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HomeMy WebLinkAbout2002- September File Copy • Jefferson County Board of Health Agenda Minutes September 19, 2002 • i JEFFERSON COUNTY BOARD OF HEALTH Thursday, September 19, 2002 2:30—4:30 PM Main Conference Room Jefferson Health and Human Services AGENDA I. Approval of Agenda II. Approval of Minutes of Meeting of August 15, 2002 III. Public Comments IV. Old Business and Informational Items 1. Civil Penalties Ordinance—Public Hearing and Potential Adoption Larry 2. Individual Water System Standards Background Larry • V. New Business 1.World Breastfeeding Week-JHHS/JGH Collaborative Efforts Promoting the Benefits of Breast Feeding Carol 2. Bioterrorism and Health Emergency Preparedness— 1 Year Post-9/11 Tom 3. Health Department Budget Briefing and Performance Measures Jean VI. Agenda Planning 1. Environmental Health regulatory review schedule 2. BOH Calendar/ Planning VII. Next Meeting October 17, 2002, 2:30—4:30 PM Main Conference Room,JHHS JEFFERSON COUNTY BOARD OF HEALTH • MINUTES Thursday, August 15, 2002 Board Members: Staff Members: Dan Titterness,Member- County Commissioner District#1 Jean Baldwin,Nursing Services Director Glen Huntingford,Member- County Commissioner District#2 Larry Fay,Environmental Health Director Richard WO,Member- Count)!Commissioner District#3 Thomas Locke,MD, Health Officer Geoffrey Masci, Vice Chairman -Port Townsend Ciy Council Jill Buhler,Member-Hospital Commissioner District#2 Sheila Westerman, Chairman- Citizen at Large(CO) Roberta Frissell,Member-Citizen at Large (Couny) Due to the lack of a quorum, the items scheduled for discussion were postponed to the next meeting on Thursday, September 19, 2002. Discussion was held by the members present(Dan Titterness,Geoff Masci,Jill Buhler,Sheila Westerman,Roberta Frissell). See attached notes. • • August 15, 2002 Discussion Notes Page: 2 Charles Chase asked for an update on his two-month old complaint about the nuisance property on Egg and • I Road.He is concerned about traffic,pollution and well safety because of his neighbor's lack of compliance with on-site sewage requirements and building permitting. He said his frustration with Staff's lack of response might move him to "go public" and to complain to the State and Federal government. As a tax- paying citizen who has waited two years for resolution to this public health concern,he feels he has no other recourse. Sheila Westerman recognized Mr. Chase's concerns and explained that the Board has been discussing creating a civil penalties ordinance,which would enable Staff to bring violators before a judge. Larry Fay provided Mr. Chase with a copy of the draft ordinance.He apologized for Staff's lack of response and acknowledged that the problem at the site in question persists despite the issuance of two notices of infraction. The first fine has now gone to collection and the second notice for the same violations has been issued.He said that while the civil penalties are limited,they do lay the groundwork for abatement.The new ordinance would allow for as many as three progressive infractions before any abatement. Jill Buhler expressed interest in Staff's process for following up with the complainant. Mr. Fay explained that individuals are given the option of being advised of any actions. Mr. Chase further commented that he, as a taxpaying citizen, is the one being penalized rather than his neighbor(who is also not paying property taxes).He has spoken to the Sheriff and anyone else he can to get some resolution, but has received none to date. Sheila Westerman again recognized Mr. Chase's frustration. She explained there has been action on this • matter in the form of infractions. If there is no response to the third infraction, the Board will determine whether to proceed with abatement. She asked Staff to notify Mr. Chase of all actions taken in this matter and invited Mr. Chase to contact her directly if this is not done. Mr.Fay clarified that while Environmental Health is dealing with one or two possible violations (on-site sewage and solid waste), there are a number of planning use and building code violations on those properties that may be out of its control. Everett Koder, of 50 Mustang Lane, said he had asked for a response regarding a complaint that he filed 2-3 weeks ago about his neighbors.He and others also had a special meeting with Larry Fay about this solid waste nuisance property. He detailed some of the many serious issues involving this family,which he has also reported to Child Protective Services and Animal Services. Mr. Koder said his Club is supportive of the Civil Penalties Ordinance. Mr. Fay said there has been some response from this family, which is contacted almost yearly for various issues.Sheila Westerman expressed sympathy for Mr.Koder's situation and thanked him for supporting the passing of this ordinance. Civil Penalties Ordinance: Sheila Westerman recognized that changes requested at the last meeting have been made but acknowledged that without a quorum the Board would not be able to adopt this ordinance. Referring to paragraph three of the cover memo, which talks about the term "offense"being changed to "violation" for consistency, Commissioner Titterness pointed to inconsistent uses of "violation" and • "infraction" in Section 5. It was noted that since consistency of terms had been discussed by the Board at the last meeting this would not be a substantive amendment for which there would need to be another notice • August 15, 2002 Discussion Notes Page: 3 hearing. Dr. Tom Locke pointed out that with this ordinance the Board is declaring violations of the public health codes to be civil infractions, so the reference to infraction in paragraph 4 should remain. Discussion of proposed changes to Section 5 as follows: • Paragraph 1 —"infractions"would be changed to "violations" and "shall be paramount to"would be changed to "shall have precedence over." • Paragraph 2—"any contested infraction"would be changed to "any contested violation" Roberta Frissell said she is happy to finally see this ordinance being finalized. Several Board members expressed their frustration about having to wait to approve this ordinance and it was suggested that a special meeting be called. After an unsuccessful attempt to reach Commissioner Huntingford by phone for his approval, the item was tabled. Mr. Fay noted that this ordinance becomes effective upon the date of adoption. Jefferson County Seawater Intrusion Policy: Natural Resource Manager David Christensen reported that the seawater intrusion provisions in the Critical Areas Ordinance were adopted by the BOCC several weeks ago and will become effective September 21. In areas where seawater intrusion has been shown to be likely, the Seawater Intrusion Ordinance would educate residents about the seawater intrusion issue,water conservation practices,and options for developing their property.This ordinance was based on what other counties are doing as well as input from the citizen-based Seawater Intrusion Task Force. A well with chloride levels over 100 mg./L creates an"at-risk zone"in a 1,000 ft.radius of that well. He noted that"at risk"relates to water quality degradation,but is below any kind of threshold for health risk. People in that zone who want to get building permits would have to monitor their water quality or sign up for a County-approved monitoring program.With annual monitoring they would have to install a flow meter and report water use results to the County. Chloride levels of 200 mg/L or more, though still below the health risk and the threshold of taste, is a definite sign of"high risk"for seawater intrusion. He referred to a map of those wells that have been tested for chloride since 1996 (when data began being collected). In high-risk areas, measures that would need to be taken in order to utilize the groundwater are: a) approval from Ecology to build the well, b) signing onto a water monitoring program, and c) mandatory water conservation.If they already had a well,then a hydrogeologic assessment would be required to demonstrate that use of the well would not further degrade groundwater.While these are the main designations under the program,additional education and outreach will occur through WSU Cooperative Extension.He noted there are inland areas with high chlorides, such as on Center Valley Road, but they are due to connate seawater that was trapped during the glacial period. Use of a well under these conditions would not degrade the groundwater. Mr.Christensen added that as part of policy implications,the Task Force felt property owners should be given alternatives to drilling new wells, so they pushed the idea of alternative water supplies. However, the group was unanimous that from an environmental and public health standpoint, the best alternative is to promote public water from safe, unaffected sources. Therefore, in all of the seawater protection zones, ionnection would be required where public water is available. August 15, 2002 Discussion Notes Page: 4 Larry Fay noted that the ordinance states that those who are in a high risk seawater intrusion zone II can develop alternative water supplies if public water is not available and Ecology has not granted a waiver to build a well. Alternatives identified in the ordinance are rainwater catchments, hauled water, and desalination systems. However, because none are established in the ordinance, it may fall to the Board of Health to establish minimum system standards.In doing so,the Board would have to weigh the public health risks of a rainwater catchment system versus drinking salty water. His concern, as expressed in his memo, is whether or not to list as an alternative a system with a potentially higher public health risk. Commissioner Titterness recognized the concerns,but said rainwater catchment systems are at work throughout the world. Geoff Masci asked to understand the rationale behind establishing an expensive rainwater catchment system when you could install a less expensive reverse osmosis system between your well water and your faucet. Dave Christensen explained that continuing to use the well would not protect the groundwater resource and the aquifer would still be impacted. Using the Growth Management Act's resource protection law,the County argued unsuccessfully before the Hearings Board for the various saltwater treatment options which would present a much lower health risk. Geoff Masci said it does not appear that the Hearings Board ruling used the best available science. He is uncertain how the Board would make an implementable policy and respond to questions from citizens. Sheila Westerman asked Staff to research standards for alternative water systems.Mr.Fay responded that Island County's standards for rainwater catchment systems were modeled after Jefferson County's. Although he will revisit these standards for a qualitative discussion, he questioned whether the Board's desire would be to promote rainwater catchment technology. Sheila Westerman then asked if the County has had specific problems with the few operating alternative water systems? Mr. Fay said he has no knowledge of whether or not there has been a problem. However,the Board may want to consider prioritizing alternative systems—e.g.,it may be safer to establish standards for hauled water rather than trusting what comes off the roof. Sheila Westerman asked what would occur if a citizen were to come in today for direction about a well that is unusable? Noting that this ordinance will not be in effect until September 30, Mr. Fay said that the only time the County gets involved with an individual water supply is when someone is applying for a building permit. Someone wanting a rainwater catchment system would receive a list of things to consider, but would otherwise be essentially told they do not need a permit unless they are using that water supply as the basis for getting a building permit. The only law under which the County regulates individual water • supplies is RCW19-23-97, which says the County and City or any building official has the authority and responsibility to determine that the person has an adequate supply of potable water for the intended use of that building. Sheila Westerman then asked what would happen if a citizen wanted to build a house? Mr. Fay responded that if a citizen wants to put in a rainwater catchment system rather than a well,the County would • say they do not have that option unless it can be demonstrated that the probability of getting potable water from a well is zero. If it can, the burden is on the applicant to design the catchment system. The County's August 15, 2002 Discussion Notes Page: 5 olicy is based on performance standards and is not prescriptive.If the citizen goes to an engineer,they will design a system that addresses certain criteria.At that point,the County would record a restrictive covenant with the property title that says that the basis for the building was the rainwater catchment system and attach a copy of the design plans. Jill Buhler said the critical link is in the testing of the water, no matter what the source. With the establishment of a monitoring program for wells in seawater intrusion areas, could the County establish a monitoring program for alternative systems? Mr. Fay saw the question as What would the County do with consistently bad water quality from an alternative system? Currently,we do not know how well they work, how they are maintained and what standards would need to be considered and developed. To the Board's further interest in why standards could not be developed, Mr.Fay explained that the County lies in an 18-inch rainfall area.A 2,000 square foot house would produce,at most, 30 gallons a day. Issues of water quality aside,this amount assumes highly efficient capture and storage.An adequate supply of potable water is fundamental to public health. Sheila Westerman suggested that the amount considered"adequate"might not be the amount needed, but may be the amount used because it is what is available. She would be happy to research alternative system standards, but is not comfortable rejecting them out of hand. Mr. Fay restated that his memo suggested that the Board begin a review of baseline minimum standards for alternatives systems.The Board will want to evaluate whether it wants to move people from one type of water to another with larger risk. Jill Buhler drew attention to a statement in the agenda packet document of Frequently Asked Questions on seawater intrusion. The last two sentences at the bottom of Page 1 state"Areas without public water supplies can always utilize Alternative Water Supplies which are ALLOWED under the new regulations. Therefore, you have several options to develop your property." Mr. Fay said that under the adopted planning ordinance, it is up to the Board of Health to establish standards for those systems. He suggested that when the Board compares those systems, it should do so against the problem we are fixing. He wonders if the Board should clarify this by saying that even though an alternative is allowed,the Board of Health would not recommend one because it lacks a set comprehensive of standards that would make it safe. Geoff Masci suggested Staff rank the alternative systems in order of preference. Sheila Westerman called attention to page 2, paragraph 4 of the Frequently Asked Questions document, which states "If you are not building a new home, then the new regulations DO NOT APPLY TO YOU. There are no regulations that are triggered at the time a landowner applies for an onsite sewage disposal permit." She felt the paragraph seems disingenuous and asked why anyone would apply for an onsite sewage disposal permit if they did not intend to,at some point,build a house?Mr.Fay explained that this statement was borne out of the BOCC's desire to not have regulations triggered with the septic permit application.Although it was Staff's recommendation to not issue a septic permit without considering other potential development needs on the lot, the BOCC advised the inclusion of a disclaimer with the septic ormit which clarifies that this development might preclude any further development. August 15, 2002 Discussion Notes Page: 6 Everett Koder noted that their development in Quilcene started as a camp area and still has many lots with septic tanks on them, which are only used once or twice a year by RVs. Dave Christensen said one positive impact of this ordinance is that public water may be coming to Marrowstone Island.Residents there appear to be interested in addressing the water problem with the PUD. 2001 Jefferson County Sexually Transmitted Disease: Jean Baldwin said the purpose of this report is to provide the Board with a program update.In September,Staff will evaluate the Department using the New Public Health Standards, criteria which she reminded the Board it chose as goals during the County's Strategic planning process. One of the Public Health Standards calls for an annual report on communicable disease activity. Staff is now beginning to ensure the protocols are written and that there is follow through on these projects. The Board will likely receive Staff program updates of the 65 reportable diseases bundled into two or three categories. Dr. Tom Locke noted that Communicable Disease and Immunization Coordinator Lisa McKenzie compiled these statistics.The report reflects activity in the major STDs: Gonorrhea,Herpes,and Chlamydia, which is the most widely seen sexually transmitted disease. Other STDs such as HIV, Hepatitis B and possibly C,which are considered blood pathogens, will be covered in future reports. STDs are very much age-linked—with 25% of those aged 18-24 having experienced an STD. The rates of STDs in the United States are an order of magnitude higher than those of Western and Northern Europe,despite equal or nearly equal rates of sexual activity. Many of these are entirely curable infections and could have been eradicated but for our inability to address them as a public policy issue and take measures to lower the rates with • intensive screening in high-risk populations and the use of barrier methods of contraception.Uncured cases have resulted in very significant problems in San Francisco and Seattle;high-risk behavior turned into higher rates of STDs. Jean Baldwin mentioned that the testing is often missed in a private practice. She noted that it is unusual for the Health Department to diagnose nearly equal the cases as private practice, but people often do not get care and it spreads without diagnosis. Roberta Frissell asked what happened between 1998-99 during which the rates almost doubled?Dr. Locke said it could be that the rate of infection increased, but it is more likely due to improved screening. He noted that rates for Jefferson County's 15-19 year olds are below those of the state,whereas females 20- 24 are above the state rate. The data does not tell how many cases were assymptomatic(picked up through screening) and how many represented more advanced disease. He added that the Department's screening program is exemplary, with the all of its clients being assessed. How close to this goal others are coming is uncertain but preventing transmission is the key to public health. We could substantially reduce the transmission if we were better at the contact tracing and treatment processes. Jean Baldwin noted that CDC just changed the recommendations for the follow-up treatment of Chlamydia. The publications highlighting the changes that came in last month have been sent to practitioners.One recommendation is for a retest for re-exposure after a positive Chlamydia test.In research done in Seattle and other sites they found the client is likely to be positive again. • August 15, 2002 Discussion Notes Page: 7 II, Jill Buhler asked why testing for STDs is not done as part of a yearly physical? Jean Baldwin esponded that there are screening criteria. Dr. Locke suggested that private practitioners should take a sexual history as part of a routine or preventive exam, but it is often not done because the subject is taboo. Roberta Frissell asked about the status of outreach and education. Sheila Westerman explained the good job Hillary Metzger with the Health Department is doing in the schools. Jean Baldwin noted that Metzger's program is paid for by the school district. Jefferson County Family Planning Program: Jean Baldwin reported that the Board received informational reports "Adolescent Pregnancy and Childbearing" and "Unintended Pregnancy" from the Washington State Department of Health.These and other handouts are also available through their website. After introducing Family Nurse Practitioner Susan O'Brien, Ms. Baldwin introduced Kellie Regan, who explained the five-year report of Family Planning Services, which she based on the client visit record (AHLERS). Ms. Regan noted that the information is presented in the BRFSS data format, similar to that which the Board has received over the past few months. The report consists of data for the first six months of the Take Charge program,which began in July 2001.Target populations were ages 15-19 and 20-24. She stressed that 2002 data is still incomplete, which is reflected in the graphs. Roberta Frissell asked whether there have been or will be cuts in family planning hours due to the budget crisis?Jean Baldwin responded that there were clinic closings,but not hour cuts. When the Hadlock clinic was closed, hours were added at the Health Department. A person was cut and the Department has Sen using on-call and other staff to fill the time slots. However, a concern is whether Staff can adequately ntinue to serve the steadily increasing numbers of clients. So far, the Department has been able to meet the same number of people with current staff levels. In response to Roberta Frissell asking whether the Health Department continues to see the same clients from the Hadlock clinic, Kellie Regan referred to Figure 5,which reflects nearly 60%of clients live in 98368. Jean Baldwin noted that this percentage was no different even when the clinic in Hadlock was open. Staff is now seeing a higher number of clients from South county than in the past because Staff is there weekly, although there is still outreach to do in that area. Sheila Westerman expressed discouragement that the figures did not increase with a Hadlock clinic. Ms. Baldwin added that because word of mouth is the only way numbers of clients grow, consistency of service and location is important. Kellie Regan reported that already in 2002,Family Planning has served 161 continuing teen clients, which is 118% of the 2001 total. Jean Baldwin commented that word of mouth has brought numbers up significantly and more clients are coming in because they are state-insured. While she is cautious about increasing outreach without assuring consistent staffing and client management, she noted that the revenues generated by Take Charge could be used for increased staff. The more clients you see, the more you can charge. Noting that there is 4 five-year Federal waiver on using Medicaid money to decrease pregnancies on people who are likely to d up on welfare, the program will only be renewed if it is successful. August 15. 2002 Discussion Notes Page: 8 Sheila Westerman said she believes family planning is fundamental to Health and Human Services. • The more unwanted pregnancies you have, the more money you will need for law and justice. She would hope that during this year's budget process,the Board of Health could weigh in on this issue.She recognized the tendency to cut department budgets equally,but this may not make sense when considering the long-term impacts. Jean Baldwin recognized this is a complicated program. The BRFSS data for 18-34 year olds show that they have problems with access to healthcare, but when you look at who comes to family planning clinics, you realize they are at least being seen in some way. This puts an additional burden on Family Planning in that it is not just reproductive health, but primary care screening. Roberta Frissell spoke favorably about this report and the data. She was happy to see the increase in clients despite local funding decreasing. She agrees these are some of the Health Department's most important programs. Dr.Locke said that, in terms of public health problems—S I'll prevention,prevention of unintended pregnancies, and access to healthcare—family planning is essentially the gateway to the local system. He added that the fundamental role of the Board of Health is to look at the impact of program cuts, the unmet needs, and to have jurisdiction over the health of the community. The Board of Health must consider the fates of effective programs that may be adversely impacted by a statewide recession. Instead of spreading the pain, it is appropriate for the Board of Health to ask what programs to cut last. 411 Susan O'Brien said she sees a wide range,from 12-14 yr olds to peri-menopausal women,from those with private insurance coverage to those without additional coverage. Over the last year, she has seen that the majority of the Take Charge clients come from the 18-20 age group. Over the years, through good outreach and education in schools,a lot of trust has been built.Teenagers often prefer the Health Department to their primary care physicians because of concerns of confidentiality. To cut the program would be like going backwards in time. Jill Buhler asked why these women would not go to their primary care providers? Susan O'Brien responded that only about half have a primary care provider. Sheila Westerman said that this program,which took years to build,would not be able to be rebuilt in a year if funding were cut.Recognizing that there may have to be further program cuts,she wants to focus support on programs that offer"the most bang for the buck"instead of imposing an across-the-board 2 or 3% cut. Commissioner Titterness explained that there might be misperceptions about how next year's budgets are being developed.From a County budget projection,departments have been asked to bring back a budget that would fit those programs. There would then need to be other discussions. Larry Fay added that the budget is being approached differently than it has in the past—by looking instead at functional clusters in the County and doing projections on what money is available for those • clusters.Health and Human Services is a little different because it is a separate fund.Staff is being told what it can expect to receive from the County, based on projections. August 15, 2002 Discussion Notes Pane. 9 • Geoff Masci clarified that as a policy-making body, the Board should be issuing policy statements based on the data that Staff brings forth as to the efficacy or effectiveness of the programs. He has heard in the discussion today that Family Planning is one of the keystones of our operation. It is an integral part to how we do a lot of business and the Board would like to see this program continue and continue at the same or greater levels because of Take Charge. Jean Baldwin said while Take Charge has helped us in the budgeting process,she is concerned about the workload and the comp time and overtime involved. In the 2003 Health and Human Services budget, Family Planning does not have any cuts.However,there were some in June and in January of 2002.Because of the County's cap on "new hires,"she will approach the BOCC about rehiring. She is still worried about the overtime and the potential for burnout from sustaining this workload. She said this may be an issue where the Board of Health policy would conflict with a policy of the BOCC. Geoff Masci stressed the need for the Board to have that policy discussion if this is how the budget is going to be formulated. An alternative might be for the Commissioners to sit out of the discussion and listen to the Board. Jill Buhler asked whether the Department is working in collaboration with the clinics at the hospital to develop an S I'D screening program?Jean Baldwin agreed that additional training and outside expertise is something that needs to be pursued more, and she and Dr. Locke have been talking about it. She agreed take this issue back to the hospital. Jill Buhler asked again about contacting Commissioner Huntingford. Jean Baldwin said Staff was continuing to try to reach him and were to interrupt the meeting if successful. Geoff Masci asked about the Department distributing its in-take/screening form to practitioners so as to standardize screening and collect the data? Jean Baldwin agreed to talk with the hospital clinic coordinator about standardizing the forms, but there could not yet be a sharing of information. However, bio-terrorism money is forthcoming for active surveillance with disease outbreaks. There was discussion and interest in holding a special meeting to continue the Public Hearing on the Civil Penalties Ordinance at a date to be determined.Dr.Tom Locke noted that,pursuant to the By-laws,a special meeting can be called with the consent of two-thirds of the Board members. It was noted that there would not have to be an additional hearing notification, given there are no substantive changes to the ordinance. Larry Fay reported that Staff has sent letters to the City Police and County Sheriff to discuss Civil Penalties Ordinance procedures.He believes there may first be a staff level meeting that returns recommendations to the Board, which may not be ready by the September meeting. • STATE OF WASINGTON 12 F • County of Jefferson Authorizing Environmental } ORDINANCE NO. 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; and, 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 Ordinanceromotes the health, welfare and safety ety 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. Enactment of this Ordinance and its terms and provisions does not impose any duty upon the Jefferson County Health and Human Services Department or any of its officers or employees unless a duty is imposed on such officers or employees by the express terms of this Ordinance. Implementation or enforcement of this ordinance by County officers or employees • shall be discretionary and not mandatory. Page 1 of 3 #J a n W 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 violation shall be a Class 3 civil infraction as established in Chapter 7.80 RCW. A second violation shall be a class 2 civil infraction as established in Chapter 7.80 RCW. A third violation shall be a class 1 civil infraction as established in Chapter 7.80 RCW. • Page 2 of 3 13 IR • Section V. Processing and Adjudicating Civil Infractions: Such violations 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, which shall have precedence over the terms and obligations of this Ordinance if this Ordinance conflicts with state statutes or court rules. Upon a determination that the County has met its burden of proof regarding any contested violation alleged against a person or entity pursuant to this Ordinance, 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 the date of its adoption. APPROVED AND ADOPTED this day of , 2002. JEFFERSON COUNTY BOARD OF HEALTH Sheila Westerman, Chair SEAL: , Member ATTEST: , Member Lorna Delaney, CMC Clerk of the Board , Member Page 3 of 3 • Board of Health Old Business Agenda Item # IV. , 2 • Individual Water System Standards Background September 19, 2002 • • Memorandum To: Jefferson County Board of Health From: Larry Fay Date: 8/28/02 Re: Individual Water System Standards, Background Materials Following last months meeting of the BOH I thought that it might prove helpful to supply the Board with background information concerning the currently adopted requirements and standards for individual water systems in Jefferson County. It is important to note that Jefferson County has not adopted any rules that establish standards for individual water • systems until the recently adopted seawater intrusion ordinance. Rather, the county has established requirements for what needs to be in place in order to obtain a building permit. There are no provisions for regulating an individual water system after the building permit is in place. So, for background you will find: 1) RCW 19.27.097 establishing the requirement that anyone applying for a building permit for a structure that needs a supply of potable water must provide proof that they have an adequate supply of water. The law says proof of adequate supply includes connection to an approved public water system, a water right permit or another form sufficient to verify the existence of an adequate water supply. "Another form" suggests that the county can be as permissive or restrictive as it chooses. 2) Excerpts from Ecology Publication 93-27, "Guidelines for Determining Water Availability for New Buildings"This document was prepared to provide guidance to counties implementing RCW 19.27.097. The guideline provides for alternative sources of water supply including rainwater hauling,rainwater catchment and desalination. However, in all cases it recommends that alternative systems should comply with the quantity and quality. Additionally the guidelines state that desalination should only be allowed if the applicant has a water right permit. The guidelines served as a framework for; 3) Jefferson County Health Department Policy Statement 93-02, "Water Availability • Requirements for Building Permits". The Policy was adopted by the Board in 1993 and has been our standard operating procedure since. The policy allows for alternative systems only if public water is not available and a well is not feasible. The • policy does not establish standards for alternative systems. In the years since the adoption of the policy probably fewer that 5 alternative systems have been recognized as providing adequate water supplies. These include two desalination systems (one of which was never installed as the applicant was able to connect to an existing well) and one rainwater catchment that I can recall. The rainwater catchment was subsequently replaced with a well. 4) Jefferson County Health and Human Services Policy Statement 97-01, "Rainwater Collection". The policy was adopted by the Board in 1997 in response to the anticipated increased demand for alternative water systems following the adoption of the original seawater intrusion standards contained in the interim critical areas ordinance. The standards were based on the experience gained having reviewed and recognizing the one rainwater system referenced above. The policy is a performance- based approach putting the burden on the applicant to demonstrate how the catchment system will provide sufficient volumes of safe drinking water to meet the basic needs of the structure. While we have received many queries about the policy I cannot recall a single design submittal based on this policy. I don't know why but suspect that there are several reasons. These include the low rainfall that we receive necessitates a large catchment area(several thousand square feet)to meet even a most minimal need, the large storage requirements necessary to address the seasonal nature of our precipitation and the limitations that an alternative water system may place on accessing financing. However,these are speculations and no formal studies have been undertaken regarding the use of rainwater catchment systems. . In addition, I have questioned all the other health departments in Washington through our list serve about whether and how they handle hauled water, catchments and desalination. As of today I have heard from only 6 depaitinents. Island, Tacoma Pierce and Thurston Counties do not allow any alternative water systems. Skagit County reports that it highly discourages alternatives and has not developed standards for them. They have allowed one rainwater system(using an approach very similar to the one contained in our policy) and one desalination system. They do not allow hauled water. Klickitat County has developed standards for hauled water, however, Kevin Barry reports that they lack the infrastructure to make it happen at the present time. San Juan County has adopted standards for rainwater catchments,hauling and desalination. • wr of a 1 UC HINGT � STATE -LE L , T 10014 Legislature Home About Us E-Mail Lists Search Help RCW TITLES » TITLE 19 >> CHAPTER 19.27 » SECTION 19.27.097 Print Version 19.27.095 « 19.27.097 » 19.27.100 RCW 19.27.097 Building permit application -- Evidence of adequate water supply -- Applicability -- Exemption. (1) Each applicant fora building permit of a building necessitating potable water shall provide evidence of an adequate water supply for the intended use of the building. Evidence may be in the form of a water right permit from the department of ecology, a letter from an approved water purveyor stating the ability to provide water, or another form sufficient to verify the existence of an adequate water supply. In addition to other authorities, the county or city may impose conditions on building permits requiring connection to an existing public water system where the existing system is willing and able to provide safe and reliable potable water to the applicant with reasonable economy and efficiency. An application for a water right • shall not be sufficient proof of an adequate water supply. (2) Within counties not required or not choosing to plan pursuant to RCW 36.70A.040, the county and the state may mutually determine those areas in the county in which the requirements of subsection (1) of this section shall not apply. The departments of health and ecology shall coordinate on the implementation of this section. 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The local permitting authority must consider to this information before proceeding with issuance of additional building permits within such an area. (7) A local permitting authority with concerns about a water source or type of water source the use of which requires a water right permit may participate in Ecology's water right permitting process. Upon receipt of a written request from the appropriate local legislative body, Ecology will: (a) Refer applicants for permits proposing to use water from that source or type of source to the appropriate local permitting authority for consultation prior to processing the application. (b) Provide copies of applications for permits to use water from that source or type of source to the local permitting authority for review and comment prior to making a decision on the application. Section 4. INDIVIDUAL WATER SUPPLY SYSTEMS. (1) A water supply for a building which requires potable water, including some limited irrigation, may be considered to be adequate if it: (a) Is capable of providing water to a residential dwelling in the amount of 400 gallons per day. If additional uses of the same water source are contemplated, the local permitting authority should determine the amount necessary to satisfy those additional uses at the time of evaluating the adequacy of the supply. Consideration should be given to a program of aggressive water conservation, including effective implementation of the Water Conservation Performance Standards (Uniform Plumbing Code amendments for plumbing fixtures and fittings). (i) If a source appears to be only marginally adequate, either in terms of quantity yielded or quality of the water, the local permitting authority may wish to attach a note to the property title advising future owners of that fact. (ii) The local permitting authority may require additional testing at the time of resale of the property to verify the continued adequacy of the water supply. • (b) Meets any and all siting criteria established by state regulations and local ordinances, and is constructed in compliance with state and local regulations. (c) Does not cause any detrimental interference with existing water rights and is not detrimental to the public interest. Investigation and identification of well interference problems and impairment to senior rights is the responsibility of Ecology. If the possibility of a problem is suspected, the local permitting authority should contact Ecology. (2) Systems which obtain water from surface water sources. (a) The use of surface water sources for individual water supplies is generally discouraged due to their potential for.contamination. For purposes of determining treatment options, surface water as used in this subsection includes ground water which is under the direct influence of surface water, but does not include springs which have been developed to preclude surface contamination. (h) Any use of surface water, including water from salt water sources, must be authorized by a water right permit or covered by a valid registered water right claim. (c) Water from the source should conform to water quality standards contained in the State Board of Health Drinking Water Regulations and, at a minimum, must he tested for bacteriological quality and nitrates. (d) The water used should he treated using a system designed by a licensed professional, using equipment which meets Department of Health certification for point-of-use/point-of-entry treatment systems and is installed in accordance with the approved design. (e) An operations and maintenance (0 & M) manual for the treatment system may he required by the local health authority for review and approval. A copy of the manual must he provided to the property owner for the treatment system. (1) A notice should be attached to the property title which states the requirement for a treatment system. This notification should include a recommendation that the water system be inspected and retested any time the property ownership changes. The notice should include 3 information regarding the potential health risks associated with utilizing surface water as a drinking water source. (g) The local health authority may require the property owner to contract with a Department • of Health-approved Satellite System Management Agency for system operation. (3) Systems which obtain water from ground water sources. (a) If the total amount of water to he used from the ground water source is in excess of 50(X) gallons per day or the area of lawn or noncommercial garden to be irrigated is greater than one-half acre, the use must be authorized by a water right permit or covered by a pre-1945 water right for which a registered water right claim has been filed. (b) If the source is a well which does not require a water right permit, i.e. those which use 5())0 gallons per day or less or irrigate one-half acre or less of lawn or noncommercial garden, the water availability notification should be accompanied by a water well report (drilling log) and, at a minimum, the results of a one-hour bailer or air lift test indicating the yield of the well. (i) In many cases, the water well report plus results of a test verifying well yield will provide all the necessary supporting evidence of physical availability of water. However, in areas where other concerns about water availability may exist (e.g. impact on instream flows and senior surface water rights or known well interference), Ecology and/or the local permitting authority may require additional testing to verify the existence of an adequate amount of water. (ii) The water well report and test indicate only the physical availability of water. They do not indicate the legal availability of water. Such wells, while exempt from the water right permitting process, are still subject to regulation by the Department of Ecology. (c) Additional supporting documents which may be required by the local permitting authority include, but are not limited to, the following: (i) A water quality laboratory analysis report. (ii) A copy of recorded notification if public disclosure of a problem is required. (iii) A copy of an operation and maintenance (0 & M) manual (if required). (iv) Copies of any other documents which may be required by the local permitting . authority. (d) The well must be constructed in conformance with the Water Well Construction Standards, Chapter 173-160 WAC. (e) Water from the source should conform to water quality standards contained in the State Board of Health Drinking Water Regulations and, at a minimum, must be tested for bacteriological quality and nitrates. (i) A lab certified by Health must perform the analyses. (ii) If the local health authority suspects that a problem may exist in a specific area, the local health authority may also require testing for trihalomethanes, pesticides, radionuclides, volatile organic chemicals and/or other chemical or physical water quality parameters. (iii) If the well is newly constructed, prior to sampling it should be properly developed (i.e. flushed for a minimum of one hour or until such time as the water runs clear and all chlorine residuals are undetectable, whichever is longer). (iv) Water samples should be collected by a "qualified individual" as determined by the local health authority. (v) Follow-up sampling may he required to provide additional data on the level of a specific contaminant in question. If the local health authority determines that several consecutive follow-up samples indicate that the water supply is in compliance with the maximum contaminant levels, treatment and public notification requirements may he waived. (f) Continuous effective treatment should he recommended, and may be required, for any water supply which fails to meet bacteriological or primary chemical or physical quality parameters. (i) Continuous effective treatment may be recommended or required, at local health • authority discretion, for any other contaminant found in the water. 4 (ii) Treatment should generally he whole house rather than point-of-use. Water used in any portion of the system, such as the irrigation system, laundry, or other non-contact • plumbing fixtures, which is isolated from the drinking water system does not have to be treated. (iii) All home treatment equipment should be certified by the Department of Health and must be installed in accordance with the approved design. (iv) In cases where treatment is recommended, a notice recommending treatment should be attached to the property title. This notification should recommend that the water system be inspected and retested any time the property ownership changes. The notice should include information regarding the potential health or aesthetic effects associated with exceeding the maximum contaminant level. (4) Alternative sources of supply. (a) Individuals may obtain water from alternative sources of supply under the following conditions: (i) Hauling water should be allowed only if the applicant can demonstrate that the proposed system will comply with the water quality and quantity criteria specified in these guidelines. (ii) Rooftop collection systems should be allowed only if the applicant can demonstrate that the proposed system will comply with the water quality and quantity criteria specified in these guidelines. (iii) Desalination systems should be allowed only if the applicant either has or obtains a water right permit and can demonstrate that the proposed system will comply with the water quality and quantity criteria specified in these guidelines. (iv) Other alternative water supply systems should be allowed only if the applicant either has or obtains a water right permit, when required, and can demonstrate that the proposed system will comply with the water quality and quantity criteria specified in these guidelines. (h) A local health authority wishing to permit the use of alternative systems should develop a process to grant waivers from these guidelines which provides for the protection of the public • health and safety. (i) Supply systems using alternative sources of supply may need to be accompanied by any necessary plans and specifications verifying that the system is capable of providing water for the purposes of the building equivalent in quantity and quality to the criteria specified in these guidelines. (5) Local permitting authorities may require additional information concerning the adequacy of a water supply, including potability information, beyond that listed above. Section 5. DETERMINATION OF EXEMPT AREAS. A local government may seek to exempt new building construction in an area from complying with the provisions of RCW 19.27.097(1) through the process outlined below. Such an exemption would apply only to individual water systems. (NOTE: The Department of Ecology intends to adopt this section as an administrative rule. The remainder of the guidelines may be adopted as rules at a later date.) (1) A local government seeking an exemption should assess the potential of the area for exemption and prepare a proposal to he submitted to the Departments of Ecology and Health for review and comment. The local government should consult informally with both Ecology and Health to minimize the effort needed to prepare such a proposal. The proposal need include no more than the following elements: (a) A map of the area proposed to he exempted. Such an area should probably he either a watershed or a discrete hydrologic unit. (h) An inventory of current water rights in the area. (c) A summary of existing water well report information for the area. (d) A summary of water quality information for the area. (e) An examination and discussion of other water uses, apart from domestic supply, in the area. 411 (f) An assessment of all land uses, including the population and building density, of the area to he proposed. 5 (g) An evaluation of the zoning and growth potential of the area. (h) Some form of local review or public hearing process. - (i) A plan for tracking and reporting information about future development in the area. (2) Ecology and Health will review the proposal and provide copies to other potentially affected parties, such as Indian tribes and fisheries and wildlife agencies. Criteria for review include the following: (a) The proposal is consistent with any applicable water resources plans developed by either Ecology or Health. (b) The area has no history of water-related regulatory problems. (c) Water appears to be available to sustain additional development. (d) Additional development and water use in the nominated area would not pose a significant threat to existing water rights, including instream flows. (e) Additional development and water use in the nominated area would not significantly harm fish or wildlife habitat. (f) Additional development and water use in the nominated area would not cause degradation of the present quality of water. (g) There is no indication that use of the water in any portion of the designated area would pose a health risk to potential users. (3) Ecology and Health will inform the local government that they: (a) Agree with the proposal, (b) Suggest specific changes, or (c) Cannot accept the proposal. (4) If the proposal cannot he accepted by Ecology or Health, the local government may pursue mediation with the Department of Community Development. If agreement still cannot he reached, local governments which are not planning under RCW 36.70A.040 may request that the Department of Community Development make a final determination. (5) Areas will only be exempted for a specified period of time. Such an exemption should not he construed to be verification by Ecology and Health that water is available for any individual • applications for water right permits or that the water is of suitable quality for drinking. A growth-related trigger mechanism or a specified period for review should be established for any exempted area. (6) Local governments may carry out a program to monitor impacts on water supply and water quality in exempted areas. Section 6. PUBLIC WATER SYSTEMS. If the operators of a public water system desire to prov,de water to one or more new buildings, they should ensure that such an expansion of service is: (I) Consistent with adopted State Board of Health Drinking Water Regulations. (2) Consistent with adopted county land use plans, development regulations and ordinances. (3) Within the scope and conditions of the system's water rights, including authorized place of use, limitations on quantity of water allowed for use, and number of connections authorized to he served. If the system is currently exempt from water right permitting requirements, the operators should determine whether the proposed expansion of service will cause water use to exceed 5000 gallons per day or the area of lawn or noncommercial garden irrigated to exceed one-half acre, thereby requiring a water right permit. (4) Consistent with Department of Health regulations and procedures, including system design standards. 410 6 JEFFERSON COUNTY HEALTH DEPARTMENT 40 ENVIRONMENTAL HEALTH DIVISION Policy Statement Number 93 - 02 Program: Drinking Water Subject: Water Availability Requirements for Building Permits--Chapter 19.27.097 Effective this date, the following policy shall be adopted concerning proof of an adequate supply of potable water as a prerequisite for a building permit: I. General Requirements. A. Each applicant for a building permit for a project necessitating potable water shall provide evidence of an adequate supply of potable water for the intended use of the building, except that those applications for permits for replacement structures, improvements or additions to buildings that will not result in an increase in water usage, or buildings not requiring a potable water supply are not subject to the provisions of this policy. B. The Jefferson County Building Department shall determine if proof of adequate • supply is required. C. The Jefferson County Environmental Health Department shall determine if the proof provided meets the adequacy and quality (potability) requirements. II. Public Water Systems A. Applicants intending to connect to a public water supply shall provide written notification from an approved water system purveyor stating that the system has the capacity and commitment to provide water. The water system must be in compliance with state water supply regulations and the state surface and ground water codes (Chapters 90.03 and 90.44 RCW). B. The health department shall review the notification supplied by the purveyor as well as the record from the Washington Department of Health to verify that the approved system has the capacity and is in compliance before finding that quantity and quality criteria has been met. III. Individual Water Supplies. A. Individual water supplies shall be capable of providing a minimum of 400 gallons per • day. • Page 2 of 3, Water Availability Requirements • B. Individual water systems shall be tested for coliform, bacteria and nitrate-N, and shall not exceed maximum contaminant limits established in the State Board of Health Drinking Water Regulations. C. The Health Department may require testing for sodium and chlorides where there is known, or suspected, sea water intrusion. D. Wells shall be constructed and sited in accordance with state standards for well construction (Chapter 173-160 WAC). A copy of the well log showing the depth, production, casing and surface seal may serve as proof of proper construction. E. Springs and surface water sources, including ground waters under the influence of surface water, shall only be considered when authorized by a valid water right permit. When surface waters or springs are considered, water quality and quantity standards apply. Because surface waters and springs are highly susceptible to microbial and other contamination, these systems shall submit a conceptual plan for continuous treatment to meet potable water standards. IV. Alternative water supplies shall only be approved when systems outlined in Sections II and III are not ilable. • A. When water quality test results indicate violation of a maximum contaminant mit, water supplies may be treated to improve quality. When on-going treatment is proposedava , a conceptual plan fora treatment system shall be submitted for reviewliby the Health Department. When on-going treatment is required to obtain compliance with water quality standards, a notice to the property title shall be recorded. The notice will specify that the water supply does not meet water quality standards, specify what parameters are exceeded, and note that continuous treatment is required. B. Water supplies that do not provide the minimum volumes specified shall only be considered adequate when accompanied by a water conservation plan. The water conservation plan shall project average daily and annual water needs. The proposed water supply system shall provide water quantities in amounts adequate for daily and annual needs. When a water supply does not meet water quantity requirements, a notice to property title shall be recorded stating that the water supply does not meet minimum quantity requirements pursuant to 19.27.097 RCW. C. The Jefferson County Health Department may develop standard forms and notices for implementing provisions of sections III.E, IV.A and IV.B. S v f I Page 3 of 3, Water Availability Requirements • The 1990 Growth Management Act includes provisions requiring proof of an adequate supply of potable water before a building permit can be issued. The law (19.27.097 RCW) authorizes the Department of Ecology to develop regulations to implement the act. The DOE has developed Guidelines for Determining Water Availability for New Buildings and is currently preparing final Guidelines. The guidelines are general in nature and allow for a certain amount of flexibility for local conditions although they do serve as minimum standards. This policy is intended to adopt those guidelines as the county standard for implementing RCW 19.27.097, clarify county procedures, and provide consistent interpretation of the Guidelines. The policy shall remain in effect until amended or repealed by the Jefferson County Board of Health. /S/J. Peter Geerlofs, M.D. Date: 5/27/93 Health Officer /S/Bob Hinton Date: 5/27/93 Chairman, Board of Health S JEFFERSON COUNTY HEALTH AND HUMAN SERVICES ENVIRONMENTAL HEALTH DIVISION • POLICY STATEMENT NUMBER 97-01 PROGRAM: DRINKING WATER SUBJECT: RAINWATER COLLECTION Effective this date the following policy shall be adopted concerning the use of a rainwater collection system for proof of water adequacy for a building permit. A. Rainwater collection systems (catchments) will be accepted as proof of meeting water adequacy requirements for a building permit as stated in Chapter 19.27.097 RCW, provided that the conditions outlined in this policy are met. All designs under review shall be submitted for individual catchment systems only. It shall be the applicant's responsibility to demonstrate that the catchment system provides adequate supplies of potable water; Jefferson County assumes no responsibility in the event of failure of the water system to provide potable or adequate supply. B. Requests for review of catchment system designs shall be submitted as a catchment system design report. The catchment system design report shall be • reviewed by Environmental Health staff. The report shall, at a minimum, address the following: 1) Estimated daily average and annual water demand based on an occupancy of two people per bedroom for residential structures. In the event that water usage is projected at less than 45 gallons per person per day, the report shall document how the use estimates have been derived. 2) Annual average precipitation in the location of the proposed structure. 3) Catchment area required based on I) and 2) above with allowances for losses in the system and dry years. 4) Required storage volume based on a water balance analysis. 5) Storage tank conceptual design which provides for protection of the water from contamination while in storage. 6) A detailed description of a treatment system that provides for disinfection and filtration sufficient for the removal of suspended solids and cysts such as those of giardia and cryptosporidium. • C. In order to receive approval, the catchment system design report must demonstrate that an adequate supply of potable water will be provided. A copy of the report shall be retained with the building permit record. In addition, a notice shall be Page 1 of 2 recorded with the property title. The notice shall identify the water source as a rainwater catchment system and specify the daily capacity of the system. The • notice will not make any assurance of continued supply of potable water. A continued supply of potable water is assured only with appropriate operation and maintenance of the water treatment system by the owner, and with sufficient rainfall. D. A combination system uses both a well and a catchment system to meet water demands. If used as proof of water adequacy for a building permit, a combination system may mix treated catchment water with well water provided that the catchment water is potable and meets all the requirements of Section B, above. E. Combination systems may be constructed, and are encouraged for uses other than proof of an adequate water supply. If used, there shall be no cross-connection between untreated catchment water and potable water supplies, as per universal plumbing code standards. II. As a part of the Growth Management Act, RCW Chapter 19.27.097 requires applicants for building permits for structures requiring a potable water supply to submit proof of an adequate supply of potable water for the intended purpose(s) of the building before a building permit may be issued. State Guidelines developed by the Washington Department of Ecology (DOE) and the Washington Department of Health (DOH) established the following criteria for adequacy of individual supplies: • * An adequate supply of water is 400 gallons per day for a single family residence. * Potable water conforms with state drinking water standards (at a minimum, bacteriological quality and nitrates). * Whole house treatment is allowed, and is recommended if water quality does not meet drinking water standards. * Alternative sources of supply (including catchments) may be adequate if all other criteria are met. Jefferson County Resolution 99-90 adopted the guidelines for the purposes of administering RCW 19.27.097. The Jefferson County Board of Health adopted Policy 93-02, "Water Availability Requirements for Building Permits," which is consistent with County Resolution 99- 90. However, neither of these policies directly addressed the use of rainwater catchment systems to establish proof of an adequate supply of potable water. This catchment policy more - specifically defines how Jefferson County will interpret the conditions required for alternative sources of supply in the state regulations. 4 ( t 7 Health Officer ate • .� ��/ i / • Chairperson Board Health / / Date Page 2 of 2 Board of Health New Business Agenda Item # V., 1 World Breastfeeding • Week September 19, 2002 • NAT 'l[O 'S , , ., . The Official Newspaper of the American Public Health Association September 2002 'I, 'Breast is best' F; Benefits of ;•,R breastfeeding "F. confirmed in .: new research 1 ROM decreased 'M rcancer risk to smarter infants, , recent studies underscore ' c- the health benefits that breastfeeding can provide , t ''=. to both mother and child. i`� Mothers who breastfeed iA,. have a lower risk of breast r cancer and are more likely ,, *• �� ,,,,,,.:41;:,,,,,..:-3-,,,,",„ to bond with their children, :. two recent studies show. P Other new research found that babies who are breast- Recently released research findings confirm that breastfeeding is fed can grow up to be less beneficial for the health of both mothers and their children. obese and develop better cognitive skills. the most public attention. tries,the birth rate was "Public health profes- The study,by the Collab- twice that of women in • sionals have long worked to spread the message that orative Group on Hormonal developed countries,lead- Factors in Breast Cancer, ing to an overall lower `breast is best,"said APHA found that each year a breast cancer risk. Executive Director Moham- mother breastfed reduced Women in developing mad N.Akhter,MD,MPH. her risk of breast cancer countries also breastfed for "These findings prove that by 4.3 percent. longer periods of time. long-term breastfeeding is The study's findings, Women in developed coun- the right choice for mothers which were Published in tries,on average, breastfed to make." the July 20 issue of the for about 3 months per Among the recent find- Lancet, may explain the child.Women in developing ings,the research on breast much higher rate of breast countries breastfed for cancer—which found that cancer in developed coun- about 24)months per child. women who breastfeed tries,where breastfeeding is "We have shown that the have a reduced risk of less frequent.The incidence small number of children breast cancer—attracted of breast cancer in devel- women have and the short ou: tk- sass _ oped countries in 1990 was duration of breastfeeding five to seven for every 100 typical of women in devel- women,or double the rate oped countries alone of breast cancer in develop- account for much of the ing countries,where one to higher rates of breast can- two cases of the disease cer in these countries," occur per 100 women,the Beral said. study said. The study,analyzing 47 "This collaboration has studies from 30 countries, uncovered the main reason took into account more for the large variation in than 80 percent of the breast cancer incidence worldwide data on breast around the world,"said cancer and breastfeeding. study researcher Valerie "It is now clear that it Beral,MD,a professor of was necessary to pool epidemiology at the Univer- results from all over the sity of Oxford. world to disentangle in a The cancer rates also reliable way the effects of • reflect the higher birth rate of developing countries. breastfeeding from...other related effects of childbear- The study found that each ing on breast cancer,"said time a woman gave birth, study researcher Gillian it reduced her risk of breast cancer by 7 percent. See BREASTFEEDING, In some developing cows- Page 8 • BREASTFEEDING, U.S.Health and Human feeding patterns of 32,200 diatrica, found an increase emically than children who Continued from Page I Services. Scottish children born in in IQ among small babies were born average size. "Society does not deem 1995 or 1996 for several who were exclusively However,the study found Reeves,PhD,a statistical it socially acceptable to years.Obesity in the chil- breastfed for periodslonger that the IQ of children epi miologist at Oxford breastfeed,"she.said."There dren was defined as a than 12 weeks. who were born small and U fl are too many barriers on body mass index score in "We have found that breastfed for more than 12 men in developed public breastfeeding." the 95th percentile. there is a larger benefit in weeks did not vary from countries breastfed each Breastfeeding is an effec- terms of cognitive develop- the average IQ of children child for 6 months longer, Breastted f,£:€it'.h➢4t3I'PA.� 4 tive public health strategy ment for babies that are born normal size. � there would be 25,000 for dealing with the current very small,"said Malla Rao, Another recent study fewer cases of breast cancer gait health oenefits obesity epidemic,Reilly MPH,principal investigator suggests that mothers who each year,and if women Breastfeeding may also said,but is not the entire and a NICHD staff scientist. breastfeed are less likely to breastfed for 12 months protect against childhood answer. Rao stressed the need abuse their children.The longer,the number of obesity,a study published "It has been suggested for mothers of small babies study was presented by breast cancer cases would in the June 8 issue of the that with a protective effect to continue breastfeeding Lane Strathearn,PhD,a drop by 50,000,the study Lancet suggests. of this magnitude,formula ' through six months, professor at the Baylor estimated. The study found that the feeding could be held explaining that many College of Medicine,at the But Reeves said it is rate of obesity in children responsible for around 10 mothers of such babies are 14th International Con- unrealistic to expect women who were breastfed was percent of cases of adult cautious to do so because gress on Child Abuse and in developed countries to significantly lower than the obesity,"Reilly said. they think that formulas or Neglect in Denver in July. adopt the childbearing and rate of obesity in children Since 1980,the percent- supplements will speed up Strathearn compared breastfeeding patterns of who weren't breastfed. age of overweight U.S.chil- infant growth. data on Australian mothers developing countries.She Breastfeeding in infancy dren and teens has almost When mothers initially to the country's child pro- noted that if women were reduced obesity in 3-year- doubled,according to fed- wean small babies,there is tective services database. to breastfeed each child for olds by 30 percent,the - eral research. a small growth spurt,"Rao He found an association 6 months longer,5 percent study found. Babies who are breastfed said."But in the long term, between breastfeeding and of breast cancers would be "The study does add to also gain a boost in cogni- this early weaning can nurturing by mothers. prevented. the evidence...to recom- tive development,especially only hurt the child." The strongest predictor Even with so many mend breastfeeding as the if they are smaller than nor- At 5 years of age,small of future abuse was the advantages to breastfeed- best approach to infant mal,according to a study babies who were breastfed length of time spent ing,only 29 percent of feeding,"said study by researchers with the for 24 weeks scored 11 breastfeeding,or whether American women breast- researcher John Reilly, National Institute of Child points higher on IQ tests • a mother breastfed longer feed their infants,said PhD,a senior lecturer in Health and Human Devel- than did small babies than four months,Strat- Amelia Cobb,MPH,a the Division of Develop- opment and Norwegian who were breastfed for hearn said.Up to four service fellow and mental Medicine at the University of Science and 12 weeks. months,there was little to public health adviser with University sf Glasgow Technology. Studies have shown that no effect of breastfeeding the National Women's Medical School. The study,published in children who were born on abuse patterns. H Department of the The study followed the the March issue of Acta Pae- small perform worse acad- —Jessica Creighton Your milk is your baby's perfect food • Babies who are breastfed for at least 6 months have fewer health problems than babies who are artificially fed,including: • 3 times fewer ear infections 5 times fewer urinary tract infections 5 times fewer serious illnesses 7 times fewer allergies • Because human milk is so easy to digest, breastfed babies spit up less often, and have less diarrhea and constipation. • For every 87 artificially fed babies who die from SIDS/crib death(Sudden Infant Death Syndrome),only 3 breastfed babies die from SIDS. • Babies who are fed only human milk for at least 26 weeks are 6 times less likely to develop lymphoma (a type of cancer) in childhood. • Babies breastfed for at least one year are only half as likely to develop diabetes. Breastmilk can begin a lifetime of good health for your baby • As adults, people who were breastfed have: • less asthma • less diabetes • • fewer skin problems,including dermatitis and eczema • fewer allergies • lowered risk of heart attack and stroke due to lower cholesterol levels • less ulcerative colitis (ulcers in the large intestine) • less Crohn's disease(chronic diarrhea in some families) • protection from certain chronic liver diseases • Breastmilk is brain food.Studies show that children who were breastfed have higher IQs (by an average of 7 points)than those who were given breastmilk substitutes. Breastfeeding is healthy for mom • Women who breastfeed lower their risk of breast cancer. Nursing for a lifetime total of: • 2 years lowers the risk before menopause by 40% • 6 years lowers the risk before menopause by 66% • 7 years the risk of breast cancer throughout a woman's lifetime to almost zero. • Breastfeeding also provides protection from cancer • of the ovaries as well as osteoporosis,a thinning of the bones. Affordable health care begins with breastfeeding • BREASTFEEDING 101 1.The Canadian Paediatric Society 20.Breastfeeding may help stabilize and the American Academy ofaittf:„;i3,- progress of maternal endometriosis. Pediatrics recommend it. 21.Breastfeeding decreases 2.Breastfeeding promotes bonding mother's risk of developing between mother and baby.Y ovarian cancer. 3.Breastfeeding satisfies baby's emotional needs. 22.Breastfeeding decreases mother's risk of developing 4.Breastmilk provides perfect infant nutrition. endometrial cancer. • 5.Breastfeeding decreases mother's risk of breast cancer. 23.Breastfeeding decreases chances of baby developing 6.Breastfeeding decreases baby girls' risk of developing allergies. breast cancer later in life. 24.Breastmilk dramatically lowers the risk of baby 7.Breastfeeding is associated with higher I.Q. developing asthma. 8.Breastmilk is always ready and comes in a nicer package 25.Breastfeeding decreases baby's risk of ear infections. than formula does. Need we say more? 26.Breastfeeding decreases the risk of sudden infant 9.Breastfed babies have better motor development. death syndrome (SIDS). 10.Breastmilk contains immunities to diseases and assists 27.Breastfeeding protects baby against diarrhoeal infections. in the development of baby's immune system. 28.Breastfeeding protects baby against bacterial meningitis. 11.Breastmilk is more digestible than formula. 29.Breastfeeding protects baby against respiratory 12.Baby's suckling helps shrink mother's uterus after infections. childbirth. 30.Breastfed babies have a lower risk of developing 13.Baby's suckling helps prevent post-partum haemorrhage certain childhood cancers. in mother. 31.Breastfeeding decreases chances of juvenile rheumatoid 14.Nursing helps mom lose weight after baby is born. arthritis. 15.Pre-term milk is specially designed for premature 32.Breastfed babies are less likely to contract Hodgkins infants. disease. 16.The World Health Organization and UNICEF 33.Breastfeeding protects baby against vision defects. recommend exclusive breastfeeding for six months. 34.Breastfeeding decreases chances of osteoporosis. 17.Breastfeeding protects against Crohn's disease. 35.Breastmilk assists in proper intestinal development. '8.Breastfeeding decreases risk of baby developing diabetes. 36. Cow's milk is an intestinal irritant. 9.Breastfeeding baby helps decrease insulin requirements 37.Breastfed babies are less likely to become obese in diabetic mothers. later in life. 38. Breastfed babies have less chance of cardiopulmonary 71. Breastfeeding means less equipment to maintain distress while feeding. and store. 39. Breastfed babies have less chance of developing 72. Breastmilk has never been recalled. ulcerative colitis. 73. With breastmilk there's no need to worry about 40. Breastmilk protects against hemophilus infections. bacterial contamination. 41. Breastfed babies require shorter pre and post-surgical 74. With breastmilk, there's no need to worry about fasting. which brand is better. 42. Breastfeeding results in less sick days for working 75. With breastmilk, there's no need to worry about parents. adding contaminated water. 43. Breastfeeding enhances vaccine effectiveness. 76. Breastfeeding helps reduce cruelty to farm animals. 44. Breastfed babies have less chance of developing 77. Breastfeeding facilitates proper dental and jaw necrotizing enterocolitis. development. 45. Breastfeeding helps delay the return of fertility. 78. Breastfed babies get fewer cavities. 46. Breastfeeding is easier than using formula. 79. Breastfeeding means less money spent on corrective 47. Breastmilk is free. orthodontia. 48. Formula is expensive. 80. Breastfeeding means better speech development. 49. Formula costs tax payers millions of dollars. 81. Breastfeeding means less chance of baby getting eczema. 50. Breastmilk is always the right temperature. 82. Breastfed babies have great skin. 51. Breastmilk always has the right proportions of fat, 83. Breastfed babies spit up less. carbohydrates and protein. 84. Spit-up breastmilk is easier to clean up than formula. 52. Breastmilk makes for more contented babies. 85. Breastmilk contains no genetically engineered 53. Breastfeeding makes for happier moms, too. ingredients. 54. Breastmilk tastes better than formula. 86. Breastmilk contains no synthetic growth hormones. 55. Breastfed babies are healthier. 87. Lack of breastfeeding is associated with multiple • 56. Breastfed babies are less likely to die before their third sclerosis in later life. birthday. 88. Breastfeeding means less chance of inguinal hernia. 57. Breastfed babies require fewer doctor visits. 89. Breastfeeding means better cognitive development. 58. Breastfeeding mothers spend less time and money 90. Breastfeeding means better social development. on doctor visits. 91. Breastfeeding decreases risk of baby developing urinary 59. Breastfed babies don't leave any garbage behind. tract infections. 60.Breastfeeding means no bottles to tote. 92. Suckling optimizes hand-to-eye coordination. 61. Breastfeeding means fewer cow-induced global 93. Breastfeeding protects babies against iron deficiency. greenhouse gasses. 94. Breastfeeding moms spend less money on menstrual 62. Breastmilk doesn't need to be refrigerated. supplies. 63. Cow's milk is designed for baby cows. 95. Breastfeeding is a self-confidence booster for mom. 64. Human milk is designed for baby humans. 96. Breastmilk may help combat eye infections. 65. Breastmilk provides natural pain relief for baby. 97. Breastmilk may be a good natural antibiotic for wounds. 66. Breastmilk provides the perfect food for sick baby. 98. Breastfeeding means no worries about the latest 67. Breastfeeding means more sleep for baby. ingredient discovered to be missing from formula. 68. Breastfeeding means more sleep for mom. 99. Breastfed babies have much sweeter smelling diapers. 69. Breastfeeding means more sleep for dad. 100. Breastfed babies smell fantastic. 70. Breastfeeding means less equipment to buy. 101. Breastfeeding is what breasts were designed for! • INFACT Canada 6 Trinity Square Toronto, ON M5G 1B1 Phone (416) 595-9819 Fax (416) 591-9355 www.infactcanada.ca Adapted from information provided by Leslie Burby©1998-2001 ProMoM,Inc.All rights reserved. • Board of Health New Business Agenda Item # V. , 3 Health Department • Budget Breifing & Performance Measures September 19, 2002 • 11111 Jefferson County Health and Human Services 2003 Performance Measures: Community Health BUDGET/PROGRAM: Communicable Disease TB,Communicable Diseases,Immunization,Travelers Immunization,Sexually Transmitted Disease,HIV, Syringe Exchange Program. MISSION: Communicable Disease The purpose of the Communicable Disease Health program is to protect Jefferson County residents from serious communicable diseases by providing disease surveillance, investigation and reporting,along with education, screening, treatment and immunization services. The program interacts with community members,medical providers,the Washington State Department of Health and other agencies while working toward this purpose. GOALS FOR 2003 1. Maintain the low rates of active TB in Jefferson County(TB) 2. Timely investigation of reportable conditions(CD) , 3. Support universal access to State supplied vaccines for all children(Imm) 4. Continue to support immunization registry in Jefferson County,promoting use by all immunization providers (Imm) 5. The Family Planning and STD clinics will assist in controlling Chlamydia transmission in Jefferson County(STD) 6. HIV testing and counseling clinic resources are focused on persons at risk for HIV infection(HIV) 7. Case management services will be easily accessed by new HIV clients who seek these services(HIV) 8. Prevent the spread of blood home communicable diseases among injecting drug users and their partners(SEP) 9. Annual report to BOH for CD,TB,Immunization Programs, STD 10. Develop bioterrorism response capacity OBJECTIVES(INTERVENTIONS)FOR 2003 1. Encourage appropriate screening&treatment for latent TB infection(TB) 2. Develop&update protocols for investigation of reportable conditions(CD) 3. Maintain an efficient system for supplying State supplied vaccine and vaccine recommendation up-dates to private • Health Care Providers in Jefferson County(Imm) 4. Continue to provide training on the Child Profile Immunization Registry to private Health Care Providers 5. Clients seen in Family Planning and STD clinics who are at higher risk for Chlamydia(age criteria)will be screened for Chlamydia(STD) 6. 75%of clients who receive HIV testing will be high risk(HIV) 7. 90%of new HIV clients who seek case management services will have an assessment within 1 week of the date requested(HIV) 8. Promote utilization of syringe exchange program services(SEP) 9. Develop bioterrorism plan, coordinating with plans of regional bioterrorism partners,local emergency response agencies and Jefferson General Hospital • ilk PERFORMANCE INDICATORS: 2002 2002 2003 Planned Projection Planned (TB)Number of clients started on preventive therapy for latent TB infection 10 5 8 •(CD)Number of communicable disease reports confirmed,interventions 56 68 62 applied and processed for reporting to the state (Imm)Number of doses of publicly funded vaccine,administered by private 3500 3500 3500 health care providers and Public Health clinics,supplied and monitored through Public Heath's immunization program (Imm)Number of local immunizations providers(clinics)provided 7 4 3-6 information and training on the Child Profile immunization registry (Imm)Number of providers participating in the Child Profile immunization 4 1 4 registry (Imm)Number of Jefferson County children<6 in Child Profile system 70% 70% 80% (STD)Percent of at risk FP and STD clinic clients at risk for Chlamydia 100% 100% 100% screened(age criteria 14-24) (HIV)Number of persons counseled and tested for HIV infection 90 60 60 (HIV)Percent of persons counseled and tested for HIV infection that were in 75% 69% 75% high-risk category (HIV)Percent of new HIV clients seeking case management services who 90% 100% 90% have an assessment within 1 week of the date requested (SEP)Number of clinics 100 100 100 (SEP)Number of visits to SEP 15 15 15 (SEP)Number of syringes exchanged 1000 1000 1000 (SEP)Number of prevention/educational materials provided 15 15 15 (SEP)Number of referrals to other services 5 5 5 (BT)Develop bioterrorism response plan 1 SUMMARY OF KEY FUNDING/SERVICE ISSUES: • Communicable disease prevention is a locally funded program since the county milage was returned from the state to counties for TB control. Immunization funds from the state have been primarily in the form of vaccine. County funded Services are important in the Strategic Plan to promote healthy communities by having the infrastructure to maintain a professional staff preventing,identifying and responding to disease outbreaks. Substantial staff time is spent on responding to public requests for information about communicable diseases and screening for reportable illnesses in the process. HIV services are funded from the state and federal government to provide basic communicable disease prevention,HIV positive client case management,testing and counseling to high-risk community members,and focused high-risk interventions.Funds are highly programmatic and based on federal case numbers,which may not represent Jefferson County epidemic profile.Volatile program funding based on formulas re-negotiated with Region VI AIDSNET every year Developing the capacity for bioterrorism response is a new project.This response capacity will be in coordination with our bioterrorism regional partners,Kitsap and Clallam Counties and our local emergency response agencies,Jefferson General Hospital and other health care providers. 9 September 2002 . ' L Jefferson County Health and Human Services 2003 Performance Measures: Community Health DGET/PROGRAM: Community Health: Family Support Services Program aternal Child Health (MCH) including newborn follow-up, Child Birth education and Breast Feeding Support, Maternity Support Services (MSS), Best Beginnings/Nurse-Family Partnership (NFP), Maternity Case Management(MCM), Children with Special Health Care Needs (CSHCN), Women Infants and Children (WIC), and the Child Protective Services (CPS) Contract Programs: Alternative Response System (ARS), Early Intervention Program (EIP), and Passport. MISSION: The purpose of the Family Support Service program is to provide community assessment, education, skill building, and support to pregnant women and families with children. Services also include voluntary home visits to prenatal, post partum families, and families at risk of Child Protective Services involvement. These services are provided so county babies are born with the best opportunity to grow and thrive, the impact of health problems are minimized, and children receive the care and nurturing they need to become functional adults. GOALS FOR FY2003: 1. All newborns and their families will receive Home Visit screening to identify needs for Family Support Services including: intensive home-visiting, case management, lactation support, special health and child development support, nutrition education and parenting education. 2. Increase the availability of the Family Nurse Partnership Program (Best Beginnings) for Jefferson 0County residents. 3. Monitor Nurse Family Partnership Program replication by tracking data on program fidelity, from data input 4. To assess the percentage of pregnant and parenting women receiving JCHHS services, in which depression is an issue. 5. Increase ongoing breastfeeding education and support so that all county mothers can provide their children with the physical and emotional benefits of breastfeeding. 6. Prevent nutritional related problems for pregnant women and children under five in Jefferson County. 7. Identify Children with Special Health Care Needs in Jefferson County and assist families with health and development interventions as needed. 8. Provide services and information in Jefferson County aimed at preventing Child Abuse and Neglect. OBJECTIVES FOR FY2003: 1. Increase newborn screening to universal screening by to all Jefferson County families of new babies, in order to identify early intervention needs and offer services and referrals. 2. Hire a full time PHN for the JCHHS Maternal Child Health Team to provide increased intensive home- visiting, as well as WIC, and Maternity Support Services, Case Management and Newborn Follow-up. 3. Send client data monthly to Nurse-Family Partnership program head office for assessment and evaluation. 4. To offer a depression screen to all pregnant and parenting women who are participating in JCHHS programs. To provide appropriate referrals for those who have a positive screen. 2002 •5. Through universal screening of newborns and their families identify those who may need referral to breastfeeding tea party or lactation consultation home-visits. 6. Provide WIC nutrition education and support to all county women and children eligible. 7. Through universal newborn screening and community outreach in the schools and other JCHHS programs children with special health and development needs will get referred for evaluation and intervention services 8. Through screening of pregnant women, families of newborns and referrals from DSHS Childrens Services identify families at risk for child abuse and neglect and offer Family Support Services. • PERFORMANCE INDICATORS: 2002 2002 2003 Planned Projection Planned 1. Number of depression screenings completed 50 50 60 2. Number of newborn screened 120 100 120 2. %of those screened receiving continuing Family Support 50% 50% 50% Services (2002 no MCH add) 3. Number of Home and Office visits provided for BB, MSS, 1600 1500 1500 MCM,MCH and Breastfeeding consultation 4. Yearly report from Family-Nurse Partnership ** ** ** 5. %of infants in Jefferson County served by WIC 40% 40% 40% 6. Number of children with special health care needs 60 60 60 receiving Public Health Nurse intervention through JCHHS. 7. Number of families served through CPS/DSHS contract. 15 10 15 **report yearly SUMMARY OF KEY FUNDING/SERVICE ISSUES: Maternity Support Services that have been provided over the last 11 years have demonstrated the positive outcomes and cost savings from visits supporting and educating pregnant women. The child abuse referrals in Jefferson County increased steadily for ten years until 2001. These rates and venue justice numbers have been decreasing with comprehensive prevention programs. In 1999 JCHHS \Organ an intensive research tested home visiting program (David Olds Nurse-Family Partnership Program Best Beginnings) for first-time parents within Jefferson County. It will be expanded in 2003 with the Off ce Of Juvenile Justice grant. Depression, another problem for Jefferson County families as identified by JCHHS health indicators work, is demonstrated by brain research to have an impact on the healthy development of a child. So, to prevent depression from being a communicable disease, screening and treatment is necessary The programs JCHHS are providing have demonstrated measurable successful outcomes. The research clearly shows that there is a relationship between the positive outcome and the frequency, dose and duration of visits in the programs. As we increase the frequency, dose and duration of our services we increase the need for stable, consistent funding. The Jefferson County Strategic Plan outlines a need for healthy citizens. Family Support programs assist families' ability to care for children and advocate for them as they grow. i a Jefferson County Health and Human Services 2003 Performance Measures: Community Health BUDGET/PROGRAM: Population&Prevention Programs • Tobacco(TP/C),School Health(S/H), Childcare health and Safety(CC),Child Death Review(CDR)and Peer-In(PI) MISSION: The purpose of the Population&Prevention Programs is to provide assessment,health education and public health interventions to county residents in order to prevent disease and unintentional injury,improve the quality of life and reduce disparities in health. GOALS FOR FY 2003: 1. Improve identified social and health indicators for school-age youth(S/H) 2. Improve indoor air quality for Jefferson County residents(TP/C) 3. Enhance the quality of child care provided in Jefferson County(CC) 4. Enhance the overall health&safety of Jefferson County children(CDR)and(PI) OBJECTIVES FOR FY 2003: 1. Increase delivery of school in-service/trainings,student health screenings, student health consults,student health care referrals(S/H) 2. Increase number of restaurants participating in smokefree campaign;number of mothers who do not smoke during pregnancy(TP/C) 3. Increase child care provider satisfaction with consultation provided to them re: health,immunizations, safety and child development(CC) 4. Active participation between child death review team and Peninsula Safe Kids Coalition,and Peer educators will provide school health classes to middle&high school students and health education classes will be provided to elementary, middle&high school students(CDR)and(PI) jilt PERFORMANCE INDICATORS: 2002 2002 2003 Plan Projection Planned Number of student health screenings 2490 2400 2400 mber of restaurants offering 100%Indoor Smoke Free Dining(TP/C) 60 62 62 ild care provider evaluations of services provided by JCHHS staff *** %of child death reviews conducted within 6 months after death(CDR) 100% 100% 100% Number of Peer-In educational presentations 50 10 10 Number of school health classes 220 50 50 Number of phone calls to State Quit line from Jefferson County 70 70 80 ***Report SUMMARY OF KEY FUNDING/SERVICE ISSUES These programs are all universal prevention programs available to all in the community. State prevention health services monies come with extensive evaluation components. Tobacco and Peer-In funding have community specific goals and measures that must be met to maintain funding. July 22,2002 Jefferson County Health and Human Services 2003 Performance Measures: Community Health •BUDGET/PROGRAM: Targeted Community Health Services Family Planning, Breast and Cervical Health Program, and Foot Care MISSION: The purpose of the Targeted Community Health Services is to provide outreach, access, health education, support treatment to specific populations in Jefferson County in order to improve the health of the community. Specific program purposes are: • Family Planning: to provide reproductive health, clinics, outreach and education for Jefferson County residents in order to promote health and well-being and reduce unintended pregnancies. • Breast and Cervical Health Program: provide public education and health screening services to women age 40-64 with low incomes and no or limited health insurance in order to assure early detection and treatment of breast and cervical cancer. • Foot Care: provide foot care and health outreach to Jefferson County seniors to prevent health complications. GOALS FOR FY 2003: 1. Insure access to breast and cervical health exams to women age 40 to 65 years old. 2. Decrease unintended pregnancy rates in Jefferson County(measure)/Assure Family Planning Services are provided in every community 3. Support seniors' independence by maintaining their mobility •OBJECTIVES FOR FY 2003: 1. Track Family Planning usage patterns and produce annual report 2. Increase breast and cervical health program outreach in Jefferson County 3. Emergency contraception to be provided under standing orders, 5 days per week, and expand community education and clinical services 4. Maintain the current level of community foot care and continue expanding into home care PERFORMANCE INDICATORS: 2002 2002 2003 Number of unduplicated clients served in Family Planning Pl o0 ProjePlanned Number of adolescents under 19 served in Family Planning 320 3 0000on 1500 Number of Breast& Cervical screening exams 320 330 65 65 65 Number of foot care contacts 2500 2500 2500 SUMMARY OF KEY FUNDING/SERVICE ISSUES: JCHHS Family Planning clinical services are funded by 12 funding sources; the federal 10% and state 16%have remained flat for years. Some funding relief became available in 2001 when the Washington State and federal negotiations over Medicaid waiver was approved called "Take Charge." This funding source is available to individuals at various sites in the state and it allows JCHHS another source to bill for client services. likuly 22, 2002 .. . , Environmental Health Program 2003 Budget Assumptions Drinking Water Programs • MISSION: The mission of the Drinking Water Program is to assure that the residents and visitors to Jefferson County have access to the best quality drinking water that is reasonably available in order to minimize the threat of waterborne disease. GOALS FOR FY 2003: 1. Assure that all new wells are constructed in accordance with requirements established by the Washington Depaitinent of Ecology. 2. Provide technical assistance when requested so that individual water supplies are safe. 3. Limit public exposure to water systems with known deficiencies. OBJECTIVES FOR FY 2003: 1. Inspect at least 50%of all new wells constructed and 100%of all wells being de-commissioned. 2. Increase compliance with state well drilling regulations. 3. Review all building permits and project applications to assure that potable water supplies meet basic public health standards as well comply with state statutory and regulatory requirements. 4. Provide technical guidance to any residents requesting assistance with their individual or small water systems to deliver safe drinking water. 5. Assure that food service establishments that operate their own water systems are in compliance with federal and state drinking water requirements. 6. Establish appropriate policies for alternative water supply systems. 7. Continue contracting with DOH for public water supply projects as long as adequate funding is provided. 8. Improve accessibility of DOE water well construction reports and other water quality data to county residents and interested stake holders PERFORMANCE INDICATORS: 2000 2001 2002 2003 • Projected Planned Percent new wells inspected Percent of inspected wells with construction deficiencies. Number and time spent providing technical assistance. Percent of building permits issued with conditions identifying water supply deficiencies. Percent of building permit applications denied based on water supply deficiencies. Percent of food service establishments with water system deficiencies. SUMMARY OF KEY FUNDING/SERVICE ISSUES: Increased tracking will be done within existing databases such as permit plan and the food service database. Databases will be updated as necessary to add new fields to track performance indicators. 411 1 Environmental Health Program 2003 Budget Assumptions IIISolid Waste Programs MISSION: The mission of the Solid Waste Enforcement and Education Program is to assure that solid waste in Jefferson County is managed in a way that is consistent with state regulatory requirements,avoids harm to the environment,is protective of the public health and promotes goals and objectives for solid waste reduction and recycling consistent with the Jefferson County Comprehensive Solid Waste Management Plan. GOALS FOR FY 2003: 1. Reduce the occurrence of promiscuous dumping. 2. Increase the awareness of small quantity generator and household hazardous waste disposal requirements through education and outreach efforts. 3. Promote construction waste recycling in order to reduce illegal dumping. 4. Increase compliance with residential sharps disposal requirements. OBJECTIVES FOR FY 2003: 1. Finish updating solid waste regulations. 2. Conduct workshops and technical consultations with SQGs 3. Establish baseline estimate of the distribution and disposition of residential sharps. 4. Complete long-term interagency agreement with Public Works for solid waste education outlining agreed upon priorities and funding. PERFORMANCE INDICATORS: 2001 2001 2002 2003 Projected Planned Percent of illegal dumps closed and cleaned up 100% Pounds of litter and illegally dumped waste collected • per capita 1.2 lbs./cap Percent of verified nuisances cleaned up SUMMARY OF KEY FUNDING/SERVICE ISSUES: Generally there have been very few compliance problems associated with permitted solid waste facilities in Jefferson County. However,illegal dumping and neighborhood nuisance conditions continue to bei a problem.Use of general funds and tipping fee funding to match DOE Solid Waste Enforcement and Solid Waste Education Grants will enable the division to maintain staffing at current levels. This level of staffing will enable the depait�uent to complete the solid waste regulation revisions,increase capacity for compliance activities and conduct regular community outreach programs. • 2 , � Environmental Health Program 2003 Budget Assumptions • On Site Sewage Program MISSION: The purpose of the Onsite Sewage Program is to minimize the threat of surface and ground water contamination from failing or improperly designed,installed or maintained onsite sewage systems. GOALS FOR FY 2003: 1. Educate homeowners,builders,real estate personnel,banks, installers,designers and onsite system maintenance personnel in the proper operation and maintenance of onsite sewage systems. 2. Assure a high quality-monitoring program. 3. Implement and enforce state and local rules and regulations governing the installation and use of onsite sewage systems. 4. Investigate Action Requests and complaints in a timely manner to reduce the threat of human contact with untreated wastewater. 5. Assure high quality customer service. 6. Reduce permit turn around time. OBJECTIVES FOR FY 2003: 1. Develop written informational materials for public distribution and conduct workshops for targeted community groups addressing onsite sewage system operation and maintenance. 2. Provide training to targeted community groups to increase awareness of regulatory requirements for onsite sewage systems. 3. Review monitoring and inspection reports and provide timely follow up. 4. Utilize existing data systems to track action requests and complaints. 5. Develop and implement a system for routinely surveying customer service. 6. Assure that site inspections in response to permit applications are conducted within 14 days of receipt of application. 7. Expand use of Laserfiche system to create electronic images of relevant onsite permit data. PERFORMANCE INDICATORS: 2000 2001 2002 2003 Projected Planned Number of systems repaired or upgraded not 7 associated with a violation or building application. Percent of systems inspected that require significant 1.8% maintenance or repair. Percent of existing systems receiving regular 3`d party 13% monitoring. Failure rate of systems less than 5 years in use 0 Number of new system applications and the percent 55% approved without major redesign Percent of complaints requiring follow-up unknown enforcement action. Number of septic permits received 42??? Number of days to initial inspection 10.23 Percent of permits issued with no clock stops 55% Average days to process with no clock stops 20 Average days to process all permits 21.3 Percent of permits applications pending 40% Average Number of days to process with clock 23 stoppers EES total 55 • Percent of failures/major maintenance 1% 3 Environmental Health Program 2003 Budget Assumptions I) SUMMARY OF KEY FUNDING/SERVICE ISSUES: Increased tracking will be done with existing data systems to evaluate effectiveness of monitoring programs. With the completion of the DOE non-point source pollution grant,ongoing O&M activities will need to be funded through permit and inspections fees. Implementation will focus on coordination with the PUD to set up systems for scheduling and tracking inspection activities and conducting community outreach to increase awareness of the new requirements. Staff allocation to onsite programs will be decreased by '/2 FTE. 11, I 4 Environmental Health Program 2003 Budget Assumptions Food Programs • MISSION: The purpose of the Food Program is to minimize the risk of the spread of disease from improperly prepared, stored or served foods handled in commercial settings. GOALS FOR FY 2003: 1. Provide classroom food safety instruction for all food service workers. 2. Assure minimum sanitary standards are observed in all food service establishments. 3. Provide basic food safety information to the general public. OBJECTIVES FOR FY 2003: 1. Offer food safety training at a frequency and in locations convenient to food service workers. 2. Review all new food service establishments for compliance with state and county requirements. 3. Inspect all food service establishments at a frequency adequate to assure compliance with state and local regulatory requirements. 4. Offer educational materials and technical assistance to non-regulated community groups and organizations where requested. PERFORMANCE INDICATORS: 2001 2001 2002 2003 Projected Planned Number of food workers trained and the percent 1,360 trained trained from out of county Percent of required inspections completed. 0 Percent of inspected establishments that required repeat inspections due to critical violations. Percent of establishments receiving Outstanding Achievement Awards Number of complaints received and the percent that resulted in corrective actions or FBI verified. SUMMARY OF KEY FUNDING/SERVICE ISSUES: Food Program activities are largely funded through permit fees. • 5 • Board of Health Media Report • September 19, 2002 • 4The Seattle Times: Let's not get complacent about a serious health foe Page 1 of 2 r' seattletime ,com t3t� tilcilitt9i •riday,August 30,2002, 12:00 a.m.Pacific Permission to reprint or copy this article/photo must be obtained from The Seattle Times. Call 206-464-3113 or e-mail resale©seattletimes.com with your request. Let's not get complacent about a serious health foe Offering advice to a Legislature with a$1-billion hole to fill is a fool's errand, but I have a simple request: Don't skimp on protecting public health. Pressure to cut programs can turn imprudent acts of budget balancing into expedient virtues. Resist the temptation. Compromising public-health programs tampers with the essential infrastructure of government. By law, a lot of public health is a responsibility of cities and counties, but the motor vehicle excise taxes that once helped pay the bills disappeared with the rollback of car-license tabs. In better times, legislators cushioned the blow with extra cash from Olympia, but the money goes away next summer. Counties cobbled together other resources but they are withering as well. Effective, persistent attention to public health tamed a nasty stew of communicable diseases. Tuberculosis is Illtiexample of a success, but it represents a latent menace if we pinch pennies and cross our fingers. Two cades ago, the nation dropped its guard on TB and paid a steep price to recover. Tuberculosis is not a significant public-health risk in this state or most of the United States. Globally, it is a leading killer, especially among those infected with HIV, and young women of child-bearing age. Washington gets roughly 250 cases a year. King County is in the 150 range. Snohomish County fewer than two dozen. These are active cases that require intensive treatment regimens. The shorthand about TB is upbeat: Most people exposed to the disease do not become infected; few of those infected become ill, and those who do are curable. But treatment is not cheap, and it requires multiple medications taken as prescribed without fail. The key is a disciplined, intense therapy. Dr. Lee Reichman, founder of the national tuberculosis center in New Jersey, knows how quickly apparent successes can come undone. I met the doctor through Seattle attorney Robert Dickerson, a volunteer with Results, a respected Washington, D.C.-based humanitarian organization that has made a global campaign against TB a priority. Dr. Reichman has been on "60 Minutes," and published a well-received book on the TB time bomb ticking in the former Soviet Union, especially in its prisons. TB infectionrates are high around the world, and immigrants are a primary source of new cases in Tashington. Their origins track the ebb and flow of humanity toward our shores. Southeast Asian refugees who fled their homelands carried TB infections along with their hopes and dreams. A half dozen years ago saw an upswing in cases from Eastern Europe and the old Soviet empire. Now, local health departments are seeing a rise in cases from East Africa. Dr. Reichman's time bomb analogy is scary, but his experience with official complacency is just as •The S.;attle Times: Let's not get complacent about a serious health foe Page 2 of 2 frightening. In the late 1970s and early 1980s, TB was considered a conquered disease in the United States, and federal money and attention went elsewhere. Dr. Reichman was director of TB programs in New York City when the disease, which never went away, exploded. Cases soared, with outbreaks in hospitals, a public-health emergency that had not happened in 50 years. That lesson in humility cost a billion dollars. Corralling TB is never easy. Medications are expensive, cultural problems complicate treatment regimens, and multiple-drug-resistance forms of TB are complete budget-busters. Such cases are rare, but five cases hit Asotin, Chelan-Douglas and Gray's Harbor counties in 1999, draining entire TB budgets for one patient. King County's experience shows treatment costs can soar from $5,000 to $150,000 per person. TB is a cunning foe. Once a person shakes the early symptoms, they do not feel sick, and typically lose interest in maintaining a demanding pill routine. The most effective therapy, here and abroad, is directly observed treatment. A health worker watches a patient take his or her medicine, for months on end. Snohomish County has used video phones to monitor TB clients, and pays some high-risk clients small cash incentives to visit a clinic and take their medicine. Given the persistent threat to public health, these are cost-effective ways to deal with a known health problem. Drganizations such as Results understand prevention begins internationally. Failing to adequately finance public-health programs does not save a dime. The expense and illness end up very close to home. Lance Dickie's column appears regularly on editorial pages of The Times. His e-mail address is ldickie@seattletimes.corn. Copyright©2002 The Seattle Times Company Used with permission, • • Jefferson County Health and Human Services AUGUST — SEPTEMBER 2002 NEWS ARTICLES 1. "Water issues hot topic on Marrowstone",Peninsula Daily News, August 14, 2002 2. "Health violations,policy examined",Peninsula Daily News, August 14, 2002 3. "Marrowstone residents voice water issues",P.T. LEADER,August 14, 2002 4. "'Open Space' proposals due",P.T. LEADER, August 14, 2002 5. "Alcohol is top drug; meth is gaining",P.T. LEADER,August 14,2002 6. "Meth often behind the crimes of Jefferson County Kicker",P.T. LEADER Online, August 14, 2002, 3 pages. 7. "Substance abuse marks county's darkest alley", Editorial, P.T. LEADER, August 14,2002. 8. "Delayed shots back on list for kids entering school", Peninsula Daily News,August 16, 2002 • 9. "Suspect in county meth case enters not-guilty plea", P.T. LEADER, August 21,2002 10. "Meth treatment possible—but hard",P.T. LEADER,August 21, 2002 11. "Meth: Alluring,sometimes deadly drug is growing in county",P.T. LEADER,August 21, 2002, 2 pages. 12. "South county has 'free dumping' project", P.T. LEADER, August 21, 2002 13. "Residue and risk: Meth destroys property, homes", P.T. LEADER, August 21, 2002 14. "Washington prepares for West Nile Virus with Web site",WA DOH News Release, August 27,2002 15. "More women are using family planning in county", P.T. LEADER,August 28,2002 16. "Some sexually transmitted diseases increase locally", P.T. LEADER, August 28, 2002 17. "Saltwater intrusion meeting clears the air",P.T. LEADER, September 4, 2002 18. "Mammograms available", P.T. LEADER, September 4,2002 19. "Health Department invites public to talk `response", P.T. LEADER, September 11, 2002 i . 0 O 4,1 i ,I''',1;-1!il2 1 I i g ! Thil 0 CD c...). V a, N O ). . 408 2 40 N 'O a~i b O. 8 0 a -d m b .. flHH 3 $ x � fil l: ° my,4101 . a - g4C -a F ° � 0Ga0 94 1 oRc o 1E0 11 8 ' a' 3H ° F��'O .0 °. q o n $ aa>>V�n A. o`4g 4 -0 U v o f 'U y +�, 40 +g cC. O T1 C7�c>'W 5 D'-,-0 a> p dpi 0 a 4.,' N O U 2O 3 & u) 3 ° k . ° 7, gy p g �'- c. 2bog0 `�.z 0s' 0000b. 'I) 'OO s 03_ _to x 42 • a • 2 2 ,1,4••• 0 ia ° Q C cl, ° Cll alp o bx g a ° y, S 8 o ai 483 a�.-.� ° 2' - 0 o ° 2 f oo T13 .[ EwtlEp° [ o° > ° c p Uz� *' O � � b [� 0 m.4 ' d... ;'O V 00 b 00 , m +� I � :; q Z a -6'a� a 0, 0! t 7 � to o4 � -2v � >, 84,w 0 �;--,' a s..� o ti� ,i1 0 20 so, %.n b N iga oO. x oyzi 2 a� C� ° Uc° � o `�x �' ' ° a°'i�o', P3 U ro °.o °'4-0 a'r4G- o la A a' ( ) w. o _o o' no Kaci 0 a1-0 a 3 O s~ 0•p..0 W a a y CD g >, o a0 ,. O w^ 1 OsO 3 2H QQ2�.0 acCd •F O C1 V upi N +4 U fn u� 0 II- 0 E f.v �� O O H ° 5 O gi a) a'400 P. o a� oawo. tx -p 8oaEo q a> >> ,.f a) . v) R 0, ",--€1 8,, -s $ E 6 2 — CID Q Z q 4 0 OCL) CU 0 a) p w p -� .n>' • 411.° 4-) 5 "' >. 2 a pb � 8 wm Op' ›0c-) 03O3N -) -Sa sit; (ll v) � - ; a .o ne ; oU °'" � a , oQ) O.) Zpp y... ,� w-,) A2 ti °- Cr3a. .o. o ov. • , • • -- Health .violations policy examined BY STUART ELLIOrr properties aren't cleaned up. p.m. to 4:30 p.m. Thursday at PENINSULA DAILY NEWS "We give people an opportu- the Jefferson Health and The Jefferson County Board nrtyo get problems squared Human Services office, 615 of HealthJwill hold a public away,"said Larry Fay,Jefferson Sheridan St., Port Townsend. _ g County environmental health During the meeting, the ahearing civil g and dicoes consider ad pat nitsdirector. "But if we have multi- board will also discuss a report pie contacts and no response, on sexually transmitted dis- meeting Thursday. we'll move into a ticket writing The ordinance would crack mode." eases in the county and a family down on property owners who If approved, the ordinance planning program report. illegally stockpile garbage or — which doesn't need to be The public health implica- have ongoing septic violations, approved by county commis- tions of a recently-approved among other issues. sioners — could go into effect Jefferson County Seawater It would also mean fines and immediately. Intrusion policy will also be dis- appearances before a judge if The board meets from 2:30 cussed. • I • 3 ____ _ .._________ Wednesday2001 B t Marrowstone residentsissues voice water Island golf course use 0 chief among concerns -0 °�, - -. By Philip I.Watneu sent to the Dc d d - ® as � ruder Stan writer panment of Ecology, s s, 1 SWRO,P.O.Box 47775,Olym C.',- • r a•a� Marrowstone Island golf Pia.WA 96504-7775. ii f c f ^ ��^^••vb to _ / - a i course developer Wally Public water system a t ..4,..±1.;.—.da . t.. "tela s si r ,. i . . Barclay admitted Monday he is Jefferson County _ `-x' Ls ,,,,j: 1 42.,..„... r•« Mang Jim a1F + 4 ( !. gf 4 a using rainwater to irrigate his try Jefferson I General ` : greens without a water rights Parker talked about the r ' process to r$ �- • t:>. permit required by the Wash• estsbhshapubbc water system for ^' _ .4..; • 4r1 1 ,r ftt,. ington State Department of Marrowstone Island.He said the f ' t "�"�: + "'"""' 1 Ol. Ecology(DOE). PUD had received a petition ask. f" ` - _.f{ ,,.a.- That didn't sit well with ing for an en - t; s- v.f'. . engineering analysis for < 'i. some of the 165 people who a water system and that the pep- - attended an informational tion more than enough sign- � ''�a -a r .- - meende sponsored bythe tura had � t ::v.-- meeting AlpN �'- require the utility agency aorn Marrowstone Comm- to goes forward the study. RomInrtIde Golf Course developer who a Welly Barclay Mod and cause Marrowstone rr wet rte Island on Barclay's One audienceawith memberhe asked ,no menal Mommy at u»14ordland �Raa Baku nerd a.w questions ofrom ta^°rto the Island project and two other issues. (ora show of hands to scale the y of the county's Garden Club to learn about his protest;,the flatus of public wade to n»bond, rtty'a seawater k+truaton rules. The other issues pros; but that idea was • Photo by Phan L WaolOss Tett for r issues wererthe waterosmatteratte by Monday,resiaywho wantedato nityAssasation President Garth to the island and the impact of learn more about the McHattie said the nearly three. "My gut a reaction is I don't spiteuthe emotionally charged process and 1 don't believeY want a commercial golf course subject matter. new Jefferson County rules re- potential costs before making up hour session provided good in- on the island because it will 'This is a very emotional is- garding protection of wells their minds. in my heart that formation,though he said he bringmore • from seawater intrusion. traffic,but 1 also be- sue because water is necessary Poker explained that the PIJD 1'm stealin wished each issue could have lien he's doing more to recharge for life,"she said"If you're "You've consistently gone will do the engineeringuWysistp g your been addressed in its own ser- the aquifer,"she said. yO1 use ahead without paying any t• determine the estimated coati for water.I don't sion. to controlling your own water n to rules and regula- bringinaterg On the public water system and then someone comes along tions,"island resident Many Marrowstone Island Each prop. d however,said she issue,Brunette said she thought to take it over,that is a very statioto believe the water - felt she didn't hear direct an. Parker provided good dims an frightening thing and it can be "You've been struggling pay to hook up to the system, IS being his golf course."There thingshe people's questions de- maddening" against the county,the sate and should the PUG determine that the of contradiction in the he everybody else. You've just plan is economically feasible, recharged.It' wusayng,"slsesaid Chimenu done as you damn well pleased. Parker stud.Once the usasmenu fitting the ground personally objected to Barclay's We don't want those with are established,the PUD would go thatmadayelopnsentpl audience man- power and rgcney to go on forward with building aw'atersys• and running herehenyortlseaad(esscemem- without asking.1 just don't like tem unless more than 51 percent bets held the woe oppretty. it' of the island's 683 property SideW S into the "Most arc Barclay said he didn't have err express objoction arta own tensed about it,"she said, in- power and money to influence water system, bay." Ray Lowrie said he reserved fadectston•making.He said the "USI percent say'no',it die;' judgment on Barclay's there, II • . DOE didn't provide him addi- Parker said."1(30 percent said Wally BarclaydeelTex have course is and I tional information he needed to 'no',we'd adjust the course developer do some concerns about seek a water rights permit, to leave as boundaries seek what itwiUdoto gotslotaquifer,but leading to a delay in his a I out as we could.It could take people a amount to$10rtime will tell.I a lot of good ing for the permit. PP y• year or two years or longer before 20 years,he said.per addtition, information,but the jury is still "I've had conversations all we decide whether to go ahead" the PUD would charge a Cheryl Brtslsettesaidshe feels the way along,"Barclay said. Several hoops need to be monthly service fee and a per. conflicted about the golf course "Al very slow process.Iwish jumped through before then. gallon fee.The current fees project beca I could say I had power and Parker said he would first deter- charged to Tri-Area water us. she doesn't want c on money. My intentions have mine whether a use on the one hand, mon t.use the canvas that I tern public water sys- err is 512 per month and S 1.60 the island,though she believes beeconsider a beautiful thing.I'm theneffeild he ounty compliance lCort peahen per 100 cubic feet of water,he Barclay's catchments do more to not tryigg to,bq e.bullY." sive Plan.The next issue is find- said. recharge the Barclay-oppliedbJone l7'for 'rola weer A new PUo • B, eft faifen than if the B sauce;liltely to be in Marrowston could incorporate ;,.i"w' =1 fallow a water rights permit to draw the Tri-Area because the PUD Fort Flagler State.Park,now as much as 400 cubic feet of cannot use its existing water wells served by en extension of the water per minute from several which service Irondale for Tri-Areawter system.Wash- rainwter catchments on the Marrowstone Island. ingion 90-acre golf course.But Man- PUD Commissioner Ken improve ifsc aterssystem to to ager Ralph Baker said he uses McMillen said he has no inter• provide better flow for fire pro- iust 13,000 gallons on two days est in building a water system if section,and officials have dis- of the week and 76,000 on residents don't want one.He en- cussed whether the PUD could • three days to water the couraged people to work to de. build a water storage tank that Morningside Golf Course.He termine whether more than 51 would serve both the park and said rainwater is collected dur- percent of the owners would ob• island residents. Mg January through March for jest to the plan. use in the summer months.The "If 51 percent said'no'to- Saltwater Intrusion ponds can hold up to 7.5 mil. morrow,we would quit tomos. Jefferson County Natural lion gallons,he said. row,"be said."We won't push Resources Manager David Several island residents ex. something where it's not Christensen briefly reviewed pressed concern that the diver• wanted." the newsion of rainwater to Barclay's Robbie Robinson expressed thatch ekyto protectgulexitions t ng holding ponds would result in the opinion that the PUD was wells from saltwater intrusion, less water reaching the island's forcing the public water system a phenomenon in which seawa- aquifers.The only source for on island residents,' but ter rushes into wells when too the island's aquifers is rainwa. McMillen said the PUD must much fresh water has been ter•according to the DOE. abide by state law that says if 10 pumped out of them.He said Na"Il don't m t believe in my heart percent of the property owners the regulations,which take e- clat said."Ig don't believe PUD must your water," ask for all ndoN engineering yThee current homeowners.e feet Sept. 21,will The more the water is being recharged. PUG must also take into account stringent regulations apply to It's hitting the ground and run- all property owners,whether new construction,he said. ring sideways into the bay.'. they live on the island or not,he Property owner who plan to Barclay and Baker also said. • 0 maintained that they don't use "The law says do this," er-1m le of the shorelines will harmful pesticides and herbi- McMillen said."I don't want to not be able to get a building tides that could contaminate go to jail by not responding to a neighboring wells.They in- petition we've received." proof that awttwatehoutr from first providing _ vited everyone to visit the golf Parker said the per-household well doesn't show elevated ed lev- �' `�" � course at 6 p.m. Wednesday, cost could range from 52,000 to els of chloride,en indication of ryx Aug.21,to have a look at she 55,000,but that will be deter- potential seawater intrusion. V —/ O potential products they use and tour the mined as the study goes for- course. ward. Depending on the Reaction to discussion Barclay said he plans to project's financing,that could Marrowstone Island Comma- seek a rezone of his property en ' ace proposals due The Jefferson County Conser- program rolling. "I hope we re- vation Futures program is under ceive some high-quality projects way. Conservation Futures tax so that the community can see the levy funds are a dedicated por- benefit of the program,"she said. tion of property taxes in Jefferson Because the program was de- County and are available,by stat- layed in starting up, the timing ute,only for acquisition of open is somewhat unusual this year. space lands. The citizen advisory committee Jefferson County is accepting must make a final recommends- applications until Aug. 30 for tion to the Jefferson County projects that involve the perma- Board of Commissioners before nent protection of open space Oct. 1. Beginning next year, the lands through acquisition of con- funding recommendations will servation easements or outright be made before July 1 and the acquisition. This year, about application deadline and project $155,000 is available. Applica- review will be focused in the tion packets can be obtained by spring. • calling Jefferson County's Divi- Natural Resources Manager sion of Natural Resources at 385- Dave Christensen is also excited 91121'l. about the program. "There is The Conservation Futures such a need to have local fund- program uses a citizen advisory ing resources to access state and committee to assist in the review federal matching funds. I've of projects and make annual rec- heard about several great project ommendations to the county ideas where the sponsors could commissioners for funding pri- not come up with the local orities. matching funding required. I Committee Chairwoman Sa- look forward to seeing those rah Spaeth is excited to get the projects happen now." c'- r&F-o 2_. • s t Townsend k Jefferson County Leader Wednesday,Au.ust 14,2002•A.• t NIcoho •is to ru • met •isgainingp g, Adult Methamphetamine Use, 2001 Putting meth in perspective 250.00 By Barney Burke Leader Staff Writer How does methamphetamine compare to alco- 200 00 hol,marijuana,cocaine,heroin and other substance abuse problems,and just how serious is the meth situation in Jefferson County? "Alcohol is the number one drug problem fin Washington],"says David Albert,senior planner 150.00 and policy analyst for the division of alcohol and substance abuse at Washington's Department of Jefferson County,3.8 per 100,000,is less than half Social and Health Services(DSHS). the state average of 8.8 per 100,000.Albert con- Albert's office compiles an annual report on curled with the observation that in counties with drug use in Washington and provided the Leader relatively older populations,it is expected that the with the most recent data,which DSHS is about to youth rates for methamphetamine would be lower 100.00 publish. for that reason. • "All the other drugs combined do not equal the Four counties rank in the top 10 statewide for cost"of dealing with alcohol abuse,Albert main- both manufacturing and consumption: Pierce, tains.Those costs include lost productivity in the Lewis,Clark and Grays Harbor. workplace,health issues,vehicle accidents,child 50.00 abuse and neglect,and domestic violence in which Drug choices alcohol is a factor,he said. Data from DSHS suggests that adults and The data that DSHS collects from the people it youths have different preferences regarding serves shows that meth is a relatively small part of drugs and alcohol. the statewide pattern of substance abuse.Nonethe- For adults,alcohol is the primary substance of 0.00 _I 1 1 1 1 1 1 I 1-Q1 1-1-1 1 1 1-] 1 1 1=1 1 1-I-Jilt j1I3I1IJJ1l1i1 1 less,meth presents very difficult problems,prima- choice but showed steady declines from 1996 to a?g c«. I I H 1 O a�c s crocS w i!`E2gw _g�cc $ • $' Sc •3 � S g i lily concerning the impact on individual users and 2001.Adult talcs for using marijuana and meth- Y ci 1 Zr!2 3°T.1 g a gLL ' tai g Q 2 ry`:§18.1f, 'd C 'a their families,and meth labs,which area growing amphetamine have climbed during that L_ c>< Br 8 Phe g period,with e a tn_ . u'] 8 8 3 hazardous waste issue.The data also shows that methamphetamine surpassing marijuana as the sec- s 3 3 �r meth use is increasing in Washington. and choice among adults in 2001. The DSHS data suggests that Jefferson County For youths in the DSHS database,marijuana Imong who seek services from DSHS,the rate per 100,000 people who Identify meth as their has a relatively small meth lab problem,but the appears to be the substance of choice,and that rate 1226 in Jefferson County,slightly higher than the state average of 95.4.This data Is not consumption rate among adults is slightly above climbed steadily from 1996 to 2001.Alcohol is the very use changes in programs can affect how many people are treated,and some people the state average.That profile appears to be corn- second choice among youths,and that rate fell acelve multiple services,according to DSHS. parable to other rural counties in Washington. steadily during the same period.Methamphetamine Source:Washington Department of Social and Health Services. - - rates for youths are rising but arc still behind maxi- County patterns . juana rates. The most recent data from DSHS,for 2001, Albert said that until 1994,alcohol was the pre- Drug Choice Trends 1996-2001 shows that manufacturing of methamphetamine ferred substance among youths.He believes that 70.00 tends to be concentrated in more urban counties, greater availability of marijuana,and changing while rural counties tend to have the highest rates parental attitudes,may have contributed to marl- of methamphetamine use. Juana becoming the top substance for youths. •1996 The top 10 counties for manufacturing,based The rate of use by adults and youths for all other 60.00u 1997 on the number of reported meth labs,are Pierce, substances as a group-including heroin and co- , ■1998 King,Spokane,Thurston,Benton,Snohomish, caine-has not changed markedly in the DSHS ■1999 Lewis,Clark,Kitsap and Grays Harbor,respec- data. O 2000 tively.Two-thirds of the meth labs reported in 50.00 02001 Washington in 2001 were located in Pierce,King, Meth use rising Spokane and Thurston counties. The statewide rate for adults seeking DSHS sex- Jefferson County ranked 20th of the 39 coon- vices who cite meth as their primary drug grew 40•00 ties for meth labs reported in 2001,with six labs, from 8 percent in 1996 to 16 percent in 2001.For " according to Department of Ecology(DOE)data youths,the statewide rate rose from 3 percent in included in the DSHS report. 1996 to 8 percent in 2001. The total number of known meth labs reported The reported number of Jefferson County adults 90.00w. • . . in Washinkton increase from 1,449 in 2000 to see krng treatment who use meth increased from - . 1,886 in 2001.The county with the biggest increase 21 in 1996 to 32 in 2001.For Jefferson County during that period was Spokane,which went from youths,the reported number was 1 in both 1996 - 137 to 248 labs.As recently as 1995,Then were and 2001,according to DSHS. fewer than 100 meth labs reported in Washington, - according to the DOE data. Data limitations Consumption data Albert cautions against making precise conclu- 10.00P sions based on the data his agency collects.Rather, The top 10 counties for consumption of meth, it should be used as a barometer of overall pat- based on 2001 DSHS data,arc Klickitat,Cowlitz, terns,he says.Data on teeth labs can vary based , 11 jt�, Clark,Yakima,Pierce,Mason,Lewis,Clallam, on the resources available to local law enforcement 0.00 L i r I r 1 I I111 'I� ' I -- •I Pend Oreille.and Grays Harbor,respectively.This and fire/hazardous materials agencies.Some are r r r z Ts T "a gl. • S ranking is based on the number of adults seeking better equipped to find and clean up labs,Albert treatment from DSHS who identify methamphet- believes. r L g m = L 1 amine as their primary drug. The data on adult and youth drug patterns is o v 3 .5 o Jefferson County ranked 15th of the 39 coun- based only on people who seek service from DSHS, < < 1• < i ties for adults seeking treatment.At a rate of 122.6 not from private treatment options,Albert points adults per 100,000 population,Jefferson County's out,and thus the pattern of the overall population mong people seeking DSHS services,alcohol is the number one choice,and rising,among adults. rate is higher than the statewide rate of 95.4 per could be different.The funding and marketing of lariluana is the number one choice,and rising,among youths.Meth use for both adults and,youths 100,000. - - substance abuse programs can affect the number ppears to be rising,and among adults,the data indicates that meth use recently surpassed marijuana The data-for youths seeking treatment in of people served,says Albert se. Source:Washington Department of Social and Health Services Click • The 111 here\, + for *The LEADER* home ti'delivery Wednesday August 14, 2002 Vol. 113 No. 33 hone Nems Flash: The Nems Opinion Forum Arts& Entertainment Classifieds 1'kitor(Guide Weather Meth often behind the crimes of Jefferson County Kicker: Not used by many, but it controls those who do By Janet Huck Leader Staff Writer A suspect told Jefferson County Sheriff Detective Dave Miller he had abused alcohol and shot heroin and cocaine. But in each case he felt he had control of the drugs. When it came to methamphetamine, his attitude changed. 411 "Meth has taken ahold of me,"he confessed to Miller. Methamphetamine's grip is taking hold throughout the country, especially in rural areas with scarce jobs, such as this one.Although alcohol and marijuana cause far more pervasive problems in Jefferson County,the use and abuse of meth are becoming prevalent. People on welfare use it.Wealthy people use it.Women use it in almost equal numbers to men. Not many adolescents have tried it-yet. No matter what their background, users are lured by the raw euphoric rush that can last for 12 to 24 hours. It's cheap-about$20 for a pinch of powder about the size of an aspirin. It's easy to buy because it's manufactured right here in Jefferson and many nearby Washington state counties.The manufacturing process, said Roger Lake, president of the Washington State Narcotics Officer Association,takes less time than does a batch of chocolate chip cookies. "My personal feeling is that we do have a methamphetamine problem [here],"said Richard Gunderson,the substance abuse coordinator for Jefferson County Department of Health and Human Services."It's a damning and damaging drug. It has some awful consequences." Habit turns ugly Although users initially can hold down jobs, go to school and manage their social life,the habit can turn ugly over time. Parents neglect their children. Long-term heavy users can become paranoid and violent. Of the five • violent deaths in Jefferson County in the last 10 years,two involved methamphetamine. Nonetheless,the measurable numbers of users in Jefferson County are still small.The reported number of Jefferson County adults seeking publicly funded treatment for meth increased from 21 in 1996 to 32 in 2001, according to Washington Department of Social and Health Services(DSHS). However,the rate of county residents seeking DSHS services in 2001 was 122.6 adults per 100,000 population,slightly higher than the statewide rate of 95.4 per 100,000. Local law enforcement officers feel meth might be a bigger problem than the numbers indicate. Miller,who is in charge of drug cases for the sheriffs office, said there were 33 arrests for meth possession and 16 arrests for manufacturing and selling since July 15,2000. "I was surprised how low the statistics were,"said Miller. "I asked in the jail,and at least half of the inmates said they were doing meth.They weren't arrested for meth, but they were doing it." Statewide meth problem Jefferson County Prosecuting Attorney Juelanne Dalzell's office won convictions on 44 meth cases from 1999 to 2002, including both the sheriffs cases and the Port Townsend Police Department's cases. Suspects charged with manufacturing and sales often plead guilty to possession charges instead of going to trial on more serious charges. Consequently,there were only five sales and manufacturing convictions. In comparison,the prosecutors won convictions on eight marijuana cases from 1999 to 2002.There were no convictions for other drugs. Washington state as a whole has a meth problem. David Albert,senior planner and policy analyst with the Washington Department of Social and Health Service, • declared in a 2001 report on drug abuse trends that Washington state is experiencing a methamphetamine epidemic. In more recent statistics collected by Albert,the number of meth labs rose from 38 in 1990 to 1,886 in 2001.A U.S. Drug Enforcement Agency report said Washington state had the second highest number of meth labs seized in the nation in 2000. Pierce County has more meth labs than any other county in the country except for one in central California. Two-thirds of the meth labs reported in Washington in 2001 were located in Pierce, King, Spokane and Thurston counties, according to the DSHS report. Jefferson County ranked 20th of the 39 counties for number of meth labs reported in 2001.That year,only six labs were busted . Jefferson County users usually buy from dealers who import their drugs,said Miller. "Even though the numbers are still small [in Jefferson County], meth creates big problems,"said Dalzell."It is devastating to the user,the user's family and friends,and the user's community.- It's also a highly addictive drug, said Ford Kessler, administrator and owner of Safe Harbor Recovery Center, that grabs ahold of the person quickly.A prominent Port Hadlock resident told an audience at a March forum on meth that his daughter's personality changed completely when she was midway through her 15th year. She had been a straight-A student involved in sports and other social activities.Within few months, "she totally went off the chart. We couldn't even communicate with her,"he said. After two years of intensive inpatient treatment, he said his daughter is headed in a good direction. • • (( All-consuming high Some people can't ever seem to get straight. One woman on meth continued breastfeeding her infant child even though she had been counseled about the dangers and warned she would lose the baby if she didn't stay clean. "We discovered she wasn't using her own urine for the urinalysis,"said Robin Biffle, a sergeant with the Port Townsend Police Department. "The mother was counseled, and she acknowledged the dangers to her child, but she still continued to use at great physical cost to the child." When the addicted child was placed in a local foster home with a specially trained registered nurse, he went through withdrawal. The all-consuming high can supersede food and hygiene. Meth eats the enamel off teeth. Open sores erupt on faces and bodies after heavy use.Though users lose weight,they often lose so many pounds they end up looking like a concentration camp victim. Although meth suppresses appetite and increases physical activity, it can also cause irritability, confusion, tremors,anxiety, paranoia and aggressiveness, according to the National Institute on Drug Abuse.The same report said that users can experience occasional episodes of sudden and violent behavior and intense paranoia. Violent response I That explains, in part, some of Jefferson County's most violent crimes in recent years. Quilcene resident Robert H. Froehlich, 30, confessed he had been high on meth for five days without sleep when he stabbed 15-year-old Allison Tornensis 23 times on July 29, 1992. Kevin Bledsoe, 23,after charging a low stone wall in the parking lot of the Port Hadlock QFC and crunching his head,was placed in a"crisis cell"at the Jefferson County Jail,where he died on March 24,2001.The death certificate said he died from a methamphetamine overdose coupled with a serious pre-existing heart condition, aggravated by the physical restraints needed to use to control the thrashing,spitting, biting and kicking man. According to Ann Marie Gordon, manager at the state toxicology lab, Bledsoe's methamphetamine level was 0.89 milligrams per liter(mg/L), close to the 0.96 mg/L found in 13 deaths attributed to overdoses of the drug statewide. If the addicts hit bottom before they die or kill someone,there is effective treatment available."Initially,we didn't think traditional treatment could work,"said Bill NeSmith, coordinator of the Port Townsend branch of Washington State Children and Family Services. "Now there's hope." Adult meth addicts complete treatment in about the same proportion as other kinds of users. Sixty-five percent of meth addicts complete publicly funded treatment in Washington state; 63 percent of marijuana users complete; 67 percent of cocaine users and 77 percent of alcoholics, according to charts prepared for DSHS' Division of Alcohol and Substance Abuse(DASA). "Treatment works,"said John Taylor, administrator of DASA's Region 6,which includes Jefferson County."If we don't do treatment,welfare use, drug use and crime could go up." • Editorial s Substance abuse marks county's darkest alley What's the cost of drug and alcohol abuse in Jefferson County? It's the insanity of a young mother trying to scratch off her freckles because she believes they are bugs. It's the helpless weave of a drunk driver on a dark county road. It's the allure of a hit of methamphetamine for a teenager whose home life is a mess and who looks at the world through a lens of hopelessness. It's more. It's the theft of tools from someone's garage or of a VCR from someone's house, to pay for a habit. It's the rage of a drunk man who takes his frustration out on his girlfriend. Amidst all the natural and constructed beauty of this corner of the Olympic Peninsula, the substance abuse problem is our county's dark alley, strewn with broken glass,busted furniture and breaking bodies. The cost is staggering, in both human and economic terms. Local law enforcement officials estimate that almost 60 percent of the inmates in the Jefferson County jail in recent years are there because of drug sales or substance abuse. Crimes which bear little resemblance to a drug crime—property theft, domestic violence, abuse of children—can be manifestations of an addiction. Each one of those inmates sitting in our hopelessly overcrowded county jail, the Hadlock Hilton, costs taxpayers$50,000 a year. While the jail will stay the same, county officials are poised to spend$2.8 million more to build new administrative offices for county law enforcement so it can keep pace with its duties.Those duties,any cop will tell you, are dominated by substance abuse crimes or their various cousins and in-laws. The modem plague of methamphetamine is the primary subject of a three-part series starting in this week's Leader. Reporters Janet Huck, Helen Hollister, Philip Watness and Barney Burke have fanned out across the county to talk to addicts,to the men and women who arrest and prosecute them, to the men and women who try to treat them back to health, to describe the problem. But at each step along the way, the reporters kept hearing the same refrain. Meth is only the dagger-sharp tip of the iceberg.Alcohol abuse, and the abuse of other drugs such as marijuana, are practically pervasive among teenagers in this county, and reflect the true depth of the challenge we face. Don't believe it?Ask anyone of high school age.They know. While they may not participate, it is the social world in which they live. This is nothing unique for Jefferson County.As in many rural counties with poor prospects for decent employment, wiping away a difficult reality with drugs or alcohol appears to be the easiest way out. It isn't.We all pay.The abusers pay with their livelihoods; some- times their lives. The rest of us pay a handful of dollars every day. 11111 For the next three weeks,take a walk down this unfortunate alley with us. It is,.after all,right behind your house. —Scott Wilson F1. 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Q.ra v ;a g ' ' _" `' c o ''=' --R' y '5 - 00 4 * A ou `e:? c . t' a0ml °o°- 4 oa° ani ou IP • ue � risk:esl Meth es o s property, h By Helen Hollister �*''yt,�.,''b,: 't=s) a..ri ;C. ..,s . +.R ` V Leader Staff Writer a•y • • • j�., "le A•�''r i " � } ea'' ' *A”, x;44• i4 4 '>:', .�34 , xr . • ^. , While methamphetamine a , R ` ;�2,._° ;•l a 4,s' ', , ;.'i .. x +w. . - .,:::',41:,.';',.• t� S`. E. - ._^ `s+e,°e��"{ 4. t a ,R"• " Sim abuse can wreak havoc on the - t,1•. n,�, 1 r.,.„, , • ';, mind and body of an addict, itsAi, t` :`,�";.= t f 111 manufacture can also have a pro . ''.. 71 n w•,* x" . • z. found impact on the environ- 9/V-:"' ` = . ''�° ; ' '�~ `'''. ment. Ingredients from 1..7. ►:' F ° : ""'rem 6�, r} ' ' 4 ♦ , methamphetamine laboratories } s'_� !tt. :i -, - a »--.. *- , - ,. = $ are highly toxic, caustic and lit • , 't4;f r"` r ! r w' flammable. ,4. ':4141140S...,,,,,i a� .. - ` fi Houses or vehicles that be- M - �� I :•* F , , � ,', come meth labs must often be .4.,,_ , �4 4 ; '' destroyed. . r • `-.4:;.;,,,,„„f .- , "It's a huge issue," said T i;� i,,..„ 3.' . . P v r '8,°" "" 'i ' Carolyn Comeau,a public health f s.�+ 4,r ;f a• , . F,- �"""' N, '�A*""!r•. ‘,„4„:;4.4 �i $s. 4,= i wiser for the Washington State w .'., ° epartment of Health. ' �� "It's " , 1 Ilk 1. ; ort-. -=‘•-*,.,..„`.1 �`, _' widespread throughout the coup , :~1"a 1,.'. <'., : r Comeau said meth producers l dump waste materials from their laboratories along roadsides,into ' septic systems or in nearby This Chevy Blazer was stolen In Port Townsend in 1999 and turned Into a mobile meth lab.By order of the streams.The byproducts left over Jefferson County Health Department,it was destroyed due to chemical contamination. from a meth lab are substantial. Photo by Scott Wilson For every pound of meth, a lab produces five to 10 pounds of erty are required to hire a certi- vices,said vehicles used to house may include headaches,nausea, waste. Along with the chemical fled contractor to come in and meth production often have to be burns, eye irritation and upper hazards associated with meth clean,removing any furniture or destroyed due to the amount of respiratory infections. Some of production, Comeau mentioned clothing made of porous mate- contamination.He recalled once the substances involved in meth biohazards such as used needles, rial. It can cost up to$30,000 to incident in Jefferson County in production include hydrochloric blood,feces and the diseases that clean up after a meth lab.Some- the early 1990s involving a van acid,iodine, sodium hydroxide, are associated with those items, times walls are painted over to that had been a mobile lab for pseudoephedrine,toluene(paint as other harmful environmental seal in the vapor,or the walls are meth production. He said the thinner), anhydrous ammonia, factors. ripped out completely,along with sheriff's office impounded it and lithium,ether(starting fluid)and When a meth lab is busted by the carpets. The contaminated the van was destroyed after the red phosphorous. authorities, a Washington State materials are transported to.a investigation was completed. A "They dump their stuff into Patrol Incident Response Team solid waste facility, usually lo- stolen Chevy Blazer used to their backyard or they try to burn reports to the scene dressed head- cated in another county. transport meth materials was it,"Comeau said."We're talking to-toe in protective suits. The Not all meth labs are located deemed not fit for use after con- about possibly carcinogenic team is called in to process the within a house.They can pop up tamination from meth ingredi- chemicals.If you have your child rime scene and collect the meth anywhere.Some people run meth ents. The Blazer was sent to a out there playing around,there's b materials before the cleanup labs out of the trunk of their car. wrecking yard and crushed for a lot of hand-to-mouth activity, crew from the Department of Larry Fay, environmental salvage,Fay said. or if you grow a garden,that soil Ecology arrives. health director for Jefferson Physical reactions from expo- is contaminated and you're put- Later,the owners of the prop- County Health and Human Ser- sure to the vapors and residue ting yourself at risk." —2.I—o 2 • South county has `free project dumping' South county residents can only, not to businesses, clarifies mark their calendars for the an- Pearson.For more information or nual Household Hazardous a complete list of acceptable Waste Roundup, 10 a.m.-2 p.m. materials, call Public Works at Saturday, Aug. 24 at the 385-9160. Quilcene drop-box site on After taking advantage of this Highway 101. free event, residents are re- The free event — sponsored minded to drop off future un- by the Jefferson County De- wanted hazardous waste at partment of Public Works and Jefferson County's Household the Washington State Depart- Hazardous Waste Facility, lo- ment of Ecology — provides a cated inside the Port of Port once-a-year opportunity to Townsend, just across from clean out all pesticides,car and McDonald's.It is open every Fri- house repair products,auto and day and Saturday for Jefferson marine batteries, oil-based and Clallam County residents; paints and stains,and unwanted phone 379-6911. household toxics of all sorts, "Check out the ReUse shelf says Molly Pearson of Public while you're there-it may have mss. Tc H t+S what you need for a project,"sug- The event is open to residents gests Pearson. x..64-0E/C. i Washington State Department of Health News Release For Immediate Release: August 27, 2002 (02-142) Contacts: Anne Duffy, Office of Environmental Health and Safety 360-236-3372 Deanna Whitman, Communications Office 360-236-4022 Washington prepares for West Nile virus with Web site OLYMPIA—The Washington State Department of Health is on alert for the West Nile virus (WNV), which is spread by mosquitoes and is responsible for serious illness in humans, birds, and horses. WNV is expected to reach the state as soon as this year. In preparation, the agency has launched a Web site featuring a variety of resources and information to educate and prepare Washingtonians for the arrival of the virus. The Web site provides answers to common questions about WNV and what's being done in Washington state to protect the public. Tips for protecting your family are also available, 40 including simple steps to reduce the number of mosquitoes around your home and how to avoid mosquito bites. The site also suggests ways for physicians, veterinarians, local health departments, and mosquito control districts to participate in preparing for the virus. It includes information regarding reporting suspected WNV cases, mosquito trapping, dead bird reporting forms, and other education. Mosquitoes carrying WNV can transmit the disease to people, horses, and birds. The virus is not transmitted person-to-person or from animals to people. On rare occasions, WNV can cause encephalitis (inflammation of the brain) or meningitis (inflammation of the spinal cord and lining of the brain). More information is available on the Department of Health West Nile virus Web page (www.doh.wa.gov/ehp/ts/zoc iWNV/WNV.html). • Visit the Washington Department of Health Web site at http://www.doh.wa.gov for a healthy dose of information. • Port Townsend&Jefferson County Leader More women are using family l gin coun p The numbers of women using that offers free consultation to the Jefferson County Health "Itis an of j`ective young women without notifying Department's family planning their parents is credited with the clinics are climbing steadily. preventive dramatic upsurge in use. In the first half of 2002, the 1{ „ Though family planning clinics served`a total of 738 cli- Service. doesn't collect statistics about ents,or 71 percent of the number pregnancies among its clients,the served in 2001. Health Depart- Sheila Westerman number of births for females ages ment officialsproject chairman 15.to 17 decreased significantly a total of 1,150 clients in Jefferson County Board of Health since the early 1990s.From 1991 2002,or 111 percent of the 2001 to 1993, births per thousand total. peaked at 36:5,but the rate fell to These increases happened de- 22.2 per thousand from 1998 to spite some budgetary setbacks for though,"warned Baldwin. 2000. • the program.In January,the Port The program has targeted teens "This is the population where • Hadlock clinic was closed and one and women in their early20swho less pregnancies means less family planning position was are at risk for unintended pregnan- money they would need for other eliminated, but Jean Baldwin, cies. In 1997, family planning services,"said Sheila Westerman, community health director, was served 207 teens ages 19 and chairman of the Jefferson County able to find enough hours from on- younger, but it served 300.teens Board of Health."It's an effective call and part-time nurses to com- in 2001,a 45 percent increase over preventive service.When we are pensate for the cut hours.She also four years.The increase from 1997 looking for cuts in the future, increased the hours in the Port to 2001 was 32,percent for clients maybe we shouldn't cut the [pre- Townsend clinic. ages 20 to 24. ventive]areas,where we get more "We can't do it any longer, The new'Pake Charge program bang for the buck." T LeAD-Er - 2' -a 2 Oit° ' • some transmitted diseases 'Increase locally In a 2001 report compiled by prehensive screening at the we don't know how well we are, the Jefferson County Department health department, said Tom . tracking down partners." of Health, the,total number of Locke,Jefferson County's pub- STDs are prevalent in cer- Jefferson County residents who lic health physician. This year tain age groups, said Locke. reported sexually transmitted the number decreased to 23, About 25 percent of young diseases(STDs)stayed exactly well below the rate for Wash- adults ages 18 to 24 will expe- the same as the previous year. ington state. rience STDs. "That's one in In both 2001 and 2000,there Untreated chlamydia can four over a period of six years," were 33 cases reported to cause pelvic inflammatory dis- stressed Locke. Jefferson County Health and ease among women and lead to Most STDs are entirely cur- Human Services. infertility or ectopic pregnancy, able. "We could have eradi- The number of people in- "Are we doing a good job of cated it because we have had fected by chlamydia, the most stopping the spread?" asked medications for 50 years, but commonly reported STD in Locke rhetorically. "Our because of social taboos,many Washington, decreased by screening for STDs is univer- people are unwilling to address about one-third, but the inti sal for everyone who comes in it as a public policy," said dence of herpes increased from [to the Health Department],but Locke. zero cases in 2000 to nine cases in 2001.There was one case of 1110 gonorrhea in 2001; in 2000 there were none._ Chlamydia reporting in Jefferson ,County.-haS1;ri§en sharply in the last five years. In 1997 there were only 16 cases in Jefferson County, but in 1999 there were 35 and in 2000, 32. The rapid increases are probably due to more coin- . CP-%, L9O6- - ?-zg- 2- • Pon Townsend Es Jefferson County Leader , Wednesday,September 4,2002• 9 Saltwater intrusion meeting clears 'tthe ai jounty, DOE, aquifer protection advocates talk problems, solutions By Barney Burke demonstrate that they have a plan,not be just an ordinance. Island County,highlighted how pumping in order to minimize salt- otherpeenceuofJeffersonCnwuy Leader Stall Writer potable water supply before a No date has been set yet for the his agency monitors the issue us- water intrusion into aquifers,he DOE's Harris also had some building permit can be issued for hearings board to determine ing a sophisticated database.Us- said. a new corrtrnents about rainwater col_ The consensus of those at- dwelling. whether the county's actions have ing well water data collected Charlie Sherk of Charlie's' leetion•suggesting thatthe prac- tending an Aug.29 workshop on satisfactorily implemented the voluntarily by hundreds of prop- Drilling shared insights from his: rice is prohibited in Washington. saltwater intrusion could prob- Misunderstanding board's previous order,she said. erty owners,Kelly said it is pos- 30 years of experience.He esti- However,he noted that the issue ably be summed up in two "It sounds like we need to go Yesterday,the county commis. sibletomonitor whether intrusion matcddutonMarowswneisl has never been enforced,adding ,andthe aquifer is often only 3 or 4 feet agency's words:Ah hah! back and review what we're tat- sioners decided they would dis- is a problem in a specific arta, that the a ea s caseload is P The workshopbrought to tin inplace,"said Commis- the the matter at 10a.m7besday, whetl>eritis8utingworse.Hesaid 8 8 deep,making it difficult to install such it takes 20 years to get light some differences between sinner Glen Huntinford at the ��•10 the cost of the program is about a da!hat:ses $120,000 annually,andgrants to- thwell and operau it properly. how Jefferson County and the meeting.The ttuningpoint ofthe Speakingspocificallyaboutthe Washington Department of workshop came when J. Mike Expert opinions �g •��payingf«ad_ Ryan an of Tillman En- application�M��� Ecology(DOE) approach the Harris of DOE indicated that his ditional studies.,. gineering did some quick calces•' dent Wally Barclay,Harris said challenge of drilling wells where agency would not be giving any County tubers aand nearly two Mike Brewer of Grundfus lations to show how rainwater that cow-se should twice decided n ago about there might be a saltwater intro- variances within the 1,000-foot dozen members of the public pumps demonstrated newtahrtol- collection systems are expensive eight t}soutldbedecidedwuse sion problem.That discovery radius of a"high risk"well.DOE turned out for the workshop, ogy whereby a well PPS and unlikely to meet typical po- eight to 12 months because could lead to changes in county would consider wells between which various u eron tett rising salinity.Such pumps table water needs because of the Barclay has agreedtopay thecost regulations. I,000and1,101feet,Harrissaid, saltwatuintnrsion. can bepro grinn nxdtoredtaxthe relatively low rainfall on diming DOEsd�osultaotspro Staged at Washington State based on how the county ordi- DougKeUy,hydrogeologistfor flow,sound an alarm or stop Marrowstone Island and some eeuitoabdtalfofDOEstaff University offices in Port nance was written. Hadlock,the workshop was part County commissioners and of a continuing effort to resolve staff members pointed out that a dispute between Jefferson the intent of the county ordi• County and two citizens'groups, nance was not to prohibit the • Olympic Environmental Council consideration of new wells and Shine Community Action within 1,000 feet of a well with Council.The two groups filed an a high reading,only to have them appeal with the Western Wash- reviewed by DOE in an effort to ington Growth Management avoid making the saltwater intru- Hearings Board in December sion problem worse. 2000,asserting that the county's The county policy"presents development regulations do not confusion for us," Harris re- adequately protect underground sponded,adding,"There prob- aquifers, i• ably will be more meetings" '• between the two agencies.Pub- Aquifer protection lie Utility District I Commis• etrtheheanngsboardruled sioner Dick Shipman, whose the county in January agency has agreed to help the he county adopted new county monitor saltwater intru- regulations on July 23 to com- sion,said,"I can see that the state ply with that order.The board of water laws need reforming." commissioners made the new After the meeting,County rules effective Sept.23 in order Commissioner Dan Tittemess to allow time totconfer with the confirmed that there was a mis- county planning commission, understanding on the interprets- members of which attended last tion of the ordinance and week's meeting along with the expressed hope that all parties, commissioners and the citizens' including the citizens'groups, groups. found the meeting useful. Under the new county rules, Colette Kostelec,the civil en- property owners must obtain a tinter representing the citizens' variance from DOE if they plan groups,said the meeting was to drill a well within 1,000 feet "really enlightening" for the of an existing well showing chlo- county.However,she maintains ride concentrations•above 200 th4tthcra.are,&n.tirsbe of issues mg/L(250 mg/L is the U.S.En- that have to be worked out be- vironmental Protection Agency's tween her clients and the county. • limit on salinity in potable wa- In a brief filed Aug.28 with ter). the hearings board,Kostelec as- In addition to such"high risk sects the county was ordered to saltwater intrusion protection be in compliance by Aug.7 but zones,•the new rules have pro- the new rules won't take effect cedures for areas near wells over until Sept.23,any further revi- 100 mg/L and for any wells sions notwithstanding.Her brief within 100 feet of a shoreline. also argues that the county's ac- The county does not issue tions do not go far enough to pro- permits for wells,Community tett aquifers and that the adopted Development Director Al Scalf actions should be incorporated said,but property owners must into the county's comprehensive What can hormone • replacement therapy do? wirgm.twiThere has been a lot of discussion lately about hormone replacement therapy(HRT)and its possible negative 'fkl side effects. What about this, and are there any options? The large federal government study on ;., hormone therapy released in July 2002 basically came to the conclusion that = Prempro—one of the many formulations for hormone therapy—has risks that out- Dear Dana weigh the benefits.The study was halted because the risk of breast cancer and car- By diovascular trouble were increased. Dana Michelsen Each woman is unique.She must con- sider her health history and also the medi- cal problems of her relatives. She must examine her symptoms,risk factors for disease,and quality of life issues. She must also evaluate her lifestyle,including her diet and amount of exercise she gets. She and her healthcare provider must then together decide the risks and benefits of hormone therapy. It is important to realize that this examina- tion and evaluation process should be done on a yearly basis, as some of these factors can change. The lifestyle factors should not be dismissed easily.It makes no sense to select HRT if a woman chooses not to exercise,is greatly overweight,ignores her diet,and smokes. There is an alternative to synthetic hormones for therapy.They • are called bio-identical hormones,and they work differently from synthetics in our bodies.They are structurally identical to hor- mones that are naturally produced by the human body.They have effectively controlled the symptoms of menopause, but future studies are needed here too. By working with a healthcare pro- vider and a pharmacy,the exact and appropriate dose for each individual can be supplied,and adjusted if necessary. Pharmacy compounding is a way of preparing these hor- mones that are unique, and it uses delivery systems that are r- not generally available from pharmaceutical companies—for example,lozenges,topical creams,under-the-tongue drops and custom-blended capsules.Don's Pharmacy is currently the only pharmacy in the county offering this service. National mail- order pharmacies are also available. If osteoporosis is a woman's main concern, there are new medications that are more specific,with fewer side effects than HRT,for those who are at risk of breast cancer. Because of this latest study,there will undoubtedly be many more studies in the coming months. Reevaluate with your healthcare provider and pharmacist your individual needs,risks and alternatives. ) Mammograms available Dear Dana, Cervical Health Program Thank you for your column (BCHP)can provide them with on mammograms. Please let a free or low-cost mammogram your readers know that for and women's health exam.For women who do not have insur- more information they can con- ' ( • ance that covers mammograms, tact the Jefferson County Health or if they can't afford the de- Department at'385-9400. 9(.1_02 ductible, and they are'low 2iri- Thank you for paling this come women between the ages on, of 40 and 64, the Breast and Margie Boyd,RN 410 Port Townsend&Jefferson County Leader Health Department iiwites to talk res. onsepublic h _ ., On Sept. 11, 2001, America progress report will be made to of emergency management and received a disturbing wake-up the Jefferson County Board of bioterrorismresponsecapabilities; call on the threat posed by inter- Health on what has been accom- communication system develop national terrorists. Shortly after- plished in the last year and the menta training exercises for staff ward, a biological attack in the substantial challenges that lie and community; coordination form of mailed envelopes. of ahead.The board is slated to hear with state and federal agencies; highly concentrated anthrax a report on bioterrorism pre- Washington state bioterrorism spores hit the East Coast. paredness efforts at a local, re- preparedness plan — workplans "Over the past year,intensive gional and state level. • and timelines; challenges for efforts at a federal, state and lo- The public is invited to attend counties—increasing service de- cal level to improve public health the'meeting,set for 2:30 p.m. at inands/declining revenues;chal- preparedness and bioterrorism the Jefferson Health and Human lenges for hospitals — lack of • response capability have been Services conference room in the surge capacity; challenges for under way," reports Dr. Tom Castle Hill center. public health departments—un- Locke of the Jefferson County Topics to be covered include: stable funding sources yet con- Department of Health. suspicious mail evaluation and re- tinual emerging'diseases and • On Thursday, Sept. 19, a sponse protocols; regionalization prevention needs. •