The URL can be used to link to this page

Home My WebLink About2002- October File Copy • Jefferson County Board of Health Agenda • & Minutes October 17, 2002 • • JEFFERSON COUNTY BOARD OF HEALTH Thursday, October 17, 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 September 19, 2002 III. Public Comments IV. Old Business and Informational Items 1. Status of meeting minutes for August 15, 2002 V. New Business 1. Local Health Jurisdiction Reorganization Jean/Tom • JHHS Budget History and Forecasts MaryAnne 2. Data Steering Committee Update Jean 3. National Smallpox Vaccination Plan Tom 4. Public Health Funding Reform: A Progress Report Tom 5. West Nile Virus Response Planning Tom VI. Agenda Planning VII. Next Meeting: November 21, 2002, 2:30—4:30 PM Main Conference Room, JHHS JEFFERSON COUNTY BOARD OF HEALTH MINUTES • T ot Psi Thursday, September 19, 2002 Board Members: Stay ffMembers: 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 Weft,Member- County Commissioner District#3 Thomas Locke,MD,Health Officer Geoffrey Masci, Vice Chairman -Port Townsend City Council Jill Buhler,Member-Hospital Commissioner District#2 Sheila Westerman, Chairman- Citizen at Large (City) DR AFT Roberta Frissell,Member-Citizen at Large(Coun ) Chairman Westerman called the meeting to order at 2:35 p.m. All Board and Staff members were present, with the exception of Commissioner Huntingford. Vice-Chairman Masci joined the meeting at 3:00 p.m. There was a quorum. APPROVAL OF AGENDA Member Buhler moved to approve the Agenda as presented. Member Frissell seconded the motion,which carried by a unanimous vote. APPROVAL OF MINUTES Chairman Westerman noted that the August 15, 2002 meeting minutes reflect that the items scheduled for discussion were postponed to the next meeting due to a lack of a quorum. Her understanding at the time was that the Board could continue its discussion, absent a quorum, but could not take any official action. She proposed that the cover page be amended to reflect that the Board had discussion but did not take any action due to the lack of a quorum. Larry Fay clarified that he was informed by the Clerk of the Board of County Commissioners, that since the meeting lacked a quorum, the Board has no official minutes, but instead discussion notes. Chairman Westerman asked Staff to get direction from the Prosecuting Attorney whether the Board could have a meeting without a quorum. She noted that the Board has had many meetings with only one Commissioner present and that this change would significantly affect the way this Board conducts its business. There was no objection to postponing action on the August discussion notes until Staff receives a recommendation from the Prosecuting Attorney. Commissioner Wojt noted a change to the August minutes, Page 3, paragraph 5. The first sentence should state that the Critical Areas Ordinance would become effective September 23 instead of *September 21. Commissioner Titterness moved to approve the minutes of July 18,2002 as amended. Changes noted at the August meeting were as follows: on Page 5, paragraph 6, the spelling of HIPPA was HEALTH BOARD MINUTES - September 19, 2002 Page: 2 corrected; on Page 5, paragraph 8, the first sentence should read "... that some legislators • erroneously assume that it costs less to treat patients in rural counties than in urban areas." Commissioner Wojt seconded the motion,which carried by a unanimous vote. PUBLIC COMMENT Charles Chase from 1700 Egg and I Road asked for an update on the Civil Penalties Ordinance. Because of the lack of a septic system on an adjacent property, he remains concerned for the safety and protection of the well that he and his neighbor share. Bob Reed spoke about his concern regarding the biosolids being sprayed on Pope Resource's land over the last 15 years. Referring to correspondence from the Department of Ecology that states Jefferson County is responsible for monitoring biosolids, he is concerned whether this practice is safe for humans and wildlife in the Hood Canal watershed. A friend noted condoms and personal hygiene items in the compost material from the City and he is also concerned that the City's compost product might not be safe. Chairman Westerman thanked Mr. Reed for his comments. Regarding the safety of the City's compost, she referred him to the City of Port Townsend Public Works Department. Mr. Reed said he has already obtained information from the City. Larry Fay identified the sources of biosolids that go on Pope Resource's land as the City of Sequim, Bainbridge Island, Port Ludlow, and Port Gamble. All their wastewater plants sample their biosolids and have records as to the quality of the septage, which is reported to the Department of Ecology. They all apply their biosolids under coverage of the general permits Ecology has issued for land applications and they all operate in conformance with the State and • Federal requirements. Ecology has an agreement with the County to conduct site inspections. Chairman Westerman asked Mr. Fay to share with Mr. Reed reports that the County may have of inspections of areas that have been sprayed with biosolids. Mr. Fay noted that Ecology regulates biosolids and has the responsibility for permitting and siting. Bob Hamlin, County Emergency Manager, was present to confirm that the agenda item Bio-terrorism Emergency Health Issues is in fact a regional issue and to point out that there is cooperation in planning on this issue. For the first time, there is resource support for these issues. Referring to the challenges of regional partnerships, he pledged his support to make this as cooperative a relationship as possible while protecting the interests of Jefferson County. OLD BUSINESS AND INFORMATIONAL ITEMS Civil Penalties Ordinance—Public Hearing and Potential Adoption: Chairman Westerman solicited comments on the ordinance. Commissioner Titterness moved to approve Ordinance No. 08-0919-02 authorizing Environmental Health civil enforcement. Member Buhler seconded the motion,which carried by a unanimous vote. EnviroStar Award: Member Frissell noted that she represented the Board of Health in presenting • Jefferson County's second EnviroStar award to SOS Printing. HEALTH BOARD MINUTES - September 19, 2002 Page: 3 wIndividual Water Systems Standards Background: Larry Fay reviewed that in considering alternative ater supplies associated with the County's adoption of the Seawater Intrusion Ordinance, he felt it would be good for the Board to have a baseline of local alternatives. Over the next couple of months,he would bring back issues and information on some of the alternatives to then build a prioritization scheme. Member Buhler asked to see standards adopted by San Juan County. Mr. Fay agreed to bring these to a future meeting, noting that they are the only county to have adopted standards for rainwater catchments as well as desalination of marine waters. Chairman Westerman noted that Policy Statement 93-02—Water Availability Requirements for Building Permits says that individual water supplies are required to provide a minimum of 400 gallons per day. She asked if rainwater catchments fall under individual water supplies? Mr. Fay explained that 93-02 implements the guidelines developed by Ecology and the State Department of Health. Within the guidelines are provisions giving the County discretion to apply lesser quantities than 400 gallons. Policy 97-01 recognizes that rainwater catchments would not produce 400 gallons a day. Chairman Westerman said it was never explained how the rainwater catchment program had been exempted from that requirement. Policy Statement 97-01, page 2, says "alternate sources of supply (including catchments) may be adequate if all other criteria are met. She noted that 400 gallons per day is obviously one of the other criteria. She believes citizens would have difficulty understanding this. Mr. Fay said one of the reasons for writing local policy is to explain state regulations. He noted that page 2 of olicy 93-02, which talks about approval of alternative water supplies was inadvertently omitted from he packet. Staff then distributed the missing page. Bob Reed noted that state regulations for installing septic systems require a 10-foot separation between the water and sewer lines. He asked whether Port Ludlow is exempt from this requirement? Chairman Westerman said Port Ludlow is not exempt, but asked Mr. Reed to follow up with Staff to get answers to his questions. Vice-Chairman Masci asked if a minimum of 400 gallons per day should be used if actual water use can be between 50 and 200?Mr. Fay said page 2 of Policy 93-02 allows for less than 400, but sets certain conditions, such as requiring a restrictive covenant on the property stating that the water supply does not meet the minimum water requirements. One problem with quantities less than 400 gallons a day—less than a half gallon a minute—is that it is very difficult to get an accurate well measurement. Since wells around here generally provide more than 400 gallons a day, water quality is generally more of an issue than quantity. However, rainwater catchments are never going to make 400 a day. While 400 gallons is a lot of water, people tend to use what they have available. The question is how far down to push that threshold while still allowing for basic personal hygiene and sanitation? Member Buhler asked about the possibility of drilling deeper to reach another aquifer?Mr. Fay said while there may be a condition where you have restrictive layers that isolate different aquifers where here is a body of fresh water below the saltwater lens, he does not know of anywhere in the County here that has occurred. Responding to a question from Chairman Westerman, Mr. Fay said the figure of 45 gallons a day comes HEALTH BOARD MINUTES - September 19, 2002 Page: 4 from our knowledge of water use on a per capita basis from water use records from municipalities and • water use for sewage treatment purposes across the country. Vice-Chairman Masci asked about Policy Statement 93-02, IV. B., which says "water supplies that do not provide minimum volumes shall only be considered adequate when accompanied by a water conservation plan." If water supplies are not adequate and we are below minimum standards why are we not specifying storage? He believes that how the storage plan integrates with the minimum water needs would be more of a public health concern. Mr. Fay said that the rainwater catchment policy recognizes storage as a key element. However, it assumes a consistent, but low volume of water as opposed to high volumes being captured for use in later months. Any storage might be handling 24-hour fluctuations in use and flow. That would be a different kind of stagnation and contamination than trying to hold 5000 gallons of water in a storage tank for six months. Vice-Chairman Masci said a solution to the problem might be to footnote another section that is applicable. Mr. Fay explained that the County is not regulating the water systems or water supply, but simply stating whether a water supply is adequate for the purposes of getting a building permit. The County simply asks for a restrictive covenant on the property that says if the proposed plan is implemented, there would be a minimal supply of water adequate for the purposes of that building. The County also does not inspect to see if an individual hooks up to a well. The only jurisdiction the County has is requiring proof of potable water with each building permit. Vice-Chairman Masci said his concern is the prevention of contamination and disease. Mr. Fay said then • an ordinance for monitoring and reporting is something for the Board to consider. He agreed to return with recommendations specific to the rainwater catchments and to such issues as hauled water and the desalination of seawater. NEW BUSINESS World Breastfeeding Week—JHHS/JGH Collaborative Efforts: Carol Hardy of the Health Department Maternal Child Health and Laura Showers from Jefferson General Hospital, both Certified Lactation Consultants, talked about events surrounding World Breastfeeding Week. Held the first week in August every year, this event is promoted by the World Breastfeeding Alliance. Ms. Hardy talked about the many benefits of breastfeeding in reducing short- and long-term healthcare costs for both the baby and mother. Among them were that breastfed babies not only get held more, but the high cholesterol they receive in breast milk enables them to better utilize cholesterol later in life and that it promotes attachment between mothers and babies, resulting in better protection of the baby. Hospital and Health Department staffs are trained in breastfeeding and together they are seeking ways to broaden consciousness and support of breastfeeding in the community. The hospital has recently changed its OB staffing method to include not only labor and delivery support but also post-delivery support and education. This year,the Department held a picnic to support World Breastfeeding Week. Ms. Hardy's goal for 2003's event is to close the entire County for one hour for a picnic celebrating this event. Jean Baldwin noted breastfeeding has moved from merely a method of feeding to health intervention. Breastfed children are less likely to suffer from obesity and diabetes. , Vice-Chairman Masci asked about the involvement of LaLeche League in Jefferson County? Ms. Hardy said the Department works with this small organization, which meets once a month. Since 1994,the • HEALTH BOARD MINUTES - September 19, 2002 Page: 5 nDepartment has also held weekly breastfeeding teas involving roughly 7 to 25 mothers and babies. They ot only address baby issues, but talk about relationships and postpartum depression. Ms. Showers noted that antidepressants do not affect nursing babies. In fact, there are few medications that you cannot take during breastfeeding. Chairman Westerman asked if more doctors are encouraging breastfeeding?Ms. Showers said that the American Academy of Pediatrics has for several years been promoting and advocating for breastfeeding. They encouraged physicians to promote it as a standard feeding practice for the first six months, but now recommend a full year. Member Buhler noted that this program has broad ramifications and asked whether our primary care physicians promote breastfeeding? Ms. Showers said that the four physicians who deliver babies advocate breastfeeding. Vice-Chairman Masci asked whether there have been in-services with physician staff and whether there is a cost involved in holding a joint in-service on breastfeeding? Ms. Showers said that cost would not be an issue but that attendance would be the biggest challenge. Vice-Chairman Masci moved to direct Staff to draft a letter from the Board of Health recommending that a breastfeeding in-service be offered to local physicians and patients on a biennial basis. Member Buhler seconded the motion,which carried by a unanimous vote. ember Frissell suggested that the Breastfeeding 101 handout be offered to every pregnant woman in e County. She also asked for the percentage of those breastfeeding in the community? Ms. Hardy agreed the handouts could be distributed to physicians' office and be included in the childbirth class packet. About 75-80% of WIC mothers in Jefferson County initiate breastfeeding, ranking us first or second in the state. At the hospital the rate is in the high 90s. Ms. Showers noted that the hospital and Health Department are working on childbirth education classes at which they also advocate for breastfeeding. They have also considered adding some classes, including an early breastfeeding class. Jean Baldwin noted that the hospital would host the classes to be sponsored by the Health Department. Bio-terrorism and Health Emergency Preparedness—One Year Post 9/11: Dr. Tom Locke noted that bio-terrorism preparedness started in the 1990s as an unfunded project. There was also a bio- terrorism assessment in Jefferson County in the fall of 2000. Following September 11 and October's anthrax scare, locally there was excellent multi-agency cooperation,protocols were established, and much was learned. The state and local health system disseminated information and handled coordination between jurisdictions. Washington was one of the few states that did not find its laboratory functions totally overwhelmed in the testing of specimens. Other state labs received hundreds and thousands compared to 70-80 samples tested in Washington where local Health Departments first screened the submissions and conducted on-site investigations. Despite an aggressive response, the experience revealed an inadequate capacity in the national system for dealing with any bio-terrorism scenarios. The Centers for Disease Control was virtually consumed by what turned out to be four letters. io-terrorism funding has triggered much of the preparedness efforts. Washington State was eligible for 8.1 million in the first year. While other states chose to allocate 80% of their funds to local jurisdictions, Washington chose an initial 50/50 split, with half going toward building capacity in the state health lab and communication systems and the other half for local Health Departments. Jefferson HEALTH BOARD MINUTES - September 19, 2002 Page: 6 County received $25K for 18 months, but it is nonrecurring. Region 2, which includes Jefferson, Kitsap, and Clallam counties, is now in the implementation phase of the bio-terrorism plan, which involves assessing strengths and weaknesses. Based on the assessment, a short- and long-range local and regional plan will be developed to address identified gaps. Ongoing funding would be used to build local and regional capacity. Dr. Locke then introduced the new regional bio-terrorism coordinator, Rick Gunderson, who will play a lead role in developing the regional plan and assisting individual counties develop their plans. The desire is to make the plans as consistent as possible, pool resources, and to develop sophisticated systems that are beyond the capability of the current resources. An example is that this region will be implementing one of the first surveillance systems in the state, which would continuously monitor emergency services and certain hospital activities for syndrome trends. This system is not expected to alert us to evidence of bio-terrorist attacks but infectious disease activities such as sexually transmitted and food borne infections. Jean Baldwin reported that our region would also contract with the University of Washington for epidemiological services. Communicable disease coordinator, Lisa McKenzie will function as local liaison and will attend regional meetings and identify gaps. Vice-Chairman Masci asked about the organizational chain of command in place today? Dr. Locke said that as a part of the Emergency Management System, there are contingency plans for how public health would interact. The public health component would only come into play if it were a biologic emergency. A natural disaster would also involve health ramifications but the Department would not take a lead role. The immediate job of the Regional Emergency Response Coordinator is to help Counties adhere to the • timeline to develop draft local and regional plans by the end of January 2003 for finalization by the end of April 2003. Bob Hamlin responded that there would be a unified command approach as opposed to a chain of command. State law specifies how disaster preparedness would be structured, one component of which is health. If health were the primary component of an emergency then health would be the lead within that emergency management system. His concern is that multi-agency involvement would lead to duplication of the existing structure. He noted that the Board of County Commissioners is in charge, with the Emergency Management System (EMS) as their agents and within its charge by state law. He noted that the health component, depending on the danger, could be a major player. Dr. Locke said that some of the major challenges, as we embark on the assessment, are state and local budgetary issues. The salaries of the people who will do the response work are paid for by a combination of different contracts, programs, and categorical funding,which is a house of cards. Although resources are very tight, there is a very high level of professionalism, motivation and dedication. He noted that the set of first responders now includes community healthcare practitioners, nurses, and lab technicians as well as postmasters and the opener of the mail. The first responder network changes for each different pathogen or agent involved, creating formidable training challenges. Member Frissell asked about plans to create a list of retired medical health professionals? Dr. Locke said there has been a national discussion of this and even though volunteers would not be a replacement for a core set of responders, there will be a need to recruit as many volunteers as feasible. Certainly with the • large retirement populations in Jefferson and Clallam Counties, it would be important to utilize all expertise in the event of an emergency. HEALTH BOARD MINUTES - September 19, 2002 Page: 7 aRick Gunderson expressed his excitement about the challenge of working on the plan and will report back to the Board on the deliverables once they are ready. He accepted the challenge of working with the Emergency Management System since there is no interest in creating a duplicate structure. Lisa McKenzie said she would work with Rick Gunderson and her counterparts in Kitsap and Clallam Counties to produce similar plans. She feels it is important to look at a regional approach. She attended a bio-terrorism training at the Northwest Center for Public Health Practice. It was valuable to look at epidemiology techniques for any outbreak and different approaches for bio-terrorism. She noted that during the anthrax scare, the New York media and cartoons made it appear that the Health Department was not responsive, but in fact they could not communicate with the community because of possibly interfering with criminal investigations. Health Department Budget Briefing and Performance Measures: Chairman Westerman solicited Board questions about the information provided in the agenda packet. Member Buhler asked who determines the goals and objectives. Ms. Baldwin responded that some of the missions came from what is required from the programs; some came from staff and what they see as the mission of the program. Staff wrote all the goals, objectives and performance indicators. The 45 programs are covered under four program topics: Communicable Disease, Targeted Community Health Services, Family Support Services, and Population and Prevention. She noted that for consistency with previous years, she did not overlay the five public health standards with the performance measures. Vice-Chairman Masci suggested marking any new performance indicator with the year it was integrated. Communicable Disease performance indicators, Chairman Westerman asked whyonlyof one three people in the Syringe Exchange Program was referred to another service? Ms. Baldwin noted that of the 15, only five were willing to go somewhere else. Chairman Westerman suggested changing this indicator from"referrals" to "accepted referrals." Family Support Services, Chairman Westerman asked why there was no information on the family nurse partnership?Ms. Baldwin responded that the data omission was an oversight. Under WIC, Vice- Chairman Masci asked Staff to show the number as well as the percentage. Member Frissell said she has difficulty jumping between whole numbers and percentages. She would like to see the total number of infants served by WIC. Under children with special health care needs, it would be nice to see the figure served over the total number. Population and Prevention: Chairman Westerman asked why there were drops in the Peer-In educational presentations and school health classes? Ms. Baldwin said the middle school health program ended in June 2001, and there was an incorrect projection for 2002. There were Peer-In presentations in Chimacum but no student participation. However, even with the drop in Chimacum and Quilcene, she does not understand the figures and agreed to provide an explanation of these figures at a future meeting. Under screenings, Vice-Chairman Masci asked that a subset of the diseases, problems or other things detected be shown. ilkarry Fay explained that Environmental Health programs lack performance indicator data because this ype of measure is fundamentally different from how it has historically tracked information. Currently, staff does not have the data systems in place to track conveniently and the reliability of the numbers was so low that they need to be verified. He noted that he wrote the mission, goals, objectives and HEALTH BOARD MINUTES - September 19, 2002 Page: 8 performance measures. Although he will try to generate numbers, he asked for feedback on the • indicators listed. Drinking Water Program: Chairman Westerman asked about Objective #7 which says "Continue contracting with DOH for public water supply projects as long as adequate funding is provided." Mr. Fay said if there was not adequate funding, he would discontinue contracting with the State Department of Health and the State would directly assume their statutory responsibilities. Solid Waste Program: Chairman Westerman expressed interest in better understanding the scope of the residential sharps issue and also asked Staff to spell out acronyms like SQGs (small quantity generators). Larry Fay said the residential sharp concerns are mostly a transfer station worker safety issue. It was also noted that Kitsap County had worked to raise the tipping fee to address the sharps problem. Vice- Chairman Masci suggested tracking through Caregivers and adult family homes that are dealing with this problem on a residential basis. Mr. Fay said he could use some help with Solid Waste performance indicators. While the pounds of trash generated per capita per year is not listed as an indicator, it should be the measurement used in our education program. If after ten years of education the trash was worse, you would ask yourself if the program should be restructured. Mr. Fay said he arrived at the per capita waste generation by comparing the total tons going across the scale to the population. Ideally, we would see the figure decreasing over the years. On-Site Sewage Program: Mr. Fay then explained that the onsite sewage program has traditionally compared the number of permits processed to the number of applications it receives. The goal of an inspection program would be to see an increase in the percentage, rather than the absolute number, of systems getting inspected. The percent of failures includes natural failure and, since premature failures would indicate a problem with the system, he has indicated those systems less than five years old. Chairman Westerman made several suggestions for making this document easier to respond to: 1) she would like to see several examples of"targeted community groups," 2)under Goals, number 2, "assuring a high-quality monitoring program," she would like to see a list of those doing monitoring, 3) it might need to be pointed out, under summary of key findings, whether permit and inspection fees are adequate, 4) she would like to know the effect of the '/2 FTE reduction of staff allocated to onsite programs as noted in the last sentence, and 5) what sort of increased tracking will be used to evaluate the effectiveness of monitoring programs. Food Service Program: Member Frissell would like to see the number of complaints received and the percent that resulted in corrective actions. Mr. Fay said he is struggling with the difference between performance indicators and numbers. Vice-Chairman Masci said over time the number of complaints and resolved complaints is going to be an indicator of efficiency. After five years, there is enough information to formulate an expectation to gauge your performance. Mr. Fay responded that he would tend to put those numbers on a population basis in order to create rate-based performance indicators. Hopefully that implies we are improving, but • if the population and the numbers show similar increases, that does not tell you much of anything. For comparison, he will try to get other communities to do similar measures, but the numbers are going to be meaningless unless tied to population or on a percentage basis. HEALTH BOARD MINUTES - September 19, 2002 Page: 9 Chairman Westerman restated her feeling that without the numbers the Board does not have any idea what it is doing. Jean Baldwin noted that while the Department could utilize the federal goal of public health indicators—Healthy Communities no one has yet done this in environmental health. Mr. Fay noted that in the baseline work performed on public health standards, one of the things that the consultants were thrilled with was the environmental health performance indicators. It is fundamentally different than how we have done things. While they may be good in terms of customer service and responsiveness, they do not tell you much about the effectiveness of your program, which is what he is trying to get at in this report. He can see why numbers are important, but that is fundamentally a different kind of report than what he understands about performance-based budgeting. Chairman Westerman proposed the Board discuss the topic of performance-based budgeting in more detail at the next meeting. AGENDA CALENDAR /ADJOURN Environmental Health regulatory review schedule: Larry Fay reviewed the list of items to be covered over the next couple of months: 1) standard operating procedure for civil penalties ordinance, 2) individual water systems, 3)new federal arsenic standards, 4) solid waste regulations, 5) establishing standardized procedure for Board of Health hearings and appeals, 6) adopt rules and regulations around methamphetamine drug lab clean-up, and 7)performance measures. BOH Calendar Plannin : Dr. Locke said the purpose of going to a monthly calendar is to give the oard more control over how to space out these issues. Ms. Baldwin said that while there are hot-button lirssues, items like the STD and family planning report should be brought to the Board on an ongoing basis. Member Buhler expressed concerned about how the saltwater intrusion ordinance will impact the ability of people to get alternative water supplies. The meeting adjourned at 4:40 p.m. The next meeting will be held on Thursday, October 17, 2002 at 2:30 p.m. at the Jefferson County Health and Human Services Conference Room. JEFFERSON COUNTY BOARD OF HEALTH Sheila Westerman, Chairman Jill Buhler, Member Geoffrey Masci, Vice-Chairman Richard Wojt, Member (Excused) Glen Huntingford, Member Roberta Frissell, Member Dan Titterness, Member • Board of Health New Business Agenda Item # V. , 1 • Local Health . Jurisdiction Reorganization / JHHS Budget History And Forecasts October 17, 2002 • Chapter "10.46.031 KC W - l he Washington State Legislature rage 1 of 1 1- ` EC Legislature Home About Us E-Mail Lists Search Help RCW TITLES » TITLE 70 >> CHAPTER 70.46 » Si CTION 70.46.031 Print Version 70.46.020 « 70.46.031 » 70.46.060 RCW 70.46.031 Districts of one county -- Health board -- Membership. A health district to consist of one county may be created whenever the county legislative authority of the county shall pass a resolution or ordinance to organize such a health district under chapter 70.05 RCW and this chapter. The resolution or ordinance may specify the membership, representation on the district health board, or other matters relative to the formation or operation of the health district. The county legislative authority may appoint elected officials from cities and towns and persons other than elected officials as members of the health district board so long as persons other than elected officials do not constitute a majority. • Any single county health district existing on *the effective date of this act shall continue in existence unless and until changed by affirmative action of the county legislative authority. [1995 c 43§ 11.] NOTES: *Reviser's note: For "the effective date of this act" see note following RCW 70.05.030. Effective dates --Contingent effective dates -- 1995 c 43: See note following RCW 70.05.030. Severability -- 1995 c 43: See note following RCW 43.70.570. 4111) http://www.leg.wa.gov/RCW/index.cfm?fuseaction=section&section=70.46.031 10/10/02 tnapter iu.'+o.uou ltt w - jne vvasningv.wUii J Lille L.cgisiaLuic l a`i, 1 Vi 1 • - _ � x:r -- "• �e'°�+' _ - _ 1 ._._ .- ata."�. �.asa._..x'!-� sem."'. • k.` Legislature Home About Us E-Mail Lists Sears Help RCW TITLES » TITLE 70 >> CHAPTER 70.46 » SECTION 70.46.060 Print Version 70.46 031 « 70.46._06{0 » 70.46.080 RCW 70.46.060 District health board -- Powers and duties. The district board of health shall constitute the local board of health for all the territory included in the health district, and shall supersede and exercise all the powers and perform all the duties by law vested in the county board of health of any county included in the health district. [1993 c 492§248; 1967 ex.s. c 51 § 11; 1945 c 183§6; Rem. Supp. 1945§6099-151 NOTES: Findings--Intent -- 1993 c 492: See notes following RCW 43.20.050. • Short title --Severability --Savings -- Captions not law -- Reservation of legislative power-- Effective dates -- 1993 c 492: See RCW 43/2.910 through 43.72.915. Severability -- 1967 ex.s. c 51: See note following RCW 7a05_010. • http://www.leg.wa.gov/RCW/index.cf n?fuseaction=section&section=70.46.060 10/10/02 Vllaplci !V.YV_VOV 1\L.VV - 111G VV 0.3111i151Vii JLULG L .51 JaLw . i uiv i va i • yVVASHINGWN STAT ,tet c�� Legislature Home About Us E-Mail Lists Search Help RCW TITLES » TITLE 70 >> CHAPTER 7046 » SECTION 70.46 080 Print Version 70.46.060 « 70,: 6.080 » "70.46.085 RCW 7146.08 District health funds. Each health district shall establish a fund to be designated as the "district health fund", in which shall be placed all sums received by the district from any source, and out of which shall be expended all sums disbursed by the district. In a district composed of more than one county the county treasurer of the county having the largest population shall be the custodian of the fund, and the county auditor of said county shall keep the record of the receipts and disbursements, and shall draw and the county treasurer shall honor and pay all warrants, which shall be approved before issuance and payment as directed by the board. Each county which is included in the district shall contribute such sums towards the expense for maintaining and operating the district as shall be agreed upon between it and the local board of health in accordance with guidelines established by the state board of health. [1993 c 492§249; 1971 ex.s. c 85 § 10; 1967 ex.s. c 51 § 19; 1945 c 183 § 8; Rem. Supp. 1945§ 6099-17.] NOTES: Findings--Intent -- 1993 c 492: See notes following RCW 43_20.050. Short title --Severability --Savings --Captions not law -- Reservation of legislative power-- Effective dates -- 1993 c 492: See RCW 43.72.910 through 4`.72.915 Severability -- 1967 ex.s. c 51: See note following RCW 70.05.010. • http://www.leg.wa.gov/RCW/index.cfm?fuseaction=section&section=70.46.080 10/10/02 x-liaptc.i. I 1_1 - 111%, V•(10111115ll./11 • • j-t4-W-----W4SHI-NGION STATE LEG SEMI- wt1411, Legislature Home About Us_ E-Mail Lists Search Help ROW TITLES >> TITLE 70 >> CHAPTER 70.46 » SECTION 70.46 085 Print Version 70 46 080 « 70 46 085 » 7046090 RCW 70.46.085 County to bear expense of providing public health services. The expense of providing public health services shall be borne by each county within the health district. [1993 c 492§250; 1967 ex.s. c 51 §20.J NOTES: Findings—Intent -- 1993 c 492: See notes following RCW 43,20.050. Short title -- Severability Savings —Captions not law -- Reservation of • legislative power-- Effective dates -- 1993 c 492: See RCW 43.72.910 through 43.72.915. Severability — 1967 ex.s. c 51: See note following RCW 70.05,010. Expenses of enforcing health laws: RCW 70.05.130. http://www.legwa.gov/RCW/index.cfm?fuseaction—section&section-70.46.085 10/10/02 RCW 70.05.130 Expenses of state, health district, or county in enforcing health laws and rules — •Payment by county. All expenses incurred by the state, health district, or county in carrying out the provisions of chapters 70.05 and 70.46 RCW or any other public health law, or the rules of the department of health enacted under such laws, shall be paid by the county and such expenses shall constitute a claim against the general fund as provided in this section. [1993 c 492 § 242; 1991 c 3 § 313; 1979 c 141 § 84; 1967 ex.s.c 51 § 18.] NOTES: Findings — Intent — 1993 c 492: See notes following RCW 43.20.050. Short title— Severability — Savings — Captions not law— Reservation of legislative power— Effective dates — 1993 c 492: See RCW 43.72.910 through 43.72.915. • • http://www.leg.wa.gov/RCW/index.cfm?fuseaction=Section&Section=70.05.13 0&printv... 09/25/2002 • Page 1 of 1 RCW 70.46.120 License or permit fees. •In addition to all other powers and duties, health districts shall have the power to charge fees in connection with the issuance or renewal of a license or permit required by law: PROVIDED, That the fees charged shall not exceed the actual cost involved in issuing or renewing the license or permit. [1993 c 492 § 252; 1963 c 121 § 1.] NOTES: Findings—Intent — 1993 c 492: See notes following RCW 43.20.050. Short title— Severability — Savings — Captions not law— Reservation of legislative power— Effective dates — 1993 c 492: See RCW 43.72.910 through 43.72.915. . • http://www.leg.wa.gov/RCW/index.cfm?fuseaction=Section&Section=70.46.120&printv... 09/25/2002 Page 1 of 1 RCW 70.46.100 Power to acquire, maintain, or dispose of property — Contracts. diIn addition to all other powers and duties, a health district shall have the power to own, construct, purchase, lease, add to, and maintain any real and personal property or property rights necessary for the conduct of the affairs of the district. A health district may sell, lease, convey or otherwise dispose of any district real or personal property no longer necessary for the conduct of the affairs of the district. A health district may enter into contracts to carry out the provisions of this section. [1957 c 100 §2.] 1l • 4' • http://www.leg.wa.gov/RCW/index.cfm?fuseaction=Section&Section=70.46.100&printv... 09/25/2002 • Board of Health New Business Agenda Item # V. , 2 Data Steering • Committee Update October 17, 2002 • Jefferson County.y Health . Human Services ',., Blueprint - t r the future of Assessment and Evaluation I i3 Access to Injury& Mental Health Morbidity& Quality of Risk& Predictive Healthcare Violence Substance Abuse Mortality Life Behaviors Personal & Family Health Demographics Education �+ Community •,, Ill Health Resources Employment Socio- Physical Housing ,1---- economics Environment Environmental Health Social& Community Support Law&Justice ; l i i I iiPrepared byKellie Ragan,g M.A. October 4, 2002 • Jefferson County Health & Human Services Virtual (web-based) Library Proposal Brief Assessment and Evaluation People want to know: • how the government spends funds • if tax dollars are being wisely spent • that programs are making an impact This development of a virtual library proposal utilizes information technology to provide local and regional agencies, taxpayers, and consumers (adults and children) with a profile of strengths and challenges that we, as a community, experience. Community Health is 'the universe' that we are proposing to monitor. Within the universe of community health, this project constructs three distinct domains, socio- economic, personal and family health, and physical environment. Within these three domains, content areas are identified. These content areas are based on scientific knowledge and public perception. Because of the availability of data and the level of sophistication of computer users, JCHHS proposes the development of a Virtual Library that houses commonly used data derived from indicators. Indicator data is available on the web. However, it is not • centrally located, and in many cases, is challenging to access (e.g. Uniform Crime reports bog down computer systems due to their complexity, county level data is often hidden in charts and tables-Governor's Juvenile Justice Advisory Committee). The benefits of a Virtual Library • Provide a higher level of accessibility regarding county-specific data • Provide a greater level of accountability by providing indicator data related to the use of tax dollars • Readily-accessible socio-demographic indicator data for use in grant applications. Socio-economic data plays a cornerstone in all human service grant applications. (FYI: Jefferson County, through various partnerships-JCHHS, Jefferson Mental Health, has recently been awarded $260,000 in grant funding). A thumbnail draft of the proposed virtual library is outlined on the following pages. This project will require significant start-up staff time from JCHHS and a commitment of Information Services to design a consumer-friendly library. Attachment A is a statement of work for the 2003 fiscal year. Attachment B is a list data sources-and although not exhaustive, gives an idea of what is available in the virtual world that could be centralized on a Jefferson County Virtual Library and updated on a regular basis. • Section 1: Personal & Family Health Page 1 10-04-02 DRAFT Content Areas I Indicators I Datasets I Insurance Status I ....... =',J BRFSS 2001 Access to .................. Healthcare I Unmet Need ' " IUsual source of care I'''.. . 1 Late Stage CA dx I Cancer Registry] I Family Planning utilization I I AHLERS-JCHHS I ILate PNC IBirth Certificates I !Senior Assistance I I 1 I I I I I I 1 • 1 I I I I I I I I • Section 1: Personal & Family Health • Page 2 10-04-02 DRAFT Content Areas Indicators Datasets Individual Health Adol. Preg/birth ................... Birth Certificates ••••••••••.••• Low Birth Weight Pregnancy Intention MPSI Child Death Review JCHHS/DOH Immunization Status Child Profile Home Health Care Need Disability Status .......••• BRFSS 2001 Self-reported Health Status Senior Assistance • Section 1: Personal & Family Health • Page 3 10-04-02 DRAFT IContent Areas I Indicators I I Datasets I Injury& Mortality J I CHARS I Violence _ ...� ._ Assault Arrests : Violent Crimes "":"4,1 UCR I Property Crimes J ' .., 0. Domestic Violence I DCFS Referrals Child Abuse/Neglect I Accepted/Open Cases ORCA I Hx of Abuse J .•� BRFSS 2001 Firearms in home J_ _ ='•~ {MPSI •;, _ • • • • _• • I al/ Seatbelt/Car Seat Use I JCSD I I I I I I I I I I I I I I I I I • Section 1: Personal & Family Health • Page 4 10-04-02 DRAFT IContent Areas I I Indicators 1 I Datasets I 4 Mental Health (death) I I Death Records J Substance Abuse* Tobacco Use I Suicide(hospitalizations) I CHARS I Mental Health Days 1••...' ------ ---- �' I "• Target 'Alcohol Use 44.;........ .•:+�'1 HYS I Drug Use F :j1� ~ .... BRFSS 2001 I (Tobacco Use • MPSI I 'School-based programs 1 I OESD 1 IChildren in Foster Care 1 ..,I DSHS J 1 Victims in Accepted Child Abuse Referrals 1. I I • I I 1 I I I I I I I * Section 1,page 8 for detailed substance abuse content areas Section 1: Personal & Family Health • Page 5 10-04-02 DRAFT Content Areas Indicators Datasets Morbidity& Leading Causes of Death Death Records Mortality —a4 ,ar,,,MMOMMatla CD Outbreaks PHIMS Bioterrism Motor Vehicle Deaths WTSC • Section 1: Personal & Family Health Page 6 10-04-02 DRAFT Content Areas Indicators Datasets b Risk& Predictive I Tobacco Use Behaviors Physical Activity '"' BRFSS 2001 Heavy Drinking Overweight • Quality of Life Risk/Predictive Self Reported Health Status .. , . .......... ... ..: :<.:. BRFSS 2001 Disability Physical/Mental Health Days Utilization of Public Recreation Facilities JCREC/ONP/USFS/PT • Section 1: Drug and Alcohol detail • Page 1 10-04-02 DRAFT Content Areas Indicators Datasets Consumption Youth Use HYS Adult Use BRFSS Syringes Exchanged SHARE Reporting System Liquor Licenses LCB J Liquor Sales Tobacco Retailers • • Section 1: Drug and Alcohol detail • Page 2 10-04-02 DRAFT Content Areas Indicators Datasets 4 b 4 Intervention & Adult Inpatient Outpatient Treatment Admissions TreatmentTarget Juvenile Inpatient Outpatient Treatment ----- Student Assistance Programs OESD Employee Assistance Programs Ill • Section 1: Drug and Alcohol detail • Page 3 10-04-02 DRAFT IContent Areas 1 Indicators Datasets b b Law&Justice t I Drug Arrests I I 1 URC Seizures I Customs/Coast Guard 1 IMeth Lab Clean-up I DOE 1 DUI Citations I 1 Law Enforcement I IDeferred Prosecution Tracking 1 I I IJuvenile Diversion I Juvenile A/D Arrests 1 GJJAC IJuvenile Property Crime Arrests Juvenile At-risk/Truancy IJuvenile Violent Crimes 1 i II I I I I I I I I I I I I I I I I I I I I I I • Section 1: Drug and Alcohol detail • Page 4 10-04-02 DRAFT Content Areas Indicators Datasets Morbidity HIV/AIDS Hepatitis CHARS Hospitalizations ""' Motor Vehicle Deaths WTSC Mortality Drug Deaths Coroner u Natural Causes VS • Section 2: Socio-economics • Page 1 10-04-02 DRAFT Content Areas Indicators Datasets Demographics Age Composition Life Expectancy "'" OFM/Census Population Growth School Enrollment OSPI Households w/w no children < 18 Census/BRFSS • I Section 2: Socio-economics • Page 2 10-04-02 DRAFT Content Areas Indicators Datasets Economics Transfer Incomes Poverty status Median Household Income OFM/Census Median Wage Living Arrangements of Children Low Income Service Utilization* DSHS/OSPI Births to Single Mothers Birth Certificate/MPSI Property Tax Exemption JC Assessor • *Food Stamps, TANF, Reduced/Free school meals • Section 2: Socio-economics • Page 3 10-04-02 DRAFT IContent Areas I Indicators I Datasets Education Educational Attainment Birth Certificate/MPSI/ School Enrollment BRFSS/Census WASUITBS Scores I OSPI High School Drop out rates Special Ed.Services College Enrollment I Colleges& Universities I I I I I I I • J I I I I • Section 2: Socio-economics • Page 4 10-04-02 DRAFT Content Areas Indicators Datasets Employment 5 Unemployment Rate ESD Businesses Licenses OFM • Housing 1 Median House Sales Price WSU CRER First time affordability Renter Occupied Housing OFM/Census • • Section 2: Socio-economics • Page 5 10-04-02 DRAFT Content Areas Indicators Datasets Law&Justice Property Crimes Violent Crimes UCR • RNifE:kE wa:^.:". lCYa Vii. Domestic Violence • Social & Arts& Leisure Community Support Utilization of Public Recreation Senior Utilization of college classes Senior meals Section 3: Environmental Health • Page 1 10-04-02 DRAFT Content Areas Indicators Datasets Environmental Indoor Air Quality Health Water Quality Outdoor Air Quality Home Heat Source BRFSS Sewage Disposal Solid Waste Disposal Respiratory related illnesses CHARS/School Nursing Utilization of Hazardous Waste Public Works Utilization of Recycling Facilities Annual Reports • Utilization of Solid Waste Facilities • Section 3: Environmental Health • Page 2 10-04-02 DRAFT Content Areas Indicators Datasets Natural Water Quality Resources Water Quantity Recreational Venues Miles of trails Utilization of trails • • ' • f 0 0) 0) 0) 0) 0) 0) 0) 0) 0) 0) 0) C C CC C C C C C C C O 0 0 0 0 0 0 0 0 0 0 c c c C C C C C 0 0 0 0 0 0 0 0 0 0 0 I U O •E z 8 .5 o i5 0 D V c au') '> L 03L- -1 vi Y O -so cui O CDw0 W c Cl)c I- a) c ) c I"" La o ) 1— 1— a0) Z Z c c a) C }• E Q 0 Lu w 0 Cl) 3 � (1) O ami -C � U L O -O C • ‘..- u) Oo o L O o Q c - L' c�i) > o I- ate) II . a ni O c M Z � —� > oo c U n c z J E Q c ca I - \a CD o O o as O < OL O >c .O -0 E Q.. -O >, Z2 Ua) Ci)) Co ,-,LLI O = o o a) C p0 c Q o D >, I co C o ce o c >, Z u) 0 u2 c 0 U T. O o >, c -) 0 >, c wp .> C a) E o C 0 ui a o o > o z C C O a) - ii— p 4- C •O '- -) I 0 >, aa) a) c O o Z c Co o Q Z o � -O - 0- m oLLJ > c co o E M (112 C >' Co a) O Da) 0 o d p 0 C C 0 N N " O LLoY Z 0m > cf) E. Q a 5• ro i U C O Z O O C L -Fn. W O O N C -o �_ E oO v p -0 •J N N CO (� U 2 -.2 Cl)vN! 0 C CII 0 < a) Q C 0 C CB Q LL -0 O w C -0 CO Co Co )- Co C C C c6 ~ W ccu U = U -t Q 73 � 0 aa) 2 > E Z . Q= C a) = Q_1 Q Q O -o W O O U ca 0 - I O -) O .2 -o U C a) Co a) .> O -) a) ) 5 a) W > 0 > > iii CD 0 0 " 0 D a_ 00 0 a) 0- 0 Q I- r- cv _6 b -a ai N ai o o -6 ai ,.. • ~ Q • E cm 0) as 0) 0) 0) 0) Cc C c C C C C 0 0 0 •0 0 0 0 0 E. 0) 0) c C C C C C C m 0 0 0 0 0 0 0 z Oz D W Cl) JY O N > 0 U (a W > C " ZZ E J E 6 w W 0 03 D � 0 • — t 0 0 o Q > • W J N :c C 0 U) W C ,_ CB aE) C (n nIS = O o _CU >-QON U a) Zu co 0 C Z F— CO0 z Q. co 4) 0D W o a) z W a) U L o_ 1— o a a) c 0 0 (a 4- (n 0 o a 0 _ a (n _ cn U ~ C I C D m -� o Wo E ca 2 '-'- z E 0) U o ) rido LL_ as U a) o 0 O E a`) Z �• 0 a) o a U) U)) U 1— o C Z co Q re o o, _ a C -o L -C Q a) LJJ u) o v aa, 0 c •Q' .� C cci _ c as H O c = O Q C J c0 •C Q � a) 0 (4 -0 = (Ti Z '° E z Q ID LL .0 ((U 0 " -o C t � ++ L 0 0 co - Ct. C 0 CD o -cri Q Q Q Q a• = > w > 8 Q }- 0 < o • -Z-iiTA as s c • C .c is a) L N LI co pa) UtoEaoo- , o CI ZE ° ZN U Q) ~ cU as E N of I m" _...co • 0)a2 . o• o_ O 0 .-, as co 1 .� a) Q_ N 1.1J 0 0 a) . 6 cEli C p N 0 pn. o • NO . _c 0)U . a C > E cu UcC ci o a)i " N cti) UO 8oa 0) oTN i • ai y n • = p a) a +3 ? (7) N ' •L .E `C .�' L .0 .0 15 15 15 N 0) N O i - 0 N O p i • Eas U C N N CasO a) ct3 U) Cl) O V a) p , O0 a) 0) N it 0 > U )0 ea N a) N ca co- co E C , ca E N O '65 N Q) O a) C o OI «� LU in p N EO U O p c6 cn a`) U N U ,� .a Q a) a) CI E a) E a) _ z V W Q) 0 o cv a) C C > U N co@ �� o O L C w- v— C U .. U) N N E as o . •� .� .r cvcLaocc �w � Q � � . NQ — 00 CD 3 if) 0 o Q 3 0 ,o ca a) Q o .. C 0 o c� E E C = O > N L ++ C a) = N N `. = U -c E N O a) Q z v Y p .c_ a) U ... Il o CIS a) aa) U U U 7 a) _ co_U U C _ � .� �� ` _ QNB E C a 0 ° N a) >, ) E :>' o = U �_ a) -a) .� a) E . N0U) QI a) oa) ca N _ E >.- D H a) ° p Q a) a) a) ' a) en a N U) a) a' _ a) = o o L a) L _ g Q3 tl 0 C o p 0- L D `n .N N c ate) w_ ° m u o L > aa) a) IX ii a) O mCO s Q c _ 65 o O c � C J 0 C a) -c o C o o a) o = iu o o (n ca C 0 a) 17) o L C N O 0 a) 0 C 0 O a) C N W w •- Z \ C W L a Q 0co ` > Q L "O vO a' E E L C >- O L C CKO U .0 v 4- p 3 Z1-10 Cl) •_,-� N 0 Eco rs _c 0 I] a)cW coo m >, N O a) U o a. O .0 o W Q E m ,' ci) C 0 co 0 0 0 Q 0 Q > rn 4- N N C p C a) >+ U E a) N -c — U) p N U) W Y E O , ' Ill CI i Q) o = a) ? "— > W ca 0 >, N O Q Q E N p Q u_ I ix 0OLLQ5u_ W 2 Q � U) 0) 22Q0] --IOD0) 2t2d _chaQ CDC C) LL I CLD H U IYI < OLUOW0) -� } 000IYUWawu- Z � - H2 cu0cntncn - U c W < O0Oin000W 0 = 2 � -) - --) JJ00001 tlU) H33D > 555 > al as 9 1 = Qa 0 0 00 0 0 0 000 0 00 0 0 0 0 I- � Q00000000000 00000000 00000 00000 °' QQz00000000000000000000 00000000000 Y • Board of Health New Business Agenda Item # V., 3 National Smallpox Vaccination Plan • October 17, 2002 • f CDC SMALLPDX INFORMATION ON LIVE VIRUS VACCINES AND VACCINIA The vaccinia virus is the "live virus"used in the smallpox vaccine. It is a "pox"-type virus related to smallpox. When given to humans as a vaccine, it helps the body to develop immunity to smallpox. The smallpox vaccine does not contain the smallpox virus. What is a "live virus"vaccine? • A"live virus" vaccine is a vaccine that contains a "living"virus that is able to give and produce immunity, usually without causing illness. • Because the virus in the vaccine is live, it can be transmitted to other parts of the body or to other people. • For most people with healthy immune systems, live virus vaccines are effective and safe. • Sometimes a person getting a live vaccine has mild symptoms of the virus in the vaccine. • Other live virus vaccines used in the United States include measles, mumps, rubella, and chickenpox. IDFacts about Vaccinia •The vaccinia virus,the virus in the smallpox vaccine, is another"pox"-type virus. • The vaccinia virus may cause rash, fever, and head and body aches. In certain groups of people, complications from the vaccinia virus can be severe. Who Should NOT Get the Smallpox Vaccine? • The smallpox vaccine is not recommended for people who have weakened immune systems, including people with leukemia or human immunodeficiency virus (HIV) infection or people undergoing treatment with certain drugs or with certain skin conditions. In rare cases, people who fall into these groups can have serious complications from the vaccine. • Individuals in any of these groups, should not get the smallpox vaccine unless they are exposed to the smallpox virus. • Individuals in close contact with people who fall into any of these groups should not get the smallpox unless they have been exposed to the smallpox virus. For more information, visit www.cdc.gov/smallpox, or call the CDC public response hotline at(888) 246-2675 (English), (888) 246-2857 (Espanol), or(866) 874-2646 (TTY). October 5, 2002 • DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION SAFER•HEALTHIER-PEOPLE°'. / SMALLPDX VACCINE OVERVIEW The Smallpox Vaccine The smallpox vaccine is the only way to prevent smallpox infection. The vaccine is made from a virus called vaccinia which is another"pox"-type virus related to smallpox. The smallpox vaccine helps the body develop immunity to smallpox. It contains the "live"vaccinia virus not dead virus like many other vaccines. For that reason,the vaccination site must be cared for carefully to prevent the virus from spreading. Also, the vaccine can have side effects (see below). The vaccine does not contain the smallpox virus and cannot give you smallpox. Currently, the United States has a big enough stockpile of smallpox vaccine to vaccinate all Americans in an emergency. Production of new vaccine is underway. Length of protection Past experience indicates that the first dose of the vaccine offers protection from smallpox for three to five years, and sometimes as long as 10 years or more. If a person is vaccinated again later, immunity lasts even longer. Historically,the vaccine has been effective in preventing smallpox infection in 95 percent of those vaccinated. In addition,the vaccine was proven to prevent or severely lessen infection when given within a few days of exposure. It is important to note, however, that at the time when the smallpox vaccine was used to eradicate the disease, testing was not as advanced or precise as it is today, so there may still be things to learn about the vaccine and its effectiveness and length of protection. Receiving the vaccine The smallpox vaccine is not given with a normal hypodermic needle. It is not a shot as most people have experienced. The vaccine is given using a bifurcated (two-pronged) needle that is dipped into and holds a droplet of the vaccine.The needle is used to poke the skin about 15 times in a few seconds. The poking is not deep, but it will cause a sore spot and one or two droplets of blood to form. The vaccine can be administered in the upper arm, or on the thigh. If the vaccination is successful, a red and itchy bump will develop at the vaccine site in three or four days. In a week,the bump becomes a large blister and fills with pus and begins to drain. During week two, the blister begins to dry up and a scab forms. The scab falls off in the third week, leaving a small scar. People who are being vaccinated for the first time have a stronger reaction than those who are being revaccinated. The following pictures show the progression of the site where the vaccine is given. . DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION SAFER•HEALTHIER•PEOPLE • Smallpox vaccination site Days 4 through 21 g Ste{ Post-vaccination care After the vaccine is given, it is very important to follow instructions to care for the site of the vaccine. Because the virus is "live," it can spread to other parts of your body, or even to other people. The vaccinia virus (the live virus in the smallpox vaccine) may cause rash, fever and head and body aches. In certain groups of people (see below), complications from the vaccinia virus can be severe. Benefit of vaccine following exposure Vaccination within 3 days of exposure will completely prevent or significantly modify smallpox in the vast majority of persons. Vaccination 4 to 7days after exposure will also likely offer some protection io from disease or modify severity of disease. Smallpox vaccine safety The smallpox vaccine is the best protection you can get if you are exposed to the smallpox virus; however,the vaccine does have some risks. People most likely to have side effects are: women who are pregnant; people who have now, or have ever had, skin conditions, (especially eczema); and, people with weakened immune systems, such as those who have received a transplant, are HIV positive, or are receiving treatment for cancer. Historically, rates of complication for people receiving the vaccine for the first time are such that for every 1 million people who receive the vaccine, about 15 will have life threatening side effects. The death rate is about 1 or 2 persons per 1 million people vaccinated. Smallpox vaccine availability Routine vaccination of the American public against smallpox stopped in 1972 after the disease was eradicated in the United States. Until recently, the U.S. Government provided the smallpox vaccine only to a few hundred scientists and medical professionals who worked with smallpox and similar viruses in a research setting. DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION SAFER•HEALTHIER•PEOPLE" After the events of September and October, 2001, however, the U.S. Government took further actions to improve its level of preparedness against terrorism. One of many such measures - designed specifically to prepare for an intentional release of the smallpox virus - included updating and releasing a smallpox response plan. In addition,the U.S. Government ordered production of enough smallpox vaccine to immunize the American public in the event of smallpox outbreak. In the event of smallpox outbreak the U.S. Government has prepared emergency guidelines to quickly vaccinate and contain a smallpox epidemic. The government policy for pre-event vaccination is under consideration, but as of October 4, 2002, no decision has been made. S For more information, visit www.cdc_gov/smallpox, or call the CDC public response hotline at(888) 246-2675 (English), (888) 246-2857 (Espanol), or(866) 874-2646 (TTY). October 5, 2002 DEPARTMENT OF' HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION SAFER.HEALTHIER•PEOPLE' • Board of Health New Business Agenda Item # V. , 4 Public Health Funding Reform: • A Progress Report October 17, 2002 • WSPHA Draft Policy Resolution- 10/3/02 Public Health Funding for a Safer, Healthier Washington IIP hereas, the people of Washington State expect, deserve p and require a safe and healthy Washington where essential programs improve health, with information that works to protect everybody every day from disease and injury, environmental threats and impacts from potential biological, chemical and nuclear terrorist threats, and Whereas, the general welfare, business and economic climate, and societal stability of the State of Washington is dependent upon protection from these same threats, and Whereas, the 2000 Public Health Improvement Plan for Washington State set as a goal "Stable and sufficient financing for Public Health", and Whereas, Washington State's public health services are integral to the state's health system, providing essential communicable disease control services, epidemiological functions, emergency response capabilities, health promotion and education services, and environmental health protection, and Whereas, public health services such as control of vaccine-preventable and other communicable diseases, maternal and child health home visits, protection of food, water, soil and air from contamination and promotion of safe disposal of hazardous wastes are among the most cost-effective programs ever devised, and Whereas, national, state, and local health systems are experiencing an unprecedented demand for rapid development of biological, chemical and nuclear response systems, protection from emerging infectious isease epidemics, control of antibiotic-resistant bacterial infections, and hereas, effective provision of the above services requires long-term investments in science-based disease surveillance, prevention and control capabilities, information systems, and a highly skilled and regularly trained professional workforce, and Whereas, the use of recent federal funding for the development of an emergency response system does not provide support for other basic and essential public health services, and . Whereas, the state's public health system is precariously funded by a non-stable mix of funds vulnerable to the effects of economic recession, political changes and intense competition with other governmental programs, and Whereas, in the face of critical health threats, high unemployment, expanding public health needs, and growing problems with access to essential health services, local governments in both urban and rural areas throughout the State are under intense budgetary pressures leading, in some cases, to dismantling or severe constriction of local public health programs, and Whereas, loss of essential public health services at a time when the need for them grows ever more critical will inevitably cause an increased burden of preventable disease for medical care providers, increase the costs of medical care by cost shifting for the care of the uninsured and further strain an already over-burdened system for providing health care access to low-income populations, oerefore be it resolved that the Washington State Public Health Association supports enactment a stable, sufficient, dedicated and equitable public health funding source to support essential public health services that are always working for a safer and healthier Washington for every man, woman and child who lives, works and recreates in Washington State, wherever that may be. • Board of Health New Business Agenda Item # V., 5 West Nile Virus • Response Planning October 17, 2002 s West Nile Virus Page 1 of 2 (7COMITY, � West Nile Health se., ce' West Nile Virus Soon to Become a Reality in Washington State West Nile Virus Tom Locke, MD, MPH, Clallam County Health Officer West Nile Virus(WNV) is named for the West Nile district of Uganda where it wq first discovered in 1937. It belongs to a family of viruses that can cause illness in humans, horses, birds, and other "vertebrate" animals. In the past decade, WNV h been expanding to Europe, Asia, and the South Pacific. In 1999 the virus made its appearance in North America, causing an outbreak that resulted in 62 know cases deaths in New York City. Since this time, the virus has been spreading relentless13 across the United States. As of September 16, 2002, 1,460 cases of the illness hav been reported for the year including 66 fatalities. The virus has been detected in 4 different states. The first case of WNV infection in Washington was diagnosed in August of this year in a traveler who appears to have acquired the infection in Louisiana. Bird species, especially "corvids" (ravens, crows,jays, and magpies) are the princil target of this infection. Humans and horses are also at risk for developing serious illness. Mosquitoes serve as the "vector" which transmits the viral infection from( • animal to another. Human to human transmission, or direct transmission from an infected animal to a human appears to be very rare and require extreme circumsta such as organ transplantation. Most people who develop WNV infection experien only mild, flu-like symptoms lasting several days. A small percentage of WNV infections will, however, progress to a life-threatening brain infection(`encephalitis Muscle pain and weakness are also predominate symptoms in WNV infection with residual weakness persisting for over a year in up to 50% of cases. People over th of 50 are at increased risk for the serious complications of WNV infection. The progression of WNV across the United States is unstoppable. If the infection to make its unwelcome arrival to Washington state this year, it is almost certain it become established by 2003. What can we do to protect ourselves and our familie As with most viral infections, PREVENTION is the name of the game. Preventioi WNV starts with educating ourselves about the infection and its symptoms. Preve mosquito bites is a very effective way to avoid infections spread by these annoying insects. Helpful tips are available at the Web Sites listed below. And finally, it is important to realize that WNV is but one of many global infectious disease threats must confront. Advances in transportation, international trade, and leisure travel 1- made virtually every corner of the world accessible in less than a days time. Disea, causing microorganisms have also become global travelers. In the final analysis, it only a strong, effective public health system that stands between each of us and the disturbing array of microbes that can rob us of our health and, sometimes, our live • Washington State West Nile Virus Web Page http.//www.doh wa ovlehpits/Zoo/WNVAV V html http://www.clallam.net/HealthServices/html/hhs topic_westnile.htm 10/10/02 West Nile Virus rage 1 ui LI 0 � 3 '1.* ;.mac ' * ea t Office o Eaviranmentaillealth Programs. f EnvIro r= Safes You are here:DOH Home * EHP * EHS * Zoonotic Disease Program *West Nile Virus Search I Employees ite IDt;ector We:- V? JS • Zoonotic Disease What was expected has arrived...West Nile virus Prgram West Nile virus,which has been steadily spreading across the United • EHS Home States, has reached Washington. A raven collected in Pend Oreille County as part of a statewide dead bird surveillance effort tested positive for the • EHS Publications virus—the first detection of West Nile virus in our state. Currently,we • EH }eiated Sites have received no reports of human or horse cases. Transmitted by mosquito bites to humans, the virus has proven itself a public health threat. As of October 7, 2,736 cases of the illness have been reported to the Centers for Disease Control and Prevention for this year, including • Find your local.health 146 fatalities. department The Washington State Department of Health coordinates surveillance • Free AcrobatReader®to throughout the state for the virus and mosquitoes that potentially carry v iew_pdf files the virus. However, all of Washington residents can help prevent • Alternate File Format outbreaks. Below are tools, resources, and information for the general . Information public, health care providers, veterinarians, local health departments, and mosquito control districts. • Learn more about Environmental Health Latest News_Dead bird surveillance work detects West Nile virus in Washington. Programs Et Services , : Ali nfor-ratiof for the P West Nile Virus Q&A Answers to common questions about West Nile virus and what's being done in Washington. Mosquitoes - Take the Bite Out of the Bug! Tips on protecting yourself against mosquito bites and possible contact with diseases they can carry. Mosquito Problems Start at Home Simple steps you can take to reduce the number of mosquitoes around your home. • The Buzz-z-z-z on West Nile Virus,Centers for Disease Control and Prevention Kids can read the latest in Disease Detectives- Trackin'& Case Crackin' at CDC. Here, they will learn about West Nile virus and http://www.doh.wa.gov/ehp/ts/Zoo/WNV/WNV.html 10/10/02 West Nile Virus Page 2 of4 ways to protect themselves. • How Do I Report a Dead Bird? Reporting of dead birds can help detect the presence of West Nile virus in your community. Here is how you can place a report. How to Use Insect Repellants SafejyU_S_Environmental Protection Agency Environmental Protection Agency's (EPA)recommendations on how to select and apply insect repellents. EPA and Mosquito Control U.S. Environmental Protection Agency EPA's information about pesticides used to control mosquitoes. News Releases on West Nile Virus Department of Health's news releases regarding West Nile virus. hif r ;at cn for Physicians Veterinarians Information for Health Care Providers on West Nile Virus General information on West Nile virus for health care providers. How to Report Suspected Cases of West Nile Virus Disease and Submit CIinical Specimens for Laboratory Testi • Physicians are now required to report unexplained critical illness or death of potential infectious etiology. Reporting this condition will aid in the surveillance of new and emerging infectious disease, such as West Nile virus. Clinical Guidance, Centers for Disease Control and Prevention CDC offers health and public health professionals West Nile virus- related clinical information and guidance. Insect Repellents Containing DEET, U.S. Environmental Protection Agency Information on EPA's action concerning DEET,which is used in many insect repellents. Information for Veterinarians on West Nile Virus Veterinarians are encouraged to report cases of equine encephalitis and to vaccinate horses prior to the arrival of West Nile virus in our state. Preventionnfcrmatm and ControlIof ealth West Nile VJertsdlctions Eirus InfectionMosalu�tc in Equine and Other Livestock or Poultry, U.S. Department of Agricutlure USDA's recommendations on reducing exposure to West Nile virus in horses, poultry,and other livestock. • �.�at�ct Districts http://www.doh.wa.gov/ehp/ts/Zoo/WNV/WNV.html 10/10/02 w est mire virus Page 3 of 4 Insect Repellents.Containing DEET U.S. Environmental Protection Agency Information on EPA's action concerning the DEET which is used in many insect repellents. Pesticides and Toxicology,National Pesticide Information Center National Pesticide Information Center,West Nile Virus Resource Guide section on health concerns about insect repellents and insecticide used to control mosquitoes. Clinical Guidance, Centers for Disease Control and Prevention CDC offers health and public health professionals West Nile virus- related clinical information and guidance. Surveillance Information Et Tools West Nile Virus Surveillance in Washington, January 2002 Report Findings of the 2000 and 2001 West Nile virus surveillance activities in Washington. Mosquito Trapping Reporting Form Reporting form used to track mosquito trapping events. Dead Bird Reparting_Form Reporting form used to track dead bird events. Educational Materials Mosquitoes -Take the Out of the Bug! Camera-ready art for a tri-fold brochure on protecting against mosquito-borne disease through bite prevention and habitat reduction. Mosquito Problems Start at Home Camera-ready art for a bookmark, 8" x 11" flyer, and 11" x 17" poster addressing steps on reducing mosquito habitat around your home. Web Resources America Mosquito Control Association Centers for Disease Control and Prevention, Arboviral Encephalitides Centers for Disease Control and Prevention, NIOSH Update- Ways to Avoid West Nile Virus Risk in Outdoor Work Centers for Disease Control and Prevention West Nile Virus Cornell University, What Going on with the West Nile Virus? National Pesticide Information Center, West Nile Virus Resource Guide Northwest_Mosquito and Vector Control Association US Department of Agriculture,West Nile Virus US Environmental Protection Agency,EPA and Mosquito Control • US Geological Survey,National Wildlife Health Center West Nile Virus Project http://www.doh.wa.gov/ehp/ts/Zoo/WNV/WNV.html 10/10/02 • Board of Health Media Report • October 17, 2002 r Jefferson County Health and Human Services SEPTEMBER — OCTOBER 2002 NEWS ARTICLES 1. "If terrorism strikes,we'll get popular", Peninsula Daily News, September 15, 2002 2. "County stuck in budget malaise", Peninsula Daily News, September 24, 2002 3. "County's draft budget proposes 1% increase in property tax revenue",P.T. LEADER, September 25, 2002 4. "AIDS Walk focuses on teens", P.T. LEADER, September 25, 2002 5. "County adopts saltwater rules", P.T. LEADER, September 25, 2002 6. "SOS is working for environment", P.T. LEADER, September 25, 2002 7. "Fewer young offenders facing court", Peninsula Daily News, October 1, 2002 • 8. "Plan B prevents unwanted pregnancy', P.T. LEADER, October 2, 2002 9. "County sponsors septic workshops", P.T. LEADER, October 2, 2002 10. "County's flu shot clinics lost with budget cut",P.T. LEADER, October 2, 2002 11. "Jamestown tribe to build dental clinic open to all', Peninsula Daily News, October 3, 2002 12. "West Nile Virus confirmed in state", Peninsula Daily News, October 3, 2002 13. "County budget hearings help commissioners decide direction", P.T. LEADER, October 9, 2002 14. "Flu clinics are ready", P.T. LEADER, October 9, 2002 11 0 0 ca Gt« a N y bna' . 0 -10 y �� ' [ ,0•o: ° aai w�i 0 C n'- c. r-, O a) Ti )•^a O^a' >, •.� m-g a, C y4• 2 4:' O H M"p • w w °� � o °y ›,m N aGOi p � 7 0 �' qg,a• 0••tv4 o. m e• m oy'- 3 -,— a E a) Oaa' 0 ti w 0 www 3 04 x o. tr w 0 by �,O o 3Aa 0 � 0 X7 0 0 g rpt a' o 0-0,-4 ;� E 0 0 0 .a+� m o 0 a g bo a 5 2^0 Q• o o �= m > 3a �a3 a) • aR w a� ° ° q^' a) a> c.•.. a� a1 >',a O O N ,.�., `.9 b N .0 0 -0 49, oc0 q .a w a tri'11.a o cyoo ° ° 0 v >... a2 .,, m > '' 3 0 .w d 0 .c��° w m > o o y a �. R y ,Q, +� O G, h0� w q„d'�"" +'�Y+ q�'4" i'' � c�cf V�'� yN., �n"'��i a) ya m �" 32 E C › , gs E., >, a, > u, �, m • .0 w o'ti x o a) 0 v U1 q...'H a!�a ,� O .Sa O a) a� C F >,q.�!'cn FJ O bD C .4 L.,� a s -o❑'d 0:^1 o E� q`a. °-:"ci;i Tj aS 0. o cd u).- 8,,.o. � +g•O coo d o C� O 8 ca a>) •[ ETH 0 `),-_ 3 03 ., w w 0 • E 8 V S�5 V ^o o,acp � -c,-)-- '88 cii JiHIhhJJWfl wUbym„, A g ti u� 9c •0 4 co o V c�0� ti 4O.a''1B G.� ` >o t. m.b a+'vi t,-I, a) a ,48 � �_ W a)Op0^. ,> w ga .'Soap o.-0 o 0 r, ,_ pg ' % o� ob w ca • o n a c 0oo,oa Wo•• ' Oy� . 0z u ." a o ° y�a^' a `�• 'Ll t+ oa°)•�c•• Z O O UHThJflM O Nai a)�u�.,o a� � DC7 > a � t ° ti a) 8,E 0 co EH O O a) d a a ° w • bD-` o ° �� xN dui o > 0V p�0- o w > 0 0 ,-. y c by Otiw ! ,i. P" Zo F•, 0 2 .8' o ` 0.5o o ,- ,, 3 Q r"� —� - .a 0 boo pb 0 ° bA o 3 0 o g 2 3 E v'6n°4 t-g W W d a)•a ti `O •07 &m 14 v o � U as .. a�.)1 v.- 000oN•E '' qUo ,o > a 3 0 n 4 a) Ci 0 Hs 0,4 aa. �,, O... ..O 0 ici. +.t%,O. 0 G -..c).--..- N c u� Uj -.7.17$ O'.° 0 4/1 E+ a o oFb �' a o•° o q� oa.. ON a, a ... q ° fA a e,E' O 8 .2 0 0 00 og Ns t F3 a °E-+ *) 0E•''oWA yO :'4 C a ....1 W ° ma a' .' % t, a °a3 ° G� wb �� w° a) o ' ie., •riat' g 1-61 t 11111P- (10) ill cr1I \1 0 sem, ..4 a� t°. o a> a) o °° ti - ""4 �L,/ �' "d p..',t^,'. O b : t 0 0.4 zi t. O [ oO0= u •5oo C9a 0a,) ��49 ��o'a y _v4 �o° � ,.^ c0• a•ti ,�� ai 1 .. _. b.2,-. 0vi.ti,-, P ,, m +., w Yi LI N y'a0""' o y.-.m aa,pay w C ll;1 !ju 6)3 'Ar^ +•' � 0�3) d �' . .�vJ 0oQj > 3 ro a)° 3 ,-ti3W.tio .c 41,)- . a ' f~ o . a, t / �i�/ • .. .„ tioboo�"00 W _ .-, aa. 8 C: � 30� 00 o? �r` d �v �3tibm du a' o., " > a o . GLA q9 3 o ° p� 0 A c c0 0,-,+-. 0 }}�� C0g w.00aCao0' C aa0i3.kto) atio,o d t.• to O q t, ..a7 v, p Q)�" c max. d •'t' a) ° o e' 0 .a•'TJ ,..,..>;-,1 > gE" o'o— 04' o c ra ro�F O °' Y m ca E • °� v a°na o ami°'m.�o d y m a 0 3 O 0- q 0 _ ;...—i c .... J a,,,, N a,' 4 byA.+� �. ill E -4.--) >, ... a) , ,,:„ co a o a) m o o y y o ro m °a' o o O o > wow N �•^ y-_q ate' .O -� a• a' y ..�,b :+' 0 0 .a a,, +Q a^vi• g g O .5., o m o ° a y b v > +� o p +� a) o eds9 �.a..a > >, a'j � ° 0, 3'E30 4tja00 "i 3 .) a 4 � q cd �,� t, pq •n Om�;;.� a9 � o� .b .n Ow > o. by >. 0"roq~ p O fo„'ate' ° O CD i0+ ,' b• w a)'°'C1 a pa.a s. g O ,-. O bD a -. m a A � g0'"-' ooau,, > a' ro80; . a ° a,�) 0 a) tiaa 0 a) bp 0Fa y� a) .a rov > . 0m0civa' ao U,a O 00Cca °w bp-, °=' 3 ° at u;.. '.-' ..+N o N O tai°W 0 Fes. a a) O °+' 'tn'al`..w•, Vi O F ;..0 a) `" y 0'y 0'L7'C7 V m c� a) k Q 0 �� m uro " at°' o N aa) ba °b q pp .� � '�U+ a m a7.b an O p a0-, a! m,c1(1)-@,,_,a,-0,4a) m m E Mq a w D a m c) ° g a ao > ocga3a) a),a '' O • k5.5. 8- E0 ° gaio0 0 �'ao ° °'t7 >,a0 J 10 o :.c a,, t4•0,_0 a a.> aa'o 0 El q 0 a' a m'S-0 v a ■7 .5%,„c,, 0.o-•. ° c8 ca•4 ,_•, y C 173 a)a., N a.' t ..., g X ow t° a) o 40'° 7-, o ° Calf/ o w 3 a� m� a� a .� g.•a. .a a3 0 y V J w� 0 3 U) Ca Q'^ v�'b •�• .n a'o to°p c� >,apps ° vagi - baa +' I m moma7 ,, k r`''n �'S oam• marl ohm,.,..., ca ot,� aat. 0 0 .aaa 0 5..o 49, F, � t°).�°.�V oo � 0 �ncyo 'a cd a" CDt t a'� a 3a2 m La4� '' �,no o y. aS ° o GN b I1JI ° ao U dojo SUit •.s s ,e y 4pOpojNW O nJ� '� a I a °bp�� au - � �CD a P-40 ^. ° 8co a aa�� o0,2 o . ao5,,,- ,.gE w V .ca . 00 tqt °• a � ` Oga1 � '" mep� a, d o z m+ m ° '- p o a) > ana' OoF q� a a a r �•^ Tom• k z oo a`a 9 t tib t0 0 o w 0 y imm:,,- d m a)--S 0 0,2 O +' w o o � O O a, �" O I I 4 d A>i i., �'+ y , �� U o a) ��-3 a_' ado � a)w•U a' N,1]ag ,-.4:, ) � d• ,i1U `„ t, a °^g `ate N+'.St,' a) 0ft ° om OI > �' 8?? 0• ti �i ° q °� 6 E; y 'D �' a° rn ,Liommi °.,. o aa' a) o a, a o y qE • a 124 0 3aS) 001 ° ycci, .o °. tcd mwa' � wo +� mo ,. •.». t.+�., 44 �� 0� I � O `a t, xat. O0-0 aw a' p g m A o a9 0 o " 0 O 4:. 0 0 0 0.� ° o .bt~,.r N� ca a v•4' to � � t0. >,O E~ T1.`C'' �''�o � > °,a0 O y >,a 1 a° a)•3 a •-d'�-' W . ° 3�„ p,ob9 ti 0 ,-,9� h � o ��'��3 t y� � il,e i.9. rn0 a.•2..-a' mC 0 a� p ° ° gq q a, 0-:^ti y p d p LL o C.[ 0w �+ rO $..4 Ow $ U m caw a $n o $ p s CF�.C.n 3 }c., a 3 Fo Y A ..—,_.. o C d 0..D ow o m`"mo' ti,..,_.„ 2. _.„ „„ro ° ,T y ° c ) C E-.6 ° ° °i u a V a.' •Ti •. `+•� c0 cO p O U CLC m 0 7 O•� o`? O iy a.. - b9 00• a C _ 0 y.... p Q 0 v 1 4, �{ T O p d V y 0.b a c— C '4i t.}'..a, O U.� oSo > a Vw �? ° `9 °�'4 0,°c °��° owwxx oT'y d 0 -p-E...-E m a "' m O 0 .4 g m � a• b0•O �. O7m •.4---' OoEEw ya ( mo Q) fiqdm 00-0UUE.- { y '3",'Z' y. ° o _s'Z, qTo w3..- m u m UY ti P.O .: G O O w m O w V � . pk241 V (1) � Y0t. COyto2ut .qCoE3� � —) E q 0 "g 2t d wa Y 2-p E E acj Q 5.. aTix o w 7:'g so**c%°-, Caw b• Rpozl w , L q C•-� vic's 0 CU v---i 7,,.0 fii 0 3 � Ecai �,� y o _ Yro ° 3-,2_omd gqa . 00 V qE Z • U CI3 .C14 0, 0000 — = -z-5 0 ›< ,„ 0 . 0 , v 0 fiox 4 d o¢.x m mmid; d.SF. 0w os. m t6› O N T 1 E VD-0.,,,.. ,,:a, E Om E • .lila a � E , O'" dE7ooI. 0m (5C � , aO1. O 2g .w° N3w , p ti .0 Oy 00 Vh•Um y a0 - gG E"-. Vw"m m T .4." a E.m •V w O,Z)-2 V pNoY co O'.V'TC O m yT _7. 2 ww u [mla � 6_411, sTioVoO O-i oa Y ?' ':w AyV. V0 p.° ' OuOoo.nv >,,T, c4r. " ..cita � 0 > .2aYm ' ,9 gap P OO [a 0.VaGYIdY .m: E ' E E' " amm °-F, t-). .D �o 0 t �V ,0 E y ;vw a .z _ mi t3,, 0 .-—a p..„„ b0• 3;ap0" 00 g o A4 a 'om to'q.cs omU ° o_ m. oT7oE ' 3W :v3^ CyO aE - . EA? L 0 (11) = amg. .❑ oQ ,.x O - Y u x s u 0 w"gt..^ 0.tQ. p0.0' .VO 7 ..Y00V 0 t. 3V W"' Y aa•^ V.0T p m'D � _ ov3gYE ' a00oa 3m°73 - . dY,o a Td 'O0Ta $ a�fao '' 0• v a,I', oo�. SQ.m'g ). :5 "47:.. yada3� = a- E $ 4.v• aEyo. > m 0- oE� muc m ° F� a0m '' Y - C0--013.,,c U. 0a0ro ° °' on. w.26-4 o w 'x � 8-.9 ,„gFa � q'�> pm0qmUa )a Q.Es .Eoau. 4010 0:1 • m o a s m ami >l c. t'c 0 9.'C �a E - Ye ov E m {-. , y t. y y j „ EE ,, W 1 A 7 A ° y .d V .-E U V flIth 3d°c e. m3 i yE ° V3 � q0. V a .0 OO E AD`W-' L v c V°.� oil l igL •N d C3 2 7 " yy8 v F N C e C E ani C C] E wav � 5. E�o .x r.�m 'E y inii N om °1 _ 171 0 CD• O N E.0 � s ,dm m, cc.8 °t ya a .,._( 820 z 0881, ma •(1) 1 0 ,(, A k b0 m V :1 L W •�+—•(-i r7 C �i�,� d ~N'1•V p8p t O _ - ...'7A �A a9 aV.N Q. (�+.J1,ci iV37gTEc' Q) . 81V:.2127 2 .1_, >-.`1 T 5 00� t' e .-,2 —Cain c c E E'c, 7 �V O ° yT � �n C o.0 m V 7 ea C C.' • ..."—( Q) nti 0 • i LI 4') ca� . � a 1 o CI) 713 = g =•,1 - t22-g, V V V 4 .§ie .2829dg Port Townsend bt Jefferson County Leader 7'�Jam` 0 County's draft budget o • 1 % proposes Increase • . in property tax revenue By Barney Burke for a 1 percent increase in prop- official position is to remain va- Leader Staff Writer erty tax revenues, according to cant, a plans examiner position Goldsmith. That works out to would be created, and an admin- Officially, Jefferson County's about$45,000,he explains. istrative assistant position,would preliminary budget for 2003 was Last year, the commissioners be restored in that department,the published on Monday,Sept. 23. voted against increasing property memo indicates. Trying to get a clear under- tax revenues. The actual Fib number was • standing of the county's overall Goldsmith confirmed that a 1 93.39 in 2000, 93.44 in 2001. In budget situation is another matter. percent increase in property tax 2002, the county originally bud- Available in the auditor's office revenues does not mean that ev- geted for 100.72 Ir'1'hs and later is a single public copy of a 2-inch- ery person's property tax bill is reduced that number to 89.72, thick,three-ring binder containing going up 1 percent.Tax bills are Goldsmith said. The draft 2003 organizational charts, mission also affected by the fluctuations in budgetcalls for 90.72 employees. statements, performance mea- the value of the entire tax base. Goldsmith's memo proposes a sures, and revenues and expendi- New property revenues gener- one-time$25,000 contract for an tures for each department. ated by development are not part economic development strategy Also available is a 257-page of the 1 percent revenue increase, and ombudsman services from the computer printout, again by de- Goldsmith noted. Jefferson County Economic De- • panment, showing line-item rev- velopment Council(EDC). enues and expenditures. Hearing scheduled Not included in the budget is But the"big picture,"the whole Public hearings on the budget the establishment of an enforce- enchilada, is hard to find. How are scheduled for 2 p.m.Monday, ment officer in community devel- rnuch for maintenance and opera- Oct. 7, and 11 a.m. and 2 p.m. opment. The current backlog of [ions altogether?Capital projects? Tuesday,Oct. 8. such cases has been mentioned at Where do all the revenues come Goldsmith said he would make recent meetings of the planning from, and what are the trends in sure that summary copies of the commission and board of commis- county revenues and expendi- budget are available to the public sioners. tures?Are taxes going up? prior to and during the hearings. The draft budget has $3 mil- Those questions can't be eas- Once the budget is adopted later lion in capital improvements, in- ily answered by the budget docu- this fall, a summary form of the eluding $40,000 to complete ments released so far. final budget will also be published, concrete work and other amenities A five-page transmittal memo he said. "That's a really good associated with a Rotary Club pro- from County Administrator David idea,"he agreed. posal for a pavilion in H.J.Carroll Goldsmith highlights some key Goldsmith's memo indicates Park, $75,000 for preparing a points in the draft budget but also that the $800,000 in budget cuts sewer plan for the Tri-Area and neglects to hazard a guess at the implemented in the middle of $57,000 to purchase an upgraded totals.Nor does the Sept.20 memo 2002 helped set the stage for a fingerprint machine for the say if an increase in property tax "balanced" 2003 budget with sheriff's office. revenues is recommended. "modest enhancements to address Goldsmith's memo identifies pressing operational needs." two policy issues in the budget. Budget, tax revenues up As drafted, the 2003 budget One is whether to use 1 percent of The total of expenditures in the restores a 4 percent:cut in em- the gas tax for regional trail main- draft 2003 budget, Goldsmith re- ployee compensation enacted this tenance,including the Larry Scott ported, is $38,914,433, up 2 per- year. However, a new labor con- Trail.The other is whether to bond • cent from the revised 2002 budget tract period in March 2003 and ris- for two capital improvements al- of$38,305,538. Most of that in- ing healthcare costs are going to ready under way: the sheriff ad- crease is for new road projects,he be an issue next year, according ministration building and E-911 explained. The general fund por- to Goldsmith. center, and the Castle Hill office tion of the total, $1 1,043,478, is It is proposed that one FTE complex.The real estate excise tax down 9 percent from the 2002 (full-time equivalent staff) be could be used for this purpose,and level. added to the community develop- inter st rates are historically low, As proposed, the budget calls mens department. The building according to Goldsmith. ICPort Townsend&Jefferson County Leader j • • f .0")'1 4 ; • '• • r; ...„. 4...„. 14 41. 4 . , t, ,,"4 ., 1 ',...,,, —, , , : ..-4-- 'i r.-'9'cil ''.'441.,-.,,‘:',1 -' ' ..ii - 4--''''‘''A -1- S 3'$.,"{' - $ pti'''a; r F.�` z +�.,.,e.a. ,' g 4-.. .* --*,:_,et t'F IIY k,�'. c E?a4 q �F .tee �� ?(, k _ A ' . , -' ,7,I.1e°.,u. . re d` '" ,' �n" "° a ',,i.",, _. a .a.?+� ^:'a ,,,;,.:...,-.---- t3'' 7-' — 'ER it g 'C.'',.P ' c;...;;;A ' , . , „,. ,4 r yx f{ \JJl1 a• ''' 5‘ A IV, -'' - y „.. a� .— ' mr ,, 8: p i? ! 57 a A LV l # r.`akq* #'tip „ r^4a� C3g fix. r S t` _ A c N!'": ,, t,,,' # Aga z • Two Blue Heron Middle School preteens carry the banner for Jefferson AIDS Services—with a little help from`a dog—during Saturday's AIDS Walk in Port Townsend. Y Photo by Janet Huck AIDS Walk on teens By Janet Huck distant in Jefferson County. world of AIDS,so they don't fear in down 2 percent while s Leader Staff Writer Now there is one case of an it anymore," said Al Hernandez, client n base increased 40 percent. HIV-positive teen here. JAS chairman, at his pre-walk Officials had to cut some pro- Across the country,50 percent So this year, Jefferson AIDS speech."We want them to fear it. grams in order to keep donations of the new HIV cases are young Services(JAS)officials decided to They think they can take the AIDS to each client at $500 a year for people between the ages of 13 try to raise awareness of the life- cocktail and they will be fine,but rent,utilities or medicines. and 25.That's been true for sev- long disease among teens at their they are looking at a lifetime of "Now,thanks to the great gen- eral years, but the statistic has AIDS Walk last Saturday,Sept.21. pills with horrific side effects" erosity of the people of Jefferson always been theoretical and "Teenagers were born into a Hernandez hoped the teens Count, we can restore lost pro- and their parents listened. grams and increase the life-sup- Saturday's walkers were gen- port payments to the clients,"said erous. The 2002 walk was a fi- Hernandez. nancial success,one of the three Every dollar raised goes to best in the last 10 years, raising JAS clients, except for some _ ,_0 more than$6,000, small fundraising costs for the Many AIDS organizations,in- all-volunteer organization. . cluding JAS, have faced dwin- "We are trying to soften the dling fundraising in recent years. blow for people with AIDS,"said In the last year,JAS saw its fund- Hernandez. • County adopts saltwater rules Barely eight hours after a new saltwater in- he had reservations with the ordinance as it ex- trusion ordinance took effect Monday morning, isted, and the changes did not relieve his con the Jefferson County Board of Commissioners cerns. "Everything we do tends to add another replaced it with an interim ordinance. $2,000 to$10,000 to the cost of that house,"he The interim ordinance followed several con- said of families trying to become homeowners. ference calls last week among county commis- Dan Titterness commented that the county was sinners and staff and personnel from the state being asked by the state to do something it Department of Ecology(DOE).Under the ordi- "doesn't have the authority to do."He noted that nance that had been slated to take effect Sept DOE drafted a policy 10 years ago suggesting 23,persons drilling a well within 1,000 feet of a the 1,000 foot radius,but it was never adopted. well with a chloride level in excess of 200 parts Back on July 23,the county adopted the ordi- per million would be referred to DOE for a pos- *nance(with a provision that it would take effect sible variance. in 60 days)in order to comply with an order from Monday,the commissioners reduced that radius the Western Washington Growth Management to 100 feet.People drilling within that range will Hearings Board.Acting on an appeal brought by still need to go to DOE, and those between 100 the Shine Comm'unity Action Council and the and 1,000 feet will be required to submit a"char- Olympic Environmental Council, the hearings acterization study"to the county under the interim board required the county to take steps to protect ordinance,county staff explained.The cost of such underground aquifers. studies was estimated at$2,000 to$10,000 each. The hearings board's conference call hearing The interim ordinance was adopted 2-1,with at 9 a.m.Tuesday,Oct 15 can be observed by the • Glen Huntingford voting no. Huntingford said public in the commissioners'chambers. 411 C-C) • Eel S -o O 4., a4, � . v ul O • oa „ o bvi > m 8 co en W A' Q a o .E 7 �" E vf] 4fIIj '0.0 b �, V) m a .S b o 'E N • > U Y Q C �, 3 z 7 � u) . 1 No • .So rw s . , q bn E c,,O Uo2O > ° E ° '; 3aa W v) o v) . fir' > W �C 1. C i 4 O -o E o o E ° o 'r .z,,� Q C d _ • Z , . I , 7 C y ,,,.�.a,,.� ,, i a... tii).4 Cl ¢ --a i 7 1W £ O ° , '4,-'''-',.,"4,_ g ','-',-- 1/111111111 -72., } Is L r ::::) % N 9 ,' .1As N C v m i •ZN LT OC C 1' , .. , ..: ::',.. 7,:"--- 14.1::#10., Ciel ,‘,>'::.:,.!_':.''jj`t.?:?•:'''',?1,.'' '"4: ,,,, ' -4-' - OO C�Y• i Y vii ._ U) To t U) N n . U) Q2L • _ (—) October 1, 200 ` • Juvenile: Crime fewer CONTINUED FROM Al pended,expelled or who consis- tently refuse to attend school. young P !n deter crime — including com- "It beefed up the laws munity-based detention facili- regaBefrding truancy," Haas said. ties like the Proctor Home in offenders ore, no one was enforcing Port Townsend and a mentor- it. ship program in ne — Family counseling were to be funded through a 0.1 • percent increase in sales tax. Family programs have also But that measure was helped make a difference, trounced by 54 percent of Jef- Haase added. ferson County voters in the He cited a state Child Pro- Sept. 17 primary election. tective Services family reconcil- A similar measure in Clal- iation program as an example. facing lam County failed with 53 per- Therapists used to believe court . cent of voters opposed to a pro- "one-on-one" with counseling posed 0.1 percent sales tax juveniles was sufficient, Haas increase. said. "But if you don't involve Preventative programs entire family,you might as well Juvenile crime niles will be charged this year in Jef- flush money down the toilet" ferson County. Despite the Jefferson tax Hwy sai , d. "We're learning measure 's defeat, Port The decline in juvenile court Townsend Police Chief Kristen what works." rec- cases halve cases follows a decline in juvenile Anderson-Post said she, too, Services like the family believes preventative programs cation program are in dan- ger arrests. are making a differaAce. of being cut back or and in past 3 years Arrests have declined in Jefferson She cited organizations like nam because of county and County from 433 arrests in 1999, to JOIN, which holds a monthly stateaudget woes,Haas said. meeting between mental Clallam County Detective 364 in 2000 and to 304 in 2001, health,school,juvenile services, S . Steve Snover said law BY STUART ELLIOTT records show. legal workers and others to dig,- enforcement is supportive of PENINSULA DAILY NEWS cuss coordinating services to preventative programs. help"at-risk"children. There are different reasons Fewer juveniles are seeing the Clallam County juveniles Port Townsend School kids do what they do," he said. Board Superintendent Carol inside of a courtroom as a defendant "In most cases, there are That's not the case in Clallam Andreasen agreed. underlying reasons that can be in Jefferson and Clallam counties. County, where more juveniles are "A lot of people are addressed. According to statistics released ing it to early intervention," • There's a need for educa- last number of felony and being arrested, but fewer are head- she said. tion and intervention." lsdee week, the charges filed against ing to court. Haas said he doesn't see g g Arrests have increased from 678 shifting demographics — the Drugs and alcohol •veniles in Jefferson County is pro- in 1998 to 845 in 1999 to 831 in possibility of less juveniles in Snover said the most coin- jected this year to be less than half of 2000, Clallam CountyJuvenile Ser- the county — as a reason for mon juvenile offenses are pos- what it was three years ago. the decline. session of alcohol or drugs, been a fairly noticeable vices figures show. "We would see schools clos- thefts,minor assaults,and bur- "It'slati if dwee had a juvenile popu- glaries. trend," said Jefferson County Figures weren't available for last lation declining at the same "We're not seeing serious rate arrests and filings are, he crimes,"he said. Deputy Prosecuting Attorney yew' Michael Haas, who handles juvenile In Clallam County, there were said. Snover said most of the ille- cases. 657 charges filed against juveniles in In Clallam County,Juvenile gal substances used by juvenile Services Director Pete Peterson offenders in Clallam are not The number of charges brought 1998, compared to 546 in 1999, 450 said it's hard to say what's "hard drugs," but marijuana i n 2000,and 434 last year in Clallam causing changes in juvenile and alcohol. against juveniles last year were at County. crime rates. He cited a study by Clallam their lowest level since 1994. "It's really hard to make a County Juvenile Services ear- The number of filings dropped Haas credits Jefferson County's black and white statement that lier this year that tracked 119 decline to aggressive preventative this is how it is,"he said. children booked into the Port from 196 in 1999, to 167 in 2000, down to 133 in 2001, according to programs. Statewide arrests Angeles youth detention center. According to the study, 89 " court records. Statewide, juvenile arrestsIn the last two or three years in percent tested positive for alco- And three-quarters of the .why ,;particular, there has been a signifi- are at a 20 year low,according hol and 70 percent for mari- can't effort placed on early interven- to statistics released earlier this loans' through this year — at the end of August — there 'had been only 55 tion in fatnily'and schools," he said. month by the Governor's Juve- nile tiveOfor metham he tested posi- charges filed against juvenile offend- "We've also had an aggressive truJustice Advisory Commit- "It's a lot more disruptive," ers, court records show. ancy program." Carol Webster, who heads he said. "And a lot harder to I7VEiY i E/A2 the committee, said the At that rate, fewer than 75 juve- TURN TO Jhide from one's parents." changes are a result of early intervention programs started in the late 1980s. "The prevention and early intervention programs are now bearing fruit," Webster said. "People in the school arena and elsewhere know what works. It's more of a science than before." 410 Haas traced the recent decline in Jefferson County to the Legislature's passage of the "Becca"bill in 1995. To supplement the "Becca" bill,state lawmakers toughened the truancy law to include stu- dents who are disruptive, sus- Port Townsend&Jefferson County Leader Plan B prevents • unwantednanc re p g y I have heard of a pill that can possi- bly stop me from getting pregnant but doesn't abort a fetus.Can you fill me in? The emergency contraception pill, or '"4:0 ECP is a safe, effective method to pre- !4y. vent a pregnancy. It first came on the market about five years ago but is still not widely used. When this drug,called Plan B,is taken within 72 hours of unprotected sex,it can prevent unwanted pregnancy. Plan B is Dear Dana the most popular emergency contracep- tive because it's the most effective and BY has the least side effects. Dana Michelsen To be effective,women have to phone • their health care providers right after hav- ing unprotected sex, and this can some- times be difficult or uncomfortable.The American College of Obstetricians and Gynecologists is encouraging providers to write prescriptions in advance so women will have access when they need it. Many health care providers encourage younger people to talk with their parents,but parental permission is not required to dispense Plan B. The health department will give a male Plan B to take to his partner if she has concerns about asking • for it herself. Many people confuse Plan B with RU 486,the"abortion pill." ECPs such as Plan B will not work if you are already pregnant. Taking them will not harm a fetus. Plan B may prevent preg- nancy by temporarily stopping the release of an egg from a woman's ovary or,in some cases,preventing fertilization. The overall success rate for Plan B is 89 percent. This is not as high as for other contraception methods such as the pill (95-99.9 percent)or condoms(up to 97 percent),so they should not be used as regular birth control. ECPs are available by prescription,or at a clinic where you can get the pill. At www.getthepill.com, for a $24.95 fee, a doctor will call in a prescription to any pharmacy,seven days a week.Washington state allows pharmacists to sell ECPs di- rectly if they have prescriptive credentials.The number of phar- macies that offer ECP in Washington has grown from 40 in 1998 to more than 250 in 2002.Contrast this to England,where women, even minors, can obtain it free from certain grocery and drug chains.Efforts are under way in the United States to offer ECP over the counter to all. Plan B can be obtained locally at: •Port Townsend:Jefferson County Health Department,615 Sheridan;phone 385-9400;9 a.m.-4:30 p.m.Monday through Friday. •Port Hadlock:QFC Pharmacy;phone 385-1900; 15-minute walk-in visit,no appointment necessary. •Quilcene: Quilcene Family Planning Clinic behind south county clinic; 12:30-4:30 p.m.Wednesday only. • Many payment options are available,from private and state insurance to sliding fee scale. Not being able to pay should not be a barrier. Call the Health Department for special pro- grams for low-income people. (L?ajia Miclielsen,has been Rork Y\theA..(e sqn Gkunty medical community for 20 years.She is past director of clini- cal services for Jefferson General Hospital,where she is cur- rently working on a special project.) – O�— • 9 • Countyon sponsors cors septic workshops Sludge. Effluent. Septage. 10 at the Masonic Hall. Flush. Sound like a sanitarians' • Brinnon—Wednesday, Oct. Scrabble game? 16 at the Booster Club. In fact, most homeowners in • Port Ludlow — Thursday, rural Jefferson County"flush"to Oct. 24 at the fire hall on Oak a "sludge/effluent/septage" sys- Bay Road. tem that treats and disposes of Learn tools for operating and their household wastewater, ac- maintaining your system. Find cording to Molly Pearson of the out what impact your landscap- county Environmental Health ing practices have on your sys- Department. tern. Discover what you can do These septic systems are to prolong its life, and learn to meant to be effective, long-last- recognize the signs of a failing ing wastewater treatment sys- or overtaxed system. tems, explains Pearson. "The Like almost_anything else, homeowner who knows the his- improper use of a septic system tory and location of the septic can cause damage, warns system uses that information Pearson. "Using a garbage dis- when making important deci- posal, for example, subjects the sions such as where to locate system to more accumulating • porches, decks, additions and solids in the tank, necessitating landscaping,"she adds. more frequent pumping," she The Environmental Division says. of the Jefferson County Health "Water use is one of the most and Human Services Department critical ways that a property plans a series of three free work- owner can affect the septic sys- shops to help homeowners un- tern.One family can easily over- derstand the workings of their load the system with excessive systems and help them be water use,"notes Pearson. trouble-free. For more information about The workshops are from 6:30 the workshops,call the Environ- to 8 p.m. at: mental Health Department at • Quilcene — Thursday, Oct. 385-94,14. fi- LCck-1 /0-2-0 • 10 County 's flu _ . shot clinics• Wednesday,October 2,2002 •A 11 lost withClinics: Cost budget cut Continued from Page A 1 get their shots." Baldwin also said,"I would An important change to this very much like to restore it on year's recommendations for flu By Barney Burke a limited basis for seniors."She vaccine is the encouragement Leader Staff Writer says she plans to meet with the that parents consider getting flu doctors employed by Jefferson shots for children ages 6 It looks as if the first victim of this General Hospital around the months through 2 years old, year's flu season is the vaccination pro- end of November to see if they said Kurata. Young children gram funded in part by Jefferson County. were able to absorb the cost who catch the flu are just as Reductions to the health and human through Medicare reimburse- likely to need hospitalization as services budget of$90,000 in January ments and other fees. the elderly.Children under age 2002 and $150,000 in June 2002 to The cost of buying flu vac- 9 receiving flu vaccine for the suited in the elimination of flu shot clin cine, Baldwin said, is about first time need two doses given ics, the Port Hadlock family planning $30,000. After April of each one month apart,she explained. clinic and other expenses, says Jean year,vaccine is no longer avail- High-risk people who Baldwin,community health director. able at the public health rate, should be immunized in Octo- Last year, flu shots from the county she said. In addition-to paying ber include: cost$10 each, Baldwin said. for the vaccine,the county has •Anyone 65 or older. Although flu shots won't be available paid for the malpractice insur- • Children and adults with through the county this year, they are ance and nursing costs associ- chronic diseases such as heart available through private physicians and ated with flu vaccinations. or lung conditions,asthma,dia- some local grocery stores. Upcoming editions of the Leader will have listings betes, kidney disease or sup- of flu shot availability in Jefferson Shots recommended pressed immune systems. County. It is not expected that there • Residents of long-term The draft health and human services will be any delay in availabil- care facilities. budget for 2003 is$3.2 million,Baldwin ity of vaccine this year,accord- • Children receiving long ing to Jane Kurata of Health term aspirin therapy. said, much of it from state and federal funding sources, plus fees paid by cli and Human Services,"but state • Women who will be mores and their insurance companies.The and federal health officials are than three months pregnant dur- entscounty general fund contribution to asking that people who are at ing the flu season. count and human services programs to high-risk for complications of • Medical providers who influenza, or children getting provide direct care to any of the been"flat"for about 10 years,Baldwin estimated. flu shots for the first time, be above persons. immunized did not put it [flu vaccination] in mu ized during October,and • Children under age 9 re- the budget"for next year,Baldwin notes. that healthy adults and children ceiving flu vaccine for the first "If it works that they can get their flu wait until November or later to time. shots,then we'll let it stay[private],"she said. See CLINICS, Page A 11 0 • Jamestown tribe to build • dental clinic- open- to all ail BY JIM MANDERS The top floor of the building will PENINSULA DAILY NEWS house a community center, she said. The tribe is providing the funding BLYN — The Jamestown S'Klal lam tribe is about to embark on a for that part of the construction, building project that will mark the Lowe said. tribe's entrance in the field of dental The tribe has targeted late 2003 as care. the opening date for the tribal dental The tribe will use$348,055 of fed- clinic,which will be open to both non- eral Housing and Urban Develop- tribal residents and tribal members. ment funds to construct a dental Eventually, Lowe said, the tribe office on the bottom floor of a build- plans to combine medical and dental ing at the tribal headquarters on Old services in a building in downtown Blyn Highway, project coordinator Sequim. Cindy Lowe said Wednesday. TURN TO TRIBE/A2 Tribe: Dentistry project CONTINUED FROM Al provide treatment 4 or 5 days • A new building housing the Our plans for the dental a week, she said. Specialists services will probably be clinic were put on hold will be under contract to pro- located near other medical when the need for a vide oral surgery, orthodontics facilities on North Fifth " and other services. Avenue downtown, she said. medical clinic came Up. CINDY LOWE The tribe originally Lowe said a number of den- planned to open the dental project coordinator tists and specialists have clinic first, but changed direc- shown an interest in working tions when seven doctors June and Lowe said a sixth is at the tribal clinic. decided to leave Virginia doing some work at Olympic Some of those are retired Mason Clinic Sequim earlier Medical Center in Port Ange- dentists who have moved to the Peninsula and are looking this year. les. Three of the seven Virginia "Our plans for the dental for something to do. Mason doctors joined the clinic were put on hold when Lowe said tribal clinics are Jamestown S'Klallam tribal the need for a medical clinic attractive for retired dentists clinic when it opened in April. came up," Lowe said. because they can avoid the Two more doctors were The tribe initially plans to high cost malpractice insur- added to the clinic staff in hire a dentist and hygienist to ance. /0 - 3 -d 2 • • West Nile fiin virus conrmed state THE ASSOCIATED PRESS Washington, found during a ington," said Jack Lilja, the fever. About 1 percent develop OLYMPIA—The West Nile state-run surveillance pro- health department's West Nile brain swelling or meningitis, gram. surveillance program manager. which can be fatal. virus has been detected for the time in state, No humans have contracted Nationally, 43 states have The virus is carried long dis- first deadimin Washington found in Pendathe mosquito-borne infection detected the virus this year, tances by birds which are then in aie County,nthe d in Washington state. and 2,477 cases have been bitten by mosquitoes. At least Ore Oreille t Healthhetate Two cases of the potentially reported to the Centers for six mosquito species in Wash- Department virus have been reported Disease Control and Preven- ington state can carry the in Washington, both acquired tion —124 of them fatal, virus, state officials said. Tests at the National in other states. Neither patient health officials said. ill- Wildlife Health Center Labora- developed a serious illness. "The risk, of West Nile d tory in Madison, Wis., con- Only about 20 percent of ness is low," Lilja said, "and "West Nile virus is moving those bitten by an infected taking precautions to protect firmed the discovery near west . . so we have been mosquito show s Newport in northeastern expecting it to arrive in Wash- the disease, typicallptams mild help reduce yourof againsttriisk " can • 0 3 - 0Z. • Port Townsend&Jefferson County Leader ' C bu et e13. ¶onimjssjoners s edecide` •direction,. By Barney Burke Leader Staff Writer « get, a number of activities that day).That represents about a 5 We just have to were previously part of the percent increase in spending. The Jefferson County Board / a county's general fund budget The proposed 2003 budget of Commissioners conducted a nu money to have been placed in their own includes a 1 percent increase in series of public hearings the funds, including community both the general fund property g make services development, cooperative ex- tax levy and the road levy. Un- draft 2003 budget Monday and „ tension, and parks and recre- der I-747, local governments Tuesday. happen. The commissioners are ation. Rowe said that the new are entitled to collect the addi- funds"give the board an easier ' tional 1 percent, which does slated to give preliminary di- Dick Gunderson way to manage funds over the not include revenues from new rection to staff at 10:30 a.m. substance abuse long term.» Thursday, Oct. 10.Final adop- coordinator construction,without a vote of of thebudget hasn't inbeen Jeffersoncoordinator Coon Rowe'said that the long- the people. However,those in- tion �' term plan is for these special creases won't boost every in- scheduled but might occur as ' funds to receive less general dividual tax bill by1 late as December, Deputy fund revenue, and to replace because of the percent County Administrator Gary P growth of the tax Rowe said. Ro last dayon that revenue with grants and base, County.Assessor Jack Kimbrough explained that fees. He also titentioned that Westerman III has explained. the job is Friday,before he be- the county has been relying on there is money in the parks and Total revenues for 2003 are comes Skagit County's new state funding, and the state recreation budget to study the y projected.at $39,140,769, up administrator. budget picture could mean that possibility of creating an inde- from the original 2002 estimate The commissioners haven't "People who don't have the re- pendent, taxpayer-supported of$35,300,025.These numbers ade too many telling com- sources — they're not going to park and recreation district are not entirely comparable ei- nts thus far in the process, get services." Currently, the next year. t Glen Huntingford made a county contracts with private they,Rowe pointed out,as they point to scrutinize$568,500 set service agencies to treat people By the numbers include inter-fund transfers aside for the purchase of 14 plus $2.9 million in bond pro- with alcohol, methamphet- General fund expenditures ceeds for the proposed sheriff cars,trucks-and other vehicles. amine and other substance are pegged at $11,043,478 for administration building. All three commissioners ex- abuse problems. next year, down $1.1 million But even though expenses pressed interest in hearing from Laurie Hampton was one of from the original 2002 budget are up,staffing levels are down. county employees about their several speakers concerned and close to the revised 2002 Next year's budget calls for ideas for saving money, some- about maintaining funding for budget of $11,351,516. How- 288.84 full-time-equivalent thing the employees requested Jefferson County 4-H pro- ever, these numbers aren't en- (FTE) employees, down 4.04 when $800,000 was cut from grams. Katherine Baril of tirely comparable,due to some from this year's 292.88 (the the budget earlier this year. Washington State University expenditures being transferred revised 2002 figure was lower Public comments Cooperative Extension said out to the new funds, Rowe but couldn't be obtained Tues- that county funding of 4-H has said. day). While some of this week's been a wise investment in terms The draft budget shows that FTEs w were 268.08,266.78 and hearings drew little or no corn- of reducing law and justice ex- adding the general fund and all 273.34, respectively. ments from the public, it was penses. other funds,projected ex endi - (Editor's note: The FT standing room only at Tuesday The only county employee tures are$40,070,717,up from numbers reported in the Sept morning's hearing on public who came forward to address 2002's $38,221,361 (the 2002 25 Leader referred only to gen- services. the commissioners as an indi- figure is the original budget era'fund employees. Other Sherry Kimbrough, chair- vidual was David Alvarez, number; a comparable number budget numbers in this story woman of the Jefferson Count woman ce Abuse Countys Advi- chief civil deputy prosecutor. for the mid-year revision in reflect updates and clarifica- Alvarez urged that the commis- 2002 was not available Tues- tions provided this week.) sory Board, and Dick sioners approve the 1'percent Gunderson, the county's sub- increase in tax revenues be= stance abuse coordinator,shared cause employees are working ' ilikoncerns over the possibil- hard. He also suggested that at the state Legislature another effort be made to fund might cut treatment funding in law and justice services follow- the next biennium."We just haveing the September defeat of a to find money to make services one-tenth of 1 percent sales tax happen," Gunderson told the for that �� _r purpose. commissioners. Starting with the 2003 bud- • • u c inl cs • • are ready Flu vaccine clinics will be tak- surance will be billed. ing place in a variety of locations •Port Townsend Family Phy- in Jefferson County in the corn- sicians, 934 Sheridan, Port ing weeks. People with a high Townsend: Saturdays, Oct. 19, risk for complications if they Nov. 2 and 16, 9-11:30 a.m. catch the flu are encouraged to Medicare patients please bring get immunized early. your Medicare cards.All others High-risk people who should pay $10; no insurance will be be immunized in October in- billed. elude: •QFC Pharmacy hosts several •Anyone 65 or older clinics throughout the county this • Children and adults with month,at a cost of$20.Pneumo- chronic diseases such as heart or nia shots are also available. lung conditions, asthma, diabe- Medicare and Medicaid clients tes,kidney disease or suppressed are asked to bring their Medicare , immune systems. cards or Medicaid coupons.No- •Residents of long-term care vember clinic dates will be an- facilities. Trounced later.- • Children receiving long- Port Hadlock QFC Store: term aspirin therapy. Thursday,Oct. 17,9 a.m.-5 p.m. • Women who will be more Brinnon Booster Club: Fri- than three months pregnant dur- day,Oct. 18, 10 a.m.-5 p.m. ing the flu season. Quilcene Community Center: • •Medical providers who pro- Thursday,Oct.24, 10 a.m.-5 p.m. vide direct care to any of the Port Hadlock QFC Store:Fri- above persons. day,Oct.25,9 a.m.-5 p.m. •Children under age 9 receiv- • Safeway Pharmacy, 442 • ing flu vaccine for the first time. Sims Way, Port Townsend: Fri- Parents of children ages 6 days and Saturdays, Oct. 11-12 months through 2 years are en- and 25-26, 11 a.m.-5 p.m.while couraged to get their children flu supplies last.Flu shots cost$20; shots. "Young children who pneumonia shots cost$30.Medi- catch the flu are just as likely to care will be billed; bring your need hospitalization as the eld- Medicare card. erly," says Jane Kurata of • South County Medical Jefferson County Health and Clinic, 294843 Highway 101, Human Services. Quilcene: Mondays through November and December are Thursdays,8-9 a.m.and 5-6 p.m. not too late for others to be vac- Please call first. Flu shots cost cinated in order to reduce their $10. Medicare patients please chance of catching the flu. bring your Medicare cards. Flu vaccination clinics •Dr.Richard Lynn,1136 Wa- ter St.,Port Townsend:Mondays through Thursdays,3-5 p.m.;es- tablished patients only. • Jefferson General Medical Group, 834 Sheridan St., Port Townsend: Saturday,Oct.26,9- 11:30 a.m. Medicare patients • please bring your Medicare /D -- Ci—0 2_ cards.All others paw�10;n9 in- surance will be billed • Olympic Primary Care, 1010 Sheridan St., Port Townsend:Saturdays,Nov.9 and 23, 9 a.m.-noon. Medicare pa- tients please bring your Medicare cards.All others pay$10;no in-