HomeMy WebLinkAbout2004-August File Copy
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Jefferson County
Board of Health
Agenda
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Minutes
August 19, 2004
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JEFFERSON COUNTY BOARD OF HEALTH
Thursday,August 19, 2004
2:30—4:30 PM
Main Conference Room
Jefferson Health and Human Services
AGENDA
I. Approval of Agenda
II. Approval of Minutes of Meetings of July 15,2004
III. Public Comments
IV. Old Business and Informational Items
1. 2004 West Nile Virus Activity
2. Hood Canal Coordinating Council Letter
3. Letters and Documents Re: Ms. Linda Sexton
• V. New Business
1. 2005 Jefferson Health and Human Services Preliminary Budget and
Community Health Performance measures
2. Public Health Emergency Preparedness and Response Region 2 Duty
Officer: Implementation Plan
3. Washington State and Jefferson County Food Service Code Revision
4. Draft Letter Re: Onsite Sewage System 0 & M and Marine Shorelines
VI. Activity Update
VII. Agenda Planning
VIII. Proposed Next Meeting: September 16,2004
Main Conference Room
Jefferson Health and Human Services
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JEFFERSON COUNTY BOARD OF HEALTH
„ MINUTES \tAl„
Thursday, July 15, 2004
Board Members: Staff Members:
Dan Tittemess, Chairman-County Commissioner District#1 Jean Baldwin,Health&Human Services Director
Glen Huntiniord-County Commissioner District#2 Lary Fay,Environmental Health Director
Patrick M Rodgers-County Commissioner District#3 Julia Danskin,Nursing Services Director
Geofrey Masci-Port Townsend City Council Thomas Locke,MD,Health Officer
Jill Buhler-Hospital Commissioner District#2
Sheila Westerman-Citizen at Large(City) Ex-officio
Roberta Frissell, Vice Chairman-Citizen at Large(County) David Sullivan,PUD#1
Chairman Tittemess called the meeting to order at 2:30 p.m. in the Health Department Conference
Room. All Board and Staff members were present with the exception of Member Westerman. There
was a quorum. Brief introductions included John Fischbach,the new County Administrator.
APPROVAL OF AGENDA
Member Masci moved to approve the agenda as written. Commissioner Rodgers seconded the
motion,which carried by a unanimous vote.
APPROVAL OF MINUTES
Member Masci moved to approve the minutes of June 17,2004. Commissioner Rodgers
seconded the motion,which carried by a unanimous vote.
PUBLIC COMMENT-None
OLD BUSINESS AND INFORMATIONAL ITEMS
Kids Bits Newsletter: Julia Danskin reported that this newsletter is being distributed to childcare
providers in the community through a grant contract with the State Department of Health to provide
public health nurse consultation to childcare centers.
Jefferson County Comprehensive Prevention Plan: Dr. Tom Locke gave the Board a fact sheet
on this prevention planning process,now underway. He solicited a member to join a review team of
the Comprehensive Prevention Plan along with representatives from the Community Network
Board,Law and Justice and other groups. Member Masci volunteered to serve on this committee.
HEALTH BOARD MINUTES -July 15,2004 Page: 2 .
1111
2004 West Nile Virus Activity: Dr. Locke noted that despite the expectation of the virus arriving
in Washington this year,the County is still in"triple zero mode,"with no cases in birds,horses,or
humans.Although the peak season is in September, dry weather is a predictor of lower activity.
Julia Danskin mentioned that the County has sent in a few birds for testing and is screening calls
from the public and providing information such as how to dispose of dead birds.
Benefits and Costs of Prevention and Early Intervention Programs for Youth: Dr. Locke
pointed out that the packet contained a small segment of a much longer cost benefit report of various
programs by the State Housing Institute. Julia Danskin also provided the Board with a letter that had
been sent to Dennis Braddock of the State Department of Social and Health Services on behalf of
the Board of County Commissioners regarding funding for the Nurse-Family Partnership.
NEW BUSINESS
Public Hearing and Possible Adoption—Jefferson County Solid Waste Ordinance: Dave
Christensen presented the Staff report on Solid Waste Regulations,the adoption of which is a
requirement for the County under both RCW 70.95.160 and the WAC 173.350.700.He offered
members of the public copies of the Staff report and regulations. The State Solid Waste Regulations
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were last amended in February 2003. He listed the various times the Board of Health has reviewed
the draft ordinance to incorporate provisions to provide for protecting human health and the
environment by defming applicability, and authorities as well as permitting requirements and fees.
The regulations also include the administrative procedures for hearings,appeals,waivers,and
variances.
The Board had no questions for Staff.
Public Comment:
Linda Sexton,while acknowledging not being very familiar with solid waste regulations added that
as the subject of a case before the County Commissioners she felt persecuted.Her property, on
which she operates her private business and conducts her religious practice and hobby,was
determined to be a solid waste handling facility. She talked further about the significant expense and
stress she suffered in defending herself against what she perceived to be a heavy-handed approach
by the Board of Health and the County Commissioners. She reviewed directives she was given by
the County,which included removing all uncovered materials being stored on her site and talked
about measures she has taken to come into compliance and to address any health hazard concerns.
She also talked about her objection to the defmition of solid waste and her efforts to appeal the
determination through the state and federal governments. She threatened to take her personal
concerns to the Supreme Court,and television shows 60 Minutes and 20/20 in order to make a
national event of what she feels is a trespass on her rights.
Member Masci moved to approve the Solid Waste Ordinance as presented. The motion was •
seconded for discussion by Commissioner Rogers.
• HEALTH BOARD MINUTES -July 15,2004 Page: 3
Commissioner Huntingford pointed out that each individual has their own perception of what they
consider solid waste. The issue for the County is to figure out how to interpret the state solid waste
defmition and regulations when dealing with solid waste concerns. The regulations provide the
County with the tools necessary for addressing nuisance properties or health threats. Enforcement
will always be a challenge.
Member Buhler agreed to the fine line in interpretation,which is where the Health Officer comes in
to make a determination. She is comfortable that the appeal process offers protection against a State
that is so heavy-handed that it would act arbitrarily or deny due process.
Commissioner Rogers said that a situation that fails to meet the fundamental criteria of having real
or potential impacts to public health would be classified as a nuisance and would not be under the
purview of Public Health.
Dave Christensen clarified that this Solid Waste ordinance defines nuisance and distinguishes
between nuisances and solid waste,but does not cover the latter.
Dr. Locke noted that this code is atypical for local Boards of Health,most extend from strict public
health authority.At the State level this ordinance is administered by the Department of Ecology as
more of an environmental protection that overlaps the health realm. State law assigns the local
Board of Health as the jurisdictional authority for the enforcement of this code. He clarified that
typically boards of health do not address nuisance codes.
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Member Masci spoke in favor of his motion,noting that the Board of Health has been thorough in
changing the definitions,adding increased appeal abilities for citizens and been more than
scrupulous in understanding the previous problems and situations that caused misunderstandings.
He believes this ordinance would sort out at least the base of the Board of Health authority and what
is expected of our agents.Also, the public can clearly see the definitions and what is expected. He
believes the ordinance is a good and fair product for the citizens and would be enforced in an even-
handed and fair manner.
Chairman Titterness wanted to ensure that the ordinance is consistent with and not more restrictive
than the fire code regarding the burning of waste.Dave Christensen said the language is consistent
with rules adopted by Ecology over a year ago.Dr.Locke added that this code is no more stringent
than the state code.
Member Masci called for the question to approve the Solid Waste Ordinance No.09-0715-04
as presented. The motion carried by a unanimous vote.
Breast Feeding and Public Health—Staff Presentation: Carol Hardy,the Health Department's
breastfeeding specialist working in the Maternal Child Health programs, spoke to the Board about
the importance of breastfeeding. She reviewed its many benefits to the community,to families and
babies; fewer instances of heart disease,cancers, diabetes,ear infections and adverse childhood
events. Breastfeeding also provides better nutrition, sensory development and absorption of
410 vitamins.It is a public health issue because breastfeeding lowers health care costs,increases
HEALTH BOARD MINUTES -July 15,2004 Page: 4
411
attachment behaviors in mothers and thereby promotes protective factors that reduce the risk of
adverse childhood experiences, and is better for the environment because it saves resources. To
better promote breastfeeding in our culture and to make it the norm(rather than formula)she
provided several suggestions—dealing with our own personal issues about breastfeeding,
encouraging others to breastfeed,and by making workplaces breastfeeding-friendly.As August 1-7
is World Breastfeeding Week,she encouraged everyone to participate in the walk from Pope Marine
Park to Chetzemoka on Wednesday of that week. She circulated pictures of the breastfeeding teas
held at the Health Department. She noted there is also a Dads' walking group that meets on
Saturdays at 8:00 a.m. at Larry Scott Trail. Member Masci spoke to the importance of mobilizing
the men in the cause.
As a pregnant and nursing mother of a two year old,Beth Wilmart spoke about her experience with
the breastfeeding teas as an opportunity to connect socially. She noted there is also a new website
for parents to connect called PT Babies. She and Carol Hardy also work in cooperation with the
LaLeche League. While Washington has laws that say breastfeeding or expressing breast milk is not
indecent exposure,unlike 20 other states,Washington stops short of saying that a mother has a right
to breastfeed or express milk anywhere and at any time.
Julia Danskin noted that the breastfeeding support services the Department provides to every new
mom in the County do not cost a lot of money to sponsor,but show positive outcomes for the
community. She spoke about the collaborative effort with Jefferson General Hospital, and
specifically Laura Showers,who helps moms in getting started with breastfeeding and helps to •
promote and support breastfeeding in the community.
David Sullivan asked if breastfeeding is promoted in public policy for workers or in contracts with
employees. He believes it would be good for the County to model this in the workplace,which
Carol Hardy agreed and said it would be good to actively support and encourage breastfeeding
through workplace policies, as is the practice in the Health Department. She added that it is a big
issue and a challenge to compete with powerful formula manufacturers who advertise heavily and
offer giveaways for moms and babies.
Public Health Fee Policy Discussion—Current System and Options for Change: Dr. Locke
reminded that at the last meeting,the Board had asked to discuss the public health fee policy.The
agenda packet included the current fee ordinance for Jefferson County Health and Human Services.
A general power of all county legislative authorities,the tradition in Jefferson County is for the
County Commissioners to adopt the fees.He understands this is fairly atypical and is usually done
by boards of health,which have specific statutory authority to levy fees to carry out their law
enforcement responsibilities. Given the precariousness of public health funding,it is unlikely the
County would be backing off on fees until a more stable funding source could be secured. He
recommended the Board and County Commissioners consider whether the Board of Health should
take over this responsibility,the main argument being that it would link statutory responsibility for
carrying out public health functions with one of the mechanisms for generating fees.
Member Masci commented that the explanation of fees does not reflect anything for
administration/handling and instruction,or pre-and post-consultation fees. A sliding fee would
• HEALTH BOARD MINUTES -July 15,2004 Page: 5
significantly mitigate the impact. At least in our public health sector there needs to be a mechanism
to make up the difference between Medicaid and Medicare reimbursements rates and the cost of
delivering services.
Member Buhler asked whether the Hospital,as a critical access hospital receiving cost-based
reimbursement might be able to work in conjunction with the Health Department and bill tfrrough
the hospital for some of these programs. Dr.Locke noted that any licensed medical provider could
provide public health clinic services. The fees for Environmental Health services would still be set
by ordinance through the County. Julia Danskin agreed with the need to discuss this and noted that
for some programs, such as Family Planning and Immunization,the Health Department is required
to do sliding scale down to minimum or zero.Services are based on public health goals and needs in
our community;this is why the Board of Health should give input on priorities and what services
should and should not be subsidized.
Member Masci suggested that involving outside health practitioners and hospital representatives in
the Board of Health fee committee would bring a broader viewpoint and better coordination. Julia
Danskin acknowledged that a good program cost analysis is necessary to determine actual costs and
a basis for fees. Staff has not yet had an opportunity to do a program cost analysis.
Dr. Locke reiterated his intent in bringing this matter up was to receive clear direction.He was
unclear whether the Board of Health wanted to become the forum for fee setting.Ultimately, it is a
• County Commissioners decision.
Chairman Tittemess said he believes the authority for the establishment of fees needs to remain with
the County Commissioners because it has to also manage the County Health Department's budget
for delivery of these services.
Member Masci said he does not take issue with retaining the authority with the County
Commissioners and understands Dr.Locke's point that the Board of Health or fee committee would
make recommendations that the County Commissioners would then approve. He is proposing that
the Board of Health take an active role in the public health side,as it did on the Environmental
Health fee committee. More research and other viewpoints might help fmd ways to make public
health services more self-supporting. Vice Chairman Frissell agreed that the current budgetary
challenges facing the Department warrants a joint review of the fee schedule by Board and Staff
members.
Chairman Tittemess recommended the Board of Health remain an advisory board to the County
Commissioners,who would retain the authority,adding that he doesn't foresee a time where the
County Commissioners would not accept their recommendation.
Member Buhler agreed to chair a committee,including all board members with the exception of the
County Commissioners and Ex-officio Member Sullivan.
HEALTH BOARD MINUTES -July 15,2004 Page: 6 •
On-Site Sewage System Operation and Maintenance for Marine Counties—Report on July 14,
2004 State Board of Health Workshop: Dr.Locke noted that State On-site Sewage Rules released
in March and scheduled for adoption in November have been under revision by the Rule
Development Committee,a large group composed of environmental health directors,industry
representatives,and other stakeholders. The only section that received less than favorable fbedback
was the Operation,Monitoring and Maintenance(O&M).He distributed the O&M section,along
with letters of objection from Governor Locke, and State Representatives such as Norm Dicks. The
two-year statewide consensus project generated results very similar to those compiled ten years ago,
which was essentially that counties should come up with individual plans to address operation and
maintenance. Political leaders believe the proposed rule is insufficient for dealing with degradation
of shellfish growing areas and marine coastline issues in areas like South Hood Canal. The State
Board of Health had been urged through public testimony to take on the issue of nitrogen loading of
Puget Sound. While this might be a complex environmental issue with human contribution, aside
from the pollution of shellfish beds it is not,by most analyses, a human health issue. Compared to
the collection of other environmental factors that are adding nitrogen to the water,the human
contribution is relatively small. Failing septic systems were thought to contribute 60%of the 8%of
human contribution to nitrogen loading. The biggest factor is atmospheric nitrogen deposition.
Given the amount of shoreline, this issue is something the Board of Health should track carefully.
Some of the proposals circulating are to move to more of an operating permit for the O&M program,
at least for certain designated areas where there is a significant watershed or marine shoreline
impact. However,since those counties that have tried this approach have not had positive •
experiences(notably Thurston County),this would have a dominant influence on the State Board of
Health. There is support for making this a multi jurisdictional effort and education is preferred over
enforcement. Dr. Locke said the Board might want to consider supporting or not supporting this in
October. He would continue to bring information to the Board as draft language is proposed.
Commissioner Huntingford asked to see some comparisons between what is being proposed and
what we are currently doing.He believes Jefferson County is already complying in many ways—
higher levels of treatment,protection of shellfish beds and against seawater intrusion. Dr.Locke
agreed that although Jefferson County is already using the new rules on O&M,many are saying they
are not restrictive enough.
Chairman Tittemess said it appears that analysis being done by different agencies is coming up with
different calculations. The State Board might want to look at the conflict of the Growth
Management Act by not addressing infrastructure versus the need to do this kind of treatment to
remove the nitrates. He referred to the Sequim water treatment facility and eluded that rather than
operating permits there might be other kinds of incentives.
Commissioner Rodgers recommended focusing on areas that have the largest impact.He also spoke
about the presentation by the Sequim Director of Public Works and how their new treatment process
has helped shellfish beds.Dr. Locke said he understands the Board is not in favor of operating
permits. With the momentum for the operating permits to go through the legislature,he agreed to
draft some of these ideas into a letter.Chairman Titterness agreed that a letter from this Board to the
State Board of Health might be appropriate.
• HEALTH BOARD MINUTES -July 15,2004 Page: 7
Environmental Health Director Recruit Update: Dr.Locke reported that the acting
Environmental Health Director,Dave Christensen,has withdrawn his application for the position.
Mr. Christensen has accepted a position with the Hood Canal Coordinating Council,resigning his
position with the Department of Natural Resources.Another qualified applicant has been found and
job offer was extended. The individual would begin August 9.
ACTIVITY UPDATE/OTHER ANNOUNCEMENTS
Dr. Locke reported that the Food Safety Code is also up for review and adoption.
AGENDA PLANNING/ADJOURN
The meeting was adjourned at 4:25 p.m.The next meeting will be on August 19,2004 at 2:30 p.m.
in the Conference Room of the Jefferson County Health Department.
JEFFERSON COUNTY BOARD OF HEALTH
Dan Titterness,Chairman Jill Buhler,Member
(Excused Absence)
Roberta Frissell,Vice Chairman Sheila Westerman,Member
Geoffrey Masci,Member Glen Huntingford,Member
Patrick M.Rodgers,Member
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Board of Health
Old Business
Agenda Item # IV., 1
•
2004 West Nile Virus
Activity
August 19, 2004
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CDC: West Nile CDC: West Nile Virus - Statistics, Surveillance, and Control >pf Maps 2004 Page 1 of 1
-Ve s' ' d
2004 West Nile Virus Activity in the United States
• (reported to CDC as of August 10, 2004*)
ElIndicates human disease case(s). roc
Avian,animal or mosquito infections.
WA 34,
ND 401101,
VT
OR MT (2) MN
C SD (3) Ir. NYrti NH FalWY 13 PI (3) .
!i3) (NE) IA (1), PA '� MA
NV (1) (3) IL OH (.1
CA (2) o CO ( } (1 RI
(102) (44) ', . , (3) 1 CT , ?
Ac
(274) NM AR NJ
(11) (3) AL
,, le DE Li
TX LA (3) (3)
AK (3) (1) MD FE
FL
• (10 DC
• cZPuerta Rico WV
HI D 0
*Currently, WNV maps are updated weekly to reflect surveillance reports released by state and local
health departments to the CDC Arbonet system for public distribution. Map shows the distribution of
avian, animal, or mosquito infection occurring during 2004 with number of human cases if any, by state.
If West Nile virus infection is reported to CDC Arbonet in any area of a state, that entire state is shaded
accordingly.
Maps detailing county-level human, mosquito, veterinary, avian and sentinel data are published each
week on the collaborative USGS/CDC West Nile virus website: http /Jwestnilemaps.usgs.govj
Data table:
Indicates avian or animal infection reported to CDC ArboNET for public distribution as of August 10, 2004
from the following states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware,
Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan,
Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York,
North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Puerto Rico, South Carolina, South Dakota,
Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, Wyoming.
Human cases have been reported in Alabama, Arizona, Arkansas, California, Colorado, Florida, Illinois,
Iowa, Kentucky, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Mexico,
New York, North Dakota, Ohio, Pennsylvania, South Dakota, Texas, and Wyoming.
http://www.cdc.gov/ncidod/dvbid/westnile/sure&contro104Maps_PrinterFriendly.htm 8/12/2004
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Board of Health
Old Business
Agenda Item # IV., 2
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Hood Canal Coordinating
Council Letter
August 19, 2004
1
iffm Caw Ilooftinaffig
• JEFFERSON,KITSAP&MASON COUNTIES; PORT GAMBLE S'KLALLAM&SKOKOMISH TRIBES; STATE&FEDERAL AGENCIES
July 28,2004
Debbie Riley,Mason County Environmental Health
Keith Greilner and Jerry Deeter,Kitsap County Health District
Dan Bruce and Linda Atkins,Jefferson County Public Health
Re: The Preliminary Assessment and Corrective Actions(PACA)Plan
Dear Debbie,Keith,Jerry,Dan and Linda:
I have taken a position with the Hood Canal Coordinating Council and will begin
working there in September. I hope that I can continue to work in a cooperative fashion
with the local and tribal governments around the Hood Canal,as I did while working on
the PACA Plan. I wanted to write this letter to help answer some questions that you or
others may have, and address some concerns that I have about how the PACA Plan is
being used and interpreted differently than was intended.
Earlier this year,the Puget Sound Action Team and the Hood Canal Coordinating
Council jointly developed the PACA Plan. The PACA Plan was completed very rapidly
• in response to a request by Congressman Norm Dicks and Governor Locke. The goal of
the PACA was to provide a rough assessment of human-related nitrogen contributions
into Hood Canal, which was to be used as a basis for prioritizing funding for early
corrective actions. The PACA Plan can be viewed at:
http://www.psat.wa.gov/Programs/hood_cananc_paca.htm
While the PACA Plan does attempt to make some statements about what is currently
known,and qualifies the data where uncertainty exists, it DOES NOT do several things.
The PACA Plan DOES NOT conclude that 60% of the low dissolved oxygen
problem in Hood Canal is caused by onsite sewage effluent.
There is nothing in the PACA Plan that suggests such a direct"cause and effect"
relationship. The analysis simply states that based on rough calculations and
assumptions, it appears that human sewage is the primary human-related source of
nitrogen input to Hood Canal. The range of nitrogen inputs from human sewage is large;
it depends on the assumptions that are made about pathways into the Canal, including
shallow and deep groundwater, springs and surface waters.
To further complicate the situation, ocean-derived nutrients are estimated to be entering
Hood Canal from the north at a much higher loading rate than the human-derived
nutrients,which enter from the watershed. The ultimate question that must be resolved is
41/ how much of each nutrient source is contributing to plankton growth and potentially to
Page 1
PHONE(360)765-4780-FAX(360)765-2202-295142 HIGHWAY 101,P.O.Box 5002,QUILCENE,WA 98376-5002-WWW.HCCC.COG.WA.US
low dissolved oxygen. The only way to answer this very complex question is to conduct
an in-depth monitoring and modeling effort. The federal government is funding that •
effort with approximately $2 million.
Another element is that other factors may contribute to low dissolved oxygen equally or
more strongly than nitrogen. These factors include physical changes or biological
changes to Hood Canal,or large-scale oceanic changes. Things such as modifications in
the Hood Canal from impoundments on the Skokomish River, diking of rivers and=
estuaries,the Hood Canal bridge and climate change may have substantially affected
precipitation and runoff patterns in the tributaries to Hood Canal.
Finally,we do not know if Hood Canal may have gone through periods of poor water
quality naturally. The federally funded study of Hood Canal will be conducted to answer
all of these questions. Before that is done,we cannot make sweeping conclusions and
have them be of any value.
The PACA Plan DOES NOT suggest that low dissolved oxygen in Hood Canal is
caused primarily by humans.
While the authors suspect that human changes are a significant contributor to low
dissolved oxygen in Hood Canal,the current evidence is not conclusive. The PACA Plan
explicitly states on page 7 that the conditions that are causing the low dissolved oxygen
are complex. In it,we stated, "We prepared this plan with the full understanding that
there is a great deal of uncertainty about the overall causes of low dissolved oxygen." It •
also acknowledges that, "modeling results will increase our knowledge about human and
natural cause-and-effect relationships for low dissolved oxygen in the Canal."
There are a number of natural factors that make Hood Canal susceptible to low dissolved
oxygen conditions. The PACA Plan focused solely on anthropogenic nutrient sources,
and did so explicitly. Human impacts are the only ones that can we can influence. Some
human impacts, such as the impoundment on the Skokomish River, are not well
understood related to the low dissolved oxygen,and will be extremely costly to modify.
The PACA recognized the need for better data before costly or controversial projects
were proposed. The PACA relied on Department of Ecology findings that plankton
growth is highly sensitive to nutrient inputs in Hood Canal. Ecology scientists have
determined that nutrient inputs limit productivity and that increases nutrients,and that
leads directly to increased plankton, and potentially to oxygen depletion at depth.
The PACA Plan DOES NOT make definitive estimates for nitrogen inputs into
Hood Canal.
The methods and estimates used were developed by a group of local experts that included
onsite sewage professionals from around the Hood Canal. The nitrogen loading estimates
used only existing population in the watershed, information provided from literature and
local health experts to estimate nitrogen loading from onsite sewage. The local health
experts also reviewed the methodologies used to make the calculations. The outcome is •
Page 2
that the loading estimates in the PACA Plan have large uncertainty. The nitrogen inputs
• from onsite sewage were estimated to be as little as 30%of the total anthropogenic
nitrogen input,to as much as 80%of the total anthropogenic nitrogen input. Even with
this large range,according to the ongoing USGS study of Hood Canal,the oceanic
sources of nitrogen may contribute 10 times as much as the human-related sources.
One important confirmation of the PACA Plan loading estimates is found in the USGS
study. Although their methods were different from those used in the PACA and direct
comparison cannot be made, the USGS results generally support the nitrogen loading
estimates found in the PACA Plan. The USGS report can be viewed at:
http://wa.water uses gov/ rrosects/hoodcanal/data/HC nhasel final odf
The PACA Plan DOES NOT recommend regulatory changes to address onsite
sewage impacts to Hood Canal.
The Hood Canal Coordinating Council and Puget Sound Action Team explicitly excluded
any mention of regulatory changes from the PACA Plan. Because of the very high
degree of uncertainty with the current causes of low dissolved oxygen,the Hood Canal
Coordinating Council did not feel that the results justify regulatory changes at this time.
Regulations must be based on"sound science"and that means the overall Hood Canal
modeling study should be completed before we spend a great deal of energy discussing of
regulations. If the study results indicate that anthopogenic nutrients are a significant
contributor to Hood Canal low dissolved oxygen,then counties might need to address the
• situation by altering onsite programs or regulations. However,the local jurisdictions
have the sole discretion to make such regulatory or programmatic changes,consistent
with state codes.
I believe that the PACA provides a good framework for actions that can be taken. It
offers ideas about programs that could help water quality in the long term. I ask that you
read the plan fully,and if you have additional questions or concerns,please contact me at
(360)301-9565 or at dave.christensen@earthlink.net. Thank you for your good work in
protecting water quality in Hood Canal. I look forward to developing and improving the
working partnerships I have with all of you.
Respectfully:
C‘.11-7
Dave Christensen
Water Quality Program Manager
•
Page 3
•
Board of Health
Old Business
Agenda Item # IV., 3
•
Letters & Documents
Re: Ms. Linda Sexton
August 19, 2004
•
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12 JEFFERSON COUNTY, DEPARTMENT OF COMMUNITY DEVELOPMENT
• I I 621 Sheridan
Street
'491Fi NG�'Ca 360/379-4450 800/831-678 • 360/379-4451 Fax 98368.
Unified Development Code (UDC) Violation:
Compliance Agreement &
Notice and Order
Via Certified Mail 7003 1680 0002 1416 0562
July 13,2004
Linda Sexton
431 Center Road CASE NO: COM01-00022
Chimacum WA 98325
You are hereby formally notified and ordered pursuant to Jefferson County UDC Section 10.6 where the Administrator believes
that the violation can be promptly and equitably corrected by an immediate administrative notice and order to correct the
following violation(s):
N UDC Violation(s):
1. Sections 4.2.3 "outdoor residential storage", 4.21.3 "transient residence or transient guest house" of the Unified
Development Code.
UBC Violation(s):
1. Section 106.1 "permits required"of the Uniform Building Code.
• Location of Violation(s)-
Address: 431 Chimacum,WA 98325
Assessor Parcel Number: 943800102
Situated in Jefferson County, Washington.
Required Correction(s):
Violation(s)must be corrected by taking the following action(s):
1• mit whtdsorahmff h
createSubanotherawritten outdoor timeline resofidhenentialtes torageouoor violationtge will or eitcompletelyerberescreen
oved othete outdoorsiteto as toragelocation fromadjacent
at doadjes not
properties and/or rights-of-ways. The timeline should incorporate schedule progress inspections by county staff.
2. A building permit is required for any structure(s)(garage,cabinette)that is being utilized as part of the transient rental
accommodations.
FAILURE TO CORRECT THE VIOLATIONS SHALL SUBJECT YOU TO THE FOLLOWING CONSEQUENCES:
• Civil Penalty/Notice of Lien:
FORMAL NOTICE REV.7 ?'
Page 1
3N E,'n
rJEFFERSON COUNTY
ti +,\� DEPARTMENT OF COMMUNITY DEVELOPMENT
0‘ . „. ....�`�`Tp621 Sheridan Street • Port Townsend • Washington 98368TNO " 360/379-4450 • 800/831-2678 . 360/379-4451 Fax
1,71(0-60e. farbo
Notice of Voluntary Correction (UDC Section 10)
June 30, 2004
•
Linda Sexton Ca..._, aye t : NI0 1 022
431 Center Road
Chimacum, WA 98325 Parcel Number: 943-800-102
Site Address: 431 Center Road
Chirnacur, WA 98325_
Re: Notice of Voluntary Correction
Dear Ms. Sexton:
Please be advised that the Jefferson County Department of Community Development has received a
complaint regarding your property located at 431 Center Road, Chimacum WA 98325. Our
"'investigation has revealed violation of the Unified Development Code. The violations are as follows:
,
1. Outdoor residential storage in a Rural Residential Zone
Section 4.2.3, Outdoor Residential Storage, Unified Development Code
2. ' Room rentals within a single family residence
Section 4.21.3, Transient Residence or Transient Guest House
The Board of County Commissioners has established a policy requiring county agencies to first seek
voluntary correction of alleged violations, We are asking you to correct the violations within 60
calendar days or no later than August 30, 2004. Our department is available to assist you by
answering any questions you may have about the steps required for voluntary correction of this
violation. For specific information please contact our office, at (360) 379-4450.
Please take notice of the above deadline, as failure to correct the violation will result in the
issuance of a Formal Notice and Order. A Notice and Order will typically assess a penalty of
$100.00 per calendar day, per violation, for each day the violation(s) continues after August
30, 2004, and may lead to civil abatement proceedings. The penalty becomes a personal
obligation and can become a lien against the property. A Notice and Order may be appealed in the
Slanner permitted in UDC section 10.8.
Please note that before initiating any corrective actions, you must first obtain all required permits.
wi. C 3 :.E.er {.r ` `
a
• - :.JEFHH•l'RSON COUNTY
Job Description
•
•
•
Job Title: Environmental Health Compliance Officer
Department: Health &Human Services
Reports To: Environmental Health Director
FLSA Exempt:NO
Union: UFCW
BBP: NO
Grade: 29
Location: Castle Hill Offii c,s
02
Human Resource Manageri�tZ.l.( cf /(kit
C U s
Approved Date: March 2004
SUMMARY : Performs field inspections to determine Enviiron.nental Health Code compliance by
Iodating and resolving cases which involve enforcement of County and State public health
codes.Attempts to achieve compliance through communications with the complainant,analyzing and •
interpreting the applicable code,andcoordinating investigations with the appropriate field person,
determining the appropriate enforcement action and pursuing legal remedies through obtaining
evidence, photos,and information that may be-presented in court by performing the following
duties.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.Other duties may be
assigned:
Receives and investigates complaints of alleged violations of County codes and ordinances using
discretion in the method of enforcement.
Coordinates with other field staff for follow-up inspections to assure compliance of violations notices
and stop work orders. •
Researches records and other information.
Prepares reports of inspections,investigations and other pertinent work performed.
Recommends and coordinates appropriate actions to be taken.
Issues stop work orders when necessary,monitors compliance, and writes letters to individuals when
necessary regarding compliance or infraction and remedies.
Gathers evidence and photos in an appropriate manner to allow presentation in court if necessary.
Confers with other County staff and legal counsel to verify code violations.
•
Participates in the review and development of amendments to County
codes. •
Assists the public by phone,in writing and in the office with code compliance questions,application
forms and general understanding of requirements.
Provides back-up to other staff as needed,including the staff that do field inspections. -
SUPERVISORY RESPONSIBILITIES:
This job has no supervisory responsibilities.
COMPETENCY: To perform the job successfully,an individual should demonstrate
competency in the following:
Cost Consciousness-Works within approved budget;Conserves organizational resources.
Ethics-Treats people with respect; Keeps commitments;Inspires the trust of others;Works with
integrity and.ethically;Upholds organizational values.
Organizational Support-Follows policies and procedures;Completes administrative tasks correctly
and on time; Supports organization's goals and values; Supports affirmative action and respects
diversity.
Judgement-Displays willingness to make decisions; Exhibits sound and accurate judgment;Supports
and explains reasoning for decisions;Includes appropriate people in decision-making process;M es
timely decisions.
Planning/Organizing-Prioritize and plan work activities;Uses time efficiently;Plans for additional
resources.
Professionalism-.Approaches others in a tactful manner;Reacts well under pressure;Treats others
with respect and consideration regardless of their status or position;Accepts responsibility for own
-
actions;Follows through on commitments.
Oualitv-Demonstrates accuracy and thoroughness.
Quantity-Cotpletes work in timely manner.
Safety and Security-Observes safety and security procedures;Reports potentially unsafe conditions;
Uses equipment and materials properly.
Adaptability-Adapts to changes in the work environment;Manages competing demands;Changes
approach or method to best fit the situation;Able to deal with frequent change,delays,or unexpected
events.
Attendance/Punctuality-Is consistently at work and on time; Ensures work responsibilities are
covered when absent;Arrives at meetings and appointments on time.
Dependability-Follows instructions,responds to management direction;Takes responsibility for own
actions; Keeps commitments.
QUALIFICATIONS To perform this job successfully, an individual must be able to perform each
essential duty satisfactorily. The requirements listed below are representative of the knowledge,skill,
and/or ability required. Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential functions.
•
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• Jefferson County
Health&Human Services Ch. ii 5 I
kJ/ %'8$z5
(k.505
2
•
_.. __
Board of Health
New Business
Agenda Item # V. , 1
1
2005 Jefferson Health &
Human Services Preliminary
Budget
August 19, 2004
•
Jefferson County Public Health
2005 BUDGET SUMMARY
• DEPARTMENT SUMMARY
In keeping with the Jefferson County Resolution establishing the 2005 Budget Goals,Jefferson County Health&
Human Services has identified how each program meets county strategic objectives on the enclosed performance
measures. The resolution also requests each department to maintain a 10%carry forward. In 2003,the unexpected
change from cash to modified accrual and the increase in building rent depleted our reserves;impacting the
department by approximately$200,000. Throughout 2004 and during the preliminary 2005 budget process we have
focused on slowly replenishing the carry forward in order to rebuild a 10%reserve.
Restructure of the department with reassignment of the Drug and Alcohol Contract and the possible reassignment of
Animal Services continued in 2004. Both of these programs required supervisory and fiscal administration time and
both contributed to the overhead of the department,so changing shapes in one year has been taxing.
• The general fund contribution is increased by 2%of the original contribution in 2004.
• To operate with a 2%increase from the general fund and the restructuring of the department,this budget
submittal represents a reduction in overall Health and Human Services staffmg levels and increased
workload throughout the department. Total FTE reduction is 4.12,which saves approximately$190,000.
• Operating expenses(excluding pass through expenses)are being reduced by approximately$115,000.
• These internal reductions are necessary to manage rising expenses by reallocating work and not reducing
services with consistent general fund money.
The 2004 appropriated budget reflects a.5%carry forward. The changes mentioned above have increased our
estimated carry forward to over 3%in 2006. This is a planned change and improvement we feel can be maintained
with the 2%increase of general fund.
COMMUNITY HEALTH(NURSING)
• • JCHHS continues to use Local Health Data profiles to determining community concerns such as substance
abuse,domestic violence,and child abuse and neglect. See"Health of Jefferson County 2003." JCHHS
programs use public funds on prevention programs proven to be cost effective in preventing these
community concerns.
• In 2004 there was a dramatic reduction in funding for Nurse Family Partnership due to the loss of a federal
grant and reduction in state funding. We are looking for other resources of funding to continue services
listed above that have proven outcome both nationally and locally in reducing child abuse and neglect and
other risk factors. At the moment,JCHHS is not filling one PHN position of a staff who resigned.
Program responsibilities are being reorganized with the hope to continue services to the highest priority
families. As of July 2004,JCHHS has approached DSHS Children's Administration to assist with funding
Nurse Family Partnership in 2005 with sustainable funding. We haven't received a response yet but have
been told it is important to their office and the request will be seriously considered.
• JCHHS anticipates maintaining the increased numbers of Family Planning clients. Increases in expenses
are being offset by reorganizing the clinic schedule in 2004 and looking for efficiencies.
• Bioterrorism and Communicable Disease programs will have a decrease in federal funding in 2004.
• Drug and Alcohol prevention services moved into Community Health when the contract for treatment
services moved to the local provider in 2004. Prevention funds are utilized primarily through the school
based,proved effective,Best Practice Programs. These funds allow prevention specialist to reach the vast
majority of middle school students.
ENVIRONMENTAL HEALTH
• Permit System study will be complete and should have some process changes for the EH and permit staff
but will not likely change budgets.
• EH fees were analyzed and changed in 2004 so these are not being changed except to reflect the cost of
living increase.
• New EH Director will be beginning to combine the EH and Natural Resources into one office. This is a
decrease in the EH administrative expense.
1 OF 2
Jefferson County Public Health
• 2005 Budget Summary- cont'd
ADMINISTRATION
• Restructuring of the department and the reassignment of the drug and alcohol treatment contract has reduced
revenues to the administrative division of HHS. To maintain a positive cash balance at the end of 2004,
staffing levels have been reduced and will continue through 2005. Concerns regarding accuracy,workload,
and production because of lower staffing levels will be evaluated throughout the year to determine whether
the department can maintain this staffing level beyond 2005.
• Contracts management,community prioritization and community Boards policy/development work is
expensive tasks and not covered in individual contracts and grants.
DEVEOPMENTAL DISABILITIES
Society has a history of discounting people with developmental disabilities,inclusion promises to be a struggle.
Division of Developmental Disabilities states, "People with developmental disabilities and their advocates work
hard to remind the rest of us that people with disabilities are people first—and that the value of a human life should
never be measured in IQ points." Services in Jefferson County continue to strive to make that position heard.
Day Program services in Jefferson County continue to be characterized by two important trends. The First trend
continues to be an emphasis on employment activities that take place in the community. The state DD policy
mandates community employment supports as the primary use of employment/day program funds for working age
adults while establishing guidelines for the Division of Developmental Disabilities(DDD)and the County when
offering and authorizing those services. The Policy applies to all eligible working age adults who receive or seek
employment,Counties under contract with DDD,County Day Program Subcontractors and all DDD field services
staff.
The Working Age Adults policy is based on RCW 71A.10.015 which states that the Legislature"recognizes the
• state's obligation to provide aid to persons with developmental disabilities through a uniform,coordinated system of
services to enable them to achieve a greater measure of independence and fulfillment and to enjoy all rights and
privileges under the Constitution and laws of the United States and the state of Washington." This legislative intent
can be accomplished by providing working age adults the supports needed to achieve gainful employment.
This policy defines employment supports as paid,competitive employment for people who have severe disabilities
and who have demonstrated an inability to gain and/or maintain traditional employment. Supported Employment
services support individuals to pursue or maintain gainful employment in integrated settings in the community.Key
elements of these services include the following: 1)Supports are tailored to the needs,interests and abilities of the
individual to obtain and maintain jobs;and 2)All individuals receive supports to achieve and maintain integrated,
gainful employment in their community;3)minimum wage pay or better;4)promotion of career development and
workplace diversity. It further defmes the pursuit of"gainful employment"as employment that reflects
achievement of or progress towards a living wage,(which is described as the amount of earned wages needed to
enable an individual to meet or exceed his or her living expenses),and defmes employment in an integrated setting,
as a typical community setting not designed specifically for individuals with disabilities.
Jefferson County continues to focus on individualized services based on the choices and needs of each person
receiving those services. We see that by developing the services based on the needs of the person as an individual
we do not have to create an array of programs and then try to fit the individual into the most appropriate program
"slot"available. An important component of the Working Age Adults Policy that reflects the individualized service
trend is called"Pathways to Employment".
•
2 OF 2
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Board of Health
New Business
Agenda Item # V., 2
•
Public Health Emergency
Preparedness & Response
Duty Officer:
Implementation Plan
August 19, 2004
1
.v„,....0,,„ $ °° • Region 2 Public Health &
`: Ktrsap COUNTY' g
_ N ``l HEALTH Hospital Emergency
ii. . A, \, +, DISTRICT
Na MUM P�S� `y,s. '�0 Preparedness & Response
III
Region 2 Public Health Regional Duty Officer
Background
The three local health jurisdictions in Region 2 (Clallam County Health & Human
Services, Jefferson County Health & Human Services, and the Kitsap County Health
District) have established a Regional Duty Officer (RDO) system as a mechanism for
providing professional public health consultation across the region on a 24/7 basis. The
RDO will triage after-hours requests for public health services,taking appropriate action
as needed; and will receive Health Alert Network (HAN) messages from the
Washington State Department of Health (DOH) that may necessitate activation of public
health emergency response plans. Region 2 plans to activate the RDO system on
September 7,2004.
Concept of Operations
During normal working hours, the Kitsap County Health District can be reached via the
main switchboard.
• Normal working hours are: Monday-Friday 8:00 AM-4:30 PM
Contact Numbers: (360)337-5235 voice
(360)337-5298 fax
Calls placed after normal working hours will be answered by a recording that refers any
emergency calls to 911. After hours, and after receiving an emergency call requiring
public health action, CENCOM will page the RDO at (360) 412 - 2556. Organizations
having direct access to the RDO pager include county emergency dispatch centers,
emergency management, regional hospitals and health care clinics, local physicians and
the Washington State Department of Health(DOH)
If the Duty Officer fails to respond within 15 minutes, then contact the Health
Officer/Health District Director,or the Deputy Director.
Dr. Scott Lindquist Scott Daniels
Health Officer/Director Deputy Director
Office (360) 337-5237 Office (360) 337-5287
Home (206) 780-6923 Home (206) 780-5320
Cellular (206) 718-2664 Cellular (360)434-0495
Please direct any questions or comments to:
Brian Arcement, Local Emergency Response Coordinator, Kitsap County Health
411 District, (360)337-5267,arcemb@health.co.kitsap.wa.us
5 August 2004
INTERLOCAL AGREEMENT
BETWEEN KITSAP HEALTH DISTRICT, JEFFERSON COUNTY
AND CLALLAM COUNTY
FOR REGIONAL DUTY OFFICER SERVICES
THIS INTERLOCAL AGREEMENT is made this day of , 2004 between
KITSAP COUNTY HEALTH DISTRICT("Kitsap County Health District"), a
Washington Municipal Corporation, JEFFERSON COUNTY("Jefferson County"), a
political subdivision of the State of Washington, and CLALLAM COUNTY("Clallam
County"), a political subdivision of the State of Washington.
RECITALS
A. Kitsap County Health District, Jefferson County, and Clallam County desire to
implement a shared 24 hour, 7 day per week public health emergency response
capability to be know as the "Regional Duty Officer"
B. Kitsap Health District, Jefferson County and Clallam County desire to establish and
delineate the terms and conditions of services to be provided and to that end and
pursuant to Chapter 39.34 RCW,the Interlocal Cooperation Act, do hereby enter into
•
this Agreement to perform services they could each perform and undertake alone.
NOW THEREFORE, In consideration of the mutual covenants and promises described
herein Kitsap County Health District, Jefferson County, and Clallam County agree to the
following roles and responsibilities.
Section 1. EMPLOYMENT OF DUTY OFFICER
Kitsap County Health District, Jefferson County, and Clallam County agree to provide
qualified employees to serve on a rotating schedule to provide continuous coverage of the
duties and responsibilities of the Regional Duty Officer.
The qualified person serving as Regional Duty Officer remain at all times relevant to this
Interlocal Agreement an employee and representative of their respective Health District
or County.
Each County and Health District represents that it currently employs or will employ a
person or persons qualified to serve as the Regional Duty Officer. A person is qualified
to serve in the capacity of Regional Duty Officer if the person is a public health
professional licensed in the State of Washington as a physician or registered nurse, a
registered sanitarian, or as otherwise determined to be qualified by the health officers of
Clallam, Jefferson, or Kitsap counties.
•
- 1 •
-
• Section 2. TERM
This agreement shall commence and continue until December 31, 2007
unless terminated earlier as provided in Section 7 below.
This Interlocal Agreement shall be automatically extended for additional terms of two (2)
years unless one of the parties to this Agreement seeks to terminate this Interlocal
Agreement in writing at least 60 days before December 31, 2007 or in writing 60 bays
before any termination date created by this automatic extension provision.
Section 3. DUTIES OF EMPLOYEES
Employees of Kitsap County Health District, Jefferson County, and Clallam County
assigned to fulfill the obligations and duties of the Regional Duty Officer will perform
the following duties:
A) Participate in a rotating call schedule to respond to requests for public
health services
B) Carry an alphanumeric pager during the hours of active duty to receive
and respond to requests for service
C) Complete all necessary orientation and training to carry out the
responsibilities of the Regional Duty Officer
D) Respond to requests for public health services within the 3 County Region
in accordance with specific policies and protocols developed jointly by Region 2.
E) Evaluate and refer requests for service to appropriate local, state, and
national public health professionals and other qualified individuals as specified in Duty
Officer Protocols
Section 4. DUTY OFFICER SCHEDULE
A schedule for Duty Officer coverage will be created and maintained by the Region 2
Lead County, Kitsap County Health District. Staffing responsibilities will be apportioned
among the participating counties using a population-based formula. The percentage of
time each County Health Department/District will provide Duty Officer coverage will be
equal to that county's population divided by the combined population of Region 2
(Kitsap, Jefferson, and Clallam). Thus, during the course of a calendar year the Regional
Duty Officer of each participating entity will serve the following portions of the year on
a regularly rotating weekly basis:
Kitsap County Health District: 72% (38 weeks)
Clallam County: 20% (10 weeks)
Jefferson County: 8% (4 weeks)
Section 5. COMPENSATION
Employees of Kitsap Health District, Jefferson County, and Clallam County serving as
Regional Duty Officers will be compensated in accordance with their existing
•
-2_
employment contract or, if applicable,their collective bargaining agreement or
resolutions of their governing bodies. •
Section 6. LIABILITY INSURANCE
Kitsap Health District, Jefferson County and Clallam County will maintain liability
insurance coverage for their respective employees for their service as Regional Duty
Officers. This liability insurance will cover medical malpractice, errors and omissions,
comprehensive general liability, automobile and similar liabilities for statutory and
contractual duties performed by the Employee as the Regional Duty Officer. Services
performed by Regional Duty Officers are and will be considered to be part of the job
responsibilities of each individual who serves in this capacity.
Section 7. TERMINATION
This agreement can be terminated or modified for any reason that does not unlawfully
discriminate or violate public policy, including but not limited to: lack of work, lack of
funds,reorganization, or unsatisfactory performance, as determined in the sole discretion
of the participating parties.
Termination of this agreement shall be as provided by mutual agreement between any
parties to this agreement. However, to terminate, sixty(60) days advance written notice
is required.
Section 8. DEFENSE AND INDEMNIFICATION •
Each party to this agreement shall defend, indemnify and hold harmless the other parties
to the agreement, including its elected and appointed officers and employees, from any
claim, demand, suit, action,judgment or expenses, including attorney fees, arising from
the indemnifying party's employee's acts and/or omissions while serving as the Regional
Duty Officer.
•
-3-
Section 9. VENUE AND JURISDICTION
• The parties to this Agreement agree that this Interlocal Agreement shall be construed and
interpreted pursuant to the laws and precedents of Washington State and that venue for
any lawsuit arising from this Interlocal Agreement shall be in the Superior Court, Kitsap
County.
Section 10. ENTIRE AGREEMENT
This agreement for the provision of professional services constitutes the entire agreement
between the parties with respect to the subject matter thereof, and supersedes all prior
written agreements and all prior or contemporaneous oral agreements or understandings
between the parties.
BOARD OF KITSAP COUNTY HEALTH DISTRICT
KITSAP COUNTY, WASHINGTON
By: Date:
Chair
BOARD OF COUNTY COMMISSIONERS
• JEFFERSON COUNTY, WASHINGTON
By: Date:
Chair
BOARD OF COUNTY COMMISSIONERS
CLALLAM COUNTY, WASHINGTON
By: Date:
Chair
ATTEST: APPROVED AS TO FORM ONLY:
By: By:
Clerk of the Kitsap Health District Kitsap County Health District Attorney
By: By:
Clerk of the Jefferson Co. BOCC Jefferson County Prosecuting Attorney
By: By:
Clerk of the Clallam Co. BOCC Clallam County Prosecuting Attorney
•
-4- •
.M Coi.,y 40 ON (+
• °T` �°Y° • �ciTsapcaur�n Region 2 Public Health &
f `) HEALTH Hospital Emergency
FST„ ... •Pte" \\,;,,,.. " ,' i DISTRICT
• h�„uMANS� rxo�° Preparedness & Response
REGIONAL DUTY OFFICER PROTOCOL
As of 5 August 2004
I. PURPOSE
This plan establishes the procedures whereby the Region 2 Public Health Duty
Officer provides professional public health consultation across Clallam,Jefferson,
and Kitsap counties on a 24/7 basis. The Duty Officer will also serve as a single
Region 2 Public Health point of contact for the purpose of after hours emergency
notification and emergency response system activation.
II. SCOPE
This plan addresses after hours emergency notification and emergency response
for the three local health jurisdictions (LHJs) in Region 2: Clallam County Health
and Human Services (CCHHS), Jefferson County Health and Human Services
(JCHHS),and the Kitsap County Health District(KCHD).
0 III. CONCEPT OF OPERATIONS
A. During normal working hours, emergency notification and response
system activation will be accomplished through the respective LHJ
switchboard numbers:
1. Clallam County Health and Human Services (CCHHS):
Normal working hours:
Monday-Friday: 8:30 AM-12:00 PM and 1:00 PM-4:30 PM.
Closed 12:00-1:00.
Switchboard number:
(360)417-2274
Fax number:
(360)417-2583
III
Region 2 Public Health
Regional Duty Officer Protocol
5 August 2004
2. Jefferson County Health and Human Services (JCHHS): •
Normal working hours:
Monday-Friday: 9:00 AM-4:30 PM.
Switchboard number:
(360)385-9400
Fax number:
(360) 385-9401
3. Kitsap County Health District(KCHD):
Normal working hours:
Monday-Friday: 8:00 AM-4:30 PM.
Switchboard number:
(360) 337-5235
Fax number:
(360)337-5298
B. Calls placed to the respective LHJ switchboard numbers after normal
working hours will be answered by a recording that refers any
emergency calls to 911.
C. The respective Central Communications/9-1-1 dispatch centers in
Clallam, Jefferson, and Kitsap counties will take all emergency calls for
the LHJ that are placed after normal working hours:
1. Clallam County 9-1-1 Dispatch/Peninsula Communications
(PenCom):
Telephone Number: (360)417-4970
2. Jefferson County 9-1-1 Center:
Telephone Number: (360) 385-3831 Extension 1
•
2
Region 2 Public Health
Regional Duty Officer Protocol
5 August 2004
.
3. Kitsap County Central Communications(CENCOM):
Telephone Number: (360)308-5400
D. The respective Central Communications/9-1-1 dispatch centers will refer
all public health related emergency calls to the Region 2 Public Health
Duty Officer via the duty officer pager number: (360) 412-2556.
E. Regional hospitals, clinics, and health care providers may contact the
duty officer during after duty hours with public health related emergency
calls (e.g.immediately reportable notifiable conditions- See Tab 2).
F. The Washington State Department of Health(DOH) may contact the duty
officer with urgent Health Alert Network (HAN) reports. Depending
upon the nature of the HAN report, the duty officer may be required to
activate one or more of the LHJ emergency response plans.
G. The respective emergency management agencies in Clallam, Jefferson,
and Kitsap counties may also contact the duty officer with emergency
related information that impacts the public health. Depending upon the
nature of the HAN report, the duty officer may be required to activate
• one or more of the LHJ emergency response plans.
H. Region 2 has ten pagers for duty officer use, each with the same number.
The individual "on-call" will turn on their pager for the duration of their
shift(a seven-day period),and the other nine pagers will be turned off.
I. If the Duty Officer does not return the page within 15 minutes, the
organization placing the page will call the appropriate county health
officer and/or LHJ director.
IV. DUTY OFFICER ROLES &RESPONSIBILITIES
A. The Region 2 Public Health Duty Officer will be a qualified public health
professional employed by one of the three Region 2 LHJs.
B. The duty officer will carry a pager (360-412-2556) accessible throughout
the region. Region 2 has ten pagers for duty officer use, each with the
same number. The individual "on-call" will turn on their pager for the
duration of their shift(a seven-day period),and the other nine pagers will
be turned off. Shifts will run from Monday to Monday, starting at 9:00
a.m.
3
Region 2 Public Health
Regional Duty Officer Protocol
5 August 2004
C. The Duty Officer's main responsibilities will be to: •
1. Triage requests for public health services as forwarded by the
respective county in accordance with Figure 1.
(a) Examples of emergency related issues include:
• Infectious diseases that meet immediately reportable
notifiable conditions- See Tabs 2 and 3
• Suspicious substance instances- See Tab 4
• Environmental health issues impacting solid and
hazardous wastes, food, water systems, and water quality
(including fuel spills that affect shellfish).
• Health Alert Network (HAN) notices advising of an
imminent threat to the public health.
• Natural disasters impacting the public health (winter
storms,earthquakes,etc.).
(b) Non-emergency calls will be referred to the appropriate LHJ for
resolution during normal working hours.
(c) Should after hours action be required, the Duty Officer will
contact the appropriate staff member in the affected LHJ and pass •
the action to them for their resolution(See Tab 7).
(d) If the appropriate staff member in the affected LHJ is not
available, the duty officer will contact the appropriate county
health officer. Subsequent to discussion with the health officer,
the duty officer may be required to take such action as is
necessary per Tab 3. Information that may be useful in initiating
necessary action includes:
• Information on the regional laboratory capacity - See Tab
5.
• County points of contact- See Tab 8.
• State and Federal points of contact- See Tab 9.
(c) The duty officer is encouraged to contact the appropriate county
health officer whenever a question arises.
Clallam&Jefferson Counties-Dr.Tom Locke
Office (Clallam): (360)417-2437
Office (Jefferson): (360)385-9448
Home: (360) 683-9152 •
4
Region 2 Public Health
Regional Duty Officer Protocol
5 August 2004
1111 Cell Phone: (360)461-9327
Pager: (360)582-8353
Kitsap County-Dr. Scott Lindquist
Office: (360)337-5237
Home: (206) 780-6923
Cell Phone: (206) 718-2664
2. Provide timely and accurate information to callers, possibly including
media inquiries (See Tab 6).
3. Receive and assess emergency-related information, including Health
Alert Network(HAN) messages,that may necessitate the activation of
the Region 2 or LHJ public health emergency response plans.
4. The duty officer will record all calls and all actions taken on the duty
officer log sheet (See Tab 14). Fax a copy of the log sheet to the LHJ
involved in the action on the next business morning. At the
conclusion of the duty officer's shift, a copy of all log sheets will be
faxed to the Region 2 Emergency Response Coordinator at (360) 337-
. 5298.
5. Assist the Health Officers and Directors as needed.
V. DUTY OFFICER ROSTER AND SHIFT ROTATION
The Duty Officer roster and shift rotation will reflect the population distribution
within the region(See Tabs 10 and 11). The total population for Clallam County
is around 65,000 people (approximately 20% of the total regional population),the
total population of Jefferson County is around 27,000 (8%), and the total
population of Kitsap County is around 240,000 (approximately 72% of the total
regional population). As a result, KCHD staff members will cover 72% of the
weekly duty shifts (37 weeks), CCHHS will cover 20% of the shifts (10 weeks),
and JCHHS will cover 8% of the shifts (5 weeks).
5
Region 2 Public Health
Regional Duty Officer Protocol
5 August 2004
Duty Officer Triage Flow Chart •
Telephone Call
Received
Determine if call is:
V
A Public Health A Call Needing A Routine
Emergency Timely LHJ Inquiry
Response
•
Contact County Consult Duty Refer to LHJ on
Health Officer Officer Handbook Next Business
Morning
1 1 1
Contact identified 4110
Take action as directed and local public health Record contact information
record action taken on duty worker And public health question on
officer log sheet duty officer log sheet
Identified
Public Health
Personnel
Yes contacted? No
Continue to attempt
Record action taken contact with back-up
on duty officer log personnel
sheet
1
If no backup available:
Contact County Health Officer
Take action as directed and
Notify Affected Local Health Jurisdiction record action taken on duty
on the next business day of all actions officer log sheet
taken
6 •
•
Board of Health
New Business
Agenda Item # V., 3
• WA State & Jefferson County
Food Service Code Revision
August 19, 2004
•
• . a, i s
ea th I
You are here: DOH Home» EH Home >> FSSP Home» Food Safety Program » Food Search I
Service Rule Revision Employees
Food Service Rule Revision
Chapter 246-215 WAC, Food Service:
Rule Revision Process
Background
• The food service rules of the State Board of Health(Chapter 246-215 WAC)were
last revised in 1992.
• At its November 2001 meeting,the State Board of Health initiated a major
revision of these rules.
• Passed in the 2002 legislative session, RCW 69.80.60 mandates special rules for
donated food distributing organizations.
• Passed in the 2003 legislative session,RCW 43.20.145 mandates consideration of
the most recent FDA Food Code for the food service rule. The most recent edition
is 2001. The FDA Food Code is a model rule.
• Food Service Rule Revision Stakeholder Input
• The Department of Health(DOH) formed advisory workgroups and began
soliciting comments from Washington food safety stakeholders in 2002.
• DOH formed a Core Workgroup to review and vote upon stakeholder comments
and subcommittee recommendations.
• Based on Core Workgroup recommendations,DOH prepared a first draft of the
proposed rule revision in August 2003 and held 19 statewide public comment
workshops in September 2003.
• The Core Workgroup reviewed comments regarding the first draft of the proposed
rule revision to provide recommendations for draft two.
• DOH prepared a second draft and held 9 statewide public comment workshops in
February and March 2004. Comments were again reviewed by the Core
Workgroup prior to DOH preparing the final proposal.
Core Workgroup Membership
15 voting members
• 3 restaurant representatives
• 2 grocery representatives (rotating representation)
• 1 food worker representative
• 1 school food service representative
• 5 local health jurisdiction(LHJ)representatives •
• 1 DOH Facilities Services & Licensing representative
• 1 Department of Social and Health Services representative
• 1 consumer representative
Core Workgroup Decision-making Principles
• Make consensus decisions (only vote as needed)
• Maintain strong, effective food safety rules
• Adopt 2001 FDA Food Code provisions as written, unless compelling reason to
change
• Ensure all affected stakeholder groups are heard
Most Discussed Issues
The following table lists the most discussed issues of the proposed rule revision and
describes the final proposal.
Issue Proposed In Draft#1 Proposal In Draft#2
Food ' Exempt certain low-risk I Clarify that activities licensed
establishment j operations from regulation 1 and regulated by WSDA and
definition , (clarify and modify to whom the USDA are exempt from these jI
rules a_..._1 1 •
pp y). rules. 1
Potlucks I Exempt potlucks from I Exempt all non-commercial
regulation, unless commercially 1 potlucks, regardless of the type
( advertised to general public. i of advertising.
Time as control € Follow the FDA Food Code and I No change.
allow potentially hazardous
foods to be held for service for 4
hours without temperature 2
control (requires written plan,
time marking, and discard at end 1
of holding period). I
Bed & breakfast I Limit the size of the operation to I Limit the size to not more than 8
operations ' not more than 6 guest rooms if ? guest rooms for certain physical
I exemptions from certain exemptions to apply. Current
physical facility requirements ? licenses are grandfathered for
apply(e.g., 3-compartment l physical facilities under Chapter
sinks and separate residential l 8 of the FDA Food Code.
kitchen). Limit meal service to 1 1
breakfast. I Allow preparation and service
i of non-potentially hazardous
baked goods to guests any time411
0 i ' of day
Cold holding ` Follow the FDA Food Code to No change.
I lower the cold holding
temperature from 45°F to 41°
F. Give a 5-year grace period
for existing equipment that
cannot maintain this lower
temperature.
Cooling € Follow the FDA Food Code and No change.
eliminate current state
requirement for pre-chilling of
ingredients for preparing
potentially hazardous salads and
sandwiches.
Cooking/thawing= Follow the FDA Food Code and No change.
allow cooking of large pieces of
frozen meat without pre-thawing
(except temporary
establishments and mobile
I units). 1
• Consumer ' Follow the FDA Food Code and No change.
advisory require both "disclosure" that
certain foods are raw or
3
undercooked and a"reminder"
I to the consumer that there could 1
be a health risk.
Farmers I Clarify that raw,whole(or i Clarify that food production
markets ; trimmed)produce is exempt activities under the jurisdiction
from the rules. Most ready-to- of the Washington State
I eat foods are subject to the rules. Department of Agriculture or
USDA are exempt from these
rules.
Date marking ; Follow the FDA Food Code to Do not adopt this FDA Food
require ready-to-eat,potentially I Code provision with this
I hazardous foods to be "date t revision.
marked" after being prepared or
opened and discarded within 4 1
i
or 7 days, depending on
refrigeration temperature.
Exempt from € Create a statewide list of foods I No change.
. permit exempt from permit(rather than I
individual local lists).
•
Inspection Revise minimum inspection I Allow less frequent inspections
frequency frequency of food than every 6 months based on
establishments from annually to i risk(including self-inspection
every 6 months unless otherwise program),without telephoning
set in a written risk-based plan operator. Specify that temporary
developed by the regulatory establishments be inspected [at
authority. least once] during permit period,
rather than periodically during
permit period.
Donated food Require permits for donated I Exempt donated food
distributing food distributing organizations. distributing organizations from
organizations ' requirement to have food
establishment permit,but
require them to meet specified
food service rules.
DOH Contacts:
Ned Therien-Phone: (360) 236-3071 email: ned.therien@doh.wa.gov •
David Gifford -Phone(360)236-3074 email: dave.gifford@doh.wa.gov
Back to Food Rule Revision page
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•
Chapter 246-215 WAC, Food Service
Highlights of Revision Proposed for
• State Board of Health Hearing
September 8, 2004
Definitions
• "Food establishment"changed to exempt more low-risk operations
• Non-commercial potlucks are exempt from the rules
• "Temporary establishment"changed to add recurring event for maximum of 3 days
per week
Person in charge
• Requires a designated person in charge to be present during hours of operation,who
must be able to demonstrate food safety knowledge
Employee hygiene
• More clearly defines employee hygiene, limits certain activities while working with
food, includes detailed hand washing instructions (20 seconds)
Approved source
• PHF must be 41°F or less at receiving
• Molluscan shellfish tags must be kept for 90 days
• • Fish served raw must be previously frozen to kill parasites
Preventing contamination
• No bare hand contact with ready-to-eat food, except under authorized handwash plan
• Single-use gloves must be discarded when soiled, damaged, or use interrupted
Cooking temperatures
• 145°F on exterior for intact whole-muscle beef steak
• 155°F for ratites, injected meats, and ground meats
• Range of 130°F-158°F (112-0 minutes) for whole beef&pork roasts
• 145°F for eggs and intact pieces of fish and meat(except poultry)
• Microwave cooking-- all PHF cooked to 165°F, stirred, let stand for 2 minutes
• Cooking of large pieces of frozen meat without pre-thawing allowed, except
temporary establishments
Heating/reheating
• Fruits/vegetables must be heated to 140°F degrees for hot holding
• Reheating to 165°F for 15 seconds for hot holding within 2 hours;
except within 60 minutes for mobiles and temporaries
Cooling
• • Maximum 6-hour cooling time to 41°F(2 hours to get to 70°F)
• Alternative is 2"depth uncovered (no monitoring required)
• No pre-chilling of ingredients for preparing PHF salads and sandwiches required
• 8/4/2004
Cold holding
• PHF must be held at 41°F
• 5-year grace period for existing equipment holding 45°F •
Time as control(without temperature control)
• Max 2 hours during active preparation
• Max 4 hours during display for immediate consumption or for a working supply
(Requires written plan, time marking,discard at end of holding period)
Reduced oxygen packaging
• Requires variance, HACCP plan,training
Consumer advisory
• Health warning added to consumer advisory required when serving raw or
undercooked ready-to-eat food of animal origin or unpasteurized juice---
menu, label, table tent,placard,brochure
Equipment
• Sponges can't be used on food contact surfaces
• Food contact surfaces must be cleaned every 4 hours and between different raw
animal foods
Exempt from permit •
• Must apply for exemption
• Statewide list of foods that may be served without permit- follow safe handling rules
Enforcement
• Existing physical facilities not required to meet new requirements unless public
health hazard determined--- except cold holding
• Regulatory authority(local health jurisdiction)may grant waiver/variance for most
provisions
• Inspection frequency every 6 months --- or less frequently if a risk-based plan is
developed by regulatory authority
Donated foods
• Minimal provisions for donated food distributing organizations
• Donated food distributing organizations are exempt from permit
• Donors and charitable kitchens are exempt from rules
Effective date
• May 2, 2005 is proposed statewide effective date
Additional information is available at http://www.doh.wa.gov/ehp/sf/FoodRuleMain.htm
8/4/2004
Summary of Proposed Revision of
Washington State's Food Service Rule:
. Major Differences between FDA 2001 Food Code,
Current Chapter 246-215 WAC, and
Proposed Rule Revision
State Board of Health Hearing
September 8,2004
• >' � � m ,Ae ° 3 1 tr,1, "ar;Y,. ... �'. � c x div �•
Definitions 1-201.10(B)(36) Food -010(22) Food Service Blended modification of both
Establishment includes almost Establishment includes almost with exemptions for private
anyone who provides food for anyone providing food to public gatherings;non-commercial
consumption regardless whether with or without charge,including potlucks;service of
there is charge. Exemptions bed&breakfast facility. commercially pre-packaged
include a home used to prepare Exemptions include private home foods;dry beans/grains;etc.
non-PHF for religious or charity gathering and farmers'produce
bake sale;a"food processing sales. Clarification that activities
plant";home day care;bed& licensed by WSDA are
breakfast facility;produce stand. exempt from this rule
1-201.10(B)(65)Potentially -010(40) PHF includes"certain" Food Code
Hazardous Food(PHF)includes cooked plant foods;water activity Clarification that fresh herbs
cooked plant food;water activity above 0.90;no exclusion for hard- in oil are PHF
above 0.85;excludes air-cooled boiled eggs
hard-boiled eggs with shell intact
• 1-201.10(B)(95)Temporary Food -010(49)Temporary Food Service Single event for 21
Establishment operates not more Establishment operates at a fixed consecutive days max;
than 14 consecutive days location for not more than 21 Recurring event for 3 days per
consecutive days week max
Person in charge 2-101.11 Be present during hours No equivalent Food Code
of operation _
2-102.11 Demonstrate knowledge No equivalent Food Code
2-201.12 Exclude food workers -260(2)(c)&(e) Health officer Blended modification
with diseases and symptoms restricts food workers
No equivalent -080(6)(a)Ensure all food workers WAC
comply with provisions of Chapter Clarification on reference to
69.06 RCW and Chapter 246-217 Chapter 69.06 RCW and
WAC regarding food worker cards Chapter 246-217 WAC
Hand washing 2-301.12 20-second wash, -080(1)Less specific Food Code
vigorous,underneath fingernails,
between fingers
2-301.16 Hand sanitizers must -080(3) No hand sanitizer Food Code
conform to specifics,when used in specifications,when used in
addition to washing addition to washing
5-203.11(C)If approved,may use No equivalent WAC(water required for
towelettes for handwashing handwashing)
Employee 2-302.11 Fingernails trimmed and No equivalent Food Code,modified to
hygiene filed;no polish or artificial nails prohibit polish or artificial
unless wear gloves fmgernails during food
preparation unless wearing
gloves
WDOH 8/4/2004