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HomeMy WebLinkAbout2005-May File Copy • Jefferson County Board-of Health .agenda • Minutes May 19, 2005 • • JEFFERSON COUNTY BOARD OF HEALTH Thursday, May 19,2005 2:30—4:30 PM Main Conference Room Jefferson Health and Human Services AGENDA I. Approval of Agenda II. Approval of April 21, 2005 Board of Health Retreat Summary III. Public Comments IV. Old Business and Informational Items 1. Region 2 Public Health Newsletter and Communicable Disease Report 2. Sexually Transmitted Disease Provider Letter 3. Press Release—Threatened Shellfish Areas • V. New Business 1. Public Hearing--Jefferson County Food Safety Code 2. Mission and Name of County Health Department 3. Future of Assessment Activities in Jefferson County 4. 2005 Legislative Session Summary 5. 2005 West Nile Fever Surveillance and Prevention Efforts 6. Jefferson County Board of County Commissioner's Resolution re: Substance Abuse Advisory Board Oversight VI. Activity Update VII. Agenda Planning VIII. Next Scheduled Meeting: June 16,2005 Main Conference Room Jefferson Health and Human Services • • JEFFERSON COUNTY BOARD OF HEALTH • 2005 Retreat - Notes Thursday, April 21, 2005 Board Members: Staff Members: Phil Johnson,Member-County Commissioner District#1 Jean Baldwin,Health&Human Services Director David Sullivan, Vice Chairman-County Commissioner District#2 Mike McNickle,Environmental Health Director Pat Rodgers,Member-County Commissioner District#3 Julia Danskin,Nursing Services Director Geoffrey Masci, Chairman-Port Townsend City Council Thomas Locke,MD,Health Officer Jill Buhler,Member-Hospital Commissioner District#2 Sheila Westerman,Member-Citien at Large(City) Roberta Frissell,Member-Citi en at Large(County) Board members present were Phil Johnson, David Sullivan, Pat Rodgers, Geoff Masci, Jill Buehler, Sheila Westerman and Roberta Frissell, Staff members in attendance were John Fischbach, Tom Locke, Jean Baldwin, Mike McNickle, Julia Danskin and Veronica Morris- Nakano. There was a quorum. • DISCUSSION ITEMS • Mission and name of agency: "Jefferson County Health and Human Services" is not necessarily recognizable as the name for public health services. The mission statement was also reviewed. Suggested by Board for staff to return at next meeting with name and mission revised and to come forward with suggestions for adoption. • 2004 Performance Measures: reviewed end-of-year summary of all HHS Board of Health reporting programs. Discussion followed on if we are measuring the right things; can we measure outcomes and not just activities; can we move toward measuring public health value to the community and the individual—if not, at what point do we look at discontinuing programs. Benefit is thought to be invisible yet performance measures continue to look at services being provided towards a goal, so we might want to talk about redefining the goals more. There was also discussion about best practices and measuring best practices. • The invisible messages of public health: the need to increase marketing and get the community to appreciate services and there was a need for an ongoing outreach to keep people interested in public health. There was discussion about press releases, web sites and entire issues of communication. Also feedback forms following up from customers so that • positive and negative feedback could be heard and acted on. HEALTH BOARD RETREAT NOTES -April 21, 2005 Page: 2 • General Fund& Jefferson County HHS programs: how each program met the Public • Health standards and what percent each program's expense is funded by County general fund. This graph allows all to see the cost of each program and how much general fund money supports the five key areas. The actual dollar amounts of general fund are available and will be provided at the June meeting. PRIORITIZATION The Board discussed prioritization (notes were made onto a flip chart). Themes included: • Statewide funding of public health as a system: issues that this Board needed to address were policy making and having the budget conform to policy. • Family planning and environmental health are big issues for Board in times of decreased revenue and increased demand. Public health staff may need to be more vocal to promote public health. • Communicating with the public and staff to show support—maybe an annual newsletter in order to educate the public. • Safety of staff and looking at the most impact for and benefit for the limited resources. • Best practices and retaining best practices for long-term benefit. i.e. Best Beginnings, Big Brothers/Big Sisters, Project Alert, Peer-in and other programs. • • Substance abuse prevention. • Community needs; health access and senior health issues should be addressed by the BOH throughout the year- these are health impacts to citizens. • Prevention and community marketing remained consistent themes. • There was support to continue with direct services. • Work force development and retention. There was concern about infrastructure and maintaining workforce. • Public health standards—after the State finishes the report it will come back to the BOH. • Safety and the Latimore report—threat and violence and how to train staff; involving staff in communication; having a zero tolerance with the BOCC support and some type of statement; a need for systems change around weapons, but since that may be impossible there's a need for ongoing discussion about safety training for people as they work in the field, the buildings or other places. • Substance abuse—the State Division of Alcohol and Substance Abuse contracted formerly with the County for treatment and prevention services. Now that treatment services are privatized, a Commissioner thought that planning for prevention and treatment are not aligned in the community. The Substance Abuse Board is currently providing advise to the Commissioners on substance abuse treatment and prevention yet few of them attend the BOH or know about the other prevention services going on in the community under the BOH direction, either in JCHHS or other community services • through funding that comes through JCHHS. There was a minimum amount of discussion to actually look at the substance abuse RCW, meet with David Alvarez and see if the HEALTH BOARD RETREAT NOTES -April 21, 2005 Page: 3 • Substance Abuse Board as it currently stands appointed by the Commissioners, is the appropriate way to handle and ongoing community health problem. • Emergency preparedness was briefly discussed, reviewing the 3 day activation of the joint Emergency Operation Center and JCHHS Emergency Coordination Center to combat an infectious disease. Discussion was tabled for another meeting to talk about the legal powers and duties of BOH and assessment capacity for JCHHS. • i i Board of 3-fealtFt Old-Business .agenda Item # n/ , 1 • Region 2 Pu6Cic Health Netivsletter & Communicable Disease Report Lay 19, 2005 • Sprang 2005 hV,-.1 r. dsr CJ_` Y .. ---- for, th. e' ,'.,4„ f- - / le :iiOn 2aMcoL byHrExiuror `� = tiy,P 8 MUMPN Why Notify? You,as physicians and health care providers, are the eyes and ears of Public Health in the community. Your surveillance is critical which is why we want to remind you why you report the notifiable conditions and that you are clear on which conditions to report. " r'• + 1. 1101110 Most recently,the list of notifiable conditions was amended, J effective February 2005,by the Washington State Board of Health. The changes are: ` x �IL 4 Keep reporting chronic hepatitis B,acute and chronic hepatitis l _= • C,herpes simplex(neonatal and initial genital �--. infections),and arboviral disease. , 4 Keep reporting autism spectrum disorder,cerebral palsy and alcohol related birth defects. 5d ' 4 Report viral encephalitis if you suspect or have confirmed an arboviral disease. / Jefferson County Communicable DiseaProgram 4 Stopreporting invasive groupA Streptococcus. It's no longer Coordinator, Lisa McKenzie, takes 0on the list. a notifiable condition call. Continue to report all notifiable conditions such as acute Hepatitis B. Your reports are recorded and provide key information about the health "If in doubt, report it out." of the community and where we need to direct our resources and education. That's why in future editions of"Public Health for the Peninsulas"we'll include updates in the table below. Region Reported Cases of Kitsap Cases Jefferson Cases Clallam Cases Total Selected Diseases in Region 2 January— January— January— January— January— January— Jan—March March 2005 March 2004 March 2005 March 2004 March 2005 March 2004 2005 2004 Camovlobacterloals 8 4 1 0 01 0 , 9 4_ Crvotosnorldlosis 1, 0 0 0 , 0 0 1 0 Chlamydia 172'I 170 21 5 20' 31 213; 206. Glardlasis4 0 0 0 0, 1 4 1 Gonorrhea 191 19 1 2 4 1 24' 22 Heoatltls A 0 0 0 0 2 0 2( 0 Hepatitis C 69, 50 2 0 0', 0 , 71 50 Heroes , 9 12 4, 3 0 0 , 13 15. HIV and AIDS(Includes only AIDS cases not pre- 5 4 0 0 0! 0 , S! 4 Malaria 0 0 1 0 0 0_ 1, Q Meningococcal Disease 0' 1 9 0 0 0 01 1 Pertussis 2 _1 1 0 0 0 3 1 Salmonellosis 3 3 1 0 , 1 0 5 3 SvohIlls _ 2 0 0 0 0 0 2 0 Tuberculosis 41 1 0 0 0 0 4 1 0 In the first quarter of 2005 and of 2004 there were no reports of the following notifiable conditions: cyclosporiasis; enterohemorrhagic E. coli (non-0157); E. coli 0157:H7;mumps;rubella; shigellosis. The Region 2 Public Health Emergency&Preparedness Program(PHEPR)endeavors,through this newsletter,to keep you,our health care providers in Clallam, Jefferson,and Kitsap Counties,informed about Public Health issues that affect you and the patients you serve.If you have questions,comments or need more information about items in this nezvsletter,please contact the editor,Ruth Westergaard,by phone at(360)337-5752,email zvester@health.co.kitsap.wa.us or at 345 Sixth Street,Suite 300,Bremerton,WA 98337. Spring 2005—page 2 New! ,,,1 ye Alternatives to DEET! „ = ,�1,E West Nile Virus—Control That Habitat Two insect repellents that do no 4� West Nile virus made it the West Coast in 2004 but Washington contain DEET are also recommended n'��` has yet to see a documented case of human infection. Reduction by the CDC. The CDC says picaridin of the habitat of Culex species of mosquito is critical. offers "long-lasting protection against Want more info? Call 1-866-78-VIRUS or log on to www.doh. mosquito bites" and oil of lemon eucalyptus wa.gov/WNV or Region 2 Public Health websites. provides protection time "similar to low- Habitat Reduction Tips concentration DEET products."For more info *Seal window and door screens and repair tears. go to www.cdc.gov/ncidod/dybid/westnile/ *Empty out all outdoor containers such as buckets and cans. Other personal protection tips include: *Dump water off tarps and plastic sheeting. *Wear long sleeves,pants,socks and shoes and *Change water in birdbaths and animal troughs once a week. cover your head if you must go in mosquito *Recycle old bottles,buckets and cans and get rid of old tires. infested areas. *Empty out children's wading pools when not in use. *Stay indoors during the biting hours of dusk and dawn. Public Health on the Web Clallam County Health & Human Services www.clallam.net/HealthServices (360) 417-2274 Jefferson County Health & Human Services www.jeffersoncountypublichealth.org (360) 385-9400 Kitsap County Health District www.kitsapcountyhealth.com (360) 337-5235 Called your RDO lately? Remember hearing about Public Health 24/7?Over the past few months nurses from Public Health have come to your office to talk to you about the Regional Duty Officer (RDO) and how the RDO is available to you when you need to report or consult regarding Public Health issues. The RDO pager was activated September 2004. Since then a Region 2 (Clallam,Jefferson and Kitsap) senior Public Health staff member has been Regional Duty Offi carrying the pager 24 hours a day, 7 days a week. Each Monday the Duty Officer submits a written report of any calls received during his/her duty tenure and then After hours transfers the pager to the next person in line for duty. On Fridays the staff discuss via Cathe p2g-200er 5 conference calls what's been happening during the week and what to be on the lookout (360o)ors or 911 11 for over the weekend. RDOs have received calls about: sewage spills, animal bites, Public 'Health 24/7 possible rabies,infectious disease and notifiable conditions. Call your RDO after hours at(360)415-2005. For more details about the RDO look in the Public Health binder in your office or call Ruth at(360) 337-5752 or Ellen at(360) 337-5254. Region 2 Public Health Kitsap County Health District 345 Sixth Street,Suite 300 Bremerton,WA 98337 Region 2 Exercises Region 2 public health, emergency management, first responders and hospitals conducted '; • • a full-scale exercise in March to test the region's ability to respond to a 1 l biological hazardous 111 . � ' " event. This exercise focused on pandemic flu. Volunteers with the Medical Reserve Corps in Kitsap practiced running a mass prophylaxis distribution center. • Board of 3-fealth OCcl Business .agenda Item # 117., 2 • Sexually transmitted Disease Provider Letter NLay 19, 2005 M4sa1 -v., JEFFERSON COUNTY PUBLIC HEALTH i° ;: Always Working for a Safer and Healthier Jefferson F5t1TN�- May 3, 2005 Dear Health Care Provider: Jefferson County Health and Human Services would like to thank you for reporting STD's. Your efforts help to fulfill crucial contact tracing and epidemiological functions at the local and state levels. Chlamydia was at a record level in Washington State in 2004 with 17,637 cases reported. Jefferson County documented 36 cases in 2004 and 59 cases in 2003. In the first quarter of 2005, a record number of 20 cases of chlamydia have already been reported in our county. Routine screening for every sexually active patient under 25 is needed to effectively address this epidemic. Patient Delivered Partner Therapy (PDPT) has been shown to be an effective method to assure contacts of chlamydia or gonorrhea cases are treated. An article reviewing PDPT is included in your packet. Treatment guidelines for STD's change over time, and it is important to consult . them before treating unfamiliar STD's. A laminated 2002 CDC STD Treatment Guideline is part of this mailing. Please note that recommended oral medications for the treatment of gonorrhea have changed since 2002. Cefixime is no longer commercially available and fluoroquinolones are no longer recommended due to increasing antimicrobial resistance. Recommended firstline treatments for gonorrhea infections of the cervix, urethra, and rectum are: • Ceftriaxone (Rocephin) 125 mg IM in a single dose Or • Cefpodoxime (Vantin) 400mg PO in a single dose For reporting purposes, or assistance with contact tracing, please call Denis Langlois, ARNP or Lisa McKenzie, RN, MPH at 385-9400. Sincerely, Thomas Locke, MD, MPH Jefferson County Health Officer • COMMUNITY ENVIRONMENTAL DEVELOPMENTAL NATURAL HEALTH HEALTH DISABILITIES RESOURCES (360) 385-9400 (360) 385-9444 (360) 385-9400 (360) 385-9444 615 Sheridan Street,Port Townsend, Washington 98368 fax: (360)385-9401 web: www.jeffersoncountypublichealth.org • Board of 3-fealth OCdBusiness .agenda Item # XV., 3 • Press Release - ThreatenecfSheffflsfi .Areas .May 19, 2005 • • Washington rrt 43( 0"7„,,.... ..........os' ...........„ PUGET SOUND ,li Health ifr ACTION TEAM For immediate release: May 2, 2005 (05-044) Contacts: Don Melvin, Shellfish Programs, Dept. of Health 360-236-3320 Bob Woolrich, Shellfish Programs,Dept. of Health 360-236-3329 Stuart Glasoe, Puget Sound Action Team 360-725-5449 Donn Moyer, Department of Health Communications 360-236-4076 Threatened shellfish areas— good news / bad news OLYMPIA—The Washington State Department of Health has listed 25 commercial shellfish growing areas in Washington as threatened with closures. Last year 22 areas were on the list. "The number of threatened areas is an indication of water quality problems," said Bob Woolrich, growing area manager for the Department of Health. "It's also true that of the 25 threatened areas, eight of them had even worse water quality in the past and had harvest 411 restrictions. Conditions in these areas have improved enough to reopen them, yet with water quality that shows the continuing threat of possible re-closure." Each year the Department of Health reviews water quality and pollution conditions in commercial shellfish growing areas and issues a list of areas threatened with closures. The "threatened" designation usually applies to only part of a shellfish area. Local, state and tribal agencies use the list to focus pollution-control efforts to avoid closures. In almost every area that has been listed, there has been some effort to identify and correct pollution sources. Many of the threatened sites are located near rivers or streams that bring nonpoint pollution in from the watershed. Nonpoint pollution includes waste from farm animals,hobby farms, stormwater, onsite sewage systems, and wildlife. Washington is the nation's leading producer of farmed oysters, clams and mussels. In the past two years,pollution-control efforts have reopened shellfish beds in five areas: Dyes Inlet in Kitsap County, Portage Bay and Drayton Harbor in Whatcom County, and Lynch Cove and • North Bay in Mason County. —More— Shellfish areas threatened by pollution May 2, 2005 Page 2 The threatened shellfish areas listed by county for 2005 are: • • Clallam County-Dungeness Bay and Jamestown • Grays Harbor County-Grays Harbor near Elk River and a section of coastline near Pacific Beach • Jefferson County-the southernmost parts of Discovery Bay and Port Townsend • Kitsap County- Cedar Cove in Port Gamble Bay • Mason County—North Bay and Annas Bay • Pacific County- South end of Long Island in Willapa Bay; mouth of the Naselle River, and part of Nemah River shellfish area • Pierce County-Burley Lagoon, Filucy Bay, Rocky Bay, a small section of northern Henderson Bay, and a small part of Fox Island • San Juan County-Barlow Bay • Skagit County- Samish Bay • Snohomish and Island Counties - South Skagit Bay • Thurston County-Henderson Inlet and the southernmost part of Eld Inlet • Whatcom County- Birch Bay, Lummi Bay, and Portage Bay "Whether we like it or not, this is exactly what the early warning system is for," said Brad Ack, Chair of the Puget Sound Action Team partnership. "This information gives us one more chance to ramp up our efforts in these areas to control pollution so we can continue to enjoy the shellfish these areas produce." • Restoration of closed and threatened shellfish growing areas is a priority objective of the 2005- 2007 Puget Sound Conservation and Recovery Plan. For more information on the state's strategy to protect shellfish areas in Puget Sound, visit the Puget Sound Action Team's Web site (http://www.psat.wa.gov/). A map of the threatened shellfish areas is posted on the Department of Health's Web site (http://www.doh.wa.gov/ehp/sf/Pubs/Threatareas04.pdf). ### Visit the Washington Department of Health Web site at http://www.doh.wa.gov for a healthy dose of information. e • Board of 3-fealth New Business .agenda Item # `V., 1 � Public 31- earing Jefferson County Food Safety Code .flay 19, 2005 • sa` ,6 6.\ JEFFERSON COUNTY PUBLIC HEALTH Always Working for a Safer and Healthier Jefferson • Ar7,,q04/ May 12, 2005 To: Jefferson County Board of Health From: Tom Locke, MD, MPH, Jefferson County Health Officer Re: May Board of Health Meeting Public Hearing on Food Safety Code: During the May 19, 2005 meeting of the Jefferson County Board of Health, a public hearing will be held on revisions to the County Food Safety Code. In reviewing the draft code language, I have noted that language was included in 8.05.030(A)(1) and (B)(1) concerning the timeline for administrative hearings. This draft language states: Upon receipt of such request, together with any applicable hearing fees, the Health Officer shall notify the person in writing of the time, date, and place of such hearing, which shall be set at a mutually convenient time not less than twenty (20) days nor more than thirty (30) days from the date the request was II/ received. On further reflection, the "not less than twenty (20) day" minimum for administrative hearings scheduling appears to be unnecessarily restrictive and may have the unintended consequence of delaying hearings that could be scheduled at an earlier time. To allow earlier scheduling of administrative hearings, I would recommend that the Board consider deleting this language. The revised code would then read: Upon receipt of such request, together with any applicable hearing fees, the Health Officer shall notify the person in writing of the time, date, and place of such hearing, which shall be set at a mutually convenient time not more than thirty (30) days from the date the request was received. For Board of Health appeal hearings, 8.05.030(B)(4)(c) does specify a 15 day minimum and 30 day maximum for such hearings. Unlike the administrative hearing requirement, this does serve a necessary 615 Sheridan Street,Port Townsend, Washington 98368 fax: (360)385-9401 web: www.jeffersoncountypublicheaith.org • COMMUNITY ENVIRONMENTAL DEVELOPMENTAL NATURAL HEALTH HEALTH DISABILITIES RESOURCES (360) 385-9400 (360) 385-9444 (360) 385-9400 (360) 385-9444 function since Board hearings are public meetings and require adequate public notice of the meeting and a certain minimum amount to • schedule Board meetings and provide Board members with necessary documents to review. I recommend adopting the time parameters for Board of Health appeals hearings as specified in the draft rule. 4110 • I. Health Department Chapter 8.05 • FOOD SERVICE SANITATION Sections: 8.05.010 Purpose 8.05.020 Regulations adopted 8.05.030 Hearings 8.05.040 Fees 8.05.050 Severability 8.05.060 Effective date 8.05.010 Purpose The purpose of Chapter 8.05 of the Jefferson County Code is to establish local Board of Health standards for food safety to supplement 246-215 WAC to promote and protect the health,safety, and well-being of the public and prevent the spread of disease through food. 8.05.020 Regulations adopted 411 The Rules and Regulations Washington State Board of Health for Food Service Sanitation,WAC 246-215,is hereby adopted by reference as the rules and regulations governing food service sanitation in Jefferson County,and including subsequent revisions thereto. 8.05.030 Hearings A. Request for a Hearing Following Notice of Suspension of a Food Establishment Permit Any permit holder who has received a notice of suspension of a food establishment permit may request a hearing by filing a written request for a hearing within ten days of receipt of the notice of suspension. The Health Officer will hear such appeals. The Health Officer's decision regarding an order prohibiting use may be appealed to the Board of Health. Any action to review the Health Officer's decision must be filed within thirty(30)days of the date of the decision. 1. Administrative Hearing: Any person aggrieved by an order suspending a food establishment permit may request,in writing,a hearing before the Health Officer or his or her designee. The appellant shall submit specific statements,in writing,of the reason why error is assigned to the Health Officer's decision. Such request shall be presented to the Health Officer within ten(10)days of the action appealed. Upon receipt of such request,together with any applicable hearing fees,the Health Officer shall notify the person in writing of the time,date,and place of such hearing,which shall be set at a mutually convenient time not less than twenty(20)days nor more than thirty(30)days from the date the request was received. The Health Officer will issue a decision affirming,reversing,or modifying the order prohibiting use. The Health Officer may require additional actions as part of the decision. • Jefferson County Code Chapter 8.05—Food service Sanitation— Public Review Draft Page 1 of 4 2. Hearing Procedures: Hearings shall be open to the public and presided over by the Health Officer. Such hearings shall be recorded.Hearings shall be opened with a recording of the time,date and place of the hearing,and a statement of the cause for the hearing.The Health Officer shall then swear in all potential witnesses.The case shall be • presented in the order directed by the Health Officer.The appellant may present rebuttal. The Health Officer may question either party.The Health Officer may allow for a closing statement or summation.General rights include: (a) To be represented by an attorney; (b) To present witnesses; (c) To cross-examine witnesses; (d) To object to evidence for specific grounds. In the conduct of the proceeding,the Health Officer may consider any evidence, including hearsay evidence that a reasonably prudent person would rely upon in the conduct of his or her affairs. Evidence is not admissible if it is excludable on constitutional or statutory grounds or on the basis of evidentiary privilege recognized in the courts of this state.The Health Officer shall decide rulings on the admissibility of evidence,and the Washington rules of evidence shall serve as guidelines for those rulings. Inasmuch as any appeal to the Board of Health from a Health Officer decision is a review on the record,the Health Officer shall ensure that the record generated contains testimonial and documentary evidence supporting the Health Officer's issuance of the order prohibiting use. The Health Officer may continue the hearing to another date to allow for additional submission of information or to allow for additional consideration.Prior to closing of the hearing,the Health Officer shall issue its oral ruling unless the Health Officer determines that the matter should be taken under advisement.Written fmdings of fact,conclusions of law,and orders shall be served on the appellant within fourteen days(14)of the oral ruling. If the matter is taken under advisement,written findings,conclusions,and orders • shall be mailed to the appellant within twenty-one(21)days of the close of the hearing. The appellant shall bear the burden of proof and may overcome the order suspending the food establishment permit by a preponderance of the evidence. 3. Appeals: Any decision of the Health Officer shall be fmal and may be reviewable by an appeal filed with the Board of Health through the Health Officer. Any action to review the Health Officer's decision must be filed within thirty(30)days of the date of the decision. B. Request for Hearing Following Notice of Revocation of a Food Establishment Permit: 1. Administrative Hearing:Any permit holder in receipt of a notice of revocation of a food establishment permit may request,in writing,a hearing before the Health Officer or his or her designee. The appellant shall submit specific statements in writing of the reason why error is assigned to the decision of the Health Officer. Such request shall be presented to the Health Officer within ten(10)days of the action appealed. Upon receipt of such request,together with any applicable hearing fees,the Health Officer shall notify the person in writing of the time,date,and place of such hearing,which shall be set at a mutually convenient time not less than twenty(20)days nor more than thirty(30)days from the date the request was received. The Health Officer will issue a decision affirming,reversing,or modifying the revocation order. The Health Officer may require additional actions as part of the decision. 2. Hearing Procedures: Hearings shall be open to the public and presided over by the Health Officer. Such hearings shall be recorded. Hearings shall be opened with a • recording of the time,date and place of the hearing,and a statement of the cause for the Jefferson County Code Chapter 8.05—Food service Sanitation— Public Review Draft Page 2 of 4 hearing.The Health Officer shall then swear in all potential witnesses.The case shall be presented in the order directed by the Health Officer.The appellant may present rebuttal. The Health Officer may ask questions. The Health Officer may allow the opportunity for • a closing statement or summation.General rights include: (a)To be represented by an attorney; (b)To present witnesses; (c)To cross-examine witnesses; (d)To object to evidence for specific grounds. In the conduct of the proceeding,the Health Officer may consider any evidence, including hearsay evidence that a reasonably prudent person would rely upon in the conduct of his or her affairs.Evidence is not admissible if it is excludable on constitutional or statutory grounds or on the basis of evidentiary privilege recognized in the courts of this state.The Health Officer shall decide rulings on the admissibility of evidence,and the Washington rules of evidence shall serve as guidelines for those rulings. Inasmuch as any appeal to the Board of Health from a Health Officer decision is a review on the record,the Health Officer shall ensure that the record generated contains testimonial and documentary evidence supporting the Health Officer's order revoking the food establishment permit. The Health Officer may continue the hearing to another date to allow for additional submission of information or to allow for additional consideration.Prior to closing of the hearing,the Health Officer shall issue its oral ruling unless the Health Officer determines that the matter should be taken under advisement.Written findings of fact,conclusions of law and orders shall be served on the appellant within fourteen days(14)of the oral ruling. If the matter is taken under advisement,written findings,conclusions and orders shall be mailed to the appellant within twenty-one(21)days of the close of the hearing. IPThe appellant shall bear the burden of proof and may overcome the permit revocation order by a preponderance of the evidence. 3. Appeals. Any decision of the Health Officer shall be final and may be reviewable by an appeal filed with the Board of Health through the Health Officer. Any action to review the Health Officer's decision must be filed within thirty(30)days of the date of the decision. 4. Appeal of Health Officer's Decision to Board of Health: a. Any person aggrieved by the fmdings,conclusions or orders of and administrative hearing conducted by the Health Officer shall have the right to appeal the matter by requesting a hearing before the Board of Health. Such notice of appeal shall be in writing and presented to the Health Officer within thirty(30)days of the Health Officer's decision. The appellant shall submit specific statements in writing of the reason why error is assigned to the decision of the Health Officer. b. The suspension or revocation of food establishment permits by the Health Officer shall remain in effect during the appeal process. Any person affected by the suspension may make a written request for a stay of the decision to the Health Officer within five(5)business days of the Health Officer's decision. The Health Officer will grant or deny the request within five(5)business days. c. Upon receipt of a timely written notice of appeal,the Health Officer shall set a time,date,and place for the requested hearing before the Board of Health and • shall give the appellant written notice thereof. Such hearing shall be set at a Jefferson County Code Chapter 8.05—Food service Sanitation— Public Review Draft Page 3 of 4 mutually convenient time not less than fifteen(15)days or more than thirty(30) days from the date the appeal was received by the Health Officer unless mutually agreed to by the appellant and Health Officer. d. Board of Health hearings shall be open to the public and presided over by the • chair of the Board of Health. Such hearings shall be recorded.Board of Health hearings shall be opened with a recording of the time,date and place of the hearing;and a statement of the cause for the hearing.The hearing shall be limited to argument of the parties and no additional evidence shall be taken unless,in the judgment of the chair, such evidence could not have reasonably been obtained through the exercise of due diligence in time for the hearing before the Health Officer. Argument shall be limited to the record generated before the Health Officer unless the chair admits additional evidence hereunder. e. Any decision of the Board of Health shall be final and may be reviewable by an action filed in Superior Court. Any action to review the Board's decision must be filed within thirty(30)days of the date of the decision. 8.05.040 Fees The Board of Health shall establish fee schedules for issuing or renewing licenses or permits or for such other services as are authorized by the law and the rules of the state board of health and necessary for the enforcement of this regulation:PROVIDED,That such fees for services shall not exceed the actual cost of providing any such services(RCW 70.05.060(7)). 8.05.050 Severability Should any part of this regulation be declared unconstitutional or invalid for any reason, such declaration shall not affect the validity of the remainder. 8.05.060 Effective date • The effective date of this regulation shall be. • Jefferson County Code Chapter 8.05—Food service Sanitation— Public Review Draft Page 4 of 4 I.Health Department • Chapter 8.05 FOOD SERVICE SANITATION Sections: 8.05.010 Purpose 8.05.020 P-emit—Required.Regulations adopted 8.05.030 .Hearings 8:0_5-048 .Fees 8:05-0-50 .Severability • 8-05:060 .Effective Date 8.05.070 '• . . . • . .•. . 8.05.080 . S.05.0% . 8:05100 . 8.05.110 . 8.05.120 • •8.05.130 :I : . , . . . • •• . 8.05.140 8.05.150 Worker-per- s 8.05460 . ' . .. . . 8.05.170Fees. 8:05:188 8.05.190 I 8.05.010 Purpose. • (1) s;., . . ,. • .. . .. - -•- - _. ... (2) The 1976 Edition of the United States Public Health-Service Food Service Sanitation (3) .. . .�' . . .. . . e I 8.05.020 Regulations adopted • • • .-: • - establishments shall not exceed a period of 11 days. [Ord.2 85;Ord.2 77 Part 1 § 2.11 • 8.05.030 Hearing A. Request for a Hearing Following Notice of Suspension of a Food Establishment Permit Any permit holder who has received a notice of suspension of a food establishment permit may request a hearing by filing a written request for a hearing within ten days of receipt of the notice of suspension. The Health Officer will h such appeals. The Health Officer's decision regarding an order prohibiting use may be appealed to the Board of Hea Any action to review the Health Officer's decision must be filed within thirty(30)days of the date of the decision. 1. Administrative Hearing: Any person aggrieved by an order suspending a food establishment permit may request,in writing,a hearing before the Health Officer or his or her designee. The appellant shall submit specific statements,in writing,of the reason why error is assigned to the Health Officer's decision. Such request shall be presented to the Health Officer within ten(10)days of the action appealed. Upon receipt of such request,together with any applicable hearing fees,the Health Officer shall notify the person in writing the time,date,and place of such hearing,which shall be set at a mutually convenient time not less than twen (20)days nor more than thirty(30)days from the date the request was received. The Health Officer will iss decision affirming,reversing,or modifying the order prohibiting use. The Health Officer may require additional actions as part of the decision. 2. Hearing Procedures: Hearings shall be open to the public and presided over by the Health Officer. Such • hearings shall be recorded.Hearings shall be opened with a recording of the time,date and place of the hear and a statement of the cause for the hearing.The Health Officer shall then swear in all potential witnesses.1' case shall be presented in the order directed by the Health Officer.The appellant may present rebuttal.The Health Officer may question either party.The Health Officer may allow for a closing statement or summatio General rights include: (a) To be represented by an attorney; (b) To present witnesses; appellant within twenty-one(21)days of the close of the hearing. iikThe appellant shall bear the burden of proof and may overcome the order suspending the food estab en permit by a preponderance of the evidence. 1. Appeals: Any decision of the Health Officer shall be final and may be reviewable by an appeal filed with th Board of Health through the Health Officer. Any action to review the Health Officer's decision must be file within thirty(30)days of the date of the decision. B. Request for Hearing Following Notice of Revocation of a Food Establishment Permit: 1. Administrative Hearing:Any permit holder in receipt of a notice of revocation of a food establishment perm may request,in writing,a hearing before the Health Officer or his or her designee. The appellant shall subm specific statements in writing of the reason why error is assigned to the decision of the Health Officer. Such request shall be presented to the Health Officer within ten(10)days of the action appealed. Upon receipt of such request,together with any applicable hearing fees,the Health Officer shall notify the person in writing the time,date,and place of such hearing,which shall be set at a mutually convenient time not less than twen (20)days nor more than thirty(30)days from the date the request was received. The Health Officer will iss decision affirming,reversing,or modifying the revocation order. The Health Officer may require additiona actions as part of the decision. 3. Hearing Procedures: Hearings shall be open to the public and presided over by the Health Officer. Such hearings shall be recorded. Hearings shall be opened with a recording of the time,date and place of the hearing,and a statement of the cause for the hearing.The Health Officer shall then swear in all potential witnesses.The case shall be presented in the order directed by the Health Officer.The appellant may sen rebuttal.The Health Officer may ask questions. The Health Officer may allow the opportunity for a g statement or summation.General rights include: (a)To be represented by an attorney; (b)To present witnesses; fp)To cross-examine witnesses; (d)To object to evidence for specific grounds. In the conduct of the proceeding,the Health Officer may consider any evidence,including hearsay evidence that a reasonably prudent person would rely upon in the conduct of his or her affairs.Evidence is not admissible if it is excludable on constitutional or statutory grounds or on the basis of evidentiary privilege recognized in the courts of this state.The Health Officer shall decide rulings on the admissibility of evidenc and the Washington rules of evidence shall serve as guidelines for those rulings. Inasmuch as any appeal to the Board of Health from a Health Officer decision is a review on the record,the Health Officer shall ensure that the record generated contains testimonial and documentary evidence suppor the Health Officer's order revoking the food establishment permit. The Health Officer may continue the hearing to another date to allow for additional submission of informati or to allow for additional consideration.Prior to closing of the hearing,the Health Officer shall issue its oral ruling unless the Health Officer determines that the matter should be taken under advisement.Written fmdin of fact,conclusions of law and orders shall be served on the appellant within fourteen days(14)of the oral ruling. If the matter is taken under advisement,written findings,conclusions and orders shall be mailed to t appellant within twenty-one(21)days of the close of the hearing. The appellant shall bear the burden of proof and may overcome the permit revocation order by a prepondera of the evidence. 4. Appeals. Any decision of the Health Officer shall be final and may be reviewable by an appeal filed h • Board of Health through the Health Officer. Any action to review the Health Officer's decision must be file • within thirty(30)days of the date of the decision. 5. Appeal of Health Officer's Decision to Board of Health: a. Any person aggrieved by the fmdings,conclusions or orders of and administrative hearing conduct by the Health Officer shall have the right to appeal the matter by requesting a hearing before the Bo of Health. Such notice of appeal shall be in writing and presented to the Health Officer within thir (30)days of the Health Officer's decision. The appellant shall submit specific statements in writin the reason why error is assigned to the decision of the Health Officer. b. The suspension or revocation of food establishment penirits by the Health Officer shall remain in effect during the appeal process. Any person affected by the suspension may make a written reque for a stay of the decision to the Health Officer within five(5)business days of the Health Officer's decision. The Health Officer will grant or deny the request within five(5)business days. c. Upon receipt of a timely written notice of appeal,the Health Officer shall set a time,date,and plac for the requested hearing before the Board of Health and shall give the appellant written notice thereof. Such hearing shall be set at a mutually convenient time not less than fifteen(15)days or m than thirty(30)days from the date the appeal was received by the Health Officer unless mutually agreed to by the appellant and Health Officer. d. Board of Health hearings shall be open to the public and presided over by the chair of the Board of Health. Such hearings shall be recorded.Board of Health hearings shall be opened with a recording the time,date and place of the hearing;and a statement of the cause for the hearing.The hearing sh be limited to argument of the parties and no additional evidence shall be taken unless,in the judgm of the chair,such evidence could not have reasonably been obtained through the exercise of due • diligence in time for the hearing before the Health Officer. Argument shall be limited to the record generated before the Health Officer unless the chair admits additional evidence hereunder. e. Any decision of the Board of Health shall be final and may be reviewable by an action filed in Superior Court. Any action to review the Board's decision must be filed within thirty(30)days of date of the decision. 8.05.040 Fees: The Board of Health shall establish fee schedules for issuing or renewing licenses or permits or for such other services as are authorized by the law and the rules of the state board of health and necessary for the enforcement of this regulation:PROVIDED,That such fees for services shall not exceed the actual cost of providing any such services(RCW 70.05.060(7)). 8.05.050 SEVERABILITY Should any part of this regulation be declared unconstitutional or invalid for any reason,such declaration shall not affect the validity of the remainder. 8.05.060 EFFECTIVE DATE The effective date of this regulation shall be. 41110 85,040 Per n=it—Is .. as established by this chapter. [Ord.2 77 Part 1 §2.3} a6ei�—�ucir;itit •• i�,i I 8.05.079 . . . • I • • . 8 :898 . 8:8Sl86 (44 • -.'b. - . , .. �• •. ... .' • ,. hazard-point-total of 40 or more on the las - -- •• r - _ • I 870544-oj44-0 Afi .,l Y hms_. I 8.05.120 • • .. . ••,=, • ,.• • •a a L R_ I 8.05.130 : • . • , I 8:05448 1 nd istp,. :, • 8.05.150 Worker-permits. [Ord.2 77 Part I § 1.1.d} I 8--05.160 • I 8.05.170 8:85;188 . .. 2.• --- . .. . . . .. . I 8.05440 Enforcement ¢l} . . . sepafat elatiei}- • chapter. the State Board of Health Food Service Sanitation)may be u ai-ved by the Jefferson County health department if it causes a hardship on the operator and it can be shown that no health hazard will result. [Ord.2 77 Part 1 § 7} • • FOOD SERVICE NEWS . 1. . '4p---,'. --, ,,,,,. Jefferson County Health and Human Services � W - 1_,;„ Spring 2005 -M- iAk, Y BRINGS NEW Jefferson_Countgade ed forMid-May ..., ....,, .......„ , ...,,,, ,,,..,„ ,,,,..„._,,..,,,-11.-----.71 Washington State Food Code WAC 246-215 takes effect May jeffersoncountypublichealth. 2, including: org has: • Consumer Advisory for undercooked or raw animal products that lets consumer know the risk. • Food worker cards info • Designated Person in Charge on duty with responsibili- • Food Worker manual ties for food safety, employee health restrictions. • Permits for restaurants, etc. • Temporary permits • New cold holding temperature of 41 degrees. _ • Inspections • Add cooked fruits and vegetables and garlic in oil to the • Regulations list of potentially hazardous foods. • No bare hand contact with ready to eat foods. lti FA • www.doh.wa.gov/ehp/sf/FoodRuleMain.htm fe .; Jefferson County Code Chapter 8.05 Food is up for adop- tion on May 19 by the Board of Health, including new Ian- -, ,� Y, guage on hearings for suspended or revoked permits. Pub- I � lic Hearing to adopt new code, May 19, 2:30-4:30 P.M. at Jef- N.,t.i,.., 1 ' q ferson County Health and Human Services, 615 Sheridan, ,�, Port Townsend, Washington. www.jeffersoncountypublichealth.org ROUTINE INSPECTIONS * * ENVIRONMENTAL HEALTH DIRECTOR r' New red/blue inspection form TAKES THE HELM has checklist, starts May 2. Complex Restaurants: 2 or Michael McNickle came on board April 25. * more inspections/yearfood safetyexperience has extensive hi * the industry and environmental health experi- Simple menu: 1 or more/year ence for the State and Kitsap County. He heads our department which includes food safety, on- fi, Temporary Events: 1 or more site sewage systems, drinking water quality, inspections/year solid waste, and natural resources. Page 2 Spring 2005 � n enAnois Pao voob ujohg ie CL Assts Contuim When will the new video be used in the class? What will the new exam be like? How can I get Food Protection Manager Certification? Starting in May, we will offer new course content for Food Worker Card Classes to include the changes in the food rules. Tacoma-Pierce County made a cartoon-like video. Look for new man- ual on www.jeffersoncountypublichealth.org soon. When your card is coming up to expire or if you are new to food handling, call 385-9444 to register for a class. The new exam looks something like the old exam. It has 32 multiple choice questions. You can miss six and still pass. You can repeat the exam if you miss more than six. The areas covered in class and on the exam are: 1. Food Worker Knowledge and Health 2. Personal Hygeine 3. Food Microbiology 4. Cold Holding 5. Thawing • 6. Cooking 7. Hot Holding 8. Cooling 9. Reheating 10.Cross-contamination 11.Cleaning and Sanitizing 61:2\ FOOD PPigaGUCUI011 mA1tAtJ CEIWGIFICAZI011 Food Protection Manager Certification is available from three approved courses: 1. ServSafe 2. Thomson Prometric (formerly Experior Assessments) 3. National Registry of Food Safety Professionals We are offering ServSafe June 28. Fee will be $181. Call 385-9444 to register. Kitsap Health District (360-337-5235) offers ServSafe Food Managers Certification classes. Food Protection Manager Certification is one way you can demonstrate knowledge of food safety when you are the Person In Charge. Your inspector will want to see your certificate. Otherwise, you must be able to answer the inspector's questions about food safety in your establishment. Page 3 Spring 2005 • Class Details FOOD WORKER CLASSES When and where: • Wednesdays at Health Department, 615 Sheridan (next to QFC in Port Townsend) at 4 to 5:30 • Fourth Thursday of the month at Tri-Area Center(Across from Chimacum Schools) at 3 to 4:30 • (Arrive 15 minutes early to check-in and reserve a seat for either class) • Holidays may mean cancelled classes. Call 385-9444 to check. Cost: $10 check or exact change please Pre-Registration: Call 385-9444 to pre-register if you can(drop-ins are welcome, but seat is not guar- anteed.)When you pre-register you still need to arrive 15 minutes early to secure your seat. After quar- ter to the hour we give away your seat to drop-ins. Special Classes During the off season(October to May) we will provide a class per request at your site if you have at least 10 people. We can no longer do this during the summer season due to our work load. If you are a food worker with a special need for assistance (language,reading difficulty, or other needs), let us know and we will assist you with a special class or assistance. We offer the class in sev- eral languages if requested. Your Food Worker Card You will receive a Washington State Food Workers card upon successful completion of the class. Keep a copy of the card at each place you work in food service. The cards are good for two years if it is a new card or you did not renew in time. You will get a three year card if you renew within 2 weeks of expiration of your previous Washington State Food Worker card. Your card is good all over the state. Take your class during the off-season to help us and your fellow food-workers if you can! u • Page 4 Spring 2005 Videos at JCHH5-Check These Out Environmental Health Staff Videos: • • FOOD SAFETY:You Make the Difference(various languages) Director Mike McNickle • THE SNEEZE Food,Water, Pools Dana Fickeisen, R.N. Susan Porto, R.S. On-Site Septic Systems Linda Atkins, R. S. Randy Marx Office Hours: Monday-Friday, 9:00 AM to 4:30 PM Food Safety Tools For Loan or Purchase Digital long stem thermometer $11.00 Dial long stem thermometers $6.00 % Test strips for measuring concentration of sanitizing solutions: chlorine $1.50 osit quaternary ammonia $2.50 kr .• Magnetic or adhesive mount thermometers to monitor refrigeration $3.00 Check Out Training Materials Glow Germ Hand Washing Awareness Tool Free We would appreciate any suggestions or comments you may have. Please contact the Environmental Health Food Safety Program at 385-9444, or stop by and see us at Jefferson County Health and Human Services, 615 Sheridan Street, Port Townsend, 98368. c a6ed uogeuiaolui sseio Z abed opal sseia MON afed saina pooj MaN "'aplSUl 89E86 VM `puesuMol pod 409a;S uepuagS 969 seo!Aaas ueuanHimeaH Alunoo uosaajlap 94'ON!IWN3d VM'ON3SNMOl12iOd albd3VCINV1 'S'fl &MON a0tn.1afOOFJ[`I a312iOS32id ►\✓ • Board of Health Wow Business .agenda Item # T., 2 • Mission & Name of County 3-Cealth Dept. .May 19, 2005 JEFFERSON COUNTY • BOARD OF HEALTH TO: Board of Health FROM: Jean Baldwin DATE: 5-10-05 SUBJECT: Mission and Name of County Health Department STATEMENT OF ISSUE: The current Mission and Name of Jefferson County Department of Heath and Human Services may not be an accurate representation of existing services and local priorities. The community work, bulk of employees and programs provide Public Health services. Human Services of the original DSHS services are no longer within department since the Drug and Alcohol services were privatized last year. Developmental Disability Services and their Board fit within the Health department. DD like Natural Resources both have a reporting & regulatory relationship to the Board of County Commissioners. ANALYSIS: )410 Name : Jefferson County Public Health clearly identifies a department and unites clinical services, environmental Health services and community prevention work. Mission: The Mission of Jefferson County Public Health is to protect the health of all Jefferson County residents by promoting, safe, healthy communities and environments. FISCAL IMPACT: JCHHS will have to modify contracts with a new name. This change will take about a year as new contracts and vendor renewals come in. Staff RECOMMENDATION: Change name to Jefferson County Public Health Adopt Mission. 0 Board of 3-lealth Wow Business .agenda Item # T., 3 • Future .assessment .activities In Jefferson County flay 19, ZooS • From: Healthy Jefferson • � _ - Jefferson Counol Health erHuman Services f 1 N4444, CASTLE HILL CENTER• 615 SHERIDAN • PORT TOWNSEND,WA 98368 April 25, 2003 Dear Community Leaders: We are pleased to provide you with the latest Health of Jefferson County Report. This report is the culmination of two years'worth of work by a community partnership made up of the City of Port Townsend,Jefferson General Hospital, Olympic Area Agency on Aging,Jefferson County WSU, Olympia, the Law&Justice Committee,Jefferson County Health & Human Services, and citizens of Jefferson County. Rural communities in Washington State face many familiar challenges—aging populations, economic recession, a fragile and fragmented health care delivery system, and limited opportunities for young workers and families. We also must confront a growing list of new, often frightening threats- • bioterrorism, infectious disease outbreaks, and clandestine drug labs. As these challenges mount and the resources we have to deal with them become more and more limited,we, as a community, must make a crucial decision. Do we retreat into our private lives or do we unite to face our common threats together? Community leaders and policy makers need accurate, detailed information to prioritize community needs and allocate scarce resources. The attached Report contains a comprehensive review of existing data. The next step is to find patterns and trends within this data that will better inform our decision-making processes. Thank you for joining us today as we move from data to action in pursuit of our common goal of a healthier community. Sincerely, Th- 'erson County Board of Health 41111111111.1b," • Geoff asci, Chair 'Wend' Wrinkle Glen Huntin: , d Roberta Frissell An (kfil 04.00471 Sheila Westerman Dan Titterness ll Buhler • Working Toward a Healthier Jefferson County Introduction • The 2003 Health of Jefferson County is a compilation of data from a growing health database about the people of Jefferson County. Its focus and structure are the result of the dedicated work of the Jefferson County Data Steering Committee, a broadly representative group of elected officials, community leaders, and health professionals. The project was funded by the City of Port Townsend and Jefferson County. The immediate goal of this assessment project is to provide policy makers with high quality data about the needs of Jefferson County residents to be used to better inform policy decisions and set priorities. The ultimate goal of this process is a healthier community. A healthy community is more than the sum of its vital statistics, health measures and economic indicators; it is also determined by the values, commitment, and leadership of community members. The next step in this process is to move from data to action, using the information gathered to better understand the complex patterns of preventable disease and disability within our community. Most, if not all, of the community health problems we will uncover are beyond the resources of any single institution or organization to resolve. Complex community problems require community-based partnerships committed to long-term efforts. To improve our community's health—to make Jefferson County a place where people are healthy, safe, and cared for–will take tremendous ongoing effort. We believe this community is ready to embrace this crucial challenge. Thank you for reviewing this material with us. We look forward to your thoughtful input and invite you to join your fellow community members in the important work that lies ahead. Sincerely, Jean,Baldwin, M.S.N., Director Dr. Thomas H. Locke Jefferson County Health and Human Services Health Officer, Jefferson County 2003 Health of Jefferson County 6 Assessment Matrix BOH Retreat 04-13-05 Population surveyed or monitored Administration JCHHS JCHHS <18 18-25 25-44 45-65 65+ Survey Tool Schedule Analysis Capacity* Census Every 10 years 1990-yes + X X X X X 2000-yes BRFSS DOH (n=200); annual 2001-yes ✓ X X X X (03, 04, 05, 06) 2003-pending County(n=603)2001 2004-pending Healthy Youth Joint-sponsors 2002-yes + D X Survey (DOH, OSPI, DASA, 2004-pending CTED); bi-annual 00, 02, 04, 06, 08 Grades 6, 8, 10, 12 Community Random Mailing TBD TBD X X X X Attitudes JCHHS Sponsor Survey Data Tool DSHS clients Annual e o X X X X X &services Intercensal WA-OFM e 0 X X X X X Population Annual Estimates Vital Records Annual e 0 X X X X X Communicable Annual e X X X X X • Disease Program Evaluation Family + p X X X X X Planning MCH ✓ © X X X X X Tobacco ✓ O X X X X X Prevention *KEY:JCHHS Analysis Capacity-Assessment of current infrastructure Infrastructure includes funding to pay for training of staff,dedicated staff time to conduct analysis and dedicated resources(web page, Information technology, printing)available to respond to community requests for information. + High capacity-agency has infrastructure to analyze data set on regular basis ✓ Developing capacity-agency is developing infrastructure to analyze data set on regular basis e Limited capacity-staff limited capacity to analyze data set on regular basis Q Available on JCPH website(http://www_jeffersoncountypublichealth.org) GD, Information that could be posted on JCPH website in html,word,or pdf format • • DSHS Human Services in Your County, July 2002 -June 2003 Jefferson IMIIIIIIIIIIIELEMIIMIIMIIIIIIII ALL AGES DOLLARS Number Served Use Rate Total Spent - Per Client DSHS Agency Total 6,440 24.1% 21,980,5183,413 P. lation 26 700 A.ing and Adult Services Total 240 0.9% 3,174,479 A•u t ami y omes 13,227 Adult Residential Care i 2 0.0% 21,3623 0.0% 7,121 Assisted Living ° 9,219 4,609 18 0.1/° 141,868 7,882 In-Home Services i 159 0.6% 1,673,284 Nursing Homes 14,277 73 0.3% 1,127,854 66,964 Additional Services(AAS Misc)a Alcohol and Substance Abuse Total 3 0.0% 36, 6 62 ADATSA Assessments; 244 "0.9%.4 336,326 1,3620 104 0.4% 21,148 203 Detoxification I 10 0.0% 7,677 Opiate Substitution Treatment; 768 1 2,379 2,379 Outpatient Assessment? 80 0.3% 15,977 Outpatient Treatment: 200 Residential Treatment 172 0.3% 132,823 1,009 72 0.3% 132,823 1,256 Additional Services(DASA Misc) Children's Services Total 43 09°f 1,285,31910 256 A.option Services I 7812 042 1,6461 Behavioral Rehabilitation Services-Emergent 121 0.5%- 280,342 2,317 Behavioral Rehabilitation Services Ongoing i 1 ° 2,295 2,295 Child Care Services; 6 0.0 h 164,092 27,349 Child Protective Services Case Management 28 1.8% 45,719 1,633 Child Welfare Services Case Management 3 475 0.5 k 100,468 212 142 0.5% 210,372 1,481 Crisis Care Family Reconciliation Service 3 128 0.5% 33,707 Family-Focused Services 263 ° 39,663 1,167 Foster Care Placement 34 0.1 h 48 0.2% 266,639 5,555 Foster Care Support iz 42 0.2% 125,534 Other Intensive Services i 3 0.0% 2,989 Additional Services(CA Misc) 2,660 1,582 Developmental Disabilities Services Total8 .5%0.0% 125 60 1,582 ,383 Case Management t 140 0 1,593,556 11,386 Community Residential Services 135 0.5% 104,818 776 26 0.1% 676,299 26,012 County Services i 46 0.2% Family Support Service i 159,015 3,457 24 0.1% 40,819 1,701 Personal Care i 44 0.2% 385,222 8,755 IIIProfessional Support Services? 23 0.1% 4,400 RHCs and Nursing Facilities 191 Voluntary Placement-Children' 1 5,364- 5,364 4 0.0% 217,619 67,706 Additional Services(DOS Misc) - Economic Services Total 2,972; 11.1% 3,821,667 1,286- Basic Foo. Program! 2,601 9.7% 1,604,005 Consolidated Emergency Assistance 3 - 617 - - Diversion Cash Assistance; 32 0.1% 13,959 General Assistance(GA-ABD, GA-I,GA-U,and GA-X)i 181 0.7% 855 Refugee Grants i 335,- - 667 1,855 Supplemental Security Income-State(SSI)i 50 0.2% TANF and State Family Assistance i 18,302 020 824 3.1% 840,825 1,020 Work First i 378 1.4% 121,700 322 Working Connections Child Care I610 2.3% Additional Services(ESA Misc) 858,415 1,407 Juvenile Rehabilitation Total 182 .10.7% 2 200,3811 158 Community P acement i 16 ©'10/a 12,524 Institutions,Youth Camps, and Basic Training f 2 0.0% 11,964 5,982 8 0.0% 154,700 19,337 Parole i 9 0.0% 26,867 2,985 Additional Services(JRA Misc) 5 0.0% 6,850 1 370 Medical Assistance Total 5,315 19.9% 9,628,733 1,312 'enta ervices i 1,313 4.9% 467,203 356 Hospital Inpatient I 419 1.6% 2,552,522 6,092 Hospital Outpatient i 1,637 6.1% 1,248,261 763 Managed Health Care i 656 2.5% 690,834 1,053 Medically Eligible Clients(T19)i 5,059 19.0% - Medically Eligible Clients(not T19)' 354 1.3% Other Medical Services 1 1,880 7.0% 1,082,030 576 Physician Services i 2,579 9.7% 1,048,737 407 Prescription Drugs 2,513 9.4% 2,539,146 1,010 Mental Health Services Total 531 2.0% 1,680,616 3,165 Chi •Stu.y an. reatment Center; Community Inpatient Evaluation and Treatment' 50 0.2% Community Services i 522 2.0% 70,984 1,420 State Hospitals(State Institutions)' 9 0.0% 1,384,187 2,348 Vocational.Rehabilitation-Total 186 0.7% 259;,185742 384440 x,,687 395 1 472 152 In.ependent Living Case Management1;392 Medical and Psychological Services • 16 • 0.1% 19,583 1,152 Personal Support Services i 46 0.2% 12,357 269 Placement Support(Work Support)i 27 0.1% 23,138 857 Training, Education, and Supplies i 28 0.1% 33,073 1,181 Vocational Assessments(Job Skills): 90 0.3% 52,230 580 Vocational Rehabilitation Case Management 184 0.7% 118,587 644 Clients and dollars come from the DSHS,Research and Data Analysis,Client Services Database:analytical extract of 01/24/2005.Population is from the Office of Financial Management,2003 projection by county. January 2005. • DSHS Human Services in Your County, July 2002 - June 2003 ' I' 92rices u YOUTH _ -` Jefferson CLIENTS DOLLARS Number Served Use Rate Total Spent Per Client • DSHS A.ency Total 54.9% 5,799,799 2,107 Population 5,011 A.in• and Adutt Services Total 2 0.0% 1,1.94 592 A•ult Fami y Homes - - - - Adult Residential Care - - - - Assisted Living - - - - In-Home Services 2 0.0% 1,184 592 Nursing Homes - - - - Additional Services(AAS Misc) - - - - Alcoholand Substance Abuse TOtal 50 1.0% - 79,626.: 1,593. A I ATSA Assessments I 1 0.0% 189 189 Detoxification - - - - Opiate Substitution Treatment•t - - - - Outpatient Assessment i 32 0.6% 6,773 212 Outpatient Treatment i 36 0.7% 39,654 1,102 Residential Treatment a 5 0.1% 24,479 4,896 Additional Services(DASA Misc) 3 0.1% 8,531 2,844 Children's Services Total 351 = 7.0%. 1,162,799 -3,323. - A.option Services i 62 1.2°k 278,382 4,490 Behavioral Rehabilitation Services-Emergent i 1 0.0% 2,295 2,295 Behavioral Rehabilitation Services-Ongoing 1 6 0.1% 164,092 27,349 Child Care Services 28 0.6% 45,719 1,633 Child Protective Services Case Management i 198 4.0% 43,908 222 Child Welfare Services Case Management i 81 1.6% 177,470 2,191 Crisis Care I - - - - Family Reconciliation Service 49 1.0% 17,817 364 Family-Focused Services S 23 0.5% 36,625 1,592 Foster Care Placement i 46 0.9% 258,282 5,615 Foster Care Support i 38 0.8% 123,162 3,241 Other Intensive Services 3 0.1% 3,827 1,276 Additional Services(CA Misc) 7 0.1% 11,222 1,603 Deveib•mental Disabilities Services Total 51 . 1.0% 201,022 3,942 Case Management 49 1.0% 36,052 736 Community Residential Services - - - - County Services R 7 0.1% 12,856 1,837 Family Support Service I 14 0.3% 25,357 1,811 Personal Care i 11 0.2% 74,499 6,773 1111 Professional Support Services 1 - - - - - RHCs and Nursing Facilities Voluntary Placement-Children 2 0.0% 52,257 26,129 Additional Services(DDS Misc) - - - - Economic Services Total 1,124 22.4% - 1,552,116 1,408 Basic Food Program! 931 18.6% 517,712 556 Consolidated Emergency Assistance; - - - - Diversion Cash Assistance S 19 0.4% 7,787 410 General Assistance(GA-ABD, GA-I,GA-U, and GA-X) - - - - Refugee Grants; - - - - Supplemental Security Income-State(55I); 1 0.0% 16 16 TANF and State Family Assistance I 493 9.8% 549,897 1,115 Work First! 9 0.2% 3,720 413 Working Connections Child Care; 374 7.5% 502,953 1,345 Additional Services(ESA Misc)i 1 0.0% 31 31 Juvenile Rehabilitation Total 9 0.21vo 126,683 14,076 Community P acement - - - - Institutions,Youth Camps,and Basic Training 6 0.1% 118,528 19,755 Parole, 3 0.1% 3,025 1,008 Additional Services(JRA Misc) 4 0.1% 5,131 1,283 Medical Assistance Total 2,604 r 52.0% 2,255,979 866 Dental Services I 950 19.0% 288,890 304 Hospital Inpatient! 45 0.9% 242,481 5,388 Hospital Outpatient I 714 14.3% 303,491 425 Managed Health Care E 541 10.8% 466,505 862 Medically Eligible Clients(T19)i 2,565 51.2% - - Medically Eligible Clients(not T19)i 69 1.4% - - Other Medical Services 818 16.3% 432,183 528 Physician Services 1,307 26.1% 293,544 225 Prescription Drugs 1,148 22.9% 228,885 199 Mental Health Services Total 125 >2.5% 390,064 3,121 Child Study an• Treatment Center E - - - - Community Inpatient Evaluation and Treatment, 6 0.1% 7,478 1,246 Community Services i 125 2.5% 382,586 3,061 State Hospitals(State Institutions)t - - - - Vocational:'Rehabilitation.Total 1 0.0°i° 326 326 Independent Living Case Management; - - - - Medical and Psychological Services i - - - - Personal Support Services - - - Placement Support(Work Support) - Training, Education, and Supplies Vocational Assessments(Job Skills), - - - - Vocational Rehabilitation Case Management S 1 0.0% 326 326 Clients and dollars come from the DSHS,Research and Data Analysis,Client Services Database:analytical extract of 01/24/2005.Population is from the Office of Financial Management,2003 projection by county. January 2005. • 4v u 9 zrA P azxiaaz`A9vaic� DSHS Human Services in Your County, July 2002 -June 2003 JeffersonADULTS CLIENFS DOLLARS Number Served Use Rate Total Spent DSHS A.ency Total p Per Client 3,213 19.8% 4,027 12,939,382 • ••• !anon 16 202 A.in. and and Adult Services Total 66 0.4% 866 233 13,125 A•u!t Fami y Homes E Adult Residential Care I 2 Assisted Living 3 0.0%0.0% 9,754 4,6091 In-Home Services; 0.4% 29,754 9 918 56 Nursing Homes? 549,026 9,804 Additional Services(MS Misc)' 10 0.1% 77 583 7 758 Alcohol and Substance Abuse Total 2 0.0%.2% 200700 100,325 'i' ' 'ssessments i93 7 10.6% 256,ZOO 1;303 Detoxification 103 0.6% 20,960 203 Opiate Substitution Treatment fff 10 0.1% 7,677 768 Outpatient Assessment 8 0.0% 2 205 2 392 Outpatient Treatment 48 0.3% 9 678 192 7% Residential Treatment 108 D.60 0.3% 105,678 979 _ Additional Services(DASA Misc) 0.3% 108,344 1,617 40 61 Children's Services Total97,290 310 i•99%% 314 Adoption Services i 1 Behavioral Rehabilitation Services-Emergent 50 0.3% 1,542 31 Behavioral Rehabilitation Services-Ongoing I -- - - - Child Care Services i - - - - Child Protective Services Case Management' Child Welfare Services Case Management 192 1.2% 30,239 582 Crisis Care 52 0.3% 30,239 582 - - Family Reconciliation Service; 53 0.3% - Family-Focused Services I 13,014 218 Foster Care Placement# 12 0.1% 8,354 301 Foster Care SupportI 2 0.0% 8,357 4 179 Services I1 4 0.0% 2,372 Other Intensive Services _ 593 Additional Services(CA Misc) - - - Develo.mental Disabilities Services Total 1 0.0% 1880 1,438 Case Management tt 82 0.5% 1,31 8 15,422 Community Residential Services 1 82 0.5% 66,048 805 County Services 1 24 0.2% 639,931 26,664 Family Support Service E 36 0.2% 130,822 Personal Care 10 0.1% 13,950 3,634 1,546 Professional Support Services 31 0.1�0 283,950184 • 9,160 21 0.0 RHCs and Nursing Facilities % 3,941 Voluntary Placement-Children 2 0 .00 5,364 5,364 Additional Services(DDS Misc) /° 165,362 82,681 - - Economic Services Total'' - - Basic oo• Program[ 1,759 10.9% 21,035, 17 1,240 Consolidated Emergency Assistance; 1,583 9.8% 1,035,971 654 Diversion Cash Assistance i 13 - General Assistance(GA-ASD, GA-I, GA-U,and GA-X) 0.1% 6,172 854 Refugee Grants j 178 1.1% 329,964 1,854 Supplemental Security Income State(SSI) - - 40 0.3% 90,46 TANF and State Family Assistance t365 Work First I 330 2.0% 290,4611 880 Working Connections Child Care ' 369 2.3% 117,981 320 Additional Services(ESA Misc) 2361 1.1% 28,762 159 1.5% 355,462 1,506 181 Juvenile Rehabilitation Total Community P acement 7 0.0% 73,698 10,528 Institutions,Youth Camps, and Basic Training 2 0.0% 11,964 5,982 Parole 2 0.0% 36,172 18,086 Additional Services(JRA Misc)le 6 0.0% 23,843 3,974 19 Medical Assistance Total, 1 0.0% 1,719 ,1 72 Dental Services; 2,390 14.8% 6,624,878. - -2,772- Hospital Inpatient t! 341 2.1 164,880 498 Hospital Outpatient# 5.01%% 2,898,956 6,608 Managed Health Carel 115 0.7% 224,329 1,951 810 5.0% 898,956 1,1101 Medically Eligible Clients(T19)I 2,173 Medically Eligible Clients(not T19)1 1 1.8% - Other Medical Services i 897 5.5% 7.2% 550,355 638 Physician Services E 1,158 7.2% 738,345 577 Prescription Drugs€ 1,138 7.0% 1,794 594 1,577 _ Child Study and Treatment Center Community Inpatient Evaluation and Treatment Community Services% 365 0.3%39 0.3%2% 57,837 1,483 State Hospitals(State Institutions)1 384,189 2,279 Vocational Rehabilitation Total 9 0.1% 384,185 42,687 In.epen•ent Living Case Management 184 1. 255,105 1,386 Medical and Psychological Services 1 0.0%1472 472 • Personal Support0.1% 19,173 1,198 6 Services 46 0.3% 12,357 Placement Support(Work Support)I 26 269 Training, Education, and Supplies# 27 0.2% 22 658 871 Vocational Assessments(Job Skills) 89 0.2% 51,151 1,186 Vocational Rehabilitation Case Management 182 .1% 17,28 575 1.1% 117,284 644 Clients and dollars come from the DSHS,Research and Data Analysis,Client Services Database:analytical extract of 01/24/2005.Population is from the Office of Financial Management,2003 projection by county. January 2005. 4 I IDSHS Human Services in Your County, July 2002 -June 2003 a 3 ,lcivvires Jefferson ELDERS DOLLARS Number Served Total Spent Per Client 40 DSHS A.enc Total 355 6.5% Po. lation 5,487 3,216,779 9,036 A.in.and Adult Services Total 172 3.1% Adult Family Homes i 3 0.1% 2,30 62 13 71 Adult Residential Care 21,362 7,121 Adult Assisted Living i 15 0.3% In-Home Services? 123,074 ,120 101 1.8% 1,123,073 111,120 Nursing Homes; 69 1.3% Additional Services(AAS Misc)' 1,050,271 15,221 Alcohol and:Substance:;Abuse:Total - - - 1 0.0% 242 242 ADATSA ssessments, Detoxification: - - Opiate Substitution Treatment - Outpatient Assessment - -- Outpatient Treatment, - - - Residential Treatment - Additional Services(DASA Misc) - - Children's Services Total Adoption Services 1 O.0% 672 672 Behavioral Rehabilitation Services-Emergent; _ - - Behavioral Rehabilitation Services-Ongoing i - - - Child Care Services l _ _ - Child Protective Services Case Management; - Child Welfare Services Case Management; 1 0.0% 248 248 Crisis Care Family Reconciliation Services 1 0.0% Family-Focused Services; - 424 424 Foster Care Placement# - Foster Care Support# - - - Other Intensive Services s' - - Additional Services(CA Misc)I - - - - Develo.mental Disabilities Services Total Case Management I 4 1% 81,655 20,414 • Community Residential Services 2 2 0.1% 2,718 679 County Services; 0.0% 36,368 18,184 3 0 Family Support Service0.1% 15,337 5,112 Personal Care 2 0.0°k • Professional Support Services 26,772 13,386 RHCs and Nursing Facilities f0.0% 459 230 Voluntary Placement-Children 2 - - - Additional Services(DDS Misc)j - - - - - Economic Services Total - Basic ood Program 87 1 % 58,734 660 Consolidated Emergency Assistance - 87 1.6% 50,322 578 Diversion Cash Assistance 3 - - - - - General Assistance(GA-ABD, GA-I,GA-U, and GA-X)f 3 Refugee Grants 0.1% 5,703 1,901 - - - Supplemental Security Income-State(SSI), 5 0.0% 2,241 467 TANF and State Family Assistance; Work Firsts - - 1 0'0% 467 467 Working Gonrections Child Cares _ - - - Additional Services(ESA Misc)( - Juvenile Rehabilitation Total immunity P acement I - Institutions,Youth Camps, and Basic Training f - - - - Parole E - _ - - Additional Services ORA Misc)s - - Medical Assistance Total 321 S.90/o - - Dental Services! 32 347,8 2,330 Hospital Inpatient{ 33 0.6% 13,433 420 Hospital Outpatient i 113 0 1% 56,622 1,716 2.1% 45,814 405 Managed Health Care; Medically Eligible Clients(T19) - - _ 321 5.g% Medically Eligible Clients(not T19)1 - - - - - Other Medical Services! 165 3.0% Physician Services 99,492 603 Prescription Drugs 114 2.1% 16,848 148 ,272 Mental Health Services Total 227 .6%4.1% 515,66716,771 2479 Chi . Study and Treatment Center> - - - 35 O.fia/o r- 474 Community Inpatient Evaluation and Treatment Community Services f' 5 0.1% 5,669 1,134 32 0.6% 11,102 347 State Hospitals(State Institutions)# Vocational Rehabilitation Total - - Independent Living Case Management f 1 IIj0% 4,009 4,009 - - - - Medical and Psychological Services s 1 0.0% • Personal Support Services _ 410 410 Placement Support(Work Support)s - - Training, Education, and Supplies 1 1 0.0% 480 480 Vocational Assessments(Job Skills) 1 0.0% 1,063 1,063 1 0.0% 1,079 1,977 Vocational Rehabilitation Case Management f 1 0.0% 977 977 Clients and dollars come from the DSHS,Research and Data Analysis,Client Services Database:analytical extract of 01/24/2005.Population is from the Office of Financial Management,2003 projection by county. January 2005. 4 • N 00 N O 0,Vl-- O N O ^ Ch -- b M M Cr,.. 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Ch 00 00 h N M Cl O V) ,, C � _ V) w Cm m Q U 76 h O V vCh CD Vl l CD C tCh rn hy' ' Ol Ch 00 N CD 411 0 00 Ch 0 411 O CA 'R OCD wl 00 VD wl Vl O E • C O V l0 VI CO Ch N V1 ^ MO V.n V N l0 V'1 N.. O r F• .-. -- -. --. Cl Cl Cl Cl -- ^ -, 1p .-. V m N m C R .0 U m m •. 04 et Of V) C) rn v rn v Of r- w CO + a h •-•,„ O e- r- N N r) C4 4 ei et C4 O Of h CA CO �" = z Q 6000000umolnoi 6100002 ft;6 0 • .- a- N N r» v v u) II tf) I t- CO - .- O m cm o • C Z M Era SPECIAL COMMUNICATION • Actual Causes of Death in the United States, 2000 Mi H.Mokdad,PhD Context Modifiable behavioral risk factors are leading causes of mortality in the United James S.Marks,MD,MPH States.Quantifying these will provide insight into the effects of recent trends and the implications of missed prevention opportunities. Donna F.Stroup,PhD,MSc Julie L.Gerberding,MD,MPH Objectives To identify and quantify the leading causes of mortality in the United States. N A SEMINAL 1993 ARTICLE, Design Comprehensive MEDLINE search of Englishlanguage articles that identified McGinnis and Foege'described the epidemiological,clinical,and laboratory studies linking risk behaviors and mortality. major external(nongenetic)modi- The search was initially restricted to articles published during or after 1990, but we fiable factors that contributed to later included relevant articles published in 1980 to December 31,2002.Prevalence death in United and and relative risk were identified during the literature search.We used 2000 mortality death the thetUnal tocaStates otend labeled Dur- data reported to the Centers for Disease Control and Prevention to identify the causes and number of deaths.The estimates of cause of death were computed by multiply- ing the 1990s,substantial lifestyle pat- ing estimates of the cause-attributable fraction of preventable deaths with the total tern changes may have led to variations mortality data. in actual causes of death.Mortality rates Main Outcome Measures Actual causes of death. from heart disease,stroke, and cancer have declined. At the same time,behav Results The leading causes of death in 2000 were tobacco(435000 deaths;18.1% • ioral changes have led to an increased of total US deaths), poor diet and physical inactivity(400000 deaths; 16.6%), and prevalence of obesity and diabetes.3 alcohol consumption(85000 deaths;3.5%).Other actual causes of death were mi- crobial agents (75000), toxic agents(55000), motor vehicle crashes (43000), inci- Most diseases and injuries have mul- dents involving firearms(29000), sexual behaviors(20000), and illicit use of drugs tiple potential causes and several fac- (17000). ton and conditions may contribute to Conclusions These analyses show that smoking remains the leading cause of mor- a single death. Therefore,it is a chal- tality.However,poor diet and physical inactivity may soon overtake tobacco as the lenge to estimate the contribution of leading cause of death.These findings, along with escalating health care costs and each factor to mortality. In this ar- aging population,argue persuasively that the need to establish a more preventive ori- tide,we used published causes of death entation in the US health care and public health systems has become more urgent. reported to the Centers for Disease Con- JAMA 2004;299:1238-1245 www.jama.com trol and Prevention (CDC) for 2000, titles including the following key deaths, we used mortality data re- relative risks(RRs),and prevalence es- timates from published literature and words:mortality,smoking,physical ac- ported in 2000 to the CDC.'We used tivity,diet, obesity, alcohol, microbial no unpublished information or data. governmental reports to update actual causes of death in the United States—a agents,toxic agents,motor vehicle,fire- We used the following formula to cal- method similar to that used by arms, sexual behavior, illicit drug use. culate attributable fractions for each dis- McGinnis and Foege. Our search allowed for words with simi- ease: [(Po+ P; (RR,))-1]/[P0+ Pi lar meaning to be included (ie, exer- (RRi)),in which Po is the percentage of METHODS cise as well as physical activity). The individuals in the United States not en- Our literature review used a MEDLINE search was initially restricted to ar- gaging in the risk behavior,Pi is the per- database search of English-language ar- tides published during or after 1990, tides that identified epidemiological, but we later included relevant articles Author Affiliations: Division of Adult and Commu- clinical, and laboratorystudies link- published in 1980 to December31, nity Health(Dr Mokdad),office of the Director(Drs Marks and Stroup),National Center for Chronic Dis- ing risk behaviors and mortality. Our 2002 (search strategies are available ease Prevention and Health Promon and Office of search criteria were to include all ar- from the authors on request).For each the Director(DrGerberding),Centersfor otiDisease Con- trol and Prevention,Atlanta,Ga. risk factor,we used the prevalence and Corresponding Author.All H.Mokdad,PhD,Divi- RR identified by the literature search. Health.sion of Adult and Community 4770 Buford For editorial comment seep 1263. Hwy, NE, Mailstop K66, Atlanta, GA 30341 To identify the causes and number of (amokdad®cdc.gov). 01238 JAMA,March 10,2004—Vol 291,No.10(Reprinted) (02004 American Medical Association.All rights reserved. CAUSES OF DEATH 11111 centage engaging in separate catego- Table 1.Leading Causes of Death in the United States in 2000* ries of the risk behavior, and RR; is Death Rate per the RR of death for each separate cat- Cause of Death No.of Deaths 100000 Population egory relative to none.For instance,in Heart disease 710 760 258.2 the case of smoking,Po is the percent- Malignant neoplasm 553091 200.9 age of persons who never smoked, P1 Cerebrovascular disease 167661 60.9 is the percentage of former smokers, Chronic lower respiratory tract disease 122 009 44.3 P2 is the percentage of current smok- Unintentional injuries 97900 35.6 ers, RRl is the RR of a certain type of Diabetes mellitus 69301 25.2 death for former smokers compared Influenza and pneumonia 65313 23.7 with those who never smoked, and Alzheimer disease 49558 18 RR2 is the RR of death for current Nephritis,nephrotic syndrome,and nephrosis 37 251 13.5 smokers compared with those who Septicemia 31224 11.3 never smoked. We then multiplied Other 499283 181.4 estimates of the cause-attributable Total 2 403 351 873.1 fraction of preventable deaths by 'Data are from Mininoetal! total mortality data. Whenever pos- sible,we used RRs of death and mor- Prevention Study II'and included deaths weight.9 Recent articles have reported tality data by other variables such as due to secondhand smoking. that overweight increased in all seg- age,sex, and race. We used data from the Behavioral Risk ments of the US population.le.11 To de- We estimated ranges for our esti- Factor Surveillance System(BRFSS),a rive the attributable number of deaths mated number of deaths by using the cross-sectional telephone survey con- due to overweight,we used estimates smallest and highest RRs and their ducted by state health departments with from the CDC's 1999 and 2000 Na- boundaries when available.When data the CDC's assistance, to determine tional Health and Nutrition Examina- were available,we used specific under- changes in US smoking prevalence from tion Surveys.12 We used the same pro- lying causes of death in deriving some 1995-1999 to 2000.A detailed descrip- cedure reported by Allison et a113 to of our estimates(ie,firearms,motor ve- tion of survey methods is available else- estimate annual overweight-attribut- • hides,and illicit drug use).Further de- where.8 A slight decline in smoking was able deaths.We used the body mass in- tails of these methods may vary due to observed from 1995-1999 to 2000.The dex(BMI)range of 23 to 25 as our ref- availability of data and are presented in prevalence of smoking in 1995-1999 was erence category to match the method each section below.We used SAS(ver- 22.8% for current smokers (males: used by Allison et al.Body mass index sion 8.2,SAS Institute Inc, Cary,NC) 25.1%;females:20.6%),24.1%for former is calcullated as weight in kilograms di- and SUDAAN (version 8.0, Research smokers(males:28.3%;females:203%), vided by the square of the height in me- Triangle Institute, Research Triangle and 53.1% for never-smokers (males: ters.Using data from the 1999 and 2000 Park,NC)statistical software. 46.5%;females:59.2%).In 2000,these National Health and Nutrition Exami- estimates were 22.2%for current smok- nation Surveys,the percentages for BMI RESULTS ers (males: 24.1%; females: 20.5%), cut points were less than 23(22.3%),23 The number of deaths in the United 24.4%for former smokers(males:283%; to less than 25(15.09%),25 to less than • States in 2000 was 2.4 million,which females: 20.7%),and 53.4%for never- 26(7.49%),26 to less than 27(7.36%), is an increase of more than 250000 smokers(males:47.6%;females:58.8%). 27 to less than 28 (6.23%), 28 to less deaths in comparison with the 1990 We estimate that approximately than 29 (6.30%), 29 to less than 30 total,due largely to population growth 435 000 deaths were attributable to (5.94%),30 to 35(16.95%),and more and increasing age.44 Leading causes smoking in 2000,which is an increase than 35(12.62%). of death were diseases of the heart of 35 000 deaths from 1990(TABLE 2). We used hazard ratios reported pre- (710760), malignant neoplasms This increase is due to the inclusion of viously"to recompute annual deaths (553 091), and cerebrovascular dis- 35000 deaths due to secondhand smok- for 6 major population-based studies. eases(167661) (TABLE 1). ing and 1000 infant deaths due to ma- The mean estimate of the total num- ternal smoking,which were not in- ber of overweight-attributable deaths in Tobacco eluded in the article by McGinnis and 2000 was 494921. For the Alameda We used methods and software used in Foege.' County Health Study, the estimated previous CDC reports to compute the number of overweight-attributable annual smoking-attributable mortality Poor Diet and Physical Inactivity deaths in 2000 was 567683;Framing- for 2000.i8 As in previous reports,we To assess the impact of poor diet and ham Heart Study,543981;Tecumseh used RRs for each cause of death from physical inactivity on mortality,we corn- Community Health Study, 462,005; the American Cancer Society's Cancer puted annual deaths due to over- American Cancer Society Cancer Pre- 02004 American Medical Association.All rights reserved. (Reprinted)JAMA,March 10,2004-Vol 291,No.10 1239 • • CAUSES OF DEATH • Table 2.Actual Causes of Death in the United States in 1990 and 2000 consumption.The National Health In- Actual Cause No.(%)in 1990* No.(%)in 2000 terview Survey,a household survey that measured alcohol intake in 1999 and Tobacco 400000(19) 435 000(18.1) Poor diet and physical inactivity 300000(14) 400 000(16.6) 2000,and the BRFSS,a telephone sur- Alcohol consumption 100000(5) 85000(3.5) vey that measured alcohol intake in Microbial agents 90 000(4) 75 000(3.1) 1999.826 We used RRs from the Australian Na- Toxic agents 60 000(3) 55 000(2.3) tional Drug and Safety Report that were Motor vehicle 25 000(1) 43 000(1.8) based on mortality rates derived from Firearms 35 000(2) 29 000(1.2) Sexual behavior 30 000(1) P0000(0.8) pooled data of several studies.272s The Illicit drug use 20000(<1) 17 000(0.7) RR values were 1.33 for hazardous drinking(4.01-6.00 drinks/d for males Total 1 060 000(50) 1159 000(48.2) *Data are from McGinnis and Foege.'The percentages are for all deaths. and 2.01-4.00 for females)and 1.47 for harmful drinking(?6.01 drinks/d for vention Study 1,451708;Nurses Health ber of deaths from the 1999-2000 data males and >_4.01 for females) in con- Study,504602;and the National Health may well be the expected number of trast to low levels of drinking (0.26- and Nutrition Examination Survey I deaths in the next few years.Thus,we 4.00 drinks/d for males and 0.26-2.00 Epidemiologic Follow-up Study, believe a more accurate and conserva- for females) and abstinence (0-0.25 439548."-19 tive estimate for overweight mortality in drinks/d for both males and females). As in the study by Allison et al, the 2000 such as 385 000, which is the We used BRFSS data to compute the estimate for the attributable number of rounded average of 2000 and 1991 es- number of alcohol-attributable deaths deaths for nonsmokers or never- timates(494921 and 280184). for the US population aged 18 years or smokers was higher than the estimate Overweight would account for the older. The BRFSS also asked ques- for the total because smoking is asso- major impact of poor diet and physi- tions about binge drinking (ie, _>5 ciated with both lower body weight and cal inactivity on mortality!'Diet may drinks per occasion).To account for the higher mortality. Also in 2000, the have a minor additional effect on mor- effect that respondents appeared not to mean estimate of the total number of tality mainly from lack of certain es- include binge drinking in their re- • overweight-attributable deaths among sential nutrients."'" Consumption of ported regular drinking,we reran our nonsmokers or never-smokers was fruits and vegetables increased in the analyses,adding 5 drinks per binge oc- 543 797. For the Alameda County 1990s,"and fat intake as a percentage casion to average drinks per day.The Health Study, the estimate of over- of calories declined.'Physical activ- total number of deaths attributable to weight-attributable deaths among non- ity has increased slightly'We esti- alcohol was 103350. smokers or never-smokers was 639026; mate that poor diet and physical Mac- We also used 3 other recent studies Framingham Heart Study,583913;Te- tivity will cause an additional 15000 to estimate alcohol-attributable mor- cumseh Community Health Study, deaths a year,although this too maybe tality. Two studies were based on the 457460;American Cancer Society Can- conservative. Nutritional deficiencies National Health Interview Survey"." cer Prevention Study 1,466729;Nurses alone(International Classification of Dis- and the National Alcohol Survey 3'Us- Health Study, 570855; and the Na- eases,10th Revision(ICD-10]codes E40- ing all-cause mortality and RRs from tional Health and Nutrition Examina- E64) were reported as the causes of these studies, we estimated approxi- tion Survey I Epidemiologic Fol- 4242 deaths in 2000. mately 60 000 deaths per year.This dif- low-up Study, 544 798. Our estimates We estimate that 400000 deaths were ference in number of deaths is mainly indicate an increase of 76.6%over the attributable to poor diet and physical due to the fact that BRFSS respon- 1991 estimate of overweight-attribut- inactivity,an increase of one third from dents report a higher percentage of able deaths,with more than 80%of ex- 300000 deaths estimated by McGinnis heavy drinking than do respondents in cess deaths occurring among individu- and Foege,' and the largest increase a household survey such as the Na- als with class 2 and 3 obesity. among all actual causes of death.How- tional Health Interview Survey. The prevalence of overweight used in ever,poor diet and physical inactivity In another approach,we aggregated this study is based on data from 1999- could account for even more deaths alcohol-related deaths from specified 2000.Because the effects of overweight (>500000)when the 1999-2000 Preva- ICD codes that were summed to pro- on mortality may not appear until some lence estimates of overweight have their vide an overall estimate of deaths. In years after a person becomes over- full effect. 2000,18 539 deaths were reported as al- weight, it is likely that the increase in cohol-induced (ICD-10 codes F10, prevalence of overweight in the 1990s Alcohol Consumption G31.2,G62.1,I42.6,K29.2,1(70,R78.0, overestimates the current actual num- We used 2 large nationally representa- X45,X65).In addition, 16653 persons ber of deaths.However,the total num- tive surveys to determine US alcohol were killed in alcohol-related crashes.32 • 1240 JAMA,March 10.2004-Vol 291,No.10(Reprinted) 02004 American Medical Association.All rights reserved. CAUSES OF DEATH We estimate another 34797 deaths in 776.4 In general,mortality from infec- daily average of PM,°concentration in • 2000 using BRFSS alcohol consump- tions and parasitic diseases has de- 2000,45'which results in an estimate of tion data and disease-specific RRs from dined since 1990.33 Because pneumo- 24000 deaths per year(range, 22000- the Australian study for oropharyn- nia and septicemia occur at higher rates 52000 deaths)from air pollution alone. geal,esophageal,liver,laryngeal,and fe- among patients with cancer,heart dis- The National Institute for Occupa- male breast cancers;stroke; hyperten- ease,lung disease,or liver disease,some tional Safety and Health(NIOSH) esti- sive heart disease;and other chronic liver of these deaths really are attributable mates that about 113000 deaths are due disease and cirrhosis (ICD-10 code to smoking,poor diet,and alcohol con- to occupational exposure from 1968 to K73-74).This totals to 69989 deaths in sumption.39-43 We estimate that ap- 1996.53 The number of deaths caused by 2000 from these factors alone. In the proximately 75000 deaths were attrib- occupational exposure has declined dur- Australian study,all-cause mortalitywas utable to microbial agents in 2000 from ing that period. In 1996, NIOSH esti- also higher than the summation of cause- all ICD-10 codes for infectious and para- mated 3119 deaths from pneumoconio- specific mortality. sitic mortality.The major cause of the sis and 1176 from asbestosis.Although, Total alcohol-attributable deaths decline was a decrease in deaths from particulate air pollution accounts for the would reach about 140000 if mortal- influenza and pneumonia probably re- majority(about 60%) of mortality re- ity among previous alcohol drinkers fleeting at least in part an increase in lated to toxic agents,54 indoor air pollu- were included.It is unclear whether ex- immunization in older adults against tion,environmental tobacco smoke,ra- cess mortality among former alcohol vaccine-preventable diseases.This con- don, lead in drinking water,and food drinkers is due to damage or illness trasts with 90000 deaths attributed to contamination are associated with in- from past alcohol consumption. microbial agents in 1990 estimates. creased mortality.sss6 We estimate that Taking these various numbers into ac- toxic agents(excluding environmental count,our best estimate for total alcohol- Toxic Agents tobacco exposure)were associated with attributable deaths in 2000 is approxi- Estimating the number of deaths due to 2%to 3.5%of total mortality in 2000.We mately 85 000,based on the conservative toxic agents is more challenging than any estimate approximately 55 000 deaths at- estimate from cause-specific deaths and of the other risk factors due to limited tributable to toxic agents in 2000.This the high estimate using all-cause mor- published research and the challenges estimate is our least certain of the vari- tality. This is a reduction of 15000 of measuring exposure and outcome.In ous causes. • deaths from the 1990 estimates. the 1990s, many improvements were made in controlling and monitoring pol- Motor Vehicles Microbial Agents lutants.44 There is more systematic moni- Motor-vehicle crashes involving pas- We excluded human immunodefi- toring of pollutants at state and county sengers and pedestrians resulted in ciency virus(HIV) from this category levels, and exposure to asbestos,ben- 43354 deaths in 2000.4 This decline and included it with sexual behaviors zene,and lead have declined.44 In fact, from 47000 deaths in 1990 represents to be consistent with the analysis by the US Environmental Protection successfulpublichealtheffortsinmotor- McGinnis and Foege.' In the past, in- Agency reported a decline of 25%from vehicle safety.5''58 Deaths from alcohol- fectious agents were the leading cause 1970 to 2001 in 6 principal air pollut- related crashes declined from 22084 in of mortality.33 These agents still pre- ants:carbon monoxide,lead,ozone,ni- 1990 to 16653 in 2000.32 Major con- sent a major threat to the nation's health trogen dioxide,sulfur dioxide,and par- tributin.g factors include the use of child and are associated with high mor- ticulate matter.45 safety seats and safety belts,59,6° de- bidity.34 Several improvements in the Toxic agents are associated with in- creases in alcohol-impaired driving,61 health system have led to a decline in creased mortality from cancer,respira- changes in vehicle and highway de- mortality from infectious diseases.The tory,and cardiovascular diseases.46-4°We sign,62°3 and national goals to reduce mo- increase in US immunization rates led used the National Morbidity, Mortal- tor-vehicle–related mortality and in- to a decline in mortality from many vac- ity,and Air Pollution Study to estimate juiy.64 We estimate that approximately cine-preventable diseases.3537 Several mortality due to air pollution.50 The 26500 deaths in 2000 were attribut- laws ensure this high immunization rate study assessed the association between able to motor-vehicle crashes in which for children by requiring vaccination for air pollution and mortality and morbid- alcohol was not a factor.This is an in- school and day-care enrollment's There ity in 90 cities in the United States.Only crease of 1500 from the 1990 report be- also have been substantial improve- particulate matter(PM)was associated cause both estimates were not adjusted ments in sanitation and hygiene,anti- with a significant increase in mortal- for the number of registered vehicles, biotics and other antimicrobial meth- ity—an approximate 0.5%increase in number of crashes,nor miles of travel. cines,and hospital-infection control.35 total mortality for each 10-p/m3 in- We included alcohol-related deaths to In 2000, influenza and pneumonia crease in PM,0. Previous studies re- stress that efforts to educate the public accounted for 65 313 deaths,septice- ported a range of 0.4%to 1%for that as- and enforce laws against driving while mia for 31224, and tuberculosis for sociation.5t.52 We used 23.8 p/m3 as the intoxicated have accounted for most of ©2004 American Medical Association.All rights reserved. (Reprinted)JAMA,March 10,2004—Vol 291,No. 10 1241 • • • CAUSES OF DEATH . the decline in deaths related to motor- HIV infection, pneumonia, violence, relatively minor changes from 1990 to vehicle crashes. mental illness,and hepatitis.2728,n•n An 2000 in the estimated number of deaths Firearms estimated 3 million individuals in the due to actual causes. Our findings in- United States have serious drug prob- dicate that interventions to prevent and Firearm-related incidents resulted in lems.78.79 Several studies have re- increase cessation of smoking, im- 28663 deaths among individuals in the ported an undercount of the number of prove diet,and increase physical activ- United States in 2000.4 This is a de- deaths attributed to drugs by vital sta- ity must become much higher priori- cline from approximately 36000 deaths tistics8°; however, improved medical ties in the public health and health care in 1990. The largest declines were in treatments have reduced mortality from systems. deaths from homicides and uninten- many diseases associated with illicit The most striking finding was the tional discharge of firearms. In 2000, drug use.In keeping with the report by substantial increase in the number of 16586 deaths were due to intentional McGinnis and Foege,' we included estimated deaths attributable to poor self-harm(suicide)by discharge of fire- deaths caused indirectly by illicit drug diet and physical inactivity. We esti- arms(ICD-10 codes X72-X74).Assault use in this category.We used attribut- mate that roughly 400000 deaths now (homicide) by discharge of firearms able fractions to compute the number occur annually due to poor diet and (ICD-1 0 codes X93-X95) resulted in of deaths due to illicit drug use.27 28,81 physical inactivity. The gap between 10801 deaths. Unintentional dis- Overall,we estimate that illicit drug use deaths due to poor diet and physical in- charge of firearms(ICD-10 codes W32- resulted in approximately 17000 deaths activity and those due to smoking has W34)resulted in 776 deaths,while dis- in 2000, a reduction of 3000 deaths narrowed substantially.Because rates charge of firearms,undetermined intent from the 1990 report. of overweight increased rapidly dur- (ICD-10 codes Y22-Y24),resulted in 230 deaths.The remaining 270 deaths were Other Factors ing the 1990s,we used a conservative approach to make our tes, ac- due to legal intervention(ICD-10 code Several other factors contribute to an counting for the delayed effects of over- Y35).These numbers were ascertained increased rate of death.There are fac- weight on mortality.In addition,over- from death certificate reports. tors that we do not know of such as un- weight lessens life expectancy.87.88 Sexual Behavior known pollutants or perhaps expo- However,it is clear that if the increas- sures that may cause a considerable ing of overweight is not re- Sexual behavior is associated with an in- number f deaths.Poverty and low edu- versed over the next few years,poor diet • creased risk of preventable disease and cation levels are associated with in- and physical inactivity will likely over- disability.65 An estimated 20 million per- creased mortality from many causes,82.83 take tobacco as the leading prevent- sons are newly infected with sexually partly due to differential exposure to the able cause of mortality. transmitted diseases each year in the risks described above. However, con- The most disappointing finding may United States.6"•67 Mortality from sexu- trolling for differential exposure to risk be the slow progress in reducing to- ally transmitted diseases is declining due factors is unlikely to explain the en- bacco-related mortality.A few states, to the availability of earlier and better tire impact on mortality. Lack of ac- notably California,have had major suc- treatment, especially for HIV.67,68 In cess to proper medical care or preven- cess in programs that led to reducing 2000,HIV disease(ICD-10 codes B20- five services is associated with increased deaths from heart disease and can- B24)resulted in 14578 deaths.In 1990, mortality.'Biological characteristics cer.89 However, efforts in most other HIV was the cause of 27695 deaths for and genetic factors also greatly affect states are too recent or short-term to persons older than 13 years,indicating risk of death.85 In most studies we re- have a similar effect.In response to the about a 48%decline in HIV mortality viewed, low education levels and in- increase in tobacco use among youth during the decade.Based on the sexual come were associated with increased in the early 1990s, state and national behavior–attributable fraction from the risk of cardiovascular disease,cancer, tobacco-control efforts increased their literature,69-71 we estimate that 20000 diabetes, and injury. The Healthy focus on prevention of initiation and deaths(range,18000-25000 deaths)in People 2010 initiative has made the recognized the importance of cessa- 2000 were due to sexual behavior— elimination of health disparities,espe- tion on reducing smoking-related mainly HIV; other contributors were cially racial and ethnic disparities,a pri- deaths. Thus, most national and state hepatitis B and C viruses and cervical mary goal.e6 efforts now address comprehensive pro- cancer. The decline of 10000 deaths from the 1990 estimates'was due to the COMMENT gram control strate efforgies.90 Current tobacco- ts decline in HIV mortality. We found that about half of all deaths sation componentslto showao needs a declineg that occurred in the United States in in tobacco deaths in a future assess- Illicit Use of Drugs 200 could be attributed to a limitedIllicit drug use is associated with sui- number of largely preventable b ha- tteel ph nee quitreports lines foron smokers are nf tide, homicide, motor-vehicle injury, iors and exposures.Overall,we found couraging,91 On the other hand,large 01242 JAMA,March 10,2004—Vol 291,No.10(Reprinted) ©2004 American Medical Association.All rights reserved. CAUSES OF DEATH state budget leading et shortfalls are to fers great potential for treating and ame- findings in this study argue persua- III large cuts in public health,with a cor- liorating risk.Identifying individuals at sively for the need to establish a more responding diversion of resources from higher risk for a disease through ge- preventive orientation in health care tobacco taxes and settlement dollars to netic testing may promote lifestyle and public health systems in the United cover deficits instead of tobacco- changes that can help prevent the on- States. control programs. set of that disease 93 Despite the call to action on these risk In this studywe also did not exam- Author Contributions: Dr Mokdad had full access to p the data in this study and takes full responsibility for factors a decade ago,there has been little Me the effects of high blood pressure the scientific integrity of the data and the accuracy of progress in reducing the total number and cholesterol or lipid profile on mor- Shescript. a"alysis and content of the concept and design:Mokdad, Stroup, of deaths from these causes. The tality, although some of the effects of Gerberding. progress that has occurred primarily in- these factors are meditated through Acquisition of data:Analysis andinterpre�so ofad,dataup, GerdrdMarks , volves actual causes of death that are poor diet and physical inactivity.These Stroup,Gerberding. less prominent.With the shift in the age risk factors are common among adults Drafting of the manuscript Mokdad,Marks.Stroup, rddistribution of the population, more in the United States.More than 30%of Ci tical $revision of the manuscript for important adults now are in the age group at high- US adults have high blood pressure or intellectual content: Mokdad, Marks, Stroup, est risk because of the cumulative ef- high cholesterol94,95 Monitoring and Staff rrdai/expertise:Mokdad,Stroup. fects of their behavior. The net effect controlling blood pressure and choles- Obtained funding:Marks,Gerberding. is that both total deaths and total terol is crucial to preventing prema- Administrative, technical, or material support: Mokdad,Marks,Stroup,Gerberding. burden due to the actual causes have ture mortality and morbidity. Study supervision:Marks,Gerberding. increased. One of the most difficult aspects of Funding/Support There was no external funding for iOur analyses have several limita- this analysis is that the attribution of Ackno work. Weadcnowledgethe valuable on- tions.Our study reported actual causes the actual cause that led to death var- tributions of Barbara A.Bowman,PhD,Robert D. eof mortality in the United States.How- ies depending on perspective.We used H weMD.Jaames M.Mend ei MPhD,CherylaPel- ever, these causes are also associated similar methods to those used by lerin.S anY.Chu,PhD,andEduardol.Simoes.MD, with a large morbidity burden.In ad- McGinnis and Foege' to allow COm- Role of the Sponsor The Centers for Disease Con- dition to premature death,years of lost parisons.We tried when possible to use trol and Prevention reviewed and approved this re- life,diminished productivity,and high RRs that are fully adjusted for other risk port before submission. rates of disability,decreased quality of factors in our analyses,but possibly not • life is also strongly associated with these eliminating duplicate attribution of REFERENCES actual causes. A recent World Health causes. We also explicitly included 1. 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Phillips DP,Christenfeld N, Ryan NM.An in- tality.N Engll Med.2002;347:1585-1592. 360:1347-1360. crease in the number of deaths in the United States 84. Franks P,Clancy CM,Gold MR. Health insur- 93. Bruke W.Genetic testing.N Engl J Med.2002; in the first week of the month-an association with ance and mortality:evidence from a national cohort. 347:1867-1875. substance abuse and other causes of death.N Engll JAMA.1993;270:737-741. 94. Ford ES,Mokdad AH,Giles WH,Mensah GA.Se- Med.1999;341:93-98. 85. Khoury MJ,Beaty TH,Cohen BH.Fundamentals rum total cholesterol concentrations and awareness, 76. Rivara FP,Mueller BA,Somes G,Mendoza CT, of Genetic Epidemiology.New York,NY:Oxford Uni- treatment,and control of hypercholesterolemia among Rushforth NB,Kellermann AL.Alcohol and illicit drug versity Press;1993. US adults:findings from the National Health and Nu- abuse and the riskof violentdeath in the home.JAMA 86. Department of Health and Human Services. trition Examination Survey 1999-2000.Circulation. 1997;278:569-575. Healthy People 2010:Understanding and Improving 2003;107:2185-2189. 77. Bruner AB,Fishman M.Adolescents and illicit drug Health.Washington,DC:Government Printing Of- 95. Najjar I,Kotchen TA.Trends in prevalence,aware- use.JAMA.1998:280:597-598- fice;2000. ness,treatment,and control of hypertension in the 78. Pope HG Jr,lonescu-Pioggia M,Pope KW.Drug 87. Fontaine KR,Redden DT,Wang C,Westfall AO, United States,1988-2000.JAMA. 2003;290:199- use and life style among college undergraduates:a 30- Allison DB.Years of life lost due to obesity.JAMA. 206. year longitudinal study.Am I Psychiatry.2001;158: 2003;289:187-193. 96. Strum R.The effects of obesity,smoking,and prob- 1519-1521. 88. Peeters A,Barendregt 11,Willekens F,et al,for lem drinking on chronic medical problems and health 79. Johnston LD,O'Malley PM, Bachman JG.Na- the Netherlands Epidemiology and Demography care costs.Health Aff(Millwood).2002;21:245- tional Survey Results on Drug Use From the Moni- Compression of Morbidity Research Group.Obesity 253. boring the Future study,1975-1999.Volume 1:Sec- in adulthood and its consequences for life expec- 97. Visscher TL,Seidel)IC.The public health impact ondary School Students.Ann Arbor: University of tancy:a life-table analysis.Ann Intern Med. 2003; of obesity.Annu Rev Public Health. 2001;22: Michigan:2000. 138:24-32. 355-375. • ©2004 American Medical Association.All rights reserved. (Reprinted)JAMA,March 10,2004-Vol 291,No.10 1245 • .Chronic Disease -Overview Page 1 of 6 I CDC Home 'Search Health Topics A-Z C National Center for Chronic Disease Prevention and Health Promotion /1-".1 Chronic Disease Prevention as,rR.•.CA Tnr`a pj°r LL"` Home I Contact Us • CHRONIC DISEASE d315Chronic Disease Overview PREVENTION • Chronic Disease Overview The profile of diseases contributing most heavily to death, illness, • cmc s Chronic and disability among Americans changed dramatically during the Disease Programs last century. Today, chronic diseases—such as cardiovascular • Tracking Conditions disease (primarily heart disease and stroke), cancer, and &Risk Behaviors diabetes—are among the most prevalent, costly, and preventable • Maior of all health problems. Seven of every 10 Americans who die each Accomplishments year, or more than 1.7 million people, die of a chronic disease. The • Scientific prolonged course of illness and disability from such chronic Observations diseases as diabetes and arthritis results in extended pain and • ExePrograms fomaJar�r State suffering and decreased quality of life for millions of Americans. g Chronic, disabling conditions cause major limitations in activity for • Sta.te_Profiles more than one of every 10 Americans, or 25 million people. • Publications •About CDCs Chronic Disease Center Causes of Death in the United States • Press Room • Grants and Most Common, 1999* Funding uses of the heart 1111.111.111.11111/11.111 • Postgraduate Opportunities AU career • Related Links Stroke IP Ohm*obstructive an pulmonarydiseese Uninlentit)ntal i ejinies 1111 Diabetes mellitus III influenza and pneu+nonia ri Alzheimer;s disease IN Nephritis sod neptrres* , 11111111111111111111 0 10 20 30 40 Mala of all deet e Actual, 1990 t 'rObeG use IIIIIMIMIIIIMIIIMI.■ Pm tit! IIIIIIIIIIIIMIIIIII lack#exnreise Alcohol use IntechOuS agents Polutantsitatins Ell . t'irearr s IIII Risky sexual Wavier, Mt vehicle crashes , IMO*ug use , III iiiee � � ieeiieiiieier 0 a'' 10 102p for s,nofi clop *All data are age adjusted to 2000 total U.S. population. http://www.cdc.gov/nccdphp/overview.htm 4/7/2005 Chronic Disease - Overview Page 2 of 6 t t McGinnis 3M, Foege WH. Actual causes of death in the United States.JAMA 1993; 270:2207-12. (Text descriptions of these charts are also available.) Leading Causes of Disability Among Persons Aged 15 Years or Older, United States, 1991-1992 Arthritisorthaumatlsm Bmk or slue rtiem Heart ltOttbte Lang tx rospory trouble _— High ha= Stiles or drmity of limb Dim attridness or otter visual impairment Deafnessizgal Stiolte 111111 0 6 10 t5 20 Percentage of al disabolties Source: CDC. Prevalence of disability and associated health conditions—United . States, 1991-1992. MMWR 1994;43(40): 730-1, 737-9 (A text description of this chart is also available.) Costs of Chronic Disease The United States cannot effectively address escalating health care costs without addressing the problem of chronic diseases: • More than 90 million Americans live with chronic illnesses. • Chronic diseases account for 70% of all deaths in the United States. • The medical care costs of people with chronic diseases account for more than 75% of the nation's $1.4 trillion medical care costs. • Chronic diseases account for one-third of the years of potential life lost before age 65. • Hospitalizations for pregnancy-related complications occurring before delivery account for more than $1 billion annually. • The direct and indirect costs of diabetes are nearly $132 billion a year. • Each year, arthritis results in estimated medical care costs of more than $22 billion, and estimated total costs (medical • care and lost productivity) of almost $82 billion. • The estimated direct and indirect costs associated with smoking exceed $75 billion annually. • In 2001, approximately $300 billion was spent on all cardiovascular diseases. Over $129 in lost productivity was http://www.cdc.gov/nccdphp/overview.htm 4/7/2005 t.hronic Disease - Overview r Page 3 of 6 due to cardiovascular disease. • The direct medical costs associated with physical inactivity was nearly $76.6 billion in 2000. • Nearly $68 billion is spent on dental services each year. • Estimated Per Capita Health Expenditures, by Age and Sex, 1995 s 8,000 16'000 lien 14,000 Women e 12,000 10,too 0 8,000 8,000 4,000 2,000 am0 Age in Years Source: From Baby Boom to Elder Boom: Providing Health Care for an Aging Population. Copyright 1996, Watson Wyatt Worldwide. Cost-Effectiveness of Prevention • • For every $1 spent on water fluoridation, $38 is saved in dental restorative treatment costs. • For a cost ranging from $1,108 to $4,542 for smoking cessation programs, 1 quality-adjusted year of life is saved. Smoking cessation interventions have been called the gold standard of cost-effective interventions. • The direct medical costs associated with physical inactivity was $29 billion in 1987 and nearly $76.6 billion in 2000. Engaging in regular physical activity is associated with taking less medication and having fewer hospitalizations and physician visits. • For each $1 spent on the Safer Choice Program (a school- based HIV, other STD, and pregnancy prevention program), about $2.65 is saved on medical and social costs. • For every $1 spent on preconception care programs for women with diabetes, $1.86 can be saved by preventing birth defects among their offspring. • According to one Northern California study, for every $1 spent on the Arthritis Self-Help Program, $3.42 was saved in physician visits and hospital costs. • A mammogram every 2 years for women aged 50-69 costs only about $9,000 per year of life saved. This cost compares favorably with other widely used clinical preventive services. • For the cost of 100 Papanicolaou tests for low-income elderly women, about $5,907 and 3.7 years of life are saved. • • After controlling for physical limitation and major socioeconomic factors, more than 12% of annual medical costs of the inactive persons with arthritis is associated with physical inactivity. Physical activity interventions may be a http://www.cdc.gov/nccdphp/overview.htm 4/7/2005 Chronic Disease - Overview Page 4 of 6' cost-effective strategy for reducing the burden of arthritis. Burden of Chronic Disease on Minority Racial Populations and Women411 Breast and Cervical Cancer • African American women are more likely to die of breast cancer than are women of any other racial or ethnic group. The incidence of cervical cancer—a 100% preventable cancer—is more than five times greater among Vietnamese women in the United States than among white women. Cardiovascular Disease • More than half of persons who die each year of heart disease are women. • Heart disease is the leading cause of death for all racial and ethnic groups in the United States. In 1998, rates of death from cardiovascular disease were about 30% higher among African American adults than among white adults. Age-Adjusted Death Rates for Diseases of the Heart* Among Women, by Race/Ethnicity,1996-1998 c 200 - Au 3 158 - 8 e100a KA - 0 I African Hispanic Avner.Indian'Asian/Pam. American Alaska illative dander RacelEthnicity *Average annual deaths per 100,000 women,age adjusted to 1940 U.S. standard population, International Classification of Diseases, 9th Rev.,codes 390-398,402, and 404-429. Source:Journal of Women's Health and Gender-Based Medicine,Vol. 10, No. 8, 2001. pp. 717-24. (A text description of this chart is also available.) Diabetes • Diabetes affects more women than men. • The prevalence of diabetes is 70% higher among African Americans and nearly 100% higher among Hispanics than among whites. The prevalence of diabetes among American Indians and Alaska Natives is more than twice that of the total population, and the Pimas of Arizona have the highest http://www.cdc.gov/nccdphp/overview.htm 4/7/2005 Chronic Disease - Overview Page 5 of 6 known prevalence of diabetes in the world. Infant and Maternal Mortality • • African American, American Indian, and Puerto Rican infants have higher death rates than white infants. In 1998, the death rate among African American infants was 2.3 times greater than that among white infants. • African American women are four times more likely to die of pregnancy-related complications than are white women, and American Indian and Alaska Native women are nearly twice as likely to die. U.S. Infant Mortality Rates, by Race/Ethnicity of Mother, 1998 15 8 14 0 0 43 5 0 White African Hispanic Amer:Indian/Asla&Pac. American Alaska Native R Ethnicity Source: CDC, National Center for Health Statistics. (A text description of this chart is also available.) Disability • Life expectancy is higher for women than for men, but women older than 70 years are more likely to be disabled. Related Information • Birth Defects and Develo.mental Disabilities • Genomics and Disease Prevention • The Burden of Chronic Disease and the Future of Public Health. • Privacy Policy I Acce_ Ssibility Home I Contact Us CDC Home I Search I Health Topics A-Z http://www.cdc,goy/necdphp/overview.htm 4/7/2005 Chronic Disease - Overview Page 6 of 6 This page last reviewed October 15, 2004 United States Department of Health and Human Services Centers for Disease Control and Prevention • National Center for Chronic Disease Prevention and Health Promotion • http://www.cdc.gov/nccdphp/overview.him 4/7/2005 • Board of.3{ealth Ne1v Business .agenda Item # 17., 4 • 2005 LegisCative Session Summary May 19, 2005 • From: Vicki Kirkpatrick[VKirkpatrick@wacounties.org] Sent: Monday, April 25, 2005 10:23 AM To: WSALPHO@listserv.wa.gov Subject: 2005 Session • Importance: High Well, the Legislature completed its work and adjourned yesterday evening with a transportation package, a capital budget, an operating budget and lots of policy decisions made in the last 105 days! For public health and counties, we have to say that this was a good session. We didn't get additional unrestricted funding for public health, but we kept the backfill funding. We recognized that the backfil funding has been flat for several years, but at the same time, the Legislature was facing a $2 billion deficit going into the session and lots of unmet needs. Following are some of the highlights of the Capital and Operating budgets that impact public health. WSAC will be preparing a summary document comparing the final budget to the previous Governor, House and Senate budgets. Once completed, I will send that out to you. We did get legislative support for HCR 4410 which commits the Legislature to studying the funding needs of the public health system in Washington over the next year. The floor speeches on the Resolution acknowledged that public health has sustained funding losses in the face of increased responsibilities and that the legislature needs to take a look at this. The backfill funding remains at$48 million for the biennium and will come to you as it always has-through the Department of Community, Trade and Economic Development. Small rural counties will also receive backfill funding as they did this biennium. DOH has$1.3 million appropriated for Marine Water Quality to assist LHJs with marine shorelines to develop and implement management plans and data systems toa ssure that septic systems are properly inventoried, monitored and maintained. The Department of Ecology provides$1 million of the state building construction account to design appropriate wastewater treatment facilities to serve the Hoodsport to Skokomish reservation areas of Hood Canal; $750,000 from the state building construction account for assistance in management and clean up activities at Long Lake in Kitsap county and $50,000 of the state building construction account for assistance in cleaning up Wapato Lake in Pierce County; $320,000 from the water quality account to Mason County to develop a septic system data base and identify failing septic systems in Hood Canal; $70,000 from the water quality account to Jefferson sounty for suveys of septic systems in Hood Canal; $70,000 from the water quality account to Kitsap county for surveys of septic systems in •Hood canal. This funding remained in the budgets even though ESHB 1458 did not pass. The Department of Ecology, from the Water Pollution Control Account is directed to give priority loan funding consideration to on-site septic system rehabilitation and replacement programs in Mason, Kitsap, and Jefferson counties for at least$1 million in the second year of the funding cycle. The funding for the Coordinated Prevention Grant has been reduced to$14.2 million (per DOE)with $4 million to implement the Beyond Waste Plan. DOE received increased funding to enhance the Well Construction Program (SB 5831)through increased fees. Local health jurisdictions accepting well delegation from DOE will received increased funding. $9 million is provided to clean up toxic sites. DOH received $250,000 to increase participation in the WIC Farmers' Market Nutrition Program. Funding is also provided for the DOH and the Kids Get Care program of PH -Seattle&King County to continue work in collaboration with local health care agencies. This funding will be matched by at least$50,000 of local funding. DOH also received $265,000 to increase the state public health laboratory's capacity to quickly identify suspected TB outbreaks. DSHS received funding to continue to provide premium-free medical and dental coverage for children with family incomes between 150 and 200 percent of the federal poverty level. Funding is also provided for health care coverage for undocumented children whose families have incomes below 100 percent of the federal poverty level. Safe Mothers/Babies Sustainable Fund is appropriated at$3.2 million for Medicaid-eligible pregnant and parenting women iedntified as"at serious risk for, or currently using" alcohol or substances. Funding is provided to develop an integrated mental health/substance abuse screening and assessment tool to be used by the Mental Health Division and Division of Alcohol and Substance Abuse. ECEAP is increased $2.994 million. Thank you all for your efforts in ensuring that our backfill funding continued and that we were successful in getting • legislative commitment to studying the funding needs of public health! • Board of Health Wow Business .Agenda Item # 1� 5 • Zoos. West Nile Fever Surveillance & Prevention Efforts .flay 19, Zoos • • .......7hc ea ii, You are here: DOH Home » News Releases Home *05-036 Search I Employees For immediate release: April 14, 2005 (05-036) Contacts: Donn Moyer, Communications Office 360-236-4076 Tim Church, Communications Office 360-236-4077 Spring approaches, bringing mosquito season and West Nile virus concerns You can take steps to protect yourself OLYMPIA—The coming of spring has Washington residents thinking of gardening, hiking and other outdoor fun. It's also time to think about preventing West Nile virus infection. The Washington State Department of Health says there's a lot you can do to protect yourself against mosquito-borne illness. We looked hard last year and tested a lot of mosquitoes, dead birds—even people— IP and we found no evidence of West Nile virus in our state," said Maryanne Guichard, director of the Office of Environmental Health and Safety. "The disease moved into Oregon and Idaho in 2004, so it seems likely that we may be next." West Nile virus has been moving west since 1999 and, though it wasn't detected in our state last year, it was confirmed in two horses and some dead birds in Washington in 2002. That year, two dead birds tested positive—one each in Pend Oreille and Snohomish Counties. Follow-up analysis by a federal lab trying a new test later identified two other West Nile virus positive dead birds from 2002. One had been collected from Pierce County, the other from Thurston County. No human cases have been acquired in our state. West Nile virus is primarily a bird disease. Mosquitoes become infected by feeding on infected birds, and then pass the virus to other birds,humans, or horses. The best defense is to avoid mosquito bites. Emptying water from old buckets, cans, and tires and frequently changing water in birdbaths and water troughs helps eliminate the small puddles of water where many mosquito species breed. Avoid being bitten by staying indoors around dawn and dusk when mosquitoes are most active; making sure door and window screens are working properly; and using a mosquito repellent containing DEET or other effective ingredients if going outdoors when mosquitoes are active. • Most people bitten by a West Nile virus-infected mosquito won't show signs of illness. • Some may develop mild flu-like symptoms that go away without treatment. In a small number of cases the virus can cause serious illness. People over age 50 have the highest risk for serious illness. With the help of local health departments around the state, the Department of Health plans to resume environmental monitoring—including dead bird testing—in mid- spring. The agency's West Nile virus information line 1-866-78-VIRUS (1-866-788- 4787) is activated and the Department of Health West Nile virus Web site (www.doh.wa.gov/WNV)has more details. The Department of Health is working with local health departments and other state agencies, including the Departments of Agriculture,Ecology, and Fish and Wildlife on West Nile virus monitoring,planning, control and prevention. More information about West Nile virus in Pierce County(www.tpchd.org/wnv)is available on the Tacoma-Pierce County Health Department Web site. ### DOH Home I Access Washington I Privacy Notice I Disclaimer/Copyright Information Contact Information for the Department of Health • Last Update : Send inquires about DOH and its programs to the Health Consumer Assistance Office Comments or questions regarding this web site? Send mail to the Webmaster . • • Board of Health Netiv Business .agenda Item # 17., 6 • BOCC's Resolution Re: Substance Abuse .advisory Board Oversight May 19, 2005 • • STATE OF WASHINGTON County of Jefferson Authorizing the Substance Abuse } RESOLUTION NO. Advisory Board (SAAB) to Report to } the Jefferson County Board of Health } WHEREAS, the misuse of substances of alcohol, tobacco and drugs impacts the health and pocketbooks of all Americans including the residents of Jefferson County; and WHEREAS, Health Data of Jefferson County reveals substance abuse is among the top three health risks for citizens of this county; and WHEREAS, both the prevention of substance abuse and treatment for those who abuse these substances will improve the health and quality of life of citizens within Jefferson County; and • WHEREAS, the Jefferson County Board of County Commissioners, acting in their parallel role as the Jefferson County Board of Health, created a Substance Abuse Advisory Board (or"SAAB") as permitted by RCW 70.96A.300 in 1975 and appointed members to the SAAB; and WHEREAS, the SAAB has been providing recommendations and advice to the County Commission since its creation; and WHEREAS, the County Commission wishes to expressly say"thank you" for all the excellent work to all of the persons who have served on the SAAB since its inception; and WHEREAS, at least three circumstances have changed since the creation of the SAAB that impact the operations of the SAAB; and WHEREAS, the first changed circumstance was the creation of a seven- member, multi jurisdictional (it now includes city, county, citizen and hospital district representatives) County Board of Health that has as it statutory obligation the duty to promote the health and welfare of the citizens of this County, thus shifting the `legislative' work relating to health issues from the County Commission to the enlarged County Board of Health; and WHEREAS, the second changed circumstance is the decision of this • County to not be a pass-through agency for many of the state-funded programs, for example, the programs relating to substance abuse treatment; and WHEREAS, the County also does not now employ a person who can staff the SAAB or be the liaison to the SAAB for the County Commission; and WHEREAS, the County Commissioners are not, because of the changed circumstances listed above, the policy-makers regarding health-related policy issues and no longer supervise or monitor substance abuse treatment programs now handled by the private sector. WHEREAS, all of the above changed circumstances make the reconstituted Jefferson County Board of Health, pursuant to its statutory obligation to promote the health and welfare of citizens of this County, better suited to be the recipient of the information, advice and recommendations of the SAAB NOW, THEREFORE, BE IT RESOLVED by the Jefferson County Board of County Commissioners as follows: 1. that the County's Substance Abuse Advisory Board shall report its findings, • recommendations, information and advice to the seven-member County Board of Health, a multi jurisdictional policy making body charged with promoting the health and welfare of the citizens of this County; and 2. that the County Commission delegates to the County Board of Health its obligation and duty to appoint in the future members to the Substance Abuse Advisory Board; and 3. that the County Commission retains for itself full authority to determine all other procedural and substantive issues relating to or arising from the Substance Abuse Advisory Board and/or the state statutes authorizing such a Board. • SResolution No. re: Substance Abuse Advisory Board Pae: 3 g APPROVED AND ADOPTED this day of 2005. SEAL: JEFFERSON COUNTY BOARD OF COMMISSIONERS Phil Johnson, Chair ATTEST: David W. Sullivan, Member Julie Matthes, CMC Deputy Clerk of the Board Patrick M. Rodgers, Member • • Board of 3{eaCth Media Report • .May 19, 2005 1 Jefferson County Health and Human Services • MARCH — APRIL 2005 NEWS ARTICLES 1. "Got the flu? Are you sure?" (2 pages),Peninsula Daily News,March 13, 2005 2. "House OKs bills to clean up Hood Canal",Peninsula Daily News,March 13, 2005 3. "Nominations sought for environmentalist award",Peninsula Daily News,March 14,2005 3. "Food workers'workshop set",P.T. Leader,March 16,2005 4. "UGN misses goal",P.T. Leader,March 16,2005 5. "Jefferson crews face `biohazard' in security test: Agencies cooperate in rehearsal for potential disaster",Peninsula Daily News,March 31,2005 6. "County prevention guide published", P.T.Leader,April 6, 2005 7. "Network names officers",Peninsula Daily News,April 10, 2005 411 8. "Substance abuse, dependence,addiction seen as `rising tide',P.T. Leader,April 13,2005 9. "Jefferson Healthcare faces$2 million loss: More patients lack insurance", P.T.Leader,April 13, 2005 10. "Welcome to Earth Day Every Day!"(2 pages),P.T.Leader, April 20, 2005 11. "Officials given a day of disability",Peninsula Daily News,April 21,2005 12. "Man arrested",Peninsula Daily News,April 21,2005 13. "Man threatens to shoot county employee",P.T.Leader,April 27,2005 14. "Zero Tolerance Policy",Board's Official Business,April 26, 2005 15. "Legislature OKs child neglect bill",Peninsula Daily News, April 24,2005 16. "Child abuse: A quiet agony"(2 pages),Peninsula Daily News,April 24, 2005 17. "West Nile Virus Precautions Strongly Encouraged",Press Release,May 9, 2005 18. 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QW P !I ! 3Nr,Oy yo_ a)o vO Z C N T C ON• u m0.3: O zOco^•a' u) m ) _ 4 w Zoc� a) m•N co a, . a) onL a.0 y , sou Nominations ht for g • environmentalist award Honor named The Earth Day committee ,• is also asking for monetary for Protection + � donations to go with the ``- " '4" i *' award,which could be used for protector z ' 7",- a' an environmental project, she Islandr 4 ,Wti �� said. h x ,, "We want it to come from BY JENNIFER JACKSON ,1 ;'4,4:'3 , ,W the heart of the community," PENINSULA DAILY NEWS ,.^ l'' ''' she said. PORT TOWNSEND — In u "F 1 The steering committee is connection with this year's %y p f also looking for exhibitors and Earth Day celebration, orga , . "1 z, 114. presenters for the second nizers are establishing an z w ,,; Earth Day Every Day! on Sat- . Environmentalist of the Year w a ,, #� %M', urday, April 23, at the Pope award and are looking for „.. * Marine Building and Sunday, nominations. �, , April 24, at Memorial Field, "We wanted to create an both in Port Townsend. award for Earth Day that rec- i � ��y The two-day event is free ognizes an individual for an / z and offers entertainment and outstanding contribution in `� ,: ' '1 ' hands-on activities with an environmental leadership, said Tami Pokorny, a member 'x2 ` " ' emphasis on sustainable agri- of the Earth Day Every Day! Eleanor Stopps namesake culture, gardening, responsi- steering committee. ble resource management, "There's no age restriction award from the Kitsap County alternative energy and trans- — it's for anyone who has Public Works Department, portation and community been a catalyst." which recognizes environmen- building. • The award is named for tai leadership in connection No commercial products ' Eleanor Stopps, 85, the Port with Earth Day. will be sold at Earth Day , Ludlow resident who blocked But she thought it.would events, Pokorny said. development of Protection mean more to the recipient if "We're trying to perpetuate Island,now a national wildlife the honor came from his or the focus on education," she sanctuary. her peers,she said. said. Stopps will present the - award on April 24 during the Earth Day weekend celebra- tion,Pokorny said. Award crateris "Of course, I'm very pleased about it," Stopps said. "It's a great honor, and I'm THE ELEANOR someone for the Eleanor thrilled that it's going to given STOPPS Environmental Award by calling Tami in my name. I hope it will Leadership Award will be Pokorny at 360-379-4498 encourage young people to ' given annually to a Jeffer- or by using the Earth Day persevere in this important son County resident who registration form. • field." has: The Earth Day Every ' Stopps, who owns an art ■Led a successful Day! Steering Committee gallery in Port Ludlow, was a resource conservation will contact eligible nomi- Girl Scout leader who took on effort that benefits Jeffer- nees, who will be requested Congress and the Rea an son County and its resi- to provide a brief descrip- g dents directly. tion of their background administration to prevent the. I Has acted as a corn- development of Protection and examples of how they Island,home for 75 percent of munity catalyst for pro- have met the three criteria. the birds who nest in the grams, initiatives or ven- Registration forms are tures that demonstrate a available at the Port state's inland waters. commitment to the future ' The island was the only of the Earth and its biodi- Townsend Food Co-op and national wildlife refuge estab- versity. the Jefferson County Envi- lished during the Reagan •Is a model for future ronmental Health office administration. business leaders, educa- next door to QFC. "I was given a scholarship tors, citizens or policy- Donations to support when I was younger that it makers by implementing the Earth Day celebration • opened my eyes to so many decisions that, though they or theaward will also be things in the field of nature may entail risks, help our accepted there. and the outdoors," Stopps communities take the next For more information, said. step toward environmental contact Pokorny at Pokorny, an environmental sustainability. tpokorny@cojefferson.us. specialist for Jefferson County, Anyone can nominate Peninsula Daily News said she got the idea for the • Port Townsend& efferso 1 n County Leader • if Briefs • Food workers' workshop set Jefferson County Environmental Health presents a new food rules workshop for food workers, 2-3:30 p.m. Tuesday, March 22 at the Harbormaster Restaurant Chart Room in Port Ludlow. The free workshop also is open to the public. • Washington state adopted.a new food code which takes effect on May 2 this year. All food workers, food business owners and man- agers, and community volunteers who serve food to the public will need to know these rules. Those attending should come away from the workshop knowing why the changes were made,how the rules apply to them,and what is new in food safety. Contact Environmental Health, 385-9444,for more information. • • •• • uGN • mis ses oa Less money to give to local programs By Patrick J.Sullivan required to reduce. We've always.had increases," said Bob Leader Staff Writer Peden, UGN manager. "It will be a tougher job this year. Agencies can expect they will not get the same amount as in United Good Neighbors will have less money this year to previous years." give to programs serving Jefferson County residents. UGN's annual fundraising campaign began last September The agency's annual fundraising campaign has fallen and officially ended in January, although pledges and other • . $35,000 short of its ambitious$265,000 goal.The donations amounts continue to trickle in.But even by adding in project- • from local businesses,groups and individuals are allocated to ed amounts pledged but not yet received, Peden said only specific programs that serve county residents young and old. $230,000 is expected—14 percent less than hoped. / "It's going to be harder this year because we haven't been See UGH,Page A 10 • • • • • A 10•Wednesday,March 16,2005 UGN S35 000 short . . • Continued from Page A 1 ference. Clallam County sur- Sound Energy.The corporation's For 2003 the target was — —8687000 passed its United Way goal,King contribution is $11,000. That's $250,000 and the campaign County made goal, but Kitsap $1,000 more than last year. raised $252,000. The allocation- 30,000 County was under goal. "To all of the individuals and committee recommended raising — —800 000 "If someone donated to businesses that contributed to the target for 2005 to$265,000. ' tsunami relief, more power to UGN this year, we extend our "That was an ambitious them;" Peden said. "That is a heartfelt thanks to each of you," increase this year," Peden ,.�1881000 great cause.We'll just have to do Peden said. "We would like to acknowledged.About 15 percent with a little bit less in Jefferson get any comments from the pub- of the amount raised goes to pay County." lic that pertain to the issue of . for UGN expenses, and the UGN money funds specific support for UGN this past year. remaining amount is distributed. �• — 50,000 programs, not agencies. The Any suggestions that will make UGN members wonder why final budget number won't go to us better in providing needed this has been the first campaign in the allocation committee until services to all the agency's pro- many years to fall short of goal. May,and agencies are notified of grams that rely on us would be Better awareness of what pro- the funding decisions in July. welcome." grams rely on UGN money is one The UGN account would Call 385- 3797, mail to 718 thought, but it's undeniable that have been even smaller if not for Washington St. Port Townsend, an outpouring of aid to Southeast a big boost in early February WA 98368,or e-mail to ugnjeff- Asia tsunami victims made a dif- through Don McDaniel of Puget co@waypt.com. • 3-16 5 • • r ' 31.-,20015'.`-'•a *fojumty's Daily Newspaper . ., March , ,. Jefferson c face ' biohazard in secure es. Agencies cooperate ,, ,c,.„,:., Drill: Emergencyin rehearsal for potential disaster * *'' ` • CONTINUED FROM Al "There is a high level • ,'""> confidence among officio � ^I ,;` "Communication is the that the situationwasme �� ?• . key; said Kilburn. BY NICK KOVESI�IIKOV _ aged well,” Kilburn said. PENINSULA DAILY NEWS ..-,..1 "There is always room to For a first serious pub r: • improve communication. health training exercise, t PORT HADLOCK—A biological agent is " °`' . "One area of concern was coordination between cour released during a motorcycle convention in getting the (county) Health officials proved to .be fai Kitsap County Department to tailor its mes- successful,officials said. Participants return home, unknowingly ' sage for the public release of That was the general ser spreading a deadly airborne flu virus to the `" information." ment at the Emergency Ml North Olympic Peninsula's population. Eventually, the message agement Center.. Kitsap authorities report nine deaths andNICA Kovesrnrrsov/Pen�rysuu DAILY NEWS was created and county health •• "This is a beginning po counting. John Fischbach, left,Jefferson County and administrative officials rather than an end to. c Jefferson County officials declare a state of conducted a simulated news training,"Kilburn said. AKgency and activate a multi-agency emer- administrator, and Pat Rodgers, county center in commissioner, conduct a mock news conference, complete with "More thorough review IT e srtuationru�der controlPort Hadlock peeve t a dst conference during a drill Wednesday. mock reporters. yet to come." aster. public health,fire and administrative services Public healthcare officials issue instruc- spent a full day of sharpening skills for an tions against contracting the disease and urge. emergency response. residents to stay calm. "Overall our department feels it was an It's only a drill extremely useful exercise," said Daphne Kil- burn, Jefferson County Emergency Manage- This is a loose scenario of the first county- ment's public information officer. wide public health emergency exercise orga- "It went fairly well. We saw some gaps in nized Wednesday,.by the Jefferson County our communication process — a couple of minor discrepancies,- like assigning specific Emergency Operation Center. telephones to an agency and using more writ- No deadly virus attacks came from any Peninsula bikers,but participants in the emer- ten communication messages as opposed to gency bioterrorism drill tried to play their verbal." roles with a seriousness that could translate Besides county officials, representatives into the real thing. from the American Red Cross and Olympic In effect, the drill gave Jefferson County Peninsula Community Action Programs also departments time to cooperatively rehearse sent representatives to learn how to better communicate with the county during an emer- for such a potential disaster. About 25 officials and representatives from gency. county and city law enforcement agencies, TURN TO DRILL/AB cpDli -,3-31,--0 • ... County prevention guide published "A Guide to Prevention in stance abuse, child abuse and Jefferson County" has been family violence from happen- produced by Jefferson County ing," according to the guide. Public Health and the Jefferson "Prevention is pro-active — it County Community Network. means identifying our priorities The guide is intended as a and working together to keep our handbook for policy makers community safe and healthy." and program planners, with the The guide is part of an ongo- . goal of providing a common ing community partnership to language and understanding improve the health and safety of among them. Jefferson County residents and --The. guide has received visitors.It is accessible online at endorsements from more than 45 w ww.jeffers oncountypub- • government; community and lichealth.org and in print at van- religious organizations,organizations, includ- ous locations throughout the • ing the Jefferson County Board county. For a copy, or to be of Commissioners and the Port included as an endorser on sub-. Townsend City'Council.• sequent printings, contact Kellie "Prevention, simply stated, Ragan at kragan@co.jeffer- keeps bad things uch as sub- son.wa.us or 385-9446. , • '• •, ._ •.. - Pe ninsulaN orthwest SUNDAY APRIL 10 2005 Pletwork names ., .„,,,,,,,,,,,,,...„,....,,,,y„ z rysahgY gs r6s �• ,x x ad vfr y �Jefferson boar " t „� y3.; su ?-p,�-:, rp t,- � a ' 4,�rf y � fi6, � , ,/ r� , ?focuses on b ,, ,, e , , , 144 Yoath issues y PENINSULA DAILY NEWS s a s } ,„..,`,:.;«,,„,,,,,!;,,r...,,,,,"‘.....-,.4 ' <p PORT TOWNSEND— ; The Jefferson County Com- � '�� '"� " munity Network recently ", new „� �`¢r elected officers to lead • �� °. �” , its policy board. : The new officers are Hol- fir ; ley Carlson, chairperson; .. ',I Chris Kluck, vice chairper- son; ' � ' son; and Julia Danskin, 'Y treasurer. The Jefferson County1. Community Network works i for the prevention of child abuse,youth substance abuse and other problems through community aware- ', Alb and by convening 1. Widens, community' groups and parents to work • '� i together. Network activities Newly elected officers of the Jefferson County Community Network are, from The board oversees all left, treasurer Julia Danskin, chairperson Holley Carlson and vice chairperson • Community Network activi- Chris Kluck. ties, including the Healthy years on the Jefferson Seattle University's Insti- experience in youth mental Youth Coalition and the County Substance Abuse tute for Public Service, health treatment. Community Mobilization Advisory Board. Kluck also serves on the program. She is a Realtor and lives board of Port Townsend Danskin was re-elected Carlson has been on the in Port Townsend with her: Sunrise Rotary and the Jef as treasurer, a position she board for the past two' husband and daughter. ferson County Big Brothers has held for five years. years, most recently serving Kluck, who has been on' Big Sisters Advisory Com- A 26-year resident of as vice chairperson. the board for one year, was. mittee. Port Townsend, Danskin She previously was chair- active in the Healthy Youth Kluck is a longtime Port has worked for Jefferson person of the Port -Coalition prior to joining Townsend resident and County Public Health for Townsend Co-operative the board. youth advocate, with more 17 years and is currently its Playschool and served three A graduate student at than five years' professional director of nursing. . , • , . -, . •{ . : Wednesday,April 13,2005•B 3 Substance a use , dependence , , addiction seen as rising tide ' (The Jefferson County sumption in larger amounts than . Q:Is treatment effective?Can absolutely necessary for a suc- Substance Abuse Advisory intended, and persistent use addiction or dependency be cessful recovery.Even individu- Board [SAAB] is appointed by despite negative consequences. "cured"? als who are determined to stay the Board of County The National Institute on A': Addiction and dependen- clean often suffer one or more Commissioners. This year, in Drug Abuse defines addiction as cy are chronic conditions that slips before achieving long-term addition to the SAAB 2004 pub- -a complex brain disease. It is can be successfully treated. sobriety. Research indicates that lication "A Rising Tide ... the "characterized by compulsive,at There is no cure,but recovery is up to 90 percent of recovering Hidden Threat," the board is times uncontrollable, drug crav- possible. We know that early addicts will have a relapse at writing a series of public infor- ing,seeking and use that persists intervention and effective ser- least one time in the four years • mation articles.This is the first.) even in the face of extremely .vices are the keys to successful- following sobriety.While this is • negative consequences. Drug ly change behavior, including a setback,it does not mean that a r Q:What is the problem? seeking becomes compulsive,in addiction. persop cannot recover from iiv A: Alcohol and other drug large part as a result of the Eliminating drug use is addiction. (AOD) use and abuse are found effects of prolonged drug use on everywhere in our society, and brain functioning and, thus, on this has a serious effect on social behavior,For many people,drug problems such as mental illness, addiction becomes chronic,with , homelessness,domestic violence relapses possible even after long and unemployment AOD abuse periods of abstinence" is a big factor in chronic diseases, the spread of infectious diseases, Q: What is treatment? How hospital emergency room visits, does it work? newborn health problems, vio- A:Treatment for people who CP. 1 , C12-8L- lence,and automobile fatalities. abuse drugs but are not yet '(„..--'l addicted to them most often con- 27 _(3 -0 Q: What is the difference sists of behavioral therapies such between abuse, dependence and as psychotherapy, counseling, addiction? support groups or family thera- A:Abuse is recurrent use over py. Addiction is also treatable • a l2-month period despite physi- but often requires a combination cally hazardous situations, legal of behavioral therapies and cried- problems and negative social and ications.Treatment may vary for interpersonal consequences. each person depending on the Dependence is the presence type of drug(s) being used. • of tolerance, an avoidance of Several courses of treatment withdrawal symptoms, eon- may be needed. - N Z. :ccE �urg E � tfl 2m _... rmmilmi e 8 ti 1914 a 4` 91 r, ed ouN� e° u � Ha.arSv Q — aC13 °uu = ifl u4aiNQ u ° u y 6 .E . 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Welcome to the second annu- worksho on creatingwearable al EarthDay EveryDay celebra- P group of individuals who have • tion in downtown Port Townsend ? animal heads out of scrap card- led successful resource conser- this Saturday and Sunday,April i board. It is recommended as a vation efforts,acted as commu- T family activity,as some cutting nity catalysts, and/or imple- 23-24.Admission is free. ...1•14.--. , • .r, R 1, and stapling is required. Those merited decisions that take our One of last year's out-of- •c • N 4wishing to create a more elabo- communities in the direction of town participants noted: "It's +r _"; p - nice to realize there are places = -,b,,� a""'` h- `•- P %..,•;`,G;' rate costume can call sustainability. Seven adults I ;i:•:.••••,:-..!.!2' Jurczynski at 385-2285. have been nominated for the on this planet that have con- .,-, ► 0 a . '• sciousness,kindness and a will- y� �� 1 R 't`1 award this year. The honoree T r._ g ELEANOR STOPPS receives a framed certificate, ingness to share information at f " ri f< ^' A r 1, 4 Nit l - Q; T r )_ I ENVIRONMENTAL and his or her name is included the grassroots level-this place - ar t "�R + 1 r� I ..... "^ LEADERSHIP AWARD in an award display to be hosted is unusual." +�,r ,a, - , H 0 •- ._..,.:g The first-ever Eleanor This yearex • \ -;$ ' N by the WSU office in Port try experimenting StoPps Environmental Leader- Hadlock. with alternative travel as a way to R r, ,,t ship Award is presented at 4 get to and from EarthDay tF ` p.m. Sunday to a Jefferson NO DOGS EveryDay. People who arrive 0 'x '" Countyresident byEleanor (exceptdogs) v- Dogs service do s "non motorized"can request a gift . I �� Stopps herself. Stopps, of Port P at the festival information booth, y y .ler. PP Sc • and the use of tobacco are pro- , the EarthDay EveryDay exhibits at Memorial Athletic Field to educate Ludlow,was a Girl Scout leader hibited at Jefferson County Pick up your questions at the yourself on"what kind of world we can become." Photo by Jell Eicken who took on Congress and the Memorial Field. gate for the Eco-In{ormatioriReagan administration to pre- Scavenger Hunt. ALL SPECIES PARADE 4:30 p.m. and features a prize vent the development of FESTIVAL COMMITTEE For just one day, come and Crawl,swim or fly on over to for best costume. Don't have Protection Island, home for 75 Judith Alexander, Melinda experience"what kind of world Memorial Field for the All anything to wear? Local artist we can become,"invite organiz- S ecies Parade on Sunday, and puppeteer Thaddeus percent of the birds who nest in Bower, Sam Bryant, Margarita P the state's inland waters. Courney;Norma Davidson,Jeff -day The honoree will be selected Eichen, Val Johnstone, Ti era. April 24. The parade starts at Jurczynski leads an altar by the EarthDay EveryDay Pokorny,Ann Raab and Tilikum Activities at Pope Marine Park Building Steering Committee from a Redding. Pope Marine Park Building + This interactive performance& at City Docker qr community dialogue engages SATURDAY,APRIL 23 ��` "T the audience in an exploration _ 1 Noon-1:30 p.m.-Jefferson # ll[ 'i '�` P�r,�� �, � of what gets in our way of tak- �` County Home Builders a _ - rM ing action toward the creation of �,. 40Association & Melinda Bower ,. s a healthierP lanet for all. '• present an introduction to �� Jefferson County's new Built SUNDAY,APRIL 24 7_, > ` Program. >ar Green Pro to 10 a.m:noon-Sam Bryant -' _ 1:30-2:30 p.m. - Robin mfr offers a workshop on Biodiesel ' ts� ' t aR _ I Shoran from the Annapurna X" E 1 ) x �� 101. , g ast t' :; Center for Self-Healing speaks a . Noon-12:30 on how to empoweryourself 1� p.m.-Jefferson ,, f Ire W,` M1. 1:i. Po n txt low-3tnpacE ltfty .' Transit provides a look at the with sustainable self-healing. he hvuaaclmld 4 proposed new facility for 2:30-4:30 p.m. - An Eco- ' I�., expansion of public transporta- .. a` Parry is hosted by Jeanne Roy, r' g- tion in Jefferson County from Music and other entertainment Is again part of the EarthDay EveryDay p1- co-founder of the Northwest �i' r ,', ebratlon, Photo b the standpoint of environmental y Jeff Eichen Earth Institute.A leading author- .y''tI , �a 8fb R considerations. e ` �s. Eco-Film Festival ity on low-impact lifestyles,Roy „. ",,,,,V, , 12:30-4 m.-Energy Talk helps participants examine ',•' s • P rSY Roundtable Discussion is led by household practices & consider tFa •'" , EarthDayEveryDay ay ro and oyl issues for Puget Y local energy enthusiasts, with Eco-Film Festival alternatives that reduce their per- �'"*" T •"` �l Sound oysters. ., a < ^t some seats open to the public on Bishop Victorian Guest sonal impact on the Earth, a "dro in" basis. The discus- 12:35 p.m.-Space top Place: til.. t� PS t P Suites Neighborhood Street Repair(15 4:30-5 p.m.-Todd Wexman ,,. : r sion explores the implications Vancouver Room speaks as Dr. Growthcrazy, or •• minutes) tcei preatutp; . to Jefferson County of the corn- 1 p.m.-End of Suburbia(78 how I learned to stop worrying s {hageie",M, ing of peak oil & the need for SUNDAY, APRIL 24 &love the GDP. '�" "'"* ' 'u•�;' minutes) explores oil depletion al-mc a than 6 E1'•oo4„. response with a sustainable & 10 a.m. - Blue Vinyl (98 & the collapse of the American 5-6 p.m. - Dick & Jeanne �'�" "" '��'`'� �' ,° "m g�•af50 rr renewable energy plan. Issues, minutes)explores the life cycle dream Roy, co-founders of the .b ,, A'i,"`r ° " ',' resources & solutions are of vinyl: past, present & future Northwest Earth Institute,speak 2:25 p.m. - The Future of explored-including tidal,solar, harm. about maintaining hope in the 7-9 p.m. - Save the Earth, hydro, wind & biomass forms 11:50 a.m.-Cartoon:Motor Food(lo minutes)provides an in- face of bad news&the seeming Save Ourselves features the of energy-ending with a dis- Mania(7 minutes) depth look into the fedrfoods. indifference of the dominant Poetic Justice Theatre cussion of formation of a local Noon -Pearls of the Sound over genetically modified foods. 4 p.m.al - Grand finale at culture. Ensemble with Marc Weinblatt. energy co-op. (30 minutes) illuminates envi-_ Memorial Field 4•JEFFERSON COUNTY WEEK:Arts&Entertainment for April 20-26,2005 The Port Townsend&Jefferson County Leader III Enjoy EarthDay EveryDay ! Education, % „,t , .: _... � - � t enterta44 inment, `. a? t . " Ii What's on at Memorial Field fFN ` and edibles = -. .�1 �, ��� .,,r,..f �/' � "'' n 54x R ._� 'Yrs+t.r ,y, war` �'-E-... �/i -..+s-"° S on Sunday >of .,� �• .ry �' :4I.1:;"!:'',, �r • -404011, on �� The following list includes presen- I mq"�'.,7;z•+�+, -1,....-;.V� ""i - lje`s a . .tea• ate` t ters registered as of April 15;more r,�� - �'° �:�...►"' ,- ��- q•. ,r�-- s may be added. Registrations are '° = �'' t taken through Friday, April 22. p. `4 ,.,s FOOD FAIR . Check the website www,earth- ,..e.",.........,;..3:.•'µ+ igialitaalail - rJ41rr. GRANDSTAND, r dayeverydaypt.com. ., -, + 0 µ TRANSPORTATION '411L.;',-,`ro �� `zsz'x`i''_ Electric Vehicle Fleet: local resi- `{ i.• K D •'°^� � -'�%- �•`„-_ •� • Vic: dents showing their vehicles .•::',.."'",:40';" ACTIVITIES • • �� Don Crabtree, aka Father Time: '" s ' electric motorcycle a ' ) B ILDIN I �� Steve & Phuoc with WilderNest: 4' gr , OMMUNI U TAINAB ' I > electric bike/scooter to test „.. ,.• ' _ • AGRICULTURE RE •UR E Curtis Stacey, Jefferson Transit: t� '. l / * MANAGEMENT •EEN how to put your bike on the bus ./. „t - BUILDING Lee Miller:bike trailer demonstration "”" }} Sally Lovell,Glenn&Nita Hughes. �. ,. < ..... 3`q• electric scooter & electric bicycle on display, handout of resources Noel Van Glisen & Sharp SUSTAINABLE AGRICULTURE what to do if stopped by police, 10:15-11 a.m.-Matt Sircely(music) available Construction: environmentally 4-H of Jefferson County: forestry, pamphlets in Spanish&Arabic 11-11:45 a.m.-Raven&Bear(music) David McCulloch, Port Townsend friendly & energy-efficient struc- how to establish a forest,free trees David Jenkins, PT Depleted 11:45-12:30 p.m.-Raven of All My Association: maps of local lural insulated panels for youths,tools,etc. Bicyclebikingroutes&free children's bik- Gretchen Brewer: paintingwith Uranium Study Team:risks&reali- Relations(music&performance) Dan Huneycutte, Second Chance ties of depleted uranium ordnance 12:30-1 p.m. - Allison y ing helmets milk paint as well as alternatives to Ranch:no-kill animal shelter rescue stored at Naval Magazine Indian Dance for the Earth performance) treated wood Keith Kiesler, North Olympic1-1&adoption Island Biodiesel:education on biodiesel fuel Dean Petrich, Aqua Alternatives: Annabelle Design, Annabelle's Phoebe Huffman, Port Townsend Rhythm p.m.en - Steve Corra with composting toilets, solar water Planet SUSTAINABLE ENERGY P g Garden:drought-tolerant&organic Friends(Quakers): Peace on Earth 1;45. 2:30m. Linc Mkwananzi heaters & water filters, non-toxic Al Latham: battery-powered lawn- gardening roulette game,war,peace,oil,etc. p' - household products whh Tones of Peace Marimba Band mower,conversion&solar-charging Sarah Fairbank, Master Garden Judy Larson:community emergen• 2;30.3 p.m. - Orion Shannon &shed,& Kir Dor ole-plavrered pumsp olar & RESOURCE MANAGEMENT answers questions about gar- cy response teams, disaster pre- Michael Phillips(music) Pens John Burke & Jessie Taylor, paredness training programs Town- photovoltaic education Skookum:demonstration of house Diane Clemens,The Neighborhood 3-4 p.m. - Dave Sheehan hold recyclables g Liz Rivera-Goldstein, Port Town- EarthDay EveryDay All-Star Band Norma Davidson: solar cooker Harvest Project: individuals/neigh- send Peace Movement:meaningful demonstration with treats Ron Brantner, Port Townsend Elks borhoods learn to grow food ways to work for a peaceful world 4 4:30 p.m. - Eleanor Stopes Jonathan Clemens,Olympic EnergyLodge 317: use of new packing organically,cooperatively Award ceremony Systems: artifacts & ools foequipment for boxes,replacing the Adam Blake, Emmy Graham with ects n availableroject:youth art pro- 4:30-5 p.m.All Species Parade and peanuts commonly used 1 closin circle demonstrations, free economic Full Circle Garden: sustainable g analysis,legislation information Pat Pearson, WSU Extension agriculture,seed saving&eco-spir- KIDS'ACTIVITIES FESTIVAL ART/ Andy Cochrane,Power Trp Energy Natural Resources Stewardship: ituality Marci Van Cleve, Pi String CONTRIBUTIONS Corp.:solar-pumped waterfall EnviroScape interactive surface Harvindar Singh, Port Townsend Orchestra: community building Peter Gritt:fabulous flag/banners water model,information on Shore Farmers Market through music education Gavin Wuttkins, Ocean Energy: Stewards, Water & Beach Scott Jester, a :bike sculpture tidal power demonstration RogerHall, Discovery Deb Weiss, Habitat for Humanity: entry bannerr Custom Marine Canvas: Watchers, watershed education g Bay kids help create a miniature habitat Linea Pay,Light Zone:full-spectrum with insert from The Leader to Landscaping:erosion control entry village lighting&other light-related prod- hand out,&firewise information Dave Sheehan:worm bins Ray Hammer:wind sculptures ucts Raven, All My Relations: biodiesel Carol Dargatz, Jefferson County The Food Co-op, Sunfield Farm & vehicle&ecopeace advocacy Ivy Street Farm:potted plants GREEN BUILDING Noxious Weed Control Board:edu- WSU: education on GMO food & Waste Warriors:recycling cans Ann Raab,Olympic Design Group: rational information reusable containers;seeds for kids Greg Ballard:plants from Henery's Garden Center Western Horticulture Products: environmental home demonstrat- John Edwards for Olympic Wild: to take home plants ing 'building green,' including impact of road intrusion on wilder- COMMUNITY BUILDING Swan School students & parents: FOOD VENDORS non-toxic, sustainable & recycled ness areas Kees Kolff, Port Townsend how to get to school on a"bicycle buildin materials school bus,"make recycled decors• Boiler Room:coffee&bagels g Alisa Meary,North Olympic Salmon EcoVillage: site map, vision state- Crepes byLucyLaRosa:varietyof James Henderson, Logic Eco Coalition: information booth, chil- ments, sustainable living ideas, tions for bikes(bring your bike) p Design & Construction: flow form dren's activities,drawing,hat-mak- ecological footprint information & John Ludwig, Oproc 4-H Club: fresh crepes water purification&herbs vel per- inplus Fin the migrating salmon Dos Okies:BBQ meats,beans&slaw p P g 9 9 questionnaire model rocket launch maculture garden Orion Shannon, Jefferson Land Helen Kolff, Northwest Earth Thaddeus Jurczynski: make masks Elevated Ice Cream:sundries Doug Milholland, Blue Heron Trust: information on land conser- Institute: calculate your ecological (for kids of all ages) for the All Heliotrope Bakery:baked goods Construction: rastra block con- vation in Jefferson County footprint, decorate your own Species Parade that closes festival In Season Catering:grilled salmon, struction & earth plaster demon- Ian Hawia, Northwest Natural reusable cloth bag, acquire an at 4:30 p.m.Sunday; experience a chowder&salad stration Resource Group: Forest Earth flag in exchange for tsunami walk-through camera obscurepow-9 9 Java Gypsy Espresso Cart:espres- Richard Berg,architect:display of a Stewardship Council-certified relief donation & share ideas for ered by sugar so drinks green roof wood products sustainable lifestyle shifts ENTERTAINMENT Mystery Bay Clams&Oysters:fresh Reuben Roche, Glacier Northwest: Tami Pokorny, Jefferson County Bill Miller, Jefferson County 9:30-10:15 a.m. - Morning music oysters green building solutions including SWAC: hazardous waste ID& dis- American Civil Liberties Union:ex• with DJ Jeffy Fresh of Port Sandwich King:Greek gyros pervious,insulating concrete forms posal felon voting rights, cards showing Townsend Dance Collective The Food Co-op:surprise! The Port Townsend&Jefferson County Leader JEFFERSON COUNTY WEEK:Arts&Entertainment for April 20-26,2005•5• • A6 THURSDAY,APRIL 21,2005 PeninsulaN orthwest Officials ;_,...,,, 0 'given a • day � - ' . e�y °f` ka „'1,4 of disability ! .._ Larry Grewell with the Port ' ' ' 4 � �&'F N ,, Jefferson Townsend Public Works ar �'� g ,,i4 I«,,:0', A''itr , Department and the Rev,Joan „r , :.4,-;' _ leaders Can Anthony of St.Paul's Episcopal '”' '- �j Church. perspective Tough tasksa z Under normal circum . -- BY NICK KOVESHNIKOV stances their assignment would _ PENINSULA DAILY NEWS be simple — start from the .� <•r r-i a -� A . PORT TOWNSEND — To heart of uptown Port It r Townsend and then walk or r -- ;r feel the true condition of a city ,� , �"= k ride in a wheelchair to Chet street or sidewalk,pedestrians - ,,i ' zemoka Park. • should try walking with their Some minor chores were ^ y •,„,,k,,,,' eyes closed or their legs immo- �� 1 bilized in a wheelchair added along the way, such as : = , -` With that in mind,eight Jef- mailing a post card or buyin•g a �`w '� + A ferson County and city of Port cookie. , Townsend business and civic But with a blindfold over ,,,,-,..- •:- ,--`0,-,:•,-:.: *,,,--,;• 7; leaders wandered through their eyes or a body-constrain- , / ,, uptown Port Townsend blind- ing wheelchair,the tasks were folded or in a wheelchairs on far from easy. It was tough. I felt totally Tamer Kirac,Jefferson County Economic Development Wednesday, taking part in the isolated, totally incapacitated explore the world of the disabled with Kay Harper, boat annual Disability Accessibility. and very dependent," Kirac the third annual disability accessibility event in Port To event. Aw said, taking off his blindfold • In its third year, the event after arriving at Chetzemoka was organized by Disability Parkareness Starts Here, which His assistant, a blind per- promotes the rights of disabled son,smiled. individuals. "Once. a person puts on DASH recruits civic leaders, sleepshades,it's a whole differ- who then participate•in an ant orld," said Carl Jarvis, a experiment that makes them DASH event volunteer who has '' aware of the challenges dis- been blind for 40 years. abled residents face daily. "When you are not used to "From experiencing the traveling without sight,it could environment from a different be pretty we want them to p y s may appreciate the accessibility," Several participants cheated by said Lesa Barnes, who orga- taking their blindfold off nized the DASH event. during the short lunch break at , >> Organizers try to bring the park. attention to Port Townsend's Volunteers quickly , cracked streets,sidewalks that reminded them that disabled lead nowhere and pedestrian individuals cannot afford such �_` ramps that end abruptly. a break. The blindfolds returned. '.1,0h. "I fell down over my cane on Different perspective the way here," said Sullivan, ...i•^ G Last year, Port Townsend arriving at the park after a City Council members explored blindfolded stroll throughAdor M their downtown from a differ- uptown. ent perspective, and they still "It's quite an experience. I ' ,:t.,,,..,_ talk about that experience. was just thinking about the , This year, County Commis- sense of isolation that people sioners David Sullivan and Phil feel." Johnson explored uptown Port Upon completion of the Townsend with Tamer Kirac, experiment, participants Jefferson'-County 'Economic returned-their blindfolds,canes Development Council executive and wheelchairs to organizers, director,Michael Colbert of the and walked or drove back into Port Townsend Historic their normal lives. Vic, Preservation Committee, and But the experience and a dif- Mary Winter,manager of Victo- ferent perspective will remain • ria House. 0 them, DASH volunteers e Also participating were believe. Se urn schools �. will discuss new • .......!%,,::-D, $ 4 Vw„ 4 11.41:c,:.,,":„..74,,,,,,,,,,.., V .i - �'$ a. .3a 99?.,}} , fl „,. .,-..,:f C Ist,:k', ' . k.i i' P4 ,'l d si d�fq+f li 3�,«g I' r'} 111{ 041.g. Yti 7 �' l.rgynrit . ii, , , 4��af SSSS^^^^xr d 1,‘ r k t f r E 31 gni 1., t''r ) ii " 10...,-,:r..,,„ t...6-.:- 4,n3l P- i0 ,fi . r _ \ ii S ' :I L 1,1E7,f � 4,4 fy 5 Otte, r , k it'`,,,%,;;',..1.f f - I. .ii bF�( `. g� rtl'f- • g f NICK KOVESHNIKOVIPENINSULA DAILY NEWS MAN ARRESTED Port Townsend Police officers Ed Green, left, and M.C. Krysinski escort loan Hgelvic of Brinnon out of the Jefferson County Health Department on Sims Way in Port Townsend on Wednesday. Hgelvic was arrested and booked in Jefferson County jail after he allegedly brought a pistol to a food handler's class and threatened.a county employee with it. PL[ q_.?„1- 69r--- . • • . . . _ Q , .3 , .. ..,, , .,.- p . ,•60 q :....^ , � O � 0 �� �Q . o l� '� _ CI w C U .0 O� 0 O..h " o ° 4,..., ai a cd X ° K v iI : h 4 _ O° LA 3 ° y � V• T O O u •: Iii i ' 4,4 x Lc h ' oy 'D Ofl � 7E 0 7c , 0 0 ° c `t L c = xc 0 E ,CDL 0 �r c• - °' ° x C y `.) `� x > ' E - U " azo r .0 0 .0 0 00 6. 45 b ,� a � 0 E � = . 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E x L •� c a, o _o 'S co E o Q c;-; o Q• 1--, =4a. .c Q., BV V✓I disOffiocca/ / • Highlights from Monday's Commissioner Meeting April 26,2005 CERTIFICATE OF APPRECIATION: The Board Committee to address the Courthouse restoration and received a Jefferson County Historical Society encourage community support and participation for the Preservation Award for the Courthouse Front Door project; the City LTAC has supplemented the Fort project. Worden parking fees for the past two years and the Fort Worden Advisory Committee is willing to work LETTER OF SUPPORT:The Board signed a letter with a County task force to study the economic and to Congressman Norm Dicks asking that he support access benefits of eliminating day-use fees at other an increase in the Payment in Lieu of Taxes (PILT) State Parks in the County; there are programs at Fort funds in the Federal budget.This funding goes Worden especially for students from Brinnon and other toward essential services such as Search and comm unities in the County;the Board should consider Rescue, law enforcement,and road maintenance. subsidizing parking fees at other State parks such as Old Fort Townsend State Park; the food service at Fort PROCLAMATION: The Board approved a Worden Commons is run by a company out of Virginia proclamation designating May 1,through May 7, and takes money away from local businesses; and 2005 as Municipal Clerks Week. people can park free at the Port Townsend Park and Ride and ride the bus to Fort Worden. ZERO TOLERANCE POLICY: As the result of two CONSENT AGENDA: All of the items on the Consent incidents at the Health Department within the last six Agenda were approved as presented. months, the Board took action to direct the County 7 AGREEMENTS: 1)Amendment No. 2 to 2005-2006 Administrator to develop a Zero Tolerance Policy. Consolidated Contract for Health Services with State The policy will address action that may be taken DOH; 2)Amendment No.3 to agreement regarding regarding threats from the public made against Breast and Cervical Health Care with Public Health of County employees in the course of their work. Seattle King County; 3) Childbirth Education with • CERTIFICATE OF INTENT:The PUD is in the Kathryn Shonsey Mattem, MSW; 4)& 5) Open Space process of taking over the County well at the Taxation to Transfer and Designate 7.65 Acres,and Quilcene Community Center. They have agreed to 9.15 Acres, as Timber Open Space for Current Use enter into a Water System Acquisition and Assessment with John and Nancy Rowe; 6) Rehabilitation Program contract for the system. Amendment to Intergovernmental Agreement for Period of Performance/Effective Date for Discovery PARKING FEE FUNDING: After reviewing the Bay Stewardship Project with Puget Sound Action Team; and,7) Emerging Issues Grant (EIG) Funding request for funding to supplement parking fees at to Develop and Conduct a Public Fort Worden State Park, Chairman Johnson and Outreach/Stakeholder Involvement Program Commissioner Sullivan directed the County Supporting a Comprehensive Amendment Process for Administrator to consult with the Civil Deputy the Unified Development Code(UDC)with CTED Prosecuting Attorney to clarify if Lodging Tax funds FEDERAL GRANT APPLICATION: Funding the can be used to subsidize parking fees according to Functional Family Therapy (FFT) Program for Eligible the State statute; to request that the Lodging Tax Juvenile Justice Involved Families with State Advisory Committee give a recommendation to the Department of Social and Health Services, Office of Board on using funds from their budget to Juvenile Justice supplement the parking fees; and to begin the ADVISORY BOARD RESIGNATION: Ralph Harder process for a budget extension for the Hotel/Motel from the Jefferson County Civil Service Corn mission Fund (LTAC Funding). PUBLIC COMMENT PERIOD: The following PLANNING COMMISSION APPOINTMENT: After comments were made: the Quilcene/Brinnonfollowing interviewing William Miller,who is interested in serving Chamber of Commerce requested $16,000 from the on the Planning Commission representing County to staff the new Visitor's Center at the Commissioner District#1, the Board appointed him to Quilcene Ranger Station because the DOT's a 4 year term on the Planning Commission that will requirements for signage on the highway state that expire on March 17, 2009. the Center be staffed full time during the summer, HEARING NOTICE: A hearing notice was approved and if County funding to supplement Fort Worden regarding the interim control enacting a moratorium • parking fees is approved,funding for parking at all against the issuance of permits or approvals pertaining the State Parks in the County should be provided; to adult businesses that was signed on March 14, the North American Rainwater Harvesting 2005. The hearing is scheduled for Monday, May 9, Association is having a conference in Seattle in July; 2005 at 10:30 a.m. in the Commissioners' Chamber. a request for the Board to create a Blue Ribbon v2)5- PENINSULA )sPENINSULA DAILY NEWS so oKs child • negi cot boil f Justice 'and to charges of second-degree murder and criminal mistreat- Raiden measure ment and is awaiting trial. An independent investiga- goes to Gregoire tion into the Robinson case con- cluded oncluded that state child protec- T a ASSOCIATED p. tion workers ignored or mis- handled complaints about the OLYMPIA — The Legisla- mother and her drinking prob- ture has passed a bill strength- lems over several years. ening child neglect laws,named after two boys who starved to Clearer definition death last November 'while The bill approved bythe their mother lay in a drunken pp stupor. Senate on Saturday defines The Justice and Raiden Act child neglect more clearly in passed the Senate unanimously state law and gives state work- on Saturday and goes next to ers more power to intervene . the governor,who is expected to when a child is being neglected. sign it. It also directs social workers • "This legislation really to pay more attention to par- shines the spotlight on child ents'substance abuse problems neglect," said Rep. Mary Lou and to patterns of chronic Dickerson, D-Seattle. "This neglect. tells our state things have got to Stevens said she has grown change." frustrated with seeing children Her original Justice and die in the state's child welfare Raiden bill missed a deadline system in similar circumstances, earlier in the session,but Dick- often at the hands of abusers erson managed to revive it by with drug and alcohol problems. adding it to a Senate bill on The bill was designed to child abuse. work with a bill by Sen. Jim The Senate bill, sponsored Hargrove, D-Hoquiam, to - by Sen. Val Stevens, R-Arling- strengthen and coordinate ton, bolsters the rights of par- mental health and substance ents who are being investigated abuse treatment in the state. for abuse or neglect. For example, parents whose "It really does fit," Stevens children have been taken into said of the combined bill. "We foster care will have to comply are going after parents who are with drug- and alcohol-treat- abusing children, and we want ment programs before they can to protect those that are not." get their kids back. Sixteen-month-old Justice The bill also requires the and 6-week-old Raiden Robin- Department of Social and son were found dead of malnu- Health Services to notify people trition and dehydration on Nov who are being investigated for 14 in their Kent apartment, possible child abuse, and to tell south of Seattle. them of their rights. Police found their mother, The change was needed to Marie Robinson, passed-out agree with federal law, Stevens drunk in a bedroom littered said. with more than 300 beer cans. If the governor signs the bill, Robinson pleaded not guilty it will take effect Jan. 1,2007. • ' d] „ >11/ 4.. • �'^�� 94 o - CO 0z -tea . 5•4 , = 6 co ty, o Aro oapcaAb-8*- P. dz •-4_ = F .o a -byo@dco7, 2 U 3Uqillawil - •.— j2 CQ0 � , p� � Nz z = ... _ ill(111) 0 1:1 p., ' 2..) .-•--a' g—. .t,) g _2.3 0- u).- - ,-, • 9 W a m p C o m S« b4 i o apo o . al cn , a) 0 , 0-, 1,-, bl) ccn r) a m o v. a o o -a>° `t ° 4' R. ' a°'i°' •"ii I I p" U f" �°�, to0o i7 .-- S. A,-5 u� a U-z 0.-.9...)d.a' a) u1•G - -ca. o.Com" aill oca q rn �y p oU.otaa p C %�o w"t a • [, a) o r� H ao o y a p y{CD CD " " .tib 4=1 40 Ya ^C a y, v p o § 5 taUi,t a) W Z` ai g a) 0 o i .p = 0 Crx,a a 0 oma'+' y.,^O o• �"n^ t+ r q a) °q �-[on map, p.-..... " a) O� "o so.,0, �'p 5 api cn '' s- O o o ocn+, m„ p o Com, m b +, s� 111144/1 o C om'bp d W cn 0 oUbirze qp Uo ,a , oqa doei c/1 i.,s' U te- a iw o --8 c9 dp 3 4°)A U ot° 0 44"..t � 000aop a) �`oCU o0 Cl) ,, .i a) a) o-60-0' o -0 w oas. a) �� Q CD ....❑cp o y N c �tia) � o ur 01) Ay0N' co a) y 0F^ ' o > aia+ >4i � -g ti 0�° a W � UIII) ,�..l ••••• 4., d o ; oc.) y as ) A yE 'o °ff CD = Q.) -... cl) tp • ca Li 4p.� >, �3 a) 6 day 0 CJ o 0 ^ G (3 y dap p L p b q U]O lig2U n, v c).n G4 U.w a C) to A2 m co .r1 / ct r=—� o -d�-t `)y o oa�w caa aA ani 0-ri 6 64°.6 3 Ct 2gx o 'd - ad v"v�� �iF, 2.c)-tg �, RHIIU IC U rl t 0.6 -8a.) mUMC oRVD ao io�4.-+ •- -( A � a w nUqi1i { iftilil o � to s"`s'• Abuser ... . . ... have threeoptions CONTINUED FROM Al support. III Still,more than 100 children "People have to be clean and theer before you can remain in out-of-home careaddress the other issues,"Martin said. supervised by the Port Angeles « CPS office. Early intervention is a key An additional 20 are super- as much as possible." vised from Forks. Martin said abusive parents need empathy,not censure. PENINSULA DAILY NEWS Fourteen are in foster homes "It's having empathy for • in Jefferson County those people whose doors you The agency can follow one of have to knock on,"she said. three routes when it finds that "We are their clean-and- Abuse: abuse or neglect has occurred sober support until they can Counselingor the police place a child or find"clean-and-sober support in children into CPS protective the community. custody. "We have a willingness to CONTINUED FROM A10 "If I didn't believe so, I ■ Return the child or chil- walk together with our clients." wouldn't be able to do this•ob dren to the parents. • But aren't addicts notorious Parents whose children have ) ," II Get theparents to workbeen removed from 'their care she said. backsliders? must undergo lengthy counsel- with the agency to recover cus- Not necessarily,said Martin,tody. "It's absolutely the last ing, but the process seems to OK,I can stopwritingnow. ■ Go to Dependency Court work,Martin said. Pe cY thing they want to have hap- « and take the child or childrenp have a pretty high rate What I can't stop are my pen,"• she said. of returningvisions of children whose mem- by court order. "Parents just feel terrible children to their parents after years of supervi- most house horrors beyond Martin, a 21-year veteran about•where they are" when sion," she said. most adults'imaginations. with CPS,can't pinpoint why a they ford themselves in court. All I can do is be on the look- parent or caregiver would Even relapsed addicts do' Of alla the"2004,ries hey office abuse a child. better, she said, because theyinvestigated in only 6 per- out for signs of abuse or neglect cent resulted in"removing,the in every child I meet. If I see "I'd be a whole lot richer if I have learned where to turn for child or children. Of that small such signs, I must summon could say, 'This is'the cause, parenting skills and support. share, only 1 percent became CPS or police. I hope you'll do she said. • Clients receive inpatient treat- Instead, she cites."a multi- ment in facilities similar to Permanso,too. Portnt. The tude of factors" that include halfway houses,then intensive, Angeles area has a" Just imagine the ha isolation and poverty, lack of outpatient counseling. network said.good foster parents, childhood you honevery social support, lack of family The children, too, get thee- Martm feelw thel have of turningtto child's "I " workd. really well par hands that child's own background: hard living and family apy from Peninsula Commu- together,"she said. parents. • nity Mental Health. They also "I think the state has better As Martin says: "It's'not a "It's a small, small number receive medical and dental care. of people who intentionallyAt Evergreen FamilyVil- screeningoto prepare potentialyf state issue.aIt's ua neighborhood � foster parents for the type of and a family issue." harm a child,"she said. lage in Port Angeles, parents child they'll take." I'd feel so 0 Still, she cites one common can live up to two years while' good if I could stop factor in manysituations; theyfind jobs and reassemble Can such effects of be abuse goodng about child abuse—for from the effects of'the abuse good. methamphetamine. It figures their lives. The village has a they've suffered? into 80 percent to 90 percent of daycare. Martin said she knows vic- Staffr cases,she said. The village is too 'small, _witer Jim Casey can Martin is a member of the however , said Martin. tiros who have completed high • be reached by e-mail at Col County adult drug "There's always a waiting fromschoocollel geone on to graduate, pen nsuladailynews.com. c "Business is good,"she said. TURN TO ABUSE/All "With methamphetamine; families fall apart quickly." An addict loses his or her house,job and family within six months,according to Martin. "It's just a wicked, wicked drug," she said. "We've watched it destroy adults before • our eyes, physically destroy them,mentally destroy them." Domestic violence is a fre- quent partner of meth abuse, she adds. i However, roads lead out of methamphetamine addiction, especially for abusers who seek • For immediate release: May 9, 2005 Contact: Michael McNickle, Environmental Health Director 360-385-9444 West Nile Virus Precautions Strongly Encouraged • The comingof spring has p g Jefferson County residents thinking of gardening, hiking and other outdoor fun. It's also time to think about preventing West Nile Virus infection. Jefferson County Health and Human Services (Public Health) says there's a lot you can do to protect yourself against mosquito-borne infection. West Nile virus is primarily a bird disease. Mosquitoes become infected by feeding on infected birds, and then pass the virus to other birds, humans, or horses. Mosquito season, when West Nile virus is of most concern, runs from spring through late fall. Experts believe that 20% of people bitten by an infected mosquito come down with West Nile fever, which may result in illness that ranges from mild to severe flu-like symptoms. One-in-150 infected people have more serious neurological illnesses such encephalitis or meningitis. The majority of people bitten by infected mosquitoes do not experience any symptoms. People over age 50 have the highest risk for serious illness. In 2004 the disease moved into Idaho and Oregon, Washington State was the only state in the lower 48 without cases. While West Nile virus wasn't detected in our state last year, it was confirmed in two horses and four dead birds in Washington in 2002. In 2003 West Nile virus killed over 250 people in the United States, and nearly 10,000 illnesses were confirmed by the Centers for Disease Control and Prevention (CDC). Many more people were likely sickened by the virus, but did not seek medical care. • What residents can do: ✓ Call Jefferson County Health and Human Services if they find a dead crow, raven, or jay. 360-385-9444. ✓ Reduce habitat and prepare the home. The mosquito life cycle is as little as 7 days. Mosquitoes need stagnant water for eggs and larva development. Tips for reducing habitat and preparing the home: ✓ Tip out barrels, buckets and wheelbarrows ✓ Tip out containers such as toys, cans or plant saucers ✓ Empty children's wading pools when not in use ✓ Change water in birdbaths and animal troughs at least once a week ✓ Get rid of used tires ✓ Clean garden ponds ✓ Recycle old bottles, buckets and cans ✓ Clean leaf-clogged gutters ✓ Empty water from flower pot dishes ✓ Dump water off of tarps and plastic sheeting ✓ Repair leaky outdoor faucets ✓ Cover rain barrels with mosquito screens ✓ Repair ripped windows and door screens and make sure they fit tight ✓ Consider adding a screen door to doors that often are left open Tips to avoid getting bitten when mosquitoes are out - often at dawn and dusk: ✓ Wear long sleeve shirts and long pants. Hats are also useful. ✓ Consider using an insect repellent. Repellents containing the chemical N,N-diethyl-meta- toluamide (DEET) are known to be very effective and safe. It is important to read the • label and follow the instructions on the label carefully. ✓ Long lasting and effective alternatives to products containing DEET are available. Insect repellents containing Picardin may be a good choice for some individuals. ✓ Repellents containing oil of lemon eucalyptus provide protection similar to those containing low concentrations of DEET. Horse owners are advised to vaccinate their horses against the disease. Plan details: Education: The Jefferson County Public Health Department plans to continue and increase the public education efforts that have been happening over the past three years. Surveillance: The surveillance portion of the plan calls for tracking bird deaths, mosquito problem areas, and larvae habitat throughout Jefferson County. Corvid birds, crows, ravens, magpies and jays are very susceptible to West Nile Virus. A small percentage of these birds will be tested for West Nile virus, but Public Health's emphasis is on recording where the dead birds were found. A spike in bird deaths may indicate that West Nile virus has arrived, and possibly the areas of the county where the virus is circulating. Dead birds reported but not tested will be used for tracking purposes. Control: Jefferson County Public Health will work with the Washington State Department of Health in collecting information on mosquito breeding habitats and areas of the county with mosquito problems. More information: • Jefferson County Health and Human Services: 1. www.jeffersoncountypublichealth.orq 2. For mosquito control questions: 360-385-9444; 3. For West Nile Virus disease questions: 360-385-9400 • To report a dead crow: 360-385-9444 • State Department of Health: www.doh.wa.gov/ehp/ts/Zoo/WNV/WNV.html The CDC's insect repellent use and safety page: www.cdc.gov/ncidod/dvbid/westnile/pa/insect repellent.htm • C Skookum �� JV £ FACTS N II Volume 3, Issue 9i i �i April 29,2005 JEFFERSON COUNTY ARD OF SSIONERS May Recyciingdes on ElectroniElectronics Birthdays T e• m-1 i � ° , ' '� : ` t'y ' Ae-,� 'an sc �.w,. ::-:.",...:41.,;-, +s,'�t,ci. �.. ,� ,. 1 ,,, ' ,' �" '. ' tea-'� ¢.,,,,,,."=; `.. ,...-,,,,%.:-...,,-,-, & .:i lo ::'," N65 � � t. '' §,, tea' r y,s,'a`,4v b Imo. ,� .* '1 { is ,F 1 Maurice Correia �� 4 s 1 Lynne Rossi 1 1 Demetria Strickland � � 2 Kenneth Lynn :A � ° y ---4S",•;--- u a .,,' N 1 Lemmons '� Dwayne Bradley Stedham County Commissioners visit Recycling Center to kick off Electronic Recycle Program.From left to right; Sandor Vansickle Richard Talbot,John Burke,David Sullivan,Phil Johnson and Pat Rogers. 0 Sylvan Wynn Patrick Marcus Jefferson County Commissioners Richard Olympics Swim team traveled to Federal Way 8 Marian Oaks Talbot,David Sullivan,Phil Johnson and last weekend to compete in the regional tour 9 Jonathon Crum Pat Rogers visited the recycle center to help nament.Skookum employee,Mike Henry, 9 Earl McLean kick off our new Electronics Recycling Pro- came home with a Gold medal while co- 9 Leah Lovel gram• Skookum has begun to accept elec- worker Janice Wilson brought home a bronze 10 David Povneer tronic equipment at the recycle center. Cus medal.The team had great fun and at the Wey- 11 Frank Farstad tomers will pay a 35 cent per Ib.fee to recy- erhaueser Aquatic Center.The Port Townsend 11 Sa Yoon Kim cle their electronic components.This exciting Sharks are now looking forward to the State 11 Jamiel Rodenhurst news will give residents of Jefferson County Tournament at Fort Lewis in the first weekend 12 Frank Dantzler an environmentally friendly option of dispos of June.I encourage anyone interestedew in vol- 13 Rodolfo Martinez ing of old and out-dated computer equipment. unteering to plan to be at this event.Every 13 Lance Perez The commissioners were thankful for the new athlete, volunteer, coach, sponsor,family 14 Teresa Paulino service and looking forward to the success of member or fan comes home a winner from this 16 Johnathan Dougherty this pilot program. great annual event.It's truly inspiring to be a part of it. Come join the fun! In other news,The Port Townsend Special -John J.Burke,Recycling Skookurn Inc. Coming in and Going mut 385 Benedict Street CIF remains busy as always.While continuing to send soldiers around the ° ,-,r—a , Port Townsend,u%A 98368 world, we see soldiers return after a year or more of deployment to various 1-800-255-9526 parts of the world in support of different operations. All are glad to return http://�tn� -.skooktun.org home and it is a pleasure to see their smiling faces and be able to expedite :.,,,,,,!::0, , • their return home. At the same time, we continue to prepare soldiers to de- Skye Wentworth,Editor ploy throughout the world to replace those who have returned.Next month,we will begin to pre 978-462-4453 pare for that C1F summer pastime--no,not Mariners baseball!—but the annual ROTC Leadership 4p10 s.wentworth@cerizon.net Camp.At the same time, we will be conducting our annual inventory. Thanks to all of the em ployees for your hard work! -Jessica Cooper, CIF New Data from Nurse-Family Partnership Shows Continued Success S ,Sprinkle always knew the lems in the borderline or clinical year as matching Medicaid funding developing child,he notes,as at Nurse-Family Partnership program range than children who did not is added to the tobacco money. least seven longitudinal studies she directs in Greensboro,N.C., receive visits,and many exhibited "The breadth of outcomes this show a relatively unique relation- worked well.After two-and-a-half behaviors suggesting they would program is able to produce is like ship between tobacco exposure in years of having a nurse visit them adjust well both academically and nothing else we have been able to the womb and severe antisocial and their new babies,many of the behaviorally in their elementary find,"says Atler."This is the gold behavior once children reach young,impoverished mothers in schools. standard for early-intervention adolescence. the program had secured jobs, "I was really excited about that," "a ro rms. P g The research shows that children had attended college,and had says Sprinkle. Colorado continues to support PP exposed to tobacco in the womb become better mothers than So was the program's founder the program.Although funding are also fussier and more irritable they ever thought they could. and the study's lead author,David for nearly all state programs has following delivery,are at greater risk But until Sprinkle read the results Olds,Ph.D.,professor of pediatrics been cut in recent years as the of having colic,and exhibit exacer- of a randomized controlled trial and director of the Prevention state's fiscal crisis worsened,the bations in the typical"terrible two" of a similar program in Memphis, Research Center for Family and Nurse-Family Partnership pro- behavior,all of which can affect Tenn.(published in the December Child Health at the University of gram continues to be fully funded. their relationship with their mother. 2004 issue of the journal Pedi- Colorado Health Sciences Center. "That's because its outcomes are "We also know that the nurse- atrics),she had no idea that the '"The conventional wisdom is phenomenal,"says Atler."We feel visited parents provided better can impact of the program extended that home-visiting programs,be- honored and privileged to help for their children in the first two so far beyond the child's 2-year cause they are focused on parental communities bring this program years of life,"says Olds."And that birthday,when the nurse visits behavior and not on altering the to families because we know it's the mothers started to improve ended.The Memphis site was one child's day-to-day experience like going to make a lifelong difference their own living conditions by of two original Nurse-Family Part- in a classroom,will have limited for parents and kids." spacing subsequent births,work- nership study sites(the other being impact on things like cognitive One reason for the program's ing more and staying off welfare Elmira,N.Y.)partially funded by performance and language func- impact,says Olds,is its ability to more.Those kinds of changes thalkert Wood Johnson Founda- tioning,"he says. affect prenatal health."We think in prenatal health and family tilt eventually led to repli- "But we find that with a that has a bearing on a child's later economic resources, cation programs Iike`Sprinkle's program that is well crafted and development,particularly neuro- home environment,in addition program in Greensboro. that alters several domains of logical functioning,"he says. to improvements in parenting,are The Pediatrics study,"Effects risk for compromised intellectual For instance,the nurses are very domains of functioning that other of Nurse Home Visiting on functioning,we have not only good at helping the mothers quit home visiting programs have had a Maternal Life-Course and Child improved children's intellectual smoking during pregnancy.That hard time affecting." Development:Age-Six Follow-Up functioning,but this effect endures can have a major impact on the of a Randomized Trial,"followed for years after the program ends. —Deena G O RDON 743 primarily African-American These children are simply better women residing in urban commu- prepared to enter school." nities who were randomly assigned Results like these led Invest ' Ft'a'1.,. ICar@1(pictured at right) to receive either nurse visits or in Kids,a nonprofit Denver- received the 2©05 Terrance Keenan comparison services beginning based organization that identi- leadership Award from Grantmakers' in midpregnancy and continuing fies research-based programs that in Health atthe.organ�zataon's annual, throughout their child's first two benefit children,to adopt the meetingon February 24 rn ah Francisco years of life. Nurse-Family Partnershipprogram The award whose l s anship nd Y P g grantmaker whose leadership antl ' The study found that four years in 1998 and work to implement thoughtful appileation ofphilanthropic ;` after the program ended,it Contin- it throughout the state.To obtain resourceshas'bad an impact onhgman 1 ued to produce positive effects on sustainable funding,Invest in Kids health at thelocat,regional natronalar ' the women,children and families convinced the state legislature to internalropal(eveh Aformer vire press; that participated.Specifically, earmark about$350 million in .Wodent of communications far tire1tobert - nurse-visited women had fewer tobacco-settlement funds to payneed 4sing cQ oundaca nonastr tegie neeretl«s�ngxPrnmunica�Rns strategies , _ subsequent pregnancies and births, for Nurse-Family Partnership asap integral part of project andpro,.• lesser use of welfare services,and programs over the next 25 yearsgram'decisions,treating a ei ew paradigm. lor'lationships with their According to Jennifer V Atler, in health philanthropy Hrstnnovative pa than women who did not Invest in Kids executive director, vision""for corpmunicatwns transformed receive the nurse visits.The chil- to date the programs have served h°W the Foundation does its work dren had sustained benefits as well: more than 4,000 families,a figure most had higher IQ and language that should grow 25 percent next scores and fewer behavioral prob-