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HomeMy WebLinkAbout2005-June File Copy • Jefferson County Board of Health .agenda • .Minutes June 16, 2005 • • JEFFERSON COUNTY BOARD OF HEALTH Thursday, June 16, 2005 2:30—4:30 PM Main Conference Room Jefferson Health and Human Services AGENDA I. Approval of Agenda II. Approval of Minutes of May 19, 2005 Board of Health Meeting III. Public Comments IV. Old Business and Informational Items 1. West Nile Virus Provider Alert 2. Avian Flu 3. Letter Re: On-Site Sewage Rule 4. E2SSB 5763-Omnibus Treatment of Mental and Substance Abuse 0Disorders Act of 2005 5. ServSafe Manager Certification Course V. New Business 1. Solid Waste Program—Board of Health as Jurisdictional Health Authority for RCW 70.95 2. Public Health Identity Communication Project 3. Powers and Duties of Local Boards of Health—Routine and Emergency 4. Joint Board Meeting—Potential Agenda Items VI. Activity Update VII. Agenda Planning VIII. Next Scheduled Meeting: July 21, 2005 2:30 PM-4:30 PM Site to be Announced • JEFFERSON COUNTY BOARD OF HEALTH ,f/"' MINUTES V Thursday,May 19,2005 Board Members: Staff Members: Phil Johnson-County Commissioner District#1 Jean Baldwin, Health &Human Services Director David Sullivan, Vice Chairman-County Commissioner District#2 Julia Danskin,Nursing Services Director Patrick M Rodgers-County Commissioner District#3 Thomas Locke,MD, Health Officer Geoffrey Masci, Chairman-Port Townsend City Council Jill Buhler-Hospital Commissioner District#2 Sheila Westerman-Citizen at Large(City) Roberta Frissell-Citizen at Large(County) Chairman Masci called the meeting to order at 2:38 p.m. in the Health Department Conference Room. All Board and Staff members were present,with the exception of Commissioner Rodgers and Member Frissell. There was a quorum. APPROVAL OF AGENDA Member Buhler moved to approve the agenda as written. Commissioner Johnson seconded • the motion,which carried by a unanimous vote. APPROVAL OF MINUTES Member Westerman moved to approve the retreat summary of April 21,2005, as written. Vice Chairman Sullivan seconded the motion,which carried by a unanimous vote. PUBLIC COMMENT—None OLD BUSINESS AND INFORMATIONAL ITEMS Region 2 Public Health Newsletter and Communicable Disease Report: Jean Baldwin's understanding was that this bi-monthly letter is mailed out of Kitsap to all medical providers. She agreed to confirm this and to suggest the publication also go to all CAM providers, such as chiropractors and acupuncture providers. Sexually Transmitted Disease Provider Letter: Dr.Tom Locke noted that he had offered this letter to healthcare providers for the Board's information. It was noted that the County's peak incidence of Chlamydia is"early and high." HEALTH BOARD MINUTES -May 19, 2005 Page: 2 • Press Release—Threatened Shellfish Areas: Environmental Health Director Mike McNickle explained that the State Department of Health had released this list of shellfish areas under threat of closure. For Jefferson County, it lists the southernmost parts of Discovery Bay and Port Townsend Bay. NEW BUSINESS Public Hearing—Jefferson County Food Code: Chairman Masci opened the hearing at 2:47 p.m. and reviewed the hearing guidelines. Dr. Locke provided background on the revision of the State Code, the intent of which was to create a consistent,statewide code that is in conformance with the federal code. Much of the existing County code is no longer needed because the State Code has been adopted by reference.The Jefferson County Code now will deal primarily with the administrative process. Staff borrowed language from the Methamphetamine Clandestine Lab Code, which had itself been drafted by an attorney to ensure its compliance with hearing procedures. He observed that administrative hearings on suspensions and appeals are rare,as are revocations.However, for these hearings the Board had specified a scheduling time period"...not less than 20 days"and"...not more than 30 days."He felt that while the 30-day figure seemed appropriate,he could fmd no purpose for this particular 20-day parameter. He recommended the Board amend the draft code to delete the 20-day language but to keep the current 15- & 30-day • language for an appeal. Chairman Masci noted that state law considers public notice to have been given when the information is e-mailed to the paper of record. Member Westerman moved to amend Food Service Sanitation Code Section 8.05.030,Hearings, A-1-Administrative Hearings,beginning with"Upon receipt of such..."to replace"convenient" with "acceptable." The motion was seconded by Member Buhler and carried by a unanimous vote. Member Buhler moved to amend Section 8.05.030(A)(1)and(B)(1)deleting the words "not less than 20 days"The motion was seconded by Commissioner Johnson and carried by a unanimous vote. Member Buhler expressed concern about the imprecise language in Section 8.05.030(A)(2)and(B)(2), which says, "The Health Officer may continue the hearing to another date."Dr. Locke agreed that in the interest of a timely process,an arbitrary time period could be set,such as 30 days.Member Buhler moved to amend Section 8.05.030(A)(2) and (B)(2)inserting a qualifier so that it instead reads, "The Health Officer may continue the hearing to another mutually acceptable date."The motion was seconded by Member Westerman and carried by a unanimous vote. Public Comment: None a r HEALTH BOARD MINUTES -May 19,2005 Page: 3 • Member Buhler moved to accept the Amended Chapter 8.05 Food Service Sanitation Code as presented adopting the underlined language and repealing the over struck language as well as the changes discussed above.The motion was seconded by Commissioner Johnson and carried by a unanimous vote. The hearing was closed at 3:04 p.m. Mission and Name of County Health Department: Jean Baldwin identified this as a discussion item carried over from the retreat,where key issues had been defining the mission, distinguishing the Department from the hospital, clarifying the roles of ensuring"public health"and providing health care.While the proposed mission is essentially that as was approved three years ago, she suggested that there was a perception that the department's present name is overly long and not explicit. It was felt that,in light of the impending remodeling,the expenses inherent in executing a change of name could be minimized. Member Westerman moved to accept the Staff recommendation to rename Jefferson County Health and Human Services to Jefferson County Public Health. Commissioner Johnson seconded the motion,which carried by a unanimous vote. The proposed change to the mission was to also change the name and add the word"safe." • Member Buhler moved to accept the Mission Statement as proposed by Staff adding the word "safe" and to reflect the department's new name.Member Westerman seconded the motion, which carried by a unanimous vote. Future of Assessment Activities in Jefferson County: Jean Baldwin reminded that this discussion had been tabled at the retreat. She distributed the Program Support/Costs by Key Areas as Defined by Washington State, a document that had not been readied before agenda packets were mailed. She discussed the availability of several surveys and reports—emergent diseases, school populations,jail occupancies, arrest records, etc.—but said the department lacks a staff person budgeted and assigned to enter the data. We are sitting on Healthy Youth data from all the school districts but are unable to integrate this statistically valuable information into the rest of the health indicators. The Department is being paid to collect and analyze data for projects but is not funded to integrate that into the community health impacts. Noting that the Department could combine"community attitudes"along with BRFSS, Chairman Masci asked whether after the CDC formatting charges and the survey company's additional charges there would be enough left over to fund the Staff person. He stressed that the value would be to establish a position, rather than to seek funding a one-shot project. Ms. Baldwin then explained that the attitudinal survey is being done without Staff involvement because we do not have the budget to do a program assessment.Even though during the retreat the Board had listed monitoring health status to identify community health problems as a top priority, I HEALTH BOARD MINUTES -May 19,2005 Page: 4 there is currently no person to do the analysis. She raised this issue as an informational item because • she would like the Board's permission to seek partners in the City, County and the hospital for grants or matching funds. Chairman Masci suggested that Jean define the role she is willing to play in developing these partnerships and added that the matter might be given more serious consideration were a Board member to accompany her to these discussions. Legislative Update—Live Bills,Dead Bills,Budget Forecasts: Dr. Locke reported that the session had adjourned on time after accomplishing quite a bit. For substance abuse, the percentage of support for treatment on-demand would increase. Funding is provided to develop an integrated mental health/substance abuse screening and assessment tool to be used by both the Mental Health Division and the Division of Alcohol and Substance Abuse. Awaiting a more stable funding source, backfill funding remains at$48 million for the biennium. Defeated was a bill that would have come up with a legislative committee to find a more stable source of funding. The deadline for proposals for consideration in the next biennium is June of 2006. The Department of Health received$1.3M to implement the on-site septic rule in marine counties. Also,there is $250,000 to increase participation in the WIC Farmer's Market Nutrition Program. Two negative impacts were reductions in the Coordinated Prevention Grant,which helps to support solid waste education activities, and stream-gauging funding. Julia Danskin reported that while important programs were funded, DSHS has yet to balance their • budget effectively to issue the contracts on time, resulting in negative impacts to Maternal Child Health and other programs. Vice Chairman Sullivan mentioned that the passage of Senator Hargrove's Omnibus Health Bill would provide a small amount of money for a broad range of issues, including mental health and substance abuse. Since the County Commissioners would have the authority to direct these funds,he suggested that the Law and Justice and Substance Abuse Advisory Boards join the Health Department in a meeting to discuss their best use. Laurie Strong agreed to provide Jean Baldwin a copy of the bill as passed. 2005 West Nile Fever Surveillance and Prevention Efforts: Dr. Locke noted that the agenda packet contained State and County press releases on West Nile Virus precautions. He then led a discussion of whether the Board would like to create a mosquito abatement district.Active surveillance was the method of prevention last year. The latest research says that the most effective way to prevent mosquito breeding is to spray an adulticide—Malathion. While a mosquito control district would be impractical to create at this point in the season, some level of mosquito abatement could be conducted if the citizens and the County Commissioners wanted to. Noting that there is neither county nor state funding, Chairman Masci asked if the County's junior taxing district could be expanded to include this activity? Dr. Locke explained the process as citizens voting to tax themselves for the sake of mosquito control. I • HEALTH BOARD MINUTES -May 19,2005 Page: 5 Mike McNickle noted that the experience of other areas is that the first priority in mosquito abatement must be education personal prevention,and referred to the effectiveness of a Mosquito Control District in Clarke County. He also mentioned that a press release should stress that property owners must take responsibility for landscape ponds and other likely breeding spots. Staff is moving into active surveillance. He sent a press release to the Peninsula Daily News to solicit about six volunteers to collect and test the types of mosquitoes in order to inform future control measures. Jefferson County Board of County Commissioner's Resolution re: Substance Abuse Advisory Board Oversight: Dr. Locke reviewed that as discussed at the retreat,members of the Substance Abuse Advisory Committee would in the future be appointed by the Board of Health and recommendations from the Substance Abuse Advisory Board would come to the Board of Health. Member Westerman moved that the Board of Health forward to the Board of County Commissioners the draft resolution requesting a change in the general oversight for the Substance Abuse Advisory Board from the Board of County Commissioners to the Board of Health.The motion was seconded by Commissioner Johnson and carried by a unanimous vote. Laurie Strong asked what this change in reporting relationship would mean and inquired what level of reporting would be necessary?If desired,the Substance Abuse Advisory Board is anxious to be vigorous with its reporting to the Board of Health. • Member Westerman asked to know more about the Substance Abuse Advisory Board and suggested there are advantages to a cross-pollination of the membership, such as with her participation on both the Developmental Disabilities Board and the Board of Health. Commissioner Johnson said he believed it would be more appropriate if the Substance Abuse Advisory Board members were to be selected by the Board of Health. ACTIVITY UPDATE/OTHER ANNOUNCEMENTS Member Westerman moved to accept Vice Chairman Sullivan's participation in the Board of Health meeting by telephone conference.The motion was seconded by Member Buhler and carried by a unanimous vote. The Board also expressed interest in having further discussion—at either the July or August meetings, and after consulting with Deputy Prosecuting Attorney Alvarez—about changing the requirement to have two of the three County Commissioners present to constitute a quorum at Board of Health meetings. Hospital District: Member Buhler explained that the recent Leader headline, "Jefferson Healthcare faces$2 million loss"was inappropriate. She provided background about the shift to the critical access designation and reviewed opportunities they have for controlling costs,mostly due to attrition. HEALTH BOARD MINUTES -May 19,2005 Page: 6 AGENDA PLANNING/ADJOURN • The meeting was adjourned at 4:20 p.m. The next meeting will be on June 16, 2005 at 2:30 p.m. in the Conference Room of the Jefferson County Health Depai tment. JEFFERSON COUNTY BOARD OF HEALTH Geoffrey Masci, Chairman Jill Buhler, Member David Sullivan, Vice Chairman Sheila Westerman,Member (Excused Absence) Phil Johnson, Member Roberta Frissell,Member (Excused Absence) Patrick M. Rodgers, Member • • • Board of Health OCdBusiness Agenda Item # rV., 1 • Nest Nile 'Virus Provider .Cert June 16, 2005 • STATE OF WASHINGTON DEPARTMENT OF HEALTH • Communicable Disease Epidemiology 1610 N.E. 150th Street•Shoreline, Washington 98155-7224 Tel: (206)418-5500•FAX: (206)418-5515 May 2, 2005 Dear Colleagues: Since the introduction of West Nile virus (WNV)into North America in 1999, the virus has been detected in birds,animals or mosquitoes in all 48 states of the contiguous United States and the District of Columbia. In 2004,WNV spread to the western U.S., with 829 human cases reported in California and locally-acquired human infections reported for the first time in Oregon and Idaho. In Washington,WNV activity affecting birds and horses was first reported in 2002; however, since then, viral activity has not been detected in birds, animals or humans here,although alert clinicians have diagnosed and reported several WNV infections in travelers exposed outside our state. West Nile virus is usually transmitted to humans by the bite of an infected mosquito,but the virus has also been transmitted by transfusion,transplantation and perinatally.While most people infected with West Nile virus have no symptoms,about 20%will develop fever,headache and fatigue,and occasionally,rash and lymphadenopathy (West Nile fever). Severe neuroinvasive disease occurs in less than 1%of infections, and is more common among patients 50 years of age and older. Neuroinvasive disease,including meningitis,encephalitis and acute flaccid paralysis,has a death rate of about 9%. Currently no human vaccine is available for the prevention of WNV • disease,and no treatment has been shown to be effective,however,clinical trials of vaccine and therapy are ongoing. The primary means of prevention of WNV infection is to avoid mosquito bites. In 2003,WNV infection became a provisionally notifiable condition in Washington, and in 2004,the State Board of Health revised Washington Administrative Code 246-101 to include Arboviral Diseases(infections caused by arthropod—borne viruses e.g.,WNV disease,dengue,Western and Eastern equine encephalitis,etc.)in the list of permanently notifiable conditions. We are asking for your continued assistance in monitoring arboviral diseases,including WNV disease in Washington State. Please report all suspected and laboratory confirmed WNV disease,including WNV fever and neuroinvasive disease,to your local health department or district. Your local health department, with the Washington State Department of Health(DOH)Communicable Disease Epidemiology Section and Public Health Laboratories,can facilitate laboratory confirmation of patients hospitalized with suspected WNV infection. Contact information for your local health department or district is available on the DOH website at: http://www.doh.wa.gov/LHJMap/LHJMap.htm For more information,call your local health department or the DOH Communicable Disease Epidemiology Section at 206.418.5500 or 877.539.4344. Attached is a list of references and websites that you may find useful. Sincerely, 4,,11, , Mira Leslie,DVM,MPH Jo Hofmann,MD State Public Health Veterinarian State Epidemiologist for Communicable Disease Enc: 1 • Board of 3--CeaCth Old Business .Agenda Item # _TV., 2 • .avian FCu June 16, 2005 • • Clinicians' Biosecurity Center for Biosecurity Network of UPMC CBN Weekly Bulletin for May 23, 2005 Clinical information for healthcare providers interested in biosecurity Unsubscribe The CBN Bulletin presents the editors'analysis of important current events in clinical biosecurity. Ebola Oubreak in Congo On May 18,the WHO reported that an outbreak of Ebola hemorrhagic fever was confirmed in the Republic of the Congo. The outbreak was apparently initiated by a family of hunters who contracted the disease after finding the body of a dead chimpanzee that they took home to eat.As of May 23,a total of 11 cases had been reported,including 9 deaths,and approximately 80 contacts were placed under surveillance for the development of symptoms. The outbreak was reported to be • under control after the implementation of swift infection control measures by local public health authorities. However,in 2003, approximately 150 people died from Ebola in the same area. Ebola virus was first identified in 1976 after outbreaks of acute hemorrhagic fever occurred in Sudan and Zaire(now Republic of the Congo). Ebola virus belongs to the Filoviridae family (which also includes the Marburg virus). There are four distinct subtypes of Ebola virus: Zaire, Sudan, Cote d'Ivoire, and Reston. The latter is not known to cause human illness. Case-fatality rates range from 50-90% in clinically ill persons, depending on the subtype. This is significant because along with a number of other "hemorrhagic fever viruses," Ebola is considered a Category A agent. However,there has never been a case of Ebola disease imported into the United States during outbreaks in Africa.This may be in part due to the fact that transmission of disease does not appear to occur prior to the development of symptoms. Additional information: WHO's Ebola hemorrhagic fever fact sheet number 103: CDC's fact sheet on Ebola hemorrhagic fever: Hemorrhagic fever viruses as biological weapons: • by Luciana Borio,M.D. • WHO: Pandemic Influenza Risk Increases This week, the WHO underscored the imminent threat posed by the current H5N1 outbreak in Southeast Asia. Speaking at the WHA,both Dr. Lee Jong-wook,Director-General of the WHO and U.S. Secretary of HHS,Mike Leavitt expressed dire concern about avian influenza, describing it as"the most serious health threat facing the world today" and an"urgent health challenge." On May 6-7, an urgent expert consultation meeting was held in Manila in response to new information indicating that"the epidemiology of H5N1 could be changing. . . and the risk for pandemic influenza could have risen."The expert panel noted specifically that in northern Viet Nam in the last 5 months: • There has been an increase in the number of clusters of cases in the north(8) as compared to the south(2). • The interval between the first and last cases in clusters in the north have prolonged,which is inconsistent with a discreet common source exposure. • The case fatality rate in the north has decreased. • Sub-clinical infections have been observed. • The age range of victims has expanded. • Although careful to say that this has not been proven,the expert group concluded that this pattern is consistent with human-to- human transmission and that the recently emerging H5N1 viruses are more infectious for humans.The implication is that the virus may be adapting to a human host,causing less mortality,infecting a greater range of people,and being spread person to person. In addition partial neuraminidase inhibitor resistance has been detected in one viral specimen.Neuraminidase inhibitors are the only antiviral drugs to which the current strain of H5N1 is sensitive. Finally,the group of experts commented on the lack of relevant surveillance information,the lack of antigenic and genetic information sharing, and the urgent need for countries and individual researchers to release information that has already been collected on the H5N1 viruses.As we have pointed out in previous articles, inadequate surveillance of the current outbreak undermines all other attempts at preparedness. by Eric Toner,M.D. • Board of 3-Cealth OCcfBusiness .agenda Item # TV., 3 Letter: On-Site Sewage RuCe June 16, 2005 • JEFFERSON COUNTY BOARD OF HEALTH • April 13, 2005 To Whom It May Concern: Jefferson County Board of Health supports recommendations in the draft rule Chapter 246-272A. We specifically support the following three Health District WAC recommendations: • Support the proposed Onsite Sewage System Draft Rule as currently written. • Support the development and implementation of the Local Plan for enhanced management of onsite sewage systems in marine counties (2SHB1458) only if funding is provided through the Legislature. • Continue to support the Health Department in its effort to ensure that onsite sewage systems are designed, installed, and maintained properly through the • approval of good sound regulations, which provide the highest level of protection for both the environment and public health. Jefferson County Board of Health supports the update of the Washington State Department of Health's proposed Draft Onsite Sewage System Rule, which is currently going through the Public Hearing process with the Washington State Board of Health. Thank you. David Sullivan Jefferson County Board of Health Co-Chair Jefferson County Commissioner • 615 Sheridan•Castle Hill Center•Port Townsend•WA (360)385-9400 • Board of Health OCdBusiness .agenda Item # 117., 4 � T2SSB .5763-Omnibus Treatment Of.Mental& Substance Abuse Disorders, Act of Zoos June 16, Zoos • Washington State Association 111 of Counties 206 TENTH AVE.S.E.,OLYMPIA,WASHINGTON 98501-1311 V TELEPHONE(360)753-1886•FAX (360)753-2842 E2SSB 5763,an act relating to creating the omnibus treatment of mental and substance abuse disorders act of 2005. This bill makes significant changes to the community mental health services act and both the mental health and chemical dependency involuntary treatment acts as well as other miscellaneous statutes. Key components include: 1. An intent section emphasizing the importance of better collaboration_and coordination of treatment for those persons with co-occurring disorders through the concrete actions taken in the act. 2. Requirement that no beds shall be closed at either state hospital until at least an equal number of community placements are available. 3. Requirement to implement the integrated screening and assessment process no later than January 1,2007. 4. Clarifying and merging where appropriate the definitions and information disclosure • sections of the community mental health services act,the involuntary treatment act, and the criminal insanity statutes to ensure rights of involuntarily committed person and confidentiality provisions are consistent and accurate. 5. ' Authority to co join the petitions for commitment under mental health and chemical dependency. 6. Creation of two integrated crisis response and involuntary treatment pilot programs for adults with resources allocated for both integrated services and secure detoxification services in the pilot areas by DSHS. The pilots will combine the crisis responder functions of the designated mental health professional and the designated chemical dependency specialist into a designated crisis responder who is authorized to complete investigations and detain a person for up to 72 hours. The pilots are to begin March 1, 2006. 7. Creates a new 14-day involuntary commitment for chemical dependency at the new secure detoxification facilities. 8. Creates two intensive case management pilot projects not to be co-located with the secure detox sites to demonstrate the impact of case management on high utilizers of emergency, crisis, and correctional facilities with an effective date of March 1,2006. 9.- The Washington State Institute for Public Policy(WSIPP)shall evaluate the pilots and recommend whether a single unified involuntary treatment act would be effective. 10.DSHS must expand chemical dependency treatment for medicaid eligible adults to 60% of need during FY 2007 and increase capacity for youth under 200%of the federal poverty level. 11.DSHS shall expand services for drug-affected and alcohol-affected mothers and infants; • 12. DSHS shall contract for chemical dependency professionals at each division of children and family services community services office. 13. Establishes a new type of facility licensed by DSHS to serve those persons who are not appropriately served in other existing facilities or programs commonly known as the "enhanced services facility". These facilities may serve persons such as those with behavioral disorders currently in nursing homes or persons with traumatic brain injury or dementia who don't require a hospital level of care. 14. The authority of a county to establish mental health and drug courts is clarified and a single therapeutic court for both is allowed. 15. DSHS shall reduce the waiting times for competency evaluations and restorations to the maximum possible within available funding and report on alternatives to addressing the increase in the forensic population and minimizing the waiting period. 16. JLARC is directed to investigate whether there are existing facilities in the state that could be converted to use as a regional jail for offenders with either mental or chemical dependency disorders or both,that need specialized housing and treatment and report back by December 15, 2005. 17. Additional clarify is provided to implement the provisions of SB 6358 regarding the exchange of communication between correctional facilities, law enforcement and treatment providers. 18. DSHS shall adopt no later than January 1,2006, an integrated and comprehensive screening and assessment process for chemical dependency and mental disorders. DOC is also required to the extent possible to utilize the same process. 19.By June 30,2006,DSHS shall develop and implement a matrix or set of matrices for • providing services using evidence-based,research-based,consensus-based practices, and promising practices that maximize a person's independence,recovery and employment and participation in treatment decisions. These practices and matrices shall be part of contracts with the RSNs and their providers. 20.DSHS shall attempt to identify and provide services for children who do not qualify for medicaid or RSN services. The RSN must at a minimum provide an evaluation of such children within available resources. 21.DSHS shall review existing children's mental health programs and services in collaboration with OSPI, the RSNs,local providers, and local school districts by December 31,2005. 22. WSIPP shall study the net short-run and long-run fiscal savings to state and local governments of implementing evidence-based treatment of chemical dependency and mental disorders and report by January 1,2006 and a final report by June 30,2006. 23.DSHS shall prioritize vendor rate increases to those chemical dependency and mental health providers or programs that maximize the use of evidence-based and research-based practices. 24. Each RSN shall provide for a separately funded mental health ombuds office that is independent of the RSN and maximizes the use of consumer advocates. 25.A county legislative authority may impose a 1/10th of one percent sales and use tax to be used solely for the purpose of providing new or expanded chemical dependency or mental health treatment services and for the operation of new of expanded therapeutic court programs. Funds collected under this section shall not be used to supplant existing • funding. Any county who authorizes the tax shall and any county may establish and • • operate a therapeutic court component for dependency proceedings designed to be effective for the court's size, location and resources. Such program may be combined with an existing drug or mental health court. 26. In a trailer amendment to HB 1290,DSHS may establish new RSN boundaries in any part of the state where more than one RSN chooses not to respond to or is unable to meet the requirements of the RFQ or is subject to reprocurement due to failure to comply with the contract requirements. 27. In a second trailer amendment to HB 1290,the section limiting the number of RSNs to no less than 8 or more than 14 is repealed. 28. The act takes effect July 1, 2005 except Sec. 503 which authorizes the therapeutic court and takes effect July 1, 2006. JWessman May 15,2005 • 411/ • d , Part II: Narrative Explanation sot II.A-Brief Description Of What The Measure Does That Has Fiscal Impact Briefly describe,by section number,the significant provisions of the bill,and any related workload or policy assumptions,that have revenue or expenditure impact on the responding agency. r Note: This fiscal note reflects E2SSB 5763. oh ovw Section 904 allows a new local sales and use tax to be imposed by counties to provide new or expanded chemical u dependency or mental health treatment services and for the operation of new or expanded therapeutic court programs.The err rate of tax is one-tenth of one percent of the selling price in the case of a sales tax,or value of the article used in the case of a use tax.This tax would be collected from those persons taxable by the state under chapters 82.08(State Sales Tax) arl and 82.12(Use Tax)RCW upon the occurrence of any taxable event within the county. ray Pira: Section 911.The act has an emergency effective date of July 1,2005,except for section 603 of this act which takes effect ff July 1,2006 and sections 302 through 374 of this act which take effect July 1,2009. II.B-Cash receipts Impact tits Briefly describe and quantify the cash receipts impact of the legislation on the responding agency,identifying the cash receipts provisions by section tt number and when appropriate the detail of the revenue sources. Briefly describe the factual basis of the assumptions and the method by which the iC cash receipts impact is derived Explain how workload assumptions translate into estimates. Distinguish between one time and ongoingfunctions Fol ASSUMPTIONS/DATA SOURCES l" Department of Revenue data were used for the estimates. ka ac: It is assumed that the state would receive 1 percent of collections for administrative costs. Counties will receive seven en months of distributions in FY 2006 due to an anticipated October 1,2005,implementation date. .I For illustration purposes,the revenue estimates below are based on every county in the state levying the new tax and the table shows county level detail of potential tax revenues. no CURRENTLY REPORTING TAXPAYERS(Impact for taxpayers who are known or estimated to be currently paying the pc tax in question) e Ihi This bill has no direct impact on state revenues,but the state would retain 1 percent of collections for administi alive costs. '�a TOTAL REVENUE IMPACT: �Vb State Government(cash basis,$000):Estimated administrative costs for a statewide 1 percent local tax. fa] FY 2006- $ 823 FY 2007- $ 1,033 .4c _ ± 4 Local Government,if applicable(cash basis,$000):Total local revenues for statewide tax. FY 2006- $ 81,481 Irk FY 2007- $ 103,288 ton 4th 'i t The following table shows the potential tax by county. 'fhh Potential Yield of 0.1 Percent Additional Local Sales Tax*for Senate Bill 5763 • Fiscal Year 2006** Fiscal Year 2007 dol Request# 5763-3-i _ _ D11-u <-7A1 F-2SSi dams $137,700 174,600 otin' 409,700 519,400 enton 1,881,300 2,384,800 helan967,700 1;226,700 1" iii 710,400 900,600 3,467,400 4,395,300 olumbia 24,400 30,900 owlitz 1,006,800 1,276,300 1 ouglas 300,000 380,300 erry 27,000 34,300 ranklin 683,500 866,400 arfield 15,000 19,000 , rant 693,200 878,700 . rays Harbor 623,100 789,800 .land 573,400 726,900 -fferson 273,500 ' 346,700 i g 32,936,100 41,750,500 'trap 2,586,200 3,278,300 ittitas 429,200 544,000 ickitat 122,700 155,500 - `"' - -wis 803,300 1,018,300 incoln 61,300 77,700 ason 367,300 465,600 tkanogan 303,000 384,000 acific 139,200 176,400 end Oreille 56,300 71,300 -erce 8,797,800 11,152,200 • 7 281,800 357,200 OW 1,766,300 2,239,100 amania 64,000 81,200 nohomish 7,229,400 9,164,100 ,pokane 5,419,800 6,870,200 tevens 238,900 302,900 e) i urston 2,839,400 3,599,200 J C. ... 10,, ,,,, a4L ahkiakum 15,800 20,100 01Q.,,,-- -(7,e_,,alla Walla 510,300 646,800vM 1 atcom 2,255,800 2,859,600el ifil _I ' itman 327,100 414,700 `+, / / lak---'/ akima 2,136,300 2,708,000 (00 , /a A ) Net receipts after deduction of 1 percent state administration fee. 1(419 Cg- ,. *Seven months of cash receipts with tax implemented on October 1,2005. v 4 r 0 C-Expenditures C ( rn "efly describe the agency expenditures necessary to implement this legislation(or savings resulting from this legislation),identifying by section tuber the provisions of the legislation that result in the expenchtures(or savings). Briefly describe the factual basis of the assumptions and the thod by which the expenditure impact is derived Explain how workload assumptions translate into cost estimates. Distinguish between one time Ed ongoing functions. Ile Department will incur implementation costs of$29,900 in FY 2006 and$15,500 in FY 2007,for a 2005-07 Biennium tal of$45,400. i e F 006 costs include: 3 ded)FIE(which represents 468 hours)at an Excise Tax Examiner 3 level to monitor,review,and maintain a 'ollection and disttibution report. Request# 5763-3-1 Form FN(Rev 1/00) 3 Bill# 5763 E 2S SB • Board of 3-Cealth Old Business .agenda Item # 5 • ServSafe Nlanager Certification Course June 16, zoos • 45°N JEFFERSON COUNTY PUBLIC HEALTH oti�� ' Always Working for a Safer and Healthier Jefferson 0 -4).--,,,,,c0 ServSafe Manager Certification Course Tuesday June 28, 2005, noon to 6 pm Jefferson County Courthouse, Lower Level, Chambers, Port Townsend Course Objectives As of May 2, 2005, the person in charge at food service establishments must demonstrate knowledge of food safety during an inspection. One way to meet this requirement is to be certified with ServSafe. Upon completing this course and passing the exam you will receive this certification and a five year Washington State Food Worker card. This course is an industry and regulatory standard for food safety training. It is designed by the National Restaurant Association Education Foundation. You will recognize common foodborne pathogens, the conditions they need to make someone sick, the steps you can take to prevent bacterial growth, transmission of viruses, bacteria and other illness-causing agents to customers, what to do if an outbreak occurs. • You will recognize the most common risk factors for foodborne illness in food service and how to minimize them. You will learn basic food safety regulations and how to apply them. You will be able to use Hazard Analysis Critical Control Points (HACCP)in your establishment. Registration Please submit this registration form to Jefferson County Public Health, 615 Sheridan, Port Townsend, WA 98368, attn. Dana, by June 21 with the class fee of $181 payable to JCHHS. You can pick up a textbook here as soon as we receive payment and registration. You need to study the book prior to class day to be successful. Name Address (mailing) Phone number Where you work Do you have any special needs? Bring textbook, and photo ID to class. We will take breaks. Call Dana for info:379-4496. • 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 31- ealth New Business .agenda Item # 1 • Solid Waste Program - B031- as jurisdictIonaf3-Leaftli June 16, ZooS b Page 1 of 3 RCW 70.95.010 Legislative finding--Priorities -- Goals. he legislature finds: (1) Continuing technological changes in methods of manufacture,packaging, and marketing of consumer products,together with the economic and population growth of this state, the rising affluence of its citizens, and its expanding industrial activity have created new and ever-mounting problems involving disposal of garbage, refuse, and solid waste materials resulting from domestic, agricultural, and industrial activities. (2) Traditional methods of disposing of solid wastes in this state are no longer adequate to meet the ever-increasing problem. Improper methods and practices of handling and disposal of solid wastes pollute our land, air and water resources, blight our countryside, adversely affect land values, and damage the overall quality of our environment. (3) Considerations of natural resource limitations, energy shortages, economics and the environment make necessary the development and implementation of solid waste recovery and/or recycling plans and programs. (4) Waste reduction must become a fundamental strategy of solid waste management. It is therefore necessary to change manufacturing and purchasing practices and waste generation behaviors to reduce the amount of waste that becomes a governmental responsibility. (5) Source separation of waste must become a fundamental strategy of solid waste .anagement. Collection and handling strategies should have, as an ultimate goal,the source separation of all materials with resource value or environmental hazard. (6)(a) It should be the goal of every person and business to minimize their production of wastes and to separate recyclable or hazardous materials from mixed waste. (b) It is the responsibility of state, county, and city governments to provide for a waste management infrastructure to fully implement waste reduction and source separation strategies and to process and dispose of remaining wastes in a manner that is environmentally safe and economically sound. It is further the responsibility of state, county, and city governments to monitor the cost-effectiveness and environmental safety of combusting separated waste, processing mixed municipal solid waste, and recycling programs. (c) It is the responsibility of county and city governments to assume primary responsibility for solid waste management and to develop and implement aggressive and effective waste reduction and source separation strategies. (d) It is the responsibility of state government to ensure that local governments are providing adequate source reduction and separation opportunities and incentives to all, including persons in both rural and urban areas, and nonresidential waste generators such as commercial, industrial, and institutional entities,recognizing the need to provide exibility to accommodate differing population densities, distances to and availability of ycling markets, and collection and disposal costs in each community; and to provide county and city governments with adequate technical resources to accomplish this responsibility. http://www.leg.wa.gov/RCW/index.cfm?fuseaction=Section&Section=70.95.010&printver=1 6/9/2005 A Page 2 of 3 (7) Environmental and economic considerations in solving the state's solid waste management problems requires strong consideration by local governments of regional solutions and intergovernmental cooperation. • (8) The following priorities for the collection, handling, management and mana ement of solid waste are necessary and should be followed in descending order as applicable: (a) Waste reduction; (b) Recycling, with source separation of recyclable materials as the preferred method; (c) Energy recovery, incineration, or landfill of separated waste; (d) Energy recovery, incineration, or landfill of mixed municipal solid wastes. (9) It is the state's goal to achieve a fifty percent recycling rate by 2007. (10) It is the state's goal that programs be established to eliminate residential or commercial yard debris in landfills by 2012 in those areas where alternatives to disposal are readily available and effective. (11) Steps should be taken to make recycling at least as affordable and convenient to the ratepayer as mixed waste disposal. (12) It is necessary to compile and maintain adequate data on the types and quantities of solid waste that are being generated and to monitor how the various types of solid waste are being managed. • (13) Vehicle batteries should be recycled and the disposal of vehicle batteries into landfills or incinerators should be discontinued. (14) Excessive and nonrecyclable packaging of products should be avoided. (15) Comprehensive education should be conducted throughout the state so that people are informed of the need to reduce, source separate, and recycle solid waste. (16)All governmental entities in the state should set an example by implementing aggressive waste reduction and recycling programs at their workplaces and by purchasing products that are made from recycled materials and are recyclable. (17) To ensure the safe and efficient operations of solid waste disposal facilities, it is necessary for operators and regulators of landfills and incinerators to receive training and certification. (18) It is necessary to provide adequate funding to all levels of government so that successful waste reduction and recycling programs can be implemented. (19) The development of stable and expanding markets for recyclable materials is critical to the long-term success of the state's recycling goals. Market development must be encouraged on a state, regional, and national basis to maximize its effectiveness. The state . shall assume primary responsibility for the development of a multifaceted market development program to carry out the purposes of this act. http://www.leg.wa.gov/RC W/index.cfm?fuseaction=Section&Section=70.95.010&printver=1 6/9/2005 Page 3 of 3 (20) There is an imperative need to anticipate,plan for, and accomplish effective storage, control, recovery, and recycling of discarded tires and other problem wastes with the subsequent conservation of resources and energy. II/002 c 299 §3; 1989 c 431 § 1; 1985 c 345 § 1; 1984 c 123 § 1; 1975-'76 2nd ex.s.c 41 § 1; 1969 ex.s.c 134 § 1.] • • http://www.leg.wa.gov/RC W/index.cfm?fuseaction=Section&Section=70.95.010&printver=1 6/9/2005 Page 1 of 1 RCW 70.95.160 Local board of health regulations to implement the comprehensive plan-- Section not to be construed to authorize counties to operate system. •Each county, or any city, or jurisdictional board of health shall adopt regulations or ordinances governing solid waste handling implementing the comprehensive solid waste management plan covering storage, collection, transportation,treatment, utilization, processing and final disposal including but not limited to the issuance of permits and the establishment of minimum levels and types of service for any aspect of solid waste handling. County regulations or ordinances adopted regarding levels and types of service shall not apply within the limits of any city where the city has by local ordinance determined that the county shall not exercise such powers within the corporate limits of the city. Such regulations or ordinances shall assure that solid waste storage and disposal facilities are located, maintained, and operated in a manner so as properly to protect the public health,prevent air and water pollution, are consistent with the priorities established in RCW 70.95.010, and avoid the creation of nuisances. Such regulations or ordinances may be more stringent than the minimum functional standards adopted by the department. Regulations or ordinances adopted by counties, cities, or jurisdictional boards of health shall be filed with the department. Nothing in this section shall be construed to authorize the operation of a solid waste collection system by counties. [1989 c 431 § 10; 1988 c 127 §29; 1969 ex.s.c 134 § 16.] • • http://www.leg.wa.gov/RC W/index.cfm?fuseaction=Section&Section=70.95.160&printver=1 6/9/2005 Page 1 of 1 RCW 70.95.163 Local health departments may contract with the department of ecology. y jurisdictional health department and the department of ecology may enter into an reement providing for the exercise by the department of ecology of any power that is specified in the contract and that is granted to the jurisdictional health department under this chapter. However, the jurisdictional health department shall have the approval of the legislative authority or authorities it serves before entering into any such agreement with the department of ecology. [1989 c 431 § 16.] http://www.leg.wa.gov/RC W/index.cfm?fuseaction=Section&Section=70.95.163&printver=1 6/9/2005 Page 1 of 1 RCW 70.95.180 Permit for solid waste handling facility --Applications, fee. (1)Applications for permits to operate a new or modified solid waste handling facility • shall be on forms prescribed by the department and shall contain a description of the proposed facilities and operations at the site,plans and specifications for any new or additional facilities to be constructed, and such other information as the jurisdictional health department may deem necessary in order to determine whether the site and solid waste disposal facilities located thereon will comply with local and state regulations. (2)Upon receipt of an application for a permit to establish or modify a solid waste handling facility,the jurisdictional health department shall refer one copy of the application to the department which shall report its findings to the jurisdictional health department. (3) The jurisdictional health department shall investigate every application as may be necessary to determine whether a proposed or modified site and facilities meet all solid waste, air, and other applicable laws and regulations, and conforms with the approved comprehensive solid waste handling plan, and complies with all zoning requirements. (4) When the jurisdictional health department finds that the permit should be issued, it shall issue such permit. Every application shall be approved or disapproved within ninety days after its receipt by the jurisdictional health department. (5) The jurisdictional board of health may establish reasonable fees for permits and renewal of permits. All permit fees collected by the health department shall be deposited in the treasury and to the account from which the health department's operating expenses are 1111 paid. [1997 c 213 §3; 1988 c 127 §30; 1969 ex.s. c 134 § 18.] • http://www.leg.wa.gov/RC W/index.cfm?fuseaction=Section&Section=70.95.180&printver=1 6/9/2005 Board of 3-feaCth Netiv Business Agenda Item # T., 2 Pu6Cic 3fealth Identity Communication Project June 16, Zoos • I,IJ j of * .x tet` -� ^ •y 4. in .II "� {,e - ♦/ E Oam s13 I = i`Jt y `x w4 i. U► O i V p m - d� rN N '" N i c r.Z „ ida r +- a >.a emsr3 •.a \r a s • Z. — c-1Grj y Zi P41. . 4- =� . N N a y • = 0 v tit i . , 0 Cn 0 2 13 3,_ , , :, ia6. ‘ ZA . stin a« .. c= a s Via s _•d i y,,, V, 0 '' Ei$ . ‘ 4. C V° ,.. aaa =,,,,..,,,,Liw,..1.,.i, 4. ' , ,,...,-:k--4.01 ,' -..., r -3.1 .c... a= = E i= OS,, OsLO f o= ri:1-: a. Tj M1 W O _ in fit,: I i.om�: if kms- }fi ,ti\ h, 3 Gf RasT i ,,'♦• s.„.i'.:,,,t fia� Sr = s r 1--.4:„,., Vi $ h Is �� � T O vi max ,.. :z''''''' r d a 'm 3 HAtZe cA. c A. -_ i J .? 5 y d S a p O 1 s �. ®® L a . r u Ittlt- H E -aa = iA c ° E v W a PUBLIC HEALTH ALWAYS WORKING FOR A SAFER AND HEALTHIER WASHINGTON • Background: Washington's public health identity campaign The campaign to improve public understanding of public health services in Washington State came about in reaction to the findings of a 1996 Harris Poll, which reported that, "Few Americans have any real idea what the words `public health' mean. However, almost everyone thinks that several of the key components of public health are very important, even more important in some cases than the medical care of people who are sick." In response, a committee was formed under the auspices of Washington's Public Health Improvement Partnership, and representatives from state and local public health organizations set about creating a stronger identity for public health. This work was undertaken with the widespread belief that if Washington's public health community is to succeed in distinguishing itself from other public services and obtaining recognition and credibility for the important work it does, the many state and local partners that form the public health system need to begin to communicate in a more common and consistent manner. Even with the higher profile brought on by current events,the connection between the services people value and the agencies that provide them is weak. A more recent Harris Poll concludes that "most public health activities—such as health promotion and disease prevention, immunization,reducing environmental risks, and scientific research into the causes and prevention of disease—are seen by almost everyone as extremely important, whether or not they are thought of as `public health.'" • • PHIP Implementation Toolkit • 2 PUBLIC HEALTH ALWAYS WORKING FOR SAFER AND HEALTHIER WASHINGTON Public Health Identity Implementation Plan S The implementation plan is a roadmap for how and why to use the public health identity platform in your work. Refer to the plan for more information on each tactic and for tips about incorporating it into existing communication tools. The following is the plan in its entirety and it can also be accessed on the website at http://www.doh.wa.gov/phip/communications/tools/. Executive Summary What: A communications plan designed to increase public understanding of, and support for, public health in Washington through the use of a new research-based identity platform. Why: Research shows public health is not well understood by the public. In order to successfully achieve our public health mission in Washington, public health employees at the state and local level can help educate key audiences about what public health is and isn't and how it contributes to the health of our state. Who: This plan is designed for use by leaders and communicators in local and statewide public health agencies in Washington. When: Now! The new identity platform and messages are already being used by many organizations around the state. How: Read on! This plan gives you step-by-step ideas and tools to implement the new public health identity platform. Developed by: The PHIP (Public Health Improvement Partnership) is a statewide coalition of public health agencies, convened under the auspices of the Department of Health in Washington State.PHIP is charged with the responsibility of assessing public perception of public health and designing and implementing improvements as needed across the state. • PHIP Implementation Toolkit 5 PUBLIC HEALTH ALWAYS WORKING FOR A SAFER AND HEALTHIER WASHINGTON • Using the Identity Platform What is an identity platform? The identity platform consists of an overarching theme and supporting ideas that explain public health's mission. It was developed using consumer, stakeholder and public health employee input. The identity theme is: "Always working for a safer and healthier Washington." This statement reflects what both internal and external audiences felt was valuable and unique about public health agencies in Washington. The theme is supported with three key ideas, or sub-themes, that answer the question of"how?"These sub-themes are: • Essential programs for improving health • Information that works • Protecting you and your family every day These ideas represent the concepts that consumers, stakeholders and public health leaders and employees felt were the most valued and unique about public health. More detailed information about the identity platform work is available at http://www.doh.wa.gov/phip/communications/tools/. How do I use the identity platform? The identity platform can be used in all of your materials. At the most basic level, it is language that helps connect your agency and programs to the value of public health in the state. Some agencies have already begun using it and a few examples are provided below. The identity theme phrase, "Always working for a safer and healthier Washington"can be used as a headline in an ad, in brochure or news release copy, on PowerPoint slides, in speeches, in radio and TV spots, on signage, etc. In order for it to be effective with the public, it should be included consistently on as many communications pieces as possible. Here are some examples: Transit ad: SPOKANE REGIONAL Always working for a safer H LTH DISTRICT and healthier community www.srhd.org 4111 PHIP Implementation Toolkit 9 PUBLIC HEALTH ALWAYS WORKING FOR A SAFER AND HEALTHIER WASHINGTON Program brochure copy: • "The communicable disease control program is one of the many ways that the Skagit County Public Health Department is always working for a safer and healthier Washington." Website copy: Public Health-Seattle& King County's Food Protection Program is always working for a safer and healthier community through education and the regulation of food service establishments. In Seattle and King County, there are nearly 10,000 "permitted" permanent food establishments, including restaurants, food and espresso carts, coffee shops, delis and the fresh food sections of grocery stores. Each of these establishments has owners, managers and employees who have passed a test on handling food safely and received a food worker card. In addition, Public Health Environmental Health Specialists inspect establishments several times each year and,if requested, offer an educational session for staff. How do I use the identity platform with my own agency's logo and identity? The identity theme is designed to support your agency's identity—not replace it. The examples above illustrate how some organizations have used the theme to describe the work of their agency in their community. What tools are available for my use? Several tools are available on the website at http://www.doh.wa.gov/phip/communications/tools/and include: • Communication tools–PowerPoint presentations, key messages, and standard language about public health. • A public information kit–Fact sheets, news release formats and samples of customized materials. • Brochure- "Public Health and You"–Promotes the public health network in Washington. Two versions are available, and you can customize them to suit your programs and your communities • Public Service Advertising–Four print ads featuring customizable formats. • Photo library–A bank of high-quality unlimited usage photos to use in communication materials to show all the ways public health is working in communities • Special event planning guide–A step-by-step guide including planning tips, samples of tools and templates for planning a public health event. • Posters–Two posters to promote public health in Washington. One version is designed as a stand- alone piece for lobbies and public spaces and the other is customizable for upcoming events. • Graphics and guidelines–Graphic elements,templates, tools and photos of the identity campaign and how to use them. • The communications plan–A coordinated set of strategies and tactics with tips on getting involved and tools to assist all partners in Washington's public health campaign. • Audience research reports–Two reports on the research that formed the basis for the communications campaign. • PHIP Implementation Toolkit 10 PUBLIC HEALTH ALWAYS WORKING FOR A SAFER AND HEALTHIER WASHINGTON • Six easy steps to implement the identityplatform in communications: your 1. Identify communication pieces in which you could add the new identity theme. Consider: website, brochures, flyers, news releases, banners, PowerPoint presentations, speeches, reports, PSAs or advertisements. 2. As you reprint and update materials, add the identity platform language. 3. When creating materials for specific audiences (like policy makers, media, or business leaders), consult the "messages at a glance"chart for tailoring messages (see page 9). 4. Visit our website http://www.doh.wa.gov/phip/communications/tools/to download ready-to- use tools like boilerplate language, a PowerPoint slide template and a print ad template. 5. Launch the new identity platform internally at your agency and train employees on its use. A training presentation is available on http://www.doh.wa.gov/phip/communications/tools/. 6. If you need assistance, or want to discuss the use of the identity platform, call one of the members of the PHIP Communications &Marketing Committee. The roster is in Appendix A. Audiences Different audiences have different information needs. For instance, a member of the media relies on a public health agency as a resource when covering a story on a disease outbreak. A policy maker may need information about how your local agency fits into the statewide or national public health network. Ideally, you want to educate both about the value and unique nature of the work your agency does in public health. The following chart outlines key audiences and the desired outcome for each: y ..., General public • Understand the value of public health and how they benefit • Support and participate in public health initiatives Business leaders • Understand the value of public health and how their business benefits • Support public health as a partner when applicable Policy makers • Understand the value of public health and how the public benefits • Understand public health's critical functions, network and funding structure Media • Understand the value of public health and how the public benefits • Use public health leaders and communicators as resources when covering stories Partners • Understand the value of public health and how they benefit • Serve as ambassadors for public health Public health agency • Understand and use the identity platform in daily work workforce • Serve as ambassadors for public health identity Different audiences respond to different messages. The chart on the following page shows the various S target audiences and what information and themes are important to them (based on the research). This chart will help you develop those messages that will most effectively support the overarching theme of how public agencies are"always working for a safer and healthier Washington." PHIP Implementation Toolkit 11 • Board of Health Netiv Business .agenda Item # 'V., 3 • Towers & Duties of Local Boards of 3{ealth - Routine & Emergency June 16, 2005 i RCW 70 . 05 CHAPTER Page 1 of 16 Chapter 70.05 RCW LOCAL HEALTH DEPARTMENTS, BOARDS, OFFICERS -- REGULATIONS diCW SECTIONS 70.05.010 Definitions. 70.05.030 Counties --Local health board -- Jurisdiction. 70.05.035 Home rule charter-- Local board of health. 70.05.040 Local board of health -- Chair --Administrative officer-- Vacancies. 70.05.045 Administrative officer-- Responsibilities. 70.05.050 Local health officer -- Qualifications --Employment of personnel -- Salary and expenses. 70.05.051 Local health officer-- Qualifications. 70.05.053 Provisionally qualified local health officers -- Appointment-- Term -- Requirements. 70.05.0.54 Provisionally qualified local health officers -- In-service public health orientation program. 70.05.055 Provisionally qualified local health officers -- Interview-- Evaluation as to qualification as local public health officer. 70.05.060 Powers and duties of local board of health. 70.05.070 Local health officer -- Powers and duties. 70.05.072 Local health officer --Authority to grant waiver from on-site sewage system requirements. 70.05.074 On-site sewage system permits --Application-- Limitation of alternative sewage systems. 70..05.077 Department of health -- Training -- On-site sewage systems --Application of the waiver authority -- Topics -- Availability. 411.05.080 Local health officer -- Failure to appoint -- Procedure. 70.05.090 Physicians to report diseases. 70.05.100 Determination of character of disease. 70.05.11.0 Local health officials and physicians to report contagious diseases. 70.05.120 Violations -- Remedies -- Penalties. 7.0..05.125 County public health account-- Distribution to local public health jurisdictions. 70.05.130 Expenses of state,health district, or county in enforcing health laws and rules -- Payment by county. 70.05.1.35 Treasurer-- District funds -- Contributions by counties and cities. 70.05.140 County to bear expense of providing public health services. 70.05.150 Contracts for sale or purchase of health services authorized. 70.05.160 Moratorium on water, sewer hookups, or septic systems -- Public hearing -- Limitation on length. 70.05.170 Child mortality review. 70.05.180 Infectious disease testing -- Good samaritans-- Rules. NOTES: Health districts: Chapter 70.46 RCW. ete board of health: Chapter 43.20 RCW. http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 RCW 70 . 05 CHAPTER Page 2 of 16 RCW 70.05.010 Definitions. For the purposes of chapters 70.05 and 70.46 RCW and unless the context thereof clearly indicates to the contrary: (1) "Local health departments" means the county or district which provides public health services to persons within the area. (2) "Local health officer" means the legally qualified physician who has been appointed as the health officer for the county or district public health department. (3) "Local board of health" means the county or district board of health. (4) "Health district" means all the territory consisting of one or more counties organized pursuant to the provisions of chapters 70.05 and 70.46 RCW. (5) "Department" means the department of health. [1993 c 492 §234; 1967 ex.s. c 51 § 1.] NOTES: Findings --Intent-- 1993 c 492: See notes following RCW 43.20.050. Short title -- Severability-- Savings -- Captions not law --Reservation of legislative power--Effective dates -- 1993 c 492: See RCW 43.72.910 through 43.72.915. Severability-- 1967 ex.s. c 51: "If any provision of this act, or its application to any person or circumstance is held invalid,the remainder of the act, or the application of the provision to other persons or circumstances is not affected." [1967 ex.s. c 51 § 24.] RCW 70.05.030 Counties -- Local health board --Jurisdiction. In counties without a home rule charter,the board of county commissioners shall constitute the local board of health, unless the county is part of a health district pursuant to chapter 70.46 RCW. The jurisdiction of the local board of health shall be coextensive with the boundaries of said county. The board of county commissioners may, at its discretion, adopt an ordinance expanding the size and composition of the board of health to include elected officials from cities and towns and persons other than elected officials as members so long as persons other than elected officials do not constitute a majority. An ordinance adopted under this section shall include provisions for the appointment,term, and compensation, or reimbursement of expenses. [1995 c 43 §6; 1993 c 492 §235; 1967 ex.s.c 51 §3.] NOTES: Effective dates -- Contingent effective dates -- 1995 c 43: "(1) Sections 15 and 16 of this act are necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its • existing public institutions, and shall take effect June 30, 1995. (2) Sections 1 through 5, 12, and 13 of this act are necessary for the immediate preservation of the public http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 -RCW 70 . 05 CHAPTER Page 3 of 16 peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect July 1, 1995. (3) Section 9 of this act is necessary for the immediate preservation of the public peace, health, or safety, or ip, 95pport of the state government and its existing public institutions, and shall take effect immediately ly [April 17, (4) *Sections 6 through 8, 10, and 11 of this act take effect January 1, 1996, if funding of at least two million two hundred fifty thousand dollars, is provided by June 30, 1995, in the 1995 omnibus appropriations act or as a result of the passage of Senate Bill No. 6058, to implement the changes in public health governance as outlined in this act. If such funding is not provided, sections 6 through 8, 10, and 11 of this act shall take effect January 1, 1998." [1995 c 43 § 17.] *Reviser's note: The 1995 omnibus appropriations act, chapter 18, Laws of 1995 2nd sp. sess.provided two million two hundred fifty thousand dollars. Severability-- 1995 c 43: See note following RCW 43.70.570. Findings -- Intent-- 1993 c 492: See notes following RCW 43.20.050. Short title -- Severability-- Savings -- Captions not law-- Reservation of legislative power--Effective dates -- 1993 c 492: See RCW 43.72.910 through 43.72.915. RCW 70.05.035 Home rule charter-- Local board of health. counties with a home rule charter, the county legislative authority may prescribe the membership and selection process for the board. he�county legislative authority mayl establish a local board of heath appanoint to the board of health elected officials from cities and towns and persons other than elected officials as members so long as persons other than elected officials do not constitute a majority. The county legislative authority shall specify the appointment, term, and compensation or reimbursement of expenses. The jurisdiction of the local board of health shall be coextensive with the boundaries of the county. The local health officer, as described in RCW 70.05.050, shall be appointed by the official designated under the provisions of the county charter. The same official designated under the provisions of the county charter may appoint an administrative officer, as described in RCW 70.05.045. [1995 c 43 §7; 1993 c 492 §237.] NOTES: Effective dates -- Contingent effective dates -- 1995 c 43: See note following RCW 70.05.030. Severability-- 1995 c 43: See note following RCW 43.70.570. Findings --Intent-- 1993 c 492: See notes following RCW 43.20.050. Short title -- Severability -- Savings -- Captions not law--Reservation of legislative power--Effective dates -- 1993 c 492: See RCW 43.72.910 through 43.72.915. i RCW 70.05.040 Local board of health -- Chair-- Administrative officer-- Vacancies. http://www.leg.wa.gov/rew/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 RCW 70 . 05 CHAPTER Page 4 of 16 The local board of health shall elect a chair and may appoint an administrative officer. A local health officer shall be appointed pursuant to RCW 70.05.050. Vacancies on the local board of health shall be filled by appointment within thirty days and made in the same manner as was the original appointment. At the first meeting of the local board of health,the members shall elect a chair to serve for a period of one year. • [1993 c 492 §236; 1984 c 25 § I; 1983 1st ex.s.c 39§ 1; 1967 ex.s.c 51 §4.] NOTES: Findings --Intent-- 1993 c 492: See notes following RCW 43.20.050. Short title-- Severability -- Savings-- Captions not law--Reservation of legislative power--Effective dates -- 1993 c 492: See RCW 43.72.910 through 43.72.915. RCW 70.05.045 Administrative officer--Responsibilities. The administrative officer shall act as executive secretary and administrative officer for the local board of health, and shall be responsible for administering the operations of the board including such other administrative duties required by the local health board, except for duties assigned to the health officer as enumerated in RCW 70_.05.070 and other applicable state law. [1984c25 §2.] RCW 70.05.050 Local health officer-- Qualifications --Employment of personnel -- Salary and expenses. The local health officer shall be an experienced physician licensed to practice medicine and surgery or osteopathic medicine and surgery in this state and who is qualified or provisionally qualified in accordance with the standards prescribed in RCW 70.05.051.through 70_05.055 to hold the office of local health officer.No term of office shall be established for the local health officer but the local health officer shall not be removed until after notice is given, and an opportunity for a hearing before the board or official responsible for his or her appointment under this section as to the reason for his or her removal. The local health officer shall act as executive secretary to, and administrative officer for the local board of health and shall also be empowered to employ such technical and other personnel as approved by the local board of health except where the local board of health has appointed an administrative officer under RCW 70.05..04.0. The local health officer shall be paid such salary and allowed such expenses as shall be determined by the local board of health. In home rule counties that are part of a health district under this chapter and chapter 70.46 RCW the local health officer and administrative officer shall be appointed by the local board of health. [1996 c 178 § 19; 1995 c 43 § 8; 1993 c 492 §238; 1984 c 25 §5; 1983 1st ex.s.c 39 §2; 1969 ex.s.c 114 § 1; 1967 ex.s.c 51 §9.] NOTES: Effective date -- 1996 c 178: See note following RCW 18.35.110. Effective dates--Contingent effective dates -- 1995 c 43: See note following RCW 70.05..0.30. 111 Severability -- 1995 c 43: See note following RCW 43.70.570. Findings --Intent-- 1993 c 492: See notes following RCW 43.20.050. http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 'RCW 70 . 05 CHAPTER Page 5 of 16 Short title -- Severability -- Savings -- Captions not law -- Reservation of legislative power-- Effective dates -- 1993 c 492: See RCW 43.72.910 through 43.72.915. CCW 70.05.051 Local health officer-- Qualifications. The following persons holding licenses as required by RCW 70.05.050 shall be deemed qualified to hold the position of local health officer: (1) Persons holding the degree of master of public health or its equivalent; (2) Persons not meeting the requirements of subsection(1) of this section,who upon August 11, 1969 are currently employed in this state as a local health officer and whom the secretary of social and health services recommends in writing to the local board of health as qualified; and (3) Persons qualified by virtue of completing three years of service as a provisionally qualified officer pursuant to RCW 70.05.053 through 70.05.055. [1979 c 141 §75; 1969 ex.s. c 114 §2.] RCW 70.05.053 Provisionally qualified local health officers --Appointment-- Term -- Requirements. A person holding a license required by RCW 70.05.050 but not meeting any of the requirements for alification prescribed by RCW 70.05.051 may be appointed by the board or official responsible for pointing the local health officer under RCW 70.05 05.0 as a provisionally qualified local health officer for a maximum period of three years upon the following conditions and in accordance with the following procedures: (1) He or she shall participate in an in-service orientation to the field of public health as provided in RCW 70.05.054, and (2) He or she shall satisfy the secretary of health pursuant to the periodic interviews prescribed by RCW 70.05.055 that he or she has successfully completed such in-service orientation and is conducting such program of good health practices as may be required by the jurisdictional area concerned. [1991 c 3 §305; 1983 1st ex.s. c 39 §3; 1979 c 141 §76; 1969 ex.s. c 114 §3.] RCW 70.05.054 Provisionally qualified local health officers --In-service public health orientation program. The secretary of health shall provide an in-service public health orientation program for the benefit of provisionally qualified local health officers. Such program shall consist of-- (1)A three months course in public health training conducted by the secretary either in the state department AiLhealth, in a county and/or city health department, in a local health district, or in an institution of higher cation; or (2) An on-the-job, self-training program pursuant to a standardized syllabus setting forth the major duties of http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 RCW 70 . 05 CHAPTER Page 6 of 16 a local health officer including the techniques and practices of public health principles expected of qualified local health officers: PROVIDED, That each provisionally qualified local health officer may choose which type of training he or she shall pursue. [1991 c 3 §306; 1979 c 141 §77; 1969 ex.s.c 114 §4.] • RCW 70.05.055 Provisionally qualified local health officers --Interview-- Evaluation as to qualification as local public health officer. Each year, on a date which shall be as near as possible to the anniversary date of appointment as provisional local health officer, the secretary of health or his or her designee shall personally visit such provisional officer's office for a personal review and discussion of the activity,plans, and study being carried on relative to the provisional officer's jurisdictional area: PROVIDED, That the third such interview shall occur three months prior to the end of the three year provisional term. A standardized checklist shall be used for all such interviews, but such checklist shall not constitute a grading sheet or evaluation form for use in the ultimate decision of qualification of the provisional appointee as a public health officer. Copies of the results of each interview shall be supplied to the provisional officer within two weeks following each such interview. Following the third such interview, the secretary shall evaluate the provisional local health officer's in- service performance and shall notify such officer by certified mail of his or her decision whether or not to qualify such officer as a local public health officer. Such notice shall be mailed at least sixty days prior to the third anniversary date of provisional appointment. Failure to so mail such notice shall constitute a decision that such provisional officer is qualified. • [1991 c 3 §307; 1979 c 141 §78; 1969 ex.s. c 114 § 5.] RCW 70.05.060 Powers and duties of local board of health. Each local board of health shall have supervision over all matters pertaining to the preservation of the life and health of the people within its jurisdiction and shall: (1) Enforce through the local health officer or the administrative officer appointed under RCW 70.05.040, if any, the public health statutes of the state and rules promulgated by the state board of health and the secretary of health; (2) Supervise the maintenance of all health and sanitary measures for the protection of the public health within its jurisdiction; (3) Enact such local rules and regulations as are necessary in order to preserve,promote and improve the public health and provide for the enforcement thereof; (4) Provide for the control and prevention of any dangerous, contagious or infectious disease within the jurisdiction of the local health department; •(5) Provide for the prevention, control and abatement of nuisances detrimental to the public health; (6) Make such reports to the state board of health through the local health officer or the administrative officer as the state board of health may require; and http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 •RCW 70 . 05 CHAPTER Page 7 of 16 (7) 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: PROVIDED, That such fees for services shall (t exceed the actual cost of providing any such services. [1991 c 3 §308; 1984 c 25 §6; 1979 c 141 § 79; 1967 ex.s. c 51 § 10.] RCW 70.05.070 Local health officer-- Powers and duties. The local health officer, acting under the direction of the local board of health or under direction of the administrative officer appointed under RCW 70.05.040 or 70.05.035, if any, shall: (1) Enforce the public health statutes of the state, rules of the state board of health and the secretary of health, and all local health rules, regulations and ordinances within his or her jurisdiction including imposition of penalties authorized under RCW 70.119A.030, the confidentiality provisions in RCW 70.24.105 and rules adopted to implement those provisions, and filing of actions authorized by RCW 43.70.190; (2) Take such action as is necessary to maintain health and sanitation supervision over the territory within his or her jurisdiction; (3) Control and prevent the spread of any dangerous, contagious or infectious diseases that may occur within his or her jurisdiction; (4)Inform the public as to the causes, nature, and prevention of disease and disability and the preservation, omotion and improvement of health within his or her jurisdiction; (5)Prevent, control or abate nuisances which are detrimental to the public health; (6) Attend all conferences called by the secretary of health or his or her authorized representative; (7) Collect such fees as are established by the state board of health or the local board of health for the issuance or renewal of licenses or permits or such other fees as may be authorized by law or by the rules of the state board of health; (8) Inspect, as necessary, expansion or modification of existing public water systems, and the construction of new public water systems, to assure that the expansion, modification, or construction conforms to system design and plans; (9) Take such measures as he or she deems necessary in order to promote the public health, to participate in the establishment of health educational or training activities, and to authorize the attendance of employees of the local health department or individuals engaged in community health programs related to or part of the programs of the local health department. [1999 c 391 §5; 1993 c 492 §239; 1991 c 3 §309; 1990 c 133 § 10; 1984 c 25 §7; 1979 c 141 § 80; 1967 ex.s.c 51 § 12.] NOTES: .Findings --Purpose -- 1999 c 391: See note following RCW 70..0.5.1.80. Findings --Intent-- 1993 c 492: See notes following RCW 43.20.050. http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 RCW 70 . 05 CHAPTER Page 8 of 16 • Short title -- Severability-- Savings-- Captions not law--Reservation of legislative power--Effective dates -- 1993 c 492: See RCW 43.72.910 through 43.72.915. Findings -- Severability -- 1990 c 133: See notes following RCW 36.94.140. • RCW 70.05.072 Local health officer--Authority to grant waiver from on-site sewage system requirements. The local health officer may grant a waiver from specific requirements adopted by the state board of health for on-site sewage systems if: (1)The on-site sewage system for which a waiver is requested is for sewage flows under three thousand five hundred gallons per day; (2) The waiver request is evaluated by the local health officer on an individual, site-by-site basis; (3)The local health officer determines that the waiver is consistent with the standards in, and the intent of, the state board of health rules; and (4) The local health officer submits quarterly reports to the department regarding any waivers approved or denied. Based on review of the quarterly reports, if the department finds that the waivers previously granted have not been consistent with the standards in, and intent of,the state board of health rules,the department shall provide technical assistance to the local health officer to correct the inconsistency, and may notify the local and state • boards of health of the department's concerns. If upon further review of the quarterly reports,the department finds that the inconsistency between the waivers granted and the state board of health standards has not been corrected,the department may suspend the authority of the local health officer to grant waivers under this section until such inconsistencies have been corrected. [1995 c 263 § 1.] RCW 70.05.074 On-site sewage system permits --Application --Limitation of alternative sewage systems. (1) The local health officer must respond to the applicant for an on-site sewage system permit within thirty days after receiving a fully completed application. The local health officer must respond that the application is either approved, denied, or pending. (2)If the local health officer denies an application to install an on-site sewage system,the denial must be for cause and based upon public health and environmental protection concerns, including concerns regarding the ability to operate and maintain the system, or conflicts with other existing laws,regulations, or ordinances. The local health officer must provide the applicant with a written justification for the denial, along with an explanation of the procedure for appeal. (3) If the local health officer identifies the application as pending and subject to review beyond thirty days,• the local health officer must provide the applicant with a written justification that the site-specific conditions or circumstances necessitate a longer time period for a decision on the application. The local health officer must include any specific information necessary to make a decision and the estimated time required for a decision to http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 'RCW 70 . 05 CHAPTER Page 9 of 16 be made. (4) A local health officer may not limit the number of alternative sewage systems within his or her Irisdiction without cause. Any such limitation must be based upon public health and environmental protection ,ncerns, including concerns regarding the ability to operate and maintain , or conflicts with other existing laws, regulations, or ordinances. If such a limitation is established,thesystemlocal health officer must justify the limitation in writing, with specific reasons, and must provide an explanation of the procedure for appealing the limitation. [1997 c 447 §2.] NOTES: Finding--Purpose -- 1997 c 447: "The legislature finds that improperly designed, installed, or maintained on-site sewage disposal systems are a major contributor to water pollution in this state. The legislature also recognizes that evolving technology has produced many viable alternatives to traditional on-site septic systems. It is the purpose of this act to help facilitate the siting of new alternative on-site septic systems and to assist local governments in promoting efficient operation of on-site septic *these systems." [1997 c 447 § 1.] *Reviser's note: Due to a drafting error, the word "these" was not removed when this sentence was rewritten. Construction -- 1997 c 447 §§ 2-4: "Nothing in sections 2 through 4 of this act may be deemed to eliminate any requirements for approval from public health agencies under applicable law in connection with the siting, design, construction, and repair of on-site septic systems." [1997 c 447 § 6.] likW 70.05.077 Department of health --Training -- On-site sewage systems --Application of the waiver authority-- Topics --Availability. (1) The department of health, in consultation and cooperation with local environmental health officers, shall develop a one-day course to train local environmental health officers, health officers, and environmental health specialists and technicians to address the application of the waiver authority granted under RCW 70.05.072 as well as other existing statutory or regulatory flexibility for siting on-site sewage systems. (2) The training course shall include the following topics: (a) The statutory authority to grant waivers from the state on-site sewage system rules; (b) The regulatory framework for the application of on-site sewage treatment and disposal technologies, with an emphasis on the differences between rules, standards, and guidance. The course shall include instruction on interpreting the intent of a rule rather than the strict reading of the language of a rule, and also discuss the liability assumed by a unit of local government when local rules,policies, or practices deviate from the state administrative code; (c) The application of site evaluation and assessment methods to match the particular site and development plans with the on-site sewage treatment and disposal technology suitable to protect public health to at least the level provided by state rule; and •(d) Instruction in the concept and application of mitigation g n waivers. (3) The training course shall be made available to all local health departments and districts in various http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 RCW 70 . 05 CHAPTER Page 10 of 16 locations in the state without fee. Updated guidance documents and materials shall be provided to all participants, including examples of the types of waivers and processes that other jurisdictions in the region have granted and used. The first training conducted under this section shall take place by June 30, 1999. [1998c34 §3.] • NOTES: Intent-- 1998 c 34: "(1) The 1997 legislature directed the department of health to convene a work group for the purpose of making recommendations to the legislature for the development of a certification program for occupations related to on-site septic systems, including those who pump, install, design, perform maintenance, inspect, or regulate on-site septic systems. The work group was convened and studied issues relating to certification of people employed in these occupations,bonding levels, and other standards related to these occupations. In addition,the work group examined the application of a risk analysis pertaining to the installation and maintenance of different types of septic systems in different parts of the state. A written report containing the work group's findings and recommendations was submitted to the legislature as directed. (2)The legislature recognizes that the recommendations of the work group must be phased-in over a time period in order to develop the necessary scope of work requirements, knowledge requirements,public protection requirements, and other criteria for the upgrading of these occupations. It is the intent of the legislature to start implementing the work group's recommendations by focusing first on the occupations that are considered to be the highest priority, and to address the other occupational recommendations in subsequent sessions." [1998 c 34 § 1.] RCW 70.05.080 • Local health officer-- Failure to appoint--Procedure. If the local board of health or other official responsible for appointing a local health officer under RCW 70.05.050 refuses or neglects to appoint a local health officer after a vacancy exists,the secretary of health may appoint a local health officer and fix the compensation. The local health officer so appointed shall have the same duties,powers and authority as though appointed under RCW 70.05.050. Such local health officer shall serve until a qualified individual is appointed according to the procedures set forth in RCW 70 05.0..50. The board or official responsible for appointing the local health officer under RCW 70.05.050 shall also be authorized to appoint an acting health officer to serve whenever the health officer is absent or incapacitated and unable to fulfill his or her responsibilities under the provisions of chapters 70.05 and 70.46 RCW. [1993 c 492 §240; 1991 c 3 § 310; 1983 1st ex.s.c 39 §4; 1979 c 141 §81; 1967 ex.s.c 51 § 13.] NOTES: Findings --Intent-- 1993 c 492: See notes following RCW 43.20.050. Short title -- Severability -- Savings -- Captions not law -- Reservation of legislative power --Effective dates -- 1993 c 492: See RCW 43.72.910 through 43.72.915. RCW 70.05.090 Physicians to report diseases. • Whenever any physician shall attend any person sick with any dangerous contagious or infectious disease, or with any diseases required by the state board of health to be reported,he or she shall, within twenty-four hours, give notice thereof to the local health officer within whose jurisdiction such sick person may then be or to the http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 •RCW 70 . 05 CHAPTER Page 11 of 16 state department of health in Olympia. [1991 c 3 §311; 1979 c 141 § 82; 1967 ex.s.c 51 § 14.] • RCW 70.05.100 Determination of character of disease. In case of the question arising as to whether or not any person is affected or is sick with a dangerous, contagious or infectious disease, the opinion of the local health officer shall prevail until the state department of health can be notified, and then the opinion of the executive officer of the state department of health, or any physician he or she may appoint to examine such case, shall be final. [1991 c 3 §312; 1979 c 141 § 83; 1967 ex.s. c 51 § 15.] RCW 70.05.110 Local health officials and physicians to report contagious diseases. It shall be the duty of the local board of health, health authorities or officials, and of physicians in localities where there are no local health authorities or officials, to report to the state board of health,promptly upon discovery thereof, the existence of any one of the following diseases which may come under their observation, to wit: Asiatic cholera, yellow fever, smallpox, scarlet fever, diphtheria, typhus, or leprosy, and of such other contagious or infectious diseases as the state board may from time tobtime splague y. [1967 ex.s.c 51 § 16.] . RCW 70.05.120 Violations -- Remedies -- Penalties. (1)Any local health officer or administrative officer appointed under RCW 70.05.040, if any, who shall refuse or neglect to obey or enforce the provisions of chapters 70.05, 70.24, and 70.46 RCW or the rules, regulations or orders of the state board of health or who shall refuse or neglect to make prompt and accurate reports to the state board of health, may be removed as local health officer or administrative officer by the state board of health and shall not again be reappointed except with the consent of the state board of health. Any person may complain to the state board of health concerning the failure of the local health officer or administrative officer to carry out the laws or the rules and regulations concerning public health, and the state board of health shall, if a preliminary investigation so warrants, call a hearing to determine whether the local health officer or administrative officer is guilty of the alleged acts. Such hearings shall be held pursuant to the provisions of chapter 34.05 RCW, and the rules and regulations of the state board of health adopted thereunder. (2)Any member of a local board of health who shall violate any of the provisions of chapters 70.05, 70.24, and 70.46 RCW or refuse or neglect to obey or enforce any of the rules, regulations or orders of the state board of health made for the prevention, suppression or control of any dangerous contagious or infectious disease or for the protection of the health of the people of this state, is guilty of a misdemeanor, and upon conviction shall be fined not less than ten dollars nor more than two hundred dollars. (3)Any physician who shall refuse or neglect to report to the proper health officer or administrative officer thin twelve hours after first attending any case of contagious or infectious disease or any diseases required by state board of health to be reported or any case suspicious one of such diseases, is guilty of a misdemeanor, and upon conviction shall be fined not less than ten dollars nor more than two hundred dollars for each case that is not reported. http://www,leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 RCW 70 . 05 CHAPTER Page 12 of 16 (4) Any person violating any of the provisions of chapters 70.05, 70.24, and 70.46 RCW or violating or refusing or neglecting to obey any of the rules, regulations or orders made for the prevention, suppression and control of dangerous contagious and infectious diseases by the local board of health or local health officer or administrative officer or state board of health, or who shall leave any isolation hospital or quarantined house place without the consent of the proper health officer or who evades or breaks quarantine or conceals a case o contagious or infectious disease or assists in evading or breaking any quarantine or concealing any case of ction thereof shall contagious or infectious disease, is guilty nor more than oneohundred dollars or, and upon lr to imprisonment inesubject to a the county jail fine of not less than twenty-five dollar not to exceed ninety days or to both fine and imprisonment. [2003 c 53 § 350; 1999 c 391 §6; 1993 c 492 §241; 1984 c 25 § 8; 1967 ex.s.c 51 § 17.] NOTES: Intent --Effective date --2003 c 53: See notes following RCW 2.48.180. Findings --Purpose-- 1999 c 391: See note following RCW 70.05.180. Findings --Intent -- 1993 c 492: See notes following RCW 43.20.050. Short title -- Severability-- Savings -- Captions not law --Reservation of legislative power--Effective dates -- 1993 c 492: See RCW 43.72.910 through 43.72.915. RCW 70.05.125 County public health account--Distribution to local public health jurisdictions. (1)The county public health account is created in the state treasury. Funds deposited in the county public healt account shall be distributed by the state treasurer to each local public health jurisdiction based upon amounts certified to it by the department of community,trade, and economic development in consultation with the Washington state association of counties. The account shall include funds distributed under RCW *82.44.110 and 82.14.200(8) and such funds as are appropriated nder RCW 43.72.902, and such ther funds asthe account from the health services ttheder RCW 43.72.900,the public health services account legislature may appropriate to it. (2)(a)The director of the department of community,trade, and economic development shall certify the amounts to be distributed to each local public health jurisdiction using 1995 as the base year of actual city contributions to local public health. (b) Only if funds are available and in an amount no greater than available funds under RCW 82.14.200(8), the department of community,trade, and economic development shall adjust the amount certified under(a) of this subsection to compensate for any annexation of an area with fifty thousand residents or more to any city as a result of a petition during calendar year 1996 or 1997, or for any city that became newly incorporated as a result of an election during calendar year 1994 or 1995. The amount to be adjusted shall be equal to the amount which otherwise would have been lost to the health jurisdiction due to the annexation or incorporation as calculated using the jurisdiction's 1995 funding formula. (c) The county treasurer shall certify the actual 1995 city contribution to the department. Funds in excess of the base shall be distributed proportionately among the health jurisdictions based on incorporated population • figures as last determined by the office of financial management. (3) Moneys distributed under this section shall be expended exclusively for local public health purposes. http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 •RCW 70 . 05 CHAPTER Page 13 of 16 [1998 c 266 § 1; 1997 c 333 § 1; 1995 1st sp.s.c 15 § 1.] NOTES: • *Reviser's note: RCW 82.44.110 was repealed by 2003 c 1 § 5 (Initiative November 5, 2002). Measure No. 776, approved Effective date -- 1998 c 266: "This act takes effect July 1, 1998." [1998 c 266 § 2.] Effective date -- 1997 c 333: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect 1, 1997." [1997 c 333 § 3.] July Effective date-- 1995 1st sp.s. c 15: "This act shall take effect January 1, 1996." [1995 1st sp.s. c 15 § 3.] RCW 70.05.130 Expenses of state, health district, or county in enforcing health laws and rules --Payment by county. All expenses incurred by the state, health district, or county in carrying 70.46 RCW or any other public health law, or the rules of the department of health enacted undersuch lawsand shall be paid by the county and such expenses shall constitute a claim against the general fund as provided in this section. ' [1993 c 492 §242; 1991 c 3 §313; 1979 c 141 § 84; 1967 ex.s. c 51 § 18.] WTES: Findings --Intent-- 1993 c 492: See notes following RCW 43.20.050. Short title --Severability-- Savings -- Captions not law--Reservation of legislative power--Effective dates -- 1993 c 492: See RCW 43.72.910 through 43.72.915. RCW 70.05.135 Treasurer--District funds -- Contributions by counties and cities. See RCW 70.46.080. RCW 70.05.140 County to bear expense of providing public health services. See RCW 70.46.085. RCW 70.05.150 Contracts for sale or purchase of health services authorized. *addition to powers already granted them, any county, district, or local health de art mnt may contract for either the sale or purchase of any or all health services from any local health department.Such contract shall require the approval of the state board of health. http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 RCW 70 . 05 CHAPTER Page 14 of 16 [1993 c 492 §243; 1967 ex.s.c 51 §22.] NOTES: • Findings --Intent-- 1993 c 492: See notes following RCW 43.20.050. Short title-- Severability -- Savings -- Captions not law --Reservation of legislative power-- Effective dates -- 1993 c 492: See RCW 43.72.910 through 43.72.915. RCW 70.05.160 Moratorium on water, sewer hookups, or septic systems --Public hearing--Limitation on length. A local board of health that adopts a moratorium affecting water hookups, sewer hookups, or septic systems without holding a public hearing on the proposed moratorium, shall hold a public hearing on the adopted moratorium within at least sixty days of its adoption. If the board does not adopt findings of fact justifying its action before this hearing,then the board shall do so immediately after this public hearing. A moratorium adopted under this section may be effective for not longer than six months,but may be effective for up to one year if a work plan is developed for related studies providing for such a longer period. A moratorium may be renewed for one or more six-month periods if a subsequent public hearing is held and findings of fact are made prior to each renewal. [1992 c 207 §7.] RCW 70.05.170 Child mortality review. • (1)(a)The legislature finds that the mortality rate in Washington state among infants and children less than eighteen years of age is unacceptably high, and that such mortality may be preventable. The legislature further finds that,through the performance of child mortality reviews,preventable causes of child mortality can be identified and addressed,thereby reducing the infant and child mortality in Washington state. (b) It is the intent of the legislature to encourage the performance of child death reviews by local health departments by providing necessary legal protections to the families of children whose deaths are studied, local health department officials and employees, and health care professionals participating in child mortality review committee activities. (2)As used in this section, "child mortality review" means a process authorized by a local health department as such department is defined in RCW 70.05.0.10. for examining factors that contribute to deaths of children less than eighteen years of age. The process may include a systematic review of medical, clinical, and hospital records; home interviews of parents and caretakers of children who have died; analysis of individual case information; and review of this information by a team of professionals in order to identify modifiable medical, socioeconomic, public health, behavioral, administrative, educational, and environmental factors associated with each death. (3) Local health departments are authorized to conduct child mortality reviews. In conducting such reviews, the following provisions shall apply: (a) All medical records,reports, and statements procured by, furnished to, or maintainedareconfidential by alocal ihealth as department pursuant to chapter 70.02 RCW for purposes of a child mortality review the identity of an individual child and his or her adoptive or natural parents is concerned. Such records may be used solely by local health departments for the purposes of the review. This section does not prevent a local http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 'RCW 70 . 05 CHAPTER Page 15 of 16 health department from publishing statistical compilations and reports related to the child mortality review, if such compilations and reports do not identify individual cases and sources of information. Wbj(b)Any records or documents supplied or maintained for the purposes of a child mortality review are not ect to discovery or subpoena in any administrative, civil, or criminal proceeding child reviewed. This provision shall not restrict or limit the discovery or subpoena from a health care p oovi er of records or documents maintained by such health care provider in the ordinary course of business, whether or not such records or documents may have been supplied to a local health department pursuant to this section. (c)Any summaries or analyses of records, documents, or records of interviews prepared exclusively for purposes of a child mortality review are not subject to discovery, administrative, civil, or criminal proceeding related to the death of achild reviewedduction into evidence in any (d)No local health department official or employee, and no members of technical committees perform case reviews of selected child deaths may be examined in any administrative, civil, or criminal ished to proceeding as to the existence or contents of documents assembled,prepared, or maintained for purposes of a child mortality review. (e) This section shall not be construed to prohibit or restrict any person from reporting suspected child abuse or neglect under chapter 26.44 RCW nor to limit access to or use of any records, documents, information, or testimony in any civil or criminal action arising out of any report made pursuant to chapter 26.44 RCW. [1993 c 41 § 1; 1992 c 179 § 1.] RCW 70.05.180 isfectious disease testing-- Good samaritans --Rules. A person rendering emergency care or transportation, commonly known as a "Good Samaritan," as described in RCW 4.24.300 and 4.24.310, may request and receive appropriate infectious disease testing free of charge from the local health department of the county of her or his residence, if: (1) While rendering emergency careshe or he came into contact with bodily fluids; and (2) she or he does not have health insurance that covers the testing. Nothing in this section requires a local health department to provide health care services beyond testin . The department shall adopt rules implementing this section. g The information obtained from infectious disease testing is subject to statutory confidentiality provisions, including those of chapters 70.24 and 70.05 RCW. [1999 c 391 §2.] NOTES: Findings -- Purpose -- 1999 c 391: "The legislature finds that citizens who assist individuals in emergency situations perform a needed and valuable role that deserves recognition and support. The legislature further finds that emergency assistance in the form of mouth to mouth resuscitation or other emergency medical procedures resulting in the exchange of bodily fluids significantly increases the odds of being exposed to a deadly infectious disease. Some of the more life-threatening diseases that can be transferred during an emergency procedure where bodily fluids are exchanged include hepatitis A, B, and C, and human immunodeficiency virus (HIV). Individuals infected by these diseases value confidentiality regarding this Iptdiformation. A number of good samaritans who perform life-saving emergency procedures such as opulmonary resuscitation are unable to pay for the tests t could have been transmitted during the emergency procedure. It is the urpose of this act to pror detecting infectiousvide infectiousiseases disease testing at no cost to good samaritans who request testing for infectious diseases after rendering emergency assistance that has brought them into contact with a bodily fluid and to further protect the sting http://www.leg.wa.gov/rew/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 RCW 70 . 05 CHAPTER Page 16 of 16 information once obtained through confidentiality provisions." [1999 c 391 § 1.] Effective date -- 1999 c 391 §§ 1 and 2: "Sections 1 and 2 of this act are necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public • institutions, and take effect immediately [May 18, 1999]." [1999 c 391 § 7.] • • http://www.leg.wa.gov/rcw/index.cfm?fuseaction=chapter&chapter=70.05&RequestTimeout=500 6/9/2005 • Board of Health Media Report 1 June 16, 2005 • Jefferson County Health and Human Services MAY — JUNE 2005 NEWS ARTICLES 1. "Join Smoke-Free Sunday",P.T.Leader,May 11,2005 2. "West Nile virus is 'out there',Peninsula Daily News,May 12,2005 3. "Take precautions for West Nile virus",P.T. Leader,May 18,2005 4. Region 2 Public Health for the Peninsulas,2-page newsletter Spring 2005. 5. "PA agrees to help fund dental clinic",Peninsula Daily News,May 18,2005 6. "DSHS offices are relocating",P.T.Leader,May 18,2005 7. "McNickle is health director",P.T.Leader,May 18,2005 8. "Two Bigs& a Little...Big Brothers,Big Sisters program to expand",P.T.Leader,May 25,2005 • 9. "Bigs make a big difference"and `I hope we can go fishing soon',P.T. Leader,May 25,2005 10. "Three local establishments provide alcohol to minors",P.T. Leader,May 25,2005 11. "Substance abuse habit is costly to taxpayers",P.T.Leader,May 25,2005 12. "Volunteers needed to trap mosquitoes",P.T.Leader,May 25,2005 13. "Chlamydia cases rise in county",P.T. Leader,June 1,2005 14. "World record for Mackie",P.T.Leader,June 1,2005 15. "Urgent Care Clinic open evenings",P.T.Leader,June 8,2005 • Wednesday,May 11,2005 •B 3 Join Smoke-Free •SUnday Local health department offi- ' cials urge residents to take part ,, .,"in the state's first-ever Smoke- k ulloFree Sunda on y 15 ( J rG �sy Ma by R; .f(0patronizing local smoke-free irestaurants. Smoke Free Sunday .•_ Wn�fr-iI r5 is sponsored by the Washington I rr 24145 State Tobacco Prevention and ,, It2,i vt` Control Program. Local restau- t j ;4 '41.N. - o. , rants that allow smoking are �l t t' �' i,v a � 3 w, encouraged to participate and try �� ;i ' '* 1 r ': ;,-..7.4 ''a',a-'',rx n�R „p .. .' .j. ,..„,,,--•%—.;,,, '"., i '':' going smoke-free for the day. 1p G• 'ay- ft �, „,,,, = �' e'en.� ., ', _ -; "Studies prove Washingtonians 9 j S t F ,,,,, ", "may '`"," 'a*,, .¢ `" 'fid. ' . .,�s b,. `/ - -��t �, «e�3 overwhelmingly prefer smoke- iii'. � �,, � :z 3 free dining, said Dr. Thomas .•' ;- 1. ,4r ± ,'� "'" Locke, health officer for both `'` �1 Clallam and Jefferson counties. "Smoking is bad. Flowers and rainbows are better" states the artwork created by Sofia Gelder(fai "Smoke-Free Sunday was creat- right) in the Tobacco Youth Art Extravaganza 2005. Other selected artists Include (from lett) Kaylee ed to show business owners that Look of Brinnon, Anna Brown of Port Hadlock, Alexis Mack of Qulicene, and Britta Jensen of Port customers support smoke-free Townsend.Not pictured Is Michelle Bradley of Port Hadlock. restaurants:" Submitted phot¢ In February, a web-based, Youth eroke- artistss get message':restaurants was unveiled by Department of Health. Since its launch, hundreds of "Smokin'Don't Worry-I will Townsend characterizes ciga- community about the dangers of restaurants have been added, and beat your funeral"is the message reties as not wanted, and 5-year- tobacco use. • the map now lists more than from 13-year-old Michelle old Kaylee Look of Brinnon has a Gary Shannon of the Sign 5 500 smoke-free eating places in Bradley of Port Hadlock. Sofie simple message: "No Smoking Station in Irondale transformed Gelder, 7, of Port Townsend Allowed." the original art into outfield Washington.The map is found at www.S e c o n d h a n d S m o k e s advises that "Cigarettes are bad. Jefferson County Tobacco signs, which can be viewed at You.com. Flowers and rainbows are better." Prevention Program encouraged Little League fields in Port Eight-year-old Anna Brown from young artists throughout the Townsend, Port Hadlock and The state Department of Health officially has a new Port Hadlock offers this strong county to submit simple tobacco Quilcene. Artists can also be "100%Smoke Free"program on message: "No Smoking! prevention messages in the viewed with their art at www.jef- Smoke-Free Sunday, in which Smoking is bad for people."Five- Tobacco Youth Art Extravaganza fersoncountypublichealth.org. smoke-free establishments will year-old Alexis Mack from 2005. From the 33 entries Contact Kellie Ragan at kra- be visibly designated with a seal Quilcene speaks from the heart, received,six were selected to be gan@co.jefferson.wa.us or 385- on their front door or window. saying, `Please don't smoke. I used to educate people in the 9446. More than 100,000 non-smok- love you."Britta Janssen of Port ers in Washington continue to be exposed to secondhand smoke while at work,making them more than 30 percent more likely to get lung cancer. Every year, about 38,000 non-smokers throughout - the nation die from exposure to secondhand smoke.And second - - hand smoke poses a special risk o children-each year it is asso- iiated with more than 8,000 new asthma cases in children and as many as 300,000 new cases of bronchitis and pneumonia in chil- dren younger than 18 months. Call Kellie Ragan,385-9446. West Nile virus iso u t ther tip, BY JEFF CHEW He said county residents quitoes come down with West fit tightly. PENINSULA DAILY NEWS can help by calling the county Nile fever, which can result in Residents are also encour- PORT TOWNSEND —Jef IF office at 360-385-9444 if they illness that ranges from mild aged to wear longsleeve shirts erson County health officials •find • a fresh dead bird. The to severe flu-like symptoms. and Ion virus is found most often in McNickle recommends that doors,and pantsse insect repellent. to collect dead birds, hich could lead them to thevess ravens,crows and jays. to control mosquito,popula- Horse owners are urged to ible source of West Nilerus. Questions about the disease tions, residents should reduce vaccinate their animals vican be asked at 360-385-9400. all standing water around •Primarily a bird disease, their homes by tipping any against the disease. est Nile virus is "out there," Increased surveillance thing that collects water from ys new county Envuonmen- Since the outbreak of West wheelbarrows to children's Health Director Michael Nile in the United States in toys. cNickle. . 1999, there has been a nation- Other measure include It's just a matter of time wide rush to increase surveil repairing all window screens fore it infects birds, animals, lance and institute adequate and making sure they ven humans,McNickle said. mosquito control measures. West Nile virus infects mos- While no West Nile virus uitoes that become infected by cases have turned up on the • eeding on infected birds, North Olympic Peninsula, hich can then pass the dis- birds and horses were infected • ase along to other birds, in Whatcom and Island coun- Ehumans or horses. ties in 2002. II . Symptoms in humans are In 2003, West Nile virus • flu-like illness,and people older killed more than 250 in the than 50 are most susceptible, United States, and nearly said McNickle. 10,000 illnesses were con- Mosquito season,when West firmed by the Centers for Dis- . Nile virus is 'of most concern, ease Control and Prevention. runs from spring through late Experts believe that 20 per- fall,according to McNickle. cent of people bitten by mos- . ' f/ .c i b. t)1 4 6-s --(D--0 • • 1110 . O 8 8•Wednesday, May 18,2005 Take p recautions for West Nile virus The coming of spring has tis.The majority of people bitten seven days. Mosquitoes need Health department efforts Jefferson County residents think- by infected mosquitoes do not stagnant water for eggs and larva The local health department ing of gardening, hiking and _ experience any symptoms; peo- development,so get rid of stand- will continue.its ongoing public other outdoor fun.It's also time to ple over age 50 have the highest ing water outside, repair leaky education efforts. It will track think about preventing infection risk for serious illness. outdoor faucets and cover rain bird deaths, mosquito problem from West Nile v' as.According In 2004 the disease moved into barrels with mosquito screen. areas and larvae habitat through- to Mike McNickie, environmen- Idaho and Oregon; Washington •Keep mosquitoes out of the out the county. Corvid birds, tal health director at Jefferson state was the only state in the home by repairing ripped win- crows,ravens, magpies and jays County Health and Human lower 48 without cases. "While dows and door screens and make are very susceptible to West Nile Services, there's a lot residents West Nile virus wasn't detected in sure they fit tight. virus. A small percentage of can do to protect themselves our state last year, it was con- • Try to avoid getting bitten these birds will be tested for the against mosquito-borne infection. firmed in two horses and four when mosquitoes are out—often at virus, but the emphasis is on West Nile virus is primarily a dead birds in Washington in dawn and dusk—by wearing long- recording where the dead birds bird disease.Mosquitoes become 2002." said McNickle. In 2003 sleeved shirts and long pants.Hats were found. A spike in bird infected by feeding on infected West Nile virus killed more than are also useful. Consider using an deaths may indicate that West birds, and then pass the virus to 250 people in the United States, insect repellent Repellents con- Nile virus has arrived, and pos- other birds, humans or horses. and nearly 10,000 illnesses were mining the chemical N,N-diethyl- sibly the areas of the county Mosquito season, when West confirmed by the Centers for meta-toluamide (DEET) are where the virus is circulating. Nile virus is of most concern, Disease Control and Prevention known to be very effective and Dead birds reported but not test- runs from spring through late fall. (CDC). Many more people were safe. It is important to read the ed will be used for tracking pur- Experts believe that 20 percent likely sickened by the virus but label and follow the instructions poses. of people bitten by an infected did not seek medical care. on the label carefully. Long-last- The health department works mosquito come down with West ing and effective alternatives to with the Washington State Nile fever, which may result in What to do products containing DEET are Department of Health in collect- illness that ranges from mild to • Call.the health department, available. Insect repellents con- ing information on mosquito severe flu-like symptoms.One in 385-9444, if you find a dead taining Picardin might be a good breeding habitats and areas of every 150 infected people have crow,raven or jay. choice for some individuals. the county with mosquito prob- more serious neurological illness- •Reduce outdoor habitat.The Repellents containing oil of lemon lems. es such encephalitis or meningi- mosquito life cycle is as little as eucalyptus provide protection sim- To learn more,visit www.jef- ilar to those containing low con- fersoncountypublichealth.org. centrations of DEET To inquire about mosquito con •Horse owners are advised to trol or to report a dead crow,call vaccinate their horses against the 385-9444. To ask questions disease. about the virus, call 385-9400. • • , Spring 2005 ,Son .. Fw coG ' t, � Region 2 1)101 !)11 f t:::: • �) wus . 6�`y.MCo, T} M,J W $HVMAs 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. , k Most recently,the list of notifiable conditions was amended, effective February 2005,by the Washington State Board of w. Health. The changes are: i e 4/ 4 Keep reporting chronic hepatitis B,acute and chronic hepatitis �. C,herpes simplex(neonatal and initial genital r x ri 1 r infections),and arboviral disease. R , 4 Keep reporting autism spectrum disorder,cerebral N'F w., ' __ , f 1 .'` palsy and alcohol related birth defects. , r` . ' 1 4 Report viral encephalitis if you suspect or have confirmed "' �°' an arboviral disease. - Jefferson County. Communicable Disease Program 4 Stop reporting invasive group A Streptococcus.It's no longer Coordinator, Lisa McKenzie, takes Aik on the list. a notifiable condition call. IIPP Continue to report all notifiable conditions such as acute Hepatitis B. Your reports are recorded and provide key information about the health "If indoubt, repo7 t 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 1 January— January— January— January— January— January— 1Jan—March March 2005 March 2004 March 2005 March 2004 March 2005 March 2004 2005 2004 Campylobacteriosis 8 4 1 0 0 0 9 4 Crvotosporldlosis 1 0 0 0 0 0 1 0 Chlamydia 172 170 21 5 20 31 213 206 G ardlasls 4 0 0 0 0 1 4 1 Gonorrhea 19 19 1 2 4 1 24, 22 Henatltls A 0 0 0 0 2 0 2 0 Hepatitis C 69 50 2 0 0 0, 71 50 Herpes 9 12 4 3 0 0 13. 15 HIV and AIDS(includes only AIDS cases not pre-' 5 4 0 0 0 0 5 4 Malaria 0 0 1 0 0 0 1 0_ Meningococcal Disease 0 1 0 0 0 0_ 0 1 Pertussis 2 1 1 0 0 0, 3 1 Salmonellosis 3 3 1 0 1 0 5 3 Syphilis 2 0 0 0 0 0 2 0 Tuberculosis 4 1 0 0 0 0 4 1 In the first quarter of 2005 and of 2004 there were no reports of the following notifiable conditions: 41, cyclosporiasis;enterohemorrhagic E. coli(non-0157);E. co/i 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 newsletter,please contact the editor,Ruth Westergaard,by phone at(360)337-5752,email wester@health.co.kitsap.wa.us or at 345 Sixth Street,Suite 300,Bremerton,WA 98337. Spring 2005—page 2 New! o t , Alternatives to DEET! %.,-t- Two West Nile Virus—Control That Habitat Two insect repellents that do no , , West Nile virus made it the West Coast in 2004 but Washington contain DEET are also recommended ,.. has yet to see a documented case of human infection.Reduction by DCthe C .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 Nob 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 Call the p2g200er 5 conference calls what's been happening during the week and what to be on the lookout (360)or 11 for over the weekend. or 911 911 RDOs have received calls about: sewage spills,animal bites, 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 i a j ¢ - hospitals conducted 4 I ., „ a full-scale exercise _,, <; F, in March to test the region's ability to respond to a T.,---- ' -1biological hazardous I t - - event. This exercise • focused on pandemic flu. Volunteers with the Medical Reserve Corps in Kitsap practiced running a mass prophylaxis distribution center. I Spring 2005—page 2 New! tlit Alternatives to DEET! • s3==%r4 West Nile Virus—Control That Habitat Two insect repellents that do no ,4 0 West Nile virus made it the West Coast in 2004 but Washington contain DEET are also recommended - i as 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 ��?�! ��-healtl� +>I?Il and dawn. Pu c . , . h+'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 Officer crying 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 Call the p2g05 conference calls what's been happening during the week and what to be on the lookout (360)or 9115 for over the weekend. or 911 RDOs have received calls about: sewage spills, animal bites, 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 I „ hospitals conducted I. fi. ,� J ', ,, ° ', a full-scale exercise . tti i ;i 4, in March to test the _ region's ability to respond to a ":— ``4! "•p -i biological hazardous L '' '' -1.- event. This exercise focused on pandemic flu. Volunteers with the Medical Reserve Corps in Kitsap practiced running a mass prophylaxis distribution center. • WEDNESDAY,MAY 18,2005 A3 'PA - ,t agrees. - o a un dental . c Council OKs patients along with a dental hygienedegree program. $120,000 for ` - "This is .the last piece b) . make this absolute vision of a low-income dental service pro-, final payment gram'become a reality," Hock-`• BY BRIAN GAWLEY ett said. PENINSULA DAILY NEWS Needed money • PORT ANGELES — The The clinic has.received all • remodeling of the Armory Mall-the.money it needs- forthe downtown for a low-income . remodeling and most of the dental services clinic and train- money it needs for equipment • the Ci program can proceed after to operate.at least 11 years in the City Council on Tuesday the location,Hockett said. night agreed to pay the y In addition to the city's $120,000 of the cost. funds, theprogramy The money will come fromalso has $140,000 in state money that received.funding for equipment . has sat unused in a city account from the Washington. State since 1986. Dental Service Foundation, "Thank you so much," said Pierce College, Washington Timothy Hockett,deputy direr- State Dental Society, Ben tor of Olympic Community Cheney Foundation and Wash- , Action Programs,as a group of ington Oral Health Foundation. ' supporters in the audience The program has received • broke into applause. remodeling money from First • Olympic Community Action Federal Savings and Loan and Programs, or OlyCAF Olympic Medical Center, both requested the $120,000 to based in Port Angeles. remodel part of Armory Square The dental clinic will operate . Mall, 228 W First. St., Port on a sliding scale according to Angeles that will be used for a the patient's income,- Hockett low-income dental service pro- 'said. gram. Those who"slide off the end .The program will create a. of the scale" can be helped by partnership among OlyCAP, the Peninsula Daily News Pierce College in Tacoma and Peninsula Home Fund, which Peninsula College to provide collects community donations dental services to low-income every holiday season,he said. • • DSHS offices are relocating Washington Department of income clients receiving cash Social and Health Services and food assistance. Also mov • - (DSHS)offices in Port Townsend ing to the new location are are scheduled to move three offices for the divisions of blocks down Sheridan Avenue Developmental Disabilities, and be open for business May 23. Children and Family Services, That's because Jefferson Vocational Rehabilitation, and County is moving its staff into Home and Community Services. the building DSHS currently Twenty-six DSHS employees leases from the county at 623 are making the move May 19- • Sheridan Ave.DSHS staff moves 20. DSHS intends to post signs to 915 Sheridan Ave. on both entrances to the current The DSHS Community facility directing clients to the Services office serves 2,885 low- new offices. • • McNickle is health By Steven J.Barry the potential Leader Staff Writer installation of sewer lines in --;;,4 MikeMcNickle, a veteran the Tri-Area, in the field of environmental explaining health, is Jefferson County's that he is still , 4" a :w new environmental health learning directot about the It was his own asthma that issue. Mike McNickle sparked his interest in air qual- McNickle, ity just after he began his 36,has worked in both the pub- undergraduate work at Western lic and private sectors. Most Washington University in the recently he worked for Darden late 1980s. Restaurants, the parent compa- Though he began college ny of the Olive Garden and Red intending to become a teacher, Lobster restaurant chains. McNickle said he became so Before that, McNickle worked interested in air and water qual- for Starbucks as the environ- • ity that he changed his major to mental health manager for environmental studies. stores in the San Francisco area. McNickle said he hopes to He said the position here "put a public face on public puts him closer to friends and • health," involving area resi- family - McNickle, married dents in preventing health with two children, grew up in problerps such as the West Nile Kitsap County. - • virus,-something he said is in "I really do care about the Jefferson County but has yet to community I live in," he said, show its head. "because I live here too" McNickle's position, which McNickle's predecessor, he started April 25, is one that Larry Fay,had been in the posi- deals with food safety,drinking tion 14 years before accepting water quality, onsite sewage a job last year in King and solid waste management. County's environmental health He declined to comment about department. r?"'st• te-a-e-(7.* • • • B 8•Wednesday,May 25,2005 Two IBi' gs 1?/ a tittle • • Summer is a great time for Big�g Brothers Big Sisters program to horizons By Jeff Shelly Randall expandn S & Big Brother&Big Sister aa It took only one outing with our Little Brother for us to know • �r', �.� becoming Bigs had been the , right thing to do. !!i r. . ,, We were driving out of Fort Flagler State Park. kite, picnic '� . , basket and scavenged beach M° ifs glass securely stowed,when Jeff ti �"' asked the proverbial question:, Well,did you have fun?" "Yeah," was Vince's polite but not particularly enthusiastic ;t answer. r�‘ 2$ From the back seat, Shelly ' ' ' wanted to know,"Ona scale of 1 1,''4f t 4. { r �.a. to 10, 10 being the funnest,how a q � k`� '—^^. i . •1 . ..y . ` _ �` funwazit? : Without hesitation or changing �, his tone of voice, Vince replied, , v.4 1 a"'"" i. "I'd say it was about a 400 y�� J F"'3 We were stunned. Not € ' _i A tSw�.' .r� L' because we had knocked our- 6r 1,!:-.-- 7--- 'f- ' 1 1 1-; • selves out on this first visit, but t J " because we hadn't.We had sim- "Little Brother"Vince Williamson on his trumpet is accompanied by-"Big Brother" Randall on his ply spent an afternoon at the park high-school marching-band trombone.Vince plays In the Chimacum Elementary School band with a 10-year-old boy, forget- Photo by Shelly Randall ting for a few hours about the filled with instruments, and we chores that awaited us at home, all jam to"Go Tell Aunt Rhody." or the jobs that would occupy our Through teaching Vince to play work week.Just talking with him his high school drumset.Jeff is about his life, about the things teaming that you're never too that matter to him—and to us. old to play the drums. Who knew it would be that We're two childless young - easy? professionals(Jeff,37,is a land- Now, three months later, use planner and Shelly,28, is a we've established a routine. writer)who wanted to give back • Midweek, we call Vince, chat to our community in a way that about school, what we had for went beyond serving on boards dinner,and what fun thing we're or answering the call for one- going to do the coming week- time event volunteers. The Big end. Sometimes he can't wait Brothers Big Sisters program and calls us first. attracted us because growing up So far we've played lots of we were both influenced by catch, gone kayaking and ice informal adult mentors, and skating, made dumplings, taken because we loved the idea of rj the ferry to Keystone and back, doing good by having fun. thrown a football,played catch. Last weekend,we staged our �✓ watched a sailboat regatta, first overnight outing(yes,those J "2—C-0)� attended an art .class, and are allowed)and headed back to • turne returned to the beach many Fon Flagler to go camping. times.Did I mention that Vince Vince helped set up the two - likes to play catch? tents, and then disappeared into Being co-Bigs to one Little his headfirst,glorying in both the Brother works well in this regard, freedom and the shelter it pro- 1111 because we can trade off when vided.A moment later,we heard our throwing arms start to tire.Or him shout,"Hey,Jeff and Shelly, if one of us has prior commit- look at me!" • menu, as long as we explain In what has tamed out to be matters to Vince beforehand,the his perpetually playful attitude, • other can handle the outing solo. just Vince's head was sticking It turns out Vince can't prac- out of the zippered tent opening. rice his trumpet in his Port By the huge grin on his face,we Hadlock apartment,so he brings didn't have to ask if he was hay• - it over to nur hn„c. ,,,ti:,.,- .- • - rigs make a big diffe,e •nce By Sylvia Platt Being a "Big" is something 4110 .',.Director of Outreach&Recruitment anyone 15 and older can do and Big Brothers Big Sisters of Jefferson is a meaningful and rewarding County volunteer experience for those who want to make a difference Big Brothers Big Sisters in a child's life. (BBBS) matches caring adults ("Bigs") with school-aged chit- Making a difference Port Townsend&Jefferson County Leader dren ("Links") in one-to-one Bigs join their Littles in mentoring relationships. everyday activities like game • - Since starting up in, late , playing,reading,making music,,, November 2004, BBBS of cooking, and helping with T Ii Dl- Jefferson County hascompleted school work. In general. they 1 e W e can 13 community-based matches exert a positive adult influence, (like the Randalls and Vince)and providing support for their JP 15 school-based matches (nine Little's goal setting and problem fish • •ofthese Bigs ane high school stu- solving. Independent studiespresence of a Bi ] ]�dents),and has eight Bigs in the show that the gOG,` soon Big IJ application pipeline, helps Littles feel more confident There is a waiting list of.15 about themselves and their By Vince Williamson Little Brothers and five Little schoolwork; have better rela- Sisters needing matches, and tions with their friends,teachers ' Little Brother more than 50 other children have and parents;reduce their use of , been referred by parents,teach- drugs and alcohol;and find non- My Big Brother and Big Sister are weird.I tell them that all ers,counselors and principals. violent ways to solve conflict. the time.But not weird in a bad way, Commitment dif- ferent from most of the adults I know.They like to have They're I have two Bigs,a Big Brother and a Big Sister.I thought if The time commitment can be . as little as one hour a week(in I only chose one,then the other person would feel left out. the school-based program) or My name is Vince.I'm 10 years old.I like to read,draw,play two to four hours a week(in the kickball,and go roller blading and skateboarding and ride bikes. community-based program).For . I've lived in Jefferson County my whole life. My fifth-grade both programs, the minimum teacher at Chimacum Elementary is Mr.Raymond.My favorite commitment is one year,during which time the volunteer is subjects are reading,writing,science,social studies and math. . le expected to meet with his Little . once a week. The choice of, activities depends entirely on the , I think this program is awesome because you get to go to cool places.This program is da bomb I interests of the adults and the almost anything ��because you get to do interests so BBBS works hard to you want.Well,the Bigs give you some options. match Bigs and Littles who will The only thing you can't do is stuff that is dangerous. be compatible. We've gone ice skating. We've gone to museums at Fort Worden and Fort Flagler that I hadn't been to before.I made a Application process model of an army base myfor Bigs A 10 to 12-page application, g after our first visit to Fort Flagler. I gave it to them after finishing it about five minutes which includes a of activities before they came to pick me up. They keep it in their living - the volunteer might enjoy, three room,right in the center of their house. reference checks, and driving- record and background-check They send me cards and pictures in the mail.It's fun to get forms.takes 30 to 40 minutes to mail.I started a scrapbook of pictures that Shelly takes on our complete.After BBBS has read the application and the volunteer outings. has read the program training And Jeff took me to the library to get a library card and I've manual,an in-person interview is checked out eight or nine books so far. scheduled with the program coor- r.Potential Littles and their I decided to join the program so I could get away from my dinatparents are also interviewed, regular big brother, who's 14. I say this because my brother Depending on the pool of annoys me.I think my mom thinks that I need time away from waiting Littles and how long the him too.So far,it's workin background check takes,a match $Out. will usually be made within a I think other kids would like being Little Brothers and month or two. Sisters because it's fun.You get to choose things you want to do that you can't do with your family.That's cool. Whom to contact I hope we cano fishing If you are interested in becom- g soon. ing a Big or know a child who - would benefit from becoming a Little,please call BBBS at 732- 4090,ext.276.If you would like • to help out but don't think you can volunteer as a Big right now, there are a number of other ways 5 • to support the BBBS program, --2s -"Q�� including making a financial con- tribution, joining the Resource Advisory Committee,and volun- teering behind the scenes. l • . Three local establishments alcohol to minors . provide On the night of May 18,the als attended,"reported the sher- Port Townsend and The Ajax Jefferson County Sheriff's iff's office.Additionally,the date Caf6 in Port Hadlock. Office and Washington State of the compliance check was Establishments receiving cer- Liquor Control Board checked published in,the.newspaper the tificates of compliance were compliance of nine 'establish- first week of April: ' Washington State Liquor Store ments licensed to sell alcohol In all three cases, identifica- in Port Townsend and Port in Jefferson County. Three of tion of the youths was either not Townsend Food Mart; Fiesta the nine served alcohol to a requested or requested after the Jalisco, QFC and Inn at Port minor. alcohol was given to the minor. Hadlock,all located hi Hadlock; All owners and employees of Two servers did not have valid and Port Ludlow General Store. licensed establishments had_` server permits.. The compliance check was been invited to attend one of two Cited for non-compliance funded by a Jefferson County Responsible Alcohol Sales class- was Key City Fish in Port Sheriff's Office Reduction of es given earlier in the day by the Townsend. Receiving a warning Underage Drinking grant Liquor Control Board enforce- of non-compliance were through the Division of Alcohol i ment officer."Only 11 individu- Highway Twenty Roadhouse in and Substance Abuse. • • . • • • C• U •O U U e oN F. U NU '. U V C , N1-. N T � uo u � -._ uvuoco E uv .S2 0e >, 3 ` • G co 8 � _ ca. yu ` o t- E vo v -= u § - to °n v 7 y 7 V N• Ae =EOQ. Jr) U •• OUZ yT N o ^ at 5 m ° uNoCU S .74 y t g o } a. o- c a-a H u ° td 0.d .o u v c 5 v .0 o a: L 5N u c 3c0. m U N C vU0E LC oo y � U U - Y altdU pC a3 oo0L '-' .E4ON .V� HOy 1.V. Lt L U T•CEu ANV = U ap _ V A O G nU > . U V O a0 �D uOO colQ QV p _WW T al wE , c8i .v. 4n . m'G 'O c 7 GA C 5 : L cc) oo O Uw � E . T� E V aF�3jV0 > u ` y ' syw o v 4- . 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N. • • Volunteers needed to trap mosquitoes Jefferson County Public Health seeks assistance in trap- ping mosquitoes throughout Jefferson County.Purpose of the project is to collect information on mosquito breeding habitats and areas of the county with mosquito problems,and to iden- tify species of mosquitoes pre- sent here. Approximately 12 to 15 vol- unteers are needed to conduct the trapping.They receive train- ing from the Washington State Department of Health on proper techniques for trapping and han- • dling mosquitoes. The trapping project starts in June and ends in September.Call Mike McNickle,385-9444. • 1110 Chiamydia case s rise in county Chlamydia was at a record she needs to be treated. level in Washington state in According to Dr.Tom Locke, 2004, with 17,637 cases report- health officer for Jefferson ed. Jefferson County document- County, the increase in reported ed 36 cases in 2004 and 59 cases cases is due to several factors. in 2003. In the first quarter of "More people are being tested, 2005, a record number of' 20 the tests have become more sensi- cases of chlamydia had already five,and the number of infections been reported in our county. is also increasing, due to risky Chlamydia is especially corn- sexual behaviors,"said Locke. mon in persons under age 25. The new screening recom- Many infected people do not mendations stress that all sexual- know that they have chlamydia. ly active women ages 14 to 25 Up to 80 percent of infected should be screened at least annu- women and up to half of infect- ally, even if symptoms are not ed men have no symptoms.Even present.Screening is also recom- without symptoms, the infection mended for men and women t can lead to pelvic inflammatory with risk factors such as those disease (PID) in women, infec- who have a new sex partner or tion of the testicles in men, and multiple sex partners.There is a • infertility in both sexes. new urine test that makes screen- Chlamydia infection also makes ing easier. it easier to catch and give HIV People can avoid becoming • Chlamydia can be treated with infected with • chlamydia. antibiotics. It is important that all Abstinence from sex is the surest sexual partners of an infected per- way to .avoid infection, Locke son are treated because re-infec- noted. The next surest way is to tion from exposure to untreated limit sex to one uninfected part- partners is common. The ner,mutual monogamy.For those Jefferson County Public Health choosing to have more than one Department can help with partner sexual partner, condoms should notification and treatment. always be used.Correct and con- Anonymous partner notification sistent condom use can minimize is available if a person is uncom- the risk of transmission, accord- fortable telling a partner that he or ing to the Health Department. Tr: La_12.t.47. •• Worldrecon orMackie .....„ ,,,.._. ia.E.Wrts_ - ... � � ` '4.,.. q Seattle's Folklife 4 ,, , • S ..,-,a,± . ----,---,-,. t, ,,- . &6;' ^ .;3F sr x s ..--- - A - tr * ', a : festival draws :14 -, t r ,d fT i ;harmonica band } I'I' , ��"*i s� .�.Vt r -: $ s F, According to the unofficial results,Andy ''''---..4 ��► Mackie of Quilcene has fulfilled his dream of ��� '11 ° !Iifr . leading •the largest and longest-playing har- yy> {' -'> f ?" 3 " '* '` monica band in recorded history. ,9' w '; >°°a 4.; :,, "It's beyond my wildest dreams, Mackie -I .� ' '• .' said Tlresday. "It's just overwhelming. You : , `l 4 , -tM ,s -1'''''r'''. = }. watch the way those little kids respond,you tam know,it's just beautiful" ) ", ''� �' a� During Seattle's Northwest Folklife Qullc nne's Andy Mackie hums along on his harmonica as his 1,706-member band In Seattle Festival on Sunday, 1,706 card-carrying Plays"Twinkle,twinkle Little Star"to break the world record for the largest and longest members of the band - led by Mackie - playing harmonica band. . played a 13 minute and 22 second rendition of"Twinkle,Twinkle Little Star."The perfor- University Learning Center in Port Hadlock Force, himself a lifelong musician, con- mance will likely land them in the Guinness has been a friend of Mackie for years. He vinced Mackie that Folklife would be a bet- Book of World Records. said Mackie,known throughout the Olympic ter venue. Mackie agreed, and Force The previous records were set in Poland Peninsula for his active sharing of the joy of arranged the world record attempt with the by an 851-member band that played for 12 music with children,came up with the idea to festival's organizers. Force worked with minutes. assemble the band at Jefferson County Mackie's assistant,JoAnn Bussa of Brinnon, Robert Force of the Washington State Memorial Field. See MACKIE,Page A 12 II _ 6 u . >, ` � . ° nUPiIiHI c3 `" " u t,c"- r : o> S Sc S " HI ru ,9P1 v °fa. o 1) g goc > 4 o '<.. ` m ^ c o�,' V' v, 5.a a-5 •5 Li -2 u o .5IL , t • m . 'i T 0-5 92 ts. t 7. h. 0as -0 E 4mNvEo .5 o E >;Fcgoc o o • >._ .' e� . E•$2SE 05AA - u° ° > ° c uc C c E uu g '- n L u - u=watluT 3 oa " iou3 , cu 2'' a T oc0 -5 va'i T .Q °. N 'iVIHIVJUH uvL = gut u1-j -- cEA =` h Es GPay o5Tg i° Oo c _ U E o 'Ci : o =. o.5 ,a 1:1-0 `° o00 O u ° o 5__o c o._ o G c _ F, o Z - -.Z 4I Ci A u u.F Ti. :z " LL g L o. 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O dg o . s- ooa j °v.82_ c 5 u 411 .. .-. ... • ... e .„ oE Z no > 2 F S.°, _T^• •L V E° u8,o -8 E uTW25 _ GTLc3a uh 96wh '" Vo, " u c= Eh--- v c ° v "a ,a"' m ca r s 2 -0E-s.. .5 u u , 8g -.z. oL^ a -T .3-6x0•0= -„, 5 0 '0 ° .. `1 ruo.0p Ta."rsS.5g .t_u u3 =oa u Ao 5 u uL u•5 5 co u^a 0.. E ,vt Z i-5� .0 v.. 5 ° < a-Ti fon ii' - (*ThCLEADER*) . ill360-385-2900 Continued from Page A 1 Ur- enPatients who have a regular, • local doctor should call him or her first before coming to the urgent care clinic. Staying open from 5:30 to 8:30 p.m. on weekdays are means the urgent care clinic pro- vides unique"after hours"access. The urgent care idea came from many sources,including the C''n 'c hospital emergency room staff, O p e n family physicians, and county health department. The service evenings will be evaluated in September, and public hospital district offi- By Patrick J.Sullivan orals will decide if it should be Leader Staff Writer continued,Dowdle said. "We know that it's summer- Jefferson Healthcare is offering a time and there are vacations for Physicians as well as for corn- new "urgent care" service for people who don't need the hospital emergency _ maty members,"Dowdle said. room and can't otherwise get into a clin- whoWe realize soneedsomething for a minor there are travelers is quickly to see a doctor. who Beginning June 13 and continuin illness and they don't need to go through September,Jefferson Healthcare to our emergency department"offers urgent care services from 5:30 to ' durance is not necessary to 830 p.m.Monday through Friday at Port receive the urgent cart. "We'll Townsend Family Physicians, 934 gyve them an estimate of how Sheridan Si,next to the hospital. much it will cost to be seen, and The clinic will have a doctor and we'll'see them and worry about nurse available to see the patient and the insurance later,"Dowdle said. '. make a diagnosis,with treatment and/or Urgentdecare issuesn inion,. referral. No urgent care a include urinary tract infection; are needed or taken.It is strictly a walk- ear infection, insect bite,nausea and diarrhea, sprains, minor in service,with patients seen in order of arrival, according to Paula Dowdle, burn, minor cut, pink eye, sore throat and skin infection. Jefferson Healthcare chief operating Hospital emergency room officer and clinic administrator. "It's for people who can't get in to issues still include uncontrol- see their regular doctor, or are new in • fable bleeding, broken bones, town and don't have a doctor, or are of•severe abdominal pain;shortness travelers who have a minor illness or breath or any cardia e injury,"Dowdle said. pain, sudden blurred vissionign orr sudden severe headache. See URGENT,Page A 12 "Urgent care is for walk-in, same-day,minor things,"Dowdle said. "If a person has any cardiac symptoms or other real emer- gency,they need to get to the hos- pital or call an ambulance." • 6^ _ d