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HomeMy WebLinkAbout2006-May File Copy i I Jefferson County Board of Health .Agenda Ml mutes I May 18, 2006 a • JEFFERSON COUNTY BOARD OF HEALTH May 18, 2006 2:30—4:30 PM Main Conference Room Jefferson Health and Human Services AGENDA I. Approval of Agenda IL Approval of Minutes of Meetings of April 20,2006 III. Public Comments IV. Old Business and Informational Items 1. Amend Ordinance 03-0505-97, Section 8.00.080 (Rules and Records of Proceedings) BOH Meetings 2. WIC Budget Letter • 3. Onsite program scheduled actions V. New Business 1. EnviroStars Award— 2. Expanded Mental Health & Substance Abuse treatment and Therapeutic Court Funds 1/10 of 1% sales tax 3. Irondale Residents Letter of Concern VI. Agenda Planning V. Adjourn Next Meeting: June 15, 2006 2:30 PM—4:00 PM Jefferson County Public Health Main Conference Room JEFFERSON COUNTY BOARD OF HEALTH MINUTES 4 j Thursday, April 20, 2006 • 4kost.44** Board Members: Staff Members: David Sullivan, Chairman—County Commissioner Jean Baldwin, Public Health Services Director District#2 Julia Dans kin,Nursing Services Director Patrick M. Rodgers, Vice Chairman— County Thomas Locke,MD,Health Officer Commissioner District#3 Mike McNickle, Environmental Health &Natural Phil Johnson—County Commissioner District#1 Resources Director Jill Buhler—Hospital Commissioner District#2 Geoff Masci—Port Townsend City Council Sheila Westerman—Citi<en at Large (City) Roberta Frissell—Citizen at Large (County) Meeting was called to order at 2:32 pm on April 20, 2006 by Vice Chair Pat Rodgers in the conference room of Jefferson County Public. All Board members were present with the exception of Commissioner Sullivan. All staff members were present. There was a quorum. APPROVAL OF AGENDA Motion was made to approve with one addition to old business. The motion was carried by a unanimous vote. • APPROVAL OF MINUTES Board Member Masci made a motion to approve the Minutes as written. Board Member Frissell seconded the motion,which carried by a unanimous vote. PUBLIC COMMENTS Chair Rodgers called on the public for comments. There were no public comments. OLD BUSINESS Letter to Law Enforcement Officials re: Jefferson County Board of Health Clean Indoor Air Ordinance Jean Baldwin shared the updates from the State Attorney General that will be shared with other jurisdictions. Community education around Initiative 901, which prohibits smoking in public indoor places and workplaces, is continuing. Tuberculosis Editorial-Kitsap Sun • There was a discussion regarding tuberculosis and its treatments. Big Brothers Big Sisters of Jefferson County 2004-05 Project Summary Kellie Ragan, Drug Free Communities Program Coordinator explained that the primary source of funding for Big Brothers Big Sisters is the Drug Free Communities Support Program (SAMHSA). This funding is scheduled to expire September 30, 2007. Big Brothers Big Sisters is a federally recognized best practice and one-to-one mentoring was identified by stakeholders as a service gap in 2000. Under the management and supervision of Big Brothers Big Sisters of King, Pierce, and Jefferson Counties, community-based and school-based matches have increased dramatically over the past two years. In 2005, 74 mentors dedicated an estimated 5,244 hours to local children in one-to-one mentoring. The goal for 2006 is to create and support 100 matches in Jefferson County. ADDED AGENDA ITEM Ordinance to Amend the Board of Health Board Member Westerman made a motion to draft a letter requesting an amendment to Ordinance Number 03-0505-97. The current ordinance requires two County Commissioners be present for a quorum or a vote to take place by the Board of Health. The proposed change would allow all Board of Health members equal voting authority by • eliminating the County Commissioners requirement. Board Member Masci moved to approve the motion for the BOCC to review the request. Board Member Buhler seconded the motion,which carried by a majority vote. Three in favor, two against and one abstention. NEW BUSINESS 2004 Jefferson County Healthy Youth Survey Ragan presented the recently released report to BOH members and noted that the Fact Sheet template was developed by Thurston County Public Health epidemiology staff. Ragan walked members through the format of the report-each fact sheet contains the actual question asked of students, data highlights, response rates by grade level, data notes that include source of question—Form A, Form B, and/or Form C,technical notes specific to questions and contact information. Appendices A-H provide detail about the report and respondents. Ragan noted that the statewide administration of the Healthy Youth survey is funding heavily through tobacco settlement dollars; analysis of local data was also heavily funding through local tobacco settlement dollars. Ragan discussed internal controls within the survey to control honesty-the following types of surveys are culled from the survey respondent pool: respondents who answered that they were not honest in filling out the survey, respondents who provide inconsistent answers (I have never used marijuana/the first time I used marijuana was when I was 11), • Christmas-tree (or similar) pattern on scan form; respondents who report using a 'fake • drug' (e.g. wagon wheels, derbisol). Ragan discussed the generalizability of the finding as set forth by the Joint Survey Planning Committee-with a 70%response rate results are likely to be representative of the population; 40%-69% %response rate results are likely to be somewhat representative of the population; less than 40% of a response rate-use these results with caution. The Jefferson County Public School participation rates by grade are as follows: Grade 6-75%; Grade 8-72%; Grade 10-61%; Grade 12-56%. Ragan also mentioned caveats about the survey-this survey provides a snapshot in time and is gross measure of what is happening among the population; the survey does not track grade cohorts over time (e.g. HYS does not control for migration or attendance therefore, the 6th grade respondents in 2002 should not be considered the 8th grade respondents in 2004). Ragan reported that Chimacum, Port Townsend, and Quilcene School Boards, the Community Network and the Substance Abuse Advisory Board will be receiving presentations during the coming weeks. The entire report is available on the Public Health website at: www.jeffersoncountypublichealth.org Nurse Family Partnership-Jefferson County Impacts Quen Zorrah presented a video to illustrate the effects of neglect and abuse on children. In dealing with child neglect cases, the two main issues that have surfaced are depression and methamphetamine use. All clients who receive services are given depression • assessments because statistics have shown that 20% of women in childbearing years will face some type of depression. Poverty is one of the biggest contributing factors to depression. The other issue in child neglect cases is the significant growth of methamphetamine use in the last five years. Quen discussed that past Boards of Health had requested services to all families in Jefferson County, not just the low income or high-risk families. Jean Baldwin mentioned this is currently paid for by the liquor excise tax the county receives and pays towards prevention. Currently those funds cover the increase of services but that is based on state and federal funding remaining stable. Board Member Masci made a motion to review the Family Support Partner protocol. Board Member Buhler seconded the motion,which carried by a unanimous vote. WIC Program 2005 Report Julia Danskin briefly discussed the WIC 2005 Annual Report. Jefferson County is unique because we have all of our programs in one location. In 2005, WIC clients spent $310,953.00 in local grocery stores and $2,222.00 at the Farmers Market. The President's budget proposes to fund the WIC program in 2006 at $5.5 billion (2005 funding was $5.235 billion). For 2007, the president has proposed capping WIC funding substantially below the program's growing needs and in 2008 requiring states to pick up 20 percent of the cost. Board Member Westerman made a motion to draft a letter • supporting the WIC program and requesting no cuts in future funding. Commissioner Johnson seconded the motion,which carried by a unanimous vote. Environmental Health Updates-Onsite Program Permitting and Hood Canal Septic • System Repair Loans Mike McNickle gave an update of the work in progress. Environmental Health,Natural Resources and Community Development continue to work on streamlining processes and procedures. The critical element in issuing permits in a timely manner is complete applications when first submitted. The new Environmental Health Technician position will review all septic applications. The goal is to have applications submitted with 100% accuracy. Jefferson County Public Health has been awarded a$330,000.00 grant to help residents living along the Hood Canal repair and replace septic systems. Residents who have a septic system that is in need of repair will be able to apply for a 1.3% interest loan to cover the expenses of the design and installation of a new septic system. Mike is the contact person for approving qualified residents' applications. The State Legislature has set aside $1.5 million in grant money for onsite installations and designs. The money will be divided among all counties in a three-tier program. Mike requested a committee be formed to assist in the design of this program. Vice Chairman Rodgers and Board Member Westerman volunteered. Health Officer Updates Dr. Locke explained that the 2006 flu season was very late. Flu vaccines given early fall 2005 in some people could be waning in months of March or April. This is a major concern for the elderly. We are preparing to begin dead bird surveillance with crows for • West Nile and mosquito trapping. Vice Chair Rodgers adjourned the meeting at 4:30 p.m. Next Board of Health meeting is May 18, 2006. JEFFERSON COUNTY BOARD OF HEALTH Excused David Sullivan, Chairman Jill Buhler, Member Patrick M. Rodgers, Vice Chair Sheila Westerman, Member Roberta Frissell, Member Phil Johnson, Member Geoff Masci, Member • • Board of Health OCd Business .agenda Item # 117., 1 .Amend Ordinance #O.3-055-97, Section 8.00.o80 • Rules & Records of Proceedings Nlay 18, 2006 • JEFFERSON COUNTY PUBLIC HEALTH tre�t�lc?` 615 Sheridan Street • Port Townsend •Washington • 98368 • wwwjeffersoncountypublichealth.org April 27,2006 Jefferson County Board of Commissioners Jefferson County Courthouse P.O. Box 1220 Port Townsend, WA 98368 Dear Commissioners: I am writing on behalf of the Jefferson County Board of Health. At the Board's April 20,2006 meeting a motion was made and seconded to request that the County Commissioners amend Ordinance 03-0505-97, section 8.00.080 (Rules and Records of Proceedings)to remove the requirement that"at least two Jefferson County Commissioners"be present in order for action to be taken by the Board of Health. The motion passed with 3 members in favor, 2 members opposed and 1 member abstaining. • As administrative officer of the Board of Health, I am forwarding the Board's request to the County Commissioners for consideration. If the Board of Commissioners are in support of this ordinance change, I would recommend it be accomplished by striking the words "including at least two Jefferson County Commissioners" from the existing language in section 8.00.080 of the County code. Should this change be made, the Board of Health would need to amend their bylaws to reflect the altered requirement for a quorum of Board members. The effect of these changes, if made,would create a quorum of the Board when 4 or more members were present, irrespective of the number of county commissioners in that quorum. On behalf of the Jefferson County Board of Health, thank you for your consideration of this request. Sincerely, Thomas Locke, MD, MPH Jefferson County Health Officer • COMMUNITY HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES PUBLIC HEALTH NATURAL RESOURCES MAIN:360-385-9400 ALWAYS WOR \G FOR ASAFER AND MAIN:360-385-9444 FAX:360-385-9401 HEALTHIER COMMUNITY FAX:360-385-9401 W • STATE OF WASHINGTON © Z JEFFERSON COUNTY C� In the matter of an Ordinance ) Defining the Responsibilities and ) 03-0505-97 Expanding the Membership ) ORDINANCE NO. of the Jefferson County ) County Board of Health ) WHEREAS: Pursuant to RCW 70.05.030,the Board of County Commissioners has constituted the Jefferson County Board of Health. WHEREAS: Section 6 of RCW 70.05.030 and 1993 c 492 s 235 were each amended in 1995 to include the • following: 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 appointment, term, and compensation, or reimbursement of expenses. WHEREAS: The health and safety of the citizens of Jefferson County,and the condition of their living environment, are of paramount importance to the County's well being. WHEREAS: The Board of County Commissioners,sitting as the Board of Health,determined at its February 25, • 1997 meeting that the addition of persons with knowledge, interest,and expertise regarding the health,safety,and well-being of Jefferson County citizens and their living environment would benefit the operation of the Board of Health and the citizens of Jefferson County. NOW, THEREFORE, BE IT ORDAINED That the Board of County Commissioners after due deliberation and in the best interest of the public, does hereby expand the size and composition of the Jefferson County Board of Health. BE IT FURTHER ORDAINED That Title 8. Health and Safety, of the Jefferson County Code be amended to include a new Chapter 8.00,Board of Health, defining the responsibilities and membership of the Jefferson County Board of Health, as follows: 8.00.010 Duties and Responsibilities: The Board of Health shall have responsibilities over all matters pertaining to the preservation of the life and health of the people of Jefferson County and shall: (I) Collect, analyze and disseminate to the community, through the Jefferson County Health & Human Services department, information about community health conditions, risks and resources,and the availability of resources to address identified problems: (2) Enact such rules, regulations and policies as are necessary to preserve,promote and improve the health status of Jefferson County residents. and guide the allocation of appropriate and necessary public health resources: (3) Assure that necessary, high quality, effective public health services are available for the protection of the people of Jefferson County, including the control and prevention of any dangerous, contagious or infectious disease within the county: (4) Provide for the prevention,control and abatement of nuisances detrimental to public health: • (5) Enforce, through the Health Officer. the public health statutes of the state and county:and (6) Establish fee schedules for issuing and renewing licenses and permits,or for such other services as are authorized by the law and rules of the State Board of Health. Ordinance No.034405 17 Board of Health 8.00.020 Members: The Board of Health shall be composed of seven members. The three elected members of the Board of County Commissioners shall be members of the Board of Health. Four members of the Board of Health shall be appointed by the County Commissioners. Appointed members of the Board of Health shall • include one elected official from the City of Port Townsend City Council and three non-elected community representatives. Community representatives shall include one resident of the City of Port Townsend and two residents of unincorporated Jefferson County. One community representative shall be a Jefferson County Public Hospital District 42 commissioner;two community representatives shall be at-large members. 8.00.030 Terms: Appointed members shall serve for three year terms. Of the members initially appointed, an equal number shall be appointed for two years and for three years. The term of office for all appointees shall commence on the first day of June in the year in which the term is to commence. 8.00.040 Appointment: The chairperson of the Board of County Commissioners shall appoint the initial members to the Board of Health with the approval of the majority of the Board of County Commissioners. The Board shall request that the City of Port Townsend and Jefferson County Public Hospital District#2 each nominate one candidate for appointment to the Board of Health. The County Commissioners shall seek applications from citizens of Jefferson County to fill the at-large membership positions on the Board of • Health. 8.00.050 Vacancies: Vacancies on the Board of Health shall be filled by appointment by the chairperson of the Board of County Commissioners in the same manner as initial appointments are made. Appointments shall be for the unexpired portion of the term of the position filled. 8.00.060 Organization: The Board of Health shall elect a chairperson and vice-chairperson from among its members. 8.00.070 Meetings: The Board of Health shall hold no fewer than one regular meeting in each month of each year:provided that if no issues over which the Board has jurisdiction are pending upon its calendar,a meeting may be canceled. All meetings of the Board of Health meetings shall be open and public, pursuant to the Open Public Meetings Act, codified at RCW 42.30 et seq. Meetings shall be held at such times and at such locations as to be convenient for attendance by Board of Health members and the public.as determined • by a Resolution passed by a majority of Board of Health members. 8.00.080 Rules and Record of Proceedings: The Board of Health shall adopt Bylaws for the transaction of its business. No actions shall be taken by the Board of Health unless a majority of members are present. including at least two Jefferson County Commissioners. The Board of Health shall keep a public record of its transactions, findings and decisions. 8.00.090 Compensation or Reimbursement: Appointed members of the Board of Health shall not receive compensation for their services. Appointed members may receive reimbursement for approved expenses related to the completion of their responsibilities. BE IT FURTHER ORDAINED That such amendment shall be effective immediately upon execution of this document by the Board of County Commissioners. � APPROVED and ADOPTED this ..� day of / .==/ . 1997. ', JEFFERSON CO T e SEAL: ` '' • 114F CO COM i •°S 3*1111rd Wojt, Chairman • N` ' , 1. Glerkkluntingford. ATTEST: / . Lorna Delaney. CMC Dan Harpole, Memb Clerk of the Board Tom Locke From: David Alvarez • Sent: Friday, October 11, 2002 9:02 AM To: Tom Locke; Juelie Dalzell Cc: Lorna Delaney; Larry Fay Subject: RE: Legal Question for Board of Health Here are some quick answers. David Alvarez Original Message From: Tom Locke Sent: Thursday,October 10,2002 7:21 PM To: Juelie Dalzell; David Alvarez Cc: Tom Locke Subject: Legal Question for Board of Health Questions for the legal eagles: The Jefferson County Board of Health was expanded by ordinance 03-0505-97. Secton 8.00.080 states"The Board of Health shall adopt Bylaws for the transaction of its business. No actions shall be taken by the Board of Health unless a majority of members are present, including at least two Jefferson County commissioners. The Board of Health shall keep a public record of tis transactions, findings, and decisions." Bylaws were adopted. In these bylaws, quorum is defined as"A majority of all Board members, including at least two Jefferson County Commissioners,shall constitute a quorum for Board meetings". At the regularly scheduled meeting of the Board of Health on 8/15/02, 5 of 7 members were present. Two County Commissioners were absent. One of the Commissioners was returning from Olympia and would possibly join the • meeting late. The other Commissioner was in China. The Chair of the Board, realizing that a quorum was not present, began the meeting for discussion purposes with the expectation that a second commissioner may arrrive. A civil penalties ordinance was scheduled for hearing and possible adoption at the August meeting. A second commissioner never arrived and the meeting was adjourned without taking any action. In preparing minutes of this meeting the Clerk of the Board of County Commissioners determined that, lacking a quorum, there should be no official minutes and instead produced a set of"discussion notes". The Board has directed me to ask the following questions: 1) Is the Clerk of the BOCC correct in her interpretation of the law? [David Alvarez] Whether they are called "minutes"or"discussion notes,"the important point is that the document generated reflect both the absence of a quorum and the fact that no official business was transacted. I can see Ms. Delaney's point that the meeting can't begin until the quorum exists and without a quorum no meeting took place and thus there can't be any"minutes"for a meeting that never occurred. Thus, I would say BoCC Clerk Delaney was correct in her interpretation of the law. 2) If the BOH lacks a quorum can it begin its meeting, taking no official action until a quorum is formed or must it wait until a quorum is present to begin the meeting? [David Alvarez] Again, the same logic as above applies. Whatever occurs before the quorum is present is not a meeting, it might be a gathering,a koffee klatch or a pleasant coincidence, but it is not a meeting of the JeffCo Board of Health. When there is a quorum present, then the presiding officer should state"I find that a quorum exists for this BOH meeting and we can proceed with the meeting agenda." So,the meeting does not begin until the quorum is present. If the BOH wants to create an internal rule that it only waits 10, 15 or 30 minutes to get to a quorum being present before disbanding and giving up the effort of trying to get to"official meeting"status,then that would be acceptable too. • 3) If the BOH is meeting,with a quorum, and a member leaves such that a quorum is no longer present, may the Board continue the meeting (while taking no official action)or must it adjourn the meeting when the quorum is lost? [David Alvarez] Believe it or not this is not a state law question, but more a question of Robert's Rules or any other 1 procedural set of rules. My understanding, from having served on at least one volunteer board, is that once a quorum has been established and once the meeting starts,then the meeting can go on, even in the absence of a quorum. However,there is a trick you need to be aware of. The procedural trick is that someone can ask the Chair person at any time during a valid meeting to re-check if there is still a quorum, and if there isn't a quorum,then the meeting has to end. I don't know how often that would apply to the BOH, since such trickery would only engender bad feelings • and perhaps ruin good personal relationships. Since we live in a very small town and a small county I assume people are hesitant to do that. This is a significant issue for the Board given the fact that Commissioners are often late for the meeting and have,on multiple occasions, left early due to scheduling conflicts. We appreciate your advice. Thanks, Tom Locke Health Officer • 2 • Board of 3-Cealth OCd Business .Agenda Item # . V., 2 WIC Budget Letter • iVLay 18, 2006 • JEFFERSON COUNTY • BOARD OF HEALTH May 1,2006 The Honorable Henry Bonilla,Chair The Honorable Rosa DeLauro,Ranking Member House Committee on Appropriations House Committee on Appropriations Subcommittee on Agriculture, Subcommittee on Agriculture, Rural Development,Food and Drug Rural Development,Food and Drug Administration,and Related Agencies Administration,and Related Agencies 2362 Rayburn House Office Building 1016 Longworth House Office Building Washington,DC 20515 Washington DC 20515 Dear Chairman Bonilla and Ranking Member DeLauro: At the April 20, 2006 meeting of the Jefferson County Board of Health, the Board reviewed costs and impacts of the WIC program in our county. 60% of infants born in Jefferson County are served by WIC. 72% of their families are living in poverty. The WIC program makes a huge difference for these families in promoting breastfeeding of infants, providing nutritional education, and assuring that adequate amounts of nutritious food is available to the most vulnerable members of our community. • We also learned,with alarm, that significant cuts and caps are being proposed in the federal WIC budget. We strongly urge your committee to reject these budget changes and the inevitable service reductions that will result. The federal, state, and local governmental partnership that provides WIC services to needy families has a long record of success in improving birth outcomes and child health. It is one of only a handful of federal programs that makes a serious investment in prevention. The presence of Nutrition Services and Administration(NSA) grants has allowed state WIC agencies to provide a wide range of essential nutritional services while significantly reducing food costs. Reducing these grants,by whatever budgetary mechanism,will have the predictable results of providing less services to less community members. Like hundreds of other local governments,Jefferson County has provided substantial local funding to assure that WIC services are available to all those who meet program eligibility criteria. They are staffed at the minimum possible level consistent with detailed federal requirements in order to maximize the nutritional benefit to women, infants, and children. State and local governments will be unable to offset proposed_ federal reductions in WIC funding. The technical jargon that has evolved over the 32 years of the federal WIC programs-caseload reductions,limited adjunctive eligibility, NSA caps - obscures the human impacts of these funding cutbacks at a community level. Federal cuts mean more infants,children, and young mothers go hungry and be • undernourished. 615 Sheridan• Castle Hill Center• Port Townsend• WA (360) 385-9400 JEFFERSON COUNTY BOARD OF HEALTH May 1,2006 The Honorable Henry Bonilla,Chair The Honorable Rosa DeLauro,Ranking Member House Committee on Appropriations House Committee on Appropriations Subcommittee on Agriculture, Subcommittee on Agriculture, Rural Development,Food and Drug Rural Development,Food and Drug Administration,and Related Agencies Administration,and Related Agencies 2362 Rayburn House Office Building 1016 Longworth House Office Building Washington,DC 20515 Washington DC 20515 Dear Chairman Bonilla and Ranking Member DeLauro: At the April 20, 2006 meeting of the Jefferson County Board of Health, the Board reviewed costs and impacts of the WIC program in our county. 60% of infants born in Jefferson County are served by WIC. 72% of their families are living in poverty. The WIC program makes a huge difference for these families in promoting breastfeeding of infants, providing nutritional education, and assuring that adequate amounts of nutritious food is available to the most vulnerable members of our community. • We also learned,with alarm, that significant cuts and caps are being proposed in the federal WIC budget. We strongly urge your committee to reject these budget changes and the inevitable service reductions that will result. The federal, state, and local governmental partnership that provides WIC services to needy families has a long record of success in improving birth outcomes and child health. It is one of only a handful of federal programs that makes a serious investment in prevention. The presence of Nutrition Services and Administration (NSA) grants has allowed state WIC agencies to provide a wide range of essential nutritional services while significantly reducing food costs. Reducing these grants, by whatever budgetary mechanism,will have the predictable results of providing less services to less community members. Like hundreds of other local governments,Jefferson County has provided substantial local funding to assure that WIC services are available to all those who meet program eligibility criteria. They are staffed at the minimum possible level consistent with detailed federal requirements in order to maximize the nutritional benefit to women, infants, and children. State and local governments will be unable to offset proposed federal reductions in WIC funding. The technical jargon that has evolved over the 32 years of the federal WIC programs - caseload reductions,limited adjunctive eligibility, NSA caps - obscures the human impacts of these funding cutbacks at a community level. Federal cuts mean more infants,children, and young mothers go hungry and be • undernourished. 615 Sheridan• Castle Hill Center•Port Townsend• WA (360) 385-9400 • Board of 3 CeaCtli New Business .Agenda Item # 17., 1 • Bnv iroS tars Award .vlaV 18, 2006 0 JEFFERSON COUNTY PUBLIC HEALTH { 615 Sheridan Street • Port Townsend • Washington • 98368 360-385-9400 Fax 360-385-9401 • SSJNG�O www.jeffersoncountypublichealth.org DATE: April 18, 2006 Board of Health, Members: Port Townsend, WA 98368 Dear Board of Health Members: Attached for your signature is an EnviroStars award for Printery Communications. Printery Communications has been awarded the 5 Star rating, the highest EnviroStar rating. They have eliminated and are recycling all of their hazardous wastes. Printery Communications is a leader in Environmental Business practices in Jefferson County. After signing the award, please return it in the cardboard file holder to: • Jasmine Fry Jefferson County Public Health Solid Waste Management Program 615 Sheridan Street Port Townsend, WA 98368 Thank you for your continued support of the EnviroStars Program! Sincerely, Jasmine Fry Environmental Health Specialist • COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES ALWAYS WORKING FOR A SAFER AND NATURAL RESOURCES 360-385-9400 HEALTHIER COMMUNITY 360-385-9444 `Omm m '\\Nittl,. '.,i,.ilre pi.':, ' CI),/1 1 It CA I ' ac pO -te�cm com y s� F 11111.1 , lut -'(D aoOON p -+• ...., i ,,-1-1._-.,,:;'.:0,':.7:1, :Iiiiinpii(it• cp g ,...,. , ,.„.....„ ,,_, ,„,,s,,,,„,,,,. .„....„...., ,. t.,,,,,---;._,:-:-.4:-,..;:-..:,--,--,....,,,,,..„---,-„,-.-v.7.!-':':-.-„„. _ ,„.4-iiiklv--- " as (-4) . „,,,,., ,,,,.,,,. _ _,,,..„,,,,„:,,.„,,,,,,„...,,,,,;„., 0 „ ,, ....._.. _,_ „,..,„:„..,,,..:„}„..).,,,,, „,..._,::,.„,,,,,.;„ _. ,,..,„:_.;„,_::_-_,-„.---,--ii*:--' ' 1, - '. ' i,:-*-' ril [.. I 0 k r ,AL. A, , . , , .....,,, ,.4: . ,,,,,,,,,,,....:-,1:7...,:.,,, . .. , „,...„4.1, _.L., 4,i1,-ir,, , L,. , , , -', „_., lip , . _ ,... . ,. , .. „ , .„ ..... „, _..,. . v olio 0 . .,„ Illi c,) ” , .,,,,,,_,,s,. - .,% , , , as ' . N , . ', �,.P,O n 14111 .. • §x t s_ c„) ..11-,34:;-:._-_,-,t,r,-_,..,„=,,,.,, iiiti„. � r•f �sy^a 5 •4 .. .,,„,,,,,.„ ..„.. ,, ....,. .,.... ., . . _,.., ,e_:,..,„._, ,_, ,_ 0 0 !rt.vJ . . . .. V,•_._...., ,,, , c,)� /'wI V ■ , . ��sL5°N coG� JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street • Port Townsend • Washington • 98368 360-385-9400 Fax 360-385-9401 • 'S/11 NG'-' www.jeffersoncountypublichealth.org DATE: May 12, 2006 Board of Health, Members: Port Townsend, WA 98368 Dear Board of Health Members: Attached for your signature is an EnviroStars award for Uptown Dental Clinic. Uptown Dental Clinic has been awarded a 3 Star rating. They have eliminated and are recycling all of their hazardous waste. Uptown Dental has set goals to continue to reduce their hazardous waste. After signing the award,please return it in the cardboard file holder to: • Jasmine Fry Jefferson County Public Health Solid Waste Management Program 615 Sheridan Street Port Townsend, WA 98368 Thank you for your continued support of the EnviroStars Program! Sincerely, Jasmine Fry Environmental Health Specialist • COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES ALWAYS WORKING FOR A SAFER AND NATURAL RESOURCES 360-385-9400 HEALTHIER COMMUNITY 360-385-9444 on pausaw. D a> z 11111 IR a A yCn 65 o c n� � y ..',11,:-. ....T.'1-..,-,,,,..eit. illitC y lit . ,. Ctfftql g , __. 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Cl) t cf) N• ,, en v Cin • • Board of- CeaCt( Netiv Business .agenda Item #v, 2 • ExpandedNlentaCHealth, & Substance Abuse Z"reatment & Therapeutic Court Funds .May 18, 2006 • • JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS ORDINANCE NO. 08- 1003-05 Tax Increase 1/10 of 1 % Expanded Mental Health & Substance Abuse Treatment & Therapeutic Courts Funds • DRAFT 04/26/06 • Table of Contents Jefferson County Ordinance No. 08-1003-05 Purpose Statement of Needs Definitions Program Creation and Authority Program Design& Evaluation Program Elements Administration & Authority Program Funding Evaluation • Termination • 2 • Expanded Mental Health & Substance Abuse Treatment And Therapeutic Courts Funds ORDINANCE Jefferson County Ordinance No. 08-1003-05. (See Attachment A) PURPOSE of Expanded Mental Health & Substance Abuse Treatment & Therapeutic Courts Funds (MH/SA Fund) The purpose of this ordinance is to use the County Legislative Authority to authorize, fix and impose a sales and use tax in addition to other taxes authorized by law with a rate not to exceed 1/10 of 1% to provide monies to be used for the purpose of providing new or expanded substance abuse or mental health treatment services and for the operation of a new or expanded therapeutic court. In the 2005 legislative session Senator Hargrove introduced the Omnibus Mental Health and Substance Abuse Reform Act SB 5763 which focused on the expansion of substance abuse and mental health treatment(co-occurring disorders). The bill passed with strong bi-partisan support. • The goals of the legislation were to: 1. Reduce negative impacts of mental health and substance abuse on children and families 2. Avoid building more jails and prisons and prevent crime victims 3. Reduce public assistance expenditures and unemployment 4. Reduce homelessness 5. Reduce physical-health care and emergency room costs 6. Improve recovery and quality of life for those with substance abuse and mental health disorders To meet these goals the legislation provides a funding mechanism to expand or provide new mental health and substance abuse treatment by authorizing counties to impose a sales and use tax in the amount of 1/10 of one percent(10 cents per $100). STATEMENT OF NEEDS The impact of substance abuse and mental health disorders on Jefferson County is significant and it is clearly recognized as the most costly issue facing Jefferson County Government today because it affects all systems. The impact is across the board from emergency services, police, • 3 courts,jails, public health, mental health,business, child abuse, domestic violence,public assistance, schools, environment, housing, crime, substance abuse services, shelters,non-profits, • insurance rates, landlords, property values and more. It is all pervasive. The available state funds are inadequate to meet these needs. In the county there is a daily lack of access to treatment. These disorders contribute to continued problems within the schools, a majority of calls to law enforcement for the city and county and for the Jefferson County Prosecutor's cases. The impact is substantial in the courts, Juvenile Justice,the jail system, the schools, Public Health, employers and agencies. The community impact is recognized in the health community and economic impact of citizens and families suffering through substance abuse and mental illness cycles. The true community impacts of the untreated diseases are difficult to measure and are indicated by accidents on the roadway; health care ER utilization rates; teen substance abuse arrests; unemployment rates and other impacts. Some impacts are silent and devastating like: the impact on schools shown by data that Olympic Educational Service District, Take Time Resources specialists found when serving 76 children that self referred from 4-5h grade 93%of them having some family alcohol abuse. Other data is public and familiar like the treatment rate of publicly funding treatment with methamphetamines as the sole drug of abuse increasing 100% in 2005 with 60 people seeking treatment after years of 28 to 30 people seeking treatment. These silent and visible behaviors impact our community negatively and pervasively. Mental Health services are very limited and most individuals receiving these services must be in crisis or have Medicaid eligibility. If the individual does not meet the proper criteria they most likely will not receive the service. The impact of the rationed nature of these services is that underserved populations end up in hospital emergency rooms,jail or being involved with law enforcement or other emergency services. DEFINITIONS Interim Services: Costs incurred for services offered a person denied admission to a treatment program on the basis of the lack of the capacity of the program. This service shall reduce the adverse health effects of substance abuse, promote the health of the individual, and reduce the risk of transmission of disease. Such services are provided until the individual is admitted to a treatment program. Services include brief screening activities, the development of a service plan, individual or group contacts to assist the person either directly or by way of referral in meeting his/her basic needs, updates to advise him/her of treatment availability, and information to prepare him/her for treatment, counseling, education and referral regarding HIV and tuberculosis. • 4 • Detoxification Services: Costs incurred for care and treatment of patients while the patient recovers from the transitory effects of acute or chronic intoxication or withdrawal from alcohol or other drugs. Examples of Detox are: 1. Acute Detox: A method of withdrawing a patient from alcohol or other drugs where nursing services and medications are routinely administered under physician supervision to facilitate the patient's withdrawal, and 2. Sub-acute Detox: A method of withdrawing a patient from alcohol or other drugs utilizing primarily social interaction between patients and staff within a supportive environment designed to facilitate safety for patients during their recovery from the effects of withdrawal from alcohol or other drugs. Assessment and Monitoring: Costs incurred in diagnosis, placement and case monitoring of persons who apply for services and other eligible clients as defined in contracts issued by the Division of Alcohol and Substance Abuse (DASA). Does not include treatment costs, protective payee, or shelter costs for such clients. • Outpatient Treatment- General: Cost incurred for services that provide non-domiciliary/non-residential chemical dependency assessments and treatment to patients. Includes services to family and significant others of person in treatment. Does not include services to family or significant others of a person not currently in treatment. These expenses should be coded as family support services. Outpatient treatment services must meet the criteria in the specific modality provisions set forth in WAC 388-805. Outpatient Treatment- Youth: Costs incurred for services that provide non-domiciliary/non-residential chemical dependency/abuse assessment and treatment to youth and young adults ages 10 through 20. Includes services to family members of persons in treatment. Does not include services to family members of a person not currently in treatment. These expenses should be coded as family support services. Outpatient treatment services must meet the criteria in the specific modality provisions set forth in WAC 388-805. Case Management - General: Costs incurred for clients assessed as needing treatment to provide case planning, case consultation and referral services, and other support services for the purpose of engaging and • retaining clients in treatment or maintaining clients in treatment. Does not include treatment planning activities required in WAC 388-805. Case management services are services provided 5 by a Chemical Dependency Professional (CDP), CDP Trainee, or person under the clinical • supervision of a CDP who will assist clients in gaining access to needed medical, social, educations, and other services. Does not include direct treatment services in this sub-element. Intensive Inpatient Residential Treatment Services: Costs incurred for a concentrated program of chemical dependency treatment, individual and group counseling, education, and related activities for alcoholics and addicts including room and board in a twenty-four-hour-a-day supervised facility in accordance with WAC 388-805 or its successor. PROGRAM CREATION AND AUTHORITY By adopting this 1/2 cent sales tax Jefferson County has increased taxing authority to create and enhance mental health and substance abuse treatment services to decrease the fiscal and emotional impact of these diseases on the community and the legal system. The vendor contractors of these programs must implement comprehensive county-wide services available to all citizens without discrimination due to lack of income, if they can serve clients with any other available funding stream this"Mental Health/Substance Abuse Fund"becomes the payment of last resort. The County Administrator may ask for proof of billing denials in year end reviews. The fund and contracting will be administered by the Board of County Commissioners/County • Administrator, who shall have the authority, along with the approval of Jefferson County Commissioners,to exercise all lawful powers necessary and appropriate for the contracting, statements of work and maintenance, operations. Community impact data and community needs will be identified by a group working with Jefferson County Public Health Data Steering Committee. This data will help identify needs and measurements on an ongoing basis. This is a moving target and we need a system that is flexible, innovative and responsive to community needs. To establish a six-year spending plan and bi-annual contracts, the County Administrator will seek input from an advisory group from the Jefferson County Law and Justice Committee,the Substance Abuse Services Advisory Board and the Jefferson County Board of Health. The director of each subcontracting agency shall submit a yearly operating plan, budget and an annual report to the County Commissioners for review and approval. This plan and budget format will be approved by the County. Program evaluation is also the responsibility of the contracting agency and will be requested by the Board of County Commissioners yearly and reviewed by the advisory group. The Board of County Commissioners will appoint a Mental Health/Substance Abuse Advisory Committee to review and make recommendations to the Board of County Commissioners. Members will be from existing boards who work with these issues; two members of Law and Justice,two from the Substance Abuse Committee; and two from the Board of Health. • 6 • PROGRAM DESIGN & EVALUATION The County believes that the programs or services that are to be implemented are informed by "evidence based", "research based", "emergency best practice", or"promising practice" as defined in the legislation and the group encourages innovative approaches to local problems where there are no applicable models. A collaborative plan to supplement services for citizens is the best way to build a service network for Jefferson County. Services will be contracted through Interlocal agreements or contract between the County and private not-for-profit agencies or other government entities in Jefferson County. The County believes in the development of a"Drug Addiction Co-Occurring Mental Health Disorders (COD) model targeted on supporting Jefferson County crisis services and therapeutic jurisprudence needs. The model will include multiple levels of mental health and substance abuse services for adults and adolescents. PROGRAM ELEMENTS Contracts shall establish/or provide access to programs for the following services, based on the priorities of the Law and Justice subcommittee and other standing committees. • Treatment for individuals with co-occurring disorders • • Therapeutic court and case management staff to coordinate Drug & Mental Health court referrals and dependency needs of families in courts • Expanded Mental Health/Substance Abuse treatment for populations not served by other public funds • Substance abuse assessment and Mental Health assessment, counseling, and medication management in the jail Additional funds could be available to contract with other vendors providing family, child counseling or substance abuse treatment. Services could be provided by additional vendors to provide care to family members coping with mental illness or substance abuse in a spouse, parent or child: • Family support in some schools providing mental health services to students • Substance abuse interventions in the schools • Ongoing Home Visits to families by Infant Mental Health & Public Health Nurses for young families or Nurse Family Partnership visitation • Other licensed treatment providers and addiction specialists are successful with county population and may need to bill for services 7 The program services and areas included in the model above could include the following components: • • Family Dependency Court • Juvenile Drug Court • Crisis Services including; Evaluation and Treatment Unit, Sub-acute and Acute Detoxification, and Residential Treatment(Inpatient) • Expanded Outpatient Treatment providing services to Adults and Adolescents who have Addition an Psychiatric Disorders (COD) • Case Expediters/Facilitators; these positions would be designed to assist patients with access to services, eligibility, and placement. • Systems Collaboration with all identified stakeholders including: mental health, crisis services, law enforcement, courts,jail, DCFS, CSO, Shelters, VA, alcohol and drug services, hospitals, emergency services, corrections,public health, and other to be determined. • Program and Project Evaluation—This component of the model would provide ongoing evaluation of programs and services. It would include accountability, outcomes,planning, efficiency, effectiveness and cost offsets. • Substance Abuse & Mental Health assessments within three working days for referrals from the Juvenile Justice; Public Health; and Jefferson General Hospital Emergency room. ADMINISTRATION &AUTHORITY • The County Administrator shall submit an operating plan,budget and an annual report to the Board of County Commissioners for review and approval. PROGRAM FUNDING Money received from tax imposed under this ordinance shall be used solely for the purpose of providing new or expanded drug, alcohol abuse &mental health treatment service and for the operation of new and expanded therapeutic court programs. Moneys collected cannot be used to supplant existing funds for these purposes. This local funding provides a unique opportunity to enhance services to community members in need of mental health and substance abuse services that are presently not able to receive those services. Because it is funding locally collected and locally distributed it would also provide an opportunity to solve local problems innovatively, in other words, free from the constraints of other levels of state and federal government. A percentage will be set aside annually for reserve and match funding. Mental Health/Substance Abuse enhancement programs and any participating municipality, agency, department or special districts may solicit additional funds through grants, to supplement • 8 • program funding or bill any available insurance or Medicaid resources that become available. The purpose of this partnership is to expand existing funds to serve more people. Receipts anticipated for this tax can best be estimated by taking the actual collections the County is experiencing on a similar tax that was imposed last year for the E911 dispatch services. We have 10 months of actual collections from this tax which is imposed on the same taxable items. In the first 10 months this tax has produced$328,358.93, or an average of$32,835.89 per month. Receipts have ranged from $41,719.44 in November 2005 to $25,257.33 in March 2006. These receipts are noted below: Month of Receipt Amount Received June $26,860.47 July $30,266.38 August $36,995.77 September $34,513.70 October $35,607.00 November $41,719.44 December $30,807.59 January $29,244.01 February $37,087.04 March $25,257.53 April N/A • May N/A Priority Funding Identified for First Two (2) Years: To meet the goals and program results discussed herein the funding mechanism has been established and will produce approximately $360,000 in its first year. The "Expanded Mental Health & Substance Abuse Treatment& Therapeutic Courts Funds" are estimated to receive $360,000 during the first year the tax is imposed. The tax has been imposed, according to the State, effective April 1st. This means, based on past experience with the State Department of Revenue, receipts should be received by the County in June, or July at the latest. The following programs/activities are recommended to be implemented early on in the program within the anticipated funds to be received during the first year. Co-Occurring Disorder Integrated Treatment Program (CODIT): is envisioned as a combined project of Jefferson Mental Health Services and Safe Harbor/Beacon of Hope. The program is explained in detail as Attachment `B' and a budget is incorporated as Attachment 'C' and is envisioned as a treatment based program for individuals with co- occurring disorders and those unable to find treatment through existing mental health or substance abuse programs. $167,608 • 9 Substance Abuse Assessment and Mental Health Assessment Counseling and III Medication Management: for clients unable to find treatment and for those in jail. This service will be provided under the auspices of the Sheriff's office or other County agencies. An Ad Hoc Committee of the Law and Justice Council will recommend to the Board of County Commissioners/County Administrator the make up of services offered and the manner in which to offer them. $33,196 Therapeutic Court and Case Management Staff to Coordinate Drug & Mental Health Court Referrals and Dependency Needs of Families in Courts: this service will be provide under the auspices of the office. To assist in determining this, a separate Ad Hoc Committee will be formed including representatives from all offices who will be involved (i.e. Juvenile Services, Courts, Health Department, Drug Court, etc.) The group should examine similar Courts in Washington State and the nation to find the model that is best suited for Jefferson County. $33,196 20% Reserve and Cash Fund Reserve: will ensure that 20% of receipts will be set aside and held in reserve to address any revenue shortfalls or provide grant matching opportunities. $72,000 10% for Baseline Studies, Community Assessments and Community Evaluation: III this service will be handled by the Department of Health. $36,000 5% Billing, Program Evaluation and Administration: this service will be provided by the County Administrator's office or a department designated by the County Administrator. $18,000 Additionally, the State passed a bill this year (Engrossed Second Substitute Senate Bill 6239) that will provide grants of up to $100,000 to those counties who pass/adopt this sales tax. The grant applications will be available in 2007 and if funded by the State will be available for three years, 2008, 2009 and 2010. It is recommended that the sales tax imposed by the Board of County Commissioners be utilized in this fashion to expand and implement new mental health and substance abuse services as well as the Therapeutic Family Court. The impacts of untreated mental health and substance abuse are great—to our economy and the quality of life in our community. Research by DASA has shown that treatment works for behavioral health diseases at the same level as treatment for other chronic diseases, such as diabetes. • 10 The County believes that the programs or services that are to be implemented are informed by III "evidence based", "researched based", "emerging best practice", or"promising practice" as defined in the legislation and innovative approaches to local problems where there are no applicable models, are encouraged. EVALUATION Needs: Residents of Jefferson County asked to pay additional taxes, deserve documentation of the needs and benefits of the use of those tax dollars. First, it is critical that an assessment of the current status of the community needs be measured to establish a baseline set of data so change can be measured. The Mental Health/Substance Abuse Services Advisory Board will be asked to establish treatment evaluation criteria. Evaluation of Impact: There is no data system that provides integration of substance abuse and mental health data for those receiving services that are not publicly funded. The lack of adequate baseline data will require that during the first year, specific data sets be established including population unable to access services; sources of information are identified; data collection be initiated; and analysis and establishment of baseline measures are created. It is expected that these measures will include data regarding the impacts of behavioral health needs within law enforcement, education, and health care. The collection of baseline data will enable the Board of County Commissioners to utilize the information in establishing outcome measures in order to IIImeasure the impacts of the program design. The program will contract with the Public Health Department to execute these functions. CONTRACT TERMINATION RULES The following rules will be incorporated into all contracts/interlocal agreements: Any party may terminate contract agreements for any reason upon 30 days prior written notification to the other party. If these agreements are so terminated, the parties shall be liable only for performance rendered or costs incurred in accordance with the terms of this Agreement prior to the effective date of termination. If for any cause, any contracting party does not fulfill in a timely and proper manner its obligations under these contract agreements, or if either party violates any of these terms and conditions, the aggrieved party will give the other party written notice of such failure or violation. The responsible party will be given the opportunity to correct the violation or failure within 15 working days. If the violation or failure is not corrected this Agreement may be terminated immediately by written notice of the aggrieved party to the other. III 11 nul AA-Vali meld A C ' STATE OF WASHINGTON • County of Jefferson In the Matter of Imposing a Sales and Use Tax; } Providing for the Administration and Collection Thereof } For Providing New or Expanded Chemical Dependency } ORDINANCE NO.08-1003-05 or Mental Health Treatment Services and } for the Operation of New or Expanded Therapeutic } Court Programs as Provided in Ch. 82.14.460 RCW. } WHEREAS, substance use disorders are a serious and treatable health problem known to impact directly or indirectly as many as 60%of Americans and mental illness is a serious and treatable health problem known to directly occur in more than 19 million Americans, the most serious and chronic conditions occurring in 3 to 5% of the population; and WHEREAS, approximately 50%of individuals with severe mental disorders are also substance abuse disordered, and approximately 37% of alcohol abusers and 53% of drug abusers are also affected by serious mental illness; and WHEREAS, individuals with co-occurring disorders(dually diagnosed mental illness and substance abuse disorders) are at high risk for negative outcomes,including hospitalization, overdose, violence, legal problems, homelessness, victimization,HIV infection, and hepatitis; and • WHEREAS, community children and youth are impacted by mental disorders, substance use disorders and co-occurring disorders both as the children of, and as individuals with,mental illness and/or substance abuse disorders, often with resulting negative impact on their health, ability to learn,home life and safety, social behavior, and emotional development; with concomitant impacts on education,juvenile justice, child and family, health, and mental health service systems; and WHEREAS, services for individuals with co-occurring disorders cost nearly twice as much as for clients with single disorders; and non-integrated parallel methods of treatment have proven to be ineffective; and WHEREAS,treatment for individuals with co-occurring substance use and mental illness requires specialized care to meet the unique and often opposing needs of both disorders; and WHEREAS, the Jefferson County Substance Abuse Advisory Board, upon review of local, state and national data and information, identified the health, social, community,and economic impact of alcohol and other drugs on Jefferson County and its citizens, and the impact of mental disorders, substance use disorders and co-occurring disorders, as a major public health and public safety problem in their October 2004 White Paper to the Jefferson County Board of County Commissioners and to the citizens of Jefferson County,and • Ordinance No.08-1003-05;Imposing a Sales&Use Tax for Providing a New or Expanded Chemical Dependency or Mental Health Treatment Services and for the Operation of New or Expanded Therapeutic Court Programs as provided in Ch.82.14.460 RCW WHEREAS,the impact of substance use disorders on the Jefferson County law and justice system is significant, accounting for more than 2/3 of law enforcement calls in the City and • County and half of the Jefferson County Prosecutor's cases; and WHEREAS,Law and Justice system response to individuals with mental disorders, substance use disorders and co-occurring disorders represents a significant and costly problem throughout Washington State, so much so that the 2005 Washington State Legislature passed E2SSB 5763, an act relating to the creation of the omnibus treatment of mental and substance abuse disorders,in the belief that identification and integrated evidence-based treatment of mental disorders, substance use disorders and co-occurring disorders is critical to successful outcomes and recovery; and WHEREAS,Jefferson County citizens,through their property taxes, are paying for the cost of mental disorders, substance use disorders and co-occurring disorders through funding of courts,jails, emergency medical technicians, schools,hospitals and law enforcement personnel; and ,. WHEREAS, sales and use taxes are funding sources that affect citizens who do not own property in Jefferson County, and apply as well to visitors to Jefferson County, and,thus,would expand the potential revenue stream to address mental disorders, substance use disorders and co- occurring disorder treatment; and WHEREAS, therapeutic courts and integrated mental disorders, substance use disorders • and co-occurring treatment programs utilizing evidence based best practices have been shown to have positive outcomes,thus decreasing negative social,health and fiscal impacts on individuals and communities; and WHEREAS,recognizing the health, social, community and economic impact of mental disorders, substance use disorders and co-occurring disorders on Jefferson County citizens as significant and negative, and desiring to achieve the goal of successful outcomes and recovery for individuals with mental disorders, substance use disorders and co-occurring disorders;and WHEREAS, Jefferson County has an aging population and older people consistently underutilize both mental health and substance abuse services, and therefore suffer a disproportionate degree of harm from these conditions, and need special services and efforts to utilize services effectively; and WHEREAS,the Board of County Commissioners recognize that successful outcomes and recovery for some citizens will be a prerequisite for becoming employable and entering the workforce, and make it possible for employers to retain valuable experienced employees; and Page 2 of 4 • Ordinance No.08-1003-05;Imposing a Sales&Use Tax for Providing a New or Expanded Chemical Dependency or Mental Health Treatment Services and for the Operation of New or Expanded Therapeutic Court Programs as provided in Ch.82.14.460 RCW WHEREAS, RCW 82.14.460(2)authorizes the County Legislative Authority to • authorize, fix and impose a sales and use tax in addition to other taxes authorized by law with a rate not to exceed one-tenth of one percent; and RCW 82.14.460(3)provides that monies collected shall be used solely for the purpose of providing new or expanded chemical dependency or mental health treatment services and for the operation of new or expanded therapeutic court programs. WHEREAS,RCW 82.14.460(3)provides that if Jefferson County authorizes the tax as provided,the County may include a new and expanded therapeutic court for dependency or mental health treatment proceedings as a component of its existing Drug Court program, effective July 1, 2005. NOW, THEREFORE,BE IT ORDAINED, by the Board of County Commissioners of Jefferson County, Washington, that: Section 1: Tax Imposed. There is hereby imposed by this ordinance a one tenth of one percent sales and use tax, as the case may be, upon every taxable event, as defined in Chapter 82.08 and 82.12 RCW, occurring within Jefferson County. The tax shall be imposed upon and collected from those persons from whom the state sales or use tax is collected pursuant to Chapters 82.08 and 82.12 RCW. This tax shall be in addition to any other sales and use tax imposed by the State of Washington and/or Jefferson County. • Section 2: Applicability of Tax. The rate of tax imposed by this ordinance shall be applied to the selling price in the case of a sales tax or the value of the article used in the case of a use tax. Section 4. Administration and Collection. The tax imposed by this ordinance shall be administered and collected in accordance with Chapter 82.14.050. The Chairman of the Board of County Commissioners is hereby authorized to and directed to execute and contracts with the Washington State Department of Revenue that may be necessary to provide for the administration or collection of the tax. Section 5: Establishment of Chemical Dependency/Mental Health Program Fund. There is hereby created the Chemical Dependency/Mental Health Program Fund. Monies collected pursuant to this ordinance shall be deposited in this fund by the Jefferson County Treasurer: The fund balance may be invested by the Treasurer and any interest earned shall be deposited in this fund as well. Page 3 of 4 S. Ordinance No.08-1003-05;Imposing a Sales&Use Tax for Providing a New or Expanded Chemical Dependency or Mental Health Treatment Services and for the Operation of New or Expanded Therapeutic Court Programs as provided in Ch.82.14.460 RCW Section 6. Use of funds. Monies deposited in such fund shall only be used solely for purposes as authorized III by the laws of the State of Washington,including,providing new or expanded chemical dependency or mental health treatment services and for the operation of new or expanded therapeutic court programs. Monies collected under this section shall not be used to supplant existing funding for these programs. Section 7. Administration of Fund. The Fund shall be administered by the Board of County Commissioners through the County Administrator. The County Administrator,with the help of the Jefferson County Law and Justice Council,the Substance Abuse Services Advisory Board, and Jefferson County Public Health, is hereby directed to prepare a six-year spending plan and an annual budget. Section 8. Effective Date. This ordinance shall take effect July 1,2005,however,the creation of a therapeutic court as provided under Ch. 26.12 RCW, as a component of the County's existing Drug Court program will not become effective until July 1,2006. Section 9. Severability. If any provision of this ordinance or its application to any person or circumstance is held invalid,the remainder of this ordinance or the application of the provisions - to other persons or circumstances in not affected. ID . {P,ROYED AND ADOPTED this -- day of OC,AO VX*1 , 2005. t4s . v .,.i,, .h . JEFFERSON COUNTY - • " BOARD OF COMMISSIONERS .d,11Phil Jo on, Chair 1 I ATTEST: ;it&), OM C- Davi ul iv ,Mem er4— i Julie Matthes, CMC ` �A�W a Deputy Clerk of the Board !' trick M. odgers, Member Approved as to Form: Prosecuting Attorney Page 4 of 4 • TANC A.B.Ks e AAVISoR'(WARD September 5, 2005 The Honorable Board of County Commissioners Jefferson County Courthouse Port Townsend,Washington 98368 Dear Commissioners, The Jefferson County Substance Abuse Advisory Board is very excited that an opportunity to positively address an aspect of Jefferson County's serious substance abuse disorder problem has occurred. We have reviewed E2SSB 5763 and the possibilities to improve the lives of Jefferson County individuals with co-occurring substance abuse and mental disorders through enhancement of our existing Treatment Court into a full Therapeutic Court as defined by the Bill, and to expand the efforts being made by Safe Harbor/Beacon of Hope and Jefferson Mental Health Services so that a true and thorough evidenced based treatment program for co-occurring disorders (CODIT) can be implemented. • We have also reviewed the Proposals for 1) enhancement of existing Treatment Court to a Therapeutic Court, and 2) a "Co-occurring Disorder Integrated Treatment" program (CODIT), that have been developed at the behest of the community to address these issues We urge you to take advantange of this unique opportunity by: • Approving a 1/10th of one percent sales and use tax; and ■ Implementing the tax by Commissioner action, immediately; and • Directing implementation of the development of the Proposal attached, so that lives (as well as money) can be saved. We strongly believe that lives literally will be saved by immediate passage of this tax and implementation of this proposal. We also believe that taxpayer money will be saved. The cost to county citizens as well as tourists will be negligible (one penny for every ten dollars spent), but the reduction in cost to the citizens who are paying for health, law and justice and other systems struggling with these disorders, through property taxes, could be significant. Please, say yes! Sincerely, Laurie Strong, Chair Jefferson County Substance Abuse Advisory Board = _ do 686 Lake Street,Suite 400 Attachment: Proposal Port Townsend,WA sass'; (360)385-3866 t it E2SSB 5763 Sales and Use Tax&Mental and Substance Abuse Disorder Treatment Background: • In the 2005 Washington State legislative session State Senator Jim Hargrove introduced Senate Bill 5763, proposing omnibus treatment of mental and substance abuse disorders. The bill that ultimately passed, E2SSB5763,makes significant changes to both chemical dependency and mental health involuntary treatment acts as well as changes to the community mental health act. The focus of the bill is to address treatment of mental and substance abuse disorders in order to improve services and effectiveness and reduce costs to society. The bill also identifies the importance of EB/BP(Evidence Based/Best Practice)programs for cost and treatment effectiveness and incentivizes their use. Additionally implicit is the recognition that mental illness and substance abuse,especially when co-occurring,have a negative impact not only on the individuals with these disorders,but on our communities and citizens,economically as well as personally. The significant and negative impact of substance abuse and mental illness on Jefferson County is clearly evident in the Health Department's"Healthy Jefferson"survey outcomes,and in the Jefferson County Substance Abuse Advisory Board's recent White Paper. The urgency of this issue is exacerbated by recent changes in mental health treatment funding which restricts treatment access for individuals who do not have Medicaid coupons. In Jefferson County,availability of"State-only(non Medicaid)"funds is so limited as to essentially preclude service for non-Medicaid funded individuals except for crisis contacts. Additionally,changes in allowable use of federal funds precludes co-occurring disorder treatment. For individuals in Jefferson County who suffer from co- occuring mental illness and chemical dependence—many of whom represent a significant drain on social service and law and justice budgets—the possibility of treatment and recovery is now foreclosed. The Hargrove Bill recognizes the urgency and seriousness of these problems. It states that: . • Integrated treatment of co-occurring mental illness and substance abuse disorder is more effective than treatment provided separately; • ■ Identification and treatment of these disorders is crucial; ■ Drug and mental health courts(Therapeutic Courts)are important and often pivotal components in identification and treatment access; • The present state system does not provide for,nor is it conducive toward, integrated services; • New money and incentives are necessary to promote integrated treatment for co-occurring disorders. To address these facts, Section 804(re: RCW 82.14)of the bill specifically provides for the development of funding for therapeutic courts and treatment programs through a 1/10"of one percent sales and use tax imposed by a county's taxing authority. This proposal urges the initiation of that 1/10th of one percent sales tax in Jefferson County as soon as possible in order to meet the county's exigent need. Through discussion with the Law and Justice Committee,Health Department personnel,Substance Abuse Advisory Board members,and mental health and substance abuse treatment staff,two needs congruent with SB 5763 criteria were identified. They are: 1. Administrative and evaluation assistance to the county's Therapeutic Courts; 2. Development of an evidence based co-occurring disorder integrated treatment program(CODIT). - The following proposal has been researched,developed and is respectfully submitted by Laurie Strong, Executive Director of Jefferson Mental Health Services,and Ford Kessler,CEO of Safe Harbor/Beacon of Hope. This Senate Bill represents a unique and important opportunity for Jefferson County and its government to move beyond concern into action,to uphold the Prevention and Healthy Jefferson principles it avows,and to literally put its money where the problem is at a time when the need is particularly urgent. • •` . - Lau e Strong,LCSW ; Ford Kessler, BA,NCACI,CDP, DVC Hargrove/SB 5763&CODIT BOCC Proposal—9/12/05 continued PROPOSAL •PROPOSAL I: Fund enhanced Therapeutic Court implementation and evaluation functions by direct contract with Safe Harbor/Beacon of Hope. • Background: the existing Jeffersn County Treatment Court activities are facilitated to a great degree by Ford Kessler,of Safe Harbor/Beacon of Hope;treatment costs are covered through ADATSA and CJTA funding, however facilitation and evaluation of outcomes is unfunded and thus limited to available good will. Jefferson County has exceeded its targeted use of this court because of high incidence and great need. Inclusion of mental health and dependency issues in a Therapeutic Court setting requires expanded personnel. • Criteria: enhanced implementation should rest on experience within the existing system and treatment needs; on collaboration capability with agencies and entities interacting with a Therapeutic Court,and with an entity with existing license,knowledge and capability to receive state"drug court"fimds,and ability to contract with Jefferson County. • Plan:Through direct contract with Safe Harbor/Beacon of Hope,expand existing and successful Treatment Court, fledgling"Mental Health Court,"and SB5763 criteria-included dependency actions to Therapeutic Court status and fund facilitation of implementation and evaluation functions: PROPOSAL II: Fund development and implementation of an Evidence Based Co-Occurring Disorder Integrated Treatment program(CODIT)through direct contract with Jefferson Mental Health Services. • Background: The importance of ensuring positive outcomes is driven by both economic and socially conscious needs. Effective treatment saves lives,and costs less. The Behavioral Health industry has been pursuing identification and implementation of Evidence Based Best Practices to increase effectiveness. •SAMHSA(the Federal Substance Abuse and Mental Health Services Administration)and its Center for Mental Health Services(CMHS)have identified six Evidence Based Practice projects to address serious mental illness. They are: 1. "Co-occurring Disorders: Integrated Dual Diagnosis Treatment," 2. "Family Psychoeducation," 3. "Medication Management Approaches in Psychiatry"(use of medication algorithms;Jefferson Mental Health Services has an existing medication algorithm protocol,"JMAP"), 4. "Illness Management and Recovery," 5. "Supported Employment"and 6. "Assertive Community Treatment" The State of Washington has identified an array of"Best Practices", including, for adults: • Integrated Mental Health and Chemical Dependency Services,(Safe Harbor/Beacon of Hope&Jefferson Mental Health Services currently co-provide a dual diagnsosis group) ■ Vocational Services, • Family Psychoeducation,and • Medication Management. A review of manualized* programs(*a criteria for being designated EB/BP)in both the substance abuse and mental health treatment disciplines was accomplished. The SAMSHA"Co-occurring Disorders: Integrated Dual Diagnosis Treatment"project includes an Implementation Manual,and appeared to be the most apt project to meet Jefferson County's flexibility needs and rural nature. Using this acquired manual,and other reviewed material,a"Co-occurring Disorder Integrated Treatment Program"—CODIT—for Jefferson County was formulated.(See Synopsis below for program details.) Ilk Criteria: Implementation of any new program should be based on 1)evident need, 2)effective- ness,3)available funding,and 4)implementation ability. Page 2 of 7 Hargrove/SB 5763&CODIT BOCC Proposal—9/12/05 continued 1) National incidence of co-occuring disorders is equal to Jefferson County's:approximately 50%of the severely mentally ill are also chemically dependent;37%of alcohol and 53%of drug abusers have a serious mental illness. Jefferson County Law Enforcement,Justice System and social service leaders identify people with these disorders as significant users of their systems,and those with co-occurring disorders as particularly difficult. Without specialized treatment,these individuals rotate serially through the law and justice,substance abuse,and mental health systems;lives are lost. 2) Research and experience is clear that serial or even concurrent interventions,if any occur at all for this population,are ineffective. Current Medicaid system rules essentially preclude integrated treatment. This _Bill makes it possible to initiate and fund a treatment strategy that has survived research and evaluation and is known to be effective(is an Evidenced Based Best Practice). 3) A 1/10t of one percent sales/use tax is projected to reap approximately$250,000 to$300,000 in Jefferson County annually once it is in place.This is an adequate amount to fund Proposal I plus this proposal for a Co-occurring Disorder Integrated Treatment program.No other funding sources exist for the two proposed programs;reduction in prior funding and changes in regulations have further eroded treatment and service options,although some direct costs for aspects of the treatment program may be recoverable. 4) Jefferson Mental Health Services(JMHS)is the only licensed community mental health center in Jefferson County,and the only entity with experience in addressing severe mental illness and meeting complex program requirements. JMHS currently uses a number of"Best Practices" in its service menu, including a medication algorith program,and is experienced in both vocd'tional and housing access requirements. JMHS works collaboratively with West End Outreach,who reach West County consumers, and with Safe Harbor/Beacon of Hope in collaborative efforts on behalf of mutual consumers. o JMHS is a 501 (c)3 non-profit entity with contractual relationships with State and Federal governments, School Districts,and historically with County government; o JMHS holds current licenses with the DSHS Mental Health Division necessary for evaluation and treatment services and meets administrative and clinical audit criteria; o Safe Harbor/Beacon of Hope holds current state Dividison of Alcohol and Substance Abuse certification for chemical dependency services,and through a Memorandum of Understanding will 110 provide authorization for offsite chemical dependency services for this program. o JMHS is financially audited by an outside CPA firm annually in accordance with governmental auditing standards("Yellow-book audit"); o JMHS,and Safe Harbor/Beacon of Hope,have mututal understandings for existing collaborations, and are able,through a CODIT Program-specific MOU,to enhance CODIT program funding through third party billing as available; o JMHS is familiar with the practices and protocols required by this Evidence Based program. • PLAN: Directly contract with Jefferson Mental Health Services to develop and implement CODIT including outside evaluation to ensure fidelity to the model and attainment of goals and identified outcomes. The CODIT Program: • Is an Evidenced Based Best Practice incorporating recovery-based philosophy • Builds-in flexibility in order to grow with need and available funding,and meet exingencies of a rural and limited population. • Includes a Multi-disciplinary Treatment Team that meets no less than weekly to review program clients,but accesses component disciplines/members on-call based on client need,thus reducing expense and increasing flexibility.(Not all disciplines will be needed all the time for every client.) • Training: • Initial training in the model occurs at the same time for all team members. • Training is also provided cross system collaborators,and subcontractors. • All Training follows the EBP Implementation Resource Kit,Users Guide and components; • Training subsequent to Initial Training is on-going and no less than annual; • Fidelity to the model is ensured through: • • monitoring client outcomes(achievement of client recovery goals),and Page 3 of 7 Hargrove/SB 5763&CODIT BOCC Proposal—9/12/05 continued ■ use of"Fidelity Scales"for this best practice as developed by SAMSH A in the"Co-occurring Disorders:Integrated Dual Diagnosis Treatment"Project; • • Supplemental program funding is accessed through billable third party payers or sliding fee schedule,through MOU between program agencies(Jefferson Mental Health Services and Safe Harbor/Beacon of Hope)utilizing their existent billing processes. ■ A CODIT Program Budget is developed annually. CODIT ACCESS: Referral Sources: Therapeutic Courts, Substance Abuse Treatment system,Mental Health Treatment system,community Entry Criteria: 1. DSM IV Axis I Disorder of -o Schizophrenia and other Psychotic Disorders o Mood Disorders o Anxiety Disorders 2. DSM IV Axis II Disorder of: o Substance—Related Disorders Per diagnosis by a Mental Health Specialist and Substance Abuse Specialist 3. GAF(Level of Functioning)score within current protocol • Entry Process: 1) Referral received, includes o Identification Set o Secondary Funding if any o Reason for referral o Documentation of reason for referral o Prospective'client's level of willingness to be enrolled • 2) Referral reviewed by Multi-disciplinary Team at weekly meeting 3) Referral approved/denied(if denied,returned to referral source with reason for denial) 4) If referral approved,enrollment scheduled a. Mental Health Assessment b. Substance Use Assessment c. Consolidated Treatment Plan developed and initiated d. Administrative set(consent to treat,privacy notice,financial set,etc.) CODIT OUTCOMES • Outside evaluator identified program outcomes(such as reduction in hospitalization and law enforcement contacts) • Fidelity Scale outcomes met Upon approval,a program budget and implementation plan will be developed. • Page 4 of 7 Hargrove/SB 5763&CODIT BOCC Proposal—9/12/05 continued CODIT Co-occurring Disorders Integrated Treatment Program III Safe Harbor/Beacon of Hope&Jefferson Mental Health Services Port Townsend,Washington An Evidence-Based Practice as identified by SAMSHA PROGRAM SYNOPSIS Program Values • Recovery—satisfying life circumstances across life domains • Inclusion-clients cannot be expelled from program for failure to succeed • Respect—all program interactions and components are respectful to clients and across disciplines Entry Criteria • Age 13 or older • Co-occurring DSM IV Axis I Mental Disorder and Axis II Substance Related Disorder • Meets Level of Functioning and Acuity Level Criteria ■ Approved for enrollment by CODIT Multi-disciplinary Team Program Requirements Components Attributes Activities 1 Multidisciplinary Treatment Combined Substance Abuse/Mental Health Team • Regularly scheduled team meetings Team: including residential and vocational components. • Includes all disciplines • • Case Manager(s) • Clients receive care from a fully Multidisciplinary • Case review and • Substance abuse specialist(s) team(vs.a series of single providers)with a strong coordination • Mental health specialist(s) emphasis on accessing a broad range of services • Program tracking/review • • Psychiatrist/Nurse and excellent communication between disciplines. • Residential specialist Team Leader designated. • Delivers services to clients ■ Vocational specialist Full team receives cross-discipline training. (Cross system stakeholders also receive training.) 2 Stage-Wise Interventions: Stages of recovery: • Interventions are overtly consistent Treatment is consistent with the Engagement with clients stage of recovery client's stage of recovery(MI/SA) Motivation • Documentation and format is Action consistent with stages of recovery Relapse Prevention awareness 3 Access to all program Recognition that broad life domain deficits impede • Overt review of needs services including: recovery and that access to all aspects of service • Individualized treatment plan MI/SA Treatment improves prognosis. • Case Management to access treatment Psychiatry • Follow-up to ensure treatment Housing accessed Supported Employment Family Psychoeducation Illness Management Intensive Case Management 4 Time-Unlimited Services No time limits ascribed to services;intensity modified • Intensive Case Management according to each client's needs • Cognitive/Behavioral Mental Health& Substance Abuse treatment • Psychiatric evaluation,medication, medication monitoring(JMAP) • Family psychoeducation • Vocational assistance • • Housing assistarfce • Illness management Page 5 of 7 Hargrove/SB 5763&CODIT BOCC Proposal—9/12/05 continued Components Attributes Activities 5 Outreach Has strategies,contacts,means to outreach • Therapeutic Court& liaison Strategic plans to outreach community for services on behalf of clients,such as • Team assessment community where appropriate legal aid,housing,medical care,safety,etc. • Individual treatment plan flexibility • Ongoing need identification • Outreach • Case Management • Cross system alliances • Subcontracts in place 6 Motivational Interventions Motivational Interventions valued and used: Interactions conform with this value Team members trained in and • Express empathy understand motivational • Develop discrepancy between goals and interventions and use them continued(substance)use • Avoid argumentation • Roll with resistance • • Instill self-efficacy and hope 7 Substance Abuse Counseling Clients in"actions stage,or'relapse prevention' Stage of recovery tracked and documented, Team members understand basic stage receive SA counseling that includes: so counseling and intervention are timely SA counseling principles • Teaching how to manage cues to use and and-on point. consequences of use • Teaching relapse prevention strategies/skills • Drug and alcohol refusal skills • Problem solving skills training to avoid high risk situations • Challenging clients beliefs about substance abuse • Coping skills and social skills training 8 Group Dual-Dx Treatment: MH/SA specialist team members provide group Group Treatment Schedule Group treatment that specifically opportunity addresses both mental health and Access is openly available substance abuse problems readily available/offered clients 9 Family Psychoeducation on Psychoeducation includes: Family Psychoeducation Curriculum Dual Diagnosis Education about Dual Diagnosis Scheduled Sessions Education,training,support offered Mental Illness Support Access family members of clients Substance use/abuse Interactions Consequences Coping skills training Collaboration with team Support 10 Alcohol and Drug Self Help Program/team facilitate access and encourage Information available Groups attendance Case Management Clients in action or relapse prevention stages attend community self-help programs 11 Pharmacological Treatment Evaluation access,includes Medication evaluation Psychiatric medication evaluation • Psychiatric medications prescribed despite Medication monitoring and provision to address mental active substance use Multidisciplinary follow-uo illness by prescriber trained in dual ■ Close coordination with multi-disciplinary team disorders • Focus on increasing adherence • JMAP inclusion(medication algorithm program) ■ Avoid benzodiazepines and other addictive substances • Use clozapine,naltrexone,disulliram - Page 6 of 7 Hargrove/SB 5763&CODIT BOCC Proposal—9/12/05 continued Components Attributes . Activities 12 Health Promotion Explicit program to promote dient health and reduce Team training in health promotion, • Interventions negative consequences: techniques in negative consequence • Avoid infectious diseases reduction,and overt and documented • Help clients avoid high-risk situations and interventions victimization • Secure safe housing • Encourage dents to pursue work,medical care, • diet,exercise 13 Non-responder Interventions Explicit strategic plan and interventions: On-going individualized review and TX Strategic plan and program to • On-going overt client review of goals reached, planning • Identify non-responders response/non-response to treatment Strategic response plans • Provide secondary • Titrated response strategies for intervention Access to secondary interventions,e.g. interventions • Secondary/increase intervention availability Medication,long term residential,trauma treatment,intensive family intervention, intensive monitoring. 110 • Page 7 of 7 Jefferson County Community Network ec ` QA Subcommittee of the Law&Justice Council isk • Special Meeting on SB5763 August 11,2005 Jefferson Mental Health Services Attending: Laurie Strong,Ford Kessler,Jean Baldwin, Crad Verser,Mark Huth,Beth Wilmart. Recommendation to the Law&Justice Council Given the requirement of the SB5763,and the unique needs of Jefferson County,the group recommends the following: 1. The BOCC go forward with the new sales tax, as provided for in the bill; 2. The proceeds be allocated to the following programs: a. Expand the existing Therapeutic Court to include a Mental Health Court; b. Expand the existing Therapeutic Court to include dependency cases(as required). It is noted that a very small number of dependency cases are filed each year. c. Add a Program Assistant (probably part-time)to the Therapeutic Court staff, to manage program evaluation and ease the current administrative burden. d. Fund.a combined chemical dependency/mental health treatment_program. i. Intensive Case Management 410 ii. Evidence-based iii. Estimate 25+clients per year iv. Clients are not necessarily court-involved • •615 Sheridan•Castle Hill Center•Port Townsend,WA 98368• •360/379-4495•FAX 385-9401 • 04i\r eVt C CODIT • Co-Occurring Disorder Integrated Treatment Program A combined project of Jefferson Mental Health Services and Safe Harbor/Beacon of Hope Budget—Year One @ full enrollment of 40 clients EXPENSE Personnel: 1 FTE Case Manager II Provides outreach and assertive Case Management for a caseload ranging from 25 to 40 clients; BA plus 4 years in MH Case Management field,Registered, plus 1 or more years experience and/or training in CD Treatment. Attends team meetings. Wages & Benefits: $38,960 .40 FTE CD Specialist II Provides S/A Education &Treatment—Individual and Group- to clients in appropriate stages of readiness;family education; referral as necessary, some case management. Certified, BA plus 4 years in CD Treatment, plus 1 or more years experience and/or training in MH. Attends team meetings: Wages & Benefits: 15,584 .40 FTE MH Specialist II Provides (billable) Mental Health Treatment to clients and Family Psychoeducation. Some case management. Certified/licensed MA/MSW plus 5 post graduate years in treatment services to individuals with severe mental illness, plus 1 or more years experience and/or training in CD field. Attends team meetings. Wages & Benefits: 18,360 .20 Psychiatric Nurse Provides (billable) medication monitoring and assistance. • Licensed, 5 years experience in psychiatric nursing. CD experience preferred. Attends team meetings. Wages & Benefits: 8,680 .15 Program/Clinical Supervisor Certified/Licensed MA/MSW with 7 or more years in treatment services to individuals with severe mental illness, training and/or experience in the CD field, and 4 or more years in program development and clinical supervision. Attends team meetings, provides program management and supervision. Wages & Benefits: 7,500 Total Wage & Benefits: $ 89,084 Personnel: Contract Psychiatrist: Licensed with experience in treatment of mental illness and chemical dependency. Provides evaluation and pharmocological treatment, including prescription of psychiatric medications within protocol for dual disordered clients and medications known to be effective in decreasing substance use. Works closely with team & client, attends weekly team meeting. $105/hour. Projected at 25 hours a month: $ 31,500 Evaluator: Research and evaluation firm (such as Maike &Associates) for first year of project: identify, evaluate outcomes, fidelity scales, and produce report, @ 11% of project total. $ 22,000 Housing and Vocational assistance are important components in establishing and maintaining stability. The need for these services varies, and once accessed may • not need to be re-accessed for successful clients. .� CODIT Budget Narrative 1 October,2005 Housing Specialist: Experience and knowledge in accessing Residential Services, including support and monitoring, for clients in need of appropriate housing. $ 8,400 • Vocational Specialist: Experience and knowledge in evaluation of work skills and needs, readiness to work, and employment development and support 9,000 Total Contract Personnel Costs: $ 70,900 Indirect Personnel costs: per JMHS Cost Allocation Plan/Federal: Accounting, bookkeeping, payroll, contract managemen/administration costs: $ 10,950 Mileage &Transportation 500 Training 750 Total Indirect Personnel Costs $ 12,200 Total Personnel Costs: $ 172,184. Other Costs Communication 2,710 Dues/Licenses 954 Equipment, large furnishings .1,530 Equipment, rental 238 Facility rent 3,000 Facility repair/improvement 954 Facility maintenance 212 Furnishings, small 160 Insurance 4,500 Miscellaneous 350 Postage & Delivery 200 • Printing & Reproduction 450 Program Expense 9,600 Supplies—Office 1,166 Supplies Other 1,250 Taxes 1,100 Utilities 2,500 Wraparound Funds 6,000 Reference Materials 550 ` Total Other Costs: $ 35,424 Total Expenses: $ 207,608 REVENUE Third party billables $ 40,000 Other revenue(county) 167,608 Total Revenue: $ 207,608 Year Day CODIT cost per client: $5,190/year ; $14.22/day • Vs. Psychiatric hospitalization cost: range of $415.79 to $1,535/day • CODIT Budget Narrative 2 ) ,'%- October,2005 • Board of 3-CeaCth .New Business .Agenda Item # 11., 3 frond-are Residents • Letter of Concern May 18, 2006 • Page 1 of 3 Irondale Residents Letter of Concern To Sheriff's Office 5/3/2006 Jefferson County Sheriffs Dept. —Attn: Officer Dave Miller • The presence of"Meth"activity is horrendously detrimental to a community. We want what everyone wants for their Community ... Safe streets,Friendly neighbors—a SAFE&DRUG-FREE environment for adults and especially kids to live and play. Thus, we want everything possible to be done to prevent the occurrence of the danger of a Meth Lab in our delightful community. We have heard rumors of"Meth"activities in the Irondale area, and our desire is to permanently eliminate all traces of that from our community ... our neighborhood ... our home! And,this is a delightful place filled with interesting and caring people. It's a great neighborhood. We want to keep it that way! Here are some of the reasons we have to suspect that there was(or still is) a "Meth"Lab on the lot at the SE corner of 7th and Maude in Irondale,WA 98339(hence, "The Lot"). We feel these suspect activities and events warrant a more in-depth examination as to the possible existence of a"Meth"lab at this location. 1. "The Lot"has been occupied for only 6 months. Yet, in that short time - within a 2 block radius-there have been break-in/thefts where personal gear and weapons were stolen. Recently, several cars were rifled through and money,credit cards, gift certificates and a cell phone were taken. 2. 4 people have told us that they owned"The Lot". One was very drunk(at 10 AM), one said he was going to cut down some trees(yikes), one moved in without power or septic,and now we get a guy well known to law enforcement. The"ownership"of"The Lot"is a moving target! 3. The people on"The Lot"are living illegally—they have no proper septic. 4. An RV was towed and left next to"The Lot"on Maude St. A man lived there on the street. A complaint was turned in and when he had to move, the RV was pushed backwards right over their own fence onto "The Lot"! That made 3 vehicles on this tiny heavily wooded lot. 5. Great quantities of trash have rapidly piled up on"The Lot". To date there have been no "cleanup"activities that we can detect—except the fervent effort after the fire-but before the inspection. This is discussed below. 6. While the RV was still on the road,we talked to the resident of the RV saying,"Is this vehicle going to be here long?" The answer was, "Yes, probably." We then stated, "We'd rather that it wasn't!"to which the RV resident shouted: "THIS IS MY FUCKING PLACE AND I'LL DO WHAT THE HELL I WANT WITH IT!" This is not a neighbor with whom we can have a positive—or even civil—relationship. 7. Neighbors on the access side have report a steady stream of traffic to that lot at all hours of the day and night. This is a Meth indication! 8. In early April,there was a loud explosion in the trailer. It blew most of one side off the trailer and was. heard as far away as Oak Bay Road! ate. gc.rlelVs and A 9. Two days later,there wasAa massive fire in the little trailer. Neighbors heard another loud explosion just before the fire. The flames were so • intense and high that it singed one Douglas fir about 30 feet up the tree. 10. If an exploding Propane tank caused the 1st explosion,what was left to cause the 2nd explosion and the fire? There is no gas tank on a trailer. I Page 2 of 3 Irondale Residents Letter of Concern To Sheriff's Office 5/3/2006 11. What was in the trailer to cause such an intense fire? Meth Chemicals? 12. The current resident was taken away in handcuffs. What were the • charges? We don't know! Why was he let go? We don't know! 13. Later that afternoon, 3 people were seen hauling stuff(evidence?)off of the property. To do so,they had to cross the"Do Not Cross"yellow crime scene tape. They worked hard for about 8 hours dismantling and hauling off parts of the exploded/burned out trailer. There never was "Cleanup" activities before! Why the rush now? Was evidence removed? 14. Besides the 3 people hauling off stuff the day of the fire, 2 guys with an old red"beater"Datsun-like pickup hauled off a load of stuff the next day. Different people,but still a"Cleanup"crew! What was removed? 15. A Jefferson County Health official inspected"The Lot" for signs of Meth activity and reported not finding any(as did the Sheriff's inspector). However,he investigated 2 days after the fire. In the meantime,two crews had spent about 40 man hours"Cleaning"up"The Lot". The attached current photos of"The Lot"show it still loaded with trash. What was hauled off? Meth evidence? When the inspections took place, had incriminating evidence already been cleared off? We don't know! Were soil tests performed? Again,we don't know! However,there were no interviews with anyone in the neighborhood. 16. Every one of the several Attorneys and Health Services people we talked to responded to the mention of current resident's name with familiarity 1111 based on contempt. Comments like,"Oh,that guy. He's a well known local problem!"were the norm. 17. Walking on"The Lot"in the afternoon of the fire, with the fire wet and "dead out"and no visible fumes or smoke created serious coughing for days afterward—even though never more than 10 feet inside"The Lot", not touching anything, and leaving within 2 minutes, 18. The day after the fire a comment was made to the new crew"Cleaning", "It may not be safe to breathe!" One loader said to the other, "What could he expect-it's a 'Meth Lab'!"They both laughed! 19. Though taken away in handcuffs,the current resident moved back the next day and continued creating trash on"The Lot". There is debris all over the property. He still seems to be active only occasionally and seems not to work. One wonders as to his means of support. We have a guess! 20. The Jefferson County Health Services has fined the current resident$500 for living without proper handling of his septic waste and ordered him off "The Lot"in 7 days. Apparently he will be fined $513 a day if he stays beyond the 7 days. We said, "Lots of luck getting anything!" 21. We have seen that the current resident is still there on the morning of 4/25/06 and later. His order to vacate in 7 days was about 14 days ago. 22. On May 2, 2006 the current resident will have had the 15 days to respond • to the$513 fine levied on him on April 17t. He'll be late on May 5 we are told. We have serious doubts that the current resident is organized or "straight"enough to respond. We bet he ignores the fine. We are told that Page 3 of 3 Irondale Residents Letter of Concern To Sheriff's Office 5/3/2006 if he doesn't make arrangements to pay and doesn't contest the judgment • within 15 days, a"Warrant for his arrest" is issued automatically. Will that be done? What happens then? 23. If there is a warrant for his arrest and all of these condemning evidences of Meth activity,what will be done? Again, we don't know! The Sheriff's office says"There was no 'Meth Lab' on that site." We're sorry, that is not adequate assurance for us. Were soil tests made? If not,why not? Why were no neighbors interviewed? What did the investigator see when he was on"The Lot"after the fire? Just saying that"There is no Meth Lab"is not enough detail. We realize that it all of this circumstantial evidence might possibly be explainable in other ways. However,with the above avalanche of"indications"of Meth activity, it doesn't seem likely. The above items point unquestionably to the likelihood of Meth Lab and Meth activities and demand further investigation. Meth is the Scourge of a community leaving babies and infants with little or no chance of a normal life. It represents a major threat to kids and teens. It destroys people, communities and our security. It often includes environmental devastation and death. Meth is extremely dangerous and cannot be treated cavalierly. We need to take all preventative actions ... NOW! WE WANT OUR NEIGHBORHOOD TO BE METH FREE AND WILL PERSIST UNTIL THAT HAPPENS! We realize that the Sheriff's budget and manpower may be stretched thin in this time of growing crime. And that dealing with Meth people can be dangerous. However, • since Meth is the main reason for rising crime and budget/manpower demands, it seems prudent for the Sheriff's office to shut down any Meth Labs they fmd,prevent new ones if possible, and to do a thorough job of checking out highly suspicious cases ... like this one! Stop them before they start! Thanks for you attention to this urgent matter. We are asking that further investigation be carried out of the suspicious situation on"The Lot". Let us know what is done ... and if there is anything we can do to help. Preventing and terminating Meth activity would be cost, safety, and man power efficient in the long nm! An ounce of prevention is still worth a pound of cure! We don't want ANY Meth ACTIVITY on "The Lot"or anywhere else in Irondale! None at all! Period! Recent articles in the Leader and Peninsula Daily News document some of the devastation Meth leaves in behind! The danger can't be overestimated! We need to eliminate Meth activity-NOW! Let's make that our goal! From: Several concerned residents in the Irondale neighborhood. We insist on remaining confidential...for obvious reasons. You may share these "indications"of Meth activity but we insist that our names and phones be withheld! Also, check with us first before spreading this outside your offices as some of the "indications"may point directly to us! We don't want to be targets! • Cc: Sheriff Mike Brasfield, Mark Nelson(Jefferson Co. Health),Jefferson Co. Board of Health, Pat Sullivan of the Jefferson County Leader, and Paul Gottlieb&Jeff Chews of the Peninsula Daily News. r Board of 3fealth Media Report 1 May is, 20 06 1 • Jefferson County Health and Human Services APRIL — MAY 2006 NEWS ARTICLES 1. "Drinking prevention: It's about education", Peninsula Daily News, March 29, 2006 2. "Officials discuss state's openness to flu spread" Peninsula Daily News,April 16, 2006 3. "Enforcement beefed up at training center" Peninsula Daily News, April 18, 2006 4. "Grant to aid with Hood Canal septic system repair" P.T. Leader, April 19,2006 S. "Child neglect is worse here than abuse"(2 pages) P.T. Leader, April 26,2006 • 6. "PT offers free helmets" P.T. Leader, April 26, 2006 7. "Meth and Motherhood" and"The hardest addiction" (3 pages) Peninsula Daily News, April 30, 2006 8. "Meth's littlest victims" Peninsula Daily News, April 30, 2006 9. "The Plight of Baby A.: Foster children because of meth (2 pages) Peninsula Daily News, May 1, 2006 10. "West Nile Virus monitoring begins" P.T. Leader, May 10, 2006 11. "'Link' for supporting teens, adults with disabilities" P.T. Leader, May 10, 2006 12. "Jumping Mouse Partners" (2 pages) Newsletter, April 2006 . 13. "Update on Hood Canal Sanitary Survey Project" (5 pages) Dana Fickeisen, Jefferson County Public Health, April 19, 2006 Drinking prevention: It's about education • • Town meetings feature tips, rr l . A : - Pr enilIT. ,:.1.1 stories about alcohol abuse -e . ; III l3Y ANDREW BINION, ment officials and school fac I ' � DIANE URBAN(DE t Paz ulty met at Blue Heron Middle t el AND EVAN CAZi School in Port Townsend. x ar" PND EVA Duty News 'This allows the people who • r are involved and the kids Steve started drinking early, involved to process the `4'....., *.. about 15 years too early P dangers • =r .- 3` of drinking," said Port '. At 6,ye had his first wine Townsend Police Chief Conner ' . • cooler. Daily,who attended the meeting. ` y° a y &f � ^ By high school, between "This is about education + waking up and first period,he Kelly Matlock, prevention /• :esr �uClel'k , l was smoking pot and drinking. specialist for Jefferson County , , y v S sou 'fit. cl The 16-year-old Port aAnge- has Public Health, facilitated the ,' ' S lea High School sophomore has rt r-"" " rw''** d - *..ce erkatu r been sober for almost a year meeting, saying the goal is to -.,,t, a'...1'.',,,,;/::;.:,.:,,..-::5':':: "' ' " }„�_: �. vices planner#ob" . bring the underage drinlung � i 't '� Chill=Cotmt"y and has taken an active interest issue to the forefront. .s ment.of Health in school after entering the "Undera a drinking is a -s :;-.,..4:7"."'. B g I frHuman SernCea: juvenile justice system. leading public health concern r 1. ` t, a-e�"'""" , I was unaware I had a prob- for the state of Washington 6 r ,.,„,i,./v,:,,,;,,,,,,,,,,,,,, r' i�+'# ,� ! drI Talkawith your thi?-,. lem the whole time. I just Matlock said. ° x F c 's 1 � I expecte' assumed d said as party ingevetoo u Adults and children broke +„i y v a • .•,,y.„.1.,.. 4 chitKnow to and your drinking. at the Roosevelt Middle School p into small groups to discuss R4'.7av*°1 i$ n •' children ate and olio the issue. Kwhb are with. Town Hall Meeting,one of four Many parents recalled their .1 ti: ;� !K�r x B • .' they Call ahead and held across the North Olympic youths and empathized y i,,,., '4.,•.''"1” rJ '• k.. .•n -� fi� -: check out the laces( Peninsula aimed at getting par- the pressures:their children - - h,!� ., ,�r ' _ places ante to talk to their children ' • ,p1�p t9 be W eee;w about the dangers ei under have,but concern for their chit- Participants at a community meeting on underage alcohol abuse watch a video on rho, dren outweighed the empathy. the topic on Tuesday at Roosevelt Middle School In Port Angeles. the seta -m rd' •=: drinking. Co-facilitator of the meeting, "sr: Sponsored by federal, state Kellie pagan,Jefferson Count �` =.uae x"�h.:1 and local governments, the Health and Human Services Police school resource officer, life. And.if you get involved encouragement to consume. meetings also intended to Healthprogradirector,said Servson said it's important to talk to with this stuff (alcohol and "Their world tells them over "They think, 'So I had a encourage parents and commu- County has a higher incidence fifth-and sixth-graders because other drugs�. there's a really and over.'It's OK.it's the way piece.It's no big deal."' nits members to address the of underage drinking than the they're more open about the good chance it's going to gel in it's done. the IIm's narrator They don't expect alcohol to problem. retie g information,rather than older the way' airs have much power over them. P Washington state average. children. Blue Heron Middle School in Were statistically signifi- Gwen Cole, a coordinator "it's frightening in this con, Parents, Renee said, have Two secrets with equim's Parents & munity ton,"said Renes "it's a more influence than they may Port Townsend, Forks High cantly higher,"said Ragan ResourceTask Force, added different scene now" realize.It's up to them to say,"I School and Sequim High School According to a 2004 Healthy also participated, as well as Youth Survey, 20 percent. of In Sequim's Town Hall that when'carting to talk with She finds binge drinking love you, and I am worried about 60 other communities eighth-graders in Jefferson meeting, Sue Renes divulged your teen about alcohol and especially scary, since it can about you." across the state as part of con- County reported binge drinking two secrets for protecting chit- other drugs.it helps to give him lead to fatal alcohol poisoning. carted push to raise awareness —five or mote drinks in a sit- dren against alcohol abuse. or her the choice of having the Washington's 2004 Healthy ReOoie q d caw 9 von mobs sad ed about the most popular abused ting.A third of eighth-graders "We're all looking tint in conversation later in the day, Youth survey found that 15 per- at 3133-417-3531 a en0rewNnion0 drug among America's youth, said they had had alcohol in the and connect."said Renes.pre- perhaps over a latte nr snack. cent„('sophomores and 28 per uenv suisowtnrwzcom. In addition to children sitar- last 30 days. vention and intervention seer "Show respect. and give cent �'I seniors had had five or Reporter Dane tlroari 055 r Paz an ins cautionary tales about their The use numbers increased dinator for the Olympic Educe- them their space.' Cole said more drinks in a row in the past ce 1NthBO at 3BD-fiat-73st a • own experiences with underage as students got older—40 Donal Service District. Leave their dignity intact. two week: da"°'m°n0pe""w tadaiyr r"s oo n drinking,counselors and public cent of sophomores and half Teens, like eve bod, else, Above all.Listen. "Kids.see alcohol like chose- Reporter Evan Ga can be reamed health officials shared informs- p want to know that the} at nsis055'oer or evancael0 seniors said they had consumed )People About 60 people — adults late cake' at first.Renes said. peniesutedairynewacom. tion on treatment,and tips for alcohol within the last 30 days. around them are paying mitten- and teenagers — came to parents. The reason,said some of the don. Sequsv High School's Perf n-rn- And at Roosevelt Middle youths at the meeting, is "If you have a relationship log Arts huilding for'I'uesdnv's School,the problem is not aced- because a small town like Port with kids—yours or niece`•and meet Ing They were regaled emit. Townsend provides fewer actio- nephews—and they know you with start ling statistics.such;is On March 23,a 14-year-old ities for youths. care,they're not going to w int 20 percent of Sequim eighth- Roosevelt student was tat g school with a bottle of v end "i thee tum to dri's not to disappoint you,"where you. graders reported drinking atm- "It's because there's nothing Also, knowing where your bol in the past 30 days. a bottle of rum in her backpack. to do in Port Townsend,"said kids see and who they're with is A frightening film titled Principal Brad Boudreau Echo Aronica,17,who attends a big protection,"she added. "This Place' showed how said it was the third occasion school at the Independent Asking the who.what.when. American culture.with its festi- this school year that a student Choice Education Program in where and why questions vals sponsored by beer compa- was found either under the Port Townsend. before children leave the house tries, ubiquitous liquor stores influence or in possession of She said it's important to is part of reminding teenagers end alcohol-saturated sporting alcohol and drugs. start talking to children about you care about their well-being events. purr vends inuth with c Mem young PpeaooPte in this the Issue as early Al passible. Teens may think p community don'titave things to All the Rids I know who trying to carve allf nntfm i do between 3 and 6 p,m.while drink started when they were their lives. their parents are working," in about seventh grade," said So Renes suggested saying Boudreau said,noting that all Aronfca. something to the effect of I three were eighth-graders. Troy Surber,Port Townsend just went you out there living The problem isn't just anec- dotal, Boudreau said, noting that a recent federal grant aimed at reducing underage drinking targeted the Roosevelt community because of survey results that say that in 2004, about 25 percent of Port Ange- les eighth-graders had used alcohol within 30 days. "That's a sobering mes- , sage,"he said. Numbers from a 2004 stir- . vey of teens in Neah Bay,Forks, Sequim and Joyce indicate that about 19 percent of teens get their alcohol from parents, either with permission or by '3-2�j -c stealing it. L Wally Seelye,a.student assis- tance professional at Port Angeles High School,said that (1),0 the"do as I say, not as Ido" • message from parents is missed a. by many youths. "Kids won't remember a thing you tell them,but they see everything you do and they won't forget,"Seelye said. About 30 parents,their mid- dle school children,law enforce- (6 -0 (,„.- 'Northwest PENINSULA DAILY NEWS • Officials discuss s openness to flu spread Trade, travel may ! , birds in Asia bird flu will spark the next and parts of worldwide influenza epidemic. put area at risk :' Europe and But the virus would have to Africa. undergo a series of genetic during pandemic -'5\' pit - Outbreaks changes before it could become 'E have killed or contagious among humans THE ASSOCIATED PRESS �:- led to the instead of just birds. slaughter of At Friday's summit, Alex TACOMA—As a global hub - more than 200 Azar, deputy secretary of the for trade and travel, Washing million chick- .U.S.Department of Health and ton state has an added burden Gregoire ens, ducks, Human Services, said local and in preparing for a possible flu turkeys and state emergency networks pandemic, Gov. Chris Gregoire other domestic fowl. would be the most important said at a summit with leading Migratory birds flying from lines of help in any major flu public health officials. Asia across the Bering Strait outbreak in humans. State and federal legislators are the most likely carriers of have responded with millions of the highly pathogenic H5N1 Hurricane response . dollars to beef up health infra- virus, scientists say. structure, but spreading the "We're watching a very spe Pointing to the fractured message of preparation to the cific virus:move very quickly response to last year's Gulf public is just as important,Gre- through a very large population Coast hurricanes,Azar and oth- goire said. of birds, and continuously ers notcountmeetingsaid the pub- lic we scare the dickens out evolve. That's worrisome,"said eral should nt alone to of them?I don't think so.Do we Julie Gerberding, director of descend with immediate help. arm them with information? the Atlanta-based Centers for "Grndoire also warnedathat Yes, that is absolutely what we Disease Control and Preven an estimated 42,000 people have to do," Gregoire told a tion. crowd of about 1,000 people, traveling to the state each week including state Rep. Jim Buck, Human transmission present a possible entry point R Joyce, on Friday. (See Buck's for pandemic diseases. report on Page A4.) The bird flu has jumped to State officials are awaiting The summit was part of humans in some cases—there nearly$2 million from the fed- state-by-state efforts coordi- are about 110 knows} human eral government to help ramp deaths,mostly in Asia. up infrastructure for public , nated by the federal govern- Still, the U.S. government's health emergencies. meet to help government offi- top bird flu scientist told The The state is matching that , cials prepare for a flu pandemic. Associated Press last week that spending with $2 million for Scientists are watching for bird flu is not likely to change public health planning, mostly the North American arrival of a overnight so that it spreads on the local level,Gregoire said. form of bird flu that has spread from person to person, nor is it State and county officials in through waterfowl and shore- , likely that a sick bird migrating Washington plan to continue a to the U.S. will trigger human series of intensive exercises to illness. work through a mock flu out- Dr. Anthony Fauci, the- break in the coming months, National Institutes of Health's and the state is launching a infectious disease chief, said in campaign to remind Washing- a Washington, D.C., interview tonians of the simplest disease that there's no way to know the control methods: covering a • odds that the H5N1 strain of cough and washing your hands. $''82ti 'o'g+°.3200 �d '' � a ,1, .3abd4-,9 > $9 o,g ''dog ' A.4o 0 § WDA b 0 8 oO+N' ice• . ,q .N 4.vcjs tv .gwIE • c. y'°,� '�idc °�po osoon� >, �v° t. a.., .,- a ,� mg o �o $o'_ ' �' o �0 .� g a-ppa 4 - >,,",2.6. 0'd828 7-1 E "Egig 'AYE .o d �. 00 °5p_cj13 11 q d0b.SFuof N ,0 Ad 8 ' coof 8 vJ 83 cn ;; °2AAd 02 A � dg0r,,., . •• g � 3� 0oo1 5 � 8E -542 c3 $ • .� 0 0•8 . t,yW.14 i..r.,.., 4 o)•doo0 0 b..-. 4 8 S «' c ft z� as o ,--. 03..9:'6' +a" a2 °, i ,a 0 m c o`z .`o af. ads- c •CPQ 2 as 2 , - o g C,D. p, a3 y 0 A �,1 8.•E o o-' 3 w aai y o `g y6 E� p�400� Q"'+a ° 8 ° > �." 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CO o V O y W 00 41 �, oA "• .4oa) 00ni +� 00 c 41) ali; t.),,, (•/ .4 ,..)fli E.,021 .0,s- apt?"!...gii.p.,,,,nt ;),1 cc.3,„ 0 42 lin -c 0 Q W %• `+>;083 3.:c.. ,n �, „d'8 Li..INia 204) bo g � w ° °° 000i ° , ;U 0 caw 05e. z 8•� 8Zv,: eP :s Wednesday,April 19,2006•B 9 Grant al . ... with H d Canalseptic srepair low-interest loans available to :homeowners Jefferson County Public p.,4= 7 € Jefferson County,is.the first program currently being crafted Health has been awarded a grant ;�� _ 4W :4t county to apply for a portion of that will allow residents who of $330,000 to help Jefferson ' ° $1 million set aside..specifically have a failing septic system,but County residents living along4 1` �° for Kitsap,Mason: and.Jefferson can't afford to fix it, an oppor- rb.Hood Canal repair and replace t �trt �k; counties to repair failing sep- tunity to repair it properly," septic systems that are in need l° � , 4 tic systems along Hood,Canal. McNickle continued."Repairing of repair. . .. 3 ' ;t•'' f?� 'y Those systems may be contribut- failing septic systems that are Residents who have a sep- s ing to the canal's low dissolved adjacent to the shoreline is a tic system that is in need of oxygen problems. crucial step in preserving Hood repair will be able to apply for a the design and installation of "The low-interest loan fund Canal's natural resources and very low-interest loan to cover a failing septic systems. provides an incredible opportu- aesthetic beauty." new septic system's design and The loan and grant funding ,Wiry for residents to fix a fail- Residents living along any por- installation cost. The loans are has been provided by the state ing septic system," said Mike tion of Hood Canal who have sep- available to anyone who needs Legislature, which has made $6 McNickle,environmental health tic system problems are strongly to repair his septic system.Plans million in loans and grants avail- director for Jefferson County encouraged to inquire about this• are also under way for Jefferson able to Puget Sound counties Public.Health. "But these low- program. To learn more, call County to apply for and obtain as part of the governor's Puget interest loans are just the first McNickle at 385-9444. grant dollars directly to pay for Sound Initiative. step in a more comprehensive • 8 • 's v 1 C147.4 _pC 4 --. . 4.)�l ti ,qC -• : - • , CI1 '� 41 y . ,^ ° 2 4E t -Pig . i x y . .�. _ 1. 4 s �; Un > $ E1w N • e i.- r2444 '4111g:8 114 " 11.8 s V la j g '4 cl. z . 44 A °:d NO II •o4 ,..,-0 8 v 1. R >-,W • 'a) (/1 a w :: c � .� oj.i ti ° ril L1. o .0b .+ 1 gq p8 g • W a CA " .4 AJ � q 'g v4 2 - a) A.)::10,.0 0 Ay Et llgi ! U - g OgE .x ad 2koR - v b � � . b to z ^, ' a+ E3 w W 0 vv O ; U :,- 041) - 2Z0 .0 0 Z .: :-:-_"-'',-. -: : a) . J44 :g. kiiive 13 0 .:,,-;,- _V-° :n Ft: 1 t. 411) ° . -g 2. .-,-. • . a...0 .2 z ; . 8 .8 ....8E [IP".aou • . '-1,\A ic E 4 a) s 0).01 - Nlu 1 r.� '\ slid :\ i u • V W ZS •d .�J .� .1'2 • gDepression,Ne lect: meth use Continued from Page 1 said Zorrah.. "I was shocked. Reaching out reach for drugs that they think Now all the nurses in the office Two community groups are « might lift them out of depres- Neglect can be have high caseloads of meth- working to address this grow- Sion.But in the end,drugs cause addicted families. The clients ing problem. The Meth Action depression just:as.harmful said,meth use is sky-high.. Teari , said Beth.WilmarVpro- "Meth use has pushed neglect Kelly explained that if a gram''rrianager for Jefferson way high," said Dott Kelly, the as abuse. „ mother is taking drugs she can't County Community Network, is executive director and therapist respond to her infant's cues. In developing a protocoh for fire- for Jumping Mouse Children's Quen Zorrah turn, the child doesn't learn to fighters,nurses,doctors'and law Center. "The parents are physi- nurse read adult cues. A couple of enforcement to follow in han- cally present,,but they are not Jefferson County Public Health years later,there is a kindergar- dung drug-endangered children. available emotionally.” ten or preschool teacher with The Family Support Coalition veral kids in the class who is reviewing community efforts agency has doubled its capacity se Tether line broken to help families and still has a can't understand the basic emo- to provide help to caregivers Decades of research on waiting list,"was her parent was tional and social cues on a teach- with mental disorders in order to maternal mental health shows er's face.They don't know if the reduce neglect and abuse. that depression - from family always escaping." facial cues mean they are safe or "We have to face this number In the last five years, local history, postpartum blues, pov- in danger. one problem,"said Zorrah. erty or meth use-can impact a Public health nurses who inter- "They have a missing piece," Her presentation moved mother's ability to provide safe, act with mothers in about half said Kelly, who added that her the Public Heath Board com- a dozen programs gave them responsive and nurturing care to agency spends a lot of time missioners. At the meeting's s a standardized test for depres- her young children,according toteaching children "the meaning end, County Commissioner Pat a Zero-To-Three Policy Center cion. About 35 percent of the of facial gestures so they feel Rodgers, who also sits on the academic paper on improv- mothers tested positive for major safe enough to learn." health board,stopped Zorrah and depression, a significantly high ing maternal and infant mental Neglect is hard to diagnose. said it was a great presentati percentage. In a recent cover health. "There aren't any bruises or bro- Then he added,"It was the LID Babies depend on emotional story on women's depression, ken bones," said Zorrah. "Kids presentation all year." Newsweek magazine said the nurturance, protection and stim- nationwide percentage is about can look cute because they have (Contact Janet Huck at ulation that depressed mothers 10 to 20 percent. a drive for survival." jhuck@ptleadercom.) cannot consistently provide, wrote Ngozi Onunaku. Infants No bruises of clinically depressed moth- Meth use in families here has ers often withdraw from daily also been rising.At first,Zorrah activities and avoid interaction with caregivers, which in tum the nurses who help local jeopardi7's infant language and families discussed whether the physical, intellectual and emo- rise was perceived or real. But t` tional development. Older chit- the nurses began noticing an is dren of mothers'depressed dur- ing mcrease in babies born with pos- ing infancy often exhibit little itive tests for meth. They found self-control, aggression, poor Children and Family Services peer relationships and difficulty was initiating more dependen- in school. cy hearings to remove children "The child [of a depressed from the homes of addicted par- mom] is like an astronaut on a ents. About 60 percent of the space walk whose tether line has dependency cases are neglect, been broken,"explained Kelly. said ZOrrai' Five years ago I saw my first One young Jumping Mouse client explained her mother's meth-addicted pregnant mom," neglect as being like a dog that was always escaping. "What she meant," said Kelly, whose T P offers free helmets Whether or not you support Mathews at 344-4609 or Port is disappointed that controversy the City of Port Townsend's Townsend Police Officer Tony. over the city helmet law seems ordinance requiring the use of Polizzi at 385-2322 to make an to have stalled efforts by the bike helmets by July 2007, you appointment, which includes a Nonmotorized Transportation can get a free bike helmet from fitting. Advisory Board to launch a bicy- the city. Helmets are also being made cle safety education program. Thanks to grant funds available at the Farmers Market in (Contact Barney Burke at being passed through fromthe Port Townsend'iuptown neigh- bburke@ptleadercom.) Emergency Medical Services borhood beginning this Saturday, Council of Kitsap County, the April 29, said Mathews. In addi- city is able to give away as many tion, the city is planning to give as 50 helmets a week, said Julie away helmets at Hadlock Days, Mathews, a volunteer commu- July 7-9,and the Jefferson County nity life safety officer with East Fair,Aug. 10-13. Jefferson Fire Rescue. As an additional means of The helmets are available in encouraging youths to wear bike a variety of child and adult sizes, helmets, Subway sandwich shop but all of the helmets are blue, on Water Street has donated cou- said Mathews. There are no pons for free sandwiches. The requirements pertaining to age, plan is for officers to be able to place of residence, or incpme, give out coupons,to youths who she said. . wear bike helnieti, said Pqli77i, To get a helmet,contact either Councilor _Laurie Medlicott, who, along with Frank Bensidn and Geoff Masci is part of the council's Public Safety Committee, said she is proud of the efforts by Subway as well as police and fire officials to encourage bicycle safety. She .a 1' • .... (fLaiLtjv- 410 . .-a rm -ri '„ £ <' s x a .+ f. ay,a -:'ar. w vxt .c d. a RaF A.,y e i► ae -,q, wV �^tTaY' P x r .€-.-amu a. ,'':;:L* -`: m€� „r�'. '¢7:'''';'..7:-."-'-=--i',::-..,-.' +Z' t .„�yr,.a. .,t'ax.�. '::t ew { ' yp _ � gi _y .,4* r�` - ► �� t x , Aprli 30;,2006 • 1. - . :;: - �, °� ''''',r-'-,.'`-..:.-.- `� E,r p2 Yy #' - X44 x,-p2.'Inflehtei x # -: . . an y, „k r,. .-° x + 3e ¢.4,7:. -'',..` , ,.,,,A,..* . ",...'. ..-3-rk--..-..'-,..Froorgt".7,Lei ' S' Aniirr,F,.. ,. ',4S-A-;'k• '� forte .P �4� ...".--•,,,„..--.2-- ,:O'1 ga PaM�#,bil. k t_a r '� - •s....:.---,.'... �� k# SSC t' "§'.�� '�,: ,k '� czaz. .c .� �9• 4 awe. r ':.. ,0-r e .zw,a 41"4,,� .F d 7'/ i" y x -Q a , "+.AV.'r xp b : # fa'+ i1 x vpi .41,. .vt ,kxx,r, ,es �� 2 • rr - -' Kristen Chilson,weighing about 75 ,a u;,, r,, Ni�tS k %, �, ,' "h 4 s'l pounds and her children when she t ., "� was addicted to meth in 2004. x � � k� h.• y� 5Fk ,{ 5`E ‘,.y.--,...,?:..:..r. hP . y . �- k K6T d R , q 3° • .:'...:;,;;;.-:.,....,-----1 F 3t ',� �� f ,.-ry .t dpi LL F „e;h F_".p 1^, ; n4 • ' an y.� t 1,: r^s Yt x1a+ .::,,','-':',',11,,e,---;;; iv-':',...,,,t-':','M'•' aF �^ r... ,t55g x a.: 4 it ,_ p • i w ., F3rg ' . r ;'r+ „ 4 ,' :f., 0 Child placements risesT�. % SL4 t \! t , f ° as drug-addict moms-- i } e . , N r _.,, 4 . Y.; , E combat their demon ''''... .::°.:•-•'''' '''.-:,';','-_.',-,-'_-.-,1:::- r , First of two parts { Y 4 y e"' "YG ‘"''''".,',':',..,„:4.,.- Y i, -.•-°^ # 'i. "I', By PAUL GOTrLIEB # < € ,. S 0f +n� „�'=�'°b PENINSULA DAILY NEWS : 1 s Y,ir+ t 11:17-3.. %.-. '. • '►nT .:..- - .. . - ';a!fq �,�4' E a° • t her lowest point,Kristen Chilson- " ' ` ' . .. t'`� ., , all 74 pounds of her—was so thin TOM THOMPSON/PENINSULA DAILY NEWS that her bones hurt when she sat in Kristen Chilson of Port Angeles sits with her two children, Kira Chilson 3, center, the bathtub. and Scott Grush, 4. Methamphetamine use caused her to4iave her children taken away by the state in 2004. They were returned following her extensive • ce. rehabilitation. in OAtctoabberout 2004the,samhere chitimel- ■Innocent r: dren were taken away by newborns state Children and Family of meth- �� addiction ServiEE?rJe'F care Chilson,a former meth mom,has been PENINSULA DAl1,Y-News It damages brain cells that contain clean for more than a year after intensive Iiiiiethamphetamine is a potent, addic- dopamine and serotonin, a neurotransmitter outpatient treatment. tive stimulant drug chemically that affects mood, appetite and sensory per- She just got her children back in Marcl related to amphetamine,which was ception. and couldn't be happier. firsts synthesized in Japan in 1919. Meth causes an increase in activity and a y p decrease in appetite. Life is"going wonderful,"the 21-year- In 87 years, it's become the most difficult Like all addictive drugs, it produces ini- old Sequim resident said. drug addiction to break, and experts say the tial pleasure followed by unpleasantness. "I can deal with things as they come, brain never recovers from its ravages, whichill gy suppressing the normal production of and reach for the tools that I learned in can include sexual impairment and depres- dopamine, it creates a chemical imbalance, treatment,like asking for help,"she said sion. with the user demanding more meth to last week,sitting outside her mother's Meth releases dopamine,a chemical in return to normal. home in Port Angeles with her son,Scott the brain that stimulates brain cells and enhances mood and body movement, accord- Symptoms of chronic use include violent Grush,4,and daughter,Kira Chilson,3, ing to the National Institute on Drug Abuse, behavior, anxiety,confusion and insomnia. playing in the yard. part of the National Institutes on Health. TURN TO METH/A7 TURN To MOMS/A Meth: Paranoia suicical thoughts • CONTINUED FROM Al cause acne, depression, tooth of impulse control," said. Symptoms also can include decay, damage to the immune McCormick said Thursday. "When the hypothalamus is paranoia, auditory hallucina- system and erectile dysfunc- "It takes between one year damaged, the end result is for tions, mood disturbances and tion: and 18 months to be able to the addict is they don't get any delusions — for example, the 18 and to be able to natural highs',anymore," she sensation of "insects creeping 18 months to`end addiction respond at a maturity level said. on the skin, called "formica- According to a 2005 study with their peers, and there is "There's nothing to indi- tion by the National Institute on always going to be a certain tate the brain ever completely The paranoia can result in Alcohol and Drug Studies, it amount of vulnerability to repairs itself,"she added. homicidal as well as suicidal takes about 18 months for return to addiction." "The brain is an organism thoughts. ' meth-induced brain damage to The recovery time is longer that will develop new abilities Other long-term impacts be repaired, said Gayle than any other addictive drug, in different areas to compen- include depression, anxiety, McCormick, clinical supervi- McCormick said. sate." fatigue, paranoia, aggression sor at Oak Street Center, a The hypothalamus, the But research also indicates and an intense craving for the Port Angeles drug and alcohol pleasure center in the brain meth addicts do respond to drug. assessment and treatment that governs impulse and plea- , treatment in a positive way, Up to 5Q percent of center. sure, is damaged during meth McCormick added. dopamine-producing,cells in "[Addicts] were still, at 18 use. "We have a gal in college the brain can be damaged months,seeing some problems "It's the part of the brain who's recovering from meth after:prolong0duse.` with the ability with cognitive that tells dopamine produc- addiction who'4 getting schol- Extended use also can thinking,especially inthe area tion to get going," McCormick arships," she said. • • • SUNDAY,APRIL30,2006 A7 M ons. Health• CONT INUED FROM Al A year to show progress Addicted to meth for nine when I ask them to Uo some- Chilson is among the dozens months, she's been drugfree of mothers whose children were A mother whose child has fil thin�g. They are on a routine taken away by Children and been. put into foster care since January 2005, she said t`schet�ul`e, an ' l't l e`lWus Family Services over the last because of factors related to her this week. ant." two years because of their drug meth abuse generally has up to Chilson took meth almost .She also'notices the. little use —..primarily meth, chil-. 12 months to get clean and any way she could. things, "like when they smile, den's health officials say — functional,though the timeline She smoked it. like when they tell me they love and put,into foster care. can be exceeded depending on She snorted it. me." Parents of 62 children in how well a parent's treatment She wrapped meth in toilet It helps, she adds, that "I Port Angeles and Sequin, 17 in is going,Heard said. paper and popped it in her have time for them.I pay atten- Forks and six in Port Townsend A meth mom whose child is mouth. tion to them." had their children put into fos- in foster care and commits to That way, the toilet paper ter care in 2005 alone, accord- turning the tables on her addic- dissolved in her system and the Monthly sessions ing to state Children and Fain- tion accepts a yearlong parent- meth could work its poison it Services. without fouling.her mouth. Chilson recently graduated y ing plan devised by state Chil- "You That's more than double the dren and Family Services that can just straight dump from weekly outpatient treat total in:2004:for Port Angeles lu4es treatment iegrjd,said, it in your mouth, which is ment to monthly sessions at and Sequin, and compares Meth's ripple effect is felt 11y gross,"she said. Oak Street Center treatment with no meth-related foster mothers who use it and rela-i ` Chilson never injected meth, facility in Port Angeles. care cases in Port Townsend in tives forced to deal with its con- and never drank alcohol Of 60 active patients at Oak 2004. sequences. because her mom was an alco- Street Center, 20 and possibly, There are already 23 foster- The Peninsula Daily News holic. more countmethamphetamine care cases'in 2006, each of recently interviewed Chilson She'd get meth by letting use as,their only or major drug which apply to an individual and a woman who would iden- other addicts take showers and _ addiction, said Gayle child, said Maureen Martin, tify herself only as Katie. eat her food. . McCormick, clinical supervisor social work supervisor for Chil 'Both were_referred to the "I probably traded $1,000 at the Oak Street Center,a drug dren and Family Services in newspaper'-by state Children worth of food." and alcohol assessment and At` her lowest point, Chil- treatment facility in Port An rt Angeles. and Family Services under ales. � Sixteen parents are involved PDN request. son's bones were so fragile and In the — 10 single moms, one. single Both moms are kicking their her weight so low that she past 10 years, dad and five two-parent house- meth addiction,they said. broke her wrist trying to pick McCormick has seen an increase in opiates holds in Port Angeles and Katie, in her 20s, asked not up a box. P , especially Sequin,she said. to be fully identified to protect Now working on her high heroin,as well as meth. Twenty of the 23 parents are her boyfriend. school diploma, Chilson, who 'We have a high population addicted to meth, including a She also said she was wor- grew up in Forks, counts her- . of single moms or impaired "vast families,"McCormick majority" single. vied about her landlord retaliat- self as lucky said. ty' of the s'ing "I know But addicts do respond to moms,Martin said.. ing against her. girls who are preg- treatment,she said. � Meth is the`major factor in She's been without her two nant now who are doing meth the majority.of cases on the children,both younger than 10, while`they are pregnant," she ung free time that Chil- North Olympic,Peninsula, said she said,for 18 months. said. son once spent.doing meth,she Mike ,heard, ;the agency's Before her children were put Those women live in Forks, now plays computer games,lis- regional-supervisor for Port 1 into foster care, addicts would where 17 dependency petitions tens to music and cleans her Angeles, Port Townsend, move into her home and live were filed in 2004 and 17 in house. Sequim,Forks and Shelton. with her and her children. 2005, supervisor Ann Simpson "I've become a clean freak," "I guess it's in 70 percent to "They lived with me,so I got said,Forks office supervisor for she said. "I'm absolutely 80 percent of our cases," he [meth]for free,"she said. Children and Family Services. happy" said. Katie used meth for eight The meth problem in Forks years, then added methadone "is horrible,"Chilson said. Commentary Page Editor Paul Gottlieb and heroin to the mix. When 'she was a mom on can be reached at 360-417-3536 or She stopped using after she meth, Chilson lived in a fog, paulgottlieb®peninsuladaitynews.com. lost her children, and she real- even around her children. ized quitting meth was the only She didn't see them that way she'd get them back,.,she much because they were at the . said. baby sitters,her mom's or day- "It didn't matter what drug I care. When they were home, did,or how much I did,it would she let them do what they not numb the pain,"she said. wanted,she said. • "I did not have anyplace I Now they have set times for could call home,"she said. meals,naps,bathing and bed. "That was the bottom I hit, "Before, when they were . and I'm thankful I hit it before with me,they never had a rou- I was in prison ordead." tine. It was just, whatever," Chilson has two .children Cin said last week. ages 3 and 4. "Now, they 'listen to me ' , , , rC / N PEtr-n...„:„.NEWS - c,..__.,, .:,IP Peninsulaorthwest . ' - e Is ,„,, 1 -m west ,„, victims WnfAr ithdrawal , t a.a3 x4-a; ..<4.....4.,`,.,,,,,.,1„,..,,,I,,,,,,,,,,,,,, '•s, Y �r �,. r" -`; 's" e> L�3 T '.a ,.- �� �� often affeta cts s e- 7 1'9., . k L�, t 9 a Taxi: e $ ; d ', i tR newly born ..,.,,, ,,,,,,,,t,„4„,44,61„1,, ,,,,,,,,,,,,,. , ,,,- ' ,, ,,,,‘ ..t, - ,,,,,,,,,,,,s- , -,--.:..,;,,,,,,,,,.?„- 4,,,,,,t,,,,,,,,,,,2,t,,,-,-. -dr a 0. . PAi..;,.lJ,..,_ n:B g:q v� :,,:,,,•-,„' . „ r's,, ; Si � §e ,, ,?%% '„• 4444 -•s•a all PENINSULA DAILY NEI” a g .�'',••• 4� ' R ' Ax a M >,g" , '''''1,,,,'''''-‘,..„, . I£2 P( The impact of a mother's '°�'''i°' As A " s ° , ...1 7t'j meth addiction on her new- E ' ' �' M y born can be difficult to dis �.�dY � ib F� ` a"Ri R t f i `` A4 , 0}� �*µ � J S cern,even among state 1 = f in agencies: � py ��... z , ¢ ys s ;' ii`` The Pediatric Interim -r��b,- \R Care Center in Kent,which "n `L 1 to -. treats babies born of drug -",; � �R€ ��� s . ar addicted moms,cared for ?. £ ,' r ,meg -,z ?; w: -,t- 192 infants in 2005— �°,. : • w �E ca including one:from Port ,: , ; �� -' :• 2( 41) • ; , ° °� Angeles. ��a , � t A quarter of those babies �``� , '� '' ea had parents on meth. - w "We have over 10,000 a cl babies.,in Washington prena- sc P( tally exposed to drugs,and =N we're seeing only 192,"Gen- ` 0„ L , a`z ter Director Dr.Barb Dren r, , ' `� � P€ nen said: r ii• �� _ Described byDrennen, '',<A'��,w _t d� meth's:effect on an infant is KEITH IHORPE/PENINSULA DAILY NEWS h€ insidious and can be grue- Port Angeles pediatrician Dr. Cathy Shubkin, shown in an examination room at some. the Port Angeles Children's Clinic, said meth addiction can span generations,but there are no definitive long-term studies on the effects of meth on a( Babies withdraw children. .1 m Babiescan be listless and disheartening. It's a form of tions only during the last 10 Mothers who are on meth sleep too much,which fools withdrawal."' years,doctors haven't had or any other drug are still ti a mom into thinking the When meth leaves the =much time to study the encouraged to breastfeed N infant is,content and simply infant's system,within the long-term impact of meth but are also usually person- M a good baby,Drennen said. first two weeks it can be moms' prenataluse of drugs ally committed to abstinence r( "What a mother sees is a , excreted from the baby's on their children, said pedia- from drugs or under court A t baby who is soft and cuddly buttocks, burning through trician Dr. Cathy Shubkin of supervision, Shubkin said. S' and looks healthy,and they tender skin. Port Angeles. Isn't the baby poisoned are not able to identify it as You heard that right. ' "We do not have great by the drug? si -withdrawal,"said Drennen, "You have open wounds long-term studies," she said. There haven't been stud- who established the center that bleed," Drennen said. "The first generation of in 199U. ies that would lend an A You can see a bottom meth-addicted kids is hitting answer to that,either, Mom's-meth often stifles that's totally clear,then it our schools now." Shubkin said. an infant's natural urge to turns redder and redder and She's seen meth use "It's a hard call.We want b ill ,, suckle.,, redder. spread to multiple members to facilitate bonding, and b "`You=want to see an "On adults,you see scabs —and generations—of the breastfeeding is n ounce of weight gain every and sores all over the body. same family, she said. gone of best 1 day,"Drennen said. That's something you don't "We are seeing some of ways to do that,but we "These babies go the see on a baby that often." our teens who are addicted don't know the impact." ii hoPPosite.waY.If you are sit- What about lon -term and going into rehab," h .ting there;for 45 minutes, effects? Shubkin said. Commentary Page Editor Paul Got- if just trying to get two ounces Because meth has "More and more, those tlieb can be reached at 360-417-3536 or of formula down;it's very reachedepidemic propor- kids are having babies." pauLgottlieb@peninsuladallynews.com. it 40iftcersan Ctoutitivi s (Dat(l0.(N'\ws a yr . .. > 'i ° r4Py FOSTER CHILDREN BECAUSE OF METH • • -Or , ' . •7y -11,--..."•;„1.2.. j St: Mh , ....e•':.-7: , t. . .,..:::1,-':. • ' -'.••••-• y.g..!....-,...-‘--..... itr. .;00tg,..;, : ..,„,,0 .., „.. , . , _.00,t..1!,.. .., . .......;,.m,,,:...,,,:, ;. :„61,„.,,,. ...,,. ,,,.4505i,i1101,440..., 1,;r::...,:,A14;i:5,..411144izts,.,..:,-51,4,4,16;. ,...-[1: I. ;..., . , ..:... x�r w isei " 1f P „N' , k I T; �' . , i q ' stip '�n°�'4 -;2t.::'f ° • k ' f 'It ;e t , %s r sa %:::: 14'") ..ilil7T--i'-',,,.. '1'1-- -"'"?.:-J\ . -:if';'.:3:--'01 :+nom, 4)06,7, n� i., a \<Y,",,, }+ n ¢ 460 i x .,.?4,7464)444,;.,.;,',v.:4'. !Y a.e. i � A KEITH THORPE/PENINSULA DAILY NEWS Diane Johnson of Port Angeles sits with her five grandchildren,from left,Natalee Amsdiil, 2, Ashlynn Amsdill,4,Harmony Johnson,5,Thomas Johnson,3,and Andrew Johnson,6.The children 0 are all under their grandmother's.foster care because of their parents'addictions to meth. See story,Page A6 Numbers tell sad tale of babies affected by their parents' meth use in Jefferson and Clallam counties ThepIightofBabyA. . . BY PAUL GoTTLtEs focused on a PENINSULA DAILY NEWS er mothers drug use is sorry Side of sn,.e ' M ET� street life, ....._. . etched into Baby A's brief, mainly in Port Angeles. y Fl painful life. and , The 3-month-old infant has Testimony ;: known only tremors,diarrhea and 111oA►J AoOL rDelated to the2004 -1,113:;:::;....i . foster care. 1 (L7J ILS A1{►J�11 ecember She's tested positive for 1 death of a 15- year-old ` "R° methamphetamine and now,in Second of two parts Melissa Carter Heard • her heart-wrenching way,is deal exposed the ing with its consequences,state meth use by down-and-out teens Children and Family Services offi- tion that"can be attributed to and adults alike that tears fami- cials say. withdrawal,"said Maureen Mar- lies asunder. Baby A. is among dozens of tin,state Children and Family North Olympic Peninsula children Services supervisor in Port Ange- Born in mid-January, Baby A. newly thrust into foster care dur- les. was just 3 days old and still at ing the past two years because Olympic Medical Center in Port • their parents—mainly moms— Scourge of addiction Angeles when Children and Fam- foster meth. ily Services placed her with foster The scourge of drug addiction parents because the agency feared Many meth moms snort, has been brought to sordid light for her safety. smoke,inject and even eat meth recently on the North Olympic "She still has slight diarrhea in combination with other drugs Peninsula. and slight tremors,but she is get- during pregnancy,like Baby A.'s The murder trial of Robert ting better,"Martin said Friday. 22-year-old mother. Gene Covarrubias in Port Ange- It's left the infant in a condi- les,who was convicted April 21, TURN TO METx/A6 A6 MONDAY,MAY 1,2006 ■ eninsulalN o. Meth: Druginjects turmoil CONTINUED FROM Al ,op ;, - 0 But Baby A's mid-January �m g3- 3 - separation from her mother WO �I'" t e*, marked the last time her 1 Mo... � : mother touched her. BabyA.never went home. -�`' ^s '"` .r�'_ ,. "We on't know where Mom ,x '; d 4 is Martin said. "This is a sad 'r 0t,, * , � drug, a sad job, sad for every •- body." ., " 1 • igtf', ..p. The 300 percent increase ini Port Angeles and Sequim and ; ' - the half-dozen new cases in ' Port Townsend in 2005 — I ' " : q': ;`'` _,., compared with none in 2004— , goes against a static statewide r, y- - I•`z , trend in foster care,state offs- '. e,0.- \ €,, r ,,,,,"-.0 dale said. �,. Area defies the states \v,- 4 w F Across the state,we are not - seeing a huge increase in foster care placements," said Mike Heard,Division of Family Ser- HEMTHORPE/PENINsuiw DAILY NEws vices administrator for Port Marueen Martin, social work supervisor for Children Angeles, Port Townsend, and Family Services, leafs through paperwork In her Forks,Sequim and Shelton. Port Angeles office.Martin helps oversee children . "I don't know why that's Placed Into foster homes In Clallam County,many of the case here." whose parents are meth users. Here's a look at the sad toll • on the North Olympic Penin- social work supervisor for Chil- abuse has likely become the :° c a . o w .,'s, a sula and statewide: dren and Family Services in problem of a government N o 5 o i. p 8 ■ About 9,000 children Port Angeles. agency somewhere else. d u $ were placed in foster care Sixteen parents are "We've had a change in a, 8 o a ,a3— statewide in 2005 for various involved — 10 single moms, demographics,"NeSmith said. ▪ S°'.9 • d x • reasons, including their par- one single dad and five two- He cites a 60 percent drop o 6 x a. w„ ents'meth abuse. parent households in Port in welfare rolls in Port ,� `' z, o c The total has "remained Angeles and Sequim,she said. Townsend and the links c 5.F j' 5b IL i i kind of static for the last sev- Twenty of the 23 parents between. poverty, drug addic- . a" y a i'- eral years,"said Kathy Spears, are addicted to meth,including tion and child abuse. -.4,2.9., 8 v d S m spokeswoman for the state a"vast majority" of the single "People in poverty in this 0• o U 3 6 =' € .-e Department of Social and moms,Martin said. area have had to move away to S • y E� ;; d 8. a Health;Services. ■ Twenty-three children rural areas or out of the 73 a ` ° °.ri .� E. State officials cite substance from Port Angeles and Sequim county,"he said. abuse as a reason for putting were placed in foster care from "I've seen that happen y'- c.tin '0 '$.E ° c children into foster care but January through Friday, here." �a°i• a v " o ?S as.5 don't tabulate whether meth mostly from single moms,Mar- ■ Only Clallam County's i §. N S '°'c r or any specific drug was the tin said. West End seems immune from y ° ` ° main culprit, which state fos- Sixteen parents were the spike. ' u ° 5 3 c 8 G ter care officials say would involved, including 10 single In Forks, 17 children were = ca ai °;Q,d 2 --- help them do their job. moms,most of whom did meth placed in foster homes in 2004, > c a .E: b "We can't break it down or meth in combination with many from the same family, a- " 1..c• 0 u N�° that way in our tem,"Spears saidomputer sys- incherreasing n or methadonh nomenonecalled entmeth.most with t least one par- � c 'o '°o w°3 4 c p gp using >e).-,-??•„9 ° �°y_° �... "There has been an increase "polydrug"use. That's identical to 2005. 0 a a . c iu ,a o E where people have said, anec- ■ In Port Townsend, three Two dependency petitions E. a u w z x=H`c, o• ,� ULA. F. dotally, that they do believe children were placed in foster were filed this year,one meth- ,� 3.5 c m .S c'i to [certain cases] are due to the care in 2004. related. meth epidemic." None was meth-related, "It's just been a consistent •- •a7-, 0 E•o 0 dor". ■ In contrast, foster care compared to seven cases in issue out here rather than get- °5 2 S c' a"i-a placements from Port Angeles 2005,six of which were related ting larger," said Ann Simp- u w d o c a =d o x and Sequim more than dou- to their parents'meth use,said son, the Children and Family iv °•°.' o w - o a ' of.. bled from 25 to 62 in 2005. Bill NeSmith,head of Children Services supervisor in Forks. N 0' 3 °"-D = .I d o a Eighty percent were meth- and Family Services' Port The relatively low numbers, `S o�'.b ` 6,.4 o related, and about 80 percent Townsend office. she said,are"curious." 2 c'lp .n o a 3 c,, ° of those were children sepa- The parents were single That doesn't mean Forks ; a,0,-,), N -"5 ° o 0 lamratedfrom CountyiHuman Services childrele moms, Clal- moms,n. "Meth of whom had three doesn'thais a problem. -issue in P' ° 5 C U S u C s.:o planner Florence Bucierka There have been no foster Forks and has been for a long •a„-' c "°°, . moa 5 A gid• care placements so far in 2006 time,"Heard said. c "' ° o w a c 0 P • There are already 23 foster- in Port Townsend, but that's "Forks is a big meth area 5 N n. °c n-o cq . .� al o care cases in 2006, each of not likely due to a drop in meth going back to the'80s." - which apply to an individual use by moms,NeSmith said. The approximately,100 chil- child, said Maureen Martin, Rather, parental meth dren in Clallam and Jefferson f • •-, Wednesday,May 10,2006•B 3 West Nile virus monitoring begins With the arrivalfwarm- o program helps us inform the include high fever and inflam- containers is essential even in er weather and mosquitoes, public about the migration of mation of the brain.The risk of winter, because mosquito lar- 1 Jefferson County Public Health West Nile virus," said Mike serious illness and death from vae may survive the cold winter is gearing up to conduct environ- McNickle,environmental health infection is highest in people months and hatch in the spring. mental monitoring for the West director. "Although our moni- over age 50. Jefferson County Public Nile virus. toring did not detect West Nile The best way to reduce the Health is recruiting volunteers to Starting June 1, the depart- virus in any of our samples last chances of West Nile virus infec- conduct mosquito surveillance ment will conduct mosquito sur- year, it did result in identifying tion is to avoid mosquito bites. in their neighborhoods. "It is a veillance (trapping) throughout several species of mosquitoes Personal protective measures great opportunity for anyone who Jefferson County to help identify known to carry the virus. We include: species of mo is interested in finding out what the mosquito present will continue to conduct mos- • Wearing long sleeves and species of mosquito inhabits their in the county as well as do sam- quito surveillance throughout full-length pants in the outdoors neighborhood," said McNickle. piing for the West Nile virus. 2006 and beyond." when mosquitoes are active and "We would provide the train- West Nile virus was not West Nile virus is spread using effective bug repellants. ing and equipment needed to detected in any mosquitoes col- to birds, horses and humans • Eliminating potential mos- do mosquito trapping throughout lected in 2005.However,several by. infected mosquitoes. Most quito breeding habitat around the summer months." species of mosquitoes known people who are bitten by an the home such as containers that Those interested in partici- to carry West Nile virus were infected mosquito do not show may catch and hold water. , pating in this project can call identified in several locations signs of illness. The virus can •Emptying or removing such McNickle at 385-9436. through East Jefferson County. occasionally cause severe ill- "Our ongoing monitoring ness; the most severe illnesses . , , .T. (_,,,L,c,,, 6---/e —0 . 411 . , • . , . • • `Links' for supporting teens, adults with disabilities Parents and guardians of said Anna McEnery, coordinator teens and adults with disabilities of the Jefferson County Public L are encouraged to attend a spe- Health Developmental Disabilities • • cial event Thursday, May 18 in Program. "Do you wonder where ` Chimacum. your child will find work?Is corn- . The Port Townsend School munity college an option? How District, in partnership with _will your child find transportation • other organizations, has orga- to his or her activities?" nized an evening for families Questions will be answered ` to meet with staff from various at the event set from 6 to 8 p.m. community agencies that support May 18 at the Chimacum High teens and adults with disabilities. School library. A free dinner is • Special education staff from the served at 5:30 p.m. schools are participating. For more information contact "As a parent •or guardian, Lydia Harrison of the Family • you may have many questions Educator Partnership Project at = about your child with a disabil-. 206-780-2731 or LydEduc a)aol. ity transitioning out of school," com. e- le • • • • •jum1PiinjousPART�� N E R S Our Annual .Report is a good Domestic Violence/Sexual Finally a most critical partner- opportunity to name some of the Assault projram and t4e ship rests with the work we do with //� ' our COunt1�S sc600f Gi'1S'tf"1Cts. partners in our community agen- C/ f/Gl Protective Services J cies who work beside us to support �7ro ram at OS7i5 These Teachers, counselors and adminis- our children and families. Gut' work with particular needs trators bring together a much more Country 7-lealtl Depart within the families, in areas that extensive base of discussion result- 'vent and our 7-leaGl Start require special linkages that reach ing in a more complete picture of the Pro ram are two vital partner- beyond the scope of care Jumping child's needs. These discussions ships. These programs provide Mouse staff can provide. include family members, since they critical assistance to the are our greatest strength. children and families that These community partnerships 40 Jumping Mouse serves. with Jumping Mouse Children's Individuals in these pro- ;� a, Center create a "bundling grams coordinate servicesN effect"of care that sust. s not with Jumping Mouse only our families,: b c e- Child-ren's Center on givers. II us wo i with behalf of the whole family. - , these fa ies and ildren are While each agency might hik * ' ..-v Cand engaged in a have a particular view into more far-reaching vision and the family's situation,when we link Individuals within tIe ju hcia( goal. In this community, Jumping together we see a more complete system and the Cluardan a1 Mouse does w k alone. picture and are more efficient in ,L'TtemJ I- route have assisted us in % 4 iour responses. creating the most effective and 4 Two other important partners broad based child/family support are 9ej Person Countsystems. ' ‘ 16 $ . ��4 -�, ,,',mea � 'fTwo years . 60 ® u s SavetIeVT1ate "7� ,. , !. , Story Night at Grant Street! 6-8 PM April 28t" 3 tai' rd }' "^ v:4yP' �' `.fes}/�/}Jy A ' $J An Evening for the whole family �'os whether ''',.P.1' of with story tellers and crafts. service Which meant- e '� s away, , Yi �� a� `: tor,to risk � 11 ral1st Annual iii u,f 4`k' k. �¢�• the Board chose Mouse tr.)..,, ..� ik J ICC to the next leu l . iia# Zdyfrerne CI"O!1uet y .9ur)ipirye more tail` � Tournament t !t. CitY + f a non July 4th 11-3 , iti Chetzamoka Park profit Bo to Jumping Mouse and see What can happen when a group of dedicated people `shake' on an z*� • ,� aNir greement. Members pulled out the stops, ;;:,'*-.„ ,.-...V.-4,„''''',--,'-', <' .� askingilk qtr friends , tries to help a g out Roar the u movement ; of -..- . f' ' 1„,J.* the';,-.--:.--,,t:;.i*,an, ,_,1 e§ve $2. .,`x� 4'1"; :44,r;-: W▪ 'Y'R ' hs3" 1 ,. S `.'i, i 6 1� T M_^•`�£ i,yy" t`w q q wirec.i>2,47..4.,,,,,,,„;,„,:i,i., ,...,,,,...,... „...,„ t t4. A �. } -,:it-*-47.1,,, ,, P,- 'the time W nm _ P . " >3 '4..',17;.' � t ¢g� are at t bop of mills; S. TM�a£ r 1-,a 4�*- x� • Date: April 19, 2006 To: Jefferson County Board of Health Re: Update on Hood Canal Sanitary Survey Project From: Dana Fickeisen, EHS The attached newsletter is being mailed this month to approximately 800 Jefferson County residents who own property on the shoreline of Hood Canal to update them about the Hood Canal Sanitary Survey Project. • • Noo.canal 4,,441,;14;:;:r- ,. ` $ - :-- ___c____ , -_ __-c__ - -_ - c__— _-c '0•"141%,,27141,&!, ', z ,I,t.,::,,, \I; /1\ ' HOOD CANAL I\' • f",'"..44,;?1:1;,;',1p..T '44'47 e.t.,./ i '/ SANITARY SURVEY ,-.61,,,,,,,,,,„0,,,k,--- - i 4\ ,,,,,,,,,,„,,,i,,,,,, , ,,, PROJECT ,,v ` � �/ Spring, 2006 �\ ;r Progress 19epoi1 The Hood Canal Sanitary Survey Project is three months old. The two year project, funded by the legislature through Washington State Department of Ecology, is designed to look for human fecal pollution going into Hood Canal and correct failing septic systems in Jefferson County. The purpose is to protect human health and to enhance the health of Hood Canal for all critters. Jefferson County Environmental Health will be sending this newsletter to county Hood Canal shoreline resi- dents quarterly to keep you updated and include educational tidbits. We had public meetings in Port Ludlow, Quilcene, and Brinnon in February. Thank you to those of you who called and those who came. Presenters talked about the shoreline project, how to keep your septic system healthy, and about the Shore Stewards program at WSU. Participants shared views on Hood Canal pollution and other topics of interest. 'a� Shoreline fresh water sampling for pollution is about 15-20%completed. We have walked ' ,:,.. .: - ,:...,, ip ,,,, the shore from Tata Point (the northern boundary of the project) to Bridgehaven and parts , of south county from the Mason County line to the Duckabush River. `' x y Some bacteria counts have been high, most are normal (see "Hits"). We will continue shoreline sampling over the next 3-4 months, and then begin the sanitary surveys. " ... ' That will entail calling on shoreline residents and asking survey ques- tions, offering information on keeping the septic system healthy, and looking at the layout of their septic system with them. Your response is voluntary. You will hear from us in the next 2 years to ask for your par- ticipation. tOtiVL (QUIZ * Low dissolved oxygen in the waters • of Hood Canal hurts * v1,/. , * 1. clam and oyster larvae * - t 2. crab and shrimp popula- ' ' `'/ ' ` ° ' '-411r4 * tions ,, e . * 3. groundfish and salmon . r m ' ' ''\ 4. all of the above ;I. " _ ° v! • , answer on page 3 ° ° • <, *° * *�; r , - ; ,- , __ , _ - = �- '4 w **** li Page g Spring, 2006 Pa Ali IP ' ts" It is called a hit when a lab sample of water shows lots of fecal bacteria or nitrogen. Where have we found hits in our sampling so far? • Paradise Bay has a stream running through the com- munity which showed high E.coli counts twice. A home in the community has bulkhead drains on the shoreline that show high E.coli counts. Work is in process to determine the source of the pollu- tion. • Another hit occurred on the shore along South Point Road. Follow-up will be oc- curring in April and May. NITROGEN IN HOOD CANAL Why are we interested in nitrogen? Human activities that add nitrogen to Hood Canal may be contributing to the fish kills that are seen in late summer and early fall. 1. Nitrogen feeds algae which bloom in warm weather 2. algae die . fall to the bottom 4. use up critical oxygen in their decomposition, oxygen supplies needed by other critters This oxygen found in water is called dissolved oxygen (DO). 1 I a._ A, a y' # - ivy,: i M'"1 A :I;., A -4 s II,' 8 eve• ' 1;r= \VII,/' V;l19fi', '�11314': 1\,iliaf? 1\;1l�', „l19f,? ,A iIii ' illi/' `�a i14,' Ai1lY.. \)l X1111. 1*,Vir fp VII, VIP,, 14 VI+ 'lit lli What can we do to keep nitrogen out of Hood Canal? • Keep the septic system healthy (nitrogen is found in human waste that is not treated adequately) • Minimize use of lawn and garden fertilizers (ask a Master Gardener about alternatives, call WSU Extension at 379- 5610) • Dispose of yard waste and pet/livestock waste properly • Landscape wisely to minimize direct run-off Landscaping Hint Use permeable materials or gravel for paths, patios and driveways to al- low natural water absorption into the soil and to minimize rapid run-off nd erosion. Did you know that a mature conifer like Douglas Fir helps absorb rainfall to the tune of 4600 gallons per year? Page 3 Spring, 2006 } SEPTIC MAINTENANCE Have your conventional septic system checked every 3 years. If you have something more elaborate than the conventional type, follow the maintenance schedule of the designer or manufacturer. DO NOT FLUSH Coffee grounds Facial tissue Kitty litter Disposable diapers Wipes Rags Q-tips Plastic Cigarette butts Newspaper Paper towels Matches • Dental floss Hair Tampons Sanitary napkins Grease and oils PRODUCTS THAT CAN KILL YOUR GOOD SEPTIC TANK AND DRAINFIELD BACTERIA: Gasoline Motor oil Paint (both latex and oil) Paint thinner Solvents Lye-based drain openers Fertilizers Pesticides Chemotherapy (if someone in the household receives chemotherapy) Antibiotics (if used over a long time) Too much bleach (more than recommended on the bottle) Antibacterial soaps may.have a bad effect ■ Hood Canal Knowledge Bowl Quiz Answer: D. All of the above. All these types of creatures depend on dissolved oxygen. If you got this right you can stop by the Health Department at 615 Sheridan,Port Townsend, and get your • free toilet tank leak detection tablets. If you got it wrong, you can get your free leak detection tablets any- way. They are also available at the PUD in Port Hadlock.Using less water is good for your septic system. Spring 2006 Page 4 • ,:,...-.------,-„„...,_-',,-; .,7,2...,,,,,," Environmental 41) vIVI4-zA_Z`1‘1 Director Mike McNickleHealthStaff • . . Food Sarah Murphy, R.S. ` ` ` ` t On-Site Septic Systems Linda Atkins, R.S. ` - • Randy Marx • t Susan Porto, R.S. Alan Gardner • • •g Solid/Hazardous Waste Jasmine Fry, Mark Nelson Drinking Water Susan Porto, R.S. [,-4k,41.-_,,v-Y.:;..fi:ltti*;44;H,,,gtsijrftrw. - Hood Canal Project Dana Fickeisen, R.N. o. e x h.t bg -.1,1 s s fr,,:iilW.f-'•.:_,2-,t,tiiiei4WAIR4'.1.,:eak**1**-A 1,,,,V1443,7,44{0204 "*TriAct:V4,.. 7 C- fie-?-,10r 44:- Gy __,,,....t,%„.. £re;*:e.-1,-,, t-t,,,.-f.r-r.;z;NI'',1.,:-43;;,,:-;P*It,;,:ZWittlal." ,V;;IIP.,:t*-11 ' ',„*-;,..?'' ": ''„ -4',,,, ,,,-„, e .11,,,,;ttrtik-,411-,,..t>- `a` h y 0 •S^.'�- rte C We would appreciate an su a w� _ ' y ggestions or comments you :$ may have. Please contact Environmental Health at 385- 4 9444, 615 Sheridan Street, Port Townsend,98368, i-r 4 *` • c a6ed aaueue u!e l 300S f� Z abed ua6OJ1iN °sl•!H 6 a6e� pode ssaJ6oJH ••.e411 p. 89£96 YM`puesum01 Pod leailS uep!JegS 91.9 a• , OO O�d VWRy}!eaH o!gnd�tuno0 uosaa r 3P°°H b5NONN,,, alVd03Jt1a1NSVOLdt'S'n • 431iOS32d 4 1 -� _ ,.\`i \ iC~ n •(C.4K r oa (11 od � vID _ rn o r. _ .) r co D 71 v c c- p Or" ' r 6 cn _ .p. , ..,„ m ,z, _. ,_ ��' ii- F � m s C p 0- O -T iT .-‹ 3 3 m rt O ", co Z 7 ::1 .> W C' C)