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Home My WebLink About2005-February File Copy • Jefferson County Board of Health .agenda • .M mutes Jebruary 17, 2005 • • JEFFERSON COUNTY BOARD OF HEALTH Thursday, February 17, 2005 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 January 20, 2005 III. Public Comments IV. Old Business and Informational Items 1. Influenza Activity—Human and Avian 2. Washington State Board of Health—2004 Annual Report 3. Gov. Gregoire Reappoints Secretary of Health • V. New Business 1. Isolation and Quarantine Conference Follow-up—Role of Local Board of Health 2. 2005 Legislative Session —Key Public Health Issues 3. Jefferson County Food Code—Board Guidance 4. Washington State Vaccine Program—Local Policy Issues VI. Activity Update 1. Access! Ability! Toward a livable community—March 23, 2005, Fort Worden State Park VII. Agenda Planning VIII. Next Scheduled Meeting: March 17,2005 2:30—4:30 PM Main Conference Room Jefferson Health and Human Services • { JEFFERSON COUNTY BOARD OF HEALTH • MINUTES w ` Thursday, January 20, 2005 Board Members: Staff Members: Phil Johnson-County Commissioner District#1 Jean Baldwin, Health &Human Services Director David Sullivan, Vice Chairman- County Commissioner District#2 Julia Danskin,Nursing Services Director Patrick M Rodgers-County Commissioner District#3 Thomas Locke,MD, Health Officer Geoffrey Masci, Chairman-Port Townsend City Council Jill Buhler-Hospital Commissioner District#2 Sheila Westerman-Citizen at Large(City) Roberta Frissell-Citi<en at Large(County) Vice Chairman Frissell called the meeting to order at 2:40 p.m. in the Health Department Conference Room. All Board and Staff members were present. There was a quorum. APPROVAL OF AGENDA Member Masci moved to approve the Agenda as written. Commissioner Rodgers seconded the motion, which carried by a unanimous vote. ELECTION OF 2005 CHAIRMAN AND VICE CHAIRMAN Vice Chairman Frissell called for nominations for the position of Chairman. Member Buhler nominated Member Masci. There being no further nominations, Member Buhler moved to elect Member Masci as Chairman. Member Westerman seconded the motion,which carried by a unanimous vote. In response to the call for nominations for Vice Chairman, Member Masci nominated Commissioner Sullivan. There being no further nominations, Chairman Masci moved to elect Commissioner Sullivan as Vice Chairman. Member Westerman seconded the motion,which carried by a unanimous vote. Member Frissell welcomed incoming Commissioners Johnson and Sullivan. APPROVAL OF MINUTES Chairman Masci moved to approve the minutes of December 16, 2004, as written. Commissioner Rodgers seconded the motion,which carried by a unanimous vote. HEALTH BOARD MINUTES -January 20,2005 Page: 2 • PUBLIC COMMENT —None OLD BUSINESS AND INFORMATIONAL ITEMS —None NEW BUSINESS 2005 Legislative Session Preview —Key Public Health Issues: Dr. Tom Locke noted that the legislature is currently in its 105-day session, the budget writing session. For the third biennium,they are beginning with a major deficit, a $1.8 billion shortfall,driven mostly by increased caseloads. The highest public health priority this year remains a stable,predictable source of funding. He was appointed public health spokesman for a campaign called "Walk the Talk for Public Health."All legislators are being given pedometers and there would be a competition between the two parties in the House and Senate for how many steps they can get in each day. Beyond individual health, the program is about the health of all communities and that the legislators should not walk out of Olympia without a plan for solving public health funding. It has been estimated that bringing the state's public health system up to the standards set in the public health improvement plan would cost $400 million. He reviewed items included in the agenda packet: a priority of public health issues from the Washington Association of Counties, a preview of 2005 Legislative Session written by the Executive Director for the State Board of Health, and highlights of Governor Locke's Budget. Dr. Locke reported that aside from the shoreline-related fund, it is uncertain whether any other funding lines would have any significant impact to the County. Jean Baldwin mentioned that a bill introduced last year by Senator Rosa Franklin of Tacoma is listed on the Legislative Overview under Physical Activity and Nutrition. It would require physical activity issues be considered when doing land use planning, including community development and transportation planning. Chairman Masci noted that last year's proposed special fund incentive for methamphetamine site clean up was not specifically mentioned in the Governor's budget proposal this year.He believes the Sheriff's Department is seeing increased methamphetamine use and production in the County. Dr. Locke noted that the degree of State funding available is largely determined by the site's level of contamination. Jean Baldwin noted that the Department did not seek another contract with Ecology because of the burdensome contract requirements. While the Governor had proposed keeping the current Public Health Backfill funding level of$49 million,it would be channeled through Health Services' rather than CTED (Community Trade and Economic Development). To help balance the Health Services account, the Governor is proposing a one percent tax on physician services. With Washington having the most regressive tax structure in the country, areas that can be taxed • A • HEALTH BOARD MINUTES -January 20,2005 Page: 3 are already heavily taxed. He further noted that Basic Health has roughly 100,000 clients/enrolled, but is authorized to go up to 130,000. 2005 Board of Health Work Plan —Program Review, Priority Setting, Rule Development and Emerging Issues: Jean Baldwin urged the Board to review the Health Department's mission and the Board's vision, as well as the expectations of its meetings. The Department is scheduled to have an external review and audit of its standards over two days in May. While the last audit was positive,during the last two years there has been a decrease in services, staffing, etc. Chairman Masci suggested that the Board schedule a retreat in February or March to prioritize programs and services before this audit occurs. This might also provide an opportunity to educate itself. Ms. Baldwin suggested holding such a retreat after the completion of the 2004 performance measures in February or March. She also reminded that the Board would need to review and adopt the Environmental Health On-Site rules and the Jefferson County Food Code. Dr. Locke commented that the County's current Food Code is very similar to the new State standards. The recently adopted On-Site Code while meeting current technical standards,will need some modification, mostly to allow for consideration of whether to use new tools/authorities from the State Code. 1111 Regarding program updates, Jean Baldwin noted that there would likely be an in-depth review of Family Planning next month, to be followed by Maternal Child Health (MCH). The Board might benefit from seeing a comparison of prevention standards and programs. At the last Board of Health meeting, there was also discussion of a workgroup to address immunizations and work with the schools and Rotary Clubs. A three-day emergency management tabletop exercise is scheduled for March. She solicited additional agenda topics or program updates the Board might find of interest. There was Board interest in scheduling an April Board retreat and Chairman Masci agreed to work with Jean Baldwin on preparing an agenda for the Board's consideration. Influenza Update—Vaccine Redistribution, Influenza Activity, Policy Implications: Dr. Locke reviewed that the shortage and delayed distribution of the vaccine has made for an unusual year, but the February and March influenza peaks in the northern hemisphere have been fairly typical. There was a small cluster outbreak of Influenza A in Grant County in Eastern Washington. Once the virus reaches the schools, there would be a shift from sporadic to widespread activity. In mild flu years,on average, the nation sees 20,000 excess deaths and hundreds of thousands of excess hospitalizations; in a bad year, this figure could reach 40-50,000. In a pandemic year, with a new strain in circulation, this number could cause 200,000 to one million excess deaths. Thanks to Jefferson Healthcare's good luck of securing 10,000 doses, Jefferson County has had good vaccine coverage and been able to 0 share its surplus to help cover regional shortages in Clallam and Kitsap Counties.Having filled providers' orders and vaccinated the high-risk populations,jurisdictions have been HEALTH BOARD MINUTES -January 20,2005 Page: 4 • loosening or lifting their restrictions on vaccine use; anyone in Washington State who can find a vaccine can now be vaccinated. Acceptance of the live virus vaccine flu mist by the public continues to be slow; not only does the vaccine cost more, its use is restricted to those healthy and under 50. Dr. Locke said there have been no reported flu cases in Jefferson County. Confirming whether a respiratory infection is influenza is costly and time-consuming. An outbreak is usually characterized by absenteeism in schools of greater than ten percent, an increase in the rates of chest x-rays, and reports of influenza-like illness by physicians. A small percentage of cases actually get cultures to determine influenza and identify the type. The severity of respiratory illness is not a good indicator of influenza because there are a number of other viral and bacterial infections that can be life threatening. The distinction with influenza is that it is highly contagious and it mutates from year to year. It is hoped that the publicity on hand-washing and respiratory etiquette would have some positive influence. ACTIVITY UPDATE/OTHER ANNOUNCEMENTS Isolation and Quarantine Conference—February 3, 2005, Fort Worden: Jean Baldwin urged the Board to attend this three-county event. She reviewed the list of invitees —those who would have a role in the event of an illness requiring isolation and quarantine. • Reproductive Health Continuing_Education Conference—January 20, 2005, Jefferson Healthcare Auditorium: This afternoon there is a presentation by Dr. Vivian Webb Hanson on cervical cancer screening and management guidelines and human papilloma virus (HPV) vaccine. Noting that there is reason to believe that this virus causes 90 percent of cervical cancer, Dr. Locke said an HPV vaccine is in the final stages of development. Environmental Health Director Opening: Jean Baldwin reported that the opening of this position would likely be extended beyond tomorrow's deadline in order to increase the pool of applicants. In the meantime, she has been meeting twice monthly with the Environmental Health team to address coverage and cross training. Staff is also working to develop a skills test for applicants. Substance Abuse Prevention: Jean Baldwin reported that the Department was represented in recent panel discussions of substance abuse and adolescent development. She then explained the Department's outreach and education efforts and leverage of funding. The Department received a six-year, broad-scope federal juvenile justice grant of roughly $100K/year in support of the following: methamphetamine home visits, re-implementing the Big Brother Big Sister programs, providing a mental health professional in the schools, coordination of the Healthy Youth Coalition in partnership with Community Network, and the Healthy Youth school survey.This federal money is matched by the City and County for the Department's substance abuse education (youth health cards on suicide prevention, J HEALTH BOARD MINUTES -January 20,2005 Page: 5 alcohol poisoning education, etc.). Some discussion ensued about the misperception that the Health Department is competing with mental health services for the funding. Jean Baldwin indicated that the Department is involved in crisis intervention and mental health screening/referrals, but is not a mental health agency. It was thought to be important that the County Commissioners review the RCWs of the different boards, and specifically the relationship between Mental Health and the Health Department. Chairman Masci noted the City had offered $5,000 for drug and alcohol prevention training with the caveat that it be disbursed through the Police Department and the City Manager. He urged the Board of Health be involved to ensure that these funds are not incorporated into the County's General Fund. Jean Baldwin agreed to give the Board a written explanation of the family violence and substance abuse prevention funding, which is matched by a substance abuse prevention grant that the Department administers for the community. She would recommend the City's funding go to Community Network rather than the Board of Health in order to complete a program development requirement for a program evaluation and competitive bid. AGg ENDA PLANNING/ADJOURN Future agenda topics: Review future funding needs for Best Beginnings and Behavioral Risk Factor Surveillance Survey (BRFSS). The meeting was adjourned at 3:52 p.m. The next meeting will be on February 17,2005 at 2:30 p.m. in the Conference Room of the Jefferson County Health Department. JEFFERSON COUNTY BOARD OF HEALTH Geoffrey Masci, Chairman Jill Buhler,Member David Sullivan, Vice Chairman Sheila Westerman, Member Phil Johnson, Member Roberta Frissell, Member Patrick M. Rodgers, Member • Board of 3-CeaCth Old Business & Informational Items • .agenda Item # 117., 1 Influenza .activity - .Tfuman and�Avian J'ebruary 17, 2005 1• 'WA State Dept of Health- Influenza Update Page 1 of 9 4.47 It Communicable Disease Epidemiology ea t Flu Update You are here: DOH Home » Flu News » Flu Update Employees I Search Site Directory Influenza Updates 2004-2005 • Communicable Disease February 10, 2005 An Epidemiology Main. Page A f su • A-ZNotifiable stiff' Vaccination: Remember it is never too late to receive influenza vaccine. im Communicable Diseases res Check with your private physician or local health jurisdiction to find out • Notifiable Conditions where influenza vaccine is available. DF Main Pape Dir • Current Issues an Washington: Washington State influenza for week five is widespread. Activity • Reports and Publications is at levels expected at this time of the influenza season. There was a slight rise Th • EpiTrends in the number of pneumonia and influenza deaths reported,but within expected an • Influenza Update limits. Overall,the number of specimens submitted to surveillance laboratories oo for respiratory testing declined slightly. aff pe • Local Health Jurisdiction sa Locator School absenteeism has shown a slight increase in the past three weeks to a total • Staff List of 43 schools reporting absenteeism of 10%or greater with influenza-like illness Inf Con.tactUs since October, 2004. inn NR Seventeen counties have reported 280 laboratory confirmed cases of influenza. Na This is the number of surveillance isolates only, not the total number of cases ERe n statewide. Fifteen percent of cases have been age 4 or under, 21%have been in su Information patients five to 19 years of age, 31%have been 20-49 years of age, and 30 sy Last update: 02/10/2005 12:47 PM percent have been fifty or older. Three percent of cases reported no age. Pa Eighty-four percent of isolates have been influenza A, of which 21%were eDe p further tested as A,H3N2. While 16% of cases have been influenza B, this ep aff � 6 percentage of total surveillance cases has steadily increased as the season W d i''i' ® ,., . continues. are Se United States: During week 4 (January 23-29), influenza activity continued to Ph increase in the United States as a whole. The proportion of patient visits to se sentinel providers for influenza-like illness(ILI)is above the national baseline ph and the proportion of deaths attributed to pneumonia and influenza is below the co epidemic threshold... There have been four influenza-associated pediatric deaths isouf reported to CDC this season. Sixteen states reported widespread influenza iiin co activity, 19 states and New York City reported regional influenza activity, and 9 wit states and the District of Columbia reported local activity. Five states and de de Puerto Rico reported sporadic influenza activity. See the CDC website for the the full national report. Dis an Da • February 10, 2005 ph co oth su Alert Avian Flu: Vietnam and Thailand have reported avian influenza A to (H5N1) human cases and outbreaks in poultry since the beginning of December of 2004. A report of a new human case in Cambodia has been announced. One an http://www.doh.wa.gov/EHSPHL/Epidemiology/CD/HTML/FluUpdate.htm 2/10/2005 CDC Update 00221 - Update on Avian Influenza A (H5N1) Page 1 of 4 Thomas Locke From: Health Alert Network[healthalert@cdc.gov] Sent: Friday, February 04, 2005 3:05 PM • Subject: CDC Update 00221 - Update on Avian Influenza A(H5N1) This is an official CDC Health Update Distributed via Health Alert Network February 04, 2005, 6:05 EST(18:05 PM EST) CDCHAN-00221-05-02-04-U PD-N Update on Avian Influenza A (H5N1) This update reviews 1) the current epidemiologic situation in Asia and 2) the U.S. surveillance, laboratory diagnostic, and infection control recommendations for avian influenza A (H5N1), which were most recently stated in August 2004. As detailed in the recommendations below, identification of possible imported cases of avian influenza A (H5N1) in the U.S. clinical setting depends on health-care providers consistently obtaining information on recent international travel and other potential exposures from persons who have certain respiratory symptoms. Current Situation • Outbreaks of avian influenza A (H5N1) among poultry are ongoing in several countries in Asia, including Thailand, Vietnam, and Cambodia. Reports of sporadically occurring human cases of influenza A(H5N1) continued through January 2005. Thailand reported five human cases of influenza H5N1 (with four deaths) in September and October 2004, but no additional cases to date. Thirteen human cases of influenza A(H5N1) infection (with 12 deaths) have been reported by Vietnam since mid-December 2004; WHO has reported that 10 of these cases (with 9 deaths) have been confirmed. One instance of probable limited human-to-human transmission of influenza A(H5N1)virus was reported in Thailand between a child and her mother and aunt in September 2004. Health authorities in Vietnam are investigating two possible instances of limited human-to-human transmission in family clusters. One instance involves two brothers in Vietnam with confirmed influenza A(H5N1) infections; a third brother was hospitalized for observation only and did not become ill. In the second instance, a daughter developed symptoms within 6 days of her mother's onset of illness, which was confirmed as influenza A(H5N1). Investigations are exploring possible sources of exposure and looking for other signs of illness in family members, other close contacts, and the general community. In addition, the first human case of influenza H5 infection in Cambodia has been confirmed in a woman who was hospitalized in Vietnam and died. A joint mission between the Cambodian Ministries of Health and Agriculture and WHO is in Cambodia investigating the circumstances surrounding this case. As of February 4, 2005, the cumulative number of confirmed human cases of influenza A (H5N1) reported in Asia since January 28, 2004, is 55 cases (with 42 deaths), according to WHO. This total includes the case from Cambodia. The avian influenza A(H5N1) epizootic in Asia poses an important public health threat, and CDC is in communication with WHO and will continue to monitor the situation. The epizootic in Asia is not expected to diminish substantially in the short term, and it is likely that influenza A (H5N1) infection among birds has become endemic to the region and that human infections will continue to occur. So far, no sustained human-to-human transmission of the influenza A(H5N1) virus has been identified, and no influenza A(H5N1)viruses containing both human and avian influenza virus genes, indicative of gene reassortment, have been detected. 2/10/2005 p'CDC Update 00221 -Update on Avian Influenza A (H5N1) Page 2 of 4 Travel Health Precaution It is expected that the number of people traveling between the United States and certain parts of Asia will increase around 4 he Lunar New Year, which occurs on February 9 this year. Chinese, Vietnamese, Cambodian, and Korean people lebrate the start of the lunar calendar year. Lunar New Year celebrations last for approximately 15 days in China, 3 ays in Vietnam, and typically only 1 day in Cambodia and Korea. On January 26, 2005, CDC issued a Travel Health__.Precaution notice about avian influenza A(H5N1). This notice is directed at travelers who may be returning from Vietnam to visit family and friends, especially during the upcoming holiday, and who may be at greater risk for exposure to poultry through food preparation or at farms and bird markets where infected poultry may not be readily detected. The notice outlines specific measures for travelers to take before, during, and after travel to Vietnam. CDC has not recommended that the general public avoid travel to any countries affected by influenza A(H5N1). For more information, see CDC's Travelers' Health website. Enhanced U.S. Surveillance, Diagnostic Evaluation, and Infection Control Precautions for Avian Influenza A (H5N1) CDC recommends maintaining the enhanced surveillance efforts by state and local health departments, hospitals, and clinicians to identify patients at increased risk for avian influenza A(H5N1) as described in HAN notices that were issued on February 3,_2004 and again on August 12,2004. Guidelines for enhanced surveillance are as follows. Testing for avian influenza A(H5N1) is indicated for hospitalized patients with • radiographically confirmed pneumonia, acute respiratory distress syndrome (ARDS), or other severe respiratory illness for which an alternate diagnosis has not been established, AND • history of travel within 10 days of symptom onset to a country with documented H5N1 avian influenza in poultry and/or humans (for a regularly updated listing of H5N1-affected countries, see the OIE website and the WHO website). 40 sting for avian influenza A(H5N1) should be considered on a case-by-case basis in consultation with state and local health departments for hospitalized or ambulatory patients with: • documented temperature of>38°C (>100.4°F), AND • one or more of the following: cough, sore throat, shortness of breath, AND • history of contact with poultry (e.g., visited a poultry farm, a household raising poultry, or a bird market) or a known or suspected human case of influenza A (H5N1) in an H5N1-affected country within 10 days of symptom onset. Laboratory Testing Procedures Virus Culture Highly pathogenic avian influenza A(H5N1) is classified as a select agent, and culturing of clinical specimens for influenza A(H5N1) virus must be conducted under laboratory conditions that meet the requirements for Biosafety Level (BSL) 3 with enhancements. These enhancements include controlled access double-door entry with change room and shower, use of respirators, decontamination of all wastes, and showering out of all personnel. Laboratories working on these viruses must be certified by the U.S. Department of Agriculture. CDC recommends that virus isolation studies be conducted on respiratory specimens from patients who meet the above criteria only if requirements for BSL 3 with enhancements can be met. Polymerase Chain Reaction (PCR) and Commercial Antigen Testing Clinical specimens from suspect influenza A (H5N1)cases may be tested by PCR assays under standard BSL 2 ditions in a Class II biological safety cabinet. In addition, commercial antigen detection testing can be conducted under nr dard BSL 2 conditions used to test for influenza. Specimens That Should Be Sent to CDC 2/10/2005 CDC Update 00221 - Update on Avian Influenza A (H5N1) Page 3 of 4" Specimens from persons meeting the above clinical and epidemiologic criteria should be sent to CDC if • The specimen tests positive for influenza A virus by PCR or by antigen detection testing, OR • PCR assays for influenza are not available at the state public health laboratory. • CDC also will accept specimens from persons meeting the above clinical criteria even if they test negative by influenza rapid diagnostic testing if PCR assays are not available at the state laboratory. This is because the sensitivity of commercially available rapid diagnostic tests for influenza may not always be optimal. Requests for testing should come through the state and local health departments, which should contact(404) 639-3747 or (404) 639-3591 and ask for the epidemiologist on call before sending specimens to CDC for influenza A (H5N1) testing. Interim Recommendations: Infection Control Precautions for Influenza A (H5N1) Infection control precautions for H5N1 remain unchanged from the CDC interim recommendations_issued on February 3, 2004. All patients who present to a health-care setting with fever and respiratory symptoms should be managed according to recommendations for Respiratory.Hygiene and Cough Etiquette and questioned regarding their recent travel history. Isolation precautions identical to those recommended for SARS should be implemented for all hospitalized patients diagnosed with or under evaluation for influenza A (H5N1) as follows: • Standard Precautions o Pay careful attention to hand hygiene before and after all patient contact • Contact Precautions o Use gloves and gown for all patient contact • Eye protection o Wear when within 3 feet of the patient • Airborne Precautions o Place the patient in an airborne isolation room (i.e., monitored negative air pressure in relation to the • surrounding areas with 6 to 12 air changes per hour). o Use a fit-tested respirator, at least as protective as a NIOSH-approved N-95 filtering facepiece respirator, when entering the room. For additional information regarding these and other health-care isolation precautions, see the Guidelines for Isolation Precautions in Hospitals. These precautions should be continued for 14 days after onset of symptoms until an alternative diagnosis is established or until diagnostic test results indicate that the patient is not infected with influenza A virus (see Laboratory Testing Procedures below). Patients managed as outpatients or hospitalized patients discharged before 14 days should be isolated in the home setting on the basis of principles outlined for the home isolation of SARS patients (see http_//www cdc.gov/ncidod tsars/guidance/i/pdf/i.pd f). Additional Avian Influenza A (H5N1) Information • For information about reported outbreaks of avian influenza A(H5N1) among poultry, see the website of the World Organization_of Animal Health((HE). • For information about human influenza A(H5N1) cases, see the WHO website. • For clinical information about human influenza A(H5N1) cases, see: o CDC. Cases of influenza A (H5N1) - Thailand, 2004. MMWR 2004;53:100-103. o Hien TT, Liem AT, Dung NT, et al. Avian influenza A (H5N1) in 10 patients in Vietnam. New England Journal of Medicine 2004;350:1179.-1188. • For information about travel and avian H5N1 influenza, see the CDC Travelers' Health website. • • For general information about influenza, see the CDC Influenza website. 2/10/2005 • Board of HeaCtGt Old Business & InformationaCltems .Agenda Item # 1"V, 2 • Washington State Board�of Health - zoo4 .annual Report Jebruarj 17, 2005 • f300 _-_,_ L_ ---F CJ 0 P....b L---=-1(< , . wAs -HiNGToN 'sTATE BOARD 0 F 1-1EA1-: T1-1 _ .. _ . ., .... ,. ,„_ . , , . . . .. . . . . .. „... . . .. . , .,--' -.....,---4,sit::';.,°,:°:..;.1'S:,',1•3-;:-.tle.,-i---i,T-41,,,,*1'-'.4`,7,.,--.. '''--t,--:••,'„-.,"F•„:4•Z,'-‘-','''''''...'''....,-'.,-•'--''',-.'•-,-'-'-',"--,'''•' ','- „."',, '' - . 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WI STATE 0 Board of Health ALWAYS WORKING FOR A SAFER AND HEALTHIER , . • • • Washington State Board of Health Home Page Page 1 of 3 4.„....:7'. 1. , -`F 4 • --:-.!':-- *"- ''''I -: - ' , ..'. ' 4.-; - .. 41.,,,4,._§-' _ .1-_-;-: -7-,, "--7.- ';'.i -''...::a a t( . ..„ .1 ._ ).. f t.:---fZt• 1,',. t '''' --, .,,,.' 7- -lir v 7 : t.,,,,,,t.. '-' tr....0" Board's Community Environmental Health Assessment Rep p c r, available -''� T is $ " � The Board's report on community environmental health assessment is now avail ---;- It was adopted on October 6 by the Board. SBoard's 2004 Annual Report to the Governor now available x i;_. - ' The Board is required to submit an annual report to the Governor on its activitie . t report is now available on line, along with reports from previous years. Navigation buttons not working? State Board of Health Board prepares for 2005 Legislature at Olympia meeting P.O. Box 47990 Olympia,WA January The State Board of Health met Wednesday, 12 at the Comfort Inn of Ti io 98504-7990 (360)236-4100 ate.enda included 2005 legislative issues,HIV/AIDS policy discussion, and an uI (360)236-4088(fax) Public Health Improvement Partnership. Meeting materials are available on line sboh@doh.wa.gov information, contact the Board staff office at 360/236-4110. www.sboh.wa.gov �b` ", Board selects new Executive Director At the Board's November 10th meeting in Kelso, Chair Tom Locke announced t 4 ...,s . fif appointment of Craig McLaughlin as the Executive Director to the Board. Mr. l� Galt joined the staff as Senior Health Policy Manager in January 2001. He has been s Acting Executive Director since March. Mr. McLaughlin earned his bachelor's c biology from Wesleyan University and his master's in journalism from the Univ California at Berkeley. Priva y Notice Keith Higman becomes Board's newest member Keith Higman,resident of Whidbey Island and Environmental Health Director f County has been appointed to the State Board of Health by Governor Gary Lock ends July 1, 2007. Mr. Higman replaces Linda Lake, who served the Board frorr 41 to July 2004 as Chair and Consumer representative. http://www.doh.wa.gov/SBOH/default.htm 2/2/2005 Washington State Board of Health Home Page Page 2 of 3 Board adopts resolution on septic systems, approves two n The Board of Health met in Wenatchee on Wednesday, October 6. It adopted tw • reports, one on zoonotic diseases and exotic pets and one on community enviro] health assessments. Both reports will go through a final round of editing and des. publication and distribution. The Board also adopted a resolution concerning the of marine waters from contamination by on-site septic systems. The agenda and meeting materials are available on line. The Board's next meeting will be Noven Kelso. Board adopts new food code based on federal code The State Board of Health adopted a new food code at its September 8 meeting Walla. The new rules are based on the current Model Food Code developed by t and Drug Administration. The federal code incorporates the best available scien. provides a framework for food safety rules nationwide. The new state food code provides guidance on donated foods and specifically exempts noncommercial pc new rule will ensure safer food for the public. It also is expected to increase the of food service regulation across the state. For more information, see the rulesp; September 8 meeting materials. Governor appoints Dr. Tom Locke to serve as Board Chair 4111 On August 25,the Governor appointed Dr. Thomas H. Locke, MD,MPH to seri the State Board of Health through August 2, 2005, the end of his current term. E represented local health officers on the Board since 1995. Former Chair Linda L in July that she would not seek reappointment. Ms. Lake will continue to serve consumer representative until the Governor selects a successor. Community Forums: Food, Fitness, and Our Kids In response to the growing childhood obesity epidemic in our state,the Board cc number of organizations including the Washington State School Directors'Asso Washington State Department of Health,the Office of Superintendent of Public the UW Center for Public Health Nutrition,the Washington State Parent Teache Association, the Washington School Food Service Association, and local health in six counties(Benton-Franklin, Clark,Island,King,Pierce, and Thurston) to o series of community meetings. These meetings will provide an opportunity to d far-reaching consequences of children's inactivity and poor nutrition and share N can help address this serious problem. Information regarding these community be found on our website at www.sboh.wa.gov/Priorities/Children/SPAN/Forums • SBOH Home (About the Board I Meetings J Rules(Publications I Bill watch I FYI I Loc. http://www.doh.wa.gov/SBOH/default.htm 9/7i7nns • Board of 3-Cealth Old Business & Informational-items genda item # �V. 3 Gov. Gregoire Reappoints Secretary of.9-Cealth Tebruary 17, 2005 • bi .larl tOrtStateDepartrrtentof Health Advisory (1-6H. • For immediate release: February 8, 2005 (MA-05-002) Contact: Tim Church, Communications Office 360-236-4077 Donn Moyer, Communications Office 360-236-4076 Governor Gregoire appoints Mary Selecky, Secretary of Health WHO: Mary C. Selecky, Washington Secretary of Health WHAT: Media availability; phone interviews on secretary appointment Governor's news release (www.governor.wa.gov/news) WHEN: Upon request WHY: Today, Gov. Christine Gregoire announced that she has appointed Mary Selecky to continue as Washington state secretary of health. Selecky has served in that capacity since 1999 when she was appointed by then Gov. Gary Locke. • '`Our state is making great progress on public health issues like tobacco prevention and emergency preparedness," said Selecky. "I am honored to serve as secretary of health and look forward to continuing this and other important work to make our state safer and healthier." The secretary of health oversees many programs and efforts that affect the health of people in Washington every day, such as screening newborn babies for treatable diseases, licensing health care providers, childhood immunization, and safe drinking water. Before becoming state secretary of health, Selecky worked for 20 years as administrator of the Northeast Tri County Health District in Colville, WA. Rural health remains a passion and a priority for Secretary Selecky. In addition to her work in state and local health, Selecky served two terms as president of the national Association of State and Territorial Health Officials, where she has been a national leader in public health. Secretary Selecky is available for media questions; please contact Tim Church or Donn Moyer to coordinate and schedule an interview. Note to editors: Gov. Gregoire's news release announcing her selection of Mary C. Selecky for Secretary of Health, along with two other state Cabinet posts, is available online: www.governor.wa.gov/news Visit the Washington Department of Health Website at http://www.doh.wa.gov for a healthy dose of information. i ### • Board of Health Netiv Business .Agenda Item # "V., 1 � Isolation & Quarantine Conference FoCCow-up - Role of LocaCBoard of Health Jebruary 17, 2005 • "pj, A' yMA, 555 �� oY�� a �� aw �cr � � � •, •r ., • L].7 p ? 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E o b . 5•n 5•� CD f'A' rD 5-2)''.E3 a Ani F: ". rD ry,o.. p co'Y `0 < "J a) `t 5•,�"y '1 0 x••a. �. 3 5rn5 0 �P' � vq �rroaa. g.rD *nd4� a 0 .,^ � O a.rpn rD c.=S �.y 0 . ...4 rt. b S S b a c aA) o �CD R.C ;vo, q0 r r o �' A, n•rp,, 0 a g'rn 'O v0, rMD O '-• = e, A,, ,, „^�,• co -: s •.,aYov, rD5'� • RA,7•Zo,r0Da• ' r ate, 00001 •0 • N I V • Public Health Risks of Disasters: Communication, Infrastructure,and Preparedness http://books.nap.edu/catalog/11201.html PUBLIC HEALTH RISKS OF DISASTERS Communication, Infrastructure, and Preparedness Workshop Summary William H. Hooke and Paul G. Rogers, Editors • Roundtable on Environmental Health Sciences, Research, and Medicine Board on Health Sciences Policy Institute of Medicine and Disasters Roundtable National Research Council INSTITUTE OF MEDICINE AND NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES THE NATIONAL ACADEMIES PRESS Washington, D.C. www.nap.edu Copyright©2004 National Academy of Sciences.All rights reserved. This executive summary plus thousands more available at http://www.nap.edu Public Health Risks of Disasters: Communication,Infrastructure,and Preparedness • http://books.nap.edu/catalog/11201.html Preface The National Research Council's Disasters Roundtable and the Institute of Medicine's Roundtable on Environmental Health Sciences,Research,and Medi- cine were established as mechanisms for bringing various stakeholders together to discuss timely issues in a neutral setting. The goal was not to resolve these issues,but to create an environment conducive to scientific debate.The members of the respective Roundtables comprise representatives from academia,industry, nongovernmental agencies, and government, whose perspectives range widely • and represent the diverse viewpoints of researchers, federal officials, and public interest. This workshop was convened by the two Roundtables as a contribution to the debate on the health risks of disasters and the related need to build capacity to deal with them. The meeting was strengthened by integrating perspectives from these two fields,so that the agenda represented information from both communi- ties and provided an opportunity to look at some of the most pressing research and preparedness needs for health risks of disasters. Disasters, almost by definition, involve health risks, and have frequently been associated with first responders saving lives in the face of extreme events such as hurricanes, earthquakes, or flooding by transporting injured victims to hospitals to receive care.Life then continues until the next disaster arrives.Per- ceptions changed, however, with the terrorist attacks of September 11 and the subsequent anthrax attacks, when the government and the public realized the need for more attention to the complex health risks associated with disasters. More emphasis has also been placed on long-term needs after disasters as recov- ery continues long after release from the hospital or the burying of the dead. In short, what is clear is that preparing for health risks must occur long before disasters strike, and addressing health problems continues long after the initial "search and rescue"and other emergency period activities. Since 2001,there has been a greater need for integrated,up-to-date scientific information to respond to the rapidly changing circumstances that occur with xi Copyright©2004 National Academy of Sciences.All rights reserved. 411 This executive summary plus thousands more available at http://www.nap.edu • Public Health Risks of Disasters: Communication,Infrastructure,and Preparedness http://books.nap.edu/catalog/11201.html xi i PREFACE disasters. Significant strides toward integration have occurred,but it is clear that additional planning,research,and integration are needed. Unlike many scientific subjects, where the practitioner's knowledge is solid, but public awareness lags, this is one area where professional understanding, capabilities, and approaches are evolving rapidly and substantially. Current discussions of disasters tend to center on terrorist attacks and health risks. It is important to remember, however, that disasters are a multi-faceted challenge and include the public health consequences of geophysical hazards, industrial/technological accidents,terrorist events, and biological disasters,such as SARS outbreaks and E. coli contamination. In addition, on the international scale, disasters include the complex disasters resulting from war, government collapse,and famine.While September 11 caught the United States offguard,it is important that not all of our resources go into one area. We need to continue to have the ability to respond to a variety of threats. Risk communication has become increasingly important as individuals receive information from various media (e.g., newspaper, television, radios, internet), and may seek to validate their knowledge with local experts, trusted friends,and personal experience.With the advent of 24-hour news coverage and the desire for up-to-date information,there are new challenges for risk communi- cation. While it is important that messages from the government be consistent across agencies,it is also important that the messages be clear and honest, while • not understating the risks. Scientists and policy makers need to build on the strength of the established literature of risk communication to fill in the gaps that are important for disasters. Personnel needs were discussed by many speakers throughout the day. The issues ranged from providing responders with ongoing training and information on health risks to replacing an aging workforce. Training will continue to be important as the disasters that we are likely to face on a national scale will involve many complex problems. Training will need to be both general and specific, because the type, the magnitude, and the timing of the threats are unknown.How to prepare for integration in a climate of uncertainty is an area of ongoing discussion. This workshop summary captures the discussions and presentations by the speakers and participants,who identified the areas in which additional research is needed, the processes by which changes can occur, and the gaps in our knowl- edge. The views expressed here do not necessarily reflect those of the National Research Council, the Institute of Medicine,the Roundtables, or their sponsors. Paul G. Rogers William H. Hooke Chair Chair Roundtable on Environmental Health Disasters Roundtable Sciences,Research,and Medicine Copyright©2004 National Academy of Sciences.All rights reserved. • This executive summary plus thousands more available at http://www.nap.edu i Board of Health New Business Agenda Item # V., 2 2005 _Legislative Session - XePubCic 3leaCth Issues February 17, 2005 i • DRAFT February 4, 2005 The Honorable Brian Sullivan, Chair House Natural Resources,Ecology&Parks Committee Post Office Box 40600 Olympia, Washington 98504-0600 Dear Representative Sullivan: I am writing as the chair of the State Board of Health in regards to House Bill 1415, an act relating to the impacts of commercial passenger vessels on the marine waters of Washington,which is scheduled to be heard before your committee this afternoon. The Board of Health is charged with regulating the sanitation of shellfish and shellfish growing areas. It is very interested,therefore,in the impact of wastewater discharge from commercial passenger vessels. Such discharges have resulted in shellfish closures in the past. In March 2004,the Board of Health heard from a representative from Jefferson County Public Health and Human Services regarding concerns about the policies and practices related to the management of marine vessel wastewater. Jefferson County had experienced a large sewage release from a cruise ship the prior year that was of great concern to the local board of health. The Board also heard from the Department of Ecology about the development of a memorandum of understating(MOU)between the State of • Washington, the Port of Seattle,and the Northwest Cruise Ship Association. The Board elected to follow the issue and asked the Dept tment of Ecology to report back on the implementation of the MOU after one year. It is awaiting a formal presentation from the Department of Ecology, tentatively scheduled for April. I understand from a recent report that the MOU has been successful in attaining some its goals to manage wastewater discharges from cruise ships.The Board believes,however,that there is not enough information available at this time regarding the effects on shellfish growing areas of continuous discharges from advanced wastewater treatment systems onboard cruise ships,particularly with regard to viruses in discharges. The Board supports efforts to give the state regulatory authority over marine vessel discharges,including pursuing a congressional exemption to the Clean Water Act. Consideration should be given,however,to the effects of wastewater discharges on the state's shellfish growing areas, and current practices may need to be adjusted if adverse effects are identified. We join the Department of Health in requesting that the Legislature consider a provision to allow for investigations on the specific impact of wastewater discharges on commercial and recreational shellfish growing areas. Sincerely, Thomas Locke,MD,MPH Chair,Washington State Board of Health cc: Representative Mary Lou Dickerson Members,House Natural Resources,Ecology&Parks Committee Ms. Chris Townley,Department of Health Washington State Board of Health Members • Craig McLaughlin, State Board of Health HB 1415 Page 1 of L Washington State BILL House of Representatives ANALYSI�i Office of Program Research �'i Natural Resources, Ecology & Parks Committee HB 1415 Brief Description: Managing impacts of commercial passenger vessels on marine waters. Sponsors: Representatives Dickerson,B. Sullivan, Dunshee, Williams, Hunt, Eickmeyer, Chase, Sells and Hasegawa. Brief Summary of Bill • Prohibits the release of certain wastewaters from commercial passenger vessels. • Establishes a system for regulating the release of treated blackwater from commercial passenger vessels. • Requires the operators of commercial passenger vessels to pay an annual operating fee to the Department of Ecology. Hearing Date: 2/4/05 111 Staff: Jason Callahan(786-7117). Background: Water quality laws The Department of Ecology (Ecology) is the primary state entity responsible for regulating discharges into state waters. This regulation includes a requirement that any person disposing of liquid or solid waste into state waters is required to first obtain a permit from Ecology, for which Ecology is authorized to charge an annual fee. A violation of the state water pollution laws can be enforced both by the Attorney General, and by Ecology. The Attorney General is authorized to bring any appropriate action, including an action for injunctive relief Ecology has the authority to levy fines of up to $10,000 per day for each violation. In addition, criminal charges can be brought against a person found guilty of violating the state's water quality laws. Civil penalties assessed by Ecology may be appealed to the Pollution Control Hearings Board Ecology is required to first notify a person violating the state's water quality laws in writing if the situation does not require immediate action. Once the notice is received,the violator has thirty days to file a report with Ecology outlining the control measures that will be taken. If immediate action is deemed necessary by Ecology, then an order or directive may be issued. 4110 Memorandum of understanding http://www.leg.wa.gov/pub/billinfo/2005-06/Htm/Bill%20Reports/House/1415.HBA.htm 2/10/2005 'HB 1415 Page 2 of 4 Prior to the 2004 cruise ship season, Ecology entered into a memorandum of understanding (MOU)with the Port of Seattle and the Northwest Cruise Ship Association. The latter signatory is a private organization that counts as members various cruise ship operators. The 2004 cruise season was the first year that the MOU was in IFffect, and it applied to cruise ship traffic calling on Washington ports from April 21st until October 3rd. The OU applied anytime a vessel that is operated by a member of the Northwest Cruise Ship Association is physically located in certain waterways. The MOU establishes industry oversight in three areas: wastewater management, solid waste management, and hazardous waste management. The bulk of the document, however, deals with wastewater management. Cruise ship operators have agreed in the MOU to not discharge any untreated wastewater or solid waste within waters subject to the MOU. In addition, the operators are prohibited from discharging sludge, which is the term given to residual solids that result from wastewater treatment, anywhere inside Puget Sound, along the American side of the Strait of Juan de Fuca, within twelve miles of the Pacific coast, or within a specified area to be avoided along the Olympic Coast National Marine Sanctuary. Cruise ships are allowed to discharge both blackwater and graywater in Washington waters as long as it is treated by an Advanced Wastewater Treatment System (AWTS), and certain conditions are met. Some of the conditions that must be satisfied in order to discharge wastewater treated by an AWTS apply to all discharges in Washington waters, while other conditions depend on where the ship is located in relation to its port of call. Vessels not satisfying these requirements are expected to hold all graywater and blackwater in on- board tanks until the vessel leaves the waters subject to the MOU. The MOU does not have an established expiration or sunset date. The current MOU was in place for the 2004 cruise season, and will remain in place for future cruise seasons unless either the State of Washington or the Northwest Cruise Ship Association decide to cancel its participation, and amendments to the MOU must be agreed to by all parties. The MOU signatories have agreed to meet at least once annually to discuss potential anges and to review the effectiveness of the MOU. Summary of Bill: Prohibited discharges Commercial passenger vessels, which is defined as vessels capable of providing overnight accommodations for at least fifty passengers for hire, are prohibited from releasing the following substances into the Puget Sound, the Strait of Juan de Fuca, or within three miles from Washington's ocean coastline: • Sewage sludge • Oily bilge water • Solid waste • Biomedical waste • Hazardous waste • Untreated blackwater(sewage) • Graywater(non-sewage wastewater), including graywater mixed with blackwater Treated blackwater state approval for release The operator of a commercial passenger vessel may release treated blackwater into waters where the activity would be otherwise prohibited if the vessel has been approved for the release by Ecology. Ecology is required to approve blackwater releases from commercial passenger vessels if the vessel has paid a mandatory annual ("rating fee and can demonstrate that the released blackwater will receive an adequate level of treatment prior elease. Each commercial passenger vessel is required to be re-approved for blackwater releases annually. The operators of commercial passenger vessels that are certified by the United States Coast Guard for the http://www.leg.wa.gov/pub/billinfo/2005-06/Htm/Bill%20Reports/House/1415.HBA.htm 2/10/2005 HB 1415 Page 3 of,le continuous discharge of blackwater in Alaska are presumed to treat the blackwater released from the vessel at adequate levels. If Ecology does not notify the owner of a commercial passenger vessel certified for discharge in Alaska that their approval for discharge is denied within sixty days of the vessel operator submitting documentation, then the operator may presume permission to release treated blackwater in Washington. • Treated blackwaterrequirements for release away from port Commercial passenger vessels approved for blackwater releases by Ecology are required to satisfy a number of conditions. These conditions vary depending on the vessel's proximity to its port. Operators of commercial passenger vessels that are moving at least six knots and are located at least one nautical mile from port may only release treated blackwater when complying with the following requirements: • Once monthly samples are conducted of blackwater released from the vessel, the results of which are shared with Ecology. • A whole effluent toxicity test on the released blackwater has been conducted. • Test results required in other jurisdictions are shared with Ecology. • Ecology staff is allowed to witness sampling events. • Ecology staff is permitted to conduct an annual inspection of the wastewater treatment system on the vessel. • Ecology is notified if material changes are made of the wastewater system. Treated blackwaterrequirements for release while berthed at port When a commercial passenger vessel is at berth in port, or within one mile of its port, additional requirements must be satisfied before blackwater can be lawfully released. In addition to satisfying the requirements for release away from port,the operator of the vessel must also comply with the following: • Twenty-four hour continuous monitoring of the turbidity of the release is conducted. • • Documentation is provided to Ecology that all releases were treated with ultraviolet light. • Copies of all water quality tests are provided to Ecology for the six months preceding the release. • Documentation is provided to Ecology regarding the vessel's capability to monitor releases and shut down releases if the system malfunctions. Emergency situations Commercial passenger vessels are permitted to release any substances, including graywater and blackwater, if the release is done to secure the safety of the vessel or to protect a life at sea. Annual operating fee The operator of a commercial passenger vessel is required to pay an annual operating fee prior to releasing treated blackwater. The amount of the fee is established each year by Ecology, and must represent the actual annual costs to Ecology for implementing the approval and monitoring of releases from commercial passenger vessels. Ecology is permitted to enter into agreements with public ports for the collection of the annual fees from the commercial passenger vessel operators. Enforcement Enforcement of the commercial passenger vessel regulations is carried out through the existing enforcement scheme for other water pollution violations, except that fines for commercial passenger vessels may be up to ill $25,000 per day for each violation instead of the $10,000 for other water quality violations. Required reports http://www.leg.wa.gov/pub/billinfo/2005-06/Htm/Bill%20Reports/House/1415.HBA.htm 2/10/2005 flB 1415 Page 4 of 4 Ecology is required to submit annual reports from 2005 until 2010 that summarizes, in lay terms, completed analyses of all water quality data collected from commercial passenger vessels. 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O m Nm 28 O R r N M m1 N d rf` Page 1 of 2 BILL REQ.#: H-0681.2 • HOUSE BILL 1516 State of Washington 59th Legislature 2005 Regular Session By Representatives Schual-Berke, Tom, Kagi, Hankins, Haler, Cody, Priest, Campbell, Kessler,Dunshee, Clibborn, Wallace, Dickerson, Linville, Fromhold, Hunter, Green, Morrell, Darneille, McDermott, Simpson, Chase, O'Brien, Sells, Roberts, Kilmer, Moeller and Ormsby Read first time 01/26/2005. Referred to Committee on Health Care. AN ACT Relating to increasing access to health services for children through the "kids get care" service delivery model; creating a new section; and making appropriations. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON: NEW SECTION. Sec. 1 (1) The legislature finds that the health of the children of Washington state is critical to their success in school and throughout their lives. While health insurance coverage is a substantial component of achieving better health outcomes for children, ensuring access to essential preventive and well-child health Wrvices is equally important. Preventive and well-child health services are a cost-effective investment of both blic and private dollars that improves the health of children and of our communities at large. (2) The legislature further finds that "kids get care" assures that integrated preventive medical, oral, and developmental health services are provided to young children. Improving the delivery of well child visits, preventive oral health services, and developmental screening can reduce the need for hospitalization, caries treatment, and developmental interventions. "Kids get care" expands the use of evidence-based preventive measures in community health centers and private medical practices that treat many low-income children. "Kids get care" also strengthens the connections between social service agencies working with low-income families and local health care providers. (3) It is therefore the intent of the legislature to facilitate low-income children's access to appropriate preventive and well-child services and to other necessary health,mental health, and dental services by supporting the extension of the successful "kids get care" model for delivering health services to children. NEW SECTION. Sec.2 $435,000 of the general fund--state appropriation for fiscal year 2006 and $760,000 of the general fund--state appropriation for fiscal year 2007 is provided solely to the department of health to develop and implement best practices in preventive health care for children statewide. The department of health and the "kids get care" program of public health- Seattle and King county shall work in collaboration with local health care agencies and providers to disseminate strategic interventions that are focused on evidence-based best practices for improving health outcomes in children and saving health care costs. An interim report shall be provided to the appropriate committees of the legislature by June 30, 2006, on the program's effectiveness and cost savings. A final report shall be provided by June 30, 2007. The department of health and the kids get care program of public health - Seattle and King county shall work with the department of social and health services to obtain any federal medicaid matching funds that could be available to support the services of kids get care WS. ( 1) Of this amount, $50,000 is provided for state fiscal year 2006 and $50,000 isrovid p ed for state fiscal year 2007 solely to support the infrastructure of the children's preventive health care collaborative, a structured set of learning sessions to train medical practices about kids get care. This amount shall be matched by an equal http://www.leg.wa.gov/pub/billinfo/2005-06/Htm/Bills/House%20Bills/1516.htm 2/10/2005 Page 2 of amount of local funding; (2) Of this amount, $325,000 is provided for state fiscal year 2006 solely to support five additional kids get care sites to be implemented during that fiscal year, and $650,000 is provided for state fiscal year 2007 solely to support ten additional kids get care sites to be implemented during that fiscal year. The sites shall use the h. services of a case manager and public health educator to enhance the ability of health care providers to meet t needs of low-income children in their care; (3) Of this amount, $60,000 is provided for state fiscal year 2006 and$60,000 is provided for state fiscal year 2007 solely for a structured evaluation of the kids get care service delivery model. Preventive health care measures and cost data shall be collected. Outcomes for children cared for by clinics that are kids get care sites shall be compared to outcomes for children not receiving care at kids get care sites. ---END --- . • http://www.leg.wa.gov/pub/billinfo/2005-06/Htm/Bills/House%20Bills/1516.htm 2/10/2005 4' At grow 4.7• trt4°y STATE OF WASHINGTON WASHINGTON STATE BOARD OF HEALTH PO Box 47990 • Olympia, Washington 98504-7.990 February 8,2005 The Honorable Eileen Cody Washington State House of Representatives House Health Care Committee Chair Post Office Box 40600 337 John L.O'Brien Building Olympia,Washington 98504-0600 Dear Representative Cody: I am writing as chair of the Washington State Board of Health to support the concept of House Bill 1516,which is scheduled to be heard before your committee today.The bill would further extend the Kids Get Care program model to other sites in Washington State. The Washington State Board of Health recognizes that the state's budget difficulties have made health care cuts difficult to avoid,but it has been discouraged by the degree to which those cuts have decreased access to critical health services in recent years.It is particularly concerned about protecting access for children and it encourages . policy makers to give their highest priority to promoting delivery of children's clinical preventive services as described in the Board's November 2000 report,Recommended Children's Preventive Services:Ages Birth through 10 Years. The Board has not taken a position on a particular delivery service model.It believes policy makers should consider a range of options to assure that all of Washington's children receive proven clinical preventive health services.The Board also recognizes that the state faces a serious budget shortfall and that the Legislature will have to make many very difficult decisions about funding this session.An appropriation for this bill was not included in Governor Locke's budget proposal. The Kids Get Care program,however,has proven itself to be a very effective delivery model.It has increased the percentage of young children with up-to-date well child visits at participating sites.Research tells us that when children have consistent preventive care they are less likely to be hospitalized for potentially avoidable reasons and less likely to use the emergency room.We also know that children with sealants are less likely to need caries treatment.The Board applauds models like Kids Get Care that emphasize evidence-based interventions that focus on improving health outcomes for children and saving health care costs. Thank you for your consideration of this important issue. Sincerely, Thomas Locke,MD,MPH Chair,Washington State Board of Health cc: House Health Care Committee Members The Honorable Shay Schual-Berke Ms.Ree Sailors,Governor's Executive Policy Office S Ms.Christina Hulet,Governor's Executive Policy Office Ms.Chris Townley,Department of Health Washington State Board of Health Members Mr.Craig McLaughlin,State Board of Health '" Page 1 of 1 BILL REQ.#: S-0874.1 • SENATE BILL 5597 State of Washington 59th Legislature 2005 Regular Session By Senators Rasmussen, Schoesler, Brown, Prentice, Roach, Jacobsen, Kastama, Shin, Fraser, Kline and Kohl- Welles Read first time 01/28/2005. Referred to Committee on Agriculture & Rural Economic Development. AN ACT Relating to expansion of farmers market nutrition programs; creating a new section; and making appropriations. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON: NEW SECTION. Sec. 1 The legislature finds that: (1) The farmers market nutrition programs promote health, alleviate hunger,prevent obesity, and encourage the development of good eating habits by enabling low-income women to purchase locally grown fresh fruit and vegetables for themselves and their young children and low-income and homebound seniors to purchase cally grown fresh fruit and vegetables for themselves through farmers markets, congregate meals sites, and for housing. Women and children in twenty-three counties and seniors in thirty-five counties of the state are presently able to participate in the program. (2) The farmers market nutrition programs support small farmers and rural economies through the promotion of Washington state agriculture. Farmers market nutrition programs increase sales of Washington grown fruits and vegetables, increase marketing opportunities for local farms, strengthen local economies and communities, preserve farmlands, reduce energy usage and pollutants, and promote collaboration among agriculture,health, and social service and food assistance programs. (3) Low-income women and children, low-income seniors, farmers markets, and agencies administering the farmers market nutrition programs will be denied the opportunity to participate in coming years because of cuts at the federal level and lack of sufficient state funds to continue current program levels. NEW SECTION. Sec. 2 During the 2005-2007 biennium, an additional four hundred thousand dollars from the general fund--state are appropriated to the department of health to maintain 2004 participation levels for the farmers market nutrition program for women, infants, and children. During the 2005-2007 biennium, seven hundred fifty thousand dollars from the general fund--state are appropriated to the department of social and health services to maintain 2004 participation levels for the senior farmers market nutrition program. ---END --- • http://www.leg.wa.gov/pub/billinfo/2005-06/Htm/Bills/Senate%20Bills/5597.htm 2/10/2005 05....„ ` III ti STATE OF WASHINGTON WASHINGTON STATE BOARD OF HEALTH PO Box 47990 •Olympia, Washington 98504-7990 February 8, 2005 The Honorable Marilyn Rasmussen Washington State Senate Agriculture and Rural Economic Development Committee Chair 409 Legislative Building PO Box 40402 Olympia, Washington 98504-0402 Dear Senator Rasmussen: I am writing as chair of the Washington State Board of Health to support the concept of Senate Bill 5597, which is scheduled to be heard before your committee today.The bill would further • expand and maintain the Farmers Market Nutrition Program for clients of the Women Infant and Children(WIC)program and low income seniors. The Board believes public policy should encourage greater levels of physical activity and improve opportunities for healthy nutrition. In response to the growing childhood obesity epidemic in our state,the Board made children's activity and nutrition one of its top priorities. It convened a number of organizations, including the Washington State School Directors' Association,the Washington State Department of Health,the Office of Superintendent of Public Instruction,the University of Washington Center for Public Health Nutrition,the Washington State Parent Teacher Association,the Washington School Food Service Association,and local health jurisdictions,to organize a series of community meetings.These meetings have provided an opportunity for communities to discuss the far-reaching consequences of children's inactivity and poor nutrition and share ways schools can help address this serious problem. It serves our state well to make fruits and vegetables more accessible to some of our more vulnerable residents, since we know that there is a link between consumption of these foods and a decreased risk of cancer, heart disease, and obesity. Unfortunately,more than half of Washington residents are already obese or overweight, and our state has some of the highest levels of hunger and food insecurity in the nation. The Board recognizes that the state faces a serious budget shortfall and that the Legislature will have to make many very difficult decisions about funding this session. An appropriation for this bill was not included in Governor Locke's budget proposal. . • The Honorable Marilyn Rasmussen February 8,2005 Page 2 We know, however,that in the long run it is usually much more cost-effective to prevent a condition than to treat it. The goals of the Farmers Market Nutrition Program are consistent with those that the Board has endorsed on behalf of Washington State residents. Thank you for your consideration. Sincerely, Thomas Locke,MD,MPH Chair, Washington State Board of Health cc: Senate Agricultural&Rural Economic Development Committee Members The Honorable Kelli Linville Ms.Ree Sailors, Governor's Executive Policy Office Ms. Christina Hulet,Governor's Executive Policy Office Ms.Chris Townley,Department of Health Washington State Board of Health Members Mr. Craig McLaughlin,State Board of Health • Board-of Health Wow Business .agenda Item # `V., 3 • Jefferson County Food-Code - Board Guidance Yebruary 17, 2005 • 1 0m O ,—... 0 Q 0 a Z 0 o .v a o a o CO. ~7 N ° Z W W w Z -Ci .- ' N W w U '� Pe W Z o m JOb V a 4 0 Ca ‘4 + W O W 1~- Z o ,1{•i;T!!� ? o z z o or i Z o °' p v ° ~ oa< < R 0 u ° � o = omW = Z wta,� � 0 • U),1 N (n W W y - �," 01 za a � Aw Lesa Ball&Dan Burden Workshop OlympicW.Agency on Aging • 11700 Rhody Drive Port I-Iadlock WA 98339-9773 ACCESS! ABILITY! Toward a livable community. A workshop with Dan Burden a0 ° N eo I f . .� O - ' w '� c� bA •U N ' • v O nre '-' U '� '7 a. �, u O 3.a) .5, Z MO C O �� :� b a� bAO �O v Pa q a 0 M to U O D ••o �+. .) Lc7 .b0 •n O v, ct p fd. p. 0 4.4 Oa) O E ct Q O O (1.) `� O p pA R-, W x Q W v) W cd �, • • bnwp - ns oO4CD co o c no cA ao • ooprn • cop0qna pn O �1 • Q— d 0PA'O ' .- G O Cr0 s ei 0 • *; '1% ,•., • N0 D GQ- s O D dco � n OaAa. o-'-8 npp� EO � p O a. O O 0 C4 x 't:, � . n - °'a ? Q O pCrT re Nr' (61 AN., sO< p � O [�O, • f. t x O n " AiCR. W '- r. -" YD rf p ° a. ... o a d ° 1W v, n 6 n o O rD ,-^ r-r ; s` `"# ^r d; ,•-s+ •'3`�' XI .. ° tat r o a. p r C 'O rn O ( P v,' F \ . Q- q • b cro 111 fl 3 N. O o � � N c c cn o N Rt � � ° D, � ..• o illi .3 N o. Nam -, m ZAD .. 1-4 h� 0 °-4 n " � � CI) 1 o cAn o o 0 z �, ;: too x co cn1 ', O n 0 0 0• P c, cn c —� 9n . . C" `a .. a > a. `° 5 • e) �C 0 0 to 0 ... a CPR co y O U, O O H ro 71 rD n g > rn b7 AD eee, a- ° .-. rD 0 ..• r) `C Uq .L O p31 O O k3 .. F* .- a. AD ,E,', o o' v c CP m o 5 n a ,..crQ c ma' rD m 0 7; O n g � . � m G) 3 p7 CO rD c a. p, r ... x N �v M CM r `c m e•* �. � rtS N CO O. V °,cm -• a. pD UR o rD rD ( o N • 0 N N N (fQ CIQ 0 O o .� O tpn -'• v �, ►��+ W o0 o f' � C � c. a o CA G►a r• i,W 70 e p : CD w „ ~' 0 `ek =n cm' i Al ° o m m m 3. -a -1 o' x arca /' o a. O0. n t'rc0 =-. aD � N ill 5. 5. mo '* a. 0 UQ e a 0 % O v K 5... *] toro r b Zt. 0. 0 N o d rD r0 fD m, o � "� C n Ill 79 I-1 O FJ1-111;4- a, a O ti a ° Al �Q. � n' r�i * r° AD 'R rt P, v C p. �Op rr�t CD Cd '. x .t o r. P CM? AD CJQ to et- o °° oo (,) p a woo 51 rrD o o . Pp " a O O 01 V)g CM ' uQ � `C O• OrD ° rD O cA w W ~ et et ?G m o x Cl O UIQ o p p � cn Cl o M 'O C cr m • Board of Health Netiv Business gena Item # 17., 4 • Washington State `Vaccine Program - LocaCPolicy Issues Yebruary 17, 2005 Consent Agenda • JEFFERSON COUNTY BOARD OF HEALTH AGENDA REQUEST TO: Board of Jefferson County Health John F. Fischbach, County Administrator FROM: Jean Baldwin, Director, Jefferson County Public Health DATE: 2/10/2005 SUBJECT: Informational Item: DOH contract agreement with Jefferson County Health Department and Jefferson Counties agreement with all MD provider offices STATEMENT OF ISSUE: Health and Human Services is notifying Board of standard Agency Agreement with DOH for Immunization Program. The Medical Provider must agree to the following statement of work to receive the free state supplied vaccine. ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S: Jefferson County Health and Human Services has contracted with DOH, Department of Health; Division of Maternal Child Health and the federal Vaccine for Children Program, to provide state supplied vaccine to qualified children. FISCAL IMPACT/COST BENEFIT ANALYSIS: This contract brings approximately $64,400 worth of vaccine to Jefferson County. This vaccine is distributed to local providers for their patient who are children. PHN staff of Jefferson County do compliance check and monitoring of quality assurance in local offices. The funding covers all costs of the vaccine but it does not cover all the costs of staff time. Staff time is paid by the County General fund contribution and fees reflected in the budget. Federal and State Guidelines designate use of vaccine and customer screening. f On behalf of myself and all the practitioners associated with this medical office, I agree to comply with the following conditions for receiving state supplied vaccine: • Provide to each patient (parent/guardian) receiving vaccine, a copy of the most current Vaccine Information Statement (VIS). B. Record the information listed below on the patient's permanent medical record, and retain this information for a period of ten (10) years following the end of the calendar year in which the vaccine is administered: •Vaccine administered and dosage •Signature and professional title of person administering the vaccine • Date vaccine is administered •Address of facility in which the vaccine is administered •Site and route of the injection •Manufacturer name and lot number of the vaccine • Date of the VIS form being issued •Receipt of current VIS for each vaccine by person(parent/guardian)receiving vaccine C. Charge no more than the maximum allowable administration fee of$15.60 per dose, as established by the federal Centers for Medicare and Medicaid Services (CMS) for children eligible for the Vaccines for * Children (VFC) program. If non-VFC eligible children in my practice are charged more than this amount, I understand this practice will be responsible for developing and implementing a system to screen every child to determine VFC eligibility, and will be required to report these data to the local health jurisdiction and/or the state Department of Health monthly. No child will be denied administration of a publicly funded vaccine because of an inability to pay this administration fee. D. Provide the patient(parent/guardian) with a personal immunization record or update his/her existing personal record (for example, Washington Lifetime Immunization Record cards, DOH 348-001, available from the local health jurisdiction). E. Use as a guideline for clinical practice, the "Standards for Pediatric Immunization Practices" (endorsed by .the Centers for Disease Control {CDC}, American Academy of Pediatrics{AAP}, American Academy of Family Physicians{AAFP}, Advisory Committee on Immunization Practices {ACIP}, and other professional organizations) and the state "Immunization Guidelines for Use of State-Supplied Vaccine" F. Comply with the appropriate immunization schedule, method of administration, dosage and true contraindications, that are established by the Advisory Committee on Immunization Practice, American Academy of Pediatrics, and the American Academy of Family Physicians, unless in my medical judgment and in accordance with accepted medical practice, I deem such compliance to be medically inappropriate. G. Inform patient(parent/guardian)to report, by telephone or in person to the office where the vaccine was administered, any illness or adverse event that occurs within 28 days after receiving an immunization and requires the patient to visit a physician, emergency room, or clinic. Such illness or adverse event must be documented on the Vaccine Adverse Event Reporting System (VAERS) reporting form and reported to the local health jurisdiction within ten (10) days of receiving the information. H. Make immunization records available to the local health jurisdiction and the state Department of Health Immunization Program (if requested). I. Participate in a site visit by the local health jurisdiction, which may include an immunization assessment (AFIX). Participate in a one-month benchmarking survey project yearly. Complete a provider satisfaction survey (if requested). J. Complete the Private Provider's Report of Vaccine Usage form provided by the local health jurisdiction, which includes: the doses of vaccine administered by vaccine type and age group of each patient; doses of *vaccine wasted, lost or expired; inventory of vaccine by vaccine type and number of doses. K. Ensure that the storage and handling of vaccine is in accordance with the manufacturer's specifications . and the guidelines as outlined in the "Guidelines for Vaccine Storage and Handling" (US Dept. of Health & Human Services). Temperature monitoring devices are to be kept in all refrigerator and freezer units that store vaccine. Record temperatures on the Temperature Monitoring Log each day of clinic operation. It is recommended that both the refrigerator and freezer temperatures be recorded at various times of the day. Completed Temperature Monitoring Logs are to be returned monthly to the local health jurisdiction. Failure to comply could result in the discontinuation of the provision of vaccine. L. Notify the local health jurisdiction as soon as possible, preferably three months before the expiration date, if it appears that any vaccine will not be used prior to its expiration. M. Consult with the local health jurisdiction immediately regarding viability of any vaccine that has been exposed to temperatures above or below the recommended range for vaccine storage. Return unopened vials of vaccine that are determined to be nonviable to the local health jurisdiction within thirty(30) days, along with a written report including the reasons for the vaccine loss and measures taken to correct the cause of the loss and to prevent reoccurrence. N. Ensure that all staff that administer and handle vaccines are properly trained and receive ongoing education and training on current immunization recommendations. Notify the local health jurisdiction when new staff are hired. It is essential that staff perform duties within their scope of practice. All health care providers need to be in good standing with the State of Washington Department of Health - Health Professions Quality Assurance Commission and federal regulation entities. O. Publicly funded vaccine may only be distributed to health care providers legally affiliated with my practice. Seeking reimbursement for publicly funded vaccines is considered to be fraudulent behavior and • will be grounds for denial of state-supplied vaccine. DOH 348-022 revised 11/2004 You are encouraged to maintain and utilize a recall system for all patients under three (3) years of age, as part of your vaccine practice. i JaSc1889• ? y O STATE OF WASHINGTON DEPARTMENT OF HEALTH Community and Family Health ADDENDUM TO 2005 OUTSIDE PROVIDER AGREEMENT FOR RECEIPT OF STATE-SUPPLIED VACCINE The federal government, under direction from Congress and others, has initiated a major campaign to uncover and investigate possible cases of Medicaid fraud and abuse within the Vaccines for Children (VFC) program. These are primarily cases where federal vaccine is given to those not eligible to receive it. Investigations may also focus on intentional improper billing practices or other potentially fraudulent circumstances related to vaccine distribution or administration. Since the state- supplied vaccine you receive is funded through a blend of state and federal funds, your practice may •ncluded in these investigations. The Department of Health and Human Services (DHHS) and the Office of the Inspector General (OIG) have begun their campaign in seven states. We do not know if or when Washington state might be included in this process, and we will not be notified prior to any investigation. Any investigation conducted by DHHS and OIG will not be coordinated through the state vaccine program or your local public health agency. If you have questions about this addendum, please contact your local immunization coordinator or vaccine distribution coordinator. • • Boarcfof Health .activity Update .Agenda Item # 'VI., 1 • .access! A6ility! T"otivarcl a Livable Community NI arch 23, Zoos Fort Norden State Park Yebruary 17, 2005 • • Board of HeaCtGG Media Report • J'ebructry 17, 2005 • Jefferson County Health and Human Services JANUARY — FEBRUARY 2005 NEWS ARTICLES 1. "Department of Health recommends lifting restrictions on influenza vaccine", WA State DOH News Release, January 13,2005 2. "Frissell is `Woman of Excellence',P.T. Leader, January 19, 2005 3. "Healthy Youth Coalition talks Internet",P.T. Leader, January 2, 2005 4. "Parents get lesson on adolescence",P.T. Leader, January 26, 2005 5. "Grant money comes for kids", P.T. Leader, February 2, 2005 6. "UGN thanks supporters", P.T. Leader, February 2, 2005 • 7. "Study: Vaccine reduces chickenpox deaths", The Seattle Times, February 3, 2005 8. "Pearson gets code enforcement position", P.T. Leader, February 9, 2005 • • Vsington State Department'of Health For immediate release: January 13, 2005 (05-002) Contacts: Tim Church, Communications Office 360-236-4077 Donn Moyer, Communications Office 360-236-4076 Department of Health recommends lifting restrictions on influenza vaccine OLYMPIA—Recommendations limiting influenza vaccine to people in high priority groups in Washington have been lifted by the state Department of Health. Effective immediately,the new state recommendations allow health care providers to administer flu shots to anyone requesting it, as long as the provider has met the demand from high risk clients. Vaccine supply and demand varies across the state, so local health officials will adopt this recommendation when it is best for their communities. IIIThe new recommendation encourages anyone over six months who wants to prevent the flu to get vaccinated. High priority populations still have the greatest need for protection, and health officials continue to encourage people in these groups who have not received a vaccine to get a flu shot. Vaccine is available and there is still time to get vaccinated. Flu season has been mild so far,but typically peaks in February or March. • "We have been focusing on reaching those at greatest risk for complications from flu," said State Health Officer Dr. Maxine Hayes. "In many communities,people in those groups who want to be vaccinated have now gotten their flu shot. The more people protected against the flu,the better. • Opening up the remaining vaccine for anyone who wants a flu shot will benefit everyone and ensure that all doses are used." A key to providing the best community protection against influenza is vaccinating as many children as possible. "Research has shown that children are huge reservoirs and spreaders of • influenza, and young children are at high risk for complications from the flu," said Dr. Hayes. • "It's important to protect them and everyone they come in contact with by making sure high risk children and children who are household contacts or caregivers of anyone in a high risk group are • vaccinated. There is plenty of childhood flu vaccine around the state." —More— Recommended restrictions on flu vaccine eased January 13, 2005 Page 2 If you have questions about flu vaccine or to find out where to get a flu vaccination,call your • health care provider, local health department or the Healthy Mothers,Healthy Babies hotline at 1-800-322-2588. High priority people can also check the American Lung Association Web site (http://www.findaflushot.com/lungusa). llll" Visit the Washington Department of Health Web site at http://www.doh.wa.gov for a healthy dose of information. • • . . issell is ' Woman of Excellence ' A standing ovation greeted through paid or volunteer work. Roberta Frissell as she received Frissell is originally from g the coveted "Woman of Chicago, received her bachelor's i s T Excellence"award at the Dec. 18 and master's degrees from the meeting of the Port Townsend University of Minnesota,and corn- ALL ' Branch of the American pleted additional studies at the y : �� • Association of University Women. University of Washington. She , �' ., ). , Each year the organization taught cultural anthropology at the .--..4,.,,,_ ,...4.-;,,,,,,,,..,:,.,,,, " yz honors an East Jefferson County college level,and in 1983 she was ij . ��; j e „ woman who has inspired and chairwoman of the Faculty r — " energized other women and Association ' of. Community ; °�_,,,,.;;_:±!J �' S .: `•. served as a role model by increas- Colleges for Washington State and ' ,r ing opportunities for women,and co-authored a retirement handboo :,,,,,,,..../ who has contributed directly and for faculty that is still in use today. `` � "�� -�� positively to the coectly a t In Roberta Frissell,left,receives the 2004 Woman of Excellence award y , giving. the award,.Jane from Jane Ansley,chairwoman of the selection committee for the Ansley, selection committee American Association of University Women. Submitted photo chairwoman,noted,"The greater community has benefited from program for teenage parents at of the University Women's Roberta's leadership as the first Port Townsend High School,and Foundation,which offers scholar- woman to hold the position of from her influence in establish- ships to women from East chairwoman of the Jefferson ing a Fibromyalgia Support Jefferson County. She partici- County Board of Health, from Group in the county." • . pates in fundraising and manage- her efforts to develop the first Frissell is one of the founders ment of the UWF Endowment Fund and is actively involved in III furthering educational opportuni- ties for women in the community. She is married to Lloyd Frissell, also a retired professor. Both were instrumental in the launch of the Jefferson Higher Education Consortium, which offers higher education to Jefferson County residents. (-a-LC-4e- -P)----'' ' The Woman of Excellence plaque, first awarded in 1996, displays the names of all recipi- 1 _ 1 i'5—Ll S ents and is on display at the Port Townsend Public Library. i Healthy Youth Coalition talks Internet The Healthy Youth Coalition Debbie Kronk. cal thinking skills necessary for pie preying on youths. meets Thursday, Feb. 3, 4-5:30 "The Internet is a wonderful personal safety." The Healthy Youth p.m. at the Jefferson County place," said Detective Kronk. Before coming to Jefferson Coalition is convened by the Library in Port Hadlock to talk "We would like to talk about County, Detective Kronk served Jefferson County Community about Internet safety for all Internet safety and how parents as a detective on a federal task Network. All citizens are wel- . ages. can take an active role.We want force in Seattle.Under the super- come, especially parents. For Featured speakers will be to give out information on how vision of the National Center for more information,contact Beth _ Port Townsend Police Detective to recognize and identify possi- Missing and Exploited Children, Wilmart, program manager, Troy Surber and .Jefferson ble dangers and to develop members of the task force went bwilmart@co.jefferson.wa.us or County Sheriff's Detective Internet safety skills and criti- online undercover to catch peo- 379-4495. • • j- ( • • • • • N. •• • A 8 •Wednesday,January 26,2005 • Education Parents •lesson get on adole scenc• e Panel discusses sex drugs alcohol and safety By Sarah J. Bell • About 100 people attended the s m Leader Staff Writer Y Po- room usage. sium coordinated by Jeanie Glaspell, a Port - Pe Sather emphasized making goals and Parents of Port Townsend High School ent,anand Monica Kelly,parent t counselor fr a ninth- Surber and par- encouraging talkegd children to achieve. Officera students gathered in the school's auditorium grader and a fourth-grader. aboutangattentiontio to example youras r Jan. 13 to learn some lessons of their own. eaparent and paying i where Discussing adolescence, sex, drugs and kids out�their bcomfo zones to ut intervention see a lard g- students are and who they're with. alcohol, experts including Juvenile Court er world. Metzger defined adolescence and the feedback forms theydistributed g Kelly said she and Glaspell plan to look at col- Administrator Barbara Carr, Public Health asked parents to remember their state of lected at the event to determine whether or urse Hilary Metzger, Adolescent Mental and mind when they were teens in trying to not they should have another symposium. Illealth Specialist Sherry NeSmith, understand their own children now.NeSmith Prevention/Intervention SpecialistKelly said she was pleasantly surprised for Port talked about adolescent depression and find- by the turnout and received "all positive Townsend High School and Blue Heron ing activities that give children self-worth. feedback." Middle School Pam Rogge,school counselor Rogge offered insight directly from stu- Marcus Sather and Port Townsend Police dents and told parents the reality of drinking "We'rencsandhoping h find a direction from Officer Troy Surber gave insights and sug- and drug usage,saying that in Port Townsend there is going to be another one,"Kellysaid. Parents see where they want to go if gestions for communicating with kids and there is a great deal of binge drinking,marl- "It's the be keeping them out of trouble. juana smoking and hallucinogenic mush- don't knowgPmg or the end—at this point I B 2•Wednesday, February 2,2005 • Grant money • comes for kids Jefferson County Explorer program. Community Network has • Peer-In, a high school awarded more than$8,000 in peer education program grants to five local organiza- offered in Port Townsend and tions for projects benefiting Chimacum by Jefferson Jefferson County children County Public Health. and families. The grants All projects include pre- range in size from $950 to venting youth substance $2,000 and must be spent by abuse and/or violence as one June 30. of their goals. Projects funded by the Community networks are agency include: part of the Washington State • • Sunfield Farm Youth Family Policy Council that Project, a collaborative effort involves communities in pre- between Sunfield Farm and venting child abuse, youth Chimacum School District's substance abuse and other Pi Program. social problems. • SISIUTL Center for The Jefferson County Learning's "Challenge Your agency promotes prevention Perceptions" program, to be principles through community administered at the new awareness and by convening Crossroads Alternative providers, community groups • School in Quilcene. . and parents. The Healthy • Tri Area Teen Resource Youth Coalition focuses on Center's"Attitude Adjustment youth substance abuse preven- Movie Theater"program. lion, and the Family Support • •Wooden ' Boat Coalition has child abuse pre- Foundation's Puget Sound vention as its focus. • P • • Wednesday,February 2,2005 • B 3 .GN thanks supporters By Patrick j. Sullivan k year are Morris returning as Leader Staff Writer �� tr president, Lloyd Cahoon, vice Working toward the common president; Carol Andreasen,sec- goal of helping the community £ "" z � `` 7 and Vicky Grauberger, brought about 70 people togeth- � ' ' zg� treasurer. er for the annual United Goodt:1":-.474.it r The annual challeng • e " between city and Jefferson Neighbors"thank you"luncheon : x ; Jan. 21. _��, 14 ., g County officials to see which �,� ,� � tY UGN raises money to support . government entity can raise £y morethan 30 health and human t. ,' � more for UGN has reached a service programs serving . � � v. new level. Since the county has Jefferson County. Donations « �' more employees, it generally come from business employees, 1 �` , $ { £ �i Count more thanthe cit businesses matching employee x, � `'t5 a'& � Y Assessor Ja k donations, from individuals and r x �x WestermanIII challenged the grants or foundations. ,M �- f • city that for the 2005 campaign, '" , -t the average commitment amon Children,the elderly and peo- ��'`�>:��3�� g O� the elected officials (seven for pie in general need are among z ��'(f tik * ;'t .. the focus areas. t 's�*' 7 both city and county) and "We want to thank the volun- teers � � j department heads (countyhas Leers and donors who have been £� � Or J3 more thancity) will be figured. Ma1�C ctive this year," said Judi ,i x �� ".. If the city wins,Westerman said s, president of the UGN Chuck Madison of Port Townsend Paper Corp.accepted an award his head of hair will get shaved Board. on behalf of the mill,which exceeded its goal of raising$33,000 to at the UGN luncheon next year. Although only 73 percent ons will support United Good Neighbors. Photo by Patrick J. Sullivan If the county wins, City ($193,000) of the UGN goal of UGN make a positive differ- First Federal Savings and Loan, get hiManas head er ashaved ve -although $265,000 has been reached to ence. "We need those stories to the City of Port Townsend, Westermannoted that he had not date, leaders are hopeful that by help sell to the public the impor Enclume Design and Edensaw talked with Timmons about this June the full amount will be tance of UGN donations," he Woods are other key business in advance. achieved, said. campaign supporters. The "This should make it easier Three outgoing board mem- The people who led commit- Jefferson County Association of to figure out just who , thise acbiggityorer bers were honored: Francesca tees and other UGN efforts were Realtors was thanked for raising supporter of UGN Drum (1993-2004), Paul thanked, and new board mem- $2 g Heinzinger (1995-2004) and bers Roger Lizut and John Watts UGat Noffi ers forle nthe 2005 quipped ounty," Westerman Chuck Madison (1999 2004). were welcomed. Heinzinger asked UGN mem- bers and supporters to help most "employer"•contributions come up with "personal stories" again this year is the Port that show how agencies and pro- Townsend Paper Corp., which grams receiving money from exceeded its goal of $33,000. • • • `) The Seattle Times: Study: Vaccine reduces chickenpox deaths Page 1 of 2 ajCSeatiteeitues Thursday,February 3,2005-Page updated at 6:56 PM Permission to reprint or copy this article/photo must be obtained from The Seattle Times. Call 206-464-3113 or e-mail resale@seattletimes.corn with your request. Study: Vaccine reduces chickenpox deaths By STEPHANIE NANO Associated Press Writer U.S. deaths from chickenpox dropped to the lowest level ever after a vaccine to prevent the childhood disease was introduced in 1995, a study shows. In the five years before the vaccine, chickenpox caused or contributed to an average of 145 deaths each year. That dropped to 66 in just a few years, researchers at the Centers for Disease Control and Prevention reported in Thursday's New England Journal of Medicine. The death rate was slashed by as much as 92 percent in the 1-to-4-year-old group. "It's really a very dramatic success story for the vaccination program,"said Jane F. Seward, one of the CDC researchers. Until the vaccine became available, nearly everyone got a case of chickenpox,which is highly contagious. Healthy children and adults can die from complications that include viral pneumonia, infection of the brain and bleeding. Now, with 85 percent of young children in the United States getting a vaccine shot, chickenpox cases have dropped from 4 million a year to 800,000. The researchers reviewed death certificates from 1990 through 2001 and found that chickenpox deaths went down as the use of the vaccine increased.The death rate did not drop for those over 50, but the researchers said those deaths were more likely due to shingles,which is caused by dormant chickenpox virus and results in a painful rash and nerve pain. The vaccine is considered about 80 effective, and vaccinated children can still get a mild case. Dr. Marietta Vazquez of the Yale School of Medicine said a second dose of vaccine may be needed to boost children's immunity, citing outbreaks at day-care centers and schools where most children were vaccinated. Seward said a second chickenpox shot is under discussion. On the Net: New England Journal: . http://nejm.org file://C:\Documents%20and%20Settings\barbm\Local%20Settinus\Temnorary%20Internet__. 2/4/2005 ?earson gets code enfo rcemeFamiliar face and name. New cases,�th many nt Position job. animal services and will do some tor. "With this new position, the still pending. code compliance work. As of Feb. 1,Molly Pearson is Pearson public will be better served!' the new codeFb compliance e Pearson is intends to "hit "I depend on him to escort me Pearson's environmental nator for Jefferson County. the ground '' to the site if there is any kind of a compliance work for the health A 16 year county employee, running" by potentially dangerous situation," department came through a state Pearson said. And if a casegets Pearson most recently worked in immediately pr'-'07,„::: grant. She's not certain how that y to a brick wall and it's headed for work will be done since she has the environmental health depart- addressing court,then Ton ste s in." ment, where she helped create those cases still `'`" y P moved to BCD. But the two the compliance program for the unresolved, Molly Pearson Examples of non-compliance areas are connected. or}site septic and solid waste freeing up the core DCD staff to or structurecould d withe l urt a a house Pearson said she not out (garbage) Programs:``She has 'address-normQ. PPr?nit> .looking for code violations,"but if permits• grading and clearing inside a they're in your face,we'll move on also worked for Jefferson "We bend over backwards to stream or wetland buffer, or them. We County Public Works. get voluntarycompliance," respond to complaints stormwater issues such as clear- that come in from the public." Prior to the creation of the code Pearson said. But when she ing and grading in such a manner t compliance coordinator position, exhausts her remedies,the case is as to cause floodingand proper- People can file a not anony- 10 DCD staff members would given to Deputy Tony Hernandez. ty damage to neighbors. confidentially but anon to each work four hours a week on A sheriff's deputy who took onry g complaino wel- o l "And if your neigogh r compliance matters.In 2004,there code compliance work last year, come' Molly Pearson pleased t o our maksure yours your own house is in were more than 100 complaint Hernandez is now in charge of staff,"said Al Scalf,DCD direc- order first,"she advised. •S g) t • „et ''i • i MSS - NURSE FAMILY PARTNERSHIP 2005 Program Expense Detail 2.42%10.34% 2.00% ,❑WAGES & BENEFITS tillPROF SVCS 1iOTHER OPER ❑INTERFUND PYMTS 85.25% MSS - NURSE FAMILY PARTNERSHIP 2005 Program Revenue Sources II 17.48% 16.08% ❑FEDERAL GRANTS i STATE GRANTS :! 14.24% ❑INTERGOVERNMENTAL \y.,. GRANTS 0.00% ❑CHARGE FOR SVCS ®COUNTY 52.20% CONTRIBUTION • MSS - NURSE FAMILY PARTNERSHIP • Program Summary Nurse-Family Partnership (Formerly Prenatal and Infancy Home Visitation by Nurses), guided by a strong theoretical orientation, consists of intensive and comprehensive home visitation by nurses during a woman's pregnancy and the first two years after birth of the woman's first child. While the primary mode of service delivery is home visitation, the program depends upon a variety of other health and human services in order to achieve its positive effects. Program Targets The program is designed to serve low-income, at-risk pregnant women bearing their first child. Program Content Nurse home visitors work with families in their homes during pregnancy and the first two years of the child's life. The program is designed to help women improve their prenatal health and the outcomes of pregnancy; improve the care provided to infants and toddlers in an effort to improve the children's health and development; and improve women's own personal development, giving particular attention to the planning of future pregnancies, women's educational achievement, and parents' participation in the work force. Typically, a nurse visitor is assigned to a family and works with that family through the duration of the program. Program Outcomes This program has been tested with both White and African American families in rural and urban settings. Nurse-visited women and children fared better than those assigned to control groups in . each of the outcome domains established as goals for the program. In a 15-year follow-up study of primarily White families in Elmira, New York, findings showed that low-income and unmarried women and their children provided a nurse home visitor had, in contrast to those in a comparison group: • 44% fewer maternal behavioral problems due to alcohol and drug abuse; • 79% fewer verified reports of child abuse or neglect; • 31% fewer subsequent births; • an average of over two years' greater interval between the birth of their first and second child; • 30 months less receipt of Aid to Families with Dependent Children; • 69% fewer maternal arrests; • 60% fewer instances of running away on the part of the 15-year-old children; • 56% fewer arrests on the part of the 15-year-old children; and • 56% fewer days of alcohol consumption on the part of the 15-year-old children. • MSS —NURSE FAMILY PARTNERSHIP Program Narrative 2005 1 of 2 Program Costs • The cost of the program is recovered by the first child's fourth birthday. Substantial savings to government and society were calculated over the children's lifetimes. In 1997, the two-and-a- half-year program was estimated to cost $3,200 per year per family during the start-up phase (the first three years of program operation) and $2,800 per family per year once the nurses are completely trained and working at full capacity. Actual cost of the program will vary depending primarily upon the salaries of local community-health nurses. Jefferson County Health&Human Services has used a variety of local, state, and federal funding sources to support the program, including Medicaid, county substance abuse prevention, welfare-reform, maternal and child health, and child abuse prevention dollars. • • MSS —NURSE FAMILY PARTNERSHIP Program Narrative 2005 2 of 2 • HEALTHY COMMUNITIES - BBBS 2005 Program Expense Detail 0.77% 2.37% 18.71% F : ❑WAGES & BENEFITS ' PROF SVCS .= fi ❑OTHER OPER ❑INTERFUND PYMTS \:::-:!;,1KgW.:',y 78.16% HEALTHY COMMUNITIES - BBBS 2005 Program Revenue Sources Ill 0.00% 7.39% -0.00% 0.00% ❑FEDERAL GRANTS e N.I STATE GRANTS ❑INTERGOVERNMENTAL GRANTS ❑CHARGE FOR SVCS ■COUNTY 92.61% CONTRIBUTION • HEALTHY COMMUNITIES -BBBS • Program Summary Big Brothers Big Sisters of America(BBBSA)has been providing adult support and friendship to youth for nearly a century. A report in 1991 demonstrates that through BBBSA's network of nearly 500 agencies across the country, more than 70,000 youth and adults were supervised in one-to-one relationships. Program Targets BBBSA typically targets youth(aged 6 to 18) from single parent homes. Program Content Service delivery is by volunteers who interact regularly with a youth in a one-to-one relationship. Agencies use a case management approach, following through on each case from initial inquiry through closure. The case manager screens applicants, makes and supervises the matches, and closes the matches when eligibility requirements are no longer met or either party decides they can no longer participate fully in the relationship. BBBSA distinguishes itself from other mentoring programs via rigorous published standards and required procedures: • Orientation is required for all volunteers. • Volunteer Screening includes a written application, a background check, an extensive interview, and a home assessment; it is designed to screen out those who may inflict • psychological or physical harm, lack the capacity to form a caring bond with the child, or are unlikely to honor their time commitments. • Youth Assessment involves a written application, interviews with the child and the parent, and a home assessment; it is designed to help the caseworker learn about the child in order to make the best possible match, and also to secure parental permission. • Matches are carefully considered and based upon the needs of the youth, abilities of volunteers, preferences of the parent, and the capacity of program staff. • Supervision is accomplished via an initial contact with the parent, youth, and volunteer within two weeks of the match; monthly telephone contact with the volunteer, parent and/or youth during the first year; and quarterly contact with all parties during the duration of the match. Program Outcomes An evaluation of the BBBSA program has been conducted to assess children who participated in BBBSA compared to their non-participating peers. After an eighteen month period, BBBSA youth were: • 46% less likely than control youth to initiate drug use during the study period. • • 27% less likely to initiate alcohol use than control youth. HEALTHY COMMUNITIES —BBBS Program Narrative 2005 1 of 2 • almost one-third less likely than control youth to hit someone. • • better in academic behavior, attitudes, and performance than control youth. • more likely to have higher quality relationships with their parents or guardians than control youth. • more likely to have higher quality relationships with their peers at the end of the study period than did control youth. Program Costs The national average cost of making and supporting a match relationship is $1,000 per year. The program is funded by local; federal; and non-federal match dollars, consisting of Liquor Excise Tax from the City, Office of Juvenile Justice, and in-kind contributions provided by the Healthy Youth Coalition, BBBS, and OESD. BBBS of Seattle manages and supervises the overall program and will seek further funding. 4111 • HEALTHY COMMUNITIES —BBBS Program Narrative 2005 2 of 2