groups Substance Abuse Seniors Families with young children Health care access • • Policy Makers • Board of Health Media Report 1 July 18, 2002 • Jefferson County Health and Human Services JUNE — JULY 2002 NEWS ARTICLES 1. "An Open Letter to the Board of County Commissioners for Jefferson County",P.T. LEADER, June 5, 2002. 2. "County cutting budget", P.T. LEADER, June 5, 2002 3. "State receives rest of bioterror grant", Peninsula Daily News, June 7, 2002 4. "County backs plan to fight salt water in wells", Peninsula Daily News, June 11, 2002 5. "Jefferson health, law officials to discuss public-nuisance controls", Peninsula Daily News, June 13, 2002 6. "County rolls back 2002 budget",P.T. LEADER, June 12, 2002 7. "County plans crackdown on dumping",Peninsula Daily News, June 14-15, 2002 • 8. "Some vaccinations excused", Peninsula Daily News, June 14, 2002 9. "County's new garbage ordinance finally has `teeth", P.T. LEADER, June 19, 2002 10. "County health budget cut",P.T. LEADER, June 19, 2002 11. "Health forum offers Clallam snapshot", Peninsula Daily News, June 25, 2002 12. "Dozens of smoke-free establishments listed in report" and "Most Stores don't sell smokes to kids", P.T. LEADER, July 3, 2002 13. "County faces widening revenue gap", Peninsula Daily News, July 10, 2002 14. "County changes budget style", P.T. LEADER, July 10, 2002 15. "Have, have-not gap widening in PT, county", P.T. LEADER, July 10, 2002 • . „ . • An Open Lto the Board of County Commissioners for Jefferson County Commissioners: As you consider reductions in the County budget for the second half of 2002 and 2003, we urge you to: • Clearly communicate with the public • about which services you intend to reduce or eliminate, and how the community will be affected. • Commit to holding future public hearings at times when most working members of the community can attend, including County employees. • Work with the unions that represent County employees to preserve services to the community. From Jefferson County Employees Represented by United Food and Commercial Workers Local 1001 S o • • County cutting budget Jefferson County's budget roll- back will be $30,000 shy of the $900,000 target the county com- missioners aimed at, but that's close enough,particularly because about $300,000 of the cuts were meant to restore reserve funds dipped into late last year to bal- ance the current budget. The county plans to pare the $12 million general fund budget as a result of a weakening • economy and the absence of by statethe funding due to cu Legislature earlier this year. The commissioners are also likely to decide to spend as much as $50,000 for a capital facilities , study of the Tri-Area. The commissioners conducted a budget workshop and public hearing May 29 on the proposed budget cuts.Some final details of the amended 2002 budget had yet to be worked out, but cutbacks amounted to a total of about $870,000.The commissioners ex- pect to have the final numbers Monday, June 10, and could ap- prove the amended budget at that time. , • • State receives rest of bioterror grant U.S. to release remaining $16.5 million disease surveillance and Washington was one of 24 after reviewing attack preparedness plan reporting. states whose plans were fully approved, so it will get the Part of national grant remainder of its allotment, THE ASSOCIATED PRESS The money is part of $1.1 billion in federal bioterrorism Thompson said Thursday. WASHINGTON — Wash- The grants were authorized Washing=ton ington state has turned in a preparedness grants to states under a $2.9 billion nation n gets a total of and U.S. territories. Besides more than $18.1 million for solid bioterrorism response wide bioterrorism plan signed general bioterrorism funding plan and will receive the helping states prepare for into law by President Bush in from the federal Centers for remaining $16.5 million of its potential attacks involving January. Disease Control and Preven- $20.6 million allocation to pre- infectious diseases, the grants States were asked to submit tion in Atlanta. In addition, pare for a potential attack, will improve the ability of hos- plans for using the grant the state gets more than $9.53 Health and Human Services pitals to deal with large num- money by Jan. 31,and all were million for regional hospital Secretary Tommy Thompson bers of casualties from such given 20 percent of their allot- plans to respond to ;r hinter- said Thursday. attacks, as well as improving ted funding at that time. rorism attack • CPb • • 1/ ° o-on • o•� • 3 0 °% o .� o )- o T'. 00-o b o / U 3 y},, o +n • O O O m U U .a;•°° E. 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E-au a a > 0) Cl) d O N h 3 C ) x-,, u ° O. °^p .a N ro C N 4.4 0 V) rob".° a C• N x v O 2 O a I MN C W •a FN. d ° .-a V -3 0''' 0,r1 ° 0 0 et Mr � oa >xN�o Ga ° a0a) o T 0rom 5 a. CZaw'ccs co.0 'cavy .o. ro I z xTb U ro is -Q y..c Ci.a 3 >1 •w , 10E T,+ ° vaa ° wan(� as v ' a w v.2�° 4c: INC m y m oo 0 ® Q:L L az z ,>)O ° u �+ ,. W w a O o °0. a t 4. Ca E•.O Ca z5 E" aa ,) 2 r OO z Oa a. aa)) '«.' z �., Z a = coeN W ami z a 3 m '> aa. • Port Townsend St Jefferson County Leader k 2002 6ountyr011s ac budget By Philip L.Watness cutbacks, however, averting the the 4 percent in cuts through vol- programs. The commissioners Leader Staff Writer latter layoff, while Sheriff Pete untary salary cuts and through have expressed an interest in Piccini said he plans to hire the eliminating a couple of positions making substantial, sustainable Jefferson County's budget security guard to temporarily fill and clerk hires, that meant less cuts to match the revenue stream rollback will be$30,000 shy of a position available due to the than a dozen workers will expe- with the expense stream,particu- the $900,000 target the county retirement of one of his staff rience a loss of hours," Gold- larly regarding personnel costs, commissioners aimed at, but members. smith said. which have traditionally in- that's close enough, particu- Employees in the offices of The Department of Commu- creased at a faster rate than in- larly because about $300,000 Auditor Donna Eldridge,Asses- nity Development and the creased revenues. of the cutbacks were meant to sor Jack WestermanIII and Trea- sheriff's office gave up the most The commissioners have restore reserve funds dipped surer Judi Morris won't have to in dollar amounts, $69,596 and also discussed whether to raise into late last year to balance the give up pay because the elected $63,071 respectively,closely fol- property taxes by reaching current budget. officials volunteered to take 4 lowed by Superior Court back in time to recapture prop- On Monday,the county pared percent pay cuts instead. ($57,754) and Juvenile Services erty tax increases they had pre- the$12 million general fund bud- County Administrator David ($52,660). v i o u s l y voted against get as a result of a weakening Goldsmith said Monday he met The cuts establish a new base imposing.They have said they economy and the absence of state with representatives of the Team- budget for next year as the com- would support placing a mea- funding due to cutbacks by the sters union and the United Food missioners turn their attention to sure on the ballot which would Legislature earlier this year. and Commercial Workers union eliminating programs that aren't ask voters whether they ap- The commissioners also ap- June 5 to discuss impacts on their mandated by state law, such as proved using the "banked ca- proved spending as much as members. the Parks and Recreation Divi- pacity" property taxes for $50,000 for a capital facilities "Because management and sionofPublic Works,theAnimal specific purposes, such as I4 study- .of the Tri-Area elected officials took more than Services.Department and other funding recreation programs. acum,Irondale,Hadlock) amended budget.The study must be done before they can establish an Urban Growth Area in Irondale and Port Hadlock. The commissioners settled on $826,844 in cuts following a public hearing and workshop on the amended budget held May 29. --a a� In early May, the commis- sioners decided to not fill open positions and to lay off two people — a courthouse security guard and a deputy prosecuting attorney. Prosecuting Attorney Juelie Dalzell proposed other • June 14.15, 2002 ----c7 oun . fans • crackdown ,, on dumpin . , Illegal septic otherof umanewaste improperly, among isCurrently, the county only mails systems also out notices to alleged offenders. Somedon't pay heed. s-It was triggered by the board's criminal target • concerns about long-term prob- lems," said Larry Fay, Jefferson BY STUART ELLIOTT County environmental health direc- PENINSULA DAILY NEWS . tor. The Jefferson County Board of "B , will get people in front of a judge.asicallythis Health is developing an ordinance "It shows them we're willing to go that would crack down on properties the whole nine yards." ' that illegally stockpile garbage or - have ongoing septic violations. Fines of up to $250 A so-called"nuisance abatement" measure under consideration would The ordinance could mean fines introduce property owners to fines of up to$250.In some instances, the and appearances before a judge if county would get .permission to – junked properties aren't cleaned up. clean up sites from a judge and send The ordinance, being drafted by the bill to the owner, Fay said. • the Department of Environmental The ordinance, discussed at a Board would target offenders who of Health meeting Thursday, • repeatedly collect mounds of could be in place by the fall. garbage on their property or dispose TURN TO DUMPING/A2 Dumping: Violation types CONTINUED FROM Al their property. get junk yards, improper set- During the past year, there Others dump illegally on backs and illegal structures. were approximately 80 corn- property on which they tres- Those rules would enforced Taints to the Environmental pass, Fay said. Former Pope by Jefferson County planners, Health Department regarding Resources land is a popular but Alvarez said that county ' junk and garbage. choice. staffers "have expressed their The majority of those — Jefferson County Chief reluctance to add enforcement about 65 — were dealt with, Civil Deputy Prosecuting duties to their already long list Attorney David Alvarez, who but around 15 illegal garbage sends letters threatening of duties." sites remain. criminal prosecution to Hiring an enforcement offi- Fay said they include sites chronic offenders, said some cer is another idea. in both the rural and urban "have a 'come and get me'atti- But its likely the county areas of the county. tude" which he attributes in doesn't have $50,000 to spare Violation scenarios part to "libertarian political with the current budget situa- beliefs or hermit-like atti- tion,Alvarez said. Some violatjons occur when tudes." Fay said that several other • RVs are set up permanently on "They are the bard-core counties in Washington have a property or a shack is built offenders that we could be recently moved forward with without a septic system in more proactive about," nuisance abatement regula- place. Alvarez wrote in a memo. tions, including Kitsap, Pierce • That can result in substan- Fay said offenders would be and Klickitat counties. dard outhouses or people subject to a series of tickets at dumping raw sewage on their first. Cases would progress He said the Jefferson ordi- property, Fay said. from Jefferson County District nance would resemble the Kit- Garbage violations typically Court to Superior Court if res- sap ordinance. involve those who don't have olution isn't achieved. Fay said his staff has been garbage collection service and The county is also looking working on a nuisance abate- allow their refuse to pile up on at regulations that would tar- ment plan since March. S) FRIDAY,JUNE 14,2002 All *Some ions excused Medicine shortage means delay, "Parents should not beThe number of children c • , who haven't been fully vac doesn't affect primary shots concerned about sending . cinated has increased over kids to school. The, the past several,years, Locke BY STUART ELLIOTT mitted person-to-person in a • said. PENINSULA DAILY News classroom setting, Locke increased risk of seeing a "It's almost a whole dif A continuing nationwide said. Diphtheria was last whooping cough Outbreak ferent story," Locke said. vaccine shortage means chil- seen in 1985. is very small," Statistics for Clallam dren vacs entering schools in Jef- The shortage only applies D . Tom LOCKE County weren't immediately to the fourth and fifth health officer, available Thursda Person and Clallam counties Y• are temporarily excused booster shots some'students. Clallam and Jefferson counties From getting certain immu- receive prior to entering Record-high nationally school. nizations,the state Board of in Jefferson County who Overall, nationwide vacci- Health decided. It doesn't apply to the have all their immunize- nation levels are at a record Dwindlingcisupplies of first three "primary" shots . PP tions. high. of the vaccine. vaccine for DtaP—diphthe- Three years ago, 8.9 per- "<This protection allows ria, tetanus and pertussis Not receiving the fourth P cent of all children in school Jeffer- us to delay some vaccina- (whooping cough)—booster ` and fifth booster shots may son County entering school tions,"Locke said,"but we shots mean students will be mean the vaccine is less weren't fully vaccinate can onlycoast on able to enroll under "condi- percent in 10 percent to 15 ' past suc- percent of those who already That was almosttxiple` cesses so long. tional status" without those the state average of 3 per- Locke said the shortage of shots this fall. have the first three shots, cent, Locke said. vaccines has been a problem'' Locke estimated that 85 that has been building After the shortage percent of children in Clal for 9 Exemptions allowed the last two years, but "only lam and Jefferson have When the shortage is • received four of their'DtaP Parents'can exempt their necentlyational radar on the over, children on conditional shots in the first several children from vaccinations national screen." •tatus will have 60 days to ;years of life, well before.. for religious, medical or It is partly a result of a ring their immunizations startingschool, decrease in theersonumber of up to date, said Dr. Tom philosophical reasons. U.S. manufacturers - "We do have a good level But Locke said there was cines='because the vaccine Locke, health officer of Clal- of timely vaccinations,"he also concern about parents lam and Jefferson counties. said. signing the exemption to businesbecs isnof profitable qual- Locke, who discussed the "rush their kids into and assurancerc ofrecentvaccine shortage at a Jeffer- Overall, students must ity problems. greceive vaccinations for school," Locke told The Seattle son County Board of Health hepatitis B, polio and "We wanted to make sure meeting Thursday, said the Times that the shortage was influenza B bacteria that Parents •making informed "a national disgrace" and shortage won't pose a seri- gt' can lead to meningitis, decision,"'he said. said the federal ous health concern in local Partiallygovernment schools. measles,mumps and as a result of a should have a stockpile of "Parents should not be rubella. public outreach campaign, vaccines in reserve for when that number had dropped to the market fails. concerned about sending Improvements cited 5 percent of all children who kids to school," he said. were not immunized this ufacturer was currently Locke said a French man- "The increased risk of see- Locke said there had been past`September. stockpiling large portions of ing a whooping cough out- major improvements in Things are heading in the the vaccine and that short- break is very small." recent years in the percent- other direction in Clallam ages could be over by the Tetanus can't be trans- age of kids entering school County, however. end of the year. . A 14•Wednesday,June 19,2002 I County 's new . garbage• ordinance finally has ` teeth' • By Janet Huck and technician, documented 84 Leader Staff Writer "We could never cases that had been reported,usu- ally by neighbors who can remain Sometimes, neighbors finally get any of the confidential.Of those 84 cases,56 get fed up and file a complaint with • cases were abated and closed the county about black bags of cases in front of through a series of letters and vis household garbage strewn over a its.Several property owners signed yard,stashed in an old car or fill- a judge 'before• up for future garbage service.Nine ing an abandoned trailer.When ap- This new illegal dumping complaints were proached by a staff member of the investigated and abated.Four were Jefferson County Environmental ordinance is an community-sponsored cleanups Health Department, many such such as the Dabob Bay cleanup. Y property owners clean up the expedient way to garbage and overflowing septic However, 15 violation investiga- garbage are still ongoing. Systems. get them in "There are a few tough nuts," But a few"hard core"offend- » court. said Pearson. ers have thumbed their noses atSome people consider Linda county rules. Sexton a tough nut.Ever since the "These remaining offenders Larry Fay director mid-1970s,there have been com- typically have a'come and get me' Taints against the Chimacum resi • attitude based in part on libertarian Environmental Health p 8 Jefferson County dent who collects garage sale political beliefs or hermit-like atti- leftovers,spring-cleaning discards Ludes and ignore the letters [we and jettisoned building supplies. send]," said David Alvarez, Alvarez recommendedthe fol- Even though Sexton said,in a 1998 .)- Jefferson County's chief civil lowing outline for the ordinance: interview,that she was a Christian deputy prosecuting attorney."They If an enforcement officer finds"just who believed hard times proph- are hard-core offenders that we cause" and the property owner esied in the Bible will come—and could be more proactive about." doesn't respond to letters and vis- her collected goods would eventu- The Jefferson County Board of its,the officer can,under the ordi- ally be needed as people struggle Health decided to crack down. nance,write a citation that is filed to survive—the county has ordered Board commissioners asked Envi- in Jefferson District Court within her at least twice to clean up her ronmental Health officials and 48 hours.If the person contests the "excessive"collection.In 1977 and Alvarez to formulate a"nuisance order,the defendant may hire a law- 1997, the health department also abatement"ordinance that would yer and request a bench trial in ruled she was operating a solid authorize tickets,fines and even an which the judge has the sole power waste facility and ordered her to appearance before a judge if gar- to make decisions.If the judge de- apply for a permit. She appealed bage-strewn home sites aren't termines that an infraction did oc- the 1997 ruling,but her appeal was cleaned up in a reasonable amount cur,he can levy fines ranging from denied.A stalemate ensued. of time.The new civil service or- $25 to$500 per infraction,accord- When asked if the new ordi- dinance,now being drafted by En- ing to the Alvarez memo. nance would handle the vironmental Health, could be in . In the past, Environmental department's enforcement prob- effect this fall but first must be au- Health could only order cleanups lems with Sexton, Fay said, "I'll thorized by the county commis- but not enforce them. A compli- let that slide." sioners. ance/abatement program for solid However,Alvarez thought the "We needed something to make waste was created last February in hard-core offenders could be our authority stick,"said Larry Fay, the environmental department that handled with the new ordinance Environmental Health director."It uses a series of carrot-and-stick let- that sends recalcitrants to District • would only have teeth if we are pre- ters and visits. Court pared to go all nine yards" In the last five months, Molly "We could never get any of the Pearson, environmental educator cases in front of a judge before," said Fay. "This new ordinance is an expedient way to get them in court" Io • • County health budget cut • Editor,Leader: I read with interest the story in the June 12 Leader concerning the budget cuts that Jefferson County departments are facing.However,I was dismayed to see no reference to the significant reduc- tion in county expenditure in Health and • Human Services. Health and Human Services has a $3.7 million dollar operating budget,of which about$750,000 comes from the county general fund.With the action that the Board of County Commissioners took on June-10, the county contribu- tion was reduced by nearly $150,000, • or about 20 percent.This reduction will have an impact on services available from the Health Department,including the elimination of flu vaccination clin- ics and reduction in clinic sites in Fam- ily Planning. I know that the county is straggling witlirnajor'fiscal challenges right now. These cofnmefts ate notintended to miniri,ize-the sacrifices that other depart- inents are being forced to live with.As , a member of the Board of Health,I am simply concerned that anyone reading the article may not be aware that the Health Department budget has been cut. as well. ROBERTA FRISSELL Port Townsend LED era__ �-19-oZ • /l • 0..0 s. ,.- �' " 'I"' >, o �-"'"5' w. 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G G ,»,-. o'IND o..cc-,?-, l� m.p,0 p G m P'r ': ! . tam- A.HL ;J.: i1 o-o goo, .+ ° °,i 0°c ° y•.ce, o. app N;' ° g `: ' gO taR o N ‘4.• � . • n - oQI�° 1 LY : ° 5 5 (�D o- G to'', o 0 co Pe'"n 0' (D °. CD c ° o cD � .o 00R0v �°•S.o a. . O • x fo ro A , `� m pnoo ' ti . u - ocD "d m - aq 0 m n c ' nmm .m ., m g ,-• a o - i • Budget: General fund inn decline? CONTINUED FROM Al Interest on county invest- excise tax on timber sales, the ballot for November, com- ments has also dropped dra- which may be experiencing a missioners said. ever m shortfall in the matically, with projected rev- turnaround,and increased fed- In a break with how bud- an2-1million budget for 2 the enue from investments in 2002 eral payment in lieu of taxes, gets were prepared in the past, will be kept in place, officials expected to he 25 percent called PILT money, for lands county departments are being said. And about a dozen lower than last year. owned by the federal govern- asked to adapt their financial unfilled positions will remain ment in Jefferson County ' plans to existing resources. P Fees offset revenue losses County administrators also Commissioners settled on a vacant. said in April that theyexpected Belt-tightening measures— The losses have somewhat P P model Monday for how to dis everything from cutting office been offset by fees collected by about$11.1 million in revenue tribute general fund money to supplies to out-of-state travel the county,which have gone up in 2003—$1 million short of a several different "functional" • — will be also be enacted, 19 percent in the last year, $12.1 million projected budget areas, at the time. Approximately Rowe said. But 4 percent cuts Rowe said. Pp y 4 1 percent previously directed in The Department. of Corn- But expected revenue has of the budget will cover law employee salaries and hours munity Development collects since been revised to about and justice expenditures, will be restored. about 90 percent of license and $11.5 million for 2003. which include the courts, A decline in projected rev- permit fees gathered by the Budges goals approved police and prosecuting attor- enue growth for 2003 is one of county. ney's office. the key reasons for the reduced The county reserve fund is In the budget goals docu- Approximately 19 percent budget. also strong,he said. ment approved Monday, com- ‘will cover general government, Genera] fund revenue At $2.5 million, it's about missioners said growth in gen- including the assessor's, audi- growth, comprising largely dodble the 10 percent reserve era] fund property taxes will tor's, county administrator, property and sales taxes, has goal previously set by commis- not exceed 1 percent next year commissioners' and trea- gone up approximately 4.9 per- sioners. —the 1 percent cap is required surer's offices as well as other cent annually for the last five The economic situation may under Initiative 747. departments. years, Rowe said. But it's only also be improving, Rowe said. And "banked capacity" Close to 12 percent goes to expected to increase a net of Earlier this year, commis- taxes will be used only for one- public services, which include 2.4 percent annually for the sioners trimmed the current time expenses that are for a departments such as parks and next five years, Rowe said. fiscal budget to $11.3 million specific duration. recreation and community "The downturn in the state to match revenue. A one-tenth of 1 percent development. and local economy has hada But Rowe said it looks like increase in sales tax, which Other categories include Ignificant effect on retail sales revenue could climb to $]1.6 would generate about non-departmental expendi- tax revenue and timber har- million by the end of the year. $220,000 to cover the cost of tures, 15 percent, and operat- i vest taxes," Rowe said. Increases could he due to juvenile detention, will be on ing transfers, 13 percent. . C ) sx A 8•Wednesday,July 10,2002 COuntychan ��� es 4budget:sty!e Revenue .forecasts,to drive,de artment spending .. r •_ By Philip L.Watness forecast Any programs or ser "budget call"Monday in which I recreation,.and community de- • Leader Staff Writer vices that aren't covered by so_ departments were officially in- ' velopment=10.69 percent. • called "shared' resources'!,, formed of the timeline.for pro- • •Non-departmental overhead '• Jefferson County departments (property and sales taxes) will vi cling preliminary budgets 14.75 percent.' -• ' will shift the way they develop have to be covered byotherfunds (Aug.',12) and finallbudgpt St.Operating transfers'to the their annual budgets following a —either fees,fines or grants: hearings (Oct''7-1 1) The 'health department and public , directive issued Monday by the The county cortimissipners :timeline itself,has been moved works-.13:34 percent: ` ' county commissioners. The •also unanimously,,adopted forward from-previous years; ! ""We're saying to departments, change is based on an expected goals and objectives for the,_ with the goal of approving the 1.'We only hive somuchresources 2003-general fund budget of 2003 budget as•a formal'reso- budget Dec. 16. ; to go around,so build your bud- $11.43 million. . . Iution. One significant objec-, gets based on that,not on what ' No longer will departments r tive calls for the.county to Budget breakdown '. you've historically spent,"Rowe • start.the;budgeting process;by `establish separate funding for; The county commissioners sand:'`The flip side is if the state ' looking at. the previous year's Animal,Services, Parks:.and., settled,on using the current'disgives them more money,they can ' budget.Instead,the county corn- ,Recreation,.Community Develc tribution of shared resources for budget for that."1 ' missioners will let them know opment andCooperatty,e Ex-, 2003.Deputy County Adminis- ' • Departments can secure what percentage of tax revenue tension rather:than.continue -trator Gary Rowe provided the ' grants, impose fines or raise they can expect to receive, and using general fund revenue. commissioners a breakdown of ' money through fees to cover ad- the departments will have to base Auditor Donna Eldridge is= .budget..allocations directed to ditional expenses beyond those • • their budgets on that revenue sued the statutorilyrequired..five functional areas..Their. covered by tax revenues.For in- ' • ,.,... . ,,shares of,the general fund tax pie' stance,the law and justice area are:. , • is expected to spend$5.4 million •Law and justice,compnsing. din 2003,but only$3.54 million . superior and district courts,ju- will.come from tax revenues. . venile and family court services, `That Means the criminal justice sheriff's office and,prosecuting system must•find $1.8 million attorney-41.84 percent. from other sources, including •General government,corn- .col* fines and state or federal -. prising the departments of audi- .grants; tor, assessor, treasurer, county t `We're encouraging collabo- commissioners and county ,ad- radon in this manner,much like ministrator—19.37 percent. we've already seen in the law and • Public services, including ,justice.area,"Rowe said. , planting commission,parks and Less revenue expected Rowe said his budget forecast • `indicates Jefferson County will have less revenue in 2003 than it expected,in 2002, although .1 •revenue,from several sources will be greater next year,specifi- cally federal money provided :counties based on the amount of `:acreage owned by the U.S.gov- ernment(parks,forests and wil- .'derness areas)under a program .called Payment In Lieu of Taxes. • Sales tax receipts are expected to be$120,000 lower than they were this year,however.Timber harvest taxes were also 58 per- -cent below projected revenues of `$213,160 in 2002,though they're expected to rebound next year. The county has also seen its re- turn on investments plummet since 2001,dropping from over / . ,$60,000'iri'early2000`to'a pro- "jected'$456, 000ahis year: County department heads will have a 4 percent salary de- crease restored for 2003,Rowe said.Elected officials and de- partment directors agreed to the 4 percent salary rollback during the second half of this year in• order to help bring the current budget into balance. lave t l iI s- ave-not , a .4 •_ • g p , . wi•denin In• PT,. . ....,,.:.:.. gcount B PhilipL.Witness' t 4..„.,,, t .,,, y ' e IIIy said the survey results can be •'' Leader Staff Writer "Children used to prioritize prevention'prevention Children under. ' . . forts,.particularly among young Young families in Jefferson 18 are much more children living at or below the County have it bad.That corn- • L : national poverty level. ' mon knowledge has been con- likely to be hying . "We have a lot�of things'slip- - firmed by'in intensive survey away quickly,"she said:"It's conducted for the Jefferson In a lZo,l[Sehold very,very inexpensive to intervene. County Health Department•by L '• ng age, ut it's very;at a youb epidemiologist Chris Hale.'. With.What Sryvery • expensive by the sling the kid is in • Hale presented a synopsis oftconsidered an • the juvenile justice systerq" the Behavioral Risk Factor Sur- ,- ,: Councilor Geoff Mascisaid veillance System(BRFSS)study t at=risk• adult.I he hoped the City Council would• Monday to the Port Townsend ' r :, consider budgeting money for City Council.The council con- 1T hat ,S thite'verSe the county health department's trstudy,conducted nducte$50,000tothetwo-year of What you'd like early prevention programs;par- study,conductedbyHale and As- • tic ularly because federal and sociates Inc.,Hale's consulting to see In•a more state governments are providing rum. „ less money for those programs. The study also indicates that perfect World, "The city may need to step up, ' elderly residents,while they are far` and fund those programs,"Masci better off both physically and fi- Chris Hale said. "If we're going to affect nancially than young families, epidemiologist ' future generations in a positive face significant health care issues, manner, we have to fund pro- particularly as the federal govern- grams for the long term." ment considers rolling back coy- housing prices outstrip the state- • Mayor Kees Kohl,Councilor erage under the Medicaid and wide average while the median Michelle Sandoval and Masci will Medicare programs,she said. ' household income continues to lag meet as an ad hoc committee to The news for children is per- behind the state average'.'That's review the data in greater detail . haps the most dire element of the even more telling of the plight of and discuss strategies the city can • survey results.Tobacco smoking young folks in light of the fact that. implement to counter some of the and heavy alcoholic consump- the statewide average is skewered more negative realities. ' tion are more common in house- by the huge populations in King, .' holds which include children Pierce and Snohomish counties Resident focus groups. younger than 18 than in house- , Thestudyfound that the same The county health department holds without children. 'statistics apply whether living in' also plans to put together focus 4110Another disturbing revelation 'nal Jefferson County or Port groups in which residents,health- 'is that a higher percentage of Townsend.Using the 98368 zip care providers,school representa- households with children under code to cull statistics for the city, tives and policy-makers will 18 than those without children Hale showed that city residents discuss portions of the findings had adults in the home who said 'and cotinty inhabitants are'not with an eye to prioritizing needs •r they had experienced physical or significantly different in educa-` and establishing responses. sexual abuse as children. - • tion,alcohol consumption or ex-. '•"We now have a baseline,and, "Children under 18 are much ercisepatterns. . we need to prioritize our goals ' more likely to,be living inahouse- .The county ass whole looks and-decide what's acceptable,'.. hold with what's considered an 'remarkably.healthy,with life ex Baldwin said."Some'of the di- `at-risk'adult,"Hale said.'That's . pectancy reaching levels only• recLions aren't for policy-makers, •the reverse of what you'd like to seen in European countries,Hale such as determining'the accept, see in a more perfect world." ` said. Residents also look more able level of senior suicide,teen Younger adults are increas- continental in their alcohol con- pregnancy and alcohol use." ingly unable to afford to buy sumption patterns,with frequent Those are societal issues, . homes as the county's median but moderate alcohol use. Baldwin said, that are best ad- The latter.concerns Hale, dressed through community en- however,who wondered whether gagement. children are getting the message' " The issue of less Medicare • that alcoholltcelis;an aceepted:;..and• Medicald reimbusen t 3S a d-- ;p behavi,Qyprt}tataloO.hPl�s.appt4-afor instance, can'best be priate in moderation. dressed'through.residents'con,2.j tatting their congressional Older population' • delegation,Hale said: Hale warned of"a demo- %`"They'need to tell their repre- graphic timebomb"due to the ex- sentatives and senators-that • plosion of elderly residents changes to'Medicare will hit. moving into Jefferson County,' home here,"Hale said. particularly those 85 years old or Baldwin said the health de; more. • partment will incorporate addi "In only three counties - tional data collected in October Jefferson,Clallam and San Juan during a countywide survey of -do you see the in-migration of grade and high school students much older age groups,"she said. regarding.their use of alcohol, "The most rapidly growing por- tobacco and drugs.The"healthy.. IP tion is the people 85 years old youth" survey will provide a- . and older,and that has very im- more complete picture than the portant implications for your BRFFS,Hale said. public health services." "We know about adult health Jefferson County Community risks,but we don't have the kids' • Health Director Jean Baldwin risk behavior,"she said. '..'• , /NO—0 Z a`. , • JEFFERSON COUNTY BOARD OF HEALTH Glen Huntingford,Jefferson County Commissioner '. jj , Dan Titterness,Jefferson County Commissioner Richard Wojt,Jefferson County Commissioner Jill Buhler,Jefferson General Hospital Commissioner Roberta Frissell, Citizen at Large Geoffrey Masci, City Council Member Sheila Westerman, Chair, Jefferson County Board of Health June 21, 2002 Dear Congressman Dicks: This country is rapidly developing a crisis situation regarding childhood vaccines. Over the past two years, shortages have developed for vaccines that protect children against measles, mumps, rubella, diphtheria, tetanus, whooping cough, chickenpox and pneumococcal disease. The health of our children is being placed at risk by deferral of recommended doses of essential vaccines. The progress that was made over the past decade in improving childhood immunization rates is being eroded. Vaccination has been repeatedly shown to be among the most effective and cost-effective disease prevention tools that we have in medicine and public health. We strongly believe that you must make al it one of your highest priorities to ensure a reliable supply of vaccines to protect our children from diseases that continue to cause millions of deaths elsewhere in the world and could do so again in our country as well. Behind this impending crisis are economic forces and a fragile vaccine manufacturing system that is increasingly concentrated in a small number of private companies. Since 1967, the number of companies in the U.S. producing vaccines has fallen from 26 to only 12. Moreover, several essential childhood vaccines are produced by a single manufacturer in the U.S. Because of the current shortages and deferrals, immunization schedules are being disrupted and many children will never be fully immunized. We are aware of the Congressional GAO study of the impact of these shortages, which will highlight the nationwide threat to our children. This is a situation that must be addressed and we believe solutions can come only from the national level. As members of the Jefferson County Board of Health, we urge you to take leadership measures quickly to address this developing crisis through whatever means are necessary. The health of the children of our nation depends on your action. Sincerely, She iCa -Westerman Sheila Westerman Chair, Jefferson County Board of Health